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Microbio PLE > Microbio > Flashcards

Microbio Flashcards

1
Q

catalase positive; coagulase postiive

A

staph aureus

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2
Q

catalase positive; coagulase negative; novobiocin SENSITIVE

A

staph epidermidis

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3
Q

catalase positive; coagulase negative; novobiocin RESISTANT

A

staph saprophyticus

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4
Q

gram positive cocci in ___, ___ hemolytic

golden colonies on blood agar

A

cocci in clusters

beta hemolytic

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5
Q

gold color in staph aureus is due to

A

staphyloxanthin

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6
Q

gram positive bacteria which is salt tolerant in mannitol salt agar

A

s. aureus

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7
Q

usual habitat of staph aureus

A

anterior nares

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8
Q

virulence factor of Staph Aureus

  1. ___ Prevents complement activation
  2. ___ builds an insoluble fibrin capsule
  3. ___ toxic to hematopoietic cells
  4. ___ detoxifies hydrogen peroxide
  5. ___incativates penicillin derivatives
  6. ___specific for WBC
A
  1. Protein A
  2. Coagulase
  3. Hemolysins
  4. Catalase
  5. Pencillinase
  6. PV Leukocidin
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9
Q

___ causes epidermal separation
___ superantigens causing food poisoning
___ superantigen leading to toxic shock syndrome
___ casuses marked necrosis of the skin and hemolysis

A

Exfoliatin
Enterotoxin (heatstable)
TSST-1
Alpha Toxin

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10
Q

Osteomyeltitis and Septic Arthritis forms from _____ spread or local introduction at wound site

A

hematogenous spread

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11
Q

Seen in Osteomyelitis and septic arthritis which is a sequestered focus of osteomyelitis arising in the _______ area of a long bone

A

Brodie abscess seen in the metaphyseal area of the long bone

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12
Q

hours– acute onset of gastroenteritis caused by s. aureus

usually by ingestion of salad made with mayonnaise (potato or tuna salad)

A

4 hours

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13
Q

Scalded Skin Syndrom is also known as

A

Ritter Disease

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14
Q

Scalded Skin Syndrome is caused by which toxin

A

Exfoliatin

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15
Q

MOA of Exfoliatin in Skin Scalded Syndrom

A

Exfoliatin cleaves DESMOGLEIN in desmosome leading to separation of EPIDERMIS from the STRATUM GRANULOSUM

comapred to TEN—> separation occurs in the Dermo-epidermal junction

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16
Q

TSST-1 causes

A

Toxic Shock Syndrome

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17
Q

Seen in tampon using menstruating women or in patients with nasal packing for epistaxis

A

TSS

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18
Q

treatment for Vancomycin Resistant S. aureus

A

Linezolid

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19
Q

Virulence factor in s. aureus that prevents phagocytosis

A

Protein A

  • prevents complement activation, opsonization and phagocytosis
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20
Q

gram positive cocci in clusters, coagulase negative, novobiocin sensitivie

A

s. epidermidis

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21
Q

whitish, non hemolytic colonies on blood agar

A

s. epidermidis

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22
Q

Novobiocin resistant staph?

A

s. saprophyticus

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23
Q

part of the bacteria for adherence and production of biofilms?

A

glycocalyx

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24
Q 
bacteria seen in 
prosthetic heart valves
prosthetic joints
shunts
indwelling catheter
A

s. epidermidis

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25
Q

2nd most common cause of UTI in sexually active women

A

s. saprophyticus

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26
Q

treatment of s. saprophyticus

A

TMP-SMX, quinolones

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27
Q

Catalase Negative
Alpha Hemolytic
Bile-Optochin Sensitive

A

S. pneumoniae

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28
Q

Catalase Negative
Alpha Hemolytic
Bile-Optochin Resistant

A

Viridans streptococci

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29
Q

Catalase Negative
Beta Hemolytic
Bacitracin Sensitive

A

S. pyogenes

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30
Q

Catalase Negative
Beta Hemolytic
Bacitracin Resistanct

A

S. agalactiae

Bacitracin Sensitive -> s. pyogenes

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31
Q

catalase negative

gamma hemolytic

A

group D streptococci

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32
Q

positive PYR test
( a test which measures hydrolysis of l-pyrrolidonyl B naphthylamide and release of b-naphthylamine, which in the presence of p-dimethylaminocinnamaldehyde forms a red compound)

A

S. pyogenes

Only positive to s. pyogenes and group d strep

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33
Q

what lancefield classification is s. pyogenes

A

Lancefield group A

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34
Q

Virulence factor in streptococci which is also known as SPREADING FACTOR

A

Hyaluronidase

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35
Q

Virulence factor that activates plasminogen

A

Streptokinase/Fibrinolysin

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36
Q

Virulence factor that degrades DNA in exudates or necrotic tissue

A

DNase / streptodornase

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37
Q

Streptococci toxin which is responsible for scarlet feve

A

Erythrogenic toxin

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38
Q

A toxin in streptococci which is highly antigenic causes antibody formation

A

Streptolysin O (oxygen-labile)

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39
Q

Oxygen stable toxin in streptococci

A

Streptolysin S

Streptolysin O (oxygen labile)

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40
Q

what causes impetigo contagiosa?

what layer of the skin is affected

A

S. pyogenes

BENEATH the stratum corneum

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41
Q

Superficial infection of s. pyogenes extending into the DERMAL LYMPHATICS

(take not of the lymphatics extension)

A

Erysipelas

also known as st anthony’s fire

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42
Q

rapidly progressive infection of s. pyogenes where the deep subcutaneous tissues are affected and what toxin is responsible ____?

A
  • necrotizing fascitis

- exotoxin B

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43
Q

disease caused by Pyogenic Exotoxin A

A

Streptococcal Toxic Shock Syndrom

Exotoxin B -> Necrotizing Fascitis

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44
Q

Test for susceptibility of scarlet fever

A

Dick Test

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45
Q

Toxin responsible for Scarlet Fever

A

Erythrogenic Toxin

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46
Q

JONES CRITERIA
2 MAJOR
1 MAJOR 2 MINOR

A 
MAJOR (PECCS)
POLYARTHRITIS
ERYTHEMA MARGINATUM
CARDITIS
CHROEA (SYNDENHAM CHOREA)
SUBCUNTANEOUS NODULES
MINOR
FEVER
ARTHRALGIA
HIGH ESR
POSITIVE STREP ANTIBODY
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47
Q

Drug of Choice of Rheumatic Fever

A

Penicillin G

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48
Q

beta hemolytic
bacitracin resistant
lancefield group B
CAMP test positive

A

S. agalactiae

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49
Q

S. agalactiae is grown in what medium

A

Lim broth

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50
Q

transmission of s. agalactiae

A

transplacental

transvaginal

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51
Q

most common cause of neonatal pneumonia, sepsis and meningitis

A

s. agalactiae

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52
Q

DOC of S. agalactiae

A

Penicillin G

Penicillin G + Aminoglycoside for serious infection

all pregnant women shoul be screened for GBS colonization at 35-37 weeks AOG
- chemoprophylaxis is IV Penciillin or Ampicllin for 4 hours prior to delivery

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53
Q

Lancefield Group D

A

Group D strep

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54
Q

UTI due to indwelling urinary catheter and urinary tract instrumentation

A

Group D Strep

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55
Q

which Group D strep can grow in 6.5 NaCl

A

E. faecalis not in S. bovis

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56
Q

major virulence factor of Group A Strep

A

M Protein

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57
Q

Virulence Factor in GABHS responsible for the inhibition of activation of complement and protects organisms from phagocytosis

A

M Protein

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58
Q

Responsible for the beta hemolysis of GABHS

Oxygen labile - inactivated by Oxygen

A

Streptolysin O

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59
Q

Alpha hemolytic
Bile - Optochin Sensitive
(+) quelling reaction

A

S. pneumoniae

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60
Q

Encapsulated Bacteria

Some Killers Have Pretty Nice and Shiny Bodies

A 
S. pneumoniae
K. pnuemonia
H. influenza
P. aureginosa
N. meningitidis
S. typhi
B group strep
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61
Q

Alpha hemolytic

Bile - Optochin Resistant

A

Viridans Streptococci (S. mutans and S. Sanguis)

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62
Q

this type of bacteria enters the bloodstream through dental procedures

A

Viridans strep specifically s. mutans

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63
Q

most common cause of subacute and native valve endocarditis

A

Viridans strep –> S. sanguis

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64
Q

spore forming bacteria

A

bacillus

clostridium

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65
Q

box-car like rods/medusa head morphology

A

bacillus anthracis

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66
Q

one of its transmission is inhalation of spores from animal hair and wool aka Woolsorter’s disease

A

bacillus anthracis

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67
Q

virulence factor of bacillus anthracis

A

poly-d-glutamate

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68
Q

Virulence factors of bacillus anthracis

A

E L P

Edema Factor
Lethal Factor
Protective Antigen

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69
Q

treatment of choice for cutaneous anthrax

A

Ciprofloxacin

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70
Q

anaerobic gram positive spore forming showing DOUBLE ZONE HEMOLYSIS on blood agar

A

c. perfringes

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71
Q

can be grown on EGG YOLK AGAR

A

c. perfringes due to Alpha toxin

to easily remember:
where do you put the EGG? in the REP “refrigerator” (PERfringes)

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72
Q

toxin responsible for gas gangrene in c. perfringes

A

alpha toxine

a lecithinase that cleaves cell membranes

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73
Q

transmission of c. difficle

A

fecal oral route

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74
Q

MOA of toxins in c. difficle

A

Exotoxin A (Enterotoxin) and Exotoxin B (Cytotoxic) inhibits GTPase leading to apoptosis and death of enterocytes leading to PSEUDOMEMBRANES

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75
Q

complication of clostridium difficile

A

pseudomembranous colitis

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76
Q

complication of pseudomembranous colitis

A

toxic megacolon

77
Q

DOC of C. difficle

A

metronidazole or vanomycin

78
Q

club shaped, comma shaped, chinese characters

A

corynebacterium diptheriae

79
Q

toxigenicity test for c. diphtheriae

A

elek test

80
Q

responsible for exotoxin inhibits the protein synthesis by adding ADP-ribose to EF -2 (elongation factor 2)

A

C. diphtheriae

81
Q

thick gray psuedomembranes on the tonsils an throat

A

C. diphteriae

82
Q

aerobic, non spore forming, gram +
V or L shaped
TUMBLING MOTILITY

A

Listeria monocytogenes

83
Q

transmission of L. monocytogenes

A

placental, ingestion of UNPASTEURIZED MILK PRODUCTS

84
Q

it causes granulomatosis infantiseptica which is a transplancental transmission characterized as late miscarriage or birth complicated by sepsis, multiorgan abscesses and disseminated granuloma

A

L. monocytogenes

85
Q

Fast Lactose Fermenters

A

K E E
Klebsiella pneumoniae
E. coli
Enterobacter

86
Q

Slow Lactose Fermenters

A

Citrobacter

Serratia

87
Q

encapsulated gram neg bacteria

MALTOSE and GLUCOSE FERMENTERS

A

Neisseria meningitidis

88
Q

gram neg bacteria
Non-maltose fermenters
glucose fermenter

A

Neisseria gonorrhea

G for Glucose only

89
Q

Clue of invasive meningococcal infection is seen in this physical examination

A

Petechial rashes

this is due to the release of endotoxinf rom the meningococcus, causing vascular necrosis, an inflam- matory reaction, and hemorrhage into the surrounding skin. Note that the diplococci can be seen (Gram stain) or cultured from biopsies of the petechiae.

90
Q

most severe form of meningoccocemia

A

Waterhouse-Friderichsen Syndrome

Bilateral hemorrhage into the adrenal glands occurs, which causes adrenal insuffi- ciency. Abrupt onset of hypotension and tachycardia oc- curs, along with rapidly enlarging petechial skin lesions. Disseminated intravascular coagulation (DIC) and coma may develop. Death can occur rapidly (6-8 hours).

91
Q

DOC for prophylaxis of N. meningitidis infection

A

rifampin

92
Q

which capsular type of n. meningitidis lacks immunogenicity hence not included in the vaccine?

A
B
C
Y
W-135
A

B

Prompt treatment with penicillin G or ceftriaxone is required at the first indication of disseminated meningococcemia. Close contacts of an infected patient are treated with rifampin. Immunization with purified capsular polysaccharides from certain strains (groups A, C, Y, and W135) is currently available and used for epidemics and in high-risk groups. The group B poly- saccharide does not induce immunity, so a vaccine is not available at present.

93
Q

Modified Thayer Martin medium contains the following antibiotics

A

VANCOMYCIN
COLISTIN
NYSTATIN

94
Q

virulence factor of n. gonorrhea that helps in adherence and prevention of phagocytosis

A

Pili

95
Q

gonococcal disease in infants

A

Ophthalmia Neonotarum

96
Q

diagnosis of n. gonorrhea

A

gram stain seen as intracellular diploccoci

97
Q

treatment of n. gonorrhea

A

ceftriaxone + doxyclyine for chlamydia coverage

98
Q

culture medium for haemophilus influeza

A

chocolate agar + factor X (hemin) and factor V (NAD)

99
Q

it confers virulence of H. influenza

A

polysaccharide capsulle

100
Q

how many types of capsule are there in h. influenza and which is the most virulent?

A

6 (a, b, c, d, e, f)

Type b - most virulent

101
Q

H. influenza causes these kinds of diseases

A 
hEMOPilus influenza EMOP
Epiglottitis
Meningitis
Otitis media
Pneumonia
102
Q

what are the 4 virulence factor of B. pertussis

A
  1. Pertussis Toxin
  2. Extra Cytoplasmic Adenyl Cyclase
  3. Filamentous Hemagglutinin
  4. Tracheal Cytotoxin
103
Q 
This b. pertussis toxin is responsible for 
hitamine sensitization
increase in insulin synthesis
promotion of LYMPHOCYTOSIS
Inhibition of phagocytosis
A

Pertussis Toxin

Pertussis toxin: Like many bacterial exotoxins this toxin has a B subunit that Binds to target cell re- ceptors, “unlocks” the cell, allowing entry of the A sub- unit. The A subunit (A for Action) activates cell-membrane-bound G regulatory proteins, which in turn activate adenylate cyclase. This results in an out- pouring of cAMP, which activates protein kinase and other intracellular messengers. The exact role of this toxin in whooping cough is not entirely clear, but it has 3 observed effects: a) histamine sensitization, b) in- crease in insulin synthesis, and c) promotion of lympho- cyte production and inhibition of phagocytosis.

104
Q

Bordatella pertussis toxin responsible for the destruction of ciliated epithelial cells, resulting in impaired clearance of mucus and inflammatory exudates

A

tracheal cytotoxin

this toxin is responsible for the violent cough of pertussis

105
Q

painful genital ulcer often associated with unilateral swollen lymph node that can rupture and release pus

A

h. ducreyi

106
Q

agar for h. ducreyi

A

chocolate agar with Factor X (Hematin)

Factor X and V for H. influenza

107
Q

most contagious phase in b. pertussis

A

catarrhal phase

108
Q

treatment for pertussis

A

erythromycin

109
Q

medium for growing b. pertusiss

A

bordet gengou medium

110
Q

visualizes using the silver stain

A

legionella pneumophilia

111
Q

these are the bacteria which invades intracellulary

A 
Some Bugs May Live FacultativeLY
S B M L F L Y
Salmonella
Brucella
Mycobacterium
Legionella
Francisella
Listeria
Yersina
112
Q

what are the atypical pneumonia

A

chlamydia pneumonia
mycoplasma pneumonia
legionella pneuphilia

113
Q

responsible for pontiac fever

A

legionella pneumophilia

114
Q

green sheen appearance in MAC agar

A

e. coli

115
Q

non lactose fermenter which produces H2S gas

A

salmonella

116
Q

Lactose Fermenter

A

CKEE (laCtose is KEE)

Citrobacter
Klebsiella
Escherichia
Enterobacter

117
Q

Treatment for L. Pneumophiia

A

Macrolides

118
Q

2nd most common neonatal meningitis

A

e. coli

Neonatal Meningitis (BEL)
B group s. agalactiae
e. coli
listeria monocytogenes

119
Q

what are the toxins in ETEC

A

heat stable toxin
heat labile toxin

MOA : inhibits reabsoprtion of Na and Cl which then secretes Cl and HCO3 followed by osmosis

120
Q

toxin in EHEC

A

shiga-like toxin –> VEROTOXIN

MOA : inhibits 60s ribosome causing enetrocyte death

121
Q

test to detect antibody against salmonella

A

Widal test

122
Q

what is the culture for salmonella

A

XLD medium

123
Q

salmonella sp responisble of enterocolitis

A

s. enteritidis

s. typhimurium

124
Q

virulence factor of Typhoid fever caused by_____

A

Vi (virulence) capsular antigen ; s. typhi

125
Q

where does the s. typhi invade and multiply in the body?

A

peyer’s patches which then spreads to the reticulo-endothelial system

126
Q

incubation period for typhoid fever

A

5-21 days

127
Q

organ for predilection of invasion of typhoid fever which can result to establishment for chronic carrier state

A

gall bladder

128
Q

Patient with Osteomyelitis in SPECIFIC CONDITIONS

  1. Burns
  2. IV Drug Users
  3. Sickle Cell Aneia
A
  1. Osteomyelitis in Burns - P. aureginosa
  2. Osteomyelitis in IV drug users - S. aureus / P. aureginosa
  3. Osteomyelitis in Sickle Cell Anemia - Salmonella choleraesui
129
Q

part of the intestine where shigella sp invade

A

distal ileum and colon

130
Q

most common cause of bacillary dysentery

A

shigella sonei - duval’s bacillus

131
Q

most severe form of bacillary dysentery

A

shigella dysenteriae type 1 - shiga bacillus

132
Q

agar for vibrio spp

A

thiosulfate citrate bile salts sucrose (TCBS)

133
Q

contaminated SEAFOODS

A

Vibrio parahaemolyticus

134
Q

contaminated SHELLFISH

A

Vibrio vulnificus

135
Q

MOA of enterotoxin of vibrio sp

A

enterotoxin (choleragen) acts on ADP-ribosylation

136
Q

pandemic vibrio is caused by

A

Vibrio cholerae O1 biotype El tor

137
Q

treatment for
Cholera - ____
V. parahaemolyticus/vulnificus - ____

A

Cholera - tetracycline / azithromycin

V. parahaemolyticus/vulnificus - minocycline + fluoroquinolone

138
Q

Watery foul smelling diarrhea followed by bloody stools accompanied by fever and abdominal pain, may mimic ulceratie colitis

A

campylobacter jejuni

139
Q

disease association of campylobacter jejuni

A 
gullain barre syndrome
reactive arthritis (reitter's syndrome)
140
Q

Reitter’s syndrome triad

A

Urethritis, Uveitis, Arthritis

CANT SEE
CANT PEE
CANT CLIMB A TREE

141
Q

Agar for C. jejuni

A

Skirrows Agar

142
Q

most common cause of bacterial gastroenteritis

A

C. jejuni

143
Q

UREASE POSITIVE BACTERIA

PaK HU

A 
PKHU Particular Kinds Have Urease
Proteus mirabilis
Klebsiella Pneumoniae
Helicobacter pylori
Ureaplasma urealyticum
144
Q

gram negative
urease positive
microaerophilic

A

H. pylori

145
Q

pathogenesis of h. pylori

A

damages the GOBLET CELLS in the gastric mucosa

146
Q

facultative gram negative rods with LARGE polysaccharide capsule

A

klebsiella pneumonia

147
Q

currant jelly sputum

A

klebsiella pneumonia

148
Q

with swarming motitlity

A

proteus mirabilis

149
Q

complicated UTI associated with nephrolithiasis

A

proteus mirabilis

UTI with staghorn calculi

150
Q

reponsible for the blue green pigment of pseudomonas aureginosa

A

pyocyanin (blue)

pyoverdin (green)
pyorubrin (red)

151
Q

gram negative, OBLIGATE AEROBE, nonlactose fermenting, oxidase positive

A

pseudomonas aureginosa

152
Q

where to grow klebsiella pneumonia

A

Cetrimide Agar

153
Q

ventilator acquired pneumonia

A

pseudomonas aureginosa

154
Q

bacteria found in irrigating solutions and intravenous solutons

A

Acinetobacter baumanii

155
Q

known as “Undulating Fever” from unpasteurized/ contaminated dairy

A

Brucella abortus “Bracillosis”

156
Q

aerobic acid fast rods

with high lipid content containing mycolic acid

A

MTB

157
Q

most important virulence factor in MTB

A

Cord Factor

  • inhibits wbc migration
  • characteristic serpentine pattern
  • induces TNF-a release
158
Q

virulence factor responsible for the initation of cell mediated immunity leading to caseation and granuloma formation, it also triggers delayed hypersensitivity

A

tuberculin surface protein

159
Q

hypopigmented plaques, thickened superficial nerves and significant anesthesia with a positive lepromin skin test

A

tuberculoid leprosy

160
Q

presence with leonine facies with a negative lepromin skin test

A

lepromatous leprosy

161
Q

anaerobe seen in patients with broken jaw or dental extraction
PE: hard, nontender swelling with sinus tracks darining sulfur granules

A

Actinomyces israelii

162
Q

aerobic, filamentous gram positive rods with AERIAL HYPHAE

weakly acid fast ( FITE-FARACO)

A

Nocardia asteroides

163
Q

smallest free living organism

A

mycoplasma pneumoniae

  • not seen in gram stain
  • only bacteria with sterol on cell membrane
164
Q

medium for culture for mycoplasma pneumonia

A

Eaton agar

165
Q

What bacteria – one of its pathogenesis is antibodies against red cells (COLD AGGLUTININS) and brain, lung and liver cells

A

Mycoplasma pnuemonia

most common type of atypical pneumonia known as walking pneumonia

166
Q

reason why Treponeman pallidum cannot be cultured in vitro?

A

this bacteria LACKS tricarboxylic acid cyle (krebs cycle)

167
Q

local, NONTENDER genital ulcer usually forms 2-10 weeks

A

PRIMARY SYPHILIS –> CHANCRE (NONTENDER)

vs H. ducreyi (PAINFUL/TENDER)

168
Q

condyloma lata, maculopapular rash occurs after 1-3months

A

SECONDARY SYPHILIS

169
Q

GUMMAS can be seen in this stage of syphilis

A

TERTIARY

others seen in tertiary:

  • Neurosyphilis
  • Aortitis
170
Q

Neurosyphilis presents with these findings

A

TABES DORSALIS
- Argyll Robertson pupils / Prostitutes Pupils
DEMENTIA PARALYTICA

171
Q

Hutchinsons triad in congenital syphilis

A
  1. Hutchinsons teeth
  2. Deafness
  3. Keratitis
172
Q

Other findings in congenintal syphilis

A

Snuffles/Saddle nose
Saber shins
Mulberry molars

173
Q

Nontreponemal tests for syphilis

A

these are screening tests, easy to perform, low cost

  • VDRL (detects flocculation)
  • RPR
174
Q

Treponemal tests

A 
Confirmatory
measures antibody 
- T pallidum immunoasay
- FTA-ABS (MOST SPECIFIC, EARLIEST POSITIVE,REMAINS POSITIVE THE LONGEST)
- TP-PA
- * western blot
175
Q

False Positive VDRL results

A 
V D R L
Viruses (EBV, Hepatitis)
Drugs (Marijuana)
Rheumatic Fever, RA
Lupus, Leprosy
176
Q

Treatment of syphilis

A

Benzathine Pen G

177
Q

Influenza like symptoms few hours after receiving penicillin due to lysis of treponemes

A

Jarisch-Herxheimer Reaction

178
Q

what is the basis of antigenicity for nontreponemal tests?

A

cardiolipin-lecithin

179
Q

largest medically important bacteria

A

Borrelia burgdorferi

180
Q

medium for growth for b. burgdorferi

A

BSK medium

181
Q

Lyme disease is transferred from

A

bite of DEER ticks - Ixodes scapularis, Ixodes pacificus

182
Q

Spectrum of disease of Lyme Disease

A

Stage 1 - ERYTHEMA CHRONICUM MIGRANS
Stage 2 - Myocarditis, AV Block
Stage 3 - Autoimmune Migratory Polyarthritis (Onion Skin Lesions), Acrodermititis chronica atrophicans

183
Q

thin coiled spirochetes that looks like a shepered crooks

A

Leptospira interrogans

184
Q

Medium for L. interrogans

A

Ellinghausen-McCullough-Johnson-Harris (EMJH) medium or FLETCHER medium

185
Q

Pathogenesis of L. interrogans

A

Penetration of INTACT mucus membrane or penetration of small cuts through skin which then multiply and damages endothelium of small blood vessels

186
Q

gold standard for identification of l. interrogans

A

Miroscopic Agglutination Test

187
Q

Acute Leptospiremic phase

A

fever chills intense headache

  • calf tenderness (due to rapid multiplication of leptospires in muscle with high oxygen tension
  • conjunctival suffusion (damage and leaky conjunctial vessels_
188
Q

Weil syndrome triad

A
  1. jaundice
  2. bleeding
  3. uremia

Most severe form of leptosirosis

Microbio PLE (2 decks)

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