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605 Cards in this Set

  • Front
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Peptidoglycan:
1. Function
2. chemical composition
1. Support, protection against osmotic pressure
2. Sugar backbone with cross linked peptide side chains
Cell Wall (gram positive):
1. function
2. chemical composition
1. major surface antigen
2. peptidoglycan for support.
Teichoic acid induces TNF and IL-1
Outer membrane (gram negative):
1. Function
2. Chemical composition
1. Site of endotoxin (lipopolysac), major surface antigen.
2. Lipid A induced TNF and IL-1,
polysacc is the antigen.
Plasma membrane:
1. function
2. chem composition
1. site of oxidative and transport enzymes
2. lipoprotein bilayer
Periplasm
1. function
2. chem composition
1. space between cytoplasmic membrane and outer membrane in gram negative bacteria.
2. contains beta-lactamases
Capsule
1. function
2. chem composition
1. protects against phagocytosis
2. polysaccharide (except Bacillus anthracis, which contains D-glutamate)
1. Pilus- composition?
2. Flagellum- composition?
1. glycoprotein
2. protein
Spore
1. function
2. chem composition
1. resistance to dehydration, heat, chemicals
2. keratin-like coat, dipicolinic acid
plasmid
1. function
2. chem composition
1. genes for antibiotic resistance, enzymes, toxins
2. DNA
Glycocalyx
1. function
2. chem composition
1. adherence to surfaces, especially foreign (catheters)
2. polysaccharide
Circular bacteria, gram positive
(2)
Staph
Strep
Circular bacteria, gram negative
(1)
Neisseria
Rods, gram positive
(5)
Clostridium
Corynebacterium
Bacillus
Listeria
Mycobacterium (acid fast)
Rods, gram negative enterics
(13)
E Coli
Shigella
Salmonella
Yersinia
Klebsiella
Proteus
Enterobacter
Serratia
Vibrio
Campylobacter
Helicobacter
Pseudomonas
Bacteriodes
Rods, gram negative, non enterics
(9)
Haemophilus
Legionella (silver)
Bordetella
Yersinia
Francisella
Brucella
Pasteurella
Bartonella
Gardnerella
Branching filamentous
(2)
Actinomyces
Nocardia (weakly acid fast)
Pleomorphic bacteria
(2)
Rickettsiae
Chlamydiae (giesma)
Spirochetes
(3)
Leptospira
Borrelia (giesma)
Treponema
Bacteria without a cell wall
(1)
Mycoplasma (sterols)
Bacteria with abnormal cell membrane/wall content:
(2)
1.Mycoplasma- sterols, no wall
2.Mycobacteria- mycolic acid, high lipid content
Poor gram staining bacteria:
These Rascals May Microscopically Lack Color
1.Treponema (too thin, darkfield and flourescent antibody staining)
2. Rickettsia (intracellular parasite)
3. Mycobacteria (high lipid = needs acid fact stain)
4. Mycoplasma (no wall)
5. Legionella pneumophila (intracellular, silver stain)
6. Chlamydia (intracellular, lacs muramic acid in wall)
Mycoplasma
Giesma stain
(4)
Borrelia
Plasmodium
Trypanosomes
Chlamydia
PAS (periodic acid-Schiff)
(1)
Whipple's
(stains glycogen, mucopolysaccharides)
Ziehl-Neelsen
Acid-fast bacteria
India Ink
Cryptococcus neoformans
Silver stain
Legionella
Fungi
Media used to isolate:
H. influenzae
Chocolate agar with factors V (NAD) and X (hematin)
Media used to isolate:
N. gonorrhoeae
Thayer Martin media
Media used to isolate:
B. pertussis
Bordet-Gengou (potato) agar
Media used to isolate:
C. diphtheriae
Tellurite plate
Loffler's media
Media used to isolate:
M. tuberculosis
Lowenstein-Jensen agar
Media used to isolate:
M. pneumoniae
Eaton's agar
Media used to isolate:
E. coli
Eosin-methylene blue agar
Media used to isolate:
lactose fermenting enterics
MacConkey's agar - pink colonies
Media used to isolate:
Legionella
Charcoal yeast extract agar buffered with iron and cysteine
Media used to isolate:
Fungi
Sabouraud's agar
Obligate aerobes:
Nagging Pests Must Breathe
Nocardia, Pseudomonas, Mycobacterium tuberculosis, Bacillus

(M. tb has a predilection for the apices of the lungs, which have the highest P02).
Obligate anaerobes:
Can't Breathe Air
Clostridium
Bacteroides
Actinomyces
(lack catalase and/or superoxide dismutase)
Obligate Intracellular bacteria:
Really Cold
Rickettsia
Chlamydia
(can't make own ATP)
Intracellular bacteria:
Some Nasty Bugs May Live FacultativeLY
Salmonella
Neisseria
Brucella
Mycobacterium
Listeria
Francisella
Legionella
Yersinia
Encapsulated bacteria:
Some Nasties Have Kapsules
Streptococcus pneumoniae
Neisseria meningitidis
Haemophilus influenzae
Klebsiella pneumoniae
(positive quellung reaction, polysaccharide capsule is antiphagocytic)
Urease positive bugs:
Particular Kinds Have Urease
Proteus
Klebsiella
H. pylori
Ureaplasma
Pigment producing bacteria
Staph aureus- yellow
Pseudomonas- blue green
Serratia marcescens- red
S. aureus virulence factor
Protein A
binds Fc region of Ig
disrupts opsonization and phagocytosis
S. pneumoniae virulence factor
IgA protease
cleaves IgA
H. influenzae virulence factor
IgA protease- cleaves IgA
Neisseria virulence factor
IgA protease- cleaves IgA
Strep pyogenes (Group A) virulence factor
M protein- prevents phagocytosis
Source of exotoxin
Certain gram positive and gram negative
Source of endotoxin
Outer cell membrane of most gram neg and Listeria
Secreted from cell:
Exotoxin or endotoxin?
Exotoxin
Exotoxin composition
polypeptide
Endotoxin composition
Lipopolysaccharide (structural part of bacteria, released when lysed)
Location of exotoxin genes
Plasmid or bacteriophage
Location of endotoxin genes
bacterial chromosome
endotoxin clinical effects
fever, shock through release of TNF and IL-1
which is more toxic? endotoxin or exotoxin
exotoxin- fatal dose on the order of 1 microgram vs. endotoxin- 100 micrograms
which is more antigenic? endotoxin or exotoxin
exotoxin- induces high titer antibodies called antitoxins
(endotoxin is poorly antigenic)
Vaccines: endotoxin vs exotoxin
Endotoxin: no vaccine
Exotoxin: toxoid used as vaccine
which is more heat stable? endotoxin vs exotoxin
endotoxin
Typical diseases caused by exotoxin?
(3)
Tetanus
Diphtheria
Botulism
Typical diseases caused by endotoxin?
Meningococcemia, sepsis by gram-negative rods
What do superantigens do?
Bind directly to MHC II and T cell receptor simultaneously, activating T cells to release IFN-gamma an IL-2
S. aureus superantigen
TSST-1 causes toxic shock syndrome (fever, rash, shock)
Other S. aureus toxins (besides superantigen)
(2)
enterotoxin (food poisoning)
exfoliatin (scalded skin syndrome)
S. pyogenes superantigen
Scarlet fever-erythrogenic toxin (toxic shock)
Explain ADP ribosylating A-B toxins
Interfere with host cell function. B (binding) component binds to a receptor on surface of host cell, enabling endocytosis. A (active) component that attaches an ADP-ribosyl to a host cell protein, altering protein function
Exotoxin examples
Superantigens
ADP ribosylating AB toxins
What has ADP ribosylating AB toxins?
(4)
1. Corynebacterium
2. Vibrio cholerae
3. E coli
4. Bordetella pertussis
C. diptheriae exotoxin
adp ribosylation inactivates elongation factor 2, causes pharyngitis and pseudomembrane
Vibrio cholerae exotoxin
adp ribosylates G protein which stimulates adenylyl cyclase, increases Cl- into gut and decreases Na+ absorption.
E coli exotoxin:
Labile like the Air
Stabile like the Ground
1. heat labile toxin stimulates adenylate cyclase
2. heat stable toxin stimulates guanylate cyclase
* both cause watery diarrhea.
Bordetella pertussis exotoxin
increases cAMP, causes whooping cough, inhibits chemokine receptor, causing lymphocytosis
Clostridium perfringens toxins
alpha toxin causes gas gangrene, get double zone of hemolysis on blood agar
-also beta toxin
C. tetani toxin
blocks the release of inhibitory neurotransmitters GABA and glycine
C. botulinum toxin
blocks the release of acetylcholine- causes anticholinergic symptoms, CNS symptoms, etc
Bacillus anthracis toxin
Edema factor is an adenylate cyclase
Shigella toxin
Shiga toxin cleaves host cell rRNA, enhances cytokine release, causing HUS
S. pyogenes toxin
Streptolysin O is a hemolysin
Antigen for ASO antibody, used to dx rheumatic fever
cAMP inducers
(4)
1. Vibrio- activates Gs, turns the "on" on.
2. Pertussis- inactivates Gi, turns the "off" off.
3. E coli heat labile toxin
4. B anthracis edema factor is an adenylate cyclase which increases cAMP.
1. What is endotoxin?
2. What does endotoxin activate (3 main things)?
1. A Lipopolysaccharide found in cell wall of gram neg bacteria
2. activates macs, activates complement, activates hageman factor
Endotoxin activates macrophages, which release what?
IL-1: fever
TNF: fever, hemorrhagic tissue necrosis
Nitric oxide: hypotension (shock)
Endotoxin activates complement, which release what?
C3a: hypotension, edema
C5a: neutrophil chemotaxis
Endotoxin activates hageman factor, which activates what?
Coagulation cascade -> DIC
The Bacterial growth curve:
What is going on in the lag phase?
metabolic activity without division
The bacterial growth phase:
What's going on in the log phase?
Rapid cell division
Aaaaggghhhh!
I'm bored of micro already and I have at least 30 more pages of First Aid. Help :(
The bacterial growth phase:
What is going on in the stationary phase?
Nutrient depletion slows growth. Spore formation in some bacteria.
What is transformation?
DNA is taken up directly from environment by prokaryotic and eukaryotic cells.
What is F+ x F- conjugation?
F+ plasmid contains genes required for conjugation process. Bacteria without plasmid are termed at F-. Plasmid is replicated and transferred through pilus from F+ cell. No transfer chromosomal genes.
What is Hfr x F- conjugation?
F+ plasmid can be incorporated into bacterial chromosomal DNA, termed Hfr. Replciation of incorporated plasmid DNA may include some of the flanking chromosomal DNA. Transfer of plasmid and chromosomal genes.
What is generalized transduction?
Lytic phage infects bacterium, leading to cleavage of bacterial DNA and synthesis of viral proteins.
What is specialized transduction?
Lysogenic phage infects bacterium, viral DNA is incorporated into bacterial chromosome. When phage DNA is excised, flanking bacterial genes may be excised with it.
What is transposition?
Segment of DNA can jump from one location to another, can transfer genes from plasmid to chromosome and vice versa.
Genes for which 5 bacterial toxins are encoded in a lysogenic phage?
ABCDE
Shig-A
Botulinum
Cholera
Diphtheria
Erythrogenic toxin of S. pyogenes
Gram positive cocci, catalase +
Staphylococcus
Gram positive cocci, catalase -
Streptococcus
Gram positive rods
Clostridium (anaerobe)
Corynebacterium
Listeria
Bacillus
Gram positive cocci, catalase +, coagulase +
S aureus
Gram positive cocci, catalase +, coagulase -, novobiocin sensitive
S epidermidis
Gram positive cocci, catalase +, coagulase -, novobiocin resistant
S saprophyticus
Gram positive cocci, catalase -, complete hemolysis (beta), bacitracin sensitive
S. pyogenes (group A)
Gram positive cocci, catalase -, complete hemolysis (beta), bacitracin resistant
S. agalactiae (group B- babies)
Gram positive cocci, catalase -, partial hemolysis (alpha, green), positive quellung, optochin sensitive, bile soluble
S pneumoniae
Gram positive cocci, catalase -, partial hemolysis (alpha, green), optochin resistant, not bile soluble
Viridans streptococci
(S mutans)
Gram positive cocci, catalase -, no hemolysis/gamma hemolysis
Enterococcus (E. faecalis)
Peptostreptococcus (anaerobe)
alpha hemolytic bacteria -green
s pneumoniae
viridans streptococci
beta hemolytic bacteria -clear
s aureus
s pyogenes
s agalactiae
listeria monocytogenes (tumbling motility)
What does catalase do?
degrades H2O2, an antimicrobial product of PMNs. Staphylococci make catalase, streptococci do not.
S. aureus virulence factor
Protein A
binds Fc IgG, inhibiting complement fixation and phagocytosis
S. aureus inflammatory diseases
skin infections
abscesses
pneumonia
S. aureus toxin-mediated diseases
1. toxic shock (TSST-1)
2. scalded skin syndrome (exfoliative toxin)
3. rapid onset food poisoning (enterotoxins)
MRSA infection
Resistant to beta lactams due to altered penicillin binding protein
S. epidermidis
prosthetics
catheters
normal skin flora
Streptococcus pneumoniae causes what?
(MOPS)
Meningitis
Otitis media (kids)
Pneumonia
Sinusitis

others: rusty sputum, sepsis in sickle cell anemia and splenectomy
Streptococcus pneumoniae characteristics
encapsulated
IgA protease
Viridans group stretococci causes what?
dental caries
subacute bacterial endocarditis
Viridans group stretococci characteristics
alpha hemolytic
normal flora of oropharynx
optochin resistant
S. pyogenes: pyogenic causes
pharyngitis
cellulitis
impetigo
S. pyogenes: toxigenic causes
scarlet fever
toxic shock syndrome
S. pyogenes: immunologic causes
rheumatic fever
acute glomerulonephritis
S pyogenes characteristics
bacitracin sensitive
M protein (host antibodies to M protein can cause rheumatic fever)
How do you detect a recent S pyogenes infection?
ASO titer
Rheumatic fever:
PECCS
Polyarthritis
Erythema marginatum
Chorea
Carditis
Subcutaneous nodules
S. agalactiae (group B) characteristics
Bacitracin resistant
Beta hemolytic
S. agalactiae (group B) causes what?
pneumonia
meningitis
sepsis
(mainly in babies)
Enterococci characteristics:
E. faecalis
E. faecium
penicillin G resistant
grows in 6.5% NaCl
lives in intestine
variable hemolysis
Enterococci causes what?
UTI
subacute endocarditis
VRE cause nosocomial infections
Lancefield group D
includes enterococci and nonenterococcal group D streptococci.

grouping is based on differences in C carbohydrate cell wall.
Streptococcus bovis
associated with colon cancer
a group D streptococci
Corynebacterium diphtheriae exotoxin
encoded by beta prophage
inhibits protein synth via ADP ribosylating EF-2
C. diphtheriae causes what?
pseudomembranous pharyngitis (grayish white membrane)
lymphadenopathy
How is C. diph. diagnosed?
Gram positive rods with metachromatic granules,
Loffler's media
tellurite plate
Bacterial spores: characteristics
formed by certain gram pos rods
at end of stationary phase
dipicolinic acid in their core
no metabolic activity
killed by autoclave
Which bacteria produce spores found in the soil?
B. anthracis
C. perfringens
C. tetani
What other bacteria produce spores (not found in soil)?
B. cereus
C. botulinum
Clostridia characteristics
gram pos
spore forming
obligate anaerobes
C. tetani exotoxin
blocks glycine release (inhibitory neurotransmitter) from Renshaw cells in spinal cord
C botulinum toxin
heat-labile, preformed
inhibits ach release at nm junction

(adults: ingestion of preformed toxin, babies: spores from honey)
C. perfringens toxin
alpha toxin (lecithinase)
causes myonecrosis (gas gangrene)
causes hemolysis
C difficile toxin
cytotoxin (exotoxin)
kills enterocytes
causes pseudomembranous colitis
(secondary to clindamycin or ampicillin)
C diff treatment
metronidazole
Bacillus anthracis characteristics
gram positive
spores
rod
produces anthrax toxin
protein capsule (D-glutamate)
B. antracis causes what?
1. Contact->
Black skin lesion: malignant papule (painless ulcer) covered by black eschar, can lead to bacteremia and death

2. Inhalation of spores-> Woolsorter's disease: flu-like that progresses to fever, pulm hemorrhage, mediastinitis, shock
Listeria monocytogenes characteristics
1. ingest unpasteurized milk/cheese, deli meat
2. vaginal transmission during birth
3. form "actin rockets" = tumbling motility
4. gram pos bacteria with endotoxin!
Listeria monocytogenes causes what in pregnant women?
amnionitis
septicemia
spontaneous abortion
Listeria monocytogenes causes what?
granulomatosis infantiseptica
neonatal meningitis
meningitis in immunocompromised, elderly
Actinomyces:
A. israelii
gram pos
branching filaments
yellow sulfur granules
anaerobe
normal oral flora
A. israelii causes what?
oral/facial abscesses that drain through sinus tracts in the skin
Nocardia asteroides
gram pos
weakly acid fact aerobe
found in soil
Nocardia causes what?
pulmonary infection in immunocomp. patients
Treatment: Nocardia vs. Actinomyces
SNAP:
Sulfa for Nocardia
Actinomyces uses Penicillin
Primary TB (nonimmune host, usually child)
Hilar nodes
Ghon focus, lower lobes
= Ghon complex
Secondary TB (partially immune hypersensitized host, usually adult)
fibrocaseous cavitary lesion, upper lobes
Primary TB --> heals by fibrosis --> ?
immunity and hypersensitivity --> tuberculin positive
Primary TB --> ? (in cases of HIV or malnutrition)
progressive lung disease --> death
Primary TB --> severe bacteremia--> ?
miliary TB --> death
Primary TB --> preallergic lymphatic or hematogenous dissemination -->?
dormancy in several organs --> reactivation as adult -->extrapulmonary TB
Extrapulmonary TB
1. CNS- parenchymal tuberculoma or meningitis
2. Pott's disease (vertebral body)
3. Lymphadenitis
4. Renal
5. GI
Secondary TB --> ?
Reactivation in lungs --> extrapulmonary TB
PPD+ means what?
current infection
past exposure
BCG vaccinated
PPD- means what?
no infection
anergic (steroids, malnutrition, immunocompromised, sarcoidosis)
Mycobacterium tuberculosis causes what symptoms?
fever
night sweats
weight loss
hemoptysis
M. kansasii
pulmonary TB-like symptoms
M. avium-intracellulare
resistant to multiple drugs
disseminated disease in AIDS
Characteristics of Mycobacterium
acid-fast
Mycobacterium leprae characteristics
acid-fact
bacillus
likes cold temps (superficial nerves, skin)
cannot be grown in vitro
armadillos
Leprosy treatment
long term oral dapsone
toxicity: hemolysis, methemoglobinemia

other treatment: rifampin, clofazimine/dapsone
M. leprae causes what symptoms?
loss of eyebrows
nasal collapse
lumpy earlobe
Hansen's disease
2 forms:
1. lepromatous (worse, failed cell mediated immunity)
2. tuberculoid (self limited)
Gram - cocci
Neisseria meningitidis
N. gonorrhoeae
Gram - cocci, maltose fermenter
N. meningitidis:
IgA protease
capsule
vaccine
Gram - cocci, maltose nonfermenter
N. gonorrhoeae
IgA protease
neonatal conjunctivitis
Gram -, coccoid rods
Haemophilus influenzae
Pasteurella- animal bites
Brucella
Bordetella pertussis
Gram - rods, lactose fermenters, fast fermenters:
(3)
Klebsiella
E Coli
Enterobacter
Gram - rods, lactose fermenters, slow fermenters:
(2)
Citrobacter
Serratia
Gram - rods, lactose fermenters:
CEEKS
Citrobacter
E Coli
Enterobacter
Klebsiella
Serratia
Gram - rods, lactose NON fermenters, oxidase -:
(4)
Shigella
Salmonella
Proteus
Yersinia
Gram - rods, lactose NON fermenters, oxidase +:
(1)
Pseudomonas
Gram - rods, lactose NON fermenters, oxidase -:
ShYPS
Shigella
Yersinia
Proteus
Salmonella
lactose fermenting enteric bacteria
grow pink colonies on MacConkey's agar
Gram - bugs: resistance
benzylpenicillin G
vancomycin
** outer membrane layer inhibits entry

(may be susceptible to ampicillin)
Neisseria characteristics
gram - cocci
ferment glucose
IgA protease
Nm ferments maltose
Ng ferments glucose
N. gonorrhoeae
no capsule
no maltose ferm
no vaccine
N. gonorrhoeae causes what?
gonorrhea
septic arthritis
neonatal conjunctivitis
PID
N. meningitidis
polysacc capsule
maltose ferm
vaccine
resp and oral secretions
N. meningitidis causes what?
meningitis
Waterhouse-Friderichsen syndrome
H. influenzae causes what?
EMOP
epiglottitis
meningitis
otitis media
pneumonia
H. influenzae
small gram neg coccobacillus
aerosol transmission
capsular type B in most invasive
IgA protease
H. influenzae vaccine
type B capsular polysacc conjugated to diptheria toxoid or other protein to promote class switching
(between 2 and 18 months)
How is H. influenzae cultured?
chocolate agar
factor V (NAD)
factor X (hematin)
H. influenzae treatment:
Ceftriaxone for meningitis
Rifampin for prophylaxis
Legionella pneumophila
gram neg rod
poor gram stain
silver stain
no person to person transmission
aerosol transmission from water source
How is legionella cultured?
charcoal yeast extract/iron/cysteine
Legionnaire's disease
severe pneumonia
Pontiac fever = mild
Legionella treatment
erythromycin
Pseudomonas causes what?
PSEUDO
pneumonia (CF)
sepsis (black lesions on skin)
External otitis (swimmers ear)
UTI
Drug use/Diabetic Osteomyelitis
(also hot tub folliculitis)
Pseudomonas characteristics
wound and burn infections
aerobic
gram neg rod
oxidase pos
non lactose ferm
produces pyocyanin (blue green)
grapelike oder
Pseudomonas toxin
endotoxin- fever, shock
exotoxin A- inactivates EF2
Pseudomonas treatment
aminoglycoside
plus extended spectrum penicillin
(piperacillin, ticarcillin)
Enterobacteriaceae
COFFEe:
Capsular K antigen- (virulence)
O antigen- (somatic, polysacc of endotoxin)
Flagellar H antigen (motility)
Ferments glucose
**oxidase negative!!
Enterobacteriaceae:
CEEKS SHYPS
Citrobacter
E Coli
Enterobacter
Klebsiella
Serratia

Shigella
Yersinia
Proteus
Salmonella
Klebsiella: 4 As
Aspiration pneumonia
Abscess in lungs
alcoholics
di-A-betics
(also nosocomial UTIs)
Klebsiella characteristics
gram neg rod
enterobacteriaceae
glucose
oxidase negative
red current jelly sputum!!
Salmonella
gram neg rod
non lactose ferm
oxid negative
glucose
invade intestinal mucosa -> bloody diarrhea
flagella = motile
produces H2S
animal reservoir
Shigella
gram neg rod
non lactose ferm
oxidase neg
glucose
invades intestinal mucosa -> bloody diarrhea
more virulent than salmonella
no flagella
propels through actin polymerization
Salmonella typhi
typhoid fever:
fever
diarrhea
headache
rose spots on abdomen
remains in gallbladder
Yersinia enterocolitica
pet feces (puppies)
contaminated milk, pork
day care outbreaks
symptoms like crohns, appendicitis
H. pylori
gastitis
duodenal ulcers
gastric adenocarcinoma
B cell lymphoma
urease positive
creates alkaline environment
Test for H pylori?
urease breath test
treat H pylori?
bisumuth
metronidazole
tetracycline or amoxicillin

(or met, omeprazole, clarithromycin)
Spirochetes: characteristics and types (3):

BLT
axial filaments
spiral shaped

Borrelia (big)
Leptospira
Treponema
Borrelia is visualized with:
analine dyes (wright or giesma stain)
in LM
Treponema is visualized with:
dark field microscopy
Leptospira interrogans
question mark shaped
water w/animal urine
tropics
Leptospira symptoms
flulike
fever
headache
abdominal pain
jaundice
Weil's disease
Weil's disease
leptospira
isterohemorrhagic leptospirosis:
severe jaundice and azotemia from liver and kidney dysfunction, fever, hemorrhage, anemia
Borrelia burgdorferi
Ixodes tick
Lyme disease
mice and deer reservoir
summer
NE US
Lyme disease
stage 1- erythema migrans (bulls eye rash), flulike
stage 2- CNS, cardiac
stage 3- chronic monoarthritis, migratory polyarthritis
Lyme disease:<BR>BAKE a key Lyme pie
bilateral Bell's palsy<BR>arthritis<BR>kardiac<BR>erythema migrans
Treponema pallidum
causes syphillus
Treponema pertenue
causes yaws; infection of skin/bone/joints --> healing with keloids--> limb deformity

disease of tropics
VDRL positive
Primary syphilis
painless chancre
Secondary syphilis
disseminated disease:
maculopapular rash (palms, soles)
condylomata lata
Tertiary syphilis
Gumma (chronic granuloma)
aortitis (vasa vasorum destruction)
neurosyphilis (tabes dorsalis)
argyll robertson pupils

signs: ataxia, pos romberg, charcot joints, stroke w/o HTN
Congenital syphilis
Saber shins
saddle nose
CN VIII deafness
Hutchinson's teeth
Argyll Robertson pupil
constricts with accomodation but not reactive to light.
Test for Treponema
FTA-ABS is specific, early positive, postive the longest

VDRRL is nonspecific, lots of false positives
VDRL +, FTA +
active syphilis
VDRL +, FTA -
false pos
VDRL -, FTA +
successfully treated
VDRL has false positives for:
Viruses
Drugs
Rheumatic fever
Lupus and Leprosy
Bartonella henselae
cat scratch fever
Borrelia burgdorferi
Lyme disease
Ixodes tick
deer/mice
Brucella
undulent fever
dairy
goats
Francisella
tularemia
rabbits
tick bite
deer
Yersinia pestis
plague
flea bite
rodents, prairie dogs
Pasteurella multocida
cellulitis
cat bite
Zoonotic bacteria:
Big bad bugs from your pet ella
bartonella
brucella
borrelia
francisella
yersinia
pasteurella
Gardnerella vaginalis
gram variable rod
vaginosis- gray/white fishy discharge
not an STD
clue cells- vaginal epithelial cells w/bacteria
positive whiff test
Treat gardnerella
metronidazole
Rickettsiae
oligate intracellular
need CoA and NAD
arthropod vector (except coxiella)
Rickettsiae symptom triad
fever
headache
rash/vasculitis
Treat Rickettsiae
tetracycline
Rickettsia rickettsii
Rocky mt spotted fever
-rash starts on hands/feet, spreads in

(Rickettsia on the rists, typhus on the trunk)
R typhi
Endemic typhus
fleas
rash starts centrally and spreads out

(Rickettsia on the rists, typhus on the trunk)
R prowazekii
epidemic typhus
human body louse
rash starts centrally and spreads out
Ehrlichia
Ehrlichiosis
tick
Coxiella burnetii
Q fever
inhaled aerosols
no rash
no vector
negative Weil-Felix
a Rickettsia
Palm and sole rashes:
CARS
Coxsackievirus A
Rocky Mountain spotted fever
Syphilis
Weil-Felix reaction
assays for antirickettsial antibodies, which cross react with proteus antigen

Positive for typhus and Rocky Mt, negative for Q fever
Chlamydiae
Cell wall lacks muramic acid
Obligate intracellular- can't make own ATP
cause mucosal infections
1. Elementary body (small, dense) enters cells via endocytosis
2. Reticulate/Initial body, replicates in cell by fission
C. trachomatis
reactive arthritis
conjunctivitis
nongonococcal urethritis
PID
C. pneumoniae
atypical pneumonia
transmitted by aerosol
C. psittaci
atypical pneumonia
transmitted by aerosol
lab diagnosis for chlamydia
cytoplasmic inclusions on Giesma or fluorescent antibody
Treatment for chlamydia
erythromycin or tetracycline
Chlamydia trachomatis serotypes A, B, C
chroinic infection
Africa
Blindness
Chlamydia trachomatis serotypes D-K
urethritis
PID
ectopic preg
neonatal pneumonia, conjunctivitis
Chlamydia trachomatis serotypes L1, L2, L1
lymphogranuloma venereum
positive Frei test
Chlamydia neonatal disease is acquired how?
passage through the birth canal
Mycoplasma pneumoniae
atypical walking pneumonia
X ray looks worse than patient
no cell wall, membrane contains cholesterol
military, prisons
Mycoplasma pneumoniae is grown on?
Eaton's agar
fungal spores
Most fungal spores are asexual
Coccidioidomycosis and histoplasmosis are transmitted by inhalation of spores

Conidia = asexual fungal spores
(blastoconidia, arthroconidia)
Histoplasmosis: where?
Mississippi and Ohio River Valleys
Histoplasmosis: What?
pneumonia
from bird/bat droppings
intracellular, inside macs
Blastomycosis: where?
East of Miss River and Central America
Blastomycosis: what?
Big, broad-based budding
lung, skin, bones
granulomatous nodules
cold = mold
heat = yeast
How is blastomycosis cultured?
On sabouraud's agar
Coccidioidomycosis: where?
SW US, California
Coccidioidomycosis: what?
Spherule filled with endospores
not dimorphic
Valley fever/desert bumps:
pneumonia
meningitis
bone
skin
Paracoccidioidomycosis: where?
Rural Latin America
Paracoccidioidomycosis: what?
captain's wheel appearance
budding yeast
Dimorphic fungi (mold in soil at cool temps, yeast at higher temps in tissue):
(3)
Histoplasmosis
Blastomycosis
Paracoccidioidomycosis
(NOT coccidioidomycosis)
Treat systemic mycoses
(histo, blasto,coccid, paracoccid)
fluconazole
ketoconazole
amphotericin B for systemic
Cutaneous mycoses
Tinea versicolor
tinea pedis, cruris, corporis, capitis
Malassezia furfur
causes tinea versicolor:
hot humid
spaghetti and meatball appearance
KOH prep
Treat tinea versicolor
topical miconazole
selenium sulfide
Tinea pedis, cruris, corporis, capitis
pruritic lesions with central clearing (ring)
not dimorphic, mold hyphae KOH prep
Tinea pedis, cruris, capitis, corporis caused by:
Microsporum, Trichophyton, Epidermophyton
Treatment for Tinea pedis, cruris, capitis, corporis
topical azoles
Candida albicans
yeast with pseudohyphae at 20 deg C
germ tubes at 37 deg C
oral thrush in immunocompromised, endocarditis, disseminated infection,
Treat Candida
nystatin for superficial
amph B for systemic
Aspergillus fumigatus
mold with septate hyphae, 45 deg angle
lung cavity fungus ball
Cryptococcus neoformans
encapsulated yeast
soil, pigeon droppings
sabouraud's agar
india ink
latex agglutination test detects cap
meningitis
Mucor and Rhizopus
mold with irregular nonseptate hyphae
wind angle branching
ketoacidotic diabetic patients
leukemic patients
frontal lobe abscesses
blood vessel/tissue necrosis
Pneumocystis jiroveci
yeast
inhaled
interstitial pneumonia
methanamine silver stain
immunosuppressed
Treatment for pneumocystis jiroveci
TMP-SMX
pentamidine
dapsone
Sporothrix schenckii
dimorphic
rose gardeners
cigar shaped budding yeast
local pustule or ulcer on skin
nodules along draining lymphatics
Treat Sporothrix
Itraconazole
potassium iodide
Giardia lamblia transmission
cysts in water
Giardia diagnosis
trophozoites or cysts in stool
Giarda disease
bloating
foul smelling watery diarrhea
campers, hikers
Giardia treatment
metronidazole
Trichomonas vaginalis disease
greenish discharge
itching
burning
strawberry colored mucosa
Trichomonas vaginalis transmission
sexual
Trichomonas vaginalis diagnosis
trophozoites (motile) on wet mount
Trichomonas vaginalis treatment
metronidazole
Trypanosoma cruzi disease
Chagas disease:
DCM
megacolon
megaesophagus

South America
Trypanosoma cruzi transmission
Reduviid "kissing" bug
Trypanosoma diagnosis
blood smear
Trypanosoma cruzi treatment
Nifurtimox
Trypanosoma gambiense and rhodesiense: disease
African sleeping sickness:
enlarged lymph nodes
recurring fever (antigenic variation)
coma
Trypanosoma g. and r. transmission
Tsetse fly
Trypanosoma g and r treatment
Suramin for bloodborne disease
Melarsoprol for CNS disease
Leishmania donovani disease
Visceral leishmaniasis (kala-azar):
spiking fevers
HSM
pancytopenia
Leishmania transmission
Sandfly
Leishmania dx
macrophages with amastigotes
Leishmania tx
Sodium stibogluconate
Plasmodium
Malaria:
cyclic fever
headache
anemia
splenomegaly
Relapsing malaria
P. vivax
P. ovale
-due to dormant hypnozoites in liver
Severe (cerebral) malaria
P. falciform
Plasmodium transmission
Anopheles mosquito
Plasmodium dx
blood smear
Plasmodium tx
Cholorquine
Primaquine prevents relapsing
Sulfadoxine + pyrimethamine
Mefloquine
quinine
Babesia disease
fever
hemolytic anemia
NE US
Babesia transmission
ixodes tick
Babesia dx
maltese cross on blood smear,
no RBC pigment
Babesia tx
quinine
clindamycin
Cryptosporidium disease
severe diarrhea w/AIDS
mild in others
Crytposporidium transmission
cysts in water
Cryptosporidium dx
cysts on acid fact stain
Cryptosporidium tx
none
Toxoplasma gondii disease
Brain abscess in HIV
birth defects (ring enhancing lesion)
Toxoplasma transmission
cysts in meat, cat feces
crosses placenta
Toxoplasma dx
serology
biopsy
Toxoplasma tx
Sulfadoxine + pyrimethamine
Entamoeba histolytica disease
bloody diarrhea
liver abscess
Entamoeba transmission
cysts (with 4 nuclei) in water
Entamoeba dx
serology
trophozoites or cysts in stool
RBCs in cytoplasm of entamoeba
Entamoeba tx
metronidazole
iodoquinol
Naegleria fowleri disease
Rapidly fatal meningoencephalitis
Naegleria fowleri transmission
freshwater lakes
enter through cribiform plate
Naegleria fowleri dx
amoebas in spinal fluid
Giardia: what type of organism?
protozoan
Trichomonas vaginalis: what type of organism?
protozoan
Trypanosoma: what type of organism?
protozoan
Leishmania: what type of organism?
protozoan
Plasmodium : what type of organism?
protozoan
Babesia: what type of organism?
protozoan
Cryptosporidium: what type of organism?
protozoan
Toxoplasma: what type of organism?
protozoan
Entamoeba: what type of organism?
protozoan
Naegleria fowleri: what type of organism?
protozoan
what is a helminth?
multicellular organism
parasitic worm
what is a nematode?
roundworm
what is a cestode?
tapeworm
what is a trematode?
fluke
Enterobius vermicularis: what type of organism?
nematode
Ascaris lumbricoides: what type of organism?
nematode/roundworm
Trichinella spiralis:what type of organism?
nematode/roundworm
Strongyloides stercoralis: what type of organism?
nematode/roundworm
Ancylostoma duodenale, necator americanus (hookworm):what type of organism?
nematode/roundworm
Dracunculus medinensis: what type of organism?
nematode/roundworm
Onchocerca volvulus: what type of organism?
nematode/roundworm
Loa loa: what type of organism?
nematode/roundworm
Wuchereria bancrofti: what type of organism?
nematode/roundworm
Toxocara canis: what type of organism?
nematode/roundworm
Taenia solium: what type of organism?
Cestode/tapeworm
Diphyllobothrium latum: what type of organism?
cestode/tapeworm
Echinococcus granulosis: what type of organism?
cestode/tapeworm
Schistosoma: what type of organism?
trematode/fluke
Clonorchis sinensis: what type of organism?
trematode/fluke
paragonium westermani: what type of organism?
trematode/fluke
Enterobius vermicularis
pinworm
food with eggs
intestinal infection
anal pruritus (scotch tape test)
Enterobius vermicularis tx
mebendazole/pyrantel pamoate
Ascaris lumbricoides
A scary giant roundworm
eggs in feces
intestinal infection
Ascaris tx
mebendazole/pyrantel pamoate
Trichinella spiralis
undercooked pork
muscle inflammation (larvae)
periorbital edema
Trichinella tx
thiabendazole
Strongyloides stercoralis
larvae in soil
penetrate skin
intestinal infection -> anemia
Strongyloides tx
Ivermectin/thiabendazole
Ancylostoma duodenale/necator americanus
hookworms
larvae penetrate feet
intestinal infection -> anemia
Ancylostoma and Necator tx
mebendazole/pyrantel pamoate
dracunculus medinensis
drinking water
skin inflammation
skin ulceration
Dracunculus tx
niridazole
Onchocerca volvulus
female blackflies
river blindness
skin nodules
"lizard skin"
Onchocerca tx
Ivermectin (Iver eye, Iver rIVER)
Loa Loa
deer fly, horse fly, mango fly
skin swelling
eye worm- ick!
Loa loa tx
diethylcarbamazine
toxocara canis
food w/eggs
granulomas
if in retina -> blindness
visceral larva migrans
toxocara tx
diethylcarbamazine
Wuchereria bancrofti
female mosquito
blocks lymph vessels
elephantitis
Wuchereria tx
diethylcarbamazine
Taenia solium
ingest larvae in undercooked pork
ingest eggs -> cysticercosis and
neurocysticercosis
"swiss cheese" appearance
Taenia solium tx
prazaquentel for intestinal worms
albendazole for neurocysticercosis
Diphyllobothrium latum
ingest larvae from freshwater fish
Vit B12 def -> anemia
Diphyllobothrium tx
praziquental
Echinococcus granulosas
eggs in dog feces
hydatid cysts in liver
can cause anaphylaxis
Echinococcus tx
Albendazole
Schistosoma
snails host
penetrate skin
granulomas
fibrosis
inflammation of spleen, liver
SCC of bladder!
Schistosoma tx
praziquantel
Clonorchis sinensis
undercooked fish
inflammation of biliary tract
pigmented gallstones
cholangiocarcinoma
Clonorchis tx
praziquantel
Paragonimus westermani
undercooked crab
infection of lung
Paragonimus tx
praziquantel
Nematodes with ingested routes of infection:
EAT
Enterobius
Ascarcis
Trichinella
Nematodes with cutaneous routes of infection:
SANd
Strongyloides
Ancylostoma
Necator
Brain cysts, seizures
parasite
Taenia solium
liver cysts
parasite
echinococcus granulosus
b12 deficiency
parasite
Diphyllobothrium latum
biliary tract disease
parasite
Clonorchus sinensis
Hemoptysis
parasite
Paragoniums westermani
Portal HTN
parasite
Schistosoma haematobium
Hematuria, bladder cancer
Schistosoma
Microcytic anemia
hookworms
Ancylostoma
Necator
Perianal pruritis
Enterobius
Typhoid fever
Salmonella typhi
Typhus
Rickettsia prowazekii (epidemic)
R. typhi (endemic)
R. tsutsugamushi (scrub typhus)
Nematodes:
EAT SAND TOWEL
Enterobius, Ascaris, trichinella
strongyloides, ancylo, necator
toxocara, onchocerca, wuchereria, loa
Cestodes:
TED has a tapeworm
Taenia
echinococcus
diphyllobothrium

(pigs, dog, fish)
Trematodes:
PSC
paragonium
schistosoma
clonorchis

(lung, bladder, gb)
(crab, snail, fish)
Recombination
exchange of genes between 2 chromosomes by crossing over within regions of significant base sequence homology
Reassortment
Viruses with segmented genomes exchange segments. High freq recombination. Causes worldwide flu pandemics
Complementation
1 of 2 viruses that infect the cell has a mutation that results in nonfunctional protein. Nonmutated virus complements the mutated one by making a functional protein that serves both
Phenotypic mixing
Simultaneous infection of cell with 2 viruses. Genomes of A can be partially or completely coated with surface proteins of B. Type B determines infectivity. Type A's genetic material make progeny
Live attenuated vaccines
induce humoral and cell mediated immunity

no booster needed
Killed vaccines
induce only humoral immunity
Live attenuated vaccine examples
MMR
Sabin polio
VZV
yellow fever
smallpox
Killed vaccine examples:
RIP Always
Rabies
Influenza
Polio- salk
HAV
Recombinant vaccine
HBV
HPV
Which DNA virus is single stranded?
Parvoviridae
("part of a virus")
Which DNA viruses are NOT linear?
papilloma
polyoma
hepadnavirus

(rest are linear)
Which RNA virus is double stranded?
Reoviridae

("repeato-virus")
Which is infectious?
+ strand or - strand ssRNA
+

(- strand and dsRNA are not infectious)
Which virus is not haploid?
Retrovirus has 2 identical ssRNA molecules
Which DNA virus does NOT replicate in the nucleus?
pox
Which RNA virus does NOT replicate in the cytoplasm?
Influenza virus
retrovirus
Naked viruses:
CPR and PAPP
Calci, Picornavirus, Reo, Parvo, Adeno, Papilloma, Polyoma
DNA enveloped viruses
Herpes
HBV
Pox
DNA nucleocapsid viruses
Adeno
papillo
parvo
RNA enveloped viruses
influenza
parainfluenza
RSV
MMR
rabies
HTLV
HIV
RNA naked viruses
Enteroviruses (polio, coxsackie, echo, HAV)
rhino
reo
DNA viruses:
HHAPPPPy
hepadna
herpes
adeno
pox
parvo
papilloma
polyoma
Almost all DNA viruses are:
double stranded
linear
icosahedral
replicate in nucleus
Which DNA virus is not icosahedral?
Pox (complex)
Herpesvirus family:
names
envelope?
dna structure
HSV
VZV
EBV
CMV
HHV6, 7, 8

(envelope, linear)
Hepadnavirus
disease
envelope?
dna structure
HBV
Envelope
ds, partial circular
Adenovirus:
disease
envelope?
dna structure
pharyngitis
pneumonia
conjunctivities (pink eye)

no env
ds linear
Parvovirus
disease
envelope?
dna structure
B19 virus- aplastic crises in sickle cell
slapped cheek rash-
erythema infectiosum (5th disease)
hydrops fetalis

no env
ss linear
Papillomavirus
disease
envelope?
dna structure
HPV- warts, CIN, cervical cancer

no env
ds circular
Polyomavirus
disease
envelope?
dna structure
JC- PML in HIV

no env
ds circular
Poxvirus
disease
envelope?
dna structure
smallpox
vaccinia- cowpox
molluscum contagiosum

envelope
ds linear
largest dna virus
HSV-1:
what does it cause
how is it transmitted
Herpesvirus
gingivostomatitis
keratoconjunctivitis
temp lobe encephalitis
*respiratory secretions,
HSV-2
what does it cause
how is it transmitted
herpes genitalis
neonatal herpes

sexual contact, perinatal
VZV
what does it cause
how is it transmitted
shingles
encephalitis
pneumonia
*respiratory secretions
EBV
what does it cause
how is it transmitted
infectious mononucleosis
burkitt's lymphoma
nasopharyngeal carcinoma
*respiratory, saliva
CMV
what does it cause
how is it transmitted
Congenital infection
mono (negative monospot)
pneumonia

congenital, transfusion, sexual, saliva, transplant, urine
***cells have owl's eye appearance***
HHV-8
what does it cause
how is it transmitted
Kaposi's sarcoma in HIV patients

sexual contact
HSV identification
Tzanck test- smear of open skin vesicle to detect multinucleated giant cells

Intranuclear Cowdry A inclusions
EBV characteristics
infects B cells
abnormal T cells

postive monospot test- heterophil antibodies detected by agglutination of sheep RBCs
EBV symptoms
fever
HSM
pharyngitis
lymphadenopathy (posterior cervical nodes)
Reovirus:
env?
structure?
capsid symmetry?
RNA
no envelope
ds linear
icosahedral
Reo diseases
reovirus- colorado tick fever
rotavirus- diarrhea in kids
Picornaviruses
env?
structure?
capsid symmetry?
no env
ss + linear
icosahedral
Pico diseases
polio
echovirus- aseptic meningitis
rhinovirus- common cold
coxsackievirus- asceptic meningitis, herpangina- febrile pharyngitis, hand/foot/mouth disease, myocarditis
HAV- acute viral hepatitis
Hepevirus
env?
structure?
capsid symmetry?
no envelope
ss + linear
icosahedral
Caliciviruses
env?
structure?
capsid symmetry?
no envelope
ss + linear
icosahedral
Calcivirus disease
Norwalk virus- viral gastroenteritis
Flaviviruses
env?
structure?
capsid symmetry?
envelope
ss + linear
icosahedral
Flavivirus diseases
HCV
Yellow fever
Dengue
St Louis encephalitis
West Nile
c yellow dengue west of st louis
Togavirus
env?
structure?
capsid symmetry?
envelope
ss + linear
icosahedral
Togavirus diseases
Rubella
EEE
WEE
Retroviruses
env?
structure?
capsid symmetry?
envelope
ss + linear
icosahedral
Retroviruses
HIV
HTLV- T cell leukemia
Coronavirus
env?
structure?
capsid symmetry?
envelope
ss + linear
helical
Coronavirus diseases
common cold
SARS
Orthomyxoviruses
env?
structure?
capsid symmetry?
envelope
ss - linear, 8 segments
helical
Orthomyxovirus disease
influenza
Paramyxoviruses
env?
structure?
capsid symmetry?
envelope
ss - linear
nonsegmented
helical
Paramyxoviruses diseases
PaRaMyxovirus:
P- parainfluenza-croup
R-RSV- bronchiolitis in babies
M- measles/rubeola
M- mumps
Rhabdovirus
env?
structure?
capsid symmetry?
envelope
ss - linear
helical
Rhabdovirus disease
rabies
Filovirus
env?
structure?
capsid symmetry?
envelope
ss - linear
helical
filovirus diseases
Ebola
Marburg hemorrhagic fever
Arenavirus
env?
structure?
capsid symmetry?
envelope
ss - linear
2 segments
helical
Arenavirus diseases
LCMV- lymphocytic choriomeningitis
lassa fever encephalitis (mice)
Bunyaviruses
env?
structure?
capsid symmetry?
envelope
ss - circular
3 segments
helical
Bunyaviruses diseases
California encephalitis
Sandfly/Rift Valley fevers
Crimean-Congo hemorrhagic fever
Hantavirus- hemorrhagic fever, pneumonia
Deltavirus
env?
structure?
capsid symmetry?
envelope
ss - circular
helical
Negative stranded viruses:
Always Bring Polymerase Or Fail Replication
Arena
Bunya
Paramyxo
Orthomyxo
Filo
Rhabdo
Segmented viruses:
BOAR
all are RNA viruses:
Bunya
Orthomyxo
Arena
Reo
Name all the picornaviruses:
PERCH on a peak
Poliovirus
Echovirus
Rhinovirus
Coxsackievirus
HAV
Rhinovirus
nonenveloped RNA
common cold
> 100 serologic types
Yellow fever virus characteristics
flavivirus
Aedes mosquito with human/monkey reservoir
Councilman bodies (acidophilic) in liver
Yellow fever symptoms
fever, black vomitus, jaundice
Rubella virus
Togavirus
German 3 day measles
fever, lymphadenopathy, arthralgias
fine truncal rash
congenital disease
Rotavirus
segmented dsRNA
infantile gastroenteritis
winter
day care
*villous destruction with atrophy leads to decreased absorption of Na+ and water
Orthomyxovirus characteristics
enveloped
ssRNA
segmented genome
hemaglutinin (promotes viral entry)
neuraminidase (progeny release)
Genetic shift
pandemic
reassortment of viral genome
(like swine flu)
Genetic drift
epidemic
minor changes based on random mutation
Measles/Rubeola
Koplik spots (red with blue/white center on buccal mucosa)
SSPE
encephalitis
giant cell pneumonia
rash from head to toe
(cough, coryza, conjunctivitis, koplik)
Mumps:
POM
Parotitis
Orchitis
asceptic meningitis
Rabies
Negri bodies-cytoplasmic inclusion bodies in neurons
Bullet shaped capsid
fatal encephalitis, hyrdophobia, hypersalivation, pharyngeal spasm
(travels up CNS retrograde)

bat, raccoon, skunk bites
Arboviruses:
Fever Transmitted by Bites
mosquitos, ticks

Flavivirus
Togavirus
Bunya
Variola
pox
HAV
asymptomatic
acute
alone (no carriers)

RNA picornavirus
HBV
Blood borne
DNA hepadna
3 mo incubation
carriers
RNA polymerase
HCV
Chronic
Cirrhosis
Carcinoma
Carriers
IV drug users, post tranfusion
HDV
defective, dependent on HBV
coinfects or superinfects
HEV
Enteric
Expectant mothers- high mortality
Epidemic- water borne
IgG HAVAb
prior infection
IgM HAVAb
active hep A
HBsAg
active
continued = carrier
HBsAb
immunity to hep B
surface antibody
HBcAg
core antigen
HBcAb:
IgM
IgG
postive during window period
IgM HBcAb = recent disease
IgG = chronic
HBeAg
indicates high infectivity
active viral replication
HBeAb
low transmissibility
HBsAg +, HBsAb -, HBcAb+
acute disease
HBsAg -, HBsAb -, HBcAb +
window phase
HBsAg -, HBsAb +, HBcAb +
complete recovery
HBsAg +, HBsAb -, HBcAb +
chronic carrier
HBsAg -, HBsAb +, HBcAb -
Immunized
HIV:
1. p24 = ?
2. gp41 = ?
3. gp120 = ?
4. p17 = ?
1. capsid protein
2. envelope protein
3. envelope protein
4. matrix protein
HIV binds which receptors on T cells?
CXCR4
CD4
HIV binds which receptors on macs?
CCR5
CD4
homozygous CCR5
immunity
heterozygous CCR5
slower HIV course
HIV diagosis
1. ELISA
2. Western blot
3. PCR- viral load
ELISA
first test for HIV
sensitive
high false positive
RULE OUT test
Western Blot
second test for HIV
specific
high false negative
high threshold
RULE IN test
AIDS diagnosis is made when?
equal to or > than 200 CD4+
with AIDS indicator condition (PCP)
or CD4/CD8 ratio < 1.5
Babies born to mothers with HIV:
positive or neg ELISA?
positive or neg Western?
positive:
anti-gp120 crosses placenta
Time course of HIV:
4 stages
1. Flu like
2. Feel fine- latent
3. falling count
4. final crisis
Opportunistic infections in AIDS:
brain
cryptococcal meningits
toxoplasmosis
CMV encephalopathy
AIDS dementia
PML (JC virus)
Opportunistic infections in AIDS:
eyes
CMV retinitis
Opportunistic infections in AIDS:
mouth and throat
thrush-candida
HSV
CMV
oral hairy leukoplakia (EBV)
Opportunistic infections in AIDS:
lungs
Pneumocystis jiroveci pneumonia
TB
Histoplasma
Opportunistic infections in AIDS:
GI
Cryptosporidiosis
MAC
CMV colitis
non-Hodgkin's lymphoma (EBV)
Opportunistic infections in AIDS:
Skin
shingles
kaposi
Opportunistic infections in AIDS:
Genitals
Herpes
warts
cervical cancer
Infections at < 400 CD4
thrush, VZV reactivation, TB reactivation,
infections at < 200 CD4
reactivation HSV, crypto, coccidiod., Pneumocystis
infections at <100 CD4
candida, toxoplasma, histoplasma
infections at < 50 CD4
MAC, CMV retinitis, crypto meningitis
HIV encephalitis
late in the course
gains CNS access via macs
microglial nodules with multinucleated giant cells
Prions
infectious proteins
spongiform encephalopathy
normal prions have alpha helix confirmation, these are beta pleated sheet that cant be digested
Prion diseases
CJD- rapid progressive dementia
kuru
mad cow
scrapie (sheep)
Skin normal flora
S. epidermidis
Nose normal flora
S. epidermidis
Oropharynx normal flora
Viridans group streptococci
Dental plaque normal flora
S. mutans
Colon normal flora
bacteroides fragilis
E coli
vagina normal flora
lactobacillus
Contaminated seafood bugs
Vibrio
Reheated rice bug
B cereus
Meat, mayo, custurd
S aureus
reheated meat
C. perfringens
canned foods
C botulinum
undercooked meat
E coli O157:H7
meat, poultry, eggs
Salmonella
bloody diarrhea bugs
Camplylobacter
Salmonella
Shigella
Enterohemorrhagic E coli
Enteroinvasive E coli
Yersinia enterocolitica
C diff
Watery diarrhea bugs
Enterotoxigenic E coli
Vibrio cholerae
C perfringens
C diff
Giardia
Crytosporidium
Rotavirus
Adenovirus
Norwalk virus
Pneumonia in neonates
Group B strep
E coli
Pneumonia in children:
Runts May Cough Sputum
RSV
Mycoplasma
C. pneumoniae
S. pneumoniae
Pneumonia in adults 18-40
Mycoplasma
C. pneumoniae
S. pneumoniae
Pneumonia in adults 40-65
S. pneumoniae
H influenzae
Mycoplasma
Pneumonia in elderly
S pneumoniae
H influenzae
Pneumonia in alcoholics
S. pneumoniae
Klebsiella
Staph
Pneumonia in Cystic Fibrosis
Pseudomonas
Meningitis in newborn
group B streptococci
E coli
Listeria
Meningitis in children 6 mo - 6 yrs
S. pneumoniae
Neisseria meningitidis
H. influenzae
Enterovirus
Meningitis in 6-60 yrs
N. meningitidis
Enteroviruses
S. pneumoniae
HSV
Meningitis 60 +
S pneumoniae
Gram neg rods
Listeria
Viral causes of meningitis
Coxsackievirus
HSV
HIV
West Nile virus
VZV
CSF findings in meningitis:
high pressure
high PMNs
high protein
low sugar
bacterial cause
CSF findings in meningitis:
high pressure
high lymphocytes
high protein
low sugar
fungal/tb
CSF findings in meningitis:
normal/high pressure
high lymphocytes
normal/high protein
normal sugar
Viral cause
Osteomyelitis in most people
S aureus
Osteomyelitis in sexually active
N. gonorrhaeae (rare)
Osteomyelitis in diabetics and drug addicts
Pseudomonas aeruginosa
Osteomyelitis in Sickle cell
Salmonella
Osteomyelitis in prosthetic replacement
S aureus and S epidermidis
Vertebral Osteomyelitis
Pott's disease- TB
Osteomyelitis and animal bites
Pasteurella
Ambulatory UTIs
E coli
Klebsiella
S saprophyticus (2nd most common in young sexually active women)
(most are ascending)
Hospital acquired UTIs
E coli
Proteus
Klebsiella
Serratia
Pseudomonas
UTI bugs:
SSEK PP
Serratia
S saprophyticus
E coli
Klebsiella
Proteus
Pseudomonas
Serratia marcescens
red pigment
nosocomial and drug resistant
UTI diagnostic markers
Leukocyte esterase positive:
bacterial

Nitrite test positive:
gram negative
Enterobacter UTIs
nosocomial
drug resistant
Klebsiella pneumoniae
large mucoid capsule
viscous colonies
Proteus mirabilis
swarming motility on agar
produces urease
associated with struvite stones
ToRCHeS infections
Toxoplasma gondii
Rubella
CMV
HIV
HSV 2
Syphilis
**others: listeria, E coli, group B strep
Toxoplasma gondii congenital problems
chorioretinitis
intracranial calcifications
hydrocephalus
Rubella congenital problems
deafness
cataracts
heart- PDA, pulmonary artery stenosis
CMV congenital problems
petechial rash
intracranial calcifications
mental retardation
HSM
microcephaly
jaundice
HIV congenital problems
HSM
neurologic
infections
HSV 2 congenital problems
encephalitis
conjunctivitis
vesicular skin lesions
***most transmitted during birth through infected maternal genital tract
Syphilis congenital problems
cutaneous lesions
HSM
jaundice
saddle nose
saber shins
Hutchinson teeth
CN VIII deafness
rhinitis
Childhood rashes
Measles
Rubella
HHV 6 (roseola)
scarlet fever (group A strep)
parvovirus B19- slapped cheek
H. ducreyi
painful chancre
("do cry" = ducreyi)
Pelvic Inflammatory disease:
causes and symptoms
C. trachomatis
N. gonorrhea

Cervical motion tenderness (chandelier sign)
discharge
Fitz-Hugh-Curtis syndrome
Fitz-Hugh-Curtis syndrome
PID
infetion of liver capsule and "violin string" adhesions of parietal peritoneum to liver
Newborn nursery bugs
CMV
RSV
Urinary catheters bugs
E coli
Proteus
Respiratory therapy equipment bug
Pseudomonas
Hyperalimentation
Candida albicans
Water aerosols bug
Legionella
Pus, empyema, abscess
bug?
S aureus
Pediatric infection
most likely bug?
H influenzae
Traumatic open wound
bug?
C perfringens
Currant jelly sputum
bug?
Klebsiella
Sepsis/meningitis in newborn
bug?
group B strep