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Low Yield Semmelweis > Clinical Microbiology > Flashcards

Clinical Microbiology Flashcards

1
Q

Skin infections (a few examples) - Gram (+)

A 
Staphylococcus Aureus
Streptococcus Pyogenes
Bacillus Anthracis and Bacillus Cereus
Corynebacterium Diphtheriae
Peptostreptococci and Enterococci
Erysipelothrix Rhusiopathiae
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2
Q

Skin infections (a few examples) - Gram (-)

A 
Escherichia Coli
Neisseria Meningitidis 
Proteus sp.
Pseudomonas Aeruginosa
Francisella Tularensis
Yersinia Pestis
Treponema Carateum and Treponema Pertenue
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3
Q

Wounds infections (a few examples) - Gram (+)

A

Staphylococcus Aureus
Streptococcus Pyogenes
Enterococci and Peptostreptococci
Clostridium Tetani and Clostridium Perfringens

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4
Q

Wounds infections (a few examples) - Gram (-)

A 
Escherichia Coli
Proteus 
Klebsiella 
Pseudomonas Aeruginosa
Pasteurella sp.
Bacteroides sp..
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5
Q

Bacteria causing endogenous and mixed abdominal infections (a few examples):

A

Aerobic and Facultative bacteria
Escherichia Coli
Enterococci
α-haemolytic streptococci

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6
Q

Bacteria causing endogenous and mixed abdominal infections (a few examples):

A

Obligate Anaerobic Bacteria
Bacteroidaceae
Anaerobic Cocci

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7
Q

Bacteria causing Peritonitis (a few examples):

A

S. Pneumoniae (Children)
Group A Streptococci
Bacteroids

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8
Q

Infections causing Cholecystitis and Cholangitis (a few examples):

A

Pseudomonas aeruginosa
Clostridium perfringens
Actinomyces sp
Fungi: Candida Albicans

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9
Q

Diagnosis of Infectious Peritonitis:

A

Sampling form: Peritoneal fluid (lavage), Blood, Pus, Gall.

Detection: Gram staining, aerobic and anaerobic bacteria, cultivation, antibiogram

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10
Q

Diagnosis of Infectious Cholecystitis:

A

Sample from: Gall (invasive techniques E.g. duodenal sonda) High Contamination→Quantitative cultivation: Germ number 105/ml means infection.
Detection: Gram staining, aerobic and anaerobic bacteria, cultivation, antibiogram

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11
Q

Diagnosis of Infectious Cholangitis:

A

Sample from: Blood, Liver biopsy, Gall (with percutan-transhepatic choledochus (PTC) or from duodenum zonda)
Detection: Gram staining, aerobic and anaerobic bacteria, cultivation, antibiogram

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12
Q

Abdominal Infections:

Surgical Therapy for appendicitis needs and Prophylaxis :

A

Appendectomy - in surgical prophylaxis Metronidazole

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13
Q

Abdominal Infections:

Medical Therapy for Complications such as perforation or long lasting cystic obstruction and appendicitis needs

A

Combination: Lactamase- stabilising penicillins or 2. - 3. Generation cephalosporins or fluoroquinolon, together with Metronidazole or Aminoglycoside

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14
Q

Bacteria causing ophthalmic infections (a few examples) - Gram (+):

A

Staphylococcus Aureus
Streptococcus Pyogenes
Streptococcus Pneumoniae

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15
Q

Bacteria causing ophthalmic infections (a few examples) - Gram (-):

A 
Chlamydia Trachomatis
Neisseria Gonorrhoeae
Haemophilus Influenzae and Haemophilus Aegyptius
Pseudomonas Aeruginosa
Moraxella Lacunata
Enterobacteriaceae
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16
Q

Viruses causing ophthalmic infections (a few examples):

A 
Coxsackie Virus
Adenovirus
Herpes Simplex Virus (HSV1)
Cytomegalovirus
Varicella Zoster Virus (HHV3)
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17
Q

Bacteria causing air-borne upper respiratory tract infections (a few examples) - Gram (+):
(Pharyngitis, tonsillitis, otitis, epiglotitis, sinusitis)

A 
Streptococcus Pyogenes
Streptococcus Pneumoniae
Staphylococcus Aureus
Streptococcus B, C, G
Arcanobacterium
Corynebacterium Haemolyticum
Enterococci and Peptostreptococci
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18
Q

Bacteria causing air-borne Upper Respiratory Tract infections (a few examples) - Gram (-):
(Pharyngitis, tonsillitis, otitis, epiglottitis, sinusitis)

A 
Haemophilus Influenzae
Neisseria Meningitidis
Klebsiella sp.
Pseudomonas Aeruginosa
Acinetobacter sp.
Neisseria gonorrhoeae
Moraxella catarrhalis
Bacteroidaceae and Enterobacteriaceae
(Treponema Vincentii Complex)
Chlamydia Trachomatis D-K
Chlamydia Pneumoniae
Xanthomonas Maltophilia
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19
Q

Diagnosis of agents causing air-borne upper respiratory tract infections:

A
  • Sputum specimens (and Blood) are cultured for bacteria, fungi and viruses.
  • Enzyme-linked immunoassay methods can be used for detections of microbial antigens as well as antibodies.
  • Detection of nucleotide fragments specific for the microbial antigen in question by DNA probe or polymerase chain reaction can offer a rapid diagnosis.
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20
Q

Diagnosis of agents causing air-borne upper respiratory tract infections:
Culture of nasal washings is usually sufficient in _____ with bronchiolitis.

A

Bacterial Diagnosis of agents causing air-borne upper respiratory tract infections:
Culture of nasal washings is usually sufficient in infants with bronchiolitis.

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21
Q

Diagnosis of agents causing air-borne upper respiratory tract infections:
_________ staining technique can be used for legionellosis.

A

Diagnosis of agents causing air-borne upper respiratory tract infections:
Fluorescent staining technique can be used for legionellosis.

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22
Q

Treatment of agents causing air-borne upper respiratory tract infections:

A

Symptomatic treatment is used for most viral infections. Bacterial pneumonias are treated with antibacterials.

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23
Q

Prevention of agents causing air-borne upper respiratory tract infections:

A

A Polysaccharide vaccine against 23 serotypes of Streptococcus pneumoniae is recommended for Individuals at high risk.

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24
Q

Viruses causing air-borne Respiratory Tract infections (a few examples):
(Pharyngitis, tonsillitis, otitis, epiglottitis, sinusitis and Pneumonia)

A 
Rhinovirus
Coronavirus
Influenza and Parainfluenza Virus
Adenovirus
Respiratory Syncytial Virus
Epstein-Barr Virus
Cytomegalovirus
Herpes Simplex Virus
Coxsackie Virus
Measles Virus
Varicella Zoster Virus
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25
Q

A Common Fungi that colonize that Upper respiratory Tract and possibly causing Pharyngitis:

A

Candida Albicans

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26
Q

Normal flora of the oral cavity: Anaerobic Bacteria (a few examples)

A

Peptostreptococcus
Veillonella
Actinomyces
Fusobacterium

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27
Q

Normal flora of the oral cavity: Aerobic Bacteria (a few examples)

A

Streptococcus
Haemophilus
Neisseria

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28
Q

Normal flora of the oral cavity: Parasites (a few examples)

A

Entamoeba

Trichomonas

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29
Q

Infective agents causing Esophagitis (Could be Iatrogenic):

A

Candida Albicans
Cytomegalovirus
Herpes Simplex Virus

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30
Q

Normal flora of the Stomach: Bacteria (a few examples)

A

Lactobacillus Casei
Streptococcus spp.
Helicobacter Pylori

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31
Q

Normal flora of the Small Intestine: Bacteria (Most are) Anaerobes (a few examples)

A

Peptostreptococcus
Porphyromonas
Prevotella

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32
Q

Agents causing Infection of Small Intestine (Could be Iatrogenic):

A

Salmonella Typhi and Salmonella Enteritidis

Campylobacter Jejuni

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33
Q

Normal flora of the Colon: Bacteria (a few examples)

A 
Bifidobacterium
Eubacterium
Bacteroides Fragilis 
Enterococcus
Escherichia Coli
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34
Q

Agents causing Infection of Colon (Could be Iatrogenic):

A 
Bacteroides Fragilis
VRE
Pseudomonas Aeruginosa
Clostridium Difficile 
EHEC
Shigella Dysenteriae
Entamoeba Histolytica
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35
Q

Normal flora of the Colon: Fungi (a few examples)

A

Candida Spp.

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36
Q

Normal flora of the Colon: Parasites (a few examples)

A 
Blastocystis 
Chilomastix 
Endolimax 
Entamoeba 
Iodamoeba 
Trichomonas
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37
Q

Which Bacteria is able to synthesize Vitamin K and Biotin in the Colon? (For Extra Knowledge, Just one Example)

A

Escherichia Coli

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38
Q

Bacterial Pathogens of the faecal-oral route causing Bloody Diarrhea (a few examples):

A 
Shigella
EHEC
Yersinia Enterocolitica
Salmonella
Campylobacter jejuni
Aeromonas spc.
Vibrio parahaemolyticus
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39
Q

Bacterial Pathogens of the faecal-oral route causing Watery Diarrhea (a few examples):

A 
Shigella
Vibrio Cholera
ETEC, EIEC, EPEC
Clostridium perfringens
Clostridium difficile
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40
Q

Bacterial Pathogens of the faecal-oral route causing Typhoid fever (a few examples):

A 
Salmonella Typhi
Salmonella Paratyphi A, B
Yersinia Enterocolitica
Yersinia Pseudotuberculosis
Campylobacter Fetus
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41
Q

Viral Pathogens of the faecal-oral route causing Diarrhea (a few examples):

A 
Rotavirus
Caliciviridae
Flavivirus
Orthomyxovirus
Crimean-Congo Virus
HHV-7
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42
Q

Protozoal Pathogens of the faecal-oral route causing Diarrhea (a few examples):

A 
Entamoeba Histolytica
Balantidium Coli
Giardia Lamblia
Cryptosporidium
Blastocystis hominis
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43
Q

Helminth Pathogens of the faecal-oral route causing Diarrhea (a few examples):

A

Strongyloides Stercoralis

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44
Q

Normal Flora of the Anterior Urethra and Vagina - (a few examples):

A 
Lactobacillus Casei
Streptococcus spp.
Staphylococcus Epidermidis 
Staphylococcus Saprophyticus
Candida Albicans
Ureaplasma spp.
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45
Q

The Most Important Microbial pathogens of the urinary tract :

A 
Escherichia Coli
Staphylococcus Saprophyticus
Candida Albicans
Neisseria Gonorrhoeae
Chlamydia Trachomatis 
Ureaplasma spp.
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46
Q

Causative agents of Arthropod-borne Bacterial infections - (a few examples):

A 
Rickettsia Prowazekii
Rickettsia Rickettsii
Coxiella Burnetii
Francisella Tularensis
Borrelia Burgdorferi
Yersinia Pestis
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47
Q

Causative agents of Arthropod-borne Viral infections - (a few examples):

A

Togavirus (Alphavirus)
Flaviviruses (Dengue, Yellow Fever, West Nile)
Reovirus (Coltivirus )
Bunyaviruses (California Encephalitis +Rift Valley Fever)

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48
Q

Bacterial pathogens of food-poisoning and toxico-infections - Contaminated Milk (a few examples):

A

Salmonella Spp.
Campylobacter Jejuni
Yersinia Enterocolitica
Mycobacteria Tuberculosis

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49
Q

Bacterial pathogens of food-poisoning and toxico-infections - Contaminated Meat (a few examples):

A

Clostridium Perfringens
EHEC and EPEC
Campylobacter Jejuni
Yersinia Enterocolitica

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50
Q

Bacterial pathogens of food-poisoning and toxico-infections - Contaminated Rice (a few examples):

A

Bacillus Cereus

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51
Q

Bacterial pathogens of food-poisoning and toxico-infections - Contaminated Water (a few examples):

A

ETEC, EPEC and EIEC

Vibrio Cholerae

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52
Q

Zoonotic infections of Bacterial Origin (a few examples):

A 
Anthrax: Bacillus Anthracis
Typhus: Rickettsia Prowazekii
Lyme disease: Borrelia Burgdorferi, Afzelii and Ganiri
Leprosy: Mycobacterium Leprae
Bubonic plague: Yersinia Pestis
Q-Fever: Coxiella Burnetii
Rabbit Fever: Francisella Tularensis
Brucellosis: B. Suis, B. Melitensis, B. Abortus, B. Canis
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53
Q

Zoonotic infections of Viral Origin (a few examples):

A 
Bird Flu: Influenza A virus
Rabies: Rhabdovirus
Lassa Virus
Hantavirus
Cardiovirus
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54
Q

Zoonotic infections of Parasitic Origin (a few examples):

A

Chagas disease: Trypanosoma Cruzi
Toxoplasmosis: Toxoplasma gondii
Leishmaniasis: Leishmania
Sleeping Sickness: Trypanosoma Brucei Gambiense

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55
Q

Zoonotic infections of Prion Origin (a few examples):

A

Mad Cow Disease/Creutzfeldt-Jakob disease (vCJD)

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56
Q

Most important bacteria causing Meningitis - Gram(+) (a few examples):

A

Streptococcus Pneumoniae
Streptococcus Agalactiae
Staphylococcus Aureus
Listeria Monocytogenes

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57
Q

Most important bacteria causing Meningitis - Gram(-) (a few examples):

A 
Neisseria Meningitidis
Haemophilus Influenzae
Escherichia Coli
Pseudomonas Aeruginosa
Proteus
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58
Q

Most important bacteria causing Meningitis - Gram Intermediate (a few examples):

A

Mycobacterium Tuberculosis

Leptospira Interrogans

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59
Q

Most important bacteria causing Encephalitis - Gram(+) (a few examples):

A

Listeria Monocytogenes

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60
Q

Most important bacteria causing Encephalitis - Gram(-) (a few examples):

A

Borrelia Burgdorferi

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61
Q

Most important bacteria causing Encephalitis - Gram Intermediate (a few examples):

A

Rickettsia Prowazekii

Chlamydia Psittaci

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62
Q

What is the classical diagnostic triad of symptoms for Meningitis?

A

1) Nuchal rigidity
2) Sudden High fever
3) Altered Mental status

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63
Q

What type of Meningitis is presented along with rapidly-spreading petechial rash?

A

“Meningococcal” Meningitis (i.e. meningitis caused by the bacteria Neisseria meningitidis)

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64
Q

Meningitis - Sample taking? What is Checked?

A

CSF is examined for WBCs, RBCs, protein content and glucose level.

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65
Q

How can we tell based on the CSF-WBC what type (Bacterial/Viral) of Meningitis ?

A

The type of white blood cell predominantly present predicts whether meningitis is due to bacterial or viral infection.
(Lymphocytes = Viral and Neutrophills =Bacteria)

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66
Q

How can we tell based on the CSF-Glucose what type (Bacterial/Viral) of Meningitis ?

A

Bacterial: CSF glucose to serum glucose ratio is < 0.4 .
Viral: CSF glucose to serum glucose ratio is 1~

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67
Q

Apart from CSF-Glucose and CSF-WBC, What other more specific diagnostic Lab test are possible for Meningitis?

A

Microbiological culture, Latex agglutination, PCR (Especially after antibiotics), Limulus lysate test for Gram Negative (Endotoxin Sensitive).

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68
Q

Meningitis - Principles of Treatment and Initial Response

A

Medical Emergency: Empiric antibiotics even before LP. Prednisone (corticosteroid) reduces rates of mortality, severe hearing loss and neurological sequelae.

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69
Q

Bacteria causing Pneumonia - Gram(+) (a few examples):

A 
Streptococcus pneumoniae
Staphylococcus aureus
Peptostreptococcus sp.
Streptococcus pyogenes
Enterococcus sp.
Actinomyces sp.
Nocardia sp.
Bacillus anthracis
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70
Q

Bacteria causing Pneumonia - Gram(-) (a few examples):

A 
Haemophilus influenzae
Bacteroidaceae
Legionella sp.
Klebsiella pneumoniae
Enterobacteriaceae
Pseudomonas aeruginosa
Moraxella catarrhalis
Francisella tularensis
Yersinia pestis.
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71
Q

Bacteria causing Pneumonia - Gram Intermediate (a few examples):

A 
Mycoplasma pneumoniae
Chlamydia Pneumoniae
Chlamydia Psittaci
Coxiella burnetii
Mycobacterium sp.
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72
Q

Bacteria causing Whooping cough: (a few examples):

A

Bordetella Pertussis

Bordatella Parapertussis

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73
Q

Bacteria causing Tuberculosis: (a few examples):

A

Mycobacterium Tuberculosis
Mycobacterium Bovis
Mycobacterium Africanum

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74
Q

Diagnostic Measures of Lower Respiratory Tract Bacterial Infections:

A

Sample from secretions of pus.

Microscopy, Culture, Serology, PCR.

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75
Q

Bacterial exotoxins and the Related diseases:

Superantigens of S. Aureus and S. Pyogenes

A 
Toxic shock syndrome:
Superantigens bridge the MHC class II protein on antigen presenting cells with the T cell receptor on the surface of T cells with a particular Vβ chain
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76
Q

Bacterial exotoxins and the Related diseases:

Heat labile toxin of E.coli

A

Gastroenteritis:
Bind and activate guanylate cyclase, which leads to ↑cGMP. This leads to the loss of electrolytes and water from intestinal cells.

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77
Q

Bacterial exotoxins and the Related diseases:

Anthrax toxins of Bacillus anthracis

A

Anthrax:

EF + PA: increase in target cell cAMP level, localized edema; LF + PA: death of target cells and experimental animals

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78
Q

Bacterial exotoxins and the Related diseases:

Bordetella adenylate cyclase and Pertussis

A

Lymphocytosis and Bronchial Cell Death:

Increase in target cell cAMP level

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79
Q

Bacterial exotoxins and the Related diseases:

Botulinum toxin of Clostridium botulinum

A

Flaccid paralysis:

Decrease in peripheral, presynaptic acetylcholine release

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80
Q

Bacterial exotoxins and the Related diseases:

Cholera toxin of Vibrio cholerae

A

Cholera - Secretory Diarrhea:

Activation of adenylate cyclase, increase in cAMP level

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81
Q

Bacterial exotoxins and the Related diseases:

Diphtheria toxin of Corynebacterium Diphtheriae

A

Diphtheria - Pharyngeal Pseudomembranes:

Inhibition of protein synthesis

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82
Q

Bacterial exotoxins and the Related diseases:

Pseudomonas exotoxin A of Pseudomonas aeruginosa

A

Similar to Diphtheria - Pharyngeal Pseudomembranes:

Inhibition of protein synthesis

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83
Q

Bacterial exotoxins and the Related diseases:

Shiga toxin of Shigella Dysenteriae

A

Shigellosis:

Inhibition of protein synthesis and Cell Death

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84
Q

Bacterial exotoxins and the Related diseases:

Tetanus toxin of Clostridium tetani

A

Tetanus, Opisthotonus:

Decrease in neurotransmitter release from inhibitory neurons, spastic paralysis

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85
Q

Septic shock - Microbiologic Diagnosis

A

Diagnosis is made by culturing local infections thought to be the source of microbemia and by culturing the blood.

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86
Q

Septic shock - Prevention and Treatment

A

Treatment consists of high-dose intravenous broad-spectrum antimicrobial agents, intravenous fluids, supplemental oxygen therapy, mechanical ventilation, hemodialysis, and transfusions of blood products and clotting factors, as needed.

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87
Q

Endocarditis - Microbiologic Diagnosis

A

Infective endocarditis is diagnosed through blood cultures

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88
Q

Endocarditis - Prevention

A

Antimicrobial prophylaxis is administered to patients with defective heart valves who are undergoing dental and other procedures known to produce bacteremia.

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89
Q

Endocarditis - Treatment

A

Prolonged intravenous treatment with bactericidal antibiotics to eradicate bacteria within the protective clot. Surgical replacement of infected valves may be required to cure prosthetic valve infections.

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90
Q

Blood cultures - Initial Importance in Diagnosis

A

Most clinical laboratories will give a preliminary report of a negative culture if no growth is detected after 4 days of incubation. A final negative report is made if there is no growth after 7 days of incubation.

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91
Q

Blood cultures - What should be done if the patient has received antimicrobial agents before sampling?

A

The Clinical Laboratory can add penicillinase to remove β-lactam antibiotics, use an antimicrobial removal device or special resin bottle to remove or inactivate the antimicrobial agent, or prolong blood incubation for 2 weeks to improve the chances of obtaining a positive culture.

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92
Q

Blood cultures - What should be done If infective endocarditis is suspected?

A

Blood culture bottles should be incubated for 2 weeks to allow growth of slow-growing or fastidious microorganisms.

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93
Q

Blood cultures - What should be done If fungemia is suspected?

A

Special media and techniques are used to grow fungi

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94
Q

Blood cultures - What should be done If central venous catheter infection is suspected?

A

Blood should be drawn both from the line and from a peripheral vein, and the results of quantitative cultures compared. If the catheter blood culture has a 10-fold greater count than the peripheral blood culture or has more than 100 CFU/ml, the catheter is probably infected.

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95
Q

Serum Procalcitonin is a definite indication of a _______ Infection.

A

Serum Procalcitonin is a definite indication of a Bacterial Infection.

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96
Q

Serum Leukocytosis and CRP elevation is an initial indication of an _______ .

A

Serum Leukocytosis and CRP elevation is an initial indication of an Infection

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97
Q

In case of Transient Bacteremia blood sample should be taken from the patient at :

A

The beginning of the fever

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98
Q

In case of Continuous Bacteremia blood sample should be taken from the patient at :

A

Blood can be taken at any time

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99
Q

How blood should be taken for Blood culture from an Adult?

A

10-20 ml

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100
Q

How blood should be taken for Blood culture from an child?

A

1-2 ml

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101
Q

How many times do we need to sample blood for blood cultures? and from which vessels?

A

3 Times and from the Peripheral Veins

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102
Q

What pathogens require a special Blood culture mixtures?

A

Fungi and Mycobacteria

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103
Q

Liquid media for Anaerobic culture - Methods of Environment Production for Anaerobes

A

Before inoculation, O2 is eliminated from media by means of boiling. After inoculation, media are sealed by means of sterile wax or Vaseline.

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104
Q

Gas-pack jar (Compartment) - Methods of Environment Production for Anaerobes

A

Cultivation of Anaerobic microbes by - Placing a Gas Pack in the Jar that releases H2 and CO2, a Catalyst in the cell produces Water from O2 and H2 thus ultimately eliminating the Oxygen in the sealed Jar.

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105
Q

Anaerostate (Compartment) - Methods of Environment Production for Anaerobes

A

Cultivation of Anaerobic microbes by - Air Expulsion by Pressure Cylinder, Air Aspiration and Filling or Anaerocult that produces the Correct Gas mixture.

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106
Q

Biological method - Fortner-technique: Environment Production for Anaerobes

A

Growing Anaerobes and Aerobes together on Blood agar - Anaerobe over consume the Oxygen allowing for an Anaerobic environment for the other Anaerobe.

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107
Q

Chemical method - Liquid media for Anaerobic culture

A

Thioglycolate broth allows for reduction of Oxygen to water in the tube. Aerobes will culture the top of the liquid (Contact with air) anaerobe the bottom.

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108
Q

Types of metabolism preformed by aerobic and anaerobic bacteria?

A

Aerobic bacteria - Respiration

Anaerobic bacteria - Fermentation

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109
Q

Enterally acquired Parasitic infections - Indirect (fecal-oral) - give a few examples:

A 
Entamoeba Histolytica
Giardia lamblia
Enterobius vermicularis
Balantidium coli
Ascaris lumbricoides
Toxocara spp.
Trichuris trichiura
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110
Q

Enterally acquired Parasitic infections - direct (venereal) - give a few examples:

A

Entamoeba Histolytica

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111
Q

Enterally acquired Parasitic infections - Contaminated Meat - give a few examples:

A

Taenia saginata
Taenia solium
Diphyllobothrium latum (Fish)

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112
Q

Enterally acquired Parasitic infections - Contaminated Eggs - give a few examples:

A

Echinococcus granulosus and multilocularis

Hymenolepis nana

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113
Q

What are the Microscopical Diagnostic Measures for Enterally acquired Parasitic infections?

A

Wet mount
Permanent stains
Stool concentrates

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114
Q

What are the Serologic Diagnostic Measures for Enterally acquired Parasitic infections?

A

ELISA: Antibody response or Antigen detection

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115
Q

What are the Nucleic acid hybridization Diagnostic Measures for Enterally acquired Parasitic infections?

A

Restriction Endonuclease and PCR

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116
Q

What are the Unique options for Diagnosis of Enterally acquired Parasitic infections?

A

Animal inoculation and Culture

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117
Q

Causative agents associated with arthropod-borne Parasitic infections - Protozoa (few examples):

A 
Plasmodium spp: Anopheles mosquito
Toxoplasma gondii: Fecal-oral route, carnivorism
Leishmania species: Phlebotomus sandfly
Trypanosoma cruzi: Reduviid bug
Trypanosoma brucei: Tsetse fly
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118
Q

Causative agents associated with arthropod-borne Parasitic infections - Helminths (few examples):

A

Wuchereria bancrofti: Mosquito
Loa loa: Chrysops fly
Onchocerca volvulus: Simulium black fly
Dirofilaria immitis: Mosquito

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119
Q

Plasmodium spp - Diagnostic Procedure

A

Blood Sample Microscopic examination (Giemsa stain) or acridine orange fluorescent stain:
●Thin film
●Thick film

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120
Q

Leishmania Donovani- Diagnostic Procedure

A

Bone Marrow Aspirate Microscopic examination (Giemsa stain), Culture, Serology (antibody).

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121
Q

Trichinella spiralis and Trypanosoma cruzi- Diagnostic Procedure

A

Muscle Biopsy Muscle Microscopic examination (permanent stains) and Serology

122
Q

Onchocerca volvulus and also Leishmania Braziliensis and Tropica - Diagnostic Procedure

A

Scrapings and Skin snip Biopsy Microscopic examination with Wet mount or Permanent stains

123
Q

Pathogens of the air-borne viral infections - Give a few examples

A 
Coronavirus
Paramyxoviruses
Influenza viruses
Picornaviruses
Rhinoviruses
Adenovirus
Varicella-zoster virus
B19 virus (Parvovirus)
Polyomavirus
124
Q

Pathogens of the enterally acquired viral infections, Specific for infants - Give a few examples

A
  • Rotavirus A
  • Adenovirus 40, 41
  • Coxsackie A24 virus
125
Q

Pathogens of the enterally acquired viral infections, General Population - Give a few examples

A
  • Norwalk virus
  • Calicivirus
  • Astrovirus
  • Rotavirus B (outbreaks in China)
  • Reovirus
  • HAV
  • HEV
126
Q

Viruses infecting the small intestine causes damage to the epithelial lining and the absorptive villi, the result is :

A

Malabsorption of Water and an Electrolyte Imbalance

127
Q

Although enteroviruses (picornaviruses) are spread by the fecal-oral route, they usually cause only mild or no gastrointestinal symptoms. Instead, these viruses establish a _______ , spread to other target organs, and then cause clinical disease.

A

Although enteroviruses (picornaviruses) are spread by the fecal-oral route, they usually cause only mild or no gastrointestinal symptoms. Instead, these viruses establish a VIREMIA , spread to other target organs, and then cause clinical disease.

128
Q

Most important Fungi causing Meningitis (a few examples):

A 
Candida Albicans
Cryptococcus Neoformans
Aspergillus Fumigatus
Coccidioides Immitis
Histoplasma Capsulatum
129
Q

Most important Fungi causing Brain Abscesses (a few examples):

A 
Candida Albicans
Cryptococcus Neoformans
Aspergillus Fumigatus
Coccidioides Immitis
Blastomyces dermatitidis
Zygomycetes - Mucor
130
Q

Most important Viruses causing Meningitis (a few examples):

A 
Enteroviruses (Echo-, Coxsackie- and Polioviruses)
Herpes simplex virus  2 
Human T-Lymphotropic Virus
Mumps virus 
Lymphocytic choriomeningitis virus 
(Flavi-) West Nile Virus
131
Q

Most important Viruses causing Paralysis (a few examples):

A

Poliovirus
Enteroviruses 70 and 71
Coxsackie A7 virus
(Flavi-) West Nile Virus

132
Q

Most important Viruses causing Encephalitis (a few examples):

A 
Herpes simplex virus 1
Varicella-zoster virus 
Rabies virus 
Coxsackie A and B viruses 
Polioviruses 
(Flavi-) West Nile Virus
133
Q

Most important Viruses causing Postinfectious Encephalitis - Immune Mediated and Long term Complications (a few examples):

A 
Measles virus - SSPE
JC virus - Progressive Multifocal Leukoencephalopathy
Mumps virus 
Rubella virus 
Varicella-zoster virus 
Influenza viruses
134
Q

Most important Bacteria causing Endocarditis -(a few examples):

A 
Staphylococcus Aureus - Acute
Viridans streptococci - Subacute
Streptococcus Bovis - Colon Cancer
Staphylococcus Epidermidis - Prosthetic Valves
Corynebacterium Diphtheriae
Bartonella Henselae
Enterococci
135
Q

Most important Fungi causing Endocarditis -(a few examples):

A

Candida Albicans
Histoplasma Capsulatum
Aspergillus Fumigatus

136
Q

Most important Viruses causing Endocarditis -(a few examples):

A

Coxsackievirus group B
Human Herpes Virus 6
Parvovirus B19

137
Q

Most important Parasites causing Heart Diseases -(a few examples):

A

Trypanosoma cruzi (Chagas)
Echinococcus multilocularis
Echinococcus granulosus

138
Q

Fungi causing Pneumonia - (a few examples):

A 
Candida Albicans
Aspergillus Fumigatus and Aspergillus Flavus
Pneumocystis jirovecii
Histoplasma Capsulatum
Blastomyces Dermatitidis
Paracoccidioides Brasiliensis
Coccidioides Immitis
Cryptococcus Neoformans
139
Q

Fungi causing Bronchitis- (a few examples):

A

Aspergillus Fumigatus and Aspergillus Flavus

Cryptococcus Neoformans

140
Q

Parasites causing Lung Abscesses - (a few examples):

A

Entamoeba Histolytica

Paragonimus Westermani

141
Q

Parasites causing Lung Nodules - (a few examples):

A

Echinococcus Multilocularis

Echinococcus Granulosus

142
Q

Parasites causing Pneumonitis - (a few examples):

A

Ascaris Lumbricoides
Toxocara Canis
Strongyloides Stercoralis
Paragonimus Westermani

143
Q

Microbes causing pre- and perinatal infections in the fetus/newborn: Bacteria

A 
Chlamydia Trachomatis
Listeria Monocytogenes
Mycobacterium Tuberculosis
Group B Streptococci
Treponema Pallidum
144
Q

Microbes causing pre- and perinatal infections in the fetus/newborn: Viral

A 
Cytomegalovirus
Zika Virus
Rubella Virus
Herpes Simplex Virus
Human Immunodeficiency Virus
Hepatitis B Virus 
Hepatitis A Virus 
Coxsackie B Virus
Parvovirus - B19
145
Q

Microbes causing pre- and perinatal infections in the fetus/newborn: Fungi

A 
Malassezia Furfur
Pneumocystis Jirovecii
Candida Albicans (and Candida Parapsilosis)
Aspergillus Fumigatus
Zygomycetes - Mucor
146
Q

Microbes causing pre- and perinatal infections in the fetus/newborn: Parasites

A

Toxoplasma Gondii
Plasmodium spp.
Trichomonas Vaginalis

147
Q

Microbes causing Malformations, Developmental Abnormalities and Spontaneous Abortion - PREnatal:

A 
Toxoplasma Gondii 
Listeria Monocytogenes
Parvovirus B19
Rubella
Cytomegalovirus (#1 Mental Retardation by Infection)
Human Immunodeficiency Virus
Ureaplasma spp.
Treponema Pallidum
148
Q

Microbes causing Malformations/Developmental Abnormalities - POSTnatal and NEOnatal:

A 
Human Immunodeficiency Virus
Cytomegalovirus
Herpes Simplex Virus
Hepatitis B virus
Coxsackie B Virus
Echovirus
149
Q

What are the 6 Childhood infections characterised by exanthems?

A

1st - Measles, Exanthema: Koplik Spots
2nd - S.Pyogenes, Scarlet Fever: Erythematous Rash
3rd - Rubella: Pin-Points Exanthema
5th - Parvovirus B19: Erythema infectiosum
6th - Roseola (HHV 6+7): Exanthema Subitum
VZV (HHV3) - Chickenpox (“Non-Classical Exanthema”)

150
Q

Sexually Transmitted Infection- Gram Positive Bacteria:

A

Streptococcus Agalactiae

Gardnerella Vaginalis

151
Q

Sexually Transmitted Infection - Gram Negative Bacteria:

A

Neisseria gonorrhoeae
Haemophilus ducreyi
Calymmatobacterium Granulomatis

152
Q

Sexually Transmitted Infection - Gram Intermediate Bacteria:

A 
Treponema Pallidum
Chlamydia Trachomatis L 1-3
Chlamydia Trachomatis D-K
Ureaplasma Urealyticum
Mycoplasma Hominis.
153
Q

Sexually Transmitted Infection - Viruses:

A 
Human Papillomavirus - 6, 11, 16, 18, 31, 33
Herpes simplex virus - Mostly HSV 2
Cytomegalovirus 
Hepatitis Viruses: B, C and D 
Human Immunodeficiency Virus
Human T-cell Lymphotropic Virus 1
154
Q

Sexually Transmitted Infection - Protozoa:

A

Trichomonas Vaginalis
Entamoeba histolytica (Oral-Anal Sex)
Giardia lamblia (Oral-Anal Sex)
Cryptosporidium (Oral-Anal Sex)

155
Q

What serological tests can help with Initial Screening of HIV?

A

ELISA
Latex Agglutination
Rapid Oral Antibody Test

156
Q

What lab tests can help to Confirm Initial Screening of HIV?

A

Western blot analysis

Immunofluorescence

157
Q

What lab tests can help with Detection and Quantitation of HIV in Blood?

A

Virion RNA RT-PCR (Detection Only)

Real Time RT-PCR

158
Q

What is the early marker of infection with HIV?

A

p24 Antigen

159
Q

What Immunological studies values are expected to be low in HIV infection?

A

The absolute number of CD4 lymphocytes and the ratio of helper to inducer lymphocytes (CD4:CD8 ratio) are low in HIV.

160
Q

Microbes causing opportunistic infections related to AIDS - Protozoa:

A

Toxoplasma Gondii (Brain)
Cryptosporidiosis with diarrhea
Isosporiasis with diarrhea

161
Q

Microbes causing opportunistic infections related to AIDS - Fungal:

A 
Candida Albicans- Esophagus, Trachea, and Lungs
Pneumocystis Jiroveci - Pneumonia
Cryptococcus Neoformans (extrapulmonary)
Histoplasma Capsulatum (disseminated)
Coccidioides Immitis (disseminated)
162
Q

Microbes causing opportunistic infections related to AIDS - Viral:

A

Cytomegalovirus
Herpes simplex virus
JC Virus (Progressive multifocal leukoencephalopathy)
Epstein-Barr virus (Hairy leukoplakia)

163
Q

Microbes causing opportunistic infections related to AIDS - Bacterial:

A

Mycobacterium Avium-complex (disseminated)
Mycobacterium Tuberculosis (disseminated)
Bartonella Henselae
Nocardia Asteroides

164
Q

Which Hepatitis viruses are transmitted in a Feco-Oral manner?

A

Hepatitis A Virus

Hepatitis E Virus

165
Q

Which Hepatitis viruses are transmitted in a Parenteral and Sexuall manner?

A

Hepatitis B Virus
Hepatitis C Virus
Hepatitis D Virus

166
Q

Structure and Family of Hepatitis A Virus

A

Picornavirus; capsid, RNA

167
Q

Structure and Family of Hepatitis B Virus

A

Hepadnavirus; envelope, DNA

168
Q

Structure and Family of Hepatitis C Virus

A

Flavivirus; envelope, RNA

169
Q

Structure and Family of Hepatitis D Virus

A

VIROID-like; envelope, circular RNA

170
Q

Structure and Family of Hepatitis E Virus

A

Norovirus; capsid, RNA

171
Q

Hepatitis A Virus - Diagnosis:

A

Anti-HAV IgM - ELISA or RIA.

172
Q

Hepatitis B Virus - Diagnosis: “SpECiES”/”SECES” mnemonic by order of appearance

A 
HBsAg -Active disease; 1st marker
HBeAg- infectivity; 2nd marker
Anti-HBc Ab; Window Period 
Anti-HBe Ab; Low infectivity
Anti-HBs Ab; Immunized/Recoverd
173
Q

Hepatitis C Virus - Diagnosis:

A

ELISA - anti-HCV Antibody
RT-PCR
Branched-chain DNA

174
Q

Hepatitis D Virus - Diagnosis:

A

Delta Antigen; RT-PCR

Anti-HDV Antibody - ELISA or RIA

175
Q

Hepatitis E Virus and Hepatitis G Virus - Diagnosis:

176
Q

Use of laboratory animals in the medical microbiology - What animal was used to form the Smallpox Vaccine?

A

Cows- Edward Jenner’s cowpox vaccine

177
Q

Use of laboratory animals in the medical microbiology - What are Embronated eggs used for?

A

Growing Viruses

178
Q

Use of laboratory animals in the medical microbiology - What infections are Armadillos associated with?

A

Armadillos- Mycobacterium Leprae (Leprosy)

179
Q

Use of laboratory animals in the medical microbiology - What Rabbit Testes used for?

A

Growing Treponema Pallidum (Syphilis)

180
Q

Use of laboratory animals in the medical microbiology - What is Römer Test?

A

Corynebacterium Diphtheria Culture from Löffler medium is injected into Guinea pigs, one of which received anti-toxin.

181
Q

Use of laboratory animals in the medical microbiology - What are sheep used for?

A

Blood in several cultures

182
Q

Use of laboratory animals in the medical microbiology - What are Horses used for?

A

Immunoglobulins serum additions

183
Q

What are the basic rules for using the Bottle cultures in the appropriate way?

A
  • NO IV for collection of samples

- 2 Samples must be taken from different anatomical positions

184
Q

Samples for detection of Microbes

A

Serum
CSF
Urine
Bronchoalveolar Lavage

185
Q

What type of Serology Test is described below?

  • Bacterial Colony is fixed to a plate and covered with matrix fluid leading to Ionization.
  • Applying a laser beam allow for ionizing particles (mostly ribosomal) to separate from Sample-Matrix
  • Electromagnetic field propels the charged particles and time of flight analysis shows the Mass spectrum which is bacteria specific!
A

Matrix-Assisted laser desorption Ionization time of flight

MALDI-TOF

186
Q

Rules and regulations of the collection, Storage and Transport of Infectious Materials: Transportation to the laboratory.
Urine sample transport- long delays before inoculation can result in the growth of : …..

A

Urine sample transport- long delays before inoculation can result in the growth of clinically insignificant bacterial contaminants in the specimen.

187
Q

Rules and regulations of the collection, Storage and Transport of Infectious Materials: Transportation to the laboratory. All specimens should be ______

A

All specimens should be labelled.

188
Q

Rules and regulations of the collection, Storage and Transport of Infectious Materials: Transportation to the laboratory. Clinicians should provide the laboratory with ______ ________.

A

Clinicians should provide the laboratory with diagnostic questions.

189
Q

Rules and regulations of the collection, Storage and Transport of Infectious Materials: Transportation to the laboratory.
Rapid transport- S.pneumoniae, N. gonorrhoeae are fastidious: …..

A

Rapid transport- S.pneumoniae, N. gonorrhoeae are fastidious- may not survive temperature extremes or drying.

190
Q

Rules and regulations of the collection, Storage and Transport of Infectious Materials:
Specimens should be collected in clean, sterile containers - Examples:

A
  • cotton swab, Dacron swab, syringe/catheter aspiration
  • sufficient material for both culture and Gram stain
  • transport medium (Stuart medium)
  • transport culture medium (Uricult Plus)
191
Q

Rules and regulations of the collection, Storage and Transport of Infectious Materials:
Specimens should be collected in a manner that: …..

A

Specimens should be collected in a manner that minimizes contamination by resident bacterial flora

192
Q

Rules and regulations of the collection, Storage and Transport of Infectious Materials:
The clinician should obtain specimens before : …..

A

The clinician should obtain specimens before initiating or changing antibiotic therapy.

193
Q

Phage typing- Examples for Diagnosed Microbes

A

Strains of : S.Aureus, Salmonella Spp and Listeria Monocytogenes.

194
Q

Phage Typing

A

Describes the strains of different bacteria - Epidimiological.
Hospital Departments check ups.
Phage could attack the specific Bacteria strain -Infecting Doctor and Carrying Patient would have same result.

195
Q

Preparation of Lawn Culture - Purpose

A

Uniform Growth:

  • Antibiotic Susceptibility
  • Bacteriophage Typing
  • Antigen Preparation for Vaccine
196
Q

What type of Serology Test is described below?

  • A culture is grown on an agar and dried
  • A grid is drawn on the base of the petri dish to mark out different regions
  • Inoculation of the grid is done by a different phage.
  • Susceptible phage regions are will show a circular clearing where the bacteria are lysed - Differentiation!
A

Phage Typing

197
Q

How does Serotyping works? What is the end goal?

A

Using Slide Agglutination or Latex Agglutination in order to detect a subspecies level antigen type for Epidemiological and Therapeutic reasons.

198
Q

Examples where serotyping is could be used for choosing therapy?

A

1) EHEC - O157:H7 a serotype causing HUS and Hemorrhagic Colitis
2) Serotype B of H. Influenzae can cause Meningitis, Vaccination

199
Q

What type of Serology Test is described below?

  • The whole bacterial genome is digested by restriction enzymes - Specific sites of Cleavage
  • Large 10k-1M Base pair fragments are pushed in a voltage gradient (Pulsating electric field) gel to be differentiated!
A

Pulsed-Field Gel Electrophoresis

200
Q

What is common for all the serological test listed below?

  • Western Blot
  • Tube Agglutination
  • Complement Fixation Test
  • Direct ELISA
A

Demonstration of Antibodies in Serum

201
Q

Diagnostic Skin tests:

Dick Test - with positive result

A

Scarlet Fever - Toxin Injection into skin

Reddening of the skin over 10 millimeters in diameter within 24 hours indicates lack of Immunity.

202
Q

What is Schick Test?

A

Skin test for Diphtheria

203
Q 
Diagnostic Skin tests:
Tuberculin test (PPD) - with Positive and False Positive results
A

Purified Protein derivative of TB- Injection into skin.
Takes 48-72 hours.
Positive - red lesion greater than 15 mm indicates TB infection or previous exposure.
False Positive - Lesser reactions indicate infections with other mycobacteria or BCG vaccination passive immunity.

204
Q 
Diagnostic Skin tests:
Tuberculin test (PPD) - with False Negative and Negative results
A

Purified Protein derivative of TB- Injection into skin.
False Negative -rare, due to AIDS/Steroids/Malnutrition.
Negative - 0 mm lesion should be recorded

205
Q

Diagnostic test using Antitoxins

A

ELEK’s Test - For C. Diphtheriae Diagnosis

206
Q

Which STD causing bacteria are not diagnosed with Serology? How are they diagnosed, Otherwise?

A
  • N.Gonorrhoeae
  • Chlamydia Trachomatis
  • Mycoplasma and Ureaplasma
  • Diagnosis by PCR (Called NAAT in Chlamydia)
207
Q

How are STD samples collected? (Instrument)

208
Q

How are Mycoplasma and Ureaplasma are cultured? (STD)

A

Eaton Agar

209
Q

Syphilis - Screening (Aka Non-Specific):
Antigen Used
Antibody Used

A

Antigen Used - Cardiolipin from catale’s heart

Antibody Used - From damaged cells during early phase, present on cell surface of T.Pallidum

210
Q

Syphilis - Screening (Aka Non-Specific):

Wassermann reaction

A

Complement fixation test:

  • Negative: Lysed Sheep’s RBCs
  • Positive: RBCs remain intact (Ag-Ab interaction fixate Complement)
211
Q

Syphilis - Screening (Aka Non-Specific):

VDRL

A

Venereal Disease Research Laboratory:

-A drop of Cardiolipin is placed on a slide with a drop of serum for microscopical investigation

212
Q

Diagnosis of Syphilis - Specific Methods for Diagnosis:

TPI

A

T. Pallidum Immobilization test:
Living T.Pallidum = Antigen, Complement of Guinea Pigs.
If in a mixture with IgGs from Serum there is no locomotion because of a Ab-Ag-Complement reaction this is a Positive result.

213
Q

Diagnosis of Syphilis - Specific Methods for Diagnosis:

TPHA

A

T.Pallidum Haemagglutination test: (Flocculation)

-Aggregation of T. Pallidum sensitized (with Ab) RBCs with exposure to patient serum means Positive result.

214
Q

Diagnosis of Syphilis - Specific Methods for Diagnosis:

FTA-ABS

A

Fluorescent Treponemal Antibodies:

  • Antigen = Killed T.Pallidum , Second Antibody = Fluorescein labeled Anti-Human Antibodies, First Antibody from Patient Serum!
  • Positive results: Bright yellow fluorescence upon triple particle Immunocomplex formation.
215
Q

What are important intracellular enzymatic reactions products in bacteria? Importance?

A

Indole, Ammonium, H2S

Detection by indicators and diagnosis

216
Q

What is the importance of extracellular enzymes found on bacteria? (Collagenases, haemolysin..)

A

In vitro - diagnostics
In vivo - virulence factors
Pharmaceutical - antibiotics

217
Q

What Serological Measurement is described here? Antibodies or Ag in vitro are bound to the surface of latex particle or red blood cells so that the binding partner will cause agglutination. Modern, fast technique. The antibodies or the Antigens are in vitro bound to latex particle.

A

Latex Agglutination - Diagnosis of meningitis
Co-Agglutination - S. Aureus Diagnosis
(Both are Passive Processes)

218
Q

Antibody Titer (Quantitative Tube Agglutination): Definition and Example

A

A serial dilution is made from patient sera, known antigen solution is added to each tube. The Result Value Corresponds to the highest dilution factor (lowest concentration) that still yields a positive reading. Grubel-Widal reaction - Salmonella typhi.

219
Q

What Serological Measurement is described here?
Precipitation ring can be seen in the equivalent zone- the zone where the amount of antigen and antibody are equal.Qualitative measurement.
Steps: introduce serum into the tube → add ag → disc-shaped zone of precipitation

A

Ring Precipitation - Liquid phase precipitation

220
Q

What Serological Measurement is described here?
The precipitation reactions can be visualised by allowing the Ag and the Ab to diffuse towards each other through agar gel - Immunodiffusion.

A

Semi-solid phase precipitation (agar gel precipitation)

221
Q

What Serological Measurement is described here?
-Filter paper impregnated with anti-toxin (antibody against bacterial toxin) is placed in agar plate.
- Bacterial strains to be tested are placed onto the surface of the plate at right angles to the paper strip.
- Antitoxin diffuses from the filter paper into the agar-gel, binds to the toxin produced by the bacteria.
- A fine precipitation line is formed in the equivalence
zone.

A

ELEK’s test - Diphtheria Toxin detection

222
Q

Complement Fixation test (for Antibody detection)

Which bacterial antibodies are diagnosed with it?

A
  • Mycoplasma Pneumoniae
  • Chlamydophila Pneumoniae
  • Chlamydia Psittaci
223
Q

Latex Agglutination- Examples for Diagnosed Microbes

A

Bacterial Antigens of : S. Agalactiae, S. Pneumoniae, H. Influenzae B, N. Meningitidis.
Primarily from CSF specimens.

224
Q

Serotype

A

a group of closely related microorganisms distinguished by characteristic set of antigens.

225
Q

Blood culture bottles:

Importance

A
  • Bacteriemia increases the mortality rate by 40+%

- Collecting the blood specimens efficiently is essential for diagnosis and treatment

226
Q

Indications for Blood culture ( Try to remember at least 5)

A
  • Bacteremia
  • Septicemia
  • Shock
  • Unexplained fever of several days
  • Chills and fever in patients (Infectious patients)
  • Debilitating patients
  • Following body piercing with signs of infection
227
Q

Eosin-Methylene-Blue medium (EMB) - What happens when a lactose fermenting bacteria is introduced? Describe the Process

A

Lactose Fermentation → pH ↓→ eosin loses its color→ The blue color remains→ the bacteria incorporate it→ the colony is BLUE in color (Klebsiella Pneumoniae).
*E.Coli → Metallic Green!

228
Q

Eosin-Methylene-Blue medium (EMB) - What happens when a non lactose fermenting bacteria is introduced? Describe the Process

A

No Lactose Fermentation → pH same→ Pink color is enhanced (Salmonella Typhi).

229
Q

What type of Serology Test is described below?

  1. Premade -Antigens are affixed to the vessel Surface
  2. Patient serum added and Ab-Ag binding occurs
  3. Enzyme-Conjugated Anti-Human Antibody (E) is added
  4. After binding of E to Ab a substrate added is converted to Chromophore - Spectrophotometric Analysis is done.
A

Direct ELISA - Antibody Detection

230
Q

What type of Serology Test is described below?

  1. Premade -Antibody are affixed to the vessel Surface
  2. Antigen specimen added and Ab-Ag binding occurs
  3. Second Premade -Enzyme-Conjugated Anti-Human Antibody (E) is added (Ab-Ag-E complex)
  4. After binding of E to Ag a substrate added is converted to Chromophore - Spectrophotometric Analysis is done.
A

Indirect ELISA - Soluble Antigen Detection

231
Q

What type of Serology Test is described below?

  1. Proteins are separated by SDS-PAGE
  2. Proteins are blotted into nitrocellulose paper
  3. Incubation with antigen-specific antibody or patient sera (1Ab)
  4. Incubation with enzyme-conjugated anti human sera sera (2Ab)
  5. Enzyme conversion of substrate identifies the antigen.
A

Western Blot

232
Q

What is common for all the serological test listed below?

  • Real-time PCR
  • Nucleic Acid Hybridization
  • Immunofluorescence assays
  • Indirect ELISA
  • Latex Agglutination
A

Direct Detection of Pathogen (Antigen)

233
Q

FITC - Definition

A

Fluorescein Isothiocyanate - Molecule covalently attached to Antibodies allowing for Direct and Indirect Immunofluorescence.

234
Q

How does Direct Immunofluorescence work?

A

Checking the presence of the Antigen by confirming its attachment to FITC-labeled Antibody.

235
Q

How does Indirect Immunofluorescence work?

A

Checking the presence of the Antigen by attachment to a Primary Antibody that will be afterwards confirmed by binding to a Second type FITC-labeled Antibody/ies.

236
Q

ELISA- Definition

Give an example in Microbiology

A

Enzyme Linked Immunosorbent Assays
B. Anthracis detection by Anti-PA (Protective Antigen, Indirect)
T. Pallidum detection by Recombinant Antigen (Direct)

237
Q

Diarrhea -Biochemical Tests:

A
  • Clinically: Bloody/Watery and Onset
  • Selective Culture Media: EMB, Brilliant-green, McConkey
  • Serology Methods using stool as a sample; Toxins/Bacterial Antigens
238
Q

Determination of MIC - Disc diffusion test

A

1)Preparation of lawn culture (Flooded Equal Bacterial Growth Solid Media)
2)Placing paper discs covered with antimicrobial drug
3)37°C overnight
4)Measuring the diameter of the zone of inhibition
around the discs

239
Q

Complement Fixation test

Indirect Method - presence of specific Ab is checked

A

Ag-Ab complex causes Complement aggregation preventing lysis of the Sheep RBCs by MAC :
Lysed RBCs - NEGATIVE
No Lysis, RBCs Intact - POSITIVE

240
Q

MALDI-TOF

A

Matrix assisted laser desorption/Ionization, Time of Flight
Culturing and using the machine to identify by Ionization of the bacterial lysed biochemical components.
Very efficient.

241
Q

Motility test Medium, how does it enable detection?

A

Semisolid Material suspension with straight line stab - Turbidity after incubation means bacteria moved away and growed.

242
Q

Determination of MIC - Punching test

A

1) Preparation of lawn culture (Flooded Equal Bacterial Growth Solid Media)
2) Making several holes on the surface (“punch”) and Pipetting Standard dilution of each Ab drug into them.
3) 37°C overnight
4) Measuring the diameter of the zone of inhibition

243
Q

TORCHES test - when is it done ?

A

Before or in the First Trimester of the Pregnancy

244
Q

Determination of MIC - Agar plate dilution test

A

1) Various concentrations of antibiotic are incorporated in a series of plates and Agar solidify them
2) Equal amount of bacteria into each Agar
3) Incubation Overnight at 37 C
4) MIC will be the Highest dilution tube that’s transparent!

245
Q

TORCH - mnemonic

A 
Toxoplasma
Other - Syphilis,VZV, S. Agalactiae
Rubella
CMV
Herpes
246
Q

MIC - Minimal inhibitory concentration

Methods of Determination: (3)

A

Micro and Macro Dilution
Agar Dilution
E-Test

247
Q

Determination of MIC - Microdilution test

Equal amount of bacteria into each

A

1) Sequential dilution:96-well polystyrene microtiter plate

2) MIC will be the Highest dilution tube that’s transparent!

248
Q

LAL test

A

Atlantic horseshoe crab blood aggregates in presence of Lipid A - Detection of Pathogens

249
Q

India Ink and Quellung test are 2 Important tests that help in visualization of _________ bacteria.

A

India Ink and Quellung test are 2 Important tests that help in visualization of Encapsulated bacteria.

250
Q

Determination of MIC - E –test

A

Placing a plastic strip impregnated with the concentration gradient of the certain antibiotic on a Lawn Culture. From the scale you can read the MIC numerically. MIC = number where the elliptic zone crosses the plastic strip.

251
Q

How can we study of the resistance of microbes to antimicrobial agents?

A

Determination of MIC: E –test, Microdilution test, Agar plate dilution test….

252
Q

Which bacteria is detected by Slide agglutination ?
How does it work?
Qualitative or Quantitative ?

A

E. Coli Serotypes Detection, E.g. O157:H7
Latex agglutination of the released antigen
Qualitative: Y/N (15 tests instead of 100 method)

253
Q

Neisser Staining: Microscopic Image

A

Rods with Club ends (Purple) and Yellow Body

חצופים בקלאב הוטל ה”סוף הסגול “ העיקר גוף צהוב

254
Q

Capsule Stain: Preparation process and Purpose
לקחתי קפסולה אחי בהודו משהו שלילי אחי משהו דארק סלייד אחי. תשמע התחממתי אז נוסע לפושקין דקה לשים קצת מים ושמן, השקעה אחי.

A
  • Drop of India Ink spread with other slide
  • Heat fix
  • Fuchsine for 1 minute
  • Water rinse and Oil Immersion for observation
255
Q

Materials for Gram staining

A

Crystal Violet with sodium oxalate
Potassium-Iodide (Lugol Solution)
Ethanol
Safranin

256
Q

3 examples for Bacteria that are not identified with gram stain in labs?

A

Mycobacteria - mycolic acid do not absorbs gram stain.
Mycoplasma - lack cell wall
Spirochaetes - too thin wall

257
Q

Flagella stains material

“Titanic Flagella”

A

Tannic Acid

258
Q

Ziehl-Neelsen Staining (Acid Fast): Preparation process and Purpose
נילסן אכל קבבול בפושקין התעצבן שלוש פעמים אז שפכו עליו מים והקיא את כל ה96% אלכוהול נהיה חיוור אז שמו לו מטלית כחול

A
  • Carbol-Fuchsin (Mycolic acid binds)
  • Heat 3 times and Wash with water
  • Decolorization with 96% alcohol
  • Counter stain with Methylene Blue
259
Q

Neisser Staining: Preparation process and Purpose

ניסר לו איזה תירס עם וולט וחצי כדי לעבוד על כלי-סידן ובלוטין

A
  • Stain fixed smear of Corynebacteria with mixture of N.1 and N.2 (2:1 ratio)
  • Water Wash
  • Chrysoidine dye then Dry with blotting paper
  • Detection of Volutin Granules
260
Q

Meningitis - Brudzinski Sign

A

Neck flexion may cause flexion of the legs

261
Q

Meningitis - Kernig Sign

A

Limitations in leg extension when knee flexed

262
Q

ID50/LD50/TCID50 Measurements Gave a value around 1 -10^2 Germs.
What does it mean?

A

High Virulence since this is a Low Germ count that causes 50% of Hosts/Cultures to have a pathologic conditions (Infection/Death/Damage).

263
Q

LD50

A

A Quantitative Determinant of Virulence

Lethal Dose - Number of Germs causing death in 50% of Hosts.

264
Q

Definition of Pathogenicity

A

Ability of an organism to cause harm to its host. Represents a genetic component of the organism. It is manifested through its Virulence and Host interaction.

265
Q

ID50/LD50/TCID50 Measurements Gave a value more than 10^5 Germs.
What does it mean?

A

Low Virulence since this is a High Germ count that causes 50% of Hosts/Cultures to have a pathologic conditions (Infection/Death/Damage).

266
Q

TCID50

A

A Quantitative Determinant of Virulence

Tissue Culture Infecting Dose - Number of Germs damaging 50% of Cultures.

267
Q

Definition of Virulence

A

Degree of pathology caused by the organism.

depends on its Virulence factors : Structural as cell wall or Capsule and Biochemical as Exotoxin or Endotoxin.

268
Q

ID50

A

A Quantitative Determinant of Virulence

Infective Dose - Number of Germs inducing disease in 50% of Hosts.

269
Q

Potential Biological weapons in Microbiology: Give

a few Bacterial examples

A 
Bacillus Anthracis
Yersinia pestis
Francisella Tularensis
Brucella Suis
Coxiella Burnetii
270
Q

Potential Biological weapons in Microbiology: Give

a few Viral examples

A

Poxvirus
Ebolavirus
Rift Valley fever virus (Bunyaviridae)
Yellow Fever Virus

271
Q

Potential Biological weapons in Microbiology: Give

a few Fungal examples

A

Coccidioides Immitis

272
Q

Parasites causing ophthalmic infections (a few examples):

A 
Onchocerca volvulus (River Blindness)
Loa Loa (aka African Eye Worm)
Acanthamoeba Keratitis
Trypanosoma Cruzi (Romaña sign)
Toxoplasma Gondii (Chorioretinitis)
Toxocara Canis and Cati (Ocular Larva Migrans)
273
Q

Lab Algorithm - DDX Options for:

Gram (+)→ Bacilli → Aerobic

A

Listeria Monocytogenes
Bacillus Anthracis and Bacillus Cereus
Corynebacterium Diphtheriae

274
Q

Lab Algorithm - DDX Options for:

Gram (+)→ Bacilli → Anaerobic

A

Clostridia: Tetani / Botulinum /Perfringens / Difficile

Cutibacterium Acne

275
Q

Lab Algorithm - DDX Options for:

Gram (+)→ Cocci→ Catalase (+) →Coagulase (+)

A

Staphylococcus Aureus

276
Q

Lab Algorithm - DDX Options for:

Gram (+)→ Cocci→ Catalase (+) → Coagulase (-) → Novobiocin Sensitive

A

Staphylococcus Epidermidis

277
Q

Lab Algorithm - DDX Options for:

Gram (+)→ Cocci→ Catalase (+) → Coagulase (-) → Novobiocin Resistant

A

Staphylococcus Saprophyticus

278
Q

Lab Algorithm - DDX Options for:

Gram (+)→ Cocci→ Catalase (-) → β Hemolytic →Bacitracin Sensitive

A

Group A, Streptococcus Pyogenes

279
Q

Lab Algorithm - DDX Options for:

Gram (+)→ Cocci→ Catalase (-) → β Hemolytic →Bacitracin Resistant

A

Group B, Streptococcus Agalactiae

280
Q

Lab Algorithm - DDX Options for:

Gram (+)→ Cocci→ Catalase (-) → α Hemolytic →Optochin Sensitive

A

Streptococcus Pneumoniae

281
Q

Lab Algorithm - DDX Options for:

Gram (+)→ Cocci→ Catalase (-) → α Hemolytic →Optochin Resistant

A

Viridans Streptococci: Mutans / Mitis / Sanguinis

282
Q

Lab Algorithm - DDX Options for:

Gram (+)→ Cocci→ Catalase (-) → γ Hemolytic →6.5% NaCl Sensitive

A

Streptococcus Bovis

283
Q

Lab Algorithm - DDX Options for:

Gram (+)→ Cocci→ Catalase (-) → γ Hemolytic →6.5% NaCl Resistant

A

Enterococci: Faecium / Faecalis

could be α hemolytic sometimes

284
Q

Lab Algorithm - DDX Options for:

Gram (-)→ Coccobacilli

A 
Haemophilus influenzae
Bordetella Pertussis
Pasteurella Multocida
Brucella Suis
Francisella Tularensis
Acinetobacter Baumannii
285
Q

Lab Algorithm - DDX Options for:

Gram (-) → Diplococci → Not Maltose Fermenting

A

Neisseria Gonorrhoeae

Moraxella Catarrhalis

286
Q

Lab Algorithm - DDX Options for:

Gram (-) → Diplococci → Maltose Fermenting

A

Neisseria Meningitidis

287
Q

Lab Algorithm - DDX Options for:

Gram (-) → Oxidase (+)→ Grows in 42°C

A

Campylobacter Jejuni

288
Q

Lab Algorithm - DDX Options for:

Gram (-) → Oxidase (+)→ Grows in Alkaline Media

A

Vibrio Cholerae

289
Q

Lab Algorithm - DDX Options for:

Gram (-) → Oxidase (+)→ Urease(+)

A

Helicobacter Pylori

290
Q

Lab Algorithm - DDX Options for:

Gram (-) → Bacilli → Fermenting Lactose Fast

A

Klebsiella Pneumoniae
Escherichia Coli
Enterobacter Cloacae

291
Q

Lab Algorithm - DDX Options for:

Gram (-) → Bacilli → Fermenting Lactose Slow

A

Serratia Marcescens

292
Q

Lab Algorithm - DDX Options for:

Gram (-) → Bacilli →Not Fermenting Lactose →Oxidase(+)

A

Pseudomonas Aeruginosa

293
Q

Lab Algorithm - DDX Options for:

Gram (-) → Bacilli →Not Fermenting Lactose →H2S(+)

A

Salmonellae: Typhi / Paratyphi / Enterica

Proteus Mirabilis

294
Q

Lab Algorithm - DDX Options for:

Gram (-) → Bacilli →Not Fermenting Lactose →H2S(-)

A

Shigella Dysenteriae

Yersinia Pestis / Yersinia Enterocolitica

295
Q

Lab Algorithm - DDX Options for:

Imaging → Lung Lesion → Cavitary / Ring-like

A 
Mycobacterium Tuberculosis
Staphylococcus Aureus
Streptococcus Pneumoniae
Aspergillus Fumigatus
Klebsiella Pneumoniae
Pneumocystis JiroveciI
Nocardia Asteroides
296
Q

Lab Algorithm - DDX Options for:

Imaging → Lung Lesion → Atypical Pneumonia → Zoonotic

A

Francisella Tularensis
Coxiella Burnetii
Chlamydia Psittaci

297
Q

Lab Algorithm - DDX Options for:

Imaging → Lung Lesion → Atypical Pneumonia → Non-Zoonotic

A

Chlamydia Pneumoniae
Mycoplasma Pneumoniae
Legionella Pneumophila

298
Q

What are the Oncogenic Microbes? Which Cancers?

A

Helicobacter Pylori - Gastric Carcinoma and MALToma
Epstein-Barr Virus - Burkitt and Hodgkin Lymphoma
Human Papillomavirus - Cervical Carcinoma
Human T-Lymphotropic Virus 1 - Adult T-Lymphoma
Hepatitis C+B Virus - Hepatocellular carcinoma
Human Herpesvirus 8 - Kaposi sarcoma
Schistosoma Haematobium - Sq. Bladder Cancer
Clonorchis Sinensis - GB Carcinoima

299
Q

Which Bacteria and Viruses have Antigenic Variation Capabilities? (Give a few examples)

A 
Neisseria Gonorrhoeae
Neisseria Meningitidis
Borrelia Burgdorferi
Flaviviruses: HCV, Dengue, West nile..
Orthomyxoviruses (Influenza)
HIV1
300
Q

Which Parasites have Antigenic Variation Capabilities? (Give a few examples)

A

Trypanosoma Brucei

Plasmodium Falciparum

Low Yield Semmelweis (37 decks)

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