Micro Flashcards
Tranformation
- what is it
- occurs
- bacteria is dead and has lysed, a piece of DNA binds to cell wall of live bacteria, DNA gets into cell and incorporates itself into genome
- only occurs w/ closely related bacterial species
Transduction
- occurs w
- normal life cycle
- generalized transduction
- specialized transduction (temperate)
- bacteriophage; virus that infects bacteria
- phage attaches to bacteria through cell wall -> injects genetic material and enzyme into bacteria -> enzymes break up bacterial DNA and takes over machinery of bacteria to replicate phage DNA -> bacteria becomes full of phages -> bacteria lyses releasing phages
- phage infected bacteria -> bacterial DNA lysed into fragments -> accidentally a piece of bacterial DNA gets incorporated into phage instead of phage DNA -> bacteria is full of phage and lyses -> the phage with bacterial DNA binds and incorporates the DNA into another bacteria -> instead of new bacteria being infected it incorporates the old bacterias DNA into its own DNA
- phage DNA is incorpoarted into genome of bacteria -> sits and lives w/ bacteria for several generations until bacteria starts to die (detects decrease in production of ATP) -> phage DNA extracted from bacterial DNA and takes some bacterial DNA with it -> lyses rest of bacterial DNA and uses machinery to replicate own DNA-> phage lyses bacteria -> phage is released w/ both its own DNA and some small pieces of bacterial DNA
Conjugation
- what is it
- what happens
- what is necessary
- bacterial sex
- direct transfer of DNA from one cell to another through plasmids
- cell to cell contact, w/ pilli
Transposon
- what is it
- cut and paste
- copy and paste
- piece of DNA w/ ability to move around
- transposon jumps to new site and gap that is left is filled in
- copy of transposon jumps to new location
Virulence Factors of bacteria
- techoic acid
- endotoxin
- capsule
- antiphago surface
- spores
- neurotoxin
- cord factor
- gram +
- gram -
- protection
- M protein, protein A
- dormant bacteria releases toxin when exposed to heat
- clostridium
- prevents bacteria from being phagocytosed
Gram + vs -
- number layer
- thickness
- oute membrane
- increased permeability
- color
- +: one, -: two
- +: thick, -: thin
- +: absent, -: present
- +: more penetrable, -: less permeable
- +: purple, - pink
Gram + pep wall
- made of
- linker
- penicillen and cephalosporin
- teichoic acid: purpose, causes
- N-AM and N-AG
- D-ala
- mimic D-ala but do not link the N-AM and N-AG -> punches holes into cell wall -> water into cell -> cell swells and lyses
- stabilize peptidoglycan wall by attracting positively charged ions; when released will cause fever and vasodilation but not sepsis
Gram - pep wall
- endo toxin: lipid A
- endo toxin: inner and out core
- endo toxin: O antigen
- importance
- how
- embedded in cell membrane is lipid A -> fever, septic shock, diarrhea
- inner core connect to lipid A and then connects to outer core, stimulates immune response; different in every bacteria
- connected to outer core; every family has same O antigen
- pts with gram - infections will get sicker after getting the antibiotic because when the bacteria starts lysing it releases the endo toxin and stimulates even greater immune response
- once released LPS binds to LPS binding protein -> LPS transferred to CD14 (on surface of macrophages) -> puts LPS on MD2 (lymphocyte antigen 96)-> associated with TLR4 -> TLR4 is PRR and will activate immune sxs through release of cytokines, NO, immunomodulators
Exotoxin
- what is it
- location of damage
- extracellular produced toxin produced by bacteria for survival advantage
- non-membrane damaging and membrane damaging
Non- membrane damaging exotoxin
- hyaluronidase
- lipase
- IgA protease: which bacterias,
- collagenase
- breaks down hyaluronic acid which is component in BM and ECM; allows
- coverts plasminogen to plasmin to break down clot
- allows bacteria to break through subcutaneous tissue
- bacteria that colonize mucus membrane; destroys IgA
- destroys fascia and collagen in muscle to take infection to bone
Membrane damaging exotoxin
- hemolysin
- leukocidins
- phospholipase
- lecithinase
- lyse RBC
- lyse WBC
- lyse all cells
- lyse all cells
Intracellular exotoxin
- ADP ribosyl transferase
- bacteria
- inactive NAD and turns it into nicotene and ADR -> stop protein synthesis -> kill cell
- diptheria, psuedomonas, cholera, e.coli, pertusis
Bacteria Specific Endotoxin
- shiga toxin
- pseudomonas
- shigella
- staph
- strep pyo
- anthracis
- diptheria
- tetanus
- botulinum
- c perf
- binds to 60 s ribosome -> inhibit protein synthesis -> cell death; causes n/v, diarrhea and neurotox
- pyro something -> interferes with electron transport chain
- NAD glycohydrolase -> produced when shigella phagocytosed -> depletes neutrophil of NAD -> w/o NAD cannot have normal cell metabolism and blocks PMN from being able to do normal function
- super antigen will bind MHC 2 protein and T cell receptor -> induce IL1 and 2 causing shock
- strep O hemolyzes RBCs and is used to detect step pyo infection, erythrogenic toxin -> leads to formation of rashes (impetigo)
- edema factor: AC -> cAMP -> edema, lethal factor: inhibits kinases and kills macrophages
- elogation factor 2 -> produces pseudomembrane in back of throat
- inhibits release of glycine -> rigid paralysis
- blocks release of Ach -> flaccid paralysis
- alpha lecithinase and causes gas gangrene -> double zone of hemolysis
Bacteria Specific Exotoxin
- E. Coli
- Vibrio
- Bordetella
- heat labile, raises cAMP, heat stable cGMP -> cause diarrhea
- heat labile exotoxin -> cause rice water diarrhea
- stimulates AC via ribosylation -> increase histamine production and phagocyte dysfunction
Septic Shock
- what is it
- importance
- bacteremia
- sepsis
- septic shock
- COD
- kidneys
- lungs
- brain
- vascular
- coagulation
- tx
- reasoning for tx
- deadly response to infection
- main cause of death in ICU
- bacteria in blood stream, can trigger immune system and can cause sepsis, shock, and death
- systemic inflammaroty/ immune response to bacteremia
- dangerous drop in BP and subsequent organ dysfunction (kidney)
- heart failure
- acute renal failure
- ARDS
- encephalopathy
- vasodilation -> decreased BO
- DIC, excessive bleeding
- treat underlying infection, give vaso constrictor (compensate for vasodilation from cytokines)
- bacteriostatic will put into plateau phase and bacterialcidal will put in death phase
- maconkey
- chocolate
- blood
- lowenstein jensen
- charcoal yeast
- thayer martin
- bordet-gengou
- cysteine tellurite
- e. coli, enterobacter, klebsiella
- hib
- diptheria
- TB
- legionella
- fungus
- nisseria, chocolate agar with vanco, polymixin, nistatin, trimethoprim
- bordatella
- diptheria
Normal Flora - skin - nose vagina - oropharynx - gingiva
- staph epi
- staph aur
- lactobacilli, group B strep
- strep viridans
- actinomyces
Skin infections
- cellulitis
- mastitis
- periorbital cellulitis in baby
- orbital cellulitis in adult
- balantitis
- folliculitis
- hot tub folliculitis
- furuncle
- carbuncle
- fascitis
- necrotizing fascitis
- flat, red, warm, will blanche; staph or step
- cellulitis around breat -> staph aureus
- from trauma; staph aureus
- elderly; srep pneumo
- proptosis (bulging forward of eye
- infection of glans of penis
- infection of hair follicle; staph aureus, pseudomonas
- due to unsanitary hot tub; pseudomonas
- deeper folliculits; staph aureus
- abcess, must be drained bc antibiotics will not be able to penetrate cavity
- infection of eyelid
- infection of fascia
- flesh eating dx; either polymicrobial or MRSA by itself
- inflammation of fascia on plantar aspect of foot, starts at calcaneus at moves towards mid foot
- infection of subcutaneous fat; will have tender skin nodules
Urease Positive Bacteria
- urease
- PUNCH KSS
- turns urea into CO2 and ammonia
- proteus, ureaplasma, nocardia, cryptococcus, h pylori, klebsiella, staph saphrophiticus and staph epi
chronic granulomatous dx
- what is it
- dx
- PMNs no longer working and can only destroy bacteria by forming granulomas
- tetrazolium blue test (NADPH oxidase present -> + which is normal) or dihydrotamine test
Hemolysis
- what is it
- alpha
- beta
- gamma
- ability to lyse RBC
- caused by hydrogen peroxide, creates dark green colonies
- complete hemolysis by streptolysin, clear or yellow colony on blood agar
- no hemoylsis
meningitis by age group
- 0-6 month
- 6 month - 6 yr
- 6 yr - 60 yr
- older than 60
- group B strep (agalactiae), e coli, listeria
- step pneumo, neisseria meningitidis, HiB
- N meningitidis, strep pneumo
- strep penumon meningitidis, listeria
Subactue Bacterial Endocarditis
- caused by
- develops after
- osler nodes
- roth spots
- splinter hemm
- janeway lesions
- strep viridans
- dental surgery -> give amoxicillin prophylaxis
- painful nodes on fingers
- retinal hemm, pale spots on fundoscopy
- emboli in nail beds
- non tender nodules on palms and soles
Group A vs Group B strep
- both are
- A
- B
- beta hemolytic; but A is fully and B is wealy
- pyogenes
- agalactaie
Acne
- caused by
- white comedones
- black comedones
- tx
- gram +, anaerobic bacteria -> propionobacterium acne
- clear vesicles
- oxidized sebum
- benzoyl peroxide (exposes bacteria to O2), antibiotics (directly kills basteria), retinoic acid (speeds up skin cell proliferation)
Penicillens
- MOA
- types
- penicillenase resistant: examples, used for
- broad spectrum
- inhibit bacterial cell wall
- pen G, Pen V, ampicillin, amoxicillin, ticaracillin, piparcillin
- oxacillin, nafcillin; D lactamase producing S aureus
- imipenem
Cephalosporin
- MOA
- 1st gen
- 2nd gen
- 3rd gen
- inhibit bacterial cell wall
- cephalexin -> gram +
- cefuroxime -> HiB, nisseria, S pneumo
- ceftriazone, ceftazadime -> gram -, n gon
Vancomycin
- MOA
- inhibit cell wall transglycosylation
Aminoglycosides
- MOA
- side effects
- examples
- bind and block 30s subunit
- ototox and nephrotox
- gentamicin, streptamicin, -icin
Tetra cycline
- MOA
- bugs
- ex
- side effects
- bind to 30 s subunit
- chlamydia, choler, lyme
- doxycycline, minocycline
- hepatotox, deposition in bones
Macrolide
- MOA
- bugs
- side effects
- ex
- chloamphenicol: MOA, indication, side effect
- clindamycin: MOA, indication, side effect
- bind to 50s subunit
- legionella, chlamydia, anthrax
- GI irritability, hepatotox, p450 inhibition
- erythromycin, azithromycin, clarithromycin
- 50s, infections including CNS; aplastic anemia and p450 inhib
- 50s, anaerobic -> S aureus; psedumembranous colitis, hepatotox
Oxazolidionones
- MOA
- indication
- example
- side effect
- 50s inhibition
- VRSE, MRSA
- linezoilid
- MAO inhibition, superinfections
Streptogramins
- MOA
- indication
- example
- metronidazole
- 50s inhibition
- VRSE, MRSA
- dalfopristin, quinupristin
- anaerobes; c diff and etamoeba, giardia, and trich
TB drugs
- rifampin
- isoniazide
- pyrazinamide
- ethambutol
- tb DNA dependent RNA polymerase inhibitor; GI, hepatotox, p450 inducer, orange/red urine
- mycolic acid synthase inhibitor; peripheral neuritis
- same as above
- only for dividing mycobacterium; neuritis (color blindness)
Anti-fungals
- ampho B: MOA, side effects
- flucytosine: MOA, side effects
- azoles: MOA, examples
- interferes w/ sterol -> apoptosis; nephro, cardio, and neuro toxic
- fungal uracil analog so inhibits mRNA production; bone marrow suppression, alopecia
- inhibits ergosterol synthesis; ketoconazole, fluconazole, itraconazole
Malaria Tx
- chloroquine
- primaquine
- mefloquine
- for malaria in RBC, prevents hemoglobin degradation
- for malaria in liver,
- for prevention; inhibit merozoite invasion and interact with proteins involved with parasite membrane lipid trafficking and nutrient uptake
Worm Tx: drug and MOA
- round
- flat - fluke
- flta - tapeworm
- tolsium
- mebendazole -> works by selectively inhibiting the synthesis of microtubules via binding to colchicine binding site of β-tubulin, thereby blocking polymerisation of tubulin dimers in intestinal cells of parasites.
- praziquantal increases the permeability of the membranes of schistosome cells towards calcium ions -> induces paralysis
- niclosamide: inhibits glucose uptake, oxidative phosphorylation, and anaerobic metabolism in the tapeworm.
- praziquantal
Influenza Tx
- amantadine
- oseltamavir
- zanamivir
- blocks M2 so no uncoating; paranoia, depression
- prevent cleavage of sialic acid-virus -> inhaled
- prevent cleavage of sialic acid-virus -> oral
Herpes Tx
- acyclovir
- trifluorothymadine
- guanine analog
- thymidine analog -> topical
AIDS Tx
- azidothymadine
- iopinavir
- enfuvirtide
- nucleoside analog reverse-transcriptase inhibitor
- inhibitor of the HIV-1 protease enzyme
- fusion inhibitor, blocks HIV attachment to cell