Micro Systems - First Aid Flashcards
Dominant flora of the skin
S. epidermidis
Dominant flora of the nose
S. epidermidis; colonized by S. aureus
Dominant flora of the oropharynx
viridans group strep
Dominant flora of the dental plaque
S. mutans
Dominant flora of the colon
B. fragilis > E. coli
Dominant flora of the vagina
Lactobacillus; colonized by E. coli and group B strep
Food poisoning that starts and ends quickly is from…
S. aureus or B. cereus.
B. cereus source
reheated rice
C. botulinum source
improperly canned foods
C. perfringens source
reheated meat dishes
E. coli O157:H7 source
undercooked meat
Salmonella source
poultry, meat, eggs
S. aureus source
meats, mayonnaise, custard; preformed toxin
V. parahaemolyticus and V. vulnificus source
contaminated seafood
Bugs that cause bloody diarrhea (7)
- campylobacter
- E. histolytica
- EHEC
- EIEC
- Salmonella
- Shigella
- Yersinia enterocolitica
Bugs that cause watery diarrhea (6)
- C. difficile
- C. perfringens
- ETEC
- Protozoa (Giardia, Cryptosporidium)
- V. cholerae
- Viruses
Common causes of pneumonia in neonates (
- Group B strep
2. E. coli
Common causes of pneumonia in children 1 mo - 18 yrs
Viruses (RSV) Mycoplasma C. trachomatis (infants - 3 yrs) C. pneumnoniae (school-aged) S. pnumoniae
Common causes of pneumonia in 18-40 yr olds
Mycoplasma
C. pneumoniae
S. pneumoniae
Common causes of pneumonia in the elderly
S. pneumoniae Influenza virus Anaerobes H. influenzae Gram-negative rods
Common causes of pneumoniae in alcoholics/IVDUs
S. pneumoniae
Klebsiella
Staph
Common causes of pneumonia (aspiration)
Anaerobes
Commona atypical pneumonias
- Mycoplasma
- Legionella
- Chlamydia
Common causes of pneumonia in Cystic Fibrosis
Pseudomonas
S. aureus
S. pneumoniae
Common causes of pneumonia in the immunocompromised
STaph enteric gram-negative rods fungi viruses P. jirovecii
common nosocomial causes of pneumonia
Stap
pseudomonas
Common causes of postviral pneumonia
staph
H. influenzae
S. pneumonia
Common causes of meningitis in newborns (0-6 mo)
Group B strep
E. coli
Listeria
common causes of meningitis inchildren 6 mo - 6 yrs
S. pnumoniae
N. meningitidis
H. ib
Enteroviruses
Common causes of meningitis in those 6-60 yrs
S. pneumnoiae
N. meningitidis
enteroviruses
HSV
common causes of meningitis in those over 60
S.pneumoniae
Listeria
To treat pneumonia, empirically give…
ceftriaxone and vancomycin. Add ampicillin if listeria is suspected.
Viral causes of meningitis include…
enterovirus (esp coxsackie), HSV-2, HIV, west nile and VZV
In HIV, likely causes of meningitis are…
Cryptococcus, CMV, toxoplasmosis (brain abscess) and JC virus.
CSF findings in bacterial meningitis
Opening pressure: increased
Cell type: increased PMNs
Protein: increased
Sugar: decreased
CSF findings in fungal/TB meningitis
Opening pressure: increased
Cell type: increased lymphocytes
Protein: increased
Sugar: decreased
CSF findings in viral meningitis
Opening pressure: normal/increased
Cell type: increased lymphocytes
Protein: normal/increased
Sugar: normal
Most common cause of Osteomyelitis is…
S. aureus.
If a pt is sexually active and has osteomyelitis, think…
N. gonorrhoeae or septic arthitis.
If a pt has osteomyelitis and diabetes/or IVDU, suspect…
P. aeruginosa or serratia.
If a pt has osteomyelitis and sickle cell, suspect…
salmonella.
If a pt has prosthetic joint replacement and osteomyelitis, suspect…
S. aureus and S. epidermidis.
If a pt has osteomyelitis with vertebral involvement, suspect…
Mycobacterium tubercuosis (pott disease).
If a pt has cat and dog bites and osteomyelitis, suspect…
pasteurella multocida.
Osteomyelitis may be subtle on…
radiographs and is more easily seen on MRI.
Cystitis presents with…
dysuria, frequency, urgency, suprapubic pain and WBCs in the urine.
Bladder infxn that ascends to the kidney presents with…
pyelonephritis (fever, chills, flank pain, CVA tenderness, hematuria, WBC casts.
Diagnostic markers for UTI are:
- positive leukocyte esterase test = bacterial UTI
2. Nitrite test positive = gram-negative bacterial UTI
3 most common causes of UTI are:
- E. coli
- Staph saprophyticus
- Klebsiella
Bacterial vaginosis signs
- no inflammation
- thin, white discharge with fishy odor
Bacterial vaginosis lab findings
- clue cells
- pH > 4.5
Bacterial vaginosis treatment
Metronidazole
Trichomoniasis signs
- inflammation
- frothy, grey-green, foul-smelling discharge
Trichomoniasis lab findings
- motile trichomonads
- pH > 4.5
Candida vulvovaginitis signs
- inflammation
- thick, white “cottage cheese” discharge
Candida vulvovaginitis lab findings
- pseudohyphae
- pH normal (4-4.5)
Treatment for Trichomoniasis
Metronidazole; also treat sexual partner
Treatment for Candida vulvovaginitis
azoles
Nonspecific signs common to many TORCHES infections are…
hepatosplenomegaly, jaundice, thrombocytopenia and growth retardation.
In neonates, Parvovirus B19 causes…
hydrops fetalis.
TORCHES infections
Toxoplasma gondii Rubella CMV HIV HSV2 Syphilis
Toxoplasma gondii transmission
cat feces or ingestion of undercooked meat
Toxoplasma maternal manifestations
asymptomatic; rare lymphadenopathy
Neotnatal manifestations of toxoplasma
Classic triad: chorioretinitis, hydrocephalus, intracranial calcifications
Transmission of rubella
respiratory droplets
Rubella maternal manifestations
rash, lymphadenopathy, arthritis
Rubella neonate manifestations
Class triad: PDA, cataracts and deafness
+/- “blueberry muffin” rash
CMV transmission
sexual contact
organ transplants
CMV maternal manifestations
asymptomatic
rare mono-like illness
CMV neonatal manifestations
hearing loss, seizures, petechial rash, “blueberry muffin” rash
HIV neonatal manifestations
recurrent infections and chronic diarrhea
HSV-2 transmission
skin or mucous membrane contact (during delivery)
HSV-2 neonatal manifestations
encephalitis, herpetic lesions
Syphilis maternal manifestations
Primary chancre and disseminated rash
Syphilis neonatal manifestations
- often results in stillbirth, hydrops fetalis
- if child survives, present with facial abnormalities (notched teeth (Hutchinson), saddle nose, short maxilla), saber shins and deafness
Coxsackie virus presentation/hand-foot-mouth disease
vesicular rash on palms and soles; vesicles/ulcers in oral mucosa
HHV-6/Roseola presentation
macular rash over body appears several days after high fever; can present with febrile seizure
Measles/Rubeola presentation
begininning at head and moving down; rash is preceded by cough, coryza, conjunctivitis and blue-white spots on buccal mucosa
Parvovirus B19/Erythema infectiosum/fifth disease presentation
“slapped cheek” rash on face
Rubella virus presentation
rash begins at head and moves down leading to a fine truncal rash; postauricular lymphadenopathy
Strep pyogenes/scarlet fever presentation
erythematous, sandpaper-like rash with fever and sore throat
VZV/Chickenpox presentation
vesicular rash begins on trunk; spreads to face and extremities with lesions of different ages
Chancroid
- painful genital ulcer, inguinal adenopathy
- H. ducreyi
Chlamydia
-urethritis, cervicitis, conjunctivitis, reactive arthritis, PID
Condylomata acuminata
- genital warts
- koilocytes
- HPV-6 and 11
Genital herpes
- painful penile, vulvar or cervical vesicles and ulcers; can cause systemic symptoms such as fever, HA , myalgia
- HSV-2
Gonorrhea
- urethritis
- cervicitis
- PID
- prostatitis
- epididymitis
- arthritis
- creamy purulent discharge
Lymphogranuloma venereum
- infxn of lymphatics; painless genital ulcers
- painful lymphadenopathy (buboes)
Trichomoniasis
- vaginitis
- strawberry cervix
- motile in wet prep
- yellow-green discharge
(trichomonas vaginalis)
Common causes of PID are…
Chlamydia trachomatis, N. gonorrhoeae.
PID presents with…
cervical motion tenderness (chandelier sign), purulent discharge. May include salpingitis, endometritis, hydrosalpinx and tubo-ovarian abscess.
PID can lead to…
Fitz-High-Curtis syndrome = infxn of the liver capsule and “violin string” adhesions of peritoneum to liver.
Salpingitis is a risk factor for…
ectopic pregnancy, infertility, chronic pelvic pain and adhesions.
Meningitis in unimmunized children is often caused by…
H. ib or poliovirus.
Epiglottitis is often caused by…
H.ib (esp in unimmunized children).
Epiglottitis presents with…
fever, dysphagia, drooling, dificulty breathing due to edematous “cherry red” epiglottis; shows thumbprint sign on X-ray.
Pharyngitis in unimmunized is usually caused by…
C. diphtheriae
Presentation of pharyngitis
graysih oropharyngeal exudate (pseduomembranes); painful throat