Term
| What is the most common cause non-specific URIs? |
|
Definition
|
|
Term
| What are the Ssx of a non-specidic URI? |
|
Definition
| rhinorrhea, nasal congestion, cough, sore throat, slight fever in kids. |
|
|
Term
| What is the difference between a bacterial and viral non-specific URI? |
|
Definition
bacterial: longer, localized, severe
viral: acute, pantropic, short term |
|
|
Term
| What are the two types of External Ear Infections? |
|
Definition
Auricular Cellulitis
Perichondritis |
|
|
Term
| What are the Ssx of auricular cellulitis? |
|
Definition
| soft tissue infection, red, swollen, warm. |
|
|
Term
| What is the Rx for auricular cellulitis? |
|
Definition
|
|
Term
| What commonly causes auricular cellulitis? |
|
Definition
| Staph. aureus, Strep. pyogenes |
|
|
Term
| What are the Ssx of perichondritis? |
|
Definition
| Affects upper portion of external ear following usually an insect bite, puncture, scratch. Cellulitis infection, similar ssx to auricular cellulitis. |
|
|
Term
| What is the Rx for perichondritis? |
|
Definition
|
|
Term
| What usually causes perichondritis? |
|
Definition
| Staph. aureus, Pseudomonas aerigenosa. |
|
|
Term
| What are the common causes of Otitis Externa? |
|
Definition
Staphylococcus aureus/epidermidis
P.aeruginosa |
|
|
Term
| What are the 4 types of Otitis Externa? |
|
Definition
1.acute localized-furunculosis
2.acute diffuse (swimmer’s)
3.chronic- repeated AOM
4.invasive (malignant, necrotizing) |
|
|
Term
| What part of the ear does the acute localized Otitis Externa affect? |
|
Definition
| The outer part of the ear canal where the hair follicles are present. |
|
|
Term
| What is the Rx for acute localized otitis externa? |
|
Definition
| Warm compress. In severe situations, use a systemic Abx. |
|
|
Term
| What bacteria tend to cause acute localized Otitis externa? |
|
Definition
| Staph aureus, Sterp pyogenes |
|
|
Term
| What commonly causes an acute diffuse Otitis externa? |
|
Definition
|
|
Term
| What are the Ssx of acute diffuse Otitis externa? |
|
Definition
| Itching, swelling in the canal, clumping blue-green discharge |
|
|
Term
| What is the Rx for acute diffuse otitis externa? |
|
Definition
| For the inflammation: hydrocortisone. No Abx b/c the bacT are multi-resistant. |
|
|
Term
| What commonly causes a chronic otitis externa? |
|
Definition
| Staph pneumoniae, Hib, Moraxella cattarhlis |
|
|
Term
| What are the Ssx of chronic otitis externa? |
|
Definition
| scaling, dermititis, itching, not much swelling, persistent drainage. Can be due to a repeated AOM. |
|
|
Term
| What are the ssx of invasive otitis externa? |
|
Definition
| pus-producing, severe pain, necrosis, danger of contiguous spread |
|
|
Term
| What commonly causes invasive otitis externa? |
|
Definition
|
|
Term
| What is the Rx for invasive otitis externa? |
|
Definition
| Treat aggressively using anti-pseudomona ear drops. |
|
|
Term
| What commonly causes Otitis Media? |
|
Definition
| Strep. pneumoniae, Hib, moraxella, MRSA in community acquired. |
|
|
Term
| How does Acute Otitis Media (AOM) manifest? |
|
Definition
| Fluid introduced in middle ear following a non-specific URI. Fluid collects and is a great environment for bacteria to grow. |
|
|
Term
| What are the Ssx of Acute otitis Media? |
|
Definition
| Fluid in middle ear, ear pain, red/bulging tympanic membrane, discharge, decreased hearing. Fever in kids. Tinitis |
|
|
Term
|
Definition
| Observation w/out Abx. Usually clears up on its own. |
|
|
Term
| What is the Dx of Recurrent Otitis Media? |
|
Definition
| More than 3 episodes of AOM. |
|
|
Term
| What commonly causes recurrent otitis media? |
|
Definition
| Strep pneumoniae, Hib, moraxella. |
|
|
Term
| What is the Rx for recurrent Otitis media? |
|
Definition
| high dose amoxicillin if you have a non-severe problem, high dose amoxicillin with clavulanic acid for severe symptoms. And in those cases where nothing works, it’s really completely refractory, then IM ceftriaxone is recommended. |
|
|
Term
| What are the Ssx of Chronic Otitis media? |
|
Definition
| Persistant, perforation of tympanic membrane, pus, can spread to bone, meninges, brain. |
|
|
Term
| What is the Rx for chronic otitis media? |
|
Definition
|
|
Term
| What are the Ssx of Mastoiditis? |
|
Definition
| Pus in mastoid air cells, increased pressure, abscess formation, pain , swelling, redness. Usually occur w/ AOM. |
|
|
Term
| What commonly causes mastoiditis? |
|
Definition
| Strep. pneumoniae, Hib, moraxella cat. |
|
|
Term
| What causes Pharyngitis/tonsilitis? |
|
Definition
Most are viral infections.
15% bacT: GAS, less common, GCS, GGS. |
|
|
Term
| When do ppl get pharyngitis/tonsilitis? |
|
Definition
BacT infections: Winter
Viral inf: summer, early fall |
|
|
Term
| What are the Ssx of a viral pharyngitis/tonsilitis? |
|
Definition
| not very severe, scratchy throat, not localized. If Adenovirus, will have conjuctivitis as well. If influenza virus: muscle aches, cough, more severe. If Coxsackie virus: small ulcers. |
|
|
Term
| What are the Ssx of a Bacterial pharyngitis/tonsilitis? |
|
Definition
| Group A strep: mild-severe pharyngeal pain, fever, chills, tonsils hypertrophy, cervical adenopathy, no sign of a "cold". Exudate on tonsils. Chance of developing Scarlet Fever. |
|
|
Term
| What are the Ssx of Scarlet Fever? |
|
Definition
| GAS: produces erythrogenic toxin that produce punctate rash that will peel off. "Slapped face look". White-red strawberry tongue. Can spread to inner ear, mastoid, to cause meningitis. |
|
|
Term
|
Definition
| Culture: gram +, Catalase -, beta-hemolytic, bacitracin sensitive. |
|
|
Term
|
Definition
| penicillin G, amoxycillin to prevent GAS sequellae. Symptoms: acetominophen, honey |
|
|
Term
| What are the Ssx of laryngitis? |
|
Definition
| hoarseness, change in pitch. in conjuction with rhinorrhea |
|
|
Term
|
Definition
Major cause: respiratory virus
BacT: GAS, mycobacterium tuberculosis (least common) |
|
|
Term
| What is the Rx for bacterial laryngitis? |
|
Definition
| GAS: penicillin, amoxycillin |
|
|
Term
| What commonly causes epiglottitis? |
|
Definition
|
|
Term
| What are the Ssx of epiglottis? |
|
Definition
| It is a cellutis of the epiglottis. Was commonly in kids, sore throat, fever, barking cough. Airway blockage and massive edema= medical emergency. |
|
|
Term
| How do you Dx epiglottitis? |
|
Definition
| Gram stain and X& V required. |
|
|
Term
| How do you Rx epiglottitis? |
|
Definition
| cephalosporin. Incidences have decreased because of conjugate vaccines. |
|
|
Term
| What causes bacterial sinusitis? |
|
Definition
| Sterp. pneumoniae, Hib , moraxella cat., MRSA. |
|
|
Term
| What are the Ssx of sinusitis? |
|
Definition
| Thick pirulent, discharge, long duration (>7 days). Inflammation, fluid, nasal congestion, fever. Rare cases spread and get orbital meningitis. Precursor usually a viral induced congestion that creates nice environment for bacteria. |
|
|
Term
|
Definition
| Most cases just observation w/out Abx. In severe cases treat with Abx. |
|
|
Term
| What are the Ssx of Diptheria? |
|
Definition
Due to intoxication
Initial: pharyngitis
Later: hoarse, nausea, low-grade fever. Psuedomembrane, respiratory obstruction, "Bull-neck Edema" if spread to lymph nodes. myocarditis, arrhythmia, heart failure if spread to blood. |
|
|
Term
|
Definition
| clinical presentations, the pseudomembrane |
|
|
Term
| What is the pseudomembrane in Diptheria? |
|
Definition
| white, fibrous, WBC and dead bacteria |
|
|
Term
| What is the Rx for Diptheria? |
|
Definition
| Erythromycin, DPT vaccine. |
|
|
Term
| What are the Ssx of pertussis? |
|
Definition
Due to intoxication:
Kids: "Whooping cough", nasopharyngeal area, irritation, coughing spasm, may cause blood vessles in eyes to burst, localized.
Adults: "100 day cough", persistant b/c causes damage to cells in airways, need those to be repaired therefore cycle continues. moderate--> severe cough, post cough vomit, crack ribs, urinary incontinence. Puck-Piss-Crack |
|
|
Term
| How do you prevent pertussis? |
|
Definition
| DPT vaccine, but it wears off by age 15 |
|
|
Term
|
Definition
|
|
Term
| What are the three types of bacterial acute pneumonia? |
|
Definition
1.acute community acquired
2.nosocomial (hospital acquired)
3.atypical pneumonia syndrome |
|
|
Term
|
Definition
|
|
Term
| What causes community acquired pneumonia? |
|
Definition
|
|
Term
|
Definition
| Common CAP: Strep pneumoniae, Hib, moraxella, MRSA. Rare: Klebsiella pneumoniae, Pseudomonas aerginosa (in cystic fibrosis patients), Legionella pneumophilia |
|
|
Term
| What are the general Ssx for Acute Pneumonia? |
|
Definition
| cough, sputum, rapid breathing, fatigue, sweats, head aches, muscle pain. 90% fever, increase pulse rate, consolidation in lungs ( distinguishes it from viral). |
|
|
Term
| How do you Dx Acute pnuemonia? |
|
Definition
Examine sputum: gram stain. perulent sputum = bacterial, lots of WBC. Rusty sprutum= alveolar tissue, suggests pneumococcus. Mucoid/red/gelatinous = current jelly sputum= Klebsiella.
Gram + and quellung rxn= Pnuemococcus.
Gram - rods+ Pseudomonas |
|
|
Term
| What causes the GI symptoms in bacterial pneumonia? |
|
Definition
|
|
Term
|
Definition
| A lot of Abx resistacnce, but try penicillin, if not quinolones or glycopeptide Abxs. Use multivalent- conjugate vaccines. They have 23 types pnuemoccus for adults, 7 for kids. |
|
|
Term
| What are the resik factors for acute nosocomial pneumonia? |
|
Definition
| >70 y/o, diabetes, COPD, alcoholism |
|
|
Term
| What usually causes nosocomial pnuemonia (HAP)? |
|
Definition
| 60% by aerobic gram - rods: Klebsiellan, Pseudomonas, E. coli. 13% by Staph aureus and S. puemoniae. |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What are the Ssx of atypical pneumonia? |
|
Definition
| milder, some cough ~fever, usually no sputum. |
|
|
Term
| How do you Dx atypical pneumonia? |
|
Definition
| Gram stain of sputum= WBC w/out bacteria |
|
|
Term
| What usually causes atypical pneuonia? |
|
Definition
| M. pneumoniae, C. pneumoniae, C. psittaci |
|
|
Term
| How do you Rx atypical pneumonia? |
|
Definition
| tetracycline or azithromycin |
|
|
Term
| What are the Ssx of Chlamydia psittaci? |
|
Definition
| Usually in birds, but in children it causes muscle aches, pains, non-productive cough, little sputum, usually an abrupt onset, chills, fever, fever can get high to 105, not usual though, or likely low grade fever and much more gradual onset |
|
|
Term
| How do you Dx Chlamydia psittaci? |
|
Definition
| A rising antibody titer, no. History of bird exposure. |
|
|
Term
| What are the ssx of C. pneumoniae? |
|
Definition
| includes throat infection, sinusitis, bronchitis, along with fever, non-productive cough, very few findings on auscultation |
|
|
Term
| What are the risk factors for getting atypical Legionella pneumonia? |
|
Definition
|
|
Term
| What is a subset of atypical Legionella pneumonia? |
|
Definition
|
|
Term
| What are the SSx of Pontiac fever? |
|
Definition
| fever, muscle pains and dry cough. |
|
|
Term
| How do you treat atypical Legionella pneumonia? |
|
Definition
|
|
Term
| What are the 2 types of chronic pneumonia? |
|
Definition
1. Ones that cause acute pneumonia: S. aureus, MRSA, Hemophilus influenza, Pseudomonas aeriginosa.
2. Myobacterium tuberculosis, Histoplasmosis, Blastomyces, Actinomyces, Cryptococcus neoformans |
|
|
Term
| What are non-specific symptoms of chronic pneumonias? |
|
Definition
| fever, chills, progressive anorexia, persistant cough, bloody sputum, shortness of breath, non-cardiac chest pain. |
|
|
Term
| What is the leading cause of death from bacterial infection? |
|
Definition
| Myocbacterium tuberculosis |
|
|
Term
|
Definition
| Multiple drug resistant tuberculosis |
|
|
Term
| What are the 2 phases of TB? |
|
Definition
primary pulmonary
post-primary |
|
|
Term
| What is the primary pulmonary phase of TB? |
|
Definition
| usually asymptomatic, ssx usually in kids w/ multi exposure, ssx diffuse, usually followed by spontaneous healing leaving a calcified lesion: Gohn lesion |
|
|
Term
| What are the SSx of primary pulmonary TB? |
|
Definition
| pleural infusions, cough, cavitation/necosis in immuno compromised or disseminate thru bloodstream |
|
|
Term
|
Definition
| 20% patients w/ primary pulmonary TB dev. it. it is a reactivation. Occur in upper lung lobes. Slight sputum to extensive necrotic cavitary disease. May get into blood and spread to organs |
|
|
Term
| Who is at risk of developing post primary TB? |
|
Definition
| Men >50 y/o, malnourished, alcoholics, drug addicts, elderly |
|
|
Term
| What are the SSx of post primary TB? |
|
Definition
| early: 20% asymtomatic, others fever, night sweats, weight loss, bloody sputum |
|
|
Term
| What is MDR TB resistant to? |
|
Definition
|
|
Term
| What is the Rx for typical TB? |
|
Definition
| isoniazid, rifampin, pyrazinamide, streptomycin. If resistant to 2, then MDR and use 5-6 drugs. therefore add ethambutol. |
|
|
Term
|
Definition
| Bacillus Calmette-Guerin, a live-attenuated vaccine made from mycobacterium bovis. It doesn't not kill the bug, it does not enhances antibody production. It enhances the formation of a granuloma leading to a tuberclec, confining the infection. |
|
|
Term
|
Definition
| extensively drug resistant TB |
|
|
Term
| What are lower urinary tract infections characterized by? |
|
Definition
| urethritis and cystitis (bladder infection). milder, superficial, easily treated empirically |
|
|
Term
| What are upper UTIs characterized by? |
|
Definition
| pyelonephritis, prostatitis, tissue invasion and possibly can go systemic. |
|
|
Term
|
Definition
| Community acquired cystitis |
|
|
Term
|
Definition
| uropathogenic E. coli w/ attachment pili specific for uroepithelial cells |
|
|
Term
| What are the 2 routes a UTI can occur? |
|
Definition
!. ascending infection via urethra->bladder->ureter->kidneys.
2. Hematogenous infection via bloode borne pathogen |
|
|
Term
| What is most likely to cause a hematogenous UTI? |
|
Definition
| S. aureus, Pseudomonas, Myocobacterium tuberculosis |
|
|
Term
| What are the SSx of a lower UTI? |
|
Definition
1. kids <2 y/o: non-specific fever, nausea, vomiting
2.>2 y/o: localized, urinary frequency, dysuria, flank pain
3. adults: frequent painful urination, cloudy/pink urine (hematuria), suprapubic pain/tenderness, NO FEVER! |
|
|
Term
| What are the Ssx of pyelonephritis |
|
Definition
| Fever, shaking, chills, loin/lower back pain, and frequently have ssx of a lower UTI. |
|
|
Term
| What are the Ssx of pyelonephritis in elderly people? |
|
Definition
| Atypical: fever, abdominal pain, mental status change. Must be carefully that infection does go to blood and turn into sepsis. |
|
|
Term
| What causes pyelonephritis? |
|
Definition
!. CA: E.coli (90%), Staph saprophyticus (10-15% in young women). Klebsiella, Enterobacter, Proteus (usually in males)
2. Nosocomial: Enterococcus, Staph epidermidis, , Pseudomonas. |
|
|
Term
| How do you differentiate between the CA and nosocomial UTI agents? |
|
Definition
| nosocomial: catheterized patients, gram (-) Rod= Pseudomonas, Gram (+) Cocci catalase (+) = Epidermidis, catalase (-) = Enterococcus. |
|
|
Term
| What is Candida albicans? |
|
Definition
| Fungus that causes UTI in catheterized patients. |
|
|
Term
| What is the percentage that E. coli is the UTI agent? |
|
Definition
CA: 80-90%
nosocomial: 40% |
|
|
Term
| How do you RX a non-complicated CA UTI? |
|
Definition
| Trimethoprim-Sulfomethoxazole (TMP-SMX) of Bactrim or Septra for E. coli infection. |
|
|
Term
| What is a complicated UTI? |
|
Definition
| In patients who have a structural of functional abnormality in the genitounrinary tract. Ex: ppl with kidney transplants, neurologic bladde dysfunction, kidney stones, diabetics, pregnant, elderly |
|
|
Term
| How do you Rx a complicated UTI? |
|
Definition
|
|
Term
|
Definition
1.Pyuria (WBC in urine, >10/cubic mm)(may be presetn w/o UTI),
2.hematuria (30-60% of UTIs)
3. Proteinuria: increase protein in urine (>3 g/24 hrs)
4. gram stain (100,000/ml urine= UTI)
5. urine nitrite test |
|
|
Term
| What are the route for acquiring prostatitis? |
|
Definition
1. Hematogenous
2. ascending infection |
|
|
Term
| What are the 2 types of prostatitis? |
|
Definition
|
|
Term
| What are the common agents of acute prostatitis? |
|
Definition
1. E. coli
2. gonorrhea
3. Staph aureus (hematogenously or contiguously)
4. Pseudomonas(hematogenously or contiguously) |
|
|
Term
| What are the SSx of acute prostatitis? |
|
Definition
| inflammation of the gland, infiltration of PMNs, edema, hyperemia of local stroma, fever, chills, perineal pain, back pain, tender when palpated |
|
|
Term
| What are the common agents of chronic prostatitis? |
|
Definition
1. E. coli
2. Klebsiella
3. Proteus
4. Enterococcus |
|
|
Term
| What are the Ssx of chronic prostatitis? |
|
Definition
| Perineal discomfort, low back pain, urinary frequency, dyuria, enlarged prostate. |
|
|
Term
| What is the problem with Rx prostatitis? |
|
Definition
| Not many abx that can diffuse into the prostate |
|
|
Term
| How do you Rx chronic prostatitis? |
|
Definition
| TMP:SMX, floroquinolone drugs for 4-6 weeks. DON'T use beta-lactams, can't penetrate prostate |
|
|
Term
|
Definition
| non-UTI renal infection caused by Leptospria interrogans |
|
|
Term
| How do you acquire Leptospria interrogans? |
|
Definition
| Penetrates mucus membrane, thru broken skin, ingested with contaminated water (RAT PISS). |
|
|
Term
| What are the SSx of leptosprirosis? |
|
Definition
!. Phase I: nonspecific flu-like ssx: fever, headache, nausea, musclce ahces/pains, vomit diarrhea.
2. Phase 2: in small bld vessels: meningitis, hepatic dysfunction, renal dysfunction, small bld vessel occulsion (especially in kidney, can cause lesions |
|
|
Term
|
Definition
| jaundice caused by leptosprirosis. Icteric, hemorrhagic conjuntiva. 10% mortality due to occulsion of renal bld vessels |
|
|
Term
| How do you Dx leptospirosis? |
|
Definition
| Immunoflorescence, dark field microscopy, PCR |
|
|
Term
| How do you Rx leptospirosis? |
|
Definition
mild cases: doxycycline
severe cases: IV of cillins (PCN) |
|
|
Term
| How does Mycobacterium TB infect the kidneys? |
|
Definition
| Gets into bloodstream during caseation, sets up metastatic phosive infection in kidneys, forms granulomatic lesions on kidney and collecting ducts, granulomas slowly replace ctive tissue, lose function--> RENAL FAILURE |
|
|
Term
| How do you DX a Mycobacterium TB renal infection? |
|
Definition
!. patient has pulmonary infection too,
2. Acid fast stains |
|
|
Term
| How do you Rx a Mycobacterium TB renal infection? |
|
Definition
|
|
Term
| What is post-streptococcal glomerular nephritis? |
|
Definition
| Occurs a month-month and a half after pharyngitis, or skin infection.Involves nephrotogenic strains of M Typse 12 and 49. Autoimmune reaction in basement membrane--> inflammatory process--> deposition of antigen binding complexes on glomeruli--> obstruction of kidney blood flow. |
|
|
Term
| What are the Ssx of post-streptococcal glomerular nephritis? |
|
Definition
| Rapid onset: fever, loin pain, edema, puffy face/feet, oliguria, increase protein urine, no bacT in urine! |
|
|
Term
| How do you Rx post-streptococcal glomerular nephritis? |
|
Definition
| Treat the strep infection that led up to it. |
|
|
Term
|
Definition
| Hemolytic Uremic Syndrome: life threatening, from a GI infection that leads to acute renal failure. |
|
|
Term
| What are the common agents of HUS? |
|
Definition
|
|
Term
| What must the agents of HUS have to cause this infection? |
|
Definition
|
|
Term
|
Definition
| Severe anemia (TTP: thrombotic thrombocytopenic purpura), eventualy renal failure. |
|
|
Term
|
Definition
| Colitis phase of GI infection, taxin absorbed thru mucosa, carried to renal tissue via RBCs, bind to renal tissue, glomeruli swell, fibrin and platelets accumulate in microvasculature--> RENAL FAILURE |
|
|
Term
|
Definition
| Supportive treatment b/c don't want more toxin produced |
|
|
Term
| How do you distinguish EHEC and 0157h7 from other E. col? |
|
Definition
| They are NEGTIVE SORBITOL |
|
|
Term
|
Definition
| Passage of an abnormally liquid or unformed stool |
|
|
Term
| What are the most common debilitating infectious diseases that people suffer from ? |
|
Definition
| Non-specific URI and GI infections |
|
|
Term
| What GI infection agents are associated with chicken? |
|
Definition
| Salmonella, Campylobacter, Shigella |
|
|
Term
| What GI infection agents are associated with beef? |
|
Definition
|
|
Term
| What GI infection agents are associated with mayonnaise or creams? |
|
Definition
|
|
Term
| What GI infection agents are associated with eggs? |
|
Definition
|
|
Term
| What GI infection agents are associated with seafood? |
|
Definition
| Vibrio, salmonella, Hepatitis A virus |
|
|
Term
| What GI infection agents are associated with daycare setting? |
|
Definition
|
|
Term
| What GI infection agents are associated with elderly ppl or in nosocomial setting? |
|
Definition
|
|
Term
| What does ETEC stand for? |
|
Definition
|
|
Term
| What does EPEC stand for? |
|
Definition
|
|
Term
| WHat does EAgg stand for? |
|
Definition
| Enteroaggregative E. coli |
|
|
Term
| How do GI infectious agents attack the body? |
|
Definition
1.INFLAMMATORY: Attach with pili then invade the enterocytes
OR
2. NON-INFLAMMATORY: Attach to cell and produce toxins that directly damage the mucosa or do something that causes an increase in intestinal secretions. |
|
|
Term
| What are the characteristics of NOn-inflammatory diarrheas? |
|
Definition
| watery, voluminous, occurring in small bowel, direct result of enterotoxin. The bug colonizes the epithelial cells, no fever, no bacteremia |
|
|
Term
| What are the characteristics of inflammatory diarrhea? |
|
Definition
| Occurs in large bowel, involving invasion of the mucosa. |
|
|
Term
| What is a penetrating GI infection? |
|
Definition
| Invade local mucosa and become systemic via the small bowel and move to the blood. Ex: Typhoid fever |
|
|
Term
| Which class of GI infection is the most common? |
|
Definition
|
|
Term
| What are the common agents of non-inflammatory diarrhea? |
|
Definition
| EPEC, ETEC (75% of traveler's diarrhea), Vibrio cholera. |
|
|
Term
| What are the Ssx of EPEC? |
|
Definition
| In children: non-inflammatory diarrhea, yellow-green watery stools. Poor feeding, dehydration. NO mucus, pus or blood. |
|
|
Term
| What are the Ssx of ETEC? |
|
Definition
| 5-15 days for onset. Therefore show SSx when the get home. Anorexia, cramps, sudden watery diarrhea, NO pus, blood, or inflammatory cells |
|
|
Term
| What happens to children that have ETEC in endemic areas? |
|
Definition
| If <3 y/o, they tend to have chronic diarrhea. If >4 y/o then kids have more of a resistance to it. |
|
|
Term
| What toxins are associated with ETEC? |
|
Definition
| enterotoxins: ST and or LT toxins |
|
|
Term
|
Definition
| Large inoculum of 10^6- 10^10 from contaminated food or water. Not common in USA. |
|
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Term
| How is Vibrio cholera acquired? |
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Definition
| Thru water, colonize sm. intestine, produce enterotoxin CHOLERAGEN. |
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Term
| What are the Ssx of Vibrio cholera? |
|
Definition
| 1-2 day incubation. Sudden painless effortless diarrhea. RICE WATER DIARRHEA w/ flecks of epithelial cells and bacT, and WBCs. Slightly sweet smell. Marked dehydration, electrolyte loss, muscle cramps, occassional vomiting, HYPOVOLEMIC SHOCK, metabolic acidosis |
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Term
| What are the characteristics of inflammatory diarrhea? |
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Definition
| invasive/cytotoxic strains acting on colonic mucosa, lower ileum, diarrhea w/ WBC, RBC, painful straing-->Tenesmus, low inoculum (10-100 bugs), hypersecretion b/c of malabsportion of fluids |
|
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Term
| What commonly causes inflammatory diarrhea? |
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Definition
| EIEC, shigella, some salmonellas, campylobacter, yersinia |
|
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Term
| What is the leading cause of bacterial diarrhea? |
|
Definition
|
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Term
| What are the Ssx of Campylobacter jejuni? |
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Definition
| abdominal pain, fever, acute inflammatory enteritis, watery diarrhea to severe dysentery w/ blood/pus, self-limiting , 3-5 days |
|
|
Term
| What sequelae are associated w/ campylobacter jejuni? |
|
Definition
| Reactive arthritis, Guillain-Barre syndrome, Miller Fisher variant of Guillain-Barre syndrome |
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Term
| What is Guillain-Barre syndrome? |
|
Definition
| cross-reacting antibodies from campylobacter jejuni, probably LPS that are similar to antigenic determinants nerve ganglioside therefore tearing up nerve gangliosides |
|
|
Term
| How do you acquire campylobacter? |
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Definition
| ingestion of contaminated water, cow milk, uncooked meat (poultry) |
|
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Term
| How do you Dx campylobacter? |
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Definition
| Gram stain, Wright stain of fecal smear--> GULL-WING SHAPE!! |
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Term
| What are the differential Dx for campylobacter? |
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Definition
| salmonella, shigella, E. coli b/c all gram (-) rods, rememer campy has GULL-WING |
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Term
| What are the micro characteristics of shigella? |
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Definition
| gram (-) rods, non-motile, does not ferment lactose, does not make H2S |
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Term
| What are the Ssx of Shigella sonnei? |
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Definition
| in USA, bacillary dysentery, fever (1 day), brief watery diarrhea, then dysentery, abdominal cramps, tenesmus, does not spread to enteric tract, incubation 1-2 days, subside in 7 days |
|
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Term
| Which bug produces Ssx similar to shigella? |
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Definition
|
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Term
|
Definition
| penetrates the epithelial cells of the colon, then invades local cells, destroys them, then moving beyond mucosa. The only intestinal E. coli that invades beyond the mucosa. resembles shigella in its pathogenic mechanism |
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Term
| Where do you tend to see EIEC? |
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Definition
| In travelers from endemic areas, some food outbreaks |
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|
Term
| What are the Ssx of EPEC in adults? |
|
Definition
| inflammatory diarrhea, ulcerative colitis, toxin not involved |
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Term
|
Definition
| attch w/ pili, get clusters of colonies--> make attachment-effacement lesions: A-E lesions--> disrupt normal absorption |
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Term
| What are the Ssx of EAggEC? |
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Definition
| intestinal inflammation w/ diarrhea, more common in industrialized countries |
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Term
|
Definition
| histo slide shows the bacT is stacked like bricks on top of the enterocytes |
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Term
| What are the Ssx of EHEC? |
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Definition
| diarrhea, hemorrhagic colitis, can cause HUS. SSx related to shiga-like toxin |
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|
Term
| What toxin does EHEC produce? |
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Definition
|
|
Term
| Which GI pathogen is found in ppl and hooved animals? |
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Definition
|
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Term
| What are the Ssx of E. coli 0157H7? |
|
Definition
incubation 2-4 days, Initial phase: watery diarrhea 24 hrs
Later phase: profuse bloody diarrhea, hemorrhagic colitis, abdominal pain, NO FEVER.
Self limiting in immunocompetent b/t 5-60 y/o |
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|
Term
| Where is EHEC commonly acquired from? |
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Definition
| undercooked hamburger meat, alfalfa sprouts, unpasteurized fruit juice, salami, lettuce, game meat, cheese curds, raw milk, apple cider |
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Term
| How do you distinguish EHEC from other E. coli? |
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Definition
| EHEC is unable to ferment sorbitol on MacConkey agar. It also contains Shiga-like toxin-->test for toxin or gene |
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Term
| What are hte Ssx of hemorrhagic colitis syndrome? |
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Definition
| copious bloody diarrhea, severe cramping, no fever. self-limiting in immunocompetent (7-10 days) |
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Term
| How do you distinguish salmonella from E. coli? From Shigella? |
|
Definition
1. Lactose (-)
2. don't produce H2S |
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Term
| What are the two types of Salmonella? |
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Definition
| Typhoidal and non-typhoidal (more common in US) |
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Term
| What are the Ssx of non-typhoidal salmonella? |
|
Definition
| Incubation 1-2 days, gastroenteritis (similar to campylobacter, shigella, E. coli), abdominal cramping, watery-->bloody stool-->inflammatory stool |
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Term
| What other complication are associated with the elderly w/ Salmonellosis? |
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Definition
| Sudden loss of fluids--> cardiac problems-->stroke |
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Term
| What kind of condition is given to salmonella bacteremia following a GI infection? |
|
Definition
| Ppl w/ sickle cell anemia |
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|
Term
| What are the Ssx of Vibrio parahaemolyticus? |
|
Definition
From seafood.
watery diarrhea, abdominal pain, vomit, fever |
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|
Term
| What are the risk factors for acquiring Vibrio vulnificus? |
|
Definition
| Immunocompromised, liver ds. b/c have elevated ferritin levels |
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Term
| What are the Ssx of Vibrio vulnificus? |
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Definition
| simple gastroenteritis, diarrhea, nausea, vomiting. |
|
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Term
| What 2 was can you acquire Vibrio vulnificus? |
|
Definition
!. wound infection at seashore that spread to GI
2. wound infection at sea (non-GI)
**these can go septic and be very fatal! |
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Term
| How can Clostridium difficile reach high concentration in GI tract? |
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Definition
| Normally in the GI tract, but following Abx treatment, resistant C. difficle can grow to large number and produce higher concentrations of cytotoxins and enterotoxins, therefore showing Ssx |
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Term
| What Abx cause increase risk in high concentrations of C. difficile in the GI tract? |
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Definition
| Fluoroquinolones. therefore avoid treating hospitalized patients w/ these drugs so there is not a colonization |
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Term
| What causes a large colonization of C. difficile in the community? |
|
Definition
Use of: 1. PPIs (proton-pump-inhibitors)--> lowers gastric acidity.
2. H2 receptor antagonists
3. NSAIDS |
|
|
Term
| What is the pseudomembrane in pseudomembranous collitis composed of? |
|
Definition
| Plaques coalescing of fibrin, leukocytes, necrotic colonic tissue |
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|
Term
| What are the Ssx of nosocomial C. difficile? |
|
Definition
| diarrhea, abdominal pain, fever, electrolyte imbalance, possibly pseudomembranous colitis |
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Term
| Who is at high risk for developing C. difficile in the hospital? |
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Definition
| Elderly suffering from respiratory or renal infection. Look for an elderly patient w/ pneumonia that developes diarrhea after Abx treatment |
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Term
| How can you Dx C. difficile (nosocomial)? |
|
Definition
| Endoscopy for colon plaques, if patient elderly, on Abx w/ diarrhea, lastly look for the toxin |
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|
Term
| What is the leading agent of food poisoning? |
|
Definition
|
|
Term
| Which foods does Staph aureus tend to infect? |
|
Definition
| high protein foods, custard, processed meats, potato salad, canned foods, things w/ mayo, ice cream, milk products. The S. aureus is usually shed onto the food, it is not hte food itself. S. aureus likes high protein foods because it grows in it. Grow at room temperature |
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Term
| What are the Ssx of food poisoning caused by S. aureus? |
|
Definition
| abrupt onset (30 min), period of intense salivation, nausea, vomiting, mild diarrhea. NO RASH, NO FEVER |
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Term
| What are the two forms of Bacillus cereus? |
|
Definition
1. Emetic: more likely, associated w/ fried rice,emetic toxin is HEAT STABLE (makes it more common), toxin similar to S. aureus enterotoxin.
2. Diarrheal form: not heat stable |
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Term
| What are the Ssx of Clostridium botulinum food poisoning? |
|
Definition
| 4 sps that produce a NEUROTOXIN. onset 12 hrs-3 days, toxin usually preformed (except in infant botulism), some GI ssx --> nausea, maybe diarrhea--> dry mouth, blurred vision, dilated pupils, muscle weakness-->paralysis. Fatal if effect respiratory muscles--> closed glottis, diaphragm not moving |
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|
Term
|
Definition
| based on outbreaks, anaerobic cultures, ELISA tst for toxin, good Hx of food eaten and test that food. |
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|
Term
| What are the Ssx of Clostridium perfringens food poisoning? |
|
Definition
| similar to S. aureus enterotoxin. diarrhea, abdominal cramps, rarely nausea/vomit |
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|
Term
| Who put forth the idea that H. pylori causes gastric ulcers? |
|
Definition
|
|
Term
| What is Helibacter pylori considered to be a risk factor for? |
|
Definition
| Peptic ulcers, gastric carcinoma, gastric MALT lymphoma |
|
|
Term
| What are the Ssx of a H. pylori infection? |
|
Definition
1. Primary:asymptomatic or 2 wks abdominal pain and mild nausea
2. Later: yrs later gastritis, peptic ulcer, duodenal ulcer, might present perforation, abdominal pain, nausea, vomiting / or w/o blood, weight loss, maybe chest pain |
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|
Term
| H. pylori etiologies are frequently associated with taking what? |
|
Definition
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|
Term
|
Definition
1. Invasive test: endoscopic biopsy, streak on medium , look for color change in a UREASE TEST--> high level indicate bug. Or do histological test noting degree of inflammation of stomach cells, atrophy, dyplasia
2. Non-invasive tests: serology for IgG w/ ELISA test ( not very sensitive)or 13C urea breath test (better), drink urea, if hydrolyzed you breath out C13 CO2, 13 C CO2 or radioactive CO2. Stool antigen test too. |
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|
Term
|
Definition
1. Quadruple therapy: bismuth (pepto-bismol), metronidazole, tetracycline, PPI (omeprazole or pantoprazole)
2.Triple therapy: PPI, amoxicillin, clarithromycin
3. Sequential therapy: omeprazole and amoxicillin for 5 days, then omeprazole, clarithromycin, and tinidazole for 5 days. |
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|
Term
| What causes Typoid or Enteric Fever? |
|
Definition
| Salmonella enterica, subspecies typi, paratyphi A or B |
|
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Term
| What is the mechanism disease for Typoid Fever? |
|
Definition
| Ingested, pass thru stomach to small bowel, starts growing-->get picked up by intestinal lymphoidal tissue via the phagocytes, which are killed by the bug, then disseminate to blood from lymphatics |
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|
Term
| What are the ssx of Typhoid Fever? |
|
Definition
| some diarrhea, maybe constipation, abdominal cramping, FEVER, head ache, , rose spot rash. Can lead to sepsis |
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Term
| How do you Dx typhoid fever? |
|
Definition
| Based on Sssx, travel history, culture blood, stool. Look for Gram (-) Rods, lactose (-), motile, make H2S in TSI agar. Can ID using antiserum |
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|
Term
| What are the most common causes of acute skin infection? |
|
Definition
| Staph aureus, Strep pyogenes, Corynebacterium minutissimum, Pseudomonas |
|
|
Term
| What are the Ssx of skin disease |
|
Definition
| erythema, edema, maybe local accumulation of pus/fluid, or maybe scaling |
|
|
Term
| What are the 2 forms of impetigo? |
|
Definition
|
|
Term
| What causes non-bullous impetigo? |
|
Definition
| Mainly GAS and also S. aureus |
|
|
Term
| How does non-bullous impetigo develop? |
|
Definition
| The GAS or S. aureus that normally colonizes the skin is introduced to the superficial epithelial layer due to trauma (scratch, cut, etc) |
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Term
| What are the Ssx of non-bullous impetigo? |
|
Definition
| Found in young children on face, legs. Small red papules that become pustules. No fever, painless lesions. Scratching lesions spread it. |
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|
Term
| In some cases, what can a GAS non-bullous impetigo infection lead to? |
|
Definition
| Acute glomerular nephritis and acute rheumatic fever. |
|
|
Term
| What causes bullous impetigo? |
|
Definition
|
|
Term
| Why doesn't GAS cause bullous impetigo? |
|
Definition
| Because S. aureus produces a bacteriocin that inhibits GAS growth. |
|
|
Term
| What are the ssx of bullous impetigo? |
|
Definition
| similar to SSSS, fluid filled lesions that form blisters. |
|
|
Term
|
Definition
| Staphylococcal scalded skin syndrome |
|
|
Term
| What toxin does both bullous impetigo and SSSS involve? |
|
Definition
|
|
Term
| What is the mechanism of SSS? |
|
Definition
| S. aureus producing exfoliative toxin and it gets into the bloodstream, carried thru body,-->blisters the skin |
|
|
Term
| What are the Ssx of SSSS? |
|
Definition
| Usually in kids, abrupt onset of fever, skin tenderness where bullae are,rash, positive Nikolsky sign. |
|
|
Term
| What causes folliculitis? |
|
Definition
| 1. S. aureus 2. GAS 3. E. coli 4. Pseudomonas (in eye, HOT TUBS, POOLS!!) |
|
|
Term
| What are the Ssx of folliculitis? |
|
Definition
| Origin is hair follicle, painful, reddish papule/pustule. Could be groups of infected follicles. Common on scalp, extremeties |
|
|
Term
| What is the precursor infection to a furuncle/boil? |
|
Definition
|
|
Term
| What causes furunculosis or carbunculosis? |
|
Definition
| Untreated folliculitis, S. aureus |
|
|
Term
| What are the ssx of furunculosis? |
|
Definition
| On face, back of neck, axilla (especially hairy regions). Painful red nodule, raised, indurates, thickened base, yellowish center, creamy purulent discharge, maybe satillite regions |
|
|
Term
| What are the Ssx of carbunculosis? |
|
Definition
| Coalescence of furuncles. Can spread through inelastic tissue. Mainly in males on the neck. Multi sinus channels |
|
|
Term
| What commonly causes carbunculosis? |
|
Definition
|
|
Term
| What are the Ssx of erythrasma? |
|
Definition
| Slow incubating reddish-brown lesion in patches, especially in pubic area, toe webs, groin, axilla. Irregular patches, scaly, long lasting. Common in male diabetics, obese |
|
|
Term
|
Definition
| Corynebacterium minutissimum |
|
|
Term
| How do you Dx erythrasma? |
|
Definition
| Wood's lamp-->red coral fluorescent color to distinguish it from fungus. Culture--> gram (+) , non-spore forming |
|
|
Term
| What is the primary agent of erysipelas? |
|
Definition
| GAS. could be co-infeccted w/ S. aureus |
|
|
Term
| What are the Ssx of erysipelas? |
|
Definition
| It is a type of cellulitis. abrupt spreading rash, red, raised margin especially around nasal fold, painful swelling, maybe blisters, fever, bright red skin |
|
|
Term
|
Definition
| GAS, S. aureus, sometimes Pseudomonas, if trauma maybe Vibrio vulnificus |
|
|
Term
| What are the Ssx of cellulitis? |
|
Definition
| Involves deeper dermal tissue, usually results from penetrating injury. GAS if occurs where lymphatic drainage ahs been disturbed, showing lymphangitis. Common in lower limbs, local pain, tenderness, swelling |
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