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FA > Micro - Clinical Bacteriology > Flashcards

Micro - Clinical Bacteriology Flashcards

1
Q

staph aureus identification

A

gram positive catalase positive (clusters) coagulase positive beta hemolytic (clear)

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2
Q

staph aureus VF

A

protein A - binds to Fc portion of IgG to prevent complement fixation + phagocytosis

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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

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4
Q

MRSA

A

methicillin-resistant staph aureus
nosocomial and community acquired infection
resistant to b-lactams (altered PBP)

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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

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6
Q

cause of staph aureus food poisoning

A

ingestion of preformed toxin (enterotoxin)

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7
Q

staph epidermidis labs

A

gram positive cocci catalase positive (clusters) coagulase negative
NESSIR - NOVOBIOCIN SENSITIVE

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8
Q

staph epidermidis

A

produces adherent BIOFILM –> prosthetic devices + IV catheters
normal skin flora
contaminates blood cultures

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9
Q

strep pneumo labs

A

lancet shaped, gram positive DIPLOcocci catalase negative (chains), alpha hemolytic (green), OVERPASS - OPTOCHIN SENSITIVE, positive quellung - capsule

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10
Q

strep pneumno diseases

A

MOPS - meningitis, otitis media (kids), pneumonia, sinusitis

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11
Q

strep pneumo associations

A

3 S’s –> rusty sputum, sepsis in sickle cell anemia and splenectomy

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12
Q

strep pneumo virulence

A

CAPSULE

IgA protease - cleaves IgA to invade resp mucosa

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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

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14
Q

strep mutans

A

dental caries

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15
Q

strep sanguis

A

glycocalx –> subacute bacterial endocarditis at damaged valves

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16
Q

strep pyogenes diseases

A

pyogenic - pharyngitis, cellulitis, impetigo
toxigenic - scarlet fever, toxic shock like syndrome, necrotizing fasculitis
immunologic - RF + (impetigo->)acute glomerulonephritis

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17
Q

strep pyogenes VF

A

M protein - inhibits phagocytosis

antibodies vs m protein can lead to RF

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18
Q

Rheumatic fever

A

JONES - polyarthritis, carditis, subcutaneous nodules, erythema marginatum, sydenhams chorea

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19
Q

how to detect recent strep pyogenes infection

A

ASO titer

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20
Q

scarlet fever

A

strep pyogenes - strawberry tongue, scarlet face sparing face, scarlet throat

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21
Q

strep agalactiae

A

colonizes vagina; BABIES - meningitis, pneuomnia, sepsis

screen preggers 35-37 weeks, psoitive = intrapartum prophylaxis with penicillin

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22
Q

produces CAMP factor

A

strep agalactiae - enlarges area of hemolysis formed by staph aureus

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23
Q

hippurate test positive

A

strep agalactiae

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24
Q

enterococcus

A

E. faecalis + E. faecium - normal colonic flora
penicillin G resistant –> UTI, biliary tract infections + subacute endocarditis
VRE - nosocomial infection

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25
Q

can grow in bile salts and 6.5% Nacl

A

Enterococci

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26
Q

streptococcus bovis

A

gut; bacteremia and subacute endocarditis in COLON CANCER PATIENTS
bovus in blood = cancer in colon

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27
Q

cystine-tellurite agar

A

corynebacterium diphtheria - black colonies

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28
Q

lab diagnosis for corynebacterium diptheria

A

gram positive CLUB-SHAPED rod, metachromatic (blue and red) granules and elek’s test for toxin

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29
Q

this prevents diphtheria

A

toxoid vaccine

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30
Q

Cornybacterium diphtheria

A

ABCDEFG - adp ribosylation, beta prophage, cornebacterium diptheria, elongation factor 2, granules

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31
Q

spores

A

highly resistant to heat and chemicals

DIPICLONILIC ACID

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32
Q

how to kill spores

A

autoclave by steaming at 121 degrees celcius for 15 minutes

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33
Q

spore producing bacteria

A

gram positive bac in soil = bacillus anthracis, clostridum perfringes, C. tetani
others = B. cereus, C. botulinum, coxiella burnetti

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34
Q

clostridium labs

A

gram positive rods, obligate anaerobes, spore-forming

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35
Q

clostridium tetani

A

tetanospasmin - exotoxin protease cleaving SNARE –> prevents release of GABA/glycine from RENSHAW cells in s/c *spastic paralysis, lock jaw (trismus), risus sardonic us

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36
Q

clostridium botulinum causes

A

adults - ingest preformed toxin

babies - ingest spores in honey

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37
Q

clostridium botulinum

A

preformed heat-labile toxin - inhibits ach release –> flaccid paralysis

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38
Q

floppy baby syndrome

A

clostridium botulinum

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39
Q

clostridium perfringes

A

alpha toxin - myonecrosis (gas gangrene) and hemolysis

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40
Q

clostridium difficle

A

toxin A - enterotoxin binds brush border of gut –> diarrhea

toxin B - cytotoxin destroys cytoskeletal strucutre of enterocytes –> pseudomembranous colitis

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41
Q

often secondary to antibiotic use

A

clostridium difficile - clindamycin or ampicillin (diagnose = toxin in stool)

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42
Q

clostridium difficile treatment

A

metronidazole or oral vancomycin

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43
Q

only bacterium with polypeptide capsule (D-glutamate)

A

bacillus anthracis

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44
Q

cutaneous anthrax

A

contact - black eschar (painless ulcer) –> possibly bacteremia and death
lethal factor + edema factor –> black skin lesions = black eschar (necrosis) surrounded by edematous ring

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45
Q

pulmonary anthrax

A

inhale spores –> flu-like sx –> rapid to fever, pulm hemorrhage, mediastinitis, shock

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46
Q

woolsorters disease

A

inhalation of bacillus anthracis spores (pulmonary anthrax) from contaminated wool

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47
Q

reheated rice syndrome

A

bacillus cereus

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48
Q

bacillus cereus

A

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

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49
Q

tumbling motility

A

listeria monocytogenes

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50
Q

this is how you get listeria monocytogenes

A

ingest unpasteurized milk/cheese + deli meats or vaginal transmission in birth

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51
Q

form actin rockets - move cell to cell

A

listeria monocytogenes

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52
Q

actinomyces

A

normal oral flora - oral/facial abscesses that drain through sinus tracts

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53
Q

nocardia

A

found in soil - pulmonar y infections in immunocompromised + cutaneous infections after trauma in immunocomptent

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54
Q

form yellow sulfur granule

A

actinomyces

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55
Q

treatment of actinomyces

A

penicillin

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56
Q

treatment of nocardia

A

sulfonamides

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57
Q

extrapulonary TB in vertebral body

A

potts disease

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58
Q

TB sx

A

fever, night sweats, weight loss, hemoptysis

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59
Q

leprosy

A

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

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60
Q

leprosy tx tuberculoid form

A

dapsone + rifampin for 6 months

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61
Q

leprosy tx lepromatous form

A

dapsone, rifampin + clofazimine for 2-5 years

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62
Q

neisseria

A

gram negative diplococci
ferment GLUCOSE
IgA protease

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63
Q

neisseria gonorrhea

A

sexually transmitted –> gonorrhea (within polymorphonuclear leukocytes), septic arthritis, neonatal conjunctivitis, PID

64
Q

neisseria meningitis

A

ferments maltose, polysach capsule, vaccine (none for type B, resp + oral secretions –> meningococcemia + meningitis

65
Q

causes fitz-hugh curtis syndrome

A

neisseria gonorrhea

66
Q

causes waterhouse-friderischsen syndrome

A

neisseria meningitis

67
Q

neiserria meningitis prophylaxis in close contact

A

rifampin, ciprofloxacin, or ceftriaxone

68
Q

treatment of neisseria gonococci

A

ceftriaxone and (azithryomycin or doxy) for possible chlamydia coinfection

69
Q

treatment of neisseria meningitis

A

ceftriaxone or penicillin G

70
Q

h flu vaccine

A

type B capsular polysaccharide conjugated to diphtheria toxoid or other protein. 2-18 months

71
Q

haemophilus influenze

A

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
Q

h flu transmission

A

aerosol

73
Q

tx h flu meningitis

A

ceftriaxone

74
Q

tx h flu prophylaxis in close contact

A

rifampin

75
Q

legionarres disease

A

severe pneumonia, fever, GI + CNS sx

76
Q

pontiac fever

A

legionella pneumophila

mild flu-like syndrome

77
Q

grows on charcoal yeast extracted with cystine and iron

A

legionella pneumophila

78
Q

legionella pneumophila dx, transmission, tx

A

dx - antigen in urine (labs - hyponatremia)
transmission - enrivonmental water source habitat
tx - macrolide or quinolone

79
Q

pseudomonas aeruginosa

A

PSEUDO - pnuemonia (CF), sepsis (black lesions on skin), external otitis (swimmers ear), UTI, drug use, diabetic osteomyelitis

80
Q

associated with wound and burn infections

A

pseudomonas aeruginosa

81
Q

produces pyocyanin (blue-green pigment)

A

pseudomonas aeruginosa

82
Q

grape-like odor

A

psueodmonas aeruginosa

83
Q

pseudomonas aeruginosa

A

endotoxin (fever, shock) + exotoxin A (inactivates EF-2)
AERuginosa - AERobic, water source + blue-green pigment, burn victims
chronic pnuemonia in CF patients = biofilm

84
Q

tx pseudomonas aeruginosa

A

aminoglycoside + extended-spectrum penicillin (piperacillin, ticarcillin)

85
Q

E coli VF

A

fimbrae - cystitis + pyelonephritis
K capsule - pneumonia, neonatal meningitis
LPS endotoxin - septic shock

86
Q

EIEC

A

INVADES intestinal mucosa –> necrosis + inflammation (dysentery)

87
Q

ETEC

A

HLT + HST

watery TRAVELERS diarrhea

88
Q

EPEC

A

PEDIATRIC diarrhea in kids

adheres to apical surface –> flattens vili + prevents absorption

89
Q

EHEC

A

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
Q

hemolytic uremic syndrome triad

A

anemia, thrombocytopenia, acute renal failure

91
Q

red currant jelly sputum

A

klebsiella - abundant polysaccaride capsule –> mucoid colonies

92
Q

lobar pnuemonia in alcoholics + diabetics that aspirated

A

klebsiella

93
Q

klebsiella

A

nosocomial infection

4 A’s –> alcoholics, abscesses in lungs/liver, diAbetics, aspiration pneumonia

94
Q

salmonella

A

flagella, disseminate hematogenously, animal reservoirs, produce hydrogen sulfide, invades intestinal mucosa –> monocytic response

95
Q

shigella

A

cell-cell transmission, human/primate reservoirs, invade intestinal mucosa –> PMN infiltration, BLOODY DIARRHEA

96
Q

salmonella typhi

A

typhoid fever, humans
rose spots on the abdomen, fever, headache + diarrhea***
carrier state - gallbladder

97
Q

campylobacter jejuni

A

bloody diarrhea in kids
fecal oral tranmission - pountry, meat, unpast milk
–> GBS + reactive arthritis

98
Q

vibrio cholerae

A

rice-water diarrhea - cholera toxin (Gs-cAMP)
endemic to developing countries
req prompt oral rehydration

99
Q

rice water diarrhea

A

vibrio cholera

100
Q

yersinia enterocolitica

A 
pet feces (puppies), contaminated milk or pork
mesenteric adentitis - mimics crohns/appendicitis
101
Q

h pylori

A

gastritis + 90% duodenal ulcers
RF - peptic ulcer, gastric adenocarcinoma + lymphoma
urease positive

102
Q

h pylori initial tx

A

PPI, clarithromycin and amoxicillin or metronidazole

103
Q

wrights stain

A

borrelia

104
Q

leptospira interoggans

A

water contaminated with animal urine –> leptospirosis = flu-like sx, jaundice, photophobia w/ conjunctivitis

105
Q

prevalent among surfers and in tropics (hawaii)

A

leptospira interrogans

106
Q

weils disease

A

leptospira interrogans - jaundice and azotemia from liver and kidney dysfunction; fever, hemorrhage, anemia

107
Q

borrelia burdorferi

A

LYME DISEASE
transmission - tick Ixodes with mouse reservoir
northeastern US

108
Q

lyme disease tx

A

doxycycline, ceftriaxone

109
Q

Lyme disease

A

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
Q

treponema pallidum

A

syphilis; visualized with dark field microscopy

111
Q

syphilis tx

A

penicillin G

112
Q

primary syphillis

A

localized w/ painless chancre - treponemes

screen = VDRL –> confirm = FTA-ABS

113
Q

secondary syphilis

A

Systemic - maculopapular rash (palms/soles), condylomata lata - treponemes
screen = FDRL –> confirm = FTA-ABS

114
Q

tertiary syphilis

A

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
Q

congenital syphilis

A

saber shins, saddle nose, CN VIII deafness, hutchinsons teeth, mulberry molars
early prevention!!! placental transmission after 1st trimester

116
Q

argyll robertson pupill

A

constracts with accomodations but is NOT reactive to light ***tertiary syphillis
prostitutes pupil = accomodates but does not react

117
Q

VDRL false positives

A

VDRL - viral infections (mono, hep), drugs, RF, SLE + Leprosy

118
Q

jarisch-herxheimer rxn

A

flu-like syndrome immediately after antibiotics started

due to killed bacteria releasing pyrogens

119
Q

cat scratch disease

A

bartonella

120
Q

lyme disease

A

borrelia burdorferi - ixodes ticks (deer/mice)

121
Q

recurrent fever

A

borrelia recurrentis - louse (variable surface antigens)

122
Q

undulant fever

A

brucella - unpasteurized diary

123
Q

campylobacter

A

bloody diarrhea - puppies/livestock (fecial oral, ingest undercooked meat)

124
Q

chlamydophila psittaci

A

parrots

125
Q

q fever

A

coxiella burnetti - aerosols of cattle/sheep amniotic fever

126
Q

lone star tick

A

ehrlichia chaffeensis

127
Q

francisella tularensis

A

tickets, rabbits, deer fly

128
Q

leptospira

A

animal urine

129
Q

armadillos

A

mycobacterium leprae

130
Q

pasteurella multocida

A

cellulitis/osteomyelitis - animal bit, cats + dogs

131
Q

rickettsia prowazekki

A

epidemic typhys - louse
rash stats centrally and spreads out - sparing palms/soles
TYPHUS - TRUNK

132
Q

rickettsia rickettsie

A

RMSF - dermacentor tick bite

133
Q

rickettsia typhi

A

endemic typhus - fleas

134
Q

yersinia pestis

A

plague - fleas (rats/prarie dog = reservoirs)

135
Q

gray vaginal discharge with FISHY smell

A

gardnerella vaginalis - I dont have a clue why i smell fish in the vagina garden!

136
Q

clue cells

A

gardnerella vaginalis

137
Q

gardnerella vaginalis tx

A

metronidazole

138
Q

rickettsia tx

A

doxycycline

139
Q

rocky mountain spotted fever

A

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
Q

palms and soles rash

A

CARS - cox A, rocky mountain spotted fever, secondary syphilis

141
Q

monocytes with morula in cytoplasm

A

ehrlichiosis (ticK)

142
Q

granulocytes with morula in cytoplasm

A

anaplasmosis (tick)

MORULA GAME - gran ana, mono erchlic

143
Q

Q fever

A

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
Q

chlamydiae

A

elementary body - enters via endocytosis

reticulate body - replicates by fission *seen on tissue culture

145
Q

chlamydia trachomatosis

A

reactive arthritis, conjunctivitis, nongonococcal urethritis + PID

146
Q

chlamydia tx

A

azithromycin (one-time) or doxycycline

147
Q

chlamydia pnuemoniae + pstitaci

A

atypical pneumonia

aerosol transmisison

148
Q

chlamydia lab dx

A

cytoplasmic inclusions on Giemsa or fluorescent antibody-stained smear

149
Q

cell wall lacks muramic acid

A

chlamydia

150
Q

chlamydia trachomatis subtypes

A

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
Q

atypical walking pneumonia

A

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
Q

mycoplasma pneumonia

A

high titer cold agglutinins (IgM)

153
Q

grown on eatons agar

A

mycoplasma pneuomnia

154
Q

mycoplasma pneuomnia tx

A

macrolide or fluoroquinolones (no cell wall = penicillins ineffective)

155
Q

cell wall contains sterols for stability

A

mycoplasma pnuemonia

FA (13 decks)

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