Clinical Medicine II Exam 1 — Infectious
Disease Review UPDATED Study Guide
QUESTIONS AND CORRECT ANSWERS
Cocci - CORRECT ANSWERS Spherical-shaped bacteria.
Bacilli - CORRECT ANSWERS Rod-shaped bacteria.
Gram-Positive Bacteria - CORRECT ANSWERS Bacteria that have a
thick peptidoglycan cell wall, and no outer membrane. They stain very darkly
(purple) in Gram stain. Retains the crystal violet stain, indicating a more
penetrable cell wall and thus more susceptible to antibiotics.
Gram-Negative Bacteria - CORRECT ANSWERS Bacteria that have a
thin peptidoglycan cell wall covered by an outer plasma membrane. They stain
very lightly (pink) in Gram stain. Do not retain stain, indicating an impenetrable
cell wall, and thus more resistant to antibiotics.
Gram Stain - CORRECT ANSWERS A staining method that
distinguishes between two different kinds of bacterial cell walls (gram positive
vs gram negative). *Gram positive = appears purple with Gram stain. Gram
negative = appears pink with Gram stain.* It was first introduced by Danish
bacteriologist Hans Christian Gram in 1882. Typically the first microbial test
performed on an organism. Crystal violet used as the primary stain, fushsin or
safranin as a counterstain.
Aerobic - CORRECT ANSWERS Organisms that thrive in the presence
of oxygen; require oxygen to live.
Anaerobic - CORRECT ANSWERS Organisms that thrive in the absence
of oxygen.
,Clostridium Botulinum - CORRECT ANSWERS A *gram-positive, rod-
shaped, spore-forming, obligate anaerobic bacteria* that is commonly seen on
surfaces of vegetables, fruits, and seafood. Exist in soil and marine sediment
worldwide. Types of infection include: infant, food-borne, or wound. It is
diagnosed through analysis of serum, stool, gastric contents, or food for toxin.
*Must notify public health department.* It is prevented by destroying spores
with heat (120 C for 5 minutes or irradiation). Also inhibit germination: acidic
environment, freezing, drying, or salting. *Clinical presentation: autonomic
symptoms (xerostomia, dysautonomia), dysarthria and dysphagia, cranial nerve
palsies, descending flaccid paralysis, eyelid drooping, floopy baby syndrome
(neonatal hypotonia), and GI symptoms like nausea, vomiting, or constipation.*
Treatment: For infants (1 < y/o) give the human-derived antitoxin. Give the
equine toxin for everyone else. *No antibiotics - may increase amount of toxin
through lysis of intraluminal spores. May consider laxatives, enemas, or
cathartics if no ileus is present to help eliminate remaining spores.
• Gram-positive, rod-shaped, spore-forming, obligate anaerobic bacteria.
Commonly seen on surfaces of vegetables, fruits, and seafood. Exist in soil and
marine sediment worldwide.
• Infant, food-borne, or wound.
• Diagnosed through analysis of serum, stool, gastric contents, or food for toxin.
*Must notify public health department.* Prevented by destroying spores with
heat (120 C for 5 minutes or irradiation). Also inhibit germination: acidic
environment, freezing, drying, or salting.
• Autonomic symptoms (xerostomia, dysautonomia), dysarthria and dysphagia,
cranial nerve palsies, descending flaccid paralysis, eyelid drooping, floppy baby
syndrome (neonatal hypotonia), and GI symptoms like nausea, vomiting, or
constipation.
• For infants (< 1 y/o) give the human-derived antitoxin. Give the equine toxin
for everyone else. laxatives, enemas, or cathartics if no ileus is present to help
eliminate remaining sp - CORRECT ANSWERS • Describe Clostridium
botulinum (gram positive vs negative, shape, spore-forming, aerobic vs
anaerobic), etc. Where is it commonly found?
• What are the types of infection?
,• Diagnosis and prevention?
• Clinical presentation of botulinum?
• Treatment? What if < 1 y/o? What if > 1 y/o? What if no ileus is present, then
what is given?
Campylobacter Enteritis - CORRECT ANSWERS A *gram-negative,
spiral-shaped, partial anaerobe* that is the leading cause of acute diarrhea
worldwide. Second MC cause in the U.S. Commonly seen in GI tracts of
animals, especially poultry. *Clinical presentation: prodromal symptoms of
fever, rigors, generalized aches, dizziness, and delirium - may last 1-3 days prior
to onset of GI symptoms. After mean incubation period of three days, observe
abdominal pain and diarrhea in adults. In children, observe diarrhea, fever,
abdominal pain, and vomiting. May also have bloody stool or
convulsions/seizures. In infants, observe vomiting and bloody stools, fever and
abdominal pain less common.* Complications: cholecystitis, peritonitis,
reactive arthritis, and Guillain-Barre syndrome (GBS) [ascending paralysis].
Treatment: usually mild and self-limiting, maintain proper
hydration/electrolytes. Antibiotics are not needed, unless severe disease present,
then give Azithromycin. Avoid anti-diarrheal medication, especially if febrile.
• Gram-negative, spiral-shaped, partial anaerobe that is the leading cause of
acute diarrhea worldwide. Second MC cause in the U.S. Commonly seen in GI
tracts of animals, especially poultry.
• Prodromal symptoms of fever, rigors, generalized aches, dizziness, and
delirium - may last 1-3 days prior to onset of GI symptoms. After mean
incubation period of three days, observe abdominal pain and diarrhea in adults.
In children, observe diarrhea, fever, abdominal pain, and vomiting. May also
have bloody stool or convulsions/seizures. In infants, observe vomiting and
bloody stools, fever and abdominal pain less common.
• Cholecystitis, peritonitis, reactive arthritis, and Guillain-Barre syndrome
(GBS) [ascending paralysis]
• Usually mild and self-limiting, maintain proper hydration/electrolytes.
Antibiotics are not needed, unless severe disease present, then give
Azithromycin. Avoid anti-diarrheal medication. - CORRECT ANSWERS
, • Describe Campylobacter enteritis (gram positive vs gram negative,
shape, aerobic vs anaerobic). Where is it commonly found?
• Clinical presentation?
• Complications that can result?
• Treatment? What if severe disease is present? What should be avoided?
Vibrio Cholera - CORRECT ANSWERS A *gram-negative, comma-
shaped rod, halophilic, anaerobic bacteria that exists in aquatic environments.*
Suspect when patients presents with severe diarrhea, dehydration, vomiting, and
recent travel to an endemic area. *Clinical presentation: voluminous diarrhea,
watery emesis. Rice-water stool - stool is liquid in consistency, gray in color,
lacks odor, blood, or pus. Incubation period is usually 1-2 days. Other
symptoms are abdominal cramping and dehydration. Can result in severe
hypovolemia (dry mouth, clammy skin, sunken eyes, decreased skin turgor,
wrinkled hands, feet, and lethargy).* Treatment: aggressive volume repletion is
mainstay, usually orally but need IV fluids. Adjunctive therapy with antibiotics:
macrolides (1st line), tetracyclines (2nd line), fluoroquinolones (3rd line).
Rice Water Stool - CORRECT ANSWERS Stool that is liquid in
consistency, gray in color, lacks odor, blood, or pus. Characteristic of infection
of Vibrio cholera.
• Gram-negative, comma-shaped rod, halophilic, anaerobic bacteria that exists
in aquatic environments. Suspect when patients presents with severe diarrhea,
dehydration, vomiting, and recent travel to an endemic area.
• Voluminous diarrhea, watery emesis. Rice-water stool - stool is liquid in
consistency, gray in color, lacks odor, blood, or pus. Incubation period is usually
1-2 days. Other symptoms are abdominal cramping and dehydration. Can result
in severe hypovolemia (dry mouth, clammy skin, sunken eyes, decreased skin
turgor, wrinkled hands, feet, and lethargy)
• Aggressive volume repletion is mainstay, usually orally but need IV fluids.
Adjunctive therapy with antibiotics: macrolides (1st line), tetracyclines (2nd
line), fluoroquinolones (3rd line). - CORRECT ANSWERS • Describe
Vibrio cholera (gram positive vs gram negative, shape, aerobic vs anaerobic)?
Disease Review UPDATED Study Guide
QUESTIONS AND CORRECT ANSWERS
Cocci - CORRECT ANSWERS Spherical-shaped bacteria.
Bacilli - CORRECT ANSWERS Rod-shaped bacteria.
Gram-Positive Bacteria - CORRECT ANSWERS Bacteria that have a
thick peptidoglycan cell wall, and no outer membrane. They stain very darkly
(purple) in Gram stain. Retains the crystal violet stain, indicating a more
penetrable cell wall and thus more susceptible to antibiotics.
Gram-Negative Bacteria - CORRECT ANSWERS Bacteria that have a
thin peptidoglycan cell wall covered by an outer plasma membrane. They stain
very lightly (pink) in Gram stain. Do not retain stain, indicating an impenetrable
cell wall, and thus more resistant to antibiotics.
Gram Stain - CORRECT ANSWERS A staining method that
distinguishes between two different kinds of bacterial cell walls (gram positive
vs gram negative). *Gram positive = appears purple with Gram stain. Gram
negative = appears pink with Gram stain.* It was first introduced by Danish
bacteriologist Hans Christian Gram in 1882. Typically the first microbial test
performed on an organism. Crystal violet used as the primary stain, fushsin or
safranin as a counterstain.
Aerobic - CORRECT ANSWERS Organisms that thrive in the presence
of oxygen; require oxygen to live.
Anaerobic - CORRECT ANSWERS Organisms that thrive in the absence
of oxygen.
,Clostridium Botulinum - CORRECT ANSWERS A *gram-positive, rod-
shaped, spore-forming, obligate anaerobic bacteria* that is commonly seen on
surfaces of vegetables, fruits, and seafood. Exist in soil and marine sediment
worldwide. Types of infection include: infant, food-borne, or wound. It is
diagnosed through analysis of serum, stool, gastric contents, or food for toxin.
*Must notify public health department.* It is prevented by destroying spores
with heat (120 C for 5 minutes or irradiation). Also inhibit germination: acidic
environment, freezing, drying, or salting. *Clinical presentation: autonomic
symptoms (xerostomia, dysautonomia), dysarthria and dysphagia, cranial nerve
palsies, descending flaccid paralysis, eyelid drooping, floopy baby syndrome
(neonatal hypotonia), and GI symptoms like nausea, vomiting, or constipation.*
Treatment: For infants (1 < y/o) give the human-derived antitoxin. Give the
equine toxin for everyone else. *No antibiotics - may increase amount of toxin
through lysis of intraluminal spores. May consider laxatives, enemas, or
cathartics if no ileus is present to help eliminate remaining spores.
• Gram-positive, rod-shaped, spore-forming, obligate anaerobic bacteria.
Commonly seen on surfaces of vegetables, fruits, and seafood. Exist in soil and
marine sediment worldwide.
• Infant, food-borne, or wound.
• Diagnosed through analysis of serum, stool, gastric contents, or food for toxin.
*Must notify public health department.* Prevented by destroying spores with
heat (120 C for 5 minutes or irradiation). Also inhibit germination: acidic
environment, freezing, drying, or salting.
• Autonomic symptoms (xerostomia, dysautonomia), dysarthria and dysphagia,
cranial nerve palsies, descending flaccid paralysis, eyelid drooping, floppy baby
syndrome (neonatal hypotonia), and GI symptoms like nausea, vomiting, or
constipation.
• For infants (< 1 y/o) give the human-derived antitoxin. Give the equine toxin
for everyone else. laxatives, enemas, or cathartics if no ileus is present to help
eliminate remaining sp - CORRECT ANSWERS • Describe Clostridium
botulinum (gram positive vs negative, shape, spore-forming, aerobic vs
anaerobic), etc. Where is it commonly found?
• What are the types of infection?
,• Diagnosis and prevention?
• Clinical presentation of botulinum?
• Treatment? What if < 1 y/o? What if > 1 y/o? What if no ileus is present, then
what is given?
Campylobacter Enteritis - CORRECT ANSWERS A *gram-negative,
spiral-shaped, partial anaerobe* that is the leading cause of acute diarrhea
worldwide. Second MC cause in the U.S. Commonly seen in GI tracts of
animals, especially poultry. *Clinical presentation: prodromal symptoms of
fever, rigors, generalized aches, dizziness, and delirium - may last 1-3 days prior
to onset of GI symptoms. After mean incubation period of three days, observe
abdominal pain and diarrhea in adults. In children, observe diarrhea, fever,
abdominal pain, and vomiting. May also have bloody stool or
convulsions/seizures. In infants, observe vomiting and bloody stools, fever and
abdominal pain less common.* Complications: cholecystitis, peritonitis,
reactive arthritis, and Guillain-Barre syndrome (GBS) [ascending paralysis].
Treatment: usually mild and self-limiting, maintain proper
hydration/electrolytes. Antibiotics are not needed, unless severe disease present,
then give Azithromycin. Avoid anti-diarrheal medication, especially if febrile.
• Gram-negative, spiral-shaped, partial anaerobe that is the leading cause of
acute diarrhea worldwide. Second MC cause in the U.S. Commonly seen in GI
tracts of animals, especially poultry.
• Prodromal symptoms of fever, rigors, generalized aches, dizziness, and
delirium - may last 1-3 days prior to onset of GI symptoms. After mean
incubation period of three days, observe abdominal pain and diarrhea in adults.
In children, observe diarrhea, fever, abdominal pain, and vomiting. May also
have bloody stool or convulsions/seizures. In infants, observe vomiting and
bloody stools, fever and abdominal pain less common.
• Cholecystitis, peritonitis, reactive arthritis, and Guillain-Barre syndrome
(GBS) [ascending paralysis]
• Usually mild and self-limiting, maintain proper hydration/electrolytes.
Antibiotics are not needed, unless severe disease present, then give
Azithromycin. Avoid anti-diarrheal medication. - CORRECT ANSWERS
, • Describe Campylobacter enteritis (gram positive vs gram negative,
shape, aerobic vs anaerobic). Where is it commonly found?
• Clinical presentation?
• Complications that can result?
• Treatment? What if severe disease is present? What should be avoided?
Vibrio Cholera - CORRECT ANSWERS A *gram-negative, comma-
shaped rod, halophilic, anaerobic bacteria that exists in aquatic environments.*
Suspect when patients presents with severe diarrhea, dehydration, vomiting, and
recent travel to an endemic area. *Clinical presentation: voluminous diarrhea,
watery emesis. Rice-water stool - stool is liquid in consistency, gray in color,
lacks odor, blood, or pus. Incubation period is usually 1-2 days. Other
symptoms are abdominal cramping and dehydration. Can result in severe
hypovolemia (dry mouth, clammy skin, sunken eyes, decreased skin turgor,
wrinkled hands, feet, and lethargy).* Treatment: aggressive volume repletion is
mainstay, usually orally but need IV fluids. Adjunctive therapy with antibiotics:
macrolides (1st line), tetracyclines (2nd line), fluoroquinolones (3rd line).
Rice Water Stool - CORRECT ANSWERS Stool that is liquid in
consistency, gray in color, lacks odor, blood, or pus. Characteristic of infection
of Vibrio cholera.
• Gram-negative, comma-shaped rod, halophilic, anaerobic bacteria that exists
in aquatic environments. Suspect when patients presents with severe diarrhea,
dehydration, vomiting, and recent travel to an endemic area.
• Voluminous diarrhea, watery emesis. Rice-water stool - stool is liquid in
consistency, gray in color, lacks odor, blood, or pus. Incubation period is usually
1-2 days. Other symptoms are abdominal cramping and dehydration. Can result
in severe hypovolemia (dry mouth, clammy skin, sunken eyes, decreased skin
turgor, wrinkled hands, feet, and lethargy)
• Aggressive volume repletion is mainstay, usually orally but need IV fluids.
Adjunctive therapy with antibiotics: macrolides (1st line), tetracyclines (2nd
line), fluoroquinolones (3rd line). - CORRECT ANSWERS • Describe
Vibrio cholera (gram positive vs gram negative, shape, aerobic vs anaerobic)?
