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Step 1 - Microbiology > Clinical Bacteriology > Flashcards

Clinical Bacteriology Flashcards

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Biology 101 flashcards
1
Q

Aerobic bacilli

A

Listeria

Bacillus

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2
Q

Anaerobic bacilli

A

Clostridium

Propionilbacterium

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3
Q

Aerobic branching filaments

A

Nocardia: weakly acid fast

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4
Q

Anaerobic branching filaments

A

Actinomyces: not acid fast

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5
Q

Catalase - cocci

A

Streptococcus

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6
Q

Catalase + cocci

A

Staphylococcus

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7
Q

Coagulase + cocci

A

S. aureus

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8
Q

Coagulase - cocci

Catalase + cocci

A

Staph. epidermidis

Staph. saprophyticus

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9
Q

Coagulase - cocci
Catalase + cocci
- Novobiocin sensitivity

A

Staph saprophyticus

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10
Q

Coagulase - cocci
Catalase + cocci
+ Novobiocin sensitivity

A

Staph. epidermidis

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11
Q

Partial hemolysis, green

A

Alpha hemolysis

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12
Q

Alpha hemolysis

A

S. pneumoniae: capsule!

Viridans: no capsule! : S mutans, S mitis

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13
Q

Alpha hemolysis

- Optochin sensitivity

A

Viridans: S mutans, Smitis

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14
Q

Complete hemolysis, clear

A

Group B streptococci: S. agalactiae

Group A streptococci: S.pyogenes

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15
Q

Complete hemolysis

+ Bacitracin sensitivity

A

Group B streptococci: S. agalactiae

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16
Q

No hemolysis

A

Gamma hemolytic

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17
Q

Gamma hemolytic

A
  1. Group D srteptococci: Enterococcus: E faecium (Ampicilin R), E faecalis (Ampicilin sensitive)
  2. S bovis
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18
Q

Enterococcus can be ___ or ____ -hemolytic

A

Alpha

Gamma

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19
Q

S aureus is ___ hemolytic

A

Beta: complete hemolysis

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20
Q

Pneumonia after influenza virus infection (flue)

A

S.aureus

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21
Q

MRSA mechanism of resistance

A

Altered penicillin binding protein

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22
Q

Toxic Shock Syndrome (TSS) is due to

A

Toxic Shock Synrome Toxin (TSST-1) of S.aureus: superantigen activates MHCII and TCR producing polyclonal T-cell activation

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23
Q

Associated with prolonged use of vaginal tampons or nasal packing

A

Toxic Shock Syndrome by S.aureus

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24
Q

Toxic Shock-Like Syndrome is due to

A

S.pyogenes (complication of chickenpox)

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25
Q

S.aureus food poisoning is due to

A

preformed toxin: Emesis (neurotoxin)! and non bloody diarrhea

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26
Q

Catalase + that does not ferment mannitol

A

S.epidermidis (S.aureus DOES ferment manitol)

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27
Q

Infects prosthetic devices (hip implant, heart valve) and IV catheters by producing biofilms

A

Staphylococcus epidermidis

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28
Q

Normal flora of skin

A

S.epidermidis

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29
Q

Normal flora of female genital tract and perneum

A

S.saprophyticus

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30
Q

Most common cause of uncomplicated UTI in young women

A

E.coli

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31
Q

Second most common cause of uncomplicated UTI in young women

A

S.saprophyticus

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32
Q

Virulence factor in S.aureus

A

Protein A: binds Fc-IgG

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33
Q

Virulence factor S.pneumoniae

A

IgA protease: SHN: Saureus, Haemophilus, Neisseria

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34
Q

S.pneumoniae is the most common responsible for

A
  1. Meningitis
  2. Otitis media
  3. Bacterial pneumonia
  4. Sinusitis
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35
Q

Rusty sputum

A

Pneumococcus

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36
Q

Sepsis in patients with sickle cell disease AND asplenic patients

A

S.pneumoniae

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37
Q

Diplococci

A

S.pneumoniae

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38
Q

Virulence of S.pneumoniae without its capsule

A

NO virulence

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39
Q

Subacute bacterial endocarditis at damaged heart valves

A

Viridans streptococci: S sanguinis: BLOOD

S.sanguinis makes dextrans which bind to fibrin platelet aggregates on damaged heart valves

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40
Q

Normal flora of the oropharynx

A

Viridans streptococci: S.mutans and mitis

Cause dental caries

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41
Q

S.pyogenes causes

A
  1. Pyogenic: pharyngitis, cellulitis, impetigo (contagioso, costras mielicéricas), erysipelas
  2. Toxigenic: scarlet fever, Toxic shock-like syndrome, necrotizing fasciitis
  3. Immunologic: rheumatic fever, glomerulonephritis
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42
Q

S.pyogenes virulence factor

A

M.protein: prevents phagocytosis but gives rise to immunological crossed reactions

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43
Q

Markers of recent S.pyogenes infection

A

Anti-streptolysin A titers

anti-DNAse B antibodies

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44
Q

Sand-paper rash

A

Scarlet Fever

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45
Q

Pneumonia, meningitis and sepsis in babies

A

S.agalactiae: Group B(babies) streptococci

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46
Q

Screening in pregnant woman for colonisation with S,agalactiae takes place at

A

35-37 weeks of gestation with rectal + vaginal swabs

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47
Q

Positive S.agalactiae culture in pregnancy screening

A

Intrapartum penicillin prophylaxis

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48
Q

Streptococcus bovis is responsible for

A

Bacteriemia: subacute endocarditis
Associated with colon cancer
Bovis in the Blood=Cancer in the colon

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49
Q

S.gallotycus

A

S.bovis type I: endocarditis

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50
Q

Enterococci are responsible for

A

UTI
Biliary tract infections
Subacute endocarditis after GI/GU procedure

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51
Q

VRE enterococci

A

Nosocomial infections

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52
Q

Can grow in 6.5% NaCl medium and bile

A

Enterococci

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53
Q

Only bacterium with polypeptide capsule

A

Bacillus anthracis

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54
Q

Medusa head colonies

A

Bacillus anthracis (halo)

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55
Q

Painless papule sourrounded by vesicles that becomes an ulcer with black eschar

A

Cutaneous anthrax

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56
Q

Woolsorter’s disease

A

Pulmonary anthrax

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57
Q

Reheated rice syndrome

A

Bacillus cereus

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58
Q

Tetanus signs

A
  1. Spastic paralysis
  2. Trismus: lockjaw
  3. Risus sardonicus: raised eyebrows and open grin
  4. Opisthotonos: spasms of spinal extensors
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59
Q

Prevent tetanus

A

Tetanus vaccine

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60
Q

Treat tetanus

A

Antitoxin
+- Vaccine booster
Diazepam: for muscle spasms
Wound debridement

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61
Q

Botulism in adults is due to

A

Ingestion of preformed toxin

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62
Q

Botulim in babies is due to

A

Ingestion of spores: food, juice and honey: FLOPPY baby syndrome

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63
Q

Treatment of botulism

A

Antitoxin

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64
Q

Symptoms of botulism

A

4 D

  1. Diplopia
  2. Dysarthria
  3. Dysphagia
  4. Dyspnea
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65
Q

Local botox injections used for

A
  1. Focal dystonia
  2. Achalasia
  3. Muscle spasms
  4. Facial wrinkles
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66
Q

Gas gangrene

A

C perfringens

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67
Q

C perfringens produces two toxins

A

Alpha toxin: phospholipase: gas gangrene

Enterotoxin: food poisoning

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68
Q

Pseudomembranous colitis is often secondary to antibiotic use, specially

A

Clindamycin

Ampicillin

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69
Q

Associated with proton pump inhibitors

A

Pseudomembranous colitis by C.difficile

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70
Q

Cdifficile toxins

A

A: enterotoxin: alters fluid secretion in brush border
B: cytotoxin, disrupts cytoskeleton: actin depolymerization

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71
Q

Pseudomembranous colitis by C.difficile diagnosis

A

Detection of one or both toxins in stool by:

  • Antigen detection
  • PCR
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72
Q

Treatment of Pseudomembranous colitis by C.difficile

A

Metronidazol
Oral vancomycin
Recurrent cases: repeat prior regimen/Fidaxomicin/Fecal microbiota transplant

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73
Q

Pseudomembranous pharyngitis
Lymphadenopathy
Myocarditis
Arrythmias

A

Corynebacterium diphteriae

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74
Q

Prevention of diphtheria

A

Toxoid vaccine

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75
Q

Test for diphtheria toxin

A

Elek test

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76
Q

Lab diagnosis of diphteria

A

Gram + rods with metachromatic granules

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77
Q

Inhibits protein synthesis via ADP-ribosylation of elongation factor 2

A

Corynebacterium diphtheriae toxin

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78
Q

Tumbling motility in broth

A

Listeria monocytogenes

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79
Q

Treatment against Listeria monocytogenes

A

Ampicillin

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80
Q

Rocket tails

A

Listeria monocytogenes

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81
Q

Unpasteurised dairy products

Cold deli meats

A

listeria monocytogenes

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82
Q 
Granulomatosis infantiseptica
Neonatal meningitis
Meningitis in immunocompromised
Gastroenteritis in healthy individuals
Amnionitis, septicemia and spontaneous abortion
A

Listeria monocytogenes

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83
Q

Actinomyces is an ____erobe

A

Anaerobe

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84
Q

Nocardia is an ____erobe

A

Aerobe

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85
Q

Nocardia is found in

A

Soil

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86
Q

Actinomyces is found in

A

Normal oral, reproductive and GI flora

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87
Q

Nocardia and Acid fast

A

Weak

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88
Q

Actynomyces and Acid fast

A

NOT acid fast

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89
Q

Nocardia causes

A
  1. Pulmonary infectinos in immunocompromised=mimic TBC
  2. Cutaneous infections after trauma in immunocompetent
  3. Can spread to CNS
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90
Q

Treatment of nocardia

A

Sulfonamides: TMP-SMX

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91
Q

Treatment of actinomyces

A

Penicillin

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92
Q

Actinomyces causes

A
  • Oral/Facial abscesses that drain through sinus tracts associated with Dental caries/extraction
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93
Q

Gohn complex

A

Primary tuberculosis: Hiliar nodes + Ghon focus

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94
Q

Gohn focus is usually located in

A

Mid-Lower Lobes

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95
Q

Primary tuberculosis history

A

90% Healing by fibrosis and calcification: may produce 2º tuberculosis in reactivation
10%Progressive primary tuberculosis (AIDS, malnutrition): bacteriemia and progressive lung disease

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96
Q

IGRA vs PPD

A

IGRA has fewer false positive from BCG vaccination

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97
Q

PPD negative

A

No infection
Sarcoidosis
HIV with low CD4 + account

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98
Q

Caseating granulomas are characteristic of

A

2ª tuberculosis

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99
Q

Caseating granulomas

A

Central necrosis

Flanking Langhans giant cells

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100
Q

Mycobacterium avium causes

A

Disseminated disease in AIDS

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101
Q

Mycobacterium avium prophylaxis

A

Azithromycin when CD4+ count <50 cells/mm3

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102
Q

Hand infection in aquarium handlers

A

Mycobacterium marinum

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103
Q

Acid fast organisms

A

Mycobacteria

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104
Q

M scrofulaceum causes

A

Cervical lymphadenitis in children

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105
Q

TB symptoms

A
  • Fever
  • Night sweats
  • Weight loss
  • Cough
  • Hempoptysis
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106
Q

Leprosy (hansen disease) cause

A

Mycobacterium leprae

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107
Q

Leprosy symptoms

A

Mycobacterium leprae infects skin and superficial nerves: gloves and stocking loss of sensation

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108
Q

Mycobacterium leprae likes ____ temperatures

A

Cool

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109
Q

Diagnosis of Mycobacterium leprae

A

Skin biopsy

Tissue PCR

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110
Q

Reservoir of Mycobacterium leprae in the United States

A

Armadillos

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111
Q

Forms of Hansen Disease

A
  1. Lepromatous:
    - Diffusely over skin, lion like face
    - Communicable
    - Lethal
    - Low cell mediated immunity with humoral Th2 response
  2. Tuberculoid:
    - Hypoesthetic, hairless skin plaques
    - High cell mediated immunitu and Th1 type response
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112
Q

Treatment of Hansen disease

A

Tuberculoid form: Dapsone + Rifampicin

lepromatous form: Clofazimine

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113
Q

Gram - Diplococci

A

Neisseria:
-(M)eningitidis: (M)altose utilization +
-gonorrhoeae: maltose -
Moraxella: maltose -

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114
Q

Gram - cocobacilli

A
  1. Haemophilus influenzae
  2. Bordetella pertussis
    - Pasteurella
    - Brucella
    - Francisella tularensis
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115
Q

Comma-shaped gram - rods

A
  1. Campylobacter jejuni: grows in 42ºC
  2. Vibrio cholerae: grows in alkaline media
  3. Helicobacter pylori: produces urease
116
Q

Gram - Bacilli: first test

A

Lactose fermentation

117
Q

Lactose fermentation + Bacilli

A
  1. Klebsiella
  2. E.coli
    Enterobacter
    Citrobacter
    Serratia
118
Q

Non-lactose fermenting, oxidase +

A

Pseudomonas

119
Q

Non-lactose fermenting, oxidase negative

A

Salmonella
Shigella
Yersinia
Proteus

120
Q

Non-lactose fermenting, oxidase negative, H2S production on TSI agar

A

Salmonella

Proteus

121
Q

Fast lactose fermentation

A

Klebsiella
E.coli
Enterobacter

122
Q

Pink colonies on MacConkey agar

A

Fermentation of lactose:

  • Klebsiella
  • E.coli
  • Enterobacter
  • Serratia
123
Q

E.coli on EMB agar

A

Colonies with green sheen

124
Q

Capsule gonococci vs meningococci

A

Meningococci=polysaccharide capsule

Gonococci=no polysaccharide capsule

125
Q

Gonococci vaccine

A

No vaccine due to antigenic variation of pilus proteins

126
Q

Meningococci vaccine

A

Yes, type B vaccine not widely available

Type C available

127
Q

Gonococci causes

A
  1. Gonorrhea
  2. Septic arthritis
  3. Neonatal conjunctivitis: 2-5 days after birth
  4. Pelvic inflammatory disease
  5. Fitz-Hugh-Curtis syndrome
128
Q

Preventa gonococcal neonatal blindness

A

Erythromycin eye ointment

129
Q

Gonococci treatment

A

Ceftriaxone (+azithromycin or doxycycline for possible chlamydial coinfection)

130
Q

Meningococci causes

A
  • Meningococcemia with petechial hemorrhages and gangrene of toes
  • Meningitidis
  • Waterhouse-Friderichsen syndrome: adrenal insufficiency, fever, DIC, shock
131
Q

Treatment of gonococci

A

Cetriaxone

Penicillin G sódica IV (meninges)

132
Q

Prophylaxis of meningococci in close contacts

A

Rifampicin
Ciprofloxacin
Cetriaxone

133
Q

HaEMOPhilus causes

A
  1. Epiglotitis
  2. Meningitis
  3. Otitis media
  4. Pneumonia
134
Q

Most common type of Haemophilus influenzae

A

Nontupable (unencapsulated) since vaccine for capsular type b was introduced

135
Q

Thumb sign on xray

A

Epiglotitis (Haemophilus influenzae)

136
Q

Treatment against H.influenzae

A
  1. Mucosal infections: Amoxicillin +- clavulanate

2. Meningitis: ceftriaxone

137
Q

Prophylaxis against H.influenzae

A

Rifampicin: close contacts

138
Q

H.influenzae type b vaccine

A

Capsular polysaccharide conjugated with diphteria toxoid or other protein: 2-18 months of age

139
Q

Bordetella pertussis virulence factors

A
  1. Pertussis toxin: disables G1

2. Tracheal cytotoxin

140
Q

Satages of infection by Bordetella pertussis

A
  1. Catarrhal: low fever, coryza
  2. Paroxysmal: intense cough followed by inspiratory “whoop” and posttussive vomiting
  3. Convalescent: recovery from chronic cough
141
Q

Prevention against Bordetella pertussis

A

Tdap, DTaP vaccines

142
Q

Gram stain and Legionella

A

Poor

143
Q

Legionella stain

A

Silver

144
Q

Legionella Culture

A

Charcoal yeast extract medium with iron and cysteine

145
Q

Detection of legionella

A

Antigen in urine

146
Q

Typical analytical finding in legionella infection

A

Hyponatremia

147
Q

person to person transmission in Legionella

A

NO

148
Q

Transmission of legionella

A

Environmental water source habitat: air conditioning systems, hot water tanks: summer camps, military facilities

149
Q

Treatment against Legionella

A

Macrolide or Quinolone

150
Q

Legionella pneumophila produces

A
  1. Legionnaires disease

2. Pontiac fever

151
Q

Pontiac fever

A

Mild flu-like syndrome caused by Legionella

152
Q

Legionnaires disease

A

Severe pneumonia: unilateral, lobar
Fever
GI
CNS symptoms

153
Q

Legionnaires disease is more common in

A

Smokers

Chronic lung disease

154
Q

Grape like odor

A

Pseudomonas aeruginosa

155
Q

Produces pyocyanin

A

Pseudomonas aeruginosa

156
Q

Pseudomonas aeruginosa produces

A
  1. Endotoxin: fever, shock
  2. Exotoxin A: inactivades EF-2 = diphteria
  3. Phospholipase C: degrades cell membrane
  4. Pyocyanin: generates ROS
157
Q

PSEUDOMONAS is associated with

A
  1. P neumonia, pyocyanin
  2. S epsis
  3. E cthyma gangrenosum in septic patients
  4. U TIs (non lactose fermenting vs E.coli)
  5. D iabetes, drug abuse
  6. O steomielitis: puncture wounds
  7. M ucoid polyssaccharide capsule
  8. O titis externa: swimmer’s ear
  9. N osocomial infections: catheters, equipment
  10. exotoxin A
  11. Skin infections: hot tub foliculitis
    + keratitis in contact lenses
158
Q

Treatments against Pseudomonas

A

CAMPFIRE

  1. Carbapenems
  2. Aminoglycosides (s/t amikacina)
  3. Monobactams (Aztreonam)
  4. Polymixins (B, colistin)
  5. Fluoroquinolones (R)
  6. ThIRd and fourth generation cephalosporins: ceftazidime and cefepime
  7. Extended-spectrum penicillins: piperacillin-tazobactam, ticarcillin-clavulanate
159
Q

Chronic pneumonia in cystic fibrosis patients due to P.aeruginosa can be explained by

A

Mucoid polysaccharide capsule that forms biofilm

160
Q

E.coli virulence factors

A
  1. Fimbriae: cystitis and pyelonephritis
  2. K capsule: pneumonia, neonatal meningitis
  3. LPS endotoxin: septic shock
161
Q

Enteroinvasive E.coli

A

Invades intestinal mucosa: Dysentery

Similar to Shigella

162
Q

Enterotoxigenic E.coli

A

Heat-labile and Heat-Stable enterotoxins: traveler’s diarrhea

163
Q

Most frequent cause of traveler’s diarrhea

A

Enterotoxigenic E.coli

164
Q

Enteropathogenic E.coli mostly affects

A

Children (P: pediatrics)

165
Q

Enterohemorrhagic E.coli most common serotype

A

O157: H7

166
Q

O157: H7 E.coli transmitted via

A
  • Undercooked meat: hamburgers

- Raw leafy vegetables

167
Q

Shiga like toxin of Enterohemorrhagic E.coli causes

A

Hemolytic-uremic syndrome

168
Q

Hemolytic-uremic syndrome

A 
Triad: 
1. Anemia
2. Thrombocytopenia
3. Acute renal failure
Due to microthrombi forming on damaged epithelium
169
Q

E. coli that does not ferment sorbitol

A

Enterohemorrhagic E.coli

170
Q

5A’s of Klebsiella

A
  1. Aspiration pneumonia in alcoholics and diabetics
  2. Abscess in lungs and liver
  3. Alcoholics
  4. DiAbetics
  5. currAnt Jelly sputum
171
Q

Nosocomial UTI

A

Klebsiella

172
Q

Microbiological antecedent of Guillain Barré syndrome

A

Campylobacter jejuni

173
Q

Major cause of bloody diarrhea in children

A

Campylobacter jejuni

174
Q

Transmission of Campylobacter jejuni

A
  1. Fecal-oral person-to person
  2. Undercooked poultry
  3. Unpasteurised milk
175
Q

Salmonella spp reservoirs

A

Typhy: humanos only

The rest: humans and animals

176
Q

H2S2 production Salmonella vs Shigella

A

Salmonella and proteus: YES

Shigella and Yersinia: NO

177
Q

Hematogenous spread Salmonella vs Shigella

A

Salmonella YES

Shigella NO: cell to cell

178
Q

Flagella Salmonella vs Shigella

A

Salmonella: YES (salmon swim)
Shigella: NO

179
Q

Virulence factor Salmonella vs Shigella

A

Salmonella: Endotoxin + (typhy: Vi capsule)
Shigella: Endotoxin + Shiga toxin

180
Q

Infectious dose of Salmonella vs Shigella

A

Salmonella: High: inactivated by gastric acids
Shigella: Low: resistant to gastric acids

181
Q

Effect of antibiotics on fecal excretion: Salmonella vs Shigella

A

Salmonella: Prolongs duration
Shigella: Shortens duration

182
Q

Immune response Salmonella vs Shigella

A

Salmonella:
-Typhy: Monocytes
-spp: PMN in disseminated disease
Shigella: PMN

183
Q

GI manifestations of Salmonella vs Shigella

A

Salmonella
-typhi: constipation–>diarrhea
-spp: diarrhea
Shigella: bloody diarrhea

184
Q

Vaccine salmonella vs shigella

A

Salmonella typhi:
-oral vaccine: live attenuated S. typhi
-IM vaccine: Vi capsular polysaccharide
Salmonella spp and Shigella: no vaccine

185
Q

Typhoid fever manifestations

A
  1. Rose spots on abdomen
  2. Constipation
  3. Abdominal pain
  4. Fever
186
Q

Typhoid fever treatment

A

Ceftriaxone / fluoroquinolone

187
Q

Carrier state with gallbladder colonization

A

Salmonella typhy

188
Q

Gastroenteritis by Salmonella is usually caused by

A

Non-typhoidal Salmonella

189
Q

Four F’s of Shigella

A
  1. Fingers
  2. Flies
  3. Food
  4. Feces:
190
Q

Most severe Shigella

A

S dysenteriae

191
Q

Less severe Shigella

A

S sonnei

192
Q

Key to pathogenicity of Shigella

A

Invasion of M cells of Peyer patches

193
Q

Rice-water diarrhea

A

Vibrio cholerae

194
Q

Treatment against Vibrio cholerae

A

Promt oral rehydration

195
Q

Inoculum for Vibrio cholerae

A

Large: high dose because its sensitive to stomach acid (=salmonella)

196
Q

Yersinia is transmitted from

A

Pet feces=puppy
Contaminated milk
Pork

197
Q

Yersinia causes

A

Acute diarrhea

Pseudoppendicitis: mesenteric adenitis

198
Q

Triple + microorganism

A

Helicobacter pylori
Catalase +
Oxidase +
Urease +

199
Q

Diagnosis of Helicobacter pylori

A

Urea breath test

Fecal antigen test

200
Q

Treatment against Helicobacter pylori

A

OCA:
Omeprazol: Proton pump inhibitor
Clarithromycin
Amoxicillin: metronidazole if allergy

201
Q

Infection with Helicobacter pylori is a risk factor for

A
  1. Peptic ulcer disease
  2. Gastric adenocarcinoma
  3. MALT lymphoma: OCA
202
Q

Spirochetes

A

BLT
Borrelia=Big
Leptospira
Treponema

203
Q

Visualisation of Treponema

A

Dark field microscopy

Direct fluorescent antibody microscopy

204
Q

Borrelia can be visualised using

A

Giemsa stain or Wright stain in light microscopy

205
Q

Found in water contaminated with animal urine

A

Leptospira interrogans

206
Q

Leptospirosis

A 
Flu like symptoms
Mialgias: calves!
JAUNDICE
Photophobia
Conjunctival suffusion
207
Q

Prevalent among suffers in Hawaii

A

Leptospira interrogans

208
Q

Weil disease

A

Leptospira interrogans: icterohemorrhagic leptospirosis: severe form of jaundice and azotemia from liver and kidney disfunction, fever, hemorrhage and anemia

209
Q

Lyme disease is caused by

A

Borrelia burgdorferi

210
Q

Lyme disease is transmitted by

A

Ixodes deer tick

211
Q

Ixodes deer tick transmites

A
  1. Lyme disease
  2. Anaplasma spp
  3. Babesia
212
Q

Reservoir of Lyme Borrelia burgdorferi

A

Mouse

213
Q

Stages of Lyme disease

A
  1. Early localied: erythema migrans: bulls-eye
  2. Early disseminted: carditis, AV block, Bell’s palsy bilateral, migratory myalgias, transient arthritis
  3. Late disseminaed: encephalopathies, chronic arthitis
214
Q

Lyme manifestations

A

A key Lyme pie to the FACE

  1. Facial nerve palsy: bilateral
  2. Arthitis
  3. Cardiac Block
  4. Erythema migrans
215
Q

Treatment of Lyme disease

A

1st line: Doxycycline

Pregnant and children: Amoxicillin and cefuroxime

216
Q

Primary syphilis finding

A

Painless chancre

217
Q

Treponemes in syphilitic chancre

A

YES: use dark-field microscopy

218
Q

VDRL in primary syphilis

A

VDRL + in 80%

219
Q

Secondary syphilis findings

A
  1. Constitucional symptoms
  2. Maculopapular rash INCLUDING palms and soles
  3. Condylomata lata
220
Q

Non-specific syphilis tests

A

Reagínicas: VDRL/RPR

221
Q

Specific test for syphilis

A

Treponémicas: FTA-ABS

222
Q

Latent syphilis

A

+ serology without symptoms

223
Q

Secondary syphilis is

A

Systemic

224
Q

Tertiary syphilis finding

A

Gummas: crhonic granulomas
Aortitis
Neurosyphilis: tabes dorsalis, general paresis
Argyll Robertson pupil

225
Q

Argyl Robertson pupul

A

Constricts with accommodation but is not reactive to light

226
Q

Signs of tertiary syphilis

A

Broad-based ataxia
Romberg +
Charcot Joint
Stroke without hypertension

227
Q

Neurosyphilis diagnosis

A

Test spinal fluid with VDRL, FTA-ABS and PCR

228
Q

Congenital syphilis

A
  1. Rhagades: linear scar at angle of mouth
  2. Snuffles: nasal discharge
  3. Saddle nose
  4. Notched teeth: Hutchinson
  5. Mulberyy molars
  6. Short maxilla: micrognatia
  7. Saber shins
  8. CN VIII deafness
229
Q

Placental transmission of syphilis occours

A

After first trimester: treat mother early in pregnancy

230
Q

False positive results on VDRL

A

Viral infection: EBV, Hepatitis
Drugs
Rheumatic fever
Lupus and leprosy

231
Q

Jarisch-Herxheimer reactin

A

Flu-like syndrome after antibiotics are started in syphilis due to killed bacteria releasing toxics

232
Q

Bartonella henselae is responsible for

A

Cat scratch disease

233
Q

Bartonella quintana is responsible for

A

Bacillary angiomatosis

234
Q

Borrelia recurrentis produces

A

RELAPSING fever

235
Q

Borrelia recurrentis source

A

Louse

236
Q

Brucella spp produces

A

Brucellosis

Undulant fever

237
Q

Brucella source

A

Unpasteurized dairy

238
Q

Chlamydophila pisttaci source

A

Parrots

239
Q

Psittacosis agent

A

Chlamydophila pisttaci

240
Q

Q fever agent

A

Coxiella burnetii

241
Q

Coxiella burnetii source

A

Aerosols of cattle/sheep amniotic fluid

242
Q

Francisella tularensis source

A

Rabbits: fiebre de los conejos
Ticks
Deer flies

243
Q

Pasteurella multocida source

A

Animal bite: cats, dogs

244
Q

Rocky Mountain spotted fever agent

A

Rickettsia rickettsii

245
Q

Epidemic typhus agent

A

Ricketssia prowazekii

246
Q

Endemic typhus

A

Rickettsia typhy

247
Q

Source of Rickettsia ricketsii

A

Dermacentor: dog tick

248
Q

Gardnerella vaginalis is a gram ____ rod

A

Variable

249
Q

Gray vaginal discharge with fishy smell

A

Gardnerella vaginalis

250
Q

Pain in infection by Gardnerella vaginalis

A

Nonexisting

251
Q

Is gardnerella vaginalis an STD?

A

NO, but it is associated with sexual activity

252
Q

Bacterial vaginosis

A

Gadnerella vaginalis

Overgrowth of anaerobic bacteria

253
Q

Clue cells

A

Vaginal epithelial cells covered with Gardnerella

254
Q

Treatment of Gardnerella vaginalis

A

Metronidazole

Clindamycin

255
Q

Test for Gardnerella vaginales

A

Amine whiff test: mixing discharge with 10 KOH enhances fishy odor

256
Q

Rickettsial diseases common treatment

A

Doxycycline

Pregnancy: Chloramphenicol

257
Q

Most common place for Rocky Mountain spotted fever

A

Despite its name, disease occurs primarily in South Atlantic states

258
Q

Classif triad for Rocky Mountain spotted fever

A
  1. Headache
  2. Fever
  3. Rash: starts at wrists and ankles and spreads to trunk, palmes and soles
259
Q

Palms and soles rash

A

Coxsackievirus A: hand,foot, mouth disease
Rocky Mountain spotted fever
2ª syphilis

260
Q

Typhus Rash

A

Starts Centrally and spreads out

261
Q

Rash that spares palms and soles

A

Typhus Rash:

  • Rickettsia typhi: Endemic typhus
  • Rickettsia prowazekii: Epidemic typhus
262
Q

Rash rare diseases

A
  1. Ehrlichiosis
  2. Anaplasmosis
  3. Q fever
263
Q

Ehrilickia vector

A

Tick

264
Q

Monocytes with morulae (mulberry-like inclusions)

A

Ehrlichia

265
Q

Granulocytes with morulare

A

Anaplasma

266
Q

No arthropod vector

A

Q fever

267
Q

Q fever presents as

A

Pneumonia

268
Q

Common cause of culture - endocarditis

A

Q fever

269
Q

2 forms of chlamydiae

A
  1. Elementary body: “Enfectious”, Enters cell via Endocytosis. Transforms into
  2. Reticulate body: Replicates in cell by fission. Reorganizes into elementary body
270
Q

Chlamydia trachomatis causes

A

Reactive arthritis: Reiter syndrome
Follicular conjunctivitis
Nongonococcal urethritis
Pelvic inflammatory Disease

271
Q

Chlamydophila pneumoniae and psittaci cause

A

Atypical pneumonia

272
Q

Treatment for Chlamydiae

A

Azithromycin or doxycycline

+ceftriaxone for possible concomitant gonorrhea

273
Q

Beta lactamics against Chlamydiae

A

No: lacks classic peptidoglycan in its wall

274
Q

Chlamydia trachomatis A,B,C

A

Chronic infection, cause blindness due to follicular conjunctivitis in Africa
A=Africa
B=Blindness
C=Chronic infection

275
Q

Chlamydia trachomatis types D-K

A

Everything else: urethritis/PID, ectopic pregnancy, neonatal pneumonia with eosinophilia, neonatal conjunctivitis (1-2 weeks after birth)

276
Q

Staccato cough

A

Neonatal pneumonia by Chlamydia trachomatis

277
Q

Chlamydia vs Gonococcal neonatal conjunctivitis

A

Gonococci: 2-5 days after birth
Chlamydiae: 1-2 weeks after birth

278
Q

Types L1, L2,L3 Chlamydia trachomatis

A

Lymphogranuloma venereum: small painless ulcers on genitals: painful infuinal lymb nodes that ulcerate (buboes)

279
Q

Lymphogranuloma venereum treatment

A

Doxycycline

280
Q

Classic cause of atypical walking pneumonia

A

Mycoplasma pneumoniae

281
Q

Cold agglutinins

A

M.pneumoniae (IgM): agglutinate or lyse RBCs

282
Q

Treatment against Mycoplasma pneumoniae

A

Macrolides
Doxycyclin
Fluoroquinolones

283
Q

Cell wall in mycoplasma

A

They don’t have cell wall: penicillin is ineffective

284
Q

M.pneumoniae typical patient’s age

A

Less than 30 yo

285
Q

Frequent outbreaks in military recruits and prision

A

Mycoplasma pneumoniae

Step 1 - Microbiology (7 decks)

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