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Flashcards in Gram stain Deck (32)
1

gram pos cocci

staph auresus- if n/surg or trauma last month add vanc
strep pneumo- vanc and ceftriaxone

2

gram neg cocci

neisseria- 3rd gen ceph

neisseria gonorrhoea
moraxella catarrhalis

3

gram pos bacilli

listeria - amp or penicillin G

ABCDL
actinomycetes
bacillus anthraxis, cereus
clostridium
diphtheria
listeria

4

Gram neg bacilli

enterobacteraceae (klebsiella or E coli)- ceftr

pseudomonas or acinetobacter - if neurosurg last months then ceftazidime, cefepime, meropenem

5

Hydatid cyst vs amoebic abscess on exam

hydatid large liver asymptomatic, non tender no fever
abscess large tender liver, fever

6

Gram positive cocci in clusters UTI

staph saprophyticus

7

enterococcus look like

gram pos cocci in chains

8

In the lab how do they figure out staph vs strep

staph catalase positive
strep catalase neg

9

No haemolysis on blood agar

enterococcus

partial = green = alpha = s pneumo (optochonin sens) and s viridans (optochonin resist)
complete = clear = beta = s pyogenes, s agalactiae

10

What are the coag neg staph?

s saprophyticus
s epidermis

11

Kaposis - cause

HHV8

12

nocardia is

gram positive
filamentous

13

olecranon bursitis

staph

14

Q fever

coxiella burnetti

pleomorphic
gram neg
bacilli or coccobacilli
obligate intracellular

15

risk factors for mucormycosis

iron overload
diabetes

once have it hihg risk for cavernous sinus thrombosis (CN III, IV, V1, V2, VI initial signs)

give amphotericin B then posaconazole

16

when would you think fusarium?

neutropaenic and blood cultures grow hyaline mould
endopthalmitis
angio invasive- stroke like events
lesions near toenails

17

drowning event, think which fungus

scedosporium

18

MOA penicillin vs ceftaroline

ceftaroline binds PBP2

penicillin inhibits formation of peptidoglcan cross links n the bacterial cell wall by binding to enzyme DD-transpeptidase-->cannot catalyse the formation of cross links -->imbalance between cell wall production and degradation

19

What in MRSA enables the necrotising lung abscess formation?

PVL gene in MRSA

20

Community vs healthcare acuired MRSA

HA: large SCCmecA, MDR, infection many sites like blood, lung skin, diabetes/dialysis/long term health care

CA: small SCCmecA, younger patients, healthy, MSM, IVDU , skin and soft tissue infection, often express PVL which allows to form lung abscesses, can be sens to bactrim, macrolide, doxy, lincosamides

21

Why VRE?

overuse of third gen cephalosporins

22

Difference between AMPC beta lactamases and ESBL

ESBL is inhibited by clavulanic acid
AMPC beta lactamases are not

23

Monocytes in CSF?

listeria monocytogenes

24

commonest viral men

enterovirus then HSV 2 then varicella

25

meningoencephalitis most common

HSV 1 adults
HSV 2 kids

26

steroids in TB mening?

Reduces mortality

27

HSV PCR negative day 1 but suspect

repeat- may be false negative

28

catalase positive gram pos cocci
catalase neg gram pos cocci

catalase pos staph
neg enterococcus or strep

29

Gram positive facultative intracellular bacteria

listeria

other IC organisms are chlamydia, rickettisa, brucella, mycobacteria

30

the only gram positive organism to produce endotoxins

listeria

give ampicillin

31

JC virus lives WHERE?

In PML it is affecting the OLIGODENDROCYTES!!

32

how can you predict if cryptosporidium diarrhoea will be self limiting?

CD4 over180 will usually self limit
otherwise unremitting
can be associated with cholangitis, papillary stenosis, cholecystitis