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STEP 1 (4) > Microbiology-Systems > Flashcards

Microbiology-Systems Flashcards

1
Q

What is the main normal skin flora?

A

S. epi

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2
Q

What is the main normal nare flora?

A

S. epi and colonized by S. aureus

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3
Q

What is the main normal oropharynx flora?

A

Viridans strep

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4
Q

What is the main normal dental plaque flora?

A

S. mutans

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5
Q

What is the main normal colon flora?

A

B. fragilis over E. Coli

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6
Q

What is the main normal vaginal flora?

A

Lactobacillus, colonized by E. coli and GBS

NOTE: Neonates delivered by C-section have no flora but are rapidly colonized after birth

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7
Q

______ and ______ cause food poisoning that starts quickly and ends quickly

A

S. aureus and B. cereus

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8
Q

The classic cause of food poisoning from fried rice is _______

A

B. cereus

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9
Q

The classic cause of food poisoning from improperly canned food and raw honey is _______

A

C. botulinum

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10
Q

The classic cause of food poisoning from maonnaise and custards is _______

A

S. aureus

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11
Q

What needs to be on the DDx for dysentery?

A

Campylobacter (comma or s-shaped and growth at 42C)

E histolytica (protozoan; liver abscesses)

EHEC (can cause HUS) and EIEC

Salmonella and Shigella

Y. enterocolitis (day care outbreaks and pseudoappendocitis)

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12
Q

What needs to be on the DDx for watery diarrhea?

A

C. difficile

C. perfringens (also causes gas gangrene)

ETEC (heat labile and heat stabile toxins)

Protozoa (Giardia and Crytposporidium)

V. cholerae (rice water diarrhea)

Virusus (Rotavirus, norovirus, adenovirus)

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13
Q

What are the most common causes of pneumonia in children less than 4 weeks old?

A

GBS and E. Coli

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14
Q

What are the most common causes of pneumonia in children 4 weeks-18 yo?

A

Viruses (RSV)

Mycoplasma

C. trachomatis (infants- 3 yo)

C. pneumoniae (school aged)

S. pneumoniae

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15
Q

What are the most common causes of pneumonia in adults 40-65 yo?

A

S. pneumo

H. influenzae

Anaerobes, Viruses, Mycoplasma

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16
Q

What are the most common causes of pneumonia in adults 65+ yo?

A

S. pneumo

Influenza virus

Anaerobes

H. influenzae

gram negative rods

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17
Q

Common causes of pneumoniae in Alcoholics and IVDU?

A

S. pneumoniae, Klebsiella, and S. aureus

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18
Q

Common causes of pneumoniae in aspiration cases?

A

Anaerobes (e.g. Peptostreptococcus, Fusobacteriu Prevotella, Bacteroides)

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19
Q

Common causes of atypical pneumoniae?

A

Mycoplasma, Legionella, Chlamydia

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20
Q

Common causes of pneumoniae in cystic fibrosis pts?

A

Pseudomonas, S. aureus, S pneumo.

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21
Q

Common causes of pneumoniae in Nosocomial (hospital acquired) cases?

A

S. aureus, Pseudomonas

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22
Q

Common causes of pneumoniae in immunocompromised pts?

A

S. aurues, P. jirovecii with HIV

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23
Q

Common causes of pneumoniae in 2ndary postvirally?

A

S. aureus, H. influenza, S. pneumo

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24
Q

What are the most common causes of meningitis in neonates (0-6 months old)?

A

GBS

E. Coli

Listeria

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25
Q

What are the most common causes of meningitis in 6 mo-6 yr?

A

S. pneumo

N. meningitidis

H. influenza type B

Enteroviruses

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26
Q

What are the most common causes of meningitis in 6-60 yo?

A

S. pneumo

N. meningitis (no. 1 in teens)

Enterovirsuses

HSV

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27
Q

What are the most common causes of meningitis in 60+ yo?

A

S. pneumo

Listeria

Gram neg rods

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28
Q

How should meningitis be tx generally?

A

Vanco and ceftriaxone and add ampicillin if Listeria is suspected

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29
Q

What are the major viral causes of meningitis?

A

Enteroviruses (esp Coxsackievirus),

HSV-2 (HSV-1 = temporal lobe encephalitis),

HIV

West Nile virus,

VZV

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30
Q

Meningitis in HIV pt, think ______

A

Cryptococcus

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31
Q

What are the CSF findings of bacterial meningitis?

A

elevated opening pressure

neutrophils dominant

elevated protein

decreased glucose

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32
Q

What are the CSF findings of viral meningitis?

A

normal/slightly elevated opening pressure

lymphocytes

normal/slightly elevated protein

normal glucose

33
Q

Brain abscesses are most commonly caused by what?

A

Strep viridans and S. aureus, or if a dental infection or extraction precedes abscess formation, consider oral anerobes

34
Q

More hints about brain abscesses

A

Multiple abscesses suggest bactermia

single lesions are commonly from contiguous sources such as otitis media and mastoiditis (found in the temporal lobe and cerebellum)

With sinusitis or dental as the source, the frontal lobe is commonly affected

35
Q

Brain abscesses in AIDs pts suggests _______

A

Toxoplasma

36
Q

Osteomyelitis in a pt without risk factors is most likely due to what?

A

S. aureus (most common overall)

37
Q

Osteomyelitis in a pt who is sexually active is most likely due to what?

A

Neisseria gonorhoeae (rare) - septi arthritis more common

38
Q

Osteomyelitis in a pt with SCD is most likely due to what?

A

Salmonella and S. aureus

39
Q

Osteomyelitis in a pt with a rposthetic joint replacement is most likely due to what?

A

S, aureus or S. epi

40
Q

Osteomyelitis in a pt with vertebral involvement is most likely due to what?

A

S. aureus, Mycobacterium tuberculosis (Pott Disease)

41
Q

Osteomyelitis in a pt with a Hx of cat/dog bites is most likely due to what?

A

Pasteurella multocida

42
Q

Osteomyelitis in a pt with a Hx of IVDU is most likely due to what?

A

Pseudomonas, Candida, or S. aureus

43
Q

How should osteomyelitis be diagnosed?

A

MRI is best for detecting acute infections and detailing anatomic involvement. Radiographs are insensitive early but can be useful with chronic osteomyelitis

44
Q

How does cystitis present?

A

dysuria. frequency, uregncy, suprapubic pain, and WBCs (but not WBC casts) in urine.Primarily due to ascension of microbes from the urethra to the bladder.

Mlaes with congenital defects and vesicoureteral reflux more liekly

Elderly, those with enlarged prostate

45
Q

Describe the findings of pyelonephritis

A

fever, chills, flank pain, CVAT, heamturia, and WBC casts

46
Q

What are the major UTI bugs?

A

E. Coli

S. Sapro

Klebsiella pneumoniae

Serratia marcescens (often nosocomial and drug resistant)

47
Q

Clues to diagnosing bacterial vaginosis

A

-No inflammation, thin white discharge with fishy odor

Clue cells and pH 4.5+

Tx with metronidazole

48
Q

Clues to diagnosing Tirchomoniasis

A

Strawberry cervix

frothy, grey-green foul smelling discharge

pH 4.5+

Tx with Metronidazole and tx partners

49
Q

What are TORCH infections?

A

Microbes that may be passed vertically- transmission is transplacental in most cases, or via delivery (esp. HSV-2).

Nonspecific signs common to many TORCH disease include HSM, jaundice, thrombocytopenia, and growth retardation

50
Q

What are the TORCH infections?

A

Toxoplasma

Rubella

CMV

HIV

HSV 2

Syphillis

51
Q

How is Toxoplasma transmitted?

A

Cat feces or ingestion or undercooked meat

52
Q

What are the maternal and neonatal manifestations of Toxoplasma?

A

Maternal: Usually asymptomatic or LAD

Neonatal: Chorioretinitis, hydrocephalus, and intrancranical calcifications +/- blueberry muffin rash

53
Q

Toxo- Chorioretinitis

A
54
Q

How is Rubella transmitted?

A

Respiratory droplets

55
Q

What are the maternal manifestations of Rubella?

A

Rash, LAD, and arthritis

56
Q

What are the neonatal manifestations of Rubella?

A

PDA (pulmonary artery hypoplasia), cataracts, and deafness +/- blueberry muffin rash

57
Q

How is CMV transmitted?

A

sexual or transplants

58
Q

How does CMV present in the mom and neonate?

A

Maternal: asymptomatic or mono-like course

Neonate: Hearing loss, seizures, petechial rash, periventricular calcifications

59
Q

How does neonatal syphillis present?

A

can result in stillbirth, hydrops fetalis

if child survives, presents with facial abnormalities including notched teeth, saddle nose, short maxilla, saber shins, and deafness

60
Q

What are the main causes of childhood rash?

A

Coxsackivirus type A (hand-foot-mouth disease)

HHV-6 (Roseola; exanthem subitum)

Measles virus

Parvovirus B19 (Erythema infectiosum; 5th disease)

Rubella S. pyogenes (Scarlet fever)

VZV

61
Q

Hand-Foot-Mouth Disease

A

Presents with oval-shaped vesicles on palms and soles and ulcers near the oral mucosa

62
Q

Roseola

A

Asymptomatic rose-colored macules appear on body after several days of high fever; can present with seizures

63
Q

Measles

A

Beginning at the head and moving down; rash is preceded by cough, coryza, conjunctivitis, and Koplik spots

64
Q

Fifth Disease

A

Slapped chee rash on face (can cause hydrops fetalis in pregnant women)

65
Q

Rubella

A
66
Q

Scarlet fever

A

Sandpaper like rash with fever and sore throat

67
Q

VZV rash

A

Begins on the trunk and spreads to the face and extremities with different lesions of different ages

68
Q

What is this?

A

Condylama acuminatum (HPV 6,11)

69
Q

What causes Lymphogranuloma venereum?

A

C. trachomatis L1-L3

70
Q

What are the top causes of PID?

A

C. trachomatis (subacute, often not diagnosed)

N. gonorrhoeae (acute)

71
Q

What nosocomial infection is most common in a pt. with altered mental status, old age, or aspiration?

A

Polymicrobial, gram negs, and often anaerobe

72
Q

What nosocomial infection is most common in a pt. with decubitus ulcers, surgical wounds, and drains?

A

S. aureus

73
Q

What nosocomial infection is most common in a pt. with IV catheters?

A

S. aurues, S. epi, and Enterobacter

74
Q

What bug should you think of in a pt with CGD?

A

Catalase positive, including S. aureus

75
Q

What bug should you think of in a pt with a cat or dog bite?

A

Pasteurella multocida

76
Q

What bug should you think of in a pt with current jelly sputum?

A

Klebsiella

77
Q

What bug should you think of in a pt with a fungal infection in a diabetic or immunocompromised?

A

Mucor or Rhizpus spp.

78
Q

What bug should you think of in a pt with organ transplant?

A

CMV

79
Q

What bug should you think of in a pt with a surgical wound?

A

S. aureus

STEP 1 (4) (18 decks)

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