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Z - Micro 05

Micro 05

Pertussis toxin A and B subunits; G protein --> andenylate cyclase --> inc cAMP --> inhibits macrophage and neutrophil phagocytosis
When is patient with whooping cough contagious? 1. catarrhal stage - regular cold like sx's, most contagious; 2. paroxysmal stage - big cough; 3. convalescent - recovering, no longer contagious
What to collect whooping cough specimens with? Why? Calcium alginate swab because B. Pertussis won't grow on cotton.
Bordet-Gengou medium potato blood,and glycerol agar; B. pertussis.
Patient over 50 yo, smoker, with pneumonia Legionella pneumophila
Water-loving bacteria Pseudomonas and Legionella
Mists - grocery stores, restaurants Legionella pneumophila
atypical pneumonia with kidney problem (hypoNa, hyperK, metabolic acidosis Legionella pneumophila
How can a patient with Legionella atypical pneumonia get hyponatremia? Legionella pneumophila affects kidneys --> interstitial nephritis --> knocks off juxtaglomerular apparatus --> low renin, low aldosterone --> lose salt in urine --> hyponatremia
How to treat Legionella atypical pneumonia? Erythromycin
Bipolar staining pattern Yersinia pestis
Patient with red hot painful lymph nodes, esp inguinal LNs, blackish discoloration from hemmorrhaging under skin Yersinia pestis, bubonic plague
well demarcated hole in skin with black base, red hot painful lymph nodes Tularemia; Francisella tularensis
Handling rabbits --> pneumonia Tularemia; Francisella tularensis
What is the vector for tularemia? tick; Francisella tularensis
drinking unpasteurized milk, worker in meat packing industry Brucella
aborted animal placenta Brucella
camping in Arizona or Mexico, swollen LNs Yersinia pestis, bubonic plague
Camping in Western U.S., rustic mountain cabin, fever that relapses Borrelia recurrentis (relapsing fever). This bug is a master at changing its antigens --> cause of the relapses. Must get blood samples during fever episodes only.
Consuming cow or goat products in Mexico Brucella
Illness with rise in temp during the day, declining at night Undulant fever --> Brucellosis, Brucella
Cat bite Pasteurella multocida (don't close the wound! --> anaerobic environment good for P multocida)
Cat bite --> low grade fever and malaise Bartonella henselae, cat scratch disease. Causes a mixed T and T cell hyperplasia in the lymph nodes --> granulomatous microabscesses. See with silver stain. Can also cause bacillary angiomatosis.
Stellate granulomas with central necrosis Bartonella henselae, cat scratch disease. Causes a mixed T and T cell hyperplasia in the lymph nodes --> granulomatous microabscesses. See with silver stain. Can also cause bacillary angiomatosis.
Why are Chlamydia and Rickettsia not considered viruses? They have both DNA and RNA while viruses have either or
Diagnosis of conjunctivitis in babies born to moms with Chlamydia infection inclusion bodies in the cytoplasm of conjunctival cells (initial bodies -- the ones that inhibit phagocytosis and reproduces itself)
Organisms that cause atypical pneumonia viruses, Mycoplasma pneumoniae, Chlamydia psittaci, Chlamydia pneumoniae
What is atypical pneumonia vs. regular pneumonia Regular (Strep pneumoniae): appears very sick, coughs up lots of pus, lungs have infiltrate, rales; Atypical: fever, headache, dry cough, no pus, normal lung exam, streaky infiltrate on lung X-ray.
Typical pneumonia in elderly Moraxella catarrhalis (G-diplococcus)
Where do Rickettsia replicate vs. Chlamydia? Rickettsia: cytoplasm of ENDOthelial cells. Chlamydia: endosomes of columnar EPIthelial cells.
Rickettsia - ticks (arthropod) Rocky Mountain Spotted Fever, Rickettsia rickettsii
Rickettsia - louse Epidemic typhus
Rickettsia - flea Endemic typhus
Patient from SouthEastern US (Appalachian range) comes in with fever, conjunctival redness, headache and rash on wrists, palms, ankles, soles. Rocky Mountain Spotted Fever, Rickettsia rickettsii
Why would removing a tick early lead to prevention of Rocky Mountain Spotted Fever? Tick transmits the Rickettsia within its first 6 to 10 hours of feeding, so if you remove before the transmission, you can prevent the disease
Exposure to flying squirrel in Texas --> abrupt fever 2 weeks later, small pink macules on trunk, palms and soles spared Epidemic typhus
Soldier in the trenches, febrile episodes every 5 days Bartonella quintana
Work with cow hides, pneumonia, no rash Q Fever, Coxiella burnetti, has endospore, must use host's ATP
Name the three genera of spirochetes 1. Treponema, 2. Borrelia, 3. Leptospira
Painless chancre with nontender LN swelling, rash on palms and soles and mouth Treponema pallidum (syphilis)
T or F: Antimicrobial therapy can make gummatous syphilis in bones resolve. TRUE
T or F: Antimicrobial therapy can make cardiovascular syphilis (aortic aneurysm and aortic valve insufficiency) resolve. FALSE
CSF analysis yeilds: high neutrophil count, high protein, low glucose Acute bacterial meningitis
CSF analysis yeilds: high lumphocyte count, high protein, low glucose Subacute meningitis: Mycobacterium TB and Treponema pallidum (neurosyphilis)
Hx of syphilis, loss of reflexes and loss of pain and T sensation Tabes dorsalis, damage to posterior columns and dorsal roots of the spinal cord
Pupil constructs during accommodation (near vision) but does not react to light Argyll-Robertson pupils, midbrain lesion, suggests syphilitic Tabes dorsalis or general paresis
In mom that has syphilis, can congenital syphilis be prevented? Treponema pallidum infxn doesn't damage fetus until 4th month, so treating the mother before then can prevent congenital syphilis.
VDRL/RPR Nonspecific tests for Treponema pallidum. Infection --> cellular damage --> release lipids including cardiolipin and lecithin --> measure the abs that bind to these lipids (in blood and CSF). May have false +
FTA-ABS Specific tests for Treponema pallidum --> soak up all abs against non-pathogenic Treponema strains, then use killed pathogenic Treponema as antigen and see if patient serum has the abs to bind to these antigens
Why would patients with syphilis seem to get worse with abx treatment? killed Treponema releases pyrogen. Sx's should resolve.
Condyloma latum painless wartlike lesion, vulva or scrotum, packed with spirochetes that ulcerates --> extremely contagious
Created by: christinapham



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