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Micro 04

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Most common cause of atypical pneumonia   Mycoplasma pneumoniae  
Second most common cause of atypical pneumonia   Chlamydia pneumoniae  
Newborn pneumonia   Chlamydia trachomatis  
When treating for gonorrheal infection, what else should you also treat?   50% of pts will be concurrently infected with both N. gonorrhea and Chl trachomatis so should empircally treat for both PLUS Ureaplasma urealyticum  
Lactose fermenters   E.coli ferments, while Shigella and Salmonella do not  
H2S production   Distinguishes between Shigella and Salmonella. Shigella does not, Salmonella does produce H2S.  
EMB Agar   Methylene blue inhibits G+ bacteria; lactose fermenters = purple/black (enterics, NOT salmonella or shigella); E. coli = metallic green.  
MacConkey agar   Bile salts inhibit G+ bacteria; lactose fermenters = pink/purple (enterics, E.coli, NOT salmonella or shigella)  
H antigen   Flagella on bugs like E.coli and salmonella (not shigella)  
Diarrhea with no cell invasion   E coli and V cholera; toxins in GI tract, but no inflammatory response  
Diarrhea with GI EC invasion   EIEC, Shigella, Salmonella enteriditis; Bind and invade EC's --> release toxins inside EC's --> cells destroyed --> inflammatory response (fever) --> WBC's and RBC's in stool  
Diarrhea with invasion of lymph nodes and bloodstream   Salmonella typhi, Yersinia enterocolitica, Campylobacter jejuni; Stool has WBC's and RBC's, systemic sx's (fever, headache, WBC elevation), lymph node enlargement, bacteremia  
ETEC   Enterotoxigenic E coli. Heat Labile Toxin (LT), Heat Stabile Toxin (ST). Inhibit NaCl reabsorption; stimulate secretion of Cl and HCO3 --> water follows osmotic pull --> rice water diarrhea (like cholera, Campylobacter jejuni, and bacillus cereus, and Y  
EHEC   Enterohemorrhagic E coli. Shiga-like toxin; inhibit 60S ribosomal unit --> inhibit protein synthesis --> EC death --> dead cells in stool and poor absorption --> diarrhea. Hemorrhagic colitis.  
EIEC   Enteroinvasive E coli. Shiga-like toxin. Also invade EC's --> inflammatory response with WBC's and RBC's in stool  
E coli 0157:H7   EHEC in hamburger meat. Caused hemolytic uremic syndrome -- anemia, thrombocytopenia, renal failure.  
red currant jelly sputum   Klebsiella pneumoniae  
Yellow sputum   Staph aureus  
UTI's in patients with Foley catheters   Klebsiella pneumoniae, Pseudomonas aeruginosa  
Klebsiella pneumoniae pneumonia   Hospitalized pts and alcoholics  
Motile and breaks down urea   Proteus mirabilis  
Alkaline pH   Proteus mirabilis and Ureaplasma urealyticum - both split urea into NH3 and CO2  
Proteus antigens similar to which antigens?   Rickettsia  
Produces bright red pigment   Serratia  
Shigella   no flagella, does NOT ferment lactose (E coli does) or produce H2S (salmonella does)  
Shigella dysentery strikes which populations?   Preshools and nursing homes.  
Rose spots on belly   Typhoid fever - Salmonella typhi  
Diagnosis of typhoid fever   Salmonella typhi found INSIDE monocytes (invades lymph nodes)  
Mimics of appendicitis (RLQ pain)   Salmonella typhi (typhoid fever), Yersinia enterocolitica  
Patients without spleens more susceptible to….   Encapsulated bacteria: Salmonella, Haemophilus influenzae,  
Those with sickle cell anemia prone to what type of infection?   Salmonella osteomyelitis (bone infection)  
Food in fridge: can still get what?   Yersinia enterocolitica because it can grow in cold  
Mechanism of cholera toxin   ADP ribosylation of GTP binding unit --> inc cAMP --> secretion of NaCl --> osmotic pull of water and electrolytes into GI tract  
Mechanism of Shiga toxin   inactivate 60S ribosomal unit of intestinal EC's --> kills ECs --> dead EC's in stool --> poor absorption --> diarrhea  
Burn victims   1. Staph aureus, 2. Pseudomonas aeruginosa  
wound dressings that smell like grape and look blue/green   P. aeruginosa, blue pigment - pyocyanin  
CF patients   lungs infected with P. aeruginosa. Normally, P cleared by binding to CFTR channel. No CFTR channel in these patients, so no clearance.  
Diabetic patients with foot ulcers   susceptible to osteomyelitis from P aeruginosa  
IV drug users   Osteomyelitis from Pseudomonas aeruginosa in clavicle or vertebrae; R heart valve endocarditis from Pseudomonas aeruginosa and Staph aureus.  
Contact lens wearers   Corneal infection from Pseudomonas aeruginosa  
Which G- bacteria has no endotoxin?   Bacterioides fragilis (abscesses)  
Periodontal disease, black pigment on blood agar   Bacterioides melaninogenicus  
What does Haemophilus influenzae require for growth   Blood: X factor (Hematin), V factor (NAD+)  
Ddx for painful genital ulcer   1. Syphilis, 2. Herpes, 3. Chlamydia infxn.  
What is difference between chancroid and syphilis?   Chancroid = Haemophilus ducreyi, painful ulcer, painful unilateral lymph node, pus. Syphilis/SyphiLESS = Treponema pallidum, painLESS ulcer, painLESS BILATERAL LN, no pus  
What is difference between chancroid and herpes?   Chancroid = Haemophilus ducreyi, painful ulcer, painful unilateral lymph node, no systemic sx's. Herpes = Herpes simplex virus 1 and 2, start as blisters that pop (looks like ulcer), painful, Systemic sx's like myalgias and fevers  
What is difference between chancroid and chlamydial infxn (lymphogranuloma venerum)?   Chancroid = Haemophilus ducreyi, painful ulcer, painful unilateral lymph node, at the same time. LGV = Chlamydia trachomatis, primary ulcer disappears before PAINLESS LNs enlarge.  
female patient with pruritis of the labia, dysuria (burning on urination), fishy-smelling discharge   Gardnerella vaginalis - bacterial vaginitis  
How to confirm bacterial vaginitis?   Clue cells: gardnerella vaginalis (G- pleomorphic bacilli) in EC cytoplasm  


   





 
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