Microbio: Bacteriology

Front 1

Beta-hemolytic bacteria

Back 1

GAS and GBS Strep
S. aureus
L. monocytogenes

Front 2

Pts with this disease are susceptible to catalase-producing microbes

Back 2

Chronic granulomatous disease (NADPH oxidase deficiency)

Have very little H2O2, which these microbes easily degrade before it can be converted into microbicidal products

Front 3

Both acute bacterial endocarditis and osteomyelitis are commonly caused by?

Back 3

Staph aureus

Front 4

Infects prosthetic devices and IV catheters by producing adherent biofilms?

Back 4

Staph epidermidis

Front 5

Most common cause of MOPS (meningitis, otitis media, pneumonia, and sinusitis)

Back 5

S. pneumoniae

Front 6

Encapsulated, Lancet-shaped diplococci

Back 6

S. pneumoniae

Front 7

"Rusty" sputum

Back 7

S. pneumoniae

Front 8

Two sequelae of viridans strep?

Back 8

Dental caries
Subacute bacterial endocarditis

Front 9

Test for recent S. pyogenes infection?

Back 9

ASO titer (testing for anti-streptolysin-O)

Front 10

What are the pyogenic, toxigenic, and immunologic sequelae of GAS?

Back 10

Pyo: pharyngitis, cellulitis, impetigo

Toxigenic: scarlet fever, toxic shock-like syndrome

Immuno: rheumatic fever, acute glomerulonephritis

Front 11

Sequelae of rheumatic fever

Back 11

SubQ plaques, polyarthritis, erythema marginatum, chorea, carditis

Front 12

Which population is mostly affected by GBS?

Back 12

Babies

Front 13

What are the sequelae of GBS in babies?

Back 13

Pneumonia, meningitis, and sepsis

Front 14

Which bacteria produces CAMP factor?

Back 14

S. agalactiae

CAMP factor enlarges the area of hemolysis formed by S. aureus

Front 15

Which bacteria are pregnant women screened for at 35-37 weeks?

Back 15

S. agalactiae: can colonize bacteria, and cause disease in babies

If +: intrapartum penicillin prophylaxis

Front 16

What medium can enterococci grow in?

Back 16

6.5% NaCl and bile

Front 17

Two important antibiotic resistances of enterococci?

Back 17

Penicillin G

Some strains vancomycin-resistant --> nosocomial infection

Front 18

Two main sequelae of enterococci infection?

Back 18

UTI

Subacute endocarditis

Front 19

Pts with what type of cancer are susceptible to Strep bovis (GDS) infection?

Back 19

Colon cancer pts --> bacteremia and subacute endocarditis

Front 20

What encodes the diphtheria exotoxin?

Back 20

Beta-prophage

Front 21

Two sequelae of diphtheria infection?

Back 21

Cardiac and neural toxicity (fatal in 10%)

Front 22

How can you kill spores?

Back 22

Autoclave

Front 23

Two bacterial species that form spores?

Back 23

Bacillus (B. anthracis and B. cereus)

Clostridium (C. perfringens, C. tetani, C. botulinum)

Front 24

Tetanus toxin?

Back 24

Tetanospasmin

Front 25

Tetanus toxin blocks the release of?

Back 25

Inhibitory neurotransmitters (GABA and glycine) from Renshaw cells in spinal cord

Front 26

Sequelae of C. tetani?

Back 26

Spastic paralysis
Trismus (lockjaw and risus sardonicus)
- Facial spasm looks like pt is grinning

Front 27

C. botulinum toxin?

Back 27

Preformed, heat-labile toxin that inhibits ACh release at NMJ

Front 28

Cause of botulism

Back 28

Preformed toxin in adults
Bacterial spores in honey in babies

Front 29

Floppy baby syndrome

Back 29

Botulism in babies

Constipation, then weakness

Front 30

C. perfringens toxin?

Back 30

Alpha toxin (lecithinase, a phospholipase)

Front 31

Sequelae of C. perfringens?

Back 31

Myonecrosis (gas gangrene)
Hemolysis
Late-onset food poisoning --> watery diarrhea

Front 32

Two toxins of C. difficile?

Back 32

Toxin A (enterotoxin): binds brush border of gut

Toxin B (cytotoxin): destroys cytoskeletal structure of enterocytes --> pseudomembranous colitis

Front 33

Two antibiotics that cause pseudomembranous colitis?

Back 33

Clindamycin
Ampicillin

Front 34

Diagnosis of C. difficile

Back 34

One or both toxins in stool

Front 35

Treatment of C. difficile?

Back 35

Metronidazole

Front 36

What is the only bacterium w/ a polypeptide capsule?

Back 36

Anthrax
(contains D-glutamate)

Front 37

Treatment of anthrax?

Back 37

Ciprofloxacin

Front 38

Two types of anthrax

Back 38

Cutaneous and pulmonary

Front 39

Sequelae of cutaneous anthrax

Back 39

Contact --> black eschar (painless ulcer surrounded by edematous ring) --> can progress to bacteremia and death

Front 40

Sequelae of pulmonary anthrax

Back 40

Inhalation of spores --> flulike symptoms -- fever, pulonary hemorrhage, mediastinitis, and shock

Front 41

Woolsorters' disease?

Back 41

Inhalation of spores from contaminated wool --> pulmonary anthrax

Front 42

Anthrax toxin

Back 42

Lethal factor
Edema factor (an adenylate cyclase)

Front 43

How is Listeria acquired in babies?

Back 43

Vaginal transmission during birth

Front 44

How is Listeria acquired in adults?

Back 44

Ingestion of unpasteurized milk/ cheese

Front 45

Actin rockets?

Back 45

Formed by Listeria; allows it to move cell to cell

Front 46

Which bacteria has characteristic tumbling motility?

Back 46

Listeria

Front 47

3 sequelae of Listeria in pregnant women

Back 47

Amnionitis, septicemia, spontaneous abortion

Front 48

2 sequelae of Listeria in neonates

Back 48

Granulomatosis infantiseptica, neonatal meningitis

Front 49

Sequelae of Listeria in i/c pts

Back 49

Meningitis

Front 50

Sequelae of Listeria in adults

Back 50

Mild gastroenteritis

Front 51

Sequelae of Actinomyces israelii

Back 51

Oral/facial abscesses

May driain thru sinus tracts in skin (yellow sulfur granules)

Front 52

Sequelae of Nocardia asteroides

Back 52

Pulmonay infection in i/c pts

Front 53

Treatment of Actinomyces and Nocardia

Back 53

SNAP
Sulfa for Nocardia
Penicillin for Actinomyces

Front 54

Caseating granulomas w/ Langhans giant cells

Back 54

Tuberculosis

Front 55

TB in vertebrae?

Back 55

Pott's disease

Front 56

Ghon complex

Back 56

TB granulomas
Ghon focus (lower lobes) of TB + hilar nodes
Reflections primary infection

Front 57

Fibrocaseous cavitary lesion of TB seen where?

Back 57

Upper lobes, after reactivation

Front 58

Severe bacteremia from TB can lead to?

Back 58

Miliary tuberculosis

Front 59

PPD+ in 3 conditions

Back 59

Current infection
Past exposure
BCG vaccination

Front 60

Size of a positive PPD test

Back 60

>15mm in normal pts
>5mm in HIV, organ transplants, and recent contacts

Front 61

PPD- in 2 conditions

Back 61

No infection
Anergic (steroids, malnutrition, i/c, sarcoidosis)

Front 62

Fever, night sweats, weight loss, hemoptysis

Back 62

TB

Front 63

Pulmonary TB-like symptoms

Back 63

M. kansasii

Front 64

M. avium-intracellulare causes disseminated disease in AIDS; what is used for prophylaxis?

Back 64

Azithromycin

Front 65

Where does M. leprae infect?

Back 65

Skin and superficial nerves (lieks cool temps)

Front 66

Reservoir of M. leprae in US?

Back 66

Armadillos

Front 67

Hansen's disease?

Back 67

Leprosy

Front 68

Lepromatous form of Hansen's disease

Back 68

- Diffuse skin involvement (thickening, hypopigmentation in plaques)

- Paresis and regional anthesia

- Leonine facies: loss of eyebrows, nasal collapse, lumpy earlobe

- Communicable; can be lethal

Front 69

Tuberculoid form of Hansen's disease

Back 69

- Few hypopigmented plaques

- Hair follicle loss

- Focally decreased sensation

Front 70

Which form of leprosy is seen in pts with weak T-cell-mediated immunity?

Back 70

Lepromatous (humoral Th2 response)

Intact T-cell immunity --> tuberculoid (Th1 response)

Front 71

Catalase positive organisms (6)

Back 71

S. aureus
E. coli
Aspergillus
Pseudomonas cepacia
Serratia marcescens

Note: M. tuberculosis, Cryptococcus, and diphtheriae are also catalase +, however no increased risk of these organisms in CGD (so catalase positivity is necessary but not sufficient for opportunistic infectivity in these pts)
Nocardia

Front 72

Only N. meningitis ferments maltose (N. gonorrheae does not); which ferments glucose?

Back 72

Both

Front 73

N. gonococci vs. meningococci:

For which is there a vaccine?

Back 73

Meningococci

Front 74

What is the cause of Waterhouse-Friderichsen syndrome?

Back 74

N. meningitidis

Consists of purpuric cutaneous lesions, adrenal hemorrhage, DIC, and shock

Front 75

Fitz-Hugh-Curtis Syndrome involves infection of?

Back 75

Liver capsule (and "violin string" adhesions of parietal peritoneum to liver)

Front 76

Fitz-Hugh-Curtis Syndrome is a complication of?

Back 76

PID (from chlamydia or gonorrhea)

Front 77

Sequelae of gonorrhea in neonates?

Back 77

Neonatal conjunctivitis

Front 78

What drug is used for N. meningitidis prophylaxis in close contacts?

Back 78

Rifampin

Front 79

What allows for repeated infection with Neisseria?

Back 79

Pili --> antigenic variation

Front 80

4 sequelae of haemophilus?

Back 80

EMOP

Epiglottitis (cherry red in kids)
Meningiits
Otitis media
Pneumonia

Front 81

Why can H. influenzae be grown with S. aureus?

Back 81

Provides Factor V (NAD+)

(H. flu needs V and X (hematin) for growth)

Front 82

Treatment for H. influenzae meningitis?

Back 82

Ceftriazone

Front 83

Prophylaxis for close contacts of pt w/ H. influenzae meningitis

Back 83

Rifampin

Front 84

Transmission of Legionella?

Back 84

Environmental water source (no person-to-person)

Front 85

Treatment for Legionella

Back 85

Erythromycin

Front 86

Legionnaires' disease

Back 86

Severe pneumonia and fever

Front 87

Pontiac fever

Back 87

Mild flulike syndrome caused by Legionella pneumophila

Front 88

8 clinical sequelae of pseudomonas

Back 88

PSEUDOmonas

Pneumonia (esp in CF)
Sepsis (black lesions: ecthyma gangrenosum)
External otitis (swimmers)
UTI
Drug use
diabetic Osteomyelitis (can also cause malignant otitis externa in diabetics)

Wound and burn infections
Hot tub folliculitis

Front 89

Bacteria to think of in burn victims?

Back 89

Pseudomonas (also common in neutropenic, diabetic, and CF pts)

Front 90

5 things produced by pseudomonas

Back 90

Pyocyanin (blue-green pigment)
Endotoxin (fever, shock)
Exotoxin A (inactivates EF-2, like diphtheria)
Elastase (dessel destruction)
Phospholipase C (degrades cell membranes)

Front 91

Grapelike odor

Back 91

Pseudomonas

Front 92

Pseudomonas treatment

Back 92

Aminoglycoside + extended-spectrum penicillin

Front 93

3 E. coli virulence factors and their sequelae

Back 93

Fimbriae --> cystitis and pyelonephritis

K capsule --> pneumonia, neonatal meningitis

LPS endotoxin --> septic shock

Front 94

Four strains of E. coli

Back 94

EIEC, ETEC, EPEC, EHEC

Front 95

Two E. coli strains that produce a Shiga-like toxin

Back 95

EIEC
EHEC

Front 96

E. coli associated w/ Traveler's diarrhea

Back 96

ETEC

Front 97

E. coli associated w/ pediatric diarrhea

Back 97

EPEC

Front 98

E. coli associated w/ invasive dysentery

Back 98

EIEC

Front 99

E. coli associated w/ non-invasive dysentery

Back 99

EHEC (toxin alone causes necrosis and inflammation)

Front 100

Which E. coli does not ferment sorbitol?

Back 100

EHEC

Front 101

Most common serotype of EHEC

Back 101

O157:H7

Front 102

Triad of hemolytic uremia syndrome (HUS)

Back 102

Anemia, thrombocytopenia, acute renal failure

Front 103

What do the letters of O157: H7 refer to?

Back 103

O: O antigen of the LPS
H: flagella

Front 104

Which E. coli does not produce a toxin?

Back 104

EPEC

Front 105

Which E. coli has attachment and effacement lesions?

Back 105

EPEC

Front 106

Which E. coli has labile and stable toxins?

Back 106

ETEC

Front 107

2 types of patients susceptible to Klebsiella?

Back 107

Alcoholics and diabetics (aspiration)

Front 108

Red currant jelly sputum?

Back 108

Klebsiella

Front 109

3 clinical sequelae of klebsiella

Back 109

Lobar pneumonia
Abscess in lungs
Nosocomial UTIs

Front 110

Salmonella vs. shigella:

Flagella?

Back 110

Salmonella

Front 111

Salmonella vs. shigella:

Hematogenous dissemination?

Back 111

Salmonella

Front 112

Salmonella vs. shigella:

Higher virulence?

Back 112

Shigella

Front 113

Salmonella vs. shigella:

Actin polymerization

Back 113

Shigella (allows them to propel themselves while within a cell)

Front 114

Salmonella vs. shigella:

Animal reservoir

Back 114

Salmonella

Front 115

Cause of typhoid fever?

Back 115

Salmonella typhi

Front 116

Clinical sequelae of typhoid fever?

Back 116

Fever, diarrhea, headache, rose spots on abdomen

Front 117

Which organ can contain S. typhi chronically?

Back 117

Gallbladder

Front 118

Transmission of shigella?

Back 118

5 Fs:

Food, Fingers, Feces, Flies, and Fomites

Front 119

Salmonella vs. shigella:

Produces H2S?

Back 119

Salmonella

Front 120

What prolongs symptoms of salmonellosis?

Back 120

Antibiotic treatment

Front 121

Antecedent to Guillain-Barre syndrome?

Back 121

Campylobacter jejuni

Front 122

Fecal-oral transmission through foods or domestic animals?

Back 122

Campylobacter jejuni

Front 123

Rice-water diarrhea

Back 123

Vibrio cholerae

Front 124

Treatment for cholera?

Back 124

Oral rehydration

Front 125

Stool findings in cholera?

Back 125

Mucus and epithelial cells (no leukocytes/ lymphocytes b/c doesn't invade)

Front 126

3 sources of Y. enterocolitica transmission?

Back 126

Pet feces
Contaminated milk
Pork

Front 127

Day care center diarrhea outbreak?

Back 127

Y. enterocolitica

Front 128

Mesenteric adenitis

Back 128

Y. enterocolitica

Can mimic Crohn's or appendicitis and can cause bacteremia

Front 129

H. pylori is a risk factor for these 3 conditions:

Back 129

Peptic ulcer
Gastric adenocarcinoma
Lymphoma (MALT)

Front 130

H. pylori treated by triple therapy: name the 3 combinations

Back 130

PPI + clarithromycin + amoxicillin or metronidazole

Metronidazole + omeprazole + cllarithromycin

Metronidazole + bismuth + tetracycline or amoxicillin (can add PPI for quad therapy)

Front 131

Three spirochetes

Back 131

Borrelia
Leptospira
Treponemia

Front 132

Largest spirochete?

Back 132

Borrelia

Front 133

Spirochete transmitted through animal urine?

Back 133

Leptospira

Front 134

Question-mark shaped bacteria

Back 134

Leptospira

Front 135

Symptoms of leptospirosis

Back 135

Flulike, fever, headache, abdominal pain, jaundice, photophobia w/ conjunctivitis

Front 136

Pt typically presenting with leptospirosis?

Back 136

Surfer

Front 137

Another name for Weil's disease?

Back 137

Icterohemorrhagic leptospirosis

Front 138

Presentation of Weil's disease

Back 138

Jaundice and azotemia from liver and kidney dysfunction

Fever, hemorrhage, anemia

Front 139

Cause of Lyme disease?

Back 139

Borrelia burgdorferi

Front 140

Transmission of Borrelia burgdorferi?

Back 140

Ixodes

Front 141

Ixodes tick transmits which 3 infectious agents?

Back 141

Borrelia burgdorferi (Lyme disease)
Babesia (babesiosis)
Francisella tularensis (tularemia); can be from various types of ticks, including Ixodes

Front 142

Rash of Lyme disease

Back 142

Erythema chronicum migrans, an expanding bull's eye red rash w/ central clearing

Front 143

3 Stages of Lyme disease

Back 143

1: erythema chronicum migrans & flulike symptoms

2: neurologic (Bell's palsy) and cardiac (AV nodal block)

3: chronic monoarthritis and migratory polyarthritis

Front 144

Animals involved in Lyme disease?

Back 144

Mice

Deer required for life cycle

Front 145

Lyme disease common in this region?

Back 145

Northeastern US

Front 146

Treatment of Lyme disease?

Back 146

Doxycycline, ceftriaxone

Front 147

Syphilis treatment

Back 147

Penicillin G

Front 148

Primary syphilis

Back 148

Painless chancre

Front 149

Secondary syphilis

Back 149

Constitutional symptoms
Maculopapular rash (palms and soles)
Condylomata lata

Front 150

Tertiary syphilis

Back 150

Gummas (chronic granulomas)
Aortitis (vas vasorum destruction)
Neurosyphilis (tabes dorsalis: degeneration of sensor neurons)
Argyll Robertson pupil

Front 151

Argyll Robertson pupil

Back 151

Accommodates(constricts) but does not react (to light)

Front 152

Congenital syphilis

Back 152

Saber shins (anterior bowing)
Saddle nose
CN VIII deafness
Hutchinson's teeth (small, widely spaced)
Mulberry molars (rounded cusps)

Front 153

Syphilis screening test

Back 153

VDRL/ RPR

Front 154

VRDL detects n antibody that reacts with?

Back 154

Beef cardiolipin

Positive test: flocculation (aggregation)

Front 155

+ VRDL confirmed with what test?

Back 155

FTA-ABS

Front 156

Test used to follow syphilis treatment?

Back 156

VDRL

Front 157

Test that will remain positive for life in syphilis pts?

Back 157

FTA-ABS

Front 158

VRDL false positives?

Back 158

VRDL

Viruses (mono, hep)
Drugs
Rheumatic fever
Lupus and Leprosy

Front 159

Cat scratch fever?

Back 159

Bartonella

Front 160

Bartonella in i/c pts?

Back 160

Bacillary angiomatosis

Front 161

Disease often confused with Kaposi's sarcoma (HHV-8)?

Back 161

Bacillary angiomatosis (from batonella

Front 162

Two forms of Borrelia

Back 162

Borrelia burgdorferi --> Lyme disease (ticks that live on deer and mice)

Borrelia recurrentis --> recurrent fever (transmitted by louse)

Front 163

Another name for brucellosis?

Back 163

Undulant fever

Front 164

Two transmission types for Brucella?

Back 164

Dairy products
Contact w/ animals

Front 165

Transmission and source for Francisella tularensis

Back 165

Tick bite; rabbits and deer

Front 166

Infectious agent of plague?

Back 166

Yersinia pestis

Front 167

Transmission and source of Y. pestis

Back 167

Fleat bite; rodents (esp prairie dogs)

Front 168

2 clinical sequelae of pasteurella multocida?

Back 168

Cellulitis
Osteomyelitis

Front 169

Transmission of pasteurella?

Back 169

Animal bite (cats, dogs)

Front 170

Gray vaginal discharge?

Back 170

Gardnerella

Front 171

Fishy vaginal discharge?

Back 171

Gardnerella

Front 172

Is gardnerella an STD?

Back 172

No, but it is associated with sexual activity

Front 173

Infection associated with clue cells?

Back 173

Gardnerella vaginalis

Front 174

What are clue cells?

Back 174

Vaginal squamous epithelial cells covered with bacteria

Front 175

Treatment of gardnerella?

Back 175

Metronidazole

Front 176

Three types of Rickettsiaceae?

Back 176

Rickettsia
Coxiella
Erlichia

Front 177

Transmission of rickettsiae?

Back 177

Arthropod vector (except coxiella: aerosol transmission)

Front 178

Classic triad of rickettsiae?

Back 178

Headache, fever, rash (vasculitis)

Front 179

Why is coxiella an atypical rickettsia?

Back 179

Aerosol transmission
Causes Q fever (a pneumonia)
Coxiella burnetii released in spores from tick feces and cattle placenta

Front 180

Treatment for all rickettsia?

Back 180

Doxycycline

Front 181

Causative agent of Rocky Mountain spotted fever?

Back 181

Rickettsia rickettsii

Front 182

Rash of Rocky Mountain Fever

Back 182

Starts on hands and feet; then migrates to wrists, ankles, then trunk

Front 183

Rash of typhus (from R. typhi or R. prowazekii)

Back 183

Starts centrally and spreads outward w/out involving palms and soles

Front 184

Endemic area for RMSF?

Back 184

East Coast

Front 185

Symptoms of erlichiosis

Back 185

Classic triad but without rash (just headache and fever)

Front 186

How is erlichiosis transmitted?

Back 186

Ticks

Front 187

Granulocytes with berry cluster organisms?

Back 187

Erlichia

Front 188

Weil-Felix reaction

Back 188

Mix pt serum with Proteus antigens: antirickettsial Abs cross-react to Proteus O antigens --> agglutination

Front 189

In which Rickettsial infection is the Weil-Felix reaction negative?

Back 189

Coxiella

Front 190

2 forms of chlamydiae

Back 190

Elementary body: infectious; enters cell via endocytosis

Reticulate body replicates in cell by fission

Front 191

What is lacking in the chlamydial cell wall?

Back 191

Muramic acid

Front 192

Diagnosis of chlamydiae?

Back 192

Cytoplasmic inclusions seen on Giemsa or fluorescent Ab-stained smear

Front 193

Clinical sequela of C. pneumoniae and C. psittaci

Back 193

Atypical pneumonia (transmitted by aerosol)

Front 194

Bacteria associated w/ exotic birds?

Back 194

C. psittaci

Front 195

4 clinical sequelae of C. trachomatis

Back 195

Reactive arthritis
Conjunctivitis
Nongonococcal urethritis
PID

Front 196

C. trachomatis serotypes A, B, and C -->

Back 196

Follicular conjunctivitis --> blindness
(seen in Africa)

Front 197

C. trachomatis serotypes D-K -->

Back 197

Urethritis/ PID
Ectopic pregnancy
Neonatal pneumonia (staccato cough)
Neonatal conjunctivitis

Front 198

C. trachomatis serotypes L1-L3 -->

Back 198

Lyphogranuloma venereum

Front 199

Treatment for chlamydia

Back 199

Azithromycin

Front 200

Only bacterial membrane containing cholesterol?

Back 200

Mycoplasma pneumoniae
(need to enrich medium w/ cholesterol to culture)

Front 201

Mycoplasma causes an _______ pneumonia

Back 201

Atypical ("walking")

Insidious onset, headache, nonproductive cough

Front 202

Xray looks worse than patient

Back 202

Walking pneumonia: diffuse interstitial infiltrate

Front 203

Why does M. pneumonia cause anemia?

Back 203

High titer of cold agglutinins (IgM) which can lyse RBCs --> hemolytic anemia

Front 204

Mycoplasma is grown on _______ agar

Back 204

Eaton's

Front 205

Pneumonia outbreak in military base or prison?

Back 205

Mycoplasma pneumoniae

Front 206

Treatment for M. pnuemoniae?

Back 206

Tetracycline or erythromycin

Front 207

Why is M. pneumoniae resistant to penicillins?

Back 207

Have no cell wall