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Step 1 > Microbio > Flashcards

Microbio Flashcards

1
Q

peptidoglycan function and structure

A
  • protects against osmotic pressure

- sugar backbone with peptide side chains cross-linked by transpeptidase

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2
Q

periplasm is the location for what?

A

hydrolytic enzymes, including b-lactamases

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3
Q

Unique to gram (-) or gram (+)

A

gram (+): lipoteichoic acid

gram (-): porins, endotoxin/LPS (outer membrane), periplasmic space

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4
Q

Special cultures (H. flu, N. gonorrhoeae, Legionella)

A

H flu - chocolate agar (requires factors X hematin and V NAD+)
N gonorrhoeae - Thayer-Martin ( Very Typically Cultures Neisseria - vanc + trimethoprim + colistin + nystatin)
Legionella - charcoal yeast

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5
Q

Aerobes - Nagging Pests Must Breathe

A

Require O2 to generate ATP

Nocardia, Pseudomonas, MycoBacterium tb

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6
Q

Anaerobes - Frankly Can’t Breathe Air

A

normal in GI tract, can’t use aminoglycosides (which require O2 to enter cell)

Fusobacterium, Clostridium, Bacteroides, Actinomyces

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7
Q

Encapsulated bacteria (SHiNE SKiS)

A

Strep pneumo, H. flu, N. meningitidis, E. coli, Salmonella, Klebsiella, group b Strep

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8
Q

Bacterial virulence proteins - Protein A, IgA protease, Protein M

A

Protein A - binds Fc region of IgG, Staph aureus
IgA protease - cleaves IgA, SHiN (S. pneumo, H. flu, N.m)
Protein M - prevent phagocytosis by decreased activation of alternate complement pathway, group A strep

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9
Q

ENDOTOXIN

A 
Edema
Nitric Oxide
DIC/Death
Outer membrane
TNF-a
O-antigen
eXtremely heat stable
IL-1
Neutrophil chemotaxis
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10
Q

Gram-positive algorithm

A

bacilli vs. cocci
catalase + (clusters) –> coagulase
catalase - (chains) –> hemolysis
then sensitivities (coag -: novobiocin, cat -/a-hemolytic: optochin, cat-/B-hemolytic: bacitracin)

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11
Q

Strep bovis (bovis in the blood = ?)

A

Group D strep

Bovis in the blood = cancer in the colon

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12
Q

Diphtheria ABCDEFG

A 
ADP-ribosylation
B-prophage
Corynebacterium
Diphtheriae
Elongation Factor-2
Granules (intracellular, polyphosphate)

Gram positive rod

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13
Q

Clostridia toxins (Gram positive rod)

A

tetani - cleave SNARE proteins, block release of NTs (spastic paralysis)
botulinum - block Ach release (floppy baby)
perfringens - alpha toxin = lecithinase - phospholipid breakdown (also, myonecrosis by collagen breakdown)
dificile - toxin A: enterotoxin. Toxin B: cytotoxin (depolymerizes actin filaments) (pseudomembranous colitis)

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14
Q

Listeria bacteria features

A

facultative intracellular Gram positive rod
rocket tails - actin polymerization, rapid movement
neonatal meningitis!
grows at 4 degrees (contaminates refrigerated food, food = most common transmission)

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15
Q

Leprosy (mycobacterium)

A
  • cool temperature distribution (glove and stocking)
  • tx: dapsone and rifampin
  • lepromatous: low immunity (Th2)
  • tuberculoid: high immunity (Th1)
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16
Q

Gram-negative algorithm

A

diplocoi vs. coccoid rods vs. cocci

  • maltose fermentation vs. not
  • lactose fermentation or not
  • oxidase + (pseudomonas) vs. not
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17
Q

Lactose fermenters (Klebsiella and E. coli)

A

MacConkey’s agar

Lactose is key with MacConKEY’s agar

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18
Q

Neisseria gono vs. mening

A

GoNO - no polysaccharide capsule, no maltose fermentation, no vaccine, FHC syndrome
Mening - maltose fermentation, W-F syndrome

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19
Q

H. flu leads to what?

hEMOPhilus

A 
haEMOPhilus causes:
Epiglottitis
Meningitis
Otitis media
Pneumonia
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20
Q

Legionella

A

use silver stain on charcoal culture with iron and cysteine (silver helmet over campfire with iron dagger - not a sissy!)

aerosol transmission

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21
Q

Pseudomonas is associated with what?

A 
PSEUDDO
Pneumonia
Sepsis
otitis Externa
UTIs
Drugs/Diabetes
Osteomyelitis

think pseudomonas in burn victims!
exotoxin A -

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22
Q

E. coli subtypes (I, T, P, H)

A

EIEC: invasive
ETEC: enteroToxins, Traveler’s (watery, heat-stable vs. heat-labile)
EPEC: Pediatrics
EHEC: O157:H7, Shiga-toxin, HUS (anemia, thrombocytopenia, renal failure due to damaged endothelium)

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23
Q

Klebsiella (4A’s)

A

Aspiration pneumonia
Abscesses (lung/liver)
Alcoholics
diAbetics

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24
Q

Campylobacter

A

Bloody diarrhea
Gullain-Barre
reactive arthritis (arthritis, conjunctivitis, urethritis)
Undercooked meat!

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25
Q

Cholera mechanism

A

Enterotoxin that permanently activates Gs, causing increased cAMP activity

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26
Q

Leptospirosis (surfers, tropics)

A

flu-like symptoms
myalgias (calves!)
jaundice
photophobia

27
Q

Lyme symptom progression (FACE)

A

early - flu-like, classic rash, facial nerve palsy (bilateral)
later - arthritis, AV nodal block, neurologic
Lyme pie to the FACE: Facial nerve palsy, Arthritis, Cardiac block, Erythema migrans

28
Q

False positives on VDRL

A

Viruses
Drugs
Rheumatic fever
Lupus/leprosy

29
Q

Animal transmission

A

cat scratch - Bartonella
armadillo - leprosy
dog tick - rickettsia (RMSF)
sheep amniotic fluid - Coxiella (Q fever)

30
Q

Gardnerella

A

bacterial vaginosis
clue cells
KOH whiff test

31
Q

Palms and soles rash

A

CARS
Coxsackie A
RMSF
Syphillis

32
Q

E’s and R’s of chlamydia

A

Elementary body is enfectious, enters cell through Endocytosis

Reticulate body Replicates in cell by fission, Reorganizes into elementary bodies for spread to other cells

Reactive arthritis - uveitis/conjunctivitis, arthritis, urethritis

33
Q

Chlam subtypes

A

ABC - Africa, blindness, chronic infection

D-K - everything else!

34
Q

High titer of cold agglutinins (IgM)

A

Mycoplasma pneumoniae
X-ray is worse than patient
antigenic similarity with RBCs, so immune response destroys RBCs!
no cell wall

35
Q

Systemic Mycoses (HBCP)

A

Histo - hides within macrophages
Blasto bus broadly
Coccidio crowds (spherule filled with spores)
Paracoccidio parasails with captain’s wheel to Latin America

36
Q

Tinea versicolor mechanism

A

degradation of lipids produces acids that damage melanocytes and cause hypopigmentation

37
Q

Opportunistic fungal infections (6 total)

A

Candida - superficial or systemic (no pulm involvement)
Aspergillus - invasive; ABPA (asthma and CF, look for eosinophilia); aspergilloma (post-TB infection). A for Acute Angles in Aspegillus.
Cryptococcus - heavily encapsulated, latex agglutination (polysaccharide capsular antigen test)
Mucor/Rhizopus - rhinocerebral, frontal lobe abscess, CST
Pneumocystis - diffuse ground-glass opacities, disc-shaped yeast
Sporothrix - ascending lymphangitis (rose in the pot)

38
Q

GI protozoa

A

Giardia - foul-smelling, fatty
Entamoeba - liver abscess (anchovy paste), RBCs in cytoplasm, cysts with 4 nuclei
Cryptosporidium - severe diarrhea in AIDS

39
Q

CNS protozoa

A

Toxo - congenital (chorioretiniti, calcifications, hydrocephalus), AIDS (brain abscess)
Naegleria - rapidly fatal, freshwater lakes
Trypanosoma brucei (African sleeping) - lymph nodes, recurring fever, somnolence. “Sure is nice to sleep with Melatonin” tx = suramin, melarsoprol

40
Q

Heme protozoa

A

Malaria (Plasmodium) - fevers are 48 hrs apart in vivax/ovale, look for spots in RBCs, quinidine = watch for G6PDH def.!
Babesia - same tick as Lyme, hemolytic anemia, Maltese cross in RBC, predilection for asplenia!

41
Q

Other protozoa

A 
Chagas dz (trypanosoma cruzi) - dilated cardiomyopathy + achlasia/megacolon + unilateral periorbital swelling, kissing bug feces
Leishmaniasis - sandfly, fevers/HSM/pancytopenia
42
Q

Trichomonas (what does cervix look like?)

A

strawberry cervix, foul-smelling, treat pt and partner!

43
Q

roundworm treatment (pinworms, hookworms, etc.)

A

Bendazoles are bendy for intestinal infection

44
Q

Biliary tract dz -cholangiocarcinoma (parasite)

A

Clonorchis sinensis (undercooked fish), pigmented gallstones

45
Q

Brain cysts/seizures (parasite)

A

Taenia solium (cysticercosis) when eggs are ingested

46
Q

Hematuria, bladder SCC (parasite), less likely =

A

Schistosoma haematobium, lives in snails!

47
Q

Liver hydatid cysts (parasite)

A

Echinococcus (dog feces, sheep, kill daughter cysts before removal with ethanol)

48
Q

Microcytic anemia (parasite)

A

Ancylostoma (blood sucker!)

49
Q

Myalgias (parasite)

A

Trichinella (undercooked meat)

50
Q

Perianal pruritis (parasite)

A

Enterobius (pinworm)

51
Q

Portal hypertension (parasite)

A

Schistosoma mansoni, schistosoma japonicum

52
Q

Vitamin B12 deficiency (parasite)

A

Diphyllobothrium latum (raw freshwater fish)

53
Q 
Match the food to the bug
Rice
Canned food/honey
Undercooked meat
Poultry/meat/eggs
Meats/mayonnaise
Seafood
A 
Rice - bacillus cereus
Canned food/honey - C. botulinum
Undercooked meat - E. coli
Poultry/meat/eggs - Salmonella, Campylobacter
Meats/mayonnaise - Staph aureus
Seafood - Vibrio
54
Q

HIV + diseases

A

<100: Aspergillus (pleuritic pain), Crypto (meningitis), Candida (esophagitis), CMV (retinitis, colitis, enceph), EBV (oral hairy leukoplakia, B-cell lymphoma), Histo (const. sx), MAC (non-specific sx)

55
Q

Three prion diseases

A

CJD: rapidly progressive dementia
Bovine spongiform encephalopathy: mad cow disease
Kuru: human cannibalism

56
Q

Diarrhea etiologies

A

Bloody: Campy, Enteamoeba, EHEC, EIEC, E. coli, Salmonella, Shigella, Yersinia
Watery: Clostridium (diff/perf), ETEC, Giardia/Crypto, Vibrio, Rota/Noro/Adeno

57
Q

Special pneumonia groups (alcoholics, atypical, CF)

A

Alcoholics: Klebsiella
Atypical: Mycoplasma, Legionella, Chlam
CF: Pseudomonas, S. aureus

58
Q

Brain abscess

A

Viridans strep
Staph aureus
Toxo reactivation

59
Q

Osteomyelitis special risk factors (generally S. aureus, except…)

A

Sickle cell - Salmonella, S. aureus
Vertebral involvement - M. tuberculosis
Cat/dog bites - Pasteurella

60
Q

UTI bugs

A

E. coli - green metallic sheen on EMB agar
Staph sapro
Klebsiella - + urease test

61
Q

Congenital infections (ToRCHeS)

A

Toxo - chorioretinitis, hydrocephalus, intracranial calcs
Rubella - PDA, cataracts, deafness
CMV - hearing loss, seizures, petechial rash
HSV-2 - encephalitis
Syphilis - facial abnormalities

62
Q

Red rashes of childhood

A

Coxsackie Type A - HFM dz
HHV-6 (roseola) - fever followed by rash
Measles (rubeola) - 3 C’s, descending rash
Rubella - post-auricular adenopathy, descending rash
Strep pyogenes - scarlet fever, sandpaper-like rash
VZV - lesions of different ages

63
Q

Random bug hints
asplenia, branching rods, chronic granulomatous dz, currant jelly sputum, dog/cat bite, health care provider, neutropenia, organ transplant, PAS +, palms/soles rash, surgical wound, traumatic open wound

A 
SHiN - strep pneumo, H. flu, Neisseria
Actinomyces (oral infections)
catalase + (S. aureus, Burkholderia)
Klebsiella
Pasteurella
HBV
Candida, Aspergillus
CMV
Tryponema Whipplei
CARS: coxsackie A, Rickettsia, Syphillis
Staph aureus
Pseudomonas

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