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Pathology -- Infectious Disease > Infectious Disease -- Bacteria II - URT/Meningitis/Childhood/G- infections > Flashcards

Infectious Disease -- Bacteria II - URT/Meningitis/Childhood/G- infections Flashcards

1
Q

Four bacteria most associated with URT, sinusitis, OM

A

Strep pneumoniae
S Aureus
H influenzae (non-type B)
Moraxella catarrhalis

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2
Q

Why don’t H flu and M catarrhalis cause meningitis?

A

No capsule

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3
Q

Pathogenesis of Sinusitis/OM?

A

Primary inflammatory response (virus/allergies)
Blockage of sinus ostia/eustachian tube
Secondary overgrowth of colonizing bacteria

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4
Q

Symptoms of URT infection

A

Fever, Pain, Purulent Drainage

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5
Q

Potential complications of URT infection

A

Abscess formation
Invasion of Cribiform plate
Damage to middle/inner ear

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6
Q

How do URT with virulent organisms happen

A 
Exposure
Local infection (pharyngitis)
Invasive Disease
Bacteremia
Systemic Disease (maybe meningitis)
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7
Q

Why would inflammation increase likelihood for contracting meningitis

A

Opens up the BBB

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8
Q

Most common causes of Invasive URT disease/Meningitis. Neonates.

A

Group B Strep

E coli

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9
Q

Most common causes of Invasive URT disease/Meningitis. Children 1-5

A

S. pneumo

H inf. type B before the vaccine

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10
Q

Most common causes of Invasive URT disease/Meningitis. Adolescents/young adults.

A

N. meningitidis

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11
Q

Most common causes of Invasive URT disease/Meningitis. Overall

A

S. pneumo

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12
Q

Key to pathogenicity for the URT disease/Meningitis bacteria

A

Encapsulation

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13
Q

How do these URT/Meningitis bacteria work

A 
URT
Invasion into deeper tissue, blood
Bacteremia/Dissemination
LPS activation of endo. and macrophate 
Vascular Leakage
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14
Q

_____ increased susceptibility to encapsulated bacteria

A

asplenia

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15
Q

Aside from meningitis, encapsulated bacteria are also associated with…

A

Sepsis, DIC

Common causes of death esp. with N. meningitidis

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16
Q

Pneumococcus. Distribution? Morphology?

A

Normal Flora

G+ Diplococcus

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17
Q

Pneumococcus. Virulence Factors.

A

Capsule

PspC (the pneumo carboydrate)

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18
Q

Pneumococcus. Invasive disease

A

Sepsis. Meningitis.

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19
Q

N. meningitidis. Distribution? Morphology?

A

Exogenous

G- Dipococcus

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20
Q

Virulence factors of N. meningitidis.

A

Capsule

LPS

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21
Q

N. meningitidis. Invasive diseases?

A

DIC, Sepsis

Menningitis

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22
Q

N. gonorrhea. Distribution and Morphology

A

Exogenous

G- Diplococcus

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23
Q

N. gonorrhea. Virulence Factors.

A

Capsule

LOS

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24
Q

N. gonorrhea. Invasive Disease

A

Septic Arthritis

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25
Q

H. influenzae (type B) distribution and morphology

A

Exogenous (only type B)

G- Pleomorphic

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26
Q

H. influenzae (type B) virulence factors?

A

Capsule

LPS

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27
Q

H. influenzae (type B) Invasive Disease.

A

Sepsis

Meningitis

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28
Q

Why no sepsis from N. gonorrhea?

A

LOS instead of LPS

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29
Q

Capsules contain LPS or PspC that triggers…

A

DIC, Sepsis

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30
Q

Why are the encapsulated bacteria so bad once they hit the CNS?

A

No complement in the CNS

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31
Q

How do encapsulated bacteria cause shock?

A

LPS stimulates toll like receptors to induce systemic cytokine secretion. Endo cells activate

More vascular permeability, loss of volume, systemic shock and organ failure

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32
Q

How do encapsulated bacteria cause DIC?

A

Systemic activation of coagulation by bacteria
Results in systemic microthrombi
Hemorrhage after factors are used up

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33
Q

Most common cause of community acquired pneumonia

A

S. pneumo

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34
Q

S. pneumo is often a secondary infection to…

A

influenze, especially in the elderly

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35
Q

Most common cause of meningitis?

A

S. pneumo

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36
Q

Streptococcal pneumoniae infections are associated with…

A 
Obstruction of Respiratory passages
Impaired Immunity
Malnutrition
Alcoholism
Under Age 2
Sickle Cell
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37
Q

Virulence factors of Streptococcal pneumoniae

A

PspC
Pneumolysin
pspA (inhibits alternate complement pathway)

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38
Q

T or F. Vaccination for Streptococcal pneumoniae is effective in high risk populations.

A

True

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39
Q

What is the vaccine for Streptococcal pneumoniae?

A

Pneumococcal conjugate vaccine (PCV13)
High risk patients – PPSV23
Risk =65+, chronic disease, immunodeficient, asplenia

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40
Q

General characteristics of Neisseria?

A 
G- 
Encapsulated
Aerobic or Facultative
Very Susceptible to adverse environmental conditions
Not normal flora
41
Q

How does Neisseria meningitidis work?

A

Into nasopharynx and colonizes
Bacteremia
Purulent Meningitis, Sepsis, DIC, Petechial hemorrhages

42
Q

Who gets Neisseria meningitidis?

A

College Students, Army recruits

43
Q

How to treat Neisseria meningitidis?

A

Penicillin or prevent with vaccination

44
Q

When Neisseria meningitidis reaches the bloodstream…

A

Microhemorrhages –> petechial rash on extremities/ears
Microthrombi –> Ischemic necrosis in limbs
Vascular Collapse

45
Q

What is Waterhouse-Friderichsen Syndrome?

A

Bacterial infection (usually Neisseria meningitidis) in the blood causes the adrenals to die by filling them up with blood

46
Q

Important things to know about Neisseria meningitidis immune response.

A

Capsue makes you need an Ab response to really handle it well. This is why we vaccinate

47
Q

How does Neisseria gonorrhea work?

A

Attaches to columnar and transitional epithelia (pili)

Gonorrhea, Cystitis in UG, rectum, nasopharynx

48
Q

Neisseria gonorrhea virulence factors?

A

Pili

IgA protease

49
Q

What does gonorrhea infection look like usually

A

Should;ve gotten a picture…

Suppurative inflammation of mucosa and subepithelia
Grossly purulent lesions and discharge

50
Q

Bonus manifestations of gonorrhea?

A

Suppurative arthritis followig bacteremia

51
Q

Why don’t we vaccinate for gonorrhea?

A

Antigenic variability

52
Q

Describe non-invasive Haemophilus influenza

A

Upper respiratory, Sinusitis, OM
Common URT
Normal Flora of about half of kids

53
Q

Describe invasive Haemophilus influenza

A

Encapsulated

Type B capsule has endotoxin characteristics

54
Q

What is Haemophilus parainfluenzae all about

A

Normal mouth flora

Can cause endocarditis

55
Q

What is Haemophilus ducreyi all about

A

Chancroid

This hasn’t been seen in the US for like a decade

56
Q

Haemophilus influenza Type B window of susceptibility

A

3 months to 3 years

57
Q

Haemophilus influenza Type B – why can’t little ones deal with it

A

Inability to make Abs to capsular antigens
Conjugated vaccine is effective in infants and toddlers
Let the breast milk carry them till that point

58
Q

Moraxella catarrhalis. What’s it all about

A

Normal flora
3rd most common cause of secondary bacterial Sin. and OM
LPS endotoxin similar to Neiss.
Rarely causes septicepia and meningitia

59
Q

Pathogenesis of Diptheria

A 
Local epithelial necrosis (pseudomembrane formation)
Systemically released (Exotoxin A)causes damage to distant organs (heart)
60
Q

What is the pseudomembrane in diptheria?

A

Coagulation of dead cells, pus, and blood

61
Q

Pathogenesis of Bordetella pertussis

A

Cell bound pertussis toxin with local epithelial inflammation
Swelling –> narrowing of epiglottis

62
Q

Bordetella pertussis has a characteristic….

A

Lymphocytosis (rather than leuko)
Loud inspiratory noise
Strong tropism for brush border

63
Q

Bordetella pertussis exotoxin causes

A

Ciliary paralysis with secondary inflammation

64
Q

How is Bordetella pertussis avoided?

A

Vaccination (DTaP, Tdap)

65
Q

Corynebacterium diptheria causes what to happen

A

Ulcerative lesions of the respiratory mucosa

Pseudomembrane

66
Q

What does the Corynebacterium diptheria toxin do

A

Inhibits protein synthesis in eukaryotic cells

Causes fatty mocardial changes, myofiber necrosis, polyneuritis

67
Q

How does Corynebacterium diptheria kill you?

A

Cardiac failure from exotoxin

68
Q

Gram negative rods – three claims to fame

A 
UTI
Intra-abdominal infections
Rare pneumonias (Nosocomial/Aspiration)
69
Q

General characteristics of G- rods

A

Endotoxins
Frequent Drug Resistance
Has replaced pyogenic Cocci as bulk of hospital-acquired and opportunistic infections

70
Q

What is endotoxin?

A

LPS, OAg

71
Q

Non obstructive UTIs are probably….

A

E. coli

72
Q

Obstructive UTIs are probably…

A

Klebsiella or Edwardsiella

73
Q

Four kinds of abdominal infections associated with G- infections

A

Perforation
Appendicitis
Cholecystitis
Diverticulitis

74
Q

Two main types of G- infections

A

Spread of organisms that have colonized the GI tract

Contamination of tissues and materials from the hospital

75
Q

E. Coli is a coliform bacteria. What the fuck does that mean

A

That it can ferment lactose

76
Q

Four types of E Coli infection

A

UTI/Cystitis
Suppurative Infections of Abdominal Cavity
G- hemorrhagic bronchopneu. in aspiration
G- sepsis

77
Q

Most common cause of uncomplicated UTI without obstruction

A

E coli

78
Q

Klebsiella and Enterobacter matter as causes of…

A

Pneumonia (maybe with necrotizing abscess)

UTI

79
Q

How do people tend to get Klebsiella pneumonia

A

associated with aspiration in a hospital setting

80
Q

How do Klebsiella UTI happen

A

Secondary to obstruction

81
Q

Septicemia in Klebsiella/Enterobacter patients

A

Thick mucoid capsule

82
Q

Why should I care about proteusmiribilis?

A

G- Facultative anaerobci rod
UTI/Pyelonephritis, Pneumonia in debilitated patients
Secretes urease

83
Q

What does proteus miribilis’s urease do?

A

Converts urea to ammonia, causing alkaline urine

84
Q

What pathological sign can be seen in chronic pyelonephritis?

A

Staghorn Calculi

85
Q

Why do I have to make another damn flashcard to mention Serratia marcescens.

A

Cause of pneumonia in debilitated patients

UTIs

86
Q

Three claims to fame for pseudomonas aeuroginosa

A

Skin Infections/Sepsis (esp. in burns)
Pneumonia (esp. in Cystic Fibrosis)
Chronic UTI (Obstruction)

87
Q

Pigments in pseudomonas

A

pyocyanin and pyoverdin

88
Q

What does pseudomonas aeuroginosa use to be such a BAMF when it is established?

A

Endotoxin - PS
Exotoxin A (leads to shock)
Leukocydin
Can cause superinfection

89
Q

What happens in bacterial superinfection

A

pseudomonas aeuroginosa replaces antibiotic suppressed organisms

90
Q

Mark of pseudomonas aeuroginosa around BV

A

“Blue Haze”

91
Q

pseudomonas aeuroginosa is a common pathologic organism in…

A

Cystic Fibrosis

92
Q

pseudomonas aeuroginosa manifests in intravenous drug abusers as…

A

Endocarditis + Osteomyelitis

93
Q

pseudomonas aeuroginosa can cause ____ in contact wearers and ______ in swimmers and diabetics

A

Corneal keratitis

External otitis

94
Q

What matters about legionella pneumophilia.

A

Pneumonia
Community outbreaks associated with contaminated, aerosolized H2O supply
90% get Pontiac Fever, 10% Legionaire’s disease

95
Q

In Legionaire’s Disease, you get…

A

Fibrinopurulent necrosis leading to scarring of pulmonary tissues.
Really messes you up.

96
Q

Helicobacter pylori. What matters?

A

Gastritis/Peptic Ulcer Disease

Urease creates protective amonia layer to protect from acid

97
Q

What matters about Bacteriodes and Peptostreptococcus (gingival infections)

A

Aspiration, Trauma, Fecal Leakage
Ischemic devitalized tissues
Mixed infections
Foul smelling Pus

98
Q

Window of vulnerability in Type B H. flu

A

3 months to 3 years

Little ones can’t make good protective antigens to Type B capsule

Pathology -- Infectious Disease (23 decks)

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