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122 Cards in this Set
- Front
- Back
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the encapsulated bacteria?
-what's special re Ig's with a few of them |
the encapsulated bacteria?
"Kapsules Shield SHiN": Klebsiella pneumoniae Salmonella Streptococcus pneumoniae Haemophilus influenzae type B Neisseria meningitidis -the SHiN have IgA protease & can do transformation |
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which bugs cannot be seen on Gram stain?
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which bugs cannot be seen on Gram stain?
-"These Rascals May Microscopially Lack Color: -Treponema (too thin) -Rickettsia (intracellular) -Mycobacteria (req's Acid-Fast stain) -Mycoplasma (no cell wal) -Legionella pneumophila (intracellular) -Chlamydia (intracellular, no muramic acid in cell wall) *Treponemes = use Darkfield Microscopy *Legionella = use Silver stain |
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Novobiocin can be used to differentiate between which bugs?
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Novobiocin can be used to differentiate between which bugs?
-Epidermidis, & Saprophyticus -NES,RS= Novobiocin: Epidermidis(Sensitive), Saprophyticus(Resistant) |
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Optochin can be used to differentiate between which bugs?
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Optochin can be used to differentiate between which bugs?
OVRPS: Optochin: strep Viridans (Resitant), strep Pneumoniae (Sensitive) |
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Bactitracin can be used to differentiate between wihch bugs?
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Bactitracin can be used to differentiate between wihch bugs?
-B-BRAS: Bacitracin: group B strep (Resistant), group A strep (Sensitive) |
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gamma-hemolytic, grow in 40% bile, next step to differentiate (and which is which?)
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gamma-hemolytic, grow in 40% bile, next step to differentiate (and which is which?)
-this is Group D strep, next test is 6.5% NaCl: -Enterococci are 6.5% NaCl (resistant) -Nonenterococci are 6.5% NaCl (sensitive) |
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Corynebacterium diptheriae virulence exotoxin does what?
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Corynebacterium diptheriae virulence exotoxin does what?
-ADP Ribosylates EF-2, thus inhibiting protein synthesis |
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6 spore-formers
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6 spore-formers
-Bacillus anthracis -Clostridium perfringens -Clostridium tetani -Bacillus cereus -Clostridium botulinum |
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common features of all Clostridia
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common features of all Clostridia
-Gram+ -spore-forming -obligate anaerobes -all motile EXCEPT C perfringes |
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Clostridium tetani toxin works how?
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Clostridium tetani toxin works how?
-blocks release of inhibitory NTs (GABA, Glycine) -Spastic paralysis |
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Clostridium botulinum toxin works how?
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Clostridium botulinum toxin works how?
-inhibiting ACh release -Flaccid paralysis |
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pt presents after being on an ABx (can't remember if it was Clindamycin or Amphicllin) and now has diarrhea...what have?
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-Clostridium difficile often causes a pseudomembranous colitis
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Clostridium dificile toxin
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Clostridium dificile toxin
-toxin A - alters fluid secretion, causes watery diarrhea -toxin B- cytotoxic to Intestinal Epithelial Cells, causes Pseudomembrane |
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two Tx for C diff?
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two Tx for C diff?
-Metronidazole -ORAL Vancomycin- b/c not absorbed, only time Van will be given Orally |
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Bacillus anthracis toxin
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Bacillus anthracis toxin
-PA: binds cell membrane & mediates endocytic entry -EF: stimulates cAMP to cause edema & inhibition of PMNs LF: causes cell death |
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Bacillus anthracis plasmids
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Bacillus anthracis plasmids
-pXO1 = anthrax toxin -pXO2 = antiphagocytic |
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only bacterium w/ a polypeptide capsule?
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B anthracis
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flu-like Sx that rapidly progress to fever, pulmonary hemorrhage, mediastinits, shock...after inhaling something
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Bacillus anthracis
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Bacillus cereus toxin
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Bacillus cereus toxin
-increases cAMP → decr reabsorption of NaCl → Diarrhea |
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Tumbling motility at 25 C
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Listeria monocytogenes
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Unpasteurized milk, cheese, deli meats, vaginal transmission during birth, a Gram+ bacillus
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Listeria monocytogenes
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yellow sulfur granules
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Actinomyces israelii
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re Actinomyces & Nocardia, Tx differences?
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re Actinomyces & Nocardia, Tx differences?
"SNAP": Sulfur for Nocardia, Actinomyces- use Penicillin |
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inhaled organism w/ Mycolic acid cell wall, causing pneumonia in immunocompromised w/ caseous granuloma
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Nocardia
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difference in location between Primary & Secondary TB?
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-Primary will form Ghon complex in lower lobes m/c
-Secondary will form in cavitary lesions in Upper Lobes |
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possible Dx if pt presents w/ fever, night sweats, wt loss, back pain
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Pott's Disease = TB spread to Vertebral Body
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5 classic Sx of TB
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fatigue, fever, wt loss, night sweats, lymphadenopathy
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Tx of TB?
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Tx of TB?
-RIPES: Rifampin, Isoniazid (INH), Pyrazinamide, Ethambutol, Streptomycin, |
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difference btw Tuberculoid Leprosy & Lepromatous Leprosy
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Tuberculoid
-milder; Granuloma formation limits spread, damage superficial nerves & skin → thickened nerves & 1-2 anestthetized lesions hypopigmented & hairless -granumolas form b/c good Th1 response Lepromatous -deficient immune response unable to contain organism → inflamm esp @ Cool skin, nerves, testes → sensory loss & charac features -Th2 response, but useless since this is intracellular |
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2 big acid-fast staining classes
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Mycobacterium
Nocardia |
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how differentiate btw N meningitidis & N gonorrheae?
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how differentiate btw N meningitidis & N gonorrheae?
MeninGitidis -Maltose+ AND Glucose+ Gonorrheae -only Glucose+ |
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vascular hemorrhage & necrosis in adrenals, shock, DIC
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Waterhouse-Friderichsen Syndrome, caused by N meningitidis
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Lactose+ grow what color on certain agar, and 5 examples
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Lactose+ grow Pink on MacConkey's agar
"test w/ macConKEE'S agar": -Citrobacter, Klebsiella, E coli, Enterobacter, Serratia |
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deficiency of C5-C8 of complement pathway increases susceptibility to?
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deficiency of C5-C8 of complement pathway increases susceptibility to?
-Neisseria (both) |
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compare N gonococci w/ N meningococci
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N gonococci
-no polysacc capsule -no maltose fermentation -no vaccine -sex transmission -gonorrhea, septic arthritis, neonatal conjunctivitis, PID, Fitz-Hugh-Curtis syndrome Meningococci -polysacc capsule -maltose fermentation -vaccine -respiratory & oral transmission -meningococcemia & meningitis, Waterhouse-Friderichsen syndrome |
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Tx of N gonorrhea
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3rd generation Ceph like Ceftriaxone + Doxycycline or Arithromycin for probably concurrent Chlamydia infection
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growth on Thayer-Martin media at 37 C w/ 5-10% CO2
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Neisseria
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m/c cause of smoker's bronchitis
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H influenzae type B
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req's of the various Haemophilus?
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req's of the various Haemophilus?
Haemophilus influenzae type B -V (NAD+) and X (hematin) on chocolate agar Haemophilus parainfluenzae -req's only V (NAD+) Haemophilus ducreyi -req's only X (hematin) |
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how remember things about Legionella pneumophila?
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think of french Legionaire w/ Silver helmet, sitting around Charcoal campfire w/ Iron dagger- he's no Sissy (Cysteine)
-visualize on Silver Stain -Cx w/ Fe & Cysteine on Charcoal agar Tx w/ Erythromycin |
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blue-green sputum w/ fruity odor
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Pseudomonas aeruginosa
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pneumonia in Cystic Fibrosis pt
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Pseudomonas aeruginosa
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Glc-, Lactose-, Oxidase+ vs Glc+, Lactose-, Oxidase+
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Glc-, Lactose-, Oxidase+
Pseudomonas aeruginosa vs Glc+, Lactose-, Oxidase+ Vibrio Cholera |
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Pseudomonas toxins
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Pseudomonas toxins:
Exotoxin A -ADP ribosylates EF2 to inhibit protein synthesis (like C diptheria) Phospholipase C -damages host membrane Elastase -cleaves elastin, collagen, complement, Ig's Endoxtin -shock |
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Osteomyelitis in Diabetics and IVDA
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Pseudomonas aeruginosa
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main anti-Pseudomonal ABx
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Ticarcillin, Carbenicillin, Piperacillin
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folliculitis (& what differentiates 1 from others)
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Group A Strep, Staph aureus, Pseudomonas aeruginosa
*Pseudomonas is a/w Hot-Tub Folliculitis |
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fever, inflammation, bloody diarrhea
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Enteroinvasive E coli (EIEC)
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EIEC main toxin
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Shiga-like Toxin (SLT)
-inactivates 60S ribosome unit → cell death -bloody diarrhea |
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red currant jelly sputum
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Klebsiella pneumonia
-esp in Alcoholics & Diabetics |
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alcoholic or diabetic w/ Aspiration pneumonia
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Klebsiella pneumoniae
*red currant jelly sputum |
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nosocomial UTI, lactose+, oxidase-, mucoid colonies
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Klebsiella pneumoniae
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differences btw Salmonella & Shigella?
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Salmonella
-H2S+, Motile -"Salmons lay eggs" Shigella -H2S-, Non-Motile "Shigella have no flagella" |
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Shiga toxin mechanism
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inactivation of 60S ribosome
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organisms whose toxin inactivates 60s ribosome, and result
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result = bloody diarrhea of:
-Shigella dysenteriae -EIEC -EHEC |
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Stepwise fever, constipation or diarrhea w/ rose spots on abdomen, fatigue
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Typhoid Fever
-Salmonella typhi |
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Osteomyelitis in Sickle Cell pts
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-Salmonella typhi
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why can S typhi be spread so wide?
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-pt can be in Chronic Carrier State- have in gallbladder, esp in gallstones, aSx, S typhi enters bowel lumen, spread via feces
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+Widal Test
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Salmonella typhi
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where detect S typhi in pt?
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Blood Cx + in 1st week, Stool Cx + in 2nd week
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Bismuth Sulfate black colonies
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Salmonella typhi
-black b/c H2S produced |
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ammonium-Mg-PO4 renal stones
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Proteus mirabilis
-b/c Ureas producer → form ammonium-OH, increases pH, this high pH allows stone formation |
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"swarming growth", urease+, alkaline urine, NH4-Mg-PO4 stones
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Proteus Mirabilis
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enterocolitis in kid w/ puppies
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Yersinia enterocolitica
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mesenteric adenitis after raw milk or fecal oral transmission
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Yersinia enterocolitica
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dudodenal ulcers that can be cured w/ ABx
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Helicobacter pylori
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the Urease producers
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H pylori, Proteus mirabilis
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(+) C14-labeled breath test
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H pylori
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100% duodenal ulcers & 70% gastric ulcers a/w what bacterium
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H pylori
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grows at 42C, microaerophilic, 5%O2, 10%CO2
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Campylobacter jejuni
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bloody or secretory diarrhea, growth at 42C, microaerophilic, comma-shaped
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Campylobacter jejuni
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3 bacteria a/w unpasteurized dairy products
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Campylobacter jejuni (growth at 42C), Listeria monocytogenes, Brucella spp
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painless chancre
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primary Syphilis
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secondary syphilis includes
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condyloma lata, maculopapular rash on PALMS & SOLES, meningitis, hepatitis, arthritis
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Palm & Sole rash DDx
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drive CARS w/ your palms & soles:
Coxsackievirus A, Rocky mtn spotted fever, Syphilis |
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Saber shins, saddle nose, CN VIII deafness, Hutchinson's teeth, mulberry molars
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Congenital Syphilis
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pupil that accommodates but does not react to light
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Argyll-Robertson "Prostitutes Pupil" of tertiary syphilis
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what can give VDRL false positives?
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VDRL:
Viruses (IM, hepatitis) Drugs Rheumatic fever Lupus & leprosy -beef cardiolipin Ab can give (+) result |
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the better test for Syphilis?
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FTA-ABS
-more specific, earlier, and stays (+) the longest - |
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cat scratch, now bacillary angiomatosis and/or fever
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Bartonella henslae
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Ixodes tick
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Borrelia burgdorferi (Lyme disease)
Babesia microti |
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tick bite after biting rabbits, or squirrels, deer, beaver
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Francisella tularensis (Tularemia)
-fever, non-productive cough, dyspnea, lymphadenopathy |
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fever, non-productive cough, dyspnea, lymphadenopathy after tick bite
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Tularemia
-Francisella tularensis |
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safety-pin bipolar staining on Giemsa, Wright, or Wayson staining
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Yersinia pestis
-Plague |
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CP, dyspnea, hemoptysis, severe bronchopneumonia, N/V, abd pain, diarrhea following flea bites
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Yersinia pestis plague
-endotoxin can cause DIC |
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cellulitis or osteomyelitis after cat/dog bites
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Pasteurella multocida
-bipolar staining on Chocolate OR Blood agar (vs H influenzae can ONLY grow on chocolate) |
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fishy smelling vagina w/ gray discharge, Clue cells under microscope
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Gardnerella vaginalis
-"I don't have a CLUE why I smell FISH in the VAGINA GARDEN" |
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what do all Ricketsiae have in common?
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-all except Cociella burnetti transmitted by arthropod and cause HA, fever, rash(vasculitis)
-all are Tx'd by Tetracycline |
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after tick bite, HA, fever, rash that starts on palms/soles & spreads to trunk
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Rocky Mountain Spotted Fever
-Rickettsia rickettsii |
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(+)Weil-Felix test
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Rickettsia (except Coxiella burnetti)
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difference in rash between Rickettsia rickettsii (RMSF) and Rickettsia typhi (epidemic typhs)
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-RMSF starts palms/soles
-epidemic typhus starts trunk and spreads out, spares palms/soles |
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atypical pneumonia after inhalation of spores carried by cattle, sheep, goats
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Q-fever
-mild atypical pneumonia, can cause hepatitis, chronic endocarditis |
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two main obligate intracellular parasites
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Chlamydiae, Rickettsiae
-req host ATP -Chlamydiae replicate in inClusion bodies, Rickettsiae replicate fRee in cytoplasm |
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how differentiate btw Chlamydiae and Rickettsiae?
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BOTH are obligate intracellular organisms, req'ing host ATP, but:
-Chlamydiae replicate in inclusion bodies -Rickettsiae replicate free in cytoplasm |
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2 forms of Chlamydiae
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Elementary body & Reticulate body
-Elementary body is small & dense, is Enfectious, & Enters the cell via Endocytosis -the Reticulate body Replicates in cell by fission |
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Chlamydia trachomatis D-K
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non-gonochoccal urethritis, PID, neonatal pneumonia, neonatal conjunctivitis
Females: to Fallopian tubes & cause PID (incr's risk of Ectopic Pregnancy) → can spill into peritoneal cavity (peritonitis) → if infects liver capsule (Fitz-Hugh-Curtis) Males: can spread to synovial joints & other organs → arthritis, conjunctivitis → Reiter's Syndrome (can't see, pee, or climb a tree; esp in HLA-B27 pts) |
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Chlamydia trachomatis A-C
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hand-eye contact, conjunctiva, corneal damage, blindness
ABC- Africa, Blindness, Chronic infection |
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Chlamydia trachomatis L1-L3
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Lymphogranuloma venereum
-sexual transmission -painLESS ulceration at infection site, heal spontaneously, but bugs spread to regional lymph nodes, cause lymphadenopathy (buboes) |
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nonproductive cough, fever, sore throat, CXR shows diffuse interstitial infiltrate
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walking pneumonia of Chlamydia pneumoniae
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HA, fever, dry cough, bilateral rales, splenomegaly, CXR shows patchy pneumonitis
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atypical pneumonia of Chlamydia psittaci
-Parrot Fever, Ornithosis |
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malaise, chills, pharyngitis, dry cough, HA, fever
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walking pneumoniae of Mycoplasma pneumoniae
-*B cell response may produce Igs that autoreact w/ RBCs (IgM cold agglutinins) |
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only bacteria w/ Cholesterol in cell membrane
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Mycoplasma
-this gives resistance to PCN |
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fried egg appearance on Eaton's agar after long growth period
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Mycoplasma pneumoniae
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Mississippi R & Ohio R valley fungal pneumonia
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Histoplasmosis
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pneumonia in spelunker (cave-explorer)
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Histoplasmosis
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pneumonia after exposure to bat guano/droppings
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Histoplasmosis
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Histoplasmosis at 25C, at 37C
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Histoplasmosis at:
25C = branched hypae (macroconidia) 37C = single yeast cells |
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productive cough, fever, chlls, wt loss, night sweats, myalgias; dust exposure in Missouri
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Blastomycosis
-states E of Miss R -*can form granulomas |
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broad-based budding
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Blastomycosis
-hyphae at 25C -yeast at 37C |
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pneumonia, fever, cough, expectoration after dust exposure in SW US
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Coccidioides immitis
-hyphae @ 25C -yeast @ 37C |
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spherule filled w/ endospores, hyphae at 25C, yeast at 37C
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Coccidioides immitis
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budding yeast w/ 'captain's wheel' formation
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Paracoccidioidomycosis
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B12 deficiency
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Diphyllobothrium latum
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Biliary tract disease, cholangiosarcoma
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Clonorchis sinensis
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Hematuria, bladder cancer
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Shistosoma haematobium
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Microcytic anemia
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Ancylostoma, Necator
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Perianal pruritis
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Enterobius
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nematode in undercooked meat
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Trichinella spiralis
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how remember which DNA viruses have ssDNA vs dsDNA?
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All DNA viruses except Parvovirus (B19) are dsDNA
"all are dsDNA (like our cells) except 'part-of-a-virus' (parvovirus) is ssDNA" -this is like RNA viruses: "all are ssRNA (like our mRNA) except 'repeatovirus' (reovirus) is dsRNA" |
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location of replication of DNA vs RNA viruses
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DNA
all in NUCLEUS except Poxvirus RNA all in CYTOPLASM except Influenza & Retrovirus |
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difference btw IM w/ +heterophile Ab, -heterophile Ab
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(+) heterophile Ab IM = EBV
(-) heterophile Ab IM = CMV |
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HHV-8 a/w
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Kaposi's Sarcoma in HIV pt's
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