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24 Cards in this Set

  • Front
  • Back
What were the four mentioned transplant infections? (2 fungal, 1 virus, 1 bacteria)
Aspergillus, Zygomycosis, CMV, Nocardia species

Aspergillus: causes variety of pulmonary diseases, can spread hematogenously to brain, eschar rhinositus can also occur

Zygomycosis: very angioinvasive. Major risk factors are uncontrolled DM, steroids, malignancy, deferoxamine therapy
CMV: very large virus of herpes virus family. Pneumonitis, colitis and hepatitis common in CMV reactivation in immunosuppressed ppl. Hostology: "owl-eye" inclusions.

Nocardia spp. : Gram + though might be slightly acid-fast too. Filamentous branching beads, causes pulmonary infection and systemic abscess in immunocompromised ppl.
Young adult complains of flu-like illness, low grade fever, arthralgias, myalgias and pustular lesions on hands feet, arms, legs and lower back. Extremities were swollen, tender and he had an erythetmatous knee. No penile discharge. What bone and joint infection does he have?

A. Gonococcemia
B. Psuedogout
C. Gout
D. Osteomyelitis
E. Infected prosthetic joint
F. Vertebral Osteomyelitis
A. Gonococcemia

Remember, Neisseria gonorrhea is a Gram negative diplococci bacterium the causeative agent of gonorrhea. Overt signs of gneital infection are frequently abesnt in disseminated gonococcemia. Biopsy lesion, culture mucosal areas. Cultures should be performed on Chocolate agar. Treatment is with Ceftriaxone or Levofloxacin. Concurrent treatment for chlamydia should be given (doxycyclin, z-pack).
If you suspect Gonococcemia, what workup should you do?

A. ask patient about what particular history
B. collect specimens via
C. culture on what type of agar
D. treat with what antibiotics
E. also do concurrent treatment for what with what
A. ask patient about SEXUAL HISTORY
B. collect specimens : BIOPSY LESION, CULTURE MUCOSAL AREAS
C. culture on CHOCOLATE agar
D. treat with IV CEFTRIAXONE, LEVOFOXACIN antibiotics
E. also do concurrent treatment for CHLAMYDIA with DOXYCYCLINE, Z-PACK
What do you treat gonoccocemia with?
ceftriaxone, levofloxacin

since concurrent infection with chlamydia is also common, treat for that too with doxicycline and z-pack
True our False:
Normal joints are sterile spaces. Don't expect to see LOTS of fluid, RBCs, WBCs. Differentiate between infectious versus inflammation with regards to WBC cells/mL, PMN%,
In both, fluid will be cloudy. If infected, there will be MUCH MORE WBCs (>50k) AND PMN% (>90%). Versus if inflammed where WBC will be >3k, and <75% PMN.
__________ is an acute or chronic inflammatory process of the bone and its structures secondary to infection with pyogenic organisms.
Osteomyelitis

From hematogenous or contiguous setup.
True or False:
Acute hematogenous osteomyelitis is primarily a disease in children whereas direct trauma and contiguous focus osteomyelitis are more common among adults and adolescents than in children.
True
What are the risk factors for prosthetic joint infections? Name some of the 8 mentioned in lecture.
Prior surgery at site of prosthesis,
Rheumatoid arthritis,
Immunocompromised state,
Diabetes mellitus,
Poor nutritional status,
Obesity,
Psoriasis,
Advanced Age
If prosthetic joint infection is locally introduced, the most likely pathogen is __________ whereas if it is hematogenously introduced, any bacteremic event such as dentogingival manipulation, or GI or GU procedures can cause _________ or __________ to spread thru blood, respectively.

A. Gram negative rods, enterococci, anaerobes
B. Strep and Staph
C. Staph aureus
D. Viridans strep and anaerobes
C. Staph aureus,

then
D. Viridans strep and anaerobes
A. Gram negative rods, enterococci, anaerobes
What antibiotic is particularly good at getting at/through biofilms and thus is used in cases of, for example, joint prosthesis infection.
Rifampin
To make a definitive diagnosis for joint infection, need to do this (to obtain fluid sample).
Arthrocentesis
What are the common (both 22%) bacteria found in prosthetic joint infections?

A. Coagulase negative staph
B. Coagulase positive staph
C. Enterococci
D. Gram negative rods
E. Staph aureus
A. Coagulase negative staph
E. Staph aureus
What are the typical organismss responsible for vertebral osteomyelitis? (3 main given + 2 general)

KNOW FOR EXAM
S. aureus is ~ 50% of cases.
Pseudomonas aeruginosa and Candida spp. are also frequently associated with intravascualr access or injection drug use.

Also noteable: Enteric gram-negative bacilli, esp after urinary tract instrumentation. Groups B adn G hemolytic strep esp in patients with DM.
True or False:
Diarrhea that lasts for 4+ weeks is almost NEVER bacterial - is usually protazoan.
True!

Common protazoan: giardia, cryptosporidium.
Currant jelly is the consistency of what clinical condition?
Consistency of dysentry!
There are two major types of dysentry due to micro-organisms: Amebic (name 1), Bacillary (name 3).
Amebic: Entamoeba histolytica (AMEBIASIS)
Bacillary: Shigellosis cause by Shigella bacteria, Campylobaceriosis cause by Campylobacter, Salmonellosis cause by Salmonella enterica typhimurium.
The presence of fecal leukocytes suggests...
an inflammatory process.
Dysentry treatment (if applicable)for bacillary dysentry, antibiotic treatment decreases what two things?
duration of symptoms and fecal shedding of organisms.
Of Shigella, Amebic dysentry and Salmonella causes of GI Infections,
A. rank from shortest to longest, their incubation periods
B. which has vomiting/nausea
C. Fever
D. Tenesmus (feeling like you need to void when you've just voided)
A. rank from shortest to longest, their incubation periods: Shigella (<24 hrs), Salmonella (8-48 hours), Amebic (20-90 days).
B. which has vomiting/nausea : Salmonella only
C. Fever : all
D. Tenesmus (feeling like you need to void when you've just voided): Shigella only usually, sometimes Amebic
What condition is NOT useful to give antibiotics?

A. Shigella or Salmonella infection causing dysentry
B. Staphylococcal food poisoning
B. Staphylococcal food poisoning

because the causative agent is heat labile toxin! Treatment is rest, fluids and anti-emetics.
The most common cause of Traveler's diarrhea is

A. E. coli (ETEC)
B. Clostridium dificile
C. Shigella
D. Staph food poisoning
A. E. coli (ETEC)

produces heat labile and stabile toxins that increase intracellular AMP/GMP and result in secretion of chloride from intestinal crypt and inhibition of absorption at sodium chloride tips --> watery diarrhea
If you purchase and eat raw oysters or shellfish, what are you at risk of getting? How does it manifest clinically?

A. Campylobacter jejuni
B. Salmonella
C. Shigella
D. Vibrio vulnificus
D. Vibrio vulnificus

manifests as wound infections (bullae esp.), gastroenteritis or primary septicemia

Transmitted to humans thru open wounds in contact with sewater or thru consumption of improperly cooked or raw shellfish. Sick w/in 16 horus of consumption usually.
Which of the following are rarely associated with C.difficile associated diarrhea?

A. Ampicillin
B. Amoxicillin
C. Cephalosoprins
D. Clindamycin
E. Metronidazole
F. Vancomycin
E. Metronidazole
F. Vancomycin
For C.difficile associated diarrhea, an ELISA for toxin detection is available. What can you do PCR on?
loose or unformed stool only!