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204 Cards in this Set
- Front
- Back
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What does Ziehl Neelsen stain?
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acid fast bacteria (AFB) - red
mycobacterium tuberculosis and Nocardia |
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What stain is used for Cryptococcus?
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India Ink
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What color does congo red stain amyloid when viewed under light microscope?
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RED
apple-green birefringence when viewed unde polarizing light microscope |
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What are the steps in gram staining?
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crystal violet (blue/purple)--> gram's iodine (mordant)--> alcohol (decolorizer) --> safranin (pink/red)
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What color does gram (+) stain?
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blue violet
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What bacteria do not have cell walls?
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mycoplasma
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What bacteria do not have peptioglycan in their cell wall?
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chlamydia (and mycoplasma because they have no cell wall)
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What is a component of a Gram (-)'s outer membrane?
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lipopolysaccharide (LPS)
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What endotoxin is associated with LPS and is that associated with Gram (-) or (+)?
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endotoxin - lipid A
associated with Gram (-)'s |
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Is the "O ag" associated with Gram + or - bacteria?
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Gram (-)
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What organisms can become spores?
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clostridium
bacillus |
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what acid does spores contain?
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dipicolinic acid
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What organisms are encapsulated?
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Haemophilus influenze
Neisseria meningitidis Streptococcus pneumoniae |
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What is the problem with encapsulated bacteria?
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It is hard for our body to phagocytize and especially problematic for those with splenectomy
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What type of molecule is endotoxin (Lipid A)?
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lipid
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Is Lipid A of LPS a good or bad antigen and is is heat stable or labile?
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It is a POOR antigen and it is heat STABLE --> because it is NOT a protein
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What does endotoxin (Lipid A) activate?
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Hageman (factor XII)
alternate complement (C3a & C5a) Macrophages (TNF, IL-1, and NO) |
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What type of molecule are exotoxins and do they all have the same effect?
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Exotoxins are polypeptides
DIFFERENT effects with different exotoxins |
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What is the action of tetanus toxin? and what organism produces it?
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produced by: Clostridium tetani
action: blocks GABA and glycine (inhibitory NTs) release |
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What is the action of botulinum toxin? and what organism produces it?
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produced by: Clostridium botulinum
action: blocks release of ACh at NMJ |
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What organisms can become spores?
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clostridium
bacillus |
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what acid does spores contain?
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dipicolinic acid
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What organisms are encapsulated?
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Haemophilus influenze
Neisseria meningitidis Streptococcus pneumoniae |
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What is the problem with encapsulated bacteria?
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It is hard for our body to phagocytize and especially problematic for those with splenectomy
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What type of molecule is endotoxin (Lipid A)?
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lipid
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Is Lipid A of LPS a good or bad antigen and is is heat stable or labile?
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It is a POOR antigen and it is heat STABLE --> because it is NOT a protein
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What does endotoxin (Lipid A) activate?
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Hageman (factor XII)
alternate complement (C3a & C5a) Macrophages (TNF, IL-1, and NO) |
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What type of molecule are exotoxins and do they all have the same effect?
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Exotoxins are polypeptides
DIFFERENT effects with different exotoxins |
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What is the action of tetanus toxin? and what organism produces it?
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produced by: Clostridium tetani
action: blocks GABA and glycine (inhibitory NTs) release |
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What is the action of botulinum toxin? and what organism produces it?
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produced by: Clostridium botulinum
action: blocks release of ACh at NMJ |
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What organisms can become spores?
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clostridium
bacillus |
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what acid does spores contain?
|
dipicolinic acid
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What organisms are encapsulated?
|
Haemophilus influenze
Neisseria meningitidis Streptococcus pneumoniae |
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What is the problem with encapsulated bacteria?
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It is hard for our body to phagocytize and especially problematic for those with splenectomy
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What type of molecule is endotoxin (Lipid A)?
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lipid
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Is Lipid A of LPS a good or bad antigen and is is heat stable or labile?
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It is a POOR antigen and it is heat STABLE --> because it is NOT a protein
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What does endotoxin (Lipid A) activate?
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Hageman (factor XII)
alternate complement (C3a & C5a) Macrophages (TNF, IL-1, and NO) |
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What type of molecule are exotoxins and do they all have the same effect?
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Exotoxins are polypeptides
DIFFERENT effects with different exotoxins |
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What is the action of tetanus toxin? and what organism produces it?
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produced by: Clostridium tetani
action: blocks GABA and glycine (inhibitory NTs) release |
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What is the action of botulinum toxin? and what organism produces it?
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produced by: Clostridium botulinum
action: blocks release of ACh at NMJ |
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How does diptheria toxin work?
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Inhibits protein synthesis (modifying elongation factor-2 (EF2)
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What organism produces diptheria toxin? and what are the features of the toxin?
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Corynebacterium diptheria
Features include pharyngeal pseudomembrane + myocarditis w/ arrhythmias, regurgitation of fluids through nose d/t paralysis of pharyngeal muscles |
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What two organisms produce Alpha toxin?
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staphylococcus aureus and clostridium perfringens
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How does alpha toxin produced by staph. aureus act?
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creates holes in cell membranes
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How does alpha toxin produced by clostridium perfringens act?
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digests lecithin, a PL in cell membrane
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How does toxic shock syndrome work?
What organism produdes it? |
works by DIRECTLY binding Class II MHC proteins --> Suger antigen
produced by staphylococcus aureus |
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What are the features of toxic shock syndrome toxin?
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fever, rash, desquamation, diarrhea THEN hypotension THEN shock
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Which toxin binds gangliosides in intestinal cell membranes stimulating Gs protein which (+) adenylate cyclase --> over producing cAMP causing secretion of Cl and H2O ions
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Cholera toxin (choleragen)
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What is the ultimate effect of the toxin produced by Vibrio cholerae?
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massive watery diarrhea
(w/o inflam/WBC's in stool) |
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What toxin bind to ciliated resp. tract epithelial cells and to lymphocytes via inhibition of Gi protein?
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pertussis toxin produced by Bordetella pertussis
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What is the name for any toxin that causes direct GI pathology with concomitant symptoms?
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Enterotoxin
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What are the two major types of enterotoxins produced by E.coli?
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heat labile (LT)
heat stable (ST) |
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How does heat labile enterotoxin work?
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like choleragen
binds gangliosides in enterocyte and stimulated Gs |
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How does heat stable enterotoxin work?
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activated guanylate cyclase--> increasing cGMP which blocks ions from entering cells from lumen so water is "drawn" into the lumen
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These organisms must have plentiful oxygen and posess many enzymes for removal of damaging oxygen radicals - what are they?
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obligate aerobes
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these organisms have NO oxygen requirement, rely on fermentation, but are able to "tolerate" low conc of oxygen because they possess SOD - what are they?
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microaerophilics
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These organisms have NO oxygen requirement and cannot tolerate any oxygen because they do not possess enzymes for removal of O2 radicals - what are they?
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obligate anaerobes
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These oranisms will use oxygen when it's available but will utilize other metabolic mechanisms when it is not available, they possess enzymes, and includes the largest number of bacterial species - what are they?
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facultative anaerobes
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What are the different types of E.coli? (6)
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ETEC
EIEC EAEC EHEC Escherichia coli0157 EPEC |
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What type of E.coli acts as one of the most common causes of diarrhea?
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ETEC
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What is the cause of Travelers diarrhea?
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ETEC
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What is the type of E.coli that causes HUS?
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E.coli 0157
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What is the cause of Hemorrhagic Colitis?
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EHEC
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This type of E.coli secretes LT and ST causing severe, watery diarrhea that starts at least 6 hours after ingestion?
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ETEC
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This type of E.coli invades enterocytes resulting in a bloddy diarrhea with WBCs in the stool?
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EIEC
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What type of E.coli is also known as STEC d/t secreting Shiga-like toxin?
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EHEC
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How is EHEC acquired?
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feces of cattle,sheep, goats, and deer; contaminated ground beef; also contact with those with current infection
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This type of E.coli has all the abilities as a "standard" EHEC, PLUS causes non-immune hemolytic anemia, thrombocytopenia, and ARF (w/ uremia) --> HUS?
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E.coli 0157
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What species of Staphylococci usually causes infection of prosthetic heart valves and hips?
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staphylococci epidermidis
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What are the famous exotoxins of staph. aureus? (4)
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Enterotoxin A-F
TSST-1 Exfoliatin toxin Alpha toxin |
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What is the toxin responsible for Scalded Skin Syndrome?
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Exfoliatin toxin
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What are the major Streptococci pathogens? (6)
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pneumoniae
agalactiae pyogenes bovis faecalis mutans |
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What organism is Group B Strep?
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streptococcus agalactiae
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what organism is Group A strep ?
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streptococcus pyogenes
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What is the #1 cause of sepsis or meningitis of the neonate in the US?
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streptococcus agalactiae
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What species of streptococcus is a marker for colon cancer?
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streptococcus bovis
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What are the top 4 organisms that infect the biliary tree?
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EEEK!
enterococcus enterobacter E.coli Klebsiella |
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What are the 3 possible diseases caused by streptococcus pyogenes?
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1) pyogenic dz
2) toxigenic dz 3) immunologic dz |
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What are the 2 different possibilites of immunologic disease caused by Streptococcus pyogenes (GrpA strep)?
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rheumatic fever --> rheumatic heart disease OR post-streptococcal glomerulonephritis
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What is the virulence factor that determines the type of Group A beta-hemolytic Strep?
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M protein
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What are the famous exotoxins of Grp A beta hemolytic strep? (8)
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streptokinase
streptodornase Hyaluronidase Erythrogenic toxin streptolysin O streptolysin S pyrogenic exotoxin A exotoxin B |
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This exotoxin of Grp A Strep digests a major component of CT causing cellulitis?
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hyaluronidase
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What toxin causes the rash of scarlet fever?
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erythrogenic toxin
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fever, rough, erythematous diffuse rash, strawberry tongue, focal streptococcal infection are characteristics of what?
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scarlet fever
rash caused by erythrogenic toxin |
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What will always be (+) in rheumatic fever?
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ASO - because streptolysin O is antigenic, stimulating the production of Abs
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What organism should make you think endotoxin, endotoxin, endotoxin!?
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Neisseria meningitidis
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Waterhouse-Friederichsen syndrome can occur d/t what organims?
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Meningococcus
(N. meningitidis) |
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untreated PID (d/t gonoccus or chlamydia) may lead to what syndrome?
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Fitz-Hugh-Curtis Syndrome
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What are the oucomes of systemic spread of gonococcus?
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gonococcal arthritis and tenosynovitis
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What are the 3 components of ANTHRAX TOXIN?
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edema factor
protective antigen lethal factor |
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What are the 3 types of anthrax and which is the most deadly?
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cutaneous anthrax
pulmonary anthrax (DEADLY) Gastrointestinal anthrax all are deadly but pulmonary is rarely treatable |
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How do you treat bacillus anthracis ?
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DOC PenG but only after proven to be sensitive until then:
cipro or doxy PLUS clinda and/or rifampin AND continue that or instead tx with PenG |
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What organisms are referred to "Chinese Characters" ?
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corynebacterium diptheriae
Listeria monocytogenes |
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What is the most common source of Listeria monocytogenes?
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unpasteurized dairy products
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What clostridium species cause gas gangrene and food poisoning?
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c. perfringens
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What organism protects the GI tract and vagina by maintaining acidid pH (<4.5)?
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lactobacillus
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How does one acquire perfringens food poisoning?
(Hint: think Mexican food!) |
spores germinate in improperly stored pre-prepared foods; once ingested enterotoxin is produced --> non-bloody diarrhea (no WBCs)
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when clostridium spores are inoculated into a deep wound and alpha-toxin is produced what occurs?
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Gas gangrene --> destruction and necrosis with gas production
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What organism causes pseudomembranous colitis?
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c. diffiicle
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what antibiotics are most famous for causing pseudomembranous colitis?
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clindamycin
ampicillin cephalosporins |
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What is the couse of profuse, FOUL SMELLING, watery diarrhea with crampy abdominal pain and leukocytosis that can lead to toxic megacolon and colonic perforation?
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pseudomembranous colitis from c. difficile
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How is pseudomembranous colitis DX and TX?
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DX: c. difficile toxin
TX: metronidazole or vancomycin + cholestyramine |
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What are the 3 major clinical forms of botulism?
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botulism - #1 type
wound botulism infant botulism - honey |
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Gram-negative bacteria that exist specifically within the bowel and are generally known as coliforms are what?
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Enterobacteriaceae
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All bacteria that have a flagellum have what antigen?
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H
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What Enterobacteriaceae have the H antigen and therefore are motile?
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Escherichia (E.coli)
Salmonella |
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What is the route of ingesting salmonella enteritidis ?
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poultry products especially eggs and contact with reptiles
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What is the number one cause of osteomyelitis in sickle cell patients?
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salmonella
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Salmonella enteritidis invade epithelium causing what?
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inflammatory diarrhea (+) for WBCs; may lead to Reiter's syndrome
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What is the cause of Typhoid fever and the route of ingestion?
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salmonella typhi
ingested via fecal-oral route |
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Does salmonella infections require a high or low dose?
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HIGH
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Does shigella infection require a high or low dose?
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LOW
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Constipation, fever, relative bradycardia, rose spots on abdomen which may progress to chronic infeciton of GB?
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Enteric fever (Typhoid fever)
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What are the 5 F's of shigella ingestion?
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fingers
food flies feces fornication |
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What organism aside from E.Coli0157 will also cause HUS?
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Shigella
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What type of diarrhea does Shigella cause?
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inflammatory; bloody, mucusy diarrhea with WBCs
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What VERY motile organism that is part of normal flora is a cause of staghorn renal calculi?
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Proteus
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What is the #1 cause of nursing home pneumonia?
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Klebsiella pneumoniae
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What organism causes rice water diarrhea SO volumnious that is causes severe vol and electrolyte loss, leading to arrhythmia and rapid ARF?
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vibrio cholerae
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This marine organism transmitted by raw seafood produces watery diarrhea and is a major cause in Japan?
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vibrio parahaemolyticus
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Watery, foul-smelling diarrhea that is invasive and associated with development of Guillian-Barre is what?
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Campylobacter jejuni
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What is the #1 inhabitant of the colon?
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Bacteroides fragilis
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What are the factors that favor the growth of Bacteroides fragilis (anaerobic G(-))
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low blood flow to gut
E.coli overgrowth necrosis |
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What is the DOC for yersinia pestis?
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STREPTOMYCIN
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What agent causes the "black death" ?
|
yersinia pestis
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organism transferred via prarie dog-->fleas-->human; causing a "bubo" and potentially DIC?
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Yersinia pestis
Bubonic plague |
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What is the prognosis of pumonary plague?
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100% die w/o tx and fatal within hours
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What is the prophylaxis for contacts of those with yersinia pestis?
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tetracycline
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What agent is acquired via dog and cat bites and causes wound infection/cellulitis?
|
pasteurella multocida
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What is the #1 complication of brucellosis?
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osteomyelitis
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Brucella species from goats and sheep?
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melitensis
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brucella species from cattle?
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abortus
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brucella from pigs?
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suis
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What are the reservoir and vector for Francisella tularensis?
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rabbit, ticks
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What is the #1 cause of osteomyelitis in IV drug users?
|
Pseudomonas aeruginosa
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what is the #1 cause of infection in burn patients?
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Pseudomonas aeruginosa
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what is the #1 cause of pneumonia in cystic fibrosis patients >6 mo?
|
Pseudomonas aeruginosa
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what is the #1 cause of malignant otitis externa?
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pseudomonas aeruginosa
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What gram (-) obligate aerobe produces a musty odor, greeenish blue pus d/t pyocyanin?
|
pseudomonas aeruginosa
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This gram (-) pleomorphic rod produces IgA protease and requires chocolate agar to grow?
|
Hemophilus species
|
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What is the cause of epiglottitis ?
|
H. influenzae
|
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What is the cause of chancroid?
|
H. ducreyi
|
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What is the treatment for ALL hemophilus infections?
|
3rd generation cephalosporins
|
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What is the treatment for Bordetella pertussis and when is it best?
|
erythromycin (best during catarrhal stage)
|
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What are the stages of whooping cough (bordetella pertussis)?
|
catarrhal stage (1-2 wks)
Paroxysmal Coughing Stage (2-4 wks) Convalescent stage 1/3 recover, 1/3 neuro problems, 1/3 severe neuro problems d/t anoxia |
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Where does Legionella pneumophila grow?
|
in man-made water reservoirs
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When a patient has pneumonia AND diarrhea what should you think?
|
Legionnaire's Disease
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What is Pontiac Disease?
|
Like Legionnaire's but without pneumonia - (+) bronchitis and loose stools
|
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What is the acid fast staining process and what is the outcome?
|
1) carbol fuschin
2) heated 3) alcohol 4) methylene blue acid fast bacteria --> red/pink non-acid fast --> blue |
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What test is used to detect primary or latent TB?
|
PPD
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How is active TB diagnosed?
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clinical findings and chest X-ray with sputum culture
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Other than a PPD what is considered a better test for TB in a BCG vaccinated person?
|
QuantiFERON-TB QFT
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What is the Ghon complex and what stage of TB is it noticed?
|
Ghon complex - Ghon focus w/ calcified tubercles in middle or lower lung
PRIMARY TB |
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How is a (+)PPD treated?
|
MUST be INH for 9 months
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If a patient has a (+)PPD but has INH-resistant strain of mycobacterium how is it treated?
|
rifampin for 4 months
|
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Where in the lung is secondary "active" TB located?
|
upper lung lobes
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Patients with weight loss, low-grade fever, and night sweats MUST be isolated because they probably have what?
|
Tuberculosis
|
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How MUST active tuberculosis be treated?
|
RIPE
rifampin Isoniazid pyrazinamide ethambutol must also give Pyridoxine to prevent B6 deficiency |
|
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name for vertebral TB?
|
Pott's disease
|
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name for cutaneous TB?
|
scrofuloderma
|
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widespread hematologic dissemination of TB yeilding "shot gun pellet" type lesions in organs
|
miliary TB
|
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ALL patients on isoniazid (INH) must also be given what?
|
pyridoxine - because INH causes vit B6 deficiency
|
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What is the reservoir for mycobacterium leprae?
|
armadillos
|
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What test was used at one time to dx leprosy d/t loss basis of loss of sensory?
|
(+) feather test
|
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What are the two types of leprosy?
|
tuberculoid and lepromatous
|
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What is the severest and most common form of Leprosy and what does it cause?
|
Lepromatous Leprosy - causes disfigurement
|
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What type of leprosy is mmilder because the patient can mount a cell-mediated response and what HLA is associated?
|
Tuberculoid Leprosy
HLA-DR3 |
|
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Which type of leprosy yields a (+) lepromin skin test?
|
Tuberculoid
|
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What AIDs defining illness is clinically indistinguisable from TB but progresses much more rapidly?
|
MAI or MAC (Mycobacterium avium-intracellulare complex)
|
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How is Mac or MAI treated?
|
clarithromycin + ethambutol +/- (rifabutin + streptomycin)
|
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Mandatory prophylaxis of MAC or MAI starts when? and what is it?
|
<50 CD4 count
azithromycin or clarithromycin |
|
|
This normal flora of the MOUTH can overgrow and form sulfur granules (bright yellow pus) and form sinuses at the sight of infection
|
Actinomyces israelii
|
|
|
What is the DOC for Actinomyces israelii?
|
ampicillin or penG
|
|
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What is the DOC for Nocardia asteroides?
|
TMP-SMX
|
|
|
What are the 3 genera of spirochetes?
|
Treponema, Borrelia, and Leptospira
Borrelia is large enough to be readily stained and visualized under ordinary lm |
|
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What are the screening tests for Treponema pallidum?
|
VDRL or RPR
|
|
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What are the confirmatory tests for Treponema pallidum?
|
FTA-ABS
TPHA |
|
|
What is the "prostitutes pupil" or Argyll-Robertson pupil?
|
a prostitute will accommodate but will not respond - patients with tertiary syphilis have pupils that will accomodate but will not respond to light
|
|
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What is the transmission rate of syphilis from mother to fetus?
|
100%
congenital syphilis |
|
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Those that survive congenital syphilis later develop what? (4)
|
Hutchinson teeth, mulberry molars, saddle nose, and saber shins
|
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What is the treatment for all infections with treponemes?
|
PCN G
|
|
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Treponema species that causes Yaws?
|
T. pertenue
|
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Treponema species that causes Pinta?
|
T.carateum
|
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|
Causative agent of Lyme Disease?
|
Borrelia burgdorferi
|
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What is the most common vector-borne disease in the US?
|
Lyme disease
Borrelia burgdorferi |
|
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What is the reservoir for borrelia burgdorferi?
|
white footed mouse
|
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What is the cause of leptospirosis and Weil's disease?
|
leptospira interrogans
|
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Where is leptospira interrogans found?
|
sewers, and water contaminated with rat, mouse, cat or dog urine
|
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What is the difference between leptospirosis and weil's disease?
|
leptospirosis causes SEVERE muscle aches of thighs and low back; weil's is a more severe leptospirosis with addition of liver damage w/ jaundice, pulm hemorrhage, and uremia
|
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What is the treatment for all leptospira interrogans infections?
|
PCN G
|
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What reaction can occur when treating spirochetal infection (syphilis and Lyme disease) d/t lysis and release of endotoxin-like molecules?
|
Jarisch-Herxheimer Reaction
|
|
|
What is the inert state of chlamydia trachomatis?
|
elementary body
|
|
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what is the metabolically active form of chlamydia trachomatis?
|
reticulate body
|
|
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What is the #1 cause of infectious blindness in the world?
|
trachoma -chlamydia
|
|
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What is the TX for chlamydial conjunctivitis?
|
doxycycline
|
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what is the TX for trachoma?
|
azithromycin
|
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what is the treatment for all chlamydial infection of the genital tract?
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azithromycin or doxycycline
-remember doxy cannot be used in those <6 yo or pregnancy |
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What causes psittacosis?
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chlamydia psittaci from bird feces, especially parrots
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What are the 3 types of Typhus?
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epidemic - R. prowazekii
endemic - R. typhi scrub - R. tsutsugamushi |
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What is the rash for typhus like?
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starts around the waist and spreads peripherally - spares palms, soles, and face
"ty around the waist" |
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A rash that is caused by R. Rickettsiae and starts on the extremities and spreads to trunk is assoc with what?
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Rocky Mtn. Spotted fever
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What is the only type of rickettsia and problems from it that is NOT spread by the bite of an arthropod?
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Coxiella burnetti
Q fever - pneumonitis w/o rash and with hepatitis |
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What is caused by Rochalimaea quintana formerly and now Bartonella Quintana?
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Trench fever
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what is the transmission for trench fever?
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inhalation of lice feces
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