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93 Cards in this Set

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Strep. Pyogenes G+/-?
O2 req's Strep. Pyogenes?
Facultative anaerobe
Streptococci are divided into 3 groups based on what?
Their specific hemolytic ability
What are the 3 streptococci groups?
Beta, alpha and gamma hemolytic
What is beta, alpha and gamma hemolytic?
Beta - complete RBC lysis
Alpha - partial RBC lysis
Gamma - no RBC lysis
What color of discoloration apears w/ alpha hemolytic streptococci?
What is a Lancefield antigen?
The C carbohydrate on cell wall of streptococci.
Streptococci pyogenes is a member of which step group?
What hemolytic class is S. pyogenes?
Is S. pyogenes sensitive to Bacitracin?
What are the 3 other major antigenic protiens in pygenes' cell wall (besides A)?
M, T, R
What potent virulence factor does S. pyogenes possess that interferes w/ phagocytosis?
M proteins
What is the reason behind S. pyogenes' (Group A) ability to hemolyse?
Sreptolysin O
Is streptolysin O oxygen labile or stabile? What is the other streptolysin?
Labile (inactivated by oxygen)
Streptolysin S (stabile)
What does ASO stand for?
Anti-streptolysin O Antibody
When and where do you find ASO?
In patient's serum after recent S. pyogenes infection
What factor do some S. pyogenes possess that can cause scarlet fever?
Pyrogenic exotoxin
What type of antigens can S. pyogenes possess that can cause toxic shock syndrome?
What are the four types of disease that Group A streptococci cause?
1. Streptococcal pharygitis
2. Streptococcal skin infections
3. Scarlet fever
4. Streptococcal toxic shock syndrome
What is the rapid antigen detection test used for? What does it detect?
Throat swabs. Highly specific for S. pyogenes group A carbohydrate antigen
What part of the body does scarlet fever spare?
What would you treat S. pyogenes infections with? (i.e. skin infections, necrotizing fasciitis, strep toxic shock syndrome)
High dose penicillin. Adding clindamycin will shut down Streptococcal metabolism too
What common Group A strep illness does rheumatic fever follow?
What are the 6 major manifestations of rheumatic fever?
1. fever
2. myocarditis
3. joint swelling
4. chorea (2-3 weeks after pharyngitis)
5. subcutaneous nodules
6. Rash - erythema marginatum
Why is the heart involved in rheumatic fever?
Because ther are antigens in the heart that are similar to the group A Streptococci antigens that cross-react w/ the antibodies produced against infection
What is the most frequently damaged part of the heart in rheumatic fever?
Mitral valve (followed by aortic valve)
Why are prophylactic antibiotics given in people who've had rheumatic fever (i.e. when having dental work done)
Because they are susceptible to recurrent Group A strep infections and their heart vavles, once damaged, are more easily infected in the future.
Child shows up in office w/ a puffy face. His urine is darker than normal. May also have high blood pressure. What is a possible diag?
Group A strep infection a few weeks ago which led to inflammation of the glomeruli leading to retention of h2o (puffy face, hypervolemia) and hematuria (dark urine)
What two viruses cause the cold?
Rhinovirus and coronaviridae
What kind of beer does the rhino drink?
From what family of viruses is SARS?
What are the two resevoirs of SARS CoV in China?
Civet cats and Racoon dogs. Cats and Dogs!
What is the incubation period of SARS CoV?
2-10 days
What are some of the symptoms af SARS?
Fevers, myalgias, chills. Later a dry cough, chest pain and SOB. Can progresss to frank ARDS.
What test diags SARS?
What type of nucleic acid do corona and rhino viruses have?
Where does replication occur?
Positive single-stranded RNA
Of the DNA virus familes, only one is SS DNA - which one is it?
What family of DNA viruses does cytomegalovirus (CMV) belong?
Where does CMV get its name from?
Infected cells swell (become mega) = cytomegaly
What are the 4 infectious states caused by CMV and what are the characteristics of each? (Hint: ACCmR)
1. Asymptomatic infection - presence of Ab's against the virus
2. Congenital disease - CMV is one of the TORCHES causing mental retardation (common cause) and various birth defects
3. Cytomegalovirus mononucleosis - similar to EBV
4. Reactivation in the immunocomprimised patient (like all herpesviridae) and cuase pneumonia, disseminated infection, retinitis (blindness i.e. AIDS) and disseminated infection.
What 3 probs does CMV cause in AIDS pts?
How about Marrow transplant pts?
1. Viremia
2. Retinitis
3. CMV colitis
Marrow - CMV pneumonia
What layer of centrifuged blood is sent to check for CMV? Why?
Buffy coat (white blood cells)
Because CMV preferentially invades WBC's
How is diag of CMV infection made? (3 ways)
1. Buffy coat
2. Antigen detection
3. PCR
What virus family is EBV a part of?
What are the two diseases caused by EBV that you always hear about?
Burkitt's Lymphoma
What cells does EBV infect?
What is the C3d receptor that EBV attaches to on B-cells?
In what part of the world do you find Burkitt's lymphoma?
Children in Central Africa
What is the cofactor believed to be the cuase of Burkitt's lymphoma in EBV infection?
A chromosomal arm translocaton
What does the chromosomal arm translocation do in Burkitt's lymphoma that leads to the disease?
Activates and oncogene
What effect does being immunocompromised have on latent EBV?
Activates it - can lead to lymphoma.
What are some of the symptoms of infectious mononucleosis?
Painful pharyngitis, fever, chills, sweats, headache and enlarged lymph nodes and enlarged spleens!
What is the name of the antibody that cross reacts w/ sheep/horse blood in monospot?
Heterophile antibody
What are the DNA virus families? (Hint: HHAPPPy)
What is the most common bacterial pharyngitis bug?
S. pyogenes
Name the two Gram positive cocci?
Strep and Staph
Name two Gram positive, spore-forming rods?
Name two Gram positive, non-spore-forming rods?
Spores - Bacillus and Clostridium

Non-spore - Corynebacterium diyptheria and Listeria monocytogenes
What is the visual appearance of the C. diptheria pseudomembrane?
Dark, gray (darker and grayer than strep)
What is the diptheria pseudomembrane made of?
Fibrin, C. diptheria cells, leukocytes and necrotic epithelial cells
What are the two ways to diagnose C. diptheria?
What do you see w/ each test that confirms C. diptheria
Potassium tellurite agar - grayish black colonies within 24 hours
Loeffler's coagulated blood serum media - After incubation for 12 hours staining with methylene blue reveals rod-shaped pleomorphic bacteria
An agar and blood serum
"TELL yoUR InTErn not to Loaf around."
Will C. diptheria always cause diptheria?
No. Needs to be lysogenized w/ bacteriophage carrying genes for the exotoxin.
What are the three methods used to immediately treat diptheria?
1. Antitoxin - works only on toxin in serum. Necessary to apply quickly to avoid damage to neuro/cardio
2. Erythromycin - kills bacteria = no more exotoxin and renders pt. non-contagious
3. DPT (diptheria, pertussis, tetnus) vaccine.
What two subunits is the diptheria exotoxin made of?
B - binding
A - enter cell
What does the A subunit of diptheria exotoxin do w/in the cell?
Binds to elongation factor EF2 which prevents translation of mRNA into protiens in eukaryotic cells.
What are diptheriods?
Other bacteria in the diptheria club that have similar morphology to C. diptheria.
Where do you find a "bull neck" and what causes it?
In C. diptheria infection.
Caused by bilateral cervical adenopathy.
I what disease would you find a yellowish, leathery, thick membrane? (or gray-brown pseudomembrane)
In C. diptheria infection
What is shape of C. diptheria?
C. diptheria gram +/-?
C. diptheria catalase +/-?
Which bact. rides at 'tellurite' on grayish-brown snow?
C. diptheria
2 ways C. diptheria spread?
resp droplets and dict skin contact
What does the dithria toxin do that is so bad?
Inhibits protein synth
By what means does C. diptheria's alpha toxin inhib cellular prot synth?
ADP-rybosylation ofelongation facto 2
Haemophilus, Bordetella and Legionella Gram +/-?
Human infections of Haemophilus are caused by H. influenzae, parainfluenzae, H. haemolyticus, parahaemolyticus. What is the difference between non-'para' and 'para' bugs?
Para bugs require V factor but not X factor for growth. Non-para require either V and X or just X.
In Haemophilus differentiation based on growth req's, what do X and Y stand for?
X = need for Heme
Y = need for nicotinamide anenine dinucleotide
How are the two different groups of Haemophilus differentiated?
By the presence or absence of a polysaccharide capsule.
What are the names of the 6 subtypes of Haemophilus group one?
Which one is the worst?
Groups a - f
Subtype b (H. influenzae type b = Hib)
What type of capsule does Hib have?
Polyribitol phosphate capsule
What does NTHi stand for?
Non-typable H. influenzae
Which group of Haemophilus (1 or 2) is responsible for H. infections in adults/kids?
Group 2 in adults and Group 1 in kids.
Adults w/ what condition are more at risk for Haemophilus infections?
Adults w/ COPD
What virulence factor do Haemophilus orgs have that allows them to colonize respiratory mucosa?
IgA protease
What does AECB stand for?
Name one infectious org that causes it?
Acute Exacerbation of Chronic Bronchitis.
Haemophilus infection
Name two families of antibiotics effective against Haemophilus?
Macrolides and Cephalasporins
In what condition do you see excessive tracheobronchial mucus production?
Name three clinical manifestations of encapsulated H. influenzae?
1. Meningitis (worst thing caused by H. influenzae)
2. Septic arthritis
3. Epiglottitis
What can NTHi cause in children? What is the path of spread anatomically?
Otitis media/sinusutis. from nasopharynx into middle ear or into the sinuses.
How long will mother's antibodies to Haemophilus capsule protect infant?
~ 6 months
What side effect does treating meningitis w/ antiboitics have on the system? What can you give pt. 15-20 minutes before giving antibiotics that will reduce this?
LPS release leading to violent immune response.
Give steroids.
With a mumps infection there is lymphedema of the neck which causes upward displacement of what?
Mumps is RNA or DNA?