Micro IV Flashcards by tcarlso 3

What are the two major coagulase negative staph?

Epidermidis

Saprophyticus

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What is the second most common cause of UTIs in young women?

S. Saprophyticus

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What are the components of the cell capsule?

Teichoic acid and peptidoglycan

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True or false: the thicker the cell wall, the more effective the PCN

True

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What is the drug that is used to prevent loss of PCN through the urine?

Probenecid

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What is the mnemonic for the hemolytic patterns?

Best lysis
Almost lysis
Garbage

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What happens to C3 with strep infections?

Decreases

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recent h/o tooth extraction = ?

Strep mutans

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h/o IV drug use = ?

S. Aureus

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h/o prosthesis placement = ?

Staph Epidermidis

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What is the treatment for staph epidermidis?

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Which heart valve is most commonly involved

in viridan endocarditis?

mitral

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What are the erythematous painless lesions
seen on the palms and soles of patients with
viridian infections?

Janeway lesions–septic valvular embolism or immune complexes

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What are the raised painful lesions on the

fingers and toes called?

Osler nodes

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A male dental patient with a childhood history
of mitral regurgitation is scheduled for extraction of two decayed teeth. The most commonly used prophylactic measure in this patient would be administration of what?

Amoxicillin

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What are the fingernail findings of strep viridans heart infx?

Subungual hematomas

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Which are painful: osler nodes or janeway lesions?

Osler nodes

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What are the Roth’s spots found with bacterial endocarditis? What causes them?

retinal hemorrhage with white or place centers composed of coagulat fibrin.

They are usually caused by immune complexes medicated vasculitis

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What is the most common cause of Otitis externa?

Pseudomonas

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What are the classic s/sx of endocarditis? (5)

infx
New murmur
Osler nodes / Janeway lesions
Roth spots
Septic shock

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What is the treatment for endocarditis?

Empiric treatment with broad spectrum abx and obtain blood cultures

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What is the only CAMP positive strep?

GBS

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What is the classic shape of N. Meningitidis?

Gram negative kidney bean diplococci

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Is Neisseria Meningitidis oxidase positive or negative?

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What is the agar that is used to culture Neisseria meningitidis?

Chocolate agar with CO2

What are the two major virulence factors associated with Neisseria meningitidis?

- CHO anti-phagocytic capsule | - Endotoxin (LPS)

What is the treatment for Neisseria meningitidis?

PCN G or ceftriaxone

How do you differentiate between Neisseria meningitidis and other Neisseria species?

Meningitidis ferments maltose Gonococcus only glucose

Is N. Meningitidis aerobic?

yes

What are the bugs that have an antiphagocytic capsule?

- Strep pyogenes - GBS - Strep pneumoniae - N. Meningitidis - HiB - E. Coli K1 - Cryptococcus neoformans ("some nasty killers have a carb Kapsule")

What type of rash is caused by Neisseria | meningitidis?

Petechial

Only two must-know bugs flip on a DIC reaction in | the body, Neisseria meningitidis and

Rickettsia rickettsii

What are the major predisposing factors in N. | meningitidis infection?

deficiencies (Complements 2, 3, 5, 6, 7 and 8). Complement 3 deficiency is by far the most common association.

What are the complements that are associated with anaphylaxis?

C3a C4a C5a

What are the complement that are used to kill virus infected cells?

C1-C4

C5-C9 deficiency = ?

Neisseria

What is the tick that transmits Rickettsia rickettsii?

Dermacentor tick

What is the progression of the rash with Rickettsia rickettsii?

CENTRIPETAL

What are the two major obligate intracellular bugs?

Rickettsia rickettsii Chlamydia ("go inside when it's Really Cold")

The spleen plays an important role in antibody synthesis and clearing of bacteria from the blood stream. Asplenic patients are at risk for life threatening infections. The top 5 such infections are:

``` The top 5 causes of infection in asplenic patients are: -Klebsiella (First 6 months of life); -E coli (First 6 months of life); -Strep pneumo (After 6 months of age); -H. Flu b (After 6 months of age); and -Neisseria meningitidis that is less common than Strep pneumo and H flu (After 6 months of age) ```

What is the most common complement deficiency?

What is the agar used to culture gonorrhea?

Chocolate (thayer martin)

What are the major virulence factors of gonorrhea?

Pili for adherence

What is the treatment for gonorrhea?

- PCN G | - Ceftriaxone/ fluoroquinolones

What is the prophylactic treatment for gonorrhea neonatal conjunctivitis?

Erythromycin in newborns eyes

What are the s/sx of gonorrhea infx?

milky Urethral d/c

What is the reservoir for trichomoniasis in males?

Prostate

What is the MOA of Cephalosporins?

inhibits peptidoglycan cross linking

Which gender is symptomatic with gonorrhea? Which is the reservoir?

Symptoms = men | Reservoir - women

Which gender is symptomatic with trichomonas? Which is the reservoir?

``` Symptoms = women Reservoir = men ```

Which bug has lipid A as a virulence factor?

N Meningitis

Which bug has hemin and NAD as a virulence factor?

HiB

What is the virulence mechanism of N gonorrhea

Fimbria for attachment of the urogenital epithelium

What is the name of the bacterial agent that also uses fibria as it virulence mechanism in the respiratory tract?

Bordetella

What is the agar that is used to culture Bordetella?

Bordet gangou

What bug causes Waterhouse friderichsen syndrome?

N. Meningitidis

What are the spores of Bacillus anthracis?

Endo spores

What are the morphological characteristics of Bacillus anthracis

Gram positive rods (boxcar stain)

What are the virulence factors of bacillus anthracis?

- Anti-phagocytic capsule | - Anthrax toxin

What are the skin infection s/sx of anthrax?

Black eschar

What is the DOC for anthrax?

PCN G and cipro

Is anthrax pneumonia contagious?

Anthrax pneumonia is fatal. Also the disease is acquired from inhalation of spores.

A 45 year old Russian farm worker developed a non-tender swelling of the upper lip followed by blistering (pustules) and necrosis of the overlying skin. Lab data confirmed presence of gram-positive rods. Diagnosis was made that the patient has acquired cutaneous anthrax. The patient was treated with a particular antimicrobial medication and showed a positive response. What was the medication?

The farmer in the above case scenario must have received penicillin therapy

What is Wool-sorter’s disease?

Wool sorters disease is the term for pulmonary anthrax

Bacillus anthracis is unique among all bugs because its virulence mechanism is due to what factor?

The uniqueness of anthrax is that it has a protein capsule. However, exotoxin is by far the most important virulence factor of anthrax

The only other major bacillus to know for the exam is Bacillus cereus. In this bug, germination of heat stable spores leads to production of toxin and food toxicity. Given the short incubation period, this poisoning quite often is very similar to the food poisoning of staph aureus. Penicillin is a good medication for Bacillus anthracis. Would you expect it to also work on B. cereus food poisoning?

Penicillin can also act on B. cereus, however, likewise Staph aureus food poisoning the disease is due to pre-formed toxin. As such it is to a large extent refractory to penicillin therapy. Hence supportive treatment is the mainstay of treatment.

What is the MOA of ciprofloxacin?

Inhibits DNA gyrase (topoisomerase)

What two anatomic locations are most commonly associated with skin manifestations of anthrax?

hands and face