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Step 1 Microbiology - First Aid 2017 > Gram negative bacteria > Flashcards

Gram negative bacteria Flashcards

1
Q

Bacteria associated with HUS

A

EHEC-O157:H7 and Shigella

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2
Q

Bacteria associated with Aspiration pneumonia and lung Abscesses with currant-jelly sputum

A

Klebsiella

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3
Q

Bacteria associated that grow pink colonies on McConkey agar, lactose fermenters, multi-drug resistant and cause nosocomial pneumonia & UTIs

A

Klebsiella, Serratia, Enterobacter

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4
Q

Acid-labile gram negative rod, non-lactose fermenter, oxidase negative causing pea-soup diarrhea

A

Salmonella typhi

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5
Q

Treatment for Salmonella typhi

A

Ceftriaxone or fluoroquinolones

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6
Q

Virulence factor for S. typhi

A

Endotoxin and Vi capsule

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7
Q

Virulence factor for non-typhoidal Salmonella

A

Type III secretion system

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8
Q

Shigella mechanism of spread

A

M-cell to M-cell in Peyer patches using rocket propulsion via actin filaments

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9
Q

Gram negative rod, non-lactose fermenter, oxidase negative with green colonies on Hektoen agar

A

Shigella

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10
Q

Salmonella grows what color colonies

A

Black colonies on Hektoen agar

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11
Q

Salmonella requirement for infectivity

A

Large inoculum since acid labile

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12
Q

Key feature of Shigella to cause infectivity

A

Invasion of M cells in Peyer patches

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13
Q

Sexually active male with asymmetric joint pain

A

N. gonorrhoeae infection

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14
Q

Gram-negative diplococci that is maltose positive

A

N. meningitidis

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15
Q

Futz-Hugh-Curtis syndrome is associated with what organism

A

N. gonorrhoeae

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16
Q

N. meningitidis close contacts require…

A

Prophylaxis treatment with either Rifampin, Ciprofloxacin, or ceftriaxone

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17
Q

N. gonorrhoeae infections require treatment with…

A

Ceftriaxone + azithromycin or doxycycline for possible chlamydial infection

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18
Q

Complications of N. gonorrhoeae infection in women

A

PID causing infertility and/or Fitz-Hugh-Curtis syndrome

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19
Q

Adrenal insufficiency, fever, DIC, shock are what type of syndrome

A

Waterhouse-Friderichsen syndrome

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20
Q

What type of immune deficiency predisposes to Neisseria infections

A

Complement deficiency C5-C9

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21
Q

What type of patients are predisposed to increased risk of meningococcal infections

A

Sickle-cell and asplenic patients are at increased risk of infections from encapsulated organisms

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22
Q

Source of resistance in N. gonorrhoeae

A

Pili have antigenic variation

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23
Q

Which vaccine type is not available for meningococcal infections

A

Type B

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24
Q

Special media needed to grow Neisseria bacteria

A

Thayer-Martin (VPN) chocolate agar

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25
Q

What allows Neisseria ability to invade

A

IgA protease permits attachment to mucosal surfaces by cleaving IgA

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26
Q

What gives Neisseria its strong endotoxin activity

A

Lipooligosaccharide (LOS)

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27
Q

E. coli virulence factor causing neonatal meningitis

A

K-capsule

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28
Q

E. coli virulence factor causing pneumonia

A

K-capsule

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29
Q

K-capsule virulence factor in E coli causes…

A

Pneumonia and neonatal meningitis

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30
Q

Main cause of UTIs in sexually active women

A

E. coli

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31
Q

E. coli virulence factor that causes cystitis and pyelonephritis

A

Fimbriae

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32
Q

E. coli endotoxin that causes septic shock

A

LPS

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33
Q

E. coli species that does not ferment sorbitol

A

EHEC

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34
Q

E. coli species that causes traveler’s diarrhea

A

ETEC

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35
Q

What causes HUS in EHEC infection

A

Shiga-like toxin inhibits 60s subunit of ribosome

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36
Q

E. coli that typically causes diarrhea in children

A

EPEC

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37
Q

E. coli that causes diarrhea similar to Shigella

A

EIEC

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38
Q

Mechanism of ETEC for causing traveler’s diarrhea

A

Heat Labile toxin increase cAMP

Heat Stable toxin increases cGMP

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39
Q

Gram negative encapsulated rod that looks like safety pin on bipolar staining

A

Yersinia enterocolitica

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40
Q

Mode of transmission for Yersinia pestis

A

Fleas from rats or prairie dogs

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41
Q

Mode of transmission for Yersinia enterocolitica

A

Pet feces (puppies) contaminated milk or pork

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42
Q

Bacteria with safety pin appearance that causes bloody diarrhea

A

Yersinia enterocolitica

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43
Q

Toddler with right lower quadrant pain and bloody diarrhea with pet puppy has what infection

A

Yersinia enterocolitica

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44
Q

Recent camper to desert has buboes was infected how

A

Flea bites (Y. pestis)

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45
Q

Treatment for Y. pestis

A

Streptomycin with tetracycline

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46
Q

Treatment for Y. enterocolitica

A

Streptomycin with tetracycline

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47
Q

Complications of gram negative, oxidase positive, S-shaped rod that grows at 42 degrees C

A

Reactive arthritis, bloody diarrhea, and ascending paralysis

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48
Q

Source of infection for gram negative, oxidase positive, S-shaped rod that grows at 42 degrees C

A

Fecal-oral via person-person or eating contaminated poultry or contact with infected animals

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49
Q

Complication of coma-shaped, gram negative, oxidase positive bacteria that grows in alkaline media

A

Profuse rice-water diarrhea

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50
Q

Mechanism of cholera toxin

A

Permanent activation of Gs increases cAMP

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51
Q

Patient on antacids is at risk of infection from this gram-negative, comma-shaped, oxidase positive organism

A

Vibrio cholerae

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52
Q

Oral fluid therapy in cholera infection stimulates what

A

Na/Glucose transporter

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53
Q

Triple positive motile gram negative curved rod is found in what section of the stomach

A

Antrum

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54
Q

Risk factors for triple positive motile gram negative curved rod

A

PUD, gastric adenocarcinoma, MALT lymphoma

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55
Q

Typical area of gastritis and peptic ulcers in a triple positive motile gram negative curved rod

A

Duodenum

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56
Q

Treatment for H. pylori

A

Amoxicillin, Clarithromycin, and PPI

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57
Q

Alternative antibiotic in H. pylori if allergic to amoxicillin

A

Metronidazole

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58
Q

Diagnostic test for H. pylori

A

Urea breath test or fecal antigen test

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59
Q

Gram-negative rod associated with hot tub folliculitis

A

Pseudomonas

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60
Q

Most common cause of respiratory failure in CF patients

A

Pseudomonas infection

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61
Q

Blue-green pigment that produces a grape-like odor

A

Pyocyanin

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62
Q

Function of pyocyanin in Pseudomonas

A

Generates ROS

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63
Q

At risk groups for Pseudomonas induced osteomyelitis

A

Diabetes and IV drug users

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64
Q

Nosocomial infections associated with Pseudomonas

A

UTIs and pneumonia

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65
Q

Skin complication of oxidase and catalase positive organism that produces a blue-green pigment

A

Ecthyma gangrenosum and hot tub folliculitis

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66
Q

Pseudomonas virulence factor that inactivates EF-2

A

Exotoxin A

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67
Q

Effect of inactivating EF-2

A

Decreased protein synthesis by inhibiting 60s ribosomal subunit

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68
Q

Treatment of choice for Pseudomonas

A

Piperacillin with beta-lactamase inhibitor

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69
Q

Treatment choice for UTI caused by Pseudomonas

A

Fluoroquinolones

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70
Q

Treatment for severe gram negative infections like Pseudomonas

A

Aminoglycosides with beta-lactamase inhibitor

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71
Q

Urease positive bacteria with swarming motility when plated that forms staghorn calculi

A

Proteus

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72
Q

Urease positive organism with fishy odor that causes UTI

73
Q

Treatment of choice for UTI caused by Proteus

A

Sulfonamides

74
Q

Mechanism of infection for Bordetella pertussis

A

Filamentous hemaglutinin attach to respiratory epithelium and releases pertussis toxin and tracheal cytotoxin

75
Q

Pertussis toxin mechanism of action

A

Ribosylates Gi activating AC which increases cAMP leading to impaired phagocytosis

76
Q

Tracheal cytotoxin mechanism of action

A

Damages ciliated cells of tracheal epithelium

77
Q

Stages of pertussis infection

A

Catarrhal phase, Paroxysmal phase, and Convalescent phase

78
Q

Phase of pertussis infection characterized by low grade fevers and coryza (stuffy nose)

A

Catarrhal phase

79
Q

Phase of pertussis infection characterized by paroxysms of intense cough followed by inspiratory “whooping cough” and possible vomiting

A

Paroxysmal phase

80
Q

Phase of pertussis infection characterized by gradual recovery of chronic cough

A

Convalescent phase

81
Q

Pertussis characteristics

A

Gram-negative aerobic, coccobacillus that causes distinctive whooping cough

82
Q

Bacteria characterized as having “100 days cough”

A

Bordetella pertussis

83
Q

Best way to prevent Bordetella pertussis

A

Acellular vaccine

84
Q

Treatment for pertussis infection

A

Early treatment with macrolides

85
Q

Small gram negative coccobacillary rod grown on chocolate agar that contains NAD+ and hematin for growth

A

Haemophilus influenzae

86
Q

What is required to grow H. influenzae when plated

A

Chocolate agar with factors V (NAD+) and X (hematin)

87
Q

Presents with cherry-red epiglottis, inspiratory stridor and drooling in children

A

Haemophilus influenzae

88
Q

The most common type of H. influenzae strain that causes otitis media, conjunctivitis, and bronchitis

A

Nontypeable (Unencapsulated) strains

89
Q

Reason H. influenzae can grow with S. aureus

A

Provides NAD+ (factor V) through hemolysis of RBCs

90
Q

H. influenzae vaccine contains what strain

A

Type b capsular polysaccharide conjugated to diphtheria toxoid or other protein given between 2 - 18 months

91
Q

Common complications of H. influenzae

A

Epiglottitis, Meningitis, Otitis media, Pneumonia

92
Q

What group of patients are at increased risk of Haemophilus infections

A

Sickle cell patients or asplenic patients

93
Q

Treatment for H. influenzae systemic disease or meningitis

A

Ceftriaxone

94
Q

What is given to close contacts in Haemophilus infections

95
Q

Haemophilus mucosal infection treatment

A

Amoxicillin +/- clavulanate

96
Q

Gram negative, oxidase positive rod, not visualized well with gram stain presents with disorientation and hyponatremia in smoker

A

Legionella

97
Q

Grown on charcoal yeast extract medium with iron and cysteine

A

Legionella

98
Q

Mild flu like syndrome characterized by fever and malaise in gram-negative rod not visualized well with gram stain

A

Pontiac fever

99
Q

Atypical pneumonia more common in smokers with patchy unilobar infiltrate on chest x-ray associated with hyponatremia and presents with confusion and high fever

A

Legionnaire’s disease

100
Q

Pneumonia, hyponatremia, and diarrhea

A

Legionnaire’s disease

101
Q

Used for rapid diagnosis of Legionnaire’s disease

A

Urine antigen test

102
Q

Complication of Bartonella infection in immunocompromised

A

Bacillary angiomatosis

103
Q

Complication of Bartonella infection in immunocompetent

A

Axillary lymphadenopathy

104
Q

Cause of Bartonella infection

A

Cat scratch

105
Q

Treatment for Bartonella infection

A

Doxycycline +/- macrolides

106
Q

Organism causing undulant fevers and anorexia after consuming unpasteurized dairy

107
Q

Treatment for Brucella infection

A

Doxycycline or tetracycline and rifampin to block oxidative burst

108
Q

Chronic complication of Brucella infection

A

Hepatosplenomegaly and osteomyelitis

109
Q

Vector that causes tularemia

A

Dermacenter tick commonly from rabbit

110
Q

Facultative intracellular, gram negative coccobacilli spread via dermacenter tick that causes painful ulcer

A

Francisella tularensis

111
Q

Reservoir for dermacenter tick that causes tularemia

112
Q

Recovery from tularemia infection depends on what?

A

Cell-mediated immunity

113
Q

Complication of tularemia

A

Granulomas with caseating necrosis in reticuloendothelial cells

114
Q

Treatment for tularemia

A

Aminoglycosides (streptomycin)

115
Q

Cause of cellulitis and osteomyelitis commonly from dog or cat bites

A

Pasteurella multocida

116
Q

Characteristics of Pasteurella multocida

A

Catalase and oxidase positive, gram negative, bipolar, encapsulated bacteria that grows on 5% sheep’s blood

117
Q

Treatment for Pasteurella

A

Penicillin + beta-lactamase inhibitor (clavulanate)

118
Q

Recent traveler to New England presents with bull’s eye rash contracted what disease?

A

Lyme disease

119
Q

Vector for Borrelia burgdorferi

A

Ixodes tick

120
Q

Main reservoir for Ixodes tick

A

White footed mouse

121
Q

Obligatory host for Ixodes tick

122
Q

Incidental host for Ixodes tick

123
Q

In addition to Lyme disease, what else does Ixodes tick transmit

A

Erlichiosis and babesiosis

124
Q

Cardiac complication of Lyme disease

A

Heart block

125
Q

Patient initially presented with bull’s eye rash now has bilateral facial paralysis recently travelled to…

A

The Northeastern United States

126
Q

Late stage complications of Lyme disease

A

Heart block, bilateral Bell’s palsy, encephalopathy and migratory arthritis

127
Q

Stains used to visualize spirochetes

A

Giemsa and Wright stain

128
Q

Borrelia burgdorferi has what shape

A

Spirochete

129
Q

Treatment for Lyme disease

A

Doxycycline; Ceftriaxone if severe

130
Q

Patient who recently travelled to Hawaii and presents with fever and conjunctivitis without pus most likely came in contact with…

A

water contaminated with animal urine

131
Q

Complications of question mark-shaped spirochete commonly found in urine contaminated water

A

Renal dysfunction and jaundice from liver damage

132
Q

Most likely organism in a water-skier who presents with azotemia, high creatinine levels and fever

A

Leptospira

133
Q

Spirochete causing painless chancre is best visualized how?

A

Dark-field microscopy

134
Q

Screening test for syphilis

135
Q

Patients with positive screening test for syphilis need what test to confirm diagnosis?

136
Q

Characteristics of secondary syphilis

A

Maculopapular rash on palms and soles of feet weeks to months after infection, Condyloma latum

137
Q

Patient who presents with gummas after initial presentation of painless chancre is at risk for developing what cardiac complications

138
Q

Mechanism of aortitis in secondary syphilis

A

Destruction of vasa vasorum

139
Q

Complication of treating syphilis with antibiotics

A

Jarisch-Herxheimer reaction (fever, chills, headache, myalgias) from killed spirochetes releasing toxins

140
Q

Organism associated with leading cause of blindness worldwide

A

Chlamydiae trachomatis A-C

141
Q

Complication in neonates born to mother’s with Chlamydiae

A

Neonatal pneumonia with eosinophilia and neonatal conjunctivitis

142
Q

Complications of Chlamydiae trachomatis in women

A

PID and ectopic pregnancy

143
Q

Those infected with Chlamydiae are often co-infected with…

A

N. gonorrhoeae

144
Q

Treatment for Chlamydiae includes…

A

Azithromycin or doxycycline and ceftriaxone (gonorrhea)

145
Q

Most common bacterial STI in the U.S.

A

Chlamydiae

146
Q

Obligate intracellular organism that cannot make its own ATP

A

Chlamydiae

147
Q

Infectious form of Chlamydiae

A

Elementary body

148
Q

Replicative form of Chlamydiae

A

Reticulate body

149
Q

The lack of cell wall in Chlamydiae renders what class of antibiotics ineffective

A

Beta-lactam antibiotics

150
Q

What strain of Chlamydiae causes atypical pneumonia

A

C. pneumonia and C. psittaci

151
Q

C. psittaci is transmitted how?

152
Q

Reticulate bodies are visualized how?

A

Giemsa or fluorescent antibody stain

153
Q

Chlamydiae is diagnosed how?

A

PCR or Nucleic Acid Amplification Test (NAAT)

154
Q

Q fever is caused by…

A

Coxiella burnetti

155
Q

Coxiella burnetti is transmitted how?

A

Inhalation of spores in animal droppings or animal amniotic fluid

156
Q

Farm worker with fever, cough and headache is at risk for developing what complication

A

Hepatitis (Q-fever)

157
Q

Q fever presents as…

A

Cough, fever, headache, pneumonia and hepatitis

158
Q

Sexually active girl who presents with gray vaginal discharge with fishy smell will have what type of cells under microscopy

A

Vaginal epithelial cells covered with gram-variable rods (Clue cells)

159
Q

Used to diagnose Gardnerella vaginalis

A

KOH prep (enhances fishy odor)

160
Q

Treatment for Gardnerella vaginalis

A

Metronidazole

161
Q

Mycoplasma pneumoniae typically affects what population group

A

Young adults < 30 years (18-40) or military recruits

162
Q

What provides stability to membrane in Mycoplasma pneumoniae

163
Q

Presentation of Mycoplasma pneumoniae

A

Insidious onset, headache, nonproductive cough, and patchy or diffuse interstitial infiltrate on x-ray

164
Q

Walking pneumonia is typically caused by what organism

A

Mycoplasma pneumoniae

165
Q

Test to confirm Mycoplasma pneumoniae infection

A

IgM cold agglutinin test; causes RBCs to agglutinate or lyse

166
Q

What is used to culture Mycoplasma pneumoniae

A

Eaton agar

167
Q

What class of antibiotics are ineffective in treating Mycoplasma pneumoniae

A

Penicillins since no cell wall

168
Q

Treatment for Mycoplasma pneumoniae

A

Macrolides, doxycycline or fluoroquinolones

169
Q

Weakly gram negative, coccobacilli, obligate intracellular organism unable to produce NAD+ and CoA

A

Rickettsia

170
Q

Used to diagnose Rickettsial infections

A

Weil-Felix agglutination test

171
Q

Treatment for Rickettsial infections

A

Doxycycline

172
Q

Presentation for Rickettsia prowazekii

A

Myalgias, arthralgias, pneumonia and encephalitis

173
Q

R. prowazekii causes what disease

A

Epidemic typhus

174
Q

Epidemic typhus is spread by what vector

A

Human body louse

175
Q

Epidemic typhus causes what type of rash

A

Rash starts centrally and spreads out sparing hands, feet and head

176
Q

What two organism cause typhus

A

R. typhi - endemic typhus

R. prowazekii - epidemic typhus

177
Q

Patient recently returned from a trip now presents with rash on wrist that spreads to trunk, palms and soles. What region of the U.S. did he visit?

A

South Atlantic states

178
Q

Patient visited his daughter in North Carolina and 2 weeks later develops a rash that starts at wrist and ankles and spreads centrally. What organism caused this?

A

Dermacenter tick

179
Q

Symptoms of Rocky Mountain spotted fever

A

Headache, fever, myalgia and centrally spreading rash

Step 1 Microbiology - First Aid 2017 (7 decks)

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