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POD 2 > Micro > Flashcards

Micro Flashcards

1
Q

What are the different hemolytic patterns?

A

Alpha-partial
Beta-complete
Gamma-no hemolysis

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2
Q

What are Lancefield classifications?

A

antigenic characteristics of carbohydrate

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3
Q

What are general characteristics of streptococcus?

A

Gram positive
Cocci in pairs
Non-motile
Facultative anaerobic or capnophilic

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4
Q

What are unique characteristics of GAS (strep pyogenes)?

A

Capsule with hyaluronic acid
M protein
F protein binding fibronectin

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5
Q

What does M protein do?

A

inhibits opsoization and degrades C3b

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6
Q

What does DNase do?

A

AntiB sign of cutaneous infection

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7
Q

What is the difference between streptolysin O and streoptolysin S?

A

O is not stable in oxygen and immunogenic

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8
Q

What does streptokinase do?

A

Promotes spread by activating plasmin to lyse blood clots

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9
Q

What are the suppurative diseases caused by GAS?

A 
pharyngitis
scarlet fever-sand paper rash and strawberry tongue
impetigo-purulent with crusting
cellulitis
erysipelas-slapped cheek
necrotizing faciitis-gangrene
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10
Q

What are the nonsuppurative GAS diseases?

A

acute glomerular nephritis-after skin or throat infection
-edema and blood in urine
-due to immune complex deposition on glomerular basement membrane
acute rheumatic fever-after throat infection
-cross reactivity of M-proteins

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11
Q

What is the diagnosis and treatment of GAS?

A

Antigen detection throat swabs
ASO for ARF
sensitive to penicillin

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12
Q

What are the unique characteristics of GBS?

A

Capsule with sialic acid

CAMP test positive-enhanced beta hemolysis with staph aureus

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13
Q

What are the features of early onset GBS infection?

A

neonate within 7 days

  • bacteremia
  • pneumonia
  • meningitis
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14
Q

What are the features of late onset GBS infection?

A

neonate within 1-3 weeks after birth

  • bacteremia
  • meningitis
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15
Q

What is the treatment for GBS infection?

A

Penicillin G (with aminoglycosides)

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16
Q

What are the characteristics of strep pneumo?

A 
Capsule
CAMP negative
bile sensitive 
catalase negative 
optochin sensitive
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17
Q

What are the hemolytic characteristics of strep pneumo?

A

aerobic-alpha

anaerobic-beta

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18
Q

What are the virulence factors of strep pneumo?

A

adhesin-attachment to epithelium
IgA protease-cleave IgA (allows for colonization of mucosa)
pneumolysin-destroys ciliated epithelial cell

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19
Q

What infections does strep pneumo cause?

A 
MOPS
meningitis
otitis media
pneumonia (lobar)
sinusitis
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20
Q

What unique test can be done to diagnose strep pneumo?

A

Quellung reaction-anti-capsular antibodies mixed and increase reactive mass around bacteria

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21
Q

What are the characteristics of the vaccine?

A

13 and 23 valent polysaccharide
13 for children-IgG mediated
23 for adults-IgM mediated

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22
Q

Where is enterococcus normally found?

A

large bowel and feces

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23
Q

What are characteristics of enterococcus?

A 
gram positive
catalase negative
bacitracin resistant
bile resistant and hydrolyze esculin
optochin resistant
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24
Q

How can enterococcus be treated?

A

Ampicillin if sensitive strains

Aminoglycoside and vanco for resistant

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25
Q

Where is strep viridans found and what are some characteristics?

A

mouth and teeth

alpha hemolytic, resistant to optochin

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26
Q

What does strep viridans cause?

A

endocarditis

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27
Q

What are some characteristics of staph?

A

non-motile
facultatively anaerobic
catalase positive

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28
Q

What is protein A?

A

found in staph aureus

affinity for Fc of IgG-prevent opsonization

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29
Q

Why is MRSA resistant?

A

mecA gene

mobile genetic element on SCCmec

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30
Q

What is clumping factor?

A

coagulase that converts fibrinogen to fibrin

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31
Q

What is PV leukocidin?

A

active against PMNs and macrophages

makes staph more resistant to phagocytosis

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32
Q

What is exfoliative toxin and what pathology does it contribute to?

A

AB

contributes to scalded skin syndrome

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33
Q

What are staph super antigens?

A

exfoliative
enterotoxins
TSST

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34
Q

What are the skin infections that staph causes and how can they be differentiated?

A

impetigo-superficial
folliculitis-hair follicles
furnuncles-deeper than follicle
carbuncle-to subcutaneous layers

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35
Q

What is the Nikolsky sign and where is it seen?

A

large blister found in SSS but not in bullous impetigo

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36
Q

What kind of pneumonia does staph cause and what would it look like on an x-ray?

A

aspiration pneumonia

patchy infiltrates

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37
Q

What are the unique features of staph epidermidis?

A

glycocalyx helps it stick
coagulase negative
mutant PBP

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38
Q

What are unique features of staph saprophyticus?

A

coagulase negative
novobiocin resistant
UTI in sexually active women

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39
Q

What are the characteristics of enterobacteriaceae?

A

gram negative rods

all ferment lactose and are oxidase negative

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40
Q

What is the serological typing system?

A

K-capsule
H-flagella
O-antigen in polysaccharide

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41
Q

Which enterobacteriaceae ferment lactose?

A

klebsiella, escherichia, enterobacter

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42
Q

What are the characteristics of ETEC?

A

fimbrial adhesions-CFA I and II
heat stable and lable enterotoxins–>L cAMP, S cGMP
watery diarrhea with no inflammation or fever

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43
Q

What are the characteristics of EPEC?

A 
nonfimbrial adhesion (intimin)
attachment-effacement (eae)
bundle forming pilus
destruction of microvilli 
children in underdeveloped countries
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44
Q

What are the characteristics of EHEC?

A

moderately invasive
produce shiga-like toxin (encoded on a phage) also called verotoxin
intense inflammation and hemolytic uremia

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45
Q

What are the characteristics of EIEC?

A

nonfimbrial adhesions-possibly OMP
invades M cells
does not produce shiga toxin
dysentery-mucous and blood in diarrhea

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46
Q

What are the characteristics of EAggEC?

A

adhesions (GVVPQ fimbriae)

produce ST like toxin and hemolysin

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47
Q

What is characteristic of a UTI from E. coli?

A

P fimbriae-pyelonephritis associated pili binds to the P blood group that contains D gal D gal

48
Q

What are the characteristics of salmonella?

A 
facultative intracellular
antigens-O, H, Vi
produce H2S (black growth on agar)
49
Q

What is enterocolitis?

A

invasion of epithelial and sub-epithelial cells of small and large intestines, PMN respond to infection (PV leukocidin would limit this ability to respond if salmonella produced it)

50
Q

How is salmonella spread?

A

fecal-oral route

replicate within the macrophages

51
Q

Which forms of shigella would you expect to see in the US vs a developing country?

A

sonnei in the US

dysenteriae in developing countries

52
Q

What are characteristics of shigella?

A

non-lactose fermenting
do not produce H2S
non-motile
shiga toxin

53
Q

What does shiga toxin do?

A

target M cells in peyers patches

AB5 cleaves 28s rRNA of 60s

54
Q

What is Reiters syndrome and what autoimmune class is predisposed to it?

A

arthritis, conjunctivitis, and urethritis

most are male with HLA-B27

55
Q

How is shigella spread?

A

finger, flies, food, feces

56
Q

What is unique about klebisella?

A

capsule for enhanced virulence leading to CAP or HAP (lobar on x-ray)

57
Q

What is unique about proteus?

A

produce UTI, produces urea that causes magnesium and calcium to precipitate into kidney stones

58
Q

What are the characteristics of mycobacterium?

A

grow slowly
acid-fast obligate aerobe
invade macrophages
transmitted by inhalation or ingestion

59
Q

What are primary TB, secondary TB, and miliary TB?

A

primary-lower lobes, damage from formation of granulomas followed by caesation
secondary-apex, delayed type hypersensitivity
miliary-not enough T cells to form granuloma–>dissemination

60
Q

What is unique about the cell wall of mycobacterium TB?

A

resistant to drying and chemicals

waxes composed of mycolic acid

61
Q

What are the virulence factors for TB?

A

growth inside macrophages
prevent phagosome/lysosome fusion
LLo (hemolysin) allows for escape of phagocytic vesicle
prevents acidification by forming NH4

62
Q

What is the treatment?

A 
6 months 
isoniazid
rifampin
streptomycin
ethambutol
63
Q

What is unique about mycobacterium leprae?

A

found in armadillos

does not grow on laboratory medium

64
Q

What is tuberculoid leprosy?

A

Th1 mediated, low infectivity

red blotchy lesions

65
Q

What is lepratomous leprosy?

A

Th2 mediated (not good response)
high infectivity
not impeded in growth

66
Q

What is the treatment of leprosy?

A

2 years of dapsone, rifampin, and clofazimine

67
Q

What is mycobacterium kansasii and what is the treatment?

A

yellow pigmented after 2 weeks of incubation in presence of light
causes cavitary pulmonary disease
treat with chemo, isoniazid, rifampin, and ethambutol

68
Q

What are the characteristics of bordatella?

A

strictly aerobic, oxidase positive
non-fermentive
gram negative rods
encapsulated

69
Q

What are teh virulence factors of bordatella?

A

filamentous hemagglutinin

pertussis toxin

70
Q

What does pertussis toxin do?

A

invasive adenylate cyclase

S1 catalyzes ADPR rection of Gi leading to activate host ACase increasing cAMP

71
Q

What does tracehal cytotoxin do?

A

cleaves cilia

72
Q

What are the characteristics of pseudomonas?

A 
gram negative rod
non-fermenter
motile with flagella
aerobic
blue and green pigment
biofilms-exopolysaccharide matrix
73
Q

What does exotoxin A do?

A

ADP ribosylation of EF2

74
Q

What does exoenzyme S do?

A

ADP ribosylation of proteins

75
Q

What does elastase do?

A

degrades elastin

quorum sensing through LasR (iron regulated)

76
Q

What other virulence factors does P. auerginosa have?

A

phospholipase C

alkaline phosphatase

77
Q

What does alginate do?

A

interferes with phagocytosis, adherence to respiratory epithelium

78
Q

What infections are CF patients susceptible to? Why?

A

mutation in ch 7 (CFTR)

s. aureus, h. influenzae, p. aeruginosa

79
Q

What are the two genera of chlamydiaceae?

A

chlamydia

chylamydolphia-pneumoniae, psittaci

80
Q

What is unique about the development of chlamydia?

A

EB and RB
EB infects cell and converts to RB
RB replicate using host cell ATP (obligate intracellular)

81
Q

What are the serovars for different kinds of trachmatis?

A

trachoma-A-C
urogenital-D-K
LGV-L1-L3

82
Q

What is the host range for chlamydia?

A

nonciliated, columnar, cuboidal, and transitional epithelial cells

83
Q

Why is LGV more invasive?

A

infects and replicate within phagocytes

84
Q

What is characteristic of active trachoma?

A

self limited follicular conjunctivitis

85
Q

What are Herbert’s pits?

A

pits in cornea from follicle rupture

86
Q

What is trichiasis?

A

eyelid is distorted and eyelashes rub over cornea

87
Q

What is pannus?

A

growth of vascular tissue over cornea

88
Q

How should you culture for chlamydia?

A

need to get epithelial cells

culture-urethra, cervix, rectum, oropharynx, conjunctiva

89
Q

What is the best test for chlamydia?

A

NAAT

nucleic acid probe to 16s rRNA

90
Q

What is unique about mycoplasma?

A

no cell wall
cell membrane contains sterols
strict aerobe

91
Q

How does mycoplasma infect?

A

P1 binds to ciliated epithelium and destroys the cilia

super antigen leading to cytokine storm

92
Q

How should you diagnose mycoplasma?

A

paired sera for IgM and IgG

PCR is very sensitive but not specific to pathogenic forms

93
Q

What are the characteristics of pasteurellaceae?

A

small gram negative rods that can be pleiomorphic

facultative anerobe

94
Q

What does aegyptis cause?

A

purulent conjunctivitis?

95
Q

What do aphophilus and parainfluenzae cause?

A

endocarditis

96
Q

What is required for growth of H. flu on agar?

A

factor X-protophorphyrin, important for ETC
factor V-NAD
chocolate agar

97
Q

What does the unencapsulated form cause?

A

otitis media
sinusitis
bronchitis
pneumonia

98
Q

What does the encapsulated form cause?

A

more invasive disease
composed of polyribitol phosphate
Hib causes most

99
Q

How does the unencapsulated form colonize mucosa?

A

OMP P2 and P5 bind
IgA protease
LPS destroys ciliated cells
take up iron

100
Q

How does the encapsulated form colonize?

A

splits tight junctions of columnar epithelium

antiphagocytic

101
Q

Where is cellulitis associated with h. flu most common?

A

cheek, periorbital region, neck

102
Q

What are the characteristics of neisseria?

A

gram negative diplococci
oxidize carbohydrates
polysaccharide capsule

103
Q

What does PorB PIA do?

A

more resistant to complement mediate serum killing

104
Q

What is LOS?

A

LPS without the O antigen

still has endotoxin activity

105
Q

What virulence factors does neisseria have?

A

transferrin binding

IgA protease

106
Q

What strains predominate in developing countries?

A

A and W-135

107
Q

Which strains are associated with pneumonia?

A

Y and W-135

108
Q

What is unique about the vaccine for neisseria?

A

does not cover B

conjugated to diptheria

109
Q

What is specificity?

A

test and recognize single pathogen

prevents false positives

110
Q

What is sensitivity?

A

lowest number needed to be detected

prevents false negatives

111
Q

What are the non-culture methods?

A

microscopy
staining
serological test
molecular methods

112
Q

What is the difference between simple and differential staining?

A

one or two stains

PAS differential for polysaccharide

113
Q

What is the difference between direct and indirect fluorescence?

A

direct-labeled antibody

indirect-labeled anti-immunoglobulin (secondary antibody)

114
Q

What does flow cytometry measure?

A

cell size and granularity measured by light scattering

115
Q

What is the culture method?

A

identify based on combination of characteristics

116
Q

What is the MIC vs MBC?

A

minimum inhibition concentration

minimum bacteriocidal concentration

117
Q

What are common media for culturing?

A

enriched-chocolate
selective-Thayer Martin
differnetial-MacConkey
Anaerobic-thioglycollate

POD 2 (5 decks)

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