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- DISEASES CAUSED BY STAPHYLCOCCAL TOXINS?
- Toxic shock syndrome (TSST-1)
Scalded skin syndrome (exfoliative toxin)
Food poisoning (enterotoxins A-E) – staphylococcal gastroenteritis
- Group A Strep: aerobic, anaerobic, facultative anaerobe?
- Facultative anaerobe
- What are the non-suppurative diseases caused by group A strep?
- Rheumatic fever, post-strep glomerulonephritis
- Enterococci: aerobic, anaerobic, facultative anaerobic?
- Facultative anaerobic
- what important disease (that we vaccinate against) is caused by a corynebacterium?
- DISEASES CAUSED BY LISTERIA MONOCYTOGENES
Infection in pregnant women
- neiserria gonorrhea: lactose fermenter?
- NO: only glucose
- moraxella bears many similarities to...?
- Which animals are the following associated with: Bartonella
- Bartonella - cat
Pasturella – cat/dog
Francisella - rabbit
Brucella – cows/sheep/goats
- Pseudomonas is important in what genetic disease?
- Which antibx is Widely used in surgical prophylaxis?
- first gen cephalosporin
- Tetracyclines are indicated when...?
- Pregnancy, age <8
- macrolides are prescribed in combo w/ what for the treatment of hospitalized patients with community acquired pneumonia?
- 3rd gen cephalosporin
- Drug of choice for pertusis?
- stevens-johnson syndrome - can be caused by which antibx?
- sulfa drugs
- Major uses of TMP-SMX?
- acute bronchitis, otitis media, lymphogranuloma venereum, PCP
- what is erysipelas? common cause?
- infection of the lymphatic system - cause is streptococcus
- When does Group A strep infection happen in relation to surgery? Staph aureus?
- 6-48 hours post.
Several days to develop
- Vibrio vulnificus?
- Raw Shellfish or traumatic wound exposed to salt water - skin infection
- necrotizing fasciitis: causes?
- type 1 or group A strep
- endocarditis: for each of the following situations, which bugs predominate?
IV drug abuser
Prosthetic valve (early)
Prosthetic valve (late)
- Native valve - S. aureus, Viridans
IV drug abuser - S. aureus
Prosthetic valve (early) - Coag (-) staph
Prosthetic valve (late) - viridans
- Symptoms of endocarditis?
- Fever 75 – 85%
Chills 45 – 75%
Arthralgias and myalgias 15 – 25%
- What are some peripheral lesions of endocarditis?
- Osler nodes 0 – 23%
Splinter hemorrhages 5 – 50%
Janeway lesions 0 – 10%
Roth Spots 2 – 10%
Petichiae 5 – 40%
- duke criteria?
- Endocarditis: Major criteria
Major criteria (2)
Microbiologic – positive blood culture in 2 of 2 sets
Evidence of endocardial involvement – new murmur ie
(2 major criteria, 1 major and 3 minor, or 5 minor)
- Antibx for endocarditis?
- Penicillins/cephalosporings (sometimes in combo with gentamicin ie for coag neg staph)
- High risk factors for infective endocarditis?
- Prosthetic valve
History of IE
History of complex cyanotic congenital heart disease – BLUE BABIES
- Common causes of atypical pneumonia?
- Which bug is responsible for most cases of uncomplicated UTI? Which bugs should be considered for complicated UTI?
- Uncomplicated - E coli
Complicated - Klebsiella, other enterobacteriaceae, Pseudomonas, serratia
- Culture or no? Woman with typical UTI symptoms, pyuria, and no complicating factors?
- Uncomplicated cystitis; what tx?
- Acute Otitis media - tx?
- Severe sepsis is defined as..?
- Sepsis with 1 or more organ failures
- Most cases of sepsis now are caused by gram + or - organisms?
- Gram +
- Clinical manifestations of sepsis?
- Fever - early
Hypotension - early
Tachypnea – sometimes earlyHypothermia - later
lactic acidosis - later
ARDS - later
- Which antibx has an exclusively anaerobic bacterial spectrum?
- DIAGNOSIS OF C Dificile Associated Diarrhea RELIES ON...?
- DETECTION OF THE TOXIN BY IMMUNOASSAY ON STERILE STOOL FILTRATE, NOT CULTURE OF THE ORGANISM
- With coastal travel or seafood, which enteric bug do you suspect?
- Traveler's diarrhea causes?
- ETEC, EIEC, Rotovirus, campylobacter.
Tx: quinalone, etc.
- Salmonella bacteremia can cause which disease?
- Typhoid fever
- Nausea and Vomiting within 6 hours of suspicious meal: what bugs likely?
- S aureus and B cereus
- Abd cramps and diarrhea within 16 hours of suspicious meal - what bugs?
- C. perfringens and B cereus
- Fever, Abd cramps, and diarrhea within 48 hours of a suspicious meal - what bugs?
- Salmonella, Shigella, Campylobacter, Vibrio, E coli
- Most common of known foodborne pathogens?
- Listeria affects who...?
- Pregnant women, fetuses, immunocompromised. Processed cold meats and dairy products
- Diagnosing HSV infection..?
- Viral isolation
- Should be suspected as the causative agent of aseptic meningitis during the summer and fall seasons?
- Coxsackie B virus
- Which arboviruses have humans as the major vertebrate host?
- Dengue and yellow fever viruses?
- Dengue, St Louis, Yellow fever, and West nile are all what type of viruses?
- Flaviviruses - Arboviruses
- West nile should be considered in people who develop what syx after transfusion?
- WNV should be considered in persons who develop unexplained fever, meningitis, or encephalitis after transfusion
- Signs and symptoms of hospitalized patients with WNV
- Fever > 38oC 98.3%
Change in consciousness 46.8%
- antiviral eyedrops?
- Which patients are likely to experience acyclovir resistance?
- Long term therapy immunocompromised patients (AIDS)
- Which drug is used for resistant Herpes or CMV? Problems with this drug?
- Foscarnet. Tons of toxicity
- main side effect of gancyclovir?
- hematologic toxicity
- what do zanamivir and oseltamivir do?
- inhibit neuraminidases of influenza A, B
- for RSV bronchiolitis
- most common cause in the us of calcified granulomas in lung, liver, and spleen?
- acute histoplasmosis
- two antifungal drugs?
- ampho B, itraconazole
- Important opportunistic fungi?
- Candida, cryptococcus, aspergillus, zygomycetes
- oropharyngeal candidiasis aka?
- tx for candida esophagitis?
- what is a key CSF finding in cryptococcal meningitis?
- Elevated opening pressure in majority of cases
- diabetic ketoacidosis is a risk factor for which fungus?
- Ampho B mechanism of action?
- Binds to ergosterol in cell membrane
Forms pores in membrane, permeability
- nocardia drug of choice?
- INH mechanism of action?
- interferes with mycolic acid synthesis (cell wall)
- Rifampin mechanism of action
- Inhibits DNA-dependent RNA polymerase, interfering with transcription
- INH drug interactions?
- Increases phenytoin, valproate, carbamazepine concentrations
Monoamine oxidase inhibition
- rifampin toxicities?
- Hepatitis (alkaline phos, bilirubin, transaminases) (milder than INH)
Flu-like illness with nephrotic syndrome and thrombocytopenia
Orange body fluids
- dapsone toxicity?
- dose-dependent anemia
- which drugs are curative of lyme's disease in early stages?
- doxycylcline or amoxicilin
- Describe Rock Mountain rash?
- petechial, with a PERIPHERAL distribution, first on hands/feet
- Characteristics of ehrlichia?
- gram -, obligate intracellular parasite,Ixodes vector, reservoir is white-tailed deer
- Ehrlichia early manifestations are similar to?
- Rocky Mountain
- tx of ehrlichiosis?
- tx of chancroid?
- cephalosporin, azithro, cipro, etc...
- Antichlamydial tx?
- Doxy or erythromycin
- normal vaginal ecology - which important organism?
- Things that disrupt normal vaginal ecology?
- antibx, douching, multiple sex partners, exposure to STD, defective lactobacilli
- non-inflammatory, discharge due to overgrowth of bacteria. absence of wbcs
- tx of bacterial vaginosis or trichomoniasis?
- HIV ELISA From...?
- whole blood or oral swab
- indications for ART in AIDS?
- CD4 < 350, HIV viral load > 100,000 (very high), pregnancy, high risk exposure, any symptoms
- ART toxicities?
- mitochondrial: lactic acidosis, hepatic steatosis, lipoatrophy (wasting), etc.
- Abacavir toxicity?
- abacavir hypersensitivity reaction,
- didanosine toxicity?
- didanosine-induced pancreatitis
- nevirapine toxicities?
- hepatitis, hypersensitivity
- efavirenz toxicity?
- PCP prophylaxis?
- which transplants have highest incidence of infection?
- heart lung
- Which types of infections predominate in solid organ transplants?
- Bacterial, CMV
- Early infections in post transplant?
- Infections during immunosuppressive period post organ transplant?
- Similar to AIDS
- Late stage (> 6 months post organ transplant) infection?
- VZV, EBV, community acquired viral infections (activation of latent state herpes virus infections)
- Anthrax diagnosis?
- Blood culture
- smallpox - what bug?
- orthopoxvirus - variola
- relative contraindications to smallpox vaccination?
- history of eczema, age < 1 y/o, pregnant, immunosuppressed, close contact with any of above
- smallpox case fatality rate?
- plague treatment?
- aminoglycosides - streptomycin
- staining of plague?
- pulse temp dissociation seen in...?
- undulant fevers?
- bartonella - trench fever
- NSIs in US per year?
- post exposure control of: HBV? HIV? HCV?
- for unvacc: HBIG + vacc
HIV - PEP within 2 hours for 28 days
HCV - no protection with PEP, acute therapy works
- Loosened prosthesis - which bugs?
- Coag negative staph
- osteomyelitis diagnosis gold standard?
- BONE BIOPSY
- diabetic foot ulcer - bone involvement - which drug?
- congenital cmv?
- microcephaly, jaundice, hepatosplenomegaly, purpuric rash,
- best method of diagnosing congenital cmv infection?
- viral isolation from infant's urine
- blueberry muffin rash?
- congenital rubella
- how is congenital syphilis diagnosed?
- serology, CSF eval, and long bone radiographs
- risk of vertical hiv transmission?
- toxoplasma exposure in the house from...? congenital tx?
- cat litter box.
- fever of unknown origin definition?
- Fever 38.3°C (101°F) or higher on several occasions.
Fever of more than 3 weeks’ duration.
Diagnosis uncertain despite appropriate investigations, after at least three outpatient visits or at least 3 days in hospital.
- Giant cell arteritis - diagnosing in FUO?
- Biopsy temporal artery
- Skin Eye Mucous Membrane (SEM)?
- Neonatal HSV
- what can mimic serious bacterial infection in the neonate?
- enterovirus and HSV
- which neonatal infection can present as a rash, encephalitis, or multisystem organ failure?
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