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MOD II > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

What are examples of pathogens that enter via the skin

A
  • S aureus, Candida albicans, pseudomonas aeginosa via mechanical defects
  • HIV, Hep viruses via needle sticks
  • Yellow fever, plague, Lyme disease, malaria, rabies via animal bites
  • schistosoma via direct penetration
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2
Q

What are examples of pathogens that enter via the GI tract

A
  • vibrio cholerae and giardia via attachment and local proliferation
  • shigella, salmonella and campylobacter via attachment and local invasion
  • poliovirus via uptake through M cells
  • Protozoa and helms
  • hep A, rotavirus and norovirus (defense: pancreatic enzymes)
  • Clostridium difficile
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3
Q

What are examples of infections that spread through nerves

A

Varicella zoster, rabies

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4
Q

What is an example of a microbe that spreads within inflammatory cells

A

M tuberculosis in macrophages

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5
Q

What are the host defenses against infection in each of the systems

A

Skin: tough keratinized barrier, low pH, fatty acids
Respiratory: alveolar macrophages, mucociliary clearance, IgA
GI: acidic gastric pH, viscous mucus, pancreatic enzymes and bile, defensins, IgA, normal flora
GU:repeated flushing and acidic environment created by commensal flora

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6
Q

What are examples of mechanisms of antigenic variation

A
  • Hight mutation rate: HIV, influenza virus
  • Genetic reassortment: influenza virus, rotavirus
  • Genetic rearrangement: BOrrelia burgdorferi, neisseria gonorrhoeae, trypanosomiasis, plasmodium
  • Large diversity of serotypes: rhinoviruses, strep pneumoniae
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7
Q

How do microbes resist phagocytosis

A

Producing a capsule

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8
Q

What are the viral STDs

A
  • herpes simplex virus: primary and recurrent herpes, neonatal herpes
  • Hep B
  • HPV:cancer of penis, cervical and vulvar cancer, condyloma acuminatum in both females and males
  • HIV
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9
Q

What are the bacterial STDs

A
  • chlamydia trachomatis: urethritis, epididymitis and proctitis in males, urethral syndrome, cervicitis, bartholinitis, salpingitis in females, lymphogranuloma venereum in both
  • Ureaplasma urealyticum: urethritis in males
  • neisseria gonorrhoeae: epididymitis, prostatitis, urethral stricture in males, cervicitis, endometritis, bartholinitis, salpingitis, infertility, ectopic pregnancy in females, urethritis, proctitis, pharyngitis, disseminated infection in both
  • Treponema pallidum: syphylis
  • Haemophilus ducreyi: chancroid in both
  • Klebsiella granulomatous: granuloma inguinal (donovanosis) in both
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10
Q

What are the Protozoa that cause STDs

A

-trichomonas vaginalis: urethritis, balanitis in males, vaginitis in females

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11
Q

What is an example of a microbe that causes purulent infection

A

Staphylococcal pneumonia

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12
Q

What are examples of microbes that cause tissue necrosis

A

Clostridium perfringens and hep B

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13
Q

What are the staining techniques used for different kinds of infections agents

A
  • gram stain: bacteria
  • Acid-fast stain: mycobacteria, nocardiae
  • silver stains: fungi, legionellae, pneumocystis
  • periodic acid schiff: fungi, amoebae
  • mucicarmine: cryptococci
  • giemsa: campylobacter, leishmaniae, malaria parasites
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14
Q

What are koplik spots

A

Ulcerated mucosal lesions in oral cavity seen in measles: marked by necrosis, neutrophilic exudate, and neovasculariziation

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15
Q

What are warthin finkeldey cells

A

Multinucleate giant cells found in the lymphoid organs in measles: have eosinophilic nuclear and cytoplasmic inclusion bodies; also found in lung and sputum

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16
Q

What are the corneal lesions caused by HSV

A

Herpes epithelial keratitis: virus induced cytolysis of superficial epithelium
Herpes stromal keratitis: infiltrates of mononuclear cells around keratinocytes and endothelial cells leading to neovascularization, scarring, opacification of cornea and blindness (caused by immune reaction, not HSV itself)

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17
Q

When does the chickenpox rash typically occur

A

2 weeks after respiratory infection

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18
Q

What is Ramsay hunt syndrome

A

If varicella zoster involves geniculate nucleus: causes facial paralysis

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19
Q

What is the frequent disease presentation of streptococcus pyogenes

A

Pharyngitis

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20
Q

What is the common disease presentation of vibrio cholerae and enterotoxigenic E. coli

A

Noninflammatory gastroenteritis

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21
Q

What it’s eh common disease presentation of shigella, salmonella, campylobacter jejuni, and enterohemorrhagic E. coli

A

Inflammatory gastroenteritis

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22
Q

What are the common disease presentations of ecoli, pseudomonas aeruginosa, enterococcus species in the GU tract

A

UTI

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23
Q

What does staphylococcus aureus cause in the skin

A

Abscess, cellulitis

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24
Q

What does steptococcus pyogenes cause in the skin

A

Impetigo, erysipelas, necrotizing fasciitis

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25
Q

What does clostridium perfringens cause in the skin

A

Gas gangrene

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26
Q

What does bacillus anthracis cause in the skin

A

Cutaneous anthrax

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27
Q

What are the effects of staphylococcal infection on different systems

A

Resp infection, toxic shock syndrome, osteomyelitis, skin infections (surrounded around hair follicle)-> boils and carbuncle, endocarditis, food poisoning *S aureus -> pyogenic inflammation

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28
Q

What is staphylococcal scalded skin syndrome

A

Called Ritter disease; usually in children with infection of nasopharynx of skin; sunburn like rash that spreads over entire body that can lead to skin loss

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29
Q

What is erysipelas

A

Caused by strep pyogenes; characterized by r avidly spreading erythematous cutaneous swelling

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30
Q

What is scarlet fever associated with

A

Strep pyogenes

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31
Q

Is listeria monocytogenes gram positive or negative

A

Positive bacillus

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32
Q

What is the classification of Bacillus anthracis

A

Spore forming gram positive rod shaped bacterium

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33
Q

What is the classification of pseudomonas aeruginosa

A

Aerobic gram negative bacillus

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34
Q

What is the difference between the ulcers/rashes formed by haemophilus ducreyi and klebsiella granulomatis

A

Klebsiella: painless

H. Ducreyi: painful

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35
Q

What do the masses formed by Klebsiella sometimes form

A

Urethral, vulvar, or anal strictures from scarring

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36
Q

What is unique about TB in immunocompromised people

A

Do not form granuloma a

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37
Q

What is the hallmark of mycobacterium avium in HIV patients

A

Abundant acid-fast bacilli within macrophages

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38
Q

What are the stages of the protean manifestations of syphilis

A

Primary: chancre
Secondary: palmar rash, LAD, condyloma Latum, neurosyphilis
Latent
Tertiary: Neurosyphilis (asymptomatic, meningovascular, tabes dorsalis, general paresis), aortitis (aneurysms, aortic regurgitation), gummas (hepar lobatum, skin, bone)

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39
Q

Contrast gram positive and negative bacteria

A

Positive: thick cell wall; envelope has outer cell wall of complex cross linked peptidoglycan
Negative: thin cell wall

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40
Q

What microbes found in the GI tract can also be spread by oral/anal sex

A

Shigella and E histolytica

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41
Q

What is the difference between erythema migrans, multiforme and marginatum

A

Migrans:single lesion
Multiform: multiple lesions
Marginatum: snake-like

42
Q

Which group of strep is normal in GI tract

A

D

43
Q

Which organisms cause necrotizing pneumonia

A

Rhodococcus equi, klebsiella pneumoniae, staphoreus

44
Q

How does staphaureus become resistant to penicillin

A

Contains beta lacrimal which breaks it down

45
Q

What is Waterhouse-friederichsen?

A

Caused by neisseria meningitis -> b/l adrenal hemorrhage

46
Q

Which STI causes one joint arthritis if left untreated

A

Gonorrhoeae

47
Q

Which microbe is associated with rose spots

A

Salmonella typhi

48
Q

Which microbe is associated with Guillian-Barre

A

Campylobacter jejuni

49
Q

Does haemophilus ducreyi cause a painful or painless ulcer

A

Painful

50
Q

What is a characteristic of late stage syphilis

A

Dissecting aortic aneurysm

51
Q

Describe the micro characteristics of staph aureus

A

Gram positive, catalase positive, coagulase positive, beta hemolytic, ferments mannitol

52
Q

What is the virulence factor of staph aureus

A

Protein A->component of cell wall; binds Fc portion of Igs; prevents opsonization and phagocytosis

53
Q

Where dose staph aureus colonize

A

Nares

54
Q

What diseases does staph aureus cause

A
  1. ) inflammation -> pneumonia with patchy infiltrate, most commonly post viral infection; septic arthritis, impetigo, faruncles, boils, abscesses, rapid onset acute endocarditis *tricuspid valve, osteomyelitis *most common cause
  2. )toxin mediated dz: scalded skin syndrome (protease; skin peels off), TSS, rapid onset food poisoning (more vomiting)
  3. ) MRSA: alters penicillin binding protein
55
Q

What does Staph epidermidis often infect

A

Artificial joints; indwelling Cath important source of infection; *endocarditis in artificial valves; normal skin flora; novobiocin sensitive; cat positive, urease positive, coagulase negative

56
Q

What does staph saprophyticus cause

A

UTI in sexually active F; cat positive, urease positive, coagulase negative

57
Q

Describe the micro characteristics of strep A pyogenes

A

Encapsulated made of hyaluronic acid which makes it non-immunogenic; beta hemolytic

58
Q

What does strep pyogenes cause

A

Impetigo ‘honey crusted’; pharyngitis, cellulitis, erysipelas

  • Rheumatic fever: M protein in cell wall *main virulence factor; interferes with opsonization; generates humoral response which makes abs to similar structure (myosin in heart) *mitral valve; ONLY after pharyngitis infections; Symptoms Joints (polyarthritis) O - heart problems, Nodules on forearms or knees, Erythema marginatum, Sydenham chorea: rapid involuntary movements
  • post strep glomerulonephritis: type III rxn; dark brown urine, facial swelling, 2 wks after onset after pharyngitis OR skin infection, virulence: streptolysin O: lyse RBCs; streptokinase: convert plasminogen->plasmin, DNAase: depollymerize DNA
59
Q

What are the infections caused by strep pyogenase toxin (SPE)`

A
  • Scarlett fever: reddening and swelling of tongue (strawberry tongue), pharyngitis, widespread rash that spares face
  • toxic shock - like syndrome
  • necrotizing fasciitis: SpeB
60
Q

What is strep agalactiae

A

Group B strep; meningitis in infants; + hippurate test (hydrolyzes sodium hippurate); poly sacc capsule; CAMP + *distinguishes from other strep -> arrowhead zone of hemolysis; beta hemolytic; swab vaginal canal at 35 wks and prevent with penicillin

61
Q

Describe the micro characteristics of strep pneumoniae

A

Alpha hemolytic** (also strep viridans); partial hemolysis (outer has green hue); encapsulated (polysaccharide) *major virulence factor; optochin sensitive; diplococci; bile soluble

62
Q

What does strep pneumoniae cause

A

Production of rust colored sputum, MOPS (meningitis, otitis media, pneumonia, sinusitis); virulence factor: cleaves IgA

63
Q

Describe strep viridans

A

No capsule; optochin resistant; bile resistant; alpha hemolytic, associated with dental caries; affects damaged heart valves (adheres to fibrin aggregates and platelets)

64
Q

Describe enterococcus

A

Inhabits intestines; 2 species: Faecalis *more common and Faecium *more serious; can grow in NaCl; 3 main infections: UTI, endocarditis, biliary tree infections *do you love trees?; nosocomial

65
Q

What is splenomegaly usually associated with

A

Viral syndromes

66
Q

What is a positive heterophil ab test diagnostic for

A

Mono; CMV can give negative test but still cause mono-like

67
Q

Does mycoplasma hominis cause neutrophilic or lymphocytosis

A

Lymphocytosis because not acute pyogenic bacteria

68
Q

What does the CSF in acute bacterial meningitis look like

A

Turbid color, increased opening pressure, decreased CSF glucose, increased protein *group B strep, ecoli, listeria, neisseria

69
Q

Describe the features of bacillus anthracis

A

Gram positive bacilli; causes black Eschar (necrotic cutaneous lesion with surrounding erythematous ring); encapsulated -> made of protein *poly D glutamate; obligate aerobe; spore former

70
Q

What are the toxins of bacillus anthracis

A
  • lethal factor: exotoxin; protease that cleaves MAPK -> necrosis
  • edema factor: adenylate cyclase increases cAMP -> fluid
  • both need to be present to cause symptoms
71
Q

Describe pulmonary anthrax

A

Starts with dry cough, progresses to hemorrhagic mediastinitis and widened mediastinum

72
Q

Describe bacillus cereus

A

Gram positive bacilli; spore forming *food poisoning in reheated fried rice

73
Q

Describe the features of clostridium tetani

A

Gram positive bacilli, obligate anaerobe, spore forming, found in soil, rigid paralysis; Risus Sardonicus *evil grin -> lock jaw; extension of back *opisthotonus; toxin - tentanospasmin -> travels retrograde to spinal cord; protease that cleaves SNARE and inhibits release of GABA and glycine *renshaw neurons

74
Q

Describe the features of clostridium botulinum

A

Gramp positive bacilli; obligate anaerobe spore former; flaccid paralysis (descending) only peripheral nerves; cleaves SNARE -> attacks motor neurons that release Ach; *babies, think honey; causes floppy baby syndrome (ingestion of spores) in adults ingestion of preformed toxin

75
Q

Describe the features of clostridium difficile

A

Gram positive spore forming nosocomial infection; clindomycin inducive to infection; exotoxins: A (bind to brush border and cause inflammation and cell death -> watery diarrhea) and B (depolymerizes actin -> enterocyte death and necrosis -> yellowish grey exudate that forms pseudomembrane covering colonic mucosa); diagnosis: toxin in stool; obligate anaerobe

76
Q

Describe the features of clostridium perfringens

A

Gram positive bacilli, associated with military combat and motorcycle wounds; spore forming obligate anaerobe; causes gas gangrene (alpha toxin inhibits lecithinase and damages cell membrane; zone of double RBC hemolysis) and food poisoning (late onset diarrhea)

77
Q

Describe the characteristics of corynebacterium diphtheriae

A

Gram positive bacilli; club shaped; metachromatic granules; exotoxin A (active: EF2) and B; inhibits ribosome function and formed pseudomembrane (gray in throat and tonsils -> LAD *bulls neck); resp transmission; causes myocarditis, arrhythmia and heart block; can demyelinate CN; diagnosis -> plate on telluride or Loeffler’s; diff btw toxic and non toxic -> eleks test

78
Q

Describe the features of listeria monocytogenes

A

santa pic Gram positive bacilli; associated with pregnant women; beta hemolytic, motile, catalase positive, survives in cold, *milk, meat, cheese; newborns -> meningitis and in adults over 60

79
Q

Describe the features of actinomyces Israeli

A

Gram positive obligate anaerobe; normal flora of oral cavity; infection associated with jaw trauma *dental work; begins as no tender lump on jaw that drains yellow pus

80
Q

Describe the features of nocardia asteroides

A

western card game pic Gram positive obligate aerobe found in soil; acid fast satin *mycolic acids; catalase positive, urease positive, *seen in immunocompromised men more than women; 3 sites of infection -> pulm (pneumonia w cavitation), CNS (brain abscess), cutaneous (pyogenic response)

81
Q

Describe the features of Neisseria overall

A

Diplococci gram negative; oxidase positive; cannot grow in blood agar; needs heat *chocolate agar; growth on VPN agar; virulence factors: pillus: allows attachment and genetic rearrangement; difficult to target; IgA protease

82
Q

Describe neisseria meningitidis

A

Gram negative, spread in close quarters via resp droplets, ferments maltose and glucose, colonizes in nasopharynx, polysaccharide capsule *main virulence factor b/c inhibits phagocytosis; infections usually type B; sickle cell -> more susceptible; spreads via blood -> inflammation generated by LOS proteins in the envelope -> increases permeability -> hypovolemia -> vasoconstriction leads to adrenal insufficiency *waterhouse Fredrich syndrome; petechial rash (DIC)

83
Q

Describe neisseria gonorrhoeae

A

Gram negative and invades PMNs; no capsule; males: urethritis, proctitis, orchitis; females: PID, white purulent discharge thicker than chylamydia; PID can spread to peritoneum (Fitz-Hugh Curtis syndrome; causes adhesions to liver); asymmetric polyarthritis; joint fluid that doesn’t gram stain (b/c intracellular); congenital -> purulent conjunctivitis (sooner onset than chlamydia)

84
Q

Describe Klebsiella pneumoniae

A

Enteric gram negative bacilli; *UTI, pneumonia, nosocomial; ferments lactose; three A’s: alcoholics, abscesses, and aspiration; polysaccharide capsule; currant jelly sputum, immotile, cavitation lesions, urease postive

85
Q

Describe enterobacter app and serratia mareasans

A

Both are motile gram negative bacilli that cause UTI, pneumonia and are nosocomial; serratia has a red pigment when cultured

86
Q

Describe salmonella enteritidis

A

Gram negative bacilli, motile, black colonies, capsule, acid labile (easily degraded so need high concentration to cause infection) ie: more susceptible if use antacids; caused from raw chicken; infects macrophages in the colon; faculatative intracellular; causes inflammatory diarrhea; virulence: type III secretion system

87
Q

Describe salmonella typhi

A

Gram negative motile bacilli; black colonies, acid labile, capsule; found in the GB of carriers; causes rose spots on the abdomen, number one cause of osteomyelitis in patients with sickle cell; constipation or diarrhea that resembles pea soup; type III secretion system

88
Q

Describe Shigella

A

Gram negative bacilli; causes bloody diarrhea; green colonies; immotile, acid stable -> fewer organisms cause infection; M tropic -> invades; facultative intracellular; shigella dysenteriae: hemolytic uremic syndrome (although more assoc with E. coli) -> shigatoxin induces endothelial damage and aggregation of platelets causes a decrease in count; also bind s the 60S subunit and inhibits translation; type III secretion system

89
Q

Describe E.coli in general

A

Gram negative bacilli; virulence factors: fibriae -> UTIs, ferments lactose, capsule (K antigen), catalase positive, LPS -> sepsis; *neonatal meningitis ONLY when positive for K antigen

90
Q

Describe EHEC (hemorrhagic E. coli)

A

From undercooked meat; causes bloody diarrhea, only ecoli that doesn’t ferment sorbitol; toxin inhibits 60S (shiga-like toxin); causes hemolytic uremic syndrome; O157-H7 Ag linked to outbreaks

91
Q

Describe ETEC (invasive)

A

*travelers diarrhea via drinking contaminated water; toxins: heat labile that increases cAMP and heat stable that increases cGMP; watery diarrhea

92
Q

Describe yersinia enterolitica

A

Gram negative bacilli transmitted via dog poop; more common in kids (cause also be spread in milk), resistant to cold temps, bipolar safety pin staining; capsule; causes bloody diarrhea, fever, leukocytosis, abscesses, intusseception, perforation and can mimic appendicitis

93
Q

Describe yersinia pestis

A

Black Plague; gram negative bacilli; reservoir: rats or prairie dogs; vector: fleas; causes buboes (swollen tender LN), abscesses and DIC from endotoxin; exotoxin and outer proteins use type III secretion system to inhibit phagocytosis

94
Q

Describe campylobacter jejuni

A

Gram negative; associated with Gillian barre ascending paralysis; thermophilic, infects intestinal tract (Fecal/oral), causes bloody diarrhea, curved rod shape; oxidase positive; invasive -> reactive arthritis

95
Q

Describe vibrio cholerae

A

Gram negative rod, comma shaped, fecal oral route; *does not invade; uses fibriae to attach to wall and secrete cholera toxin which increases cAMP by activated adenylate cyclase leading to increased H2O in lumen; acid labile; oxidase positive; non-cholerae vibrio is transferred via contaminated seafood

96
Q

Describe H pylori

A

Gram negative, motile, curved rod, urease positive (reduces acidity and helps it invade) urea breath test, oxidase positive, causes duondenal ulcers

97
Q

Describe psuedomonas aeruginosa

A

Gram negative rod, thrives in water *hot tub folliculitis (ecthyma gangrenosum), oxidase positive, catalase positive, blue/green pigment when plated b/c pyocynin; grape like odor; obligate aerobe; number one cause of nosocomial pneumonia; causes osteomyelitis in IV drug users and diabetics, capsule; *causes fatal complications in burn victims; indwelling cath -> UTI; otitis externa *swimmer’s ear; toxin: exotoxin A -> inactivates EF-2 by ribosylation

98
Q

Describe proteus mirabilis

A

Gram negative facultative anaerobe, motile, urease positive which causes the formation of staghorn calciculi (kidney stones); UTI’s, fishy odor

99
Q

Describe bordatella pertussis

A

Gram negative bacilli; spread by resp droplets which attach to epithelium via pilli(filamentous hemagglutinin) *doesn’t invade -> releases toxins -> pertussis toxin and andenylate cyclase-> ribosylates Gi -> increases cAMP; tracheal toxin ->part of peptidoglylcan wall, damages ciliated cells; initial infxn non specific; paroxysmal stage -> cough, convalescent stage lasts 3 months

100
Q

Describe haemophilus influenzae

A

choc covered cherry pic Gram negative cocci-bacilli; grown on chocolate agar which needs factor V (NAD) and X (hematin); aerosol trasmission; causes pneumonia, cherry red epiglottitis with inspiratory stridor and drooling, otitis media, meningitis only when capsular form and type B strain; septic arthritis; asplenic more susceptible

101
Q

Describe legionella pneumophila

A

battleship Gram negative but doesn’t stain well so need silver stain; grown on charcoal in presence of cysteine and iron; oxidase positive; causes legionnaires; Pontiac fever -> fever and malaise; atypical pneumonia: patchy infiltrate with consolidation in one lobe; *unique -> associated with hyponatremia, HA with confusion, and diarrhea; high fever; use rapid urine ag test or sputum culture

MOD II (2 decks)

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