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201 Cards in this Set
- Front
- Back
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Gram -
Bacilli Strict Anaerobe Liver Abscess What is it and how did it get there? |
Bacteroides Fragilis
ruptured intestinal mucosa (trauma, Sx, perf.) |
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Makes Vit K for Host
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Bacteroides Fragilis
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Type B Polysaccharide capsule
Coccobacilli pleomorphic |
H Influenza Type B
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Fruiting body, narrow angled, branching septate hyphae
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Aspergillus Fumigatus
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Fungus ball that develops in preexisitng hypersensitivity reactions
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aspergillus fumigatus
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Vessel invading fungi with hemorrhagic infarctions and a necrotizing bronchopneumonia
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aspergillus fumigatus
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Wide angled hyphae without septa
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mucor spcies
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vessel invades that produces hemorrhagic infarcts in the lung
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mucor
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diabetic with a fungus.
what is it and where does it invadE? |
rhinocerebral mucormycosis
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spherules with endospores in tissue, increased after California earthquakes
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Coccidioides immitus ("Valley Fever")
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erythema nodosum, granulomatous inflammation with caseous necrosis
Fungi of California |
coccidioides
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most common systemic fungal infection
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Histoplasma Capsulatum
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endemic in Ohio, Center Mississippi River valleys; inhalation of microconidia in dust
Bats, starlings, chickens |
Histoplasma Capsulatum
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Granulomatous inflammation with caseous necrosis
Yeast forms in Macs Simulates TB lung Disease Produces Coin Lesions, consolidation, miliary spread, and cavitation |
Histoplasmosis Capsulatum
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Marked dystrophic calification of granulomas in lung, multiple calcifications in spleen
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Histoplasmosis Capsulatum
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Broad-based buds and nuclei
Occurs in Great Lakes region and southeastern United States |
blastomcyes dermatitidis
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Cysts and trophozoites present, cysts attach to type I Pneumocytes, primarily an opportunistic infection
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pneumocystic jiroveci
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At what CD4 Cell count does pneumocystic jiroveci infect?
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CD4 < 200
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signs and symptoms of pneumocystic jiroveci infection
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fever, dyspnea, severe hypoxemia; diffuse intra-alveolar foamy exudates with cup-shaped cysts
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to visualize Pneumocystis Jiroveci
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silver / Giemsa Stains
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Treatment for P. Jiroveci
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TMP/ SMX (given prophylactically when CD4 count < 200.
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most common cause of common cold
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rhinovirus
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viral cause of atypical pneumonia and bronchiolitis (wheezing) in children
occurs in late fall/ winter |
respiratory synctial virus
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Croup causing in infants
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parainfluenza
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inspiratory stridor (upper airway obstruction) due to submucosal edema in trachea
Anterior X-ray showing "steeple sign" in trachea |
Parainfluenza
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Common pneumonia in immunocompromised host
Enlarged alveolar macs/ pneumocytes |
CMV
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Type A virus mostly involved
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Influenzavirus
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HA bings virus to cell receptor in nasal passages
NA dissolves mucus and facilitates release of viral particles |
Influenza virus
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common superinfection of influenza virus
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staph aureus
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Fever, cough, conjunctivitis, excessive nasal mucus production
Koplik spots in mouth precede onset of the rash |
Rubeola Virus (measles)
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Characteristic finding in Rubeola (measles virus)
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Warthin-Finkeldey multinucleated giant cells are a characteristic finding
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Lower respiratory tract and then spreads systematically to produce severe respiratory infection
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SARS
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Civets
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SARS
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Dx of SARS
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viral detection by PCR or detection with Ab
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2nd most common cause of atypical pneumonia
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Chlamydia Pneumoniae
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newborn pneumonia (birth canal)
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Chlamydia Trachomatis
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Afebrile, staccato cough (choppy cough), conjunctivitis, wheezing
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Chlamydia Trachomatis
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dairy farmers, veterinarians
associated with the birthing of infected sheep, cattle, and goats, handling of milk |
coxiella burnetti
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atypical pneumonia, myocarditis, granulomatous hepatitis
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coxiella burnetti
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bullous myringitis, cold autoimmune hemolytic anemia due to anti-IgM Ab
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Mycoplasma pneumonia
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Gram + Lancet Shaped
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Step Pneumoniae
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common bacterial infection superimposed on influenza pneumoniae and measles pneumonia
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staph aureus
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major lung pathogen in IV drug users / CF patients
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S. Aureus
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hemorrhagic pulmonary edema, abscess, tension pneumatocyst (intrapleural blebs) which can rupture to form tension pneumo
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staph aureus
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describe the bug:
corynebacterium diptheriae |
gram positive rod
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how does corynebactierum dipheriae work?
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toxin inhibits protein synthesis by ADP ribosylation of EF-2 involved in protein synthesis; toxin impairs B-oxidation of fatty acids in heart
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toxin induced pseudomembranous inflammation produces shaggy gray membranes in the oropharyn and trachea
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c. diptheriae
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sinusitis, otitis media, conjunctivitis (pink eye)
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h. influenza
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inspiratory stridor due to acute epiglottitis
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h. influenza
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thumbprint sign on lateral x-ray
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h. influenza causing epiglottitis
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most common bacterial cause of acute exacerbation of COPD
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h. influenza
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typical pneumonia, especially in elderly
gram - diplococcus |
moraxella catarrhalis
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green sputum (pyocyanin)
gram - rod |
pseudomonas aeruginosa
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water-loving bacteria most often transmitted by respirators
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pseudomonas aeruginosa
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most common cause of nosocomial pneumonia and death due to pneumonia in cystic fibrosis
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p. aeruginosa
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pneumonia often associated iwth infarction due to vessel invasion
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pseudomonas aeruginosa
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gram - rod ID by IF stain or Dieterle silver stain
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Legionella pneumophilia
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antigens of this gram - rod bacteria can be detected in urine
it causes pneumonia |
legionella pneumophilia
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water lover bacteria (water coolers, mists in grocery stores, outdoor restaurants in summer, rain forests in zoos)
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legionella pneumophilia
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pneumonia associated with high fever, dry cough, flu-like symptoms - water loving bacteria
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legionella
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tubulointerstitial disase with destruction of the JGA leading to hyporeninemic hypoaldosteronism
(type IV RTA - hyponatremia, hyperkalemia, met. acidosis) |
legionella
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narrow based buds, surrounded by a THICK capsule
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cryptococcus neoformans
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found in pigeon excreta
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cryptococcus neoformans
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fruiting body and narrow-angled (45 degrees) branching septat hyphae
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aspergillus fumigatus
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fungus ball that develops in TB cavity
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aspergillus
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vessel invader with hemorrhagic infarctions and necrotizing bronchopneumonia
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aspergillus fumigatus
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Increased IgE in lungs, eosinophilia, intense inflammation of airways and mucus plugs in terminal bronchioles FUNGUS
can cause bronchiesctasis, interstitual lung disease |
aspergillus fumigatus
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wide angled hyphae without septa
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mucor
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who gets mucor infections?
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immunocompromised, mucor
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what lobe of the brain does the diabetic fungus invade?
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mucor infects the FRONTAL lobe
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spherules with endospores in tissue, inhaling arthrospores in dust
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coccidiodes immitis
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what on bacterial cell wall/cell membrane induced TNF and Il-1
(Gram +) |
Techoic Acid
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What on outer membrane of gram - induces TNF and Il-1
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Lipid A
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what makes up a bacterial capsule?
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polysaccharide
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what makes up the capsule of bacillus anhracis?
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Not polysaccharide, it is D- glutamate
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what is a spores chemical composition?
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keratin like coat; dipicolinic acid
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name the Gram + rod (bacillus) (5 of them)
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clostridium
corynebacterium bacillus listeria mycobacterium |
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Branching filamentous gram + organisms
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Acinomyces
Nocardia (weakly acid fast) |
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what are the pleomorphic gram - bacteria?
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rickettsiae
Chlamydia (giemsa) |
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Name the spirochetes.
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Gram -
Leptospira borrelia (Giemsa) Treponema |
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What makes up mycoplasma's cell membrane?
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Sterols (has no cell wall)
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what makes up the cell wall for mycobacterium?
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has mycolic acid. High lipid content makes it hard to gram stain
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what type of agglutins does mycoplasma make?
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cold agglutinates to human RBC
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Name some bugs that don't gram stain well (6)
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treponema (too thin, need darkfield microscopy)
Rickettsia (intracellular parasite) Mycobacteria (high lipid content req. acid fast stain) Legionella pneumophilia (primarily intracellelar, stain with silver stain) Chlamydia (intracellular parasite that lacks muramic acid) |
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Giema Stain
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Borrelia, Plasmodium, Trypanosomes, Chlamydia
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PAS Staining organisms
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Stains glycogen, mucopolysaccharides
Used to dx Whipple's disease |
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Ziehl- Neelsen stains what?
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Acid fast bacteria. Thinkin TB!
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India Ink stains what?
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cryptococcus neoformans
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Silver Stain stains what?
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Fungi, legionella
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What grows on Chocolate agar with factors V (nad) and X (hematin)?
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H. Influenza
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What grows on Thayer-martin media?
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N. Gonorrhoeae
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What grows on Bordet-Gengou (potato) agar?
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B. pertussis
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What grows on tellurite place?
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Clostridium diptheriae
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What grows on loffler's media?
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clostridium diptheriae
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What grows on Lowenstein-Jensen agar?
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mycobacterium TB
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What grows on Eosin-methylene blue (EMB) agar
forms blue-black colonies with green metallic sheen) |
E. Coli
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What grows pink on MacConkey's agar?
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Lactose-fermenting enterics
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What grows on Charcoal yeast extract agar buggered with iron and cysteine?
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Legionella
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What grows on Sabouraud's agar?
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Fungi
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Name 4 OBLIGATE aerobes.
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Pseudomonas
Nocardia Mycobacterium Tuberculosis Bacillus |
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Name 3 OBLIGATE Anaerobes
and why are they obligate anaerobes? |
Clostridium
Bacteriodes Actinomyces they lack catalase and/or superoxide dismutase -foul smelling, produce gas in tissue (CO2 and H2) |
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Name 2 intracellular bugs.
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Ricketssia
Chlamydia |
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Name some faculatative intracellular organisms
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Salmonella
Neisierria Brucella Mycobacterium Listeria Francisella Legionella Yersinia |
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Some Nasty Bugs May Live FacultativeLY
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Shigella
Neisseria Brucella Mycobacterium Listeria Francisella Legionella Yersenia |
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Positive quellung reaction = ?
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positive for capsule
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examples of encapsulated bacteria
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step pneumoniae
Neisseria Meningitidis Haemophilus influenzae Klebsiella Pneumoniae |
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Urease Positive Bugs
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Proteus
Klebsiella H. Pylori Ureaplasma Some Kinds Have Urease |
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yellow pigment is related to what bacteria?
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staph aureus
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Blue-green pigment is related to what organisms?
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Pseudomonas aeruginosa
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Red pigment is related to what bacteria?
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Serratia Marcescens
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Virulence Factor of Stap Aureus
Name it and what does it do? |
Protein A - binds Fc region of Ig.
Disrupts opsonization and phagocytosis |
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Name 3 bugs with an IgA protease.
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S. Pneumoniae
H. Influenzae Neisseria these bugs are also protected by thier polysaccharide capsule |
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Name the thing in Group A Strep (strep pyogenes) that prevents phagocytosis.
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M Protein
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Endotoxin of gram - bacteria does what to macs?
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IL-1 --> fever
TNF --> fever, hemorrhagic tissue necrosis NO --> hypotension, shock |
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Endotoxin of gram - activates coagulation cascade/ DIC by activating what?
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Hageman factor
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When does spore formation of a bacteria take place?
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during the stationary phase of growth
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Transformation is...
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DNA taken up DIRECTLYfrom environment by competent prokaryotic and eukaryotic cells
can occur after cell lysis releases a bunch of DNA |
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Hfr is what?
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Bacterial plasmid incorporated into bacterial chromosomal DNA; may include some flanking chromosomal DNA --> transfer of plasmid and chromosomal genes
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Generalized Transduction
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LYTIC phage infects bacterium, cleaves up bacterial DNA, synthesizes viral proteins;
part of bacterial DNA may be incorporated into virus --> transfer when virus infects another cell |
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Specialized transduction
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LYSOGENIC phage infects bacterium; incorporates viral DNA into bacterial chromosomal DNA. When phage DNA excised, may take some flanking bacterial genes with it.
DNA packaged into phage viral capsid and can infect another bacterium |
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Transposition
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segment of DNA that can "jump" (excision and reincorporation) fmor one location to another
Can transfer genes form plasmid to chromosome and vice versa excision may include some flanking DNA |
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genes for the following 5 bacterial toxins encoded in a lysogenic phage
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ABCDE
ShigA- like toxin Botulinum toxin (certain strains) Cholera toxin Diphtheria toxin Erythrogenic toxin of step pyogenes |
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alpha hemolytic gram +
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S. Pneumoniae (optochin sensitive, bile soluble, encapsulated)
Viridans Steptococcus (no capsule, optochin resistant, not bile soluble) |
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B Hemolysis
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Group A = strep pyogenes (bacitracin sensitive)
Group B = strep agalactiae (bacitracian sensitive) Group B = Strep agalactiiae |
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Gamma Hemolytic
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Enterococcus (E. Faecalis)
Peptosteptococcus |
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Coagulase -, Novobiocin Sensitive
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Staph epidermidis
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Coagulase -, Novobiocin resistant
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Staph saprophyticus
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on the office Staph Retreat, there was No StRES
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Novobiocin - Saprrophyticus Resistant
Epidermidis Sensitive |
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OVRPS
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optochin - veridans resistant
pneumoniae sensitive |
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B-BRAS
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Bacitracin - Group B (Strep Agalactiae) Resistant
Group A (Strep Pyogenes) sensitive |
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Enterococcus Faecalis
what does it grow in and name 3 infections of it |
grows in 40% Bile, grows in 6.5% NaCl
UTI (nosocomial) biliary tract infections |
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B hemolytic bacteria (4; 2 step and 1 Staph, and another)
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clear ring of hemolysis
Staph Aureus Strep Pyogenes Step. Agalactiae Listeria Monocytogenes |
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tumbling motility, meningitis in newborns, unpasteurized milk
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listeria monocytogenes
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What degrades H202?
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Catalase
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name the organism that causes:
a skin infection, organ abscesses, and pneumoniae |
Staph Aureus
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name the organism:
seperation of the skin between the granulosum and spinosum; presents with easily ruptured fluid filled blisters |
Staph Aureus causing scalded skin syndrome
Toxic Shock Syndrome - TSST-1 toxin |
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What is TSST
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superantigen that binds to MHC II and T-cell receptor, resulting in POLYCLONAL T-cell activation
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What are 4 things that strep pneumoniae is the most common cause of?
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MOPS
Meningitis Otitis media Pneumonia Sinusitis |
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Name the virulence factor for strep pneumoniae
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IgA protease
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what gives you a rusty sputum?
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step pneumoniae infection
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what cases sepsis in sickle cell anemia?
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step pneumoniae
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Gram - bacteria, bacilli, strict anaerobe, normal GI flora
GI / Pelvic abscesses |
BActeroides Fragiles
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Large capsule, inactive LPS that does not cause shock, introduced through trauma, sx, perforation from normal GI flora
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Bacteroides Fragiles
catalase +, superoxide dismutase + |
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Only gram - without typical endotoxin
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Bacteroides
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1 year old with fever, becomes drowsy (drools)
PE: neck rigidity, seizures needs Hemin and NAD to grow |
H. Influenza
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cause of epiglottis, otitis media, pneumonia
systemic- meningitis, septic arthritis, cellulitis |
H. Influenza type B
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67 y.o., smoker
Fever, loss of appetite, HA, chest pain, dry cough watery diarrhea nodular infiltrates on chest X-ray |
Legionella Pneumophilia
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pontiac fever
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flu like illness lasting 2-5 days with Legionelle infection
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Visualizing Legionella
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gram stains poorly, do a silver stain
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Most common causes of atypical pneumonia
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Mycoplasma
Legionella Chlamydia Viruses |
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infant born in rural area, severe coughing
strong characteristic cough, green phlegm, no vaccines |
Bordetella Pertusis
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how does pertussis bind to respiratory epithelium?
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filamentous hemagglutinin (which release enterotoxins)
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Tell me about the toxin: pertussis toxin
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AB toxin; ADP ribosylates and inactivates Gi proteins--> increase in cAMP, lymphocytosis, decrease phagocytosis
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fever that peaks after dinner, fatigue, spinal tenderness, loss of appetite, lymphadenopathy
Goat Cheese |
Brucella
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rising fever that climbs during the day and declines at night
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Undulating fever; seen with Brucella
most commonly associated with eating Goat Cheese |
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What does Brucella cause?
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granulomas and abscess formation, osteomyelitis
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Pleomorphic, black ulcers (erythematous, tender), ipsilateral lymphadenopathy
Tick bite at rabbit farm |
Francisella Tularemias
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What does Francisella require for growth?
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cysteine
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How is francisella transmitted?
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human by tickets, lice, or mites
most cases occur in Arkansas, Oklahoma, Missouri |
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How do you Dx francisella?
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Skin test (DTH Response)
serology cultures has a live attenuated virus vaccine |
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young girl, bitten by cat--> redness, heat, induration and tenderness
local lymphadenopathy Gram - coccobacilli with bipolar staining |
Pasteurella - causes cellulitis, osteomyelitis after dog/cat bites
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normal flora to dog/cat mouth, causes inflammatory response on bite --> cellulitis and osteomyelitis
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PAsteurella (p.s. don't suture the wound)
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What are common causes toxic shock syndrome?
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tampon use, trauma/surgery introducing bacteria
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skin/wound infection in neonates causes local epidermal infection that causes skin exfoliation (epidermis separates and sloughs off)
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Scalded Skin syndrome
S. Aureus released a toxin |
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Ritter Syndrome
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severe scalded syndrome when s. aureus infects umbilicus
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prosthetic heart valve develops endocarditis. What is most likely to have caused it?
What is it if it develops 60 days post replacement? |
Staph epidermidis
strep viridans |
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Yellow crusts are characteristic of what bacteria?
|
Strep Pyogenes
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Fever, "sandpaper" rash (begins on trunk and spreads outward), "strawberry tongue" within 2 days, desquamation of palms and soles after rash subsides
previous sore throat |
Scarlet fever, seen with Strep Pyogenes
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Skin infections of Strep Pyogenes can cause what two complications?
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1. Toxic Shock Syndrome
2. Post-streptococcal Glomerulonephritis |
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Name three presentations for Enterococcus Faecalis.
|
UTI
Biliary Tract Infection Subacute Bacterial endocarditis |
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What drug are all enteroccus faecalis resistant to?
|
they are all resistant to cephalosporins
some are also resistant to vancomycin |
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Where does Staph Intermedius often colonize and why?
|
thrive in LOW OXYGEN areas such as Brain/ liver
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Name the two toxins that B. Cereus has and how it works.
|
Heat-stable enterotoxin--> N/ V
Heat-labile enterotoxin (AB5 toxin)--> Increase cAMP and decrease reabsorption o NaCl-->diarrhea |
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Name the three components of Anthrax's toxin.
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Protective Antigen (binds cell membrane and mediates entry of EF and LF)
EF - increase cAMP--> edema, non-fx PMN LF- cell death |
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What is special about B. Anthracis capsule and what is it made of?
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B. Anthracis is the only bacteria with a protein capsule; made of poly-D glutamic acid
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What does Clostridium Tetani do to neurotransmitters?
|
Blocks release of inhibitory GABA and glycine from Renshaw cells interneurons
causes spastic paralysis |
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What does Clostridium Tetani look like?
|
Like a TENNIS RACKET! contains a terminal spore
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How does Clostridium Tetani travel?
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It travels retrogradely in axons and in the bloodstream
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What is the characteristic distribution of paralysis seen in clostridium botulinum?
|
Decscending paralysis, starting at the head and going to etremities
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What does toxin A do in clostridium difficile?
What does toxin B do? |
Toxin A - causes watery diarrhea
Toxin B - causes pseudomembrane formation |
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how do you treat clostridium difficile?
|
oral metronidazole or oral vancomycin (they are not absorbed, work on intestinal bacteria)
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Name three things that clostridium perfringers causes?
|
cellulitis
gas gangrene food poisoning |
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what toxin causes the muscle cell necrosis in clostridium perfringens?
|
the ALPHA toxin (lecithinase)
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What is characteristic of listeria monocytogenes?
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Tumbling motility
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What do newborns get when they are infected with Listeria on the way out?
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Disseminated abscesses
Meningitis |
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How do you distinguish L. Monocytogenes from B hemolytic Streptococco?
|
L monocytogenes is Catalase +
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Name two organisms that are Catalse Positive.
|
Listeria Monocytogenes
Staph |
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Gram + rod with "Chinese letter" appearance
What is it and what media do you grow it on? |
Corynebacerium diptheriae
grown on Tellurite medium |
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What don't you do to the pseudomembranes of Corynebacterium diphtheriae?
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it may cause bleeding and toxin spread
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How is diptheriae toxin carried?
|
It's carried by a phage, so only LYSOGENIC organisms cause system disease
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How is actinomyces israelli diagnosed?
|
filamentous branching, LACK OF ACID-FAST STAINING, SULFUR GRANULES
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How do you distinguish Actinomyces from Nocardia (two ways)?
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Actinomyces does not have ACID FAST staining, while Nocardia does
Actinomyces - Obligate anaerobe and has sulfur granules Nocardia - Obligate Aerobe |
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Where are the abscesses of nocardia found?
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Kidney and Brain
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What disease does nocardia cause and in who?
|
it causes PNEUMONIA in IMMUNOCOMPROMISED
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where is nocardia found?
|
in the soil
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what allows nocardia to survive intracellularly?
|
it has a mycolic acid cell wall
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How do you distinguish Nocardia and Mycoplasma?
|
Both are acid fast organisms due to mycolic acid
however, Nocardia has BEADED, FILAMENTOUS GROWTH |
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What is the classic triad seen in Wiskott Aldrich syndrome?
|
pyogenic infections
Thrombocytopenic purpura Eczema WIPE -Wiskott -Infections -Purpura -Eczema |
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What is the defect in Wiskott alrdrich?
|
X linked defect in the ability to mount IgM response to encapsulated bacteria
cytoskeletal defect |
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What is the classic triad seen in Wiskott Aldrich syndrome?
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pyogenic infections
Thrombocytopenic purpura Eczema WIPE -Wiskott -Infections -Purpura -Eczema |
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What is the defect in Wiskott alrdrich?
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X linked defect in the ability to mount IgM response to encapsulated bacteria
cytoskeletal defect |
