Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

General ID 2019 > Nocardio, > Flashcards

Nocardio, Flashcards

1
Q

what are the 3 types of acyclovir-resistant viruses?

A
  • thymidine kinase negative
  • thymidine kinase altered substrate
  • DNA polymerase mutations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what ages do you start the HPV vaccine and dose schedule? (2018)

A

age 11 or 12 until age 26 for females, and age 21 for males not previously vaccinated.

MSM and immunocompromised until age 26

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what’s the difference between PCV13 and PPSV23?

A
  • PPSV23 – contains polysaccharide antigens
  • • PCV13 – contains immunogenic proteins conjugated to pneumococcal polysaccharides
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the two zoster vaccines that you can give?

A

Lived attenuated vaccine (VZL) and the recombinant subunit vaccine (RZV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the dose schedule and when do you give zoster vaccine?

A
  • • RZV is preferred over ZVL
  • • Healthy adults > 50 years
  • – Regardless of prior h/o HZ
  • – No need to wait any specific period of time after HZ to give RZV
  • (just not during acute episode)
  • • 2 doses, 2‐6 months apart
  • • Wait a minimum of 8 weeks after giving ZVL to give RZV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the meningococcal quadrivalent vaccines? types and approval ages

A

Meanctra (MCV4) - conjugate vaccine, 9 months to 55 years

Menveo (MCV4) - conjugate vaccine 2 months to 55 years

Menomune (MPSV4) - polysaccharide vaccine >2 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what serogroups are covered in the meningococcal quadrivalent vaccines?

A

A,C,Y,W-135

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what serogroup is not covered in the meningococcal quadrivalent vaccine? What can you use?

A

Meningococcal B vaccine

  • MenB-4C (Bexsero) ages 10-25, 2 dose series>1 month apart
  • MenB-fHbp (Trumenba) - 10-25;
  • Healthy - 2 dose series (0,6 months)
  • Risk for MC - 3 doses 0,1-2, and 6 months
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

who needs the Meng B vaccine ?

A

meng b risk patients

asplenia

complement deficiencies

On ecluizumab (solaris)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are the CDC recommendations before starting a patient on soliris?

A
  • Immunize with both quadrivalent and B vaccines at least 2 weeks prior to giving eculizumab if possible
  • – Repeat immunization every 5 years while on eculizumab
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

who should get hep A vaccination?

A
  • Travelers
  • MSM
  • IVU
  • chronic liver disease
  • post-exposure prophylaxis for healthy humans
  • persons who anticipate close contact with an international adoptee
  • person who work with nonhuman primates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are the basic microbiology characteristics of nocardia?

A
  • beaded & branching gram-positive rods
  • partially acid-fast
  • aerobic (unlike actinomyces)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the pathogenesis of Nocardia?

A
  • inhalation (most common)
  • Direct inoculation through the skin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the clinical presentation of nocardia?

A
  • 90%: slowly progressive pneumonia with cough, dyspnea, & fever
  • Aspergillus similar; co-infections occur
  • Similar to cryptococcal disease & actinomycosis
  • Can disseminate to any organ (brain in particular: get MRI)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

who is at risk for getting nocardia disease?

A
  • Transplant, steroids, alcoholism, diabetes, CGD, anti-TNF therapy, AIDS
  • Occurs month to years after transplantation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the norcardia skin lesions and who gets them?

A
  •  Immunocompetent host in tropical region (N. brasiliensis)
  •  Immunocompromised patient who gardens or walks barefoot
  •  Sporotrichoid lesions
  •  Mycetomas: chronic, progressive, lower limbs, draining sinuses
  • (similar to Actinomycetes)
17
Q

what radiology findings suggest nocardiosis?

A
  • Chest imaging: nodules, cavities, infiltrates with consolidation,effusions, ground-glass opacities
  •  MRI brain: single or multiple abscesses
18
Q

what are the nocardia buzzwords?

A
  • Beaded
  • branching
  • brain (+ lung)
  • Bactrim
19
Q

what is the empiric combination therapy for nocardia?

A
  • Amikacin + imipenem/meropenem + TMP/SMX
  •  Ceftriaxone & linezolid as alternate agents
  • If skin only, bactrim monotherapy
20
Q

what is the clinicla findings and radiological findings for rhodococcus?

A
  •  Indolent pneumonia (80%) in immunocompromised host
  •  Fever, cough, hemoptysis, fatigue, subacute, pleuritic CP
  •  Nodules, thick-walled cavities, infiltrates, effusions possible
  •  Extrapulmonary dissemination possible (skin & brain)
  •  Mimic of TB, NTM, Aspergillus, Nocardia
21
Q

what does the typical patient transmission risk factors and pathogenesis for Rhodococcus?

A

 T cell immunosuppressed

 HIV+ & CD4<200; organ txp

 Inhalation or ingestion

 Farm/soil/manure or horse exposure in some patients

22
Q

what is the common microbiology for Rhodococcus?

A
  • Microbiology: R. equi is the most common
  •  Gram positive, aerobe, coccobacillary
  •  Colonies can be salmon pink
  •  Weakly acid fast: can be mistaken for Nocardia but no branching
23
Q

what is the treatment for Rhodococcus?

A
  •  Combination therapy
  •  2 or 3 drug regimens: vanc + imipenem/meropenem + fluoroquinolone
  • or rifampin 2-3 wks then oral FQ + azithro/clari or rifampin
  •  Linezolid an alternative
24
Q

how is the diagnosis of rhodococus made?

A
  •  Culture followed by 16S rRNA, MALDI
  •  Tissue: gram stain, necrotizing granulomatous reaction; microabscess
  •  Blood cultures may be positive (>25%)
25
Q

Rhodococcus buzzwords?

A
  • Short Gram positive rod (coccobacillus)
  • Cavitary pneumonia (hemoptysis)
  • Salmon pink colonies
  • Advanced HIV
  • Horse / manure exposure
26
Q

bacteria with a “safety pin” appearance?

A
  • Yersinia pestis
  • Vibrio parahemolyticus
  • Burkholderia mallei & pseudomallei
  • Haemophilus ducreyi
  • Klebsiella granulomatis
  • Melioidosis
27
Q

what does Meliosis look like in the microbiology lab?

A
  • Facultative intracellular gram-negative rod, Burkholderia pseudomallei
  •  Oxidase positive
  •  Characteristic bipolar staining with a “safety pin”
  • appearance
28
Q

typical patient location for Meliodosis?

A

 Southeast Asia, northern Australia, South Asia (+ India), &
China;

 Esp. Northeastern Thailand & northern Australia

29
Q

Meliodosis take-aways?

A

SE Asia (Thailand)/Australia

Soil/water exposure (inhalation/inoculation/rainy season)

Pneumonia + severe sepsis/shock or multiple abscesses

Can be years after exposure (not usually)

Safety pins on Gram stain; Gram negative rods

30
Q

Meliodosis treatment?

A
  • Treatment: Treat all cases
  •  Mild disease: initial intensive IV therapy for two weeks followed by eradication therapy orally for 3-6 months
  •  B. pseudomallei resistant to penicillin, ampicillin, 1st/2nd generation cephalosporins, polymyxin, aminoglycosides
  •  Ceftazidime or carbapenem first then tmp/smx (+/- doxycycline) for 3-6 months
31
Q

Glanders cause, transmission, location?

A
  •  Caused by Burkholderia mallei & is rare in humans
  •  Requires close contact w/ infected animals (horses, donkeys,mules)
  •  Bacteria enter through the eyes, nose, mouth, or skin wounds
  •  B. mallei is an obligate mammalian pathogen & must cause the disease to be transmitted between hosts
  •  Africa, Asia, Middle East, Central America, South America
32
Q

Glanders symptoms and treatment?

A
  •  Incubation period usually 1 to 21 days but can be months or years
  •  1st symptom usually fever, followed by pneumonia, pustules & abscesses
  •  The acute form is highly lethal without treatment
  •  Treatment = imipenem + doxycycline for 2 weeks, then azithromycin + doxycycline for 6 months
33
Q

Actinomyces microbiology lab?

A
  •  Gram-positive, anaerobic, non–spore-forming bacteria
  •  Part of the normal mucosal flora of the oral, gastrointestinal, respiratory, & genital tracts
  •  Actinomyces israelii most common species
  •  Produce sulfur granules
34
Q

typical patient that would be at risk for actinomyces?

A
  • Recent dental procedures
  • aspiration (thoracic)
  • IUD (pelvic)
35
Q

Clinical findings, Dx, DDX, treatment of Actinomyces?

A
  •  Clinical findings: Oral-cervicofacial disease most common, followed by abdominal & thoracic infection; Lumpy jaw
  •  Slow growing mass, ignores tissue planes, can necessitate/form sinuses/fistulas
  •  DDx: Cancer, TB, Nocardia
  •  Diagnosis:  Culture, histopathology (sulfur granules)
  •  Treatment:  Penicillins (PCN, ampicillin) x weeks to months
36
Q

what are the actinomyces buzzwords?

A
  • Sulfur granules
  •  Dental work
  •  IUD
  •  Erosive mass
  •  Filamentous anaerobe
37
Q

what are the 4 causes of sporotrichoid lesions?

A
  • Sporothrix schenckii - gardening, soil, splinters, animal bites/scratches
  • Nocardia brasilensis - gardening, soil, splinters
  • Mycobacterium marinum - Aquarium, fish handling, water exposure
  • Leishmania brasilensis - endemic reigon

General ID 2019 (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions