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MOD Final > Bacteria > Flashcards

Bacteria Flashcards

1
Q

What are the 6 major gram positive bacteria and their general characteristics

A

Staphylococcus

  • Cocci
  • Catalase +

Steptococus/Enterococus

  • Cocci
  • Catalase -

Bacillus

  • Bacilli
  • Spore forming
  • Aerobic

Clostridium

  • Bacilli
  • Spore forming
  • anerobic

Corynebacterium

  • Non-spore forming
  • Club shaped

Listeria

  • Bacilli
  • Non-spore forming
  • Motile at 25 C
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2
Q

Are catalase or coagulase present in the following gram positive bacteria:

Staphylococcus Aureus

Staphylococcus epidermis

Staphylococcus saprophyticus

A

Staphylococcus Aureus: catalase +, coagulase +

Staphylococcus epidermidis: catalase +, coagulase -

Staphylococcus saprophyticus: catalase +, coagulase -

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3
Q

Staphylococcus Aureus

Major disease manifestations

A

Pneumonia

Superifical skin & underlying soft tissue infections

  • Folliculitis
  • Impetigo
  • Cellulitis
  • Abscess

Endocarditis (acute, necrotizing)

  • Classic case is IV drug abuser using dirty needles
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4
Q

Staphylococcus Aureus

Role of key Toxins

A

Gastroenteritis (food poisoning)

  • preformed enterotoxin (quick onset)
  • Nausea, vomiting, diarrhea, abdominal pain

Scalded Skin Syndrome

  • Exfoliative toxin A & B
  • Peeling of skin

Toxic Shock Syndrome

  • Due to TSST-1 toxin (superantigen)
  • Long term superabsorbant tampon use
  • Diffuse Rash (involves palms and soles)
  • Shock, hypotension, death
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5
Q

What organism is known for infecting prosthetic devices (heart valves, hardware, cathethers, shunts) and uses a biofilm as it’s virulence factor?

What is the disease manifestation of this organism

A

Staphylococcus epidermidis

Subacute endocarditis - low grade fever

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6
Q

What organism is the common cause of community acquired UTIs

A

Staphylococcus saprophyticus

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7
Q

Categorize the alpha, beta and gamma streptococcus

A

Alpha (partial hemolysis)

  • S. pneumoniae
  • Viridans Group

Beta (complete hemolysis)

  • S. pyrogenes
  • S. agalactiae

Gamma (no hemolysis)

  • Enterococci group
  • S. bovis
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8
Q

Streptococcus pyogens (Group A)

  1. Disease manifestation
  2. Virulence factor
A
  1. Disease Manifestations
  • Streptococcal pharyngitis (strep throat): white exudate of tonsils/pharynx
  • Scarlet fever
  • Erysipelas: sunburn type appearance (face), warm to touch, peak age 60-80
  • necrotizing facitis: rapidly progressive, purplish discoloration
  • Impetigo: golden crusted rash see in children
  • Cellulitis: Non-necrotizing on subcutaneous tissue, swollen, erythematous, warm
  • Rheumatic fever
  • Post-Streptococcal Glomerulonephritits
  1. M protein = inhibits activation of complement
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9
Q

What causes Scarlet fever & what are the clinical manifestations

A
  1. Due to pyrogenic exotoxin of Streptococcus pyogenes
  2. Fever, rough “sandpaper” like rash on trunk and neck. Stawberry tongue. School age children
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10
Q

Rheumatic fever

  1. Disease manifestation
  2. Pathogenesis
  3. Diagnostic test
A
  1. JONES: Fever, migratory polyarthritis, large joints, subcutaneous nodules, erythema marginatum (macular rash), heart involment (pericarditis, mitral valvulitis), sydenham chorea (hopping, halthing gait, grimacing)
  2. Disorder that occurs following a group A S. pyogenes pharyngeal infection caused by antibodies created to the M streptococcal antigen
  3. Detection of antibodies to streptolysin O and DNase B
    * Said will definitly expect us to recognize a classic case presentation of this disease*
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11
Q

Post-streptococcal Glomerulonephritits

  1. Disease manifestation
  2. Pathogenesis
  3. Diagnostic test
A
  1. Usually in children, edema, hypertension, hematuria, proteinuria
  2. Immune mediated rxn to Group A streptococcus, S. pyogenes following pharyngitis or skin infection
  3. Detection of antibodies to streptolysin O and DNase B
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12
Q

Streptococcus agalactiae (Group B)

Disease manifestation

A

A galacta baby

Neonatal meningitis, pneumonia, sepsis

“B” = Babies, Group B Strep & Beta hemolytic

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13
Q

Streptococcus pneumoniae

  1. Identifying characteristics
  2. Clinical manifestations
A
  1. Characteristics
  • Encapsulated alpha hemolytic
  • Positive quellung reaction (swollen capsule)
  • Optochin sensitive (antibiotic)
  1. # 1 cause of MOPS (meningitis, otitis media, pneumonia, sinusitis)
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14
Q

What is the most common cause of community aquired pneumonia & what is the manifestation of pneumonia

A

Streptococcus pneumoniae

Lobar consolidation on chest x-ray w/ high fever, chills, cough, SOB frequently seen in elderly (older than 65)

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15
Q

What is the #1 cause of meningitis in young children and what is the classic presentation

A

Streptococcus pneumoniae

Classic triad:

  1. high fever >100.4 F
  2. Nichal rigidity
  3. Abnormal mental status change
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16
Q

What is the most common cause and basic presentation of otitis media in children

A
  1. Bacterial causes
  • Streptococcus pneumoniae
  • Haemophilus influenzae
  • Moraxella catarrhalis
  1. Ear pain, tugging/pulling at ear
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17
Q
  1. What role does the spleen have on encapsulated bacteria
  2. What are the 3 main disease causing encapsulated bacteria
A
  1. Encapsulated bacteria are opsonized and cleared by the spleen
  2. Streptococcus pneumoniae, Haemophilus influenza (type B), Neisseria meningitis
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18
Q

Viridans Group Streptococci

Major disease manifestations

A
  • Dental carries
  • Subacute bacterial endocarditis (low grade fever, fatigue). Same in HACEK organisms
  • Typical clinical history: Endocarditis following dental procedures that allows organisms to spread hematogenously to heart valves*
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19
Q

Differentiate Enterococci & Group D non-Enterococci

A

Enterococci (Group D)

  • Cause nosocomial infections
  • grow on bile and 6.5% salt

Non-Enterococci Group D

  • Strongly associated with colon cancer (Streptococci bovis)
  • Grown on bile but not salt
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20
Q

Bacillus cereus

  1. Characteristic
  2. Major disease manifestation
A
  1. Gram positive, spore forming rod that is extremely resistant to heat. Spores germinate, bacteria create toxins.
  2. Heat stable toxin: emetic disease (nausea/vomiting, abdominal pain)

Heat labile toxin: Watery diarrhea

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21
Q

Bacillus anthracis

  1. Characteristics
  2. Risk factors for acquiring
  3. Disease manifestation
A
  1. Gram positive, encapsulated, spore forming rod
  2. Spore found on herbivore animals products (hides) - sheep
  3. Manifestations
  • Cutaneous anthrax: malignant pustile
  • Inhalation anthrax: pulmonary spores —> mediastinal hemorrhage -> death (agent of bioterrorism)
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22
Q

Clostridium difficile

  1. Predisposing factor
  2. Virulence
  3. Pathologic findings
A
  1. causative organisms of antibiotic associated colitis (clindamycin, penicillins)
  2. Virulence factors
  • Toxin A: Increases inflammation, increase fluid secretion (diarrhea)
  • Toxin B: Cytotoxic to colonic epithelial cells
  1. Pseudomembranous colitis
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23
Q

Clostridium botulinum

  1. Mechanism of action
  2. Risk factors for disease
  3. Disease manifestation
A
  1. Neurotoxin in bacteria inhibits release of acetylcholine at the NMJ
  2. Canned food, honey
  3. Bilateral cranial neuropathies, symmetric descending muscle weakness –> respiratory paralysis, death.

Infantile botulism: Spore consumption from honey –> constipation–>difficulty swallowing, muscle weakness

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24
Q

Clostridium tetani

  1. Mechanism of action
  2. Risk factors for disease
  3. Disease manifestation
A
  1. Neurotoxin inactivates glycine and GABA leading to sustained contraction of motor neurons
  2. Deep puncture wounds
  3. Severe muscle spasms, autonomic instability, Opsisthotonos (arching of headm neck &spine/body), clenched jaw
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25
Q

Clostridium perfringens

  1. Risk factors for disease
  2. Disease manifestation
A
  1. Deep wounds/trauma
  2. Manifestation
  • hemolysis & hemorrhage
  • Cellulitis/wound infections that can progress to myonecrosis (gas gangrene, CO2 production, crepitus), dark purple to black skin discoloration
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26
Q

Corynebacterium (club shaped)

  1. Virulence factor
  2. Clinical presentation
  3. What potentiates its systemic absorption
A
  1. AB exotoxin
  2. Pharyngitis w/ pseudomembrane formation
  3. Scraping causes systemic absorption of toxin which can lead to
  • Myocarditis: Dysrhythmias, AV conduction block
  • Neural involvement
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27
Q

Rhodococcus equi (club shaped)

Clinical presentation

A

Cause pulmonary disease in immunocompromised and can cause abscess cavities with prominent air fluid levels on chest x ray

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28
Q

Listeria Monocytogenes

  1. Optimal growth conditions
  2. Risk factors
  3. Disease manifestation
A
  1. Grows at cooler temperatures
  2. Dairy products, deli meats, sprouts (pregnant women told to avoid)
  3. Manifestations
  • Fetus/neonates: granulomatous infantiseptica & neonatal meningitis
  • Pregnant women: sepsis
  • Older adults & immunocompromised: meningitis
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29
Q

List the gram (-) diplococci

A

Neisseria meningitis

Neisseria gonorrhea

Moraxella catarrhalis

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30
Q

Neisseria meningitis

  1. Characteristics
  2. Susceptible populations
  3. Clinical presentation
A
  1. Grows on chocolate agar (Thayer Martin agar)
  2. Neonates, 1/2 to 2 yrs, military recruits, college students (dorms), asplenia/hyposplenia
  3. Clinical presentation
  • Meningitis (fever, stiff neck, nausea/vomiting, rash)
  • Meningococcemia: meningitis + septicemia
    • Waterhouse-Friderichsen syndrome: bilateral adrenal hemorrhage with insufficiency, severe hypotension, disseminated intravascular thrmbosis, death
31
Q

Neisseria gonorrhea

  1. Agar growth conditions
  2. Clinical presentation in men, women & neonates
A
  1. Intracellular gram negative diplococci that grows on Thayer-Martin chocolate agar
  2. Clinical presentatin
  • Men: Urethritis, acute epididymitis (posterior testicular pain, swelling)
  • Women: Urethritis, cervitis (itiching,discharge), pelvic inflammatory disease (can cause sterility and present with pelvic/abdominal pain)
  • Infants: opthalmia neonatorum = neonatal conjunctivitis
32
Q

Moraxella catarrhalis

  1. Features
  2. Disease presentation
A
  1. Gram negative diplococcis grown on blood and chocolate agar
  2. Third most common cause of otitis media in children
33
Q

Escherichia coli

  1. Principal properties
  2. Diseases
A
  1. Gram negative rod, lactose fermenter, normal flora of GI tract
  2. Diarrhea, meningitis, UTI, pneumonia
    * common cause of neonatal meningitis and most common cause of UTI*
34
Q

Enterotoxigenic E. coli (ETEC)

  1. Risk factor
  2. Key toxins
  3. Clinical presentations
A
  1. Fecally contaminated food or water
  2. Heat labile (LT) and heat stable (ST) toxins
  3. Watery diarrhea
35
Q

Enteroinvasive E. coli (EIEC)

Clinical presentations

A

Invasive plasmid leading to bloody diarrhea

36
Q

Enterohemorrhagic E. coli (EHEC)

  1. Risk factor
  2. Key toxins
  3. Clinical presentations
A
  1. Foods
  2. Shiga-like toxin
  3. Hemolytic uremic syndrome (HUS)
  • Caused by EHEC E. coli 0157
  • Anemia, thrombocytopenia, renal damage/failure (uremia)
37
Q

Shigella

  1. Disease manifestations
  2. Pathogenesis
A

Gram negative rod, always pathogenic

  1. High fever with bloody diarrhea
  2. S. dysenteriae produced Shiga toxin resulting in cell death
38
Q

Typhoid fever

  1. cause
  2. clinical fidings
A
  1. Salmonella typhi
  2. Clinical findings
  • “stepwise fever”
  • colicky RUQ abdominal pain
  • Delirium “typhoid encephalopathy”
  • “rose spots” on abdomen
39
Q

Yersinia enterocolitica

  1. Presentation
  2. Risk factors
A

Gram negative rod

  1. Fever, abdominal pain, diarrhea, RLQ pain = pseudoappendicitis
  2. Milk products
40
Q

Proteus mirabilis

Unique features

A

Swarming motility

urease positive

common cause of UTI especially in nosocomial settings

41
Q

Klebsiella pneumoniae

  1. Types of patients affected
  2. Disease manifestation
A

Gram negative rod, encapsulated

  1. Alocholics and hospitalized patients
  2. Pneumonia (necrotizing, cavitary) w/ red currant jelly sputum
42
Q

Pseudomonas aeruginosa

  1. Characteristic
  2. Patients commonly affected
  3. Major types of infections causes
A
  1. Gram negative rod, produces green-blue pigment and had distinct grape like scent
  2. Patients
  • Cystic fibrosis (CF)
  • Burn victims
  • debilitated, typically hospitalized patients
  1. Infections
  • Pulmonary infections (mild bronchitis to pneumonia)
  • Primary skin/wound infections (burn wounds, otitis externa, hot tub folliculitis)
43
Q

Bacteroides fragilis

  1. Features
  2. Disease manifestations & Predisposing factors to infection
A
  1. Gram negative bacillus, obligate anaerobe
  2. Manifestation/predisposing
  • Abscess after traumatic bowel injury
  • Abscess after ischemic bowel perforation
  • Deep abscess (deep surgical sites)
44
Q

Vibrio cholerae

  1. Clinical manifestation
  2. Predisposing factors
A
  1. Profuse watery diarrhea leading to dehydration
  2. Transmitted from brackish and marine water. Cholera toxin activates cAMP causing an osmotic pull of water into bowel lumen.
45
Q

Vibrio vulnificus

  1. Predisposing factors
  2. Clinical manifestations
A
  1. Consumption of raw seafood
  2. Consumption: Severe diarrhea, septicemia (sudden fever, chills, hypotension, nausea/vomiting)

Direct handling: progressive wound infection

46
Q

Vibrio parahaemolyticus

  1. Predisposing factors
  2. Clinical manifestations
A
  1. Consumption of raw seafood
  2. Watery diarrhea, nausea/vomiting (most common cause of food poisoning in Japan)
47
Q

Campylobacter jejuni

  1. Predisposing factor
  2. Clinical findings
  3. Notable association
A
  1. Uncooked meat (chicken), unpasteurized milk
  2. Invades small bowel & colon causing fever, diarrhea (+/- blood), severe abdominal pain, can mimic acute appendicitis
  3. Guillain-Barre syndrome: an immune mediated neuropathy causing ascending flaccid paralysis
48
Q

Reiter’s Syndrom/Reactive arthritis

  1. Trigger
  2. clinical manifestations
A
  1. Associated with HLA-B27. Can be triggered by many of the enteric bacteria
  2. Classic triad: conjunctivitis, urethritis, arthritis
49
Q

Helicobater pylori

  1. Clinical manifestations
  2. Long term risk
  3. Diagnosis
A
  1. Chronic gastritis (nausea/vomiting), gastric and duodenal ulcers (pain)
  2. Gastric B-cell lymphoma (MALT), Gastric adenocarcinoma
  3. Positive rapid urease test
50
Q

Bordetella pertussis

  1. What disease does it cause
  2. Associated toxin
A
  1. Whooping cough: hacking cough followed by a high pitched inspiratory whoop
  2. Pertussis toxin (increases cAMP lymphocytosis)
51
Q

Legionella pneumophila

  1. Risk factors
  2. What disease does it cause
A
  1. Found in water system (cooling towers, condensers, showers, tubs)
  2. Disease
  • Pontiac fever: self limited febrile illness (2-5 days): fever, chills, myalgia, malaise, headache)
  • Legionnaires’ disease: more severe multilobular pneumonia with abscess
52
Q

Haemophilus influenzae

  1. Disease manifestation
  2. Growth characteristics
  3. Importance of vaccination
A
  1. Manifestation
  • Encapsulates
    • Early childhood meningitis
    • acute epiglottitis
    • wheezing, drooling
  • Unencapsulated
    • Otitis media
  1. Require hemin and NAD (X and V factors) for growth, both found in blood.
  2. Hib vaccination
53
Q

Haemophlius ducreyi “chancroid”

Typical presentation

A

Painful genital ulcer “chancroid” that can cause unilateral pus forming inguinal lymphadenopathy

sexually transmitted

LOOK AT AND KNOW SLIDE 107/ PPT 91

54
Q

Gardnerella vaginalis

Basic presentation

A

Cause of bacterial vaginitis detected on Pap smear as “clue cell”. Replaces normal vaginal flora resulting in malodorous “fishy smelling” discharge, prutitus and dysuria

55
Q

Yersinia pestis

  1. Disease manifestation
  2. Transmission
A
  1. Bubonic plague (hemorrhage under skin) & pneumonic plaque
  2. Reservoir (prarier dogs), vector (fleas)
56
Q

Francisella tularensis

  1. Disease manifestation
  2. Transmission
A
  1. Similar to bubonic plague except presents with skin ulcers
  2. Rabbits or via tyick/deerfly bite
57
Q

Brucella species

  1. Describe infection
  2. Risk factor
A
  1. Fever, night sweats, undulant fever (rising and falling), anemia, leukopnia
  2. Domesticated animal products, milk, meat, placenta
58
Q

Pasteurella multocida

  1. Describe infection
  2. Risk factor
A
  1. Localized wound infection (cellulitis)
  2. Bite or scratch from cats and dogs
59
Q

Chlamydia trachomatis

Clinical manifestations

A

Non-goococcal urethritis

  • Dysuria, discharge in men
  • Dysuria, increased frquency in women

Epididymitis (men)

Pelovic inflammatory disease (women)

  • Infertility

Trachoma (pediatricts)

  • Chronic eye infection

Neonatal inclusion conjunctivitis

Lymphogranuloma venereum

  • Caued by L1-L3. Tender suppurative inguinal lymphadenitis which can ulcerate
60
Q

Chlamydia pneumoniaq & Chlamydia psittaci

  1. Presentation
  2. Major transmission risk
A
  1. Atypical pneumonia (dry cough, low grade fever, with patchy interstitial inflammatory changes)
  2. Chlamydia psittaci - bird exposure
61
Q

Rickettsia species

  1. General clinical presentation
  2. Vector & reservoir of Rickettsia rickettsii
A
  1. Fever, rash, thrombocytopenia
  2. Ticks/Dogs, rabbits, wild rodents
62
Q

Rocky Mountain spotted fever

  1. Presentation
  2. Geographic distribution
  3. Causative organism
A
  1. Fever, centripetal rash including palms and soles
  2. Central, southeast U.S.
  3. Rickettsia rickettsii
63
Q

Ehrlichia chaffeensis

  1. Characteristics
  2. Clinical manifestation
A
  1. Intracellular tick born illness
  2. Similar to RMSF except no rash transmitted by ticks in Southeast and Central United States
64
Q

Coxiella burnetti (Q fever)

  1. Clinical manifestations
  2. Risk factors
A
  1. Fever, headache, atypical pneumonia
  2. Found in cattle, sheep, goats. Airborne transmission from spore contaminated hide and birth products
65
Q

Treponema pallidum

Time course & key clinical features

A

Primary

  • 3-6 weeks
  • painless chancre

Secondary

  • 6 weeks
  • Condyloma lata, macular red rah (including palms and soles)

Tertiary syphilis

  • 6-40 yrs
  • Gummatous lesions
  • Thoracic aortic aneurysm
  • Neurosyphilis (meningitis, tabes dorsalis)
  • Argyll Robinson pupils
66
Q

Treponema pallidum

Congenital syphilis key features

A

Congenital syphilis

  • 2 years after birth
  • mucous membrane involvement (rhinitis) “snuffles”
  • Manifestations of sencondary syphilis (rash-including palms and soles)

Late congenital syphilis

  • >2 yeard after birth
  • tertiary syphilis
  • neurosyphilis
  • bone and teeth involvement
67
Q

Treponema pallidum

Syphilis Screening and Diagnostic test

A

Screening test

  • VDRL (venereal disease research laboratory)
  • RPR (Rapid plasma reagin)

Diagnostic tests

  • FTA-ABS
68
Q

Borrelia burgdorferi

  1. Disease
  2. Vector, reservoir, geographic location
A
  1. Lyme disease (#1 tick-borne illness)
  2. Ixodes tick (blacklegged ticks), deer/mice, Northeast U.S., Upper Midwest
69
Q

Borrelia burgdorferi

Lyme disease manifestation

A

Early localized disease

  • erythema migrans (at bite site)

Early disseminated disease

  • nervous system (Bell’s palsy), heart, joints

Late disease

  • chronic arthritis
  • encephalopathy
70
Q

Mycobacterium tuberculosis

Differentiate primary and secondary Tb

A

Primary tuberculosis (Tb)

  • Aerosolized transmission
  • begins in the lungs
  • immunocompromised elderly & young
  • Fever, chest pain, hilar lymphadenopathy
  • histologic findings: necrotizing granulomas

Secondary tuberculosis

  • Appears months to years
  • low grade fever, night sweats & hemoptysis
  • Apex UL
  • Can disseminate casuing miliary tuberculosis (innumerable lesions throughout organs)
  • Any organ can be involved: (If verterbal involvement = Pott’s disease)
71
Q

What is the screening test for tuberculosis

A

Tuberculin skin test & interferon-gamma release assays

72
Q

Differentiate between tuberculoid leprosy and lepromatus leprosy

Primary reservoir in US

A

Tuberculoid leprosy

  • Strong cell mediated response (Th1, IFN-gamma)
  • Localized skin lesions
  • Granulomatous inflammation
  • Unilateral skin/ nerve; loss of nerve sensation

Lepromatous leprosy

  • No/minimal cell mediated response
  • disseminated disease: skin lesion cover the body; involvement of organs

Rservoir: armadillos in southern U.S.

73
Q

Mycobacterium pneumoniae

  1. Clinical presentation
  2. Key associations
A
  1. Presentation
  • Walking pneumonia - mild, self limited bronchitis and penumonia
  • very common cause of atypical penumonia
  1. Associations
  • Nonspecific cold agglutinins diagnostic test
  • Associated with erythema multiforme: multiple target lesions
74
Q

What organisms with no cell wall are a cause of urethritis

A

Mycoplasma genitalium

Ureaplasma urealyticum

MOD Final (3 decks)

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