Fa - Micro Part 2

Front 1

Actinomyces is an ANaerobe; Nocardia =

Back 1

aerobe and is acid-fast staining

Front 2

What are the 4 major groups of GP rods?

Back 2

Clostridium

Listeria

Bacillus

Corynebacterium

Front 3

Which are the non-hemolytic (y) streptococci (2 groups)? How are they differentiated?

Back 3

Enterococcus (think E. faecalis), can grow in bile AND 6.5% NaCl

Nonenterococcus (think S. bovis), canNOT grow in 6.5% NaCl

Front 4

besides GAS and GBS, what other 2 bacteria are beta-hemolytic?

Back 4

S. aureus and Listeria monocytogenes

Front 5

What does protein A of staph aureus do?

Back 5

binds the Fc portion of IgG, inhibiting Complement fixation and phagocytosis

Front 6

What are the 3 major toxin-mediated dz's of staph aureus?

Back 6

1. toxic shock syndrome (TSST-1)

2. SSSS (exfoliative toxin)

3. rapid-onset food poisoning (enterotoxins)

Front 7

Which class of bact. is known for infecting prosthetic devices, IV catheters, and contaminating blood cultures?

Back 7

S. epidermidis

Front 8

Strep. pneumoniae is the most common cause of what 4 major diseases (acronym)?

Back 8

MOPS

Meningitis, Otitis media (in children), Pneumonia, Sinusitis

Front 9

S. pneumoniae has a virulence factor that attacks which Ig?

Back 9

IgA

via IgA protease

Front 10

Classically, what is the color of sputum in S. pneumoniae respiratory infection?

Back 10

rust colored sputum

Front 11

Which bacteria is known for causing dental caries and endocarditis at damaged valves?

Back 11

Viridans streptococci

(S. mutans, S. sanguis)

Front 12

Which bacteria is associated with pharyngitis, impetigo, scarlet fever, rheumatic fever, toxic-shock-like syndrome?

Back 12

GAS

(S. pyogenes)

Front 13

What is the significance of the M protein?

Back 13

AB's to M protein can react with tissue in heart and joints => rheumatic fever

Front 14

What is used to dx rheumatic fever?

Back 14

anti-ASO titer

(anti-streptolysin O)

Front 15

Strep agalactiae (GBS) is associated with which types of infections?

(3)

Back 15

pneumonia, meningitis, and sepsis, mainly in babies

Front 16

GDS are mainly associated with which types of infections?

(2)

Back 16

1. UTI

2. subacute endocarditis

Front 17

Enterococci resistance to which antibiotic are an important form of nosocomial infection?

Back 17

Vancomycin

- VRE can be problematic in-hospital infections

Front 18

S. bovis (gut bacteria that CANNOT grow in 6.5% NaCl) infect the heart in which group of patients?

Back 18

pts with CRC

Front 19

the Corynebacterium diphtheriae exotoxin is encoded by:

Back 19

Beta-prophage (a lysogenic phage)

Front 20

How does the diphtheria exotoxin work?

Back 20

inhibits translation

(via ADP-ribosylation of EF-2)

Front 21

What are 3 symps of diphtheria exotoxin?

Back 21

1. coalescing, **gray pseudomembranous exudates,**

2. pharyngitis,

3. and Cervical LAD

Front 22

On what type of agar is Corynebacteria grown?

Back 22

tellurite agar

=> black colonies

Front 23

what class and shape of bact. are the only ones that produce spores?

Back 23

GP rods

(Clostridium, Bacillus, and Coxiella burnetii)

Front 24

What notable substance is in the core of spores?

Back 24

Dipicolinic acid

Front 25

Which cells are affected by tetanus toxin (blockage of glycine, GABA release)?

Back 25

Renshaw cells

(inhibitory interneurons found in the gray matter of the SC that connect to alpha MN's)

Front 26

Which bacteria is associated with gas gangrene (and what is the toxin)?

Back 26

C. perfringens produces gas gangrene via alpha toxin (lecithinase)

Front 27

What is the action of C. diff toxins A and B?

Back 27

toxin A binds to brush border, toxin B destroys the cytoskeletal structure of enterocytes

Front 28

What is the presentation of cutaneous anthrax?

Back 28

Black PAINLESS eschar surrounded by edematous ring

Front 29

What are the 2 components of the anthrax toxin?

Back 29

lethal factor and edema factor

Front 30

Which bacteria is responsible for Woolsorter's disease?

Back 30

Bacillus anthracis - inhalation of anthrax spores

=> pulmonary anthrax

=> pulmonary hemorrhage

=> shock

- nearly 100% mortality

Front 31

Listeria can be acquired from --- in the adult and --- in the infant.

Back 31

unpasteurized dairy and via vaginal transmission during birth.

Front 32

Listeria forms __________________ to move from cell to cell and has characteristic --- motility.

Can cause _______________ in neonates and immunocompromised individuals. (Causes mild gastroenteritis in normal adults)

Back 32

Forms actin jets to move from cell to cell and has tumbling motility.

Can cause meningitis in infants and immunocompromised.

Front 33

symps of Actinomyces inf?

Back 33

oral/facial abscesses (with yellow sulfur granules) with sinus tracts to skin

Front 34

symps of Nocardia inf?

Back 34

Nocardia causes pulmonary inf. in the imm-comp

Front 35

What is the difference between primary and secondary TB?

Back 35

Primary TB usually occurs in naive host (child), forming a Ghon focus in the LOWER LOBES of the lung

- not really symptomatic, but +PPD

Secondary TB usually occurs in imm-comp host (re-infection), forming caseous granuloma cavities lesion in the UPPER lobes

Front 36

What is the Ghon complex?

Back 36

Ghon focus + perihilar LN involvement

Front 37

What is Pott's disease?

Back 37

TB infection of the vertebral body

Front 38

What type of granuloma is associated with TB? What are the names of the multinucleated cells involved in these lesions?

Back 38

caseating granulomas with Langerhans giant cells

Front 39

which agar are Mycobacteria grown on?

Back 39

Lowenstein-Jensen agar

Front 40

What type of infection does Mycobacteria kansasii cause?

Back 40

TB-like inf. (fever, night sweats, wt loss, hemoptysis)

Front 41

What prophylactic treatment is used for M. avium-intracellulare?

Back 41

Z-pak

Front 42

which notable bact. cannot be grown in vitro?

(1)

Back 42

Mycobacterium leprae

Front 43

What is the first line, long-term treatment for leprosy?

Back 43

long-term oral Dapsone

Front 44

What is the difference between lepromatous and tuberculoid leprosy?

Back 44

Lepromatous = diffuse/SEVERE skin inf. with WEAK Th1 immune response

Tuberculoid = few skin plaques with predominant STRONG Th2 immune response
- milder form
- often self-limited

Front 45

Which disease is characterized by "leonine facies" (loss of eyebrows, nasal collapse, lumpy earlobes)?

Back 45

Lepromatous leprosy

Front 46

how are the Neisserias differentiated?

Back 46

Neisseria Meningitidis --> Maltose fermenter

gonorrhea is not

Front 47

There are 4 "coccoid" rods - 2 are "more" important. What are they?

Back 47

H. influ

Bordetella pertussis

Brucella

Pasteurella (animal bites)

Front 48

how are the Vibrio's differentiated?

Back 48

Campylobacter jejuni will grow in heat;

Vibrio cholerae will grow in alkaline media

Front 49

What are the big 3 GP's that ferment lactose?

Back 49

1. Klebsiella,

2. E. coli,

3. Enterobacter

Front 50

H. pylori is also:

Back 50

lactose-neg.

Front 51

What does it mean to grow pink colonies in MacConkey's agar?

Back 51

the bug is a lactose fermenter

(Klebsiella, E. coli, and Enterobacter - fast;

Serratia - slow)

Front 52

N. gonorrhoeae is commonly seen within which type of cells from a swab of infected pt?

Back 52

N's

- nearly sufficient for dx of gonorrhea

Front 53

what bug causes Waterhouse-Friderichsen syndrome?

Fitz-Hugh-Curtis syndrome?

Back 53

N. meningitidis causes W-F synd;

N. gonorrhea ~~ Fitz-Hugh-Curtis syndrome (promiscuous in naming)

Front 54

What media is used for growing Neisseria gonorrhoeae?

Back 54

Thayer-Martin/VPN media

Front 55

What are the 4 main diseases caused by H. influ?

Back 55

EMOP

epiglottitis, meningitis, OM, and pneumonia

Front 56

H. influ is grown on:

Back 56

chocolate agar, with factors V (NAD+) and X (hematin)

- will grow next to S. aureus without them on the plate

Front 57

What are the big IgA protease producers?

(3)

Back 57

Neisseria (gonococci and meningococci)

S. pneumoniae

H. influenzae

Front 58

how do you visualize Legionella pneumophila?

Back 58

silver stain

Front 59

Legionella is grown on:

Back 59

charcoal yeast extract, with Fe and cysteine

Front 60

How does Legionnaire's dz present and what abx is used to treat it?

Back 60

severe pneumonia with fever

- treat with Erythromycin

Front 61

Pseudomonas aeruginosa in diabetics ~~
(3)

Back 61

burn wounds, osteomyelitis, malignant OE

Front 62

how do you treat Pseudomonas?

Back 62

Aminoglycoside and an extended-spectrum penicillin

- add specific B-lactams here

Front 63

What are the 3 major virulence factors of E. coli?

Back 63

Fimbriae (think UTI),

K capsule (think meningitis),

LPS' toxin A (shock)

Front 64

What is the distinguishing characteristic of the following organisms?

EIEC, ETEC, EPEC, EHEC (2 things for EHEC)?

Back 64

EIEC: invades mucosa and causes necrosis/inflammation

ETEC: labile/stable toxins (but NO inflam.)

EPEC: prevents absorption, => diarrhea

EHEC: HUS; does NOT ferment sorbitol

Front 65

Klebsiella is associated with aspiration pneumonia in which 2 major groups?

Back 65

Diabetics and alcoholics

Front 66

Salmonella and shigella both cause inflammatory diarrhea.

Which has flagella?

In which will abx prolong disease?

Which requires a smaller inoculate?

What does typhoid Mary teach us about salmonella?

(what is an interesting characteristic of typhoid fever?)

Back 66

Salmonella 'swim' - have flagella, shigella 'jet' - actin comet tails.

Abx prolong Salmonella symptoms.

Shigella requires smaller inoculate.

Typhoid Mary teaches us that a carrier state is possible with salmonella.

(Typhoid fever can be differentiated by rose spots on abdomen).

Front 67

Campylobacter jejuni has what characteristic appearance in culture and is associated with which syndrome?

Back 67

characterized by microscopic 'seagull shape';

Associated with Guillain-Barre syndrome (ascending paralysis)

Front 68

Which organism is associated with rice-water diarrhea and growth in alkaline media?

Back 68

Vibrio cholerae

Front 69

Yersinia enterolitica associated with:

(3)

Back 69

1. transmission from pets and contaminated food

2. diarrhea in daycare centers

3. can cause mesenteric adenitis (mimics appendicitis)

Front 70

What are the big 3 spirochetes? Which can be seen via light microscopy, i.e. which is the biggest?

Back 70

Borrelia (biggest, visualized with light microscopy),

Leptospira,

and Treponema

Front 71

Leptospira interrogans (question-mark-shaped) causes:

Back 71

Weil's disease (icterohemorrhagic leptospirosis)

Front 72

The tick Ixodes transmits 2 notable organisms. What are they?

Back 72

Borrelia burgdorferi

and Babesia

Front 73

3 stages of Lyme disease:

Back 73

1. flu-like symptoms

2. Bell's palsy and AV node block

3. Chronic monoarthritis and migratory polyarthritis

Front 74

tx for Lyme dz =

(2)

Back 74

Doxycyline, Ceftriaxone

Front 75

What is the standard treatment for syphilis?

Back 75

Penicillin G

Front 76

What are the characteristic features of primary, secondary, and tertiary syphilis (4)?

Back 76

Primary: painless chancre

Secondary: palms and soles rash, condylomata lata

Tertiary: gummas (often on skin), aoritis (attack of the vaso vasorum), neurosyphilis/Tabes Dorsalis, and Argyll Robertson pupil (accommodate but do NOT constrict to bright light)

Front 77

What are the characteristic features of congenital syphilis?

(5)

Back 77

1. saber shins,

2. deafness (CN8),

3. Hutchinson's teeth,

4. mulberry molars

5. hemorrhagic rhinitis

Front 78

screening and confirmatory tests for syphilis:

Back 78

VDRL to screen,

FTA-ABS to confirm

Front 79

the problem with VDRL is FP's, due to:

Back 79

(VDRLL)

Viruses

Drugs

Rheumatic fever

Lupus

and Leprosy

Front 80

What are the 2 major characteristics of a gardnerella vaginalis vaginosis? Standard tx?

Back 80

1. fish-smelling gray vaginal discharge
2. Clue cells

Standard tx: metronidazole

Front 81

What is the classic triad of symptoms of RMSF?

Back 81

HA,

fever,

rash starting on palms and soles

Front 82

Describe the typhus rash:

Back 82

"rose spots" starts on the trunk

- does not involve palms or soles (unlike RMSF)

Front 83

What is the key histological finding in Ehrlichiosis?

Back 83

berry cluster organisms in granulocytes

Front 84

What is the standard treatment for Rickettsial diseases?

Back 84

Doxycycline

Front 85

The Weil-Felix rxn is positive in pts with what type of inf?

Back 85

Rickettsia

(serum is mixed with Proteus O antigens)

Front 86

What do Rickettsial and Chlamydiae organisms have in common?

Back 86

they're both obligate intracellular organisms

Front 87

What are the 2 forms of the Chlamydiae organism, and what are their main functions?

Back 87

1. Elementary body is Extracellular and Enters cells

2. Reticulate body Replicates in cells

Front 88

C. trachomatis can cause what types of infections in addition to urethritis and cervicitis?

(3)

Back 88

arthritis, *conjunctivitis*, and PID

Front 89

What is the standard tx for chlamydial infection?

(2)

Back 89

Azithromycin, Doxycycline

Front 90

What notable infection is caused by serotypes A, B, and C of C. trachomatis?

Back 90

chronic infection

=> blindness in Africa

Front 91

What about serotypes L1, L2, and L3?

Back 91

L1, L2, and L3 --> lymphogranuloma venereum

Front 92

Mycoplasma pneumoniae is 'special' because these organisms have no _____________ and are the only bacteria to have _________ in their cell membranes.

Back 92

No cell wall;

cholesterol

Front 93

Mycoplasma pneumoniae are grown on:

Back 93

Eaton's agar

Front 94

tx for Mycoplasma pneumoniae =

(1 or 2)

Back 94

Tetracyclines or Erythromycin