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Phase 2a > Microbiology > Flashcards

Microbiology Flashcards

1
Q

What is a pathogen

A

Organism that causes or is capable of causing disease

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2
Q

What is a commensal

A

Organism which colonises the host but causes no disease in normal circumstances

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3
Q

What is opportunist pathogen

A

microbe that only causes disease if host defences are compromised

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4
Q

What is virulence/pathogenicity

A

The degree to which a given organism is pathogenic

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5
Q

What is asymptomatic

A

When a pathogen is carried harmlessly at a tissue site where it causes no disease

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6
Q

What is an endotoxin

A

Component of the outer membrane of bacteria e.g lipopolysaccharide in Gram negative bacteria

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7
Q

What is an exotoxin

A

Secreted proteins from gram positive and gram negative bacteria

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8
Q

Give the virulence factors, normal habitat, spread, resistant strain and resistant medication for Staphylococcus Aureus

A

virulence factors;pore-forming toxins (alpha-haemolysin and Pantone-valentine leucocidin (PVL)), protease (exfoliatin), toxic shock syndrome toxin (TSST) which stimulates cytokines release, protein A (surface protein which binds Ig’s in wrong orientation)

Normal habitat; nose and skin

Spread; aerosol and touch

Resistant strain; MRSA

Resistant medication; B-lactams, Gentamicin, Erythromycin, Tetracycline

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9
Q

Staphylococcus are divided into coagulase positive and negative. How can are coagulate positive bacteria tested for

A

Coagulase positive bacteria release coagulate enzymes which clot blood plasma. The fibrin clot formation around the bacteria may protect from phagocytosis.

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10
Q

What is the most important coagulase positive bacteria

A

Staphylococcus Aureus

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11
Q

Give 2 examples of coagulase-negative Staphylococci

A

Staphylococci epidermidis; in prostheses, catheters and debilitated patients. Main virulence factor is the ability to form persistent bio films

Staphylococcus Saprophyticus; causes acute cystitis (inflammation of urinary bladder). Main virulence factor are haemagglutinin for adhesion, urease causing kidney stones

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12
Q

Give the 3 classifications of Streptococci

A
  • Haemolysis
  • Lancefield typing
  • Biochemical properties
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13
Q

Give 3 classes of Haemolysis Streptococcus Pyogenes

A

Alpha-partial, greening e.gStreptococcus intermedius which releases H2O2 that reacts with haemoglobin

Beta-complete lysis e.g Streptococcus pyogenes

Non(or gamma) so lysis e.g some streptococcus mutans

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14
Q

What is lancefield grouping

A

A method of grouping catalase negative, coagulase negative bacteria based on bacterial carbohydrate cell surface antigens

Lancefield A-H and K-V

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15
Q

Most important Lancefield Group B bacteria

A

Streptococcus Agalactiae for neonatal infections

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16
Q

Most important Lancefield Group A bacteria

A

Streptococcus Pyogenes

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17
Q

What type of bacteria is Enterobacter

A

Gram-negative rod-shaped (bacillus) bacteria

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18
Q

What infections are enterobacter bacteria most associated with

A

Respiratory and urinary symptoms

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19
Q

Which enterobacter bacteria are the most common opportunistic pathogens

A

Enterobacter cloacae

Enterobacter Aerogenes

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20
Q

Give 6 characters of Enterobacter

A
  • motile
  • non-spore forming
  • facultative anaerobic (can only survive in oxygen)
  • oxidase negative (doesn’t produce oxidase)
  • urease positive (urease enzyme that converts urea to CO2 and ammonia)
  • grows well on macconkey agar (identifies if lactose fermenters or not)
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21
Q

Gives 3 gram negative lactose fermenting bacteria

A
  • Enterobacter
  • Klebsiella
  • Escherichia Coli
    Pink colonies on agar
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22
Q

Give 2 gram negative bacteria that can’t ferment lactose

A

Salmonella
Shigella
Colourless colonies on agar

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23
Q

Gives some virulence factors of Enterobacter

A

Fimbriae (secrete Haemolysis which put holes in cells)

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24
Q

Give examples of respiratory conditions caused by Enterobacter

A

Inflammation of Trachea and Bronchi
Pneumonia
Lung Abscesses
Pleural Empyema (collection of pus in the pleura cavity)

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25
Q

What would diagnosis of Enterobacter include

A

Blood test, sputum, urine and pus test

Urinary tract infections urine

  • alkaline urine pH>7
  • pyuria (white blood cells in urine)
  • bacteriuria (bacteria in urine)

X-ray for respiratory infections
CT or ultrasound for abdominal infections
Endocardiogram for endocarditis

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26
Q

What medications are used to endobacter

A
  • carbapenems
  • aminoglycosides
  • fluoroquinolones
  • polymyxins
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27
Q

What type of bacteria is Escherichia coli (E.Coli)

A

Rod-shaped gram negative bacteria

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28
Q

Gives 4 characteristics of Escherichia Coli

A
  • catalase positive (produces catalase)
  • lactose fermenter
  • facultative anaerobe (lives with or without oxygen)
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29
Q

How to test for catalase enzyme

A
  • Few drops of hydrogen peroxide are added to bacteria
  • A foamy appearance shows dissociation to water and oxygen
  • encapsulated
  • motile
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30
Q

How are Escherichia coli classified

A
  • by stereotypes based on antigens

- pathotypes (same virulence factors)

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31
Q

Give the 4 types of antigens located on E.coli

A

Somatic (O)
Capsular (K)
Fimbrial (F)
Flagellar (H)

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32
Q

What are pathotypes

A

group of organisms of the same species that cause disease in the same way (same virulence factors)

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33
Q

What are the 5 E.Coli pathotypes

A

1) shiga-like toxin-producing E.coli (STEC)
2) enterotoxigenic E.coli (ETEC)
3) enteroinvasive E.coli (EIEC)
4) enteropathogenic E.coli (EPEC)
5) Uropathogenic E.Coli (UPEC)

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34
Q

How does shiga-like toxin-producing E.coli work

A
  • makes toxin similar to the one called shiga toxin by shigella
  • attaches to host’s intestinal cells an d releases toxins
  • causing inflammation and bloody diarrhoea so sometimes referred to as enterohemorrhagic E.coli (EHEC)
  • can cause haemolytic uremic syndrome (HUS) which leads to proteinuria, thrombocytopenia, anaemia from microangiopathic hemolysis, uremia
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35
Q

How does enterotoxigenic E.coli work

A
  • E.coli releases two enterotoxins
  • heat stable enterotoxin (not easily destroyed by heat) and heat-labile enterotoxin (destroyed by heat) causing loss of water from intestine and watery diarrhoea
  • unlikely to damage cell walls so no bloody diarrhoea
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36
Q

How does enteroinvasive E.coli work

A
  • destroys intestinal cells, enters the cells and multiplies
  • this triggers inflammation leading to damage of cells
  • so might be bloody diarrhoea
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37
Q

How does enteropathogenic E.coli work

A

Causes disease in children under 2 years of age

  • invades intestinal cells and destroys cell cytoskeleton
  • makes intestinal cells flatten and inhibits ability to absorb water and nutrients
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38
Q

How does uropathogenic E.coli work

A
  • Commensal pathogen which can become opportunistic pathogen when around urinary tract
  • produce alpha and beta hemolysins which cause lysis of urinary cells
  • cystitis and polynephritis
  • dysuria (pain during urination)
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39
Q

Give 4 characteristics of Staphylococcus Aureus

A
  • gram positive
  • facultative anaerobes
  • non-motile
  • no spores
  • catalase positive (produces catalase)
  • coagulase positive (converts fibrinogen into fibrin)
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40
Q

What is a superficial impetigo

A

Infection of the epidermis

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41
Q

What is cellulitis

A

Infection of the dermis

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42
Q

Give the 5 superantigens (toxins) associated with Straphylcoccus Aureus

A
  • pore-forming toxins (alpha-haemolysin (in red blood cells) and Pantone-valentine leucocidin (PVL)(in white blood cells))
  • protease (exfoliatin)
  • toxic shock syndrome toxin1 (TSST1) which stimulates cytokines release
  • protein A (surface protein which binds Ig’s in wrong orientation)
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43
Q

Give 5 characteristics of Staphylococcus Epidermidis

A
  • gram-positive
  • non-motile
  • doesn’t spore
  • facultative anaerobe
  • catalase positive
  • urease positive
  • coagulase negative
  • novobiocin sensitive
  • dominant bacteria on normal skin flora
  • most common complication with prosthetics
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44
Q

Which bacteria does the novobiocin test differentiate

A

Staphylococcus epidermidis (novobiocin sensitive)

Staphylococcus saprophyticus (novobiocin resistant)

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45
Q

Give 5 characteristics of streptococcus pneumoniae

A
  • gram positive
  • non-motile
  • no spores
  • catalase negative
  • facultative anaerobes
  • alpha hemolysis (green ajar) and optochin sensitive
  • bile soluble
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46
Q

Which species of bacteria does the optochin test differentiate

A

Streptococcus pneumoniae (optochin sensitive)

Streptococcus viridans (optochin resistant)

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47
Q

Which species does the bile solubility test

A

Streptococcus pneumoniae (bile dissolves)

Other alpha haemolytic streptococcus (bile insoluble)

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48
Q

Virulence factors of streptococcus pneumoniae

A
  • fimbria
  • biofilm
  • pneumococcal surface protein A (PSPA) which inhibits complement activation and avoid opsonisation
  • IgA protease
49
Q

Give examples of different types of agar

A

Blood agar
Chocolate agar - heated to 80 degrees for 5 mins
Cysteine Lactose electrolyte deficient (CLED) agar - used to examine microorganisms in urine and differentiate between lactose fermenting (yellow) and non-lactose fermenting (blue) gram negative bacilli
MacConkey Agar - helps to differentiate lactose fermenting (pink) and non-lactose fermenting (yellow/colourless) gram negative bacilli
Gonococcus agar - used to grow Neisseria Gonorrhea
XLD agar - xylose lysine deoxycholate agar (XLD), shigella is red and salmonella is red with black Centers
Sabouraud’s agar - used for fungi

50
Q

Give 5 characteristics of Mycobacteria

A
  • rod-shaped (bacillus)
  • strict aerobes
  • waxy cell wall (made from mycolic acid)
  • acid fast (red with Ziehl-Neelsen stain)
51
Q

What is caseous necrosis

A

Necrosis associated with Tuberculosis (ghon focus)

Where the inner part of the granuloma dies off and looks like cheese

52
Q

What is a ranke complex

A

Fibrosed and calcified granuloma found on an X-ray

53
Q

What complications are associated with systemic military TB?

A
  • sterile pyuria in the kidneys
  • meningitis in the meninges of the brain
  • pott disease in the lumbar vertebrae
  • Addison’s disease in the adrenal glands
  • hepatitis in the liver
  • lymphadenitis in the neck (scrofula)
54
Q

How to test for TB

A
  • purified protein derivative (PPD) Intradermal skin test (also called tuberculin test, mantoux test, TB test). Positive is when a bump and redness shows after being injected with some TB
  • interferon gamma release assay (IGRA), evidence in the blood and more specific than PPD
  • chest X-ray after positive result on any of the test
55
Q

Give 5 characteristics of Epstein-Barr Virus (EBV)

A
  • also known as Human Herpes Virus-4 (HHV-4)
  • linear, double-stranded DNA
  • enveloped
  • most common cause of infectious mononucleosis (mono)
56
Q

Which cells does EPV infect

A
  • epithelial cells

- b lymphocytes

57
Q

What is a virus

A

An infectious obligate intracellular parasite compromising genetic material (DNA or RNA) surrounded by a protein coat and or a membrane

58
Q

Are viruses living

A

No they are not

59
Q

How do virus replicate

A
  • Attachment to specific receptor
  • cell entry (uncoating of virion within the cell)
  • host cell interaction + replication
  • assembly of virion
  • release new virus particles (bursts out e.g rhinovirus or exocytosis e.g HIV/Influenza)
60
Q

How do virus cause disease

A
  • direct destruction of host cells e.g poliovirus
  • modification of host cell e.g rotavirus (which atrophies villi and flattens epithelial cells
  • over-reactivity of immune system e.g hepatitis B (jaundice)
  • damage through cell proliferation e.g human papilloma virus (causes cervical cancer)
  • evasion of host defences e.g herpesviridae
61
Q

Give examples of anti-penicillin treatments that MRSA is resistant too

A

Nafcillin
Oxacillin
Cloxacillin
Dicloxacillin

62
Q

What is spongiform encephalopathy and what causes it

A
  • brain degeneration that turns healthy tissue into cysts and makes the brain look like a sponge
  • caused by misfolded proteins called prions (which make other prions misfolded to cause cell apoptosis)
  • caused by Creutzfeldt-Jakob Disease (CJB)
  • caused by mutation in prion protein gene (PRNP)
  • caused by kuru (cannibalism of infected human flesh)
63
Q

What does a prion protein do

A
  • contains 230 amino acids longs

- found in neurone cytoplasm and used in neurones for uptake of copper in cells

64
Q

How does variant Creutzfeldt-Jakob disease cause prions in people

A

Prions in cows = bovine spongiform encephalopathy (also known as mad cow disease)

Prions in sheep = scrapie

When human eats animal with prions, the prions enter human brain through absorptive endocytosis

65
Q

Give the 5 plasmodium species that cause malaria in humans

A 
Plasmodium falciparum (invades RBCs of all ages)
Plasmodium vivas (invades reticulocytes)
Plasmodium malarial (invades older RBCs)
Plasmodium ovale (invades RBCs of all ages)
Plasmodium knowlesi (invades older RBCs)
66
Q

Which conditions offer protection against malaria

A
  • Sickle cell anemia (no Duffy antigen)
  • Thalassemia (makes parasite infected erythrocytes more susceptible to dying from oxidative stress)
  • G6PD deficiency
67
Q

How is malaria contracted in a human from a mosquito

A
  • plasmodium-infected female anopheles mosquito looking for a blood meal
  • mosquito are attracted to CO2 and human smells
  • developing plasmodium (called sporozoite) is in mosquitoe’s salivary gland
  • mosquito’s proboscis (needle mouth) pierce skin, sporozoites spill into bloodstream and go to the liver and reproduces asexually (called schizogony)
  • next 2 weeks, these species become merozoites (p.faciparum, p.malaria, p.knowlesi)
  • next months to years, these species become hypnozoites and don’t divide (p.vivax, p.ovale)
68
Q

What is the exoerythrocytic phase of plasmodium

A
  • next 2 weeks, these species become merozoites (p.faciparum, p.malaria, p.knowlesi)
  • next months to years, these species become hypnozoites and don’t divide (p.vivax, p.ovale)
  • usually asymptomatic
69
Q

What is the erythrocytic phase

A
  • merozoite inside the red blood cell
  • lasts 2 to 3 days
  • stage 1= early trophozoite (a ring)
  • stage 2 = late trophozoite
  • stage 3 = schizont (replicative stage with hemozoin - a brown smudge)
70
Q

Describe sporogony of plasmodium

A
  • merozoites becomes gametocytes through gametogony
  • gametocytes in blood are sucked up by another female mosquito
  • gametocytes become zygote and then ookinete and then oocyst which rupture into sporozoites
  • the sporozoites then move to the salivary glands of the mosquito
71
Q

What causes chagas disease (American trypanosomiasis)

A
  • caused by protozoan called trypanosome Cruzi which transmitted through the feaces of triatominae
  • triatominae is a reduviid bug that bites people on the face when they are sleeping (also called the kissing bug)
72
Q

Describe the life cycle of trypomastigote

A
  • starts as epimastigote in gut of reduviid’s midgut
  • multiplies through binary fission
  • becomes typomastigote which can no longer divide and can now enter human cells
  • become amastigote (loses flagellum) and infects cells and divides through binary fission
  • becomes trypomastigote and enters lymph and blood
  • becomes amastigote when in cells again
73
Q

Symptoms of Chagas’ disease

A
  • Romana’s sign (swollen eye)
  • chagoma (swelling at bite site)
  • local inflammation
  • hepatosplenomegaly
  • meningoencephalitis
  • pericardial effusion
74
Q

Symptoms of chronic Chagas’ disease

A
  • can be asymptomatic
  • cardiomyopathy
  • nerve damage
  • gastrointestinal tract symptoms (megaesophagus, megacolon)
75
Q

Medication for acute phase of Chagas’ disease

A

Anti-parasitic medication

  • benznidazole
  • nifurtomox
76
Q

Give 5 characteristics of Streptococcus Pyogenes

A
  • gram positive
  • non-motile
  • no spores
  • facultative anaerobe
  • catalase negative
  • pyrrolidonyl arylamidase positive (produces this enzyme)- turns red
  • beta-hemolysis (complete hemolysis) on blood agar - releases streptolysins which hydrolyses hemoglobin
  • bacitracin sensitive
77
Q

Virulence factors of streptococcus pyogenes

A
  • encapsulated
  • hyaluronidase (destroys hyaluronic acid)
  • streptolysin S & O (destroys red blood cells)
  • streptococcal pyrogenic exotoxins (Spe) - SpeA, SpeB and SpeC (triggers cytokine storm that can lead to toxic shock syndrome)
78
Q

Where can streptococcus pyrones be found as commensal flora

A
  • skin
  • mucosa of pharynx or throat
  • vagina
79
Q

Conditions that can be caused by streptococcus pyogenes

A
  • strep throat (pharyngeal mucosa, tonsils)
  • scarlet fever (bright skin rash and tongue has sandpaper feel)(intracapillary hemolysis)
  • impetigo (epidermis)
  • erysipelas (upper dermis)
  • cellulitis (lower dermis)
  • necrotising fasciitis (muscle fascia)

Complications

  • type 2 sensitivity after bacteria eliminated from body (post-infectious sequelae) - M protein on bacteria mimics myosin and glycogen on heart
  • post-streptococcal glomerulonephrotis (Acute inflammation of of kidneys after impetigo due to type 3 sensitivity reaction)
80
Q

What are the symptoms of acute rheumatic fever

A

JONES

Joint inflammation
Heart damage (new murmurs)
Nodules (on elbows, knees and forearm)
Erythema marginatum (rash with thick margins)
Sydenham’s Chorea (rapid involuntary movements of the face and hands

81
Q

Give some bacteria that increase risk of C. Difficile

A

The ones that start with C

  • cephalosporins
  • carbapenems
  • ciprofloxacin
82
Q

In which situations would you be cautious giving antibiotics

A
  • allergies, anaphylaxis
  • pregnancy
  • liver and Renal function
  • drug interactions
83
Q

How do antibiotics kill bacteria

A
  • inhibits cell wall synthesis
  • inhibits of protein synthesis
  • inhibitors of nuclei acid synthesis
  • anti-metabolites
  • inhibitors of membrane function
84
Q

Give 5 characteristics of streptococcus agalactiae (group B strep - GBS)

A
  • gram positive
  • non-motive
  • non-spores forming
  • facultative anaerobe
  • catalase negative
  • beta hemolysis (uses beta-hemolysin enzyme)
  • bacitracin resistant
  • only hippurate positive strep (hippuricase)
  • camp positive
85
Q

Who does streptococcus agalactiae (GBS) infect normally

A
  • commonly affects pregnant women and newborns

- infects cattle involved in milk production (cows)

86
Q

Where can streptococcus agalactiae be found in the body

A
  • GI tract

- vagina

87
Q

What can an infection of streptococcus agalactiae lead to

A
  • miscarriage or premature delivery
  • intrauterine death
  • cystitis
  • pneumonia in newborns
  • neonatal sepsis
  • neonatal meningitis
  • septic arthritis
88
Q

Give 5 groups within the streptococcus viridans group

A 
Streptococcus Anginous
Streptococcus Mitis
Streptococcus Sanguinis 
Streptococcus Salivarius 
Streptococcus Mutans
89
Q

Give 5 characteristics of streptococcus viridans

A
  • gram positive
  • catalase negative
  • alpha, beta and gamma hemolytic
  • optochin resistant
  • bile insoluble
  • no capsule
90
Q

Where can viridans streptococcus be found

A
  • oral cavity
  • teeth
  • skin
  • GI tract
  • genitourinary tracts
91
Q

Which species of streptococcus encourages dental caries and gum disease

A

Streptococcus Mutans

Streptococcus Mitis

92
Q

Which bacteria is the most common cause of subacute bacterial endocarditis

A
  • streptococcus sanguinis
93
Q

Which streptococcus species is found to be most commonly responsible for brain abscesses

A

Streptococcus Intermedius

94
Q

which disease conditions are streptococcus viridans associated with causing

A
  • dental plaques
  • dental caries
  • periodontal disease
  • brain and liver abscesses
  • bacterial endocarditis
  • viridans group streptococcal shock
95
Q

Give the two types of herpes simplex virus

A
  • HS1 (above waist lesions)

- HS2 (below waist lesions)

96
Q

What type virus are the herpesviridae

A
  • enveloped

- double-stranded DNA virus

97
Q

Where do the herpes virus usually reside after infection permanently

A
  • trigeminal ganglia (face)
  • sacral ganglia (genitalia)
  • herpes sores develop on the same side as affected ganglia
98
Q

With herpes simplex virus (HSV), what is prodrome

A
  • a tingling and burning sensation felt a few days before herpes symptom flair up
99
Q

Give symptoms of herpes simplex virus

A
  • Fluid filled small painful blisters found on the vermillion border, gums, palate, tongue, lip, tongue and facial area
  • blisters on females and males genitalia
  • herpetic whitlow (herpes on fingers
  • keratoconjunctivitis (inflammation of cornea and conjunctivitis) - branching dendritic lesion (like thunder branch in eye)
  • meningitis or encephalitis (usually temporal lobe)
100
Q

What does varicella zoster (a type of herpes virus) cause

A
  • varicella (chickenpox)

- herpes zoster (shingles)

101
Q

What tests are used to test for chickenpox and shingles

A
  • tzanck test (multinucleated giant cells in skin)
  • blood test for varicella antibodies
  • PCR to look for viral DNA
102
Q

What medication should not be given to people with chicken pox and why

A
  • aspirin
  • because it might trigger Reye syndrome which when varicella zoster virus and aspirin affect the liver causing toxic buildup of ammonia in the body
103
Q

Give an example of an oncovirus (cancer causing virus)

A
  • human herpesvirus 8 (HHV-8)
  • also called the Kaposi’s sarcoma - associated herpesvirus (KSHV)
  • in the family of human gamma herpesviruses
104
Q

Give 5 characteristics of the kaposi’s sarcoma-associated herpesvirus (KSHV)

A
  • icosahedral capsid
  • double stranded linear DNA
  • protein tegument
  • viral glycoproteins
105
Q

How is kaposi sarcoma-associated herpesvirus transmitted

A
  • through sexual contact
106
Q

What are the two stages of viral infection in the body

A
  • lytic phase (DNA transcribed and translated into viral proteins)
  • latent phase
107
Q

Which virus is usually associated with causing roseola infantum (also called exanthema subitum or 6th disease)

A
  • human herpesvirus 6 (HHV-6)

- roseolovirus

108
Q

What conditions are associated with adenoviruses

A
  • respiratory (sore throat, common cold, pneumonia)
  • gastrointestinal (diarrhoea)
  • genitourinary infections (cystitis)
  • conjunctivitis (pink eye)
109
Q

How does the herpesvirus differ from the adenovirus

A
  • Naked as no lipid membrane

- fibres like projections from each of the vertices of the virus

110
Q

How does adenovirus get into epithelial cells

A
  • binds to the coxsacki adenovirus receptor on the cell
111
Q

How does the adenovirus cause cell death

A
  • Prevent synthesis of cellular DNA

- Prevents production of proteins

112
Q

What is the smallest known DNA animal virus

A

Parvovirus B19 (18-28nm)

113
Q

What is parvovirus associated with causing in children

A
  • fifth disease (slapped cheek syndrome)
114
Q

Give 5 characteristics of parvovirus

A
  • single stranded linear DNA
  • icosahedral capsid
  • naked (no lipid membrane)
115
Q

Which cells are parvovirus attracted to and why

A
  • proerythroblasts
  • parvovirus need P- antigen and cells within the S phase
  • the proerythroblasts has lots of P antigens and usually were in the S phase (DNA duplication stage)
  • the parvovirus uses cells to produce non-structural protein 1 (NS1) which are toxic and cause apoptosis
  • this leads to less new red blood cells being released into the blood stream
116
Q

What is the first line HIV test given at Sheffield teaching hospital

A
  • Roche COBAS assay
117
Q

What are the two second line HIV tests given at Sheffield teaching hospitals

A
  • Liason X

- a line assay

118
Q

What is the fourth HIV test given if the previous ones were inconclusive

A
  • Rescreen Ultra (an ELISA assay)

Phase 2a (6 decks)

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