Tom wagners high yield - micro Flashcards
Inflammatory component of gram negative LPS
G-: Lipid A.
G+: Lipoteichoic acid induces TNFa and IL-1 from G+
Novobiocin–
Sensitive: Staph epidermidis
Resistant: Staph saprophyticus
Quellung Reaction
Strep Pneumo. Strep pneumo capsule swells when bound by Ab (specific); Lancet shaped diplococci
Bacitracin:
Sensitive: Strep Pyogenes,
Resistant: Strep agalactiae
Endocarditis following GI/GU procedures? grows on?
Enterococcus. Can grow in bile and 6.5% NaCl
Gram Positive Rods with Metachromatic (blue and red) granules. grows on? mech?
Corynebacterium diptheriae. Black colonies on cystine-tellurite agar; ADP Ribosulates EF-2; ELEK test for toxin
tetanospasmin block GABA and glycine release from?
Renshaw cells in the spinal cord. trismus (lockjaw), Risus Sardonicus, and Opisthonotos (eyes locked)
Serpentine chains of G+ rods?
Bacillus anthracis. spore forming; edema factor inc cAMP; + lethal toxin
Only G+ that produces LPS? grows in?
Listeria. Tumbling motility and can grow at 4 degrees celcius (cold enrichment)
Acid fast+ and G+, causes pulmonary infections. tx?
Nocardia. weakly acid fast (carbolfuschin); TX with sulfonamides
Oxidase+, G- that grows at 42 degrees. structure? spread via? diseases?
Camplyobacter. Comma shaped, undercooked chicken; Guillane-Barre and Reactive Arthritis
Oral abscess or facial abscess (draining through sinus tract) with yellow sulfur granules. structure? tx?
Actinomyces. Branched G+ bacteria; TX with penecillin
Asthma and CF pts at risk for this infection causing bronchiectasis and Eosinophilia
Allergic Bronchopulmonary Aspergillosis (ABPA). Leads to bronchiectasis
Bacteria that causes Lymptocytic Leukocytosis
Bordetella pertussis. Lympthocytosis promiting factor that blocks lymphocyotes from leacing blood for LNs
Grows in both bile and 6.5% NaCl (G+ coccus)
Enterococcus
Only bacteria with a polypeptide capsule
Bacillus anthracis. D-glutamate; Cutaneous- ulcer with black eschar
Gonorrhea immune evasion
Rapid Ag variation of Pilus proteins. Intracellular in PMNs. Culture negative. UTI
Chlamydia/Gonorrhea Tx regimen
Ceftriaxone + Azithromycin/doxycycline
G- coccobacillus causing otitus media, bronchitis, conjunctivitis
Nontypable Haemophilus influenze. No capular Ag
Pneumonia with Hyponatremia, watery diarrhea, heachahe and GI pain. grows on?
Legionella. can cause SIADH and decreased tubular reabsorption; Charcoal Yeast Extract
Key E coli virulence factor for: UTI? Pneumonia? Neonatal Meningitis? Sepsis?
UTI- Fimbrae/P-pili; Shock-LPS
Pneumonia/Meningitis- K Capsule
E. Coli strain that does not ferment sorbitol or produce glucuronidase
EHEC. O157:H7, Shiga-like/Verotoxin causes microthrombi to form on toxin-damaged endothelium–>HUS
Woolsorter’s disease
Bacillus anthracis. inhalation of SPORES from contaiminated wool; flu-like with rapid progression to fever, hemorrhage, mediastinitis and shock
Two toxins that inhibit EF-2
Diptheria toxin and Pseudomonas Exotoxin A
Gardener with skin ulcer on arm and nodules traced up the arm; CIGAR-shaped budding yeast
Sporothrix Schenkii. Ascending lymphangitis
Optochin-
Sensitive: Strep Pneumo (bile solube);
Resistant: viridans strep (bile insoluble). Strep pneumo also has a capsule and is bile soluble (lysed by bile)
Bacteria grown in culture w/ Staph aureus (which provides Factor V/NAD+
Haemophilus influenza. otherwise grown on chocolate agar–>NAD/Factor V and Hemitin/Factor X
Bloody diarrhea w/ bacteria that invades @ M cells in Peyer’s patch and spreads cell to cell (not hematogenous spread)
Shigella. does not produde H2S; Invasion of intestinal mucosa is the most important virulence factor
Diarrhea after eating raw oysters
Vibrio vulnificus
Appendicitis-like mesenteric adenitis from a puppy (2bugs)
Yersinia enterocolitica. bloody diarrhea with puppy may also be campylobacter
Flu, Jaundice, and Photophobia after contact with animal urine in Hawaii. can also cause what dz?
Leptospira interrogans. Can cause Weil disease–>severe jaundice with azotemia, anemia, fever and hemorrhage
Screen and confirm tests for Syphilis
VDRL/RPR screen; FTA-ABS confirms. Can also try to visualize the spirochete on Darkfield microscopy; CSF for VDRL/RPR for tertiary
Bacteria that causes Kaposi like purpura after cat scratch
Bartonella (Bacillary angiomatosis)
Deer hides/pelts in Arkansas/Missouri, Rabbits
Francisella tularensis
Osteomyelitis/cellulitis after a dog/cat bite
Pasteurella multocida
Dermacentor tick spreads these bacteria
Ricketsia and Francisella
Monocytes with morulae
Erlichiosis. blue, berry like inclusions
Granulocytes with morulae
Anaplasmosis. Ixodes tick with Borrelia and Babesia.
there is no rash with anaplasmosis compared to rocky moutain spotted fever.
Infectious form of Chlamydia? Intracellular form?
Elemenatary is infectious, Reticulate is intracellular. Cannot make own ATP; Visualized on Giemsa stain
Atypical pneumonia with bird exposure
Chlamydophila psittaci (C. pneumoniae also causes atypical pneumonia)
Cold agglutinin Immune hemolytic anemia
Mycoplasma, infectious mononucleosis. IgM
Dimorphic fungus intracellular in Macrophages
Histoplasmosis. Immunocomprimised patients can have hepatosplenomegaly and ulcerated tongue lesions
Spaghetti and Meatball appearence, damage melanocytes
Malassezia furfur. Tinea Versicolor, spot that does not tan
Yeast that branch at 45deg? 90deg?
45-Aspergillus; 90-Mucor/Rhizopus
Germ Tubes at 37 deg
Candida
Key immune cell to prevent Candida superficial vs systemic
Superficial–T lymphocyte; Systemic-Neutrophils
Pt in North Carolina with rash that starts at wrists. spread via?
Rocky Mountain Spotted Fever/Rickettsia. Starts are wrists and ankles then spreads to the palms/soles and trunk; Dermacentor Tick
This is the site of cryptococcus initial infections
LLUNGS (not nasopharynx). inhalation of yeast, pidgeon droppings
Most specific test for Cryptococcus
Latex Agglutination. detects polysaccharide capsular Ag; India Ink is also characteristic but a shittier test, Mucicarmine stains red
Fungus that causes frontal lobe abscesses after penetrating cribiform plate in Ketoacidotic diabetic or leukemia pt. structure of this fungi?
Mucor/Rhizopus. Black, necrotic eschar on face; Branch at 90, nonseptate;
Fungal infection that can be treated with Potassium Iodide. what else do you need to add to tx regimen?
Sporothrix Schenkii. Also with itraconazole–>Rose Gardener’s disease
Liver abscess w/ anchovy paste exudate and flask shaped ulcer. tx? compared size to RBC?
Entamoeba histolytica. Metronidazole/Iodoquinol; RBC in entamoeba
AIDS pt with amoeba infection in brain causing focal deficits, dementia and coma; no lake exposure
Ancanthamoeba
IgE mechanisms to block/kill parasites
Antibody-Dependent Cellular Cytotoxicity via Eosinophils. binds FcER1 on eosinophils causing Major Basic Protein release
Green nasal discharge after jumping in a lake. what dz does it cause?
Naeglaria fowleri. enters cribiform plate causing rapidly fatal meningoencephalitis w/ amoeba in CSF
African Sleeping Sickness TX
Trypanosoma brucei
Suramin (Blood) and Melarsoprol (CNS)
Winterbottom’s sign–>swollen lymph nodes on back of the neck
African Sleeping Sickness/Trypanosoma brucei TX: Suramin (Blood) and Melarsoprol (CNS)
Chorioretinitis, Hydrocephalus, and intracranial calcifications. And TX?
Toxoplasma gondii. tachyzoite on biopsy;
Sulfadiazine and Pyrimethamine
Hemolytic anemia with “Maltese cross” in RBC on smear. tx?
Babesia. Ixodes tick with Lyme/Borrelia and Anaplasma–>Atovaquone+azithromycin
Trophozoites with RBC in cytoplasm or Cysts w/ 4 nuclei. tx?
Entamoeba histolytica. Metronidazole/Iodoquinol; Entamoeba is the only amoeba that phagocytizes RBC
Chagas Tx. s/s
Nifurtimox. mega colon, megaesophagus, dilated cardiomyopathy
Macrophage with Amastigotes. s/s? spread?
Leishmania donovani. Sandfly bite; spiking fever, hepatomegaly, pancytopenia
TX for Leishmania
Sodium Stibogluconate
TX for anal pruritis/Scotch tape test +. What is the organism?
Mebendazole or Pyrantel Pamoate (Enterobius vermincularis/Pinworm (nematode))
Filiform larvae in soil penetrate skin after rhabdiform larve lost in stool
Strongyloides. Can have autoinfection if rhabdiform becomes filiform in the gut
TX for Strongyloides
Ivermectin or Albendazole
Black skin nodules and blindness
Onchocerca volvulus. “River” blindness due to RXN to bacteria inside onchocerca (Wolbachia intracellular bacteria within filarial nematodes)
TX for Riverblindness
Ivermectin (Onchocerca volvulus. )
Elephantiasis organism and TX
Wucheria bancrofti; Diethycarbamazine (takes 9mo-1year; blocks lymphatics)
Scabes (skin lesions on hand) TX
Permethrin or Ivermectin
Forms cysts in liver than require ethanol injection prior to surgery to prevent anaphylaxis. Organism? Tx?
Echinococcus. Hydatid cyst; Ingestion of eggs from dog feces;
TX with albendazole;
sheep Dog is definitive host
TX for Taenia solium
Praziquantel. Albendazole for neurocystacercosis–>ingestion of eggs (not cysts in pork–>tapeworm)
Organism that causes Squamous Cell carcinoma of bladder and can lead to bilateral hydronephrosis. Organism? Tx?
Schistosoma. Cercariae leave snails and penetrate skin; Egypt and China; Praziquantel
Cholangiocarcinoma and pigment gallstone association. tx?
Clonorchis sinensis. China, undercooked fish, liver fluke, Praziquantel
Pt with brain cysts and Seizures
Neurocystacercosis
Parasite causing Microcytic Anemia? Macrocytic? Tx for each?
Microcytic: Hookworm (Necator americanus/Ancylostoma. larvae penetrate skin (Bendazole or pyrantel pamoate)
Macrocytic: Diphyllobothrium latum. Undercooked fish (Praziquantel)
Parasites treated with Ivermectin
Strongyloides and Onchocerca
Undercooked crabmeat
Paragonimus Westernmanii
Inflammation of the liver capsule by Neisseria gonorrhea
Fitz-Hugh Curtis Syndrome. due to ascention of the gonorrhea, can also cause salpingitis/PID leading to infertility
Comma shaped bacteria that grows in alkaline medium
Vibrio cholera
Rabies binds to this recepter to cause infection
Nicotinic Ach Receptor. Replicates initially in muscle and connective tissue–>Retrograde transport in axons to CNS
Bartonella TX
Azithromycin. G- but very fastidious (difficult to grow and test for susceptability)
Live Vaccines
VZV, Polio MMR. small pox and yellow fever
(Live polio vaccine allows production of gut IgA against polio (unlike killed)
DNA virus with reverse transcriptase. Also tx?
HepB. Circular partially dsDNA; can cause HCC via integration into host genome (no cirrhosis first). Lamivudine and Tenofovir TX (HIV NRTI)
RNA viruses that do not replicate in the cytoplasm
influenza and HIV
Killed Vaccines
Rabies, Influenze, HAV, polio
Herpes virus envelope are from?
nuclear membrane
Pts immune to HepB will not have what Ab if vaccinated
Anti-HBcAg
Recombinant vaccines
HepB (HbsAg) and HPV
Pt has punch out lesions in the esophagus
HSV-1. CMV also causes esophageal lesions–>linear ulcers
Most common cause of acute hemorrhagic cystitis in kids
Adenovirus. dsDNA linear, also causes pink eye, febrile pharyngitis, and pneumonia
Temporal lobe encephalitis with acute mood, memory, and behavioral changes and Cowdry Type A Inclusions
HSV-1
JC viurs genome type. Name similar virus
dsDNA circular (Polyomavirus). similar to BK virus that infects the kidney in transplant patients
Pts with infectious mononucleosis are at risk for rupture of what organ? S/s of mono?
spleen. hepatosplenomegaly with fever, pharyngitis, and lymphadenopathy (poster cervical especially)
EBV receptor
CD21. Infects B cells and blood smear shows atypical CD8+ T cells (Downey cells)
Virus that can cause high fevers/febrile seizures followed by a diffuse macular rash on the body after several days
Roseola. HHV6; Febrile SEIZURES key for differentiating from other Rashes of Childhood
Where is VZV latent? Spread?
Dorsal root or trigeminal ganglia. Single dermatome, transmitted by respiratory secretions
Characteristic test for genital herpes
Tzanck test. detects multinuclear giant cells in opened skin vesicle
Immature Squamous cell with Dense pink cytoplasm and a perinuclear halo
Koilocyte. HPV, Nucleus may be enlarged with undulating membrane
dsRNA with linear, segmented genome
Reovirus (rotavirus). Most common cause of fatal diarrhea in children, more common in winter
Hepatitis with high mortality in pregant women. Describe structure of virus?
Hep E. Hepevirus->ssRNA+ linear
4 virus in Paramyxovirus (ssRNA- linear)
Parainfluenza, RSV, Measles, Mumps
Key TX for RSV
Ribavirin: Inhibits duplication of viral genome via inhibiting IMP dehydrogenase; #1 cause of respiratory death in infants, causes fusion of respiratory epithelial cells and giant cells via Fusion (F) protein. Ribavirin also used for chronic HepC. Ribavirin is not used that much for RSV anymore, not effiacious.
Rabies virus genome
Rhabdovirus–ssRNA (-) linear