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Clinical Micro > Final > Flashcards

Final Flashcards

1
Q

If a GNB can only grow on chocolate agar it would be considered fastidious__.
List some of these organisms

A

•Neisseria Gonorrhea

Haemophilus

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2
Q

Mac is?

A

Selective and differential

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3
Q

MAC that turns pink indicates?

A

Lactose fermentation

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4
Q

How do we quantitate CFUs in a urine culture?

A

Count multiplied by 1000.

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5
Q

S. aureus morph and bio-chem testing?

A

Smooth, buttery, creamy yellow

Catalase (+)
Coagulation bound & free (+)

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6
Q

Size, shape, color, size, growth, surface, margin, elevation and hemolysis characteristics describe?

A

Colonial morph

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7
Q

Types of margins?

A

Smooth (Entire)

Rough

Irregular

Curled

Filamentous

Swarming

Star-like (Yeast)

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8
Q

Mutation

A

Change in DNA coding for an organism.

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9
Q

Where do mutations occur?

A

Cell division

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10
Q

Antigen

A

Something from outside/inside, causes body to antibodies.

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11
Q

Antibody

A

Produced against antigen.

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12
Q

S. pneumo when treated W/ bile?

A

Melts in bile.

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13
Q

What is the test on s. Pneumo W/bile?

A

Bile solubility test

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14
Q

PMNs or nets in a gram stain are a sign of?

A

Infection

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15
Q

Special quality of some bacillus?

A

Spore former (Heat resistant)

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16
Q

Camp Test

A

Causes arrowhead, when it touches S. aureus.

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17
Q

When an arrowhead reaction is seen, what happens to the hemolysis?

A

Stronger beta hemolysis

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18
Q

CAMP positive organisms?

A

GBS A. galactiae

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19
Q

Modes of direct transmission?

A

Hand to hand contact

Sex

Congenital

Droplet

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20
Q

Modes of indirect transmission?

A

No hand contact: Fomites, water, food, animals, vectors, airborne (Inhalation, aerosols,)

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21
Q

IMVC: ++–, glucose +, nitrate +, TDA -, citrate -, H2S-, ONPG +, TSI A/A + gas, LDC +, unease-

A

E. coli

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22
Q

DNase +, Lipase +, Gelatine +,
Glucose +, nitrate +, citrate +, LDC +, ODC +, H2S -, Red pigment

A

S. marcescens

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23
Q

H2S+, Urease-, Motility+, ONPG+, LDC+, lactose-

A

Salmonella

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24
Q

Glucose+, nitrate+, LDC-, Citrate-, H2S-, lactose-, non-motile

A

Shigella

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25
Q

H2S+, glucose +, nitrate +, citrate -, indole-

A

Salmonella typhi

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26
Q

Glucose+, nitrate+, TDA+, urease+, H2S+, indole+

A

Proteus vulgaris

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27
Q

Oxidase+, indole+, arginine-, TSI K/A, 6% NaCl growth+, TCBS agar blue-green

Vibrio

A

Vibrio parahemolyticus

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28
Q

Oxidase+, TSI A/A, indole+, arginine+, lysine+, ornithine-

A

Aeromonas hydrophilia

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29
Q

oxidase +, catalase +, urease -, Hippurate hydrolysis +, growth temps 25 – 37 +, nalidixic acid S, cephalothin R, darting motility, microaerophilic

Associated infections: Bacteremia, Endocarditis, meningitis, wound infections, pneumonia.

Multiple ABX resistances

White pinpoint colonies on SBA W/ increased CO2

“Gull-wings”

A

Campylobacter jejuni

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30
Q

glucose +, TDA -, citrate +, LDC +, ODC -, indole -, oxidase -, VP +, mucoid +, motility -, ADH -

A

Klebsiella pneumoniae

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31
Q

oxidase +, oxidizes glucose +, yellow pigment

A

Chryseobacterium or
Elizabethkingia

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32
Q

TCBS agar green colonies, oxidase +, glucose fermentation +, lactose fermentation +, sucrose fermentation -, LDC +, ODC +, ADH -

A

Vibrio vulnificus

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33
Q

oxidase -, TSI A/A, indole -, urease +, ODC +, sucrose +, H2S -, motility
at 25 C +

A

Yersinia Enterocolitica

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34
Q

TSI K/A gas +, H2S +

A

Salmonella typhimurium

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35
Q

violet pigment, almond smell, MAC growth +, growth at 42 C +, oxidase +, glucose fermentation +, indole -

A

Chromobacterium

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36
Q

morph GN coccobacilli, oxidase -, catalase +, nitrate -, ONPG -, LDC -, ODC -

A

Acineobacter baumannii

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37
Q

oxidase W+, TSI K/K, glucose oxidation +, lactose oxidation +, maltose oxidation +, mannitol oxidation +, fluorescence -,
LDC +

Commonly seen in PTs W/ Cystic fibrosis

A

Burkholderia cepacia

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38
Q

glucose +, gas +, indole -, urease +, TDA +, H2S +

A

Proteus mirabillis

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39
Q

green pigments pyocyanin & pyoverdin, grape smell, ADH +, LDC -, ODC +, most isolated non-fermenter, alginate capsule, oxidase +, nitrate +,
70-80% of all isolated
non-fermenters, found t/o environment & nature?

A

Pseudomonas aeruginosa

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40
Q

Pyocyanin Pigment?

A

blue pigment that is soluble in water and choloroform.

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41
Q

Pyoverdin pigment?

A

Yellow- yellow/green fluorescent pigment.

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42
Q

Pseudomonas aeruginosa is intrinsically resistant to?

A

Penicillin

Ampicillin

1st & 2nd gen cephalosporins

Trimethoprim

Chloramphenicol

Tetracyclines

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43
Q

What acquired resistance can P. aeruginosa gain, especially as an HAI?

A

Aminoglycosides (Tobra, gent, amikacin)

Beta-lactams

Carbapenems

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44
Q

Non-motile, weakly oxidase positive, only non-motile pseudomonad, possible bioterrorism, on SBA smooth cream-white colonies, “Glanders”

A

Burkholderia mallei

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45
Q

abundant H2S + motility, gas +, indole +

A

Edwarsiella spp

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46
Q

Endogenous infection

A

Something of normal flora, traumatically introduced to sterile site.

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47
Q

Nosocomial infections

A

HAIs (MRSA)

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48
Q

Community acquired infections?

A

Normal everyday environment, associated W/ the patient (GBS).

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49
Q

What is our primary stool pathogen?

A

Toxigenic E. coli (0157, ETEC, EHEC)

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50
Q

Most common primary stool pathogens?

A

Shigella and Salmonella

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51
Q

Other common stool pathogens?

A

Yersinia and Campylobacter

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52
Q

What agars can be used to isolate stool pathogens?

A

XLD

HE

SS

EMB

Campy plates

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53
Q

What are peak levels?

A

Highest level of antibodies in the body, any higher could kill someone.

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54
Q

What is a trough level?

A

Lowest level of antibodies in the body, any lower would allow microbial growth.

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55
Q

When are trough levels drawn?

A

Just before next dose.

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56
Q

What is the range between peak and trough levels?

A

Therapeutic range

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57
Q

What are some medications that have peak and trough levels drawn?

A

Vancomycin

Gentamycin

Amikacin

Tobramycin

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58
Q

Define fermentation?

A

The chemical breakdown of an organic compound.

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59
Q

What is the product of fermentation?

A

Acid

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60
Q

Types of immunity?

A

Humoral- Adaptive

Innate-Inborn

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61
Q

Characteristics of GN cell walls?

A

Thinner layer of peptidoglycan

Outer membrane of lipopolysaccharide.

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62
Q

Characteristics of GP cell walls?

A

Thick peptidoglycan

Allows them to hold crystal violet (W/ mordant- Iodine)

Teichoic acid

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63
Q

Pseudomonadaceae was first isolated from?

A

Soldier’s wounds oozing a green exudate.

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64
Q

Describe the Proteus genus?

A

UTIs of the urinary tract

Swarming motility on SBA

Wound Infections

Soil, water, or fecal-contaminated materials

Not mucoid

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65
Q

Labelled Immunoassays?

A

Immuno-fluorescent testing, used in Legionella or Bortella diseases.

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66
Q

Types of labeled immunoassays?

A

Antibody labelled for antigen assay (Direct)

Antibody labelled for antibody assay (Indirect)

Antigen labelled for antibody assay.

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67
Q

AB labelled for antigen assay?

A

Direct fluorescent assay (DFA)

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68
Q

Antibody labelled for antibody assay?

A

Indirect fluorescent assay (DFA)

69
Q

EIA?

A

Enzyme-linked Immunosorbent Assay (ELISA), also called Enzyme Immunoassay (EIA).

70
Q

EIA’s clinical applications?

A

Antigens of: Giardia, Cryptosporidium, viral antigens.

Antibodies of: Legionella, mycoplasma, Borrelia burgdorferi (Lyme disease), viruses.

71
Q

What is used to detect Chlamydia and N. gonorrhoeae?

A

PCR testing

72
Q

Are EIAs qualitative or quantitative?

A

Both

73
Q

Bacterial modes of resistance to antimicrobial agents?

A

Efflux

Modification to targe site for antibodies.

Decreasing cell wall permeability.

Enzymatic (B-lactam)

Alterations of the porin.

74
Q

What is the complement complex?

A

20 different proteins that are reactive for inflammation.

75
Q

What is the latex agglutination test?

A

testing for the antibody-antigen complex, creates particulates in the sample.

76
Q

Why is latex used in the agglutination test?

A

It is a detector W/ multiple active sites and it is bio chemically inert.

77
Q

What is an organism positive on the latex agglutination test?

A

S. aureus

78
Q

What is the microscopic arrangement of micrococcus?

A

GP clusters

79
Q

Microscopic arrangement of streptococcus?

A

GP chains

80
Q

Neisseria’s arrangement?

A

GN diplococci in pairs

81
Q

GPB W/ terminal spores?

A

Clostridium

82
Q

Spore forming GNB?

A

B. Cereus

B. anthracis

83
Q

Non-spore forming GNB

Non-branching

Catalase (+)

Non-acid fast

L or V shapes

Club-shaped

SBA or Chocolate

A

Corynebacterium

84
Q

Bench tests?

A

Catalase

Oxidase

Coagulase

Urease

Indole

PYR

Hippurate Hydrolysis

Beta-Lactamase

85
Q

Antigen

A

Foreign compounds that stim an immune response.

86
Q

Antibodies

A

Proteins formed in response to stimulation from antigens.

87
Q

Affinity

A

strength of the reaction

88
Q

Avidity

A

strength of the bond

89
Q

Epitope

A

part of the antibody that reacts W/ antigen (antigenic determinant.

90
Q

Specificity

A

ability of an antibody to distinguish between Antigens, that have very small differences.

(Like what they like)

91
Q

Cross-reactivity

A

antibody that is specific for 1 antigen reacts W/ another antigen W/ similar structure.

92
Q

Sensitivity

A

ability to detect small amounts of antigen or antibody.

93
Q

What does the Cefinase antibody susceptibility test for?

A

Beta-lactamase resistance

94
Q

Cefoxitin disk diffusion screen test for?

A

Methicillin resistance s. aureus

95
Q

What test is used for penicillin resistance in S. pneumoniae?

A

Oxacillin test

96
Q

Acquired resistance means?

A

Gained from another bacteria, via plasmid transfer.

97
Q

Intrinsic resistance means?

A

Inborn resistance

98
Q

What do bacteria use to move?

A

Flagella

99
Q

What part of a bacteria makes it antiphagocytic?

A

The capsule

100
Q

Lipopolysaccharide membrane helps W/?

A

Attachment

101
Q

Barlett’s classification indicates what?

A

Inflammation

102
Q

What does Bartlett’s classification compare?

A

Neuts in sputum to epi cells.

103
Q

Scoring system for Neuts per low power field?

A

< 10 = 0

10-25= +1

> 25 = +2

Mucus= +1

104
Q

Scoring system for Epi cells per low-power field?

A

10-25 = -1

> 25 = -2

105
Q

Scores of what indicate a lack of inflammation or presence of saliva?

A

0

106
Q

An endogenous infection commonly caused by E. coli?

A

UTIs

107
Q

In nucleic acid testing, what does target mean?

A

Sequence of interest in suspected organism.

108
Q

What is a probe in nucleic acid testing?

A

fully ID a specimen.

109
Q

Bacteremia

A

bacteria in the blood

110
Q

Septicemia

A

inflammation response to bacteria in the blood.

111
Q

Septic shock

A

Organ shut down

112
Q

What part of S. pyogenes cause necrotizing fasciitis?

A

Pyogenic Exo-toxin

113
Q

H. influenzae growth requirements?

A

Requires X and V factors

Beta-hemolytic on rabbit blood agar ( - ).

114
Q

H. parainfluenzae growth requirements?

A

Requires V factor

115
Q

H. haemolyticus growth requirements?

A

Requires X and V factors

Beta-hemolytic on rabbit blood agar (+)

116
Q

H. parahaemolyticus growth requirements?

A

Requires V factor

Beta-hemolytic on rabbit blood agar (+)

117
Q

N. gonorrhoeae produces infections where?

A

Children during birth (Eyes)
(Ophthalmia Neonatorum)

Gonorrhoeae of the knees

STDs

118
Q

How can we biochemically ID S. agalactiae?

A

Bacitracin test (R)

PYR (+)

Camp factor (+)

119
Q

All Enterobacteriaceae are negative for?

A

Oxidase

120
Q

What is the only enterobacteriacea, that is oxidase negative?

A

Plesiomonas

121
Q

How can Legionella spread?

A

Potable water

A/C

122
Q

What is listeriosis?

A

ingested contaminated foods (meats, dairy, veggies, fruits)

Causes: meningitis, conjunctivitis, endocarditis, septicemia

123
Q

Listeria monocytogenes

A

Tiny, GP diphtheroid

124
Q

Catalase positive

Oxidase negative

H2S negative

Tumbling motility

Bile esculin positive

CAMP: Rectangle with beta-hemolytic S. aureus

Can survive refrigerator temperatures

A

Listeria monocytogenes

125
Q

Non-Spore forming

GPB

Non-branching

Catalase ( - )

Normal mouth flora

Produce large amounts of lactic acid.

Tolerates acidic pH of 3-4

A

Lactobacillus acidophilus

126
Q

Bacterial Vaginosis

Pleomorphic

Gram variable- GPB

Fastidious

Grows on SBA, Chocolate

Loves human blood agar

Clue cells

A

Gardnerella vaginalis

127
Q

Branching filaments that fragment into rods and cocci.

Slow growers

Variable colonial morph

Found in soil and water

A

N. asteroids

128
Q

Virulence factors of S. aureus?

A

Protein A- inhibits complement fixation

Capsular polysaccharide- antiphagocytic

Peptidoglycan and teichoic acid- attach to mucous membranes and sustain environmental stresses.

Penicillin binding protein (2)

129
Q

S. aureus extracellular toxins?

A

Hemolysin

Clumping factor

Staphylocoagulase

Staphylokinase- Fibrinolysin (Infection spreader)

130
Q

S. aureus enzymes and exotoxins?

A

Lipase- hydrolyze lipids

Exfoliative A & B toxins- hydrolyze tissue

Hyaluronidase- lyses hyaluronic acid in connective tissue

Leukocidin- toxic to neuts and macros

131
Q

Superantigens

A

Includes enterotoxins and other pyogenic toxins that promote cytokine release and progression of toxic shock syndrome.

132
Q

Superantigen example?

A

Toxic-shock syndrome toxin (TSST-1)

133
Q

How are shigella and klebsiella similar?

A

Non-motile

134
Q

E. coli’s appearance on MAC plates?

A

Pink because it’s a lactose fermenter

135
Q

E. coli on EMB plates?

A

Ferment lactose and turn agar green.

136
Q

How is Y. pestis spread (plague)?

A

Rats and rat fleas

137
Q

GN straight/curved bacilli

Facultative Anaerobe

Oxidase (+)

Catalase (+)

Ferments carbs

A

Vibrio

138
Q

Classic strain Non-hemolytic

El tor strain Beta-hemolytic

Can have choleragen toxin (CT)

Ferment glucose and sucrose

Indole (+)

LDC (+)

ODC (+)

ADH ( - )

String test (+)

A

Vibrio cholerae

139
Q

Nonhemolytic on sheep blood agar

TCBS: Green colonies

Ferments glucose

Halophilic (will not grow in nutrient broth without NaCl)

Oxidase and indole positive

LDC and ODC positive

ADH negative

Vibrio spp

A

Vibrio parahaemolyticus

140
Q

TCBS Green colonies

Ferments glucose and LACTOSE

Halophilic

Oxidase and indole positive

LDC and ODC positive

ADH negative

A

Vibrio vulnificus

141
Q

Curved GNB

Motile

Polar glaellum

Microaerophilic

Capnophilic

Oxidase (+)

Non-saccharolytic

Very low infectious load

A

Campylobacteraceae

142
Q

Enteric Campylobacters?

A

C. jejuni

C. coli

143
Q

Most infectious campylo

Curved bacilli (may appear S-shaped)

Growth @ 42 degrees (slow @ 37)

Catalase and oxidase (+)

No carb oxidation/ferment

Cephalothin (R)

Nalidixic acid (S)

A

Campylobacter jejuni

144
Q

How do we differentiate C. jejuni and c. coli, when all the tests are the same?

A

Nalidixic acid or cephalothin testing

145
Q

Rare cause of extraintestinal infections.

Febrile systemic disease

Does not grow @ 42 degrees

Similar bio-chemically to C. jejuni and C. coli

A

C. fetus

146
Q

Helicobacter

Stomach is the natural habitat

Strong urease (+)

Motile W/ 4-6 polar flagella

Oxidase (+)

Microaerophilic

Curved GNB U shape

Hippurate ( - )

A

H. pylori

147
Q

How can we non-invasively confirm Hl pylori?

A

Urease breath test

148
Q

Shigella and salmonella differentiate from other enterobacteriaceae on HE and XLD?

A

Non-lactose fermenter

149
Q

How can you differentiate Acinetobacter and Neisseria?

A

Neisseria is oxidase (+)

150
Q

Lancefield Group A?

A

Strep throat

Pyoderma

Streptococcal toxic shock syndrome

Necrotizing fasciitis

151
Q

Lancefield Group B?

A

Neonatal bacteremia

Pneumonia

Meningitis

152
Q

Lancefield Group D

A

UTIs

Intra-abdominal infections

Endocarditis

VRE

153
Q

Lancefield Group F?

A

Wound infections

154
Q

What type of infections does Pasteurella cause?

A

Wound infections

155
Q

Early sign of Lyme disease?

A

Erythema migrans rash (bull’s eye)

156
Q

What is the RPR test?

A

Rapid plasma reagin

Syphilis, caused by Treponema pallidum

157
Q

Anthrax types?

A

Cutaneous

Inhalation (pulmonary)

Gastrointestinal/Oropharyngeal

Injectional

158
Q

Inhibits GPC W/ Vancomycin

Inhibits GNB W/ Colistin

A

Modified Thayer-Martin Agar
(MTM)

159
Q

Veterinary pathogen

Contaminated milk or infected livestock

Rare lymphadenitis

A

C. pseudotuberculosis

160
Q

How can S. lugdunensis be mistaken for S. aureus?

A

It is bound coagulase (+)

S. aureus is bound and free coagulase (+)

161
Q

Shiga- toxin producer

Most common serotype is 0157:H7

Bloody diarrhea

A

Enterohemorrhagic E. coli (EHEC)

162
Q

How are the ABXs related?

Penicillin, Cephalosporins, Vancomycin

A

Cell wall synthesis inhibitors

163
Q

What does tetracycline, erythromycin, and chloramphenicol ABXs have in common?

A

Protein synthesis inhibitors

164
Q

Sulfonamide ABXs work by?

A

Producing antimetabolites or are antimetabolites

165
Q

All staph organisms grow on what?

A

MSA

166
Q

Virulence factors of GAS?

A

Streptococcal pyogenic exotoxins or superantigens

Streptolysin O- lyses blood cells, oxygen liable, very immunogenic.

Streptolysin S- lyses RBCs and PLTs.

Streptokinase- fibrinolysin

M (emm) protein-antiphagocytic

167
Q

Bile esculin (+)

6.5% NaCl broth (+)

PYR ( - )

Penicillin (R)

A

Enterococcus

168
Q

The EM rash (Bull’s eye) is diagnostic for what?

A

Lyme disease

169
Q

Borrelia recurrenitis is the etiologic agent for what?

A

Relapsing fever

Clinical Micro (2 decks)

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