Final Bacteria

Question 1

The gram - endotoxin is ____ and this is important because when these are lysed, the Lipid is released in our circulating causing fever, diarrhea, and possibly fatal endotoxic shock (septic shock)

Answer 1

Lipid A

Question 2

In gram ___ bacteria, their thick peptidoglycan layer does NOT block diffusion of low molecular weight compounds so antibiotics, dyes, detergent, etc can pass through and damage the cytoplasmic membrane

Gram ___ bacteria have LPS so it blocks the passage of substances through the peptidoglycan layer and no damage to the sensitive inner cytoplasmic membrane occurs aka these are resistant to penicillin and lysozymes

Answer 2

Positive

Negative

Question 3

___ and its reaction allows bacteria in the presence of Oxygen to break down the toxic Hydrogen peroxide (2H2O2 into 2H2O and O2) so bacteria that can grow in the presence of oxygen MUST have these enzymes and those that can’t grow in the presence of oxygen lack these enzymes

^** Peroxidase and Superoxide Dismutase also are enzymes that help break down toxic ROS

Answer 3

Catalase

Question 4

1) Obligate aerobes have all the necessary enzymes to live in oxygen
2) Facultative anaerobes can also live in oxygen, and even prefers to do so, but they CAN live in anaerobic conditions by switching to fermentation for energy if need be
3) Microaerophilic bacteria aka aerotolerant anaerobes can survive in low O2 content but since they lack catalase, they prefer no oxygen settings
4) Obligate anaerobes HATE oxygen and have no enzymes to protect against it

All viruses are ___ organisms, and even though some bacteria can be as well (Chlamydia and Rickettsia), not all are

^** These are organisms not capable of the metabolic pathways for ATP and therefore must steal ATP from their host

Answer 4

Obligate intracellular

Question 5

All the medically important bacteria are ____ since they use chemical and organic compounds (such as glucose) for energy

Answer 5

Chemoheterotrophs

Question 6

___ are much shorter than flagella (used to help the organism move) and can serve as ___ factors aka adhesins

Capsules are another virulent factor (allow them to not be phagocytosed) that surround bacteria and one special bacterium, _____ has a unique capsule made up of amino acid residues (aka the anthrax capsule)

Answer 6

Pili, adherence

Bacillus anthracis

Question 7

1) Two examples of visualizing capsules include the India ink stain (a transparent halo appears) to identify ____ (only done on CSF if we suspect cryptococcus which is a fungal organism)
2) Or the ___ reaction which causes the capsule to swell via mixing the bacteria with Abs that bind to the capsule and not only does this allow it to be visualized, but binding of Abs to a bacteria (opsinization) also allows it to be phagocytosed and one example of this is ____ and a vaccine against it via Abs binding to the capsule

Answer 7

1) Cryptococcus

2) Quellung, Streptococcus pneumoniae

Question 8

The only two bacteria that form the virulent factor of endospores are ___ and ___ and these endospores are metabolically dormant forms of bacteria that are resistant to heat, cold, drying, and chemical agents and allow these bacteria to persist forever

Biofilms are another virulent factor and allows the bacteria to form a scaffold such as those on intravascular catheters like staphylococcus ____ bacteria

Answer 8

Bacillus and Clostridium

Staphylococcus epidermidis

Question 9

Facultative intracellular organisms inhibit phagolysosome formation and can be remembered by the mneumomic ____

Answer 9

LISTen, SALly, YER, FRiend, BRUCE, Must, LEave, NOw

Listeria monocytogenes, Salmonella typhi, Yersinia, Francisella tularensis, Brucella, Legionella, Mycobacterium, Nocardia

Question 10

Septic shock is often called endotoxic shock, but realize that not all septic shocks are due to endotoxins

Septic shock is sepsis (bacteria in the blood that causes a systemic immune response to the infection) that results in dangerous drops in blood pressure and organ dysfunction

The activated immune cells release endogenous mediates (proteins) with the most common being ___ (also called cachectin), which triggers the release of ___, and then various other cytokines and prostaglandins are released

Answer 10

TNF, IL-1

Question 11

The 4 bacteria that produce exotoxins which result in increased cAMP levels are ____, ____, ___, and ____

^*** DONT MEMORIZE THIS YET, wait until youve covered these bacteria

Answer 11

C = Cholera (Vibrio Cholera)

A = Anthrax (Bacillus anthracis)

M = Montezumas revenge (aka E. Coli)

P = Pertussis (Bordetella pertussis)

Question 12

Viruses that infect bacteria in order to give them their particular virulence mechanism is called a ____ so when a bacteriophage carries a piece of bacterial DNA from one infected bacterium to another, it is called ____

A phage infects a bacterium and hijacks its RNA polymerase activity allowing it to make multiple new capsids, DNA, and enzymes and if it is a virulent phage, it causes the cell to lyse and the new phage go on to infect more bacteria

If it is a temperate phage, the viral DNA is simply incorporated into the hosts DNA (aka a ____) and then lies dormant until a signal comes along and activates it

^** Bacteria with a prophage incorporated into it is called ___

There is also generalized transduction and specialized transduction

^** Generalized has a bacteriophage with incorporated bacterial DNA rather than viral DNA packed inside the capsid’s head

Specialized has an error in splicing the viruses incorporated DNA (the prophage) causing some bacteria to be taken with it and this is called LYSOGENIC CONVERSION

Conjugation is when DNA is transfered directly by cell to cell contact and the donor cell must contain an ___ (which lie outside the chromosome and carry many genes including those for antibiotic resistance (1 F+ -> 1 F- causes 2 F+)

^** If the F plasmid gets integrated into the bacterial chromosome it is called a ___ cell

Answer 12

Bacteriophage, transduction

Prophage

Lysogenic

F plasmid

Hfr (high frequency of chromosomal recombinants)

Question 13

For streptococci, Lancefield Group A, B, and D are based on the antigenic characteristics of the C carbohydrate

X-hemolytic is based on blood agar plating and the ability of the bacteria to lyse RBCs (___ = complete lysing of RBCs, ___ = partial lysing of RBCs, and ___ = No lysing of RBCs)

Which ones produce a greenish discoloration on agar plating?

^** The combination of these two is used to classify the type of streptococci so for example, Group A beta-hemolytic strep means it has Group A antigens and completely lyses RBCs on a blood agar plate

Answer 13

Beta, Alpha, Gamma

Alpha

Question 14

Streptococci pyogenes is catalase ____ and ____ (for the type of oxygen it lives in)

^** REALIZE THAT ALLLLLLLLL OTHER STREPs are catalase ___ and _____ (for their type of oxygen)

The virulence factors for Streptococci pyogenes are

1) The “Lancefield Group ___” C carbohydrate
2) ___ protein to inhibit complement and phagocytosis

^** Both antigens

3) Streptolysin ___ is responsible for B hemolysis and ___ (is or is not?) antigenic (stands for oxygen Stabile)
4) Steptolysin ___ is an enzyme that destroys RBCs and WBCs and is inactivated by oxygen (oxygen labile) and ___ (is or is not?) antigenic… ASO (anti-streptolysin O Abs will be present)
5) Pyrogenic exotoxins (aka erythrogenic toxin), which can produce a toxin known as a superantigen leading to ___ and therefore toxic shock syndrome

Clinical signs of Strep Pyogenes include strep throat (pharyngitis), purulent exudate on tonsils, fever, swollen lymph nodes, ___ infections including folliculitis/cellulitis/____ (blisters around the mouth)/necrotizing fasciitis, scarlet fever (with a red rash on body), and Toxic shock syndrome

Untreated strep throat can result in ____ which is characterized by myocarditis, migratory ____, a rash called ____, heart valve damage, and fever

Acute post-streptococcal ____ can also develop in untreated cases (aka a patient had a soar throat about a week ago) characterized by ___-colored urine and a puffy face (since kidneys are not working correctly)

Answer 14

Catalase -, microaerophilic

Catalase -, FAs

A

2) M protein
3) S, is not
4) O, is
5) Scarlet fever

Skin, Impetigo

Rheumatic fever, polyarthritis, erythema marginatum

Glomerulonephritis, tea

Question 15

What 3 organisms can lead to meningitis in neonates and infants less than three months of age?

** ____ and ____ can cause meningitis later in life after maternal Abs passively given to the fetus wane and before new ones develop

^** H. Influenzae is 6 months to 3 years for risk

Answer 15

Group B strep, Listeria, and E.coli

Neisseria meningitides and Haemophilus influenzae

Question 16

Viridans Group Steptococci are a huge group of ___-hemolytic organisms (since they produce a greenish color on agar plating)

^** SPANISH WORD VERDE = GREEN

They are part of the normal oral flora found in the GI tract, nasopharynx, or gingiva

The major manifestation is ____

Viridans Steptococcus eats heart valves ____ (versus staph aureus, which eats it fast)

^** Extracellular ___ allows strep viridans to bind to the heart valves

So ____ bacterial endocarditis = Strep and ____ bacterial endocarditis = Staph

^** Both Viridan Strep and ____ causes subacute bacterial endocarditis

In addition to SBE, ____ infections and biliary tract infections can be seen in Enterococci

What common activity can lead to Strep Viridians (more specifically, strep mutans?)

Answer 16

Alpha

Subacute bacterial endocarditis

Staph Aureus

Slowly

Dextran

Subacute, Acute

Group D strep (aka Enterococcus)

UTIs

Cavity fillings

Question 17

Pneumococcus is to ___ as group B strep is to ____ aka they both cause pneumonia, meningitis, and sepsis

Pneumococcus is ___-hemolytic and has a ___

The best way to test for Pneumococcus is the ____ reaction (which remember, causes the cells to swell) in order to test for ENCAPSULATED bacteria or optochin sensitivity can be used

^** Optochin sensitivity allows one to differentiate the difference between Step Pneumoniae (Pneumococcus) and Viridan Strep (because they are both Alpha hemolytic) and this is done by using a disc with optochin and ___ will not grow whereas ____ will CONTINUE to grow

Answer 17

Parents, Babies

Alpha, capsule

Quellung

Streptococcus Pneumoniae, Streptococcus Viridans

^** Think Pne Neu Nou No No NONONONONON, strep Pneumonia will NOT grow

Question 18

In children, Strep Pneumoniae is the major cause (30%) for ____ in children, with ____ (25%) and ____ (15-20%) being the other causes

Answer 18

Otitis media, Haemophilus influenzae, Moraxella catarrhalis

PHtitis Media -> PHM

Question 19

The only coagulase positive Staphylococci is ____

^** Dont confuse coagulase with catalase, remember, all staph is catalse ___ since they are all ____ for their oxygen needs

Along with the fact that staph aureus is coagulase and catalse +, it can be distinguished from the other Beta-hemolytic strep from the fact that it creates a ___ pigment on sheep agar

Staph aureus can cause diseases via 2 ways

1) Via exotoxin release (Exfoliatin, Enterotoxins, or TSST-1)

The exotoxin dependent clinical manifestations include ____ and ____

^** It can grow in food and produce an exotoxin (aka enterotoxin which are heat stable toxins that cause food poisoning)

If a women leaves a tampon in, it cause cause the ____ exotoxin to be released leading to ___ syndrome characterized by ____-like syndromes (high fever, nausea, vomiting, watery diarrhea) AND ____-like syndromes (erythematous rash aka erythema marginatum)

2) Via direct organ invasion from tissue invasive toxins that degrade the stroma and promote tissue spread (like Hyaluronidase, staphylokinase, lipase, and protease) characterized by ____ acquired necrotizing pneumonia (since remember, this is tissue destroying proteins at work), meningitis, osteomyelitis, ____ bacterial endocarditis, septic arthritis, skin infections, sepsis, and UTIs

Answer 19

Aureus, +, FAs

Golden yellow (REMEMBER, A STAFF of people with GOLD medals around their neck and CATS)

1) Food poisoning (aka gastroenteritis) and Toxic Shock Syndrome

TSST-1, Toxic shock syndrome, Enterotoxin-like, Scarlet fever-like

2) Community, acute

Question 20

Skin infections are almost exclusively caused by either ____ or ____ and it is almost impossible to tell the difference

High fever, nausea and vomiting, watery diarrhea it could be due to food poisoning from an exotoxin released by Staph aureus, and if this is accompanied by a erythematous rash (similar to that seen in strep pyogenes from scarlet fever) then you should be thinking ____ syndrome due to ____ released by staph aureus

^** Realize that Toxic shock syndrome can also be seen in strep pyogenes, so you wouldnt be able to tell the difference between which toxic sock syndrome it was unless given diagnostic tests like clusters vs strips, etc…

Answer 20

Strep Pyogenes or Staph Aureus

Toxic shock syndrome, TSST-1

Question 21

If there is the consolidation of an entire lobe in the lung, due to community-acquired bacterial pneumonia, and then the disease begins to get better and then all a sudden the patient becomes extremly sick and a new X ray shows necrotizing areas in the lung… You should think “secondary infection due to ____ or ____”

Answer 21

Staphylococcus Aureus or Klebsiella Pneumoniae

Question 22

Most staphylococcus aureus are penicillin-resistant HA-MRSA or CA-MRSA (unlike streptococcus) due to the fact that they secrete ____ (aka the secreted form of beta-___)

Answer 22

Penicillinase, Beta-lactamase

Question 23

The most common way to become infected by ___ is through Indwelling catheters or prosthetic devices and it does so via a ___

^** Normally it lives peacefully in our skin

Staph Saprophyticus causes ____ via community acquired ____

^**It is the second most common cause of UTIs in sexually active young women, behind E. Coli

Answer 23

Staphylococcus epidermidis, biofilm

UTIs, STDs (Think S.S for Std)

Question 24

The only bacterium with a capsule composed of proteins/amino acids is ___

Is this bacteria motile? What type of metabolism (oxygen) does it have?

A chest radiograph or CT scan will show a ___ if the spores have been taken up by macrophages in the lungs and taken to the hilar and mediastinal lymph nodes to germinate aka Pulmonary anthrax (sometimes called woolsorters disease)

Cutaneous anthrax has black vesicles called ____(aka an ___) and these vesicles _____ (are or are not?) painful

GI anthrax can also occur causing abdominal pain, bloody diarrhea, etc…

The pXO___ plasmid codes the protein capsule and the pXO__ codes the exotoxins

The exotoxin released has 3 proteins, ___ promotes the entry of ____, which increases ____. The other protein ___ inactivates protein kinase to aid in anthrax death

Answer 24

Bacillus anthracis

Non-motile, FA

Mediastinal hemorrhage

Malignant pustules, eschar, are NOT

pXO2, pXO1

PA (Protective antigen), EF (Edema factor), cAMP, LF (Lethal factor)

Question 25

Unlike Bacillus anthracis, Bacillus cereus causes ____ and it ____ (does or does not?) have a capsule, and it ____ (is or is not?) motile ^** Just think it's the opposite as BA The enterotoxins that this bacteria releases include ____ and ___

Answer 25

Poisoning, Does not, Is ^** Remember, Be Cereus there is no treatment for Food Poisoning Heat labile (LT) and Heat stable (ST)

Question 26

Clostridium tetani has ____ metabolism and ____ (does or does not?) have a flagella aka H antigen It releases is exotoxin ___ that inhibits ____ (inhibitory NTs) causing excess muscle spasms (often in the jaw aka ___ aka lock-jaw), risus sardonicus (aka ____) and therefore tetany Clostridium botulism has ___ metabolism and ____(does or does not?) have a flagella aka H antigen It causes flacid muscle paralysis in adults and kids via inhibiting ____ via a neurotoxin Along with muscle weakness/paralysis, adults have ____ manifestations and kids have ____ ^** In adults, they will also have dysphagia (difficulty swallowing) and diplopia (double vision) along with muscle paralysis and in kids they will be constipated for 2-3 days and then also have muscle paralysis Clostridium is a gram ___, ___ forming, obligate anaerobe Which one can be obtained due to eating honey as a baby or grows in zip-lock bags? Which one can be obtained through wounds due to the endospores being in the soil

Answer 26

OAN (Obligate Anaerobe), does Tetanospasmin, GABA and glycine, trismus, grinning OAN, does ACh Diplopia and dysphagia, constipation +, spore Clostridium botulinum Clostridium tetani

Question 27

Clostridium difficile is also called ____ because it destroys the ___ epithelial cells (via Toxin ___) and causes ___-associated diarrhea (via toxin ___) *** AKA when a patient develops severe diarrhea, abdominal cramping, and fever while on antibiotics, think this bacteria **Also note that pseudomembranes look like areas of white exudate upon colonoscopy Clostridium perfringens can lead to ___ which includes cellulitis (crepitus), clostridial myonecrosis (pockets of gas in subcutaneous muscle tissue), watery diarrhea, or loss of digits Clostridium difficile has ____ metabolism and ____ (does or does not?) have a flagella aka H antigen Clostridium perfringens has ____ metabolism and ____ (Does or does not?) have a flagella aka H antigen ******* So realize that ALLLLLLLLL clostridiums have ____ metabolism and ONLY clostridium ____ is non-motile and ALLLLLLLLLLL bacillus are aerobic and one is motile (cereus) and one is not (Anthrax)

Answer 27

Pseudomembranous enterocolitis, Colon, Toxin B, antibiotic, Toxin A Gas gangrene OAN, does OAN, does NOT OAN, Perfringens

Question 28

Both non-spore forming G+ rods (Corynebacterium and Listeria) infect ___ age groups Corynebacterium diphtheriae has ____ metabolism aka catalase ____, gram ____ rod shape, NON-spore forming, and ____ (is or is not?) motile Listeria monocytogenes has ____ metabolism aka catalase ___, gram ___ rod shaped, NON-spore forming, and ____ (is or is not?) motile ^** What type of specific motility is seen with listeria when grown at 25C?

Answer 28

Pediatric FA, +, +, Is NOT FA, +, +, IS Tumbling

Question 29

____ would be suspected in a pediatric patient with a soar throat and fever that upon inspection of the back of the throat (the pharynx) there are pseudomembranes ^** Now remember, Clostridium difficile also had pseudomembranes but they were in the intestinal tract (pseudomembranous enterocolitis).... However diphtheriaes are at the back of the pharynx.... Another confusing concept is that C. Difficile had Toxin A (causing diarrhea) and Toxin B (causing colin destruction).... SIMILAR to this, C. Diphtheriae also has something called A and B, but these are subunits to the diphtheriae exotoxin coded by a bacteriopahge called subunit ___ which binds to ___ cells and ___ cells and this allows entry of subunit ____ that blocks ___ synthesis to inactivate ____ involved in mRNA -> protein translation causing damage to the cells The appropriate culture medium for Corynebacterium diphtheriae is ____ agar (which become gray to black in 24 hours) and ____ blood serum (shows rod shaped pleomorphic bacteria) The heart cells involved cause A-V conduction block and dysrhythmia due to myocarditis and neural involvement causes peripheral nerve palsies, Guillian Barre-like syndrome, and palatal paralysis/cranial neuropathies If ____ is inhaled by immunocomprimised patients it can form a necrotizing pneumonia that is seen as upper lobe lung nodules and cavities that form AIR-FLUID levels (and this is similar to the pneumina of mycobacterium tuberculosis or Nocardia, except those do NOT have AIR-FLUID levels)

Answer 29

Corynebacterium diphtheriae B (B for Binds), Cardiac and Neural, A, protein, EF2 (elongation factor) Potassium tellurite agar, Loeffler's coagulated blood serum ^** AKA TELL yoUR InTErn not to LOAF around Rhodococcus equi

Question 30

Both Group A beta-hemolytic Strep and Corynebacterium toxins must be lysoginized by a temperate ___ to produce the erythrogenic (aka pyrogenic) toxin that causes ____ for Strep or the exotoxin that causes ___ for Corynebacterium toxins

Answer 30

Bacteriophage, Scarlet fever, diptheria

Question 31

Listeria monocytogenes is grown at ___ temperatures (0 degrees celcius) and when grown at 25 degrees tumbling motility is seen ^** Facultative intracellular organism that has Listeriolysin) and phospholipases to allow them to escape phagolysosomes of macrophages ____ is protective against this bacteria, which is why this bacteria can infect patients with a decreased immunity Pregnant women, fetus and neonates, and immunocompromised patients can be infected and leads to ___ in infected babies (aka neonates), ___ in pregnant women, or ___ in adults who are immunosuppressed or over the age of 50 aka elderly with lowered immune systems

Answer 31

Cold Cell-mediated Meningitis, septicemia, meningitis

Question 32

The classic clue to an invasive ____ infection is petechial rashes due to the endotoxin LPS (since it is gram -) Bilateral adrenal hemorrhage in a Neisseria meningitidis infection with a petechial rash is called ____ syndrome aka Fulminant meningococcemia (aka septic shock) Neisseria ___ ferments glucose AND maltose and Neisseria ____ ferments ONLY glucose If you see the virulence factor ____, it MUST be a Neisseria infection since those are the only bacteria ones who have it Along with septicemia (aka waterhouse friderichsen syndrome aka meningococcemia), Neisseria meningitidis causes ____ in babies 6-24 months old, army recruits, or college frehsman

Answer 32

Meningococcal Waterhoue Friderichsen syndrome Meningitidis, Gonorrheae IgA1 Meningitis

Question 33

Men with ****purulent urtheral discharge, *****epididymitis*******, prostatitis, urethritis, painful urination, and urethral strictures with bacteria that grows on a chocolate agar and Thayer Martin VCN is due to ____ Women are mostly asymptomatic, but some can have gonococcal urethritis with painful urination and purulent discharge just like men OR sometimes women can have their cervix infected aka cervical gonorrhoeae, which can progress in 50% of the women (usually about a week after menstruation) to ___ leading to an infection in the uterus (endometritis), fallopian tubes (salpingitis), and/or ovaries (oophoritis) that presents as fever, lower abdominal pain, menstrual bleeding, and cervical motion tenderness ^** Ectopic pregnancies, one complication of PID, most often occurs when the ___ are infected/inflamed In both men and women, untreated cases can cause gonococcal bacteremia and gonococcal ___, which is the most common cause of septic arthritis in sexually active individuals and this localizes to the joints ____ can be obtained in children through the birth canal from infected mothers ___ is another disease that can cause otitis media in children or respiratory tract infections like sinusitis, bronchitis, pneumonia, etc that can exacerbate COPD

Answer 33

Neisseria gonorrhea PID (Pelvic inflammatory disease) Fallopian tubes (Salpingitis) Arthritis Opthalmia neonatorum (aka conjunctivitis aka blindness) Moraxella catarrhalis

Question 34

___ and most of the enterobacteriaceae ferment lactose, while Salmonella, Shigella, and Pseudomonas aeruginosa does not ^** Don't confuse this with the Neisseria that are involved with glucose (gonorrhoeae) and glucose/maltose (meningitidis) 2 types of culture media to determine the differences of the enterics 1) ___ agar inhibits growth of Gram + bacteria and colonies that ferment lactose turn deep purple - black and ___ specifically turns metallic green sheen 2) ___ agar inhibits growth of Gram + bacteria and colonies that ferment lactose turn pink-purple The urea-splitting bacteria is called ____

Answer 34

E. Coli 1) EMB, E. Coli 2) MacConkey Proteus mirabilis

Question 35

Does E.coli have a capsule? Does E. Coli have an H antigen (aka motile)? Fecal contamination of water is a good way to show how to test for coliforms aka normal inhabitants of the intestinal tract aka coli-form = Colon = E. Coli Presumptive test - First place water in test tube with ___ and if lactose is fermented, gas produced that changes color (since remember, e. Coli ferment lactose) Confirmed test - Next, plate on EMB and wait for ___ sheen (do this on one plate at 45.5C and one at 37C since E. Coli can grow at both temps but nonenterics can't grow at the higher 45.5C temp) Complete test - Take metallic green colonies and put back in test tube and make sure they produce gas

Answer 35

Yes Yes Lactose Metallic green

Question 36

Along with biochemical classifications of the enterics, they can also be classified via antigens which include 1) ___ which is the most external component of the LPS 2) ___ is the capsule that covers the O antigen 3) ___ is the subunits of the bacterial flagella ^** Shigella ____ (does or does not?) have H antigen and Salmonella ___ (does or does not?) Does klebsiella have a capsule? Is it motile?

Answer 36

1) O (O = outer) 2) K (K = Kapsule) 3) H Does not, does ^** (Think Salmonella is like a lil fish, so it can move around) Yes No Shigella and Klebsella have NO flagella

Question 37

What enterotoxins does E. Coli produce? Watery diarrhea WITHOUT systemic symptoms (like fever) is an example of ____ diarrhea and the two infections that act this way are ____ and ____ and they work by enterotoxins in the GI tract being released Invasion of the ____ cells results in bloody diarrhea with a systemic immune response, local white blood cell infiltration, as well as fever and examples include Enteroinvasive E coli (EIEC), Shigella, and Salmonella enteritidis Invasion of the ____ and blood stream causes systemic symptoms of fever, headache, and WBC count elevation along with mesenteric lymph node enlargement, bacteremia, and sepsis and examples include Salmonella typhi, Yersinia enterocolitica and Campylobacter jejuni

Answer 37

LT, ST, and Shiga-like toxin No cell invasion, E. Coli (ETEC) and Vibrio Cholera Epithelial cells Lymph nodes

Question 38

E. Coli Can cause ____, hospital acquired pneumonia and sepsis, Neonatal ____, and different forms a diarrhea E. Coli can have different types of diarrhea including 1) ____ due to LT (Heat labile) and ST (Heat stable) toxins that cause a watery (rice-water looking) diarrhea aka travelers diarrhea 2) Shiga like toxin released with NO fever, NO pus, hemorrhagic colitis leading to bloody diarrhea (due to destruction of the intestinal epithelial cells) and ____ that is associated with anemia, thrombocytopenia, and renal failure (uremia) and is due to a strain of ___, specifically, ____ 3) Shiga like toxin released causing invasion of epithelial cells leading to bloody diarrhea WITH pus in the stool AND fever (since remember, when the cells are invaded it leads to systemic responses) is due to ____

Answer 38

UTIs, meningitis 1) ETEC (EnTerotoxigenic E. Coli) 2) Hemolytic-uremic syndrome (HUS), EHEC (Enterohemorrhagic Escherichia Coli), Escherichia Coli 0157:H7 3) EIEC (Enteroinvasive E. Coli)

Question 39

Klebsiella pneumoniae ___ (is or is not) encapsulated (AKA O antigen) and ___ (is or is not) motile (aka H antigen) It causes nectrotizing pneumonia characterized by a bloody sputum that looks like ___ currant ___ It also causes hospital acquired UTIs and sepsis Which other pneumonia is also necrotizing?

Answer 39

Is, Is not Red currant jelly Staph aureus

Question 40

If a culture has the bacteria swarmed over the entire plate, and can split urea it is ____ Using the ___ test, Abs against Proteus can be used to detect ____ since they share common Ags (OX-19, OX-2, and OX-K) Proteus causes ____-acquired ____s that has a urine with a high pH due to the urease (aka alkaline pH)

Answer 40

Proteus mirabilis Weil-Felix, Rickettsia Hospital, UTIs ^** Think urease splitting so it must have to do with urine = UTI

Question 41

To tell the difference between Shigella, E. Coli and Salmonella, you can look at lactose fermentation and H2S production ____ does NOT ferment lactose and does NOT produce H2S ____ does NOT ferment lactose and DOES produce H2S ____ DOES ferment lactose and has an H antigen (motile) and ____ ALSO ferments lactose but does NOT have an H antigen (non-motile)

Answer 41

Shigella (Shhhhhhh = no no no, no lactose production and no H2S production) Salmonella E. Coli, Klebsiella pneumonia

Question 42

Shigella dysenteriae releases ___ toxin to inhibit the ____ ribosome to stop protein synthesis and kill the intestinal epithelial cells, it is similar to ___ E. Coli since it leads to ____ diarrhea ___ (With or without?) mucus and pus ^** Note, its's not like EHEC since EHEC DOES have blood diarrhea, but does NOT have pus or mucus because it is non invasive So you could tell Shigella vs EIEC based on lactose fermentation, and the fact that shigella has NO H antigen either (Shigella has NO flagella rhyme) Salmonella has a ___ antigen instead of a K capsule Characteristic rose spots on the abdomen, fever, abdominal pain in the RLQ, and liver or spleen enlargement indicate ____ due to ____ (aka enteric fever) Chornic carries can have the bacteria living in their ___ for years and while they themselves are not actively infected, they can infect others The non-typhi groups like salmonella choleraesuis normally cause ____ or gastroenteritis Finally, patients with sickle cell and salmonella infection are prone to ____ What patients are at increased risk for this organism?

Answer 42

Shiga toxin, 60S, EIEC, bloody, with Vi (for VIrulence) Salmonella typhi, typhoid fever Gallbladder Sepsis Osteomyelitis Immunocompromised or patients who don't have a spleen

Question 43

Fever, diarrhea (due to invasion of lymph nodes and blood stream), and abdominal pain (RLQ pseudoappendicitis) is seen in this EXACT SAME manner in both ____ and Salmonella typhi However, some differences is that typhi has the characteristic rose spots and hepatosplenomegaly. It is also only found in humans and transmitted via the fecal oral route Yersinia is also transmitted via the fecal oral route, but it is found in ___, not humans that can be transmitted via unpasteurized milk. It also is due to an enterotoxin similar to ___ toxin that increases cGMP and along with fever, diarrhea, and RLQ abdominal pain... ___ and ___ are seen that sets it apart from S. Typhi (which is characterized by rose spots on the abdomen) and one might also see arthritis and a rash in this disease Also realize Yersinia enterocolitica is similar to Yersinia pestis (which causes the bubonic plague) except for Y. Enterocolitica has ____ transmission and Y. Pestis is ____ transmission

Answer 43

Yersinia enterocolitica Zoonotic (like pigs), ST (Heat stable), Acute enterocolitis and mucosal ulcerations Fecal-oral, flea bite

Question 44

Vibrio cholera is similar to ____ in the fact that it has fecal-oral contamination, ___ cell invasion (NON-INVASIVE), and rice water diarrhea with no pus... However, this is due to the enterotoxin ____ that increases ___ rather than LT in E.coli, and another way to tell them apart is E. Coli ___ (does or does not) ferment lactose and V. Choleae ____ (does or does not?) and E. Coli is shaped differently from V. Cholera, which has a ___ rod shape with a ___ flagella ____ is the leading cause of diarrhea in Japan ____, along with ETEC and rotavirus are the three most common causes of diarrhea in the world C. Jejuni is suspected when fever, headache, ____ diarrhea, and a ___ gram negative rod with a polar flagellum is seen ^** What type of invasiveness is this bacteria? ^** Realize that C. Jejuni can be distinguished from the others that cause bloody diarrhea since it has a curved gram - rod shape, whereas the other ones that cause bloody diarrhea do not H. Pylori obviously causes duodenal ulcers and chronic gastritis and is a urease + and microaerophilic organism

Answer 44

ETEC, NO, Choleragen, cAMP Does, does not, curved, single Vibro Parahemolyticus Campylobacter Jejuni (** Think CAMPing bacteria in the JEJUNUM with nothing better to do that cause DIARRHEA) Bloody, Curved Lymph node and blood stream invasion

Question 45

If you see a patient after trauma like a gunshot wound with abscesses in the GI tract, pelvis, and lungs (aka the peritoneal cavities) and when cultured the G- bacteria does NOT contain Lipid A (aka no endotoxin) it is ____ ____ also has NO lipid A, but this can be told apart from B. Fragilis because it produces a ___ pigment when grown on blood agar ^** Bacteroides melaninogenicus causes ___ disease and a ____ with blood sputum, but remember Klebsiella pneumoniae also produces the same thing (and so does staph aureus), but the difference is that K. Pneumoniae is usually hospital acquired, does not stain black on blood agar, has lipid A, and does NOT cause gum disease (peridontal, which F. Melaninogenicus does) ** Also realize ____ is pretty much the same thing as B. Melaninogeniucs except for it also can cause abdominal pelvic abscess and rarely otitis media So ALL the bacteroidaceaes have ___ metabolism, gram ___ rods, Non-spore formers, and Polysaccharide capsules

Answer 45

Bacteriodes fragilis (**Think it is FRAGILE since it has NO Lipid A) Bacteroides melaninogenicus, black Gum (aka Periodontal), Necrotizing anaerobic pneumonia Fusobacterium OAN, Negative (-)

Question 46

Highly resistant gram - bacteria (aka Multi-drug resistant MDR) include what 4 bacteria? ALL of these bacteria have ___ metabolism, Non-lactose fermenters, and ___ and ___ is oxidase + and ___ and ___ is oxidase - A fruity grape smell with a greenish-blue coloration is seen in patients with _____ and this ONLY occurs in sick, immunocompromised, or hospitalized patients aka healthy people DO NOT get this This can cause a LOT of different manifestations (BE PSEUDO) and is due to the exotoxin ____ ``` B = ___ E = ___ commonly seen in IV drug abusers on the ___ heart valve P = ___ commonly seen in ___ patients S = ___ E = External malignant Otitis media U = ___ D = ___ ``` Burkholderia cepacia is most commonly seen in ___ patients causing pneumonia So if you were to be given the descritption of a CF patient with Pneumonia, you couldnt tell Burkholderia vs aeruginosa apart although I think CF has a stronger association with Burkholderia **Stenotrophomonas maltophilia and Acinetobacter baumannii both cause hospital related pneumonia (such as patients on a ventilator and broad antibiotics) and line related bacteremia

Answer 46

Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Burkholderia cepacia, and Acinetobacter ^**PABS OA, Aeruginosa and Cepacia = +, Maltophilia and Baumannii = - ^** Think the two ones that you've discussed more are oxidase + Pseudomonas aeruginosa A ``` Burns Endocarditis, right Pneumonia, Cystic Fibrosis Sepsis UTI Diabetic osteomyelitis ``` Cystic fibrosis

Question 47

Two bacteria under the family Enterobacteriaceae (E. Coli and Klebsiella) are the gram - bacteria most commonly seen in hospital acquired infections however mutli-drug resistant gram - bacteria have also emerged in the hospital setting including the family ____ and Acinetobacter

Answer 47

Pseudomonads

Question 48

The most virulent Hemophilus influenzae subtype is the ___ capsule (those without a capsule can not invade and therefore only cause localized infections) The encapsulated B H. Inflenzae can cause ____ in babies (3-36 months old), acute ____ characterized by a soar throat and fever followed by stridor (severe upper airway wheezing) and dysphagia, septic ___ in kids can also occur and sepsis/pneumonia as well ^** Remember, septic arthritis can also be caused by ____ in sexually active individuals The non-encapsulated strains like we said above have limited pathogenicity and therefore cause ___ in kids, sinusitis, and can exacerbate COPD and pneumonia (Remember that also Moraxella can cause Otitis media and exacerbate COPD in patients) Haemophilus needs two factors for growth, ___ factor for hematin (which is needed for the bacterias cytochrome system) and ___ factor for NAD+ (which is needed for metabolic activity) and both will be seen on culture So just to recap, the ____ (encapsulated or non-encapsulated?) form causes Otitis media in kids and the ___ form causes Meningitis in kids, Epiglottitis, Septic arthritis in kids, sepsis, and pneumonia Also as a recap, patients with COPD often can become infected with ___ or ____

Answer 48

B Meningitis, Epiglottitis, arthritis Neisseria Gonorrhoeae Otitis media X, V Non,encapsulated, encapsulated Moraxella or H. Influenzae

Question 49

An STD called ___ associated with a PAINFUL genital ulcer and RAPIDLY developing PAINFUL UNILATERAL adenopathy that can rupture and release pus and is due to ___ bacteria ^** Don't confuse the ulcer with ___ because this also produces an ulcer but unlike H. Ducreyi, this is NOT painful and also there is BILTAERAL adenopathy Also don't confuse chancroids with ___ because they also produce a PAINFUL genital ulcer but these are accompanied by a SYSTEMIC response (fever and myalgias) whereas H. Ducreyi has NO systemic response Finally, don't confuse H ducreyi with ___, which has NO painfull adenopathys and these swollen lymph nodes develop much SLOWER than H. Ducreyi So just to recap, 1) A chancroid from H. Ducreyi has a ____ ulcer, ____lateral adenopathy that ___ (does or does not?) produce pus, and ___ (does or does not?) have a systemic fever 2) Syphilis has a ____ ulcer, ____lateral adenopathy that ___ (does or does not?) produce pus, and idk about fever 3) Herpes has a ___ ulcer, no adenopathy, and _____ (does or does not?) have a systemic fever 4) LGV has a ____ ulcer, followed by matted suppurative inguinal lymph nodes that develop much ____ that a chancroid and ____ (does or does not?) produce pus ^** LGV is caused by ___

Answer 49

Chancroid, Hemophilus ducreyi Syphilis Herpes LGV (Lymphogranulmoa venereum) 1) Painful, Unilateral, does, does not 2) Painless, bilateral, does not 3) Painful, DOES 4) Painless, slower, does L1, L2, and L3 serotpyes of Chalmydia Trochomatis

Question 50

Gardnerella vaginalis that causes bacterial ___ characterized by foul smelling vaginal discharge, fishy odor, vaginal pruritus, and dysuria and is observed when ___ cells are seen

Answer 50

Vaginitis, Clue

Question 51

Bordetella pertussis causes ___ There are 4 major virulence factors 1) ___ toxin - increases cAMP 2) Extracytoplasmic ___ (weakens neutrophils, lymphocytes, and monocytes) 3) ___ allows binding to ciliated epithelial cells of the bronchi 4) ___ - Kills ciliated epithelial cells resulting in whooping cough There are three phases, the ___ phase has low grade fever, runny nose, mild cough, etc... The ___ phase has ***bursts of non-productive cough***, increases lymphocytes in blood smear, etc... And the ___ phase is when the patient is no longer contagious A bordet-gengou media can detect this bacteria

Answer 51

Whooping cough (**Pertusis means Violent Cough) 1) Pertussis 2) AC (Adenylate cyclase) 3) FHA (Filamentous hemagglutinin) 4) Tracheal cytotoxin Catarrhal, Paroxysmal, Convalescent

Question 52

Patients who have their own air conditioning installation business or work in a cooling tower would be susceptible to ____ It can cause ___ fever (headache, fever, muscle aches, fatigue, etc and goes away in a week) or Legionnaire's disease which has community acquired -atypical pneumonia, fever, and non-productive cough ^** This can often be confused for influenza or pneumococcal pneumonia, but realize that patients who get this work near air-conditiong systems or cooling towers and an important distinct characterization for Legionella pneumophilia patients that relates to the atypical pneumonia is that fact that there is a ____ aka (high fever, low heart rate) which is not seen anywhere else ^** Think that your'e sweating like a mother fucker with a high fever, so you turn the AC down realllllly low (low heart rate) that way you can relate pulse-temp dissociation and AC systems

Answer 52

Legionella pneumophilia Pontiac Pulse-temperature dissociation

Question 53

If a patient comes in that recently that went camping in Arizona or New Mexico and has a fever, conjunctivitis, and regional swollen lymph nodes that are red and tender aka a ___, suspect the ___ bacteria aka the bubonic plague (blackish skin discoloration aka a dry gangrene of the extremities can also be seen) ^** This bacteria has ___, ___, and ___ to help it resist phagocytosis because it lives inside cells (Facultative intracellular parasite) The bacteria can then spread to through the blood causing sepsis and during times of an epidemic, the bacteria can spread into the lungs from person to person by aerosolized respiratory secretions where it causes ____ (100% fatal if not treated) The reservoir for Y. Pestis is wild rodents and squirrles and transmitted via a ___ Similar to the bubonic plague, ___ has the same symptoms (swollen lymph nodes, fever, etc BUT there is a characteristic well-demarcated hole in the skin with a black base called ____) transmitted via a tick, deerfly, or some other infected animal Along with ulceroglandular tularemia, ____ tularemia is the other major clinical manifestation of this disease via aerosolization of bacteria during skinning of an infected rabbit or hematogenous spread from the skin to the lungs

Answer 53

Bubo, Yersinia pestis F1, V and W Pneumonic plague Flea Francisella tularensis, ulceroglandular tularemia Pneumonic

Question 54

A slow rise in temp during the day and the slow decline during the night is called ____ and is seen in a ___ infection ^** Along with undulant fever, chills, sweats, loss of appetite, backache, headache, and lymphadenopathy can also occur A dog or cat bite can have ___ to infect wounds, which can progress to infection of nearby bones and joints and this is the only NON Facultative intracellular organism in the group Out of all the Zoonotic gram - rods (Yersinia pestis, Francisell tularensis, Brucella, and Pasteurella multocida), they all ___ (do or dont?) have a capsule and they are all ___ (motile or non-motile)?

Answer 54

Undulant fever, Brucella ^** Think BRUCE going LOOSE aka getting high, crashing, getting high, crashing, etc... Just like undulant fever Pasturella multocida ^** Think a CAT chasing a bird in a PASTURE aka Pasturella multocida Do (since they are facultative intracellular, they would have to), Non-motile

Question 55

Both Rickettsia and Chlamydia are ____ organisms because they are not capable of the metabolic pathways for ATP synthesis and therefore must steal ATP from their host (aka energy parasites) Which other bacterias are Obligate Intracellular parasites? They do this via an ATP/ADP translocator, but they differ in the fact that ____ can oxidize certain molecules and create ATP via oxydative phosphorylation while ____ has no mechanism for ATP production

Answer 55

Obligate intracellular NONE, only Rickettsia and Chlamydia are (But viruses can be as well) Rickettsia, Chlamydia

Question 56

Chlamydia trachomatis affects the ___ and ____ Chlamydia trachomatis serotypes ____ causes corneal scaring and blindness aka ____ (a type of chronic conjunctivitis) The chlamydia life cycle is ___ infects the cells -> Turns into ___ inside the cells -> and then back into ___ before it leaves the cells to infect new cells Serotypes ___-___ can cause infant pneumonia, ___ in newborns passing through the birth canal (which is inflammation of the eyes with a purulent yellow discharge and swelling of the eyelids) ^** This is seen via intracytoplasmic inclusion bodies within the conjunctival epithelial cells ^** THIS IS THE EAXCT SAME THING that is seen in _____ Also, just like in N. Gonorrhoeae, ___ can be seen in these patients Also just like in N. Gonorrhoeae, men can have urethritis, epididymitis, prostatitis, etc... But now it is called ____ urethritis since it is NOT due to gonorrhoeae ^** Realize you can't tell the difference between NGU and urethritis from N. Gonorrhoeae except for treating the patient with penicillin, and since C. Trachomatis has NO ____ layer (which is a unique characteristic) it can not be cured by penicillin and therefore NGU will not die Conjunctivitis, urethritis, and septic arthritis is a triad called ____ syndrome seen in Chlamydia Trachomatis patients Finally serotypes L2, L3, and L4 can cause ____ which is a painless genital ulcer followed by lymph nodes breaking open and draining puss (A + Frei test is used to determine) Fitz-Hugh-Curtis syndrome is another complication of chlamydia that causes perihepatitis aka a liver capsule infection in the RUQ

Answer 56

Eyes and Genitals (think of a naked lady with clamp sunglasses) A, B, and C, trachoma EB -> IB -> EB D-K, Inclusion conjunctivitis (AKA the EXACT same thing as opthalmia neonatorum ) Neisseria gonorrhoeae, PID NGU (Nongonococcal urethritis) peptidoglycan Reiter's syndrome LGV (Lymphogranuloma Venereum)

Question 57

Viruses, Chlamydiae ___ and ____; ____ pneumoniae = Walking pneumonia), and Legionella all cause ____ which means they do not respond to penicillin treatment and present with a dry non-productive cough, fever, and are less sick than normal pneumonia (like that caused by strep pneumonia) Also on radiographs, atypical have less well-defined infiltrates

Answer 57

Psittaci and serogroup TWAR (aka chlamydophila pneumoniae), Mycoplasma, Atypical Pneumonia

Question 58

DIfferences between Rickettsia vs Chlamydia is that Rickettsia is spread via an ___ whereas Chlamydia is via ___ Rickettsia replicates in the ____ and Chlamydia in the ___ Rickettsia has tropism for ___ cells and Chlamydia has it for ___ cells Both cause different manifestations

Answer 58

Arthropod vector, Person-Person contact Cytoplasm, endosomes Endothelial, Columnar epithelial * Think CE (the letter C) which means Chlamydia replicates in the Endosomes, and then E doesnt go with E so instead of it having tropism for Endothelial cells, it has tropism for columnar epithelial cells

Question 59

Remember, the bacteria ___ shares common antigenic characteristics with Rickettsiae (OX-2, OX-19, and OX-K) so if one performs the ____ reaction, they can use the Proteus Ags to determine a Rickettsiae infection Name if the disease has + Ags for in the Weil Felix 1) RMSF 2) Epidemic and Endemic typhus 3) Scrub typhus 4) Trench fever 5) Q fever

Answer 59

Proteus, Weil-Felix 1) 19 and 2 +, K - 2) 19 +, 2 and K - 3) 19 and 2 -, K + 4) All - 5) All -

Question 60

To tell the difference between Rickettsia rickettsii aka ____ and Rickettsia prowazekii aka ____, both will present with fever and headache (although prowazekii might be more abrupt onset) and ____ presents with a rash on the ENTIRE body (with the wrist, ankles, soles, and palms the first to get it and then it becomes more generalized later) This is different from ____, which has a rash but it is NOT on the palms, soles, and face ^** Think Prowazekii looks like Nazii and Hitler spared the Germans aka Prowazekii spares the face, soles, and palms Another difference is the RMSF has a ___ infection (which has redness) Note that Epidemic typhus is different than typhoid fever (aka enteric fever) caused by ____ due to the fact that typhoid fever has fever, abdominal pain, liver or spleen enlargement, and ____ spots on the ___ If R. Prowazekii is not treated with antibiotics, it can live in a latent phase and if reactivated it is a less severe form called ____ disease Also note epidemic typhus is transmitted via the ____ Rickettsia rickettsii is transmitted by the ___ in western US and the ___ in eastern US Rickettsia tsutsugamushi (aka ____ typhus) is characterized by a ___ aka scab at the bite site, followed by a rash, fever, and headache Rickettsia typhi is also called ____ and causes a fever, headache, and rash similar to that seen in epidemic typhus, just not as severe Rickettsia ____ causes Rickettsial Pox characterized by a vesicular rash similar to chicken pox

Answer 60

Roucky mountain spotted fever, epidemic typhus, Roucky mountain spotted fever Epidemic typhus Conjunctival (redness) Salmonella typhi, Rose, abdomen Brill-zinsser diseases Human body Louse, Wood tick, Dog tick Scrub, Eschar Endemic (aka Murine) typhus Rickettsia akari (**Rickey with Pox, playing Atari, with his friend Mitey Mouse)

Question 61

1) Rickettsia rickettsii is carried by dogs, rabbits, and wild rodents and transmitted via ___ 2) Rickettsia akari is carried by a ___ and passed on via a ___ 3) Rickettsia prowazekii is carried via humans or ___ and passed on via ___ 4) Rickettsia typhi is carried by rats/rodents and passed on via a ___ 5) Rickettsia tsutsugamushi is carried by rats, shrews, mongooses, and birds and passed on via a ___ aka ___ 6) Bartonella quintana, even though it is not a rickettsia, it is carried by humans and passed on via a ___

Answer 61

1) Wood/dog tick (dermacentor) 2) Mouse, mite 3) Flying squirrels, lice (a human body louse) aka pediculus corporis 4) Rat flea (Typhi = Fli) aka Xenopsylla cheopis 5) Mite larvae aka chiggers 6) louse

Question 62

___ is transmitted by lice and occurs in 5 day intervals (which is called ____ fever) characterized by the fever, headaches, and back pain ^** Think about fighting in a trench you don't get to shower for 5 days straight Bartonella henselae is also called ___ disease ^** Dont confuse this with Pasteurella multocide, which is also due to a bite from a dog or cat leading to wound infections... You can tell the difference because Pasteurella can cause infections to nearby bones and joints and bartonella henselae can cause bacteremia, bacillary angiomatosis, or endocarditis The ONLY Rickettsia or Rickettsia like organism that does not need to be transmitted via a vector is ___ due to the fact that it has an ___ and therefore can have direct airborne transmission from cow hide or a dried placenta The ONLY Rickettsia that is seen WITH OUT a skin rash is ____ and and since it can be inhaled into the lung, it cause ____... Other complications include hepatitis and endocarditis ** So if you see a question talking about a bacteria with an endospore, you first thing bacillus or clostridium, but if you see pneumonia like symtpoms then it must be Q fever since bacillus and clostridium don't cause pneumonia

Answer 62

Bartonella QUINTANA (QUINT = 5), trench fever Cat-scratch disease ^**Bart the cat** Coxiella burnetti (aka Q fever), endospore ^**Q you ya fucking Cox Q fever, pneumonia (viral like)

Question 63

Spirochetes multiply by transverse fission, have six axial filaments that allow them to move, have ____ for their exotoxin and visualized via ____ since they can not be cultured on artificial mediums Also, all of the spirochete metabolsim is ____ except for Leptospira interrogans which is aerobic For Treponema pallidum (a STD common in men to men transmission), the bacteria that causes ____, there are 3 stages with the latent stage being between ___ and ___ 1) Primary has a ___ 2) Secondary Syphilis causes 2 main problems... It becomes SYSTEMIC, and therefore has a rash on the ___ and a painless wart-like lesion commonly on the vulva or scrotum called ____ along with other systemic symptoms like bones, eyes, CNS, kidneys, joints, etc... Latent period - Asymptomatic 3) Tertiary syphilis causes 3 problems including ___, ____, and ____ It can cause ___ of the skin and bone (localized granulomatous lesions that necrose and become fibrotic), cardiovascular syphilis (with aortic dissection), or Neurosyphilis (often seen with an ____ pupil) ^** Neurosyphilis can cause a ____ (characterized with a high ___ count)... So realize most bacteria cause an ACUTE meningitis (characterized by a high ___ count), but T. Pallidum and M. Tuberculosis are two that cause subactue meningitis Also if a child has similar symptoms to adult ____ syphilis, it is called early congenital syphilis and if the symptoms are similar to adult ____ syphilis it is called late congenital syphilis What 3 tests (2 non-specific and 1 specific) shows syphilis infection?

Answer 63

NO EXOTOXIN!!! (Diseases are caused by the hosts OWN immune responses), Dark field microscopy MA Syphilis, 2 and 3 1) Painless Chancer (aka skin ulcer) 2) Palms and soles, Condyloma latum 3) Gummas, Cardiovascular syphilis, and Neurosyphilis Gummas, Argyll-Robertson Subacute meningitis Lymphocyte, neutrophil Secondary, tertiary VDRL or RPR and FTA-ABS

Question 64

Syphilis subspecies (aka Treponema pallidum subspecies) include Endemicum that causes ___ (ulcers in oral mucosa) see in the desert zones of africa and the middle east, Pertenue causes ____ (facial dysfiguration called ___) often seen in moist tropical regions, and Carateum causes ____ (red and blue lesions that do NOT ulcerate) and this has NO gummas present ^** So all three cause primary, secondary, and tertiary lesions similar to T. Pallidum, except for the tertiary lesions DO NOT have any ___ or ___ involvement aka the only tertiary invovlement is skin and bone lesions/gummas These three cause skin ulcers and gummas of the skin and bones in children with the EXCEPTION of Carateum (only causes skin discoloration, no gummas) for the tertiary manifestations So just to recap T. ____ causes BEJEL T. ____ causes YAWS T. ____ causes PINTA ^** ALL of these will have VDRL and FTA-ABS +

Answer 64

BEJEL, Yaws, gangosas, Pintas CNS or CV Endemicum Pertenue ^** PERTENd you don't look ugly Carateum

Question 65

More spirochetes Similar to syphilis, Borrelia burgdorferi has 3 stages and causes ___ disease ^** Think about using an Umrrelia to protect you from lyme juice being squeezed 1) Early localized stage has a ____ skin lesion that starts out as a flat round rash and spreads out overtime to cause the outer border to remain bright red while the center turns blue or even necroses 2) Early disseminated stage affects the skin (small ECMs), Nervous system (most common ____), heart (AV nodal blocks), and large knee joints (arthritis) 3) Late stage has chronic ___ and chronic neuro damage leading to encephalopathy Lyme disease is transmitted via ___ with the white footed mouse and white tailed deer as the reservoirs There are 18 other species of Borrelia and all are transmitted via ticks except for Borrelia recurrentis, which is transmitted via ___ and characterized by recurring fever every ___ days and breaks with drenching sweats and the recurrent fever is due to antigenic variation from ____ lipoproteins ^** Make sure you know the other infection that has antigenic variation and relapsing fever

Answer 65

Lyme 1) ECM (Erythema chronicum migrans) 2) Bells palsy 3) Arthritis ticks (ixodes) Lice, 8, Vmp

Question 66

If a patient has high fevers, headache, muscle aches, and spiral shaped bacteria that looks like ice tongs, along with the emergence of IgM Abs, it is due to ____ ___ disease (aka infectious jaundice) is a severe form of leptospirosis with renal failure, hepatitis, jaundice, hemorrhage of organs, and mental status changes ^** Due to the subgroup serotype icterohemorrhagiae

Answer 66

Leptospira interrogans (a spirochete) Weil's

Question 67

Mycobacteria, and Nocardia are referred to as ____ organisms ___s are involved in organism virulence and include Cord factor, Sulfatides, and Wax D M. Tuberculosis is a ___ shaped gram ___, catalase ___, ____ metabolism, NON-motile organism

Answer 67

Acid-fast Mycosides Rod, +, +, OA

Question 68

____ necrosis in the lungs, leading to a granuloma (which is due to the body trying to wall off and kill the bug with macrophages via Cell-mediated immunity) is seen in ____ These granulomas eventually heal with fibrosis, calcification, and scar formation and tiny granulomas can also be called tubercles, so if one were to see tiny calcified tubercles (aka granulomas) in the middle or lower lung, you would call them ____ and since the patient isn't presenting with any symptoms, this occurs in asymptomatic primary infections ^** asymptomatic since no symptoms are occurring, and primary infection since the bacteria have been walled off and contained for now and until they are reactivated again (secondary infection) due to cell-mediated immunity A + PPD test shows DTH, a type ___ reaction that shows one has been previously exposed to the infection Secondary TB commonly has pulmonary manifestations and many others

Answer 68

Caseous, Tuberculosis Ghon focus 4

Question 69

For mycobacterium leprae that cause leprosy, the manifestations are broken up based on their level of ____ ^** So realize cell mediated immunity affects both mycobacterium ____s are the type that have NO immune response to the bacteria resulting in a sever form of leprosy that affects the skin, nerves, eyes, and testes ___laterally ____ CAN have an immune response to the bacteria resulting in only a mild form of leprosy leading to ____lateral one or two skin and nerve involvements and nothing more Also a lepromin skin test can determine between ___ if it's + or ___ if it's - ___ has a gun and stock peripheral neuropathy causing hand and feet numbness, ____ facies (thick facial skin), saddlenose deformity (from nasal cartilage being destroyed), infertility, and more ____ has complete loss of sensation in lesions of the extremities but the nerves are well defined (aka LOCALIZED superficial, UNILATERAL nerve involvement), hypopigmented elevated blotches often near areas of hairless or diminished sensation also occur ^** In TL, the enlarged nerves near the skin lesions can be palpated and usually include major nerves like the greater auricular, ulnar, posterior tibial, peroneal, etc....

Answer 69

Cell-mediated immunity LL (Lepromatous leprosy), Bilaterally TL (Tuberculoid leprosy), Unilaterally TL (Think T looks like +), LL LL, leonine TL

Question 70

___ are the most common Non-tuberculous mycobacteria (NTM) that cause Fever of unknown origin and lung disease ^** Occurs in AIDS or immunosuppressed hosts

Answer 70

MAC (Mycobacterium avium-intracellulare)

Question 71

Mycoplasma pneumoniae has NO ___, is the SMALLEST bacteria, requires ___ for membrane formation (since it has no cell wall and instead is packed with sterols) and is a FA for metabolism ___s are seen on sputum culture and also on chest X-ray ____ infiltrates will be seen ^** Protein ___ allows this bacteria to bind to the epithelial cells of the respiratory tract and cause tracheo___ and ____ (fever, dry and non-productive cough, patient does not seem as sick aka atypical) in teenagers and young adults Remember, Neisseria gonorrhoeae and Chlamydia trachomatis are the two bacteria that cause urethritis/Nongonococcal urethritis, but ALSO ___ can cause NGU (and this bacteria does not have a cell wall) and this is identified from the other 2 bacteria since it can metabolize ____ and produces ___ colonies when cultured Both of these have NO ____ and this is why antibiotics don't work Also remember that Mycoplasma pneumoniae, Chlamydia trachomatis, Legionella, and viruses cause atypical pneumonia

Answer 71

Cell wall (so it is not a gram + or gram - bacteria), cholesterol Mulberry colonies (aka fried egg appearance), patchy (aka streaky) P1, tracheobronchitis, Walking pneumonia (a form of atypical pneumonia) Ureaplasma urealyticum, Urea, tiny Cell wall

Question 72

Name the major group of the bacteria 1) E. Coli 2) Vibrio cholerae 3) Bacteroides fragilis 4) Klebsiella Pneumoniae 5) Vibrio parahaemolyticus 6) Proteus mirabilis 7) Pseudomonas aeruginosa 8) Campylobacter jejuni 9) Shigella dysenteriae 10) Salmonella typhi 11) Helicobacter pylori 12) Bacteroides melaninogenicus 13) Yersinia enterocolitica 14) Burkholderia cepacia 15) Stenotrophomonas maltophilia

Answer 72

1) Enterobacteriaceae 2) Vibrionaceae 3) Bacteroidaceae 4) Enterobacteriaceae 5) Vibrionaceae 6) Enterobacteriaceae 7) Pseudomonadaceae 8) Vibrionaceae 9) Enterobacteriaceae 10) Enterobacteriaceae 11) Vibrionaceae 12) Bacteroidaceae 13) Enterobacteriaceae 14) Pseudomonadaceae 15) Pseudomonadaceae