Micro: Gram -

Waterhouse-Friderchsen

spetic shock caused by meningococcus
bilateral hemorrhage into adrenal glands, tachy, enlarging petechia -- purpura, DIC, death in hrs

classic medium for Neisseria

Thayer-Martin VCN
V: vancomyscin - to kill gram +s
C: colistin (polymixin) to kill gram -s
N: nystatin to kill fungi

Fitz-Hugh-Curtis syndrome (peri-hepatitis)

Neisseria gonorrhea of the capsule of the liver
pt complains of URQ pain following gonoccus-like syndrome or chlamydial PID

EMB agar

eosine methyline blue - inhibits gram + bacteria; colonies of fermenters become deep purple/bld; e.coli becomes metalic sheen

MacConkey agar

Bile salts inhibit gram + growth, lactose fermenters deveop pink color ("lactose is KEE" = Klebsiella, E.coli, Enterobacter)

Culprits of watery diarrhea w/o systemic symptoms (meaning no cell invasion)

ETEC
cholera
salmonella enteritidis
C.perfringes
Protoza (Giardia, Cryptosporidium)
Viruses (roravirus, adneovirus, norwalk)
c.diff

culprits of bloody diarrhea (meaning invasion of intestinal epithelial cells)

EIEC
shigella
salmonella enteritidis
C.diff

culprits of bloody diarrhea w/ lymph node enlargement, bacteriam and maybe sepsis

Salmonella typhi
Yersinia enterocolitica
Campylobacter jejuni

Pseudomonas aeruginosa

P: pneumona (esp in CF)
S: sepsis (blk lesion on skin)
E: extenral otitis (swimmer's ear) & endo + exotoxin
U: UTI
D: drug use
O: diabetic osteomyelitis
*hot tube folliculitis

what covers pseudomonas?

Aminoglycosides + extended specturm pen (ticar or piper)

Big Bad bugs from your pets (relatively common zoonotic bacteria)

Bartonella henselae
Borrelia burgdorferi
Brucella spp.
Francisella tularensis
Yersinia Pestis
Pasturella multocida

Bartonella henselae

cat scratch fever (fever, chills, back ache, abd pain, regional lymphadenopathy, menal status changes, papules as innoculation site)

Borrelia burgodrferi

lyme disease (tick bite - deer and mice)
1: Bullseye rash pattern (erythema migrans) at innoculation and flulike symptoms
2: (wks -mo later) neuro and caridac manifestations
3: chronic monoarthritis and migratory polyarthritis

Pasteurella multocida

cellulitis (animal bite - cat, dog)

Haemophilus ducreyi

Chancroid! painful genital ucler; unilateral painful swollen inguinal lymph nodes rapidly devleop in 50% of pts (note diff includes lymphogranuloma venerum - which has painless LN's the progress much slower than chancroid LN's)

Gardnerella vaginalis

bacterial vaginitis; clue cells seen on slide; Rx: metro

reasons for veneral disease research lab (VDRL) test to read falsely positive:

V: viruses (hepatis, mono)
D: drugs
R: Rheumatic fever (s.pyogenes)
L: Lupus and leprosy

Tuberculoid Leprosy characterisitcs
1) number of lesions
2) hair growth on skin lesions
3) sensation in lesions
4) bacilli in skin scraping?
5) lepromin skin test?

1) single
2) absent
3) completely loss
4) none
5) strongly positive

Lepromatous Leprosy characteristics:
1) number of lesions
2) hair growth on skin lesions
3) sensation in lesions
4) bacilli in skin scraping?
5) lepromin skin test?

1) many
2) not affected
3) not affcted *but stocking glove distribution loss from peripheral nn loss
4) innumerable
5) no rxn

EHEC presentation:

throbocytopenia, anemia, uremia, bdy diarrhea, abd pain