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121 Cards in this Set
- Front
- Back
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What is the term for a bladder infection? Symptoms?
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Cystitis |
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What is the method of infection that causes cystitis / UTI?
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Ascension of microbes from urethra to bladder
- 10x more common in women because shorter urethra and urethra is colonized by fecal flora |
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What are possible causes of UTIs in males?
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- Infants with congenital defects
- Vesicoureteral reflex - Elderly with enlarged prostate |
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What is the term for when a UTI / cystitis ascends to the kidney? Symptoms?
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Pyelonephritis |
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In what situations will you see WBC casts? When would you not see WBC casts?
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- Cystitis (bladder infection): no WBC casts
- Pyelonephritis (kidney infection): WBC casts |
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What are some predisposing factors for UTIs?
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- 10x more common in females
- Obstruction - Kidney surgery - Catheterization - GU malformation - Diabetes (sugar in urine feeds bacteria) - Pregnancy |
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What are the diagnostic markers for UTIs?
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- Leukocyte esterase test (+) = bacterial UTI |
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What are the most common bugs that cause UTIs?
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1. E. coli
2. Staphylococcus saprophyticus 3. Klebsiella pneumoniae - Serratia marcescens - Enterobacter cloacae - Proteus mirabilis - Pseudomonas aeruginosa |
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Which bug that causes UTIs shows colonies with green metallic sheen on EMB agar?
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Escherichia coli (leading cause of UTI)
- Negative urease test |
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Which bug that causes UTIs is the 2nd leading cause of UTI in sexually active young women?
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Staphylococcus saprophyticus
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Which bug that causes UTIs has a large mucoid capsule and viscous colonies?
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Klebsiella pneumoniae (3rd leading cause of UTI)
- Urease test positive |
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Which bug that causes UTIs produces a red pigment?
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Serratia marcescens (think maraschino cherry for red pigment)
- Usually nosocomial and drug resistant |
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Which bugs that causes UTIs are often nosocomial and drug resistant?
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- Serratia marcescens
- Enterobacter cloacae - Pseudomonas aeruginosa |
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Which bug that causes UTIs has motility allowing it to "swarm" on agar and is associated with struvite stones?
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Proteus mirabilis
- Produces urease |
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Which bug that causes UTIs produces a blue-green pigment and fruity odor?
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Pseudomonas aeruginosa
- Usually nosocomial and drug resistant |
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What marker will be positive if a UTI is positive?
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Leukocyte esterase
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What marker will be positive if a UTI is due to a gram negative bug?
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Nitrite test
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What are the common vaginal infections?
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- Bacterial vaginosis
- Trichomoniasis - Candida vulvovaginitis |
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Which vaginal infection causes no inflammation and a thin, white discharge with a fishy odor? Lab findings? Treatment?
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Bacterial Vaginosis
- Clue cells - pH > 4.5 (elevated) - Treat with Metronidazole |
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Which vaginal infection causes inflammation and a frothy, grey-green, foul-smelling discharge? Lab findings? Treatment?
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Trichomoniasis |
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Which vaginal infection causes inflammation and a thick, white, cottage cheese discharge? Lab findings? Treatment?
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Candida vulvovaginitis
- Pseudohyphae - pH normal (4.0-4.5) - Treat with -azoles |
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What are the signs/symptoms of Bacterial Vaginosis? Lab findings? Treatment?
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- No inflammation
- Thin, white discharge with fishy odor - Clue cells - pH >4.5 (elevated) - Treat with Metronidazole |
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What are the signs/symptoms of Trichomoniasis? Lab findings? Treatment?
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- Inflammation
- Frothy, grey-green, foul-smelling discharge - Motile trichomonads - pH >4.5 (elevated) - Treat with Metronidazole and treat sexual partner(s) |
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What are the signs/symptoms of Candida Vulvovaginitis? Lab findings? Treatment?
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- Inflammation
- Thick, white, "cottage cheese" discharge - Pseudohyphae - pH normal (4.0-4.5) - Treat with -azoles |
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What are the "ToRCHeS" infections?
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Microbes that may pass from mother to fetus
- Transmission is transplacental and in most cases via delivery |
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What are the non-specific signs common to many ToRCHeS infections?
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- Hepatosplenomegaly
- Jaundice - Thrombocytopenia - Growth retardation |
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What are the infections that may pass from mother to fetus transplacentally or via delivery?
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ToRCHeS:
- Toxoplasma gondii - Rubella - CMV - HIV - HSV-2 - Syphilis |
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What are the non-ToRCHeS infections that all cause meningitis in neonates?
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- Streptococcus agalactiae (group B streptococci)
- E. coli - Listeria monocytogenes |
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What bug causes hydrops fetalis?
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Parvovirus B19
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Which infection presents with chorioretinitis, hydrocephalus, and intracranial calcifications in neonates? Presentation in mother? Mode of transmission?
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Toxoplasma gondii
- Usually asymptomatic in mom or lymphadenopathy (rarely) - Acquired via cat feces or ingestion of undercooked meat |
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Which infection presents with PDA (or pulmonary artery hypoplasia), cataracts, and deafness ± blueberry muffin rash in neonates? Presentation in mother? Mode of transmission?
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Rubella
- In mother: rash, lymphadenopathy, arthritis - Transmitted via respiratory droplets |
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Which infection presents with hearing loss, seizures, petechial rash, and "blueberry muffin" rash in neonates? Presentation in mother? Mode of transmission?
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CMV
- Usually asymptomatic in mom or mononucleosis like illness - Transmitted via sexual contact or organ transplants |
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Which infection presents with recurrent infections and chronic diarrhea in neonates? Presentation in mother? Mode of transmission?
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HIV
- Variable presentation in mom depending on CD4+ count - Transmitted via sexual contact or needlestick |
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Which infection presents with encephalitis, herpetic (vesicular) lesions in neonates? Presentation in mother? Mode of transmission?
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HSV-2 |
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Which infection presents with stillbirth or hydrops fetalis in neonates; if the child survives presents with facial abnormalities (notched teeth, saddle nose, short maxilla), saber shins, and CN VIII deafness? Presentation in mother? Mode of transmission?
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Syphilis
2 presentations in mom that are associated with fetal infection: - 1° chancre - 2° disseminated rash Spread via sexual contact |
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Which neonatal infection is transmitted to the mom via cat feces or ingestion of undercooked meat? Neonatal manifestation? Maternal manifestation?
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Toxoplasma gondii
- Neonatal: chorioretinitis, hydrocephalus, intracranial calcifications - Maternal: usually asymptomatic, lymphadenopathy (rare) |
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Which neonatal infection is transmitted to the mom via respiratory droplets? Neonatal manifestation? Maternal manifestation?
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Rubella
- Neonatal: PDA (or pulmonary artery hypoplasia), cataracts, and deafness ± blueberry muffin rash - Maternal: rash, lymphadenopathy, arthritis |
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Which neonatal infection is transmitted to the mom via sexual contact or organ transplants? Neonatal manifestation? Maternal manifestation?
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CMV
- Neonatal: hearing loss, seizures, petechial rash, blueberry muffin rash - Maternal: usually asymptomatic or mononucleosis-like illness |
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Which neonatal infection is transmitted to the mom via sexual contact or needlestick? Neonatal manifestation? Maternal manifestation?
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HIV
- Neonatal: recurrent infections and/or chronic diarrhea - Maternal: variable presentation depending on CD4+ count |
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Which neonatal infection is transmitted to the mom via skin or mucous membrane contact? Neonatal manifestation? Maternal manifestation?
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HSV-2
- Neonatal: encephalitis, herpetic (vesicular) lesions - Maternal: usually asymptomatic, herpetic (vesicular) lesions |
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Which neonatal infection is transmitted to the mom via sexual contact but not organ transplant or needlesticks? Neonatal manifestation? Maternal manifestation?
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Syphilis
- Neonatal: often results in stillbirth, hydrops fetalis - Neonatal if child survives: facial abnormalities (notched teeth, saddle nose, short maxilla), saber shins, CN VIII deafness - Maternal: chancre (1°) and disseminated rash (2°) are the two stages likely to result in fetal infection |
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Which neonatal infections can cause a blueberry muffin rash?
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- Rubella
- CMV |
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Which neonatal infections can cause deafness?
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- Rubella
- Syphilis (CN VIII deafness) |
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Which bugs cause red rashes in childhood?
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- Coxsackievirus type A
- HHV-6 (Roseola) - Measles virus - Parvovirus B19 - Rubella virus - Streptococcus pyogenes - VZV |
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What bug is responsible for a vesicular rash on palms and soles as well as vesicles and ulcers in oral mucosa in children? Associated disease?
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Coxsackievirus type A - hand-foot-mouth disease
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What bug is responsible a macular rash over body that appears after several days of high fever, can present with febrile seizures, and usually affects infants? Associated disease?
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HHV-6 - Roseola
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What bug causes a rash that begins at the head and moves down, rash is preceded by cough, coryza, conjunctivitis, and blue-white (Koplik) spots on buccal mucosa in children? Associated disease?
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Measles virus - Rubeola
(a paramyxovirus) |
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What bug causes "slapped cheek" rash on the face of children and can cause hydrops fetalis in pregnant women? Associated disease?
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Parvovirus B19 - Erythema Infectiosum (fifth disease)
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What bug causes a rash that begins at the head and moves down making a fine truncal rash and postauricular lymphadenopathy in children? Associated disease?
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Rubella virus (Rubella)
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What bug causes an erythamtous, sandpaper-like rash with fever and sore through in children? Associated disease?
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Streptococcus pyogenes - Scarlet Fever
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What bug causes a vesicular rash that begins on the trunk, spreads to the face and extremities with lesions of different ages in children? Associated disease?
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VZV - Chickenpox
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What disease is caused by Coxsackievirus Type A? Clinical presentation?
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Hand-foot-mouth disease
- Vesicular rash on palms and soles - Vesicles and ulcers in oral mucosa |
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What disease is caused by HHV-6? Clinical presentation?
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Roseola
- Macular rash over body - Rash appears after several days of high fever - Can present with febrile seizures - Usually affects infants |
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What disease is caused by Measles Virus? Clinical presentation?
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Measles / Rubeola
- Paramyxovirus - Rash begins at head and moves down - Rash is preceded by cough, coryza, conjunctivitis, and blue-white Koplik spots on buccal mucosa |
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What disease is caused by Parvovirus B19? Clinical presentation?
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Erythema Infectiosum (Fifth Disease)
- "Slapped cheek" rash on face - Can cause hydrops fetalis in pregnant women |
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What disease is caused by Rubella Virus? Clinical presentation?
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Rubella
- Rash begins at head and moves down - Fine truncal rash - Postauricular lymphadenopathy |
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What disease is caused by Streptococcus pyogenes? Clinical presentation?
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Scarlet Fever
- Erythematous, sandpaper-like rash - Fever and sore throat |
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What disease is caused by VZV? Clinical presentation?
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Chickenpox
- Vesicular rash begins on trunk - Rash spreads to face and extremities with lesions of different ages |
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What are the sexually transmitted diseases?
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- AIDS
- Chancroid - Chlamydia - Condylomata acuminata - Genital herpes - Gonorrhea - Hepatitis B - Lymphogranuloma venereum - Syphilis (1°, 2°, and 3°) - Trichomoniasis |
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Which STD is caused by HIV? Clinical features?
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AIDS
- Opportunistic infections - Kaposi sarcoma (HHV-8) - Lymphoma |
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Which STD is caused by Haemophilus ducreyi? Clinical features?
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Chancroid
- Painful genital ulcer (ducreyi - "it's so painful you DO CRY") - Inguinal adenopathy |
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Which STD is caused by Chlamydia trachomatis (D-K)? Clinical features?
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Chlamydia
- Urethritis - Cervicitis - Conjunctivitis - Reactive arthritis - PID |
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Which STD is caused by HPV 6 and 11? Clinical features?
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Condylomata acuminata
- Genital warts - Koilocytes |
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Which STD is caused by HSV-2 (less commonly HSV-1)? Clinical features?
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Genital herpes
- Painful penile, vulvar, or cervical vesicles and ulcers - Can cause systemic symptoms such as fever, headache, myalgia |
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Which STD is caused by Neisseria gonorrhoeae? Clinical features?
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Gonorrhea
- Urethritis - Cervicitis - PID - Prostatitis - Epididymitis - Arthritis - Creamy purulent discharge |
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Which STD is caused by HBV? Clinical features?
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Hepatitis B
- Jaundice |
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Which STD is caused by Chlamydia trachomatis (L1-L3)? Clinical features?
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Lymphogranuloma venereum
- Infection of lymphatics - Painless genital ulcers - Painful lymphadenopathy (ie, buboes) |
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Which STD is caused by Treponema pallidum? Clinical features?
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Syphilis
- 1° - painless chancre - 2° - fever, lymphadenopathy, skin rashes, condylomata lata - 3° - gummas, tabes dorsalis, general paresis, aortitis, Argyll Robertson pupil |
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Which STD is caused by Trichomonas vaginalis? Clinical features?
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Trichomoniasis
- Vaginitis - Strawberry cervix - Motile in wet prep |
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Which STD presents with opportunistic infections, Kaposi Sarcoma, and lymphoma? Causative organism?
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AIDS - HIV
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Which STD presents with painful genital ulcers and inguinal adenopathy? Causative organism?
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Chancroid - Haemophilus ducreyi (it's so painful you "do cry")
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Which STD presents with urethritis, cervicitis, conjunctivitis, reactive arthritis, and PID? Causative organism?
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Chlamydia - C. trachomatis (D-K)
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Which STD presents with genital warts and koilocytes? Causative organism?
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Condylomata acuminata - HPV-6 and -11
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Which STD presents with painful penile, vulvar, or cervical vesicles and ulcers; can cause systemic symptoms such as fever, headache, and myalgia? Causative organism?
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Genital herpes - HSV-2 (less commonly HSV-1)
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Which STD presents with urethritis, cervicitis, PID, prostatitis, epididymitis, arthritis, and creamy purulent discharge? Causative organism?
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Gonorrhea - Neisseria gonorrhoeae
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Which STD presents with jaundice? Causative organism?
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Hepatitis B - HBV
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Which STD presents with infection of lymphatics, painless genital ulcers, and painful lymphadenopathy (buboes - armpit or groin)? Causative organism?
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Lymphogranuloma venereum - Chlamydia trachomatis (L1-L3)
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Which STD presents with a painless chancre? Causative organism?
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1° Syphilis - Treponema pallidum
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Which STD presents with fever, lymphadenopathy, skin rashes, and condylomata lata (wart-like lesions on genitals)? Causative organism?
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2° Syphilis - Treponema pallidum
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Which STD presents with gummas, tabes dorsalis, general paresis, aortitis, and Argyll Robertson pupil? Causative organism?
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3° Syphilis - Treponema pallidum
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Which STD presents with vaginitis, strawberry cervix, and motility in wet prep? Causative organism?
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Trichomoniasis - Trichomonas vaginalis
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Which bugs cause Pelvic Inflammatory Disease?
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- Chlamydia trachomatis (subacute, often undiagnosed)
- Neisseria gonorrhoeae (acute) |
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What is the most common bacterial STD in the US?
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Chlamydia trachomatis
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What are the signs of Pelvic Inflammatory Disease?
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- Cervical motion tenderness (chandelier sign)
- Purulent cervical discharge (picture) - May include salpingitis (inflammation of fallopian tubes), endometritis, hydrosalpinx (distally blocked fallopian tube by clear or serous fluid), and tubo-ovarian abscess |
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What can Pelvic Inflammatory Disease lead to?
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Fits-Hugh-Curtis syndrome
- Infection of the liver capsule - "Violin string" adhesions of peritoneum to liver |
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What is this a sign of?
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Fits-Hugh-Curtis syndrome
- Infection of the liver capsule - "Violin string" adhesions of peritoneum to liver This is caused by Pelvic Inflammatory Disease |
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What are the nosocomial infections?
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- Candida albicans
- CMV, RSV - E. coli, Proteus mirabilis - HBV - Legionella - Pseudomonas aeruginosa - S. aureus |
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What nosocomial infection are you at risk for if you have hyperalimentation (tube feeding)?
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Candida albicans
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What nosocomial infection are you at risk for in the newborn nursery?
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- CMV
- RSV |
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What nosocomial infection are you at risk for if you have urinary catheterization?
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- E. coli
- Proteus mirabilis |
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What nosocomial infection are you at risk for if you have a wound infection?
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S. aureus
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What nosocomial infection are you at risk for if you work in the renal dialysis unit?
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Hepatitis B Virus
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What nosocomial infection are you at risk for if you are around water aerosols?
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Legionella (think Legionella when a water source is involved)
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What nosocomial infection are you at risk for if using respiratory therapy equipment?
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Pseudomonas aeruginosa
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What nosocomial infection are you at risk for if burned?
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Pseudomonas aeruginosa
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What are the two most common causes of nosocomial infections?
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- E. coli (UTI)
- S. aureus (wound infection) |
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What bugs most commonly affect unimmunized children?
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- Rubella virus
- Measles virus - H. influenzae type B - Poliovirus - Corynebacterium diphtheriae |
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An unimmunized child presents with a rash that begins at the head and moves down with postauricular lymphadenopathy. What do you suspect they have?
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Rubella virus
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An unimmunized child presents with a rash taht begins at the head and moves down with the rash preceeded by cough, coryza, conjunctivitis, and blue-white (Koplik) spots on buccal mucosa. What do you suspect they have?
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Measles virus
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An unimmunized child presents with meningitis caused by a microbe that colonizes the nasopharynx. What do you suspect they have?
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H. influenzae type B
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An unimmunized child presents with meningitis that leads to myalgia and paralysis. What do you suspect they have?
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Poliovirus
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An unimmunized child presents with fever with dysphagia, drooling, and difficulty breathing due to edematous "cherry red" epiglottis (thumbprint sign on x-ray). What do you suspect they have?
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H. influenzae type B (also capable of causing epiglottitis in fully immunized children)
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An unimmunized child presents with a grayish oropharyngeal exudate ("pseudomembranes" may obstruct airway) and a painful throat. What do you suspect they have?
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Corynebacterium diphtheriae (elaborates toxin that causes necrosis in pharynx, cardiac, and CNS tissue)
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If you have an asplenic patient (due to surgical splenectomy or autosplenectomy, eg, chronic sickle cell anemia), what organism are they at risk for?
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Encapsulated microbes, espeically SHiN
- S. pneumoniae >> - H. influenzae type B >> - N. meningitidis |
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What organism is branching rods in oral infection and has sulfur granules?
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Actinomyces israelii
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Which organisms produce chronic granulomatous disease?
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Catalase (+) microbes, especially S. aureus
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Which organism produces "currant jelly" sputum?
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Klebsiella
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Which organism is associated with a dog or cat bite?
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Pasteurella multocida
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Which organism is associated with facial nerve palsy?
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Borrellia burgdorferi (Lyme disease)
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Which fungal infection is associated with a diabetic or immunocompromised patient?
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Mucor or Rhizopus species
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What organism is associated with health care providers?
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Hepatitis B Virus (from a needle stick)
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Which organisms are associated with neutropenic patients?
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- Candida albicans (systemic)
- Aspergillus |
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Which organism is associated with organ transplant recipients?
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Cytomegalovirus
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Which organism is associated with PAS (+)?
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Tropheryma whipplei (Whipple's disease)
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Which organism is associated with pediatric infections?
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Haemophilus influenzae (including epiglottitis)
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Which organism is associated with pneumonia in cystic fibrosis?
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Pseudomonas aeruginosa
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Which organism is associated with burn infections?
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Pseudomonas aeruginosa
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Which organisms are associated with rash on hands and feet?
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- Coxsackie A virus
- Treponema pallidum - Rickettsia rickettsii |
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Which organism is associated with sepsis / meningitis in a newborn?
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Group B strep
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Which organism is associated with surgical wounds?
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S. aureus
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Which organism is associated with a traumatic open wound?
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Clostridium perfringens
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