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Micro 1 Flashcards

1
Q

peptidoglycan structure

A

sugar backbone with peptide side chains cross linked with transpeptidase

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2
Q

lipoteichoic acid in what organisms and activity

A

Gram positives, induces TNG and IL-1

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3
Q

Lipopolysaccharide in what and does what

A

Endotoxin of gram negatives. Induces TNF and IL-1. O polysaccharide is the antigen.

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4
Q

Space between cytoplasmic membrane and outer membrane in gram negatives

A

Periplasm: contains hydrolytic enzymes including Beta-lactamases

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5
Q

what is a capsule made of

A

polysccharide

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6
Q

exception to polysaccharide capsule

A

Bacillus anthracis, contains D-glutamate

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7
Q

sex pilus for what process

A

conjugation

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8
Q

pilus and fimbria made of

A

glycoprotein

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9
Q

spore made of

A

keratin-like coat; dipicolinic acid; peptidoglycan

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10
Q

dipicolinic acid??

A

????

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11
Q

glycocalyx structure and function

A

polysaccharide, adheres to surfaces (biofilms)

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12
Q

capsules in what organisms

A

both gram positives and negatives

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13
Q

Name the gram + cocci

A

staph and strep

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14
Q

gram - cocci

A

neisseria (gram - diplococci)

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15
Q

What are the branching filamentous bacteria

A

actinomyces and nocardia (weakly acid fast) Gram positives!!!

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16
Q

What are the pleomorphic bacteria

A

Rickettsiae (Giemsa) and Chlamydiae (Giemsa) Gram negatives!!!!

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17
Q

What are the spiral bacteria

A

Spirochetes (gram negatives): Borrelia (Giemsa), Leptospira, Treponema

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18
Q

No cell wall bacteria

A

Mycoplasma (does not Gram stain)

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19
Q

Mycoplasma cell membrane

A

Contain sterols and have no cell wall

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20
Q

Mycobacteria cell wall

A

Contains mycolic acid with high lipid content.

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21
Q

Name the gram positive rods

A

Clostridium, corynebacterium, bacillus, listeria, mycobacterium (acid fast), gardnerella (gram variable)

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22
Q

The gram-negative rods

A

There are a ton.

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23
Q

Make a table of the different kinds of bacteria, at least be able to recognize what each one is.

A

…………………….If you know all the gram-positives (there are only a few), you can know what all the gram negatives are!!!!!

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24
Q

Everything is gram negative except for

A

Staph, strep, clostridium, corynebacterium, bacillus, listeria, gardnerella, actinomyces, nocardia, (not sure about nocardia)

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25
Q

Is mycoplasma gram +?

A

??????????????

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26
Q

What is in acid fast stain

A

Carbolfuchsin to stain the high lipid content of mycobacteria

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27
Q

Legionella is found where

A

Priarmily intracellular

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28
Q

Legionella staining

A

silver stain

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29
Q

Rickettsia gram stain?

A

Intracellular parasite (doesn’t gram stain)

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30
Q

Chlamydia stain?

A

IC parasite; lacks muramic acid in cell wall

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31
Q

Muramic acid?

A

???

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32
Q

What is Giemsa stain?

A

?????

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33
Q

What bugs stain with Giemsa???

A

Chlamydia, Borrelia, Rickettsia, Trypanosomes, Plasmodium (these sound intracellular, but are all of them?….nope..fuck)

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34
Q

What is PAS stain

A

Periodic acid-Schiff: stains glycogen!!!!, mucopolysaccharides. PASs the sugar.

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35
Q

PAS stain for what

A

Tropheryma whipplei (Whipple disease)

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36
Q

Ziehl-Neelsen stain

A

Carbolfuchsin (Acid fast: nocardia, mycobacterium)

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37
Q

India ink stain

A

Cryptococcus

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38
Q

Other way of staining cryptococcus

A

Mucicarmine to stain thick polysaccharide capsule red

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39
Q

Silver stain for what

A

Fungi (pneumocystis), legionella, helicobacter

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40
Q

Special culture requirements….Know them???

A

?????????

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41
Q

Growing neisseria gonorrheae or meningitidis

A

Thayer-Martin or VPN media (Vancomycin, Polymyxin, and Nystatin.

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42
Q

Growing Bordetella pertussis

A

Bordert-Gengou (potato) agar (Bordet for Bordertella)

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43
Q

Growing E. coli

A

Eosin-Methylene blue (EMB) agar as colonies with green metallic sheen

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44
Q

Growing Fungi

A

Sabouraud agar. “Sab’s a fun guy!”

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45
Q

What are the obligate aerobes

A

Pseudomonas, Mycobacterium tuberculosis, and Nocardia! All lung infections

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46
Q

What part of lung has the highest PO2

A

Apices of lung, where M. tuberculosis goes after reactivation from immune compromise or TNF-alpha inhibitor.

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47
Q

Bacteria in burn wounds

A

P. aeruginosa

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48
Q

Where do you see P. aeruginosa

A

Burn wounds, complications of diabetes, nosocomial PNA, and pneumonias in cystic fibrosis patients.

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49
Q

What are the obligate anaerobes

A

Clostrium, bacteroides, and actinomyces (actinomyces and nocardia are at opposite ends)

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50
Q

What do obligate anaerobes lack

A

Catalase and/or superoxide dismutase

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51
Q

Characteristics of obligate anaerobes

A

Smell bad (short-chain fatty acids), difficult to culture, and produce gas in tissue (CO2 and H2).

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52
Q

What ABx can’t be used against anaerobes

A

Aminoglycosides because they require O2 to enter.

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53
Q

Obligate intracellular bugs

A

Rickettsia, Chlamydia (can’t make own ATP)

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54
Q

Facultative intracellular bugs

A

Salmonella, neisseria, brucella, mycobacterium, listeria, francisella, legionella, yersinia pestis

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55
Q

Mnemonic for facultative intracellular bugs

A

Some Nasty Bugs May Live FacultativeLY

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56
Q

Encapsulated Bacteria

A

SHiNE SKiS: Strep pneumo, HiB, N. meningitidis, E. coli, Salmonella, Kleb, group B Strep

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57
Q

How to kill encapsulated bacteria

A

Opsonized and cleared by spleen

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58
Q

What vaccines to give aplenics

A

S. pneumo, H. flu, and N. meningitidis

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59
Q

Catalase-positive organisms

A

Pseudomonas, Listeria, Aspergillus, Candida, E.coli, S. aureus, Serratia (You need PLACESS for your CATs)

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60
Q

What kind of vaccine activates T-cells

A

Conjugated vaccine (to protein), polysaccharide antigen cannot be presented to T cells.

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61
Q

Pneumovax kind of vaccine

A

Pneumococcal Polysaccharide Vaccine (PPSV) with no conujugated protein

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62
Q

Prevnar is what kind of vaccine

A

Pneumococcal Conjugate Vaccine (PCV)

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63
Q

HiB vaccine

A

Conjugate

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64
Q

Meningococcal vaccine

A

Conjugate vaccine

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65
Q

Urease-positive bugs

A

Cryptococcus, H. pylori, Proteus, Ureaplasma, Nocardia, Klebsiella, S. epidermidis, S. saprophyticus

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66
Q

Pigment-producing bacteria

A

Actinomyces israelii (Yellow), S. aureus (Yellow), Pseudomonas aeruginosa (blue-green), Serratia marcescens (red)

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67
Q

What does Protein A do?

A

Binds Fc region of IgG. Prevents opsonization and phagocytosis. Expressed by S. aureus.

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68
Q

What does IgA protease do?

A

Cleaves IgA. Secreted by S. pneumo, HiB, and Neisseria (SHiN)

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69
Q

What does M protein do?

A

Helps prevent phagocytosis. Expressed by group A strep.

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70
Q

Compare exotoxin and endotoxin..

A

………….

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71
Q

Basics of endotoxin

A

Outer cell membrane of most gram-negative bacteria, is not secreted, is made out of LPS (released when lysed), made by bacterial chromosome, low toxicity, creates fever, chock (hypotension), and DIC, induces TNF,IL-1, and IL-6, poorly antigenic, no toxoids formed and no vaccine avaialble, stable at 100 degrees celsius for 1 hr. Found in meningococcemia, sepsis by gram negative rods

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72
Q

What is a toxoid?

A

Toxoid is the toxin that has been inactivated chemically or with heat but still has its immunogenicity and is used as vaccine.

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73
Q

Basics of exotoxin

A

Certain species of gram + and gram - bacteria, secreted from cell, polypetide, from plasmid or bacteriophage, high toxicity, induces hihg-titer antibodies called antitoxins, toxoids used as vaccines, destroyed rapidly at 06 degrees celsius (except staph enterotoxin), causes tetanus, botulism, and diphtheria.

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74
Q

Write out a table of bugs with exotins

A

……..

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75
Q

Dysentery from what bacteria

A

Shigella

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76
Q

ETEC toxins mnemonic

A

Labile int he Air, Stable on the Ground (cAMP and cGMP)

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77
Q

ENDOTOXIN mnemonic

A

Edema, nitrix oxide, DIC/Death, Outer membrane, TNF-alpha, O-antigen, eXtremely heat stable, IL-1, Neutrophil chemotaxis

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78
Q

What are endotoxins

A

A LPS in outer membrane of gram negatives

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79
Q

What does Lipid A do

A

It is an endotoxin, activates macrophages, complement, and tissue factor.

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80
Q

What activated macrophages do

A

IL-1, TNF, and NO

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81
Q

What activated complement does

A

C3a and C5a

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82
Q

What activated tissue factor does

A

Coagulation cascade and subsequent DIC

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83
Q

What is competence

A

The ability to take up naked DNA from environment for Transformation

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84
Q

What bacteria are known for transformation

A

SHiN: S. pneumo, HiB, and Neisseria

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85
Q

What is optochin

A

Optochin is used to distinuish alpha-hemolytic strep. Strep pneumo is optochin sensitive but strep viridans is resistant.

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86
Q

Example of Viridans strep

A

S. mutans

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87
Q

F+ conjugation

A

From a F+ plasmid which contains genes for sex pilus and conjugation. no chromosomal genes. The entire plasmid is shuttled through sex pilus.

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88
Q

Hfr conjugation

A

Incorporated into bacterial chromosome. Transfers plasmid and chromosome genes.

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89
Q

Transposition in bacteria

A

Transposons between plasmid and chromosome. Abx resistance genes on R plasmid.

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90
Q

Generalized transduction

A

Lytic phage gets DNA incorporated into the virion.

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91
Q

Specialized transduction

A

Lysogenic phage gets flanking DNA from bacteria

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92
Q

5 bacterial toxins encoded in a lysogenic phage

A

ABCDE: ShigA-like toxin, Botulinum, Cholera, Diphtheria, Erythrogenic of Strep pyogenes.

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93
Q

Do strep have catalase?

A

No, all strep lack catalase, staph has catalase

94
Q

Is staph aureus hemolytic?

A

Yes, beta-hemolytic

95
Q

Is listeria hemolytic

A

Yes

96
Q

Listeria describtion

A

Tumbling motion, newborn meningitis, unpasteurized milk

97
Q

Where to find Staph aureus

A

The nose.

98
Q

What is protein A

A

Virulence factor of staph aureus binding Fc-IgG, inhibits complement activation and phagocytosis.

99
Q

Bacterial superinfection after flu

A

Staph aureus

100
Q

Staph aureus toxins

A

TSST-1 (toxic shock syndrome), scalded skin syndrome (exfoliative toxin), rapid-onset food poisoning (enterotoxins)

101
Q

MRSA (methicillin-resistant S. aureus infection) MOA of resistance

A

Altered penicillin binding protein

102
Q

What is TSST and what does it do

A

Superantigen activating a huge percentage of T-cells with MHCII. Presents with fever, vomiting, rash, desquamation, shock, end-organ failuire, use of vaginal or nasal tampons predisposes to toxic shock syndrome.

103
Q

Incubation period of s. aureus food poisoning

A

2-6 hrs. Enterotoxin is heat stable, not destroyed by cooking

104
Q

What does coagulase do

A

Forms fibrin clot around self to lead to an abscess

105
Q

Staph epidermidis blurb

A

Biofilms on prosthetics and catheters. Contaminates blood cultures. Novobiocin sensitive.

106
Q

Staph saprophyticus blurb

A

Second MCC of uncomplicated UTI in young women (1. is E. coli). Novobiocin resistant

107
Q

Strep pneumo MCC of what diseases

A

MOPS: meningitis, otitis media (children), pneumonia, and sinusitis.

108
Q

Morphology of strep pneumo

A

Lancet-shaped, gram-positive diplococci, encapsulated. IgA protease

109
Q

Pneumococcus sputum

A

Rusty sputum

110
Q

Pneumocccus causes sepsis in what

A

Sickle cell and splenectomy

111
Q

What happens if you remove pneumococcus capsule

A

No virulence without it!

112
Q

Pneumococcus and optochin

A

Sensitive

113
Q

Name the viridans group strep and description

A

S. mutans in mouth (caries), cause subacute bacterial endocarditis at damaged valves (S. sanguinis). Resistant to optochin. Alpha-hemolytic.

114
Q

Strep pyogenes infections

A

Scarlet fever is toxin induced (rheumatic fever is immunologic), can cause cellulitis, impetigo, necrotizing fasciitis.

115
Q

Strep pneumo description

A

Group A beta-hemolytic strep. Bacitracin sensitive. Antibodies to M protein enhance host defense but give rise to rheumatic fever. .

116
Q

Recent strep pyo infection dx

A

ASO titer (anti-streptolysin O antibodies)

117
Q

JONES criteria for rheumatic fever

A

Joints (polyarthralgias), carditis, nodules (subQ), Erythema marginatum, sydenham chorea.

118
Q

What strep pyo infections can cause rheumatic fever and glomerulonephritis

A

Pharyngitis can do both. Impetigo more commonly precedes glomerulonephritis than pharyngitis.

119
Q

Scarlet fever sxs

A

Scarlet rash with sandpaper-like texture, strawberry tongue, circumoral pallor.

120
Q

What does erythema marginatum look like

A

it looks like pink rings

121
Q

Strep agalactiae description

A

beta-hemolytic (Group B strep), in vagina. Bacitracin resistant. Causes PNA, meningitis, sepsis in babies.

122
Q

What is CAMP factor

A

Made by strap agalactiae, enlarges the area of hemolysis formed by S. aureus

123
Q

What to diagnose strap agalactiae with

A

CAMP test (named after authors). It turns hippurate test positive.

124
Q

Screening and management for strep agalactiae

A

Screen pregnant women at 35-37 weeks. patients with positive culture receive intrapartum penicillin ppx.

125
Q

Enterococci cause what infections

A

UTI, biliary tract infections, and subacute endocarditis after GI/GU procedures.

126
Q

Enterococci tx

A

Resistant to penicillin G

127
Q

Nonenterococcal group D strep

A

Can’t grow in 6.5% NaCl and bile (enterococci can)

128
Q

Where to find strep bovis

A

In the gut, can cause bacteremia and subacute endocarditis in colon cancer patients.

129
Q

What kind of strep is strep bovis

A

gamma-hemolytic group D strep

130
Q

What is pseudomembranous mean?

A

For diphtheria, it is gray-white exudative layer of necrotic epithelium and debris, fibrin, bacteria, and neutrophils. Removing it causes hemorrhage.

131
Q

Diphtheria presentatin

A

Pseudomembranous pharyngitis, bull neck lymphadenopathy, myocarditis, and arrythmias.

132
Q

Diphtheriae dx

A

Gram-positive rods with metachromatic (blue and red) granules and Elek test for toxin.

133
Q

What does diphtheria look like on agar

A

Black colonies on cystine-tellurite agar.

134
Q

Diphtheriae mnemonic

A

ADP-ribosylation, beta-prophage, corynebacterium, diphtheriae, elongation factor 2, granules

135
Q

Diphtheriae path

A

Exotoxin encoded on Beta-prophage. Potent exotoxin hibits protein synthesis via ADP-ribosylation of EF-2

136
Q

What do spores have??

A

Dipicolinic acid in their core with nometabolic activity.

137
Q

What bacteria form spores

A

Bacillus anthracis, clostridium perfringens, C. tetani. SPORE FORMING GRAM POSITIVES IN SOIL.
other spore formers are B. cereus, C. botulinum, and Coxiella botulinum

138
Q

Full name for B. cereus

A

Bacillus cereus

139
Q

What is a bacteroides species?

A

Bacteroides fragilis

140
Q

What are the clostridia

A

Gram-positive, spore-forming, obligate anaerobic bacilli.

141
Q

What does tetanospasmin do

A

Blocks glycine and GABA release from REnshaw cells in spinal cord.

142
Q

What is floppy baby syndrome?

A

Caused by Botulinum toxin.

143
Q

What does C. perfringens make?

A

Alpha toxin (“lecithinase” a phospholipase) that causes myonecrosis (gas gangrene) and hemolysis.

144
Q

C. difficile toxins

A

Toxin A, enterotoxin, binds to the brush border of the gut. Toxin B, cytotoxin, causes cytoskeletal disruption via actin depolymerization leading to pseudomembranous colitis and diarrhea.

145
Q

C. diff most commonly due to what Abx

A

clindamycin and ampicillin.

146
Q

What is bacillus anthracis

A

Gram-positive, spore forming rod that produces anthrax toxin. The ONLY bacterium with a polypeptide capsule (contains D-glutamate)

147
Q

Cutaneous anthrax presentation

A

Painless, necrotic black eschar that starts out as a boil-like lesion. Does not lead to bacteremia and death.

148
Q

Pulmonary anthrax presentation

A

Inhalation of spores causes flu-like sxs that progresses to fever, pulm. hemorrhage, mediastinitis, and shock.

149
Q

What is woolsorters’ disease

A

Pulm. anthrax from breathing in spores from contaminated wool.

150
Q

What causes Reheated Rice Syndrome

A

Bacillus cereus

151
Q

How can Bacillus cereus cause disease in boiled rice?

A

Spores!!!

152
Q

Types of bacillus cereus infections

A

Emetic type: rice and pasta. n/V within 1-5 hrs. Caused by cereulide, a preformed toxin.

Diarrheal type: Water, nonbloody diarrhea and GI pain within 8-18 hr

153
Q

Listeria monocytogenes description

A

Facultative intracellular microbe, from unpasteurized dairy products and deli meats, via transplacental transmission, or from vagina during birth.

154
Q

How does listeria get around

A

Rocket tails from actin polymerization. Characteristic tumbling motility; is only gram positive organism to produce LPS

155
Q

The only gram positive to produce LPS

A

Listeria

156
Q

What can listeria cause

A

Amnionitis, septicemia, and spontaneous abortion in pregnant women; granulomatosis infantiseptica; neonatal meningitis; meningitis in immunocompromised patients; mild gastroenteritis in healthy individuals.

157
Q

Treating listeria

A

Gastroenteritis is self-limited. Ampicillin in infants, immunocompromised patients, and elderly in empirical treatment of meningitis

158
Q

Distinguish actinomyces from nocardia

A

Make a table to compare……

159
Q

Nocardia infections

A

Pulm. infections in immunocompromised and cutaneous infections after trauma in immunocompetent

160
Q

Actinomyces infections

A

oral/facial abscesses that drain through sinus tracts, forms yellow “sulfur granules”

161
Q

What to treat Nocardia with

A

Sulfonamides

162
Q

What to treat Actinomyces with

A

Penicillin

163
Q

What is primary tuberculosis

A

The Ghon complex (hilar lymph nodes and Ghon focus in mid-lung field). Occurs in infection naive people, usually children. Can proceed to several endpoints like death or heals.

164
Q

What can happen to primary tuberculosis

A
  1. Heal by fibrosis with hypersensitivity and immunity and tuberculin +
  2. Progressive lung disease and death (malnutrition, HIV)
  3. Severe bacteremia, miliary tuberculosis leading to death.
  4. Preallergic lymphatic or hematogenous dissemination leading to dormant tubercle bacilli in several organs and reactivation in adult life.
165
Q

How does secondary tuberculosis happen?

A

Partially immune hypersensitized host gets reinfected or patient with latent TB gets reactivation.

166
Q

How does secondary tuberculosis present?

A

Fibrocaseous cavitary lesion (usually upper lobes)

167
Q

Examples of extrapulmonary tuberculosis

A

CNS (parenchymal tuberculoma or menigitis), vertebral body in Pott’s disease), lymphadenitis, Renal, GI, and adrenal infection.

168
Q

BCG + on PPD?

A

Yes

169
Q

When is PPD negative?

A

steroids, malnutrition, immunocompromise leading to anergy AND SARCOIDOSIS

170
Q

What does a caseating granuloma have?

A

Central necrosis with multinucleated Langhans giant cells.

171
Q

More specific test than PPD?

A

Interferon-gamma release assay IGRA is more specific. Fewer false positives than BCG.

172
Q

TB symptoms

A

Fever, night sweats, weight loss, and hemoptysis.

173
Q

Mycobacterium kansasii presentation

A

Pulmonary TB like symptoms

174
Q

Mycobacterium avium-intracellulare presentation

A

Disseminated, non-TB dsiease in AIDS; often resistant to multiple drugs. Prophylactic treatment with azithromycin.

175
Q

Which mycobacterium is not acid fast?

A

All are acid fast

176
Q

What is cord factor

A

For M. tuberculosis that inhibits macrophage maturation and induces release of TNF-alpha. Sulfatides (surface glycolipids) inhibit phagolysosomal fusion.

177
Q

Other name for leprosy

A

Hansen disease

178
Q

Agar media for Mycobacterium leprae

A

Cannot be grown in vitro. Reservoir is armadillos.

179
Q

M. leprae does what path

A

Likes cool temps (skin and superficial nerves, glove and stocking loss of sensation)

180
Q

Forms of leprosy

A

Lepromatous and Tuberculoid

181
Q

Lepromatous leprosy presentation

A

Presnts diffusely over the skin with leonine facies, communicable, characterized by low cell-mediated immunity with a humoral TH2 response.

182
Q

Tuberculoid leprosy presentation

A

Limited to a few hypoesthetic, hairless skin plaques; characterized by high cell-mediated immunity with a largely Th1-type immune response.

183
Q

Treating leprosy

A

Multidrug therapy with dapsone and rifampin for 6 months for tuberculoid form; and dapsone, rifampin, and clofazimine for 2-5 years for lepromatous form.

184
Q

Is lepromatous leprosy lethal?

A

It can be!

185
Q

Know the gram-negative lab algorithm

A

What are the gram negative diplococci

186
Q

What grows pink colonies on MacConkey agar

A

Lactose fermenting enteric bacteria. Citrobacter, Klebsiella, E. coli, Entergoacter, and Serratia (weak fermenter).

187
Q

What enzyme does E. coli produce

A

Beta-galactosidase which breaks down lactose into glucose and lactose

188
Q

EMB agar grows what

A

Lactose fermenters grow as purple/black colonies. E. coli is purple colonies with a green sheen.

189
Q

Penicillin and gram-negative bugs.

A

Gram negative bacilli are resistant to penicillin G but may be susceptible to ampicillin and amox. Gram neg. outer lmembrane inhibits penicillin G and vancomycin entry.

190
Q

Neisseria general description

A

Gram-negative diplococci.

Both ferment glucose and produce IgA proteases. N. gonorrhoeae is often intracellular (within neutrophils)

191
Q

Neisseria mnemonics

A

MeninGococci ferment Maltose and Glucose.

Gonococci ferment Glucose.

192
Q

Compare gonococci to meningococci in a table

A

….

193
Q

Mnemonic for Haemophiluis

A

HaEMOPhilus (epiglottitis, meningitis, otitis media, and PNA.

194
Q

H. flu tx

A

mucosal infection with augmentin.
Meningitis with ceftriaxone.
Rifampin ppx in close contacts.

195
Q

H flu characteristics

A

small gram-negative coccobacillary rod. Aerosol transmission.

196
Q

Nontypeable strains cause what

A

Mucosal infections (otitis media, conjunctivitis, bronchitis)

197
Q

What does Hib vaccine contain

A

Type B capsular polysaccharide (polyribosylribitol phosphate) conjugated to diphtheria toxoid or other protein. Given between 2-18 months of age.

198
Q

Legionella description

A

Gram negative rod stained with silver stain.

199
Q

Legionella growth

A

Charcoal yeast extract culture with iron and cysteine.

200
Q

legionella dx

A

Urine antigen

201
Q

Legionella transmission

A

Aerosol around water sources. No person to person transmission

202
Q

Legionella tx

A

Macrolide or quinolone

203
Q

Legionnaires’ disease presentation

A

Severe PNA, fever, GI and CNS sxs

204
Q

Pontiac fever presentation

A

Mild flu-like syndrome

205
Q

Legionella bloodwork

A

Hyponatremia.

206
Q

Pseudomonas description

A

Aerobic gram-negative rod. non-lactose fermenting, oxidase positive. Produces pyocyanin (blue green); grade like odor. Water source. Produces endotoxin (fever, shock) and exotoxin A (inactivates EF-2).

207
Q

Pseudomonas mnemonic

A

PSEUDOmonas: associated with wound and burn infections, PNA (cystic fibrosis), Sepsis, External otitis (swimmer’s ear), UTI, Drug use and Diabetic Osteomyelitis, and hot tub folliculitis. Malignant otitis externa in diabetics

208
Q

Ecthyma gangrenosum

A

Rapidly progressive, necrotic cutaneous lesions caused by Pseudomonas bacteremia. Typically seen in immunocompromised patients.

209
Q

Ecthyma tx

A

Aminoglycoside plus extended-spectrum penicillin (e.g. piperacillin, ticarcillin, cefepime, imipenem, meropenem.

210
Q

E. coli virulence factors

A

Fimbriae: cystitis and pyelonephritis
K capsule: PNA, neonatal meningitis
LPS endotoxin: septic shock

211
Q

4 A’s of Klebsiella

A

Aspiration PNA, Abscess in Lungs and Liver, Alcoholics, di-A-betics

212
Q

Typhoid fever presentation

A

Only in humans. Rose spots on the abdomen, fever, headache, and diarrhea. Can remain in gallbladder and cause a carrier state.

213
Q

Campylobacter jejuni

A

Major cause of bloody diarrhea, especially in children.

214
Q

Campylo transmission

A

Fecal-oral through poultry, meat, unpasteurized miolk.

215
Q

Campylo morph.

A

s-shaped, oxidase +, grows at 42 degrees (campylobacter likes the hot CAMPfire)

216
Q

Extraintestinal findings of Campylobacter

A

Guillain-Barre and reactive arthritis

217
Q

Vibrio cholerae morph.

A

comma shaped, oxidase +, grows in alkaline media. Endemic to developing countries.

218
Q

Yersinia enterocolitica transmission

A

From puppy feces, contaminated milk, or pork. Causes mesenteric adenitis that can mimic Crohn disease or appendicitis.

219
Q

What does H. pylori increase the risk of

A

Peptic ulcer, gastric adenocarcinoma, and lymphoma

220
Q

H. pylori morph

A

Catalase, oxidase, and urease + (can use urea breath test or fecal antigen test for diagnosis).

221
Q

H. pylori tx

A

Triple therapy: Proton pump inhibitor + clarithromycin + either amoxicillin or flagyl

222
Q

Name the spirochetes

A

Borrelial (big size), Leptospira, Treponema (BLT).

223
Q

Imaging spirochetes

A

Only Borrelia can be visualized with aniline dyes (Write or Giemsa stain) in light microscopy. Treponema is dark-field microscopy.

224
Q

Leptospira disease

A

Leptospira interrogans causes leptospirosis from water contaminated with animal urine: flu-like sxs, jaundice, photophobia with conjunctival suffusion (erythema without exudate). Prevalent among surfers and in tropics (i.e. Hawaii)

225
Q

What is Weil disease

A

Icterohemorrhagic leptospirosis: severe form with jaundice and azotemia from liver and kidney dysfunction; fever, hemorrhage, and anemia

226
Q

Lyme disease mnemonic

A

FAKE a Key Lyme pie: Facial nerve palsy (bilateral), Arthritis, Kardiac block, Erythema migrans

227
Q

VDRL false positives

A

VDRL: viruses (mono, hepatitis), drugs, rheumatic fever, lupus and leprosy

228
Q

Treatment for all Rickettsial diseases and vector-borne illness

A

Doxycycline!!!!

229
Q

Where do you seen rash on palms and soles

A

CARS: Coxsackievirus A (hand food mouth), RMSF, and Secondary Syphilis

230
Q

Difference in rash between Typhus and RMSF

A

Typhus starts centrally, RMSF starts peripherally

231
Q

Cause of Q fever

A

Coxiella burnetii

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