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152 Cards in this Set
- Front
- Back
Characteristics of Staph aureus
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Gram+ cocci in clusters, catalase+, coagulase+, β hemolytic, ferments mannitol, salt tolerant
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Characteristics of Staph epidirmidis
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Gram+ cocci in clusters, catalase+, coagulase-, novobiocin sensitive
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Characteristics of Staph saprophyticus
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Gram+ cocci in clusters, catalase+, coagulase-, novobiocin resistant
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Characteristics of S. pneumoniae
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Gram+ catalase- lancet-chapes diplococci in chains, α hemolytic, "MOPS" optochin sensitive, bile soluble, +quellung
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Characteristics of Viridans strep
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Gram+ catalase- cocci, α hemolytic, optochin resistant, bile insoluble
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Characteristics of S. pyogenes
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Gram+ catalase- cocci, group B, β hemolytic, bacitracin sensitive, PYR+
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Characteristics of S. agalactiae
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Gram+ catalase- cocci, group A, β hemolytic, bacitracin resistant, cAMP test+
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Characteristics of Enterococcus
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Gram+ catalase- cocci, PYR+, hydrolizes esculin in 40% bile and 6.5% NaCl
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Characteristics of Clostridium tetani
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Gram+ spore-forming anaerobic rods
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Characteristics of Clostridium botulinum
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Gram+ spore-forming anaerobic rods
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Characteristics of Clostridium perfingens
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Gram+ spore-forming anaerobic rods, double zone of β hemolysis
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Characteristics of Clostridium difficile
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Gram+ spore-forming anaerobic rods
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Characteristics of Corynebacterium diptheriae
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Gram+ aerobic club-shaped rods, V or L shapes on tellurite, metachromatic granules on Leoffler. β-prophage contains diptheria toxin gene (lysogeny)
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Characteristics of Bacillus
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Gram+ spore-forming aerobic rods
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Characteristics of Listeria
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Gram+ rods with tumbling or actin jet motility, β hemolutic, cold growth, facultative intracellular
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Characteristics of Actinomyces
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Gram+, long branching filaments, non-acid fast anaerobic rods
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Characteristics of Nocardia
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Gram+, long branching filaments, partially acid-fast aerobic rods
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Characteristics of Mycobacterium tuberculosis
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Acid-fast aerobic rods on Lowenstein-Jensen medium, auramine-rhodamine stainning (fluorescent apple green). Mycolic acid lipids on cell wall
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Characteristics of Mycobacterium lepreae
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Acid-fast aerobic rods, can't be cultured (obligate intracellular). Mycolic acid lipids on cell wall
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Characteristics of Neisseria menigitidis
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Gram- kidneybean-shaped diplococci, growws on chocolate agar, maltose fermenter, polysaccharide capsule
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Characteristics of Neisseria gonorrhoeae
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Gram- kidneybean-shpaed diplococci, growws Thayer-Martin, maltose non-fermenter, no polysaccharide capsule
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Characteristics of Haemophilus influezae
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Gram- cocobacillus, requires factor X and V (chocolate agar). Satellite phenomenon near staph aureus on blood agar
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Characteristics of Pasteurella
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Gram- cocobacillus, anaerobic
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Characteristics of Brucella
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Gram- cocobacillus, aaerobic, zoonosis, biowarfare
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Characteristics of Bordetella pertussis
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Gram- aerobic cocobacillus
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Characteristics of Klebsiella
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Gram- lactose-fermenting rods on MacConkey, polysacchride capsule, oxidase-
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Characteristics of E. coli
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Gram- lactose-fermenting rods on MacConkey, oxidase-
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Characteristics of Shigella
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Gram- nonlactose-fermenting rods on MacConkey, nonmotile, no H2S production, oxidase-
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Characteristics of Salmonella
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Gram- nonlactose-fermenting rods on MacConkey, highly motile, H2S producer, oxidase-
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Characteristics of Proteus
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Gram- nonlactose-fermenting rods with swarming motility, H2S producer, urease+, oxidase-
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Characteristics of Pseudomonas
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Gram- nonlactose-fermenting rods on MacConkey oxidase+, aerobic, produces green pigment pyocyanin
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Characteristics of C. jejuni
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Gram- nonlactose-fermenting curved rods with flagella, oxidase+, microaerophillic
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Characteristics of H. pylori
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Gram- nonlactose-fermenting helical rods with flagella, oxidase+, urease+, microaerophillic
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Characteristics of Vibrio cholera
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Gram- nonlactose-fermenting curved rod with flagella, oxidase+ grows on alkaline media (thiosulfate)
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Characteristics of Francisella
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Gram- facultative intracellular rods, zoonosis, biowarfare
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Characteristics of Yersinia
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Gram- coagulase+ rods with bipolar stainnning, facultative intracellular, zoonosis
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Characteristics of Gardnerella
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Gram variable rod, positive whiff fishy smell test
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Characteristics of Bacteroides
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Gram- anaerobic rod
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Characteristics of Treponema
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Gram- spirochete, spiral-shaped with axial filaments, dark microscopy
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Characteristics of Borrelia
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Gram- spirochete, spiral-shaped with axial filaments, microaerophilic
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Characteristics of Leptospira
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Gram- spirochete, spiral question mark-shaped with axial filaments
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Characteristics of Rickettsia
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Gram- (doesn't stain well) obligate intracellular rods
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Characteristics of Coxiella
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Gram- (doesn't stain well) obligate intracellular rods
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Characteristics of Chlamydia
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Obligate intracellular bug seen in Giemsa stain. Wall lacks muramic acid. Elementary body is infective, reticulate bodies are replicating in the cell
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Characteristics of Mycoplasma
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Lacks peptidoglycan cell wall, does not gram stain. Cholesterols in membrane
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Staph gastroenteritis
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Nausea, abdominal pain, vomiting, followed by diarrhea 2-6 hours after ingesting enterotoxin in custards, pastries, potato salad, canned meats
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Infective acute endocarditis
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Staph aureus. Fever, malaise, leukocytosis, murmur
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Abscess and mastitis
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Staph aureus. Pain, pus, redness, edema, warmth.
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Toxic shock syndrome
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Staph aureus or GAS. Fever hypotension, scarlatiform desquamating rash on palms and soles, multiorgan failure. Produced by superantigen TSST-1 toxin
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Impetigo
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Staph aureus or GAS. Erythematous papules to bullae (staph) or honey-crusted lessions (GAS)
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Staph pneumonia
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Typical acute severe pneumonia. Associated to Ccystic Phibrosis, CGD
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MCC surgical infecitons
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Staph aureus. Fever with cellulitis or abscess
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MCC osteomyelitis
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Staph aureus. Bone pain, fever, inflammation, lytic bone lessions on x-rays
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"Honeymoon" cystitis
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Staph saprophyticus. 2nd MCC UTI in sexually active women. Dysuria, frequency, urgency, suprapubic pain.
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3 MCC of ambulatory UTIs
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E. coli, S. saprophyticus, Klebsiella
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Infection of prosthetic devices and catheters
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Staph. epidirmidis
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Rx.: staph infections
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Nafcillin, oxacillin. For MRSA: vancomycin
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Pharyngitis
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GAS. Abrupt onset of sore throat, fever, tonsillar abscesses, tender anterior cervical nodes. Rx.: penicillin or macrolide in case of allergy
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Scarlet fever
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GAS. Pharyngitis plus sandpaper rash (palm and soles spared), strawberry tongue, nausea
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Rheumatic fever
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Antibodies against GAS M protein cross-react with heart two weeks after a pharyngitis (Type II hypersensitivity). Jones major criteria: Fever, subcutaneous nodules, polyarthritis, carditis, erythema marginatum, chorea.
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Acute postsrep glomerulonephritis
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GAS M12 serotype. Immunocomplex deposition on GBM (type III hypersensitivity). Nephritic syndrome: hypertension, azotemia, edema, smoky urine (hematuria).
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3 MCC of neonatal meningitis
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GBS agalactiae, E. coli, Listeria
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Diseases caused by Strep pneumoniae
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MOPS: Meningitis, Otitis media (in children), Penumonia, Sinusitis; sepsis in asplenic sickle cell anemia.
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Strep pneumonia virulence factors
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Polysacchride capsule is major factor, IgA protease cleaves mucosal IgA, teichoic acids and peptidoglycan are highly inflammatory in CNS
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Clinical features of typical pneumonia and Rx.
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High fever, dyspnea, tachypnea, pleuritic chest pain, productive rusty sputum cough, lobar consolifation on x-ray. Rx.: macrolides
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Pathophysiology of Strep. Viridans infection
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Dextran biofilm mediated adherence to teeth or damaged/prosthetic heart valve and growth in vegetations. Causes dental caries and subacute endocarditis.
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Subacute bacterial endocarditis
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Strep viridans following dental work. "FROM JANE": fever, Roth retinal lessions, Osler painful nodules, murmur, Janeway painless lessions, anemia, nailbed hemorrhages, emboli. Rx.: penicillin G with aminoglycosides
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Disease caused by enterococcus
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Urinary/billiary tract infections and subacute bacterial endocarditis following prostate or GI surgery
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Malignant pustule
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Cutaneous anthrax by B. anthracis. Painless ulcer papule with vesicles have a central eschar necrosis with erythematous border and painful regional lymphadenopathy
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Wool sorter's disease
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Life-threatening pneumonia by B. anthracis on contact with animal hides. Cough, fever, facial edema, dyspnea, diaphoresis, cyanosis and shock with mediastinal hemorrhagic lymphadenitis
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Bacillus gastroenteritis
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Rapid onset gastroenteritis with watery diarrhea associated with reheated fried rice
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Tetanus
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C. tetani. Risus sardonicus (lock jaw), opisthotonus, extreme muscle spasms caused by tetanosmin block of inhibitors glycine and GABA. Rx.: Hyperimmune gamma globulin, metronidazole, diazepam
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Disease caused by C. botulinum
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"Floppy baby" flaccid paralysis by botulinum toxin block of acetylcholine at neuromuscular junction. Flaccid paralysis, diplopia, dysphagia, disphonia. Associated with honey and canned vegetables
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Gas gangrene
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C. perfringes. Dirty wound with increasing pain, edema, gas, fever and tachycardia. Caused by alpha toxin which is a lecithinase that lyses tissue
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Clostridium food poisoning
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Enterotoxin in reheated meat dishes causes noninflammatory watery diarrhea in 8-24 hours
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Pseudomembranous colitis
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C. difficile enterotoxin damages mucosa. Diarrhea, colitis, pseudomembrane. Associated with clindamycin use in hospitalized patients. Tx.: metronidazole
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MCC of meningitis in renal transplant or cancer patients
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Listeria
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Granulomatosis infactisepticum
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Neonatal sepsis with disseminated granulomas after in-uterus transmission of Listeria. Associated with unpasterurized milk products, cold deli meats, soft cheeses.
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Diptheria
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Diptheria toxin inhibits EF-2 and protein synthesis. Causes pharyngitis with gray pseudomembrane. Complications are larynx obstruction, myocarditis, recurrent laryngeal nerve palsy
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Actinomycosis
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Oral/facial drainnning abscesses with sinus tracts in tissues with low oxygenation: cervicofacial, pelvic, solitary brain abscess
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Nocardiosis
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Cavitary pulmonary mycetomas in immunocompromised and cancer patients. Cough, fever, dyspnea, cavitations.
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Pathophysiology of tuberculosis
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Primary TB: replication in macrophages with subsequent CMI produces Gohn focus which is transported to hilar lymph nodes remaining latent. Secondary TB: a reinfection or immunocrompromise produces granulomas and cavitary lessions or disseminated milliary TB (CNS, vertebrae, kidneys GI).
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M. tuberculosis pathogenic factors
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Sulfatides in cell envelope inhibit phagosome lysosome fusion. Tuberculin induces CMI with casseating granulomas.
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Clinical features of TB
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Chronic productive cough, hemoptysis, weight loss
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Leprosy
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M. leprae invades nerve endings producing a strong CMI with granulomas (tuberculoid leprosy) or a weak CMI in which theres bacterial damage to nerves. Paresthesia (leads to trauma and burns), loss of eyebrows, destruction of nasal septum, lumpy ears, leonine features.
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Meningococcus virulence factors
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Polysacchride capsule is antiphagocytic; IgA protease allow oropharync colonization; endotoxin leads to septic shock in meningococcemia; deficiency of C5-C8 predisposes to bacteremia
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Meningococcemia and meningitis
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N. meningitidis. Abrupt onset of fever, chills, prostration and petecchial rash, nuchal rigidity. CSF: high pressure, high neutrophils, high protein, low glucose.
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Waterhouse-Friderichsen syndrome
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Meningococemia leads to ecchymoses, DIC, bilateral adrenal infarct, shock, death.
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Diseases caused by N. gonorrheae
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Uretheral/vaginal leukorrhea; endocervicitis/PID; septic arthritis; neonatal opthalmia
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Diseases caused by pseudomonas
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"PSEUDOmonas": Pneumonia in CF and CGD; Sepsis with black necrotic lessions; External otitis "swimmer's ear"; UTI in catheterized patients; Diabetes and Drug-user Osteomyelitis. Associated with burns and wound infections; associated with respirators, humidifiers and water.
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Legionnaires disease
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Legionella. Atypical pneumonia associated with old age, immunosuppressed, smokers, water aerosols and air conditioning systems.
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Tularemia
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Francisella. Dermacentor tick bite produces ulceroglandular disease with ulcer at bite site and lymph node enlargement and necrosis. Associated with rabbit skinning in Arkansas and Missouri.
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Whooping cough
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B. pertussis. Repetitive cough with inspiratory whoops, anoxia and eye hemorrhages in unvaccinated children
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Brucellosis/undulant fever
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Brucella. Acute septicemia with high fever, profuse sweating and hepatomegaly. Associated with slaughterhouse animals and unpasteurized dairy products in California, Texas or travel to Mexico
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Campylobacter gastroenteritis
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MCC of inflammatory diarrhea in US. Abdominal pain, vomitting, bloody diarrhea with fecal leukocytes. Complication: Guillain-Barre syndrome due to cross-reactivity between Campylobacter oligosacchrides and neural glycosphingolipids.
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Guillain-Barre syndrome
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Inflammatory demyelinating polyneuropathy caused by antibodies against Campylobacter (or other agents) cross reacting with neural glycosphingolipids. Acute onset of ascending paralysis with areflexia.
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Helicobacter virulence factors
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Motile flagella; Urease covers the bug in ammonium which neutralizes stomach acid; Mucinase aids in penetrating the mucin layer of stomach.
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Diseases associated with Helicobacter
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Chronic gastritis and 90% of duodenal peptic ulcers; gastric adenocarcinoma.
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E. coli serotypes
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"PITCH": EPEC (enteropathogenic=pediatric); EIEC (enteroinvasive=inflammatori diarrhea); ETEC (enterotoxigenic=traveler's diarrhea); EHEC (enterohemorrhagic=undercooked hamburgers)
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MCC UTI
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E.coli. Colonization of uroepithelium from fecal flora. Pyelonephritis-associated pilli (p. pili) is major virulence factor and allows adherence to uroepithelium
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2nd MCC neonatal septicemia
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E. coli from maternal fecal flora infects neonate during parturition. K1 serotype capsule and endotoxin are virulence factors
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3 MCC nosocomial UTIs
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E. coli, proteus, klebsiella
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MCC gram- sepsis
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E. coli. From indwelling IV catheters
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Traveler's diarrhea
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E coli. Associated with travel to third-world countries and children < 3 in third-world countries. Watery diarrhea produced by LT and ST toxins that stimulate adenylate cyclase and guanylate cyclase increasing cAMP.
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2nd MCC of infantile diarrhea
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EPEC (enteroPathogenic=Pediatric). Noninflamatory watery diarrhea in babies in developing countries. Adherance to M cells is virulence factor.
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Diseases by EHEC
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Bloody diarrhea withour leukocytes in stool or fever (distinguishes from shigellosis). Can cause HUS. Verotoxin shiga-like toxin inhibits protein synthesis by interfering with 60S ribosomal subunit.
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Disease caused by EIEC
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Watery inflammatory diarrhea with fever and fecal leukocytes
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Shigella virulence factors
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Endotoxin; invasion of M cells and polymeriazation of actin jet trails produce shallow ulcers; shiga toxin inhibits protein synthesis by interfering with 60S ribosomal subunit
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Shigellosis
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1-10 acid-resistant organisms needed for infection. Invasive bloody diarrhea with fever, abdominal cramps, tenesmus.
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Diseases caused by K. pneumoniae
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Typical pneumonia in alcoholics and diabetics with currant-jelly bloody sputum and lung abscesses. Nosocomial UTIs (3rd MCC) related with catheters. Septicemia in immunocompromised patients.
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Granuloma inguinale
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Subcutaneous nodules on genitals with bleeding ulcers. Caused by K. granulomatis. Associated with Caribbean and New Guinea patients. Donovan bodies encapsulated bacteria inside macrophages
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Typhoid fever
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Salmonella typhi. Large number of organisms ingested infect ileocecal region cause constipation. Bacteria reach basolateral side of M cells, lymph nodes and blood with positive blood culture at 1 week. Infection of liver and spleen with fever, headache and septicemis. 85% of stool cultures postive by week 3. Complication: necrosis and perforation of Peyer patches.
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MCC inflammatory diarrhea
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Campylobacter, salmonella enterica
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MCC infantile diarrhea
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Rotavirus, EIEC
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Diseases caused by Salmonella enterica
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Gastroenteritis with nausea, vomiting, abdominal pain, occasionally bloody stools; MCC osteomyelitis in sickle cell anemia patients. Associated with reptile pets and poultry.
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Bubonic plague
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Yersinia pestis. Rapidly increasing fever, regional buboes, conjunctivitis, pneumonia. Highly contagious zoonosis associated with rodents and prairie dogs.
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Yersinia enterocolitis
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Inflammatory bloody diarrhea, fever, pseudoappendicitis. Associated with cold northern climates (Michigan, Scandinavia), unpasteurized milk and pork, pet puppies.
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Disease associated with proteus
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2nd MCC nosocomial UTIs, struvite renal stones due to urease.
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Weil-Felix reaction
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Anti-rickettsial antibodies cross-react with proteus antigens. Positive for Rocky Mountain spotted fever (ricketsia rickettsi) and typhus (rickettsia typhi). Negative for Q fever (coxiella)
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Gardnerella vaginosis
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Vaginal fishy odor and thin gray vaginal discharge. Caused by reduction of vaginal Lactobacillus when vaginal pH > 4.5.
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Cholera
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Vibrio cholerae. Profuse rice watery diarrhea and dehydration. Cholera toxin ADP ribosylates Gs increasing adenylate cyclase and cAMP with efflux of Cl- and H2O.
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Disease caused by Pasteurella
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Cellulitis and lymphadenitis associated with cat bites
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Disease caused by Haemophilus influenzae
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"haEMOPhilus": Epiglotitis (MCC); Meningitis in unvaccinated children (MCC); Otitis media; Pneumonia in COPD patients.
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Painful chancroid
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Haemophilus ducreyi. Chancroid and soft painful genital ulcers
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Diseases caused by Bacteroides
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Septicemia, peritonitis, abdominal abscess after trauma or emergency abdominal surgery
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Primary syphilis
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T. pallidum. Painless indurated chancre, highly contagious, heals in 3-6 weeks.
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Secondary syphilis
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T. pallidum. Condylomata lata flat wartlike perianal and mucous membrane lessions, highly contagious. Maculopapular rash
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Tertiary syphilis
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T. pallidum. Gumman (syphilitic granulomas); aortitis and syphilitic aneurysms (obliterative endarteritis of vasa vasorum); tabes dorsalis (ataxia, Romberg+); "Prostitute" pupil "accomodates but does not react"
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Congenital syphilis
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Stillbirth, keratitis, deafness, desquamating maculopapular rash
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VDRL test
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Antitreponemal antibodies in 1ary and 2dary syphilis cross-react with cow heart antigens. Sensitive but not specific.
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FTA-ABS test
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Fluorescent antibodies agglutinate treponema sample. Specific for syphilis.
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Lyme disease
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Ixodes deer ticks transmit Borrelia. Bull's eye erythema migrans; severe headache, meningitis, Bell palsy; arrhythmias and miocarditis; migratory poliarthritis. Associated with northeastern states.
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Leptospirosis
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Myalgia, abdominal pain, hepatitis with combined jaundice. Associated with urine-contaminated waters (jet skiers and sewer workers)
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Rocky Mountain spotted fever
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R. rickettsii transmitted by tick dermacentor. Fever, headache and maculopapular to petechial rash begins in wrists and ankles and spreads to trunk (centripetal rash). Associated with east coast mountains. Weild-Felix+
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Q fever
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Coxiella. Fever, pneumonia and granulomatous hepatitis. Weil-Felix negative
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MCC of bacterial STD
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Chlamydia trachomatis serotypes D-K
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Diseases caused by chlamydia trachomatis
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Serotypes D-K cause urethritis, cervicitis, PID and infertility, inclusion conjunctivitis; Lymphogranuloma venereum and genital elephatiasis in Africa, Asia, South America. Serotypes A, B, C follicular conjunctivitis with corneal scarring and blindness.
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3 MCC of atypical pneumonia
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Mycoplasma, Legionella, Chlamydia pneumoniae
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Walking pneumonia
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Mycoplasma. MCC of pneumonia in adults 18-40 years. Atypical pneumonia with persistent hacking cough and no sputum.
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What is a plasmid?
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Extra chromosomal genetic elements non-essential for life. Contain genes for fertility, antibiotic resistance and exotoxins.
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What is a bacteriophage?
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Prophage (bacterial virus) DNA is stable inside the bacterial chromosome (temperate phage). Usually encodes virulence factors such as exotoxins. Temperate phages = lysogeny.
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What is a transposon?
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Mobile genetic elements (jumping genes). From plasmid to chromosome or vice versa. Ususally associated with multiple drug resistance genes.
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What is homologous recombination?
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Incorporates and stabilizes genes acquired by transformation, conjugation or transduction. A linear sequence of DNA is exchanged into a homologous or similar sequence of the bacterial chromosome. DNA outside the bacterial chromosome is lost.
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What is site-specific recombination?
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Integration of circular pieces of DNA (plasmids, phages, transposons) into the bacterial chromosome. No homology is required, no DNA is lost.
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What is transformation?
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DNA is taken up from the environment by competent bacteria and incorporated by homologous recombination.
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F+ x F- conjugation
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F+ contains conjugation genes. Sex pilus coded by F+ plasmid tranfers plasmid to F- cell. No chromosomal genes are transferred.
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Hfr x F- conjugation
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Hfr cell has plasmid integrated into the chromosomal DNA which is transferred to F- cell along with chromosomal DNA.
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Generalized transduction
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A lytic phage acquires some bacterial DNA and carries to the next bacteria after lysis. Any gene can be transduced.
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Specialized transduction
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A temperate lysogenic phage carries a mistankenly excised flanking chromosomal gene to the next bacteria. Only specific flanking genes are transferred with phage.
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Autoclave
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Steam under 15lbs pressure at 121 degrees celsius for 15-20 minutes. Or dry heat for 2 hours at 180 degrees celsius.
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Membrane damaging disinfectants
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Use for enveloped viruses: detergents (benzalkonium), alcohol, phenols
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Protein denaturing disinfectants
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Use for naked capsid viruses. Chlorine, iodine, H2O2, formaldehyde, alkylating agents.
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