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Micro > Gram Negative Algorithm > Flashcards

Gram Negative Algorithm Flashcards

1
Q 
Neisseria Meningitidis (gram - diplococci)
(catalase and oxidase +)
A
  1. ferments glucose (and Maltose)
  2. IgA protease
  3. Polysaccharide capsule, vaccine (none for B)
  4. Respiratory and oral secretions
  5. Waterhouse-Friderichsen syndrome
    5a. catalase and oxidase +
  6. treat: Pen G, ceftriaxone
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2
Q

Neisseria Gonococci (catalase and oxidase +)

A
  1. Sexually transmitted
  2. No polysaccharide capsule
  3. septic arthritis
  4. Fitz Hugh Curtis syndrome (adhesions to liver capsule)
  5. No maltose fermentation
  6. catalase and oxidase +
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3
Q

Haemophilus Influenza

child with trouble breathing and swallowing, “sitting dog position”, and increased drooling–> comporamised airway (dont upset kid)

A
  1. Capsular Type B–most invasive disease
  2. IgA protease production
  3. MOPS
  4. Cherry red epiglottis in children
  5. Chocolate agar for growth (factors V-NAD and X-hemantin)
    TX: amoxacillin + clavulanate acid
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4
Q

Haemophilus Ducreyi

A

Chancroid, genital ulcer, solitary and painful. (unlike syphilis which is a painless chancre)

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5
Q

Legionella Pneumophila

A
  1. cause of atypical pneumonia
  2. Silver stain
  3. grow on charcoal yeast extract (with iron and cysteine)
  4. Urine test (antigen in urine)
  5. Water source transmission (air conditions, hot water tanks)
  6. no person to person
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6
Q 
Pseudomonas Aeruginosa 
(lactose non fermenter, oxidase +)
A
  1. grape like odor
  2. pyocyanin (blue green pigment)
  3. Water source, Wound infections, BURNS
  4. Chronic Pneumonia in CF
  5. endotoxin, exotoxin A (inactivated EF-2)
  6. hot tub folliculitis, swimmer’s ear
  7. Ecthyma gangrenosum
  8. immunocompramised (AIDS)
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7
Q

EColi virulence factors

A
  1. Fimbriae–cystitis and pyelonephritis (allows ascension of bacteria up urinary tract)
  2. K capsule– pneumonia and neonatal meningitis
  3. LPS endotoxin–septic shock
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8
Q

EIEC

A
  1. invades intestinal mucosa
  2. intestinal necrosis and inflammation
  3. Dysentery (bloody)
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9
Q

ETEC

A
  1. traveler’s diarrhea
  2. heat labile toxin-(high AC–high cAMP)
    3 heat stable toxin-(high GC–high cGMP)
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10
Q

EPEC

A
  1. adheres to apical surface of intestinal cells and flattens villi (decreases absorption)
  2. Children
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11
Q

EHEC (O157:H7)

A
  1. Shiga like toxin (ADP ribosylating AB toxin-inactivates 60s subunit–removes adenine)
  2. Dysentery
  3. HUS (anemia, thrombocytopenia, renal failure)
  4. NO ferment of Sorbitol ( all other Ecoli do)
  5. No glucuronidase (other Ecoli do)
  6. Microthrombi formed–> schistiocytes, and thrombocytopeia (use up platelets)
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12
Q

Klebsiella (lactose fermenter-fast)

A
  1. Aspiration Pneumonia (lobar type)
  2. Alcoholics, diabetics, ICU?
  3. Mucoid colonies– Red Currant Jelly
  4. Abscesses in lungs and liver
  5. Nosocomial UTI’s
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13
Q

Salmonella (lactose non fermenter, oxidase -)

A
  1. flagella, hematogenous spread
  2. H2S
  3. monocytic intestinal response
  4. bloody diarrhea
  5. antibiotics–prolong fecal excretion
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14
Q

Shigella (lactose non fermenter, oxiade -)

A
  1. No flagella
  2. No H2S
  3. PMN intestinal response
  4. bloody diarrhea
  5. Antibiotics–shorten fecal excretion
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15
Q

Salmonella Typhi

A
  1. Typhoid fever
  2. Rose spots on the abdomen
  3. fever, headache, diarrhea
  4. Carrier state–remains in the gallbladder
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16
Q

Campylobacter jejuni (oxidase +, comma shaped)

A
  1. Bloody diarrhea in children
  2. Grows in hot environment (42)
  3. poultry, meats, unpasteurized milk
  4. Guillen Barre (ascending paralysis)
  5. Reiter’s (reactive arthritis)
17
Q

Vibrio Cholera (comma shaped, (oxidase +, comma shaped)

A
  1. Grows in alkaline media
  2. Cholera toxin: increases cAMP (permanently activates Gs)
  3. Rice water diarrhea
18
Q

Yersina Enterocolita

A
  1. Pet feces, contaminated milk, pork
  2. Appendicidis like pain
  3. mesenteric adenitis
19
Q

H. Pylori (comma shaped, oxidase +, catalase +)

A
  1. Urease +
  2. gastritis, peptic ulcers
  3. intestinal type gastric carcinoma
  4. Triple therapy: PPI+clarithromycin+amoxacillin/metronidazole
20
Q

Leptospira (spirochete)

A
  1. water contaminated with animal urine
  2. jaundice, photophobia
  3. conjunctival suffusion (erythema no exudate)
  4. surfers in hawaii
  5. Weil Disease –liver and kidney dysfunction
21
Q

Borrelia Burgdorfi (Lyme Disease)

A
  1. Mass. (northeast US)
  2. Ixodes tick (natural reservoir is the mouse)
  3. Bull’s eye rash (erythema migrans)
  4. 3 stages
  5. later stages–> monoarthritis, migratory polyarthritis
  6. Bell’s palsy (often bilateral)
    AV node block
    Wright or Geimsa stain to visual on light microscopy
22
Q

Treponema Pallidum (syphilis)

A
  1. Painless chancre –primary syphilis
  2. dark field microscopy
  3. 2* syphilis–> maculopapular rash on palms and soles
    condylmata lata
  4. 3* syphilis–> Gummas (chronic granulomas), Aortitis (vasa vasorum destruction), Argyll Robertson pupil ( not reactive to light, but constricts on accomodation)
23
Q

Congenital Syphilis

A

Saber shins, saddle nose, deafness (CN VIII), Hutchinson teeth, mulberry molars,
Transfer is in 1st semester.

24
Q

Bordatella Pertussis

A
  1. Whooping Cough

2. Pertussis toxin – inhibit phagocyte ability . disable Gi, increases cAMP, impairs phagocytosis.

25
Q

Rocky mountain Spotted fever (Rickettsia R.)

A
  1. Rash (palms and soles) and then spreads to trunk
  2. Classic triad: headache, rash, vasculitis
  3. Intracellular
  4. vector-tick, south atlantic states (North carolina)
26
Q

Chlamydiae (unusual cell wall no muramic acid)

a. ABC–Blindness, chronic, africa
b. D-K– PID, urethritis, ectopic pregnancy (scarring of fallopian tubes). Neonatal conjunctivitis
c. L1,L2,L3– buboes.

A
  1. intracellular (cannot make own ATP)
  2. elementary body, reticulate body
  3. Trachamotis–STD, PID, Reiter’s, follicular conjunctivitis
  4. Psittaci–Pneumonia, bird vector (parrots)
  5. C. pneumonia–atypical pneumonia
  6. Geimsa stain
27
Q

Mycoplasma Pneumoniae (gram pos?)

A
  1. No cell wall

2. atypical pneumonia

28
Q

Mycoplasma Pneumoniae (gram pos?)

A
  1. No cell wall

2. atypical pneumonia

Micro (7 decks)

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