Clinical Bacteriology III

Question 1

silver stain

Answer 1

for legionella pneumophilia

Question 2

charcoal yeast extract with iron and cysteine

Answer 2

legionella

Question 3

AC system and hot water tanks

Answer 3

legionella pneumophila

Question 4

legionairres disease

Answer 4

severe pneumonia

• unilateral and lobar
• fever, GI and CNS sx

Question 5

pontiac fever

Answer 5

mild flu-like syndrome

-from legionella infection

Question 6

pyocyanin

Answer 6

blue green pigment
-pseudomonas aeruginosa infection

has grape like odor as well

Question 7

ecthyma gangrenosum

Answer 7

rapid progresive necrotic cutaneous lesion

• caused by pseudomonas bacteremia
• in immunocompromised

Question 8

burn victim

Answer 8

pseudomonas

Question 9

pneumonia in cystic fibrosis pt

Answer 9

pseudomonas

Question 10

hot tub folliculitis

Answer 10

pseudomonas

Question 11

E. coli virulence factors

Answer 11

LPS - shock

K capsule - pneumonia, neonate meningitis

fimbriae - cystitis and pyelonephritis

Question 12

EIEC

Answer 12

microbe invade intestinal mucosa

• necrosis and inflammation
• dysentery

Question 13

ETEC

Answer 13

heat stable and heat labile toxins

-travelers diarrhea

Question 14

travelers diarrhea

Answer 14

ETEC - watery diarrhea

Question 15

EPEC

Answer 15

no toxin

• adhere to apical surface
• diarrhea in children

Question 16

EHEC

Answer 16

shiga-like toxin
O157:H7

shiga-like toxin HUS - anemia, thrombocytopenia, acute renal failure

mechanical hemolysis - schistocytes

Question 17

currant jelly sputum

Answer 17

klebsiella

Question 18

lobar pneumonia in alcoholic and diabetic who aspirate

Answer 18

klebsiella

intestinal flora

Question 19

campylobacter jejuni infection

Answer 19

bloody diarrhea in children

fecal oral transmission

poultry, meat, unpasteurized mlik

comma or S shaped
oxidase +
grows at 42C - likes warm temp

precede guillan barre and reactive arthritis

Question 20

salmonella flagella

Answer 20

yes

Question 21

salmonella typhi infectious dose

Answer 21

high

destroyed by gastric acids

Question 22

shigella infectious dose

Answer 22

low

not destroyed by gastric acids

Question 23

turtles

Answer 23

salmonella

Question 24

typhoid fever

Answer 24

salmonella typhi

rose spots abdomen
constipation
abdomen pain
fever

Question 25

tx typhoid fever

Answer 25

ceftriaxone

FQ

Question 26

salmonella carrier state

Answer 26

in gallbladder

Question 27

salmonella vaccine

Answer 27

live attenuated s. typhi

Question 28

vibrio cholera toxin

Answer 28

rice water diarrhea
permanent activation Gs
-increased cAMP

comma shape, oxidase positive, grow alkaline media

need oral rehydration

Question 29

pseudoappendicitis

Answer 29

yersinia enterocolitica

Question 30

gastritis and peptic ulcers

Answer 30

h. pylori

Question 31

risk fx for peptic ulcer, gastric adenocarcinoma, MALToma

Answer 31

h. pylori

Question 32

urea breath test

Answer 32

h. pylori

gram neg rod
catalase positive
oxidase positive
urease positive

Question 33

tx of h. pylori

Answer 33

proton pump inhibitor
clarithromycin
amoxicillin (or metro if PCN allergy)

Question 34

spirochetes

Answer 34

borrelia - large
leptospira
treponema - small - darkfield microscopy

Question 35

surfer in tropics, photophobia, conjunctival suffusion, myalgia of calves, flu-like sx

Answer 35

leptospira interrogans

Question 36

weil disease

Answer 36

icterohemorrhagic leptospirosis

severe form - jaundice and azotemia

Question 37

lyme disease

Answer 37

borrela burdorferi
-ixodes deer tick
mice - important to tick life cycle

Question 38

erythema chronicum migrans

Answer 38

bulls eye rash

pathognomonic of lyme disease

Question 39

facial nerve palsy, flu-like sx, erythema chronicum migrans

Answer 39

lyme disease - borrelia burgdorferi

Question 40

late sx of lyme disease

Answer 40

monoarthritis
migratory polyarthritis
cardiac - AV node block

Question 41

tx lime disease

Answer 41

doxycylcine

ceftriaxone

Question 42

primary syphilis

Answer 42

painless chancre

Question 43

VDRL

Answer 43

test for treponema pallidum

non-specific

confirm with specific test - FTA-ABS

Question 44

secondary syphilis

Answer 44

disseminated disease

• maculopapular rash - palms/soles
• condyloma lata - smooth moist, painless wart on genitals

dark field microscopy dx

Question 45

tertiary syphilis

Answer 45

gumma - chronic granuloma
aortitis
neurosyphilis,
argyll robertson pupil

Question 46

aortitis with tertiary syphilis

Answer 46

vaso vasorum destruction

Question 47

argyll robertson pupil

Answer 47

constrict with accomodation but not reactive to light
-prostitute pupil

with tertiary syphilis

Question 48

diagnosis neurosyphilis

Answer 48

spinal tap - VDRL and PCR

Question 49

congenital syphilis

Answer 49

facial abnormalities
rhagades - linear scar angle of mouth
snuffles - nasal discharge
saddle nose
notched teeth - hutchinson
mulberry molars
short maxilla
saber shins
CN VIII deafness

transmission from mother - first trimester - tx early

Question 50

VDRL test for syphilis

Answer 50

sensitive and cheap
not specific

false positives - VDRL
V - viral infection - mono/hepatitis
D - drugs
R - rheumatic fever
L - lupus and leprosy

Question 51

jarisch herxheimer rxn

Answer 51

flu-like syndrome following antibiotic tx initiation

killed bacteria release endotoxin