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Step 1 > Micro > Flashcards

Micro Flashcards

1
Q

Chocolate Agar

- Factors V (NAD+) and X (hematin)

A

H. influenzae

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2
Q

Thayer-Martin Agar

A

Neisseria gonorrhoeae and meningitidis

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3
Q

Bordet Gengou Agar (potato) or Regan Lowe Medium (charcoal, blood, Abx)

A

Bordatella pertusssis

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4
Q

Tellurite Agar, Loffler Medium

A

C. diptheriae

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5
Q

Lowenstein-Jensen Agar

A

M. tuberculosis

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6
Q

Eaton Agar (requires cholesterol)

A

M. pneumoniae

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7
Q

MacConkey Agar

- Fermentation –> acid –> pink colonies

A

Lactose-fermenting enterics (E. coli, Klebsiella)

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8
Q

EMB Agar

A

E. coli

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9
Q

Charcoal yeast extract agar buffered with cysteine and iron

A

Legionella

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10
Q

Sabouraud Agar

A

Fungi

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11
Q

Yellow “sulfur” granules

A

Actinomyces israelii

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12
Q

Yellow pigment

A

Staph aureus

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13
Q

Blue-green pigment

A

Pseudomonas aeruginosa

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14
Q

Red pigment

A

Serratia marcescens

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15
Q

Protein A

- S. aureus

A

Binds Fc region of IgG –> prevents opsonization and phagocytosis

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16
Q

IgA Protease

- S. pneumo, H. flu type B, Neisseria

A

Cleaves IgA to colonize respiratory mucosa

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17
Q

M Protein

- Group A Strep

A

Prevents phagocytosis

  • Molecular mimicry
  • AI response in rheumatic fever
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18
Q

Type III Secretion System (Injectisome)

- Pseudomonas, Salmonella, Shigella, E. coli

A

Needle-like protein appendage facilitating direct delivery of toxins from certain gram negative bacteria to eukaryotic host cell

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19
Q

Transformation

- S. pneumo, Hib, Neisseria

A

Take up naked DNA from environment

- Add deoxyribonuclease –> degrades naked DNA –> no transformation seen

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20
Q

Conjugation

A 
F+ = sex pilus, conjugation
F- = no plasmid
Hfr = F+ plasmid incorporated into bacterial chromosomal DNA (can bring flanking DNA)
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21
Q

Transposition

A

Segment of DNA jumps from one location to another (can bring flanking DNA)
- Ex. vanA gene from vancomycin-resistant Enterococcus to S. aureus

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22
Q

Generalized Transduction

A

Lytic phage infects bacterium –> cleavage of bacterial DNA –> parts of bacterial chromosomal DNA may become packaged in phage capsid –> phage infects another bacterium –> transfers genes

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23
Q

Specialized Transduction

A

Lysogenic phage infects bacterium –> viral DNA incorporates into bacterial chromosome –> phage DNA excised with some flanking bacterial genes –> DNA packaged into phage capsid –> infects another bacterium

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24
Q

Spore Forming Bacteria

  • highly resistant to heat and chemicals
  • dipicolinic acid in core
  • must autoclave to kill
A
  • Bacillus anthracis (anthrax)
  • Bacilus cereus (food poisoning)
  • C. botulinum (botulism)
  • C. difficile (pseudomembranous colitis)
  • C. perfringens (gas gangrene)
  • C. tetani (tetanus)
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25
Q

C. diphtheriae

- Diphtheria toxin

A

ADP-ribosylation –> inactivates EF-2 –> no protein synthesis
- Pharyngitis with pseudomembranes in through and severe LAD (bull neck)

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26
Q

Pseudomonas aeruginosa

- Exotoxin A

A

ADP-ribosylation –> inactivates EF-2 –> no protein synthesis
- Host cell death

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27
Q

Shigella spp.

- Shiga toxin

A

Inactivates 60S ribosome by removing adenine from rRNA

  • GI mucosal damage –> dysentery
  • Enhances CK release –> HUS
  • INVADES host cells
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28
Q

EHEC

- Shiga-like toxin

A

Inactivates 60S ribosome by removing adenine from rRNA

  • Enhances CK release –> HUS (O156:H7)
  • Does NOT invade host cells
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29
Q

ETEC

- Heat labile and heat stable toxin

A

Heat LABILE: overactivates adenylate cyclase –> increased cAMP –> increased Cl- secretion in gut and H2O efflux
Heat STABLE: overactivates guanylate cyclase –> increased cGMP –> decreased reabsorption of NaCl and H2O in gut
- Watery diarrhea

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30
Q

Bacillus anthracic

- Edema toxin

A

Mimics adenylate cyclase enzyme –> increased cAMP

- Edematous borders of black eschar in cutaneous anthrax

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31
Q

Vibrio cholerae

- Cholera toxin

A

Permanently activates Gs –> overactivates adenylate cyclase –> increased cAMP –> increased Cl- secretion in gut and H2O efflux
- Voluminous rice-water diarrhea

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32
Q

Bordatella pertussis

- Pertussis toxin

A

Disables Gi –> overactivates adenylate cyclase –> increases cAMP –> impairs phagocytosis –> permits survival of microbe
- Whooping cough

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33
Q

Clostridium tetani

- Tetanospasmin

A

Protease that cleaves SNARE –> inhibits vesicular fusion –> no NT release

  • Spastic paralysis, risus sardonicus, “lockjaw”
  • Prevents release of inhibitory (GABA and glycine) NT from Renshaw cells in spinal cord
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34
Q

Clostridium botulinum

- Botulinum toxin

A

Protease that cleaves SNARE –> inhibits vesicular fusion –> no NT release

  • Flaccid paralysis, floppy baby
  • Prevents release of stimulatory (ACh) at NMJ
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35
Q

Clostridium perfringens

- Alpha toxin

A

Phospholipase (lecithinase) –> degrades tissue and cell membranes

  • Myonecrosis (gas gangrene)
  • Hemolysis (“double zone” of hemolysis on blood agar)
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36
Q

Streptococcus pyogenes

  • Streptolysin O
  • Exotoxin A
A

Streptolysin O: degrades cell membrane –> Lyses RBC –> contributes to beta-hemolysis
- Host Ab against toxin (ASO) used to dx rheumatic fever
Exotoxin A: binds to MHC II and TCR outside of Ag binding site –> overwhelming release of IL-1, IL-2, IFN-gamma, TNF-alpha –> toxic shock syndrome

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37
Q

Staph aureus

  • Toxic shock syndrome toxin (TSST-1)
  • Exfoliative toxin
  • Enterotoxin
A
  • TSST-1: binds to MHC II and TCR outside of Ag binding site –> overwhelming release of IL-1, IL-2, IFN-gamma, TNF-alpha –> toxic shock syndrome
  • Exfoliative toxin: scalded skin syndrome
  • Enterotoxin: food poisoning
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38
Q

Endotoxin

A
  • Macrophage activation –> IL-1/6 (fever), TNF-alpha (fever and hypotension), NO (hypotension)
  • Complement activation –> C3a (HA release –> hypotension, edema), C5a (neutrophil chemotaxis)
  • Tissue factor activation –> coagulation cascade –> DIC
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39
Q

Catalase positive

A

Staph

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40
Q

Coagulase positive

A

Staph aureus

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41
Q

Novobiocin resistant

A

Staph saprophyticus

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42
Q

Novobiocin Sensitive

A

Staph epidermidis

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43
Q

Catalase negative

A

Strep

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44
Q

Alpha hemolytic

- Partial reduction –> greenish/brown w/o clearing around growth

A

Strep viridians, Strep pneumo

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45
Q

Optochin resistant

A

Strep viridans

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46
Q

Optochin sensitive

A

Strep pneumo

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47
Q

Beta hemolytic

- Complete lysis of RBCs –> clear area surrounding colony on blood agar

A

Strep agalactiae (Group B), Strep pyogenes (Group A), Staph aureus

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48
Q

Bacitracin resitatnt

A

Group B strep

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49
Q

Bacitracin sensititve

A

Strep pyogenes (Group A)

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50
Q

Staph aureus

A
  • Protein A

- TSST-1 (superantigen), exfoliative toxin, enterotoxin

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51
Q

Most common cause of septic arthritis in adults

A

Staph aureus

52
Q

Most common cause of osteomyelitis

A

Staph aureus

53
Q

R sided (tricuspid) endocarditis in IV drug user

A

Staph aureus

54
Q

Secondary pneumonia after influenza infection

A

Staph aureus

55
Q

Staph epidermidis

A

Normal flora of skin
Prosthetic devices and IV catheters
BIOFILMS

56
Q

Staph saprophyticus

A

Uncomplicated UTI in young sexually active women (2nd to E. coli)

57
Q

Strep pneumo

A

Lancet-shaped diplococci
Encapsulated
IgA protease
No virulence without capsule

58
Q

Most common cause of meningitis

A

Strep pneumo

59
Q

Most common cause of otitis media in children

A

Strep pneumo

60
Q

Most common cause of pneumonia

A

Strep pneumo

- Rusty sputum

61
Q

most common cause of sinusitis

A

Step pneumo

62
Q

Strep pneumo vaccine

A
  • Adults: polysaccharide w/o protein (23 valent) –> T cell independent –> IgM
  • Kids: conjugated to protein (7 valent) –> robust response of T cells and B cells –> IgG
63
Q

Strep viridans

A 
Dental caries (mutans and mitis)
Subacute bacterial endocarditis at DAMAGED heart valves (sanguinis)
Makes dextrans --> bind to fibrin-platelet aggregates on damaged heart valves
64
Q

Strep pyogenes (Group A Strep)

A 
PYR +
M protein --> rheumatic fever
ASO titer detects infection
Pharyngitis --> rheumatic fever and PSGN
Scarlet fever
65
Q

Most common cause of erysipelas (rash)

A

Strep pyogenes

66
Q

Acute Rheumatic Fever

- Strep pyogenes

A

Polyarthritis, carditis, subcutaneous nodules, erythema marginatu, sydenham chorea

67
Q

Scarlet Fever

- Strep pyogenes

A

Blanching, sandpaper-like body rash
Strawberry tongue
Circumoral pallor
Erythrogenic toxin +

68
Q

Strep agalactiae (Group B Strep)

A
  • Pneumonia, meningitis, & sepsis in babies
  • CAMP factor –> enlarges area of hemolysis formed by S. aureus
  • Hippurate test +
  • PYR+
69
Q

Most common cause of neonatal meningitis

A

Strep agalactiae

70
Q

Strep bovis

A

Subacute endocarditis

COLON CANCER

71
Q

Enterococci

A

UTI, biliary tract infections, subacute endocarditis
PYR +
VRE –> nosocomial infections
Ca grow in 6.5% NaCl and bile

72
Q

Bacillus anthracis

A

Spore-forming rod
Anthrax toxin
Polypeptide capsule (D-glutamate)
Cutaneous anthrax –> black eschar
Pulmonary anthrax –> pulmonary hemorrhage, mediastinitis, shock (WOOL, GOAT HAIR)
Edema factor –> increases cAMP –> inhibits phagocytosis
Lethal factor –> protease –> cleaves MAPK –> tissue necrosis

73
Q

Bacillus cereus

A

Reheated rice syndrome
Spores
Cereulide (preformed toxin)

74
Q

Clostridium tetani

- PUNCTURE WOUND

A

Tetanospasmin –> blocks release of inhibitory GABA And glycine from Renshaw cells in spinal cord –> spastic paralysis
Rx: antitoxin +/- vaccine booster, diazepam, wound debridement

75
Q

Clostridium botulinum

  • Adults: improper food canning (preformed toxin)
  • Babies: honey (spores)
A

Produces heat-labile toxin (protease) that inhibits ACh release –> flaccid paralysis
Rx: antitoxin

76
Q

Clostridium perfringens

  • Motorcycle accidents
  • Penetrating wound form military combat
A 
Alpha toxin (lecithinase) --> myonecrosis and hemolysis
Spores in undercooked food --> heat-labile enterotoxin --> food poisoning (late onset)
77
Q

Clostridium difficile

  • Clindamycin or ampicillin use
  • PPI use
A

Toxin A: enterotoxin –> binds to brush border of gut
Toxin B: cytotoxin –> actin depolymerization –> cytoskeletal disruption –> diarrhea –> pseudomembranous colitis
Dx: stool toxins via PCR
Rx: metronidazole or oral vancomycin

78
Q

Corynebacterium diptheriae

A

Exotoxin encoded by beta-prophage –> ADP-ribosylation of EF-2 –> inhibits protein synthesis
Psuedomembranous pharyngitis
Dx: metachromatic (blue and red) granules, Elek test+ (toxin)
Black colonies on cystine-tellurite agar

79
Q

Diphtheria vaccine

A

Toxoid

IgG response against exotoxin B

80
Q

Listeria monocytogenes

A

Pregnant women
Rocket tails - actin polymerization –> IC movement and cell-to-cell spread
Tumbling motility
Rx: ampicillin

81
Q

Nocardia

A

Aerobe
Acid fast
Pulmonary infections (IC), cutaneous infections after trauma
Rx: sulfonamides

82
Q

Actinomyces

A 
Anaerobe
Oral/facial abscess
Yellow sulfur granules
PID w/ IUDs
Rx: penicillin
83
Q

Mycobacterium tuberculosis

A

Caseating granulomas with central necrosis and Langerhans giant cells
Cord factor –> serpentine cord –> inhibits mac maturation, induces release of TNF-alpha
Sulfatides –> inhibit phagolysosomal fusion
Acid fast (mycolic acid)
Lowenstein Jensen medium

84
Q

Mycobacterium leprae

A

Cool temperatures
Armadillo reservoir
Lepromatous: low cell-mediated immunity, humoral Th2 response, numerous acid fast bacilli
Tuberculoid: high cell-mediated immunity, largely Th1-type immune response, rare acid fast bacilli
Rx: dapsone, rifampin, clofazimine

85
Q

Utilizes maltose

A

N. meningitidis

86
Q

Doesn’t utilize maltose

A

N. gonorrhoeae

Moraxella

87
Q

Grows in 42 C

A

Campylobacter jejuni

88
Q

Grows in alkaline media

A

Vibrio cholerae

89
Q

Produces urease

A

H. pylori

90
Q

Fast lactose fermenter

A

Klebsiella
E. coli
Enterobacter

91
Q

Slow lactose fermenter

A

Citrobacter

Serratia

92
Q

H2S production on TSI agar

A

Salmonella

Proteus

93
Q

Neisseria

A

VPN agar (Thayer Martin)
Metabolize glucose
Produce IgA protease
Gonococci: IC (within neutrophils), no vaccine (Ag variation of pilus), Fitz-Hugh-Curtis Syndrome
Meningococci: polysaccharide capsule, maltose fermenter, vaccine, Waterhouse-Friderichsen syndrome

94
Q

Haemophilus influenze

A

IgA protease

Chocolate agar - V (NAD+), X (hematin)

95
Q

Most common cause of mucosal infections (otitis media, conjunctivitis, bronchitis)

A

Nontypeable (unencapsulated) H. flu

96
Q

Cause of epiglottitis

- drooling, inspiratory stridor

A

H. flu

97
Q

Hib vaccine

A

Type b capsular polysaccharide + PRP conjugated to diptheria toxoid
- Given between 2 and 18 mo

98
Q

Bordatella pertussis

A

Pertussis toxin (disables Gi)
Tracheal cytotoxin (cleaves cilia epi of resp tract)
Whooping cough
Vaccine (Tdap, DTap)
Lymphocytic infiltrate from immune resopnse

99
Q

Legionella pneumophila

A 
Gram stains poorly - use silver stain
Charcoal yeast extract medium with iron and cysteine
Dx: Ag in urine
HYPONATREMIA
Water sources (AC)
Pneumonia + diarrhea + hyponatremia
100
Q

Legionnaires’ Disease

- Legionella pneumophila

A

Sever pneumonia, fever, GI, and CNS sx

Smokers, chronic lung DZ

101
Q

Pontiac Fever

- Legionella pneumophila

A

Mild flu-like syndrome

102
Q

Pseudomonas aeruginosa

A 
Non-lactose fermenting
Pyocyanin (blue-green)
Grape-like odor
Endotoxin (fever, shock)
Exotoxin A (inactivates EF-2)
Phospholipase C (degrades cell membranes)
Pyocanin (generates ROS)
Mucoid polysaccharide capsule --> biofilm formation
103
Q

Malignant otitis externa

A

Pseudomonas
Can spread to mastoid, temporal bones
Increased risk in elderly, IC, DM

104
Q

Ostemyelitis in diabetics and IV drug users

A

Pseudomonas

105
Q

Most common cause of respiratory failure in CF patients

A

Pseudomonas

Mucoid polysaccharide capsule –> biofilm formation

106
Q

Burn patients

A

Pseudomonas

107
Q

Hot tub folliculitis

A

Pseudomonas

108
Q

Ecythema gangrenosum

A

Pseudomonas
Rapidly progressive necrotic cutaneous lesion
Seen in IC

109
Q

Proteus mirabilis

A

Swarming motility
Urease + –> staghorn struvite stones
Fish odor

110
Q

Helicobacter pylori

A

Flagellated
Catalase +, oxidase +, urease +
Dx: urea breath test, fecal antigen test
Produces ammonia –> alkaline environment
Colonizes stomach antrum
Risk of gastric adenocarcinoma and MALT lymphoma

111
Q

Leptospira interrogans

A

Spirochete

Water contaminated with animal urine

112
Q

Leptospirosis

- Leptospira interrogans

A

Flue-like sx, myalgias (CALVES), jaundice, photphobia with conjunctival suffusion (erythema w/o exudate)
Surfers and in tropics (Hawaii)

113
Q 
Weil Disease (Icterohemorrhagic Leptospirosis)
- Leptospira interrogans
A

severe form with jaundice and azotemia from liver and kidney dysfunction, fever, hemorrhage, anemia

114
Q

Borrelia burdorferi

A 
Lyme DZ
Vector: Ixodes deer tick
Reservoir: mouse
NE US
Erythema migrans 
AV block
Bells palsy
Encephalopathy
Chronic arthritis
115
Q

Treponema pallidum

A 
Painless chancre
Dark field microscopy
VDRL +
Maculpapular rash on palms and soles
Condyloma lata
VDRL/RPR+, confirm with FTA-ABS
Gummas
Aortitis (vasa vasorum destruction)
Neurosyphilis (tabes dorsalis)
Argyll Robertson pupil
Broad-based ataxia, + Romberg, Charcot joints
116
Q

Congenital Syphilis

A

rhagades, snuffles, saddle nose, notched teeth, mulberry molars, short maxilla, saber shins, CNIII deafness

117
Q

VDRL false positives

A

Viral infection
Drugs
Rheumatic fever
Lupus and leprosy

118
Q

Anaplasma spp.

A 
Anaplasmosis
Ixodes tick (live on deer and mice)
119
Q

Bartonella spp.

A

Immunocompetent –> Cat scratch DZ –> fever, LAD (stellate granulomas w/ central necrosis)
IC –> bacillary angiomatosis –> raised red vascular lesions

120
Q

Borrelia recurrentis

A

Relapsing fever

Louse (variable surface Ag)

121
Q

Brucella spp.

A

Brucellosis undulant fever –> organomegaly, osteomyelitis

Unpasteurized dairy, vets, ranchers, slaughter houses

122
Q

Campylobacter

A

Bloody diarrhea

Feces from infected pets/animals, contaminated meats/foods/hands

123
Q

Chlamydiophila psittaci

A

Psittacosis

Parrots, other birds

124
Q

Coxiella burnetii

A 
Q fever (no rash)
Aerosols of cattle/sheep amniotic fluid
125
Q

Eherlichia chaffeensis

A

Ehrlichiosis

Amblyomma (Lone Star tick)

126
Q

Francisella tularensis

A

Tularemia
Rabbits, ticks, deer flies
Type IV HSN

127
Q

Pasteurella multocida

A

Cellulitis, osteomyelitis
Animal bite, cats, dogs
Mouse like odor

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