TRANS 043 MICROPARA Flashcards
1
Q
NORMAL FLORA-CONJUNCTIVAL SAC
A
- Staphylococcus epidermidis
* Lactobacillus sp
2
Q
comes from the tears, can destroy
peptidoglycan layers
A
Lysozyme
3
Q
Bacterial or viral conjunctivitis? mucopurulent discharge?
A
Bacterial; watery in viral
4
Q
Bacterial or viral conjunctivitis? bilateral
A
Bacterial; unilateral in Viral
5
Q
Bacterial or viral conjunctivitis? pharyngitis?
A
viral; otitis media in bacterial
6
Q
Bacterial or viral conjunctivitis? with adenopathy
A
viral. no adenopathy in bacterial
7
Q
antibiotics for MRSA and S. pneumonia but resistant to H. influenza
A
Aminoglycosides (Gentamicin and Tobramycin)
8
Q
Sensitive to S. pneumoniae but resistant to H. influenza and MRSA
A
Polymxin B and Trimethoprim
9
Q
Sensitive to H. Influenza and S. Aureus
A
Erythromycin
10
Q
Azithromycin is sensitive to?
A
S.Pneumoniae and MRSA
11
Q
Newer fluoroquinolones is sensitive to
A
MRSA
12
Q
because of the vaginal delivery from a mother infected with
N. gonorrhoeae.
So you have a mucopurulent discharge because Neisseria is
one of the pyogenic cocci
A
Ophthalmia neonatorum
13
Q
Treatment before for ophthalmia neonatorum however it causes
pigmentation and blackening of the skin
A
silver nitrate
14
Q
Neisseria gonorrhoeae virulence factors:
A
▪ Pili
▪ LOS
▪ IgA protease
15
Q
Able to lyse and destroy the IgA which is in the mucosal barrier
A
IgA protease
16
Q
Type of Neisseria: with pili, virulent; smaller and raised; bright in reflected light
A
Type T1 and T2-
17
Q
Type of N. gonorrhea: no pili, avirulent (extracellular); larger; flatter colonies
A
Type T3 to T5
18
Q
smaller colonies; grows more slowly; more difficult to identify biochemically
A
AHU strains – (Arginine-hypoxanthine-uracil)-
19
Q
genes both expressed in N. meningitidis
A
por A and por B;
but por B only in N. Gonorrhea
20
Q
blocks host serum bactericidal (IgG) action against the organism (virulence of N. gonorrhea)
for adherence?
A
Protein III – Rmp (reduction modified protein)
Protein II- Opa (opacity)
21
Q
o Enterotoxins ▪ Heat stable exotoxins; A-E, G-J (stable at 100 C, 30 mins) • A, B, D – food poisoning • B, C > G, I – TSS • B pseudomembranous enterocolitis o TSST-1 (enterotoxin F) o Exfoliative toxin – epidermolytic/SSS/Ritter o Cytolytic ▪ Alpha ▪ Beta (Sphingomyelinase C; hot-cold lysin – CAMP) ▪ Gamma (PVL) ▪ Delta o Enzymes ▪ coagulase (virulence marker) ▪ protease ▪ hyaluronidase ▪ lipase o Protein A
virulence factors of?
A
staphyloccocus
22
Q
which is realted to community acquired MRSA, [Panton Valentine Leucocidin/ mec A gene]
A
Panton valentine leucocidin (PVL)
mec A gene is related to MRSA
23
Q
• skin and wound infection o folliculitis o furuncle (boil) o carbuncle (with fever and chills) o bullous impetigo • Food poisoning (enterotoxins) (2-8 hours after) o A (78%) o D (38%) o B (10%) • Toxic shock syndrome (Todd,1978), tampons o menstruating & non menstruating associated • Scalded skin syndrome/ Ritter • Osteomyelitis • Pneumonia
what causative agent?
A
Staphylococcus aureus
24
Q
• Pink eye conjunctivitis • Fastidious • X and V factors • Satellite phenomenon need a special media called chocolate agar
what causative agent?
A
Hemophilus Aegypti
25
one of the common causes of blindness that presents wiht eye pain, swelling and irritation
Chlamydia trachomatis
26
lack mechanisms for production of metabolic energy & cannot synthesize ATP → obligate intracellular
gram neg or gram pos?
gram neg
27
elementary body (infectious form) and the reticulate body
what agent?
Chlamydia
28
in the development cycle of chlamydia, which particle is this?
o small, environmentally stable, infectious particle, high affinity for host epithelial cells near base of microvilli; rapid entrance via:
• Heparan sulfate-like proteoglycans
• MOMP- major outer membrane protein (DFA direct Fluorescent Ab- principle detection
• Glycosylated MOMP
• Engulfment – receptor – mediated endocytosis into clarithrin-coated pits & pinocytosis via non coated pits
elementary body
29
in the developmental cycle of chlamydia, which particle is this?
no electron dense nucleoid, divides by binary fission, entire vacuole with EB to form cytoplasmic inclusion
Reticulate Body
30
outer cell wall of chlamydia is like gram neg or gram pos?
gram neg; No typical peptidoglycan; with Penicillin body protein (PBP); no N-acetylmuramic acid (NAM)
• EB: RNA=DNA; RB: 4x RNA=DNA
31
for staining chlamydia in giemsa, what stain will be the color of Eb and RB?
EB purple
| RB blue
32
in C. Trachomatis, you can see brown inclusion in what stain?
Lugol’s iodine
33
which trachoma antigen is for blindness?
A, B Ba, C
34
which antigen of trachoma is for STD?
D to K
35
it is a diagnosis of exclusion, so pag hindi sya nagrespond sa ibang meds at nagrespond sya sa tetracycline then most likely it is
Chlamydia
36
* Chronic keratoconjunctivitis→ scarring → blindness (possibly with bacterial conjunctivitis)
* 3-10 days incubation
* Lacrimation, mucopurulent discharge, conjunctival hyperemia, follicular hypertrophy
* Epithelial keratitis, subepithelial infiltrates, extension of limbal vessels into cornea (pannus)
what organism?
C. Trachoma
37
in lab diagnosis of trachoma, which is the most sensitive? and which test will let you know if you really have an infection or not?
Serology (Immunoflourescence);
PCR
38
Treatment for Chlamydia trachoma?
```
o S-A-F-E program
o Surgery for deformed eyelids
o Azithromycin
o Face washing
o Environmental improvement
```
39
this are the sheathed round worm
Wuchureria bancrofti, Brugia malayi, loa loa
40
what spcimen do you need to diagnose loa loa?
since this is a tissue nematode, you need blood to diagnose this
41
The risk of infection is highest in the rainforests of west and central Africa and during the rainy season, when the deerfly (or mango fly or mangrove fly as they are commonly known) are most prevalent
AFRICAN EYE WORM loa loa
42
Loiasis, commonly known as “African eye worm” is an infectious disease caused by the nematode Loa loa, which is transmitted to humans via the bite from one of two female Chrysops deerfly species:
Chrysops silacea and Chrysops dimidiate.
43
Herpes ZOster type 1?
HZ type 2?
Type 3?
all are post varicella
type 3- herpes zoster ophthalmicus
type 2- genital
type 1- oral
44
they are very fond of latency
all herpes viruses, retrogade sa dorsal root ganglion
45
Other herpes is oncogenic like EBV which causes
nasopharyngeal carcinoma and Burkitt’s lymphoma
46
External ear infectious organism if in swimming pool?
P. aeruginosa
47
highest organism isolates in external ear infections?
P. Aueroginosa follwed by Staph aureus
48
major players in otitis media?
```
• Pneumoocci- 33%
• H. influenzae – 20%
• S. pyogenes – 8%
• Others: 1 to 6 %
o M. catarrhalis
o S. aureus
o Enterics
o Anaerobes
```
49
otomycosis, bacterial viral, fungal?
fungal
50
Is a fungal ear infection, a superficial mycotic infection of the outer ear canal.
• It is more common in tropical countries.
• The infection may be either subacute or acute and is characterized by malodorous discharge, inflammation, pruritus, scaling and severe discomfort
OTOMYCOSIS
51
Most fungal ear infections are caused by:
```
Aspergillus niger
Aspergillus fumigatus
Penicillium
Candida albicans
Opportunistic infection
```
52
in aspergillus niger, Lactophenol cotton blue (LPCB)- what is the response?
not decolorized, still black pa rin ang kulay
53
Most common viral sinusitis causes
Rhinovirus
54
• Viral vector for the AstraZeneca
Adenovirus
55
bacterial causes of acute sinusitis?
```
▪ Acute sinusitis
• S. pneumoniae
• H. influenzae
• Moraxella
• Streptococcus pyogenes
```
56
bacterial causes of chronic sinusits?
Anaerobes (>50%)- “would like to have a deep-seated infection
o Bacteroides
o Anaerobic gram (+) cocci
o Fusobacterium species
57
Fungal causes of sinusitis?
• Fungal (immunocompromised or DM)
o Aspergillus
o Mucormycosis
58
Indwelling nasogastric and nasotracheal tubes predispose to nosocomial sinusitis, which is often caused by
gram (-) bacteria (Klebsiella and Pseudomonas)
59
Sinusitis in neutrogenic and immunocompromised persons may be caused by
Aspergillus and the zygomycetes (e.g Mucor Rhizopus
60
Contraindication for doing a throat swab-
when you have a pseudomembrane kasi pwede mag bleed or asphyxia
61
pseudomembrane is preventable via?
Diphtheria vaccine
62
S. pyogenes sequelae is acute tonsillopharyngitis that will
| lead to
Rheumatic fever, and later, Rheumatic heart
| disease = mitral valves affected
63
```
• Enterococcus
• Gram (+) cocci in pairs or chains
• Catalase negative
• Types of hemolysis
o wide zone or alpha-prime
• Serologic grouping
• Facultative anaerobe
• Aerotolerant anaerobe
o they grow in the presence of oxygen but cannot use oxygen for respiration
• Capnophilic
```
what org?
Streptococcus
64
ttachment parts of the organism into the mucosa in streptococcus?
M protein fimbriae-
65
```
• Group A
• M protein
• Infections:
o pharyngitis / strep throat
heart disease (RF)
o pyodermal infections
kidney = skin infection
o toxic shock syndrome
```
Strep pyogenes
66
attached to the peptidoglycan of the cell wall and extends to the cell surface essential for virulence
o best defined virulence factor encoded by emm genes
o resists phagocytosis
o adherence of bacterial cell to mucosal cells
what antigenic structure of Strep pyogernes?
M protein
67
o both are adhesion molecules that mediate adherence to host epithelial cells.
o both with M proteins – attachment to oral mucosal cells
Lipoteichoic acid
68
o weakly immunogenic; prevents opsonized phagocytosis by neutrophils or macrophages; allows bacterium to mask its antigens and remain unrecognized by its host
antigenic structure of strep pyogenes
Hyaluronic acid capsule
69
Most affected valve in rheumatic heart disease
Mitral valve
70
4 Ds in epiglotittis?
dysphagia, dysphonia, drooling, and distress—the four D's.
71
• Hemophilic, pyogenic, capnophilic, pleomorphic, encapsulated
• Needs X and V factors
• Capsular Ag, somatic Ag, outer membrane protein, IgA protease
• Capsular Ag (major antigenic determinant – confers specificity & basis for serovar grouping:
o a to f ; b has pentose – critical determinant of virulence, essential for invasiveness
what organism?
Haemophilus
72
bull neck appearance?
Diphtheria
73
• Whooping Cough Stages
o Catarrhal
Most infectious
o Paroxysmal
o Covalescent
74
* Viral etiology
* The infection leads to swelling inside the trachea, which interferes with normal breathing and produces the classic symptoms of "barking" cough, stridor, and a hoarse voice.
1. Croup/ Laryngotracheobronchitis
75
sputum vs saliva
Sputum vs Saliva. If you see >25 PMN and <10 Squamous EC per field, that means it is satisfactory for culture.
pag hindi, saliva lang nakuha mo.
we do not culture saliva
76
“postanginal septicemia” which referred to a series of patients who developed:
o Acute oropharyngeal infection
o Suppurative jugular vein thrombosis
o Sepsis
o Septic embolization of the lungs with abscess
* Fever, malaise, cervical, & submandibular lymphadenopathy
* Antecedent upper severe pharyngitis
* Severe neck pain
* Possible tender palpable “cord” at the anterior margins of SCM indicative of thrombus
2. Lemierre’s Syndrome (rare)
77
in ENT infections, gold standard is?
CULTURE
78
Infectious Mononucleosis is caused by
ebv
