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171 Cards in this Set
- Front
- Back
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Bugs that do not gram stain well
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These Rascals May Microscopically Lack Color
tTreponema, Rickettsia, Mycobacteria, Mycoplasma, Legionella pneumophila, Chlamydia |
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Stain to dx Whipple's disease
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PAS
stains glycogen, mucopolysaccharides |
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Silver stain for
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Legionella, and fungi ex pneumocystis
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Obligate aerobes
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Nagging Pests Must Breathe
Nocardia, Pseudomonas, Mycobacterium tb, Bacillus |
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Obligate anaerobes
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Can't Breathe Air
Clostridium, Bacteroides, Actinomyces |
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Obligate intracellular
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Rickettsia, Chlamydia
Can't make own ATP stay inside cells when its Really Cold |
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Facultative intracellular
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Some Nasty Bugs May Live FacultativeLY
Salmonella, Neisseria, Brucella, Mycobacterium, Listeria, Francisella, Legionella, Yersinia pestis |
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Positive quelling reaction
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Capsular swelling
it is an encapsulated organism! |
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Encapsulated bacteria
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SHiN SKiS (group B)
Strep pneumo, H flu, N meningitidis, Salmonella, Klebsiella pneumo, group b Strep |
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Catalase positive organisms
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Staph aureus, Serratia, Pseudomonas, Candida, E.Coli
CGD pts have recurrent infxns with these microbes |
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Urease positive bugs
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PUNCH-K
Proteus, Ureaplasma, Nocardia, Cryptococcus, H. pylori, Klebsiella |
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Actinomyces israelii
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yellow "sulfur" granules, composed of a mass of filaments and formed in pus
Israel has yellow sand |
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S. aureus pigment
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Yellow
aureus is Latin for gold |
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Serratia marcescens pigment
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Red pigment
think red maraschino cherries! |
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Host antibodies against Streptolysin O toxin used to dx
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Rheumatic fever
Toxin is from Strep pyogenes (GAS) |
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Toxic Shock Syndrome
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caused by exotoxin A from strep pyogenes or TSST-1 from staph aureus
fever, rash, shock |
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Transformation
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ability to take up DNA from environment
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Transposition
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segment of DNA that can jump- excision and reincorporation- from one location to another
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Transduction
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DNA is transferred from one bacteria to another by a virus
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genes for 5 bacterial toxins encoded in lysogenic phage
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shigA like toxin, Botulinum toxin, Cholera toxin, Diphtheria toxin, Erythrogenic toxin of strep pyogenes
ABCDE |
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Coag negative staph identification
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On the office's staph retreat, there was NO StRES
Novobiocin- S. Sapophticus Resistant S. Epidermidis Sensitive |
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Alpha hemolytic strep identification
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OVRPS overpass
Optochin- Viridans is Resistant S. Pneumonia is Sensitive |
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Beta hemolytic strep identification
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B-BRAS
Bacitracin- Group B strep- agalactiae- Resistant Group A strep- pyogenes- Sensitive |
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Part of the normal flora of oropharynx, Cause dental caries
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Streptococcus mutans- a viridans streptococci
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Cause of subacute bacterial endocarditis
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Streptococcus sanguis- a viridans strep
sanguis is blood in latin, there is lots of blood in the heart |
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Where do viridans group strep live
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In the mouth because they are not afraid of-the-chin (optochin resistant!)
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PHayngitis can result in
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rheumatic PHever and glomerulonePHritis
from GAS (strep pyogenes) |
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Rheumatic Fever sx
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No rheum for SPECCulation
Subcutaneous plaques, Polarthritis, Erythema marginatum, Chrea, Carditis |
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Colonizes the vagina
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GBS
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Colonized the gut
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Streptococcus bovis- nonenterococcus group D strep
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Cornyebacterium lab dx
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gram positive rods with metachromatic- blue and red- granules and Elek test for diphtheria toxin
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Diphtheria toxin
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potent exotoxin, inhibits protein sythesis via ADP ribosylation of EF-2, encoded by beta prophage
ABCDEFG- ADP ribosylation beta prophage corynebacterium diphtheria elongation factor 2 granules |
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C. perfringens toxin
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alpha toxin- lecithinase, a phospholipase, causes myonecrosis (gas gangrene) and hemolysis
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C. difficile toxins
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Toxin A- enterotoxin, binds to brush border of gut
Toxin B- cytotoxin, destroys cytoskeletal structure of enterocytes, causing pseudomembranous colitis |
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tx of C. diff
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metronidazole or oral vancomycin
Difficile cause Diarrhea |
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Only bacterium with a polypeptide capsule
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Bacillus anthracis
contains D glutamate get black skin lesions- black eschar (necrosis) surrounded by edematous ring |
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Woolsorter's disease
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inhalation of anthrax spores from contaminated wool
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Listeria monocytogenes
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faculatative intracellular gram positive rod, beta hemolytic, from unpasteurized milk/cheese, deli meets, vaginal transmission during birth, form actin rockets that move from cell to cell, characteristic tumbling motility
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Actinomyces
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gram positive anaerobe, forms yellow sulfur granules in sinus tracts, can cause oral/facial abscesses that may drain through sinus tracts in skin
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Nocardia
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gram positive, weakly acid fast aerobe in soil, pulmonary infxn in immunocompromised
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SNAP
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tx Sulfa for Nocardia, Actinomyces use Penicillin
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Ghon complex
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TB granulomas- ghon focus usually in lower lobes + lobar and perihilar LN involvement
reflects primary infection or exposure |
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Mycobacterium avium intracellulare
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often resistant to multiple drugs, causes disseminated disease in AIDS, prophylactic tx with azithromycin
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Hansen's disease
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Leprosy, causes by m. leprae, acid fast bacillus that likes cool temps, 2 forms- lepromatous diffuse over skin, low cell med immunity with humoral th2 response, and tuberculoid- high cell med immunity with largely th1 immune response
tx long term DAPSONE |
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Lactose fermenting enteric bacteria
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grow pink colonies on MacConkey's agar
lactose is KEE- fast fermenters klebsiella, e coli, enterobacter test wtih macConKEE'S agar slow fermenters- citrobacter, serratia |
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E. coli produces
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beta galactosidase, which breaks down lactose into glucose and galactose
e. coli is gram negative, lactose fermenting rod |
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Gram negative outer membrane layer inhibits entry of
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penicillin G and vancomycin
may still be susceptible to penicillin derivative such as ampicillin |
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Neisseria fermenting
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MeninGoccci ferment Maltose and Glucose
Gonococci ferment Glucose |
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Culture on chocolate agar with factors V (NAD+) and X (hematin) for growth
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Haemophilus influenza
when child has "flu" mom goes to five V and dime X store to buy chocolate h flu does not caus ethe flu- influenze virus does |
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Legionella pneumophila
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gram negative rod, stains poorly, use silver stain, grow on charcoal yeast extract culture with iron and cysteine
aerosol transmission from water source habitat- no person to person, tx erythromycin |
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Legionnaire's disease
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from legionella pneumophila-severe pneumonia and fever
pontiac fever- mild flu like sx |
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Hemolytic uremic syndrome
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triad of anemia, thrombocytopenia, and acute renal failure
endothelium swells and narrows lumen- mechanical hemolysis, red renal blood flow, damaged endothelium consumes platelets EHEC can produce it |
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Distinguish EHEC from other E. coli
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Does not ferment sorbitol
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Red currant jelly sputum
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Klebsiella
causes lobar pneumonia in alcoholics and diabetics when aspirated 4 A's- aspiration pneumonia, abscess in lungs and liver, alcoholics, diAbetics |
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Rose spots on the abdomen
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Typhoid fever from salmonella typhi, found only in humans, have fever, headache, diarrhea, has potential to remain in gallbladder and cause a carrier state
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Comma shaped and grows in 42 degrees C
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Campylobacter jejuni
oxidase positive fecal oral transmission campylobacter likes the hot camp fire common antecedent to Guillian Barre syndrome |
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Usually transmitted from pet feces ex puppies, contaminated milk or pork
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Yersinia enterocolitica
outbreaks of diarrhea in day care centers causes mesenteric adenitis that can mimic Crohn's or appendicitis |
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Visualized in dark field microscopy
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Treponema
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Spirochetes
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BLT
B is big Borrelia, leptospira, Treponema |
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Can be visualized using aniline dyes (wrights or giemsa stain)
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Borrelia
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Weil's disease
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icterohemorrhagic leptospirosis- severe form with jaundice, azotemia from liver and kidney dysfunction, fever, hemorrhage, anemia
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Leptospirosis
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flulike sx, jaundice, photophobia with conjunctivitis
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Ixodes tick
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transmits Borrelia burgdorferi- lyme disease and Babesia
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Lyme dse
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BAKE a Key Lyme pie- Bilat bells palsy, Arthritis, Kardiac block, Erythema migrans
tx doxycycline, ceftriaxone |
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Screening test for syphilis
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VDRL
many false positives- with viruses- mono, hepatitis, drugs, rheumatic fever, lupus and leprosy Confirm syphilis with FTA-ABS |
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Reservoir of Mycobacterium leprae in US
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Armadillos
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Clue cells
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vaginal epithelial cells covered with bacteria
Gardnerella vaginalis gray fishy smelling vaginal discharge tx metronidazole |
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Endemic typhus
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Rickettsia typhi
fleas vector |
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Epidemic typhus
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Rickettsia prowazekii
human body louse vector rash starts centrally and spreads out sparing palms and soles |
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Palms and Soles rash seen in
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you drive CARS with your palms and soles
Coxsackievirus A infxn- hand foot and mouth dse, Rocky mountain spotted fever, and Syphilis |
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Rocky mountain spotted fever
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caused by rickettsia rickettsii, sx rash on palms and soles- vasculitis, headache, fever, endemic to EAST COAST
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Chlamydia trachomatis serotypes
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A,B,C- africa, blindness, chronic infection
D-K- urethritis/PID, ectopic preg, neonatal pneumonia and conjunctivitis L1-3- lymphogranuloma venereum |
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Frequent outbreaks in military recruits and prisions
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Mycoplasma pneumonia
high titer of cold agglutinins (IgM) grown on Eaton's agar tx with tetracyclin or erythromycin |
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Tinea versicolor
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caused by Malassezia furfur
degrades lipid, produc acids that damage melanocytes and cause hypo/hyper pigmented patches spaghetti and meatball appearance on KOH prep tx miconazole, selenium sulfide |
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Dimorphic cigar shaped budding yeast
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Sporothrix schenckii
nodules along draining lymphatics tx itraconazole or POTassium iodide plant rose in a pot! |
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Septate hyphae branch at acute angles
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Aspergillus
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Disk shaped yeast forms on methenamine silver stain
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Pnemocystis jiroveci
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Spindle cells with cigar shaped nuclei, interweaving fascicles, mitoses
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Leiomyosarcoma
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Congenital toxoplasmosis
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classic triad of chorioretinitis, hydrocephalus, and intracranial calcifications
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Tx toxoplasmosis
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sulfadiazine and pyrimethamine
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Naegleria fowleri
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swinning in freshwater lakes, rapidly fatal meningoencephalitis, dx amoebas in spinal fluid, tx amphotericin effective in few
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Tx african sleeping sickness- Trypanosoma brucei
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Suramin for blood borne dse, Melarsoprol for CNS penetration
It SURe is nice to go to sleep, MELAtonin helps with sleep dx blood smear transmit from tsetse fly painful bite |
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Cycles for plasmodium
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P. vivax/ovale- 48 hr cycle, tertian, fever on first and third day, 48 hrs apart
P. falciparum- irr fevers P. malariae- 72 hr cycle, quartan tx chloroquine, mefloquine if resistant vivax/ovale- primaquine |
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Maltese cross
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Babesiosis
fever and hemolytic anemia northeaster US Ixodes tick tx quinine, clindamycin |
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Chaga's disease
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Trypanosoma cruzi
dilated cardiomyopathy, megacolon, megaesophagus, predom in South America Reduviid bug, painless bite dx blood smear, tx nifurtimox |
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Macrophages containing amastigotes
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Leishmania donovani
visceral leishmaniasis- kala azar spiking fevers, HSM, pancytopenia transmitted by sandfly tx sodium stibogluconate |
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Causes anal pruritis
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enterobius vermicularis
pinworm use the scotch tape test tx with meBENDazole or pyrantel pamoate |
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River blindness
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Onchocerca volvulus
transmitted by female blackflies, get black skin nodules, "black sight" tx IVERmectin for rIVER blindness |
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Can see worm crawling in conjunctiva
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Loa loa
transmitted by deer horse and mango fly, causes swelling in skin tx diethylcarbamazine |
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Elephantiasis
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9 mo-1 yr after female mosquito bite with wuchereria bancrofti, causes blockage of lymphatic vessels, tx diethylcarbamazine
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Taenia solium
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ingest larvae from undercooked pork- intestinal tapeworms- tx praziquantel
ingest eggs- cysticercosis tx bendazoles for neurocyst |
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Liver cysts
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echinococcus granulosus
eggs in dog fecers, causes anaphylazis if ag released from cysts tx bendazoles |
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Cestode (tapeworm) causing B12 def
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Diphullobothrium latum
ingest larvae in raw freshwater fish tx praziquantel |
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Trematode (fluke) causing biliary tract dse, cholangiocarcinoma
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Clonorchis sinersis
in undercooked fish tx praziquantel |
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Undercooked crab meat
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Paragonimus westermani
hemoptysis inflam and 2ndary bacterial infxn of lung tx praziquantel |
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Schistosoma mansoni
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portal htn
snails are host tx praziquantel |
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Schistosome haematobium
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hematuria, squamous cell carcinoma of bladder
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Live attenuated vaccines
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induce humoral and cell med immunity
small pox, yellow fever, chicken pox, sabin's polio virus, MMR Live! See small yellow chickens get vaccinated with Sabin's and MMR! |
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Killed vax
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RIP Always
Rabies Influenza Salk Polio HAV SalK = Killed |
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DNA viruses
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ds DNA except parvovirus- ssDNA
linear except papilloma, polyoma and hepadnaviruses- circular |
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RNA viruses
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ss DNA except reovirus- ds DNA
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Positive stranded RNA viruses
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i went to a RETRO TOGA party, where i drank FLAVored CORONA and ate HIPPY CALIfornia PICkles
retrovirus, togavirus, flavivirus, coronavirus, hepevirus, calicivirus, picornavirus |
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Causes pink eye- conjunctivitis
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Adenovirus
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Aplastic crisis in sickle cell disease
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Parvo B19 virus
non enveloped SS DNA virus |
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JC and BK
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polyomavirus- non enveloped ds DNA virus
JC- progressive multifocal leukoencephalopathy in HIV BK- transplant patients, commonly targets kidneys JC junky cerebrum BK bad kidney |
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Congenital CMV infxn
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SIGHTomegalovirus
infected cells have owl's eyes inclusions |
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Tzanck test
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smear of an opened skinvesicle to detect multinucleated giant cells in HSV 1, HSV 2 and VZV
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EBV
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infects B cells, atypical lymphocytes infected with reactive cytotoxic T cells
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#1 cause of fatal diarrhea in children
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Rotavirus
type of reovirus- non enveloped ds RNA virus |
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Types of picornaviruses
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PERCH on a peak (pico)
non enveloped ss + linear RNA viruses Poliovirus, Echovirus, Rhinovirus, Coxsackievirus, HAV all are enteroviruses - fecal oral spread- except rhinovirus |
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Hand foot and mouth disease
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Coxsackievirus, herpangina febrile pharyngitis myocarditis
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HEV
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Hepevirus
non enveloped ss+ linear RNA virus |
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HCV
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flavivirus
enveloped ss + linear RNA virus other flavis- yellow fever, dengue, st louis encephalitis, west nile virus |
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Rubella
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Togavirus
enveloped ss + linear RNA virus other toga- eastern and western equine encephalitis |
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Paramyxoviruses
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enveloped ss - linear nonseg helical RNA virus
parainfluenza RSV- tx ribavirin Rubeola Measles Mumps |
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Icosahedral RNA viruses
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all positive stranded RNA viruses + ortho + reo
pos- toga, flavi, hepe, corona, calici, picorna, retro |
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Segmented viruses
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all RNA viruses
BOAR Bunya- 3, Ortho- 8, Arena- 2, Reo 10-12 |
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Acute hemorrhagic cystitis
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Adenovirus
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Acid labile virus
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rhinovirus- destroyed by stomach acid, does not infect GI tract
non enveloped ss + linear RNA virus |
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Yellow fever virus
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flavivirus, also arbovirus, transmitted by Aedes mosquitos
enveloped ss + linear RNA virus sx high fever, black vomitus, jaundice |
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Most important global cause of infantile gastroenteritis
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Rotavirus
segmented dsRNA virus Right Out The Anus villous destruction with atrophy leads to dec absorption of Na and water |
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Genetic shift
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reassortment of viral genome, high freq recombination, pandemic
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Genetic drift
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minor changes based on random mutation, epidemic
Sudden Shift more deadly than graDual Drift |
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Postauricular adenopathy, lymphadenopathy, arthralgias, fine truncal rash that starts at head and moves down
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Rubella- german measles, togavirus, enveloped ss + linear RNA virus
serious congenital dse- fetal infxn in 1st trimester causes sensorineural deafness, cataracts, cardiac malformations ex PDA |
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Contain surface F (fusion) protein
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Paramyxoviruses
cause respiratory epithelial cells to fuse and form multinucleated cells |
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Difference between maculopapular rash in rubeola and rubella
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Rubella- truncal rash
Rubeola- includes hands and feet |
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Mumps
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paramyxovirus- enveloped ss - linear non seg RNA virus
Parotitis, Orchitis, aseptic Meningitis mumps make your parotid glands and testes as big as POM poms |
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Positive during window period
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anti HBcAg
igm=acute/recent infxn igg= chronic dse |
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High transmissibility
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HBeAg
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Low transmissibility
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Anti HBeAg
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Immunity to HIV infection
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homozygous CCR5 mutation
heterozygous- slower course virus binds CXCR4 or CCR5 coreceptor and CD4 on T cells, binds CCR5 and CD4 on macrophages |
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Superficial vascular proliferation in HIV pt
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Bartonella henselae
bx reveals neutrophilic inflammation |
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Superficial neoplastic proliferation of vasculature in HIV pt
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HHV-8
bx reveals lymphocytic inflammation |
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Prion disease
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accumulation of beta pleated form of prion protein- PrPsc, resuls in spongiform encephalopathy, dementia, ataxia, death
sporadic- creutzfeldt jakob inherited- gerstmann straussler scheinker acquired- kuru |
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Mimic appendicitis by causing mesenteric adenitis
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Yersinia enterocolitica, campylobacter jejuni, non typhoidal Salmonella
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Tx of meningitis
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Ceftriaxone and vancomycin empirically
Add ampicillin if Listeria is suspected |
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Herpes that causes meningitis
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HSV-2
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Herpes that causes encephalitis
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HSV-1
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MCC of osteomyelitis
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Staph aureus
diabetics and IV drug users- pseudomonas |
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Vertebral osteomyelitis causative agent
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Mycobacterium tuberculosis
Pott's disease |
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Diagnostic markers of UTI
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positive leukocyte esterase test= bacterial UTI
positive nitrite test= gram negative bacterial UTI |
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Leading cause of UTI
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E. Coli
colonies show green metallic sheen on EMB agar |
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Urease positive bugs
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PUNCH-K
Proteus, Ureaplasma, Norcardia, Cryptococcus, H. pylori, Klebsiella |
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Swarming on agar
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Proteus mirabilis, motile, producses urease, associated with struvite stones, causes UTI
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Can pass from mother to fetus during delivery
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HSV-2
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What does parvovirus B19 cause in neonates?
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Hydrops fetalis
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Toxo in neonate
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chorioretinitis, hydrocephalus, intracranial calcifications
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Rubella in neonate
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PDA, cataracts, deafness
+/- blueberry muffin rash |
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CMV in neonates
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hearing loss, sz, petechial rash, blueberry muffin rash
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HSV-2 in neonates
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temporal encephalitis, herpetic (vesicular) lesions
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Syphilis in neonates
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stilbirth, hydrops fetalis, facial abnormalities- notched teeth, saddle nose, short maxilla, saber shins, CN VIII deafness
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Scarlet fever
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from strep pyogenes (gas)\
erythematous, sandpaper like rash with fever and sore throat |
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Chancroid
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PAINFUL genital ulcer, inguinal adenopathy
Haemophilus ducreyi its so painful you do cry! |
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strawberry colored mucosa
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Trichomonas vaginalis
vaginitis, corkscrew motility on wet prep |
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Most common bacterial STD in US
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Chlamydia trachomatis
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Fitz Hugh Curtis syndrome
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PID can lead to this
infection of the liver capsule and violin string adhesions of parietal peritoneum to liver |
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Microbe that colonizes nasopharynx and can cause meningitis
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H influenza type B
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Fever with dysphagia, drooling, difficulty breathing due to edematous cherry red epiglottis
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H influenza type B
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Branching rods in oral infection, sulfur granules
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Actinomyces israelii
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Positive PAS stain
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Tropheryma whippelii- Whipple's disease
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Fungal infection in diabetic
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Mucor or Rhizopus spp
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Neutropenic pts at risk for
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Candida albicans, Aspergillus
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INH tox
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Injures Neurons and Hepatocytes
give pyridoxine to prevent neurotox, lupus |
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Isoniazid
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dec synthesis of mycolic acids
only solo prophylaxis against TB different half lives in fast v slow acetylators tox neuro, hepato, lupus |
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Rifampin
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inhibits DNA dep RNA polymerase
4 Rs- RNA poly inhib, Revs up microsomal P-450, Red/orange body fluids, Rapid resistance if used alone used in TB, delays resistance to dapsone in leprosy, prophylazis in contacts of children with H flu type b |
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Pyrazinamide
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effectve in acidic pH of phagolysosomes, where is TB engulfed by macrophages
tox hyperuricemia, hepato |
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Ethambutol
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dec carb polymerization of mycobacterium cell wall by blocking arabinosyltransferase
tox- optic neuropathy! red green color blindness |
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HIV prophylaxis with
CD4 <200 CD4 <100 CD4 <50 |
bactrim for PCP
bactrim for PCP and toxo azithromycin for MAI complex |
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Produces a trivalent exotoxin composed of protective antigen, edema factor and lethal factor
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Bacillus anthracis
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Unique capsules
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Bacillus anthracis- D glutamic acid
GBS- sialic acid Pasteurella- hyaluronic acid |
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Clindamycin
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best initial therapy for infxns predominantly anaerobic
lung abscess, aspiration pneumonia licosamide antibiotic, inhibits the ribosome |
