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Microbiology Flashcards

1
Q

Streptococcus Workup

A

All Strep Catalase Negative

1) Bile Solubility and Optochin sensitivity:
- Bile soluble or Optochin Sensitive - S. pneumo (alpha hemolytic)

If optochin resistant:
2) Bile-esculin test:
- Bile-esculin Positive - Group D Strep

If bile-esculin negative:
3) Hemolysis
- Alpha or gamma hemolytic - Viridans Strep (S. mutans)

If beta hemolytic:
4) Bacitracin sensi
- Group A strep = Bacitracin sensitive (S. pyogenes)
- Group B strep = Bacitracin resistant and CAMP positive (S. agalactiae)

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2
Q

Staph Workup

A

All Staph Catalase Positive, Glucose fementers

1) Coagulase
- Coagulase positive - S. aureus
(S. lugdunensis - positive on slide, negative in tube)

If coagulase negative,
2) Novobiocin resistant
- Novobiocin resistant - S. saprophyticus (UTIs)

  • Novobiocin sensitive- S. epidermidis (heart valves. IVDU, catheters)
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3
Q

Malaria - cycle / severity
P. vivax
P. ovale
P. knowlesi
P. falciparum
P. malariae

A

P. vivax - 48 h, Benign

P. ovale - 48 h, Benign

P. knowlesi - 24 h, Severe

P. falciparum - 48 h, Severe

P. malariae - 72 hour, Moderate

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4
Q

Which malaria has 72 hours cycle?

A

P. malariae

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5
Q

Which malaria has 24 hour cycle?

A

P, knowlesi

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6
Q

Which malaria causes severe disease?

A

P. knowlesi and P. falciparum

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7
Q

Which malaria infects all stages of RBC?

A

P. falciparum (rest are retic only)

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8
Q

High risk HPV subtypes

A

16, 18, 31, 33

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9
Q

Low risk HPV subtypes

A

6, 11, 42, 43, 44

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10
Q

Malaria stages

A

Sporozoite - transmitted by mosquito, infects liver

Merozoite - exits liver, enters RBC

Trophozoite - forms in RBC then can become more merozoite or gametocyte

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11
Q

Filarial worms - sheath vs nuclei in tail

A

Brugia malayi - sheathed, 2 tail nuclei)

Loa loa - sheathed, + tail nuclei

Wuchereria bancrofti - sheathed, NO tail nuclei

Onchocerca volvulus - unsheathed, NO tail nuclei

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12
Q

Chronic active HBV infection serology

A

HBsAg positive

Total anti-HBc positive, IgM negative

HBeAg positive

(Negative anti-HBs, anti-HBe)

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13
Q

Chronic inactive HBV infection serology

A

HBsAg positive

Total anti-HBc positive

anti-HBe positive

(Negative anti-HBs, HBeAg)

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14
Q

CAMP Test

A

Streak 90 degrees to S aureus culture

Increased clearing at intersetion for:
- Listeria
- Group B strep

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15
Q

Non motile enterobacteria

A

Shigella
Klebsiella

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16
Q

MacConkey agar

A

Gram negatives
Pink = lactose fermentation
“LEECKS” - Lactose = E coli, Enterobacter, Citrobacter, Klebsiella, Serratia

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17
Q

Thayer-Martin agar

A

Neisseria

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18
Q

Martin-Lewis agar

A

Neisseria

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19
Q

Regan-Lowe agar

A

Bordatella pertussis and parapertussis

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20
Q

TCBS agar

A

stool culture, Vibrio

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21
Q

S. saprophyticus
Clinical
Catalase
Coagulase
Novobiocin

A

S. saprophyticus
UTIs
Catalase positive
Coagulase negative
Novobiocin resistant

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22
Q

S. epidermidis
Clinical
Catalase
Coagulase
Novobiocin

A

S. epidermidis
Heart valves, IVDU, catheters
Catalase positive
Coagulase negative
Novobiocin sensitive

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23
Q
A
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24
Q

Schistosoma hematobium
Risk factors
Clinical
Egg

A

Schistosome hematobium
Middle East, Africa, snail infested water
Bladder infection, hematuria
Egg with large terminal spine

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25
Q

Schistosoma mansoni
Risk factors
Clinical
Egg

A

Schistosoma mansoni
Caribbean, MIddle East, Africa, snail infested water
GI infection
Eggs with large terminal spine

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26
Q

Runyon Group 4

A

Runyon Group 4 - Fast Growers (< 7d)

M. fortiuitum
M. abscessus
M. chelonae
M. mucogenicum

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27
Q

Enterobacteriaceae
Aerobic/anaerobic
Glucose
Nitrate
Catalase
Oxidase
Lactose
Motility
H2S

A

Enterobacteriaceae
Facultative anaerobes
Glucose fermenter
Nitrate reducer
Catalase positive
Oxidase negative
Lactose fermenters - E coli, Klebsiella, Enerobacter, Citrobacter
Mostly motile - except Klebsiella and Shigella
H2S producers - Salmonella, Citrobacter Proteus

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28
Q

Rickettsia

A

Ehrlichia and Anaplasma
Intracellular in neutrophils or monocytes
Ehrlichiosis, Rocky Mountain Spotted fever

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29
Q

Culture negative endocarditis

A

“HACEK”
Haemophilis
Aggregatibacter
Cardiobacterium
Eikenella
Kingella

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30
Q

Runyon Group 1

A

Runyon Group 1 - Photochromogens
(colored with light)

M. kansasii
M. simiae
M. marinum
M. asiaticum
M. szulgai at 25 C

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31
Q

Runyon Group 2

A

Runyon Group 2 - Scotochromogens
(colored all the time)

M. gordonae
M. flacescens
M. szulgai at 37 C
M. scrofulaceum
M. xenopi (most)

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32
Q

Runyon Group 3

A

Runyon Group 3 - Non-photochromogen

MAI
M. bovis
M. ulcerans
M. haemophilum
M. xenopi (some)

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33
Q

CNA agar

A

inhibits Gram Negatives

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34
Q

Bile esculin

A

Inhibits Gram positives

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35
Q

Haemophilus growth requirements
- H. influenzae
- H. parainfluenzae
- H. ducreyi

A

H. influenzae - factor X (heme) and factor V (NAD)
H. ducreyi - Factor X (sex = X)
H. parainfluenzae - factor V (not sex = not X)

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36
Q

Y. pestis growth requirement

A

25C

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37
Q

Vibrio growth requirements

A

Salts

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38
Q

Egg - Football with double knobs

A

Trichuris trichuris

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39
Q

D. latum complication

A

B12 deficiency

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40
Q

Trichuris trichuria complication

A

Rectal prolapse

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41
Q

Fasciola hepatica complication

A

Bile obstruction

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42
Q

Broad based budding

A

Blastomyces

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43
Q

Narrow based budding

A

Cryotococcus or Histoplasma

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44
Q

Germ tubes / pseudohyphae

A

Candida

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45
Q

Large spherules with endospores

A

Coccioides

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46
Q

Candida resistant to fluoconazole

A

C. krusei
Some C. glabrata

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47
Q

Which Candida has no hyphae or pseudohyphae (grow only in yeast form)

A

C. glabrata

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48
Q

Malaria - Banana shaped gametocyte

A

P. falciparum

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49
Q

Malaria - Band forms

A

P. malariae

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50
Q

Malaria - Large intracellular forms

A

P. ovale
P. vivax

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51
Q

Micrococcus
Microscopy
Catalase
Bacitracin
Diff test

A

Micrococcus:
- Gram positive cocci, clusters of usually 4
- Catalase positive
- Bacitracin sensitive
- Diff from Staph - Modified oxidase test. Also does not ferment glucose (most staph do)

52
Q

Tellurite agar

A

Selective for Corynebacterium

53
Q

Tinsdale agar

A

Selects C. diphtheriae from other Corynebacterium

54
Q

B. cereus vs B. anthracis - common vs diff

A

Common - Catalase+

B. cereus:
- Beta hemolytic
- Motile

B. anthracis
- Gamma hemolytic
- Non motile

55
Q

TSI slant
- Top vs Bottom
- Results

A

TSI Slant
Top (slant) = lactose/sucrose
Bottom = glucose

  • If bottom, facultative anaerobe
  • If black, H2S production
56
Q

Swarming pattern of growth

A

Proteus

57
Q

Brick red pigment

A

Serratia

58
Q

Vibrio
- Microscopy
- Glucose

A

Vibrio
- Curved, Gram Negative rod
- Glucose fermenter

59
Q

P. aeruginosa
- Growth pattern
- Growth condition
- Oxidase

A

P. aeruginosa
- Diffusible blue-green pigment, mucoid colonies in CF patients
- 42C
- Oxidase+

60
Q

Bordatella pertussis - colony morphology

A

Drop of mercury

61
Q

Francisella - culture requirements

A

Cysteine

62
Q

Campylobacter - morphology, culture requirements

A
  • Small curved Gram Negative bacilli
  • Selective media - Campy CVA. 42C microaerophillic
63
Q

Nocardia vs Actinomyces - common vs diff

A

Nocardia vs Actinomyces
- Common = anaerobe, Gram positive rods, sulfur granules

  • Actinomyces = modified acid fast negative
  • Nocardia = modified acid fast positive
64
Q

Molar tooth colonies

A

Actinomyces

65
Q

C. perfringens - hemolysis

A

Double zone
Inner beta
outer alpha

66
Q

Mucicarmine stain

A

Capsule of Cryptococcus

67
Q

Six common dimorphic fungi

A

Histoplasma capsulatum
Blastomyces
Coccioides
Pracoccioides
Sprotothrix schenckii
Penicllium marneffei / Talaromyces

68
Q

HIstoplasma in tissue

A

Yeast intracellular in macrophages

69
Q
A
70
Q

Coccioides
- Geography
- Risks
- Sx
- Dx
- Mold color / appearance

A

Coccioides
- SW USA, Mexico, S America
- Deserts
- Flu-like sx, some erythema nodosum
- Enzyme immunoassay
- Mold: White and waxy to woolly, “barrell arthrocondia”

71
Q

Coccioides in tissue

A

Large spherule with endospores

72
Q

Sporothrix schenckii
- Risks
- Sx
- Mold color / appearance
- Yeast color / appearance

A

Sporothrix
- Rose gardeners disease
- Skin lesion, lymphocutaneous spread
- Mold: beige to black, Daisy wheel or rosette
- Yeast: elongated, Cigar bodies

73
Q

Penicillium / Talaromyces
- Geography
- Sx
- Mold color / appearance
- Yeast color / appearance

A

Penicillium / Talaromyces
- SE Asia
- Cutaneous or pneumonia in immunocomp
- Mold: green with red diffusible pigment, Skeleton Hands
- Yeast: Transverse fission

74
Q

Cryptococcus neoformans
- Risks
- Sx
- Dx
- Yeast appearance

A

Cryptococcus neoformans
- Pigeon droppings
- Neuro infection, can infect lungs too
- Dx = antigen test
- Thick capsule (India ink), narrow based budding

75
Q

Malassezia furfur
- Sx
- Culture

A

Malassezia furfur
- Pityriasis / tinea versicolor
- Lipophillic yeast - requires fatty acid (olive oil)

76
Q

Malassezia furfur in tissue

A

Spaghetti and meatballs

77
Q

Three dermatophytes

A

Microsporum
Epidermophyton
Trichophyton

78
Q

Microsporum canis
- Color
- Appearance

A

While mold with yellow reverse
Thick walled macroconidia, “snap peas”

79
Q

Trichophyton rubrum - culture

A

White mold with red reverse / diffusion
Pencil shaped macroconidia with tear-shaped microcondia “birds on a wire”

80
Q

Epidermophyton floccosum
- Color
- Appearance

A

Yellow - khaki green
Large Beaver Tail macroconidia

81
Q

Mold appearances:
Histoplasma
Blastomyces
Coccioides
Paracoccioides
Sporothrix
Talaromyces
Malasseiza furfur
Microsporum
Trichophyton
Epidermphyton

A

Histoplasma - slender with big roudn buds
Blastomyces - Lollipops
Coccioides - Barrels
Paracoccioides - Mariner’s wheel
Sporothrix - Daisy wheel / rosettes
Talaromyces - Skeleton hands
Malasseiza furfur - spaghetti and meatballs
Microsporum - snap peas
Trichophyton - birds on a wire
Epidermphyton - beaver tail

82
Q

Aspergillus family - microscopic appeatance

A

Large vesicles with conidia branching off (Dandelions)

83
Q

Aspergillus family - mold colors, disease
A. fumigatus
A. flavus
A. niger
A. terreus

A
  • A. fumigatus - blue/green that turns grey, pulmonary
  • A. flavus - brownish green-yellow, pulmonary
  • A. niger - black with white border, otitis media
  • A. terreus - sand colored, immunocomp infection
84
Q

Mucorales
- Appearance
- Sx

A

Mucorales
- Non-septate hypahe with sac-like sporangium
- Mucormycosis (soft tissue nasal ifection), pulmonary in immunocomp

85
Q

Mucor vs Rhizopus

A

Rhizopus = has rhizoids

Mucor = no rhizoids

86
Q

Mycobacteria media

A

Middlebrook

Lowenstein-Jensen

87
Q

Acid Fast Stains
- Ziehl-Neelsen
- Kinyoun

A

Both carbol fuchsin

ZN - heat

Kinyoun - phenol

88
Q

Mycobacterium TB vs Mycobacterium bovis

A

M. TB:
- Nitrate / Niacin Positive
- T2H growth
- Pyrazinamide enzyme positive
- Pyrazinamide susceptible

M. bovis:
- Nitrate / Niacin Negative
- T2H no growth
- Pyrazinamide enzyme negative
- Pyrazinamie resistant

89
Q

Mycobacterium that grows at 42C

A

M. xenopi

90
Q

Mycobacterium leprae - culture, risk, tissue

A

M. leprae
- No culture
- Risk = armadillo reservoir
- Tissue - AFB in nerve fibers

91
Q

Infection - Transmission,Stage
Giardia
Entamoeba histolytica
Cryptosporidium parvum/hominis
Toxoplasma gondii

A
  • Giardia - fecal-oral, cyst
  • Entamoeba histolytica - fecal oral, cyst
  • Cryptosporidium - contaminated water, oocyst
  • Toxoplasma - oocyst in cat feces or tissue cyst in meat
92
Q

Malaria - only ring forms in RBCs

A

P. falciparum

93
Q

Trypanosoma brucei
- Vector
- Sx

A

Trypanosoma brucei
- Tsetse fly (Glossina spp)
- African sleeping sickness - 1) chancre at bite, 2) fever/LAD, 3) CNS disease (sleeping sickness)

94
Q

Trypanosoma cruzi
- Vector
- Sx

A

Trypanosoma cruzi
- Reduvid or Kissing bug (feces)
- Chagas disease - fever, LAD, HSM, myocarditis, Romana’s sign (conjunctival inoculation with vector feces), cardiomyopathy, megaesophagus / megacolon

95
Q

Leishmania
- Vector
- Sx
- Appearance

A

Leishmania
- Sandfly (promastigote injected)
- Cutaneous = ulcerating lesions; Visceral = mosrtly L. donovani, HSM, cytopenia
- Intracellular organisms

96
Q

Toxoplasma gondii
- Vector
- Sx

A

Toxoplasma gondii
- Cat feces (oocyst) or undercooked meat (tissue cyst)
- Asx or mononucleosis; if congenital, chorioretinitis, encephalitis, hydrocephalu; ring enhacing lesion in immunocomp

97
Q

Trichomonas vaginlais
- Vector

A

Trichomonas vaginalis
- Human STD, NO cyst

98
Q

Enterobius vermicularis
- Common name
- Infective form
- Sx
- Egg

A

Enterobius vermicularis
- Pinworm
- Embryonated ova (ingested or inhaled)
- Perianal pruritus
- Egg flattened on one side

99
Q

Trichuris trichiura
- Common name
- Infective form
- Sx
- Egg

A

Trichuris trichuria
- Whipworm
- Embyonated ova
- Mostly asx, but can cause abdominal pain, diarrhea, rectal prolapse
- Egg barrel shaped (each end with plug)

100
Q

Ascaris lumbricoides
- Infective form
- Sx
- Egg

A

Ascaris lumbricoides
- Embryonated ova
- Larvae in lungs can cause eosinophilic pneumonitis, then adults bowel obstruction or migrate many places
- Egg - fertilized is ruffled oval, but unfertilied elongated with knobbly shell

101
Q

Necator americanus / Ancylostoma duodenale
- Common name
- Infective form
- Sx
- Egg

A

Necator americanus / Ancylostoma duodenale
- Hookworm
- Filiaform Larvae - penetrate skin, migrate to lungm swallowed
- 1) Cutaneous ground itch, 2) Respiratory symptoms, 3) Intestinal symptoms, ***Iron deficiency anemia
- Egg - Colorless shell with embryo inside

102
Q

Strongyloides stercoralis
- Common name
- Infective form
- Sx
- Egg

A

Strongyloides stercoralis
- Threadworm
- Filiariform larvae - penetrate skin, migrate to lungs, swallwed, then autoinfection
- 1) Cutaneous ground itch, 2) Respiratory symptoms, 3) Intestinal symptoms, *** Eosinophilia

103
Q

Wuchereria bancrofti, Brugia malayi
- Vector
- Infective form
- Sx

A

Lymphatic filaria (Wuchereria, Brugia)
- Mosquito (Culex, Anopheles, other)
- Larvae
- Lymphatic obstruction - lymphedema, elephantiasis, eosinophilia

104
Q

Onchocerca volvulus
- Vector
- Infective form
- Sx

A

Onchocerca volvulus
- Black fly
- Larvae
- Cutaneous - pruritus, dermatitis, subQ nodules; River blindness (keratitis, uveitis)

105
Q

Loa loa
- Vector
- Infective form
- Sx

A

Loa loa (African eye worm)
- Deer fly
- Infective larvae
- Often asx but cornea / calabar swelling

106
Q

Diphyllobothrium latum / Dibothriocephalus latus
- Common name
- Infective form
- Sx
- Egg
- Proglottid

A

Diphyllobothrium latum / Dibothriocephalus latus
- Fish tapeworm
- Larvae (eat fish that ate infected crustacean)
- Abdominal sx + *** B12 deficiency
- Only tapeworm with operculum on egg
- Proglottid wider than long

107
Q

Taenia saginata / Taenia solium
- Common name
- Infective form
- Sx
- Egg
- Proglottid

A

Taenia
- T. saginata = beef tapeworm, T. solium = pork apeworm
- Larvae - in undercooked meat
- Mild GI sx, appendicitis or cholangitis; vs. cysticercosis (T. solium) - ingest ova and migrate
- Egg - thickwalled with radial striations
- Proglottid - T. saginata = 7-13 uterin barnches, vs T. solium = 15-30

108
Q

Echinococcus granulosus
- Common name
- Infective form
- Sx

A

Echinococcus granulosus
- Sheep tapeworm
- Eggs - from dog that got from sheep
- Liver cysts - contain protoscoleces

109
Q

Hymenolepis nana
- Common name
- Infective form
- Sx
- Egg

A

Hymenolepis nana
- Dwarf tapeworm
- Eggs ingested
- Usually asx, some GI
- Egg w two poles with filaments

110
Q

Clonorchis
- Common name
- Vector / infective form
- Sx
- Egg

A

Clonorchis
- Oriental Liver fluke
- Larvae - ingested in fish that was infected by snail
- Acute abdominal pain and diarrhea, chronic cholangiis, cholelithiasis, pancreatitis
- Egg - shouldered operculum

111
Q

Fasciola hepatica
- Common name
- Vector / infective form
- Sx
- Egg

A

Fasciola hepatica
- Sheep liver fluke
- Larvae - on watercress or sheep liver
- Acute abdominal pain, hepatomegaly, diarrhea, eosinophilia. Chonic biliary obstruction
- Egg - oblong with small operculum

112
Q

Fasciolopsis buski
- Common name
- Vector / infective form
- Sx
- Egg

A

Fasciolopsis buski
- Large intestinal fluke
- Larvae on water plants (from ig feces)
-
- Egg - oblong with small operculum

113
Q

Paragonimus westermani
- Common name
- Vector / infective form
- Sx
- Egg

A

Paragonimus westermani
- Lung fluke
- Larvae - in undercooked crustaceans
- Acute diarrhea, cough, HSM. Chronic pulmonary sx
- Egg - long with operculum at broad end

114
Q

Schistosoma mansoni
- Vector / infective form
- Sx
- Egg

A

Schistosoma mansoni
- Larvae - direct contact with infected snail
- Acute swimmer’s itch, possible hypersensitivity and fever. Chronic - Colonic polyposis, bloody diarrhea, portal HTN, splenomegaly
- Egg - large lateral spine (Manson had a knife)

115
Q

Schistosoma haemotobium
- Vector / infective form
- Sx
- Egg

A

Schistosoma haemotobium
- Larvae - direct contact with infected snail
- Acute swimmer’s itch, possible hypersensitivity and fever. Chronic - cystitis, urethritis
- Egg terminal spine

116
Q

Schistosoma japonicum
- Vector / infective form
- Sx
- Egg

A

Schisotosoma japonicum
- Larvae - direct contact with infected snail
- Acute - swimmer’s itch, possible hypersensitivity and fever. Chronic - portal HTN, splenomegaly
- Egg with small or absent spine (Japan peaceful)

117
Q

Germ tube positive Candida

A

C. albicans
C. stellatoidea
C. dubliniensis

118
Q

Hot growing mycobacteria

A

M. xenopi, M. thermoresistible

119
Q

Cold growing mycobacteria

A

M. marinum, M. ulcerans

120
Q

M. bovis vs M. TB

A

M. bovis = niacin neg, nitrate neg
M. TB = niacin pos, mitrate pos

M. bovis = TCH susceptible
M. TB = TCH resistant

M. bovis = pyrazinamide resistant
M. TB = pyrazinamide susceptible

121
Q

Necator americanus vs Strongyloides stercolis
- Common names
- Unique sx

A

Necator americanus:
- Hook worm
- Iron defic anemia

Strongyloides stercolis:
- Thread worm
- Eosinophilia

122
Q

Malaria - RBCs with irregular edges

A

P. ovale

123
Q

Acute HBV infection Window period serology

A

Total anti-Hb Core positive
anti-Hb Core IgM positive
(HBsAG negative)

124
Q

Acute infection non-window period serology

A

HBsAG positive
Total anti-Hb Core positive
anti-Hb Core IgM positive
(anti-HBs negative)

125
Q

M. kansasii vs M. TB

A

M. kansasii:
- Photochromogen, slow growing
- Niacin negative, nitrate positive

M. TB:
- Niacin and nitrate positive

126
Q

Bacterial vs Viral vs Fungal Meningitis
- WBC
- Protein
- Glucose

A

Bacterial:
- WBC > 1000, PMNs
- Very High protein (>200)
- Low glucose (<40)

Viral:
- Less elevated WBC < 300, lymphocytes
- Less elevated protein (<200)
- Normal glucose

Fungal:
- WBC < 500
- Very high protein (>200)
- Normal-ish glucose

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