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MDL 252 Microbiology 2 > Unit 2 Exam Review > Flashcards

Unit 2 Exam Review Flashcards

1
Q

Inhibitory Mold Agar

A

Primary recovery of pathogenic fungi exclusive of dermatophytes

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2
Q

Sabhouroud Dextrose Agar

(Sab dex)

A

Primary recovery of saprobic and pathogenic fungi

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3
Q

Brain heart infusion agar

A

(with antibiotics) primary recovery of pathogenic fungi exclusive of dermatophytes

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4
Q

Cornmeal agar

A

Identification of C. albicans by chlamydospore production;

identification of Candida by microscopic morphology

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5
Q

Birdseed agar

A

Identification of C. neoformans

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6
Q

Dermatophyte test media

A

primary recovery of dermatophytes, recommended as screening medium only

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7
Q

PPLO media

A

agars and broths used for isolating and cultivating Mycoplasma when supplemented with nutritive enrichments

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8
Q

SP4

A

recommended for the isolation, differentiation and maintenance of mycoplasma

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9
Q

What is a yeast?

A

Unicellular organism

round to oval

2 to 60 um

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10
Q

Yeast microscopic morphologic features

A

limited utility to differentiate or identify;

have characteristics that suggest the ID or are pathogenic for a particular organism

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11
Q

What is a mold?

A

tubelike projections - hyphae mycelium - loose network of hyphae which penetrates the substrate to obtain nutrients for growth

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12
Q

Powerpoint definition of a yeast

A

single-celled fungus reproduces by budding to form blastoconidia

Colonies are moist or mucoid

may or may not produce pseudohyphae

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13
Q

Powerpoint definition of a mold

A

vegetative groth of filaments.

mushrooms consist of many filaments packed tightly together.

Reproduction by spores or conidia.

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14
Q

Conidia

A

born on specialized hyphae or conidiophores

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15
Q

What is the bio safety level of mold

A

BSL 2

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16
Q

How should Histoplasma capsulatum or Blastomyces dermatitidis be handled?

A

severe bio-hazard

handled with extreme caution in an appropriate pathogen handling cabinet.

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17
Q

How much specimen is required to ID?

A

The lab needs enough specimen to perform both microscopy and culture.

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18
Q

How was Blastomyces dermatitidis IDed in the past?

A

conversion from the mould form to the yeast form was necessary for dimorphic ID.

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19
Q

Chlamydophila psittaci ID

A

BSL3

indirect microimmunofluorescence

(hens egg yolk)

PCR

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20
Q

Is Chlamydophila psittaci endemic?

A

yes in all bird species.

Also seen in turkey processing workers and pigeon aficionados

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21
Q

Symptoms of Chlamydophila psittaci

A

pneumonia

severe headache

mental status changes

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22
Q

What is the treatment for Chlamydophila psittaci?

A

Tetracycline (fatality 20% if untreated)

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23
Q

Cutaneous

A

Involve the hair, skin, nails with no involvement of deeper tissues.

(Tinea, ringworm, piedra)

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24
Q

Subcutaneous

A

Only subcutaneous tissue with no dissemination

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25
Q

Systemic

A

Invade the lungs and become widely disseminated (agents usually dimorphic fungi)

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26
Q

Opportunistic

A

Immunocompromised patients (underlying diseases) Candidiasis, Aspergillosis

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27
Q

Dermatophytes

A

agents of ringworm, athlete’s foot, and so on

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28
Q

Examples of subcutaneous infections

A

chromoblastomycosis

mycetoma

phaeopyphomycotic cysts

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29
Q

Examples of systemic fungal infections

A

Blastoyces

Coccidioides

Histoplasm

Paracoccidioides

Infections usually involve the lungs but may also be widely disseminated and involve any organ system.

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30
Q

Most commonly encountered opportunistic pathogens

A

Aspergillus

Zygomycetes

Candida

Cryptococcus

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31
Q

Cutaneous Infections

A

Superficial mycoses

Tinea

Piedra

Candidosis

Dermatophytosis

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32
Q

Opportunistic Infections

A

Aspergillosis

Candidosis

Cryptococcosis

Zygomycosis

Trichosporonosis

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33
Q

What is the use of Calcafluor White Stain

A

Detection of fungi

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34
Q

What is the time required for calcafluor White Stain?

A

1 minute

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35
Q

What is the advantages of Calcafluor White Stain

A

Can be mixed with KOH

detects fungi rapidly due to bright fluorescence

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36
Q

What are the disadvantages of Calcafluor White Stain?

A

Fluorescence microscope

vaginal secretions are hard to interpret; background fluorescence prominent, but fungi exhibit more intense fluoresence

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37
Q

What is the use of KOH (Potassium hydroxide)

A

Clearing of specimen to make fungi more readily visible

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38
Q

What is the time required of KOH?

A

5 min; if clearing is not complete, and additional 5-10 min might be necessary

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39
Q

What are the advantages of KOH?

A

Rapid detection of fungal elements

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40
Q

What are the disadvantages of KOH?

A

Experience required clearing of some specimens require extended time

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41
Q

What is the use of India Ink?

A

Detection of C. neoformans in CSF

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42
Q

What is the time required for India Ink?

A

1 minute

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43
Q

What are the advantages of India Ink

A

When positive in CSF it is diagnostic of meningitis

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44
Q

What are the disadvantages of India Ink

A

Positive in less than 50% of cases of meningitis

not sensitive in non-HIV infected patients

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45
Q

What is the use of Darkfield stain?

A

Detection of syphilis or treponema pallidum

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46
Q

Calcoflour White appearance

A

cell walls of fungi will bind the stain which enhances fungal visibility in tissue.

Flurochrome used to detect fungi in clinical material and observe fungi grown in culture

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47
Q

What specimens is calcoflour white used on

A

microscopic exam of skin, hairs, nails and other specimens

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48
Q

Other uses of calcofluor white

A

used as whitening agents by paper industry to bind cellulose and chitin

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49
Q

What is the use of Lactophenol Cotton Blue

A

Staining and microscopic identification of fungus cultures

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50
Q

Germ Tube Test

A

Generally accepted and economical method to ID yeast within 3 hours

appear as hyphae like extensions of yeast cells w/o constriction at the point of origin from the yeast cell

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51
Q

Cryptococcal Antigen Test

A

Performed on CSF or serum

replaced use of India ink

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52
Q

What organism shares an antigen that is similar to C. neoformans

A

Trichosporon

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53
Q

What is the method of choice for diagnosing patients with cryptococcal meningitis?

A

detection of cryptococcal capsular polysaccaride antigen in spinal fluid

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54
Q

How often can cryptococcal antigen be detected in serums?

A

AIDS patients - 100%

non-AIDS - 60%

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55
Q

What should serum specimens be treated with and why?

A

Pronase detects antigen to avoid false negative results.

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56
Q

What should be kept for cryptococcal antigen testing and what is processed.

A

Supernatant for antigen testing and process the sediment.

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57
Q

What are the two most widely used nontreponemal serological tests used?

A

RPR and FTA-ABS

RPR - 80% positive in syphilis

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58
Q

How does a nontreponemal serological test function?

A

An agglutination test in which soluable antigen particles clump when they are aggregated by an antibody.

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59
Q

What are the 3 things a mold ID is based upon?

A
  1. Growth rate
  2. Colonial morphological features (Sab Dex Agar)
  3. Microscopic morphological features using lactophenol blue stain
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60
Q

What are identifiable microscopic morphological features?

A

Microconidia

macroconidia

phialides

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61
Q

Candida albicans gram stain

A

gram positive large oval bodies

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62
Q

Candida albicans on cornmeal agar

A

blastoconidia

pseudohyphae

chlamdoconidia

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63
Q

Candida albicans on media

A

yeast like growth on Sab Dex

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64
Q

Candida albicans growth requirements

A

25-30 degrees (optimal) can grow at 37 degrees

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65
Q

Candida albicans infections

A

Opportunistic to systemic

urogenital, respiratory, bloodstream

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66
Q

Candida albicans specimen

A

blood

urine

wounds

throat

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67
Q

Candida albicans ID

A

germ tube positive

chlamydoconidia observed

growth on cyclohexamide

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68
Q

ID this image

A

Candida albicans

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69
Q

ID this image

A

Candida albicans

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70
Q
A

Candida albicans

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71
Q

Gram stain of Rhizopus spp*

A

unbranched sporangiosphores with rhizoids that appear at the point where the stolon arises, at the base of the sporangiophore

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72
Q

What does Rhizopus spp* look like on media?

A

Blood enriched medium - colonies are extremely fast growing, wooly, and gray to brown to gray black. The reverse is white to pale

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73
Q

Rhizopus growth requirements

A

45C

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74
Q

Rhizopus infections

A

Wound infections, zygomycosis

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75
Q

Rhizopus specimens

A

nasal mucosa

sinuses

face and brain

76
Q

Rhizopus spp* ID

A

LPCB

77
Q

ID this image

A

Rhizopus microscopic LPCB prep

78
Q

ID this image

A

Rhizopus on sab dex agar

gray wooly colony fills the sab-dex plate

79
Q

Cryptococcus neoformans gram stain

A

gram positive cocci

80
Q

Cryptococcus neoformans on cornmeal agar

A

following 72 hours incubation at 25C it produces globose yeast cells only (2.5-10um in diameter)

81
Q

Penicillium gram stain

A

gram positive

82
Q

Penicillium on media

A

fast growing, flat, filamentous, and velvety, wooly or cottony in texture. Initially white and become blueish gray, yellow or pinkish in time. The plate reverse is usually pale to yellowish.

83
Q

Penicillium growth requirements

A

subculturing to BHI, incubate at 35C, 7 days, yeast like structures dividing by fission and hyphae with arthroconidia are formed

84
Q

Penicillium infections

A

Opportunistic, infections are rare except with P. marneffei

85
Q

Penicillium specimen

A

respiratory secretions, gastric washings, skin, urine, ear, cornea

86
Q

Penicillium reservoirs

A

Humans with P. marneffei

87
Q

Aspergillus fumigatus gram stain

A

gram positive, hyphae are septate and hyaline. Conidial heads are strongly comumnar in an undisturbed culture. Conidiophores are smooth-walled, uncolored, up to 300 um long

88
Q

Aspergillus fumigatus colony appearance

A

smoky gray-green with a slight yellow reverse

89
Q

Czapek agar

A

differential identification of aspergillus spp

90
Q

Aspergillus fumigatus growth requirements

A

potato dextrose agar at 25C

91
Q

How does Aspergillus fumigatus grow?

A

rapid growing mold (2 to 6 days) that produces a fluffy to granular, white to blue-green colony. Mature sporulating colonies most often exhibit the blue-green powdery appearance

92
Q

Aspergillus fumigatus special growth requirements

A

Thermotolerant and grows at temps up to 55C. Cosmopolitan mould and has been found on many types of substrates, especially soil and decaying organic debris

93
Q

Cryptococcus neoformans media

A

Bird Seed agar, colonies on Sabouraud dextrose at 25C are cream to beige and mucoid due the capsule surrounding the yeast cells

94
Q

Cryptococcus neoformans growth requirements

A

72 hour @ at 25C

95
Q

Cryptococcus neoformans infections

A

opportunistic, cryptococcosis

96
Q

Cryptococcus specimen

A

all respiratory secretions

97
Q

Cryptococcus neoformans ID

A

India Ink, for the direct microscopic examination of CSF for cryptococcus neoformans

98
Q

Cryptococcus neoformans Unique

A

Urease positive but fails to grow on medium containing cycloheximide or at 40C. This species is found in nature in avian excreta, especially weathered pigeon droppings, which are believe to the the source of infection.

99
Q

Cryptococcus neoformans reservoirs

A

Humans and domestic wild animals. In humans, C. neoformans affects immunocompromised hosts predominatly and is the most common cause of fungal meningitis worldwide, 7-10% patients with AIDS are infected

100
Q

AIDS associated cryptococcus accounts for _____ of all cryptococcal infections reported annully.

A

50%

101
Q

Cryptococcus neoformans usually occurs in HIV patients when their _______ is below ______

A

CD4 lymphocyte; 200/mm3

102
Q

What is the predominant clinical presentation and symptoms with Cryptococcus neoformans

A

Meningitis; fever and headache

103
Q

What percent of secondary cutaneous infections occur with disseminated cryptococcosis and indicate a poor prognosis

A

15

104
Q

What do lesions look like when they begin?

A

small papules that ulcerate, but may also present as abscesses, erythematous nodules, or cellulitis

105
Q

Aspergillus fumigatus infections

A

important human pathogen and is the most common cause of all forms aspergillosis

106
Q

Aspergillus fumigatus specimen

A

nasal cultures

respiratory secretions

GI

genitourinary

skin

subcutaneous tissue

blood

bone

CNS

107
Q

Aspergillus fumigatus unique

A

Most common aspergillosis

grows @ 40C and beyond

Hyphae in tissue may or may not display 45C angle branching. Fruiting heads may be seen in air cavities in the lung.

108
Q

Aspergillus reservoirs

A

humans

109
Q

What kind of organism is Microsporum canis?

A

Dermatophyte

110
Q

Microsporum canis gram stain

A

gram positive

111
Q

Microsporum canis colony morphology

A

white/cream over orange-yellow reverse

112
Q

Microsporum canis growth rate

A

1 week

113
Q

Microsporum canis Microscopic Identification

A

Thick walled spindle-shaped

rough-walled macroconidia - some with a curved tip

microconidia rarely seen

114
Q

Microsporum canis infections

A

infections of the hair and skin; tinea

115
Q

Microsporum canis specimen

A

hair and skin

116
Q

Microsporum canis ID

A

5-7 days time required for ID

117
Q

Microsporum canis unique

A

in vitro hair perforation test positive

118
Q

Microsporum canis reservoirs

A

natural reservoir-cats and dogs. It causes tinea in humans, rarely mycetoma like lesions have been observed in immunocompromised hosts.

119
Q

Coccididdes immitis gram stain

A

gram positive

120
Q

coccididdes immitis sab dex agar

A

colonies are moist, membranous, and grayish. later producing white and cottony aerial mycelium. With age, colonies become tan to brown in color

121
Q

Coccididdes immitis media

A

sabouraud dextrose agar

122
Q

Coccididdes immitis infections

A

arthroconidia

123
Q

Coccididdes immitis unique

A

Southwestern US

Valley fever

124
Q

Coccididdes immitis reservoirs

A

mode of transmission - inhalation, humans. Comon sites of infection: lungs, skin, meninges

125
Q

Rickettsia gram stain

A

small pleomorphic gram negative rods - reproduce inside host lyse host when released

126
Q

rickettsia Special Growth

A

Obligate intracellular parasite; survive only briefly outside host

127
Q

Rickettsia infections

A

Causes Rocky Mountain Spotted Fever, typus, scrub typhus and other spotted fevers

128
Q

Rickettsia symptoms

A

fever, headache, rash

129
Q

Rickettsia specimen

A

Recovered in blood or tissue and identified serologically; not reoutinely recovered from culture, labs need specialized techniques and precautions

130
Q

Rickettsia ID

A

Weil-Felix test; agglutination of P. vulgaris by serum of infected patients and P. mirabilis **presumptive test

131
Q

Rickettsia treatment

A

Tetracycline

132
Q

Rickettsia unique

A

3 groups, spotted fever, typhus group and scrub typhus group

133
Q

Rickettsia reservoirs

A

wild animals infected; we are incidental hosts through insect vectors

134
Q

Chlamydia trachomatis gram stain

A

non-motile gram negative intracellular parasites; EB elementary body looks like a gram neg rod, but no peptidoglycan layer on cell wall

135
Q

Chlamydia trachmatis infections

A

STD - Most common STD in US, major cause of PID. 4 million infections in US/year; ocular trachoma; lymphogranuloma venereum is very common venereal disease in Africa, Asia and SA. Specific LGV strain of C. trachomatis. Neonatal infections include conjunctivitis, pneumonia, enteric infections, mother to child during delivery

136
Q

Chlamydia trachmatis Specimen

A

collection of swabs for culture or testing; cell cultures; McCoy, Hela, and monkey kidney cells - grow 48 hours, add iodine and view under scope

137
Q

Chlamydia trachmatis ID

A

Frei’s test - intradermal skin test of LGV bubo - poor recovery, always positive for many years; DFA staining - elementary bodies; ELISA - Chlamydia antigen, gen-probe testing- PCR of urine specimens

138
Q

Chlamydia trachmatis treatment

A

Erythromycin and tetracycline

139
Q

chlamydia trachmatis reservoirs

A

exclusively human, sexual transmission 25% men and 70-80% women asymptomatic

140
Q

Mycoplasma pneumoniae gram stain

A

spherical, griny, yellowish forms that are embedded in the agar, with a thin outer layer

141
Q

Mycoplasma pneumoniae media

A

biphasic SP-4 triphasic system, PPLO broth or agar with yeast extract and horse serum, modified NYC medium

142
Q

Mycoplasma pneumoniae growth requirements

A

agar and broths 37C, ambient air for up to 4 wk

143
Q

Mycoplasma pneumoniae infections

A

Asymptomatic infection, upper respiratory tract infection in young children; lower respiratory tract infections in adults

144
Q

Mycoplasma pneumoniae symptoms in young children

A

mild, nonspecific symptoms including runny nose, coryza, and cough, most without fever

145
Q

Mycoplasma pneumoniae symptoms in adults

A

typically mild illness with non productive cough, fever, malaise, pharyngitis, myalgias

146
Q

Mycoplasma pneumoniae extra infections

A

4 to 13% of patients develop pneumonia; complications include rash, arthritis, encephalitis, mycorditis, pericarditis, and hemolytic anemia

147
Q

Mycoplasma pneumoniae ID

A

definitive ID of M. pneumoniae is accomplished by overlaying suspicious colonies with 0.5% guinea pig erythrocytes in phosphate-buffered saline instead of water. After 20 to 30 minutes at room temp, colonies are observed for adherence of red blood cells

148
Q

Mycoplasma pneumoniae reservoirs

A

humans and mainly children

149
Q

ID this organism

A

Aspergillus

150
Q

Borrelia burgdorferi gram stain

A

spirochetes are not classified as either. When borrelia burgdorferi is gram stained, the cells stain a weak gram neg by default since safranin is the last dye used. Like most spirochetes, Borrelia does have an outer membrane that contains an LPS like substance, an inner membrane and a periplasmic space which contains a layer of peptidoglycan. Therefore it has a gram-negative bacterial type cell wall, despite its staining characteristics

151
Q

Borrelia burgdorferi media

A

can be cultivated in vitro. Bacterium is fastidious and requires a complex growth medium. The media preferred is Barbour Stoenner Kelly (BSK). It contains 13 ingredients in a rabbit serum base.

152
Q

Borrelia burgdorferi growth requirements

A

Optimal temp of 32C, in a microaerobic environment. Generation time is slow, about 12-24 hours

153
Q

Borrelia burgdorferi infections

A

Causative agent of lyme disease, which is a sever protracted epidemic arthritis, spread by the deer tick, often appearing during the waning months of summer in northeastern US, certain central regions and on the west coast. Now in Europe, Japan, Russia and Australia. Multiple stages

154
Q

What is Stage One of lyme disease

A

Tick bite elicits an enlarging erythematous path (erythema migrans)

155
Q

What is Stage Two of lyme disease

A

Spirochetemia with the rise of arthritis, meningitis and debilitaiton

156
Q

What is Stage Three of lyme disease

A

Chronic phase, skin and neurologic symptoms and chronic arthritis

157
Q

Borrelia burgdorferi specimens

A

Peripheral blood is specimen of choice for direct detection of borrelia that cause relapsing fever. Specimens submitted for stain or culture include: blook, biopsy specimens, synovial and CSF.

158
Q

Borrelia burgdorferi specimen collection requirements

A

no special requirements for collection, transort or processing

159
Q

Borrelia burgdorferi vectors

A

ticks

160
Q

Borrelia burgdorferi reservoirs

A

ticks and humasn

161
Q

Treponena pallidum gram stain

A

stains neither positive or negative, not routinely cultured in lab

162
Q

Treponena pallidum infections

A

causative agent of syphilis; exclusively infects huans, transmitted from one person to another; produces a chronic systemic infection, affecting about 30/100,000 in USA per year

163
Q

Treponena pallidum ID

A

RPR 80% positive; Venereal disease research laboratory test 70% positive. Fluroscent Treponemal Antibody Absorbed test

164
Q

Treponena pallidum unique

A

stains neither positive or negative, not routinely cultured in lab

165
Q

Treponena pallidum reservoirs

A

Exclusively infects humans, transmitted from one person to another, transmitted via sexual contact; orther forms of transmission are extremely rare

166
Q

Histoplasma capsulatum - DIMORPHIC gram stain

A

gram positive; large, rounded, single-celled tuberculate macroconidia formed on short, hyaline, undifferentiated conidiophores. Microscopically, numerous small round to oval budding yeast-like cells are observed

167
Q

Histoplasma capsulatum media

A

Macroscopic - sabouraud’s dextrose agar at 25C, colonies are slow growing, white or buff brown, suede like to cottony with a pale yellow-brown reverse. Macroscopically on BHI blood agar incubated at 37C, colonies are smooth, moist, white and yeast like

168
Q

Histoplasma capsulatum growth

A

Sab dex @ 25C

169
Q

Histoplasma capsulatum infections

A

intracellular mycotic infection of the reticuloendothelial system caused by the inhalation of the fungus; histoplasmosis

170
Q

Histoplasma capsulatum ID

A

postive ID required conversion of mold form to yeast phase by 37C growth on enriched, however culture ID by the exoantigen test is now method of choice

171
Q

Histoplasma capsulatum unique

A

represent a sever biohazard to lab personnel and must be handled with extreme caution in an appropriate pathogen cabinet

172
Q

Histoplasma capsulatum etiological agent

A

from soil enriched with excreta from chicken, starlings and bats

173
Q

Histoplasma capsulatum reservoirs

A

world-wide, especially in USA, skporadic cases do occur in Australia

174
Q

ID this organism

A

Aspergillus

175
Q

ID this organism

A

Aspergillus

176
Q

ID this organism

A

Aspergillus

177
Q

ID this organism

A

Coccidiodes immitis

178
Q

ID this organism

A

Coccidiodes immitis

179
Q

ID this organism

A

Histoplasma capsulatum

180
Q

ID this organism

A

Microsporum canis

181
Q

ID this organism

A

Penicillium lactophenol cotton blue prep

182
Q

ID this organism

A

Penicillium sab dex

183
Q

What is Mycoplasma Broth Base (Frey) used for?

A

Used for the cultivation of avian mycoplasmas.

184
Q

What is zygomycosis?

A

includes mucocutaneous, rhinocerebral, geniturinary, gastrointestinal, pulmonary and disseminated infections

185
Q

Cryptococcus growth requirements

A

72 hours @ 25C

186
Q

How is Blastomyces dermatitidis IDed now?

A

culture ID by the exoantigen test

MDL 252 Microbiology 2 (7 decks)

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