Quizlet - Microbiology - Clinical Patterns Flashcards
Tricky T’s: Typhoid fever
caused by bacterium Salmonella typhi.
Tricky T’s: Typhus
caused by bacteria Rickettsia prowazekii (epidemic), Rickettsia typhi (endemic), and Rickettsia tsutsugamushi (scrub typhus)
Tricky T’s: Chlamydia trachomatis
Bacteria, STD
Tricky T’s: Treponema
Spirochete; causes syphilis (T. pallidum) or yaws (T. pertenue)
Tricky T’s: Trichomonas vaginalis
Protozoan, STD.
Tricky T’s: Typanosoma
Protozoan, causes Chagas’ dz (T. cruzi) or African sleeping sickness.
Tricky T’s: Toxoplasma
protozoan, a TORCH infxn.
Tricky T’s: Trichinella spiralis
Nematode in undercooked meat.
Prions What are they? What dz’s do they cause? Normal vs. pathologic prions?
Infectious agents that do not contain RNA or DNA (consist only of proteins); encoded by cellular genes. Dz’s: Creutzfeldt-Jakob dz (CJD – rapidly progressive dementia), kuru, srapie (sheep), mad cow dz Associated w/ spongiform encephalopathy . Normal prions have alpha-helix conformation; pathologic prions (like CJD) are beta-pleated sheets. Pathologic conformation accumulates b/c it is resistant to proteinase digestion.
Dominant normal flora of the: Skin
Staphylococcus epidermis
Dominant normal flora of the: Nose
S. epidermis; colonized by S. aureus
Dominant normal flora of the: Oropharynx
Viridans group streptococci
Dominant normal flora of the: Dental plaque
Streptococcus mutans
Dominant normal flora of the: Colon
Bacteroides fragilis > E. coli
Dominant normal flora of the: Vagina
Lactobacillus, colonized by E. coli and GBS
Neonates and normal flora
Neonates delivered by cesarean section havve no flora, but are rapidly colonized after birth.
Food poisoning from: Vibrio parahemolyticus and V. vulnificus
Food: Contaminated seafood (V. vulnificus can also cause wound infxn from contact w/ contaminated water or shellfish)
Food poisoning from: Bacillus cereus
Food: reheated rice. (Food poisoning from reheated rice? Be Serious! [B. cereus])
Food poisoning from: S. aureus
Food: Meats, mayonnaise, custard (pre-formed toxin)
Food poisoning from: Clostridium perfringens
Food: reheated meat dishes
Food poisoning from: Clostridium botulinum
Food: improperly canned foods (bulging cans)
Food poisoning from: E. coli O157:H7
Food: Undercooked meat
Food poisoning from: Salmonella
Food: poultry, meat, and eggs.
What are two bacteria that cause a food poisoning that starts quickly and ends quickly?
S. aureus and B. cereus
Bugs that cause diarrhea: Campylobacter Type of diarrhea? Findings?
Bloody diarrhea. Comma- or S-shaped organisms; growth at 42C; Oxidase (+) [bugs that cause diarrhea: type of diarrhea and findings]
Bloody diarrhea. Comma- or S-shaped organisms; growth at 42C; Oxidase (+) [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: Campylobacter
Bugs that cause diarrhea: Salmonella Type of diarrhea? Findings?
bloody diarrhea. Lactose (-); Flagellar motility [bugs that cause diarrhea: type of diarrhea and findings]
bloody diarrhea. Lactose (-); Flagellar motility [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: Salmonella
Bugs that cause diarrhea: Shigella Type of diarrhea? Findings?
Bloody diarrhea Lactose (-) Very low ID50 Produces Shiga toxin [bugs that cause diarrhea: type of diarrhea and findings]
Bloody diarrhea Lactose (-) Very low ID50 Produces Shiga toxin [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: Shigella
Bugs that cause diarrhea: Enterohemorrhagic E. coli (EHEC) Type of diarrhea? Findings?
Bloody diarrhea O157:H7 Can cause HUS Makes Shiga-like toxin [bugs that cause diarrhea: type of diarrhea and findings]
Bloody diarrhea O157:H7 Can cause HUS Makes Shiga-like toxin [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: Enterohemorrhagic E. coli (EHEC)
Bugs that cause diarrhea: Enteroinvasive E. coli (EIEC) Type of diarrhea? Findings?
Bloody diarrhea. Invades colonic mucosa. [bugs that cause diarrhea: type of diarrhea and findings]
Bloody diarrhea. Invades colonic mucosa. [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: Enteroinvasive E. coli (EIEC)
Bugs that cause diarrhea: Yersinia enterocolitica Type of diarrhea? Findings?
Bloody diarrhea Day-care outbreaks Pseudoappendicitis [bugs that cause diarrhea: type of diarrhea and findings]
Bloody diarrhea Day-care outbreaks Pseudoappendicitis [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: Yersinia enterocolitica
Bugs that cause diarrhea: C. difficile Type of diarrhea? Findings?
Can cause both watery and bloody diarrhea. Pseudomembranous colitis. [bugs that cause diarrhea: type of diarrhea and findings]
Can cause both watery and bloody diarrhea. Pseudomembranous colitis. [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: C. difficile
Bugs that cause diarrhea: Entamoeba histolytica Type of diarrhea? Findings?
Bloody diarrhea. Protozoan. [bugs that cause diarrhea: type of diarrhea and findings]
Bloody diarrhea. Protozoan. [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: Entamoeba histolytica
Bugs that cause diarrhea: Enterotoxigenic E. coli (ETEC) Type of diarrhea? Findings?
Watery diarrhea. Traveler’s diarrhea Produces ST and LT toxins [bugs that cause diarrhea: type of diarrhea and findings]
Watery diarrhea. Traveler’s diarrhea Produces ST and LT toxins [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: Enterotoxigenic E. coli (ETEC)
Bugs that cause diarrhea: Vibrio cholerae Type of diarrhea? Findings?
Watery diarrhea. Comma-shaped organisms Rice-water diarrhea. [bugs that cause diarrhea: type of diarrhea and findings]
Watery diarrhea. Comma-shaped organisms Rice-water diarrhea. [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: Vibrio cholerae
Bugs that cause diarrhea: C. perfringens Type of diarrhea? Findings?
Watery diarrhea. Also causes gas gangrene. [bugs that cause diarrhea: type of diarrhea and findings]
Watery diarrhea. Also causes gas gangrene. [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: C. perfringens
Bugs that cause diarrhea: Protozoa Type of diarrhea? Findings?
Watery diarrhea Giardia, Cryptosporidium (in immunocompromised) [bugs that cause diarrhea: type of diarrhea and findings]
Watery diarrhea Giardia, Cryptosporidium (in immunocompromised) [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: Protozoa
Bugs that cause diarrhea: Viruses Type of diarrhea? Findings?
Watery diarrhea. Rotavirus, adenovirus, Norwalk virus (norovirus). [bugs that cause diarrhea: type of diarrhea and findings]
Common causes of pneumonia in neonates (< 4wks)
Group B streptococci E. coli
Common causes of pneumonia in children (4wks - 18yrs)
Viruses (R SV) M ycoplasma C hlamydia pneumoniae S treptococcus pneumoniae (R unts M ay C ough S putum)
Common causes of pneumonia in adults (18-40yrs)
Mycoplasma Chlamydia pneumoniae Streptococcus pneumoniae
Common causes of pneumonia in Adults (40-65yrs)
Streptococcus pneumoniae H. influenzae Anaerobes Viruses Mycoplasma
Common causes of pneumonia in the elderly (>65)
Streptococcus pneumoniae Viruses Anaerobes H. influenzae Gram (-) rods
Common causes of nosocomial (hospital-acquired) pneumonia
Staphylococcus Enteric Gram (-) rods
Common causes of pneumonia in the immunocompromised
Staphylococcus Enteric Gram (-) rods Fungi Viruses Pneumocystis jiroveci (w/ HIV)
Common cause of pneumonia w/ aspiration
Anaerobes
Common cause of pneumonia in alcoholics/IV drug users
Streptococcus pneumoniae Klebsiella Staphylococcus
Common causes of pneumonia in CF
Pseudomonas
Common causes of post-viral pneumonia
Staphylococcus H. influenzae
Common causes of atypical pneumonia
Mycoplasma Legionella Chlamydia
Common causes of meningitis in newborn (0-6 months
Group B streptococci E. coli Listeria
Common causes of meningitis in children (6mos - 6yrs)
Streptococcus pneumoniae Neisseria meningitidis Haemophilus influenzae type B Enteroviruses
Common causes of meningitis (6-60yrs)
N. miningitidis Enteroviruses S. pneumoniae HSV
Common causes of meningitis in 60+ year-olds
Streptococcus pneumoniae Gram (-) rods Listeria
Viral causes of meningitis
Enteroviruses (esp. coxsackievirus) HSV HIV West Nile virus VZV
Common causes of meningitis in HIV
Cryptococcus CMV Toxoplasmosis (brain abscess) JC virus (PML)
Incidence of H. influenzae meningitis?
Has decreased greatly w/ introduction of H. influenzae vaccine in last 10-15 years.
CSF findings in meningitis: Bacterial [Pressure? Cell type? Protein? Sugars?]
Increased pressure Increased PMNs Increased protein Decreased sugar
Increased pressure Increased PMNs Increased protein Decreased sugar [CSF findings in meningitis – what is the bug?]
Bacterial
CSF findings in meningitis: Fungal/TB [Pressure? Cell type? Protein? Sugars?]
Increased pressure Increased lymphocytes Increased proein Decreased sugar
Increased pressure Increased lymphocytes Increased proein Decreased sugar [CSF findings in meningitis – what is the bug?]
Fungal/TB
CSF findings in meningitis: Viral [Pressure? Cell type? Protein? Sugars?]
Normal/increased pressure Increased lymphocytes Normal/increased protein Normal sugar
Normal/increased pressure Increased lymphocytes Normal/increased protein Normal sugar [CSF findings in meningitis – what is the bug?]
Viral
Osteomyelitis in most ppl is due to…? Who gets most osteomyelitis?
Staph aureus in most ppl. Most osteomyelitis occurs in children.
Elevated CRP and ESR in osteomyelitis?
Classic findings, but nonspecific
Osteomyelitis in sexually active pt
Neisseria gonorrhoeae (rare) Septic arthritis more common
Osteomyelitis in diabetics and drug addicts
Pseudomonas aeruginosa
Osteomyelitis in Sickle cell
Salmonella
Osteomyelitis in prosthetic replacement
S. aureus and S. epidermis
Osteomyelitis in vertebra
Mycobacterium tuberculosis (Pott’s dz)
Osteomyelitis with cat and dog bites/scratches
Pasteurella multocida
3 Most common causes of ambulatory UTI
1.) E. coli (50-80%) 2.) Staphylococcus saprophyticus (10-30%): 2nd most common cause of UTI in young, sexually active, ambulatory women 3.) Klebsiella (8-10%)
Common causes of UTI in a hospital setting
E. coli Proteus Klebsiella Serratia Pseudomonas
Gender and epidemiology of UTIs
10:1 women to men (b/c of short urethra colonized by fecal flora)
Predisposing factors to UTIs
Flow obstruction Kidney surgery Catheterization Gynecologic abnormalities Diabetes Pregnancy
Mechanisms of UTI infxn
Mostly caused by ascending infxns. In males: babies w/ congenital defects, elderly w/ enlarged prostates
Sx of UTI
Dysuria Frequency Urgency Suprapubic pain
Sx of Pyelonephritis
Fever Chills Flank pain CVA tenderness (costovertebral angle – tender above kidneys on back)
UTI bugs: Serratia maracescens Features?
Some strains produce a red pigment; often nosocomial and drug-resistant.
Features: Some strains produce a red pigment; often nosocomial and drug-resistant. Which UTI bug is this?
Serratia maracescens
UTI bugs: Staphylococcus saprophyticus Features?
2nd leading cause of community-acquired UTI in sexually active women.
Features: 2nd leading cause of community-acquired UTI in sexually active women. Which UTI bug is this?
Staphylococcus saprophyticus
UTI bugs: Escherichia coli Features?
Leading cause of UTI. Colonies show metallic sheen on EMB agar.
Features: Leading cause of UTI. Colonies show metallic sheen on EMB agar. Which UTI bug is this?
Escherichia coli
UTI bugs: Enterobacter cloacae Features?
Often nosocomial and drug resistant.
Features: Often nosocomial and drug resistant. Which UTI bug is this?
Enterobacter cloacae
UTI bugs: Klebsiella pneumoniae Features?
Large mucoid capsule and viscous colonies
Features: Large mucoid capsule and viscous colonies Which UTI bug is this?
Klebsiella pneumoniae
UTI bugs: Proteus mirabilis Features?
Motility cuases swarming on agar. Produces urease; associated w/ struvite stones.
Features: Motility cuases swarming on agar. Produces urease; associated w/ struvite stones. Which UTI bug is this?
Proteus mirabilis
UTI bugs: Pseudomonas aeruginosa Features?
Blue-green pigment and fuity odor. Usually nosocomial and drug-resistant.
Features: Blue-green pigment and fuity odor. Usually nosocomial and drug-resistant. Which UTI bug is this?
Pseudomonas aeruginosa
List of UTI bugs
SSEEK PP S erratia marcescens S taphylococcus saprophyticus E scherichia coli E nterobacter cloacae K lebsiella pneumoniae P roteus mirabilis P seudomonas aeruginosa
Diagnostic markers of UTI
Leukocyte esterase: (+) = bacterial Nitrite test: (+) = Gram(-) organism
ToRCHeS infxns What are they? List?
These important infxns are transmitted in utero or during vaginal birth: T oxoplasma gondii o R ubella C MV H IV H SV-2 e S yphilis
Other important congenital infxns that do not fit into ToRCHeS
Listeria E. coli Group B streptococci All can be acquired placentally or from birth canal.
ToRCHeS infxns, organism: Toxoplasma gondii Major clinical manifestations?
Classic triad of chorionitis, intracranial calcifications, and hydrocephalus. May be asymptomatic at birth.
Major clinical manifestations: Classic triad of chorionitis, intracranial calcifications, and hydrocephalus. May be asymptomatic at birth. Which ToRCHeS organism is this?
Toxoplasma gondii
ToRCHeS infxns, organism: Rubella Major clinical manifestations?
Deafness Cataracts Heart defects (PDA, pulmonary artery stenosis) Microcephaly Mental retardation Blueberry muffin baby due to rash
Major clinical manifestations: Deafness Cataracts Heart defects (PDA, pulmonary artery stenosis) Microcephaly Mental retardation Blueberry muffin baby due to rash Which ToRCHeS organism is this?
Rubella
ToRCHeS infxns, organism: CMV Major clinical manifestations?
Petechial rash Intracranial calcifications Mental retardation Hepatosplenomegaly Microcephaly Jaundice 90% are asymptomatic at birth.
Major clinical manifestations: Petechial rash Intracranial calcifications Mental retardation Hepatosplenomegaly Microcephaly Jaundice 90% are asymptomatic at birth. Which ToRCHeS organism is this?
CMV
ToRCHeS infxns, organism: HIV Major clinical manifestations?
Hepatosplenomegaly Neurologic abnormalities Frequent infxns
Major clinical manifestations: Hepatosplenomegaly Neurologic abnormalities Frequent infxns Which ToRCHeS organism is this?
HIV
ToRCHeS infxns, organism: HSV-2 Major clinical manifestations?
Encephalitis Conjuntivitis Vesicular skin lesions Often asymptomatic at birth Most infxns are transmitted during birth thru an infected maternal genital tract.
Major clinical manifestations: Encephalitis Conjuntivitis Vesicular skin lesions Often asymptomatic at birth Most infxns are transmitted during birth thru an infected maternal genital tract. Which ToRCHeS organism is this?
HSV-2
ToRCHeS infxns, organism: Syphilis Major clinical manifestations?
Cutaneous lesions Hepatosplenomegaly Jaundice Saddle nose Saber shins Hutchinson teeth CN VIII deafness Rhinitis (snuffles)
Major clinical manifestations: Cutaneous lesions Hepatosplenomegaly Jaundice Saddle nose Saber shins Hutchinson teeth CN VIII deafness Rhinitis (snuffles) Which ToRCHeS organism is this?
Syphilis
Red rashes of childhood
Measles Rubella HHV-6 (roseola) Scarlet fever (group A streptococcus) Parvovirus B19 (slapped cheek rash)
STD’s: Gonorrhea Organism? Clinical features?
Neisseria gonorrhoeae Urethritis, cervicitis, PID, prostatitis, epididymitis, arthritis, creamy purulent discharge
Neisseria gonorrhoeae Urethritis, cervicitis, PID, prostatitis, epididymitis, arthritis, creamy purulent discharge Disease?
Gonorrhea
STD’s: Primary syphilis Organism? Clinical features?
Treponema pallidum Painless chancre
Treponema pallidum Painless chancre Disease?
Primary syphilis
STD’s: Secondary syphilis Organism? Clinical features?
Treponema pallidum Fever, lymphadenopathy, skin rashes, condylomata lata
Treponema pallidum Fever, lymphadenopathy, skin rashes, condylomata lata Disease?
Secondary syphilis
STD’s: Tertiary syphilis Organism? Clinical features?
Treponema pallidum Gummas (a non-cancerous growth, a form of granuloma) Tabes dorsalis General paresis Aortitis Argyll Robertson pupil
Treponema pallidum Gummas (a non-cancerous growth, a form of granuloma) Tabes dorsalis General paresis Aortitis Argyll Robertson pupil Disease?
Tertiary syphilis
STD’s: Genital herpes Organism? Clinical features?
HSV-2 Painful penile, vulvar, or cervical ulcers; can cause systemic Sx such as: fever, HA, myalgia
HSV-2 Painful penile, vulvar, or cervical ulcers; can cause systemic Sx such as: fever, HA, myalgia Disease?
Genital herpes
STD’s: Chlamydia Organism? Clinical features?
Chlamydia trachomatis (D-K) Urethritis, cervicitis, conjunctivitis, Reiter’s syndrome, PID
Chlamydia trachomatis (D-K) Urethritis, cervicitis, conjunctivitis, Reiter’s syndrome, PID Disease?
Chlamydia
STD’s: Lymphogranuloma venereum Organism? Clinical features?
Chlamydia trachomatis (L1-L3) Ulcers, lymphadenopathy, rectal strictures.
Chlamydia trachomatis (L1-L3) Ulcers, lymphadenopathy, rectal strictures. Disease?
Lymphogranuloma venereum
STD’s: Trichomoniasis Organism? Clinical features?
Trichomonas vaginalis Vaginitis Strawberry-colored mucosa
Trichomonas vaginalis Vaginitis Strawberry-colored mucosa Disease?
Trichomoniasis
STD’s: AIDS Organism? Clinical features?
HIV Opportunistic infxns, Kaposi’s sarcoma, lymphoma
HIV Opportunistic infxns, Kaposi’s sarcoma, lymphoma Disease?
AIDS
STD’s: Condylomata accumulata Organism? Clinical features?
HPV 6 and 11 Genital warts, koilocytes
HPV 6 and 11 Genital warts, koilocytes Disease?
Condylomata accumulata
STD’s: Hepatitis B Organism? Clinical features?
HBV Jaundice
HBV Jaundice Disease?
Hepatitis B
STD’s: Chancroid Organism? Clinical features?
Haemophilus ducreyi (it’s so painful, you do cry ) Painful genital ulcer, inguinal adenopathy.
Haemophilus ducreyi (it’s so painful, you do cry ) Painful genital ulcer, inguinal adenopathy. Disease?
Chancroid
STD’s: Bacterial vaginosis Organism? Clinical features?
Garnderella vaginalis Noninflammatory, malodorous discharge (fishy smell) Positive whiff test Clue cells
Garnderella vaginalis Noninflammatory, malodorous discharge (fishy smell) Positive whiff test Clue cells Disease?
Bacterial vaginosis
Top bugs that cause Pelvic inflammatory dz
Chlamydia trachomatis (subacute, often undiagnosed) Neisseria gonorrhoeae (acute, high fever) Chlamydia trachomatis (the most common STD in the USA: 3-4milliion cases/year)
Signs and Sx’s of Pelvic inflammatory dz
Cervical motion tenderness (chandelier sign) Purulent cervical discharge. May include: Salpingitis, endometritis, hydrosalpinx, and tubo-ovarian abscess.
Pelvic inflammatory dz can lead to… ?
Fitz-Hugh-Curtis Syndrome: infxn of the liver capsule and violin string adhesions of parietal peritoneum to liver.
What is salpingitis a risk factor for?
Ectopic pregnancy Infertility Chronic pelvic pain Adhesions
Other STD’s that cause PID
Garnderella (clue cells) Trichomonas (corkscrew motility on wet prep)
Nosocomial pathogen: CMV, RSV Risk factor?
Newborn nursery
Risk factor for a nosocomial pathogen: Newborn nursery
What is the pathogen? CMV, RSV
Nosocomial pathogen: E. coli, Proteus mirabilis Risk factor?
Urinary catheterization
Risk factor for a nosocomial pathogen: Urinary catheterization What is the pathogen?
E. coli, Proteus mirabilis
Nosocomial pathogen: Pseudomonas aeurginosa Risk factor?
Respiratory therapy equipment
Risk factor for a nosocomial pathogen: Respiratory therapy equipment What is the pathogen?
Pseudomonas aeurginosa
Nosocomial pathogen: HBV Risk factor?
Work in renal dialysis unit
Risk factor for a nosocomial pathogen: Work in renal dialysis unit What is the pathogen?
HBV
Nosocomial pathogen: Candida albicans Risk factor?
Hyperalimentation
Risk factor for a nosocomial pathogen: Hyperalimentation What is the pathogen?
Candida albicans
Nosocomial pathogen: Legionella Risk factor?
Water aerosols
Risk factor for a nosocomial pathogen: Water aerosols What is the pathogen?
Legionella
The 2 most common causes of nosocomial infxns?
E. coli (UTI) S. aureus (wound infxn)
Presume Pseudomonas aeruginosa as the cause of a nosocomial infxn when…?
Presume Pseudomonas AIR uginosa when AIR or burns are involved.
When do you suspect Legionella as a cause of nosocomial infxn?
Suspect Legionella when a water source is involved.
Bug hints (if all else fails):Pus, empyema (collection of pus in pre-existing anatomical cavity), abscess What is the bug?
S. aureus
Bug hints (if all else fails):Pediatric infxn What is the bug?
haemophilus influenzae (including epiglottitis)
Bug hints (if all else fails):Pneumonia in CF, burn infxn What is the bug?
Pseudomonas aeruginosa
Bug hints (if all else fails):Branching rods in oral infxn What is the bug?
Actinomyces israellii
Bug hints (if all else fails):Traumatic open wound What is the bug?
Clostridium perfringens
Bug hints (if all else fails):Surgical wound What is the bug?
S. aureus
Bug hints (if all else fails):Dog or cat bite What is the bug?
Pasteurella multocida
Bug hints (if all else fails):Currant jelly sputum What is the bug?
Klebsiella
Bug hints (if all else fails):Sepsis/meningitis in newborn What is the bug?
group B strep