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Microbiology > Bacteriology Exam 12 (Spirochetes, Rickettsia, Chlamydia) > Flashcards

Bacteriology Exam 12 (Spirochetes, Rickettsia, Chlamydia) Flashcards

1
Q

What 3 spirochete genera are pathogenic to humans?

A

Leptospira
Borrelia
Treponema

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2
Q

What allows for spirochete motility?

A

Axial fibrils wound around a flexible cell wall, surrounded by an outer sheath (periplasmic flagella)

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3
Q

How does Treponema reproduce, as compared to Borrelia or Leptospira?

A

Treponema - transverse fission
Borrelia + Leptospira - binary fission

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4
Q

Describe the difference in “spirochete shape” between the 3 spirochetes discussed.

A

Leptospira - many tight coils with one or both ends being hooked
Borrelia - thicker with fewer and loose coils
Treponema - in between ^ with straight ends

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5
Q

What specimen types can be observed by WHICH type of microscopy of the Leptospira sp.?

A

Urine, Blood, CSF by darkfield or fluorescence microscopy

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6
Q

Virulence mechanisms of Leptospira

A

Reduced phagocytosis
Hemolysin production by some strains
Endotoxins

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7
Q

How is Leptospira typically spread from animals to humans?

A

Through urine of infected animals (usually rodents) and humans ingest contaminated food/water or swim in infected water

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8
Q

What media should be inoculated for optimal recovery of Leptospira?

A

EMJH or Fletcher’s medium

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9
Q

What tick is associated with Lyme disease?

A

Western black-legged deer tick (Ixodes, hard tick)

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10
Q

What tick is associated with Rocky Mountain Spotted Fever?

A

Brown dog tick

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11
Q

Which spirochetes readily uptake stain and can be visualized with a gram stain or Wright-Giemsa stain, unlike other spirochetes?

A

Borrelia

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12
Q

What spirochete is grown using Kelly medium?

A

Borrelia

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13
Q

Borrelia spp. causes 2 main diseases, which are?

A
  1. Lyme disease
  2. Relapsing fever
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14
Q

Louse-borne relapsing fever is caused by what?

A

Borrelia recurrentis

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15
Q

Hard tick-borne relapsing fever is caused by what?

A

Borrelia miyamotoi

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16
Q

Soft tick-borne relapsing fever is caused by what?

A

Borrelia hermsii

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17
Q

Lyme disease is caused by what?

A

Borrelia burgdorferi

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18
Q

Relapsing fever (B. recurrentis) S&S

A

Reoccurring high-grade fevers associated with rigors and muscle spasms, abruptly ends with humoral response and reoccurs weeks later again and again

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19
Q

Endemic relapsing fever vs epidemic relapsing fever

A

Endemic - tick borne (B. hermsii) - Ornithodorus
Epidemic - louse borne (B. recurrentis) - Pediculus humanus

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20
Q

What louse spreads B. recurrentis causing relapsing fever?

A

Pediculus humanus

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21
Q

Drug of choice for treatment of B. recurrentis

A

Tetracycline

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22
Q

What is Jarisch-Herxheimer reactions?

A

fever, chills, headache, and myalgia due to B. recurrentis release of endotoxin

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23
Q

Clinical S&S of Lyme disease

A

Bulls-eye rash at site of tick bite (stage 1)
Bone/joint pain and fatigue (stage 2)
Chronic neurological/cardiac involvement with memory loss, arthritis (stage 3)
Only move to higher stages if disease goes untreated.

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24
Q

Virulence + pathogenicity of B. burgdorferi

A

B. burgdorferi binds plasminogen and urokinase plasminogen activators to its surface

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25
Q

Do we need to know western blotting for B. burgdorferi??

A
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26
Q

What is the first test performed for B. burgdorferi?

A

IFA or EIA
If positive and S&S >30 days: IgG western blot
If positive and S&S <30 days: IgG and IgM western blot

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27
Q

Treatment for Borrelia burgdorferi in early stages of disease

A

Doxycycline + amoxicillin (synergy)

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28
Q

Treatment for Borrelia burgdorferi in chronic stages of disease

A

Ceftriaxone

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29
Q

What does T. pallidum pallidum cause?

A

Syphilis

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30
Q

What does T. pallidum pertenue cause?

A

yaws

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31
Q

What does T. pallidum endemicum cause?

A

Bejel aka endemic syphilis

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32
Q

What does T. carateum cause?

A

Pinta

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33
Q

T. pallidum pathogenicity and virulence

A
  • Can cross mucous membranes and placenta
  • Can disseminate to any organ
  • Antigenic variation makes humoral response chronic
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34
Q

Differentiate between the 3 stages of syphilis

A

Stage 1: Localized chancre
Stage 2: Generalized prodromal illness with rashes on hands/feet
Stage 3: No longer contagious unless relapse, 66% develop gummas on skin/organs, and 33% spontaneously cure

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35
Q

S&S of congenital syphilis

A

Hutchinson’s sign on teeth
CNS damage
Hepatosplenomegaly
Anemia
Mucocutaneous lesions
Osteochondritis

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36
Q

Why should oral lesions for Syphilis testing be treated with care?

A

Treponema can be normal oral flora, so may not always be T. pallidum

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37
Q

Most commonly used diagnostic method for T. pallidum

A

Serology testing
Non treponemal - RPR/VDRL flocculation reactions
Treponemal - TP-PA, EIA

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38
Q

Treponemal vs non-treponemal testing

A

Treponemal testing is for confirmatory testing (IFA, Trep antibody)
Non-treponemal testing is for screening (RPR)

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39
Q

What is the principle behind the RPR/VDRL test?

A

Detects Reagin directed against cardiolipin
VDRL can use serum or CSF
RPR uses serum only and uses charcoal particles

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40
Q

drug of choice for treatment of Syphilis

A

Penicillin

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41
Q

S&S of Yaws and what Treponema causes this?

A

Granulomatous nodules in skin with gangosa, soft/hard palate/nasal infection, erodes bone/cartilage/soft tissue in face
Caused by T. pallidum pertenue

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42
Q

S&S of Pinta and what Treponema causes this?

A

Skin papules leading to skin de-pigmentation
Caused by T. carateum

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43
Q

What is the main sexually transmitted Treponema?

A

T. pallidum pallidum

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44
Q

Differentiate the elemental body shapes of C. trachomatis, C. pneumoniae, and C. psitacci

A

C. trachomatis: round
C. pneumoniae: pear
C. psitacci: round

45
Q

what are the natural hosts of C. trachomatis, C. pneumoniae, and C. psitacci?

A

C. trachomatis: humans
C. pneumoniae: humans
C. psitacci: birds

46
Q

Which of the following have glycogen inclusions: C. trachomatis, C. pneumoniae, or C. psitacci

A

C. trachomatis

47
Q

Which of the following are susceptible to sulfa drugs: C. trachomatis, C. pneumoniae, or C. psitacci

A

C. trachomatis

48
Q

Which is the infective form and which is the non-infective form? (Elemental bodies and reticulate/inclusion bodies)

A

Elementary bodies: infective form
Reticulate/inclusion bodies: non-infective form

49
Q

Describe the unique growth cycle of Chlamydia

A

Elementary bodies infect host cell through phagocytosis or endocytosis
Intracellular replication to increase size and form –> reticulate bodies
Continued multiplication and reorganization into elementary bodies
Elementary bodies released from infected cell and cell dies
Cycle repeats, elementary bodies go on to infect more and more cells

50
Q

What serovariants of Chlamydia are associated with severe eye infections?

51
Q

What serovariants of Chlamydia are associated with conjunctivitis?

A

D/E/F/G/H/I/J/K

52
Q

What serovariants of Chlamydia are associated with STDs?

53
Q

T/F: Chlamydia is the most common STD.

54
Q

Signs of Chlamydia transmitted to newborn

A
  • Can only come from vaginal birth
    Swollen eyelids with yellow discharge
    Pneumonia, conjunctivitis, nasopharyngeal infections
55
Q

Ideal Chlamydial specimen

A

Will contain epithelial cells and NOT exudative fluid
First morning urines and vaginal swabs

56
Q

Ideal collection for Chlamydial specimen (also what is NOT acceptable)

A

Ideal collection = rayon/dacron/cytobrush tip
Not acceptable = calcium alginate, cotton, wooden shaft
This is bc PCR is most common form of Chlamydia testing.

57
Q

What type of testing is recommended for NEWBORN chlamydia testing?

A

Direct microscopic examination (95% sensitivity)

58
Q

What was the gold standard for Chlamydia testing before PCR?

A

Cell culture; not used anymore

59
Q

What cell culture media can Chlamydia grow on, although not performed anymore?

A

Buffalo green monkey kidney
McCoy
HEp-2
HeLa

60
Q

What is MOMP?

A

Major outer membrane protein, part of infectious elementary bodies

61
Q

What is the gold standard for Chlamydia testing? What is it testing for? What specimens are acceptable for this method?

A

PCR testing; tests for rRNA of C. trachomatis
Acceptable = endocervical swabs of women, urethral swabs in men, and urine from both sexes

62
Q

Which method of Chlamydia testing is useful for screening very large volume specimens?

A

Immunoassays (using blood, detecting antigen against LPS/MOMP) not as common

63
Q

Treatment of LGV C. trachomatis (STD)

A

Doxycycline or erythromycin

64
Q

Treatment of conjunctivitis C. trachomatis

A

Azithromycin or tetracycline

65
Q

What does C. pneumoniae cause?

A

Pneumonia or respiratory-like illness (pretty self explanatory)

66
Q

Treatment for c. pneumoniae

A

Macrolides (Azithromycin or erythromycin)

67
Q

Gold standard specimens/testing for C. pneumoniae

A

Serology
Any respiratory related specimen

68
Q

What to associate C. psittaci with?

A

BIRDS - pneumonia-like illness
very rare.

69
Q

Treatment for c. psittaci

A

Tetracycline

70
Q

What genus are included in the family anaplasmataceae?

A

anaplasma
ehrlichia

71
Q

What genus are included in the family Rickettsiaceae?

A

Rickettsia
Orientia
(Coxiella was removed)

72
Q

Rickettsia Typhus group

A

R. prowazekii
R. typhi

73
Q

Rickettsia Spotted Fever group

A

R. rickettsia

74
Q

ID50 for Rickettsia sp.

A

LOW (less of the organism needed to infect)

75
Q

Eastern vs Western US vector for Rocky Mountain Spotted Fever

A

Eastern: american dog tick (Dermacentor variabilis)
Western: Rocky mountain wood tick (Dermacentor andersoni)

76
Q

What is the most severe form of Rickettsial infection?

A

Rocky Mountain Spotted Fever

77
Q

correlated lab values to rocky mountain spotted fever

A

Thrombocytopenia
DIC
Hyponatremia
Elevated liver enzymes

78
Q

Treatment for rocky mountain spotted fever

A

Doxycycline

79
Q

T/F: Rickettsia will grow on routine media

80
Q

What is Brill-Zinsser Disease/Epidemic Typhus and what is it caused by?

A

Caused by R. prowazekii
Louse-borne typhus (Pediculus humanus corporis)
Brill-Zinsser is a rare complication of Epidemic Typhus

81
Q

Causative agent of Murine Typhus (Vector + bacteria)

A

Vector = flea (Xenopsylla cheopsis)
Bacteria = R. typhi

82
Q

What is the causative agent of Scrub Typhus? (vector + bacteria)

A

Scrub Typhus AKA Bush Typhus
Vector = infected chiggers
Bacteria = Orientia tsutsugamushi

83
Q

S&S of Scrub Typhus

A

ESCHAR formation**

84
Q

What BS level is required for Rickettsial organisms if cultured?

85
Q

Samples of choice for Rickettsia

86
Q

The Weli-Felix test is a non-specific agglutination test for Rickettsia against Proteus sp.
- What strain of Proteus does Orientia tsutsugamushi react with?

A

Proteus mirabilis OXK

87
Q

The Weli-Felix test is a non-specific agglutination test for Rickettsia against Proteus sp.
- What strain of Proteus does the Typhus group (R. prowazekii and R. typhi) react with?

A

Proteus vulgaris OX19

88
Q

The Weli-Felix test is a non-specific agglutination test for Rickettsia against Proteus sp.
- What strain of Proteus does Spotted Fever Group (R. rickettsia) react with?

A

Proteus vulgaris OX2 and OX19

89
Q

Where does Ehrlichia multiply inside vs Chlamydia or Rickettsia?

A

Chlamydia and Rickettsia = cytoplasm

Ehrlichia = phagosomes and phagolysosomes

90
Q

Lone star tick genus and species

A

Amblyomma americanum

91
Q

Black legged tick genus and species

A

Ixodes scapularis

92
Q

What does E. chaffeensis cause?

A

Human monocytic ehrlichiosis

93
Q

Natural reservoir of Ehrlichia

94
Q

Ehrlichiosis late vs early disease sign and symptoms

A

Early: acute febrile illness, fever, headache, myalgia, GI issues, rash

Late: renal failure, hepatic failure, toxic shock, coagulopathies, ARDS, meningitis

95
Q

Ehrlichia infects __________.
Anaplasma infects _________.

A

Monocytes
Granulocytes

96
Q

CBC of someone with Ehrlichia would look like?

A

Leukopenia
Thrombocytopenia
Elevated liver enzymes
Anemia

97
Q

Where is Anaplasma most prevalent and what does it cause? Vector?

A

Most prevalent in upper Midwest and Northeast USA
Causes HGA
Vector = Ixodes scapularis and Ixodes pacificus

98
Q

Anaplasma may be spread by ________ __________.

A

Blood transfusions

99
Q

What species causes Q fever?

A

Coxiella burnetti

100
Q

Characteristics of Coxiella?

A

SPORE FORMING
intracellular pathogen
triggered by acidic environment

101
Q

What disease that we talked about is considered a bioterrorism agent?

A

C. burnetti causing Q fever

102
Q

Reservoir of C. burnetti

A

Goats/sheep/cattle
Spread by dairy products
ASSOCIATE WITH FARMER/LIVESTOCK

103
Q

What is the most commonly sexually transmitted bacterial pathogen?

A

Chlamydia trachomatis

104
Q

What strains of C. trachomatis are more invasive, producing a more serious infection and pronounced antibody response?

A

LGV strains

105
Q

______ are better assays for the diagnosis of C. trachomatis infections compared with cultures.

106
Q

C. __________ is a relatively common respiratory tract pathogen considered responsible for many cases of community-acquired pneumonia.

A

pneumoniae

107
Q

_____________ is the cause of psittacosis, aka parrot fever or ornithosis. This bacterium produces lower respiratory tract infections in humans.

A

C. psittaci

108
Q

Ehrlichia and Anaplasma are intracellular parasites of WBCs – ____________, and ___________, respectively.

A

mononuclear cells and granulocytes

Microbiology (24 decks)

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