First AID Gram Negative Bacteria
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| Gram -, Cocci, Maltose fermenter | N.meningitidis
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| Gram -, Cocci, Maltose non-fermenter | N.gonorrhoeae
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| Gram -, "Coccoid" rods | H.influenza, Pasteurella, Brucella, Bordetella
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| Gram -, Bacilli, Lactose fermenter, Fast fermenter | Klebsiella, E.coli, Enterobacter
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| Gram -, Bacilli, Lactose fermenter, Slow fermenter | Citrobacter, Serratia
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| Gram -, Bacilli, Lactos Non-fermenter, Oxidase - | Shigella, Salmonella, Proteus
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| Gram -, Bacilli, Lactose non-fermenter, Oxidase + | Pseudomonas
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| Why are gram-negative bugs resistant to penicillin? | Gram-negative outer membrane layer inhibits entry of penicillin G and vancomycin. Gram-negatives are susceptible to penicillin derivatives such as ampicillin
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| Lipooligosaccharide endotoxin | N.meningitidis
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| N.gonorrhea vs. N.meningitidis | GONOCOCCI (No polysaccharide capsule, No maltose fermentation, No vaccine). MENINGOCOCCI (Yes polysaccharide capsule, Yes maltose fermentation, Yes vaccine)
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| Causes gonorrhea, septic arthritis, neonatal conjunctivitis, PID | N.gonorrhoeae
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| Causes meningococcemia and meningitis. Waterhouse-Friderichsen syndrome | N.meningitidis
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| Mnemonic to remember clinical manifestations of Haemophilus influenza | HaEMOP - Epiglottitis, Meningitis, Otitis media, and Pneumonia
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| Culture medium for H.influenza | Chocolate agar with factors V (NAD) and X (hematin). Mnemonic: When a child has "flu," mom goes to five (V) and dime (X) store to buy some chocolate
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| Most invasive type of H.influnza | Capsular type B (Vaccine contains type B capsular polysaccharide conjugated to diphtheria toxoid or other protein)
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| DOC of H.influenza meningitis | Ceftriaxone. Use Rifampin prophylaxis in close contacts.
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| H.influenza vaccine | Given between 2 and 18 months. Contains type B polysaccharide conjugated to diptheria toxoid or other protein
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| Mnemonic to remember the Enterobacteriaceae | "Citizens Eat Kitkats Every Seventh daY. Some People May Prefer Salad." (Citrobacter, E.coli, Klebsiella, Enterobacter, Serratia, Yersinia, Shigella, Proteus, Morganella, Providencia, Salmonella)
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| Mnemonic to remember characteristics of Enterobacteriaceae | "COFFEE" (Capsular, O antigen/Oxidase -, Flagellar antigen, Ferment glucose, Electron reducers of nitrate-nitrite, Enterobacteriaceae)
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| Somatic O antigen | Polysaccharide of endotoxin, found in enterobacteriaceae
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| Virulence of Enterobacteriaceae | the capsular K antigen is related to the virulence of the bug
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| Presents as pneumonia in alcoholics and diabetics. Red currant jelly sputum | Klebsiella. Note it also is a common cause of nosocomia UTIs
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| The 3A's of Klebsiella | Aspiration pneumonia, Abscess in lungs, Alcoholics
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| Pink colonies on MacConkey's agar | Lactose-fermenting enteric bacteria
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| Mnemonic to remember which enterobacteriaceae ferment lactose | "laCtose is KEE" (Klebsiella, E.coli, Enterobacter, and Citrobacter)
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| Salmonella vs. Shigella | Both are non-lactose fermenters, both invade intestinal mucosa and cause dysentery. Salmonella is motile (Salmon swim) and has animal reservoir. Shigella is non motile and is transferred via Food, Fingers, Feces, and Flies. Shigella is much more virulent.
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| Symptoms of what bacterium can be prolonged with antibiotic txt | Salmonella
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| What bacterium is commonly transmitted from pet feces (puppies), contaminated milk, or pork? | Yersinia enterocolitica. (outbreaks are very common in day-care centers)
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| What bacterium can mimic Crohn's disease or appendicitis? | Yersinia enterocolitica
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| Food poisoning from seafood | Vibrio parahaemolyticus and Vibrio vulnificus
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| Food poisoning from undercooked meat (cheeseburger) | E.coli 0157:H7
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| Food poisoning from poultry, meat, and eggs | Salmonella
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| What organisms cause bloody diarrhea? | Campylobacter, Salmonella, Shigella, Enterohemorrhagic E.coli, Enteroinvasive E.coli, Yersinia enterocolitica, C.difficile, Entamoeba histolytica
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| Bloody diarrhea from a comma- or S-shaped organism growing at 42C and oxidase positive | Campylobacter
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| Bloody diarrhea from gram -, motile, lactose negative bacteria | Salmonella
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| Gram -, non-motile, lactose negative, low ID50 organism causing bloody diarrhea | Shigella
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| Shiga-like toxin | Enterohemorrhagic E.coli (bloody diarrhea)
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| Organism causing bloody diarrhea. Picked up at daycare. Presents as pseudoappendicitis | Yersinia enterocolitica
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| Causes of Watery Diarrhea | Enterotoxigenic E.coli, Vibrio cholerae, C.perfringens, Protozoa (Giardia, Cryptosporidium), Viruses (Rota, Adeno, Norwalk)
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| Classic traveler's diarrhea | Enterotoxigenic E.coli (no preformed toxin)
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| Rice-water diarrhea | Vibrio cholerae (comma shaped organism)
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| cAMP inducing bacteria | Vibrio cholera, Pertussis, E.coli, Bacillus antracis
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| Mechanism of Vibrio cholera toxin | Is a cAMP inducer. It permanently activates Gs. "turns the 'on' on."
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| Mechanism of Pertussis toxin | A cAMP inducer. Permanently disables Gi. "turns the 'off' off.
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| Mechanism of E.coli heat labile toxin | A cAMP inducer. Ribosylates Gs protein to permanently activate AC thus increasing cAMP.
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| Culture for Legionella pneumophila | Charcoal yeast extract culture with iron and cysteine. (Think of a French leegionnaire (soldier) with his silver helmet, sitting around a campfire (charcoal) with his iron dagger - he is no sissy (cysteine)
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| Stain for Legionella pneumophilia | Silver stain. (Think of a French leegionnaire (soldier) with his silver helmet, sitting around a campfire (charcoal) with his iron dagger - he is no sissy (cysteine)
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| DOC for Legionnaires' disease | Erythromycin
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| Transmission of Legionella | Aerosol transmission from environmental water source habitat
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| Mnemonic to remember clinical manifestations of Pseudomonas | PSEUDOmonas: Pneumonia (especially in CF), Sepsis (black lesions on skin), External otitis (swimmer's ear), UTI, Drug use and Diabetic Osteomyelitis. Also associated with wound and burn infections and hot tub folliculitis.
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| Aerobic gram-negative rod. Non-lactose fermenting. Oxidase + | Pseudomonas aeruginosa
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| Pyocyanin | A blue-green pigment produced by Pseudomonas aeruginosa.
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| Produces both an endotoxin and exotoxin A. | Pseudomonas. Endotoxin (fever, shock). Exotoxin A (inactivates EF-2)
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| Txt of Pseudomonas aeruginosa | Aminoglycoside plus extended-spectrum penicillin (eg: piperacillin and ticarcillin)
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| Common cause of gastritis and up to 90% of duodenal ulcers | Helicobacter pylori
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| Urease positive organisms | H.pylori and Proteus
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| Gram negative curved-rod with polar flagella. Urease positive | H.pylori
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| Does H.pylori cause an acidic or alkaline environment? | Alkaline
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| Txt of H.pylori | Triple therapy: 1) bismuth, metronidazole, and either tetracycline or amoxicillin. or 2) (more expensive) metronidazole, omeprazole, and clarithromycin
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| Undulant fever | Brucella spp. "Unpasteurized dairy products give you Undulant fever"
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| Prarie dog vector | Yersinia pestis (also caused by flea bites, or rodents)
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| Mnemonic to remember Zoonotic bacteria | "Bad Bugs From Your Pet" (Borrelia burgdorferi, Brucella spp, Francisella tularensis, Yersinia pestis, Pasteurella multocida)
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| Cellulitis post animal bite | Pasteurella multocida
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| What could give one fever, chills, malaise, and an ulceroglandular (eschar) | A rabbit bite. Francisella tularensis. Remember b/c St. Francis loved rabbits.
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| Infection as site of tongue piercing | Fusobacterium spp
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| If suspect Pasteurella multocida, what do you do with the wound? | Make sure to NOT suture.
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| Positive PPD | Current TB infection, Past exposure to TB, BCG vaccination
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| Negative PPD | No TB infection, or immunocompromised (steroids, malnutrition, AIDS)
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| Primary TB localizes where | Ghon complex focus usually in lower lobes. Also affects the hilar nodes
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| Possible results of Primary TB infection | 1) Heals by fibrosis - have immunity and hypersensitivity. 2) Progressive lung disease - HIV and malnuorished pts. 3) Severe bacteremia - miliary tb. 4) Preallergic lymphatic or hematogenous dissemination - dorman tb bacilli in several organs - 2ndary TB
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| Secondary TB infection location | Usually in apex of lung. Causes a fibrocaseous cavitary lesion. Caused by reinfection.
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| What are the signs of extrapulmonary TB? | extrapulmonary TB? CNS (parenchymal tb or meningitis), VERTEBRAL BODY (Pott's dz). LYMPHADENITIS, RENAL, GI
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| What is a Ghon complex? | Primary TB. Lobar and perihilar lymph node involvement
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| Types of Mycobacteria | 1) Mycobacteria TB 2) Myocobacteria kansasii 3) M.scrofulaceum 4) M.avium-intracellulare 5) M.leprae 6) M.marinum
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| PPD is what type of hypersensitivity | Type IV
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| Acid-fast organism causing disseminated disease in HIV | Mycobacteria avium-intracellulare
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| Hot-tub lung | Mycobacterium avium-intracellulare
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| Armadillo reservoir | Mycobacterium leprae (Leprosy)
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| Classic TB sx | Night sweats, weight loss, hemoptysis
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| Which type of Hansen's disease is worse? | Two types of Leprosy: Lepromatous and Tuberculoid. Lepromatous is worse
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| Why is lepromatous leprosy worse than tuberculoid leprosy | Lepromatous has failed cell-mediated immunity. Tuberculoid is self-limited
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| Chronic disease with hypopigmented skin and loss of sensation that prefers cooler areas of skin | Dapsone, Rifampin, Clofazamine
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| Toxicity of dapsone | Hemolysis and methemoglobinemia
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| Leonine facies | Lepromatous leprosy (LEpromatous = LEthal)
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| Gram -, obligate intracellular organisms that infect vascular endothelium | Rickettsiae
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| Classic Triad of Rickettsiae | Headache, fever, rash
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| Transmission of Rickettsiae | All except Coxiella are transmitted by an arthropod vector and cause headache, fever, and rash. Coxiella is an atypical rickettsia because it is transmitted by aerosol and causes penumonia.
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| DOC for Rickettsial infections | Tetracycline
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| Rat flea vector | Endemic typhus (R.typhi)
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| Centrifugal rash (outward) | Endemic typhus (R.typhi) - "TyPHus has centriPHugal rash"
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| Centripetal rash (inward) | Rocky mountain spotted fever (R.rickettsii). "sPotted fever is centriPetal"
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| Human body louse | Epidemic typhus (R.prowazekii)
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| Positive Weil-Felix | Rickettsial diseases (except Q fever)
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| Rash on palms and soles migrating to wrists, ankles, and trunk. Headache and fever. | Rocky Mountain spotted fever (R.rickettsii)
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| Palm and Sole Rash | Rocky Mountain spotted fever, Syphilis, and Coxsackievirus A infection
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| Reaction that assays for antirickettsial antibodies which cross react with Proteus antigen | Weil-Felix reaction (negative for Q fever)
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| Insidious onset of headache, non-productive cough, with X-ray showing diffuse interstitial infiltrate | Mycoplasma pneumoniae
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| Eaton's agar | Mycoplasma pneumoniae
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| Only bacterial membrane containing cholesterol | Mycoplasma pneumoniae (no cell wall)
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| DOC for mycoplasma pneumoniae | Tetracycline or erythromycin (bugs are penicillin resistant because they have to cell wall)
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| Small, non-motile, obligate intracellular (need ATP/NAD from host) bacteria/parasites that cause mucosal infections | Chlamydiae
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| Two forms of Chlamydiae | 1. Elementary body (small and dense) which Enters cell via Endocytosis. 2) Initial or Reticulate body, which Replicates in cell by fusion
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| Reactive arthritis, conjunctivitis, and nongonococcal urethritis | Chlamydia trachomatis
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| Peptidoglycan wall that lacks muramic acid | Chlamydia
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| Atypical pneumonia with positive Giemsa | Chlamydia pneumonia or C.psittaci
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| What type of hypersensitivity is caused by Chlamydia salpingitis? | Type IV hypersensitivity (TH1 lymphocyte response
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| Types A, B, C of Chlamydia trachomatis | ABC = Africa/Blindness/Chronic infection (common cause of blindness in Africa)
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| Types D-K of Chlamydia trachomatis | Urethritis/PID, ectopic pregnancy, neonatal pneumonia, or neonatal conjunctivitis. (remember that ABC causes African Blindess/Chronic infections, and L causes Lymphogranuloma venereum. D-K causes everything else)
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| Types L1, L2, and L3 of Chlamydia Trachomatis | Lymphogranuloma venereum (L=L)
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| How txt neonatal chlamydial conjunctivitis | Erythromycin eye drops
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| Positive Frei test | Lymphogranuloma venereum (acute lymphadenitis) of Chlamydia trachomatic (type L)
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