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Flashcards in Day 2.1 Micro Deck (87):
1

What part of the bacteria stains with crystal violet?

Peptidoglycan layer.
Gram+ have big peptidoglycan layer, so they turn purple (violet)

2

What are the acute phase cytokines?

IL-1
IL-6
TNF-alpha

3

Where are Beta-lactamases located?

In the periplasm (space) of gram-neg bacteria. B-lactamases break down Abx like penicillin

4

What bacteria are encapsulated?

Some Killers Have Nice Shiny Bodies:
Strep pneumonia
Klebsiella
Hemohilus influenza B
Neisseria
Salmonella
B (gp B strep)

5

How do you test for encapsulated bacteria?

+ quelling reaction
Capsule swells with anti-capsular Ab.
(Doesn't swell w/o Ab bc capsule protects)

6

The capsule serves an the Ag in which vaccines?

Pneumococcal (Pneumovax)
HiB
Meningiococcal
These vaccines are all derived from capsular Ag

7

What are the spore-forming bacteria

Only gram+ rods do this:
Bacillus (anthrax, B. cereus)
Clostridium (perfringens, tetani, botulinum)
Coxiella burnetti (Q fever)

8

Where is the DNA for Abx-resistance proteins (e.g. B-lactamase) found?

On plasmids. Not part of regular genome.

9

How does Endotoxin (lipid A) cause septic shock?

It activates macrophages, which release NO. NO causes vasodilation, which leads to hypotension and septic shock.

10

Where is endotoxin (LPS) found?

On the cell wall of gram-neg bactera, and in one gram+ bacteria: Listeria monocytogenes.

11

How does endotoxin (LPS) cause anaphylactic shock?

It activates the complement pathway, which causes C3a activation. C3a causes basophils and mast cells to degranulate and rls histamine, which causes vasodilation, hypotension, and edema.

12

What does C5a cause?

Neutrophil chemotaxis

13

Which are secreted, endotoxins or exotoxins?

Exotoxins are secreted. Endotoxin (LPS) is part of the cell wall.

14

Which needs a lower dose in order to be fatal, endo or exotoxin?

Exotoxin is the more fatal, meaning it needs only a small amt to be toxic. The toxicity of endotoxin is low, meaning it needs a higher dose to be toxic.

15

What are superantigens?

Exotoxins (secreted toxins)- bind directly to MHC-II and TCR simultaneously, activating lg numbers of Tcells to stimulate rls of IFN-gamma and IL-2.
S. aureus and S. pyogenes (gp A) have a lot of them.

16

What are the S. aureus superantigens (exotoxins)?

alpha-toxin - hemolysis
beta-toxin - sphingomyelinase
gamma-toxin (proteins A, B, C) - A + B = hemolysin (hemolysis), B + C = leukocidin (destroys leukocytes)
Enterotoxins A-E - food poisoning-vom/D
TSST-1 - rls cytokines - TSS
Epidermolytic/exfoliative - epithel cell lysis-scalded skin syndr

17

What are the Strep pyogenes (Gp A Strep) superantigens (exotoxins)?

Streptolysin O - hemolysis (O2 labile)
Streptolysin S - hemolysis (O2 stabile)
Erythrogenic /pyrogenic toxins - skin rash, fever of scarlet fever

18

What do ADP-ribosylating A-B toxins do?

Interfere w host cell fn
B (binding) part binds to a receptor on host cell surf, enabling endocytosis of the toxin.
A (active) part attaches and ADP-ribosyl to host cell protein (ADP ribosylation), altering protein fn

19

What are the pathogens with ADP ribosylating A-B toxins?

C. diptheriae
V. cholera
E.coli (ETEC)
B. pertussis

20

How does the ADP ribosylating toxin of Corynebacterium diptheria work?

Inactivates EF-2 (elongation factor), causes pharyngitis and pseudomembrane (gray) in throat. Don't scrape or will get into blood and kill pt.

21

How does the ADP ribosylating A-B toxin of Vibrio cholera work?

ADP ribosylation of Gs protein stim's adenylate cyclase, causes incrsd pumping of Cl- into gut and decrsd Na+ absorption. H20 follows salt in gut, causing voluminous rice-water diarrhea

22

How does the ADP ribosylating A-B toxin of ETEC work?

Heat-labile toxin stim's adenylate cyclase
Heat-stabile toxin stim's guanylate cyclase
both cause watery diarrhea
Labile like Air (A = adenylate)
Stabile like Ground (G = guanylate)

23

How does the ADP ribosylating A-B toxin of Bordetella pertussis work?

Increases cAMP by inhibiting Gi (Inhibits the inhibitor). Causes whooping cough. Inhibits chemokine receptor, causing lymphocytosis (increased lymphocytes)

24

When C. diptheria inactivates EF-2, this can interfere with protein synthesis in which cells?

Heart cells and nerve cells

25

What does the toxin of C. perfringens do?

alpha toxin- it's a lecithinase that acts as a phospholipase to cleave cell membranes
causes gas gangrene

26

What does the toxin of C. tetani do?

Tetanospasmin
Blocks rls of inhibitory NTs GABA and Glycine.
Causes lockjaw

27

What drugs potentiate GABA?

Benzos and Barbituates.
GABA is the main inhibitory NT of the brain, so potentiating it means slowing down the brain.

28

What does the toxin of C. botulinum do?

Blocks rls of ACh, causing anti-cholinergic symptoms, CNA paralysis (esp cranial nerves) and floppy baby flaccid paralysis.
Spores in canned food and honey, don't give to kids <1 yo

29

What does the toxin of B. anthracis do?

Includes edema factor, which is itself an adenylate cyclase- so it increases cAMP. (Without the Gprotein first)

30

What does the toxin of Shigella do?

Shiga toxin cleaves host cell rRNA, inactivating the 60S eukaryotic ribosome. Also enhances cytokine rls, causing HUS.
Shiga toxin is also md by E.coli

31

What does the toxin of S. pyogenes (Gp A Strep) do?

Streptolysin O- it's a hemolysin.
It serves as the Ag for ASO Ab, which is used to dx rheumatic fever.
Also Streptolysin S and erythrogenic and pyrogenic toxins.

32

What toxins induce cAMP?

Vibrio cholera toxin (permanently activates Gs
Pertussis toxin (permanently inactivates Gi)
E. coli (ETEC) heat-labile toxin
B. anthracis (includes edema factor, which is an adenylate cyclase)

33

What causes scarlet fever? What are the toxins?

S. pyogenes (Gp A strep)- erythrogenic toxin (red skin) and pyrogenic toxin (fever)

34

What neurotransmitters does Tetanus toxin block?

GABA and Glycine (inhibitory NTs)

35

Which pathogens are intracellular?

Rickettsia and Chlamydia
Stay inside bc it's Really Cold.
Also Legionella is primarily intracellular

36

What organisms are too thin to be gram stained?

Treponema
Use darkfield microscopy and fluorescent Ab staining instead

37

What organisms have a high lipid content and therefore do not gram stain well?

Mycobacteria.
Use acid-fast (Ziehl-Neelson) stain instead

38

What organisms have no cell wall and therefore do not gram stain well?

Mycoplasma

39

What stains with Giemsa?

Borrelia, Plasmodium, trypanosomes, Chlamydia

40

What stains with India Ink?

C. neoformans.

41

What is congo red stain used for?

Amyloid

42

What is silver stain used for?

Fungi
Legionella

43

What media does H. influenza need to grow?

Chocolate agar with factors V (NAD+) and X (hematin)

44

What agar is M. tuberculosis grown on?

Lowenstein-Jensen agar
(takes 3-4 wks to grow)

45

What is MacConkey's agar made of?

Bile salts, crystal violet (these kill gram+)
Lactose, Neutral red (gram-neg lactose fermenters take up both of these, making colonies pink)

46

What agar is E. coli grown on?

MacConkey's (pink colonies) or
EMB eosin-methyline blue (blue-black colonies with metallic sheen)

47

What agar is fungi grown on

Sabourad's agar

48

In what environment does Pseudomonas (aeruginosa) love to grow?

Aerobe (needs air) and loves moist environment:
hot tub (folliculitis)
sweaty shoes
contact lenses
burn victims

49

At which point on the bacterial growth curve does spore formation occur?

At the end of the stationary phase, when nutrients are almost depleted.

50

What are the 4 methods of bacterial DNA exchg?

1. Transformation (take up from env)
2. Conjugation (with pilus)
3. Transduciton (phages)
4. Transposition (jump from plasmid to chromosome)

51

Which bacteria can undergo transformation (take up DNA from env)

SHiN:
S. pneumoniae
H. influenza B
Neisseria

52

Staph are gram+ and catalase+, meaning they make catalase. What does catalase do?

Degrades H2O2 into O2 and H2O.
H2O2 is usually converted by myeloperoxidase to a microbicide. Staph prevents this by getting rid of the H2O2 in the first place.

53

S. aureus is gram+ catalase+ coagulase+. What does coagulase do?

Coagulase converts fibrinogen to fibrin. This makes it easy for S. aureus to hide in blood clots (since it helps make fibrin)

54

What gram+ bacteria is found as diplococci?

S. pneumonia

55

What are the Coag-neg staph?

S. epidermidis
S. saprophyticus

56

What strep are alpha-hemolytic?

S. pneumonia and Viridans group (S. mutans)

57

What bacteria causes endocarditis, esp in drug users

S. epidermis (coag-neg)

58

What bacteria cause subacute bacterial endocarditis?

Coag-neg S. epidermis
Enterococci
Viridans group (S. sanguis)

59

What bacteria causes dental caries?

S. mutans (viridans group)

60

What diseases can be caused by S. aureus?

Inflam dz:
Skin/wound infection
Organ abscess
Respi infection/pneumonia
Bacteremia/sepsis
UTI
Endocarditis, meningitis, osteomyelitis, septic arthritis

Toxin-mediated dz:
TSS (TSST-1 toxin)
Scalded skin syndrome (epidermolytic/exfoliative toxin)
Gastroenteritis/food poisoning (enterotoxins)

61

What is Protein A?

Virulence factor of S. aureus.
Binds to the Fc region of IgG, preventing opsonization (complement fixation) and phagocytosis.

62

Is S. aureus ever normal flora?

Yes, in nose!

63

Who should get the pneumococcal vaccine? (Against S. pneumonia)

>65 yo
Asplenic
Sickle cell anemia
HIV+
Hx of chronic lung dz (COPD, asthma)

64

What skin infections can be caused by both S. pyogenes and S. aureus?

Folliculitis
Celluitis (deep skin infection)
Impetigo (skin vessicles around mouth, rupture and make thick yellow weeping crusted lesions- honeycomb lesion)

65

What does S. pyogenes (Gp A Strep) cause?

Proliferative/pyogenic dz:
pharyngitis
endocarditis
skin infections
necrotizing fasciitis
bacteremia, sepsis

Toxin-mediated dz:
Scarlet fever
TSS

Autoimm Ab-mediated (but initiated by S. pyogenes):
Acute glomerulonephritis
Rheumatic fever

66

What bacterial virulence factor does S. pyogenes (Gp A Strep) have?

M protein- helps prevent phagocytosis

67

What organisms cause neonatal death?

Group B Strep (S. agalactiae)
E. coli
Listeria
(These can all cause meningitis in newborns)

68

What is the most common organism in the large intestine?

Bacteroides fragilis (obligate anaerobe)

69

What are the obligate anaerobes?

Clostridiium
Bacteroides
Acintomyces

70

What is the Rx for obligate anaerobes?

Metronizadole or Clindamycin

71

What organism causes acute endocarditis?

S. aureus

72

What organism causes mastitis of breast?

S. aureus

73

What bacteria is common in neonates bc it's normal vag flora in 25% of women?

Group B Strep (S. agalactiae)

74

What can Gp B Strep cause in neonates?

Meningitis
Sepsis
Pneumonia

75

Most common cause of meningitis?

S. pneumonia

76

Most common cause of osteomyelitis?

S. aureus

77

Cause of cellulitis?

S. pyogenes or S. aureus

78

Cause of otits media in children

S. pneumonia

79

Pharyngitis which leads to glomerulonephritis is cause by which organism?

Group A Strep (S. pyogenes)

80

Food-poisoning w vom that resolves quickly

Caused by S. aureus (ingested enterotoxins)

81

S. pneumonia is the most common cause of what 4 things?

MOPS:
Meningitis
Otitis media in kids
Pneumonia
Sinusitis

All of these are protected by IgA (IgA is in mucus) normally, but S. pneumonia is an IgA protease.

82

15% of colon cancer pts are colonized with which bacteria?

Strep bovis (Gp D strep)

83

What is the treatment for Diptheria?

Diptheria anti-toxin (Ab)
Penicillin
Dpt vaccine

84

C. diff produces pseudomembranous coliits. What is a pseudomembrane of the gut?

Necrosis of gut epithelium, with exudate, fibrin, and leukocytes

85

How do you dx C. diff?

Look for C. diff toxin in stool

86

What is the Rx for C. diff?

Metronidazole (oral or IV)
Vancomycin (oral)- this is the only time Vanc can be given orally. When given orally it will be metabolized and not go systemically. Here, that's okay bc you just want it in gut. Also, the oral dose is not nephrotoxic bc it doesn't go systemic, so it's okay for pts w renal dz

87

Nocardia and Acintomyces: both are gram+ filamentous branching rods. Are they aerobic or anaerobic?

Acintomyces = anaerobic
Nocardia = aerobic