Other Bacteria Flashcards
1
Q
Organisms not seen in gram stain. (11)
A
“These Little Microbes May Unfortunately Lack Color But Are Everywhere.”
1. Treponema
2. Leptospira
3. Mycobacteria
4. Mycoplasma
5. Ureaplasma
6. Legionella
7. Rickettsiae
8. Chlamydia
9. Bartonella
10. Anaplasma
11. Erlichia
2
Q
Most important virulence factor of Mycobacterium tuberculosis that inhibits leukocyte migration.
A
Cord factor
3
Q
Stage of Syphilis where aneurysms appear.
A
Tertiary Syphilis
4
Q
Term used in an influenzae like symptoms a few hours after receiving penicillin in patients with syphilis.
A
Jarisch-Herxheimer reaction
5
Q
Mixture of antibodies combining with the cardiolipin-cholesterol-lecithin complex in non-treponemal tests for syphilis.
A
Reagin
6
Q
Sexually transmitted organism causing suppurative inguinal adenitis known as buboes.
A
Chlamydia trachomatis serovars L1-L3
( this is lymphogranuloma venereum LGV )
7
Q
Vector for epidemic typhus.
A
Human body louse
8
Q
Causative agent of a chronic genital ulcer that when sampled, showed pleomorphic bacilli present in the cytoplasm of macrophages and neutrophils demonstrated by Giemsa or Wright’s stain.
A
Klebsiella granulomatis
- this is a case of granuloma inguinale or donovanosis. The pleomorphic bacilli in leukocytes are known as Donovan bodies.
9
Q
Route of transmission of granuloma inguinale.
A
Sexual transmission
10
Q
Primary reservoir of leptospirosis.
A
Rats
DOC is Doxycycline for prophylaxis and mild infection.
DOC is Penicillin for severe.
11
Q
Etiology of Syphilis.
A
Treponema pallidum
12
Q
What is needed for direct visualization of T. pallidum?
A
Darkfield microscopy
13
Q
The ulcer seen in primary Syphilis.
A
Chancre
14
Q
Characteristic of Syphilis ulcers.
A
Painless
15
Q
Lesions seen in secondary Syphilis.
A
Maculopapular rash on palms and soles
16
Q
Wart like lesions seen in secondary Syphilis.
A
Condyloma lata
17
Q
Predominant WBC in Syphilis infiltrates.
A
Plasma cell
18
Q
Hutchinson’s triad in congenital syphilis?
A
- Notched teeth
- 8th nerve deafness
- Interstitial keratitis
19
Q
What do you call the unilateral sternoclavicular enlargementin congenital syphilis?
A
Higoumenakis Sign
20
Q
What sensory pathology is seen in neurosyphilis?
A
Tabes dorsalis
( from affectation of the dorsal columns)
21
Q
What part of the spinal cord is most affected in neurosyphilis?
A
Posterior columns
22
Q
Ophthalmologic findings in neurosyphilis?
A
Argyll-Robertson pupil or the “Prostitute’s Pupil”
23
Q
In neurosyphilis, the pupil will constrict to ________ but not to light.
A
Accommodation
24
Q
Cardiovascular complication of tertiary syphilis.
A
Aortitis
25
Characteristic appearance of aortitis in tertiary syphilis.
Tree bark appearance
26
Cardiovascular involvement in tertiary syphilis causes destruction of what blood vessel?
Vasa vasorum ( the vessel that supply the aorta)
27
What population is at greatest risk for symptomatic neurosyphilis?
Patient with untreated HIV
28
Most common presentation of meningovascular syphilis?
Stroke syndrome involving the MCA
29
Description of the nose in classic stigmata of congenital syphilis.
Saddle nose
30
Description of the shins in classic stigmata of congenital Syphilis.
Saber shins
31
Description of the molars in classic stigmata of congenital syphilis?
Mulberry molars ( molars with multiple , poorly-developed cusps)
32
Mostly widely -used screening tests for syphilis?
RPR and VDRL
33
Standard non-treponemal test for CSF examination?
VDRL (Superior to RPR for CSF)
34
Drug of choice for all stages of syphillis ?
Penicillin G
35
Reaction of mild hypotension fever, chills, tachycardia experienced after treating syphilis?
Jarisch-Herxheimer Reaction
36
Stage of syphilis most associated with the Jarisch-Herxheimer reaction?
Secondary Syphilis
37
What causes the Jarisch-Herxheimer reaction?
Release of lipoproteins by dying T. pallidum bacteria
38
Which tests for syphilis will remain positive for life even with adequate treatment?
Treponemal tests (FTA-ABS)
39
What is the largest medically important bacteria?
Borrelia burgdorferi
40
Animal reservoirs of Borrelia burgdorferi?
White-footed mouse and White tailed Deer
41
Mode of transmission of Lyme disease?
Bite from deer tick (Ixodes tick)
42
Classic skin lesion in 1st stage of Lyme disease?
Erythema chronicum migrans
43
Cardiovascular pathology in 2nd stage of Lyme disease?
Myocarditis (AV block)
44
What is the only spirochete that can be visualized using dyes in light microscopy?
Borrelia
45
What two stains can be used to visualize Borrelia burgdorferi?
Wright stain, Giemsa stain
46
First line treatment of Lyme disease?
Doxycycline
47
What causes relapsing fever?
Borrelia recurrentis
48
What spirochete is described as having Sheperds crook appearance?
Leptospira interogans
49
Ophthalmic finding in leptospirosis?
Conjuctival suffusion (redness without exudates)
50
Triad of Weil Syndrome.
1. Jaundice
2. Bleeding
3. AKI
51
Most common cause of death in Weil Syndrome?
Respiratory failure from massive pulmonary hemorrhage
52
Where are leptospires most present in acutr stage of leptospirosis ?
Blood (leptospiremic stage)
53
Where can leptospires be cultured from during the immune phase of leptospirosis?
Urine
54
Most common chest radiographic finding in severe leptospirosis?
Snow-flake lesions (patchy bilateral alveolar pattern)
55
Preferred diagnostic test for leptospirosis in those with clinical evidence of infection?
Lepto MAT (Microscopic Agglutination Test)
56
Vector of Rocky Mountain Spotted Fever?
Dermacentor Tick
57
Vector of Endemic typhus?
Fleas
58
Vector of epidemic typhus ?
Human body louse
59
Causative agent of epidemic typhus?
Rickettsia prowazekii
(P= ePidemic)
60
Causative agent of endemic typhus?
Rickettsia typhi
61
Rickettsia spp. cannot produce what two factors?
1. CoA
2. NAD+
(Hence, they are obligate intracellular)
62
Stain used to visualize Rickettsia.
Giemsa stain
63
Organism that causes relapsing fever.
Borrelia recurrentis
64
Rickettsial infection that causes a rash which starts at the wrist then spreads to the trunk.
Rocky Mountain Spotted Fever
65
What causes Q fever?
Coxiella burnetti
66
Coxiella burnetti causes what disease?
Q fever
67
Atypical bacteria that can cause pneumonia from aerosolized spores in cattle placenta.
Coxiella burnetti
68
What component in Mycobacterium cell walls is responsible for their acid fastness.
Mycolic acid
69
Which serotypes of Chlamydia trachomatis are associated with neonatal conjunctivitis ?
D-K
70
Which serotypes of Chlamydia trachomatis are associated with trachoma blindness?
A, B, C
71
Which serotypes of Chlamydia trachomatis are associated with lymphogranuloma venerem?
L1, L2,L3
72
What stage of C. trachomatis enters the cell?
Elementary body
73
What stage of C. trachomatis replicates intracellularly?
Reticulate body
74
What stain can be used to visualize C. trachomatis?
Giemsa stain
75
Neonatal pneumonia from C. trachomatis presents with what type of cough?
Staccato cough
76
What bacteria can cause atypical pneumonia transmitted from bird droppings?
Chlamydophila psittaci
77
Rickettsial disease that presents with morulae in neutrophils?
Anaplasmosis
78
Rickettsial disease that presents with morulae in monocytes?
Ehrlichiosis
79
What agglutination test is used to diagnose Rickettsial infection?
Well-Felix Test
80
Most common cause of atypical pneumonia in young adults ?
Mycoplasma pneumonia
81
Mycoplasma pneumonia is the only bacteria with _____ in its cell membrane.
Cholesterol
82
What hematologic abnormality can be seen with M. pneumonia infections?
Autoimmune hemolytic anemia
83
What antibodies are associated with M. pneumonia infections?
Cold agglutinins (IgM)
84
What is responsible for acid fastness of Mycobacteria?
Long chain mycolic acids in their cell walls
85
Oxygen requirement of Mycobacteria?
Obligate aerobes
86
What virulence factor of M. tuberculosis inhibits leukocyte migration?
Cord Factor
87
Cord factor allows Mycobacterium tuberculosis to clump in what formation?
Serpentine formation
88
A positive PPD Test is an example of what type of hypersensitivity reaction?
Type IV hypersensitivity reaction
89
Pathologic hallmark of M. tuberculosis infections?
Caseating granulomas
90
Fatsest growinh mycobacterium?
M. fortuitum
91
Gold standard for diagnosis of M. tuberculosis?
Culture
92
Risk for developing MAC infections in HIV increases when CD4 count is below what value?
100 /uL
93
Which type of Leprosy infection is seen in those with deficient cell-mediated immunity?
Lepromatous
94
Peripheral nerve classically affected by leprosy?
Ulnar nerve
95
Mycobacterium that appears like packs of cigars on culture media?
M. Leprae
96
Treatment of the lepromatous form of leprosy?
Rifampicin + Dapsone + Clofazimine
(DR C Lepromatous Leprosy)
97
Treatment of the tuberculoid form of leprosy?
Rifampicin + Dapsone
(DR tuberculoid Leprosy)
98
Which mycobacterium causes skin infections in aquarium handlers?
Mycobacteria marinum
99
Which mycobacterium causes cervical lymphadenitis in children?
Mycobacteria scrofulaceum
100
A Ghon complex that heals and calcifies.
Ranke Complex
101
Cytokine necessary to prevent TB reactivation?
TNF-a
102
TB infection of the vertebrae?
Pott’s disease
103
Caseating granuloma near the pleura in primary TB?
Ghon focus
104
Hilar lymphadenopathy + Ghon foci in primary TB?
Ghon complex
105
Vitamin to administer with isoniazid .
Pyridoxine ( Vitamin B6)
106
Anti TB drug that inhibits mycolic acid production.
Isoniazid
(Mysoniazid)
107
Anti TB drug that blocks arabinosyl transferase?
Ethambutol
(arab si etham)
108
Anti-TB drug associated with Hyperuricemia?
Pyrazinamide
109
Most serious side effect of Ethambutol?
Optic neuritis
Ethambutol (Eyes )
110
Mutation in this Mtb gene causes Isoniazid resistance?
KatG (catalase peroxidase)
111
What activates Isoniazid?
KatG ( Catalase Peroxidase)
112
Anti-TB drug that causes red-orange discoloration of body fluids?
Rifampin (Red-orange)
113
The Quantiferon gold assay measures ______________?
IFN-gamma levels released from Th1-cells
114
Does a PPD test cross-react with previous BCG vaccine?
Yes
115
Does a Quantiferon Gold Assay cross react with previous BCG vaccine?
No
116
Characteristic of Syphilis?
Penicillin remains to be the best treatment of choice for syphilis. It is given for all stages.
117
Smoker suffering from sharp chest pain, fever, and audible friction rub. What’s your clinical impression?
Tuberculosis pericarditis
118
Causative agent of relapsing fever?
Borrelia burgdorferi ( tick borne relapsing fever)
119
Q fever is diagnosed by ______________.
Serologic means: IFA (Immunofluorescence antibody) using C. burnetti antigen
120
Causative agent.
Leptospira interrogans
121
Infection of the lymph nodes , liver, spleen, kidney, bone marrow, myocardium.
Clinical picture consists of fever, chills, headache, myalgia, dizziness, backache, followed by nausea, vomiting, and bradycardia.
Leptospirosis
122
Severe form of this disease can progress to fever, jaundice, and renal failure and hemorrhagic manifestations leading to hepatorenal failure.
Leptospirosis
123
How is leptospirosis acquired?
Penetration of skin exposed to contaminated water.
124
Predominant organism in cat bites?
Pasteurella multocida
125
Ghon lesion is seen in __________.
Primary tuberculosis
126
Signs & Symptoms of Tuberculosis in adults. (4)
1. Dry cough, low grade afternoon fever
2. Emaciated (thin & weak)
3. Harsh breath sounds
4. Increased upper lung fields densities on xray
127
Positive tuberculin test means?
Latent infection , Infection in the past.
128
Layer of tubercle ( TB granuloma) where TB bacilli is isolated and cultured.
Central zone
129
Signs & Symptoms of Mycoplasma pneumoniae?
From malaise, fever,sore throat, , non-productive cough
To productive cough with blood tinged sputum
130
Lab findings of Mycoplasma pneumoniae?
1. Mild leukocytosis
2. CXR: pulmonary consolidation
131
Treatment of Mycoplasma pneumoniae?
Treated with Tetracycline & Erythromycin
132
Mycoplasma pneumoniae is diagnosed through _______________.
Serology
133
Pathophysiology of Mycoplasma pneumonia?
Cell wall defective
134
More malignant and progressive type of Leprosy?
Negative lepromin test
135
Laboratory procedure to establish leprosy diagnosis?
Skin biopsy
136
A case with vesicle at anorectal area , ulcerated, painful lymphadenopathies in inguinal and rectal areas. What’s your clinical impression?
Lymphogranuloma venereum
137
A case where papule or vesicular lesions which ulcerates and leads to suppurative inguinal lymphadenitis (buboes).
Lymphogranuloma venereum
138
Signs of successful treatment of Lymphogranuloma venereum ?
Complete healing os suppurative adenitis
139
Describe Hansen’s Disease? (3)
1. Clawing deformity of both hands
2. Reduced sensation at small patches of skin
3. Macular rashes without sensation
140
What’s your clinical impression on a patient with foul smelling vaginal discharge due to overgrowth of anaerobes , decreased lactobacilli, increased vaginal pH?
Bacterial Vaginosis
141
What’s your clinical impression on a patient having whitish gray color vaginal discharge adherent to vaginal wall but none on cervical os. Positive clue cells, no PMN cells seen.
Bacterial Vaginosis
142
Treatment of Bacterial Vaginosis?
Metronidazole BID for 7 days
