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Z - Micro 04

Micro 04

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
Created by: christinapham



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