MICROBIOLOGY- Clinical Bacteriology Flashcards
1
Q
Staphylococcus is a catalase + or -?
A
+
2
Q
Which form does stahphylococcus has?
A
Cocci Clusters
3
Q
Staphylococcus is gram + or -?
A
+
4
Q
Which kind of Staphylococcus is coagulase +?
A
S. aureus
5
Q
If we have Stahpylococcus coagulase -, which is the next test to differentiate?
A
Novobiocin
6
Q
If we have cocci gram +, Catalase +, coagulase -, and Novobiocin sensitive, Which bacteria is?
A
S. epidermidis
7
Q
In order to have S. saprophyticus, which labs results are required?
A
Cocci gram +, catalase +, coagulase - and Novobiocin resistant
8
Q
If we have Gram + cocci, what do we need to have Staphylococcus?
A
Catalase +
9
Q
You have a Gram + cocci, catalase -, α hemolysis and Optochin sensitive
A
Streptococcus pneumoniae
10
Q
What is α hemolysis?
A
Partial hemolysis
11
Q
Which special characteristics does S. pneumoniae have compare to other α hemolytic?
A
It has capsule, Bile soluble (lysed by bile), Optochin sensitive
12
Q
In the lab algorithm how is classified Viridians streptococci?
A
Gram + cocci, catalase -, α hemolysis, Optochin resistant
13
Q
Which bacteria is an example of Viridains strectococci?
A
S. mutans
14
Q
Which bacterias form green ring around colonies in blood agar?
A
α hemolytic bacteria
15
Q
Which bacterias form clear area of hemolysis on blood agar?
A
β hemolytic bacteria
Staphylococci aureus
Listeria monocytegenes
16
Q
These bacterias are gram + cocci, catalase - and produce β hemolysis
A
Group A- Streptococcus pyogenes
Group B- Streptococcus agalactiae
17
Q
What does β hemolysis means?
A
Complete hemolysis
18
Q
What else do you do to differentiate between Streptococcus pyogenes and Streptococcus agalactiae?
A
Bacitracin
Streptococcus pyogenes Bacitracin sensitive
Streptococcus agalactiae Bacitracin resistant
19
Q
These bacterias are gram + cocci, catalase - and don´t produce hemolysis (γ hemolysis)
A
Group D Enterococcus and
Non enterococcus
20
Q
In which common enviroment do Group D Enterococcus and Non enterococcus have growth?
A
Growth in bile
21
Q
In order to differentiate between Group D enterococci and non enterococci, What would we need to do?
A
6.5% NaCl enterococci presents growth and non enterococci does not growth
22
Q
This Gram + bacterias are consider branching filaments
A
Actinomyces
Nocardia
23
Q
Which characteristics does Actinomyces have to differentiate from Nocardia?
A
Actnimyces- Anaerobe and not acid fast
Nocardia- aerobe and acid fast
24
Q
This gram + rod bacteria has tumbling motility and also form a clear area of hemolysis on blood agar
A
Listeria monocytogenes
25
What can Listeria monocytogenes causes in newborn?
Meningitis
26
In which kind of food can Listeria monocytogenes appear?
Unpasteurized milk
27
Consider a gram positive cocci in clusters
Staphylococcus aureus
28
Is consider the virulence factor for Staphyloccocus aureus
Protein A
29
How does Protein A works as virulence factor of S. aureus?
Binds Fc-IgG, inhibiting complement activation and phagocytosis
30
This place is commonly colonize by S. aureus
Nose
31
Which diseases are characteristic of S. aureus?
Inflamatory disease
Toxin mediated disease
MRSA (methicillin resistant S. aureus)
32
These manifestations can be caused by Inflamatory disease by S. aureus
```
Skin infection
Organ abscesses
Pneumonia
Endocarditis
Osteomyelitis
```
33
Which organism is commonly the first infection before pneumonia caused by S. aureus?
Influenza virus infection
34
What is the result of Toxin mediated disease caused by S. aureus?
Toxic Shock syndrome
Scalded skin syndrome
Rapid onset Food poisoning
35
Which S. aureus toxin causes Scalded skin syndrome?
Exfoliative toxin
36
Which S. aureus toxin causes Rapid onset Food poisoning?
Enterotoxins
37
These could be the consequenses of MRSA (methicillin resistant S. aureus) infection
Important cause of serious nosocomial and community acquired infection
38
Which other antibiotic presents resitance by MRSA infection? and why?
Resistant to Methicillin and nafcillin of altered penicillin binding protein
39
What happens in the Toxic shock syndrome?
Toxic shock syndrome is a superantigen that binds to MHC II and T cell receptor resulting in polyclonal T cell activation
40
Which is the clinical manifestation of Toxic shock syndrome?
Fever, vomiting, rash, desquamation, shock, end organ failure
41
What predisposes to toxic shock syndrome?
Use of vaginal or nasal tampons
42
Which is the incubation time for enterotoxins of S. aureus?
2-6 hours
43
Are the enterotoxin of S. aureus destroyed by cooking?
No, they´re heat stable
44
How are the abscess form by S. aureus?
Form fibrin clot around self
45
Who is infected by Staphylococcus epidermidis?
Infects prosthetic devices and intravenous catheters
46
How does S. epidermidis Infects prosthetic devices and intravenous catheters?
By producing adherent biofilms
47
Where can we find S. epidermidis?
Normal skin flora
48
Which bacteria commonly contaminates blood cultures?
S. epidermidis
49
Once we have gram positive cocci, catalase +, what else is needed to have S. epidermidis?
Coagulase negative and Novobiocin sensitive
50
Which is the first agent cause of uncomplicated UTI in young women?
E. coli
51
Which is the second agent cause of uncomplicated UTI in young women?
Staphylococcus saprophyticus
52
How do we know if is S. saprophyticus or S. epidemidis?
S. saprophyticus is Novobiocin resistant
| S. epidemidis is Novobiocin sensitive
53
From which diseases is Streptococcus pneuminae the most common cause?
Meningitis
Otitis media (in children)
Pneumonia
Sinusitis
54
Structurally how is S. pneumoniae composed?
Lancet shaped, gram positive diplococci. Encapsulated
55
Which is the mechanism of infection of S. pneumuniae?
IgA protease
56
If one elemental structure is not present S. pneumoniae cannot be virulent, Which is this element?
No virulence without Capsule
57
How is the sputum if infected by S. pneumoniae?
Rusty sputum
58
Who are at higher risk of sepsis by S. pneumoniae?
Sickle cell anemia and splenectomy
59
Which Bacteria Family is Viridians?
Streptococci α hemolytic
60
Which Bacterias are part of Viridians streptococci?
Streptococcus Mutans
| Streptococcus Sanguinis
61
Where do we normally find Streptococcus mutans?
Normal flora of the orophanrynx
62
Which Bacteria can cause dental caries?
Streptococcus mutans
63
This bacteria is present in subacute bacterial endocarditis at damaged valves
Streptococcus sanguinis
64
How do we differentiate Streptococcus Viridians group of Streptococcus pyogenes?
Both are α hemolitic
Streptococcus Viridians group Optochin resistant
Streptococcus pyogenes Optochin sensitive
65
What does S. Sanguinis produces in order to bind to fibron platelet aggregates on damaged heart valves?
Dextrans
66
Which group is Streptococcus pyogenes?
Group A streptococci
67
Gram + coccus, catalase negative, β hemolytic, Bacitracin sensitive
Streptococcus pyogenes
68
Which could be the consequences of S. pyogenes infection?
Pyogenic
Toxigenic
Immunologic
69
These are the pyogenic manifestations of S. pyogenes infectio n
Pharyngitis, cellulitis, impetigo
70
Which are the Toxigenic manifestations of S. pyogenes?
Scarlet fever, toxic shock syndrome, necrotizing fascitis
71
Rheumatic fever, acute glomerulonephritis...How do we classifie this manifestations of S. pyogenes infection?
Immunologic
72
Which antibodies enhance host defence against S. pyogenes?
Antibodies M
73
If antibodies M enhance host defence against S. pyogenes, which is the risk?
Can give rise to theumatic fever
74
How can you detect recent S. pyogenes infection?
ASO titter
75
Which are the criteria for rheumatic fever?
```
Polyarthritis
Carditis
Subcutaneous Nodules
Erythema marginatum
Syndenham chorea
```
76
Which could be the worst result of a pharyngitis by S. pyognes?
Rheumatic Fever and glomerulonephritis
77
What more commonly precedes glomerulonephritis caused by S. pyogenes?
Impetigo more commonly than pharyngitis
78
Which are clinical manifestations of Scarlet Fever?
Scarlet rash with sandpaper like texture, strawberry tongue, circumoral pallor
79
Gram + coccus, catalase negative, β hemolytic, Bacitracin reistant
Streptococcus agalactiae
80
Which group is Streptococcus agalactiae?
Group B streptoccoci
81
Where is the site of colonization of Streptococcus agalactiae?
Colonizes Vagina
82
Which are the manifestations of Streptococcus agalactiae?
Pneumonia, meningitis and sepsis
83
Who is mainly affected by Pneumonia, meningitis and sepsis caused by S. agalactiae?
Babies
84
How is related Streptococcus agalactiae to S. aureus?
Produces CAMP factor, which enlarges the area of hemolysis formed by S. aureus
85
Which other test is positive with S. aureus?
Hippurate test +
86
Which preventive measures for Streptococcus agalactiae will you take in a pregnant woman?
Screen pregnant women at 35-37 weeks
87
What would you do if the screening for S. agalactiae results positive?
Patients with positive culture receive intrapartum penicillin prophylaxis
88
These bacterias are group D strectococci on the Lancefield grouping
Enterococci
| Nonesterococci
89
Give examples of Enterococci
Enterococcus faecalis
| Enterococcus faecium
90
Normally where do Enterococci are found?
Normal colonic flora
91
Which medicines are Enterococci resistant to?
penincilin G resistant
92
Which kind of infections can Enterococci cause?
UTI, biliary tract infections, and subacute endocarditis (following GI/GU procedures)
93
On what is based the Lancefield grouping?
Is based on differences in the C carbohydrate in the bacterial cell wall
94
What hemolysis does Enterococci produces?
Variable hemolysis or non hemolysis
95
Which variable of enterococcus are an important cause of nosocomial infection?
VRE (vancomycin resistant enterococci)
96
Which laboratory test is needed to diferentiate between Enterococci and nonenterococcal?
Enterococcus can grow in bile and 6.5 NaCl
97
How do we classify Streptococcus bovis?
Group D Streptococci Nonenterococcus
98
Where is commonly found S. bovis?
Colonizes the gut
99
In which patients can S. bovis cause bacterimia and subacute endocarditis?
In colon cancer patients
100
Lab diagnosis based on gram positive rods with metachromatic granules
Corynebacterium diphteriae
101
Which family is Corynebacterium diphteriae?
Clostridium
102
Is Corynebacterium diphteriae anaerobe or aerobe?
Anaerobe
103
How can Corynebacterium diphteriae causes diphteria?
Via exotoxin encoded by β prophage
104
Which is the effect of β prophage?
Potent exotoxin inhibits protein synthesis via ADP-ribosylation of EF-2
105
Which symptoms can be present with Corynebacterium diphteriae?
Pseudomembranous pharyngitis (grayish white membrane) with lymphadenopathy, myocarditis and arrhytmias
106
How is the lab dianosis based for Corynebacterium diphteriae?
Gram positive rods with metachromatic granules and Elek test for toxin
107
What method is useful to prevent Corynebacterium diphteriae?
Toxoid vaccine prevents diptheria
108
Which agar is needed to cultivate Corynebacterium diphteriae?
Cysteine tellurite agar and we see black colonies
109
When can some bacteria form spores?
At the end of the stationary phase when nutrients are limited
110
Which conditions can spores resist?
Highly resistant to heat and chemicals
111
What do spores have in their core?
Dipicolinic acid
112
Do spores have metabolic activitie?
No
113
What is needed to kill spores?
Must autoclave to kill spores by steaming at 121º C for 15 minutes
114
Which situation is an example of killing spores?
As is done to surgical equipment
115
Which gram positive bacterias found in soil are spore forming?
Bacillus anthracis, Clostridium perfringens and C. tetani
116
Which are other spore formers?
B. cereus, C. botulinum, Coxiella burnetti
117
Gram positive, spore forming, obligate anaerobic bacilli
Clostridia
118
Which bacterias are example of Clostridia (with exotoxins)?
C. tetani
C. botulinum
C. perfringens
C. difficile
119
Which is the toxin produce by C. tetani?
Tetanospasmin, causing Tetanus
120
Which is the effect of Tetanus toxin?
Is a protease that cleaves releasing proteins for neurotransmitters
121
Which other exotoxin Is a protease that cleaves releasing proteins for neurotransmitters, other than Tetanus toxin?
Botulinum toxin
122
What does the tetanus blocks?
Blocks glycine and GABA release
123
How are consider glycine and GABA?
Inhibitory neurotransmitters
124
Who produces glycine and GABA inhibited by Tetanus?
Renshae cells in the spinal cord
125
Which are the clinical manifestations of C. tetani?
Spastic paralysis, trismus (lockjaw), and risus sardonicus
126
What is produce by C. Botulinum? and what is the effect?
Produces a preformed, heat labile toxin that inhibits ACh release at the neuromuscular junction, causing botulism
127
How is aquired the disease produced by C. Botulinum in adults?
Disease is caused by ingestion of preformed TOXIN
128
In babies how is aquired the disease caused by C. Botulinum?
Ingestion of SPORES in honey (floppy baby syndrome)
129
How is manifested the disease by C. Botulinum?
Flacid paralysis
130
What can C. perfringens cause?
Myonecrosis (gas gangrena) and hemolysis
131
Which is the toxin that causes myonecrosis (gas gangrena) and hemolysis produced by C. perfringens
α Toxin (lecithinase a phospholipase)
132
These are the two toxins produced by C. Difficile
Toxin A and Toxin B
133
What is Toxin A produced by C. Difficile? and where does it acts?
Enterotoxin, binds to the brush border of the gut
134
What is Toxin B produced by C. Difficile? and which are its effects?
Cytotoxin, causes cytoskeletal disruption via actin depolymeration
135
Which disease is the consequence of C. Difficile infection with Toxin B?
Pseudomembranous colitis causing diarrhea
136
Which is commonly the cause of C. Difficile infection?
Secondary to antibiotic use
137
Which are the main antibiotic responsable of Pseudomembranous colitis?
Clindamicin and ampicillin
138
How is diagnosed C. Difficile infection?
By detection of one or both toxins in stool
139
Which is the treatment for C. Difficile infection?
Metronidazole or oral vancomycin
140
For recurring cases of C. Difficile infection, which is the alternative?
Fecal transplant
141
It´s the only bacterium with a polypeptide capsule
Bacillus Anthracis
142
Which kind of bacteria is Bacillus anthracis?
Gram positive spore forming rod that produces anthrax toxin
143
What does the polypeptide capsule of Bacillus anthracis contains?
Contains D glutamate
144
Which are the manifestation of Anthrax disease?
Cutaneous anthrax
| Pulmonary anthrax
145
What is seen in the cutaneous anthrax?
Boil like lesion→ Ulcer with black eschar (painless, necrotic)
146
Which might be the results of cutanous anthrax?
Uncommonly progresses to bacterimia and death
147
How it´s adquired the pulmonary anthrax?
Inhalation of spores
148
Once inhalated the anthrax spores how is manifested the pulmonary anthrax?
Flu like symptoms that rapidly progress to fever, pulmonary hemorrhage, mediastinitis and shock
149
This disease is caused by inhalation of spores from contaminated wool
Woolsorter´s disease
150
This bacteria causes the reheated rice syndrome
Bacillus cereus
151
How is adquired the Bacillus cereus?
Causes food poisoning. Spores survive cookoing rice
152
What predisponses germination of spores and enterotoxin formation of Bacillus cereus?
Keeping rice warm
153
Which are the clinical types manifestastation of Bacillus cereus?
Emetic type
| Diarrheal type
154
After which kind of food you suspect that the emesis is due to Bacillus cereus?
Emetic type usually seen with rice and pasta
155
At what time is common to see the emetic manifestation after B. cereus is ingested?
Nausea and vomiting within 1-5 hr
156
Which preformed toxin causes the Emeric type of B. cereus?
Cereulide
157
Which kind of diarrhea is caused by B. cereus?
Watery, nonblody diarhea and GI pain
158
When is common to see the Diarrheal type manifestations of B. cereus?
Within 8-18 hr
159
What kind of microbe is consider Listeria monocytogenes?
Facultative intracellular microbe
160
How is adquired Listeria monocytogenes?
By ingestion of unpasteurized dairy products and deli meats
Via transplacental transmission
Vaginal Transmission during birth
161
How does Listeria monocytogenes avoid antibodies?
Form "rocket tails" (via actin polymerization) that allow them to move through the cytoplam and into the cell membrane
162
Has a characteristic tumbling motility, is the only gram positive organism to produce LPS
Listeria monocytogenes
163
Which are the clinical manifestation caused to pregnant women by Listeria monocytogenes?
Amnionitis, septicemiam spontaneous abortion
164
This is the clinical manifestation of Listeria monocytogenes in infants
Infantiseptica
165
In neonates and immunocompromised patients this could be the manifestation of Listeria monocytogenes
Meningitis
166
Which is the clinical manifestation of Listeria monocytogenes in healthy individuals?
Gastroenteritis
167
How do you treat Gastroenteritis caused by Listeria monocytogenes?
Usually self limited
168
This is the treatment of Listeria monocytogenes in infants
Ampicillin
169
How is treated the meningitis caused by Listeria monocytogenes in immunocompromised patients and eldery?
Empirical treatment
170
These bacterias form long branching filaments resembling fungi
Actinomyces and nocardia
171
Branching filament, gram + anaerobe not acid fast
Actino myces
172
Where is commonly found Actinomyces?
Normal oral flora
173
When patologic, how is the manifestation of Actinomyces?
Causes oral/ facial abscesses that drain throug sinus tracts, forms yellow sulfur granules
174
How do you treat actinomyces?
With penicillin
175
These are the characteristics of Nocardia that differentiate from actinomyces
Nocardia is a Gram positive aeorbem acid fast (weak)
176
Where can you find Nocardia?
Found in soil
177
Which are the clinical manifestations of Nocardia in immunocompromised?
Causes pulmonary infections in immunocompromised
178
This is the clinical manifestation of Nocardia in immunocompetent
Cutaneous infection after trauma in immunocompetent
179
When does PPD results positive?
If current infection, past exposure or BCG vaccinated
180
These are the cases when PPD results negative
If no infection or anegic (steroidsm malnutrition, immunocompromise) and in sarcoidosis
181
This test is a more specific test; has fewer false positive from BCG vaccination than PPD
Intergeron γ release assay (IGRA)
182
Which is the bacteria that causes Tuberculosis?
Mycobacterium tuberculosis
183
Who are commonly the patients that adquired the primary tuberculosis?
Nonimmune host (usually child)
184
When is present the Ghon complex, during the primary tuberculosis or secondary?
Primary
185
Where is formed the Ghon complex?
```
Hiliary nodes
Ghon focus (ussualy in mid zone of lung)
```
186
Which could be the posible results of Primary tuberculosis?
Heals by fibrosis
Progressive lung disease
Severe bacterimia
Preallergic lymphatic or hematogenous dissemination
187
Who manages healed by fibrosis primary tuberculosis?
Immunity and hypersensitivity
188
Which test do we expect to be positive in healed by fibrosis primary tuberculosis patients?
Tuberculin +
189
Which patients are at higher risk to adquired progressive lung disease caused by primary tuberculosis?
HIV and malnutrition
190
Which kind of primary tuberculosis is at higher risk of death?
Severe bacteremia
191
What other name does severe bacterimia caused by Tuberculosis have?
Miliary tuberculosis
192
Which is the common evolution of Preallergic lymphatic or hematogenous dissemination has?
Dormant tubercle bacilli in several organs→ Reactivation in adult life
193
Who are at risk of reinfection of Secondary Tuberculosis?
Partially immune hypersensized host (ussualy adult)
194
How do we see a secondary tuberculosis?
As Fibrocaseous cavitation lession
195
Where is commonly found Secondary tuberculosis?
Usually at upper lobes
196
When can we see a extrapulmonary tuberculosis?
Primary tuberculosis if it´s a Reactivation in adult life
| Secondary tuberculosis when there is a reactivation tuberculosis of the lungs
197
Where are the sites of Extrapulmonary Tuberculosis?
```
CNS
Vertebral body
Lymphadenitis
Renal
GI
Adrenals
```
198
How is manifested the extrapulmonary Tuberculosis in the CNS?
Parenchymal Tuberculosis or meningitis
199
If extrapulmonary tuberculosis is present in vertebral body, What is the name of the disease?
Pott disease
200
In microscope, What can we find in Tuberculosis?
Caseating granuloma
201
Describe a caseating granuloma
Central necrosis with multinuclated Lnaghans giant cell
202
Which are the manifestations of Mycobacterium Kansaii?
Pulmonary TB like symptoms
203
What manifestation does Mycobacterium avium has in AIDS patients?
Causes disseminated non TB disease
204
Which is the prophylactic treatment of M. avium?
Azithromycin
205
Which are the TB symptoms?
Fever, night sweats, weight loss and hemoptysis
206
In mycobacteria, What does the Cord Factor in virulent strain causes?
Inhibits macrophage maturation and induces relase if TNF α
207
In order to protect themselves, what does mycobacterias have to inhibit phagolysosomal fusion?
Sulfatides
208
This is an alternative name for Leprosy
Hansen disease
209
Who causes Hansen disease?
Mycobacterium leprae
210
Which are the charesteristics of Mycobacterium leprae and its normal enviroment?
An acid Fast bacillus that likes cool temperatures, and cannot be grown in vitro
211
Where is the common sites infected by M. leprae?
Skin and superficial nerves
212
Which is the clinical manifestation of infection of superficial nerves by M. leprae?
Glove and stocking loss of sensation
213
Which animal is the reservoir in United States of M. leprae?
Armadillos
214
Which are the two forms of Hansen disease?
Lepromatous
| Tuberculoid
215
How is presented the Lepromatous Leprosy?
Presents diffusely over the skin
| with Leonine fascies and is communicable
216
How is the immunity response in Lepromatous Leprosy?
Characterized by low cell mediated immunnity with humoral TH2 response
217
Which findings can Tuberculoid Leprosy might have?
Limited to a few hypoesthetic hairless skin plaques
218
How is the immunity response in Tuberculoid Leprosy?
Characterized by high cell mediated immunity with largely Th1 type immune response
219
For Tuberculoid Leprosy which is the treatment?
Multidrug therapy consisting of dapsone and rifampin for 6 monthsfor tuberculoid form
220
... and for Lepromatous Leprosy, which is the treatment?
Dapsone, rifampin, clofazimine for 2-5 years
221
Which Bacterias are consider Gram negative diplococi?
Neisseria meningitidis
| Neisseria gonorrhoeae
222
Its a Gram negative diploccoci produces maltose fermentation
N. Meningitidis
223
Which Lab charasteristics does N. gonorrhoeae has?
Gram -, diploccoci, maltose nonfermenter
224
Name 4 bacterias gram -, coccoid rods
Haemophilus influenzae
Pasteurella
Brucella
Bordetella pertussis
225
What is required to cultivate Haemophilus influenzae
Factors V and X
226
This is the classification of gram - rods
Lactose fermenter and Lactose non fermenter
227
How do you classifiy Lactose Fermenters?
Fast fermenter
| Slow fermenter
228
These bacterias are consider Gram - Rods, lactose fermenters and fast fermenters
Klebsiella
E. Coli
Enterobacter
229
And who are slow fermeters
Citrobacter
| Serratia
230
Which bacterias are examples of Gram - rods, lactose nonfermenters oxidase negative?
Shigella
Salmonella
Proteus
Yersinia
231
How do you lab classify Pseudomona?
Gram - rod, Lactose non fermenter oxidase positive
232
Which bacterias are classify Gram - oxidase + comma shaped?
Campylobacter jejuni
Vibrio cholerae
Helicobacter pylori
233
In Which conditions Campylobacter jejuni can grow?
Grows in 42º C
234
Which kind of media is required for Vibrio cholerae?
Grows in alkaline media
235
This is a gram -, oxidase + comma shaped bacteria that produces urea
Helicobacter pylori
236
Which characteristics does the agar of Lactose fermenting enteric bacterias has?
Grow pink colonieson MacConkey agar
237
What does E. coli produces in order to break down the lactose?
β galactosidase
238
Which are the products of Lactose broken down by β galactosidase?
Glucose and galactose
239
Which other agar helps for Lactose fermenters?
EMB agar
240
Which characteristics do Lactose fermenters have on EMB agar?
Grow as Purple black colonies
241
A part from the growth as Purple black colonies, which other characteristic does E. coli has on EMB agar?
Green sheen
242
From which medicines are Gram negative bacilli resistant to?
To penicillin G and vancomycin
243
How are gram negative resistant to penicillin G and vancomycin?
Gram negative outer membrane layer inhibits entry to this medicines
244
From which penicillin derivates are Gram negative bacilli suceptible to?
Ampicillin and amocixillin
245
Which characteristics do Neisseria Gonococci and Meningococci have in common?
Gram negative diplococci
Both ferment glucose
Produce IgA proteases
246
Cellulary, where is the common place N. gonorrhoeae is located?
Is often intracellular (within neutrophils)
247
What can N. Meningococci ferment?
Maltose and glucose
248
What can N. Gonorrhoeae ferment?
Glucose
249
Which characteristics does N. Meningococci has?
Polysaccharide capsule
| Maltose fermentation
250
Is there a way to prevent N. Meningococci?
With Vaccines
251
Which N. Meningococci type isn´t present in the Vaccine?
Type B
252
Where can you find N. Meningococci?
Respiratory and oral secretions
253
Which diseases can be caused by Neisseria Meningococci?
Meningococcemia
Meningitis
Waterhouse-Frierichsen syndrome
254
This is the prophylaxis of N. Meningitidis in case of close contacts
Rifampin
Ciprofloxacin
Ceftriaxone
255
Which is the treatment in case of Meningococci?
Ceftriaxone or penicillin G
256
Which differences Gonococci presents from Meningococci?
No polysaccharide capsule
| No maltose fermentation
257
Is there a vaccine for N. Gonorrhoeae?
No
258
Why isn´t any Vaccine for N. Gonorrhoeae?
Due to a rapid antigen variation of pilus protein
259
How is transmitted N. Gonorrhoeae?
Sexually transmitted
260
Which diseases are caused by Gonococci?
```
Gonorrhea
Septic arthritis
Neonatal conjuctivitis
Pelvic inflamatory disease
Fitz Hugh Curtis syndrome
```
261
What helps to prevent Gonococci?
Condoms prevent sexual transmission
262
Which medicine works as a ointment to prevetn neonatal transmission?
Erythromycin
263
Which is the treatment for Gonococcci?
Ceftriaxone + (azithromycin or doxycycline)
264
Why do we administer in Gonococci infection Ceftriaxone + (azithromycin or doxycycline) in conjunction?
For possible chlamydia coinfection
265
How do you classify Haemophilus influenzae?
Small gran negative (coccobacillary) rod
266
How is transmitted Haemophilus influenzae?
Aerosol transmission
267
Which is worst form of H. influenzae that causes the most invasive disease?
Capsular type B
268
Which type of H. influenzae causes mucosal infections?
Nontypeable
269
These are the possible mucosal infection caused by nontypeable H. influenzae
Otitis media
Conjuntivitis
Bronchitis
270
Which protease does H. influenzae produces?
Produces IgA
271
Which culture is required for H. influenzae in order to grow?
Culture in chocolate agar requires factors V (NAD+) and X (hemantin) for growth
272
This Bacteria also grows with H. influenzae in Chocolate agar
S. aureus
273
What does S. aureus provides, in order to help H. influenzae to grow in Chocolate agar
Provides factor V
274
Name some diseases caused by H. influenzae
Epiglottitis (cherry red in children)
Meningitis
Otitis media
Pneumonia
275
How do you treat mucosal infections caused by H. influenzae?
Amoxicillin +/- Clavulanate
276
In case of Meningitis caused by H. influenzae, which is the selected treatment?
Ceftriaxone
277
For close contacts of Meningitis infected patients caused by H. influenzae, which is the prophylaxis?
Rifampin
278
What is contained in H. influenzae vaccine?
Type B capsular polysaccharide conjugated to diphteria toxoid or other protein
279
At what age do we administer H. influenzae vaccine?
2 and 18 months
280
It´s a gram negative rod, but gram strains poorly this bacteria
Legionella pneumophila
281
So, if gram strains poorly Legionella pneumophila, which other strain is used?
Silver strain
282
Which culture is used for Legionella pneumophila?
Grow on charcoal yeast extract culture with iron and cysteine
283
Clinically, how is detected Legionella pneumophila?
By presence of antigen in urine
284
How is Legionella pneumophila transmitted?
Aerosol transmission from enviromental water source habitat (air conditioning systems, hot water tanks)
285
Is it posible to have a person to person transmission of Legionella pneumophila?
No person to person transmission
286
Which is the treatment for Legionella pneumophila?
Macrolide or quinolone
287
These are the two main diseases caused by Legionella pneumophila
Legionnaires disease and Pontiac fever
288
These are manifestations of Legionnaires disease
Severe pneumonia
Fever
GI and CNS symptoms
289
What characterizes Pontiac fever?
Mild flu like syndrome
290
What do we find in Labs with Legionella pneumophila?
Hyponatremia
291
How do we classify Pseudomona aeruginosa?
Aerobic gram negative rod
| Non lactose fermenting, oxidase +
292
What gives the blue green pigment of Pseudomona aeruginosa?
Production of pyocyanin
293
Which odor does Pseudomona aeruginosa has?
Grape like odor
294
Which toxins does Pseudomona aeruginosa produces?
Endotoxin
| Exotoxin A
295
Which toxin produced by Pseudomona aeruginosa causes fecer and shock?
Endotoxin
296
These toxin produced by Pseudomona aeruginosa inactivates EF-2
Exotoxin A
297
Which diseases are associated to Pseudomona aeruginosa?
```
mnemonic PSEUDO
Wound and burn inffections
Pneumonia
Sepsis
External otitis
UTI
Drug use
Diabetic Osteomelytis
Hot tub folliculitis
```
298
Which patients are at higher risk for Pneumonia caused by Pseudomona aeruginosa?
Cystic fibrosis
299
For these patients is more common the external otitis caused by Pseudomona aeruginosa
Swimmer´s ears
300
This could be a complication from Pseudomona aeruginosa in diabetic patients
Malignant otitis externa
301
Necrotic cutaneous lesions caused by Pseudomona bacteremia
Ecthyma gangrenosum
302
What is the ecthyma gangrenosum?
Rapidly progressive, necrotic cutaneus lesions caused by Pseudomona bacteremia
303
When do we see Ecthyma gangrenosum?
Typically seen in immunocompromised patients
304
So... what is the treatment for Pseudomona aeruginosa infection?
Aminoglycoside plus extended spectrum penicillin
305
Which medicines are consider extended expectrum penicillin?
Piperacillin, ticarcillin, cefepime, imipenem, meropenem
306
In a burn victim, which is the first bacteria infection we suspect?
Pseudomona aeruginosa
307
What is associated in chronic pneumonia in cystic fibrosis patients?
Associated with biofilm
308
Which are the virulence factors of E. coli?
Fimbriae
K capsule
LPS endotoxin
309
Which clinical manifestations of E. coli are related to its virulence factor the fimbriae?
Cystitis and pyelonephritis
310
Which virulence factor of E. coli is associated to pneumonia and neonatal meningitis?
E. coli
311
This is the clinical manifestation caused by LPS endotoxin produced by E. Coli
Septic shock
312
Which are the four strains of E. Coli?
EnteroInvasive E. Coli (EIEC)
EnteroToxigenic E. Coli (ETEC)
EnteroPathogenic E. Coli (EPEC)
Enterohemorragic E. Coli (EHEC)
313
Which is the mechanism of damage caused by EIEC?
Microbe invades intestinal mucosa and causes necrosis and inflammation
314
From which bacteria is similar the clinical manifestations caused by EIEC?
Shigella
315
Which is the clinical manifestation of EIEC?
Dysentery
316
Which toxins does ETEC produces?
Heat labile and heat stable enterotoxins
317
Does ETEC produces inflamation or invasion?
No
318
Which disease does ETEC causes?
Travelers diarrhea (watery)
319
Which kind of toxins does EPEC produces?
EPEC doesn´t produce toxins
320
So... which is the mechanism of action of EPEC?
Adheres to apical surfacem flattens villi, prevents absorption
321
Which patiens are more often affected by EPEC?
Diarrhea usually in children
322
Which is the most common serotype of EHEC?
O157: H7
323
These are the toxins produced by EHEC?
Shyga like toxin
324
What does Shyga like toxin produced by EHEC causes in the human body?
Hemolytic uremic syndrome
325
Which is the triad caused by the hemolytic uremic syndrome?
Anemia
Thrombocytopenia
Acute renal failure
326
Which other name does EHEC receives?
STEC- Shiga toxin producing E. Coli
327
By which other mechanism does EHEC produces thrombocytopenia?
Microthrombin form on endothelium damaged by toxin→ mechanical hemolysis and ↓ renal blood flow; microthrombi consume platelets → Thrombocytopenia
328
Which is the presentation of EHEC?
Dysentery (toxin alone causes necrosis and inflamation)
329
Which is the difference between EHEC and the other forms of E. Coli?
Does not ferment sorbitol
330
An intestinal flora that causes lobar pneumonia when aspirated
Klebsiella
331
Who are commonly at higher risk for aspiration of Klebsiella?
Alcoholics
| Diabetics
332
How are the colonies of Klebsiella? and why?
Very mucoid colonies caused by abundant polysaccharide capsule
333
How is the sputum seen with Klebsiella?
Red "currant jelly" sputum
334
Which is the presentation of Klebsiella?
```
4 As
Aspiration pneumonia
Abscess in lungs and liver
Alcoholics
diAbetics
```
335
Which structure does Salmonella has that Shigella does not?
Salmonella has flagella
336
How is Salmonella disseminsated?
Hematogenously
337
Who are the reservoirs of Salmonella?
Many animal reservoirs
338
What does Salmonella produces that Shigella doesn´t?
Salmonella produces hydrogen sulfide
339
What does antibiotics produce if administer in Salmonellosis?
May prolong fecal excretion of organism
340
How is the mechanism of action of Salmonella?
Invades intestinal mucosa and causes a monocytotic response
341
Who produces more often bloody diarrhea between Salmonella and Shigella?
Shigella
342
Does Shigella or Salmonella ferment lactose?
Neither of them
343
How is transmitted Shigella?
Cell to cell transmission, no hematogenous spread
344
Who are the reservoirs of Shigella?
Humans and primates
345
How is the mechanism of action of Salmonella?
Invades intestinal mucosa and causes a PMN infiltration
346
Who causes the Typhoid fever?
Salmonella Typhy
347
Which species can have Salmonella Typhy?
Found only in humans
348
Which clinical findings are common in Thypoid fever?
Rose spots in the abdomen, fever, headache and diarrhea
349
Which organ can store Salmonella typhy and causes a carrier state?
Gallblader
350
Major cause of bloody diarrhea, especially in children
Campylobacter jejuni
351
How is transmitted Campylobacter jejuni?
Fecal oral transmission through foods such as poultry, meat, unpausterized milk
352
How is classify Campylobacter jejuni?
Gram - Comma or S-Shapped, oxidase +
353
Which condition is required for Campylobacter jejuni?
Grows at 42º C
354
From which diseases is Campylobacter jejuni related as a common antecedent?
Guillain Barre syndromeand reactive arthritis
355
Which is the effect of Vibrio cholerae?
Produces profuse rice water diarrhea via enterotoxin that permanently activates Gs, ↑cAMP
356
How is classify Vibrio cholerae?
Gram - Comma or S-Shapped, oxidase +
357
What is needed for Vibrio cholerae grow?
Alkaline media
358
Which group of people are at higher risk to get inffected by Vibrio cholerae?
Endemic to developing countries
359
What is needed for the management in Vibrio cholerae infection?
Oral rehydration is needed
360
How is Yersinia enterocolitica adquired?
Ussualy transmitted from pet feces, contaminted milk of pork
361
Which is the presentation of Yersinia enterocolitica infection?
As Mesenteric adenitis
362
Which diseases can mesenteric adenitis caused by Yersinia enterocolitica infection mimic?
Chron disease or apendicitis
363
This bacteria causes gastritis and peptic ulcers
Helicobacter pylori
364
Which kind of peptic ulcers does H. pylori can cause?
Especially Duodenal ulcers
365
Which diseases are at higher risk to appear with H. pylori?
Peptic ulcer
Gastric adenocarcinoma
Lymphoma
366
How do we classify Helicobacter pylori?
Curved gram negative rod that is catalase, oxidase and urease +
367
What can be used to diagnose H. pylori infection?
Urea breath test or fecal antigen test for diagnosis
368
Which kind of environment does Helicobacter pylori creates to survive?
Alkaline environment
369
Which is the most common initial treatment for H. pylori?
Triple therapy; proton pump inhibitor + clarithromycin+ either amoxicillin or metronidazole
370
These bacterias are classify as Spirochetes
Borelia
Leptospira
Treponema
371
What is needed to visualized Borrelia in light microscope?
Using aniline dyes (Wright or Giemsa stain)
372
What is needed to visualized Treponema?
Dark field micrioscopy
373
Where can we find Leptospira interrogans?
In water contamined with animal urine
374
Which is the clinical presentation of Leptosporiosis?
Flu like symptoms, jaundice, photophobia with conjuntival suffusion (erythema without exudate)
375
Where is prevalent the Leptosporiosis?
Tropics (Hawaii)
376
Which patients are more expose to Leptospira interrogans?
Prevalent among Surfers
377
What is Weil disease?
Icterohemorragic leptosporiosis
| Severe form with jaundice and azotemia from liver and kidney dysfunction
378
Which are the findings in Icterohemorragic leptosporiosis?
Fever, hemorrhage and anemia
379
Who causes Lyme disease?
Borrelia burgdoferi
380
Who transmits Borrelia burgdoferi?
Tick ixodes (also vector for Babesia)
381
Who is the reservoir of Tick ixodes?
Mouse
382
Which animal is important to thick life cycle?
Mouse
383
Where is more common Lyme disease?
Northeastern United States
384
How do we classify the symptoms in Lyme disease?
Initial symptoms and Later symptoms
385
Which are the initial Symmptoms in Lyme disease?
Erythema chronicum migrans, "Bulls eye" red erythema
Flu like symptoms
+/- Facial nerve palsy
386
Which are the later symotoms of Lyme disease?
Monoarthritis (large joints) and migratory polyarthritis
Cardiac (AV nodal block)
Neurologic (encephalopathy, facial nerve palsy, polyneuropathy)
387
This is the treatment for Lyme disease
Doxycycline, ceftriaxone
388
Who causes Syphilis?
Treponema Pallidum
389
Which is the the treatmet for Syphilis?
Penicilin G
390
Which are the types of Syphilis?
1º, 2º, 3º and congenital syphilis
391
Localized disease presentig with painless chancre
1º syphilis
392
If avaible, what is recomended to diagnose 1º syphilis?
dark field microscopy to visualize treponemes in fluid from chancre
393
Which serologic testing helps in the diagnosis of 1º syphilis, but isn´t specific test?
VDRL/ RPR
394
Which laboratory test helps to confirm the diagnose of 1º syphilis?
FTA- ABS
395
What is included in 2º syphilis?
Diseminated disease with constitutional symptoms, maculopapular rash (palms and soles), condylomata lata
396
What is needed to confirm 2º syphilis?
Dark field microscopy
397
Which labs help in the diagnosis of 2º syphilis?
VDRL/ RPR (non specific) and FTA- ABS
398
So...what is the meaning of a Secondary syphilis?
Secondary syphilis= Systemic
399
What does Latent syphilis means?
+ serology without symptoms
400
These are the manifestations of 3º syphilis
Gummas (chronic granulomas)
Sortitis (vasa vasorum destruction)
Neurosyphilis
Argyll Robertson pupil
401
How is manifested the neurosyphilis?
Tabes dorsalis, "general paresis"
402
Which are the signs found in 3 syphilis?
Broad based ataxia
+ Romberg
Charcot joint
Stroke without hypertension
403
Which test is made in neurosyphilis?
Test spinal fluid with VDRL or RPR
404
What is found in congenital syphilis?
Saber shinsm saddle nose
CN VIII deafness
Hutchinson teeth
Mulberry molars
405
What helps to prevent congenital syphilis?
Treat mother early in pregnancy
406
When is common the placental transmission of congenital syphilis during pregnancy?
After first trimester
407
Which disease is associated to Argyll Robertson pupil?
3º Syphilis
408
What happens in Argyll Robertson pupil?
Pupil constrics with accomodation but is not reactive to light
409
Which is the alternative name for Argyll Roberton pupil?
"Prostitute pupil" accomodates dut does not react
410
What does the VDRL test detect?
Nonspecific antibody that reacts with beer cardiolipin
411
Which kind of test is VDRL?
Quantitative, sensitive but not specific
412
What can give false positive with VDRL test?
Viral infection (mononucleosis (EBV), hepatitis)
Some drugs
SLE
413
Which is th mnemonic for VDRL false positives?
```
VDRL
Virus (mono, hepatitis)
Drugs
Rheumatic Fever
Lupues and Leprosy
```
414
What is the Jarisch Herxheimer reaction?
Flu like syndrome after antibiotics are started due to killed bacteria releasing pyrogens
415
What is a Zoonosis?
Infectious disease transmitted between animals and humans
416
How is transmitted the Anaplasmosis?
By Ixodes ticks
417
Which animals are carriers of Ixodes ticks?
Deer and mice
418
Which disease is caused by bartonella spp?
Cat scratch disease, bacilliary angiomatosis
419
Who causes Lyme disease?
Borrelia burgdorferi
420
How carries Borrelia burgdorferi?
Ixodes ticks
421
This bacteria causes Relapsing fever
Borrelia recurrentis
422
Who transmits Borrelia recurrentis?
Louse (recurrent due to variablesurface antigens)
423
Which other names does Brucellosis receives?
Undullant fever
424
How is adquired the Brucella spp?
Unpasteurized dairy
425
Which disease can campylobacter cause?
Bloody diarrhea
426
Who carries Campylobacter?
Puppies, livestock (fecal- oral, ingestion of uncooked meat)
427
Who causes Psittacosis?
Chlamydophilia psitacci
428
These animals carry Chlamydophilia psitacci causing Psittacosis
Parrots, other birds
429
Which disease is caused by Coxiella burnetti?
Q Fever
430
Aerosols of cattle/ sheep amniotic fluid are the source of this bacteria
Coxiella burnetti
431
Which is the bacteria that causes Ehrlichiosis?
Ehrlichia chaffeensis
432
Who transmits Ehrlichia chaffeensis?
Lone star ticks
433
Who causes Tularemia?
Francisella tullarensis
434
Who are the source of Francisella tullarensis?
Ticks, rabbits, deer fly
435
This disease is caused by Leptospira spp.
Leptospirosis
436
Which is the way of transmission of Leptospira spp?
Animal urine
437
Which bacteria causes Leprosy?
Mycobacterium leprae
438
How is transmitted Leprosy?
Humans with lepromatous leprosy, Armadillo (rare)
439
Which diasese is caused by Pasteurella multocida?
Cellulitits, osteomyelitis
440
Who transmists Pasteurella multocida?
Animal bite, cats, dogs
441
Which bacterias can causes Epidemic typhus?
Ricketssia prowazekii
| Ricketssia typhi
442
Who transmits Ricketssia prowazeki?
Louse
443
This disease is caused by Rickettsia ricketssi
Rocky Mountain spotted fever
444
Dermacentor ticks are the way if transmission of this bacteria
Ricketssia ricketssi
445
Who transmits Rickettsia typhi?
Fleas
446
Which problem can Yersinia pestis can cause?
Plague
447
Who are reservoir of Yersinia pestis?
Rats and praire dogs
448
Who transmits Yersinia pestis?
Fleas
449
This rod bacteria is involved in vaginosis
Gardenrella Vaginalis
450
How do we clasify Gardnerella Vaginalis?
A pleomorphic gram variable rod
451
How is presented Gardnerella vaginalis?
Presents as a gray vaginal discharge with fishy smell
452
Which is the difference of Vaginosis caused by Gardnerella Vaginalis and Vaginitis?
Vaginosis is not painful otherwise vaginitis is painful
453
With what is associated Gardnerella vaginalis?
Associated with sexual activity but not sexual transmitted
454
By what is characterized bacterial vaginosis?
By overgrowth of certain anaerobic bacteria in vagina
455
Which is the key in the dianogis of Gardnerella vaginalis?
Clue cells or vaginal ephitelial cells cover with Gardnerella bacteria, are seen under the microscope
456
Which is the treatment for Gardenerella vaginalis?
Metronidazole or (to treat anaerobic bacteria) clindamycin
457
Which is the treatment for all Rickettsial diseases?
Doxycyline
458
How do we classify Rickettsial diseases?
Rash common
| Rash rare
459
Which Ricketssial diseases are classify as Rash common?
Rocky mountain spotted fever
| Typhus
460
These diseases are classify as Rash rare in Rickettsial diseases
Ehrlichiosis
Anaplasmosis
Q fever
461
Where is more common Rocky mountain spotted fever?
Despite its name, disease occurs primarily in the South Atlantic state, especially North Carolina.
462
Which is the common evolution of Rocky mountain spotted fever?
Rash typically starts at wrists and ankles and then speads to trunk, palms and soles
463
Which conditions does Rickettsiae need to live?
Are obligate intracellular organisms that need CoA and NAD+ because they cannot synthezise ATP
464
Which is the classic triad present in Rocky mountain spotted fever?
Fever, Rash and headache
465
Which microorganims can present with palms and soles rash?
Coxsackievirus A infection (hand, foot and mouth)
Rocky mountain spotted fever
Secondary syphilis
466
This is the manifestation of Typhus
Rash starts centrally and spreads out, sparing palms and soles
467
In the microscope how do we see Ehrlichia?
Monocytes with morulae (berry like inclussions) in cytoplasm
468
What is seen in the microscope with Anamplasma?
Granulocytes with morulae in cytoplasm
469
What is the difference of vector between Q fever and Ehrlichiosis, anaplasmosis? (this three are Rickettsial diseases rash rare)
Ehrlichia and anaplasma have in common the tick as vector
| Coxiella burnetti have no arthropod vector
470
So... how are we infected by Coxiella burnetti?
Tick feces and cattle placenta release spores that are inhaled as aerosols
471
How is presented Q fever?
As pneumonia
472
Which requirements are needed for Chlamydiae in order to live?
They are obligate intracellular organisms that cause mucosal infections
473
Which are the two forms of Chlamydiae?
Elementary body
| Reticulate body
474
Which are the characteristics of the elementary body of Chlamydiae?
Is infectious and enters cell via endocytosis
475
After entering the cell, what happens to the elementary body of Chlamydiae?
Transforms intoreticulate body
476
What happens to the reticulate body of Chlamydiae?
Replicates in cell by fission, reorganizes into elementary bodies
477
What can Chlamydia trachomatis cause?
Reactive arthritis
Follicular conjuntivitis
Nongonococcal urethritis
PID
478
What is Reiter syndrome?
Reactive arthritis
479
Which forms of Chlamydiae cause atypical pneumonia?
C. pneumoniae and C. psittaci transmitted by aerosol
480
Which is the treatment for Chlamydiae?
Azitromycin (favored because one time treatment) or doxycycline
481
Which are the labs that make the diagnosis of Chlemydiae?
Cytoplasmic inclussions seen on Giemsa or fluorescent antibody stained smear
482
Why the Clamydial cell wall is different to others?
Lacks muramic acid
483
Which are the serotypes of Chlamydia trachomatis?
Types A, B and C
Types D-K
Types L1, L2 and L3
484
Which are the characteristics of Chlamydia trachomatis types A, B and C?
Chronic infectionm cause blindness due to follicular conjunctivitis in Africa
485
This is the mnemonic used for Chlamydia trachomatis types A, B and C
ABC
| Africa/Blindness/Chronic infection
486
Which diseases are caused by Chlamydia trachomatis types D-K?
Urethritis/PID
Ectopic pregnancy
Neonatal pnemumonia
Neonatal conjuntivitis
487
Which types of Chlamydia trachomatis can be adquired by infected Birth canal?
D-K
488
Which kind of cough do neonatal pneumonia patients have?
Staccato cough
489
These types of Chlamydia trachomatis can cause Lymphogranuloma venerum
Types L1, L2 and L3
490
Which is the evolution of Lymphogranuloma venerum?
small painless ulcers in genitals→ Swollen, painful inguinal lymph nodes that ulcerate (buboes)
491
How do you treat Lymphogranuloma venerum?
Doxycycline
492
Who causes atypical walking pneumonia?
Mycoplasma pneumoniae
493
Which are the characteristics of walking pneumonia?
Insidious onset, headache, non productive cough, patchy or diffuseintertitial infiltrate
494
Which are the characteristics of X-ray with the walking pneumonia?
X ray looks worse than patient
495
What is found in labs with Mycoplasma pneumoniae?
High titer of colf agglutinins (IgM) which can agglutinate or lyse RBCs
496
Which agar is special for Mycoplasma pneumoniae growth?
Grown in Eaton agar
497
These are the optional treatments for Walking pneumonia
Macrolidem doxycycline or fluoroquinolone
498
Why penicillin is inefecttive against Mycoplasma?
Because they don´t have cell wall
499
This is the reason why Mycoplasma can´t Gram stain
Because they don´t have cell wall
500
What does the bacterial membrane has in Mycoplasma that gives stability?
Contains sterols for stability
501
Which group of age is more common to see Mycoplasmal pneumonia?
< 30 years old
502
Which kind of patients is more frequent to see outbreaks of Mycoplama pneumoniae?
Military recruits and prisions
