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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
MOA of rice-water diarrhea, by a comma shaped GN bug What media does it grow in?
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.
26
What bugs have exotoxins that increase fluid secretion?
ETEC Bacillus anthracis Vibrio cholerae
27
What is the MOA of Whopping cough? What is bug and and its component causing it?
- Impairs phagocytosis to help microbe survival (Lymph and Neutrophil dysFx): Overactivates Adenylate cyclase (↑cAMP) by disablin Gi. - Bordetella pertussis: Pertussis exotoxin
28
Pertussis toxin effect on sugar?
Increases insulin, and can cause hypoglycemia
29
How does Whopping cough bug appear in lab?
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
Which bugs inhibit neurotransmitter release and what is MOA?
Clostridium tetani & Clostridium botulinum. | Their exotoxins cleave SNARE protein required for NT release
31
Sx of Tetanus. Cause?
Muscle rigidity, "lock'jaw" trismus, risus sardonicus. Exotoxin prevents release of inhibitory GABA & glycine in spinal cord by Renshaw cells. Also, respiratory failure.
32
Sx of Botulism
Flaccid paralysis Floppy baby (spore ingestion from honey) Heat labile exotoxin stops stimulatory Ach release at NMJ.
33
How does one treat adult w/ Botulism? | What Tx C/I in babies?
Adults not infected w/ bug, but w/ Toxin. Give Anti-toxin. Avoid Antiobiotics in baby with C. botulinum, bug destruction → toxin release, toxemia
34
How do clostridia appear on GS?
GPR, spore forming obligate anaerobe
35
What causes Myonecrosis "gas gangrene"? | MOA?
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
How do you diagnose myonecrosis gas gangrene bug?
- Neglar rxn: Egg-yolk agar w/ anti-alpha toxin. - Double-zone hemolysis - Milk media: "stormy fermentation"
37
MOA of Clostridium difficile and presentation
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
Cause of Clostridium difficile
Secondary to Antibiotic use: Clindamycin or ampicillin
39
How to Tx C. diff?
Metronidazole or | oral Vancomycin
40
How do you treat Tetanus?
-Neutralize unbound toxin. Hyperimmune humn globulin (TIG) + penicillin or metronidazole. -Diazepam for muscle spasms
41
What are the intestinal roundworms?
- Enterobius vermicularis - Ascaris lumbricoides - Strongyloides stercoralis - Ancylostoma duodenale, Necator americanus
42
How do you treat nematodes, intestinal type ?
All can be treated w/ Bendazoles or or Pyrantel pamoate Strongyloides Tx: Ivermectin or albendazole
43
Which parasite diagnosed w/ Scotch Tape test? How does it present?
Enterobius (Pinworm) Intestinal infection causing anal pruritis
44
What is technical name for "giant roundworm"? | How does it present, and how is it transmitted?
Ascaris lumbricoides Intestinal infection. Eggs visible in feces under microscope. Fecal-oral transmission
45
Which nematodes passed through skin?
Strongyloides, Anclostoma, Necator | "These get into your feet from the SANd"
46
Sx of Strongyloides?
Intestinal infection causing: - anemia - vomiting - diarrhea
47
Which parasite cause microcytic anemia? How?
Hookworms: Ancylostoma duodenale Necator americans sucks blood from intestinal blood
48
List the tissue Nematodes (roundworms)
``` Dracunculus medinensis Onchocera volvulus Loa Loa Wuchereria bancrofti Toxocara canis ```
49
Which parasite causes skim inflammation & ulceration, and acquired from drinking water? How do you treat?
Dracunculus medinensis Tx: slow extraction of worm
50
Mode of transission of Ochocerca volvulus? | Symptoms?
Female blackfly bite Sx: Hyperpigmented skin & river blindness "black flies, black skin nodules, black sight"
51
What is Tx for Ochocerca volvulus?
Ivermectin | "think rIVER blindness"
52
Carrier for Loa loa? Sx?
Deer fly, hoarse fly, & mango fly Swelling in skin, worm in conjunctiva
53
Which parasites are treated by Diethylcarbamazine?
Loa loa | Wuchereria bancrofti
54
Carrier for Wuchereria bancrofti? | Disease and cause?
Female mosquito | Sx: Elephantitis due to blockage of lymph vessels. Presents 9mo. to 1 yr after bite.
55
What bug causes Visceral lara migrans? Mode of transmission? Tx?
Toxocara canis Transmitted by food w/ eggs. Tx: Albendazole or mebendazole
56
Which nematodes caused by ingestion?
Enterobius, Ascaris, Trichinella, Toxocara "You'll get sick if you EATT these!" also, Dracunculus from drinking water
57
Treatment for Cestodes (tapeworms) & Trematodes (flukes)
Praziquantel -bendazoles for Echinococcus & T. solium
58
How is Taenia sollium spread and Sx?
Ingestion of larvae encysted in under-cooked pork. Ingestion of eggs. Sx: Cysticercosis, neurocysticercosis
59
How to treat neuroogical Sx by Taenia sollium? What are these Sx?
Epileptic seizures Tx w/ -bendazoles
60
Which parasite causes Vit B12 deficiency and how?
Diphyllobothrium latum Tapeworm competes for B12 in intestine
61
How does Echinococcus granulosus present? | Tx procedures?
Cysts in liver causing anaphylaxis if antigens released. | Ethanol pre-injected by surgeon to kill cysts before removal. Also give -bendazole drug.
62
What are the cestodes (tapeworms)
Taenia solium Diphyllobathrium latum Echinococcus granulosus
63
What disease is caused by Schistosoma?
- Liver and spleen granulomas, fibrosis, and inflammation | - Chronic infection w/ S. haematobium can lead to squamous cell carcinoma in bladder
64
How does a patient get Schistosoma?
Cercariae penerate skin. Host: SNAILS
65
Disease caused by Clonorchis sinensis? | Mode of transmission
- Biliary tract inflammation → pigmented gallstones - Associated w/ cholangiocarcinoma From under-cooked fish
66
Sx of infection by Paragonimus westermani
- Lung inflammation and secondary bacterial infection | - ***Hemoptysis***
67
How is Paragonimus westermani?
undercooked crab

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