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147 Cards in this Set

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Food poisoning within 2 hours of ingestion
staph aureus
bacillus cereus

N+V
Germ tube test
candida
felix weil test
heterophile antibody test used for Rickettsial dz dx.
Depends on cross rxn btw rickettsial infections and OX strain of proteus vulgaris
Reovirus
Rotovirus - #1 cause of fatal diarrhea in kids
Reovirus - Colorado tick fever
Only family of DS RNA virus
Nake capsid
Extremely segmented genomes
Icosahedral and double shelled
Poxvirus
Ds DNA - largest DNA virus
Enveloped
not icosahedral - COMPLEX
Doesn't replicate in nuc - in CYTO - bc carries own DNA dependent RNA p
Ds DNA
enveloped virus
Hepadnovirus - partial circ dna
not a retrovirus - but has reverse transcriptase
Herpes virus - linear
HSV1,2, VZV, EBV, CMV, HHV6,8
Poxvirus: linear - largest DNA virus
smallpox, vaccinia-cowpox (milkmaids blister), Molluscum Contagiosum
Ds DNA naked icosahedral virus
Papovirus/polyomavirus: HPV
JC virus -progressive multifocal leukoencephalopathy
adenovirus: febrile pharyngitis (sore throat), Pneumonia, conjunctivitis
ss DNA Naked virus
parvovirus
B19 - aplastic crisis in sickle cell
rash - erythema infectiosum (fifth dz)- hydrops fetalis
ssRNA segmented enveloped
helical virus
Orthomyxovirus
Bunyavirus
Arenavirus
ss neg sense RNA
bullet shaped helical virus
Rhabdovirus
rabies
Helical Viridae (compared to icosahedral)
must have an envelope
all RNA
ss pos sense RNA
enveloped diploid
icosahedral
retrovirus
HIV
HTLV
ss pos sense RNA
enveloped icosahedral virus
flavivirus:HCV, Yellow fever, dengue, St. Louis Encephalitis, West Nile
togavirus:
Rubella, Eastern Equine encephalitis, Western Equine Virus
ss pos sense RNA
naked icosahedral
Picornovirus
Polio
Echo (aseptic menigitis), Rhinovirus (common cold),
Coxsackie: aseptic mengitis, herpangina-febrile pharyngitis, hand foot mouth dz, myocarditis,
HAV
Calcivirus: HEV, Norwalk
ETEC
travelers diarrhea
toxin that activates intestinal adenylate or guanylate cyclase
overproduction of cAMP
CagA
VacA
H. Pylori
Cytotoxin ass gene A - type 3 secretory system injects CagA prot into cells.
ass with the malginancy
Vacuolating toxin - causes apoptosis.
4 most important traits acquired through bacterial lysogeny
Temparate or lysogenic bacteriophage inserts its DNA into the bacterial chromosome by site specific recombination.
O ag of salmonella
Botulinum Exotoxin
Erythrogenic exotoxin A of S. Pyogenes
Diptheria Toxin
hypha with microconida and tuburculate macroconida
histoplasma capsulatum
cigar shaped yeasts
sporothrix schenki
rose gardener dz
arthroconidia
cocciodioides immitis - valley fever

mexico, sonoran desert, US
sporangiospores
mucor rhizopus and absidia

nonseptate filamentous fungi
Transmitted by the phlebotamous sand fly
leishmaniasis
tx with antimony cmpds (sodium stibogluconate, meglumine antimonate), ampho B, pentamidine
sx - night sweats, wt loss, dark ashen skin, ulcers on face, dsyphagia, dyspnea
Viral envelope
makes a virus more succeptible to drying
composed of viral proteins and host lipid
Most DNA viridae get theirs from the nuclear membrane
Most RNA get theirs from the plasma membrane
RNA virus that replicates in the nucleus
Orthomyxovirus: Influenza virus
retrovirus: HIV, HTLV
only DNA virus that replicates in the cytoplasm
Poxvirus
Cold agglutinins
IgM
cauliflower lesions
Blastomycosis
broad based budding yeasts
Diploclinic acid
spores
Teichoic acid response
TNF and Il-1
Endotoxin
response
antigenicity
vaccination
stability
Lipid A especially
activates MP: IL1-fever
TNF- fever, hemorrhagic tiss necrosis
NO: HoTN, shock
Alternative complement: C3a (HoTN, edema), C5a (N/Tchemotaxis)
Activates Hageman Factor: Coag Cascade-DIC
poorly antigentic
no toxoids formed and no vaccine available
stable at 100 deg C
Glycocalyx
mediates adherence to surfaces esp foreign surfaces like indwelling cats.
Polysaccharide
Only GP that has endotoxin
Listeria monocytogenes
Location of exotoxin (genetic)
plasmid or bacteriophage
location of endotoxin gene
bacterial Cr
Superantigen
Ag binds directly to MHCII and TCR activating lots of T cells t stim rls Il-1, Il-2
S. Aureus - TSST-1, tampons
S. pyogenes -scarlet fever SPE toxin, toxic shock like syndrome
ADP ribosylating
CD: inactivates EF-2 - pseudomembrane
V. Cholera: ADP ribosylation of G prot stim adenyl cyclase, incr pumping of Cl and H2O into gut - rice water diarrhea
E. Coli: Heat labile toxin stim adenylate cyclase (like cholera)-> watery diarrhea, heat stable toxin stim guanylate cyclase
BP: stim adenylate cyclase, whooping, inhibts chemokine rec causing LYMPHOCYTOSIS
A+B toxins
B binds to rec on surface enabling endocytosis.
A attaches an ADP-ribosyl to a host cell protein.
Corneybacterium Dipth
Vibrio Cholerae
E. Coli
Bordetella Pertussis
inhibition of EF-2
Corneybacterium Diptheria
Pseudomonas
double zone of hemolysis on blood agar
Clostridium perfringins
alpha toxin
C. Tetani
blocks rls of inhibitory glycine -> lockjaw
Bacillus Anthracis
adenylate cyclase toxin
S. Pyogenes
streptolysin O - hemolysin
antigen for ASO ab in rheumatic fever
Streptolysin O
ASO abs
Shigella exotoxin
shiga toxin (also made by E.COli)
cleaves host cell rRNA
enhances cytokine rls -> HUS
Neisseiria Fermenting patterns
Meningococci - Maltose, Glucose
Gonococci - Glucose
Pigment
S. Aureus
Pseudomonas
Serratia Marcescens
S. Aureus - yellow
Pseduomonas - blue green
Serratia - red
IgA proteases
(4)
allow for colonization of mucosal surfaces
S. Pneumonia, N. Meningitides, N. Gonorrhea, Haemophilus Influenza
Cough + silver stain
Legionella
Bordet-Gengou Potato auger
bordetella pertussis
tellurite plate
C. Diptheria
Lofflers Medium
C. Diptheria
Lowenstein Jensen Auger
M. Tuberculosis
Pink Colonies on MacConkey auger
Lactose fermenting enterics
Klebsiella, E. Coli, Enterobacter, Serratia, Citrobacter
Charcoal yeast extract agar buffered with incr iron and cystein
Legionella
Sabourauds Agar
Fungi
Silver stain
Legionella
Fungi
PCP
Giemsa stain (4)
Borrelia, plasmodium, trypanosomes, chlamydia
Ziehl Neelsen
acid fast bacteria
Tumbling motlity

Swarming motilit
Listeria monocytogenes

Proteus
repeated neisseria infection
C5 deficiency
Conjugation vs transduction vs transformation
conjugation - Chromasomal or plasmid transer -
Transduction - transferred via virus - any gene in generalized transduction, only certain genes in specialized
Transformation: purifed DNA taken up by cell.
Obligate Aerobes
Nagging Pests Must Breath
Nocardia
Pseudomonas
Mycobacterium TB
Bacillus
Obligate anaerobes
Clostridium
Actinomycetes
Bacteroides

Lack catalase or SOD - succeptible to oxidative damage
difficult to culture, produce gas in tiss
Obligate intracellular

Facultative intracellular
obligate: Chlamydia, Rickettsiae

facultative: Salmonella, Neisseria, Brucella, Myco TB, Legionella, Francisella, Listeria, Yersinia
Some Nasty Bugs May Live FacultativeLY
Encapsulated Bacteria
S. Pneumonia (Pneumovax)
N. Meningitides (thus vaccine- but none for Gonorrhea)
Haemophillus Flu (esp B)
Klebsiella
Polysaccharide capsule is an antiphagocytic virulence factor - IgG2 necessary for immune response.
beta hemolytic bacteria
S. Aureus
S. Pyogenes
S. Agalactiae
Listeria
Rheumatic Heart Dz
After infection from S. Pyogenes pharyngitis
Fever, Erythema Marginatum, Valvular damage (mitral>aorta>tricuspid), ESR, Red hot joints (polyarthritis), SubQ nodules, St Vitus Dance
Aschoff bodies (granuloma with giant cells)
Anitschkow cells(activated histiocytes)
Bacterial Endocarditis
FROM JANE
Complication:
Chordae rupture
Glomerunephritis
Suppurative pericarditis
Emboli
Tricuspid valve - IV drug abuse
Mitral Most Often
Fever, Roth spots, Osler nodes (raised lesions on pads), Murmur (new onset), Anemia, Nail Bed hemorrhage, Emboli
S. Aureus: Acute, large vegetations on b4 nl valves
Viridans Strep: Subacute- smaller vegetations on congenital abnl valves or dzed valves - dental procedures.
Can also be nonbacterial - from mets or renal failure (marantic/thrombotic)
Pericarditis
serous
fibrinous
hemorrhagic
Serous: SLE, RA, infection, uremia
Fibrinous: Uremia, MI, rheumatic fever
Hemorrhagic: TB, malignancy
EKG changes
diffuse ST elevations all leads
pulsus paradoxis
distant heart sounds
Bacteremia and endocarditis ass w/ colon cancer and other colon dz
Group D Strep Bovis
Protein A
Virulence factor
S. Aureus - binds Fc-IgG
inhibits complement fixation and phags
S. Pneumonia
most common cause of what?
Sensitive to what?
Group B - alpha hemolytic
Meningitis
Otitis Media
Pharyngitis
Sinusitis
Encapsulated, IgA protease
Optochin Sensitive
Ass with rusty sputum
sepsis in sickle cell
splenectomy
Enterococci
Group D
Pen G resistant
Subacute endocarditis, UTI
Beta prophage
encodes diptheria exotoxin
Inhibits prot synth via ADP ribosylation and EF2
metachromic granules
Actinomycetes vs Nocardia
Both are GPR - long branching filaments resembling Fungi
Actinomycetes: anaerobe, nl flora - PENICILLIN
Nocardia asteroides: acid fast aerobe in soil, pulm infection in IC - SULFA
Waterhouse friderichsen syndrome
N. Menigitides
Haemophilus Influenza
stx

treatment -prophylaxis
Capsular type B is more virulent
IgA protease, capsule
Tx meningitis with ceftriaxone
Rifampin prophylaxis if close contact
Enterobacteriaceae
E. Coli, Salmonella, Shigella, klebsiella, enterobacter, serratia, proteus
All have somatic O ag - endotox
Capsular - K ag is a virulence factor
H ag - flagella
All ferment glucose and are oxidase Negative
Salmonella vs Shigella
Both are nonlactose fermenters and oxidase neg
Salmonella is motile - can invade further and disseminate hematogenously - infection may be prolonged with abx - typical monocyte response
Shigella much more virulent
bloody diarrhea
Bugs causing food poisoning
Vibrio
Clostrium
Vibrio parahaemolyticus and vulnificus: contaminated seafood
Clostridium Perfringins: reheated meat products
C. Botulinum
Cleavage of host rRNA -
Shiga toxin
E. Coli
also enhances cytokine rls causing HUS
Causes of bloody diarrhea
Campy (oxidase +), Salmonella, shigella, EHEC, EIEC, C. Diff,
Yersinia: day care outbreaks, pseudoappendicitis
Entamoeba histolytica
Causes of watery diarrhea
Viruses: rotovirus, adenovirus, Norwalk virus
ETEC - no preformed toxin, travelers diarrhea
V. Cholerae: comma shaped
protozoa, C. Perfringens
Cholera vs Pertussis
Both ADP ribosylate - permanently activating adenyl Cyclase (incr cAMP)
Cholera: - perm activates Gs
Pertussis: perm inactivates Gi
also causes lymphocytosis by inhibiting lymphokine receptor
Legionella
culture
appearance - stain
treatment
charcoal yeast extract with iron and cystine
GNR, silver stain
Tx - erythromycin
Pseudomonas
dzs
toxin
tx
Aerobic GNR
Oxidase pos - lactose neg
Pneumonia -esp in CF, Burns and wounds
Sepsis: black eschar
Diabetic Osteomyelitis, UTI
External Otitis
Hot tub folliculitis
endotoxin
Exotoxin A - inactivates EF2
A/G + piperacillin/ticarcillin
Urease Positive
H. Pylori
Proteus
Brucella
Francisella
Pasteurella
Brucella: undulant fever, dairy, contact with animals
Francisella: tick bite: rabbits, deer
Pasteurella: cellulitis, animal bite: dogs, cats
Pleomorphic gram variable rod -
gardnerella vaginalis
clue cell
stinky greenish vaginal discharge
metronidazole
Leprosy
types, severity, treatment
sx
Acid fast baccili likes cool temp
Infects skin and superficial nerves
Lepromatous - si worse - failed CMI - leonine facies
Tuberculoid - is self-limited
treat with dapsone
Loss of eyebrows, nasal collapse, lumpy earlobes
Chlamydia
cell wall
infectious forms
3 types
tx
Obligate intracell
Cell wall peptidoglycan lacks muramic acid
Elementary body infects and is endocytosed.
Reticulate body multiplies in cell - reorganizes into EB.
EB rls and is extracellular infectious
C. Trachomatis: reactive arthritis, conjunctivitis, urethritis
C. Pneumonia, Psittaci - atypical pneumona
Tx - erythromycin, tetracycline
Chlamydial Trachomatis serotypes
A,B,C - chronic infections, blindness in africa
D-K - urethritis/PID, neonatal conjunctivitis + pneumonia
L1-L3 - lymphogranuloma venereum
Spirochetes
Spiral shaped bacteria with axial filaments
Leptospira, Treponema, Borrelia
Borrelia is large - only one visible by light microscopy
Borrelia Burgdorferi
what is it
sx
tx
Borrelia is large - only spirochete visible by light microscopy
Affects Joints, CNS- Bells Palsy, Heart
Tetracycline
Northeastern US
Stages: 1. erythema chronicum migrans, flulike 2. Neurologic and Cardiac block etc 3. AI migratory polyarthritis
Treponema Pertenue
Caues yaws (tropical infection that is not an STD - but is VDRL positive)
Syphillis
progression
1' painless chancre
2' Disseminated - condyloma lata, rash on palms and soles
3' , gummas, aortitis, neurosyphyllis - broad based ataxia, pos rhomberg, charcot jts, stroke w/out HTN
argyl robertson pupil - constricts with accomadation, but is not reactive to light
Congential syphillis
Symptoms
Saber Shins
saddle nose
deafness
FTA-ABS vs VDRL
FTA-ABS - positive earliest -
VDRL - if pos but FTA is neg - prob false pos
When VDRL is neg and FTA is pos - you have cleared infection
VDRL false Positive
Virus (mono, hepatitis)
Drugs
Rheumatic fever, RA
Lupus/leprosy
Only DNA virus that is non DsDNA
Parvovirus - ssDNA
smallest DNA virus
B19
Non linear DNA virus (2)
Papovirus - circular
Hepadnovirus - circular
Only non ssRNA virus
Segemented
Double icosahedral
Reovirus (CTF, rotovirus)
Naked RNA virus
Calcivirus - HEV, norwalk,
Picornavirus - polio, echo, rhino, coxsackie, HAV
Reovirus - CTF, roto
Salk/sabin vaccine
Poliovirus (picornavirus)
Herpangina
Coxackie - (picornavirus)
febrile pharyngitis
Naked DNA virus
Parvovirus, Adenovirus, Papovavirus
Enveloped DNA virus
Hepadnavirus, Poxvirus, herpes
Paramyxovirus
ss neg RNA enveloped helical
Parainfluenza - croup
RSV - tx ribvarin
Measles
Mumps
Filovirus
ss neg linear RNA, helical enveloped
Ebola/ marburg hemorrhagic fever
Corona virus
ss + RNA linear, helical enveloped
SARS -
coronavirus - common cold
Bunyavirus
ss neg RNA - helical enveloped
california encephalitis
sandfly/rift valley fever
crimean - congo hemorrhagic fever
Hantavirus - hemorrhagic fever, pneumona
Hantavirus
ss neg RNA - helical enveloped
bunyavirus
hemorrhagic fever, pneumona
HDV
delta virus
ss - RNA circ virs
helical enveloped
viral vaccines
live attenuated vs killed
LIve attenuated - generate CMI + humoral immunity - but can rarely infect - don't give to IC - MMR, VZV
Killed - only Humoral - but stable.
Egg based - flu, MMR, Yellow fever
Segmented virus
All RNA
Bunyavirus
Orthomyxo :influenza
Arenavirus
reovirus
Phenotypic mixing
Genome of virus A can be coated with the surface proteins of virus B
Type B protein coat determine the infectivity of the phenotypically mixed virus.
Progeny has type A coat and is encoded by its type A genetic material
Picornavirus
Naked ss +RNA
Polio
Echo
Rhino
Coxsacki
HAV
Rabies
rhabdovirus
enveloped ss-Linear- helical
Negri bodies
bullet shaped capsid
long incubation - wks to months
Arbovirus
Flavivirus: ss + RNA linear HCV, yellow fever, dengue, st. louis virus, west nile
Togavirus: rubella, eastern/western equine encephalitis
Bunyavirus: hantavirus, california encephalitis, snafly/rift valley fever, crimean -congo hemorrhagic fever
High fever, black vomit, jaundice
Councilman bodies in liver
Monkey or human reservoir
Yellow fever - flavivirus
transmitted by aedes mosquito
temporal lobe encephalitis
HSV-1
Positive heterophile antibody test
monospot test - heterophile abs detected by agglutination with sheep RBC
Atypical Lymphocytes
virion DNA dependent DNA polymerase
HBV
diagnosis of HBV
Incubation period: HBsAG
Prodrome-acute phase: HBsAg, anti-HBc IgM
Window phase: HBcAb
HIV
gp 41,120, 24
reverse transcriptase
retrovirus -diploid -RNA
reverse transcriptase: produces dsDNA from RNA - dsDNA integrates into host genome
gp41, gp120 - envelope prot
gp24 -nucleocapsid
CCR5 vs CXCRI mutations
CCR5 - homozygous -immunity
heterzygous - slower course
CXCR1 - rapid progression to AIDS
malignancy in AIDs
Kaposi
Nonhodgkins lymphoma - EBV
cervical cancer
Pneumonia
6wks - 18yrs
Viruses (RSV)
Mycoplasma
Chlamydia
S. Pneumona
Pneumonia
18-40
Mycoplasma
C. Pneumonia
S. Pneumonia
Pneumonia
40-65
S. Pneumonia
H. Flu
Anaerobes (aspiration)
Virus
Mycoplasma
Elderly
S. Pneumonia
virus
Anaerobes
H. Flu
GNR
Pneumonia in Alcoholic/IV drug user
S. Pneumonia, klebsiella, Staph
Osteomyelitis
most people
DM - drug addicts
Sickle Cell
Prosthesis
Most ppl - S. Aureus
DM-Druggies - Pseudomonas
Sickle Cell - salmonella
Prosthesis - S. Epidermidis, S. Aureus
Most common cause of UTI normal ppl

Hospitals
85% E. Coli
10% klebsiella

Hosptials: E. Coli, proteus, Klebsiella, serratia, pseudomonas
UTI
bugs
SSEEK PP
Leukocyte esterase (+) =bacterial
Nitrite(+) gram neg
Serratia
Staph Saphrophyticus
E. Coli
Enterobacter
Klebsiella
Proteus: swarming on agar, urase + - struvite stones
Pseudomonas
Urinary catherization UTI
E. Coli
Proteus Mirabilis
Ventilator infection
Pseudomonas
Abx - mechanisms
A/G
A/G: STANG -Cidal, inhibits formation of initiation complex - leads to misreading of mRNA, synergistic with beta lactams
must have O2 - to get in
Nephro/ototoxic, teratogenic
Mechanisms
Tetracyclines
Static - binds 30s and prevents attachment of aminoacyl-tRNA,
Dox: can be used in renal failure
Don't use with Milk, antacids
Vibrio cholera, Acne, chlamydia, ureaplasma urealyticum, mycoplasma pneumonia, tularemia, H. Pylori, borrelia, rickettsia
Macrolides
mechanism
erythromycin, azithromycin, clarithromycin
Blocks translocation, binds to 23s rRNA of 50s ribosomal subunit. Static
URI, STD
GPC, mycoplasma, legionella, chlamydia, neisseria
Acute cholestatic hepatitis, eosinophilia, incr theophyllines, oral anticoagulans
Chloramphenicol
mechanism
inhibits 50s peptidyltransferase - static
Meningitis -
Clindamycin
blocks peptide formation at 50s - static
anaerobes - above diagphragm
Sulfonamides
smx etc
PABA antimetabolites inhibit dihydropteroate synthase
static
G+, G-, Nocardia, Chlamydia,UTI
nephrotoxic, kernicterus in infants, displaces other drugs from albumin
Trimethoprim
inhibits DHFR
used with SMX causing sequential block of folate synth -for recurrent UTI
shigella, salmonella, PCP
megaloblastic anemia, leukopenia, granulocytopenia
F/Q
mech
enoxacin, nalidixic acid etc
inhibits DNA gyrase (topoII)
GNR of urinary and GI tracts
pseudomonas, neisseria,
Metronidazole
mech
Toxic metabolites
antiprotozoal, giardia, entamoeba, trichomonas, gardnerella vaginalis, anaerobes.
disulfirm rxn
Polymyxin
B, E
bind cell membranes and disrupt osmotic properties. Cationic basic prot act like detergents
Resistant GN infection
Neurotoxic, ATN
INH
decr synth of mycolic acids
Hemolysis if G6PD def, neurotoxic (give pyridoxine), hepatotoxic, SLE-like
Rifampin
Inhibits DNA dep RNA pol
TB, leprosy, meningococcal prophylaxis, H.FLU capsular B prophylaxis
Rapid resistance if used alone, red orange body fluids,inducer p450