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274 Cards in this Set
- Front
- Back
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Human Monocytic Ehrlichiosis
cause |
ehrlichia chaffeensis, a Rickettsiales (OIP,G-), grows in vacuoles of monocytes.
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Human Monocytic Ehrlichiosis
epi |
tick: Amblyomma americanum
SE and S US |
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Human Monocytic Ehrlichiosis
Sx |
F, HA, malaise, N/V, look for tick bite, take Hx. rash may not be present
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Human Granulocytic Anaplasmosis
cause |
Anaplasma phagocytophila, a Rickettsiales (OIP, G-), grows in vacuoles of granulocytes
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Human Granulocytic Anaplasmosis
epi |
tick: Ixodes scapularis, NE and Ncentral US
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Human Granulocytic Anaplasmosis
Sx |
F, HA, malaise, rarely rash
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Rocky Mountain Spotted Fever
cause |
Rickettsia rickettsi (OIP, G-), phospholipase liberates from vacuole so it can live in cytoplasm
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Rocky Mountain Spotted Fever
epi |
Most common in SE. Tick: dermacentor variabilis and andersoni.
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Rocky Mountain Spotted Fever
Sx |
abrupt fever onset, HA, malaise, Rash starts on ankles feet and wrists--> petechial on trunk palms and soles. (no rash= highly fatal)
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Rickettsial pox
cause |
Rickettsia akari (OIP, G-)
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Rickettsial pox
epi |
urban poor. spread by mites
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Rickettsial pox
Sx |
papulovesicular rash that mimics chickenpox c escar bite. chills, F, anorexia, photophobia.
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Epidemic typhus
cause |
Rickettsia prowazekii (OIP, G-)
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Epidemic typhus
epi |
Two types 1. wartime/ africa. recurs as brill zinsser dz. (50yrs later). louse feces. 2. E USA sylvatic typhus- fleas of flying squirrels.
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Epidemic typhus
Sx |
F HA myalgias, meningoenph, myocarditis, thrombocytopenia, pul edema. Maculopapular rash on trunk that spreads to extremities (NOT palms and feet like RMSF).
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Endemic typhus
cause |
Rickettsia typhi (OIP, G-)
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Endemic typhus
epi |
world wide. US=S.CA & Gulf.
rat flea feces scratched into bite. |
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Endemic typhus
Sx |
mild to mod in sev, thrombocytopenia uncommon.
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yellow fever
cause |
Flavivirdae infects and goes from lymph node, to hepatocyte, to renal.
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yellow fever
epi |
Africa, Carib, S.America. mosquito. NOT Asia.
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yellow fever
Sx |
high F, chills, malaise, HA, lumbosacral pain, N/V, Faget's sign.
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Flavivirdae
enveloped? genome? dz's? reservoir? spread? |
enveloped, spherical, ss+RNA, yellow fever and dengue, primates, mosquitos
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dengue
cause |
Flavivirdae infects and goes from lymph node to blood stream. hemolytic
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dengue
epi |
tropical regions of whole world.
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dengue
Sx |
HA, retro-obital pain, N/V, puffy face. Two manifestations: 1. Classic 2. Hemorrhagic fever/ dengue shock syndrome ( due to cross reactivity upon reinfec c diff serotype of v)
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Filoviruses
enveloped? genome? dz's? reservoir? spread? |
enveloped, filamentous, ss-RNA, marburg/ebola, bats, direct pt/pt bat poo
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marburg/ebola
cause |
Filovirus, direct pt/pt, bat poo, macrophages infected, its spread via lymph to necrose liver spleen and nodes.
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marburg/ebola
epi |
Africa
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marburg/ebola
Sx |
sev hemorrhagic fever, joint pain, N/V, bleeding into skin
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Bunyaviridae
species? enveloped? genome? dz's? reservoir? spread? |
phlebovirus, nairovirus, hantavirus, enveloped, spherical, 3 ss-RNA, Rift Valley Fever cerimean-congo hemorrhagic fever, deps on dz
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Rift Valley Fever
cause |
Bunyaviridae- phlebovirus, reservoir- sheep and cattle, spread by mosquitos and direct pt/pt
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Rift Valley Fever
epi |
Africa
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Rift Valley Fever
Sx |
usually benign febrile, but can be hemorrhagic and cause encephalitis, retinitis, and uveits.
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Crimean-Congo Hemorrhagic Fever- cause
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Bunyaviridae, reservoir- herbivores, transmitted by ticks and direct pt/pt contact
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Crimean-Congo Hemorrhagic Fever- epi
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Africa, Eastern Europe, Middle East, and Asia
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Crimean-Congo Hemorrhagic Fever- Sx
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varies, acture febril illness with flu like sx c hepatomeg --> hemorrhagic and neuro sx.
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Hemorrhagic fever c renal syndrome- cause
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Bunyaviridae- hantavirus. reservior- murids (maybe domesticated verts), aero'ed urine, feces, and saliva
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Hemorrhagic fever c renal syndrome- epi
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old world and new world.
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Hemorrhagic fever c renal syndrome- Sx
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5 phases
1. febrile (days 3-7) 2.hypotensive(days 3-6) 3.oliguric(days 8-11) 4.diuretic(days 11 onward) 5.convalescent (3wks-6m.s) |
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Arenaviridae
enveloped? genome? dz's? reservoir? spread? |
enveloped, spherical, ss-RNA, old world- lassa and new world many, rodents, aerosols
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lassa fever
cause |
Arenaviridae, rodent areosols.
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lassa fever
epi |
west africa
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lassa fever
Sx |
gradual onset, flu like c prostration and GI--> hemorrhagic sx. death from shock
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what's alpha toxin? what has it?
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inserts self to form pores in human cell membranes= cell leakage. S. aureus
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what's teichoic acid?
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G+ cell wall comp. that binds to fibronectin of damaged host cells. Both strep and staph
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what's protein A? what has it?
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surface protein that binds Fc portion of IgG and inhibs phag. S. aureus
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why can S. aureus bind to NL <3?
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bound coagulase can bind fibrinogen. Note: ONLY S. aureus is coag+ other strep sp. and staph are coag -
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Pt c acute endocarditis. What bact do u suspect?
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S. aureus
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IVDA c endocarditis. What bact do you suspect?
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S. epidermidis
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Bact found on caths?
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S. epidermidis
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Bact assoc c dental caries
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Staph. mutans
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Pt c endocarditis that had pre existing heart dz and just had GU surg, what bact caused this?
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enterococci
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bact that is able to grow in high Na or bile and are part of NL gut flora.
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enterococci
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what is the role of dextran in bact cell wall? what bact has it?
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adheres to PLT-fibrin aggs on aortic valve. viridins streptococci.
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How does candida get inside the pt?
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GI overgrowth c abx usage.
Catheters IVDAs |
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endocarditis in homeless often caused by this bact.
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Bartonella quintana
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pt got scratched by a cat and got endocarditis. what was it from?
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Bartonella henslae
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pt had a sore throat and now has heart probs. What is the causitive agent?
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Strep pyogenes- Rheumatic heart dz.
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Why is the heart damaged in Rheumtic heart dz?
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molecular mimicry b/w Strep pyogens M proteins and human ags.
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Dx for Strep pyogenes
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A serology report c high anti- streptolysin O titer
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A virus infects the heart. what would it be and what part of the heart would effected?
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coxsackie or enterovirus. myocardium.
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How does a pt get coxsackie virus?
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fecal oral.
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Diphtheria toxin mech?
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ADP-ribosylates eukaryotic EF-2 shutting down protein synth.
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Name the three main causative agents of myocarditis.
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coxsackie
t cruzi diphtheria |
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What is the extracelluar form of chlamydia called?
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elementary bodies
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Limes dz is caused by? and spread by?
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Borrelia Burgdorferi, Ixodes
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state the genetic shift borrelia uses to transmit from vector to human.
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in ixodes- OspA- outersurface proteinA
in human-OspC |
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Name the major skin sign present in Lyme's dz.
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erythema migrans
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name the 3 trypanosomas we studied.
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T. gambiense
T. rhodensiense T. cruzi |
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what dz'es does the tsetse fly spread?
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T. gambiense (west africa)
T. rhodensiense (east africa) |
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how does person get Chagas' dz?
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they get bitten by a T. cruzi infected Reduviid bug.
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what is romana's sign and what dz is it associated c?
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swelling on face b/c of Reduviid bug bite. Assoc. c Chagas' dz
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Visceral Leishmaniasis
cause? vector? Sx? |
L. donovani, sandfly, Asymp--> cachexia, hempatosplenomeg, pancytopenia, myocarditis/ pericarditis
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What does Entamoeba histoytica cause?
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amoebiasis/amebic dysentery that can spread to liver, brain, and cause pericarditis.
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Pt was around cat poo and got flu like Sxs then got heart probs. What caused it?
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Toxoplasma gondii
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Pt has sweats c no periodicity, hepatosplenomeg, and anemia. They also have a tick bite. Tetrads present on blood smear. What is a protozoa could have cause this?
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Babesiosis
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What kind of intestinal helminthes can cause heart probs?
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Trichinella spiralis
Echinococcus granulosus Taenia solium |
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What kind of intestinal helminthes can cause severe anemia?
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Necator americanus
Acylostoma duodenale Diphyllobothrium latum (fish tapeworm- megaloblastic) |
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Pt. has a crazy enlarged leg, or scrotum. What can cause this? And what is it spread by?
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Filariae: Wuchereia bancrofti and Brugia malayi/timori. Spread by mosquitos
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What are two ways to Dx filariae?
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Blood smear taken at night or circulating ag.
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A pt has greatly increased eosinophils, antifilarial ab, IgE, IgG4 in their blood. What do they have? What is it caused by?
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Filariasis: Wuchereria bancrofti, Brugia malayi/timori spread by a mosquito
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A pt from S.America or Africa present with blindness and bump on the skin. What is the Dx? what caused this? How did the pt get it?
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River blindness, Onchocerca volvulus, black fly.
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Very dry skin on an African pt infected with a metazoa. What this skin condition called? What is caused by? How did they get it?
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onchodermatitis, Onchocerca volvulus, black fly.
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A pt saw a "worm" crawl over their eyeball. what is it? how did the pt get it?
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loa loa. deerfly
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Pt has debilitating skin eruptions. They live in an area where they share drinking water with their farm animals. What do they have? What stage of the bug infected them?
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Dracunculus medinensis. larval stage in cyclops
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Pt from Africa, S.America or Carib. c headache, joint pain, pruritis that was self limiting. What caused this? How did they get it?
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Mansonella ozzardi/perstans. black fly/ midges
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What is the sig of polysaccharide capsule
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prevents phago
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What is the sig of pneumolysin
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cytotoxin sim to streptolysin O, activates complement
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What is the sig of phosphorylcholine
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cell wall component that binds PLT activating factor receptor on respiratory epith cells
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Name 4 virulence factors of strep pneumo
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polysaccharide capsule
pneumolysin phosphorylcholine IgA protease |
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How is otitis media Dx'ed?
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visualization of bulging TM
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How is sinusitis Dx'ed?
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transillumination or radiographs
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Cause of otitis media that is resistant to all pediatric abx.
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serotype 19A Strep pneumo
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bacteria culture from otitis media shows to be G+ and alpha hemolytic on blood agar. What is it?
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Strep pneumo
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URI culture shows G- and doesn't grow on blood agar. Why is this? What do u try next? What do u suspect it is?
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Needs X and V factors, Chocolate agar. Haemophilus influenza
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What are X and V factors
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X=hemin, V=NAD The factors are found in chocolate agar and are needed by H. Flu to be cultured
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name 3 H. Flu virulence factors
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1 capsule has polymer of polyribitol phosphate
2 IgA protease 3 endotoxin LPS |
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What is Hib?
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encapsulated type b strain of H. flu. causes life threatening meningitis and epiglottitis
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H. flu: motile? G? shape? an/aerobic?
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nonmot, G-, coccobacili, facultative anaerobes
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Moraxella carrhalis: G? shape?
an/aerobic? |
G-, diplococci, aerobic
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name 3 Moraxella carrhalis virulence factors
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1.LPS
2.resists compliment 3.seqs Fe |
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MCC of otitis externa
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pseudomonas
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4 causes of Acute Pharyngitis
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1. Strep pyogens
2. H. influ 3. Coryne. diphtheriae 4. Bordetella pertussis |
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MCC of pharyngitis
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viruses!
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What is strep throat caused by?
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Strep pyogenes (Group A) beta hemolytic streptococci
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Group A Strep: G?, shape?, an/aerobic? hemolysis? catalase? spore?
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Strep pyogenes, G+, cocci chains, faculatative anerobes, beta, neg, nonspore
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Group A strep effects what age group?
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Strep pyogenes 4-6 y/o
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Scarlet fever caused by:
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Strep pyogenes group A strep
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Scarlet fever Sx
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strep throat + erythematous skin rash and red tongue
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Scarlet fever toxin
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erythrogenic toxin- streptococcal pyrogenic exotoxin
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what is erysipelas and what causes it?
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acute skin infec on face, Strep pyogenes
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what is cellulitis and what causes it?
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deep soft tissue infection usually of extremities. Strep pyogenes
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name 5 group A strep virulence factors
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1. capsule (hyaluronic acid)
2. M protein 3. hemolysins 4. enzymes 5. SPEs |
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what is M protein and what has it?
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coat fimbriae on Strep pyogenes what enhances binding and antigenicity (ag taget)
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what is streptolysin O?
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hemolysin produced by Strep pyogenes that hemolyzes erythrocytes and is good for Strep pyogenes ID
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what is streptolysin S?
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hemolysin produced by Strep pyogenes in the presence of serum which damages membranes of neutrophils, PLTs ect
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What enzymes does Strep pyogenes produce?
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DNAses, streptokinases, C5a peptidase, hyaluronidase
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what does SPE's cause?
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Strep pyogenes exotoxins produce pyrogenic effects and toxic shock
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What is Rheumatic heart dz caused by? what two mechs cause damage?
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Strep pyogenes. 1. a cross reaction by abs to both antigens of M proteins and heart sarcolemmal membranes. 2. abs again group A CHO rx c heart valves
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Pt presents with a tongue that is erythematous c swollen papillae. what is ur Dx?
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scarlett fever b/c of Strep pyogenes infect
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What do u look for in Bx to confirm RF?
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Aschoff bodies: granulomatous structures consisting of fibrinoid change, lymphocytic infiltration, occasional plasma cells, and macrophages surrounding necrotic centres. Some of these macrophages may fuse to form multinucleated giant cells. Others may become Anitschkow cells or "caterpillar cells", so named because of the appearance of their chromatin.
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What is erysipelas
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skin that is erythmatous, swollen, and cracked due to Strep pyogenes infect
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properties of H. flu polysacc capsule
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avoid phago and complement mediated destruction= colonization of URT and ability to invase and disseminate
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Sx of H. Flu
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sudden onset of F, sore throat, hoarseness, stridor, swollen cherry red epiglottis, meninigitis preceded by sinusitis, otitis media or pharyngitis
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H. flu age group most effected?
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6-18m.
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PRP vaccine: prevents? given at what age? why?
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H. flu, >24 m.s, CHO based
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PRP conjugated vaccine: prevents? give at what age? why?
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H. flu, 2 m.s, protein based
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Corynebacteria diphtheriae: G? capsule? motile? shape? catalase? an/aerorbic? spore?
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G+, no capsule, nonmotile, club shaped rod (pleomorphic), catalase +, aerobic, nonspore
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Corynebacteria diphtheriae:
culture specifics |
G+, whole sheep's blood c tellurite, gray black colonies
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what is tellurite?
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its a mineral used to culture Corynebacteria diphtheriae, it inhibits NL throat commensals
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Corynebacteria diphtheriae: Sx
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sore throat, malaise, low grade fever, bull neck (cervical adenopathy), leather hide pseudomembrane forms on URT
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Corynebacteria diphtheriae: virulence factor
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exotoxin (two parts 1. frag A- active 2. frag B- binds to host). produced by lysogenic bacteriophage gene (tox+)
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Corynebacteria diphtheriae exotoxin
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binds to herparin binding epidermal growth factor on host cell. Frag A gets in to cell and inactivates tRNA translocase EF2. This prevents mRNA- tRNA interaction and stops protein synth.
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Corynebacteria diphtheriae's characteristic "leather hide" URT is coposed of
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dead epith, inflam cells, fibrin rich exudate. under lying ulcerated mucosa contains bacilli
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Corynebacteria diphtheriae prevention
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DPT toxoid vaccine
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Corynebacteria diphtheriae systemic complications include
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exotoxin mediated cardiac dysfcn 1-2wks after infect and neurotoxicity of URI= death
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Bordetella pertussis: G? shape? an/aerobic? dz?
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G-, pleomorphic coccobacilli, strict aerobes, whooping cough
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Bordetella pertussis: toxin
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A-B toxin, ADP ribosylates Gi protein to cAMP= increase cAMP and blocks cell fcn.
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Bordetella pertussis: how and what does it effect?
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attaches to ciliated respir epith via hemagglutinins and releases an exotoxin.
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Bordetella pertussis: stages
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initial catarrhal- just like all other URI
2nd paroxysmal phase- intense cough lasting sev mins 3rd convalescent phase- chronic cough |
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Bordetella pertussis: how to prevent?
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DPT vaccine
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Bordetella pertussis: Dx
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whooping cough.
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MCC of the common cold
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Rhinovirus 40-50%
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Common cold Sx due to:
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kinins and IL-8
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Rhinovirus: class?
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picornaviridae
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Coronavirus: class?
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coronaviridae
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Rhinovirus: genome?
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+ssRNA
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Rhinovirus: shape?
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naked icosahedral capsid
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Rhinovirus: season
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early fall to late spring
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Coronavirus: genome
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+ssRNA,
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Coronavirus: shape?
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enveloped pleomorphic
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Coronavirus: antigenic groups?
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229E OC43
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coronavirus: season?
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winter or spring
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Influenza virus:class
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orthomyxoviridae
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Influenza virus:genome
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segmented (7-8) -ssRNA
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Influenza virus:shape
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enveloped spherical
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Influenza virus:types
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15 HA(hemagglutinin) subtypes, 9 NA(neuroaminidase) subtypes
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Influenza virus:season
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winter to early spring
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Influenza virus:hosts
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birds, swine, humans
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Top three causes of viral pharyngitis
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1. Rhinovirus
2. coronaviruses 3. Influenza A and B |
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virus that can cause vesicular lesions and ulcers in throat
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coxsackievirus
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Common causes of pneumonitis
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viral and mycoplasma
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Common causes of pneumonia
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bacteria and fungi
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most virulet type of Influenza
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A
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three viral specific membrane proteins
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M2
Neuraminidase hemagglutinin |
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What is an M2 channel? Where is it found?
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an ion channel Influenza virus membrane
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What is Neuraminidase? Where is it found?
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aids in release of newly formed virus particles from infected cells. acts as antigenic and Rx target. influenza membrane
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What is hemagglutinin? Where is it found?
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agglutinates RBC's and attaches to N-acetylneuraminic acid on host cells. influenza membrane
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structure of Neuraminidase
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N tetramer catalytic site
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structure of hemagglutinin
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H trimer cell binding sire
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antigenic variation is:
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mutation responsible for cont'ed suscept w/n pops
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major antigenic shifts are:
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reassortment responsible for epidemics and pandemics
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Def of drift:
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subtle antigenic changes w/n H and N that yields strains slightly immunologically diff
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Def of shift:
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major changes in H or N due to reassortment occurs when two diff strains infect same cell
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new strains of a virus cause
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predominant strains w/n a pop b/c of maintenance w/n pop
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major antigentic shifts in a virus cause
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new strains in animal or avian reservoirs to readapt and infect humans= epidemics
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How are Influenza virus strains named?
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serotype/location/year(subtype)
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Influenza Tx
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symptomatic care, antivirials, and neuraminidase inhibs
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What is Reye's syndrome?
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cerebral edema and fatty infiltration of liver seen in severe Influenza virus infections
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Influenza virus prevention
|
vaccine made of killed virus
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Respiratory Synctial virus: family? genome? enveloped?
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paramyxovirus, -ssRNA, enveloped
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RSV is major cause of?
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bronchiolitis and pneumonitis in infants <1yr
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RSV season
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late fall to early spring
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Where does RVS infect?
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epith cells
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RSV radiograph shows:
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hilar interstital infiltrates
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RSV histo shows
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diffuse alveolar damage with intertitial inflam. large synctial cells sluffing off into alveoli
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How are viruses Dx in lab?
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rapid immunofluorescence or immunoassay to dectect antigens
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RSV prevention
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No vaccine but there is monoclonal abs against F protein that requires monthly injections and is very expensive
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Herpes Varicella Zoster: dz's caused
|
chicken pox and shingles
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Herpes Varicella Zoster: enveloped? genome?
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enveloped, large DNA
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Varicella season
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winter and spring
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Varicella stages? do they occur at once or in progresson.
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can see all at once
1.papule 2.vesicle 3.pustule 4.scab |
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If Varicella progresses what can occur
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pneumonitis, encephalitis, hepatitis, nephritis
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Zoster Sx
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vesicular eruptions in distrubution of dermatome
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Zoster complications
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postherpetic neuralgia
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HVZ during pregnancy can cause
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limb hypoplasia, microcephaly, cataracts, chorioretinitis, and microphthalmia
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What is a Tzanck smear
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lab Dx for HVZ, shows multinucleated cells c viral inclusions. does not distinguish from HSV
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Varicella prevention
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live attenuated vaccine for healthy children and IC over 12 mos
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Shingles prevention
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live attenuated vaccine given once for adults NOT for IC
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Adenovirus: enveloped?genome?
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naked, dsDNA
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Adenovirus prevention
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there is none
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Adenovirus dz groups
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1. Respiratory-bronchilitis and pneumonitis
2. Systemic 3. gastroenteritis |
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Hantavirus Pulmonary Syndrome: cause
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Bunyaviridae virus from deer mouse. NOT pt/pt
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Hantavirus: enveloped? genome?
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enveloped, -ssRNA
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Hantavirus clinical
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50% die. F, myalgias, H, V, cough-->rapid to ARDS
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SARS stands for and is caused by
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Severe acute respiratory distress syndrome. coronavirus SARS-CoV
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Where does SARS come from
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Palm Civet
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Cytomegalovirus: enveloped? genome?
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enveloped, dsDNA
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how is CMV spread?
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pt/pt
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CMV Sx
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visceral, pulmonary, eye infections in IC pts
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Strep pneumo: G? shape? hemolysis? catalase?
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G+, lancet diplococci, alpha, catalase neg
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Strep pneumo causes
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lobar pneumonia in infants, elderly, IC, SCA pts, and alchies that inprire stuff from URT.
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Strep pneumo Sx
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rapid onset fever, rigors, productive cough c bloody sputum
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how do you dx strep pneumo
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empirically, no rapid test is avail
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H. influ risk factors
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COPD, HIV, nursing home pts, influenza
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Klebsiella pneumoniae: motile?, G? shape?
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nonmotile, G-, rod c polysacch capsule
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Klebsiella pneumoniae risk factors
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elderly, alchies, DM, and COPD
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Hallmark Sx of Klebsiella pneumoniae
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currant jelly sputum: blood tinged mucus
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Klebsiella pneumoniae outcome
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high mortality ~50%, 100% in alchies
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Klebsiella pneumoniae virulence factors
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1. capsule
2. LPS 3. siderophores |
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what is a siderophore?
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high-affinity iron chelating compounds secreted by Klebsiella pneumoniae
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Staph aureus: G? shape? hemolysis? catalase? coagulase?
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G+, cocci,beta, +, +
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What culture tech is good to use to differentiate between Staph and Strep
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Catalase. Staph=+
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A pt presents with wound infection. What bact do you think did this and how did it cause this?
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Staph aureus, coagulase
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A girl presents to your office and she is very sick after leaving a tampon in for a long time. What organism do you think caused this?
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Staph aureus, TSST-1 endo toxin
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Pseudomonas aeruginosa: G?, shape? an/aerobic?, oxidase? motile?
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G-, rods, aerobic, +, motile
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What color pus is pseudomonas known to produce
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blue
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Where is Pseudomonas aeruginosa found normally?
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soil, water, plant roots. NO PLANTS in the BURN Unit!
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MCC of nosocomial pneumonia
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Pseudomonas aeruginosa
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What does Exoenzyme S do? And what has it?
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ADP ribosyl transferase that inactivates EF-2 and stops protein synthesis. pseudomonas
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What does procyanin do? And what has it?
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cytotoxin to epith and endothelial cells. pseudomonas
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What does alginate do? And what has it?
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exopolysacch that binds to mucus and forms biofilms. pseudomonas
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What is exotoxin A? What has it?
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an ADP ribosyl transferase that inactivates EF-2 and shuts off protein synthesis. pseudomonas and diphtheria
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List pseudomonas invasins
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exotoxin A and exoenzyme S, Pyocyanin, LPS
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what kind of media and what would you want to look for to make a postive Dx of pseudomonas?
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pigment production on Mueller-Henton agar
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what kind of media and what would you wat to look for to make a positive Dx of Klebsiella?
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pink colonies grown on MacConkey agar
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A urease test is run on a bacteria and it comes up postive. What is it?
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Klebsiella
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On radiograph you see a bronchiopneumonia pattern with abscess formation and hemorrhagic necrosis. What is this causes by?
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pseudomonas
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On radiograph you see a lobar or bronchiopneuomia pattern with cavitatin, abseccesses and emphyema. What do you think caused this?
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klebsiella
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A quellung test is helpful to ID
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Strep pneumo or H. flu because they have a capsule.
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2/3 of all pneumonia deaths are due to
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Strep pneumo
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Radiograph of a typical CAP appears
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lobar in distribtion with PMNs
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Panel of a typical pneumonia
wbc, CXR, sputum, cough, outcome, Dx, Rx |
increased, lobar pattern, G+ cocci, productive, severe, sputum/culture, PCN
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Panel of a atypical pneumonia
wbc, CXR, sputum, cough, outcome, Dx, Rx |
NL or slight increase, intersitial, mixed(NL), nonproductive, rarely fatal, clinical, tetracyclines
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Mycoplasma pneumoniae: G? shape? an/aerobic?
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don't stain, filamentous, both
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Mycoplasma pneumoniae season
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fall and winter
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Mycoplasma pneumoniae Sx
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initially pharyngitis, sinusitis, conjunctivitis dry NP cough 3-10% progress to pneumonitis which takes 3-4 weeks to get over,
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Mycoplasma pneumoniae histo
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exudate in lumen and walls of bronchiole filled with MNCs
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Mycoplasma pneumoniae Dx
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no bacteria in sputum unilateral or bilat patchy interstitial or nodular infiltrates
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Mycoplasma pneumoniae complications
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bronchiolitis obliterans, CNS involvement, intersitial fibrosis, ARDS, steven johnson syndrome
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what are the Sx of steven johnson syndrome
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dermis seperated from epidermis due to hypersensitivity complex
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infective stage of Chlamdydia is called
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Elementary bodies, they are metabolically inert but contain ATP and inactive ATPase
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A school aged child presents with gradual onset of NP cough. A CXR is taken and shows funnel shaped infiltrates. What do you suspect?
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Chlamydia pneumo
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Pt presents with flu like Sxs c F, myalgia, and malaise. It has progessed to sev pneumonitis with HA, NP cough and hempatosplenomeg. CXR shows lobular or lobal consolidation. The pt has a bird. What do you suspect
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Chlamydia psittaci
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Legionella pneumophila: G? shape? an/aerobic? found?
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G-, rods with vacules, aerobic, lives w/n fresh water amoebae
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An outbreak occurs. Pts present with flu-like Sx with an aburpt onset. F HA cough. It goes away in week. No one dies. What do you suspect?
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Pontiac Fever (Legionella)
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An outbreak occurs. Pts present with flu-like Sx with an aburpt onset. F HA cough. It rapidly progresses to include bradycardia, hyponatremia, chills, and confusion. Some people die. What do you suspect? What would a CXR look like?
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Legionaire's Dz (Legionella), upper and middle lobe consolidated
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Bacillus anthracis: G? shape? an/aerobic? motile?
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G+, spore forming rod, aerobic, nonmotile
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Woolsorter's Dz: Dx
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CXR showing widened dense mediatinum, medusa head on blood agar
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Bacillus anthracis toxins
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PA, EF, LF
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edema factor mech, and what has this?
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PA- increase cAMP=water efflux from cells=edema
Bacillus anthracis |
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What is lethal factor, and what has this?
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LF-cleaves MAPKK=cell death
Bacillus anthracis |
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What is the ghon complex and what dz it is associated c?
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peripherial and hilar lymph nodes that are caseated. Primary TB
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Name two very important cytokines that are important mechs to fight off TB.
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TNF gamma and NOS
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If you suspected TB what stain would you use?
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ziel neelsen
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What is is called when TB spreads to the vert?
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pott's dz
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caseating lymph nodes are found in the neck What is this called? And what caused it?
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scrofula, M. bovis
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What is the is the diff b/w M. avium and M.tb histologically?
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MAI has intracellular reproduction within macrophages
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A pt c AIDs from the midwest presents w/ cavitary lesions in UL on CXR and skin lesion. They have never been out of the country. What do suspect they have?
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M. kansasii
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Actinomyces israeli: G? shape? an/aerobic? distinguishing characteristic
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G+, large filamentous rod, anaerobe. sulfur granules
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Nocardia asteroides: G? shape? an/aerobic? what is characteristic about how it grows?
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G+, long filamentous rods, aerobic, red/orange colonies
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A chicken farmer presents with pneumonia Sx. A CXR shows granulmonas. The sputum sample shows pinwheel organisms. What do you expect?
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Histoplasmosis
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Histoplasma capsulatum: morphism? vector? place in country?
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dimorphic (yeast- (narrow neck at body temp, tuberculate macrocondidia at room temp), bird/bat/chicken shit, MS MO OH.
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Blastomycosis: morphism? place in country?
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dimorphc (very LARGE! double thick walled broad based bud yeast at body temp, filamentous at room temp), OH SEUS, Great Lakes
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