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147 Cards in this Set
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Food poisoning within 2 hours of ingestion
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staph aureus
bacillus cereus N+V |
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Germ tube test
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candida
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felix weil test
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heterophile antibody test used for Rickettsial dz dx.
Depends on cross rxn btw rickettsial infections and OX strain of proteus vulgaris |
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Reovirus
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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 |
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Poxvirus
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Ds DNA - largest DNA virus
Enveloped not icosahedral - COMPLEX Doesn't replicate in nuc - in CYTO - bc carries own DNA dependent RNA p |
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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 |
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Ds DNA naked icosahedral virus
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Papovirus/polyomavirus: HPV
JC virus -progressive multifocal leukoencephalopathy adenovirus: febrile pharyngitis (sore throat), Pneumonia, conjunctivitis |
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ss DNA Naked virus
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parvovirus
B19 - aplastic crisis in sickle cell rash - erythema infectiosum (fifth dz)- hydrops fetalis |
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ssRNA segmented enveloped
helical virus |
Orthomyxovirus
Bunyavirus Arenavirus |
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ss neg sense RNA
bullet shaped helical virus |
Rhabdovirus
rabies |
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Helical Viridae (compared to icosahedral)
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must have an envelope
all RNA |
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ss pos sense RNA
enveloped diploid icosahedral |
retrovirus
HIV HTLV |
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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 |
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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 |
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ETEC
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travelers diarrhea
toxin that activates intestinal adenylate or guanylate cyclase overproduction of cAMP |
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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. |
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4 most important traits acquired through bacterial lysogeny
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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 |
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hypha with microconida and tuburculate macroconida
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histoplasma capsulatum
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cigar shaped yeasts
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sporothrix schenki
rose gardener dz |
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arthroconidia
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cocciodioides immitis - valley fever
mexico, sonoran desert, US |
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sporangiospores
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mucor rhizopus and absidia
nonseptate filamentous fungi |
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Transmitted by the phlebotamous sand fly
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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 |
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Viral envelope
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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 |
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RNA virus that replicates in the nucleus
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Orthomyxovirus: Influenza virus
retrovirus: HIV, HTLV |
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only DNA virus that replicates in the cytoplasm
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Poxvirus
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Cold agglutinins
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IgM
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cauliflower lesions
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Blastomycosis
broad based budding yeasts |
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Diploclinic acid
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spores
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Teichoic acid response
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TNF and Il-1
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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 |
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Glycocalyx
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mediates adherence to surfaces esp foreign surfaces like indwelling cats.
Polysaccharide |
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Only GP that has endotoxin
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Listeria monocytogenes
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Location of exotoxin (genetic)
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plasmid or bacteriophage
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location of endotoxin gene
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bacterial Cr
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Superantigen
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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 |
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ADP ribosylating
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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 |
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inhibition of EF-2
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Corneybacterium Diptheria
Pseudomonas |
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double zone of hemolysis on blood agar
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Clostridium perfringins
alpha toxin |
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C. Tetani
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blocks rls of inhibitory glycine -> lockjaw
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Bacillus Anthracis
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adenylate cyclase toxin
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S. Pyogenes
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streptolysin O - hemolysin
antigen for ASO ab in rheumatic fever |
Streptolysin O
ASO abs |
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Shigella exotoxin
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shiga toxin (also made by E.COli)
cleaves host cell rRNA enhances cytokine rls -> HUS |
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Neisseiria Fermenting patterns
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Meningococci - Maltose, Glucose
Gonococci - Glucose |
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Pigment
S. Aureus Pseudomonas Serratia Marcescens |
S. Aureus - yellow
Pseduomonas - blue green Serratia - red |
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IgA proteases
(4) |
allow for colonization of mucosal surfaces
S. Pneumonia, N. Meningitides, N. Gonorrhea, Haemophilus Influenza |
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Cough + silver stain
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Legionella
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Bordet-Gengou Potato auger
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bordetella pertussis
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tellurite plate
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C. Diptheria
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Lofflers Medium
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C. Diptheria
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Lowenstein Jensen Auger
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M. Tuberculosis
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Pink Colonies on MacConkey auger
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Lactose fermenting enterics
Klebsiella, E. Coli, Enterobacter, Serratia, Citrobacter |
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Charcoal yeast extract agar buffered with incr iron and cystein
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Legionella
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Sabourauds Agar
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Fungi
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Silver stain
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Legionella
Fungi PCP |
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Giemsa stain (4)
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Borrelia, plasmodium, trypanosomes, chlamydia
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Ziehl Neelsen
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acid fast bacteria
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Tumbling motlity
Swarming motilit |
Listeria monocytogenes
Proteus |
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repeated neisseria infection
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C5 deficiency
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Conjugation vs transduction vs transformation
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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. |
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Obligate Aerobes
Nagging Pests Must Breath |
Nocardia
Pseudomonas Mycobacterium TB Bacillus |
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Obligate anaerobes
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Clostridium
Actinomycetes Bacteroides Lack catalase or SOD - succeptible to oxidative damage difficult to culture, produce gas in tiss |
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Obligate intracellular
Facultative intracellular |
obligate: Chlamydia, Rickettsiae
facultative: Salmonella, Neisseria, Brucella, Myco TB, Legionella, Francisella, Listeria, Yersinia |
Some Nasty Bugs May Live FacultativeLY
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Encapsulated Bacteria
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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. |
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beta hemolytic bacteria
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S. Aureus
S. Pyogenes S. Agalactiae Listeria |
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Rheumatic Heart Dz
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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) |
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Bacterial Endocarditis
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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) |
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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 |
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Bacteremia and endocarditis ass w/ colon cancer and other colon dz
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Group D Strep Bovis
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Protein A
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Virulence factor
S. Aureus - binds Fc-IgG inhibits complement fixation and phags |
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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 |
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Enterococci
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Group D
Pen G resistant Subacute endocarditis, UTI |
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Beta prophage
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encodes diptheria exotoxin
Inhibits prot synth via ADP ribosylation and EF2 metachromic granules |
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Actinomycetes vs Nocardia
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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 |
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Waterhouse friderichsen syndrome
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N. Menigitides
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Haemophilus Influenza
stx treatment -prophylaxis |
Capsular type B is more virulent
IgA protease, capsule Tx meningitis with ceftriaxone Rifampin prophylaxis if close contact |
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Enterobacteriaceae
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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 |
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Salmonella vs Shigella
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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
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Bugs causing food poisoning
Vibrio Clostrium |
Vibrio parahaemolyticus and vulnificus: contaminated seafood
Clostridium Perfringins: reheated meat products C. Botulinum |
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Cleavage of host rRNA -
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Shiga toxin
E. Coli also enhances cytokine rls causing HUS |
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Causes of bloody diarrhea
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Campy (oxidase +), Salmonella, shigella, EHEC, EIEC, C. Diff,
Yersinia: day care outbreaks, pseudoappendicitis Entamoeba histolytica |
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Causes of watery diarrhea
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Viruses: rotovirus, adenovirus, Norwalk virus
ETEC - no preformed toxin, travelers diarrhea V. Cholerae: comma shaped protozoa, C. Perfringens |
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Cholera vs Pertussis
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Both ADP ribosylate - permanently activating adenyl Cyclase (incr cAMP)
Cholera: - perm activates Gs Pertussis: perm inactivates Gi also causes lymphocytosis by inhibiting lymphokine receptor |
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Legionella
culture appearance - stain treatment |
charcoal yeast extract with iron and cystine
GNR, silver stain Tx - erythromycin |
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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 |
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Urease Positive
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H. Pylori
Proteus |
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Brucella
Francisella Pasteurella |
Brucella: undulant fever, dairy, contact with animals
Francisella: tick bite: rabbits, deer Pasteurella: cellulitis, animal bite: dogs, cats |
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Pleomorphic gram variable rod -
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gardnerella vaginalis
clue cell stinky greenish vaginal discharge metronidazole |
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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 |
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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 |
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Chlamydial Trachomatis serotypes
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A,B,C - chronic infections, blindness in africa
D-K - urethritis/PID, neonatal conjunctivitis + pneumonia L1-L3 - lymphogranuloma venereum |
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Spirochetes
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Spiral shaped bacteria with axial filaments
Leptospira, Treponema, Borrelia Borrelia is large - only one visible by light microscopy |
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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 |
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Treponema Pertenue
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Caues yaws (tropical infection that is not an STD - but is VDRL positive)
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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 |
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Congential syphillis
Symptoms |
Saber Shins
saddle nose deafness |
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FTA-ABS vs VDRL
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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 |
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VDRL false Positive
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Virus (mono, hepatitis)
Drugs Rheumatic fever, RA Lupus/leprosy |
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Only DNA virus that is non DsDNA
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Parvovirus - ssDNA
smallest DNA virus B19 |
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Non linear DNA virus (2)
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Papovirus - circular
Hepadnovirus - circular |
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Only non ssRNA virus
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Segemented
Double icosahedral Reovirus (CTF, rotovirus) |
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Naked RNA virus
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Calcivirus - HEV, norwalk,
Picornavirus - polio, echo, rhino, coxsackie, HAV Reovirus - CTF, roto |
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Salk/sabin vaccine
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Poliovirus (picornavirus)
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Herpangina
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Coxackie - (picornavirus)
febrile pharyngitis |
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Naked DNA virus
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Parvovirus, Adenovirus, Papovavirus
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Enveloped DNA virus
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Hepadnavirus, Poxvirus, herpes
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Paramyxovirus
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ss neg RNA enveloped helical
Parainfluenza - croup RSV - tx ribvarin Measles Mumps |
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Filovirus
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ss neg linear RNA, helical enveloped
Ebola/ marburg hemorrhagic fever |
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Corona virus
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ss + RNA linear, helical enveloped
SARS - coronavirus - common cold |
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Bunyavirus
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ss neg RNA - helical enveloped
california encephalitis sandfly/rift valley fever crimean - congo hemorrhagic fever Hantavirus - hemorrhagic fever, pneumona |
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Hantavirus
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ss neg RNA - helical enveloped
bunyavirus hemorrhagic fever, pneumona |
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HDV
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delta virus
ss - RNA circ virs helical enveloped |
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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 |
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Segmented virus
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All RNA
Bunyavirus Orthomyxo :influenza Arenavirus reovirus |
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Phenotypic mixing
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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 |
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Picornavirus
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Naked ss +RNA
Polio Echo Rhino Coxsacki HAV |
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Rabies
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rhabdovirus
enveloped ss-Linear- helical Negri bodies bullet shaped capsid long incubation - wks to months |
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Arbovirus
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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 |
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High fever, black vomit, jaundice
Councilman bodies in liver Monkey or human reservoir |
Yellow fever - flavivirus
transmitted by aedes mosquito |
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temporal lobe encephalitis
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HSV-1
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Positive heterophile antibody test
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monospot test - heterophile abs detected by agglutination with sheep RBC
Atypical Lymphocytes |
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virion DNA dependent DNA polymerase
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HBV
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diagnosis of HBV
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Incubation period: HBsAG
Prodrome-acute phase: HBsAg, anti-HBc IgM Window phase: HBcAb |
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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 |
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CCR5 vs CXCRI mutations
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CCR5 - homozygous -immunity
heterzygous - slower course CXCR1 - rapid progression to AIDS |
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malignancy in AIDs
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Kaposi
Nonhodgkins lymphoma - EBV cervical cancer |
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Pneumonia
6wks - 18yrs |
Viruses (RSV)
Mycoplasma Chlamydia S. Pneumona |
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Pneumonia
18-40 |
Mycoplasma
C. Pneumonia S. Pneumonia |
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Pneumonia
40-65 |
S. Pneumonia
H. Flu Anaerobes (aspiration) Virus Mycoplasma |
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Elderly
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S. Pneumonia
virus Anaerobes H. Flu GNR |
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Pneumonia in Alcoholic/IV drug user
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S. Pneumonia, klebsiella, Staph
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Osteomyelitis
most people DM - drug addicts Sickle Cell Prosthesis |
Most ppl - S. Aureus
DM-Druggies - Pseudomonas Sickle Cell - salmonella Prosthesis - S. Epidermidis, S. Aureus |
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Most common cause of UTI normal ppl
Hospitals |
85% E. Coli
10% klebsiella Hosptials: E. Coli, proteus, Klebsiella, serratia, pseudomonas |
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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 |
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Urinary catherization UTI
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E. Coli
Proteus Mirabilis |
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Ventilator infection
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Pseudomonas
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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 |
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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 |
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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 |
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Chloramphenicol
mechanism |
inhibits 50s peptidyltransferase - static
Meningitis - |
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Clindamycin
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blocks peptide formation at 50s - static
anaerobes - above diagphragm |
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Sulfonamides
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smx etc
PABA antimetabolites inhibit dihydropteroate synthase static G+, G-, Nocardia, Chlamydia,UTI nephrotoxic, kernicterus in infants, displaces other drugs from albumin |
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Trimethoprim
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inhibits DHFR
used with SMX causing sequential block of folate synth -for recurrent UTI shigella, salmonella, PCP megaloblastic anemia, leukopenia, granulocytopenia |
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F/Q
mech |
enoxacin, nalidixic acid etc
inhibits DNA gyrase (topoII) GNR of urinary and GI tracts pseudomonas, neisseria, |
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Metronidazole
mech |
Toxic metabolites
antiprotozoal, giardia, entamoeba, trichomonas, gardnerella vaginalis, anaerobes. disulfirm rxn |
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Polymyxin
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B, E
bind cell membranes and disrupt osmotic properties. Cationic basic prot act like detergents Resistant GN infection Neurotoxic, ATN |
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INH
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decr synth of mycolic acids
Hemolysis if G6PD def, neurotoxic (give pyridoxine), hepatotoxic, SLE-like |
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Rifampin
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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 |
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