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Microbiology > E4 > Flashcards

E4 Flashcards

1
Q

What is the normal flora of the nose?

A
  • staph epidermis and staph aureus

- corynebacterium

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2
Q

What are the characteristics of staph epidermis?

A
  • gram positive cocci
  • catalase positive
  • coagulase negative
  • novobiocin sensitive positive
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3
Q

What are the characteristics of staph aureus?

A
  • gram positive coci
  • catalase positive
  • coagulase positive
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4
Q

What are the characteristics of corynebacterium?

A
  • gram positive rod

- non-spore forming

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5
Q

What are the normal flora of the nasopharnx?

A
  • streptococcus
  • viridans: strep mutans, strep mitis, strem milieri
  • moraxella cat
  • bacterioids
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6
Q

What is group A strep?

A

S. pyogenes

-beta hemolytic

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7
Q

What is group B strep?

A

S. agalactial

-beta hemolytic

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8
Q

What is group D strep?

A

S. Bovis and Enterococcius faecalis

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9
Q

What does strep pyogens present as?

A
  • pharyngitis: red throat, patches of pus, tiny hemorrhage and fever
  • beta hemolytic
  • negative catalase
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10
Q

How is strep pyogens diagnosed?

A

-rapid strep test that targets cell wall

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11
Q

What are the virulence factors of strep pyogens?

A
  • M protein virulence factor: antiphagocytic 80 serotypes

- capsule in more virulent strains

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12
Q

What do the 9 SPE superantigens of strep pyogens cause?

A

Scarlet fever, toxic shock, necrotizing fascitis

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13
Q

What is scarlet fever?

A

SPE release

-red skin, white tongue

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14
Q

What is acute rheumatic syndrome?

A

Fever, joint and chest pain and cross reaction with self MHC

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15
Q

What is necrotizing fascitis?

A

SPE release, skin infections

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16
Q

What is acute glomerulonephritis?

A

1-4 weeks psot strep pyogens

  • deposition of immune complexes in glomerulus
  • immune response= edema, hypertension, proteinuira, hematuria
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17
Q

What does corynebacterium cause and how does it present?

A

Diptheria
-mild sore thorat, fever, fatigue, malaise, neck swelling, white grey membrane of clotted blood and epithelial cells (cant scrape away)

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18
Q

How does diptheria do damage?

A

toxin mediated

  • exotoxin from bacteriophage
  • B subunit binds host
  • A subunit ianctivates elongation factor 2 to stop protein synthesis and casue cell death
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19
Q

How is diptheria mnaged?

A

toxoid vaccine

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20
Q

What bacteria cause conjunctivitis?

A

H influenzae and strep pneumo

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21
Q

What is H influenzae?

A

gram negative rods

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22
Q

How is pink eye treated?

A
  • remove from school
  • handwashing
  • local gentamicin or ciprofloxiciin
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23
Q

What causes otitis media?

A

H influenzae, strep pneumo, moraxella catarrhalis

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24
Q

What causes sinusitis?

A

Strep pneumo, H influenzae, moraxella catarrhalis

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25
Q

What disease does chlamydia cause?

A

Trachoma, adult and neonate conjunctivitis, and infant pneumonia

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26
Q

What are the components of chlamydia?

A

smal obligate parasite

  • elementary body: metabolically inactive, infectious
  • reticulate body: metbolically active, noninfectious
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27
Q

How does chlamydia do damage?

A

direct destruction of host cells during replication

  • granuloma formation of immune response
  • start with follicular conjunctivitis = inflammation and scarring and turning inward, abrasive surface = more inflammation and blindness
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28
Q

What are the considerations when dealing with adult inclusion conjucntivits?

A

Same disease as genital

-treat for both

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29
Q

What are the considerations when dealing with infant with conjunctiviitis?

A

-exposed at birth so treat topically and for pneumonia

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30
Q

What is chlamydophila pneumoniae?

A
  • pneumonia, bronchitis, and sinusitis
  • very common tends to resolve on own
  • severe = affects 1 lobe of lung
  • involved in atherosclerosis
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31
Q

What is assoicated with chlamydia psittaci?

A

parrots

-treat with macrolides

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32
Q

what are the symptoms of the common cold?

A
  • rhinitis
  • pharyngitis
  • no high fever, LRT involvement, or respiratory distress
  • complications: otitis media, sinus infection, exaserbation of asthma
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33
Q

What is rhinovirus?

A
  • picornavirus, nonenveloped
  • lots of serotypes
  • in respiratory secretions = transmission
  • low inoculum with 1-3 day incubation time
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34
Q

What is non-sars coronavirus?

A
  • enveloped favored for cooler temperature
  • transmit in large droplets
  • incubation 3 days, peak in spring and winter
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35
Q

What is adenovirus?

A
  • nonenveloped with fiber proteins
  • 1, 2 and 5
  • transmission: oral, droplet inhalation, conjunctiva
  • Gi: 40 and 41
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36
Q

What is coxsackie virus?

A

entero nonenveloped

-transmission: oral-fecal

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37
Q

What is Hand, Foot, Mouth?

A

caused by coxsackie B

  • fever, lesions on soles, palms, and oral areas
  • children and caregivers
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38
Q

What is croup?

A

caused by parainflunenza type 1

  • swelling of subglottic larynx causing seal cough
  • mild to severe depending on stridor at rest
  • steeple sign on xray
  • children under 6
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39
Q

What is Herpangia?

A

caused by coxsackie virus

  • sudden fever with white ulcers on soft palate
  • children 1-7
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40
Q

What is the treatment for croup?

A
  • mild stridor not present at rest: humidified air and hydration
  • severe stridor at rest: O2, Epi, Glucocorticoids
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41
Q

What are the syptoms of RSV?

A
  • most common cause of bronchiolitis and pneumonia in kids under 1 year
  • bronchiolitis: expiratoyr wheeze, air trapping, subcostal retraction
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42
Q

What is ribaverin?

A

treatment for RSV

  • inhaled
  • inhibits nucleotide biosyntehsis and mRNA capping
  • poor antiviral
43
Q

What is passive immunoprophylaxis?

A

treatment for RSV

  • given durign 1st year of life if at risk during RSV seaseon
  • in 2nd year if immunocompromised
  • uses palizumab = human mouse monoclonal antibody
44
Q

What are the symptoms of uncomplicated influenza?

A

myalgia, headache, fever, chills, cough 2-6 week duration

-2 day incubation

45
Q

What is hemagglutinin?

A

attachment protein of influenza that agglutinates RBC

46
Q

What is neuraminidase?

A

cleaves sialic acid so influenza virus can release from cell and spread to other cells

47
Q

What is influenza type A?

A

wide host range

  • severe disease
  • endemic and pandemic
  • antigenic drift and shift
48
Q

What is influenza type B?

A
  • human host
  • occassionally severe
  • occassional epidempic
  • antigenic drift
49
Q

What is influenza type C?

A
  • human and swine host
  • mild disease
  • limited outbreak
  • antigenic drift
50
Q

What is antigenic drift?

A

small changes in polymerase mutation and replication

-significant every 2-3 years

51
Q

What is antigenic shift?

A

reassortment of 2 viruses

-causes pandemic

52
Q

What is an innactivated influenza vaccine?

A
  • inactivated virus
  • intramusuclar: anyone 6mo/o or older even with chronic medical issues (3 o 4)
  • intradermal: 18-64y/o (3)
53
Q

What is the live attenuated influenza vaccine?

A

intranasal

2-49 y/o non-pregnant (4)

54
Q

What is recombinant influenza vaccine?

A
  • hemagglutinin protein

- intramusuclar: 18-49 y/o trivalent

55
Q

what is amantadine and rimantadine?

A
  • influenza drug
  • block replication before release
  • agaisnt influenza A but there is a lot of resistant
56
Q

What is zantamivir, oseltamivir, and peramivir?

A

inhibit vrion relase and spread

  • agsint influenza A and B
  • must be given early on in uncomplciated
  • z= inhale, o = oral, p = IV
57
Q

What is primary influenza pneumonia?

A
  • influenza A
  • affects children and elderly
  • 1-4 days after onset = increase cough, tachypnea, dyspnea, acute respiratory distress
  • sputum: gram negative, PMN cell
  • CXR: bilateral interstitial
58
Q

What is bacterial pneumonia secondary to influenza?

A
  • 1 week after symptoms
  • return of fever and repiratory distress
  • find s pneumoniae, s aureus, and H influenzae
59
Q

What is the primary agent of fungal sinusitis?

A

Zygomycoses

60
Q

What are zygomycoses?

A
  • common in environment, uncommon infection
  • non septate hyphae
  • predisposed: immunosuppressed, burn, diabetic
  • diagnose: hyphae at 90 degree angles
  • treat: amphotericin B
61
Q

What disease does zygomycoses cause?

A

Rhinocerebral zygomycoses: infection of sinuses to neighboring tissues
-diabetics

62
Q

What is the treatment for PCP?

A

trimethoprim and sulfamethazole

aids pt = prophylaxis and suppressive therapy

63
Q

WHat is the treatment for zygomycoses?

A

Amphotericin B

64
Q

What is pneumocysits carinii pneumonia (PCP)?

A

lethal form of pneumonia

  • immunocompromised AIDs pt
  • difficult to grow in lab
  • infected by inhalation of cysts
  • symptoms: dyspnea, non-productive cough and fever
  • interstital pneumonitis with cellualr infiltrate
  • diagnose:j biopsy and stain
  • treat: trimethoprim and sulfamethoxazole
    • aids pt = prophylaxis and suppressive therapy
65
Q

What is C albicans?

A
  • oral candidasis or thrush
  • infants, immunosuppressed adults, AIDS
  • present: erythema, white patch of uccal mucosa, throat, tongue, and gums
  • diagnose: germ tube in culture
  • treat: oral nystatin or azoles
66
Q

What is the treatment for thrush?

A

-oral nystatin or azoles

67
Q

What is Histoplasm capsulatum?

A
  • histoplasmosis
  • found in midwest
  • found in soil in humid conditions with lots of bird droppings
  • infection = inhalation of conida
  • destruction = through macrophages, yeast forms and disseminate through lymphatic system
  • pulmonary: only in lung seen as small calcified lesions
  • chronic and disseminated: immunocompromised, macrophages to spleen, liver, and lymph can be life threatening
  • diagnose: cultivate, Ag detection
  • treat: amphotericin b (severe), or azole (AIDS)
68
Q

What is the treatment for histoplasmosis?

A
  • severe = amphotericin B

- AIDS pt = Azole

69
Q

What is blastomyces dermatitidis?

A
  • blastomycosis
  • missouri river valley dogs and horses
  • hard to find in envrionemtn
  • pulmonary with ability to disseminate to skin and ulcer
  • acute clinical: cough, fever, flu-like
  • chronic: cough, night sweat, wt loss
  • disseminated: skin lesion, bone infection, prostate infection
  • diagnose: obs in culture
  • treat: amphotericin b, azole (uncomplicated)
70
Q

How is blastomycosis treated?

A
  • severe = amphotericin b

- uncomplicated = azole

71
Q

What is paracocciiodes brasillenses?

A
  • pracoccidiomycosis
  • regions of south and cetnral america
  • similar to toehrs
  • diagnose: direct observation, culture, and serology
72
Q

What is cocidioideimmitus?

A
  • cocidiomycosis
  • -valley fever in arizona
  • epidemics associated with drought-rain-drought
  • diagnose: sphorules in biopsy
  • treat: azole and amphotericin b
73
Q

What is the treatment for coccidiomycosis?

A

azole and amphotericin b

74
Q

What is cryptococcsis meningitis?

A

slow developing meningitis

  • common in aids
  • diagnose india ink
  • combo of amphotericin b and furoaltosine
75
Q

What is treatment for crypto meningitis?

A

amphotericin b and furoaltosine

76
Q

What is aspergillomas?

A
  • aspergillus
  • rarely pathogenic except in immunosuppressed
  • a. fumigatus adn a flavus
  • always a mold
  • spectrum of disease caused by hyphal growth
  • acute: asperguillomas, lung lesions of hyphae and fibrin, unilateral and asymptomatic
  • disseminated: can be fatal, into lung parenchyma = blood vessel = clot and hemorrage
  • diagnose: septate hyphae at 45 degree
  • treat: azole, echinocandin, amphotericin b, and surgery
77
Q

How do you treat aspergillus?

A

azole, echinocandin, amphotericin b and surgery

78
Q

What are the characteristics of typical pneumonia?

A

-sudden
-toxic facies
productive cough
bloody sputum
high fever
frequent pleurisy
frequent consolidation
elevated left shift WC
CXR: defined lobe
cause = strep pneumo

79
Q

What are the characteristics of atypical pneumonia?

A 
gradual
well facies
nonproudctive cough
scant sputum
lwo fever 
rare pelurisy
rare consolidation
normal to elevated WBC
cxr: patchy infiltrate
cause = mycoplasm pneumo
80
Q

What is the treatment for atypical pneumonia?

A

tetracycline and erythromycin

81
Q

What is epiglottitis?

A
  • strep pyogens, staph aureus, kelbsiella pneumoniae

- infection and swelling of epiglottis can close airway

82
Q

What is hamophilus influenzae b?

A
  • can cause sinusitis, otitis media, pneumonia, bacteremia
  • polysaccharide capusle made of polyribosylripitol phosphate (PRP)
  • pediatric pathogen
  • transmit: respiratory droplets
  • virulence: LPS, IgA, protease, PRP caspule
  • diagnose: culture gram negative, PRP, serum/urine Ag
    treat: severe = broad cephalosporin, mild = amoxicilin
  • hib vaccine
83
Q

What is the treatment for H. influenzae b?

A
  • conjugate vaccine
  • severe = broad cephalosporin
  • mild = amoxicillin
84
Q

What is mycoplasm pneumo?

A

acute bacterial bronchitis

-sign: dry cough, treat symptoms

85
Q

What is pertussis?

A

whooping cough

  • gram negative fastidious
  • toxins = increase lung secretions and decrease clearance
  • in humans, under 1 yr or unvaccinated
  • worst of symptoms is when contagious
  • major adhesin: filamentous hemagglutinin bind to epithelal cells
  • major toxin: pertussis toxin = increase cAMP to increase secretions
  • diagnose: sound, culture, nucleic acid test
  • treat: macrolides
  • vaccinate: DTaP detox toxin, peractin, and filament hemagglutinin
86
Q

What is the treatment for whooping cough?

A

macrolides

87
Q

What is strep pneumo?

A
  • normal gram postive cocci, alpha hemolytic with lots of serotypes
  • present: cough, fever, chest pain, rust colored sputum and poor O22
  • diagnose: gram stain, culture, urine test for polysaccharide
  • treat: penicillin for sensitive, marolide if not, both if severe
  • vaccines: 23 adn 13 valent
88
Q

What is the treatment for strep pneumo?

A
  • sensitive = penicllin
  • non senstive = macrolide
  • severe = both
89
Q

What is staph aureus?

A
  • gram postiive clusters catalase postive and coag postiive
  • coagulace
  • protein A binds Fc
  • PVL = severe necrotizing
  • resistant to beta lactams = MRSA
  • treat: penciillin/cephalosporin, if resistant - linezolid or vancomycin
90
Q

What is the treatment for staph aureus and MRSA?

A

Staph: penicllin/ cephalosporin
MRSA: linezolid or vancomycin

91
Q

What is klebsiella pneumoniae?

A

gram negative rod, non-motile, mucoid, oxidase negative

  • produce beta lactamases
  • present: lobar pneumonia, bloody sputum
  • virulence factors: LPS and capsule
  • treat: macrolides
  • prevent: disinfect environment
92
Q

What is treatment for klebseilla pneumoniae?

A

macrolides

93
Q

What is pseudomonas aerugionsa?

A

gram negative rod, obligate aerobe, smell like grapes

  • metabolize all organic
  • grow in nutrient free o2, hand soap, and dilute antiseptic
  • grow in biofilms
  • pneumonia, septicemia, endocarditis, ecthyma
  • predisposed: burn, immunosuppressed, ventilator, CF
  • virulence: Toxin A (riboxylate EF2), capusle, pyocyanin (toxin to host), pyoverdin (iron uptake)
  • treat: ticarcillin/pipercillin and aminoglycoside
94
Q

What is the treatment for pseudomonas aeruginosa?

A

-ticarcillin/pipercillin and aminoglycoside

95
Q

What is mycoplasm pneumoniae?

A

smallest disease causing bacteria

  • no peptidoglycan = beta lactams dont work
  • restricted to humans
  • low infectious dose - tracheobronchitis
  • p1 adhesin: binds base of cilia and cause escalator issue = mucus fills lungs
  • symptoms: bronchopneumonia, anemia, patchy infiltrates
  • long process
  • diagnose: cold agglutinin: non specific, pcr, serolgoy
  • treat: tetracycline and macrolide
96
Q

What is the treatment for mycoplasm pneumoniae?

A

Tetracycline and macrolide

97
Q

What is chlamydophila pneumoniae?

A

atypical pneumonia

  • athersclerosis, asthma, ms, rehumatoid arthritis
  • dianose: microimmunofluoresence and PCR
  • treat: tetracycline and macrolide
98
Q

What is legionella pneumoniae?

A

gram negative rod, difficult to culture

  • form man made water aerosolized
  • virulence: attach to alveolar macrophage inject with T4ss into host, hijack cell, no lysosome fuse, recruit to LCV, replicate at high numbers
  • in cell as LCV = recruits stuff to feed it
  • clinical: progressively ill 3-6 dyas, chills, diarrhea, confusion
  • diagnose: WBC, CXR (patchy), fluorescent Ab, nucleic acid amp.
  • treat: macrolide or fluoroquinolone
99
Q

What is the treatment for legionella?

A

macrolide or fluoroquinolone

100
Q

What is mycobacterium tuberculosis?

A

Gram +, acid fast

  • latent and active phases
  • humans only reservoir
  • transmit: aersolized respiratory secretions
  • granuloma form in lungs
  • alveolar macrophage engulf = t and NK cells = granuloma
  • primary asymptomatic = clear, latent or active
  • cell mediated: causes necrosis and inflammation with granuloma
  • disseminated: millet seeds in organs
  • symtpoms: wt loss, night sweats, cough
  • diagnsois: rapid lab test, chon focus and complex on CXR or focal infiltrate
  • tuburculin skin test not good if have had vaccine
  • IFN-gamma measure T cell realse with Mtb Ag
  • treat: INH, ethambutol, pyrazamide, and rifampin for 2 mo then INH and rifampin for 4-6mo
  • lots of resistance
  • vaccine: in endemic countries
101
Q

What is the treatment for MTb?

A

INH, ethambutol, pyrazamide, and rifampin for 2 mo and then INH and rifampin for 4-6 mo

102
Q

What is mycobacterium avium and itnracellulare?

A
  • pulmonary infection like TB

- common in immunocompromised

103
Q

What is mycobacterium kansaii?

A

elderly chronic granulomatous pulmonary disease

Microbiology (5 decks)

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