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Microbiology > Systems > Flashcards

Systems Flashcards

1
Q

Normal flora: nose

A

Staph epidermidis, colonized by staph aureus

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2
Q

Normal flora: oropharynx

A

Strep viridans spp

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3
Q

Normal flora: Dental plaque

A

Strep mutans

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4
Q

Normal flora: Colon

A

B.fragilis>E.coli

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5
Q

Normal flora: vagina

A

Lactobacillus, colonized by E.coli and group B strep

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6
Q

Food poisoning: reheated rice

A

B.cereus

Starts and ends quickly

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7
Q

Food poisoning: canned foods or honey

A

C.botulinum

Improperly canned foods (toxins - adults), raw honey (spores - infants)

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8
Q

Food poisoning: reheated meats

A

C.perfringens

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9
Q

Food poisoning: undercooked meat

A

E.coli O157:H7

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10
Q

Food poisoning: Poultry, meat, eggs

A

Salmonella

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11
Q

Food poisoning: Meats, mayonnaise, custard

A 
S.aureus 
Preformed toxin (start quickly and ends quickly)
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12
Q

Food poisoning: Contaminated seafood

A

V.parahaemolyticus & V.vulnificus

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13
Q

Bloody diarrhea

A

Campylobacter - comma or S-shaped organisms; growth at 42C
E.histolytica - protozoan, amebic dysentery, liver absces
enterohemorrhagic E.coli - O157:H7; can cause HUC, shiga-like toxin
Enteroinvasive E.coli - invades colonic mucosa
Salmonella - lactose -, flagella the motility; has animal reservoir; esp. Poultry & eggs
Shigella - lactose -, very low ID, produces shiga-toxin (human reservoir); bacillary dysentery
Y.enterocolitica - day care outbreaks, pseudoappendicitis

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14
Q

Watery diarrhea

A

C.difficile - pseudomembranous colitis; caused by antibiotics, occasionally bloody diarrhea
C.perfringens - also causes gas gangrene
Enterotoxigenic E.coli - travelers diarrhea; produces heat-labile (LT and heat-stable (ST) toxins
Protozoa - giardia, cryptosporidium
V.cholerae - comma-shaped organisms; rice water diarrhea; often from infected seafood
Viruses - rotavirus, Norovirus, adenovirus

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15
Q

Common causes of pneumonia: Neonates (

A

Group B strep

E.coli

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16
Q

Common causes of pneumonia: Children (4wk-18yr)

A 
Viruses (RSV)
Mycoplasma
C.trachomatis (infants-3yr)
C.pneumoniae (school age children)
S.pneumoniae
*Runts May Cough Chunky Sputum*
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17
Q

Common causes of pneumonia: Adults (18-40yr)

A

Mycoplasma
C.pneumoniae
S.pneumoniae
Viruses (influenza)

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18
Q

Common causes of pneumonia: Adults (40-65yr)

A 
S.pneumoniae
H.influenzae
Anaerobes
Viruses
Mycoplasma
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19
Q

Common causes of pneumonia: Elderly (>65yr)

A 
S.pneumoniae
Influenza virus
Anaerobes
H.influenzae
Gram - rods
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20
Q

Special causes of pneumonia: Alcoholics

A

Klebsiella

Anaerobes (peptostreptococcus, fusobacterium, prevotella, bacteroides)

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21
Q

Special causes of pneumonia: IV drug users

A

S.pneumoniae

S.aureus

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22
Q

Special causes of pneumonia: Aspiration

A

Anaerobes

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23
Q

Special causes of pneumonia: atypical

A

Mycoplasma
Legionella
Chlamydia

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24
Q

Special causes of pneumonia: Cystic Fibrosis

A

Pseudomonas
S.aureus
S.pneumoniae
Burkholderia cepacia

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25
Q

Special causes of pneumonia: Immunocompromised

A 
S.aureus
enteric gram - rods
Fungi
Viruses 
P.jirovecii (with HIV)
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26
Q

Special causes of pneumonia: Nosocomial (hospital acquired)

A

S.aureus
Pseudomonas
Other enteric gram - rods

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27
Q

Special causes of pneumonia: Postviral

A

S.pneumoniae
S.aureus
H.influenzae

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28
Q

Common causes of meningitis: Newborn (0-6mo)

A

Group B strep
E.coli
Listeria

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29
Q

Common causes of meningitis: Children (6mo-6yr)

A

S.pneumoniae
N.meningitidis
H.influenza type B
Enteroviruses

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30
Q

Common causes of meningitis: 6-60yr

A

S.pneumoniae
N.miningitidis (#1 cause in teens)
Enteroviruses
HSV

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31
Q

Common causes of meningitis: 60+yr

A

S.pneumoniae
Gram - rods
Listeria

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32
Q

Viral causes of meningitis

A 
Enteroviruses (Coxsackievirus)
HSV-2 (HSV-1 = encephalitis)
HIV
West Nile virus (also causes encephalitis)
VZV
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33
Q

Treatment of meningitis

A

Give ceftriaxone and vancomycin empirically
Add ampicillin if Listeria is suspected
Note: incidence of HiB meningitis has decreased dramatically due to the conjugate HiB vaccine (usually seen in non-immunized pts)

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34
Q

CSF findings in meningitis: Bacterial

A

Increased opening pressure
Increased PMNs
Increased proteins
Decreased sugar

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35
Q

CSF findings in meningitis: fungal/TB

A

Increased opening pressure
Increased lymphocytes
Increased protein
Decreased sugar

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36
Q

CSF findings in meningitis: viral

A

Normal to increased opening pressure
Increased lymphocytes
Normal to increased proteins
Normal sugar levels

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37
Q

Infections causing brain abscess

A

Most commonly viridans streptococci and S.aureus. If dental infection or extraction precedes abscess, oral anaerobes commonly involved
Multiple abscesses are usually from bacteremia; single lesions from contiguous sites:
-otitis media and mastoiditis –> temporal lobe and cerebellum
-sinusitis or dental infection –> frontal lobe
Toxoplasma reactivation in AIDS

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38
Q

Osteomyelitis with no risk factors

A

S.aureus (most common overall)

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39
Q

Osteomyelitis: risk factor of sexual activity

A 
Neisseria gonorrhoeae (rare)
Septic arthritis is more common
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40
Q

Osteomyelitis: risk factor - sickle cell disease

A

Salmonella

S.aureus

41
Q

Osteomyelitis: risk factor - prosthetic joint replacement

A

S.aureus

S.epidermidis

42
Q

Osteomyelitis: risk factor - Vertebral involvement

A 
S.aureus
Mycobacterium tuberculosis (Pott disease)
43
Q

Osteomyelitis: risk factor - cat and dog bites

A

Pasteurella multocida

44
Q

Osteomyelitis: IV drug abuse

A

Pseudomonas
Candida
S.aureus

45
Q

Osteomyelitis

A

Elevated CRP and ESR common but nonspecific finding
MRI is best for detecting acute infection and detailing an atomic involvement
Radiographs are insensitive early but can be useful in chronic osteomyelitis

46
Q

Urinary Tract Infections

A

Cystitis: dysuria, frequency, urgency, suprapubic pain, & WBCs in urine
Primarily caused by ascension of microbes from urethra to bladder
-Males: infants with congenital defects, vesicoureteral reflux
-elderly: enlarged prostate
Ascending to kidney results in pyelonephritis, which presents with fever, chills, flank pain, CVA tenderness, hematuria, WBC casts in urine
Ten times more common in women (shorter urethra colonized by fecal flora)
-other factors: obstruction, kidney surgery, catheterization, GU malformation, diabetes, pregnancy

47
Q

UTI bugs: E.coli

A

Leadin cause of UTI
Colonies show green metallic sheen on EMB agar
Diagnostic markers - +leukocyte ester are (evidence of WBC activity) & + nitrite test = reduction of urinary nitrates by E.coli

48
Q

UTI bugs: Staph saprophyticus

A

second leading cause of UTI in sexually active women

Diagnostic markers: + leukocyte esterase (evidence of WBC activity)

49
Q

UTI bugs: Klebsiella pneumoniae

A

3rd leading cause of UTI
Large mucoid capsule and viscous colonies
+leukocyte esterase & +urease test

50
Q

UTI bugs: Serratia marcescens

A

Some strains produce a red pigment; often nosocomial and drug resistant
+leukocyte esterase

51
Q

UTI bugs: Enterococcus

A

Often nosocomial and drug resistance

+Leuocyte esterase

52
Q

UTI bugs: Proteus mirabilis

A

Motility causes “swarming” on agar; produces urease
Associated with struvite stones
+leukocyte esterase and +urease test

53
Q

UTI bugs: Pseudomonas aeruginosa

A

Blue-green pigment and fruity odor
Usually nosocomial and drug resistant
+leukocyte esterase

54
Q

Bacterial vaginosis

A

S&S: No inflammation, thin white discharge with fish odor
Labs: clue cells; pH>4.5
Treatment: metronidazole
Gardnerella vaginalis

55
Q

Trichomonas vaginitis

A

S&S: inflammation (“strawberry cervix”), frothy yellow-green, foul smelling discharge
Labs: motile trichomonads (pear shaped); pH>4.5
Treatment: metronidazole (treat sexual partner as well)

56
Q

Candida vulvovaginalis

A

S&S: Inflammation, thick white “cottage cheese” discharge
Labs: pseudohyphae, normal pH (4.0-4.5)
Treatment: -azoles

57
Q

ToRCHeS infections

A

Microbes that may pass from mother to fetus
Transmission is transplacental in most cases or via delivery (esp HSV-2)
Nonspecific findings: hepatosplenomegaly, jaundice, thrombocytopenia, growth retardation
other infectious agents: Strep agalactiae (group B), E.coli, Listeria monocytogenes - all causes of meningitis in neonates
Parvovirus B19 - hydrops fetalis

58
Q

ToRCHeS: Toxoplasmosis gondii

A

Transmission: cat feces or ingestion of undercooked meat
Maternal symptoms: asymptomatic with rare lymphadenopathy
Neonatal symptoms: chorioretinitis, hydrocephalus and intracranial calcifications +/- “blueberry muffin” rash

59
Q

ToRCHeS: Rubella

A

Transmission: respiratory droplets
Maternal symptoms: rash, lymphadenopathy, polyarthritis, polyarthralgia
Neonatal symptoms: abnormalities of eye (cataract) and ear (deafness) and congenital heart disease (PDA) +/- blueberry muffin rash
(I heart Ruby Earrings)

60
Q

ToRCHeS: Cytomegalovirus

A

Transmission: sexual contact, organ transplants
Maternal symptoms: usually asymptomatic; mononucleosis-like illness
neonatal symptoms: hearing loss, seizures, petechial rash, “blueberry muffin” rash, periventricular calcifications

61
Q

ToRCHeS: HIV

A

Transmission: sexual contact, needle stick
Maternal symptoms: variable presentation depending on CD4+ count
Neonatal symptoms: recurrent infections, chronic diarrhea

62
Q

ToRCHeS: HSV-2

A

Transmission: skin or mucous membrane contact
Maternal symptoms: usually asymptomatic; hermetic (vesicular) lesions
Neonatal symptoms: encephalitis, herpetic (vesicular) lesions

63
Q

ToRCHeS: Syphilis

A

Transmission: sexual contact
Maternal symptoms: chancre (primary), disseminated rash (secondary)
Neonatal symptoms: often results in still birth, hydrops fetalis; if child survives presents with facial abnormalities (notched teeth, saddle nose, short maxilla), saber shins, CN VIII deafness

64
Q

Red Rashes of Childhood: Coxsackievirus type A

A

hand-foot-mouth disease
Oval-shaped vesicles on palms and soles
Vesicles and ulcers in oral mucosa

65
Q

Red Rashes of Childhood: HHV-6

A

Roseola (exanthem subitum)
Asymptomatic rose-colored macules appear on body after several days of high fever
Can present with febrile seizures, usually affects infants

66
Q

Red Rashes of Childhood: Measles virus

A

Measles (rubeola)
Beginning at head and moving down; rash preceded by cough, coryza, conjunctivitis and blue-white (Koplik) spots on by cal mucosa

67
Q

Red Rashes of Childhood: Parvovirus B19

A

Erythema infectiously (fifth disease)
Slapped cheek rash of face
Can cause hydrops fetalis in pregnant women

68
Q

Red Rashes of Childhood: strep pyogenes

A

Scarlet fever

Erythematous, sandpaper like rash with fever and sore throat

69
Q

Red Rashes of Childhood: VZV

A

Chickenpox

Vesicular rash begins on trunk; spreads to face and extremities with lesions of different stages

70
Q

STIs: AIDS

A

Opportunistic infections. Kaposi sarcoma, lymphoma

Organism: HIV

71
Q

STIs: Chancroid

A

Painful genital ulcer with exudate, inguinal adenopathy
Organism: Haemophilus ducreyi
(it’s so painful, you “do cry”)

72
Q

STIs: Chlamydia

A

Urethritis, cervical is, epididymitis, conjunctivitis, reactive arthritis, PID
Organism: Chlamydia trachomatis (D-K)

73
Q

STIs: Condylomata acuminata

A

Genital warts, koilocytes

Organism: HPV 6&11

74
Q

STIs: Genital herpes

A

Painful penile, vulvar or cervical vesicles and ulcers; can cause systemic symptoms such as fever, HA, myalgia
Organism: HSV-2 (less commonly HSV-1)

75
Q

STIs: Gonorrhea

A

Urethritis, cervicitis, PID, prostatitis, epididymitis, arthritis, creamy prudent discharge
Organism: Neisseria gonorrhoeae

76
Q

STIs: Hepatitis B

A

Jaundice

Organism: HBV

77
Q

STIs: Lymphogranuloma venereum

A

Infection of lymphatic system, painless genital ulcers but painful lymphadenopathy (burboes)
Organism: C.trachomatis (L1-L3)

78
Q

STIs: Primary syphilis

A

Painless chancre

Organism: treponema pallidum

79
Q

STIs: secondary syphilis

A

Fever, lymphadenopathy, skin rashes, condylomata lata

Organism: treponema pallidum

80
Q

STIs: Tertiary syphilis

A

Gummas, tabes dorsal is, general paresis, aortitis, Argyll Robertson pupil
Organism: treponema pallidum

81
Q

STIs: Trichomoniasis

A

Vaginitis, strawberry cervix, motile in wet prep

organism: trichomonas vaginalis

82
Q

Pelvic Inflammatory Disease (PID)

A

Top bugs: Chlamydia trachomatis (subacute - often undiagnosed), Neisseria gonorrhoeae (acute), C.trachomatis (most common bacterial STI in US)
Cervical motion tenderness (chandelier sing), purulent cervical discharge
PID may include salpingitis (risk factor for ectopic pregnancy, infertility, chronic pelvic pain, adhesions) endometriosis, hydrosalpinx & tubo-ovarian abscess

83
Q

Fitz-Hugh-Curtis syndrome

A

PID with salpingitis –> infection of the liver capsule and “violin string” adhesions of peritoneum to liver

84
Q

Nosocomial infections: Antibiotic use

A

Clostridium difficile

Watery diarrhea, leukocytosis

85
Q

Nosocomial infections: aspiration (secondary to altered mental status, old age)

A

Polymicrobial gram - bacteria, often anaerobes

Right lower lobe infiltrate or right upper middle lobe (patient recumbent); purulent malodorous sputum

86
Q

Nosocomial infections: decubitus ulcers, surgical wounds, drains

A

S.aureus (including MRSA); S.epidermidis (long term), enterobacter
Erythema, tenderness, induration, drain gins from surgical wound sites

87
Q

Nosocomial infections: intravascular catheters

A

S.aureus (including MRSA), gram - anaerobes (bacteroides, prevotella, Fusobacterium)
Erythema, induration, tenderness, dating from access sites

88
Q

Nosocomial infections: Mechanical ventilation, endotracheal intubation

A

Late onset: P.aeruginosa, Klebsiella, Acinetobacter, S.aureus
New infiltrate on CXR, increase sputum production, sweet odor (pseudomonas)

89
Q

Nosocomial infections: Renal dialysis unit, needlestick

A

HBV

90
Q

Nosocomial infections: urinary catheterization

A

E.coli, Klebsiella, Proteus spp.

Dysuria, leukocytosis, flank pain or CVA tenderness

91
Q

Nosocomial infections: Water aerosols

A

Legionella

Signs of pneumonia, GI symptoms (N/V), neurological abnormalities

92
Q

Unvaccinated Kids: Rubella virus

A

Dermatologic

Rash - beginning at head and moving down with postauricular lymphadenopathy

93
Q

Unvaccinated Kids: Measles virus

A

Dermatologic
Rash - beginning at head and moving down; rash preceded by cough, coryza, conjunctivitis and blue-white Koplik spots on buccal mucosa

94
Q

Unvaccinated Kids: HiB

A

Neurologic

Meningitis - microbe colonized nasopharynx

95
Q

Unvaccinated Kids: Poliovirus

A

Neurologic

Meningitis - can also lead to myalgia and paralysis

96
Q

Unvaccinated Kids: HiB (respiratory)

A

Respiratory
Epiglottitis - fever with dysphagia, drooling and difficulty breathing due to edematous “cherry red” epiglottis; “thumbprint” sign on XR
Can also cause epiglottitis in fully immunized kids as well

97
Q

Unvaccinated Kids: C.diptheriae

A

Respiratory
Pharyngitis - grayish oropharyngeal exudate (pseudomembranes that may obstruct airway), painful throat
-elaborates toxin that causes necrosis in pharynx, cardiac and CNS tissue

98
Q

Normal flora: skin

A

Staph epidermidis

Microbiology (8 decks)

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