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100 Cards in this Set
- Front
- Back
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Where is Streptococcus pneumoniae a normal inhabitant?
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Upper respiratory tract
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What are some illnesses caused by Strep. pneumoniae?
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Otitis media
Sinusitis Brain abcesses Meningitis Osteomyelitis Septic arthritis Cellulitis Pneumonia |
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________ is the most common cause of bacterial meningitis in adults and children?
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Streptococcus pneumoniae
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In which age groups in pneumococcal pneumonia most common in?
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Very young and very old.
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Is Strep. pneumoniae gram + or gram -?
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Gram +
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Describe what Strep. pneumoniae would look like under magnification?
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Lancet-shaped diplococci
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Differentiate Strep. viridans and Strep. pneumoniae.
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S. pneumoniae is optochin sensitive where S. viridans is not.
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Would Strep. pneumoniae have a positive or negative Quellung reaction?
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Positive, due to its polysaccharide capsule.
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S. pneumoniae is found in the _____ of 5-10% of healthy adults and 20-40% of healthy children.
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nasopharynx
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How does S. pneumoniae attach to nasopharyngeal cells?
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Through interactions with bacterial surface adhesins.
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The polysaccharide capsule makes S. pneumoniae resistant to what?
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Phagocytosis
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What are the 4 virulence factors associated with S. pneumoniae?
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1. IgA1 protease
2. Polysaccharide capsule 3. Surface proteins (inhibit complement-mediated opsonization) 4. Pili (contribute to septic shock) |
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Can S. pneumoniae lead to bacteremia?
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Yes
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Risk of pneumococcal infection increases with what?
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Persons with:
1. Impaired phagocytosis. 2. Aspenic 3. Sickle Cell Disease 4. Impaired IgG synthesis |
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Is S. pneumoniae catalase negative or positive?
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Negative
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Treatment of S. pneumoniae typically begins with?
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PCN
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What age groups should be vaccinated for S. pneumoniae?
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Children below 23 months
At-risk children from 24-59 months Adults age 65 years or older American College of Physicians: between 2-65 when indicated |
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When should revaccination for S. pneumoniae be considered?
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Patients with splenectomy or nephrotic syndrome.
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Describe campylobacter jejuni in terms of its morphology and optimal environment.
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Comma-shaped/S-shaped
Gram - Bacilli Non-spore forming Microaerophillic |
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What is the most common cause of human gastroenteritis in the world?
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Campylobacter jejuni
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C. jejuni has been linked with what neuromuscular disease?
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Guillan-Barre Syndrome
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Which animal group has C. jejuni been linked to?
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Poultry
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Transmission of C. jejuni is usually via?
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Fecal-oral route
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What are the signs and symptoms of C. jejuni enteritis?
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1. Malaise
2. Foul-smelling diarrhea 3. Severe abdominal pain 4. Fever |
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The severe abdominal pain associated with C. jejuni makes this the most commonly mistaken bacterial infection for __________________.
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Appendicitis
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Symptoms of C. jejuni enteritis may last for?
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24 hours to a week to longer
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What temperature does C. jejuni grow best at?
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107.4 F (42 C)
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Treatment of C. jejuni enteritis includes:
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Erythromycin and supportive fluids
May subsitute Cipro for Erythro |
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What is the significance of blood in diarrhea?
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Indicates that the infection has invaded the intestinal mucosa.
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Salmonella may last for ______ in water and ______ in the soil.
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Weeks, years
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Salmonellae is what kind of organism?
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Gram negative
Bacillus Facultative |
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In humans, Salmonella are the cause of what two diseases called salmonellosis?
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1. Typhoid fever (from bacterial invasion of bloodstream)
2. Acute gastroenteritis (from foodborne infection) |
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What are the symptoms of typhoid fever?
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1. N/V
2. Fever 3. Death |
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Which Salmonellae organism can only infect humans?
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S. typhi
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S. typhi is usually contracted from?
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Drinking contaminated water
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What is the single most common cause of food poisoning in the US?
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Salmonellae enterica serovar Enteritidis
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S. enteritidis is usually contaminated via...
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Contaminated food (poultry/eggs) or water
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S. typhimurium is usually transmitted via....
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Person-to-Person
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What is the initial treatment for Salmonella-related gastroenteritis?
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Normal saline volume repletion
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Salmonella can be shed from the liver to the _______, where it can remain dormant for years in typhoid fever carriers.
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Gallbladder
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What are teh 3 kinds of major antigens associated with Salmonella?
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1. Somatic/"O" Antigens
2. Surface/Envelope/"Vi" Antigens 3. Flagellar/"H" Antigens |
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Which of the Salmonella antigens is heat stable and alcohol resistant and is used for SEROLOGICAL IDENTIFICATION?
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O Antigens
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These Salmonella antigens can mask O antigens...
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Surface/Envelope Antigens
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These Salmonella antigens are heat-labile proteins that, when mixed with salmonella cells, gives a characteristic pattern of agglutination.
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Flagellar antigens
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Incubation of Salmonella last?
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6-72 hours
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Treatment of Salmonella infection?
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Supportive care
Bactrim & Ampicillin (Can use Cipro too) |
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Do Salmonellae ferment lactose? How would they show up on MacConkey's or EMB agar?
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NO
Colorless on agar |
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Do Salmonellae produce H2S?
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YES
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With entercolitis, salmonella penetrate into the _____?
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Lamina propria
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Where does S. typhi multiply during typhoid fever?
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Mononuclear phagocytes of Peyer's patches (spread to the phagocytes of the liver, gall bladder, and spleen).
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Salmonella related septicemia occurs in one of what 2 settings?
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1. Patient with underlying chronic disease (SCD)
2. Child with enterocolitis |
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Most common sequelae of salmonella related bacteremia?
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Osteomyelitis
Pneumonia Meningitis |
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Most frequent sites of metastatic abscesses associated with Salmonella?
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Previously damaged tissues (infarcts or aneurysm)
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Salmonella is protected from phagocyte destruction by what 2 mechanisms?
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1. Acid tolerance response gene
2. Sips/Ssps: Salmonella secreted invasion proteins |
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Salmonella induced gastroenteritis may present with a positive ____ test, indicating fluid depletion.
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TILT
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Rose spots are associated with what salmonella-related disease?
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Typhoid fever
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Fecal leukocytes may be associated with what bacteria?
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Salmonella
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Shigella is what kind of bacteria?
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Gram negative
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Does Shigella ferment lactose?
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NO
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How can Shigella be distinguished from Salmonella?
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1. Produce no gas from glucose fermentation
2. DO NOT produce H2S 3. Nonmotile |
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What are the most effective pathogens among the enteric bacteria?
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Shigellae
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Can Shigella be found with any other host organisms?
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No, just human.
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What are the 4 Fs involved with transmission of Shigella?
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Fingers
Flies Food Feces |
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Transmission of Shigella is most likely through....
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fecal/oral route
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Shigella outbreaks commonly occur in what facilities?
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Daycare centers or mental hospitals
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What is characteristic about the kind of diarrhea seen in Shigella-infected pateints?
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It is bloody, indicating invasion of the mucosa of the distal ileum and colon
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Unlike Salmonellae, Shigella rarely results in...
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bacteremia
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Incubation of Shigella is...
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1-4 days
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Clinical findings associated with Shigella are?
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1. Fever
2. Abdominal cramps 3. Diarrhea: watery at first but eventually with mucus and blood |
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How do Shigella present of a TSI agar?
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Cause alkaline slant and acid butt but with no gas or H2S
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A methylene blue stain of a fecal sample with Shigella reveals what?
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PMNs
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What are the invasive bacteria?
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Salmonella
Shigella Campylobacter jejuni |
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Treatment of Shigellosis?
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Bactrim & Ampicillin
Fluids/Electrolytes |
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Septic shock occurs when an overwhelming infection leads to what 2 things?
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1. Low BP
2. Low blood flow |
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Some risk factors for septic shock include...
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1. Diabetes
2. Diseases that weaken the immune system 2. GU, biliary, or intestinal diseases |
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When you suspect septic shock, what may the CXR exhibit?
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Pneumonia or pulmonary edema
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What is one possible complication of septic shock that could lead to death?
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Cardiac failure
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Shaking chills in a patient may suggest...
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bacteremia
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Extermities may be warm and pink with what kind of shock?
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Septic
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What two clinical findings suggest SEPTIC SHOCK?
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Sudden onset of:
Hypotension Fever |
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Which interleukin factor causes fever, hypotension, and chemotaxis?
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IL-1
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What does Haegman factor do?
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initiates the coagulation cascade
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What are the 3 major encapsulated organisms that cause septic shock?
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1. Strep. pneumoniae
2. Meningococci 3. H. influenza |
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A patient presents with what is described as a "yellow, honey-crusted lesion." What do you suspect?
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Impetigo
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Treatment of impetigo includes:
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Bactroban (topical) or Cephlex
Alternative: Augmentin |
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This type of impetigo is characterized as "flaccid."
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Bullous impetigo
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The virus behind the chicken pox is...
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Varicella zoster
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How can you distinguish VZV from folliculitis?
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Chicken pox (VZV) has a faster onset and itches more.
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Incubation of VZV is...
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2-3 weeks
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Patient presents with "dew drop on a rose petal;" you assume....
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Chicken pox
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When is VZV most contagious?
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From 2-3 days before the rash develops until all blisters crust over.
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Giving a child with the chicken pox aspirin may cause development of what potentially fatal condition?
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Reye's syndrome
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Streptococcus pyogens can be characterized as...
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- Group A Streptococcus
- Gram positive - Catalase negative - Large zones of beta-hemolysis |
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Strep. pyogens can cause:
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Strep throat
Scarlet Fever PSGN |
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PSGN most commonly occurs 10-14 days after...
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throat or skin infection via strep. pyogenes
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If your patient presents with strawberry tongue, sandpaper rash, or desclamation, what would you suspect?
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Scarlet fever
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How do you treat strep throat?
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PCN (if allergic use erythromycin)
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What do you do first after a diagnosis of necrotizing fasciitis?
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DEBRIDEMENT
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This organism is gram positive, catalase positive, is seen in grape-like clusters and can cause boils, folliculitis,...
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Staphylococcus aureus
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If your patient has a history of recent influenza and presents with pneumonia think....
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STAPH AUREUS
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