Micro - Systems (Osteomyelitis, UTIs, & Vaginal infections) Flashcards
Pg. 172-173 in First Aid 2014 Sections include: -Osteomyelitis -Urinary tract infections -UTI bugs -Common vaginal infections
What pathogen should be assumed as cause of osteomyelitis if no other information is available, and why?
S. aureus (most common overall)
What pathogen is a likely cause of osteomyelitis if the patient is sexually active, and why?
Neisseria gonorrhoeae (rare), septic arthritis more common
What 2 pathogens are a likely cause of osteomyelitis if the patient is a diabetic and/or IV drug user?
(1) Pseudomonas aeruginosa (2) Serratia
What pathogen is a likely cause of osteomyelitis if the patient has sickle cell?
Salmonella
What 2 pathogens are a likely cause of osteomyelitis if the patient has history of a prosthetic joint replacement?
(1) S. aureus (2) S. epidermidis
What pathogen is a likely cause of osteomyelitis if the patient has vertebral involvement? What is this condition called?
Mycobacterium tubuerculosis (Pott disease)
What pathogen is a likely cause of osteomyelitis if the patient has a history of cat and/or dog bites?
Pasteurella multocida
In what patient population does most osteomyelitis occur?
Most osteomyelitis occurs in children
What are 2 nonspecific findings that may be observed with osteomyelitis?
Elevated CRP and ESR observed but nonspecific
What are the imaging considerations/options regarding osteomyelitis?
Can be subtle on radiographs; same lesion more easily seen on MRI
What are 5 components of the presentation of cystitis?
Cystitis presents with (1) dysuria (2) frequency (3) urgency (4) suprapubic pain (5) WBCs (but not WBC casts) in urine
What is the primary cause of cystitis?
Primarily caused by ascension of microbes from urethra to bladder
What are 2 causes of and/or contexts for cystitis in males?
Males - (1) Infants with congenital defects (2) Vesicoureteral reflux
What is a cause of and/or context for cystitis in elderly?
Elderly - enlarged prostsate
What is the primary cause of pyelonephritis?
Ascension (of microbes from urethra) to kidney results in peylonephritis
What are 6 components of the presentation of pyelonephritis?
Presents with (1) fever (2) chills (3) flank pain (4) costovertebral angle tenderness (5) hematuria (6) WBC casts
In which patient population are urinary tract infections more common, and why? How much more common are they in this patient population?
Ten times more common in women (shorter urethras colonized by fecal flora)
Besides female gender, what are 6 other factors that predispose patients to urinary tract infections?
Other predisposing factors include: (1) obstruction (2) kidney surgery (3) catheterization (4) GU malformation (5) diabetes (6) pregnancy
What diagnostic marker is positive in bacterial UTI? What diagnostic marker is positive for gram-negative bacterial UTI?
Diagnostic markers: leukocyte esterase test (+) = bacterial UTI; nitrite test (+) = gram-negative bacterial UTI
What bug is the leading cause of UTI?
Escherichia coli
Which agar distinguishes Escherichia coli, and how does it appear on this agar?
Colonies show green metallic sheen on EMB agar
What is the second leading cause of UTI in sexually active women?
Staphylococcus saprophyticus
What is the 3rd leading cause of UTI?
Klebsiella pneumoniae
What distinguising product do some strains of serratia marcescens produce?
Some strains produce a red pigment
Name 3 UTI bugs that are often/usually nosocomial and drug resistant.
(1) Serratia marcescens (2) Enterobacter cloacae (3) Pseudomonas aeruginosa
In what unique fashion does Proteus mirabilis appear on agar, and why?
Motility causes “swarming” on agar
Name a urease positive UTI bug.
Proteus mirabilis
With kind of stones are associated with Proteus mirabilis?
Associated with struvite stones
With what pigment and odor is Pseudomonas aeruginosa associated?
Blue-green pigment and fruity odor
What do each of the following UTI diagnostic makers suggest if positive: (1) Leukocyte esterase (2) Nitrite test
(1) (+) Leukocyte esterase = bacterial (2) (+) Nitrite test = gram-negative bugs
What UTI bugs would a positive versus negative test suggest?
(+) Urease test = urease-producing bugs (e.g., Proteus, Klebsiella); (-) Urease test = E. coli, Enterococcus
What are 2 defining features of Klebsiella pneumoniae’s appearance?
Large mucoid capsule and viscous colonies
Name 3 common vaginal infections.
(1) Bacterial vaginosis (2) Trichomoniasis (3) Candida vulvovaginitis
Of the following common vaginal infections, which is associated with inflammation: (1) Bacterial vaginosis (2) Trichomoniasis (3) Candida vulvovaginitis?
(1) No inflammation (2) Inflammation (3) Inflammation
What are the defining signs and symptoms of bacterial vaginosis (in terms of inflammation and discharge)?
No inflammation; Thin, white discharge with fishy odor
What are the defining signs and symptoms of Trichomoniasis (in terms of inflammation and discharge)?
Inflammation; Frothy, grey-green, foul-smelling discharge
What are the defining signs and symptoms of Candida vulvovaginitis (in terms of inflammation and discharge)?
Inflammation; Thick, white “cottage cheese” discharge
What are the lab findings that distinguish each of the following common vaginal infections: (1) Bacterial vaginosis (2) Trichomoniasis (3) Candida vulvovaginitis?
(1) Clue cells, pH > 4.5 (2) Mobile trichomonads, pH > 4.5 (3) Pseudohyphae, pH normal (4.0-4.5)
What is the treatment for each of the following common vaginal infections: (1) Bacterial vaginosis (2) Trichomoniasis (3) Candida vulvovaginitis? In which condition is treatment of sexual partner recommended?
(1) Metronidazole (2) Metronidazole, Treat sexual partner (3) -azoles
What is the pH in each of the following common vaginal infections: (1) Bacterial vaginosis (2) Trichomoniasis (3) Candida vulvovaginitis?
(1) pH > 4.5 (2) pH > 4.5 (3) pH normal (4.0-4.5)
