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193 Cards in this Set

  • Front
  • Back
What is the dominant normal flora in the skin?
Staphylococcus epidermidis
What is the dominant normal flora in the nose?
- Staphylococcus epidermidis
- Colonized by Staphylococcus aureus
What is the dominant normal flora in the oropharynx?
Viridans group Streptococci
What is the dominant normal flora in dental plaques?
Streptococcus mutans
What is the dominant normal flora in the colon?
Bacteroides fragilis > E. coli
What is the dominant normal flora in the vagina?
- Lactobacillus
- Colonized by E. coli and Group B Strep
What is the normal flora in neonates delivered by C-section?
No flora, but rapidly colonized after birth
Which bugs cause food poisoning that starts quickly and ends quickly?
- Staphylococcus aureus (preformed toxin)
- Bacillus cereus
Which microorganisms cause food poisoning?
- Bacillus cereus
- Clostridium botulinum
- Clostridium perfringens
- E. coli O157:H7
- Salmonella
- S. aureus
- Vibrio parahaemolyticus and Vibrio vulnificus
Which microorganism causes food poisoning after eating reheated rice?
Bacillus cereus ("Food poisoning from reheated rice, Be serious!")
Which microorganism causes food poisoning after eating improperly canned foods (sign is bulging cans)?
Clostridium botulinum
Which microorganism causes food poisoning after eating reheated meat dishes?
Clostridium perfringens
Which microorganism causes food poisoning after eating undercooked meat?
E. coli O157:H7
Which microorganism causes food poisoning after eating poultry, meat, or eggs?
Salmonella
Which microorganism causes food poisoning after eating meats, mayonnaise, or custard?
Staphylococcus aureus (preformed toxin)
Which microorganism causes food poisoning after eating contaminated seafood?
- Vibrio parahaemolyticus
- Vibrio vulnificus
Which microorganism causes wound infections from contact with contaminated water or shellfish?
Vibrio vulnificus
Which bugs cause bloody diarrhea?
- Campylobacter
- Entamoeba histolytica
- Enterohemorrhagic E. coli (EHEC)
- Enteroinvasive E. coli (EIEC)
- Salmonella
- Shigella
- Yersinia enterocolitica
Which bug that causes bloody diarrhea is comma- or S-shaped and grows at 42°C?
Campylobacter
Which bug that causes bloody diarrhea is a protozoan, causes amebic dysentery and liver abscesses?
Entamoeba histolytica
Which bug that causes bloody diarrhea can cause Hemolytic Uremic Syndrome and makes Shiga-like toxin?
Enterohemorrhagic E. coli (EHEC) - O157:H7
Which bug that causes bloody diarrhea invades colonic mucosa?
Enteroinvasive E. coli (EIEC)
Which bug that causes bloody diarrhea is lactose (-), has flagellar motility, animal reservoir, and especially found in poultry and eggs?
Salmonella (remember flagella because salmon swim)
Which bug that causes bloody diarrhea is lactose (-), has a very low ID50, produces Shiga toxin, only human reservoir, and causes bacillary dysentery?
Shigella
Which bug that causes bloody diarrhea is associated with day-care outbreaks and pseudoappendicitis?
Yersinia enterocolitica
Which bugs cause watery diarrhea?
- Clostridium difficile
- Clostridium perfringens
- Enterotoxigenic E. coli (ETEC)
- Giardia and Cryptosporidium in immunocompromised
- Vibrio cholerae
- Rotavirus, Norovirus
Which bug that causes watery diarrhea causes pseudomembranous colitis, caused by antibiotics, and occasionally may be bloody?
Clostridium difficile
Which bug that causes watery diarrhea also causes gas gangrene?
Clostridium perfringens
Which bug that cause watery diarrhea is aka travelers' diarrhea and produces heat-labile (LT) and heat-stable (ST) toxins?
Enterotoxigenic E. coli (ETEC)
Which protozoa can cause watery diarrhea in healthy patients?
Giardia
Which protozoa can cause watery diarrhea in immunocompromised patients?
Cryptosporidium
Which bug that causes watery diarrhea is comma-shaped, associated with "rice-water" diarrhea, and often from infected seafood?
Vibrio cholerae
Which viruses cause watery diarrhea?
- Rotavirus
- Norovirus
What are the common causes of pneumonia in neonates?
- Group B streptococci
- E. coli
What are the common causes of pneumonia in children (4 weeks - 18 years)?
Runts May Cough Chunky Sputum
- Viruses (RSV)
- Mycoplasma
- Chlamydia trachomatis (infants - 3 years)
- Chlamydophila pneumoniae (school-aged children)
- S. pneumoniae
What are the common causes of pneumonia in adults (18-40 years)?
- Mycoplasma
- Chlamydophila pneumoniae
- S. pneumoniae
What are the common causes of pneumonia in adults (40-65 years)?
- S. pneumoniae
- H. influenzae
- Anaerobes
- Viruses
- Mycoplasma
What are the common causes of pneumonia in elderly (>65)?
- S. pneumoniae
- Influenza virus
- Anaerobes
- H. influenzae
- Gram negative rods
Which bugs are common in alcoholics and IV drug users?
- S. pneumoniae
- Klebsiella
- Staphylococcus
Which bugs are common to aspirate?
Anaerobes
Which bugs are "atypical"?
- Mycoplasma
- Legionella
- chlamydia
Which bugs are associated with Cystic Fibrosis?
- Pseudomonas
- S. aureus
- S. pneumoniae
Which bugs are common in the immunocompromised?
- Staphylococcus
- Enteric G- rods
- Fungi
- Viruses
- P. jirovecii (with HIV)
What are the nosocomial (hospital acquired) infections?
- Staphylococcus
- Pseudomonas
- Other enteric G- rods
Which bacteria are common post-viral infection?
- Staphylococcus
- H. influenzae
- S. pneumoniae
What are the common causes of meningitis in newborns (0-6 months)?
* Group B streptococci
* E. coli
- Listeria

* = same as pneumonia
What are the common causes of meningitis in children (6 months - 6 years)?
* S. pneumoniae
- N. meningitidis
- H. influenzae type B
- Enteroviruses

* = same as pneumonia
What are the common causes of meningitis in 6 to 60 year olds?
* S. pneumoniae
- N. meningitidis
- Enteroviruses
- HSV

* = same as pneumonia
What is the number one cause of meningitis in teens?
N. meningitidis
What are the common causes of meningitis in elderly (>60)?
* S. pneumoniae
* G- rods
- Listeria

* = same as pneumonia
How should you treat suspected cases of meningitis?
Treat empirically with Ceftriaxone and Vancomycin
- Add Ampicillin if Listeria is suspected
What are the viral causes of meningitis?
- Enteroviruses (especially coxsackievirus)
- HSV-2 (HSV-1 = encephalitis)
- HIV
- West Nile Virus
- VZV
What are the common causes of meningitis in HIV patients?
- Cryptococcus
- CMV
- Toxoplasmosis (brain abscesses)
- JC virus (PML)
What are cases of meningitis due to H. influenzae more common?
In unimmunized children (rates have gone down significantly in last 10-15 years since introduction of the conjugate H. influenzae vaccine)
What are the CSF findings in bacterial meningitis?
- ↑ opening pressure
- ↑ PMNs
- ↑ Protein
- ↓ Glucose
What are the CSF findings in fungal / TB meningitis?
- ↑ opening pressure
- ↑ lymphocytes
- ↑ Protein
- ↓ Glucose
What are the CSF findings in viral meningitis?
- Nl/↑ opening pressure
- ↑ lymphocytes
- Nl/↑ Protein
- Nl Glucose
What kind of infection is likely if there are increased PMNs in the CSF?
Bacterial meningitis
What kind of infection is likely if there are increased lymphocytes in the CSF?
Either fungal / TB meningitis or viral meningitis
What kind of infection is likely if there is a normal glucose?
Viral meningitis
(both bacterial and fungal/TB cause decreased glucose)
What is the most common cause of Osteomyelitis?
Staphylococcus aureus
What should you suspect as the cause of osteomyelitis in a patient who is sexually active?
- Neisseria gonorrhoeae (rare)
- Septic arthritis more common
What should you suspect as the cause of osteomyelitis in a patient who is diabetic?
- Pseudomonas aeruginosa
- Serratia

(Same as IV drug users)
What should you suspect as the cause of osteomyelitis in a patient who is an IV drug user?
- Pseudomonas aeruginosa
- Serratia

(Same as for diabetics)
What should you suspect as the cause of osteomyelitis in a patient who has sickle cell disease?
Salmonella
What should you suspect as the cause of osteomyelitis in a patient who has a prosthetic joint replacement?
- S. aureus
- Staphylococcus epidermidis
What should you suspect as the cause of osteomyelitis in a patient who has vertebral involvement?
Mycobacterium tuberculosis (Pott disease)
What should you suspect as the cause of osteomyelitis in a patient who has cat and dog bites?
Pasteurella multocida
What should you suspect as the cause of osteomyelitis in a patient who has no other information available?
Staphylococcus aureus (most common overall)
When do most cases of Osteomyelitis occur?
Most in children
What are the lab tests in a patient with Osteomyelitis?
Elevated CRP and ESR (but non-specific)
What does osteomyelitis look like on radiographs? MRI?
- Radiograph: more subtle (arrow in top picture)
- MRI: more easily seen
- Radiograph: more subtle (arrow in top picture)
- MRI: more easily seen
What is the term for a bladder infection? Symptoms?
Cystitis
- Dysuria
- Frequency
- Urgency
- Suprapubic pain
- WBCs (but not WBC casts) in urine
What is the method of infection that causes cystitis / UTI?
Ascension of microbes from urethra to bladder
- 10x more common in women because shorter urethra and urethra is colonized by fecal flora
What are possible causes of UTIs in males?
- Infants with congenital defects
- Vesicoureteral reflex
- Elderly with enlarged prostate
What is the term for when a UTI / cystitis ascends to the kidney? Symptoms?
Pyelonephritis
- Fever
- Chills
- Flank pain
- Costovertebral angle tenderness
- Hematuria
- WBC casts
In what situations will you see WBC casts? When would you not see WBC casts?
- Cystitis (bladder infection): no WBC casts
- Pyelonephritis (kidney infection): WBC casts
What are some predisposing factors for UTIs?
- 10x more common in females
- Obstruction
- Kidney surgery
- Catheterization
- GU malformation
- Diabetes (sugar in urine feeds bacteria)
- Pregnancy
What are the diagnostic markers for UTIs?
- Leukocyte esterase test (+) = bacterial UTI
- Nitrite test (+) = G- bacterial UTI
- Urease test (+) = urease producing bugs (eg, Proteus, Klebsiella)
- Urease test (-) = E. coli, Enterococcus
What are the most common bugs that cause UTIs?
1. E. coli
2. Staphylococcus saprophyticus
3. Klebsiella pneumoniae
- Serratia marcescens
- Enterobacter cloacae
- Proteus mirabilis
- Pseudomonas aeruginosa
Which bug that causes UTIs shows colonies with green metallic sheen on EMB agar?
Escherichia coli (leading cause of UTI)
- Negative urease test
Which bug that causes UTIs is the 2nd leading cause of UTI in sexually active young women?
Staphylococcus saprophyticus
Which bug that causes UTIs has a large mucoid capsule and viscous colonies?
Klebsiella pneumoniae (3rd leading cause of UTI)
- Urease test positive
Which bug that causes UTIs produces a red pigment?
Serratia marcescens (think maraschino cherry for red pigment)
- Usually nosocomial and drug resistant
Which bugs that causes UTIs are often nosocomial and drug resistant?
- Serratia marcescens
- Enterobacter cloacae
- Pseudomonas aeruginosa
Which bug that causes UTIs has motility allowing it to "swarm" on agar and is associated with struvite stones?
Proteus mirabilis
- Produces urease
Which bug that causes UTIs produces a blue-green pigment and fruity odor?
Pseudomonas aeruginosa
- Usually nosocomial and drug resistant
What marker will be positive if a UTI is positive?
Leukocyte esterase
What marker will be positive if a UTI is due to a gram negative bug?
Nitrite test
What are the common vaginal infections?
- Bacterial vaginosis
- Trichomoniasis
- Candida vulvovaginitis
Which vaginal infection causes no inflammation and a thin, white discharge with a fishy odor? Lab findings? Treatment?
Bacterial Vaginosis
- Clue cells
- pH > 4.5 (elevated)
- Treat with Metronidazole
Which vaginal infection causes inflammation and a frothy, grey-green, foul-smelling discharge? Lab findings? Treatment?
Trichomoniasis
- Motile trichomonads
- pH >4.5 (elevated)
- Treat with Metronidazole and treat sexual partner
Which vaginal infection causes inflammation and a thick, white, cottage cheese discharge? Lab findings? Treatment?
Candida vulvovaginitis
- Pseudohyphae
- pH normal (4.0-4.5)
- Treat with -azoles
What are the signs/symptoms of Bacterial Vaginosis? Lab findings? Treatment?
- No inflammation
- Thin, white discharge with fishy odor
- Clue cells
- pH >4.5 (elevated)
- Treat with Metronidazole
What are the signs/symptoms of Trichomoniasis? Lab findings? Treatment?
- Inflammation
- Frothy, grey-green, foul-smelling discharge
- Motile trichomonads
- pH >4.5 (elevated)
- Treat with Metronidazole and treat sexual partner(s)
What are the signs/symptoms of Candida Vulvovaginitis? Lab findings? Treatment?
- Inflammation
- Thick, white, "cottage cheese" discharge
- Pseudohyphae
- pH normal (4.0-4.5)
- Treat with -azoles
What are the "ToRCHeS" infections?
Microbes that may pass from mother to fetus
- Transmission is transplacental and in most cases via delivery
What are the non-specific signs common to many ToRCHeS infections?
- Hepatosplenomegaly
- Jaundice
- Thrombocytopenia
- Growth retardation
What are the infections that may pass from mother to fetus transplacentally or via delivery?
ToRCHeS:
- Toxoplasma gondii
- Rubella
- CMV
- HIV
- HSV-2
- Syphilis
What are the non-ToRCHeS infections that all cause meningitis in neonates?
- Streptococcus agalactiae (group B streptococci)
- E. coli
- Listeria monocytogenes
What bug causes hydrops fetalis?
Parvovirus B19
Which infection presents with chorioretinitis, hydrocephalus, and intracranial calcifications in neonates? Presentation in mother? Mode of transmission?
Toxoplasma gondii
- Usually asymptomatic in mom or lymphadenopathy (rarely)
- Acquired via cat feces or ingestion of undercooked meat
Which infection presents with PDA (or pulmonary artery hypoplasia), cataracts, and deafness ± blueberry muffin rash in neonates? Presentation in mother? Mode of transmission?
Rubella
- In mother: rash, lymphadenopathy, arthritis
- Transmitted via respiratory droplets
Which infection presents with hearing loss, seizures, petechial rash, and "blueberry muffin" rash in neonates? Presentation in mother? Mode of transmission?
CMV
- Usually asymptomatic in mom or mononucleosis like illness
- Transmitted via sexual contact or organ transplants
Which infection presents with recurrent infections and chronic diarrhea in neonates? Presentation in mother? Mode of transmission?
HIV
- Variable presentation in mom depending on CD4+ count
- Transmitted via sexual contact or needlestick
Which infection presents with encephalitis, herpetic (vesicular) lesions in neonates? Presentation in mother? Mode of transmission?
HSV-2
- Usually asymptomatic in mom or presence of herpetic (vesicular) lesions
- Transmitted via skin or mucous membrane contact
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 trans...
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?
Syphilis

2 presentations in mom that are associated with fetal infection:
- 1° chancre
- 2° disseminated rash

Spread via sexual contact
Syphilis

2 presentations in mom that are associated with fetal infection:
- 1° chancre
- 2° disseminated rash

Spread via sexual contact
Which neonatal infection is transmitted to the mom via cat feces or ingestion of undercooked meat? Neonatal manifestation? Maternal manifestation?
Toxoplasma gondii
- Neonatal: chorioretinitis, hydrocephalus, intracranial calcifications
- Maternal: usually asymptomatic, lymphadenopathy (rare)
Which neonatal infection is transmitted to the mom via respiratory droplets? Neonatal manifestation? Maternal manifestation?
Rubella
- Neonatal: PDA (or pulmonary artery hypoplasia), cataracts, and deafness ± blueberry muffin rash
- Maternal: rash, lymphadenopathy, arthritis
Which neonatal infection is transmitted to the mom via sexual contact or organ transplants? Neonatal manifestation? Maternal manifestation?
CMV
- Neonatal: hearing loss, seizures, petechial rash, blueberry muffin rash
- Maternal: usually asymptomatic or mononucleosis-like illness
Which neonatal infection is transmitted to the mom via sexual contact or needlestick? Neonatal manifestation? Maternal manifestation?
HIV
- Neonatal: recurrent infections and/or chronic diarrhea
- Maternal: variable presentation depending on CD4+ count
Which neonatal infection is transmitted to the mom via skin or mucous membrane contact? Neonatal manifestation? Maternal manifestation?
HSV-2
- Neonatal: encephalitis, herpetic (vesicular) lesions
- Maternal: usually asymptomatic, herpetic (vesicular) lesions
Which neonatal infection is transmitted to the mom via sexual contact but not organ transplant or needlesticks? Neonatal manifestation? Maternal manifestation?
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°...
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
Which neonatal infections can cause a blueberry muffin rash?
- Rubella
- CMV
Which neonatal infections can cause deafness?
- Rubella
- Syphilis (CN VIII deafness)
Which bugs cause red rashes in childhood?
- Coxsackievirus type A
- HHV-6 (Roseola)
- Measles virus
- Parvovirus B19
- Rubella virus
- Streptococcus pyogenes
- VZV
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?
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?
Coxsackievirus type A - hand-foot-mouth disease
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?
HHV-6 - Roseola
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?
Measles virus - Rubeola
(a paramyxovirus)
What bug causes "slapped cheek" rash on the face of children and can cause hydrops fetalis in pregnant women? Associated disease?
What bug causes "slapped cheek" rash on the face of children and can cause hydrops fetalis in pregnant women? Associated disease?
Parvovirus B19 - Erythema Infectiosum (fifth disease)
Parvovirus B19 - Erythema Infectiosum (fifth disease)
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?
Rubella virus (Rubella)
What bug causes an erythamtous, sandpaper-like rash with fever and sore through in children? Associated disease?
Streptococcus pyogenes - Scarlet Fever
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?
VZV - Chickenpox
What disease is caused by Coxsackievirus Type A? Clinical presentation?
Hand-foot-mouth disease
- Vesicular rash on palms and soles
- Vesicles and ulcers in oral mucosa
Hand-foot-mouth disease
- Vesicular rash on palms and soles
- Vesicles and ulcers in oral mucosa
What disease is caused by HHV-6? Clinical presentation?
Roseola
- Macular rash over body
- Rash appears after several days of high fever
- Can present with febrile seizures
- Usually affects infants
What disease is caused by Measles Virus? Clinical presentation?
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
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
What disease is caused by Parvovirus B19? Clinical presentation?
Erythema Infectiosum (Fifth Disease)
- "Slapped cheek" rash on face
- Can cause hydrops fetalis in pregnant women
Erythema Infectiosum (Fifth Disease)
- "Slapped cheek" rash on face
- Can cause hydrops fetalis in pregnant women
What disease is caused by Rubella Virus? Clinical presentation?
Rubella
- Rash begins at head and moves down
- Fine truncal rash
- Postauricular lymphadenopathy
What disease is caused by Streptococcus pyogenes? Clinical presentation?
Scarlet Fever
- Erythematous, sandpaper-like rash
- Fever and sore throat
What disease is caused by VZV? Clinical presentation?
Chickenpox
- Vesicular rash begins on trunk
- Rash spreads to face and extremities with lesions of different ages
What are the sexually transmitted diseases?
- AIDS
- Chancroid
- Chlamydia
- Condylomata acuminata
- Genital herpes
- Gonorrhea
- Hepatitis B
- Lymphogranuloma venereum
- Syphilis (1°, 2°, and 3°)
- Trichomoniasis
Which STD is caused by HIV? Clinical features?
AIDS
- Opportunistic infections
- Kaposi sarcoma (HHV-8)
- Lymphoma
Which STD is caused by Haemophilus ducreyi? Clinical features?
Chancroid
- Painful genital ulcer (ducreyi - "it's so painful you DO CRY")
- Inguinal adenopathy
Which STD is caused by Chlamydia trachomatis (D-K)? Clinical features?
Chlamydia
- Urethritis
- Cervicitis
- Conjunctivitis
- Reactive arthritis
- PID
Which STD is caused by HPV 6 and 11? Clinical features?
Condylomata acuminata
- Genital warts
- Koilocytes
Which STD is caused by HSV-2 (less commonly HSV-1)? Clinical features?
Genital herpes
- Painful penile, vulvar, or cervical vesicles and ulcers
- Can cause systemic symptoms such as fever, headache, myalgia
Which STD is caused by Neisseria gonorrhoeae? Clinical features?
Gonorrhea
- Urethritis
- Cervicitis
- PID
- Prostatitis
- Epididymitis
- Arthritis
- Creamy purulent discharge
Which STD is caused by HBV? Clinical features?
Hepatitis B
- Jaundice
Which STD is caused by Chlamydia trachomatis (L1-L3)? Clinical features?
Lymphogranuloma venereum
- Infection of lymphatics
- Painless genital ulcers
- Painful lymphadenopathy (ie, buboes)
Which STD is caused by Treponema pallidum? Clinical features?
Syphilis
- 1° - painless chancre
- 2° - fever, lymphadenopathy, skin rashes, condylomata lata
- 3° - gummas, tabes dorsalis, general paresis, aortitis, Argyll Robertson pupil
Which STD is caused by Trichomonas vaginalis? Clinical features?
Trichomoniasis
- Vaginitis
- Strawberry cervix
- Motile in wet prep
Which STD presents with opportunistic infections, Kaposi Sarcoma, and lymphoma? Causative organism?
AIDS - HIV
Which STD presents with painful genital ulcers and inguinal adenopathy? Causative organism?
Chancroid - Haemophilus ducreyi (it's so painful you "do cry")
Which STD presents with urethritis, cervicitis, conjunctivitis, reactive arthritis, and PID? Causative organism?
Chlamydia - C. trachomatis (D-K)
Which STD presents with genital warts and koilocytes? Causative organism?
Condylomata acuminata - HPV-6 and -11
Which STD presents with painful penile, vulvar, or cervical vesicles and ulcers; can cause systemic symptoms such as fever, headache, and myalgia? Causative organism?
Genital herpes - HSV-2 (less commonly HSV-1)
Which STD presents with urethritis, cervicitis, PID, prostatitis, epididymitis, arthritis, and creamy purulent discharge? Causative organism?
Gonorrhea - Neisseria gonorrhoeae
Which STD presents with jaundice? Causative organism?
Hepatitis B - HBV
Which STD presents with infection of lymphatics, painless genital ulcers, and painful lymphadenopathy (buboes - armpit or groin)? Causative organism?
Lymphogranuloma venereum - Chlamydia trachomatis (L1-L3)
Which STD presents with a painless chancre? Causative organism?
1° Syphilis - Treponema pallidum
Which STD presents with fever, lymphadenopathy, skin rashes, and condylomata lata (wart-like lesions on genitals)? Causative organism?
2° Syphilis - Treponema pallidum
Which STD presents with gummas, tabes dorsalis, general paresis, aortitis, and Argyll Robertson pupil? Causative organism?
3° Syphilis - Treponema pallidum
Which STD presents with vaginitis, strawberry cervix, and motility in wet prep? Causative organism?
Trichomoniasis - Trichomonas vaginalis
Which bugs cause Pelvic Inflammatory Disease?
- Chlamydia trachomatis (subacute, often undiagnosed)
- Neisseria gonorrhoeae (acute)
What is the most common bacterial STD in the US?
Chlamydia trachomatis
What are the signs of Pelvic Inflammatory Disease?
- 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-o...
- 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
What can Pelvic Inflammatory Disease lead to?
Fits-Hugh-Curtis syndrome
- Infection of the liver capsule
- "Violin string" adhesions of peritoneum to liver
Fits-Hugh-Curtis syndrome
- Infection of the liver capsule
- "Violin string" adhesions of peritoneum to liver
What is this a sign of?
What is this a sign of?
Fits-Hugh-Curtis syndrome
- Infection of the liver capsule
- "Violin string" adhesions of peritoneum to liver

This is caused by Pelvic Inflammatory Disease
Fits-Hugh-Curtis syndrome
- Infection of the liver capsule
- "Violin string" adhesions of peritoneum to liver

This is caused by Pelvic Inflammatory Disease
What are the nosocomial infections?
- Candida albicans
- CMV, RSV
- E. coli, Proteus mirabilis
- HBV
- Legionella
- Pseudomonas aeruginosa
- S. aureus
What nosocomial infection are you at risk for if you have hyperalimentation (tube feeding)?
Candida albicans
What nosocomial infection are you at risk for in the newborn nursery?
- CMV
- RSV
What nosocomial infection are you at risk for if you have urinary catheterization?
- E. coli
- Proteus mirabilis
What nosocomial infection are you at risk for if you have a wound infection?
S. aureus
What nosocomial infection are you at risk for if you work in the renal dialysis unit?
Hepatitis B Virus
What nosocomial infection are you at risk for if you are around water aerosols?
Legionella (think Legionella when a water source is involved)
What nosocomial infection are you at risk for if using respiratory therapy equipment?
Pseudomonas aeruginosa
What nosocomial infection are you at risk for if burned?
Pseudomonas aeruginosa
What are the two most common causes of nosocomial infections?
- E. coli (UTI)
- S. aureus (wound infection)
What bugs most commonly affect unimmunized children?
- Rubella virus
- Measles virus
- H. influenzae type B
- Poliovirus
- Corynebacterium diphtheriae
An unimmunized child presents with a rash that begins at the head and moves down with postauricular lymphadenopathy. What do you suspect they have?
Rubella virus
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?
Measles virus
An unimmunized child presents with meningitis caused by a microbe that colonizes the nasopharynx. What do you suspect they have?
H. influenzae type B
An unimmunized child presents with meningitis that leads to myalgia and paralysis. What do you suspect they have?
Poliovirus
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?
H. influenzae type B (also capable of causing epiglottitis in fully immunized children)
An unimmunized child presents with a grayish oropharyngeal exudate ("pseudomembranes" may obstruct airway) and a painful throat. What do you suspect they have?
Corynebacterium diphtheriae (elaborates toxin that causes necrosis in pharynx, cardiac, and CNS tissue)
If you have an asplenic patient (due to surgical splenectomy or autosplenectomy, eg, chronic sickle cell anemia), what organism are they at risk for?
Encapsulated microbes, espeically SHiN
- S. pneumoniae >>
- H. influenzae type B >>
- N. meningitidis
What organism is branching rods in oral infection and has sulfur granules?
Actinomyces israelii
Which organisms produce chronic granulomatous disease?
Catalase (+) microbes, especially S. aureus
Which organism produces "currant jelly" sputum?
Klebsiella
Which organism is associated with a dog or cat bite?
Pasteurella multocida
Which organism is associated with facial nerve palsy?
Borrellia burgdorferi (Lyme disease)
Which fungal infection is associated with a diabetic or immunocompromised patient?
Mucor or Rhizopus species
What organism is associated with health care providers?
Hepatitis B Virus (from a needle stick)
Which organisms are associated with neutropenic patients?
- Candida albicans (systemic)
- Aspergillus
Which organism is associated with organ transplant recipients?
Cytomegalovirus
Which organism is associated with PAS (+)?
Tropheryma whipplei (Whipple's disease)
Which organism is associated with pediatric infections?
Haemophilus influenzae (including epiglottitis)
Which organism is associated with pneumonia in cystic fibrosis?
Pseudomonas aeruginosa
Which organism is associated with burn infections?
Pseudomonas aeruginosa
Which organisms are associated with rash on hands and feet?
- Coxsackie A virus
- Treponema pallidum
- Rickettsia rickettsii
Which organism is associated with sepsis / meningitis in a newborn?
Group B strep
Which organism is associated with surgical wounds?
S. aureus
Which organism is associated with a traumatic open wound?
Clostridium perfringens