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OMS II BECOM Exam 1 > Osteomyelitis - Staph and other Pathogens - Atchley > Flashcards

Osteomyelitis - Staph and other Pathogens - Atchley Flashcards

1
Q

gram positive cocci

A
  1. staphylococci
  2. streptococci
  3. enterococci (once a type of strep)
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2
Q

catalase

A
  • splits hydrogen peroxide into water and O2
  • bubbles if positive
  • test to differentiate strep and staph
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3
Q

staphylococci

A
  • catalase positive and gram positive
  • arranged in clusters
  • coagulase + –> staph aureus (fibrin blood clots) –> ferments mannitol (yellow)
  • coagulase - –> staph saprophyticus and epidermidis –> does not ferment mannitol (pink)
  • mannitol salt agar (7.5% NaCl)
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4
Q

streptococci

A
  • catalase negative and gram positive
  • arranged in chains
  • alpha hemolysis –> strep viridans and pneumonia
  • beta hemolysis –> strep pyogenes (GAS) and agalactiae (GBS)
  • gamma hemolysis –> strep Bovis and faecalis
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5
Q

what organism looks like staph aureus on mannitol agar?

A

enterococcus faecalis

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6
Q

staph aureus

A
  • gram +
  • beta hemolytic (total hemolysis)
  • coagulase +
  • ferments mannitol
  • colonized in nose
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7
Q

staph aureus virulence factors

A
  1. protein A –> binds IgG Fc –> prevents opsonization/phagocytosis
  2. coagulase –> fibrin coat
  3. hemolysins and leukocidins –> lyse RBCs and WBCs
  4. Penicillinase –> degrades penicillin
  5. hyaluronidase –> digest connective tissue
  6. lipase –> degrade fat and oil
  7. protease –> destroy tissue proteins
  8. exfoliatin (exotoxin) –> scalded skin syndrome (skin slough)
  9. enterotoxin –> heat stable exotoxin
  10. TSST –> superantigen; release TNF-alpha and IL-1
  11. PVL –> kills WBCs and tissues by forming pores in leukocytes –> necrotizing skin/pneumoniae
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8
Q

staph aureus toxin related diseases

A
  1. food poisoning (enterotoxins) –> meats and mayo; nausea and vomiting (common); diarrhea (rare)
  2. Toxic Shock Syndrome (TSST-1) –> fever, shock, red rash, diarrhea; peeling of palms/soles; tampons aka packing; organ system failure
  3. scalded skin syndrome (exfoliatin) –> skin sloughs off –> liquify stratum granulosum and detach keratinocytes (heals with no scar)
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9
Q

staph aureus infectious/inflammatory diseases

A
  1. bullous impetigo (only staph aureus) –> superficial skin infection; children; skin blistering
  2. pneumonia –> lobar pneumonia (rare)
  3. acute endocarditis –> healthy tissue; no preexisting heart valve
  4. osteomyelitis –> children (leg long bones); adults (spine); hematogenous spread; tissue damage
  5. cellulitis (usually strep pyogenes) –> deep dermis and subq infection
  6. abscesses –> pockets of pus (folliculitis, furuncle, carbuncle)
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10
Q

impetigo can be caused by what 2 organisms?

A
  • staph aureus (common)

- strep pyogenes (rare)

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11
Q

what causes subacute endocarditis?

A
  • strep viridans
  • slower onset of symptoms
  • mouth flora, dental procedures
  • history of valve abnormality
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12
Q

organism of central lines and IV drug abusers?

A

staph aureus

-can lead to sepsis

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13
Q

organisms that cause osteomyelitis

A
  1. staph aureus (main)
  2. strep pneumonia
  3. strep pyogenes
  4. salmonella in sickle cell patients
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14
Q

puncture wound through a shoe?

A

pseudomonas

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15
Q

2 organisms that can cause foliculitis?

A

staph (common) and strep (rare)

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16
Q

MRSA - methicillin resistant staph aureus

A
  • resistant to beta lactams
  • alters PBP (blocks binding) due to mecA gene
  • treatment: vancomycin, daptomycin, linezolid
17
Q

staph epidermidis

A
  • nosocomial infections –> blood culture contaminant, prosthetic devices (forms biofilms)*
  • always methicillin resistant
  • coagulase neg, novobiocin sensitive*
18
Q

staph saprophyticus

A
  • 2nd most common cause UTIs in active women
  • nitrite neg
  • E. coli is #1 cause UTIs (nitrite pos)
  • honeymooner cystitis
  • coagulase neg, novobiocin resistant*
19
Q

strep galloylyticus

A
  • high chance of colon cancer

- do colonoscopy

20
Q

strep pyogens GAS

A
  • strep throat
  • beta hemolytic
  • bacitracin sensitive*
21
Q

strep pyogenes virulence factors

A
  1. M protein –> autoantibodies against endocardium and synovial connective tissue –> mitral valve damage
  2. streptolysin O –> digests RBCs (hemolysins); ASO titer to look for antibodies of once infected strep
  3. streptococcal pyrogenic exotoxin –> scarlet fever and toxic shock like syndrome
  4. streptokinase –> activate plasminogen –> digest fibrin clot
  5. hyaluronidase –> break connective tissue
22
Q

strep pyogenes infections

A
  1. strep throat

2. skin infections (ex. impetigo, folliculitis, #1 cause of cellulitis)*

23
Q

strep pyogens toxin mediated disease

A
  1. scarlet fever –> strep throat, sunburn skin rash post fever, strawberry tongue; spare palms/soles; “sandpaper skin”
  2. necrotizing fasciitis –> infection of deep tissues; gangrene; pyogenic exotoxin; muscle fascia
24
Q

3 types of necrotizing fasciitis

A
  1. type 1: polymicrobial and anaerobes (bactericides, clostridium); vibrio vulnificus (saltwater)
  2. type 2: strep pyogenes flesh eating bacteria; sometimes staph aureus
  3. type 3: gas gangrene (clostridium)
25
Q

strep pyogenes autoimmune disease

A
  1. rheumatic fever –> type 2 hypersensitivity; M protein targets joints and heart valves
  2. post streptococcal glomerularnephritis –> hypersensitivity type 3; acute kidney failure (reversible)
26
Q

infectious diseases that have rashes of the palms and soles

A
  • cocksackie virus: hand, foot, and mouth disease
  • Rocky Mountain spotted fever
  • syphilis
27
Q

stigma of acute endocarditis

A
  • Janeway lesions –> hemorrhagic macules on hands/feet

- osler nodes –> lumps on fingers/toes

28
Q

strep agalactiae GBS

A
  • produces CAMP factor (arrowhead) –> enhance beta hemolysis
  • bacitracin resistant*
29
Q

strep agalactiae GBS diseases

A
  • serious in babies –> meningitis, pneumonia, sepsis
  • peaks in < 3 months in babies
  • carried vaginally by 25% of women –> screen 36 weeks*
30
Q

strep pneumonia

A
  • alpha hemolytic, gram + in pairs
  • diplococci –> lancets
  • polysaccharide capsule
  • asplenic –> high risk for sepsis with encapsulated organisms
  • IgA protease and pneumolysin –> green halo
  • # 1 cause of meningitis and pneumonia in adults**
  • # 1 cause of otitis media in children**
  • lobar pneumonia
31
Q

strep viridans

A
  • mouth flora –> dental carries (strep mutans)
  • alpha hemolytic
  • subacute endocarditis (strep sanguis) –> affect abnormal heart valves (mitral)
  • adhere to platelets by producing dextran to bind fibrin
32
Q

enterococcus GDS

A
  • normal gut flora
  • grow in 6.5% NaCl and bile –> also grows staph
  • nitrite negative…E. coli is nitrite +
  • UTIs and endocarditis
  • faecalis ferments mannitol salt
  • resistant to vancomycin
33
Q

strep gallolyticus aka strep bovis

A
  • normal gut flora
  • colon cancer –> order colonoscopy
  • grows in bile, not salt
34
Q

optochin

A
  • strep viridans resistant

- strep strep pneumonia sensitive

35
Q

bacitracin

A
  • GBS resistant

- GAS sensitive

36
Q

CAMP

A
  • GBS positive

- GAS negative

OMS II BECOM Exam 1 (30 decks)

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