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Sketchy > Bacteria > Flashcards

Bacteria Flashcards

1
Q

Staph Aureus

A

Golden Staph of Moses

  • bundle of grapes
  • golden growth on plate
  • gram positive
  • catalase positive
  • coagulase positive
  • beta hemolitic
  • protein A
    • virulence factor
    • part of cell wall that binds Fc portion of Ig
    • prevent opsonization and phagocytosis
      • pneumonia
        • patchy infiltrate on chest Xray
        • post viral is most common time to get this infection
      • septic arthritis
        • staph aureus is most common cause of this condition
      • abcesses
      • rapid onset endocarditis (acute bacterial endocarditis)
        • happens in IV drug users
        • R side heart infection
          • tricuspid valve
      • osteomyelitis
        • most common cause of osteomyelitis in adults
      • scalded skin syndrome
        • protease mediated
      • toxic shock syndrome
        • TSST is the toxin
      • food poisoning
        • rapid onset
        • preformed toxin
        • vomitting&raquo_space;> diarrhea
        • meat and cream based foods that have been left out too long
      • MRSA
        • altered penecillin binding proteins
        • treat with vancomycin
        • menthycillin, nafcillin
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2
Q

staph epidermitis

A

PLUMBER

  • gram positive- purple stain
  • enemy of orthopedic surgeons
    • infects artificial joints and other hardware (indwelling catheters)
    • most common cause of endocarditis infecting artifically implanted heart valves
    • sticks to sleek metal and plastic surface
      • use of biofilms
    • gotta replace most anything that gets infected
  • part of normal skin flora
  • treat with vancomycin
  • contamination of blood cultures
  • novobiocin sensitive
  • catalase positive
  • urease positive
  • coagulase negative
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3
Q

Staph saprophyticus

A

BEAUTY

  • gram positive- purple
  • novobiocin resistant
  • UTI in sexually active females
  • catalase positive
  • urease positive
    • converts urea to ammonia
  • coagulase negative
    • blood does not clot
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4
Q

Strep Pyogenes (group A)

A

(bakery- pie genies)

  • these grow in long chains
  • catalase negative
  • group A strep
    • bacitracin sensitive
  • encapsulated
    • Hot Apple pie (Hyaluronic acid makes up the capsule- so our immune system leaves it alone)
  • beta hemolytic
    • made possible by streptolysin O
      • we make ASO antibodies against this guy
      • ASO titer tells us if we’ve recently had group A strep infection
  • streptokinase
    • converts plasminogen to plasmin
    • given as medication to lyse clots during strokes
  • DNA-ases
    • depolymerize DNA
  • pyogenic infections
    • impetigo
      • honey crusted skin
      • can also be caused by staph aureus
    • pharyngitis— strep throat
    • cellulitis and erisypela
      • strep pyogenes is most common cause of this
  • toxin (strep pyrogenic exotoxin— SPE) causes the following
    • scarlet fever
      • strawberry tongue
      • pharyngitis
      • widespread rash sparing the face
    • toxic shock like syndrome
    • necrotizing fascitis
      • invades fascia under skin and spreads rapidly
      • specifically caused by SPEB
  • rheumatic fever
    • type II hypersensitivity
    • M protein
      • cell wall protein virulence factor
        • interferes with opsinization = anti phagocytic
        • elicits strong humoral response
          • meaning we make Ab to M protein
          • causes molecular mimicry to heart valves (mitral valve most commonly affected= mitral stenosis)
    • only after strep pharyngitis (not after skin infection)
    • symptoms: JONES
      • J — joints
        • polyarthritis
      • <3 — heart stuff
        • valvular damage leading to murmur, pericarditis
      • N — nodules subq appearing on forearms, elbows, knees
      • E — erythema marginatum
      • S — sydenham’s chorea
        • rapid involentary movements of hands and face
  • poststreptococcal glomerulernephritis
    • type III hypersensitivity
      • AbAg complexes deposit in glomerulus
    • cola colored urine
    • facial edema
    • 2 wk after onset of initial strep infection
    • can occur after pharyngitis or a superficial infection like impetigo
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5
Q

strep agalactiae (group B)

A

Baby galaxy

  • infections in newborns
    • meningitis
    • sepsis
    • pneumonia
    • acquired during vaginal passage of infant delivery
      • vagina and rectum get swabbed at 35 wk to see if she is colonized
      • if colony is detected, we give mom interpartum penicillin
  • positive hipurate test
  • has a polysacaride capsule
  • CAMP test positive
    • distinguishes from other strep
    • grows with staph aureus on a plate in the shape of an arrow
  • beta hemolytic
  • bacitracin resistant
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6
Q

strep pneumo

A

numero uno– knight fighting in alpha contest

  • alpha hemolytic
    • partial RBC lysis
    • surrounding area is green bc of Hb oxidation
  • encapsulated
    • we need spleen to remove encapsulated bacteria
    • sickle cell patietns therefore are particularly susceptible
  • has protease that cleaves IgA
    • reduces host defenses
  • optochin sensitive
    • inhibits growth of strep pneumo
  • lancet shaped gram pos diplococci
  • bile soluble: cannot grow in bile
  • # 1 cause of community acquired pneumonia in adults
    • rust colored sputum
    • lobar in lower lobes usually
  • most common cause of these diseases: MOPS
    • meningitis
    • otitis media
    • pneumonia
    • sinusitis
  • antibiotics to use: macrolide sensitive, ceftriaxone sensitive
  • prevent with vaccine
    • adults—IgM
      • T cell independent response
    • children— IgG
      • polysaccaride conjugated to protein
      • t cell response leads to IgG
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7
Q

strep viridans

A

jester in the alpha competition

  • alpha hemolytic
  • no capsule
  • optochin resistant
  • bile resistant (insoluble)
  • mutans and sanguinis are strep viridans strains that can cause
    • dental caries
    • subacute endocarditis: mitral valve
    • adheres to fibrin platelet agregates at damaged tissue by creating dextrans from glucose
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8
Q

enterococcus

A

california caucus protest

  • gram positive cocci
  • grow in 6.5% NaCl
  • bile resistant
  • causes 3 main infections
    • UTI’s
    • endocarditis
    • infections of biliary tree
  • nosocomial infection resistant to vancomycin
    • VRE: vanco resistant enterococcus
    • instead we use linezolid or tigecycline
  • e faecalis
    • more common
  • e faecium
    • less often, superbug causing more serious problems
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9
Q

bacillis

A

vikings

  • anthracis
    • black center surrounded by red (black eschar) cutaneous lesion
    • large gram positive rods in chains
    • encapsulated — protein capsule
      • polyD
    • obligate aerobe
    • weaponized: spores sent in envelopes
    • toxins
      • LF: lethal factor
        • protease that cleaves MAPK
        • leads to tissue necrosis —> black escar
    • wool sorter disease
    • pulmonary hemorrhage is associated with almost 100% mortality rate
    • widened mediastinum on CXR
      • EF: edema factor
        • increases cAMP —> edema inhibiting host defense
    • floroquinolones and doxycycline to treat
  • cereus
    • reheated fried rice
    • nausea / vomit / diarrhea
    • symptoms caused by pre formed enterotoxin so antibiotics won’t help
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10
Q

clostridium

A

robots, monkeys, chocolate factory
spore forming
* Tetani
* rigid paralysis (spastic)
* evil smile
* lock jaw
* arching of back due to spasm
* obligate anaerobe
* inside puncture wound
* from rusty nails
* spores embed in flesh and produce toxin
*
* travels retrograde to spinal cord
* inhibits GABA and glycine release from renshaw cells
* cleave snare protein
* vaccine of toxin + protein
* Botulinum
*
* flaccid paralysis: descending
*
* toxin absorbed in gut goes to PNS but cannot cross BBB
* inhibits SNARE of motor neurons that release ACh
* floppy baby: avoid honey for babies (spores are ingested)
* canned food allow survival of spores (ingest the preformed toxin
* obligate aneorobe
* Difficile
*
* spore forming
* hits patients who are on antibiotics (clindemycin especially)
* exotoxin A: target brush border causing watery diarrhea
* exotoxin B: depolymerizes actin leading to pseudomembrane in colon
* look for toxin in stool to dx
* obligate anerobe
* tx with oral vancomycin or metronidazole

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11
Q

Corynebacterium Diphtheriae

A

bull fight- non spore forming rod

  • club shape with granules that stain metacramatic granules in V or Y formation
  • exotoxin
    • A active subunit ribosylation / inhibition EF2
      • inhibits protein synthesis at the ribosome
      • thick grey exudate in the oropharynx
    • B subunit
  • lymphadenopathy in neck — bulls neck
  • transmitted by respiratory droplet
  • systemic efffects on heart and nerves (spread via blood)
    • myocarditis / heart block, arrhythmia
    • toxin damages myelin of nerve fibers
  • tellurite and loefflers medium to culture
  • elek’s test tells us whether diphtheria is an active infection
  • occurs in underdeveloped countryies that aren’t activated
    • given with pertussis and tetanus
    • provides powerful IgG response
    • vaccine targets toxin that inh EF2
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12
Q

Listeria

A

Santa’s List

  • pregnant women (early termination or infection of the newborn), meningitis in children and adults over 60 (treat with vanco and cephtriaxone AND ampicillin)
  • grows in near freezing cold (refrigeration)
    • meat, milk, soft cheeses
  • beta hemolytic
  • motile, flagella, use actin to rocket from cell to cell
  • catalase positive
  • treat with ampicillin
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13
Q

actinomyces

A

Israeli soldier

  • gram pos filamentus branching rods
  • obligate aneorobe
  • cervicofascial actinomyces infection
    • after jaw trauma
    • nontender lump on jaw —> abscess —> drainage of thick yellow pus through sinus tracks onto skin
      • yellow sulfur granules
  • penicillin G and sometimes surgical drainage
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14
Q

nocardia

A

no card game

  • obligate aerobe
  • gram pos branching rod
  • soil is where you find it (no spores though)
  • weak acid fast staining
    • mycolic acid
  • catalase positive
    • increase susceptibility for those with chronic granulomatous disease (CGD)
  • urease positive
  • affects immunocompromised (esp without cell mediated), men are more affected, pneumonia with lung abscesses and cavitary lesions, disseminates to neural tissue (brain abscess), cutaneous
  • tx is sulfonamides
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15
Q

Neisseria

A

dorm crime, violinist crime

  • grows on chocolate auger (heated blood auger) and VPN auger
  • gram negative diplococci
  • occurs in those with complement deficiency
    • C5-9 (MAC formers)
  • oxidase positive
  • attaches mucosa via pilli with antigenic variation
    • prevents lasting immune response
  • IgA protease
  • meningitidis
    • spread by respiratory droplets
      • college, military, kids 6 mo to 2 years
      • usually the B strain cause sikcnes because we don’t vaccinate against it
    • ferments maltose
    • first colonize the nasopharynx
    • encapsulated- inhibits phagocytosis
    • sickle cell disease makes patients more susceptible to infection
    • spreads hematogenously- LOS envelope blebs
      • inflammatory response
      • increase capillary permeability
      • edema
      • peticial rash (thrombocytopenia)
        • DIC (bleeding gums)
      • shock
      • adrenal insufficiency (waterhouse fredrickson syndrome)
      • 15% mortality rate
      • cephtrioxone for treatment
      • close contacts get rifampin as prophelactic
  • gonorrhoeae
    • STD
    • facultative intracellular in PMN
    • men and women
      • prostatitis / orchitis
      • PID: pelvic inflammatory disease
        • scarring leading to infertility or ectopic pregnancies
        • white purulent discharge (thicker than chlamydia)
        • infection can spread to peritoneum
          • fits hugh curtis syndrome
          • can cause adhesions to liver
            • violin string adhesions
        • polyarthritis affecting the knee
    • babies
      • purulent conjunctivitis passed from infected mother
        • early onset
    • cephtriaxone to treat
    • always assume co-infection with chlamydia and also give the patient azythromycin or doxycycline
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16
Q

Enterobacter

A

nosocomial dinosaurs

  • pneumonia, UTI are most common manifestations of these guys
  • multi drug resistant
    • carbapenum to treat
  • lactose fermenters- grow pink
  • enterobacter
    • motile
  • serratia
    • motile
    • produces red pigment when cultured
  • klebsiella
    • not motile
    • alcoholics, abcesses, aspiration (started from aspiring)
    • encapsulated
    • cough up currant jelly sputum
    • CXR with cavitary lesion that look like TB
    • urease positive
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17
Q

Salmonella

A

salmon dinner

  • motile
  • gram negative
  • H2S positive (along with all motile enteric bacteria)
    • grows black colonies plate
  • encapsulated
  • acid labile
    • high dose required to cause infection otherwise stomach acid kills it
    • opeperazole makes you more susceptible
  • facultative intracellular
    • in macrophages
  • salmonella typhi
    • harbored in the gallbladder of carriers
    • typhoid mary—
    • enteric fever gives you red spots on your abdomen
    • # 1 cause of osteomyelitis in patients with sickle cell disease
    • constipation or diarrhea (looks like pea soup)
    • treated with fluoroquinolone - antibiotic
    • yes vaccine
  • salmonella interidtus
    • undercooked chicken
    • inflammatory diarrhea
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18
Q

Shigella

A

gorilla circus act

  • gastroenteritis — bloody diarrhea
  • green colonies on hectoin auger
  • immotile
  • acid stable (doesn’t take much to cause infection)
  • intestinal epithelium (in peyer’s patches) contain M cells
    • shigella gets into M cells but escapes from phagolysosome
    • then it makes an actin tail and uses that to get from cell to cell
    • facultative intracellular
  • infected child with shigella dysinteria can lead to HUS- hemolytic uremic syndrome
    • acute renal failure 1 wk after diarrheal sickness
    • shiga toxin induces endothelial damage (including in glomerulus)
      • binds and inhibits 60S subunit of ribosome- inhibit translation
      • aggregation of platelets lyse RBC’s (hemolysis)
      • kids under 10
  • type III secretion system
19
Q

E Coli

A

cola soda shop

  • ferments lactose- grow pink colony (or green on GMB auger)
  • encapsulated
  • K antigen: on capsule used for serotyping
  • catalase positive
  • fimbriae
  • # 1 cause of UTI’s and gram negative sepsis (specifically done by LPS)
  • causes meningitis in neonates only if it has K antigen
  • EHEC- enterohemorrhagic e coli
    • eating undercooked meat like hamberger
    • bloody diarrhea
    • does not ferment sorbitol
    • toxin: inhibits 60S ribosomes just like shiga toxin (shiga like toxin)
    • can cause HUS: shiga toxin damages glomerular capillary endothelium which becomes thrombogenic and platelets adhere which will lyse RBCs that pass by.
    • O157:H7 serotype causes massive outbreaks
  • ETEC- traveler’s diarrhea
    • water source transmission (usually someone who has recently been to mexico)
    • watery diarrhea
    • “montesuma’s revenge”
    • toxins
      • heat labile increasing cAMP
      • heat stable increasing cGMP
20
Q

Yersinia

A

Pet shop

  • entericolytica
    • transmitted through puppy feces and contaminated milk product
    • resistant to cold temperatures
    • commonly affects toddlers
    • bipolar staining so it looks like a safety pin in culture
    • encapsulated
    • bloody diarrhea, fever, bowel problems, mimics appendicitis
  • pestis
    • bubonic plague
      • swollen tender lymph nodes
      • armpits
    • reservoir is rodents / prarie dogs
      • vector is fleas
    • abscess, DIC (from endotoxin- can lead to appendix necrosis)
    • exotoxins
    • yersinia associated outer proteins
      • cause macrophage and neutrophil dysfunction by inhibiting phagocytosis and cytokine release
      • type III secretion
    • tx with tetracycline + streptomycin
    • vaccine not routinely given: killed vaccine
21
Q

Campylobacter Jejuni

A

guy and bears camping

  • guianne barre syndrome: rare complication of this infection
    • autoimmune response causing demyelination of periferal nerves
    • ascending demyelination
  • grows in heat 42 C
  • found in GI tract of poultry
  • bloody diarrhea and lots of it
  • curved gram neg rod
  • oxidase positive
  • invasive: penetrates gut and gets in blood stream
  • reactive arthritis
22
Q

Vibrio Cholera

A

base camp

  • comma shaped
  • perfuse rice water stools
  • transmitted by fecal oral via poor sanitation or contamination of food / water
  • cholera does not invade- it attaches intestine by fimbriae and secretes cholera toxin
    • binds and activates AC (Gs pathway)
    • increases cAMP
  • oral rehydration for tx
  • cholera grows on alkaline media (acid labile)
  • oxidase positive
  • two other vibrios
    • contaminate seafood - oysters
23
Q

Helicobacter Pylori

A

helicopter pilot

  • gram neg, curved
  • motile (flagella)
  • urease positive
    • urea breath test
    • biopsy during endoscopy can be tested for urea as well
  • oxidase positive
  • causes duodenal ulcers
    • increase risk of adenocarcinoma
    • increase risk of lymphoma of MALT (maltoma)
  • tx with 3 antibiotics
    • amoxicillin
    • clarithromycin (a macrolide)
    • proton pump inhibitor
24
Q

Pseudomonas

A

mona’s suitors

  • gram neg rod
  • thrives in aquadic environments
    • causes hottub folliculitis
    • puritis papulopusticular folliculitis
    • underchlorinated hot tubs
  • toxin can circulate and land in skin causing necrosis
    • called ecthyma gangrenosum
    • black necrotic skin lesions
  • otitis externa (swimmers ear)
  • oxidase positive
  • catalase positive
    • problematic in patients with CGD
  • obligate aerobe
  • encapsulated
  • associated with nosocomial UTI’s
  • respiratory infection and failure in CF patients
  • most common gram neg pneumonia
  • exotoxin A
    • ribosylation
    • EF2 inhibiting toxin
    • protein synthesis is inhibited and cell dies
  • makes blue green pigment, grape smelling
  • worry about this in burn patients
  • causes osteomyelitis in IV drug users and diabetics
  • tx with piperacillin, aminoglycocides and fluoroquinolones
25
Q

Proteus Mirabilis

A

bathroom god

  • gram neg
  • facultative aneorobe
  • smells like fish
  • tx with sulfonamides
  • swarming motility
  • causes UTI’s, staghorn calculi (kidney stone)
  • urease positive
    • why we get kidney stone
26
Q

bordatella pertussis

A

soldier boarding

  • gram neg
  • spreads by respiratory droplet- attach via pilli that release toxins
  • pertussis toxin
    • ribosylates Gi disabling it
    • increases cAMP
    • disables chemokine receptors for lymphocytes
      • lymphocytosis
  • adenylate cyclase toxin
    • increase cAMP
  • tracheal toxin
    • damages ciliated cells in respiratory epithelium
  • initally present as cataral phase (1-2 wk) conductive injection and lacrimation
  • paroxysmal stage (2 wk- 2 mo) develop whooping cough
  • convalescent stage (up to 3 mo) reduction gradually of symptoms
  • tx with macrolides
  • prevent with killed or acellular vaccine (TDaP)
27
Q

Haemophilus Influenzae

A

chocolate covered cherry shop

  • gram neg
  • grown on chocolate auger
    • add factor 5 (NAD) and factor 10 (hematin)
  • aerosol transmission
  • pneumonia
  • epiglotitis
    • inspiratory stridor and drooling and cherry red epiglottis
  • otitis media
  • meningitis (only the type B capsular form)
    • vaccine for only type B Hinfluenza
    • polysaccaride of capsule + diptheria toxoid to increase immunogenicity
      • IgG response is strong
    • vaccinate at 2-18 months old
  • sepsis and septic arthritis in those without a spleen (sickle cell disease pts)
  • tx with cephtriaxone
  • give rifampin to those in close contact of anyone with influenza
28
Q

Legionella

A

ss cysteine

  • gram neg - does not stain well - visualize with silver stain
    • grow on buffered charcoal yeast with cysteine and iron
  • oxidase positive
  • pontiac fever
    • self limited fever and malaise
  • legionaires disease
    • occurs in smokers
    • atypical pneumonia
    • CXR shows patchy infiltrate with consolidation to one lobe
    • hyponatremia (<130)
    • neuro symptoms: headache, confusion
    • diarrhea
    • fever
  • rapid urine antigen test to dx more quickly than culture
  • tx with macrolides or fluoroquinolones
29
Q

Bordatella Henslae

A

leopard “bart”

  • gram neg
    • visualize with wharthrin stary stain (silver stain)
  • cat scratch disease
    • fever
    • regional lymph enlargement
      • axilla, unilateral
    • in immunocompetent people
  • bacillary angiometosis
    • fever, chills, headaches
    • raised red vascular lesions all over the skin
    • in immunocompromised pts
      • HIV infected pts
      • looks like kaposi sarcoma gotta culture it to know for sure
  • tx with doxycycline or macrolides
30
Q

Brucella

A

Bruce farm

  • zoonotic from farm animals or farm animal products
    • vet, slaughterhouse worker, rancher, recent consumptio of milk or cheese
  • gram neg
  • facultative intracellular
    • prevents phagolysosome fusion to escape macrophages
    • travels through reticuloendothelial system to spread systemic organs
      • enlarged spleen, liver, lymph nodes
  • brucellosis
    • undulating fever, chills, anorexia
    • osteomyelitis in chronic infection
    • tx with doxycycline, rifampin
31
Q

Francisella Tularensis

A

Rabbit “Francis”

  • reservoir is rabbits (direct contact) or tick vectors (dermacentor tick)
  • gram neg
  • facultative intracellular
    • recovery requires cell mediated immunity
    • easily spread
  • tick bite creates an ulcer in the skin at infection site
    • travels through lymph system to reticuloendothelial organs
    • granlomas with caseating necrosis
    • lymph nodes swell (lymphadenopathy)
    • tx with amino glycosides
32
Q

Pasteurella Multocida

A

L Pasteur’s Lab

  • found in respiratory tract of cats and dogs
    • transmit via pet bites
    • erythematous and cellulitis within 24 hours
    • can spread to nec fasch OR osteomyelitis
  • encapsulated
  • grown on 5% sheeps blood auger
  • catalase positive
  • oxidase positive
  • bipolar (safety pin) staining
  • tx with penicillin
33
Q

Mycobacterium Tuberculosis

A

shootout

  • stains acid fast (carbol fusion stain)
  • mycolic acid in cell wall
    • cell wall also has glycolipids that help clump the bacterium into serpentine formation
      • “cord factor”
      • protect bacteria from destruction
      • increases TNF alpha—> activate other macrophages —> granuloma —> bacteria grows in here
    • sulfatides prevent phagolysosome fusion (TB accumulates sulfa tides)
  • grown on lowentein auger
  • obligate aerobe
  • respiratory droplet transmission
    • proliferates in macrophages
    • primary infection: affects lower and middle lobes of lungs then lesion becomes necrotic (caseating granulomas- surrounded by scar we call it a tubercle) and calcifies with hilar lymph node involvement (Ghan complex) — prolonged fever
      • healed latent infection:
        • usually in children
        • resolves via fibrosis
        • positive PPD skin test
        • positive also if person has received BCG vaccine
      • systemic infection
        • bacteremia often spreading to bone, liver, and lymph
        • miliary means it hits multiple organs— potentially lethal
      • reactivation TB
        • cavitary lesions in upper lung lobes on CXR
        • immunosuppression causes reactivation through downregulation of TNF alpha
        • immune system is defenseless if TNF is inhibited
        • cough, night sweats, hemoptysis (bloody cough), cachexia
      • skeletal system: pott’s disease is when TB has infected spine and multiple vertebra are demineralized with soft tissue swelling
      • CNS: cavitary lesion (tuberculoma) can form
    • tx with RIPE: rifampin, isoniazid, pyrazinamide, ethambutol
    • prevent with RI
34
Q

Micobacterium leprosy

A

jail house breakout

35
Q

borellia

A

archery competition

LYME DISEASE

36
Q

leptospirosis

A

surfer

37
Q

treponema pallidum

A

observatory

syphillus

38
Q

chlamydia

A

clam island

39
Q

coxiella

A

Curly Q the ram

Q fever

40
Q

gardenella vaginalis

A

fish detective

41
Q

mycoplasma pneumonia

A

hockey
walking pneumonia
sterol in the cell wall

42
Q

rickettsia prowazeki

A

tennis / football
typhus
transmitted via lice
rash starts on trunk and spreads outward sparing hands, feet, head

43
Q

rickettsia ricketsii

A

tennis / rock climbing
dermacenter ticks
rocky mountain spotted fever
rash starts on extremities and moves inward

Sketchy (2 decks)

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