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Micro II Flashcards

1
Q

What are the criteria to diagnose sepsis?

A
  1. infection + SIRS (2 s/sx)

2.

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2
Q

How many s/sx of SIRS are needed to diagnose sepsis? What are they?

A
  • Tachycardia
  • Hypo or hyperthermia
  • Tachypnea (hypocapnia)
  • WBC (less than 4 or more than 12)

Need 2+

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3
Q

What is the MOA of vanco? Is it bacteriostatic or bactericidal?

A

Inhibits cell wall peptidoglycan formation by binding D-ala, D-ala portion of the cell wall precursors

Bactericidal

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4
Q

What are the two major components of the cell wall of bacteria?

A

NAM and NAG

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5
Q

What is the MOA of TMP-SMX?

A
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6
Q

What are the morphological features of strep pyogenes?

A

Gram positive cocci in chains.

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7
Q

What is the role of the M protein of strep pyogenes? What role does this play in rheumatic fever?

A

Inhibits phagocytosis and complement activation

Similar to heart proteins = rheumatic fever

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8
Q

What type of hypersensitivity reaction is rheumatic fever?

A

Type II

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9
Q

What type of hypersensitivity reaction is acute glomerulonephritis 2/2 strep pyogenes?

A

Type III

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10
Q

What is the reservoir of strep pyogenes?

A

Human throat and skin

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11
Q

How is strep pyogenes transmitted?

A

Respiratory aerosols

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12
Q

What is the toxin that strep pyogenes produces to cause scarlet fever?

A

Erythrogenic toxin–pyrogenic toxin (TSST)

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13
Q

What is the treatment for strep pyogenes infection?

A
  • PCN G

- All beta lactam abx

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14
Q

What are the two toxins that strep pyogenes that causes cellulitis?

A

Hyaluronidase

Streptokinase

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15
Q

What are the jones criteria for strep pyogenes caused scarlet fever?

A
  • Joints
  • Heart
  • Nodules
  • Erythema marginatum
  • Sydenham chorea
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16
Q

What are the s/sx of scarlet fever? (3)

A
  • Sandpaper like rash
  • Strawberry tongue
  • circumoral pallor
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17
Q

What are the histological findings of rheumatic heart disease?

A

Aschoff bodies (granulomatous response to strep)

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18
Q

Nephrotic or nephritic syndrome: strep?

A

Nephritic

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19
Q

What are the s/sx of strep nephritis?

A

H2O

HTN
Hematuria
Oliguria

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20
Q

What can be measured in the serum to monitor for strep therapy?

A

Rise in ASO titers

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21
Q

What is the toxin that strep produces to lyses RBCs?

A

Streptokinase

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22
Q

What is the function of streptolysin O of strep pyogenes?

A

Immunogenic (lyses RBCs and PMNS)

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23
Q

What is the function of streptokinase that strep pyogenes produces?

A

dissolves clots

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24
Q

What is the function of hyaluronidase that strep pyogenes produces?

A

Dissolves CT

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25
What is the function of erythrogenic toxin that strep pyogenes produces?
Scarlet fever
26
What is the 1 cause of bacterial pharyngitis?
Strep pyogenes
27
What is the pathogenesis of rheumatic fever?
Ab formation to M protein cross reacts with heart tissue in a type II hypersensitivity rxn, activates the complement system to create aschoff bodies
28
Which more commonly precedes poststreptococcal glomerulonephritis: strep throat, or impetigo
Impetigo
29
How long after strep pharyngitis rheumatic fever kicks in?
3 weeks ish
30
The top two causes of pharyngitis are viral and strep. What Is the rapid test to r/i strep?
Identifies a specific carb antigen in GAS
31
What are the characteristics cell findings in the granulomas from strep pyogenes? (5)
- Lymphocytes and plasma cells - Macrophages - FIbroblasts - Giant cells - Epithelioid macrophage
32
What are the macrophages in the kidney?
Mesangial cells
33
What are the joints that are affected with rheumatic fever? How?
Large joints, one at a time
34
Where are the nodules found with rheumatic fever?
On bony surfaces
35
What are the characteristics of the rash with rheumatic fever?
Circular rash that worsens in the heat
36
What are the 8 S's of scarlet fever?
``` Strep Sydenham Sore throat She Sed rate See (C) reactive protein Subcutaneous nodules St. Vitus dance ```
37
In which gender are the sydenham chorea more common in?
Women
38
Which gender is more affected with reactive arthritis?
Men
39
What are the two inflammatory markers that are elevated with rheumatic fever?
CRP | Sed rate
40
What is migratory arthritis? What is it classically seen in?
Rheumatic fever | One large joint at a time
41
What are anitschkow cells?
Multinucleated giant cells in the heart
42
What are the structural lesions of rheumatic heart disease? (4)
- Commissural fusion of valve - Aschoff bodies - Anitschkow - Thickening of the chordae tendinae
43
What are the top two valves affected by rheumatic fever?
1. Mitral 2. Aortic 3. Tricuspid
44
What is the fish mouth deformity with rheumatic fever?
Stenotic mitral valve 2/2 rheumatic dz fibrosis causes a fish like appearance
45
What is the only heart chamber not affected with mitral stenosis?
Left ventricle
46
What happens to the left atrium in mitral stenosis 2/2 rheumatic fever?
Enlargement and formation of mural thrombi d/t stasis along the sides of the atrium
47
What is the pathophysiology of post streptococcal glomerulonephritis?
Impetigo infx produces antigen-antibody complexes that deposit in the glomeruli / engulfed by macrophages (type III hypersensitivity rxn)
48
Where in the glomeruli are strep antigen-ab complexes deposited in the glomeruli?
Subendothelial
49
What causes the HTN with poststreptococcal GMN?
Thrombosis of the renal arteries cause a release of ANG II
50
Casts in the urine come from where: kidney or bladder?
Kidney--from the tubules
51
What are the two organs affected with Reye's syndrome? What is the relation between these two?
Liver and brain BUN builds up, causing a hepatic encephalopathy
52
What happens to BUN with liver disease?
Low
53
What happens to BUN with kidney disease?
High
54
Where does the urea cycle occur in the liver?
- Starts in mito | - Ends up in the cytoplasm
55
What is the metabolic abnormalities in Reye's syndrome?
Metabolic alkalosis from NH4)
56
What is the effect of ammonia on neurons?
Neurotoxic
57
What is the complication of chlamydia?
Reactive arthritis
58
What is the classic complication of H Pylori infx?
PUDs and gastritis
59
What is the classic complication of campylobacter jejuni?
Guillain-Barre syndrome
60
What is the classic complication of Strep pyogenes
Rheumatic fever | GN
61
What is the classic complication of meningococcal?
Waterhouse friderichsen syndrome
62
What is the classic complication of varicella or flu + ASA?
Reye's syndrome
63
What is the classic complication of EHEC?
HUS
64
What causes the schistocytes from HUS?
Toxin from EHEC causes roughening of the glomeruli
65
What is the classic complication of lyme disease?
Bell's palsy
66
How many days after the first disease may the associated s/sx show up?
4 days - 4 weeks

All the Small Things (29 decks)

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