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80 Cards in this Set
- Front
- Back
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What is the treatment for histoplasma capsulatum?
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Most are self-limiting in healthy pts. IV Itraconazole for less severe manifestations
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What drug is used in the treatment of pts with histoplasma capsulatum with severe symptoms or disseminated histoplasmosis?
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Amphotericin B
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Child pt presents with cough, cyanosis s/p coughing spell, post-coughing vomiting. Chest x-ray showed no infiltrates. Pathogen?
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Bordetella pertussis
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What is the treatment for B.pertussis?
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Supportive care. Macrolide if cough has not started yet
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How are the haemophilus bacteria differentiated?
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metabolic requirements: X: heme V: NAD
Species named para require V but not X Others need X and V or just X |
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Which group of H. influenza are encapsulated?
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group 1
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Which group of H. Influenza is not encapsulated?
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Group 2
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Which group of H. influenza is the most pathogenic in adults?
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Group 2
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Which group of H. influenza is the most pathogenic in children?
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Group 1
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Which three bacteria are commonly found in pts with COPD?
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H. Influenza
M. Catarrhalis S. Pneumonia |
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What are the 4 clinical symptoms of atypical pneumonia?
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1) dry cough
2) variable chest x-ray 3) No bacteria on smear 4) No response to B-lactams |
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What is the term for the inhibition of ciliary movement caused by bacterial infection?
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ciliostasis
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What is the treatment for Mycoplasma pneumonia?
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Erythromycin or doxycyclin for 14-21 days
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What is Stevens-Johnson syndrome?
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An extensive rash in young pts involving the mucous membranes and large areas of the body, known as erythema multiform. Occurs in untreated M. pneumonia pts
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What is the structure of adenovirus?
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Nonenveloped, double stranded, linear DNA virus with icosahedral nucleocapsid that contains fibers protruding from all 12 vertices
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Where does adenovirus live and replicate within the cells
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In the nucleus
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how is adenovirus transmitted?
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Extremely hardy virus:
Direct contact Fecal-oral waterborne |
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What is the latent period of adenovirus?
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5-12 days
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What is the treatment for adenovirus?
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Symptom relief, no antivirals work
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What are the clinical features of adenovirus infections and what serotype is predominant in each?
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Pharyngeoconjunctival fever: 3,4,7
Acute RDS: 4,7 Epidemic keratoconjunctivitis: 8, 19, 37 Gastroenteritis: 40,41 Acute hemorrhagic cystitis: 11,21 |
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What % of pharyngitis is viral?
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70%
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Is streptococci pyogenes Catalase + or -, and Bacitracin sensitive or non-sensitive in susceptibility tests?
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Catalase -
Bacitracin sensitive |
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What is the peak incidence age of strep throat?
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5-15 yrs
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Antibodies to what surface protein of Strep.pyogenes facilitates host defense?
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M protein
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What is the treatment for streptococcus pyogenes?
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Penicillin or cephalosporin (no resistance has been reported)
Erythromycin if allergic |
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What are the signs of scarlet fever?
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Systemic rash that begins on trunk and spreads outward, sparing the soles and palms. Also circumporal pallor and red papillae of the tongue (strawberry tongue)
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What type of hypersensitivity reaction causes the cutaneous manifestations of scarlet fever?
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Delayed-type hypersensitivity
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What type of hypersensitivity reaction causes rheumatic fever/rheumatic heart disease following strep. pyogenes infection?
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Type 2 hypersensitivity
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How is C diphtheriae transmitted?
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Respiratory droplets
Direct contact |
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What is the mechanism of diptheria toxin?
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1A and 1B domain. The A domain inhibits protein synthesis by ADP-ribosylating EF-2
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What is the treatment for C. diphtheria?
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Diphtheria antitoxin
Penicillin or erythromycin |
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How often should people receive DTP boosters?
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10 years
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What is the structure of the Mumps virus?
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negative sense, single stranded RNA virus of the paramyxoviridae family
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How is mumps virus transmitted?
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Respiratory secretions
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Where does the mumps virus live in cells?
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Within epithelial cells of the oropharynx
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What is the treatment for mumps?
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Supportive (pain) symptom relief
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What are the complications associated with hematologic dissemination of mumps virus?
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Meningitis
Pancreatitis Orchitis (testicular swelling) |
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What are the characteristic features of K.pneumonia?
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Lactose fermenting
Urease + Indole - |
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What is the treatment for K. pneumonia?
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Extended spectrum penicillin's
Aminoglycosides quinolones |
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How is K. pneumonia becoming more resistant to penicillins?
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Plasmids
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Stimulation of T and B cells by M. pneumonia causes release of what antibody?
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IgM
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How is Legionella pneumonia transmitted?
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Water environments (like water towers, nebulizers, humidifiers, ect)
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What are the characteristics of Legionella pneumonia?
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Motile
flagellated Faint G - staining |
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What medium is needed to grow Legionella pneumonia?
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buffered charcoal yeast extract
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What is Pontiac fever?
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Acute, flu-like, non-pneumonic illness occuring a few hours to 2 days after Legionella pneumonia infection
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When does legionnaires disease begin to show symptoms after infection?
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2-10 days
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What is the treatment of Legionella pneumonia?
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Macrolide
Quinolone Doxycycline |
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Where does influenza virus live and replicate?
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Mucus secreting, ciliated cells
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What are the histological findings in influenza virus infected lungs?
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Interstitial in location with diffuse patchy inflammation localized to interstitial areas of alveolar walls
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What is the most frequently infected age group on RSV?
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2-6 months
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What is the medium used to grow TB?
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Lowenstein-Jensen
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What pathogen usually shows a wedge shaped legion in the lung field and a small nodules with a hazy rim (halo sign) on CT?
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Aspergillus fumigatus
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What are the histological characteristics of A. fumigatus?
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Thin hyphae that branch at 45 degree angles (V shaped)
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How is A. fumigatus transmitted?
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Airborne conidia (spores). Usually from decaying vegetation
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What type of people are more susceptible to A. fumigatus infections?
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People with phagocytosis deficiencies (chronic granulomatous disease)
profound neutropenia |
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What is the cause of the pathogenesis in A. fumigatus infections?
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Hydrolases
Hemolysins/secondary metabolites |
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What is the treatment for A. fumigatus?
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Amphotericin (old standard)
Voriconazole Granulocyte stimulating factor |
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What are the complications of A. fumigatus infections?
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Allergic bronchopulmonary aspergillosis (ABPA)
Aspergilloma (fungus ball that grows in TB cavitary lesions) |
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What stain is needed for Histoplasmosa capsulatum?
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Giemsa
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How is Histoplasmosa capsulatum transmitted?
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Disruption of soil causing conidia inhalation
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Where does Histoplasmosa capsulatum live in cells?
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In neutrophils and macrophages where is changes to the budding yeast form
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What medium is needed to grow Blastomyces dermatitidis?
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Sabouraud
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Where is Blastomyces dermatitidis endemic to?
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Southeastern US
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Which pathogen presents with a characteristic verrucous skin lesions caused by focal abcesses in the dermis?
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Blastomyces dermatitidis
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What is the treatment for Blastomyces dermatitidis?
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Itraconazole
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How is coccidioides immitis transmitted?
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Arthroconidia (hyphea fragment forming hardy structures) are disturbed in soil
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Where is coccidioides immitis endemic?
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Western US (known as valley fever)
Mexico |
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Which pathogen can disseminate causeing characteristic erythema nodosum lesions?
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coccidioides immitis
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Which bacteria is weakly staining for G+ and acid fast stains?
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Nocardia asteroides
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How is Nocardia asteroides transmitted?
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Inhalation of contaminated dust from soil
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What type of people are at inceased risk for Nocardia asteroides infections?
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Steroid users
Cytotoxic or immuno suppressors AIDS |
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What is Madura foot?
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Nocardia asteroides of agricultural workers in tropical countries caused by skin inoculation. Causes chronic, subcutaneous infection that spreads along lymphatics or destruction of deep tissues
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Where does Nocardia asteroides live within cells?
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In phagocytes. Prevents lysosome fusion and acidification
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What are the long term complications of Nocardia asteroides infection?
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diffuse pneumonitis
Abcesses CNS involvement is common |
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What is the treatment for Nocardia asteroides?
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Sulfonamides (especially trimethoprim/sulfamethoxazole)
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What are the characteristic of Actinomyces israeli?
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Gram + anaerobes
Form branching filaments that can resemble fungi Form "molar tooth) colonies from sulfur granules |
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What pathogen forms dense sulfur granules?
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Actinomyces israeli
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What people are at increased risk of Actinomyces israeli infection?
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Women with intrauterine contraceptive devices
Poor oral hygiene |
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How is Actinomyces israeli transmitted?
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Its an endogenous flora of the oral cavity and GI. Aspiration requiring synergistic infections
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What is the treatment for Actinomyces israeli?
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Prolonged (1 mo) high dose Penicillin G followed by 6-12 mos of amoxicillin
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