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5/31/06

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
        Help!  

Question
Answer
What does peptidoglycan do?   gives rigid support and protects against osmotic pressure; sugar backbone w/x-linked peptide sidechains  
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What is so special about G+ bacterial cell wall/cell membrane?   it is a major Surface Antigen; TEICHOIC acid induces TNF and IL-1  
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What is up with the G(-) outer membrane?   it is the ENDOTOXIN/LPS site (major surface Antigen); Lipid A induces TNF and IL-1; Polysaccharide is the antigen  
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What does the plasma membrane do in bacteria?   it is a lipoprotein bilayer and is the site of oxidative and transport enzymes  
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Where are beta-lactamases (& other hydrolytic enzymes) contained in Gram (-) bacteria?   in the periplasmic space btw cytoplasmic and outer membrane  
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What is the purpose of a capsule?   it is a polysaccharide that protects against phagocytosis; in Bacillus anthracis it has D-glutamate  
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Glycoprotein Bacterial Pilus/fimbria mediate...   bacterial adherence to cell surface (ex: sex pili during conjugation)  
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What are spores?   bacterial forms that resist dehydration, heat and chemicals d/t a keratin-like coat (dipicolinic acid)  
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Plasmids contain what kind of genetic matereial?   DNA containing a variety of genes for Abx resistance, enzymes and toxins  
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Glycocalyx mediate?   adherence to foreign surfaces, like indwelling catheters; (it is a polysaccharide)  
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What is unique to Gram+ Bacteria?   TEICHOIC acid, Cell Wall, lots of Peptidoglycan  
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What is unique to Gram (-) Bacteria?   Endotoxin/LPS in Outer Membrane; very little peptidoglycan  
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Bacterial Lag Phase   metabolic activity w/o division  
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Bacterial Log Phase   Rapid cell division  
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Bacterial Stationary Phase   Nutrient depletion slows growth  
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Bacterial Death Phase   prolonged nutrient depletion and buildup of waste products lead to death  
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Features of Exotoxins   either G+ or G(-); secreted; polypeptide; from plasmid or bacteriophage; Highly TOXIC; variable effects/modes; Induce high-titer Abs (Anti-toxins); Toxoids used as VACCINE; Heat labile (60*C, except Staph); a/w Tetanus, Botulism, Diphtheria  
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Features of Endotoxins   G(-) Cell Wall; not secreted; LPS from bacterial chromosome; Low toxicity; Fever/Shock; Induces TNF & IL-1; Poorly antigenic; No toxoids or vaccine; Heat Stabile at 100*C for 1hr; a/w Menigococcemia, Sepsis by G(-) Rods  
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Gram Positive Exotoxigenic Bugs   Corynebacterium diptheriae; Clostridium tetani, botulinum, perfringens; Bacillus antracis; S. aureus; Strep pyogenes  
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Gram Negative Exotoxigenic Bugs   E. coli; Vibrio cholerae; Bordatella pertussis  
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Mode of action of Corynebacterium diphtheriae Exotoxin   EF-2 inactivation via ADP Ribosylation (similar to exotoxin a in Pseudomonas); a/w Pharyngitis and "Pseudomembrane" in throat  
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Mode of action of Clostridium tetani Exotoxin   Blocks release of Glycine (inhib NT); a/w "Lockjaw"  
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Mode of action of Clostridium botulinum Exotoxin   blocks release of ACh; a/w anticholinergic symptoms & CNS paralysis; floppy baby; spores in honey/canned food  
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Mode of action of Clostridium perfringens Exotoxin   alpha toxin is a LECITHINASE; a/w Gas Gangrene; double zone of hemolysis on blood agar (alpha and theta)  
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Mode of action of Bacillus anthracis Exotoxin   One of the toxins in the complex is an Adenylate Cyclase  
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Mode of action of Staph. aureus Exotoxin   Superantigen binds MHC II ptn and TCR, inducing IL-1 & IL-2 synthesis; a/w Toxic Shock Syndrome and food poisoning  
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Mode of action of Strep. pyogenes Exotoxin   Erythrogenic superantigen (a/w Scarlet Fever Rash) and Streptolysin O hemolysin (Ag for ASO Ab in Rheumatic Fever)  
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Mode of action of E. coli Exotoxin   Heat-LABILE stimulates Adenylate Cyclase by ADP Ribosylation of G ptn; a/w Watery Diarrhea; Heat-STABLE stimulates Guanylate Cyclase  
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Mode of action of Vibrio cholerae Exotoxin   Stimulates Adenylate Cyclase by ADP Ribosylation of G ptn; pumps Cl- & H20 into gut; a/w voluminous rice water diarrhea  
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Mode of action of Bordetella pertussis Exotoxin   Stimulates Adenylate Cyclase by ADP Ribosylation; a/w WHOOPING cough; Inhibits Chemokine Receptor a/w LYMPHOCYTOSIS  
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LPS/Endotoxin, especially Lipid A activates...   Macrophages (IL-1/TNF = fever; tissue hemorrhagic necrosis; NO = hypotension/shock), Alternate Complement Pathway (C3a = hypotension/edema; C5a = PMN chemotaxis), & Hageman Factor (coag cascade/DIC)  
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Which bugs don't stain well on Gram stain?   Treponema (too thin), Rickettsia (intracellular), Mycobacteria (high lipid content in cell wall), Mycoplasma (no cell wall), Legionella (usu intracellular), Chlamydia (intracellular)  
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How can you see Treponema?   darkfield microscopy with fluorescent antibody stains  
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How can you see Legionella?   silver stain  
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Neisseria MeninGococcus ferments which sugars?   Maltose and Glucose  
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Neisseria Gonorrhea ferments which sugars?   Glucose only  
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What color pigment does S. aureus make?   yellow  
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What pigment does Pseudomonas make?   blue-green  
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What pigment does Serratia marcescens produce?   Red  
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IgA Proteases allow which bugs to colonize on mucosal surfaces?   Strep pneumoniae, Neisseria meningitidis, Neisseria gonorrhea and Haemophilus influenzae  
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Growth requirement for H. influenzae?   chocolate agar with factors X (hematin) and V (NAD)  
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Growth requirement for N. gonorrheae?   Thayer-Martin (VCN) media  
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Growth requirement for B. pertussis?   Bordet-Gengou (potato) agar  
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Growth requirement for C. diphteriae?   Tellurite plate, Loffler's medium  
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Growth requirement for M. tuberculosis?   Lowenstein-Jensen agar (ogawa)  
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Growth requirement for Latose-fermenting enterics (E. coli, Klebsiella, Enterobacter)?   Pink colonies on MacConkey's agar  
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Growth requirement for Legionella pneumophila?   Charcoal yeast extract agar buffered w/increased Iron and Cysteine  
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Growth requirement for Fungi?   Sabouraud's agar  
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Congo Red stains for:   Amyloid; apple-green birefringence in polarized light d/t beta-sheets  
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Geimsa stains for:   Borrelia, Plasmodium, trypanosomes, Chlamydia  
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PAS (periodic acid Schiff) stains for:   Glycogen, Mucopolysaccharides; Diagnoses Whipple's disease and ALL  
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Ziehl-Neelsen stains for:   Acid-fast bacteria  
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India Ink stains for:   Cryptococcus neoformans  
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Silver stain stains for:   Fungi, PCP, Legionella  
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Conjugation involves...   chromosomal or plasmid DNA transfer from 1 bacteria to another; prokaryotic only  
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Transduction involves...   DNA transfer by a virus from 1 cell to another; any gene if generalized; only certain genes if specialized  
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Transformation involves   prokaryotic or eukaryotic uptake of purified DNA by a cell  
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Obligate anaerobes: "Nagging Pests Must Breathe"   Nocardia, Pseudomonas, Mycobacterium tuberculosis, Bacillus  
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Obligate Anaerobes: A,B,C   Actinomyces, Bacteroides, Clostridium; normal flora in GI but pathogenic anywhere else; they are foul-smelling, difficult to culture and produce H2 or CO2 gas in tissues  
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Which antibiotic is ineffective against Anaerobes?   AminO2glycosides b/c they require O2 to enter into the bacterial cell  
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What do obligate anaerobes lack?   catalase and/or superoxide dismutase (susceptible to oxidative damage)  
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Obligate Intracellular bugs: they stay inside (cells) when it is "Really Cold"   Rickettsia and Chlamydia; they cannot make their own ATP  
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"Some Bugs May Live FacultativeLY," which ones are facultative intracellular bugs?   Salmonella, Brucella, Mycobacterium, Listeria, Francisella, Legionella, Yersinia  
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What are the encapsulated bacteria? think about vaccines...   Strep pneumoniae (pneumococcus), Haemophilus influenza (Hib), Neisseria meningitidis (meningococcus), Klebsiella pneumoniae  
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Why is th polysaccharide capsule on encapsulated bacteria virulent?   it is antiphagocytic  
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What is a positive Quellung reaction?   it makes the capsule of an encapsulated bacteria SWELL when the antisera is added  
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What is pneumococcus a/w?   rusty sputum, sepsis in sickle cell anemia and splenectomy  
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What type of bacteria makes spores?   certain G+ rods (Bacillus anthracis, C. perfringens, C. tetani) when nutrients are limited; no metabolic activity; DIPICOLINIC ACID core; must autoclave  
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what are the alpha hemolytic bacteria?   Strep pneumoniae and Strep viridens  
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How can you tell the difference btw Strep pneumoniae and Strep viridens since they are both alpha-hemolytic and catalase negative?   pneumoniae is OPTOCHIN sensitive  
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Which bugs are beta-hemolytic?   Staph aureus, Strep pyogenes, Strep agalactiae, Listeria monocytogenes  
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What makes beta-hemolytic S. aureus stand out?   it is both CATALASE and COAGULASE positive  
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What makes b-hemolytic S. pyogenes stand out?   it is catalase negative and BACITRACIN sensitive  
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What is so different about S. agalactiae?   it is catalase negative and bacitracin resistant  
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In a b-hemolytic culture, how do you know you have Listeria?   there is tumbling motility, meningitis in newborns and comes from unpasteurized milk products  
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What is Catalase and which G+ cocci species makes it?   it degrades H2O2 (the antimicrobial biproduct of PMNs); Staphylococcus makes it  
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Which of the Catalase + Staphylococcus strains also makes Coagulase and Toxins?   Staph aureus  
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Which bug makes Protein A and what does it do?   S. aureus; it is a virulence factor that binds Fc-IgG, inhibiting complement fixation and phagocytosis  
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What diseases does S. aureus cause?   Inflammatory disease (skin, organ abscess, pneumonia); Toxin-mediated (Toxic Shock (TSST-1 toxin), Scalded skin syndrome (exfoliative toxin), Rapid-onset food poisoning (preformed enterotoxins), also Acute Bacterial Endocarditis  
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What type of toxin is TSST?   a superantigen that binds MHC II and the TCR, resulting in POLYCLONAL Tcell activation  
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What types of infection does Streptococcus pyogenes (group A b-hemolytic strep) cause? (3)   Pyogenic, Toxigenic and Immunologic  
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Pyogenic Strep pyogenes infections...   pharyngitis (& Rheumatic Fever), cellulitis, impetigo  
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Toxigenic Strep pyogenes infections...   Scarlet Fever, Toxic Shock Syndrome  
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Immunologic Strep pyogenes infections...   Rheumatic Fever, Acute Glomerulonephritis  
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What is the "JONES" criteria for Rheumatic Fever?   it is caused by S. pyogenis; Joints, O = carditis, Nodules, Erythema marginatum, Sydenhams chorea  
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What is S. pyogenes sensitive to? What is it's virulent protein?   BACITRACIN; M protein  
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Enterococci cause what type of infection? What are they resistant to?   UTI and Subacute Endocarditis; PCN G  
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How can you distinguish Enterococci from Nonenteroccoci in the lab?   they are able to grow in 6.5% NaCl  
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The Strep viridens group (S. mutans, S. sanguis) lives in the mouth because they are not afraid of-the-chin...   normal flora; "Optochin" resistant; alpha-hemolytic  
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What does S. mutans (viridens) cause?   dental caries  
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What does S. sanguis (viridens) cause?   Subacute Bacterial Endocarditis  
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Clostridia species   G+, spore-forming, obligate anaerobic bacilli  
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Clostridium tetani   exotoxin causes tetanus; blocks the release of inhibitory NT "glycine" from Renshaw cells in spinal cord  
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Clostridium botulinum   preformed heat-labile toxin inhibits ACh release causing flaccid paralysis  
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Clostridium perfringens   alpha-toxin and lecithinase "perforates a gangrenous leg..." myonecrosis, gas gangrene, hemolysis  
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Clostridium difficile   cytotoxin (exotoxin) kills enterocytes, causing pseudomembranous colitis; usu 2* to Ampicillin or Clindamycin  
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What can you treat C. difficile with?   Metronidazole  
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Corynebacterium diphtheria produces an exotoxin that is encoded by...   a beta-prophage! it inhibits ptn synthesis by ADP ribosylation of EF-2  
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What are the symptoms of Diphtheria?   pseudomembranous pharyngitis with lymphadenopathy  
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How do you diagnose Diphtheria in the lab?   G+ rods with Metachromic Granules  
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Anthrax is caused by...   Bacillus anthracis (G+ spore-forming rod) with a toxin  
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Describe contact anthrax...   black malignant pustule/vesicle (painless ulcer); can progress to bacteremia and death  
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Describe inhalation anthrax...   infectious spores can cause life-threatening pneumonia (Woolsorter's disease)  
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Actinomyces and Nocardia are both...   G+ rods forming long branching filaments that RESEMBLE FUNGI  
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Actinomyces israelii   G+ anaerobe, causes Oral/Facial Abscesses with "SULFUR GRANULES" that may drain thru sinus tracts in skin; normal oral flora  
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Nocardia asteroides   G+/weakly acid-fast soil aerobe; Pulmonary Infection in Immunocompromised pts  
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How do you treat bacteria that look like fungi? "SNAP"   Sulfa for Nocardia; Actinomyces needs Penicillin  
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If G(-) bugs are resistant to Penicillin G, can we use other derivatives to treat infection?   Yes; PCN-G and Vancomycin may not penetrate the outermembrane, BUT Ampicillin can  
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Which bugs cause food poisoning?   Vibrio (seafood); Bacillus cereus (rice); S. aureus (meat, mayonnaise, custard); C. perfringens (reheated meats); C. botulinum (improperly canned food); E. coli 0157:H7 (undercooked meat); Salmonella (poultry, meat, eggs)  
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Which food poisoning starts quick and ends quick?   S. aureus  
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"Food poisoning from reheated rice? B serious!"   B. cereus  
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E. coli diarrhea   ferments lactose  
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Vibrio cholerae diarrhea   comma shaped bugs  
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Salmonella diarrhea   Motile; does not ferment lactose  
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Campylobacter jejuni diarrhea   comma or s-shaped; growth at 42*C  
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Vibrio parahaemolyticus diarrhea   seafood transmission  
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Yersinia enterocolitica diarrhea   usu transmitted by pet feces (ex: puppies)  
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Watery diarrhea bugs   Vibrio cholerae; Enterotoxigenic E. coli (traveler's); Rotavirus, Cryptosporidium, Giardia  
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Bloody diarrhea bugs   Salmonella, Shigella, Campylobacter, enterohemorrhagic/enteroinvasive E. coli (O157:H7); Yersinia; Entamoeba  
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Enterobacteriaceae family includes   E. coli, Salmonella, Klebsiella, Enterobacter, Serratia, Proteus  
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What is common between all the members of Enterobacteriacea? COFFEe   Capsular (K) antigen, O antigen, Flagellar (H) antigen, Ferment glucose, Enterobacteriaceae; also they are oxidase negative  
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What does HaEMOPhilus cause?   Epiglottitis, Meningitis, Otitis media, Pneumonia  
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How do you treat Haemophilus meningitis?   Ceftriaxone  
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What do you give close contacts when someone has Haemophilus infection?   prophylactic Rifampin  
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Hib Vaccine contains...   type B capsular polysaccharide CONJUGATED to diphtheria toxoid or other protein; given btw 2 months and 18 months of age  
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Why does Haemophilus need to be grown on chocolate agar or with Staph?   it needs factors V and X for growth released from hemolyzed blood  
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PSEUdomonas causes...   wound and burn infections, Pneumonia (cystic fibrosis pts), Sepsis (black lesions on skin), External otitis (swimmer's ear), UTI, and hot tub fasciculitis  
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Tell me about Pseudomonas the bug...   Aerobic G(-) rod; Oxidase positive, non-lactose fermenting, Pyocyanin (blue-green pigment); Endotoxin (fever/shock) and Exotoxin A (activates EF-2); likes water  
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Which bugs inactivate EF-2 with their Exotoxins?   Pseudomonas and Diphtheria  
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How do you treat a Pseudomonas infection?   Aminoglycoside PLUS Extended Spectrum PCN (Piperacillin or Ticarcillin)  
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Helicobacter pylori cause   Gastritis and up to 90% of duodenal ulcers; Risk factor for Gastric Carcinoma; G(-) Rod, UREASE positive (creates an alkaline environment for survival)  
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How do you treat H. pylori infection?   Bismuth, Metronidazole, Tetracycline/Amoxicillin OR Metronidazole, Omeprazole, Clarithromycin (more costly)  
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Which bugs ferment lactose? KEE   Klebsiella, E. coli, Enterobacter...they make pink colonies on MacConkey's agar  
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ETEC   traveler's diarrhea; secretory, cAMP  
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EHEC   O157:H7; undercooked burger; Shiga-like toxin; HUS  
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EIEC   invades mucosa, inflammation, dysentery, no Abx indicated  
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EPEC   adheres to glycocalyx; disrupts microvilli; impairs absorption, causes diarrhea  
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Treatment of Traveler's diarrhea   Fluoroqunolones or TMP-SMX in kids  
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Salmonella vs. Shigella   both are non-lactose fermenters; both invade intestinal mucosa and can cause bloody diarrhea, BUT only salmonella can invade hematogenously, AND Shigella is more virulent (requiring fewer bugs to cause dz)  
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Salmonella has a reservoir in...   animals  
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How is Shigella transmitted?   Food, fingers, feces, flies  
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Cholera versus Pertussis toxins...   Cholera turns the "on" on (Gs; rice water), and Pertussis turns the "off" off (Gi; whoop); Both act via ADP ribosylation to permanently activate cAMP; Pertussis also promotes lymphocytosis by inhibiting chemokine receptors  
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Borrelia burgdorferi causes   Lyme dz; via tick bite (Ixodes)  
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Brucella spp. causes   Brucellosis (flu-like)/undulant fever; via dairy products and contact with animals  
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Francisella tularensis causes   Tularemia (flu-like); via tick bite, rabbits/deer in Arkansas, Missouri  
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Yersinia pestis causes   plague; flea bite; rodents, prairie dogs  
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Pasteurella multocida causes   Cellulitis; via animal bite; cats, dogs  
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Gardnerella vaginalis (pleomorphic G-variable rod) causes   greenish vaginal discharge w/fishy smell; nonpainful; "Clue" cells are epithelial cells covered in bacteria, visible under scope  
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How do you treat Vaginosis (gardnerella vaginalis)?   Metronidazole  
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Neisseria gonococci   Gonorrhea, Septic Arthritis, Neonatal conjunctivitis, PID: G(-), no capsule, glucose fermentation only, no vaccine, R plasmids, Opa proteins, attach to CD4 cells  
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Neisseria meningococci   Meningococcemia, meningitis, Waterhouse-Freidrichsen syndrome (bilateral Adrenal hemorrhage); polysaccharide capsule, maltose AND glucose fermentation, vaccine  
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Primary TB localizes where?   Ghon Focus (lower lobes) and Hilar nodes...forming Ghon Complex  
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Secondary Reactivation TB localizes where?   Apical lobe of lung in fibrocaseous cavitary lesion  
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Severe Bacteremia with TB cause?   Miliary TB and Death  
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Disseminated TB ends up in which organs?   CNS (parenchymal tuberculoma or meningitis), Vertebral body (Pott's dz), Lymphadenitis, Renal, GI  
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Mycobacterium kansasii   pulmonary TB-like symptoms  
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Mycobacterium scrofulaceum   cervical lymphadenitis in kids  
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Mycobacterium Avium Intracellulare   often resistant to multiple drugs; causes Disseminated Disease in AIDS when CD4 is very low (<60)  
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Mycobacterium tuberculosis and AIDS   usu presents when CD4 levels are near 200; resistant to multiple drugs; causes fever, night sweats, wt loss, hemoptysis  
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Mycobacterium leprae   acid fast; skin/superficial nerves; reservoir in US is Armadillos;  
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Lepromatous Leprosy   loss of eyebrows, nasal collapse, lumpy earlobe = Leonine Facies; worse Px; Failed cell-mediated immunity (TH1 --> MQ response)  
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Tuberculoid Leprosy   self-limited; TH2 --> lympho response  
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Treatment of Leprosy   long term oral DAPSONE; toxicity causes hemolysis and methemoglobinemia; Alternatively, use Rifampin or Clofazimine + Dapsone  
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Classic Triad of Rickettsial Infections...   Headache, Fever, Rash (vasculitis)  
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What kind of parasite is Rickettsiae?   obligate intracellular; needs CoA and NAD; most transmitted by arthropod and Treated by TETRACYCLINE  
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Which is the oddball in the Rickettsiae family?   Coxiella, which is aerosal and causes Pneumonia (Q FEVER); Tx = Tetracycline  
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Rocky Mountain Spotted Fever   Rickettsia rickettsii via Tick; Rash begins on palms and soles and migrates in; HA, Fever; endemic to East Coast; Tx = Tetracycline  
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What are the infections that cause rashes on the palms and soles of feet?   Rocky Mountain Spotted Fever, Syphilis, Coxsackie A (hand, foot, mouth)  
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Typhus (endemic = R. typhi via fleas; Epidemic = R. prowazekii via body louse)   Rash starts on body and spreads to limbs; HA, Fever; Tx = Tetracycline  
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Weil-Felix Reaction is an assay for?   antirickettsial antibodies which x-react with Proteus antigen; usu positive for Rocky Mt Spotted Fever and Typhus, NOT for Q fever  
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Mycoplasma pneumoniae causes..   atypical "walking pneumonia" in pts <30yo (insidious, HA, nonproductive cough, diffuse interstitial infiltrate looks worse than pt)  
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Where is Mycoplasma pneumoniae likely to cause an outbreak?   amongst military recruits and prisons; <30yo  
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What does Mycoplasma pneumoniae do in the lab?   high titer of Cold Agglutinins (IgM); Grows on Eaton's agar; has NO CELL WALL; membrane has CHOLESTEROL  
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Can you treat Mycoplasma pneumoniae with PCN?   NO!! They don't have a cell wall! You need to use: Tetracycline or Erythromycin  
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Chlamydiae are what kind of parasite?   Intracellular, causing mucosal infections; 2 forms: Reticulate and Elementary Bodies  
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Which form of Chamydiae is "Infectious?"   ELEMENTARY Bodies  
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What does Chlamydiae cause?   Arthritis, Conjunctivitis, Pneumonia, Nongonococcal urethritis, PID  
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How can you treat a Chlamydial infection?   Erythromycin or Tetracycline  
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How do you diagnose Chlamydiae?   Cytoplasmic Inclusions on Giemsa or Fluorescent Ab-stained smear  
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C. trachomatis causes   urethritis, PID  
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C. pneumoniae causes   atypical pneumonia, transmitted by aerosol  
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Chlamydia trachomatis serotypes A, B, C are a/w...   chronic infection; Blindness in Africa; "Africa, Blindness, Chronic"  
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Chlamydia trachomatis serotypes D-K are a/w:   urethritis/PID; ectopic pregnancy, neonatal pneumonia, or neonatal conjunctivitis  
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Chlamydia trachomatis serotypes L1, L2, L3 are a/w:   Lymphogranuloma venereum (acute lymphadenitis = Positive Frei test)  
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Spirochetes: BLT   Borrelia, Leptospira, Treponema; spiral w/axial filaments  
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Visualization of Borrelia spirochete:   aniline dyes (Wright's or Giemsa)  
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How can you visualize Treponema?   dark-field micrscopy  
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Lyme diseas has 3 stages...what are they?   1. Erythema chronicum migrans, flu-like; 2. neurologic (Bell's palsy), cardiac probs; 3. Autoimmune migratory polyarthritis  
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What is Lyme disease caused by?   Borrelia burgdorferi via Ixodes tick; mice are reservoirs, deer required for tick life cycle; usu in NE USA in summer  
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How do you treat Lyme disease?   Tetracycline  
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Syphilis is caused by and treated with what?   Treponema pallidum; Penicillin G  
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1* Syphilis   painless chancre; localized dz  
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2* Syphilis   Disseminated dz; consitutional symptoms, maculopapular rash (SOLES, PALMS); condylomata lata  
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3* Syphilis   Gummas, aortitis, neurosyphilis (Tabes Dorsalis, dorsal columns); Argyll Robertson pupil (responds to accommodation, not to light)  
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VDRL   screening test for syphilis; detects non-specific antibodies that react with beef cardiolipin; high false positives (ex: lupus, mono, hepatitis, RA, drugs, leprosy)  
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FTA-ABS   specific for Treponemes  
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Strychnine blocks inhibitory neuronal input by binding...   the glycine receptor  
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Tetanus toxin inhibits Renshaw cell release of...   glycine through presynaptic binding  
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What two toxins both have actions that prevent Glycine from inhibiting muscle contraction?   Strychnine and tetanus  
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Black widow spider and scorpian venom affect ACh release in what way?   they have presynaptic binding that causes an excessive release of ACh at the NMJ  
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Botulinum toxin does what to ACh release?   it inhibits the release of ACh at the NMJ  
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What does the alpha-Bungarotoxin do?   it blocks the ACh receptor at the NMJ by irreversibly binding to Nicotinic receptors  
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Atropine can treat what?   poisoning from insectisides and nerve gases  
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