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LAST EXAMMMMMM Year I > micro- Gram- bacteria > Flashcards

micro- Gram- bacteria Flashcards

1
Q

What are the virulence factors of N meningitidis

A 
polysaccharide capsule that is antiphagocytic
Endotoxin- LPS
IgA1 protease
ability to extract iron form transferrin
Pili
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2
Q

how many capsule serotypes are there for N meningitides? which ones causes menigitis

A

13

meningitis- A B and C

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3
Q

what results from meningococcal release of endotoxin

A

hemorrhage as petechiae on the skin and sepsis

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4
Q

What is IgA1 protease- N meningitidis

A

only found in pathogenic and cleaves IgA in half

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5
Q

What are the high-risk groups for N meningitidis

A

infants 6 mo- 2 yr
army recruits
college freshman

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6
Q

what is the clinical key to knowing that there is invasive meningococcal infection

A

petechial rash

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7
Q

What is the presentation of meningococcemia

A

spiking fevers, chills, arthralgia, muscle pains and petechial rash

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8
Q

What is Fulminant meningococcemia

A 
Waterhouse-Friederichsen syndrome
septic shock
b/l hemorrhage to adrenal glands
rapid hypotension and tachycardia
DIC and coma may develop
death 6-8 hrs
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9
Q

What are the signs of meningitis in an infant

A

lethargy, fever, vomiting

sometimes a buldging open anterior fontanelle

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10
Q

What bacteria are responsible for meningitis in an infant less than 3 mo

A

E coli, L monocytogenes, Group B strep

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11
Q

What are the culprits for meningitis in older infants

A

H influenza

N meningitidis

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12
Q

What is the agar used to grow Neisseria

A

Thayer-martin VCN chocolate agar
V- vancyomycin (kills gram +)
C- colistin that kills gram- not Neisseria
N- Nystatin kills fungi

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13
Q

how do you differentiate between the neisseria species

A

meningitidis can produce acid from latose but gonorrhea cannot

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14
Q

What are the two most common STDs

A

1 chlamydia

2 Gonorrhea

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15
Q

What are the virulence factors of gonococcal infections

A

Pili
outer membrane protein porin
Opa proteins

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16
Q

What is the role of pili on N gonorrhea

A

not only help for adhesion but able for antigenic variation to escape phagocytosis

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17
Q

what is the role of outer membrane protein porin in N gornorrhea

A

promote invasion into cell

Por A and B- used to be PorI

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18
Q

What is the role of Opa proteins in N gonorrhea

A

promote adherence and invasion of epithelial cells

result in opaque colonies

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19
Q

Where does the gonococci multiply

A

in the endocytotic vacuoles

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20
Q

What can gonorrhea cause in men

A

urethritis

epididymitis, prostatis and urethral strictures

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21
Q

Describe gonorrhea in women

A

usually asymptomatic, sometimes urethritis
infects columnar epithelium of cervix
can progress to PID

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22
Q

What is PID

A

infection of uterus-endometriosis, fallopian tubes- salpingitis and or ovaries- oophoritis

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23
Q

What is the presentation of PID

A

fever, lower abdominal pain, abnormal menstrual bleeding and cervical motion tenderness

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24
Q

What are the complications with PID

A

sterility, ectopic pregnancy, absecess, peritonitis, peri-hepatisis(fitz-hugh-curtis syndrome)

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25
Q

what is the mechanism behind sterility caused by STDs

A

scarring of the fallopian tubes

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26
Q

what is Fitz-hugh-curtis syndrome

A

from N gonorrhea

inflames capsule around liver causing RUQ pain and tenderness

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27
Q

What is gonococcal bacteremia

A

invasion of blood stream
fever, joint pain, skin lesions
sometimes pericarditis, endocarditis and meningitis

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28
Q

Describe the presentation of septic arthritis in a gonorrhea infection

A

acute onset fever with pain and swelling in 1 or 2 joints

progressive destruction of the joint

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29
Q

What do you order to confirm gonococcal septic arthritis

A

examination of synovial fluid for incWBC, gram stain and culture

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30
Q

What is the most common kind of septic arthritis in young, sexually active inidividuals

A

N gonorrhea

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31
Q

If a pregnant mother transmits gonorrhea to child during birth what is presentation

A

ophthalmia neonatorum so give erythromycin in eyes

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32
Q

What diseases does Moraxella catarrhalis cause

A

otitis media and URI in patients with COPD or emphysema or in elderly

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33
Q

What is otitis media and 3 top culprits

A 
middle ear infection
80% children by age 3
Strep pneumoniae
H influenza
Moraxella catarrhalis
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34
Q

A COPD patient with worsening wheezing SOB and cough can be assoc with what

A

new strain H influenza or Moraxella catarrhalis

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35
Q

What can kingella kingae cause

A

septic arthritis and osteomyelitis in children

endocarditis of native and prosthetic valves in children and adults

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36
Q

What are the slow growing gram - pathogens that cause endocarditis

A 
Haemophilus spp
Actinobacillus spp
Cardiobacterium spp
Eikenella spp
Kingella spp
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37
Q

Describe morphology of Neisseria meningitidis

A

diplococci gram -
facultative anaerobe
high Co2 environment
ferment maltose

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38
Q

describe morphology of N gonorrhea

A

diplococci gram -
facultative anaerobe
high CO2
can only ferment glucose

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39
Q

What is Moraxella catarrhalis Resistant to

A

penicillins

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40
Q

What enteric bacteria canNOT ferment lactose

A

Salmonella, Shigella and Pseudomonas

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41
Q

What type of agar are used to grow enteric bacteria

A

EMB and MacConkey

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42
Q

describe EMD agar

A

methylene blue inhibits gram + and the lactose fermenters become deep purple to black
E coli become metallic green

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43
Q

Describe macconkey agar

A

inhibit gram + and lactose fermenters are pink/purple

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44
Q

What are the 3 major surface Ag on enteric bacteria

A

O Ag- outside LPS
K Ag- capsule over O Ag
H Ag- antigenic determinant making up subunits of flagella

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45
Q

What enteric does not have H Ag

A

shigella- because not mobile

Klebsiella penumoniae

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46
Q

What type of diseases are caused by enteric bacteria

A

diarrhea and UTI, pneumonia, bacteremia and sepsis

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47
Q

What is diarrhea without invasion

A

enterotoxins causing electrolyte and fluid loss from intestinal epithelial cells or epithelial cell death
watery diarrhea without systemic systems

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48
Q

What are enteric bacteria that invade intestinal epithelial cells

A

E coli, Shigella and salmonella

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49
Q

What does is a key clinical sign to an enteric that invades intestinal epithelial cells

A

bloody stool

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50
Q

What are the symptoms of an enteric bacteria that invades the lymph nodes and blood

A

abdominal parin and diarrhea containing WBC and RBC

deeper invasion has fever, headache and WBC

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51
Q

What are the enteric bacteria that invade lymph nodes and blood

A

salmonella typhi, yersinia enterocoitica and campylobacter jejuni

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52
Q

What are the common hospital acquired gram - enterics

A

E coli, Klebsiella pneumoniae, Proteus mirabilis, Enterobacter, Serratia and Pseudomonas aeruginosa

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53
Q

What are the virulence factors that make E coli pathogenic

A

Mucosal accumulation of pili and ability to invade epithelial cells
Exotoxin production of heat labile and stable toxins, also shiva-like toxin
Endotoxin- Lipid A
iron binding siderophore which takes iron from transferrin or lactoferrin

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54
Q

What diseases can E coli cause

A

diarrhea, UTI, neonatal meningitis, gram - sepsis

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55
Q

Describe the presentation of Enterotoxigenic E coli

A

inhibit reabsorption of NaCl and stimulate secretion Cl and HCO3- leading to severe watery diarrhea
looks like rice water- cholera

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56
Q

Describe presentation of Enterohemorrhagic E coli

A

secrete shiga-like toxin that inhibit 60s ribosome

bloody diarrhea with severe abdominal cramps called hemorrhagic colitis

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57
Q

Describe Hemolytic uremic syndrome from E coli

A

anemia, thrombocytopenia and renal failure is assoc with strain EHEC 0157:H7
cattle may be the reservoir- hamburgers

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58
Q

Describe Enteroinvasive E coli EIEC

A

has ability to invade epithelial cells
fever
WBC invade intestinal wall and the diarrhea is bloody with WBC

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59
Q

What allows E coli to causes UTI and cystitis possible higher up causing pyelonephritis

A

the pili virulence factor

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60
Q

What is the most common cause of gram - sepsis? second to most?

A

E coli

Klebsiella penumoniae

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61
Q

Which type of patient is prone to klebsiella penumonia

A

hospital patients and alcoholics

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62
Q

What is kelbsiella pneumoniae pneumonia look like

A

bloody sputum

destroys lung tissue

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63
Q

What are the cross reacting Ag of Proteus and Ricketssia

A

OX2 OX19 OX-K

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64
Q

What is the presentation of Proteus UTI

A

urine is alkaline from the ability to split urea into NH3 and CO2

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65
Q

how can you distinguish shigella from E coli and Salmonella

A

shigella does not ferment lactose or produce H2S
E coli ferments lactose
Salmonella: produces H2S, cannot ferment lactose

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66
Q

What population is prone to shigella

A

preschool and nursing homes

contaminated water of hand to hand

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67
Q

What is presentation of shigella

A

fever abdominal pain, diarrhea with flecks of blood and pus

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68
Q

describe mechanism of shiga toxin

A

5 B subunits that bind and allow A subunit in that inactivates 60S ribosome inhibiting protein synthesis thus killing epithelial cell

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69
Q

What other virulent factor does salmonelly have instead of K Ag

A

the Vi factor which surrounds O Ag

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70
Q

What are the 3 gorups of Salmonella

A

typhi, cholerae-suis, enteritidis

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71
Q

Salmonella is most commonly acquired how in US

A

eating uncooked eggs and chickens

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72
Q

Which Salmonella is not zoonotic

A

typhi, only humans

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73
Q

What are the diseases that Salmonella causes

A

typhoid fever, carrier state, sepsis and gastroenteritis

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74
Q

What type of parasite is Salmonella

A

facultative intracellular

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75
Q

Describe presentation of typhoid fever

A

1-3 weeks post exposure including fever Ha and abdominal pain over RLQ
may have splenomegaly and diarrhea
rose spots on abdomen

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76
Q

How do you Dx salmonella typhi

A

culture of blood, urine or stool

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77
Q

what population is more prone to salmonella infections and why

A

asplenic like from sickle cell because Vi capsule is opsonized then taken to spleen because macrophages and neutrophils phagocytose opsonized bacteria

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78
Q

Patients with sickel cell anemia with salmonella are at high risk for what

A

osteomyelitis

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79
Q

what does diarrhea from salmonella look like

A

usually just watery

sometime mucus or blood but rare

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80
Q

What is the presentation of yersinia enterocolitica

A

fever, diarrhea, abdominal pain in RLQ

terminal ileum usually has mucosal ulceration

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81
Q

what is the shape of V cholera

A

curved gram - rod with single polar flagellum

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82
Q

What toxin does V cholera release

A

choleragen

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83
Q

What is the presentation of V cholera

A

watery diarrhea like rice water
Shock from isotonic fluid loss will occur if not rehydrated
diminished pulses, sunken eyes and poor skin turgor

84
Q

Describe mech of choleragen

A

5 B subunits attached to GM1 ganglioside on intestinal epithelial cell allowing entry A. A will activate G protein increasing cAMP leading to active secretion Na Cl and inhibition of Na and Cl resorption

85
Q

What will the stool look like in V cholera

A

no WBC but many curved rods with fast darting movements

86
Q

What is the leading cause of diarrhea in japan

A

Vibrio parahaemolyticus

87
Q

What are the most common causes of diarrhea in the world

A

Campylobacter jejuni, ETEC and Rotavirus

88
Q

what is the presentation of Campylobacter jejuni

A

bloody loose diarrhea

89
Q

What toxin does campylobacter jejnui release

A

LT toxin similar to that of E coli and a cytotoxin that kills mucosal cells

90
Q

What is the most common cause of duodenal ulcers? second?

A

Helicobacter pylori

aspirin

91
Q

What are the 2 leading causes of stomach ulcers (gastric)

A

1 is aspirin

2 is helicobacter pylori

92
Q

99% of our flora in GI are what

A

obligate anaerobes fram - rods of the family Bacteroides

93
Q

Which gram - rod does not have lipid A

A

bacteroides fragilis

94
Q

What are risk factors to bacteroides fragilis proliferation

A

after surgery or tears in intestine or infection the bacteria will create abscesses

95
Q

what organism produces a black pigment on blood agar and involved in necrotizing anaerobic pneumonias caused by aspiration of lots of sputum

A

Bacteroides melaninogenicus

96
Q

What can Fusobacterium cause

A

aspiration peneumonia
abdominal and pelvic abscesses
otitis media

97
Q

What are the anaerobic gram + cocci that are normally in our flora of mouth, vagina and intestine

A

peptpstreptococcus and peptococcus

98
Q

What are the most common hospital acquired infections

A

penumonia- endo-trach tubes and mechanical ventilation
UTI- foley catheters
wound infections- recent surgery and implanted devices
blood infections- intravenous and intra-arterial lines
4Ws: wind water wound wires

99
Q

What are the most common bacteria that cause hospital-acquired infections

A

E coli, Klebsiella and Enterobacter

100
Q

What 4 highly resistant bacteria are becoming popular in hospital settins

A

Pseudomonas
Acinetobacter
Stenotrophomonas
Burkholderia

101
Q

what type of pathogen is pseudomonas aeruginosa

A 
obligate aerobe that doesN't ferment lactose
gram - rod
produces green (pyoverdin) and blue (pyocyanin) pigments with a sweet grape-like scent
102
Q

What is the exotoxin released by P aeruginosa

A

exotoxin A that stops protein synthesis

103
Q

What are important infections caused by P aeruginosa

A 
Pneumonia
Osteomyelitis
Burn wound
Sepsis
UTI, pyelonephritis
Endocarditis
Malignant external otitis
Corneal infections
104
Q

What patients are at high risk for pseudomonas penumonia

A

CF patients and immunocompromised patients

105
Q

What type of patients are at a higher risk for osteomyelitis due to pseudomonas infection

A

DM patients with ulcers

IV drug abusers in their vertebrae and clavicles

106
Q

What type of endocarditis is pseudomonas responsible for

A

usually right heart valve

107
Q

where is malignant external otitis seen with pseudomonas

A

in the mastoid bone

usually DM patients

108
Q

What is the BEPSEUDO pneumonic

A 
Burns
Endocarditis
Pneumonia
Sepsis
External malignant otitis media
UTI
Diabetic Osteomyelitis
109
Q

What population is at greatest risk for Burkholderia cepacia infection

A

CF

110
Q

What type of pathogen is Acinebacter and what does it commonly cause

A

aerobic gram - common cause hospital pneumonia, burn infections and foley catheter-assoc UTI

111
Q

What are Acinebacter bacteria commonly mistaken for

A

Neisseria

112
Q

What are the virulent factors of H influenza

A

has polysaccharide capsule of polyribitol ribose phosphate 6 types a-f

113
Q

What capsule of H influenza is assoc with invasive influenza in children

A

capsule b

114
Q

What do the non encapsulated(nontypeable) strains of H influenza cause in children and adults?

A

otitis media in children

respiratory disease in adults that have weakened or pre-existing lung disease

115
Q

What population is at higher risk for H influenza

A

COPD patients

children between 6 mo and 3-5yrs

116
Q

What is the most serious infection that type b H influenza can cause? presentation?

A

meningitis
fever, vomiting and altered mental status in infants
sometimes neurodefects, mental retardation and seizures

117
Q

What are the infections that H influenza type b can cause

A

meningitis, acute epiglottitis
septic arthritis
sepsis

118
Q

what does acute epiglottitis look like

A

follows a sore throat and fever
severe wheezing
salaiva drooling out
large red epiglottis looks like red cherry

119
Q

what is the most common cause septic arthritis in children between 6 mo and 3 yr

A

H influenzae

120
Q

what is common presentation of septic arthritis from H influenza

A

usually one joint

fever, pain, swelling and decreased mobility of the joint

121
Q

how does H influenza lead to sepsis

A

gets in blood from upper resp tract

122
Q

What is in the H influenza vaccine

A

polyribotol ribose phostate( the capsule of H influenza) with mutatn diphtheria toxin protein and a N meningitidis outer membrane to activate T cells and Ab production

123
Q

When is the Hib capsule vaccine given to children in the US

A

ages 2 4 6 and 15 mo

with DPT and polio vaccines

124
Q

What species is responsible for painful chancroid

A

Haemophilus ducreyi

125
Q

what is the Ddx for chancroid

A

syphilis, herpes, lympho granuloma venerum and H ducreyi

126
Q

what is lymphogranuloma venerum assoc with

A

chlamydia trachomatis

127
Q

What is a great way to Dx a genital ulcer

A

PCR multiplex that detects H ducreyi, T. palladium and herpes 1/2

128
Q

What are included in the list of slow growing bacteria that can cause endocarditis

A 
Haemophilus spp
Actinobacillus spp
cardiobacterium spp
eikenella spp
kingella spp
129
Q

a women with pruritis and burning of her labia
dysura and fishy odors
with a slide of discharge having the presence of clue cells she probably has what infection

A

gardnerella vaginalis

130
Q

what are the virulence factors of Bordetella pertussis

A

pertussis toxin
extra cytoplasmic adenlyate cyclase
filamentous hemagglutinin
tracheal cytotoxin

131
Q

what is the mech of pertussis toxin

A

B subunit that binds and lets A in that increases cAMP causing histamine sensitization, increase insulin synthesis and promotion of lymphocyte production and inhibition of phagocytosis

132
Q

what is the role of B pertussis extra cytoplasmic adenylate cyclase

A

increase cAMP in neutrophils lymphocytes and monocytes impariing chemotaxis and impaired generation of H2O2 and superoxide

133
Q

What is the role of B pertussis filamentous hemagglutinin FHA

A

pili rod extending from bacterial surface involved in its binding

134
Q

what is the role of B pertussis tracheal ctyotoxin

A

destroys epithelial cells causing the violent cough

135
Q

How long is the incubation period for whooping cough and what are the 3 stages

A

1 week uncubation
Catarrhal stage
paroxysmal stage
convalescent stage

136
Q

Describe the catarrhal stage of whooping cough

A

1-2 weeks
low grade fevers, runny nose, sneezing and mild cough
most contagious during this stage

137
Q

describe the presentation of the paroxysmal stage of whooping cough

A

no fever
bursts of nonreproductive coughs
5-20 forceful coughs followed by inspiratory gasp through narrowed glottis sounds like a whoop
lasts a month or longer

138
Q

what will the WBC count look like in B pertussis infection

A

increased lymphocyte count with just a modest increase in neutrophils

139
Q

What is the convalescent stage of whooping cough

A

attacks are less frequent and patient is no longer contagious

140
Q

what type of swab and agar is used for B pertussis

A

calcium alginate swab

Bordet- gengou medium

141
Q

how do hospitals identify B pertussis

A

ELISA serological tests and PCR assays

142
Q

What is the primary Tx for B pertussis

A

supportive

sometimes erythromycin

143
Q

When is TDaP given

A

2 4 6 15-18 mo 4-6 yrs

144
Q

When is Tdap given

A

19-64 yrs booster

145
Q

What type of organism is legionella pneuomophila

A

aerobic gram - rod
facultative intracellular parasite for amoebas
can survive in biofilm

146
Q

where is legionella primarily found as the source of infection

A

that is ubiquitous in natural and man-made water environments
Air conditioning units!

147
Q

What are the two manifestations of legionella

A

Pontiac fever

Legionnaires disease

148
Q

Descibe presentation of pontiac fever

A

HA, muscle aches, fatigue with fever and chills

strikes suddenly and lasts a week

149
Q

describe legionnaires disease

A

high fevers and severe pneumonia

150
Q

What is the presentation of pneumonia caused by legionella

A

lobar consolidative pneumonia that can be hard to differentiate from pneumococcal pneumonia

has fever with pulse-temperature dissociation (high fever and low HR) severe HA, confusion, myalgia and sometimes with rhabdomyolysis detected by increased serum CPK and myoglobinuria, cough, hyponatremia, hypophosphatemia, and elevated AST ALT alkaline phosphatase, LDH

151
Q

What is common in Yersinia, Francisella, brucella and pasteurella

A

they are all gram - rods

all are zoonotic

152
Q

What type of Dx testing would you do to confirm previous infection of yersinia, francisela or burcells

A

intradermal skin testing and DTH

153
Q

What is Yersinia pestis known to cause

A

bubonic plague

154
Q

What virulence factors does yersinia pestis have

A

F1- capsular Ag with antiphagocytic properties

V and W Ag unknown actions

155
Q

Describe the staining of yersinia pestis

A

ends take up more stain than the middle

gram - rods

156
Q

Where do the yersinia pestis bacteria replicate and invade

A

replicate in macrophages that take them up then move to nearest lymph nodes (usually inguinal)

157
Q

What is the presentation of bubonic plague

A

swollen hot red painful nodes
fever and HA
hemorrhages under skin causing blackish color

158
Q

patient has been camping in Arizona and New mexico how presents with fever what would you start to suspect

A

bubonic plague

159
Q

What is tularemia

A

looks like bubonic plague

from handling rabbits

160
Q

what diseases are caused from francisella tularensis

A

ulceroglandular tularemia

pneumonic tularemia

161
Q

what is the presentation of ulceroglandular tularemia

A

well demarcated hole in the skin with black base

fever local swollen lymph nodes are red and painful

162
Q

What is usually the transmission causing pneumonic tularemia

A

aersolization of bacteria during skinning and evisceration of an infected rabbit

163
Q

What are the other organs invaded by francisella tularemia

A

eyes oculoglandular tularemia

GI typhoidal tularemia

164
Q

How do you Dx francisella tularensis

A

clincal picture
skin test
measurement of titers
Not culture because extremely virulent

165
Q

How do humans acquire brucella

A

direct contact with infected animal mear, aborted placentas, ingestion of infected milk

166
Q

What is the presentation of brucella? including population seen in

A

penetrates skin, conjunctiva, lungs, or GI
fever chills, sweats, loss appetite, backache, HA and sometime lymphadenopathy
cyclical fever”undulant”
meat packin industry workers, veterinarian, farmer, traveler

167
Q

how do you Dx brucella

A

culture from blood, bone marrow liver or lymph nodes

168
Q

how do you prove active brucella infection

A

serologic examination with elevated anti-brucella Ab

169
Q

why do you not close a wound if someone comes in with a cat or dog bite

A

perfect environment for Pasteruella multocida growth invading local joints and bones

170
Q

What are shared characteristics of chlamydia and Rickettsia

A

gram neg

obligate intracell parasites because need host ATP

171
Q

What is different in energy metabolism between ricketssia and chlamydia

A

ricketssia can oxidize certain materials to create ATP though still needed from host
chlamydia has no mech for ATP production

172
Q

where does chlamydia like to inhabit

A

columnar epithelial cells that line mucous membranes

173
Q

What types of infections does chlamydia cause

A

conjunctivitis, cervicitis and pneumonia

174
Q

What are the two forms of chlamydia

A

Elementary body that does not divide but attaches and enters columnar epithelial cells and inhibits phagolysosomal fusion in endosome then can transfrom into IB
Initial Body “reticulate” inhibits phagolysosome fusion and grows then binary fission

175
Q

What are the 3 types of chlamydia

A

trachomatis, psittaci and pneumonia

176
Q

where does C trachomatis primarily infect

A

eyes and genitals

177
Q

what is the leading cause of preventable blindness

A

C trachomatis

178
Q

describe the conjunctival infection from C trachomatis

A

inflammation and scarring

scar tractino pulls folds of eyelids inward

179
Q

What is inclusion conjunctivits and when is it seen

A

inflammation with purulent yellow discharge and swelling of eyelids
seen after birth 5-14 days

180
Q

How do you Dx inclusion conjunctivits from C trachoma tis

A

basophilic intracytoplasmic inclusion bodies from scrapings of palpebral conjunctival surface

181
Q

describe infant pneumonia from chlamydia

A

4-11 weeks of life

upper respiratory symptoms followed by rapid breathing, cough and respiratory distress

182
Q

How do you Dx infant pneumonia from chlamydia

A

clinically

later confirmed by presence of anti-chlamydial IgM Ab

183
Q

what are the primary infections causing Non gonococcal urethritis

A

chlaymdia and ureaplasma urealyticum

184
Q

Why does chlamydia not respond to penicillin

A

has no peptigoglycan

185
Q

What is indicative of NGU on gram stain

A

polymorphonuclear leukocytes but no intracell or extracell gram - diplococcie

186
Q

What is the preferred Dx test for differntiating gnorrhea and chlamydia

A

nucleic acid amplification test like PCR on an endocervical swab or urine sample

187
Q

What is super dangerous about untreated chlamydia

A

an lead to infertility from untreated PID

188
Q

What is the clinical presentation of male chlamydia

A

epidiymitis with unilateral scrotal swelling, tenderness and pain assoc with fever

189
Q

Wat Reiters sydnme and what is it assoc wit

A

inflammation arthritis of large joints in men btwn ages 20-40
inflammation eyes and urethritis
C trachomatis

190
Q

What serotypes of C trachomatis cause lymphogranuloma venereum? presentation?

A

L1L2L3
painless papule or ulceration on genitals that heals spontaneously
migrate to regional lymph nodes which become tender and may break open and drain pus

191
Q

What can be transmitted by working with pigeons, veterinarians and wooers at pet shops?
presentation

A

Chalmydophila psittaci

atypical pneumonia psittacosis 1-3 weeks after exposure

192
Q

What type of cells does Rickettsia like to invade

A

endothelial cells that line blood vessels

193
Q

What Ag does Ricketssia share with Proteus Vulgaris

A

Ox2 OX19 OX-K

194
Q

What is the weil-felix test

A

reaction to use Ag cross reacting with P vulgaris to Dx rickettsial infection
Agglutination is + test

195
Q

Describe presentation of Ricketssia ricketsii or RM spotted feer

A

within a week from a tick bite
fever conjunctival redness, severe headache and a rash that is on wrists, ankles soles and palms that spreads to trunk
resolves in 3 233k but can lead to death

196
Q

What does rickettsial akari cause

A

tickettsial pox
from house mice mites
febrile with localized red skin papule that turns into a vesicle

197
Q

What is an endemic

A

infectious disease that exists constantly thorughout a population

198
Q

What is an epidemic

A

sudden onset and rapid spread of infection that affects large proportion of population

199
Q

What spcies of Rickettsia cause typhus

A

Rickettsia prowazekii causes epidemic

Rickettsia typhi causes endemic

200
Q

Presentation of epidemic typhus from Rickettsia prowazekii

A

abrubt onset fever and HA with 2 week incuvation period
small pink macules on upper trunk and cover body
not on palms and face
flying squirrels are vectors a lot. or lice

201
Q

What is Brill Zinsser Disease

A

latent Rickettsia prowazekii with milder symptoms

detect with high IgG for the bacteria

202
Q

presentation of endemic thyphus from Rickettsia typhi

A

10 day incubation from rat flea

fever, HA and flat rash

203
Q

describe trench fever and what is the bacteria that causes it

A

Bartonella quintana
high fevers, rash, HA and severe back and leg pains
relapse 5 days later

204
Q

What bacteria causes cat scratch disease

A

Bartonella henselae

205
Q

What is the rickettsial disease that causes pneumonia and its presentation

A 
Coxiella burnetti Q fever
abrupt fever with soaking sweats 2-3 weeks after infection
also have pneumonia
 NO rash
transmitted from ticks and cattle

LAST EXAMMMMMM Year I (24 decks)

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