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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
Where is strep viridans found and what are some characteristics?
mouth and teeth | alpha hemolytic, resistant to optochin
26
What does strep viridans cause?
endocarditis
27
What are some characteristics of staph?
non-motile facultatively anaerobic catalase positive
28
What is protein A?
found in staph aureus | affinity for Fc of IgG-prevent opsonization
29
Why is MRSA resistant?
mecA gene | mobile genetic element on SCCmec
30
What is clumping factor?
coagulase that converts fibrinogen to fibrin
31
What is PV leukocidin?
active against PMNs and macrophages | makes staph more resistant to phagocytosis
32
What is exfoliative toxin and what pathology does it contribute to?
AB | contributes to scalded skin syndrome
33
What are staph super antigens?
exfoliative enterotoxins TSST
34
What are the skin infections that staph causes and how can they be differentiated?
impetigo-superficial folliculitis-hair follicles furnuncles-deeper than follicle carbuncle-to subcutaneous layers
35
What is the Nikolsky sign and where is it seen?
large blister found in SSS but not in bullous impetigo
36
What kind of pneumonia does staph cause and what would it look like on an x-ray?
aspiration pneumonia | patchy infiltrates
37
What are the unique features of staph epidermidis?
glycocalyx helps it stick coagulase negative mutant PBP
38
What are unique features of staph saprophyticus?
coagulase negative novobiocin resistant UTI in sexually active women
39
What are the characteristics of enterobacteriaceae?
gram negative rods | all ferment lactose and are oxidase negative
40
What is the serological typing system?
K-capsule H-flagella O-antigen in polysaccharide
41
Which enterobacteriaceae ferment lactose?
klebsiella, escherichia, enterobacter
42
What are the characteristics of ETEC?
fimbrial adhesions-CFA I and II heat stable and lable enterotoxins-->L cAMP, S cGMP watery diarrhea with no inflammation or fever
43
What are the characteristics of EPEC?
``` nonfimbrial adhesion (intimin) attachment-effacement (eae) bundle forming pilus destruction of microvilli children in underdeveloped countries ```
44
What are the characteristics of EHEC?
moderately invasive produce shiga-like toxin (encoded on a phage) also called verotoxin intense inflammation and hemolytic uremia
45
What are the characteristics of EIEC?
nonfimbrial adhesions-possibly OMP invades M cells does not produce shiga toxin dysentery-mucous and blood in diarrhea
46
What are the characteristics of EAggEC?
adhesions (GVVPQ fimbriae) | produce ST like toxin and hemolysin
47
What is characteristic of a UTI from E. coli?
P fimbriae-pyelonephritis associated pili binds to the P blood group that contains D gal D gal
48
What are the characteristics of salmonella?
``` facultative intracellular antigens-O, H, Vi produce H2S (black growth on agar) ```
49
What is enterocolitis?
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
How is salmonella spread?
fecal-oral route | replicate within the macrophages
51
Which forms of shigella would you expect to see in the US vs a developing country?
sonnei in the US | dysenteriae in developing countries
52
What are characteristics of shigella?
non-lactose fermenting do not produce H2S non-motile shiga toxin
53
What does shiga toxin do?
target M cells in peyers patches | AB5 cleaves 28s rRNA of 60s
54
What is Reiters syndrome and what autoimmune class is predisposed to it?
arthritis, conjunctivitis, and urethritis | most are male with HLA-B27
55
How is shigella spread?
finger, flies, food, feces
56
What is unique about klebisella?
capsule for enhanced virulence leading to CAP or HAP (lobar on x-ray)
57
What is unique about proteus?
produce UTI, produces urea that causes magnesium and calcium to precipitate into kidney stones
58
What are the characteristics of mycobacterium?
grow slowly acid-fast obligate aerobe invade macrophages transmitted by inhalation or ingestion
59
What are primary TB, secondary TB, and miliary TB?
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
What is unique about the cell wall of mycobacterium TB?
resistant to drying and chemicals | waxes composed of mycolic acid
61
What are the virulence factors for TB?
growth inside macrophages prevent phagosome/lysosome fusion LLo (hemolysin) allows for escape of phagocytic vesicle prevents acidification by forming NH4
62
What is the treatment?
``` 6 months isoniazid rifampin streptomycin ethambutol ```
63
What is unique about mycobacterium leprae?
found in armadillos | does not grow on laboratory medium
64
What is tuberculoid leprosy?
Th1 mediated, low infectivity | red blotchy lesions
65
What is lepratomous leprosy?
Th2 mediated (not good response) high infectivity not impeded in growth
66
What is the treatment of leprosy?
2 years of dapsone, rifampin, and clofazimine
67
What is mycobacterium kansasii and what is the treatment?
yellow pigmented after 2 weeks of incubation in presence of light causes cavitary pulmonary disease treat with chemo, isoniazid, rifampin, and ethambutol
68
What are the characteristics of bordatella?
strictly aerobic, oxidase positive non-fermentive gram negative rods encapsulated
69
What are teh virulence factors of bordatella?
filamentous hemagglutinin | pertussis toxin
70
What does pertussis toxin do?
invasive adenylate cyclase | S1 catalyzes ADPR rection of Gi leading to activate host ACase increasing cAMP
71
What does tracehal cytotoxin do?
cleaves cilia
72
What are the characteristics of pseudomonas?
``` gram negative rod non-fermenter motile with flagella aerobic blue and green pigment biofilms-exopolysaccharide matrix ```
73
What does exotoxin A do?
ADP ribosylation of EF2
74
What does exoenzyme S do?
ADP ribosylation of proteins
75
What does elastase do?
degrades elastin | quorum sensing through LasR (iron regulated)
76
What other virulence factors does P. auerginosa have?
phospholipase C | alkaline phosphatase
77
What does alginate do?
interferes with phagocytosis, adherence to respiratory epithelium
78
What infections are CF patients susceptible to? Why?
mutation in ch 7 (CFTR) | s. aureus, h. influenzae, p. aeruginosa
79
What are the two genera of chlamydiaceae?
chlamydia | chylamydolphia-pneumoniae, psittaci
80
What is unique about the development of chlamydia?
EB and RB EB infects cell and converts to RB RB replicate using host cell ATP (obligate intracellular)
81
What are the serovars for different kinds of trachmatis?
trachoma-A-C urogenital-D-K LGV-L1-L3
82
What is the host range for chlamydia?
nonciliated, columnar, cuboidal, and transitional epithelial cells
83
Why is LGV more invasive?
infects and replicate within phagocytes
84
What is characteristic of active trachoma?
self limited follicular conjunctivitis
85
What are Herbert's pits?
pits in cornea from follicle rupture
86
What is trichiasis?
eyelid is distorted and eyelashes rub over cornea
87
What is pannus?
growth of vascular tissue over cornea
88
How should you culture for chlamydia?
need to get epithelial cells | culture-urethra, cervix, rectum, oropharynx, conjunctiva
89
What is the best test for chlamydia?
NAAT | nucleic acid probe to 16s rRNA
90
What is unique about mycoplasma?
no cell wall cell membrane contains sterols strict aerobe
91
How does mycoplasma infect?
P1 binds to ciliated epithelium and destroys the cilia | super antigen leading to cytokine storm
92
How should you diagnose mycoplasma?
paired sera for IgM and IgG | PCR is very sensitive but not specific to pathogenic forms
93
What are the characteristics of pasteurellaceae?
small gram negative rods that can be pleiomorphic | facultative anerobe
94
What does aegyptis cause?
purulent conjunctivitis?
95
What do aphophilus and parainfluenzae cause?
endocarditis
96
What is required for growth of H. flu on agar?
factor X-protophorphyrin, important for ETC factor V-NAD chocolate agar
97
What does the unencapsulated form cause?
otitis media sinusitis bronchitis pneumonia
98
What does the encapsulated form cause?
more invasive disease composed of polyribitol phosphate Hib causes most
99
How does the unencapsulated form colonize mucosa?
OMP P2 and P5 bind IgA protease LPS destroys ciliated cells take up iron
100
How does the encapsulated form colonize?
splits tight junctions of columnar epithelium | antiphagocytic
101
Where is cellulitis associated with h. flu most common?
cheek, periorbital region, neck
102
What are the characteristics of neisseria?
gram negative diplococci oxidize carbohydrates polysaccharide capsule
103
What does PorB PIA do?
more resistant to complement mediate serum killing
104
What is LOS?
LPS without the O antigen | still has endotoxin activity
105
What virulence factors does neisseria have?
transferrin binding | IgA protease
106
What strains predominate in developing countries?
A and W-135
107
Which strains are associated with pneumonia?
Y and W-135
108
What is unique about the vaccine for neisseria?
does not cover B | conjugated to diptheria
109
What is specificity?
test and recognize single pathogen | prevents false positives
110
What is sensitivity?
lowest number needed to be detected | prevents false negatives
111
What are the non-culture methods?
microscopy staining serological test molecular methods
112
What is the difference between simple and differential staining?
one or two stains | PAS differential for polysaccharide
113
What is the difference between direct and indirect fluorescence?
direct-labeled antibody | indirect-labeled anti-immunoglobulin (secondary antibody)
114
What does flow cytometry measure?
cell size and granularity measured by light scattering
115
What is the culture method?
identify based on combination of characteristics
116
What is the MIC vs MBC?
minimum inhibition concentration | minimum bacteriocidal concentration
117
What are common media for culturing?
enriched-chocolate selective-Thayer Martin differnetial-MacConkey Anaerobic-thioglycollate

POD 2 (5 decks)

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