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Gram Negative Rods GIT GUT Flashcards

0
Q

Characteristic appearance of E. coli in EMB?

A

Metallic green sheen

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1
Q

Special mediums used for gram negative enterics?

A

EMB
MacConkey
Lactose vs Non lactose fermenters

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2
Q

Lactose fermenters?

A 
maCconKEE
Citrobacter
Kleb
Enterobacter
E. coli
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3
Q

Habitat of E. coli?

A

Human colon

Colonize vagina and urethra

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4
Q

Most common cause of community acquired UTI in the Philippines (underdeveloped countries)?
Also the most common cause of gram negative sepsis?

A

E. coli

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5
Q

Transmission of E. coli is via?

A

UTI - ascending
Neonatal men - birth
Diarrhea - fecal oral

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6
Q

Top three causes of neonatal meningitis?

A

GEL
GBS
E. coli
Listeria

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7
Q

Which E. coli strain causes watery diarrhea also known as traveler’s diarrhea?

A

ETEC

T - Toxigenic - Travelers

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8
Q

What causes watery stools in travelers diarrhea?

A

Pili + HST and HLT (cholera-like)
Inhibit Na reabsorption
Increase Cl and HCO3 secretion
TX: Hydrate!!

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9
Q

Which E. coli strain causes bloody diarrhea?

A

EHEC

H - Hemorrhagic - HUS

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10
Q

EHEC strain that causes HUS?

Anemia. Thrombocytopenia. Renal failure

A

E. coli O157:H7

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11
Q

Virulence factor responsible for bloody diarrhea and HUS?

A

Shiga like verotoxin

Inhibit 60s - no protein synthesis - cell death

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12
Q

Strain of E. coli that also causes bloody diarrhea due to invasion of epithelial cells with fever and CRAMPY abdominal pain?

A

EIEC
Invasive
Same toxin as shigella

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13
Q

Strain of E. coli that causes watery diarrhea of long duration in developing countries?

A

EPEC

P Pathogenic Pedia Philippines

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14
Q

Strain of E. coli that cause watery diarrhea in the immunocompromised?

A

EAEC

A Adherent AIDS

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15
Q

DOC for E. coli meningitis and sepsis? UTI?

A

Men and sepsis - Ceftriaxone

UTI - Ampicillin

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16
Q

Top three causes of gram negative sepsis

A

EK
E. coli
Kleb

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17
Q

Urease positive, with ESBL that cause nosocomial pneumonia in alcoholics?

A

Klebsiella pneumoniae

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18
Q

Characteristic sputum of Kleb pneumonia?

A

Currant jelly sputum

Intussusception

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19
Q

Antigens present in Kleb?

A

Only K antigen (Kapsule)

No H antigen - nonmotile

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20
Q

Gram negative enteric that causes rice water stools?

A

Vibrio cholerae

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21
Q

Toxin responsible for watery stools in cholera?

A

Choleragen - ADP ribosylation
Inhibit Na reabsorption
Increase Cl and HCO3 secretion

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22
Q

Characteristic shape and motility of Vibrio cholerae?

A

Comma shaped
Shooting star motility
(Trichomonas falling leaf, Proteus swarming, Listeria tumbling)

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23
Q

What special medium is used to culture Vibrio cholerae?

A

TCBS

Thiosulfate Citrate Bile salts Sucrose

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24
Q

Habitat of Vibrio cholerae?

A

Colon

Transmitte fecal oral by ingestion of fecal contaminated water

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25
Q

Species of Vibrio in raw seafood and in seafood handlers?

A

Raw - V. parahemolyticus

Handlers - V. vulnificus

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26
Q

DOC for cholera?

A

Tetracycline

Fluid replacement

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27
Q

DOC for v. parahemolyticus and vulnificans?

A

Minocycline

FQ

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28
Q

MCC of bacterial diarrhea overall?

A

Campylobacter jejuni

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29
Q

MCC of adult diarrhea? Pedia diarrhea?

A

Adult - Norwalk virus

Pedia - Rotavirus

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30
Q

Special medium for Campylobacter jejuni?

A

Campy’s agar

Skirrows agar

31
Q

Habitat of Campylobacter jejuni and transmission?

A 
In animals (poultry)
Fecal oral, drinking contaminated water or unpasteurized milk
32
Q

Characteristic stools in Campylobacter jejuni gastroenteritis?

A

Watery, foul smelling, bloody

33
Q

Two diseases associated with Campylobacter jejuni?

A

Guillain Barre
Reactive arthritis (Reiter’s) can’t pee can’t see can’t climb a tree
Urethritis uveitis arthritis

34
Q

DOC for Campylobacter?

A

Supportive

Erythromycin only in severe

35
Q

Urease positive gram negative enteric that is the MCC of duodenal ulcers and second MCC of gastric ulcers?

A

Helicobacter pylori

36
Q

What are urease positive bacteria?

A 
PKHU Particular kinds have urease
Proteus
Kleb
H. pylori
Ureaplasma
37
Q

Pathogenesis of H. pylori?

A

Urease converts urea to ammonia, neutralize gastric acid to facilitate invasion

38
Q

Tests done to detect H. pylori?

A

Urea breath test
Stool antigen
EGD with biopsy

39
Q

Complications of PUD?

A

Bleeding
Perforation - left gastric if lesser curvature, GD if duodenal ulcer
Obstruction

40
Q

Triple therapy of H. pylori?

Quadruple?

A

ACO
Amox, clarith, omep
OBMT
Omep, bismuth, metro, tetra

41
Q

TSI Agar is used to check for H2S production. What is the appearance of Salmonella cultures?

A

H2S producer!

vs Ecoli, acid slant and butt with gas but no H2S

42
Q

Special medium used for Salmonella?

A

XLD

Xylose lysine deoxycholate

43
Q

Obsolete test to check for antibodies against Salmonella in the serum? What is used today?

A

Widal test

Salmonella typhi IgM test

44
Q

Transmission of Salmonella is via?

A

Fecal oral route

Ingestion of uncooked eggs

45
Q

Most impt virulence factor that causes typhoid fever?

A

Capsular Vi (virulence) antigen

46
Q

Chronic carrier states of typhoid invade what organ?

A

Gallbladder

Salmonella in bile, excreted in stool

47
Q

Definition of stepwise fever seen in typhoid week 1

A

Pulse fever disproportion

No inc in HR by 10 with 1 degree inc in temp

48
Q

Culture source during week 1, 2, 3?

A

BUS

1 Blood 2 Urine 3 Stool

49
Q

Rose spots appear during what week?

Ileitis?

A

Rose spots week 2 only in fair skinned people salmon colored

Ileitis (invade peyers) week 3

50
Q

Dissemination of Salmonella affects what organs?

A

Bone, lung, brain

51
Q

Population more prone to salmonella sepsis or osteomyelitis?

A

Sickle cell
Asplenic

Salmonella choleraesius

52
Q

Species of Salmonella that cause GE?

A

S. enteritidis and typhimurium
Low virulence
More prone: antacid users and post gastrectomy

53
Q

DOC of Salmonella?

A

Ciprofloxacin
Ceftriaxone

Vaccines?

54
Q

Shigella cultured in what agar?

A

XLD
Xylose lysine deoxycholate
Salmonella Shigella agar

55
Q

Shigella transmission via?

A

Four F’s

Fingers. Food. Feces. Flies.

56
Q

Shigella invades what part of the GIT?

A

Distal ileum

Colon

57
Q

Shigella species that causes bacillary dysentery?

A 
Shigella sonnei
Duval bodies (Group D)
58
Q

Shigella species that causes the MOST SEVERE form of bacillary dysentery?

A

Shigella dysenteriae type I

60
Q

Treatment for shigella dysentery?

A

Supportive
Resolves after 2-3 days
Ciproflox if severe

61
Q

Urease positive gram negative enteric that causes struvite stones?

62
Q

Proteus has what type of motility?

63
Q

Composition of struvite stones?

A

MAP
Magnesium ammonium phosphate
Urease converts urea to ammonia, alkalinizing the urine forming stones

64
Q

DOC for Proteus?

A

TMP SMX
Ampicillin
If too large, surgically remove stone

65
Q

Obligate aerobe Pseudomonas exhibit what pigment and odor?

A

Pyocyanin (blue green pigment) - damages the cilia

Fruity grapelike odor

66
Q

MCC of ventilator acquired pneumonia?

A

Pseudomonas

67
Q

What structural lung lesions predispose to Pseudomonas pneumonia?

A

Bronchiectasis

Cystic fibrosis

68
Q

Pseudomonas causes what in diabetics?

A

Foot ulcers

Mastoid bone infection

69
Q

Pseudomonas is the MCC of this ear infection?

A

Otitis externa

CSOM

70
Q

Osteomyelitis secondary to Pseudomonas by IV drug users affect what bone?

A

Vertebrae (Pubis)

71
Q

Mild form of typhoid fever caused by Pseudomonas?

A

Shanghai fever

72
Q

Suitable combination for treatment of Pseudomonas?

A

Antipseudomonal drug + Aminoglycoside

Piperacillin/Ceftaz + Amikacin

73
Q

Drug given to Pseudomonas if refractory to other drugs?

74
Q

Anaerobic gram negative enteric that causes abscess and peritonitis secondary to bowel trauma or perforation during surgery?

A

Bacteroides fragilis
ABC Anaerobes
Actinomyces, Bacteroides, Clostridium

75
Q

DOC for bacteroides?

A

Clinda, Metro, Cefoxitin

Microbiology (7 decks)

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