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116 Cards in this Set
- Front
- Back
What are the different bugs of clostridia?
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tetani- tetanus
botulinum- botulism perfringens- alpha toxin- myonecrosis, gas gangrene, hemolysis Dificile- cytotoxin, kills enterocytes- pseudomembronous colitis. (metronidazole) |
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what are the buzz words in tetanus?
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rusty nail
tetanus toxi prevents Gaba and glycine- inhibition of inhibitors lockjaw risus sardonicus- grotesque grinning Formalin inactivated toxin is prophylaxis |
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What happens with anthrax infection?
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Contact- malignant pustule (painless ulcer) can cause bacteremia and death
Inhalation- flu symps that progress to fever, pulm hemorrhage and shock Black skin lesions- vesicular papules covered by black eschar Woolsorter's disease- inhalation of spores from contaminated wool |
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What is Edema Factor, Protective Antigen, and Lethal Factor?
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Proteins in the toxin of anthrax
Edema factor - A subunit of the exotoxin. Calmodulin-dependant. Increase cAMP, impairs neutrophils- massive edema Protective Antigen- promotes entry of EF into phagocytic cells Lethal Factor- Zn MMP that inactivates protein kinase. simms TNF alpha |
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What are the ABCDEFG of Diphtheria?
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ADP ribosylation
Beta Prophage Corynebacterium Diphtheriae Elongation Factor 2 Granules (metachromatic)/Grows on Tellurite |
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What must be done on first suspicion of Diptheria?
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Antitoxin- only works on circulating toxin
Penicillin or Erythromycin- kill the bacteria, prevent more toxin Vaccinate- immunity does not develop w/o vaccine |
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What's special about Listeria?
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Only G+rod with endotoxin
meningitis in neonates and immunosuppressed ampicillin and trimethoprim-sulfamethoxazole kill. |
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What is the difference between Actinomyces and Nocardia
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Aw SNAP
Sufa for Nocardia Actinomyces give Penicillin Actinomyces forms sulfur granules Nocardia is acid-fast Actino- facial abcess (normal oral flora) Nocardia- pulmonary infection in the immunocomprimised |
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What are the virulence factors of Neisseria Meningitidis?
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Capsule- surrounds the bacterium and is antiphagocytic. A,B,C cause meningitis
Endotoxin- can release endotoxin, cause blood vessel destruction and sepsis. IgA1 protease- Only found in pathogenic, cleaves IgA Can extract Iron from transferrin |
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What are the symptomes of Meningococcemia?
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spiking fevers, chills, arthralgia, muscle pain, rash
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What are the symptoms of fulminant meningococcemia?
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septic shock, bilateral hemmorage into adrenals. Hypotension, tachy
DIC, Coma |
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What are the symptoms of Meningitis?
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neonates- bulging ant fontanelle
older infants- stiff neck, Kernig's, bruzinski's |
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What is thayer-martin VCN?
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chocolate agar (heated blood) with vancomycin, colistin and nystatin to kill G+, G-, and fungi
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Which can ferment maltose gonorrhea or meningococcus?
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meningo
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What is the treatment for neisseria?
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penicillin G, ceftriaxone
close contacts- rifampin |
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What is the Rx for clostridium perfringens?
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Hyperbaric O2, abtics-penicillin, and removal of nectrotic tissue
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What are the virulence factors of N. gonorrhoeae?
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Pili- changes like crazy. adhere to host, prevent phagocytosis by holding bacteria very close to host cells
Protein II- also involved in adherance to host |
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What are the differences between meningo and gonococcus?
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Gono
no polysaccharide no maltose no vaccine |
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What are the symps of gonococcal disease?
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Men- penetrates mucous membranes of the urethra- inflamm, painful urination. discharge
Women- PID, endometritis, salpingitis, oophoritis. fever, pain, abnl bleeding, cervical motion tenderness |
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What are the complications of PID?
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Scarring of the fallopian tube
Sterility ectopic pregnancy abscesses peritonitis peri-hepatitis- infection of the capsule around the liver RUQ pain and tenderness |
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What is Fitz-Hugh-Curtis Syndrome?
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peri-hepatitis- chlamydia or gonococcal infection of the capsule of the liver
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What are the symptoms of septic arthritis?
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Acute fever with swelling of the joints. Can have rapid destruction of the joint.
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What are the symptoms of Gonococcal bacteremia?
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fever, joint pain, skin lesions (extremities)
Pericarditis, endocarditis, meningitis. |
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What is ophthalmia neonatorum?
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eye infection from delivery transmission to newborn. can damage the cornea
Rx- erythromycin eye drops |
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What is the Rx of choice for Gonorhea?
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ceftriaxone
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Which capsule in H. Influenza is bad?
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Capsule= a-f, B is Bad
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How long does mom immunity for H. Influenza last in kids?
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6months.
kids develop their own at 3yrs |
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What does H. Influenza cause?
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haEMOPhilus Influenza
E-epligottitis- rapid swelling, blocks resp and esophagus. exam of airway can cause laryngospasm. drool Meningitis- Nonspecific signs- fever, vomit, altered mental status Otitis Media Pneumonia Septic Arthritis- single joint- fever, pain swelling, most common arthritis in kids sepsis- fever, lthargy, loss of appetite, no localized disease |
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What is the treatment for H. flu?
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cefotoxime, ceftriaxone for serious
ampicillin or amoxicillin for less serious |
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What is the vaccine of H. Flu contain?
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B capusle attached to diptheria toxin to activate t-cells.
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What bug causes achancroid, unilaterally painful, swollen lymphnoses that can rupture?
What's the DDx and what can differentiate? |
Haemophilus ducreyi
Syphilis and chlamydia are painless Herpes has systemic symps |
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What are clue cells?
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Diagnostic of Gardnerella/Haemophilus vaginalis.
Rx- metronidazole |
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How does the exotoxin of bordatella pertussis function?
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activates cell-membrane bound G regulatory proteins. Turns off the inhibition. Increase in cAMP.
Histamine sensitization Insulin synthesis inhibition of phagocytosis |
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What are the virulence factors of pertussis?
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Toxin
extracytoplasmic Adenylate cyclase- swallowed by neutrophils, lymphocytes, and monotcytes. Impaired chemotaxis, increase in H2O2 Filamentous hemagglutinin- attaches to ciliated epi cells. Tracheal cytotoxin- destroys the ciliated epi cells |
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What are the stages of pertussis?
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Catarrhal- 1-2 wks, liek a URI
Paroxysmal- the cough, can cause vomiting, cyanosis. Large increase in lymphocytes Convalescent- no longer contagious, attacks die down. |
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What organism do you need a calcium alginate swab for?
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Pertussis
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What type of medium must be used for b. pertussis?
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Bordet-Gengou medium- potato, blood and glycerol
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How do you treat pertussis?
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Erythromycin in the catarrhal stage may prevent disease.
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Didn't you ever see the movie Legionairre?
what's the low-down |
Jean Claude Van Damme
aerosolized contaminated water intracellular Pontiac fever- muscle aches, fatigue, fever and chills. quick legionnaires- high fever and severe pneumonia. Older, smoker, Gram stain with neutrophils and no organisms. erythromycin |
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What culture must be used for Legionaire's?
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silver stain,
Charcoal Yeast cysteine? |
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what does H2S give bacteria the ability to do?
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liquify gelatin, hydrolize urea, and decarboxylate
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What's so special about Eosine Methylene Blue and MacConkey Agar?
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for lactose fermenters
EMB- become blue, and G+ are inhibbed MacConkey- bile salts, inhibit G+, lactose fermenters become pink |
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What are the O, K and H antigens in the enterics?
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O- LPS, O is outer
K- capsule H- flagella, antigenic. |
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What bugs can get all up and in them lymph nodes?
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Salmonella typhi, Yersinia enterocolitica, campylobacter
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What bugs are enteroinvasive?
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Salmonella, Shigella, E. Coli
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Which bugs ferment lactose?
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Lactose is KEE
Klebsiella, E. Coli, Enterobacter, Citrobacter |
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What are the virulence factors of E. Coli?
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Mucosal:
adhereance with pili Can invade Exotoxin Heat-labile and Stable Shiga like Endotoxin Libid A Fe binding siderophore |
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What is the mechanism of the heat labile and stable toxin?
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Prevent resorbstion of Na and Cl, and stim secretion of Cl and HCO3
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What is the mechanism of shiga-like toxin?
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Inhibit protein synthesis by the 60s Ribosome
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What is Hemolytic Uremic Syndrome?
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anemia, thrombocytopenia, infection of O157:H7
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What is EIEC?
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same disease as Shigella, can invade epithelial cells. Fever, WBCs in stool.
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What virulence factor allows E. coli to cause UTIs?
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pili
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What does Klebsiella cause?
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Hospitals, sepsis
UTI in foley catheters. Hospitalized patients and alcoholics. Bloody sputum, 50% of cases. Produces cavities. red currant jelly. O antigen capsule. |
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Breakdown Proteus mirabilis:
What happens on agar? what's it's relationship with urea? What disease? How do you Dx? |
Moves around on agar
splits urea causes UTI, Dx- alkaline urine. |
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What are the similarities and differences between Salmonella and Shigella?
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Both non-lactose fermenters
Invade Intestine and cause bloody diarrhea SalMonella is Motile and can disseminate further. Symptoms can be prolonged with abtics. has an animal reservoir Shigella does not have a reservoir and is transmitted by Food, Fingers, Feces, and Flies. Shigella is more virulent |
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What are the four disease states of salmonella?
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1. typhoind
2. carrier state 3. sepsis 4. gastroenteritis |
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What is typhoid Fever?
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enteric fever
can invade regional lymph nodes. seeds in multiple organ systems. Bacteria are pahgocytosed by monos and can survive intracellularly, !!!How facultative!!! tenderness over Right lower quadrant. rose spots on abdomen. Can be a carrier if it just hangs in the gallbladder. treat with cipro or ceftriaxone encapsulated, so no spleen = more likely to be infected |
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What are the sources of Yersinia enteroliticus infection?
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puppie poo
contaminated milk pork Outbreaks in daycare |
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How does Yersinia enteroliticus cause disease?
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Invades -> notes and bloodstream
Enterotoxin- secrete enterotoxin similar to heat -stable toxin to cause diarrhea survives in the cold |
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What would microscopic examination of the stool of a cholera patient show?
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no WBCs, but some curved, darting rods.
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What bug gives the japanese fits, with their sushi habits?
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Vibrio parahaemolyticus
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Campylobacter jejuni:
What's the reservoir? what are the symptoms? How does it cause disease? |
Reservoir- chickens, domestic animals
Sx- fever, headache, bloody, loose diarrhea Invades the intestine and secretes a toxin that destroys mucosal cells. |
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What bug will make you wish you never ate rice?
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Bacillus cereus
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What bug will make you wish you never ate reheated meat?
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C. perfringens
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What bugs cause bloody diarrhea?
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Every Year Eighty-Eight Commoners Can Shit Something
Entamoeba histolytica Yersinia enterocolitica EHEC EIEC Campylobacter C. Difficile Salmonella Shigella |
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What bugs cause watery diarrhea?
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Even Very Common People Are Normally Runny
ETEC Cholerae C. perfringens Protozoa Adenovirus Norwalk Rotavirus |
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What are some fun facts about H. pylori:
What type of bug? How can you test for it? How do you treate? |
G- rod
Urease + breath test (alkaline environment) Rx- bismuth, metronidazole, and amoxicillin/tetracycline Rx2- costs more: metronidazole, omeprazole, and clarithromycin |
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What does Psuedomonas Aeruginosa cause?
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Pneumonia- Cystic fibrosis
Sepsis- Black lesions on skin External otitis- swimmer's ear UTI Drug Use and Diabetic Osteomyelitis Hot Tub folliculitis Wound and burn infections Can cause endocarditis in IV drug users |
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When you think blue-green what do you think?
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Pseudomonas- pyocyanin
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What are some virulence factors for Pseudomonas?
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exotoxin A- inactivates EF-2
Endotoxin- fever, shock |
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How do you treat Psuedomonas?
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aminoglycoside and extended spectrum pnicillin- piperacillin, ticarcillin
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What bug has a grape-like scent?
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Pseudomonas
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When does Bacteroides fragilis become a problem?
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Bullet
seat belt laceration abdominal surgery bowel rupture forms abscesses |
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What are the virulence factors in Yersinia pestis?
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F1- capsular antigen, anti phagocytic
V and W |
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What is the host of the bubonic plague now adays?
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squirrels and prairie dogs in SW U.S.
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How does yersinia pestis manifest itself as a disease?
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bacteria invade, gobbled up by macrophages. Reproduce intracelularly. to the inguinal nodes Hot red and painful. Fever and headache. Bacilli invade the bloodstream, liver, lungs, and other discoloration.
In an outbreak, can be pneumonic and spread person to person treat with gentamicin |
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What is the reservoir for francisella tularensis?
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Rabbits, ticks, flea
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What is ulceroglandular tularemia?
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Bite is with a black base, skin ulcer (Different from Yersinia)
fever swollen lymph nodes |
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What is pneumonic tularemia?
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lung infection during skinning of the rabbit.
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What diesease does franciscella tularensis cause?
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Ulceroglandular
pneumonic oculoglandular typhoidal (GI) only a few bacteria are needed. |
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How do you get brucellosis?
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unpasteurized milk
someone who works in meat, or meat packing, a vet causes undulant fever- can last montsh to years. |
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What are Chlamydia and Rickettsia uncapable of ?
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making their own ATP
They have an ATP/ADP translocator |
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What can rickettsia do that chlamydia can't?
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it can oxidize and make ATP.
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What are the two phases of chlamydia?
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Elementary body- does not divide. has bonds to stabalize for extracellular existance. enters cell with endocytosis
Initial/Reticulate body- larger, more RNA binary fission Starts off as EB, some EB remain to be released and infect other cells |
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What is the treatment for chlamydia?
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tetracycline, erythromycin
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What is the disease of chlamydia trachomatis?
What is the reservoir? |
eyes and genitals
trachoma- chronic conjunctivitis- preventable blindness. Kids are the reservoir |
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What is diagnostic of inclusion conjunctivitis by Chlamydia?
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intracytoplasmic inclusion bodies
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Urethritis, with a gram stain w/ mad neutrophils, but no G-diplococci is more likely Gonorrhea or Chlamydia?
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Chlamydia
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What is tricky about Chlamydia and PID?
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can be asymptomatic and lead to infertility
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What is teh Rx for PID?
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ceftriaxone and doxycycline
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What is Reiters?
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Inflamm of large joints by chlamydia, inflam of eyes- uveitis can also occur.
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What is lymphogranuloma Venereum?
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STD caused by Chlamydia, spontaneously healing sore, enlarged nodes that explode
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Why should you think that parrots are filthy?
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they have chlamydia psittaci- if you inhale chlamydia dust, you can get pneumonia, psittacosis
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What are the roles of the tick, louse, and flea in Rickettsia?
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tick- Rocky Mountain
louse- epidemic typhus - prowazekii flea- endemic typhus - typhi |
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What are the difference between chlamydia and rickettsia:
where do they replicate? what cells do they attack? |
chlamydia- endosomes, columnar
rickettsia- cytoplasm, endothelium |
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What is the Weil-Felix reaction?
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test using Proteus vulgaris Ags to look for Rickettsia
Ox19,2=RMSF OxK=scrub typhus |
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What is unusual about the chlamydia peptidoglycan wall?
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does not have muramic acid
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What is the Rx for Rickettsia?
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doxycycline and chloramphenicol
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What is the difference between the rash in RMSF and Typhus?
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typhus- spares palms, face
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What is trench fever?
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Caused by Bartonella. Not an obligate intracellular.
high fevers rash, headache, severe back and leg pains. 5 day interval between episodes |
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What is cat scratch disease?
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Bartonella- lymph node or nodes will enlarge, low grade fever.
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What causes Q fever?
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Coxiella burnetti
has an endospore mild pneumonia- fever 2-3 weeks after infection. no rash |
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What would cause something similar to RMSF with a dog bite?
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Ehrlichia
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Breakdown 1ry, 2ry, and 3ry syphilis.
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1ry- painless chancre
2ry- rash on plams and soles, condyloma latum, CNS, eyes, bones, joints 3ry- Gummas of skin and bone, CV- AA, Neurosyphilis (tabes dorsalis) latent- 25% relapse into 2ry again |
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What are gummas?
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localized granulomatous lesions that necrose and become fibrotic. Skin and bones. skin are painless, bone are crazy painful.
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How does CV syphilis come about?
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inflam destruction of the vasa vasorum-> necrosis of the media layer of the aorta.
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How does neurosyphillis present?
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asymptomatic- syphilis in the CSF
subacute meningitis- fever, stiff neck, and headache. SCF high lymphocyte count, high protein, low glucose, and + syphilis (most bacteria have high glucose, low protein) Meningovascular syphilis- spirochetes attack blood vessels in the brain and meninges- CV occlusions Tabes dorsalis- disruption of the posterior columns- disruption of vibratory and proprioceptive sensations, ataxia. General Paresis- mental deterioration |
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What is the Argyll-Roberston pupil?
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Prostitute pupil- accomodates but does not react. Constricts with near vision, but no reaction to light.
midbrain lesion |
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What happens in congenital syphilis?
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Early- 2 yrs. rash and condyloma latum, snuffles (runny nose)
Late- like 3ry- deafness is common. Bone and teeth. saddle nose Rx for mom before 4th month. |
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How do you Dx syphilis?
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FTA-ABS- positive early in disease, stays positiver for a while.
VDRL- nonsecific ab that reacts with cariolipin. can have false positives. Viruses, Drugs, Rheumatic fever and arthritis, and Lupus can give false +. +VDRL +FTA= infection +VDRL -FTA=false + -VDRL +FTA=treated syphilis -VDRL -FTA=-unless aids or recent infection |
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What is the Jarisch-Herxheimer phenomenon?
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most spirochetes- worse symps right after Abtic use.
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What are the 3 subspecies of syphilis and what do they cause?
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enemicum- endemic
pertenue- yaws carateum- pinta |
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What are the stages of lyme disease infection?
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Early localized stage- Erythema chronicum migrans, flulike
Early disseminated stage- multiple smaller ECM Neurologic- meningitis, Bell's palsy, peripheral neuropathy Cardiac- heart block or myocarditis arthritis Stage 3 Chronic arthritis Encephalopathy |
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How do you Dx and Rx lyme disease?
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ELISA for Abs
culture the edge of a bite Rx- doxycycline or penicillin |
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What does Ixodes mean?
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the tick that carries lyme disease.
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What are the phases of Leptospira infection?
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first - leptospiremic phase, blood and CSF- high temps. red conjunctiva, photophobia
2nd phase- IgM |