Microbio - 8 (AIDS pts)

arold001's version from 2015-12-30 17:39

Section 1

Question Answer
pt with AIDS presents with SYSTEMIC infection: fever, cough, hepatosplenomegaly, TONGUE ULCERHistoplasma (causes only pulmonary sxs in immunoCOMPETENT hosts)
Oval yeast cells within macrophages?histoplasma
yeast associated with BATS or bird droppings?Histoplasma
pseudohyphae (oral if CD4 <400)candida
what CD4+ count will esophageal candida show?CD4 <100
pt with AIDS presents with superficial vascular proliferation and biospy reveals neutrophilic inflammationBacillary Angiomatosis = Bartonella henselae
what causes bacillary angiomatosis?Bartonella hensalae
Name 2 orgs that causes DERMATOLOGIC disorders in AIDS ptsCandida (thrush) and Bartonella henselae (bacillary angiomatosis)
which org causes chronic, watery diarrhea in AIDS pts?crytosporidium
acid-fast CYSTS seen in stool when CD4 <200. Causes watery diarrhea in AIDs ptscryptosporidum
AIDS pts presents with encephalopathy showing demyelinationJC virus reactivation (PML)
at what CD4 count does PML shows?CD4 <200
AIDS pt presents with many ring-enhacing lesions on imaging? whats his CD4 count?Toxoplasmosis. CD4 <100
AIDS pt presents with meningitis. whats his CD4?cryptococcus neoformans. CD <50!
indian ink reveals yeast with narrow-based budding and large/thick capsulecryptococcus neoformans
what causes retinitis in AIDS pts?CMV (look for owls eye NUCLEAR inclusion)
cotton wool spots on fundoscopic examretinitis due to CMV
at what CD4 count does CMV retinitis occur?CD <50
what causes dementia in HIV pts?having HIV!!
biopsy shows silver staining CYSTS in frothy ALVEOLAR exudates...?PCP (tx with TMP-SMX)
what causes superficial NEOPLASTIC proliferation of vasculature. Biospy reveals lymphocytic inflammation?HHV-8 = Kaposi Sarcoma
difference btw bacillary angiomatosis (Bartonella) VERSUS superficial proliferation of vasculature (Kaposi)Bacillary = NEUTROPHILIC inflammation.
Kaposi = LYMPHOCYTIC inflammation
what causes white lesions on the LATERAL tongue that CANT be scrapped off?Hairy leukoplakia due to EBV!
what virus causes hairy leukoplakia?EBV
AIDS pt presents with anal squamous cell carcinoma?HPV 16, 18
AIDS pt presents with CNS lymphoma, focal or multipleEBV!
Non-hodgkins lymphoma on Waldeyers ring in the oropharynx?EBV!
AIDs pt presents with INTERSTITIAL pneumonia?CMV
AIDS pt presents with pleuritic pain, hemoptysis, migratory pulmonary infiltrates on imaging?Invasive aspergillosis
pneumonia when CD4 <200PCP
Tuberculosis-like disease when CD <50MAC
spongiform encephalopathy, dementia, ataxia, death Prions = CJD
What is Gerstmann-Straussler Scheinker symdrome?INHERITED prion disease

Section 2

Question Answer
whats the normal dominant flora in the skin?Staph epidermidis
whats the normal dominant flora in the nose?Staph epidermidis; colonized by staph aureus
whats the normal dominant flora in the oropharynx?Strep viridans
whats the normal dominant flora in dental plaque?strep mutans
whats the normal dominant flora in the colon?Bacteroides fragilis > E. coli
whats the normal dominant flora in the vagina?Lactobacillus, colonized by E. coli and GBS

Section 3

Question Answer
Which 2 bacteria causes food poisoning thats STARTS and ENDS quickStaph aureus and Bacillus cereus
food poisoning from contaminated SEAFOOD?Vibrio parahemolyticus and Vibrio vulnificus
diarrhea after eating shellfish?Vibrio parahemolyticus and Vibrio vulnificus
food poisoning from RICE?Bacillus cereus
food poisoning from meats, mayonnaise, custard?Staph aureus
food poisoning from POTATO SALADStaph aureus
food poisoning from REHEATED meat dishesClostridium perfringens
food poisoning from improperly canned foods (sign is bulging cans)C. botulinum
food poisoning from UNDERCOOKED meats?E.coli O157:H7
food poisoning from eggssalmonella
what is the most common cause of mesenteric adenitis that mimics appendicitis?Yersenia entercolitica
Name 3 orgs that can mimic appendicitis?Yersenia enterolitica,
Nontyphoidal Salmonella
C. jejuni

Section 4

Question Answer
comma or S-shaped org that grows at 42 C (hot!!) and causes BLOODY diarrhea?campylobacter
lactose negative, flagellar motility, has animal reservoir in poultry and eggs - causes BLOODY diarrheaSalmonella
lactose negative, very low ID50, produces Shiga toxinShigella
causes bloody diarrhea and HUS?EHEC
causes bloody diarrhea by INVADING thru the colonic mucosaEIEC
causes bloody dairrhea in daycaresYersenia enterolitica
what protozoan causes BLOODY diarrhea?Entamoeba histolytica
What E.coli type causes watery diarrhea?ETEC (travelers diarrhea) = Heat stable and Heat Labile toxins
what comma-shaped organism causes rice watery diarrhea?Vibrio cholerae
what are 2 comma shaped orgs that cause diarrhea?vibrio and campylobacter
what causes watery or bloody diarrhea AND pseudomembranous colitis?C. diff = cytotoxin B = binds to actin and causes depolymerization, leading to enterocyte death and necrosis
Name 2 protozoans that cause WATERY diarrhea?Giardia and Cryptosporidium in immunocompromised
Name 2 viruses that cause WATERY diarrhea?rotavirus and norovirus

Section 5

what are the common causes of pnuemonia in neonates (< 4 weeks old)? : GBS > E.coli
Question Answer
Whats are the common causes of pneumonia in CHILDREN (4 weeks-18 yrs)? (Runts, May, Cough, Chunky, Sputum)RSV, Mycoplasma, Chlamydia trachomatis (infants - 3 years old), Chlamydia pneumonia (school age), Strep penumonia
What age group does Chlamydia trachmotis cause pneumonia in?infants - 3 years
what age group does Chlaymydia pneumonia cause pneumonia in?school-age kids
what are the 3 most common causes of pneumonia in adults (18-40 years)?Mycoplasma, Chlamydia pneumonia, Strep, pneumonia
what are the most common causes of pneumonia in older adults (40-65)?Strep. pneumo, H. influenza, Mycoplasma, Anaerobes, viruses
What are the most common causes of pneumonia in eldery?Strep pneumo, H. influenza, Influenza, anaerobes, gram neg rods

Section 6

Question Answer
whats the most common cause of pneumonia in nosocomial pts? (hospital acquired)Staph, enteric gram neg rods
whats the most common cause of pneumonia in immunocompromised pts?PCP, staph, enteric gram neg rods, fungi
whats the most common cause of pneumonia in ALCOHOLICS/IV drug users?Klebsiella, Strep pneumo, staph
what are the 3 most common causes of pneumonia POST-VIRAL INFECTION?staph, H.influenza, strep pneumo
whats the most prevalent PROTOZOA in the small bowel?Giardia lamblia
pt with foul smelling diarrhea shows biopsy: crescent-shaped protozoa adjacent to brush border?Giardia lamblia

Section 7

Question Answer
What are the 3 most common causes of meningitis in neonates?GBS > E.coli > Listeria
What are the most common causes of meningitis in children (6 months - 6 yrs)?Strep pneumo, Neisseria, H.influenza, Enteroviruses
What are the most common causes of meningitis in 6-60 yrs olds?Strep pneumo, Neisseria, HSV
What are the 3 most common causes of meningitis in the eldery (>60 yrs)strep pneumo > Gram negative rods > Listeria
Name 5 viral causes of meningitiscoxsackievirus, HSV-2 (HSV-1 = encephalitis), HIV, West Nile virus, VZV
how do you empirically tx meningitis?ceftriaxone and vancomycin (add Ampicillin if listeria is suspected)
whats the DDx for meningitis in HIV pts?cryptococcus, CMV, toxoplasmosis, JC virus (PML)
what unique lab findings will you see in CSF in meningitis due to VIRAL causes?opening pressure will be NORMAL, normal proteins and sugars
whats the most common cause of osteomyelitis?staph aureus
what causes osteomyelitis in SEXUALLY active pts?Neisseria
what causes septic arthritis in sexually active pts?Neisseria
What causes osteomyelitis in DIABETICS and DRUG users?P. aeruginosa or serratia
What causes osteomyelitis in SICKLE CELL pts?Salmonella
What causes osteomyeliitis in pts with recent prosthetic replacement?Staph aureus or Staph epidermidis
What causes osteomyeliitis and vertebral disease?TB (potts disease)
Name 2 nonspecific lab findings in a pt with osteomyelitis?increased ESR and CRP
What does a postive leukocyte esterase test indicate for UTI?bacterial UTI
what does a positive NITRITE TEST indicate for UTI?gram-NEGATIVE bacteria UTI
what does a positive UREASE test indicate for UTI?urease producing bug = Ureaplasma, Proteus, Klebsiella
what does a NEGATIVE urease test indicate for UTI?E. coli or Enterococcus

Section 8

Question Answer
pt presents with UTI sxs and EMB agar shows GREEN metallic sheen?E.coli
whats the 2nd leading cause of community acquired UTI in sexually active women?Staph saprophyticus
Whats the 3rd leading cause of UTI?Klebsiella pneumonia = large mucoid capsule!
what are the 3 most common causes of UTI?E.coli > staph saprophyticus > Klebsiella
UTI bug that produces RED pigment?serratia marcescens
UTI bug that shows "swarming" motility on agarProteus mirabilus

Section 9

Question Answer
Whats the route of transmission in TORCHES infections?transplacental! or via delivery (esp HSV-2)
what does ToRCHeS stand for?Toxoplasmosis, Other, Rubella, CMV, HIV/HSV-2, Syphillis
what are 2 ways to get Toxoplasmosis?cat feces or eating undercooked meat
whats the triad of congenital toxoplasmosis?chorioretinitis, hydrocephalus, intracranial calcifications
Neonate presents with PDA, cataracts, deafness, blueberry muffin rashrubella
what are the 2 ways to get CMV?Sexual contact or organ transplants
neonate presents with hearing loss, seizures, petechial rash, "blueberry muffin" rashCMV
neonate presents with encephalitis and herpetic vesicular rashHSV-1
Neonate is a stillbirth, hydrops fetalisSyphillis
neonate presents with notched teeth, saddle nose, short maxilla, SABER shins, deafnesscongenital syphillis