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Gram Negative Flashcards

1
Q

Cite examples of your aerobic diplococci

A
  1. N. gonorrhea
  2. N. meningitidis
  3. Moraxella
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2
Q

How will you distinguis N. meningitides from N. gonorrhea?

A

Maltose utilization test

N. meningitidis = able to utilize maltos

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3
Q

Maltose utilization negative
Aerobic diplococci
Gram negative

A

N. gonorrhoeae

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4
Q

Cite examples of your gram negative coccobacilli

A
  1. Haemophilus influenzae
  2. Pasterurella
  3. Brucella
  4. Bortadella pertussis
  5. Francisella tularensis
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5
Q

Cite examples of your oxidase positive gram negative comma-shaped rods

A
  1. C. jejuni (42 deg C)
  2. V. cholerae (alkaline media)
  3. H. pylori (urease producer)
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6
Q

Cite examples of your fast lactose fermenters, bacilli, gram negative

A
  1. Klebsiella
  2. E. coli
  3. Enterobacter
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7
Q

Cite examples of your slow lactose fermenters, bacilli, gram negative

A
  1. Citrobacter

2. Serratia

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8
Q

Cite examples of your oxidase positive, bacilli, gram negative bacteria

A

P. aeruginosa

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9
Q

How will you distinguish Shigella from Salmonella?

A

Check for the production of hydrogen sulfide on TSI Agad

Shigella - negative
Salmonella - present hydrogen sulfide

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10
Q

Cite examples of your hydrogen sulfide producer, oxidase negative bacilli, gram negative

A

Salmonella

Proteu

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11
Q

Cite examples of your non hydrogen sulfide producer, oxidase negative, gram negative bacilli

A

Shigella

Yersinia

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12
Q

Gram negative diplococci that ferments glucose only

A

N. gonorrhea

Gonorrhea = Glucose only

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13
Q

Gram negative diplococci that ferments maltose

A

N. meningitidis

Meningitides = Maltose only

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14
Q

Thayer-Martin agar used to culture N. gonorrhea from unsterile sites contain what antibiotics?

A
  1. Vancomycin - inhibti G+
  2. Polymixin - inhibit G- excluding Neisseria
  3. Nystatin

Thayer Martin has VPN

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15
Q

Gram negative kidney bean diplococci

A

N. meningitidis

N. gonorrhea

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16
Q

[Diagnosis]

URTI,
military recruits, dormitories, camps, Hajj pilgimage

A

N. meningitidis

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17
Q

What complement deficiencies make an individual susceptible to N. meningitidis?

A

C6-C9 deficiency

since they cannot form MAC

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18
Q

N. meningitides is the most common cause of meningitis in what age group?

A

2-18 years od

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19
Q

[Diagnosis]

Due to N. meningitides, multiorgan disease, DIC, petechial or purpuric rash

A

Meningococcemia

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20
Q

What is the most severe form of meningococcemia?

A

Waterhouse-Friderichsen Syndrome

Meningococcemia + Adrenal insufficiency

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21
Q

What are the capsular polysaccharides included in the meningococcal strains

A

ACY W135

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22
Q

Meningococcal vaccine is coupled with what other vaccine

A

Diphteria toxoid

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23
Q

What is the DOC as chemoprophylaxis to patients with close contact to a confirmed meningcococcemia?

A

rifampin

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24
Q

Which serogroup of N. meningitides is poorly immunogenic?

A

Serogroup B

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25
Q

[N. gonorrhea]

promote adherence of bacteria to epithelial cells

A

pili

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26
Q

[N. gonorrhea]

expression of this outer membrane proteins promote adherence and invasion into epithelial cells

A

Opa protein

gives it an opaque colonies in thayer martin

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27
Q

[N. gonorrhea]

usually co-infected with what organism

A

Chlamydia trachomatis

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28
Q

What is the most common cause of urethritis?

A

gonococcal

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29
Q

Most common cause of PID

A

gonococcal

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30
Q

Violin string adhesion associated with gonorrhea is called ___ syndrome

A

Fitz-Hugh-Curtis Syndrome

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31
Q

What is the most common cause of septic arthritis in sexually active men?

A

N. gonorrhea

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32
Q

What is the DOC for gonorrhea?

A

Ceftriaxone + Doxycycline

due to C. trachomatis coinfection

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33
Q

What is the DOC to prevent conjuctivitis?

A

Erythromyin or silver nitrate

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34
Q

Antigenic variation in N. gonorrhea are due to what factors

A
  1. Pili
  2. Membran protein P. II
  3. Lipo-oligosaccharide
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35
Q

What bacteria can cause culture negative subacute bacterial endocarditis in patients with preexisting heart disease

A
  1. Eikenella corrodens

2. Kingella kingae

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36
Q

Organism that can cause subacute endocarditis that is culture negative

A
  1. Haemophilus aphrophilus
  2. Actinobacillus actinomycetemcomitans
  3. Cardiobacterium hominis
  4. Eikenella corrodens
  5. Kingella kingae

HACEK

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37
Q

has polyribitol phosphate capsule

A

Haemophilis influenza tupe B

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38
Q

Poorly gram staining, gram negative respiratory rod, seen on silver stain

A

Legionella pneumophila

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39
Q

H. influenza can frown in a chocolate agar but requires what factor?

A
  1. Factor X (hemin)

2. Factor V (NAD)

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40
Q

__ phenomenon happens around S. aureus colonies wherein S. aureus liberates factor V needed by H. influenzae

A

Satellite phenomenon

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41
Q

What is the most common cause of epiglottitis

A

Haemophilus influenza

This can also cause meningitis, otitis media, pneumonia

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42
Q

[Etiology]

thumb sign, cherry red epiglottis

A

Epiglotitis - H. influenzae

Tx: ceftriaxone

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43
Q

HiB vaccine is conjugated with diphtheria toxin given between ___ age

A

2 and 18 months of age

Conjugated vaccine elicits Tcell response

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44
Q

What enable B. pertussis to bind to ciliated epithelial cells of the bronchi?

A

filamentous hemagglutinin

it is apili rod

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45
Q

Pertussis toxin can cause to increased sensitivity to histamin, increased insulin release, and peripheral lymphocytisis due to ___

A

ADP-riboxylation leading to increase in cAMP

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46
Q

Presence of this in B. pertussis inhibits phagocytosis, weakens neutrophils

A

Extracytoplasmic adenylate cyclase

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47
Q

What causes the whooping in patients infected with B. pertussis

A

Tracheal cytotoxin that damages ciliated cells

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48
Q

In B. pertussis, when dies whooping couch happens

at the peak of bacterial load or after it?

A

after the peak of the bacterial load

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49
Q

What is the DOC for pertussis?

A

Erythromycin

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50
Q

acellular Pertussis vaccine is combined with what other vaccines?

A
  1. Diphtheria
  2. Tetanus

DTaP

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51
Q

Legionella antigen can be detected by using this sample

A

Urine

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52
Q

what are examples of you facultative intracellular bacteria

A
  1. Salmonella
  2. Brucella
  3. Mycobacteria
  4. Listeria
  5. Francicella
  6. Legionella
  7. Yersinia

Some Bugs May Live FacultativeLY

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53
Q

What protect L. pneumophila from macrophage superoxide and hydroperoxide oxidative burst?

A
  1. Cu-Zn SOD

2. Catalase peroxidase

54
Q

What promotes attachment and adhesion in Legionella?

A
  1. Pili

2. Flagella

55
Q

[Diagnosis]

pneumonia with confusion, non-bloody diarreha, hyponatremia, proteinuria, hematuria

A

Legionella

56
Q

Pontiac fever is caused by

A

L. pneumophila

Tx: Azithromycin or Erythromycin

57
Q

[Gram Neg: GUT]

lactose fermenter,

green sheen

58
Q

[Gram Neg: GUT]

lactose fermenter,
urease positive
ESBL

A

klebsiella pneumoniae

59
Q

[Gram Neg: GUT]

comma shaped, motile, oxidase positive

A

V. cholerae

60
Q

[Gram Neg: GUT]

Comma-shaped, microaerophilic, skirrow agar

61
Q

[Gram Neg: GUT]

comma-shaped, urease positive

62
Q

[Gram Neg: GUT]

non-lactose fermenter, Gram neg rods

motile, oxidase negative, H2S producer

A

Salmonella

63
Q

[Gram Neg: GUT]

non-lactose fermenter, Gram neg rods

Non-motile, oxidase negative, H2S non-producer

64
Q

[Gram Neg: GUT]

non-lactose fermenter, Gram neg rods

swarming, oxidase negative, H2S producer, urease

A

Proteus mirabilis

65
Q

[Gram Neg: GUT]

non-lactose fermenter, Gram neg rods

oxidase positive, H2S non-producer, obligate aerobe

A

P. aeruginosa

66
Q

What are your lactose fermenters

A

Citrobacter
Klebsiella
E. coli
Enterobacter

67
Q

What virulence in E. coli is associated with pneumonia and neonatal meningitis

68
Q

What E. coli enterotoxin cause cholera-like effect

A

ST and LT cause watery diarrhea

69
Q

What E. coli enterotoxin causes bloody diarrhea?

A

verotoxin (shiga-like) toxin

Cholera-like = ST and LT

70
Q

What are your enterobacteriaceae?

A

MESSY SPECK

Morganella
Escherichia
Shigella
Salmonella
Yersinia
Serratia
Proteus
Enterobacter
Citrobacter
Klebsiella
71
Q

What is the most common cause of community acquired UTI?

72
Q

What is the second most common cause of neonatal meningitis?

73
Q

[E. coli strain]

Watery diarrhea, travel to developing country

74
Q

[E. coli strain]

Watery diarrhea in infants

75
Q

[E. coli strain]

Bloody diarrhea, HUS

76
Q

[E. coli strain]

Bloody diarrhea, no HUS

77
Q

[E. coli strain]

persistent watery diarrhea, patient with HIV

78
Q

What is the DOC for UTI caused by E. Coli

A
  1. Ampicillin

2. Sulfonamides

79
Q

What is the DOC for meningitis and sepsis caused by E. coli

A

3rd gen cephalosporin

80
Q

__ test detect salmonella antibodies

A

Widal Test

81
Q

Salmonella strain who’s habitat is in the human colon only

82
Q

Typhoid fever is due to what virulence factor in S. typhi?

A

Vi capsular antigen

83
Q

S. typhi preferentially multiply to ____ before invading the reticuloendothelial system

A

peyer patches

84
Q

Chronic carrier state of S. typhi is due to invasion of what organ

A

gallbladder

85
Q

[Culture source of salmonella]

best source in ALL stages of Salmonella infection

A

Bone marrow

86
Q

[Culture source of salmonella]

week 1 on disease: stepwise fever, anorexia, malaise, relative BRADYcardia, bacteremia

87
Q

[Culture source of salmonella]

Week 2, abdominal pain, bloating constipation, rose spots, hepatosplenomegaly, jaundice

88
Q

[Culture source of salmonella]

patients present with bleeding, ileitis, pneumonia

89
Q

[Culture source of salmonella]

chronic carrier state

90
Q

Patients with sickle cell anemia are most commonly infected with this bacteria causing septicemia

A

Salmonella

91
Q

[Etiology of Osteomyelitis]

Burn patient

A

P. aeruginosa

92
Q

[Etiology of Osteomyelitis]

IV drug users

A
  1. S. aureus

2. P. aeruginosa

93
Q

[Etiology of Osteomyelitis]

Sickle cell anemia

A
  1. Salmonella choleraesius
94
Q

Shigella preferentially invades which part of the GIT?

A

distal ileum and colon

95
Q

How many bacilli is needed for Shigella to cause symptoms

A

200

Invasion is due to M cells

96
Q

What shigella strain is the most common cause of bacillary dysentery?

A

Duval’s bacillus

Shigella sonnei

97
Q

What shigella strain is presents with the most severe form of bacillary dysentery?

Can cause epidemic dysentery

A

Shigella dysenteriae type 1

98
Q

[Spectrum of shigella]

Fever, abdominal cramps then bloody diarrhea

A

Bacillary dysentery

Tx: Ciprofloxacin

99
Q

Shooting star motility

100
Q

Strain of vibrio that is seen in salwater

A
  1. V. parahaemolyticus

2. V. vulnificus

101
Q

In Vibrio infection, what enhancement to the intestinal mucosa?

102
Q

What strain of vibrio causes pandemics?

A

V. cholerae O1 biotype El Tor

103
Q

What GPCR is affected by pertussis toxin?

A

Gi

It inhibits G1 leading to increased cAMP

Cholera, stimulate Gs, leading to increased cAMP

104
Q

DOC for V. parahaemolyticus and V. vulnificus

A
  1. Minocycline + FQ OR

2. Minocyline + Cefotaxime

105
Q

What is the most common cause of bacterial gastroenteritis?

A

C. jejuni

Tx: Erythromycin

106
Q

C. jejuni infection mimics what inflammatory bowel disease?

107
Q

C. jejuni is associated with Reiter syndrome which presents as

A
  1. Urethritis
  2. Uveitis
  3. Arthritis
108
Q

What are your urease positive bacteria?

A
  1. Proteus mirabilis
  2. Klebsiella pneumoniae
  3. H. pylori
  4. Ureaplasma urealyticum
109
Q

H. pylori preferentially damages what cells of the gastric mucosa?

A

goblet cells

110
Q

What is produced by H. pylori to neutralize stomach acid?

A

Ammonia from urea

111
Q

What are the diseases associated with H. pylori infection?

A

Gastric CA

MALT lymphomas

112
Q

What is the most common cause of pneumonia in alcoholics?

A

K. pneumoniae

113
Q

What is the characteristic sputum of K. pneumoniae?

A

Thich
Blooddy

“currant-jelly” sputum

114
Q

“Swarming motility”

A

Proteus mirabilis

Tx: TMP-SMX

115
Q

Urease in proteus can lead to stone formation due to ___

A

ammonia alkalinizing the uring

struvite stone formation

116
Q

What is the composition of struvite stone (associated with Proteus mirabilis)

A

Magnesium-ammonium-phosphate

117
Q

Grape-like odor, pyocyanin, obligate aerobe

A

P. aeruginosa

118
Q

Exotoxun A of P. aeruginosa inactivates ___ of the cell

119
Q

What facilitates P. aeruginosa exotoxin transfer?

A

Type III secretion system

120
Q

Pyocyanin produced by P. aeruginosa damages ___ cells

A

cilia, mucosal cells

121
Q

What is the etiology of malignant otitis externa in diabetics?

A

P. aeruginosa

122
Q

Shanghai fever presents with mild form of typhoid. It is due to

A

P. aeruginosa

123
Q

What is the THIRD most common cause of nosocomial UTI?

A

P. aeruginosa

124
Q

What causes ecthyma gangrenosum

A

P. aeruginosa

125
Q

What are your anti-pseudomonal drugs: Cephalosporin

A
  1. Ceftazidime

2. Cefepime

126
Q

in refractory pseudomonas aeruginosa infection, what medication is added?

A

Rifampicin

127
Q

___ pleomorphic gram negative bacillus, isolated in hospital environment and hospitalized patients; colonized IV solution; seen in organs

A

Acinetobacter baumanii

128
Q

___ ubiquitous gram negative bacillus, neonatal meningitis.

nonfermenting, nonmotile, oxidase positive, gram negative aerobic bacillus

A

Elizabethkingia meningosepticum

129
Q

___ may be confused with pseudomonas species

catalase and oxidase positive, motile, gram negative rod, oxidizes xylose and glucose

A

Achromobacter xylosoxidans

130
Q

___ anaerobic, gram negative, spreads to blood or peritoneum during bowel trauma, perforation or surgery

foul smelling discharge

A

B. fragilis

has LPS but low endotoxic activity

Tx: metronidazole, Clinda or cefoxitin

Infectious Disease (OSI type) (24 decks)

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