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Bacteria Flashcards

1
Q

what 4 bacteria cause cellulitis

A

staph aureus
strepto pyrogenes
clostridium perfringes
pasteurella multocida

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2
Q

what 2 bacteria cause impetigo

A

staph aureus
strepto pyrogenes

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3
Q

what 4 bacteria cause necrotizing fasciitis

A

strepto pyrogenes
clostridium perfringes
acinectobacter baumannii
vibrio vulnificius

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4
Q

what bacteria causes cutaneous anthrax

A

bacillus anthracis

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5
Q

what bacteria causes gas gangrene

A

clostridium perfringes

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6
Q

what bacteria causes erisipylas

A

strepto pyrogenes

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7
Q

what bacteria causes scalded skin syndrome

A

staph aureus

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8
Q

what is the main bacteria that causes absesses

A

staph aureus

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9
Q

what bacteria causes pulmonary anthrax

A

bacillus anthracis

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10
Q

what bacteria causes pneumonia especially in neonates

A

strepto agalactiae

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11
Q

what bacteria causes necrotizing pneumonia

A

staph aureus

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12
Q

what 2 bacteria cause lobar pneumonia

A

strepto pneumoniae
klebsiella pneumoniae

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13
Q

what 2 bacteria cause toxic shock syndrome

A

staph aureus
strepto pyrogenes

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14
Q

what bacteria causes scarlet fever

A

strepto pyrogenes

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15
Q

what bacteria causes neonatal sepsis (within 1 week of birth)

A

strepto agalactiae

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16
Q

what bacteria causes acute glomerularnephritis

A

strepto pyrogenes

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17
Q

what 3 bacteria cause food poisoning

A

staph aureus
bacillus cereus
clostridium perfringes

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18
Q

what 3 bacteria cause food poisoning

A

staph aureus
bacillus cereus
clostridium perfringes

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19
Q

what 3 bacteria cause otitis media (which is the main)

A

staph aureus
haemophilus influenzae
strepto pneumoniae (main cause)

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20
Q

what 2 bacteria causes pharyngitis

A

strepto pyrogenes
neisseria gonnorheae

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21
Q

what 2 bacteria causes ocular infection

A

bacillus cereus
pseudomonas aeruginosa (abrasion from contact lenses)

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22
Q

what bacteria causes rheumatic fever

A

strepto pyrogenes

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23
Q

what bacteria causes endocarditis on prosthetic valves

A

staph epidermidis

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24
Q

what 2 bacteria causes endocarditis on native valves without pre-existing murmurs

A

staph aureus
staph lugdunensis

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25
Q

what bacteria causes endocarditis on native heart valves, more so when there is a pre-existing murmur

A

strepto mutans

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26
Q

what bacteria causes septic arthritis in kids

A

staph aureus

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27
Q

what 2 bacteria cause paralysis

A

clostridium tetani
clostridium botulinum

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28
Q

what bacteria causes flaccid paralysis

A

clostridium botulinum

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29
Q

what bacteria causes rigid paralysis

A

clostridium tetani

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30
Q

what 2 bacteria causes osteomyelitis

A

staph aureus
pseudomonas aeruginosa (only in immunocompromised)

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31
Q

what 2 bacteria cause myonecrosis

A

clostridium perfringens
clostridium septicum

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32
Q

what is the main bacteria that causes UTI in pregnant women

A

strepto agalactiae

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33
Q

what are the 5 main bacteria that causes UTI

A

strepto saprophyticus
enterococcus faecalis
corynebacterium urealyticum
proteus mirabilis
*e.coli

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34
Q

what 6 bacteria causes adult meningitis

A

strepto pneumoniae
listeria monocytogenes
mycobacterium tuberculosis
neisseria meningiditis (young adults)
haemophilus influenzae
e.coli (in hospitalized patients w/underlying inflammation in brain/stroke)

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35
Q

what are 2 bacteria that cause neonatal meningitis

A

strepto agalactiae
listeria monocytogenes

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36
Q

what are the 4 main virulence factors of staph aureus that allows for colonization

A

fibronectin binding protein
collagen binding protein
coagulase
exfoliating toxin A and B cleave desmoglein 1 (top layer of skin)

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37
Q

what are the 3 main virulence factors of staph aureus that allows for immune evasion

A

catalase
spa proteins
ability to survive in/travel with neutrophils

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38
Q

what is the result of TSST-1 and SE-A/B/C release by staph aureus

A

superantigen release (inflammation)

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39
Q

what 2 virulence factors allow for antibiotic resistance by staph aureus

A

mecA gene (resistance to most beta lactams due to alternative transpeptidase)
beta-lactamase production

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40
Q

what are the 3 main virulence factors of strepto pyrogenes

A

streptolysin O and S (hemolysis)
SpeA/B/C (superantigen=imflammation)
M protein/hyaluronic acid capsule (immune mimicry)

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41
Q

what are the 3 main virulence factors of strepto pneumoniae

A

pneumolysin (alpha hemolysis)
polysaccharide capsule (immune evasion)
adhesins (bind to cell surface, cross epithelium)

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42
Q

what are the 2 main virulence factors of bacillus cereus

A

heat stable cereolysn (similar to MAC)
heat liable A/B toxin upregulates cAMP

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43
Q

what is the main virulence factor of bacillus anthracis

A

2 A/B toxins (1 A= edema (increase cAMP), another A= lethal (cleave MAP kinase to decrease translation and kill bacteria)

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44
Q

what is the main virulence factor of clostridioides difficle

A

toxins A and B (pseudomembrane sloughing of colon epithelial cells)

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45
Q

long term use of what 2 antibiotics increases the risk for developing C. diff

A

clarithromycin
ciprofloxacin

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46
Q

C. difficile with increased toxin genes are resistant to what antibiotic

A

fluoroquinolones

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47
Q

what are the 4 treatment options for C. difficile

A

oral vancomycin
metronidazole
fecal transplant
fidaxomicin

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48
Q

what is the best antibiotic for use with tetanus or botulism infection

A

metronidazole (they’re obligate anaerobes which are killed by ROS produced by metronidazole)

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49
Q

how does tetanus differ from botulism in terms of the effect of the A/B toxin released

A

tetanus- stops GABA+glycine release
botulism- stops acetylcholine release

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50
Q

how do you test for botulism in adults vs in babies

A

adults- test food for botulism toxin
babies- test baby’s stool

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51
Q

why is botulism considered an infection rather than an intoxication in babies

A

bacteria spores germinate in the baby’s gut

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52
Q

what are the 2 main virulence factors of listeria monocytogenes

A

listeriolysin O (acts as MAC)
actA (reconstruction of our cell cytoskeleton= becomes intracellular= bacteria can move from one cell to another, and protects bacteria against ROS)

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53
Q

what is the main concern about listeria infection in pregnant women

A

listeria can cross the placenta, leading to granulomas in tissues of fetus

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54
Q

why does listeria lead to granulomas if acquired in utero

A

fetus early in development has not developed a thymus for T cell development= no Th1 cells to fight intracellular infection

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55
Q

listeria is grown best at what temperature

A

4C

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56
Q

how is listeria acquired

A

food-borne, especially with unpasturized dairy products

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57
Q

what are the 2 best antibiotics for listeria infection

A

penicillin or ampicillin

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58
Q

what bacteria causes erisipeloid

A

erysipelothrix rhusiopathiae

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59
Q

what bacteria can cause granulomas in fetal tissues and organs

A

listeria monocytogenes

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60
Q

what bacteria causes pseudomembranous colitis

A

clostridiodes difficile

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61
Q

what is C.diff symptoms progression like

A

watery diarrhea–>mucous, bloody diarrhea

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62
Q

are staphylococci gram + or -

A

+

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63
Q

are staphylococci motile or non-motile

A

non-motile

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64
Q

are staphylococci catalase + or -

A

+

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65
Q

many staphylococci are resistant to what bacteria

A

1st generation beta lactams

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66
Q

what are the 3 main determinants of staphylococcus aureus

A

beta hemolytic
can ferment mannitol
clots blood plasma on slide and in test tube

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67
Q

what is the virulence factor of staphylococcus aureus that allows for abscess formation

A

coagulase

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68
Q

is staphylococcus epidermidis coagulase positive or negative

A

negative

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69
Q

what is the virulence factor of staphylococcus epidermidis that allows for infection on artificial surfaces such as heart valves and prosthetic joints

A

biofilm

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70
Q

how can you differentiate staphylococcus epidermidis and staphylococcus saprophyticus from other staphylococcus bacteria

A

gamma hemolytic
coagulase negative

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71
Q

how can you differentiate staphylococcus epidermidis from staphylococcus saprophyticus in terms of novobiocin susceptibility

A

s. epidermidis is killed by novobiocin

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72
Q

how can you differentiate staphylococcus lugdunensis from other staphylococcus bacteria (2 characteristics)

A

CAMP+
slide coagulase + but tube coagulase -

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73
Q

are streptococcus gram + or -

A

+

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74
Q

are streptococcus catalase + or -

A

”-“ but make some catalase

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75
Q

are streptococcus motile or non-motile

A

non-motile

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76
Q

what type of -philes are streptococci

A

capnophiles

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77
Q

what is a differentiating characteristic of streptococci, which also acts as a virulence factor

A

polysaccharide capsule

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78
Q

is streptococcus pyrogenes bacitracin susceptible or resistant

A

susceptible

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79
Q

what is the only streptococci species which is PYR test +

A

streptococcus pyrogenes

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80
Q

is streptococcus agalactiae bacitracin susceptible or resistant

A

resistant

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81
Q

is streptococcus agalactiae alpha, beta, or gamma hemolytic

A

beta

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82
Q

is streptococcus pyrogenes or agalactiae CAMP test +

A

s. agalactiae

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83
Q

is streptococcus pneumoniae alpha, beta, or gamma hemolytic

A

alpha

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84
Q

what streptococcus species is optochin susceptible

A

streptococcus pneumoniae

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85
Q

is steptococcus pneumoniae bile susceptible or bile reistant

A

susceptible

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86
Q

how do streptococcus pneumoniae appear on blood agar

A

caved in centers of colonies due to autolysin expression at high population densities (end of stationary phase)

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87
Q

what 2 antibiotic types are best to use with streptococcus pneumoniae due to their autolysin characteristic

A

beta lactams
vancomycin

*turn on autolysin genes

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88
Q

how do streptococcus pneumoniae appear with gram stain

A

diplococci (short chain of 2)

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89
Q

what are the 5 main virulence factors of streptococcus pneumoniae

A

pneumolysin
polysaccharide capsule
neuraminidase A (cleaves sialic acid on cell surface= better adhesion)
cleavage of IgA (IgA protease)
disable complement (C3b)

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90
Q

what are the symptoms of lobar pneumonia caused by streptococcus pneumoniae

A

brown/red sputum
fever
dyspnea/SOB
low level bacteremia

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91
Q

why is the 13 variant protein conjugated anti-capsular vaccine effective in adults and children

A

you get an immune memory response with T cells

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92
Q

why is a 23 variant polysaccharide (no protein conjugation) anti-capsular vaccine used in elderly populations

A

elderly already don’t have any T cells due to a decrease in thymus activity

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93
Q

what are the 2 best antibiotic classes to use for streptococcus pneumoniae infection

A

beta lactams (trigger autolysis= increase inflammation due to release of PAMPS)
macrolides

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94
Q

is the viridan group of streptococcus (S.mitis, salivarius, and mutans) alpha, beta, or gamma hemolytic

A

alpha

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95
Q

is the viridan group of streptococcus (S.mitis, salivarius, and mutans) bile susceptible or resistant

A

resistant

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96
Q

what is the main bacteria that causes cavities

A

streptococcus mutans (makes biofilm)

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97
Q

is the viridan group of streptococcus optochin susceptible or resistant

A

resistant

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98
Q

what are the 5 main characteristics of enterococcus faecalis

A

grow in high salt concentrations
can break down esculin
not lysed by bile
optochin resistant
PYR +

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99
Q

what antibiotics are enterococcus faecalis resistant to
why

A

vancomycin
beta lactams

it has a vanA cassette which codes for a different cell wall structure

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100
Q

are bacillus bacteria aerobic or anaerobic

A

aerobic

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101
Q

what is the class of bacteria which are aerobic, spore forming

A

bacillus

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102
Q

are bacillus gram + or -

A

+

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103
Q

are bacillus cereus motile or non-motile

A

motile

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104
Q

are bacillus cereus alpha, beta, or gamma hemolytic

A

beta (due to cereolysin)

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105
Q

are bacillus cereus catalase positive or negative

A

positive

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106
Q

is bacillus anthracis motile or non-motile

A

non-motile

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107
Q

is bacillus anthracis alpha, beta, or gamma hemolytic

A

gamma

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108
Q

how does bacillus anthracis appear on blood agar

A

white, ground glass colonies

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109
Q

why can bacillus anthracis not cross the BBB

A

its capsule is made of poly-glutamate instead of carbohydrates

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110
Q

who is most likely to be infected by anthrax

A

farmers/ranchers, as bacillus anthracis infects livestock (spores are found in soil, animals get spores on their skin)

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111
Q

what antibiotic is used for “mass casualty events” with bacillus anthracis

A

fluoroquinolones

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112
Q

what 2 antibiotics can be used for anthrax infection in an agriculture related patient

A

fluoroquinolones
beta lactams

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113
Q

what class of bacteria are obligate anaerobe spore forming rod bacteria

A

clostridium

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114
Q

are clostridium gram + or -

A

+

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115
Q

are clostridium perfringes alpha, beta, or gamma hemolytic

A

beta (due to phospholipase C which destroys phospholipids in our cell membrane)

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116
Q

are clostridium tetani motile or non-motile

A

motile

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117
Q

what type of spores do clostridium tetani and botulinum produce

A

terminal

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118
Q

are clostridium botulinum motile or non-motile

A

non-motile

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119
Q

is listeria monocytogenes gram + or -

A

+

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120
Q

is listeria monocytogenes alpha, beta, or gamma hemolytic

A

weakly beta (listeriolysin O)

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121
Q

is listeria monocytogenes motile or non-motile

A

motile at 25C (room temp)
non-motile at 37C (body temp)- expresses actA and acts using “actin rocket”

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122
Q

what type of motility does listeria monocytogenes display

A

tumbling

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123
Q

how does listeria monocytogenes appear with gram stain

A

very short

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124
Q

how does listeria monocytogenes appear with gram stain of CSF sample with meningitis patient

A

often not seen

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125
Q

erysipelothrix rhusiopathiae affects what organisms

A

swine- people who work with pigs are at risk

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126
Q

how is the erysipeloid infection caused by erysipelothrix rhusiopathiae different from erysipelas caused by strepto. pyrogenes in terms of appearance and pain causing

A

erysipeloid is darker purple and painful throbbing

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127
Q

erysipelothrix rhusiopathiae are ___-philes

A

microaerophiles

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128
Q

how do erysipelothrix rhusiopathiae appear with gram stain

A

often stain pink

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129
Q

are corynebcterium gram + or -

A

+

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130
Q

do corynebacterium form spores

A

no

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131
Q

what is the arrangement of corynebacterium under gram stain

A

palisading rods (rods clustered together lined up)

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132
Q

what is the main virulence factor of corynebacterium diphtheriae

A

A/B toxin- A subunit binds to EF2 inhibiting protein synthesis

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133
Q

the B subunit of corynebacterium diphtheriae heparin binding epidermal growth factor on epithelial cells found is in what 3 cell types

A

respiratory
cardiac
some neurons

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134
Q

is corynebacterium diphtheriae an example of lytic or lysogenic conversion

A

lysogenic

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135
Q

the phage of corynebacterium diphtheriae which contains the toxin is in an operon which is turned off by what

A

iron

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136
Q

what are the 2 main signs of corynebacterium diphtheriae infection

A

grey pseudomembrane on pharynx
bull neck

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137
Q

corynebacterium diphtheriae infection symptoms begins with ___ symptoms that can spread to __ and __

A

pharyngeal
myocarditis and neural symptoms

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138
Q

cutaneous diphtheria results from what

A

wound infection

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139
Q

the diphtheria component of the DTap vaccine is what type of vaccine

A

diphtheria subunit toxoid

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140
Q

what are 2 ways in which isolates can be tested for corynebacteria diphtheria

A

toxin production through PCR
anti-toxin antibodies using Elek test

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141
Q

what are the 2 main antibiotic classes used for corynebacterium diphtheria infection

A

macrolides or tetracycline due to their ability to stop translation, inhibiting A/B toxin production

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142
Q

what type of corynebacterium makes H2S, visible as black with Tinsdale media

A

corynebacterium diphtheria

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143
Q

what class of corynebacterium can grown on medical devices due to biofilm production

A

corynebacterium jeikeium

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144
Q

what 2 classes of corynebacterium are rare in healthy people, however are more common in hospitalized patients

A

c. jeikeium and c.urealyticum

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145
Q

what 2 bacteria cause UTIs which produce kidney stones

A

corynebacterium urealyticum
proteus mirabilis

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146
Q

what allows for UTI infection with corynebacterium urealyticum or proteus mirabilis to result in kidney stones

A

they have urease activity which leads to an increase in NH3+ production
this increases the pH of urine and allows for crystallization of Ca2+ and Mg2+, leading to stones

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147
Q

are actinomyces gram + or -

A

+

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148
Q

are actinomyces spore forming rods or non-spore forming rods

A

non-spore forming

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149
Q

what allows for actinomyces to have a waxy look and clump together in masses on a slide

A

mycolic acid production

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150
Q

what bacteria is normal dental and vaginal flora

A

actinomyces

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151
Q

what causes cervicofacial actinomycosis

A

trauma that allowed for normal oral actinomyces to drain down lymphatics

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152
Q

what is the treatment for cervicofacial actinomyces

A

debride affected tissue, leading to expression of yellow nodules (sulfur granules) of actinomyces stuck together

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153
Q

what is one way in which actinomyces can cause pelvic actinomycosis

A

colonization on objects such as IUDs–> inflammation and tissue destruction

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154
Q

what 2 classes of antibiotics are best to use with actinomyces

A

beta lactams
macrolides

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155
Q

what is the only mycolic acid containing bacteria which can grow anaerobically

A

actinomyces

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156
Q

are cutibacterium acnes gram + or -

A

+

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157
Q

what TLRs recognize LTA of cutibacterium acnes, leading to an inflammatory response

A

TLR2+6

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158
Q

what is the result of benzoyl peroxide use for acne

A

dissolves sebrum

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159
Q

what is the result of salicylic acid use for acne

A

sloughs keratin

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160
Q

what is the result of retinol use for acne

A

increases cell turnover

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161
Q

what 3 bacteria classes are the main bacteria of the normal skin flora

A

staphylococcus
cutibacterium
corynebacterium

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162
Q

lactobacillus bacteria are the main contributor to normal __ flora

A

vaginal

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163
Q

what antibiotic is lactobacillus resistant to

A

vancomycin

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164
Q

what bacteria can cause septicema and endocarditis in very immunocompromised patients

A

lactobacillus

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165
Q

what bacteria is beta hemolytic and displays tumbling motility

A

listeria monocytogenes

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166
Q

what bacteria causes food poisoning with an onset of 1-6 hours with nausea and vomiting

A

bacillus cereus

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167
Q

what bacteria causes food poisoning with an onset of 8-18 hours with nausea and diarrhea

A

bacillus cereus

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168
Q

what bacteria causes food poisoning with an onset of 2-6 hours with nausea and vomiting

A

staph. aureus

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169
Q

what bacteria causes food poisoning with an onset of 8-24 hours with diarrhea

A

clostridium perfringens

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170
Q

what bacteria is associated with rice food poisoning

A

bacillus cereus

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171
Q

what bacteria is associated with meat, vegetable, and sauce food poisoning

A

bacillus cereus

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172
Q

what bacteria is associated with meat, fatty, lipid food poisoning

A

staph. aureus

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173
Q

what bacteria is associated with meats prepared in mass (buffet style) food poisoning

A

clostridium perfringes

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174
Q

what do mycobacterium tuberculosis produce that allow them to live around ROS

A

catalase and superoxide dismutase

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175
Q

what is the structure of a tuberculosis granuloma

A

caseum center due to dead macrophages
fibrous cuff
foamy macrophage
lymphocytes on outermost layer

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176
Q

what causes the release of mycobacterium tuberculosis from its granuloma

A

granuloma fails
(defect in collagen or decrease in T cells–>inability to maintain)

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177
Q

caseating centers of mycobacerium tuberculosis can fuse together, creating areas of necrosis that can eventually become more and more liquid, creating ___

A

cavitary lesions (Ghon complexes)
*leaves an open hole in the lung

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178
Q

what are 3 symptoms of mycobacterium tuberculosis

A

coughing liquid blood (blood is continuously leaking into bronchi)
SOB
“wind tunnel” sound breathing

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179
Q

in maintaining the granuloma in mycobacterium tuberculosis, macrophages secrete ___, Th1 cell secretes ___

A

TNF and IL-12
IFN gamma

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180
Q

what is the general appearance of someone with mycobacterium tuberculosis

A

pale
skinny (cachexia- losing a lot of weight)
sweaty/nightsweats

*TNF increases metabolism
IL-12 induces fever
IFN gamma maintains granuloma

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181
Q

when mycobacterium tuberculosis is completely walled off and only a few granulomas are formed, are there symptoms and is the person infectious

A

no symptoms
not infectious

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182
Q

what is an example of an immunosuppressant drug that can reactivate tuberculosis bacterium due to decrease in TNF

A

Remicade (infliximab) is an TNF inhibitor

*TNF will be unable to maintain the granuloma

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183
Q

mycobacterium tuberculosis can spread to other tissues, most likely to ___

A

secondary lymphoid tissue (spleen)

*body site with a lot of macrophages

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184
Q

what is miliary tuberculosis

A

a patient initially had a pulmonary tuberculosis infection but the bacteria got from lungs through bloodstream and got to another part of the body

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185
Q

would a patient with miliary tuberculosis have tuberculosis bacteria in their sputum

A

no

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186
Q

what are the symptoms of miliary tuberculosis

A

pale
skinny (cachexia- losing a lot of weight)
sweaty/nightsweats

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187
Q

how are mycobacterium tuberculosis able to cause meningitis and cross the BBB even though they don’t have a capsule

A

travel in macrophages

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188
Q

what are the 2 growth medium used to grow mycobacterium tuberculosis, which is most used

A

Lowenstein-Jensen media or Middlebrook (LJ most used)

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189
Q

since growing mycobacterium tuberculosis requires a sputum sample, and other bacterium are normally found in the mouth, what is done to prevent growth of the other bacteria

A

treat with NaOH

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190
Q

what type of vaccine is the bacillus calmette guerin vaccine (BCG) for mycobacterium tuberculosis

A

live attenuated

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191
Q

since the BCG vaccine for mycobacterium tuberculosis is a live attenuated vaccine, what occurs following vaccination

A

formation of a granuloma that can take weeks to resolve

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192
Q

why is the BCG vaccine for TB given as such an early age (days after birth)

A

that is when the thymus is working at the best so there will be the best T/B cell response/memory

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193
Q

when a TB test is performed, what is being looked for

A

type IV HSR to TB cell envelope proteins

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194
Q

the highest risk group for TB following a TB skin test are those with >/= 5mm, why

A

less zone of induration= less T cell response

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195
Q

why is TB infection more common in areas with higher rates of HIV

A

HIV decreases the amount of CD4+ T cells which are needed to fight TB infection

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196
Q

what is an alternate way of testing for TB besides the TB skin test

A

IFN gamma release assay (T-spot)

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197
Q

how does T-spot test (IGRA) work

A

looks for release of IFN gamma

gather blood samples, centrifuge, collect monocytes/B and T cells, put in well plate with TB antigens

if response, release of IFN gamma
use a tagged antibody against IFN gamma to see how much was released

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198
Q

sarcoidosis is thought to be an autoimmune sequela of TB infection that lead to a ___HSR with symptoms similar to TB

A

IV

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199
Q

what is the presentation of sarcoidosis

A

fever, dyspnea, night sweats, SOB

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200
Q

what is the most common drug for use of mycobacterium tuberculosis

A

isoniazid (stops mycolic acid synthesis)

*need to be on drug for approximately 6 months since they take a while to grow–>can lead to liver damage

*liver enzyme function needs to be tested before being put on the drug, and be tested periodically during course of treatment

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201
Q

what are the 4 most common drugs to use for TB infection

A

isoniazid
ethambutol
pyrazinamide
rifampin

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202
Q

how does ethambutol work

A

inhibits the synthesis of lipoarabinomannan (a component of the cell wall which attaches mycolic acid to peptidoglycan layers in acid fast bacteria)

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203
Q

TB is becoming increasingly resistant to what 2 drugs

A

rifampin and isoniazid

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204
Q

what are the 2 main mechanisms of TB drug resistance

A

efflux pump
mutations to drug target

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205
Q

Bedaquiline/Sirturo and Pretomanid/Delamanid are new drugs being used to treat extensively drug-resistant __ infection

A

TB

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206
Q

direct observation therapy is important for 6-9 months in what kind of bacterial infection

A

TB

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207
Q

what type of infection is mycobacterium leprae always

A

skin

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208
Q

how can you differentiate tuberculoid leprosy from lepromatous leprosy based on patient symptom presentation

A

tuberculoid- slightly discolored flakey skin patches, anesthesia (loss of sensation) of digits
lepromatous- build up hyperkeratic lesions, paraesthesia (pins and needles feeling) of digits

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209
Q

tuberculoid leprosy is a Th__, type __ HSR while lepromatous is a Th__ response

A

tuberculoid- Th1, type IV
lepromatous- Th2 (no type IV HSR)

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210
Q

how does granuloma formation in tuberculoid leprosy differ from lepromatous leprosy

A

tuberculoid- granuloma holds bacteria= no symptoms
lepromatous- granuloma no longer holds bacteria= bacteria seen in lesions= symptoms

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211
Q

what cytokines are high in tuberculoid leprosy

A

IL-2, IFN gamma, IFN beta (TH1)

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212
Q

what cytokines are high in lepromatous leprosy

A

IL-4, IL-5, IL-10 (Th2)

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213
Q

how does the granuloma formed in mycobacterium tuberculosis differ from that formed in tuberculoid leprosy

A

tuberculoid leprosy does not have a caseating center

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214
Q

what are the 2 best drugs for use in mycobacterium leprae

A

sulfa+dapsone

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215
Q

how does dapsone antibiotic work

A

stops macrophage migration

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216
Q

since mycobacterium leprae grows better at lower temperatures, where are you more likely to find lesions

A

extremities

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217
Q

why is thalidomide not used for treatment of leprosy anymore

A

leads to birth defects

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218
Q

what are the symptoms of mycobacterium avium complex

A

tuberculosis-like symptoms
cavitary lung lesions
wasting
fever

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219
Q

mycobacterium avium is most likely to cause disease only in ___ patients

A

very immunocompromised

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220
Q

why is mycobacterium avium rarely seen in healthy individuals

A

you need a very low CD4+ level to see symptoms

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221
Q

what is the main symptom of mycobacterium marinum

A

slow, self resolving subcutaneous granulomas

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222
Q

what causes mycobacterium marinum infection

A

inoculation of the bacteria found in seawater

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223
Q

acid bast bacteria are all what shape

A

bacillus

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224
Q

all mycobacteria are __, replicate in __, and form __

A

acid fast
macrophages
granulomas

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225
Q

are neiserria gram + or -

A

-

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226
Q

what is the shape of neiserria

A

cocci

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227
Q

what is the appearance of neiserria bacteria using gram stain

A

cocci in pairs or tetrads found in neutrophils or extracellularly

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228
Q

what are the 2 main bacteria that can travel in neutrophils

A

staph aureus
neiserria

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229
Q

what are the 4 main virulence factors of Neiserria bacteria

A
  1. pili with opa protein (opa protein allows for adhesion)
  2. hold C3b in an altered confirmation (decreases MAC formation
  3. IgA protease (increase susceptibility of infection at mucosal surfaces)
  4. lipo-oligosaccharide (LOS instead of LPS= lipid A is more exposed to TLR4–>increased inflammation)
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230
Q

what is the importance of opa proteins as a virulence factor for Neiserria

A

they perform antigenic variation
–>bind to different cell types
–>symptoms may go through a cycle of resolving then coming back

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231
Q

what are the 4 main symptoms in neiserria gonorrhea

A

inflammation
mucopurulent exudate (mucous+neutrophils+bacteria)
burning while urinating (for men)
pressure based pain (men)

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232
Q

what is the main cause of septic arthritis in adults

A

neisseria gonnorhea

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233
Q

what 2 bacteria cause pelvic inflammatory disease

A

neiserria gonorrheae
clamydia trachomatis

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234
Q

what 2 bacteria cause conjunctival infection more in adults

A

neisseria gonorrhea
chlamydia trachomatis

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235
Q

what is the main media used to grow neissera gonorrhea

A

Thayer Martin media

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236
Q

what are the 5 components of Thayer Martin media, used to grow neisseria gonnorhea, that prevent other bacterial growth

A

chocolate agar
vancomycin
trimethoprim
colistin
antifungal drug

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237
Q

are neissera oxidase + or -

A

+

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238
Q

what is the best antibiotic for use of neisseria infection

A

ceftriaxone

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239
Q

what bacteria class are never used with neisseria, why

A

beta lactams due to exchange of beta lactamase genes

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240
Q

what 2 types of gene transfer are most common in Neisseria infection

A

conjugation
natural transformation

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241
Q

are neisseria gram + or -

A

-

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242
Q

what shape are neisseria bacteria

A

cocci

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243
Q

are neisseria catalase + or -

A

+

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244
Q

what allow for nasopharynx colonization of neisseria

A

pili

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245
Q

are neisseria capsulated or unencapsulated

A

capsulated

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246
Q

what allows for neisseria to evade the immune system

A

capsule

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247
Q

what is meningococcoemia

A

septicemia caused by neisseria meningiditis

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248
Q

what are the symptoms of meningococcemia

A

small blood vessel thrombosis leads to petechial skin lesions on trunk and lower extremities

can lead to tissue necrosis

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249
Q

what are the 2 physical diagnostic techniques for identifying meningitis in children or anyone unable to follow instructions

A

Kernig’s sign
Brudzinski neck sign

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250
Q

what is shown with a positive Kernig’s sign for meningitis

A

inability to straighten leg when lying on back

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251
Q

what is shown with a positive Brudzinski’s neck sign for meningitis

A

knee flexes when head is pushed forward while lying down

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252
Q

what is the leading cause of bacterial meningitis in children and young adults

A

neisseria meningiditis

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253
Q

what type of vaccine is the MCV4 against neisseria meningiditis

A

anti-capsular

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254
Q

since neisseria performs capsule switching, an additional vaccine besides MCV4 has been introduced. what is the other vaccine for older children and young adults

A

MenB

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255
Q

what antibiotics are used against neisseria gonorrhea

A

ceftriaxone+azithromycin

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256
Q

how does neisseria gonorrhea differ from neisseria meningiditis in terms of oxidation of carbohydrates

A

gonorrhea oxidizes glucose, not maltose

meningiditis oxidizes glucose and maltose

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257
Q

are haemophilus bacteria gram + or -

A

-

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258
Q

what shape are haemophilus bacteria

A

rods

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259
Q

what ingredients are required for haemophilus bacteria to grow

A

factor X- hemin
factor V- nicotinamide adenine dinucleotide (NAD)

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260
Q

what media is used to grow haemophilus bacteria

A

chocolate agar

261
Q

how is haemophilus influenzae able to cause meningitis

A

it can spread from upper respiratory tract–>blood–>CSF

262
Q

is haemophilus influenzae or neisseria meningitidis meningitis more severe

A

neisseria meningitidis

263
Q

what are the 2 virulence factors of haemophilus influenzae

A

capsule (only 1 type)
IgA protease

264
Q

what is the main cause of epiglottitis

A

haemophilus influenzae

265
Q

what are the 4 main symptoms of epiglottitis caused by haemophilus influenzae

A

stridor on breathing
drooling
croup cough
thumb sign on X-ray

266
Q

what type of infection is associated with meningitis or epiglottitis caused by haemophilus influenzae

A

orbital cellulitis

267
Q

the haemophilus influenzae vaccine against haemophilus influenzae B is what type of vaccine

A

anti-capsular subunit, protein conjugated

268
Q

what are the 5 main antibiotics for treatment of haemophilus influenzae

A

amoxicillin
azithromycin
cephalosporins
doxycycline
fluoroquinolones

269
Q

haemophilus influenzae mainly uses what genetic transfer type

A

natural transformation

270
Q

what is the main cause of pink eye conjunctivitis in children <10 years

A

haemophilus influenzae+haemophilus aegyptius

271
Q

what are the symptoms of haemophilus ducreyi

A

ulcerated painful lesion
easily bleeding lesion (chancroid)
pain w/ urination

272
Q

what bacteria causes whooping cough

A

bordetella pertussis

273
Q

are bordetella pertussis aerobes or anaerobes

274
Q

what 4 components make up the acellular pertussis component of the DTaP vaccine

A

pertactin
filamentous hemagglutinin
pertussis toxoid
adenylate cyclase toxoid

275
Q

what are the 7 virulence factors of bordetella pertussis

A

pertussis toxin (increases cAMP= increase mucous)
adenylate cyclase toxin (inhibits Gi= increase cAMP=increase mucous)
tracheal cytotoxin (kills trachea cilia)
dermonecrotic toxin (skin necrosis)
pili (adhesion)
filamentous hemagglutinin (adhesion)
pertactin (adhesion to tracheal epithelial cells)

276
Q

how does pertussis toxin and adenylate cyclase toxin of bordetella pertussis work

A

it’s an A/B toxin that increased cAMP, leading to water secretion and cough reflex

277
Q

what are the 3 stages of whooping cough

A

catarrhal
paroxysmal
convalescent

278
Q

when do each of the stages of whooping cough, catarrhal, paroxysmal, and convalescent, occur

A

catarrhal= 1-2 weeks
paroxysmal= 2-4 weeks
convalescent= 3-4 weeks

279
Q

what occurs in the catarrhal stage of whooping cough

A

common cold symptoms
peak level of number of bacteria= highly contagous

280
Q

what occurs during the paroxysmal stage of whooping cough

A

impairment of mucous clearance
increased mucous production
whooping cough

281
Q

what occurs during the convalescent stage of whooping cough

A

decrease in cough
may lead to secondary complications

282
Q

what media is needed to grow bordetella pertussis

A

Bordet-Gengou or Regan Lowe

*charcoal containing

283
Q

what are the advantages of PCR vs culture for bordetella pertussis testing

A

PCR= quicker
culture= more specific

284
Q

how does bordetella pertussis spread

A

respiratory droplets

285
Q

who is at greatest risk for bordetella pertussis

A

children less than 1 year

286
Q

bordetella pertussis is most common in what age group

A

older children/young adults (those living closely such as in a dorm)

287
Q

what is the best antibacteria class against bordetella pertussis

A

macrolides (-mycin) such as azithromycin and clarithromycin

288
Q

where are pseudomonads found

A

soil, fresh water, sea water

289
Q

are pseudomonads gram + or -

290
Q

are pseudomonads aerobic or anaerobic

291
Q

what shape are pseudomonads

292
Q

do pseudomonads perform fermentation

293
Q

are pseudomonads oxidase + or -

294
Q

are most pseudomondas motile or non-motile

295
Q

what are the 2 mechanism of antibiotic resistance by pseudomonads, which is the main

A

main= change in porin size reduces ability for antibiotics to enter
beta lactamase production

296
Q

do pseudomonas aeruginosa have a capsule

297
Q

are pseudomonads catalase + or -

A

+ (they’re aerobic)

298
Q

are pseudomonas aeruginosa alpha, beta, or gamma hemolytic

299
Q

what allows for pseudomonas aeruginosa to be beta hemolytic

A

exotoxin A and phospholipases

300
Q

what is the main virulence factor of pseudomonas aeruginosa

A

biofilm production

301
Q

what are the characteristics of the biofilm that allow you to identify a pseudomonas aeruginosa infection

A

green color
smell of grape flavoring

302
Q

what 2 components of pseudomonas aeruginosa biofilm contribute to its anti-gram + antibiotic characteristic and green color

A

pycocyanin
pyoverdin

303
Q

what is the main virulence factor or pseudomonas aeruginosa

304
Q

what 2 bacteria can cause lung infections in cystic fibrosis patients, which is the main

A

burkholderia cepacia
*pseudomonas aeruginosa

305
Q

what bacteria is associated with infections in burn wounds with production of green appearance

A

pseudomonas aeruginosa

306
Q

what are the top 4 bacteria that cause hospital acquired catheter associated UTIs

A

e. coli
enterococci
pseudomonas aeruginosa
burkholderia cepacia

307
Q

what bacteria is the main cause of hot tub folliculitis

A

pseudomonas aeruginosa

308
Q

what allows for hot tub folliculitis by pseudomonas aeruginosa

A

depletion of sebum from hair follicles caused by drying out of skin

309
Q

what bacteria causes swimmer’s ear (otitis externa)

A

pseudomonas aeruginosa

310
Q

what bacteria can cause swimmers ear in diabetic patients (malignant external otitis)

A

pseudomonas aeruginosa

311
Q

is pseudomonas aeruginosa spread in the bloodstream

A

only in immunocompromised patients

312
Q

in immunocompromised patients, pseudomonas aeruginosa can lead to what 2 infections

A

osteomyelitis
ecthyma gangrenosum skin lesions

313
Q

are pseudomonas aeruginosa gram + or -

314
Q

burkholderia cepacia are similar to what species or bacteria

A

pseudomonads

315
Q

how can you differentiate pseudomonas aeruginosa from burkholderia cepacia in cystic fibrosis patient lung infection

A

pseudomonas aeruginosa biofilm is green with a grape smell
burkholderia cepacia biofilm appears white/yellow with a dirt smell

316
Q

what bacteria causes meloidosis (pulmonary disease in healthy people)

A

burkholderia pseudomallei

317
Q

burkholderia pseudomallei is often mistaken for what infection due to the overlap in symptoms

318
Q

burkholderia pseudomallei infection is treated with what 2 antibiotic options

A

sulfa
doxycycline

319
Q

acinectobacter baumanii is similar to what species of bacteria

A

pseudonomads

320
Q

what bacteria is the main cause of necrotizing fasciitis in soldiers in the Middle East

A

acinetobacter baumanii

321
Q

acinetobacter baumanii is a cause of hospital acquired infections due to what characteristic

A

biofilm which allows them to stick to indwelling devices such as catheters/IV lines

322
Q

what is seen before necrotizing fasciitis with acinetobacter baumanii

A

orange peel cellulitis

323
Q

what is the name of the necrotizing fasciitis caused by acinetobacter baumanii

A

hemmorhagic bullae

324
Q

are enterobacteriaceae gram + or -

325
Q

are enterobacteriaceae oxidase - or +

326
Q

are enterobacteriaceae catalase + or -

327
Q

are enterobacteriaceae aerobic or anaerobic

A

facultatively anaerobic

328
Q

what agar is used to differentiate enterobacteriaceae

A

MaConkey or EMB agar

329
Q

what 3 characteristics are used to differentiate enterobacteriaceae

A

motility
use citrate as a sole carbon source
make urease

330
Q

what enterobacteriaceae is Simmons citrate test positive

A

salmonella

331
Q

what 3 enterobacteriaceae are motile

A

e. coli
salmonella
proteus

332
Q

what enterobacteriaceae is nonmotile

333
Q

what enterobacteriaceae is urease positive

334
Q

what antibiotics are enterobacteriaceae resistant to

A

beta lactams

335
Q

what 3 features does the triple sugar iron agar slant test for

A

lactose fermentation
gas production
hydrogen sulfide production

336
Q

what are the 6 virulence factors of enterobacteriaceae

A

capsule
resistance to complement (C3b)
type 3 secretion system
cAMP and ribosome A/B toxin
hemolysins
pili

337
Q

are E.coli motile

338
Q

what fermentation do E.coli perform

A

lactose aerobically and anaerobically
*and produce gas

339
Q

do E.coli produce H2S

340
Q

do E.coli produce urease

341
Q

e.coli is typically described to perform __ hemolysis, however it depends on the strain

342
Q

what is the mechanism of watery diarhea

A

AB toxin increases cAMP= lack of water absorption

343
Q

what is the mechanism of water, slightly bloody diarrhea

A

invasion of cell leads to effacement of vili (decreased surface area) leading to lack of water absorption and some cell damage

344
Q

what is the mechanism of bloody diarrhea

A

ribosomes disabling AB toxin leads to cell death and sloughing of cells

345
Q

what is infectious dose

A

the number of bacteria you have to ingest in one sitting to actually get sick

346
Q

are you more likely to get sick with a higher or lower ID

347
Q

the infectious dose for a low ID is __

A

less than 100

348
Q

what is the mechanism of enterotoxigenic e.coli (ETEC)

A

heat liable toxin and heat stable toxin increase cAMP= watery diarrhea

349
Q

what is the mechanism of enteropathogenic e.coli (EPEC)

A

type III secretion system injects Tir protein that restructures our cell actin cytoskeleton, creating a pedestal
this decreases the surface area of villi, leading to decrease in reabsorption of water= watery diarrhea

350
Q

what is the mechanism of enteroaggregative e.coli (EAEC)

A

aggregative adherence fimbriae of bacteria cover villi, decreasing surface area= less water absorption= watery diarrhea

351
Q

what e.coli infection can cause outbreaks in daycares

A

enteroaggregative e.coli (EAEC)

352
Q

what is the mechanism of enteroinvasive e.coli

A

bacteria injects invasive plasmid antigen into our cells using type III secretion system causing actin cytoskeleton rearrangement
this leads to cell death–>watery, slight bloody diarrhea and cramping

353
Q

what 3 e.coli infections have low ID

A

ETEC
EPEC
EAEC

354
Q

what is the mechanism of enterohemorrhagic e.coli

A

it has shiga toxin 1 and 2 with it’s AB toxin
A subunit bind to ribosome, prevents translation, leading to cell death
Stx-1 B subunit binds to intestinal epithelial cells and causes bloody diarrhea as dead cells are sloughed
Stx-2 subunit binds to glomerular endothelial cells, leading to hemolytic uremic syndrome

355
Q

what bacteria causes hemolytic uremic syndrome

A

e.coli (enterohemorrhagic e.coli)

356
Q

is the A/B shiga toxin of e.coli lytic or lysogenic conversion

357
Q

at what stage of bacterial growth curve does lysogenic conversion occur

A

late exponential

358
Q

how many days after original diarrhea with enterohemorrhagic e.coli (EHEC) does hemolytic uremic syndrome occur

359
Q

what triad of conditions makes up hemolytic uremic syndrome

A

kidney failure
thrombocytopenia
microangiopathic hemolytic anemia

360
Q

RBC of what characteristic are seen in enterohemorrhagic e.coli

A

schistocytes (helmet shaped deformed RBC)

361
Q

what strain of e.coli has a very low ID

A

enterohemorrhagic e.coli

362
Q

what organism carries enterohemorrhagic e.coli in their gut asymptomatically

363
Q

why is it a risk to humans that cattle carry enterohemorrhagic e.coli in their gut (2 reasons)

A

during ground meat processing, the bacteria in the gut can be introduced to other area

cow manure is used to grow produce

364
Q

what bacteria are the most common cause of UTIs in women

365
Q

what are the 3 main virulence factors of e.coli that allow them to cause UTIs

A

P-pilin attaches strongly to bladder
flagella
Stx-2 causes kidney failure

366
Q

what bacteria is the main cause of cystitis

367
Q

what bacteria causes pyelonephritis

368
Q

what is pyelonephritis

A

kidney infection that ascends from the bladder to kidneys due to ability of e.coli to swim up ureters

369
Q

in addition to typical cystitis symptoms, what are 2 additional symptoms of pyelonephritis caused by e. coli

A

flank pain
high fever

370
Q

how can you differentiate kidney failure causes by enterohemorrhagic e.coli hemolytic uremic syndrome vs e.coli

A

there would be no bacteria in the urine of hemolytic uremic syndrome patients

371
Q

what are the top 4 causes of catheter associated UTIs

A

e.coli
enterococcus
pseudomona aeruginosa
candida

372
Q

are gram + or - bacteria the leading cause of septicemia

373
Q

among the gram - bacteria, which is the main cause of septicemia

A

enterobacteriaecae

374
Q

what gram + bacteria is the main cause of septicemia caused by gram - bacteria

375
Q

what factor of e.coli leads them to being multi-drug resistant

A

efflux pump

376
Q

what e.coli infection are antibiotics contraindicated for

A

enterobacteriae hemorrhagic e.coli

377
Q

are salmonella motile or non-motile

378
Q

do salmonella ferment lactose

379
Q

do salmonella produce urease

A

no

the only enterobacteriacae that produces urease is proteus

380
Q

do salmonella produce H2S

381
Q

are salmonella gram + or -

382
Q

what selective media is used to differentiate salmonella enterica subspecies

A

Hektoen enteric agar

*differential on basis of H2S production–>black colonies

383
Q

what symptoms are present with salmonella enterica caused gastroenteritis

A

cramping, vomiting, watery slightly bloody diarrhea, and nausea

384
Q

what virulence factor does salmonella enterica use

A

type 3 secretion system injects salmonella-secreted invasion proteins, leading to actin cytoskeleton rearrangement

385
Q

what type of diarrhea does salmonella enterica cause

A

watery, slightly bloody

386
Q

what 2 salmonella species can lead to system bloodstream infection

A

salmonella typhi
salmonella paratyphi

387
Q

what bacteria causes typhoid fever

A

salmonella

388
Q

what are the symptoms of typhoid fever

A

fever
rose spot rash on torso

389
Q

is salmonella an infection or intoxication

390
Q

what is the antibiotic of choice for salmonella typhi

A

fluoroquinolones (usually ciprofloxacin)

391
Q

do shigella produce H2S

392
Q

what toxin does shigella produce

393
Q

what is the most common species of shigella

A

shigella flexneri

394
Q

what is the most severe species of shigella

A

shigella dysenteriae

395
Q

do shigella ferment glucose

A

yes, in the absence of O2

396
Q

are shigella motile

397
Q

what virulence factor does shigella have

A

grow in M cells of intestines and produce Stx-1–>actin rearrangement

398
Q

what type of diarrhea does shigella cause

399
Q

unlike salmonella that is spread through chickens, shigella is spread in what way

A

person to person

400
Q

shigella causes symptoms how many days after ingestion

401
Q

what are the 3 main symptoms of shigella infection

A

bloody diarrhea
cramping
fever

402
Q

are yersinia motile or nonmotile

A

non-motile

403
Q

what is the appearance of yersinia histologically

A

safety pin appearance

404
Q

what bacteria causes bubonic plaque

A

yersinia pestis

405
Q

how does yersinia pestis cause bubonic plaque

A

flea bites infected rodent, flea gets infected and bites humans

bacteria divide and spread through bloodstream, grown in lymph nodes

406
Q

what is the main symptom of bubonic plaque

A

buboes (very swollen lymph nodes)

407
Q

yersinia pestis can cause __ plague, __ plague, or __ plague

A

bubonic
systemic
respiratory

408
Q

what type of diarrhea do yersinia enterocolitica cause

A

watery, slightly bloody

409
Q

what is the main virulence factor of yersinia enterocolitica

A

replicate in M cells of intestines and use type 3 secretion system with Yop protein to restructure actin (turns off MAPK)

410
Q

what is the main source of yersinia enterocolitica

A

undercooked pork

411
Q

yersinia bacteria, like listeria, grow best at what temperature

412
Q

what are the symptoms of yersinia enterocolitica

A

diarrhea, fever, abdominal pain

413
Q

what allows for klebsiella pneumoniae to cause lobar pneumonia

A

large polysaccharide capsule

414
Q

what class of bacteria do klebsiella belong to

A

enterobacteriacae

415
Q

are klebsiella gram + or -

416
Q

are klebsiella catalase + or -

417
Q

are klebsiella oxidase + or -

418
Q

are klebsiella anaerobes or aerobes

A

facultative anaerobes

419
Q

what type of pneumonia does klebsiella pneumoniae cause

420
Q

what are the characteristics of the sputum produced by klebsiella pneumoniae

A

bright red, jelly like

421
Q

what bacteria can cause non-alcoholic fatty liver disease

A

klebsiella pneumoniae

422
Q

what bacteria causes auto-brewery syndrome

A

klebsiella pneumoniae

423
Q

what is auto-brewery syndrome causes by klebsiella pneumoniae

A

occurs due to the ability of klebsiella pneumoniae to ferment carbs into ethanol in the intestines

424
Q

do proteus mirabilis ferment lactose

A

yes, anaerobically and aerobically

425
Q

how are you able to identify proteus mirabilis on blood agar

A

they perform swarming motility

426
Q

how can you differentiate strepto pneumoniae from klebsiella pneumoniae based on blood agar features

A

strepto pneumonia- beta hemolytic due to streptolysin

klebsiella- gamma hemolytic= intact RBC

427
Q

how can you differentiate lobar pneumonia caused by strepto pneumoniae from lobar pneumonia caused by klebsiella pneumonia based on sputum production

A

strepto- brown sputum due to RBC lysis

klebsiella- red, jelly like

428
Q

what are the 3 species of gram - spirilla

A

vibrio, campylobacter, helicobacter

429
Q

are vibrios motile or non-motile

430
Q

what is an addition that must to made to blood agar to allow vibrios to grow, why

A

salt

they live in salt water

431
Q

what bacteria can ferment sucrose

432
Q

what media is used to identify vibrios

A

TCBS (thiocitrate bile and sucrose)

433
Q

what type of diarrhea does vibrio cholera produce

434
Q

do bacteria with a high sensitivity to gastric acid have a high or low ID

435
Q

what are the 3 main virulence factors of vibrio cholera

A

toxin-coregulated pilus for adherence to intestinal epithelia
cholera cAMP AB toxin
accessory cholera enterotoxin (ACE)

436
Q

strains of vibrio cholerae are identified by what feature

A

O-carbohydrate of LPS

437
Q

how is vibrio cholera spread

A

contaminated water

438
Q

cholera toxin is an example of what type of conversion

439
Q

what phage leads to the AB toxin genes in vibrio cholerae

440
Q

what are the 2 most virulent strains of vibrio cholerae

441
Q

why are the strains O1 and O139 the most virulent strains of vibrio cholera

A

they have 2 copies of AB toxin genes

442
Q

what is the main symptom of vibrio cholerae infection

A

rice water stool (3-6L of watery diarrhea per day)

443
Q

what is the main consequence that vibrio cholera infection can lead to

A

hypovolemic shock due to high amount of water loss in diarrhea

444
Q

what is the treatment for vibrio cholerae

A

oral rehydration therapy

445
Q

where do vibrio cholerae live

A

guts of copepod

446
Q

vibrio cholerae is associated with what food

447
Q

a ___ vaccine is given against vibrio cholerae in endemic areas

A

live-attenuated

448
Q

in places that don’t have access to treated water, what can be done to decrease the risk for vibrio cholerae infection

A

filter water through a cloth to remove copepods

449
Q

what are the 2 restrictions of growing vibrio parahaemolyticus on blood agar

A

they only lyse human RBC, not any other mammal’s
require high salt concentration to grow

450
Q

what type of hemolysis do vibrio parahaemolyticus perform

451
Q

what type of diarrhea does vibrio parahaemolyticus cause

A

gassy, watery (explosive)

452
Q

what is the most common cause of seafood associated gastroenteritis

A

vibrio parahaemolyticus

453
Q

does vibrio parahaemolyticus cause an infection or intoxication

454
Q

vibrio parahaemolyticus lives in the gut of what organism

A

shellfish

*contamination usually from raw oyster consumption

455
Q

the main cause of vibrio parahaemolyticus is consumption of what

A

raw oysters

456
Q

vibrio vulnificius can cause what 2 types of infection

A

necrotizing fasciitis
gangrene

457
Q

what is the only bacteria that can cause necrotizing fasciitis due to eating a contaminated food that spreads in the bloodstream

A

vibrio vulnificus

458
Q

what are the 2 most common antibiotics for virbrio species

A

macrolides
tetracycline

459
Q

what type of growth requirement do helicobacter require

A

5% O2, 10% CO2

460
Q

how do campylobacters lead to watery, slightly bloody diarrhea and cramping

A

they disrupt junctions between cells and cause inflammation

461
Q

what is the main concern with campylobacter jejuni O19

A

they have the same polysaccharide that human motor neurons have–> Guillain Barre syndrome

462
Q

what is Guillain Barre syndrome

A

IgM antibody production against gangliosides found on our nodes of Ranvier–>demyelination–>flaccid paralysis

463
Q

in Guillain Barre syndrome, IgM leads to __, which leads to the turn off of __ production

A

complement deposition
myelin sheath

464
Q

IgM is produced against what type of substance

A

polysaccharide

465
Q

does IgM produce immune memory

466
Q

what are the symptoms of Guillain Barre syndrome

A

rapidly progressive upward flaccid paralysis

467
Q

what is involved with plasmaphoresis used for Guillain Barre syndrome

A

replace patient’s plasma with IgM against their myelin sheath with another person’s plasma who doesn’t have the antibody

468
Q

what type of HSR is Guillian Barre syndrome

469
Q

where do campylobacter live that can cause harm to humans

A

digestive tract of cattle
digestive tract of chicken
bloodstream of chicken

470
Q

what temperature do campylobacter jejuni grow best at

471
Q

what antibiotic is most commonly used for campylobacter

A

macrolides (to prevent IgM production)

472
Q

where are helicobacter bacteria normally found

A

gastric mucosa

473
Q

what are the 4 main virulence factors of helicobacter pylori

A

urease (slightly neutralizes gut acidity)
flagella
type 3 secretion system (cagA and vacA)
mucinase secretory enzyme

474
Q

what bacteria are the most common cause of gastric ulcers

A

helicobacter pylori

475
Q

in most cases, helicobacter pylori are symptomatic or asymptomatic

A

asymptomatic

476
Q

what bacteria can lead to gastric cancer

A

helicobacter pylori

477
Q

how can helicobacter pylori be beneficial to humans if they don’t cause ulcers

A

they produce urease which decreases gastric acidity and decreases the risk for esophageal cancer

478
Q

what type of Th response can be beneficial to prevent ulcer activity of helicobacter pylori

A

Th2 (IL-10 production= anti-inflammatory)

479
Q

what are the 2 main ways to test for helicobacter pylori

A

breathalyzer for urease
bacterial antigens in stool sample

480
Q

helicobacter pylori infections causing ulcers are typically treated with what 3 antibiotics

A

antacids
clarithromycin
amoxicillin

481
Q

what mechanism do antacids use

A

they are a proton pump inhibitor

482
Q

how can proton pump inhibitors such as antacids increase risk for infection

A

ID is lowered by gastric acidity
lower ID= increased risk

there is now an increase in infection risk for bacteria that typically have a high ID

483
Q

how are spirochetes visualized

A

darkfield microscopy

484
Q

how does the flagella of spirochetes differ from spirilla

A

spirochetes- internal flagella
spirilla- external flagella

485
Q

how does transmission of infection differ in spirochetes and spirilla

A

spirochetes- blood borne (body fluid)
spirilla- food borne (ingestion)

486
Q

what class of bacteria are the least drug resistant, allowing them to be very susceptible to beta lactams

A

spirochetes

487
Q

how are borrelia species of spirochetes spread

A

vector-borne

488
Q

what does it mean to say borrelia species of bacteria are vector borne

A

spread through bite of infected insect

489
Q

what bacteria causes lyme disease

A

borrelia burgdorferi

490
Q

what are the 2 main virulence factors of borrelia burgdorferi

491
Q

how do OspA and OspC of Borrelia burgdorferi work

A

OspA allows for colonization of tick guts at 25C
OspC allows for spread from tick to humans at 37C

492
Q

what tick species is the only vector for lyme disease

A

Ixodes species

493
Q

what occurs in stage 1, acute illness, of lyme disease

A

regional lymphadenopathy
flu-like symptoms
erythema migrans (bulls-eye rash)

494
Q

symptoms of lyme disease in stage 1 are caused by __, while symptoms of lyme in late 2 and 3 are caused by __

A

1/early 2= bacteria
late 2/e= autoimmune

495
Q

what happens in stage 2 of lyme disease

A

bloodstream spread of infection
generalized lymphadenopathy
cardiac and CNS involvement

496
Q

what happens in stage 3 of lyme disease

A

autoimmune response years later (type II and IV HSR)
destructive chronic arthritis

497
Q

what is the clinical case definition of lyme disease

A

erythema migrans and/or one late manifestation (system involvement) with lab confirmation

498
Q

what is the lab case criteria for diagnosis of lyme disease

A

IgM/IgG or significant increase in antibodies between acute and convalescent serum samples

*acute= bad symptoms today with high antibody level
convalescent= good symptoms today with lower antibody level

499
Q

IgG or IgM response would indicate that lyme is in what stage

500
Q

antibody difference between acute and convalescent serum samples would indicate lymes disease is in what stage

501
Q

ticks must be attached for how long in order for transmission to occur

A

> /=12 hours

502
Q

what is the best antibiotic for lyme disease

A

doxycycline to cover all tick borne illnesses (or penicillin if specific)

503
Q

what bacteria causes syphilis

A

treponema pallidum

504
Q

what occurs in the primary stage of syphilis

A

chancre
regional lymphadenopathy

505
Q

what occurs in the secondary stage of syphilis

A

body-wide rash
palmar rash
condyloma latum
asymptomatic neurosyphilis
flu-like symptoms

506
Q

what occurs in the tertiary, later stage of syphilis

A

neurosyphilis
aortitis
gummas

507
Q

when does primary vs secondary vs tertiary syphilis develop

A

primary= 10 days -3 months after infection
secondary= 3-6 months after infection
tertiary= years-decades after infection

508
Q

are chancre which occur in syphilis painful

509
Q

do chancre which occur in syphilis require antibiotics

A

no, they are self resolving in approximately 2 months

510
Q

how does syphilis (T. pallidum) spread

A

sexual transmission

511
Q

where is the swollen lymph node in cases of primary syphilis

A

closes to the original point of infection

512
Q

what bacteria causes palmar rash

A

syphilis by t. pallidum

513
Q

what are gummas seen in tertiary syphilis

A

granumola like collection of T cells with antibody involvement

514
Q

what is the autoimmune target in tertiary syphilis

A

fibronectin –> CT deficiency

515
Q

what is congenital syphilis

A

in utero infection of a baby carried by a mother with primary or secondary syphilis

516
Q

what are the 4 symptoms of congenital syphilis

A

sloughing of multiple layers of skin on palms/feet/face at birth
snuffles rhinitis at birth
deficiencies in cartilage, bone, and teeth development with growth
saber shins (abnormal bone growth)

517
Q

what is the best antibiotic for use in syphilis

A

penicillin

518
Q

are males or females more likely to have syphilis

519
Q

who is at the most risk for syphilis

A

males who have sexual contact with males

520
Q

what is the time frame for stage 1 vs 2 vs 3 of lyme disease

A

stage 1= 1 week-1 month after bite
stage 2/3= 2 months-6 months after bite

521
Q

what is the initial test used to test for syphilis

A

rapid plasma reagin test

522
Q

how does the rapid plasma reagin test for syphilis work

A

tests for antibodies against cardiolipin

*tests for antibody against type III HSR damage done by T. pallidum

523
Q

what is the special stain used to visualize spirochetes

A

Steiner silver

524
Q

if the initial test for syphilis is positive, what test is performed next

A

fluorescent antibody test to test for IgG and IgM antibodies against T. pallidum

525
Q

for a syphilis lesion in primary stage, the rapid plasma reagin test is __% __
for secondary syphilis, it is __% __

(percent, false/positive)

A

50% false
95% accurate

526
Q

darkfield microscopy and fluorescent microscopy are both used to test for syphilis is what stage

A

primary or secondary

527
Q

rapid plasma reagin test (VSRL) is used to test for syphilis in what stage

A

secondary or tertiary

528
Q

what are the disadvantages of rapid plasma reagin test (VSRL) used to test for syphilis

A

false positives common in pregnant, elderly, and lupus patients (type 3 HSR)

529
Q

what is the Jarisch Herxheimer reaction

A

when treatment for a bacterial infection (especially primary and secondary syphilis) makes the inflammatory symptoms immediately worse

530
Q

what is the main drug to treat syphilis

A

penicillin (especially penicillin G given IM)

531
Q

what is leptospirosis

A

a systemic infection with leptospiro interrogans which usually causes mild flu-like symptoms

532
Q

what bacteria causes Weil’s disease, what is it

A

a severe leptospirosis infection with kidney, liver, and meningeal involvement

533
Q

how is leptospirosis acquired

A

by skin exposure to water contaminated with urine of an infected animal

534
Q

where has one of the highest infection rates or leptospira infection

A

Guadeloupe

535
Q

what bacteria infection risk increases with tropical storms

A

leptospira (flood water with contaminated urine of infected animals)

536
Q

what is the drug of choice for leptospirosis

A

penicillin
penicillin+doxycycline

537
Q

what sample is best to use to test for leptospirosis

A

urine (bacteria is shed in urine for years to decades)

538
Q

what are the most common component of human GI tract

A

bacteriods

539
Q

what is unique about bacteriods LPS that prevents TLR4 binding

A

their LPS is altered

540
Q

are bacteriods aerobic or anaerobic

A

obligately anaerobic

541
Q

are bacteriods drug resistant

542
Q

are bacteriods gram + or -

543
Q

what species of bacteriod is the most pathogenic

A

bacteriodes fragilis becuase of it’s polysaccharide capsule

544
Q

what is the effect of bacteriod polysaccharide capsule in terms of T cell response

A

it pushes T cells towards a Treg response

545
Q

what bacteria is the most common cause of post surgical infection, especially after GI surgeries

A

bacteriod fragilis

546
Q

what bacteria can cause brain abscess in immunocompromised patients

A

bacteriod fragilis

547
Q

what is the drug of choice for bacteriod fragilis

A

metronidazole (+something else)

*obligately anaerobic

548
Q

are mobilinucus and gardnerella vaginalis aerobic or anaerobic

A

obligately anaerobic

549
Q

are mobilinucus and gardnerella vaginalis gram - or +

550
Q

what is unique about the cell envelope of mobilinucus and gardnerella vaginalis

A

they don’t have LPS

551
Q

how are mobilinucus and gardnerella vaginalis both harmless and harmful

A

they’re part of normal vaginal flora but can cause bacterial vaginosis

552
Q

what stain is used to see mobilinucus and gardnerella vaginalis

A

methylene blue

553
Q

how will mobilinucus and gardnerella vaginalis appear with methylene blue stain

A

clue cells

cells are stuck to vaginal epithelial cells

554
Q

pasteurella multocida are normal flora of what

A

domestic animals (cats and dogs)

555
Q

what are the most common symptoms of infection with pasteurella multocida

A

non-directional cellulitis with regional swollen lymph node closest to bote of cat/dog

556
Q

what bacteria causes cat scratch fever

A

bartonella henselae

557
Q

what are the symptoms of cat scratch fever

A

swollen, warty lesion at site of cat scratch or bite progresses to lymphadenopathy of regional lymph node and slight fever

558
Q

what is the appearance of the warts caused by bartonella henselae causing causing cat scratch fever

A

infiltrated with new blood vessels recruited by the bacteria

559
Q

what are the shape of francisella tularensis

560
Q

are francisella tularensis gram - or +`

561
Q

how are francisella tularensis able to replicate in the cytoplasm

A

they replicate inside macrophages

562
Q

what is the activity of francisella tularensis and brucella species in macrophages

A

after being internalized by macrophages, francisella tularensis escapes from the phagosome and replicates in the cytoplasm

this causes a lot of NOD-protein activated inflammation and cell death

*intracellular= Th1 response

brucella causes not as much inflammation and leads to granuloma formation with if smooth strain

563
Q

what is ulceroglandular tularemia, what bite causes it

A

wound infection and lymph node swelling caused by Ixodes tick or rabbit blood

564
Q

what is the progression of ulceroglandular tularemia caused by francisella tularensis

A

painful papule progresses to a necrotizing wound with raised, red edges followed by regional lymphadenopathy

565
Q

how can you differentiate a necrotizing wound caused by francisella tularensis vs bacillus anthracis

A

anthracis= not painful
tularensis= painful

566
Q

what causes oculoglandular tularemia

A

conjunctiva infection and cervical lymph node swelling caused by infected blood from rabbit/tick getting in the eye

567
Q

pulmonary tularemia caused by francisella tularensis is most common in what population

A

lab workers who work with patient samples

568
Q

how does francisella tularensis show on Xray

A

bilateral infiltration

569
Q

what must be done with a sample of francisella tularensis

A

send to bio-safety level 3 lab

570
Q

are brucella bacteria intracellular or extracellular

A

intracellular

571
Q

where are brucella bacteria found

A

reproductive tissue of non-human mammals

572
Q

how does brucella bacteria spread

A

they can be aerosolized from body fluid of infected animal through milking animal or with unpasteurized milk, then inhaled by humans

573
Q

what is the difference between rough and smooth strains of brucella

A

rough lack O-polysaccharide of LPS so they’re phagocytized by macrophages

smooth have the O-polysaccharide so they grow in macrophages and are lead to T cell inflammation

574
Q

brucella species causes infection that starts as __ infection then progresses to __ and __

A

pulmonary

GI and arthritis involvement

575
Q

what is a unique symptom of brucella infection

A

undulant fever

576
Q

what does brucella abortus cause

A

mild infection in humans, fetal loss in cattle

577
Q

what does brucella suis cause

A

severe and chronic infection, found only in pigs and deer

578
Q

what brucella species causes the most severe symptoms in humans, what animal carries it

A

brucella melitensis
sheep and goats

579
Q

brucellosis cases are associated with exposure to what

580
Q

what is used to test for brucella infection

A

rRNA sequencing to test for IgG against brucella

581
Q

legionella pneumophila live in what (2)

A

ameobae
alveolar macrophages

582
Q

legionella can replicate in alveolar macrophage cytoplasm, how

A

rER wraps around the phagosome, bacteria replicate in phagosome, bacteria escape in cytoplasm

583
Q

pontiac fever is caused by what bacteria

A

inhalation of aerosolized legionella

584
Q

what causes pontiac fever

A

outbreak due to contaminated H2O

585
Q

pontiac fever causes __ symptoms for many but for few it causes __

A

flu-like
Legionnaires’ disease

586
Q

what are the symptoms of Legionnaire’s disease

A

bilateral infiltration on chest X-ray
little-no sputum production
SOB
fever
dyspnea

587
Q

Legionella infections caused by legionella bacteria are associated with what population

A

those with a history of smoking and alcohol consumption

smoking= reduced ciliary beating= inhale whole amoeba

alcohol= decreased liver function= reduced clearance from bloodstream

588
Q

how can you get legionella infection

A

amoeba in sitting still fresh water gets aerosolized (ex: air conditioner so most common in summer months when air conditioners are used most)

589
Q

how are legionella diagnosed through staining

A

fluorescent or silver staining

590
Q

what culture type is used to diagnose Legionella

A

urine (bacteria are passed in urine for 1 month-1 year after infection)

591
Q

Legionella that are grown on buffered charcoal yeast extract agar have what appearance

A

glossy white “ground glass” colonies

592
Q

what antibiotic class are not used for intracellular bacteria

A

beta lactams

593
Q

what are 12 intracellular bacteria

A

francisella (macrophages)
brucella (macrophages)
legionella (macrophages)
pasteurella (macrophage)
rickettsiae (endothelial and epithelial cells)
ehrlichia (WBC- monocytes)
anaplasma (WBC- neutrophils/granulocytes)
coxiella
mycoplasma
ureaplasma
clamydia
clamydophilia

594
Q

are rickettsiae gram + or -

595
Q

are rickettsiae motile or non-motile

A

non-motile

596
Q

what staining is used for rickettsiae

A

silver stain or Giesma

597
Q

rickettsiae has what effect on blood vessels

A

causes vasculitis with blood clots

598
Q

what bacteria causes Rocky Mountain Spotted Fever

A

rickettsiae rickettsii

599
Q

what spreads rickettsiae rickettsii

A

Dermacentor species of tick (American dog tick)

600
Q

what are the symptoms of Rocky Mountain Spotted Fever

A

fever
petechial rash that starts on palms/soles and spreads to trunk
myalgia
headache

601
Q

___ tick eggs can be infected before birth
___ tick eggs are born sterile

A

dermacentor (rickettsiae rickettsii with Rocky Mountain Spotted Fever)
bordetella burgdorferi (Lyme)

602
Q

tick infection with __ is common at any time of year, not just late summer

A

dermacentor (rickettsiae rickettsii with Rocky Mountain Spotted Fever)

603
Q

where is Rocky Mountain Spotted Fever most common

A

Ozark and Blue Ridge mountains (southeastern and midwest states)

604
Q

what bacteria causes epidemic typhus and Brill-Zinsser disease

A

rickettsiae prowazekii

605
Q

what are the symptoms of epidemic typhus

A

high fever
headache
myalgia
rose spot rash (vasculitis)

*same as typhoid caused by salmonella typhi

606
Q

how is epidemic typhus, caused by rickettsiae prowzekii, spread, what population is it most common in

A

human body lice

homeless- no shower, no clean laundry

607
Q

epidemic typhus caused by rickettsia prowazekii can turn into Brill-Zinsser disease, what is the difference

A

symptoms of untreated epidemic typhus occur years after initial infection but with milder symptoms= Brill-Zinsser disease

608
Q

what is the drug of choice for epidemic typhus and Brill-Zinsser disease

A

doxycycline

609
Q

rickettsiae typhi/rickettsiae felis is similar to rickettsiae prowzekii but is less severe. it is caused by __ and is most common in what region of the US

A

cat fleas
southern US

610
Q

is untreated rickettsiae typhi/rickettsiae felis or rickettsiae prowzekii reoccuring

A

rickettsiae prowzekii

611
Q

how is rickettsiae typhi/rickettsiae felis diagnosed

A

serology to look for antigens

612
Q

how is rickettsiae typhi/rickettsiae felis treated

A

doxycycline

613
Q

how are ehrlichia and anaplasma able to replicate in leukocytes

A

they stop phagosome-lysosome fusion

614
Q

ehrlichia and anaplasma are spread by what

A

Ixodes species of ticks or lone star ticks

615
Q

what are the symptoms of ehrlichia and anaplasma

A

severe flu-like symptoms
high fever
headache
possible body-wide rash 1-2 weeks after infection

616
Q

how are ehrlichia and anaplasma treated

A

doxycycline

617
Q

where is ehrlichia and anaplasma infection most common

A

southeastern US (similar to Lyme)

618
Q

how do you test for ehrlichia and anaplasma

A

PCR or serological testing for looking for gene antibodies

619
Q

how can you differentiate ehrlichia and anaplasma based on CBC count

A

ehrlichia= low monocytes
anaplasma= low neutrophils

620
Q

what characteristic is seen with ehrlichia and anaplasma infected cells

A

morulae (clumps of bacteria in the WBC)

621
Q

what 4 bacteria lack a cell wall

A

mycoplasma
ureaplasma
chlamydia
chlamydophilia

622
Q

what drug would be used against bacteria that don’t have a cell wall

A

tetracycline (doxycycline)

623
Q

what 2 drug classes would not be used against bacteria that lack a cell wall

A

beta lactams
vancomycin/daptomycin

624
Q

what is the main cause of walking “atypical” pneumonia

A

mycoplasma pneumoniae

625
Q

what allows for mycoplasma pneumoniae to cause walking pneumoniae

A

P1 adhesin on pilus surface attaches to epithelial cell causes cilia to stop beating and releases pro-inflammatory cytokines

626
Q

what age group is most common to have mycoplasma pneumoniae infection, walking/atypical pneumonia

627
Q

any intracellular bacteria that causes pneumonia shows as __ on X-ray

A

patchy, diffuse infiltration

628
Q

before PCR was used, and still now currently, how is mycobacterium pneumoniae infection diagnosed

A

cold agglutinin production

patient serum with IgM against the bacteria is added to Type O- blood and clots when on ice

629
Q

what bacteria causes non-gonococcal (not caused by neisseria gonorrhea) urethritis and can’t make its own ATP

A

chlamydia trachomatis

630
Q

how do the 2 forms of chlamydiae (elementary body and reticulate body) differ

A

elementary- non-metabolic, transmissible
reticulate- metabolically active (can reproduce), non-transmissible

631
Q

how does chlamydiae switch from elementary to reticulate body

A

elementary body is formed, attached to host cell, host cell ingests bacteria, elementary body reorganizes into reticulate body and uses our ATP to replicate in cytoplasm and phagosomes (slow replication rate)

632
Q

what allows for chlamydiae to cause low level infection

A

TLR-9 recognizes DNA in the vacuole

633
Q

how do the symptoms of gonorrhea differ from chlamydia

A

gonorrhea- mucopurulent discharge with neutrophils seen on gram stain, pain while urinating and pressure pain in men

chlamydia- mucoid (clear) discharge no bacteria seen on gram stain (it’s an intracellular bacteria), asymptomatic in men and women

634
Q

what is the main cause of pelvic inflammatory disease in women

A

chlamydia (chlamydia trachomatis)

635
Q

what technique is used to test for chlamydia

636
Q

what is the drug of choice to treat chlamydia

A

azithromycin (or you can use doxycycline or another ribosome disabling antibiotic)

637
Q

what bacteria causes trachoma

A

chlamydia (chlamydia trachomatis)

638
Q

what is trachoma

A

a conjunctivitis caused by chlamydia (chlamydia trachomatis)

639
Q

trachoma, caused by chlamydia (chlamydia trachomatis), can lead to __ and __

A

corneal scarring
blindness

640
Q

what is the main symptom of trachoma caused by chlamydia (chlamydia trachomatis)

A

eyelashes flip under, causing scratching when blinking which can lead to blindness

641
Q

what 2 bacteria can cause neonatal conjunctivitis

A

neisseria gonorrhea
chlamydia (chlamydia trachomatis)

642
Q

face flies can spread what infection

A

chlamydia (chlamydia trachomatis)

643
Q

are chlamydia infections more common in males or females

A

young females

644
Q

syphilis is more common in __
chlamydia is more common in __
males or females

A

syphilis- males
chlamydia- females

645
Q

neisseria gonorrhea can lead to __ arthritis in __
chlamydia (chlamydia trachomatis) can lead to __ arthritis in __

(what type of arthritis, males/females)

A

gonorrhea- septic in femals
chlamydia- reactive in males

646
Q

reactive arthritis caused by chlamydia (chlamydia trachomatis) is most common in males with what HLA type

647
Q

what bacteria survive in macrophages

A

nocardia
mycobacterium tuberculosis
francisella tularensis
brucella (smooth strain)

648
Q

what 7 bacteria survive in macrophages

A

nocardia
mycobacterium tuberculosis
francisella tularensis
brucella (smooth strain)
legionella
bordetella pertussis
yersinia pestis

Bacteria (1 decks)

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