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#‼️MICROBIOLOGY - PLE TOPNOTCH 2020 > BACTERIOLOGY > Flashcards

BACTERIOLOGY Flashcards

1
Q

o typhlitis (necrotizing enterocolitis)

o Shanghai fever (mild form of typhoid)

o peritonitis in patients undergoing peritoneal dialysis

A

Pseudomonas

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2
Q

most common STD overall

A

CHLAMYDIA TRACHOMATIS

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3
Q

endocarditis in patients who underwent GIT surgery

A

E. faecalis

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4
Q

type b (polyribitol phosphate) = 95% of invasive disease

A

H. influenzae

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5
Q

“snow shoe” / “tennis racket” terminal spores

A

C. tetani

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6
Q
  • gram-positive cocci in chains
  • Catalase-negative

• Alpha-hemolytic

• Bile and optochin-resistant

A

VIRIDANS STREPTOCOCCI (S. MUTANS, S. SANGUIS)

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7
Q

paroxysmal pattern of hacking coughs, accompanied by production of copious amounts of mucus, that end with an inspiratory “whoop”

A

Pertussis or Tuspirina

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8
Q

Scarlet Fever

  • postpharyngitic
  • due to erythrogenic toxin, seen in lysogenized strains
  • fever, strawberry tongue, centrifugal rash (sandpaper-like), Pastia lines, desquamation
A

S. pyogenes (GAS)

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9
Q

Treatment of Lepromatous leprosy

A

o dapsone, rifampin, and clofazimine

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10
Q
  • types D–K
  • most common cause of STDs
    • NGU in males; PID in females
    • usual coinfection with gonorrhea
  • birth complications
    • neonatal conjunctivitis
    • neonatal pneumonia
  • associated with Reiter syndrome
A

• Genital Tract Infections sec to C. trachomatis

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11
Q

Exotoxin A of _______ – inhibits elongation factor-2 (EF-2), resulting in decreased protein synthesis in gastrointestinal mucosal

A

Pseudomonas aeruginosa

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12
Q

SPECTRUM OF DISEASE: LYME DISEASE

  • Stage 1: erythema chronicum migrans
  • Stage 2: myocarditis (AV block), meningitis, Bell palsy
  • Stage 3: autoimmune migratory polyarthritis (onion skin lesions), acrodermatitis chronica atrophicans
A

BORRELIA BURGDORFERI

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13
Q

Associated with gastric carcinoma and MALT lymphomas

A

H. pylori

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14
Q

antibiotic-containing selective medium, is used for unsterile specimens (e.g. urethral, endocervical) suspected for N. gonorrhea inf.

A

Thayer-Martin agar,

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15
Q
  • gram-positive cocci in grape-like clusters
  • b -hemolytic yellow or golden colonies on blood agar
  • catalase-positive
  • coagulase-positive
  • salt-tolerant on mannitol salt agar (halotolerant)
  • “Gold” color is due the pigment staphyloxanthin
A

STAPHYLOCOCCUS AUREUS

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16
Q

ATYPICAL PNEUMONIA associated with atherosclerosis

A

CHLAMYDIA PNEUMONIAE

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17
Q

meningococcal vaccine contains capsular polysaccharide of strains

A

A, C, Y, and W-135

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18
Q

o 3-4 weeks (or longer)

o Diminished paroxysmal cough

o Development of secondary complications (pneumonia, seizure, encephalopathy) in pertussis

A

Convalescent stage

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19
Q

increases intracellular cAMP in gastrointestinal mucosal cells, resulting in decreased absorption and increased secretion in the digestive tract

A

Cholera Toxin

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20
Q

MESENTERIC ADENITIS (pseudoappendicitis)

A

YERSINIA ENTEROCOLITICA

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21
Q

• weakly staining, gram-negative spirochetes

• largest medically-important bacteria

  • stain well with aniline dyes (Giemsa or Wright stain)
  • cultured on BSK medium
A

BORRELIA BURGDORFERI

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22
Q

DOC for Lyme disease

A

doxycycline

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23
Q

bullous impetigo

A

S. aureus

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24
Q

STAPHYLOCOCCI

A
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25
Q

most common cause of osteomyelitis in an otherwise healthy patient is

A

Staphylococcus aureus.

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26
Q

Gas Gangrene

  • alpha toxin, a lecithinase that cleaves cell membranes
  • Gas produced by anaerobic metabolism
A

CLOSTRIDIUM PERFRINGENS

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27
Q

Phase of pertussis

o 1-2 weeks

o rhinorrhea, malaise, fever, sneezing, anorexia

o Antibiotics most effective

A

Catarrhal phase

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28
Q

promote adherence and invasion of N. gonorrhea into epithelial cells; expression results in opaque colonies

A

Opa proteins

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29
Q

• comma-shaped gram-negative rods

• motile

• oxidase-positive

• cultured on thiosulfate citrate bile salts sucrose (TCBS) agar

• shooting star motility

A

VIBRIO

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30
Q

influenza-like symptoms few hours after receiving penicillin, due to lysis of treponemes

A

Jarisch-Herxheimer reaction

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31
Q

classical detection using Weil-Felix reaction - cross-reaction with antigens of OX strains of Proteus vulgaris

A

RICKETTSIAE

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32
Q

VIRULENCE FACTORS OF S. AUREUS

A
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33
Q

• Culture: Potassium tellurite: dark black colonies

• Loeffler’s medium: after 12 hours of growth, stain with methylene blue.

A

C. diphtheriae

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34
Q

o 2-4 weeks

o ‘Whoop’ → burst of non-productive coughs

o Increased number of lymphocytes in blood smear

o Antibiotics ineffective during this stage of pertussis

A

• Paroxysmal phase

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35
Q
  • Gram-positive “lancet-shaped” cocci in pairs or chains
  • Catalase-negative

• Alpha-hemolytic

• Bile and optochin-sensitive

• positive Quellung reaction

A

STREPTOCOCCUS PNEUMONIAE

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36
Q

cell-wall component that prevents phagocytosis in group A streptococci (Streptococcus pyogenes).

A

Protein M

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37
Q

VIRULENCE FACTORS OF E.COLI

A

• pili or fimbriae – attachment, colonization factor, associated with UTI (cystitis, pyelonephritis)

• flagellum (H)

• capsule (K) – associated with pneumonia and neonatal meningitis (K1)

• endotoxin (O)

• enterotoxins

  • ST and LT cause watery diarrhea, increase cAMP (similar to cholera toxin)
  • verotoxin (Shiga-like toxin) causes bloody diarrhea (HUS), inhibits protein synthesis by inactivating the 60S subunit of eukaryotic cells (E. coli O157:H7, STEC, EHEC)
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38
Q

Encapsulated Bacteria

A

Some Killers Have Pretty Nice and Shiny Bodies.

Streptococcus pneumoniae

Klebsiella pneumoniae

Haemophilus influenzae

Pseudomonas aeruginosa

Neisseria meningitidis

Salmonella typhi

B group streptococci

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39
Q

• sinusitis, otitis media, pneumonia

• meningitis

• epiglottitis - most common cause; cherry red epiglottis; thumb sign

• COPD exacerbations

A

H. influenzae

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40
Q

most common cause of bacterial gastroenteritis

A

CAMPYLOBACTER JEJUNI

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41
Q

TRIAD OF BOTULISM

A
  1. Symmetric descending flaccid paralysis (with prominent bulbar involvement)
  2. Absence of fever
  3. Intact sensorium
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42
Q

most common cause of meningitis among aged 2-18 yrs

A

N. meningitidis

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43
Q
  • gram-positive cocci in chains
  • catalase-negative

• beta-hemolytic

• bacitracin-sensitive

• Lancefield group A

• positive PYR test

A

STREPTOCOCCUS PYOGENES

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44
Q

Vibrio species found in trauma to skin, especially in shellfish handlers, or by ingestion of raw shellfish

A

V. vulnificus

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45
Q
  • anaerobe (normal oral flora)
  • setting: local trauma (broken jaw or dental extraction)
  • PE: hard, nontender swelling with sinus tracts draining sulfur granules
A

ACTINOMYCES ISRAELII

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46
Q

Vibrio species contaminated with raw seafood

A

V. parahaemolyticus)

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47
Q

DOC FOR LEGIONELLA PNEUMOPHILA

A

azithromycin or erythromycin

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48
Q

False Positive VDRL Results

A

VDRL

Viruses (EBV, Hepatitis)

Drugs (marijuana)

Rheumatic fever, RA

Lupus, Leprosy

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49
Q

Vector of Lyme disease

A

bite from deer ticks (Ixodes scapularis, Ixodes pacificus)

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50
Q

BACITRACIN SENSITIVITY

A

B – BRAS

Bacitracin

group B strep Resistant

group A strep Sensitive

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51
Q

PONTIAC FEVER

A

LEGIONELLA PNEUMOPHILA

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52
Q

CAT SCRATCH DISEASE

A

BARTONELLA HENSELAE

  • gram-negative rod
  • normal oral flora of cats

• cat-scratch fever in immunocompetent individuals

• bacillary angiomatosis in immunocompromised

• transmission: cat bite or scratch

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53
Q

Impetigo contagiosa

A

S. PYOGENES (GAS)

  • perioral blistered lesions with honey-colored crust
  • accumulation of neutrophils beneath stratum corneum
  • complication: poststrep GN
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54
Q

• comma-shaped gram-negative rods

• microaerophilic

  • positive oxidase and catalase tests
  • grows well at 42°C on Skirrow agar
A

CAMPYLOBACTER JEJUNI

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55
Q

Optochin Sensitivity

A

OVERPASS

Optochin

Viridans = Resistant

Pneumoniae = Sensitive

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56
Q

drug of choice for all rickettsial infections

A

doxycycline

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57
Q

Scalded Skin Syndrome (Ritter disease)

A

S. aureus

  • exfoliatin cleaves desmoglein in desmosomes
    • separation of epidermis at stratum granulosum
    • distinguish from TEN (Lyell disease) where separation occurs at dermo-epidermal junction
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58
Q

most common cause of CAP

A

S. pneumoniae

o Blood-tinged, pink, or rusty sputum

o Blood cultures often positive

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59
Q

DOC for mycoplasma pneumoniae

A

erythromycin or azithromycin

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60
Q

• gram-negative “kidney-bean” diplococci

  • insignificant capsule
  • oxidase-positive colonies on Thayer-Martin medium

• ferment glucose only

A

. NEISSERIA GONORRHOEAE

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61
Q
  • facultative gram-negative rods with large polysaccharide capsule
  • extended spectrum beta-lactamase (ESBL) activity in drug resistant strains

• urease-positive

A

KLEBSIELLA PNEUMONIAE

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62
Q

• facultative gram-negative rods

  • lactose-fermenting colonies on EMB or MacConkey agar
  • green sheen on EMB agar; metallic sheen

• typing by O and H antigens

A

ESCHERICHIA COLI

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63
Q
  • fever, chills, intense headache
  • calf tenderness
    • due to rapid multiplication of leptospires in muscles with high oxygen tension
  • conjunctival suffusion
    • due to damaged and leaky conjunctival vessels
    • painful and itchy but with minimal tearing
A

Acute Leptospiremic Phase

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64
Q

What virulence factor causes Typhoid Fever (S. typhi)?

A

Vi (virulence) capsular antigen

o organisms enter, multiply in Peyer patches, and then spread to reticulo-endothelial system

o predilection for invasion of the gallbladder, which can result in establishment of the chronic carrier state

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65
Q

LACTOSE FERMENTERS

A

LaCtose is KEE. Grow in MacConKEE agar.

Citrobacter

Klebsiella

Escherichia coli

Enterobacter

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66
Q

most important virulence factor of TB

A

cord factor

o inhibits WBC migration

o causes characteristic serpentine growth pattern

o induces TNF-α release

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67
Q

for detection of toxigenicity of C. diphtheriae

A

modified Elek test

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68
Q

Treatment of Cholera

A
  • Cholera
    • fluid and electrolyte replacement
    • tetracycline or azithromycin shortens duration
  • V. parahaemolyticus, V. vulnificus Infection
    • minocycline plus fluoroquinolone or cefotaxime
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69
Q
  • thin, coiled spirochetes
  • hook at one or both pointed ends (Shepherd’s crook)
  • obligate aerobe
  • grown on Ellinghausen-McCullough-Johnson-Harris (EMJH) medium or Fletcher medium
A

LEPTOSPIRA INTERROGANS

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70
Q

all pregnant women should be screened for GBS colonization at what AOG

A

35-37 weeks AOG

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71
Q

• aerobic, acid-fast rods

o Ziehl-Neelsen (or Kinyoun)

• high lipid content

o mycolic acids and wax D

  • produces catalase and niacin
  • slow-growing on Löwenstein-Jensen medium

• luciferase assay for drug resistance

A

MYCOBACTERIUM TUBERCULOSIS

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72
Q
  • infections commonly due to combinations of bacteria in synergistic pathogenicity
  • LPS with low endotoxic activity
  • capsule (antiphagocytic and anticomplement)
  • foul-smelling discharge → because of short-chain fatty-acid products of fermentation
A

BACTEROIDES FRAGILIS

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73
Q

antibodies decrease efficacy of streptokinase in managing MI

A

anti-streptokinase

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74
Q

Marantic endocarditis AKA nonbacterial thrombotic endocarditis (NBTE) in patients with abdominal malignancy

A

Strep bovis

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75
Q

GRAM NEGATIVE RODS - GIT AND GUT

A
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76
Q
  • anaerobic, gram-positive, spore-forming rods
  • double hemolysis on blood agar
  • growth on egg-yolk agar - nonmotile but with rapidly spreading growth on culture media
A

CLOSTRIDIUM PERFRINGENS

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77
Q

DOC for cutaneous anthrax

A

ciprofloxacin

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78
Q

NOVOBIOCIN SENSITIVITY

A

NO StRES

NOvobiocin

Saprophyticus Resistant

Epidermidis Sensitive

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79
Q

ANTIBIOTICS FOR ACTINOMYCETES

A

S–N–A–P

Sulfa for Nocardia; for Actinomyces, use Penicillin.

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80
Q

Which capsular type of Neisseria meningitidis lacks immunogenicity even with protein conjugation, hence, not included in the vaccine?

A

B

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81
Q

• non-lactose-fermenting, gram-negative rods

• produce no gas from the fermentation of glucose

• do not produce H2S

• nonmotile

  • have O antigens
  • cultured in XLD medium
A

SHIGELLA SPP.

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82
Q

cultured in Eaton’s agent - requires cholesterol and nucleic acids; penicillin is added to inhibit growth of contaminating bacteria; dome-shaped colonies with “fried egg” appearance or “mulberry” appearance (in the case of Mycoplasma pneumoniae)

A

Mycoplasma pneumoniae

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83
Q

DOC for Salmonella

A

Ceftriaxone

Philippines: amoxicillin, chloramphenicol, co-trimoxazole

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84
Q

TULAREMIA

A

FRANCISELLA TULARENSIS

  • small gram-negative rods
  • reservoir: rabbits, deer, and rodents
  • transmission: ticks (e.g., Dermacentor), aerosols, contact, and ingestion
  • treatment: streptomycin or gentamicin
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85
Q

• Pneumonia

o thick, bloody sputum (“currant-jelly” sputum)

o usually nosocomial

o most common cause in alcoholics

A

Klebsiella pneumoniae

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86
Q

REITER SYNDROME

A

Triad of urethritis, uveitis, and arthritis

CAN’T PEE

CAN’T SEE

CAN’T CLIMB A TREE

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87
Q

o clinically similar but milder than S. aureus TSS

o due to pyrogenic exotoxin A

o recognizable site of pyogenic inflammation

o blood cultures are often positive

A

Streptococcal Toxic Shock Syndrome

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88
Q
  • ecthyma gangrenosum
    • hemorrhagic lesions
  • febrile neutropenia
    • leukemia or lymphoma post chemo- or radiation therapy
    • severe burns
A

Pseudomonas

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89
Q
  • aerobic, filamentous gram-positive rods with aerial hyphae
  • weakly acid-fast (Fite-Faraco)
  • transmission: inhalation of particles from soil
  • manifests as mycetomas and lung and brain abscesses (orange colonies)
  • treatment: TMP-SMX + drainage
A

NOCARDIOSIS

(NOCARDIA ASTEROIDES)

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90
Q

most common cause of urethritis

A

Gonococcal Urethritis

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91
Q

o post-impetigo (commonly the M12 type) OR postpharyngitic

o M protein incites immune complex deposition on the glomerular basement membrane

o ssx: hypertension, periorbital edema, hematuria

A

PSAGN

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92
Q

o most common bacterial cause of sore throat

o inflammation, exudate, fever, leukocytosis, and tender CLAD

o pyogenic complications: peritonsillar and retropharyngeal (Quincy) abscess, otitis, sinusitis, meningitis

A

S. pyogenes (GAS)

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93
Q

Floppy Baby Syndrome

  • when babies ingest spores found in household dust or honey
  • due to absence of competitive bowel microbes
A

Infant Botulism

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94
Q

most common cause of acute endocarditis

A

S. aureus

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95
Q

Virulence factors of Pseudomonas

A
  • endotoxin
  • exotoxin A
    • tissue necrosis and inactivates EF-2
    • type III secretion system facilitates exotoxin transfer
  • elastase and proteases
  • pyocyanin damages the cilia and mucosal cells
  • verdoglobin from hemoglobin breakdown → any of several green compounds derived from hemoglobin or related compounds by cleavage of the porphyrin ring
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96
Q

Virulence factors of MYCOPLASMA PNEUMONIAE

A
  • toll-like receptor 2 protein (P1 adhesin)
    • attachment, inhibition of ciliary motion and necrosis
  • hydrogen peroxide
    • contributes to the damage to the respiratory tract cells
  • autoantibodies against red cells (cold agglutinins) and brain, lung, and liver cells
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97
Q

FACULTATIVE INTRACELLULAR BACTERIA

A

Some Bugs May Live FacultativeLY.

Salmonella

Brucella

Mycobacterium

Listeria

Francisella

Legionella

Yersinia

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98
Q

• IgA protease for colonization

• c-substance reacts with CRP

A

S. pneumoniae

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99
Q

ABCDEFG of Diphtheria

A

ADP-ribosylation

Beta-prophage

Corynebacterium

Diphtheriae

Elongation Factor-2

Granules (metachromatic)

100
Q

For N. gonorrhea, sterile clinical specimens (e.g. blood, synovial fluid, CSF) should be inoculated onto

A

enriched chocolate agar

101
Q

GRAM POSITIVE BACTERIA

MEMOOORRRIIIIZZZEEEE!!!!

A
102
Q

DOC for Shigella

A

ciprofloxacin

103
Q

injection of diphtheria exotoxin into the skin, to determine whether a person is susceptible to infection by diphtheriae (not to be confused with Dick test in scarlet fever)

A

Schick test

104
Q

Q fever

A

Coxiella burnetti

105
Q
  • anaerobic, gram-positive, spore-forming rods
  • spore is at one end (terminal spore) so organism looks like a tennis racket
A

CLOSTRIDIUM TETANI

106
Q

o triggers cell-mediated immunity in TB→ caseation and granulomas

o triggers delayed hypersensitivity reaction

o a surface protein

A

tuberculin surface protein

107
Q

• gram-negative “kidney-bean” diplococci

  • large polysaccharide capsule
  • oxidase-positive colonies on chocolate agar

• ferments maltose and glucose

A

NEISSERIA MENINGITIDIS

108
Q

FORMS OF CHLAMYDIA

A

Elementary body = Enfectious, Enters cell via Endocytosis

Reticulate body = Replicates in cell by fission

109
Q

o within hours, enters lymphatics and multiplies

o local, nontender ulcer (chancre) usually forms in 2–10 weeks

o Highly infectious, heals spontaneously in 3-6 weeks

A

Primary Syphilis

110
Q

DOC for S. pyogenes (GAS)

A

Penicillin G

111
Q

Osteomyelitis in IV drug abusers

A
  • Staphylococcus aureus
  • Pseudomonas aeruginosa
112
Q

C. difficile exotoxins A (enterotoxin) and B (cytotoxin) inhibit GTPases, leading to apoptosis and death of enterocytes leading to ___

A

pseudomembranes

113
Q
  • many years after inoculation
  • clinical spectrum
    • granulomas (gummas)
    • neurosyphilis
      • tabes dorsalis
      • Argyll-Robertson pupil / Prostitute’s pupil
      • dementia paralytica
  • cardiovascular (aortitis)
    • obliterative invasion of small blood vessels and vasa vasorum, causing endarteritis
A

Tertiary Syphilis

114
Q

LYME DISEASE

A

BAKE a Key LYME pie

Bell Palsy

Arthritis

Kardiac block

Erythema chronicum migrans

115
Q

Toxic Shock Syndrome

A

S. aureus

  • due to TSST-1
  • fever, hypotension, sloughing of the filiform papillae → strawberry tongue, desquamating rash and multi-organ involvement (>3)
  • usually no site of pyogenic inflammation; blood CS negative
  • usual scenario: tampon-using menstruating women or in patients with nasal packing for epistaxis
116
Q

Ehrlichiosis

A

Ehrlichia chaffeensis

117
Q

o Non-bloody diarrhea associated with pseudomembranes (yellow-white plaques) on the colonic mucosa

o toxic megacolon can occur

A

Pseudomembranous Colitis

118
Q
  • C. trachomatis types L1–L3
  • papule or vesicular which ulcerates and leads to suppurative inguinal lymphadenitis (buboes)
  • positive Frei test
    • intradermal injection of antigen
A

Lymphogranuloma Venereum

119
Q
  • aerobic, non-spore-forming, gram-positive rods
  • arranged in V- or L-shape

• tumbling motility

• narrow zone of beta-hemolysis

• cold enhancement: paradoxical growth in cold temperature

A

LISTERIA MONOCYTOGENES

120
Q

Reddish metachromatic (Babes-Ernst / Volutin) granules can be seen

A

C. diphtheriae

121
Q
  • aerobic, gram-positive box-car like rods
  • nonmotile
  • spore-forming
  • Medusa head morphology - dry “ground glass” surface and projections along lines of inoculation
A

BACILLUS ANTHRACIS

122
Q

2nd most common cause of UTIs in sexually active women

A

STAPHYLOCOCCUS SAPROPHYTICUS

123
Q
  • Seen in lepromatous form
  • Tender red nodules or humps on both shins
  • Signals acute flare-ups of disease
  • Treated with Thalidomide → category X drug; associated with phocomelia if given during pregnancy
A

Erythema Nodosum Leprosum

124
Q
  • most common cause of crippling of the hand
  • Damage in the following nerves is characteristic impairments in leprosy:
    • Ulnar and median: clawed hand
    • Posterior tibial: plantar insensitivity and clawed toes
    • Common peroneal: foot drop
    • Radial cutaneous, facial, and greater auricular nerves (may also be involved)
A

Leprosy / Hansen Disease

125
Q

most commonly identified cause of GBS

A

Campylobacter infection

126
Q

Thayer-Martin agar composition

A

Mueller-Hinton agar with 5% chocolate sheep blood plus the following antibiotics (VPN):

  • Vancomycin (inhibits gram-positive organisms)
  • Polymyxin* inhibits gram-negative organisms excluding Neisseria species)
  • Nystatin (inhibits fungi)

*Alternatively, polymyxin can sometimes be replaced with colistin (hence, VCN) or trimethoprim.

127
Q

Which of the following refers to an obsolete skin test for venereal lymphogranuloma that uses antigens prepared from chlamydia grown in the yolk sac of a chick embryo?

A

Frei test

128
Q
  • poorly gram-negative rods
    • visualize with silver stain
  • facultative intracellular bacteria
  • culture on charcoal yeast extract agar
    • increased amounts of iron and cysteine
    • optimal between 28 and 40°C; organisms are dormant below 20°C and are killed at temperatures above 60°C
  • rapid urinary antigen test
A

LEGIONELLA PNEUMOPHILA

129
Q

Epidemic Typhus

A

Rickettsia prowazekii

130
Q

o watery diarrhea in large volumes (rice-water stools)

o patients with severe hypovolemia may have sunken eyes, dry mouth, cold clammy skin, decreased skin turgor, or wrinkled hands and feet, aka ‘washerwoman’s hands’

A

Cholera

131
Q
  • gram-positive cocci in chains
  • catalase-negative

• gamma hemolytic colonies

• Lancefield group D

• bile and optochin-resistant

• hydrolyzes esculin in bile-esculin agar (BEA)

• positive PYR test

• E. faecalis can grow in 6.5% NaCl while S. bovis cannot

A

GROUP D STREPTOCOCCI

132
Q

bird fancier’s disease - sudden onset pneumonia with malaise, fever, anorexia, sore throat, photophobia, and severe headache

A

CHLAMYDIA PSITTACI

133
Q

satellite phenomenon around S. aureus colonies - hemolysis by S. aureus liberates factor V

A

H. influenzae

134
Q

DOC for Pseudomembranous Colitis

A

oral metronidazole or vancomycin should be given and fluids replaced - oral vancomycin because it has poor intestinal absorption, hence, it ‘coats’ the lesions with antibiotic

135
Q
  • gram-positive cocci in clusters
  • catalase-positive

• coagulase-negative

• novobiocin-sensitive

• whitish, non-hemolytic colonies on blood agar

A

STAPHYLOCOCCUS EPIDERMIDIS

136
Q

Two genera of bacterial pathogens are known to produce endospores:

A

aerobic Bacillus and anaerobic Clostridium

137
Q

exotoxin inhibits protein synthesis by adding ADP-ribose to elongation factor-2 (EF-2)

o subunit A, has ADP-ribosylating activity

o subunit B, binds the toxin to cell surface

o exotoxin encoded by b -prophage

A

C. diphtheriae

138
Q

GRAM NEGATIVE BACTERIA

MEMMMOOOORRRIIIZZZEEEE!!!

A
139
Q

o most severe form of meningococcemia

o high fever, shock, widespread purpura, disseminated intravascular coagulation, thrombocytopenia, and adrenal insufficiency

§ bilateral hemorrhagic destruction of the adrenal glands

A

Waterhouse-Friderichsen Syndrome

140
Q

OSTEOMYELITIS in burns

A

Pseudomonas aeruginosa

141
Q
  • gram-positive cocci in chains
  • Catalase-negative

• Beta-hemolytic

• Bacitracin-resistant

• Lancefield group B

  • hydrolyze hippurate
  • CAMP test–positive
  • grow using Lim broth
A

STREPTOCOCCUS AGALACTIAE

(GROUP B STREPTOCOCI)

142
Q

S. pyogenes preotein that prevents phagocytosis by binding to the Fc region of IgG

A

Protein A

143
Q

o postpharyngitic

o cross-reacting antibodies to M proteins and antigens of joint, heart, and brain tissue

o Jones Criteria:

§ migratory polyarthritis

§ pancarditis

§ erythema marginatum

§ Sydenham chorea

§ subcutaneous nodules

A

Acute Rheumatic Fever sec to S. pyogenes (GAS)

144
Q
  • small gram-negative rod
  • culture on chocolate agar with heme (factor X)
  • PE: painful genital ulcer
A

CHANCROID

(HAEMOPHILUS DUCREYI)

145
Q

Pseudomonas susceptible drugs

A

o antipseudomonal penicillins (ticarcillin, piperacillin)

o penicillin plus beta-lactamase inhibitor (ticarcillinclavulanate, piperacillin-tazobactam)

o third generation cephalosporins (ceftazidime)

o fourth generation cephalosporins (cefepime)

o monobactam (aztreonam)

o carbapenems (imipenem, meropenem)

o fluoroquinolones (ciprofloxacin)

146
Q

OBLIGATE INTRACELLULAR BACTERIA

A

Stay inside cells when it is Really Cold

Ricketssia

Chlamydia

147
Q

blocks acetylcholine release causing flaccid paralysis (descending pattern)

A

botulinum toxin (heat-labile neurotoxin)

148
Q

• culture on Bordet-Gengou agar or Regan-Lowe charcoal medium

A

BORDETELLA PERTUSSIS

149
Q

ABCDE of beta-prophage encoded toxins

A

ShigA-like toxin (EHEC)

Botulinum toxin

Cholera toxin

Diphtheria toxin

Erythrogenic toxin (S. pyogenes)

150
Q

o nosocomial pneumonia, VAP, necrotizing pneumonia, complicated by empyema, abscess or pneumatocele

o post-viral pneumonia

A

S. aureus

151
Q

o bacteremia results in the seeding of many organs, with osteomyelitis, pneumonia, and meningitis as the most common sequelae

o commonly in patients with sickle cell anemia or cancer

A

Salmonella choleraesuis

152
Q

• smallest free-living organisms

• not seen on Gram-stain

o no cell wall

o only bacteria with sterol in cell membrane

A

MYCOPLASMA PNEUMONIAE

153
Q

Exotoxin A and B - cause depolymerization of actin filaments in gastrointestinal mucosal cells, leading to mucosal cell death (i.e. pseudomembranes)

A

Clostridoides difficile

154
Q

Cellulitis

A

S. pyogenes and Staphyloco

§ deeper infection involving subcutaneous/dermal tissues

§ facilitated by hyaluronidase (spreading factor)

155
Q

VIRULENCE FACTORS OF S.PYOGENES / GROUP A STREP

A
156
Q
  • Osteomyelitis & Septic Arthritis
    • from hematogenous spread or local introduction at wound site
    • Brodie abscess
      • sequestered focus of osteomyelitis arising in the metaphyseal area of a long bone
A

S. aureus

157
Q

(woolsorter’s disease)

A

BACILLUS ANTHRACIS

158
Q

method of determining susceptibility to scarlet fever by injection into the skin of 0.1 cubic centimetre of scarlet fever toxin (do not consufe this with the Schick test for diphtheria susceptibility)

A

Dick test

159
Q

treatment of erythema nodosum leprosum

A

thalidomide

160
Q

Virulence factors of LISTERIA MONOCYTOGENES

A

• internalin: interacts with E-cadherin on the surface of cells

• listeriolysin: escape from phagosomes

• actin rockets (actin polymers): propels the bacteria through the membrane of one human cell and into another

161
Q

cultured in mouse footpad or in the armadillo

A

MYCOBACTERIUM LEPRAE

162
Q

DOC for pertussis

A

Erythromycin

163
Q

UNDULATING FEVER

A

BRUCELLA ABORTUS

  • transmission: contaminated dairy or direct contact
  • treatment: doxycycline plus rifampin
164
Q

Enterotoxin produced by B. cereus

A

Heat-Labile Enterotoxin

o cholera-like enterotoxin causes ADP-ribosylation, increasing cAMP

165
Q

o most severe form of leptospirosis

o triad: jaundice, bleeding, uremia

o orange cast skin (severe jaundice)

o most common cause of death is respiratory failure due to massive pulmonary hemorrhage

A

Weil Syndrome

166
Q

Endemic typhus

A

Rickettsia typhi

167
Q
  • anaerobic, gram-positive, spore-forming rods
  • exotoxin in stool detected by cytopathic effect (final phase by which viral cells infect cells) on cultured cells or ELISA
A

CLOSTRIDIUM DIFFICILE now CLOSTRIDIOIDES DIFFICILE

168
Q
  • Ubiquitous in man and natural water environments
  • Freshwater amoebae appear to be the natural reservoir for the organisms.
  • transmission via aerosol (e.g. AC, cooling towers)
  • person-to-person transmission does not occur
A

LEGIONELLA PNEUMOPHILA

169
Q

• most virulent bacteria

  • small gram-negative rods with bipolar (safety pin) staining
  • reservoir: wild rodents
  • transmission: flea bite, inhalation
  • PE: buboes, cutaneous hemorrhage
  • treatment: streptomycin and tetracycline
  • No vaccine available
A

YERSINIA PESTIS

170
Q

antiphagocytic capsule of B. anthracis

A

poly-D-glutamate)

171
Q

titers to document antecedent skin infection

A

anti-DNAse B

172
Q

GRAM POSITIVE RODS

A
173
Q

UREASE-POSITIVE BACTERIA

A

Particular Kinds Have Urease.

Proteus mirabilis

Klebsiella pneumoniae

Helicobacter pylori

Ureaplasma urealyticum

174
Q
  • most common type of atypical pneumonia (walking pneumonia)
  • clinical findings not compatible with chest x-ray

• extra-pulmonary manifestations:

o hemolysis, Stevens-Johnson syndrome, Raynaud, GuillainBarre syndrome

A

MYCOPLASMA PNEUMONIAE

175
Q

BITES and OSTEOMYELITIS

  • short, encapsulated gram-negative rod that exhibits bipolar staining (‘closed safety pin appearance’)
  • buttery colonies with musty odor due to indole production
  • reservoir: cats and dogs
  • transmission: animal bites
  • treatment: penicillin G
A

PASTEURELLA MULTOCIDA

176
Q

MCC of neonatal pneumonia, sepsis and meningitis

A

STREPTOCOCCUS AGALACTIAE

(GROUP B STREPTOCOCI)

177
Q

• urease hydrolyzes the urea in urine to form ammonia

o raises pH producing alkaline urine

o encourages the formation of struvite stones, composed of magnesium-ammonium-phosphate

A

PROTEUS MIRABILIS

178
Q

ATYPICAL PNEUMONIA

  • pneumonia accompanied by confusion, non-bloody diarrhea, hyponatremia, proteinuria and hematuria
A

LEGIONELLA PNEUMOPHILA

179
Q

NEONATAL MENINGITIS

A

B–E–L

B group streptococci (S. agalactiae)

Escherichia coli

Listeria monocytogenes

180
Q

DOC of MRSA

A

Vancomycin

181
Q

• facultative gram-negative rods

• non-lactose-fermenting

  • produces H2S
  • Widal test detects antibodies in patient’s serum
  • cultured in XLD medium
A

SALMONELLA SPP.

182
Q

What is the vector of plague (Yersinia pestis)?

A

FLEA

183
Q

granulomatosis infantiseptica

o transplacental transmission

o characterized by late miscarriage or birth complicated by sepsis, multiorgan abscesses, and disseminated granulomas

A

Early-Onset Neonatal Listeriosis

184
Q
  • facultative gram-negative rods
  • non-lactose-fermenting

• urease-positive

• swarming motility

A

PROTEUS MIRABILIS

185
Q

Drugs associated with Psudomembranous colitis secondary to C. difficile

A

clindamycin, 2 nd & 3 rd gen cephalosporins, ampicillin

186
Q
  • tracheal cytotoxin
    • damages ciliated cells
    • causes whooping
  • extracytplasmic (false) adenylate cyclase
    • ‘weakens’ neutrophils lymphocytes and monocytes
    • inhibits phagocytosis
  • filamentous hemagglutinin
    • pili rod that extends from the surface of B. pertussis, enabling the bacteria to bind to ciliated epithelial cells of the bronchi
    • mediates attachment
  • pertussis toxin
    • causes ADP-ribosylation
    • activates G proteins that increases cAMP resulting in:
A

BORDETELLA PERTUSSIS

187
Q

o central area of Langhan giant cells surrounded by a zone of epithelioid cells

o tubercle is a granuloma surrounded by fibrous tissue that has undergone central caseation

A

Granulomatous Lesions in TB

188
Q
  • may mimic ulcerative colitis
  • disease associations
    • Guillain-Barré syndrome
      • antigenic cross-reactivity between oligosaccharides in bacterial capsule and glycosphingolipids on surface of neural tissues
  • reactive arthritis (Reiter syndrome)
A

CAMPYLOBACTER JEJUNI

189
Q

Methicillin resistance in S aureus is mediated by what gene?

A

mecA gene

* encodes for a novel penicillin-binding protein (PBP), PBP2a, with reduced binding affinity for antibiotic.

190
Q

§ most severe form of bacillary dysentery

§ most common cause of epidemic dysentery

A

Shigella dysenteriae type 1 – Shiga bacillus

191
Q

o condyloma lata, maculopapular rash, fever headache, malaise, anorexia, lymphadenopathy

o occurs after 1 to 3 months

A

Secondary Syphilis

192
Q

gold standard for leptospirosis diagnosis

A

leptospire microscopic agglutination test (lepto MAT)

193
Q

DOC for Tetanus

A

Metronidazole or penicillin - Metronidazole (400mg rectally or 500 mg IV every 6 h for 7 days) is the preferred antibiotic. An alternative is penicillin (100,000–200,000 IU/kg per day), although this drug theoretically may exacerbate spasms (Harrisons)

194
Q

Necrotizing fasciitis AKA flesh-eating disease

A

S. pyogenes (GAS)

  • rapidly progressive infection of deep subcutaneous tissues
  • facilitated by exotoxin B
  • Fournier’s gangrene
    • form of necrotizing fasciitis involving the male genital area and perineum; often caused by mixed organisms but can be caused by GABHS
195
Q

STREPTOCOCCI - OVERVIEW

A
196
Q
  • encapsulated, pleomorphic gram-negative bacillus
  • bipolar densities (Donovan bodies) look like closed safety pins
  • small painless papule ulcerates to form beefy red ulcer with velvety surface
  • pseudobuboe formation → lump in the groin similar in appearance to bubo (remember bubonic plague?); it is actually a granuloma and not an inflamed lymph node, hence, it is a ‘false’ bubo
  • treatment: azithromycin
A

GRANULOMA INGUINALE /DONOVANOSIS

(KLEBSIELLA GRANULOMATIS)

197
Q

NEISSERIA

A

Neisseria MeninGitidis ferments Maltose and Glucose

Neisseria GOnorrhoeae ferments Glucose Only

198
Q

BUBONIC, PNEUMONIC and SEPTICEMIC PLAGUE

A

YERSINIA PESTIS

199
Q

• ingestion of unpasteurized milk products, e.g., cheese

A

LISTERIA MONOCYTOGENES

200
Q

Rockey mountain Spotted fever

A

Rickettsia rickettsii

201
Q

ZOONOSES

A

Bugs From Your Pets.

Brucella abortus

Francisella tularensis

Yersinia pestis

Pasteurella multocida

202
Q

TETANUS PROPHYLAXIS

A
203
Q

DRUGS USED IN TB TREATMENT

A
204
Q

DOC of VRSA

A

Linezolid

205
Q

prevents phagosome-lysosomal fusion in TB

A

exported repetitive protein (sulfatides)

206
Q

• most common cause of

o prosthetic valve endocarditis

o septic arthritis in prosthetic joints

o ventriculoperitoneal shunt infections

A

S. Epidermidis

207
Q

protein complex responsible for the massive, watery diarrhea (e.g. rice water stools) characteristic of cholera infection

A

Cholera toxin (a.k.a. choleragen, sometimes abbreviated as CTX, Ctx or CT)

  • CT acts by causing constitutive activation of adenylate cyclase, leading to elevated cAMP levels in intestinal epithelial cells. Cyclic AMP (cAMP) activates protein kinase A, which causes the opening of ion channels in the membrane, leading to chloride and bicarbonate secretion by intestinal crypt cells and disruption in absorption by villus cells.
208
Q

Halberstaedter-Prowazek inclusions

A

C. trachomatis

209
Q

​LEPTOSPIROSIS PHASE?

  • aseptic meningitis
    • CSF pleocytosis with or without meningeal symptoms
    • coincides with appearance of antibody titers
  • pulmonary involvement
    • snow-flake lesions in CXR
  • hepatic necrosis
  • glomerulonephritis
    • due to immune-complex deposition
A

Immune Leptospiruric Phase

210
Q

most common cause of bacillary dysentery

A

Shigella sonnei – Duval’s bacillus

211
Q

Neonatal Pneumonia

  • types D–K
  • late-onset (2-4 weeks) o striking tachypnea, characteristic paroxysmal cough (staccato cough), absence of fever, and eosinophilia
A

C. trachomatis

212
Q

The heat resistance of bacterial spores, such as those of B. anthracis, is due in part to their dehydrated state and in part to the presence of large amounts of which of the following?

A

Calcium dipicolinate

* Dipicolinic acid forms a complex with calcium ions within the endospore core. This complex binds free water molecules, causing dehydration of the spore.

213
Q

• looks like Chinese characters

• metachromatic granules

A

C. diphtheriae

214
Q
  • gram-negative rods
  • obligate aerobe

• non-lactose-fermenting

• oxidase-positive

• pyocyanin (blue-green pigment)

• sweet grape-like odor

• grown on Cetrimide agar

A

PSEUDOMONAS AERUGINOSA

215
Q

VIRULENCE FACTORS OF VIBRIO

A
  • enterotoxin (choleragen) acts by ADP ribosylation
  • mucinase enhances attachment to the intestinal mucosa
  • high infectious dose
  • pandemics caused by Vibrio cholerae O1 biotype El Tor (cholera El Tor)
216
Q
  • glycocalyx adheres well to foreign bodies and form biofilms
    • prosthetic heart valves
    • prosthetic joints
    • ventriculoperitoneal shunts
    • indwelling catheters
A

STAPHYLOCOCCUS EPIDERMIDIS

217
Q

tetanus toxin

A

tetanospasmin

o protease that cleaves proteins involved in the release of glycine from Renshaw cells in spinal cord

o Prevents release of GABA by cleaving of synaptobrevin 2

218
Q

only bacteria with sterol in cell membrane

A

MYCOPLASMA PNEUMONIAE

219
Q

TRACHOMA = TYPES A, B, C

A

ABC:

Africa

Blindness

Chronic infection

220
Q

DOC of inhalational/gastrointestinal anthrax

A

DOC is ciprofloxacin or doxycycline with one or two additional antibiotics (rifampin, vancomycin, penicillin, imipenem, clindamycin, clarithromycin)

221
Q

GROUP A STREP TOXINS

A
222
Q

o alkaline vegetables such as green beans, peppers, and mushrooms

o smoked fish

o canned goods (bulging)

o honey

A

CLOSTRIDIUM BOTULINUM

223
Q

cause pulmonary disease in immunocompromised hosts (AIDS patients with CD4 <50)

A

MYCOBACTERIUM AVIUM-INTRACELLULARE COMPLEX (MAI, MAC)

224
Q
  • gram-positive cocci in clusters
  • catalase-positive

• coagulase-negative

• novobiocin-resistant

  • whitish, non-hemolytic colonies on blood agar
  • Nitrite negative (unlike E. coli)
A

STAPHYLOCOCCUS SAPROPHYTICUS

225
Q

titers to document antecedent pharyngitis

A

anti-streptolysin O (ASO)

226
Q

direct epidermal contact with spores causes formation of a malignant pustule with subsequent eschar and central necrosis

A

Cutaneous Anthrax

227
Q

most common cause of subacute and native endocarditis

A

S. sanguis (VIridans Strep), for subacute bacterial endocarditis (SBE)

228
Q

most common cause of septic arthritis in sexually active adults

A

N. gonorrhea

229
Q

• curved gram-negative rods

• urease-positive

• microaerophilic

A

HELICOBACTER PYLORI

230
Q

MCC of death is pulmonary hemorrhage in the ff:

A

• Anthrax (pulmonary) aka wool sorter’s disease

• Leptospirosis, severe (Weil’s syndrome)

• Congenital syphilis

231
Q

allows adherence of bacteria to the mucous membranes of the respiratory, genitourinary and gastrointestinal tracts

A

IgA protease

232
Q

• Skin & Soft Tissue Infections

o bullous impetigo, folliculitis, furuncles, carbuncles, cellulitis, hidradenitis suppurativa, mastitis, surgical site infections

A

S. aureus

233
Q

cause culture negative subacute bacterial endocarditis in patients with preexisting heart disease

A

HACEK ORGANISMS

Haemophilus aphrophilus

Actinobacillus actinomycetemcomitans

Cardiobacterium hominis

Eikenella corrodens

Kingella kingae

234
Q

o snuffles / saddle nose

o mulberry molars

o Hutchinson triad: Hutchinson teeth, deafness, keratitis

o saber shins

o rhagades (angle of mouth)

o Higoumenakis sign (clavicle) → unilateral enlargement of the sternoclavicular portion of the clavicle, leads to detachment

o Clutton’s joints (synovitis)

o pulmonary hemorrhage

A

Congenital Syphilis

235
Q

Treatment of tuberculoid leprosy

A

dapsone and rifampin

236
Q

o acute onset (4 hrs) of vomiting and diarrhea due to ingestion of preformed heat-stable enterotoxin

o source: salad made with mayonnaise (potato or tuna salad)

A

Gastroenteritis sec to S. aureus

237
Q

ENTEROBACTERIACEAE

A
238
Q

• obligate intracellular bacteria

• energy parasites that use host ATP

  • cell wall lacks muramic acid
  • grown in cycloheximide culture

• cytoplasmic inclusions in Giemsa

A

CHLAMYDIA TRACHOMATIS

239
Q

Erysipelas AKA St. Anthony’s Fire

A

S. pyogenes (GAS)

superficial infection extending into dermal lymphatics

240
Q

Virulence factors of B. anthracis

A
241
Q

Bacillary angiomatosis presents with cutaneous nodules very similar in appearance to those found in which disease?

A

Kaposi sarcoma

242
Q

Shiga-like toxin (just like the real Shiga toxin produced by Shigella) inhibits ____ ribosomal subunits, resulting in decreased protein synthesis in gastrointestinal mucosal cells.

A

60S

243
Q
  • small gram-negative (coccobacillary) rods
  • requires factor X (hemin) and V (NAD) for growth (chocolate agar)
A

HAEMOPHILUS INFLUENZAE

244
Q

o dissemination of meningococci into the bloodstream

o multiorgan disease, consumptive coagulopathy, petechial or purpuric rash (purpura fulminans)

A

Meningococcemia

245
Q

NONE of the cephalosporins are active against the following:

A

• Enterococci

• Listeria monocytogenes

• MRSA

#‼️MICROBIOLOGY - PLE TOPNOTCH 2020 (5 decks)

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