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Step 1 > Bacteria > Flashcards

Bacteria Flashcards

1
Q

All bacterial capsules contain polysaccharide except which one?

A

Bacillus anthracis which contains D-glutamate (a polypeptide)

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2
Q

Are lipoteichoic acids on gram positives or negatives?

A

Positives

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3
Q

What do lipoteichoic acids induce in host’s immune system?

A

TNF and IL-1

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4
Q

What does Lipid A induce in host’s immune system?

A

TNF, IL-1, and IL-6

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5
Q

Is endotoxin (LPS) on gram positives or negatives?

A

Negatives

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6
Q

Where exactly are beta-lactamases located on a bacterium?

A

In the periplasm layer of gram negatives

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7
Q

What is the purpose of a bacterium’s capsule?

A

Protects against phagocytosis

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8
Q

What does catalase do?

A

Catalyzes the following reaction: 2H2O2 –> O2+2H2O

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9
Q

What is LPS composed of?

A

Lipid A (toxic), core polysaccharides, and O antigen

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10
Q

A deficiency in C5-C9 predisposes a patient to disease by which species of bacteria?

A

Neisseria

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11
Q

What are the 7 Gram positive rod species?

A

Clostridium, Propionibacterium acnes, Gardnerella, Corynebacterium, Bacillus, Listeria, Mycobacterium

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12
Q

What are the 2 pleomorphic bacterial species? And which stain must you use to visualize them?

A

Rickettsiae and Chlamydiae; Giemsa stain

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13
Q

What are the 3 spirochete bacterial species? And how can you visualize them?

A

Borrelia, Leptospira, Treponema; Dark field microscopy

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14
Q

Which bacterial species has no cell wall?

A

Mycoplasma

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15
Q

Giemsa stain is used to visualize which bacterial species?

A

Chlamydia, Borrelia, Rickettsiae, Trypanosomes, Plasmodium; “Certain Bugs Really TRY my Patience”

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16
Q

PAS stain is used to visualize which bacterial species?

A

Stains glycogen, used to diagnose Whipple disease (Tropheryma whipplei)

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17
Q

Ziehl-Neelsen (carbol fuchsin) stain is used to visualize which bacterial species?

A

Acid-fast organisms (Nocardia, Mycobacterium)

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18
Q

India ink stain is used to visualize what?

A

Cryptococcus neoformans

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19
Q

Silver stain is used to visualize what?

A

Fungi, Legionella, H pylori

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20
Q

Chocolate agar with factors V (NAD+) and X (hematin) is used to grow which bug?

A

H flu

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21
Q

Thayer-Martin agar (or VPN) media contains what?

A

Vancomycin (inhibits gram +), Polymyxin (inhibits gram - except Neisseria), and Nystatin (inhibits fungi)

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22
Q

Thayer-Martin agar (or VPN) is used to isolate which bug?

A

Neisseria spp.

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23
Q

Bordet-Gengou (potato) agar is used to isolate which bug?

A

Bordetella pertussis

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24
Q

Tellurite agar (Loffler medium) is used to isolate which bug?

A

C diphtheriae

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25
Q

Lowenstein-Jensen agar is used to isolate which bug?

A

Mycobacterium TB

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26
Q

Eaton agar - which bug?

A

M pneumoniae “don’t EAT ON ice”

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27
Q

Charcoal yeast extract agar buffered with cysteine and iron (aka BYCE) is used to isolate which bug?

A

Legionella “SS Cysteine”

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28
Q

Sabouraud agar is used to isolate what?

A

Fungi

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29
Q

Which bugs are obligate aerobes?

A

Nocardia, Pseudomonas, and MycoBacterium “Nagging Pests Must Breathe”

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30
Q

Which bugs are obligate anaerobes?

A

Clostridium, Bacteroides, and Actinomyces (lack catalase and/or superoxide dismutase) “anaerobes Can’t Breathe Air”

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31
Q

Which class of antibiotic is ineffective against anaerobes?

A

Aminoglycosides

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32
Q

Which bugs are obligate intracellular?

A

Rickettsia, Chlamydia

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33
Q

Which bugs are facultative intracellular?

A

Salmonella, Neisseria, Brucella, Mycobacterium, Listeria, Francisella, Legionella, Yersinia pestis; “Some Nasty Bugs May Live FacultativeLY”

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34
Q

Which bacteria are encapsulated?

A

S pneumo, H flu, Neisseria meningitidis, E coli, Salmonella, Klebsiella pneumo, group b Strep ; “SHiNE SKiS”

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35
Q

Patients with chronic granulomatous disease are susceptible to which organisms?

A

Catalase positive organisms because they are deficient in NADPH oxidase

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36
Q

How does Protein A evade the immune system and which bug is it associated with?

A

S aureus; Binds Fc region of IgG and prevents opsonization and phagocytosis

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37
Q

Which bugs express IgA protease?

A

S pneumo, H flu type B, and Neisseria

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38
Q

How does M protein evade the immune system and which bug is it associated with?

A

Group A strep; Helps prevent phagocytosis

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39
Q

Which 5 bugs are lactose fermenters?

A

E coli, Klebsiella, Enterobacter, Citrobacter, Arizona

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40
Q

What is the heat stability of endotoxin?

A

Stable at 100 degrees C for 1 hour

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41
Q

What is the genetic location of genes of exotoxins? Of endotoxins?

A

Plasmid/bacteriophage and bacterial chromosome, respectively

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42
Q

What is the heat stability of exotoxin?

A

Destroyed rapidly at 60 degrees C (except staph enterotoxin)

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43
Q

What are the names and mechanisms of Staph aureus’ exotoxins?

A

TSST-1; Brings MHC II and TCR in proximity to outside of antigen binding site to cause overwhelming release of IFN-gamma and IL-2 –> shock

Enterotoxin; Rapid-onset food poisoning

Exfoliative toxin; Scalded skin syndrome

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44
Q

What are the names and mechanisms of E coli’s exotoxins (3)?

A

Shiga-like toxin (SLT) EHEC; Inactivates 60S ribosome by removing adenine from rRNA –> dysentery

Heat-labile toxin (LT) ETEC; Overactivates AC to increase cAMP which leads to increased Cl secretion in gut and water efflux

Heat-stabile toxin (ST) ETEC; Overactivates GC to increase cGMP which leads to decreased resorption of NaCL and water in gut

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45
Q

What is the name and mechanism of Vibrio cholerae’s exotoxin?

A

Cholera toxin; A-B toxin that overactives AT and increases cAMP by permanently activating Gs –> increased Cl secretion in gut and water efflux –> “rice water” diarrhea

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46
Q

What are the names and mechanisms of Streptococcus pyogene’s exotoxins?

A

Streptolysin O; Protein that degrades cell membrane

Exotoxin A; Brings MHC II and TCR in proximity to outside of antigen binding site to cause overwhelming release of IFN-gamma and IL-2 –> shock

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47
Q

What is the name and mechanism of Bacillus anthracis’ exotoxin?

A

Edema factor; Mimics the AC enzyme to increase cAMP

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48
Q

What is the name and mechanism of Bordetella pertussis’ exotoxin?

A

Pertussis toxin; Overactivates AC (increasing cAMP) by ribosylating and disabling Gi, impairing phagocytosis to permit survival of microbe

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49
Q

What is the name and mechanism of Clostridium perfringens’ exotoxin?

A

Alpha toxin; Phospholipase (lecithinase) that degrades tissue and cell membranes

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50
Q

What is the name and mechanism of Shigella’s exotoxin?

A

Shiga toxin; Inactivates 60S ribosome by removing adenine from rRNA, ST also enhances cytokine release causing HUS

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51
Q

What is the name and mechanism of Pseudomonas aeruginosa’s exotoxin?

A

Exotoxin A; Inactivate EF-2

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52
Q

What is the name and mechanism of Clostridium botulinum’s exotoxin?

A

Botulinum toxin; Cleaves Snare proteins that release ACh vesicles –> descending flaccid paralysis

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53
Q

What is the name and mechanism of Clostridium tetani’s exotoxin?

A

Tetanospasmin; Cleaves Snare proteins that release GABA and glycine vesicles –> spastic paralysis

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54
Q

What is the name and mechanism of Corynebacterium diphtheriae’s exotoxin?

A

Diphtheria toxin; ADP-ribosylationof EF-2 prevents protein synthesis

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55
Q

What is the most common cause of septic arthritis?

A

S aureus

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56
Q

What is the most common cause of osteomyelitis?

A

S aureus

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57
Q

What is the treatment for MRSA?

A

Vancomycin

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58
Q

What is the treatment of MSSA?

A

Naphcillin

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59
Q

What is the treatment for staph epidermidis and saprophyticus?

A

Vancomycin

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60
Q

What is the second most common cause of UTIs in sexually-active young women?

A

Staph saprophyticus

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61
Q

Strep pneumo is the #1 cause of what?

A

“MOPS” Meningitis, otitis media (kids), pneumonia, and sinusitis

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62
Q

Pneumonia with rust-colored sputum may indicate infection with what bug?

A

S pneumo

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63
Q

What is the virulence factor of S pneumo?

A

IgA protease, capsule

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64
Q

What is the treatment of S pneumo?

A

Macrolides or ceftriaxone

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65
Q

The adult S pneumo vaccine is what kind of vaccine?

A

A polysaccharide vaccine with an IgM response

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66
Q

The child S pneumo vaccine is what kind of vaccine?

A

A conjugate vaccine with an IgG response

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67
Q

What is the #1 cause of necrotizing fasciitis?

A

Group A strep (S pyogenes) - specifically SPEb protease toxin

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68
Q

S pyogenes capsule is made of what?

A

Hyaluronic acid (also found in humans, therefore not immunogenic)

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69
Q

What is the #1 cause of erysipelas?

A

S pyogenes

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70
Q

What causes Scarlet fever?

A

SPE exotoxin of S pyogenes

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71
Q

What are the main symptoms of scarlet fever?

A

Reddening of the tongue, pharyngitis, widespread rash that spares the face

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72
Q

Which bug causes Toxic shock-like syndrome?

A

S pyogenes

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73
Q

How long after infection does post-strep glomerulonephritis occur?

A

2 weeks after onset of initial infection

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74
Q

What is the main virulence factor responsible for rheumatic fever?

A

M protein of S pyogenes - prevents phagocytosis

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75
Q

In bacterial genetics, what is Transformation?

A

Ability to take up DNA (from cell lysis) from environment.

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76
Q

In bacterial genetics, what is Conjugation?

A

Two types of conjugation

F+ x F- : F+ plasmid contains genes for sex pilus and conjugation. Plasmid (dsDNA) is replicated and transferred through pilus from F+ cell to F- cell. No transfer of chromosomal genes.

Hfr x F- : F+ plasmid can be incorporated into bacterial chromosomal DNA (high frequency recombination). Replication of incorporated plasmid DNA may include some flanking chromosomal DNA.

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77
Q

In bacterial genetics, what is Transposition?

A

Segment of DNA (transposon) that can “jump” from one location to another, can transfer genes from plasmid to chromosome and vice versa. Excision may include some flanking chromosomal DNA, which can be incorporated into a plasmid and transferred to another bacterium.

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78
Q

In bacterial genetics, what is Generalized Transduction?

A

Lytic phage infects bacterium, leading to cleavage of bacterial DNA. Parts of bacterial chromosomal DNA may become packaged in viral capsid. Phage infects another bacterium, transferring these genes.

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79
Q

In bacterial genetics, what is Specialized Transduction?

A

Aka prophages. Lysogenic phage infects bacterium; viral DNA incorporates into bacterial chromosome. When phage DNA is excised, flanking bacterial genes may be excised with it. DNA is packaged into phage viral capsid and infects another bacterium.

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80
Q

Genes for which 5 bacterial toxins are encoded in lysogenic phages?

A

Shiga-like toxin, Botulinum toxin, Cholera toxin, Diphtheria toxin, Erythrogenic toxin of S pyogenes

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81
Q

Which virulence factor of S pyogenes is responsible for rheumatic fever and why?

A

M protein - Very antigenic and illicits a very strong humoral response. Molecular mimicry causes Abs to attack the myosin in cardiac muscle.

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82
Q

What is the most severe form of rheumatic fever?

A

Myocarditis

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83
Q

What is the clinical presentation of rheumatic fever?

A

Acute migratory polyarthritis, carditis, subcutaneous nodules, erythema marginatum, Sydenham chorea (JONES criteria)

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84
Q

How does acute glomerulonephritis from a GAS infection present?

A

Cola-colored urine and facial edema

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85
Q

How can we detect a recent GAS infection?

A

ASO titer (anti-streptolysin O antibodies)

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86
Q

Can early treatment of GAS infection prevent rheumatic fever?

A

Yes

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87
Q

Can early treatment of GAS infection prevent acute glomerulonephritis?

A

No

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88
Q

What is the treatment of GAS infection?

A

Penicillin

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89
Q

What is the role of GAS’s virulence factor streptokinase?

A

Converts plasminogen –> plasmin *plasmin is fibrinolytic

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90
Q

What is the role of GAS’s virulence factor streptolysin O?

A

(Oxygen labile) Lyses RBCs

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91
Q

What does GBS cause in babies?

A

Pneumonia, meningitis, and sepsis.

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92
Q

Which Strep bacterium tests hippurate positive?

A

GBS

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93
Q

What is the CAMP test and what does it test for?

A

GBS; GBS produces CAMP factor, which enlarges the area of hemolysis of S aureus

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94
Q

Which of the two enterococi is more common?

A

Enterococcus faecalis > Enterococcus faecium

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95
Q

What is a common bug that causes subacute endocarditis following GI/GU procedures?

A

Enterococcus

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96
Q

What are the three most common diseases caused by enterococcus?

A

UTIs, biliary tract infections, and subacute endocarditis

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97
Q

What can be used to treat enterococcus?

A

Linezolid or tigecycline (resistant even to vancomycin, VRE)

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98
Q

What is the most life-threatening manifestation of Corynebacterium diphtheriae?

A

Myocarditis and arrhythmias

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99
Q

What test is used to determine the toxicity of Corynebacterium diphtheriae?

A

Elek test for toxin

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100
Q

What kind of vaccine is the vaccine for Corynebacterium diphtheriae?

A

Toxoid - IgG response

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101
Q

A blood infection with Strep bovis would cause you to look for what in a patient?

A

Colon cancer

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102
Q

What kind of vaccine is the tetanus vaccine?

A

Toxoid

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103
Q

Describe floppy baby syndrome

A

Ingestion of spores of Clostridium botulinum causes flaccid paralysis - adults cannot get sick with spores due to mature gut flora

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104
Q

Is C botulinum an ascending or descending paralysis?

A

Descending

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105
Q

What are the 2 diseases caused by C perfringens?

A

Gas gangrene and late-onset food poisoning (ingestion of spores)

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106
Q

What is the treatment of C perfringens?

A

IV penicillin G

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107
Q

Which clostridium species causes a double zone of hemolysis on blood agar?

A

C perfringens

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108
Q

What toxins are produced by C dif and what are their mechanisms of action?

A

Exotoxin A: Binds to brush border and causes inflammation, cell necrosis, and watery diarrhea

Exotoxin B: Disrupts cytoskeleton integrity by depolymerizing actin –> pseudomembranous colitis

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109
Q

How is C diff diagnosed?

A

Detection of one or both toxins in the stool

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110
Q

How is C diff treated?

A

Metronidazole or oral vancomycin. Recurring cases may benefit from fecal transplant.

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111
Q

What are anthrax’s toxins and their MOAs?

A

EF (edema factor): Activates AC, increase in cAMP, edema, indirectly prevents phagocytosis

LF (lethal factor): Exotoxin that acts as a protease and cleaves map kinase –> tissue necrosis

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112
Q

What is the treatment of Bacillus anthracis?

A

Fluoroquinolones or doxycycline

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113
Q

How does Bacillus anthracis look under the microscope?

A

Gram positive rods in chains

114
Q

Infection with which bacteria is known as “woolsorter’s disease?”

A

Pulmonar anthrax

115
Q

How does cutaneous anthrax present?

A

Black eschar - painless, necrotic

116
Q

What is the pathogenesis of pulmonary anthrax?

A

Inhalation of spores –> flu-like symptoms that rapidly progress to fever, pulmonary hemorrhage, mediastinitis, and shock.

117
Q

Bacillus cereus causes what disease? Which toxin?

A

Food poisoning; cereulide, a preformed toxin

118
Q

How does Listeria move inside the cell? Outside the cell?

A

Inside, actin tails. Outside, tumbling motility.

119
Q

Who is more likely to get a Listeria infection?

A

Pregnant women

120
Q

A Listeria infection in a pregnant woman may lead to what?

A

Early termination of pregnancy, disease in newborn including meningitis.

121
Q

How is Listeria infection acquired?

A

Ingestion of unpasteurized dairy products and deli meats, via transplacental transmission, or by vaginal transmission during birth.

122
Q

What kind of hemolysis does Listeria exhibit?

A

Beta hemolysis

123
Q

How is Listeria treated?

A

Ampicillin

124
Q

What is a branching filamentous gram positive anaerobic rod?

A

Actinomyces israelii

125
Q

What is a branching filamentous gram positive aerobic rod?

A

Nocardia

126
Q

What is the main disease manifestation of Actinomyces?

A

Cervicofacial actinomycosis

127
Q

What is the clinical presentation of cervicofacial actinomycosis?

A

Oral/facial abscesses that drain through sinus tracts. Thick yellow pus due to yellow sulfur granules.

128
Q

What is the treatment of Actinomyces?

A

Penicillin G and possibly surgical drainage

129
Q

Where is Nocardia found?

A

Soil; does not form spores

130
Q

What are the possible clinical manifestations of Nocardia?

A

Pulmonary infections, cutaneous infections after trauma, and CNS infections in the immunocompromised.

131
Q

What is the treatment of Nocardia?

A

Sulfonamides

132
Q

What kind of lung lesions does TB cause?

A

Fibrocaseous cavitary lesions

133
Q

What test for TB is more specific than the PPD skin test?

A

IF-gamma release assay (IGRA) - no false positives from BBG vaccine

134
Q

What kind of vaccine is the BBG vaccine?

A

Live-attenuated mycobacterium bovis

135
Q

What is another name for acid-fast stain?

A

Ziehl-Neelson

136
Q

What kind of disease does Mycobacterium avium cause?

A

Disseminated non-TB disease in AIDS

137
Q

What is the prophylactic treatment for Mycobacterium avium?

A

Azithromycin

138
Q

What are 2 of Mycobacterium TB’s virulence factors?

A

Cord factor and sulfatides

139
Q

What is the role of cord factor in TB?

A

Inhibits macrophage maturation and induces release of TNF-alpha

140
Q

What is the role of sulfatides in TB?

A

Inhibit phagolysosomal fusion

141
Q

What is responsible for the weight loss seen in TB?

A

TNF-alpha promotes wasting

142
Q

The lepromatous form of leprosy illicits what kind of immune response?

A

Th2 - humoral response

143
Q

The tuberculoid form of leprosy illicits what kind of immune response?

A

Th1 - cell mediated immunity

144
Q

What is the treatment for the lepromatous form of leprosy?

A

Dapsone, rifampin, and clofazamine for 2-5 years!

145
Q

What is the treatment for the tuberculoid form of leprosy?

A

Dapsone and rifampin

146
Q

What are the lactose-fermenting enteric bacteria?

A

Citrobacter, klebsiella, e coli, enterobacter, serratia

147
Q

N gonorrhoeae is often intracellular; within what cells?

A

Neutrophils

148
Q

Of N gonorrhoeae and N meningiditis, which ferments glucose? Maltose?

A

Both ferment glucose and only mening ferments maltose

149
Q

Why is there no vaccine availabe for N gonorrhoeae?

A

Rapid antigenic variation of pilus proteins

150
Q

What kind of arthritis can N gonorrhoeae cause?

A

Monoarticular (usu knee) septic arthritis

151
Q

What is Fitz-Hugh-Curtis syndrome?

A

N gonorrhoeae spread into peritoneum

152
Q

What is the treatment of N gonorrhoeae?

A

Ceftriaxone + azithromycin for possible chlamydia infection

153
Q

What is the treatment of N meningiditis?

A

Ceftriaxone or penicillin G

154
Q

What is Waterhouse-Friderichsen syndrome?

A

Hemorrhage of adrenals due to meningococcemia

155
Q

What is used for prophylaxis in contacts of N mening?

A

Rifampin

156
Q

Culturing of H flu on chocolate agar requires which additional growth factors?

A

Factors V (NAD+) and X (hematin)

157
Q

What classic diseases does H flu cause in children?

A

Epiglottitis, meningitis, otitis media, and pneumonia “EMOP”

158
Q

Describe the H flu vaccine

A

Type B capsular polysaccharide (polyribosylribitol phosphate) conjugated to diphtheria toxoid

159
Q

When is the H flu vaccine administered?

A

Between 2-18 months of age

160
Q

How is mucosal infection with H flu treated?

A

Amoxicillin +/- clavulanate

161
Q

How is H flu meningitis treated?

A

Ceftriaxone

162
Q

What is used for prophylaxis in contacts of H flu?

A

Rifampin

163
Q

What can labs show in Legionella infection?

A

Hyponatremia

164
Q

How is Legionella pneumophilia diagnosed?

A

Presence of antigen in urine

165
Q

What is Legionella’s mode of transmission?

A

Aerosol transmission from environmental water source habitats. No person-to-person transmission.

166
Q

What is the treatment of Legionella pneumophilia?

A

Macrolide or quinolone

167
Q

What kind of pneumonia does Legionnaires’ disease cause?

A

Atypical patchy pneumonia with consolidation in 1 lobe

168
Q

How does Legionnaires’ disease present?

A

Severe atypical pneumonia, ferver > 40 degrees C, GI and CNS symptoms

169
Q

How does Pontiac fever present?

A

Mild flu-like symptoms

170
Q

What is pseudomonas’ color and odor?

A

Blue-green pigment (pyocyanin) and grape-like odor, or Fritos

171
Q

Which bug causes malignant otitis externa in diabetics?

A

Pseudomonas aeruginosa

172
Q

How does Pseudomonas aeruginosa manifest?

A

wound and burn infections, Pneumonia (esp in CF), Sepsis, External otitis, UTI, Drug user and Diabetic Osteomyelitis, and hot tub follicultis - “PSEUDOmonas

173
Q

Which bug causes ecthyma gangrenosm?

A

Pseudomonas

174
Q

What is ecthyma grangrenosum?

A

Rapidly progressive, necrotic cutaneous lesions caused by Pseudomonas bacteremia. Typically in immunocompromised patients.

175
Q

What is the treatment of infection with Pseudomonas?

A

Aminoglycoside plus extended-spectrum penicillin (Pip/Taz), or fluoroquinolones

176
Q

What is the #1 cause of gram-negative nosocomial pneumonia?

A

Pseudomonas

177
Q

What is the #1 cause of UTIs?

A

E coli

178
Q

What is the #1 cause of gram negative sepsis?

A

E coli

179
Q

What are E coli’s virulence factors?

A

Fimbriae (cystitis and pyelonephritis), K capsule (pneumonia, neonatal meningitis), LPS (septic shock)

180
Q

What is the presentation of EIEC?

A

Invasive dystentery

181
Q

What is the presentation of ETEC?

A

Travelers’ diarrhea

182
Q

What is the presentation of EPEC?

A

Diarrhea usu in children “P for peds”

183
Q

What is the presentation of EHEC?

A

Dysentery

184
Q

What is the most common serotype of EHEC?

A

O157:H7

185
Q

Which strain of E coli produces HS and HL enterotoxins?

A

ETEC

186
Q

What is the virulence mechanism of EPEC?

A

No toxin produced. Adheres to apical surface of gut, flattens villi, and prevents absorption.

187
Q

Is E coli a sorbitol fermenter?

A

Yes, except for EHEC

188
Q

A metallic green sheen on EMB agar indicates what bug?

A

E coli

189
Q

How is EHEC transmitted?

A

Eating undercooked meat

190
Q

Which strain of EHEC produces Shiga-like toxin?

A

EHEC

191
Q

What disease processes do Klebsiella, Enterobacter, and Serratia cause?

A

UTIs and pneumonia

192
Q

In what setting are Klebsiella, Enterobacter, and Serratia found?

A

Nosocomial

193
Q

Klebsiella, Enterobacter, and Serratia cause lobar pneumonia in what patient populations?

A

Aspiration pneumonia in alcoholics and diabetics

194
Q

The x-ray of pneumonia caused by Klebsiella, Enterobacter, and Serratia may look like what other disease process?

A

TB

195
Q

Of Klebsiella, Enterobacter, and Serratia, which one is urease positive?

A

Klebsiella

196
Q

Of Klebsiella, Enterobacter, and Serratia, which one is a lactose fermenter?

A

All three!

197
Q

What does it mean to be H2S positive?

A

Forms black colonies on Hektoen agar plate

198
Q

Which organisms are H2S positives?

A

All motile enteric bacteria

199
Q

Chronic carriers of Salmonella typhi harbor it where?

A

Gall bladder

200
Q

What is the #1 cause of osteomyelitis in patients with sickle cell disease?

A

Salmonella typhi

201
Q

What is the clinical presentation of Salmonella typhi?

A

Rose spots on the abdomen, fever, headache, constipation or “pea soup” diarrhea

202
Q

What is the treatment of Salmonella typhi?

A

Fluoroquinolone

203
Q

Which Salmonella species has an available vaccine and what kind of vaccine is it?

A

S typhi - live attenuated

204
Q

How does Shigella invade the intestinal mucosa and cause infection?

A

Passes into lumen of intestine easily (acid-stabile) and invade M cells in Peyer’s patches. Shigella induces M cells to phagocytose them, then Shigella escapes phagolysosome before it’s degraded, and then uses host cell actin to propel itself from cell to cell (similar to Listeria)

205
Q

Which species of Shigella can cause HUS in children?

A

Shigella dysenteriae

206
Q

What is the most common cause of viral encephalitis?

A

Herpes simplex encephalitis

207
Q

What is the reservoir for Campylobacter jejuni?

A

Poultry

208
Q

Campylobacter can grow at what temperature?

A

42 degrees Celsius

209
Q

What are three consequences (besides diarrhea) of Campylobacter infection?

A

Guillain-Barre, reactive arthritis, and bacteremia

210
Q

What kind of media does cholera grow in?

A

Alkaline

211
Q

What part of the GI tract does Yersinia enterocolitica infect?

A

Terminal ileum

212
Q

Which oxidase + curved gram negative rods can cause reactive arthritis?

A

Campylobacter and Yersinia enterocolitica

213
Q

Which oxidase + curved gram negative rods can cause bloody diarrhea and abscesses?

A

Yersinia enterocolitica

214
Q

Which bacteria has a “safety pin” appearance, meaning it stains bipolar?

A

Yersinia and Pasteurella

215
Q

What is the treatment of Yersinia enterocolitica infection?

A

Streptomycin (with tetracycline)

216
Q

How is H pylori diagnosed?

A

Urea breath test or fecal antigen test

217
Q

How is H pylori treated?

A

Triple therapy: PPI + clarithromycin + either amoxicillin or metronidazole

218
Q

H pylori is a risk factor for what?

A

Peptic and duodenal ulcers, gastric adenocarcinoma, and lymphoma (MALToma)

219
Q

What is the odor of Proteus?

A

Fishy

220
Q

What can Proteus cause?

A

UTI, struvite staghorn calculi

221
Q

What is the treatment of Proteus

A

Sulfonamides

222
Q

Vibrio vulnificus affects what patient population?

A

Immunocompromised

223
Q

How do humans usually acquire Vibrio parahaemolyticus?

A

Shellfish

224
Q

What is the clinical presentation of infection with Vibrio parahaemolyticus?

A

Watery diarrhea, halophilic acute diarrhea, cramps, nausea, vomiting, occasionally bloody stools

225
Q

Ixodes ticks are involved in transmission of what bugs?

A

Borrelia, ehrlichiosis, and babesiosis

226
Q

Heart block, migratory polyarthritis, and bilateral Bell’s paulsy are manifestations of infections with what bug?

A

Borrelia

227
Q

What is the treatment for Lyme disease?

A

Doxycycline and ceftriaxone

228
Q

What are the clinical manifestations of Leptospirosis?

A

Flu-like symptoms, jaundice, fever, photophobia with conjunctival suffusion (erythema without exudate)

229
Q

What is the treatment of Leptospirosis?

A

Penicillin and tetracycline

230
Q

Weil disease is the more serious form of what?

A

Leptospirosis

231
Q

What is the treatment for syphilis?

A

Penicillin G

232
Q

Which bug causes syphilis?

A

Treponema pallidum

233
Q

Which bug causes Yaws?

A

Treponema pertenue

234
Q

Which bug causes endemic syphilis?

A

Treponema endemicum

235
Q

Which bug causes Pinta?

A

Treponema carateum

236
Q

How is syphilis diagnosed? First, VDRL/RPR (nonspecific), then a specific test (FTA-Abs)

A

First, VDRL/RPR (nonspecific), then a specific test (FTA-ABS)

237
Q

What is the FTA-Ab test?

A

Test to detect Abs directly against Treponema pallidum

238
Q

What is the pathogenesis of the painless genital chancres produced by Treponema pallidum?

A

Locally invades small blood vessels and damages them, which leads to small areas of ischemic necrosis (also takes out nerves - painless)

239
Q

How does primary syphilis present?

A

Painless genital chancre, 2-6 weeks after exposure to bug

240
Q

How does primary syphilis present?

A

Disseminated disease with constitutional symptoms, maculopapular rash on palms and soles, and condylomata lata

241
Q

How does tertiary syphilis present?

A

Gummas (chronic granulomas), aortitis (vasa vasorum destruction), neurosyphilis (tabes dorsalis), Argyll Robertson pupil, borad-based ataxia, positive Romberg, Charcot joint, stroke without hypertension

242
Q

What are the clinical features of congenital syphilis?

A

Saber shins, saddle nose, CN VIII deafness, Hutchinson teeth, congenital deafness, and mulberry molars

243
Q

What is Jarisch-Herxheimer reaction?

A

Flu-like syndrome after antibiotics are started - due to killed bacteria releasing pyrogens

244
Q

Warthin-Starry stain (a type of silver stain) is used to visualize what?

A

Bartonella

245
Q

Bacillary angiomatosis is caused by what bug? Who does it affect?

A

Bartonella, immunocompromised

246
Q

How is Bartonella treated?

A

Doxycylcine or macrolides

247
Q

How is one infected with Brucella?

A

Direct contact with farm animals or ingestion of unpasteurized milk

248
Q

How is Brucellosis treated?

A

Doxycycline + rifampin

249
Q

How is tularemia treated?

A

Streptomycin

250
Q

Dog and cat bites typically transmit what bug?

A

Pasteurella multocida

251
Q

What are the manifestations of infection with Pasteurella?

A

Cellulitis and osteomyelitis

252
Q

What is the treatment for Pasteurella?

A

Penicillin, or Augmentin

253
Q

What is the treatment for Gardnerella vaginosis?

A

Metronidazole

254
Q

What pH does Gardnerella vaginosis thrive in?

A

> 4.5

255
Q

What is the disinfectant mechanism of alcohols? Are they sporicidal?

A

Disruption of cell membranes, denaturation of proteins; No

256
Q

What is the disinfectant mechanism of chlorhexidine? Is it sporicidal?

A

Disruption of cell membranes, coagulation of cytoplasm; No

257
Q

What is the disinfectant mechanism of hydrogen peroxide? Is it sporicidal?

A

Produces destructive free radicals that oxidize cellular components; Yes

258
Q

What is the disinfectant mechanism of iodine? Is it sporicidal?

A

Halogenation of proteins and nucleic acids; Yes

259
Q

An “undulating fever,” chills, and anorexia are suggestive of what?

A

Brucellosis

260
Q

Which bug causes Q fever?

A

Coxiella burnetii

261
Q

Which bug causes Rocky Mountain spotted fever?

A

Rickettsia rickettsii

262
Q

Which bug causes endemic typhus?

A

Rickettsia typhi

263
Q

Which bug causes epidemic typhus?

A

Rickettsia prowazekii

264
Q

Which bug causes psittacosis?

A

Chalmydophila psittaci

265
Q

What is the treatment for all Rickettsial disesase?

A

Doxycycline?

266
Q

Describe the rash of Rocky Mountain spotted fever

A

Starts at wrists and ankles then spreads to trunk, palms, and soles. Incubation period of 2-14 days.

267
Q

Describe the rash of typhus

A

Starts at trunk and moves towards extremities, sparing hands feet and head

268
Q

What is the clinical presentation of typhus?

A

Myalgias, arthralgias, pneumonia, encephalitis, and coma

269
Q

How does Ehrlichia look under the microscope?

A

Monocytes with morulae (berry-like inclusions) in cytoplasm

270
Q

How does Anaplasma look under the microscope?

A

Granulocytes with morulae in cytoplasm

271
Q

How is Q fever contracted?

A

Tick feces and cattle placenta release spores that are inhaled as aerosols

272
Q

What is the clinical presentation of Q fever?

A

Fever, cough, headache, hepatitis, no rash

273
Q

What is the classic cause of walking pneumonia?

A

Mycoplasma pneumoniae

274
Q

What is the treatment of Mycoplasma?

A

Macrolide

275
Q

Mycoplasma grows on what agar?

A

Eaton agar

276
Q

What is the treatment for Chlamydia?

A

Azithromycin (plus ceftriaxone for gonorrhea co-infection)

277
Q

Which Chlamydia species and subtype causes chronic infection and blindness?

A

Chlamydia trachomatis types A B and C

278
Q

Which Chlamydia species and subtypes cause urethritis, PID, ectopic pregnancy, neonatal pneumonia, and neonatal conjunctivitis?

A

Chlamydia trachomatis types D-K

279
Q

Which Chlamydia species and subtype cause Lymphogranuloma venereum?

A

Chlamydia trachomatis types L1, L2, and L3

280
Q

How can you differentiate neonatal conjunctivitis caused by Chlamydia vs Gonorrhea?

A

Neonatal conjunctivitis caused by Chlamydia presents much later

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