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150 Cards in this Set
- Front
- Back
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How do we stain bacteria with thick waxy cell walls?
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Ziehl-Neelsen AKA acid fast stain = uses heat and acid to drive stain into bacteria
-good for Mycobacterium tuberculosis |
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What is India ink used for?
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Cryptococcus
Used for negative staining = everything else but the organism is stained black |
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What is Giemsa stain used for?
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General stain for Blood Smears
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What does PAS AKA periodic acid-schiff stain test for?
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polysaccharides, such as glycogen and mucopolysaccharides
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Prussian blue tests for what?
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Detects iron presence
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Congo Red stains what?
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Amyloid red
but looks apple green when viewed under a polarized microscope |
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Gram + bacteria have thick or thin cell walls?
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thick peptidoglycan walls
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What are the steps in staining Gram + and - bacteria?
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1. Crystal violet - stains walls blue/purple
2. Gram's Iodine - ensures stain doesn't wash off 3. Alcohol - Decolorizes = washes out stain 4. Safranin - stains pink/red...if bact is gram + thick wall, not all the blue/violet stain washes out, so mized with safranin bact. will appear blue-violet, vs gram - will appear pink/red |
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T/F: All bacteria except mycoplasma have a cell wall
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TRUE
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T/F: All bacteria except mycoplasms and chlamydia have peptidoglycan in cell wall
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TRUE
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T/F: All gram positive bact. have a thick peptidoglycan wall and techoic acid (=antigen our bodies can detect)
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TRUE
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Outer membrane of all Gram - bact. contains what?
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Lipopolysaccharide (LPS) = a component of LPS is lipid A
The outer membrane has porins |
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T/F: The O specific side chain, "O Ag" of LPS is only found in Gram - bact.
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TRUE
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What are the structures that make up the LPS?
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O specific side chain, Core polysaccharide, Lipid A
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What part of the LPS makes Endotoxin?
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Lipid A
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T/F: mycobacteria have waxy well walls containing mycolic acid
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T
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T/F: Mycoplasma have no cell wall, just a membrane with cholesterol
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T
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Define Spores
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Contain dipicolinic acid (=dehydrates the spore) and can survive for thousands of years.
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Endotoxin A ie Lipid A of the LPS activates what?
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Macrophages --> IL-1, TNF, NO --> fever
Complement --> alternate pathway --> C3a and C5a --> inc histamine --> dec BP and exudation Hageman (factor 12) --> coagulation --> consumption of clotting components --> DIC |
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Differences between Endotoxin and Exotixin?
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Endotoxin = Lipid A of the LPA, POOR antigen (b/c its not a protein, its a lipid), Heat stable b/c its not a protein
Exotoxin = polypeptide = its a protein, specific in its effect, very antigenic b/c its a protein, heat labile (heat can destroy it) |
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Define Tetanus toxin
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Produced by Clostridium tetani, Blocks glycine and GABA release (inhibitory NTs)
Muscle spasms result Features tetany with lock jaw, risus sardonicus (facial muscle tetany), opisthotonus, paralysis of respiratory muscles |
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Define Botulinum Toxin
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The MOST POTENT exotoxin
Produced by Clostridium botulinum |
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How does the muscle affects seen with tetanus toxin differ from botulinum?
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tatanus toxis causes tetany (muscle spasm)
Botulinum causes muscle paralysis = blocks Ach at NM junction Constipation, descending flaccid paralysis, flaccid paralysis of respiratory muscles |
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Define Diptheria toxin?
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Inhibits protein synth in human cells
Produced by Corynebacterium diptheria |
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How does Diptheria toxin work?
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inhibits protein synth by modifying elongation factor 2 (EF-2)
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What does Diptheria toxin affect first?
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throat, then binds heart and neural tissue
Features: pharyngeal pseudomembrane development + myocarditis with arrhythmias, life-threatening circulatory collapse, muscle weakness or paralysis of pharyngeal muscles leading to regurgitation of fluids through nose + peripheral neurtitis/ neuropathy |
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Define Alpha toxin
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Produced by: Clostridium perfringens and Staph. aureus
C. perfringens = Digests lecithin --> holes in cell membrane --> marked necrosis or deep tissues, esp muscles and hemolysis Staph. aureus = creates holes in cell membrane --> marked necrosis of skin and hemolysis |
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Toxic Shock Syndrome Toxin works how?
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Binds class II MHC proteins (HLA) directly, without intracellular processing --> means its a Super Antigen
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What produces Toxic Shock Syndrome Toxin? Symptoms?
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staph aureus
Symptoms = fever, rash, desquamation, diarrhea, Hypotension then shock |
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Define cholera toxin
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Produced by vibrio cholera
Binds glycosides in intestinal cell membrane --> stimulate Gs protein --> adenylate cyclase stimulated --> over-production of cAMP --> secretion of chloride ion and water --> massive watery diarrhea |
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Define pertussis toxin
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Produced by Bordatella pertussis. Toxin binds ciliated respiratory tract epi cells and lymphocytes --> inhibits Gi --> Adenylate cyclase stimulated --> over-production of cAMP
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Wha tare the two types of Enterotoxin produced by E. coli?
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Heat Labile (same MOA as cholera)
Heat Stabile - water drawn into lumen by attraction to excess ions in lumen |
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Whats the oxygen requirement of microaerophilics?
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have NO oxygen requirement - rely on fermentation for metabolism
Have superoxide dismutase |
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T/F: Obligate Anaerobes will die upon exposure to oxygen
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TRUE
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Most common cause of exudative tonsillitis?
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viruses (#1 of EBV)
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Most common cause of Rhinitis?
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Rhinovirus
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Most common cause of Acute Sinusitis?
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viruses, strep. pneumo
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Most common cause of Otitis media?
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strep. pneumo, H. influensae
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Most common cause of malignant otitis externa?
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Pseudomonas aeruginosa
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Most common cause of acute bronchitis?
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rhinovirus
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Most common cause of Nosocomial (hospital-acquired) pneumonia?
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E. coli
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Most common cause of nursing home pneumonia?
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Klebsiella pneumo.
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Most common cause of ICU pneumonia?
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Pseudomonas aeruginosa
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Most common cause of Atypical pneumonia?
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Mycoplasma pneumonia
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Most common cause of community-acquired pneumonia?
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Strep. pneumo.
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Most common cause of UTI?
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E. coli
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Most common cause of infections of burn pts?
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Pseudomonas aeruginosa
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Most common cause of bacterial meningitis neonate? child? adult? immunocompromised?
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Neonate = E. coli, strep agalactiae, listeria monocytogenes
Child = Neisseria meningitidis Adult = strep. pneumo. Immunocompromised = strep. pneumonia |
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Most common cause of Aseptic meningitis?
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Summer = enterovirus
Winter = mumps virus |
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Most common cause of Diarrhea acute infections in kids, adults, bloody, parasitic? Chronic? + stool WBCs? - stool WBCs? food-associated?
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kids = rotavirus
Adults = norwalk virus bloody = campylobacter jejuni parasitic = entamoeba histolytica Chronic = Giardia lamblia + stool WBCs = Camplylobacter jejuni - stool WBCs = Norovirus and rotavirus food-associated = Salmonella enteritidis |
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What are all the different types of Diarrhea caused by E. coli?
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ETEC, EIEC, EAEC, EHEC (including E.coli 0157), EPEC
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Differences between E. coli-derived Diarrheas?
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ETEC = enterotoxigenic. secretes LT and ST --> high chloride loss and blocks ions moving into enterocytes --> severe watery diarrhea. Traveler's diarrhea (fecal-oral route)
EIEC = enteroinvasive. invades enterocytes --> fever, WBCs in stool, bloody diarrhea, leukocytosis. (fecal-oral route) EAEC = enteroaggressive. toxin causes watery diarrhea. stacked brick appearance in cultures. (fecal-oral route) EHEC = enterohemorrhagic. secretes shiga-like toxin --> death of enterocytes --> bloody diarrhea, abd cramps, hemorrhagic colitis (from ground beef, etc) |
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A pt ingests e. coli 0157. What will they're symptoms be?
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This is a EHEC.
Will cause non-immune hemolytic anemia, thrombocytopenia and acute renal failure (with uremia) --> Hemolytic Uremic Syndrome EPEC = enteropathogenic. adheres to bowel wal but doesn't enter --> severe watery diarrhea that occurs in kids almost exclusively under 2 years old (fecal-oral) |
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Staph. aureus enterotoxin A-F is responsible for what symptoms?
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Its a preformed toxin responsible for staph. a. food poisoning. Stimulates peristalsis causing diarrhea and abd. pain
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What symptoms does Toxic Shock Syndrome Toxin cause?
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N, V, watery diarrhea, may damage liver, kidney, CNS, muscle, blood cells, red rash occurs
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What toxin is responsible for scalded skin syndrome?
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Exfoliatin toxin
causes fever, bullae, and red macular rash --> middle epidermis of skin is cleaved, causing large areas of skin on palms and soles to slough off along with loss of fluids and electrolytes. hair and nails may also slough off. |
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What are the actions and result of Alpha toxin?
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Forms pores in cell membranes --> cellular death and tissue necrosis --> skin necrosis and hemolytic anemia
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Strep. agalctiae (Group B step) causes what?
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Sepsis or meningitis in neonate
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Strep. pyogenes (Group A strep) causes what?
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Pharyngitis, tonsillitis, impetigo, scarlet fever, post-strep glomerulonephritis, acute rheumatic fever, necrotizing fasciitis, cellulitis/skin infections
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Strep. bovis (Group D strep) causes what?
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Sub-acute infective endocarditis
Check for colon cancer if pt has this |
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Enterococcus faecalis (Group D strep) causes what?
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UTI, endocarditis, cholecystitis, ascending cholangitis
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Strep mutans causes what?
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Subacute infective endocarditis
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What are the 3 possible diseases Group A beta-hemolytic strep causes?
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Pyogenic disease --> purulent lesions
Toxigenic disease --> high fever with hypotension, necrotizing fasciitis, scarlet fever, tissue necrosis Immunologic disease --> rheumatic fever with rheumatic heart disease or post-streptococcal glomerulonephritis |
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What are all the exotoxins Group A beta hemolytic strep can cause?
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Streptokinase, Streptodornase, Hyaluronidase, Eythrogenic toxin, Streptolysin O, Streptolysin S, Pyrogenic exotoxin A, Exotoxin B
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Define Streptokinase and Streptodornase, Exotxins
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Streptokinase = activates plasminogen --> dissolves clot
Streptodornase = DNAse = degrades DNA |
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Hyaluronidase and Erythrogenic toxin do what?
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Hyaluronidase = contributes to development of cellulitis
Erythrogenic toxin - causes rash of scarlet fever. fever, rough, erythramatous diffuse rash, strawberry tongue, focal streptococcal infection |
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Which exotoxin is responsible for the flesh eating bateria that causes necrotixing fasciitis?
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Exotoxin B
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Where must we culture Neisseria?
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Chocolate medium
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Define Meningococcus
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Neisseria meningitidis. IgA protease = destroys IgA Abs on mucosal surfaces
Encapsulated = confers anti-phagocytic qualities and induces protective Abs LPS causes fever and shock and launches DIC mechanisms. Waterhouse-Friendrichson syndrome can occur (fever, cyanosis, petechiae, bilateral adrenal hemorrhage) |
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Define Gonococcus
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Neisseria gonorrheae
IgA protease NOT encapsulated = more easily phagocytosed but no protective Ab development Purulent urethral or vaginal discharge |
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Untreated PID can lead to what?
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Fitz-Hugh-Curtis syndrome = RUQ abd pain, +/- fever, violin-string adhesions from liver to adnexa or abd. wall
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What are the outcomes of systemic spread of gonococcus?
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gonococcal arthritis (monoarticular, red, hot, purulent)
Tenosynovitis (inflamm of tendon sheath) |
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Define Bacillus anthracis
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Spores persist for many years in soil
produces anthrax toxin with 3 components: Edema factor, protective antigen (forms pores in cell membrane, antigenic), lethal factor |
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What are the 3 types of anthrax?
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Cutaneous anthrax = most common form. black crust (eschar) with massive local edema
Pulmonary antrhax AKA woolsorter's dis. Spores inhaled --> germinate --> cough, fever, malase --> hemorhagic mediastinitis = mediastinal widening on x-ray, bloody effusion --> death Gastrointestinal anthrax = Spores ingested and germinate --> vomiting, abd pain, bloody diarrhea --> shock, death (from contaminated meat) |
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DOC for Anthrax?
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Penicillin (ONLY if its proven sensitive to it...until then use Ciprofloxacin or Doxycyclin PLUS clindamycin and or Rifampin and continue until penicillin is confirmed to work
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Do you excise the lesion caused by anthrax?
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NO! this will enable it to spread to systemic system
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Define Corynebacterium diptheriae
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Produces diptheria toxin but only if it itself is infected with a bacteriophage
Signs and Symptoms = pseudomembrane in throat, fever, myocarditis, paralysis and posible death CHINESE CHARACTER formation (Listeria monocytogens has this too) |
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Listeria monocytogenes affects primarily who?
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neonates, immunosuppressed, preggos
Look for CHINESE CHARACTERS, but dif. from Corynebacterium because its movement is tumbling |
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Affects of Listeria monocytogenes?
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Sepsis and meningitis is new borns, abortion or premature delivery in preggos, or gastroenteritis in anyone w/o optimal immune system
Source = hot dogs/processed meats, unpasteurized dairy |
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Which Clostridium species cause gas gangrene and food poisoning?
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Clostridium perfrongens
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Which Clostridium species causes pseudomembraneous colitis?
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Clostridium difficile
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What bact. cause dental caries and protects the GI tract and vagina by maintaining an acidic environment
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Lactobacillus
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Characteristics of Clostridia?
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Obligate Anaerobes, form spores, exotoxins responsible for disease, Gram + rods
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Pathogenesis of C. perfringens?
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spored germinate in food --> ingested --> enterotoxin produced --> Food poisoning (Diarrhea etc)
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Pathogenesis of gas gangrene associated with c. perfringens?
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spores inoculated into deep wounds --> spores germinate --> bact multiply in tissue --> bact. elaborate alpha toxin --> gas gangrene
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Pathogenesis of C. difficile?
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causes peeudomembraneous colitis
Abx use --> bact overgrowth in bowel of C. Dificile --> bacterial endotoxins A and B --> Destruction of enterocytes actin by toxin B --> Enterocyte death --> Pseudomembraneous colitis = foul smelling, watery diarrhea |
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How do we Dx C. dificile? Tx?
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with the c. dificile toxin, NOT the stool culture
Tx = withdrawal of Abx. If severe, metronidazole or vancomycin+ cholestyramine |
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Pathogenesis of C. botulinum?
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Spores germinate in canned food --> bacteria multiple, produce gas a botulinum toxin --> food and pre-formed toxin ingested --> toxin blocks Ach release at NM junction --> Botulism (flacid paralysis)
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What are the 3 major forms of botulism?
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1. Botulism = regular. acquired from canned foods
2. wound botulism = spores germinate in wound 3. Infant botulism = spres in honey ingested by infants |
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Pathogenesis of C. tetani?
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Spores enter via deep wound --> spores germinate in anoxic tissue, create tetanospasmin = blocks release in inhibitory NTs in spinal cord --> tetanus
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All Gram negative bact. have what?
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O antigen
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All flagellated bact. have what?
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H antigen
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All capsulated bact. have what?
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K antigen
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Difference between salmonella food infection and enteric fever (typhoid fever)?
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Salmonella = poultry --> incubation 1-2 days --> bact invade epi, sm intestine and colon --> causes inflamm diarrhea --> bacteremia --> Tx = fluids if mild, Cirpo if severe
Enteric Fever (typhoid fever) = fecal-oral route bact ingested --> incubation 10-12 days --> bact multiply in peyers patches --> affect small intestine --> constipation, fever, brady, rose spots on abdomen --> progresses to chronic infection with gallbladder, excretion of bact in stool--> tx = ciprofloxacin or levofloxacin |
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Shigella - low or high infectious dose needed?
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low
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Bacteria are ingested by one of te 5 F's. What are they?
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Fingers, Food, Flies, Feces, Fornication, anal
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Does shigella invade the distal ileum and colon?
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yep
fever, abd cramps, bloody mucusy diarrhea, stool WBCs no bacteremia, so will not cause + blood culture |
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Proteus causes what?
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staghorn renal calculi
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Currant jelly sputum clues you into the fact that the pt is prob infected with what?
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Klebsiella pneumoniae
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Vibrio cholerae increases chloride and water into intestinal lumen to create what type of Diarrhea?
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rice water diarrhea --> electrolyte and volume loss leading to arrhythmia and rapid acute renal failure
Tx = PO and IV fluids |
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Vibrio parahaemolyticus is transmitted how?
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raw or undercooked seafood, esp shellfish and oysters
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Which bact is Associated with the development of Guillain-Barre syndrome?
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Campylobacter jejuni = Invasive, causes watery, foul-smelling diarrhea, fever, severe abd pain
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What does the Urease of Helicobacter pylori do?
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Splits urea into NH3 and CO2
ID with urease breath test, gram stain smear, H. pylori antigen in stool/serum |
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Whats the only gram neg that doesn't have LPS?
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Bacteroides fragilis
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Whats the most common cause of serious anaerobic infections?
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Bacteroides fragilis
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Whats the cause of black death?
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Yersinia pestis
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How is the bubonic plague transmitted vs Pulmonary plague?
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Bubonic = rodents --> fleas --> humans
Pulmonary plague = human--> human or bio-warfare aerosol or bubonic plague |
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DOC for the plague?
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Streptomycin
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T/F: Yersinia enterocolitica has a very high infective dose and you can get it from puppies (poop).
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TRUE
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How does one acquire Pasturella multocida?
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cat and dog bites
would infections and cellulitis result |
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Brucella is associated with what?
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Unpasteurized dairy products
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Pathogensis of Francisella tularensis?
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rabbits, deer, squirrel --> ticks, flies, mosquitoes --> humans --> Tularemia, Tularemia pneumonia
If acquired via skin, ulcer develops at bite site, then granuloma forms |
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Describe Pseudomonas aeruginosa
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Obligate anaerobe, oxidase +, slime layer +, colonizes lungs of most CF pts.
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What does Pseudomonas aeruginosa cause?
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osteomyelitis in IV drug users, infection in burn pts, pneumonia in CF pts, malignant otitis externa
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Describe Hemophilus
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produces IgA protease = destroys IgA, gram - pleomorphic rod, requires blood, grows around staphylococci
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Which Haemophilus can cause chancres?
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H. ducreyi
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Why is the Hib vaccine so effective in preventing meningitis?
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95% of Hemphilus have a capsule
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Cause of whooping cough?
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Bordatella pertussis
Gram - rod, produces pertussis toxin, |
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What are the stages of pertussis?
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Catarrhal stage (1-2 weeks) rhinorrhea, malaise, fever, URI --> Coughing Stage (2-4 weeks) severe episodes every day, LRI --> Convalescent Stage (several months), mild cough --> 1/3 Recover Fully (1/3 have neuro problems, and 1/.3 of these have SEVERE neuro problems like coma, seizure, blindness, paralysis)
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Describe Legionella pneumophila
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Gram - rod, facultative intracellular parasite, causes Legionnaire's disease (fever, brady, pneumonia, diarrhea, hyponatremia) and Pontiac fever (like legionnaire's but w/ milder symptoms + bronchitis and loose stool).
Catalase + Grows in man-made water reservoirs |
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How do we detect primary or latent TB?
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PPD test
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What often causes a positive PPD test?
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QuantiFERON-TB = whole blood interferon gamma
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Symptoms of primary TB?
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Asymptomatic, Demonstrates primary lesion (Ghon complex, Ranke complex)
Ghon complex = Ghon focus with calcified tubercles in middle or lower lung and perihilar lymph node calcified granulomas Yields + PPD |
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How do we Dx Secondary TB, which occurs after the primary TB infection and then the Latent period?
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Lesions and cavity formation in upper lung lobes
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Symptoms of Tuberculosis?
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Weight loss, low grade fever, night sweats, symptoms related to whatever system is affected
Tx = 3 anti-microbials |
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Vertebral TB is TB where?
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Pott's disease
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Scrofuloderma TB is TB where?
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cutaneous TB
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Miliary TB is TB where?
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wide spread hematologic dissemination yielding shot gun pellet type lesions in lung, CNS, GI, kidney, bones, or any other organ
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Difference between Tuberculoid Leprosy and Lepromatous Leprosy?
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Tuberculoid Leprosy = Limited granulomas form = disease is contained. rare, = Lepromin skin test. HLA-DR3 associated
Lepromatous Leprosy = Nodular skin lesions or ganulomas = pt can't mount a cell-mediated immune response. Systemic involvemnet, negative Lepromin skin test. NO HLA ASSOCIATION |
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Describe Actinomyces israelii
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Gram + rod, water and soil saprophyte and normal flora of mouth. Over-gorwth = poor oral hygiene
Sites of infection form sulfer granules = bright yellow pus draining from abcess |
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Describe Nocardia asteroides
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Gram + rod, grows in soil, infection mimics TB, avidly forms in sinuses
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3 genera of Sporochetes?
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Treponema, Borrelia and Leptospira
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Describe Treponema pallidum
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Sexually transmitted or transmitted via placenta
screening tests = VDRL or RPR Confirm with TPHA |
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What are the stages of Trepenema pallidum?
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Stage 1 = primary syphillis = painless hard chancre
Stage 2 = Seecondary syphillis = rash, condyloma lata, F/H, Latent syphilis (1/3rd progress to this). Asymptomatic Stage 3 = Tertiary Syphillis = gummas, CV (aortic insuff), neuro (dementia, psychosis, tabes dorsalis,), Charcot's joints |
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What causes Lyme disease?
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Borrelia burgdorferi
Reservoir = white-footed mouse Obligatory host = large mammels, esp deer vector = tick Ixodes |
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Stages of Lyme disease?
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Stage 1 = etrythema chronicum migrans
Stage 2 = multiple ECMs = neurologic problems (meningitis, Bell's palsy, tic doularoux, myocrditis) Stage 3 = chronic arthritis (esp knees), progressive CNS disease that mimics MS |
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What causes relapsing fever every 8 days or so?
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Borrelia recurrentis
vector = louse human--> louse --> human Dx = blood smear |
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Phases of Leptospirosis caused by Leptospirosis interrogans? (note: Weil's disease is like this)
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Phase 1 = high spiking fever, H, conjunctival reddening, severe muscle aches of thighs and low back
Resolution = period of asymptomatic disease Phase II = recurrence of stage 1 symptoms |
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Reticulate body is what?
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C. trachomatis
Can cause Epididymitis and Prostatitis if untreated Cervicitis and PID can also result |
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Chlamydia trachmatis can develop trachoma which is what?
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conjunctivitis - blindness develops over 10-15 years
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Chlamydia trachmatis can develop Neonatal inclusion conjunctivitis which is what?
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Conjunctifvitis of neonates, yellow purulent discharge begins 5-12 days after birth
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Chlamydia trachmatis can develop Chalmydia conjunctivitis which is what?
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Adult conjunctivitis due to cross-contamination with infected genital secretions
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Chlamydia trachmatis can develop Reiter's syndrome which is what?
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Develops after Chalmydia genital infections = an immunological disease
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C. psittaci can cause what?
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pneumonia called psittacosis
get it from bird feces esp parrots |
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What are the symptoms of Typhus?
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Sudden onset chills/flu-like feelings 1-3 weeks after arthropod bite. Then rash and meningeal problems. Death from vascular collapse or bacterial pneumonia
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What are the 3 types of Typhus?
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Epidemic, Endemic, (vector = lice, reservoir for epidemic = flying squirrel an humans, reservoir for Endemic = rats) Scrub (vector = mites, reservoir = rodents)
Rash starts around waist and spreads peripherally. spares palms, soles, face. |
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Very high predilection for capillary endothelium and can cause fulminant vasculitis, shock, and thrombosis. Primarily in Apalachia, Abrupt fever, H, chills, rash starts on extremities and spreads to trunk
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Rocky Mt. Spotted Fever
caused by Rickettsia Rickettsiae reservoir = dogs, rodents |
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Describe Q Fever
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Fever, chills, pneumonitis, WITHOUT rash
The ONE Rickettsia disease NOT spread by bit of arthropod. reservoir = cattle, sheep, no vector cause = Coxiella burnetti |
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Describe trench fever
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2-4 weeks after louse contact, fevers every 5 days, chills, H, severe BONE PAIN and rash
Caused by Rochalimaea quintana vector = lice, reservoir = humans |
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T/F: Rocky Mt. Spotted Fever starts peripherally and moves centrally
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TRUE
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