Gram - Flashcards

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1
Q

causes waterhouse-fredrichsen syndrome

A

n. meningococci

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2
Q

symptoms of waterhouse frederichsen syndrome

A

adrenal insufficiency, fever, DIC, shock

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3
Q

What neisseria ferments maltose and glucose

A

meningococci

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4
Q

what neisseria ferments glucose

A

gonococci

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5
Q

what neisseria does not have a polysaccharide capsule

A

gonococci

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6
Q

what neisseri has a polysaccharide capsuel

A

meningococci

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7
Q

purpose of polysaccharide capsuel

A

impairs phagocytosis

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8
Q

causes gonorrhea, septic arthritis, neonatal conjuncitivits, PID, Fitz hugh curtis syndrome

A

gonococci

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9
Q

meningococcemia w petechial hemorraghes. gangrene of toes. meningitis.

A

meningoocoocci

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10
Q

which neisseria has a vaccine

A

meningococci

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11
Q

why does gonoccoci not have a vaccine

A

due to antigenic variation of pilus proteins (porins, proteins, LPS)

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12
Q

which bug produces IgA proteases

A

neisseria

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13
Q

Thayer martin selective media contains

A

vancomycin, colistin, nystatin, trimethoprim

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14
Q

Explain purpose of thayer martin selective media

A

grows N. gonorrhoea, also kills potential contaminants such as gram + (vancomycin), gram - other than neisseria (colistin and trimethorpim), and fungi (nystatin)

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15
Q

purpose of IgA protease

A

cleaves secretory IgA that would otherwise inactivate pili

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16
Q

meningitis affects what layer of brain (parenchyma or connective tissue layer

A

connective tissue layer

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17
Q

meningococci pili

A

attachment and colonization of nasopharyngeal epithleium

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18
Q

Lipooligosaccharide prodcued by neissseria purpose

A

induces cytokine production , leading to circulated collapse

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19
Q

purulent arthitrits of knee, oligoarticular joint pain, vesiculopustular lesions on extremies, sexually active perosn

A

disseminated gonoccocal infection: septic arthritis

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20
Q

Treatment of gonoccocic

A

Ceftriaxone + (azitrhomycin or doxycycline) for possible chlamydial coinfection

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21
Q

H. influenze transmission

A

aerosol transmission

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22
Q

HaEMOPhilus

A

epiglottitis, meningitis, otitis media, pneumonia in H. influenzae

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23
Q

what is most common cause of mucosal infections (otitis media, conjunctivitis, bronchitis) in H. influenze

A

nontypeable (unencapsulated

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24
Q

culture on chocolate agar, which contains factors V (NAD+) and X (hematin) for growth

A

h. influenzea

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25
Q

H. influenze can also be grown w what bug because it provides factor V thorugh hemolysis of RBC’s

A

S. auerus

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26
Q

Vaccine for contains type b capsular polysaccharide (polyribosylribitol phosphate) conjugated to diphtheria toxoid or other protien

A

h . influenze

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27
Q

fever, inflamed, perforated tympanic membrane w purulent otorrhea

A

acute otitis media

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28
Q

polyribosylribitol phsoosphate protects H. influenze against

A

phagocytosis and complement mediated lysis by binding Factor H; a circulating regulator prtoein that normally prevents complmeent C3b deposition on host cells.

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29
Q

resevoir of leprosy in US

A

armadillos

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30
Q

Virulence factors of bordatella

A

pertussis toxin, adenylate cyclase toxin, AB exotoxin, tracheal cytotoxin

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31
Q

bordetella pertusis toxin function

A

disables Gi: causes excessive adenylate cyclase activity: prevents effective phagocytosis and allows organism to perisit in alveor macs and epithleium cells

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32
Q

bordatella tracheal cytotoxin function

A

promotes local tissue destruction resulting in cough

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33
Q

increase cAMP from which bordatella toxin

A

Pertussis toxin: causes edema and phagocyte dysfucntion

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34
Q

3 stages of bordatella

A
  1. catarrhal
  2. paroxysmal
    convalescent
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35
Q

explain catarrhal stage

A

bordatella: low grade fever, coryza, rhinorrhea, malaise

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36
Q

paroxysmal phase explain

A

paroxysms of intense cough followed by inspiratory whoop: posttussive vomiting

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37
Q

convalescent phase explain

A

gradual recovery of chronic cough

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38
Q

Prevented by Tdap, DTaP vaccines

A

bordatella pertussis

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39
Q

it is a gram rod that uses silver stain and grows on charcoal yeast extract medium with iron and cysteine

A

legionella pneumophila

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40
Q

this bug shows hyponatremia

A

legionella pneumophila

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41
Q

legionella grows on what medium

A

yeast extract medium

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42
Q

yeast extract medium contains

A

iron and cysteine

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43
Q

Aerosol transmission from environemntal water source habitat (air conditioning system, hot water tanks)

A

legionella (no person to person transmission

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44
Q

extremely high fever, brady cardia relative to high fever, headache confusion

A

legionella

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45
Q

on the sputum gram stain what does legionella show

A

many neutrophils but few or no organisms

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46
Q

Symptoms of legionnaire’s diseae

A

severe pneumonia, high fever, GI and CNS symptoms

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47
Q

Legionarres disease most common in who

A

smokers and chorinc lung disasee

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48
Q

Pontiac fever symptom

A

mild flu like syndrome

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49
Q

treatment of legionella

A

macrolide or quinolone

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50
Q

does pseudomonas have a capsule

A

yes

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51
Q

Pseudomonas produces a blue green pigment known as

A

pyocyanin

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52
Q

pseudomonas a motile gram - rod that is aerobic or anerobic

A

aerobic

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53
Q

Toxins for psuedomonas:

A

endotoxin (fever, shock), exotoxin (inactivates EF-2), phospholipase C(degrades cell membranes) and pyocyanin

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54
Q

pyocyanin function

A

generates ROS

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55
Q

exotoxin A function in pseudomonas

A

inactivate EF2

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56
Q

PSEUDOMONAS mneumonic

A

P: pneumonia, pyocyanin
S: sepsis
E: echthyma gangrenosum
U: UTI’s- think cathethers
D: diabetes, drug use
O: osteomyelitis (puncture wounds)
M: mucoid polysaccharide capsuel
O: otitis externa (swimmer’s ear): malignant
N: nosocomial infectiosn (cathehters, equipment
A: exotoxin A
S: skin infections (hot tub folliculitis)

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57
Q

AERuginosa

A

AERobic

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58
Q

what does the mucoid polysaccharide capsule in pseudomas contribute to

A

chronic pneumonia in cystic fibrosis patients due to biofilm production

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59
Q

wound infection in BURN victims

A

pseudomonas

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60
Q

Pseudomonas does what to eyes

A

corneal ulcers/keratitis in contact lens wearers/ minor eye trauma

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61
Q

hot tub folliculuits symptoms

A

pruritic, papulopustular rash = out breaks from public pools.

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62
Q

symptoms of ecythma gangrenosum

A

rapidly progressiev necrotic cutaneous lesion

characteristic skin patches exhibiting necrosis and ulceration: insufficient blood flow)

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63
Q

UTI in catheter can be caused by

A

Proteus mirablis

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64
Q

sepsis + circulatory collapse in previously healthy young adults with petechial/ecchymotic rash due to DIC

A

n. meningitidis

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65
Q

curved gram - rod that is triple +

A

h. pylori

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66
Q

triple pos in h pylori means

A

catalase, oxidase, urease _

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67
Q

function of urease in h pylori

A

produces ammonia, creating an alkaline environment which helps H. pylori survive in acidic mucosa

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68
Q

where does h. pylori colonize

A

antrum of stomach

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69
Q

Triple therapy for h pylori

A

Amoxicilin + clarithromycin + PPI

acronmym : APC: antiboitics Cure Pylori

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70
Q

spiral shaped bacteria with axial filmanets

A

spirochetes

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71
Q

BLT acronmy for spirochetes

A

borrelia, leptospira, treponmea

72
Q

what is only spirochete that can be visualized by aniline dyes (wright or giemsa stain)

A

borrelia due to its size

73
Q

how is trepomena visualized

A

dark field microscopy or direct fluorescent antibody (DFA) microscopy

74
Q

spirochete with hook shaped ends found in contaminated water with animal urine

A

leptospira interrogans

75
Q

Symptoms of leptospirosis

A

flue like symptoms, myalgias, jaundice, photobia with conjunctival suffusion (erythema w/o exudate)

76
Q

Prevalent among surfers and in tropics

A

leptospirosis

77
Q

myalgia in leptospirois is where

A

calves

78
Q

Weil disease (icterohemorraghic leptospirosis)

A

severe form w jaundice azotemia from liver and kidney dysfunction, fever, hemorrageh, anemia

79
Q

Lyme disease caused by what bug

A

Borrelia burgoderfi

80
Q

lyme disase transmited by what tick

A

ixodes deer tick

81
Q

natural resevoir of Lyme disease

A

mouse

82
Q

ixodes deer tick is also a vector for

A

anaplasma spp. and protozoa babesia

83
Q

LYme disease is common in what region

A

NE US

84
Q

A Key LYME to the FACE

A

Facial nerve palsy (bilateral)
arthritis
cardiac block
erythema migrans

85
Q

3 stages of lyme disease

A

Stage 1: erythema migrans : early localized (bulls eye configuration) flue like symptoms

86
Q

Stage 2 of lyme disaes

A

early disseminated : secondary lesions, carditis, AV block, facial nerve palsy, migratory myalgias/transient arthritis . asymmetric arthritis

87
Q

Stage of 3 lyme disaese

A

late dissemenited: encephalopathies, chronic arthirits

88
Q

serologic testing for lyme disase

A

IgG/IgM against Borrelia

89
Q

treponema pallidus causes

A

syphillis

90
Q

Explain where you see a painless chancre

A

PRIMARY SYPHILIS

91
Q

IS CHANCRE painful or painless

A

painless

92
Q

gummas is what syphillis

A

tertiary

93
Q

Secondary syphilis

A

systemic

94
Q

disseminated diseaes with constitutional symptoms is what stage of syphilis

A

secondary

95
Q

what is condyloma lata

A

smooth, moist, painless wart like white lesions on genitals

96
Q

maculopapular rash in secondary syphilis involves waht

A

palms and soles

97
Q

secondary syphilis

A

disseminted disease, maculopapular rash, condyloma lata, LYMPHADENOPATHY , PATCHY HAIR LOSS

98
Q

serologic testing in secondary syphilis

A

VDRL/RPR

99
Q

explain VDRL/RPR

A

antibody to cardiolipin-cholesterol-lecithin antigen: aggregation of flocculation (clumping) indicates presence of antticardiolipin antibodies.

100
Q

confirm syphilis with what

A

FTA ABS: specific test

101
Q

FTA-ABS is what

A

antibody to treponemal antigens

102
Q

You will see neurosyphilis in which stage

A

tertiary syphilis

103
Q

explain neurosyphilis

A

tabes dorsalis, general paresis

104
Q

how to test for neurosyphilis

A

test spinal fluid w VDRL, FTA-ABS, PCR

105
Q

a chronic granuloma in syphiliis

A

gummas

106
Q

characersitic of teritiary syphilis. it begins as painless indurated granulomatous lesions that progress to white-gray rubbery lesions that may ulcerate

A

gummas

107
Q

this type of pupil is seen in tertiary syphilis

A

argyll robertson pupil

108
Q

constricts w accomodation but is not reactive to light

A

argyll robertsin pupil

109
Q

vasa vasorum destruction in syphilis

A

tertiary. known as aortitis: ascending anuerysm

110
Q

neurosypihlis can occur at any stage. true or false

A

true

111
Q

Sings of tertiary syphilis

A

broad based ataxia, +romberg, charcot join, stroke w.o. htn

112
Q

CV syphilis symptoms

A

asymptomatic murmur w loud S2, ascending aortic arch calcification

113
Q

untreated syphilis ainfects what roots of spinal column

A

dorsal causeing tabes dorsalis

114
Q

facial abnormalities, such as rhagades, snuffles, saddle nose, notched (hutchinson teeth), mulberry molars, short maxilla, saber shins, cn viii deafness

A

congenital syphilis

115
Q

what is a ragade

A

linear scars at angle of mouth seen in congenital syphilis

116
Q

VDRL detects nonspeciifc antibody that reacts with what cardiolipin

A

beef

117
Q

false pos on VDRL

thin mmnenonimc

A
VDRL
virus
drugs
rheumatic fever 
lupus and leprosy
118
Q

Explain the jarisch-herxheimer reaction

A

flue like syndrome after antiboitcs are started

119
Q

it is usally due to killed bacteria (usually spirochetes) releasing toxins

A

jarisch-herxheimer reaction

120
Q

zoonosis:

A

infectious disease transmiitted bw animals and humans

121
Q

anaplasma spp. trnasmission

A

ixodes (live on deer and mice)

122
Q

anaplasma spp. causes what disease

A

anaplasmosis

123
Q

bartonella disease

A

cat scatch disease, bacillary angiomatosis

124
Q

bacillary angiomatosis is

A

red purple papular skin lesions, found within viscera

125
Q

in cat scratch disease: what type of lymphadenopathy

A

tender region lymphandeonmay, axillary lymphadenopathy common

126
Q

Borrelia recurrentis disease

A

relapsing fever

127
Q

transmission is louse

A

borrelia recurrentis

128
Q

brucella spp disease

A

brucellosis / undulant fever ( wax and wane fever)

129
Q

unpasteurized dairy is the transmission of what zoonotic bacteria

A

brucella

130
Q

campylobacter causes what type of diarrhea

A

bloody

131
Q

transmission , source of campylobacter

A

feces from infected pets/animals; contaminated meats/foods hands

132
Q

Chlamydophila psittaci source

A

parrots, other birds

133
Q

Coxiella burnetti (obligate intracellualr parasite disse)

A

Q fever

134
Q

aerosols of cattle/sheep amniotic fluid is trasnission of what

A

coxiella burnetti

135
Q

ehrlichia chaffeensis transmission

A

amblyomma (lone star tick)

136
Q

Francisella tularensis causes

A

tularemia: severe febrile pul infection; ulcerartive disease to inoculation site

137
Q

transmission of francisella tularensis

A

ticks, rabbits, deer flies, beavers, squirrels

138
Q

pasturella multocida causes what disaease

A

cellulitis, osteomyelitis

139
Q

pasturella is a gram

A

gram negative rod

140
Q

cellulitis in pastuerella mutlocida

A

skin + soft tissue infection; within 24hrs + MOUSE like odor (indole + species)

141
Q

transmission of pastuerella multocida

A

animal bite, cats, dogs

142
Q

rickettsia prowazekii disease

A

epidemic typhus

143
Q

rickettsia prowazekii transmision

A

human to human via human body louse

144
Q

rickettsia rickettsii

A

Rocky mountain spotted fever

145
Q

transmiision of rickettsia rickettsii

A

dermacentor (dog tick)

146
Q

rickettsia typhi disdeease

A

endemic typush

147
Q

transmision of rickettsia typhi

A

fleas

148
Q

salmonell spp (except S. typhi) disease

A

fever, diarrhea (which may be bloody), vommitng, fever, abdominal cramps,

149
Q

source ofor salmonella spp (except S. typhi)

A

reptiles and poultry

150
Q

yersinia pestis disease

A

plauge

151
Q

transmission/source for yersinia pestis

A

fleas (rats and prairie dogs are reservoirs)

152
Q

Anaerobic gram variable rod

A

gardnerella vaginalis

153
Q

bacterial vaginosis

A

gardnerella vaginalis

154
Q

symptoms of bacterial vaginosis

A

gray vaginal discharge with FISHY smell; non painful (vs vaginitis)

155
Q

what is characterized by overgrowth of certain anaerobic bacteria in vagina

A

bacterial vaginosis

156
Q

clue cells (vaginal epithelial cells covered w?)

A

gardnerella

157
Q

clue cells have what type of apperance along outer margin

A

stippled apperance

158
Q

DO a amine whiff test_ mix discharge with 10% KOH enhances fishy odor in what disease

A

bacterial vaginosis

159
Q

change in vaginal flora from lactobacilli to anaerobic gram neg rods

A

bacterial vaginosis

160
Q

treatment of gardnerella vaginalis

A

metronidazole or clindamycin

161
Q

Vector for Rocky mountain spotted fever

A

dog tick. rickettsia rickettssii

162
Q

South atlantic states: esp in NOrth carolina

A

rocky mountain spotted fever

163
Q

Classic triad of rocky moutnain spotted fever

A

headache, fever, rash, (vasculitis)

164
Q

In rocky mountain spotted fever; rash will start

A

at wrists and ankles and then spread to trunk, palms, soles

165
Q

palms and soles rash seen in what

A

Coxsackie A, Rocky Mountain spotted fever, and 2 syphilis

166
Q

you drive CARS using your palms and soles

A

coxsackie a, rocky moutnain spotted fever, 2 syphilis

167
Q

In typhus, rash starts

A

rash starts centrally and spread out, sparing palms and soles

168
Q

Ehrlichiosis what type of immune cell

A

Monocytes with morulae (mulberry like inclusiosn in cytoplasm)

169
Q

Anaplasmosis. what type of immune cell

A

Granulocytes with morulae in cytoplasma

170
Q

Coxiellla burnetti has no

A

arthropod vector

171
Q

spores inhaled as aerosols from cattle/sheep amniotic fluid

A

coxiella burnetti

172
Q

common cause of culture - endocarditis

A

Q fever

173
Q

Acute Q fever symptoms

A

non specific febrile illness w fever lastin ?10 days, fatigue, myalgias, severe debilitating headaches, which are often retroorbital and assoc w photophobia

174
Q

acute q fever pneumonia

A

pneumonia on x ray lobar consolidation. normal leukocyte count. increase liver enzymes, thrombocytopenia

175
Q

Chronic Q fever

A

Is frequently fatal; may occur in pt’s w or w/o previous symptomatic acute infection; mainfests as infective endocarditis in pt’s wi valvular disease

176
Q

Eikenella corrodens

A

human bite: clenched fist injury (fight bite)