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FA complete review part 2 Gram Positive and Gram Negative organism

Partial reduction of hemoglobin causes greenish or brownish color without clearing around growth on blood agar. Alpha-hemolytic anemia
Which bacterial is included in Alpha-hemolytic bacteria? 1. Streptococcus pneumoniae 2. Viridans streptococci
Which a-hemolytic bacteria is Optochin resistant? Viridans streptococci
Complete lysis of RBCs --> clear area surrounding colony on blood agar. Beta-hemolytic bacteria
What are the 3 most common bacterial denomited Beta-hemolytic? 1. Staphylococcus aureus 2. Streptococcus pyogenes 3. Streptococcus agalactiae
Catalase (-), bacitracin sensitive, gram + Strept pyogenes
Which beta-hemolytic bacteria is bacitracin resistant? Streptococcus agalatiae
Group A streptococcus = Strep pyogenes
Complete bacterial description of S. aureus Gram (+), B-hemolytic, catalase (+), coagulase (_) cocci in clusters
What virulence factor is seen in S. Aureus? Protein A
Where are the common locations for S. aureus colonization? Nares, ears, axilla, and groin
What are common complications of an S. aureus infection? 1. Inflammatory disease 2. Toxin-mediated disease 3. MRSA
What is the clinical manifestation of description of S. aureus - induced inflammatory disease? Skin infections, organ abscesses, pneumonia, endocarditis, septic arthritis, and osteomyelitis
What are Toxin-mediated diseases by S. aureus? TSST-1, scalded skin syndrome, rapid-onset food poisoning
What is MRSA? Methicillin-resistant S. aureus
What are common complications of MRSA infection? Serious nosocomial and community-acquired infects
Why is MRSA resistant to methicillin and nafcillin? Altered penicillin-binding protein
Where does the TSST-1 superantigen bind to? MHC II and T cell receptors --> polyclonal T cell activation
Main signs and symptoms of Staphylococcal toxic shock syndrome (TSS)? Fever, vomiting, rash, desquamation, shock, and endo-organ failure
What are common causative association of Staphylococcus TSS? Prolonged use of vaginal tampons or nasal packaging
Streptococcus TSS is associated with an __________________, unlike Staphylococcal TSS. Painful skin infection
Staph epidermidis description Gram (+), catalase (+), coagulase (-), urease (+) cocci in clusters
S. epidermidis is Novobiocin ______________________ and it does not ferment ______________. Sensitive; Mannitol
Which staph specie ferments Mannitol? Aureus
What is commonly infected by S. epidermidis? Prosthetic devices (hip implant, heart valve), and IV catheters by proeicudn adherent biofilms
What aids in the infections of S. epidermidis? Biofilm production
Novobiocin resistant. Staph saprophyticus
Which staphylococcal specie is found in normal flora of female genital tract and perineum? Staph saprophyticus
S. saprophyticus is: The 2nd MCC of uncomplicated UTI in young women
Gram (_), lancet-shaped diplococci Streptococcus pneumoniae
S. pneumoniae is ____________________ and ______________________. Encapsulated and Optochin sensitive
What mnemonic is often used to summarize some clinical manifestations of S. pneumoniae? MOPS
What does MOPS stand for? M. meningitis O. Otitis media (in children) P. Pneumonia S. Sinusitis
Pneumococcus is associated with _____________ sputum. "rusty"
What kind of patients have increased risk of sepsis by S. pneumoniae? Sickle cell disease patients and those asplenic patients
A S. pneumoniae losses it capsule. It means? NO virulence
Which alpha-hemolytic gram (+) bacteria is Optochin resistant? Viridans group streptococci
Which species of Viridans cause dental caries? S. mutans and S. mitis
What viridian streptococci specifically creates dextrans? S. sanguinis
S. sanguinis creation of Dextrans causes: Dextrans to bind to fibrin-platelet aggregates on damaged heart valves causing Subacute bacterial endocarditis
What type of endocarditis is associated with S. sanguinis? Subacute Bacterial endocarditis
A Group A strep infection causes: 1. Pyogenic manifestations 2. Toxigenic conditions 3. Immunologic diseases
What are the clinical manifestation of Pyogenic Group A infection? Pharyngitis, cellulitis, impetigo ("honey-crusted" lesion), and erysipelas
Scarlet fever, toxic shock-like syndrome, and necrotizing fasciitis, are: S. pyogenes toxigenic manifestations
What thow Immunologic conditions are associated with S. pyogenes infection? Rheumatic fever and PSGN
S. pyogene-induced pharyngitis can cause __________________ if left untreated. Rheumatic fever
Rheumatic fever is often preceded by: Pyogenic Pharyngitis
What is the most common preceding S. pyogenes manifestation leading to PSGN? Impetigo
What is Scarlet Fever? Blanching, sandpaper-like body rash, strawberry tongue, and circumoral pallor i the setting of group A streptococcal pharyngitis (erythrogenic toxin (+).
Gram (+) cocci, bacitracin resistant, B-hemolytic, colonizes vagina. Streptococcus agalactiae (group B streptococci)
What are the possible results of a S. agalactiae infection in a baby? Pneumonia, Meningitis, and sepsis
Which factor is produced by Group B streptococcus? CAMP
What is the role of CAMP? Enlarges the area of hemolysis form by S. aureus
Hippurate test (+). PYR (-) Streptococcus agalactiae (group B streptococci)
Woman intrapartum, (+) S. agalactiae should be given? Intrapartum penicillin prophylaxis
Which weeks are usual times for screening pregnant mother for S. agalactiae infection? 35-37 weeks
S. gallolyticus is a subspecies of: Streptococcus bovis
What conditions or diseases are associated to S. gallolyticus? Bacteremia and Subacute endocarditis
What cancer type is associated with S. gallolyticus? Colon cancer
What area is colonized by Strep bovis? Gut
What are the 2 most common species of Enterococci? E. faecalis and E. faecium
What are some features of Enterococci? - Resistant to penicillin G - Cause: UTI, biliary tract infections, and subacute endocarditis
Catalase (-), PYR (+), and variable hemolysis. Enterococci
What does VRE stand for? Vancomycin-resistant enterococci
VRE are a imporntac cause of: Nosocomial infections
Entero = intestine
Which are more resilient, Streptococci or Enterococci? Enterococci
Strepto = Twisted (chains)
What organism is gram (+), spore-forming rod that produces anthrax toxin? Bacillus anthracis
What is caracheirstic of B. anthracis' capsule? Only one with a polypeptide capouse that contains D-glutamate
The description of colonies as "Medusa head" refers to: Bacillus anthracis
What are the tow types of B. anthracis? 1. Cutaneous anthrax 2. Pulmonary anthrax
What is th clinical presentation of Cutaneous anthrax? Painless papules surrounded by vesicles --> ulcer with black eschar --> not common to progress to bacteria and death
What is another name given to Pulmonary anthrax? Woolsorter's disease
CXR may show a widened mediastinum. Dx? Pulmonary anthrax
Pathogenesis of Pulmonary anthrax: Inhalation of spores --> flu-like symptoms that rapidly progress to fever, pulmonary hemorrhage, mediastinitis, and shock
Common gram positive rod that causes food poisoning? Bacillus cereus
Spores of which organism are often seen in Cooking rice? Bacillus cereus
What causes reheated rice syndrome? Spore infection by B. cereus
What is the preformed toxin of B. cereus? Cereulide
What is the clinical presentation of the B. cereus infection of diarrheal type? Waterry, nonbloody diarrhea and GI pain within 8-18 hr
Clostridia (all) are: Gram (+), spore-forming, obligate anaerobic rods
Where is GABA and glycine secreted from? Renshaw cell in Spinal cord
What is trismus? Lockjaw
What is sardonicus? Raised eyebrows and open grin
What is Opisthotonos? Spasms of spinal extensors
What condition is seen with Trismus, Sardonicus, and Opisthotonos? Tetanus
Heat-labile toxin that inhibits ACh release at the NMJ causing botulism. Organism? C. botulinum
What is the a common mode of ingestion of Botulinum toxin in babies? Ingestion of spores in honey
What are the 4 D's of Botulism? Diplopia, Dysarthria Dysphagia Dyspnea
What specific symptoms of Botulism are treated with local botox injections? Dystonia, achalasia, and muscle spasms.
What is a better description of the alpha toxin produced by C. perfringens? Lecithinase, a phospholipase
What are the clinical manifestations of C. perfringens? 1. Myonecrosis (gas gangrene) which presents with tissue crepitus and hemolysis
How many toxins are produced by C. difficile? 2 toxins
What is Toxin A of C. difficile? An enterotoxin, which binds to brush border of gut and alters fluid secretion.
What is the action of Toxin B of C. difficile? Cytotoxin, which disrupts cytoskeleton via actin depolymerization
How does Toxin B of C. difficile causes disruption of the cytoskeleton? Via actin depolymerization
What organism causes Pseudomembranous colitis? C. difficile
What is the MCC of Pseudomembranous colitis? Secondary use of antibiotic, especially clindamycin or ampicilin
Which are often the most associated antibiotics that cause Pseudomembranous colitis? Clindamycin and Ampicillin
What is the treatment of C. difficile infection? Metronidazole or oral vancomycin
Treatment for recurrent cases of Pseudomembranous colitis (C. diff infection)? Fidaxomicin, or fecal microbiota transplant
What encodes for the diphtheria exotoxin? B-prophage
Coryne = Club shaped
Color of Corynebacterium diphtheriae colonies on cysteine-tellurite agar? Black
What are the clinical manifestations of C. bacterium? 1. Pseudomembranous pharyngitis (grayish-white membrane) 2. Lymphadenopathy, myocarditis, and arrhythmias
Common test for Corynebacterium diphtheriae toxin (+) Elek test
What type of vaccine is made from Corynebacterium diphtheria? Toxoid
What are the ABCDEFG of Corynebacterium diphtheria? A. ADP-ribosylation B. Beta-prophage C. Corynebacterium D.- Diphtheriae E. Elongation Factor 2 G. Granules (blue and red)
What color are granules found in C. diphtheriae? Blue and red
What biochemical process causes the elongation of factor 2 by C. diphtheriae exotoxin? ADP-ribosylation
Listeria is an __________________________________. Gram (+), facultative intracellular rod
What are the MC modes of acquiring Listeria monocytogenes? 1. Ingestion of unpasteurized dairy products and cold deli meats 2. Transplacental transmission 3. Vaginal transmission during birth
Which bacteria grows well at refrigerator temperatures 4-10 C ? Listeria monocytogenes
How are the "rocket tails" in Listeria made? Via actin polymerization that allow intracellular movement and cell-to-cell spread across cell membranes, thereby avoiding antibody
Tumbling motility Listeria monocytogenes
"Cold enrichment" Listeria monocytogenes
What is caused by L. monocytogenes infection? 1. Amnionitis, septicemia, and spontaneous abortion in pregnant women 2. Granulomatosis infantiseptica 3. Neonatal meningitis, 4. Meningitis in immunocompromised
What is the treatment for Listeria monocytogenes infection? Ampicillin
Nocardia and Actinomyces both are: Gram (+) and form long, branching filaments resembling fungi
Nocardia is: Anaerobe, acid fast (weak), and is found in soil
Where is Nocardia often or most commonly found? Soil
What is caused by a Nocardia infection? - Immunocompromised --> Pulmonary infections (mimic TB) - Immunocompetent --> Cutaneous infections after trauma
Common spread of Nocardia infection is to the _______. CNS
What is the treatment for Nocardia infections? TMP-SMX (sulfonamides)
Where is Actinomyces often found? Normal oral, reproductive, and GI flora
Actinomyces is _______________________ and not __________________. ANAerobe ; acid fast
What are some clinical manifestation of Actinomyces infection? 1. Oral/facial abscesses that drain through sinus tracts 2. Yellow "sulfur granules" 3. PID with IUDs
What organism is associated with dental caries/extraction ian dother maxillofacial trauma, along with oral abscesses? Actinomyces
Yellow "sulfur granules" Actinomyces
SNAP Sulfonamides --------Nocardia Actinomyces ------- Penicillin
Common subtypes of Mycobacterium? 1. M. tuberculosis 2. M. avium-intracellulare 3. M. scrofulaceum 4. M. marinum
Which mycobacteria is often resistant to multiple drugs? M. tuberculosis
Which mycobacteria specie causes disseminated non-TB disease in AIDS? M. avium-intracellulare
What antibiotic is used in prophylaxis of M. avium intracellulare infection in AIDS patients? Azithromycin
M. scrofulaceum causes: Cervical lymphadenitis in children
Hand infection in aquarium handlers is often due to __________________ infection. M. marinum
All mycobacteria are _____________________ organisms. Acid-fast
What are the most significant TB symptoms? Fever, night sweats, weight loss, cougu (non productive or productive), and hemoptysis
Shape of the Cord factor in Mycobacteria? Serpentine cord
"Serpentine cord" indicates: M. Tuberculosis infections
What is the role of the Cord factor of M. tuberculosis? 1. Activates macrophages (promote granuloma formation) 2. Induces release of TNF-alpha
What are the components of the Ghon complex? Hilar nodes and Ghon focus
Where in the lung are Ghon focus most commonly located? Mid/lower lobes
Which lung lobes usually develop secondary tuberculosis cavitary lesions? Upper lobes
What does a PPD (+) indicate? Current infection or past exposure
What does a negative PPD test indicate? NO infection and in sarcoidosis or HIV infection
Which pathological conditions can produce a negative PPD test? 1. Sarcoidosis 2. HIV infection (especially with low CD4+ count)
What is an important characteristic of Secondary TB? Caseating granulomas with central necrosis and Langerhans giant cell
Caseating granulomas with central necrosis are key sign of ___________. Secondary Tuberculosis
Secondary TB that is disseminated into the vertebrae. Dx? Pott Disease
Another name for Leprosy? Hansen disease
Why bacteria causes Leprosy? Mycobacterium leprae
What are some features of M. leprae? 1. Acid-fast bacillus 2. Likes cool temperatures 3. Produces a "glove and stocking" loss of sensation 4. Cannot be grown in vitro
Which two lab techniques are used to Dx Leprosy? Skin biopsy and PCR
What is the MC reservoir of M. leprae in the U.S.A? Armadillos
What are the 2 forms of Hansen disease? 1. Lepromatous 2. Tuberculoid
Lepromatous leprosy: Presents diffusely over skin, with leonine facies, and is communicable. It can be lethal Low cell-mediated immunity with a humoral Th2 response
What are the characteristics of Tuberculoid leprosy? Few hypoesthetic, hairless skin plaques; High cell-mediated immunity with Th1 immune response and low bacterial load
What is the treatment for Leprosy? Tuberculoid form: Dapsone and Rifampin Lepromatous form : Dapsone and Rifampin + CLOFAZIMINE
Gram negatives are stained _________________. (color) Pink
What characteristic have all gram (-) comma-shaped rods? Oxidase (+)
What are the 3 comma shaped gram negative organisms? 1. Campylobacter jejuni 2. Vibrio cholerae 3. Helicobacter pylori
Grown in 42 C. C. jejuni
C. jejuni features: Gram negative, Comma shaped Oxidase (+) Grows in 42 Celsius
What is a key characteristic of V. cholera growth? Grows in alkaline media
What organism, gram negative, grown in basic media? Vibrio cholerae
H. pylori is ___________-shaped, oxidase _________, and produces ________________. Comma-shaped; Oxidase (+); Urease
Which gram negative comma-shaped rod produces urease? H. pylori
What are the 4 MC shpates of gram negative bacteria? Diplococci, Coccobacilli, Bacilli, and Comma-shaped
WHich are the gram (-) diplococci? N. gonorrhoeae and N. meningitidis
N. meningitis is: Gram negative, diplococci, Aerobic, and (+) Maltose fermentation
N. gonorrhoeae does not ferment _________________. Maltose
Which a lesser known Maltose negative gram (-) diplococci? Moraxella
N. gonorrhoeae shares most laboratory characteristics with? Moraxella
Which are the 2 MC gram negative coccobacilli? 1. H. influenzae 2. Bordetella pertussis
Which are 3 not so common gram negative coccobacilli? Pasteurella, Brucella, and Francisella tularensis
What is the first test done to different gram negative bacilli? Lactose fermentation
Lactose (+) fermenters then are divided into: Fast and slow fermenters
Which are the most common gram negative fast lactose fermenters? E. coli and Klebsiella
What is a key distinguish features of Citrobacter and Serratia? Slow lactose fermenters
If bacilli are Lactose negative (non-fermenters), which is the next applied test to differentiate bacteria? Oxidase
Which bacteria is a lactose non fermenter, oxidase positive, gram negative bacilli? Pseudomonas
Oxidase positive lactose fermenter bacilli, are finally categorized as: H2S producers or non produces
Salmonella is a H2S __________________. Producers
Which are the 2 H2S non-production? Shigella and Yersinia
According to the Gram (-) algorithm, E. coli is: Gram negative bacilli, Fast Lactose fermenter
What characteristics are shared by all Neisseria species? Metabolize glucose and produce IgA proteases. 2. Contain lipooligosaccharides (LOS) with strong endotoxin activity
N. gonorrhoeae is often intracellular, as it is found within ___________________. Neutrophils
N. meningitidis ferments _______________ and _______________. Glucose and Maltose
Which Neisseria species has a polysaccharide capsule? Meningococci
Which features are present in N. meningococci and not in N. gonorrhoeae? Polysaccharide capsule, maltose fermentation, and Vaccine
Mode of transmission of N. meningitidis? Respiratory and oral secretions
What are conditions caused by N. meningococci? 1. Meningococcemia with petechial hemorrhages and gangrene of toes 2. Meningitis 3. Waterhouse-Friderichsen syndrome
What is the prevention or prophylaxis of N. meningococcal infection? Rifampin, ciprofloxacin, or ceftriaxone
Most commonly used treatment of N. meningococci infection? Ceftriaxone or penicillin G
What penicillin is used to treat N. meningitidis? Penicillin G
What are the most common complications due to N. gonorrhoeae infection? Gonorrhea, septic arthritis, neonatal conjunctivitis, PID, and Fitz-Hugh-Curtis syndrome
N. gonococci causes which important syndrome? Fitz-Hugh-Curtis syndrome
N. meningococci causes with important syndrome? Waterhouse-Friderichsen syndrome
What is seen in Waterhouse-Friderichsen syndrome? Adrenal insufficiency, fever, DIC, and shock
What measures are taken to prevent or reduce N. gonorrhoeae infections? Condoms in sexual transmission, and erythromycin eye ointment prevent neonatal blindness
What is the treatment of N. gonorrhoeae infection? Ceftriaxone
Which antibiotic is often co-adiminter with Ceftriaxone in N. gonorrhea infections? Azithromycin or doxycycline
Why is azithromycin added to treatment of N. gonorrhoeae? Due to possible chlamydia coinfection
Which a common small gram negative coccobacillary rod? Haemophilus influenzae
Which type or form of H. influenzae is most common to cause disease? Nontypeable (unencapsulated)
Which type of H. influenzae has a vaccine developed? Type b
What type of virulence factor is produced by H. influenzae? IgA protease
Which common gram positive bacteria can be co-cultured with H. influenzae to promote its growth? S. aureus
Why is Staph aureus co-cultured with H. influenzae? Provides factor V via RBC hemolysis
What factors are needed for culture growth of H. influenzae? Factors V (NAD+) and X (hematin)
What are some common conditions caused by H. influenzae infection? EMOP: E - epiglottitis M - Meningitis O - Otitis media P - pneumonia
What signs are seen in Epiglottitis? 1. Epiglottis appears "cherry red" 2. Lateral neck X-ray shows the "thumb sign"
What is the treatment for H. influenzae mucosal infections? Amoxicillin +/- clavulanic acid
H. influenzae meningitis is treated with ______. Ceftriaxone
What is H. influenzae vaccine conjugated with: Diphtheria toxin or other protein
At what age is H. influenzae type b vaccine applied? Between 2-18 months of age
What are the virulence factors of Bordetella pertussis? 1. Pertussis toxin 2. Adenylate cyclase toxin 3. Tracheal cytotoxin
What is the function of Pertussis toxin? Disables Gi
Why is Bordetella pertussis infection often confused by a viral infection? Due to lymphocytic infiltrate results in form immune response
Which vaccines prevent Bordetella pertussis infection? Tdap and DTaP
What is the 1st stage of Bordetella pertussis infection? Catarrhal -- low-grade fever, and Coryza
The "whooping cough" in B. pertussis infection is seen in which stage of the infection? Paroxysmal (2nd)
Describe the Paroxysmal stage of B. pertussis infection: Paroxysms of intense cough followed by inspiratory "whoop", posttussive vomiting
What stain is used for Legionella? SIlver stain. Grow on charcoal yeast extract medium with iron and cysteine.
What is the most common way to detect legionella? Antigen in the urine
What important electron imbalance is seen in Legionella pneumophila? Hyponatremia
What is the MC mode of transmission of Legionella? Aerosol transmission from environmental water source habitat (AC systems, hot water tanks)
Legionella pneumophila treatment? Macrolide or quinolone
What is Legionnaires' disease? Severe pneumonia (often unilateral na lobar), fever, GI, an CNS symptoms.
Mild flu-like syndrome due to Legionella pneumophila infection? Pontiac disease
Low sodium levels in the blood is a key characteristic of ____________________________ infection. Legionella pneumophila
What gram negative oxidase (+) organism is often described to produce a grape-like odor? Pseudomonas aeruginosa
What is Ecthyma gangrenosum? Rapidly progressive, necrotic cutaneous lesion caused by Pseudomonas bacteremia. Most likely seen in immunocompromised
What does the mnemonic PSEUDOMONAS describe? Condition and features caused by Pseudomonas aeruginosa: P- Pnuemonia S- Sepsis E- Ecthyma grangrenosum U- UTIs D - Diabetes O- Osteomyelitis M- Mucoid polysaccharide capsule O - Otitis externa N - Nosocomial infections A - Addicts to drugs S - Skin infections
What is a common skin infection due to Pseudomonas aeruginosa? Hot tub folliculitis
Common skin condition in which hair follicles become inflamed? Folliculitis
What time of Otitis is associated with Pseudomonas infection? Externa
Which patients are at higher risk of pseudomonas pneumonia? Cystic fibrosis patients due to Mucoid polysaccharide capsule and biofilm production
What are some features produced by Pseudomonas aeruginosa? 1. Phospholipase C 2. Exotoxin A 3. Endotoxin 4. Pigments
What pigments are produced by Pseudomonas aeruginosa? Pyoverdin and Pyocyanin (blue-green pigment)
Swimmers ear is: Otitis externa caused by P. aeruginosa
What are some common treatments for Pseudomonas? 1. Carbapenems 2. Aminoglycosides 3. Monobactams 4. Polymyxins 5. Fluoroquinolones 6. Third and Fourth generation cephalosporins 7. Extended-spectrum penicillins
How do Shigella and Salmonella invade the GI tract? Via the M cells of Peyer patches
How is the spread of all Salmonella types? Hematogenously
How does Shigella spread? Cell to cell
Salmonella has a _______________, and Shigella does not. Flagella
Salmonella has an ________________ and Shigella has an ____________. Salmonella ---- endotoxin Shigella ----- Exotoxin (Shiga toxin)
Which is more infectious, Salmonella or Shigella? Shigella; requires a very small inoculum
What is the GI manifestation of Shigella infection? Bloody diarrhea (or bacillary dysentery)
What is the pathogenesis of Salmonella infection affecting the GI tract? Constipation, followed by diarrhea
What is the vaccine of Salmonella typhi? Oral vaccine contains live attenuated S. typhi IM vaccine contains Vi capsular polysaccharide
Typhoid fever is caused by: Salmonella typhi
What are the clinical features of Typhoid fever? Rose spots on abdomen, constipation, abdominal pain, fever
What is the normal treatment of Typhoid fever? Ceftriaxone or fluoroquinolone
What are the 4 F's associated with Shigella? Fingers, Flies, Food, and Feces
Which the most severe subtype of Shigella? Shigella dysenteriae
What defines the severity of Shigella species? The amount of toxin produced
Order of Shigella species severity: S. dysenteriae > S. flexneri > S. boydii > S. sonnei
What are possible developments of Yersinia enterocolitica infection? Acute diarrhea or Pseudoappendicitis
What is Pseudoappendicitis? Right lower abdominal pain due to mesenteric adenitis and/or terminal ileitis.
Lactose fermenting enteric bacteria have pink colonies when cultured in _________________. MacConkey agar
What enzyme is produce by E. coli that breaks down Lactose? B-galactosidase
Lactose is broken down by E. coli's beta galactosidase into: Glucose and Galactose
What color do all lactose fermenters, except E. coli, when cultured in EMB agar? Purple/black colonies
E. coli on EMB agar produces: Colonies with a green sheen
What are E. coli virulence factors? 1. Fimbriae 2. K capsule 3. LPS endotoxin
What is caused by fimbriae of E. coli? Cystitis and Pyelonephritis
K-capsule in E. coli causes: Pneumonia and Neonatal meningitis
What Virulence factor of E. coli is responsible for septic shock development? LPS endotoxin
Which E. coli strain is a microbe that invades intestinal mucosa an causes necrosis and inflammation? Enteroinvasive E. coli
EIEC ahs similar clinical presentation to: Shigella
Enterotoxigenic E. coli: Produces heat labile and heat-stable enterotoxins No inflammation or invasion
Whe E. coli strain is responsible for Traveler's diarrhea? ETEC
What is the toxin and mechanism of Enteropathogenic E.coli? NO toxin produced Adheres to apical surface, flattened villi, prevents absorption
What E. coli strain causes diarrhea in children? EPEC
What is the most common E. coli strain in the United States? Enterohemorrhagic E. Coli (O157:H7)
How is EHEC transmitted? Via undercooked meat, raw leafy vegetables
What is the toxin name of EHEC? Shiga-like toxin
Shiga-like toxin in EHEC cause? Hemolytic-uremic syndrome (HUS)
What is HUS? Triad of anemia, thrombocytopenia, and acute renal failure due to microthrombi forming on damaged endothelium
What kind of RBCs are seen in HUS? Schistocytes
Dysentery toxin ca cause: Necrosis and inflammation
What fermentation features is different in strain EHEC than other E. coli presentations? EHEC does NOT ferment sorbitol
What are the 5 Ks of Klebsiella? Aspiration pneumonia Abscess in lungs and liver Alcoholics diAbetes "currAnt jelly" sputum
Found in intestinal flora that causes lobar pneumonia in alcoholics and diabetics when aspirated. What is the most likely bacteria? Klebsiella
Why Klebsiella produces very mucoid colonies? Due to abundant polysaccharide capsules
What is the description of sputum in a Klebsiella patient? Dark red "currant jelly"
What organism is the MCC of bloody diarrhea in children? Campylobacter jejuni
C. jejuni infection is a common antecedent to: Guillain-Barre syndrome and reactive arthritis
Which animal contact may cause a C. jejuni infection? Dogs, cats, pigs
Gram (-) , comma or "S" shaped, oxidase (+), grown at 42 Celsius Campylobacter jejuni
What is the most common mode of transmission of vibrio cholerae? Contaminated water or undercooked food (raw shellfish)
What is the mechanism of action of V. cholerae toxin? Permanently activates Gs, leading to increase in cAMP.
Grows in alkaline media? V. cholerae
How is it possible for H. pylori to survive in gastric acidic mucosa? It is Urease positive which produces ammonia, creating an alkaline environment
What part of the stomach is most likely colonized by H. pylori? Antrum of stomach
What are the most common type of peptic ulcers caused by H. pylori infection? Duodenal ulcers
H. pylori is a risk factor for: Peptic ulcer disease, gastric adenocarcinoma, and MALT lymphoma
What lymphoma is associated with H. pylori infection? MALT
What is the term or therapy denomination for H. pylori infection? Triple therapy
What is the composition or parts of the Triple therapy in treatment of H. pylori? Amoxicillin (metronidazole if penicillin allergy), + Clarithromycin + Proton pump inhibitor (PPI)
Category of bacteria of spiral-shaped and with axial filaments? Spirochetes
What are common spirochetes? Borrelia, Leptospira, and Treponema
How can treponema be visualized? Dark-field microscopy or direct fluorescent antibody (DFA) microscopy
What organism causes Lyme disease? Borrelia burgdorferi
What transmits BOrrelia burgdorferi? Ixodes deer tick
The Ixodes deer tick is a vector for: 1. Borrelia burgdorferi 2. Anaplasma spp. 3. Protozoa Babesia
Which area of the USA is Borrelia burgdorferi commonly found? Northeastern United States
Description of Stage 1 of Lyme Disease: Early localized; erythema migrans and flu-like symptoms
What is the description of Erythema migrans? "Bulls-eye" configuration
Stage 2 Lyme disease is seen with: Early disseminated; Secondary lesions, carditis, AV block (3), facial nerve (Bell) palsy, and migratory myalgias/transient arthritis
3 AVB and Bell palsy are part of the ________________ stage of Lyme disease. Second
What are the symptoms seen in the Third and last stage of Lyme disease? Encephalopathy and chronic arthritis
What is the 1st line of treatment in Lyme disease? Doxycycline
What are secondary treatment options of Lyme disease? Amoxicillin and cefuroxime in pregnant women and children
Leptospira interrogans is: Spirochete with hook-shaped ends found in water contaminated with animal urine
Animals urinating in bodies of water. Which is a common bacteria to be found? Leptospira interrogans
What are the two conditions due to Leptospira interrogans infection? 1. Leptospirosis 2. Weil Disease
What is Weil disease? Icterohemorrhagic leptospirosis; Severe form with jaundice and azotemia from liver and kidney dysfunction, fever, hemorrhage, and anemia
What is a key clinical finding of Leptospirosis? Photophobia with conjunctival suffusion (erythema without exudate)
What condition is common or prevalent among surfers ? Leptospirosis
What organism causes syphilis? Treponema pallidum
What is the main characteristic of Primary syphilis? Genital painless chancre
Is the chancre in Primary syphilis painful? NO
Which stage of syphilis is seen with condylomata lata? Secondary
What are the key features of Secondary syphilis? Maculopapular rash, condylomata lata, lymphadenopathy, and patchy hair loss
What is Condylomata lata? Smooth, painless, wart-like white lesions on genitals
Gummas are found in? Tertiary syphilis
What are "gummas"? Chronic granulomas in tertiary syphilis
What are some key features of Tertiary syphilis? Gummas, aortitis, neurosyphilis, Argyll Robertson pupil, broad-based ataxia, and positive Romberg, Charcot joint, stroke without hypertension
What is seen with aortitis in syphilis? Vasa vasorum destruction
Tabes dorsalis and "general paresis" are part of _________________ Neurosyphilis in Tertiary stage
What fluid is tested to Dx for Neurosyphilis? Spinal fluid
What are some key features of Congenital syphilis? Facial abnormalities such as rhagades, snuffles, saddle nose, notched (Hutchinson) teeth, mulberry molars, and short maxilla
What Cranial Nerve cause deafness in congenital syphilis? CN VIII
What are rhagades? Linear scars at angle of mouth
What are conditions that can produce VDRL false positives? Pregnancy, Viral (EBV) infection, Drugs, Rheumatic fever, and Lupus and Leprosy
What is detected by VDRL? Nonspecific antibody atha reacts with beef cardiolipin
Flu-like syndrome after antibiotics are started. MC Dx? Jarisch-Herxheimer reaction
What does a Jarisch-Herxheimer reaction occurs? Due to killed bacteria (usually spirochetes) releasing toxins
A pleomorphic, gram-variable rod involved in bacterial vaginosis. Gardnerella vaginalis
What is the most common presentation of Gardnerella vaginalis? Gray vaginal discharge with a fishy smell; nonpainful
What histoloigical finding is key for Gardenela vaginosis? Clue cells
What are Clue cells? Vaginal epithelial cells covered with Gardnerella
What is the best treatment option of Gardnerella vaginalis? Metronidazole or clindamycin
What is the Amine whiff test? Mixing vaginal discharge with 10% KOH enhances fishy odor
When is the Amine whiff test often used? To diagnose bacterial vaginosis by Gardnerella vaginalis
What are the 2 forms of Chlamydiae? 1. Elementary body 2. Reticulate body
What of Chlamydiae is infectious? Elementary body
Reticulate body of Chlamydiae serves to: Replicate in cell by fission
Chlamydia psittaci causes: Atypical pneumonia
What is the preferred treatment for chlamydia infection? Azithromycin or doxycycline
Why does chlamydia lack the classic peptidoglycan wall? Due to reduced muramic acid rendering B-lactam antibiotics ineffective.
What are the cytoplasmic inclusions seen with Chlamydia? Reticulate bodies
Chlamydia trachomatis causes: Reactive arthritis (Reiter's syndrome), neonatal and follicular adult conjunctivitis, nongonococcal urethritis, and PID
Chlamydia pneumoniae and Chlamydophila psittaci cause: Atypical pneumonia
Which species of chlamydia is the most important? Chlamydia trachomatis
What is caused by C. trachomatis Types A, B, and C? Chronic infection, cause blindness due to follicular conjunctivitis in Africa
What conditions are associated to C. trachomatis types D-K? Urethritis/PID, ectopic pregnancy, neonatal pneumonia (staccato cough) with eosinophilia, neonatal conjunctivitis (1-2 weeks after birth)
What condition is associated to C. trachomatis types L1, L2, and L3? Lymphogranuloma venereum
What is Lymphogranuloma venereum? Small, painless ulcers on genitals --> swollen, painful ighilan lymph nodes atha ulcerate (boubous).
What is the treatment for Lymphogranuloma venereum? Doxycycline
Ulcer due to C. trachomatis type L1-L3 are ___________________. Painless
Bartonella spp causes? Cat scratch disease and Bacillary angiomatosis
Relapsing fever is caused by: Borrelia recurrentis
What condition is due to a Borrelia recurrentis infecion? Relapsing fever
What conditions are due to Brucella infection? Brucellosis and Undulant fever
Q fever is due to _____________________ infection. Coxiella burnetii
What condition is due to Francisella tularensis? Tularemia
What is the source animal of Francisella tularensis? Ticks, rabbits, and deer flies
Dog bites often cause a _____________ infection. Pasteurella multocida
What some associated condition to Pasteurella multocida infection? Cellulitis and Osteomyelitis
Rickettsia rickettsii infection causes Rocky Mountain spotted fever
Dermacentor is: Source of Rickettsia rickettsii
What is the name of a dog tick? Dermacentor
What are the common sources of Salmonella species, except for Salmonella typhi? Reptiles and poultry
The plague is due to _________________ infection. Yersinia pestis
What is the main treatment Rickettsial diseases and vector-borne illnesses? Doxycycline
Description of rash of RMSF? Rash starts at wrist and ankles and then spreads to trunk, palms, and soles
RMSF rash is similar in spread to: Secondary syphilis, Coxsackievirus A infection
Typhus rash: Start centrally and spreads out, sparing palms and soles
Created by: rakomi
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