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Gram Negative and Other Bacteria Flashcards

1
Q

What are the gram negative cocci

A

N. meningitidis
N. Gonorrhoae
Moraxella catarrhalis
All are oxidase +

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2
Q

How to differentiate b/w the two neisserias

A

Meningitidis: Fermenter
Gonorrhea: Non fermenter

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3
Q

What are the coccoid rods

A

H Influenza
B pertussis
Pasteurella
Brucella

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4
Q

How are the gram negative rods differentiated?

A

Lactose fermenter - pink

Lactose non fermenter

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5
Q

What are the lactose fermenting GNR’s?

A 
Klebsiella
Ecoli
Enterobacter
Citrobater
Serratia
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6
Q

What are the slow lactose fermenters

A

citrobacter

serratia

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7
Q

What are the lactose nonfermenters?

A 
White colonies:
Shigella
Salmonella
Proteus
Pseudomonas (oxidase +)
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8
Q

What are the fast lactose fermenters

A

Klebsiella
E coli
Enterobacter

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9
Q

How are the lactose nonfermenters differentiated?

A

If they have oxidase

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10
Q

Oxidase positive gram negative rod

A

Pseudomonas

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11
Q

What gram negative bacteria are curved or comma shaped?

A

Campylobacter jejuni
Vibrio cholera
H Pylori

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12
Q

Neisseria

A

Gram negative diplococci

Both ferment glucose and make IgA proteases

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13
Q

N. Gonorrhea clinically

A

Urethritis, PID, STI

Can travel in blood and cause septic arthritis, conjunctivitis

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14
Q

N. gonoccoi structure

A

Maltose non fermenter
Gram neg diplococci
No polysaccharide capsule

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15
Q

1st line tx for N gonorrhea

A

Ceftriaxone

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16
Q

N. Meningococci transmission

A

Respiratory and oral secretions

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17
Q

N. meningococci structure

A

Maltose fermenter

Polysaccharide capsule

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18
Q

What bug can cause Waterhouse-Friedrichsen syndrome

A

N. meningitidis

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19
Q

Prophylaxis for meningococci

A

Rifampin, ciprofloxacin, ceftriaxone

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20
Q

Treatment for meningococci

A

Ceftriaxone or PCN G (only after culture)

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21
Q

Haemophilus influenza structure

A

Gram neg coccoid rod

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22
Q

What does H Flu cause

A 
Epiglottitis
Meningitis
Otitis media
Pneumonia
Sinusitis
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23
Q

Thumb sign on XR

A

Thickening of epiglottis = H Flu epiglottitis

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24
Q

Treatment of H Flu

A

Treat mucosal infxn w/amoxicillin+/- clavulanate

Treat meningitis with ceftriaxone

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25
What's most invasive form of H flu
Capsular type B (there's a vaccine now)
26
What does H flu produce
IgA protease
27
How to culture H Flu
Chocolate agar w/factors V and X
28
Hemophilus ducreyi
Causes chancroid - painful solitary genital ulcer
29
Legionella pneumophila
Gram negative rod but stains poorly so use silver stain
30
What do you have to grow legionella on
Charcoal yeast extract culture with iron and cysteine
31
How is legionella diagonsed
Antigen in urine
32
Transmission of legionella
NO person to person | Aerosol transmission from environmental water source habitate
33
Tx of legionella
Macrolide (erythromycin) or quinolone
34
Pseudomonas aeurginosa
``` Gram negative rod Oxidase positive Lactose non fermenter Moist environments Blue-green pigment ```
35
Infxns from pseudomonas
``` PNA - cystic fibrosis Otitis externa UTI Osteomyelitis - diabetics Sepsis Contaminates medical equipment and catheters Associated with burn and wound infections Hot tub folliculitis ```
36
Pseudomonas toxin
Exotoxin A - inactivates EF-2 - cell necrosis
37
Tx of pseudomonas
Piperacillin, Ticarcillin Cefepime, ceftazidime Imipenem, meropenem
38
H Pylori triple therapy
PPI + Clarithromycin + either amoxicillin or metronidazole
39
Gram negative, oxidase positive, diplococci
N gonorrhea or N meningitidis
40
Sepsis, DIC, adrenal hemorrhage
N. meningitidis
41
5 year old w/pharyngitis, drooling, and x ray reveals thumb sign
H flu type B (epiglottitis)
42
What are the virulence factors of E Coli
Fimbriae K Capsule LPS endotoxin
43
What does K capsule of E coli cause
PNA, neonatal meningitis
44
What does fimbriae of E coli cause
Cystitis, pyelonephritis
45
What does LPS endotoxin of E coli cause
Septic shock
46
What does EIEC strain of E coli do
Invades intestinal mucosa and causes necrosis and inflammation Similar to shigella
47
Presentation and treatment of EIEC
Fever + bloody diarrhea | Tx: Fluoroquinolones
48
Toxin and mechanism of ETEC
Produces heat labile and heat stable enterotoxins | No inflammation or invasion
49
Presentation of ETEC
Travelers diarrhea - watery, similar to cholera
50
Toxin and mechanism of EPEC
No toxin produced | Adheres to apical surface and flattens villi which prevents absorption
51
Presentation of EPEC
Diarrhea, usually in kids
52
EHEC presentation and treatment
Dysentery, HUS (Anemia, thrombocytopenia, ARF) | Tx = supportive
53
How to differentiate EHEC from other E Coli strains
It does not ferment sorbitol
54
What is klebsiella
Gram negative rod, fast fermenter of lactose
55
Red currant jelly sputum
Klebsiella
56
What does Klebsiella cause
Intestinal flora that causes lobar pneumonia in alcoholics and diabetics when aspirated Mucoid colonies caused by abundant polysaccharide capsules Nosocomial UTI
57
What are the 4 A's of klebsiella
Aspiration pneumonia Abscess in lungs and liver Alcoholics diAbetics
58
How are salmonella and shigella similar
Both cause bloody diarrhea and fever, both do not ferment lactose and both are oxidase negative
59
Salmonella typhi clinical presentation
Typhoid fever Rose spots on abdomen, fever, HA, diarrhea Can stay in gallbladder and cause carrier state
60
Treatment of shigella
Fluoroquinolones
61
How is shigella spread in body
Cell-cell - no hematogenous spread
62
How is shigella spread in environment
Humans and primates
63
Cellular response of salmonella vs shigella
Salmonella: Monocyte response Shigella: PMN infiltration
64
What is campylobacter jejuni
Gram negative oxidase + comma shaped, grows in hot temperature.
65
What does campylobacter cause
Guillain-Barre, reactive arthritis, bloody diarrhea in kids
66
What is vibrio cholera
Gram negative oxidase + comma shaped. Grows in alkaline media
67
How does vibrio cholera produce rice water diarrhea
Heat labile endotoxin permanently activates Gs, increasing cAMP.
68
What does Yersinia enterocolitis cause
Mesenteric adenitis that can look like appendicitis or crohn's disease
69
How is yersinia transmitted
Pet feces (puppies), contaminated milk, or pork
70
What is yersinia
Similar to shigella and salmonella, it's a gram negative rod, non lactose fermenting and oxidase negative.
71
What is borrelia
Spirochete - spiral shaped bacteria w/axial filaments, only spirochete that can be visualized on LM
72
What is Leptospira interrogans
Spirochete that causes leptospirosis
73
What is leptospirosis
Flu like symptoms, jaundice, photophobia with erythema
74
Who is leptospirosis found in
Surfers, in the tropics | It's found in water contaminated with animal urine
75
What is Weil disease
Icterohemorrhagic leptospirosis | Severe form of leptospirosis with jaundice and azotemia (kidney and liver dysfunction), fever, hemorrhage, and anemia
76
What is the natural vector for Borrelia burgodrferi
Mouse | The tick can transmit it
77
Treatment of Lyme disease
Doxycycline, Ceftriaxone
78
What characterizes the Bell's palsy of Lyme disease
Bilateral and affects forehead
79
What is an Argyll Robertson pupil
Constricts with accomodation but is not reactive to light | Associated with tertiary syphilis
80
What are some causes of VDRL false positives
``` VDRL detects nonspecific antibody that reacts w/beef cardiolipin Viruses - mono, hepatitis Drugs Rheumatic fever Lupus, leprosy ```
81
What is the treatment for all rickettsial diseases
Doxycycline
82
What is the rickettsial triad
Headache, fever, rash (vasculitis)
83
What causes rocky mountain spotted fever
Rickettsia rickettsii - obligate intracellular
84
Clinical pres of RMSF
Rash that starts at wrists and ankles, then spreads to trunk, palms, and soles
85
What causes Typhus
R. typhi - endemic | R. prowazekii - epidemic
86
What is the rash like in typhus
Rash starts centrally, then spreads, spares palms and soles
87
Ehrlichiosis
Ehrlichia - vector is tick | Monocytes with morula in cytoplasm
88
Anaplasmosis
Anaplasma - vector is tick | Granulocytes with morulae in cytoplasm
89
Q fever agent
Coxiella burnetii - tick feces and cattle placenta release spores that are inhaled.
90
Q fever presentation
Atypical Pneumonia
91
How is Q fever unique from other Rickettsia species
No Weil-Felix reaction | Spores that can survive in endospore form
92
What are the two forms of chlamydia
1. elementary body - infectious, enters cell via endocytosis, transforms into reticulate body 2. Reticulate body- replicates in cell by fission and reorganizes into elementary bodies
93
What species of chlamydia cause atypical PNA
C. pneumoniae, C. psittaci
94
What species of chlamydia can cause reactive arthritis, follicular conjunctivitis, urethritis, and PID
Chlamydia trachomatis
95
Tx of chlamydia
Azithromycin
96
Dx of chlamydiae
Giemsa or fluorescent aby-stained smear shows cytoplasmic inclusions
97
Lymphogranuloma venerum
Types L1-L3 of chlamydia trachomatis cause small painless ulcers on genitals that cause swollen and painful inguinal lymph nodes which ulcerate. Tx = doxycycline
98
What is the classic cause of atypical walking pneumonia
Mycoplasma pneumoniae
99
Lab findings in mycoplasma pna
High titer of cold agglutinins (IgM) that can agglutinate or lyse RBCs
100
How is mycoplasma pneumo grown
Eaton agar
101
Tx of mycoplasma pneumo
Macrolide, doxycycline, or fluoroquinolone | NO pcn - no cell wall
102
What is contained in mycoplasma pneumo bacterial membrane
No cell wall | Membrane contains sterols for stability

Micro (8 decks)

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