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62 Cards in this Set

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Listeria has the ability to?
REPLICATE, not just survive, inside the host cell (macrophage)
Main virulence factor for N. gonorrhoeae
IgA protease

IgA is importanat in protecting us from organisms at mucosal surfaces
What are fomites?
Inanimate objects that can transmit infection (ie needle)
Are parasites pus-forming?
NO
What is an empyema?
collection of pus in a BODY CAVITY
Common clinical presentation of Herpese encephalitis?

Hallmark?
Alterations in seemingly healthy middle-aged people: Mood, Memory, Behavior

Hallmark = PERIVASCULAR CUFFING
Rabies has what kind of inclusion bodies? Called?
intraCYTOPLASMIC, eosinophilc (as opposed to intranuclear of herpes).

Hep B also has dark magenta intracytoplamsic inclusions

Negri bodies
RMSF spots caused by?
Hemorrhage in subcutaneous tissue (THROMBOSIS OF SMALL BV!)
What kind of dz is Rheumatic fever?
Immune-mediated (from molecular mimicry); No organism can be cultured from teh heart valves or Aschoff bodies
When does Jarish-herxheimer reacion occur? What can it cause?
See with antibiotic treatment of many Borriallial and spirochete organisms

Can cause HYPOTENSTION and myalgias (may be life threatening
when do cases of Lyme disease peak? Endemic to where in the US? Most efficient transporters?
Summer

Wisconsin to Minnesota & NE

nymph tick
Tell me about the 3 stages of Lyme disease (similar to Syphilis)
1) Erythema migrans (bull's eye appearance) & acute flu-like symtoms (fever, myalgias, stiff neck, HA)

2) Heart (AV Block), Neurological (bilateral Bells palsy (rare)), and Arthritic symptoms (80%)

3) Chronic stage: chronic sskin conditions, Neurologic changes (encephalitis, dementia, transverse myelitis), Chronic Artritis similar to RA
Mos diagnosis of Lyme dz is based on?
Serology - ELISA tests and Western Blot
Tell me about the diagnosis of RMSF
Diagnosis is going to be CLINICAL, becaue serology takes too long

1)fever, HA, rash (appears on 3rd day, first on extremities then spreads centrally)
2)summertime
3)absence of tick exposture DOES NOT exlude the illness

GOOD NEWS: SOLID IMMUNITY
Endemic typhus vector? Epiemic typhus vector?
Flea
Lice (louse)
Scrub typus bug? Notable for?
Orienta tsutusgamushi

ESCHAR (thick coagulating crust @ bite site)
Human Ehrilichiosis bug? Presentation (2)?

Symptoms?
Erlichia chaffeensis

1)Human MONOYTE ehrlichiosis: RMSF w/no rash ("rocky mountain spotless fever)

2)Human GRANULOCYTE ehrilichiosis: form morlas in granulocytes: More serious illness


Symptoms like RMSF: fever, HA, myalgia, thromboocytopenia, summertime
Q fever bug?
Coxiella burnetti (not similar to rickettsia at all...more kin to legionella)

Infectious for long periods OUTSIDE the host (unlike rickettsia (obligate intracellular))

NOT transmitted by vector but by ENDOSPORE from animal waste

Tissue response is granuloma formation
Name a microaerophilic bacteria. Capnophilic
Campylobacter

Haemophilus & Neisseria species
Anaerobes located where (3)

THEME?
1) periodontal pockets
2) Dental plaques
3) Colon (largest population!)

Theme: most anaerobic infections are NOT ONE ORGANISM but a mixture of organisms (ie mixed flora).

Therefore infections are usually CLOSE to where the bacteria reside (EXCEPTION: CLOSTRDIA)
Vincent Angina
Synergistic infection present in the ORAL CAVITY due to POOR HYGIENE. Bacteria produce toxins and deteriorate GUMS -> infect bloodstream and SPREAD -> BACTEREMIA (ie can cause endocarditis)
Adult Periodontitis
Chronic and less inflammatory form of Vincent Angina (less prone to bacteremia)

LOOSENING OF TEETH
5 Characteristics of Mixed Anaerobic Infection?
1)Presence of Pus
2)Mixed Flora
3)Foul Smelling
4)Proximity to mucosal surface
5)Gas in tissue
GENERAL RULES:

Infections above diaphragm (ie lung) have?

Infections below diaphragm (ie lung) have?

Female Genital tract?
Above: Prevotella melaninogica
Below: Bacteroides fragilis

Fusobacterium BOTH above & below

Female Genital Tract = Prevotella
What bacteria may cause a NECTROTIZING FASCIITIS?
Bacteroides fragilis (ass with flesh-eating Strep pyogenes)
Where can you find Actinomyces israelii?
Oral, Respiratory & Female genital tract infections
DACRYOCYSTITIS?

What would we have suspected before?
A benign colonization of Actinomyces with BLOCK OF TEAR DUCTS by sulfur-like granules -> Swelling

before perhaps Haemopilus influenza but raer now b/c of vaccine
What other classic way may Actinomycosis present?

Why is it important to do a gram stain?
"Lumpy Jaw"

Because fungal infections can also cause draining sinueses
Common nuisance in acquisistion of blood cultures do to faulty skin decontamination prior to drawing cluture?
Propionibacterium

Staph Epi is also often presnet)
What is a bacteria that is par tof the normal flora of vagina that protect against bacterial vaginosis by keeping vagina ACIDIFIED?
Lactobacillus - but still may appear in mixed ifections
Are Clostridium part of normal flora?
Nope
Common lethan toxin in all C. perfringens? Causes? What else can C perfringens cause
Lecithinase or phospholipase C (alpha-toxin) -> Gas Gangrene

Food poisoning - ass wih meat not cooked at high enough temps
Spore Size (1) & Location on cell (2) for:

C Tetani

C Perfringens
C Tetania = Large spore and END of cell, also SWARMING

C Perfringes = Smaller spore and INTERIOR of cell, DISTINCT colonies
Double-zone Hemolysis found with? due to?
C perfringens - 12 different toxins
Key Pathogenesis factors of Anaerobes?
1) Work in synergy with facultative organisms

2) Beta-lactamase

3) Capsule: BACTEROIDES FRAGILIS IS ANTIPHAGOCYTIC
What drugs are Anaerobes resistant to?
Aminoglycosides
What fungal infection causes "copper pennies? (a SUBcutaneous mycoses)
Chromoblastmycosis ("Copper Chrome pennies")
Key sign of meningitis?
Neutorphils in CSF (never find in a healthy person)
CSF: PMN cells w/ low glucose, high protein
Bacteria infection (N. meningitis or S. pneumonia)
CSF: lymphocytic w/ normal glucose, high protein
Viral infection ("Aseptic meningitis" - Enterovirla infection, HSV-1, West-Nile (Flavi cuaseing maningoencephalitis)
CSF: partilally PMN cells, partially lymphocytes w/ normal glucose
Listeria or Partially-treated bacterial infection
CSF: lymphocytic w/ low glucose, high protein
Fungal (Cryptococcus, Histoplama, Coccidioides) or TB infection
Meningitis with defects in cell-mediated immunity?
Listeria (most common cause of bacterial meningitis in renal transplant pts)
Meningitis with neonates?
Group B strep & Listeria
Meningitis withclosed skull fractures, CSF Leaks?
S pneumoniae & H influenza
Meningitis with military, college or people in close-quaters living?
N. meningitis
Meningitis with Open skull fracture
N. meningitis
Most sensitive meningitis bacteria for Gram stain?
S. Pneumoniae

Others like N. meningitidis (meningococcus), Listeria & H. influenza not so good with Gram stain
Concentrate on what cause if patient has chronic meningitis (4+ weeks)
TB & Fungi
*Good diagnostic test for viral encephalitis?
CSF PCR for HSV-1 (not so good for TB)

CSF IgM for WEST NILE
Temporal horn necrosis = ?
HSV-1 memnigoencephalitis
Good diagnostic test for Brain Abscesses? Why not CSF?
CT/MRI

No lumbar puncture b/c there bay be a lot fo pressure
Forms of Chlamydia?
Elementary Body (EB) = INFECTIOUS form but metabolically INACTIVE

Reticular Body (RB) = NONINFECTIVE but metabollically ACDTIVE
How does Chlamydia protect itself intracellularly?
Prevents cell fusion with lysosome
Chlamydia psittaci & pneumoniae cause?
Respiratory infections
Chlamydia trachomatis:

1) Serovars A-C = ?

2) Serovars D-K = ?

3) Serovars L1-L3 = ?
1) A-C - ocular

2) D-K - urethritis, salpingitis & cervicitis

3) L1-L3 - lymphogranuloma venereum

Chlamydial Immunity is SEROVAR-SPECIFIC & SHORT DURATION (reinfections common)
Chlamydial Inclusion conjunctivitis from infected mother caused by serovars?

Infant Pneumonia?
Congenital Inclusion conjuctivitis = serovars D-K (same as STD serovars)

Congenital Chlamydial Infant Pneumonia also = serovars D-K (same as STD serovars)
Lymphogranulma Venerum from serovars?

Survive in what? Symptoms?
Serovars L1-L3; survive in Macrophges

Macrophages go to lymph nodes, block lymphatic drainage -> ELEPHANTITIS OF GENITALIA
Bacterial vaginosis arise b/c

Signs/Symptoms (need 3 of 4)?
Depletion of H2O2 by Lactobacilli

1)Grey/white discharge

2) Vaginal pH > 4.5

3)Clue cells

4) Fishy odor after KOH prep
Symptoms of Trichomonas vaginalis
1)Yellow frothy vaginal discharge

2) Strawberry cervix
Vulvovaginal Candidasis is acquired?
NOT SEXUALLY

White plaque discharge
Stages of Syphilis?
1) PAINLESS ucler

2) RASH (NONpurulent on palms & soles), lymphadenopathy

3) affects EYES & CV system; ass w/ gummas and NEUROSYPHILIS