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MicroB Flashcards

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1
Q

what bacterials grow as diplococci?

A
  • strep pneumoniae (gram pos cocci)

- Neisseria spp. (gram neg cocci)

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2
Q

out of all the streps, which is the one that is not part of normal flora

A

strep pneumo (group A)

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3
Q

out of all the staphs, which is the coagulase positive one?

A

staph aureus - it is the only coagulase positive staph

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4
Q

are all the staphs part of normal flora?

A

yes! staph aureus found in anterior nares of 30% of people; staph saprophytic found part of vagina

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5
Q

what is a group A beta haemolytic gram pos cocci?

A

strep pyogenes

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6
Q

what type of haemolytic bacteria is strep pneumonia?

A

alpha haemolytic

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7
Q

what is the test for alpha haemolytic bacteria?

A

green tinge on blood agar

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8
Q

what is the virulence for strep pneumo?

A

anti-phagocytic capsule with pneumolysin

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9
Q

what can strep pneumo cause?

A 
Young: otitis media and URTI
Enter: endocarditis
P: pneumonia
M: meningitis
S: septicemia
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10
Q

how to test for strep pneumo?

A

culture, gram stain, urine antigen test

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11
Q

how to treat strep pneumo?

A

benzylpenicillin or ceftriaxone if meningitis

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12
Q

is there a vaccine for strep pneumo?

A

yes - the pneumococcal vaccine which is a conjugated vaccine (compulsory for kids in sg)

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13
Q

what can strep viridans cause?

A

subacute endocarditis secondary to septicemia

dental caries

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14
Q

what type of haemolytic bacteria is strep viridans?

A

alpha haemolytic (like strep pneumo)

it is a group A alpha haemolytic cocci

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15
Q

what type of hemolytic bacteria is strep pyogenes?

A

beta haemolytic

it is the only group A beta haemolytic bacteria

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16
Q

what does it mean to be beta haemolytic?

A

leaves a yellow tinge after breaking down the RBC on blood agar

VS alpha haemolytic which leaves a green stain

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17
Q

what is the virulence of strep pyogenes?

A

streptolysin O and M protein

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18
Q

what can strep pyogenes cause?

A

P: pharyngitis with sequelae of acute rheumatic fever

S: skin and soft tissue infections (e.g. scalded skin syndrome, erysipelas, bullies impetigo)

S: Scarlett fever

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19
Q

how to treat strep pyogenes?

A

benzylpenicillin

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20
Q

what is an example of group B strep?

A

strep agalactiae

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21
Q

what type of haemolytic bacteria is strep agalactiae?

A

beta haemolytic

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22
Q

what is special about strep agalactiae?

A

there is vaginal carriage in 30% of women, 30% of the time

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23
Q

why is the 30%/30% thing special about strep agalactiae?

A

it means it is not persistent and can be cleared by antibiotics

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24
Q

what is the treatment of strep agalactiae?

A

benzylpenicillin

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25
Q

what is a group D strep?

A

enterococcus spp.

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26
Q

is enterococcus part of the normal flora?

A

yes, its part of the GIT

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27
Q

what are the presentations of enterococcus?

A

E: endocarditis

N: nosocomial infections

U: UTI

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28
Q

how to treat enterococcus? (note that its a special gram pos cocci)

A

any beta lactam that is not cephalosporin

or vancomycin

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29
Q

how does staph aureus grow?

A

yellow clusters on blood agar

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30
Q

what is the virulence of staph aureus?

A
  • alpha toxin
  • toxic shock syndrome -1 toxin
  • enterotoxin
  • epidermolytic toxins
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31
Q

what does staph aureus cause?

A

mnemonic: it’s dangerous so must SET BP Fast

S: skin and soft tissue infections
E: endocarditis
T: toxic shock syndrome

B: bone infections
P: pneumonia secondary to influenza

Fast: food poisoning

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32
Q

how to treat staph aureus?

A

cloxacillin or 5th gen cephalosporin (ceftaroline)

vancomycin for MRSA

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33
Q

what type of coagulase bacteria is staph saprophyticus?

A

coagulase negative

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34
Q

what do coagulase negative bacteria usually cause?

A

usually the ones contaminating blood cultures, prosthetics and line infections

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35
Q

what does staph sapro cause?

A

UTI in young, sexually active women

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36
Q

what type of bacteria is moraxella catarrhalis?

A

gram neg cocci

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37
Q

what does moraxella catarrhalis cause?

A

opportunistic chest infections like bronchopneumonia

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38
Q

what is special about the way Neisseria grows?

A

grows as diplococci, just like strep pneumo

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39
Q

on which medium does Neisseria grow on?

A

need charcoal medium for transport and to be grown in a Thayer-martin medium with rich CO2

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40
Q

what does Neisseria gonorrhoea cause?

A

males: acute urethritis
females: asymptomatic carriage or PID
neonates: ophthalmia neonatorum
blood: disseminated gonorrhea

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41
Q

how to treat Neisseria gonorrhoea

A

ceftriaxone

azithromycin if resistant

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42
Q

do we have prophylactic treatment for Neisseria gonorrhoea and if so, what is it?

A

silver nitrate eyedrops for neonates

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43
Q

what is special about the virulence of Neisseria meningitidis?

A

it was 4 subtypes; type A, C, Y and W135

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44
Q

what does Neisseria meningitidis present as?

A

meningitis
meningococcemia

unique: waterhouse-friderichsen syndrome (adrenal gland failure)

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45
Q

what are the general signs of meningitis?

A

fever, neck stiffness, headache, non-specific macular rash

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46
Q

what are the signs of meningicoccemia?

A

non-blanching rash which results in a positive tumbler test

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47
Q

what does a non-blanching rash mean?

A

it means there is inflammation that makes the blood vessels so leaky, that the blood has entered the epidermal layers

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48
Q

how to treat Neisseria meningitidis

A

ceftriaxone (clears throat carriage)

benzylpenicillin (does not clear throat carriage)

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49
Q

is there a vaccine for n. meningitidis?

A

yes, the meningococcal vaccine that is conjugated

compulsory for kids in sg

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50
Q

list the important gram positive rods (aerobic and anaerobic)

A 
aerobic: 
listeria monocytogenes
corynebacterium diphtheria 
bacillus cereus 
bacillus anthracis
anaerobic:
clostridium tetani 
clostridium botulinum 
clostridium difficile 
clostridium perfringens
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51
Q

list the important gram negative rods (4 main types)

A 
enterobacteriaceae:
E. coli
klebsiella 
proteus spp
shigella dysenteriae 
salmonella type
salmonella enteritidis

pseudomonads:
burkholderia pseudomallei
pseudomonas aeruginosa

vibrio:
vibrio cholerase
vibrio vulnificus

fastidious rods:
legionella pneumophila
haemophilus influenzae

52
Q

what does listeria monocytogenes cause?

A

neonatal infections

meningitis in immunocompromised

53
Q

how to treat listeria monocytogenes?

A

ampicillin

NOTE: resistant to all cephalosporins like enterococcus

54
Q

what does corynebacterium diphtheria grow on?

A

tinsdale medium and looks like Chinese characters

55
Q

what is the virulence of corynebacterium diphtheria?

A

exotoxin - diphtheria toxin

56
Q

what does corynebacterium diphtheria cause?

A

URTI
bull neck appearance
myocarditis (the cause of death)

57
Q

is there a vaccine for corynebacterium diphtheria?

A

yes there is and its compulsory for children (but you inject the bacteria without the toxin)

58
Q

what is special about the treatment about corynebacterium diphtheria?

A

use an anti-serum and not some antibiotic

59
Q

what does bacillus cereus cause?

A

food poisoning that is self-limiting

60
Q

what does bacillus anthracis cause?

A

causes anthrax which results in black ulcers all over

61
Q

how to treat bacillus anthracis?

A

benzylpenicillin

ciprofloxacin

62
Q

what is the virulence of clostridium tetani?

A

tetanoplasmin toxin - blocks the inhibitory signals of LMN

63
Q

what does clostridium tetani cause?

A

spastic paralysis

64
Q

how to treat clostridium tetani?

A

human tetanus immunoglobulin

65
Q

what is the virulence of clostridium botulinum?

A

preformed botulinum toxin that blocks the NMJ junction

66
Q

what does clostridium botulinum cause?

A

flaccid paralysis

67
Q

how to treat clostridium botulinum?

A

antiserum

68
Q

what is the virulence of clostridium difficile?

A

alpha toxin

69
Q

what does clostridium difficile cause?

A

c. diff associated colitis

70
Q

how to treat clostridium difficile?

A

metronidazole

oral vancomycin

71
Q

what is the virulence of clostridium perfringens?

A

lithicinase toxin

72
Q

what does clostridium perfringens cause?

A

gas gangrene

73
Q

how to treat clostridium perfringens?

A

penicillin

74
Q

what is special about all the clostridiums?

A

they all have toxins as virulence and the first two have special treatments

75
Q

what are the lactose fermenters of the enterobacteriaceae group?

A

E. coli and klebsiella (the only 2)

76
Q

what are the different types of e.coli?

A

ETEC: enterotoxigenic

EPEC: enteropathogenic

EHEC: enterohemorrhagic (O157) is most common

VTEC: shigatoxin-producing

UPEC: uropathogenic

77
Q

how to treat e.coli?

A

ceftriaxone, cipro, cotrimox, nitrofurantoin

78
Q

what does klebsiella spp. cause?

A

UTI, liver abscess, pneumonia (caused by klebsiella pneumoniae)

79
Q

what does proteus spp cause?

A

UTI

80
Q

what does shigella dysenteriae cause?

A

dysentry

81
Q

what does salmonella typhi cause

A

typhoid fever (this differs from typhus! which is caused of rickettsia typhi)

82
Q

what does salmonella enteritidis cause

A

common bacterial cause of gastroenteritis

83
Q

what is special about the way pseudomonas aeruginosa grows?

A

it grows green on blood agar

84
Q

what does pseudomonas aeruginosa cause?

A

contact lens keratitis

pneumonia or other nosocomial infections

85
Q

how to treat pseudomonas aeruginosa?

A

like e.coli, it is very extensive

common treatments: ceftriaxone and cipro

86
Q

what is special about the way burkholderia pseudomallei grows?

A

grows as wrinkled colonies

87
Q

what does burkholderia pseudomallei cause?

A

melioidosis: fever, pneumonia, liver abscess

88
Q

how to treat burkholderia pseudomallei?

A

D: doxycycline
C: coamox
C: cotrimox
C: chloramphenicol

89
Q

what is special about the way vibrio cholerase grows?

A

grows in yellow colonies

90
Q

what is the virulence of vibrio cholerase?

A

cholerase toxin

91
Q

what does vibrio cholerase cause?

A

cholera

the O1 type causes outbreaks

92
Q

how to treat vibrio cholerase?

A

cipro and rehydration

93
Q

what does vibrio vulnificus cause?

A

self-limiting watery diarrhea

94
Q

what does legionella pneumophila cause?

A 
pontiac fever 
legionnaires disease (non-productive pneumonia)
95
Q

how to diagnose legionella pneumophila?

A

since its a non-productive cough, can use a bronchoalveolar lavage to get sputum samples

can also get urine antigen test

96
Q

how to treat how to diagnose legionella pneumophila?

A

IV erythromycin

rmb leeeee-gionella, so eeeeee-rythromycin

97
Q

what does h. influenzae grow on?

A

chocolate agar with X and Y factors

98
Q

what is the virulence of h. influenzae

A

like strep pneumo, its capsule is the virulence factor

99
Q

what does h. influenzae cause

A

encapsulated and non-encapsulated diseases

encapsulated: meningitis, pneumonia post influenza

non-encapsulated: URTI

100
Q

how to treat h. influenzae?

A

ceftriaxone

101
Q

what are the important mycoplasma/chlamydia bacteria?

A
  • mycoplasma pneumoniae
  • chlamydia psittaci
  • chlamydia trachomatis
  • chlamydia pneumoniae
102
Q

what does m. pneumo cause?

A

“walking pneumonia” in adults = essentially atypical pneumonia

paroxysmal cough in children

103
Q

how to treat m. pneumo?

A

any protein synthesis inhibitor (TAG/MCL)

104
Q

what does c. psittaci cause?

A

atypical pneumonia

105
Q

what does c. trachomatis cause?

A

it essentially is the STD, but different variants present differently

type A-B: trachoma (eye blindness)

type D-K: inflammatory diseases such as urethritis

type L1-L3: genital warts

106
Q

what does c. pneumoniae cause?

A

atypical pneumonia

107
Q

what are the important intracellular obligate parasites?

A

just rickettsia, so there’s:

  • rickettsia typhi
  • rickettsia rickettsii
  • rickettsia prowazeki
108
Q

what does rickettsia typhi cause?

A

typhus (different from typhoid fever caused by salmonella typhi)

109
Q

what does rickettsia prowazeki cause?

A

typhus too (abdominal pain, fever, headache, general malaise)

110
Q

what does rickettsia rickettsii cause?

A

Rocky Mountain fever + centripetal rash

111
Q

what are the important spiral bacteria?

A
  • treponema pallidum
  • helicobacter pylori
  • campylobacter jejuni
112
Q

what does treponema pallidum cause? (consider its various stages - primary, secondary, late stage, latent, neonatal)

A

essentially syphilis

primary syphilis: chancres and enlarged lymph nodes

secondary syphilis: mucous tracks, acute meningitis, rash on palms and soles

late stage: neurosyphilis and gummatous syphilis

latent: asymptomatic with some flares
neonatal: hutchinson’s triad (eye blindness, deafness, teeth malformation)

113
Q

how to diagnose treponema pallidum?

A
  • dark illumination
  • non-treponema antibody test (tp hemagglutinin test + tp particle agglutinin test)
  • treponemal antibody test (VDRL + RPR)
114
Q

can spiral bacteria be gram stained?

A

no!

115
Q

what does h. pylori cause?

A

acute and chronic gastritis
PUD
increased risk for gastroadenocarcinoma

116
Q

how to diagnose h. pylori?

A

fecal antigen test and urease breath test

117
Q

how to treat h. pylori?

A

O: omeprazole (antacid)
A: amoxicillin
C: clarithromycin

118
Q

what does c. jejuni cause?

A

gastroenteritis

119
Q

how to treat c. jejuni?

A

erythromycin

ciprofloxacin

120
Q

how to treat treponema pallidum?

A

penicillin (surprisingly easy)

121
Q

what does primary m. tb cause?

A

AFB have cord factor –> are phagocytosed but survive in macrophages –> accumulation of macrophages and formation of granulomas called goon’s focus –> need a while for T cells to secrete TB-specific IFN-y to increase microbicidal effect of macrophages to attack these AFB-filled macrophages

122
Q

what does secondary m. tb cause?

A

if there is a reinfection or reactivation of latent tb, there will be formation of caseous necrosis with cavitating granulomas

123
Q

what does miliary tb cause?

A

hematogenous spread to other organs to cause caseous necrosis

124
Q

how to diagnose tb?

A
  • chest xray
  • AFB test with ziehl-neelson stain
  • Mantoux test for secondary TB (but note BCG vaccine will also have positive reaction)
125
Q

how to treat TB?

A 
R: rifampicin 
I: isoniazid (must give with pyridoxine)
P: pyrazinamide
E: ethambutol
[2 months RIPE + 4 months RI]

if secondary tb, just give isoniazid for 6 months daily

126
Q

what does m. leprae cause?

A

tuberculoid leprosy: Th1 cell response

lepromatous leprosy: Th2 cell response

127
Q

how to treat m. leprae?

A

6 months of rifampicin with dapsone

Microbiology and Antimicrobials (2 decks)

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