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Cojo's Step Cards, Bugs > Gram + Bacteria > Flashcards

Gram + Bacteria Flashcards

1
Q

S. Aureus Lab Algorithm

A

Gram +
Cocci in Clusters
Catalase +
Coagulase +

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2
Q

S. Aureus Virulence Factor, Main Toxin, and Colonization

A

Virulence Factor: Protein A (binds Fc-IgG, inhibiting complement and phagocytosis)
Toxin: TSST (binds MHCII and TCR, inducing T cells)
Colonization: Commonly colonizes the nose and skin

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3
Q

S. Aureus Diseases (2 main ones)

A 
Inflammatory Disease (skin, organs, pneumonia, endocarditis, osteomyelitis)
Toxin-mediated disease (toxic shock:TSST1, scalded skin:exfoliative toxin, food poisoning:entertoxins)
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4
Q

Staph epidermidis Lab Algorithm

A 
Gram +
Cocci in clusters
Catalase +
Coagulase -
Novobiocin sensitive
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5
Q

Staph epidermidis Pathology and Flora

A

Infects prothetic devices and intravenous catheters by producing adherent biofilms
Component of normal skin flora (contaminates blood cultures)

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6
Q

Staph saprophyticus Lab Algorithm and Presentation

A

Gram + cocci in clusters, catalase +, coagulase -, novobiocin resistant
Second most common cause of uncomplicated UTI in young women (first is E. coli)

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7
Q

Staphylococcus epidermidis and saprophyticus Treatment

A

Needs to include Vancomycin

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8
Q

Streptococcus pyogenes Lab Algorithm

A

Gram + cocci in chains, catalase -, beta hemolytic,

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9
Q

Strep pyogenes (Group A) Lab Algorithm

A

Gram + cocci in chains, catalase -, beta hemolytic, bacitracin sensitive
ASO titer detects regent infection

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10
Q

Strep pyogenes Presentation (3 Main Categories)

A

Pyogenic: pharyngitis, cellulitis, impetigo
Toxigenic: scarlet fever, toxic shock-like
Immunologic: rheumatic fever, acute glomerulonephritis

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11
Q

JONES Criteria for rheumatic fever

A 
Polyarthritis
Carditits
Subcutaneous nodules
Erythema marginatum
Sydenham chorea
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12
Q

Scarlet Fever

A

Caused by toxins (exotoxin A?) secreted by Strep pyogenes
Scarlet rash with sandpaper-like texture
Strawberry tongue (also kawasaki)
Circumoral pallor

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13
Q

M Proteins

A

These are proteins on Strep pyogenes

Antibodies to M proteins enhance host defenses against Strep pyogenes, but also can give rise to rheumatic fever

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14
Q

Strep agalactiae (Group B) Lab Algorithm

A

Gram + cocci in chains, catalase -, beta hemolytic, bacitracin resistant

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15
Q

Strep agalactiae Presentation

A

Colonizes vagina
Can cause pneumonia, meningitis, and sepsis in babies
Produ

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16
Q

Strep agalactiae Presentation

A

Colonizes vagina
Can cause pneumonia, meningitis, and sepsis in babies
Produces CAMP factor (enlarges S aureus hemolysis)
Pregnant women screened at 35 weeks and positive cultures receieve intrapartum penicillin prophylaxis

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17
Q

Strep pneumoniae Lab Algorithm

A

Gram + cocci in chains (diplococci?), catalase -, alpha hemolytic, optochin sensitive
Lancet-shaped

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18
Q

Strep pnuemoniae Presentation

A 
Associated with a "rust colored sputum" 
Most common cause of:
Meningitits
Otitis media (in children)
Pneumonia
Sinusitis
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19
Q

Strep pneumoniae Virulence Factor

A 
IgA protease (cleaves IgA in order to colonize respiratory mucosa)
Polysaccharide Capsule
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20
Q

Strep pneumoniae Lab Algorithm

A

Gram + cocci in chains (diplococci?), catalase -, alpha hemolytic, optochin sensitive, bile soluble (lysed by bile)
Lancet-shaped

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21
Q

Strep pneumoniae Virulence Factor

A 
IgA protease (cleaves IgA in order to colonize respiratory mucosa)
Polysaccharide Capsule
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22
Q

Viridans Group Streptococci Lab Algorithm

A

Gram + cocci in chains, catalase -, alpha hemolytic, optochin resistant, bile insoluble (not lysed by bile)

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23
Q

Viridans Group streptococci Presentation

A

Normal flora of the oropharynx
Cause dental caries (mutans)
Cause subacute bacterial endocarditis and damaged valves (sanguinis–makes dextrans which bind to fibrin-platelet aggregates on damaged valves)

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24
Q

Viridans Group streptococci Presentation

A

Normal flora of the oropharynx
Cause dental caries (mutans)
Cause subacute bacterial endocarditis and damaged valves (sanguinis–makes dextrans which bind to fibrin-platelet aggregates on damaged valves)

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25
Q

Enterococci (Group D strep) Lab Algorithm

A

Gram + cocci in chains, catalase -, gamma hemolytic (but variable actually), growth in bile and 6.5% NaCl (E. faecalis)

26
Q

Enterococci Presentation

A

Normal colonic flora that are penicillin G resistant
UTI, biliary tract infections, and subacute endocarditis following GI/GU procedures
Treat with vancomycin (unless VRE)

27
Q

Strep bovis (Group D strep) Lab Algorithm

A

Gram + cocci in chains, catalase -, gamma hemolytic (but variable actually), growth in bile but not 6.5% NaCl

28
Q

Enterococci (Group D strep) Lab Algorithm

A

Gram + cocci in chains, catalase -, gamma hemolytic, growth in bile and 6.5% NaCl (E. faecalis)

29
Q

Strep bovis (Group D strep) Lab Algorithm

A

Gram + cocci in chains, catalase -, gamma hemolytic (but variable actually), growth in bile but not 6.5% NaCl

30
Q

Strep bovis Presentation

A

Colonizes the gut

Can cause bactermia and subacute endocarditis in colon cancer patients

31
Q

Strep bovis Presentation

A

Colonizes the gut

Can cause bactermia and subacute endocarditis in colon cancer patients

32
Q

Gram + Rods

A 
Clostridium (anaerobe)
Corynebacterium
Listeria
Bacillus (aerobe)
Mycobacterium (acid-fast)
33
Q

Corynebacterium diphtheriae Lab Diagnosis

A 
Gram + Rod (coryne=club shaped)
Non-spore forming
Motile
Metachromatic (blue and red) Granules
Elek test for diptheria toxin
Black colonies on cystine-tellurite agar
34
Q

Corynebacterium diphtheriae Presentation

A

Diptheriae:
Pharyngitis with pseudmomembranes in throat
Severe lymphadenopathy (bull neck)
Myocarditis
Arrhythmias
Note that toxoid vaccine prevents diphtheria

35
Q

Costridia Lab Diagnosis

A

Gram positive bacilli
Spore forming
Obligate anaerobes
All motile spores except C. perfringens

36
Q

C. tetani Toxin and Presentation

A

Tetanus Toxin

Spastic paralysis, trismus (lockjaw), and risus sardonicus (facial spasm–looks like grinning)

37
Q

C. botulinum Toxin, Transmission, and Presentation

A

Heat labile Botulin Toxin
Transmitted in adults by ingesting preformed toxin
Transmitted in kids by ingesting spores in honey
Presentation: botulism (descending flaccid paralysis)

38
Q

C. perfringes Toxin and Presentation

A

Alpha toxin (a phospholipase)
Myonecrosis (gas gangrene)–may need amputation
Hemolysis

39
Q

C. difficile Toxins, Presentation, and Treatment

A 
Toxin A (enterotoxin) and Toxin B (cytotoxin)
Leads to pseudomembranous colitis and diarrhea often secondary to antibiotic use (especially clindamycin or ampicillin)
Treatment: metronidazole or ORAL vancomycin or fecal transplant for recurrent cases
40
Q

Bacillus Lab Algorithm

A

Gram + Bacilli
Spore forming
Obligate aerobe
B. cereus is motile and B. anthracis is not motile

41
Q

Bacillus anthracis Toxin, Capsule, and Presentation

A

Anthrax toxin
PolyPEPTIDE capsule (D glutamate)
Causes cutaneous, pulmonary, or ingested anthrax

42
Q

Cutaneous Anthrax Presentation

A

Boil-like lesion leads to ulcer with black eschar which can uncommonly progress to bacteremia and death

43
Q

Pulmonary Anthrax Presentation

A

Inhalation of spores leads to flu-like symptoms that rapdily progress to fever, pulmonary hemorrhage, mediastinitis, and shock. Death is 100%.
Woolsorters’ disease is inhalation of spores from contaminated wool

44
Q

Ingested Anthrax Presentation

A

Throat and intestine lesions leads to dysentery

45
Q

Bacillus cereus Presentation

A

Causes food poisoning
Emetic type usually seen with rice and pasta from the heat stable toxin and is seen 1-5 hours after ingestion
Diarrheal type is from the heat labile toxin and is seen 8-18 hours after ingestion

46
Q

Listeria monocytogenes Lab Algorithm

A

Gram + bacilli
Non-spore forming
Motile
Only Gram + with LPS

47
Q

Listeria monocytogenes Transmission

A

Ingestion of unpasteurized dairy products and deli meats, transplacental transmission, or vaginal transmission during birth

48
Q

Listeria monocytogenes Presentation

A

Can cause amnionitis, septicemia, and spontaneous abortion in pregenant women
Meningitis in immunocompromised or neonates
Mild gastroenteritis in healthy

49
Q

Listeria monocytogenes Treatment

A

Gastroenteritis self limited

Ampicillin for meningitis

50
Q

Actinomyces Information

A

Gram + beaded filaments (resembling fungi)
Transmitted by trauma
Anaerobic and not acid fast
Normal oral flora
Causes oral/facial abscesses that drain through sinus tracts, forming yellow “sulfur granules”

51
Q

Nocardia Information

A

Gram + beaded filaments (resembling fungi)
Transmitted by inhalation (found in soil)
Acid fast
Pulmonary infections in immunocompromised (also kidney/brain abscesses) and cutaneous infections after trauma in immunocompetent

52
Q

Actinomyces/Nocardia Treatment

A

SNAP:
Sulfonamides for nocardia (SN)
Actinomyces: penicillin

53
Q

Primary TB

A

ASK RJ

54
Q

Secondary TB

A

ASK RJ

55
Q

Mycobacteria Lab Diagnosis

A

Gram + Rod

Acid Fast

56
Q

M. kansasii and M. avium Presentation

A

M. kansasii: pulmonary TB like symptoms

M. avium: disseminated, non-TB disease in AIDS

57
Q

TB Symptoms

A

Fever
Night Sweats
Weight Loss
Hemoptysis

58
Q

Leprosy Basic Information

A

Caused by M. leprae (likes cool temperatures)
Infects skin and superficial nerves (glove and stocking loss of sensation)
Reservoir of ARMADILLOS
Treatment: Multidrug therapy (dapsone and rifampin for 6 months + clofazimine and 2-5 years instead for lepromatous)

59
Q

Tuberculoid Leprosy

A

Limited to a few hypoesthetic hairless skin plaques
High cell mediated immunity with a largely TH1 immune response (strong immune response)
Could have granulomas

60
Q

Lepromatous Leprosy

A

Diffusely over the skin and is communicable

Low cell-mediated immunity with a HUMORAL and TH2 response (weak immune response)

Cojo's Step Cards, Bugs (14 decks)

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