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137 Cards in this Set
- Front
- Back
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chocolate agar with factors V (NAD) and X (hematin)
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H. influenzae
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Thayer-Martin media -
vancomycin (gram-positive) polymyxin (gram-neg) nystatin (fungi) |
N. gonorrhoeae
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Bordet-Gengou (potato) agar
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B. pertussis
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Tellurite plate, Loffler's media
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C. diphtheriae
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Lowenstein-Jensen agar
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m. tuberculosis
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Eaton's agar
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M. pneumoniae
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Pink colonies on MacConkey's agar
eosin-methyline blue (EMB) agar |
Lactose-fermenting enterics
E. coli |
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Charcoal yeast extract agar buffered with cysteine
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Legionella
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Sabourad's agar
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Fungi
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capsule swells when specific anticapsular antisera are added
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positive Quellung reaction
S. pneum, Klebsiella, H. influ, N. meningitidis, Salmonella, group B strep |
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red pigment
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serratia marcescens
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binds Fc region of Ig.
prevents opsonization and phagocytosis |
Protein A
(S. aureus) |
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enzyme that cleaves Ig A
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IgA protease
SHiN |
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helps prevent phagocytosis
inhibits complement activtion mediates bacterial adherence target of type-specific humoral immunity to S. pyogenes |
M protein
(group A strep) |
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mode of action for endotoxins
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includes TNF and IL-1
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bind directly to MHC II and TCR simultaneously, activating large numbers of T cells to stimulate release of IFNy and IL-2
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Superantigens
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TSST-1 superantigen
food poisoning exfoliatin |
S. aureus
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scarlet fever
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S. pyogenes
erythrogenic toxin >> toxic shock-like syndrome |
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inactivates elongation factor (EF-2);
>>pharyngitis and "pseudomembrane" in throat |
C. diphtheriae
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ADP ribosylation of G protein stimulates adenylyl cyclase;
increased pumping of Cl- into gut and decreased Na+ absorption H2O moves into gut lumen; causes voluminous rice-water diarrhea |
V. cholerae
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heat-labile toxin stimulates adenylate cyclase.
heat-stable toxin stimulates guanylate cyclase both cause watery diarrhea |
E. coli
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increases cAMP by inhibiting Ga1,
whooping cough; inhibits chemokine receptor >> lyphocytosis |
Bordetella pertussis
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double zone of hemolysis on blood agar
alpha toxin, a lecithinase that acts as a phospholipase to cleave cell membranes >> gas gangrene |
Clostridium perfringens
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blocks release of GABA and glycine
>>lockjaw |
C. tetani
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blocks release of ACh;
>>ACh-ic sxs, CNS paralysis, especially cranial nerves |
C. botulinism
spores found in canned food, honey (floppy baby) |
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edema factor, part of the toxin complex, is an adenylate cyclase
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Bacillus anthracis
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produced by E. coli O157:H7 cleaves host cell rRNA (inactivates 60S ribosome
enhances cytokine release >> HUS |
Shigella
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Streptolysin O is a hemolysis
Ag for ASO Ab (for rheumatic fever Dx) |
S. pyogenes
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cAMP inducers (4)
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V. cholerae
Bordetella pertussis E coli Bacillus anthracis |
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alpha-hemolysis
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partial hemolysis
S. pneum (optochin sens) S. viridans (optochin resis) |
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beta-hemolysis
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complete hemolysis (clear)
group A -- S. pyogenes (Bacitracin sens) group B -- S. agalactiae Bacitracin resis) |
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catalase positive, coagulase negative
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S. epidermidis (novobiocin sens)
S. saprophyticus (novobiocin resis) |
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degrades H2O2 before it can be converted to microbicidal products by the enzyme myeloperoxidase
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catalase
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Lancet-shaped, encapsulated. IgA protease
rusty sputum |
Streptococcus pneumoniae
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most common cause of meningitis
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strep pneum
(2nd is neisseria meningitidis) |
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normal flora of oropharynx and cause dental caries; subacute endocarditis
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strep vidiridans
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subcutaneous plaques, polyarthritis, erythema marginatum, chorea, carditis
carditis is the result of what process? |
rheumatic fever (S. pyogenes)
Antigenic mimicry (both have similar Ag protein sequences; mounted response from immune system >> myocarditis + valvular destruction) |
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colonizes vagina >> phenumonia, meningitis, sepsis in babies
produces CAMP factor, which enlarges the area of hemolysis formed by S. aureus |
Strep agalactiae (group B)
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normal colonic flora
cause UTI and subacute endocarditis |
Enterococci (group D Lancefield streptococci)
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can cause bacteremia and subacute endocarditis in colon cancer
part of normal gut flora |
Streptococcus bovis
(gropu D streptococci) |
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psuedomembranous pharyngitis (grayish-white membrane) with lymphadenopathy
tellurite agar; club-shaped metachromatic (blue and red) granules |
C. diphtheria
stain deeply with aniline dyes |
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produces 2 toxins
Toxin A, enterotoxin, binds to the brush border of the gut Toxin B, cytotoxin, destroys the cytoskeletal structure of enterocytes >> pseudomembranous colitis; diarrhea activates neutrophils; secondary to antibotics |
C. difficile
tx: metronidazole |
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the only bacterium with a polypeptide capsule (contains D-glutamate)
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B. anthracis
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black eschar >> bacteremia
inhalation of spores; flulike; pulmonary hemorrhage, mediastinitis, shock, contaminated wool |
cutaneous anthrax
pulmonary anthrax; Woolsorters' disease |
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actin rockets that move cell-to-cell; tumbling motlitiy
amnionitis, septicemia, spontaneous abortion, neonatal meningitis, mild gastroenteritis (healthy PTs) |
Listeria monocytogenes
facultative intracellular microbe; unpastereurized milk/cheese and deli meats; vaginal transmission during birth |
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oral/facial abscesses, drain through sinus tracts in skin.
yellow "sulfur granules" |
Actinomyces israelii
tx: Sulfa |
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pulmonary infection in immunocompromised patients; acid-fast aerobe in soil
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Nocardia asteroides
tx: Penicillin |
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Ghon complex + lobar + perihilar lymph node involvement reflects primary or secondary infection/exposure?
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primary infection/exposure
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prphlactic treatment of M. avium-intracellulare with what treatment?
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azithromycin
all mycobacteria = acid-fast organisms |
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"serpentine cords" on enriched media is also known as...
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cord factor (a mycoside)
establishes virulence via: neutrophil inhibition, mitochondrial destruction, activation TNF release |
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what is the preferred treatment for mycobacterium leprae (an acid-fast bacillus that infects skin and superficial nn)?
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dapsone (long-term, oral)
--toxicity = hemolysis and methemoglobinemia also, rifampin + clofazimine/dapsone |
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E. coli produces beta-galactosidase, which breaks down....
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lactose >> glucose + galactose
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which group of bacteria is resistant to penicillin G but may be susceptible to penicillin derivatives (eg ampilicillin)?
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gram-negative bacilli
outer membrane layer inhibits entry of penicillin G and vancomycin |
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pilus with antigenic variation
army recruit college student |
Neisseria
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what is the preferred N. meningococci prophylaxis in close contacts?
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Rifampin
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cherry red epiglottis in children, meningitis, otitis media, pneumonia
produces IgA protease what is the preferred treatment? |
H. influenzae
tx: ceftriaxone; prophylaxis with close contacts |
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vaccine for what disease contains type B capsular polysaccharide conjugated to diphtheria toxoid or other protein?
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H. influenzae
given between 2 and 18 mo |
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pneumonia, fever, flulike syndrome, HA, diarrhea, unilateral infiltrate >> consolidation, decreased Na+
grow on charcoal yeast extract culture with iron and cysteine what is the route of transmission? preferred treatment? |
Legionella pneumophila
water source habitat tx: erythromycin |
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wound and burn infections
cystic fibrosis/pneumonia, sepsis, external otitis, UTI drug use Diabetic osteomyelitis hot tub folliculitis what is the preferred treatment? |
pseudomonas aeruginosa
tx: aminoglycoside + extended-spectrum penicillin (piperacillin, ticarcillin) |
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produces pyocyanin pigment, fruit/grape-like odor
c/o water source endotxin (fever, shock) and exotoxin A (inactivates EF-2) |
psuedomonas aeroginosa
oxidase positive, non-lactose fermenting |
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fimbriae-- cystitis and pyelonephritis
K capsule -- pneumonia, neonatal meningitis LPS endotoxin -- septic shock |
E. coli virulence factors
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invasive diarrhea; dysentery
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produces Shiga-like toxin.
microbe invades intestinal mucosa and toxin causes necrosis + inflammation (EIEC) |
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watery diarrhea during international trip
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labile toxins/stable toxin
no inflammation or invasion (ETEC) |
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diarrhea in 5yo
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No toxin produced.
adheres to apical surface, flattens villi, prevents absorption (EPEC) |
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dysentery
does not ferment sorbitol undercooked beef, unclean hands, raw unpasteurized milk |
O157:H7 is most common serotype
produces Shiga-like toxin and Hemolytic-uremic syndrome (anemia, thrombocytopenia, acute renal failure) endothelium swells and narrows lumen >> mechanical hemolysis + reduced RBF; damaged endothelium consumes platelets (EHEC) |
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lobar pneumonia in alocoholics and diabetics when aspirated
red current jelly sputum UTIs |
Klebsiella
Aspiration pneumonia, abscess in lungs, alcoholics, diabetics |
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have flagella and can disseminate hematogenously
produce H2S; monocytic response w/ antibiotics |
salmonella
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fever, diarrhea, headache, rose spots on abdomen
where in the body can this disease remain? |
gallbladder
(Salmonella typhi--typhoid fever) |
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1. enters via M cells in Peyer's patches
2. lyse its containment vacuole + enter cytosol 3. induce apoptosis of neutrophils AB exotoxin inhibits 60s ribosome |
Shigella
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no flagella but can propel itself within a cell by actin polymerization
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Shigella
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bloody diarrhea in 5yo
comma/s-chaped, oxidase positive, grows at 42 C this disease is a common precursor to what condition? |
Campylorbacter jejuni
Guillain-Barre syndrome |
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rice-water diarrhea via toxin that permanently activates Gs, increases cAMP
what is the preferred treatment? |
Vibrio cholerae
tx: prompt oral rehydration stool = mucus + epithelial cells |
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diarrhea in preschooler
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Yersinia enterocolitica
causes mesenteric adenitis that can mimic Crohn's or appendicitis |
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creates alkaline environment
>> gastritis and up to 90% of duodenal ulcers what is the triple therapy designated for this disease? |
1. metronidazole, bismuth
2. tetracycline, amoxicillin 3. metronidazole, omeprazole, clarithromycin |
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spirochete that can be visualized using aniline dyes (Wright's or Giemsa stain) on LM
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Borrelia
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flulike symptoms, fever, HA, abdominal pain, jaundice, photophobia + conjunctivitis
question-mark shaped bacteria what is the severe form? |
Leptospira interrogans
found in water contaminated with animal urine Wei's disease --- + jaundice and azotemia from liver and kidney dysfunction; fever, hemorrhage, anemia |
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erythema chronicum migrans, red rash w/ central clearing
arthritis, cardiac block, Bell's palsy what is the preferred treatment? |
Lyme disease (Borrelia burgdorferi, by Ixodes tick)
tx: doxycycline, cetriaxone |
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condylomata lata, maculopapular rash, constitutional symptoms
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secondary syphilis (systemic)
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gummas, aorititis, tabes dorsalis, constricted pupils, stroke without HTN
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teritary syphilis
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Saber shins, saddle nose, CN VIII deafness, Hutchinson's teeth mulberry molars
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congenital syphilis
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screen for syphilis with...
confirm with... |
VDRL
FTA-ABS |
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VDRL
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visurses (mono, hepatitis)
drugs rheumatic fever lupus and leprosy |
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prolonged PTT and false-positive VDRL
APAs + venous/arterial thromboembolism; increased miscarriages |
SLE --> APLA syndrome
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cat scratch + culture-negative endocarditis/bacillary angiomatosis
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Bartonella spp.
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undulant fever; from dairy products, contact with animals
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Brucella spp.
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flea bite; rodents, prairie dogs
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plague
(Yersinia pestis) |
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gray vaginal discharge w/ fishy smell
clue cells or epithelial cells covered with bacteria |
Gardnerella vaginalis
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need CoA and NAD+
transmitted bia arthropod vector headache, fever, rash what is the preferred treatment? |
Rickettsiae
(obligate intracellular organism) tx: doxycycline |
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rash starts on hands and feet
rash starts on the trunk |
1. ricketssial
2. typhus |
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when patient serum is mixed with Proteus antigens, antirickettsial antibodies cross-react to Proteus O antigens and agglutinate
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Weil-Felix reaction
(negative in Coxiella) |
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palm and sole rash >> trunk, headache, fever, East Coast
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Rocky Mountain spotted fever
(Rickettsia rickettsii) |
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Labs = cytoplasmic inclusions seen on Giemsa or fluorescent antibody-stained smear
what are the 2 forms of this organism? how is its structure unique? what is the preferred treatment? |
1. elementary body -- infectious + enters cell via endocytosis
2. reticulate body --- replicates in cell by fission, seen on tissue culture cell wall lacks muramic acid tx: azithromycin or doxycycline |
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chronic infection, blindness due to follicular conjunctivitis in Africa
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Types A, B, C
Chlamydia trachomatis |
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urethritis/PID, ectopic pregnancy, neonatal pneumonia, neonatal conjunctivitis
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Types D-K
Chlamydia trachomatis |
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lymphogranuloma venerum; can be acquired during passage throught infected birth canal
what is the preferred teratment? |
Types L1, L2, L3
Chlamydia trachomatis tx: azithromycin |
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headache, nonproductive cough, diffuse interstitial infiltrate; military recruits, prisons, <30 yo
high titer of cold agglutinins (IgM) grown on Eaton's agar What is the preferred treatment? |
Mycoplasma pneumoniae
("walking pneumonia") tx: tetracycline or erythromycin |
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this organism has no cell wall and not seen on gram stain
the only bacterial membrane containing cholesterol |
mycoplasma pneumoniae
penicillin resistant because they have no cell wall |
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preferred treatment for mycoses? (local v. systemic)
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local-- fluconazole or ketoconazole
systemic -- amphotericin B |
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bird or bat caves
pneumonia-like Mississippi and Ohio river valleys |
Histoplasmosis
hiding in macrophages |
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inflammatory lung disease >> skin and bone
granulomatous nodules East Coast and Central America |
Blatomycosis
broad-base budding (same size as RBC) |
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pneumonia + meningitis >>bone + skin
Southwestern US, California |
Coccidiodomycosis
spherules filled with endospores (larger than RBC) |
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Latin America
budding yeast with "captain's wheel" formation (larger than RBC) |
Paracoccidoidomycosis
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degradation of lipids produces acids that damage melanocytes >> hipopigmented/hyperpigmented patches
"spaghetti and meatball" appearance on KOH prep what is the cause? what is the preferred treatment? |
Tinea versicolor
(Malassezia furfur) tx: topical miconazole, selenium sulfide (Selsun) |
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pruritic lesions with central clearing (ring-like) caused by dermaphytes
See mold hyphae in KOH prep, not dimorphic what is the reservoir? what is the preferred treatment? |
pets
tinea pedis, cruris, corporis, capitis ( c/o Microsporum, Trichophyton, Epidermophyton) tx: topical azoles |
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dimorphic yeast with pseudohyphae
stacked budding yeasts + germ tubes what is the preferred treatment? |
candida albicans
tx: nystatin for superficial amphotericin B for systemic |
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mold with septate hyphae that branch at acute angles, not dimorphic
type I hypersensitivity |
Aspergillus fumigatus
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encapsulated yeast, not dimorphic
narrow-based budding Sabourad's agar; muscarmine circles latex agglutination test detects polysaccharide capsular Ag and is more specific. "soap bubble" lesions in brain |
Cryptococcus neoformans
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diffuse interstitial pneumonia
bdiffuse bilateral CXR methenamine silver stain of lung tissue for ID saucer-shaped yeast forms what is the preferred treatment? |
Pneumocystis jiroveci
tx: TMP-SMX, pentamidine, dapsone start prophylaxis when CD4 drops <200 cells/mL in HIV patients |
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dimorphic fungus (cigar-shaped yeast forms with unequal budding)
caused by thorn >> local pustule or ulcer with nodules along draining lymphatics dimorphic fungus what is the preferred treatment? |
Sporothrix schenckii
tx: itraconazole or potassium iodide |
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ring-enhancing brain lesions on CT/MRI
chorioretinitis, hydrocephalus, intracranial calcifications what is the preferred treatment? |
Toxoplasma gondii
tx: sulfadiazine + pyrimethamine |
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enlarged lymph nodes, refurring fever (d/t antigenic variation), somnolence, coma
treatment? |
Trypanosoma brucei, gambiense, rhodesiense (tsetse fly)
tx: Suramin (blood) Melarsoprol (CNS) |
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dilated cardiomyopathy, megacolon, megaesophagus
S. America (Reduviid bug) treatment? |
Trypanosoma cruzi
(Chagas disease) tx: Nifurtimox |
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spiking fevers, hepatoslenomegaly, pancytopenia
sandfly macrophages w/ amastigotes (lack flagella) |
Leisnmania donovani
tx: Sodium stibogluconate |
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cyclic fever, HA, anemia, splenomegaly
mosquito (Anopheles) |
Plasmodium vivax/ovale, falciparum, malariae
tx: 1. chloroquine 2. mefloquine vivax/ovale -- add primaquine for dormant forms in liver (hypnozoite) |
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vaginitis, foul-smelling greenish discharge, itching, burning
trophozoites on wet mount |
Trichomonas vaginalis
tx: Metronidazole |
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preferred treatment of nematodes?
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-bendazoles
(ivermectin -- strongyloides stercoralis) (pyrantel pamoate -- ancylostoma duodenale, necator americanus) |
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ingestion of larvae encysted in undercooked pork >> intestinal tapeworms.
cysticerosis and neurocysticercosis, swiss cheese appearance in brain preferred treatment? |
Taenia solium
tx: praziquantel (use -bendazoles for neurocysticercosis |
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enterobius, ascaris, trichinella
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nematodes infect via INGESTION
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strongyloides, ancylostoma, necator
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nematodes infect via CUTANEOUS route
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brain cysts, seizures
(parasite) |
Taenia solium
(cysticercosis) |
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liver cysts
(parasite) |
Echinococcus granulosus
(eggs in dog feces >> anaphylaxis; surgeons inject ethanol before removal to kill daughter cells) tx: -bendazoles |
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B12 deficiency
(parasite) |
Diphyllobothrium latum
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Biliary tract disease,
cholangiocarcinoma (parasite) |
Clonorchis sinesis
(undercooked fish) tx: praziquantel |
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hemoptysis
(parasite) |
Paragonimus westermani
(undercooked crab meat >> lung infection) tx: praziquantel |
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portal hypertension
(parasite) |
Schistosoma mansoni
(snails) |
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hematuria, bladder cancer
(parasite) |
Schistosoma haematobium
(snails) |
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microcytic anemia
(parasite) |
Ancylostoma, Necator
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perianal pruritus
(parasite) |
Enterobius
(pinworm) |
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inflammation of muscle (larvae encyst in muscle)
periorbital edema undercooked pork |
Trichinella spiralis
tx: -bendazoles |
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block cell wall synthesis by inhibition of peptidoglycan cross-linking (drugs)
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penicillin
ampicillin, ticarcillin, piperacillin imipenem, aztreonam, cephalosporins |
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block peptidoglycan synthesis
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bacitracin, vancomycin
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disrupt bacterial cell membranes
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polymyxins
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block nucleotide synthesis
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sulfanomides, trimethoprim
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block DNA topoisomerases
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fluoroquinolones
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block mRNA synthesis
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rifampin
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block protein synthesis at 50S ribosomal subunit
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chloramphenicol, macrolides, clindamycin, streptomgramins (quinupristin, dalfopristin),
linezolid |
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block protein synthesis at 30S ribosomal subunit
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aminoglycosides,
tetracyclines |
