Bacteria that do not Gram Stain

Question 1

What are properties of Myco. tuberculosis?

Answer 1

produces niacin slowly, needs Lowenstein Jensen agar and either, Ziehl Neelsen, Kinyon, or Rodamine stain

Question 2

Treatment for TB

Answer 2

BCG vaccine, rifampin, isoniazid

Question 3

What are characteristics of spirochetes?

Answer 3

gram -, corkscrew motility via axial filaments, enter through skin and mucous.

Question 4

How is TB virulent and spread?

Answer 4

mycolic acid prevents macrophage killing, has LAM which prevent phagocyte activation, it spreads via aerosols and infects those who are usually malnourished, drug users, or alcoholics.

Question 5

Which nonstaining bacteria has LPS and acts like a virus?

Answer 5

Chlamydia

Question 6

Ghon complex

Answer 6

fibrotic lesions on upper lobes of lungs found in patients with TB

Question 7

What are properties of mycobacterium leprae?

Answer 7

strict human pathogen in macrophage and schwann cells. Spread from inhalation or if you play with armadillos. HLA predisposition in western and southern states. Comoes in two forms: tuberculoid = no disfigurement, more sensory loss. Lepromatous form = nodules, tissue/ cartilage destruction, and some sensory loss.

Question 8

What are treatments for chlamydia?

Answer 8

doxycycline treats the urethritis, conjunctivitis, LGV, and trachoma. You can also use azithromycin.

Question 9

What are symptoms of tuberculosis?

Answer 9

CNS - meningitis, granulomas that cause IL-2, TH1, and IFNy release leading to overactive macrophages, night sweats, cough, Pott’s disease (CNS damage of vertebrae), and miliary dissemination. Diagnose with PPD test (secondary) , chest X ray (miliary or granulomas), or sputum.

Question 10

What do you treat M. pneumoniae and M. genitalium with?

Answer 10

pneumoniae = tetracycline, fluoroquinolones, and erythromycin. genitalium =azithromycin

Question 11

Which non staining bacteria is an intracellular parasite of macrophages?

Answer 11

Mycobacteria

Question 12

Chlamydia serotypes

Answer 12

A-C = trachomatis which is blindness
D-K = non gonococcal urethritis and cervicitis; STIs that cause Reiter’s and PID
L1-L2 = lymphopathy

Question 13

Which non staining bacteria requires Eaton agar and has sterols in it’s membrane, but NO cell wall?

Answer 13

Mycoplasma

Question 14

What is pathogenesis of syphilis?

Answer 14

Primary = 2-3 weeks of rash and painless chancre. Secondary stage = 2-24 weeks dissemination and condoyloma lota = warty papillar lesions on soles. Latent = 1-2 years, may relapse. Tertiary = several years later, granulamatous, cardiovascular = aoritis or replacement of elasticity, and CNS damage.

Question 15

What diseases does Mycobacteria avium intracellularae cause?

Answer 15

pulmonary disease in COPD and TB patients, subacute lymphadenitis usually in kids under 5, disseminated disease in patients with AIDS

Question 16

What are properties of legionella pneumophilia?

Answer 16

gram neg, aerobic, motile rod, urease +, and found in intracellular amoeba in tap water. It is fastidious because needs Dieterel silver stain, and grows on BYCE agar which is a cysteine iron agar. Clincally: opportunistic, flu-like, pontiac fever can be nosocomial, and lethal pneumonia.

Question 17

What are properties of nocardia?

Answer 17

catalase, aerobic, gram pos, spread air borne (aibrone for aerobic)

Question 18

How do you treat MAC

Answer 18

in immunocompetent = clarithromycin and ethambutol w either clofazaminine or ciprofloxacin. Immunocompromised = rifabutin and ethambutol with either clarithromycin or clofazaminine

Question 19

What the 4 types of disease causing treponema (spirochetes)?

Answer 19

Trep Pertenue = in tropical areas, direct contact with lesions cause “yaws”, bone/skin warts. Trep endimicum = Mediterranean, transmission through saliva causes “Bejel”, mouth sores and bone lumps. Trep carateum = Mexico, direct contact causes “pinta”, raised flaky papules. Trep pallidum = STI, common in prostitutes and homosexual men.

Question 20

What are clinical presentations of Nocardia asteriodes?

Answer 20

bronchopulmonary nocardoisis causing pneumonia, CNS abscess (like mycobacteria), or cutaneous inoculation.

Question 21

When and what type of pneumonias does legionella cause?

Answer 21

Usually in fall and causes lethal or nosocomial

Question 22

What are clinical manifestations of mycoplasma?

Answer 22

common in military and colleges because droplets spread then adhere via P1 protein to glycolipids of cilia. Clinically causes inflammation, tracheobronchitis (wheezing) in babies, ear aches in adults, high morbidity low mortality, Steven Johnson syndrome (erythemic rash), and M. pneumoniae can be gradual and produce agluttins

Question 23

What is treatment for nocardia?

Answer 23

sulfomides or TMP-SMX

Question 24

How do you screen and treat syphillus?

Answer 24

Screen via RPR = which looks for IgG, VDRL = looks for cardiolipin antibodies, FTA = treponemal antibodies. Treat with penicillin G

Question 25

How do granulomas form?

Answer 25

macrophages in lungs produce TNFa and IL-12, activates T cells which produce IFNy and TH1, that Th1 is going to recruit more macrophages and NKs to form granuloma ball. The TB can survive in this latent/ hypoxic environment because it has LAT genes

Question 26

What are 4 species of mycoplasmataceae?

Answer 26

1. M. pneumoniae = upper RT diseases and metabolize glucose
2. M. hominis = yields pelvic inflammatory disease, post partum fever
3. M. genitalium = causes nongonoccal urethritis
4. Urealyticum = causes non gonnococal urethritis or pneumoniae in infants.

Question 27

What are 5 non-tubercular mycobacteria?

Answer 27

1. Marinum = from water, causes fever, cellulitis
2. Konasaii = mines, causes pulmonary
3. Sacrofulacum = cervical problems
4. ulcerans = skin (Nile)
5. MAC = pulmonary disease, lymphadentis, or disseminated Gi

Question 28

TB test positivity

Answer 28

Based on area of induration: > 5mm for HIV, recent contacts. >10 for immigrants, drug users, children under 4, >15 random person.

Question 29

What are phases and treatments of legionella?

Answer 29

incubation is 2-10 days, prodromal phase = malaise, fever, headache, diarrhea. Treat with macrolides and quinolones.

Question 30

What’s pathogenesis of chlamydia?

Answer 30

elementary body binds to cell and once phagocytosed is converted to reticular body and replicate. The reticular body isn’t infectious until released

Question 31

Leprosy treatment

Answer 31

dapsone and rifampin

Question 32

What are manifestations of the three types of chlamydia: trachomatis, pneumoniae, and psittaci?

Answer 32

Trachomatis - is serotypes D-K causing cervicitis, urethritis, and nongonnoccal urethritis. Pneumoniae = usually asymptomatic (walking pneumonia), spread via respiration causing asthma or Guillen Barr. Psittaci = from inhaling bird poop, parrot fever, edema, necrosis.

Question 33

Granulomas

Answer 33

allow us to have microenvironment to fight infection, for bacteria they can turn on LAT genes becasue latent enviroment due to recruitment of macrophages, lymphocytes via IFNy.

Question 34

How’s Mycoplasma pneumoniae different than hominis and urealyticum?

Answer 34

It metabolizes glucose

Question 35

How does mycoplasma pneumoniae infect?

Answer 35

spread via respiratory droplets, common in dorms and military barracks. P1 protein attaches to neuraminic acid of cilia inhibiting it, and causes inflammation. Also produces cold agglutins which causes anemia

Question 36

How do you see treponema pallidum?

Answer 36

dark microscopy or fluorescent staining, and can only be grown on rabbit testis

Question 37

What’s pathogenesis of Syphilis?

Answer 37

Primary = rash, painless chancres (2-3 weeks)
Secondary = hands/feet rash, condylomata (warty lesions), lymphadenopathy (2-24 weeks)
Latent = asymptomatic, may relapse (1-2 years)
Tertiary = gumma which are granulomatous lesions, CNS tabes dorsalis which is damage to vertebrae which causes loss sensation, and aoritis which is when elastic heart tissue replaced with fibrous (several years later)