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CV 1 > Microbio > Flashcards

Microbio Flashcards

1
Q

S. aureus virulence factors

A

biofilm formation, capsule, adhesins, secreted enzymes and hemolysins, and pathogenicity islands which contain information for methicillin resistance., protein A (bind IgG to evade), coagulase (fibrin coat around organism), MSCRAMMS

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2
Q

S. viridans virulence factors

A

Dextran for glycocalyx formation, surface adhesion proteins that assist colonization (FimA, GspB)

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3
Q

Enterococci virulence factors

A

pili, surface proteins, extracellular enzymes like proteases and hyaluronidases, biofilm

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4
Q

R. rickettsii virulence factors

A

OmpA and B for adherence

T4SS for intracellular invasion

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5
Q

Most common cause Acute Endocarditis

A

Usually S. aureus, sometimes strep pyogenes

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6
Q

Most common cause subacute Endocarditis

A

Streptococcal species (viridans), Enterococcal species

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7
Q

strep viridans is ____ hemolytic

A

alpha (thus the green)

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8
Q

strep viridans is common where

A

normal flora, particularly oral cavity

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9
Q

S. aureus –> ___ valve

A

tricuspid

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10
Q

S. viridans –> ____ valve

A

mitral

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11
Q

Duke Criteria, what’s needed for a positive result

A

2 major criteria, 1 major and 3 minor criteria met, or 5 minor criteria.

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12
Q

Dukes: Major criteria

A

Positive blood culture (2 separately, all of 3 or majority of 4 taken within an hour, or Coxiella brunetii culture + positive IgG titer)

Evidence of endocardial involvement (intracardiac mass, abscess, or messed up valve)

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13
Q

Dukes: Minor criteria

A

Predisposition
Fever above 38C (100.4F)
Vascular phenomena (petechiae, Janeway, splinter hemmorhages)
Immunological phenomena (Roth’s spots, Osler nodes, glomerulonephritis, Rh factor)
Microbiological evidence

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14
Q

Enterococci gram status

A

Gram + Cocci

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15
Q

HACEK organisms

A

Hard to culture, gram -, sometimes cause infective endocarditis (rare)

Haemophilus
Aggregatibacter (Actinobacillus)
Cardiobacterium
Eikenella
Kingella
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16
Q

Tx acute endocarditis

A

Nafcillin or oxacillin +/- gentamicin or tobramycin
(naf for staph)
OR
Vancomycin + gentamicin

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17
Q

Mechanism Nafcillin, what makes it special, spectrum

A

Inhibit cross-linking of peptidoglycan by transpeptidase (D-al-D-al spot)
Not susceptible to penicillinase (large R group)
MSSA (staph)

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18
Q

Mechanism gentamicin or tobramycin, class

A

Aminoglycoside - bactericidal

Bind 30S ribosome to prevent initiation complex, cause misreading of mRNA, and induce early termination (initiation)

19
Q

Vancomycin mechanism

A

Bind D-al-D-al of cell wall precursor to inhibit release from bactoprenol carrier, inhibiting peptidoglycan cell wall synthesis – transglycosylase

20
Q

Why cotreat with aminoglycosides

A

Hard to get into the cell - use with a cell wall inhibitor = synergy

21
Q

Tx subacute endocarditis

A

Ampicillin/sulbactam + gentamicin or tobramycin OR Vancomycin + Ceftriaxone or Gentamycin/tobramycin

22
Q

Ampicillin mechanism, spectrum, why special

A

Inhibit cross-linking of peptidoglycan by transpeptidase (D-al-D-al spot)
Gram + and more gram -
More broad spectrum (more water soluble to pass through porin channels in gram -)

23
Q

Sulbactam mechanism

A

Beta-lactamase inhibitor, give with beta-lactam drugs susceptible to betalactamases (binds to the enzyme and does not allow it to degrade the abx)

24
Q

Ceftriaxone mechanism

A

Cell wall inhibitor, binds to penicillin binding protein

Bind transpeptidase to block crosslinking of peptidoglycan polymers of cell wall formation (same as penicillins)

25
Q

Tx endocarditis if allergic to penicillins

A

Cephalosporins (3rd to 5th generation) or carbapenems IF no hx of immediate HS to beta-lactam

Vancomycin

26
Q

Strep pyogenes vs. Strep viridans

A

Both Gram + cocci, catalase -

Viridans = alpha hemolytic
Pyogenes = beta hemolytic
27
Q

Myocarditis common cause

A

Coxsackievirus B

Adenovirus (kids)

28
Q

Coxsackievirus classifications (genome, segment, capsid, envelope, etc.)

A 
ssRNA(+), Group IV
Nonsegmented
Icosahedral Nucleocapsid
Nonenveloped
Picornavirus
Enterovirus
Cox A & B
29
Q

Pericarditis common causes

A

Cox A & B
Echoviruses
Influenza virus

30
Q

Triad of RMSP

A

Fever, headache, rash

31
Q

Tx RMSP

A

Doxycycline - even in kids

32
Q

Mechanism doxy

A

Bacteristatic

Bind 30S to prevent attachment of aminoacyl-tRNA (elongation)

33
Q

Obligate intracellular organism - think:

A

Chlamydia, R. rickettsii

34
Q

Palm and sole rash - think:

A

RMSF, syphilis, coxsackievirus (also, Kawasaki vasculitis)

35
Q

Rheumatic Heart disease due to what type of Hypersensitivity

A

Type II (ab, also some T cell mediated)

36
Q

Symptoms Rheumatic Fever/HD

A

Joint swelling, fever, weakness, prior strep infection, muscle aches, SOB, chest pain, N/V, hacking cough, circular rash (EM), lumps under skin

37
Q

Strep pyogenes virulence factors

A 
Streptokinase (plasminogen → plasmin)
M protein (resists phagocytosis)
Hyaluronidase (breaks CT)
DNase (digests DNA)
Streptolysin O (destroys RBCs)
Streptolysin S (destroys WBCs)
38
Q

Endocarditis from Enterococci associated with

A

GU problems in older men, obstetric procedures in young women

39
Q

Flu-like illness with chest pain, arrhythmias

A

Myocarditis

40
Q

Tachycardia, three-component friction rub, changes in ECG

A

Pericarditis

41
Q

Intravascular Catheter related infections - usually

A

staph aureus

42
Q

VF that helps bacteria colonize vascular catheter infection

A

biofilm production

43
Q

Prosthetic valves causative organisms

A

First year: Staph epidermidis > Staph aureus

After 1 year: strep viridans

44
Q

Pacemaker and defibrillators infection causative organisms

A

Within 2 weeks: Staph aureus
2 weeks - 1 year: Staph epidermidis (coagulase negative staph)
After 1 year: Strep viridans

CV 1 (3 decks)

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