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Microbiology - systems Flashcards

1
Q

normal flora dominant - skin / nose / oropharynx / dental plaque, colon, vagina

A

skin –> S. epidermidis
nose –> S. epidermidis, colonized by S. aureus
oropharynx: viridans
dental plaque: S. mutans
colon: Bacteroid fragilis > E. coli
vagina: lactobacillus, colonized by E. coli and group B strep

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2
Q

Foods poisoning - bugs (and source)

A
  1. B. cereus (reheated rice)
  2. C. botulinum (inproperly canned foods, raw honey)
  3. C. perfingerns (reheated meat)
  4. E. coli O157:H7 (undercooked meat)
  5. Salmonealla (poultry, meat eggs)
  6. S aureus (meats, mayonnaise, custard) –> preformed toxin
  7. V. parahaemolyticus and V. vulnificus (contaminated food)
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3
Q

Beside food poisoning, V. vulnificus can cause

A

wound infection from contact with contaminated water or shellfish

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4
Q

Bags that cause bloody diarrhea

A
  1. campylobacter jejuni
  2. E. histolytica
  3. EHEC
  4. EIEC
  5. Salmonella
  6. Shigella
  7. Y. enterocolitica
  8. C difficile
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5
Q

salmonella source

A

eggs, pets, turtles,

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6
Q

Y. enterocolitica - situations

A

day care oubreaks

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7
Q

Y. enterocolitica causes

A
  1. bloody diarrhea

2. pseudoappendicitis

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8
Q

bacillary dysentery is caused by

A

shigella

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9
Q

Watery diarrhea - bacs

A
  1. C difficile
  2. C. pefringens
  3. ETEC
  4. Protoza (giardia, Cryptosporidium)
  5. V cholerae
  6. Viruses (Rotavirus, norovirus, adenovirus)
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10
Q

Viruses that causes watery diarrhea

A

Rotavirus, norovirus, adenovirus

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11
Q

common cuase of pneumonia in neonates (less than 4 weeks)

A
  1. S. agalactiae

2. E. coli

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12
Q

common cuase of pneumonia in children (4wks - 18yr) (in order)

A
  1. viruses (RSV)
  2. mycoplasma
  3. C. trachomatis (infants - 3 years)
  4. C. pneumoniae (school-aged children)
    S. pneumoniae
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13
Q

common cuase of pneumonia in adults (18-40yr) (in order)

A
  1. mycoplasma
  2. C. pneumoniae
  3. S. pneumoniae
  4. viruses (eg. influenza)
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14
Q

common cuase of pneumonia in adults (40-65yr) (in order)

A
  1. S. pneumoniae
  2. H. infuenzae
  3. Anaerobes
  4. viruses
    5, Mycoplasma
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15
Q

common cuase of pneumonia in elderly (in order)

A
  1. S. pneumoniae
  2. Influenza virus
  3. Anaerobes
  4. H Influenzae
  5. Gram (-) robs
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16
Q

pneumonia in alcoholics/iv drug users - bugs

A

S. pneumoniae, klebsiella, S. aureus, anaerobes

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17
Q

pneumonia with aspiration - bugs

A

anaerobes

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18
Q

atypical pneumonia - bugs

A

mycoplasma, legionella, chlamydia

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19
Q

pneumonia with cystic fibrosis

A

pseudomonas (adolscent), s. aureus (infants),
s. pneumoniae
+ Burkholderia cepacia

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20
Q

postviral pneumonia - bugs

A

s. aureus, H. infuenzae, S pneumoniae

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21
Q

Nosocomial (hostpital acquired) pneumonia - bugs

A

s. aureus, Pseudomonas, other enteric gram (-) negative robs

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22
Q

pneumonia in immunocompromised

A

s. aureus, enteric gram-negative robs, fungi, viruses, P. jirovecii (with HIV)

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23
Q

common cause of meningitis in newborn (0-6months) (in order)

A
  1. Group B streptococci
  2. E. coli
  3. Listeria
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24
Q

common cause of meningitis in children (6months-6yr) (in order)

A
  1. S. pneumoniae
  2. N. meningitis
  3. H. influenzae type B
  4. Enteroviruses
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25
Q

common cause of meningitis in 6-60 years (in order)

A
  1. S. pneumoniae
  2. N. meningitis (1st in teens)
  3. Enteroviruses
  4. HSV
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26
Q

common cause of meningitis in 60+ (in order)

A
  1. S. pneumoniae
  2. Gram - robs
  3. Listeria
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27
Q

meningitis - how to treat

A

give ceftriaxone + vancomycin (empirically)

add ampicillin if Listeria is suspected

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28
Q

viral causes of meningitis

A
  1. enteroviruses (esp coxsackievirus)
  2. HSV-2
  3. HIV
  4. West Nile virus (also causes encephalitis)
  5. VZV
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29
Q

West Nile virus causes

A

encephalitis and meningitis

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30
Q

HSV causes (on CNS)

A

HSV-1 –> encephalitis

HSV-2 –> meningitis

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31
Q

H. influenzae - meningitis?

A

incidence has decreased greatly with indroduction of the conjugate. H. influenzae vaccine in last 10-15 yrs. Today, cases are usually seen in unimmunized children

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32
Q

CSF findings in bacterial meningitis

A
  1. Increased opening pressure
  2. increased PMNs
  3. increased protein
  4. decreased sugar
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33
Q

CSF findings in fungal meningitis

A
  1. Increased opening pressure
  2. increased lymphocytes
  3. increased protein
  4. decreased sugar
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34
Q

CSF findings in viral meningitis

A
  1. normal/Increased opening pressure
  2. increased lymphocytes
  3. normal/increased protein
  4. normal sugar
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35
Q

CSF findings in TB meningitis

A
  1. Increased opening pressure
  2. increased lymphocytes
  3. increased protein
  4. decreased sugar
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36
Q

infections causing brain abscess - most commonly by

A

Viridans streptococci and S. aureus

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37
Q

infections causing brain abscess - if dental infection - bugs?

A

oral anaerobes

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38
Q

infections causing brain abscess - if extraction precedes abscess

A

oral anaerobes

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39
Q

infections causing brain abscess - Multiple abscess are usually from

A

bacteremia

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40
Q

infections causing brain abscess - single lesion from contiguous sites - sites (and area of the brail lesion)

A
  1. otitis media –> temporal lobe and cerebellum
  2. mastoiditis –> temporal lobe and cerebellum
  3. sinusitis –> frontal lobe
  4. dental infection –> frontal lobe
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41
Q

MCC of osteomyelitis

A

S. aureus

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42
Q

osteomyelitis associated with IV drug use - bugs

A
  1. pseudomonas
  2. Candida
  3. S. aureus
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43
Q

osteomyelitis associated with sickle cell anemia - bugs

osteomyelitis associated with cat and dog bites - bugs

A

SC anemia: salmonella and S. aureus

dog: pasteruella multocida

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44
Q

osteomyelitis associated with sexually active - bugs

A 
Neisseria gonorrhoeae (RARE)
septic arthritis more common
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45
Q

osteomyelitis associated with prosthetic joint replacement - bugs

A

S. aureus and S. epidermidis

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46
Q

osteomyelitis with vertebral involvement - bugs

A

S. aureus

M. tuberculosis (Pott disease)

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47
Q

osteomyelitis - test for diagnosis (and characteristics)

A
  1. elevated CRP (nonspecific)
  2. elevated sedimentation rate (nonspecific)
  3. MRI –> best for detecting acute infection and detailing anatomic involvement
  4. Radiographs –> insensitive early but can be useful in chronic osteomyelitis
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48
Q

Sexual transmitted infections - bugs and diseases

A
  1. HIV –> aids
  2. Haemophilus ducreyi –> Chancroid
  3. Chlamydia trachomatis (D-K)
  4. HPV –> Condylomata acuminata (6 + 11)
  5. HSV-2 (less commonly HSV-1) –> Genital herpes
  6. Neisseria gonorrhoeae –> Gonorrhea
  7. HBV –> Hepatitis B
  8. Clamydia trachomatis (L1-L3) –> Lymphogranuloma venereum
  9. Treponema pallidum –> syphilis
  10. Trichomonas vaginalis –> Trichomoniasis
  11. HHV-8 –> kaposi sarcoma
49
Q

Condylomata acuminata are caused by / special feature in biopsy

A

HPV-6 and HPV-11

koilocytes

50
Q

Chancroid is caused by ….

clinical features

A

Haemophilus ducreyi

Painful genital ulcer with exudate, inguinal adenopathy

51
Q

genital herpes are caused by? clinical features

A
  • HSV-2 (Less commonly HSV-1)
  • Painful penile, vulvar or cervical vesicles, and ulcers
  • can also cause systemic symptoms (fever, headache, myalgia)
52
Q

Rashes in childhood - bugs and disease

A
  1. Coxsackievirus type A –> Hand-foot-mounth disease
  2. HHV-6 (Less commonly HHV-7)–> Roseola (exannthem subitum or 6th disease)
  3. Measles virus –> Measles (rubeola)
  4. B19 –> Erythema infectiosum (Slapped cheek, 5th disease)
  5. Rubella virus –> Rubella (German measles)
  6. S. pyogenes –> Scarlet fever
  7. VZV –> chickenpox
53
Q

Hand-foot-month disease is caused by? clinical presentation

A

Coxsackievirus type A
OVAL-haped vesicles on palms and soles
vesicles and ulcers in oral mucosa

54
Q

Rubeola is caused by? clinical presentation

A

Beginning at head and moving down (maculopapular). Rash is preceded by cough, coryza, conjuctivitis, and blue white (Koplik) sptos on buccal mucosa

55
Q

Scarlet fever is caused by? clinical presentation

A

Streptococcus pyogenes

Erythematus sandpaper-like rash with fever and sore throat

56
Q

Chickenpox is caused by? clinical presentation

A

VZV

vesicular rash begins on trunk –> spreads to face and extremities with lesions of DIFFERENT STAGES

57
Q

Bugs affecting unimmunized children (group with symptoms)

A 
RASH
1. Rubella 
2. Measles 
Meningitis
1. H. influenzae type B
2. Polioviris 
Epiglottitis 
H. influenzae type B
Pharyngitis 
1. C. diptheriae)
58
Q

Epiglotitis is caused by/clinical presentation/findings etc

A

H. influenzae type B
Fever with dysphagia, drooling and difficulty breathing due to edematous “cherry red” epiglottis
Thumbprint sign on X-ray

59
Q

H. influenzae type B mediated Epiglotitis - immunization

A

it usually protects
but
H. influenzae type B is also capable to of causing epiglottitis in fully immunized children

60
Q

pelvic inflammatory disease is caused by - bugs (and onset)

A 
Chlamydia trachimatis (sabacute --> OFTEN UNDIAGNOSED) 
Neisseria gonorrhoeae (acute)
61
Q

MCC bacterial sexuall trasnmited infection in US

A

Chlamydia trachimatis

62
Q

pelvic inflammatory disease - clinical findings

A
  1. purulent cervical discharge

2. Cervical motion tenderness (Chadnderier sign)

63
Q

pelvic inflammatory disease may include

A
  1. saplingitis
  2. endometritis
  3. hydrosalpinx
  4. tubo-ovarian abscess
64
Q

salpingitis is a risk factor for

A
  1. ectopic pregnancy
  2. infertility
  3. chronic pelvic pain
  4. adhension
65
Q

pelvic inflammatory disease can lead to (explain)

A

FItz-Hugh-Curtis syndrome: infection of the liver capsule and “violin string” adhesion of peritoneum to liver

66
Q

Common vaginal infections - types and bugs

A
  1. Bacterial vaginosis (Gardnerella vaginalis)
  2. Thrichomoniasis (trichomonas vaginalis)
  3. Candida vulvovaginitis (Candida)
67
Q

Common vaginal infections - treatment

A
  1. Bacterial vaginosis –> metronidazole/clinddamycin
  2. Thrichomoniasis –> metronidazole (also treat sexual partner)
  3. Candida vulvovaginitis –> -azoles
68
Q

Common vaginal infections - labs

A
  1. Bacterial vaginosis –> clue cells, ph>4.5, amine whiff test (mixing discharge with 10% KOH enhance, fishy odor
  2. Thrichomoniasis –> motile trichomonas, ph>4.5
  3. Candida vulvovaginitis –> pseudohyphae, ph normal (4-4.5)
69
Q

Common vaginal infections - signs and symptoms

A
  1. Bacterial vaginosis –> no inflammation, thin white discharge with fishy odor
  2. Thrichomoniasis –> inflammation (strawberry cervix), frothy, grey geen, foul smeeling discharge
  3. Candida vulvovaginitis –> inflammation, thick white cottage cheese discharge
70
Q

Common vaginal infections - discharge

A
  1. Bacterial vaginosis –> thin, white with fishy odor
  2. Thrichomoniasis –> frothy, grey green, foul smelling dishcarge
  3. Candida vulvovaginitis - thick, white cottage cheese discharge
71
Q

Candida vulvovaginitis - predisposition

A
  1. diabetes

2. antibiotics

72
Q

Cystitis - symptoms

A
  1. dysuria
  2. Frequenct
  3. Urgency
  4. Suprapubic pain
  5. WBCs (not casts) in urine)
73
Q

Cystitis is primarily caused by (not bugs, mechanism)

A

ascension of microbes from urethra to bladder

74
Q

Cystitis in males (mechanism)

A

infacts –> congenital defects, vesicoulateral refulx

elderly –> enlarged prostate

75
Q

pyelonephritis - symptoms

A
  1. fever
  2. chills
  3. Flank pain
  4. Costovertebral angle tenderness
  5. Hematuria
  6. WBC casts in urine
76
Q

UTI - men vs women (why)

A

ten times more common in women: shorter urethras colonized by fecal flora

77
Q

UTI - predisposing factors

A
  1. women
  2. obstruction
  3. kidney surgery
  4. catheterization
  5. GU malformation
  6. diabetes
  7. pregnancy
78
Q

UTI - diagnostic markers

A
    • leukocyte esterase –> WBC activity
    • Nitrate test –> reduction of urinary nitrates by bacterial species (eg. E. coli)
    • Urease test –> urease-producing bags (eg. Proteus, klebsiella)
79
Q

UTI - –> + Nitrate test –>

A

reduction of urinary nitrates by bacterial species (eg. E. coli)

80
Q

UTI - bags

A
  1. E. Coli
  2. S. saprophyticus
  3. Klebsiella pneumoniae
  4. Serratia marcescens
  5. Enterococcus
  6. Proteus mirabilis
  7. Pseudomonas aeruginosa
81
Q

3 MCC of UTI (in order)

A
  1. E. Coli
  2. S. saprophyticus
  3. Klebsiella pneumoniae
82
Q

Proteus mirabilis - appearance

Klebsiella pneumoniae - appearance

A

proteus: Motility causes swarming on agar
klebsiella: large mucoid capsule and viscous colonies

83
Q

Serratia marcescens - special features (2)

A
  1. red pigment (some stains)

2. often nosocomial and drug resistance

84
Q

enteroccocus - special features

A

often nosocomial and drug resistance

85
Q

Proteus mirabilis - beside UTI is also associated with

A

struvite stones

86
Q

Pseudomonas aeruginosa - - special features (2)

A
  1. Bleu-green pigment and fruity odor

2. often nosocomial and drug resistance

87
Q

Congenital infections - definition / transmission

A

microbes that may pass from mother to fetus:

1. transplacental (MC) 2. delivery

88
Q

Non-specific signs of congenital infection

A
  1. hepatosplenomegaly
  2. jaundice
  3. thrombocytopenia
  4. growth retardation
89
Q

Congenital infections - bugs

A

ToRCHeS infections: (+ other)

  1. Toxoplasma gondi
  2. Rubella
  3. CMV
  4. HIV
  5. HSV-2
  6. Syphilis
  7. S. agalactiae 8. E.coli 9. Listeria, 10. B19
90
Q

Toxoplasma gondi - maternal manifestation

A

asymptomatic

lympadenopathy (rarely)

91
Q

Toxoplasma gondi - neonatal manifestation

A

classic triad: 1. chorioretinitis 2. hydrocephalus 3. intracranial calcifications
+/- blueberry muffin rash

92
Q

Rubella - neonatal manifestation

A

classic triad: 1. PDA (or pulmonary artery stenosis, or septal defects)
2. Hearing loss 3. Deafness
+/- blueberry muffin rash

93
Q

CMV - neonatal manifestation

A
  1. hearing loss
  2. seizures
  3. petechial rash
  4. blueberry muffin rash
  5. periventricular calcifications
94
Q

HIV - neonatal calcification

A
  1. Reccurent diarrhea

2. chronic diarrhea

95
Q

HSV -2 neonatal manifestation

A
  1. encephalitis

2. herpetic (vesicular) lesions

96
Q

syphilis - neonatal manifestation

A

OFTEN RESILTS IN STILLBIRTH, HYDROPS FETALIS

  1. facial abnormalities
  2. snuffles (nasal discharge)
  3. saddle nose
  4. notched (Hutchinson) teeth
  5. mulberry molars
  6. short maxilla
  7. saber shins
  8. CN VIII deafness
97
Q

infection in asplenic patients

A 
encapsuled microbes (S. pneum>H. inf type b> N. meningitis)
babesia
98
Q

Chronic granoulomatous disease - infection?

A

Catalase + (esp S. aureus)

99
Q

infection in neutropenic patients

A
  1. Candida (systemic)
  2. Aspergilus
  3. Mucor
  4. Rhizopus
100
Q

nosocomial infection - water aerosols - pathogen
nosocomial infection - renal dialysis unit
nosocomial infection - needle-stick

A

water: legionella

renal dialyisis + needle-stick: HBV

101
Q

nosocomial infection - urinary catheterization - pathogens

A

E. coli
klebsiella
Proteus

102
Q

nosocomial infection - intravascular catheters - pathogens

A

s. aureus (including MRSA), s. epidermides (Long term), Enterobacter

103
Q

nosocomial infection - Decubitus ulcers, surgical wound drains

A

S. aureus (including MRSA), gram (-) anaerobes

104
Q

nosocomial infection - mechanical ventilation, endotracheal intubation - pathogens

A

P. aeruginosa, Klebsiella, Acinetobacter, S.aureus

105
Q

nosocomial infection - altered mental status - old age, aspiration - pathogens and findings

A

gram (-) often anaerobes, polymicrobal

right lower lobe infiltrate or right upper/middle lobe (patient recumbent), purulent malodorous sputum

106
Q

traumatic open wound - bug

A

Clostiriduim pefringens

107
Q

Infection control techniques - goals

A

reduction of pathogenic organism counts to safe levels (disinfection) and the inactivation of self-propagating biological entities (sterilization)

108
Q

disinfection?

A

reduction of pathogenic organism counts to safe levels

109
Q

sterilization

A

inactivation of self-propagating biological entities

110
Q

Infection control techniques - types and definitions

A
  1. Autoclave: pressurized steam at >120c. May be sporicidal
  2. Alcohols: denature proteins and disrupt cell membranes. Not sporocidal
  3. Chlorhexidine: denature proteins and disrupt cell membranes. Not sporocidal
  4. Hydrogen peroxide: Free radical radiation. Sporocidal
  5. Iodine and iodophors: Halogenation of DNA, RNA and proteins. May be sporicidal
111
Q

Infection control techniques - sporocidal

A
  1. autoclave (may be)
    2 Free radical radiation
  2. Iodine and iodophors (May be)
112
Q

Ectoparasites - bugs / treatment

A
  1. Scabies (sarcoptes scabiei) –> pemethrin cream, washing/drying all cothing, bedding, treat close contacts
  2. Lice (Pediculus humanus/Phthirus pubis) –> Pyrethroids, malathion or ivermectin lotion, and nit combing
113
Q

Anti-mite/louse therapy - drugs and mechanism of action

A
  1. Pemethrin –> blocks Na+ ch –> neurotoxicity
  2. Malathion –> acetylcholinesterase inhibitor
  3. Lindane –> blocks GABA ch –> neurotoxicity
114
Q

Scabies (sarcoptes scabiei) - epidimiology / transmission

A

common in children, crowded populations (jails, nuesing homes)
trasmission through fomites

115
Q

Lice (Pediculus humanus/Phthirus pubis) can transmit

A
  1. Ricketsia prowazekii (epidemic typhus)
  2. Borreia recurrentis (relpapsing fever)
  3. Bartonella quintana (trench fever)
116
Q

Ectoparasites - bugs / mechanism

A
  1. Scabies (sarcoptes scabiei) –> Mites that burrow into the stratum corneum and cause pruritus and cause pruritus
  2. Lice (Pediculus humanus/Phthirus pubis) –> blood-sucking insects that prefer to live on clothing
117
Q

Scabies (sarcoptes scabiei) - epidimiology / transmission

A

common in children, crowded populations (jails, nuesing homes)
trasmission through fomites

118
Q

Ectoparasites - bugs / manifestation

A
  1. Scabies (sarcoptes scabiei) –> causes serpiginous burrows (lines) in wedscape of hands and feet
  2. Lice (Pediculus humanus/Phthirus pubis) –> intense pruritus, pink macules and papules commonly in intertiginous regions

Microbiology (25 decks)

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