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151 Cards in this Set

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  • Back
If a bug is gram negative what color will it stain?
pink
If a bug is gram positive what color will it stain?
purple/blue
What are the three big groups of gram negative organisms?
1. Cocci
2. Coccoid rods
3. Rods
What are gram negative cocci?
Neisseria meningitidis, Neisseria gonorrhoeae
How do you differentiate between N. meningitidis and N. gonorrhoeae?
Whether they ferment maltose or not.
maltose frementer: N. meningitidis
maltose nonfermenter: N.gonorrhoeae
What are the gram negative coccoid rods?
1. Haemophilus influenzae
2. Pasteurella: animal bites
3. Brucella: brucellosis
4. Bordetella pertussis
How do you differentiate between the gram negative rods?
Lactose fermenter or nonlactose fermenter
How do you differentiate between the lactose fermenters for the gram negative rods?
fast or slow fermenter
Fast fermenter: Klebsiella, E.coli, Enterobacter
Slow fermenter: Citrobacter, Serratia, Others
How do you differentiate between the lactose nonfermenters?
Oxidase + or -
Oxidase +: Pseudomonas
Oxidase - : shigella, salmonella, proteus
What is a gram - rod, that ferments lactose quickly?
Klebsiella, E.coli, Enterobacter
What is a gram negative rod that ferments lactose slowly?
Citrobacter, Serratia, Others
What is a gram negative rod that does not ferment lactose and is oxidase positive?
Pseudamonas
What is a gram negative rod that does not ferment lactose and is oxidase negative?
Shigella, salmonella, proteus
What is a gram negative cocci that ferments maltose?
N. meningitidis
What is a gram negative cocci that does not ferment maltose?
N. gonorrhoeae
What is a gram negative coccoid rod?
Haemophilus influenzae
Pasturella multicide
Bordatella pertussis
Brucella
What are the spirochetes?
1. Borellia
2. Leptospira
3. Treponema
What are the poorly staining rods?
1. Legionella
2. Chlamydia trachomatis
3. Mycoplasm pneumoniae
4. Rickettsia: R. typhi, R. rickettsii, R. prowazekii, Ehrlichoiois, Coxiella burnetti
What is a gram variable rod?
Garderella vaganalis
What media do lactose fermenting bacteria grow on?
"Lactose is KEE, test with MacConKEE's"

MacConkey's agar - they grow pink colonies
What are the lactose fermenting enteric bacteria?
"KC SEE"
1. klebsiella
2. Citrobacter
3. Serratia
4. E. coli
5. Enterobacter
Gram - bacilli are resistant to what drug?
Benzylpenicillin G (penicillin) but may be susceptible to penicillin derivatives such as ampicillin
Why are gram negative bacilli resistant to penicillin?
The gram negative outer membrane layer inhibits entry of penicillin G and vancomycin
Diplococci - two types?
N. meningitidis, N. gonorrhoeae
Difference between meningococcal and gonococcal neisseria?
MeninGococcal ferment Maltose and Glucose, has polysaccharide capsule, there is a vaccine, it is in respiratory and oral secretions, causes meningococcemia, meningitis, and waterhouse friderichsen syndrome
Gonoccal: only ferments glucose, no polysaccharide capsule, No vaccine (rapid antigenic variation), sexually transmitted, causes gonorrhea, septic arthritis, neonatal conjunctivitis, PID, and Fitz-Hugh- Curtis syndrome
Fitz-Hugh-Curtis syndrome is a complication of what organism?
N. gonorrhoeae - inflammation of the liver from gonorrhea infection - can see violin string adhesions on the liver
Epiglottis (cherry red), meningitis, otitis media, and pneumonia
HaEMOPhilus influenzae
What do you grow H. influenzae on?
"Mom goes to five (V) and dime (X) store to buy some chocolate"

Grows on chocolate agar - needs factors V (NAD+) and X (hematin)
What is the most invasive type of H. influenzae caused by?
Capsular type B - produces IgA protease
all H. influenzae transmitted aerosol
What do you use to treat H. influenzae? What do you use for prophylaxis?
Treatment: ceftriaxone
Prophylaxis: rifampin (for close contacts)
Does H. influenzae cause the flu?
NO!
Is there a vaccine for H. influenzae?
Yes - contains type B capsular polysaccharide conjugated to diphtheria toxoid (or another protein) used to improve immune system recognition of the polysaccharide and promote class switching
* given between 2 and 18 months of age
2 diseases legionella pneumophila can cause?
Legionnaires' disease: severe pneumonia and fever
Pontiac fever: mild flulike syndrome
Silver stain used to visulize what?
Legionella pneumophila, and fungi (pneumocystis)
Charcoal yeast extract with iron and cysteine is used to grow what?
"think charcol, iron and cysteine for the legionerres"
Legionella pneumophila
Antigen in the urine is used to diagnose what and how is it transmitted?
Legionella pneumophila
*transmitted aerosolly from environmental water source habitat - NO person to person transmission
How do you treat legionella pneumophlia?
erythromycin
pseudamonas aeruginosa causes what?
"PSEUDOmonas"
wound and burn infections
Pneumonia (especially in those with CF)
Sepsis (black lesions on skin)
External otitis (swimmer's ear)
UTI
Drug use and Diabetic Osteomyelitis
plus hot tub folliculitis
malignant otitis externa in diabetics
Pseudomonas - also causes diabetic osteomyelitis
Aerobic, Non-lactose fermenting, oxidase positive organism.
Pseudomonas aeruginosa (aer - aerobe)
Infection in burn victims is commonly caused by what bug? HOw do you treat it?
pseudomonas aeruginosa - treat using aminoglycoside plus extended spectrum penicillin (e.g. piperacillin, ticarcillin)
pyocyanin (blue-green) pigment, grape like odor - how does it cause disease?
Pseudomonas aeruginosa causes disease by producing endotoxin (fever and shock) and exotoxin A (inactivates EF-2)
Produces endotoxin (causing fever and shock) and exotoxin A (inactivating EF-2)
Pseudomonas aeruginosa
Piperacillin, ticarcillin used to treat what bug?
pseudomonas aeruginosa causes
Pneumonia (in CF)
Sepsis
External otitis
UTI
Drug use Diabetic Osteomyelitis
and hot tub folliculitis
Enterobacteriaceae includes what bugs?
"KEEPSSS"
E.coli, Salmonella, Shigella, Klebsiella, Enterobacter, Serratia, Proteus
What do all enterbacteriaceae have in common?
COFFEe
Capsule (K antigen related to virulence of the bug)
O antigen (somatic - is polysaccharide of endotoxin) and oxidase negative
Flagellar (H antigen - in more motile species)
Ferment glucose
Enterobacteriacae
"metallic sheen"
E. coli
E.coli can cause...
UTI (most common cause), pyelonephritis, pneumonia, neonatal meningitis, septic shock, dysentery and travelers diarrhea
EHEC can cause...
HUS - anemia, thrombocytopenia, acute renal failure
*endotheilum swells (due to toxins?) and narrows the lumen, leading to mechanical hemolysis and reduced renal blood flow; damaged endothelium consumes platelets
The type of E.coli that can invade intestinal mucosa and the types that can't.
invades intestinal mucosa EIEC: shiga like toxin - causes dysentery (microbe invades and toxin causes necrosis and inflammation)
Do not invade intestinal mucosa:
EHEC: shiga like toxin - causes dysentery (toxin alone causes necrosis and inflammation)
HTEC: labile toxin/stable toxin - causes traveler's diarrhea
EPEC: No toxin produced; adheres to apical surface, flattens villi, prevents absorption - causes diarrhea (usually in children)
What are the E.coli's that produce shiga like toxin?
EIEC and EHEC
What E.coli does not produce a toxin?
EPEC - flattens villi so they cannot absorb
What is the virulence factor in E.coli (most important one)?
adhesion - P. fimbriae
pneumonia in alcoholics and diabetics when aspirated?
Klebsiella
Red currant jelly sputum
Klebsiella - also cause nosocomial UTI's
What can klebsiella cause?
4 A's:
Aspiration pneumonia
Abscess in lung
Alcoholics
diAbetics
2 bugs that are non-lactose fermenting, invade intestinal mucosa, can cause bloody diarrhea?
Salmonella and Shigella
Salmonella features vs. Shigella
Salmonella: flagella, can disseminate hematogenously, produce H2S, symptoms can be prolonged with antibiotic treatment, monocytic response, has animal reservoir ( not S. typhi - only in humans)
Shigella: more virulent (10^1 organism needed to Salmonellas (10^5), propel themselves inside a cell via actin polymerization, transmission via (Food, fingers, feces, flies)
What can Salmonella typhi cause?
typhoid fever: fever, diarrhea, headache, rose spots on abodmen, can remain in gall bladder chronically
Bacteria transmitted in pet feces (puppies), contaminated milk or pork?
Yersinia enterocolitica (puppies)
What disease can mimic crohn's or appendicitis in adolescents?
Yersinia entercolitica
Where are Yersinia enteroclitica outbreaks common?
Daycare centers
H. pylori causes 90% of what?
duodenual ulcers

*also causes gastritis
H. pylori is a risk factor for what?
gastic ulcers, lymphoma, gastric adenocarcinoma
H. pylori is gram + or -, rod or cocci?
gram negative rod
Urease breath test is used to test for what?
H.pylori infection- it creates an alkaline environment
What do you treat H. pylori with?
Triple therapy
1. Metronidazole, bismuth (pepto-bismol), and either tetracycline or amoxicillin
2. metronidazole, omeprazole, and clarithromycin - more expensive than #1
What bugs are spirochetes?
"BLT"
1. Borrelia (big size) - only one that can be visualized with aniline dyes (Wrights or Giemsa) in light microscopy
2. Leptospira
3. Treponema
What is the only spirochete that can be visualized by aniline dyes (Wrights or Giemsa) in light microscopy?
Borrelia
What bug can be visualized in dark microscopy?
Treponema
Bug that is question marked shaped? Where is it found?
Leptospira interrogans - found in water contaminated with animal urine
symptoms of leptospirosis
flulike symptoms, fever, headache, abdominal pain, jaundice, photophobia with conjunctivitis - most common in the tropics
Weil's disease
(icterohemorrhagic leptospirosis) - severe form of leptospirosis, with jaundice and azotemia from liver and kidney disfunction; fever, hemorrhage, and anemia
Ixodes tick is a vector for what 2 bugs and what disease can one of the bugs cause?
1. Borrelia burgdorferi
2. Babesia - maltese cross
Erythema chronicum migrans
bull's eye rash - seen in lyme's disease - central clearing
Where does lyme's disease affect?
BAKE a key LYME pie
Bell's palsy
Arthritis
Kardiac block
Erythema migrans
*can affect the CNS
What animals are important in the life cycle of lyme's disease?
Mice are important reservoris
Deer is required for the tick's life cycle
What drugs do you treat lyme's disease with?
doxycycline, ceftriaxone
Where is Lyme's disease most common - how did the name come to be?
Named after city in Connecticut (Lyme), most common in the NE USA
What are the stages of lyme's disease?
1. erythema chronicum migrans, flulike symptoms
2. neurologic symptoms (Belly's palsy) and cardiac block (AV nodal block)
3. chronic monoarthritis and migratory polyarthritis
painless chancre
Treponema pallidum - syphilis
What are the 2 treponem's?
1. Treponema pallidum - causing syphilis
2. Treponema. pertenue - causing yaws (infection of skin, bones, and joints) - healing with keloids - severe limb deformaties - disease of tropics - not and STD - but VDRL positive
Treponema pertenue
causes Yaws
*infection of skin, bone, and joints - healing with keloids - severe limb deformities
*disease of the tropics - not an STD but VRDL positive
What do you treat Treponema pallidum with?
It is syphilis - treat with penicillin G
painless chancre
primary syphilis (localized disease)
secondary syphilis
disseminated disease with constitutional symptoms - maculopapular rash (palms and soles), condylomata lata (genital warts)
Where can T. pallidum be found in primary and secondary sypilis?
In the chancre in primary syphilis and in the condylomata lata in secondary syphilis
tertiary syphilis
gummas (chronic graulomas), aortitis (vasa vasorum destruction), neurosyphiils (tabes dorsalis), argyll robertson pupil
Signs of tertiary syphilis
broad-based ataxia, positive romberg, charcot joints, stroke without hypertension
saber shins, saddle nose, CNS VIII deafness, Hutchinson's teeth, mulberry molars
congenital syphlis
argyll robertson pupil
Will constrict with accomidation but not react to light - associated with tertiary syphilis
*prostitue's pupil"
Secondary syphilis
is systemic!
Test used to diagnose syphilis?
VDRL and FTA-ABS
FTA-ABS
used to check for syphilis - specific for treponemes, turns positive earliest in the disease and remains positive the longest - it is the most specific
If FTA-ABS and VDRL are both positive what does that mean?
that there is an active infection
What if a test shows that someone is VDRL + and FTA-ABS -
likely a false positive
WHat if VDRL is - and FTA-ABS +
syphilis successfully treated
What does VDRL detect?
nonspecific antibody that reacts with beef cardiolipin - many false positives in diagnosis of syphilis.
1. viral infections (mononucleosis, hepatitis)
2. some drugs, rheumatic fever, SLE, and leprosy
What can cause a false positive VDRL?
"VDRL"
Viruses (mono, hepatitis)
Drugs
Rheumatic fever
Lupus, leprosy
What are the zoonotic bacteria?
BBB FYP
Bartonella
Borrelia burgdorferi
Brucella spp.
Francisella tularenisis
Yersinis pestis
Pasteurella multicia
Cat scratch fever's trasmission and source?
From Bartonella spp.
From a cat scratch; can cause bacillary angiomatosis in ICH (often confused with Kaposi's sarcoma)
What can be confused with Kaposi's sarcoma?
Cat scratch fever - from bartonella spp. (hensle)
Lyme's disease's transmission and source?
From Borrelia burgdorferi
From tick bite; Ixodes tick that live on deer and mice
Brucellosis/undulant fever's transmission and source?
From Brucella spp.
From dairy products, and contact with animals
Tularemia transmission and source?
From Francisella tularensis
From tick bite; rabbits, deer
Plague's transmission and source?
From Yersinia pestis
From flea bite; rodents, especially prairie dogs (carry infection)
Cellulitis transmission and source?
From pasteurella multicida
From animal bites: cats, dogs
pleomorphic, gram variable rod
Gardnerella vaginalis - causes vaginosis presenting as a gray vaginal discharge with a fishy smell; nonpainful
Cancer of the Stomach
Gastric Adenocarcinoma; intestinal type or diffuse type
bugs that can cause BV
Gardnerella vaginalis and Mobiluncus (anaerobe)
Is BV a STD?
NO - it is associated with sexual activity but it is not an STD
* it is an overgrowth of certain bacteria in the vagina
What do you use to treat BV?
Metronidazole
Clue cell
vaginal epithelial cells covered with bacteria - characteristic for BV - caused by gardnerella vaginalis
Obligate intracellular organisms that require NAD+ and CoA
Rickettsiae - all except Coxiella is transmitted by arthropod vector and cause headache, fever, rash
Transmission of Coxiella?
aerosol and causes pneumonia
What do you use to treat rickettsiae?
tetracycline
Rickettsiae bugs
1. R. rickettsii
2. R, typhi
3. R. prowazekii
4. Ehrilichia
5. Coxiella burnetii

*all treat with tetracycline
What does Rickettsia rickettsii cause? What do you treat it with?
Causes rocky mountain spotted fever - treat with tetracycline
What causes endemic typhus? What is it transmitted by?
Rickettsia typhi
treat with tetracycline
What causes epidemic typhus? What is it trasmitted by?
Richkettsia prowazekii
transmitted by human body louse
ePidemic Prowazekii
What is Ehrlichiosis caused by? What transmits it?
Caused by Ehrilichia and transmitted by a tick
What causes Q fever?
"Q fever is queer"
Coxiella burnetii
from inhaled aerosols
NO rash, No vector, negative Weil-Feliz

Treat with tetracylines
Where does rickettsial rash start compared to typhus rash?
"Rickettsie on the wRists, Typhus on the Trunks"
Rickettsial on hands and feet
typhus starts centrally and spreads outward w/o involving palms or soles
Rash on palms and soles (migrating to wrists, ankles, then trunk) headache and fever
Rocky Mountain spotted fever
Disease that present with rash on palm and soles
1. Rocky Mountain Spotted fever
2. Secondary syphilis
3. Coxsackevirus A (hand foot and mouth disease)
Where is Rocky Mountian spotted fever endemic?
East coast - despite its name!
What is the Weil Felix reaction what is it used to test for?
Combine patients serum with Proteus antigen - if the patients have a rickettsial infection they will have antibodies against rickettsiae and they will agglutinate when cross reacted to proteus antigen
What is the only rickettsial infection that does not show the Weil-Felix reaction?
Coxiella - cause of q fever
also has NO vector, NO rash!
Obligate intracellular organisms that cause mucosal infections - cannot make own ATP
Chlamydiae

the other obligate intracellular organism is Rickettsiae (it cannot make its own ATP either)
What are the two groups of Chlamydiae?
1. Elementary body (small, dense) is Enfectious and Enters cell via Endocytosis
2. Reticulate body Replicates in cell by fission
What is the reservoir for Chlamydiae psittaci?
Avian reservior
Bug whose cell wall lacks muramic acid
Chlamydiae
Cytoplasmic inclusions seen on Giemsa or fluorescent antibody - stained smear what bug?
Chlamydia - how you diagnose it with a lab test
types of Chlamydiae
C. trachomatis - reactive arthritis, conjunctivitis, nongonococcal urethritis, PID
C. pneumoniae
C. psittaci
What Chlamydiae infections are trasmitted by aerosol?
C. pneumoniae and C. psittaci
What do you use to treat Chlamydiae?
Erythromycin or tetracycline
What can C. trachomatis cause?
reactive arthritis, conjunctivitis, nongonococcal urethritis, and PID
What is the cycle for chlamydiae?
Elementary bodies attach to a cell (enters via endocytosis) - reticulate body is formed intracellularly - reticulate bodies replicate via fission - reorganization of recitulate bodies into elementary bodies - elementary bodies are released and go and infected another cell!
what is the #1 STD?
Chlamydia trachomatis
Chlamydia trachomatis serotypes A, B and C cause what?
Africa, Blindness, Chronic infection
Chlamydia trachomatis serotypes D and K cause what?
urethritis/PID, ectopic pregnancy, neonatal pneumonia, or neonatal conjunctivitis
Chlamydia trachomatis serotypes L1, L2 and L3 cause what?
lymphogramuloma venereum (acute lymphadenitis - positive frei test(L1-L3 cause Lymphogranuloma)
What causes granuloma inguinale (donovanosis)?
Calymmatobacterium granulomatis
How are neonates infected with Chlamydia trachomatis?
during passage through infected birth canal
Bug that causes atypical walking pneumonia
Mycoplasma pneumoniae - has no cell wall!
symptoms include: insidious onset, headache, nonproductive cough, diffuse interstitial infiltrate
disease that x-ray looks worse than patient
atypical "walking" pneumonia - caused by mycoplasma pneumoniae
Grown on eaton's agar, high titer of cold agglutinins (IgM), which can agglutiante or lyse RBC's
mycoplasma pneumoniae - atypical "walking" pneumoniae
How do you treat atypical walking pneumoniae?
tetracycline or erythromycin (bugs are penicillin resistant because they have no cell wall)
What is the only bacterial membrane that contains cholesterol?
Mycoplasma pneumoniae
Age group mycoplasmal pneumoia is most common in
those under 30
Bug that causes frequent outbreaks in military recruits and in prisons?
Mycoplasma pneumoniae