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Microbiology
FA complete review part 5 Systems
| Question | Answer |
|---|---|
| What is the most common normal flora in the skin? | S. epidermidis |
| What microorganism are the MC flora in the nose? | S. epidermidis; colonized by S. aureus |
| What gram positive bacteria is known to readily colonize the nose? | S. aureus |
| What is the dominant flora found in the Oropharynx? | Viridans group streptococci |
| Viridans group streptococci are dominant flora in the __________________. | Oropharynx |
| Which microorganism is found normally in dental plaque? | S. mutans |
| What are the two dominant microorganisms that colonize the colon? | B. fragilis > E. coli |
| Normal dominant flora of the vagina? | Lactobacillus |
| What microoganism are nkonw to colonize the vagina floara? | E. coli and group B strep |
| What delivery method gives neonates no flora? | C-section |
| Which microorganisms are known to cause food poisoning that starts quickly and ends quickly? | S. aureus and B. cereus |
| Source of infection of B. cereus? | Reheated rice |
| What kind of microorganism is associated with reheated rice? | B. cereus |
| Which are some source os C. botulinum infection? | Improperly canned food (toxins), raw honey (spores) |
| Which food type commonly provides spore form of C. botulinum? | Raw honey |
| What form of C. botulinum is found in improperly canned foods? | C. botulinum toxins |
| Reheated meat? | C. perfirengs |
| What organism is found to be causing disease in undercooked meat? | E. coli O157: H7 |
| Which food type is classically known wth cause an E. coli O157:H7 infection? | Undercooked meat |
| L. monocytogenes causes foodborne illness by the consumption of : | Deli meats and soft cheeses |
| What are common sources of food-illness caused by Salmonella? | Poultry, meat, and eggs |
| Meats, mayonnaise, custard; preformed toxin. MC microorganism? | S. aureus causing food-borne illness |
| Contaminated seafood causes an foodborne illness by the infection with: | V. parahaemolyticus and V. vulnificus |
| V. vulnificus can cause: | 1. Foodborne illness by ingestion 2. Wound infections by contact with contaminated water or shellfish. |
| List of bugs that cause BLOODY diarrhea | 1. Campylobacter jejuni 2. E. histolytica 3. Enterohemorrhagic E. coli 4. Enteroinvasive E. coli 5. Salmonella (non-typhoidal) 6. Shigella 7. Y. enterocolitica |
| Which comma-or S-shaped organism that grows at 42 C causes bloody diarrhea? | C. jejuni |
| What are some features of E. histolytica? | Protozoan; amebic dysentery; liver abscess |
| Which is a protozoan cause of bloody diarrhea? | E. histolytica |
| Amebic dysentery is caused by: | E. histolytica |
| O157:H7; can cause HUS; makes Shiga-like toxin | Enterohemorrhagic E. coli |
| Which type of E. coli invades the colonic mucosa? | Enteroinvasive E. coli |
| Why type of Salmonella causes bloody diarrhea? | Non-typhoidal |
| Features of nontyphoidal Salmonella: | Lactose (-); flagellar motility; has animal reservoir, especially poultry and eggs |
| What bloody causing microorganism produces the Shiga toxin? | Shigella |
| What type of dysentery is seen with Shigella? | Bacillary |
| Bacillary dysentery. MC infective microorganism? | Shigella |
| Common cause of Daycare bloody diarrhea outbreaks? | Y. enterocolitica |
| What infection is responsible for bloody diarrhea and pseudoappendicitis? | Y. enterocolitica |
| List of bugs that are known to cause Watery diarrhea | 1. C. difficile 2. C. perfringens 3. Enterotoxigenic E. coli 4. Giardia and Cryptosporidium (protozoans) 5. V. cholerae 6. Viruses (rotavirus, norovirus, enteric adenovirus) |
| C. difficile causes diarrhea? | Watery mostly but sometimes bloody |
| Pseudomembranous colitis is due to infection with: | C. difficile |
| What organism causes watery diarrhea and gas gangrene? | C. perfringens |
| What E. coli type causes Travelers' diarrhea? | Enterotoxigenic E. coli |
| What are the types of protozoa that cause watery diarrhea? | Giardia and Cryptosporidium |
| Rice water diarrhea is due to ___________________ infection. | V. cholerae |
| What are the common viruses that provoke watery diarrhea? | Rotavirus, Norovirus, and enteric adenovirus |
| Viruses are more prone to cause ________________ diarrhea. | Watery |
| What are the two main causes of pneumonia in neonates (<4wk)? | 1. Group B streptococci 2. E. coli |
| MCC of Pneumonia in children of 4 weeks old to 18 years? | 1. Viruses (RSV) 2. Mycoplasma 3. C. trachomatis (infants - 3 year old) 4. C. pneumoniae (school aged children) 5. S. pneumoniae |
| What is the MCC of pneumonia in an adult of 18-40 yr? | Mycoplasma |
| What is the MCC of pneumonia in adults over 40 and elderly? | S. pneumoniae |
| Which virus is most common shared causes of pneumonia in all adults over 18 years of age? | Influenza virus |
| What is the second MCC of pneumonia in an 50 year old adult? | H. influenzae |
| What are the most common causes of pneumonia in alcoholics? | 1. Klebsiella 2. Anaerobes due to aspiration |
| IV drug user MCC of pneumonia are: | S. pneumoniae and S. aureus |
| Anaerobes are the MCC of pneumonia due to ______________. | Aspiration |
| What are the MCC of atypical pneumonia? | Mycoplasma, Chlamydophila, Legionella, viruses (RSV, CMV, influenza, adenovirus) |
| A patient with Cystic fibrosis most commonly will develop pneumonia due to the following infections: | Pseudomonas, S. aureus, S. pneumonie, and Burkholderia cepacia |
| Pseudomonas infection often causes pneumonia in _____________ patients. | Cystic fibrosis |
| What are the MCC of nosocomial acquired pneumonia? | S. aureus, Pseudomonas, and other enteric gram (-) rods |
| What are the MCC of pneumonia to the immunocompromised? | S. aureus, enteric gram (-) rods, fungi, viruses, P. jirovecii |
| An HIV patient MCC of pneumonia is due to _______________ infection. | P. jirovecii |
| What are post viral causes of pneumonia? | S. pneumoniae, S. aureus, and H. influenzae |
| Top 3 causes of Meningitis in the Newborn | 1. Group B streptococci 2. E. coli 3. Listeria |
| Top causes of meningitis in children between 6 months and 6 years old | S. pneumoniae N. meningitis H. influenzae type b Enteroviruses |
| What is the #1 causes of meningitis in teens? | Neisseria meningitidis |
| What is the most common cause of meningitis for any person over the age of 6 years old, except for teens? | S. pneumoniae |
| What is the second MCC of meningitis in the elderly? | Gram (-) rods |
| What is the empiric treatment of bacterial meningitis? | Ceftriaxone and vancomycin |
| What medication is added to the empiric treatment of bacterial meningitis if Listeria is suspected to be the cause of the infection? | Ampicillin |
| What are the most common causes of viral meningitis? | Enteroviruses, HSV-2, HIV, West Nile virus, and VZV |
| Which is the most common enterovirus that causes viral meningitis? | Coxsackievirus |
| MCC of meningitis in HIV patient | Cryptococcus spp |
| As of today, most cases of H. influenzae type b meningitis, are due to: | Unimmunized children |
| What cell type is predominant in Bacterial meningitis? | PMNs |
| Decreased levels of glucose are seen in which type(s) of meningitis causes? | Bacterial and fungal/TB |
| Increased lymphocytes in CSF are found in ____________ and ____________ causes of meningitis. | Viral and Fungal/TB |
| Which are the two distinguish CSF findings for Bacterial meningitis? | 1. Predominant PMNs in CSF 2. Decreased glucose levels in CSF |
| CSF findings of Fungal/TB meningitis are distinctive due to: | Increased levels of lymphocytes and decreased glucose level |
| Elevated protein levels are seen in which type of meningitis? | All have increased protein levels |
| What are the MCC of infections cause brain abscesses? | Viridans streptococci and Staphylococcus aureus |
| What is the most common reason for multiple brain abscesses due to infections? | Due to bacteremia |
| Toxoplasma gondii reactivation in HIV patients causes? | Multiple brain abscesses |
| What lobe is often affected by multiple brain abscess in cases of Otitis media and mastoiditis? | Temporal lobe and cerebellum |
| What conditions lead to appearance of multiple brains abscesses in the frontal lobe? | Sinusitis or dental infection |
| In healthy individual, what is the MCC of Osteomyelitis? | S. aureus |
| MCC of osteomyelitis in sexually active individual? | Neisseria gonorrhoeae |
| What is the MCC of Osteomyelitis in a patient with Sickle cell disease? | Salmonella and S. aurus |
| What infections are prone to cause osteomyelitis in a patient with a prosthetic joint replacement? | S. aureus and S. epidermidis |
| What microorganisms are involved in infections of osteomyelitis when there in vertebral involvement? | S. aureus, M. tuberculosis |
| What is Pott disease? | Osteomyelitis with M. TB reactivation and vertebral involvement |
| What risk factor is commonly seen in Pasteurella multocida-osteomyelitis? | Cat and dog bites |
| What are the most common causes of Osteomyelitis in IV drug users? | S. aureus; also Pseudomonas and Candida |
| What is the best diagnostic tool for diagnosing Osteomyelitis? | MRI |
| What two inflammatory proteins are elevated in osteomyelitis but are not specific enough for diagnosis? | Elevated C-reactive protein (CRP) and ESR |
| What are the main presenting signs of cystitis? | Dysuria, frequency, urgency, suprapubic pain, and WBCs (not WBC casts) in urine. |
| What is the main reason for development of cystitis? | Ascension of microbes from urethra to bladder |
| The ascension of microbe from bladder to kidney results in development of: | Pyelonephritis |
| What are the presenting signs of Pyelonephritis? | Fever, chills, flank pain, costovertebral angle tenderness, hematuria, and WBC casts. |
| Which urinary disorder presents with WBC casts, cystitis or pyelonephritis? | Pyelonephritis |
| Key: Costovertebral angle tenderness and WBC casts. Dx? | Pyelonephritis |
| Which gender is more common to develop an URI? | Women |
| What is the main reason women are more prone to develop an URI? | Shorter urethras colonized by fecal flora |
| What are the diagnostic markers of URIs? | 1. (+) Leukocyte esterase 2. (+) Nitrite test 3. (+) Ureae test |
| A positive leukocyte esterase test indicates: | Evidence of WBC activity in the urine sample |
| (+) Nitrite test indicates ---> | Reduction of urinary nitrates by bacterial species (E. coli) |
| Which bacterial infections produce an (+) Urease test in urine sample? | S. saprophyticus, Proteus, and Klebsiella |
| What is the leading cause of UTIs? | E. coli infection |
| What is the second leading cause of UTI in sexually active women? | S. saprophyticus infection |
| What is the third MCC of UTI? | Klebsiella infection |
| What organism produces a red pigment, and is often seen in nosocomial and drug resistant UTIs? | Serratia marcescens |
| What are the features of UTI due to Proteus mirabilis infection? | Motility causes "swarming" on agar; associated with struvite stones |
| Blue-green pigment and fruity odor; usually nosocomial and drug resistant? | Pseudomonas aeruginosa |
| What are the signs and symptoms of Bacterial vaginosis? | - No inflammation - Thin, white discharge with fishy odor |
| What some key lab findings of bacterial vaginosis? | Clue cells pH > 4.5 |
| What is the treatment of Gardenella vaginosis? | Metronidazole or clindamycin |
| What are the most significant signs and symptoms of Trichomonas vaginitis? | 1. Inflammation ("strawberry cervix") 2. Frothy, yellow-green, foul-smelling discharge |
| What are some lab findings in Trichomonas vaginitis? | Motile trichomonads and pH > 4.5 |
| What is the treatment for patient and patient's partner of Trichomonas vaginitis? | Metronidazole |
| Candida vulvovaginitis is clinically presented with: | 1. Inflammation 2. Thick, white, "cottage cheese" discharge |
| What are lab findings in Candida vulvovaginitis? | - Pseudohyphae - pH normal (4.0-4.5) |
| What is the best treatment option for Candida vulvovaginitis? | Azoles |
| Thin, white discharge with fishy odor | Bacterial (gardenella) vaginosis |
| Frothy, yellow-green, foul-smelling discharge | Trichomonas vaginitis |
| Thick, white, "cottage cheese" discharge | Candida vulvovaginitis |
| Which common vaginal infection is seen with pH> 4.5? | Bacterial vaginosis and Trichomonas vaginitis |
| How is the pH in Candida vulvovaginitis? | Normal (4.0-4.5) |
| Clue cells are seen in : | Bacterial vaginosis |
| Metronidazole is the best option to treat which common vaginal infections? | Bacterial vaginosis and Trichomonas vaginitis |
| "Strawberry cervix" | Trichomonas vaginitis |
| Which vaginal infection is seen histologically, with Pseudohyphae? | Candida vulvovaginitis |
| Azoles are the main option to treat which vaginal infection? | Candida vulvovaginitis |
| Microbes that may pass from mother to fetus, produce ___________ infections. | Torches |
| What is the most common type of transmission of TORCHES infections? | Transplacental, except for HSV-2 which is via delivery |
| What are the nonspecific signs and symptoms of TORCHES infections? | Hepatosplenomegaly, jaundice, thrombocytopenia, and growth retardation |
| What are some common organisms that cause meningitis in neonates? | Strepto agalactiae, E. coli, and Listeria monocytogenes |
| Parvovirus B19 infection in fetus causes: | Hydrops fetalis |
| Neonatal manifestations of Toxoplasma gondii infection: | Classic triad: 1. Chorioretinitis 2. Hydrocephalus 3. Intracranial calcifications +/- "blueberry muffin" rash |
| Modes of maternal transmission of Toxoplasma gondii | Cat feces or ingestion of undercooked meat |
| What are the maternal manifestations of Toxoplasma gondii infection? | Usually asymptomatic; lymphadenopathy (rarely) |
| How is the maternal transmission of Rubella? | Respiratory droplets |
| What are the maternal manifestations of Rubella? | Rash, lymphadenopathy, polyarthritis, and polyarthralgia |
| What are the neonatal manifestations of Rubella infection? | Classic triad of: Abnormalities of eye (cataract) and ear (deafness and congenital heart disease (PDA). +/- "blueberry muffin" rash |
| Cataracts, deafness, and PDA, plus "blueberry muffin" rash. Dx? | Rubella infection neonatal manifestations (Torches) |
| How is CMV (torches) maternally transmitted? | Sexual contact and/or organ transplant |
| Which TORCHES infection cause the mother to present mononucleosis-like illness? | Cytomegalovirus |
| What are the most common neonatal features with CMV infection? | Hearing loss, seizures, petechial rash, "blueberry muffin" rash, chorioretinitis, periventricular calcifications |
| What are the most common ways a mother can acquire HIV? | Sexual contact and needlestick |
| What are neonatal presentation of HIV infection? | Recurrent infections and chronic diarrhea |
| What are , if any, the clinical manifestations of a mother with HSV-2 infection? | Herpetic (vesicular) lesions |
| Meningoencephalitis, herpetic (vesicular) lesions. | Neonatal manifestations of HSV-2 infection |
| What syphilis stages are the most common to cause neonatal syphilis infection manistains? | Primary and secondary |
| What are neonatal manifestations of a TORCHES infection due to Syphilis? | Often result in stillbirth, hydrops fetalis. If child survives, presents with: facial abnormalities, saber chin, and CN VIII deafness |
| What are some facial abnormalities seen in a neonatal syphilis? | Notched teeth, saddle nose, short maxilla |
| What type of deafness is produced in a child with neonatal syphilis? | CN VIII (8) deafness |
| Saddle nose, saber chin, deafness, and notched teeth. Represents what? | Neonatal manifestations of Syphilis |
| What are the TORCHES infections? | Toxoplasma gondii Rubella CMV HIV HSV-2 Syphilis |
| What is the syndrome or disease of Coxsackievirus type A? | Hand-foot-mouth disease |
| Rash seen in Hand-foot-mouth disease? | Oval-shaped vesicles on palms and soles; vesicles and ulcers in oral mucosa. |
| Red oval-shaped vesicles in hands (palms) and foot (soles), plus vesicles and ulcer in the oral mucosa. Associated disease? | Hand-foot-mouth disease |
| What is the associated conditions of HHV-6? | Roseola (exanthem subitum) |
| Descrioption of Roseola rash | Asymptomatic rose-colored macules appear on body after seveal days of high fever; can present with fevrile seizures; usually afect infants |
| Which population is at highest risk of HHV-6 Roseola? | Infants |
| A new red rash appears after 3-4 days of high fever. Dx? | Roseola due to HHV-6 infection |
| Common name for exanthem subitum | Roseola |
| What is another name for measles? | Rubeola |
| Description of measles rash | Confluent rash beggining at head and moving down |
| What are preceding symptoms and signs to the appearance of the red rash of measles? | Cough, coryza, conjunctivitis, and blue-white (Koplik) spots on buccal mucosa |
| Koplik spots. Dx? | Measles |
| Where in the body do Koplik spots appear? | Buccal mucosa |
| What is the old name of Erythema infectiosum? | Fifth disease |
| What is the description or clinical presentation of the rash caused by Parvobirus B19? | "Slapped cheek" rash on face |
| What is the most severe risk of Parvovirus B19 infection to a pregnant women? | Hydrops fetalis |
| Suspect infection of Rubella with which important clinical sign? | Postauricular lymphadenopathy |
| Where does Rubella and Rubeola rashes start and move? | Start at head and move down |
| Fine desquamating truncal rash, that began at the head and moved down. Dx? | Rubella |
| Which rash, Rubella or Measles, start at the hairline? | Rubeola |
| Rubella's red rash starts at the _____________ and moves down. | Face |
| German measles = | Rubella |
| What mouth feature is seen with Rubella? | Forchheimer spots on soft palate |
| Forchheimer spots appear on _______________________________ infection. | Soft palate of Rubella |
| What is the associated rash syndrome of Strep pyogenes? | Scarlet fever |
| Describe the rash seen in Scarlet fever. | Flushed cheeks and circumoral pallor on the face; erythematous, sandpaper-like rash from neck to trunk and extremities and sore throat. |
| If the red rash starts at the neck and moves down to the trunk and arms, it can be suspected to be? | Scarlet fever |
| Scarlet fever is due to infection with: | Strep pyogenes |
| What is the disease that causes a red rash in VZV infection? | Chickenpox |
| Vesicular rash begins on trunk; spreads to face and extremities with lesions of different stages. | Chickenpox |
| Where does the Chickenpox rash starts? | Trunk |
| Red rash, with lesions of different stages. | Chickenpox |
| What virus produces a chancroid? | Haemophilus ducreyi |
| What is a chancroid? | Painful genital ulcer with exudate, and inguinal adenopathy |
| What are the clinical fatures of chlamydia infection? | Urethritis, cervicitis, epididymitis, conjuntivitis, reactive arthritis, and PID |
| Which subtypes of Chlamydia are the ones causing sexually transmitted diseases? | Chlamydia trachomatis (D-K) |
| Condylomata acuminata is seen with with organism infection? | HPV-6 and -11 |
| What is condylomata acuminata? | Genital warts; seen with Koilocytes |
| Clinical features of Genital herpes: | Painful penile, vulvar, or cervical vesicales and ulcers |
| Which, HSV-2 or HSV-1, is more common to cause genital herpes? | HSV-2 |
| What conditions are associated with Gonorrhea? | Urethritis, cervicitis, PID, prostatitis, epididymitis, arthritis, creamy purulent discharge |
| What is the description of the discharge often seen with N. gonorrhoeae infection? | Creamy purulent discharge |
| Another name for Granuloma inguinale? | Donovanosis |
| Painless, beefy red ulcer that bleeds readily on contact. | Granuloma inguinale |
| What organisms are associated in the development of Granuloma inguinale? | Klebsiella granulomatis; |
| What are histological findings in Granuloma inguinale due to Klebsiella granulomatis infection? | Cytoplasmic Donovan bodies (bipolar staining) |
| What organism causes Lymphogranuloma venereum? | Chlamydia trachomatis (L1-L3) |
| Infection of lymphatics; painless genital ulcers, painful lymphadenopathy (buboes) | Lymphogranuloma venereum |
| Painless chancre | Primary syphilies |
| What are the clinical features seen in secondary syphilis? | Fever, lymphadenopathy, skins rashes, and condylomata lata |
| Condylomata lata is seen in: | Secondary syphilis |
| What organism causes syphilis? | Treponema pallidum |
| What are the main features of Tertiary syphilis? | Gummas, tabes dorsalis, general paresis, aortitis, Argyll Robertson pupil |
| Gummas are seen in: | Tertiary syphilis |
| Tabes dorsalis is a neurological manifestation often seen in: | Tertiary syphilis |
| What are the main bugs causing Pelvic inflammatory disease? | Chlamydia trachomatis and N. gonorrhoeae |
| What organism is the MCC of bacterial STI in the United States? | C. trachomatis |
| What are the signs of PID? | Cervical motion tenderness, adnexal tenderness, purulent cervical discharge |
| What are some conditions that may be part of PID? | Salpingitis, endometritis, hydrosalpinx, and tubo-ovarian abscess. |
| Salpingitis is a risk factor for which disorders? | Ectopic pregnancy, infertility, chronic pelvic pain, and adhesions. |
| What is another name for perihepatitis? | Fitz-Hugh-Curtis syndrome |
| What is Fitz-Hugh-Curtis syndrome? | Infection and inflammation of liver capsule and "violin string" adhesions of peritoneum to liver. |
| What organism is causative of development of Fitz-Hugh-Curtis syndrome? | C. trachomatis |
| What is the risk factor for nosocomial infection with Clostridium difficile? | Antibiotic use |
| What are the unique signs/symptoms of Nosocomial infection by C. difficile? | Watery diarrhea and Leukocytosis |
| What are the 2 MCC of nosocomial infections? | E. coli (UTI) and S. aureus (wound infection) |
| Hospital infections due to aspirations are due infections of which pathogen? | Polymicrobial, gram (-) bacteria, often anaerobes |
| Clinical presentation of nosocomial infection due to aspiration issues? | Right lower lobe infiltrate or right upper/middle lobe (patient recumbent); purulent malodorous sputum |
| What are common infectious agents in patients in intravascular catheters? | S. aureus (including MRSA), S. epidermidis (long term), Enterobacter |
| Infection with Poliovirus to an unvaccinated child will lead to: | Lead to myalgia and paralysis |
| Asplenic patient are highly susceptible to which organisms? | Encapsulated microbes |
| Branching rods in oral infection , sulfur granules | Actinomyces israelii |
| Chronic granulomatous disease | Catalase (+) microbes, especially S. aureus |
| "Currant jelly" sputum | Klebsiella |
| Dog or cat bite | Pasteurella multocida |
| Facial nerve palsy (typically bilateral) | Borrelia burgdorferi (Lyme disease) |
| Fungal infection in diabetic or immunocompromised patient | Mucor or Rhizopus spp. |
| Health care provider | HBV, HCV (from needlestick) |
| Neutropenic patients | Candida albicans (systemic), Aspergillus |
| Organ transplant recipient | CMV |
| PAS (+) | Tropheryma whipplei (Whipple disease) |
| Pediatric infection | Haemophilus influenza (including epiglottis) |
| Pneumonia in cystic fibrosis, burn infection | Pseudomonas aeruginosa |
| Pus, empyema, abscess | S. aureus |
| Rash on hands and feet | Coxsackie A virus, Treponema pallidum, and Rickettsia rickettsii |
| Sepsis/meningitis in newborn | Group B strep |
| Surgical wound | S. aureus |
| Traumatic open wound | Clostridium perfringens |
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rakomi
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