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Step 1 (Let's Do This)! > Micro > Flashcards

Micro Flashcards

1
Q

Corynebacterium diphtheriae.
Lab presentation?
Symptoms?

A
  • GPRs, metachromic (blue/red) granules, Elek’s test for toxin.
  • Sx: Diphtheria. Pseudomembranous pharyngitis w/ blue/gray membrane (bleeds if scraped).Lymphadenopathy (“bull-neck”), myocarditis, & arrhythmias.
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2
Q

Cause of infection by Corynebacterium diphtheriae? How does it spread?

Tx?

A

Potent exotoxin, encoded by Beta-prophage.
Inhibits protein synthesis via ADP ribosylation of EF-2.

Spreads by respiratory droplets.
Tx: Anti-toxin, passive immunization. Toxoid vaccine prevents diphtheria (DTaP, DTP, etc). Give Penicillin and aminoglycosides for endocarditis.

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3
Q

What is acronym for C. diph?

A

ABCDEFG

ADP-ribosylation, Beta-prophage, Corynebacterium Diphtheria, EF-2, Granules

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4
Q

What is lab presentation of Pseudomonas aeruginosa?

Sx?

A

Aerobic GNR. Non-lactose fermenting, oxidase positive. Pyocyanin (blue/green) pigment). Grape like smell.

Sx: Pneumonia, Sepsis (black skin lesions), External otitis (swimmer’s ear), UTI, Drug use & Diabetic Osteomyelisis, hot tub follicuitis
P-S-E-U-D-O

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5
Q

What are diabetic patients at risk for with Pseuodomons aeruginosa?

A

Malignant otitis media

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6
Q

MCC infection of burn injuries?

What is the other site it is MC infection?

A

Pseudomonas aeruginosa

MC bug to colonize medical equipment

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7
Q

Pseudomonas causes chronic pneumonia in what disease? What property causes this?

A

Cystic fibrosis

Bug’s biofilm

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8
Q

What is virulence factor for Pseudomonas aeruginosa?

A

Endotoxin: Fever, shock.

Exotoxin A, inactivates EF-2

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9
Q

How do you Treat Pseudomonas aeruginosa?

A

Aminoglycoside plus extended-spectrum penicillin (e.g. piperacillin, ticarcillin)

Cephalosporins: Ceftazidime, Cefepime

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10
Q

Which bugs inactivate 60S ribosome by removing rRNA adenine?

A

Shigella sps., EHEC including O157:H7 strain

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11
Q

Which bugs MC cause HUS and how?

A
  • E. coli O157: H7 & Shigella enhance cytokine release.
  • Both also release exotoxins that inactivate 60S ribosome by removing adenine from rRNA.
  • ***endothelium swells→narrows lumen→mechanical hemolysis & reduced renal blood flow→damaged endothelium consumes PLTs (Microthrombi)
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12
Q

Differentiate Shigella and EHEC regarding infection.

A

EHEC does not invade host cells

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13
Q

Sx of HUS?

A

Anemia
Thrombocytopenia
Acute Renal failure

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14
Q

What are the virulence factors of E. coli and specific diseases by each?

A

Fimbriae- cystitis and pyelonephritis
K capsule- pneumonia, neonatal meningitis
LPS endotoxin- septic shock

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15
Q

What are the 4 types of E. coli?

A

EIEC- Invasive
ETEC- Traveler’s diarrhea (watery)
EPEC- Peds
EHEC- HUS, O157:H7

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16
Q

Which E. coli strains have toxins? What diseases are then caused

A
  • ETEC- Labile & Stable toxins. No inflammation or invasion. Traveler’s watery diarrhea
  • EHEC- SLT. Causes, Dysentery (toxin alone causes necrosis & inflammation)
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17
Q

Which E coli strains lack toxins? What diseases do they cause?

A

EIEC- dysentery like Sx. Invade intestinal mucosa & causes necrosis & inflammation.
EPEC- Adheres to apical surface, flattens villi, and prevents absorption Diarrhea in kids.

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18
Q

MOA of ETEC

A

Exotoxin:
Heat-labile (LT)- Overactivates adenylate cyclase (↑cAMP)→↑Cl- secretion in gut & H2O efflux.
Heat-stabile (ST)- overactivates guanylate cyclase (↑cGMP)→↓resorption of NaCl & H2O in gut

“Watery diarrhea is Labile in Air, Stable on the Ground”

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19
Q

Which bacteria inhibit protein synthesis w/ a toxin?

A

Corynebacterium diphtheriae
Pseudmonas aeurignosa
Shigella
EHEC

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20
Q

Describe cutaneous anthrax. How is it spread and cause of Sx

A

Black eschar (necrosis); skin lesion, surrounded by edematous ring. Can progress to bacteremia & death.
Spread by touch.
Caused by Lethal factor & Edema factor.

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21
Q

What is cause of Woolsorter’s disease?

A

Pulmonary anthrax

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22
Q

What are Sx of pulmonary anthrax?

A
  • flu-like Sx that progress to fever
  • pulmonary hemorrhage
  • Mediastinitis
  • Shock
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23
Q

How does anthrax present on slide?

A

GPR
Spore-forming
Capsule

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24
Q

What is only bacteria w/ Polypeptide capsule?

What is the MOA of bug?

A

Bacillus anthracis. Capsule has D-glutamate

Edema factor exotoxin. Mimics AC enzyme, ↑cAMP

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25
Q

MOA of rice-water diarrhea, by a comma shaped GN bug

What media does it grow in?

A

Vibro cholerae permanently activates Gs, overactivating AC enzyme→ ↑cAMP→↑Cl- gut secretion, w/ H2O following. (via CFTR receptors Phosphorylated by PKA)
Grows in alkaline media.

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26
Q

What bugs have exotoxins that increase fluid secretion?

A

ETEC
Bacillus anthracis
Vibrio cholerae

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27
Q

What is the MOA of Whopping cough? What is bug and and its component causing it?

A
  • Impairs phagocytosis to help microbe survival (Lymph and Neutrophil dysFx): Overactivates Adenylate cyclase (↑cAMP) by disablin Gi.
  • Bordetella pertussis: Pertussis exotoxin
28
Q

Pertussis toxin effect on sugar?

A

Increases insulin, and can cause hypoglycemia

29
Q

How does Whopping cough bug appear in lab?

A

A nasopharyngeal or an oropharynx swab, Gram stain: Gram-negative, coccobacilli, diplococci arrangement.
Growth on Bordet-Gengou agar or BCYE plate with added cephalosporin to select for the organism, which shows mercury-drop-like colonies.

30
Q

Which bugs inhibit neurotransmitter release and what is MOA?

A

Clostridium tetani & Clostridium botulinum.

Their exotoxins cleave SNARE protein required for NT release

31
Q

Sx of Tetanus. Cause?

A

Muscle rigidity, “lock’jaw” trismus, risus sardonicus. Exotoxin prevents release of inhibitory GABA & glycine in spinal cord by Renshaw cells. Also, respiratory failure.

32
Q

Sx of Botulism

A

Flaccid paralysis
Floppy baby (spore ingestion from honey)
Heat labile exotoxin stops stimulatory Ach release at NMJ.

33
Q

How does one treat adult w/ Botulism?

What Tx C/I in babies?

A

Adults not infected w/ bug, but w/ Toxin. Give Anti-toxin.

Avoid Antiobiotics in baby with C. botulinum, bug destruction → toxin release, toxemia

34
Q

How do clostridia appear on GS?

A

GPR, spore forming obligate anaerobe

35
Q

What causes Myonecrosis “gas gangrene”?

MOA?

A

Clostridium perfringens.
Produces alpha-toxin (“lecithinase” a phospholipase) that degrades tissue & ce;; membrane.
Degradation of phospholipid C causes the myonecrosis and double zone hemolysis on blood agar

36
Q

How do you diagnose myonecrosis gas gangrene bug?

A
  • Neglar rxn: Egg-yolk agar w/ anti-alpha toxin.
  • Double-zone hemolysis
  • Milk media: “stormy fermentation”
37
Q

MOA of Clostridium difficile and presentation

A

2 toxins:
Toxin A: enterotoxin, bings to GI brush border
Toxin B: cytotoxin, destroys the cytoskeletal structure of enterocytes → PSEUDOMEMBRANOUS COLITIS

DIARRHEA, can mimic IBS

38
Q

Cause of Clostridium difficile

A

Secondary to Antibiotic use: Clindamycin or ampicillin

39
Q

How to Tx C. diff?

A

Metronidazole or

oral Vancomycin

40
Q

How do you treat Tetanus?

A

-Neutralize unbound toxin.
Hyperimmune humn globulin (TIG) + penicillin or metronidazole.
-Diazepam for muscle spasms

41
Q

What are the intestinal roundworms?

A
  • Enterobius vermicularis
  • Ascaris lumbricoides
  • Strongyloides stercoralis
  • Ancylostoma duodenale, Necator americanus
42
Q

How do you treat nematodes, intestinal type ?

A

All can be treated w/ Bendazoles or or Pyrantel pamoate

Strongyloides Tx: Ivermectin or albendazole

43
Q

Which parasite diagnosed w/ Scotch Tape test? How does it present?

A

Enterobius (Pinworm)

Intestinal infection causing anal pruritis

44
Q

What is technical name for “giant roundworm”?

How does it present, and how is it transmitted?

A

Ascaris lumbricoides

Intestinal infection. Eggs visible in feces under microscope.
Fecal-oral transmission

45
Q

Which nematodes passed through skin?

A

Strongyloides, Anclostoma, Necator

“These get into your feet from the SANd”

46
Q

Sx of Strongyloides?

A

Intestinal infection causing:

  • anemia
  • vomiting
  • diarrhea
47
Q

Which parasite cause microcytic anemia? How?

A

Hookworms:
Ancylostoma duodenale
Necator americans

sucks blood from intestinal blood

48
Q

List the tissue Nematodes (roundworms)

A 
Dracunculus medinensis
Onchocera volvulus
Loa Loa
Wuchereria bancrofti
Toxocara canis
49
Q

Which parasite causes skim inflammation & ulceration, and acquired from drinking water?

How do you treat?

A

Dracunculus medinensis

Tx: slow extraction of worm

50
Q

Mode of transission of Ochocerca volvulus?

Symptoms?

A

Female blackfly bite

Sx: Hyperpigmented skin & river blindness
“black flies, black skin nodules, black sight”

51
Q

What is Tx for Ochocerca volvulus?

A

Ivermectin

“think rIVER blindness”

52
Q

Carrier for Loa loa?

Sx?

A

Deer fly, hoarse fly, & mango fly

Swelling in skin, worm in conjunctiva

53
Q

Which parasites are treated by Diethylcarbamazine?

A

Loa loa

Wuchereria bancrofti

54
Q

Carrier for Wuchereria bancrofti?

Disease and cause?

A

Female mosquito

Sx: Elephantitis due to blockage of lymph vessels. Presents 9mo. to 1 yr after bite.

55
Q

What bug causes Visceral lara migrans?
Mode of transmission?
Tx?

A

Toxocara canis
Transmitted by food w/ eggs.
Tx: Albendazole or mebendazole

56
Q

Which nematodes caused by ingestion?

A

Enterobius, Ascaris, Trichinella, Toxocara

“You’ll get sick if you EATT these!”

also, Dracunculus from drinking water

57
Q

Treatment for Cestodes (tapeworms) & Trematodes (flukes)

A

Praziquantel

-bendazoles for Echinococcus & T. solium

58
Q

How is Taenia sollium spread and Sx?

A

Ingestion of larvae encysted in under-cooked pork.
Ingestion of eggs.

Sx: Cysticercosis, neurocysticercosis

59
Q

How to treat neuroogical Sx by Taenia sollium? What are these Sx?

A

Epileptic seizures

Tx w/ -bendazoles

60
Q

Which parasite causes Vit B12 deficiency and how?

A

Diphyllobothrium latum

Tapeworm competes for B12 in intestine

61
Q

How does Echinococcus granulosus present?

Tx procedures?

A

Cysts in liver causing anaphylaxis if antigens released.

Ethanol pre-injected by surgeon to kill cysts before removal. Also give -bendazole drug.

62
Q

What are the cestodes (tapeworms)

A

Taenia solium
Diphyllobathrium latum
Echinococcus granulosus

63
Q

What disease is caused by Schistosoma?

A
  • Liver and spleen granulomas, fibrosis, and inflammation

- Chronic infection w/ S. haematobium can lead to squamous cell carcinoma in bladder

64
Q

How does a patient get Schistosoma?

A

Cercariae penerate skin. Host: SNAILS

65
Q

Disease caused by Clonorchis sinensis?

Mode of transmission

A
  • Biliary tract inflammation → pigmented gallstones
  • Associated w/ cholangiocarcinoma

From under-cooked fish

66
Q

Sx of infection by Paragonimus westermani

A
  • Lung inflammation and secondary bacterial infection

- Hemoptysis

67
Q

How is Paragonimus westermani?

A

undercooked crab

Step 1 (Let's Do This)! (10 decks)

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