Term
| What are the enterobcateriaceae? Are they Gram positive or negative? What are some of the common identifying antigens? |
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Definition
(E. coli, Salmonella, Shigella, Klebsiella, Enterobacter, Serratia, Proteus)
• Gram (-) rods
• All species have somatic (O) antigen
• Capsular (K) antigen- related to the virulence of the bug
• Flagellar (H) antigen- motile species
• All ferment glucose and are oxidase negative |
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Term
| What's the most common form of traveler's diarrhea (Montezuma's revenge)? |
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Definition
ETEC
➡ Rx: TMP-SMX, fluoroquinolones
➡ Similar to cholera (water, shellfish)
➡ No intestinal wall invasion
➡ no fever |
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Term
| What are some symptoms of general E. coli infection? |
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Definition
| diarrhea, UTI, neonatal meningitis/pneumonia/sepsis |
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Term
| What is the most common cause of gram negative sepsis? |
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Definition
|
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Term
| What E. coli gives you HUS from hamburger meat? |
|
Definition
EHEC
E. coli O157:H7
HUS = hemolytic anemia, renal failure (uremia), thrombocytopenia |
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Term
| What E. coli flattens villi and leads to watery diarrhea in children? |
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Definition
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Term
| What E. coli invades the intestinal wall and causes fever and bloody diarrhea? |
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Definition
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Term
| What do you treat E. coli infections with? |
|
Definition
| fluoroquinolones, cipro or levo, or bactrim |
|
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Term
| What organism causes staghorn calculi because of urease activity? |
|
Definition
Proteus spp. (P. mirabilis, P. vulgaris), very motile, no distinct colonies can be grown
Common cause of UTI
Urease converts urea to NH3 and CO2 |
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|
Term
| What are the four classic A's of Klebsiella |
|
Definition
Aspiration pneumonia, abcess in the lungs, alcoholics, diabetics
Also, currant jelly sputum is classic! |
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|
Term
| What organisms most commonly cause UTIs? |
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Definition
| E. coli, S. saprophyticus, Klebsiella pneumoniae, Proteus |
|
|
Term
| What do you treat UTIs with? |
|
Definition
| Sulfonamides, trimethoprim, aminopenicillins, fluoroquinolines, nitrofurantoin |
|
|
Term
| What is the mechanism of action of sulfonamides? |
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Definition
PABA antimetabolite, inhibits dihydropteroate synthetase, inhibits folic acid synthesis, bacteriostatic
Can cover Gram +, Gram-, Nocardia, Chlamydia, UTIs
Used in combo with trimethoprim which inhibits dihydrofolate reductase (bactrim!)
Toxicities: hypersensitivity reaction, hemolysis (esp with G6PD deficiency), nephrotoxicity, photosensitivity |
|
|
Term
| What drugs have photosensitivity reactions? |
|
Definition
| Sulfonamides, Amiodarone, Tetracyclines (SAT for a photo) |
|
|
Term
| What other drugs should be avoided in patients with an allergy to sulfa? |
|
Definition
Celecoxib (Cox2 inhibitor), Furosemide (loop diuretic), Probenecid (thiazide diuretic), thiazides, TMP-SMX, Sulfasalazine, Sulfonylureas, Acetazolamide
Fever, thrombocytopenia, urticaria, hemolytic anemia, pruritic rash, Stevens-Johnson syndrome |
|
|
Term
| What drugs can cause Stevens-Johnson syndrome (SJS)? |
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Definition
| Penicillins, Sulfa, Seizure (ethosuximide, lamotrigine, carbamazapine, phenobarbital, phenytoin), Allopurinol |
|
|
Term
| What is the mechanism of action of trimethoprim? |
|
Definition
| Inhibits dihydrofolate reductase |
|
|
Term
| What are the clinical uses for TMP-SMX? |
|
Definition
| UTIs, Shigella and Salmonella, MRSA, AIDS (pneumocystis jirovecii pneumonia) for prophylactic (CD4 count <200) |
|
|
Term
| Is Nitrofurantoin safe in pregnancy? What do you use it for? |
|
Definition
• Mechanism: Bacteriocidal. Reduced by bacterial proteins to a reactive intermediate that inactivates
bacterial ribosomes
• Indication: UTI cystitis (not pyelonephritis) by E. coli or Staph. saprophyticus (not Proteus)
• SE: rarely nausea, HA, flatulence
• Safe in pregnancy |
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|
Term
| What is the mechanism of action of quinolones? What are the clinical uses for fluoroquinolones? |
|
Definition
Inhibit DNA Gyrase (topoisomerase II)
Gram (-) infections, 1st and 2nd gen; Pseudomonas; Gram (+) infections, 3rd and 4th generation |
|
|
Term
| What are the side effects of fluoroquinolones? |
|
Definition
GI upset, contraindicated in pregnancy and childhood (hurt cartilege), tendonitis, tendon rupture
Can use fluoroquinolones in children in cystic fibrosis |
|
|
Term
| Which form of E. coli causes hemolytic-uremic syndrome (HUS)? |
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Definition
|
|
Term
| What infections is Klebsiella pneumoniae known for causing? |
|
Definition
| Aspiration pneumonia, lung abscesses, UTI |
|
|
Term
| What organisms are the most common causes of UTI? |
|
Definition
| E. coli, Proteus mirabilis, Staph. saprophyticus, Klebsiella |
|
|
Term
| What is the function of the enzyme urease? |
|
Definition
| Splits Urea into NH3 and CO2 |
|
|
Term
| What drug should be avoided when suspecting Salmonella? |
|
Definition
• Common cause of osteomyelitis in sickle cell patients
• S. enterica and S. enteritidis: the most common cause of food associated diarrhea in developed countries
(poultry, eggs, reptiles)
• Antibiotics should be avoided because they may prolong the carrier state in Salmonella GI tract
infections.
• S. typhi: causes typhoid fever |
|
|
Term
| What is the most common cause of food associated diarrhea in developed countries? |
|
Definition
| S. enteria and S. enteritidis (poultry, eggs, reptiles) |
|
|
Term
| What organism is associated with causing Reiter syndrome? |
|
Definition
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|
Term
| What medications are commonly used to treat C. diff colitis? |
|
Definition
C. diff causes pseudomembrane, necrosis
Clindamycin and ampicillin commonly cause this
Check for C. diff toxin
Use metronidazole or oral vancomycin |
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|
Term
| Food poisoning as a result of mayonnaise sitting out too long |
|
Definition
|
|
Term
| Diarrhea caused by Gram (-) nonmotile organism that does not ferment lactose |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Diarrhea caused by a C- or S-shaped organism |
|
Definition
|
|
Term
| Diarrhea transmitted from pet feces |
|
Definition
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|
Term
| Food poisoning resulting from reheated rice (Chinese food) |
|
Definition
|
|
Term
| Diarrhea caused by Gram (-) motile organism that doesn’t ferment lactose |
|
Definition
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|
Term
| Most common cause of “travelers’ diarrhea” |
|
Definition
|
|
Term
| Diarrhea after a course of antibiotics |
|
Definition
|
|
Term
| Diarrhea caused by Gram (-) lactose fermenting bacteria, no fever |
|
Definition
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|
Term
| Diarrhea caused by Gram (-) comma-shaped organism, no fever |
|
Definition
|
|
Term
| Diarrhea + recent ingestion of water from a stream |
|
Definition
| Giardia or Entamoeba histolytica |
|
|
Term
| Food poisoning from undercooked hamburger meat |
|
Definition
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