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STEP 1: MICRO > GRAM - > Flashcards

GRAM - Flashcards

1
Q

Diplococci, maltose & glucose oxidizer

A

Neissieria meningitidis

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2
Q

Diplococci, only glucose oxidizer

A

Neissieria gonorrhoeae

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3
Q

Diplococci, oxidase +

A

Moraxella catarrhalis

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4
Q

Bacillus, lactose fermenter/pink on MacConkey’s agar, fast fermenter

A

Klebsiella pneumoniae

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5
Q

Bacillus, lactose fermenter/pink on MacConkey’s agar, fast fermenter, indole +

A

Escherichia coli

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6
Q

Bacillus, lactose non-fermenter/white on MacConkey’s agar, oxidase -, produces H2S (black on TSI agar), urease -

A

Salmonella spp. (typhi and enteritidis)

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7
Q

Bacillus, lactose non-fermenter/white on MacConkey’s agar, oxidase -, produces H2S (black on TSI agar), urease +

A

Proteus mirabilis

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8
Q

Bacillus, lactose non-fermenter/white on MacConkey’s agar, oxidase -, does not produce H2S (not black on TSI agar)

A

Shigella sonnei/flexerni

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9
Q

Bacillus, lactose non-fermenter, oxidase +, glucose non-fermenter

A

Pseudomonas aeruginosa

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10
Q

Bacillus, lactose non-fermenter, oxidase +, glucose fermenter

A

Vibrio cholerae

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11
Q

Bacillus, lactose non-fermenter, motile at 25 C but not 37 C

A

Yersinia enterocolitica

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12
Q

Bacillus, lactose non-fermenter, bipolar staining

A

Yersinia pestis

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13
Q

Bacillus, curved small growth on Campy agar, urease +

A

Helicobacter pylori

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14
Q

Bacillus, curved small growth on Campy agar, urease -

A

Campylobacter jejuni

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15
Q

Bacillus, strict anaerobe

A

Bacteroides fragilis

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16
Q

Coccobacilli, factors V and X required

A

Haemophilus influenza B

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17
Q

Cocobacilli, growth on Bordet-Gengou medium

A

Bordetella pertussis

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18
Q

Neissieria meningitidis

A

Diplococci, maltose & glucose oxidizer

IgA protease
LPS capsule (pt goes into shock after antibiotics because the bacterial cells lyse and LPS runs wild)

Respiratory and oral secretions
Vaccine
Rifampin for prophylaxis

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19
Q

Neissieria gonorrhoeae

A

Diplococci, only glucose oxidizer

IgA protease
NO LPS capsule

Grows on Thayer-Martin media, which contains vancomycin, polymixin, nystatin

20
Q

Moraxella catarrhalis

A

Diplococci, oxidase +

IgA protease
No capsule

Ear and sinus infections

21
Q

Klebsiella pneumoniae

A

Bacillus, lactose fermenter/pink on MacConkey’s agar, fast fermenter

Urease +
Capsule

Lobar pneumonia (esp. in alcoholics)
-Must aspirate (normal gut flora)
-Cause abscesses in LOWER lung
-Horrible breath
-Red currant jelly sputum
UTI and would infections
-More common
-Diabetics and immunocompromised
22
Q

Escherichia coli

A

Bacillus, lactose fermenter/pink on MacConkey’s agar, fast fermenter, indole +
Blue/Black metallic sheen on EMB agar

Fimbriae=attaches to uroepithelium and travels up–>cystitis and pyelonephritis
K capsule=enables it to be invasive
LPS capsule=shock

23
Q

Salmonella enteritidis

A

Bacillus, lactose non-fermenter/white on MacConkey’s agar, oxidase -, produces H2S (black on TSI agar), urease -

Motile and disseminates (“swims like a salmon”)

Invades M cells of intestines: fever, headache, bloody, inflammatory, diarrhea

In sickle cell pts who get Salmonella, osteomyelitis is a common complication

24
Q

Proteus mirabilis

A

Bacillus, lactose non-fermenter/white on MacConkey’s agar, oxidase -, produces H2S (black on TSI agar), urease +

***Swarming motility on agar

Urease positive–>stag horn calculi/struvite stone/stone shaped like renal calyx, which can also be a nidus for UTIs

25
Q 
Shigella sonnei (USA and Europe)
Shigella flexerni (third world countries)
A

Bacillus, lactose non-fermenter–>white/yellow on MacConkey’s agar, oxidase -, does not produce H2S (not black on TSI agar)

Invades M cells of intestines
Non-motile, no flagella
Propel from cell to cell using actin polymerization (similar to, but not the same as Listeria)

Shiga toxin (similar to EHEC)=cleaves 60s subunit of rRNA and releases cytokines-->necrosis and inflammation of mucosa-->profuse bloody diarrhea, high fever, large & painful bowel movements, abdominal cramping, leukocytes in stool
[shiga toxin is phage encoded transferred in lysogenic phage

Complications

  • HUS (shiga toxin, much like EHEC)
  • Reactive arthritis (Reiter’s syndrome)
  • Seizures in children
26
Q

Pseudomonas aeruginosa

A

Bacillus, lactose non-fermenter, oxidase +, glucose non-fermenter
Aerobic

Exotoxin A=similar to diphtheria toxin–>inactivates EF-2 via ADP ribosylation
Endotoxin=capsule causing fever and shock
Pyocin–>Gives blue-greeen pigment
Alginate=biofilm

Think “PSEUDO”

  • Pneumonia
  • Sepsis
  • External otitis
  • UTI
  • Diabetic/Druggy Osteomyelitis

Tx ALWAYS w/ more than one antibiotic–>use strong gram neg=aminoglycoside + “antipseudomonals” (ticarcillin, pipercillin)

27
Q

Vibrio cholerae

A

Bacillus, lactose non-fermenter, oxidase +, glucose fermenter, alkaline media

***Rice water diarrhea (profuse, watery diarrhea)

Cholera toxin=permanently activates Gs–>↑cAMP (cholera toxin encoded by lysogenic phage)
TCP (toxin coregulated pilus)=required for colonization

28
Q

Yersinia enterocolitica

A

Bacillus, lactose non-fermenter, motile at 25 C but not 37 C

Day care diarrhea, puppy poop

Terminal ileitis: fever, RLQ pain, diarrhea (no diarrhea in appendicitis), mesenteric adenitis

Siderophilic
Very common in hemochromatosis pts

29
Q

Yersinia pestis

A

Bacillus, lactose non-fermenter, bipolar staining

Flea bite

“The Plague”

  • Fever, large painful lymph nodes in axilla or inguinal area, failure to respond to antibiotics
  • Pneumonia
  • Sepsis
  • Can lead to DIC
30
Q

Helicobacter pylori

A

Bacillus, curved small growth on Campy agar, urease +

CagA=inflammation and ulceration
VacA=damages epithelial cells

Causes most gastric and duodenal ulcers–>epigastric pain, belching, dyspepsia, nausea, melena
Causes acute and chronic gastritis
Associated with greater risk of stomach cancer

Diagnose w/ H2 breath test, esophageal pH test, and biopsy
Tx w/ 2 antibiotics (METRONIDAZOLE plus either tetracycline, amoxicillin, or clarithromycin) plus a “stomach soother” (Pepto-Bismol or PPI like omeprazole)

31
Q

Campylobacter jejuni

A

Bacillus, curved small growth on Campy agar (***Seagull-shaped), urease -, oxidase +, grows at 42 C

Inflammatory diarrhea with mucus, pus, and WBC in stool

Associated w/ Guillan-Barre Syndrome

32
Q

Bacteroides fragilis

A

Bacillus, strict anaerobe

Usually forms abcess
MC anaerobe in anaerobic peritoneal infections

33
Q

Haemophilus influenza B

A

Coccobacilli, factors V and X required
***CHOCOLATE AGAR (contains factor V=NAD+ and factor X=hematin)

IgA protease
Capsule–>+Quellung reaction

Otitis media, pneumonia,meningitis
***EPIGLOTTITIS (respiratory stridor, hot potato voice, barking cough, fever, drooling)

Vaccine available (type B capsular polysaccharide attached to diphtheria toxoid)
Tx with Ceftriaxone
Prophylaxis w/ Rifampin

34
Q

Bordetella pertussis

A

Cocobacilli, growth on Bordet-Gengou medium
***Whooping cough

Pertussis toxin=inhibitis Gi–>↑cAMP (this prevents lymphocytes from getting into the lymph nodes and start an immune reaction)
Grows on Bordet-Gengou (Potato) agar

Catarrhal stage=most infectious
-common cold symptoms
Paroxysmal stage=whooping cough
-↑severity–>can vomit or become cyanotic

35
Q

UPEC

A

Uropathogenic E. coli (“U”: think–>URINARY)

Fimbriae (motile)

Cystitis/UTI (w/ no fever), pyelonephritis, or prostatits in men

36
Q

EIEC

A

Enteroinvasive E. coli (“I” think–>INVASIVE or irritating)
mc due to poor sanitation/fecal matter in drinking water

Non-motile
Shiga-like toxin (similar to EHEC)=cleaves 60s subunit of rRNA and releases cytokines–>necrosis and inflammation of mucosa–>profuse bloody diarrhea, high fever, abdominal cramping, leukocytes in stool
[shiga toxin is phage encoded transferred in lysogenic phage)

Invades mucosa=dysentery=bloody, profuse diarrhea
(High fever, abdominal cramping, leukocytes in stool)

37
Q

ETEC

A

Enterotoxigenic E. coli (“T” think–>TOXIC)
mc cause of diarrhea worldwide; Traveler’s/Troop diarrhea

Heat labile toxin=similar to cholera toxin–>↑cAMP–>secretory diarrhea
Heat stabile toxin–>↑cGMP–>secretory diarrhea

38
Q

EPEC

A

Enteropathogenic E. coli (“P” think–>PEDIATRICS

No toxin
Intimin=adheres to intestinal mucosa–>causes actin in cells to deform causing flattening of villi–>malabsorption

May or may not have bloody diarrhea

39
Q

EHEC

A

Enterohemorrhagic E. coli (“H” think–>HEMORRHAGIC)
***O157:H7 serotype from undercooked beef

Shiga-like toxin (similar to EIEC)=cleaves 60s subunit of rRNA and releases cytokines–>necrosis and inflammation of mucosa–>profuse bloody diarrhea, high fever, abdominal cramping, leukocytes in stool–>can cause HUS
[shiga toxin is phage encoded transferred in lysogenic phage)

DOES NOT FERMENT SORBITOL which distinguishes it from all other E. coli strains

40
Q

Klebsiella granulomatosis

A

STD

Forms a nodule–>PAINLESS genital ulcer–>destruction of tissue
***No inguinal lymphadenopathy, in contrast to syphyllis

Donovan bodies in lymph nodes

41
Q

Enterobacter cloacae

A

Bacillus, lactose fermenter/pink on MacConkey’s agar, fast fermenter

Nosocomial, multidrug resistant UTI bug
Normal gut flora

42
Q

Citrobacter

A

Bacillus, lactose fermenter/pink on MacConkey’s agar, slow fermenter

uses CITRATE for carbon source
rare

43
Q

Serratia Marcescens

A

Bacillus, lactose fermenter/pink on MacConkey’s agar, slow fermenter
Casein hydrolysis
Red pigment

R factor plasmid=contains numerous resistance genes

MC catheter-associated UTI

44
Q

Salmonella typhi

A

Bacillus, lactose non-fermenter/white on MacConkey’s agar, oxidase -, produces H2S (black on TSI agar), urease -

Motile and disseminates (“swims like a salmon”)

“Typhoid fever”

  • Fluctuating fever w/ bradycardia (Faget sign) and epistaxis
  • Dicrotic pulse wave***
  • Delirium (nervous fever) and rose spots
  • Can have bloody diarrhea and hepatosplenomegaly
45
Q

Vibrio vulnificus

A

***Raw oysters or swimming in infected waters

Vomiting, diarrhea, abdominal pain, and blistering dermatitis

46
Q

Vibrio parahaemolyticus

A

***Raw oysters

Vomiting, diarrhea, abdominal pain

47
Q

Legionella pneumophila

A

Bacillus, silver staining, aerobic
***Intracellular–>forms a Legionella containing vacuole used for site of replication and pathogenesis
Transmitted via infected waters (e.g. pool of water, AC units, aerosolizing water units)

Charcoal yeast extract culture, contains iron and cysteine

Legionella urine antigen test=diagnosis

Pontiac Fever

  • Mild flu
  • No pneumonia symptoms
  • Healthy people

STEP 1: MICRO (4 decks)

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