Bacteria Flashcards
(648 cards)
1
Q
what 4 bacteria cause cellulitis
A
staph aureus
strepto pyrogenes
clostridium perfringes
pasteurella multocida
2
Q
what 2 bacteria cause impetigo
A
staph aureus
strepto pyrogenes
3
Q
what 4 bacteria cause necrotizing fasciitis
A
strepto pyrogenes
clostridium perfringes
acinectobacter baumannii
vibrio vulnificius
4
Q
what bacteria causes cutaneous anthrax
A
bacillus anthracis
5
Q
what bacteria causes gas gangrene
A
clostridium perfringes
6
Q
what bacteria causes erisipylas
A
strepto pyrogenes
7
Q
what bacteria causes scalded skin syndrome
A
staph aureus
8
Q
what is the main bacteria that causes absesses
A
staph aureus
9
Q
what bacteria causes pulmonary anthrax
A
bacillus anthracis
10
Q
what bacteria causes pneumonia especially in neonates
A
strepto agalactiae
11
Q
what bacteria causes necrotizing pneumonia
A
staph aureus
12
Q
what 2 bacteria cause lobar pneumonia
A
strepto pneumoniae
klebsiella pneumoniae
13
Q
what 2 bacteria cause toxic shock syndrome
A
staph aureus
strepto pyrogenes
14
Q
what bacteria causes scarlet fever
A
strepto pyrogenes
15
Q
what bacteria causes neonatal sepsis (within 1 week of birth)
A
strepto agalactiae
16
Q
what bacteria causes acute glomerularnephritis
A
strepto pyrogenes
17
Q
what 3 bacteria cause food poisoning
A
staph aureus
bacillus cereus
clostridium perfringes
18
Q
what 3 bacteria cause food poisoning
A
staph aureus
bacillus cereus
clostridium perfringes
19
Q
what 3 bacteria cause otitis media (which is the main)
A
staph aureus
haemophilus influenzae
strepto pneumoniae (main cause)
20
Q
what 2 bacteria causes pharyngitis
A
strepto pyrogenes
neisseria gonnorheae
21
Q
what 2 bacteria causes ocular infection
A
bacillus cereus
pseudomonas aeruginosa (abrasion from contact lenses)
22
Q
what bacteria causes rheumatic fever
A
strepto pyrogenes
23
Q
what bacteria causes endocarditis on prosthetic valves
A
staph epidermidis
24
Q
what 2 bacteria causes endocarditis on native valves without pre-existing murmurs
A
staph aureus
staph lugdunensis
25
what bacteria causes endocarditis on native heart valves, more so when there is a pre-existing murmur
strepto mutans
26
what bacteria causes septic arthritis in kids
staph aureus
27
what 2 bacteria cause paralysis
clostridium tetani
clostridium botulinum
28
what bacteria causes flaccid paralysis
clostridium botulinum
29
what bacteria causes rigid paralysis
clostridium tetani
30
what 2 bacteria causes osteomyelitis
staph aureus
pseudomonas aeruginosa (only in immunocompromised)
31
what 2 bacteria cause myonecrosis
clostridium perfringens
clostridium septicum
32
what is the main bacteria that causes UTI in pregnant women
strepto agalactiae
33
what are the 5 main bacteria that causes UTI
strepto saprophyticus
enterococcus faecalis
corynebacterium urealyticum
proteus mirabilis
*e.coli
34
what 6 bacteria causes adult meningitis
strepto pneumoniae
listeria monocytogenes
mycobacterium tuberculosis
neisseria meningiditis (young adults)
haemophilus influenzae
e.coli (in hospitalized patients w/underlying inflammation in brain/stroke)
35
what are 2 bacteria that cause neonatal meningitis
strepto agalactiae
listeria monocytogenes
36
what are the 4 main virulence factors of staph aureus that allows for colonization
fibronectin binding protein
collagen binding protein
coagulase
exfoliating toxin A and B cleave desmoglein 1 (top layer of skin)
37
what are the 3 main virulence factors of staph aureus that allows for immune evasion
catalase
spa proteins
ability to survive in/travel with neutrophils
38
what is the result of TSST-1 and SE-A/B/C release by staph aureus
superantigen release (inflammation)
39
what 2 virulence factors allow for antibiotic resistance by staph aureus
mecA gene (resistance to most beta lactams due to alternative transpeptidase)
beta-lactamase production
40
what are the 3 main virulence factors of strepto pyrogenes
streptolysin O and S (hemolysis)
SpeA/B/C (superantigen=imflammation)
M protein/hyaluronic acid capsule (immune mimicry)
41
what are the 3 main virulence factors of strepto pneumoniae
pneumolysin (alpha hemolysis)
polysaccharide capsule (immune evasion)
adhesins (bind to cell surface, cross epithelium)
42
what are the 2 main virulence factors of bacillus cereus
heat stable cereolysn (similar to MAC)
heat liable A/B toxin upregulates cAMP
43
what is the main virulence factor of bacillus anthracis
2 A/B toxins (1 A= edema (increase cAMP), another A= lethal (cleave MAP kinase to decrease translation and kill bacteria)
44
what is the main virulence factor of clostridioides difficle
toxins A and B (pseudomembrane sloughing of colon epithelial cells)
45
long term use of what 2 antibiotics increases the risk for developing C. diff
clarithromycin
ciprofloxacin
46
C. difficile with increased toxin genes are resistant to what antibiotic
fluoroquinolones
47
what are the 4 treatment options for C. difficile
oral vancomycin
metronidazole
fecal transplant
fidaxomicin
48
what is the best antibiotic for use with tetanus or botulism infection
metronidazole (they're obligate anaerobes which are killed by ROS produced by metronidazole)
49
how does tetanus differ from botulism in terms of the effect of the A/B toxin released
tetanus- stops GABA+glycine release
botulism- stops acetylcholine release
50
how do you test for botulism in adults vs in babies
adults- test food for botulism toxin
babies- test baby's stool
51
why is botulism considered an infection rather than an intoxication in babies
bacteria spores germinate in the baby's gut
52
what are the 2 main virulence factors of listeria monocytogenes
listeriolysin O (acts as MAC)
actA (reconstruction of our cell cytoskeleton= becomes intracellular= bacteria can move from one cell to another, and protects bacteria against ROS)
53
what is the main concern about listeria infection in pregnant women
listeria can cross the placenta, leading to granulomas in tissues of fetus
54
why does listeria lead to granulomas if acquired in utero
fetus early in development has not developed a thymus for T cell development= no Th1 cells to fight intracellular infection
55
listeria is grown best at what temperature
4C
56
how is listeria acquired
food-borne, especially with unpasturized dairy products
57
what are the 2 best antibiotics for listeria infection
penicillin or ampicillin
58
what bacteria causes erisipeloid
erysipelothrix rhusiopathiae
59
what bacteria can cause granulomas in fetal tissues and organs
listeria monocytogenes
60
what bacteria causes pseudomembranous colitis
clostridiodes difficile
61
what is C.diff symptoms progression like
watery diarrhea-->mucous, bloody diarrhea
62
are staphylococci gram + or -
+
63
are staphylococci motile or non-motile
non-motile
64
are staphylococci catalase + or -
+
65
many staphylococci are resistant to what bacteria
1st generation beta lactams
66
what are the 3 main determinants of staphylococcus aureus
beta hemolytic
can ferment mannitol
clots blood plasma on slide and in test tube
67
what is the virulence factor of staphylococcus aureus that allows for abscess formation
coagulase
68
is staphylococcus epidermidis coagulase positive or negative
negative
69
what is the virulence factor of staphylococcus epidermidis that allows for infection on artificial surfaces such as heart valves and prosthetic joints
biofilm
70
how can you differentiate staphylococcus epidermidis and staphylococcus saprophyticus from other staphylococcus bacteria
gamma hemolytic
coagulase negative
71
how can you differentiate staphylococcus epidermidis from staphylococcus saprophyticus in terms of novobiocin susceptibility
s. epidermidis is killed by novobiocin
72
how can you differentiate staphylococcus lugdunensis from other staphylococcus bacteria (2 characteristics)
CAMP+
slide coagulase + but tube coagulase -
73
are streptococcus gram + or -
+
74
are streptococcus catalase + or -
"-" but make some catalase
75
are streptococcus motile or non-motile
non-motile
76
what type of -philes are streptococci
capnophiles
77
what is a differentiating characteristic of streptococci, which also acts as a virulence factor
polysaccharide capsule
78
is streptococcus pyrogenes bacitracin susceptible or resistant
susceptible
79
what is the only streptococci species which is PYR test +
streptococcus pyrogenes
80
is streptococcus agalactiae bacitracin susceptible or resistant
resistant
81
is streptococcus agalactiae alpha, beta, or gamma hemolytic
beta
82
is streptococcus pyrogenes or agalactiae CAMP test +
s. agalactiae
83
is streptococcus pneumoniae alpha, beta, or gamma hemolytic
alpha
84
what streptococcus species is optochin susceptible
streptococcus pneumoniae
85
is steptococcus pneumoniae bile susceptible or bile reistant
susceptible
86
how do streptococcus pneumoniae appear on blood agar
caved in centers of colonies due to autolysin expression at high population densities (end of stationary phase)
87
what 2 antibiotic types are best to use with streptococcus pneumoniae due to their autolysin characteristic
beta lactams
vancomycin
*turn on autolysin genes
88
how do streptococcus pneumoniae appear with gram stain
diplococci (short chain of 2)
89
what are the 5 main virulence factors of streptococcus pneumoniae
pneumolysin
polysaccharide capsule
neuraminidase A (cleaves sialic acid on cell surface= better adhesion)
cleavage of IgA (IgA protease)
disable complement (C3b)
90
what are the symptoms of lobar pneumonia caused by streptococcus pneumoniae
brown/red sputum
fever
dyspnea/SOB
low level bacteremia
91
why is the 13 variant protein conjugated anti-capsular vaccine effective in adults and children
you get an immune memory response with T cells
92
why is a 23 variant polysaccharide (no protein conjugation) anti-capsular vaccine used in elderly populations
elderly already don't have any T cells due to a decrease in thymus activity
93
what are the 2 best antibiotic classes to use for streptococcus pneumoniae infection
beta lactams (trigger autolysis= increase inflammation due to release of PAMPS)
macrolides
94
is the viridan group of streptococcus (S.mitis, salivarius, and mutans) alpha, beta, or gamma hemolytic
alpha
95
is the viridan group of streptococcus (S.mitis, salivarius, and mutans) bile susceptible or resistant
resistant
96
what is the main bacteria that causes cavities
streptococcus mutans (makes biofilm)
97
is the viridan group of streptococcus optochin susceptible or resistant
resistant
98
what are the 5 main characteristics of enterococcus faecalis
grow in high salt concentrations
can break down esculin
not lysed by bile
optochin resistant
PYR +
99
what antibiotics are enterococcus faecalis resistant to
why
vancomycin
beta lactams
it has a vanA cassette which codes for a different cell wall structure
100
are bacillus bacteria aerobic or anaerobic
aerobic
101
what is the class of bacteria which are aerobic, spore forming
bacillus
102
are bacillus gram + or -
+
103
are bacillus cereus motile or non-motile
motile
104
are bacillus cereus alpha, beta, or gamma hemolytic
beta (due to cereolysin)
105
are bacillus cereus catalase positive or negative
positive
106
is bacillus anthracis motile or non-motile
non-motile
107
is bacillus anthracis alpha, beta, or gamma hemolytic
gamma
108
how does bacillus anthracis appear on blood agar
white, ground glass colonies
109
why can bacillus anthracis not cross the BBB
its capsule is made of poly-glutamate instead of carbohydrates
110
who is most likely to be infected by anthrax
farmers/ranchers, as bacillus anthracis infects livestock (spores are found in soil, animals get spores on their skin)
111
what antibiotic is used for "mass casualty events" with bacillus anthracis
fluoroquinolones
112
what 2 antibiotics can be used for anthrax infection in an agriculture related patient
fluoroquinolones
beta lactams
113
what class of bacteria are obligate anaerobe spore forming rod bacteria
clostridium
114
are clostridium gram + or -
+
115
are clostridium perfringes alpha, beta, or gamma hemolytic
beta (due to phospholipase C which destroys phospholipids in our cell membrane)
116
are clostridium tetani motile or non-motile
motile
117
what type of spores do clostridium tetani and botulinum produce
terminal
118
are clostridium botulinum motile or non-motile
non-motile
119
is listeria monocytogenes gram + or -
+
120
is listeria monocytogenes alpha, beta, or gamma hemolytic
weakly beta (listeriolysin O)
121
is listeria monocytogenes motile or non-motile
motile at 25C (room temp)
non-motile at 37C (body temp)- expresses actA and acts using "actin rocket"
122
what type of motility does listeria monocytogenes display
tumbling
123
how does listeria monocytogenes appear with gram stain
very short
124
how does listeria monocytogenes appear with gram stain of CSF sample with meningitis patient
often not seen
125
erysipelothrix rhusiopathiae affects what organisms
swine- people who work with pigs are at risk
126
how is the erysipeloid infection caused by erysipelothrix rhusiopathiae different from erysipelas caused by strepto. pyrogenes in terms of appearance and pain causing
erysipeloid is darker purple and painful throbbing
127
erysipelothrix rhusiopathiae are ___-philes
microaerophiles
128
how do erysipelothrix rhusiopathiae appear with gram stain
often stain pink
129
are corynebcterium gram + or -
+
130
do corynebacterium form spores
no
131
what is the arrangement of corynebacterium under gram stain
palisading rods (rods clustered together lined up)
132
what is the main virulence factor of corynebacterium diphtheriae
A/B toxin- A subunit binds to EF2 inhibiting protein synthesis
133
the B subunit of corynebacterium diphtheriae heparin binding epidermal growth factor on epithelial cells found is in what 3 cell types
respiratory
cardiac
some neurons
134
is corynebacterium diphtheriae an example of lytic or lysogenic conversion
lysogenic
135
the phage of corynebacterium diphtheriae which contains the toxin is in an operon which is turned off by what
iron
136
what are the 2 main signs of corynebacterium diphtheriae infection
grey pseudomembrane on pharynx
bull neck
137
corynebacterium diphtheriae infection symptoms begins with ___ symptoms that can spread to __ and __
pharyngeal
myocarditis and neural symptoms
138
cutaneous diphtheria results from what
wound infection
139
the diphtheria component of the DTap vaccine is what type of vaccine
diphtheria subunit toxoid
140
what are 2 ways in which isolates can be tested for corynebacteria diphtheria
toxin production through PCR
anti-toxin antibodies using Elek test
141
what are the 2 main antibiotic classes used for corynebacterium diphtheria infection
macrolides or tetracycline due to their ability to stop translation, inhibiting A/B toxin production
142
what type of corynebacterium makes H2S, visible as black with Tinsdale media
corynebacterium diphtheria
143
what class of corynebacterium can grown on medical devices due to biofilm production
corynebacterium jeikeium
144
what 2 classes of corynebacterium are rare in healthy people, however are more common in hospitalized patients
c. jeikeium and c.urealyticum
145
what 2 bacteria cause UTIs which produce kidney stones
corynebacterium urealyticum
proteus mirabilis
146
what allows for UTI infection with corynebacterium urealyticum or proteus mirabilis to result in kidney stones
they have urease activity which leads to an increase in NH3+ production
this increases the pH of urine and allows for crystallization of Ca2+ and Mg2+, leading to stones
147
are actinomyces gram + or -
+
148
are actinomyces spore forming rods or non-spore forming rods
non-spore forming
149
what allows for actinomyces to have a waxy look and clump together in masses on a slide
mycolic acid production
150
what bacteria is normal dental and vaginal flora
actinomyces
151
what causes cervicofacial actinomycosis
trauma that allowed for normal oral actinomyces to drain down lymphatics
152
what is the treatment for cervicofacial actinomyces
debride affected tissue, leading to expression of yellow nodules (sulfur granules) of actinomyces stuck together
153
what is one way in which actinomyces can cause pelvic actinomycosis
colonization on objects such as IUDs--> inflammation and tissue destruction
154
what 2 classes of antibiotics are best to use with actinomyces
beta lactams
macrolides
155
what is the only mycolic acid containing bacteria which can grow anaerobically
actinomyces
156
are cutibacterium acnes gram + or -
+
157
what TLRs recognize LTA of cutibacterium acnes, leading to an inflammatory response
TLR2+6
158
what is the result of benzoyl peroxide use for acne
dissolves sebrum
159
what is the result of salicylic acid use for acne
sloughs keratin
160
what is the result of retinol use for acne
increases cell turnover
161
what 3 bacteria classes are the main bacteria of the normal skin flora
staphylococcus
cutibacterium
corynebacterium
162
lactobacillus bacteria are the main contributor to normal __ flora
vaginal
163
what antibiotic is lactobacillus resistant to
vancomycin
164
what bacteria can cause septicema and endocarditis in very immunocompromised patients
lactobacillus
165
what bacteria is beta hemolytic and displays tumbling motility
listeria monocytogenes
166
what bacteria causes food poisoning with an onset of 1-6 hours with nausea and vomiting
bacillus cereus
167
what bacteria causes food poisoning with an onset of 8-18 hours with nausea and diarrhea
bacillus cereus
168
what bacteria causes food poisoning with an onset of 2-6 hours with nausea and vomiting
staph. aureus
169
what bacteria causes food poisoning with an onset of 8-24 hours with diarrhea
clostridium perfringens
170
what bacteria is associated with rice food poisoning
bacillus cereus
171
what bacteria is associated with meat, vegetable, and sauce food poisoning
bacillus cereus
172
what bacteria is associated with meat, fatty, lipid food poisoning
staph. aureus
173
what bacteria is associated with meats prepared in mass (buffet style) food poisoning
clostridium perfringes
174
what do mycobacterium tuberculosis produce that allow them to live around ROS
catalase and superoxide dismutase
175
what is the structure of a tuberculosis granuloma
caseum center due to dead macrophages
fibrous cuff
foamy macrophage
lymphocytes on outermost layer
176
what causes the release of mycobacterium tuberculosis from its granuloma
granuloma fails
(defect in collagen or decrease in T cells-->inability to maintain)
177
caseating centers of mycobacerium tuberculosis can fuse together, creating areas of necrosis that can eventually become more and more liquid, creating ___
cavitary lesions (Ghon complexes)
*leaves an open hole in the lung
178
what are 3 symptoms of mycobacterium tuberculosis
coughing liquid blood (blood is continuously leaking into bronchi)
SOB
"wind tunnel" sound breathing
179
in maintaining the granuloma in mycobacterium tuberculosis, macrophages secrete ___, Th1 cell secretes ___
TNF and IL-12
IFN gamma
180
what is the general appearance of someone with mycobacterium tuberculosis
pale
skinny (cachexia- losing a lot of weight)
sweaty/nightsweats
*TNF increases metabolism
IL-12 induces fever
IFN gamma maintains granuloma
181
when mycobacterium tuberculosis is completely walled off and only a few granulomas are formed, are there symptoms and is the person infectious
no symptoms
not infectious
182
what is an example of an immunosuppressant drug that can reactivate tuberculosis bacterium due to decrease in TNF
Remicade (infliximab) is an TNF inhibitor
*TNF will be unable to maintain the granuloma
183
mycobacterium tuberculosis can spread to other tissues, most likely to ___
secondary lymphoid tissue (spleen)
*body site with a lot of macrophages
184
what is miliary tuberculosis
a patient initially had a pulmonary tuberculosis infection but the bacteria got from lungs through bloodstream and got to another part of the body
185
would a patient with miliary tuberculosis have tuberculosis bacteria in their sputum
no
186
what are the symptoms of miliary tuberculosis
pale
skinny (cachexia- losing a lot of weight)
sweaty/nightsweats
187
how are mycobacterium tuberculosis able to cause meningitis and cross the BBB even though they don't have a capsule
travel in macrophages
188
what are the 2 growth medium used to grow mycobacterium tuberculosis, which is most used
Lowenstein-Jensen media or Middlebrook (LJ most used)
189
since growing mycobacterium tuberculosis requires a sputum sample, and other bacterium are normally found in the mouth, what is done to prevent growth of the other bacteria
treat with NaOH
190
what type of vaccine is the bacillus calmette guerin vaccine (BCG) for mycobacterium tuberculosis
live attenuated
191
since the BCG vaccine for mycobacterium tuberculosis is a live attenuated vaccine, what occurs following vaccination
formation of a granuloma that can take weeks to resolve
192
why is the BCG vaccine for TB given as such an early age (days after birth)
that is when the thymus is working at the best so there will be the best T/B cell response/memory
193
when a TB test is performed, what is being looked for
type IV HSR to TB cell envelope proteins
194
the highest risk group for TB following a TB skin test are those with >/= 5mm, why
less zone of induration= less T cell response
195
why is TB infection more common in areas with higher rates of HIV
HIV decreases the amount of CD4+ T cells which are needed to fight TB infection
196
what is an alternate way of testing for TB besides the TB skin test
IFN gamma release assay (T-spot)
197
how does T-spot test (IGRA) work
looks for release of IFN gamma
gather blood samples, centrifuge, collect monocytes/B and T cells, put in well plate with TB antigens
if response, release of IFN gamma
use a tagged antibody against IFN gamma to see how much was released
198
sarcoidosis is thought to be an autoimmune sequela of TB infection that lead to a ___HSR with symptoms similar to TB
IV
199
what is the presentation of sarcoidosis
fever, dyspnea, night sweats, SOB
200
what is the most common drug for use of mycobacterium tuberculosis
isoniazid (stops mycolic acid synthesis)
*need to be on drug for approximately 6 months since they take a while to grow-->can lead to liver damage
*liver enzyme function needs to be tested before being put on the drug, and be tested periodically during course of treatment
201
what are the 4 most common drugs to use for TB infection
isoniazid
ethambutol
pyrazinamide
rifampin
202
how does ethambutol work
inhibits the synthesis of lipoarabinomannan (a component of the cell wall which attaches mycolic acid to peptidoglycan layers in acid fast bacteria)
203
TB is becoming increasingly resistant to what 2 drugs
rifampin and isoniazid
204
what are the 2 main mechanisms of TB drug resistance
efflux pump
mutations to drug target
205
Bedaquiline/Sirturo and Pretomanid/Delamanid are new drugs being used to treat extensively drug-resistant __ infection
TB
206
direct observation therapy is important for 6-9 months in what kind of bacterial infection
TB
207
what type of infection is mycobacterium leprae always
skin
208
how can you differentiate tuberculoid leprosy from lepromatous leprosy based on patient symptom presentation
tuberculoid- slightly discolored flakey skin patches, anesthesia (loss of sensation) of digits
lepromatous- build up hyperkeratic lesions, paraesthesia (pins and needles feeling) of digits
209
tuberculoid leprosy is a Th__, type __ HSR while lepromatous is a Th__ response
tuberculoid- Th1, type IV
lepromatous- Th2 (no type IV HSR)
210
how does granuloma formation in tuberculoid leprosy differ from lepromatous leprosy
tuberculoid- granuloma holds bacteria= no symptoms
lepromatous- granuloma no longer holds bacteria= bacteria seen in lesions= symptoms
211
what cytokines are high in tuberculoid leprosy
IL-2, IFN gamma, IFN beta (TH1)
212
what cytokines are high in lepromatous leprosy
IL-4, IL-5, IL-10 (Th2)
213
how does the granuloma formed in mycobacterium tuberculosis differ from that formed in tuberculoid leprosy
tuberculoid leprosy does not have a caseating center
214
what are the 2 best drugs for use in mycobacterium leprae
sulfa+dapsone
215
how does dapsone antibiotic work
stops macrophage migration
216
since mycobacterium leprae grows better at lower temperatures, where are you more likely to find lesions
extremities
217
why is thalidomide not used for treatment of leprosy anymore
leads to birth defects
218
what are the symptoms of mycobacterium avium complex
tuberculosis-like symptoms
cavitary lung lesions
wasting
fever
219
mycobacterium avium is most likely to cause disease only in ___ patients
very immunocompromised
220
why is mycobacterium avium rarely seen in healthy individuals
you need a very low CD4+ level to see symptoms
221
what is the main symptom of mycobacterium marinum
slow, self resolving subcutaneous granulomas
222
what causes mycobacterium marinum infection
inoculation of the bacteria found in seawater
223
acid bast bacteria are all what shape
bacillus
224
all mycobacteria are __, replicate in __, and form __
acid fast
macrophages
granulomas
225
are neiserria gram + or -
-
226
what is the shape of neiserria
cocci
227
what is the appearance of neiserria bacteria using gram stain
cocci in pairs or tetrads found in neutrophils or extracellularly
228
what are the 2 main bacteria that can travel in neutrophils
staph aureus
neiserria
229
what are the 4 main virulence factors of Neiserria bacteria
1. pili with opa protein (opa protein allows for adhesion)
2. hold C3b in an altered confirmation (decreases MAC formation
3. IgA protease (increase susceptibility of infection at mucosal surfaces)
4. lipo-oligosaccharide (LOS instead of LPS= lipid A is more exposed to TLR4-->increased inflammation)
230
what is the importance of opa proteins as a virulence factor for Neiserria
they perform antigenic variation
-->bind to different cell types
-->symptoms may go through a cycle of resolving then coming back
231
what are the 4 main symptoms in neiserria gonorrhea
inflammation
mucopurulent exudate (mucous+neutrophils+bacteria)
burning while urinating (for men)
pressure based pain (men)
232
what is the main cause of septic arthritis in adults
neisseria gonnorhea
233
what 2 bacteria cause pelvic inflammatory disease
neiserria gonorrheae
clamydia trachomatis
234
what 2 bacteria cause conjunctival infection more in adults
neisseria gonorrhea
chlamydia trachomatis
235
what is the main media used to grow neissera gonorrhea
Thayer Martin media
236
what are the 5 components of Thayer Martin media, used to grow neisseria gonnorhea, that prevent other bacterial growth
chocolate agar
vancomycin
trimethoprim
colistin
antifungal drug
237
are neissera oxidase + or -
+
238
what is the best antibiotic for use of neisseria infection
ceftriaxone
239
what bacteria class are never used with neisseria, why
beta lactams due to exchange of beta lactamase genes
240
what 2 types of gene transfer are most common in Neisseria infection
conjugation
natural transformation
241
are neisseria gram + or -
-
242
what shape are neisseria bacteria
cocci
243
are neisseria catalase + or -
+
244
what allow for nasopharynx colonization of neisseria
pili
245
are neisseria capsulated or unencapsulated
capsulated
246
what allows for neisseria to evade the immune system
capsule
247
what is meningococcoemia
septicemia caused by neisseria meningiditis
248
what are the symptoms of meningococcemia
small blood vessel thrombosis leads to petechial skin lesions on trunk and lower extremities
can lead to tissue necrosis
249
what are the 2 physical diagnostic techniques for identifying meningitis in children or anyone unable to follow instructions
Kernig's sign
Brudzinski neck sign
250
what is shown with a positive Kernig's sign for meningitis
inability to straighten leg when lying on back
251
what is shown with a positive Brudzinski's neck sign for meningitis
knee flexes when head is pushed forward while lying down
252
what is the leading cause of bacterial meningitis in children and young adults
neisseria meningiditis
253
what type of vaccine is the MCV4 against neisseria meningiditis
anti-capsular
254
since neisseria performs capsule switching, an additional vaccine besides MCV4 has been introduced. what is the other vaccine for older children and young adults
MenB
255
what antibiotics are used against neisseria gonorrhea
ceftriaxone+azithromycin
256
how does neisseria gonorrhea differ from neisseria meningiditis in terms of oxidation of carbohydrates
gonorrhea oxidizes glucose, not maltose
meningiditis oxidizes glucose and maltose
257
are haemophilus bacteria gram + or -
-
258
what shape are haemophilus bacteria
rods
259
what ingredients are required for haemophilus bacteria to grow
factor X- hemin
factor V- nicotinamide adenine dinucleotide (NAD)
260
what media is used to grow haemophilus bacteria
chocolate agar
261
how is haemophilus influenzae able to cause meningitis
it can spread from upper respiratory tract-->blood-->CSF
262
is haemophilus influenzae or neisseria meningitidis meningitis more severe
neisseria meningitidis
263
what are the 2 virulence factors of haemophilus influenzae
capsule (only 1 type)
IgA protease
264
what is the main cause of epiglottitis
haemophilus influenzae
265
what are the 4 main symptoms of epiglottitis caused by haemophilus influenzae
stridor on breathing
drooling
croup cough
thumb sign on X-ray
266
what type of infection is associated with meningitis or epiglottitis caused by haemophilus influenzae
orbital cellulitis
267
the haemophilus influenzae vaccine against haemophilus influenzae B is what type of vaccine
anti-capsular subunit, protein conjugated
268
what are the 5 main antibiotics for treatment of haemophilus influenzae
amoxicillin
azithromycin
cephalosporins
doxycycline
fluoroquinolones
269
haemophilus influenzae mainly uses what genetic transfer type
natural transformation
270
what is the main cause of pink eye conjunctivitis in children <10 years
haemophilus influenzae+haemophilus aegyptius
271
what are the symptoms of haemophilus ducreyi
ulcerated painful lesion
easily bleeding lesion (chancroid)
pain w/ urination
272
what bacteria causes whooping cough
bordetella pertussis
273
are bordetella pertussis aerobes or anaerobes
aerobes
274
what 4 components make up the acellular pertussis component of the DTaP vaccine
pertactin
filamentous hemagglutinin
pertussis toxoid
adenylate cyclase toxoid
275
what are the 7 virulence factors of bordetella pertussis
pertussis toxin (increases cAMP= increase mucous)
adenylate cyclase toxin (inhibits Gi= increase cAMP=increase mucous)
tracheal cytotoxin (kills trachea cilia)
dermonecrotic toxin (skin necrosis)
pili (adhesion)
filamentous hemagglutinin (adhesion)
pertactin (adhesion to tracheal epithelial cells)
276
how does pertussis toxin and adenylate cyclase toxin of bordetella pertussis work
it's an A/B toxin that increased cAMP, leading to water secretion and cough reflex
277
what are the 3 stages of whooping cough
catarrhal
paroxysmal
convalescent
278
when do each of the stages of whooping cough, catarrhal, paroxysmal, and convalescent, occur
catarrhal= 1-2 weeks
paroxysmal= 2-4 weeks
convalescent= 3-4 weeks
279
what occurs in the catarrhal stage of whooping cough
common cold symptoms
peak level of number of bacteria= highly contagous
280
what occurs during the paroxysmal stage of whooping cough
impairment of mucous clearance
increased mucous production
whooping cough
281
what occurs during the convalescent stage of whooping cough
decrease in cough
may lead to secondary complications
282
what media is needed to grow bordetella pertussis
Bordet-Gengou or Regan Lowe
*charcoal containing
283
what are the advantages of PCR vs culture for bordetella pertussis testing
PCR= quicker
culture= more specific
284
how does bordetella pertussis spread
respiratory droplets
285
who is at greatest risk for bordetella pertussis
children less than 1 year
286
bordetella pertussis is most common in what age group
older children/young adults (those living closely such as in a dorm)
287
what is the best antibacteria class against bordetella pertussis
macrolides (-mycin) such as azithromycin and clarithromycin
288
where are pseudomonads found
soil, fresh water, sea water
289
are pseudomonads gram + or -
-
290
are pseudomonads aerobic or anaerobic
aerobic
291
what shape are pseudomonads
bacillis
292
do pseudomonads perform fermentation
no
293
are pseudomonads oxidase + or -
+
294
are most pseudomondas motile or non-motile
motile
295
what are the 2 mechanism of antibiotic resistance by pseudomonads, which is the main
main= change in porin size reduces ability for antibiotics to enter
beta lactamase production
296
do pseudomonas aeruginosa have a capsule
yes
297
are pseudomonads catalase + or -
+ (they're aerobic)
298
are pseudomonas aeruginosa alpha, beta, or gamma hemolytic
beta
299
what allows for pseudomonas aeruginosa to be beta hemolytic
exotoxin A and phospholipases
300
what is the main virulence factor of pseudomonas aeruginosa
biofilm production
301
what are the characteristics of the biofilm that allow you to identify a pseudomonas aeruginosa infection
green color
smell of grape flavoring
302
what 2 components of pseudomonas aeruginosa biofilm contribute to its anti-gram + antibiotic characteristic and green color
pycocyanin
pyoverdin
303
what is the main virulence factor or pseudomonas aeruginosa
biofilm
304
what 2 bacteria can cause lung infections in cystic fibrosis patients, which is the main
burkholderia cepacia
*pseudomonas aeruginosa
305
what bacteria is associated with infections in burn wounds with production of green appearance
pseudomonas aeruginosa
306
what are the top 4 bacteria that cause hospital acquired catheter associated UTIs
e. coli
enterococci
pseudomonas aeruginosa
burkholderia cepacia
307
what bacteria is the main cause of hot tub folliculitis
pseudomonas aeruginosa
308
what allows for hot tub folliculitis by pseudomonas aeruginosa
depletion of sebum from hair follicles caused by drying out of skin
309
what bacteria causes swimmer's ear (otitis externa)
pseudomonas aeruginosa
310
what bacteria can cause swimmers ear in diabetic patients (malignant external otitis)
pseudomonas aeruginosa
311
is pseudomonas aeruginosa spread in the bloodstream
only in immunocompromised patients
312
in immunocompromised patients, pseudomonas aeruginosa can lead to what 2 infections
osteomyelitis
ecthyma gangrenosum skin lesions
313
are pseudomonas aeruginosa gram + or -
-
314
burkholderia cepacia are similar to what species or bacteria
pseudomonads
315
how can you differentiate pseudomonas aeruginosa from burkholderia cepacia in cystic fibrosis patient lung infection
pseudomonas aeruginosa biofilm is green with a grape smell
burkholderia cepacia biofilm appears white/yellow with a dirt smell
316
what bacteria causes meloidosis (pulmonary disease in healthy people)
burkholderia pseudomallei
317
burkholderia pseudomallei is often mistaken for what infection due to the overlap in symptoms
TB
318
burkholderia pseudomallei infection is treated with what 2 antibiotic options
sulfa
doxycycline
319
acinectobacter baumanii is similar to what species of bacteria
pseudonomads
320
what bacteria is the main cause of necrotizing fasciitis in soldiers in the Middle East
acinetobacter baumanii
321
acinetobacter baumanii is a cause of hospital acquired infections due to what characteristic
biofilm which allows them to stick to indwelling devices such as catheters/IV lines
322
what is seen before necrotizing fasciitis with acinetobacter baumanii
orange peel cellulitis
323
what is the name of the necrotizing fasciitis caused by acinetobacter baumanii
hemmorhagic bullae
324
are enterobacteriaceae gram + or -
-
325
are enterobacteriaceae oxidase - or +
-
326
are enterobacteriaceae catalase + or -
+
327
are enterobacteriaceae aerobic or anaerobic
facultatively anaerobic
328
what agar is used to differentiate enterobacteriaceae
MaConkey or EMB agar
329
what 3 characteristics are used to differentiate enterobacteriaceae
motility
use citrate as a sole carbon source
make urease
330
what enterobacteriaceae is Simmons citrate test positive
salmonella
331
what 3 enterobacteriaceae are motile
e. coli
salmonella
proteus
332
what enterobacteriaceae is nonmotile
shigella
333
what enterobacteriaceae is urease positive
proteus
334
what antibiotics are enterobacteriaceae resistant to
beta lactams
335
what 3 features does the triple sugar iron agar slant test for
lactose fermentation
gas production
hydrogen sulfide production
336
what are the 6 virulence factors of enterobacteriaceae
capsule
resistance to complement (C3b)
type 3 secretion system
cAMP and ribosome A/B toxin
hemolysins
pili
337
are E.coli motile
yes
338
what fermentation do E.coli perform
lactose aerobically and anaerobically
*and produce gas
339
do E.coli produce H2S
no
340
do E.coli produce urease
no
341
e.coli is typically described to perform __ hemolysis, however it depends on the strain
beta
342
what is the mechanism of watery diarhea
AB toxin increases cAMP= lack of water absorption
343
what is the mechanism of water, slightly bloody diarrhea
invasion of cell leads to effacement of vili (decreased surface area) leading to lack of water absorption and some cell damage
344
what is the mechanism of bloody diarrhea
ribosomes disabling AB toxin leads to cell death and sloughing of cells
345
what is infectious dose
the number of bacteria you have to ingest in one sitting to actually get sick
346
are you more likely to get sick with a higher or lower ID
lower
347
the infectious dose for a low ID is __
less than 100
348
what is the mechanism of enterotoxigenic e.coli (ETEC)
heat liable toxin and heat stable toxin increase cAMP= watery diarrhea
349
what is the mechanism of enteropathogenic e.coli (EPEC)
type III secretion system injects Tir protein that restructures our cell actin cytoskeleton, creating a pedestal
this decreases the surface area of villi, leading to decrease in reabsorption of water= watery diarrhea
350
what is the mechanism of enteroaggregative e.coli (EAEC)
aggregative adherence fimbriae of bacteria cover villi, decreasing surface area= less water absorption= watery diarrhea
351
what e.coli infection can cause outbreaks in daycares
enteroaggregative e.coli (EAEC)
352
what is the mechanism of enteroinvasive e.coli
bacteria injects invasive plasmid antigen into our cells using type III secretion system causing actin cytoskeleton rearrangement
this leads to cell death-->watery, slight bloody diarrhea and cramping
353
what 3 e.coli infections have low ID
ETEC
EPEC
EAEC
354
what is the mechanism of enterohemorrhagic e.coli
it has shiga toxin 1 and 2 with it's AB toxin
A subunit bind to ribosome, prevents translation, leading to cell death
Stx-1 B subunit binds to intestinal epithelial cells and causes bloody diarrhea as dead cells are sloughed
Stx-2 subunit binds to glomerular endothelial cells, leading to hemolytic uremic syndrome
355
what bacteria causes hemolytic uremic syndrome
e.coli (enterohemorrhagic e.coli)
356
is the A/B shiga toxin of e.coli lytic or lysogenic conversion
lysogenic
357
at what stage of bacterial growth curve does lysogenic conversion occur
late exponential
358
how many days after original diarrhea with enterohemorrhagic e.coli (EHEC) does hemolytic uremic syndrome occur
6-10
359
what triad of conditions makes up hemolytic uremic syndrome
kidney failure
thrombocytopenia
microangiopathic hemolytic anemia
360
RBC of what characteristic are seen in enterohemorrhagic e.coli
schistocytes (helmet shaped deformed RBC)
361
what strain of e.coli has a very low ID
enterohemorrhagic e.coli
362
what organism carries enterohemorrhagic e.coli in their gut asymptomatically
cattle
363
why is it a risk to humans that cattle carry enterohemorrhagic e.coli in their gut (2 reasons)
during ground meat processing, the bacteria in the gut can be introduced to other area
cow manure is used to grow produce
364
what bacteria are the most common cause of UTIs in women
e.coli
365
what are the 3 main virulence factors of e.coli that allow them to cause UTIs
P-pilin attaches strongly to bladder
flagella
Stx-2 causes kidney failure
366
what bacteria is the main cause of cystitis
e.coli
367
what bacteria causes pyelonephritis
e.coli
368
what is pyelonephritis
kidney infection that ascends from the bladder to kidneys due to ability of e.coli to swim up ureters
369
in addition to typical cystitis symptoms, what are 2 additional symptoms of pyelonephritis caused by e. coli
flank pain
high fever
370
how can you differentiate kidney failure causes by enterohemorrhagic e.coli hemolytic uremic syndrome vs e.coli
there would be no bacteria in the urine of hemolytic uremic syndrome patients
371
what are the top 4 causes of catheter associated UTIs
e.coli
enterococcus
pseudomona aeruginosa
candida
372
are gram + or - bacteria the leading cause of septicemia
gram -
373
among the gram - bacteria, which is the main cause of septicemia
enterobacteriaecae
374
what gram + bacteria is the main cause of septicemia caused by gram - bacteria
e.coli
375
what factor of e.coli leads them to being multi-drug resistant
efflux pump
376
what e.coli infection are antibiotics contraindicated for
enterobacteriae hemorrhagic e.coli
377
are salmonella motile or non-motile
motile
378
do salmonella ferment lactose
no
379
do salmonella produce urease
no
the only enterobacteriacae that produces urease is proteus
380
do salmonella produce H2S
yes
381
are salmonella gram + or -
-
382
what selective media is used to differentiate salmonella enterica subspecies
Hektoen enteric agar
*differential on basis of H2S production-->black colonies
383
what symptoms are present with salmonella enterica caused gastroenteritis
cramping, vomiting, watery slightly bloody diarrhea, and nausea
384
what virulence factor does salmonella enterica use
type 3 secretion system injects salmonella-secreted invasion proteins, leading to actin cytoskeleton rearrangement
385
what type of diarrhea does salmonella enterica cause
watery, slightly bloody
386
what 2 salmonella species can lead to system bloodstream infection
salmonella typhi
salmonella paratyphi
387
what bacteria causes typhoid fever
salmonella
388
what are the symptoms of typhoid fever
fever
rose spot rash on torso
389
is salmonella an infection or intoxication
infection
390
what is the antibiotic of choice for salmonella typhi
fluoroquinolones (usually ciprofloxacin)
391
do shigella produce H2S
no
392
what toxin does shigella produce
Stx-1
393
what is the most common species of shigella
shigella flexneri
394
what is the most severe species of shigella
shigella dysenteriae
395
do shigella ferment glucose
yes, in the absence of O2
396
are shigella motile
no
397
what virulence factor does shigella have
grow in M cells of intestines and produce Stx-1-->actin rearrangement
398
what type of diarrhea does shigella cause
bloody
399
unlike salmonella that is spread through chickens, shigella is spread in what way
person to person
400
shigella causes symptoms how many days after ingestion
3
401
what are the 3 main symptoms of shigella infection
bloody diarrhea
cramping
fever
402
are yersinia motile or nonmotile
non-motile
403
what is the appearance of yersinia histologically
safety pin appearance
404
what bacteria causes bubonic plaque
yersinia pestis
405
how does yersinia pestis cause bubonic plaque
flea bites infected rodent, flea gets infected and bites humans
bacteria divide and spread through bloodstream, grown in lymph nodes
406
what is the main symptom of bubonic plaque
buboes (very swollen lymph nodes)
407
yersinia pestis can cause __ plague, __ plague, or __ plague
bubonic
systemic
respiratory
408
what type of diarrhea do yersinia enterocolitica cause
watery, slightly bloody
409
what is the main virulence factor of yersinia enterocolitica
replicate in M cells of intestines and use type 3 secretion system with Yop protein to restructure actin (turns off MAPK)
410
what is the main source of yersinia enterocolitica
undercooked pork
411
yersinia bacteria, like listeria, grow best at what temperature
4C
412
what are the symptoms of yersinia enterocolitica
diarrhea, fever, abdominal pain
413
what allows for klebsiella pneumoniae to cause lobar pneumonia
large polysaccharide capsule
414
what class of bacteria do klebsiella belong to
enterobacteriacae
415
are klebsiella gram + or -
-
416
are klebsiella catalase + or -
+
417
are klebsiella oxidase + or -
-
418
are klebsiella anaerobes or aerobes
facultative anaerobes
419
what type of pneumonia does klebsiella pneumoniae cause
lobar
420
what are the characteristics of the sputum produced by klebsiella pneumoniae
bright red, jelly like
421
what bacteria can cause non-alcoholic fatty liver disease
klebsiella pneumoniae
422
what bacteria causes auto-brewery syndrome
klebsiella pneumoniae
423
what is auto-brewery syndrome causes by klebsiella pneumoniae
occurs due to the ability of klebsiella pneumoniae to ferment carbs into ethanol in the intestines
424
do proteus mirabilis ferment lactose
yes, anaerobically and aerobically
425
how are you able to identify proteus mirabilis on blood agar
they perform swarming motility
426
how can you differentiate strepto pneumoniae from klebsiella pneumoniae based on blood agar features
strepto pneumonia- beta hemolytic due to streptolysin
klebsiella- gamma hemolytic= intact RBC
427
how can you differentiate lobar pneumonia caused by strepto pneumoniae from lobar pneumonia caused by klebsiella pneumonia based on sputum production
strepto- brown sputum due to RBC lysis
klebsiella- red, jelly like
428
what are the 3 species of gram - spirilla
vibrio, campylobacter, helicobacter
429
are vibrios motile or non-motile
motile
430
what is an addition that must to made to blood agar to allow vibrios to grow, why
salt
they live in salt water
431
what bacteria can ferment sucrose
vibrio
432
what media is used to identify vibrios
TCBS (thiocitrate bile and sucrose)
433
what type of diarrhea does vibrio cholera produce
watery
434
do bacteria with a high sensitivity to gastric acid have a high or low ID
high
435
what are the 3 main virulence factors of vibrio cholera
toxin-coregulated pilus for adherence to intestinal epithelia
cholera cAMP AB toxin
accessory cholera enterotoxin (ACE)
436
strains of vibrio cholerae are identified by what feature
O-carbohydrate of LPS
437
how is vibrio cholera spread
contaminated water
438
cholera toxin is an example of what type of conversion
lysogenic
439
what phage leads to the AB toxin genes in vibrio cholerae
CTX
440
what are the 2 most virulent strains of vibrio cholerae
O1
O139
441
why are the strains O1 and O139 the most virulent strains of vibrio cholera
they have 2 copies of AB toxin genes
442
what is the main symptom of vibrio cholerae infection
rice water stool (3-6L of watery diarrhea per day)
443
what is the main consequence that vibrio cholera infection can lead to
hypovolemic shock due to high amount of water loss in diarrhea
444
what is the treatment for vibrio cholerae
oral rehydration therapy
445
where do vibrio cholerae live
guts of copepod
446
vibrio cholerae is associated with what food
shellfish
447
a ___ vaccine is given against vibrio cholerae in endemic areas
live-attenuated
448
in places that don't have access to treated water, what can be done to decrease the risk for vibrio cholerae infection
filter water through a cloth to remove copepods
449
what are the 2 restrictions of growing vibrio parahaemolyticus on blood agar
they only lyse human RBC, not any other mammal's
require high salt concentration to grow
450
what type of hemolysis do vibrio parahaemolyticus perform
beta
451
what type of diarrhea does vibrio parahaemolyticus cause
gassy, watery (explosive)
452
what is the most common cause of seafood associated gastroenteritis
vibrio parahaemolyticus
453
does vibrio parahaemolyticus cause an infection or intoxication
infection
454
vibrio parahaemolyticus lives in the gut of what organism
shellfish
*contamination usually from raw oyster consumption
455
the main cause of vibrio parahaemolyticus is consumption of what
raw oysters
456
vibrio vulnificius can cause what 2 types of infection
necrotizing fasciitis
gangrene
457
what is the only bacteria that can cause necrotizing fasciitis due to eating a contaminated food that spreads in the bloodstream
vibrio vulnificus
458
what are the 2 most common antibiotics for virbrio species
macrolides
tetracycline
459
what type of growth requirement do helicobacter require
5% O2, 10% CO2
460
how do campylobacters lead to watery, slightly bloody diarrhea and cramping
they disrupt junctions between cells and cause inflammation
461
what is the main concern with campylobacter jejuni O19
they have the same polysaccharide that human motor neurons have--> Guillain Barre syndrome
462
what is Guillain Barre syndrome
IgM antibody production against gangliosides found on our nodes of Ranvier-->demyelination-->flaccid paralysis
463
in Guillain Barre syndrome, IgM leads to __, which leads to the turn off of __ production
complement deposition
myelin sheath
464
IgM is produced against what type of substance
polysaccharide
465
does IgM produce immune memory
no
466
what are the symptoms of Guillain Barre syndrome
rapidly progressive upward flaccid paralysis
467
what is involved with plasmaphoresis used for Guillain Barre syndrome
replace patient's plasma with IgM against their myelin sheath with another person's plasma who doesn't have the antibody
468
what type of HSR is Guillian Barre syndrome
type II
469
where do campylobacter live that can cause harm to humans
digestive tract of cattle
digestive tract of chicken
bloodstream of chicken
470
what temperature do campylobacter jejuni grow best at
42C
471
what antibiotic is most commonly used for campylobacter
macrolides (to prevent IgM production)
472
where are helicobacter bacteria normally found
gastric mucosa
473
what are the 4 main virulence factors of helicobacter pylori
urease (slightly neutralizes gut acidity)
flagella
type 3 secretion system (cagA and vacA)
mucinase secretory enzyme
474
what bacteria are the most common cause of gastric ulcers
helicobacter pylori
475
in most cases, helicobacter pylori are symptomatic or asymptomatic
asymptomatic
476
what bacteria can lead to gastric cancer
helicobacter pylori
477
how can helicobacter pylori be beneficial to humans if they don't cause ulcers
they produce urease which decreases gastric acidity and decreases the risk for esophageal cancer
478
what type of Th response can be beneficial to prevent ulcer activity of helicobacter pylori
Th2 (IL-10 production= anti-inflammatory)
479
what are the 2 main ways to test for helicobacter pylori
breathalyzer for urease
bacterial antigens in stool sample
480
helicobacter pylori infections causing ulcers are typically treated with what 3 antibiotics
antacids
clarithromycin
amoxicillin
481
what mechanism do antacids use
they are a proton pump inhibitor
482
how can proton pump inhibitors such as antacids increase risk for infection
ID is lowered by gastric acidity
lower ID= increased risk
there is now an increase in infection risk for bacteria that typically have a high ID
483
how are spirochetes visualized
darkfield microscopy
484
how does the flagella of spirochetes differ from spirilla
spirochetes- internal flagella
spirilla- external flagella
485
how does transmission of infection differ in spirochetes and spirilla
spirochetes- blood borne (body fluid)
spirilla- food borne (ingestion)
486
what class of bacteria are the least drug resistant, allowing them to be very susceptible to beta lactams
spirochetes
487
how are borrelia species of spirochetes spread
vector-borne
488
what does it mean to say borrelia species of bacteria are vector borne
spread through bite of infected insect
489
what bacteria causes lyme disease
borrelia burgdorferi
490
what are the 2 main virulence factors of borrelia burgdorferi
OspA
OspC
491
how do OspA and OspC of Borrelia burgdorferi work
OspA allows for colonization of tick guts at 25C
OspC allows for spread from tick to humans at 37C
492
what tick species is the only vector for lyme disease
Ixodes species
493
what occurs in stage 1, acute illness, of lyme disease
regional lymphadenopathy
flu-like symptoms
erythema migrans (bulls-eye rash)
494
symptoms of lyme disease in stage 1 are caused by __, while symptoms of lyme in late 2 and 3 are caused by __
1/early 2= bacteria
late 2/e= autoimmune
495
what happens in stage 2 of lyme disease
bloodstream spread of infection
generalized lymphadenopathy
cardiac and CNS involvement
496
what happens in stage 3 of lyme disease
autoimmune response years later (type II and IV HSR)
destructive chronic arthritis
497
what is the clinical case definition of lyme disease
erythema migrans and/or one late manifestation (system involvement) with lab confirmation
498
what is the lab case criteria for diagnosis of lyme disease
IgM/IgG or significant increase in antibodies between acute and convalescent serum samples
*acute= bad symptoms today with high antibody level
convalescent= good symptoms today with lower antibody level
499
IgG or IgM response would indicate that lyme is in what stage
1 or 2
500
antibody difference between acute and convalescent serum samples would indicate lymes disease is in what stage
3
501
ticks must be attached for how long in order for transmission to occur
>/=12 hours
502
what is the best antibiotic for lyme disease
doxycycline to cover all tick borne illnesses (or penicillin if specific)
503
what bacteria causes syphilis
treponema pallidum
504
what occurs in the primary stage of syphilis
chancre
regional lymphadenopathy
505
what occurs in the secondary stage of syphilis
body-wide rash
palmar rash
condyloma latum
asymptomatic neurosyphilis
flu-like symptoms
506
what occurs in the tertiary, later stage of syphilis
neurosyphilis
aortitis
gummas
507
when does primary vs secondary vs tertiary syphilis develop
primary= 10 days -3 months after infection
secondary= 3-6 months after infection
tertiary= years-decades after infection
508
are chancre which occur in syphilis painful
no
509
do chancre which occur in syphilis require antibiotics
no, they are self resolving in approximately 2 months
510
how does syphilis (T. pallidum) spread
sexual transmission
511
where is the swollen lymph node in cases of primary syphilis
closes to the original point of infection
512
what bacteria causes palmar rash
syphilis by t. pallidum
513
what are gummas seen in tertiary syphilis
granumola like collection of T cells with antibody involvement
514
what is the autoimmune target in tertiary syphilis
fibronectin --> CT deficiency
515
what is congenital syphilis
in utero infection of a baby carried by a mother with primary or secondary syphilis
516
what are the 4 symptoms of congenital syphilis
sloughing of multiple layers of skin on palms/feet/face at birth
snuffles rhinitis at birth
deficiencies in cartilage, bone, and teeth development with growth
saber shins (abnormal bone growth)
517
what is the best antibiotic for use in syphilis
penicillin
518
are males or females more likely to have syphilis
males
519
who is at the most risk for syphilis
males who have sexual contact with males
520
what is the time frame for stage 1 vs 2 vs 3 of lyme disease
stage 1= 1 week-1 month after bite
stage 2/3= 2 months-6 months after bite
521
what is the initial test used to test for syphilis
rapid plasma reagin test
522
how does the rapid plasma reagin test for syphilis work
tests for antibodies against cardiolipin
*tests for antibody against type III HSR damage done by T. pallidum
523
what is the special stain used to visualize spirochetes
Steiner silver
524
if the initial test for syphilis is positive, what test is performed next
fluorescent antibody test to test for IgG and IgM antibodies against T. pallidum
525
for a syphilis lesion in primary stage, the rapid plasma reagin test is __% __
for secondary syphilis, it is __% __
(percent, false/positive)
50% false
95% accurate
526
darkfield microscopy and fluorescent microscopy are both used to test for syphilis is what stage
primary or secondary
527
rapid plasma reagin test (VSRL) is used to test for syphilis in what stage
secondary or tertiary
528
what are the disadvantages of rapid plasma reagin test (VSRL) used to test for syphilis
false positives common in pregnant, elderly, and lupus patients (type 3 HSR)
529
what is the Jarisch Herxheimer reaction
when treatment for a bacterial infection (especially primary and secondary syphilis) makes the inflammatory symptoms immediately worse
530
what is the main drug to treat syphilis
penicillin (especially penicillin G given IM)
531
what is leptospirosis
a systemic infection with leptospiro interrogans which usually causes mild flu-like symptoms
532
what bacteria causes Weil's disease, what is it
a severe leptospirosis infection with kidney, liver, and meningeal involvement
533
how is leptospirosis acquired
by skin exposure to water contaminated with urine of an infected animal
534
where has one of the highest infection rates or leptospira infection
Guadeloupe
535
what bacteria infection risk increases with tropical storms
leptospira (flood water with contaminated urine of infected animals)
536
what is the drug of choice for leptospirosis
penicillin
penicillin+doxycycline
537
what sample is best to use to test for leptospirosis
urine (bacteria is shed in urine for years to decades)
538
what are the most common component of human GI tract
bacteriods
539
what is unique about bacteriods LPS that prevents TLR4 binding
their LPS is altered
540
are bacteriods aerobic or anaerobic
obligately anaerobic
541
are bacteriods drug resistant
very
542
are bacteriods gram + or -
-
543
what species of bacteriod is the most pathogenic
bacteriodes fragilis becuase of it's polysaccharide capsule
544
what is the effect of bacteriod polysaccharide capsule in terms of T cell response
it pushes T cells towards a Treg response
545
what bacteria is the most common cause of post surgical infection, especially after GI surgeries
bacteriod fragilis
546
what bacteria can cause brain abscess in immunocompromised patients
bacteriod fragilis
547
what is the drug of choice for bacteriod fragilis
metronidazole (+something else)
*obligately anaerobic
548
are mobilinucus and gardnerella vaginalis aerobic or anaerobic
obligately anaerobic
549
are mobilinucus and gardnerella vaginalis gram - or +
-
550
what is unique about the cell envelope of mobilinucus and gardnerella vaginalis
they don't have LPS
551
how are mobilinucus and gardnerella vaginalis both harmless and harmful
they're part of normal vaginal flora but can cause bacterial vaginosis
552
what stain is used to see mobilinucus and gardnerella vaginalis
methylene blue
553
how will mobilinucus and gardnerella vaginalis appear with methylene blue stain
clue cells
cells are stuck to vaginal epithelial cells
554
pasteurella multocida are normal flora of what
domestic animals (cats and dogs)
555
what are the most common symptoms of infection with pasteurella multocida
non-directional cellulitis with regional swollen lymph node closest to bote of cat/dog
556
what bacteria causes cat scratch fever
bartonella henselae
557
what are the symptoms of cat scratch fever
swollen, warty lesion at site of cat scratch or bite progresses to lymphadenopathy of regional lymph node and slight fever
558
what is the appearance of the warts caused by bartonella henselae causing causing cat scratch fever
infiltrated with new blood vessels recruited by the bacteria
559
what are the shape of francisella tularensis
irregular
560
are francisella tularensis gram - or +`
-
561
how are francisella tularensis able to replicate in the cytoplasm
they replicate inside macrophages
562
what is the activity of francisella tularensis and brucella species in macrophages
after being internalized by macrophages, francisella tularensis escapes from the phagosome and replicates in the cytoplasm
this causes a lot of NOD-protein activated inflammation and cell death
*intracellular= Th1 response
brucella causes not as much inflammation and leads to granuloma formation with if smooth strain
563
what is ulceroglandular tularemia, what bite causes it
wound infection and lymph node swelling caused by Ixodes tick or rabbit blood
564
what is the progression of ulceroglandular tularemia caused by francisella tularensis
painful papule progresses to a necrotizing wound with raised, red edges followed by regional lymphadenopathy
565
how can you differentiate a necrotizing wound caused by francisella tularensis vs bacillus anthracis
anthracis= not painful
tularensis= painful
566
what causes oculoglandular tularemia
conjunctiva infection and cervical lymph node swelling caused by infected blood from rabbit/tick getting in the eye
567
pulmonary tularemia caused by francisella tularensis is most common in what population
lab workers who work with patient samples
568
how does francisella tularensis show on Xray
bilateral infiltration
569
what must be done with a sample of francisella tularensis
send to bio-safety level 3 lab
570
are brucella bacteria intracellular or extracellular
intracellular
571
where are brucella bacteria found
reproductive tissue of non-human mammals
572
how does brucella bacteria spread
they can be aerosolized from body fluid of infected animal through milking animal or with unpasteurized milk, then inhaled by humans
573
what is the difference between rough and smooth strains of brucella
rough lack O-polysaccharide of LPS so they're phagocytized by macrophages
smooth have the O-polysaccharide so they grow in macrophages and are lead to T cell inflammation
574
brucella species causes infection that starts as __ infection then progresses to __ and __
pulmonary
GI and arthritis involvement
575
what is a unique symptom of brucella infection
undulant fever
576
what does brucella abortus cause
mild infection in humans, fetal loss in cattle
577
what does brucella suis cause
severe and chronic infection, found only in pigs and deer
578
what brucella species causes the most severe symptoms in humans, what animal carries it
brucella melitensis
sheep and goats
579
brucellosis cases are associated with exposure to what
livestock
580
what is used to test for brucella infection
rRNA sequencing to test for IgG against brucella
581
legionella pneumophila live in what (2)
ameobae
alveolar macrophages
582
legionella can replicate in alveolar macrophage cytoplasm, how
rER wraps around the phagosome, bacteria replicate in phagosome, bacteria escape in cytoplasm
583
pontiac fever is caused by what bacteria
inhalation of aerosolized legionella
584
what causes pontiac fever
outbreak due to contaminated H2O
585
pontiac fever causes __ symptoms for many but for few it causes __
flu-like
Legionnaires' disease
586
what are the symptoms of Legionnaire's disease
bilateral infiltration on chest X-ray
little-no sputum production
SOB
fever
dyspnea
587
Legionella infections caused by legionella bacteria are associated with what population
those with a history of smoking and alcohol consumption
smoking= reduced ciliary beating= inhale whole amoeba
alcohol= decreased liver function= reduced clearance from bloodstream
588
how can you get legionella infection
amoeba in sitting still fresh water gets aerosolized (ex: air conditioner so most common in summer months when air conditioners are used most)
589
how are legionella diagnosed through staining
fluorescent or silver staining
590
what culture type is used to diagnose Legionella
urine (bacteria are passed in urine for 1 month-1 year after infection)
591
Legionella that are grown on buffered charcoal yeast extract agar have what appearance
glossy white "ground glass" colonies
592
what antibiotic class are not used for intracellular bacteria
beta lactams
593
what are 12 intracellular bacteria
francisella (macrophages)
brucella (macrophages)
legionella (macrophages)
pasteurella (macrophage)
rickettsiae (endothelial and epithelial cells)
ehrlichia (WBC- monocytes)
anaplasma (WBC- neutrophils/granulocytes)
coxiella
mycoplasma
ureaplasma
clamydia
clamydophilia
594
are rickettsiae gram + or -
-
595
are rickettsiae motile or non-motile
non-motile
596
what staining is used for rickettsiae
silver stain or Giesma
597
rickettsiae has what effect on blood vessels
causes vasculitis with blood clots
598
what bacteria causes Rocky Mountain Spotted Fever
rickettsiae rickettsii
599
what spreads rickettsiae rickettsii
Dermacentor species of tick (American dog tick)
600
what are the symptoms of Rocky Mountain Spotted Fever
fever
petechial rash that starts on palms/soles and spreads to trunk
myalgia
headache
601
___ tick eggs can be infected before birth
___ tick eggs are born sterile
dermacentor (rickettsiae rickettsii with Rocky Mountain Spotted Fever)
bordetella burgdorferi (Lyme)
602
tick infection with __ is common at any time of year, not just late summer
dermacentor (rickettsiae rickettsii with Rocky Mountain Spotted Fever)
603
where is Rocky Mountain Spotted Fever most common
Ozark and Blue Ridge mountains (southeastern and midwest states)
604
what bacteria causes epidemic typhus and Brill-Zinsser disease
rickettsiae prowazekii
605
what are the symptoms of epidemic typhus
high fever
headache
myalgia
rose spot rash (vasculitis)
*same as typhoid caused by salmonella typhi
606
how is epidemic typhus, caused by rickettsiae prowzekii, spread, what population is it most common in
human body lice
homeless- no shower, no clean laundry
607
epidemic typhus caused by rickettsia prowazekii can turn into Brill-Zinsser disease, what is the difference
symptoms of untreated epidemic typhus occur years after initial infection but with milder symptoms= Brill-Zinsser disease
608
what is the drug of choice for epidemic typhus and Brill-Zinsser disease
doxycycline
609
rickettsiae typhi/rickettsiae felis is similar to rickettsiae prowzekii but is less severe. it is caused by __ and is most common in what region of the US
cat fleas
southern US
610
is untreated rickettsiae typhi/rickettsiae felis or rickettsiae prowzekii reoccuring
rickettsiae prowzekii
611
how is rickettsiae typhi/rickettsiae felis diagnosed
serology to look for antigens
612
how is rickettsiae typhi/rickettsiae felis treated
doxycycline
613
how are ehrlichia and anaplasma able to replicate in leukocytes
they stop phagosome-lysosome fusion
614
ehrlichia and anaplasma are spread by what
Ixodes species of ticks or lone star ticks
615
what are the symptoms of ehrlichia and anaplasma
severe flu-like symptoms
high fever
headache
possible body-wide rash 1-2 weeks after infection
616
how are ehrlichia and anaplasma treated
doxycycline
617
where is ehrlichia and anaplasma infection most common
southeastern US (similar to Lyme)
618
how do you test for ehrlichia and anaplasma
PCR or serological testing for looking for gene antibodies
619
how can you differentiate ehrlichia and anaplasma based on CBC count
ehrlichia= low monocytes
anaplasma= low neutrophils
620
what characteristic is seen with ehrlichia and anaplasma infected cells
morulae (clumps of bacteria in the WBC)
621
what 4 bacteria lack a cell wall
mycoplasma
ureaplasma
chlamydia
chlamydophilia
622
what drug would be used against bacteria that don't have a cell wall
tetracycline (doxycycline)
623
what 2 drug classes would not be used against bacteria that lack a cell wall
beta lactams
vancomycin/daptomycin
624
what is the main cause of walking "atypical" pneumonia
mycoplasma pneumoniae
625
what allows for mycoplasma pneumoniae to cause walking pneumoniae
P1 adhesin on pilus surface attaches to epithelial cell causes cilia to stop beating and releases pro-inflammatory cytokines
626
what age group is most common to have mycoplasma pneumoniae infection, walking/atypical pneumonia
5-15
627
any intracellular bacteria that causes pneumonia shows as __ on X-ray
patchy, diffuse infiltration
628
before PCR was used, and still now currently, how is mycobacterium pneumoniae infection diagnosed
cold agglutinin production
patient serum with IgM against the bacteria is added to Type O- blood and clots when on ice
629
what bacteria causes non-gonococcal (not caused by neisseria gonorrhea) urethritis and can't make its own ATP
chlamydia trachomatis
630
how do the 2 forms of chlamydiae (elementary body and reticulate body) differ
elementary- non-metabolic, transmissible
reticulate- metabolically active (can reproduce), non-transmissible
631
how does chlamydiae switch from elementary to reticulate body
elementary body is formed, attached to host cell, host cell ingests bacteria, elementary body reorganizes into reticulate body and uses our ATP to replicate in cytoplasm and phagosomes (slow replication rate)
632
what allows for chlamydiae to cause low level infection
TLR-9 recognizes DNA in the vacuole
633
how do the symptoms of gonorrhea differ from chlamydia
gonorrhea- mucopurulent discharge with neutrophils seen on gram stain, pain while urinating and pressure pain in men
chlamydia- mucoid (clear) discharge no bacteria seen on gram stain (it's an intracellular bacteria), asymptomatic in men and women
634
what is the main cause of pelvic inflammatory disease in women
chlamydia (chlamydia trachomatis)
635
what technique is used to test for chlamydia
PCR
636
what is the drug of choice to treat chlamydia
azithromycin (or you can use doxycycline or another ribosome disabling antibiotic)
637
what bacteria causes trachoma
chlamydia (chlamydia trachomatis)
638
what is trachoma
a conjunctivitis caused by chlamydia (chlamydia trachomatis)
639
trachoma, caused by chlamydia (chlamydia trachomatis), can lead to __ and __
corneal scarring
blindness
640
what is the main symptom of trachoma caused by chlamydia (chlamydia trachomatis)
eyelashes flip under, causing scratching when blinking which can lead to blindness
641
what 2 bacteria can cause neonatal conjunctivitis
neisseria gonorrhea
chlamydia (chlamydia trachomatis)
642
face flies can spread what infection
chlamydia (chlamydia trachomatis)
643
are chlamydia infections more common in males or females
young females
644
syphilis is more common in __
chlamydia is more common in __
males or females
syphilis- males
chlamydia- females
645
neisseria gonorrhea can lead to __ arthritis in __
chlamydia (chlamydia trachomatis) can lead to __ arthritis in __
(what type of arthritis, males/females)
gonorrhea- septic in femals
chlamydia- reactive in males
646
reactive arthritis caused by chlamydia (chlamydia trachomatis) is most common in males with what HLA type
HLA-B27+
647
what bacteria survive in macrophages
nocardia
mycobacterium tuberculosis
francisella tularensis
brucella (smooth strain)
648
what 7 bacteria survive in macrophages
nocardia
mycobacterium tuberculosis
francisella tularensis
brucella (smooth strain)
legionella
bordetella pertussis
yersinia pestis
