FA Micro II Flashcards
Which kind of neisseria is sexually transmitted
gonococci
What does gonococi cause
gonorrhea, septic arthritis, neonatal conjunctivitis, PID, fitz-hugh curtis
What does meningococci cause
meningitis, waterhouse friderichsen,
What drug is give as prophylaxis for close contacts of of meningococci
rifampin
haEMOPhilus causes….
epiglottitis (cherry-red in kids) meningitis, otitis media and pneumonia
what is the most invasive H flu disease caused by and what virulence factor does it produce
type B protease IgA
What are the laboratory findings for H Flu
gram neg coccobacillary rods, cultured on chocolate agar with factors V and X NAD+ and hematin OR with S. aureus
What is the treatment for meningitis from H flue
ceftriaxone, rifampin for close contacts
What is the H flu vaccine
type B capsular polysaccharide conjugated to diptheria toxoid or other protein
When is H flu vaccine give
between 2 and 18 months
What is legionnaires disease
severe pneumonia
What is pontiac fever
mild flulike symptoms with legionella
What are the laboratory findings of legionella
gram neg rod, poor gram stain, use silver stain, grow on charcoal yeast extract with iron and cysteine
How is legionella detected clinically
antigen in urine
How is legionella transmitted
aerosal, from environmental water source
Is there person to person transmissino of legionella and what is the TX
no, erythromycin
What are the assiaction of pseudomonas and what can it cause
wound and burn infectinos - Pneumonia in CF, sepsis, external otitis (swimmer’s ear), UTI, drug use and diabetic osteomyelitis and hot tub follculitis
What malignancy is pseudomans associated with in diabetics
malignant otitis externa
What are the lab findings of pseudomonas
aerobic gram pos rod, non lactose fermenting, oxidase pos, blue-green pigment, grapelike odor
What is the source of pseudomonas and what does virulence factors does it have
water source, endotoxin causing fever and shock, exotoxin A (inactivates EF-2)
What is the TX for pseudomonas
aminoglycoside plus extended spectrum pen (pipercillin, ticarcillin)
what are the different virulence factors in E. coli and what do they cause
fimbriae- cystitis and pyelonephritis; K capsule - pneumonia, neonatal meningitis, LPS endotoxin - septic shock
What is the presentation of EIEC and what is the mechanism of the toxin
invasive, dysentary - shiga like toxin; microbe invades mucosa and toxin causes necrosis and inflammation
What is the presentation of ETEC and what is the mechanism of the toxin
traveler’s diarrhea -labile toxin/stable toxin - no inflammatino or invasion
What is the presentation of EPEC and what is the mechanism
diarrhea in children - no toxin, adheres to apical surface, flattens villi, prevents absorption
What is the presentation and mechanism of toxin in EHEC
dysentery from shiga like toxin, O157:H7 is common serotype, produces HUS
What is the triad of HUS
anemia, thrombocytopenia, acute renal failure
What is the mechanism of renal failure and thrombocytopenia in HUS
endothelium swells and narrows lumen, leading to mechanical hemolysis and reduced renal blood flow - damaged endothelium consumes platelets
How do you distinguish EHEC from other kinds of E. Coli
does not ferment sorbitol
Intestinal flora that causes lobar pneumonia in alcoholics and diabetics when aspirated
klebsiella
What color is the sputum in klebsiella infxn an besides pneumonia, what else can it cause
red current jelly, nosocomial UTI
What features are common to both salmonella and shigella
both are lactose fermenters, both invade intestinal mucosa and can cause blood diarrhea
What features are unique to salmonella
have flagella, disseminate hematogenously, produce H2S, symptoms can be prolonged with Abx, typically a monocytic response
What feature is unique to shigella
more virulent - 10^1 vs 10^5 organisms
What does salmonella typhi cause
fever diarrhea, headache, rose spots on abdomen
Where can salmonella typhi remain chronically
gallbladder
What is the resevoir of salmonella
animal, except typhi - only in humans
How do shigella propel themselves without flagella
actic polymerization
What is the mode of transmission of salmonella and shigella
food, fingers, feces, flies
This bacteria is a majore cause of bloody diarrhea, esp in children, fecal-oral transmission through mean (poultry, met unspasteurized milk
campylocobacter jejuni
What shape are campylobacter and what are the lab findings
comma shaped, s-shaped, oxidase positive, grows at 42 C
Campylobacter is a common antecedent to what neurologic disorder
guillain barre
What does infxn with vibrio cholerae produce and how does it produce it
profuse rice water diarrhea via toxin that permantnely activates Gs inc cAMP
What are the lab findings for cholera
comma shaped, oxidase positive, grows in alkaline media
What treatment is required for cholera
prompt oral rehydration
this bacteria is usually transmitted from pet feces, contaminated milk or pork - what does it cause
yersinia, enterocolitica - diarrhea (in day care centers), causes mesenteric adenitis
What other disease can mesenteric adenitis mimic
crohns or appendicitis
This bacteria causes gastritis and up to 90% of duodenal ulcers, risk factor for peptic ulcer, gastric adenocarcinoma, lymphoma
H. pylori
What are the lab findings for H pylori
gram neg rod, urease pos, creates alk envrionment
What is the TX for h pylori
triple therapy - metronidazole, bismuth, either tetracycline or amoxicillin OR metro, omeprazole and clarithromycin
Which bacteria are spirochetes
Borrelia, leptospira, treponema
Which spirochete can be visulized using aniline dyes in light microscopy
only borrelia
How is treponema visualized
dark field microscopy
What question mark shaped bacteria is found in water contaminated with animal urine and what does it cause
leptospira interrogans - flulike symptoms, fever, HA, abdominal pain, jaundice, and photophobia with conjuctivitis
Who mostly gets infected with leptospira
surfers in the tropics
What is weil’s disease
icterohemorrhagic leptospriosis - sever form with jaundice and azotemia from liver and kidney dysfxn, ; fever hemorrhage and anemia
What bacteria causes Lyme disease, how is transmitted, how does it present, and what other systems does it effect
borrelia burgdorferi, transmited by Ixodes, erythema chronicum migrans (bulls eye rash with central clearing) effects joints, CNS and heart
What are important resevoirs for borrelia and what animal is required for tick life cycle
mice, deer
How do you treat lyme disease
doxycycline and ceftriaxone
What happens in stage 1 of lyme disease
bulls eye rash, flulike symptoms
What happens in stage 2 of lyme disease
neurologica like bell’s palsy and cardiac AV block
What happens in stage 3 of lyme disease
chronic monoarthritis and migratory polyarthritis
What organism causes syphillis and what happens in primary syphillis
treponema palladium, painless chancre
What happens in secondary syphillis
disseminated disease with constintutional symptoms including maculopapular rash on palms and soles, condylomata lata
What is present in the condylomata and chancres in primary and secondary syphillis
many treponemas
What happens in tertiary syphillis
gummas (chronic granulomas), aortitis (vasa vasorum destruction) neurosyphillis (tabes dorsalis), argyll robertson pupils
What are the signs of neurosyphillis
broad based ataxia, positive ataxia, charcot joint, stroke without HTN
What test screens for syphillis and what test confirms it
VDRL screens and FTA-ABS
What are agryll roberston pupils
accommodate but does not react, associated with tertiary syphillis
What is the treatment for syphillis
pen
What does VDRL detect, what it is used for and what are the limitations
nonspecific antibody test that reacts with beef cardiolipin, used for screening of syphillis but many biologic false pos including viral infection (mono or hepatitis) some drugs, rheumatic fever, SLE and leprosy (V=viruses, D =drugs R = rheum fever L = leprosy and lupus
Cat scratch disease, can cause bacillary angiomatosis in immuncoCised patients, can be confused with KS
bartonella sp
lyme dz, ixodes tick that lives on deer and micd
borrelia burgdorferi
recurrent fever from variable surface antigen, transmitted by louse
borrelia recurrentis
undulant fever, transmitted in dairy products, contact with animals
brucella sp
tularemia, tick bite, rabbits and deer
francisella tularenis
plague, flea bite, rodents esp prarie dogs
yersinia pestis
cellulitis, osteomyelitis from animal bite: cats and dogs
pasteurella multocida
pleomorphic gram variable rod that causes vaginosis presenting as gray vaginal discharge with a fishy smell; non painful
gardnerella vaginalis
What other organism is involved in vaginosis from gardnerella
mobiluncus, an anaerobe