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Y3 Medical Micro > L7 Aerobic +ve pathogens > Flashcards

L7 Aerobic +ve pathogens Flashcards

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USMLE® Step 1 flashcards
1
Q

what are the groups of gram positive bacteria

A

firmicutes

actinobacteria

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2
Q

what are firmicutes characterised by

A

low GC

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3
Q

what are actinobacteria characterised by

A

high GC

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4
Q

what is the ‘respiration’ of staphylococci

A

facultative anaerobe

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5
Q

are staphylococci motile

A

no

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6
Q

what are the diagnostic tests for staphylococci

A 
catalase positive
coagulase positive(s. auerus) others are negative
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7
Q

what differentiates staph aureus in diagnostic tests

A

it is coagulase positive

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8
Q

where are s. aureus a normal part of flora

A

skin

mucosal surfaces

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9
Q

where are the most common sites for s.aureus to be

A

anterior nares, throat and groins

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10
Q

how does s. aureus spread

A

direct contact or formites (survives on dry surfaces)

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11
Q

what type of pathogen is s. aureus

A

opportunistic

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12
Q

where is s. aureus a risk

A

presence foreign body (e.g. splinter, catheter)

surgical proceudre

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13
Q

how is s. aureus diagnosed

A 
selective media (e.g. salt mannitol) 
biochemical tests (e.g. coagulase)
PCR/molecular probes
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14
Q

what is antibiotic resistant s. aureus called

A

Methicillin resistant S. aureus

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15
Q

what percentage of the population are carriers of s. aureus

A

20%

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16
Q

what is enterocolitis

A

inflammation of the digestive tract caused by s. aureus

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17
Q

what is empyema

A

collection of pus in the pleural cavity caused by s. auerus

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18
Q

what is pyomyositis

A

rare bacterial infection of skeletal muscles caused by s. aureus

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19
Q

what is the treatment for MRSA

A

vancomycin

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20
Q

does s. aureus have a capsule

A

yes

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21
Q

what is the capsule for in s. aureus

A

inhibits phagocytosis, facilitates adherence

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22
Q

what is protein A for in s. auerus

A

immune evasion factors

inhibits complement/AB function, reduce opsonisation

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23
Q

why does s. aureus have teichoic acids

A

bind fibronectin

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24
Q

what are the enzymes that s. aureus has

A 
coagulase
nucleuase
fibrinolysin
hyaluronidase
lipase
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25
Q

what are coagulase enzymes for in s. auerus

A

clot plasma

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26
Q

what are nucleuase enzymes for in s. auerua

A

hydrolyse DNA

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27
Q

what are fibrinolysin enzymes for in s. aureus

A

degrade fibrin clots

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28
Q

what are hyaluronidase enzymes for in s. aureus

A

degrade hyaluronic acid

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29
Q

what are lipase enzymes for in s. aureus

A

degrade lipids

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30
Q

where is s.epidermis a normal commensal

A

skin
gut
respiratory tract

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31
Q

what pathogen is s. epidermis

A

opportunistic

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32
Q

where does s. epidermis colonise

A

implants as a biofilm

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33
Q

why is s. epidermis hard to treat

A

often resistant to most anti‑staphylocccal agents: methicillin-resistant S. epidermidis (MRSE)
produce a biofilm - glycocalyx

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34
Q

what is the ‘respiration’ of streptococcus and enterococcus

A

mainly facultative anaerobes

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35
Q

what is capnophilic

A

some strep and entrococcus need some co2 for growth

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36
Q

are strep and entrococcus motile

A

no

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37
Q

what morphology are strep and enterococcus found in

A

pairs or chains

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38
Q

what is the catalase for strep and enterococcus

A

negative

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39
Q

what do strep and enterococcus ferment carbohydrates into

A

lactic acid

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40
Q

how many strep species are there

A

> 100

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41
Q

how many enterococcus species are there

A

> 50

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42
Q

what are the schemes to classify strep

A

serologic properties - lancefield groupings (A, B, C, F, G)
haemolytic patterns:
biochemical (physiological) properties

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43
Q

types of hemolysis

A
  1. complete (beta [β]) haemolysis
  2. incomplete (alpha [α]) haemolysis
  3. no (gamma [γ]) haemolysis
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44
Q

how are beta haemolytic strep categorised

A

lancefield grouping (A, B, C, F, G)

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45
Q

how are alpha and gamma haemolytic strep categorised

A

collectively termed viridans streptococci

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46
Q

what is GAS

A

group A strep

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47
Q

what is s. pyogenes

A

GAS

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48
Q

where is s. pyogenes present

A

nasopharynx of healthy adults and children: strep throat

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49
Q

what caused scarlet fever

A

s. pyogenes

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50
Q

how does s. pyogenes spread

A

from person to person through respiratory droplets

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51
Q

how are s. pyogenes grouped

A

subdivided into Griffith types based on serology of three surface protein antigens: M, R, T

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52
Q

what is the virulent strains of s. pyogenes

A

with M protein

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53
Q

why is M protein virulent in s. pyogenes

A

inhibits phagocytosis

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54
Q

what is the treatment for s. pyogenes

A

penicillin and amoxicillin

no vaccine

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55
Q

what is the presumptive identification method for s. pyogenes

A

PYR and bacitracin test

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56
Q

what infections does s. pyogenes cause

A

suppurative

non suppurative

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57
Q

what are the suppurative infections that s. pyogenes causes

A 
pharyngitis & tonsillitis
scarlet fever 
necrotizing fasciitis (“flesh-eating disease”)
otitis media
pneumonia  
streptococcal TSS
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58
Q

what are the non suppurative infections s. pyogenes causes

A

rheumatic fever

acute glomerulonephritis

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59
Q

how is scarlet fever seen physically

A

rash and strawberry tongue

60
Q

what are the virulence factors of s.pyogenes - structural

A

capsule (some strains)
M proteins
teichoic acids

61
Q

what are capsules for in s. pyogenes

A

inhibits phagocytosis, facilitates adherence

62
Q

what are M proteins for in s. pyogenes

A

anti-phagocytic, prevents opsonisation

63
Q

what are teichoic acids for in s. pyogenes

A

bind fibronectin

64
Q

what are s. agalactiae

A

group B strep

65
Q

what is GBS

A

group B strep

66
Q

where does s. agalactiae colonies

A

lower GI tract

genitourinary tract

67
Q

what is the haemolysis of s. agalactiae

A

beta

1-2%strains none

68
Q

what does s. agalactiae cause in newborns

A

meningitis
pneumonia
sepsis

69
Q

why does s. agalactiae affect newborns

A

absence of maternal protective AB

low complement levels

70
Q

what does s. agalactiae cause in adults

A

bacteremia, pneumonia
bone and joint infections
skin and soft tissue infections
pregnant women: urinary tract infections

71
Q

what bacterias work together to give a bigger haemolysis

A

s. aureus and GBS

s. aureus makes another protein that synergistically works with GBS = bigger clearing

72
Q

what is the haemolysis of s. pneumoniae

A

alpha

can be beta if grown anaerobically

73
Q

what do the virulent s. pneumoniae carry

A

capsule

74
Q

where does s. pneumoniae colonise

A

upper respiratory tract
mouth
pharynx

75
Q

what does s. pneumoniae cause

A

pneumonia
meningitis
otitis media
sinusitis

76
Q

why is s. pneumoniae difficult to isolate

A

fastidious

77
Q

how is s. pneumoniae diagnosed

A

sensitive to optochin, ferments inulin, and lysed by bile salts

78
Q

what is the treatment for s. pneumoniae

A

vaccines available: PCV and PPV in the UK

79
Q

how many species of bacillus are there

A

~300

80
Q

does bacillus species make spores

A

endospore forming

81
Q

what is the ‘respiration’ of bacillus

A

aerobic or facultative anaerobe

82
Q

what is the shape of bacillus

A

rod

83
Q

are bacilli motile

A

some

84
Q

which are the pathogenic bacillus

A

b. cereus

85
Q

where is b. cereus present

A

ubiquitous - all environments

86
Q

what pathogen is b. cereus

A

opportunisitic

87
Q

what does b. cereus cause

A

vomiting disease – toxin in food
diarrheal disease – GI tract infection
ocular infections, complete eye loss in 48 h
intravenous catheter - sepsis
severe pneumonia (rare; after acquiring B. anthracis toxin genes)

88
Q

how do you get infected by b.cereus

A

food poisoning (gastroenteritis)

89
Q

what are the vomiting toxins of b. cereus

A

heat stable enterotoxin

90
Q

what are the diarrhoea disease toxins of b. cereus

A

heat liable enterotoxin

91
Q

what are the eye destruction toxins of b. cereus

A

necrotic toxin (heat-labile)
cerolysin (alpha haemolysin)
phospholipase C

92
Q

what shape is b. anthracis

A

large vegetative cell

93
Q

is b. anthracis motile

A

no

94
Q

what is the characteristic growth of b. anthracis

A

medusa head colonies

95
Q

what encodes the toxin and capsule for b.anthracis

A

plasmid encoded

96
Q

what does b. anthracis cause

A

anthrax

97
Q

how does b. anthracis infect

A

humans infected through contaminated animals/animal products (also drug abusers – heroin injection)
inoculation (95%), ingestion (very rare), inhalation

98
Q

do b. anthracis have spores

A

yes

survive for years in soil

99
Q

what is the treatment for b. anthracis

A

vaccines

100
Q

how is b. anthracis detected

A

direct fluorescent antibody test

101
Q

what are the virulence factors of b. anthracis

A

capsule (poly D-glutamate)
lethal toxin
edema toxin

102
Q

what is the lethal toxin of b. anthracis made of

A

protective antigen + lethal factor

103
Q

what is the edema toxin of b. anthracis made of

A

protective antigen + edema factor

104
Q

types of anthrax

A

cutaneous
gastrointestinal
inhalation

105
Q

what does listeria monocytogenes cause

A

listeriosis

106
Q

is listeria monocytogenes motile

A

tumbling motility at 25 degrees

107
Q

what shape are listeria monocytogenes

A

short rods

108
Q

what is the haemolytic activity of listeria monocytogenes

A

beta

109
Q

how is listeria monocytogenes acquired

A

contaminated food: soft cheese, milk, undercooked meat, unwashed raw vegetable

110
Q

what temp ph does listeria monocytogenes grow at

A

wide pH and temperature range (1 – 45 °C; fridge!)

111
Q

where is listeria monocytogenes present

A

widely distributed in nature restricted to
neonatal disease
pregnant women
healthy adults

112
Q

what is the effect of early onset neonatal disease by listeria monocytogenes

A

spontaneous abortion

113
Q

how is early onset neonatal disease by listeria monocytogenes trasnmitted

A

via placenta in uterus

114
Q

what is the effect of late onset neonatal disease by listeria monocytogenes

A

meningitis, septicaemia

115
Q

what is the effect of listeria monocytogenes on pregnant women/immune defect patients

A

bacteraemia

meningitis

116
Q

what is the effect of listeria monocytogenes on healthy adults

A

mild influenza-like illness, gastrointestinal symptoms, often asymptomatic = listeriosis

117
Q

what is the group for gram positive bacteria with high GC

A

actinobacteria

118
Q

what is the shape of Corynebacterium diphtheriae

A

club

119
Q

is Corynebacterium diphtheriae motile

A

no

120
Q

is Corynebacterium diphtheriae catalase +/-

A

positive

121
Q

what is in the cell wall of Corynebacterium diphtheriae

A

mycolic acid

122
Q

what is the ‘respiration’ of Corynebacterium diphtheriae

A

facultative anaerobe

123
Q

what are the hosts of Corynebacterium diphtheriae

A

only humans

124
Q

what does Corynebacterium diphtheriae cause

A

diphtheria

  • respiratory
  • cutaneous (less servere)
125
Q

what are the diphtheria toxins

A

A-B exotoxin

126
Q

what does A-B exotoxin do

A

inhibit protein synthesis

127
Q

what is the diphtheria toxin encoded by

A

lysogenic phage (b-phage)

128
Q

what is the treatment for diphtheria

A

anti-toxin and antibiotics; prevention through vaccination (now part of 5 component vaccine) & contact tracing

129
Q

how many species of mycobacterium are there

A

> 100

130
Q

are mycobacterium motile

A

no

131
Q

what is the ‘respiration’ of mycobacterium

A

aerobic

132
Q

what are the pathogenic mycobacterium

A

Mycobacterium tuberculosis
Mycobacterium leprae: lepra
Mycobacterium africanum
Mycobacterium bovis

133
Q

what is different in mycobacterium

A

Highly complex cell wall with mycolic acid = acid fast stain

134
Q

what is the growth of mycobacterium

A

slow growing

135
Q

what does the cell wall of mycobaterium include

A

lipid-rich
high % mycolic acid
hydrophobic

136
Q

what is the cell wall of mycobacterium like with disinfectants/antibiotics

A

resistant

137
Q

how are acid fast organisms characterised

A

hydrophobic, wax-like, nearly impermeable cell walls

138
Q

what does mycobacterium tuberculosis cause

A

tuberculosis

139
Q

what is tuberculosis

A

infects lungs but can disseminate to other sites

140
Q

what type of pathogen is mycobacterium tuberculosis

A

intracellular - replicates in unactivated alveolar macrophages

141
Q

what is the mycobacterium tuberculosis infection like

A

can remain dormant and establish lifelong infection

142
Q

why does mycobacterium tuberculosis cause disease

A

primarily due to host response (no myco-bacterial toxin/enzyme known to destruct tissue)

143
Q

where is mycobacterium tuberculosis present

A

humans are only natural reservoir: 1/3 of world population infected

144
Q

how is mycobacterium tuberculosis spread

A

inhalation of infectious aerosols

145
Q

how is mycobacterium tuberculosis diagnosed

A

molecular probes, tuberculin skin test (with proteins from cell wall)
QuantiFERON-TB (blood) test: ELISA-based interferon gamma release assay

146
Q

what is the RBC virulence factor that strep pyogenes group A has

A

Streptolysin S

147
Q

examples of actinobacteria (high GC)

A

Corynebacterium

Mycobacterium

Y3 Medical Micro (16 decks)

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