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78 Cards in this Set
- Front
- Back
Endemic areas for Histoplasma
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Ohio and MS river valleys
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Mech of spread for Histoplasma
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inhalation conidia from soil contaminated by of bird or bat feces
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Etiology of Actinomyces
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Gram positive, filamentous, non acid fast, anaerobic
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Describe spread of Actinomyces
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Is normal flora so it is endogenous
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Infection with what organism is increased with steroid use?
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Nocardia
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Etiology of Nocardia
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Gram positive, acid fast
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Describe spread of Nocardia
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through soil dust
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Possible complication of Nocardia infection
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CNS abscess
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Etiology of Influenza A
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enveloped virus with 8 segments of neg sense RNA
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Means of developing Staph aureus pneumonia
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aspiration
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Lab value for Na with Legionella infection
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decreased Na
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Test to dx Legionella
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direct antigen on urine
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What causes tissue damage in Legionella infection?
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PMNs and T cells
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Etiology of Klebsiella
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mucoid on culture, lactose fermenting, indole negative
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Possible complication of Klebsiella pneum
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bacteremia
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Who should receive the pneumo vaccine?
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Sickle cell pt (no spleen)
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What organism has a pos cold agglutinin (IgM agglutinates RBCs)?
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Mycoplasma pneum
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Tx for Mycoplasma pneum
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Erythromycin (no cell wall, so no beta-lactams)
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SE of Isoniazid
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liver injury
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Etiology of EBV
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enveloped ds linear DNA
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EBV causes increase in what lab values?
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AST, ALT, bilirubin, alkaline phosphatase
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Who is at greatest risk for complications with EBV infection?
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African kids with malaria
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Action of Pertussis toxin
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inactivates Gi which increases cAMP activity and increases protein kinase activity
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DOC for Strep pneum that is resistant to penicillin
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cefotaxime
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Organism that causes cauliflower lesion on skin (verrucous) and undergoes broad base budding
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Blastomyces
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Organism that causes erythema nodosum and forms septae to form endospores
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Coccidiodes
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Endemic areas for Coccidiodes
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desert
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Tx for Coccidiodes
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fluconazole
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Describe spread of Coccidiodes
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via arthroconidia
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Etiology of diphtheria
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Gram positive rod, aerobic, grows on tellurite agar
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What type of toxin does diphtheria produce?
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bacteriophage A-B toxin
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Tx for diphtheria
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antitoxin
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Manifestations of Adenovirus infection (2)
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pharyngitis and conjunctivits
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Possible complication of Adenovirus
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ARDS
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Describe macroconidia of Histoplasma
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has fingerlike projections
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Most common organisms of rhinitis (2)
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rhinovirus and coronavirus
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Most common organisms of AOM (3)
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Strep pneumo, H influ, Moraxella
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Most common organisms of sinusitis (3)
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Strep pneumo, H influ, Moraxella
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Most common organisms of eye infections (unilateral) (7)
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Adenovirus, CMV, HSV, S aureus, Neisseria gonorrhea, Chlamydia, Toxoplasma
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Most common organisms of pharyngitis (5)
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Adenovirus, EBV, Mycoplasma, Strep pyogenes, Corynebact diphtheriae
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Type of organism that causes the following: bulging and inflamed TM, opaque liquid in middle ear, occuring after common cold
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Gram neg cocci (Moraxella)
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Main reason to give antibiotics for AOM
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to prevent further suppurative complications like chronic effusions of middle ear that don't respond well to antibiotics
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Tx of STI infection in 2 week old
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Erythromycin
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Etiology of agent: fever, sore throat, red left eye with feeling of sand in it, hx of playing in water
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naked, ds-linear DNA (adenovirus)
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What virulence factor is most likely to be involved in pathogenesis of petechiae on soft palate during a strep pyogenes infection?
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erythrogenic toxin
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Which important Gram pos bacterium is catalase positive?
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Staph aureus
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Are all streptococci catalase negative?
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yes
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2 organisms that are gamma hemolytic
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enterococcus and staphylococcus epidermidis
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Course of action if the following: 5 yo immigrant with fever, sore throat, dyspnea, lymphadenopathy, whitish-gray adherent membrane over tonsils/pharynx
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passive immunization against diphtheria toxin
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Mech by which non-capsular strains become capsular
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transformation
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Mech by which nontoxic strains become toxic
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trunsduction (via lysogeny)
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Mech by which drug sensitive strains become resistant
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conjugation (plasmids)
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Mech of diphtheria toxin
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inactivates EF2
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oncogenic DNA viruses (2)
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EBV, HBV
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Most common organisms of croup (2)
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parainfluenza, RSV
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Most common organisms of epiglottitis (1)
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HiB
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Most common organisms of bronchitis (3)
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resp viruses, Mycoplasma pneum, H influ (AECB)
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Most common organisms of bronchiolitis (3)
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RSV, influenza, pneumovirus
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Dx: barking cough, wheezing, preceeded by coryza, perioral cyanosis, virus is nonseg neg sense ssRNA, nucleocapsid with surface spikes of hemagluttinin
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parainfluenza
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Toxin associated with following sx: increased cough with repetitive dry cough followed by inspir whistle; incomplete immunizations
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ADP-ribosylase
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ADP-ribosylase associated with pertussis causes what change in lymphocytes?
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preferential increase in lymphocytes by inhibiting chemokine receptor
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special media for pertussis
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Boredet-Gengou charcoal blood agar with cephalexin
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Common organisms of typical pneumonia (4)
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Strep pneumo, Klebsiella, E coli and GBS
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Common organisms of atypical pneumo (9)
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Mycoplasma pneum, Chlamydophila pneum, Legionella pneum, Influenza, RSV, Adenovirus, Sin Nombre, SARS, H5N1
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Common organisms of TB/chronic pneum (5)
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TB, Histoplasma, Blastomyces, Coccidioides, Actinomyces
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Common organisms of pneumo in comorbids (9)
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Pseudomonas (CF), MDR-GNB (ICU), S aureus (flu), anaerobes (elderly), Nocardia (CMI), Pneumocystis (HIV), Aspergillis and Candida (neutropenic), CMV (AIDS/transplant)
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What best differentiates Strep mutans from Strep pneumo
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Strep pneumo is Optochin sensitive
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Tx for a Gram neg rod that is mucoid in colony, oxidase neg, lactose fermenting and causes cough, fever, muscle aches, chest pain
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ceftriaxone and gentamicin (3rd or 4th ceph plus aminoglycoside) (for Klebsiella)
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Dx: fever, cough, muscle aches, delirium, watery diarrhea, clear sputum, urine antigen test confirms dx
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Legionella pneum
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special media for Legionella
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BCYE with Fe and cysteine
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Target of drug used to tx influenza
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neuraminidase
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What genetic changes of influenza are responsible for a number of epidemics and pandemics?
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reassortment
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Dx: CXR shows ground-glass appearance and air bronchograms in lung fields
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bronchiolitis
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INH must be given with what vitamin?
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B6
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Drug that is directed against the synthesis of ergosterol
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fluconazole
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Dx and Tx: fever, chills, hemoptysis, cytotoxic chemotherapy for leukemia, CXR with multiple nodular infiltrates, Galactomannan positive
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Aspergillus; drug that causes pores in membrane by binding with ergosterol
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Dx: works with wool, cyanosis, hemoptysis, chest pain, fever, rales, mediastinitis
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anthrax
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Anthrax produces what type of toxin?
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adenyl cyclase toxin
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