Micro Block Ii

Front 1

properties of Ecoli(5)

Back 1

gram negative rods
Enterobacteriaceae
Ferments Lactose
Oxidase negative
Facultative anaerobe

Front 2

URINARY TRACT INFECTIONS

Back 2

Ecoli

Front 3

Main pathogenicity factor or Ecoli causing UTI

Back 3

pili associated with pyelonephritis
Mobility enables E. coli to ascend urethra into bladder & ureter into kidney.

Front 4

UTI limited to bladder

Back 4

cystitis or uretritis characterized by pain & frequency of urination

Front 5

UTI limited to kidneys

Back 5

pyelonephritis – characterized by fever, chills, & flank pain, means infection is systemic and is ascended pyelonephritis

Front 6

Patient presents with fever, shaking chills, dysuria (burning urination), increased in frequency of urination, risk factors: indwelling catheter, disurea, burning urination, or increased frequency of urination. Lab shows gram negative rod, lactose fermenter, or facultative

Back 6

E. coli

Front 7

Patient with a bladder indwelling catheter starts to develop a fever, hypotension, and going into multi-organ failure.

Back 7

Patient is going into septic shock.

Front 8

what is the mechanism of action of E. coli causing septic shock?

Back 8

Endotoxin in the outer lipopolysaccharide memberane, blood culture will grow a gram negative organism

Front 9

Enterotoxigenic E. coli (ETEC)

Back 9

- “Travellers’ diarrhea” - Watery, non-bloody diarrhoea.
- Disease is of short duration (1 to 3 days) & self-limiting.

Front 10

History if travel to South America or another developing country, person drank tap water or juice with ice, patient comes down with watery diarrhea

Back 10

traveler’s diarrhea. bacteria produces a toxin (comparable to Cholera toxin – but cholera causes MASSIVE diarrhea) that ADP-ribosylates a Gs protein, increasing cAMP, causing water retention & watery diarrhea

Front 11

Enterohemorrhagic E. coli

Back 11

EHEC or VTEC - O157:H7 is most common)
Causes bloody diarrhea but NO INFLAMMATION, NO NEUTROPHILS in stools (no PMNs)
Fecal oral route of spread

Front 12

VEROTOXIN

Back 12

shiga-like toxin

Front 13

• Associated with outbreaks of diarrhea following ingestion of undercooked hamburgers

Back 13

VEROTOXIN – “shiga-like toxin”

Front 14

HEMOLYTIC-UREMIC SYNDROME

Back 14

Life-threatening complication of O157:H7 (risk may be increased by treatment of infection with antibiotics)
o Non-immune hemolytic anemia, thrombocytopenia, & acute renal failure

Front 15

O157:H7

Back 15

HEMOLYTIC-UREMIC SYNDROME

Front 16

Patient comes in with bloody diarrhea, increased BUN & serum creatinine, symptoms indicated hemolysis & renal failure

Back 16

hemolytic-uremic syndrome

Front 17

Patient comes in with bloody diarrhea, increased BUN & serum creatinine, symptoms indicated hemolysis & renal failure. How does the child contract this disease?

Back 17

Most common sources of enterohemorrhagic E. coli infection is undercooked beef burgers. Toxin is SHIGELLA-LIKE toxin

Front 18

SHIGELLA-LIKE toxin MOA

Back 18

nicks the 60s subunit and interferes with protein synthesis.

Front 19

HISTORY OF BLOODY DIARRHEA WITH INGESTION OF UNDERCOOKED BEEF

Back 19

ENTEROHEMORRHAGIC E. coli, but if HEMOLYTIC-UREMIC SYNDROME (ELEVATED BUN & SERUM CREATININE) = O157:H7 strain

Front 20

how do you distinguish O157:H7 from other strains of E. coli

Back 20

O157:H7 does not ferment sorbital

Front 21

xteristics Salmonella enteric

Back 21

MOTILE Gram negative
Oxidase negative
Urease negative (distinguishes Salmonella from Proteus on TSI)
Produces H2S (shigella does not), does NOT ferment LACTOSE (different with E. coli)

Front 22

How do you dintinguish salmonella from proteus on TSI

Back 22

Salmonella is Urease negative

Front 23

how do u disntiguish Salmonella from E coli

Back 23

E coli ferments lactose

Front 24

Vi (virulence) antigens

Back 24

Salmonella

Front 25

Enterocolitis
Enteric fever (ex. typhoid fever)
Septicemia with metastatic infections

Back 25

Salmonella

Front 26

Which category of salmonella have only human reservoirs with no animal reservior

Back 26

S. typhi

Front 27

o Inadequately cooked meat, dogs, & less common pets (turtles, snakes, lizards, & iguanas)

Back 27

Salmonella

Front 28

Typhoid fever

Back 28

S. typhi

Front 29

Enteric fever

Back 29

S. Paratyphi

Front 30

Infection starts in ileocecal region of small intestine with few GI symptoms, organisms multiply & enter mononuclear phagocytes of Peyer’s patches, then spread to phagocytes of liver, gallbladder – can result in carrier state, & spleen (characteristic feature: multiplication in phagosomes & invasion of gallbladder) leading to bacteremia causing fever & other symptoms resulting from endotoxin. Patient can get ulcers.

Back 30

Salmonella

Front 31

Patient comes in with a history of constipation then person starts to develop a fever, goes to liver, then spleen, has an enlarged abdomen, hepatosplenomegaly, characteristically they will tell you there is a presence of ROSE SPOTS on the abdomen

Back 31

Salmonella

Front 32

what causes enterocolitis

Back 32

S. Enteritidis & S. typhimurium

Front 33

incubation period of enterocolitis

Back 33

24 to 48 hours

Front 34

symptoms enterocolitis

Back 34

nausea, vomiting, progressing to abdominal pain, mild to severe diarrhea (with or without blood – usually mild and self resolving

Front 35

child playing with turtles at home and didn’t wash hands, ate food and came in with a diarrhea type of illness; diarrhea can be watery but can also become bloody

Back 35

- ENTEROCOLITIS
Caused by S. Enteritidis & S. typhimurium

Front 36

SEPTICEMIA

Back 36

S. cholerasius

Front 37

A patient with sickle cell anemia has a hemolytic crisis or vaso occlusive crisis, they present with excruciating bone pain. X-ray of bone is taken, a diagnosis is made, and you treat the patient with antibiotics. What is the causative agent causing the pain in the patient

Back 37

Salmonella is the #1 cause of OSTEOMYELITIS in children with sickle cell anemia

Front 38

Shigella xteristics

Back 38

- NON-MOTILE Gram (-)
- Does NOT ferment LACTOSE or H2S
- Species: S. Dysenteriae, S. Flexneri, S. Boydii, & S. Sonnei
o S. sonnei – 75% of cases in US – most common cause
o S. dysenteriae – causes most serious disease
o Some strains produce SHIGA TOXIN (exotoxin) nicks 60s subunit and interferes with protein synthesis.

Front 39

Bacilliary (bacterial) dysentery

Back 39

Shigella - bloody diarrhea occasionally may get septicemia

Front 40

pathogenesis of shigella

Back 40

Invades mucosal cells of ileum & colon resulting in bloody diarrhea

Front 41

: Patient presents with fever, abdominal cramps, watery diarrhea which later turns bloody with mucous (may say blood with pus or bloody stool that produces dysentery),

Back 41

this is an INVASIVE DIARRHEA. Toxin responsible for all clinical effects is SHIGA TOXIN – causes BLOOD DIARRHEA or BACILLIARY DYSENTARY

Front 42

Vibrio xteristics

Back 42

Gram negative - Curved, comma-shaped
Oxidase positive
Polar Flagella (at the end - key point to distinguish from Enterobacteriaceae, goes under genus: Vibrioaceae)
Grows in alkaline media or TCBS (thiosulfate citrate bile salt sucrose medium)

Front 43

transmission of vibrio

Back 43

FECAL ORAL, water contamination, or by ingestion of inadequately cooked shellfish, can get outbreaks

Front 44

watery diarrhea

Back 44

Vibrio cholera

Front 45

vibrio cholera MOA AB exotoxin

Back 45

- AB exotoxin: ADP-ribosylates Gs, leading to overproduction of cAMP & efflux of Cl- & water, but the key is that the person is losing a lot of potassium & bicarbonate, massive diarrhea (massive fluid loss of > 16-19L/day), leads to decreased CO – heart failure, decreased GFR – renal shut down, stool has hardly any fecal matter, a few shed epithelial cells, and specks of mucus – called rice water stool. There is no RBCs & WBCs, or PMNs in the stool

Front 46

Vibrio cholera diarrhoea contains which of the ff
1 RBCs & neutrophils
2 Only neutrophils
3 Just mucus & shed epithelial cells

Back 46

• Just mucus & shed epithelial cells****correct answer

Front 47

Pt. produces a traumatic type of illness where you have a profound water loss, pt. is hypokalemic, and has cardiac failure

Back 47

think about losing volume, GFR is low, reduced urinary output, & renal shut down - vibrio cholera

Front 48

pt. presents with a diarrheal illness, develops cardiac toxicity or renal failure, and dies

Back 48

vibrio cholera

Front 49

pt. presents with a diarrheal illness, develops cardiac toxicity or renal failure,
Pt. is taking antacids like Omiprazole -effect

Back 49

cholera cause decreased acid ph -antacids will increase ph and kill organism