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Step 1 > Microbio Clinical bacteriology > Flashcards

Microbio Clinical bacteriology Flashcards

1
Q

gram pos, branching filament, anaerobe, not acid fast

A

actinomyces

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2
Q

gram pos, branching filaments, aerobe, acid fast

A

nocardia

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3
Q

gram pos cocci in clusters, catalase pos

A

staph

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4
Q

gram pos cocci in chains, catalase neg

A

strep

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5
Q

gram pos cocci in clusters, catalase pos, coag pos

A

staph aureus

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6
Q

gram pos cocci in chains, cat pos, coag neg

A

staph epidermis and staph saprophyticus

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7
Q

gram pos cocci in chains, cat neg, alpha hemolytic

A

strep pneumo, viridans strep (strep mutans)

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8
Q

gram pos cocci in chains, cat negative, beta hemolytic

A

group A strep (strep pyogenes), group B strep (strep agalactiae)

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9
Q

gram pos cocci in clusters, catalase neg, gamma hemolytic (no hemolysis)

A

group D strep (enterococcus and non-enterococcus)

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10
Q

distinguishing between the two kinds of gram pos cocci, cat pos, coag neg staph

A

novobiocin sensitive is staph epi; novobiocin resistant is staph saprophyticus

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11
Q

distinguishing between gram pos cocci, clusters, cat neg, alpha hemolytic

A

strep pneumo is optochin sens and viridans strep is optochin resistant

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12
Q

distinguish between gram pos cocci, clusters, cat neg, beta hemolytic

A

group A strep is bacitracin sens; group B strep is bacitracin resistant

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13
Q

beta hemolytic bacteria

A

staph aureus (cat pos and coag pos); strep pyogenes (group A strep), strep agalactiae (GBS), listeria

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14
Q

TSST

A

superantigen produced by staph aureus that binds to MHC II and T cell receptor, resulting in polyclonal T cell activation;

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15
Q

staph epidermis association

A

prosthetic devices and IV atheters by producing biofilm. coag neg. novobiocin sensitive

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16
Q

staph sapro

A

second most common cause of uncomplicated UTI in young women (first is E. coli). Coag neg. novobiocin resistant

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17
Q

strep pneumo

A

most common cause of meningitis, OM, pneumonia, sinusitis

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18
Q

lancet shaped, gram pos diplococci. Encapsulated

A

strep pneumo

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19
Q

viridans group strep

A

alpha hemolytic (like strep pneumo), but optochin resistant; normal flora of the oropharynx (cavities); types are strep mutans (dental caries) and strep sanguinis (subacute endocarditis at damaged heart valves)

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20
Q

strep pyogenes (group A strep)

A

pharyngitis, cellulitis, scarlet fever, rheumatic fever, glomerulonephritis; M protein; ASO titer detect recent Strep pyogenes infxn

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21
Q

JONES major criteria for acute rheumatic fever

A

joints (polyartritis), carditis, nodules (subcutaneous), erythema marginatum, syndenham chorea

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22
Q

scarlet fever rash

A

scarlet rash with sandpaper-like texture, strawberry tongue, circumoral pallor, subsequent desquamation

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23
Q

strep agalactiae

A

Group B strep; bacitracin resistant; beta hemolytic; colonizes vagina; causes infxn mainly in babies;

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24
Q

Group D strep

A

there are enterococcal and non-enterococcal group D strep

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25
Q

strep bovis

A

a type of group D strep that colonizes the gut; assoc with colon cancer; can cause bacteremia and subacute endocarditis

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26
Q

Corynebacterium ditheriae

A

causes diptheria via exotoxin encoded by beta-prophage; exotoxin works through EF-; sx include pseudomembraneous pharyngitis with lymphadenopathy, myocarditis and arrhythmias; toxoid vaccine prevents diptheria

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27
Q

gram pos rods

A

clostridium (anaerobe), corynebacterium, listeria, bacillis (aerobe)

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28
Q

bacterial spores

A

bacillus anthracis, bacillus cereus, clostridium botulinum, clostridium difficile, clostridium perfringens, clostridium tetani, coxiella burnetii (Q fever)

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29
Q

clostridium tetani

A

producses tetanospasmin (cleaves SNARE proteins)

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30
Q

clostridium botulinum

A

toxin inhibits Ach release; in adults, ingestion of preformed toxin; in babies, ingestion of spores in honey causes disease; tx with antitoxin

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31
Q

clostridium perfringens

A

produces alpha toxin that can cause myonecrosis (gas gangrene) and hemolysis

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32
Q

clostridium difficile toxins

A

Toxin A (enterotoxin) binds to brush border of gut. Toxin B (cytotoxin) causes cytoskeletal disruption leading to pseudomembraneous colitis and diarrhea. Often 2/2 clinda or ampicillin. Dx by detection of one or both toxins in the stool by PCR

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33
Q

anthrax

A

caused by b. anthracis, a gram pos spore forming rod that produces anthrax toxin. This is the only bacterium with a polypeptide capsule (contains D-glutamate)

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34
Q

cutaneous anthrax

A

painless papule surrounded by vesicles which eventually ulcerates with a black eschar; uncommonly progresses to bacteremia and death

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35
Q

pulmonary anthrax

A

inhalation of spores leads to flu like sx that rapidly progress to fever, pulmonary hemorrhage, mediastinis, and shock

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36
Q

b. cereus

A

food poisoning; spores sens to cooking; keeping rice warm leads to germination of spores and enterotoxin formation; emetic type (rice and pasta) and diarrheal type (watery, nonbloody)

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37
Q

listeria monocytogenes

A

acultative intracellular microbe; acquired by ingestion of unpasteurized dairy products and cold deli meats or during pregnancy or birth; forms rocket tails that allow intracellular and trans-cellular movement; tumbling motility”; only gram pos organism to produce endotoxin

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38
Q

what kinds of diseases can gram pos rod listeria monocytogenes cause?

A

amnionitis, stpticemia, and spont abortion in pregnant women; granulomatosis infantiseptica; neonatal meningitis; mild gastroenteritis in healty people; treat gastroenteritis supportively use ampicillin in infants, elderly and immunocomp

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39
Q

acid fast gram pos branching filaments

A

nocardia (actinomyces is not acid fast)

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40
Q

actinomyces

A

gram pos branching filaments, not acid fast, normal oral flora, causes oral/facila abscesses, treat with penicillin

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41
Q

nocardia

A

gram pos branching filaments, acid fast, found in the soil, causes pulm infextion in immunocompromised and cutaneous infextions after trauma in immunocompetent; treat with sulfonamides

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42
Q

features of primary TB

A

ghon complex in hilar nodes and ghon focus in lower to mid zones of lung

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43
Q

secondary TB

A

either due to reinfection in a partially immune hypersesntized host or reactivation; fibrocaseous cavitary lesion, usually in upper lobes of lung

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44
Q

Extrapulmonary TB

A

CNS (parenchymal TB or meningitis); vertebral body (Pott disease); lymphadenitis; renal; GI; adrenals

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45
Q

intergeron gamma release assay for TB

A

has fewer false positives from BCG vaccination than the PPD

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46
Q

mycobacteria

A

m. tuberculosis, m. avium intracellulare (AIDS, proph with azithro with CD4 less than 50); m. scrofulaceum (cervical lymphadenitis in kids); m. marinum (hand infection in aquarium handlers); all mycobacteria are acid fast

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47
Q

“cord factor” in virulent strains of mycobacteria

A

inhibits macrophage maturation and induces release of TNF-a

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48
Q

leprosy (Hansen disease)

A

caused by mycobacterium leprae (acid fast bacillus) that likes cool temps (infects skin and superficial nerves); glove and stocking loss fo sensation; resevoir in US is armadillos

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49
Q

Hansen disease has two form

A

lepromatous presents diffusely over the skin of lion-like facires and is communicable; characterized by low cell-mediated immun with a humorial TH2 response; tuberculoid form is limited to a few hypoesthetic hairless skin plaques; characterized by high cell-mediated immunity with largely TH1 type immune response

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50
Q

treatment of Hansen disease (leprosy)

A

dapsone and rifampin for tuberculoid form; clofazimine is added for lepromatous form

51
Q

gram neg diplococci

A

neiserria meningitidis and neisseria gonorrhea

52
Q

gram neg diplococci maltose fermenter

A

n. meningitidis

53
Q

gram neg diplococci maltose nonfermenter

A

n. gonorhea

54
Q

gram neg “coccoid” rods

A

Haemophilus influenza, pastuerella, brucella, bordatella pertusis

55
Q

gram neg comma shaped

A

campylobacter jejuni, v. cholera, h. pylori

56
Q

gram neg rods lactose nonfermenter

A

pseudomonas, salmonella, proteus, yersinia, shigella

57
Q

gam neg rods lactose fermenter

A

klebsiella, e coli, enterobacter, cirtobacter, serratia, others

58
Q

gram neg rods lactose nonfermenter oxidase pos

A

pseudomonas

59
Q

gram neg rods lactose nonfermenter oxidase neg

A

salmonella, proteus, yersinia, shigella

60
Q

gram neg rods lactose fermenter, fast fermenters

A

klebsiella, e coli, enterobacter

61
Q

gram neg rods lactose fermenter slow fermenter

A

citrobacter, serratia, others

62
Q

lactose fermenting bacteria

A

fermentation of lactose leads to pink colonies on MacConkey agar. Examples include citrobacter, klebsiella, e coli, enterobacter, and serratia

63
Q

neisseria gonococci

A

no polysaccharide capsule (unlike meningococci), no maltose fermentation (unlike mening), no vaccine, treat with ceftriaxone

64
Q

neisseria meningitidis

A

polysaccharide capsule, maltose fermentation, vaccine, trasmitted via resp and oral secretions, causes meningococcemia and meningitis and waterhouse-friderichsen syndrome; prophylaxis with rifampin, cipro, or ceftriaxone in close contacts; treat with ceftriaxone or penicillin G

65
Q

h. influenza

A

smal gram neg coccobacillary rod; aerosol transmission; mucosal infections; produces IgA protease; culture on chocolate agar; treat mucosal infxn with amox-clav and meningitis with ceftriaxone.

66
Q

HIB vaccine

A

contains type B capsular polysaccharide conjugated to diptheria toxoid or other protein; given between 2 and 18 mos of age

67
Q

legionella

A

gram neg rod; use silver stain (bc gram stains poorly); grow on charcoal yeast extract and cx with irone an dcysteine; detect antigen in urine; labs may show hyponatremia; aerosol transmission from environental water source habitat, no person to person transmission; treat with macrolide or quinolone

68
Q

Legionairre’s disease

A

caused by legionella (obvi); severe pneumonia, often unilateral and lobar, fever, Gi, and CNS sx

69
Q

Pontiac fever

A

mild flu-like syndrom caused by legionella

70
Q

pseudomonas

A

gram neg rod, lactose fermenter; produces blue-green pigment; aerobic; grape-like odor; endotoxin and exotoxin; common n burn victms;chronic PNA in CF patients due to biofilm; hot tub folliculitis

71
Q

ecthyma gangrenosum

A

rapidly progressive, necrotic cutaneous lesion caused by pseudomonas bacteremia; typically seen in immunocomp patients

72
Q

E coli virulence factors

A

fimbrae- cystitis and pyelo; K capsule- pneumonia, neonatal meningitis; LPS endotoxin- septic shock

73
Q

EIEC

A

invades intestinal mucosa and causes necrosis and inflamm; causes invasive dysentery

74
Q

ETEC

A

heat-labile and heat-stabile enterotoxin; no inflamm or invasion; causes traveler’s diarrhea (water)

75
Q

EPEC

A

no toxin produced; adhere to apical surface, flattens villi, prevents absorption; diarrhea, usually in kids (P=pediatrics)

76
Q

EHEC

A

shiga toxin producing; O157:H7 is most common serotype in the US; shiga-like toxin causes HUS (triad of anemia, thrombocytopenia, and acute renal failure); mechanical hemolysis, platelet consumption; dysentary; does not ferment sorbtol (distinguishes EHEC from other E coli)

77
Q

Klebsiella

A

intestinal flora that causes lobar pneumonia in alcoholics nad diabetics when aspirated; dark red “currant jelly” sputum (blood/mucus); also cause of nosocomial UTIs

78
Q

campylobacter jejuni

A

comma or S-shaped gram neg; major cause of bloody diarrhea, esp in kids; fecal-oral transmission through person to person contact or via ingestion of poultry, meat, unpast milk. Contact with infected animals is another RF. Common antecdent to GB and reactive arthritis

79
Q

salmonella and shigella

A

both are gram neg bacilli that are non-lactose fermenters and oxidase neg

80
Q

salmonella typi in particular

A

resevoid is humans, can dissem hematogenously, H2S production, flagella, endotoxin, large inoculum required for infxn bc organism inactivated by gastric acids; abx prolong duration of fecal excretion; immune response is monocytes; constipation followed by diarrhea; oral vaccine available; causes typhoid fever (tx with ceftriazone or quinolone); carrier state with GB colonization

81
Q

salomonella species not typhi)

A

resevoir is humans and animals; can dissem hematogenously, H2S producton, flagella, endotoxin, large inoculum required; abx prolongs duration; PMNs in dissem disease; bloody diarrhea; no vaccine; sources are poultry, eggs, pets and turtles; gastroenteritis is usually caused by non-typhoidal salmonella

82
Q

shigella

A

humans only; cell to cell transmission (no hematogenous spread); no flagella, endotoxin and enterotoxin; low inoculum required; abx shortens duration; primarily PMN infiltration; bloody diarrhea; no vaccine

83
Q

vibrio cholera

A

rice water diarrrhea via enterotoxin that permanently activates cAMP; comma shaped; oxidase pos; endemic in dveloping counties; prompt oral rehydration necessary

84
Q

yersinia enterocolitica

A

usually transmitted from pet feces, contaminated milk, or pork; causes acute diarrhea or pseudoappendicitis (right lower abdominal pain due to mesenteric adenitis and/or terminal ileitis)

85
Q

h. pylori

A

curved gram neg rod that is catalase, oxidase, and urease pos; gastirits and peptic ulcers (esp duodenal); FR for peptic ulcer, gastric adenocarcinoma, and MALT lymphoma. Creates alkaline environment

86
Q

spirochetes examples

A

borrelia, leptospira, and treponeme; borrelia is big

87
Q

leptospira interrogans

A

type of spirochete; found in water contaminated with animal urine; causes leptospirosis (flu-like illness, jaundice, photophobia with conjunctival suffusion; prevalent among surfers and in tropics (Hawaii)

88
Q

Weill disease

A

severe form of leptospirosis with jaundice and azotemia from liver and kidney dysfunction, fever, heomrhage, and anemia

89
Q

Lyme disease

A

caused by borrelia burgdorferi, which is transmitted by the Ixodes tick (also vactor for anaplasma and babesia) but natural resevoir is the mouse; treat with doxy or ceftrizone; facial nerve palsy may be seen, cardiac block, erythema chronicum migrans

90
Q

primary syphilis

A

painLESS chnacre; dx by using darkfield microscopy to visualize treponemes from the chancre; VDRL pos in 80%

91
Q

secondary syphilis

A

constitutional sx, maculopapular rash (incl palms and soles); condylomata lata

92
Q

congenital syphilis

A

facial abnormalities like rhagades (linear scars at angle of mouth), snuffles (nasal discharge), saddle nose, notched (Hutchinson) teeth, mulerry molars, and short maxilla; saber shins; CN 8 deafness

93
Q

how to prevent congenital syphilis

A

treat mother early in pregnancy, as placental transmission typically occurs after the first trimester

94
Q

VDRL false positives

A

test is sensitive but not specific; false pos are Viral infection (mono, hepatitis), Drugs, Rheumatic fever, Lupus and leprosy

95
Q

Jarish-Herxheimer reaction

A

flu-like syndrome after abx are started; due to killed bacteria (usually spirochetes) releasing endotoxins

96
Q

anasplasma species of bacteria

A

carried by the ixodes ticks (on deer and mice)

97
Q

bartonella

A

cat scratch disease, bacillary angiomatosis

98
Q

borrelia recurrentis

A

relapsing fever; carried by the louse

99
Q

brucella

A

brucellosis/indolent fever; get from unpastuerized dairy

100
Q

campylobacter

A

bloody diarrhea; get from puppies and livestock (fecal-oral, ingestion of undercooked meat)

101
Q

chlamydophila psittaci

A

psittacosis; get from parrots and other birds

102
Q

coxiella burnetii

A

Q fever; get from aerosols of cattle/sheep amniotic fluid

103
Q

ehrlichia chaffensis

A

get from ambyloma (Lone star tick)

104
Q

francisella tularensis

A

causes tularemia; get from ticks, rabbits, deer fly

105
Q

leptospira species

A

get from animal urine

106
Q

mycobacterium leprae

A

causes leprosy; get from humans with lepromatous leprosy and also from armadillos (rare)

107
Q

pastuerella multicoda

A

causes cellulitis or osteomyelitis; get from animal bites, dog or cats

108
Q

rickettsia prowazekii

A

causes epidemic typhus; carried by the louse

109
Q

rickettsia rickettsii

A

rocky mountain spotted fever; get from Dermacentor (dog tick)

110
Q

rickettsia typhi

A

epidemic typhus; get from fleas

111
Q

salmonella

A

causes diarrhea, vomitting, fever, abd cramps; get from reptiles and poultry

112
Q

yersinia pestis

A

caused the plauq; get from fleas (rats and prarie dogs are resevoirs)

113
Q

gardnerella vaginalis

A

pleomorphic gram variable rod; involved in bacterial vaginosis; gray vaginal dc with a fishy smell; assoc with sexual activity but not sexually transmitted; clue cells; treat with metronidazole or clindamycin; amine whiff test gives fishy odor

114
Q

rocky mountain spotted fever

A

rickettsia rickettsii; vector is tick; disease occurs primarily in the south atlantic states (esp North carolina); rash starts at wrists and ankles and spread to trunk, palms, and soles

115
Q

palms and soles rash

A

RMSF, coxsackie virus (hand, foot, mouth disease), and secondary syphilis

116
Q

typhus

A

rickettsia typhi, rickettsia prowazekii; rash starts centrally and spreads peripherally, sparing the palms and soles

117
Q

ehrlichiosis

A

vector is tick; monocytes with morulae (berry-like inclusions) in cytoplasm

118
Q

anaplasmosis

A

vector is tick; granulocytes with morulae in cytoplasm

119
Q

Q fever

A

coxiella burnetii; no arthropod vector; spores inhaled as aerosoles from cattle/sheep amniotic fluid; presents as PNA; most common cause of culture negative endocarditis; Q fever has no rash or vector and its causative organism can survive outside in its endospore form

120
Q

chlamydiae

A

obligate intracellular organism; cause mucosal infxns in 2 forms (elementary body enters the cell and transforms into reticulate body, which replicates and reforms into elementary body)

121
Q

types of chlamydia

A

trachomatis is the nl one I think of (PID, urethritis, reactive arthritis, conjunctivitis); pneumoniae and psittaci cause atypical pneumonia, transmitted by aerosol, has an avian resevoir

122
Q

chlamydia trachomatis serotypes

A

A,B, and C (“africa, blindness, chronic infection”); Types D-K (urethritis/PID, neonatal pneumonia with eosinophilia, neonatal conjunctivitis); Types L1,L2, L3 cause lymphogranuloma venereum (small, painless ulcers on genitals and painful swollen inguinal lymph nodes that ulcerate, treat with doxy)

123
Q

treatment for chlamydia (in general)

A

azithromycin (favored bc one time treatment) or doxy

124
Q

mycoplasma pneumonia

A

classic cause of atypical (“walking”) PNA; xray looks worse than patient; treat with macrolides, doxy or quinolones (penicillins ineffective because mycoplasma has no cell wall); common in people less than 30 yo, military recruits and prisons; bacterial membrane contains sterols for stablity; pleomorphic and no cell wall so not seen on gram stain

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