Bacteriology Flashcards
0
Q
What is the drug of choice for all rickettsial infections?
A
Doxycycline
1
Q
What organism present with atypical pneumonia and associated with atherosclerosis?
A
Chlamydia pneumoniae
2
Q
What causes Q fever and has no vector, no rash, no weil-felix reaction and has a 65% mortality?
A
Coxiella burnetti
3
Q
What do you call the cross reaction with antigens of OX stains of Proteus vulgaris?
A
Weil-Felix reaction
4
Q
What organism causes Cat Scratch Disease?
A
Bartonella Henselae
5
Q
Organism that cause mesenteric adenitis (pseudoappendicitis), gram negative rods, oro-fecal route of transmission and domestic animals as reservoir
A
Yersinia enterocolitica
6
Q
Organism that is catalase positive and coagulase positive
A
Staphylococcus aureus
7
Q
Organism that is catalase positive, coagulase negative, novobiocin sensitive
A
Staphylococcus epidermidis
8
Q
Organism that is gram positive cocci in clusters, catalase positive, coagulase negative, and novobiocin resistant
A
Staphylococcus saprophyticus
9
Q
Organism that is gram positive cocci in chains, catalase negative, alpha hemolytic, bile-optochin-sensitive
A
Streptococcus pneumoniae
10
Q
Gram-negative diplococci Oxidase-positive on chocolate agar Ferments maltose and glucose Complement deficiencies in late-acting complement components (C5-C9)
A
Neisseria meningitidis
11
Q
Spectrum of disease of Neisseria menigitidis
A
Meningitis Meningococcemia Waterhouse-friderichsen syndrome
12
Q
Neisseria gonorrhoeae is oxidase positive on _____.
A
Thayer-Martin medium
13
Q
Treatment of Neisseia gonorheoae when co-infected with Chalmydia trachomatis
A
Ceftriaxone + doxycycline
14
Q
Other Neisseriaceae that cause culture-negative subacute bacterial endocarditis in patients with pre-existing heart disease
A
Eikenella corrodens Kingella kingae
15
Q
Haemophilus influenzae requires (1) _____ (hemin) and (2) _____ (NAD) for growth on chocolate agar, and causes a Satellite Phenomenon on (3) _____ colonies.
A
(1) factor X (2) factor V (3) Staphylococcus aureus
16
Q
This vaccine contains the type b capsular polysaccharide conjugated to diphtheria toxoid, and is given between 2 and 18 months of age.
A
Haemophilus influenzae b vaccine
17
Q
Grows on Bordet-Gengou agar or Regan-Lowe charcoal medium Habitat is the upper respiratory tract Transmitted via respiratory droplets Causes whooping cough
A
Bordetella pertussis
18
Q
3 most common cause of atypical pneumonia
A
Mycoplasma pneumoniae Legionela pneumophila Chlamydia pneumoniae
19
Q
Spectrum of disease of atypical pneumonia in Legionella pneumophila
A
Pneumonia Confusion Nonbloody diarrhea Hyponatremia Proteinuria Hematuria
20
Q
Facultative intracellular bacteria
A
Some Bugs May Live FacultativeLY Salmonella Brucella Mycobacterium Listeria Francisella Legionella Yersinia
21
Q
Lactose-fermenting colonies on Eosin-Methylene Blue or MacConkey’s agar Triple sugar iron agar shows acid slant and acid butt with gas but no H2S Typing by O and H antigen Most common cause of community-acquired UTI Second most common cause of Neonatal meningitis
A
Escherichia coli
22
Q
Match the antigen with the pathogen Antigen: H, K, O Pathogen: capsule, endotoxin, flagellum
A
Flagellum - H Capsule - K Endotoxin - O
23
Q
Treatment for Escherichia coli infection (1) worldwide (2) Philippines
A
(1) ampicillin or sulfonamides (UTI), 3rd generation for meningitis and sepsis (2) quinolones
24
Antigen that causes typhoid fever that can result in the establishment of a chronic carrier state
Vi capsular antigen
25
Incubation period of 12-48 hours Nausea and vomiting and then progresses to abdominal pain and nonbloody diarrhea
Enterocolitis (Salmonella enteritidis / Salmonella typhimurium)
26
Chloramphenicol is used for the treatment of Salmonella infection. It is also used for the empiric treatment of meningitis. What are the other common causes of meningitis?
Neisseria meningitidis Bacteroides fragilis Streptococcus pneumoniae Haemophilus influenzae
27
Shigella dysenteriae type 1: _____ bacillus Shigella sonnei: _____ bacillus
Shiga bacillus Duval's bacillus
28
Non-lactose fermenting, gram-negative rods Produce no gas from the fermentation of glucose Do not produce H2S Nonmotile Have O antigens Cultured inXLD medium
Shigella spp.
29
Habitat: saltwater Transmission: contaminated raw seafood Spectrum of disease: gastroenteritis, wound infections
Vibrio parahaemolyticus
30
Enterotoxin of Vibrio that acts by ADP-ribosylation
Choleragen
31
Most common cause of bacterial gastroenteritis Produces histologic damage to the mucosal surafces of the jejunum Watery, foul-smelling diarrhea followed by bloody stools Associated with Guillain-Barrè syndrome and Reiter's syndrome
Campylobacter jejuni
32
Urease-positive bacteria
Particular Kinds Have Urease Proteus mirabilis Klebsiella pneumoniae Helicobacter pylori Ureaplasma urealyticum
33
Facultative gram-negative rods with large polysaccharide capsule Extended spectrum beta-lactamase activity in drug-resistant strains Urease-positive Necrotizing pneumonia with currant-jelly sputum
Klebsiella pneumoniae
34
Proteus mirabilis isnassociated with complicated UTI, particularly those that form staghorn calculi on renal calyces. What type of motility is exhibited by this bacteria?
Swarming motility
35
Gram-negative rods Obligate aerobe Non-lactose fermenting Oxidase-positive Grown on Cetrimide agar Seen in many diseases such as: hot tub folliculitis, burn wound infections, otitis externa, CSOM, VAP, high-risk CAP, tyhplitis, Shanghai fever, perionitis (in those undergoing PD), nosocomial UTI, ecthyma gangrenosum
Psudomonas aeruginosa
36
Toxin of Pseudomonas aeruginosa that causes tissue necrosis and inactivates EF-2, with type III secretion systemthat facilitates the toxin's transfer
Exotoxin A
37
Grape-like clusters Beta hemolytic yellow or golden colonies on blood agar Catalase and coagulase positive Salt tolerant on 1)\_\_\_\_\_\_\_ Gold color due to 2) ________ What is this organism?
1) Mannitol Salt Agar 2) Staphyloxanthin pigment Staphylococcus Aureus
38
This organism has Protein A, Coagulase, Hemolysins, PV Leukocidin, Catalase, and Penicillinase. What is the organism and what do you call these immunomodulators?
Staphylococcus aureus and these are immunomodulators. (Note: Definition of Terms Protein A: Prevents complement activation Coagulase:Builds an insoluble fibrin capsule Hemolysins: Toxic to hematopoietic cells PV leukocidin: Specific for white blood cells Catalase:Detoxifies hydrogen peroxide Penicillinase: Inactivates penicillin derivatives)
39
This organism can hydrolyze hyaluronic acid, dissolve fibrin clot and spread in fat-containing areas of the body. It can also cause epidermal separation, necrosis of the skin and hemolysis, cause food poisoning and can lead to TSS. What is this?
Staphylococcus aureus [Note: Definition of Terms Hyaluronidase: hydrolyzes hyaluronic acid Fibrinolysin/Staphylokinase: dissolves fibrin clot Lipase: spread in fat-containing areas of the body Exfollatin: causes epidermal separation Heat-stable Enterotoxins: superantigens causing food poisoning Toxic Shock Syndrome toxin (TSST-1): superantigen leading to TSS Alpha Toxin: causes marked necrosis of the skin and hemolysis]
40
Most common cause of acute endocarditis and what valve is usually involved in IV drug abusers? Also causes penumonia, osteomyelitis, brodie abscess and septic arthritis.
Staphylococcus aureus Tricuspid valve (Brodie abscess: sequestered focus of osteomyelitis arising in the metaphyseal area of a long bone)
41
Causes bullous impetigo, folliculitis, furuncles, carbuncles, cellulitis, hidradenitis suppurativa, mastitis and surgical site infections.
Staphylococcus aureus (Examples of skin and soft tissue infections caused by S. aureus)
42
Treatment for S. aureus? MSSA, MRSA and VRSA
Methicillin sensitive: penicillinase-resistant penicillins like Nafcillin, Oxacillin and Dicloxacillin Methicillin resistant: Vancomycin Vancomycin resistant: Linezolid
43
Fever, hypotension, sloughing off of the filiform papillae in the tongue, desquamating rash, multi-organ involvement, blood CS negative What presents with these and what is the organism responsible?
Toxic shock syndrome Staph aureus (Note: due to TSST-1 Usually there is no site of pyogenic inflammation that's why blood CS is negative Usual patients are those that uses tampons and who have nasal packing)
44
Difference of TEN and Ritter disease?
Both affects the skin Ritter: separation of epidermis at STRATUM GRANULOSUM because exfollatin cleaves desmoglein in desmosomes. Organism involved is Staph aureus TEN: separation occurs at the dermo-epidermal junction Ritter disease is Scalded Skin Syndrome TEN is Toxic Epidermal Necrolysis
45
Low virulence organism Forms biofilm because its glycocalyx adheres well to foreign bodies Transmitted through autoinfection or direct contact What is the organism and what are the diseases it causes?
Staphylococcus Epidermidis It is the most common cause of: Prosthetic valve endocarditis Septic arthritis in prosthetic joints Ventriculoperitoneal shunt infections
46
Gram positive cocci in clusters Catalase positive Coagulase negative Novobiocin sensitive Normal skin flora What is the treatment if you get infected?
Removal of prosthetic device Vancomycin because over 50% are methicillin resistant (Organism: Staph epidermidis)
47
What is the 2nd most common cause of UTIs in sexually active women?
Staphylococcus saprophyticus (#1: E. coli)
48
Gram-negative rods Predominant anearobe of human colon Associated with spread during bowel trauma, perforation or surgery Infections due to combinations of bacteria in synergistic pathogenicity
Bacteroides fragilis
49
Zoonoses
Bugs From Your Pets Brucella abortus (Bruce the cow) Francisella tularensis (Francis the rabbit) Yersinia pestis (Yeye the rat) Pasteurella multocida (Papa the cat)
50
Brucellosis is associated with undulating fever. What medium is used to identify this organism?
Castañeda medium
51
Treatment for Tularemia from Francisella tularensis
Streptomycin / Gentamicin
52
What disease did Yersinia pestis cause that made it the most virulent bacteria?
Bubonic, pbeumonic and septicemic plague
53
The buttery colonies with musty odor in Pasteurella multocida infection is due to?
Indole production
54
Mycobacterium tubeculosis uses (1) What stain? (2) What medium? (3) What assay for drug resistance?
(1) Zieh-Neelsen or Kinyoun stain (2) Löwenstein-Jensen medium (3) Luciferase assay
55
Mycobacterium tuberculosis virulence factors: (1) exported repetitive protein that prevents phagosome-lysosomal fusion (2) most important virulence factor (3) elicits delayed hypersensitivity
(1) sulfatides (2) cord factor (3) tuberculin surface protein
56
In Mycobacterium tuberculosis, (1) granulomatous lesions exhibit a central area of these cells surrounded by a zone of epithelioid cells = _____ (2) primary complex have subpleural granuloma + associated lymph node = _____ (3) reactivation tuberculosis is usually occurs in apices and is seen as this = \_\_\_\_\_
(1) Langhan's giant cells (2) Ghon's complex (3) Simon's focus
57
This bacteria causes pulmonary disease in the immunocompromised, most especially AIDS patients with CD4 \< 50
Mycobacterium avium - intracellulare complex
58
(1) This bacteria's reservoir are humans and armadillos. One of its spectrum of disease exhibits the following characteristics: (a) few lesions, little tissue destruction, few AFB, low likelihood of transmission, with cell-mediated response to the bacteria, positive skin test (b) many lesions, marked tissue destruction, many AFB, high likelihood of transmission, reduced cell-mediated response to the bacteria, negative skin test
(1) Mycobacterium leprae (a) Tuberculoid leprosy (b) Lepromatous leprosy
59
Hard, nontender swelling with sinus tracts draining sulfur granules Treated with Penicillin G + drainage
Actinomycosis (Actinomycoses israelii)
60
Obligate intracellular bacteria
Ricketssia Chlamydia
61
Cell wall lacks muramic acid Grown in cycloheximide culture Cytoplasmic inclusions in Giemsa Balance is often reached between host and parasite, resulting in prolonged persistance of infection Infection persists in the presence of high antibody titers This organism has 2 forms: (1) inactive, extracellular, enters cells by endocytosis (2) metabolically active, intracellular, seen microscopically as inclusion bodies
Chlamydia trachomatis (1) elementary body (2) reticulate body
62
Spectrum of disease of Chlamydia trachomatis (1) types A-C, chronic keratoconjunctivitis, Halberstadter-Prowazek inclusions (2) types D-K, most common cause of STDs, neonatal conjunctivitis (ophthalmia neonatorum), neonatal pneumonia, associated with Reiter's syndrome (3) types L1-L3, buboes (papule or vesicles which ulcerates and leads to suppurative inguinal lymphadenitis), positive Frei test
(1) Trachoma (2) Genital tract infections (3) Lymphogranuloma venereum
63
Atypical pneumonia associated with atherosclerosis
Chlamydia pneumoniae
64
Bird fancier's disease
Psittacosis (Chlamydia Psittaci)
65
Generalization of treatment for Chlamydia STD : _____ \_\_\_\_\_ : erythromycin _____ : doxycycline Psittacosis : \_\_\_\_\_
STD : azithromycin Conjunctivitis : erythromycin LGV : doxycycline Psittacosis : azithromycin
66
Rickettsiae is classically detected using \_\_\_\_\_, which is done by the cross-reaction with antigens of OX strains of Proteus vulgaris.
Weil-Felix reaction
67
Cat-scratch fever in immunocompetent individuals Bacillary angiomatosis in immunocompromised
Bartonella henselae
68
Transmitted by dog tick bite Forms morulae in cytoplasm of monocytes
Ehrlichiosis (Ehrlichia chaffensis)
69
Signs of bacterial vaginosis or infection with Gardenella vaginosis
Presence of clue cells Positive whiff test Malodorous vaginal discharge
70
Chancroid is characterized with painful genital ulcer and presence of heme (factor X) on chocolate agar. What bacteria causes this disease?
Haemophilus ducreyi
71
Staphylococcus aureus is able to prevent complement activation die to which virulence factor.
Protein A
72
S. aureus exhibits which pattern of hemolysis when grown on blood agar? What do colonies look like?
B-hemolysis. Yellow or golden colonies due to staphyloxanthin
73
Gram positive cocci in clusters Catalase positive Coagulase negative Novobiocin resistant Whitish, non hemolytic colonies on blood agar What is the organism and its treatment?
Staphylococcus saprophyticus TMP-SMX or Quinolones
74
Measures hydrolysis of 1-pyrrolidonyl-Beta-naphthylakide and release of Beta-naphthylamine, which in the presence of p-dimethylaminocinnamaldehyde forms a red compound. What is this test and what it implies?
PYR test If positive (red) then the organism is either S. pyogenes or group D streptococci. If negative then all the other streptococci. It only takes less than a minute to perform this test.
75
Gram positive cocci in chains Beta hemolytic Catalase negative Bacitracin sensitive Lancefield group A PYR test positive
Streptococcus pyogenes
76
\_\_\_\_\_\_\_\_\_\_: Degrade hyaluronic acid Streptokinase/Fibrinolysin: ____________ Degrade DNA in exudates or necrotic tissue Inactivate complement C5A \_\_\_\_\_\_\_: produce scarlet fever Rapidly destroy tissue It is highly antigenic, causes AB formation and has a superantigen similar to TSST What is the organism?
Streptococcus pyogenes Hyaluronidase: Degrade hyaluronic acid Streptokinase/Fibrinolysin: Activate plasminogen DNase/Streptodornase: Degrade DNA in exudates or necrotic tissue C5A peptidase: Inactivate complement C5A Erythrogenic toxin: Produce Scarlet Fever Exotoxin B: protease that rapidly destroys tissue Streptolysin O: highly antigenic, causes AB formation Pyogenic exotoxin A: superantigen similar to TSST
77
\_\_\_\_\_\_\_\_\_: titers to document antecedent pharyngitis \_\_\_\_\_\_\_\_\_: titers to document antecedent skin infection \_\_\_\_\_\_\_\_\_: decrease efficacy of streptokinase in managing MI
Antistreptolysin O Anti-DNase B Antistreptokinase antibodies (We don't use ASO to document antecedent skin infections because streptolysin O is IRREVERSIBLY inhibited by cholesterol in skin lipids)
78
Pseudoappendicitis common in children caused by Yersinia enterocolitica Tranmission: oro-fecal route Reservoir: domestic animals
Mesenteric adenitis
79
Encapsulated, pleomorphic gram-negative bacillus Small painless papule ulcerates to form beefy red ulcer with velvety surface Pseudobobe formation Bipolar densities (\_\_\_\_\_)
Granuloma inguinale / Donovanosis (Klebsiella granulomatis) Donovan bodies
80
Weakly acid-fast with Fite-Faraco stain Manifests as mycetomas and lung & brain abscesses (orange colonies) Treated with TMP-SMX + drainage
Nocardiosis (Nocardia Asteroides)
81
Smallest free-living organism Obligate aerobe No cell wall Only bacteria with sterol on cell membrane Cultured on _____ medium Most common cause of atypical pneumoniae
Mycoplasma pneumoniae Eaton's medium
82
Autoantibodies against red blood cells in Mycoplasma pneumoniae
Cold agglutinins
83
Treponema pallidum cannot be cultured in vitro because \_\_\_\_\_
It lacts tricarboxylic acid (Kreb's cycle)
84
What type of syphilis exhibits the ff and what is used to detect them: (1) condyloma lata, maculopapular rash, fever, headache, malaise, anorexia, lymphadenopathy (2) granulomas, neurosyphilis (tabes dorsalis, dementia paralytica), aortitis (3) local, non-tender ulcer (chancre) (4) saddle nose, mulberry molars, Hutchinson triad, saber shins, rhagades, Higoumenakis sign, Clutton's joints, pulmonary hemorrhage
(1) Secondary syphilis; Rapid Plasma Reagin/Venereal Disease Research Laboratory for screening, Fluorescent Treponemal Antibody-Absorption for confirmation (2) Tertiary syphilis (3) Primary syphilis - dark-field microscopy (4) Congenital syphilis
85
The largest medically important bacteria is cultured on what medium?
BSK medium
86
Stage 1: erythema chronicum migrans Stage 2: myocarditis, meningitis, Bell's palsy Stage 3: autoimmune migratory polyarthritis, acrodermatitis chronica atrophicans
Lyme disease (Borrelia burgdorferi)
87
Rapid antigenic changes due to programmed rearrangements of bacterial DNA encoding surface proteins
Relapsing fever (Borrelia recurrentis)
88
Leprospira interrogans is grown on _____ medium and only becomes positive after 2 weeks of incubation. However, the gold standard in detecting this bacteria is \_\_\_\_\_.
Ellinghausen-McCollough-Johnson-Harris (EMJH) medium or Fletcher's medium Leptospire microscopic agglutination test (Lepto MAT)
89
Most severe form of Lepstospirosis: _____ Triad of: \_\_\_, \_\_\_, ___ Treated with \_\_\_\_\_
Weil's syndrome Jaundice, bleeding, uremia Penicillin G
90
Phase of Leptospirosis that exhibits: (1) calf tenderness, conjunctival suffusion (2) aseptic meningitis, pulmonary involvement, hepatic necrosis, glomerulonephritis
(1) acute leptospiremic phase (2) immune leptospiruric phase
91
\_\_\_\_\_\_\_\_\_: perioral blistered lesions with honey-colored crust because there is an accumulation of neutrophils beneath the stratum corneum Erysipelas: _____________ \_\_\_\_\_\_\_\_\_: deeper infection involving subcutaneous/dermal tissues facilitated by hyaluronidase \_\_\_\_\_\_\_\_\_: rapidly progressive infection of deep subcutaneous tissues facilitated by \_\_\_\_\_\_.
1) Impetigo contagiosa 2) superficial infection extending into dermal lymphatics 3) Cellulitis 4) Necrotizing fasciitis 5) Exotoxin B
92
Most common bacterial cause of sore throat?
Streptococcus pyogenes
93
Tests for Scarlet Fever susceptibility
Dick Test
94
What are the components of the JONES criteria and what is it for?
Migratory Polyarthritis Erythema marginatum Chorea (Syndenham's) Carditis (Pancarditis) Subcutaneous nodules P-E-C-C-S For acute rheumatic fever (Strep pyogenes)
95
Aerobic, non-spore forming, non-motile gram-positive rods Club or comma-shaped rods arranged in V or L shape Looks like Chinese characters Black colonies on tellurite plate Toxigenicity detected using _____ test
Corynebacterium diphteriae Modified Elek test
96
In Diphtheria Exotoxin inhibits protein synthesis by adding ADP-ribose to (1) \_\_\_\_\_. Exotoxin encoded by (2) _____ via transduction. (3) _____ result from death of mucosal epithelial cells.
(1) elongation factor-2 / EF-2 (2) beta-prophage (3) pseudomembranes
97
Beta-prophage encoded toxins
ABCDE shigA-like toxin Botulinum toxin Cholera toxin Diphtheria toxin Erythrogenic toxin
98
Anaerobic, gram-positive, spore-forming rods Tennis racket organism Habitat is soil Enters through traumatic breaks in the skin
Clostridium tetani
99
(1) What disease has the following signs and symptoms: strong muscle spasm, trismus, risus sardonicus, opisthotonos, respiratory failure? (2) What is the toxin that causes it? (3) This toxin releases glycine from what cells in the spinal cord?
(1) Tetanus (2) Tetanus toxin (3) Renshaw cells
100
If the patient is uncertain if he was given Tetanus vaccine or not, what should be given if: (1) contaminated wound? (2) clean, minor wound?
(1) Toxoid (TeANA) & TIG (ATS) (2) Toxoid (TeANA) only
101
(1) Clostridium botulinum is usually acquired from what source? (2) Botulinum toxin is a heat-labile or heat-stable toxin? And it blocks Acteylcholine release causing what type of paralysis? What is the pattern of paralysis?
(1) Bulging canned goods, honey, alkaline vegetables such as green peas, peppers and mushrooms, smoked fish (2) Heat-labile; flaccid paralysis; descending pattern
102
Bulbar signs of food-borne botulism
4 Ds Diplopia Dysphonia Dysarthria Dysphagia
103
Clostridium perfringens: (1) seen as _____ on blood agar (2) growth on _____ shows a nonmotile organism but with rapidly spreading growth on culture media (3) what toxigenic disease is seen as pain, edema and crepitation on affected limb, with hemolysis and jaundice? And what lecithinase cleaves the cell memebranes of C. perfringens leading to this spectrum of disease?
(1) double hemolysis (2) egg-yolk agar (3) gas gangrene; alpha toxin
104
(1) The suppression of normal flora, allowing the overgrowth of Clostridium difficile is facilitated by the following antibiotics? (2) Exotoxins A and B inhibit GTPases causes apoptosis and death of enterocytes, leading to \_\_\_\_\_.
(1) Clindamycin, 2nd & 3rd generation Cephalosporins, Ampicillin (2) Pseudomembranes
105
What causes: (1) Pseudomembranous colitis? (2) Pseudomembranous pharyngitis? (3) Pseudomembranous esophagitis?
(1) Clostridium difficile (2) Diphtheria (3) Candida
106
Listeria monocytogenes are aerobic, non-spore-forming gram positive rods, arranged in V or L shape, with (1) _____ motility. It exhibits paradoxical growth in cold temperature, called (2) \_\_\_\_\_. Pathogenesis is due to: (3) _____ - interacts with E-cadherin on the surface of cells. (4) _____ - escape from phagosomes. Actin rockets - propels the bacteria through the membrane of one human cell into another.
(1) tumbling motility (2) cold enhancement (3) internalin (4) listeriolysin
107
Spectrum of disease in Listeria monocytogenes Early-onset neonatal listeriosis (\_\_\_\_\_): transplacental transmission, late miscarriage, birth complicated by sepsis, multiorgan abscesses, disseminated granulomas \_\_\_\_\_: transmitted during childbirth, manifests as meningitis or meningoencephalitis \_\_\_\_\_: bacteremia, sepsis, meningitis in pregnant, elderly or immunocompromised
Granulomatosis infantiseptica Late-onset neonatal listeriosis Adult listeriosis
108
What is the causative agent of bulbous impetigo? Of impetigo contagiosa?
Bullous impetigo caused by S. aureus. Impetigo contagiosa caused by S. pyogenes.
109
Which Streptococcus spp are PYR-positive?
1. Streptococcus pyogenes 2. Group D streptococcus
110
Streptococcus pyogenes is able to cause cellulitis because of this virulence factor which degrades components of subcutaneous/dermal tissues.
Hyaluronidase aka spreading factor
111
Streptococcus pyogenes releases this enzyme which has the end effect of reducing neutrophil chemotaxis.
C5a peptidase inactivates complement C5a. C5a is a major chemotactic agent of neutrophils.
112
S. pyogenes secretes exotoxins A and B, which are implicated in the pathogenesis of which two conditions.
Exotoxin A: streptococcal toxic shock syndrome. Exotoxin B: necrotizing fasciitis.
113
Which type of hypersensitivity reaction is exhibited by Rheumatic Fever? PSGN?
RF: Type II aka cytotoxic PSGN: Type III aka immune-complex mediated
114
What is the most common cause of neonatal sepsis worldwide? In the Philippines?
Group B streptococci worldwide; E. coli in the Philippines
115
What is the most common cause of endometritis?
Polymicrobial
116
How does one differentiate the Group D streptococci (E. faecalis, S. bovis)?
Culture in 6.5% NaCl. E. faecalis would grow; S. bovis would not.
117
Which etiologic agent in pneumonia causes... A. Currant-jelly sputum B. Rust-colored sputum C. Empyema, pneumatocele
A. Klebsiella pneumoniae (also most common etiologic agent in alcoholics) B. Streptococcus pneumoniae (also most common etiologic agent overall) C. Staphylococcus aureus (also most common cause of post viral pneumonia)
118
What is the most common cause of... A. Subacute endocarditis B. Acute endocarditis C. Endocarditis in patients with prosthetic valves
A. S. sanguis B. S. aureus C. S. epidermidis
119
What is the drug of choice for cutaneous anthrax?
Ciprofloxacin
120
Spore-forming Gram-(+) rod Aerobic Non motile Box-car shaped
Bacillus anthracis
121
Spore-forming Gram (+) rod Aerobic, motile Reheated fried rice
Bacillus cereus
122
Spore-forming Gram-(+) rod Anaerobic Tennis racket like
Clostridium tetani
123
Spore-forming Gram-(+) rod Anaerobic Bulging cans
Clostridium botulinum
124
Spore-forming Gram positive rod Anaerobic Lecithinase + Gas forming
Clostridium perfringens
125
Spore-forming Gram positive rod Anaerobic Pseudomembrane
Clostridium difficile
126
Non-spore forming Gram positive rod Aerobic, nonmotile Chinese characters
Corynebacterium diphtheriae
127
Non-spore forming Gram positive rod Aerobic, curved Tumbling motility
Listeria monocytogenes
128
3 etiologic agents associated with pulmonary hemorrhage
Bacillus anthracis (pulmonary anthrax) Leptospira interrogans (leptospirosis) Treponema pallidum (congenital syphilis)
129
What are the three antimicrobials in Thayer Martin agar?
Vancomycin (kills most G+ except Lactobacillus, Pediococcus) Colistin (kills most G- except Neisseria) Nystatin (kills most fungi)
130
Name three spirochetes.
BLT. Borrelia (Lyme disease) Leptospira (Leptospirosis) Treponema (Syphilis)
131
What antibiotic do you give as prophylaxis to close contacts expose to patients infected with Neisseria meningitidis?
Rifampin
132
Most common cause of septic arthritis: A. Overall B. Sexually active adults
A. S. aureus B. N. gonorrheae
133
Which phase in the natural history of pertussis is described? A. Highest yield for culture B. Repetitive cough with whoops C. Secondary complications (seizures, pneumonia, encephalopathy)
A. Catarrhal B. Paroxysmal C. Convalescent
134
Name facultative intercellular bacteria
Some Bugs May Live FacultativeLY. Salmonella Brucella Mycobacterium Listeria Francisella Legionella Yersinia
135
E. coli strains 1. Causes hemolytic uremic syndrome 2. Watery diarrhea in AIDS 3. Watery diarrhea in infants, developing countries 4. Traveller's diarrhea
1. EHEC (enterohemorrhagic) 2. EAEC (enteroadherent) 3. EPEC (enteropathogenic) 4. ETEC (enterotoxigenic)
136
Site of chronic typhoid infection
Gallbladder
137
Most common cause of septicemia in patients with sickle cell anemia
Salmonella cholerasuis
138
Chloramphenicol is a bacteriostatic drug except on the following pathogens in which it is cidal.
No Boyfriend Since HS Neisseria meningitidis Bacteroides fragility Streptococcus pneumoniae Haemophilus influenzae
139
Characteristic motility of: A. Vibrio spp B. Proteus C. Listeria D. Giardia
A. Shooting star B. Swarming C. Tumbling D. Falling leaf
140
Campylobacter jejuni infection is associated with these 2 diseases.
1. Guillan-Barre 2. Reiter's syndrome
141
Name cephalosporins with activity against Pseudomonas.
Ceftazidime Cefepime Cefoperazone
142
Most important virulence factor in Mycobacterium tuberculosis which prevents leukocyte migration
Cord factor
143
Most common extrapulmonary site of TB
Lymph nodes
144
Type 3 immune mediated Postpharyngitic or post-impetigo M protein incites immune complex deposition on the glomerular basement membrane What is the disease and the causative organism?
Glomerulonephritis Streptococcus pyogenes
145
1) What is the drug of choice for patients infected with S. pyogenes? 2) If a patient has a history of rheumatic fever what does he need to prevent recurrence?
1) Penicillin G 2) Long term antibiotic prophylaxis
146
Gram + cocci in chains Beta hemolytic Catalase negative Bacitracin resistant Hydrolyze hippurate CAMP test positive Lancefield group B Grown using LIM broth What is the organism?
Streptococcus Agalactiae (Group B Strep)
147
What is the most common cause of neonatal pneumonia, sepsis and meningitis? Predisposing factors include intrapartum fever PROM of \>18H Complement deficiency
Streptococcus Agalactiae (Group B strep) Also, part of the predisposing factors is Vaginal Colonization
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1) What is DOC for patients with S. agalactiae? 2) For those seriously infected? 3) as chemoprophylaxis for pregnant women given 4 hours prior to delivery?
1) Pen G 2) Pen G + Aminoglycoside 3) IV Penicillin or Ampicillin
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Spectrum of disease: UTI in pregnancy Endometritis Neonatal pneumonia What is the organism?
Strep agalactiae
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Gram + cocci in chains Catalase - Gamma colonies Lancefield group D Bile and optochin resistant Hydrolyzes esculin in Bile-Eschulin Agar Positive PYR test
Group D Streptococci
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True or False 1) E. faecalis can grow in 6.5% NaCl? 2) S. bovis can grow in 6.5% NaCl?
1) True 2) False
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Habitat is the colon Urethra and female genital tract can be colonized UTIs are due to catheters or other instrumentation Endocarditis in patients who underwent GIT surgery What is the offending organism and its treatment?
Group D streptococci Penicillin plus Gentamicin Vancomycin for Penicillin-resistant Linezolid for Vancomycin-resistant (Endocarditis sec to GIT surgery is usually caused by E. faecalis)
153
What kind of endocarditis is seen in patients with abdominal malignancy and what specific organism caused this?
Marantic endocarditis Streptococcus bovis (Group D Strep)
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Gram (+) "lancet-shaped" cocci in pairs (diplococci) or short chains Alpha-hemolytic Catalase negative Bile and optochin sensitive Prominent polysaccharide capsule (+) Quellung reaction What is the Organism?
Streptococcus pneumoniae Quellung reaction is the swelling of the capsule
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Found in the upper respiratory tract Capsule retards phagocytosis IgA protease for colonization C-substance reacts with CRP Can cause pneumonia, otitis media, bacterial meningitis, and septic shock What is the organism and its treatment?
Streptococcus pneumoniae Penicillin G Levofloxacin or Vancomycin combined with Ceftriaxone for penicillin resistance
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Most common cause of CAP and what pattern will you see? How does one go about prevention of this organism?
Strep. pneumoniae Lobar pattern Polyvalent (23-type) polysaccharide vaccine Conjugated vaccine: pneumococcal polysaccharide couple with carrier protein (diphtheria toxoid)
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Most common cause of otitis media, sinusitis and bacterial meningitis? What predisposes a patient infected by this organism to septic shock?
Streptococcus pneumoniae Splenectomy predisposes to sepsis (Skull fracture w/ spinal fluid leakage from nose predisposes to meningitis)
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Gram + cocci in chains Alpha hemolytic Catalase negative Bile and optochin resistant Found in the oropharynx Usual culprit are dental procedures
E. viridans streptocci (S. mutans, S. sanguis, S. intermedius)
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Its glycocalyx enhances adhesion to damaged heart valves They are protected from host defenses w/in vegetations With these info, what specific organism cause 1) dental caries 2) subacute bacterial endocarditis 3) brain abscess
(Organisms are under E. viridans strep) 1) S. mutans 2) S. sanguis (the most common cause of subacute and native valve endocarditis) 3) S. intermedius
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How do you treat patients infected with E. viridans strep?
Pen G with or without an Aminoglycoside Vancomycin for penicillin-resistant Linezid for vancomycin-resistant
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Aerobic Gram + box-car like rods Nonmotile Spore-forming Medusa head
Bacillus anthracis (Medusa head: dry "ground glass" surface and irregular edges with projections along lines of inoculation)
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Treatment for anthrax?
Ciprofloxacin for cutaneous anthrax Ciproflixacin or Doxycycline with 1 or 2 additional antibiotics (Rifampin, Vancomycin, Penicillin, Imipenem, Clindamycin, Clarithromycin)
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Causes Woolsorter's disease Has poly-D-glutamate Can form edema toxin and lethal toxin What is the organism and what factors causes the toxins?
Bacillus anthracis Edema toxin: Edema Factor + Protective Antigen Lethal toxin: Lethal Factor + Protective Antigen Notes: Poly-D-glutamate: antiphagocytoc capsule Edema factor: Calmodulin-dependent adenylate cyclase Lethal factor: inhibits signal transduction in cell division Protective antigen: mediates entry of edema and lethal factors into the cell
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These are all manifestations of one disease but differentiate the types 1) Malignant pustule, eschar and central necrosis with a 20% mortality rate 2) Massively enlarged mediastinal lymph nodes, Pulmo hemorrhage, Meningeal symptoms with a 100% mortality rate w/o immediate treatment 3) UGI ulceration, edema, sepsis with a mortality rate that approaches 100%
1) Cutaneous anthrax 2) Inhalational anthrax (there can also be a prolonged latent period of 2 mos before rapid deterioration) 3) Gastrointestinal anthrax
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Recommended test in cases of dubious/equivocal PPD result (Jawetz)
IGR assay (interferon-gamma release assay)
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Another use of BCG aside from TB prevention
Bladder CA
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Drugs used in lepromatous leprosy
Dapsone Rifampin Clofazimine
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Drugs used in tuberculoid leprosy
Dapsone Rifampin
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Antibiotic of choice for Actinomycosis? Nocardia asteroides?
Actinomycosis: penicillin G Nocardia: TMP+SMX
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Most common infectious cause of Stevens-Johnson syndrome
Mycoplasma pneumoniae
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Causes of false positive VDRL results:
Viruses (EBV, Hepatitis) Drugs (marijuana) RF, RA Lupus, Leprosy
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2 diseases in which Ixodes scapularis is the vector
Babesiosis Lyme disease (Borrelia burgdorferi)
173
This organism are aerobic, gram-positive spore forming rods that lives on grains and reheated fried rice. It has several toxins. Identify if the description describes a heat-labile or heat-stable toxin: (1) cholera-like enterotoxin causing ADP-ribosylation, increasing cAMP (2) short incubation period, consists primarily of nausea and vomiting (3) the diarrheal form has a long incubation period, with watery, nonbloody diarrhea (4) staphylococcal-like eneterotoxin that functions as a superantigen
(1) heat-labile (2) heat-stable (3) heat-labile (4) heat-stable
