Micro Biology....finals

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KID DAYCARE INFREQUENT DIARRHEA, ABDOMINAL CRAMPS, RECTAL SPASMS, HIGH FEVER. Frank blood/pus in stools due to

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Shigella sonnei
(shigella toxin negative)

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Pt w/upper abdominal pain, chronic stomach pain not relieved by antacids-is given urease breath test- Dr ordered test because she believes infections is....

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H Pylori

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Pt returns from Guatamala, persisitant, not severe watery diarrhea. Better in a few days--swears never to drink water in the crappy hotel again

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enterotoxic e coli

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pt returns from Pakistan, rice water diarrhea, and severe dehydration. ORT for 2 days, losing 1 liter of fluid per hour--
this epidemic diarrhea is due to

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Vibrio Cholerae

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10 yo pt mild, bloody diarrhea, high fever, bloody urine, and eventually DIC. Organism commonly associated with Hemolytic Uremic Syndrome

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E coli 0157:H7

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Older, alcoholic male develops severe pne. coughs up large amounts of thick, gelled bloody sputum--goes into shock, then dies. Hemorrhagic pneumonia is due to aspiration(in alcoholics) is often due to

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Klebsiella pneumoniae

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Post midterm party at Joe's Crab shack, students develop volumious water diarrhea, described by the PA as rice water diarrhea--Since none had been out of the country this is probably

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Vibrio parahemolyticus

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Retired Marine SGT collapses due to lower back pain, taken to ER eventually passes a 5 mm stone. His urine has a pH of 9.5 when releived by catheter, and smelled strongly of ammonia. Culture of the stone reveals highly motile urease postive organism that swims across agar. It is undoubtedly

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Proteus Vulgaris

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1000+ people ate french vanilla ice cream develop fever, nausea, some vomiting and diarrhea. A few go on to develop septicemia. Lactose negative bacteria is isolated from many of them and traced to eggs used to make ice cream. The organism grew well on sselective media, both aerobically and anaerobically. It was

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Salmonella

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Hospitalized pt who is intubated develops pneumonia. The ogranis is not E coli--but is enteric.
It is likely to be one of the

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Enteric organisms

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Severe outbreak of diarrhea associated with chicken salad at the local grade school. No salmonella, or ETEC was revealed but curved, motile microaerobe that gros aerobically or anaeerobically or ferments sugars. It is

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Campyulobacter Jejuni

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Kid spent weekend at public school develops otitis externa, his mom who wears contacts while swimming, develops a corneal infection and folliculitis. Cuture of the infected ear canal and mom's infections reveals a thing G- rod that produces a blue green pigment. THe organism most commmmonly associated with these infections and a host of other opportunistic infections, particularly of hospitalized pts is

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Pseudomonas

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Recent imigrant from Phillipines develops a sever headache, very high fever, muscle and abdominal pain, rose colored rash on the abdomen and sepsis. This inection was formerly common in the USA--but now is limited to traveleers and immigrants is

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Typhoid

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Epidemic of bloody diarrhea in Afghanistan refugee camp. 10% of victims die--organism responsible for epidemic dysentary is

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Shigella Dysenteriae
Shiga toxin +

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12 people at the local county fair develop slurred speech, inability to focus their eyes, difficulty swallowing and breathing. 1 dies--all were found to have consumed homemade 3 bean salad that was entered in the home canned foods competition. THe organism that may cause food-associated epidemic paralysis is

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c. Botulinum

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Everyone who ate cheese cake at the party, comes down with severe vomiting within hours of eating. None one has a fever, just projectile vomiting. The organism associated with this true food poisoning(often acquired from milk products...ice cream, sauces, cream filled pastries is

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Staph aureus
enterotoxin b strain

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Catalase +,
beta-hemolytic pygenic cocci, R--environment, salt and disintectants

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Staph Aureus

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Catalase -,
beta-hemolytic fastidious pyogenic cocci requiring enriched media for isolation

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Group A strep

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30=-50% of population that is colonized by this pyogenic cocci-often nasally

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Staph Aureus

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organism that is pcn r and resistant to pcn-ase resistent ABX

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MRSA

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Beta hemolytic pyogenic cocci often found to colonize vaginal mucosa

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Group B strep

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non hemolytic pyogenic cocci characterized by resisten to environmental conditions and ocmmonly isolated from the human digestive tract

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E. Fecalis

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Non hemolytic pyogenic cocci responsible for 2/3 of CAP and large % of sinusitis and middle ear infections in children

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Strep Pneumoniae

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Non hemolytic pyogenic cocci responsible for nosocomial infections and common inhabitants of the skin of all humans

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S epidermis

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Non hemolytic pyhogenic cocci responsible for sub-acute endocarditis in rheumatic fever pt. Often acquired from Dental Procedures introducing bacteria to the bloodstream

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Viridians strep

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Streptococci of the digestive tract that are resistant to pcn-ase resistant ABX and the non-betalactam cell wall inhibiting antibiotic of "OFTEN" last resort.

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Vanco Resistant enterococci

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disease due to GAS characterized by deep red, raised, sandpapery rash and shock syndromes.

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Scarlet Fever

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S. Aureus toxin responsible for bright red facial rash, high fever, low bp and shock

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TSST
toxic shock syndrome toxin

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the most common food poisoning due to food contamination, with pyogenic cocci

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Staph Enterotoxin

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Enzyme(toxin) that is produced by S. Aureus that initiates clottinf for serum, definitive for its Identification of all other staph

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Coagulase

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Surface protein of GAS that is Antiphagocytic and certain versions of which elicit cross reacting antibodies to cartilage and cardiac muscle protein

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M protein

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Immunogenic attack on heart, cartilage follow SOME (1/200)untreated GAS infection with fever, murmur and rheumatic arthritis

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Rheumatic fever

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Primary virulence factor of S Pneumoniae

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100 capsule types

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Toxin that is responsible for death of WBC and occurs in most pyogenic cocci

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Leukocidin

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Most commonly used pcn-ase resistant ABX

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Methicillin--but really oxacillin or naficillin

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ABX most commonly used to interfere with cell wall synthesis

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Penicillin

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Prefered drug for treating pyogenic cocci resistant to pcn-ase resistant ABX

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Vancomycin

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drug used for prophylaxis to eliminate but not always, nasa colonization with S. Aureus

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Bactroban

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most common abx resistance found in S aureus

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PCN resistant

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preferred treatment to preven meningitis of newborns

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amoxicillin prophylaxis of mother

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Chills fever shaking sweating painful cough and =/- bloody sputum and consolidation of one or more lobes of the lungs is commonly known as

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pneumococal pneumoia

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characteristic pathology of an infection due to S. Aureus

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Abscess

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Boils, cystic acne, cellulitis and surgical wound infections are the most common epidermal infections due to this organism

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Group A strep

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The most common cause of abscesses of any organ or bone, following a cutaneous infections.

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Group A strep

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leading cuase of septic arthritis and bursitis

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Group a strep

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Common sites of infection with these organisms are --iv lines, csf shunts, prosthetic heart valves, dialysis and urethral catheters

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S. Epidermidis and E. Fecalis

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Meningitis of neonates is most commonly due to this organism(ecoli- is #2)

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Group B strep

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most common epidermal infection of childrean due to GAS

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impetigo

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erysipelas, cellulitis and necrotizing fasciitis are epidermal infections more severe than impetigo and due to the same ogranism

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Group a strep

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Most important reservoir of GAS in the in the population

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occult infection of tonsils

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tonsillitis acute bacterial pharyngitis are most commonly due to this organism

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Group A strep

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Bacteria that is common cause of acute urethritiis in males with drip of pus

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Neisseria Gonnorhea

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Non-gonococcal urethritis (STD) is caused by this

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Chlamydia Trachomatis

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Cause of painless genital ulcers due to a spirochete

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primary syphilitic chancres

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after the intial infection witha spriochete there is a rash of palms and soles and almost everywhere else too

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secondary syphilis

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neruosyphillis and gummatic lesions are this late stage of syphilis

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Tertiary syphyillis

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spirochete infections that is transmitted by ticks,m and often causing arthritis

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lYME dISEASE

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pREFERRED TREATMENT FOR SYPHILLIS

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pENICILLIN BY INJECTION OR iv for tertiary cases

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treatment for Gonorrhea

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3rd generation cephalosporin

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Treamtent for Chlamydia

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Doxycycline

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Why chlamydia and gonorrhea are treated together

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organisms often cause co-infection

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Common route of HSV 1 transmission

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Saliva

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Common route of HSV 2 transmission

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Sexual Transmission

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Routes of HIV transmission

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Sex, transfusion, needle sharing, transplacental, breast feeding

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viruses transmitted by animal and insect bites

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West Nile, yellow fever, and rabies

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Viruses generally transmitted through the enteric tract

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Most non-enveloped RNA viruses except Rhinovirus

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viruses are generally sexually transmitted in humans

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HIV & HSV & HPV !6

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route of transmission fo HAV & HEV

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Food handlers and contaminated Water

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route of transmission of HBV & HCV

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transfusion and needle sharing

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the most common HSV in USA

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HSV 1

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in 8 years it has become the most commonly transmitted virus in USA

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West nIle Virus

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These viruses transcribe viral RNA into DNA, and integrate the DNA into host cell DNA

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Retroviruses

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Viruses that are generally stable in the environment

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non enveloped viruses

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viruses that are generally no tstable in environment

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enveloped viruses

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these viruses are transmitted as cough and sneeze aerosols from the respiratory tract of humans

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influenza, parainfluenza and coronoa

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HSV 2 is transmitted in this manner to nenonates

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Vaginal birth

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drug for CMV--not HSV & VZV

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Ganglocylovir for prophylaxis of retinits

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drug for HSV & VZV but not CMV

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Acyclovir or longer acting valtrex

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Reverse transcriptase inhibitor that binds to the enzyme active site

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Nucleoside RT inhibitor

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Reverse transcriptase inhibitor that binds next to the enzyme active site

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NON-nucleoside RT inhibitor

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Antiviral drug for HBV (& HIV)

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Epivir
(lamivudine)

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Neuraminidase inhibitor for flu

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Tamiflu
(oseltamivir)

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uncoating inhibitor for influenza

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amantidine and rimandtidine

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standard therapy for HCV

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Interferon and ribivarin

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HIV drug that inhibits fusion of viral and cell membranes

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Fuseon

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Polio vaccine that may revert to wild type virulence

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1962 Sabin live oral vaccine

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Genetically stable polio vaccine that cannot replicate in the pt and can't rever to teh wild type

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1955 killed Salk vaccine

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3 viral vaccines that replicate in the pt and are avirulent

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MMR

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viral vaccine made from a cloned gene of a viral protein

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subunit vaccine

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new vaccine made yearly that cannot replicate in the pt

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influenza vaccine

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original vaccine for small pox

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vaccina or cowpox vaccine

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immunity acquired by gamma globulin injection (ie. for HAV)

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Passive immunity

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the time to generate antibodiees after first vaccination

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2 weeks

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Genetic immunity to HIV is due to this

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Homozygous recessive mutation in the cxc r4 receptor

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name and function of HIV envelope proteins

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gp 120 receptor binding protein and gp 41 fusion protein

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mutation rate of HIV and influenza

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1/10 4th bp

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cause of infrequent pandemics of influenza

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genetic shift-reassortment of viral genes in an animal infected with 2 different flu viruses

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cause of yearly epidemics of influenza

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genetic drift-constant mutation due to error prone RNA copying
(D for Drift then E for Epidemic)

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influenza protein that binds to the lung cell receptor protein

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Hemmagglutinin H

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influenza protein that cleaves the mucin protein in mucus

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Neuraminidase
(n for neuraminidase to the m for mucin)

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number of all influenza N alleles in the world

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9
(n for nine)

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number of all influenza H alleles in the world

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14

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number of influenza variants known to be transmitted between human pts.

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6

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nerves that are chronically infected by HSV & VZV

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Sensory neurons

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nerves that are infected and killed by polio virus

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Motor neurons

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membrane surrounding a virus and its envelope proteins are acquired by the virus during this process

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Budding out

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cause of HSV pain

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neuritis-inflammation of sensory nerves

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factors that cause VZV reactivation

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age, chemo, cancer, HIV

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common clinical finding of HSV1 during recurrence of the infection

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recurrent vessicles at lip edge(often)

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common clinical findings of HSV2

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recurrent genital vessicles (mostly

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reactivation of VZV causes shingles to appear here

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generally unilateral line of vesicles above a sensory nerve of the trunk or head

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disease due to CMV in Aids pt

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chronic retinitis

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symptoms of EBV infection

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extreme fatigue lasting weeks/months, pharyngitis, swollen lymph nodes of the neck/jaw

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symptoms of HIV primary infection

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lymphadenopathy, mculopapular rash on trunk, sore throat, lethargy,(but not severe fatigue)

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common opportunistic infections of HIV

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cryptococcal meningitis, thrush, atypical TB, CMV retinitis, pneumoscystis pneumonia, kaposi's sarcoma

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symptoms of acute influenza

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acute onset of fatigue, backache, cough with retrosternal pain, high fever chills, sweating and shaking

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common flu complications in elderly

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bacterial pneumonia, particularly Staph Aureus, and pneumococcus, up to 4 weeks post infection

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#1 severe respiratory disease of infants, with recurrent infections up to age 12 or so

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respiratory syncitial virus

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the 2 most common causes of viral otitis media

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RSV & parainfluenza

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common diseases due to parainfluenza

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chest colds in all ages, croup in children, laryngititis and bronchitis

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sub-clinical polio infection of infants

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abortive polio

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polio infection that leads to death or permanent muscular disability

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parylitic polio

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hand foot mouth disease herpangia, hemorrhagic conjuctivitis and aseptic meningitis

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Coxsackie A virus
(a virus and aseptic meningitis)

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viruses are leading cuase of viral carditits and pericarditis

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Coxsackie B virus
(b for b virus then c for carditis)

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virus causes a high fever and brigh tred facial rash-slapped cheek syndrome -sometimes a lacy buttocks rash or a characteristic "gloves and socks" rash of the hands and feet

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Parvovirus B19

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beningn keratomas of the skin and other tissues are due to these viruses

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Papilloma viruses

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most common cause of cervical cancers

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HPV 16

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pt in which HBV is most likely to become permanent and lead to cancer

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babies, infected transplacentally or perinatally

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standard therapy for food acquired hepatitis

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passive immunity with anti-HAV antibodies

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pts that generally do not become jaundiced with HAV

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infants and young children
(

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pts that generally do exhibit jaundice and hepatic inflammation with HAV

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older children and almost all adults

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correct name for shingles

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Herpes Zoster