Micro Kaplan Review – Flashcards
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| 3 GPC |
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| staph strep entero |
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| 6 GPR |
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| listeria bacillus clostridium corynebacterium actinomyces nocardia |
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| 1 GNC |
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| neisseria |
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| most common neonatal meningitis |
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| S. aglactia |
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| Staph aureus: distinguishing lab markers 4 |
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| catalase neg coagulase pos B-hemolytic ferments mannatol yellow on blood agar |
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| staph epidermidis: distinguishing lab markers 4 |
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| catalase neg coagulase neg y-hemolytic novobicin sensitive |
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| staph saphrophiticus: distinguishing lab markers 4 |
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| catalase neg coagulase neg y-hemolytic novobicin resistant |
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| strep pneumo: distinguishing lab markers 3 |
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| catalase neg a-hemolytic optochin sensitive encapsulated lancet diplococci |
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| strep viridans: distinguishing lab markers 3 |
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| catalase neg a-hemolytic optochin resistant |
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| GAS (S. pyogenes): distinguishing lab markers 5 |
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| catalase neg B-hemolytic bacitracin sensitive cAMP neg PYR+ |
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| GBS (S. agalacticae): distinguishing lab markers 5 |
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| catalase neg B-hemolytic bacitracin resistant cAMP pos hydraulizes urate |
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| Enterococcus: distinguishing lab markers 4 |
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| catalase neg y-hemolytic PYR+ bile and salt tolerance |
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| S. bovis: distinguishing lab markers 2 |
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| catalase neg y-hemolytic |
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| #1 cause meningitis, otitis media, and CA pneumonia |
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| S. pneumo |
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| how to read MacConkey agar |
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| only grows GNR lactose fermentation is puruple |
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| lactose fermenters 3 |
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| E. coli klebsiella pneumonia enterobacter cloacae |
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| how to read mannitol salt agar |
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| only grows GPC mannitol fermentation in yellow coag negative (non-aureus) staph is clear coag positive staph (aureus) is yellow |
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| what is regan lowe agar, how do you read it |
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| charcoal blood agar selective: charcoal, blood, antibiotic only grows bordetella pertussis and bordetella parapertussis |
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| S. aureus: locations, transmission, risk factors |
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| flora in nares and hands sneezing, surgery, food, hands surgical packing, tampons, neutropenia, IV drug users, chronic granulomatous disease, CF |
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| 4 virulence factors of S. aureus and their basic mechanism |
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| protein A: binds FC of IgG stopping phagocytosis enterotoxins: heat stable, causes food poisoning TSST1: superantigen, overstimulates immune response SSS: bolus lesions cytolytic / a toxin: pore forming |
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| 7 diseases of S. aureus and the toxin that causes them |
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| gastroenteritis: enterotoxin endocarditis: cytolytic toxin abscess/mastitis TSS: TSST1 impetigo: exfolatoxin, coagulase, bullase pneumonia: cytolysins osteomyelitis: non HIV |
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| what pneumonia has salmon colored sputum |
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| A. aureus |
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| TX of staph aureus |
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| naficillin/oxacillin vancomycin if MRSA |
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| 5 virulence factors of GAS and their basic MOA |
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| hyaluronic acid: non-immunogenic M-protein: anti-phagocyte, associated with acute GN streptolysin O: hemolysin/cytolysin, immunogenic streptolysin S: non-immunogenic exotoxins: rash and fever in scarlet fever |
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| what GPC can spread fast and why |
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| GAS streptokinase, DNAase, hyluronase |
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| 5 diseases of GAS |
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| pharyngitis rheumatic fever: auto-Ab to heart, HSN II scarlet fever: sandpaper rash, groin erythema, strawberry tongue pyoderma/impetigo acute GN: HSN III |
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| what glomerularnephritis causes smoky urine |
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| post-streo (GAS) GN |
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| how is GAS diagnosed |
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| streptolysin O |
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| TX GAS |
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| B lactams |
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| what microbes have capsules |
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| Streptococcus pneumo Klebsiella pneumonia Hemophalus influenza Pseudomonas Neisseria meningitidis cryptococcus |
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| most common cause of meningitis in neonate, kid, young adult, adult, unvaccinated, AIDS, transplant pt |
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| neonate- GBS kid- S. pneumo young adult- neisseria adult- S. pneumo unvaccinated- H. influenzae AIDS- cryptococcus transplant- listeria |
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| treatment GBS |
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| ampicillin and aminoglycoside or cephalosporin must prevent at birth |
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| S. pneumo: location, risk factors |
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| colonizes nasopharynx asplenia, COPD, CHF |
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| 4 strep pneumo virulence factors and their basic function |
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| capsule IgA protease pneumolysin O: damages respiratory epithelium, decrease respiratory burst techichoic acid: chemoattractant for neutrophils |
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| what pneumonia has rust colored sputum |
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| S. pneumo - lobar |
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| most common cause of CA pneumonia |
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| S. pneumo - lobar |
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| how do we diagnose S. pneumo 2 |
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| qualling reaction: see swelling of capsule latex agglutination: test for antigen in CSF |
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| treatment of S. pneumo |
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| pneumonia - macrolide meningitis - cephalosporin otitis - B lactam |
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| types of S. pneumo vaccinations 2 |
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| peds: conjugate adult: just polysaccharides |
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| give a few examples of S. viridans |
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| sanginus mutans |
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| S. viridans: location, 2 diseases, treatment |
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| oral flora subacute endocarditis cavities prophylaxis needed for susceptible patients in dental procedures |
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| S. bovis: 2 diseases |
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| endocarditis POSSIBLE SIGN OF COLON CANCER |
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| E. fecalis disease and tx |
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| endocarditis in damaged valves often vancomycin resistant |
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| diseases of enterococci 3 |
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| UTI biliary endocarditis |
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| B. cerus: appearance, location, disease |
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| spores, GPR, box like rods chinese food gastroenteritis |
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| B. anthryx: appearance, locations |
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| spores, box like rods, GPR animals, skins, warfare |
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| B. anthryx: virulence factors |
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| anthryx toxin: increases cAMP causing edema and diarrhea |
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| B. anthryx: clinical signs 2 |
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| CXR: mediastinal widening cutaneous: black eschar, red border, edema |
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| B. anthryx: treatment |
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| careful with antibiotics because breaking up the bug releases the toxin cipro or doxycycline toxoid vaccine |
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| 3 obligate anaerobes |
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| cant breathe air clostridium bacteroides actinomyces |
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| clostridium tetani: stain type, appearance, location |
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| GPR, soil spores puncture wounds (killed by O2) |
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| clostridium tetani: virulence |
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| tetanus toxin: tetanospasm - blocks glycine and GABA causing muscle spasms |
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| clostridium tetani diseases 2 |
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| risus sardenicus: lock jaw tetnus: muscle spasms |
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| tx c. tetani |
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| TIG antitoxin metrenidazole penicillin DTaP vaccine prevention of TOXIN NOT INFECTION |
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| C. botuliniun: appearance, location, 2 virulence factors |
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| GPR spores soil and food AB neurotoxin blocks ACh release heat labile toxin |
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| C. botulinium diseases |
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| adult: INTOXICATION in canned foods infant: INFECTION causes limpness, flaccid paralysis, due to infection of spores in honey |
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| tx C. botulinium |
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| adult: trivalent antitoxin infant: antibiotics can worsen by releasing toxin |
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| C profringens: locations, medial growth, risk factors, appearance |
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| GPR soil, colon, food traumatic implantation stormy fermentation in milk media double zone hemolysis |
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| C. profringens: virulence |
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| a toxin: causes cell lysis (lecthinas) |
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| C. profringens identifications |
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| neigler reaction: growth on egg yolk agar on side without antitoxin signaling lecthinas activity |
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| C. profringens disease and tx |
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| gangrene: tense skin hyperbaric O2 antibiotics |
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| Clostridium difficile: 2 virulence factors ad diagnostic method |
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| toxin A: enterotoxin damages mucosa and attracts granulocytes toxin B: cytoplasmic cytotoxin screen stool for toxin |
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| C. diff diseases and treatment |
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| associated with clindamycin and cephalosporins causes pseudomembranous colitis (yellow plaques) metronidazole, vancomycin if resistant |
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| listeria: appearance, location, virulence factors |
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| GPR without spores facultative intracellular tumbling motility / actin jet motility listrolysin O B hemolysin cold growth: ice cream, cold cuts, hot dogs, cheese |
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| what is actin jet motility and what 3 bugs have it |
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| listeria, shigella, EIEC spear of actin punctures cell |
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| listeria: diseases 3 |
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| pregnancy listeriosis: pregnancy allows immune supression, fever, chills, mono like, crosses placenta neonatal: early granuloma, later meningitis meninigits: in elderly and renal pt |
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| listeria TX |
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| ampicillin gentamycin |
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| corynebacterium: appearance, growth requirements, |
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| no spores, GPR aerobic diptheroids club shape tellurite medium chinese letters (V/L) |
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| corynebacterium virulence factor |
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| diptheria toxin: decreases protein synthesis adds ADP-ribose to eEF-2 |
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| what two bugs decrease protein synthesis via ADP-ribose/eEF-2 pathway |
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| diptheria and pseudomonas |
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| diptheria disease |
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| localized microbe but toxin goes systemic dirty gray pseudomembrane that bleeds when scraped toxin targets heart and nerves (myocarditis, palsies, neuritis) |
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| diptheria diagnosis |
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| elik test: if strain makes toxin it makes percipitation line with antitoxin |
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| diptheria tx |
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| erythromycin and antitoxin prevent with vaccine |
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| two branching bacteria, how can you tell them apart |
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| actinomyctes: GPR, branching, ANAEROBE, has SULFUR GRANULES, causes SOLITARY brain abscess nocardia: GPR, branching, AEROBE, caues SINGLE brain abscess |
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| actinomyces israelli diseases |
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| location: gingiva, vagina dental infection invades bone tissue swelling and draining abscess lumpy jaw: cervicofacial swelling due to poor dental hygiene or trauma CNS: solitary brain abscess |
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| tx actinomyces |
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| penicillin G |
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| nocardia asteroides and brasiliensis and mycetoma: location and risk factors |
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| soil, transplant, trauma, immune supression, cancer |
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| nocardia asteroides disease |
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| cavitary bronchopulmonary disease can spread to brain and cause solitary abscess |
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| nocardiamycetoma disease |
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| draining SC granules cellulitis |
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| tx nocardia |
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| sulfa |
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| mycobacteria: stain type, growth media, growth requirements, special cell features |
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| GPR, acid fast, ogligate aerobes cell wall has increased lipids so resists drying and detergents facultative intracellular: escape macrophages grow on lowenstein johnson stain with auramine: rhodamine staining bacilli (sputum screen) |
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| TB: transmission, 5 virulence factors |
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| respiratory sulfatides: inhibit phagolysosome, waxy cord factor: decrease WBC migration No LPS layer exotoxin ilicts HSV IV response causing ghon complexes/granulomas) |
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| primary pulmonary TB events |
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| HSV IV response causing ghon focus and complex granulomas with macrophages |
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| reactivated TB events |
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| erosion of granulomas into airway |
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| when is a PPD positive |
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| HIV >5mm AIDS anything at all (have no T cells...) >10mm in high risk for exposure, IV drug users >15mm in low risk for exposure |
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| how do you treat a person with a positive PPD |
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| you dont! positive PPD does not diagnose TB. you do more tests and such |
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| mycobacterium scofulaceum sign |
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| lymphadenitis of cervical nodes in kids |
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| mycobacterium marinium: cause, signs |
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| fish tank abrasion causes single granuloma soft tissue infection |
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| mycobacterium leprae: stain type, growth requirements, locations |
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| acid fact rods punch bopsy lesion to test obligate intracellular nasal discharge and armadillos |
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| 2 types of leprae and the difference |
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| tuberculoid: less severe, Th1 response can supress. LEPROMIN POSITIVE, MACULAR lesions, granuloma, parasthesia DUE TO MACULE MASS EFFECT leprematous: severe weak CMI response, FOAM CELLS, lepromin negative, NODULAR lesions, parasthesia due to DAMAGE TO TISSUE, LION FACES due to CT distruction |
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| tx leprosy |
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| dapsone rifampin |
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| difference between neisseria meningitis and gonorrhea |
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| meningitidis: capsule, vaccine, respiratory, mannose fermenting gonorrhea: genital, B-lactaminase |
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| neisseria characteristics of all |
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| GPC diplococci flat sides oxidase positive glocuse fermenting |
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| N. meningitidis: growth, properities, appearance |
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| GNC diplococci kidney bean shape maltose fermenting capsule latex grows on chocolate agar with 5% CO2 LPS layer |
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| N. meninigitids: location, transmission, signs |
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| 5% of population has in nasopharynx respiratory droplets in crowds abrupt fever, chills, vomiting, rash fulminent: in younger kids, adrenal collapse (waterhouse fredricheson) death in 24h |
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| N. meningitidis: virulence |
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| LPS layer: septic shock, decreases C5-9 causing bacteremia polysacchardia capsule B antigen: most common in US, not immunogenic NOT IN VACCINE |
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| components of N. meningitidis vaccine and tx |
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| conjuate: Y, W-135, C, A (NO B IN IT) tx: rifampin for close contacts |
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| what is the most common cause of urethritis |
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| chalmydia |
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| features of neisseria gonorrhea |
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| kidney shaped diplococci sensitive to drying and cold pilli with antigenic variation outer membrane proteins: serotype opa: antigenic, variable, adherance |
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| gonorrhea growth requirements |
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| thayer marin chocolate and antibiotics to decrease flora |
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| diseases of gonorrhea |
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| urethritis arthritis endocervicitis PID opthalmia: blindness |
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| tx gonorrhea |
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| erythromycin drops for opthalmia ceftriaxone |
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| moraxella catarahallis: stain type, diseases |
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| GNC otitis media and sinusitis #3 |
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| pseudomonas: growth requirements, stain type, color, appearance, cell features |
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| aerobic non-fermenting GNR oxidase positive catalase positive grape odor slime layer capsule blue green on EMB/MacConkey |
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| pseudomonas virulence factors |
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| exotoxin ADD ribosylates eEF2 (like diptheria) capsule- penetrates well in CF and pneumonia patients |
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| pseudomonas diseases |
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| pneumonia hot tub folliculitis eye ulcer with contacts erythema gangrinosum: black eschar UTI HA swimmers ear DM malignant otitis externa |
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| what type of microbes florish in a patient with chronic granulomatous disease |
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| catalase positive |
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| legionella: stain type, shape, growth requirements |
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| GNR stains poor needs cystine, Fe for growth (yeast extract with charcoal buffer, fastidious) grows in water |
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| legionella pneumonia: location, transmission, risk factors |
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| facultative intracellular transmission in air conditioning not human to human risk in smokers >55, alcoholics, immune supressed |
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| legionares disease |
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| atypical penumonia, confusion, hyponatremia, diarrhea |
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| pontiac fever |
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| legionares disease in younger pt less severe pneumonitis |
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| francisella: cause, stain |
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| facultative intracellular rabbit fever GNR |
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| bordatella: location, transmission, growth requiremenet, stain |
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| GNR, strict aerobe human resivour on mucosa |
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| bordatella virulence |
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| fillamentous hemagluttin: allows to attach to cillia pertussis toxin: activates islets causing hypoglycemia, attachment adenylate cyclasetoxin: decreases leukocyte chemotaxis trachial cytotoxin: kills cillia |
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| 4 phases of pertussis |
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| incubation 7-10d catarrhal 1-2wk: best cultures, cold like paroxysmal 2-4wk: whoop, vomiting convalescent 3-4wk: decreased cough, pneumonia, seizure |
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| growth of pertussis |
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| raganlow media of direct cough plate or nasopharynx culture |
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| tx pertussis |
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| erythromycin, macrolides |
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| brucella: stain type, location, sign |
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| GNR zoonotic sweating |
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| 6 causes of bloody diarrhea |
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| camplobacter shigella EIEC EHEC salmonella E. histolytica |
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| 5 causes of non-bloody diarrhea |
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| ETEC vibro norovirus rotavirus persistant = parasites (cryptrosporidium, giardia) intoxications: B. cerus, S. aures, etc |
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| what bacteria is an exception to bloody diarrhea and why |
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| EHEC: blood does not come from damage from the bacteria it comes from the toxin so there will be NO fever and NO PMN |
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| why is bloody diarrhea bloody, what are some signs |
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| invasive and inflammatory blood, puss, PMN, fever |
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| most common cause of adult and kid diarrhea |
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| adult: norovirus kid: rotavirus |
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| most common cause diarrhea in AIDS |
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| cryptosporidium |
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| main way to tell shigella and salmonella apaet |
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| both are non-lactose fermenting shigella is not motile and has no H2S salmonella is motile and has H2S |
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| most common cause of bloody diarrhea |
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| camplobacter (usually starts watery) |
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| how can you tell apart the two bloody diarrhea E. coli |
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| EIEC: + fermentation of sorbitol EHEC: - fermentation of sorbitol |
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| camplobacter: stain type, appearance, locations, complications |
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| GNR curved at 42 deg poultry, invasive, infective at low dose bloody gastroenteritis, guillian barre, reactive arthritis |
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| H. pylori: appearance, growth requirements, lab reactions, transmission |
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| curved rod microaerophilic oxidase positive urease positive fecal oral motile silver stain |
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| H. pylori diseases |
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| invades stomach lining causing duodenal ulcer MALToma (resolves with tx) gastric adenocarcinoma (does not resolve) |
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| tx h. pylori |
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| omeprazole amoxicillin clathromyicn |
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| vibro: shape, stain, growth requirements, lab signs |
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| GNR curved, polar flagella oxidase positive ferments sucrose |
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| V. colera: virulence, signs, location |
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| toxin causes voluminous watery diarrhea, increases cAMP have to ingest lots has low virulence acidity in stomach in human colon, cocepods, shellfish |
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| Vibro parahaemolyticus: disease, cause |
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| gastroenteritis from undercooked seafood |
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| vibro vulmificus 2 diseases |
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| gastroenteritis from undercooked seafood cellulitis: rapid spreading |
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| properities of enterobacter |
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| GNR facultative anaerbe cytochrome C oxidase turn nitrates into nitrites LPS layer endotoxin antigens (O, H, K, V1) |
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| enterobactericae antigens |
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| O- cell envelope H- flagella K- capsule polysaccharide V1- virulence capsule on salmonella |
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| how do tell apart the 4 enterobactericae |
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| E. coli ferments lacrose, klebsiella doesnt salmonella has H2S and is motile, Shigella isnt |
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| E. coli: stain, fermentation, lab signs, locations |
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| GNR ferment lactose oxidase negative human colon enterohemorrhagic comes from cow poo |
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| most common cause of UTI and why |
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| E. coli, pilli attach to urethra |
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| second most common causes of neonatal sepsis and meningitis (to GBS) and why |
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| E. coli: K1 capsule |
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| why does E. coli cause sepsis |
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| LPS layer endotoxin, nosocomal, central lines |
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| 4 types of E. coli and who/how to get |
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| ETEC: travelers diarrhea EPEC: peds diarrhea EIEC: distractor for dissentary EHEC: |
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| #2 infantile diarrhea |
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| EPEC |
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| what E. coli have toxin |
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| ETEC: LT toxin heat labile, increases cAMP like vibro EHEC 0157:H7: verotoxin decreases protein synthesis |
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| what two bugs have toxin that increase cAMP to cause diarrhea |
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| vibro ETEC |
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| what two bugs decrease protein synthesis with verotoxin |
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| EHEC 0157:H7 and shigella |
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| disease of verotoxin |
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| hemolytic uremic syndrome |
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| signs of EHEC |
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| not invasive, no fever bloody diarrhea no PMM (toxin causes the problem) no fermentation or sorbitol unlike normal flora E. coli |
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| klebsiella: stain, characteristics |
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| GNR capsule ferments lactose |
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| what causes thick gelantenous red sputum |
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| currant jelly sputum klebsiella |
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| diseaes of klebsiella |
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| UTI nosocomal pneumonia lobar (esp in alcoholic) |
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| what is the most common lobar pneumonia |
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| s. pneumo |
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| shiella: transmission, markers |
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| fecal oral, daycare, humans only non motile no H2S non-lactose fermenting |
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| plaque: types, signs, appearance, tx |
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| bubonic: infective bubos pneumonia: warfare, death fast coagulates in flea and it regurgitates into person bipolar safety pin, coagulase positive tx aminoglycocides |
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| 4 yersenia |
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| plaque coccidiodes hanta virus enterocolitica |
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| enterocolitica: growth requirements, signs |
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| grows in cold bloody diarrhea pseudoappendicitis |
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| proteus:lab signs, growth, staining, disease signs |
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| GNR swarms no lactose fermentation makes urease which makes stones increases urine pH which makes strones |
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| salmonella: staining, lab markers, types |
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| GNR no lactose fermentation motile H2S enterolyticus, tymphanirum, typhi |
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| s. typhi: transmission, progression of disease |
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| fecal oral human to human mucosa > M cells > lymph > primary septicemia > seeds organs > gallbladder (home base) |
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| signs of S. typhi |
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| rose colored spots DIARRHEA AND CONSTIPATION osteomyelitis in sickle cell septicemia |
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| salmonella enteritidis and tynaphrium: location, MOA, diseases |
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| undercooked chicken, reptiles need large dose because it is sensitive to stomach acid no toxin causes inflammation itslf gastroenteritis osteomyelitis: esp sickle cell |
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| how can you diagnose salmonella |
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| hektoen agar: H2S shows as black colonies |
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| hemophalus: staining, shape, lab signs, growth requirements |
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| GNR pleomorphic not hemolytic needs heme, X (hematin) and Y (NAD) to grow |
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| hemophalus virulence factors |
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| capsule: major virulence factor satellite: staph is B hemolytic and releaes X and V so hemophalus can grow next to it |
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| diseases of hemophalus |
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| otitis bronchitis/pneumonia epiglogttitis |
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| hemophalus vaccine type |
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| 1st conjugate vaccine that has protein allowing class switch to get bettr Ab response |
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| hemophalus ducrei: signs |
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| lesion open (increases transmission) painful cancre slow to heal without tx |
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| gardenerella: stain, lab signs, growth requirements |
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| GN facultative anaerobe catalase postiive oxidase negative |
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| gardenerella disease |
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| vaginal pH disruption, odor thin gray fluid clue cell: vaginal epithelial cell coated with bacteria |
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| pasturella: disease, cause, tx |
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| cellulitis due to cat bite (dogs pant so less O2 which kills it) rapid spread augmentun and clauvonic acid |
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| eikenella corrodens: cause, signs, disease |
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| human bite bleach smell carodes agar cellulitis |
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| capnocytophagia: risk factures, stain type, cell sign |
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| dog bite encapsulated so splenectomy is risk factor GN fillamentous |
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| bartonella: stain type, cause |
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| cat scratch GNR |
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| HAECK disease |
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| subacute endocarditis |
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| bacteroides: stain type, growth need, disease |
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| GNR anaerobic infect surgical wounds |
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| treopnema pallidum: growth requirements, how to test for it and in what phase |
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| obligate pathogen primary: spiralis on microscopy secondary: non specific AB test and specific FTA ABS test positive tertiary: nonspecific test negative, specific positive |
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| signs of syphillis in all stages |
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| prmary: chanker, painless, lasts few weeks secondary: rash on palms and soles, condolymata lata, flat wart like, highly infectious latent none tertiary: gumma, AORITIS |
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| signs of congenital syphillis |
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| stillbirth keratitis CN VIII dammage hutchensons teeth: notched desquamation rash snuffles saddle nose saber shins |
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| tx and SE of syphillis tx |
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| pen G jarish-herxheimer rxn: LPS fly off dueing TX inducing shock when tx spirochetes |
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| borellia: appearance, stain, transmission, growth requirements |
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| large GN microaerophillic ixodes tick |
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| borella signs |
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| primary: bulls eye annular lesion secondary: fever, chills, muscle pain, nodes enlarged tertiary: HSN III arthritis migratory, myocarditis, meningitis, bells palsy |
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| leptospira: where does it come from, distinguishing cell feature |
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| pet pee hooks |
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| chalmydicea: stages of replication |
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| elementary enters cell but cannot replicate so turns into reticulate body it replicates and turns into elementary to leave cell |
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| serotypes and diseases of chalmydia |
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| D-K: nongonoccal urethritis, PID, conjunctivits L1-3: lymphogranuloma venerium: swollen nodes, genital elemphantitis, fistula A-C trauma: follicular conjunctivitis, conjunctival scaring due to inturned lashes leads to blindness |
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| tx chalmydia |
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| doxycycline |
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| C. psitaci: transmission, disease |
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| bird poo atypical pneumonia |
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| C. pneumonia: disease |
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| walking pneumonia |
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| rickettsia rikettsia: disease, transmission, pathogenesis, signs, tx |
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| RMSF dermacentor tick vasculitis invades endothelium rash begins at ankles.wrist involving palms and soles tx doxycycline |
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| R. prowazekii: transmission, disease |
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| lice in crowded unsanatary area epidemic |
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| mycoplasma: disease, cell features, growth agar |
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| extracellular, no cell wall no B-lactams work!! peptidoglycan wall fried egg colonies on Eatons agar dry hacking cough, atypical pneumonia spreads fast young adults cold agglutinins |
