Micro Flashcards
What are the two microoganisms that are:
Gram positive
Catalase negative
alpha hemolytic
how do you tell the apart?
Optochin Sensitive, Bile soluble
positive: Strep Pneumonia (Encapsulated)
negative: Strep Viridans (mutans)
What are three organism you become susceptible with sickle cell or after a splenectomy?
which is the most common involved in pneumonia?
Encapsulated Organisms
- Streptococcus Pneumonia
- Haemophilus influenza
- Neisseria Meningitidis
How does Parvovirus B19 present in children?
- “Slapped Cheeks” rash in children
- Aplastic crisis in sickle cell disease
- fetus - Hydrops fetalis (RBC dectruction)
in adults - pure RBC aplasia and RA-like Sx
What is the most important protective immunologic mechanism against encapsulated organisms?
IgG-mediated opsonization
What are three tests that can confirm Cryptococcus neoformans as the cause of meningitis in AIDS patients?
Latex particle agglutination - most specific, detects polysaccharide capsular antigen
India Ink - clear halo
Mucicarmine - red inner capsule
24 year old woman shows up to office with copious green vaginal discharge. What is the dx? what is the best dx test?
Trichomoniasis
Saline microscopy - motile protozoan
best dx test = Nucleic Acid Amplification test (NAAT)
What is the most common cause of osteomyelitis?
If an african american pt presents w anemia and osteomyelitis which combo should you treat with?
Staphylococcus aureus
Ciprofloxacin and Vancomycin
- -cipro - for salmonella
- -vanco - s. aureus
Cephalosporins bind to what type of bacterial structure?
cephalosporins irreversibly bind to penicillin binding proteins
Transpeptidases = PBP thatcross links peptidoglycans in bacterial cell wall
What viruses cause B cells to enter a immortal stage and maintain the capacity to secrete immunoglobulins?
What type of Abs?
Epstein-Barr virus
Heterophile IgM antibodies
What are two bacteria that can cause impetigo?
S. aureus
S. pyogenes (GAS)
What systemic symptoms usually follow a Group A Strep infection (impetigo)
what is the first line treatment?
facial puffiness
Dark urine
–Poststreptococcal glomerular nephritis (PSGN)
first line Tx: Penicillin
What technique is described:
bacteria fail to decolorize with hydrochloric acid and alcohol after staining carbofuschin?
Acid fast staining
What is the bacteria:
gram positive, lancet shaped diplococci?
Streptococcus Pneumoniae
What is the main source of rabies in the US?
bats
what bacteria is a/w ecthyma gangrenosum (skin patches with necrotic centers and occasional ulceration)
Pseudomonas aeruginosa
KOH stain shows large, round yeast with doubly refractory wall, and single broad-based bud
-Ohio and mississippi, river valleys, great lakes
Blastomyces dermatitidis
immunosuppressed pt
fungal rhinositis
light microscopy: v-shaped, narrow septate hyphae invading the tissue
Aspergillosis fumigatus
How does Isoniazid work?
inhibition of mycolic acid synthesis
group of kids get sick at summer camp
present with fever, cough, congestion, sore throat, red eyes, erythematous oropharynx
Crackles present in lower left field upon auscultation
Adenovirus
Pyrrolidonyl arylamidase postivity (PYR-positive)
S. pyogenes (GAS)
Oxidase-positive
gram negative bacilli
grows well on highly alkaline selective media (thiosulfate-citrate-bile salts-sucrose TCBS agar)
- identify bacteria and shape
- what is the mechanism of action of toxin
- what is tx?
- vibrio cholera - comma shaped (curved rod, mobile)
- stimulates G protein to activate adenylate cyclase
- if no altered mental status, no lethargy, strong pulse = ORAL fluid and electrolyte replacement
if serious sx = IV fluid, electrolytes
non-lactose fermenting, gram-negative rods on MacConkey agar.
bacteria ferments glucose without gas production
do not generate hydrogen sulfide when grown on triple sugar iron agar, cannot replicate at refrigeration temps
identify and its route of pathogenesis
shigella - mucosal invasion through Mcells over peyers patches
How are are E. coli and Enterobacter cloacae
- similar
- different
- both are gram negative, lactose fermenting
2. only ecoli is indole positive
What are the two most common causes of PID leading to infertility?
Neisseria Gonorrhea
Chlamydia trachomatis
What is the abx category of cefuroxime and what is its mechanism of action?
second gen cephalosporin, beta-lactam abx
acts against cell wall synthesis
What virus is strongly associated with cervical and anal squamous cell carcinoma? prevalence is increased with HIV infection
HPV types 16, 18
What is a common route of Hep A transmission in the US?
contaminated water/food
raw or steamed shellfish
Gram negative coccobacilli, associated with dog bite, mouse-like odor
Pasteurella multocida
what should you suspect in a patient from south america with achalasia
trypanosome cruzi infection
How does C.difficile damage the intestinal mucosa?
what would the colonoscopy biopsy most likely reveal?
Toxin A and B both damage cytoskeletal integrity
Colonic bx: inflammatory exudate composed of mucinous debris, fibrin, necrotic epithelial cells, polymorphonuclear cells
What abxs should be used with toxoplasmosis?
Pyrimethamine
Sulfadiazine
What should be suspected with a MRI showing ring-enhancing lesions
- negative toxoplasmosis
- positive EBV
primary central nervous system lymphoma (PCNSL)
–abnormal population of B-lymphocytes
How do Shiga-like toxins work?
inhibit protein synthesis in human cells (60s subunit)
–leads to intestinal mucosal cell death
=renal epithelial cell toxicity
What is Metronidazole used for?
treat anaeroes and parasites:
Giardia lamblia
Entamoeba histolytica, Trichomonas vaginalis.
Bacterial vaginosis (Gardnerella vaginalis)
How can neonatal tetanus be avoided?
Maternal Vaccination
What bacteria is a/w axillary lymphadenopathy and scratches from pets
-what is an additional Symptom that can appear
Cat-scratch disease: Bartonella henselae
Bacillary angiomatosis - in immunocompromised pts - red, purple papular skin lesions
How do you distinguish EHEC from other Ecoli?
Colorless colonies on sorbitol MacConkey (does not ferment sorbitol)
-shiga-like toxin = HUS (anemia, thrombocytopenia, acute renal failure)
identify the disease:
agitation, disorientation, pharyngospasm, photophobia leading to coma and death
what is the receptor that this disease binds to?
Rabies encephalitis
acetylcholine receptors
-widened mediastinum on chest xray
-microscopy: shows long chains described as “serpentine” or “medusa head”
what is special about the capsule formed by this agent?
bacillus anthracis
-forms capsule with D-glutamate instead of polysaccharide
recent history of viral esophagitis and pneumocystis pneumonia is virtually diagnostic of what infection?
HIV
What is this disease and how is it usually contracted?
fever lasting >10 days
severe, retroorbital pain a/w photophobia
pneumonia
increased liver enzymes
thrombocytopenia
q fever - coxiella burnetii
through animal waste
What disease and congenital defects are a/w the following symptoms in the mother:
immigrant, low-grade fever, macupapular rash w cephalocaudal progression, posterior auricular and suboccipital lymphadenopathy, eventual polyarthralgia
Rubella
sensorineural deafness
cataracts
cardiac malformations (PDA)
What type of virus is Herpes simplex I
double stranded, DNA, enveloped
What type of virus is rubella?
togavirus
what type of outer covering is a/w gram negative bean-shaped diplococci?
Neisseria meningitidis
–Outer membrane Lipooligosaccharide
what two infections are commonly the cause of ectopid pregnancy?
Neisseria gonorrhoeae
Chlamydia trachomatis
How does CMV infections present in:
- immunocompetent
- immunocompromised
- Mononucleosis-like illness
2. Odynophagia (linear esophageal ulcers), Retinitis
What activity is giardia lamblia infection a/w?
drinking contaminated water:
hx of camping, hiking in the mountains, white-water rafting
What secondary infection can form the in the cavitary lesion caused by a prior TB infection of the lung?
Aspergilloma colonization
what are the 3D’s of clostridium botulinum infection sx?
diplopia
dysphagia
dysphonia
Nikolsky’s sign, epidermal necrolysis, fever, pain a/w skin rash are symptomatic of what?
Staphylococcal Scaled Skin Syndrome
exotoxin
What is the use of fidaxomicin and what is the mechanism of action?
Clostridium difficile infection
inhibits the sigma subunit of RNA polymerase
A young woman with asymmetric polyarthritis (knee, elbow, wrist)
synovial fluid analysis = neutrophilic predominance and intracellular organisms
what is the cause?
Neisseria Gonorrhea
disseminated gonococcal infection (DGI)
What are serum electrolyte findings of a Legionella pneumonia infection?
What is the treatment of Legionnaire’s dz?
Hyponatremia
Tx: Fluroquinolones or Macrolides (Azithromycin)
What type of virus is parvovirus?
Nonenveloped single stranded DNA virus
What type of presentation can Listeria cause? what abx is used? why?
Meningitis in young infants or immunocompromised
-use Ampicillin (because Cephalosporin resistant)