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103 Cards in this Set
- Front
- Back
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What is Cougulase Negative Catalase positive Gram + cocci which is novobiocin Sens
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Staph. epidermidis from catehrters
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What is Cat +,
Coagulusa Neg GRAM + cocci NOVO RESISTANT |
S. Saphrophyticus: Honey moon cystitus
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What is GRam + Catalase and Couagulase POSITIVE
Beta-Hemolytic and FERments Mannitol |
S. Aureus: causes TSST, Salmon-pneumoniae, Osteomyleitis, Gastroenteritis (2-6) hrs, after ingestion,
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What is the PATH of S. Aureaus
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HEat stable-Enterotoxin
TSST-1: Superantigen Coagulase: Fibrin CLot Cytolytic: Alpha toxin: Pore forming |
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What are the TX: OF S. Aureus?
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Gastro-Self limitng
Nafcillin/oxacillin: DOC MRSA: Vancomycin VISA: Quino-Dalto |
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WHAT ARE THE GENUS FEATURES OF STREPTOCOCCI
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gRAM + COCCI: IN cHAINS, cATALASE negATIVE
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wHAT ARE THE FEAT. OF STREPH. PYOGENES
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BETA-HEMOLYTIC, BAC. SENSITIVE, PYR-POSITIVE
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Path: Of Strep. Pyogenes?
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Hyloronic acid: non-immunogenic
M: Protein: M12: Ass. w/ Acute glomerulonephritis. Streptolysin O: immunogenic, hemolysin and cytolysin Steptolysin S: NOT immuno. hemo/ ctyolysin |
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What are the spreading factors of strep., pyogenes
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Hyaloronidase: Hydrolyse the ground sub. conn. tissue.
Exo A-C: Fever-Rash of scarlet fever. inhbitis liver clearance of endotoxin. Superantigens |
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What does Beta and alpha hemolysis look like
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Beta-Clear
Alpha-Green |
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Group A Strep:
Strep Pyogenes: Dz: Phayngitis |
Abrupt onset of SORE throat, fever, malasise tonsilar abcess, and tender ant. cervical lymph node.
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Strep. Pyogenes
Describe Scarlet Fever |
Blanching SANDPAPER rash, strawberry tongue.
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Describe the CHAR. of Group A Streph
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CATALASE NEG, Beta-HEmolytic and BAcitracin Sensitive:
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Non-Suppurtive Sequale of GAS.
Rheumatic Fever |
Due to Sequlae of Pharyngitis: AB to <3 tissue: 2 weeks post phyrngitis: TYPE 2: joint infllammation erythema.
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Acute Glomerulonephritis:
S.Pyogenes |
DUE to M12: Immune Complex: Type 3: Hypersentitivity.
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Lab Diag: OF S.Pyogenes
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Rapid Strep test (Elisa)
Ab to Streptolysin O.(ASO >200): Rheumatic Fever |
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Tx of S. Pyogenes infections
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Beta lactams:
Macrolides: Pen. Allergy |
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What are the distinguising features of Strep. Agalacticae?
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Beta-Hemolytic
Bacitracin Sens. Hydrolyze Hippurate CAMP Positive |
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How is Strep. Agal Transmitted
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Prolonged rupture of membranes...#1 cause of NEONATAL MENINGITS: Especially in cases of PROLONGED delivery
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How Is Step. Agalacticae treated?
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Ampicllin with AG or a Cephalosporin
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What are the Distinguishing Features of Strep. Pneumo.
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Alpha-Hemolytic
Optochin Sens. Lancet-Shaped Diplococci Lysed by Bile IT IS GRAM +, CATALASE NEG. SOLUBLE IN BILE, OPTOChin Senstive |
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What is the Pathogenesis of Strep. Pneumoniae?
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IT HAS A POLYSACHARIDE capsule: Major virulance Factor.
It has IgA protease, techoic acid, Pneumolysin O; Hemolysin/Cytolysin: Dammages the respiratory Epithelium, Inhbits leukocyte resp. burst. and inhbits classical complement fixation. |
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How does Strep. Pneumonia present in TYPICAL PNEUMoniae?
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MOST COMMON CAUSE: Esp. adult.
Shaking, chills, high fever, Blood tinged RUSTY sputum |
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How deos Streph. Pneumonie present in adult meningitis?
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MCC:
peptidoglycan and teichoic acids r highly inflammatory in the CNS. CSF: HIGH WBC, LOW GLUCOSE AND HIGH PROTIEN. |
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What is the most common cause of OTITIS MEDIA in children
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Streptococcus. Pneumo.
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How is STREP. PNEUMONIAE Diag?
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Quelleng Reax.
Latex agglutination: Test 4 Capsular Ag in CSF. |
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What are the 3 TYPICAL PNEUmonias?
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1.) Klebsiella Pneumoniae
2.) H. Influenzae 3.) S.Aureus |
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What are the 3 ATYPICAL pneumonias?
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1.) N. Meningitidis
2.) M. Pneumoniae 3.) C. Pneumoniae |
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How does typical Pneumonia with Streptococcus Pneumoniae Dev?
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S. Pneum. Elicits NEUTROPHILS, Arachodonic metabolites and causes Pain and FEVER... It produces a LOBAR PNEUMONIA with a PRODUCTIVE COUGH.. Grows on Blood AGAR..responds well 2 PENEcillin TX.
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How do you Tx. Adult Meningitis?
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#1: CEftaxime
#2 Ceftriaxone |
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How do you TX. OTITIS MEDIA in KIDS?
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Amoxicillin, Erythromycin especially for ALLErgic INDividuals.
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What is the Difference between the ADULT and Pediatiric Pneumococcal Vaccines?
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The Adult PNEUMOCCOAL POLYSACHARIDE VACCINE; Has 23 of the most common capsular serotypes..
Recc. For adults >65 years of age and @ any risk individuals |
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What are the DISTINGUISHING FEATURES oF Strep. Viridans?
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ALPHA hemolytic
Optochin RESISITANT Gram +, Catalase NEG. BILE INSOLUBLE |
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What is the Pathogenesis of Streph. Viridians infection?
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It has a DEXTRAN Biofilm that mediates Adherance on2 tooth enamel or dammaged <3 Valve and to each other.
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What dz. are caused by S.Viridians
S. MUTANS |
Dental caries: Dextran mediated adhereance to glues oral flora onto teeth.
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What does S. Viridians cause in the <3
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INFECTIVE ENDOCARDITIS: (SUbacute)
Malaise, fatigue, anorexia, wieght loss, splinter hemmorages. |
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How do you TX S. Viridians?
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Penecillin G with AG for endocarditis
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What are the Distinguishing feat. of enterococcus faecilis/ Faecium?
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They r PYR +.
GROUP D GRAM + cocci in chains. They HYDROLUZE ESCHULIN in 40% Bile and 6.5 NaCl (agar turns Black) |
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How does Enterococcus cause disease?
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E. faecilis goes to the bloodstream and causes ENDOcarditis in Previoslu dammages <3 Valves: Causes Endocarditis
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What are some KEY Vignette Clues E. Faecilis/faecium?
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They are GRam POSTIVE, CATAlase Neg.. and Hydrolyzes ESCULIN:
Causes UTI's and Billiary Tract in elderly males.. also causes Subacute bacterial endocarditis: Following Gu/Gi surgery, or pre-existing <3 Valve dammage |
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How do you treat VANCOMYCIN resistant strains of Enterococcus faecium or E. faecilis
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Have no reliably effective Tx,
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How do you prevent enterococcus infections?
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Penacillin and Gentamicin in people with dammaged <3 valves
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What are the Features of Bacillus?
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They are Gram + and Spore forming and AEROBIC
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What are the features of B. Anthracis?
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They are LARGE and BOXCAR like
SPORE forming rods, Capsule is a poly peptide: Poly-D-Glutamate |
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What is the pathogenesis of anthrax?
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It has a ANTHRAX TOXin
3 parts 1.) Protective antigen: Mediates entery of lethal factor and edema factor into eukaryotic cells 2.) Lethal Factor: Kills Cells 3.) Edema Factor: Adenylate Cyclase; |
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What is cutaneous anthrax
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there are malignant pustules (Papule) with Vesicles and there is central necrosis or a eschar with a erythematous border with painful lymphadenopathy,
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What is Pulmonary anthrax (wool sorter's dz)?
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It is life threatening pnuemoniae with shock, facial edema, dyspnea and MEDIASTINAL HEMMORAGIC LYMPHAdenitis
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How is B. Anthracis Diag?
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Gram stain and culture of resp. secretions or lesions
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What is the Tx of anthrax?
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Ciprofloxacin or DOXYcyline
Give toxoid vaccine to those in high risk occupations |
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How is Bacillus Cerrus Transmitted
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Reheated Fried rice
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What are the toxins of B. Cereus?
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Emetic Toxin: Fast 1-6 hrs: Similar to S. Aureus w/ vomiting and diarrhea.
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What are the genus features of Clostridium?
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Gram + RODS, SPORE forming
ANaerobic |
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What are the features of Clostridium tetani?
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LArge GRAM +, Spore-forming rods, anaerobic and produces the tetanus toxin.
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What is the pathogenesis of clostridium tetani?
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Spores produce tetanus toxin: TETANOSPASMIN.
Binds to GANGlioside receptors. Blocks release of inhbitory mediators of GLYCINE and GABA @ spinal synapses. Excitatory muscles r unopposed: Extreme muscle spasm, |
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How does the dz. TETANUS present?
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Risus Sardonicus: Grinning smile (Spasm of facial muscles)
Opisthotonus: Severe arching of the back. |
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What are the key clinical vignette for Clostridium tetani?
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Dirty puncture wound and rigid paralysis.
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What is the tx of the disease TETANUS?
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Hyperimmune human globin (TIG) to neutralize toxin plus METRONIDAZOLE or PENECILLIN
Spasmolytic drugs: debride and delay closure |
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What is a non-tetanus prone wound?
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Linear 1 cm DEEP cut withOUT devitilized tissue, w/o major contaminants LESS than 6hrs.
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What is a tetanus prone wound?
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Blunt/ missle, burn, frostbite, 1 cm deep: DEVITILIZED tissue and contaminants..any wound 6 hrs old.
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How would you tx a non tetanus prone wound where vaccination history is unknown?
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VAccine" Toxoid is a fromaldehyde inactivated toxin
If the person has had the primary vaccine then give them a vaccine if only more than 10 yrs. |
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How would you tx a tetanus prone wound, where you do NOT know the vaccination history?
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Vaccine + TIG
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In a tetanus prone wound when would you give them the vaccine if they completed the primary series?
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Vaccine if more than 5 yrs. SInce last booster.
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What are the distinguishing features of Clostridium Botulinum?
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Anaerobic GRAM + spore forming ROD
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What is the pathogenesis of C. Botulism?
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SPores germinates in NOn-acidic and anaerobic conditions.
ThE BOTULISM TOxin: A-B polypeptide neurotoxin. Coded for by a prophage Heat LAbile MEchanism of Act; It is absorbed by thew gut and carried to pheripheral nerves and BLOCKS the release of acetylcholine,,,causes a flaccid paralysis.. Prevention: DO NOT GIVE BABIES HONEY in their 1st yr. |
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How is Botulism tx in a baby?
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RESPIRATORY SUPPORT, Hyperimmune human serum AB.
ABx will worsen symptoms. |
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How is botulism tx in a Adult?
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Respiratory support: Triivalent (A-B-E) antitoxin
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How is a wound infected with Botulism toxin tx
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Amoxicillin, Antitoxin, and Resp. Support
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What are the Features of Clostridium Perferinges?
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Large Gram + Spore forming rods,
AnaerobicL STORMY fermentation in MILK media, Double Zone of beta-hemolysis |
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What are the clinical aspects of a clostridium infection?
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Clostridium perferinges can be in a conntaminated wound,
Pain, edema, gas, fever, and tachycardia.. Ass. W/ FOOD Poisoning: Reheated meats and NON-inflammatory diarrhea. |
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What is the pathogenesis of Clostridium Perferinges?
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Alpha toxin: LEcithinase : Disrupts membranes dammages RBC's, WBC's entothelial cells: Causes a MAssive hemolysis, tissue destruction and Hepatic tox.
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How Clostridium Perferinges Identified?
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Nagler reaction: Egg yolk on agar plate
One side has anti-alpha toxin lecithinase act. on side with no antitoxin. |
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What are the diseases caused by clostridium perferinges?
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Gas Gangerene: Contamination of wound with soil or feces
Tense tissue Systemic: Tachy and Fever High Mortality |
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How is clostridium perferinges aquired?
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Food Posiining
REheated MEAT Enterotoxin prod in gut Self-limit: Non-inflamm. watery diarrhea |
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Treat of gas gangere
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Debridement delayed closure, CLINdamycin and PEnecillin, hyperbaric chamber.
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What is the pathogenesis of clostridium difficille?
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Toxin A: Enterotoxin dammages mucosa leads to fluid increase and attracts granulocytes.
Toxin B: CYTOXIN and Cytopathic |
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What are the diseases ass. w/ C. Difficile?
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ANTIBIOTIC ASSOCIATED (Clindamycin, cephalosporins, amoxi, and ampicillin)
Diarrhea, colitis or psuedomembranous colitis. |
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How is Clostridium DIff treated?
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Metronidazole
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What is the clinical Vignette for Clostridium Difficile?
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Hospitalized pt. Dev. colitis and diarrhea.
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What are the features of Listeria?
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Gram + NON-SPORE forming rods...faculative and intracellular...tumbeling motility.
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What r the distinguising features of Listeria Monocytogenes?
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Small Gram + rods..beta-hemolytic and NONspore forming rod on blood agar.
TUmbeling motility Faculative Intracellular COLD GROWTH |
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What is the clinical vignette for Listeria?
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GRAM POSITIVE
Beta-Hemolytic Fac. Intracellular Delhi foods Transplacental Granulmatosis infantisepticemia Neonatal Septicimia and Meningitis Meningitis in RENAL or CANCER pt.s |
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What is the Pathogenesis of Listeria?
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Listeriolysin O,
Beta-Hemolysin immunologic immaturity predisposes to seriosus infection. Resevoir: UNPASTURIZED milk products. |
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What does listeria cause in immunocompromised pt.s
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Septicemia and Meningitis
Listeria meningitis Most common cause of meningtis in renal transplant pt.s and adults with cancer. |
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How is Listeria diagnosed?
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Blood or CSF (wet mount) or g.stain.
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How is Listeria monocytogenes tx?
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Ampicillin with Gentamycin added for immunocomp. pt.s
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What are the features of Corynebacterium?
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GRAM + ROD, NON-SPORE forming
AEROBIC |
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What is the clinical Vignette of CORYNEbacterium infection?
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Gram + Aerobic ROD
NO SPORES Toxin producing strains have Beta-prophage (Beta-Corynephage) |
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What is the DISTINGUISHING features of Corynebacterium?
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Gray-black colonies of club shaped GRAM + rods arrananged in V or L shapes on tellurite medium
Granules--> VOLUTIN Toxin strains have a beta-prophage. |
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What is the path. of corynebacterium?
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It is a NON-INVASIVE organism
Has DIptheria toxin (A-B) inhbits protien synthesis by adding ADP-ribose to EF-2 Dirty Gray-Psuedomembrane Extension in2 larynx/ trachea Cuases <3 and Nerve dammage. |
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How is Corynebacterium diagnosed?
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Elek test to document toxin production..there is precipitant line
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What is the treatment of corynebacterium diptheriae
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Erythromycin and antitoxicn
Endocarditis: IV PEN adn AG for 4-6 weeks |
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What r the features of Actinomyces?
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ANAEROBIC
GRAM + BRANCHING RODS NON-ACID FAST |
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Clinical Vignette of Actinomyces
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mycetoma on JaW line or spread from IUD.
Sulfur GRanuels in PUS grow ANAerobic GRAM + Non-acid fast BRANCHING RODS |
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What is the resevoir for actinomyces
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Fem. Genital tract and Gingival crevices
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What are the diseases caused by actinomyces?
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Tissue swelling--> Draining abcess with "Sulfur granules"
Only in tissues with LOW 02: Cervicofacial (Lumpy Jaw): Dental trauma, Poor Oral hygeine. Pelvic: Thoracic or IUD;s CNS: SOlitary brain abcess |
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How is Actinomyces Identified
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GRAM POSITIVE BRANCHING bacilli in sulfur granules..
colonies resemble molar tooth, |
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How is actinomyces treated?
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Ampicillin or Penecillin
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What are the features of Nocardia?
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They r gram + filaments breaking up in2 rods
Aerobic Partially acid fast: Some blue/red |
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What r the clinical vignette of nocardia asteroides and nocardia brasilianes
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They are GRAM POSITIVE filamentous bacilli, aerobic and pt. acid fast.
They cause CAVITARY bronchopulmonary dz. mycetomas |
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What conditions predispose to nocardia path.
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immunosuppression and cancer.
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What disease does Nocardia cause
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Cavitary bronchopulmonary nocardiosis
May spread to brain hematogenously: Brain ABcess |
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What causes cutaneous or SUBQ. nocardiosis?
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Cellulitis w/ swelling--> Draining SUbQ abcess w/ granules: Mycetoma
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How is Nocardiosis TX?
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Sulfonamides or TMP-SMZ
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