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Concepts in medical science > Exam 3: Gram Negative Bacilli > Flashcards

Exam 3: Gram Negative Bacilli Flashcards

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USMLE® Step 1 flashcards Biology 101 flashcards
1
Q

VFs of enteric E. coli species

A

enterotoxins, O antigen (LPS endotoxin), capsules

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2
Q

Enterotoxins are

A

exotoxins that cause secretion and diarrhea

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3
Q

O antigen

A

LPS endotoxin

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4
Q

E. coli lab ID

A

anaerobic gram-negative rod

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5
Q

do e.coli species form spores?

A

no

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6
Q

Are E. coli species facultative anaerobes or aerobes?

A

anaerobes

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7
Q

Which bacteria are part of the enterics group

A

E. coli, shigella, salmonella

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8
Q

E. coli colonizes where

A

lower GI tract

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9
Q

what is the most common aerobic and non-fastidious bacterium in the gut?

A

E. Coli

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10
Q

Enterics reduce

A

nitrate to nitrite

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11
Q

what would a positive nitrite on a dipstick mean?

A

you have an enteric pathogen causing the UTI

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12
Q

enterics are ____ when introduced to ____ _____ ____

A

opportunistic, normally sterile sites

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13
Q

what is the most common cause of UTIs? Accounts for up to 90% of cases of cystitis and pyelonephritis in healthy young women

A

E. Coli

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14
Q

how are pathogenic strains of E. coli that cause diarrhea organized?

A

grouped by virulence properties (toxins and invasiveness)

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15
Q

groups of e. coli

A

enterotoxigenic, enteroinvasive, enterohemorrhagic

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16
Q

what bacteria accounts for 70% of traveler’s diarrhea?

A

enterotoxigenic e. coli

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17
Q

enterotoxigenic e. coli is spread by

A

water and food that has been contaminated by feces

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18
Q

enterotoxigenic e. coli presents with

A

severe watery diarrhea

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19
Q

2 enterotoxins that cause severe watery diarrhea in enterotoxigenic e. coli

A

Shiga toxin, labile toxin

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20
Q

shiga toxin

A

produced by both e. coli and shigella – inhibits synthesis, causing cell death

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21
Q

which toxin causes cell death by inhibiting protein synthesis?

A

shiga toxin

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22
Q

this toxin stimualtes Cl secretion out of the cell and blocks absorption of sodium

A

labile toxin

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23
Q

true or false, enterotoxigenic e. coli invade and causes inflammation

A

false

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24
Q

which strain of e. coli is the only to NOT cause inflammatory diarrhea

A

enterotoxigenic e. coli

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25
Q

causes inflammation and dysentery of the large intestine

A

enteroinvasive e. coli

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26
Q

what happens when enteroinvasive e. coli invades the mucosa of the large bowel

A

ulcerates it

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27
Q

what will be seen in the tool of someone with enteroinvasive e. coli?

A

blood and pus

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28
Q

what bacteria presents similar symptoms but in a milder form like shigellosis

A

enteroinvasive e. coli

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29
Q

uses invasion plasmid antigens and injects them into enterocytes –> enterocytes engulf bacteria in a phagosome which bacteria escape and then use cytoskeletal actin filaments to create “tails” for themselves –> propel to the next cell and invade, destroying enterocytes and creating FOCAL ULCERS

A

enteroinvasive e. coli

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30
Q

enteroinvasive e. coli is primarily seen in what population?

A

children younger than 5 in DEVELOPING NATIONS

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31
Q

bloody diarrhea in DEVELOPED NATIONS & can lead to HUS and permenant kidney damage

A

Enterohemorrhagic e. coli (O157:H7)

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32
Q

HUS

A

hemolytic uremic syndrome

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33
Q

hemolytic uremic syndrome

A

hemolytic anemia (RBC hemolysis), renal failure, thrombocytopenia

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34
Q

t/f antiobiotic treatment is effective against enterohemorrhagic e. coli

A

false

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35
Q

jack in the box

A

enterohemorrhagic e. coli

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36
Q

what is the main source of enterohemorrhagic e. coli

A

contaminated animal products

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37
Q

what is the infectious dose of enterohemorrhagic e. coli?

A

100 bacteria

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38
Q

what is the bacteria that is behind the reason you should not eat uncooked hamburger

A

enterohemorrhagic e. coli

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39
Q

where else is enterohemorrhagic e. coli found (other than undercooked hamburgers)

A

fruits, vegetables, ground water (due to contamination by animal waste)

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40
Q

VF of enterohemorrhagic e. coli

A

cell wall receptor that can fuse with the host cell membrane and shiga toxin

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41
Q

is enterohemorrhagic e. coli self limiting?

A

no

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42
Q

shiga toxin can get reabsorbed where?

A

into renal tissue

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43
Q

shiga toxin causes

A

capillary thrombosis and inflammation of the colonic mucosa

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44
Q

VF of pseudomonas aeruginosa

A

can survive and multiply in wide range of environments
exotoxin A
exoenzyme s
phagocytosis-resistant slime layer

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45
Q

Exotoxin A

A

pseudomonas aeruginosa

shuts down protein synthesis and causes CELL DEATH

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46
Q

exoenzyme S

A

pseudomonas aeruginosa

transported directly into host cells and induced apoptosis

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47
Q

what is present outside the cell wall in pseudomonas aeruginosa that helps resist phagocytosis?

A

mucoid polysaccharide slime layer

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48
Q

lab ID of pseudomonas aeruginosa

A

aerobic gram-negative rods with single polar flagellum; characteristic green pigmentation on culture and fruity odor

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49
Q

cultured a bacteria and it showed up green with a fruity odor… this is most like

A

pseudomonas aeruginosa

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50
Q

famous for hot tub folliculitis

A

pseudomoas aerugniosa

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51
Q

pt presents with red itchy rash all over body and said they went hot tubbing recently

A

pseudomonas aeruginosa

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52
Q

pseudomonas aeruginosa is a common inhabitant of

A

soil and water

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53
Q

pseudomonas aeruginosa isa an opportunistic pathogen therefore

A

there must be some sort of breakdown in the host defense

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54
Q

common cause of nosocomial infections esp. in immunocompromised

A

pseudomonas aeruginosa

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55
Q

what frequently contaminates ventilators, IV solutions, meds, anesthesia equipment

A

pseudomonas aeruginosa

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56
Q

what is the most common bacterial pathogen to colonize and infect patients with cystic fibrosis?

A

pseudomonas aeruginosa

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57
Q

otitis externa esp in diabetics is usually caused by

A

pseudomonas aeruginosa

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58
Q

why should you not sleep with contacts in?

A

pseudomonas aeruginosa can cause corneal ulcers

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59
Q

environmentally contaminated wounds by pseudomonas aeruginosa can cause ____ from an open fracture

A

osteomyelitis

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60
Q

which bacteria is notoriously multidrug resistant and always requires susceptibility testing?

A

pseudomonas aeruginosa

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61
Q

bordetella pertussis VF

A

surface protein: filamentous hemagglutinin (FHA)
Pertussis toxin
Tracheal cytotoxin (TC)

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62
Q

FHA

A

binds to and agglutinates red blood cells; bordetella pertussis VF

63
Q

VF toxins of bordetella pertussis (PT and TC)

A

destroy ciliated respiratory epithelial cells

64
Q

lab ID of bordetella pertussis

A

tiny aerobic gram-negative coccobacillus

65
Q

Pertussis (whooping cough) is caused by

A

bordetella pertussis

66
Q

which population carries largest mortality rate from bordetella pertussis?

A

infants less than 12 months

67
Q

what percentage of deaths from bordetella pertussis occur in children under 1?

A

70%

68
Q

What disease is being described?
one of the top 10 causes of death in children globally
follows a 7-10 incubation period

A

pertussis

69
Q

first phase of pertussis last for

A

1-2 weeks with fever, malaise, rhinorrhea

70
Q

prolonged course of pertussis lasts for

A

several weeks with coughing bouts

71
Q

post-tussive gagging and/or vomitting

A

pertussis

72
Q

true or false, bordetella pertussis is extremely contagious?

A

true, infects more than 90% exposed

73
Q

how is bordetella pertussis spread?

A

airborne droplet nuclei –> transmitted usually via inhalation of aerosols during coughing phase of infection

74
Q

where do the bacteria remain localized in bordetella pertussis?

A

tracheobronchial tree

75
Q

since the bacteria remain localized in bordetella pertussis in the tracheobronchial tree is leads to

A

tracheobronchitis (WHICH IS A URI NOT PNEUMONIA)

76
Q

Attach to the cilia of the bronchial epithelium with pili –> produce PT and TC which leaves a vulnerable mucosa –> bacteria does NOT directly invade or spread –> PT is absorbed into the bloodstream and interferes with the immune response –> can induce apoptosis

A

bordetella pertussis

77
Q

dx of bordetella pertussis

A

nasopharyngeal secretions/wash or NP swab

78
Q

TX of bordetella pertussis

A

azithromycin (Z pack)

79
Q

DTap is given to

A

infants (2, 4, 6, months)

80
Q

Tdap

A

booster given to adolescence and for all family members of a newborn

81
Q

the DTap and Tdap are whole cellular vaccines or acellular and why?

A

acellular, the whole cell vaccine was causing febrile seizures in children

82
Q

named for the 1976 outbreak at the American Legion convention

A

Legionella pneumophila

83
Q

VF of legionella pneumophila

A 
serogroup strains (16) 
survives harsh environments by living and multiplying intracellularly
84
Q

most common serogroup strain seen with legionella pneumophila

A

Philadephia strain = serogroup 1 (accounts for 90% of cases)

85
Q

Lab ID of legionella pneumophila

A

aerobic, gram-negative rods

thin, pleomorphic, motile, polar and lateral flagella

86
Q

t/f legionella pneumophila are facultative intraceullar pathogens

A

true

87
Q

where does legionella pneumophila like to live?

A

amoebas, protozoa, macrophages

88
Q

how was legionella pneumophila spread at the American Legion Convention?

A

AC system via aerosols

89
Q

Legionella pneumophila causes

A

necrotizing pneumonia aka Legionnarie’s diseae

90
Q

Legionella pneumophila is widely distributed where?

A

water (tap water, spas, ponds, fresh water, ac systems, cooling towers of hospitals, over vegetables in supermarkets)

91
Q

Aerosol with water

A

legionella pneumophila

92
Q

aerosols –> inhaled bacteria reach the alveoli –> adhere to alveolar macrophages –> BLOCKS FUSION OF THE ENDOCYTIC VACUOLE WITH THE LYSOSOME –> takes over the host machinery to create its own phagosome –> bacteria multiply to high numbers, kills the macrophage, release new cells –> repeat the cycle

A

legionella pneumophila

93
Q

in re to legionella pneumophila when are the enzymes released? what does this lead to

A

when the macrophage is destroyed; leading to inflammation and DESTRUCTIVE LESIONS IN THE LUNG, and systemic toxicity related to immune response

94
Q

destructive lesions in the lung

A

legionella pneumophila

95
Q

Severe, destructive pneumonia that can lead to shock and/or respiratory failure within a week

A

Legionnaire’s disease

96
Q

initial s/sx of Legionnaire’s disease

A

fever, chills, headaches, myalgias, dry cough, pleuritic chest pain

97
Q

what is the infection rate of legionella pneumophila?

A

5%

98
Q

t/f legionella pneumophila can be spread human to human?

A

false

99
Q

Dx of legionella pneumophila

A

PCR for serogroup 1 in urine (if it is any other serogroup you will get a false negative)

100
Q

lab id of pasteurella multocida

A

anaerobic gram-negative rods, small, coccobacillus

101
Q

normal respiratory flora in animals –> transmitted to humans via BITE or SCRATCH

A

pasteurella multocida

102
Q

when does the local infection associated with pasteurella multocida usually present?

A

within 24 hours

103
Q

what does the infection of pasteurella multocida usually look like?

A

cellulitis with well-defined borders; can also cause an abscess than can spread to joints, bones, and lymph nodes

104
Q

all patients with animal bites should be given

A

prophylactic antibodies (augmentin)

105
Q

VF of shigella species

A

O antigens in LPS layer
Able to invade and multiply in variety of epithelial cells including enterocytes
shiga toxin
endotoxin

106
Q

4 species of shigella

A

s. dysenteriae s. sonnei, s. flexneri, s. boydii

107
Q

shiga toxin causes

A

cell death

108
Q

endotoxin causes

A

fever

109
Q

lab id of shigella species

A

anaerobic gram-negative rods, non-motile, lack flagella

110
Q

shigella species is famous for

A

shigellosis

111
Q

incapacitating dysentery with crippling abdominal pain and watery stool filled with mucus and blood

A

shigellosis caused by shigella species

112
Q

shigellosis spreads

A

person to person under poor sanitary conditions

113
Q

t/f shigellosis infection does not spread outside the GI tract

A

true

114
Q

erosion of the lining of the large bowel

A

shigella dysentery

115
Q

shigella species initial transmission route

A

fecal- oral route –> the four F’s

116
Q

the four F’s of shigella transmission

A

feces, flies, fingers, food

117
Q

shigella species invades

A

villi of large intestine

118
Q

does the shigella species perforate the intestine to invade the bloodstream?q

A

no

119
Q

invasion plasmid antigens and shiga toxin damage the mucosa and villi leading to

A

mucus secretion, focal ulcers, and bleeding

120
Q

shiga toxin in shigella can cause damage to the

A

kidneys by same MOA as E. coli 0157:H7

121
Q

lab id of salmonella species

A

anaerobic gram-negative rods

122
Q

salmonella is spart of the

A

enterics group

123
Q

shigella is part of the

A

enterics gruops

124
Q

responsible for typhoid fever

A

salmonella typhi

125
Q

salmonella typhi transmission route

A

fecal-oral

126
Q

t/f typhoid fever still runs rampant throughout the rest of the world outside of the US?

A

true

127
Q

infectious dose of salmonella typhi

A

1,000-10,000

128
Q

VF of salmonella typhi

A

secretion systems that allow it to invade, multiply in, and kill macrophages
Vi surface polysaccharide that inhibits neutrophil phagocytosis
endotoxin

129
Q

ingested bacilli adhere to small intestine, cause diarrhea, invade and ULCERATE INTESTINAL LINING –> ingested by macrophages and other cells of the immune system –> bacilli then travel within macrophages to infiltrate the lymph nodes, liver, and spleen, where abscesses can form –> can also invade the blood stream either at this point or by perofrating intestine –> fever produced by endotoxin

A

salmonella typhi

130
Q

chronic carriers of salmonella typhi have bacteria in there

A

gallbladder (chronic infection of the biliary tract when gallstones present)

131
Q

less severe than typhoid fever but more prevalent

A

salmonella gastroentertitis

132
Q

what is a very common source of salmonella gastroenteritis?

A

poultry

133
Q

kid doesn’t watch hands before eating dinner after he was playing with his pet turtle, he has been puking for 2 days, what is he most likely infected by right now?

A

salmonella gastroenteritis

134
Q

sx’s of salmonella gastroenteritis

A

v/d, fluid loss, lasting 3-4 days

135
Q

vf of haemophilus species

A

polysaccharide capsule

136
Q

lab id of haemophilus s.

A

anaerobic gram-negative rods, coccobacilli, tiny; require culture media with blood or blood products (prefer chocolate agar)

137
Q

Haemophilus influenzae capsulated strains cause

A

acute life-threatening infection of CNS and soft tissues (i.e. bacteria meningitis, epiglottitis, septic arthritis, sepsis, pneumonia)

138
Q

capsulated strains of haemophilus influenzae occur primarily in

A

children

139
Q

non-capsulated strains of h. influenzae cause

A

otitis media, bronchitis, sinusitis, conjunctivitis

140
Q

H. influenzae is a strict

A

pathogen of humans

141
Q

H. influenzae is found in ______ _____ of up to 80% of normal people (usually noncapsulated form)

A

nasopharyngeal flora

142
Q

how is h. influenzae spread?

A

respiratory droplets

143
Q

t/f h. influenzae causes the flu

A

false

144
Q

vf of h. influenzae

A

polysaccharide capsule
antiphagocytic
allows invasion past respiratory epithelium to deep tissues

145
Q

H. influenzae is subtyped ast ___ strains based on

A

6, polysaccharide antigens

146
Q

which strain of h. influenzae is associated with 95% of the invasive diseases? which disease accounts for 50% of these cases?

A

Tybe b (aka Hib); Hib meningitis

147
Q

chiefly responsible for infections at the mucosal surface (i.e. otitis media, bronchitis, sinusitis, conjunctivitis)

A

non-capsulated or non-typeable h. influenzae

148
Q

t/f immunization with conjugated Hib vaccine does not confer protection against the non-typeable strains

A

true

149
Q

what remains a major cause of otitis media in children?

A

non-typeable H. influenzae

150
Q

sexually transmitted infection found in africa, southeast asia, india, latin america

A

H. ducreyi

151
Q

tender papule on the genitalia that develops into a soft, PAINFUL ulcer called CHANCROID; often associated with unilateral tender inguinal lymphadenitis

A

h. ducreyi

152
Q

vaccines for haemophilus s.

A

Hib vaccine (uses the Hib capsule conjugated to the other bacterial proteins); administered to infants 2 mo and up)

153
Q

Most common cause of UTIs are

A

enterics

Concepts in medical science (7 decks)

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