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LAST EXAMMMMMM Year I > Chap8- Bacterial Infections > Flashcards

Chap8- Bacterial Infections Flashcards

1
Q

What are the pyogenic cocci and what they typically cause

A

Staph aureus and Staph epidermidis: Abscess, cellulitis, penumonia, sepsis
Strep pyogenes: pharyngitis, scarlet fever
Strep pneumoniae: lobar pneumonia, meningitis
Neis gonorrhea: gonorrhea
Neis meningitis: meningitis

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2
Q

What are the common gram - infections and what do they cause

A 
E coli, Klebsiella penumoniae
Enterobacter aerogenes
Proteus spp
Serratia marcescens
Pseudomonas spp
All above cause UTI, wound infection, abscess, pneumonia, sepsis, shock, endocarditis
Bacteroides spp: anaerobic infection
Legionella spp: legionnaires disease
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3
Q

What are the contagious childhood bacterial disease pathogens and what do they cause

A

Haemophilus influenze: meningitis, upper and lower respiratory tract infections
Bordetella pertussis: Whooping cough
Corynebacterium diphtheriae: diphtheria

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4
Q

What are the enteric infections and what do they cause

A

Enteropathogenic E coli and shigella spp

Vibrio Choleae, Campylobacter jejuni, C coli

Yersinia enteroclitica, salmonella spp

ALL above cause invasive or noninvasive gastroentercolitis
Salmonella typhi causes typhoid fever

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5
Q

What are the clostridial infections and what do they cause

A

clostridium tetani: tetanus
clostridium botulinum: botulism
Clostridium perfringens and C septicum: gas gangrene, necrotizing cellulitis
C difficile: pseudomembranous colitis

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6
Q

What are the zoonotic bacterial infections and what they cause

A 
bacillus anthracis: anthrax
yersinia pestis: bubonic plague
Francisella tularensis: tularemia
Brucella melitensis, B suis and B abortus: brucellosis
Borelia recurrentis: relapsing fever
Borrelia burgdorferi: lymes
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7
Q

What is the human treponemal infection and what does it cause

A

treponema pallidum: syphilis

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8
Q

What are the mycobacterial infections and what they cause

A

M tb, M bovis: TB
M leprae: leprosy
M kansasii, avium, intracellulare: atypical mycobacterial infections

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9
Q

What does nocardia asteroides cause

A

nocardiosis

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10
Q

What are the gram + cocci

A

staphylococcus and streptococcus and enterococcus

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11
Q

What are the gram+ rods

A

diphtheria, listeriosis, anthrax and nocardiosis, and clostridia

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12
Q

What can staphylococcus infections cause

A

skin lesions, absecesses, sepsis, osteomyelitis, pneumonia, endocarditis, food poisoning and TSS

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13
Q

What staph infection is common in UTI of young women

A

S saprophyticus

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14
Q

How does S aureus attach to endothelial cells

A

has surface R for fibrinogen, fibronectin and vitronectin

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15
Q

What enzyme does S aureus have to cause skin abscesses

A

lipases

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16
Q

How does S aureus escape Ab-mediated immunity

A

have protein A that binds to Fc R of Ig

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17
Q

describe the toxins in S aureus

A

alpha toxin- pore forming protein that will depolarize cell
beta toxin- sphingomyelinase
delta toxin- detergent like peptide
y toxin and leukocidin lyse RBC and phagocytic cells

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18
Q

What are the A and B toxins from S aureus

A

serine proteases that cleave protein desmoglein 1 causing keratinocyte detachment and loss of barrier function

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19
Q

TSS is characterized how clinically

A

hypotension (shock) renal failure, coagulopathy, liver disease, respiratory distress, generalized erythematous rash, soft tissue necrosis

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20
Q

What other than S aureus can cause TSS

A

Strep pyogenes

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21
Q

What is a furuncle or boil

A

focal suppurative inflammation of skin and subcut

hariy areas like face, axilla, groin and legs

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22
Q

what is a carbuncle

A

deeper suppurative infection that spreads laterally beneath deep sub cut fascia and surfaces in multiple adjacent skin sinuses
upper back and posterior neck

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23
Q

What is hidradenitis

A

chronic suppurative infection of apocrine glands most often in axilla

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24
Q

What are paronychia and felons

A

S aureus infections of nail bed or palmar side of fingertips that is painful

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25
Q

What does s aureus look like in lungs

A

polymorphonuclear infiltrate with alot of tissue destruction

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26
Q

What is Ritter disease

A

Staph scalded skin syndrome which occurs alot in children

sunburn like rash over entire body and evolves to bullae

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27
Q

how do you determine scalded skin syndrome vs toxic epidermal necrolysis or lyells disease

A

syndrome occurs at the level of granulosa layer rather than the epidermal-dermal junction

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28
Q

What is S aureus becoming resistant to

A

Methicillin, penicillins and cephalosporins

beta lactam cell wall synthesis inhibitors

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29
Q

What does strepcocci usually cause

A

suppurative infections of skin, oropharynx, lungs and heart valves

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30
Q

What post infectious syndromes are tied to strepcocci

A

rheumatic fever
IC glomerulonephritis
erythema nodosum

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31
Q

group A strepcocci cause what

A

pharyngitis, scarlet fever, erysipelas, impetigo, rheumatic fever, TSS and glomerulonephritis

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32
Q

Group B strepcoccie cause what

A

colonize female genital tract and cause sepsis
neonates- meningitis
intrauterine- chorioamnionitis

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33
Q

What is the main cause of dental a=caries

A

Strepcocci mutans

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34
Q

Enterococci are related to what infections

A

endocarditis and UTIs

and vancomycin Resistant!

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35
Q

Which Strepcocci have capsules to resist phagocytosis

A

S pyogenes, S agalactiae and S pneumoniae

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36
Q

What are the virulent factors of S pyogenes

A

M protein that prevents phagocytosis
complement C5a peptidase
exotoxin that causes fever and rash in scarlet fever
can cause rapid necrotizing fasciculitis

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37
Q

What exotoxin does strep pneumoniae have

A

pneumolysin that lyses cells and activates classical C’ pathway reducing C’ opsonization

38
Q

What is characterization of strepcocci infections

A

diffuse interstital neutrophilic infiltrates with minimal destruction–! key to differentiating staph

39
Q

what is erysipelas

A

rapidly spreading erythematous cutaneous swelling on face or body or extremity
butterfly distribution on face
maybe microabscesses

40
Q

What is the major antecedent of poststrep gomerulonephritis

A

strept pharyngitis

edema, epiglottic swelling, punctate abscess of tonsillar crypts

41
Q

When is scarlet fever most common

A

btwn age 3 and 15
punctate erythematous rash over trunk and inner arms/legs
leads to hyperkeratosis

42
Q

What virulent factor does C diphtheriae have

A

phage encoded A-B toxin that blocks host cell protein synthesis
A fragment catalyzes covalent transfer of ADP-ribose to elongation factor-2 inhibiting it so mRNa cannot be tralated

43
Q

how does the formalin fixed C diphtheria vaccine work

A

protects against the toxin that is released, does not prevent colonization

44
Q

Describe how C diphteriae is transmitted

A

inhaled attaches to mucosa and then release of exotoxin causes epithelial necrosis with fibrinosuppurative exudate

45
Q

why is there HSM seen in C diphtheria infections

A

soluble exotoxin in the blood

46
Q

What population is more susceptible to L monocytogenes and what is the main risk for each

A

pregnant women- amnionitis resulting in stillbirth, abortion or neonatal sepsis
neonate: meningitis or granulomatous infantiseptica
immunocompromised, elderly

47
Q

Describe the virulence factors of L monocytogenes

A

internalins on surface that bind E cadherin and internalize the bacteria
poreforming protein listerolysin O and 2 phospholipases that degrade phagolysosomes
induces actin polymerization in the cell to propel bacteria to other cells

48
Q

What cells are primary defense on L monocytogenes infections and why

A

NK cells and T cells because respond to IFN-y

evade C3 activated macrophage killing

49
Q

what is the main lymphocyte in an acute L monocytogenes

A

neutrophils

50
Q

What is Diganostic for L monocytogenes

A

gram + bacilli in CSF

51
Q

What is the most virulent factor of bacillus anthracis

A

spores that are formed

52
Q

What are the 3 major anthrax syndromes

A

cutaneous anthrax
inhalational anthrax
gastrointestinal anthrax

53
Q

describe cutaneous anthrax rxn

A

painless, pruritic papule that develops into a vesicle with edema around it and lymphadenopathy
after vesicle ruptures there is black eschar with dries and heals

54
Q

describe inhalational anthrax

A

hemorrhagic mediastinitis
1-6 days fever, cough, chest or abdominal pain
fever, hypoxia and sweating
leads to shock in death in 1-2 days

55
Q

describe GI anthrax

A

nausea, abdominal pain, vomiting, severe bloody diarrhea with mortality over 50%

56
Q

What are the other virulent factors of bacillus anthracis once in the cell

A

have antiphagocytic capsule with AB toxins
B fragment is protective Ag
A fragment has 2 subunits: edema factor or lethal factor
3 A units and B heptamer endocytosed and then a channel is formen where EF and LF move into cytoplasm activating cAMP causing water efflux and intersitial edema
LP kills MAPKKinases that regulate MAPKs

57
Q

What is suggestive of B anthracis Dx

A

large box car shaped gram+ bacteria in chains

58
Q

Where does B anthracis predominately inhabit in lungs

A

alveolar capillaries and venules and sometimes alveolar space

59
Q

What do nocardia bacteria look like

A

gram + in distinctive branched chains

stain with modified Acid Fast

60
Q

Most patients with N. asteroides have defects in what

A

T cell mediated immunity like steroid use, HIV or diabetes

61
Q

What is respiratory N asteroides mistaken for alot

A

TB

62
Q

What does a N asteroides infection look like morphologically

A

suppurative with central liquefactive necrosis and surrounding granulation and fibrosis
NO granulomas

63
Q

When does N meningitidis become an invasive disease

A

when a person is exposed to a serotype (13) that they are not immune to
usually close quarter living like dormitories

64
Q

Describe what has to occur in order for an infected patient with N meningitidis to actually get meningitis

A

bacteria invade resp epithelial cells and enter blood where they inhibit opsonization and destruction by C’

65
Q

What are the two most common STDs

A

1 is C trachomatis

2 is N gonorrhea

66
Q

What does gonorrhea look like in males? females?

A

m: urethritis
f: asymptomatic

67
Q

What can untreated infeciton of gonorrhea in a woman lead to

A

ectopic pregnancy, infertility

68
Q

Infection of gonorrhea is Dx how

A

PCR and culture

69
Q

What type of people are prone to disseminated gonorrhea? and what does this look like

A

C’ defects
septic arthritis
rash of hemorrhagic papules and pustules

70
Q

What do we give newborns to prevent blindness from gonorrhea directly after birth

A

silver nitrate or antibiotics

71
Q

How does neisseria escape immune defenses

A

able to change its expressed Ag on the Pili which bind to CD46

72
Q

What factor do the neisseria genus have to increase binding and promotion of entry into host cells

A

OPA proteins
gonorrhea has 4
meningitidis has 12

73
Q

What type of bacteria causes whooping cough and what does it look like

A

bordetella pertussis

gram negative coccobacillus

74
Q

Where does bordetella pertussis colonize

A

brush border bronchial epithelium and invades macrophages

75
Q

Describe pertussis toxin

A

5 distinct proteins
catalytic peptide S1 which ADP-ribosylates and inactivates guanine nucleotide binding proteins so G proteins can’t transduce signals
also the toxin paralyzes the cilia

76
Q

What does P aeruginosa cause

A 
pulmonary failure
keratitis
endocarditis
osteomyelitis
external otitis
77
Q

What are the exotoxins in pseudomonas aeruginosa

A

alginate biofilm
exotoxin A that inhibits protein syntehsis by ADP ribsylating EF-2
releases exoenzyme S which ADP ribsylates RAS and other G proteins
Secretes phospholipase C to lyse RBC and pulm surfactant

78
Q

What toxic component is released by p aeruginosa that is super toxic to endothelial cells

A

iron-containing compunds

79
Q

What does pseudomonas pneumonia look like

A

necrotizing through terminal airways with pale necrotic centers and red hemorrhagic periphery

80
Q

What is the appearance of p aeruginosa in burns

A

ecthyma gangrenosum

necrotic and hemorrhagic oval skin lesions

81
Q

What type of bacteria is yersinia pestis

A

gram - facultative intracell bacterium that is trasnmitted from rodents or flea bites
causing the plague

82
Q

What is the virulent factor or Y pestis

A

Yop virulon which kills host phagocytes

type III secretion that syringe like projects from bacterial surface into host to inject toxins

83
Q

What Yop from Y pestis inhibits LPS pathways

A

YopJ

84
Q

What is the morphology of Y pestis

A

lymph node enlargement, pneumonia, sepsis, neutrophilia
massive proliferation of organisms with protein and polysaccharide rich effusions with dew inflammatory cells but lots of swelling
necrosis of tissues and blood vessels and neutrophilic infiltrates accumulate next to necrotic areas

85
Q

Describe bubonic plague

A

infected fleabite that starts as small pustule and grows rapidly becomes pulpy and plum colored then ruptures

86
Q

What is the pneumonic plague

A

severe confluent hemorrhagic and necrotizing bronchopneumonia with fibrinous pleuritis

87
Q

What is septicemic plague

A

lymph nodes are rich in mononuclear phagocytes that develop areas of necrosis

88
Q

What causes chancroid

A

hemophilus decreyi

89
Q

What does a chancroid look like

A

irregular ulcer may be a couple lesions

shaggy yellow gray exudate and there is regional lymph node enlargement

90
Q

Describe appearance of granuloma inguinale

A

begins as raised papular lesion on moist stratified squamous epithelium of genitalia
usually ulcerates and makes alot of granulation tissue

91
Q

What stains are used for granuloma inguinale

A

donovan bodies in macrophages and silver stains

LAST EXAMMMMMM Year I (24 decks)

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