Term
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Definition
- Gram+ diplococci, a-hemolytic, catalase -
- Spread by respiratory droplets --> colonizes nasopharynx epithelium --> induces rusty sputum
- Capsule, IgA protease
- Often associated with otitis media, sinusitis, arthritis, endocarditis
- Treated with penicillin or cephalosporins
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Term
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Definition
- Gram+ cluster, catalase +, coagulase +
- Natural flora of skin
- Protein A, coagulase, hemolysin, pus forming, spreading factors (hyaluronidase, staphylokinase, lipase)
- Treat with penicillinase-resistant penicillins, vancomycin (if MRSA)
- Pts with chronic granulomatous disease susceptible
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Term
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Definition
- Gram- bacillus
- Right upper lobe, necrotizes tissue, forming cavities and inducing bloody "currant jelly" sputum
- Capsule
- Treat with 3rd generation cephalosporin
- Frequent cause of pneumonia in alcholics
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Term
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Definition
- Gram - bacillus, ferments lactose
- Spread by aspiration or bacteremia
- Treat with TMP-SMX, penicillin, 3rd generation cephalosporin
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Term
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Definition
- Gram - bacillus, form blue-green colonies with fruity odor
- Environmental pathogen (soil, water) generally infecting immune compromised individuals (CF pts)
- Multiple virulence factors, but as pneomania, primarily capsule forming and non-invasive
- Treat with fluoroquinolones
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Term
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Definition
- Gram- bacillus, highly fastidious.
- Inhaled in aerosole,
- IgA protease.
- Treat with 3rd generation cephalosporins
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Term
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Definition
- Gram – bacillus, forms blue colonies with fruity color.
- Found throughout environment, colonizes CF fibrosis pts.
- Multiple virulence factors, but as pneomania, primarily capsule forming and non-invasive
- Treat with fluoroquinolones
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Term
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Definition
- Poor gram stain, visualize with silver stain.
- Inhabits water, aerosolized in A/C and respiratory devises, phagocytosed but proliferates within phagosome.
- Often seen in elderly smokers.
- Treat with erythromycin
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Term
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Definition
- Require Giemsa stain
- Community acquired, exists in two states (elementary body and reticular body), EB swallowed by phagocyte, proliferates as RB, released as EB
- Treat with doxycyclin
- Infects young adults
- Note: similar to Chlamydia psittaci, which is acquired from birds
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Term
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Definition
- Obligate intracellular organism
- Carried in cattle, sheep and goats, form spores which can be inhaled
- Treated with tetracycline
- Unlike other Rickettsial disease, does not cause rash and is not carried by arthropod
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Term
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Definition
S3 sounds
Mnemonic: SLOSH’-ing-in
S1 - - - S2 - S3
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Term
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Definition
S4
Mnemonic: A-STIFF WALL = S4-S1 ... S2 |
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Term
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Definition
| S2 split (physiologically normal if during inhalation, paradoxical if during exhalation) |
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Term
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Definition
Late aortic stenosis
Late systolic murmur |
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Term
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Definition
Mitral stenosis (diastolic murmur)
More common in female, associated with rheumatic disorder. Best heard at the apex with little radiation.
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Term
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Definition
| Mitral regurgitation (systolic murmur) |
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Term
| You listen to a patients chest at the left 5th intercostal space, midclavicular. You hear a harsh, holosystolic murmur. S1 sounds are slightly diminished, with a regular beat occuring after S2. What is the most likely pathology? Which area of the heart are you listening to? What causes the diastolic sound? |
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Definition
- Mitral regurgitation- valve fails to close in systole, causing systolic regurgitation of blood from LV --> LA
- Apex
- S3 caused by volume overload on left ventricle
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Term
| You listen to a patients chest at the left 5th intercostal space, midclavicular. You hear a low-pitched rumble during diastolsis, preced by an opening "snap." S1 is accentuated. What is the most likely cause? Which area of the heart are you listening to? |
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Definition
- Mitral stenosis - thickening of mitral valve leaflets, preventing complete opening. Two component: middiastolsis and pressystolsis.
- Apex
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Term
| You listen to a patients chest at the 2nd-4th interspace, close to the right sternal border. You here a high pitched diastolic murmur, and ask the patient to sit leaning forwards. What is the most likely pathology? What would be an indication of severe pathology? What are some associated findings? |
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Definition
- Aortic regurgitation- leaflets of aortic valve fail to close completely during diastole, leading to back flow and volume overload on left ventricle.
- S3 or S4 (ventricular overload and increased resistance to ventricular filling, respectively)
- Increase pulse pressure, large and bounding arterial pulse, lateral and downward displacement, widened diameter
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Term
| You listen to the patient's right, 2nd intercostal space, noticing a systolic murmur that increases in volume, climaxing midsystole, before quieting. There's an S2 split during exhalation. You ask the patient to sit and lean forward. What is the most likely pathology? What causes the parodoxical split? What would you see if you looked at the carotid pulse? |
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Definition
- Aortic stenosis (congenital, rheumatic, degenerative)
- Premature closure of the aortic valve
- Delayed upstroke and decreased amplitude
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Term
| When listening to the left intercostal spaces (2nd-4th), you notice a soft pitched, midsystolic murmur. There is no ejection sounds, paradoxical splitting, or diastolic murmur. What is the most likely cause? |
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Definition
| Turbulent blood flow, most likely generated by ventricular ejection of blood into the aorta. (Innocent murmur) |
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Term
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Definition
Aortic regurgitation
Early diastolic decresendo |
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