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478 Cards in this Set
- Front
- Back
T/F E. Coli ferments lactose?
|
TRUE;
|
|
These E. Coli are responsible for travelers diarrhea and children's diarrhea?
|
ETEC
|
|
This E.coli shows bacillary dysentary similar to shigella?
|
EIEC
|
|
This E. Coli shows infant diarrhea?
|
EPEC; also EAEC
|
|
This E. Coli produce shiga toxin and displays hemorrhagic colitis and Hemolytic Uremic Syndrome?
|
EHEC/STEC
|
|
What are the steps of pathogenesis for ETEC?
|
ingestion (food/water - human feces) > colonization small intestine (colinization fimbria CFA and CS) > elaboration of enterotoxins (ST and LT)
|
|
ETEC (watery diarrhea or inflammatory diarrhea)?
|
Watery
|
|
CF, LT and ST genes (virulence factors) are encoded where in ETEC?
|
Large plasmids
|
|
What is the mechanism of action of the ST and LT enterotoxins in ETEC?
|
increase in cAMP and cGMP
|
|
What pathogen is responsible 30-57% of diarrhea among military personnel in African and mid east?
|
ETEC
|
|
ETEC (is there blood in stool)?
|
NO
|
|
In ETEC, immunity to endemic serotyopes leads to adult immunity T/F?
|
TRUE;
|
|
ETEC (intracellular or extracellular)?
|
Extracellular; antibody
|
|
What is the major difficulty in developing vaccine for ETEC?
|
variety of serotypes
|
|
This E. coli is identical to shigella disease (range of watery diarrhea to dysentery); has a lrage shigella virulence plasmid; World-wide and common in children?
|
EIEC (enteroinvasive)
|
|
This E.Coli is a major pathogen and cause of acute and chronic diarrhea in infants < 2 years old; and is a true age-restricted pathogen?
|
EPEC
|
|
T/F breast milk is protective for EPEC?
|
TRUE;
|
|
The gene for the bundle-forming pillus involved in the intial adherence of EPEC to Small Intestin mucosa is located where in the bacteria?
|
Virulence plasmid
|
|
What is the Late (intimate) adherence of EPEC mediated by, and where are these factors encoded?
|
Intimin; encoded on a chromosomal pathogenicity island
|
|
What are the symptoms of hemorrhagic colitis?
|
abd pain; NO FEVER; bloody diarrhea; VARIABLE presence of fecal PMN
|
|
microangiopathic hemolytic anemia, thrombocytopenia, glomerular thrombosis
|
|
|
EHEC such as E. coli 157 has attaching and effacing intestinal lesion which are encoded where in the chromosome?
|
Pathogenicity island
|
|
The shiga toxin produced by EHEC is bacteriophage produced T/F?
|
TRUE;
|
|
What is the difference between STEC and EHEC?
|
STEC has no intimin and no LEE (pathogenicity island); Both have bacteriophage encoded shiga toxin
|
|
What does shiga toxin bind to in glomeruli?
|
Gb3 receptor
|
|
What two factors increase the risk of hemolytic-uremic syndrome?
|
High initial WBC; Antibiotic treatment (due to phage induction)
|
|
EHEC/STEC (human specific or zoonoses)?
|
Zoonoses (hamburger)
|
|
EHEC/STEC (low infectious dose or high infectious dose)?
|
LOW
|
|
What bacteria may you get from unpasteurized apple cider and milk?
|
EHEC/STEC (as well as salmonella)
|
|
What type of AGAR would be useful if you wanted to grow E. COLI 157 H7?
|
sorbitol MacConkey (O157 does not ferment sorbitol)
|
|
BFP and virulence plasmid usefule for ID'ing what E. Coli?
|
EPEC
|
|
EAE probes are specific for what?
|
Intimin (EPEC and/or EHEC)
|
|
Does STEC have intimin?
|
NO
|
|
ETEC (secretory or inflammatory)?
|
Secretory
|
|
Attaching and Effacing Lesions in intestinal (which E. Coli)?
|
EPEC and EHEC
|
|
Invasion of epithelial cells, colonic ulcers, dysentery (EHEC, EPEC, EIEC, ETEC)?
|
EIEC
|
|
Inflammatory diarrhea, carried by new puppies, gull shaped rods?
|
Campylobacter jejuni
|
|
C. jejuni is microaerophilic T/F?
|
TRUE;
|
|
C. Jejuni (oxidase negative or positive)?
|
Positive
|
|
Campylobacter jejuni (human specific or zoonoses)?
|
Zoonoses (birds and other amimals)
|
|
What are the two major complications of campylobacter jejuni?
|
Guillain Barre and Reiter's Syndrome
|
|
What is the mechanism for Guillain Barre developed from campylobacter jejuni?
|
antibody cross reacts with peripheral nerve myelin
|
|
This syndrome complicates campylobacter jejuni and Shigella, causes a reactive arthritis, affects the urinary tract, eyes, skin and mucus membranes, and affects HLA b27 patients more?
|
Reiter's Syndrome
|
|
What do you need to culture campylobacter jejuni?
|
selective medium WITH antibiotics, 42 degree C, Increased CO2, look for oxidase +
|
|
Which vibrio cholera cause epidemic and pandemic cholera?
|
O1 and O139
|
|
Cholera (inflammatory or secretory diarrhea)?
|
Secretory (watery, vomiting, leg crasmps)
|
|
Which biotype of V. cholera is more severe (El Tor or Classical)?
|
Classical
|
|
What are some clinical signs of cholera gravis?
|
rice water stool; absent peripheral pulse; decreased BP; sunken eyes; decreased turgor; hyperventilation; muscle cramps (decreased K)
|
|
How does V cholera colonize the small intestine?
|
Toxin co-regulated pili (TCP)
|
|
The A subunit of cholera toxin does what?
|
activates adenyalte cyclase via ADP ribosylation of the GTP-binding protein
|
|
The B subunit of cholera binds to what?
|
GM1 ganglioside molecules
|
|
Where is the Cholera toxin encoded?
|
bacteriophage
|
|
Which virulence factor is most important for cholera (TCP or cholera toxin)?
|
cholera toxin
|
|
Cholera toxin increase Cl secretion in crypt cells T/F?
|
TRUE;
|
|
Cholera toxin causes decreased absorption of Cl and Na in villus cells T/F?
|
TRUE;
|
|
V. Cholera (low infectious dose, or high infectious dose)?
|
HIGH (person to person not important)
|
|
T/F seafood can transmit V. Cholera?
|
TRUE
|
|
T/F decreased acidity in the stomach (achloridia) will increase severity of Cholera?
|
TRUE;
|
|
What blood group increases the severity of cholera infection?
|
O
|
|
T/F V. Cholera can be transmitted through frozen fresh coconut milk?
|
TRUE;
|
|
What kind of AGAR should you use for V. Cholera?
|
TCBS (sucrose fermenting)
|
|
What kind of therapy is recommended for Cholera?
|
Oral rehydration salts and Ringers lactate
|
|
This bacteria produces a thermostable hemolysin (Tdh) previously called Kanagawa toxin?
|
V. Parahaemolyticus
|
|
Common in JAPAN, Seafood, watery diarrhea?
|
V. Parahaemolyticus
|
|
Raw Oysters?
|
V. cholera, parahaemolyticus, vulnificus
|
|
What happens to the incidence of V. parahaemolyticus as temperature increases ?
|
Increases; something with oysters
|
|
Exposure to contaminated sea water leading to wound infections?
|
V. vulnificus
|
|
What pathogen was responsible for the multistate 2008 outberak associated with jalapenos, and responsible for a huge economic blow to the tomato industry?
|
Salmonella enterica saint paul
|
|
This Surveillance System was establishe din 1996, estimates illness burden, and monitors trends for 10 specific pathogens, with 10 sites in the US?
|
US FoodNet
|
|
This surveillance network is a dynamic internet accessible pattern database and uses PGFE to detect pathogens?
|
PulseNet
|
|
What are the two probabale factors for the emergence of ETEC in the US population?
|
Increasing free trade and greater international travel
|
|
A boy comes in with generalized muscle weakness and had a reported case of acute diarrhea 8 days before onset?
|
Campylobacter jejuni (guillen-barre)
|
|
What are the findings on electrophysiology for guillen barre?
|
very low compund muscle action potentials in lower limbs with normal compound sensory nerve action potentials
|
|
What is the most common cause of acute flaccid paralysis in humans?
|
Guillen-Barre Syndrome
|
|
What is the most common antecedent infection of Guillen Barre?
|
Campylobacter jejuni
|
|
What is the cause of cross reacting antigen with GM1 antigen on Myelin from campylobacter jejuni?
|
Sialyltransferases which synthesize ganglioside-like epitopes
|
|
What cancer is H. pylori associated with?
|
Gastric adenocarcinoma
|
|
Compared to the distribution of world H. Pylori infection and Gastric Cancer, are they the same or are there differences?
|
Differences exist indicating a multifactorial cause of cancer
|
|
Curved, gram negative rods, microaerophilic, + urease?
|
Helicobacter Pylori
|
|
What does urease do for the H. Pylori?
|
forms a protective cloud of ammonia around the bacteria within the acidic intestinal and gastric cavity
|
|
What virulence factors do H. Pylori use for colonization?
|
Urease, Mucinase, Phospholipase Flagella
|
|
How does H. Pylori defend itself from phagocytes?
|
arginase (prevents NO synthesis); catalase; SOD
|
|
How can H. Pylori cause direct damage to tissue?
|
urease; and vacuolating cytotoxin
|
|
Describe the pathogenesis of H. Pylori?
|
Binds to gastric mucosa (with urease, mucinase, phospholipase, and flagella) > causes epithelial damage (Urease, vacuolating cytotoxin) > Chronic superficial gastritis and Chronic deep gastritis (arginase; SOD; catalase) > Early CAG > Late CAG > Gastric carcinoma
|
|
In developing countries, people are colonized at a (younger or older) age?
|
Younger
|
|
T/F studies have shown that once H. Pylori colonize, genetic change occurs over time?
|
TRUE;
|
|
T/F In H. Pylori, Co-infections have been found to be rare
|
TRUE;
|
|
What stain will be used to identify H. Pylori histologically?
|
Wurthrin-Starry stain (or Giemsa also)
|
|
What are some ways of diagnosing H. Pylori?
|
Breath test, stain (wurthin-starry), Urease, culture, antibody, gastroscope
|
|
What color does urea agar turn if H. Pylori is present?
|
Pink (from yellow)
|
|
What is the preferential treatment for H. Pylori?
|
metronidazole; bismuth (pepto); tetracycline
|
|
What does metranidazole do?
|
Bacteriocidal antibiotic affecting nucleic acid synthesis. Must be broken down into active form by oxidoreductases. Use to treat, H. Pylori.
|
|
What are the symptoms of pyelonephritis?
|
Flank pain, fever, nausea, vomiting, Increased C-reactive protein, Bacteremia (30%)
|
|
What are the symptoms of cystitis?
|
Dysuria, frequent urination, suprapubic pain
|
|
What is the most common organism in uncomplicated community aquired UTI?
|
Escherichia Coli
|
|
What is the most common cause of UTI in spinal cord injury patients?
|
Proteus Rettgeri
|
|
What do catheter placement do to the incidence of hospital-aquired Proteus Mirabalis infection?
|
Increases the percent
|
|
What sex is predominatly affected by UTI ?
|
females (males in infancy and elderly life)
|
|
Virulence factors in UPEC are found where?
|
on Pathogenicity Islands
|
|
This virulence factor is present in all UPEC, is important for colonization of the bladder, and causes exfoliation of the bladder cells?
|
Type 1 fimbria
|
|
What do the UPEC type 1 fimbria do that allow the organism to ascend from the bladder?
|
Phase variation
|
|
Culture of how many colonies of bacteria establishes the diagnosis of UTI?
|
> 100,000
|
|
This virulence factor present in UPEC adheres to digalactoside-reeptors (P blood group) and is important for colonization of the upper urinary tract?
|
P pili (pap pili)
|
|
Does UPEC have hemolysin?
|
YES
|
|
This virulence factor present in UPEC inhibits Rho GTPase and affects the actin cytoskeleton?
|
Cytonecrotizing factor (CNF toxin)
|
|
This cause of UTI is a member of the enterobacteriacaea and produces a "swarming motility" on solid agar?
|
Proteus Mirabilis
|
|
Which does proteus mirabilis prefer (upper urinary or lower urinary tract)?
|
Upper urinary tract
|
|
UTI is suspected and cultures are drawn. Colonies show a metallic sheen on EMB agar?
|
UPEC (eosin methylene blue)
|
|
What does proteus mirabalis secrete that is associated with kidney stone formation?
|
Urease (prescribe a urease inhibitor)
|
|
Which type of kidney stones is protease mirabalis more likely to create?
|
Struvite stones
|
|
How do you diagnose an uncomplicated UTI?
|
obtain a clean catch mid-stream sample > 100,000
|
|
How many bacteria is diagnostic in a complicated UTI?
|
between 100 - 10000
|
|
How many organisms are diagnostic in a suprapubic tap?
|
Any organisms
|
|
Which enterics produce Secretory diarrhea?
|
ETEC and Cholera
|
|
Which enterics produce Inflammatory diarrhea?
|
Shigella, Nontyphoidal Salmonella, Campylobacter, Yersinia
|
|
Which enterics cause Hemorrhagic colitis?
|
EHEC, STEC
|
|
Which enteric produce LT and ST?
|
ETEC
|
|
What kinds of colonization fimbriae does Cholera have?
|
toxin co-regulated pili TCP
|
|
Which enterics cause an increase in cAMP?
|
ETEC and Cholera
|
|
Comma shaped organisms produce watery diarrhea?
|
V. Cholera
|
|
Which enterics destroy M-cells as part of their pathogenesis?
|
Shigella
|
|
Which enterics cause enteric fever?
|
Salmonella Typhi, Paratyphi
|
|
Which enterics have a Vi antigen capsule?
|
Typhoidal Salmonella
|
|
Which enteric uses macrophages to travel throughout the body?
|
Typhoidal Salmonella
|
|
Which enterics cause Hemolytic Uremic Syndrome?
|
Shigella (if produce shiga toxin); EHEC; STEC
|
|
Which enterics produce shiga toxin?
|
EHEC, STEC, Shigella (few)
|
|
Kanagawa toxin, Oystres, Non-inflammatory bloody diarrhea?
|
Vibrio Parahaemolyticus
|
|
3 Ps of EPEC?
|
Protracted pediatric diarrhea; Pedestal formation (attaching and effacing lesions); Passive protection from breast milk
|
|
Two T's of ETEC?
|
Travers diarrhea; Two Toxins LT and ST
|
|
Which enterics are Zoonotic?
|
Nontyphoidal salmonella; Yersinia; Campylobacter; EHEC/STEC
|
|
Which enterics are human specific?
|
Shigella, typhodial salmonella, vibrio cholerae, Vibrio parahaemolyticus, ETEC, EIEC, EPEC
|
|
Whats the #1 cause of bacterial diarrhea in the US?
|
Salmonella (non-typhodial)
|
|
Which enterics are the big killers of the world?
|
Salmonella typhi, paratyphi
|
|
Which enterics do we have vaccines for?
|
Typhoid fever and Cholera
|
|
Which enterics cause Tan/Clear -lac response on McConkey Agar?
|
Shigella and Salmonella
|
|
What response does EHEC have on SORBITOL McKonkey AGAR?
|
TAN/CLEAR (does not ferment)
|
|
Unpasteurized juice?
|
Ecoli 0157
|
|
Raw Oysters?
|
Vibrio Parahaemolyticus
|
|
Ground Beef?
|
E Coli 0157
|
|
Raw Eggs?
|
Salmonella Enterica Non Typhi
|
|
Chicken?
|
Salmonella and Campylobacter
|
|
Cooked Meat (esp beef)?
|
Clostridium perfringens
|
|
Raw Honey?
|
Clostridium Botulinum
|
|
Fresh Spinach?
|
E. Coli 0157
|
|
Which enteics have a very low ID?
|
Shigella and EHEC
|
|
Apple Cider (unpasteurized)?
|
E. Coli 0157
|
|
What therapy is appropriate for Salmonella Typhi infection?
|
ciprofloxacin or ceftriaxone
|
|
Where can salmonella typhi be carried in a carrier state (like typhoid mary)?
|
Gallbladder
|
|
Asplenic patients have a harder time clearing infections from what general class of bacteria of which salmonella typhi belongs to?
|
Encapsulated
|
|
What are patients with sickle cell anemia more prone to from Salmonella Infetion?
|
Osteomyelitis
|
|
Which part of the GI does Salmonella colonize?
|
Smal intestine
|
|
This organism mimics appendicitis?
|
Yersinia (enterocolitic and pseudotuberculosis)
|
|
Which organism causes mesenteric lymphadenitis?
|
Yersinia
|
|
What enteric bacteria can survive in refrigeration, and must be screened for in blood transfusion?
|
Yersinia
|
|
How does cholera cause death?
|
Dehydration
|
|
Where is cholera toxin coded for in V. cholera?
|
Chromosome
|
|
Leading cause of diarrhea in japan?
|
V. parahaemolyticus
|
|
Complications of Campylobacter Enterocolitis?
|
Guillain Barre and Reiters
|
|
Bloody diarrhea, cramps, vomiting, fever, and gull shaped rods?
|
Campylobacter Jejuni
|
|
What is the oxygen dependance of Staphylococci?
|
Facultative Anaerobes
|
|
A yellow, beta-hemolyticu colony on a blood agar is suggestive for what?
|
S. aureus
|
|
A White, non hemolytic colony on blood agar is suggestive for what?
|
S. epidermis
|
|
Gram positive cocci in cluster; Catalase positve; Coagulase Postive?
|
S. Aureus
|
|
Gram postivei cocci in clusters; Catalase Positive; Coagulase Negative; Acid from glucose positive?
|
S. epidermidis
|
|
Gram postive cocci in clusters; Catalase Positive; Coagulase Negative; Acid from glucose negative?
|
S. Saprophyticus
|
|
What gram positive cocci are easy to distinguish by a catalase test?
|
Staphylococcus (positive) and Streptococcus (negative)
|
|
What are the 5 skin infections caused by Staphylococcus Aureus?
|
Furnuncle,impetigo, carbuncle, mastitis, cellulits (folliculitis)
|
|
What are the 2 wound infections caused by staph aureus?
|
community aquired and surgical
|
|
What can infection of the apocrine sweat glands with staph aureus lead to?
|
Hidradentis suppurtiva
|
|
What is impetigo usually due to?
|
group A strep (30% are due to group A strep and S. Aureus)
|
|
What are some deep lesion (metastatic infections) that can be caused by S. Aureus?
|
osteomyelitis, septic arthritis, meningitis, pneumonia
|
|
What are some bacteremia related diseases caused by Staph Aureus?
|
endocarditis, meningitis, pneumonia, pyelonephritis, septicemia, and septic shock
|
|
What is septic shock caused by in S. aureus?
|
Peptidoglycan
|
|
What can diabetes mellitus predispose a person through s. aureus infections?
|
boils, furnuncles, carbuncles, and wound infections and bacteremia
|
|
What are the risk factors for endocarditis caused by S. aureus?
|
heroin addiction and prosthetic heart valve
|
|
What is the #1 host defense against S. Aureus infections?
|
Opsonophagocytosis (granulocytopenic and C3b deficient individuals are at high risk)
|
|
What three virulence factors of S. aureus protect it from phagocytes?
|
protein A, catalase, leukocidin
|
|
How does protein A protect S. aureus from phagocytosis?
|
it bonds the Fc region of Ig's
|
|
What does techoic acid do in S. aureus?
|
binds fibronectin and induces shock
|
|
What does coagulase in S. aureus do?
|
initiates conversion of fibrinogen to fibrin
|
|
What does the virulence factor hyaluronidase do for S. aureus?
|
acts on hyaluronic acids in CT and facilitates dissemination through subcutaneous tissues
|
|
What are the differnet cytotoxins that S. aureus produce?
|
Alpha hemolysin; Beta toxin (sphingomyelinase C - kills cells by hydrolysis of membrane phospholipids); Delta toxin; Gamma toxin and Panton-Valentine Leukocidin (lysis of neutrophils and macrophages)
|
|
What toxins are produced by S. aureus which cause clinical diseases?
|
Exfoliatin A, B; Toxic shock syndrome toxin (TSST-1); Staphylococcus enterotoxin
|
|
What are the 5 toxin mediated diseases caused by S. Aureus?
|
Bullous impetigo, Scalded Skin Syndrome; Staphylococcal scarlet fever; toxic shock syndrome; food poisoning
|
|
What diseases do the exfoliatin A and B toxins secreted by S. Aureus cause?
|
Bullous impetigo; scalded skin syndrome; staphylococcal scarlet fever
|
|
How do Exfoliatins cause scalded skin syndrome?
|
Serine proteases - cause splitting of desmosomes in the stratum granulosum epidermis
|
|
What is the superantigen that is produced by S. aureus?
|
TSST-1 (toxic shock syndrome toxin 1)
|
|
Who are at risk for developing toxic shock syndrome?
|
menstruating women; women with barrier contraceptive devices; persons who have undergone nasal surgery
|
|
What are the top three lab findings in toxic shock syndrome?
|
elevated serum creatinine; thrombocytopenia; hypocalcemia
|
|
What are the major clinical signs and symptoms of toxic shock syndrome?
|
diarrhea, myalgia, vomiting, fever
|
|
What do staphylococcus enterotoxin cause?
|
food poisoning
|
|
Is there fever due to S. aureus enterotoxin induced diarrhea?
|
NO
|
|
Where are S. aureus enterotoxins coded?
|
many are phage-encoded
|
|
This is a gram-positive facultative anaerobe which is spore forming capable of producing diarrheal disease, emetic disease, and other opportunistic infections?
|
Bacillus cereus
|
|
What bacillus cereus toxin causes diarrheal disease due to increased cAMP?
|
Heat labile enterotoxin
|
|
What bacillus Cereus toxin causes emetic disease?
|
Heat stabile enterotoxin
|
|
Which B. cereus disease has a longer incubation and a longer duration (diarrheal or emetic)?
|
Diarrheal (caused by heat labile toxin)
|
|
Which B. cereus disease is due to ingestion of PRE-FORMED toxin?
|
Emetic disease (found in RICE)
|
|
Which foods would cause the diarrheal disease due to B cereus?
|
meat, vegetables, sauces
|
|
What is the difference between food poisoning due to S. aurues and B. cerues?
|
S. aureus has vomiting AND diarrhea
|
|
What kind of diarrhea is caused by B. cereus (watery, inflammatory, bloody)?
|
Watery
|
|
Studies show that non-carriers are inherently resisten to colonization by S. aureus T/F?
|
TRUE; may be due to host or bacterial factors
|
|
What are some places highly susceptible to MRSA?
|
outpatient clinics, sports settigns, tattoo parlors (many others)
|
|
What is bacteriophage typing useful for ?
|
Useful in tracking antibiotic resistance, investigating outbreaks in food poisoning
|
|
Where is the Penicilinase gene encoded for in S. aureus?
|
plasmid
|
|
Where is the MecA gene (responsible for methicillin resistance) encoded within the MRSA?
|
in the chromosome (rare transfer)
|
|
What gram positive, coagulase positive will you suspect if a patient has an infected wound and history of a dog bite?
|
Staph intermedius
|
|
What are the two coagulase negative Staphylococcus capable of causing disease in humans?
|
S. epidermidis, and S. saprophyticus
|
|
What are the infections caused by Staph epidermidis?
|
UTI (hospital aquired); osteomyelitis; endocarditis; bacteremia (immunosuppresed); endophtalmitis (ocular surgery); indwelling foreign devices
|
|
What protects Staphylococcus epidermidis from antibiotics when found on indwelling medical devices?
|
Biofilms
|
|
What is the 2nd most common cause of community-aquired UTI?
|
Staphylococcus saprophyticus
|
|
What does staphylococcus saprophyticus make that can increase the pH of urine?
|
urease
|
|
What is the benefit of coagulase for S. aureus?
|
forms a fibrin formation around the bacteria protecting it from phagocytosis
|
|
Staphylokinase is secreted from S. aureus to do what?
|
lyses fibrin clots (used to penetrate)
|
|
A patient has comes in with severe hypotension, rash, hx of vomiting and diarrhea and her hands and soles appear to be sloughing off. She is currently menstruating?
|
Toxic Shock Syndrome
|
|
Sexy staff often make people excited directly?
|
septic arthritis; skin infections; osteomyelitis; meningtis; pneumonia; endocarditis; DIRECT ORGAN INVOLEMENT
|
|
What is impetigo?
|
A contagious disease often in the face; vesicles led to pustules which crust over to become honey-colored, wet and flaky
|
|
What is currently being used to treat MRSA although resitance to it is slowly occuring?
|
Vancomycin
|
|
What gives S. epidermidis the ability to stick to medical devices?
|
Polysaccharide capsule (extracellular polymers)
|
|
Pyogenic cocci are (obligate intracellular, obligate extracellular, facultative intracellular) organisms?
|
Obligate extracellular (staph and strep cannot live in PMNs)
|
|
What are cocci pairs (lancet shaped) typical of?
|
Strep pneumo
|
|
Streptococci are catalase (positive or negative)?
|
Negative (distinguishes them from Staph)
|
|
What does staph aureus look like on blood agar?
|
Yellow ("gold"); with a clear zone around them (B-hemolytic)
|
|
Are polysaccharide antigens t-dependent or t-independent responses? What antibody is formed?
|
T-independent; Form IgM antibody
|
|
Can infants form an immune response to polysaccharide antigens (like those given in older Strep Pneumo vaccines)?
|
NO - cannot form T-independent immune response (need conjugate vaccines)
|
|
Streptococci pneumo is (non-hemolytic, Beta-hemolytic, Alpha hemolytic)?
|
Alpha hemolytic
|
|
What color will strep pneumo display if grown on blood agar? What causes this color?
|
Are very mucoid looking (glistening, goopy) and around the colonies look Green due to breakdown of hemoglobin by pneumolysin
|
|
What causes certain strains of bacteria which look glistening and goopy on agar?
|
polysaccharide (encapsulated organisms)
|
|
Streptoccoci pneumo is Bile (soluble or insoluble)?
|
Soluble (autolytic enzymes elicited when bile is added)
|
|
What other autolytic enzyme inducing compound (aside from bile) will result in lysis of a colony in streptococci pneumo?
|
Optochin
|
|
What are the different ways to detect polysaccharide capsules?
|
Quellung reaction; latex agglutination; co-agglutination
|
|
What is co-agglutination?
|
Killed staph aureas uses it's protein A to bind antibodies of polysaccharides
|
|
What are the surface adhesins for streptococcus pneumoniae?
|
PspA and Choline-binding proteins
|
|
What is a major viral predisposing factor for Streptococci pneumonia infection?
|
Influenza infection
|
|
What are the clinical manifestations of Pneumococcal pneumonia?
|
Usually Lobar; sudden onset chills, fever, pleuritic pain, rusty collered sputum (always take blood cultures)
|
|
What are some other Streptococcus pneumonia infections of the upper respiratory tract (aside pneumonia)?
|
otitis media, mastoditis, sinusitis
|
|
What are some extrapulmonary infections caused by S. pneumo (aside upper respiratory infections)?
|
meningitis (especially due to skull fracture); septic arthritis; endocarditis
|
|
What do you treat acute otitis media caused by S. pneumonia?
|
amoxicillin
|
|
What do you treat sinusitis caused by S. pneumonia in children and adults?
|
amoxicillin (both); quinolones (adults)
|
|
What do you treat pneumococcal pneumonia?
|
third generation cephalosporins
|
|
What do you treat meningitis caused by S. pneumo?
|
vancomycin plus B-lactam
|
|
What vaccine is currently recommended for children to prevent S. pneumo?
|
PCV13 - conjugated polysaccharides with 13 serotypes
|
|
What vaccine is recommended for adults , chronic and immunosuppresed patients (asthma and smokers) to prevent S. pneumo?
|
23PS - non-conjugated vaccine (all polyvalent polysacharride with 23 serotypes)
|
|
What is group A strep also commonly called?
|
Streptococci pyogenes
|
|
This carbohydrate antigen is part of the cell wall of Strep pyogenes and often used in rapid detection tests?
|
Lancefield group A antigen
|
|
Group A strep is (alpha-hemolytic, beta-hemolytic, non-hemolytic)?
|
B-hemolytic (just like S. aureus)
|
|
Is group A strep sensitive to bacitracim?
|
Yes
|
|
Group A strep is catalase (negative/positve)?
|
Negative
|
|
Group A strep is PYR (positive or negative)?
|
Positive (pyrrolidonyl arylamidase)
|
|
Can vaccines against the capsule of Group A strep be made?
|
No; capsule has hyaluanic acids and thus it would react with human cells as well
|
|
What is the major virulence factor of strep pyogenes?
|
M protein (binds to epidermis; anti-phagocytic)
|
|
Why don't we use protein M to make a vaccine against strep pyogenes?
|
sequence homolgy between mammalian proteins (anti self)
|
|
What are some toxin mediated responses that S. pyogenes is capable of?
|
scarlet fever and toxic-shock like syndrome (due to exotoxins)
|
|
What are some extracellular virulence factors made by group A strep?
|
Pyrogenic exotoxins (superantigens); Streptolysin O; DNAase; Streptokinase; C5a peptidase
|
|
What does streptolysin O do and how is it clinically significant?
|
(produced by S. pyogenes); lyses red blood cells; antigenic (antibodies in throat infections made can be detected by anti-streptolysin ASO test
|
|
This virulence factor is made by group A strep and is used by surgeons during enzymatic debridement?
|
Streptokinase
|
|
What are the two general classes of diseases caused by group A strep?
|
suppurative vs non-suppurative
|
|
What are the 2 non-suppurative diseases caused by group A strep?
|
Rheumatic fever and Acute glomerulonephritis
|
|
What is a way to detect wether or not a person had a strep A infection who now presents with rheumatic fever /glomerulonephritis?
|
Antibody titer to Streptolysin O or DNAases
|
|
What does the throat look like in Streptococcal pharyngitis?
|
inflamamtion with petechia or small red spots on the soft palate
|
|
Strawberry tongue, circumoral pallor, desquamation. What bacteria cause the symptoms due to a toxin?
|
Streptococal pyogenes (group A strep)
|
|
What do you use to treat streptococcal pharyngitis?
|
penicillin
|
|
What type of pyodermas can S. pyogenes produce?
|
impetigo, erysipelas, cellulitis, and necrotizing fasciitis
|
|
What is the differnce between toxic shock caused by Staph and Strep A?
|
Strep A and toxin are in the blood (bacterimia) vs Staph where the bug is localized and making the toxin. (also necrotizing fasciitis present with group A strep)
|
|
What must patients with rheumatic fever be placed on for the rest of their lives?
|
penicillin (prevent further antibody response to protein M and acute heart damage)
|
|
What neurological abnormalities, which is abrupt in onset, and episodic, is associated with group A strep infection?
|
PANDAS syndrome (pediatric autoimmune neuropsychiatric disorder associated with group A strep)
|
|
What treatment is given for group A strep infecitons?
|
Penicillin G
|
|
What is the current most common cause of neonatal meningitis?
|
Group B strep infections
|
|
Group B strep is catalase (positive or negative)?
|
Negative
|
|
Group B strep is (alpha hemolytic; B hemolytic; non-hemolytic)?
|
Beta hemolytic
|
|
Group B strep is bacitracin (insensitive or sensitive)?
|
Insensitive
|
|
Group B strep will test positive or negative for CAMP?
|
Positive (extracellular protein produced by group B that will react with a B lysin of S. aureus)
|
|
What is the treatment for group B strep?
|
Penicillin G and aminoglycoside
|
|
What is given to a pregnant women with a history of a baby born with group B strep?
|
Penicillin G
|
|
A baby is born with meningitis and you as a physician would like to rule out group A strep (you think its group B strep)? What test could you give?
|
Bacitracin (group B will culture and grow because its resistant); CAMP (Broup B will be positive)
|
|
This organism is part of the normal flora of the gut, and a leading cause of hospital aquired secondary infection (due to catheters, etc)?
|
Enterococci (facalis and faecium)
|
|
enterococci are (beta hemolytic; alpha hemolytic; non-hemolytic)?
|
Alpha and NON (rarely beta)
|
|
Enterococci are catalase (negative or positive)?
|
Negative (all strep)
|
|
What Streptococci is th eonly one to be able to survive Bile and Sodium chloride?
|
Enterococci
|
|
Enterococci are PYR (negative/positive)?
|
Positive
|
|
These two streptococci produce PYR. What is a lab test to separate the two?
|
Enterococci and group A strep; (either Bile or hemolysis - group A is B hemolytic and degrades on bile)
|
|
What clinical syndromes are caused by enterococci?
|
UTI, bacteremia, subacute endocarditis, and Wound and tissue infections
|
|
Viridans streptococci is (alpha hemolytic, beta hemolytic, non-hemolytic)?
|
Alpha
|
|
Viridans streptococci is optochin (sensitive, resistant)?
|
Resistant
|
|
Viridan streptococci is bile (sensitive, resistant)?
|
resistant
|
|
Viridans streptococci is PYR (positive/negative)?
|
Negative
|
|
What gram positive, catalase negative, alpha hemolytic organism is responsible for dentists to ask if you had previous heart disease, which, if you had a damaged heart valve would predispose you to one of the effects of this organism?
|
Viridans streptococci
|
|
Which is part of the normal flora of the skin and nares (S. aureus, S. pyogenes, Both)?
|
S. Aureus
|
|
Which causes Bullous impetigo (S. aureus, S. Pyogenes, Both)?
|
S. Aurues
|
|
Which one causes food poisoning (S. aureus, S. pyogenes, Both)?
|
S. aureus
|
|
Which one causes pharyngitis (S. aureus, S. pyogenes, Both)?
|
S. pyogenes
|
|
Which one causes necrotizing fascitis (S. aurues, S. pyogenes, Both)?
|
S. pyogenes
|
|
Which one is B hemolytic (S. aureus, S. pyogenes, Both)?
|
BOTH
|
|
Which one is catalase negative (S. aureus, S. pyogenes, both)?
|
S. pyogenes
|
|
Which one is a pus former (S. aureus, S. pyogenes, Both)?
|
BOTH
|
|
Which one causes Impetigo (S. aureus, S. pyogenes, BOTH)?
|
BOTH (S. aureus causes Bullous impetigo)
|
|
Which one causes toxic shock syndrome and associated bacteremia (S. aureus, S. pyogenes, BOTH)?
|
S. pyogenes (S. aureus is localized and secreting the toxin)
|
|
What are the characteristics of a strict anaerobe?
|
Can't use O2; can't breakdown H2O2 (no catalase); In presence of O2 superoxide accumulates (no SOD)
|
|
Clostridia can cause these diseases?
|
butulism, tetanus, gas gangrene, food poisoning, Clostridum difficile associated disease, pseudomembranous collitus (Because the gas fucks clostridium plenty)
|
|
Which two gram positive rods make spores?
|
Baccili and Clostridium
|
|
What is it called when a spore turns into a rod?
|
germination
|
|
What are the three kinds of botulism infections in the US?
|
food poisoning, wound botulism, infant botulism (floppy baby syndrome)
|
|
What causes botulism food poisoning (Bacteria, toxin)?
|
Toxin made in the food (spore are in the food, they germinate and produce the toxin)
|
|
What kind of paralysis is botulism?
|
descending flaccid paralysis (vs guillain Barre which is an ascending paralysis)
|
|
Can antibodies made against one type of botulism toxin react with those of another ?
|
No
|
|
What are the three most common types of botulism toxin?
|
A, B, E (Use another for weopanization)
|
|
Can heating destroy botulism toxin?
|
YES (100c for 10 mins)
|
|
What is the mechanism of action of Botilinum toxin?
|
prevents release of acetylcholine from neuromuscular junctions (flaccid paralysis)
|
|
What is the enzymatic activity of botulism that prevents acetylcholine release?
|
zinc-dependent endoprotease (cleaves a protein needed for acetylcholine release)
|
|
What are the best conditions for botulism toxin in food poisoning?
|
canned foods (anerobic, increased pH)
|
|
What are the clinical presentations of botulism?
|
dry mouth, difficulty swallowing, visual disturbances, descending paralysis; BUT NO confusion (not stroke); NO fever or GI (unless type E)
|
|
What do people with botulism often die from?
|
respiratory paralysis/ cardiac arrest
|
|
Why don't patients who survive botulism toxin develop antitoxin?
|
too little toxin in the blood for adequate immune response
|
|
What population is at risk for botulism via wound infection?
|
heroin users
|
|
What is the postulated pathogenesis for infant botulism?
|
environmental source (honey in milk) is infected with spores; SPORES germinate in BABY (CANNOT germinate in ADULT); rods make toxin
|
|
How is botulism diagnosed in the laboratory?
|
isolation of patient's serum/stool/food and injection of MICE with it; Once mice become ill varying antibodies to the 7 types are used to figure out which type it is
|
|
How do you treat botulism ?
|
trivalent antitoxin (prepared in horses)
|
|
What do we treat floppy baby syndrome?
|
botulism immune globin IV (prepared from adult immunization with toxoid) - - very expensive
|
|
How many antigenic types are there for C. tetani toxin?
|
One type (allows successful vaccination)
|
|
What is the mode of action of C. tetani toxin?
|
Cleaves VAMP (synaptobrevin) and prevents the release of glycine from inhibitory interneurons > Stimulations > spasms
|
|
What is the protein that is cleaved by tetanus?
|
VAMP or synaptobrevin
|
|
Where in the world is tetanus commonly found?
|
developing countries; In US from older adults who aren't immunized
|
|
What are the clinical presentations of tetanus?
|
lockjaw; risus sardonicus (characteristic facial expression); stiff neck, difficulty swallowing, rigid abdomen, spasms DEATH by respiratory
|
|
What do you do after someone recovers from tetanus?
|
immunize
|
|
Is antitoxin to tetanus effective once the toxin has bound ?
|
NO
|
|
What antibiotic would you give to a patient if you think that C. tetani is still there?
|
metronidazole
|
|
T/F infections by anaerobes are normally not mixed (no other bacteria will be found)?
|
FALSE; normally other anaerobes are present
|
|
Which clostridium is the most common cause of invasive clostridial infections?
|
C. perfringens
|
|
What does C. Perfringens produce that is capable of in vivo lysis of cells?
|
Alpha Toxin (lecithinase)
|
|
What can alpha toxin (C. Perfringen) lyse in vivo?
|
red blood cells; platelets; endothelial cells and leukocytes
|
|
What is a diagnostic test for Clostridium Perfringens?
|
place it in milk; look for "stormy fermentation"
|
|
Describe what happens to a person if they ingest cooked beef which has had C. perfringens spores in them?
|
Ingest RODS (which replicated in the beef)> rods sporulate in the intestine > during sporulation enterotoxin is produced > diarrhea (self-limiting
|
|
What is the most frequently identified cause of nosicomial diarrhea?
|
Clostridium Difficile
|
|
What is the relationship between C. Difficle and antibiotic use in the hospital?
|
antibiotics kill off normal flora and allow difficile to outgrow (antibiotic resistant)
|
|
What do the C. difficile toxins (enterotoxin and cytotoxin) do?
|
add a glucos to the RhoA of cell's cytoskeletons and cause the cells to "round up"
|
|
What is the range of symptoms of C.Difficile associated diseases?
|
mild diarrhea to pseudomembranous colitis
|
|
What part of the GI is C. Difficile a problem ?
|
Large Intestine (antibiotics destroy normal flora)
|
|
A patient has been in the hospital for a while, has diarrhea, and has been on antibiotics?
|
C. Difficile
|
|
What are some ways C. Difficile can be diagnosed?
|
ELISA, culture, sigmoidoscope
|
|
What gram negative anaerobe are associated in mixed infections, present in the colon, usually infect after surgical procedures?
|
Bacteriodes Fragilis
|
|
Do bacteriodes fragilis have a capsule?
|
YES (they are fragile )
|
|
Can penicillin be used to cure bacteroides fragilis infection?
|
NO - B lactamase
|
|
Where can bacteroides fragilis grow which protects them and allows for detection in the lab?
|
Bile
|
|
Are deep infections due to anaerobes from exogenous or endogenous sources?
|
Mostly endogenous (our own)
|
|
How do facultative anaerobes help anaerobes live?
|
They partner up and lower the O2 tension in injured tissue sites
|
|
What is synergism?
|
one organism producing materials that facilitate the growth of another, or its protection (anaerobes producing penicillinases to protect group a strep in tonsillitis)
|
|
T/F For the most part, anaerobic infections are mixed and rarely due to a single species?
|
TRUE;
|
|
What do anaerobes NEED in order to facilitate spread in tissue and growth?
|
"injury" - compromised oxygen supply, trauma, tissue destruction, and antecedent infections with aerobes (lower the O2)
|
|
What are some unique clinical characteristics of anearobes?
|
crepitation (gas former, bad odors, brownish serous fluid); Abscess formation
|
|
Where in our bodies are most of the endogenous anaerobes located?
|
internal mucous membranes
|
|
What are anaerobic infections above the waste normally due to ?
|
dentition
|
|
What are babies more prone to once they develop teeth?
|
anaerobic infections
|
|
What is a very common oral gram negative rod anaerobe?
|
prevotella (B lactamase)
|
|
What is the peak age of periodontal disease?
|
20-35
|
|
What antibiotics can be used for above the waist anaerobes?
|
all - mostly use penicillin/clindamycin
|
|
What part of the GI has the most anaerobes?
|
Colon
|
|
What are the antibiotics used for anaerobe infections?
|
penicillins, carbapenems, clindamycin, metronidazole, cephalosporins (cephamycins), vancomycin, quinolones
|
|
What can surgeons do to cure anaerobic infections?
|
remove devitalized tissue, expose to good oxygen
|
|
A patient was treated with both ceftriaxone and clindamycin, which one was used for anaerobic infections?
|
clindamycin
|
|
What antibiotic would be used for a anaerobe in the CNS (need good penetration)?
|
metronidazole
|
|
What anaerobe stains to show sulfur filamentous rods?
|
actinomyces (dental)
|
|
What antibiotic was used in the case of actinomyces infection as well as to cover for gram negative rods?
|
Unasyn (ampicillin and B-lactamase inhibitor - sulbactam)
|
|
What is the natural reservoir for actinomyces?
|
humans
|
|
"lumpy wooden jaw"
|
actinomyces infection
|
|
What is the treatment for actinomyces infection ?
|
long term high dose penicillin
|
|
T/F E. Coli ferments lactose?
|
TRUE;
|
|
These E. Coli are responsible for travelers diarrhea and children's diarrhea?
|
ETEC
|
|
This E.coli shows bacillary dysentary similar to shigella?
|
EIEC
|
|
This E. Coli shows infant diarrhea?
|
EPEC; also EAEC
|
|
This E. Coli produce shiga toxin and displays hemorrhagic colitis and Hemolytic Uremic Syndrome?
|
EHEC/STEC
|
|
What are the steps of pathogenesis for ETEC?
|
ingestion (food/water - human feces) > colonization small intestine (colinization fimbria CFA and CS) > elaboration of enterotoxins (ST and LT)
|
|
ETEC (watery diarrhea or inflammatory diarrhea)?
|
Watery
|
|
CF, LT and ST genes (virulence factors) are encoded where in ETEC?
|
Large plasmids
|
|
What is the mechanism of action of the ST and LT enterotoxins in ETEC?
|
increase in cAMP and cGMP
|
|
What pathogen is responsible 30-57% of diarrhea among military personnel in African and mid east?
|
ETEC
|
|
ETEC (is there blood in stool)?
|
NO
|
|
In ETEC, immunity to endemic serotyopes leads to adult immunity T/F?
|
TRUE;
|
|
ETEC (intracellular or extracellular)?
|
Extracellular; antibody
|
|
What is the major difficulty in developing vaccine for ETEC?
|
variety of serotypes
|
|
This E. coli is identical to shigella disease (range of watery diarrhea to dysentery); has a lrage shigella virulence plasmid; World-wide and common in children?
|
EIEC (enteroinvasive)
|
|
This E.Coli is a major pathogen and cause of acute and chronic diarrhea in infants < 2 years old; and is a true age-restricted pathogen?
|
EPEC
|
|
T/F breast milk is protective for EPEC?
|
TRUE;
|
|
The gene for the bundle-forming pillus involved in the intial adherence of EPEC to Small Intestin mucosa is located where in the bacteria?
|
Virulence plasmid
|
|
What is the Late (intimate) adherence of EPEC mediated by, and where are these factors encoded?
|
Intimin; encoded on a chromosomal pathogenicity island
|
|
What are the symptoms of hemorrhagic colitis?
|
abd pain; NO FEVER; bloody diarrhea; VARIABLE presence of fecal PMN
|
|
microangiopathic hemolytic anemia, thrombocytopenia, glomerular thrombosis
|
|
|
EHEC such as E. coli 157 has attaching and effacing intestinal lesion which are encoded where in the chromosome?
|
Pathogenicity island
|
|
The shiga toxin produced by EHEC is bacteriophage produced T/F?
|
TRUE;
|
|
What is the difference between STEC and EHEC?
|
STEC has no intimin and no LEE (pathogenicity island); Both have bacteriophage encoded shiga toxin
|
|
What does shiga toxin bind to in glomeruli?
|
Gb3 receptor
|
|
What two factors increase the risk of hemolytic-uremic syndrome?
|
High initial WBC; Antibiotic treatment (due to phage induction)
|
|
EHEC/STEC (human specific or zoonoses)?
|
Zoonoses (hamburger)
|
|
EHEC/STEC (low infectious dose or high infectious dose)?
|
LOW
|
|
What bacteria may you get from unpasteurized apple cider and milk?
|
EHEC/STEC (as well as salmonella)
|
|
What type of AGAR would be useful if you wanted to grow E. COLI 157 H7?
|
sorbitol MacConkey (O157 does not ferment sorbitol)
|
|
BFP and virulence plasmid usefule for ID'ing what E. Coli?
|
EPEC
|
|
EAE probes are specific for what?
|
Intimin (EPEC and/or EHEC)
|
|
Does STEC have intimin?
|
NO
|
|
ETEC (secretory or inflammatory)?
|
Secretory
|
|
Attaching and Effacing Lesions in intestinal (which E. Coli)?
|
EPEC and EHEC
|
|
Invasion of epithelial cells, colonic ulcers, dysentery (EHEC, EPEC, EIEC, ETEC)?
|
EIEC
|
|
Inflammatory diarrhea, carried by new puppies, gull shaped rods?
|
Campylobacter jejuni
|
|
C. jejuni is microaerophilic T/F?
|
TRUE;
|
|
C. Jejuni (oxidase negative or positive)?
|
Positive
|
|
Campylobacter jejuni (human specific or zoonoses)?
|
Zoonoses (birds and other amimals)
|
|
What are the two major complications of campylobacter jejuni?
|
Guillain Barre and Reiter's Syndrome
|
|
What is the mechanism for Guillain Barre developed from campylobacter jejuni?
|
antibody cross reacts with peripheral nerve myelin
|
|
This syndrome complicates campylobacter jejuni and Shigella, causes a reactive arthritis, affects the urinary tract, eyes, skin and mucus membranes, and affects HLA b27 patients more?
|
Reiter's Syndrome
|
|
What do you need to culture campylobacter jejuni?
|
selective medium WITH antibiotics, 42 degree C, Increased CO2, look for oxidase +
|
|
Which vibrio cholera cause epidemic and pandemic cholera?
|
O1 and O139
|
|
Cholera (inflammatory or secretory diarrhea)?
|
Secretory (watery, vomiting, leg crasmps)
|
|
Which biotype of V. cholera is more severe (El Tor or Classical)?
|
Classical
|
|
What are some clinical signs of cholera gravis?
|
rice water stool; absent peripheral pulse; decreased BP; sunken eyes; decreased turgor; hyperventilation; muscle cramps (decreased K)
|
|
How does V cholera colonize the small intestine?
|
Toxin co-regulated pili (TCP)
|
|
The A subunit of cholera toxin does what?
|
activates adenyalte cyclase via ADP ribosylation of the GTP-binding protein
|
|
The B subunit of cholera binds to what?
|
GM1 ganglioside molecules
|
|
Where is the Cholera toxin encoded?
|
bacteriophage
|
|
Which virulence factor is most important for cholera (TCP or cholera toxin)?
|
cholera toxin
|
|
Cholera toxin increase Cl secretion in crypt cells T/F?
|
TRUE;
|
|
Cholera toxin causes decreased absorption of Cl and Na in villus cells T/F?
|
TRUE;
|
|
V. Cholera (low infectious dose, or high infectious dose)?
|
HIGH (person to person not important)
|
|
T/F seafood can transmit V. Cholera?
|
TRUE
|
|
T/F decreased acidity in the stomach (achloridia) will increase severity of Cholera?
|
TRUE;
|
|
What blood group increases the severity of cholera infection?
|
O
|
|
T/F V. Cholera can be transmitted through frozen fresh coconut milk?
|
TRUE;
|
|
What kind of AGAR should you use for V. Cholera?
|
TCBS (sucrose fermenting)
|
|
What kind of therapy is recommended for Cholera?
|
Oral rehydration salts and Ringers lactate
|
|
This bacteria produces a thermostable hemolysin (Tdh) previously called Kanagawa toxin?
|
V. Parahaemolyticus
|
|
Common in JAPAN, Seafood, watery diarrhea?
|
V. Parahaemolyticus
|
|
Raw Oysters?
|
V. cholera, parahaemolyticus, vulnificus
|
|
What happens to the incidence of V. parahaemolyticus as temperature increases ?
|
Increases; something with oysters
|
|
Exposure to contaminated sea water leading to wound infections?
|
V. vulnificus
|
|
What pathogen was responsible for the multistate 2008 outberak associated with jalapenos, and responsible for a huge economic blow to the tomato industry?
|
Salmonella enterica saint paul
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This Surveillance System was establishe din 1996, estimates illness burden, and monitors trends for 10 specific pathogens, with 10 sites in the US?
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US FoodNet
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This surveillance network is a dynamic internet accessible pattern database and uses PGFE to detect pathogens?
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PulseNet
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What are the two probabale factors for the emergence of ETEC in the US population?
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Increasing free trade and greater international travel
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A boy comes in with generalized muscle weakness and had a reported case of acute diarrhea 8 days before onset?
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Campylobacter jejuni (guillen-barre)
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What are the findings on electrophysiology for guillen barre?
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very low compund muscle action potentials in lower limbs with normal compound sensory nerve action potentials
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What is the most common cause of acute flaccid paralysis in humans?
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Guillen-Barre Syndrome
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What is the most common antecedent infection of Guillen Barre?
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Campylobacter jejuni
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What is the cause of cross reacting antigen with GM1 antigen on Myelin from campylobacter jejuni?
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Sialyltransferases which synthesize ganglioside-like epitopes
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What cancer is H. pylori associated with?
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Gastric adenocarcinoma
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Compared to the distribution of world H. Pylori infection and Gastric Cancer, are they the same or are there differences?
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Differences exist indicating a multifactorial cause of cancer
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Curved, gram negative rods, microaerophilic, + urease?
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Helicobacter Pylori
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What does urease do for the H. Pylori?
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forms a protective cloud of ammonia around the bacteria within the acidic intestinal and gastric cavity
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What virulence factors do H. Pylori use for colonization?
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Urease, Mucinase, Phospholipase Flagella
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How does H. Pylori defend itself from phagocytes?
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arginase (prevents NO synthesis); catalase; SOD
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How can H. Pylori cause direct damage to tissue?
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urease; and vacuolating cytotoxin
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Describe the pathogenesis of H. Pylori?
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Binds to gastric mucosa (with urease, mucinase, phospholipase, and flagella) > causes epithelial damage (Urease, vacuolating cytotoxin) > Chronic superficial gastritis and Chronic deep gastritis (arginase; SOD; catalase) > Early CAG > Late CAG > Gastric carcinoma
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In developing countries, people are colonized at a (younger or older) age?
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Younger
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T/F studies have shown that once H. Pylori colonize, genetic change occurs over time?
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TRUE;
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T/F In H. Pylori, Co-infections have been found to be rare
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TRUE;
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What stain will be used to identify H. Pylori histologically?
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Wurthrin-Starry stain (or Giemsa also)
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What are some ways of diagnosing H. Pylori?
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Breath test, stain (wurthin-starry), Urease, culture, antibody, gastroscope
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What color does urea agar turn if H. Pylori is present?
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Pink (from yellow)
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What is the preferential treatment for H. Pylori?
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metronidazole; bismuth (pepto); tetracycline
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What does metranidazole do?
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Bacteriocidal antibiotic affecting nucleic acid synthesis. Must be broken down into active form by oxidoreductases. Use to treat, H. Pylori.
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What are the symptoms of pyelonephritis?
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Flank pain, fever, nausea, vomiting, Increased C-reactive protein, Bacteremia (30%)
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What are the symptoms of cystitis?
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Dysuria, frequent urination, suprapubic pain
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What is the most common organism in uncomplicated community aquired UTI?
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Escherichia Coli
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What is the most common cause of UTI in spinal cord injury patients?
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Proteus Rettgeri
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What do catheter placement do to the incidence of hospital-aquired Proteus Mirabalis infection?
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Increases the percent
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What sex is predominatly affected by UTI ?
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females (males in infancy and elderly life)
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Virulence factors in UPEC are found where?
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on Pathogenicity Islands
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This virulence factor is present in all UPEC, is important for colonization of the bladder, and causes exfoliation of the bladder cells?
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Type 1 fimbria
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What do the UPEC type 1 fimbria do that allow the organism to ascend from the bladder?
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Phase variation
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Culture of how many colonies of bacteria establishes the diagnosis of UTI?
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> 100,000
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This virulence factor present in UPEC adheres to digalactoside-reeptors (P blood group) and is important for colonization of the upper urinary tract?
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P pili (pap pili)
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Does UPEC have hemolysin?
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YES
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This virulence factor present in UPEC inhibits Rho GTPase and affects the actin cytoskeleton?
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Cytonecrotizing factor (CNF toxin)
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This cause of UTI is a member of the enterobacteriacaea and produces a "swarming motility" on solid agar?
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Proteus Mirabilis
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Which does proteus mirabilis prefer (upper urinary or lower urinary tract)?
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Upper urinary tract
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UTI is suspected and cultures are drawn. Colonies show a metallic sheen on EMB agar?
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UPEC (eosin methylene blue)
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What does proteus mirabalis secrete that is associated with kidney stone formation?
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Urease (prescribe a urease inhibitor)
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Which type of kidney stones is protease mirabalis more likely to create?
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Struvite stones
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How do you diagnose an uncomplicated UTI?
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obtain a clean catch mid-stream sample > 100,000
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How many bacteria is diagnostic in a complicated UTI?
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between 100 - 10000
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How many organisms are diagnostic in a suprapubic tap?
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Any organisms
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