DIT Micro Bacteria Flashcards Preview

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Flashcards in DIT Micro Bacteria Deck (305):
1

lipoteichoic acid is found where and leads to what?

found in gram + cell walls and leads to, IL1 IL6, TNF alpha

2

Lipopolysacharide is found where and causes what?

found in gram -

Contains lipid A - lysed ->
and leads to IL1, IL6, and TNF alpha

3

Transpeptidase is?

an enzyme that is targeted that links peptide side chains together to make peptidylglycan wall

4

Ribosomal sub units of prokaryotes

30s and 50s -> 70s

s refers to sedimentation not units

5

Bacterial w/ capsules (8+1)

Even Some Nasty Killers Have Pretty Shiny Bodies

E Coli -some
Streptococcus pneumonia*
Nisseria meningitis*
Klebsiella
Hamophelis influenza*
Pseudomonas aerugenosa
Salmonella typhi
Group B strep

SHiN

Cryptococcus neoformis - fungi

6

Splenectomy leads to what concerns?

Of encapsulated bugs

Make sure vaccinated agains SHiN bugs

7

Only fungus that is encapsulated ?

Stain?

Causes?

Cryptococcus neoformis

India ink

meningitis in AIDS

8

Bacteria w/out a cell wall

myocplasma

- high sterol count

9

Bacteria w. high lipid count in cell wall making it difficult to gram stain

Mycobacteria

contains mycolic acid

10

6 bugs that do not gram stain well

Treponema - too thin - dark field instead
Ricketsia - intracellular
Chlamydia - intracellular
Mycobacteria - high lipid content
Mycoplasma - no cell wall
Legionella - intracellular

11

Silver stain useful for which 2 organisms

Legionella

Pneumocystis

12

Zeil neelsen positive organisms?(2)

Acid fast stain

Mycobacteria
Norcardia

13

Giemsa stain useful for? (5)

Chlamydia
Borrelia
Ricketsia
Trypanosomes
Plamodium

14

Positive Quelleng Test in

Bugs w/ capsules

E Coli -some
Streptococcus pneumonia*
Nisseria meningitis*
Klebsiella
Hamophelis influenza*
Pseudomonas aerugenosa
Salmonella typhi
Group B strep

15

3 organisms capable of taking in naked DNA from the environment

SHiN can do Transformation

Streptococcus pneumonia
Hamophelous influenza
Nesseria meningitis

16

Spore forming bacteria (2 families)

gram +

Bacillus
-anthacis
-cereus

Clostridium
-perfinges
-botulinum
-tetani

17

Lipid A endotoxin found where?

Leads to activation of what 3 pathways

in the LPS wall of gram -

Macrophage activation
-IL1, IL6 -> fever
-TNF alpha -> fever and hypotension
-Nitric Oxide -> vasodialation

Complement
-C3a -> hypotension/edema (histamine)
-C5a -> PMN chemotaxis

Activates tissue factor -> coag + DIC

18

Macrophage activation post Lipid A encounter leads to (3)

Septic shock
-IL1, IL6 -> fever
-TNF alpha -> fever and hypotension
-Nitric Oxide -> vasodialation

Also have complement and tissue factor activation

19

Complement activation in septic shock gram -

-C3a -> hypotension/edema (histamine)
-C5a -> PMN chemotaxis

Macrophage activation and tissue factor as well

20

Why is gram - septic shock lead to DIC?

Activates tissue factor -> coag + DIC

21

Two gram + bacteria associated w/ super antigens and their respective antigen

Staph aureous
-TSST1

Streptococaal pyrogenes
- pyrogenic toxin A-C

22

Superantigens binds to (2)

leads to?

MHC II and TCR

leads to polycolonal T cel activation

23

2 toxins associated w/ inactivation of E2F

Diptheria on Corynebacterium dipheriae

Exotoxin A on Pseudomonas aerugunosa

24

2 toxins that inactivate 60s ribosome leading to HUS

Shiga toxin in shigella

Shiga like toxin in EHEC

25

Hemolytic uremic syndrome is characterized by what 3 symptoms and found w/which 2 bugs

thrombocytopenia
hemolytoc anemia
acute renal failure

Shigella and EHEC (O157:H70

26

2 toxins -> Over activates adenylate cyclase -> increased cAMP -> Cl secretion and diarrhea

Cholera toxin in vibrio Toxin

heat labile toxin in ETEC

27

heat stable toxin is found where and leads to what

found in ETEC also

leads to diarrhea due to increase of guanate cyclase action and increasing cGMP and decreased NaCL reabsorbtion

28

Edema factor, lethal factor and protective antigen make up?

Bacillus anthra toxin -> edemotous border and black eschar

29

Activation of Gs via this toxin leads to 12-20 L of fluid loss per day

Cholera
overactivationof adenylate cyclase -> increased cAMP and Cl excretion

~ HL toxin in ETEC

30

activation of Gi by this toxin leads to

Pertussis

100 day cough in adults and wooping in kids

inactivation of Gi leads to increase adenylate cyclase and increased cAMP

31

Neurotoxins are secreted by which family.

What are their 2 toxin and MOA

Clostridium, both cleave SNARE proteins holding vesicles of NT near the synapse

Clostriudum tetani -> tetanospasim toxin, blocks GABA and glycine release (spasm)

Clostridium botulinum -> butulinum toxin, blocks release of ACh (flaccid)

32

Clostridium botulinum has 2 food borne associations w/ dif mechanisms of action

spores in honey -> floppy baby

Eneterotoxins in canned foods -> diarrhea in adults

33

Alpha toxin is found where and leads to what 2 problems

Clostridum perfinges

degradation of phospholipid C ->
- myonecosis
- gas gangrene

34

Streptolysin O and S are associated w/ what organism and leads to what

Streptococcal pharynges

hemolysis

O being oxygen labile -ASO titre
S being stable

35

Scarlet fever is due to

differs from rheumatic fever how?

Streptococcal pyrogenes -> erythrogenic and pyrogenic toxins

Rheumatic fever is an immune response weeks later due to cross reactivity to the M antigen

36

Spores are formed during what part of the bacterial graph

Stationary, plateau

37

Penicillins and cephasporins work best at what stage of infection

exponential growth phase

38

7 bugs that secrete enterotoxins(watery diarrhea/ electrolyte imbalances)

Staph aureus
Vibrio cholera
ETEC
Shigella
Yessernia enterolita
Clostridium perfinges
Clostridium difficle

39

Enterotoxin producing bacteria that may mimic appendicitis

Prefers what environment

Yessernia enterocolitica

colder temps - fridge, do not kill it

40

Leukocodin is what and found where

exotoxin made by Staph aureus that kills leukocytes

2 types - delta and panton valentine

41

Protein A is found where and responsible for what? (2)

Found in Staph aureus and associated w/ hemolysis

also binds to Fc-IgG inhibiting opsonization and phagocytosis

type of hemolysin along w/ Protein B

42

3 main branches of gram +

Cocci
-Staph and Strep

Rods
-Clostridium
-Bacillus
-corynebacterium
-Listeria
-Mycobacterium

Branching filaments
-actinomyces
-Nocardia

43

Catalase test is what and used to seperate

Breaks down H2O2 into CO2 and H20

Separates cocci Staph (+) and Strep (-)

44

Coagulase test is what and used to separate which 3 organisms

how do you differentiate the last 2?

Whether gram + bunches together blood or not, also used to coat w/ fibrin to protect itself

S. aurous is (+)

S. epidermidis (-)
-(novobiocin sensitive)
S. straphrolyticus (-)
-novobiocin resistant

45

S. saphrolyticus is known for causing

UTIS

46

common aerobic bug found complicating prosthetic valves and joints

S. epidermidis

47

Partial hemolysis streptococcus (2)

differentiate how?

S pneumonia
- Optochin +
- Capsule (quelleng)

S. mutans

48

Complete beta hemolysis strep (2)

Differentiate how?

Group A -S pyrogenes
-bacitracin sensitive

Group B -S Agalactiae
-bacitracin resistant

49

gamma hemoysis gram + organisms (3)

Enterococcus Group D
E. faeceium
E. faecalis

S bolvis

50

Branching Filament Gram Positive organisms (2)

differ how?

Actinomyces
-anaerobic

Nocardia
-aerobic
acid fast

51

Gram + rods (5)

Spore formers
-Clostridium
-Bacillus

Nonspore
-listeria
-corynebacterium

Mycobacteria - acid fast

52

Bug forming yellow sulfur ganules

Actinomyces israleii

53

Bug staining the bandages blue-green

Pseudomonas aergunosa

Remember pseudo loves water

54

S aureous creates what colored pigment?

Yellow

Au = gold

55

Serratia marcescens is associated w/ what pigment?

Red

56

Toxin mediated Staph aureous infections?(3)

Enterotoxin - fast food poisoning
TSS1T - toxic shock syndrome
exfolotoxin - scalded skin syndrome

57

Staph virulence factor that binds to Pc-Ig inhibiting obsinization

Protein A

58

Gram + dipplococci think

Strep pneumonia

59

Streptococcus pneumonia most commonly causes (4)

MOPS

Meningitis - community aquired, elderly

Otitis media - kids

Pneumonia

Sinusitis

60

IgA protease is found in ?

Staph aureus
Nesseria meningitis
H influenza

61

2 virulence factors of strep pneumo

Encapsulated
IgA protease

62

Rusty colored suptum

Pneumonia w/ Strep pneumo

63

Concern of sepsis w/ these 2 patients w/ S pneumonia

Splenectomy

Sickle cell

64

3 classifications of diseases due to Strep pyrogenes- total of (8)

Pyrogenic
-Impetigo
-cellulitis
-pharyngitis

Toxin mediated
-scarlet fever
-Toxic shock
-necrotizing fascitiis

immunologic
-rheumatic heart disease
-glomerulonephritis

65

Cellulitis and impetigo most often due to(2)

S. pyrogenes

S. aures

66

Glomerulonephritis can be seen a week after this infection

Strep pneumonia

either pharyngitis or cellulite/impetigo

67

Rheumatic fever due to ?

Diagnosed by?

Molecular mimicry to the M antigen of Strep pyrogens

J - joints, polyarthritis
O - heart - pancarditis
N - nodules - sub Q
E - Erythema migratans
S - sydenhams Chorea

68

ASO titer preformed to check for

S pyogenes

69

3 main worries w/ Group B in babies

Test what?

Meningitis #1
Pneumonia
Sepsis

CAMP factor

70

Strep bovis in the blood be concerned w?

Strep bovis also causes

Colon cancer

Sub acute endocarditis

71

Enterococci Group D causes

UTI and sub acute endocarditis
resisitant to treatment when found where it shouldn't be

72

grows in 6.5% NaCl and bile

Enterococci Grop D
-E facecalis
-E Faecum

73

Grows in 6.5% NaCl but NOT bile

S bolvi

74

ADP ribosylation of EF2 is due to?

dyptheria exotoxin or pseudomonas exotocin A

75

Rx for dyptherisa(3)

ABx
-erythromycin/penicillin
-anti toxin
-Vaccine

76

Club shaped baceria

corynebacterium

77

Obligate anaerobic bacteria (3)

Clostridium
Bacteriodes
Actinomyes

lack catalase and/or superoxide dismutase

Rx - metronidazole and clindamycin

78

Rx for obligate anaerobic bacteria(2)

Rx - metronidazole and clindamycin

Clostridium
Bacteriodes
Actinomyes

79

Toxin A enterotoxin and Toxin B
causing cytotoxin destruction(kills enterocytes)

C difficile

- leading to psudomembranous colitis due to binding

80

small papule leading to bleach eschar surrounded by edema due to?

Bacillus anthacis
- cutaneous

81

Woolsorter w/ flu like symptoms that rapidly progress to fever, pulmonary hemorrhage and shock caused by?

CXR shows ?

Pulmonary bacillus anthacis

->mediastinal widening

82

Only bacterium w/ a polypeptide (D glutamate) capsule?

B anthracsis

83

B cereus cause what pathology(2)?

Emetic type
- w/ rice and pasta w/in 1-5 hrs -due to a toxin

diarrheal type
-non bloody w/in 8-18 hrs

Spores survive heating and -> toxin production

84

Neonatal disease bugs biggest concern (3)

Step B
E coli
listeria

85

listeria affects who (4)

Neonates
inmmuncompromised
elderly
pregnant women -> neonatal death

86

Listeria monocytogens can reside in what cell?

Monocytes
faculative intracellular

move by actin rockets

87

Gram + anaerobe that has large branching filaments that cause oral/fascial abscesses?

Characteristic color?

Actinomyces israllii

yellow sulfur granules

88

Partially acid fast positive bacteria w/ large branching filaments that is aerobic?

Causes?(2)

Nocardia

pulmonary infection and cutaneous infection in the immune compromised

89

Gram - dipplocci

Nesseria

Urease +

90

Gram - coccii (3)

Nesseria meningitidis,
Nesseria gonorrhoeea
Morallela catarrlis

91

Cocciod Rod (gram -)

4

Haemophilus influnezae
Bordetella pertussis
Pasturella
Brucella

92

Gram - rods (10)

Broken up by

Lactose fermenters- FAST
-Klebsiella
-E Coli
-Enterococcii

Lactose femermenters -SLOW
-Citrobacter
Serratia

Lactose NON fermentors
-Shigella
-Salmonella
-Protease
-Pseudomonas*
-H pylori*

93

Gram - rods Lactose nonfermentors(5)

broken up by?

Oxidase -
-Shigella
-Salmonella
-Proteus

Oxidase +
-Psuedomonas
-H pylori

94

Gram - rods Lactose fermentors (5)

Broken up by

Fast
-Klebsiella
-E coli
-Enterobacter

Slow
-Citrobacter
-Serratia

95

Gram - comma shaped (2)
-Oxidase +

Unique characteristic of each?

Camplobacter jejuni
-grows at 42 degrees C

Vibrio Cholera
-grows in alkaline material

96

Nesseria that does not have a capsule?

gonococci and thus no vaccine

97

Prophylactiv Rx for N meningitidis (3)

Definitive (2)

Prophylactic
-rifampin
-cipro
-ceftriaxone

Ceftriaxone definitive

98

Adrenal hemorrhage is due to this bug,

Called?

waterhouse friderichsen syndrome

due to N meningitis

99

sniffing dog position and thumb sign on CXR may indicate what by what organism?

Epiglotitis

by Haemophilus influenza

100

Haemophilus influenza causes (5)

Epiglottis - Cherry red
Meningitis
Otisis media
sinusitis
Pneumonia

IgA protease
chocolate agar w/ V and X

101

Culturing requires a chocolate agar w/ factors V and X

Haemophilus influenza

Vaccine avaialable

102

Small painful lesion, solitary, on the genitalia?

Haemophilus ducreyi

103

Legionella can be detected through what 2 tests?

Silver stain
antigen in urine

104

Legionella pneumophila spreads via

aerosolized water
NOT person to person

105

Grows on a charcoal yeast extract culture w/ iron and cysteine

Legionella pneumophilia

106

atypical pneumonia w/ fever and GI symptoms that does not gram stain

legionella

107

Erythema gangreosum (black escar) seen w/ a sepsis think of?


- may be a burn patient

PSeudomonas

108

Special victims of pseudomonas (3)

Burn victims
CF
Diabetics

109

Pseudomonas causes

Pneumonia- CF
Spepsis
External otitis - swimmer
UTI
Diabetic Osteomylitis

110

Triple Therapy in gram - nonlactose fermentor causing increased risk for Lymphoma and gastric adenocarcinoma

Helicobacter pylori

Use
-PPI
-Clarithromycin
- Amoxicillin/metronidazole

111

Breath test for gastric ulcer takes advantage of what feature of this organism

Urease + -> alkaline environment

H pylori

112

osteromyolitis in sickle cell disease

maybe after a diarrheal illness

Salmonella

113

diarrhea caused by gram - non motile organism that does not ferment lactose

shigella

114

diarrhea caused by gram - motile organism that doesn't ferment lactose

Salmonella

115

MacConkey agar turns pink w/ this enzyme

lactose fermenters
- like E coli, klebsiella etc

116

Heat labile and heat stabile toxin are produced by this bacteria and lead to the same result by different mech

Rx

ETEC e coli -
- floroquinolones

Heat labile increase cAMP
~cholera

Heat stabile increases cGMP

117

Has a shigella like toxin leading to HUS but is lactose fermenting

EHEC O157-H7

Does not ferment sorbitol

HUS - anemia, thrombocytopenia and acute renal failure
(mech hemolysis, low renal flow and platelet consumption)

118

Diarrhea seen in kids due to adherence, no invasion

EPEC

119

Diarrhea due to invasion causing necrosis and inflammation similar to shigella

EIEC

Rx floroquinilones, TMP/SMX

120

Shigella presentation progression

Starts as water diarrhea that becomes bloody as the toxn does its work and then have invasion leading to fever

No flagella, very virulent
- food to water spread

121

produces hydrogen sulfide and has a flagella causing diarrhea

Salmonella

122

Picinic and egg salad or chicken was consumed causing diarrhea 1-3 days later

salmonella

123

Reactive arthritis seen it 2 GI bugs

Salmonella and Shigella

In addition to Chlamydia

124

Salmonella typhi differs in that(3)

typhoid fever
-rose spots on the abdomen
- fever
- HA
-Nausea

gallbladder is a carrier state

125

diarrhea w/ rose colored spots on the abdomen

salmonella typhi

126

Major cause of bloody diarrhea found in poultry, meat and unpasturized milk?

2 unique features?

camplobacter jejuni

S shaped
grows at 42 degrees C

127

Sequllea associated w/ camplobacter jejuni?

Guillain Barre

128

Grows in alkaline media and has a flagella to move around. Slight comma shape

Vibrio cholera

activates Gs

129

Diarrhea associated w/ puppies

also found in?(2)

yersernia enterocolitica

contaminated milk or pork

130

Turtles can harbor

salmonella

131

mesenteric adenitis epidemic found in a daycare due to

yersernia enterocolitica
- mimics appendicitis

Found in cooler climates as well

132

Aspiration pneumonia in someone that is immune compromised

may see on sputum

Klebsiella, especially in alcoholics and diabetics

red current jelly from lobar pneumonia

133

oral vancomycin really only ever used for?

another Rx if that does not work

C dif
- no nephrotoxicity due to no oral absorption

metronidazole

134

Post clindamycin or ampicillin Rx worry about

How would you diagnose this disorder if suspected?

C dif

C dif Toxin A or B

A - enterotoxin
B - cytotoxic to enterocytes

135

Contaminated seafood or shellfish due to

vibrio parahemolyticus and vulificans

136

Clostridium perfengiens enterotoxin can be found in?

reheated meat dishes

137

bulging food can may indicate contamination w.

C botulinum

138

Dysurea, increased frequency urgency and suprapubic pain, WBCs are all seen in

Cystitis

139

WBC casts are seen when and why?

Seen in pylonephritis or anytime the renal tubules are involved. Need the compression of the tubules to lead to cast formation

140

Positive leukocyte esterase test indicates in urine

bacterial UTI, enzyme is being expeller but can also just beinflammation

141

positive nitrite test in urine is indicative of

gram - bacteria UTI

enterobacteriacea

142

4 most common causes of UTIs

E coli
Staph saprophyticus
Klebsiella pneumonia
Proteus mirabilis

others
- Pseudomonas
Serratia macescens
-enterobacter cloacae

143

Urease is found in (2)

What does it do?

Found in H pylori and Proteus mirabillis

Splits urease into NH3 and Co2 to make the environment more hospitable

144

Motility causes swarming when trying to culture this UTI

Associated feature?

Proteus mirabilis

causes struvite stones

145

Green metallic sheen on EMB agar

E coli

146

Rx for UTIs

TMP-SMX*
Aminopenicillins
Floquinolines*
Nitrofurantoin

147

Spirochetes are defined by?(2)

3 examples

spiral shape
axial location of flagella (axial filaments)

BLT

Borrelia
Leptospira interrogans
Treponema

148

Weils Disease characterized by

Severe Leptospira interrogans infection - tropical disease

jaundice, azotemia, kidney dysfunction, hemorrhage, fever and anemia

149

animal urine think of 2 organisms

leptospira interrogans

rats - hanta virus

150

Leptospirosis symptoms (6)

1st -flu like

2nd - jaundice, photophobia, meningitis, liver damage and renal failure

Severe form - Weil disease

151

question mark shaped organism

leptospira interogans

152

Tick carrying borrelia burdorferi

Also carries?

Ixodes

babesia microti -> babesiosis

153

3 Stages of lyme Disease

2 symptoms for 1st 2
3 for the last

1
- erythema migraines,
- flu like symptoms

2
- neurologic (bi lateral bells palsy)
-cardiac - AV block

3
-migratory polyarthritis
- chronic monoarthritis (knee)
- encephalopathy/polyneuropathy

154

Bilateral bells palsy think of

Lymes

155

Diseases w/ bells palsy associated?(5)

Lymes
Herpes Zoster
Sarcoidosis
Tumors
Diabetes

156

2 tests looking for syphilis antibodies

False positives due to (5)

Confirm w?

RPR or VDRL

V- viruses (EBV, mono, hepatitis)
D- drugs
R- Rheumatic fever
L- Lupes, leprosy

FTA-ABS

157

condylomata lata

wart like lesion in moist areas associated w/ secondary syphilis

158

1st stage of syphilis

solitary painless ulcer

159

secondary stage of sphyilis has (3)

Maculopapular rash (hands/feet)
conylomata lata
fever/malaise/chills

160

3rd stage of syphilis has (4)

tabes dorsales/neurosyphilis
gummas - anywhere
aoritis - tree barking
argyll robertson pupil

161

Congenital syphillis one may see? (4)

saber shins - anterior bowing
hutchingsons teeth - notched incisors
saddle nose - frontal bossing
hearing loss

162

Argyll Robertson pupil is seen in what and defined by

tertiary syphilis

defined by pupils that accommodate but do not react to light

163

tabes dorsales is ?

signs and symptoms (3)


associated w

degeneration of the dorsal column and roots leads to loss of pain and sensation

leads to wide ataxic gait
charcots joints
positive rhomberg

tertiary syphilis

164

Charcot joints found in (2)

Tabes dorsales in tertiary syphilis

Diabetic neuropathy

165

bartonella causes?

Found in?

cat scratch fever - regional LAD and angiomitosis in immune compromised

cat scratch

166

borrelia burgdorferi causes?

Found in

Lymes disease

Ixodes ticks

167

Borreila recurrentis causes?

Found in?

recurrent fever

louse

168

brucella spp causes?

found in

brucellosis/undulant fever (granulomatous caseating)

unpasturized dairy (vets and ranchers)

169

Chlamydophila psittaci causes?

found in?

psittacosis - severe pneumonia

parrots/birds

170

coxiella burnetti causes?

found in?

Q fever - severe flu, abrupt fever

aerosols of cattle sheep amniotic fluid

171

erlichia caffeenis causes?

Found in

ehrlichiosis (HA, muscle ache, fever)

lone star tick

172

Francisella tularensis causes?

Found in?

tularemia (LAD, ulcer and granuloma formation)

Dermacator tick (rickettsia); rbabits and deer

173

Mycobacertium leprae causes?

Found in

leprosy

Armadillos

174

Pasteurella multocida causes?

Found in?

Cellulitis, osteomyolitis

Dog and Cat bites

175

Rickettsia prowazekki causes?

Found in?

epidemic typhus

louse

176

Rickettsia rickettsii causes?

Found in

Rocky mountain spotted fever

Dermencetor tick (franciella tularensis)

177

Rickettsia typhi causes?

Found in

endemic typhus

fleas

178

Yersernia pestis causes?

Found in?

plague

Fleas (rats/ praiare dogs)

179

Gohn complex

combination of hilar LAD
and john focus - calcified lung scar mid to low lung lobe

Primary TB

180

Gohn focus

Calcified lung scar in the mid to bottom lobe in primary TB

181

Primary TB most often becomes

Complications of Primary TB (3)

healed by fibrosis leading to immunity and hypersensitivity, Tuberculin +

progressive lung disease (HIV or malnutrition) -> infection/death

bacteremia w/ hematogenous spread -> milady TB and death

reactivation later in life leading to secondary TB

182

Secondary TB characterized by?

Location of lesion?

fibrocasious cavitary lesion in the upper lobes

Symptomatic w/ fever hemoptysis, weight loss and night sweats

183

lower back pain, nigh sweats, fever, hemoptysis think of?

Potts disease

extra pulmonary TB

184

extra pulmonary TB locations(5)

CNS -> parenchymal tuberculoma or meningitis

Vertebral bodies -> Potts disease

Lymphadenitis

Renal

GI

185

PPD + test means (3)

Current infection
past infection
BCG vaccine

186

PPD - test means (2)

No infection

Immune compromised to the point of anergic response (steroids,HIV, sarcoidosis, malnutrition)

187

Diagnosis of TB (2)

3 sputum cultures over 3 days
-any one can be positive

Culture takes 2-4 wks and should be done regardless

188

Acid fast + bacteria that causes pulmonary TB like symptoms in chronic bronchitis and emphysema

M kansaii

189

disseminated TB in AIDS patients w/ fever diarrhea, and malabsorbtion

Prophylactic treatment w/ what, when?

M. avium

Prophylactic treat Azythromycin when CD4 <50

190

Aquatic associated TB, seen in those that work at shipyard and aquarium workers

M marinum

191

Rx for active TB(4)

RIPE

Rifampin
Isoniazid - B6 pyradoxine
Pyrazinamide
Ethambutol

192

Rx for latent TB (2)

6-9 months of Isonizid

193

some virulence factors of mycobacterium tuberculosis(2)

cord factor - inhibits macrophage maturation, induces TNF alpha release

sulfatides - inhibit phagolysosomal fusion

194

mycobacterium that prefers cool temperatures of skin and superficial nerves

causes?

mycobacterium leprae

Causes
-lepramatous leprosy
-tuberculoid leprosy

195

Lepramatous leprosy is due to?

m leprae

communicable form of leprosy is due to an improper Th2 stimulation(humoral), Th1 response is low(cell mediated)

diffuse skin involvement

196

Tuberculoid leprosy is due /

m leprae

same pathogena as in lepromatous but immune response is primarily Th1 cell mediates and the disease is limited to few hypesthetic hairless plaques

197

Rx of lepromatous leprosy vs tuberculoid leprosy

lepromatous (2-5 yrs)
-dapsone
-rifambin
clofazimine

tuberculoid (12 months)
-dapsone
-rifampin

198

Dapsone is used in? (2)

Concern?

leprosy - tuberculoid and lepromatous

pneumocystis pneumonia prophylaxis (2nd line)


Concern in G6PD patients

199

fishy nonpainful vaginal discharge (gray)

Rx?

Gardenella vaginosis

metronidazole

200

Clue cells are ?

associated w?

Gardenella vaginosis

vaginal epithelial cells covered in bacteria

201

Rickettisia triad?

Fever
HA
Rash

202

Rash starting at the wrists and ankles making its way to the trunk?

Rickettsia rickettsii

- obligate intracellular

203

some obligate intracellular organisms(2)

Chlamydia
rickttsia

204

tick born rash that develops centrally and spreads out sparing the palms and soles (2)

R typhi - endemic

R. prowazekii - rpidemic

205

Monocytes w/ morula (berry like inclusions) in cytoplasm - tick borne

Ehlichiosis - in Ehlichia

NO rash

206

Granulocytes w. morula in cytoplasm tick born

Anaplasmosis w/ anaplasma

NO rash

207

Coxiella burnetti causes?

transmitted by?

Q fever
- NO rash,
-fever and interstital pneumonia

aerosolized spores in tick feces and cattle placenta release

208

Weil felix reaction is?

what is positive, what is negative

Test for rickettsia and tick borne illness

Coxiella is negative

the rest: rickettsia etc are positive

209

atypical pneumonia w/ a person that has a pet parrot

Chlamydophilia psittaci

210

pneumonia in a 20 something that presents w/ low grade fever, tachypnea, crackles/wheezing

chlamydia pneumonia

or mycoplasma pneumonia

211

Chronic infection leading to blindness in Africa

Types A, B, C chlamydia trachomatis

212

neonatal pneumonia and conjunctivitis found in a subclinical mother w/ reticulate bodies

Prevention and Rx?

Chlamydia D-K
- May also cause PID/Urethritis

Rx w/ azithromycin, Prevent w/ erythromycin eye drops

213

solitary painless chancre on the penis that may progress to rectal disease that is confused for IBD

Chlamydia tachmomatis L1, L2 L3

Painful LAD

214

Walking pneumonia due to (3)

Rx for each

Mycoplasma pneumonia - (macrolide)

Chlamydia pneumonia (azithromycin)

Liegenella (macrolide or quinolone)

215

bacteria characterized by high sterol content in bacterial membrane

mycoplasma pneumonia

leads to atypical pneumonia in <30s especially in prisons/military recruits

216

Cold agglutinin anemia seen sometimes w/ atypical m pneumonia is to what antibody?

IgM

217

Where is the major mode of resistance to penicillin located in gram -?

what is another mech of resistance

Penicillinase is located in the periplasm

Alteration of the penicillin binding protein also a mech of resistance

218

What drug given to a patient w/ mono leads to inappropriate assumption of allergy

Amoxicillin leads to rash when given to EBV + patients

not a hypersensitivity reaciton

219

What are the concerns w/ penicillin (3)

hypersensitivity

Rarely
-thrombocytopenia
-hemolytis uremia

220

ampicillin and amoxicllin spectrum?

Extended
Gram +
HELPSS

Haemophilus
E Coli
Listeria
Proteus mirabilis
Salmonella
Shigella

URI, UTIs and neonatal

221

Penicillins used in pseudomonal infections (3)

Ticarcillin
piperacillin
Carbenicillin

222

MRSA reisistance due to ?

Changing of the penicillin binding protein target of Staph Aureus

Use methicillin to test for not used clinically

223

Oral penicillin vs IV

Oral - Penicillin V

IV - G

224

Organisms not covered by cephalsporins

LAME

Listeria
Atypical pneumonia - chlamydia, mycoplasma
MRSA
Enterococci

225

1st generation Cephalosporins(2)

Coverage(4)

Cefazolin
Cephalexin

gram + and PEcK

Proteus mirabilis
E Coli
Klebiella

226

2 Generation Cephalosporins (4)

Coverage (8)

cefoxitin
cefaclor
cefuroxime
cefprozile

gram + and HEN PEcKS

Haemophilus
Enterobacter
nesseiria (not gon)
Proteus mirabilis
E Coli
Klebsiella
Serratia

227

3rd gen Cephalosporins(4)

Coverage(10)

cefTriaxone* (Nesseria go to)
cefoTaxime
cefdinir
cefTazidime * (anti pseudo)

only gram + is strep pneumo

serious gram -

Haemophilus
Enterobacter
nesseiria
Proteus mirabilis
E Coli
Citrobacter (new)
Klebsiella
Serratia

228

4th Gen Cephalosporin(1)

Coverage

Cefepime

Pseudomonals and gram +
- broad spectrem

229

Antipseudomonals Cephalosporins (2)

Ceftazidime
Cefepime

230

Increased nephrotoxicity is seen when these 2 ABx classes are paired together

Aminoglycocides and cephalosporins

231

Go to neisseria ABx

Excreted?

Ceftriaxone

Excreted in bile so safe for kidneys

232

UTI prevention prophylactically give

1st or 2nd gen cephalosporin

233

Cell wall inhibitor w/ No cross reactivity w/ penicillin allergies

Spectrum

Aztreonam

Gram -

234

Great drug to use in those w/ a gram - infection and have renal insufficiency

Aztreonam

235

Imipenem is always coadministed w/ what

why?

cilastatin to prevent renal degradation of imipenem by renal dehydroppeptidase I

236

Broad spectrum beta lactamase inhibitor for maybe appendicitis?(2)

Not used all the time why?

Carbapenems
-Imipenem/cilastatin
-meropenem

not used to concern w/ serious side effects like seizures (imipenem), GI and skin rash

237

What is the one bug carbapenems do not hit

MRSA

238

Antipseudomonial drugs in general (4)

Cefepime
Ceftiazdime
Aztreonam
Carbapenems

239

Red man syndrome w/ vancomycin Rx

pause the treatment, give an antihistamine and run again at a slower rate

not an IgE mediated hypersensitivity; nonspecific mast cell degranulation

240

Protein synthesis inhbitors
2 acting on 30 s

5 on 50 s

buy AT 30 CCEL at 50

30s
-Aminoglycoside
-Tetracycline

50s
Clindamycin
Choramphenicol
Erythromycin (macrolides)
Linezolid

241

Situation of Linezolid use?

When you want to oral outpatient Rx for MRSA instead of Vanco (IV)

also used for VRE

binds to 23s (50s) and interacts w/ bacterial initiation complex

242

Tetracyclines indicated for (9)

VACUUM THe BedRoom

Vibrio cholera
Acne
Clamydia
Ureaplasma Ureayticum
Mycoplasma
Tularemia
Helicobacter pylori
e
Borrelia urgdorferi
ed
Rickettsia Ricketsii

243

Why don't we give tetracycline to Kids?

teeth discoloration - yellow
premature epiphyseal plate closing

244

Taking a tetracycline can cause upset stomach. Why is this a bad coinicidence

What other adverse effects are there?

because taking an antacid (Ca, Mg Fe, vitamins) will limit the effectiveness of the drug and lower absorption

Photo toxicity, teratogen,

245

Chronic use of minocycline can lead to what unique toxicity

blue tinged skin

246

Clinical use of macrolides

Azithromycin, Erythromycin, Clindamycin

Used in PUS - atypical Pneumonia, URIs( Strep pneumo and pyrogenes); STDs (Chlamydia)

247

Concern w/ macrolides w

prolonged QT

acute cholestatic hepatitis - rare w/ erythromycin

Rash

p450 inhibitor (CRACK AMIGOS) -> increased concentrations of Warfarin and theophylline

248

Synergistic drug for a neonatal infection w/ ampicillin

aminoglycoside

aminoglycosides used severe gram - infections

Streptomycin, Amikacin, Gentamycin, Neomycin, Tobramycin

249

Toxicity of aminoglycosides(3)

Different kind of NOT vs vanco

Nephrotoxicity
Ototoxicity
Teratogen*

250

Which drug class requires O2 limiting its effectiveness in anaerobes to 0

Indicated for what bacteria?

Aminoglycosides

Severe gram - rods

251

Old drug used primarily for meningitis - very toxic but still used in developing countries

Biggest concern (2)

Grey baby syndrome

Anemia (aplastic, dose dependent)

252

Grey baby syndrome casued by what drug and why?

Symptoms

Chloramphenicol - bacteriostatic

due to decreased UDP gycouronyl transferase activity in neonates to take care of the toxic metabolites

ashen grey colored baby, flaccid, cyanotic, refuse to suckle, abdominal distention

253

Go to drug for anaerobes w/ metronidazole

Indicated for what else (3)

Clindamycin - bacteriostatic

anaerobes but also MRSA(skin abcesses), protozoal infections, acne

254

Toxicity associated w/ Clindamycin

C dif infection w/ a psuedomembranous overgrowth

255

drug used topically more than iv due to sever nephrotoxic and neurotoxic effects

Used for?

Polymyxin

Used for severe last resort gram - infections

256

prophylaxis in meningococcal infection

Ciprofloxacin in adults
rifampin in kids

257

gonorrhea prophylaxis

ceftriaxone

258

syphillis prophylaxis

penicillin G

259

History of UTIs prophylaxis

TMP-SMX, nitrofurantoine, 1st and 2nd gen cephalosporins, amoxicillin

260

endocarditis w/ surgical or dental procedure prophilaxis

penicllins - aminopenicllins, cephalexins

261

Pregnant woman that is group B positive give

ampicillin

262

Prevention of gonorrhea and chlamydia conjunctivitis in newborns

erythromycin drops

263

H infleunzae meningicoccal exposure give

Rifampin

264

Pneumocystis jiroveci prophylaxis w/ CD4 <200

TMP-SMX

if allergic - pentamidine, dapsone

265

Most common causes of pneumonia in neonates(2)

Group B strep

E coli

rx ampicillin w/ gentimicin

266

Pneumonia in 8wks -18yrs (5)

RSV

Mycoplasma
Chlamydia trachimonas- (infant -3)
Chlamydophila pneumonia

Strep pneumo

267

common cause of pneumonia in adults 18-40 (3)

Strep pneumo (older)
Mycoplasma (younger)

Chlamydophila pneumonia

268

Common Cause of pneumonia in adults 40-65 (5)

Strep Pneumo

H influenza
anaerobes
viruses
mycoplasma

269

Pneumonia in the elderly >65

Strep pneumonia
Influenza
Anerobes
H influenza
gram - rods (new)

270

Nocosomial pneumonia (2)

staph aureus and enteric gram - rods

271

Immunocompromised pneumonia

pneumocystis jirovecii

272

Aspiration pneumonia

Anaerobes

273

pneumonia in alcoholics

klebsiella

274

Cystic fibrosisi pneumonia

pseudomonas

S aureus
S pneumonia

275

Atypical pneumonia (3)

Mycoplasma
Chlamydiophila
legionella

276

Common cause of meningitis in neonates

Group B strep #1
E coli
Listeria

277

Causes of meningitis in children 6 months to 6 yrs (4)

Strep pneumonia #1
Nesseria Meningitidis - serious

Hamophelous influenza type B
Enteroviruses (echo and coxsackie)

278

Causes of meningitis ages 6 -60(4)

Strep pneumona

N meningitidis (#1 in teens)
enterovirus
HSV (tempora encephalitis)

279

Causes of meningitis in elderly

S pneumonia
Gram - rods
Listeria

280

Rx for meningitis empirically? (2)

Vancomycin and ceftriaxone

Dexamethosine to reduce inflammation

281

Most common cause of osteomyolitis

Staph aureous

282

Most common cause of osteomyolitis in a sickle cell patient

Salmonella

283

Most common cause of vertebral disease (infectious)

Mycobacterium tuberculosis (Potts)

284

Cat and dog bites that go deep to the bone worry about

Pateurella multocida - osteomyolitis

285

R/o osteomyolitis if you have negative what?

ESR or CRP

can get MRI, plain radiographs, Bone biopsy = gold standard

286

Most common fungal infection of the lung in Texas/gulf

histoplamosis

287

Mist common fungal infection of the lung in SW Cali, Arizona, NM, Texas

cocciodes

288

Osteomyolitis concerns in an IV drug user(2)

Staph aureous and pseudomonas

289

painful indurates, ulcerated genital lesion w/ exudate

chancroid due to Haemophilus ducreyi

290

Stippled vaginal epithelial cells on a wet prep of vaginal discharge

clue cells

291

strawberry cervix

trichimonoa

292

infection of lymphatics, genital ulcers (painless) and rectal strictures (mimics IBD)

lymphogranuloma vereum due to chlamydia L1 - L3

293

Fitzs Hugh Curtis syndrome

infection of the liver capsule in PID ascending infection-> violin string adhesions of parietal peritoneum to liver

294

risks of exposure in a newborn nursery (2)

CMV
RSV

295

Risks w/ urinary catheterization (4)

E coli
proteous mirabilis
MRSA
pseudomonas

296

Respiratory therapy equipment use linked to what infection

pseudomonas

297

Working in a renal dialysis unit and w/ sharps

HBV

298

Hyperalimentation (total parental feeding) have increased risk of what infection

Candida albicans

299

TORCHeS infections

Toxoplasma gondii
O- other like parvovirus B19
R- Rubella
C - CMV
H- Herpes and HIV
e
S -syphilis

300

Congenital toxoplasmosis infection

Risk

Symptoms(3)

due to maternal exposure to cat feces or undercooked meat

Choriorectinitis
hydrocephalus
intracranial calcifications

301

Congenital Rubella infection symptoms (3)

PDA
Cataracts
deafness

+/- blueberry muffin appearance

302

Congenital CMV infection (3)

Hearing loss (unilateral)
Seizures
petechial rash (blueberry muffin)

303

Herpes simplex 2 congenital infection (2)

encephalitis - temporal lobe
herpetic lesions

304

Congenital syphilis infection complications
-5 early
-4 late

early
-snuffles
-hemolytic anemia
-rash/desquamation
-jaundice
-radiographic changes(metatarsal dystrophy)

late
-saber shins (tibial bowing)
-hutchingson's teeth (notched incisers)
-Saddle nose
-Frontal bossing

305

Congenital Parvo B19 exposure

Hydrops fetalis