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First Aid STEP 1 - Microbiology > Clinical Bacteriology I > Flashcards

Clinical Bacteriology I Flashcards

1
Q

Describe characteristics of S. aureus

A

Gram +
Catalase +
Coagulase +

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2
Q

Describe characteristics of Clostridium

A

Gram +
bacilli
anaerobe

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3
Q

Describe characteristics of Listeria

A

Gram +
bacilli
aerobe

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4
Q

Describe characteristics of Mycobacterium

A

acid fast

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5
Q

Describe characteristics of Strep. pneumoniae

A 
Gram +
Cocci
catalase -
capsule
alpha hemolysis
optochin sensitive
bile soluble (lysed by bile)
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6
Q

Describe characteristics of Strep. pyogenes

A 
Gram +
cocci
catalase - 
beta hemolysis
bacitracin sensitive
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7
Q

Describe characteristics of Strep. agalactiae

A 
Gram +
cocci
catalase -
beta hemolysis
bacitracin resistant
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8
Q

Is Staph. epidermidis or Staph. saprophyticus resistant to novobiocin?

A

Staph. saprophyticus - resistant

Staph. epidermidis - sensitive

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9
Q

Is Strep. pneumoniae or Strep. viridans resistant to optichin?

A

Strep. pneumoniae - sensitive

Strep. viridans - resistant

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10
Q

Is group B strep or group A strep resistant to bacitracin?

A

group B strep - resistant

group A strep - sensitive

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11
Q

Which bacteria are alpha-hemolytic?

A

Streptoccocus pneumoniae

Viridans streptococci

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12
Q

What do alpha-hemolytic bacteria look like on blood agar?

A

green

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13
Q

What do beta-hemolytic bacteria look like on blood agar?

A

clear area of hemolysis on blood agar

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14
Q

Which bacteria are beta-hemolytic?

A

staph. aureus
Strep. pyogenes
Strep. agalactiae
Listeria monocytogenes

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15
Q

What is MRSA and why is it important?

A

Methicillin resistant S. aureus

important cause of serious nosocomial and community-acquired infections

resistant to methicillin and nafcillin because of altered penicillin-binding protein

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16
Q

What is TSST from S. aureus and what symptoms does it cause?

A

Toxin shock syndrome toxin

Binds to MHC II and T-cell receptor –> polyclonal T-cell activation

Presentation: fever, vomiting, rash, desquamation, shock, end-organ failure

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17
Q

What predisposes individuals to toxic shock syndrome?

A

vaginal or nasal tampons

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18
Q

Where does St. aureus commonly colonize in the body?

A

nose

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19
Q

How does Staph. epidermidis infect?

A

infects prosthetic devices and IV catheters by producing adherent BIOFILMS

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20
Q

What is the 2nd MCC of uncomplicated UTIs in young women?

A

Staph. saprophyticus

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21
Q

What are the diseases that S. pneumoniae commonly causes?

A

Meningitis
Otitis media (in children)
Pneumonia
Sinusitis

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22
Q

What is the characteristic shape of S. pneumoniae?

A

Gram + lancet-shaped diplococci

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23
Q

Where are viridans streptococci normally located?

A

normal flora of the oropharynx

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24
Q

What diseases do viridans streptococci cause?

A 
dental caries (Strep. mutans)
subacute bacterial endocarditis (S. sanguinis)
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25
Q

How does Strep. sanguinis cause subacute bacterial endocarditis?

A

makes dextran –> bind to fibrin-platelet aggregates on damaged heart valves

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26
Q

What is the JONES Criteria for rheumatic fever?

A

MAJOR CRITERIA
Joints - polyarthritis
O - carditis (O should be shaped like a heart…)
Nodules (subcutaneous)
Erythema marginatum
Sydenham chorea (face, tongue, upper limbs)

MINOR CRITERIA
fever
arthalgias
increased ESR (or CRP)
increase PR interval
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27
Q

What are physical symptoms of Scarlet Fever?

A

scarlet rash (starting on trunk and neck but SPARES the face) with sandpaper-like texture

strawberry tongue

circumoral pallor

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28
Q

What location does Strep. agalactiae (group B strep) colonize in the body?

A

vagina

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29
Q

If a women screens + for a group B strep culture before delivery, what should be done?

A

intrapartum penicillin prophylaxis

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30
Q

What location does enterococci (group D strep) colonize in the body?

A

normal colonic flora

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31
Q

What diseases are caused by enterococci (group D strep)?

A

UTI
biliary tract infections
subacute endocarditis (following GI/GU procedures)

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32
Q

What diseases are caused by Strep. bovis?

A

bacteremia

subacute endocarditis in colon cancer patients

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33
Q

What are symptoms on Diphtheria?

A

pseudomembranous pharyngitis
lymphadenopathy
myocarditis
arrythmias

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34
Q

What type of agar is used to detect c. diphtheriae?

A

black colonies on cystine-tellurite agar

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35
Q

What are examples of spore-forming Gram + bacteria found in soil?

A

Bacillus anthracis
Clostridium perfringens
C. tetani

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36
Q

How can spores be killed?

A

steaming at 121 degrees Celsius for 15 minutes

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37
Q

What is unique about Bacillus anthracis compared to other bacteria?

A

only bacterium with a polypeptide capsule (contains D-glutamate)

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38
Q

What are the two types of anthrax infections?

A

Cutaneous anthrax

Pulmonary anthrax

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39
Q

What is the pathogenesis of a cutaneous anthrax infection?

A

boil-like lesion –> ulcer from black eschar (painless, necrotic) –> uncommonly progresses to bacteremia and death

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40
Q

What is the pathogenesis of a pulmonary anthrax infection?

A

inhalation of spores –> flu-like symptoms that rapidly progress to fever, pulmonary hemorrhage, mediastinhtis, and shock

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41
Q

Why is the pulmonary anthrax infection also called Woolsorters’ disease?

A

inhalation of spores from contaminated wool

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42
Q

In what food is bacillus cereus usually found?

A

reheated rice

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43
Q

What disease does Bacillus cereus cause?

A

emetic type food poisoning

diarrheal type food poisoning

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44
Q

Where does Listeria monocytogenes like to live?

A

intracellularly

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45
Q

How is Listeria monocytogenes acquired?

A

ingestion of unpasteurized dairy products and deli meats

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46
Q

What is unique about Listeria monocytogenes?

A

only gram + organism to produce LPS

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47
Q

What is the treatment for Listeria monocytogenes infection?

A

gastroenteritis is usually self limiting

infants, IC pts, and elderly w/ symptoms of meningitis - AMPICILLIN

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48
Q

Actinomyces vs. Nocardia

A

Gram + anaerobe —– Gram + aerobe
Not acid fast ————- acid fast (weak)
normal oral flora ——– found in soil
causes oral/facial abscesses that drain through sinus tracts, forms yellow “sulfur granules” ——– causes pulmonary infections in IC pts and cutaneous infections after trauma in IC pts

Treat w/ penicillin ——– Treat with sulfonamides

BOTH form long, branching filaments resembling fungi

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49
Q

What will result in positive PPD test?

A

current infection
past exposure
BCG vaccination

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50
Q

What will result in a negative PPD test?

A

no infection
anergic (steroids, malnutrition, IC pts)
sarcoidosis

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51
Q

What is a more specific test than PPD?

A

Interferon- gamma release assay (IGRA)

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52
Q

What are symptoms of TB?

A

fever, night sweats, weight loss, and hemoptysis

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53
Q

What are the strains of mycobacteria and what diseases do they cause?

A

Mycobacterium TB - TB
M. kansasii - pulmonary TB-like symptoms
M. avium- intracellulare - causes disseminated, non-TB disease in AIDS

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54
Q

What inhibits macrophage maturation and induces release of TNF-alpha in virulent TB strains?

A

cord factor

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55
Q

What inhibit phagolysosomal fusion on mycobacteria?

A

sulfatides (surface glycolipids)

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56
Q

What microorganism causes Leprosy (Hansen disease)?

A

Mycobacterium leprae

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57
Q

What are characteristic findings seen in lepromatous Hanson Disease?

A

presents diffusely over the skin
leonine (lion-like) facies
communicable

low cell-mediated immunity with a HUMORAL TH2 response

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58
Q

What are characteristic findings seen in tuberculoid Hanson Disease?

A

limited to a few hypothetic, hairless skin plaques

high cell-mediated immunity with a largely TH1-TYPE immune response

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59
Q

What is the treatment for Leprosy?

A

Tuberculoid Form: Multi drug therapy consisting of dapsone and rifampin for 6 months

Lepromatous Form: dapsone, rifampin, and clofazimine for 2-5 years

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60
Q

What is a signature finding of Leprosy?

A

“glove and stocking” loss of sensation

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61
Q

Which microorganisms are lactose-fermenting enteric bacteria?

A

Grow PINK COLONIES on MACCONKEY agar

Test with MacConKEE’S agar

Citrobacter
Klebsiella
E. coli
Enterobacter
Serratia
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62
Q

Are Gram - bacilli susceptible to penicillin G?

A

NO

But they may be susceptible to ampicillin and amoxicillin

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63
Q

What are the characteristics of Neisseria?

A

Gram - diplococci
ferment glucose
IgA proteases
often intracellular

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64
Q

What are the differences between N. gonococci and N. meningococci?

A

No polysaccharide capsule ——— polysaccharide capsule
No maltose fermentation ———— maltose formation
no vaccine ——————————– vaccine (none for type B)
sexually transmitted ——————- respiratory and oral secretions
gonorrhea, septic arthritis, neonatal conjunctivitis, PID, and Fitz-Hugh-Curtis Syndrome ——— meningococcemia and meningitis, Waterhouse-Friderichsen Syndrome
Condoms prevent transmission. Erythromycin ointments prevents neonatal transmission —— rifampin, ciprofloxacin, and ceftriaxone prophylaxis in close contacts

Tx: ceftriaxone + (azithromycin or doxycycline) for possible chlamydia coinfection ———— Tx: ceftriaxone or penicilin G

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65
Q

What are diseases caused by Haemophilus influenzae?

A

HaEMOPhilus

Epiglottitis* (“cherry red” in children)
Meningitis
Otitis media
Pneumonia

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66
Q

What is the treatment for H. influenzae infections?

A

mucosal infections - amoxicillin +/- clavulanate

meningitis - ceftriaxone (rifampin for prophylaxis in close contacts)

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67
Q

What stain is used best to detect Legionella pneumophila?

A

silver stain

Or can also grow on charcoal yeast extract culture with Fe and cysteine

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68
Q

How can you clinically detect Legionella pneumophila?

A

presence of Ag in urine

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69
Q

What are signs of Legionnaire’s Disease?

A

severe pneumonia
fever
GI and CNS symptoms

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70
Q

What is the treatment for Legionella pneumophila infection?

A

macrolide or quinolone

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71
Q

What are notable characteristics of Pseudomonas aeruginosa?

A 
produces pyocyanin (blue-green pigment)
grape-like odor
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72
Q

What diseases are associated with Pseudomonas aeruginosa infection?

A

PSEUDOmonas

Pneumonia
Sepsis
External otitis 
UTI
Drug use
Diabetic Osteomyelitis
hot tub folliculitis
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73
Q

What is the treatment for Pseudomonas aeruginosa infections?

A

aminoglycoside + extended-spectrum penicillin (e.g. piperacillin, ticarcillin, cefepime, imipenem, meropenem)

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74
Q

When you think of Pseudomonas you should think of two things…

A
  1. WATER

2. BURNS

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75
Q

Ecthyma gangrenosum is a rapidly progressive, necrotic cutaneous lesion caused by Pseudomonas bacteremia. It is commonly seen in which patients?

A

IC pts

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76
Q

What are E. coli virulence factors and which diseases do they help cause?

A

fimbriae - cystitis and pyelonephritis
K capsule - pneumonia, neonatal meningitis
LPS endotoxin - septic shock

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77
Q

What are the strains of E. coli and which diseases do they cause?

A

EIEC - dysentery (invasive)
ETEC - traveler’s diarrhea (watery)
EPEC - diarrhea usually in children
EHEC - dysentery, can cause HUS and thrombocytopenia

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78
Q

What distinguishes EHEC from the other forms of E. coli?

A

EHEC does NOT ferment sorbitol

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79
Q

What is notable about sputum from a Klebsiella infection?

A

looks like “currant jelly”

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80
Q

What are the 4 A’s to remember for Klebsiella?

A 
4 A's:
Aspiration pneumonia
Abscess in lungs and liver
Alcoholics
di-A-betics
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81
Q

Compare Salmonella and Shigella

A

have flagella ——— no flagella
can disseminate hematogenously ——- cell to cell transmission; no hematogenous spread
many animal reservoirs ——- only reservoirs are humans and primates
antibiotics may prolong fecal excretion ——– antibiotics shorten duration of fecal excretion

invades intestinal mucosa and causes a monocytic response ——– invades intestinal mucosa and causes a PMN response

can cause bloody diarrhea —— OFTEN causes bloody diarrhea

BOTh do NOT ferment lactose

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82
Q

What disease is characterized by rose spots on the abdomen, fever, HA, and diarrhea?

A

Typhoid fever from salmonella typhi

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83
Q

Campylobacter jejuni 101

A

major cause of BLOODY diarrhea (esp. children)
fecal-oral
poultry, meat, unpasteurized milk
Comma or S-shaped, oxidase +

***common antecedent to Guillain-Barre Syndrome and reactive arthritis

84
Q

Vibrio cholerae

A

rice-water diarrhea via enterotoxin by permanently activating Gs –> increases cAMP

comma shaped, oxidase +
alkaline media
developing countries
oral rehydration therapy

85
Q

Yersinia enterocolitica

A

transmitted through pet feces (e.g. puppies), contaminated milk, or pork

mesenteric adenines that mimics Crohn disease or appendicitis

86
Q

Helicobacter pylori

A

Causes: gastritis, peptic ulcers (esp. duodenal)

Risk factor for adenocarcinoma and lymphoma

curved, Gram - rod, catalase, oxidase, and urease +

87
Q

What is the initial treatment for H. pylori infection?

A

PPI + clarithromycin + either amoxicillin or metronidazole

88
Q

What are the 3 spirochetes to know?

A

BIG

Borrelia
Leptospira
Treponema

89
Q

What group of people and where is leptospirosis often found?

A

surfers and in tropics

90
Q

What are symptoms of leptospirosis?

A

flu-like symptoms
jaundice
photophobia with conjunctival suffusion (erythema with exudate)

91
Q

What is the reservoir of leptospira interrogans?

A

water contaminated with animal urine

92
Q

What is the causative microorganism of Lyme Disease and what is the natural reservoir?

A

Causative microorganism: Borrelia burgdorferi (transmitted in tick)Natural reservoir: mouse

93
Q

What are the symptoms of Lyme Disease?

A

Initial symptoms- erythema chronic migrans (bulls eye rash)- flu-like symptoms- +/- facial nerve palsyLater symptoms- monoarthritis (large joints)- migratory polyarthritis- cardiac (AV nodal block)- neurologic (encephalopathy, facial nerve palsy, polyneuropathy)

94
Q

What is the treatment for Lyme Disease?

A

Doxycycline (1st line)Ceftriaxone (better for neuro Sx)

95
Q

What is the causative microorganism of syphilis?

A

Treponema pallidum

96
Q

What is the treatment for syphilis infection?

A

Penicillin G

97
Q

What are the stages of syphilis and what is the characteristic finding in each stage?

A

Primary syphilis - PAINLESS chancreSecondary syphilis - systemic constitutional symptoms, maculopapular RASH (palms and soles too)Tertiary syphilis - GUMMAS, aortitis, neurosyphilis, Argyll Robertson pupil

98
Q

What is the most specific test to detect syphilis infection?

A

fluorescent treponemal antibody absorption (FTA-ABS)

99
Q

What is a non-specific test to detect syphilis infection? What other diseases or conditions will give a positive result with this test?

A

VDRL/RPR - tests for beef cardiolipinVDRLViruses (mono, hepatitis)DrugsRheumatic feverLupus and Leprosy

100
Q

What are signs of congenital syphilis?

A

saber shinssaddle noseCN VIII deafnessHutchinson teethmulberry molars

101
Q

When does transmission of syphilis to the placenta occur?

A

typically after 1st trimester

102
Q

What is the Jarish-Herxheimer reaction?

A

flu-like syndrome after antibiotics are started d/ t killed bacteria releasing pyrogens

103
Q

What are symptoms of a Gardnerella vaginalis infection?

A

BACTERIAL VAGINOSIS- gray vaginal discharge- fishy smell*- nonpainful (vs. vaginitis)

104
Q

Clue cells are found in which infection?

A

Gardnerella vaginalis infection

105
Q

What is the treatment for bacterial vaginosis?

A

metronidazole or clindamycin

106
Q

What is the treatment for all Rickettsial diseases and vector-borne illnesses (for the most part…)?

A

doxycycline

107
Q

Where does Rocky Mountain Spotted Fever typically occur?

A

South Atlantic states (esp. North Carolina)

108
Q

Rash starting at wrists and ankles –> spreading to trunk, severe HA, and red conjunctivae after a tick bite would indicate what infection?

A

Rocky Mountain Spotted Fever

109
Q

Palms and soles rash is caused by which microorganisms?

A

Coxsackievirus ARMSFSecondary syphilis

110
Q

Which rickettsial disease is endemic and which is epidemic?

A

endemic (fleas) - R. typhiepidemic (louse) - R. prowazekii

111
Q

What is the difference b/t the Rickettsii rash and the typhus rash?

A

Rickettsii - starts on wRistTyphus - starts on the Trunk

112
Q

What is the vector for Ehrlichiosis?

113
Q

What is a unique blood smear finding with Ehrlichiosis infection?

A

morulae (“berry-like” inclusion in the cytoplasm of monocytes)

114
Q

What is the vector for Anaplasmosis?

115
Q

What is a unique blood smear finding with Anaplasmosis?

A

granulocytes with moralae in cytoplasm

116
Q

How is Q fever transmitted?

A

tick feces and cattle placenta release spores that are inhaled as aerosols

117
Q

How does Q fever present?

118
Q

What microorganism causes Q fever?

A

Coxiella burnetii

119
Q

What are the 2 forms of chlamydia and how do they contribute to infection?

A
  1. Elementary body - enters cell via endocytosis and is infectious2. Reticulate body - replicates in cell by fission
120
Q

What complications are associated with Chlamydia infection?

A

Reactive arthritis (Reiter Syndrome)Follicular conjunctivitisNongonococcal urethritisPID

121
Q

What stain is most useful to see Chlamydia?

A

Giemsa or fluorescent Ab-stained smear

122
Q

What is the treatment for Chlamydia infection?

A

azithromycin (1st line) or doxycyclineCeftriaxone - Azithromycin often used together b/c high rate of co-infection with N. gonorrhea

123
Q

Chronic infection causing BLINDNESS d/t follicular conjunctivitis in Africa is associated with what types of chlamydia?

A

Types A, B, and C

124
Q

Urethritis/PID, ectopic pregnancy, neonatal pneumonia, and neonatal conjunctivitis is associated with what types of chlamydia?

A

Types D - K

125
Q

Small, painless ulcers on genitals –> swollen, painful inguinal lymph nodes that ulcerate (“buboes”) is associated with what types of chlamydia?

A

This is a description of Lymphogranuloma VenereumTypes L1, L2 and L3

126
Q

What is the MC causative organism in atypical “walking” pneumonia?

A

Mycoplasma pneumoniae

127
Q

An infection of mycoplasma pneumoniae will result in a high titer of what protein?

A

high titer of cold agglutinins (IgM) –> agglutinate or lyse RBCs

128
Q

What agar is mycoplasma pneumoniae grown on?

A

Eaton agar

129
Q

What is the treatment for mycoplasma pneumoniae infection?

A

macrolide (1st line)doxycyclinefluoroquinolone*penicillin ineffective since Mycoplasma have no cell wall

130
Q

What is the causative microorganism of Lyme Disease and what is the natural reservoir?

A

Causative microorganism: Borrelia burgdorferi (transmitted in tick)Natural reservoir: mouse

131
Q

What are the symptoms of Lyme Disease?

A

Initial symptoms- erythema chronic migrans (bulls eye rash)- flu-like symptoms- +/- facial nerve palsyLater symptoms- monoarthritis (large joints)- migratory polyarthritis- cardiac (AV nodal block)- neurologic (encephalopathy, facial nerve palsy, polyneuropathy)

132
Q

What is the treatment for Lyme Disease?

A

Doxycycline (1st line)Ceftriaxone (better for neuro Sx)

133
Q

What is the causative microorganism of syphilis?

A

Treponema pallidum

134
Q

What is the treatment for syphilis infection?

A

Penicillin G

135
Q

What are the stages of syphilis and what is the characteristic finding in each stage?

A

Primary syphilis - PAINLESS chancreSecondary syphilis - systemic constitutional symptoms, maculopapular RASH (palms and soles too)Tertiary syphilis - GUMMAS, aortitis, neurosyphilis, Argyll Robertson pupil

136
Q

What is the most specific test to detect syphilis infection?

A

fluorescent treponemal antibody absorption (FTA-ABS)

137
Q

What is a non-specific test to detect syphilis infection? What other diseases or conditions will give a positive result with this test?

A

VDRL/RPR - tests for beef cardiolipinVDRLViruses (mono, hepatitis)DrugsRheumatic feverLupus and Leprosy

138
Q

What are signs of congenital syphilis?

A

saber shinssaddle noseCN VIII deafnessHutchinson teethmulberry molars

139
Q

When does transmission of syphilis to the placenta occur?

A

typically after 1st trimester

140
Q

What is the Jarish-Herxheimer reaction?

A

flu-like syndrome after antibiotics are started d/ t killed bacteria releasing pyrogens

141
Q

What are symptoms of a Gardnerella vaginalis infection?

A

BACTERIAL VAGINOSIS- gray vaginal discharge- fishy smell*- nonpainful (vs. vaginitis)

142
Q

Clue cells are found in which infection?

A

Gardnerella vaginalis infection

143
Q

What is the treatment for bacterial vaginosis?

A

metronidazole or clindamycin

144
Q

What is the treatment for all Rickettsial diseases and vector-borne illnesses (for the most part…)?

A

doxycycline

145
Q

Where does Rocky Mountain Spotted Fever typically occur?

A

South Atlantic states (esp. North Carolina)

146
Q

Rash starting at wrists and ankles –> spreading to trunk, severe HA, and red conjunctivae after a tick bite would indicate what infection?

A

Rocky Mountain Spotted Fever

147
Q

Palms and soles rash is caused by which microorganisms?

A

Coxsackievirus ARMSFSecondary syphilis

148
Q

Which rickettsial disease is endemic and which is epidemic?

A

endemic (fleas) - R. typhiepidemic (louse) - R. prowazekii

149
Q

What is the difference b/t the Rickettsii rash and the typhus rash?

A

Rickettsii - starts on wRistTyphus - starts on the Trunk

150
Q

What is the vector for Ehrlichiosis?

151
Q

What is a unique blood smear finding with Ehrlichiosis infection?

A

morulae (“berry-like” inclusion in the cytoplasm of monocytes)

152
Q

What is the vector for Anaplasmosis?

153
Q

What is a unique blood smear finding with Anaplasmosis?

A

granulocytes with moralae in cytoplasm

154
Q

How is Q fever transmitted?

A

tick feces and cattle placenta release spores that are inhaled as aerosols

155
Q

How does Q fever present?

156
Q

What microorganism causes Q fever?

A

Coxiella burnetii

157
Q

What are the 2 forms of chlamydia and how do they contribute to infection?

A
  1. Elementary body - enters cell via endocytosis and is infectious2. Reticulate body - replicates in cell by fission
158
Q

What complications are associated with Chlamydia infection?

A

Reactive arthritis (Reiter Syndrome)Follicular conjunctivitisNongonococcal urethritisPID

159
Q

What stain is most useful to see Chlamydia?

A

Giemsa or fluorescent Ab-stained smear

160
Q

What is the treatment for Chlamydia infection?

A

azithromycin (1st line) or doxycyclineCeftriaxone - Azithromycin often used together b/c high rate of co-infection with N. gonorrhea

161
Q

Chronic infection causing BLINDNESS d/t follicular conjunctivitis in Africa is associated with what types of chlamydia?

A

Types A, B, and C

162
Q

Urethritis/PID, ectopic pregnancy, neonatal pneumonia, and neonatal conjunctivitis is associated with what types of chlamydia?

A

Types D - K

163
Q

Small, painless ulcers on genitals –> swollen, painful inguinal lymph nodes that ulcerate (“buboes”) is associated with what types of chlamydia?

A

This is a description of Lymphogranuloma VenereumTypes L1, L2 and L3

164
Q

What is the MC causative organism in atypical “walking” pneumonia?

A

Mycoplasma pneumoniae

165
Q

An infection of mycoplasma pneumoniae will result in a high titer of what protein?

A

high titer of cold agglutinins (IgM) –> agglutinate or lyse RBCs

166
Q

What agar is mycoplasma pneumoniae grown on?

A

Eaton agar

167
Q

What is the treatment for mycoplasma pneumoniae infection?

A

macrolide (1st line)doxycyclinefluoroquinolone*penicillin ineffective since Mycoplasma have no cell wall

168
Q

What is the causative microorganism of Lyme Disease and what is the natural reservoir?

A

Causative microorganism: Borrelia burgdorferi (transmitted in tick)Natural reservoir: mouse

169
Q

What are the symptoms of Lyme Disease?

A

Initial symptoms- erythema chronic migrans (bulls eye rash)- flu-like symptoms- +/- facial nerve palsyLater symptoms- monoarthritis (large joints)- migratory polyarthritis- cardiac (AV nodal block)- neurologic (encephalopathy, facial nerve palsy, polyneuropathy)

170
Q

What is the treatment for Lyme Disease?

A

Doxycycline (1st line)Ceftriaxone (better for neuro Sx)

171
Q

What is the causative microorganism of syphilis?

A

Treponema pallidum

172
Q

What is the treatment for syphilis infection?

A

Penicillin G

173
Q

What are the stages of syphilis and what is the characteristic finding in each stage?

A

Primary syphilis - PAINLESS chancreSecondary syphilis - systemic constitutional symptoms, maculopapular RASH (palms and soles too)Tertiary syphilis - GUMMAS, aortitis, neurosyphilis, Argyll Robertson pupil

174
Q

What is the most specific test to detect syphilis infection?

A

fluorescent treponemal antibody absorption (FTA-ABS)

175
Q

What is a non-specific test to detect syphilis infection? What other diseases or conditions will give a positive result with this test?

A

VDRL/RPR - tests for beef cardiolipinVDRLViruses (mono, hepatitis)DrugsRheumatic feverLupus and Leprosy

176
Q

What are signs of congenital syphilis?

A

saber shinssaddle noseCN VIII deafnessHutchinson teethmulberry molars

177
Q

When does transmission of syphilis to the placenta occur?

A

typically after 1st trimester

178
Q

What is the Jarish-Herxheimer reaction?

A

flu-like syndrome after antibiotics are started d/ t killed bacteria releasing pyrogens

179
Q

What are symptoms of a Gardnerella vaginalis infection?

A

BACTERIAL VAGINOSIS- gray vaginal discharge- fishy smell*- nonpainful (vs. vaginitis)

180
Q

Clue cells are found in which infection?

A

Gardnerella vaginalis infection

181
Q

What is the treatment for bacterial vaginosis?

A

metronidazole or clindamycin

182
Q

What is the treatment for all Rickettsial diseases and vector-borne illnesses (for the most part…)?

A

doxycycline

183
Q

Where does Rocky Mountain Spotted Fever typically occur?

A

South Atlantic states (esp. North Carolina)

184
Q

Rash starting at wrists and ankles –> spreading to trunk, severe HA, and red conjunctivae after a tick bite would indicate what infection?

A

Rocky Mountain Spotted Fever

185
Q

Palms and soles rash is caused by which microorganisms?

A

Coxsackievirus ARMSFSecondary syphilis

186
Q

Which rickettsial disease is endemic and which is epidemic?

A

endemic (fleas) - R. typhiepidemic (louse) - R. prowazekii

187
Q

What is the difference b/t the Rickettsii rash and the typhus rash?

A

Rickettsii - starts on wRistTyphus - starts on the Trunk

188
Q

What is the vector for Ehrlichiosis?

189
Q

What is a unique blood smear finding with Ehrlichiosis infection?

A

morulae (“berry-like” inclusion in the cytoplasm of monocytes)

190
Q

What is the vector for Anaplasmosis?

191
Q

What is a unique blood smear finding with Anaplasmosis?

A

granulocytes with moralae in cytoplasm

192
Q

How is Q fever transmitted?

A

tick feces and cattle placenta release spores that are inhaled as aerosols

193
Q

How does Q fever present?

194
Q

What microorganism causes Q fever?

A

Coxiella burnetii

195
Q

What are the 2 forms of chlamydia and how do they contribute to infection?

A
  1. Elementary body - enters cell via endocytosis and is infectious2. Reticulate body - replicates in cell by fission
196
Q

What complications are associated with Chlamydia infection?

A

Reactive arthritis (Reiter Syndrome)Follicular conjunctivitisNongonococcal urethritisPID

197
Q

What stain is most useful to see Chlamydia?

A

Giemsa or fluorescent Ab-stained smear

198
Q

What is the treatment for Chlamydia infection?

A

azithromycin (1st line) or doxycyclineCeftriaxone - Azithromycin often used together b/c high rate of co-infection with N. gonorrhea

199
Q

Chronic infection causing BLINDNESS d/t follicular conjunctivitis in Africa is associated with what types of chlamydia?

A

Types A, B, and C

200
Q

Urethritis/PID, ectopic pregnancy, neonatal pneumonia, and neonatal conjunctivitis is associated with what types of chlamydia?

A

Types D - K

201
Q

Small, painless ulcers on genitals –> swollen, painful inguinal lymph nodes that ulcerate (“buboes”) is associated with what types of chlamydia?

A

This is a description of Lymphogranuloma VenereumTypes L1, L2 and L3

202
Q

What is the MC causative organism in atypical “walking” pneumonia?

A

Mycoplasma pneumoniae

203
Q

An infection of mycoplasma pneumoniae will result in a high titer of what protein?

A

high titer of cold agglutinins (IgM) –> agglutinate or lyse RBCs

204
Q

What agar is mycoplasma pneumoniae grown on?

A

Eaton agar

205
Q

What is the treatment for mycoplasma pneumoniae infection?

A

macrolide (1st line)doxycyclinefluoroquinolone*penicillin ineffective since Mycoplasma have no cell wall

First Aid STEP 1 - Microbiology (4 decks)

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