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DISEASES CAUSED BY STAPHYLCOCCAL TOXINS?: Toxic shock syndrome (TSST-1)
Scalded skin syndrome (exfoliative toxin)
Food poisoning (enterotoxins A-E) â€“ 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?: Diptheria
DISEASES CAUSED BY LISTERIA MONOCYTOGENES: Meningitis
Endocarditis
Neonatal infection
Infection in pregnant women
neiserria gonorrhea: lactose fermenter?: NO: only glucose
moraxella bears many similarities to...?: neisseria
Which animals are the following associated with: Bartonella Pasturella Francisella Brucella: Bartonella - cat
Pasturella â€“ cat/dog
Francisella - rabbit
Brucella â€“ cows/sheep/goats
Pseudomonas is important in what genetic disease?: CF
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?: Macrolides
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? Native valve 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 â€“ 85%
Chills 45 â€“ 75%
Arthralgias and myalgias 15 â€“ 25%
What are some peripheral lesions of endocarditis?: Osler nodes 0 â€“ 23%
Splinter hemorrhages 5 â€“ 50%
Janeway lesions 0 â€“ 10%
Roth Spots 2 â€“ 10%
Petichiae 5 â€“ 40%
duke criteria?: Endocarditis: Major criteria
Major criteria (2)
Microbiologic â€“ positive blood culture in 2 of 2 sets
Evidence of endocardial involvement â€“ 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 â€“ BLUE BABIES
Common causes of atypical pneumonia?: Mycoplasma
Chlamydia
Legionella
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?: NO
Uncomplicated cystitis; what tx?: TMP/SMX
Acute Otitis media - tx?: Amoxicilin
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
Tachycardia -early
Tachypnea â€“ sometimes earlyHypothermia - later
lactic acidosis - later
ARDS - later
Which antibx has an exclusively anaerobic bacterial spectrum?: Metronidazole
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?: Vibrios
Traveler's diarrhea causes? Empiric tx?: 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?: Noroviruses
Listeria affects who...? Food sources?: 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%
Headache 57.9%
Change in consciousness 46.8%
Confusion 39.5%
Vomiting 31.3%
antiviral eyedrops?: triflurothymidine
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
Ribavirin?: 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?: thrush
tx for candida esophagitis?: Fluconazole
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?: mucormycosis
Ampho B mechanism of action?: Binds to ergosterol in cell membrane
Forms pores in membrane, ï‚ permeability
nocardia drug of choice?: tmp/smx
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)
Hypersensitivity
Flu-like illness with nephrotic syndrome and thrombocytopenia
Cutaneous vasculitis
Flushing, pruritus
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?: doxycycline
tx of chancroid?: cephalosporin, azithro, cipro, etc...
Antichlamydial tx?: Doxy or erythromycin
normal vaginal ecology - which important organism?: Lactobacillus
Things that disrupt normal vaginal ecology?: antibx, douching, multiple sex partners, exposure to STD, defective lactobacilli
vaginosis?: non-inflammatory, discharge due to overgrowth of bacteria. absence of wbcs
tx of bacterial vaginosis or trichomoniasis?: metronidazole
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?: teratogenesis
PCP prophylaxis?: TMP-SMX
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?: NOSOCOMIAL
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?: 30%
plague treatment?: aminoglycosides - streptomycin
staining of plague?: bipolar
pulse temp dissociation seen in...?: tularemia
undulant fevers?: bartonella - trench fever
NSIs in US per year?: 390,000
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?: clindamycin
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?: 25%
toxoplasma exposure in the house from...? congenital tx?: cat litter box.
pyimethamine/sulfadiazine
fever of unknown origin definition?: Fever 38.3Â°C (101Â°F) or higher on several occasions.
Fever of more than 3 weeksâ€™ 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?: HSV

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Number of cards 118