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Microbiology > Basic Bacteriology And mycology > Flashcards

Basic Bacteriology And mycology Flashcards

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1
Q

Name structures and specialized structure of bacterias

A

Flagellum/ pilus fimbria and spore

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2
Q

What is the chemical composition and function of flagellum

A

Proteins/motility

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3
Q

What is the chemical composition and function of pilus or fimbria

A

Glycoprotein and they mediate adherence of bacteria to cell surface sex pilus forms during conjugation

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4
Q

Chemical composition and function of spores

A

Keratin like coat dipicolinic acid, peptidoglycan, DNA. Gram + only survival resiste dehydration heat chemicals

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5
Q

What are the structures of cell envelope chemical composition

A

Discrete layer usually made of polysaccharide (and rarely proteins)

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6
Q

What is the function of the capsule

A

Protects against phagocytosis

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7
Q

What is the chemical composition of slime layer and their function

A

Loose network of polysaccharides and they mediates adherence to surface, plays a role in biofilm formation

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8
Q

What is the chemical composition of outer membrane

A

Outer leaflet contains endotoxin (LPS/LOS).
Embedded proteins: porins and other outer membrane proteins (OMPs)
Inner leaflet: phospholipids

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9
Q

What are the outer membrane and what is their function

A

Gram negative only. Endotoxin: lipid A induces TNF and IL-1; antigenic O polysaccharide component. Most OMPs are antigenic. Porins: transport across outer membrane

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10
Q

Space between cytoplasmic membrane and outer membrane in gram negative bacteria peptidoglycan in middle is

A

Periplasm

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11
Q

What is the function of periplasm

A

Accumulates components exiting gram negative cells, including hydro lyric enzymes (eg beta lactamases)

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12
Q

What is the chemical composition of cell wall and their function

A

Peptidoglycan is a sugar backbone with peptide side chains cross linked by transpeptidase. Function: netlike structure gives rigid support, protects against osmotic pressure damage

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13
Q

Is a phospholipid bilayer sac with embedded proteins (penicillin binding proteins PBPs) and other enzymes

A

Cytoplasmic membrane

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14
Q

Where is lipoteichoic acids and where do they extended itself

A

Gram positive and extend from membrane to exterior

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15
Q

What is the function of cytoplasmic membrane

A

Site of oxidative and transport enzymes; PBPs involves in cell wall synthesis.

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16
Q

What does lipoteichoic acid do

A

Induce TNF Alfa and IL-1

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17
Q

What structure are unique of gram positive bacteria

A

Lipoteichoic acid

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18
Q

What are the structures common to both

A

Flagellum
Pilus
Capsule
Cell wall
Peptidoglycan
Cytoplasmic membrane

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19
Q

What are the structures unique to gram negative

A

Endotoxin LPS Poron that composes outer membrane. And wide periplasmic space containing Beta lactamase

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20
Q

Is the first lab test in bacterial identification. Bacteria with thick peptiglycan layer retain crystal violet dye en who are positive to this stain and bacteria’s who has thin peptidoglycan layer turn red or pink (they are negative) with counterstain

A

Gram stain

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21
Q

These Little Microbes May Unfortunately Lack Real Color But Are Everywhere (gram negative bacteria’s)

A

Treponema m, leptospira, mycobacteria, mycoplasma, ureaplasma, Legionella, Ricketsia, Chlamydia, Bartonella, Anaplasm, Ehrlichia

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22
Q

Why treponema and leptospira are gram negative bacteria’s

A

Because they have too thin peptidoglycan layer to be visualized

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23
Q

Why mycobacteria is gram negative

A

Because cell wall has high lipid content

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24
Q

Why mycoplasma and ureaplasma are gram negative

A

They don have cell wall

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25
Q

Why legionella, rickettsia, chlamydia, bartonella, ana plasma and ehrlichia are gram negative

A

Because they are primarily intracelular; also chlamydia lack classic peptidoglycan because of decrease it muramic acid

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26
Q

what are the bacteria’s which have giemsa stain positive (CLuMsy Rick TRiPped on a BORRowed HELICOpter PLAStered in GEMS)

A

chlamydia, rickettsia, trypanosomes, borrelia helicobacter pylori plasmodium

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27
Q

What stain periodic acid schiff stain and mention one stain bacterial use

A

Stain glycogen, mucopolysaccharides it can be use to diagnose Whipple disease causes by tropheryma whipplei

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28
Q

Uses of Ziegler Nelson stain also called carbon fuchsin

A

It is usefully to identify acid fast bacteria eg. Mycobacteria, Nocardia; stains mycolic acid un cell wall, Protozoa (eg cryptosporidiumboocysts)

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29
Q

Alternative stain to Ziehl-Neelsen stain (carbon fuchsin) that is more often used for screening (inexpensive more sensitive)

A

Auramine rhodamine stain

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30
Q

Uses for India ink stain

A

Cryptococcus neoformans; mucicarmine can also be used to stain thick polysaccharide capsule red

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31
Q

Uses of silver stain HELiCOPters Are silver)

A

Helicobacter pylori, legionella, bartonella henselae, and fungi (eg Coccidioides, pneumocystis jorovecii, aspergillus fumigatus)

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32
Q

Used to identify many bacteria, viruses, pneumocystis jirovecii, giardia and cryptosporidium

A

Fluorescent antibody stain

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33
Q

Give an example of fluorescent antibody stain

A

FTA-ABS for syphilis

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34
Q

What is the media used to isolation H. Influenzae and what does it contain

A

Chocolate agar, factors V (NAD+) and X (hematin)

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35
Q

To what bacteria’s is the Thayer Martin agar

A

N gonorrhoeae and N meningitidis

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36
Q

What does media Thayer Martin agar contain Very Typically Cultures Neisseria

A

Selectively favors growth of Neisseria by inhibiting growth of gram positive organism with vancomycin, gram negative organism except Neisseria with trimethoprim and colisión and fungi nystatin

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37
Q

What are the media for isolation Bordetella pertussis

A

Border Gengou agar and regan lowe medium

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38
Q

What do medium bordet gengou agar and regan lowe medium

A

Potato extract/ charcoal, blood and antibiotic

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39
Q

What is the name of media to isolation c diphtheriae

A

Tellurite agar, Loffler medium

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40
Q

What are the media to isolation M tuberculosis

A

Löwenstein-Jensen medium, middlebrook medium, rapid automated broth cultures

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41
Q

For what bacteria is the Eaton agar

A

M pneumoniae

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42
Q

What does Eaton agar M pneumoniae require

A

It require cholesterol

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43
Q

For what kind of bugs is use MacConkey agar

A

Lactose fermenting enterics

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44
Q

What does the McConckey agar do

A

Fermentation produces acid, causing colonies to turn pink

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45
Q

What is the name of media to isolation E. coli and please mention a characteristic of this media

A

Eosin methylene blue (EMB) agar. Colonies with green metallic sheen

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46
Q

What are the bugs which grow up in charcoal yeast extract agar buffered with cysteine and iron (the ella siblings, BRUCE, FRANCIS, a LEGIONnaire and a PASTEUR built the Sistine (cysteine) chapel out of charcoal and iron

A

Brucella, Francisella, Legionella, Pasteurella

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47
Q

What is the media for isolation fungi

A

Sabouraud agar

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48
Q

Give examples of anaerobes bacteria’s (anaerobes Can’t Breathe Fresh Air)

A

Clostridium, bacteroides, fusobacterium, and Actinomyces Israelii

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49
Q

Describes the characteristics of anaerobes bacteria’s

A

They lack catalase and or superoxide dismutase and are thus susceptible to oxidative damage. Generally foul smelling (short chain fatty acids) are difficult to culture and produce gas in tissue (CO2 and H2)

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50
Q

What does the aminO2glycosides are ineffective against anaerobes

A

Because these antibiotics require O2 to enter into bacterial cell

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51
Q

This kind of bacteria’s may use O2 as a terminal electron acceptor to generate ATP, but can also use fermentation and other O2 independent pathways

A

Facultative anaerobes

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52
Q

Name the facultative anaerobes examples

A

Streptococci, staphylococci and enteric gram negative bacteria

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53
Q

What kind of intracelular bacteria exists

A

Obligate intracelular and facultative intracellular

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54
Q

What are the obligate intracelular bacteria’s (stay inside cells when it is Really Chilly and Cold

A

Ricketssia, Chlamydia and Coxiella

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55
Q

Name the facultative intracellular (Sone Nasty Bugs May Live FacultativeLY)

A

Salmonella Neisseria brucella mycobacterium listeria francisella legionella Yersinia pestis

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56
Q

Name the encapsulated bacteria’s (Please SHINE my SKiS)

A

Pseudomonas aeruginosa, streptococcus pneumoniae Haemophulis influenzae type B, Neisseria meningitidis, E. coli, salmonella, klebsiella pneumoniae and group B Strep

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57
Q

Who opsonized the encapsulated bacteria’s

A

Spleen

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58
Q

What happens in the asplenics people (No Spleen Here)

A

They have less opsonized h ability and thus increase risk for severe Infections and need vaccines to protect against: N meningitidis S pneumoniae H influenzae

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59
Q

What are the uses of bacterial capsule

A

Capsules serve as an anti phagocytic virulence factor. Capsular polysaccharide +/- protein conjugate can serve as an antigen in vaccine. A polusaccharide antigen alone cannot be presented to T cells; immunogenicity can be enhanced by conjugating capsule antigens to a carrier protein

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60
Q

Why are the urease positive organism (Pee CHUNKSS)

A

Proteja, cryptococcus, H pylori, ureaplasma, Nocardia, klebsiella, S epidermjdis, S saprophyticus.

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61
Q

How bacterial urease works

A

Urease hydrolysis urea to release ammonia and CO2 increase pH. Predisposes to struvite (magnesium ammonium phosphate) stones particularly proteus

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62
Q

How works catalase positive organism

A

Catalase degrades H2O2 into H2O and bubbles of O2 before it can be converted to microbicidal products by the enzyme meyloperoxidase.

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63
Q

What kind of people have recurrent infections with certain catalase positive organism

A

Who have chronic granulomatous disease (NADPH oxidase deficiency)

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64
Q

Name the catalase positive organism Cats Have BeeN to PLACESS

A

Bordetella pertussis, Helicobacter pylori, Burkholderia cepacia, Nocardia, pseudomonas, Listeria, Aspergillus, Candida, E. coli, Serratia, Staphylococcci

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65
Q

What are the pigment producing bacteria

A

Actinomyces israelii (yellow sulfur granules) which are composed of filaments of bacteria m.
S aureus golden yellow pigment
P aeriginosa bluee green pigment (pyocyanin and pyoverdin)
Serratia marceacens red pigment

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66
Q

What are the bacteria’s who in vivo biofilm producing bacteria

A

S epidermidis, viridans streptococci (S mutans, S sanguinis), P aureginosa and nontypeable (unencapsulated) H influenzae

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67
Q

In what kind of biofilm growth a epidermidis

A

Catheter and prosthetic device infections

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68
Q

In what kind of biofilm there is Viridans streptococci (s mutans and S sanguinis)

A

Dental plaques, infective endocarditis

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69
Q

In what kind of biofilm it produce pseudomonas aureginosa

A

Respiratory three colonization in patients with cystic fibrosis, ventilator associated pneumoniae, contact lens associated keratitis

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70
Q

In what kind of biofilm it is produce nontypeable (unencapsulated) H influenzae

A

Otitis media

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71
Q

They are gram positive bacteria Can form spores when nutrientes are limited

A

Spore forming bacteria

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72
Q

How are the spores

A

They are lack of metabolic activity and are highly resistant to heat and chemicals. Core contains dipicolinic acid

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73
Q

Why the spores are heat resistant

A

By their core contains dipicolinic acid responsible for heat resistance

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74
Q

How the spores can died

A

Autoclave bye ateaminb121celcius grade for 15 minutes. Hydrogen peroxide and iodine based agents ara also sporicidal

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75
Q

Give examples of spore forming bacteria

A

B anthracis (anthrax), B cereus (food poisoning), C botulinum (botulism) C difficult (pseudo membranous colitis) C perfringens (as gangrene) C tetani (tetanus).

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76
Q

Is the characteristic which promote evasion of host immune response

A

Bacterial virulence factors

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77
Q

Name the bacterial virulence factors

A

Capsular polysaccharide, Protein A, IgA protease, M protein

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78
Q

Higlhy charged, hydrophilic structure, Acts as barrier to phagocytosis and complement mediated lysis. Major determinant of virulence

A

Capsular polysaccharide

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79
Q

Binds Fc region of IgG prevents opsonization and phagocytosis. Expressed by S aureus

A

Protein A

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80
Q

What is IgA protease

A

Enzyme that cleaves IgA, allowing bacteria to adhere to and colonize mucous membranes. Secreted by S pneumoniae, H influenzae type b, and Neisseria

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81
Q

Who secreted IgA protease SHiN

A

S pneumoniae H influenzae type b and Neisseria

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82
Q

Helps prevent phagocytosis. Expressed by group A streptococci. Sequence homology with human cardiac myosin (Molecular Mimicry) possible underlies the autoimmune responses seen in acute rheumatic fever

A

M protein

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83
Q

Bacterial genetics processes

A

Transformation, conjugation, transduction, transposition

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84
Q

Competent bacteria can bind and import short pieces of environmental naked bacterial chromosomal DNA (from bacterial cell lysis). The transfer and expression of newly transferred genes is called ?

A

Transformation

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85
Q

What bacterias specially has transformation SHiN

A

S pneumoniae, H influenzae type b, and Neisseria

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86
Q

What preventing transformation ?

A

Adding deoxyribonuclease degrades naked DNA

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87
Q

Types of conjugation

A

F+ x F - and Hfr x F-

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88
Q

F+ plasmid contains genes required for sex pilus and conjugation. Bacteria without this plasmid are termed F-

A

F+XF-

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89
Q

What is mating bridge

A

A single strand of plasmid DNA is transferred across the conjugal bridge that is call mating bridge. No transfer of chromosomal DNA

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90
Q

HfrXF-

A

F+ plasmid can become incorporated into bacterial DNA termed high-frequency recombination (Hfr) cell. High frequency recombination may integrate some of those bacterial genes. Recipient cell remains F - but now may have new bacterial genes

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91
Q

What types of transduction exits

A

Generalized and specialized

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92
Q

A packing error. Lytic phage infects bacterium, leading to cleavage of bacterial DNA. Parts of bacterial chromosomal DNA may become packaged in phage capsid. Phage infects another bacterium transferring these genes

A

Transduction generalized

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93
Q

An excision event. Lysogenic phage infects bacterium; viral DNA incorporates into bacterial chromosome. When phage DNA is excised flanking bacterial genes may be excised with it. DNA is packaged into phage capsid and can infect another bacterium

A

Specialized transduction

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94
Q

Genes for the following 5 bacterial toxins are encoded in a lysogenic phage (ABCD’S)

A

Group A strep erythrogenic toxin, B botulinum toxin, Cholera toxin, Diphteria toxin, Shiga toxin

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95
Q

A jumping process involving a transposon (specialized segment of DNA) which can copy and excise itself and then insert into the same DNA (eg plasmid or chromosome)

A

Transposition

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96
Q

Give and example of transposition

A

Critical in creating plasmids with multiple drug resistance and transfer across species lines eg. Tn 1546 with vanA from Enterococcus to S aureus

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97
Q

Describe characteristics (source, secreted from cell, chemistry, location of genes and toxicity) of exotoxins

A

Source: certain species of gram + and gram negative bacteria, they are secreted from cell, their chemistry is polypeptide, the location of genes are plasmid or bacteriophage, their toxicity is high (fatal dose on the order of 1 microgramo)

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98
Q

Name the clinical effects, mode of action, antigenicity, vaccines, heats stability and typical disease of exotoxins

A

Various effects, various modes, induces high titer antibodies called antitoxins, toxoid a used as vaccines, destroyed rapidly at 60 Celsius grade (except staphylococcal enterotoxin and E. coli heat stable toxin). Typical diseases tetanus botulism diphtheria cholera

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99
Q

Endotoxin source, secreted from cell, chemistry, location of genes and toxicity:

A

Source: Outer cell membrane of most gram negative bacteria, secreted from cell: No, Chemistry: lipid A component of LPS (structural part of bacteria; released when lysed). Location of genes: bacterial chromosome. Toxicity Low (fatal dose on the order of hundreds of micrograms)

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100
Q

Clinical effects, mode of action, antigenicity, vaccines, heat stability, typical diseases

A

1.Fever, Shock (hypotension), DIC
2. Induces TNF, IL-1 and IL-6
3. Poorly antigenic
4. Stable at 100 C for 1 h
5. Neningococcemia; sepsis by gram negative rods

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101
Q

Name the 14 bacterias with exotoxins

A

Corynebacterium diphtheriae, pseudomonas aureginosa, shigella spp, enterohemorrhahic E. coli, enterotoxigenic E. coli, bacillus anthracis, vibrio cholerae, bordetella pertussis, clostridium tetani, clostridium botulinum. Clostridium perfringens, streptococcus pyogenes and staphylococcus aureus

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102
Q

Bacteria with exotoxins which inhibit protein synthesis

A

Corynebacterium diphtheriae, pseudomonas aeruginosa, shigella spp, entero hemorrhagic E. coli

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103
Q

What is the toxin and mechanism of corynebacterium diphtheriae

A

Diphtheria toxin. Inactivate elongation factor (EF-2) through ADP rybosylation

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104
Q

Manifestation of corynebacterium diphtheriae

A

Pharyngitis with pseudo membranes in throat and severe lymphadenopathy (bull neck) myocarditis

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105
Q

What is the toxin, mechanism and manifestation of pseudomonas aeruginosa

A

Exotoxin A, inactivate elongation factor (EF-2) through ADP ribosylation. Host cell death

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106
Q

What is the shared toxin mechanism and manifestation of shigella spp, enterohemorrhagic E. coli

A

Shiga toxin. Inactivate 60S ribosome by removing adenine from rRNA. Damage GI mucosa causing dysentery enhances cytokine release hemolytic uremic syndrome (HUS; prototypically in EHEC serotype O157:H7)

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107
Q

What is the difference between shigella spp and enterohemorrhagic e Coli

A

EHEC does not invade host cells unlike shigella

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108
Q

What are the bacteria’s with exotoxins which increase fluid secretion

A

Enterotoxigenic E. coli, bacillus anthracis, vibrio cholerae

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109
Q

What are the two toxins of enterotoxigenic E. coli

A

Heat labile toxin (LT) and heat stable toxin (ST)

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110
Q

What is the mechanism and manifestation of enterotoxigenic E. Coli heat labile toxin LT

A

Overactivates adenylate Cyclase (increase cAMP) that conducts to cloró secretion in gut and H2O efflux causing watery diarrhea

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111
Q

What are the mechanism and bacteria’s (CAPE) which share this mechanism of heat stable toxin of enterotoxigenic E. coli

A

Overactivates guanylate Cyclase (increase cGMP) causing decrease resorption of NaCl and HO2 in gut, cholera, anthracis, pertussis, E. Coli (increase cAMP)

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112
Q

Toxins, mechanism of action and manifestation of bacillus anthracis

A

Anthrax toxin mimics adenylate Cyclase (increase cAMP) likely responsible characteristics edematous borders of black eschar in cutáneos anthrax

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113
Q

Toxin, mechanism and manifestations of cholerae toxin

A

Overactivates adrnylate Cyclades (increase cAMP) by permanently activating Gs. Voluminous rice water diarrhea

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114
Q

Bacteria with exotoxins which inhibit phagocytosis ability

A

Bordetella pertussis

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115
Q

Toxin and mechanism of bordetella pertussis

A

Pertussis toxin activates adenylate cyclase (increase cAMP) by inactivating inhibitors subunit G I

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116
Q

Manifestations of bordetella pertussis

A

Whooping cough: child coughs on expiration and whoops on inspiration, can cause 100 day cough in adults associated with posttuauve emesis

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117
Q

Bacteria’s with toxins who inhibit release of neurotransmitter

A

Clostridium tetani and clostridium botulinum

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118
Q

What are the toxins and shared mechanism of clostridium tetani and botulinum

A

Tetani spasm in and botulinum toxin
Both are protests that cleave SNARE (soluble NSF attachment protein receptor) a set of protein requires for neurotransmitter release via vesicular fusion

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119
Q

Manifestation of clostridium tetani

A

Toxin prevents release inhibitory (GABA and glycine) neurotransmitter from renshaw cell in spinal cord results in spastic paralysis tissue sardonicus trismus (lockjaw) opisthotonos

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120
Q

Manifestations of clostridium botulinum

A

Infant botulism caused by ingestion of spores (from soil, raw honey) toxin produced in vivo. Foodborne botulism caused by ingestion of preformed toxin ( from canned foods)

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121
Q

What are the bacteria’s with exotoxins which puse cell membranes

A

Clostridium perfringens and streptococcus pyogenes

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122
Q

What are the bacteria’s with toxins which has superantigens causing shock

A

Staphylococcus aureus and streptococcus pyogenes

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123
Q

What is the toxin and mechanism of clostridium perfringens

A

Alpha toxin. Phospholipase (lecithinase ) that degrades tissue and cell membranes

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124
Q

Manifestations of clostridium perfringens

A

Degradation of phospholipids causes myonecrosis (gas gangrene) and hemolysis (doble zone of hemolysis on blood agar)

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125
Q

What is the name of streptococcus pyogenes that muse cell membranes and how is it mechanism

A

Streptolysin O. Protein that degrades cell membrane.

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126
Q

Manifestation of streptolysin O of streptococcus pyogenes

A

Lyses RBC contributes to beta hemolysis host antibodies against toxin ASO used to diagnose rheumatic fever (do not confuse with immune complexes of poststreptococcal glomerulonephritis)

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127
Q

What is the toxin of staphylococcus and how it’s works

A

Toxic shock syndrome toxin (TSST-1) cross links B region of TCR to MHC class II on APCs outside of the antigen binding site conducts ton overwhelming release of IL-1, IL-2, IFN gamma and TNG Alfa conducts to shock.

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128
Q

How are the manifestation of staphylococcus aureus

A

Toxic shock syndrome: fever, rash, shock; other toxins cause scalded skin syndrome (exfoliating toxin) and food poisoning (heat stable enterotoxin)

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129
Q

What are the manifestations of endotoxins ENDOTOXINS

A

Edema, nitric oxide, DIC/Death, Outer membrane, TNF Alfa, O antigen + core polysaccharide + lipid A, eXtremely heat stable IL-1 and IL-6 Neutrophil chemotaxis Shock

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130
Q

Composition of endotoxin

A

LPS found in outer membrane of gram negative bacteria (both occurs and rods). Composed of O antigen + core polysaccharide + lipid A (the toxic component). Neisseria have lipooligosaccharide. Released upon cell lysis or by living cells by blebs detaching from outer surface membrane

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131
Q

Name three main effects of endotoxin

A

Macrophage activation (TLR4 CD14 ) complement activation and tissue factor activation

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132
Q

What does the macrophage activation (TLR4/CD14) of endotoxin do?

A

Deliver IL-1, IL-6 which cause fever TNF Alfa which cause fever and hypotension and nitric oxide which cause hypotension.

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133
Q

What does complement activation of endotoxin and their lipid A component do ?

A

It active C3a which cause histamine release: hypotension and edema and C5a which cause neutrophil chemotaxis.

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134
Q

What does Tissue factor activation of endotoxin (an their lipid A component) do?

A

Ig axtivates coagulation cascade and causes DIC

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135
Q

How is the division of gram + bacteria’s regarding gram positive lab algorithm

A

By their shape: Bacili, cocci and branching filaments

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136
Q

How does bacilli and branching filaments gram positive bacteria are divided

A

Between aerobic, anaerobic

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137
Q

How does cocci gram + bacteria are divided ?

A

Catalase negative and positive

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138
Q

What are the bacilli aerobic ? And what are the bacili anaerobic ?

A

Listeria bacillus corynebacterium/ clostridium cutibacterium (formely propionibacterium)

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139
Q

What are the aerobic branching filaments gram + bacteria’s and anaerobic

A

Nocardia (weakly acid fast) / anaerobic: actinomyces ( not acid fast)

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140
Q

What are the gram positive cocci which are catalase negative and how is their subsequent classification by hemólisis

A

Streptococcus/ Alfa hemolytic, Beta hemolytic and gamma which are not hemolytic

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141
Q

How are the Alfa hemolytic streptococcus and how are they divided

A

They are partial hemolysis green organism and they are divided by optochin sensitivity and bile solubility

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142
Q

Who are the streptococcus Alfa hemolytic optochin sensitivity and bile solubility negative

A

Viridiana streptococci (no capsule) S mutans and S mitis

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143
Q

Who are the Alfa hemolytic streptococcus optochin sensitivity and bile solubility positive

A

S pneumoniae (encapsulated)

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144
Q

How are the beta hemolytic streptococcus and how does it is divided

A

They do complete hemolysis that is clear (no green) and they are divided by bacitracin sensitivity and PYR status

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145
Q

Who are the bacitracin sensitivity and PYR negative beta hemolytic streptococcus

A

Group B S agalactiae

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146
Q

Who is the beta hemolytic streptococcus bacitracin sensitivity and PYR positive

A

Group A S pyogenes

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147
Q

What are the gamma (no hemolysis grows in bile ) streptococcus and how are they divided

A

They are: non enterococcus S gallolyticus who is negative to growth in 6.5% NaCl and PYR status and enterococcus E. Faecium and E. Faecalis who are positive to growth in 6.5% NaCl and PYR status

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148
Q

Who is the gram + cocci that is catalase positive and how is he divided

A

Staphylococcus coagulase negative and positive

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149
Q

How is coagulase negative divided

A

By novobiocin sensitivity

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150
Q

Who is the staphylococcus coagulase negative nonsensitive novobiocin and novobiocin sensitivity positive

A

S saprophyticus / s epidermis respectively

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151
Q

What is PYR

A

Pyrrolidonyl aminopeptidase

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152
Q

Partial oxidation of hemoglobin greenish or brownish color without clearing around growth on blood agar. Include s pneumoniae and viridans

A

Alfa hemolytic bacteria

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153
Q

Complete lysis of RBCs conducts to pale clear area surrounding colony in blood agar. Include staphylococcus aureus m, streptococcus pyogenes (group A strep), streptococcus agalactiae (group B strep) listeria monocytogenes

A

Beta hemolytic bacteria

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154
Q

What is the classification of staphylococcus aureus

A

Gram + beta hemolytic catalase + coagulase + cocci in clusters

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155
Q

What is the main virulencia factor of staphylococcus aureus and how it is work

A

Proteínas A, binds Fc-IgG, inhibiting complement activation and phagocytosis.

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156
Q

Staphylococcus aureus commonly are ?

A

Nares, ears, axilla and groin.

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157
Q

What Kind of diseases causes staphylococcus aureus

A

Inflammatory disease: skin infections, organ abscesses, pneumoniae (often after influenza virus infection), infective endocarditis, septic arthitis and osteomyelitis
Toxin mediated disease: toxic shock syndrome (TSST-1) scalded skin syndrome (exfoliative toxin), rapid onset food poisoning (enterotoxins)

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158
Q

Why Methicillin resistant S aureus MRSA is resistant

A

Due to altered penicilin binding proteins (conference by mecA gene). Come atraían release Panton valentine leukocidin PVL which kills leikocytes and caídes tissue necrosis

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159
Q

How works TSST-1 (toxic shock syndrome)

A

TSST-1 is a superantigen that binds to MHC II and T cell receptor resultona in polyclonal T cell and cytokines release

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160
Q

Manifestation of Staphylococcal toxic syndrome

A

Fever vomiting diarrhea rash desquamation shock, end organ failure. TSS results in increase AST, ALT, increase bilirrubin. Associated with prolonged use of vaginal tampons or nasal packing. Compare with streptococcus pyogenes TSS is associated with painful skin infection

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161
Q

S aureus food poisoning by ingestion of preformed toxin has a short incubation period that is ?

A

2-6 Hours and enterotoxins are heat stable don’t destroyed by cooking

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162
Q

How does S aureus makes abscess

A

S aureus makes coagulase and toxins. Forms fibrin clot around itself

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163
Q

Staphylococcus epidermidis classification and characteristics

A

Gram + catalase + coagulate - urease + cocci in clusters. Novobiocin sensitive does not fermented mannitol

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164
Q

Where is the staphylococcus epidermidis

A

Normal microbiota skin, contaminates blood cultures, infects prosthetic devices (eg hip implant, heart valve) and IV catheters by producing adherent biofilms

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165
Q

What is the classification and characteristics of staphylococcus saprophyticus

A

Gram +, catalase +, coagulase - urease + cocci in clusters. Novobiocin resistant.

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166
Q

Where is staphylococcus saprophyticus

A

Normal microbiota of female genital tract and perineum and is the second most common cause of uncomplicated UTI in young females (most common is E. coli)

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167
Q

What is the Streptococcus pneumoniae clasification and characteristics

A

Gram +, Alfa hemolytic, lancet shaped diplococci. Encapsulated IgA protease. Optochin sensitive and bile soluble.

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168
Q

What are the most commonly diseases causes by streptococcus MOPS

A

Meningitis, Otitis media in children’s , Penumonia, sinusitis

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169
Q

Pneumococcal penumonia is associated with?

A

Rusty sputum

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170
Q

Who are the patients predispose to streptococcus pneumoniae

A

Patients with anatomic or functional hypoesplenia or asplenia are predisposed to infection

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171
Q

What are the two types of pneumococcal vaccines

A

Conjugate (PCV13, PCV 15, PCV20) and polysaccharide (PPSV23) formulations

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172
Q

What is the classification and characteristics of viridana group streptococci

A

Gram +, Alfa hemolytic cocci optochin resistant and bile insoluble.

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173
Q

Where is viridans group streptococci normally ?

A

Normal microbiota of the oropharynx

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174
Q

Streptococcus belong to viridans group which cause varies

A

Streptococcus mutans and S mitis

175
Q

What kind of streptococcus belong to viridans group streptococci causes endocarditis

A

S sanguinis makes dextrans that bind to fibrin- platelet aggregates on damage heart valves cause infective endocarditis

176
Q

What are the streptococcus pyogenes (group A streptococci) classification and characteristics

A

Gram + cocci in chains. Bacitracin sensitive, beta hemolytic, pyrrolidonyl arylamidase (PYR) + (positive)

177
Q

Name diseases that are caused by streptococcus pyogenes

A

Pyogenic - pharyngitis, cellulitis, impetigo (honey crusted lesions), erysipelas.
Toxigenic - scarlet fever, toxic shock-like syndrome, necrotizing fasciitis
Immunologic- rheumatic fever, glomerulonephritis

178
Q

Mechanism of M protein of streptococcus pyogenes

A

Hyaluronic acid capsule and M protein inhibit phagocytosis

179
Q

What are the diagnose test which can diagnose strep pharyngitis

A

Via throat swab which can be tested with an antigen detection assay (rapid in office results) or cultured on blood agar (results in 48 hours)

180
Q

Key virulence factors of streptococcus pyogenes

A

DNase, erythrogenic exotoxin, streptokinase, streptolysin O. ASO titer or anti DNase B antibodies indicate recent S pyogenes infection

181
Q

What are scarlet fever characteristics

A

Blanching sandpaperlike body rash strawberry tongue and circumoral pallor in the setting of group A streptococcal pharyngitis (erythrogenic toxin +)

182
Q

What are the characteristics of streptococci agalactiae (group B streptococci)

A

Gram + cocci, bacitracin resistant, beta hemolytic. Polysaccharide capsule confers virulence. Produces CAMP factor, which enlarges the area of hemolysis formed by S aureus.

183
Q

Where is streptococci agalactiae (group B streptococci) and what diseases cause ?

A

Colonizes vagina; causes pneumonia, meningitis and sepsis mainly in babies.

184
Q

What is the utility of looking for streptococcus agalactiae (group B streptococci) and what are the tests

A

Screen pregnant patients at 35-37 weeks of gestation with rectal and vaginal swabs. Patients with positive culture recieve intrapartum penicillin/ampicillin prophylaxis. This bacteria has a hippurate tests + and pyrrolidonyl arylamidase PYR -

185
Q

What are the characteristics of streptococcus galllolyticus? Where is it ? And what kind of diseases cause

A

Gram + cocci (formerly S bovis) colonizes gut, causes bacteremia and infective endocarditis. Patients with S gallolyticus endocarditis have more incidence of colon cancer

186
Q

What are the characteristics of enterococci (what includes)

A

Gram + cocci. Include E. Faecalis and E faecium they are catalase negative pyrrolidonyl arylamidase (PYR) positive typically nonhemolytic they are pinicilin G resistant.

187
Q

What kind of infection cause enterococci

A

UTI, biliary tracts infection, and infective endocarditis (following GI/GU procedures). VRE (vancomycin resistant enterococci) are an important cause of health care associated infection

188
Q

What are the bacteria’s characteristics of bacillus anthracis

A

Gram + spore forming rod that produces anthrax toxin, exotoxin consisting of protective antigen, lethal factor, has a polypeptide capsule (poly D glutamate). Colonies show a halo of projections sometimes called Medusa head appearance

189
Q

How does bacillus anthacis acts

A

Lethal factor (inhibits MAP kinase, macrophage apoptosis) and edema factor (acts as adenylyl cyclase this increase intracellular cAMP upsetting homeostasis results in edema and necrosis.

190
Q

Describe how is cutaneous anthrax

A

Painless papule surrounded by vesicles that has evolution? To a ulcer with black eschar (painless necrotic) that uncommonly progresses to bacteremia and death

191
Q

Describe how is pulmonary anthrax

A

Inhalation of spores, most commonly from contaminated animals or animal products although also a potential bio weapon. Causes flulike symptoms that rapidly progress to fever pulmonary hemorrhage, mediastinitis (CXR may show widened mediastinum) and shock. Also called woolsorter disease.

192
Q

What is the prophylaxis of bacillus anthracis when there is exposition and what is a important complication of both types of anthrax

A

Ciprofloxacin or doxycycline. Both cutaneous and pulmonary anthrax may be complicated by hemorrhagic meningitis

193
Q

What are the characteristics of Bacillus cereus

A

Gram + rod

194
Q

What does bacillus cereus cause (disease manifestations)

A

Food poisoning. Spores survive cooking rice (reheated rice syndrome) keeping rice warm results in germination of spores and enterotoxin formation. Emetic type cause nausea and vomiting within 1-5 horas. Caused by very life a preformed toxin. Diarrheal type causes watery nonbloody diarrhea and GI pain within 8-18 hours. Management supportive care (antibiotics are ineffective against toxins)

195
Q

What kind of disease cause clostridioides difficile and how it’s works and

A

Produces toxins A and B which damage enterocytes. Both toxins lead to watery diarrhea—> paeudomembranous colotis. Often secondary to antibiotic use especially clindycin, ampicillin cephalosporins, fluoroquinolones; associated with PPI. Fulminant infection: toxic mega colon ileus shock

196
Q

What are the diagnostic methods of clostridioides difficile and treatment

A

Diagnosed by PCR or antigen detection of one or both toxins in stool. Treatment: oral vancomycin or fidaxomicin for recurrent cases, consider repeating prior regimen of fecal microbiota transplant

197
Q

What bacteria’s are include in “clostridia”?

A

Clostridium tetani, clostridium botulinum, clostridium perfringens

198
Q

Describe characteristics of clostridia

A

Gram +, spore forming, obligate anaerobic rods. Tetanus toxin and botulism toxin are proteases that cleave SNARE proteins involved in neurotransmission

199
Q

Describe how works clostridium tetani

A

Pathogen is noninvasive and remains localized to wound site. Produce tetanospasmin an exotoxin causing tetanus. Tetanospasmin spread by retrograde axonal transport to CNS and blocks release of GABA and glycine from renshaw cells in spinal cord. Causes spastic paralysis trismus (lockjaw) risks sardonic (raised eyebrows and open grin) opisthotonos (spasm of spinal extensors)

200
Q

How does tetanus prevents

A

Tetanus vaccine. Treat with antitoxin +/- vaccine booster, antibiotics, diazepam (for muscular spasm) and wound debridement

201
Q

What is opisthotonos

A

Spasms of spinal extensors

202
Q

Produces a heat labile toxin that inhibits ACh release at the neuromuscular junction, causing botulism. In babies ingestion of spores (eg in honey) in adults disease is causes by ingestion of preformed toxin in canned food

A

Clostridium botulinum

203
Q

How is the name of the disease caused by clostridium botulinum spores in babies

A

Floppy baby syndrome

204
Q

Name the 5 D’s of symptoms of botulism

A

Diplopia, dysarthria, dysphagia, dyspnea, descending flaccid paralysis. They don’t present with sensory deficits

205
Q

Treatment of botulism

A

Human botulinum immunoglobulin

206
Q

Name some therapeutics uses of botulism toxin

A

Local botulinum toxin A (Botox) injections used to treat focal dystonia, hyperhydrosis, muscle spasm and cosmetics reduction of facial wrinkles

207
Q

Produces Alfa toxins (lecithinase that is a phospholipase) that can cause myonecrosis (gas gangrene presents as soft tissue crepitus) and hemolysis

A

Clostridium perfringens

208
Q

What happens if the food is contamined by clostridium perfringens

A

If heavely spores contaminated food is cooked but left standing too long at less of 60C spores germinate results in vegetative bacteria conducts to heat labile enterotoxin late onset 10-12 hours. Food poisoning symptoms resolution in 24 hours

209
Q

Which what kind of condition is associated spontaneous gas gangrene

A

This could be by hematogenous seeding associated with colonic malignancy is most commonly causes by clostridium septicum

210
Q

What are the bacteria’s characteristics of corynebacterium diphtheriae

A

Gram + rods. Causes diphtheriae via exotoxin inhibits protein synthesis via ADP ribosylation of EF-2, leading to possible necrosis in pharynx cardiac and CNS tissue.

211
Q

What are the characteristics of diphteria disease

A

Transmitted via respiratory droplets. Symptoms include pseudomembranous pharyngitis (grayish white membrane) with lymphadenopathy (bulls neck appearance) toxin dissemination may cause myocarditis arrhythmias neuropathies.

212
Q

What are the labs diagnosis to diphtheria

A

Gram + rods with metachromatic ( blue and red) granules on Löffler media and + Elek test for toxin
Black colonies on cystine tellurite agar.

213
Q

Treatment and prevent to diphtheria

A

Toxoid vaccine prevents diphtheria. Treatment diphteria antitoxin +/- erythromycin or penicillin

214
Q

ABCDEFG describe the characteristics of corynebacterium diphtheriae

A

ADP rybosilation (inhibition pathway of protein synthesis)
Beta prophage (who encodes exotoxin)
Corynebacterium
Diphtheria
Elongation factor 2 (owner of ADP ribosylation)
Granules

215
Q

Is gram + facultative intracellular rod that is acquired by ingestion of unpasteurized dairy products and cold deli meats transplacental transmission by vaginal transmission during birth. Grows well at refrigeration temperatures (cold enrichment)

A

Listeria monocytogenes

216
Q

Why listeria monocytogenes avoid antibody

A

Aldrin’s rocket tails via actin polymerization that allow intracellular movement and cell to cell spread across cell membranes thereby avoiding antibody

217
Q

What are the characteristics of listeriolysis

A

Generates pores in phagosomes, allowing its scape into cytoplasm characteristics tumbling motility in broth.

218
Q

Diseases that can be caused by listeria monocytogenes

A

Amnionitis, septicemia, and spontaneous abortion in pregnant patients; granulomatosis infantiaseptica, meningitis in immunocompromised patients, neonates and older adults; mild, self limited gastroenteritis in healthy individuals

219
Q

What is the treatment of lysteria monocytogenes is ?

A

Ampicillin

220
Q

Bacterial characteristics of Nocardia and actinomyces

A

Both are gram + and form long, branching filaments resembling fungi

221
Q

Name at least three main differences between Nocardia vs actinomyces

A

Nocardia: aerobe, acid fast (weak), found in soil. Actinomyces: aerobe, not acid fast and is found in normal oral reproductive and GI microbiota

222
Q

What are the main diseases manifestation of Nocardia and what is the treatment

A

Causes pulmonary infections in immunocompromised (can mimic TB but with negative PPD); cutaneous infections after trauma in immunocompetent; can spread to CNS resulting in cerebral abscess
Treatment with sulfonamides (TMP-SMX)

223
Q

What are the main diseases by actinomyces and treatment

A

Causes oral facial abscesses that drain through sinus tracts; often associated with dental Caries/ extraction and other maxilla facial trauma; forms yellow sulfur granules; can also cause pelvic inflammatory disease with intrauterine dispositive. Treatment with penicillin

224
Q

Bacterial characteristics of mycobacteria

A

Acid fast rods

225
Q

What kind of mycobacteria is there

A

Mycobacterium tuberculosis (TB often resistant to multiple drugs) M avium (cause disseminated non TB disease in AIDS; often resistant to multiple drugs) M scrofulaceum (cervical lymphadenitis in children) and M Marinum (hand infection in aquarium handlers)

226
Q

What are the main symptoms of TB

A

Include fever, night sweats, weight loss, cough (nonproductive or productive$ hemoptysis

227
Q

What structure appears in virulent M tuberculosis

A

Cord factor that create a serpentine cord , activates macrophages (promoting granuloma formation ) and induces release of TNF Alfa. Sulfatides (surface glycolipids) inhibit phagolysosomal fusion

228
Q

What does PPD positive means

A

If current infection or past exposure

229
Q

When PPD is negative

A

On no infection and I’m immunocompromised patients especially with Low CD4 cell count

230
Q

iGRA ( interferon gamma realease assay) has fewer ?

A

False positive from BCG vaccination

231
Q

Who are in highest risk of m tuberculosis a
reactivation

A

Immunocompromised individuals eg HIV, organ transplant recipients TNF Alfa inhibitors use

232
Q

Where does the deactivation is in lungs

A

Has predilection for the apices of the lung ( due to the bacteria bienvenida highly aerobic)

233
Q

What is the ghon complex

A

Primary infection foci is a ghon complex and they are on hiliar nodes and ghon focus usually mild lower lobes

234
Q

What percentage of TB is progressive primary tuberculosis and what predispose it
And name manifestations

A

Less than 10% is associated with AIDS and malnutrition
Can cause bacteremia but also progressive lung disease, meninges, spleen adrenal gland joints and long bones lymph nodes lung liver

235
Q

How is the way of more than 90% of primary tb isn’t progressive

A

By healing by fibrosis calcification and has PPD +

236
Q

What are the lesions of secundary TB

A

Fibrovaseuous cavitary lesion ?usually upper lobes
In lung cavity caseations and scars and suprarrenal caseation

237
Q

What is the other name of leprosy

A

Hansen disease

238
Q

What is the bacteria that cause leprosy and what are their characteristics

A

Mycobacterium leprae, an acid fast bacillus that likes cool temperatures (infects skin and superficial nerves) glove and stocking loss of sensation and cannot be grown in vitro

239
Q

What is the diagnostic test of leprosy and what is their reservoir

A

Skin biopsy or tissue PCR. Reservoir in United States: armadillos

240
Q

What are the two forms leprosy

A

Lepromatous and tuberculoid

241
Q

Describe lepromatous

A

Present diffusely over the skin with leonine facies and is communicable. (High bacterial load) characterized by low cell mediated immunity with a largely th2 response. Lepromatous form can be lethal

242
Q

Describe tuberculoid way of leprosy

A

Limited to a few hypoesthetic hairless skin plaques characterized by high cell mediated immunity with a largely th1 type response an low bacterial load

243
Q

What are the treatments for leprosy lepromatous and leprosy tuberculoid

A

Tuberculoid form: dapsone and rifampin and clofazimine is added for lepromatous form

244
Q

How does gram negative can be divided

A

By their shape as diplococci, cocobacilli, bacilli and curved rods

245
Q

How is the diplococci clasification

A

Aerobic with maltose fermentation negative and positive

246
Q

What are the bacteria’s gram negative diplococci maltose fermentation negative

A

N gonorrhoeae and moraxella

247
Q

What is the clasification of N meningitidis

A

Gram negative diplococci aerobic maltose fermentation positive

248
Q

What are the gram negative coccobacilli

A

Haemophilus influenzae, bordetella pertussis, Pasteurella, brucella, francisella tularensis acinetobacter baumanii

249
Q

How gram negative curved rods are divided

A

Oxidase positive that grows in 42C, grows in alkaline media, and produces urease

250
Q

What is the bacteria which is gram negative curved rods oxidase + and grows in 42 C

A

Campylobacter Jenjuni

251
Q

What is the clasification of vibrio cholerae

A

Gram negative curved rods oxidase positive grows in alkaline media

252
Q

Gram negative curve rods oxidase positive produce urease

A

Helicobacter pylori

253
Q

How gram negative bacilli are classify

A

By lactose fermentation negative and positive. And negative are classified agin regard their oxidase is positive or negative. And lactose fermentation positive that it’s divided in fast and slow

254
Q

The gram negative bacilli lactose fermentation negative oxidase negative are subdivided in ?

A

H2S production on TSI agar negative and positive

255
Q

What is the classification of shigella yersinia

A

Gram negative bacilli lactose fermentation negative oxidase negative H2S production on TSI agar negative

256
Q

What is the salmonella and proteus classification

A

Gram negative bacilli lactose fermentation negative oxidase negative and H2S production on TSI agar positive

257
Q

They are gram negative bacilli lactose fermentation negative oxidase positive

A

Pseudomonas and burkholderia

258
Q

What are the clasification of E. coli klebsiella and enterobacter

A

They are gram negative bacilli lactose fermentation positive fast

259
Q

What is the citrobacter and serratia clasification

A

They are gram positive bacilli lactose fermentation positive slow

260
Q

Describe the bacterial characteristics of neisseria

A

Gram negative diplococci. Metabolize glucose and produce IgA proteases. Contain lipooligosaccharides (LOS) with strong endotoxin activity. N gonorrhoeae is often intracellular (within neutrophils) acid production: meningococci maltose and glucose gonococci glucose

261
Q

What are the differences between gonococci and meningococci about polysaccharide capsule acid maltose detection and vaccines

A

Gonococci doesn’t have polysaccharide capsule, and meningococci has polysaccharide capsule. Gonococci doesn’t have maltose acid detection and meningococci has, gonococci doesn’t have vaccine due to antigenic variation of pilus proteins and meningococci has vaccine (type B vaccine available for at risk individuals)

262
Q

What is the transmitted via of gonococci and what kind of diseases it is caused

A

Sexually or perinatally. Causes gonorrhoeae, septic arthritis, neonatal conjunctivitis (2-5 days after birth) pelvic inflammatory disease PID and fits Hugh Curtis syndrome

263
Q

What is the diagnosis method and treatments of gonococci

A

Diagnosed with NAAT, condoms reduce sexual transmission, erythromycin eye ointment prevents neonatal blindness. Treatment: single dose IM ceftriaxone of chlamydial confection not excluded by molecular testing add doxycycline

264
Q

How is the transmitted via, diseases, diagnosis method and treatment of meningococci

A

Respiratory and oral secretion. Causes meningococcemia with Petechial hemorrhages and gangrene of toes, meningitis, Waterhouse friderichsen syndrome . Diagnosed via culture based tests or PCR. Treatment is ceftroaxone or penicillin G

265
Q

What are the prophylaxis of meningococci in close contacts

A

Rifampin, ciprofloxacin, or ceftriaxone

266
Q

Is an acute hemorrhagic adrenal insufficiency

A

Water hose friderichsen syndrome

267
Q

Describe the bacterial characteristics of hemophilia influenzae

A

all gram negative coccobacillary rod is no type able (unencapsulated) produce IgA protease

268
Q

What are the diseases and findings of haemophilus influenzae

A

Strains of it are the most common cause of mucosal infections (otitis media, conjunctivitis, bronchitis) as well as invasive infections. Causes epiglotitis endoscopic appearance can be cherry red, thumb sign on lateral neck d ray meningitis otitis media and pneumonia

269
Q

What is the culture media of haemophilus influenzae

A

Factors V (NAD+) and X (hematin) for growth; can also be grown with S aureus which provides factor V via RBC hemolysis

270
Q

What is the vaccine of haemophilus influenzae and how is

A

Contains type b capsular polysaccharide (polyribosylribitol phosphate) conjugated to diphteria toxoid or other protein. Given between 2 and 18 months of age

271
Q

What is the treatment of hemophilia influenzae

A

Amoxicillin +/- clavulanate for mucosal infections; ceftriaxone for meningitis, rifampin prophylaxis for close contacts

272
Q

Describe the bacterial characteristics of burkholderia cepacia complex

A

Aerobic, catalase + gram negative rod. Often multidrug resistant. Infection is a relative contraindication to undergoing to lung transplantation due poor prognosis

273
Q

How is transmitted burkholderia cepacia complex

A

Causes pneumoniae in and can be transmitted between patients with cystic fibrosis.

274
Q

Describe the bacterial characteristics of bordetella pertussis

A

Gram negative aerobic coccobacillus. Virulence factors include pertussis toxin (disables G) adenylate Cyclase toxin ( cAMP) and tracheal cytotoxin.

275
Q

What are the three clinical stages of bordetella pertussis

A
  1. Catarrhal-low grade fevers, Coryza
  2. Paroxysmal paroxysms of intense cough followed by inspiratory whoop whooping cough posttusive vomiting
  3. Convalescent - gradual recovery of chronic cough
276
Q

How is prevented bordetella pertussis

A

Tdap, DTap, vaccines.

277
Q

A interesting finding in lymphocytes in bordetella pertussis

A

Produce lymphocytosis unlike most acute bacterial infections

278
Q

What is the treatment of bordetella pertussis

A

Macrolides if allergic use TMP SMX

279
Q

Describe the bacterial characteristics of brucella

A

Gram negative aerobic cocobacillus. Survive Macario haves in the reticuloendothelial system. Can form a caseating granulomas

280
Q

How is transmitted, manifestations and treat brucella

A

Via ingestion of contaminated animal products (eg unpasteurized milk) typically presents with undulant fever, night sweats and arthralgia. Treatment doxycycline + rifampin or streptomycin

281
Q

Describe the characteristic bacterial of legionella pneumophila

A

Gram negative rod. Gram strains poorly- use silver stain. Grow on charcoal yeast extract medium with iron and cysteine. Is detected by antigen in urine.

282
Q

Transmission findings and treatment

A

Aerosol transmission from environmental water source habitat (eg air condition systems hot water tanks). Labs may show hyponatremia. Outbreaks associated with cruise ships, nursing homes. No person to person transmission treatment with macrolide or quinolone

283
Q

How is the legionnaires disease

A

Severe pneumoniae, often unilateral and lobar, fever, GI and CNS symptoms. Risk factors include older age, tobacco smoking, chronic lung disease.

284
Q

What is Pontiac fever

A

Is a mild flulike symptoms by legionella pneumophila

285
Q

Describe the bacterial characteristics on pseudomonas aureginosa

A

Aerobic motile catalase positive gram negative rod Non lactose fermenting oxidase + frequently found in water increase virulence in acidic environments. Has a grape like odor mucous polysaccharide capsule may contribute to chronic pneumonia in patients with cystic fibrosis due to biofilm. Produce phospholipase C (degrades cell membranes, Endotoxin (fever shock ) Exotoxin A )inactivated EF-2) pigments proceeding and pyocianin (bluer green pigment) also generates ROS

286
Q

Diseases associated with pseudomonas aureginosa

A

Pneumonia, sepsis, ecthyma gangrenosum, UTIS Diabetes Osteomyelitis Mucoid polysaccharide capsule Otitis externa (swimmers ear) nosocomial (health care associated) infections addiction skin infections (hot tubs folliculitis,wound infection in burn victims) corneal ulcers /keratitis in contact lens wearers minor eye trauma

287
Q

It’s a tepid progressive necrotic cutaneous lesion caused by pseudomonas bacteremia. Typically seen in immunocompromised patients

A

Ecthyma gangrenosum

288
Q

Treatments of pseudomonas aureginosa

A

Anti pseudomonas penicillin’s in combination with beta lactamase inhibitor
3rd and 4th generation cephalosporin (eg ceftazidime cefepime )
Monobactams
Fluoroquinolones
Carbapenems
Despite antipaeudomonal activity aminoglycoside mono therapy is avoided due to poor performance in acidic environments

289
Q

Despite the bacterial characteristics of salmonella and shigella

A

Are gram negative rods, non lactose fermenters, oxidase negative and can invade the GI tract via M cells of peyer patches

290
Q

What are the reservoirs, spread, H2S production, fagella, virulence factors and infectious dose of salmonella typhi

A

Humans only, hematogenous spread, yes, yes, endotoxin Vi capsule, high large inoculum required, acid labile inactivated by gastric acid

291
Q

What are the effect of antibiotics on fecal excretion, immune response, vaccine and unique properties of salmonella

A

Prolongs duration, primarily monocytes, oral vaccine contains live attenuated s typhi IM vaccine contains Vi capsular polysaccharide. Cause fever typhoid with salmon colored truncated macular rash abdominal pain pulse temperature dissociation later GI ulceration and hemorrhage. Treat with ceftriaxone or fluoroquinolones. Carries state with gallbladder colonization

292
Q

GI symptoms of salmonella typhi

A

Constipation followed by diarrhea

293
Q

Reservoirs, spread, H2S production, flagella, virulence factors, infectious dose (ID50), effect of antibiotics on decal excretion and immune response od salmonella except typhi

A

Humans and animals, hematogenous spread, yes, yea, endotoxin, high ID50, prolongs duration, PMNs in disseminated disease

294
Q

What about GI symptoms, vaccine and unique propierties of salmonella except typhi

A

Diarrhea (possibly bloody) no vaccine, poultry, eggs, let’s and turtles are common source. Treatment is supportive antibiotics are not indicated in immunocompetent individuals

295
Q

What are the reservoir, spread, H2S production flagella virulence factors infections dose (ID50)

A

Humans only, cell to cell NO hematogenous spread, No No, endotoxin Shiga toxin (enterotoxim). Los very small inoculjm required acid stable

296
Q

What the effect of antibiotics on decal excretion, immune response, GI manifestations, vaccine, unique propierties

A

Shortens duration , primarily PMN cramps abdominal pain teneamus bloody mucoid stools no vaccine

297
Q

In order of decreasing severity in toxin produced of shigella are

A

A dysenteries, fkexneri Boydii a sonnei

298
Q

Charcateristcs of yersinia enterocolitica

A

Gram negative pleomorphic rod cocobacilli with polar staining. Usually transmitted form peg feces contaminated milk or pork. Can use acute bloody diarrhea, pseudoappendicitis (right lower abdominal pain due to mesenteric adenitis and or terminal ileitis) reactive arthritis in adults

299
Q

Lactose fermenting enteric bacteria

A

Fermentation of lactose pink colonies on MacConkey agar. Examples include Citrobacter, E. coli, enterobacter, klebsiella serratia

300
Q

How is the EMB what with lactose fermenting enteric bacteria

A

Lactose fermenters grow as purple black colonies E. Coli grows colonies with a green sheen

301
Q

Its gram negative índole + Rod. His virulencia factores are fimbriae P pilli,
Cause cystitis and pyelonephritis and K cápsule cause pneumonia neonatal meningitis, LPS endotoxin- septic shock

A

E. Coli

302
Q

Name the 4 types (strain/cepa) of E. coli

A

Enteroinvasive E. coli, enterotoxigenic E. coli, enteropathogenic E. coli and enterohemorrhagic E. coli

303
Q

Toxins and mechanism of enteroinvasive E. coli- EIEC- and how is it presentation

A

Microbe invade intestinal mucosa and causes necrosis and inflammation . Dysentery clinical manifestations similar to shigella

304
Q

Produces heat labile and heat stable enterotoxins there is no inflammation or invasion is cause of travelers diarrhea (watery)

A

Enterotoxigenic E. coli

305
Q

What are the enteropathogenic E. coli toxin and mechanism and presentation

A

Not toxin produced, adheres to apical surface, flattens villi and prevents absorption causing diarrhea usually in children (think EPEC and pediatrics)

306
Q

Which is the most common serotype of enterohemorrhagic E. coli in US usually trabamittes vianundercooked meat raw leafy vegeta les

A

O157:H7

307
Q

Anemia, thrombocytopenia, and acute kidney injury due to microthrombi forming on damaged endothelium is triad of ? And what is the toxin

A

Hemolytic uremic syndrome, Shiga toxin

308
Q

Name the findings of HUS

A

Mechanical hemolysis (with schistocytes on peripheral blood smear) platelet consumption and decrease renal blood flow

309
Q

What are the presentation of enterohemorrhagic E. coli

A

Dysentery (toxin alone causes necrosis and inflammation) doesn’t ferment sorbitol (vs other E. coli)

310
Q

Gram negative rod intestinal microbiota that causes lobar pneumoniae more common in patients with heavy alcohol use or with impaired host defenses

A

Klebsiella

311
Q

Has very mucous colonies caused by abundant polysaccharide capsules. Dark red currant jelly sputum (blood/mucus) also cause of healthcare associated UTIs associated with evolution of multi drug resistant

A

Klebsiella

312
Q

Describe ABCDE of klebsiella

A

Aspiration pneumonia
aBscess in lung and liver
Currant jelly sputum
Diabetes mellitus
EtOH over use

313
Q

Is a gram negative, comma or S shaped with polar flagella oxidase + grows at 42 Celsius grades

A

Campylobacter jejuni

314
Q

Is the major cause of bloody diarrhea especially in children. Fecal oral transmission through person to person contact or via ingestion of undercooked contaminated poultry or meat unpasteurized milk

A

Campylobacter jejuni

315
Q

Campylobacter jejuni is a common antecedent of what diseases

A

Guillain barre syndrome and reactive arthritis

316
Q

Gram negative flagellated comma shaped oxidase +grows in alkaline media endemic to developing countries produce profuse rice water diarrhea via enterotoxin that permanently activates Gs increase cAMP acid all bile high ID50 (large inoculum) unless host has decrease gastric acidity

A

Vibrio cholerae

317
Q

Transmitted via ingestion of contaminated water or uncooked food (raw shellfish). Treat promptly with oral rehydration solution

A

Vibrio cholerae

318
Q

Gram negative bacillus usually found in marine environments cause severe wound infections or septicemia due to exposure to contaminated sea water. Presenta as cellulitis that can progress to necrotizing fasciitis in high risk patients specially those with liver disease (cirrhosis hemochromatosis). Serious wound infection el requires surgical debridement

A

Vibrio vulnificus

319
Q

Is a curved flagellated (motile) gram negative rod. That is triple +: catalase + oxidase + and urease + (can use urea breath test or decal antigen test for diagnosis. Urease produce ammonia, creating an alkaline environment which help to survive

A

Helicobacter pylori

320
Q

Where does h pylori colonize and what kind of diseases cause

A

Antrum of stomach causes gastritis and peptic ulcers (specially duodenal) risk factor for peptic ulcer disease, gastric adenocarcinoma and MALT lymphoma

321
Q

What about h pylori in United States

A

Most common initial treatment is triple therapy/ amoxicillin (metronidazole of peniclinnallergy + clarithromycin + proton pump inhibitor antibiotics cure pylori, bismuth based for quadruple therapy if concerned about macro life resistente

322
Q

How are the characteristics of spirochetes

A

Spiral shaped bacteria with axial filaments.

323
Q

What bacteria’s are included in spirochetes

A

Leptospira treponema and borrelia

324
Q

What are the diagnosis method is spirochetes

A

Only borraría can be visualized using aniline dyes (weight or hienas stain) in light microscopy due to size. Treponema is visualized bye dark field microscopy or direct fluorescent antibody microscopy (DFA)

325
Q

What is jarisch herxheimer reaction

A

Flulike symptoms (fever, chills, headache, myalgia) after antibiotics are started due to host response to sudden release of bacterial antigens. Usually occurs during treatment of spirochetes infections

326
Q

Is a disease caused by borrelia burdogferi which is transmitted by the oxides deer tick (also vector for ana plasma spp and Protozoa babesia)

A

Lyme disease

327
Q

What is the natural reservoir of borrelia burdogferi

A

reservoir is the mouse; deer are essential to tick life cycle but don’t harbor borrelia

328
Q

How many stage does Lyme disease has and what are they

A

Stage 1 early localized that includes erythema migraña (typical bull eyes configuration is pathognomonic but not always present flulike) symptoms
Stage 2 early disseminated: secondary lesions, carditis, AV block, facial, nerve (bell) palsy, migratory myalgias /transient arthritis
Stage 3 late disseminated: encephalopathy chronic arthritis peripheral neuropathy

329
Q

Describe FACE of Lyme disease

A

Facial nerve palsy ( typically bilateral) arthritis cardiac block erythema migraña

330
Q

What is the treatment of Lyme disease

A

Doxycycline (first line) amoxicillin (pregnant patients children menor de 8 asños ceftroazibe if IV therapy required

331
Q

Spirochete with hoook shaped ends found in water contaminated with animal urine

A

Leptospira interrogansn

332
Q

What types of Leptospira interrogans is there

A

Lepoatoapiros and Weil

333
Q

Describe the symptoms of leptospirosis

A

Flulike symptoms myalgias of calves jaundice photophobia with conjunctival suffusing (erythema without exudate) prevalent among surges and in tropics

334
Q

Describe Weil disease

A

Icterohemorragic leptospirosis severe form with jaundice and azotemia from liver and kidney, fever, hemorrhage and anemia

335
Q

How many types of syphilis are there

A

Primary, secondary, tertiary and congenital syphilis

336
Q

Who is the cause of syphilis

A

Caused by spirochete treponema pallidum

337
Q

Localized disease presenting with painless chancre. Use fluorescent or dark field microscopy to visualize treponema in fluid from chanchreDEL+

A

Primary syphilis

338
Q

Disseminated disease with constitutionally symptoms maculopapular rash (including palms and soles) condylomata lata (smooth painless, wart like white lesions on genitals) lymphadenopathy patchy hair loss also confirmarle with dark field microscopy

A

Secondary syphilis

339
Q

What are the serologic tests

A

VDRL/RPR (nonspecific) confirm diagnosis with specific test (FTS-ABS)

340
Q

What is latent syphilis

A

Syphilis + serology without symptoms

341
Q

Describe tertiary syphilis

A

Gummas (chronic granulomas) aortitis (vasa vasorum destruction) neurosyphilis (tabes dorsalis general paresis) argyl Robertson pupil. Signs: broad based ataxia + Romberg, Charcot joint, stroke without hypertension

342
Q

What is argyl Robertson pupil

A

Pupils that constricts with accommodation but is not reactive to light

343
Q

Presents with facial abnormalities such as rhagades (linear scars at angles of mouth) snuffles (nasal discharge ) saddle nose notched (huntchinson) teeth mulberry molars and short maxilla, saber shins CNVIII deafnes

A

Congenital syphilis

344
Q

In pregnancy syphilis patients when it is transmitted

A

First trimester

345
Q

About diagnosis syphilis with VDRL and RPRnon treponema tests

A

VDRL and RPR detects nonspecific antibody that reacts with beef cardiolipin. Quiantotatibe inexpensibe and widely available test sensitive but not specific. Non treponema tests revert to negative after treatment and treponema remain+

346
Q

Name the false positive of VDRL

A

Pregnancy, viral infection (eg BEV hepatitis) Drugs (eg chlorpromazine procainamide) Rheumatic fever (rare) lupus (anti cardiolipin) and leprosy

347
Q

What are the treponema specific tests of syphilis

A

FTA-ABS and TPPA

348
Q

Direct testing of syphilis

A

Darkrfiels microscopy and PCR

349
Q

Is a bacteria who can not make their own ATP. They are obligate inttacellular organism that cause 2 firmas of mucosal infections

A

Chlamydiae

350
Q

What are the intracellular shape of chlamydiae

A

Elementary body’s and reticulate body

351
Q

Describe how are the two bodies intracellular

A

Elementary body (small dense)
Reticulate body replicates in cells by fission reorganizes into elementary mejor bodies

352
Q

Disease caused by chlamydiae

A

Chlamydiae trachomata’s causes neonatal and follicular adult conjunctivitis nongocococal urethritis PID and reactive arthritis. Atípical pneumonia by chlamydophyla strains

353
Q

Chlamydophyla pneumoniae and chlamydophila psitacci cause ?

A

Atypical pneumonia

354
Q

What is the reservoir of C psittaci

A

Avians reservoir

355
Q

Name the treatment and diagnosis to chlamydiae

A

PCT,NAAT. Cytoplasmic inclusions (reticulate bodies) are seen on giemsa or fluorescent antibody stained smear. Treatment doxycycline azithromycin (for pregnancy) add ceftriaxone for possible concomitant

356
Q

Name the chlamydia trachomatis serotype a

A

Types A,B and C
Types D-
Types L1, L2 L3

357
Q

What kind of disease cause type A,B and C chlamydia trachomatis

A

Chronic infection, cause blindness due to follicular conjunctivitis in resource limited areas

358
Q

What kind of disease cause chlamydia trachomatis serotype D-K

A

Urethritis PID ectopic pregnancy neonatal pneumoniae (staccato cough) with eosinophilia neonatal
Conjunctivitis (1-2 weeks after birth)

359
Q

What kind of disease cause Types IL1? IL2 and

A

Lymphohganoma venereum

360
Q

Describe lymphogranuloma venereó

A

Shall painless ulcers on genital swollen painful ingiinal lymph nodes that ulcerate (bulboes) treats with doxycycline

361
Q

It’s a pleomorphic gram variable rod involved in bacterial vaginosis presents gray vaginal discharge with fishy smell non painful (vs vaginitis). Associated with sexual activity but not sexually transmitted

A

Gardenerella vaginalis

362
Q

What is the pathophysiology cause of vaginosis

A

Is characterized by overgrowth of certain anaerobic bacteria in vagina (due to decreased lactobacilli)

363
Q

Describe the clue cells of gardenerella infection

A

Are vaginal epithelial cells covered with Gardnerella have stippled appearance along outer margin

364
Q

Name the test of gardenerella and describe. What is the treatment of gardenerella

A

Amine whiff test-mixing discharge with 10% KOH enhances fishy odor. Vaginal pH more than 4.5 during infection. Metronidazole or clindamycin

365
Q

Name the eighteen zoonotic bacteria

A

Anaplasma spp. Bartonella spp. Borrelia burgdorferi, borrelia recurrentis, brucella spp. campylobacter. Chlamydophila psittaci. Coxiella burnetii, ehrlichia chaffeensis, francisella tularensis, Leptospira spp, mycobacterium leprae, pasteurella multocida, rickettsia prowazekii, rickettsia rickettsii, rickettsia typhi, salmonella spp (except S typhi) yersinia pestis

366
Q

What is a zoonosis

A

Infectious disease transmitted between animals and humans

367
Q

Disease and transmission and source of anaplasma spp

A

Anaplasmosis, oxides ticks (live on deer and mice)

368
Q

Disease and transmission and source of bartonella spp

A

Cat scratch disease, bacillary angiomatosis. Cat scratch

369
Q

Disease and transmission and source of borrelia burgdorferi

A

Lyme disease, oxides ticks (live on deer and mice)

370
Q

Borrelia recurrentis disease, transmission and source

A

Relpasing fever, louse and it’s recurrent due to variable surface antigens

371
Q

Brucella spp disease, transmission and source

A

Brucellosis/undulant fever. Unpasteurized dairy; inhalation of protein contact with infected animal tissue or fluids

372
Q

Campylobacter disease transmission and source

A

Bloody diarrhea. Feces from infected pets/animals contaminated meats foods hands

373
Q

Chlamydophila psittaci disease, transmission and source

A

Psittacosis. Parrots other birds

374
Q

Coxiella burnetii disease, transmission and source

A

Q fever, aerosols of cattle/sheep amniotic fluid

375
Q

Ehrlichia chaffeensis disease, transmission and source

A

Ehrlichiosis, amblyomma (lone star tick)

376
Q

Francisella tularensis disease, transmission and source

A

Ticks, rabbits, deer flies.

377
Q

Leptospira spp disease, transmission and source

A

Leptospirosis, animal urine in water; recreational water use

378
Q

Mycobacterium leprae disease, transmission and source

A

Leprosy humans with lepromatous leprosy, armadillo (rare)

379
Q

Pasteurella multocida disease, transmission and source

A

Celulitis, osteomyelitis.
Animal bite, cats, dogs

380
Q

Rickettsia prowazekii disease, transmission and source

A

Epidemic typhus, human to human via human body louse

381
Q

Rickettsia rickettsii disease, transmission and source

A

Rocky Mountain spotted fever. Derma ventor (dog tick)

382
Q

Rickettsia typhi disease, transmission and source

A

Endemic typhus,fleas

383
Q

Salmonella spp (except S typhi ) disease, transmission and source

A

Diarrhea (which may be bloody) vomiting fever abdominal cramps. Reptiles and poultry

384
Q

Yersinia pestis disease, transmission and source

A

Plate. Fleas (rats and prairie dogs are reservoirs)

385
Q

What is the treatment of rickettsial diseases and vector borne illnesses

A

Doxycycline

386
Q

What are the rickettsial diseases and vector borne illnesses with rash common (2) and rash rare (3)

A

Rash common: Rocky Mountain spotted fever and typhus
Rash rare: Ehrlichiosis, anaplasmosis, Q fever.

387
Q

Where does Rocky Mountain spotted fever used to occurs country and body part

A

North Carolina rash typically starts at wrists and ankles and then spreads to trunk, palms and soles.

388
Q

Classic triad of Rocky Mountain spotted fever

A

Headache, fever, rash (vasculitis)

389
Q

Which diseases have palms and soles -CARS-

A

Coxsackievirus A infection (hand, foot and mouth disease), Rocky Mountain spotted fever, and 2 Syphilis

390
Q

What are the two rickettsia that can cause typhus (Rickettsii on the wrists, typhus on the trunk)

A

R typhi endemic (fleas) and R prowazekii (human body louse) rash starts centrally and spreads out, sparing palms and soles

391
Q

Name a cellular finding of herlichiosis

A

Monocytes with morulae (mulberry like inclusions) in cytoplasm

392
Q

Name findings of anaplasmosis

A

Granulocytes with morulae in cytoplasm

393
Q

What are the clinical findings of Q fever

A

Presents with headache, cough, flulike symptoms pneumonia, possibly in combination with hepatitis. It’s common cause of culture negative endocarditis

394
Q

What is the pathogen of walking pneumonia (insidious onset, headache, nonproductive cough, patchy or diffuse interstitial infiltrate macular rash).

A

Mycoplasma pneumoniae

395
Q

Occurs frequently in those are less of 30 years old; outbreaks in military recruits, prisons, colleges. It’s a atypical pneumoniae bacteria

A

Mycoplasma pneumoniae

396
Q

What is the treatment of mycoplasma pneumoniae

A

Macrolides, doxycline, or fluoroquinolone (penicillin ineffective since mycoplasma has no cell wall) not seen on gram stain.

397
Q

Grown on Eaton agar, CXR appears more severe than patient presentation. Can cause atypical variant of stevens jhonson syndrome typically in children and adolescents

A

Mycoplasma pneumoniae

398
Q

All of them can cause pneumonia and can disseminate all are caused by dimorphic fungi: cold (20c) mold; heat 37 yeast.

A

Systemic mycoses

399
Q

What is the unique systemic mycoses that is a spherule (not yeast) in tissue

A

Coccidioides

400
Q

Endemic location of histoplasmosis and pathological features

A

Mississippi and Ohio river valleys. Macrophages filled with histoplasmosis (smaller than RBC)

401
Q

Signs and symptoms of histoplasmosis and notes

A

Palatal tongue ulcers splenomegaly. Pacitopenia erythema nodosum. Associated with bird or bat droppings (caves) diagnosis via urine/serum antigen

402
Q

Endemic location, pathological features, signs and symptoms of blastomycosis

A

Eastern and central US, Great Lakes. Broad based budding of blastomyces same size as RBC) inflammatory lung disease. Disseminated to bone/ skin (verrucous lesiona may mimics SCC)

403
Q

Endemic southwestern IS California, spherule filled with Endosco tea of coccidioides (much larger than RBC) Disseminated to bone skin erythema nodosum or multiforme arthalgias (desert rheumatism) can cause meningitis

A

Coccidioidomycosis

404
Q

Is associated with dust exposure in endemic areas (archeological excavations earthquakes)

A

Coccidiodomycosis

405
Q

Para coccidioidomycosis is endemic in what location? What are the pathological features signs and symptoms

A

Latin America, budding yeast of paracoccidiodes with captains wheels formation (much larger than RBC)

406
Q

Similar to blastomycosis is more frequent in males than females

A

Paracoccidioidomycosis

407
Q

Name the opportunistic fungal infections pathogens 4

A

Candida albicans, aspergillus fumigatus, cryptococcus neoformans, mucor and rhizopus spp

408
Q

It’s a dimorphic; forms pseudo hyphae and budding yeast at 20celsius germ tubes at 37. Cause systemic or superficial fungal infection cause oral and esophageal thrush immunocompromised for example

A

Candida albicans

409
Q

Name the kind of diseases that candida albicans can cause and in what kind of people happenes

A

Causes oral and esophageal thrush in immunocompromised (neonates steroids diabetes AIDS) vulvovaginitis (diabetes use of antibiotics) diaper rash, infective endocarditis (people who inject drugs). Disseminated candidiases (especially in neutropenia patients) chronic mucocutaneous candidiasis

410
Q

What is the treatment of Candida albicans

A

Oral fluconzole topical azoles for vaginal; nystatin, azoles or rarely echinocandins for oral; fluconazole, echinocandins or amphotericin B for esophageal or systemic disease

411
Q

What is the morphologic of asoergillus fumigatus

A

Acute angle 45 grades branching of septate hyphae

412
Q

Causes invasive aspergillosis in immunocompromised patients especially those with neutrophil dysfunction (eg chronic granulomatous disease) because aspergillus is catalase +

A

Aspergillus fumigatus

413
Q

In adittion asprergillosis what other disease aspergillus fumigatus can cause

A

Aspergillus I’m pre existing lung cavities especially after TB infection. Some species of aspergillus produce aflatoxin. Allergic bronchopulmonary aspergillosis ABPA

414
Q

What does aflatoxin induce

A

TP53 mutations leading to Hepato cellular carcinoma

415
Q

What is the treatment plan f aspergillosis and aspergillosis

A

Vírico azoles or echinocandins (second line)

416
Q

What is ABPA

A

Hypersensitivity response to aspergillus growing in lung mucus. Associated with asthma and cystic fibrosis may cause bronchiectasis and eosinophilia

417
Q

It’s a pathogen with 5 to 10 micrómetros narrow budding heavily encapsulated yeast not dimorphic PAS+ staining found in soil, pigeon droppings. Acquired through inhalation with hematogenoua dissemination to meníngea

A

Cryptococcus neoformans

418
Q

It’s highlighted with India ink (clear halo) and mucicarmine (red inner capsule). Latex agglutination test detects polysaccharide capsular antigen and is more sensitive and specific to diagnosis to?

A

Cryptococcus neoformans

419
Q

How is manifested cryptococcosis

A

Which can manifest with meningitis pneumonia and or encephalitis (soap bubble lesions in brain) primarily immunocompromised

420
Q

How is the treatment cryptococcus neoformans

A

Amphotericin B + flucytosine followed by fluconazole for cryptococcal meningitis

421
Q

They are broad nonseptate hyphae branching at wide angles causes of mucormycosis mostly in patients with DKA and/or neutropenia. Inhalation of spores

A

Mucor and rhizopus spp

422
Q

How is the pathway of entrance of Mucor and rhizopus

A

Inhalation spores fungi proliferate in blood vessel walks penetrate cribiform plate and enter brain

423
Q

Clinical finding of Mucor mycosis

A

Rhinocerebral frontal lobe abscess cavernous sinus thrombosis. Hedeache facial pain black necrotic eschar on face; may have cranial nerve involvement.

424
Q

What is the treatment of Mucor and rhizopus

A

Surgical debridement amphotericin B or isavuconazole

425
Q

Cause pneumonia a diffuse interstitial pneumonia. It’s a yeastlike fungus (was originally classified as protozoan). Most infection are symptomatic. Immunosupression (eg AIDS) predispose to disease.

A

Pneumocystis jiroveci pneumonia

426
Q

How is the damage caused by pneumocystis jiroveci in tc or chest imagings

A

Diffuse bilateral ground glass opacities on chest imaging with pneumatoceles.

427
Q

How is made the diagnosis in pneumocystis jiroveci infection

A

Bronchoalveolar lavage or lung biopsy. Disc shaped yeast seen in methenamine silver stain of lung tissue or with fluorescent antibody

428
Q

What is the treatment and prophylaxis of pneumocystis jiroveci

A

TMP SMX, pentamidine, dapsone (prophylaxis as single agent or treatment in combination with tmp) atovaquone.

429
Q

In what moment it’s necessary start prophylaxis for pneumocystis jiroveci in people living with HIV

A

CD4 + Less than 200 cells/mm3

430
Q

It’s a dimorphic fungus exists as a cigar-shaped yeast at 37 Celsius grade in the human body and as hyphae with spores in soil (Conodia) lives on vegetation.

A

Sporothrix schenckii

431
Q

How is aquired sporothrix schenckii and how is manifested

A

Spores are traumatically introduced into the skin typically by a thorn cause local pustule or ulcer with nodules along draining lymphatics (ascending lymphangitis) disseminated disease possible in immunocompromised host

432
Q

What is the rose gardeners disease

A

Sporotrichosis by sporothrix schenckii

433
Q

What is the treatment of sporothrix psi’s

A

Itraconazole or potassium iodide (only for cutaneous lymphocutaneous)

Microbiology (4 decks)

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