Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
166 Cards in this Set
- Front
- Back
|
Strep pyogenes (group A) causes which three types of disease?
|
Pyogenic
Toxigenic Immunologic |
|
|
Types of Pyogenic diseases caused by strep pyogenes?
|
Pharyngitis
Cellulitis Impetigo |
|
|
Types of Toxigenic diseases caused by group A strep?
|
Scarlet Fever
Toxic Shock Syndrome |
|
|
Types of Immunologic diseases?
|
Rheumatic Fever
Acute GN |
|
|
Sx's of Rheumatic Fever?
|
Subcutaneous Nodules
Polyarthritis Erythema marginatum Chorea Carditis |
|
|
What is Strep pyogenes sensitive to?
|
bacitracin
|
|
|
What is up w/ M protein and strep pyogenes?
|
Antibodies to M enhance host defenses against strep pyogenes, but can give rise to rheumatic fever
|
|
|
What is used to detect strep pyogenes?
|
ASO titer
|
|
|
Characteristics of Strep agalactiae?
|
Group B
Bacitracin resistant Beta hemolytic mainly in Babies |
|
|
What does GBS cause?
|
Pneumonia
Meningitis Sepsis |
|
|
Enterococci species?
|
E. faecalis and faecium
|
|
|
resitance/sensitivity in Enterococci?
|
Penicillin G resistant
|
|
|
What is Enterococci also called?
|
Group D strep
|
|
|
What are lancefield grouping based on?
|
C carbohydrate on bacterial cell wall
|
|
|
Hemolysis of Group D (enterococci)
|
Variable
|
|
|
What do Enterococci cause?
|
UTI's
Subacute endocarditis |
|
|
Lab test of Group D?
|
6.5% NaCl growth for enterococcal group D
Enterococci are hardier than nonenterooccal group D |
|
|
Who is the main bad@ss Enterococci?
|
VRE (vancomycin-resistant enterococci)
|
|
|
I say "strep bovis," you say?
|
Associated w/ colon cancer
Group D |
|
|
Who causes diphtheria?
|
Corynebacterium diphtheria via exotoxin
|
|
|
Who encodes the diphtheria exotoxin?
|
Beta-prophage
|
|
|
How does the diphtheria exotoxin fxn?
|
ADP ribosylation of EF-2
|
|
|
Sx's of diphtheria?
|
pseudomembranous pharyngitis w/ lymphadenopathy
|
|
|
Lab Dx of diptheria depends on?
|
Gram-positive rods w/ metachomatic granules
|
|
|
What does corynebacterium diphtheria grow on?
|
Tellurite agar
|
|
|
The ABCDEFG's of Diphtheria?
|
Adp ribosylation
Beta-prophage Corynebacterium Diphtheria Elongation Factor-e Granules (metachromatic) |
|
|
What is in the core of bacterial spores?
|
dipicolinic acid
|
|
|
how do you kill bacterial spores?
|
autoclave
|
|
|
What kind of bacterial spores are found in soil?
|
Bacillus anthracis
Clostridium perfringens C. tetani |
|
|
Who else makes spores?
|
B. cereus
C. botulinum |
|
|
Mechanism of botulism?
|
Inhibition of ACh release at NMJ
|
|
|
How is the disease caused in adults vs infants?
|
Adults ingest preformed toxin
Infants ingest spores in honey |
|
|
What is up w/ C. perfringens' toxin?
|
Alpha-toxin = lecithinase
Causes myonecrosis (gas gangrene) and hemolysis |
|
|
What's up w/ C. difficil's toxin?
|
Cytotoxin = exotoxin that kills enterocytes--->pseudomembranous colitis
Often secondary to antibiotic use (clindamycin, ampicillin) |
|
|
Rx for C. diffficile?
|
Metronidazole
|
|
|
Kicker about B. anthracis' structure?
|
Only bacterium w/ protein capsule (D-glutamate)
|
|
|
What happens after contact w/ Anthrax?
|
Malignant Pustule (painless ulcer eventually w/ black eschar)--->bacteremia, death
|
|
|
What happens after inhalation of anthrax?
|
flulike sx's--->rapidly progressive fever, pulmonary hemorrhage, mediastinitis, and shock
|
|
|
what is Woolsorter's disease?
|
inhalation of anthrax spores from contaminated wool
|
|
|
How do you get infected w/ Listeria monocytogenes?
|
Unpasteurized milk/cheese/deli meat
Vaginal transmission at birth |
|
|
Three main kickers for Listeria?
|
Actin Rockets (how they move from cell to cell)
Only gram pos. w/ endotoxin Tumbling motility |
|
|
What does Listeria monocytogenes cause?
|
Amnionitis
Septicemia Spontaneous abortion Granulomatosis infantiseptica Neonatal meningitis Meningitis in immunocompromised Mild gastroenteritis in health people |
|
|
What do Actinomyces and Nocardia have in common?
|
Gram Positive Rods
Form long branching filaments resembling fungi |
|
|
Kicker species for actinomyces and nocardia?
|
A. israelii
N. asteroides |
|
|
Kickers' for A. israelii?
what it causes? where do you find it? |
Anaerobe
Causes oral/facial abscesses that may drain through sinus tracts in skin Forms yellow sulfur granules in sinus tracts Normal oral flora? |
|
|
general characteristics of N. asteroides?
|
Gram-Pos
Weakly acid-fast aerobe Found in soil |
|
|
What does nocardia asteroides cause?
|
Pulmonary infection in immunocomp pts
|
|
|
Rx for actinomyces and nocardia?
|
SNAP
Sulfa drugs for Nocardia Actinomyces gets Penicillin |
|
|
Who normally gets primary vs secondary TB?
|
primary = nonimmune kid
secondary = partially immune hypersensitized adult |
|
|
What part of lungs does primary TB go after?
|
Ghon Complex =
Hilar nodes Ghon focus (lower lobes) |
|
|
what part of lungs does secondary TB go after?
|
Fibrocaseous cavitary lesions usually in Upper Lobes
|
|
|
how many disease pathways can primary TB take?
|
4
1. it heals by fibrosis--->immunity/hypersensitivity 2. Progressive Lung Disease (malnourished, HIV)---> death 3. Severe bacteremia--->miliary TB--->death 4. Preallergic lymph/blood dissemination--->dormant TB in several organs---->gets reactivated (secondary) |
|
|
What happens w/ TB Reactivation/
|
Hits the lungs
or goes Extrapulmonary |
|
|
What happens w/ extrapulmonary TB?
|
CNS: (parenchymal tuberculoma, Meningitis)
Vertebral Body (Pott's disease) Lymphadenitis Renal GI |
|
|
When do you get a + PPD?
|
Current infection
Past exposure BCG Vaccinated |
|
|
Kickers for different types of Mycobacteria?
|
All Acid-Fast
M. TB is often super resistant M. kansasii is pulmonary w/ TB-like sx's M. avium-intracellulare is often really resistant and causes disseminated disease in AIDS |
|
|
TB sx's?
|
Fever
Night Sweats Wt. Loss Hemoptysis |
|
|
When do you see Leonine facies and what are the characteristics?
|
Leprosy
Loss of eyebrows Nasal Collapse Lumpy earlobe |
|
|
Who causes Leprosy?
|
M. leprae
|
|
|
General characteristics of M. leprae?
|
Acid-Fast Bacillus
Cool temperatures (skin, superficial nerves) Can't grow in vetro |
|
|
Where do you find leprosy in the US?
|
armadillos
|
|
|
Types of Leprosy?
|
Lepromatous (worse due to failed cell-mediated immunity)
Tuberculoid (self-limited) |
|
|
Rx. for leprosy? SE's?
|
long term oral Dapsone
toxicity-->hemolysis, methemoglobinemia |
|
|
Alternate Rx for leprosy?
|
Rifampin
Combo of clofazimine and dapsone |
|
|
Gram Negative Lab Algorithm?
|
Gram Stain---> Negative
Shape----> Cocci, "Coccoid" rods, Rods Cocci: Maltose fermentation Coccoid Rods: done Rods: Lactose Fermentation Lactose Fermenters: slow or fast Lactose Nonfermenters: Oxidase +/- |
|
|
Ok, so who are the Gram Negative Cocci? how do you tell them apart?
|
Neisseria!
N. meningitidis = maltose fermenter N. gonorrhea = Maltose Nonfermenter |
|
|
Who are the Gram-Neg Coccoid Rods?
|
Haemophilus influenzae
Bordatella pertussis Pasteurella Brucella |
|
|
How do you get Pasteurella?
|
Animal Bites
|
|
|
So what was the next step if it is a Gram-Neg Rod?
|
Lactose Fermentation?
|
|
|
who are the Lactose Fermenters and how do you tell them apart?
|
Fast Fermenters:
Klebsiella E. coli Enterobacter Slow Fermenters citrobacter serratia |
|
|
Who are the Lactose Nonfermenters and how do you tell them apart?
|
Oxidase -
Shigella Salmonella Proteus Oxidative + Pseudomonas |
|
|
What medium and result do you get for Lactose Fermenters?
|
The grow pink colonies on MacConkey's agar
|
|
|
What's up w/ penicillin and Gram-Negatives?
|
The outer membrane layer inhibits Penicillin G and Vancomycin
They may be susceptible to penicillin derivatives like ampicillin |
|
|
When it comes to fermenting, what do the Neisserias have in common?
|
Both ferment Glucose and both produce IgA
|
|
|
N. gonorrhea vs N. meningitidis
capsule? maltose fermentation vaccine? |
G doesn't have a polysac capsule, doesn't ferment maltose, and has no vaccine
M has a polysac capsule, ferments maltose, and has a vaccine |
|
|
How are N. gonorrhea and N. meningitidis transmitted?
|
G is sexually transmitted
M is via resp. or oral secretions |
|
|
what do N. gonorrhea and N. meningitidis cause?
|
G causes gonorrhea, septic arthritis, neonatal conjunctivitis, PID
M causes meningococcemia, meningitis, Waterhouse-Friderichsen Syndrome |
|
|
What does H. influenzae cause?
|
Epiglottis
Meningitis Otitis Media Pneumonia haEMOPhilus |
|
|
Tx of H. influenzae?
|
Aerosol
|
|
|
H. influenzae toxins?
|
makes IgA protease
|
|
|
Lab requirements for H. influenzae culture?
|
Chocolate Agar w/ factors V (NAD) and X (hematin)
|
|
|
What does H. influenzae not cause?
|
the flu
|
|
|
how do you Rx H. influenzae infection?
|
Rx meningitis w/ ceftriaxone
Rifampin prophylaxis w/ close contacts |
|
|
When do you get H. influenzae vaccine?
|
between 2 and 18 months
|
|
|
2 main things Legionella pneumophila causes and what they really are?
|
Legionnaire's Disease = severe pneumonia
Pontiac Fever = mild influenza |
|
|
Kickers for Diagnosing Legionella?
|
Gram Neg Rod, but stains poorly so use Silver Stain
Charcoal Yeast Extra w/ Iron and Cysteine |
|
|
Tx of Legionella?
|
Aerosal from environmental water source
Not person-to-person |
|
|
Rx for Legionella?
|
Erthromycin
|
|
|
Common places we get a Pseudomonas infection?
|
wounds
burns |
|
|
what does Pseudomonas cause?
|
PSEUDO
Pneumonia (CF) Sepsis (black skin lesions) External otitis (swimmer's ear) UTI Drug Use diabetic Osteomyelitis and hot tub folliculitis |
|
|
General characteristics of Pseudomonas?
|
Gram Neg
Aerobic Non-lactose fermenting Oxidase Positive Produces Pyocyanin (blue-green) Grape-like odor |
|
|
Pseudomonas toxin?
|
Endotoxin--->fever, shock
Exotoxin A--->inactivates EF-2 |
|
|
Rx for Pseudomonas?
|
aminoglycoside + extended-spectrum penicillin (piperacillin, ticarcillin)
|
|
|
Enterobacteriaceae family includes?
|
E. coli
Salmonella Shigella Klebsiella Enterobacter Serratia Proteus |
|
|
What do all Enterobacteriaceae have in common?
|
COFFEe
Capsular Ag (K) O antigen Flagellar Ag (H) Ferment Glucose Enterobacteriaceae |
|
|
What does Klebsiella cause?
|
4 A's
Aspiration Pneumonia Alcoholics Abscess in lungs diAbetics (that's a stretch) also nosocomial UTI's |
|
|
Sputum for Klebsiella?
|
Red Currant Jelly
|
|
|
What do Salmonella and Shigella have in common?
|
Non-lactose fermenters
Invade intestinal mucosa--->bloody diarrhea |
|
|
How do Salmonella and Shigella differ?
|
Salmonella have a flagella and can disseminate hematogenously
Shigella don't have a flagella but can propel themselves by actin polymerization Shigella is more virulent Only Salmonella produces H2S |
|
|
Tx of Salmonella and Shigella?
|
Food
Fingers Feces Flies |
|
|
What does Salmonella typhi cause? Sx's?
|
Typhoid Fever
fever diarrhea HA rose spots on abdomen can remain in gall bladder chronically |
|
|
How do you get Yersinia enterocolitica?
|
Pet poo
Contaminated Milk Pork Day Care centers |
|
|
Yersinia infection mimics?
|
Crohn's
Appendicitis |
|
|
Who causes up to 90% of duodenal ulcers?
|
Helicobacter pylori
|
|
|
What else is H. pylori a risk factor for?
|
peptic ulcers
gastric adenocarcinoma lymphoma |
|
|
What is key test for H. pylori?
|
Urease Breath test b/c its Urease positive
|
|
|
Rx for H. pylori?
|
Triple Therapy
1. Bismuth, Metronidazole, and Tetracycline or amoxicillin 2. $$$= Metronidazole, Omeprazole, Clarithromycin |
|
|
Who are the main Spirochetes?
|
Borrelia (big)
Leptospira Treponema |
|
|
How do you visualize the spirochetes?
|
Only borrelia using aniline dyes (wright's, giemsa) in light microscopy
Treponema w/ dark-field microscopy |
|
|
What is a question mark shaped bacteria and where is it found?
|
Leptospira interrogans
water contaminated w/ animal pee |
|
|
Sx's of Leptospirosis?
|
flu-like sx's
fever HA abd pain jaundice |
|
|
Where do you normally see Leptospirosis?
|
Tropics
|
|
|
What is Weil's Disease? Sx's?
|
Icterohemorrhagic Leptospirosis
severe form jaundice and azotemia of liver Kidney dysfxn Fever hemorrhage anemia |
|
|
Who causes Lyme Disease?
|
Borrelia burgdorferi in a Ixodes tick
|
|
|
Stages and Sx's of Lyme Disease?
|
Stage 1:
erythema chronicum migrans (bull's eye) flu-like sx's Stage 2: CNS (bell's palsy) and cardiac (blockade) manifestations Stage 3: chronic monoarthritis migratory polyarthritis |
|
|
Other animals involved in life of Borrelia burgdorferi?
|
Mice are reservoirs
Deer are required for the tick life cycle |
|
|
Rx for Lyme Disease?
|
doxycycline
|
|
|
Who causes syphillus?
|
Treponema pallidum
|
|
|
What are treponemes?
|
spirochetes
|
|
|
Other type of treponeme besides pallidum?
|
T. pertenue
|
|
|
What does Treponema pertenue cause?
|
yaws
infection of skin, bone, joints--->healing w/ keloids--->severe limb deformities |
|
|
Tx for T. pertenue?
|
in the Tropics
Not an STD, but you get a positive VDRL |
|
|
Rx for Syphilis?
|
Penicillin G
|
|
|
Sx's of Primary Syphilis?
|
Painless chancre
|
|
|
Sx's of Secondary Syphilis?
|
Disseminated disease w/ constitutional Sx's
Maculopapular Rash (palms, soles) Condylomata lata |
|
|
Sx's of tertiary syphilis?
|
Gummas (chronic granulomas)
Aortitis (vasa vasorum destruction) Neurosyphilis (tabes dorsalis) Argyll Robertson pupil |
|
|
What is tabes dorsalis?
|
sensory demyelination--->
weakness parasthesias dec reflexes broad based ataxia Postive romberg |
|
|
What does an argyll robertson pupil look like?
|
Bilaterally small pupils that, like prostitutes, accommodate but don't react (to light)
i.e. they'll constrict when focusing on a near object, but won't react to bright light |
|
|
Sx's of Congenital Syphilis?
|
Saber Shins (sharp ant. bowing)
Saddle Nose CN VIII deafness Hutchinson's teeth (small, wide spaced) |
|
|
VDRL vs FTS-ABS?
|
FTS is most specific, earliest positive, remains positive the longest
VDRL can have false positives |
|
|
What else gives a positive VDRL?
|
Viruses (mono, hep)
Drus Rheumatic Fever Lupus and Leprosy VDRL |
|
|
Who are the Zoonotic bacteria?
|
Bartonella henselae
Borrelia burgdorferi Brucella spp. Francisella tularensis Yersinia pestis Pasteurella multocida |
|
|
What does Bartonella henselae cause? Tx?
|
Cat Scratch Fever...from a daggum cat scratch
|
|
|
What does Brucella cause? Tx?
|
Brucellosis/undulant fever
Dairy products, animal contact |
|
|
What does Francisella tularensis cause? Tx?
|
Tularemia
Ticks, rabbits, deer |
|
|
What does Yersinia pestis cause? Tx?
|
Plague
Fleas, rodents, esp prairie dogs |
|
|
What does Pasteurella multocida cause? Tx?
|
Cellulitis
Animal bite, cats dogs |
|
|
What does Gardnerella vaginalis cause? Sx's?
|
Bacterial Vaginosis
off-white/gray discharge w/ fishy smell Nonpainful |
|
|
Tx of G. vaginalis?
|
Not an STD, but associated w/ sexual activity
|
|
|
Histo kickers for Gardnerella vaginalis?
|
Clue Cells = vaginal epithelial cells covered w/ bacteria
|
|
|
Rx for Gardnerella vaginalis?
|
Metronidazole
|
|
|
What do Rickettsiae have to have?
|
CoA
NAD must be intracellular |
|
|
Tx and Sx's of all Rickettsiae? exception?
|
Tx: arthropod vector
Sx's: HA, Fever, Rash except Coxiella: Tx aerosol, Sx: pneumonia |
|
|
Rx for most rickettsial infections?
|
Tetracycline
|
|
|
Types of Rickettsiae, their diseases, and vectors?
|
Rickettsia rickettsii - Rocky Mt Spotted Fever - Tick
R. typhi - Endemic typhus (fleas) R. prowazekii - Epidemic typhus (human body louse) Ehrlichia - Ehrlichiosis (tick) Coxiella burnetii - Q fever (inhaled aerosols) |
|
|
Rickettsiae Rashes and their spread?
|
Rickettsial rashes start on limbs and spread in
Typhus rashes start on Trunk and spread out |
|
|
Sx's of Rocky Mt. Spotted Fever?
|
Rash on palms and soles migrates to trunk
HA Fever |
|
|
Where do most cases of RMSF occur?
|
EAST coast
|
|
|
Who else besides RMSF gets palm and sole rash?
|
Secondary Syphilis
Coxsackievirus A (hand, foot, mouth disease) |
|
|
What is the Weil-Felix Rxn?
|
Assays for antirickettsial antibodies which cross-react w/ Proteus Ag.
Positive for RMSF and Typhus, but not Q fever |
|
|
What does Chlamydiae have to have?
|
Must be intracellular b/c they can't make their own ATP
|
|
|
2 forms of Chlamydiae seen in its life cycle?
|
Elementary Body (small dense), which Enters cell via Endocytosis
Initial/Reticulate Body, which Replicates in cell by fission |
|
|
Main species of Chlamydiae?
|
C. trachomatis
C. pneumoniae C. psittaci |
|
|
What does C. trachomatis cause?
|
Reactive arthritis
Conjunctivitis Nongonococcal urethritis PID |
|
|
What do C. pneumonia and C. psittaci cause? Tx?
|
Atypical pneumonia
Aerosol? |
|
|
Special vector for Chlamydiae?
|
C. psittaci has an avian reservoir
|
|
|
What's the Chlamydia cell wall kicker?
|
Lacks Muramic Acid
|
|
|
Lab Dx of Chlamydia?
|
Cytoplasmic inclusions seen on Giemsa or fluorescent antibody-stained smear
|
|
|
Rx for Chlamydiae?
|
Erythromycin
or Tetracycline |
|
|
Chlamydia trachomatis Serotypes and what they cause
|
A, B, C = chronic infection, blindness in africa
D-->K = urethritis, PID, ectopic preg, neonatal pneumonia, neonatal conjunctivitis L1, L2, L3 = lymphogranuloma venereum |
|
|
Classic cause of walking pneumonia?
|
Mycoplasma pneumoniae
|
|
|
Sx's of Mycoplasma pneumoniae infection?
|
Insidious onset
HA Nonproductive cough Diffuse interstitial infiltrate X-ray looks worse than patient |
|
|
Lab stuff for M. pneumoniae infection?
|
High titer of cold agglutinins (IgM)
Grown on Eaton's Agar |
|
|
Structural kickers for Mycoplasma pneumoniae?
|
No cell wall
Not seen on gram stain Only bacterial membrane w/ cholesterol |
|
|
Who usually gets infected w/ Mycoplasma pneumoniae
|
Under 30
Military and Prisons |
|
|
Rx for Mycoplasma pneumoniae?
|
Tetracycline or Erythromycin
penicillin resistant b/c of lack of cell wall |
