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Microbiology Flashcards

1
Q

What is considered mild diarrhoea?

A

3 or few stools per day ( without abdominal or systemic symptoms)

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2
Q

What is considered moderate or severe diarrhoea?

A

4 or more stools per day associated with [abdominal symptoms (cramps, nausea, vomiting, tenesmus) systemic symptom (fever, malaise, dehydration)].

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3
Q

What is Dysentery?

A

Passage of frequent , small- volume stools accompanied by blood, mucus, abdominal pain (cramping) and tenesmus. (ineffectual and painful straining at stool.

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4
Q

What are the most common sources of Dysentry?

A
  1. Shigella spp.
  2. Campylobacter spp
  3. Enteroinvasive Escherichia Coli
  4. Salmonella enteritidis (?)
  5. Yersinia enterocolitica (?)
  6. Antibiotic –associated diarrhoea Clostridium difficile
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5
Q

What type of bacteria is Shigella?

A

Gram - negative bacilli

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6
Q

What type of Shigella is seen primarily in underdeveloped countries?

A

Shigella flexneri

“They can’t flex because they’re underdeveloped “

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7
Q

What type of Shigella is the most common in the industrial world ?

A

Shigella sonnei

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8
Q

Shigella outbreaks normally occur in?

A
  • Homosexuals men
  • Under conditions of crowding
  • Where personal hygiene is poor, such as in jails, institutions for children, daycare centres, mental hospitals and crowded refugee camps.
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9
Q

What is the infectious dose for Shigella?

A

10-100 or 100-200 Low infectious dose

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10
Q

What type of cells does the Shigella bacteria adhere and invade?

A

M cells in Peyer’s patches.

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11
Q

From what type of bacteria is Shiga toxin produced in?

A

Shigella dyenteriae type 1

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12
Q

What is the Shiga Toxin?

A

This toxin is a subunit protein composed of one A subunit and five B subunits with binding specificity for a specific microvillus membrane glycolipid receptor

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13
Q

Fill in the blanks. “In relation to the Shiga toxin, The glycolipid receptor for the B subunit are located on __________.”

A

The villus cells

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14
Q

True or False? The glycolipid receptor for the B subunit are located on the villus cells and NOT the crypt cells, thereby impairing sodium adsorption without affecting chloride secretion and leading to net luminal fluid accumulation.

A

TRUE!!

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15
Q

What does the A unit for the Shigella Toxin cleaves ?

A

The A subunit enzymatically cleaves the 28S ribosomal RNA of the 60S ribosomal subunit in eukaryotic cells with resultant inhibition of protein synthesis .

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16
Q

Haemolytic - uremic syndrome , Toxic Megacolon , Disseminated intravascular coagulation (DIC) & Sepsis is associated with which type of Shigella?

A

Shigella Dysenteriae Type 1

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17
Q

What is Reiter’s syndrome?

A

It is a post infectious arthropathy-the triad of nongonococcal urethritis, conjunctivitis and arthritis, frequently with mucocutaneous lesions.

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17
Q

What is the culture used for the diagnosis of Shigella?

A

MacConkey (indicator).

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17
Q

How is the culture presented for Shigella?

A

Shigella forms a non-lactose fermenting pale coloured or colourless and transparent colonies.

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18
Q

What is the preffered drug of choice to treat Shigella?

A

Antimicrobial therapy

For cases in which susceptibility is unkown or an ampicillin-resistant strain is isolated, Bactrim is the drug of choice.

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18
Q

What is Food Poisoning?

A

A non-specific term applied to the syndrome of acute anorexia, nausea and vomiting +/- diarrhoea that is attributed to food intake especially if it afflicts groups of persons. It may or may not be accompanied by fever.

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18
Q

What are chemically - related food poisonings?

A
  1. Ackee, mushroom poisoning
  2. Heavy metals eg. Copper, Zinc, Selenium, Cadmium
  3. Toxic fish poisoning eg. Shellfish - saxitoxin - clams, oysters - ciguatera - ciguatoxin-snapper - barracuda 4. Chinese Restaurant syndrome –MSG
  4. Salt petre: methaemoglobinemia
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19
Q

What is the pathophysiology for non- inflammatory diarrhoea from food posoining?

A

It is caused by action of enterotoxins on the secretory mechanisms of the mucosa of the SI without invasion (watery, no leukocytes)

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20
Q

What is the pathophysiology for inflammatory diarrhoea from food posioning?

A

It is caused by cytoyoxins on the mucosa leading to invasion & destruction. Colon or distal small bowel involved.
* Diarrhoea bloody with leukocytes.

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21
Q

What is the time period for clinical presentation of chemical poisoning?

A

Within 30 minutes

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22
Q

What is the time period for clinical presentation of Preformed toxin ?

A

Within 1-6 hours

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23
Q

What are the steps in the investigation of outbreaks due to food poisoning?

A

1.Identify index case
2. Proper clinical history
3. Determine I.P. eg. Illness
4. Identify common foods eaten
5. Determine food specific attack rates for everything served

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24
Q

What are the specimens to be collected from patients with suspected food poisoning ?

A

Stool
Vomitus
Blood

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24
Q

What are the specimens to be collected from Foodhandlers with suspected food posioning?

A

Stool
Nose
Hand

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25
Q

True or False? Most cases of Food-Poisoning are self- limiting.

A

TRUE!!

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26
Q

What are indications for antibiotic treatment for Food poisoning?

A
  • Fever of >38C plus…
  • Faecal leukocytes +blood or mucus in stool
  • Isolation of some organisms eg Shigella, S typhi
  • Immunocompromised patients
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27
Q

Fill in the blanks. “ Salmonella is a genus in the family _________.”

A

Enterobacteriaceae

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28
Q

True or False? Salmonella is a gram- positive cocci in chains.

A

FALSE!! Gram-negative rods

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29
Q

What type of Salmonella species is a contaminant found in marijuana?

A

S. munchen

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30
Q

Which type of Salmonella species can be found in eggs?

A

S. enteritidis

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31
Q

Salmonella Dublin is mostly associated with what substances?

A

Milk , cow liver

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32
Q

What are the three kinds of surface antigens for Salmonella?

A
  1. Flagellar or ‘H’ antigen
  2. Somatic or polysaccharide ‘O’ antigen
  3. Polysaccharide Vi antigen in S. typhi/paratyphi
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33
Q

What is the laboratory diagnosis used for Salmonella using a stool sample?

A

MacConkey agar & SS ( Salmonellla / Shigella )agar - non lactose fermenting colonies

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34
Q

What are the most common sites for Intra-abdominal infections?

A
  • Peritoneal cavity
  • Retroperitoneal space
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35
Q

What are the two types of Intra-abdominal infections?

A
  1. Diffuse ( Peritonitis)
  2. Localized ( Abscesses)
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36
Q

What are the most common locations for Intra peritoneal abscesses?

A

1.Pelvic space

2.Perihepatic spaces

3.Within lesser sac

4.Paracolic gutter

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37
Q

What are the different types of visceral abscesses?

A

Hepatic
Renal
Splenic
Tubo-Ovarian

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38
Q

What are the types of Infective Peritonitis?

A

Primary & Secondary

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39
Q

What are the types of Peritonitis?

A
  1. Infective
  2. Chemical
  3. Combination fo 1& 2
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40
Q

Explain Chemical Peritonitis.

A

It involves the escape of bile, gastric or pancreatic secretions into the peritoneal cavity.

41
Q

What normally leads to the formation of abscesses?

A

Phagocytosis resistant anaerobes

42
Q

What is an expected laboratory result for a confirmation of Peritonitis?

A

Leucocytosis with predominant polymorphs, increased hematocrit, blood urea, serum amylase etc.

43
Q

What is the treatment for Peritonitis caused by Group A Streptococcus?

A

Penicillin G

44
Q

What is the treatment for Peritonitis due to Staph Aureus ?

A

Cephalosporin

45
Q

Fill in the blanks.” The treatment for Peritonitis due to Anaerobes are ______, _____ & ______.”

A

Metronidazole
Gentamicin
Clindamycin

46
Q

Augmentin, PIP/TAZ, carbapenems, cephalosporins is used to treat Peritonitis caused by what organism?

A

Enterobactericeae

47
Q

What is the most common bacteria associated with Intraabdominal Abscesses?

48
Q

Which lobe of the liver is more commonly involved with amoebic abscesses?

A

Right lobe!

49
Q

What are the two types of Hepatic abscesses?

A

Pyogenic ( Bacterial)
Amoebic

50
Q

What type of abscess has uncommon lesions and may occur in sicklers, after trauma or bacteriemia?

A

Splenic Abscess

51
Q

What are the clinical presentations primary peritonitis in a cirrhotic patient?

A
  • jaundice
  • hepatic encephalopathy
  • ascites
  • azotemia
52
Q

True or False? If there is a hepatic abscess in the right lobe, there is localized tenderness, pain in right shoulder and respiratory signs while if it were in left lobe, epigastric pain with tenderness and rigidity of left rectus muscle.

53
Q

True or False? An ultrasound can be used in the diagnosis of a hepatic abscess.

54
Q

What is the treatment for Amoebic abscesses?

A

Metronidazole

55
Q

What is Group A Shigella known as?

A

Shigella Dysenteriae

‘AD’ Shigella has an ad

56
Q

What is Group B Shigella known as?

A

Shigella Flexneri

‘BFfr’

57
Q

What is the Incubation period for Shigella?

A

6 hours -9 days ( usually 72 hours)

58
Q

By what process does Shigella survive phagocytosis?

A

Apoptosis

’ Shigella survives phagocytosis by apoptosis’

59
Q

What is the most important test in diagnosing Shigella?

A

Fecal leukocytes

60
Q

True or False? Fecal lactoferrin is a more sensitive test than Fecal leukocyte in the diagnosis of Shigella.

61
Q

What is the treatment of choice for Shigella?

A

Fluroquinolone ( ciprofloxacin)

62
Q

True or False? Serotypes 2-15 do not elaborate Shiga toxin.

63
Q

Fill in the blanks. “Reactive Arthritis is associated ________.”

64
Q

What is the rate of transmission for Campylobacter?

A

230,000 cases annually

65
Q

What type of bacteria is Campylobacter?

A

Gram-negative rods & Microaerophilic ( 5-10%)

66
Q

At what temperature is Campylobacter best grown at ?

A

42 degrees Celsius

67
Q

What is the Incubation period for Campylobacter?

68
Q

Which type of Campylobacter is commonly found in Dogs & Cats?

A

Campylobacter Upsaliensis

69
Q

Which type of Camnpylorbacter is associated with Guilliane-Bar syndrome and Reactive Arthritis?

A

Campylobacteria Jejuni

70
Q

What is the infective dose of Campylobacter?

A

5-8 x 102 cells/ml

71
Q

What is the treatment for Campylobacter?

A

Macrolides: Azithromycin (adults), Ciprofloxacin, Tetracycline

Erythromycin ( Children 10mg/kg for 3 days)

72
Q

What is the most common cause of Traveler’s Diarrhea?

A

Campylobacter

73
Q

True or False? Campylobacter is usually self-limiting.

74
Q

What is the stool transport mediums for suspected Food poisoning cases.

A

Sterile container, Buffered glycerol saline (BGS)

75
Q

Which bacteria is associated with Hospital - associated diarrhoea.

A

Chlostridium dificile

76
Q

What is the solid stool culture methods for persons with Food poisoning?

A

MacConkey agar, Sorbitol MacConkey, Salmonella/ Shigella agar , XLD( Xylose- lysine-deoxycholate) agar, Campy agar

77
Q

What is the liquid stool culture for persons with Food poisoning .

A

Gram negative broth
Selenite Broth

78
Q

What is the causative agent in Acute diarrheal infection ?

A

Vibrio Cholera

79
Q

What is the Gram reaction of Vibrio cholera?

A

Short curved Gram negative rods

80
Q

Which types of Vibrio cholera produce Cholera toxin?

A

V. cholerae O1 and O139

81
Q

What is the name of the receptor to which the B in the AB- toxin binds to?

A

GM1 Ganglioside

82
Q

What is the selective media for Vibrio cholera?

A

TCBS (thiosulfate citrate bile salt sucrose)

83
Q

Fill in the blanks. “ The immunoassays are used to detect types ____________ & _______ of the vibrio cholera?”

84
Q

What are the symptoms of Cholera?

A

Profuse watery diarrhea
“rice-water stools”
Vomiting
Thirst
Leg cramps
Restlessness or irritability

85
Q

What are the signs of Cholera?

A

Tachycardia
Decreased skin turgor
Dry mucous membranes
Hypotension

86
Q

What is the treatment for Cholera?

A
  • Oral rehydration and electrolyte replacement
  • Prevent hypovolemic shock – rapid administration of IV fluids
  • Antibiotic therapy
  • Single dose of azithromycin (drug of choice) OR
  • Single dose doxycycline or ciprofloxacin (non-pregnant females)
    Resistance is increasing
87
Q

Which types of E.coli are associated with Traveller’s Diarrhoea from Nosocomial and daycare outbreaks?

A

Enteropathogenic E. coli (EPEC)

88
Q

Which type of E.Coli is associated with Traveler’s diarrhea” in persons < 5 yrs. Foodborne outbreaks?

A

Enterotoxigenic E. coli (ETEC)

89
Q

Which type of E.coli, causes bloody diarrhoea like Shigella?

A

Enteroinvasive E. coli (EIEC)

90
Q

Which type of E-coli causes Mild non-bloody diarrhea, hemorrhagic colitis, HUS?

A

Shiga toxin-producing E. coli (STEC)

91
Q

What is the Gram-reaction for E-coli?

A

Short Gram-negative rods

92
Q

What agar are used in the culture of Shiga-Toxin E.Coli?

A
  • Sorbitol MacConkey Agar (differential media)
  • Cefixime tellurite Sorbitol McConkey agar
  • CHROMagar™ O157
93
Q

How does Enteropathogenic E.coli attach to the mucous surface?

A

Bundle-forming pili (BfpA)

94
Q

How does Enterotoxigenic E. coli attach to the mucous surface?

A

CFA Colonization Factor Antigen)

96
Q

Which E.Coli is associated with a Honeycomb appearance?

A

Enteroaggregative E. coli (EAEC)

97
Q

Which organism is Catalase positive, oxidase negative and can reduce nitrate to nitrite?

A

Salmonella

98
Q

Which classification restricts genus of Salmonella to only 3 subtypes?

99
Q

Which salmonella species has 6 subspecies?

A

Salmonella enterica

100
Q

What are the serogroups of Salmonella?

A
  • Salmonella enteritidis
  • Salmonella typhi
  • Salmonella paratyphi
  • Salmonella typhimurium
  • Salmonella choleraesuis
101
Q

What is the mode of Transmission for Salmonella?

A

Especially poultry, eggs, meat, milk and cream

102
Q

What are the causative agents of Salmonella IN GASTROENTERITIS?

A

S. enteritidis and S. typhimurium

103
Q

What is an Enteric fevers?

A

A multi-organ system salmonella infection
characterized by prolonged fever, sustained
bacteremia and prolonged involvement of the
mesenteric lymph nodes, liver and spleen.

104
Q

What is the aetiology for Enteric fevers?

A
  • Salmonella typhi – most common cause
  • Salmonella paratyphi A, B, C
105
Q

What are the clinical features of Typhoid fever?

A
  • Bradycardia (infrequent in children)
  • Malaise
  • Myalgia
  • Diarrhoea uncommon (< 1/3)
  • Splenomegaly – may be found
  • Headache and constipation (common)
  • “Rose spots”
106
Q

What is the drug of choice for Typhoid fever?

A

Chloramphenicol

Digestive System (16 decks)

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