Micro - Clinical Bacteriology Flashcards
1
Q
staph aureus identification
A
gram positive catalase positive (clusters) coagulase positive beta hemolytic (clear)
2
Q
staph aureus VF
A
protein A - binds to Fc portion of IgG to prevent complement fixation + phagocytosis
3
Q
staph aureus diseases
A
inflammatory - skin infection, organ abscesses (coagulase - fibrin clot), pneumonia
toxin-mediated - TSS (TSST-1), scalded skin syndrome (exfoliative toxin), rapid onset food poisoning (enterotoxins)
acute bacterial endocarditis and osteomyelitis
4
Q
MRSA
A
methicillin-resistant staph aureus
nosocomial and community acquired infection
resistant to b-lactams (altered PBP)
5
Q
toxic shock syndrome
A
staph aureus
TSST-1 - MHC + TCR –> IL2 + IFNy –> fever, shock, rash, desquamation, end organ failure due to polyclonal T cell activation
6
Q
cause of staph aureus food poisoning
A
ingestion of preformed toxin (enterotoxin)
7
Q
staph epidermidis labs
A
gram positive cocci catalase positive (clusters) coagulase negative
NESSIR - NOVOBIOCIN SENSITIVE
8
Q
staph epidermidis
A
produces adherent BIOFILM –> prosthetic devices + IV catheters
normal skin flora
contaminates blood cultures
9
Q
strep pneumo labs
A
lancet shaped, gram positive DIPLOcocci catalase negative (chains), alpha hemolytic (green), OVERPASS - OPTOCHIN SENSITIVE, positive quellung - capsule
10
Q
strep pneumno diseases
A
MOPS - meningitis, otitis media (kids), pneumonia, sinusitis
11
Q
strep pneumo associations
A
3 S’s –> rusty sputum, sepsis in sickle cell anemia and splenectomy
12
Q
strep pneumo virulence
A
CAPSULE
IgA protease - cleaves IgA to invade resp mucosa
13
Q
viridans group strep labs
A
gram positive catalase negative (chains), alpha hemolytic (green), overpass - optochin resistant
strep mutans and strep sanguis
normal flora of the oropharynx
14
Q
strep mutans
A
dental caries
15
Q
strep sanguis
A
glycocalx –> subacute bacterial endocarditis at damaged valves
16
Q
strep pyogenes diseases
A
pyogenic - pharyngitis, cellulitis, impetigo
toxigenic - scarlet fever, toxic shock like syndrome, necrotizing fasculitis
immunologic - RF + (impetigo->)acute glomerulonephritis
17
Q
strep pyogenes VF
A
M protein - inhibits phagocytosis
antibodies vs m protein can lead to RF
18
Q
Rheumatic fever
A
JONES - polyarthritis, carditis, subcutaneous nodules, erythema marginatum, sydenhams chorea
19
Q
how to detect recent strep pyogenes infection
A
ASO titer
20
Q
scarlet fever
A
strep pyogenes - strawberry tongue, scarlet face sparing face, scarlet throat
21
Q
strep agalactiae
A
colonizes vagina; BABIES - meningitis, pneuomnia, sepsis
screen preggers 35-37 weeks, psoitive = intrapartum prophylaxis with penicillin
22
Q
produces CAMP factor
A
strep agalactiae - enlarges area of hemolysis formed by staph aureus
23
Q
hippurate test positive
A
strep agalactiae
24
Q
enterococcus
A
E. faecalis + E. faecium - normal colonic flora
penicillin G resistant –> UTI, biliary tract infections + subacute endocarditis
VRE - nosocomial infection
25
can grow in bile salts and 6.5% Nacl
Enterococci
26
streptococcus bovis
gut; bacteremia and subacute endocarditis in COLON CANCER PATIENTS
bovus in blood = cancer in colon
27
cystine-tellurite agar
corynebacterium diphtheria - black colonies
28
lab diagnosis for corynebacterium diptheria
gram positive CLUB-SHAPED rod, metachromatic (blue and red) granules and elek's test for toxin
29
this prevents diphtheria
toxoid vaccine
30
Cornybacterium diphtheria
ABCDEFG - adp ribosylation, beta prophage, cornebacterium diptheria, elongation factor 2, granules
31
spores
highly resistant to heat and chemicals
| DIPICLONILIC ACID
32
how to kill spores
autoclave by steaming at 121 degrees celcius for 15 minutes
33
spore producing bacteria
gram positive bac in soil = bacillus anthracis, clostridum perfringes, C. tetani
others = B. cereus, C. botulinum, coxiella burnetti
34
clostridium labs
gram positive rods, obligate anaerobes, spore-forming
35
clostridium tetani
tetanospasmin - exotoxin protease cleaving SNARE --> prevents release of GABA/glycine from RENSHAW cells in s/c *spastic paralysis, lock jaw (trismus), risus sardonic us
36
clostridium botulinum causes
adults - ingest preformed toxin
| babies - ingest spores in honey
37
clostridium botulinum
preformed heat-labile toxin - inhibits ach release --> flaccid paralysis
38
floppy baby syndrome
clostridium botulinum
39
clostridium perfringes
alpha toxin - myonecrosis (gas gangrene) and hemolysis
40
clostridium difficle
toxin A - enterotoxin binds brush border of gut --> diarrhea
| toxin B - cytotoxin destroys cytoskeletal strucutre of enterocytes --> pseudomembranous colitis
41
often secondary to antibiotic use
clostridium difficile - clindamycin or ampicillin (diagnose = toxin in stool)
42
clostridium difficile treatment
metronidazole or oral vancomycin
43
only bacterium with polypeptide capsule (D-glutamate)
bacillus anthracis
44
cutaneous anthrax
contact - black eschar (painless ulcer) --> possibly bacteremia and death
lethal factor + edema factor --> black skin lesions = black eschar (necrosis) surrounded by edematous ring
45
pulmonary anthrax
inhale spores --> flu-like sx --> rapid to fever, pulm hemorrhage, mediastinitis, shock
46
woolsorters disease
inhalation of bacillus anthracis spores (pulmonary anthrax) from contaminated wool
47
reheated rice syndrome
bacillus cereus
48
bacillus cereus
food poisoning - spores survive cooking rice
emetic - rice/paste; N&V in 1-5 hours due to cereulide (preformed toxin)
diarrheal type - water, nonbloody diarrhea + GI pain 8-18 hours
49
tumbling motility
listeria monocytogenes
50
this is how you get listeria monocytogenes
ingest unpasteurized milk/cheese + deli meats or vaginal transmission in birth
51
form actin rockets - move cell to cell
listeria monocytogenes
52
actinomyces
normal oral flora - oral/facial abscesses that drain through sinus tracts
53
nocardia
found in soil - pulmonar y infections in immunocompromised + cutaneous infections after trauma in immunocomptent
54
form yellow sulfur granule
actinomyces
55
treatment of actinomyces
penicillin
56
treatment of nocardia
sulfonamides
57
extrapulonary TB in vertebral body
potts disease
58
TB sx
fever, night sweats, weight loss, hemoptysis
59
leprosy
hansens disease
glove and stocking loss of sensation, ARMADILLOS
lepromatous - diffusy over skin + communicable - low CMI w/ humoral TH2 response (can be lethal)
tuberculoid - few hypoesthetic hairless skin plaques, high CMI w/ large TH1 response
60
leprosy tx tuberculoid form
dapsone + rifampin for 6 months
61
leprosy tx lepromatous form
dapsone, rifampin + clofazimine for 2-5 years
62
neisseria
gram negative diplococci
ferment GLUCOSE
IgA protease
63
neisseria gonorrhea
sexually transmitted --> gonorrhea (within polymorphonuclear leukocytes), septic arthritis, neonatal conjunctivitis, PID
64
neisseria meningitis
ferments maltose, polysach capsule, vaccine (none for type B, resp + oral secretions --> meningococcemia + meningitis
65
causes fitz-hugh curtis syndrome
neisseria gonorrhea
66
causes waterhouse-friderischsen syndrome
neisseria meningitis
67
neiserria meningitis prophylaxis in close contact
rifampin, ciprofloxacin, or ceftriaxone
68
treatment of neisseria gonococci
ceftriaxone and (azithryomycin or doxy) for possible chlamydia coinfection
69
treatment of neisseria meningitis
ceftriaxone or penicillin G
70
h flu vaccine
type B capsular polysaccharide conjugated to diphtheria toxoid or other protein. 2-18 months
71
haemophilus influenze
EMOP - epiglottis (cherry red in kids), meningitis, otitis media, pneumonia
most invasive = capsular type B
nontypable strains - mucosal infectinos (otitis media, conjunctivitis, bronchitis)
IgA protease
72
h flu transmission
aerosol
73
tx h flu meningitis
ceftriaxone
74
tx h flu prophylaxis in close contact
rifampin
75
legionarres disease
severe pneumonia, fever, GI + CNS sx
76
pontiac fever
legionella pneumophila
| mild flu-like syndrome
77
grows on charcoal yeast extracted with cystine and iron
legionella pneumophila
78
legionella pneumophila dx, transmission, tx
dx - antigen in urine (labs - hyponatremia)
transmission - enrivonmental water source habitat
tx - macrolide or quinolone
79
pseudomonas aeruginosa
PSEUDO - pnuemonia (CF), sepsis (black lesions on skin), external otitis (swimmers ear), UTI, drug use, diabetic osteomyelitis
80
associated with wound and burn infections
pseudomonas aeruginosa
81
produces pyocyanin (blue-green pigment)
pseudomonas aeruginosa
82
grape-like odor
psueodmonas aeruginosa
83
pseudomonas aeruginosa
endotoxin (fever, shock) + exotoxin A (inactivates EF-2)
AERuginosa - AERobic, water source + blue-green pigment, burn victims
chronic pnuemonia in CF patients = biofilm
84
tx pseudomonas aeruginosa
aminoglycoside + extended-spectrum penicillin (piperacillin, ticarcillin)
85
E coli VF
fimbrae - cystitis + pyelonephritis
K capsule - pneumonia, neonatal meningitis
LPS endotoxin - septic shock
86
EIEC
INVADES intestinal mucosa --> necrosis + inflammation (dysentery)
87
ETEC
HLT + HST
| watery TRAVELERS diarrhea
88
EPEC
PEDIATRIC diarrhea in kids
| adheres to apical surface --> flattens vili + prevents absorption
89
EHEC
shiga-like toxin + HUS --> necrosis + inflammation (dysentry)
O157:H7
does not ferment sorbitol
endothelium swells + narrows lumen - mechanical hemolysis + reduced renal blood flow, damaged endothelium consumes platelets
90
hemolytic uremic syndrome triad
anemia, thrombocytopenia, acute renal failure
91
red currant jelly sputum
klebsiella - abundant polysaccaride capsule --> mucoid colonies
92
lobar pnuemonia in alcoholics + diabetics that aspirated
klebsiella
93
klebsiella
nosocomial infection
| 4 A's --> alcoholics, abscesses in lungs/liver, diAbetics, aspiration pneumonia
94
salmonella
flagella, disseminate hematogenously, animal reservoirs, produce hydrogen sulfide, invades intestinal mucosa --> monocytic response
95
shigella
cell-cell transmission, human/primate reservoirs, invade intestinal mucosa --> PMN infiltration, BLOODY DIARRHEA
96
salmonella typhi
typhoid fever, humans
rose spots on the abdomen, fever, headache + diarrhea***
carrier state - gallbladder
97
campylobacter jejuni
bloody diarrhea in kids
fecal oral tranmission - pountry, meat, unpast milk
--> GBS + reactive arthritis
98
vibrio cholerae
rice-water diarrhea - cholera toxin (Gs-cAMP)
endemic to developing countries
req prompt oral rehydration
99
rice water diarrhea
vibrio cholera
100
yersinia enterocolitica
```
pet feces (puppies), contaminated milk or pork
mesenteric adentitis - mimics crohns/appendicitis
```
101
h pylori
gastritis + 90% duodenal ulcers
RF - peptic ulcer, gastric adenocarcinoma + lymphoma
urease positive
102
h pylori initial tx
PPI, clarithromycin and amoxicillin or metronidazole
103
wrights stain
borrelia
104
leptospira interoggans
water contaminated with animal urine --> leptospirosis = flu-like sx, jaundice, photophobia w/ conjunctivitis
105
prevalent among surfers and in tropics (hawaii)
leptospira interrogans
106
weils disease
leptospira interrogans - jaundice and azotemia from liver and kidney dysfunction; fever, hemorrhage, anemia
107
borrelia burdorferi
LYME DISEASE
transmission - tick Ixodes with mouse reservoir
northeastern US
108
lyme disease tx
doxycycline, ceftriaxone
109
Lyme disease
stage 1 - erythema chronicum migrans (bulls eye rash w/ central clearing), flu-like sx
stage 2 - neuro (facial nerve palsy) + cardiac (AV nodal block) manifestations
stage 3 - MSK (monoarthritis + migratory polyarthritis), neuro (encephalopathy + polyneuropathy) + cutaneous manifestation
FAKE - facial n palsy (BL), arthritis, kardiac block, erythema migrans
110
treponema pallidum
syphilis; visualized with dark field microscopy
111
syphilis tx
penicillin G
112
primary syphillis
localized w/ painless chancre - treponemes
| screen = VDRL --> confirm = FTA-ABS
113
secondary syphilis
Systemic - maculopapular rash (palms/soles), condylomata lata - treponemes
screen = FDRL --> confirm = FTA-ABS
114
tertiary syphilis
gummas (chronic granulomas), aortitis (vaso vasorum destruction), neurosyph (tabes dorsalis), argyll robertson pupil
sign = broad-based ataxia, positive romberg, charcot joints, stroke w/o HTN
test spinal fluid w/ VDRL
115
congenital syphilis
saber shins, saddle nose, CN VIII deafness, hutchinsons teeth, mulberry molars
early prevention!!! placental transmission after 1st trimester
116
argyll robertson pupill
constracts with accomodations but is NOT reactive to light ***tertiary syphillis
prostitutes pupil = accomodates but does not react
117
VDRL false positives
VDRL - viral infections (mono, hep), drugs, RF, SLE + Leprosy
118
jarisch-herxheimer rxn
flu-like syndrome immediately after antibiotics started
| due to killed bacteria releasing pyrogens
119
cat scratch disease
bartonella
120
lyme disease
borrelia burdorferi - ixodes ticks (deer/mice)
121
recurrent fever
borrelia recurrentis - louse (variable surface antigens)
122
undulant fever
brucella - unpasteurized diary
123
campylobacter
bloody diarrhea - puppies/livestock (fecial oral, ingest undercooked meat)
124
chlamydophila psittaci
parrots
125
q fever
coxiella burnetti - aerosols of cattle/sheep amniotic fever
126
lone star tick
ehrlichia chaffeensis
127
francisella tularensis
tickets, rabbits, deer fly
128
leptospira
animal urine
129
armadillos
mycobacterium leprae
130
pasteurella multocida
cellulitis/osteomyelitis - animal bit, cats + dogs
131
rickettsia prowazekki
epidemic typhys - louse
rash stats centrally and spreads out - sparing palms/soles
TYPHUS - TRUNK
132
rickettsia rickettsie
RMSF - dermacentor tick bite
133
rickettsia typhi
endemic typhus - fleas
134
yersinia pestis
plague - fleas (rats/prarie dog = reservoirs)
135
gray vaginal discharge with FISHY smell
gardnerella vaginalis - I dont have a clue why i smell fish in the vagina garden!
136
clue cells
gardnerella vaginalis
137
gardnerella vaginalis tx
metronidazole
138
rickettsia tx
doxycycline
139
rocky mountain spotted fever
rash at wrist/ankles --> spreads mediately to trunk/palms/soles
rickettsia = obligate intracell requiring CoA and NAD+
WRICKETTSIA - WRISTS
triad - headache, fever, rash (vasculitis)
140
palms and soles rash
CARS - cox A, rocky mountain spotted fever, secondary syphilis
141
monocytes with morula in cytoplasm
ehrlichiosis (ticK)
142
granulocytes with morula in cytoplasm
anaplasmosis (tick)
| MORULA GAME - gran ana, mono erchlic
143
Q fever
coxiella burnetti
tick feces + cattle placenta release spores -> inhaled as aerosols -> pneumonia
queer - no rash no vector and causative organism can survive outside in endospore form
144
chlamydiae
elementary body - enters via endocytosis
| reticulate body - replicates by fission *seen on tissue culture
145
chlamydia trachomatosis
reactive arthritis, conjunctivitis, nongonococcal urethritis + PID
146
chlamydia tx
azithromycin (one-time) or doxycycline
147
chlamydia pnuemoniae + pstitaci
atypical pneumonia
| aerosol transmisison
148
chlamydia lab dx
cytoplasmic inclusions on Giemsa or fluorescent antibody-stained smear
149
cell wall lacks muramic acid
chlamydia
150
chlamydia trachomatis subtypes
ABC - chronic infection - blindness due to follicular conjunctivitis in africa (AFRICA, BLIND, CHRONIC)
D-K - everything else (urethritis/PID, ectopic preggers, neonatal penumonia (staccato cough) or neonatal conjunctivitis) *neonatal - passage through infected birth canal
L1,L2,L3 - lymphogranuloma venereum
151
atypical walking pneumonia
mycoplasma pneumonia, < 30 year old, freq outbreak in military recruits/prisons
sx - insidious onset, headache, nonproductive cough, diffuse interstitial infiltrate. Xray worse than prognosi
152
mycoplasma pneumonia
high titer cold agglutinins (IgM)
153
grown on eatons agar
mycoplasma pneuomnia
154
mycoplasma pneuomnia tx
macrolide or fluoroquinolones (no cell wall = penicillins ineffective)
155
cell wall contains sterols for stability
mycoplasma pnuemonia
