Introduction Definition gram-positive bacteria stain purple on a gram-stain test the bacterial cell wall of these organisms have thick peptidoglycan layers, which take up the purple/violet stain Treatment gram-positive bacteria are susceptible to antibiotics that target the cell wall, as they often lack an outer membrane penicillins vancomycin carbapenem daptomycin other antibiotics used include linezolid clindamycin Gram-Positive Bacteria COCCI Staphylococcus Bacteria Disease Treatment Staphylococcus aureus Abscesses and mastitis Endocarditis Gastroenteritis Osteomyelitis Pneumonia Scalded skin syndrome Skin infections Toxic shock syndrome Penicillinase-resistant penicillins Vancomycin Linezolid Staphylococcus epidermidis Normal skin and genital tract flora Associated with use of catheters and prosthetic devices and biofilm development Vancomycin Staphylococcus saprophyticus Normal genital tract flora Urinary tract infection Trimethoprim-sulfamethoxazole Streptococcus Streptococcus pneumoniae "MOPS" Meningitis Otitis media Pneumonia Sinusitis Penicillins 3rd generation cephalosporins Streptococcus pyogenes (Group A) Pyogenic infections pharyngitis cellulitis impetigo erysipelas Toxigenic infections scarlet fever necrotizing fasciitis Immunologic infections glomerulonephritis rheumatic fever Penicillins Streptococcus agalactiae (Group B) Normal vaginal flora Neonatal septicemia Neonatal meningitis Ampicillin Streptococcus viridans Normal throat flora Dental caries Endocarditis Penicillin G Streptococcus bovis (Group D) Normal gut flora Bacteremia Endocarditis (subacute) Associated with colon cancer Penicillin or ceftriaxone Enterococci Enterococci faecalis (Group D) Normal gut flora Endocarditis (subacute) Urinary tract infection Biliary tract infections Some strains are vancomycin-resistant (VRE) Linezolid and streptogramins Penicillins, vancomycin, or daptomycin Often resistant to penicillin G BACILLI Spore-Forming Bacillus anthracis Cutaneous anthrax Pulmonary anthrax Ciprofloxacin Doxycycline Bacillus cereus Food poisoning (rice) Self-limiting Clindamycin Aminoglycosides Clostridium tetani Tetanus Antitoxin with or without vaccine booster Benzodiazepines for muscle spasms Surgical debridement Clostridium botulinum Botulism Human botulinum immunoglobulin Clostridium perfringens Gas gangrene Food poisoning Clindamycin Penicillin Clostridium difficile Antibiotic-associated diarrhea Colitis Pseudomembranous colitis Metronidazole Vancomycin (oral) Fidaxomicin Fecal microbiota transplant Non-Spore Forming Corynebacterium diphtheriae Diphtheria Erythromycin Penicillin G Diphtheria antitoxin Listeria monocytogenes Meningitis neonatal immunocompromised Amnionitis Spontaneous abortion Granulomatosis infantiseptica Gastroenteritis Ampicillin Trimethoprim-sulfamethoxazole BRANCHING FILAMENTS Nocardia spp. Pulmonary infection (immunocompromised) Cutaneous nocardiosis (associated with trauma) Trimethoprim-sulfamethoxazole Carbapenems Actinomyces spp. Oral and facial abscesses associated with poor dental hygiene or maxillofacial trauma Yellow "sulfur granules" Pelvic inflammatory disease associated with intrauterine devices Penicillin Tetracycline
QUESTIONS 1 of 1 1 Previous Next Lab Values Blood Hematologic Cerebrospinal Sweat, Urine, and BMI Blood, Plasma, Serum Reference Range ALT 8-20 U/L Amylase, serum 25-125 U/L AST 8-20 U/L Bilirubin, serum (adult) Total // Direct 0.1-1.0 mg/dL // 0.0-0.3 mg/dL Calcium, serum (Ca2+) 8.4-10.2 mg/dL Cholesterol, serum Rec: < 200 mg/dL Cortisol, serum 0800 h: 5-23 μg/dL //1600 h: 3-15 μg/dL 2000 h: ≤ 50% of 0800 h Creatine kinase, serum Male: 25-90 U/LFemale: 10-70 U/L Creatinine, serum 0.6-1.2 mg/dL Electrolytes, serum Sodium (Na+) 136-145 mEq/L Chloride (Cl-) 95-105 mEq/L Potassium (K+) 3.5-5.0 mEq/L Bicarbonate (HCO3-) 22-28 mEq/L Magnesium (Mg2+) 1.5-2.0 mEq/L Estriol, total, serum (in pregnancy) 24-28 wks // 32-36 wks 30-170 ng/mL // 60-280 ng/mL 28-32 wk // 36-40 wks 40-220 ng/mL // 80-350 ng/mL Ferritin, serum Male: 15-200 ng/mLFemale: 12-150 ng/mL Follicle-stimulating hormone, serum/plasma Male: 4-25 mIU/mL Female: premenopause: 4-30 mIU/mL midcycle peak: 10-90 mIU/mL postmenopause: 40-250 pH 7.35-7.45 PCO2 33-45 mmHg PO2 75-105 mmHg Glucose, serum Fasting: 70-110 mg/dL2-h postprandial:<120 mg/dL Growth hormone - arginine stimulation Fasting: <5 ng/mLProvocative stimuli: > 7ng/mL Immunoglobulins, serum IgA 76-390 mg/dL IgE 0-380 IU/mL IgG 650-1500 mg/dL IgM 40-345 mg/dL Iron 50-170 μg/dL Lactate dehydrogenase, serum 45-90 U/L Luteinizing hormone, serum/plasma Male: 6-23 mIU/mL Female: follicular phase: 5-30 mIU/mL midcycle: 75-150 mIU/mL postmenopause 30-200 mIU/mL Osmolality, serum 275-295 mOsmol/kd H2O Parathyroid hormone, serume, N-terminal 230-630 pg/mL Phosphatase (alkaline), serum (p-NPP at 30° C) 20-70 U/L Phosphorus (inorganic), serum 3.0-4.5 mg/dL Prolactin, serum (hPRL) < 20 ng/mL Proteins, serum Total (recumbent) 6.0-7.8 g/dL Albumin 3.5-5.5 g/dL Globulin 2.3-3.5 g/dL Thyroid-stimulating hormone, serum or plasma .5-5.0 μU/mL Thyroidal iodine (123I) uptake 8%-30% of administered dose/24h Thyroxine (T4), serum 5-12 μg/dL Triglycerides, serum 35-160 mg/dL Triiodothyronine (T3), serum (RIA) 115-190 ng/dL Triiodothyronine (T3) resin uptake 25%-35% Urea nitrogen, serum 7-18 mg/dL Uric acid, serum 3.0-8.2 mg/dL Hematologic Reference Range Bleeding time 2-7 minutes Erythrocyte count Male: 4.3-5.9 million/mm3Female: 3.5-5.5 million mm3 Erythrocyte sedimentation rate (Westergren) Male: 0-15 mm/hFemale: 0-20 mm/h Hematocrit Male: 41%-53%Female: 36%-46% Hemoglobin A1c ≤ 6 % Hemoglobin, blood Male: 13.5-17.5 g/dLFemale: 12.0-16.0 g/dL Hemoglobin, plasma 1-4 mg/dL Leukocyte count and differential Leukocyte count 4,500-11,000/mm3 Segmented neutrophils 54%-62% Bands 3%-5% Eosinophils 1%-3% Basophils 0%-0.75% Lymphocytes 25%-33% Monocytes 3%-7% Mean corpuscular hemoglobin 25.4-34.6 pg/cell Mean corpuscular hemoglobin concentration 31%-36% Hb/cell Mean corpuscular volume 80-100 μm3 Partial thromboplastin time (activated) 25-40 seconds Platelet count 150,000-400,000/mm3 Prothrombin time 11-15 seconds Reticulocyte count 0.5%-1.5% of red cells Thrombin time < 2 seconds deviation from control Volume Plasma Male: 25-43 mL/kgFemale: 28-45 mL/kg Red cell Male: 20-36 mL/kgFemale: 19-31 mL/kg Cerebrospinal Fluid Reference Range Cell count 0-5/mm3 Chloride 118-132 mEq/L Gamma globulin 3%-12% total proteins Glucose 40-70 mg/dL Pressure 70-180 mm H2O Proteins, total < 40 mg/dL Sweat Reference Range Chloride 0-35 mmol/L Urine Calcium 100-300 mg/24 h Chloride Varies with intake Creatinine clearance Male: 97-137 mL/minFemale: 88-128 mL/min Estriol, total (in pregnancy) 30 wks 6-18 mg/24 h 35 wks 9-28 mg/24 h 40 wks 13-42 mg/24 h 17-Hydroxycorticosteroids Male: 3.0-10.0 mg/24 hFemale: 2.0-8.0 mg/24 h 17-Ketosteroids, total Male: 8-20 mg/24 hFemale: 6-15 mg/24 h Osmolality 50-1400 mOsmol/kg H2O Oxalate 8-40 μg/mL Potassium Varies with diet Proteins, total < 150 mg/24 h Sodium Varies with diet Uric acid Varies with diet Body Mass Index (BMI) Adult: 19-25 kg/m2 Calculator ( ) xy AC 7 8 9 ÷ 4 5 6 × 1 2 3 - 0 . = + (M1.MC.78) A 43-year-old patient with a history of esophageal cancer presents with sudden onset slurred speech. On CT scan, she is found to have an acute intraparenchymal hemorrhage, likely from a metastasis, with interventricular extension. Due to concern for hydrocephalus, an external ventricular drain is placed in order to control the intracerebral pressure. Two weeks later, she undergoes a lumbar puncture due to altered mental status, and the gram stain of the fluid is depicted in Figure A. Which part of the bacteria is responsible for the blue color on the stain? Review Topic QID: 106887 FIGURES: A 1 Cell wall 95% (19/20) 2 Mitochondria 0% (0/20) 3 Golgi 0% (0/20) 4 Nucleus 5% (1/20) 5 Endoplasmic reticulum 0% (0/20) M1 Select Answer to see Preferred Response PREFERRED RESPONSE 1