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Gram Positive Flashcards

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1
Q

Important surface antigen for Gram +

A

Teichoic acid

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2
Q

D-glutamic acid capsule

A

B. anthracis

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3
Q

Catalase +, Coagulase +

A

Staphylococcus aureus

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4
Q

Catalse -, beta hemolytic

A

Strep. agalactiae or pyogenes

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5
Q

Clinical presentation of toxin mediated Stap aureus

A

Toxic shock syndrome, salded skin syndrome, food poisoning

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6
Q

TSST-1 antigen

A

Increases release of cytokines leading to acute fever, rash, desquamation on palms and soles, and hypotensive shock

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7
Q

“5-month old baby consuming honey has loss of extremity muscle tone”

A

Think Clostridium botulinum

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8
Q

6 yo pt comes in with a fever and sore throat; no immunization record; PE reveals a grey pharyngeal exudate and gram stain with gram positive organisms. What is the organism?

A

1) Cornybacteria diphtheriae

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9
Q

Gram positive club shaped rod, catalase positive; grown on Cysteine tellurite agar; causes grey pharyngeal exudate

A

Cornybacteria diphtheriae

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10
Q

How does the Cornybacteria diphtheriae exotoxin work?

A

1) AB exotoxin
2) A unit (active)- transfers a ribose residue from NAD to a histidine on EF2 (elongation factor 2)
3) EF2 is essential for peptide chain translocation on the ribosomes which results in inhibition of protein synthesis

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11
Q

What organism releases lecithinase?

A

1) Clostridium perfringens

2) Enzyme degrades membrane phospholipids leading to cell membrane destruction

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12
Q

How do you prevent Clostridium tetani in newborns?

A

1) Immunize the mother

2) IgG created from the mother are passed on to the baby

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13
Q

Gram positive cocci found in clusters, catalase and coagulate positive, cause of toxic shock syndrome and scalded skin syndrome

A

Staphylococcus aureus

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14
Q

What component of staphylococcus aureus binds to the Fc portion of host IgG

A

Protein A

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15
Q

What organism has the exotoxin TSST-1 released and diffused symmetrically. What is the result of the presence of this superantigen?

A

1) staphylococcus aureus
2) superantigen promotes excess cytokine release resulting in acute fever, desquamation of the palms and soles, hypotensive shock

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16
Q

How does scalded skin syndrome occur?

A

1) caused by skin wound or cutting of the umbilicus
2) staphylococcus aureus releases exofoliative toxins
3) toxins cause epidermis to slough off

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17
Q

What is the cause of food poisoning from staphylococcus aureus?

A

1) Bacteria release toxin in food such as custard

2) heat stabile toxin known as endotoxin se-a

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18
Q

What is Ritter’s Syndrome?

A

1) most severe form of scalded skin syndrome in neonates

2) occurs after cutting umbilical cord

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19
Q

Cause of Ritter syndrome

A

Staphylococcus aureus

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20
Q

Gram positive cord cocci; catalase positive, coagulate negative; novobiocin sensitive; polysaccharide capsule; generally occurs with infection on in dwelling medical devices

A

Staphylococcus epidermidis

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21
Q

Treatment for staphylococcus epidermidis

A

1) vancomycin

2) removal of foreign body

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22
Q

Endocarditis within 60 days of prosthetic valve placement? After 60 days?

A

1) staphylococcus epidermidis

2) viridans streptococci

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23
Q

Gram positive cords of cocci that are catalase positive and coagulate negative; novobiocin resistant; common cause of uti in sexually active women

A

Staphylococcus saprophyticus

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24
Q

Treatment for staphylococcus saprophyticus

A

Trimethoprim and sulfamethoxazole

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25
Q

Gram positive cocci arranged in chains; catalase negative, beta hemolytic; cause of scarlet fever and necrotizing fasciitis; group A classification

A

Group A Streptococcus pyogenes

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26
Q

Young girl complains of rough appearing rash on trunk and neck, desquamation of palms and soles; also complains of sore throat and fever

A

Group A Streptococcus pyogenes

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27
Q

Cause of Rheumatic fever

A

Group A Streptococcus pyogenes

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28
Q

Describe the renal complications associated with group A streptococcus pyogenes infection

A

1) infection that results in glomerulonephritis due to the deposit of immune complexes in the subepithelium

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29
Q

What are the major points of the Jones criteria?

A 
2 major or one major and two minor
think: J<3NES
Major criteria
1) Joints (polyarthritis)
2) carditis (endocarditis, myocarditis, and pericarditis)
3) Nodules (subucutaneous - aka Osler nodes)
4) Erythema marginatum (Janeway lesions)
5)Sydenham chorea
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30
Q

Scarlet rash sparing face, strawberry (scarlet tongue), scarlet throat

A

Streptococcus pyogenes

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31
Q

Adolescent presents with brownish urine. Two weeks earlier had a sore throat that resolved. Positive ASO. Renal biopsy shows subepithelial humps in glomerulus

A

Group A Streptococcus pyogenes (immune mediated)

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32
Q

What is the protein found on Group A Streptococcus pyogenes that has immune cross reaction resulting in endocarditis and the deposition of immune complexes? What is its function?

A

1) M protein

2) Blocks phagocytosis

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33
Q

What are the possible clinical presentations of Group A Streptococcus pyogenes?

A

1) pharyngitis

2) impetigo

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34
Q

What are the causes of impetigo?

A

1) Streptococcus pyogenes

2) staphylococcus aureus

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35
Q

Young child presents with fever and rash that appears pustular with yellow crust, a honey comb appearance, with the presence on gram stain of gram positive cocci

A

Impetigo

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36
Q

Treatment for Streptococcus pyogenes

A

Penicillin G

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37
Q

Gram positive cocci arranged in diplococci, catalase negative, alpha hemolytic, positive Quellung test

A

Streptococcus pneumoniae

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38
Q

Elderly woman presenting with cough producing rusty colored sputum, also has chest pain, chills and fever

A

Streptococcus pneumoniae

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39
Q

How does Streptococcus pneumonia infect?

A

1) Spread by respiratory droplets

2) evades host by capsule and IgA proteases

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40
Q

Treatment for Streptococcus pneumoniae

A

1) penicillin or cephalosporin

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41
Q

Gram positive cocci arranged in chains that is catalase negative and grows in bile

A

Streptococcus bovus

42
Q

What bacteria should be suspected with endocarditis with carcinoma of the colon?

A

Streptococcus bovis

43
Q

Gram positive cocci arranged in chains, beta hemolytic, catalase negative, infection occurs by being carried in maternal genital tract, cause of neonatal meningitis or neonatal pneumonia

A

Group B streptococcus agalactiae

44
Q

Gram positive cocci; catalase negative, alpha hemolytic; cause of dental caries; normally inhabits the oropharynx epithelium

A

Streptococcus mutans

45
Q

Gram positive cocci; catalase negative, alpha hemolytic; cause of brain or abdominal abscessess; normally inhabits the GI tract

A

Streptococcus intermedius

46
Q

Gram positive fungi appearing bacteria with beaded filaments; weakly acid fast obligate aerobe; cause of pneumonia and abscesses in the kidney/brain

A

Nocardia

47
Q

What makes Nocardia acid fast?

A

The presence of mycolic acid in the cell wall

48
Q

Treatment for Nocardia

A

1) Trimethoprim/Sulfamethoxalate

49
Q

Gram Positive fungi appearing bacteria with beaded filaments; not acid fast; causes of abscesses in the mouth, lungs, and GU tract; forms yellow sulfur granules

A

Actinomyces israelii

50
Q

yellow Sulfur granules?

A

Actinomyces israelii

51
Q

What are the two bacteria that appear as beaded filamentous fungi?

A

1) Nocardia

2) Actinomyces

52
Q

Gram positive cocci; catalase negative, grows in bile (group D); grows in 6.5% NaCl; all strains are resistant to cephalosporin; 2nd most common nosocomial infection

A

Enterococcus faecalis

53
Q

Gram positive rod; spore forming; aerobic; motile; causes food poisoning (reheated rice); heat labile and stabile eneterotoxins

A

Bacillus cereus

54
Q

What does the heat labile Bacillus cereus toxin cause? Heat stabile enterotoxin?

A

1) Heat labile causes vomiting and nausea

2) Heat stabile causes diarrhea increasing cAMP leading to less NaCl reabsorption

55
Q

Gram positive rod; spore forming; aerobic; non-motile; death if inhaled; protein capsule (poly-D-glutamic acid capsule)

A

Bacillus anthracis

56
Q

What is so important about the capusle of Bacillus anthracis?

A

It is a protein capsule made up of poly-D-glutamic acid

57
Q

What are the toxins of Bacillus anthracis?

A

1) Protective Factor antigen (PF) - binds to cell membrane and mediates EF and LF
2) Edema Factor (EF) antigen- increases cAMP causing edema and inhibition of leukocytosis (acts like adenyly cyclase)
3) Lethal Factor (LF) antigen- causes cell death

58
Q

Gram positive rod; spore forming; obligate anaerobe; motile; has a terminal spore; causes spastic paralysis and lockjaw

A

Clostridium tetani

59
Q

What is the toxin produced by Clostridium tetani and how does it work?

A

1) Telanospasmin
2) Travels down the axons of peripheral motor neurons and blocks release of inhibitor neurotransmitters GABA and glycine
3) Nerves become hyperexcited and results in spastic paralysis

60
Q

Telanospasmin

A

Clostridium tetani

61
Q

What does Telanospasmin inhibit?

A

It inhibits the release of GABA and glycine neurotransmitters resulting in spastic paralysis

62
Q

Gram positive rod; spore forming; obligate anaerobe; motile; cause of botulism

A

Clostridium botulinum

63
Q

Sx of Adult Botulism

A

1) Diplopia
2) Descending paralysis
3) Dysphagia
4) ptosis

64
Q

How does the heat labile toxin of Clostridium botulinum work?

A

1) Toxin is released after ingestion of contaminated food in to the vascular system
2) Toxin spreads to the peripheral cholinergic nerve terminals
3) Blocks the release of acetylcholine

65
Q

How does infant botulism occur? What are the symptoms?

A

1) Caused by ingestion of spores found in honey
2) Spores germinate in intestine
3) Results in the release of toxins
4) Toxins absorbed and slowly blocks the release of acetylcholine
5) Results in flaccid paralysis

66
Q

How would you differentiate the symptoms of food poisoning from Clostridium botulinum and tetani?

A

1) botulinum = floppy paralysis

2) tetani = tight, spastic paralysis

67
Q

Gram positive rod; spore forming; obligate anaerobe; motile; cause of pseudomembrane colitis

A

Clostridium difficile

68
Q

Treatment for C. diff

A

1) Oral metronidazole

2) Vancomycin

69
Q

What antibiotic is associated with the presence C. diff after use ?

A

Clindamycin and ampicillin

70
Q

Gram positive rod; spore forming; obligate anaerobe; non-motile; cause of gas gangrene

A

Clostridium perfringens

71
Q

Gram positive rod; motile (tumbling motility); facultative intracellular organism; cause of meningitis; only gram positive bacteria with an endotoxin

A

Listeria monocytogenes

72
Q

What is the only gram positive bacteria that has an endotoxin?

A

Listeria monocytogenes

73
Q

Gram positive rod; non-motile; appear as chinese letters; causes grey pseudomembrane

A

Corynebacterium diphtheriae

74
Q

What are the functions of the toxins produced by Corynebacterium diphtheriae?

A

1) Toxin AB ADP ribosylates the EF2 protein resulting in the inhibition of protein synthesis

75
Q

Streptococcus that completely lyse rbcs

A

Beta hemolytic

76
Q

Streptococci that only partially lyse, leaves a greenish discoloration media

A

Alpha hemolytic

77
Q

Streptococci that are unable to hemolyze rbcs

A

Gamma hemolytic

78
Q

What does protein A on Staphylococcus aureus do?

A

Binds to the Fc portion of the IgG preventing opsonization and phagocyotosis

79
Q

How does the exotoxin of C. difficile work?

A

1) Exotoxin A- neutrophil chemoattractant

2) Exotoxin B - causes actin depolymerization and loss of cellular cytokeleton integrity

80
Q

What is the role of a capsule?

A

Prevents opsonization and phagocytosis of organisms

81
Q

Gram positive coccus; catalase negative; alpha hemolytic; optochin resistant

A

Streptococcus viridans

82
Q

Gram positive coccus, catalase negative, alpha hemolytic; optochin sensitive; cannot be culture in bile

A

Streptococcus pneumoniae

83
Q

Gram positive coccus catalase negative, beta hemolytic; bacitracin resistant

A

Streptococcus agalactiae

84
Q

Gram positive coccus; catalase negative; beta hemolytic; bacitracin sensitive

A

Streptococcus pyogenes

85
Q

Gram positive coccus; catalase negative; gamma hemolytic; growth in bile; no growth in 6.5% saline

A

Streptococcus bovis

86
Q

Gram positive coccus; catalase negative; gamma hemolytic; growth on both bile and 6.5% saline

A

Enterococci

87
Q

Catalase positive; novobiocin sensitive

A

Staphylococcus epidermidis

88
Q

Catalase positive; novobiocin insensitive

A

Staphylococcus saprophyticus

89
Q

What gram positive bacteria has metachromatic granules (red and blue)?

A

Corynebacterium diphtheria

90
Q

Cause of black painless ulcer (eschar) surrounded by an edematous ring

A

Cutaneous infection of B. anthracis

91
Q

Pt. comes in 1-5 hours after eating rice and beans with nausea and vomitting; after staying in the hospital around 3 hours later from his nausea e begins to have diarrhea that is watery

A

B. cereus

92
Q

Facultative intercellular gram positive bacteria acquired from unpasteurized milk/cheese; tumbling mobility

A

Listeria monocytogenes

93
Q

What does Listeria monocytogenes cause?

A

1) Meningitis in the neonate and immunocompromised

2) Gastroenteritis

94
Q

Fungi appearing bacteria with branching filaments that causes pulmonary infections in immunocompromised

A

Nocardia

95
Q

Gram positive rod that grows at low temperatures

A

Listeria monocytogenes

96
Q

Pt. presents with progressive difficulty walking over the last two days accompanied by tingling in feet. Absent DTRs; Hx of diarrhea 2 weeks ago. What does he have? What caused the diarrhea 2 weeks ago?

A

1) Guillan Barre syndrome (demylination of the peripheral nerves)
2) Campylobacter jejuni

97
Q

What bacteria is associated with Guillan Barre syndrome

A

Campylobacter jejuni

98
Q

What is Staph. aureus enterotoxin found in?

A

Custard, mayonnaise and processed meats

99
Q

What is enterococci resistant to by aceytlating the drug?

A

Aminoglycosides

Note: Also resistant to penicillin, TMP/SM, and Vancomycin

100
Q

Cause of liver abscess through hematogenous seeding

A

Staphylococcus aureus

Microbiology (10 decks)

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