Microbiology: Gram Negative Bacteria

Front 1

If a bug is gram negative what color will it stain?

Back 1

pink

Front 2

If a bug is gram positive what color will it stain?

Back 2

purple/blue

Front 3

What are the three big groups of gram negative organisms?

Back 3

1. Cocci
2. Coccoid rods
3. Rods

Front 4

What are gram negative cocci?

Back 4

Neisseria meningitidis, Neisseria gonorrhoeae

Front 5

How do you differentiate between N. meningitidis and N. gonorrhoeae?

Back 5

Whether they ferment maltose or not.
maltose frementer: N. meningitidis
maltose nonfermenter: N.gonorrhoeae

Front 6

What are the gram negative coccoid rods?

Back 6

1. Haemophilus influenzae
2. Pasteurella: animal bites
3. Brucella: brucellosis
4. Bordetella pertussis

Front 7

How do you differentiate between the gram negative rods?

Back 7

Lactose fermenter or nonlactose fermenter

Front 8

How do you differentiate between the lactose fermenters for the gram negative rods?

Back 8

fast or slow fermenter
Fast fermenter: Klebsiella, E.coli, Enterobacter
Slow fermenter: Citrobacter, Serratia, Others

Front 9

How do you differentiate between the lactose nonfermenters?

Back 9

Oxidase + or -
Oxidase +: Pseudomonas
Oxidase - : shigella, salmonella, proteus

Front 10

What is a gram - rod, that ferments lactose quickly?

Back 10

Klebsiella, E.coli, Enterobacter

Front 11

What is a gram negative rod that ferments lactose slowly?

Back 11

Citrobacter, Serratia, Others

Front 12

What is a gram negative rod that does not ferment lactose and is oxidase positive?

Back 12

Pseudamonas

Front 13

What is a gram negative rod that does not ferment lactose and is oxidase negative?

Back 13

Shigella, salmonella, proteus

Front 14

What is a gram negative cocci that ferments maltose?

Back 14

N. meningitidis

Front 15

What is a gram negative cocci that does not ferment maltose?

Back 15

N. gonorrhoeae

Front 16

What is a gram negative coccoid rod?

Back 16

Haemophilus influenzae
Pasturella multicide
Bordatella pertussis
Brucella

Front 17

What are the spirochetes?

Back 17

1. Borellia
2. Leptospira
3. Treponema

Front 18

What are the poorly staining rods?

Back 18

1. Legionella
2. Chlamydia trachomatis
3. Mycoplasm pneumoniae
4. Rickettsia: R. typhi, R. rickettsii, R. prowazekii, Ehrlichoiois, Coxiella burnetti

Front 19

What is a gram variable rod?

Back 19

Garderella vaganalis

Front 20

What media do lactose fermenting bacteria grow on?

Back 20

"Lactose is KEE, test with MacConKEE's"

MacConkey's agar - they grow pink colonies

Front 21

What are the lactose fermenting enteric bacteria?

Back 21

"KC SEE"
1. klebsiella
2. Citrobacter
3. Serratia
4. E. coli
5. Enterobacter

Front 22

Gram - bacilli are resistant to what drug?

Back 22

Benzylpenicillin G (penicillin) but may be susceptible to penicillin derivatives such as ampicillin

Front 23

Why are gram negative bacilli resistant to penicillin?

Back 23

The gram negative outer membrane layer inhibits entry of penicillin G and vancomycin

Front 24

Diplococci - two types?

Back 24

N. meningitidis, N. gonorrhoeae

Front 25

Difference between meningococcal and gonococcal neisseria?

Back 25

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

Front 26

Fitz-Hugh-Curtis syndrome is a complication of what organism?

Back 26

N. gonorrhoeae - inflammation of the liver from gonorrhea infection - can see violin string adhesions on the liver

Front 27

Epiglottis (cherry red), meningitis, otitis media, and pneumonia

Back 27

HaEMOPhilus influenzae

Front 28

What do you grow H. influenzae on?

Back 28

"Mom goes to five (V) and dime (X) store to buy some chocolate"

Grows on chocolate agar - needs factors V (NAD+) and X (hematin)

Front 29

What is the most invasive type of H. influenzae caused by?

Back 29

Capsular type B - produces IgA protease
all H. influenzae transmitted aerosol

Front 30

What do you use to treat H. influenzae? What do you use for prophylaxis?

Back 30

Treatment: ceftriaxone
Prophylaxis: rifampin (for close contacts)

Front 31

Does H. influenzae cause the flu?

Back 31

NO!

Front 32

Is there a vaccine for H. influenzae?

Back 32

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

Front 33

2 diseases legionella pneumophila can cause?

Back 33

Legionnaires' disease: severe pneumonia and fever
Pontiac fever: mild flulike syndrome

Front 34

Silver stain used to visulize what?

Back 34

Legionella pneumophila, and fungi (pneumocystis)

Front 35

Charcoal yeast extract with iron and cysteine is used to grow what?

Back 35

"think charcol, iron and cysteine for the legionerres"
Legionella pneumophila

Front 36

Antigen in the urine is used to diagnose what and how is it transmitted?

Back 36

Legionella pneumophila
*transmitted aerosolly from environmental water source habitat - NO person to person transmission

Front 37

How do you treat legionella pneumophlia?

Back 37

erythromycin

Front 38

pseudamonas aeruginosa causes what?

Back 38

"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

Front 39

malignant otitis externa in diabetics

Back 39

Pseudomonas - also causes diabetic osteomyelitis

Front 40

Aerobic, Non-lactose fermenting, oxidase positive organism.

Back 40

Pseudomonas aeruginosa (aer - aerobe)

Front 41

Infection in burn victims is commonly caused by what bug? HOw do you treat it?

Back 41

pseudomonas aeruginosa - treat using aminoglycoside plus extended spectrum penicillin (e.g. piperacillin, ticarcillin)

Front 42

pyocyanin (blue-green) pigment, grape like odor - how does it cause disease?

Back 42

Pseudomonas aeruginosa causes disease by producing endotoxin (fever and shock) and exotoxin A (inactivates EF-2)

Front 43

Produces endotoxin (causing fever and shock) and exotoxin A (inactivating EF-2)

Back 43

Pseudomonas aeruginosa

Front 44

Piperacillin, ticarcillin used to treat what bug?

Back 44

pseudomonas aeruginosa causes
Pneumonia (in CF)
Sepsis
External otitis
UTI
Drug use Diabetic Osteomyelitis
and hot tub folliculitis

Front 45

Enterobacteriaceae includes what bugs?

Back 45

"KEEPSSS"
E.coli, Salmonella, Shigella, Klebsiella, Enterobacter, Serratia, Proteus

Front 46

What do all enterbacteriaceae have in common?

Back 46

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

Front 47

"metallic sheen"

Back 47

E. coli

Front 48

E.coli can cause...

Back 48

UTI (most common cause), pyelonephritis, pneumonia, neonatal meningitis, septic shock, dysentery and travelers diarrhea

Front 49

EHEC can cause...

Back 49

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

Front 50

The type of E.coli that can invade intestinal mucosa and the types that can't.

Back 50

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)

Front 51

What are the E.coli's that produce shiga like toxin?

Back 51

EIEC and EHEC

Front 52

What E.coli does not produce a toxin?

Back 52

EPEC - flattens villi so they cannot absorb

Front 53

What is the virulence factor in E.coli (most important one)?

Back 53

adhesion - P. fimbriae

Front 54

pneumonia in alcoholics and diabetics when aspirated?

Back 54

Klebsiella

Front 55

Red currant jelly sputum

Back 55

Klebsiella - also cause nosocomial UTI's

Front 56

What can klebsiella cause?

Back 56

4 A's:
Aspiration pneumonia
Abscess in lung
Alcoholics
diAbetics

Front 57

2 bugs that are non-lactose fermenting, invade intestinal mucosa, can cause bloody diarrhea?

Back 57

Salmonella and Shigella

Front 58

Salmonella features vs. Shigella

Back 58

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)

Front 59

What can Salmonella typhi cause?

Back 59

typhoid fever: fever, diarrhea, headache, rose spots on abodmen, can remain in gall bladder chronically

Front 60

Bacteria transmitted in pet feces (puppies), contaminated milk or pork?

Back 60

Yersinia enterocolitica (puppies)

Front 61

What disease can mimic crohn's or appendicitis in adolescents?

Back 61

Yersinia entercolitica

Front 62

Where are Yersinia enteroclitica outbreaks common?

Back 62

Daycare centers

Front 63

H. pylori causes 90% of what?

Back 63

duodenual ulcers

*also causes gastritis

Front 64

H. pylori is a risk factor for what?

Back 64

gastic ulcers, lymphoma, gastric adenocarcinoma

Front 65

H. pylori is gram + or -, rod or cocci?

Back 65

gram negative rod

Front 66

Urease breath test is used to test for what?

Back 66

H.pylori infection- it creates an alkaline environment

Front 67

What do you treat H. pylori with?

Back 67

Triple therapy
1. Metronidazole, bismuth (pepto-bismol), and either tetracycline or amoxicillin
2. metronidazole, omeprazole, and clarithromycin - more expensive than #1

Front 68

What bugs are spirochetes?

Back 68

"BLT"
1. Borrelia (big size) - only one that can be visualized with aniline dyes (Wrights or Giemsa) in light microscopy
2. Leptospira
3. Treponema

Front 69

What is the only spirochete that can be visualized by aniline dyes (Wrights or Giemsa) in light microscopy?

Back 69

Borrelia

Front 70

What bug can be visualized in dark microscopy?

Back 70

Treponema

Front 71

Bug that is question marked shaped? Where is it found?

Back 71

Leptospira interrogans - found in water contaminated with animal urine

Front 72

symptoms of leptospirosis

Back 72

flulike symptoms, fever, headache, abdominal pain, jaundice, photophobia with conjunctivitis - most common in the tropics

Front 73

Weil's disease

Back 73

(icterohemorrhagic leptospirosis) - severe form of leptospirosis, with jaundice and azotemia from liver and kidney disfunction; fever, hemorrhage, and anemia

Front 74

Ixodes tick is a vector for what 2 bugs and what disease can one of the bugs cause?

Back 74

1. Borrelia burgdorferi
2. Babesia - maltese cross

Front 75

Erythema chronicum migrans

Back 75

bull's eye rash - seen in lyme's disease - central clearing

Front 76

Where does lyme's disease affect?

Back 76

BAKE a key LYME pie
Bell's palsy
Arthritis
Kardiac block
Erythema migrans
*can affect the CNS

Front 77

What animals are important in the life cycle of lyme's disease?

Back 77

Mice are important reservoris
Deer is required for the tick's life cycle

Front 78

What drugs do you treat lyme's disease with?

Back 78

doxycycline, ceftriaxone

Front 79

Where is Lyme's disease most common - how did the name come to be?

Back 79

Named after city in Connecticut (Lyme), most common in the NE USA

Front 80

What are the stages of lyme's disease?

Back 80

1. erythema chronicum migrans, flulike symptoms
2. neurologic symptoms (Belly's palsy) and cardiac block (AV nodal block)
3. chronic monoarthritis and migratory polyarthritis

Front 81

painless chancre

Back 81

Treponema pallidum - syphilis

Front 82

What are the 2 treponem's?

Back 82

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

Front 83

Treponema pertenue

Back 83

causes Yaws
*infection of skin, bone, and joints - healing with keloids - severe limb deformities
*disease of the tropics - not an STD but VRDL positive

Front 84

What do you treat Treponema pallidum with?

Back 84

It is syphilis - treat with penicillin G

Front 85

painless chancre

Back 85

primary syphilis (localized disease)

Front 86

secondary syphilis

Back 86

disseminated disease with constitutional symptoms - maculopapular rash (palms and soles), condylomata lata (genital warts)

Front 87

Where can T. pallidum be found in primary and secondary sypilis?

Back 87

In the chancre in primary syphilis and in the condylomata lata in secondary syphilis

Front 88

tertiary syphilis

Back 88

gummas (chronic graulomas), aortitis (vasa vasorum destruction), neurosyphiils (tabes dorsalis), argyll robertson pupil

Front 89

Signs of tertiary syphilis

Back 89

broad-based ataxia, positive romberg, charcot joints, stroke without hypertension

Front 90

saber shins, saddle nose, CNS VIII deafness, Hutchinson's teeth, mulberry molars

Back 90

congenital syphlis

Front 91

argyll robertson pupil

Back 91

Will constrict with accomidation but not react to light - associated with tertiary syphilis
*prostitue's pupil"

Front 92

Secondary syphilis

Back 92

is systemic!

Front 93

Test used to diagnose syphilis?

Back 93

VDRL and FTA-ABS

Front 94

FTA-ABS

Back 94

used to check for syphilis - specific for treponemes, turns positive earliest in the disease and remains positive the longest - it is the most specific

Front 95

If FTA-ABS and VDRL are both positive what does that mean?

Back 95

that there is an active infection

Front 96

What if a test shows that someone is VDRL + and FTA-ABS -

Back 96

likely a false positive

Front 97

WHat if VDRL is - and FTA-ABS +

Back 97

syphilis successfully treated

Front 98

What does VDRL detect?

Back 98

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

Front 99

What can cause a false positive VDRL?

Back 99

"VDRL"
Viruses (mono, hepatitis)
Drugs
Rheumatic fever
Lupus, leprosy

Front 100

What are the zoonotic bacteria?

Back 100

BBB FYP
Bartonella
Borrelia burgdorferi
Brucella spp.
Francisella tularenisis
Yersinis pestis
Pasteurella multicia

Front 101

Cat scratch fever's trasmission and source?

Back 101

From Bartonella spp.
From a cat scratch; can cause bacillary angiomatosis in ICH (often confused with Kaposi's sarcoma)

Front 102

What can be confused with Kaposi's sarcoma?

Back 102

Cat scratch fever - from bartonella spp. (hensle)

Front 103

Lyme's disease's transmission and source?

Back 103

From Borrelia burgdorferi
From tick bite; Ixodes tick that live on deer and mice

Front 104

Brucellosis/undulant fever's transmission and source?

Back 104

From Brucella spp.
From dairy products, and contact with animals

Front 105

Tularemia transmission and source?

Back 105

From Francisella tularensis
From tick bite; rabbits, deer

Front 106

Plague's transmission and source?

Back 106

From Yersinia pestis
From flea bite; rodents, especially prairie dogs (carry infection)

Front 107

Cellulitis transmission and source?

Back 107

From pasteurella multicida
From animal bites: cats, dogs

Front 108

pleomorphic, gram variable rod

Back 108

Gardnerella vaginalis - causes vaginosis presenting as a gray vaginal discharge with a fishy smell; nonpainful

Front 109

Cancer of the Stomach

Back 109

Gastric Adenocarcinoma; intestinal type or diffuse type

Front 110

bugs that can cause BV

Back 110

Gardnerella vaginalis and Mobiluncus (anaerobe)

Front 111

Is BV a STD?

Back 111

NO - it is associated with sexual activity but it is not an STD
* it is an overgrowth of certain bacteria in the vagina

Front 112

What do you use to treat BV?

Back 112

Metronidazole

Front 113

Clue cell

Back 113

vaginal epithelial cells covered with bacteria - characteristic for BV - caused by gardnerella vaginalis

Front 114

Obligate intracellular organisms that require NAD+ and CoA

Back 114

Rickettsiae - all except Coxiella is transmitted by arthropod vector and cause headache, fever, rash

Front 115

Transmission of Coxiella?

Back 115

aerosol and causes pneumonia

Front 116

What do you use to treat rickettsiae?

Back 116

tetracycline

Front 117

Rickettsiae bugs

Back 117

1. R. rickettsii
2. R, typhi
3. R. prowazekii
4. Ehrilichia
5. Coxiella burnetii

*all treat with tetracycline

Front 118

What does Rickettsia rickettsii cause? What do you treat it with?

Back 118

Causes rocky mountain spotted fever - treat with tetracycline

Front 119

What causes endemic typhus? What is it transmitted by?

Back 119

Rickettsia typhi
treat with tetracycline

Front 120

What causes epidemic typhus? What is it trasmitted by?

Back 120

Richkettsia prowazekii
transmitted by human body louse
ePidemic Prowazekii

Front 121

What is Ehrlichiosis caused by? What transmits it?

Back 121

Caused by Ehrilichia and transmitted by a tick

Front 122

What causes Q fever?

Back 122

"Q fever is queer"
Coxiella burnetii
from inhaled aerosols
NO rash, No vector, negative Weil-Feliz

Treat with tetracylines

Front 123

Where does rickettsial rash start compared to typhus rash?

Back 123

"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

Front 124

Rash on palms and soles (migrating to wrists, ankles, then trunk) headache and fever

Back 124

Rocky Mountain spotted fever

Front 125

Disease that present with rash on palm and soles

Back 125

1. Rocky Mountain Spotted fever
2. Secondary syphilis
3. Coxsackevirus A (hand foot and mouth disease)

Front 126

Where is Rocky Mountian spotted fever endemic?

Back 126

East coast - despite its name!

Front 127

What is the Weil Felix reaction what is it used to test for?

Back 127

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

Front 128

What is the only rickettsial infection that does not show the Weil-Felix reaction?

Back 128

Coxiella - cause of q fever
also has NO vector, NO rash!

Front 129

Obligate intracellular organisms that cause mucosal infections - cannot make own ATP

Back 129

Chlamydiae

the other obligate intracellular organism is Rickettsiae (it cannot make its own ATP either)

Front 130

What are the two groups of Chlamydiae?

Back 130

1. Elementary body (small, dense) is Enfectious and Enters cell via Endocytosis
2. Reticulate body Replicates in cell by fission

Front 131

What is the reservoir for Chlamydiae psittaci?

Back 131

Avian reservior

Front 132

Bug whose cell wall lacks muramic acid

Back 132

Chlamydiae

Front 133

Cytoplasmic inclusions seen on Giemsa or fluorescent antibody - stained smear what bug?

Back 133

Chlamydia - how you diagnose it with a lab test

Front 134

types of Chlamydiae

Back 134

C. trachomatis - reactive arthritis, conjunctivitis, nongonococcal urethritis, PID
C. pneumoniae
C. psittaci

Front 135

What Chlamydiae infections are trasmitted by aerosol?

Back 135

C. pneumoniae and C. psittaci

Front 136

What do you use to treat Chlamydiae?

Back 136

Erythromycin or tetracycline

Front 137

What can C. trachomatis cause?

Back 137

reactive arthritis, conjunctivitis, nongonococcal urethritis, and PID

Front 138

What is the cycle for chlamydiae?

Back 138

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!

Front 139

what is the #1 STD?

Back 139

Chlamydia trachomatis

Front 140

Chlamydia trachomatis serotypes A, B and C cause what?

Back 140

Africa, Blindness, Chronic infection

Front 141

Chlamydia trachomatis serotypes D and K cause what?

Back 141

urethritis/PID, ectopic pregnancy, neonatal pneumonia, or neonatal conjunctivitis

Front 142

Chlamydia trachomatis serotypes L1, L2 and L3 cause what?

Back 142

lymphogramuloma venereum (acute lymphadenitis - positive frei test(L1-L3 cause Lymphogranuloma)

Front 143

What causes granuloma inguinale (donovanosis)?

Back 143

Calymmatobacterium granulomatis

Front 144

How are neonates infected with Chlamydia trachomatis?

Back 144

during passage through infected birth canal

Front 145

Bug that causes atypical walking pneumonia

Back 145

Mycoplasma pneumoniae - has no cell wall!
symptoms include: insidious onset, headache, nonproductive cough, diffuse interstitial infiltrate

Front 146

disease that x-ray looks worse than patient

Back 146

atypical "walking" pneumonia - caused by mycoplasma pneumoniae

Front 147

Grown on eaton's agar, high titer of cold agglutinins (IgM), which can agglutiante or lyse RBC's

Back 147

mycoplasma pneumoniae - atypical "walking" pneumoniae

Front 148

How do you treat atypical walking pneumoniae?

Back 148

tetracycline or erythromycin (bugs are penicillin resistant because they have no cell wall)

Front 149

What is the only bacterial membrane that contains cholesterol?

Back 149

Mycoplasma pneumoniae

Front 150

Age group mycoplasmal pneumoia is most common in

Back 150

those under 30

Front 151

Bug that causes frequent outbreaks in military recruits and in prisons?

Back 151

Mycoplasma pneumoniae