Infectious Disease -- Bacteria II - URT/Meningitis/Childhood/G- infections Flashcards
(98 cards)
1
Q
Four bacteria most associated with URT, sinusitis, OM
A
Strep pneumoniae
S Aureus
H influenzae (non-type B)
Moraxella catarrhalis
2
Q
Why don’t H flu and M catarrhalis cause meningitis?
A
No capsule
3
Q
Pathogenesis of Sinusitis/OM?
A
Primary inflammatory response (virus/allergies)
Blockage of sinus ostia/eustachian tube
Secondary overgrowth of colonizing bacteria
4
Q
Symptoms of URT infection
A
Fever, Pain, Purulent Drainage
5
Q
Potential complications of URT infection
A
Abscess formation
Invasion of Cribiform plate
Damage to middle/inner ear
6
Q
How do URT with virulent organisms happen
A
Exposure Local infection (pharyngitis) Invasive Disease Bacteremia Systemic Disease (maybe meningitis)
7
Q
Why would inflammation increase likelihood for contracting meningitis
A
Opens up the BBB
8
Q
Most common causes of Invasive URT disease/Meningitis. Neonates.
A
Group B Strep
E coli
9
Q
Most common causes of Invasive URT disease/Meningitis. Children 1-5
A
S. pneumo
H inf. type B before the vaccine
10
Q
Most common causes of Invasive URT disease/Meningitis. Adolescents/young adults.
A
N. meningitidis
11
Q
Most common causes of Invasive URT disease/Meningitis. Overall
A
S. pneumo
12
Q
Key to pathogenicity for the URT disease/Meningitis bacteria
A
Encapsulation
13
Q
How do these URT/Meningitis bacteria work
A
URT Invasion into deeper tissue, blood Bacteremia/Dissemination LPS activation of endo. and macrophate Vascular Leakage
14
Q
_____ increased susceptibility to encapsulated bacteria
A
asplenia
15
Q
Aside from meningitis, encapsulated bacteria are also associated with…
A
Sepsis, DIC
Common causes of death esp. with N. meningitidis
16
Q
Pneumococcus. Distribution? Morphology?
A
Normal Flora
G+ Diplococcus
17
Q
Pneumococcus. Virulence Factors.
A
Capsule
PspC (the pneumo carboydrate)
18
Q
Pneumococcus. Invasive disease
A
Sepsis. Meningitis.
19
Q
N. meningitidis. Distribution? Morphology?
A
Exogenous
G- Dipococcus
20
Q
Virulence factors of N. meningitidis.
A
Capsule
LPS
21
Q
N. meningitidis. Invasive diseases?
A
DIC, Sepsis
Menningitis
22
Q
N. gonorrhea. Distribution and Morphology
A
Exogenous
G- Diplococcus
23
Q
N. gonorrhea. Virulence Factors.
A
Capsule
LOS
24
Q
N. gonorrhea. Invasive Disease
A
Septic Arthritis
25
H. influenzae (type B) distribution and morphology
Exogenous (only type B)
| G- Pleomorphic
26
H. influenzae (type B) virulence factors?
Capsule
| LPS
27
H. influenzae (type B) Invasive Disease.
Sepsis
| Meningitis
28
Why no sepsis from N. gonorrhea?
LOS instead of LPS
29
Capsules contain LPS or PspC that triggers...
DIC, Sepsis
30
Why are the encapsulated bacteria so bad once they hit the CNS?
No complement in the CNS
31
How do encapsulated bacteria cause shock?
LPS stimulates toll like receptors to induce systemic cytokine secretion. Endo cells activate
More vascular permeability, loss of volume, systemic shock and organ failure
32
How do encapsulated bacteria cause DIC?
Systemic activation of coagulation by bacteria
Results in systemic microthrombi
Hemorrhage after factors are used up
33
Most common cause of community acquired pneumonia
S. pneumo
34
S. pneumo is often a secondary infection to...
influenze, especially in the elderly
35
Most common cause of meningitis?
S. pneumo
36
Streptococcal pneumoniae infections are associated with...
```
Obstruction of Respiratory passages
Impaired Immunity
Malnutrition
Alcoholism
Under Age 2
Sickle Cell
```
37
Virulence factors of Streptococcal pneumoniae
PspC
Pneumolysin
pspA (inhibits alternate complement pathway)
38
T or F. Vaccination for Streptococcal pneumoniae is effective in high risk populations.
True
39
What is the vaccine for Streptococcal pneumoniae?
Pneumococcal conjugate vaccine (PCV13)
High risk patients -- PPSV23
Risk =65+, chronic disease, immunodeficient, asplenia
40
General characteristics of Neisseria?
```
G-
Encapsulated
Aerobic or Facultative
Very Susceptible to adverse environmental conditions
Not normal flora
```
41
How does Neisseria meningitidis work?
Into nasopharynx and colonizes
Bacteremia
Purulent Meningitis, Sepsis, DIC, Petechial hemorrhages
42
Who gets Neisseria meningitidis?
College Students, Army recruits
43
How to treat Neisseria meningitidis?
Penicillin or prevent with vaccination
44
When Neisseria meningitidis reaches the bloodstream...
Microhemorrhages --> petechial rash on extremities/ears
Microthrombi --> Ischemic necrosis in limbs
Vascular Collapse
45
What is Waterhouse-Friderichsen Syndrome?
Bacterial infection (usually Neisseria meningitidis) in the blood causes the adrenals to die by filling them up with blood
46
Important things to know about Neisseria meningitidis immune response.
Capsue makes you need an Ab response to really handle it well. This is why we vaccinate
47
How does Neisseria gonorrhea work?
Attaches to columnar and transitional epithelia (pili)
| Gonorrhea, Cystitis in UG, rectum, nasopharynx
48
Neisseria gonorrhea virulence factors?
Pili
| IgA protease
49
What does gonorrhea infection look like usually
Should;ve gotten a picture...
Suppurative inflammation of mucosa and subepithelia
Grossly purulent lesions and discharge
50
Bonus manifestations of gonorrhea?
Suppurative arthritis followig bacteremia
51
Why don't we vaccinate for gonorrhea?
Antigenic variability
52
Describe non-invasive Haemophilus influenza
Upper respiratory, Sinusitis, OM
Common URT
Normal Flora of about half of kids
53
Describe invasive Haemophilus influenza
Encapsulated
| Type B capsule has endotoxin characteristics
54
What is Haemophilus parainfluenzae all about
Normal mouth flora
| Can cause endocarditis
55
What is Haemophilus ducreyi all about
Chancroid
| This hasn't been seen in the US for like a decade
56
Haemophilus influenza Type B window of susceptibility
3 months to 3 years
57
Haemophilus influenza Type B -- why can't little ones deal with it
Inability to make Abs to capsular antigens
Conjugated vaccine is effective in infants and toddlers
Let the breast milk carry them till that point
58
Moraxella catarrhalis. What's it all about
Normal flora
3rd most common cause of secondary bacterial Sin. and OM
LPS endotoxin similar to Neiss.
Rarely causes septicepia and meningitia
59
Pathogenesis of Diptheria
```
Local epithelial necrosis (pseudomembrane formation)
Systemically released (Exotoxin A)causes damage to distant organs (heart)
```
60
What is the pseudomembrane in diptheria?
Coagulation of dead cells, pus, and blood
61
Pathogenesis of Bordetella pertussis
Cell bound pertussis toxin with local epithelial inflammation
Swelling --> narrowing of epiglottis
62
Bordetella pertussis has a characteristic....
Lymphocytosis (rather than leuko)
Loud inspiratory noise
Strong tropism for brush border
63
Bordetella pertussis exotoxin causes
Ciliary paralysis with secondary inflammation
64
How is Bordetella pertussis avoided?
Vaccination (DTaP, Tdap)
65
Corynebacterium diptheria causes what to happen
Ulcerative lesions of the respiratory mucosa
| Pseudomembrane
66
What does the Corynebacterium diptheria toxin do
Inhibits protein synthesis in eukaryotic cells
| Causes fatty mocardial changes, myofiber necrosis, polyneuritis
67
How does Corynebacterium diptheria kill you?
Cardiac failure from exotoxin
68
Gram negative rods -- three claims to fame
```
UTI
Intra-abdominal infections
Rare pneumonias (Nosocomial/Aspiration)
```
69
General characteristics of G- rods
Endotoxins
Frequent Drug Resistance
Has replaced pyogenic Cocci as bulk of hospital-acquired and opportunistic infections
70
What is endotoxin?
LPS, OAg
71
Non obstructive UTIs are probably....
E. coli
72
Obstructive UTIs are probably...
Klebsiella or Edwardsiella
73
Four kinds of abdominal infections associated with G- infections
Perforation
Appendicitis
Cholecystitis
Diverticulitis
74
Two main types of G- infections
Spread of organisms that have colonized the GI tract
| Contamination of tissues and materials from the hospital
75
E. Coli is a coliform bacteria. What the fuck does that mean
That it can ferment lactose
76
Four types of E Coli infection
UTI/Cystitis
Suppurative Infections of Abdominal Cavity
G- hemorrhagic bronchopneu. in aspiration
G- sepsis
77
Most common cause of uncomplicated UTI without obstruction
E coli
78
Klebsiella and Enterobacter matter as causes of...
Pneumonia (maybe with necrotizing abscess)
| UTI
79
How do people tend to get Klebsiella pneumonia
associated with aspiration in a hospital setting
80
How do Klebsiella UTI happen
Secondary to obstruction
81
Septicemia in Klebsiella/Enterobacter patients
Thick mucoid capsule
82
Why should I care about proteusmiribilis?
G- Facultative anaerobci rod
UTI/Pyelonephritis, Pneumonia in debilitated patients
Secretes urease
83
What does proteus miribilis's urease do?
Converts urea to ammonia, causing alkaline urine
84
What pathological sign can be seen in chronic pyelonephritis?
Staghorn Calculi
85
Why do I have to make another damn flashcard to mention Serratia marcescens.
Cause of pneumonia in debilitated patients
| UTIs
86
Three claims to fame for pseudomonas aeuroginosa
Skin Infections/Sepsis (esp. in burns)
Pneumonia (esp. in Cystic Fibrosis)
Chronic UTI (Obstruction)
87
Pigments in pseudomonas
pyocyanin and pyoverdin
88
What does pseudomonas aeuroginosa use to be such a BAMF when it is established?
Endotoxin - PS
Exotoxin A (leads to shock)
Leukocydin
Can cause superinfection
89
What happens in bacterial superinfection
pseudomonas aeuroginosa replaces antibiotic suppressed organisms
90
Mark of pseudomonas aeuroginosa around BV
"Blue Haze"
91
pseudomonas aeuroginosa is a common pathologic organism in...
Cystic Fibrosis
92
pseudomonas aeuroginosa manifests in intravenous drug abusers as...
Endocarditis + Osteomyelitis
93
pseudomonas aeuroginosa can cause ____ in contact wearers and ______ in swimmers and diabetics
Corneal keratitis
| External otitis
94
What matters about legionella pneumophilia.
Pneumonia
Community outbreaks associated with contaminated, aerosolized H2O supply
90% get Pontiac Fever, 10% Legionaire's disease
95
In Legionaire's Disease, you get...
Fibrinopurulent necrosis leading to scarring of pulmonary tissues.
Really messes you up.
96
Helicobacter pylori. What matters?
Gastritis/Peptic Ulcer Disease
| Urease creates protective amonia layer to protect from acid
97
What matters about Bacteriodes and Peptostreptococcus (gingival infections)
Aspiration, Trauma, Fecal Leakage
Ischemic devitalized tissues
Mixed infections
Foul smelling Pus
98
Window of vulnerability in Type B H. flu
3 months to 3 years
| Little ones can't make good protective antigens to Type B capsule
