IDR study party 3
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| What three things make up the Hemolytic uremic syndrome (HUS) | •Acute renal failure
•Thrombocytopenia
•Micro-angiopathichemolytic anemia
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| What do the B-units of Shiga Toxin 1 and 2 bind to? | 1-intestinal epithelial cells
2-glomerular endothelial cells
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| why do antibodies make E_EC worse? | H; because shiga toxins are in the operon that is turned on by Ab.
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| ________leading cause of septicemia caused by Gram-negative bacteria but is always the result of intestinal leakage due to trauma | E. coli
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| treatment for S.typhi? | quinolones
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| A bacteria that shows growth in APCs in lymph nodes can lead to very swollen “buboes” which can burst; septicemia. | Y.pestis
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| 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
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| treatment for Yersinia's? | macrolides or quinolones
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| US outbreaks of _________________ are mainly associated with consumption of raw oysters | V. parahaemolyticus
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| 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
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| drug treatment for Vibrio's | Macrolides and tetracyclines most commonly used to treat infections
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| Toxin in Vibrio that allows bacteria to adhere to intestinal epithelial surface | toxin-coregulated pilus
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| What are the two bad strains of V. Cholerae | 01, 0139
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| 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
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| 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
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| is V. parahaemolyticus an infection or intoxication? | infection
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| __________________ 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
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| two ways a person can get necrotizing fasciitis from v. vulnificius | traumatic inoculation or as a sequela of a gastroenteritis
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| _________________ 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
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| 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
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| Acrodermatitis chronica atrophicans is associated with what disease? | Lyme disease (more often seen in Europe)
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| 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
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| 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.
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| what are the treatment of primary, secondary, tertiary lyme disease? | Primary and secondary: penicillin and doxycycline
tertiary: Ab not useful, manage sxm's
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| what is Weil's Disease | A severe leptospirosis infection with liver, kidney, and meningeal involvement
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| _______________ is acquired by skin exposure to water containing urine from infected animals. | Leptospirosis
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| treatment for leptospirosis | Penicillin or penicillin + doxycycline
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| you get in a bar fight and pop the fucker in the teeth, what are you gonna get | Eikenella corrodens
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| two bacteria you can get from a cat or dog bite that have similar sxm's | Pasteurella multocida , Capnocytophaga
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| are very small, irregularly-shaped Gram-negative bacteria that can replicate inside of macrophages (Intracellular pathogen) | Francisella tularensis
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| Brucella _________: Most severe symptoms in humans, found in sheep and goats | melitensis
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| Brucella that is most likely to cause pneumonia and urdulant fevers. Most likely to disseminate to different body sites: joints, hearts | Brucella melitensis
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| ____________ can replicate in alveolar macrophages’ cytoplasm because they can escape the phagosome | Legionella
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| _______________is a mild disease that is the most common consequence of a Legionella infection | Pontiac fever
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| Gram - pleomorphic coccibacilli that can cause Bi-lateral inflammation with little to no sputum produced from cough | Legionnaires’ Disease
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| Who gets Legionella infections and why? | Especially older people with a history of smoking (Reduced ciliary beating) and alcohol consumption (Reduced liver function)
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| treatment of legionella? | Treat with a macrolide or a quinolone, NOT a beta-lactam
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| 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
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| see this in little kids where they bite each other to resolve conflict | Eikenella corrodens
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| normal oral flora in carnivorous domestic animals, like cats and dogs | Pasteurella multocida
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| most common symptom of Pasteurella multocida | cellulitis and swollen lymph node closest to bite site
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| Pasteurella cultured best on what kind of media | blood or chocolate agar
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| intracellular bacteria that must have CO2 to grow in culture; contracted from cat/dogs with symptoms similar to Pasteurella | Capnocytophaga
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| 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
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| 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
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| criteria to diagnose Streptobacillus monoliformis | rodent bite + rash + arthralgias
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| gram stain of Streptobacillus monoliformis looks like what | plemorphic - lots of different shapes
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| treatment for Streptobacillus monoliformis? | treat with any drug (no resistance reported) ASAP
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| very small, irregularly-shaped Gram-negative bacteria that can replicate inside of macrophages | Francisella tularensis
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| which 2 bacteria escapes from the phagosome, replication in cytoplasm, and cause lots of NOD-protein activated inflammation & death of cells | Francisella, Brucella
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| 3 key symptoms of Francisella tularemia | ulceroglandular tularemia, oculoglandular tularemia, pulmonary tularemia
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| what animals does Francisella infect? | infects rabbits, cats, and Ixodes ticks
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| where is Francisella most common | Southern Midwest
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| 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
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| can transition from “rough” strains that lack the O-polysaccharide of LPS to “smooth” strains that have lots of O-polysaccharide | Brucella
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| 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
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| can’t survive outside of amoeba so you have to be able to inhale this as an infected amoeba | Legionella
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| create a double-layer phagosome, that never fuses with a lysosome (Wrapped up in layers of RER) | Legionella
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| mild disease that is the most common consequence of a Legionella infection | Pontiac Fever
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| a much more serious condition experienced by some Legionella-infected patients following their initial “Pontiac fever” symptoms | Legionnaire's Disease
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| Who gets Legionella infections? | older people with a history of smoking and alcohol consumption.
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| how do I get a legionella infection? | Anything that aerosolizes standing cool fresh (not chlorinated) water can inhalation of Legionella-infected amoebae
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| 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.
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| 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.
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| causes Rocky Mountain Spotted Fever, spread by American dog tick. Symptoms = high fever, classic rash, myalgias, headaches (possibly with photophobia) | Rickettsia rickettsii
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| 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
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| Spread by human body lice, (humans main host); also in squirrels in eastern US/Canada | Rickettsia prowazekii
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| 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
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| demographic likely to get R. prowazekii | homeless
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| 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
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| spread by Ixodes species ticks and by “Lone Star” ticks that fed on infected mice or deer | Ehrlichia and Anaplasma
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| “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
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| causes “Q fever” | Coxiella burnetii
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| asymptomatic; most common presentation mild flu-like symptoms. Can cause chronic endocarditis. Treat with doxycycline. | Coxiella burnetii
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| _____ can be inhaled but all _____ must be transmitted via arthropod bite | coxiella, rickettsia and erlichia
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| Mycoplasma and Ureaplasma can make their own ______, but Chlamydia and Chlamydophila can’t and must use____ made by their host cells. | ATP
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| the #1 cause of “atypical” or “walking” pneumonia and is also frequently carried asymptomatically. | Mycoplasma pneumoniae
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| : a conjunctivitis caused by Chlamydia trachomatis that can lead to corneal scarring and blindness | Trachoma
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| 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
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| painless lesions accompanied by regional lymph node swelling and painful lymph nodes close to initial infection site 1 – 4 weeks post-infection. | lymphogranulum venerum
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| caused by the dimorphic Malassezia furfur, which infects skin and alters color. | Pityriasis (Tinea) versicolor
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| caused by Hortaea werneckii, causes skin to darken. | Tinea Nigra
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| superficial infection of the hair shaft caused by Piedra hortae. | Black piedra
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| fungal infection of fingernails and toenails caused by Trichophyton rubrum and T. mentagrophytes. | Onychomycosis
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| Dermatophytes don't typically penetrate deeper, and acquire nutrition because they are ______ | keratinolytic
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| an infection that forms warty pigmented lesions which grow outward from site of introduction | Chromoblastomycosis
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| 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
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| Fungi are cultured on specialty media, especially | SDA
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| what are main stains used to visualze fungi with microscopy | Silver stain and Calcofluor White
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| bind to and lyse ergosterol in fungal cell membrane membrane destruction | polyenes i.e. amphotericin B
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| stop synthesis of ergosterol, can be used topically or taken orally | azole
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| stop synthesis of beta-glucans in fungal cell wall, can only be administered via IV | echinocandins like capsofungin
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| ______ is converted to ________ in cell by cytosine deaminase, 5-FU stops DNA and RNA synthesis in fungi | flucytosine, 5fu
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| _______ interfere with ergosterol synthesis at an earlier step than triazoles do. Because of potential for renal damage, they’re typically only used topically | allylamines
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| Example of allylamine | Terabinafine, the active ingredient in the anti-Athlete’s foot infection Lamisil.
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| Inhaled mold spores go to alevoli, differentiate into yeast forms which avoid phagocytosis based on size and WI-1 shedding | Blastomyces
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| Disseminated disease most likely in pregnant women, Pacific islanders, those of African descent *and immunocompromised | Coccidioides
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| cultured and characterized microscopically as a mould producing both tuberculate macroconidia and microconidia | H. capsulatum
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| 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
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| Pulmonary infection flulike symptoms with fever, chills, headache, cough Disseminated disease can ulcers on oral mucosa, skin, hepatosplenomegaly | Histoplasma
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| 1,3 alpha-glucan in cell wall prevents killing by neutrophils | Paracoccidioides
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| May have very prolonged latency (>40 years) between initial infection and onset of disseminated disease. | Paracoccidioides
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| 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
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| 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
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| 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
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