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Microbio > Gram neg/Spirochetes/Mycoplasma > Flashcards

Gram neg/Spirochetes/Mycoplasma Flashcards

1
Q

Neisseria meningitides

A
  • Gram - , diplocci (BEAN shaped)
  • Encapsulated (LOS** correlates w M and M ~LPS), Maltose and glucose fermenting (meningitides for maltose)
  • Vaccine exists (for type A)
  • Found in respiratory/oral secretions
  • -> Meningococcemia, meningitis (2nd most common children-adults, but # 1 in teens), rash on soles and palms (small vessel vasculitis) Waterhouse-Friderichsen syndrome
  • IgA Protease +
  • Chocolate agar

-tend to happen in outbreaks in close quarters (think College DORMS!)

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2
Q

Waterhouse-Friderichsen syndrome

A

<– N. meningitides

  • 1) Bilateral adrenal hemorrhage
  • 2) DIC
  • 3) Shock (hypotension)
  • 4) Purple rash
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3
Q

Neisseria gonococci

A

Gram- DIPLOCCI
-Facultative intracellular: often see in Neutrophils
Only glucose fermenting
-spread by sexual contact
–> gonorrhea, septic arthritis, neonatal conjunctivitis, PID, Fitz-Hugh-Curtis syndrome (Fibrotic Hepatic Capsule syndrome)
-IgA protease+
-Thayer-martin media (choc. sheep blood + ABX - make sure you get rid of all the other bacteria from the vagina swab) = Prostitutes on Thayer Street
-Rx: IM Ceftriaxone + treatment for chlamydia

Think Gonorrhea when you see asymmetric polyarthritis (knees, elbows) in a sexually active young adult

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4
Q

HaEMOPhilus. influenzae

A

Gram - coccobacillus

  • -> Epiglottis* (“cherry red”), Meningitis, Otitis media (nontypeable strains cause mucosal infxns), Pneumonia
  • IgA protease (type B is encapsulated)
  • Chocolate agar w V, X.
  • OR Chocolate agar, S. Aureus, X
  • Vaccine: Type B capsular polysaccharide + diptheria toxioid/other . Give to infants! produces anti-PRP** antibodies.
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5
Q

Gram Negative Bacilli/rods

A

Outer membrane inhibits entry of PCN G and Vancomycin! Resistant!
-May be susceptible to derivatives like Ampicillin and Amoxicillin

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6
Q

Lactose fermenters

A

Test w macConKEES agar, turn PINK
-on EMB agar turn Purple/black (except E. coli has green sheen)

Citrobacter
Klebsiella
E. coli
Enterobacter
Serratia
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7
Q

Legionella pneumonphila

A

Gram - rod, Lactase -, Oxidase +

  • -> Legionnaires’ ds: atypical pneumonia, high fever, Diarrhea, and CNS sxs/confusion; all in a smoker!
  • -> Pontiac fever: mild flu-like sxs
  • Use Silver stain
  • grown on charcoal yeast w iron and cysteine
  • HYPONATREMIA, test for antigen in urine

The Legionnaire wears a silver helmet and sits at a charcoal fire w an iron stoker before he decides to charge the Pontiac. He is no Sissy/Cysteine. But he’s chugging a lot of water before he goes so he doesn’t get dehydrated (–> Hyponatremic)

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8
Q

PSEUDOmonas aeruginosa

A

Gram - rod, Oxidase POS, Aerobe. NON-lactose fermenting.

  • -> Pneumonia (CF), Sepsis (black skin lesions/burn pts), Ecythema gangrenosum (pts w neutropenia), UTI (w indwelling cath), Dermatitis (hot-tube users), Otitis externa (swimmers)/Osteomyelitis (Diabetes, IV drug users)
  • Produces Pyocyanin* (blue-green) pigment w grape-like odor.
  • -> Endotoxin (fever, shock), and Exotoxin A (inactivate EF-2)
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9
Q

E. coli EIEC

A 
Gram - rod, Lactose fermenter, motile
-No toxin produced
-Microbe invades intestinal mucosa --> necrosis, inflammation
~ clinical pic of Shigella
I for INVASIVE, dysentery

Ferments Sorbitol/glucose (vs EHEC) –> gas
Stool: would see many erythrocytes and some leukocytes

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10
Q

E. coli ETEC

A

Gram - rod, lactose fermenter, motile
-T for Traveler’s diarrhea
LT/ST toxins. No inflammation or invasion

Ferments Sorbitol/glucose (vs EHEC) –> gas

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11
Q

E. Coli EPEC

A

Gram - rod, lactose fermenter, motile

  • P for Pediatrics (diarrhea in children)
  • No toxin
  • Adheres to apical surface, flattens villi, prevents absorption

Ferments Sorbitol/glucose (vs EHEC) –> gas

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12
Q

E. coli EHEC

A

Gram - rod, lactose fermenter, motile
-H for Hemorrhagic diarrhea (does not invade the cells*, toxin alone causes necrosis/inflmtn)
-O157:H7 most common type –> SLT –> HUS (TAU - thrombycotpenia, Anemia, Uremia)
(endothelium swells and narrows lumen –> microangiopathic anemia and reduced renal flow. Damaged endothelium consumes plts).
*Does NOT ferment sorbitol or produce glucuronidase.
-Stool: erythrocytes w/o pus (bc not invasive)

FAT RN in kids who ate hamburgers

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13
Q

E. Coli Virulence factors

A
  • Fimbriae –> UTI (#1), cystitis, pyelonephritis
  • K capsule (prevents phagocytosis) –>, neonatal meningitis (#2) and neonatal pneumonia (#2) (#1 in both is group b strep)
  • LPS endotoxin –> septic shock
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14
Q

Klebsiella

ABCD

A

Gram - rod, Lactose fermenter

  • A: Aspiration pneumonia (DM/ETOHpts)
  • B: Burning urine/nosocomial UTI
  • C: (red) currant jelly sputum
  • D: Donovan bodies (STI called “granuloma inguinale”)
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15
Q

Salmonella typhi

or paratyphi

A

Gram - rod, Lactose -, Oxidase -

  • Flagellate organism, can dissem hematogenously**, animal reservoirs, invades intestinal mucosa –> monocytic response, produce H2S on triple sugar iron (TSI) agar–> black
  • antibiotics may prolong sxs*/fecal excretion of bacteria
  • Fecal-oral
  • multiples in mesenteric LN’s and is phagocytosed by macrophages, lives inside them (facultative intracellular)
  • -> Typhoid Fever. Only in humans. ROSE spots on abdomen, fever, HA, diarrhea, abdml pain, HEPATOSPLENOMEGALY –> hemorrhagic enteritis w possible bowel perf. Can remain in GALLBLADDER = carrier state

(common OUTSIDE the States - think of it when someone travels and gets a rash peri-umbilically)

Salmonella and Shigella are SOL: no oxidase OR lactose fermenting

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16
Q

Shigella dysenteriae

A

Gram - rod, Lactose - , Oxidase -

  • Invades intestinal mucosa via M cells and causes PMN infiltration
  • ->severe bloody diarrhea (Shiga-Toxin)
  • Stool: many erythrocytes and some leukocytes
  • Not* carried by animals. Fecal-oral route - daycare center, food contaminated etc
  • as few as 10 cells of any shigella spp can cause infection**

Salmonella and Shigella are SOL: no oxidase OR lactose fermenting

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17
Q

Campylobacter jejuni

A

Gram - , Comma shaped, Oxidase +

  • likes the HOT CAMPfire. grows at 42C
  • -> diarrhea (activate adenylate cyclase; initially watery –> bloody)
  • Fecal oral route by poultry, milk, domestic animals (cattle, sheep, puppies!)
  • -> Guillain Barre, Reactive arthritis
  • has a filament so it moves in a “corkscrew” fashion
  • Most common cause of acute gastroenteritis of children and adults in industrialized countries*
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18
Q

Vibrio cholerae

A

Gram -, Comma shaped, Oxidase +

  • Grows in ALKALINE media
  • -> Rice water diarrhea by permanantly activating Gs to incr cAMP
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19
Q

Yersinia enterocolitica

A

gram - rod, Oxidase -, Lactose -
-transmitted by Puppy Poop and unpasteurized Milk
~ETEC/ST in that it activates guanylate cyclease and incr cGMP
–> Pediatric diarrhea, Mesenteric Adenitis = abdl pain (~ CD or appendicitis)

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20
Q

Yersnia Pestis

A

Gram-, Lactose-, Oxidase-
Bubonic Plague (swollen LNs)
-sepsis in SouthWestern Rancher exposed to fleas or terrorist attack
-Fleas get it from rats and prairie dogs

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21
Q

Proteus mirabilis

A

Gram - rod, Lactase -, Oxidase -

  • DO have flagella and make H2S (like salmonella) –>black on TSI agar
  • Urease Positive (like H. pylori) but prefers GU tract
  • -> Staghorn calculi (Struvite Kidney Stones)
22
Q

H. Pylori

A

Gram - , comma-shaped.

  • Urease+ in GI tract –> Alkaline environment
  • RX: PPI, Clarithryomycin, Amoxocillin
23
Q

Spirochetes

A

BLT

  • Borrelia (BIG!) - visualized w aniline dye (Wright’s or Giemsa) in LM
  • Leptospira
  • Treponema - visualized by dark-field micro
24
Q

Mycoplasma pneumoniae

A
  • No cell wall, sterols in plasma membrane (they can get all of us 25 yr olds! and they’re like us: we don’t have cell walls, and we do have cholesterol in our membranes)
  • -> atypical “walking” pneumonia (insidious onset, HA, nonproductive cough, diffuse interstital infiltrate), transient anemia
  • High titer of COLD AGGLUTININS (IgM) –> agglutinate or lyse rbcs (may see anemia)
  • Grows on Eaton’s agar
  • most common pneumonia adults 18-40 (everyone older Strep pneumo)
25
Q

Cold agglutinins (IgM) assoc w.

A

Mycoplasma pneumoniae
Epstein Barr Virus
hemolytic malignancies

26
Q

E. coli EAEC

A

Enteroaggregative

-Cause “Stacked-brick” intestinal adhesions

27
Q

Leptospira Interrogans

A

Spirochete

  • Found in : animal/RAT urine. See in SURFERS/tropics/Hawaii
  • -> Leptospirosis (mild): flu-like sxs, jaundice, photophobia w conjunctivitiis (meningitis-like)
  • -> Weil’s ds (Bad). Icterohemorrhagic ds: severe jaundice, azotemia from LIVER/KIDNEY dysfxn, fever, hemorrhage, edema
28
Q

Borrelia burgdorferi

LYME DS

A

-Spirochete
-In mice and deer, transmitted by tick Ixodes
-Think CAMPERS in the North East
-“Ticks Find Folds Amongst inAppropriate NE Clothes”
RX: doxycycline (tetracycline), ceftriaxone (3-cephalosporin)

29
Q

Stages of Lyme ds <– Borrelia burgdorferi

A
  • 1) Erythema migrans, flu-like sxs
  • 2) Neuro/Facial n palsy, Cardiac/AV block
  • 3) MS (arthritis, esp knees), neuro (encephalopathy/polyneuropathy), cutaneous manifestations

Ticks Find Folds Amongst inAppropiate NE Clothes

Target Flu-like sxs, Facial n palsy AV block, Arthritis Neuro/enceophalopathy Cutaneous manifestations

30
Q

Treponema pallidum

Primary Syphillus

A
  • Spirochete
  • -> (P)rimary for (P)ainless* chancre (treponemes present in the chancre)
  • Screen w VDRL and confirm dx w FTA-ABS (fluorescent treponemal antibodies - Absorption)
31
Q

VDRL; False positives

A

Used to test for syphillis/Treponemal pallidum
-check for ABs against beef Cardiolipin

False positives: VDRL

  • Viruses (mono, hepatitis - also mycoplasma pneumoniae*)
  • Drugs
  • Rheumatic Fever
  • Lupus, leprosy (anti-cardiolipin/phosphlipid abs)
32
Q

Treponema pallidum

Secondary syphillis

A
  • Spirochete
  • (S)econdary for (S)ystemic and (S)ole/palm rash
  • -> Disseminated: constitutional sxs, maculopapular rash (palms, soles), Condyloma Lata (treponemes present in it)
  • Screen w VDRL and dx w FTA-ABS
33
Q

Treponema pallidum

Tertiary Syphillis

A
  • Spirochete
  • (T)ertiary for Tabes Dorsalis –> sensory ataxia
  • -> Gumma (chromic GRANULOMAS) in liver/bone/skin, Aortitis (vasa vasorum destruction), Neurosyphillis (tabes dorsalis), Argyll Robertons pupil (Prostitutes pupil)
  • Signs: Broad-based ataxia, Rhomberg+, Charcot joint (degeneration of joint/no pain/deform), stroke w/o HTN
  • Test CSF w VDRL
34
Q

Treponema Pallidum

Congenital syphillis

A
  • plancental transmission: 1st trimester
  • Saber shins, Saddle noes, CN8 deafness, Hutchinson’s teeth (small/wide spaced/notches), mulberry molars (rounded enamel cusps on permanent first molars)
35
Q

Jarisch-Herxheimer Rxn

A
  • Flu-like syndrome when give someone AB’s bc of all the cell’s lysing - release pyrogens
  • May seem like you get worse when you start treatment
36
Q

Gardenella Vaginalis

A

-Gram VARIABLE rod.
I don’t have a CLUE (cell) why I smell FISH in the VAGINA GARDEN!
–> Bacterial vaginosis: gray fishy discharge
-not an STD
-Rx: Metronidazole

37
Q

Rickettsia Rickettsi

A

-Obligate intracellular organism, needs CoA and NAD+
-> Rocky Mtn spotted fever: throughout US.
-Triad: FEVER, HA, RASH (wrists/ankles –> trunk/palms/soes)
+Weil-Felix rxn (anti-rickettsial IgM cross-reacts w Proteus antigen)

Rickettsi on the wRists, Typhus on the Trunk

38
Q

Rickettsia Typhus

A

-Fleas –> Endemic Typhus
-RASH on the TRUNK
+Weil-Felix rxn

Rickettsi on the wRists, Typhus on the Trunk

39
Q

Rickettsia Prowazekii

A
  • human louse –> Epidemic Typhus
  • RASH on trunk –> spread outward but SPARES the Palms and Soles.

Rickettsi on the wRists, Typhus on the Trunk

40
Q

Palm and sole rash, seen in:

A

Coxsackievirus A
Rocky Mtn Spotted Fever
Secondary Syphillis
**and N. meningitides –> small vessel vasculitis

Monkeys drive CARS w their PALMS and SOLES

41
Q

Ehrlichia Chaffeensis

Rickettsial spp

A

Lone star tick –> Ehrlichiosis
-No rash. See Monocytes w Morula (berry-like inclusions) in your cytoplasm
+Weil-Felix rxn

The lone star sheriff could er LICK your butt. But first he needs to have his monocyte cereal breakfast w berries w his coffee/Chaffeen

42
Q

Anaplasma

Rickettsial spp

A

Tick –> Anaplasmosis

-No rash. See Granulocytes w Morula in cytoplasm

43
Q

Coxiella Burnetti

A

tick feces/cattle placenta –> Q fever
–> Pneumonia
-No Rash or Vector, organism can survive outside in its endospore form.
NEGATIVE Weil-Felix rxn

Honora wants to be an ob gyn for cows and sheep, Q fever

44
Q

Chlamydiae

A
  • obligate intracellular, cell wall lacks muramic acid
  • 1) Elementary body (small,dense) is “Enfectious”and Enters cell via Endocytosis –>
  • 2) Reticulate body Replicates in cell by fission - seen on tissue culture –> Elementary bodies + Reticulate bodies –> Released
  • Rx: Azithromycin or Doxycycline
45
Q

Chlamydiae trachomatis

A

–> Reactive arthritis, conjunctivitis, nongonococcal urethritis, and PID

Reiters + PID

46
Q

Chlamydiae pneumoniae

A

Atypical pnuemonia, aerosol spread

Along w mycoplasma and legionella

47
Q

Warm agglutins seen in

A

SLE
CLL
–> AI Hemolytic Anemia

48
Q

Chlamydia type A,B,C

A

all cause:
African/Blindness/Chronic infxn
-Blindiness from follicular conjunctivitis

49
Q

Chlamydia type D-K

A

STI (co-treat w gonorrhea) –> PID

  • Neonatal pneumonia (staccato cough)
  • neonatal conjuncitivits
50
Q

Chlamydia types L!, L2, L3

A

lymphogranuloma venereum (Inguinal lymphadenopathy)

51
Q

Salmonella enteriditis

A

Causes invasive diarrhea most frequently without hemorrhage

-stool: Neutrophils predominate

52
Q

H. influenza capsule

A

Polyribitol ribose phosphate (PRP)
the vaccine provides anti-PRP antibodies. Esp Protective against Epiglottis, Meningitis
-Epiglottis caused almost exclusively by H. influenza.
-The vaccine: PRP combined w tetanus or diptheria toxoid.

Microbio (13 decks)

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