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38 Cards in this Set

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what are the 2 most common causes of non-gonococcal urethritis (NGU)?
chlamydia trachomitis
ureaplasma urealyticum
What are the diseases caused by Chlamydia trachomatis?
1.Trachoma: chronic conjunctivitis
2.Inclusion Conjuntivitis (birth canal)
3. Infant Pneumonia
4. Urethritis
5. PID
6. Epididymis
7. Lymphogranuloma Venereum
8. Reiter's and Fitz-Hugh-Curtis syndromes
What is the most common sexually transmitted disease in the US?
Chlamydia trachomatis
A patient has a painful genital ulcer. What is the differential diagnosis?
1. Syphilis (Treponema pallidum): not painful; bilat adenopath
2. Herpes(HSV1or2): start as vesicles
3. Lymphogranuloma venerum (Chlamydia trachomatis): ulcer dissappears before adenopath
4. Chancroid (Hemophilus ducreyi): ulcer present during unilat adenopath
5. Granuloma inguinale (Klebsiella granulomatis): southeast asia
What Chlamydial species is associated with transmission from birds?
Chlamydia psittaci
What is the most common form of neonatal conjuctivitis?
Inclusion conjuntivitis (C trachomatis from birth canal)
How do you diagnose a Chlamydia trachomatis infection?
1. NAAT - nucleic acid amplification test
2. Cell culture in chick embryo or cell line(medicolegal)
3. Direct Immunofluorescence of Elementary Bodies
How can you visualize Chlamydia trachomatis?
GIEMSA STAIN: Basophilic intra-cytoplasmic inclusion bodies
LUGOL's IODINE: brown clumps of EBs
What causes Fitz-Hugh-Curtis syndrome?
Fitz-Hugh-Curtis: infection of liver capsule

1. Chlamydia trachomatis
2. Niesseria gonorrhea
How do you treat gonococcal or Chlamydia infections
1. IM ceftriaxone(3rd gen ceph) for Neisseria
2. 7 days doxycycline or 1 day azithromycin for C. trachomatis

don't use penicillins because resitance in N. gonorrhea.
What are the major virulence factors for N. gonorrhea?
1. Pili: adherance; antigenic and phase variation
2. Opa proteins: adherance and invasion; make colonies opaque; antigenic variation
3. LOS (lipo-oligosacchar): LPS without O side chain; toxin that kills ciliated cells
4. IgAase: escape opsonization and phago
5. Porins: invasion and destruction of epithelium
What kind of media is used to determine the presence of N. gonorrhea?
Thayer-Martin VCN media.
1. Vancomycin kills gram +
2. Colistin kills other gram -
3. Nystatin kills fungi

N. gono needs CO2 and absence of fatty acids and salts
Grows well on chocolate agar but this media is not selective
How do you visualize spirochetes?
Dark field or immunofluorescence.

Too thin to be seen by light-field.
How do you culture Treponema?
Trick effing question silly. you can't culture these rat bastards.
What is special about spirochete fission?
It occures in a transverse (not binary) plane.
How do you differentiate between N. gonorrhea and N. meningitides?
N. meningitides ferments maltose. N. gono does not.
Other than syphilis, what diseases do subspecies of T. pallidum cause?
1. Bejel/Endemic syphilis: desert areas
2. Yaws: tropical environments
3. Pinta: latin america, limited to skin
What is the standard therapy for active TB infection?
6 months:
Isoniazid (inhib mycolic acid synth)
Rifampin (inhib RNA synth via DNA-dep RNA poly)
2 months:
Ethambutol (inhib arabinosyltransferase)
Pyrazinamide (unknown MOA)
What are the goals of TB control?
1. Tx active infections to prevent death and transmission.
2. Tx contacts of active infection to prevent disease and transmission.
3. Tx latent infection in high-risk indiv to prevent disease
4. Use BCG to prevent disseminated disease in children.
What are the other Mycobacteria (other than M. tuberculosis) and what are the diseases they cause?
1. M. avium-intracellulare: dissem disease w/AIDS pts; pulm disease in immunocomp
2. M. abscessus: pulm and cutaneous disease; harder to Tx than XDR TB
3. M. kansasii: sim to TB, easier to treat
4. M. ulcerans: Buruli ulcer
5. M. leprae: lepromatous or tuburculoid leprosy
What protein products are associated with the ability of M. tuberculosis to survive within phagocytic cells?
1. PIM: allows for fusion of nutrient-rich endosomes with phagosome
2. ManLAM: prevents maturation of phagosome
3. SapM: cleaves late endosomal marker PI3P in phagosomal membrane - prevents fusion with lysosomes
Why can't N. gonorrhea grow on blood agar?
Fatty acids are toxic.

In choco agar the fatty acids are denatured.
What bacteria have mycolic acid in their cell wall?
Mycobacterium
Corynebacterium
Nocardia
What causes Q fever?
Coxiella burneti: grows in cattle ticks, deposited in tick feces, inhaled by humans

NO ARTHROPOD VECTOR
What causes trench fever?
Bartonella quintana

vector: human body body louse and feces
What causes Rocky Mountain Spotted Fever?
Rickettsiae rickettsii

Vector: wood tick
Reservoir: wild mammals, birds, ticks
What causes epidemic typhus?
Rickettsia prowazekii

vector: human body louse and squirrel fleas
reservoir: humans, flying squirrels in US

common during war
What causes scrub typhus?
Orienta tsutsugamushi

vector: larval mites (chiggers)
What causes Brill's disease?
Re-emergence of previous epidemic typhus disease.

Rickettsia prowazekii

Vector: likely human body louse

*Brill's can start a new epidemic of typhus.
What causes endemic (aka "murine") typhus?
Rickettsia typhii

Vector: feces from rat fleas
Reservoir: rats
What diseases does Ehrlichia cause?
Human Monocytotrophic Ehrlichiosis: infects monocytes and macrophages

Vector: hard tick
Reservoir: deer

E. chaffeensis and ewingii
What disease does Anaplasma cause?
Human anaplasmosis: infects circulating neutrophils; less severe than HME

Vector: ixodes tick (same as lyme disease)
What is the major difference between Ehrlichia and Rickettsia/Orienta?
Rickettsia infects vascular endothelial cells.

Ehrlichia and Anaplasma infect phagocytic cells (monocytes and neutrophils respectively)
What is the major difference between Bartonella spp and Rickettsia?
It is a FACULTATIVE, not obligate intracellular bacteria.

Capable of extracellular growth.
What is the major metabolic difference between Chlamydia spp and Rickettsia spp?
Chlamydia does not have the ability to make its own ATP.

Rickettsia has TCA cycle enzymes and can utilize oxidative phosphorylation.
What causes oroya fever (aka verruga peruana)?
Bartonella bacilliformis

Vector: sandflies in Andes
What causes Catch Scratch Disease?
Bartonella henselae

Vector: fleas of cats
What causes Bacillary angiomatosis-peliosis?
Bartonella henselae (angio & pelio) and quintana (just angio)

Disease of immunocompromised - esp AIDS patients

Angiomatosis: resembles lesions of kaposi sarcoma
Peliosis hepatitis: lesions on liver and spleen