Clinical Bacteriology Flashcards
1
Q
Aerobic bacilli
A
Listeria
Bacillus
2
Q
Anaerobic bacilli
A
Clostridium
Propionilbacterium
3
Q
Aerobic branching filaments
A
Nocardia: weakly acid fast
4
Q
Anaerobic branching filaments
A
Actinomyces: not acid fast
5
Q
Catalase - cocci
A
Streptococcus
6
Q
Catalase + cocci
A
Staphylococcus
7
Q
Coagulase + cocci
A
S. aureus
8
Q
Coagulase - cocci
Catalase + cocci
A
Staph. epidermidis
Staph. saprophyticus
9
Q
Coagulase - cocci
Catalase + cocci
- Novobiocin sensitivity
A
Staph saprophyticus
10
Q
Coagulase - cocci
Catalase + cocci
+ Novobiocin sensitivity
A
Staph. epidermidis
11
Q
Partial hemolysis, green
A
Alpha hemolysis
12
Q
Alpha hemolysis
A
S. pneumoniae: capsule!
Viridans: no capsule! : S mutans, S mitis
13
Q
Alpha hemolysis
- Optochin sensitivity
A
Viridans: S mutans, Smitis
14
Q
Complete hemolysis, clear
A
Group B streptococci: S. agalactiae
Group A streptococci: S.pyogenes
15
Q
Complete hemolysis
+ Bacitracin sensitivity
A
Group B streptococci: S. agalactiae
16
Q
No hemolysis
A
Gamma hemolytic
17
Q
Gamma hemolytic
A
- Group D srteptococci: Enterococcus: E faecium (Ampicilin R), E faecalis (Ampicilin sensitive)
- S bovis
18
Q
Enterococcus can be ___ or ____ -hemolytic
A
Alpha
Gamma
19
Q
S aureus is ___ hemolytic
A
Beta: complete hemolysis
20
Q
Pneumonia after influenza virus infection (flue)
A
S.aureus
21
Q
MRSA mechanism of resistance
A
Altered penicillin binding protein
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
23
Q
Associated with prolonged use of vaginal tampons or nasal packing
A
Toxic Shock Syndrome by S.aureus
24
Q
Toxic Shock-Like Syndrome is due to
A
S.pyogenes (complication of chickenpox)
25
S.aureus food poisoning is due to
preformed toxin: Emesis (neurotoxin)! and non bloody diarrhea
26
Catalase + that does not ferment mannitol
S.epidermidis (S.aureus DOES ferment manitol)
27
Infects prosthetic devices (hip implant, heart valve) and IV catheters by producing biofilms
Staphylococcus epidermidis
28
Normal flora of skin
S.epidermidis
29
Normal flora of female genital tract and perneum
S.saprophyticus
30
Most common cause of uncomplicated UTI in young women
E.coli
31
Second most common cause of uncomplicated UTI in young women
S.saprophyticus
32
Virulence factor in S.aureus
Protein A: binds Fc-IgG
33
Virulence factor S.pneumoniae
IgA protease: SHN: Saureus, Haemophilus, Neisseria
34
S.pneumoniae is the most common responsible for
1. Meningitis
2. Otitis media
3. Bacterial pneumonia
4. Sinusitis
35
Rusty sputum
Pneumococcus
36
Sepsis in patients with sickle cell disease AND asplenic patients
S.pneumoniae
37
Diplococci
S.pneumoniae
38
Virulence of S.pneumoniae without its capsule
NO virulence
39
Subacute bacterial endocarditis at damaged heart valves
Viridans streptococci: S sanguinis: BLOOD
| S.sanguinis makes dextrans which bind to fibrin platelet aggregates on damaged heart valves
40
Normal flora of the oropharynx
Viridans streptococci: S.mutans and mitis
| Cause dental caries
41
S.pyogenes causes
1. Pyogenic: pharyngitis, cellulitis, impetigo (contagioso, costras mielicéricas), erysipelas
2. Toxigenic: scarlet fever, Toxic shock-like syndrome, necrotizing fasciitis
3. Immunologic: rheumatic fever, glomerulonephritis
42
S.pyogenes virulence factor
M.protein: prevents phagocytosis but gives rise to immunological crossed reactions
43
Markers of recent S.pyogenes infection
Anti-streptolysin A titers
| anti-DNAse B antibodies
44
Sand-paper rash
Scarlet Fever
45
Pneumonia, meningitis and sepsis in babies
S.agalactiae: Group B(babies) streptococci
46
Screening in pregnant woman for colonisation with S,agalactiae takes place at
35-37 weeks of gestation with rectal + vaginal swabs
47
Positive S.agalactiae culture in pregnancy screening
Intrapartum penicillin prophylaxis
48
Streptococcus bovis is responsible for
Bacteriemia: subacute endocarditis
Associated with colon cancer
Bovis in the Blood=Cancer in the colon
49
S.gallotycus
S.bovis type I: endocarditis
50
Enterococci are responsible for
UTI
Biliary tract infections
Subacute endocarditis after GI/GU procedure
51
VRE enterococci
Nosocomial infections
52
Can grow in 6.5% NaCl medium and bile
Enterococci
53
Only bacterium with polypeptide capsule
Bacillus anthracis
54
Medusa head colonies
Bacillus anthracis (halo)
55
Painless papule sourrounded by vesicles that becomes an ulcer with black eschar
Cutaneous anthrax
56
Woolsorter's disease
Pulmonary anthrax
57
Reheated rice syndrome
Bacillus cereus
58
Tetanus signs
1. Spastic paralysis
2. Trismus: lockjaw
3. Risus sardonicus: raised eyebrows and open grin
4. Opisthotonos: spasms of spinal extensors
59
Prevent tetanus
Tetanus vaccine
60
Treat tetanus
Antitoxin
+- Vaccine booster
Diazepam: for muscle spasms
Wound debridement
61
Botulism in adults is due to
Ingestion of preformed toxin
62
Botulim in babies is due to
Ingestion of spores: food, juice and honey: FLOPPY baby syndrome
63
Treatment of botulism
Antitoxin
64
Symptoms of botulism
4 D
1. Diplopia
2. Dysarthria
3. Dysphagia
4. Dyspnea
65
Local botox injections used for
1. Focal dystonia
2. Achalasia
3. Muscle spasms
4. Facial wrinkles
66
Gas gangrene
C perfringens
67
C perfringens produces two toxins
Alpha toxin: phospholipase: gas gangrene
| Enterotoxin: food poisoning
68
Pseudomembranous colitis is often secondary to antibiotic use, specially
Clindamycin
| Ampicillin
69
Associated with proton pump inhibitors
Pseudomembranous colitis by C.difficile
70
Cdifficile toxins
A: enterotoxin: alters fluid secretion in brush border
B: cytotoxin, disrupts cytoskeleton: actin depolymerization
71
Pseudomembranous colitis by C.difficile diagnosis
Detection of one or both toxins in stool by:
- Antigen detection
- PCR
72
Treatment of Pseudomembranous colitis by C.difficile
Metronidazol
Oral vancomycin
Recurrent cases: repeat prior regimen/Fidaxomicin/Fecal microbiota transplant
73
Pseudomembranous pharyngitis
Lymphadenopathy
Myocarditis
Arrythmias
Corynebacterium diphteriae
74
Prevention of diphtheria
Toxoid vaccine
75
Test for diphtheria toxin
Elek test
76
Lab diagnosis of diphteria
Gram + rods with metachromatic granules
77
Inhibits protein synthesis via ADP-ribosylation of elongation factor 2
Corynebacterium diphtheriae toxin
78
Tumbling motility in broth
Listeria monocytogenes
79
Treatment against Listeria monocytogenes
Ampicillin
80
Rocket tails
Listeria monocytogenes
81
Unpasteurised dairy products
| Cold deli meats
listeria monocytogenes
82
```
Granulomatosis infantiseptica
Neonatal meningitis
Meningitis in immunocompromised
Gastroenteritis in healthy individuals
Amnionitis, septicemia and spontaneous abortion
```
Listeria monocytogenes
83
Actinomyces is an ____erobe
Anaerobe
84
Nocardia is an ____erobe
Aerobe
85
Nocardia is found in
Soil
86
Actinomyces is found in
Normal oral, reproductive and GI flora
87
Nocardia and Acid fast
Weak
88
Actynomyces and Acid fast
NOT acid fast
89
Nocardia causes
1. Pulmonary infectinos in immunocompromised=mimic TBC
2. Cutaneous infections after trauma in immunocompetent
3. Can spread to CNS
90
Treatment of nocardia
Sulfonamides: TMP-SMX
91
Treatment of actinomyces
Penicillin
92
Actinomyces causes
- Oral/Facial abscesses that drain through sinus tracts associated with Dental caries/extraction
93
Gohn complex
Primary tuberculosis: Hiliar nodes + Ghon focus
94
Gohn focus is usually located in
Mid-Lower Lobes
95
Primary tuberculosis history
90% Healing by fibrosis and calcification: may produce 2º tuberculosis in reactivation
10%Progressive primary tuberculosis (AIDS, malnutrition): bacteriemia and progressive lung disease
96
IGRA vs PPD
IGRA has fewer false positive from BCG vaccination
97
PPD negative
No infection
Sarcoidosis
HIV with low CD4 + account
98
Caseating granulomas are characteristic of
2ª tuberculosis
99
Caseating granulomas
Central necrosis
| Flanking Langhans giant cells
100
Mycobacterium avium causes
Disseminated disease in AIDS
101
Mycobacterium avium prophylaxis
Azithromycin when CD4+ count <50 cells/mm3
102
Hand infection in aquarium handlers
Mycobacterium marinum
103
Acid fast organisms
Mycobacteria
104
M scrofulaceum causes
Cervical lymphadenitis in children
105
TB symptoms
- Fever
- Night sweats
- Weight loss
- Cough
- Hempoptysis
106
Leprosy (hansen disease) cause
Mycobacterium leprae
107
Leprosy symptoms
Mycobacterium leprae infects skin and superficial nerves: gloves and stocking loss of sensation
108
Mycobacterium leprae likes ____ temperatures
Cool
109
Diagnosis of Mycobacterium leprae
Skin biopsy
| Tissue PCR
110
Reservoir of Mycobacterium leprae in the United States
Armadillos
111
Forms of Hansen Disease
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
112
Treatment of Hansen disease
Tuberculoid form: Dapsone + Rifampicin
| lepromatous form: Clofazimine
113
Gram - Diplococci
Neisseria:
-(M)eningitidis: (M)altose utilization +
-gonorrhoeae: maltose -
Moraxella: maltose -
114
Gram - cocobacilli
1. Haemophilus influenzae
2. Bordetella pertussis
- Pasteurella
- Brucella
- Francisella tularensis
115
Comma-shaped gram - rods
1. Campylobacter jejuni: grows in 42ºC
2. Vibrio cholerae: grows in alkaline media
3. Helicobacter pylori: produces urease
116
Gram - Bacilli: first test
Lactose fermentation
117
Lactose fermentation + Bacilli
1. Klebsiella
2. E.coli
Enterobacter
Citrobacter
Serratia
118
Non-lactose fermenting, oxidase +
Pseudomonas
119
Non-lactose fermenting, oxidase negative
Salmonella
Shigella
Yersinia
Proteus
120
Non-lactose fermenting, oxidase negative, H2S production on TSI agar
Salmonella
| Proteus
121
Fast lactose fermentation
Klebsiella
E.coli
Enterobacter
122
Pink colonies on MacConkey agar
Fermentation of lactose:
- Klebsiella
- E.coli
- Enterobacter
- Serratia
123
E.coli on EMB agar
Colonies with green sheen
124
Capsule gonococci vs meningococci
Meningococci=polysaccharide capsule
| Gonococci=no polysaccharide capsule
125
Gonococci vaccine
No vaccine due to antigenic variation of pilus proteins
126
Meningococci vaccine
Yes, type B vaccine not widely available
| Type C available
127
Gonococci causes
1. Gonorrhea
2. Septic arthritis
3. Neonatal conjunctivitis: 2-5 days after birth
4. Pelvic inflammatory disease
5. Fitz-Hugh-Curtis syndrome
128
Preventa gonococcal neonatal blindness
Erythromycin eye ointment
129
Gonococci treatment
Ceftriaxone (+azithromycin or doxycycline for possible chlamydial coinfection)
130
Meningococci causes
- Meningococcemia with petechial hemorrhages and gangrene of toes
- Meningitidis
- Waterhouse-Friderichsen syndrome: adrenal insufficiency, fever, DIC, shock
131
Treatment of gonococci
Cetriaxone
| Penicillin G sódica IV (meninges)
132
Prophylaxis of meningococci in close contacts
Rifampicin
Ciprofloxacin
Cetriaxone
133
HaEMOPhilus causes
1. Epiglotitis
2. Meningitis
3. Otitis media
4. Pneumonia
134
Most common type of Haemophilus influenzae
Nontupable (unencapsulated) since vaccine for capsular type b was introduced
135
Thumb sign on xray
Epiglotitis (Haemophilus influenzae)
136
Treatment against H.influenzae
1. Mucosal infections: Amoxicillin +- clavulanate
| 2. Meningitis: ceftriaxone
137
Prophylaxis against H.influenzae
Rifampicin: close contacts
138
H.influenzae type b vaccine
Capsular polysaccharide conjugated with diphteria toxoid or other protein: 2-18 months of age
139
Bordetella pertussis virulence factors
1. Pertussis toxin: disables G1
| 2. Tracheal cytotoxin
140
Satages of infection by Bordetella pertussis
1. Catarrhal: low fever, coryza
2. Paroxysmal: intense cough followed by inspiratory "whoop" and posttussive vomiting
3. Convalescent: recovery from chronic cough
141
Prevention against Bordetella pertussis
Tdap, DTaP vaccines
142
Gram stain and Legionella
Poor
143
Legionella stain
Silver
144
Legionella Culture
Charcoal yeast extract medium with iron and cysteine
145
Detection of legionella
Antigen in urine
146
Typical analytical finding in legionella infection
Hyponatremia
147
person to person transmission in Legionella
NO
148
Transmission of legionella
Environmental water source habitat: air conditioning systems, hot water tanks: summer camps, military facilities
149
Treatment against Legionella
Macrolide or Quinolone
150
Legionella pneumophila produces
1. Legionnaires disease
| 2. Pontiac fever
151
Pontiac fever
Mild flu-like syndrome caused by Legionella
152
Legionnaires disease
Severe pneumonia: unilateral, lobar
Fever
GI
CNS symptoms
153
Legionnaires disease is more common in
Smokers
| Chronic lung disease
154
Grape like odor
Pseudomonas aeruginosa
155
Produces pyocyanin
Pseudomonas aeruginosa
156
Pseudomonas aeruginosa produces
1. Endotoxin: fever, shock
2. Exotoxin A: inactivades EF-2 = diphteria
3. Phospholipase C: degrades cell membrane
4. Pyocyanin: generates ROS
157
PSEUDOMONAS is associated with
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
Treatments against Pseudomonas
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
Chronic pneumonia in cystic fibrosis patients due to P.aeruginosa can be explained by
Mucoid polysaccharide capsule that forms biofilm
160
E.coli virulence factors
1. Fimbriae: cystitis and pyelonephritis
2. K capsule: pneumonia, neonatal meningitis
3. LPS endotoxin: septic shock
161
Enteroinvasive E.coli
Invades intestinal mucosa: Dysentery
| Similar to Shigella
162
Enterotoxigenic E.coli
Heat-labile and Heat-Stable enterotoxins: traveler's diarrhea
163
Most frequent cause of traveler's diarrhea
Enterotoxigenic E.coli
164
Enteropathogenic E.coli mostly affects
Children (P: pediatrics)
165
Enterohemorrhagic E.coli most common serotype
O157: H7
166
O157: H7 E.coli transmitted via
- Undercooked meat: hamburgers
| - Raw leafy vegetables
167
Shiga like toxin of Enterohemorrhagic E.coli causes
Hemolytic-uremic syndrome
168
Hemolytic-uremic syndrome
```
Triad:
1. Anemia
2. Thrombocytopenia
3. Acute renal failure
Due to microthrombi forming on damaged epithelium
```
169
E. coli that does not ferment sorbitol
Enterohemorrhagic E.coli
170
5A's of Klebsiella
1. Aspiration pneumonia in alcoholics and diabetics
2. Abscess in lungs and liver
3. Alcoholics
4. DiAbetics
5. currAnt Jelly sputum
171
Nosocomial UTI
Klebsiella
172
Microbiological antecedent of Guillain Barré syndrome
Campylobacter jejuni
173
Major cause of bloody diarrhea in children
Campylobacter jejuni
174
Transmission of Campylobacter jejuni
1. Fecal-oral person-to person
2. Undercooked poultry
3. Unpasteurised milk
175
Salmonella spp reservoirs
Typhy: humanos only
| The rest: humans and animals
176
H2S2 production Salmonella vs Shigella
Salmonella and proteus: YES
| Shigella and Yersinia: NO
177
Hematogenous spread Salmonella vs Shigella
Salmonella YES
| Shigella NO: cell to cell
178
Flagella Salmonella vs Shigella
Salmonella: YES (salmon swim)
Shigella: NO
179
Virulence factor Salmonella vs Shigella
Salmonella: Endotoxin + (typhy: Vi capsule)
Shigella: Endotoxin + Shiga toxin
180
Infectious dose of Salmonella vs Shigella
Salmonella: High: inactivated by gastric acids
Shigella: Low: resistant to gastric acids
181
Effect of antibiotics on fecal excretion: Salmonella vs Shigella
Salmonella: Prolongs duration
Shigella: Shortens duration
182
Immune response Salmonella vs Shigella
Salmonella:
-Typhy: Monocytes
-spp: PMN in disseminated disease
Shigella: PMN
183
GI manifestations of Salmonella vs Shigella
Salmonella
-typhi: constipation-->diarrhea
-spp: diarrhea
Shigella: bloody diarrhea
184
Vaccine salmonella vs shigella
Salmonella typhi:
-oral vaccine: live attenuated S. typhi
-IM vaccine: Vi capsular polysaccharide
Salmonella spp and Shigella: no vaccine
185
Typhoid fever manifestations
1. Rose spots on abdomen
2. Constipation
3. Abdominal pain
4. Fever
186
Typhoid fever treatment
Ceftriaxone / fluoroquinolone
187
Carrier state with gallbladder colonization
Salmonella typhy
188
Gastroenteritis by Salmonella is usually caused by
Non-typhoidal Salmonella
189
Four F's of Shigella
1. Fingers
2. Flies
3. Food
4. Feces:
190
Most severe Shigella
S dysenteriae
191
Less severe Shigella
S sonnei
192
Key to pathogenicity of Shigella
Invasion of M cells of Peyer patches
193
Rice-water diarrhea
Vibrio cholerae
194
Treatment against Vibrio cholerae
Promt oral rehydration
195
Inoculum for Vibrio cholerae
Large: high dose because its sensitive to stomach acid (=salmonella)
196
Yersinia is transmitted from
Pet feces=puppy
Contaminated milk
Pork
197
Yersinia causes
Acute diarrhea
| Pseudoppendicitis: mesenteric adenitis
198
Triple + microorganism
Helicobacter pylori
Catalase +
Oxidase +
Urease +
199
Diagnosis of Helicobacter pylori
Urea breath test
| Fecal antigen test
200
Treatment against Helicobacter pylori
OCA:
Omeprazol: Proton pump inhibitor
Clarithromycin
Amoxicillin: metronidazole if allergy
201
Infection with Helicobacter pylori is a risk factor for
1. Peptic ulcer disease
2. Gastric adenocarcinoma
3. MALT lymphoma: OCA
202
Spirochetes
BLT
Borrelia=Big
Leptospira
Treponema
203
Visualisation of Treponema
Dark field microscopy
| Direct fluorescent antibody microscopy
204
Borrelia can be visualised using
Giemsa stain or Wright stain in light microscopy
205
Found in water contaminated with animal urine
Leptospira interrogans
206
Leptospirosis
```
Flu like symptoms
Mialgias: calves!
JAUNDICE
Photophobia
Conjunctival suffusion
```
207
Prevalent among suffers in Hawaii
Leptospira interrogans
208
Weil disease
Leptospira interrogans: icterohemorrhagic leptospirosis: severe form of jaundice and azotemia from liver and kidney disfunction, fever, hemorrhage and anemia
209
Lyme disease is caused by
Borrelia burgdorferi
210
Lyme disease is transmitted by
Ixodes deer tick
211
Ixodes deer tick transmites
1. Lyme disease
2. Anaplasma spp
3. Babesia
212
Reservoir of Lyme Borrelia burgdorferi
Mouse
213
Stages of Lyme disease
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
Lyme manifestations
A key Lyme pie to the FACE
1. Facial nerve palsy: bilateral
2. Arthitis
3. Cardiac Block
4. Erythema migrans
215
Treatment of Lyme disease
1st line: Doxycycline
| Pregnant and children: Amoxicillin and cefuroxime
216
Primary syphilis finding
Painless chancre
217
Treponemes in syphilitic chancre
YES: use dark-field microscopy
218
VDRL in primary syphilis
VDRL + in 80%
219
Secondary syphilis findings
1. Constitucional symptoms
2. Maculopapular rash INCLUDING palms and soles
3. Condylomata lata
220
Non-specific syphilis tests
Reagínicas: VDRL/RPR
221
Specific test for syphilis
Treponémicas: FTA-ABS
222
Latent syphilis
+ serology without symptoms
223
Secondary syphilis is
Systemic
224
Tertiary syphilis finding
Gummas: crhonic granulomas
Aortitis
Neurosyphilis: tabes dorsalis, general paresis
Argyll Robertson pupil
225
Argyl Robertson pupul
Constricts with accommodation but is not reactive to light
226
Signs of tertiary syphilis
Broad-based ataxia
Romberg +
Charcot Joint
Stroke without hypertension
227
Neurosyphilis diagnosis
Test spinal fluid with VDRL, FTA-ABS and PCR
228
Congenital syphilis
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
Placental transmission of syphilis occours
After first trimester: treat mother early in pregnancy
230
False positive results on VDRL
Viral infection: EBV, Hepatitis
Drugs
Rheumatic fever
Lupus and leprosy
231
Jarisch-Herxheimer reactin
Flu-like syndrome after antibiotics are started in syphilis due to killed bacteria releasing toxics
232
Bartonella henselae is responsible for
Cat scratch disease
233
Bartonella quintana is responsible for
Bacillary angiomatosis
234
Borrelia recurrentis produces
RELAPSING fever
235
Borrelia recurrentis source
Louse
236
Brucella spp produces
Brucellosis
| Undulant fever
237
Brucella source
Unpasteurized dairy
238
Chlamydophila pisttaci source
Parrots
239
Psittacosis agent
Chlamydophila pisttaci
240
Q fever agent
Coxiella burnetii
241
Coxiella burnetii source
Aerosols of cattle/sheep amniotic fluid
242
Francisella tularensis source
Rabbits: fiebre de los conejos
Ticks
Deer flies
243
Pasteurella multocida source
Animal bite: cats, dogs
244
Rocky Mountain spotted fever agent
Rickettsia rickettsii
245
Epidemic typhus agent
Ricketssia prowazekii
246
Endemic typhus
Rickettsia typhy
247
Source of Rickettsia ricketsii
Dermacentor: dog tick
248
Gardnerella vaginalis is a gram ____ rod
Variable
249
Gray vaginal discharge with fishy smell
Gardnerella vaginalis
250
Pain in infection by Gardnerella vaginalis
Nonexisting
251
Is gardnerella vaginalis an STD?
NO, but it is associated with sexual activity
252
Bacterial vaginosis
Gadnerella vaginalis
| Overgrowth of anaerobic bacteria
253
Clue cells
Vaginal epithelial cells covered with Gardnerella
254
Treatment of Gardnerella vaginalis
Metronidazole
| Clindamycin
255
Test for Gardnerella vaginales
Amine whiff test: mixing discharge with 10 KOH enhances fishy odor
256
Rickettsial diseases common treatment
Doxycycline
| Pregnancy: Chloramphenicol
257
Most common place for Rocky Mountain spotted fever
Despite its name, disease occurs primarily in South Atlantic states
258
Classif triad for Rocky Mountain spotted fever
1. Headache
2. Fever
3. Rash: starts at wrists and ankles and spreads to trunk, palmes and soles
259
Palms and soles rash
Coxsackievirus A: hand,foot, mouth disease
Rocky Mountain spotted fever
2ª syphilis
260
Typhus Rash
Starts Centrally and spreads out
261
Rash that spares palms and soles
Typhus Rash:
- Rickettsia typhi: Endemic typhus
- Rickettsia prowazekii: Epidemic typhus
262
Rash rare diseases
1. Ehrlichiosis
2. Anaplasmosis
3. Q fever
263
Ehrilickia vector
Tick
264
Monocytes with morulae (mulberry-like inclusions)
Ehrlichia
265
Granulocytes with morulare
Anaplasma
266
No arthropod vector
Q fever
267
Q fever presents as
Pneumonia
268
Common cause of culture - endocarditis
Q fever
269
2 forms of chlamydiae
1. Elementary body: "Enfectious", Enters cell via Endocytosis. Transforms into
2. Reticulate body: Replicates in cell by fission. Reorganizes into elementary body
270
Chlamydia trachomatis causes
Reactive arthritis: Reiter syndrome
Follicular conjunctivitis
Nongonococcal urethritis
Pelvic inflammatory Disease
271
Chlamydophila pneumoniae and psittaci cause
Atypical pneumonia
272
Treatment for Chlamydiae
Azithromycin or doxycycline
| +ceftriaxone for possible concomitant gonorrhea
273
Beta lactamics against Chlamydiae
No: lacks classic peptidoglycan in its wall
274
Chlamydia trachomatis A,B,C
Chronic infection, cause blindness due to follicular conjunctivitis in Africa
A=Africa
B=Blindness
C=Chronic infection
275
Chlamydia trachomatis types D-K
Everything else: urethritis/PID, ectopic pregnancy, neonatal pneumonia with eosinophilia, neonatal conjunctivitis (1-2 weeks after birth)
276
Staccato cough
Neonatal pneumonia by Chlamydia trachomatis
277
Chlamydia vs Gonococcal neonatal conjunctivitis
Gonococci: 2-5 days after birth
Chlamydiae: 1-2 weeks after birth
278
Types L1, L2,L3 Chlamydia trachomatis
Lymphogranuloma venereum: small painless ulcers on genitals: painful infuinal lymb nodes that ulcerate (buboes)
279
Lymphogranuloma venereum treatment
Doxycycline
280
Classic cause of atypical walking pneumonia
Mycoplasma pneumoniae
281
Cold agglutinins
M.pneumoniae (IgM): agglutinate or lyse RBCs
282
Treatment against Mycoplasma pneumoniae
Macrolides
Doxycyclin
Fluoroquinolones
283
Cell wall in mycoplasma
They don't have cell wall: penicillin is ineffective
284
M.pneumoniae typical patient's age
Less than 30 yo
285
Frequent outbreaks in military recruits and prision
Mycoplasma pneumoniae
