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First Aid 2014 > MICROBIOLOGY- BACTERIA > Flashcards

MICROBIOLOGY- BACTERIA Flashcards

1
Q

What is unusual about Mycoplasma bacteria?

A

Does NOT contain a cell wall i.e. does NOT Gram stain

- Contains cholesterol

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2
Q

What is unusual about Mycobacteria?

A

Contains MYCOLIC ACID

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3
Q

What culture media is used for the isolation of H. influenza?

A

Chocolate agar with factors V and X

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4
Q

What culture media is used for the isolation of N. gonorrhea and N. meningititis?

A

Thayer-Martin

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5
Q

What culture media is used for the isolation of B. pertussis?

A

Bordet-Gengou

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6
Q

What culture media is used for the isolation of C. diptheria?

A

Tellurite agar

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7
Q

What culture media is used for the isolation of M. tuberculosis?

A

Lowenstein-Jensen agar

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8
Q

What culture media is used for the isolation of M. pneumonia?

A

Eaton agar

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9
Q

What culture media is used for the isolation of Lactose-fermentering enterics?

A

MacConkey= pink colonies

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10
Q

How does E. coli appear when grown of eosin-methylene blue agar (EMB)?

A

Green metallic

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11
Q

What culture media is used for the isolation of Legionella?

A

Charcoal yeast extract buffered w/ cysteine and iron

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12
Q

What bacteria expressed Protein A? What is the function?

A

S. aureus

- Prevent opsonization and phagocytosis

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13
Q

What bacteria secrete IgA protease? What is the function?

A

SHiN= S. pneumonia, H. influenza, Neisseria

- Cleaves IgA to colonize respiratory mucosa

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14
Q

What bacteria contains M protein? What is the function?

A

Group A Streptococci (S. pyogenes)

- Prevent phagocytosis

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15
Q

What is “Endotoxin?” What bacteria is this virulence factor associated with?

A

LPS –associated with the Gram negatives

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16
Q

What is Exotoxin?

A

This is a polypeptide toxin that is SECRETED from various Gram positive and negative bacteria

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17
Q

What bacteria contain an exotoxin that inhibits protein synthesis?

A

1) Corynebacterium diptheria
2) Pseudomonas aeruginosa
3) Shigella
4) EHEC (O157:H7)

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18
Q

What is the MOA of the Corynebacterium diptheria toxin?

A

Inactivation of EF-2

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19
Q

What is the manifestation of the Diptheria toxin?

A
  • Pharyngitis with pseudomembranes

- “Bull neck” lymphadenopathy

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20
Q

What exotoxin is associated with Pseudomonas aeruginosa?

A

Exotoxin A

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21
Q

What is the MOA of Exotoxin A?

A

Inactivation of EF-2

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22
Q

What is the manifestation of Exotoxin A?

A

Host cell death

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23
Q

What toxin is associated with Shigella?

A

Shiga Toxin (ST)

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24
Q

What is the MOA of the Shigella Toxin?

A

Inactivation of 60S ribosome by removing adenine from rRNA

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25
Q

What is the manifestation of the Shiga Toxin?

A
  • GI mucosal damage–> dysentery (bloody diarrhea)

- HUS

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26
Q

What toxin is associated with E. coli O157:H7?

A

Shiga-like Toxin (SLT)

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27
Q

What is the MOA of the STL toxin in E. coli O157:H7?

A

Inactivation of the 60S ribosome by removing adenine from rRNA

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28
Q

How does EHEC differ from Shigella?

A

Does NOT invade host cells but does cause HUS

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29
Q

What kind of diarrhea is seen with E. coli O157:H7?

A

Bloody

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30
Q

What bacterial exotoxins will increase fluid secretion?

A

1) ETEC
2) Bacillus anthracis
3) Vibrio cholerae

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31
Q

What toxins are associated with ETEC?

A

Enterotoxigenic E. Coli=

1) Heat-labile toxin (LT)
2) Heat-stable toxin (ST)

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32
Q

What is the MOA of ETEC’s LT?

A

Heat-Labile Toxin:

  • Activates cAMP
  • cAMP increases Cl- secretion
  • H20 efflux

Think watery diarrhea is Labile in the Air (cAMP), and Stable on the Group (cGMP)

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33
Q

What is the MOA of ETEC’s ST?

A

Heat-Stabile Toxin:

  • Activates cGMP
  • cGMP decreases resorption of NaCl
  • Increased H20 in gut

Think watery diarrhea is Labile in the Air (cAMP), and Stable on the Group (cGMP)

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34
Q

What toxin is associated with Bacillus anthracis that will increased fluid secretion? What clinical manifestation does this toxin cause?

A

Edema factor

Causes the edematous borders of black eschars in Anthrax

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35
Q

What is the MOA of edema factor (Bacillus anthracis)?

A

Mimics adenylate cyclase to increase cAMP

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36
Q

What toxin is associated with Vibrio cholerae?

A

Cholera Toxin

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37
Q

What is the MOA of the Cholera Toxin?

A
  • Activation of cAMP via Gs activation
  • Cl- secretion into the gut
  • H20 follows
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38
Q

What is the manifestation of the Cholera Toxin?

A

Rice-water stool associated with Vibrio Cholera or Cholera

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39
Q

What bacteria has an exotoxin that inhibits phagocytosis?

A

Bordetella pertussis

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40
Q

What is the MOA of the pertussis toxin?

A
  • Overactivation of adenylate cyclase via disabling Gi

- Increased cAMP

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41
Q

What is the clinical manifestation of the pertussis toxin?

A

Whooping cough

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42
Q

What bacterial have exotoxins that inhibit neurotransmitter release?

A

Clostridium tetani

Clostridium botulinum

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43
Q

What toxin is associated with C. tetnai?

A

Tetanospasmin

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44
Q

What is the MOA of Tetanospasmin?

A
  • Tetanospasmin is a protease that cleaves SNARE proteins
  • Prevents the release of inhibitory NT (GABA and Glycine)

Specifically, this action occurs in RENSHAW cells of the spinal cord

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45
Q

What is the clinical manifestation of the Tetanospasmin toxin?

A
  • Spasticity
  • Risus sardonicus
  • Lock-jaw
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46
Q

What is the MOA of Botulinum toxin?

A

Protease that cleaves SNARE proteins

- Prevents the release of ACh

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47
Q

What are the clinical manifestations of the Botulinum toxin?

A
  • Flaccid paralysis

- Floppy baby

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48
Q

What bacteria contain toxins that lyse cell membranes?

A

1) Clostridium perfringens

2) Streptococcus pyogens

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49
Q

What toxin is associated with Clostridium perfringens?

A

Alpha toxin

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50
Q

What is the MOA of Alpha Toxin?

A

This is a phospholipase or “lecithinase” that degrades the cell membrane

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51
Q

What are the clinical manifestations of the Alpha Toxin?

A
  • Myonecrosis b/c of phospholipid degradation that causes “gas gangrene”
  • Hemolysis
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52
Q

What toxin is associated with Streptococcus pyogenes?

A

Streptolysin O

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53
Q

What is the MOA of Streptolysin O?

A

This is a protein that degrades cell membranes

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54
Q

What is the clinical manifestation of Streptolysin O?

A

RBC lysis

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55
Q

How are antibodies to Streptolysin O measured?

A

ASO (Streptolysin O antibody) titer

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56
Q

What is the clinical utility of an ASO titer?

A

Diagnosis of Rheumatic Fever (S. pyogenes)

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57
Q

What superantigens cause shock?

A

1) S. aureus – TSST-1

2) S. pyogenes – Exotoxin A

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58
Q

What is the MOA of superantigens causing shock?

A

TSST-1 and Exotoxin A

  • Bring MHC II and TCR in proximity–>antigen binding
  • IFN-gamma and IL-2 are released

Shock ensues

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59
Q

Draw the Gram-positive lab algorithm.

A

p. 129

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60
Q

How do alpha-hemolytic bacteria appear on blood agar?

A

Green rings

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61
Q

How do beta-hemolytic bacteria appear on blood agar?

A

Clear rings

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62
Q

What inflammatory diseases are caused by S. aureus?

A

1) Skin infections
2) Organ abscesses
3) Pneumonia
4) Endocarditis
5) Osteomyelitis

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63
Q

What toxin mediated diseases are caused by S. aureus? What toxin are these diseases associated with?

A

1) Toxic Shock Syndrome–> TSST-1
2) Scalded Skin Syndrome–> “Exfoliative toxin”
3) Food poisoning–> “Enterotoxin”

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64
Q

What causes MRSA?

A

Resistance to Methicillin (Beta-Lactam) b/c of ALTERED PBP

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65
Q

What behavior is associated with S. aureus mediated Toxic Shock Syndrome?

A

Retained tampon

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66
Q

Where is S. epidermidis normally found?

A
  • Normal flora of the skin

- Frequently contaminates blood cultures

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67
Q

What infections are associated with S. epidermidis?

A
  • Prosthetic devices

- IV catheters

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68
Q

What is S. saprophyticus infection associated with?

A

This is the 2nd most common cause of UTI (E. coli is first)

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69
Q

What is the mnemonic to remember the infections caused by S. pneumonia?

A

MOPS

M= Meningitis 
O= Otitis media 
P= Pneumonia 
S= Sinusitis
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70
Q

What color sputum is pathognomonic for S. pneumonia induced pneumonia?

A

Rust colored

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71
Q

Describe the shape of S. pneumonia.

A

Lancet-shaped diplococci

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72
Q

Where are viridans streptococci normally found in the body?

A

Part of the normal flora of the mouth

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73
Q

What species of viridans streptococci is associated with dental carries?

A

Streptococcus mutans

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74
Q

What species of viridans streptococci is associated with subacute bacterial endocarditis?

A

Streptococcus sanguinis

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75
Q

What are the three categories of disease caused by Streptococcus pyogenes?

A

1) Pyogenic= pus-producing
2) Toxigenic
3) Immunologic

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76
Q

What are the pyogenic diseases caused by S. pyogenes?

A

1) Pharyngitis
2) Cellulitis
3) Impetigo

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77
Q

What are the toxigenic diseases caused by S. pyogenes?

A

1) Scarlet fever
2) Toxic shock-like syndrome
3) Necrotizing fasciitis

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78
Q

What are the immunologic diseases caused by S. pyogenes?

A

1) Rheumatic fever

2) Acute glomerulonephritis

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79
Q

What is the mnemonic to remember the features of Rheumatic Fever?

A

JONES

J= Joints, polyarthritis 
O= Heart, carditis 
N= Nodules (subcutaneous)
E= Erythema miarginatum (pink rings on the chest)
S= Syndenham chorea (rapid purposeless movements of the face, feet, and hands)
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80
Q

What are the clinical features of scarlet fever?

A

1) Scarlet rash with sandpaper-like texture
2) Strawberry tongue
3) Circumolar pallor

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81
Q

What is an alternate name for Streptococcus agalacticae?

A

Group B Strep

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82
Q

What is the first thing that should come to mind when you hear Group B Strep (GBS)?

A

Group B is for babies

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83
Q

What diseases are caused by GBS?

A

1) Pneumonia
2) Meningitis
3) Sepsis

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84
Q

What is the screening protocol for GBS?

A

Screen pregnant women at 35-37 weeks

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85
Q

What is protocol for GBS positive pregnant women?

A

Intrapartum PCN prophylaxis

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86
Q

What is an alternate name for the Group D Strep?

A

Enterococci and Streptococcus bovis (both fall under the GDS heading)

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87
Q

What infections are caused by GDS or Enterococci?

A

1) UTI
2) Biliary tract infection
3) Subacute endocarditis following GI/GU procedures

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88
Q

What infections are caused by S. bovis?

A

1) Bacteremia

2) Subacute endocarditis in colon cancer patients

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89
Q

What organism causes Diptheria?

A

Corynebacterium diptheriae

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90
Q

What are the symptoms to diptheria?

A
  • Pseudomembranous pharyngitis
  • Lymphadenopathy
  • Myocarditis
  • Arrhythmia
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91
Q

How is Diptheria diagnosed?

A

1) Gram positive rods with metachromatic granules

2) Elek test for toxin

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92
Q

What lab test detects the presence of the diptheria toxin?

A

Elek

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93
Q

What type of vaccine is given to prevent diptheria?

A

Toxoid

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94
Q

What causes Botulinum in adults?

A

Ingestion of preformed toxin

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95
Q

What causes Botulinum in kids?

A

Ingestion of spores–often in honey

*Causes “Floppy Baby Syndrome”

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96
Q

What toxins are produced by Clostridium difficile?

A

Toxin A

Toxin B

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97
Q

What is the MOA of the C. diff toxins?

A

Toxin A= enterotoxin, binds the brush border of the gut

Toxin B= cytotoxin, causes cytoskeletal disruption via actin depolymerization

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98
Q

How is C. diff diagnosed?

A

Detection of either Toxin A or B in the stool

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99
Q

What is unique about the composition of Bacillus anthracis?

A

Only bacterium with a polypeptide capsule

*Specifically, D-glutamate capsule

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100
Q

Describe the presentation of cutaneous anthrax.

A

Boil-like lesion that progresses to a black eschar

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101
Q

Describe the presentation of pulmonary anthrax.

A

Flu-like symptoms that rapidly progress to:

  • Fever
  • PULMONARY HEMORRHAGE
  • Mediastinitis (inflammation of mid-chest structures)
  • Shock
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102
Q

What is a colloquial term for pulmonary anthrax?

A

“Woolsorter’s Disease” –historically caused by inhalation of spores from contaminated wool

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103
Q

What does Bacillus cereus cause?

A

“Reheated rice syndrome”

- Food poisoning associated with bacteria that grow in warm rice

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104
Q

What are the two timeframes of disease presentation with Bacillus cereus infection?

A

1) Emetic-type= 1-5 hours post ingestion

2) Diarrheal= 8-18 hours post ingestion

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105
Q

How is Listeria monocytogenes commonly acquired?

A
  • Ingestion of unpasteurized dairy products and deli meats
  • Transplacental
  • Transvaginal
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106
Q

What is the unique mechanism of pathogenesis associated with L. monocytogenes?

A

Actin rockets that allow for transmission from cell to cell while avoiding antibodies

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107
Q

What is unique about the composition of L. monocytogenes?

A

Only gram positive bacteria with LPS

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108
Q

What type of infection is seen with L. monocytogenes in a healthy adult?

A

Mild gastroenteritis

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109
Q

What can L. monocytogenes infection cause in a pregnant woman?

A

1) Amnionitis
2) Sepsis
3) Spontaneous abortion

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110
Q

What can L. monocytogenes cause in neonates?

A

1) Neonatal meningitis

2) Granulomatosis infantiseptica–pus-filled granuloma formation distributed throughout the whole body of the newborn

111
Q

What infections are caused by Actinomyces?

A

Oral and facial abscess that drain through sinus tracts

112
Q

How is the appearance of Actinomyces described?

A

Yellow sulfur granules

113
Q

What infections are caused by Nocordia?

A

Immunocompromised= pulmonary infection

Immunocompetent= cutaneous infections post trauma

114
Q

How are actinomycyes infections treated?

A

PCN

115
Q

How are Nocordia infections treated?

A

Sulfonamides

116
Q

What bacteria causes TB?

A

Mycobacterium tuberculosis

117
Q

How is TB transmitted?

A

Inhalation of aerosolized TB

118
Q

What is Primary TB?

A

This is the infection that a patient gets when they are FIRST exposed to TB

119
Q

Describe the clinical manifestations of Primary TB.

A
  • Focal caseating necrosis of the lower lung lobe
  • AND focal caseating necrosis of the hilar lymph nodes

Hilar= mediastinal lymph nodes

120
Q

What is a Ghon complex?

A

In Primary TB, necrotic areas in the lower lung lobe and hilar lymph nodes undergo:

  • Fibrosis
  • Calcification

These fibrotic and calcified nodules are called Ghon complexes

121
Q

What symptoms are seen with Primary TB?

A

Primary TB is typically ASYMPTOMATIC, but it does lead to a POSITIVE PPD

122
Q

What is Secondary TB?

A

This is when a Ghon complex is reactivated

123
Q

What causes reactivation of TB?

A

1) AIDS

2) Aging

124
Q

Where does reactivation of TB commonly occur?

A

Apex of the lung

- Oxygen tension is highest here

125
Q

What are the manifestations of the reactivation of TB?

A

1) Formation of cavitary foci of caseous necrosis
2) May cause miliary TB
3) May cause tuberculous bronchopneumonia

126
Q

What are the symptoms associated with Secondary TB?

A
  • Fever
  • Night sweats
  • Cough with hemoptysis
  • Weight loss
127
Q

What will biopsy reveal in Secondary TB?

A

Caseating granuloma

*Note, AFB stain will show red acid-fast bacilli, differentiating this from ASPERGILLUS

128
Q

When a patient has secondary TB, what will often happen?

A

Systemic spread

129
Q

Where will TB commonly go to with systemic spread?

A

1) Meninges
2) Cervical lymph nodes
3) Kidney
4) Lumbar vertebrae

130
Q

What is the tell-tale sign of TB meningitis?

A

Caseating granulomas involving the meningies at the base of the skull

131
Q

What is the result of systemic spread of TB to the kidney?

A

“Sterile pyuria”

132
Q

What is the disease called when TB spreads to the lumbar vertebrae?

A

Pott’s Disease

133
Q

What is the presentation of M. kansaii infection?

A

Pulmonary TB-like symptoms

134
Q

What kind of infection is seen with M. avium-intracellulare in AIDS patients?

A

Disseminated disease

135
Q

How is M. avium intracellulare treated prophylactically?

A

Azithromycin

136
Q

What is the reservoir for M. leprae in the US?

A

Armadillos

137
Q

What are the two forms of Hansen Disease?

A

This is the disease caused by M. leprae:

1) Lepromatous
2) Tuberculoid

138
Q

What are the distinguishing features of Lepromatous Hansen’s Disease?

A
  • Leonine facies
  • Low cell mediated immunity
  • Th2 response
139
Q

What are the distinguishing features of Tuberculoid Hansen’s Disease?

A
  • Limited to hypopigmented and hairless skin plaques
  • Robust cell mediated immunity
  • Th1 response
140
Q

What is the treatment for Lepromatous Disease?

A

1) Dapsone
2) Clofazimine
3) Rifampin

For 2-5 years

141
Q

What is the treatment for Tuberculoid Disease?

A

1) Dapsone
2) Rifampin

For 6 months

142
Q

Draw the gram negative lab algorithm.

A

p. 136

143
Q

From a treatment perspective, what is unique about Gram negative bacteria?

A

Outer membrane inhibits the entry of:

  • PCN G
  • Vancomycin
144
Q

What is the difference between N. meningitidis and N. gonorrhea in terms of fermented sugars?

A
  • N. MeninGitidis ferments both maltose and glucose

- N. Gonorrheae only ferments glucose

145
Q

What is the difference between N. meningitidis and N. gonorrhea in terms a capsule?

A
  • N. meningitidis has a polysaccharide capsule

- N. gonorrheae does NOT have a capsule

146
Q

What is the difference between N. meningitidis and N. gonorrhea in terms of vaccination?

A
  • N. meningitidis= vaccine

- N. gonorrheae= no vaccine

147
Q

What diseases are caused by N. meningitidis?

A

1) Meningitis

2) Waterhouse-Friderichsen Syndrome

148
Q

What diseases are caused by N. gonorrheae?

A

1) Gonorrhea
2) Septic arthritis
3) Neonatal conjunctivitis
4) PID
5) Fitz Hugh Curtis Syndrome

149
Q

What is the treatment for N. meningitidis?

A

Cetfriaxone or PCN G

150
Q

What is the treatment for N. gonorrhaea?

A

Ceftriaxone + (azithromycin or doxycycline) for possible chlamydia infection

151
Q

What is H. influenza transmitted?

A

Aerosol

152
Q

What type of H. influenza causes the most invasive disease?

A

HiB i.e. H. influenza type B

153
Q

What is the mnemonic to remember the diseases caused by H. influenza?

A

HaEMOPhilus

E= Epiglottitis
M= Meningitis 
O= Otitis Media 
P= Pneumonia
154
Q

How are mucosal H. influenza infections treated?

A

Amoxacillin +/- clavulanate i.e. augmentin

155
Q

How is H. influenza meningitis treated?

A

Ceftriaxone

156
Q

What medication is used as prophylaxis for close contacts of individuals with H. influenza meningitis?

A

Rifampin

157
Q

What is contained in the H. influenza vaccine?

A

Type B capsular polysaccharide conjugated to diptheria toxin

Note that a child can still get an H. influenza disease s/p vaccination but it will be from a non-B strain

158
Q

How is Legionella pneumophila detected clinically?

A

Detection of the antigen in urine

159
Q

How is Legionella penumophila transmitted?

A

Aerosol transmission from aqueous habitat

160
Q

What two diseases are cased by Legionella pneumophila?

A

1) Legionnaires Disease

2) Pontiac fever

161
Q

What is the difference between Legionnaires Disease and Pontiac Fever?

A

Legionnnaires= Sever pneumonia with GI and CNS symptoms

Pontiac Fever= mild-flu

162
Q

What type of odor is associated with Pseudomonas aeruginosa?

A

Grape-like

163
Q

What is the mnemonic to remember the diseases caused by P. aeruginosa?

A

PSEUDOmonas

P= Pneumona (esp. in CF)
S= Sepsis 
E= External otitis 
U= UTI 
DO= Drug use and DM osteomyelitis
164
Q

What skin infection is caused by P. aeruginosa?

A

Hot-tub folliculitis

Also, think burn victims

165
Q

What is Ecthyma Gangrenosum?

A
  • Rapidly progressive necrotic ulcer
  • Seen in immunocompromised
  • Caused by P. aeruginosa
166
Q

How is P. aeruginosa infection treated?

A

Aminoglycoside + extended spectrum PCN

167
Q

What infections are associated with the fimbriae of E. coli?

A

Cystitis and pyelonephritis

168
Q

What infections are associated with the K capulse of E. coli?

A

Pneumonia and neonatal meningitis

169
Q

What is associated with LPS endotoxin of E. coli?

A

Sepsis

170
Q

How does EIEC present?

A

EnteroInvasive= dysentery

171
Q

How does ETEC present?

A

EnteroToxigenic= Traveler’s diarrhea

172
Q

How does EPEC present?

A

Diarrhea usually in children i.e. Pediatrics

173
Q

How does EHEC present?

A

Dysentery and HUS

174
Q

How is EHEC differentiated from the other E.coli species?

A

Does NOT ferment sorbitol

175
Q

Where is Klebsiella normally found?

A

Gut normal flora

176
Q

How can you remember the diseases caused by Klebsiella?

A

Four A’s

  • Aspiration pneumonia
  • Abscess in the lungs or liver

*Associated with Alcoholics and Di-A-betics

177
Q

What is the pathognomonic feature of Klebsiella pneumonia?

A

Currant jelly sputum

178
Q

Salmonella vs. Shigella: which is flagellated?

A

Salmonella

179
Q

Salmonella vs. Shigella: undergoes cell-to-cell transmission.

A

Shigella

Salmonella undergoes hematogenous spread

180
Q

Salmonella vs. Shigella: only reservoir is humans and primates?

A

Shigella

Salmonella has many animal reservoirs

181
Q

Salmonella vs. Shigella: produces H2S.

A

Salmonella

182
Q

Salmonella vs. Shigella: antibiotics are recommended?

A

Shigella

183
Q

Salmonella vs. Shigella: invades intestinal mucosa and causes a monocytic response?

A

Salmonella

184
Q

Salmonella vs. Shigella: invades intestinal mucosa and causes a PMN response?

A

Shigella

185
Q

Salmonella vs. Shigella: often causes bloody diarrhea.

A

Shigella

186
Q

What disease is caused by Salmonella typhi?

A

Typhoid fever

187
Q

What are the symptoms of Typhoid Fever?

A
  • Fever
  • Headache
  • Rose-spots on the abdomen
  • Diarrhea
188
Q

Where in the body can Salmonella typhi remain to cause a carrier state?

A

Gallbladder

189
Q

How is C. jejuni transmitted?

A

Fecal-oral through foods including:

  • Poultry
  • Meat
  • Unpasteurized milk
190
Q

How does C. jejuni present?

A

Bloody diarrhea, esp. in kids

191
Q

What temperature does C. jejuni grow in?

A

42 C

192
Q

What are unique sequelae of C. jejuni infection?

A
  • Gullian-Barre Syndrome

- Reactive arthritis

193
Q

What type of diarrhea is associated with Vibrio cholera?

A

Rice-water

194
Q

How is Yersinia enterocoliticia transmitted?

A
  • Pet feces

- Contaminated milk or pork

195
Q

How can Y. enterocolitica present?

A

Mesenteric adenitis that mimics Crohn’s Disease or appendicitis

196
Q

What is triple therapy for H. pylori?

A

1) PPI
2) Clarithromycin
3) Amoxicillin or metronidazole

197
Q

What is the mnemonic to remember the three spirochetes?

A

BLT

B= Borrelia 
L= Leptospira 
T= Treponema
198
Q

How is Treponema visualized in the lab?

A

Dark-field microscopy

199
Q

Where is Leptospira interrrogans found?

A

Water contaminated with animal urine

200
Q

What are the symptoms of Leptospirosis?

A
  • Flu-like sx.
  • Jaundice
  • Photophobia
201
Q

Where is Leptospirosis seen in the US?

A

Surfers in HI

202
Q

What is Weil Disease?

A

Severe “incterohemorrhagic leptospirosis”

  • Severe jaundice
  • Azotemia (high level of nitrogen containing compounds)
  • Hemorrhage
  • Anemia
203
Q

What is the vector for Borrelia burgdorferi?

A

Ixodes tick

Same vector for Babesia

204
Q

What is the natural reservoir for Borrelia burgdorferi?

A

Mouse

205
Q

What is the mnemonic to remember the symptoms of Lyme Disease?

A

FAKE a Key Lyme pie

F= Facial nerve palsy 
A= Arthritis 
K= Kardiac Block 
E= Erythema migrans--bull's eye rash
206
Q

How is Lyme Disease treated?

A

1) Doxycycline

2) Cetfriaxone

207
Q

What causes Syphilis?

A

Treponema Pallidum

208
Q

How is Syphilis treated?

A

PCN G

209
Q

How does primary syphilis present?

A

Painless chancre

210
Q

How is primary Syphilis diagnosed?

A

Serologic testing:

- VDRL/RPR

211
Q

What is secondary Syphilis?

A

Disseminated Syphilis

212
Q

What are the sx. of secondary Syphilis?

A

1) Constitutional sx.
2) Maculopapular rash on palms and soles
3) Condylomata lata

213
Q

What is tertiary Syphilis?

A

Spread of Syphilis to the heart and CNS causing:

1) Gummas
2) Aortitis
3) Neurosyphilis/ Argyll Robertson pupil

214
Q

What are the signs of tertiary syphilis?

A
  • Broad-based ataxia
  • Positive Rhomberg
  • Charcot joint
  • Stroke without HTN
215
Q

What are the signs of congenital syphilis?

A
  • Saber shin
  • Saddle nose
  • CN VIII deafness
  • Hutchinson teeth
  • Mulberry molars
216
Q

What is the mnemonic to remember what an Argyll Robertson pupil is?

A

Prostitute pupil i.e. accomodates but does not react

  • Constricts with near-vision
  • Does NOT react to light
217
Q

What is the VRDL test used to detect Syphilis?

A

Detection of nonspecific antibody that reacts with cardiolipin

218
Q

What is the mnemonic to remember the false positives seen with VDRL?

A

VDRL

V= viruses 
D= drugs 
R= rheumatic fever 
L= lupus and leprosy
219
Q

What disease is caused by Anaplasma?

A

Anaplasmosis

220
Q

What is the vector for Anaplasma?

A

Ixodes tick

221
Q

What disease is caused by Bartonella?

A
  • Cat Scratch Disease

- Bacillary angiomatosis

222
Q

What disease is caused by Borrelia recurrentis?

A

Relapsing fever

223
Q

What is the vector for Borelia recurrentis?

A

Louse

224
Q

What disease is caused by Brucella?

A

Brucellosis/ undulant fever

225
Q

What is Brucellosis associated with?

A

Unpasteurized dairy products

226
Q

What disease is caused by Coxiella burnetii?

A

Q fever

227
Q

What are the common sources for Coxiella burnetti?

A
  • Aerosols of cattle

- Sheep amniotic fluid

228
Q

What disease is caused by Ehrlichia chaffeensis?

A

Ehrlichiosis

229
Q

What is the vector for Ehrlichia chaffeensis?

A

Lone star tick

230
Q

What disease is caused by Francisella tularensis?

A

Tularemia

231
Q

What disease is caused by Pasteurella multocida?

A

Cellulitis and osteomyelitis

232
Q

How is Pasteurella multocida transmitted?

A

Cat and dog bites (found on their salvia)

233
Q

What disease is caused by Rickettsia prowazekii?

A

Epidemic typhus

234
Q

What is the vector for Rickettsia prowazekii?

A

Louse

235
Q

What disease is caused by Rickettsia rickettsii?

A

Rocky Mountain Spotted Fever

236
Q

What is the vector for Rickettsia rickettsii?

A

Dermacentor ticks

237
Q

What disease is caused by Rickettsia typhi?

A

Endemic typhus

238
Q

What is the vector for Rickettsia typhi?

A

Fleas

239
Q

What disease is caused by Gardnerella vaginalis?

A

Bacterial vaginosis

240
Q

What type of discharge is seen with bacterial vaginosis?

A

Gray discharge with a fishy smell

241
Q

On microscopy, what is pathognomonic for bacterial vaginosis?

A

Clue cells i.e. vaginal epithelial cells with Gardnerella bacteria

242
Q

What is the treatment for Gardnerella vaginalis infection?

A

Metronidazole or Clindamycin

243
Q

How are all the Rickettsial disease treated?

A

Doxycycline

244
Q

Where is Rocky Mountain Spotter Fever commonly seen?

A

NOT in the Rockies; rather, South Atlantic states i.e. North Caroline

245
Q

How is the rash seen in Rocky Mountain Spotted Fever described?

A

“Centripetal” or center seeking

  • Starts on wrist and ankles
  • Spreads to trunk palms and soles
246
Q

What organism is responsible for Rocky Mountain Spotted Fever?

A

Rickettsia rickettsii

247
Q

What type of rash is seen in Typhus?

A

“Centrifugal”

  • Rash starts centrally and spreads out
  • Spares the palms and soles
248
Q

What is the mnemonic to remember the difference between Typhus and Rocky Mountain Spotted Fever?

A

Rickettsii on the wRists, Typhus on the Trunk

249
Q

What are the two types of Typhus?

A

Endemic and Epidemic

250
Q

What is the difference between Endemic and Epidemic Typhus?

A

Endemic=

  • Rickettsia typhi
  • Fleas

Epidemic=
- Rickettsia prowazekii

251
Q

What is Ehrlichiolsis?

A

Ehrlichiolsis is a vector borne disease that causes flu-like symptoms and a rare rash

252
Q

What is the vector for Ehrlichiolsis?

A

Tick

253
Q

How is Ehrlichiolsis diagnosed?

A

Monocytes with morula i.e. berry-like inclusions

254
Q

How is Anaplasmosis diagnosed?

A

Granuylocytes with morulae in cytoplasm

255
Q

What causes Q fever?

A

Coxiella brunetii

256
Q

How is Q fever transmitted?

A
  • Tick feces and cattle placenta that release spores

- Spores are inhaled as aerosols

257
Q

How does Q fever present?

A

Pneumonia

258
Q

What is the mnemonic for Q fever?

A

Q fever is Queer b/c:

1) No rash
2) No vector

259
Q

What are the two forms of Chlamydiae?

A

Elementary body= Enfectious/ Enters the cell and then transforms into:

Reticulate body= Replicates

260
Q

What infections are caused by Chlamydiae trachomatis?

A

1) Nongonococcal urethritis
2) PID
3) Follicular conjunctivitis
4) Reactive arthritis

261
Q

What diseases is caused by Chlamydiae pneumoniae and pisttaci?

A

Atypical pneumonia

262
Q

How are Chlamydiae infections treated?

A

Azithromycin or Doxycycline

263
Q

What is unique about the structure of the Chlamydiae species?

A

Lack muramic acid in cell wall

264
Q

How is Chlamydiae diagnosed?

A

Cytoplasmic inclusions seen on Giemsa stain or flourescent antibody staining

265
Q

What infection is predominantly caused by Chlamydiae trachomatic Types A, B, and C?

A

Chronic follicular conjunctivitis

266
Q

What is the mnemonic to remember the important clinical features associated with Chlamydiae trachomatis Types A, B, and C?

A

ABC=

  • Africa
  • Blindness
  • Chronic infection
267
Q

What infections are predominantly caused by Chlamydiae trachomatic Types D-K?

A
  • Urethritis/ PID
  • Ectopic pregnancy
  • Neonatal pneumonia
  • Neonatal conjunctivitis
268
Q

What infection is predominantly caused by Chlamydiae trachomatic Types L1, L2, and L3?

A

Lymphogranuloma venereum=

1) Painless ulcers on genitals that swell
2) Transition to painful inguinal LN that ulcerate (buboes)

269
Q

How is Lymphgranuloma venereum treated?

A

Doxycycline

270
Q

What is caused by Mycoplasma pneumonia?

A

Atypical “walking” pneumonia

271
Q

What is Mycoplasma pneumonia associated with?

A

Military recruits and prisons

272
Q

How is Mycoplasma pneumonia treated?

A

Macrolide, doxycycline or fluoroquinolone

273
Q

What antibiotics should NOT be used to treat Mycoplasma pneumonia? Why?

A

PCNs b/c Mycoplasma has NO cell wall

First Aid 2014 (8 decks)

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