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120 Cards in this Set
- Front
- Back
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Immunocompromised susceptible to which pneumonias?
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Pneumocystis Jirovecchi ; CMV ; Aspergillus ; Adenovirus
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Pneumonia Affecting AIDS patients
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Pneumocystis Jirovecch
See crushed "ping pong" shape in silver stain |
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Drugs used to treat GVHD
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Cyclosporine and Prednisone
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Used to treat VRE and MRSA
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Linezolid (50 S subunit)
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Signs of bacterial infection in blood
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CRP, ESR
Perform blood culture |
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Pneumonia which causes hemoptysis that is "bloody jelly"
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Klebsiella (gram -) lactose fermenting bacilli
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Macconkey's agar
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Lactose fermenting gram negatives.
Klebsiella; E. Coli ; Enterobacter |
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How does HSV appear on Tzanck smear?
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Giant Multinucleate Cells
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Encapsulated bacteria
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SHiN
Strep Pneumon, H. Influenzae, Neisseria Meningitidis Klebsiella, Salmonella |
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Treating Atypical pneumonias
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Mycoplasma, legionella, Chlamydia
W/ macrolide or fluoroquinolones |
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Gram + diplococci, Gram - diplococci
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Strep Pneumo ; Neisseria (-)
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Group B Strep
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"Strep Agalactiae"
Bacitracin sensitive, Beta hemolytic Causes: Pneumoniae, meningitis, sepsis Mainly babies |
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Drug that blocks uncoating of virus (flu)
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Amantidine / Rimantidine
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Common cause of croup in infants
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Parainfluenza
"Barking seal" |
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Infections causing cavitary lung lesions
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Klebsiella
Staph Aureus Mycobacterium TB Aspergillus Fumigatus |
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Treatment of HSV1, HSV2, EBV, VZV
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Acyclovir / Gancyclovir
Valacyclovir is an oral prodrug for acyclovir **Nephrotoxic |
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TNF- alpha
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Cytokine release by macrophages - causes fever, dilated blood vessels
Inflammation: activates endothelium, cytokine production |
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Role of flagella in bacteria
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Motility
Chemotaxis: swim towards food or away from toxins |
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Fever temp in infants and children/adults
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Infants >38C , 100.4 F
Children/Adults 37.7 C >99.9F |
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Fever impairment
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Infants < 90 days ;
Elderly: hypothalamus not as functional Renal failure Steroid use |
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Hyperthermia
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Caused by heat stroke, serotonin syndrome, hyperthyroidism, CNS damage
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Carrier state
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temporary presence of organism that is not normal flora but is causing disease
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Anopheles mosquito
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Malaria and arboviruses
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Culex Mosquito
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Arboviruses
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Impetigo
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Bacterial Staph or Strep
Honey crusted look, seen commonly around lips. Affects stratus corneum |
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Cause of Molluscum Contagiosum
(Henderson Paterson bodies in histology) |
Poxvirus
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Folliculitis
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Infected hair follicle
Pseudomonas (hot tub) and Staph caused. Furuncle and Carbuncle |
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What is furuncle and carbuncle
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Furuncle is a boil, infected hair follicle that extends into SubQ tissue
Carbuncle: several furuncles |
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Sx of necrotizing fasicitis
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Presence of necrosis, severe pain or numbness, High WBC, fever,
Crepitus on physical exam |
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Cause of Erysipelas
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A superficial dermis caused by Group A Strep
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Cause of Cellulitis
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Due to strep, staph, or other bacteria that goes deep into dermis/ subcutaneous
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Septic arthritis organisms
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Staph (mainly aureus
Strep A,B,C H. Influenzae (infants) Neisseria Salmonella (in sickle cell patients) Various gram negative rods |
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Presentation of septic arthritis
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Mainly seen in knee, decreased ROM,
Diagnosis: high WBC, CRP, ESR Perform arthrocentesis |
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Granulomatous inflammation
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Caused by TB, fungi, sarcoidosis, Chrohn's.
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Caseating
vs Noncaseating |
Noncaseating: no necrosis - such as by sarcoidosis
Caseating: Reactivated Tuberculosis, aspergillus See |
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Mono like symptoms, "Owl eyes" in staining . Virus.
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Cytomegalovirus
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Osteomyelitis Risk groups
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Most people- staph aureus
Sexually active: Neisseria gonorrhoeae Diabetics/Drug addicts: Pseudomonas aeruginosa Sickle Cell- Salmonella (asplenic) Prosthetic replacement: S. Aureus and S. epidermidis Vertebral- mycobacterium tuberculosis Cat/dog bites: Pasteurella multocida |
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4 phases of bacterial growth:
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Lag, logarithmic, stationary, death
Faster growth in log, stationary phase when growth= rate of bacterial death |
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Spore forming gram + rods, and their resistance
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Bacillus and Clostridium. Drugs can't easily penetrate spore coat
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Two types of bacterial pili
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1) Common Pili (bacterial adhesion)
2) Sex pili (exchange of genetic material) |
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Where does staph aureus commonly colonize?
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In the nose / anterior nares
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Meningitis in Newborns (main organisms)
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Group B Strep, E. Coli, Listeria
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Meningitis in Children
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strep pneumo, neiserria menigitis, H Inf B, enteroviruses
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Meningitis in Elderly
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Strep Pneumo, gram - rods, listeria
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Viral causes of meningitis
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HSV2, EBV, Enterovirus, VZV
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Neonatal sepsis. Symptoms, Suspicions
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fever, poor feeding, lethargy
;E. Coli, Group B Strep, N. Gonorrhea, Listeria monocytogenes, Enterococci |
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Pharyngitis suspicions
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Group A strep, Coxsackie virus, Adenovirus, RSV
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Common cold. Symptoms.
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Sneeze, nasal congestion, runny nose, pharyngitis, cough, fever headache
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Common Cold suspicions in children
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*RSV, rhinovirus, Influenza A, parainfluenza, adenovirus, coronavirus
All RNA except for adenovirus DX: DFA/ PCR/ ELISA Culture |
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Respiratory distress. Exposure to Rabbits
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Francisella Tularensis
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Atypical Pneumonia from parrot / bird droppings
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Chlamydia Psitacci
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Bacteria which cause pneumonia
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Strep Pneumo, Staph Aureus, Klebsiella, Pseudomonas Aeruginosa, H. influenzae
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Chocolate Yeast agar
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Legionella (Travel associated in pneumonia cases)
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Atypical Pneumonias
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Mycoplasma, Coxiella burnetti, Chlamydia pneumoniae, Legionella, all Viral
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Hemoptysis: Possible causes
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Klebsiella, Tuberculosis (Reactive), Aspergillus, Sarcoidosis, Squamous Cell Carcinoma, Wegener's granulomatosis, Pulmonary embolism, Trauma
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Criteria for acceptable sputum sample
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< 10 epithelial cells per Low Power Field
PMNs> + to epi per LPF |
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Approach reading a CXR (before A-G)
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Patient Date/ identified; comparison film ; correct penetration ; correct rotation; Adequacy of inspiration (11 ribs visible)
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Toxicity of fluoroquinolone
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headache, dizziness, N&V
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Lab tests to perform on suspected respiratory problem
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Sputum sample for gram stain
Sputum Culture Blood Culture Strep Pneumo Rapid antigen Legionella Urine antigen |
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Patient with stridor and lower lung problems. Suspect...
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Gram negative Rods (klebsiella, bordetella, legionella, H. Inf, Pseudomonas Aeruginosa)
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What is the role of CD3
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Protein complex associated with T cell Receptor. Req'd for T cell activation.
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Pneumonia with diarrhea symptoms, recent attendance of conference
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Legionella
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Immunosuppressed patient, large amounts of hemoptysis
Dx, Tx |
Most likely aspergillosis
Tx:Voriconazole, amphotericin B |
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Otitis Externa
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External ear infection. "Swimmer's ear" . Pseudomonas Aeruginosa
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DDx for mono
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EBV (mono), CMV (mono-like), toxoplasma gondii
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3 most important exotoxins produced by S. Aurueus
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Enterotoxin, Toxic Shock Syndrome Toxin, Exfoliatin (scalding skin syndrome)
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Mechanism of Acyclovir
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Guanisine nucleoside analog, gets phosphorylated and competes for binding to viral DNA polymerase, preventing further elongation of DNA
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Mechanism of Oseltamivir and Zanamivir?
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Inhibit neuraminidase on surface of virus, decreasing ability of influenza virus to be release from infected cells.
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Where does HSV-1 become latent
Diagnosed? |
Trigeminal Ganglia
PCR |
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What is zoster?
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Painful vesicular rash that occurs along a dermatome as a result of reactivation of VZV
(Immunocompromised might develop across dermatomes) |
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Where does HSV-2 become latent?
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Sacral Root ganglia
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Where does VZV usually become latent?
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Dorsal root ganglia
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What is chorioamnionitis?
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Inflammation of fetal membranes due to bacterial infection
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What are toxic granulations?
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Indicative of inflammation. Immature granulocytes. Dohle bodies: light blue, leftover ER.
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What is coagulase?
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Conversion of fibrinogen to fibrin.
Test to differentiate Staph Aureus is Coag + |
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What is parvovirus?
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SS DNA virus. "5th disease"
Causes aplastic anemia crisis or erythema infectiosum (slapped cheek) |
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Erythrocyte sedimentation rate
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Rate at which RBC sediment in a 1 hour period. Falls faster, then more inflammation is present. RBC binds fibrin in inflammation.
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Hepatitis panel: Positive only for Hep B surface antibody
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HBV vaccination
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Coccidiomycoses
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Fungal, from South West, aspirated
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Rhinovirus. Season? Sx?
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Spring and Fall time
Cause of common cold and pharyngitis |
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Drugs which prevent conversion of lanosterol into ergosterol by inhibiting 14-alpha-demethylase
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Fluconazole/Voriconazole - (triazole)
Miconazole - (imidazole) |
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Treatment of Dermatophyte Infections. Mechanism
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Terbinafine. Inhibit squalene epoxidase. (ergosterol depletion)
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Verruca Vulgaris
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Wart caused by HPV
Raised wart with roughened surface, most common on hands, but can grow anywhere on the body such as eyelid |
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Hantavirus
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From rodent feces.
Headache, nausea, vomiting, shortness of breath, low platelet count, high hematocrit |
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Sweet grape like scent, secretes exotoxin A
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Pseudomonas Aeruginosa
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Organism that causes food poisoning in rice
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Bacillus Cereus
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Whooping Cough
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Bordetella Pertussis
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Lyme Disease
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Spread by Ixodes tick
(Borrelia bugdorfi) "Rickettsial" |
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Candida can cause:
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Diaper Rashes, Oral Thrush, Vaginal yeast infections
Tx: Fluconazole, Miconazole, Nystatin |
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Bed bugs cause:
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Red Wheals (harmless bites)
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Brown Recluse Spider and black widow
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Bites causes necrosis, highly lethal
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3 targets of Antibiotics
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Cell wall, protein synthesis, DNA replication
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How is antibiotic resistance passed along?
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accumulating different transposons from different host cells as it is passed around. Acquiring genes. Conjugation can occur between different species.
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Obligate Anaerobes
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Clostridium
Bacteroids Actinomyces "Can't breath air" - utilize fermentation So aminoglycosides don't affect them |
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infections which can cause cavitary lung lesions
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Klebsiella, Staph aureus , mycobacterium TB, Aspergillus fumigatus
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Macrolides used for typically...
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Chlamydia/ mycoplasma / legionella pneumonias
(Chlamydia Gonorrhoea though is treated with Azithromycin) |
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Common opportunistic Fungi
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Candida, Aspergillus, pneumocystis
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What causes floppy baby syndrome?
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Clostridium botulism
TOxin blocks acetylcholine release In adults it causes food poisoning |
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What does enterococcus (gram +) cause
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UTIs and possibly subactute bacterial endocarditis
Tx: Ampicillin |
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Organisms that crosses placenta
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"TORCHES)
Toxoplasmosis Rubella CMV Herpes / HIV Syphilis |
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Typhoid Fever
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Salmonella Typhi (gram -, bacilli) motile and produces H2s
can cause osteomyelitis in sickle cell lpatients Release endotoxin |
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How is PoxVirus contracted? Presentation?
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Aerosoles, enters bloodstream. Begin as macules and progresses to vesicles
Vaccines: cowpox virus "Molluscum Contagiosum" |
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Group A strep (Gram + cocci in chains) causes
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"Strawberry tongue"
- Pharyngitis Toxic Shock Syndrome Necrotizing fascitis Rheumatic Fever (when untreated) and can cause endocardial damage Tx: Penicillin Clindamycin for TSS |
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Regions for Histoplasma, Coccidio, blastomycoses, Aspergillus
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Histoplasma: mississippi / ohio
Blastomycosis: East of mississipii (forms in soil) Coccidio: Southwest U.S. (grows in soil) |
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2 most common causes of cold in children
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RSV
Parainfluenza virus (causes Croup) |
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Causes of Common Cold
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Rhinovirus, Coronavirus, adenovirus, coxsackievirus
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Whooping Cough
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Bordetalla pertusis (Gram -)
Tx: erythromycin Vaccine: DTAP every 10 years |
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Whooping Cough
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Bordetalla pertusis (Gram -)
Tx: erythromycin Vaccine: DTAP every 10 years |
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Chlamydia pneumoniae
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Community acquired
Tx: Doxycycline |
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Atypical pneumonias
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Mycoplasma, Legionella, Chlamydia pneumoniae, and viruses
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Causes pneumonia in CF patients ; osteomyelitis in IV drug users ; folliculitis from hot tubs
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Pseudomonas Aeruginosa
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Coxiella Burnetti transmission, symptoms
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Atypical Pneumonia from cattle/sheep/goats shedded from animal products
Tx: Tetracycline |
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H. Influenzae : medium, diseases...
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Gram -, Fastidious only grows on chocolate agar, it is encapsulated
Tx: 3rd gen cephalosporin Otitis media, pneumonia, septic arthritis Cause of meningitis in children. |
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Splenomegaly in a 20 year old suspect? Tiredness...
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Test for EBV
Monospot test Atpical Lymphocytes under microscope |
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Corynebacterium diptheriae causes?
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Airway obstruction.Can cause gray fibronous exudate
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Hemolysis in gram negatives
SBA |
Alpha- green (partial or incomplete)
Beta - complete - becomes lightened and transplarent Gamma - no hemolysis |
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Pneumonia associated with alcoholics?
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Klebsiella
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Toxic Granulations
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refers to changes in granulocyte cells seen on examination of the peripheral blood film of patients with inflammatory conditions. They are commonly found in patients with SEPSIS
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Dohle Bodies
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light blue-gray, oval, basophilic, leukocyte inclusions located in the peripheral cytoplasm of neutrophils.
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Changes seen in Neutrophils / leukocytes in a patient with Sepsis/ inflammation
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Dohle Bodies (blue inclusions) and Toxic granulations
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