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USMLE microbiology > other gram positives > Flashcards

other gram positives Flashcards

1
Q

draw the algorith for gram negative bacteria

A
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2
Q

what do all clostridium have in common ?

A

all form spors
all are obligate anaerobes
all form toxins

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3
Q

what are the obligate intracellular anaerobes ?

A

rickettsia
chlamydia
coxiella
clostridiu,

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4
Q

who are the pore forming bacteria ?

A

ABC
autoclave to kill bacillus and clostridium

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5
Q

where is clostridium tetani found and how do they enter the body ?

A

spores are found in the soil
enter through penetrating injuries , as with walking barefoot

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6
Q

what is the toxin of tetanus and what does it do ?

A

teanospasmin
travels to the spinal cord
blocks glycine and GABA release by inhibitory neurons
attacks renshaw cells
causes spastic paralysis

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7
Q

what are the classic spasm of tetanus ?

A

lock jaw
risus sardonicus ( permanent smile)

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8
Q

what is the treatment of tetanus?

A

debriement of the wound
metronidazole
tetanus immunoglobulin
benzos or neuromuscular blockers

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9
Q

what is in the vaccination for tetanus ?

A

the toxoids

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10
Q

what is so special about botulinum spores ?

A

heat resistant spores

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11
Q

what is the mechanism of botulinium toxin ?

A

blocks the release of ACH so no muscle contraction
leads to flaccid paralysis

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12
Q

where is the DNA for c botulinium usually found ?

A

found in many different variants
carried by bacteriophages

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13
Q

what are the three types of botulinium and what are their features ?

A

food - usually in adults , from canned undercooked food
infant - ingestion of spores , grow in intestines , associated with honey
wound - infection

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14
Q

what are the symptoms of botulism ?

A

usually ocurs after 12-48 hours of ingestion
3D symptoms :
diplopia
dysphagia
dysphonia

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15
Q

what is the treatment of botulism ?

A

antitoxin
supportive care

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16
Q

where is clostridiu perferinges found ?

A

widespread in soil

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17
Q

what are the effects of infection by c perferinges ?

A

causes gas gangrene - clostridial myonecrosis

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18
Q

what is the toxin associated with clostridium perferinges ?

A

alpha toxin
causes hemolysis of muscles
it is a phospholipase that acts on lecithin and degrades it in the cell membrane

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19
Q

what bis the presentation of food poisoning in association with c perferinges ?

A

1- it happens after the ingestion of the spores in association with undercooked meats
2- late onset with watery diarrhea because the ingestion of spores makes the presentation late

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20
Q

what is the classic clinical scenario associated with c difficile infection ?

A

ingestion of the spores are not harmful
colonic flora prevents the overgrowth
the environment only becomes favourable after antibiotic administration

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21
Q

what bacteria is associated with antibiotic associated colitis ?

A

c difficile

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22
Q

what are the toxins associated with c difficile ?

A

toxin a - enterotoxin causes watery diarrhea
toxin b - cytotoxin causes cell necrosis and fibrin deposition
toxin b is more potent

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23
Q

what is the mechanism of action associated with the toxins made by c difficile ?

A

both toxins bind to GI cells and are internalized
destroy the cytoskeleton of GI cells and form a pseudomembrane

24
Q

massive watery diarrhea and history of ab therapy ?

A

suspect c difficile

25
Q

how is a diagnosis of c difficile made ?

A

stool detection of toxin a or b

26
Q

what is the treatment for c difficile ?

A

metronidazole
ORAL vancomycin

27
Q

what is the toxin associated with diphtheria ?

A

diphtheria exotoxin
not part of bacterial genoe
carried by b prophage
inactivates EF2 by ADP ribosylation

28
Q

what is the shape of corynebacterium features ?

A

curved gram positive rods
Chinese character distribution

29
Q

what are the media used for c diptheria ?

A

loefflers media or tinsdale

30
Q

what test is used for the diagnosis of diphtheria ?

A

elek test for diagnosis and toxin detection

31
Q

what are the symptoms of diptheria ?

A

gray white membrane in the back of the throat
lymphadenopathy
fever
sore throat

32
Q

what is the treatment for acute infection of diphtheria ?

A

penicillin
diphtheria anti toxin ( passive immunization)
diphtheria toxoid ( active immunization )

33
Q

what is the unique moving mechanism of listeria ?

A

tumbling motility
moves from cell to cell to avoid extracellular responses
it polymerizes actin in cells to move “ actin rockets”

34
Q

what type of patients are most likley to get listeria ?

A

in people with poor cell mediated immunity
in adults who consume undercooked meats
unpasteurized cheese or milk
likes cold temperatures

35
Q

what are the three clinical pictutes associated with listeria ?

A

gastroenteritis - self limited
meningitis - elderly or newborns
infection in pregnancy - usually in 3rd trimester

36
Q

what happens if a pregnant mother infects her foetus with listeria ?

A

newborn gets granulomatosis infantiseptica
severe in utero infection
most babies will be still born

37
Q

what is distinctive in the placenta with babies that develop granulomatosis infantiseptica ?

A

chorioamnionitis
villitis
abscess formation

38
Q

what are the two types of bacillus ?

A

bacillus anthrax
baciilus cereus

39
Q

which is the only bacteria with a polypeptide capsule ?

A

bacillus anthrax and contains d-glutamate
most are polysacchrides

40
Q

what type of workers are more at risk of bacillus anthrax ?

A

farm workers

41
Q

what are the toxins associated nwith bacillus anthrax ?

A

edema toxin - edema factor , mimics adenyl cyclase , inceases cAMP
lethal toxin - inhibits cell signaling , causes apoptosis

42
Q

what is the cutaneous disease of anthrax ?

A

painless black ulcer forms
edema surrounds the black ulcer from edema factor

43
Q

what is the clinical picture associated with the pulmonary disease of anthrax ?

A

woolsorters disease , caused by the inhalation of spores
fluu symptoms then eventually may cause pulm hge

44
Q

what is the classic finding on chest x ray of people with wool sorters disease ?

A

wide mediastinum

45
Q

what is the classic scenario associated with bacillus cereus ?

A

classically in undercooked or reheated rice
cause by ingesting the enterotoxin
reheated rice syndrome

46
Q

what are the two types bacillus cereus disease ?

A

emetic type - rice dished direct ingestion of toxin
diarrheal type - caused by several enerotoxins , heat labile toxins

47
Q

what gram positive bacteria is normally found in both the oral flora and in the female genital tract ?

A

actinomyces

48
Q

what is the shape of actinomycen ?

A

long filaments resembling fungi

49
Q

what is the classic disease presentation associated with actinomyces ?

A

head and neck abscess

50
Q

if there is an IUD associated infection what is the most likely causative organism ?

A

actinomyces

51
Q

dental work , or orofacial truma followed by a mass on the face ?

A

associated with actinomyces

52
Q

what colour is associated with actinomyces ?

A

yellow sulfur granules

53
Q

what is the only bacteria that is acid fast that isnt mycobacterium ?

A

nocardia

54
Q

what are the urease positive organisms ?

A

Pee CHUNKS
proteus
cryptococcus
H pylori
Ureaplasma
Nocardia
Klebsiella
S epidermidis

55
Q

what are the 2 illnesses associated with nocardia ?

A

pneumonia because they are obligate aerobes
skin infections

56
Q

how does the skin infection happen in nocardia ?

A

invades the skin during gardening or farming

57
Q

what is the drug of choice when treating nocardia ?

A

TMP-SMX

USMLE microbiology (14 decks)

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