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MOD > Intro to Bacteria Part 2 > Flashcards

Intro to Bacteria Part 2 Flashcards

1
Q

Three major species of Staphylococci

A

S. aureus, S. epidermidis, S. saprophyticus

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2
Q

S. aureus on blood agar

A

gold pigment, B-hemolytic

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3
Q

Staph catalase test

A

all positive

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4
Q

Which type of staph is coagulase positive?

A

S. aureus, elaborates coagulase (activates prothrombin)

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5
Q

S. aureus virulence proteins

A

Protein A (protects from opsonization), coagulase (fibrin forms around bacteria), hemolysins, leukocidins, penicillinase (B-lactamase), penicillin binding protein

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6
Q

S. aureus proteins that degrade tissues

A

hyaluronidase (proteoglycans), staphylokinase (lyses fibrin), lipase, protease

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7
Q

S. aureus exotoxins

A

exfoliation - scalded skin syndrome
enterotoxins - vomiting and diarrhea
TSST-1 - super antigens that bind to MHCII causing massive T cell response

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8
Q

Diseases caused by release of S. aureus exotoxins

A

Gastroenteritis, TSS, scalded skin syndrome

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9
Q

Diseases caused by direct organ invasion by S. aureus

A

pneumonia, meningitis, osteomyelitis, acute bacterial endocarditis, septic arthritis, skin infections, sepsis, UTI

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10
Q

Presentation of gastroenteritis

A

nausea, vomiting, diarrhea, abd pain, fever lasting 12-24 hours

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11
Q

Pathology of TSS

A

penetrates vaginal mucosa and stimulates TNF and IL1

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12
Q

Presentation of TSS

A

high fever, N/V/D, diffuse erythematous rash, desquamation of palms and soles

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13
Q

Presentation of staphylococcal scalded skin syndrome

A

exfoliative toxin A and B, neonates typically affected, cleavage of middle epidermis

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14
Q

S. aureus pneumonia presentation

A

CA-pneumonia; follows viral influenza with onset of fever, chills, lobar consolidation, destruction of lung parenchyma

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15
Q

Meningitis, cerebritis, Brain abscess presentation

A

high fever, stiff neck, HA, coma, obtundation, focal neurologic signs

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16
Q

Osteomyelitis presentation

A

boys < 12 yo, warm, swollen tissue over bone with system fever and shakes

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17
Q

Acute endocarditis presentation

A

destruction of heart valves with high fever, chills, myalgias; may lead to vegetations on valves and embolization to lungs or brain

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18
Q

Septic arthritis presentation

A

acutely painful red swollen joint with decreased ROM, often occurs in peds and elderly

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19
Q

Impetigo

A

small vesicles lead to pustules; honey-colored crust, wet, flaky

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20
Q

Cellulitis

A

tissue becomes hot, red, shiny, and swollen

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21
Q

Local abscesses

A

collection of pus

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22
Q

furuncle

A

infection of follicle that penetrates into subcutaneous tissues

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23
Q

Carbuncles

A

furuncles bore through to produce multiple contiguous painful lesions communicating under the skin

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24
Q

Blood and Cath infections

A

S. aureus can migrate from the skin and colonize catheters resulting in bacteremia, sepsis, septic shock

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25
Q

MRSA

A

multi-drug resistant bug, mecA encodes penicillin binding protein 2A that avoids penicillin damage

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26
Q

CA-MRSA

A

often occurs among sports teams; skin and soft tissue infections in close contact settings, spreads much more quickly than HA-MRSA, still tends to be susceptible to some oral abx

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27
Q

S. epidermidis metabolism

A

catalase-positive, coagulase-negative, facultative anaerobe

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28
Q

Common source of S. epidermidis infection

A

foley catheter, IV line

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29
Q

S. epidermidis virulence

A

polysaccharide capsule that adheres to variety of prosthetic devices, highly resistant to abx

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30
Q

Common S. epidermidis infections

A

prosthetic joints, prosthetic heart valves, sepsis from IV lines, UTI, skin contaminant in blood culture

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31
Q

S. saprophyticus

A

leading cause of UTI second to E. coli among females, coagulase negative

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32
Q

Bacillus characteristics

A

G+, aerobic, spore forming rods

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33
Q

Bacillus anthracis capsule

A

only bacterium with capsule composed of protein

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34
Q

How is Bacillus anthracis acquired?

A

direct contact with infected animals or soil

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35
Q

How are Bacillus anthracis spores activated?

A

phagocytosed by macrophages, germinate and then become active

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36
Q

Cutaneous anthrax

A

exotoxin causes localized tissue necrosis, painless round black lesion with rim of edema (malignant pustule)

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37
Q

Pulmonary anthrax

A

spores taken up macrophages in lungs and transported to hilar and mediastinal LN where they germinate, mediastinal hemorrhage occurs and results in mediastinal widening and pleural effusions

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38
Q

GI anthrax

A

often results in death, exotoxin causes necrotic lesion with intestine, pt presents with vomiting, abd pain and bloody diarrhea

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39
Q

Three proteins of exotoxin of B. anthracis

A

Edema factor, protective antigen, lethal factor

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40
Q

Edema factor

A

active A subunit of exotoxin, increases cAMP which impairs neutrophil function and causes edema

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41
Q

Protective antigen

A

promotes entry of EF into phagocytic cells

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42
Q

Lethal factor

A

zinc metalloprotease that inactivates protein kinase, stimulates release of TNF and IL1

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43
Q

Bacillus cereus vs. B. anthracis

A

B. cereus is motile, non-encapsulated, resistant to penicillin

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44
Q

Major infection associated with B. cereus

A

food poisoning

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45
Q

Enterotoxins secreted by B. cereus

A

heat-labile toxin, heat-stable toxin

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46
Q

Heat-labile toxin causes what sxs

A

nausea, abd pain, diarrhea lasting 12-24 hours

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47
Q

Heat-stable toxin causes what sxs

A

nausea, vomiting, limited diarrhea

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48
Q

Clostridium characteristics

A

G+ spore-forming rods, anaerobic

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49
Q

Clostridium is responsible for what diseases?

A

botulism, tetanus, gangrene, pseudomembranous colitis

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50
Q

C. botulinum produces…

A

lethal neurotoxin that blocks the release of Ach and causes flaccid paralysis

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51
Q

Adult Botulism is acquired from

A

smoked fish or home-canned vegetables

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52
Q

Presentation of adult botulism

A

afebrile, bilateral cranial nerve palsies, diplopia, dysphagia, general muscle weakness, respiratory paralysis and death

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53
Q

Infant botulism is acquired from

A

food contaminated with C. botulinum spores

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54
Q

Presentation of infant botulism

A

constipation 2-3 days, difficulty swallowing and muscle weakness; “floppy baby”

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55
Q

Presentation of wound botulism

A

fever, high white count, cranial nerve palsies, respiratory paralysis

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56
Q

Clostridium tetani

A

causes tetanus, releases tetanospasmin

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57
Q

tetany

A

sustained contraction of skeletal muscles

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58
Q

Presentation of tetany

A

severe muscle spasms especially in jaw, risus sardonicus (grotesque grin)

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59
Q

C. perfringens infections

A

causes gas gangrene; cellulitis, clostridial myonecrosis, diarrheal illness

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60
Q

Cellulitis/wound infection by C. perfringens

A

grows and damages local tissue; moist, spongy, crackling consistency to skin (crepitus)

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61
Q

Clostridial myonecrosis (C. perfringens)

A

C. perfringens in muscle will secrete exotoxins that destroy adjacent muscle, seen on CT as pockets of gas in muscles and subcutaneous tissue

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62
Q

Diarrheal Illness (C. perfringens)

A

toxin production in gut and subsequent watery diarrhea, can lead to hemorrhagic necrosis of jejunum

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63
Q

Clostridium difficile

A

associated with abx-associated pseudo-membranous colitis following use of broad spectrum antibiotics

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64
Q

Toxin A C. diff

A

causes diarrhea

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65
Q

Toxin B C. diff

A

cytotoxic to colonic cells

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66
Q

Diagnostic tests for C. diff

A

PCR for toxin A and B, Enzyme immunoassay

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67
Q

Non-spore forming gram positive bacteria commonly present in what patients

A

pediatric patients

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68
Q

Corynebacterium diphtheriae

A

responsible for diphtheria; colonizes pharynx, releases toxins into blood stream that damages heart and neural cells

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69
Q

Clinical presentation of Corynebacterium diphtheriae

A

child with sore throat and fever, dark inflammatory exudate on child’s pharynx

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70
Q

Culture medium for C. diphtheriae

A

potassium tellurite agar (gray to black colonies), Loeffler’s coagulated blood serum

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71
Q

Diphtheria antiotoxin

A

inactivates circulating toxin that has not reached target tissue

72
Q

DPT vaccine

A

formalin inactivated diphtheria toxin

73
Q

Similarity between Grp A B-hemolytic strep and C. diphteriae

A

must be lysogenized by bacteriophage to produce toxin

74
Q

Rhodococcus equi

A

G+, aerobic nonmotile, bacillary bacteria; typically infects animals; can form necrotizing pneumonia when inhaled

75
Q

Characteristic presentation of Rhodococcus equi

A

upper lobe lung nodules that form air-fluid levels, may stain partially acid-fast

76
Q

Listeria monocytogenes characteristics

A

facultative anaerobe, non-spore forming G+ rod

77
Q

How is L. monocytogenes grown?

A

low temperatures

78
Q

L. monocytogenes virulence factor

A

listeriolysin O, allows bacteria to escape phagolysosomes and avoid intracellular killing

79
Q

Who is most at risk for L. monocytogenes?

A

Pregnant women, neonates, elderly, immunocompromised

80
Q

L. monocytogenes in pregnant women

A

infection occurs in third trimester, fetus will be infected and may die or be born prematurely with active infection

81
Q

How may L. monocytogenes be acquired?

A

contaminated foods such as soft cheeses and cold cuts, through vaginal colonization

82
Q

L. monocytogenes in neonates

A

neonatal meningitis presenting 2 weeks post-partum

83
Q

L. monocytogenes in elderly and immunocompromised

A

second most common cause of meningitis

84
Q

L. monocytogenes as a facultative intracellular organism

A

bacteria able to survive inside or outside of cells, in immunocompetent pts it will be killed via cell-mediated immunity

85
Q

Major pathogenic G- cocci

A

N. meningitidis, N. gonorrhoeae

86
Q

N. meningitidis major disease association

A

meningitis

87
Q

N. meningitidis capsule

A

antiphagocytic polysaccharide capsule

88
Q

N. meningitidis endotoxin

A

blebs of endotoxin cause blood vessel destruction and sepsis (petechiae)

89
Q

N. meningitidis IgA1 protease

A

cleaves IgA in half

90
Q

N. meningitidis and iron

A

bacteria can extract iron from transferrin

91
Q

N. meningitidis pili

A

allow attachment to human NP cells and undergo antigenic variation to avoid attach by immune system

92
Q

N. meningitidis carriers

A

bacteria is a part of their normal flora of the nasopharynx, develop anti-meningococcal antibodies

93
Q

N. meningitidis high risk groups

A

infants 6mo to 2 yo, army recruits, college freshmen

94
Q

How does N. meningitidis spread?

A

via respiratory secretions

95
Q

Classic clue to invasive meningococcal infection

A

petechial rash, due to release of endotoxin

96
Q

Meningococcemia

A

abrupt onset of fevers, chills, arthralgia, muscle pains, petechial rash

97
Q

Fulminant meningococcemia

A

Waterhouse-Friderichsen syndrome; bilateral adrenal gland hemorrhage, abrupt hypotension and tachycardia, DIC, coma, death

98
Q

Meningitis

A

usually infants <1 yr; fever, vomiting, irritability, lethargy, bulging anterior fontanelle, possibly a stiff neck

99
Q

Medium for N. meningitidis growth

A

Thayer-Martin VCN (chocolate agar with antibiotics); vancomycin, colistin, nystatin; increased CO2

100
Q

Nisseria and maltose metabolism

A

meningitidis will produce acid, gonorrheae cannot

101
Q

Second most common STI

A

gonorrhea

102
Q

N. gonorrheae pili

A

have hypervariable aa sequences, protect bacteria from abx and our own immune system, prevent phagocytosis

103
Q

N. gonorrheae outer membrane protein porins

A

promote invasion into epithelial cells

104
Q

N. gonorrheae Opa proteins

A

promote adherence and invasion into epithelial cells

105
Q

Presentation of gonorrhea in men

A

urethritis, painful urination and purulent discharge; epididymitis, prostatitis, urethral strictures

106
Q

Rectal gonococcal infection presentation

A

MSM, anal pruritis, tenesmus, rectal bleeding and purulent discharge

107
Q

Presentation of gonorrhea in women

A

most likely to be asymptomatic with minimal urethral discharge although they may develop urethritis; reddened and friable cervix, lower abd pain, dyspareunia, purulent vaginal discharge

108
Q

Pelvic inflammatory disease

A

infection of uterus, fallopian tubes, or ovaries resulting from gonococcal infection of cervix; pt will present with ffever, lower abd pain, abn menstrual bleeding, cervical motion tenderness

109
Q

PID and menses

A

menstruation allows bacteria to spread upward, most cases present within one week of menstruation, IUD will also increase risk

110
Q

Complications of PID

A

sterility, ectopic pregnancy, abscesses, peritonitis, peri-hepatitis

111
Q

Gonococcal bacteremia presentation

A

bacteria invades blood stream and manifests as fever, joint pains, skin lesions; further complications include pericarditis, endocarditis, meningitis

112
Q

Septic arthritis due to gonococcal infection

A

acute fever with pain and swelling of 1-2 joints, increased WBC. G- diplococci

113
Q

Gonococcal disease in infants

A

ophthalmia neonatorum, eye infection that may cause blindness

114
Q

Moraxella catarrhalis is associated with what diseases

A

otitis media and URI in pts with COPD or in the elderly

115
Q

G- bacteria known to cause endocarditis

A 
Haemophilus
Actinobacillus
Cardiobacterium
Eikenella
Kingella
116
Q

Enterics

A

G- bacteria part of normal GI flora or cause GI disease

117
Q

Main groups of enterics

A

Enterobacteriaceae, vibrionaceae, pseudomonadaceae, bacteroidaceae

118
Q

Classifying the enterics

A

ability to ferment lactose, production of H2S

119
Q

EMB agar

A

Methylene blue inhibits G+ bacteria, lactose fermenters become deep purple to black

120
Q

MacConkey agar

A

Bile salts inhibit G+ bacteria, lactose fermentors develop pink-purple color

121
Q

Testing for coliforms

A

ability to ferment lactose, green colonies on EMB agar

122
Q

O antigen on enterics

A

most external component of LPS

123
Q

K antigen on enterics

A

capsule that covers O antigen

124
Q

H antigen on enterics

A

makes up bacterial flagella subunits

125
Q

Diarrhea without cell invasion

A

bacteria bind to intestinal epithelial cells resulting in electrolyte and fluid loss; watery diarrhea without systemic problems (E. coli, V. cholera)

126
Q

Diarrhea due to invasion of intestinal epithelial cells

A

toxins destroy cells, WBC and RBC in stool, fever (Enteroinvasive E. coli, Shigella, Salmonella enteriditis)

127
Q

Diarrhea due to invasion of LN and vlood stream

A

abd pain, diarrhea containing RBC and WBC, fever, HA, high white count, mesenteric LN enlargement, bactermia, sepsis (S. typhi, Y. enterocolitica, C. jejuni)

128
Q

Common nosocomial G-‘s

A

E. coli, K. pneumoniae, P. mirabilis, Enterobacter, Serratis, P. aeruginosa

129
Q

E. coli virulence factors

A

mucosal interaction (pili and epithelial cell invasion), exotoxin production (heat-labile, heat stable toxin; shiga-like toxin), Lipid A, Iron binding siderophore

130
Q

Diseases caused by E. coli

A

diarrhea, UTI, meningitis, G- sepsis

131
Q

Enterotoxigenic E. coli (ETEC)

A

traveler’s diarrhea, LT and ST prevent reabsorption of Na and Cl and stimulate secretion of bicarb and Cl, extreme water loss

132
Q

Enterohemorrhagic E. coli (EHEC)

A

shiga-like toxin prevents protein production and leads to cell death; bloody diarrhea with severe abd cramps

133
Q

Hemolytic uremic syndrome

A

anemia, thrombocytopenia, renal failure due to E. coli 0157:H7

134
Q

Enteroinvasive E. coli (EIEC)

A

bacteria invade epithelial cells and produce shiga-like toxin, systemic inflammatory disease with fever and diarrhea (RBC and WBC)

135
Q

E. coli UTIs

A

pili allow E. coli to travel up urethra to bladder and possibly to kidneys, most common cause of UTIs; presents as dysuria, frequency, bladder fullness

136
Q

E. coli meningitis

A

common cause of neonatal meningitis after Grp B Strep

137
Q

E. coli sepsis

A

most common cause of G- sepsis, often occurs in debilitated hospitalized pts

138
Q

E. coli pneumonia

A

fairly common cause of nosocomial pneumonia

139
Q

Klebsiella pneumoniae

A

encapsulated, non-motile enteric (no H antigen), can cause sepsis and UTIs especially in hospitalized and debilitated patients (pneumonia)

140
Q

Presentation of pneumonia due to K. pneumoniae

A

Hospitalized or alcoholic patient with bloody sputum, violent pneumonia that destroys lung tissue

141
Q

Proteus mirabilis

A

very motile, splits urea, cross-reactive with Rickettsia; urine will be alkaline

142
Q

Enterobacter

A

highly motile G- rod part of normal GI flora

143
Q

Serratia

A

bright red pigment, causes UTI, wound infections, or pneumonia

144
Q

Shigella species

A

dysenteriae, flexneri, boydii, sonnei

145
Q

Shigella characteristics

A

non-motile, does not ferment lactose and will not produce H2S

146
Q

Populations often affected by Shigella

A

preschool aged children, nursing homes

147
Q

Where is Shigella normally found in the body?

A

NO WHERE! It is always a pathogen

148
Q

Shigella action

A

invade intestinal epithelial cells and release Shiga toxin; often begins with a fever, abd pain, diarrhea (blood and pus)

149
Q

Shiga toxin

A

B subunits bind to cell, A subunits inactivate ribosomes

150
Q

Salmonella

A

Non-lactose fermenter, mobile, produces H2S

151
Q

Vi antigen of Salmonella

A

polysaccharide capsule that surrounds O antigen and protects bacteria from antibody attack

152
Q

How is salmonella most commonly acquired?

A

contaminated food or water with animal feces (chicken and eggs in US)

153
Q

Disease states in human due to Salmonella

A

typhoid fever, carrier state, sepsis, gastroenteritis

154
Q

Typhoid fever

A

invades intestinal epithelial, lymph nodes, and then seeds organ systems; facultative intracellular parasite

155
Q

Presentation of typhoid fever

A

1-3 weeks after exposure, fever, HA, abd pain esp in RLQ, enlarged spleen, diarrhea, rose spots on abdomen

156
Q

Salmonella carrier state

A

harbor S. typhi in gallbladders

157
Q

What tissues does salmonella target in sepsis?

A

Lungs, bone, brain

158
Q

Salmonella osteomyelitis

A

sickle-cell patients are most prone due to lack of effective spleen

159
Q

Yersinia enterocolitica characteristics

A

G- motile rod that causes gastroenteritis

160
Q

Which organism is Y. enterocolitica closely related to?

A

Y. pestis (causes bubonic plague), differs in that enterocolitica is transferred via fecal-oral route

161
Q

Presentation of gastroenteritis due to Y. enterocolitica

A

fever, diarrhea, abd pain after ingestion of domestic milk or fecally contaminated water

162
Q

Vibrio cholera

A

G- rod with single flagella, fecal-oral transmission

163
Q

Cholera diarrhea

A

no epithelial cell attachment, release choleragen and causes rice water diarrhea

164
Q

Vibrio parahaemolyticus

A

marine bacterium that causes gastroenteritis after ingestion of uncooked seafood

165
Q

Campylobacter jejuni

A

One of the most common causes of diarrhea in the world, zoonotic disease, fecal-oral transmission

166
Q

C. jejuni diarrhea presentation

A

fever and HA followed by abd cramps and bloody, loose diarrhea

167
Q

H. pylori

A

most common cause of duodenal ulcers and chronic gastritis

168
Q

Most of our intestinal flora is made up of what bacteria family?

A

bacteroidaceae, obligate anaerobic G- rod

169
Q

B. fragilis

A

no endotoxin, often a common form of abscesses following intestinal laceration

170
Q

B. melaningoenicus

A

produces a black pigment when grown on blood agar, involved in necrotizing anaerobic pneumonias due to GI aspiration, associated with periodontitis

171
Q

Fusobacterium

A

periodontal disease and aspiration pneumonia, can cause abscesses and otitis media

172
Q

Anaerobic G+ cocci

A

peptostreptococcus and peptococcus are apart of the normal flora but can be involved in abscesses and aspiration pneumonias

173
Q

Pseudomonas aeruginosa

A

often colonizes very sick patients (wind, wires, wound, water) and is very resistant to antibiotics; G- obligate aerobe, green-blue color with a grape like scent

174
Q

Common P. aeruginosa infections

A

pneumonia (CF and immunocompromised pts), osteomyelitis (diabetics, IV drug users, puncture wounds of foot) burn wound infections, sepsis, UTI, endocarditis, malignant external otitis, corneal infections

175
Q

Burkholderia cepacia

A

oxidase positive, aerobic G- bacillus; common in CF patients

176
Q

Actineobacter

A

aerobic G- found in soil and water; often causes nosocomial infections

MOD (34 decks)

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