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IDR study party 3

QuestionAnswer
What three things make up the Hemolytic uremic syndrome (HUS) •Acute renal failure •Thrombocytopenia •Micro-angiopathichemolytic anemia
What do the B-units of Shiga Toxin 1 and 2 bind to? 1-intestinal epithelial cells 2-glomerular endothelial cells
why do antibodies make E_EC worse? H; because shiga toxins are in the operon that is turned on by Ab.
________leading cause of septicemia caused by Gram-negative bacteria but is always the result of intestinal leakage due to trauma E. coli
treatment for S.typhi? quinolones
A bacteria that shows growth in APCs in lymph nodes can lead to very swollen “buboes” which can burst; septicemia. Y.pestis
In Y.pestis fleas express __________ at 25 degrees and rats express __________ at 37 degress. What is the function of each virulence factor hemagglutinin: clots blood plasminogen activator: lyses clots and spreads disease
treatment for Yersinia's? macrolides or quinolones
US outbreaks of _________________ are mainly associated with consumption of raw oysters V. parahaemolyticus
4 Things that cause necrotizing fasciitis: 1.Streptococcus pyogenes (Gram-positive coccus) 2.Clostridium perfringens (spore-forming, strictly anaerobic bacillus) 3.Acinetobacter baumannii (Gram-negative coccobacillus; extremely antibiotic resistant) 4.Vibrio vulnificius-Gram-negative curved rod
drug treatment for Vibrio's Macrolides and tetracyclines most commonly used to treat infections
Toxin in Vibrio that allows bacteria to adhere to intestinal epithelial surface toxin-coregulated pilus
What are the two bad strains of V. Cholerae 01, 0139
Why are the 01 and 0139 strains of V.cholerae more virlulent? becasue they have dubplications of the A/B toxin genes which means more expression of the toxins
3-6 liters of rice water diarrhea per day can lead to these sxm's in people with v.cholerae severe dehydration, possibly hypovolemic shock
is V. parahaemolyticus an infection or intoxication? infection
__________________ requires high salt concentrations to grow and so can’t grow on standard media. Virulent strains make a hemolysin that’s effective against human blood cells but not other mammalian blood cells V. parahaemolyticus
two ways a person can get necrotizing fasciitis from v. vulnificius traumatic inoculation or as a sequela of a gastroenteritis
_________________ are very fastidious, and can only be cultured in a “campy jar” that creates a 5% O2, 10% CO2 environment. samples found in gram stained stool. Campylobacters
B. burgdorferi 2 key virulence factors and their function OspA leads to the colonization of tick guts, expressed at 25 C OspC leads to the spread from tick to mammals, expressed at 37 C
Acrodermatitis chronica atrophicans is associated with what disease? Lyme disease (more often seen in Europe)
Laboratory Criteria for Diagnosis of lyme disease Isolation of Borrelia burgdorferi OR Demonstration of diagnostic levels of immunoglobulin M (IgM) or IgG antibodies to the spirochetes OR Significant increase in antibody titer between acute and convalescent serum samples
Clinical Case Definition of Lyme disease Erythema migrans (≈5 cm in diameter) AND/OR At least one late manifestation (i.e., musculoskeletal, nervous system, or cardiovascular involvement) and laboratory confirmation of infection.
what are the treatment of primary, secondary, tertiary lyme disease? Primary and secondary: penicillin and doxycycline tertiary: Ab not useful, manage sxm's
what is Weil's Disease A severe leptospirosis infection with liver, kidney, and meningeal involvement
_______________ is acquired by skin exposure to water containing urine from infected animals. Leptospirosis
treatment for leptospirosis Penicillin or penicillin + doxycycline
you get in a bar fight and pop the fucker in the teeth, what are you gonna get Eikenella corrodens
two bacteria you can get from a cat or dog bite that have similar sxm's Pasteurella multocida , Capnocytophaga
are very small, irregularly-shaped Gram-negative bacteria that can replicate inside of macrophages (Intracellular pathogen) Francisella tularensis
Brucella _________: Most severe symptoms in humans, found in sheep and goats melitensis
Brucella that is most likely to cause pneumonia and urdulant fevers. Most likely to disseminate to different body sites: joints, hearts Brucella melitensis
____________ can replicate in alveolar macrophages’ cytoplasm because they can escape the phagosome Legionella
_______________is a mild disease that is the most common consequence of a Legionella infection Pontiac fever
Gram - pleomorphic coccibacilli that can cause Bi-lateral inflammation with little to no sputum produced from cough Legionnaires’ Disease
Who gets Legionella infections and why? Especially older people with a history of smoking (Reduced ciliary beating) and alcohol consumption (Reduced liver function)
treatment of legionella? Treat with a macrolide or a quinolone, NOT a beta-lactam
are small, Gram-negative bacteria that are normal oral flora in humans, and very inflamed infection if traumatically inoculated under skin (like from a bite) Eikenella corrodens
see this in little kids where they bite each other to resolve conflict Eikenella corrodens
normal oral flora in carnivorous domestic animals, like cats and dogs Pasteurella multocida
most common symptom of Pasteurella multocida cellulitis and swollen lymph node closest to bite site
Pasteurella cultured best on what kind of media blood or chocolate agar
intracellular bacteria that must have CO2 to grow in culture; contracted from cat/dogs with symptoms similar to Pasteurella Capnocytophaga
causative agent of cat scratch fever; swollen, warty-like lesion at site of cat scratch or bite (or broken skin infected by cat flea feces) progresses to lymphadenopathy of region lymph node, slight fever Bartonella henselae
abrupt onset of fever, headache, mylagias and joint pain 2-10 days following bite, and ~3-4 days after these symptoms, petechial progressing to purulent papular rash develops on hands and feet (even if distant from original bite site) Streptobacillus monoliformis
criteria to diagnose Streptobacillus monoliformis rodent bite + rash + arthralgias
gram stain of Streptobacillus monoliformis looks like what plemorphic - lots of different shapes
treatment for Streptobacillus monoliformis? treat with any drug (no resistance reported) ASAP
very small, irregularly-shaped Gram-negative bacteria that can replicate inside of macrophages Francisella tularensis
which 2 bacteria escapes from the phagosome, replication in cytoplasm, and cause lots of NOD-protein activated inflammation & death of cells Francisella, Brucella
3 key symptoms of Francisella tularemia ulceroglandular tularemia, oculoglandular tularemia, pulmonary tularemia
what animals does Francisella infect? infects rabbits, cats, and Ixodes ticks
where is Francisella most common Southern Midwest
intracellular bacteria that grow in reproductive tissues of non-human mammals, can be aersolized from those body fluids, and then infect humans who inhale them Brucella
can transition from “rough” strains that lack the O-polysaccharide of LPS to “smooth” strains that have lots of O-polysaccharide Brucella
Undulant fever” of __________ due to immune responses to O-chain of smooth strain switch to rough switch to new O-chain new immune response….and the cycle repeats Brucella
can’t survive outside of amoeba so you have to be able to inhale this as an infected amoeba Legionella
create a double-layer phagosome, that never fuses with a lysosome (Wrapped up in layers of RER) Legionella
mild disease that is the most common consequence of a Legionella infection Pontiac Fever
a much more serious condition experienced by some Legionella-infected patients following their initial “Pontiac fever” symptoms Legionnaire's Disease
Who gets Legionella infections? older people with a history of smoking and alcohol consumption.
how do I get a legionella infection? Anything that aerosolizes standing cool fresh (not chlorinated) water can inhalation of Legionella-infected amoebae
how to visualize/detect legionella Fluorescent stains or “silver staining” used to visualize bacteria in sputum or BAL samples. Legionella-specific antigens passed in urine of infected patients for 1 month – 1 year. PCR for Legionella-specific genes in sputum or BAL sample also works.
how to grow legionella Grow on buffered-charcoal yeast extract (BCYE) agar with antifungal additives. Legionella is very fastidious, and takes >1 week to grow into glossy white “ground glass” colonies.
causes Rocky Mountain Spotted Fever, spread by American dog tick. Symptoms = high fever, classic rash, myalgias, headaches (possibly with photophobia) Rickettsia rickettsii
what causes High fever, severe headache, mylagias + “rose spots” rash because of vasculitis from growth in endothelial cells High fever lasts ~2 weeks, mylagias can persist for 2 – 3 months Rickettsia prowazekii
Spread by human body lice, (humans main host); also in squirrels in eastern US/Canada Rickettsia prowazekii
which bacteria causes symptoms that can recur years after initial infection because of declining immune response, but are much milder on recurrence (=Brill-Zinsser disease) R. prowazekii
demographic likely to get R. prowazekii homeless
Endemic/murine typhus symptoms look similar to those caused by R. prowazekii but are less severe, with symptoms lasting <1 month and not recurring R. typhi/R. felis
spread by Ixodes species ticks and by “Lone Star” ticks that fed on infected mice or deer Ehrlichia and Anaplasma
“Morulae” are clumps of bacteria growing in vacuoles in _______ and _______ infected WBC cells that can be seen in Giemsa-stained samples of patient WBCs (sometimes). Ehrlichia and Anaplasma
causes “Q fever” Coxiella burnetii
asymptomatic; most common presentation mild flu-like symptoms. Can cause chronic endocarditis. Treat with doxycycline. Coxiella burnetii
_____ can be inhaled but all _____ must be transmitted via arthropod bite coxiella, rickettsia and erlichia
Mycoplasma and Ureaplasma can make their own ______, but Chlamydia and Chlamydophila can’t and must use____ made by their host cells. ATP
the #1 cause of “atypical” or “walking” pneumonia and is also frequently carried asymptomatically. Mycoplasma pneumoniae
: a conjunctivitis caused by Chlamydia trachomatis that can lead to corneal scarring and blindness Trachoma
symptoms like gonorrhea, but with a thinner discharge. It’s more likely to be asymptomatic in both men and in women than gonorrhea is. chlamydia
painless lesions accompanied by regional lymph node swelling and painful lymph nodes close to initial infection site 1 – 4 weeks post-infection. lymphogranulum venerum
caused by the dimorphic Malassezia furfur, which infects skin and alters color. Pityriasis (Tinea) versicolor
caused by Hortaea werneckii, causes skin to darken. Tinea Nigra
superficial infection of the hair shaft caused by Piedra hortae. Black piedra
fungal infection of fingernails and toenails caused by Trichophyton rubrum and T. mentagrophytes. Onychomycosis
Dermatophytes don't typically penetrate deeper, and acquire nutrition because they are ______ keratinolytic
an infection that forms warty pigmented lesions which grow outward from site of introduction Chromoblastomycosis
Mycetomas including the most common one, _________, may be painful or not, but even painless ones can do a lot of damage to deeper tissues and bones Madura foot
Fungi are cultured on specialty media, especially SDA
what are main stains used to visualze fungi with microscopy Silver stain and Calcofluor White
bind to and lyse ergosterol in fungal cell membrane membrane destruction polyenes i.e. amphotericin B
stop synthesis of ergosterol, can be used topically or taken orally azole
stop synthesis of beta-glucans in fungal cell wall, can only be administered via IV echinocandins like capsofungin
______ is converted to ________ in cell by cytosine deaminase, 5-FU stops DNA and RNA synthesis in fungi flucytosine, 5fu
_______ interfere with ergosterol synthesis at an earlier step than triazoles do. Because of potential for renal damage, they’re typically only used topically allylamines
Example of allylamine Terabinafine, the active ingredient in the anti-Athlete’s foot infection Lamisil.
Inhaled mold spores go to alevoli, differentiate into yeast forms which avoid phagocytosis based on size and WI-1 shedding Blastomyces
Disseminated disease most likely in pregnant women, Pacific islanders, those of African descent *and immunocompromised Coccidioides
cultured and characterized microscopically as a mould producing both tuberculate macroconidia and microconidia H. capsulatum
soil fungus endemic to river valleys worldwide, and to the Mississippi, Missouri and Ohio river valleys in the US. This soil is enriched in nitrate from bird droppings. Histoplasma capsulatum
Pulmonary infection flulike symptoms with fever, chills, headache, cough Disseminated disease can  ulcers on oral mucosa, skin, hepatosplenomegaly Histoplasma
1,3 alpha-glucan in cell wall prevents killing by neutrophils Paracoccidioides
May have very prolonged latency (>40 years) between initial infection and onset of disseminated disease. Paracoccidioides
A KOH wet mount of pus or superficial scrapings from mucosal lesions detects "Pilot’s wheel" type yeast cells. The “Pilots wheel” is a mother cell producing multiple daughter cells by budding.   Paracoccidioides
A typical infection by _________ involves traumatic wounding and soil, such as with rose gardeners or people who work with sphagnum moss or wood. Sporothrix schenckii
forms narrow-based yeast cells in tissue and delicate hyphae with a cluster (“flowerette”) of spores (spores) at the end of a narrow stalk. S. schenckii
Created by: moore420
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