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Micro Quiz 3 > 21b: normal flora - jonathan > Flashcards

21b: normal flora - jonathan Flashcards

1
Q

What are the benefits of normal intestinal flora?

A

Interfere with colonization of pathogens

Produce Vitamin K and B 12

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2
Q

What can bacterial overgrowth in the small intestines cause?

A

Fat malabsorption
B12 Deficiency
bacteria belong in the large intestine, not the small intestine

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3
Q

What are five normal AEROBIC/ FACULATIVE bacteria in the oral cavity and saliva?

A 
Viridans streptococci
Neisseria species
Diphtheroids aka Corynebacterium species not including C. diphtheriae (these are usually not pathogenic)
Staphylococci epidermidis
Eikenella corrodens
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4
Q 
What is the gram stain and shape of...
Viridans streptococci
Neisseria species
Diphtheroids aka Corynebacterium species not including C. diphtheriae
Staphylococci epidermidis
Eikenella corrodens
A

Viridans streptococci: Gram + cocci
Neisseria species: Gram - diplococci
Diphtheroids aka Corynebacterium species: Gram + rods pleomorhic
Staphylococci epidermidis: Gram + cocci in grape like clusters
Eikenella corrodens: faculative Gram - rod

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5
Q

What is the mouth heart connection via Viridans streptococci?

A

Predominant microorganism in the mouth and are the most common cause of subacute endocarditis

Note: they also make tooth plaque and hasten dental carries with lactic acid sugar fermentation

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6
Q

T/F Neiseria are pathogenic in the mouth.

A

Neiseria have non-pathogenic and pathogenic strains which need to be distinguished for proper Tx
N. meningitis can cause meningitis and can colonize the throat or the nasopharynx

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7
Q

What are the most common contaminants in blood cultures?

A

Diphtheroids and S. epidermidis colonize the skin and can infect blood when drawn.

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8
Q

What is the role of normal aerobic oral cavity flora in disease (3)?

A

1) if normal flora are eliminated by antibiotics, they may be replaced by drug resistant Gram - rods or yeast
2) Small percentage of normal through flora are still pathogenic (eg. Pneumococcus and S. aureus
3) Aerobic Gram - rods (eg. E. coli or Klebsiella) can colonize the oral cavity (this number was highlighted in the notes)

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9
Q

What illnesses does Eikenella corrodens cause?

A

faculative gram - rod
Skin and soft tissue infections associated with human bites and clenched-fist injuries
(Like they said in kindergarden: No biting! My girlfriend does not listen to this)

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10
Q

What are five ANAEROBES that are common in the oral cavity?

A

1) Fusobacterium
2) Prevotella
3) Anaerobic streptococci aka peptostreptococcus
4) Actinomyces
5) others, such as anaerobic spirochetes

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11
Q

What are the gram stain, shape, and penicillin sensitivity of…

1) Fusobacterium
2) Prevotella
3) Anaerobic streptococci aka peptostreptococcus
4) Actinomyces

A

1) Cigar-shaped gram - rod, penicillin sensitive
2) gram - rod, penicillin sensitive
3) gram + cocci in chains, penicillin sensitive
4) Gram + branching rods, doesn’t say

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12
Q

What bacteria are normally found in the lower trachea?

A

Trick question! None.

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13
Q

What is a common disease related to normal oral cavity flora?
(hint: it is not in the oral cavity)

A

Aspiration pneumonia caused by aspirating one’s own oral secretions aka passing out at late night parties

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14
Q

What Tx would you use for aspiration pneumonia?

Is Dx of causative organism useful?

A

Penicillin
Most of the aerobic and anaerobic oral cavity bacteria are penicillin sensitive
No need to find causative agent. It is probably a mixture.

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15
Q

Under what conditions do bacteria grow in the stomach?

A

Immediately after meals

In the case of illness, such as Gastric Achlorhydia or Gastric Obstruction

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16
Q

Why are there few bacteria (<10^5) in the upper small intestine?

A

Bile acids are antibiotic

Peristalsis moves bacteria down the GI tract

17
Q

When can bacteria grow in the upper small intestine?

A

Anatomical alterations (gastric bypass) can cause stasis and bacterial growth

18
Q

There is some natural stasis in th ileum that allow bacteria to grow. (<10^6)
What bacteria are found in the terminal ileum?

A

Resemble colon bacteria
E. coli, enterobacter, and other gram - are common
Anaerobes, such as Bacteroides fragilis also predominate (RESISTANT TO PENICILLIN)

19
Q

What are common bacteria found in the colon (7)?

A

1) Bacteroides
2) Bifidobacterium
3) Lactobacili
4) Clostridia
5) Coliforms and Enterococcus
6) More than 400 other anaerobes
7) small amounts of aerobes, such as S. aureus, Pseudomonas, Proteus, Klebsiella

20
Q

Explain how Bacteroides produce ammonia.

A

The metabolic activity of theses bacteria generates ammonia, acid, and gas in the colon.
Ammonia is formed by splitting urea and from proteins.

21
Q

What is the single most common bacteria in the stool?

When can this cause injury?

A

Bacteroides fragilis
Trauma or bowel rupture can cause intraabdominal infection
produces anaerobic infection: foul smelling, gas producing, and necrotic

22
Q

What antibiotics are used for intraabdominal infection?

A

NOT penicillin. Bacteroides is resistant to penicillin
DO USE: Clindamycin, Cefoxitin, Metronidazole
Also: aminoglycoside, such as Gentamicin is useful for treating the aerobic Gram - rods

23
Q

Page Q-11 is a quick review of the following as they relate to Colon health

2) Bifidobacterium
3) Lactobacili
4) Clostridia
5) Coliforms (E. coli) and Enterococcus
6) More than 400 other anaerobes
7) small amounts of aerobes, such as S. aureus, Pseudomonas, Proteus, Klebsiella

A

.

24
Q

What is the establishment of normal intestinal flora in newborns

A

Fetal intestine is sterile
Breast fed babies have bifidobacterium
Bottle fed babies have flora that resembles adults (they also are commonly overweight and have health troubles later in life)

25
Q

Quickly, what keeps the intestines in healthy flora?

A

Low oxygen
Low pH
Commensal bacteria produce synergistic products, such as vit K
Commensal bacteria produce antibiotics that target harmful bacteria

26
Q

The use of antibiotics can cause what bacteria to overgrow?

A

Commonly, Salmonella and Shigella

Also C. diff

27
Q

What is the relationship between Bile and bacteria?

Note: it is a two way street.

A

Bile is antibiotic.

Overgrowth of bacteria can convert conjugated bile into free bile&raquo_space; leads to fat malabsorbtion

28
Q

What is Hepatic Coma and how can bacteria be involved?

A

Bacteria are a major source of ammonia in the blood.
Liver converts ammonia to urea and amino acids.
If the liver is impaired, high blood ammonia can cause coma.
Antibiotics may be used to treat.
Cathartics and enemas are also used to reduce intestinal bacteria.

29
Q

fyi:

colon bacteria convert bilirubin to urobilin and sterobilin.

A

fyi:

colon bacteria convert bilirubin to urobilin and sterobilin.

30
Q

fyi:

Carbs not absorbed in the small intestine, feed the bacteria in the large intestine and keep the pH low

A

fyi:

Carbs not absorbed in the small intestine, feed the bacteria in the large intestine and keep the pH low

31
Q

What are normal flora of the skin?

A

Staphylococcus epidermidis
S. aureus
Diphtheroids (non-diphtheriae Corynebacteria)
Anaerobes, such as proprionibacterium and peptococcus reside in the dermis.
Also: proprionibacterium acnes

32
Q

What are normal flora in the Upper Respiratory Tract?

A

Similar to oral flora
Nose: S aureus
Throat: Viridan Streptococci, Neisseria, and S. eidermidis
Anaerobes: Bacteroides, Fusobacterium, Clostridium, Peptostreptococcus

33
Q

Normal flora in the genitorurinary tract?

A

Vagina: lactobacili
Sometimes E. coli and Enterobacter is in the VJay
15-20% of women in childbearing age have Group B Streptococci in the Vjay. This can lead to sepsis in newborns.

34
Q 
Why are the following antibiotics used in intraabdominal infections?
CLINDAMYCIN
CEFOXITIN
METRONIDAZOLE
GENTAMICIN
A

CLINDAMYCIN static G+ anaerobes is a 50s protein synthesis inhibitor
CEFOXITIN (static/cidal unknown) G+ and G-, anaerobe cell wall inhibitor
METRONIDAZOLE cidal anaerobic DNA replication inhibitor
GENTAMYCIN cidal G- rods 30s protein inhibitor

Micro Quiz 3 (12 decks)

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