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Microbiology Flashcards

1
Q

When to give tetanus immune globulin

A

If patient is unvaccinated, uncertain of vaccination, or <3 tetanus toxoid doses with a DIRTY wound

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2
Q

Patients with asplenia are at risk for

A

infection due to encapsulated bacteria due to deficiency in antibody-mediated phagocytosis

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3
Q

Newborn with microcephaly, ventriculomegaly, periventricular calcifications, hepatosplenomegaly, thrombocytopenia

A

Congential CMV (saliva)

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4
Q

Pt with HIV (CD4 <100) & febrile wasting, cough, SOB, night sweats, mucocutaneous ulcer, LAD, HSM, pancytopenia

A

disseminated Histoplasmosis

  • dx with urine histoplasma antigen
  • tx w/ amphotericin B
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5
Q

Pt with fever, muscle stiffness, trismus/lockjaw, and painful muscle spasms triggered by physical stimuli

A

tetanus

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6
Q

cephalocaudal spread of maculopapular rash with fever and arthralgias

A

Rubella (German measles)

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7
Q

19 year old with dry cough, sore throat, headache, maculopapular rash on extremities. Small pleural effusion and increased interstitial markings

A

Mycoplasma pneumonia

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8
Q

elderly man with severe unilateral ear pain. Ear canal is mildly erythematous with purulent drainage and granulation tissue

A

necrotizing otitis externa

  • pseudomonas
  • defecits in lower cranial nerves (vii, x, xi)
  • tx: iv cipro with surgical drainage
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9
Q

Patient with acute febrile illness and AMS. Was recently bit by a tick. Leukopenia, thrombocytopenia, and elevated LFTs

A

Ehrliciosis (carried by lone star tick/reservoir is white tail deer)
-tx: doxycycline empirically

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10
Q

Pt on mission trip around pig farmers has a new seizure. CT show multiple cysts with surrounding edema

A

neurocysticercosis

  • Taenia solium (pork tapeworm) eggs
  • tx with albendazole, steroids, phenytoin
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11
Q

Pt with fever, hemoptysis, and chest pain with neutropenia. Ct scan pf chest shows multiple nodular lesions with surrounding ground-glass opacities

A

Invasive aspergillosis

  • RF: immunocompromised
  • tx: Voriconazole + capsofungin
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12
Q

Tx of food borne botulinum

A

horse-derived antitoxin

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13
Q

Young patient with viral URI (flu) develops worsening sx with fever of 104. Xray showed multilobar cavitary infiltrates and thin walled cavities

A

Staph aureus (MRSA)

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14
Q

HIV patient with linear ulcers with intranuclear and intracytoplasmic inclusions in distal esophagus. Was treated with oral oral fluconazole 2 weeks ago for odynophagia

A

CMV
tx: Ganciclovir
CD4 <50

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15
Q

Infection after starting chemotherapy

  • organism
  • treatment
A

Pseudomonas aeruginosa

Pip-tazo, meropenem, cefepime (covers gram + and -)

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16
Q

Pregnant patient that had a fever and diffuse maculopapular rash (non-pruritic) several weeks ago. U/S of infant shows enlarged ventricles and multiple intracranial calcifications. Hepatomegaly also noted.

A

Toxoplasma gondii

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17
Q

4 year old girl with “itchy private parts” mostly at night. Perianal area is excoriated and erythematous. No vaginal discharge but erythematous vulva.

A 
Enterobius vermicularis (pinworms) - helminth
tx: pyrantel pamoate or albendazole for pt and home contacts
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18
Q

Pt recently traveled to the Caribbean now returns with fever, malaise, polyarthralgias, throbocytopenia, pymhopenia

A

Chikungunya fever (from Aedes mosquito)

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19
Q

Pt presents with fever, double vision, painful swelling around his eyes, pain in neck and jaw muscles. Lab studies show increased eosinophils

A

Trichinellosis

  • endemic in Mexico, China, Thailand
  • ingestion of undercooked meat
  • Intestinal phase (1 week): asx, abdominal pain, N/V, diarrhea
  • muscle stage: myositis, fever, sugunal splinter hemorrhages, periorbital edema, esosinophilia (>20%)
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20
Q

Side effect of aminoglycosides

A

Ototoxicity by damaging cochlear cells

Gentamicin can also damage the motion-sensitive hair cells

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21
Q

complications of infectious mono

A

acute airway obstruction
autoimmune hemolytic anemia and thrombocytopenia
splenic rupture

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22
Q

infectious endocarditis causes:
hospital acquired
community acquired
post dental procedure

A

Staph (hospital)
Strep (community)
Viridans/sanguinis (post dental)

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23
Q

Severe watery diarrhea in an HIV patient with CD4 of 94 and a low grade fever. Started working at a horse breeding farm

A

Cryptosporidium parvum

- modified acid fast stain

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24
Q

Infant born with diffuse intracranial calcifications, ventriculomegaly, hepatomegaly, jaundice

A

Congenital toxoplasmosis

25
Q

infant fails hearing screen. Mom traveled out of country while she was pregnant, got sick and had arthralgias. Pt has loud murmur heard over second ICS on left.

A

Rubella (German measles) - congenital

  • sensorineural hearing loss
  • cataracts
  • PDA
26
Q

Plantar hyperkeratotic papules that are painful to walk on. Pt is sexually active

A

HPV

27
Q

Pt from Wisconsin develops fever, night sweats, weight loss. Pt has multiple skin lesions and CXR shows left upper lobe consolidation and two lytic lesions in the anterior ribs

A

Blastomycosis

28
Q

Pt is traveling to India and wants to be protected from malaria

A

Mefloquine chemoprophylaxis until 4 weeks after return

  • can use chloroquine in sensitive areas
  • in non-sensitive areas, can give atovaquone-proguanil, doxycycline, mefloquine
29
Q

Pneumonia, diarrhea, and hyponatremia

A

Legionella

  • urine antigen test
  • treat with macrolides or fluoroquinolones
30
Q

Pt presents with fever, chills, dysphagia, and drooling. Has a fever, tongue is displaced posterior and superior due to swollen area on floor of mouth. B/l submandibular area is tender, indurated, nonfluctuant with palpable crepitus

A

Ludwig angina

  • rapidly progressive cellulitis of submandibular space
  • many cases arrive from dental infections
  • tx: IV abx (ampicillin-sulbactam, clindamycin)
31
Q

Diarrhea in HIV patients

A

<180: Cryptosporidium (watery diarrhea)
<100: mycrosporidium (fever rare)
<50: MAC (fever >102.2 & watery diarrhea)
CMV (frequent, small volume diarrhea, hematochezia)

32
Q

Pt with HIV develops red/purple papules that enlarge into nodules. They are friable and bleed easily when palpated. He also has hepatosplenomegaly

A

Bartonella - bacilliary angiomatosis

- tx with doxy or erythromycin

33
Q

Immunocompromised patient presents with bloody diarrhea, mild hepatitis, and pulmonary complaints

A

CMV

34
Q

Pt has deep puncture wound by neighbor’s cat. Vaccinations are UTD. Most recent tetanus was 3 years ago

A

Pasturella - tx with Augmentin

35
Q

Pt has single intrahepatic cyst that is well-defined with eggshell calcifications. She has had dogs at home for 10 years

A

Hydatid cyst due to Echinococcus granulosus

- causes unilocular cystic lesions that can occur in any organ

36
Q

Pt returned from kenya 2 weeks ago now has fevers, headache, and malaise. He developed intense chills followed by fever and diaphoresis. He experienced similar sx a few days ago

A

Malaria - cyclical fevers

37
Q

Pt develops submandibular mass after tooth extraction. Mass expresses fluid with yellow granules. Anaerobic culture grows filamentous gram positive rods with rudimentary branching.

A

Actinomyces

tx = penicillin

38
Q

Tx of PCP

A

Bactrim and corticosteroids

39
Q

Pt presents with fever, right cheek pain and bloody nasal discharge. Pt has a 30 year hx of DM type 2. CT scan shows opacification and bony erosion of the right maxillary sinus

A

Mucormycosis (Rhizopus)

40
Q

Where does E corrodens come from

A

periodontal infection

41
Q

Polyarthralgias, tenosynovitis, and painless vesiculopustular skin lesions

A

disseminated gonoccocal infection

42
Q

Common cause of cellulitis in burn victims and patients with uncontrolled DM

A

Psuedomonas - gram neg rod

43
Q

Pt was bit on the leg while skinning small game in Arkansas. There is a painful ulcer with regional LAD

A

Francisella tularensis

- tx with aminoglycosides

44
Q

Progressive abdominal discomfort and nausea. Previous farmer in Guatemala. Hepatomegaly present with 10 cm , smooth, round cyst with daughter cysts inside.

A

Echinococcus granulosus

  • dog tapeworm
  • tx: albendazole
  • hydatid cyst with internal septations
45
Q

50 year old male develops abdominal pain, bloody stools, and malaise 4 months after kidney transplant. Blood smear shows atypical lymphocytes and colonoscopy shows multiple ulcerations throughout colon.

A

CMV colitis

46
Q

Tx of H. ducrei

A

single PO dose of azithromycin

47
Q

nasopharyngeal carcinoma is associated with reactivation of

A

EBV - usually in those from asia

- early spread to cervical LN is common

48
Q

Patient with worsening pharyngitis develops thrombosis in IJ, sever neck swelling and tenderness. CXR shows multiple peripheral lung nodules, some with cavitation

A

Fusobacterium necrophorum

- Lemierre syndrome

49
Q

southeast Asian man presents with a well-demarcated hypopigmented skin lesion on the left upper arm with no pinprick sensation. The ulnar nerve is thickened and tender to palpation at the elbow and he has numbness and tingling in his fingers.

A

Leprosy

  • Mycobacterium leprae
  • need full thickness biopsy
  • tx: dapsone + rifampin
50
Q

clostridium septicum

A

highly associated with colon cancer
- can cause gas gangrene and tissue necrosis
(as well as strep bovis)

51
Q

most common cause of nosocomial blood infections

A

central venous catheters

  • staph aureus
  • candida
52
Q

parvovirus in adults

A

acute, symmetric arthralgias (looks like RA)

53
Q

pneumonia in a patient with prior lung dz. CT shows dilated airways (bronchiectasis)

A

pseudomonas

- b-lactam + fluoroquinolone

54
Q

Pts with neutropenic fever should be immediately treated for

A

pseudomonas

- pip/tazo, ceftazidime, meropenem, imipenem, and cefepime

55
Q

candida appearance on KOH

A

pseudohyphae and budding yeast

56
Q

aminoglycosides

A

can cause sensorineural hearing loss and ATN

57
Q

antibiotics most likely to cause c diff

A

ampicillin and clindamycin

58
Q

14 year old with 2-week history of a non-productive cough, low-grade fever, sore throat, and occasional chest pain that worsens with deep inspiration.

A 
Atypical pneumonia (walking)
tx: macrolides

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