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Microbiology and Immunology - systems


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Normal flora of skin =
Staphylococcus epidermidus
Normal flora of nose =
Staphylococcus aureus
Normal flora of oropharynx =
Viridans streptococci
Normal flora of dental plaque =
Streptococcus mutans
Normal flora of colon (2) =
Bacteroides fragilis > E.coli
Normal flora of vagina =
Lactobacillus, E.coli, Group B Strep (Streptococcus agalactiae)
An elderly person with pneumonia likely is infected with:
- S.pneumoniae
- viruses
- anaerobes
- H.influenza
- Gram negative rods
A child or teenager with pneumonia is likely infected with:
- Mycoplasma
- Chlamydia pneumoniae
- S.pneumoniae
Pneumonia acquired in a hospital is most likely to be:
- Staphylococcus
- Gram negative rods
Immunocompromised patients who get pneumonia are usually infected by:
- Staphylococcus
- Gram negative rods
- fungi (PCP)
- viruses
Alcoholics and drug users who get pneumoniae generally are infected by:
- S.pneumoniae
- Klebsiella
- Staphylococcus
Neonates who get pneumonia are usually infected by:
- Group B strep
- E.coli
What are 3 organisms that cause atypical pneumonia?
- Chlamydia
- Legionella
- Mycoplasma
Post-viral infection pneumonia usually due to:
- Staphylococcus
- H.influenzae
Newborn meningitis:
- Group B strep
- E.coli
- Listeria monocytogenes
Meningitis in kids from 6 months - 6 yrs:
- S.pneumoniae
- N.meningitidis
- H.influenza type B
Meningitis in older kids and adults:
- N.meningitidis
- enteroviruses
- S.pneumoniae
- Herpes Simplex Virus
Eldery person meningitis:
- S.pneumoniae
- Gram negative rods
HIV patient meningitis:
- Cryptococcus neoformans
- toxoplasmosis
- JC virus (PML)
What type of organism causes a meningitis with: increased CSF pressure, increased neutrophils, elevated protein, low glucose?
What organism causes meningitis with: increased CSF pressure, increased lymphocytes, elevated protein, low glucose?
fungal, Tuberculosis
What kind of organism causes a meningitis with: normal CSF pressure, increased lymphocyte count, normal protein level, and normal glucose level?
Osteomyelitis in most ppl =
Osteomyelitis in diabetics & drug users =
Pseudomonas aeruginosa
Osteomyelitis in sickle cell =
Osteomyelitis in sexually active =
Osteomyelitis affecting vertebral column =
TB (aka Pott's disease)
Most UTI's are caused by which 2 bacteria?
- E.coli (80%)
- Klebsiella (10%)
What is the 2nd most popular cause of UTI in young sexually active women?
S.saprophyticus (Novobiocin resistant)
What are some common causes of UTI in a hospital setting?
- E.coli
- Proteus
- Klebsiella
- Serratia
- Pseudomonas
What factors increase risk of UTI?
- urine outflow obstruction
- kidney surgery
- catheter
- GU abnormalities
- diabetes!!!
- pregnancy!!!
UTI manifests clinically with:
- dysuria
- frequency, urgency
- suprapubic pain
You take a urine sample of a patient with UTI, and culture out viscous, mucoid encapsulated colonies. The organism is:
Your patient has a UTI and you want to culture the urine sample. The colonies that grow out appear to be "swarming" on the agar and are urease positive. The culprit bacteria is:
Proteus mirabilis - associated with struvite kidney stones (radiopaque)
Your patient has a UTI and when you culture the urine sample, you grow out colonies that have a metallic sheen on EMB agar. What is the bacteria?
E.coli - leading cause of UTI
A positive urine nitrite test means:
Gram negative bacteria causing UTI
A positive urine leukocyte esterase test means:
bacterial infection
What is the typical clinical presentation for gonorrhea?
- urethritis
- cervicitis
- prostatitis, epididymitis
- arthritis (like knee joint)
- creamy purulent discharge!
Primary syphilis presents as:
painLESS chancre (localized to where spirochete has touched)
Secondary syphilis presents as:
fever, lymphadenopathy, skin rash involving palms & soles, condyloma lata
Tertiary syphilis presents as:
gummas (soft tumor), tabes dorsalis, general paresis, aortitis, Argyll Robertson pupil
Painful penile/vulva/cervical ulcers =
genital herpes (HSV-2)
A patient presents with urethritis, cervicitis (with extreme motion tenderness), arthritis, and conjunctivitis (Reiter's syndrome). You think:
Chlamydia trachomatis D-->K - top bug for PID and STD (next is gonorrhea)
What do Chlamydia trachomatis strains L1-L3 cause?
Lymphogranuloma venereum - ulcers, lymphadenopathy, rectal strictures
Your female patient comes in complaining of itching in the vagina and a foul green-yellow discharge. You take a swab of the cervix and put the contents on wet mount, see motile flagellated critters, and diagnose:
Trichomonas vaginalis - protozoan, causes strawberry cervix and vaginitis, Tx Metronidazole
Condyloma acuminata is caused by:
HPV-6,11 - genital warts, koilocytes (large cells with pyknotic nuclei)
Hepatitis B manifests with:
Chancroids (painFUL genital ulcers) with inguinal lymphadenopathy (buboes) highly suggest:
Haemophilus ducreyi
Your female patients complains of foul fishy-smelling vaginal discharge and very minor itching. You put KOH on a sample of the discharge and diagnose:
bacterial vaginosis - Gardnerella vaginalis (see fuzzy looking clue cells)
Both Neisseria and Chlamydia cause PID, but the kind caused by Neisseria presents as:
ACUTE high fever (vs. Chlamydia, subacute and often undiagnosed)
The 2 most common causes of nosocomial infections are:
1) E.coli - UTI
2) S.aureus - wound infection
Pseudomonas aeruginosa nosocomial infections often are associated with:
1) burn wounds
2) respirator equipment
Newborns that get nosocomial infections are often infected with:
1) CMV - fever, hepatitis, mononucleosis
2) RSV - interstitial pneumonia
Which infectious agents can cross the placenta? "torches"
1) Toxoplasma gondii
2) Rubella
3) CMV
4) Herpes Simplex Virus
5) HIV
6) Syphilis

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