Bacteriology Flashcards
1
Q
Features unique to Gram (+)
A
Spores
No outer membrane
Thicker peptidoglycan cell wall (peptidoglycan is crosslinked by transpeptidase)
Lipoteichoic acid that extends from the cytoplasmic membrane to exterior to induce TNF alpha and IL1
2
Q
Features unique to Gram (-)
A
Outer membrane that consists of a outer leaflet (endotoxin/LPS), Porin for transport embedded in membrane, Inner leaflet which is just phospholipids
Outer membrane functions as an endotoxin : Lipid A induces TNF alpha and IL-1. Antigenic O polysaccharide component
Periplasmic space (Beta lactamase lcoation)
Think peptidoglycan wall thats covered by the outer membrane
3
Q
Bacteria that cannot be gram stained
A
These- Treponema Little - Leptospira Microbes - Mycobacteria May- Mycoplasma Unfortunately - Ureaplasma Lack - Legionella Real - Rickettsia Color - Chlamydia But - Bartonella Are - Anaplasma Everywhere - Ehrlichia
4
Q
Giemsa stain
A
Rickettsia Chlamydia Trypanosomes Plasmodium Borrelia
“Ricky got Chlamydia Trying to Pass Borrelia near Giemsa”
5
Q
Periodic Acid - Schiff stain
A
stains glycogen
Dx Whipple disease (Tropheryma whipplei)
6
Q
Ziehl Neelsen Stain (carbol fuchsin)
A
Acid fast bacteria (i.e. mycobacteria) - stains the mycolic acid in cell wall
Protozoa (cryptosporidium oocyts)
7
Q
India ink stian
A
cryptococcus neoformans
8
Q
Silver stain
A
Fungi (coccidiodes and pneumocystis jirovecci)
Legionella
Helicobacter pylori
9
Q
Fluorescent antibody stain
A
Many bacteria and viruses
10
Q
Chocolate agar
A
H influenzae
Factors V (NAD+) and X (hematin)
11
Q
Thayer-Martin Agar
A
Neisseria gonorrhoeae and meningitidis
inhibit the growth of gram (+) organisms with vancomycin
inhibits the growth of gram (-) with Trimethoprim and Colistin
Inhibits fungi with Nystatin
12
Q
Bordet-Gengou agar
A
Bordetella pertussis
or Regan Lowe medium (charcoal blood and antibiotic)
13
Q
Tellurite agar
Loffler medium
A
C diphtheriae
14
Q
Lowenstein Jensen agar
A
M tuberculosis
15
Q
Eaton agar
A
Requires cholesterol
M Pneumoniae
16
Q
MacConkey Agar
A
Lactose fermenting enterics
PH indicator - lactose fermenters will convert lactose to acidic metabolites which causes color change
Fermentation produces acid causing colonies to turn pink
17
Q
Eosin- methylene blue (EMB) agar
A
E coli
colonies with green metallic sheen
18
Q
Charcoal yeast extract agar buggered with cysteine and iron
A
Legionella
19
Q
Sabouraud agar
A
Fungi
“sabs a fun guy”
20
Q
Aerobes
A
“Nagging Pests Must Breathe”
Nocordia Pseudomonas aeruginosa MycoBacterium tuberculosis (apex of lung)
21
Q
Anaerobes
A
” Anaerobes Cant breathe Fresh Air”
Clostridium
Bacteroides
Fusobacterium
Actinomyces israelii
lack catalase and or superoxide dismutase and are thus susceptible to oxidative damage
Aminoglycosides are ineffective against anaerobes because these antibiotics require O2 to enter the bacterial cell. Think Amin(O2)glycosides
22
Q
Facultative anaerobes
A
Strep, staph, and enteric gram (-)
23
Q
Obligate intracellular
A
stay inside because its Really CHilly and COld
Rickettsia
CHlamydia
COxiella
24
Q
Encapsulated Bacteria
A
Please SHiNE my SKiS
Pseudomonas aeruginosa Streptococcus pneumoniae Haeumophilus influenxae type b Neisseria meningitidis E Coli Salmonella Klebsiella pneumoniae Group B strep
Are opsonized and then cleared by spleen. A splenic pts therefore are at increased risk and need vaccines agains N meningitidis, S pneumo, H influenzae “No Spleen Here”
25
Urease positive organisms
Pee CHUNKS
```
P-proteus
C-Cryptococcus
H- H pylori
U- Ureaplasma
N-Nocardia
K- Klebsiella
S- S epidermidis
S- S saprophyticus
```
urease hydrolyzes urea to release ammonia and CO2 which increases the PH. this predisposed to struvite (ammonium magnesium phosphate) stones, particularly proteus
26
Catalase + organisms
Cats Need PLACESS to Belch their Hairballs
```
Nocardia
Pseudomonas
Listeria
Asperfillus
Candida
E coli
Staph
Serratia
B cepacia
H pylori
```
27
Pigment colors for:
1) Actinomyces israelii
2) S aureus
3) P aeruginosa
4) Serratia marcescens
1) Yellow ( Israel has yellow sand)
2) Gold
3) green
4) red (red sriracha hot sauce)
28
Which bacteria is important when considering catheter and prosthetic device infections
S epidermidis
29
Which bacteria is important when considering dental plaques and infective endocarditis
Viridans streptococci
- S mutans
- S sanguinis
30
Which bacteria is important for resp infections in CF, ventilator associated pneumonia, and contact lens associated keratitis
P aeruginosa
31
Which bacteria is important in Otitis media
Nontypeable (unencapsulated) H influenzae
32
What protein is expressed by S aureus
Protein A
it binds Fc region of IgG and prevents opsonization and phagocytosis
33
IgA protease
cleaves IgA --> can colonize mucous membranes
S. pneumo
H influenza type b
Neisseria
34
M protein
M= mimics human cellular proteins
helps prevent phagocytosis
Group A strep
35
Type III secretion system
injectisome
needle like protein appendage that facilitates direct delivery of toxins from certain gram (-) bacteria to eukaryotic host cells
36
Transformation
Bacteria lysis releases short pieces of naked bacterial chromosomal DNA --> competent bacteria binds and imports --> expression
S pneumo
H influenzae type b
Neisseria
37
Conjugation
F+ x F- : A single strand of plasmid DNA is transferred from F+ to F- . F- becomes F+. No chromosomal DNA
Hfr x F- : F+ plasmid can become incorporated into bacterial chromsomal DNA --> high frequency recombination cell (Hfr). F- recipient will remain F- but now recombinant
38
Transduction
Foreign DNA is introduced into a cell by a virus or viral vector
Generalized: Lytic phage. packaging error causes bacterial chromosomal DNA to become package in phage capsid too
Specialized: Lysogenic phage. Viral DNA incorporates into bacterial chromosome. When phage DNA is excised the bacterial genes may be excised with it. DNA is packages into phage capsid and can infect another bacterium
ex: ABCD'S - Group A strep erythrogenic toxin, Botulinum toxin, Cholera toxin, Diphtheria toxin, Shiga toxin
39
Transposition
segment of DNA that can "jump" from one location to another and transfer genes
antibiotic resistnace
40
Exotoxin vs Endotoxin
Exotoxin: some gram + or gram -, polypeptide, vaccines
Endotoxins: outer cell membrane of most gram - bacteria, lipid A component of LPS, can cause fever shock(hypotension) and DIC, induces TNF, IL1, and IL6
41
This bacteria is gram +, beta hemolytic, catalase +, coagulase +. It has protein A virulence factor.
Staph aureus
Protein A - binds Fc-IgG. inhibiting complement activation and phagocytosis
- Inflammatory disease
- Toxic shock syndrome (TSST-1) : super antigen that binds MHC II and T cell receptor, resulting in polyclonal T cell activation
- scalded skin syndrome (exfoliative toxin)
- rapid onset food poisoning (entertoxins)
42
This bacteria infects prosthetic devices and IV catheters by producing adherent biofilms?
Staph epidermidis
43
This bacteria is the second most common cause of uncomplicated UTI in young women
Staph saprophyticus
first is e coli
44
This bacteria causes a "rusty sputum"
Strep pneumoniae
lancet shaped diplococci
Encapsulated
IgA protease
MOPS (most common cause of) : meningitis, Otitis media in children, pneumonia, sinusitis
45
This group of bacteria is known for causing dental caries (sp?) and endocarditis (sp?)
Viridans group strep
Normal flora of the mouth. Live in the mouth because they are not afraid of the chin (optochin resistant)
Strep mutans and S mitis cause dental caries
Strep sanguinis makes dextrans that bind to fibrin platelet aggregates on damaged heart valves, causing subacute bacterial endocarditis
46
This bacteria can cause scarlet fever and is bacitracin sensitive
Strep Pyogenes (group A step)
- beta hemolyic
- PYR +
- hyaluronic acid capsule and M protein inhibit phagocytosis. Antibodies to M protein enhance host defenses against S. pyogenes but can give rise to rheumatic fever.
- pyogenic: pharyngitis, cellulitis, impetigo (honey crusted lesions), erysipelas
- toxigenic: scarlet fever, toxic shock like syndrome, necrotizing fasciitis
- Immunologic- rheumatic fever, glomerulonephritis
- ASO titer or anti-DNase B antibodies indicate recent S pyogenes infection
47
scarlet fever
S pyogenes
blanching, sandpaper like body rash, strawberry tongue, and circumoral pallow in the setting of group A strep pharyngitis (erythrogenic toxin +)
48
Common cause of pneumonia, meningitis, and sepsis in babies
Strep agalactiae (group B strep)
Beta hemolytic
CAMP factor
Hippurate test +
PYR -
Screen pregnant women 35-37 weeks. REceive intrapartum penicillin prophylaxis is +
49
Common indicator of colon cancer
Strep Bovis
Bovis in the blood = cancer in the colon
Colonizes the gut
Bacteremia and subacute endocarditis
associated with colon cancer
50
Enterococci
vancomycin-resistant enterococci are an important cause of nosocomial infection
More resilient than streptococci, can grow 6.5% NaCl and bile
E. Faecalis and E faecium ( think feces because normal colonic flora)
51
The only bacterium that has a polypeptide capsule with D-glutamate
Bacillus anthracis
Spore forming rod that produces anthrax toxin
Colonies show a halo of projections, sometimes referred to as "medusa head"
Cutaneous anthrax: painless papule surounded by vesicles. Ulcer with black eschar thats painless and necrotic.
Pulmonary anthrax: Inhalation of spores can cause flu like symptoms that rapidly progress to fever, pulmonary hemorrhage, mediastinitis, and shock. "Woolsorters disease". widened mediastinum on cxr
52
Pt presents with watery diarrhea 12 hours after eating a plate of reheated rice
The spores survive cooking and cause nausea and vomiting iwthin 1-5 hours.
Cereulide is the preformed toxin
water diarrhea
53
Pt presents with spastic paralysis, trismus (lockjaw), risus sardonicus (raised eyebrows and open grin), and opisthotonos (spasms of the spinal extensors).
Clostridia tetani
Tetanospasmin exotoxin causes tetanus
It is a protease that cleaves SNARE proteins for NT. It blocks the release of inhibitory NT like GABA and glycine from renshaw cells of the spinal cord
54
pt presents with descending flaccid paralysis
Clostridia botulinum
heat labile toxint hat inhibits the release of Ach
Adults: ingestion of preformed toxin
Babies: ingestion of spores in honey lead to floppy baby syndrome (descending flaccid paralysis)
4 Ds: Diplopia, Dysarthria, Dysphagia, Dyspnea
55
Pt presents with a gangrenous leg
Clostridium perfringens
Alpha toxin lecithinase that causes myonecrosis (gas gangrene, presents as soft tissue crepitus) and hemolysis
Enterotoxin --> food poisoning when ingested
56
Patients presents with diarrhea and pseudomembranous colitis
Clostridia difficile
Toxin A (enterotoxin) binds to the brush border of gut and alters fluid secretion
Toxin B (cytotoxin) disrupts cytoskeleton via actin depolymerization
Esp due to clindamycina nd ampicillin
Tx with metronidazole or oral vancomycin
57
Patients presents with pseudomembranous pharyngitis ?
Corynebacterium diphtheriae
pseudomembrane, lymphadenopathy, myocarditis, and arrhythmias
Metachromatic (blue and red) granules and + Elek test for toxin
Endotoxin coded by Beta-prophage causes ADP-ribosylation of EF2 (elongation factor 2) which ultimately inhibits protein synthesis
58
This bacteria is commonly spread by ingestion of unpasteurized dairy products and cold deli meats
Listeria monocytogenes
grows at refrigeration temperatures "cold enrichment" at 4-10C
Actin rocket tails and characteristic tumbling motility in broth
Causes spontaneous abortion in pregnant women, granulomatosis infantiseptica, neonatal meningitis, meningitis in immunocompromised patients
tx with ampicillin
59
Pts was dx with HIV and now presents with TB symptoms but a negative PPD. On culture the bacteria is a long branching filament
Nocardia
Forms long branching filaments resembling fungi
Aerobe, acid fast, found in soil and causes pulmonary infections in immunocompromised, cutaneous infections in immunocompetent, can spread to CNS
TX with TMP-SMX
60
Patient presents with an oral abscess after having her tooth removed prior
Actinomyces
forms long branching filaments resembling fungi
Not acid fast, normal flora, oral abscess after extraction, forms yellow sulfur granules
TX with penicillin
61
TX of Nocardia vs Actinomyces
think SNAP
Sulfonamids - nocardia; Actinomyces-penicillin
62
Mycobacteria characteristics
all are acid fast organisms (pink rods)
```
M tuberculosis
M avium (causes dissemniated non-TB disease in AIDS
M scrofulaceum (cervical lymphadenitis in children)
M marinum (hand infection in aquarium handlers)
```
63
What is the unique "factor" associated with virulent M tuberculosis strains
cord factor creates a "serpentine cord" appearance
activates macrophages (promoting granuloma formation) and induces release of TNF alpha
Sulfatides (surface glycolipids) inhibit phagolysosomal fusion
64
Progression of tuberculosis
Primary tuberculosis has a Ghon complex (lesions consist of a calcified focus of infection and an associated lymph node). Ghon focus is ususally in the mid/lower lobes
90% will heal by fibrosis but can reactivate into secondary TB which has a fibrocaseous cavitary lesion in the upper lobes
Also risk of bacteremia and miliary TB
65
An acid fast bacillus that likes cool temperatures and therefore infects skin and superficial nerves
Mycobacterium leprae ---> Leprosy (Hansen disease)
cannot be grown in vitro
known as a "glove and stocking loss of sensation"
Reservoir: armadillos
Two types:
1) lepromatous - presents diffusely over the skin with leonine facies (lion like) . High bacterial load, low cell mediated immunity with humoral Th2 response. Can be lethal
Tx: clofazimine + dapsone + rifampin
2) Tuberculoid- few hypoesthetic hairless skin plaques characterized by high cell mediated immunity with a largely Th1 type immune response and low bacterial load
Tx: dapsone and rifampin
66
Neisseria Gonococci vs Meningococci ?
Gonococci ferments Glucose
MeninGococci ferments Maltose and Glucose
Gonococci has no polysaccharide capsule. Use eryhromycin eye oitment to prevent neonatal blindness. Tx: ceftriazone ( + azithromycin or doxycycline, for possible chlamydial coinfection)
Meningococci has a polysaccharide capsule. There is a vaccine. Causes meningococcemia with petecial hemorrhages and gangrene of toes, meningitis, waterhouse friderichsen syndrome (adrenal insufficiency, fever, DIC, shock). Tx is ceftriaxone or penicillin G
67
Cause of epiglottitis with a "cherry red" appearance and a thumb sign on xray
Haemophilus influenzae
nontypeable/unencapsulated is most common cause of mucosal infections
culture on chocolate agar, which contains factor V (NAD+) and X (hematin) for growth
Epiglottitis, thumb sign on lateral neck, meningitis, otitis media, and pneumonia
TX: amoxixillin +/- clavulanate for mucosal infections
Ceftriaxone for meningitis
Rifampin prophylaxis for close contact
68
"whooping cough"
Bordetella pertussis
pertussis toxin disables Gi, adenylate cyclase toxin increases cAMP, and tracheal toxin
stages:
1) catarrhal- low grade fevers and Coryza (inflammation of mucous membranes of the nose)
2) Paroxysmal -intense cough followed by inspiratory whoop. Posttussive vomiting
3) Convalescent- gradual recovery of chronic cough
69
Aerosol transmission from environmental water source habititat
Legionella pneumophila
Silver stain
Grow on charcoal yeast extract medium with iron and cysteine
Legionnaires disease - severe pneumonia which is often unilateral and lobar
Pontiac fever- mild flu like snydrome
Tx with macrolides or quinolone
70
Pseudomonas aeruginosa
Aerobic, motile, non lactose fermenting
```
PSEUDOMONAS mnemonic
P-pneumonia
S-sepsis
E- Ecthyma gangrenosum (rapidly progressive necrotic cutaneous lesion in immunocompromised patients)
U- UTI
D- Diabetes
O-Osteomyelitis
M-mucoid polysaccharide capsule
O-Otitis externa (swimmers ear)
N-Nosocomial infections (catheters etc)
A- Addicts (drug abusers)
S- skin infections (hot tub folliculitis, wound infection in burn victims)
```
Mucoid polysaccharide capsule can form biofilm --> Chronic pneumonia in CF
```
produces PEEPR:
Phospholipase C (degrades cell membrane)
Endotoxin (fever, shock)
Exotoxin A (inactivates EF-2)
Pigments pyoverdine and pyocyanin (blue green pigment)
Reactive oxygen species
```
Corneal ulcers in contact lens wearers
```
TX with CAMPFIRE drugs
Carbapenems
Aminoglycosides
Monobactams
Polymyxins
Fluoroquinolones
ThIRD and fourth generation cephalosporins
Extended spectrum penicillins
```
71
Pt presents with rose spots on abdomen, constipation followed by diarrhea, abdominal pain, fever
Salmonella typhi - Typhoid fever
H2S production
Flagella - salmon swim
Endotoxin and Vi capsule
High infectious dose required
Acid labile - inactivated by gastric acids
Carrier state with gallbladder colonization
GI sx due to invasion of M cells in peyer patches
give oral vaccine
72
Pt has a pet turtle and is now experiencing diarrhea
```
Salmonella spp. (Except typhi)
GI sx due to invasion of M cells in peyer patches
H2S production
Flagella (salmon swim)
Endotoxin
High infectous dose needed
Diarrhea can be bloody
No vaccine
poultry, eggs, pets, and turtles
```
antibiotics not indicated
73
Shigella
```
Invasion of M cells is key to pathogenicity
No H2S
No flagella
Endotoxin
Shiga toxin (enterooxin)
Low infectious dose required
Acid stable - resistant to gastric acids
Blood diary (bacillary dysentery)
```
(highest severity) S dysenteriae> S flexneri>S Boydii> S sonnei
74
Pt ate pork and now has right lower abdominal pain
Yersinia enteroclitica
Pet feces, contaminated milk, or pork
acute diarrhea or pseudoappendicits (mesenteric adenitis and terminal ileitis)
75
E. Coli
produces Beta galactosidase which breaks down lactose into glucose and galactose
fimbriae- cystitis and pyelonephritis (p-pili)
K capsule - pneumonia and neonatal meningitis
LPS endotoxin- septic shock
76
EIEC
EnteroInvasive E coli
Invasive, dysentery, similar to shigella
77
Travelers diarrhea
Enterotoxigenic E coli
produces heat labile and heat stable enterotoxins
No inflammation or invasion
Travelers diarrhea
78
Child with diarrhea
EPEC: EnteroPathogenic E coli
adheres to apical surface, flattens villi, and prevents absorption
usually in children (think EPEC and pediatrics)
79
pt presents with anemia, thrombocytopenia, and acute renal failure
EHEC: Enterohemorrhagic E coli
O157:H7
causes dystentery
Does not ferment sorbitol
shiga like toxin causes hemolytic uremic syndrome: triad of anemia, thrombocytopenia, and acute renal failure due to microthrombi forming on damaged endothelium --> mechanical hemolysis (with schistocytes on peripheral blood smear), platelet consumption, and decreased renal blood flow
80
Bacteria known for lobar pneumonia in alcoholics and diabetics when aspirated. "currant jelly" sputum
Klebsiella
Very mucoid colonies caused by abundant polysaccharide capsules
Dark red "currant jelly" sputum (blood/mucus)
81
Bacteria commonly associated with Guillian barre syndrome and reactive arthritis
campylobacter jejuni
comma or S shaped with polar flagella
Oxidase +
Grows at 42 C
Blood diarrhea
82
Rice water diarrhea
Vibrio cholerae
Gram -, flagellated, coma shaped, oxidase +
grows on alkaline media
enterotoxin that permanently activates Gs which increases cAMP --> watery diarrhea
Sensitive to stomach acid/acid labile
requires large inoculum
83
Duodenal peptic ulcers
Helicobacter pylori
curved, flagellated, gram - rod that is triple positive: catalase, oxidase, and urease
urease produces ammonia, creating an alkaline environment which helps H pylori survive in acidic mucosa
associated with gastric adenocarcinoma and MALT lymphoma
triple therapy: amoxicillin + clarithromycin + PPI
if penicillin allergy then replace amoxicillin with metronidazole
84
Patient went hiking and now has a bullseye rash
Borrelia burgdorferi - lyme disease
Ixodes deer tick
Natural reservoir is the mouse
Spirochetes - borrelia is BIG
stage 1 - erythema migrans
stage 2 - early disseminated, carditis, AV block, bells palsy, migratory myalgias/transient arthritis
stage 3- late disseminated, encephalopathy and chronic arthitis
tx: doxycycline
amoxicillin and cefuroxime in pregnant women and children
85
Found in water contaminated with animal urine
Leptospira interrogans
spirochete with a hook shape end
leptospirosis - flu like, myalgia in calves, jaundice, photophobia with conjunctival suffusion (erythema without exudate). Prevalent among surfers and in tropics
Weil disease- icterohemorrhagic leptospirosis. Severe form with jaundice and azotemia from liver and kidney dysfunction, fever, hemorrhage, and anemia
86
Syphillis
spirochete Treponema pallidum
primary - painless chancre. Dark field microscopt. VDRL + in 80%
Secondary- Disseminated disease. Maculopapular rash (palms and soles), condylomata lata, dark field microscopy, confirm dx with FTA-ABS
Latent
Tertiary syphilis - Gummas (chronic granulomas), aortitis (vasa vasorum destruction), neurosyphilis (tabes dorsalis or general paresis), Argyll robertson pupil or prostitute pupil ( accommodates (constricts) but does not react (to light)). Pt presents with broad based ataxia and a + romberg sign, charcot joint (progressive degeneration of a weight bearing joint), stroke w/o HTN
87
Congenital syphilis
facial abnormalities such as rhagases (linear scars at angle of mouth), snuffles (nasal discharge), saddle nose, notched (hutchinson ) teeth, mulberry molars
88
VDRL false positives
test for syphilis
```
Pregnancy
Viral infection
Drugs
Rheumatic fever
Lupus and leprosy
```
89
pt is started on antibiotics and starts to develop fever, chills, headache, myalgia
Jarisch Herxheimer rxn
flu like sx due to bacteria being killed and releasing toxins
90
Pt presents with a fishy odor and vaginal discharge
Gardnerella vaginalis
"I dont have a clue why I smell fish int he vagina garden"
```
Bacterial vaginosis
Gray vaginal discharge
Fishy smell
Nonpainful
Clue cells : vaginal epithelial cells covered with Gardnerella have stippled appearance along outer margin
```
amine whiff test- mixing discharge with 10% KOH enhances fishy odor
tx with metronidazole or clindamycin
91
Chlamydia
cell wall lacks peptidoglycan and tehrefore rendering beta lactams anitbiotics ineffective
Elementary body (small and dense) is infectious and enters cell via endocytosis
Then transforms into reticulate body which replicates in cell by fission
reorganizes into elementary bodies
chlamydia trachomatis causes reactive arthritis (reiter syndrome), neonatal and follicular adult conjunctivitis, nongonococcal urethritis, and PID
tx: azithromycin or doxycycline ( + ceftriazone for possible gonorrhea)
92
Chlamydia trachomatis sertypes
ABC : Africa, blindness due to follicular conjunctivitis, and chronic infection
D-K: everything else. urethritis/PID, ectopic pregnancy, neonatal pneumonia with staccato cough with eosinophilia, neonatal conjunctivitis
L1,L2,L3: lymphogranuloma venereum- small painless ulcers on genitals --> swollen painful inguinal lymph nodes that ulcerate (buboes). tx with doxycycline
93
Cat scratch dz
Bartonella spp
| bacillary angiomatosis
94
Relapsing fever
Borrelia recurrentis
| spread by louse
95
Plague
Yersinia pestis
| Fleas from rats and prairie dogs
96
Brucellosis/undulant fever
unpasteurized dairy
| Brucella spp
97
Pt presents with a rash that started on wrists and ankles and has now spread to her trunk, palms, and soles. She also complains of a headache and a fever.
Rocky mountain spotted fever
Rickettsia rickettsii, vector is the dermacenter dog tick
South atlantic states (i.e. N carolina)
98
Pt developed a rash that started centrally and spreads out. It has spared the palms and soles
Endemic (fleas) - R typhi
Epidemic (human body lous) - R prowazekii
Typhus
99
Ehrlichiosis
Ehrlichia
Vector is a tick
Monocytes with morulae (mulberry like inclusions) in cytoplasm
100
Anaplasmosis
Anaplasma
Vector is a tick
Granulocytes with morulae in cytoplasm
101
Q fever
coxiella burnetii
spores are inhaled as aerosols from cattle/sheep amniotic fluid
presents as pneumonia
common cause of culture - endocarditis
102
Mycoplasma pneumoniae
atypical "walking" pneumonia (insidious onset, headache, nonproductive cough, patchy or diffuse interstitial infiltrate)
cold agglutinins (IgM), Eaton agar
bacterial membrane contains sterols for stability
pt < 30 yo, military recruits and prisons
tx: macrolides, doxycycline, or fluoroquinolones. No penicillin because mycoplasma lack a cell wall
103
Common cause of pneumonia in neonates
Group B streptococci
| E coli
104
common cause of pneumonia in 4 wk-18 yr
```
RSV
Mycoplasma
C trachomatis (infant - 3 yr)
C pneumo (school aged)
S pneumo
```
105
Glucose levels drop in ______ meningitis
bacterial or fungal
106
What infections most commonly cause brain abscess
Strep and staph aureus
107
Most common bug to cause osteomyelitis
Staph aureus
note: MRI is best for acute infections and fetailing anatomic involvement. Xrays are for later/chronic
108
TX for bacterial vaginosis and trichomonas vaginitis
Metronidazole
109
Chancroids
painful genital ulcer with exudate and inguinal adenopathy
Haemophilus ducreyi ( its so painful you "do cry")
110
Granuloma Inguinale (Donovanosis)
Painless, beefy red ulcer that bleeds readily on contact
klebsiella (calymmatobacterium) granulomatis
cytoplasmic donovan bodies (bipolar staining) seen on microscopy
111
Pt was dx with PID that was left untreated. She now presents with infection and inflammation of the liver capsule and "violin string" adhesions of peritoneum to the liver
PID can lead to perihepatitis (Fitz Hugh Curtis syndrome)
112
Urinary catheterization infections
infections of your PEcKer
Proteus spp
E coli
Klebsiella
