Skinny bacteria II Flashcards

1
Q

What is the result for alpha, beta, and gamma hemolysis?

A
alpha = partial/green
beta = total
gamma = none
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2
Q

What are the lancefield antigens?

A

Cell wall carbs used to define beta-hemolytic into groups A through U

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3
Q

What is GAS?

A

S. Pyogenes

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4
Q

What is GBS?

A

S. agalactiae

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5
Q

What is GDS?

A

Enterococcus

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6
Q

What are the two groups of strep that do not get lancefield designations?

A

S. pneumoniae

S. mutans

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7
Q

What are the four major diseases GAS is responsible for?

A

Strep throat
Skin infections
Rheumatic fever
Glomerulonephritis

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8
Q

How do you differentiates GAS from other Beta hemolytic strep?

A

GAS is bacitracin sensitive

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9
Q

What are the three major virulence factors for GAS?

A

Hyaluronic acid capsule
Adhesins
Toxins

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10
Q

What is significant about that capsule of GAS

A

Hyaluronic acid is a poor immunogen (looks like self) and interferes with phagocytosis

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11
Q

What are the two toxins of GAS?

A

Streptolysin

Superantigens

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12
Q

What is the M protein found on Strep A? (3)

A

Myosin-like protein that:

  • prevents phagocytosis
  • allows for attachment
  • Inhibits complement attack
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13
Q

What is the function of streptolysin O and streptolysin S?

A

Pore forming toxins

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14
Q

What percent of GAS produce superantigens?

A

10%

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15
Q

What are the superantigens that some strep produce? What are their function?

A

Pyrogenic exotoxins SpeA, SpeB, SpeC

Increase proinflammatory cytokine production

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16
Q

What is the function of C5a peptidase of GAS?

A

Prevents complement formation, and PMN chemotaxis

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17
Q

Strep gets into a cell using what protein? What happens then?

A

Streptolysin O

Produces more causing apoptosis of the cell

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18
Q

What are the four major skin infections caused by strep?

A

Impetigo (pyoderma)
Erysipelas
Cellulitis
Necrotizing fasciitis

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19
Q

How can you distinguish between staph and strep impetigo?

A

Staph is more extensive, with bullous lesions

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20
Q

Sharply demarcated erythematous skin = ?

A

Erysipelas

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21
Q

NOT sharply demarcated erythematous and warm skin = ?

A

Cellultis

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22
Q

What bacteria is the most common cause of cellulitis?

A

Strep pyogenes

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23
Q

GAS causes what % of necrotizing fasciitis?

A

60%

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24
Q

What are the symptoms of necrotizing fasciitis? (2)

A

Extreme pain/TTP

Grayish skin coloration initially, moving to erythema and edema

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25
Q

What is the treatment for necrotizing fasciitis?

A

Prompt debridement and removal of tissue

Broad spectrum Abx

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26
Q

What causes scarlet fever? Symptoms?

A

Strep pyogenes exotoxin Spe

Strawberry tongue
Petechial rash

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27
Q

Strawberry tongue + Petechial rash = ?

A

Scarlet fever

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28
Q

What are the complications of acute rheumatic fever? What causes it?

A

Heart valve tissue damage

d/t cross rxn w/ M protein and type II hypersensitivity

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29
Q

Glomerulonephritis is a complication of what?

A

Pharyngeal OR cutaneous GAS

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30
Q

What type of hypersensitivity is glomerulonephritis?

A

Type III

31
Q

When does glomerulonephritis present?

A

1-4 weeks post GAS pharyngitis or 3-6 week post cutaneous infection

32
Q

Symptoms of glomerulonephritis? (3)

A

Hematuria, HTN
Recent strep infx
Reduced serum complement

33
Q

Strep toxic syndrome usually follow what disease?

A

Necrotizing fasciitis caused by strep

34
Q

True or false: Strep toxic syndrome is the result of bacteremia

A

True

35
Q

How do you diagnose GAS, besides serology and culture?

A

Antistreptolysin O abs

36
Q

What is the treatment for GAS? Is staph susceptible to this?

A

PCN–staph would be resistant to this

37
Q

What is the gram stain and morphology of pseudomonas aeruginosa? Hemolysis pattern? Oxidase? Ferment?

A

Gram negative motile rod
Beta hemolysis.
Oxidase positive
Non-fermenter

38
Q

Is staph sensitive to PCN?

A

no, has beta lactamases

39
Q

Where can pseudomonas grow?

A

Anywhere there is water–even soap

40
Q

Blue green pigment on agar = ?

A

Pseudomonas aeruginosa

41
Q

Pseudomonas aeruginosa usually are associated with what?

A

Recent hospitalization

42
Q

True or false: Pseudomonas aeruginosa is an opportunistic pathogen, and has loads of abx resistance

A

True

43
Q

What are the soluble pigments that Pseudomonas aeruginosa produces?

A

Pyocyanin

Pyoverdin

44
Q

What is the capsule associated with Pseudomonas aeruginosa?

A

Alginate

45
Q

What are the adhesins for Pseudomonas aeruginosa? (4)

A

Pili
Flagella
LPS
Alginate

46
Q

What is the major exotoxin for Pseudomonas aeruginosa? Function? How is it administered to cells?

A

Exotoxin A
Blocks protein synthesis through inhibition of EF-2
Type III secretion system

47
Q

What is the MOA of abx resistance for Pseudomonas aeruginosa?

A

Mutation of pore proteins

48
Q

CF and burn patients hate what bacteria?

A

Pseudomonas aeruginosa

49
Q

What is the common cause of swimmer’s ear (otitis externa)?

A

Pseudomonas aeruginosa

50
Q

What are the two major soft tissue infections that Pseudomonas aeruginosa causes?

A

Folliculitis

Osteochondritis

51
Q

Pseudomonas aeruginosa infections are associated with what type of skin problem?

A

Burns

52
Q

Bacteremia caused by Pseudomonas aeruginosa causes what?

A

Ecthyma gangrenosum

53
Q

What is Ecthyma gangrenosum?

A

Necrotic skin lesions and infections of the blood vessels

54
Q

What predisposes burns to Pseudomonas aeruginosa?

A

Moist surface + inability of PMNs to penetrate skin

55
Q

What is Hot tub skin rash? Symptoms?

A

Pseudomonas folliculitis

Pruritic erythematous papules x5 days

56
Q

What is the cause of “green nails”?

A

Pseudomonas aeruginosa biofilm/infection of the paronychia

57
Q

What is webspace intertrigo? Cause?

A

Macerated and eroded skin on interdigital toes, usually caused by Pseudomonas aeruginosa

58
Q

What is the treatment for Pseudomonas aeruginosa infections?

A

Combination therapy with aminoglycosides

59
Q

What is the function of LTA that strep produces?

A

Involved in adhering to fibronectin on epithelial cell surfaces

60
Q

What is the function of proteins F and M on strep?

A

F = adhesion

M = blocks C3b

61
Q

What is the MOA of the superantigens produced by strep?

A

Increase proinflammatory cytokines

62
Q

What is the function of DNAase that strep produces?

A

Depolymerizes DNA in pus, decreasing viscosity

63
Q

What is the function of streptokinase produced by strep?

A

Cleaves plasminogen

64
Q

Sharply demarcated erythema, with associated fever and chills = ?

A

Erysipelas

65
Q

What is the pathogenesis of necrotizing fasciitis?

A

Dead tissue blocks circulation to the wound creating heaven for bacteria

66
Q

What is the pathogeneis of rhemuatic fever heart damage?

A

Strep Pyogenes m M protein looks like heart tissue

67
Q

Gram positive cocci in clusters = ? (usually)

A

Staph Aureus

68
Q

Gram positive cocci in chain = ? (usually)

A

Strep Pyogenes

69
Q

What are the symptoms of rheumatic fever? How long after a pharyngeal infx?

A

Diffuse, erythematous rash on upper chest, then extremities

Coating of the tongue (strawberry)

3 week post GAS pharyngitis

70
Q

How do you distinguish between strep and staph toxic shock syndrome?

A
Staph = intoxication
Strep = bacteremia
71
Q

Antibodies against streptolysin O (ASO test) is useful for confirming what disease(s)?

A

Rheumatic fever or glomerulonephritis

72
Q

Can cutaneous infections of strep cause acute rheumatic fever?

A

No

73
Q

TSST is produced by what bacteria?

A

Staph