Micro Flashcards
Test for capsule on bacteria
Quellung leads to swelling if there is a capsule
Even Some Pretty Nasty Killers Have Shiny Bodies
Also SHiN
encapsulated bacteria E.Coli Strep pneumoniae Pseudomonas aeruginosa Neisseria meningitidis Klebsiella pneumoniae Haemophilus influenza type B Salmonella typhi Group B Streptoccocus
SHiN organisms
These are unique in ability to undergo transformation, or DNA- uptake from lysed bacteria. Also they are all encapsulated and have vaccines available that you should give to asplenics
Mycoplasma- unique membrane
sterols, no cell wall (abx often target cell wall so this is a challenge)
Mycobacteria- unique outer layer
mycolic acid in membrane, rish in lipis so resistant to gram stain and resilient in many environments
bacteria that can form spores (dipicolinic acid core) when resources are limited. highly resistant to heat, cold, disinfectants, lack of nutrients
bacillus and clostridium
bacillus anthracis
anthrax
bacillus cereus
food poisoning
c. botulinum
botulism
c. diff
antibiotic- associated colitis
c. perfringens
gas gangrene
c. tetani
tetanus
coxiella burnetii
q fever
giemsa stain
chlamydia borrelia rickettsia trypanosomes plasmodium
and histoplasma
certain bugs really try my patience
PAS
stains glycogen, mucopolysccharides, used to fiagnose Whipple disease (tropheryma whipplei), PASs the sugar
Ziehl- Neelson (carbol fuschin)
acid- fast bacteria (nocardia, mycobacteria), protozoa (cryptospordium oocysts)
India ink
for fungus. cryptococcus neoformans (mucicarmine can also be used to stain thick polysaccharide capsule red)
silver stain
fungi (pneumocystis, such as PCP which is pneumocystis jirovecii), legionella, helicobacter pylori
organisms that do not gram stain well: These Microbes May Lack Real Color
Treponema (too thin, dark- field microscopy and fluorescent antibody staining instead), mycobacteria (high lipid content, mycolic acids in cell wall detected by carbolfuchsin in acid- fast stain), mycoplasma (no cell wall), legionella (silver stain instead, primarily intracellular), rickettsia (intracellular parasite), chlamydia (intracellular parasite; lacks classic peptidoglycan because of low muramic acid)
lipopolysaccharide endotoxin in outer membrane of gram negative bacteria, released upon cell lysis
ENDOTOXIN edema nitric oxide DIC/Death Outer membrane TNFa O- antigen eXtremely heat stable IL1 Neutrophil chemotaxis
Hemolytic uremic syndrome
subsequent to Enterohemorrhagic E. Coli O157:H7 EHEC, which causes bloody diarrhea and damage to renal and endothelial cells
Syndrome= hemolytic anemia, thrombocytopenia, acute renal failure
enterotoxigenic E. coli
heat- labile (LT), overactive adenylate cyclase leads to increased cAMP and subsequent chloride secretion into gut, H2O efflux.
heat stable toxin (ST), overactivates cGMP, leading to decreased resoprtion of NaCl and H2O in the gut.
Watery diarrhea either way “labile in the air (adenylate cyclase), stable on the ground (guanylate cyclase)”
aka montezuma’s revenge, jelly belly, traveler’s diarrhea
Bacillus anthracis exotoxin
anthrax toxin: edema factor (adenylyl cyclase; causes edema), lethal factor, protective antigen
yersinia enterocolitis
heat- stable toxin activates guanylyl cyclase, increased cGMP, pseudoappendicitis
vibrio cholerae
choleragen (cholera toxin) stimulates adenylyl cyclase, increasing cAMP, chloride and water cross into lumen of intestine –> “rice water stools”
Jones criteria for RF which is a type 3 hypersensitivity reaction
Joint arthalgia pancarditis nodules erythema marginatum sydenham chorea
organisms associated with subacute endocarditis
viridans s bovis enterococci coag negative staph HACEK (haemophilus aphrophilus, actinobacillus actinomycetan comitans, cardiobacterium hominis, eikenella corrodens, kingella kingae)
obligate anaerobes
fusobacterium
clostridium
bacteroides
actinomyces
frankly can’t breathe air
suseptible to ROS since they lack catalase and SOD. smelly, difficult to culture, gas producint.
ABX: metronidazole, clindamycin, NOT aminoglycosides
Waterhouse Friederichson Syndrome of N. meningitidis
sepsis, adrenal hemorrhage, DIC
5 yr old with pharyngitis, drooling, xray shows thumbprint sign
Haemophilus influenzae type B
Burn wound infection
pseudomonas aeruginosa
life- threatening meningitis + purpura
n. meningitidis
septic arthritis in young, sexually active patients
n. gonorrhoeae
infections associated with animal urie
leptospira
hantavirus
maculopapular rash on hands and feet
drive kawasaki cars with your hands and feet
Kawasaki
Coxsackie A
Rocky mountain spotted fever
Secondary Syphilis
False positive results on VDRL
VDRL: viruses (EBV) drugs Rheumatic fever lupus/ leprosy/other autoimmune pregnancy
Bartonella spp
cat scratch disease, with lymphadenopathy proximal to the scratch site, and bacillary angiomatosis that looks like Kaposi in immunocompromised patients
borrelia burgdorferi
Lyme disease:
rodents to humans via ixodes scapularis
borrelia recurrentis
pathogensis due to varying surface antigens: relapsing fever
transmitted from rodents and lice
brucella spp
brucellosis: cattle, sheep, goats, unpasteurized dairy products
campylobacter
diarrhea from birds, pigs
chlamydophila psittaci
fever, dry cough, birds (parrots)
coxiella burnetti
Q fever: flu-like symptoms, fever for several weeks, transmitted by aerosols from infected placenta or contaminated fluid on coats of newborn farm animals
Ehrlichia chaffeensis
headaches, muscle aches, fatigue known as ehrlichiosis. transmitted by the lone star tick
francisella tularensis
tularemia- rabbit, squirrel, tick, high risk for use in bioterrorism
mycobacterium leprae
armadillo
pasteurella multocida
introduced into wounds from cat or dog bite leading to cellulitis, osteomyelitis
rickettsia prowazeckii
epidemic typhus (lice)
rickettsia typhi
endemic (murine) typhus (fleas)
rickettsia rickettsii
RMSF, tickborn illness, fever, headache, rash on palms and soles
yersinia peptis
bubonic plague, fleas, prairie dogs
inactivates EF2
corynebacterium diphteriae, pseudomonas (exotoxin A)
activates Gs
vibrio cholerae, e. coli (ETEC heat- labile toxin)
disables Gi
pertussis toxin
bacterial adenylate cyclase (no G protein involved)
bacillus anthracis
blocks GABA and glycine
c. tetani
passive immunity is possible
tetanus toxin, botulinum toxin, HBV, Varicella, rabies come as preformed antibodies (To Be Healed Very Rapidly)
Attenuated live virus vaccines: Attention! Please Vaccinate Young Infants with MMR Regularly
Attenuated virus vaccines Polio vaccine (Sabin, oral) Varicella Yellow fever Intranasal influenza MMR Rotavirus
Attention! Please Vaccinate Young Infants with MMR Regularly
vaccines that can be given to HIV patients with CD4> 200
MMR, varicella, yellow fever as long as the patient has a CD4> 200
inactivated or killed vaccine
rabies, influenza (injection), polio (Salk), hepatitis A (RIP Always)
Egg- based vaccines
influenza, yellow fever vaccines
Anti- IgG antibodies
RA
Anti- citrullinated protein antibodies (ACPA)
RA
Antinuclear antibodies (ANA)
SLE
Anti- Smith
SLE
Anti- dsDNA
lupus renal disease
Anti- histone
Drug- induced lupus
Anti- centromere
CREST scleroderma
Anti- scl-70
diffuse scleroderma
anti- jo-1
polymyositis, dermatomyositis
Anti- SSA (anti-Ro)
Sjogren syndrome
Anti- SSB (anti- La)
Sjogren syndrome
Anti- U1- RNP
Mixed connective tissue disease
Anti- desmoglein
pemphigus vulgaris
Anti- acetylcholine receptor
myasthenia gravis
Anti- endomysial (anti- tissue transglutaminase)
celiac disease
anti-gliadin
celiac disease
anti- mitochondrial
primary biliary cirrhosis
anti- smooth muscle
autoimmune hepatitis
anti- glutamate decarboxylase
type 1 DM
anti- thyrotropin receptor
Graves disease, binds TSH receptor
Anti- thyroid peroxidase (anti- TPO)
Hashimoto thyroiditis
Anti- thyroglobulin
Hashimoto thyroiditis, Graves disease
Anti- basement membrane
Goodpasture disease
c- ANCA
Wegener (granulomatosis with polyangiitis), affecting kidney and lungs
p-ANCA
Churg- Struass, microscopic polyangiitis, pauci- immune crescentic GN
What makes coxiella burnetti different from other rickettsial organisms
negative Weil- Felix test no vector transmitted by aerosolized droplets endospore does not cause rash; causes interstital PNA
obligate intracellular bacteria
rickettsia
coxialle
chlamydia
proteus vulgaris renal stones
ammonium magnesium phosphate stone
staghorn calculus
causes cervical lymphadenitis in children
mycobacterium scrofulaceum
causes disseminated disease in AIDS patients
mycobacterium avium intracellulare (MAI)
mycobacterium avium complex (MAC)
causes pulmonary TB- like symptoms in COPD patients
mycobacterium kansasii
obligate aerobes:nagging pests must breath
nocardia
pseudomonas
mycobacterium tb
bacillus
small intestinal mucosa laden with distended macrophages in the lamina propria
Whipple disease
defect in chylomicron exportation
abetalipoproteinemia
crampling associated with milk products
lactase deficiency
chlamydia trachomatis types A, B, C
trachoma eye infections mainly in Africa
Chlamydia trachomatis types D through K
STDs and PID, also neonatal conjunctivitis, urethritis
Chlamydia trachomatis types L1, L2, L3
lymphogranuloma venereum, looks like IBD with primary ulcer and then lymphadenopathy of the inguinal nodes
Chlamidophila psittaci
PNA in patients who are exposed to birds
Chlamidophila pneumoniae
walking PNA
treatment for most chlamydia and chlamydophila
macrolides or tetracyclines
What can cause acute pancreatitis
autodigestion of pancreas by pancreatic enzymes
PANCREATITIS
hyperParathyroidism (increased calcium) Alcohol Neoplasm (blocks the ducts) Cholelithiasis (gallstones!) Rx (drugs) ERCP (reverse flow through pancreatic ducts) Abdominal surgert hyperTriglyceridemia Infection (mumps) Trauma Idiopathic Scorpion sting
Chronic pancreatitis
chronic inflammation, atrophy, calcification of the pancreas p.376
Pancreatic adenocarcinoma
tumor markers, risk factors, presentation- Trousseau
average surgical of about 1 year after diagnosis, very aggressive tumor arising from pancreatic ducts
CA19-9 and CEA tumor markers
RF:tobacco use, chronic pancreatitis >20yrs, dm, age>50, Jewish, black
trousseau syndrome:
hypercoagulability, venous thrombosis, mogratory thrombophlebitis
other sx: abd pain radiating to back, weighloss, malabsorption, anorexia
Treat with Whipple, chemo, rads
chorioretinitis+hydrocephalus+intracranial calcifications
toxoplasma gondii
hydrops fetalis (fluid accumulations in the body such as ascites, pleural effusion)
Parvovirus B19
PDA+cataracts+deafness
+/- blueberry muffin rash
congenital rubella
saddle nose, snuffles, Hutchinson teeth, saber shins
late manifestations of congenital syphilis
hepatomegaly, sniffles, skeletal abnormalities, desquamating hands and feet
early manifestations of congenital syphilia
recurrent infections, chronic diarrhea
SCID, congenital HIV
encephalitis, herpetic skin lesions, meningoencephalitis, sepsis- like picture if disseminated
HSV2
sensorineural hearing loss, seizures, petechial rash, blueberry muffin rash, periventricular calcifications
CMV
what toxins are associated with GAS
- streptolysin O
-hemolysis on blood agar plates
-oxygen labile - Streptolysin S
-oxygen stable - Streptococcal pyrogenic exotoxins A, B, C
-erythrogenic toxins (superantigens), scarlet fever, also
leading to toxic shock syndrome
bloody diarrhea, hemolytic anemia, thrombocytopenia, acute renal failure
hemolytic uremic syndrome