Other Gram Negatives, spirochetes, and zoonotics Flashcards
Campylobacter algorithm findings Gram Shape Oxidase Grows at which temperature
Gram Negative
**Comma shaped
Oxidase +
Grows at 42 degrees C
Major symptom of campylobacter? Which patient population
Major cause of BLOODY DIARRHEA in CHILDREN
Transmission of campylobacter? Through which foods?
Antecedent to which other diseases (2)
Fecal-oral transmission through foods such as poultry, meat, and unpasteurized milk
Common antecedent to Guillain-Barre syndrome and reactive arthritis
Vibrio cholerae gram stain shape oxidase growth media
Gram negative
Comma shaped (curved rod)
oxidase +
grows in ALKALINE media
What is Vibrio best known for causing? How does this come about good sir? Walk me through the whole bit from toxin to diarrhea
Profuse, “rice-water” diarrhea.
The vibrio toxin ADP-sibsylates the G(s) -alpha subunit. This G(s)-a subunit activates adenylyl cyclase but cannot hydrolyze the bound GTP to GDP. Therefore, the G(s)-a subunit continuously activates adenylyl cyclase which increases cAMP levels and overactivates PKA. PKA phosphorylates the CFTR chloride channel which increases chloride secretion and causes the subsequent water efflux and characteristic “rice water diarrhea”
Yersinia enterocolitica lab findings gram shape lactose oxidase
Gram negative rod
lactose negative
oxidase negative
(similar to shigella and salmonella)
How is Y. enterocolitica trasmitted (3)?
What does Y. enterocolitica cause?
Transmitted through PET FECES (dogs), contaminated milk, or pork
Causes MESENTERIC ADENITIS that can mimic Crohn disease or appendicitis
Lab findings for H. pylori
catalase, oxidase, urease
Curved, gram negative rod
catalase +
oxidase +
**urease +
H. pylori causes what? These patients are at risk for what (3)?
Causes gastritis and peptic ulcers (usually duoedenal)
Patients at risk for peptic ulcer, gastric adenocarcinoma, and lymphoma
Best ways to diagnose H. pylori (2)
Urease breath test
Fecal antigen
How to treat H. pylori?
Triple Therapy: PPI + 2 antibiotics
Antibiotics choice: Clarithromycin + amoxicillin or metronidazole
What are spirochetes? Which three do I care about
Spiral-shaped bacteria with axial filaments
Borrelia (big one)
Leptospira
Treponema
Where is leptospira interrogans found and what does it cause
Found in water contaminated with animal urine (rats) and causes leptosporosis
What are the symptoms of leptosporosis (4)?
ILI
Jaundice
Photophobia
**Conjunctival suffusion (means erythema without exudate)…this is not a common symptom for anything except leptosporosis and maybe Hanta virus
What is Weil Disease…no not Alison
Icterohemorrhagic leptosporosis…severe leptosporosis
What are the symptoms of Weil Disease (5)
Jaundice (liver dysfunction) Azotemia (renal dysfunction) Fever Hemorrhage Anemia
What spirochete causes Lyme Disease…which tick transmits this? This tick also transmits which other disease?
Borrelia burgdoferi
The tick is Ixodes…also transmits Babesia
What is the natural reservoir for borrelia? Where is this disease common?
Mouse
Northeast and Midwest (Minnesota, Wisconsin, Iowa, and Illinois
Initial symptoms of Lyme Disease (3)
Erythema chronicum migrans (Bulls Eye rash)
ILI/flu
+/- facial nerve palsy
Late Symptoms of Lyme disease (4)
Monoarthritis–large joints
Migratory polyarthritis
Cardiac–AV block
Neurologic– encephalopathy, facial palsy, polyneuropathy)
Major symptom mnemonic for Lyme disease:
“FAKE a key LYME pie”
Facial nerve palsy
Arthritis
Kardiac block
Erythema migrans
Treatment for Lyme disease
Doxycycline (oral for early)
ceftriaxone (IV for late)
What does Treponema pallidum cause and how do I kill it?
Causes Syphilis you useless reptile and you kill it with PCN G
Primary syphilis primary symptom
Best way to see T. pallidum? Best sample?
- *Painless chancre (not sure how an ulcerated lesion on yo dick is painless but whatevs)
- *Dark-field microscopy on fluid from the chancre**
Serological testing for primary or secondary syphilis?
VDRL/RPR initially (non-specific)
Confirm with specific test (FTA-ABS)
What does VDRL/RPR and FTA-ABS stand for?
Venereal disease research laboratory test
Rapid Plasma Reagin
fluorescent treponemal antibody absorption
Symptoms of secondary syphilis (3)
Disseminated disease
Maculppapular rash (palms and soles)
Condylomata lata
Which state of syphilis follows secondary syphilis?
Latent syphilis–? +serology without symptoms
Symptoms of tertiary syphilis (4)
Gumma (chronic granulomas on skin…nasty and obvious)
Aortitis –> vasa vasorum destruction
Neurosyphilis –> tabes dorsalis
Argyll Robertson pupil –> accommodates but does not react to light
Signs of tertiary syphilis (4)
Broad-based ataxia –> from instability
+Romberg –> same reason
Charcot joint
“Stroke without HTN”
How to diagnose neurosyphilis?
VDRL or RPR on spinal tap
Congenital syphilis signs (5)
How to prevent
Saber Shins Saddle nose CN VIII deafness Hutchinson teeth Mulberry molars
Treat mother in first trimester
When can neurosyphilis occur? When can transmission occur?
Any stage
What causes “VDRL” false positives? 4
Viruses (EBV, hepatitis)
Drugs
Rheumatic fever
Lupus and Leprosy
What does the VDRL test test for?
Nonspecific antibody to beef cardiolipin…sensitive but not specific
What inflammatory flu-like syndrome that resembles bacterial sepsis is classically associated with syphilis after starting PCN and other spirochete diseases?
Jarisch-Herxheimer reaction.
Monitor closely and give anti-inflammatory meds…steroids don’t work
Leptosporosis is prevalent among which demographic?
“Surfer’s in the tropics (ie. Hawaii)
What does Gardnerella vaginalis look like? What is it involved with?
Pleomorphic, gram-variable rod
Vaginosis
How does Gardnerella vaginalis present?
Gray vaginal discharge with a fishy smell
Non-painful
G. vaginalis is associated with what?
How is it characterized?
Associated with sexual activity but not an STD
Characterized by anaerobic bacterial overgrowth in the vagina
Best way to diagnose G. Vaginalis?
You mean other than a fishy smell from the vagina? CLUE cells (vaginal epithelial cells that are literally covered with Gardnerella)
How to kill/treat G. vaginalis?
Metronidazole or
Clindamycin
