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146 Cards in this Set
- Front
- Back
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what is the MC cause of bacterial blepharitis?
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Staph aureus
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what are the 3 causes of bacterial conjunctivitis in adults? what about in infants?
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Adults: Staph aureus, Strep pneumoniae, H. influ. Infants: Strept pneumoniae, H. influ B, N gonorrhea
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what is the most common cause of bacterial endophthalmitis? what bacteria is a/w a poor prognosis?
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MC= Staph epidermidis; Poor prog: Pseudomonas
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when is endopthalmitis MC?
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after cataract surgery
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what is unique about anterior uveitis (iritis)? Intermediate uveitis (cyclitis)? Posterior uveitis?
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anterior: they have pain & photophobia; intermediate: they have floaters; posterior uveitis: they are usually painless
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what is a complication of periorbital cellulitis?
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meningitis
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what two microorganisms grow on chocolate agar?
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Haemophilus influenza and Pastruella tularenesis
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what can happen with pts w/ COPD or CF with an H influ infection?
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nontypable H influ can colonize lower RT & exacerbate these conditions
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what is the virulence factor for Strept pneumo?
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Capsule which interferes w/ phagocytosis by blocking C3b opsonization
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what microorganism is serotyped using the quellung rxn?
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strep. pneumoniae
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how does Staph aureus avoid phagocytosis?
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Protein A: binds to Fc portion of ab
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scarring on conjunctiva which forces eyelid to turn inward where eyelashes can rub the cornea. dx:
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trachoma caused by Chlamydia trachomatis
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What pathogen causes parinaud's oculoglandular syndrome?
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Bartonella henselae
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what microorganism requires only hemin to grow?
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Eikenella corrodens
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what are the four most common viruses a/w eye infections?
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HSV, varicella zoster, adenovirus, CMV
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what microorganism is associated with dendritic keratitis?
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Herpes simplex virus
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what virus is responsible for epidemic episodes of keratoconjunctivitis that are HIGHLY contagious?
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Adenovirus
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HIV pt presents complaining of floaters and flashes in his vision. He also says that he has blind spots. On examination you see hemorrhages and wool spots on the retina. what is the Most likely pathogen?
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CMV--> CMV retinitis
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what is the 2nd MC opportunistic infection following Candida?
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aspergillus
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which fungus a/w eye infection doesn't grow on sabouraud dextrose agar?
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Acremonium- grows on potato dextrose
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what is the MC endogenous cause of endophthalmitis?
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Candida
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what eye infection causing pathogen is a/w Roth's spots?
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Candida
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what fungis is called "black bread mold"?
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rhizopus
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what causes 90% of rhinocerebral infections?
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mucormycosis from rhizopus infection
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what is one of the most virulent microorganisms to infect the eye?
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bacillus cereus
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what two microorganisms cause corneal ulcers?
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MOTT & bacillus cereus
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what microorganism causes keratitis in contact wearers and granulomatous amebic encephalitis?
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acanthamoeba
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what is the active form of toxoplasma gondii?
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tachyzoiites
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In regards to eye infections, what 2 parasites are mature in subq tissues?
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Loa Loa, Onchocerca volvulus
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what is oestrus ovis?
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severe conjunctivitis contracted from working w/ sheep or goat
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what two microorganisms cause pancytopenia?
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toxoplasmosis gondii and fransciella tularenesis
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what is the main cause of hemophagocytic syndrome?
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overactivation of macrophages--> leads to macrophages phagocytizing erythrocytes, leukocytes, platelets, etc
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what are the characteristics of hemophagocytic syndrome?
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fever, splenomegaly, jaundice, hypocellualr jaundice, hypertriglyceridemia, neutropenia, anemia, thrombocytopenia, hypofribinogenemia
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what particular population is HLH a/w?
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HIV pts w/ pneumococcal dz, pneumocystosis, histoplasmosis
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what is the infective form of T. gondii called?
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tachyzoites
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what organs does T. gondii have a predilection for?
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heart, lymphoid organs, CNS, eye, lung
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how do you judge the virulence of brucellosis microorganis?
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based on O ag of LPS: if smooth= more virulent, if rough= less virulent
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where are the amastigotes found in leishmaniasis?
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reticuloendothelial cells
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which microorganism can cause bleeding mucous membranes?
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Leishmaniasis
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what 3 disease can lead to HLH when associated with travel?
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Leishmaniasis, Brucelosis and Ricketsiosis
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exposure to human body lice + splenomegaly + high fever + vascular collapse: Dx
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Epidemic typhys caused by rickettsia prowazekii
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this dz is transmitted bya a chigger found in Asiatic pacific areas causing splenomegaly & interstitial myocarditis. Dx
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scrub typhus (Rickettsia tstsugamushi)
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what is the role of hepcidin? what happens to hepcidin during anemia?
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regulator of iron metabolism; during anemia hepcidin production is 100x normal
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what are the 3 best known parasitic infections that cause hemolytic anemia? what can cause hemolytic anemia that is not a parasite?
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Malaria, bartonellosis, babeiosis; C. perfringens
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in malaria caused by plasmodium falciparum, what stage of the life cycle is present in the saliva? how about the liver?
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saliva: sporozoites; liver: merozoites
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what is the gold standard for detecting malaria?
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giemsa & wright stain
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what two microorganisms are a/w relapsing malaria?
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plasmodium vivax & ovale
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what will you find on histology of RBCs parasitized by vivax?
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schuffer's dots: small purplish red granules on wright's stain
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what hematologic infection is limited to the andes mts: peru, ecuador & columbia?
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Bartonella baciiliformis= oroya fever
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what microorganism can be found in the NE US, is transmitted by a tick and forms a tetrad formation on diagnosis?
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babesia microti & divergens= babesiosis
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what does C. perfringens release that causes cells to lyse?
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A-Toxin which produces lecithinase which will react w/ RBcell membrane lipoproteins and produce lysolecithin
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what two toxins that are released from C. perfringens is toxic to heart muscle?
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theta and Alpha toxin
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what are the donath-landteiner abs? what is a/w donath-landteiner abs?
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IgG abs that react w/ the RBCs in the cold; a/w paroxysmal cold hemoglobinuria
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how does M. pneumonia cause cell necrosis?
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by inhibiting ciliary action in the respiratory tract
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how does M. pneumonia cause cold AI hemolytic anemia?
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d/t autoIgM antibodies directed against the I ag on RBCs
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what are the 5 infections a/w cold AI hemolytic anemia?
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M. pneumonia, Rubella, mumps, EBV- mono, legionella
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a child presents w/ viremia, rash and hemorrhage manifestations. you take their blood and test it for agglutination and it comes back positive for Cold agglutination. Dx; what abs are reacting w/ RBCs in cold here?
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Rubella; IgG abs
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what does polyagglutination cause?
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exposition of RBC surface ags that are normally hidden which will lead to abs attacking these newly exposed ags
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what can enteric bacteria produce that act as a polyagglutinin?
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neuraminidase
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what is the life cycle of ancylostoma duodenale & necator americanus (hookworm)?
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enter via penetration--> carried to lungs--> coughed up --> swallowed--> mature in small intestine
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what type of anemia is caused by hookworm?
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microcytic hypochromic anemia (hook worms: necator americanus, ancylostoma duodenale)
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what two microorganisms are most responsible for causing katayama's fever?
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Schistoma Japonicum and mansoni
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what microorganisms from the trematodes causes CNS lesions by invading the spinal cord? or invading the brain?
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spinal cord: Schistoma mansoi & haematobium; brain: Japonicum
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where can you find fasciolopsis buski?
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China, Vietnam, Thialand, Indonesia, Malaysia, India --> in their aquatic vegetables (water chestnuts)
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where does fasciolopsis buski attach?
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immature flukes attach to duodenum mucosa
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what microorganism can cause pernicious anemia? what is it commonly found in?
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diphyllobothrium latum-- common in areas where their is raw or pickled fish.
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what can be found on microscopy of trypansomas in their cytoplasm?
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kinetoplastids (mitochondrial DNA)
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T brucei gambiense = _____, T brucei rhodesiense= _______
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chronic; acute
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what are the 3 species of filariasis that is known to be responsible for most of morbidity d/t filariasis?
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onchocercia volvulus, wucheria bancrofti, brugia malayi
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what two filariasis invade the lymphatics?
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brugia, wuchereria
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what are the sxs of filariasis?
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elephantiasis, eosionphilia, lymphedema
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how do you dx filariasis?
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take blood samples at different time of the day to catch it.
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two microorganisms that grow on skirrow medium?
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h. pylori and campylobacter jejuni
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Air under the diaphragm on a plain xray of the abdomen, what microorganism is a/w this plain xray?
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H. pylori
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risk of guillan barre comes with what microorganism
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Campylobacter jejuni
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what is th MOA of vibrio cholerae?
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TCP (toxin coregulated pilus), AB toxin (cholera toxin)--> A1 induces activation of adenylate cyclase and locks Gs protein in an activated state. B is bound to GM1 irreversibly
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what is the chief regulator of V. cholerae?
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ToxR which directly actives PAI
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what three microorganisms work via an AB type toxin mechanism?
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ETEC, vibrio cholera, EHEC
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what toxin produced by ETEC acts on guanylate cyclase?
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ST
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what two microorganisms work via attachment/ effacement?
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EPEC and EHEC
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which microorganism causes a "stacked brick appearance"?
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EAEC
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which microorganism acts via cleaving a single adenine residue from 28S rRNA? what does that lead to?
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EHEC- leads to a shut-down of host protein synthesis
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what microorganism fails to ferment lactose and therefore needs a MacConkey agar with sorbitol?
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EHEC
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what animal is most a/w EHEC? campylobacter? Clostridium perfringens? Yersinia?
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Cows; poultry; poultry; swine
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what two microorganisms work via the same method involving M cells and inhibiting protein synthesis?
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Shigella & EIEC- entry via M cells--> replication and then steal actin from host cell and burrow into neighboring cells to spread infections. Shiga toxin= inhibits 60S ribosomal subunit.
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what are the two MC type of shigella in the US?
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Shigella Sonnei and flexneri
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a child presents w/ HUS and culture reveals a clear colony on Hektoin Ekter. Dx
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Shigella dysenteriae--> shiga toxin causes HUS, TTP (adults)
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What microorganism is sensitive to Fe levels?
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Yersinia entercolitica
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what 5 microorganisms involved the reticuloendothelial system?
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Yersinia, Fransciella, Brucella, salmonella Typhi, picornaviruses
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what severe GI infection is endemic to Latin America and Asia (esp India)?
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Salmonella typhi
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fever of 104 + rose spots on abdomen & chest + relative bradycardia. What is the MOA?
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Salmonella typhi: invasion of M cells --> carried in lymph circulation tor eticuloendosystem--. spread to biliary tract and reinfect bowel
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dx of salmonella typhi
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widal tests: week 1= use blood, week 3= use feces
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what is the MOA of salmonella enterica (all, but typhi)?
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M cells--> ruffle formation
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how does Salmonella typhi prevent phagocytosis? what about the other members of the salmonella family?
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Typhi= Vi ag which interferes w/ complement deposition by inhibiting PMN phagocytosis; others= cause apoptosis of the macrophage
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what special medium does fracisella tularensis need?
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one enriched with cysteine
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what two microorganisms can cause a fever up to 104?
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salmonella typhi & francisella tularenesis
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what two microorganisms can cause a GI infection by ingestion of unpasturized dairy products?
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Campylobacter jejuni and Brucella melitenesis
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what are the 3 possible manifestations of brucella melitenesis?
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1) febrile illness that resemble typhoid, but less severe 2) a kid with fever and acute monoarthritis (hip or knee) 3) older man with long-lasting fever, low back pain or hip pain.
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what microorganism needs a break in the epithelium to cause a severe form of this infection?
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bacteroides fragilis: BFT strains cause acute diarrhea w/o a break in the skin; but non BFT strains need a break in the skin
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what can cause secondary peritonitis (N/V, tachy, abdominal pain, absent bowel sounds)?
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Bacteroides fragilis non BFTstrain--> entry via break in the epithelium
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what is the main complication of bacteroides fragilis?
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abscess formation
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what two microorganisms do NOT have an associated fever when causing their GI infection?
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EHEC & clostridium perfringens
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what toxin is release by C. perfringens to cause GI infection?
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binary toxin (heat labile enterotoxin)
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how do you dx C. perfringens?
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Egg-yolk agar with lecinthinase activity or double zone hemolysis shown on blood agar
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what is a complication of c. perfringens infections?
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enteritis necrotans- severe necrotizing disease of small intestine a/w swine. 40% die d/t perforation
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what is the progression of clostridium botulinum intoxication?
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1st- cranial nerve paralysis--> respiratory muscle weakness--> preceding of following onset of paralysis (descending symmetric flaccid paralysis)
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after how long do you see C. botulinum intoxication?
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12-36 hrs
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what is the MOA of C. botulinum?
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toxins enter blood stream--> absorbed in small intestine & stomach --> binds to receptors of presynaptic terminals--> preteolysis of components of calcium induced exocytosis apparatus
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what microorganism can cause a diarrheal form of GI infection and a vomitus form?
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bacillus cereus. Diarrheal: 20-34 hrs; vomiting= 8-10 hours
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what food is a/w bacillus cereus?
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Fried rice
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what is the MOA of bacillus cereus?
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activated adenylate cyclase via enterotoxin
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pt comes to the ER after eating a pastry 4 hours ago. pt has been consistently vomiting ever 2 hours. what is the microorganism? how long will it last?
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S. aureus= should last 24-48 hours
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how do you dx cryptosporidium?
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Ziehl nelson stain or AFB positive oocysts in stool
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an HIV pt complains of very loose stool that has a LOT of water in it. He feels dehydrated and his skin tenting is positive. He denies recent travel, but does say that he went swimming at the local HS a few days ago. what is the microorganism and what is the MOA?
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Cryptosporidium parvum: sporozoite attaches to epithelial mucosal cells and they release cytokines that activate phagocytes. These phagocytes incr secretion of water and cl from epithelial cells and the cells are damaged by invasion & T cell mediated inflammation (villus atrophy). Tx: parocmycin (if immunocompromised)
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what are the two spore forming coccida that can cause a GI infection?
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cryptosporidium parvum & cyclospora cayetanensis
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which GI infection is a/w Guatemalan fruits and veggies? where else can this microorganism be found?
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cyclospora cayetanesis- can be also found in Haiti, Peru, Mexico, Morocco, Pakistan, Indonesia
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what two microorganism do you think when you hear Peru?
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Bartonella henselae and Cyclospora cayetanesis
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what two microorganisms do you think when you hear Indonesia?
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Fasciolopsis buski and cyclospora cayetanesis
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when comparing the two microorganisms that are spore forming coccidia that cause GI infectious, how do they differentiate in regards to their oocysts?
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Cyclospora oocyst's are non-infective, unlike cryptosporidium which have infective oocysts
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where does Giardia lamblia reproduction occur? tx?
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Proximal small bowel; Tx: metronidazole
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what are the extraintestinal manifestations of an infection by entamoeba histolytica?
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hepatic abscess (d/t pathogen completely eroding through the intestinal mycosa) and lung abscess (d/t penetration of diaphragm by pathogen from hepatic abscess)
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how does entamoeba histolytica adhere to the mucosal layer of intestine?
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via its adherence lectin= N-acetyl D galactosamine
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what pathogen creates flash shaped ulcers in the intestines? tx?
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entamoeba histolytcia; tx: metronidazole or tinidazole is symptomatic
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SS+ RNA linear icosahedral virus causing GI infection
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Picornavirus: poliovirus, coxsackie, echovirus, hep A virus AND calciviruses (norwalk agent)
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pt presents w/ a mild sore throat and watery diarrhea. A few days later, those sxs have passed, but he now presents with a rash, photophobia and a stiff neck. Microorganism?
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Picornavirus--> will have sxs of GI infection + rashes, lesions, photophobia and tachycardia
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what is abortive poliomyelitis? aseptic meningitis? paralytic poliomyelitis?
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abortive poliomyelitis: nonspecific febril illness for 2-3 days w/o CNS involvement; aseptic meningitis: meningeal irritation signs + abortive poliomyelitis; paralytic poliomyelitis: all 2+ asummetric flaccid paralysis w/no significant sensory loss (can include respiratory muscles)
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double stranded RNA icosahedral linear virus w/ 10-12 segments that causes GI infection
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Reovirus: rotavirus
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what microorganism is a/w ETEC?
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rotavirus
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what is the 1st sxs of rotavirus? Norwalk virus?
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rotavirus= Vomiting, Norwalk virus= Nausea
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which virus causes osmotic diarrhea w/o involving adenylate cyclase?
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Calcivirus (norwalk)
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southeastern US + eggs in stool + hypereosinophilia +matures in the ileocecal area. microorganism?
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Trichuris trichuria
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A group of prisoners came to the nurse complaining of perianal itching. They said it gets worse at night. Microorganism? dx?
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Enterobius vermicularis, dx: tape test from perianal region
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which helminth does not have eosinophilia or elevated IgE?
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Enterobius vermicularis
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which microorganism causes visceral larva migrans?
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ascaris lumbircoides
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which microorganism further matures in the lung?
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ascaris lumbricoides
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which helminth can cause bowel obstruction?
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ascaris lumbricoides (roundworm)
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which microorganisms cause pruritic maculopapular dermatitis at the site of entry?
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acylostoma duodenale & necator americanus &strongyloides stercoralis
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which microorganism causes cutaneous larva migrans creating serpingious erythematous tracts?
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acylostoma duodenale & necator americanus
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which helminth is carried to both the heart & lungs before maturing in the small intestine?
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acylostoma duodenale & necator americanus
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how do you dx: necator americanus and acylostoma duodenale?
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eggs in fresh stool, larva in old stool
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what is the primary syndrome associated with an infection w/ acylostoma duodenale & necator ameircanus (hook worms)?
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iron deficiency anemia
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what four helmniths cause loeffler's syndrome?
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Ascaris lumbricoides, necator americanus, acylostoma duodenale and strongyloides stercoralis (threadworm)
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which microorganism causes larva currens on the trunk or near anus?
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strongyloides stercoralis --> linear erupution in which larvae migrate under skin causing an itchy, non indurated wheal w/ a red flare that disappears in a few hrs
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"puffed rice lesions"
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cystercerci d/t t. solium (pig), T. saginata (beef)
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Biliary duct swelling trematode?
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clonorchi sinesis, opisthorchis viverrini, opisthorchi felinues.
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liver dwelling trematode?
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fasciola hepatica (aquatic plants= waterchestnut)
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