Micriobio: Gram positive Flashcards

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1
Q

which type of bacteria has a cell wall/cell membrane

A

this is in gram positive. it is mostly peptidoglycan for support and has lipotechoic acid which induces TNF and IL1.

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2
Q

which type of bacteria has an outer membrane

A

this is in gram negatives and it has lipid A which induces TNF and IL1. it also can have O polysaccharide which is the antigen

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3
Q

which type of bacteria has the periplasm?

A

this is in the gram negative and it has hydrolytic enzymes including beta lactamases

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4
Q

which bacteria has a capsule that is not made of polysaccharide?

A

B anthracis and it is made of D glutamate

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5
Q

why can’t you stain mycoplasma

A

no cell wall. the cell membrane contains steroids

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6
Q

why can’t you stain mycobacteria

A

cell wall has mycolic acids and a high lipid content

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7
Q

pneumonic for those that don’t stain

A
These Microbes May Lack Real Color
Treponema
Mycobacteria
Mycoplasma
Legionella (silver stain)
Rickettsia (intracellular parasite)
Chlamydia (intracellular and lacks muramic acid)
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8
Q

Giemsa stain

A
Certain Bugs Really Try my Patients
Chlamydia
Borrelia
Rickettsiae
Trypanosomes
Plasmodium
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9
Q

PAS stain

A

tropheryma whipplei

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10
Q

Ziehl Nelson Stain

A

Nocardia and Mycobacteria- this is an acid fast stain

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11
Q

India ink stain

A

cryptococcus neoformans

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12
Q

Silver stain

A

fungi, legionella, H pylori

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13
Q

special media requirements for H influenzae

A

chocolate agar with factor V (NAD+) and factor X (hemetin)

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14
Q

special media for Neisseria

A

thayer martin or VPN media
V- vanco against gram positives
P- polymyxin against gram neg except Neisseria
N - nystatin against fungus

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15
Q

special media for Bordetella pertussis

A

Bordet Gengoup (potato agar)

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16
Q

special media for C diptheriae

A

tellurite agar. loffler medium

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17
Q

special media for TB

A

lowenstein Jensen agar

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18
Q

special media for M pneumoniae

A

Eaton agar, requires cholesterol

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19
Q

lactose fermenting bugs

A

these guys like E coli are pink on Maconkey and purple with a green metallic sheen on EBM or eosin methylene blue

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20
Q

special media for legionella

A

charcoal yeast extract with iron and cystine

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21
Q

special media for fungi

A

Sabouraud agar.

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22
Q

pneumonic for obliagate aerobes

A

Nagging Pests Must Breathe

Nocardia, Pseudomonas, MycoBacterium,

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23
Q

pneumonic for oligate anerobes

A

can’t breathe air
clostridium
bacteriodes
actinomyces

remember that anerobes are resistant to all aminoglycosides because they require O2 to be taken up into the cell.

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24
Q

intracellular bugs

A

Really Cold
Rickettsia
Chlamydia

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25
Q

Facultative intracellular

A
Some Nasty Bugs May Live FacultativeLY
Salmonella
Neisseria
Brucella
Mycobacteria
Listeria
franciesella
Legionella
Yersinia pestis
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26
Q

encapsulated bacteria

A

SHiN
S. pneumonia
H influenza
N meningitidis

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27
Q

catalase positive organisms

A
PLACESS
psuedomonas
listeria
aspergillus
candida
Ecoli
S aureus
Serratia
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28
Q

3 conjugate vaccines

A

S pneumonia, H influenza, N meningitidis

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29
Q

urease positive bugs

A
cryptococcus
H pylori
Proteas
Ureplasma
Nocardia
Klebsiella
S epidermidis
S saprophyticus
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30
Q

color of serratia marcescens

A

red pigment.

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31
Q

function of protein A

A

binds to Fc region of IgG. prevents opsonization and phagocytosis

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32
Q

bug that expresses protein A

A

Staph aureus

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33
Q

IgA protease function

A

enzyme that cleaves IgA

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34
Q

bugs that have IgA protease

A

SHiN organisms

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35
Q

M protein function

A

helps prevent phagocytosis

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36
Q

bug that has M protein

A

group A strep

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37
Q

endotoxin is gram negative or positive

A

negative

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38
Q

exotoxin is gram negative or positive

A

both

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39
Q

where is the endotoxin

A

in the cell membrane of the gram negative bacteria and it is released when the cell is lysed

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40
Q

where is the exotoxin?

A

secreted from the cell

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41
Q

endotoxin location of genes

A

bacterial chromosome

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42
Q

exotoxin location of genes

A

plasmid or bacteriophage

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43
Q

which two bacteria have exotoxins that inhibit EF2

A

corynebacteria diptheria and psuedomonas aerginosa

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44
Q

shiga and shiga like exotoxin effect

A

inactivate the 60S ribosome by removing the adenine from the rRNA

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45
Q

Enterotoxigenic Ecoli has two exotoxins

A

Heat labile- overactivates cAMP and increases Cl secretin into the gut.
Heat stabile- increases guanylyl cyclase increasing cGMP and decreasing NaCL reabsorption in the gut

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46
Q

edema factor exotoxin found in which bug

A

bacillus anthracis. mimics the adnylate cyclase enzyme and increases cAMP. gives the black border on eschar lesions

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47
Q

cholera toxin

A

this is in vibrio cholera and it overactives adenylate cyclase and increases cAMP by permanently activating Gs. causes increase in Cl secretion into the gut and water to follow

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48
Q

pertussis toxin

A

seen in bordatella pertussis. increase cAMP by disabling Gi impairing phagocytosis to permit survival. this causes whooping cough

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49
Q

tetanospasmin enterotoxin

A

this is in C tetani. it is a protease that cleaves the SNARE proteins, preventing NT release. this works on the inhibitory GABA and glycing neurons of the Renshaw cells of the spinal cord. causes risus sardonicus and lock jaw

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50
Q

alpha toxin

A

this is from C perfringes. it is a phospholipase or lecithinase that degrades tissue and cell membranes. gives gas gangrene and double hemolysis on blood agar

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51
Q

streptolysin O enterotoxin

A

this is in S pyogenes. protein that degrades cell membrane. lyses RBCs, contributes to beta hemolysis etc.

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52
Q

Exotoxin A

A

this is found in psueodmonas where it is an inihbitor of E2F and it is found in Strep pyogenes where it brings the MHC II and TCR in proximity to cause an overwhelming release of IFN gamma and IL2 leading to shock. toxic shock syndrome

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53
Q

TSST-1 extoxin

A

this is from S aureus. brings MHC II with TCR to cause increase in IFN gamma dn IL2 leading to shock.

54
Q

two organisms that cause toxic shock syndrome

A

S pyrogenes and S aureus

55
Q

novobiacin use

A

to distinguish staph organisms. saprophyticus is resistant and epidermitis is sensistive. No Stress.

56
Q

optochin use

A

works on alpha hemolytic strep.

viridans is resistant and pneumonia is sensative

57
Q

bacitracin

A

works to distinguish beta hemolytic strep organisms.

Group B strep is resistant and Group A or pyogenes is sensitive.

58
Q

green ring on blood agar

A

this means the colonies are alpha hemolytic

59
Q

clearing on the blood agar plate

A

this means the colonies are beta hemoltic

60
Q

4 beta hemolytic organisms

A

S aureus
strep pyogenes
Strep agalactiae
Listeria monocytogenes- tumbling motility

61
Q

gram positive clusters

A

staph!

62
Q

gram positive chains

A

Strep

63
Q

two organisms that are branching gram positive filaments

A

Nocardia and actiomyces

64
Q

how to distinguish nocardia from actinomyces

A

actinomyces is anaerobe, not acid fast

nocardia is mildly acid fast and aerobe

65
Q

what is special about group D strep

A

enteroccocus. grows in bile and in 6.5% NaCL

example- E faecalis

66
Q

Nonenteroccus

A

this is different from group D strep because it grows in bile but not in 6.5% NaCL.
example- S bovis

67
Q

organism that causes skin infections, organ abscesses, pneumonia, endocarditis and osteomyelitis

A

S aureus

68
Q

what is the mutation in MRSA that makes methicilin resistant

A

mutation in the penicillin binding protein (PBP)

69
Q

what two things does S aureus produce

A

catalase (just because it is staph) and then it also makes coagulase

70
Q

bug that infects prosthetic devices and IV catheters by producing adherent biofilms

A

S epidermis. often a contaminant of blood cultures because it is a normal part of the flora

71
Q

second most common cause of uncomplicated UTI in young women

A

Staph saprophyticus

72
Q

4 conditions caused by Strep pneumoniae

A
MOPS
Meningitis
Otitis media
Pneumonia
Sinusitis
73
Q

lancet shaped gram positive diplococci

A

Strep pneumniae

74
Q

what is the virulence factor with Strep pneumoniae

A

IgA protease and encapsulated.

75
Q

rusty sputum and sepsis in sickle cell anemia and splenectomy patients

A

Strep pneumonia infection

76
Q

bug that causes dental caries

A

Strep viridans (Strep mutans)

77
Q

bacteria that causes subacute bacterial endocarditis at damaged valves

A

Strep viridans (strep sanguinis)

78
Q

cause of rheumatic fever

A

Strep pyogenes

79
Q

Jones criteria

A
this is for rheumatic fever
migrating arthalgias
subcutaneous nodules
carditis
erythema marginatum
syndham chorea
80
Q

Strep pyogenes pharyngitis can cause

A

this can cause rheumatic fever or glomerulonephritis

81
Q

Strep pyogenes imetpigo infection can cause

A

mostly just leads to glomerulonephritis.

82
Q

scarlet fever

A

this is scarlet rash, sandpaper like texture, strawberry tongue, circumoral pallor

83
Q

another name for group B strep

A

strep agalactae

84
Q

disease normally caused by Group B strep

A

colonizes vagina, causes pneumonia, meningitis and sepsis, mostly in babies

85
Q

CAMP factor

A

this is produced by group B strep and it increases the hemolytic area formed by S. aureus.

86
Q

bacteria that gives a positive hippurate test

A

group B strep

87
Q

when should women be screened for group B strep

A

35-37 weeks

88
Q

enteroccoci

A

normal colonic flora that are penicillin G resistant and cause UTI, biliary tract infections and subacute endocarditis (most commonly after Gi/GU procedures)

89
Q

subacute endocarditis after GI/GU procedure

A

enterococcus

90
Q

subacute endocarditis with colon cancer

A

Strep Bovis

91
Q

acute endocarditis

A

S. aureus

92
Q

subacute endocarditis of damaged valves

A

Viridans strep- most specifically S sanguinis

93
Q

what is lancefield grouping based on

A

C carbohydrate on the bacterial cell wall. variable hemolysis. includes both enterococcus and non enterococcus

94
Q

how to differentiate enterococci from non enterococci

A

the non enterococci cannot grow on 6.5% naCl while the enterococci can. both can grow in bile

95
Q

strep bovis infection

A

colonizes the gut. can cause bacteremia or subacute endocarditis in colon cancer patients.

96
Q

corynebacterium diptheriae

A

causes diptheriae via exotoxin encoded by beta prophage. potent exotoxin inhibits protein synthesis via ADP ribosylation of EF2.

97
Q

symptoms of corynbacterium diptheriae infection

A

pseudomembranous pharyngitis, lymphadenopathy, myocarditis, and arrythmias.

98
Q

Elek test

A

this is for the toxin from corynbacteria diptheraie

99
Q

lab shows gram positive rods with metachromatic blue and red granules

A

this is positive for corynbacteria diptheraie

100
Q

intracellular polyphosphate granules which are metachromatic with methylene blue staining

A

this is positive for corynbacteria diptheraie

101
Q

black colonies on cystine-tellurite agar

A

this is positive for corynbacteria diptheraie

102
Q

how do we kill spores in the hospital

A

must autoclave to kill spores- by steaming to 121 for 15 minutes

103
Q

spore forming organisms from soil

A

bacillus anthracis, C perfringes, C tetani

104
Q

non soil spore forming organisms

A

B cereus, C botulinum, Coxiella burnetti

105
Q

organism that produces tetanospasmin

A

C tetani

106
Q

organism that produces alpha toxin

A

C perfringes. this is a lecithinase, a phospholipase that can cause myonecrosis or gas gangrene and hemolysis.

107
Q

organism that produces two toxins- Toxin A and Toxin B

A

this is C diff

108
Q

Toxin A and Toxin B from C diff

A

Toxin A: enterotoxin: binds to the brush border of the gut.
Toxin B: cytotoxin: cytoskeletal disruption via actin depolymerization and this is what leads to psuedomembranous colitis.

109
Q

two antibiotics commonly causing C diff infections

A

clindamycin and ampicillin.

110
Q

treatment for C diff infection

A

metronidazole, or oral vancomycin

111
Q

lab shows lancet shaped gram positive diplococci

A

this is strep pneumoniae

112
Q

symptom of cutaneous anthrax

A

boil like lesion that turns to an ulcer with black eschar which is painless and necrotic. unlikely to become septic or anything.

113
Q

symptoms of pulmonary anthrax

A

inhalation of spores- gives flu like symptoms that rapdily progress to fever, pulmonary hemorrhage, mediastinitis and shock

114
Q

vomiting and nausea from cereulide

A

this is the toxin from bacilis cerues that causes emetic type of illness seen with rice and pasta consumption. nausea and vomiting will start within 1-5 hours of infection. it is a preformed toxin.

115
Q

diarrheal type of Bacillus cereus

A

this type causes watery non bloody diarrhea and GI pain within 8-18 hours

116
Q

listeria monocytogenes

A

facultative intracellular microbe

117
Q

organism that forms rocket tails via actin polymerization that allows them to move through cytoplasm with head over tail movement (tumbling motility) to avoid antibodies

A

this is listeria monocyotgenes

118
Q

only one gram positive organism to produce LPS

A

listeria monocytogenes

119
Q

how to treat infants and elderly with listeria infections

A

ampicillin

120
Q

organism that causes oral/facial abcesses that drain through sinus tracts, form yellow sulfur granules

A

actinomyces

121
Q

organism that causes pulmonary infections in immunocompromised patients and cutaneous infections after trauma in immuno normal or competent people

A

nocardia

122
Q

how to treat actinomyces infections

A

penicillin

123
Q

how to treat nocardia infections

A

treat with sulfonamides

124
Q

which organism is gram positive but weakly acid fast

A

nocardia

125
Q

prophylatic treatment in AIDS patient with mycobacterium avium intracellurae infection

A

azithromycin

126
Q

what is the cord factor

A

this is found in virulent strains of mycobacterium and inhibits macrophage maturation and induces release of TNF alpha.

127
Q

which organisms have sulfatides

A

this is found with cord factor in mycobacterum. it is a surface glycolipid that inhibits phagolysosomal fusion

128
Q

which form of leprosy has more of a TH2 response?

A

lepromatous (low cell mediated immunity)

129
Q

which form of leprosy has more of a TH1 cell mediated response

A

Tuberculoid

130
Q

which form of leprosy shows the lion faces

A

this is lepromatous

131
Q

treatment for leprosy

A

dapsone and rifampin with clofazimine if lepromatous. if tuberculoid you do not need the clofazimine.

132
Q

how long is treatment for leprosy

A

2-5 years