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Exam C Flashcards

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USMLE® Step 1 flashcards Biology 101 flashcards
1
Q

Diff between neisseria and moraxella:

Which is DNAase pos?

A

Moraxella

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2
Q

True or false:

Neisseria gonorrhoeae and meningitidis are ALWAYS pathogenic, but other Neisseria species are normal flora of the upper respiratory tract

A

True

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3
Q

Streptococcus agalactiae
Characteristics / Morphology

A

GPC arranged in pairs and chain

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4
Q

Streptococcus agalactiae:

facultative _________.

A

anaerobe

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5
Q

Streptococcus agalactiae is catalase __________.

A

neg

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6
Q

Streptococcus agalactiae:

spores?
motile?

A

Non-motile & non-spore forming

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7
Q

Streptococcus agalactiae:

______ - hemolytic streptococci.

A

Beta

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8
Q

Streptococcus agalactiae:

Possess ___ carbohydrate antigen (Lance - field antigen) on cell wall making it Group ___ streptococci.

A

B, B

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9
Q

Where does Streptococcus agalactiae colonize in the body?***

A

gastrointestinal and genitourinary tract

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10
Q

Is Streptococcus agalactiae a concern for infection?

A

Able to cause severe invasive infection in newborn, immuno-compromised, and elderly people

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11
Q

Streptococcus agalactiae:

Can cause __________ and __________ in newborn. Acquired during delivery through maternal genital tract.

A

septicemia, meningitis

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12
Q

What type of infections can Streptococcus agalactiae cause in adults?

A

Septicemia, endocarditis, osteomyelitis, pneumonia, skin and soft tissue infection

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13
Q

What are the virulence factors of Streptococcus agalactiae?

A

-Capsular polysaccharide - resistance to phagocytosis
-Hyaluronidase - Destroys connective tissues between host tissue
-Beta - hemolysis
-Peptidase - breaks peptides
-CAMP factor - protein that enhances hemolysis

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14
Q

Colony Morphology
of Streptococcus agalactiae?

A

Grows on blood agar plate as gray - white colonies that have soft outer margin and narrower zone of beta - hemolysis

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15
Q

Streptococcus agalactiae appearance on Granada medium? (a type of medium selective and differential towards GBS) that allows its straight identification

A

an produce orange brick - red non-isoprenoid polyene pigment

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16
Q

Selective & differential to selectively isolate streptococcus agalactiae. The medium relies on detection of granadaene which is a red polyenic pigment specific to GBS.

A

Granada Medium

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17
Q

Granada Medium uses ________ and _________ as pigment enhancer.

A

starch, methotrexate

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18
Q

Granada Medium:

Crystal violet used to inhibit gram __________ bacteria.

A

positive

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19
Q

Granada Medium:

_________ used to inhibit growth of gram negative bacteria

A

Colistin sulfate

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20
Q

Granada Medium:

______________ is used to inhibit anaerobic bacteria.

A

Metronidazole

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21
Q

S. agalactiae produces a _________ result with CAMP factor test.

A

pos

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22
Q

S. agalactiae is hippurate test _______.

A

pos

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23
Q

Bile esculin hydrolysis test - S. agalactiae produces a _________ result where other enterococcus produces a ________ test result.

A

neg

pos

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24
Q

Important test that differentiates Streptococcus agalactiae (positive test) from other streptococcus species (negative test, no arrow head).

A

CAMP test

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25
Q

CAMP test:

S. agalactiae has a synergistic effect with ____________ enhancing hemolysis on BAP creating an arrow head.

A

Staphylococcus aureus

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26
Q

CLO test =

A

urea, H.pylori

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27
Q

How does the Rapid Urease Test work?

A

by placing the specimen in an agar or onto a paper strip containing urea and a pH indicator (phenol red) and it will turn pink/red (alkaline)* in the presence of urea

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28
Q

Urea Breath Test for H. pylori:

Detects ___ and ____ isotopes (carbon dioxide levels are measured)

A

C13 and C14

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29
Q

E Coli O19241024829 = ____ growth on SMAC

A

no

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30
Q

EHEC has a serotype E. coli _______ and a differentiating factor for this serotype is that it can grow on ___________ unlike other serotypes that cannot.

A

O157:H7***

Sorbitol MacConkey (SMAC)***

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31
Q

E. coli O____:H__ is nonmotile

A

157, 7

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32
Q

What is the cause of hemorrhagic colitis and hemolytic uremic syndrome (HUS)?

A

EHEC (aka STEC – Shiga Toxin producing E. coli)

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33
Q

Which org is biochemically inactive?

A

Eikenella

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34
Q

CAMPY = microaerophile @ _____ C

A

42

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35
Q

Campylobacter are
motile or non-motile?

A

motile

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36
Q

Campylobacter is…

Catalase ____________
Oxidase ____________

A

pos, pos

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37
Q

Campylobacter is nit __________.

A

pos

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38
Q

Campylobacter is urease ________

A

negative

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39
Q

Campylobacter is _____________ which is why it can grow at 42C

A

thermophilic

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40
Q

Morphology for Campylobacter?

A

Gull (bird) wing morphology

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41
Q

Campylobacter media for ID

if you run out of this media, what could you use instead?

A

CAMPY blood agar

(HE)

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42
Q

what is in MAC?

A

bile salt and crystal violet

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43
Q

MAC:

_________ red is the indicator that turns red at a pH below ____

A

Neutral

6.8

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44
Q

Shigella TSI/KIA =

A

K/A

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45
Q

Salmonella TSI/KIA =

A

K/AG H2S+

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46
Q

Shigella color on HE agar?
XLD?

A

green

colorless

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47
Q

Salmonella color on HE agar?
XLD agar?

A

-Green with or without black centers***

Red with black centers

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48
Q

Where is salmonella isolated from in the body?

A

intestines

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49
Q

What does salmonella look like on HE agar?

A

blue/green with or without black center

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50
Q

Does sputum require refrigeration?

A

does NOT require refrigeration unless it is going to be more than a 1-2 hour delay

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51
Q

An accepted sputum sample has ___ or fewer epithelial cells per LPF and ____ or more leukocytes***

A

10

25

-Samples that contain predominantly upper respiratory tract material should be rejected.

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52
Q

Endotracheal aspirates (ETAs) from mechanically ventilated adult patients can be screened by…

A

gram stain

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53
Q

Presence of ciliated columnar bronchial epithelial cells, goblet cells, or pulmonary macrophages in specimens by bronchoscopy or BAL indicates specimen is from…

A

lower respiratory tract

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54
Q

100 colonies = _________ cfu

A

100,000

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55
Q

where does Trep comes from in the body (darkfield of trep)

A

vagina

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56
Q

Corynebacterium:

gram-________

What shape?

A

positive

V-shaped

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57
Q

bacteria with a pseudomembrane?

A

Corynebacterium

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58
Q

True or false:

Corynebacterium diphtheria is acid fast bacilli

A

False.

non acid fast bacilli

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59
Q

What is the toxin-virulent gene produced by Corynebacterium diphtheria?

A

bacteriophage-tox gene)

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60
Q

Aerobic/elek test-positive for virulent stains (precipitation test)

A

Corynebacterium diphtheria:

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61
Q

Arrangement of Corynebacterium diphtheria?

A

Curved or Chinese letter arrangement

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62
Q

Corynebacterium diphtheria motility, capsule, and spore ___________.

A

negative

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63
Q

Corynebacterium diphtheria ____________ granules.

A

Metachromatic

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64
Q

Is Corynebacterium diphtheria indigenous bacteria?

A

no!

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65
Q

Corynebacterium diphtheria catalase __________.

A

positive

66
Q

Corynebacterium diphtheria Cystine tellurite BA/modified tin scale medium-______ colonies (because it has potassium chloride).

A

black

67
Q

What is the vaccine for Corynebacterium diphtheria?

A

DTaP

68
Q

What illnesses does Corynebacterium diphtheria cause?

A

Primarily upper respiratory tract illness, pharyngitis, dysphagia, membrane can form in throat, cutaneous diphtheria, polyneuritis

69
Q

How can C. diphtheria be treated?

A

Treat w/ horse serum antitoxin, BUT serum sickness can occur (allergic to horse serum protein

70
Q

Bacterial infection associated with the placenta

A

Listeria. monocytogenes

71
Q

What can Listeria. monocytogenes infection cause?

A

can cause influenza like symptoms, followed by placentitis, amnionitis, infection of the fetus, abortion, stillbirth, or premature birth

72
Q

Early diagnosis of listeriosis in neonates:
Gram _________ bacilli in CSF, blood, amniotic fluid, respiratory secretions, placenta, or cutaneous swabs, gastric aspirate, or meconium

A

positive

73
Q

Enterobacteriacea:

almost all are…
Catalase _________
Nitrate __________
oxidase _________

A

pos
pos
neg

74
Q

MacConkey agar isolates gram __________ bacteria

A

negative

75
Q

What does MacConkey agar contain?

A

bile salts, crystal violet, and neutral red pH indicator

Lac (+) = pink
Lac(-) = yellow

76
Q

Hektoen - isolates ___________ and ___________.

A

Salmonella and Shigella

77
Q

What does Hektoen agar contain?

A

contains bile salts and the dyes bromothymol blue and acid fuchsin. Ferric ammonium citrate allows H2S production.

78
Q

On Hektoen agar

 Lac(+)= 
 Lac(-)=
 H2S(+)=
A

Lac(+)= Orange
Lac(-)= Blue-Green
H2S(+)= Black center

79
Q

Xylose Lysine Deoxycholate (XLD) - isolates gram ____________ organisms, contains phenol _____ indicator

A

negative

red

80
Q

Xylose Lysine Deoxycholate (XLD):

Lac (+) =
Lac (-) =
H2S (+) =

A

yellow
red
black center

81
Q

SS agar:

Gram-__________ enteric organisms.

A

negative

82
Q

SS agar contains…

A

neutral red indicator, sodium thiosulfate and ferric citrate enable the detection of H2S

83
Q

What is CNA agar used for?

A

isolating and differentiating pathogenic gram positive cocci from clinical and non-clinical samples

84
Q

How does CNA agar inhibit gram-negative bacteria?

A

Antimicrobials colistin (C) and nalidixic acid (NA)

85
Q

Thioglycollate broth:

Gram positive cocci frequently grow as…

A

discrete “puffballs”

86
Q

which broth for enrichment of stool specimens?*

A

-Selenite Enrichment broth is an enrichment broth for stool samples (Salmonella and Shigella)
-Cary-blair transport medium

87
Q

What is the media for vibrio?

A

TCBS

88
Q

Which bacteria is associated with seafood?

A

V. parahaemolyticus

89
Q

Which media helps diff for org that shows swarming?

A

?

90
Q

P. vulgaris is indole ________
P. mirabilis is indole ________

A

pos

neg

91
Q

which orgs are orange/salmon on HE?

A

-E. coli and K. pneumonia are both orange/salmon on HE because they are lactose fermenters
-Y. ENTEROCOLITICA also produces salmon color colonies on HE

92
Q

Organism that….

No growth on mac
Gram neg
Oxi pos
Nonmotile

A

Pasteurella

93
Q

What agar for Corynebacterium diphtheriae?

A

Loeffler agar

94
Q

what org Martin lewis look for?

A

Neisseria gonorrhoeae

95
Q

Martin-Lewis Agar is the formulation made after modification that contains an increased level of _____________ for greater inhibition of gram-positive organisms.

A

vancomycin

96
Q

Martin-Lewis Agar:

Vancomycin inhibits gram-_______ bacteria.

A

positive

97
Q

Martin-Lewis Agar:

colistin inhibits gram-__________ bacteria including the commensal Neisseria spp.

A

negative

98
Q

Martin-Lewis Agar:

__________ inhibits swarming of Proteus spp.

A

trimethoprim

99
Q

Martin-Lewis Agar:

_________ is an antifungal agent

A

nystatin

100
Q

Staining used for fungi that binds chitin and cellulose.

A

calcofluor stain

101
Q

Gardnerella is associated with what type of infection?

A

bacterial vaginosis

102
Q

What bacteria?

Pseudomembranous when toxin produced

A

Corynebacterium diphtheriae

103
Q

The bacteria that causes Whooping cough.

A

Bordetella pertussis

104
Q

How is Whooping cough (from Bordetella pertussis) confirmed?

A

with fluorescent antibody test

105
Q

Causes acute epiglottitis in children (Do not attempt throat culture; blood culture is best)

A

Hemophilus influenzae

106
Q

“Normal” flora of the throat, oropharynx?

A

Alpha strep, staph sp., Neisseria sp., Gram pos Rods anaerobes

107
Q

What two organisms can cause infection the eyes of newborns?

A

-Chlamydia
-Neisseria gonorrhoeae

108
Q

Bacteria associated with simmer’s ear

A

Pseudomonas aeruginoosa

109
Q

Two bacteria associated with otitis media infection?

A

-H. influenzae
-Streptococcus pneumoniae

110
Q

Criteria for a suitable sputum sample for testing?

A

Early morning sputum specimen is best; should have less than 10-15 squamous epith. cells per LPF

111
Q

Expected infection source for H. influenzae?

A

lower respiratory tract (sputum)

112
Q

Expected infection source for S. aureus

A

lower respiratory tract (sputum) (???)

113
Q

Expected infection source for Streptococcus pneumoniae?

A

lower respiratory tract (sputum)

114
Q

Expected infection source for Klebsiella pneumoniae?

A

lower respiratory tract (sputum)

115
Q

Expected infection source for Mycoplasma pneumoniae?

A

lower respiratory tract (sputum)

116
Q

Expected infection source for Mycobacterium tuberculosis?

A

lower respiratory tract (sputum)

117
Q

Expected infection source for Legionella?

A

lower respiratory tract (sputum)

118
Q

Expected infection source for Fungi?

A

lower respiratory tract (sputum) (others too)

119
Q

What type of bacterial infections are associated with transtracheal aspirate, and lung tissue?

A

anaerobes (normally should be sterile)

120
Q

AFB and mycology set-up should be used for __________ washings.

A

bronchial

121
Q

What is the test for H. pylori?

Where is the organicism found?

A

rapid urase test

stomach

122
Q

EIA is best for….

A

Clostridium difficile

123
Q

Genital tract infection that is significant in pregnant women?

A

Strep Group B

124
Q

What is used to culture BYCE (Buffered Charcoal Yeast Extract)?

A

Legionella

125
Q

fastidious slow growing obligate aerobe, use BYCE media

A

Legionella spp.

126
Q

What is in BYCE (Buffered Charcoal Yeast Extract) media?

A

-yeast extract
-L-cystine
-charcoal activate
-ferric pyrophosphate
-ACES (buffer for pH)
-alpha-ketoglutarate

127
Q

Quad plate interpretation:

Quad 1: growth
Quad 2: growth
Quad 3: growth
Quad 4:growth, no hemolysis

A

H. aphrophilus

128
Q

Quad plate interpretation:

Quad 1: no growth
Quad 2: no growth
Quad 3: growth
Quad 4: growth, no hemolysis

A

H. influenzae

129
Q

Quad plate interpretation:

Quad 1: no growth
Quad 2: growth
Quad 3: growth
Quad 4: growth, beta-hemolysis

A

H. parahaemolyticus

130
Q

Quad plate interpretation:

Quad 1: no growth
Quad 2: growth
Quad 3: growth
Quad 4: growth, no hemolysis

A

H. parainfluenzae

131
Q

H. influenzea:

requires X factor (hemin)?
V factor (NAD)?

A

yes, yes

132
Q

H. parainfluenzae:

requires X factor (hemin)?
V factor (NAD)?

A

no, yes

133
Q

H. aegyptius:

requires X factor (hemin)?
V factor (NAD)?

A

yes, yes

134
Q

H. haemolyticus:

requires X factor (hemin)?
V factor (NAD)?

A

yes, yes

135
Q

H. parahaemolyticus:

requires X factor (hemin)?
V factor (NAD)?

A

no, yes

136
Q

H. ducreyi:

requires X factor (hemin)?
V factor (NAD)?

A

yes, no

137
Q

Quad 1 contains…

A

Factor X (hemin)

138
Q

Quad 2 contains…

A

Factor V (NAD)

139
Q

Quad 3 contains…

A

Factor X and V

140
Q

Quad 4 contains….

A

horse blood agar (determines hemolysis pattern), contains both X and V factor.

141
Q

Which has growth in 3 out of the 4 on the quad plate?

A

H. para (quad 2, 3, and 4)

142
Q

between s.epi and s.aureus which has red growth on MSA (Mannitol Salt Agar)?

A

S. epidermidis (no fermentation)

S. aureus (yellow for fermentation)

143
Q

What type of media is Mannitol Salt Agar?

A

differential and selective

144
Q

MSA agar:

__________→ inhibitor
___________→ indicator

A

7.5% NaCl

Phenol Red

145
Q

Which organism has red slant for LIA?

A

Proteus

146
Q

LIA slant is used to identify __________ and ____________.

A

Salmonella and Shigella

147
Q

What is the indicator used for LIA slant?

A

Bromocresol purple***

148
Q

LIA slant:

__________ → Source of reduced sulfur

A

Sodium Thiosulfate

149
Q

LIA slant:

purple color throughout indicates…

A

Lysine Decarboxylation***

150
Q

Lysine Decarboxylation (on LIA slant):

If the organism produces lysine decarboxylase, it removes CO2 from L-lysine and forms __________ (alkaline)

A

cadaverine***

151
Q

LIA slant, Lysine Deamination:

ysine deamination will only be seen in the slant because…

A

It requires oxygen

152
Q

LIA slant, Lysine Deamination:

If the organism produces lysine deaminase, ferric ammonium citrate & Flavin mononucleotide, forming a ______________ color on the slant

A

burgundy (dark red)

153
Q

LIA slant:

Red slant/yellow butt =

A

Lysine deamination

154
Q

What are the sugars in HE agar?

A

***lactose and sucrose

155
Q

HE
(Hektoen Enteric):

What are the indicators?

A

Bromothymol blue and
Acid fuchsin

156
Q

HE
(Hektoen Enteric):

lactose positive is _______ in color.

A

Salmon

lactose neg = Green to Blue
(H2S+ = Black)

157
Q

HE
(Hektoen Enteric):

What is the selective agent?

A

bile salts

158
Q

HE
(Hektoen Enteric):

Wht is the H2S indicator?

A

Sodium Thiosulfate

159
Q

HE
(Hektoen Enteric):

Differentiating agent?

A

Lactose
Sucrose
Salicin

160
Q
A

Medical Microbiology (12 decks)

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