Term
| Name the layers of infection from skin to bone. |
|
Definition
| impetigo, erysipelas, cellulitis, fasciitis, myositis, osteomyelitis |
|
|
Term
| 2 common causes of cellulitis? |
|
Definition
| S. aureus and S. pyogenes (GAS) |
|
|
Term
| Cause of cellulitis in pts with diabetes? |
|
Definition
|
|
Term
| Who gets a pseudomonas cellulitis? |
|
Definition
| netropenics, diabetics, steroid use, water exposure |
|
|
Term
| Liver disease will make you susceptible to what kinds of infections? |
|
Definition
| Neisseria b/c of complement deficiency and V. vulnificans because of increased iron |
|
|
Term
| What mycobacterium is acquired from exposure to water? |
|
Definition
|
|
Term
| T/F You can get toxic shock from a VZV infection. |
|
Definition
|
|
Term
| What are the endemic fungi that can cause ulcers? |
|
Definition
| blastomyces, crytococcus, and histoplasma |
|
|
Term
| Blood cultures are often contaminated with... |
|
Definition
|
|
Term
| Likely cause of celulitis d/t trauma in brakish water in the summertime? |
|
Definition
|
|
Term
| T/F Yersinia enterolytica is an iron lover. |
|
Definition
|
|
Term
| What is a cause of cellulitis in Crohn's disease? |
|
Definition
| gram negative organisms and anaerobes |
|
|
Term
| Lupus or complement deficiency can predispose you to a cellulitis caused by... |
|
Definition
| S. pneumoniae (in lupus, necrotizing fasciitis is more common than S. pneumo) |
|
|
Term
| IUD with chronic pelvic abscess is likely d/t... |
|
Definition
|
|
Term
| Complement deficiency puts you at risk for infection with... |
|
Definition
| neisseria and encapsulated bacteria |
|
|
Term
| Sun burn rash is a ____ mediated phenomena. |
|
Definition
|
|
Term
| Exposure to conga drums put you at risk for... |
|
Definition
|
|
Term
| Treat cellulitis empirically with.. |
|
Definition
| vancomycin + clindamycin because vanc will increase the amount of toxin (Daptomycin or linezolid would work) |
|
|
Term
| What are the pros and cons of treating cellulitis with TMP/SMX? |
|
Definition
| can tx MRSA and MSSA but not strep |
|
|
Term
|
Definition
| determine susceptibility to clindamycin |
|
|
Term
| Cellulitis is toxin mediated so you should treat it with antibioitcs that.. |
|
Definition
| .inhibit ribosomes (clindamycin and linezolid) |
|
|
Term
| Why is Daptomycin particularly good for cellulitis? |
|
Definition
| kills organism quickly to decrease the amount of toxin produced |
|
|
Term
| Staph can be differentiated from Strep infection clinically by... |
|
Definition
| presence of abscesses is characteristic of staph infeciton |
|
|
Term
| What is the gold standard treatment for strep cellulitis? |
|
Definition
| Penicillin V or amoxicillin or 1st generationo cephalosporin (ceftalaxin + anti-MRSA) |
|
|
Term
|
Definition
| prevents being killed by ROS |
|
|
Term
| What is the most important mode of transmission for GAS? |
|
Definition
| droplet transmission from nasopharnyx (also peuperal fever from not washing hands) |
|
|
Term
| What type of pneumonia has a high incidence of peluritic chest pain? |
|
Definition
|
|
Term
| T/F Empyemas are common in GAS pneumonia. |
|
Definition
|
|
Term
| What is the MC GAS infection? |
|
Definition
|
|
Term
| What is the most common precursor to GAS bacteremia? |
|
Definition
| skin/soft tissue infection |
|
|
Term
| What is the most common precursor to GAS bacteremia? |
|
Definition
| skin/soft tissue infection |
|
|
Term
| What is the most common precursor to GAS bacteremia? |
|
Definition
| skin/soft tissue infection |
|
|
Term
| What is the most common precursor to GAS bacteremia? |
|
Definition
| skin/soft tissue infection |
|
|
Term
| GAS in urine means the patient also has... |
|
Definition
| bacteremia (hematogenous spread is the only way GAS gets to the UT) |
|
|
Term
| What are the symptoms/signs associated with Scarlet fever? |
|
Definition
| strawberry tongue, circumoral pallor, desquamation of skin during healing and sore throat |
|
|
Term
| T/F Scarlet fever can present with a papulovesicular rash. |
|
Definition
| false erythema marginatum is not vesicular |
|
|
Term
| What type of GAS infection will more likely predispose you to PSGN over ARF? |
|
Definition
|
|
Term
| T?F Serious GAS infection should be treated with penicillin. |
|
Definition
|
|
Term
| T/F Doxycycline has poor strep coverage. |
|
Definition
|
|
Term
| Where is the most important reservoir for asymptomatic carriage of s. aureus? |
|
Definition
|
|
Term
| What is the most important mode of transmission of S. aureus? |
|
Definition
| direct person to person contact |
|
|
Term
| What types of precautions must be taken with GAS to prevent transmission? |
|
Definition
|
|
Term
| How is N. meningitidis transmitted? |
|
Definition
|
|
Term
| T/F It is possible to transmit S. Aureus via sexual intercourse. |
|
Definition
|
|
Term
| Does S. aureus cause pharyngitis? meningitis? |
|
Definition
| NOT pharyngitis, meningitis is uncommon |
|
|
Term
| 50% of osteomyelitis is caused by... |
|
Definition
|
|
Term
| What are the 2 MC organisms of IE? |
|
Definition
| S. aureus and viridans strep |
|
|
Term
| What are some symptoms of staph TSS? |
|
Definition
| V/D at onset, desquamation of palms and soles, hyperemia of mucous membranes, thrombocytopenia |
|
|
Term
| You are unlikely to have (+) blood cultures if you have ___ TSS. |
|
Definition
|
|
Term
| What are the laboratory findings of staph TSS? |
|
Definition
| azotemia, increased CK ( d/t rhabdomyolysis), pyuria and thrombocytopenia |
|
|
Term
| Staph TSS disease is not invasive but causes systemic diases by the way of... |
|
Definition
|
|
Term
| Can you get a positive blood culture in a patient with TSS? |
|
Definition
| staph is usually negative (toxemia) but strep is usually positive (like in necrotizing fasciitis) |
|
|
Term
|
Definition
|
|
Term
| Agammaglobulinemia puts you at risk for infection with.. |
|
Definition
| extracellular encapsulated bacteria |
|
|
Term
| Hyper IgE (Job's syndrome) puts you at risk for what kind of infection? |
|
Definition
| recurrent staph infection |
|
|
Term
|
Definition
| S. viridans and S. aureus, S. lugdenensis, HACEK (haemophilus, aggregatibacter, cardiobacterium, Eikenella, Kingella) |
|
|
Term
| What mycobacteria can cause IE? |
|
Definition
| atypical and fast growing ones like M. fortuitum |
|
|
Term
| What is the emperic treatment for IE? |
|
Definition
| vancomycin for 4-6 weeks + aminoglycoside |
|
|
Term
| What bacteria cause sinusitis? |
|
Definition
| S. pneumo, H. flu, other haemophilus, M. Catarrhalis, GAS, S. aureus, anaerobes |
|
|
Term
| What is pott's puffy tumor? |
|
Definition
| pus infection breaks into orbit and eye pops out |
|
|
Term
| When is it appropriate to use antibiotics for a respiratory tract infection? |
|
Definition
| if symptoms last for more than 7 days you are increasing the cure rate from 60-80% |
|
|
Term
| What antibiotics do you give for sinusitis? |
|
Definition
| high doses of amoxicillin |
|
|
Term
| What common organism is not covered by standard antibiotic tx for sinusitis? |
|
Definition
| M. Catarrhalis (produces a beta lactamase) |
|
|
Term
| If amoxicillin doesn't treat sinusitis switch to a... |
|
Definition
| macrolide or beta lactam inhibitor combo like augmentin (amoxicillin + clavulanate) |
|
|
Term
| What would you use for a pseudomonas sinusitis infection? |
|
Definition
| piperacillin or tazobactam |
|
|
Term
| Different microscopy of aspergillus and zygomyces? |
|
Definition
aspergillus= septate hyphae with acute angle branching (tx with voriconazole)
zygomyces= nonseptate hyphae with 90 degree branching (Tx with amphotericin B) |
|
|
Term
| Chronic means the infection has lasted for more than... |
|
Definition
|
|
Term
| What causes a necrotizing pneumonia? |
|
Definition
| pseudomonas, S. aureus, Klebsiella |
|
|
Term
|
Definition
| allergic bronchopulmonary aspergillosis |
|
|
Term
| Bacteria from Winn DIxie produce misters= |
|
Definition
|
|
Term
| T/F COxiella is associated with a rash. |
|
Definition
|
|
Term
| What causes a pulmonary meningitis syndrome? |
|
Definition
| S. pneumo, H. influenzae, and legionella |
|
|
Term
| What is a major symptome of tularemia? |
|
Definition
|
|
Term
| What are the most common causes of pneumonia? |
|
Definition
| mycoplasma, chlamydia, S. pneumo, H. flu, M cat and legionella |
|
|
Term
| What is the necrotizing pneumonia you get from eating raw crawfish? |
|
Definition
|
|
Term
| Proton pump inhibitor can increase you risk of what nonGI infection? |
|
Definition
|
|
Term
| Smokers have an increase risk of pneumonia by what specific organism/ |
|
Definition
|
|
Term
| What are the causes of community acquired pneumonia? |
|
Definition
| S. pneumo, mycoplasma, and chlamydia |
|
|
Term
| How do you treat legionella? |
|
Definition
| moxifloxacin IV, azithromycin + ceftriazone |
|
|
Term
| What are bacterial causes of encephalitis? |
|
Definition
| S. pneumo, H. influenzae, Listeria, N. meningitidis, gram negative enteric |
|
|
Term
| What are the advantages to treating encephalitis with ceftriaxone? |
|
Definition
| CSF penetration, covers H. flu, N. men and most penicillin resitant pneumococci (but NOT LISTERIA which is why you add amphicillin) Also could use vancomycin to cover penicillin resistant pneumococci |
|
|
Term
| Which organisms are common causes of diarrhea in HIV patients? |
|
Definition
| cryptosporidium, salmonella |
|
|
Term
| Name some toxin mediated causes of diarrhea? |
|
Definition
| B. cereus, C. difficile, S. aureus |
|
|
Term
| What are some causes of diarrhea that require the actuall presence of the bacteria (not just toxin)? |
|
Definition
| V. choelra, shigella, salmonella, campylobacter, H. pylori, ETEC, EHEC< EIEC, EAggEC, MTB, MAC, Yersinia, Plesiomonas, aeromonas |
|
|
Term
| How sensitive is the stool culture for routine pathogens? |
|
Definition
|
|
Term
| What are the GIroutine pathogens? |
|
Definition
| shigella, salmonella, campylobacter, yersinia and EHEC |
|
|
Term
|
Definition
| metronidazole (vanc if severe) |
|
|
Term
| What is the MC cause of diarrhea in day care workers? |
|
Definition
| shigella (cryptosporidia, giardia and salmonella) |
|
|
Term
| How do you test for EHEC? |
|
Definition
|
|
Term
| What is a complication of EHEC? |
|
Definition
| Hemolytic Uremic synrome= anemia, thrombocytopenia and renal problems d/t endothelial injury, fibrin stranding, schistocytes |
|
|
Term
|
Definition
| cow manure, petting zoos, public pools |
|
|
Term
|
Definition
| NO ANTIBIOTICS, supportive |
|
|
Term
| What bacteria can cause hepatitis? |
|
Definition
| leptospira, legionella, ricketsia, ehrlichia, salmonella |
|
|
Term
| How do you treat most spirochetes? |
|
Definition
| penicillin or doxy, watch out for jarisch herxheimer reaction |
|
|
Term
| How do you prevent Hep B? |
|
Definition
|
|
Term
| Which hepatitis virus has HIV synergy? |
|
Definition
|
|
Term
|
Definition
| pegylated IFN, ribavirin, protease inhibitor (boceprevir or telaprevir, esp if genotype I or AA) |
|
|
Term
| How do you differentiate pyelonephritis from cystitis? |
|
Definition
|
|
Term
| Why is it important to distinguish whether a patient ahs cystitis or pyelonephritis? |
|
Definition
| pyelo is treated longer and can lead to bacteremia |
|
|
Term
| What allows ecoli to be a good UTI pathogen? |
|
Definition
| motility and adhesion (EHEC, ETIC and most GI commensals do not cause UTIs because they do not have adhesions which is CRUCIAL to causing a UTI) |
|
|
Term
| What are the UTI natural host defenses? |
|
Definition
| acid, peristalsis, psuedovalves of ureter and flwo |
|
|
Term
| What are the risk factors for UTI? |
|
Definition
| female, sexual trama, not being hydrated, diaphragm use, urethral reflux, DM |
|
|
Term
| What is the most resistant UTI pathogen? |
|
Definition
| new delhi metallo-carbapenemase (NMD1) from pakistan |
|
|
Term
| What is the #3 MC TB site? |
|
Definition
|
|
Term
| What is the significance of casts in urine? |
|
Definition
| WBC casts implicate pyelonephritis, RBC casts indicate glomerularnephritis |
|
|
Term
| What are the most common cuases of UTI? |
|
Definition
GN= Ecoli and Klebsiella pneumonia
GP= Staph saprophyticus, beta hemolytic strep (strep agalactiae), alpha hemolytic strep, and gamma hemolytic strep (enterococcus faecalis), mycoplasma hominis |
|
|
Term
| What Urinary pathogen can also cause IE? |
|
Definition
|
|
Term
| Whata re the pros and cons to using nitrofurantoin for UTI |
|
Definition
| concentrates in urine (not suitible for systemic disease) proteas is resistant |
|
|
Term
| What are the pros/cons to using fosfomycin to cover UTIs? |
|
Definition
| covers everything but is expensive and induces vomiting |
|
|
Term
| What is S. saprophyticus resistant to? |
|
Definition
| very susceptible to everything |
|
|
Term
| What is E coli resistant to? |
|
Definition
| 60% to ampicillin, 20% to cefazolin 5% to genatmycin and 2% to ceftriazone |
|
|
Term
| What are teh pros and cons to using ceftriaxone to treat a UTI? |
|
Definition
| causes less GI changes and will cover Ecoli |
|
|
Term
| Whata re the pros and cons of using gentamycin to treat ecoli UTI/ |
|
Definition
| renal failure is a side effect |
|
|
Term
| What is the best treatment for ecoli UTI? |
|
Definition
|
|
Term
| When do you treat asymptomatic bacteruria? |
|
Definition
|
|
Term
| How long do you treat for UTI? |
|
Definition
| if flouroquinolone susceptible you treat for 7 days if nonflouroquinolone suceptible you treat for 14 days |
|
|
Term
| Why does pregnancy increase your risk of UTI? |
|
Definition
| decrease flow because of mechanical pressure on ureters and increase estrogen which decreases peristalsis of the ureters |
|
|
Term
| What MUST YOU NOT USE to treat asymptomatic bactiuria in a pregnant patient? |
|
Definition
|
|
Term
| What do you use to treat asymptomatic bactiuria during pregnancy? |
|
Definition
| ampicillin, gentamycin, nitrofuratoin |
|
|
Term
| UTI with kidney stones and high pH is likely d/t-> |
|
Definition
|
|
Term
| Parasite Dracunculus medinensis is aka... |
|
Definition
|
|
Term
| What are the symptoms of sarcoidosis? |
|
Definition
| skin lesion, arthritis, erythema nodosum and lung disease |
|
|
Term
| What disease causes calcification of skin? |
|
Definition
|
|
Term
| What bacteria are common in the feces? (What bacteria were present in teh skin lesions of the 19 yo morman girl)? |
|
Definition
| Ecoli, bacteroides, enterococcus, clostridium |
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