Micro COMLEX review Flashcards
Bugs that don’t gram stain?
Treponema, Rickettsia, Mycoplasma, Mycobacteria, Listeria, Chlamydia (These Rascals May Microscopically Lack Color)
Obligate Aerobes?
Nocardia, Pseudomonas, Mycobacterium TB, Bacillus (These Nagging Pests Must Breathe)
Obligate Anaerobes?
Clostridium, Bacteroides, Actinomyces (Can’t Breathe Air)
Intracellular bugs?
Ricketsia, Chlaymidia, Salmonella, Neisseria, Brucella, Mycbacterium, Listeria, Francicella, Legionella, Yersinis pestis ( when its Really Cold Some Nasty Bugs May Live FacultativeLY)
Bugs with Capsules?
Strep pnemo, Haemophilus influenza B, Neisseria meningitis, E.coli, Salmonella, Klebsiella, group B strep. (SHiNE SKiS)
Catalase + bugs?
Pseudomonas, Literia, Aspergillus, Candida, E. coli, Staph aureus, Serratia (cats need PLACESS)
Protein A MOA?
binds the FC portion of Ig and prevents opsonizaion, thus prevents PHAGOCYTOSIS! (S. aureus)
IgA protease MOA?
cleaves IgA (S. pneumo, H. influ, Neisseria)
M protein MOA?
prevents phagocytosis. (S pyogenes). This is what causes Rhuematic fever
What is endotoxin?
inside the walls of gram (-) bacteria. It is part of the LPS. Protein A is the core and it is the antigen.
What is exotoxin?
Proteins that get released from the bacteria. Exotoxins are released by all the major gram + bacteria except Listeria.
exotoxin: diptheria toxin?
inactivates EF2, whick will stop protein synthesis. (Corneybacterium diptheriae)
exotoxin: exotoxin A?
MOA: EF2 (stops protein synth = cell death). Pseudomonas aurigenosa
exotoxin: Shiga toxin?
MOA: inactivates 60S ribosome, invades intestinal mucosa = bloody diarrhea, HUS. Shigella
exotoxin: Shiga-like toxin?
MOA: inactivates 60s ribosome, bloody diarrhea, HUS.
exotoxins that inhibit protein synth?
diptheria toxin (corneybaceria), Exotoxin A (pseudomonas), Shiga toxin, Shiga-like toxin (EHEC)
Exotoxins that increase fluid secretion?
Heat labile, heat stable, choleara toxin, edema factor.
exotoxin: heat labile?
+ cAMP = increased Cl-H20 secretion = Diarrhea (ETEC)
exotoxin: heat stabile?
+ cGMP = decreased NaCl absorption = Diarrhea (ETEC)
exotoxin: edema factor?
+ cAMP (Bacillus anthrax)
exotoxin: cholear toxin?
permanetly switches on Gs = increased Cl-H2O secretion = RICE WATER DIARRHEA!
Pertussis toxin: MOA, SX
disables Gi so it is permanetly turned on = + cAMP. SX Whooping cough
Tetanus toxin: MOA
cleaves the SNARE protein and prevents release of inhibitor toxin GABA = lock jaw
Botulism toxin: MOA
cleaves the SNARE protein and prevents release of ACh = floppy baby, flaccid paralysis.
Streptolycin O: MOA
degrades the cell membrane (lyses), Ab against it is used to dx rhuematic fever. (S. pyogenes)
Alpha toxin: MOA
degrades the phospholipid cell wall (Clostridium perfrengens = gas gangrene)
TSST-1 toxin: MOA
binds MHC to T-cell receptor ouside antigen binding site = massive release of IFN-y and IL-2. (S. aureus)
Endotoxin from what structure, and made of what?
LPS, made from the core of Lipid A
F+ plasmid: MOA?
contains genes for sex pili and congugation.
Transductin general vs. specific?
general: bacterial DNA gets packaged with viral. Specific: bacterial DNA get integrated WITH viral DNA.
Staph aureus: virulance factors?
Protein A (binds FC on Ig –prevents phagocytosis. TSST-1,
Staph epidermidis: virulance, complications?
biofilm, sticks on prosthetic devices! (heart valves, hip replacements, etc)
Strep pneumo: virulance, complications?
capsule, IgA protease. “MOPS” = meningitis, otitis media, pneumonia, sinutitis
Strep pyogenes: virulance, complications?
M protein (rhuematic fever), pharyngitis, cellulitis, impetigo, scarlet fever, glomerulonephritis, rhuemtic fever.
JONES criteria for rhuematic fever?
Joints (arthritis), carditis, Nodules (sub-q), Erythema marginatum, Sydenhams chorea
Strep agalactae (group B): SX
B for BABIES! Colonizes vagina if mother is infected, passes to baby during delivery. SX: meningitis, pneumonia, septicemia
Strep bovis? SX
bacteremia, endocarditis…. Bovis in blood = cancer in the colon!
Corneybacterium diptheria: gram, MOA, SX
gram +, EF2 block protein synth = cell death. SX: pseudomembranous pharyngitis, lymphadenopathy, bull neck, myocarditis.
Spore forming bugs?
Bacillus, Clostridium, Coxciella bunetti
Clostridum perfrengens: gram, MOA, SX
gram +, alpha toxin (lecithinase). SX: gas gangrene
C. diff: gram, toxin, SX
gram +, toxin A,B. SX: diarrhea MOA: overgrowth due to antibiotic use
Bacillus cereus: gram, MOA, SX
gram +, MOA: spores in warm RICE. SX: N/V diarrhea in 1-5 hours!!!!
Listeria: MOA, SX
gram +, toxin on deli meat/cheese. SX: diarrhea, spontaneous abortion, neonatal meningitis.
Actinomyces israeli: DX, SX
gram +, normal oral flora, “yellow sulfur granules”. SX: facial absecess
Nocardia: DX, SX
acid fast. SX: pulmonary infection in immuno compromised
Mycobacterium TB: DX, MOA
DX acid fast (gram -), mycolic acid in the cell wall. MOA: Cord factor: inhibits macrophage, Sulfatides: inhibit lysosom-phagosome fusion.
Mycobacterium TB: SX
1’: lung infection. 2’ re-infection: night sweats, fever, hempotysis (blood sputum).
Identifying diagnostic characteristics of TB?
1’ Ghon complex (ghon focus + hilar lymphadenopathy). 2’ caseating granulomas in apex (usuall)
Complication of systemic TB?
Pott’s disease (infects vertebrae)
Mycobacteria leprae: DX
acid fast rod. Armadillo is the reservoir
N. Meningitis: DX, SX
DX: gram -, diplococci, ferments maltose & glucose, Chocolate & blood agar. SX: meningitis, waterhouse-fridricksen syndrome.
Waterhouse freidricksen syndrome? CX, SX
CX: N. meningitis SX: massive adrenal hemorrhage (damages renal gland), hypotension. DIC can occur too.
N. gonorrhea: DX, SX
DX: gram -, diploccci, ferments glucose, chocolate agar. SX: gonorrhea, arthritis, neo-natal conjunctivitis, PID, Fitz-Hugh-Curtis synd.
Fitz-Hugh-Curtis syndrome?
thinning of the cervix allows vaginal bacteria to spread into the uterus and oviduct, can scar tissu on Glisons capsule.
H. influenza: DX, SX
DX: gram - pleomorphic cocci, chocolate agar. SX: “EMOP”: epiglotitis, meningitis, otitis media, pheumonia.
H. influenza: MOA
IgA protease, Type B has a capsule. Spreads via aerosol droplets.
Legionella pneumophilia: DX, SX
DX: buffered charcoal agar w/ cysteine, iron. SX: severe pneumonia. TXN: contaminated water
Pseudomonas aureginosa: DX, SX
DX: gram - rod, oxidase +. SX: “PSEUDO”, burn pts. Pneumonia, Sepeis, External otitis, UTI, Drug use Disbetic Osteomyelitis.
Pseudomonas aureginosa: MOA
endotoxin A (EF2) stops protein synth
E. Coli: DX subtypes
gram - rod, lactose +, indole +. Subtypes: EIEC, ETEC, EPEC, EHEC
EIEC: moa
invades inestinal mucosa = bloody diarrhea (I= invasive)
ETEC: moa
labile (+ cAMP), stabile (+ cGMP) toxins = diarrhea
EPEC: moa
adheres to intestinal villi and flatens them = H20 not absorbed = diarrhea. (P= pediatric)
EHEC: TXN, MOA
TXN: undercooked beef/pork. MOA: shiga like toxin = bloody diarrhea (inactivates 60s ribosome, GI mucosa damage)
Klebsiella: DX, MOA
DX: gram - rod, lactose +, indole -. SX: bloody ‘currant jelly’ sputum. Lobar penumonia due to aspiration. Usually seen in elderly and alcoholics.
Salmonella: DX, MOA
DX: gram - rod, lactose -, oxidase -, H2S +. Flagella (salmon swim!), invades intestinal mucosa = bloody diarrhea
Shigella: DX, MOA
DX: gram - rod, lactose -, oxidase -H2S -. Invades intestinal mucosa = bloody diarrhea
Campylobacter jejuni: DX, MOA
DX: gram - comma shaped, oxidase +. Stable at high temps (42C, 107F), TXN: undercooked beef/chicken = bloody diarrhea.
Vibrio cholorea: DX, MOA
DX: gram -, oxidase +. MOA: Gs + cAMP = RICE water diarrhea!
Which are the spirochetes bugs?
Boriella, Leptospira, Treponema
Boreiella burgdorferi: SX, TXN
SX: lyme disease bull’e eye rash. TXN: Ixodes tick. Reservoir = mouse
Treponema pallidum: SX
shyphillus. SX: 1’ painless ulcer. 2’ systemic rash on palms and soles. 3’ gumma, aortitis, neurosyphillus, argyl robertson pupil (prostitutes)
Congenital syphillus: SX, DX
hutchinson teeth, saber shins, sadle nose, CN-8 deafness. VDRL, ELISA confirmatory
Q-fever: CX
coxciella burnetti: cattle/sheep placenta
Parrot fever: CX
Chlamydophilis psittaci
Pasturella multocids: SX
animal bites = cellulitis, osteomyelitis
Ricketsia prosasaki: SX
epidemic typhus (louse): rash starts on trunk and spreads outward.
ricketsia ricketsii: SX
Rky Mtn spotted fever: starts on periphery and spreads toward trunk.
yersenia pestis: SX
plague
Gardenilla vaginalis: SX
gray discharge, fish odor, clue cells (epithelial cells covered in bacteria). “I don’t have a CLUE why I smell FISH in the vagina GARDEN.”
Chlaymidia: infection, replication cycle
elementary bodies = infectious. Reticular bodies = replicating
Chlaymidia: SX
reactive arthritis, conjunctivitis, urethritis
Mycoplasma pneumonia: DX, SX
DX: cold agglutinin (IgM), gram - (no cell wall). SX: #1 cause of ATYPICAL pneumonia: slow onset, no sputum.
Histoplasmosis: TXN, MX
TXN: Mississippi, Ohio river valleys. From: bird/bat dropings. MX: histo hides IN the macrophages.
Blastomycosis: DX, Location, SX
“broad base budding yeast”. East of Mississippi. SX: granulomatous nodules 70% lung infections.
Coccidiodomycosis: Location, DX, SX
SW U.S. (san juaquin valley california). DX: spherule full of endospores. SX: pneumonia, meningitis
Paracoccidiomycosis: location, DX
S. America. DX: captain’s wheel.
Tinea versicolor: CX, DX
CX: Malasezia furfur. DX: spaghetti and meatballs on KOH prep. SX: hypo pigmentation.
Candida: who, SX?
who: immuno compromised. SX: ortal, esophageal thrush, vulvovaginalis, diaper rash.
Aspergillus: who, DX
who: immuno compromised, chronic granulomatous disease, can get in lung cavity fromTB pt. DX: hyphae that branch at 45’. A= aspergillus, acute angle
Cryptococcus: DX, TXN
DX: encapsulated yeast (it’s in a crypt), stains w/ India ink. TXN: pigeon poop
Pneumocystis jerovecii: who, SX
who: immuno compromise (AIDS) <200 CD4. SX: interstitial pneumonia (diffuse infiltrates on x-ray)
Sporothrix schneckii: TXN, SX
TXN: “rose gardner’s thumb. SX: ulceration with ascending lymphedema.
Giardia: TXN
contaminated water (beavers in the water)
Giardia: DX
trophotoite or cyst in the stool
Giardia: SX
very foul, greasy stool
Entamoeba: TXN
water
Entamoeba: SX
bloody diarrhea, liver abscess
Entamoeba: DX
multi-nucleate cyst in stool
Cryptosporidium: TXN
contaminated water
Cryptosporidium: DX
acit fast cysts
Cryptosporidium: SX
diarrhea, especially in AIDS pts
Toxoplamsosis: DX
ring shaped lesions on CT scan
Toxoplasmosis: SX
intracranial calcifications, hydrocephalus, retinitis
Toxoplasmosis: TXN
cat poop
Trypanisoma brucei: TXN
Tsttse fly.
Trypanosoma brucei: SX
“African sleeping sickness” coma, somnolence
Plasmodium Vivax: SX
regular fever patterns: 1 and 3 days, dormant form “hypnozoite” in the liver. DX: signet ring shape
Plasmodium falciparum: SX
irregular fever patterns, DX: parasites in RBC
Babesia: CX, DX, SX
CX: Ixodes tick DX: blood smear, ring, maltese cross. SX: fever, hemolytic anemia
Trypanosoma cruzi: CX, DX, SX
CX: kissing bug “Chagas disease” DX: 2 forms: Trypomastigote in the blood (t in b), Amastigote in the tissue, this is what causes tissue death. SX: C’s: children, chagoma, cardiac, colon, cruzi
Leishmannia brazilinsis: SX
SX: mucocutaneous (kid with massive face cavity)
Leishmania donovani: SX
SX: black skin, hepato/spleno megaly
Leishmania: CX, DX
CX: sand fly DX: macrophage containing amastigotes
Trichomonas vaginalis: DX, SX
DX: green vaingal discharge, foul smelling. SX: burn, itchy, stingy TXN: sexual
Wucheria bancrofti: TXN, SX
TXN: female mosquito SX: elaphantitis (big balls!) MOA: block lymph vessels
Enterobius vermicularis: TXN, DX, SX
TXN: fecal-oral. DX: scotch tape test SX: peri-anal itching
Taenia Solium: TXN, SX
TXN: pork tape worm = undercooked pork. SX: cysticercosis, neurocysticercosis
Diphyllobotherum latum: TXN, SX
TXN: raw fresh water fish. SX: anemia, the worm takes most of the Vit B12
Schistasoma: TXN, SX
TXN: enter through the skin. SX: liver and spleen granulomas
Schistasoma haematobrium: SX?
bladder cancer
Chlonorchis sinensis: TXN, SX
TXN: undercooked fish. SX: pigmented gallstones
Paragonimus westermani: TXN, SX
TXN: undercooked crab SX: lung infection w/ hemoptysis
Schistosoma mansoni: SX
portal hypertension
AIDS CD4 <500
candida, kaposi
AIDS CD4 <200
pneumocystis jerovecii, histoplasmosis
AIDS CD4 <100
Toxoplasmosis, Cryptosporidosis, cryptococcus
AIDA CD4 <50
Mycbacterium avium complex (MAC), and CMV
Non-typical pneumonia is caused by?
MLS: Mycoplasma pneumonia, Legionella, Chlamydia pneumonia
Meningitis in babies: CX
group B strep (strep agalactae)
Meningitis #1 cause in everyone (not babies, not teens)?
Strep pneumonia
meningitis #1 cause in teens?
Neisseria meningitis
CSF findings for bacterial infection?
increased PMN, increased protein, decreased glucose
CSF findings for viral infection?
increased lymphocytes, normal protein, normal glucose
Genetic drift causes?
epidemic
Genetic shift causes?
pandemic
Rubella rash?
starts on upper TRUNK and spreads down
Rubella AKA?
german measles
Rubella SX?
trunkal rash that starts at head and moves down.
Rubella congenital?
cataract, cardiact, deafness
Measles rash?
rash starts at head and moves down, including HANDS and FEET! C’s: cough, conjunctivits, coryza, koplick spots, photophobia
Diptheria toxin: MOA, SX
EF2 which blocks protein synthesis (exotoxin A is also EF2). SX: bull neck, psudomembranous pharyngitis
Exotoxin A?
EF2 which blocks protein synthesis (diptheria toxin is also EF2).
Shiga toxin? CX, SX
CX: Shigella DX: inactivates 60s in Gi = Bloody Diarrhea!
Tetanospasmin toxin?
cleaves the SNARE protein and prevents release of GABA (which inhibits muscle tone), thus you get “lock jaw”
Shiga-like toxin? MOA, CX, SX
MOA: permanetly switches on Gs = + cAMP = increased Cl-H20 excretion = RICE WATER diarrhea!
