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Concepts in medical science > Exam 3: Miscellaneous Bacterial Agents of Disease > Flashcards

Exam 3: Miscellaneous Bacterial Agents of Disease Flashcards

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USMLE® Step 1 flashcards Biology 101 flashcards
1
Q

comma-shaped rods, single polar flagellum, gram negative

A

vibrio species lab id

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2
Q

vibrio cholerae possess unique

A

O & H antigens

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3
Q

cholera is caused by

A

toxigenic strains of V. cholerae (O1 and O139 serotypes)

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4
Q

how does someone get vibrio cholerae?

A

ingested via contaminated food or water

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5
Q

where does vibrio cholerae infect?

A

surface of small intestine

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6
Q

t/f vibrio cholerae is invasive?

A

false

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7
Q

incubation period of vibrio cholerae

A

2 hours to 5 days

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8
Q

VF of vibrio cholerae

A

cholera toxin

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9
Q

cholera toxin causes

A

electrolyte and water loss through dramatic, high, volume, secretory diarrhea RICE WATER STOOLS

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10
Q

rice water stools is associated with which pathogen

A

vibrio cholerae

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11
Q

`Pt from Haiti presents with severe, watery diarrhe with mild to severe dehydration due to toxin production, you’re worried because death can occur within 48 hours, what pathogen infected this pt?

A

vibrio cholerae

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12
Q

Causes cells to pump out large amounts of cl and bicarbonate so positively charged Na and K go out which then causes water to follow leading to dehydration

A

vibrio cholerae

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13
Q

causes gastroenteritis via its 2 enterotoxins from RAW SEAFOOD, SHRIMP, TUNA, SQUID, CRAB

A

vibrio parahaemolyticus

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14
Q

t/f vibrio parahaemolyticus is self limited

A

true–usually resolves itself within 3 days

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15
Q

pt presents with explosive, watery diarrhea, abdominal pain, fever

A

vibrio parahaemolyticus

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16
Q

gastroenteritis usually from RAW OYSTERS; can lead to bacteremia and sepsis esp. in IC and diabetics

A

vibrio vulnificus

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17
Q

causes RAPIDLY PROGRESSIVE WOUND INFECTIONS eg. cellulitis in the setting of contaminated salt water and carry a HIGH MORTALITY RATE if not treated early

A

Vibrio vulnificus

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18
Q

3 bacteria pathogens found within saltwarer

A

Vibrio cholerae, vibrio parahaemolyticus, vibrio vulnificus

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19
Q

how is the vibrio species diseases transmitted?

A

either by consumption or contamininated shellfish or traumatic injury associated with infected water

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20
Q

heat-labile enterotoxin CJT causes most of the symptoms

A

VF of campylobacter jejuni

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21
Q

curviform bacteria, short spirals or curved rods; one flagellum

A

campylobacter jejuni lab id

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22
Q

import cause of bacterial gastroenteritis in DEVELOPED COUNTRIES; ingested via CHICKEN, milk, water, other meats

A

campylobacter jejuni

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23
Q

incubation period of campylobacter jejuni

A

1-7 days

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24
Q

reaches mucosa at the ileum near colon; adheres & invades leading to inflammation, abscesses, & occasionally bacteremia

A

campylobacter jejuni

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25
Q

Sx: HA, fever, abdominal pain, secretory diarrhea; MAY MIMIC APPENDICITIS

A

campylobacter jejuni

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26
Q

pt presents will appendicitis like pain but on CT is shows inflammation of the colon rather than acute inflammation of the appendix…what pathogen infected this pt?

A

campylobacter jejuni

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27
Q

how long does campylobacter jejuni usually last

A

typically 3-5 days but can last up to 2 weeks

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28
Q

VF of helicobacter pylori

A

able to inhabit the human stomach, UREASE allows it to live in low pH due to generation of ammonia

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29
Q

lab id of helicobacter pylori

A

curviform bacteria; curved rods with severeal polar flagella

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30
Q

causes stomach and duodenal ulcers (90%)

A

helicobacter pylori

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31
Q

how is h. pylori spread?

A

person to person via fecal-oral route

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32
Q

dx or h. pylori

A

direct: biopsy, indirect: urea breath test or stool antigen test

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33
Q

tx of h. pylori

A

triple therapy! PPI + amoxicillin + clarithromycin

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34
Q

lab id of treponema pallidum

A

weakly gram negative –> need special stains; darkfield microscopy, immunofluorescence
thin, regular, coiled cells

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35
Q

strict parasites that can only be cultured in live cells

A

treponema pallidum

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36
Q

what is the sole natural host of treponema palldium?

A

humans

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37
Q

where on humans does treponema pallidum like to live?

A

genital region and oral cavity

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38
Q

t/f treponema pallidum is extremely fastidious and sensitive; it cannot survive long outside of the host

A

true

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39
Q

how is syphilis (treponema pallidum) transmitted

A

contact with lesions or via placenta

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40
Q

wherever the spirochete (treponema pallidum) lands is where

A

lesion will occur

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41
Q

Pt is contagious
first stage of infection, localeized, PAINLESS chancre (progresses from erythemic macule to papule to ulcer); serologic tests may not be positive during early in this stage (bc body takes a few weeks to make antibodies)

A

primary syphilis

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42
Q

what causes syphilis?

A

treponema pallidum

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43
Q

Contagious; weeks to few months later, 25% of untreated patients will develop a systemic illness that presents with GENERALIZED, DIFFUSE MACULOPAPULAR RASH –> affecting the palms and sole, does not hurt or itch, can persist for months; may also present with conylomata lata; serologic tests are usually highest in titer during this stage

A

secondary stage of syphilis

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44
Q

look similar to genital warts but are smoother, typically have a flat top to them, usually skin color or redish brown

A

condylomata lata

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45
Q

condylomata lata are associated with which stage of syphilis?

A

secondary

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46
Q

host suppresses infection, but spirochete is still present –> no lesions are clinically apparent; asymptomatic
only evidence is positive serologic test
can occur between primary and secondary stages or after secondary stages

A

latent stage of syphilis

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47
Q

which stage of syphilis is the patient usually not contagious during?

A

tertiary

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48
Q

occurs months to years later untreated patients can develop neurologic symptoms and gumma

A

tertiary syphilis

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49
Q

granulomatous lesions that destroy soft tissue, cartilage, and bone; can occur in skeletal, spinal, and mucosal areas; the eyes, and viscera (lung, stomach, liver, genitals, breast, brain, and heart)

A

gummas

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50
Q

results from damage by the spirochete, presents as ascending aortic aneurysm, aortic valve insufficiency and/or heart failure

A

cardiovascular syphilis

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51
Q

usually occurs during the tertiary stage but literature say it can occur at any stage; occurs when the bacteria invades the CNS; spirochetes destroy the blood vessels in the brian, cranial nerves, and dorsal roots of the spinal cord

A

neurosyphilis

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52
Q

via placenta
most common manifestationsa re recgonzied at 2 years of age
bone and tooth deformities (hutchinson’s teeth), deafness, nervous system abnormalities; may lead to stillbirth, neonatal death, infant disorders; transmission can occur during any stage of syphilis but risk if much higher during primary and secondary stages

A

congenital syphilis

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53
Q

what happens if syphilis is not treated

A

it will become chronic

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54
Q

tx for syphilis

A

penicillin

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55
Q

populations at increased risk for syphilis

A

men who have sex with men, men who have sex with both men and women, african american/black population

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56
Q

T. pallidum enters body via

A

abraded skin and mucous membranes during sexual contact –> binds to mucous membranes or dmaged skin using its hooked endoflagellum

57
Q

incubation period of t. pallidum

A

3 weeks – asymptomatic

58
Q

dx of early syphilis

A

clinical presentation + id of tremponema pallidum in lesion exudate or tissue (antibodies might not be present yet)

59
Q

dx or secondary, latent, and tertiary syphilis

A

serology (nontreponemal and treponemal)

60
Q

measure ANTIBODY DIRECTED AGAINST A CARDIOLIPIN ANTIGEN; not specific

A

nontreponemal test

61
Q

VDRL and RPR are examples of

A

notreponemal tests

62
Q

nontreponemal tests are considered

A

screening tests, but are used to follow treatment responses as well

63
Q

results from nontreponemal tests are reported

A

quantitatively

64
Q

specific; if RPR is positive, we order one of these; CONFIRMATORY TEST; measure antibody against T. pallidum antigens; qualitative; reactive for life

A

treponemal tests

65
Q

FTA-ABS (fluorescent treponemal antibody test), Treponemal agglutination test (MHA-TP or microhemagglutination test)

A

examples of treponemal tests

66
Q

penicillin for treatment of t. pallidum is injected

A

IM

67
Q

lab id of Borrelia burgdorferi

A

weakly gram negative, darkfield microscopy, immunofluorescence; LARGE, 3-10 COILS, ABUDANCE OF PERIPLASMIC FLAGELLA

68
Q

borrelioses is transmitted by

A

arthropod vector

69
Q

what does borrelia burgdorferi cause?

A

Lyme disease

70
Q

lyme disease is transmitted by

A

Ixodes tick – black legged deer ticks

71
Q

what is the most common vector-borne disease in the U.S.?

A

Lyme disease

72
Q

Nonfatal, slowly progressive syndrome that mimics neuromuscular and rheumatoid conditions if untreated

A

lyme disease

73
Q

bull’s eye rash called

A

erythema migrans (lyme disease)

74
Q

in lyme disease is untreated it can disseminate and progress to

A

cardiac damage, neurological symptoms and polyarthritis

75
Q

tx for lyme disease

A

doxycycline for 8 years and above; amoxicillin for 8 and younger

76
Q

why do we not give 8 and younger doxycycline?

A

causes tooth deformities and discoloration

77
Q

prevention against lyme disease

A

DEET

78
Q

small, gram-negative, fastidious but not obligate parasites

A

bartonella henselae lab id

79
Q

trench fever

A

bartonella quintana – spread by human lice

80
Q

bartonella henselae causes

A

cat-scratch disease

81
Q

cat-scratch disease

A

lymphatic infection associated with a clawing injury by cats

82
Q

starts as a small patch/cluster of papules at site within 7 days, then spreads via lymphatics to draining regional lymph nodes –> progresses to tender, regional lymphadenopathy within 1-2 weeks; can lead to bacteremia and endocarditis in IC; usually self-limiting

A

bartonella henselae (cat-scratch disease)

83
Q

obligate INTRACELLULAR parasitic bacteria; small, gram-negative cell wall

A

chlamydiae

84
Q

chlamydia lab testing

A

Direct nucleic acid antigen testing (NAAT) from patient swab samples

85
Q

what type of samples do you need to check for chlamydiae on NAAT?

A

male: urethral swab or urine
female: cervical swab

86
Q

STD, neonatal and ocular disease

A

chlamydia trachomatis

87
Q

ATYPICAL PNEUMONIA

A

chlamydophila pneumoniae

88
Q

pt presents with fever, dry cough, sore throat, HOARSENESS/LARYNGITIS

A

chalmydophila pneumoniae

89
Q

dx of chlamydophila pneumoniae

A

culture; immunofluorescence microscopy

90
Q

zoonotic atypical pneumonia usually transmitted from BIRDS

A

chlamydoophila psittaci

91
Q

chlamydophila psittaci causes

A

atypical pneumonia and can lead to endocarditis, myocarditis, encephalitis

92
Q

pathogenisis of c. trachomatis

A

infects columnar epithelial cells

93
Q

when c. trachomatis gets into the urogenital tract –>

A

urethritis, cervicitis, prostatitis, PID, lymphogranuloma venereum

94
Q

when c. trachomatis gets into the conjunctiva

A

trachoma, conjunctivitis

95
Q

manifestations of c. trachomatis

A

trachoma, reiter’s syndrome, lymphogranuloma venereum, urethritis

96
Q

severe infection of the epithelial cells of the eye causing deformity of eyelids & cornea, can cause blindness –> typically seen in neonates of mothers who were not treated

A

trachoma (caused by c. trachomatis)

97
Q

trio of arthritis, urethritis, and conjunctivitis

A

reiter’s syndrome (caused by c. trachomatis)

98
Q

caused by the invasion of lymphatic tissue of the genitalia –> leads to disfiguring disease of the external genitalia and pelvic lymphatics

A

lyphogranuloma venereum (caused by c. trachomatis)

99
Q

clinical appearance of advanced lymphogranuloma venerum

A

chronic local inflammation blocks the lymph channels, causing swelling and distortion of the external genitalia

100
Q

most common sexually transmitted disease in both men and women – more common than gonorrhea and syphilis combined

A

chlamydia trachomatis urethritis

101
Q

1 bacterial STD

A

chlamydia trachomatic urethritis

102
Q

pts are often asymptomatic; males: nongonoccocal urethritis (NGU) – can cause mild dysuria, mild discharge; females: urethritis can lead to cervicitis and PID – can elicit a yellowish-whitish discharge and or dysuria (BUT 90% ARE ASYMPTOMATIC)

A

chlamydia trachomatis urethritis

103
Q

lab id of rickettsia rickettsii

A

OBLIGATED INTRACELLULAR parasitic bacteria; gram-negative; non-motile pleomorphic rods

104
Q

ticks, fleas, & lice are involved in their life cycle

A

ricketssia rickettsii

105
Q

have tropism for endothelial cells –> enter vascular endothelial cells & cause NECROSIS of the vascular lining –> vasculitis, vascular leakage & PINPOINT HEMORRHAGING in vessels of the heart and lungs

A

rickettsia rickettsii

106
Q

ricketssia rickettsii causes

A

rocky mountain spotted fever

107
Q

what usually carries rickettsia rickettsii

A

dogs and wood ticks

108
Q

second most common tick-borne disease

A

rickettsia rickettsii (rock mountain spotted fever)

109
Q

engulfed by endothelial cells via endocytosis and takes over the cells machiner –> spreads through the bloodstream or the lymphatics and causes widespread damage to the SMALL BLOOD VESSELS (vasculitis) –> leads to hemorrhage, increased vascular permeability, edema, and the activation of inflammatory and coagulation mechanisms

A

patho of rickettsia rickettsii

110
Q

onset usually between 207 days after exposure; fever, chills, HA, n/v, myalgias; DISTINCT SPOTTED RASH THAT OCCURS WITHIN 2-5 DAYS OF ONSET OF FEVER

A

s/sx of rickettsia rickettsii (rocky mountain spotted fever)

111
Q

blanching erythematous rash with mucules that become petechial over time

A

rocky mountain spotted fever – rickettsia rickettsii

112
Q

rash begins on the ankles and wrists and spreads to the trunk (inclusion of the palsm and soles at later stage)

A

rickettsia rickettsii; rocky mountain spotted fever

113
Q

T/F all patients get the erythematous rash with macules that become petechial over time in rocky mountain spotted fever

A

false

114
Q

mycoplasma lab id

A

naturally lack cell walls, highly pleomorphic, attachment tip

115
Q

walking pneumonia

A

mycoplasma pneumoniae

116
Q

common cause of pneumonia in children and young adults; most common cause of atypical community acquired pneumonia

A

mycoplasma pneumoniae

117
Q

pt presents with gradual onset of sx: FEVER, malaise, persistent and slowly worsening DRY COUGH; HA, chills and sore throat

A

mycoplasma pneumoniae

118
Q

what does a chest XR of mycoplasma pneumoniae usually show?

A

patchy infiltrates

119
Q

dx of mycoplasma pneumoniae

A

serology or PCR

120
Q

causes GU tract infections; historically regarded to be weak sexually transmitted pathogens but now linked to PID in women and urethritis in men

A

Mycoplasma genitalum

121
Q

average duration of incubation stage of syphilis

A

3 weeks

122
Q

clinical setting of syphilis incubation stage

A

no lesion; treponemes adhere and penetrate the epithelium; after multiplying, they disseminate

123
Q

clinical setting: initial appearance of chancre at inoculation site; intesnse treponemal activity in body; chancre later disappears

A

primary stage of syphilis

124
Q

average duration of primary stage of syphilis

A

2-6 weks

125
Q

diagnosis of syphilis during primary stage of syphilis

A

dark-field microscopy; VDRL, FTA-ABS, MHA-TP testing

126
Q

clinical setting: healed chancre; little scarring; treponemes in blood; few if any sypmtoms

A

primary latency stage of syphilis

127
Q

average duration of primary latency stage of syphilis

A

2-8 weeks

128
Q

dx during primary latency stage of syphilis

A

serological tests

129
Q

clinical setting: skin, mucous membrane lesions; hair loss;patient highly infectious; fever, lymphadenopathy; symptoms can persist for months

A

secondary stage syphilis

130
Q

average duration of secondary stage of syphilis

A

2-6 weeks after chancre leaves

131
Q

dx of syphilis during secondary stage

A

dark-field testing of lesions; serological tests

132
Q

clinical setting: treponemes quiescent unless relapse occurs; lesions can reappear

A

latency stage of syphilis

133
Q

average duration of latency stage of syphilis

A

6 months to 8 or more years

134
Q

dx of syphilis during latency period

A

seropositive blood test

135
Q

clinical setting: neural, cardiovascular symptoms; gumma develop in organs; seropositivity

A

tertiary stage of syphilis

136
Q

average duration of tertiary stage of syphilis

A

variable; up to 20 years

137
Q

dx of syphilis during tertiary stage

A

treponeme may be demonstrated by DNA analysis of tissue

138
Q

what is the tx for syphilis

A

Benzathine penicillin G, 2 x 10^6 units; doxycycline

Concepts in medical science (7 decks)

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