MICRO Flashcards
gram neg coccobacillus
Urease +
H. pylori
fever in malaria coincides with what
rupture of RBC’s
what is the best protection against syphilis
condom
mcc of meningitis of newborn?
S. agal (Group B strep)
mcc of meningitis in 1month old-18 yo?
N. meningitis
mcc of meningitis >18 yo?
S. pneumo
what is mc seen with osteomyelitis in HbSS patients
S. aureus
cave explorer in ARIZONA with resp infection
Coccidioidomycosis
*large spherule endospores
AIDS pt with acute cholecystitis
Cryptosporidium and CMV are MCC
traveler to mexico who 1 week later develops a watery diarrhea with mucus and blood and colicky bowel movements
Amebiasis
MCC of pneumonia in cystic fibrosis
P. aeruginosa
1-6 hours after eating contaminated food with preformed toxin, self limited
S. aureus food poisoning
serotype of E. coli
-HUS
-raw hamburger
O157:H7
Bridge painter in NYC with resp infection, MC is histoplasmosis/cryptococcus (pigeons).. what do u tx pt with
Amph B
oocysts that are acid fast positive in a patient with AIDS
cryptosporidium (oocysts with 4 sporozoites)
elderly man who lives at home with his wife, develops pneumonia
S. pneumo
(MC typical CAP)
squamous cancer of the bladder
**host is a snail
painless blood in urine, vague abd pain
**SWIMMERS ITCH
-contaminated water sources, cercarieae
S. hematobium (egg has nipple on end)
how to tx syphilis
penicillin
how to tx gonorrhea
ceftriax+ doxy
tx of BV (clue cells, gardnerella vaginalis)
metronidazole
tx of trichomoniasis (anaerobe)
metronidazole **TREAT THE PARTNER TOO
tx of pseudomembranous colitis
metronidazole
india ink prep with narrow based bud/
monomorphic encapsulated yeast
cryptococcus neof
resp problem with pigeons
cryptococcus
fungus ball in abandoned TB cavity
-hemoptysis
-fruiting body
aspergillus
frontal lobe abscess in patient with DKA
mucormycosis
CF pneumonia (green colored sputum)
-MCC of death in burns
-malignant otitis externa
-exthyma gangrenosum
-“step on nail with smelly shoes”
-“hot tub folliculitis”
-resp infxns “loves water”
pseudomonas related infections
water coolers
flu like syndrome
hyponatremia
hyPERkalemia from interstitial nephritis
dieterle SILVER STAIN
TX WITH ERYTHROMYCIN
legionella
cat bite
potential for septic arthritis/tendinitis
pasteurella multocida
MCC of myocarditis, pericarditis, aseptic meningitis
COXSACK BIRUS
PEAR shaped flagella
** uninucleate trophozoites with 4 motile flagella
trichomonas
pseudohyphae and yeast
candida
owl eyes with flagella
*pear shaped trophozoite
*small bowel inflammation and villous atrophy
**troph have 4 pairs of flagella and 2 nuclei which attach to crypts thru a SUCKING DISK ON VENTRAL SURFACE
giardia
trophozoite in protozoa (diarrhea w ulcer)
E. histolytica- protozoa
(trophozoite with single nucleus containing central karyosome)
neonatal pneumonia
afebrile
staccato cough, eosinophilia
wheezing
C. trachomatis
(contracted while passing thru birth canal)
squamous cells
koilocytosis
pyknotic nucleus with clear halo
HPV
gram pos branching filaments (anaerobic-not acid fast)
IUD
sulfur granules (yellow)
draining sinus from jaw/cutaneous fistulas after dental surgery
Actinomycosis israelii
endometriosis, plasma cells present
S. Agal (GBS)
MOA of s. agal (GBS)
inhibits phagocytosis
receptor for HIV
CD4 molecule on helper T cells
Protein A attaches to Fc receptor of macrophages, blocking opsonization of bacteria
S. aureus
moves with flagella
Urease +
P. mirabilis
alpha toxin inhibits EF-2 by ADP ribosylation, blocking protein synthesis
*GRAY PSEUDOMEMBRANE in back of mouth
*BULL NECK (neck edema)
C. diphtheria
requires sterols
M. pneumonia
tumbling motility, gram pos rod,
b hemolysis on blood agar
*mainly contracted from eating unpasteurized cheese
listeria monocytogenes
gray membrane that bleeds when removed
C. diphtheria
transmitted by aedes aegypti mosquito
-breakbone fever
-hemorrhagic
Dengue fever
infxn associated with premature rupture of membrane
S. agalact (GBS)
*CAMP test
where is location for S. aureus carriers
Anterior nares
mcc of diarrhea in children
rotavirus
attaches to urogenital epithelium
-#1 for UTI
E. coli
person working with animal hides develops lung disease
**SOLITARY ULCER W BLACK CENTER
B. anthrax
evades host destruction via polysaccharide capsule
cryptococcus
child with anemia and diarrhea
hookworm- produces iron deficiency
lymphocutaneous nodules in a rose gardener
sporotrichosis
TX: with potassium oxide
-elderly male smoker
-non productive cough, bacteria cant grow on ordinary media (must have iron/cysteine)
**silver stain
Legionella
Tx: erythromycin
how to destroy C. diff in bedpan
autoclave
spores associated with beaver dams and inland water ways
blastomycosis
impetigo (THICK YELLOW GOLDEN CRUSTS)
S. aureus (MCC) or GAS (s. progenies)
impetigo in strep can lead to glomerulonephritis (abnormal urinalysis)
tx of schistomsomiasis
praziquantel
what 2 bacteria have quick onset (1-6 hours) after food contamination?
*have preformed heat stable toxins (does NOT respond to antibiotics since they are preformed)
*VOMITING is predominant
s. aureus
B. cereus
reheated rice
enterotoxin= nonbloody diarrhea
cereulide toxin= n/v
B. cereus
heat labile toxin
improper canned foods, raw honey
*floppy baby syndrome, descending paralysis (unable to lift head)
*ptosis of eye
“homemade organic baby food”
C. botulinum
reheated meat
C. perfringens
undercooked meat
E. coli O157:H7
deli meats and soft cheeses
listeria
raw poultry, eggs, meat, turtles
**ACID LABILE- NOT ACID STABLE
**H2S PRODUCING ON HEKOTEN AGAR (black colonies)
OSTEOMYELITIS IN SCD
Salmonella
mayo/custard -food poisoning
**SIALOADENITIS- tender swollen salivary glands/neck mass, purulent oral discharge, Inflammation, fever/chills
S. aureus
contaminated seafood
V. vulnificus
campy
EHEC
EIEC
E. histolytica
nontyphoidal salmonella
shigella
yersinia
bloody/inflammatory diarrhea
gastroenteritis organisms w/ direct intestinal mucosal invasion (bloody diarrhea)
Campy
E. histolytica
salmonella
shigella
food borne illness organisms that directly invade intestinal epithelial cells
C. perfringens
ETEC
Vibrio cholera
heat labile: activates adenylate cyclase, INC camp, INC Cl secretion in gut, H20 efflux
ETEC
*travelers diarrhea/no fever
heat stabile: guanylate cyclase, INC cgmp, DEC absorption of NaCl/H2O
ETEC
*travelers diarrhea/no fever
shiga like toxin: inactivates 60s ribosome by removing adenosine from ribosomal RNA
Enhances cytokine release–> HUS
EHEC
inactivates 60s ribosome by removing adenosine from ribosomal RNA
**HIGHLY VIRULENT, ACID STABLE
Enhances cytokine release–> HUS
Shiga toxin, shigella
Cholera toxin: over activates adenylate cyclase, INC camp, INC Cl secretion in intestine, H20 efflux
**rice water diarrhea, infected seafood
V. cholerae
virulence factor of E. coli in UTI
p-fimbriae, allows adhesion to uroepithelium
VF of E.coli in neonatal meningitis
K1 capsular polysaccharide: prevents phagocytosis/complement mediated lysis
3 C’s : cough, coryza, conjunctivitis
koplik spots (blue/white in mouth)
rash start on head
–>trunk/extremities
**CAN LEAD TO SUBACUTE SCLEROSING PANCEPHALITIS (neuro probs, behavior changes, problems w schoolwork, myoclonus-involuntary spasms 7-10 years after measles dx)
**usually says no vax
measles/rubeola
rash on head–> trunk/extremities
occipital/postauricular lymph
Rubella/german measles
high fever for 3-5 days, rash once fever subsides
trunk–>extremitis
<5 yo
Roseola/ HHV6
sandpaper like rash on neck/Upper trunk
fever/sore throat
**RF/Glomerulonephritis
S. pyrog/ GAS/ scarlett fever
can cause hydrops fetalis in pregnancy women, “slapped cheek”
parvovirus b19
T. solium
E. granulosus
D. latum
Tapeworms/Cestodes
Schistosoma
C. sinensis
Flukes/Trematodes
hyatid liver cysts
dominant host: dog
E. granulosus
Vit B12 deficiency, ingesting larvae from raw freshwater fish
D. latum
cysticercosis/neurocysticercosis
ingestion of larvae from undercooked pork
T. solium
Sand fly
Leishmaniasis
Deer fly/Loa Loa
Loiasis
Black fly/Onchocerca volvulus
-black river blindness
*female black fly, black skin nodules, black sight)
TX: ivermectin
Onchocerciasis (eye pain/redness)
Tsetse fly/ T. brucei
Trypanosomiasis
rabbits, ticks, deer flies
F. tularensis
Fleas (rat reservoir)
Yersinia pestis/plague
tick borne illness, flu like symptomsc
*Rocky mountain spotted fever/dermacentor (dog tick)
**rash that STARTS ON WRISTS/ANKLES AND SPREADS INWARDS CENTRALLY
Rickettsia
Lyme disease/burgdorferi
*scleral icterus, erythema migrans
*spiral shaped bacterium, merozoites arranged in tetrads
Ixodes (deer tick)
“if you hurt your knee, You Can Certainly CuSS”
Yersinia enter.
Campy
C. diff
Chlamydia trach
Salmonella
Shigella
Causes of reactive arthritis
-PAINFUL genital lesion
-curved gram neg rod
-gray exudate, ragged borders, inguinal lymphadenopathy
H. ducreyi/chancroid
HSV 2/ multiple vesicular lesions
H. ducreyi/chancroid
PAINFUL genital lesions
“Kansas City Takes Shane Hynes”
Klebs/granuloma inguinale
Chlamydia / Lymphogranuloma
Trep Pallidum/ prim syphil/chancre
Sec syphilis/condyloma lata
HPV
PAINLESS genital lesions
painless beefy red ulcer that bleeds easily
Klebs/granuloma inguinale
painless genital lesion, with PAINFUL lymph
**BUBOES
-PID, reactive arthritis
Chlamydia (L1-L3)
condyloma acuminata
genital warts, kilocytes
HPV 6 and 11
Urethritis, cervicitis, PID, prostatitis
creamy copious purulent discharge
-gram neg intracellular diplococci
N. Gonorrhea
GUMMAS
tabes dorsalis
argyll robertson pupil
Tertiary syphillis
T. pallidum
FROTHY YELLOW GREEN FOUL SMELL vaginitis
strawberry cervix
FLAGELLATED PROTOZOA- ** uninucleate trophozoites with 4 motile flagella
motile in wet prep
Trichomonas vaginalis, trichomoniasis
GRAY MILKY FISHY ODOR
CLUE CELLS
BV
ph > 4.5
gardnerella vaginalis
white crumbly thick cottage cheese like, ODORLESS
-pseudohyphae
ph <4.5
Candida albicans/ vaginal yeast infection
BLOODY/MUCOPURULENT DISCHARGE
obligate intracellular organisms that gram stain poorly
**INTRACELLULAR INCLUSION BODIES (YELLOW AND BROWN HISTO PIC)
(has neutrophils but no organism on gram stain)
**leads to PID, reactive arthritis
**GIEMSA stain, NAA
Chlamydia trach
Inflammatory lung disease, verrucous skin lesions
lytic bone lesions
great lakes region
Blastomycosis
**broad based budding
Bird/bat droppings
mississippi/ ohio valleys
palate/tongue ulcers/ splenomegaly
Histoplasmosis
*small uniform yeast with narrow based budding
M. pneumo
Adenovirus
Chlamydia pneumo
(insidious onset, low fever, DRY cough, HA, fatigue)
***PATCHY INFILTRATES
Atypical Pneumonia
*COLD AGGLUTIN TES
“KASH”
Klebs pneumo- currant jelly sputum/thick, bloody, mucoid
staph AUREUS
S. pneumo
H. pneumo
(acute onset, HIGH FEVER, PRODUCTIVE COUGH, PLEURITIC CHEST PAIN)
**LOBAR CONSOLIDATION
TYPICAL PNEUMO (CAP)
HIGH WBC (>1000)
HIGH opening pressure
HIGH protein
LOW glucose
NEUTROPHILS
BACTERIAL meningitis (H. infl/N. men)
HIGH WBC (< 500)
HIGH opening pressure
HIGH protein
LOW glucose
LYMPHOCYTES
FUNGAL meningitis/TB (crypto neof)
HIGH WBC ( <300)
NORMAL OR HIGH open pressure
NORM OR HIGH protein
NORMAL glucose
LYMPHOCYTES
VIRAL meningitis/encephilitis (HSV1)
**temporal lobe encephalitis
GRAM POS, AEROBIC bacilli
Listeria
Bacillus (spore forming)
Corynebacterium
GRAM POS, ANAEROBIC bacilli
Clostridium (spore forming, spores are filled with dipicolinic acid)
GRAM POS, AEROBIC branching filaments
Nocardia (WEAKLY acid fast)
GRAM POS, ANAEROBIC branching filaments
Actinomyces (NOT acid fast)
GRAM POS, AEROBIC cocci (CHAINS)
catalase NEG
coagulase NEG
A-hemolysis (partial)
OPTOCHIN SENS
ENCAPSULATED
s. pneumo
GRAM POS, AEROBIC cocci (CHAINS)
catalase NEG
coagulase NEG
A-hemolysis (partial)
OPTOCHIN RESISTANT
UN- ENCAPSULATED
S. viridian’s (S. mutans/mitis)
GRAM POS, AEROBIC cocci (CHAINS)
catalase NEG
coagulase NEG
B-hemolysis (complete)
BACITRACIN SENSITIVE
CAMP -
S. Pyogens (GAS)
GRAM POS, AEROBIC cocci (CHAINS)
catalase NEG
coagulase NEG
B-hemolysis (complete)
BACITRACIN RESISTANT
CAMP +
S. Agalact (GBS)
GRAM POS, AEROBIC cocci (CHAINS)
catalase NEG
coagulase NEG
Y-hemolysis (none)
GROW IN 6.5% NaCL
Enterococci (E. faecium, E. faecalis)
GRAM POS, AEROBIC cocci (CHAINS)
catalase NEG
coagulase NEG
Y-hemolysis (none)
DO NOT GROW IN 6.5% NaCL
Nonenterococcus S. bovis
GRAM POS, AEROBIC cocci (CLUSTER)
catalase POS
coagulase POS
B- hemolytic growth
s. aureus
GRAM POS, AEROBIC cocci (CLUSTER)
catalase POS
coagulase NEG
NOVOBIOCIN SENS
GAMMA hemolytic
S. epidermis
S. sapro
B. pertussis, VF that is Ga1, protein coupling inhibited, blocking signal transduction
Pertussis toxin
VF of C. Dipth (protein synthesis is blocked)
Diphtheria Toxin (inactivates eukaryotic host ribosomal protein elongation factor 2)
VF of Pseudomonas (protein synthesis is blocked)
Exotoxin A
VF of B. Anthrax
Edema toxin (ET) and Lethal toxin (LT)
VF of C. botulinum
botulinum neurotoxin
VF of C. Diff
Toxins A and B
VF of C. tetani
tetanus toxin
VF of Listeria
Listeriolysin
VF of staph aureus that causes SSSS, bullous impetigo
Exfoliatin Toxin (ETA)
Vf of staph aureus that causes watery diarrhea
Staph Enterotoxin
Vf of staph aureus that causes Shock, fever, inflammation
Toxic shock syndrome toxin (TSST-1)
what has hyaluronic acid capsules that prevents opsonization and phagocytosis, and has M protein, streptolysin, TSST
S. pyogenes
what 3 bacteria have IgA protease
S. pneumo
H. influenza
Neisseria
CD4 <500
candida (oral thrush)
EBV (oral hairy leukoplakia
HPV (SCC anus/cervix)
HHV8 (kaposi)
what bacteria has Pneumolysin
S. pneumo
CD4 < 250
Coccidioides
CD4< 200
PJP
Histoplasma
CD4 <100
asperillus
crypto neo
cryptosporidium
JC virus (PML)
HSV
CD4 < 50
CMV
MAC
T. gondii
Bartonella henselae
what 2 bacteria uses CHOCOLATE agar (NAD (factor V), AND HEME (factor x))
H. influenza
N. mening
what bacteria uses LJ AGAR
Mycobacterium TB
what bacteria uses MACCONKEY AGAR (gram neg rods)
**pink
**LACTOSE FERMENTING, yellow growth on Hektoen agar
E. coli
Enterobacter
Klebs
what bacteris uses THAYER MARTIN AGAR (chocolate sheep blood/abx)
N. gonorrhea vs. N. meningitis
what uses SILVER STAIN
Legionella
PJP
what uses india ink stain
crypto neof
what use SABOURAUD AGAR (peptones)
Crypto Neof,
coccid immitis
candida
what uses BUFF CHARCOAL YEAST AGAR W/ L CYSTIENE AND IRON
Legionella
what uses BLOOD AGAR W/ CYSTEINE AND GLUCOSE
F. Tularenis
what bacteria causes acute mastitis in breast/nipple discharge/fever after postpartum
S. aureus
what can lead to monoarticular septic arthritis
S. aureus
what can lead to polyarticular SEPTIC arthritis in a young person
N. gonorrhea
-beaver fever
-contaminated water/hiking trip/mountains
-INC fecal fat (steatorrhea)
-Diarrhea
-BINUCLEATE TROPH W MULTIPLE FLAGELLA
Giardia Duodenalis (protozoa)
foul smell/fatty oilly stools
IV DRUG USERS/prosthetic valves
-right sided endocarditis
-TRICUSPID valve
holosystolic murmur
S. aureus
subacute left sided endocarditis
following dental procedures/gingivitis
MITRAL valve
**positive Echo showing oscillating intracardiac mass, gingivitis, splinter hemorrhages
S. mutans/Viridians group
-guillian barr syndrome, bilateral LE weakness that can ascend upwards, bloody diarrhea
-CSF: elevated protein, normal leukocyte
campylobacter
*PLAQUE ON TONGUE THAT WILL NOT SCRAPE OFF
**LATERAL TONGUE
CD4< 500
**oral hairy leukoplakia
EBV
-positive PCR testing
*plaque on tongue that DOES scrape off
**BASE OF TONGUE, pseudohyphae
CD4<500
**oral thrush
Candida
-from inhaled corticosteroids
CD4 <500
EBV
Candida
non enveloped, pos sense, linear SSRNA
Picornaviridae
-Cox A
-polio
-echovirus
-rhinovirus
-Hep A
**DAYCARE
Cox A (hand foot mouth butt)
DSDNA virus
herpesviridae family
-HSV 1
-HHV 6/7
-VZV
enveloped neg sense, linear SSRNA
Paramyxoviridae family
-Measles (rubeola)
-
how do you tx obligate intracellular bacteria (like chlamydia/rickettsia)
tetracyclines/macrolides
60 day course of abx (cipro or doxy) + 3 dose vax series
B. anthrax
gas gangrene
red/purple/black discoloration
necrotizing soft tissue
crepitus
C. perfring
increased risk of gallbladder cancer, colon cancer, Inflammatory bowel disease
Chronic Salmonella typhi
functional asplenia in sickle cell disease
S. pneumo
increased risk of osteomyelitis in sickle cell disease (painful swelling of finger/toes- dactylitis)
salmonella
tick borne relapsing fever (camping in colorado)
**fever, headache, malaise, no appetite, joint pain, N/V
**spirochetes !!
Borellia Hermsii
dx: dark field microscopy
tx: doxy
tick borne illness, flu like symptoms
hemolytic anemia
maltese cross/rings
Babesia microti
how do you treat chlamydia/gonorrhea if unsure which
(inc vag discharge, no odor, dx w/ NAA test)
doxy (chlamy) + ceftriax (gon)
**azithro replaces doxy in preg woman
gram neg pleomorphic coccobacillus
*drooling, dysphagia, distress, inspiratory stridor= esophagitis
*needs to lean over, super high fever
H. influenza type B
Hep C
yellow fever
Dengue
St. louis encephalitis
West Nile
Zika
Flavaviruses
enveloped non segmented pos sense linear RNA
Aedes mosquito/Haemogus
tropical areas
fever, ha, severe hemorrhagic jaundice
flavivirus (yellow fever)
what is part of matonavirus family
Rubella
what is part of togavirus family
enveloped non segmented pos sense linear SS pRNA
Eastern equine encephalitis (EEE)
Western equine encephalitis (WEE)
chikagunya
All e. coli strands ferment sorbitol except for which one?
**stool is negative for WBC
*no fever
EHEC (noninflammatory bloody diarrhea)
inflammatory bloody diarrhea in E. coli
ferments sorbitol
fever, abd pain
**fecal leukocytes in stool/stool is positive for WBC
EIEC
what fungus can cause hair loss, tinea corpus, tinea capitum, ringworm
*fusiform football shaped macroconidia
Microsporum
few 3-4 cell club shaped macroconida, and many club shaped microconida
-can also cause tinea captious
TX: oral griseofulvin or terbinafine
Trichophyton
spaghetti and meatballs dimorphic fungus
tinea versicolor- hypo/hyper pigmented rashes
tx: ketoconazole or selenium sulfide
Malassezia
*dimorphic lipid dependent fungus that is normal skin flora
Enveloped non segmented neg sense SS RNA virus
filovirus family
-ebola
travels to africa, flu like symptoms with maculopapular rash
-RT-PCR to detect viral RNA
Ebola virus
HIV
human-T-Lymphotrophic
Retrovirus family
enveloped non segmented pos sense linear RNA
5 features of klebs
(3 manifestations are Multidrug resistance, aspiration pneumonia, nosocomial UTI )
“5 A’s”
aspiration pneumonia (air space consolidation involving much of RUL)
-alcoholics
-diAbetics
-abscess (lungs- progression causes large abscess cavity with air fluid level)
-currAnt jelly sputum
CD4 <500
candida (oral thrush)
EBV (oral hairy leukoplakia
HPV (SCC anus/cervix)
HHV8 (kaposi)
what causes pneumocystis pneumonia
“dented helmet cells on Gomori methenamine silver stain”
PJP
micro vesicular steatosis without inflammation. tiny fat vacuoles surround hepatocytes
reye syndrome
cigar shaped fungi
sporothrix schenckii
name 3 infections reactivated in AIDS
shingles
TB
HBV
examples of fungi include
mold
yeast
mushrooms
HUS disease manifests as triad of
anemia
thrombocytopenia
acute renal failure
all dna viruses are double stranded except for
parvovirus b19
TACHY
hypotension
AMS
warm extremities
septic shock
what part of gram neg bacterial wall contributes to sepsis
Lipopolysaccharide
chorioretinitis, intracranial calcifications, hydrocephalus, hepatosplenomegaly in babies
Congenital toxoplasmosis
gram variable pleomorphic rod
gardner vaginalis (BV)
dimorphic
mold in cold 20 c AND IN
yeast in heat 37 c
