Bacti infections
Terms
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- What are the normal flora in the female urogen spec?
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LACTOBACILLUS
Coag neg staphs
Diphtheroids
Strep viridans
Saprophytic Neisserias
Commensal Mycobacteria
Anaerobes - What are the normal flora in the male urogen spec?
- normal skin flora
- How are specimens collected from urogenital?
- Sterile swab
- What is vital when collecting a spec for viral STD?
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-COTTON or DACRON swab - other kills herpes simplex.
-Use viral transport media - what is a viral transport media?
- Hanks balanced salt solution
- What is Sucrose buffer with antibiotics used for?
- -collecting a specimen for Chlamydia or Mycoplasma
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What type of media for GC?
-Swabs
-culture media -
-Modified Stuart's or Amies charcoal for SWABS
-JEMBEC/MTM for culture - What shoud be done with urogenital specimens on arrival?
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-Prompt setup
-DON'T refrigerate swabs - List 9 pathogenic agents in urogenital specs from A-M
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1. Bacterial vaginosis (G. vaginalis and Mobiluncus)
2. Calymmatobacterium inguinale
3. Chlamydia trachomatis
4. Haemophilus ducreyi
5. Herpes simplex virus
6. Human papillomavirus
7. Listeria monocytogenes
8. Molluscum contagiosum
9. Mycoplasma hominis - List the 7 pathogenic agents in urogenital specs from N-Z
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1. Neisseria gonorrhoeae
2. Phthirus pubis
3. Staph aureus TSS
4. Treponema pallidum
5. Trichomonas vaginalis
6. Ureaplasma urealyticum
7. Yeast - C. albicans - What bacterial agents are often found in gay males?
- Intestinal bacteria - Shigella, Salmonella, Campylo, Cryptosporidium..
- What is the most common cause of neonatal meningitis?
- Strep B
- What are the 3 vaginal infections with discharge?
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1. Trichomonas vaginalis
2. Bacterial Vaginosis
3. Yeast vaginitis - What are the 5 STDs with genital ulcers?
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1. Herpes simplex
2. Syphils
3. Chancroid
4. Calymmatobacterium inguinale
5. Chlamydia trachomatis - What are the 2 STDs that exhibit genital growths?
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1. HPV- papilloma virus
2. Molluscum contagiosum - What are the 2 STDs w/ PID, urethritis, or cervicitis?
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1. Chlamydia trachomatis
2. Neisseria gonorrhoeae - What can "infest" the urogenital region?
- Phthirus pubis
- List the 4 "miscellaneous" urogenital pathogens:
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1. Mycoplasma/ureaplasma
2. Staph aureus
3. Neisseria meningitis/ enteric pathogens.
4. Strep group B/Listeria - Why is bacterial vaginosis called "osis" inst of "alis"?
- Because no WBCs respond
- What are the agents that are associated with bacterial vaginosis?
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-Gardnerella vaginalis
-Mobiluncus - How is it clinically diagnosed?
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-Gray/white sticky discharge
-Vaginal pH is >4.5
-Clue cells
-Fishy odor w/ KOH - How is bacterial vaginosis diagnosed in the lab?
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-Culture not recommended
-Direct smear shows low amts of lactobacillus, clue cells, few WBCs.
-VPIII test affirms - What are some complications of Bacterial vaginosis?
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post op infections
cervical dysplasia
preterm births
post delivery problems
fetal development problems - What is the most common cause of vaginitis?
- Yeast vaginitis - usually from C. albicans
- Is yeast vaginitis an infection?
- No, it's endogenous from normal flora
- What causes chancroid?
- haemophilus ducreyi
- What does alymmatobacterium inguinale cause?
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an STD exhibiting ulcers;
-Aka Granuloma inguinale
-Aka Donovanosis - Where is donovanosis usually seen?
- in the tropics
- How is donovanosis diagnosed?
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-Scraping of lesions
-Observe donovan bodies - What are Donovan bodies?
- Mononuclear cells w/ intracellular bacteria
- What is the specimen of choice for isolating Chlamydia trachomatis? Why?
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-Bubo aspirate
-Because bubos are a symptom of this infection
-To make sure it's not Plague - Seeing intracellular bacteria on a male urethral smear would make you suspect:
- Neisseria gonorrhoeae
- What are the normal flora in the throat?
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-Diphtheroids
-S. viridans
-Saprophytic neisseria
-coag neg Staphs
-Stomatococcus
-Haemophilus
-Lactobacillus - What are the disease states that occur in the oropharynx/throat?
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1. Pharyngitis
2. Laryngitis
3. Epiglottitis
4. Whooping cough - What causes pharyngitis?
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1. Strep group A
2. other beta Streps
3. neisseria gonorrhoeae
4. arcanobacterium hemolyticum
5. Corynebacterium diphtheria - What causes pharyngitis in young adults?
- arcanobacterium hemolyticum
- what usually causes laryngitis?
- viral infections
- what causes whooping cough?
- bordatella pertussis
- what does corynebacterium diphtheria cause?
- a pharyngeal membrane
- What type of white cell response is seen in diphtheria?
- Lymphocytic
- what type of media and swab are used for bordatella pertussis?
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-Nasopharyngeal swab
-Regan lowe, Bordet gengout - what causes epiglottitis?
- Haemophilus influenzae
- What's the normal nasal flora?
- Staphylococci/anaerobes
- what are the usual pathogens in the nose?
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-Haemophilus influenzae
-Strep pneumo
-Strep A/M. catarrhalis (less)
-Anaerobes - What are the 2 common disease states in the nose?
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1. Rhinitis - viral/allergic
2. Sinusitis - bacterial - How are specimens processed for the nose?
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1. Sinus aspirate
2. Serum IgG RIA
3. Skin tests -
What usually causes:
-Otitis externa
-Otitis media -
Externa = p. aeruginosa
Media = Sinusitis pathogens (h. influenzae, strep pneumo) - What are the 3 disease states in the mouth?
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1. Lumpy Jaw
2. Thrush
3. Vincent's angina - What causes lumpy jaw?
- Actinomyces israelii
- What causes Vincent's angina?
- Fusobacterium + Borellia
- What causes bacterial parotitis?
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1. Staph aureus
2. Strep viridans
3. Anaerobes - What does the isolation of Neisseria meningitidis in a nasal specimenindicate?
- Carrier state of the bug
- What plate should be swabbed for carrier state testing?
- Jembec
- What's normal flora in the lower spiratory tract?
- nothing
- what is the pneumonia mechanism?
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1. Organism gets into alveoli
2. Inflammation - fluid/wbcs
3. Junk consolidates/bad xchange
4. Fever, chest pain, cough -
What usually causes community acquired pneumonia in:
-Children
-Adults -
Children:
-Viral - RSV/Parainfluenzae
-Bactrial - S. pneumo/H. influenzae/M. catarrhalis
Adults:
-Strep pneumo, H. influenzae, Staph aureus. - What usually causes nosocomial pneumonia?
- -Enterobacteriacae: Klebsiella pneumoniae, Enterobacter, E. coli, Serratia, Pseudomonas.
- How does nosocomial pneumonia develop?
- from oral colonizatoin of bacteria and barrier compromise.
- What are 5 mechanisms of pneumonia other than community and nosocomial acquired?
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1. Viral destruction of cilia
2. Chemicals
3. Tracheostomy
4. Underlying disease
5. Hematogenous spread - What causes aspiration pneumonia, and how does it differ from other?
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-Aspiration of food/stomach or oral contents or medicine.
-Involves upper Resp tract organisms in lower right lobe.
-Will see WBC response but culture shows NORMALFLORA -
What's the choice specimen for aspiration pneumonia?
What type of lab workup should be done? -
-Transtracheal aspirate
-Do a ANAEROBE workup - What 3 anaerobes commonly cause aspirate pneumonia?
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-Peptostreptococcus
-Fusobacterium
-Bacteroides - What 2 disease states occur in lungs other than pneumonia?
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1. Chronic obstructive pulmonary disease (COPD)
2. Bronchitis/Bronchiolitis - What type of sputum is mostly collected for pneumonia?
- Sputum - rinse w/ water, cough deeply, don't spit.
- What type of specimens are used for collecting lower resp tract?
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1. transtracheal aspirate
2. Aspiration (thoracentesis)
3. Blood culture
4. Lung puncture - How should a tuberculosis specimen be cared for?
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Very carefully!
-3 first morning specimens
-Acid fast stain immediately
-Culture for 8 weeks
-Molecular testing -
What is an acceptable sputum?
What is a rejectable sputum? -
Accept: >25 PMNs : <10 epis/lpf
Reject: >25 epis/lpf