MICRO Flashcards by Alexis McKay

gram neg coccobacillus
Urease +

H. pylori

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fever in malaria coincides with what

rupture of RBC’s

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what is the best protection against syphilis

condom

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mcc of meningitis of newborn?

S. agal (Group B strep)

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mcc of meningitis in 1month old-18 yo?

N. meningitis

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mcc of meningitis >18 yo?

S. pneumo

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what is mc seen with osteomyelitis in HbSS patients

S. aureus

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cave explorer in ARIZONA with resp infection

Coccidioidomycosis

*large spherule endospores

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AIDS pt with acute cholecystitis

Cryptosporidium and CMV are MCC

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traveler to mexico who 1 week later develops a watery diarrhea with mucus and blood and colicky bowel movements

Amebiasis

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MCC of pneumonia in cystic fibrosis

P. aeruginosa

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1-6 hours after eating contaminated food with preformed toxin, self limited

S. aureus food poisoning

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serotype of E. coli
-HUS
-raw hamburger

O157:H7

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Bridge painter in NYC with resp infection, MC is histoplasmosis/cryptococcus (pigeons).. what do u tx pt with

Amph B

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oocysts that are acid fast positive in a patient with AIDS

cryptosporidium (oocysts with 4 sporozoites)

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elderly man who lives at home with his wife, develops pneumonia

S. pneumo

(MC typical CAP)

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squamous cancer of the bladder
**host is a snail
painless blood in urine, vague abd pain
**SWIMMERS ITCH
-contaminated water sources, cercarieae

S. hematobium (egg has nipple on end)

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how to tx syphilis

penicillin

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how to tx gonorrhea

ceftriax+ doxy

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tx of BV (clue cells, gardnerella vaginalis)

metronidazole

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tx of trichomoniasis (anaerobe)

metronidazole **TREAT THE PARTNER TOO

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tx of pseudomembranous colitis

metronidazole

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india ink prep with narrow based bud/

monomorphic encapsulated yeast

cryptococcus neof

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resp problem with pigeons

cryptococcus

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fungus ball in abandoned TB cavity -hemoptysis -fruiting body

aspergillus

frontal lobe abscess in patient with DKA

mucormycosis

CF pneumonia (green colored sputum) -MCC of death in burns -malignant otitis externa -exthyma gangrenosum -"step on nail with smelly shoes" -"hot tub folliculitis" -resp infxns "loves water"

pseudomonas related infections

water coolers flu like syndrome hyponatremia hyPERkalemia from interstitial nephritis dieterle SILVER STAIN TX WITH ERYTHROMYCIN

legionella

cat bite potential for septic arthritis/tendinitis

pasteurella multocida

MCC of myocarditis, pericarditis, aseptic meningitis

COXSACK BIRUS

PEAR shaped flagella ** uninucleate trophozoites with 4 motile flagella

trichomonas

pseudohyphae and yeast

candida

owl eyes with flagella *pear shaped trophozoite *small bowel inflammation and villous atrophy **troph have 4 pairs of flagella and 2 nuclei which attach to crypts thru a SUCKING DISK ON VENTRAL SURFACE

giardia

trophozoite in protozoa (diarrhea w ulcer)

E. histolytica- protozoa (trophozoite with single nucleus containing central karyosome)

neonatal pneumonia afebrile staccato cough, eosinophilia wheezing

C. trachomatis (contracted while passing thru birth canal)

squamous cells koilocytosis pyknotic nucleus with clear halo

HPV

gram pos branching filaments (anaerobic-not acid fast) IUD sulfur granules (yellow) draining sinus from jaw/cutaneous fistulas after dental surgery

Actinomycosis israelii

endometriosis, plasma cells present

S. Agal (GBS)

MOA of s. agal (GBS)

inhibits phagocytosis

receptor for HIV

CD4 molecule on helper T cells

Protein A attaches to Fc receptor of macrophages, blocking opsonization of bacteria

S. aureus

moves with flagella Urease +

P. mirabilis

alpha toxin inhibits EF-2 by ADP ribosylation, blocking protein synthesis *GRAY PSEUDOMEMBRANE in back of mouth *BULL NECK (neck edema)

C. diphtheria

requires sterols

M. pneumonia

tumbling motility, gram pos rod, b hemolysis on blood agar *mainly contracted from eating unpasteurized cheese

listeria monocytogenes

gray membrane that bleeds when removed

C. diphtheria

transmitted by aedes aegypti mosquito -breakbone fever -hemorrhagic

Dengue fever

infxn associated with premature rupture of membrane

S. agalact (GBS) *CAMP test

where is location for S. aureus carriers

Anterior nares

mcc of diarrhea in children

rotavirus

attaches to urogenital epithelium -#1 for UTI

E. coli

person working with animal hides develops lung disease **SOLITARY ULCER W BLACK CENTER

B. anthrax

evades host destruction via polysaccharide capsule

cryptococcus

child with anemia and diarrhea

hookworm- produces iron deficiency

lymphocutaneous nodules in a rose gardener

sporotrichosis TX: with potassium oxide

-elderly male smoker -non productive cough, bacteria cant grow on ordinary media (must have iron/cysteine) **silver stain

Legionella Tx: erythromycin

how to destroy C. diff in bedpan

autoclave

spores associated with beaver dams and inland water ways

blastomycosis

impetigo (THICK YELLOW GOLDEN CRUSTS)

S. aureus (MCC) or GAS (s. progenies) impetigo in strep can lead to glomerulonephritis (abnormal urinalysis)

tx of schistomsomiasis

praziquantel

what 2 bacteria have quick onset (1-6 hours) after food contamination? *have preformed heat stable toxins (does NOT respond to antibiotics since they are preformed) *VOMITING is predominant

s. aureus B. cereus

reheated rice enterotoxin= nonbloody diarrhea cereulide toxin= n/v

B. cereus

heat labile toxin improper canned foods, raw honey *floppy baby syndrome, descending paralysis (unable to lift head) *ptosis of eye "homemade organic baby food"

C. botulinum

reheated meat

C. perfringens

undercooked meat

E. coli O157:H7

deli meats and soft cheeses

listeria

raw poultry, eggs, meat, turtles **ACID LABILE- NOT ACID STABLE **H2S PRODUCING ON HEKOTEN AGAR (black colonies) OSTEOMYELITIS IN SCD

Salmonella

mayo/custard -food poisoning **SIALOADENITIS- tender swollen salivary glands/neck mass, purulent oral discharge, Inflammation, fever/chills

S. aureus

contaminated seafood

V. vulnificus

campy EHEC EIEC E. histolytica nontyphoidal salmonella shigella yersinia

bloody/inflammatory diarrhea

gastroenteritis organisms w/ direct intestinal mucosal invasion (bloody diarrhea)

Campy E. histolytica salmonella shigella

food borne illness organisms that directly invade intestinal epithelial cells

C. perfringens ETEC Vibrio cholera

heat labile: activates adenylate cyclase, INC camp, INC Cl secretion in gut, H20 efflux

ETEC *travelers diarrhea/no fever

heat stabile: guanylate cyclase, INC cgmp, DEC absorption of NaCl/H2O

ETEC *travelers diarrhea/no fever

shiga like toxin: inactivates 60s ribosome by removing adenosine from ribosomal RNA Enhances cytokine release--> HUS

EHEC

inactivates 60s ribosome by removing adenosine from ribosomal RNA **HIGHLY VIRULENT, ACID STABLE Enhances cytokine release--> HUS

Shiga toxin, shigella

Cholera toxin: over activates adenylate cyclase, INC camp, INC Cl secretion in intestine, H20 efflux **rice water diarrhea, infected seafood

V. cholerae

virulence factor of E. coli in UTI

p-fimbriae, allows adhesion to uroepithelium

VF of E.coli in neonatal meningitis

K1 capsular polysaccharide: prevents phagocytosis/complement mediated lysis

3 C's : cough, coryza, conjunctivitis koplik spots (blue/white in mouth) rash start on head -->trunk/extremities **CAN LEAD TO SUBACUTE SCLEROSING PANCEPHALITIS (neuro probs, behavior changes, problems w schoolwork, myoclonus-involuntary spasms 7-10 years after measles dx) **usually says no vax

measles/rubeola

rash on head--> trunk/extremities occipital/postauricular lymph

Rubella/german measles

high fever for 3-5 days, rash once fever subsides trunk-->extremitis <5 yo

Roseola/ HHV6

sandpaper like rash on neck/Upper trunk fever/sore throat **RF/Glomerulonephritis

S. pyrog/ GAS/ scarlett fever

can cause hydrops fetalis in pregnancy women, "slapped cheek"

parvovirus b19

T. solium E. granulosus D. latum

Tapeworms/Cestodes

Schistosoma C. sinensis

Flukes/Trematodes

hyatid liver cysts

dominant host: dog E. granulosus

Vit B12 deficiency, ingesting larvae from raw freshwater fish

D. latum

cysticercosis/neurocysticercosis ingestion of larvae from undercooked pork

T. solium

Sand fly

Leishmaniasis

Deer fly/Loa Loa

Loiasis

Black fly/Onchocerca volvulus -black river blindness *female black fly, black skin nodules, black sight) TX: ivermectin

Onchocerciasis (eye pain/redness)

Tsetse fly/ T. brucei

Trypanosomiasis

rabbits, ticks, deer flies

F. tularensis

Fleas (rat reservoir)

Yersinia pestis/plague

tick borne illness, flu like symptomsc *Rocky mountain spotted fever/dermacentor (dog tick) **rash that STARTS ON WRISTS/ANKLES AND SPREADS INWARDS CENTRALLY

Rickettsia

Lyme disease/burgdorferi *scleral icterus, erythema migrans *spiral shaped bacterium, merozoites arranged in tetrads

Ixodes (deer tick)

"if you hurt your knee, You Can Certainly CuSS" Yersinia enter. Campy C. diff Chlamydia trach Salmonella Shigella

Causes of reactive arthritis

-PAINFUL genital lesion -curved gram neg rod -gray exudate, ragged borders, inguinal lymphadenopathy

H. ducreyi/chancroid

HSV 2/ multiple vesicular lesions H. ducreyi/chancroid

PAINFUL genital lesions

"Kansas City Takes Shane Hynes" Klebs/granuloma inguinale Chlamydia / Lymphogranuloma Trep Pallidum/ prim syphil/chancre Sec syphilis/condyloma lata HPV

PAINLESS genital lesions

painless beefy red ulcer that bleeds easily

Klebs/granuloma inguinale

painless genital lesion, with PAINFUL lymph **BUBOES -PID, reactive arthritis

Chlamydia (L1-L3)

condyloma acuminata genital warts, kilocytes

HPV 6 and 11

Urethritis, cervicitis, PID, prostatitis creamy copious purulent discharge -gram neg intracellular diplococci

N. Gonorrhea

GUMMAS tabes dorsalis argyll robertson pupil

Tertiary syphillis T. pallidum

FROTHY YELLOW GREEN FOUL SMELL vaginitis strawberry cervix FLAGELLATED PROTOZOA- ** uninucleate trophozoites with 4 motile flagella motile in wet prep

Trichomonas vaginalis, trichomoniasis

GRAY MILKY FISHY ODOR CLUE CELLS BV ph > 4.5

gardnerella vaginalis

white crumbly thick cottage cheese like, ODORLESS -pseudohyphae ph <4.5

Candida albicans/ vaginal yeast infection

BLOODY/MUCOPURULENT DISCHARGE obligate intracellular organisms that gram stain poorly **INTRACELLULAR INCLUSION BODIES (YELLOW AND BROWN HISTO PIC) (has neutrophils but no organism on gram stain) **leads to PID, reactive arthritis **GIEMSA stain, NAA

Chlamydia trach

Inflammatory lung disease, verrucous skin lesions lytic bone lesions great lakes region

Blastomycosis **broad based budding

Bird/bat droppings mississippi/ ohio valleys palate/tongue ulcers/ splenomegaly

Histoplasmosis *small uniform yeast with narrow based budding

M. pneumo Adenovirus Chlamydia pneumo (insidious onset, low fever, DRY cough, HA, fatigue) ***PATCHY INFILTRATES

Atypical Pneumonia *COLD AGGLUTIN TES

"KASH" Klebs pneumo- currant jelly sputum/thick, bloody, mucoid staph AUREUS S. pneumo H. pneumo (acute onset, HIGH FEVER, PRODUCTIVE COUGH, PLEURITIC CHEST PAIN) **LOBAR CONSOLIDATION

TYPICAL PNEUMO (CAP)

HIGH WBC (>1000) HIGH opening pressure HIGH protein LOW glucose NEUTROPHILS

BACTERIAL meningitis (H. infl/N. men)

HIGH WBC (< 500) HIGH opening pressure HIGH protein LOW glucose LYMPHOCYTES

FUNGAL meningitis/TB (crypto neof)

HIGH WBC ( <300) NORMAL OR HIGH open pressure NORM OR HIGH protein NORMAL glucose LYMPHOCYTES

VIRAL meningitis/encephilitis (HSV1) **temporal lobe encephalitis

GRAM POS, AEROBIC bacilli

Listeria Bacillus (spore forming) Corynebacterium

GRAM POS, ANAEROBIC bacilli

Clostridium (spore forming, spores are filled with dipicolinic acid)

GRAM POS, AEROBIC branching filaments

Nocardia (WEAKLY acid fast)

GRAM POS, ANAEROBIC branching filaments

Actinomyces (NOT acid fast)

GRAM POS, AEROBIC cocci (CHAINS) catalase NEG coagulase NEG A-hemolysis (partial) OPTOCHIN SENS ENCAPSULATED

s. pneumo

GRAM POS, AEROBIC cocci (CHAINS) catalase NEG coagulase NEG A-hemolysis (partial) OPTOCHIN RESISTANT UN- ENCAPSULATED

S. viridian's (S. mutans/mitis)

GRAM POS, AEROBIC cocci (CHAINS) catalase NEG coagulase NEG B-hemolysis (complete) BACITRACIN SENSITIVE CAMP -

S. Pyogens (GAS)

GRAM POS, AEROBIC cocci (CHAINS) catalase NEG coagulase NEG B-hemolysis (complete) BACITRACIN RESISTANT CAMP +

S. Agalact (GBS)

GRAM POS, AEROBIC cocci (CHAINS) catalase NEG coagulase NEG Y-hemolysis (none) GROW IN 6.5% NaCL

Enterococci (E. faecium, E. faecalis)

GRAM POS, AEROBIC cocci (CHAINS) catalase NEG coagulase NEG Y-hemolysis (none) DO NOT GROW IN 6.5% NaCL

Nonenterococcus S. bovis

GRAM POS, AEROBIC cocci (CLUSTER) catalase POS coagulase POS B- hemolytic growth

s. aureus

GRAM POS, AEROBIC cocci (CLUSTER) catalase POS coagulase NEG NOVOBIOCIN SENS GAMMA hemolytic

S. epidermis S. sapro

B. pertussis, VF that is Ga1, protein coupling inhibited, blocking signal transduction

Pertussis toxin

VF of C. Dipth (protein synthesis is blocked)

Diphtheria Toxin (inactivates eukaryotic host ribosomal protein elongation factor 2)

VF of Pseudomonas (protein synthesis is blocked)

Exotoxin A

VF of B. Anthrax

Edema toxin (ET) and Lethal toxin (LT)

VF of C. botulinum

botulinum neurotoxin

VF of C. Diff

Toxins A and B

VF of C. tetani

tetanus toxin

VF of Listeria

Listeriolysin

VF of staph aureus that causes SSSS, bullous impetigo

Exfoliatin Toxin (ETA)

Vf of staph aureus that causes watery diarrhea

Staph Enterotoxin

Vf of staph aureus that causes Shock, fever, inflammation

Toxic shock syndrome toxin (TSST-1)

what has hyaluronic acid capsules that prevents opsonization and phagocytosis, and has M protein, streptolysin, TSST

S. pyogenes

what 3 bacteria have IgA protease

S. pneumo H. influenza Neisseria

CD4 <500

candida (oral thrush) EBV (oral hairy leukoplakia HPV (SCC anus/cervix) HHV8 (kaposi)

what bacteria has Pneumolysin

S. pneumo

CD4 < 250

Coccidioides

CD4< 200

PJP Histoplasma

CD4 <100

asperillus crypto neo cryptosporidium JC virus (PML) HSV

CD4 < 50

CMV MAC T. gondii Bartonella henselae

what 2 bacteria uses CHOCOLATE agar (NAD (factor V), AND HEME (factor x))

H. influenza N. mening

what bacteria uses LJ AGAR

Mycobacterium TB

what bacteria uses MACCONKEY AGAR (gram neg rods) **pink **LACTOSE FERMENTING, yellow growth on Hektoen agar

E. coli Enterobacter Klebs

what bacteris uses THAYER MARTIN AGAR (chocolate sheep blood/abx)

N. gonorrhea vs. N. meningitis

what uses SILVER STAIN

Legionella PJP

what uses india ink stain

crypto neof

what use SABOURAUD AGAR (peptones)

Crypto Neof, coccid immitis candida

what uses BUFF CHARCOAL YEAST AGAR W/ L CYSTIENE AND IRON

Legionella

what uses BLOOD AGAR W/ CYSTEINE AND GLUCOSE

F. Tularenis

what bacteria causes acute mastitis in breast/nipple discharge/fever after postpartum

S. aureus

what can lead to monoarticular septic arthritis

S. aureus

what can lead to polyarticular SEPTIC arthritis in a young person

N. gonorrhea

-beaver fever -contaminated water/hiking trip/mountains -INC fecal fat (steatorrhea) -Diarrhea -BINUCLEATE TROPH W MULTIPLE FLAGELLA

Giardia Duodenalis (protozoa) foul smell/fatty oilly stools

IV DRUG USERS/prosthetic valves -right sided endocarditis -TRICUSPID valve holosystolic murmur

S. aureus

subacute left sided endocarditis following dental procedures/gingivitis MITRAL valve **positive Echo showing oscillating intracardiac mass, gingivitis, splinter hemorrhages

S. mutans/Viridians group

-guillian barr syndrome, bilateral LE weakness that can ascend upwards, bloody diarrhea -CSF: elevated protein, normal leukocyte

campylobacter

*PLAQUE ON TONGUE THAT WILL NOT SCRAPE OFF **LATERAL TONGUE CD4< 500 **oral hairy leukoplakia

EBV -positive PCR testing

*plaque on tongue that DOES scrape off **BASE OF TONGUE, pseudohyphae CD4<500 **oral thrush

Candida -from inhaled corticosteroids

CD4 <500

EBV Candida

non enveloped, pos sense, linear SSRNA

Picornaviridae -Cox A -polio -echovirus -rhinovirus -Hep A

**DAYCARE

Cox A (hand foot mouth butt)

DSDNA virus

herpesviridae family -HSV 1 -HHV 6/7 -VZV

enveloped neg sense, linear SSRNA

Paramyxoviridae family -Measles (rubeola) -

how do you tx obligate intracellular bacteria (like chlamydia/rickettsia)

tetracyclines/macrolides

60 day course of abx (cipro or doxy) + 3 dose vax series

B. anthrax

gas gangrene red/purple/black discoloration necrotizing soft tissue crepitus

C. perfring

increased risk of gallbladder cancer, colon cancer, Inflammatory bowel disease

Chronic Salmonella typhi

functional asplenia in sickle cell disease

S. pneumo

increased risk of osteomyelitis in sickle cell disease (painful swelling of finger/toes- dactylitis)

salmonella

tick borne relapsing fever (camping in colorado) **fever, headache, malaise, no appetite, joint pain, N/V **spirochetes !!

Borellia Hermsii dx: dark field microscopy tx: doxy

tick borne illness, flu like symptoms hemolytic anemia maltese cross/rings

Babesia microti

how do you treat chlamydia/gonorrhea if unsure which (inc vag discharge, no odor, dx w/ NAA test)

doxy (chlamy) + ceftriax (gon) **azithro replaces doxy in preg woman

gram neg pleomorphic coccobacillus *drooling, dysphagia, distress, inspiratory stridor= esophagitis *needs to lean over, super high fever

H. influenza type B

Hep C yellow fever Dengue St. louis encephalitis West Nile Zika

Flavaviruses enveloped non segmented pos sense linear RNA

Aedes mosquito/Haemogus tropical areas fever, ha, severe hemorrhagic jaundice

flavivirus (yellow fever)

what is part of matonavirus family

Rubella

what is part of togavirus family enveloped non segmented pos sense linear SS pRNA

Eastern equine encephalitis (EEE) Western equine encephalitis (WEE) chikagunya

All e. coli strands ferment sorbitol except for which one? **stool is negative for WBC *no fever

EHEC (noninflammatory bloody diarrhea)

inflammatory bloody diarrhea in E. coli ferments sorbitol fever, abd pain **fecal leukocytes in stool/stool is positive for WBC

EIEC

what fungus can cause hair loss, tinea corpus, tinea capitum, ringworm *fusiform football shaped macroconidia

Microsporum

few 3-4 cell club shaped macroconida, and many club shaped microconida -can also cause tinea captious TX: oral griseofulvin or terbinafine

Trichophyton

spaghetti and meatballs dimorphic fungus tinea versicolor- hypo/hyper pigmented rashes tx: ketoconazole or selenium sulfide

Malassezia *dimorphic lipid dependent fungus that is normal skin flora

Enveloped non segmented neg sense SS RNA virus

filovirus family -ebola

travels to africa, flu like symptoms with maculopapular rash -RT-PCR to detect viral RNA

Ebola virus

HIV human-T-Lymphotrophic

Retrovirus family enveloped non segmented pos sense linear RNA

5 features of klebs (3 manifestations are Multidrug resistance, aspiration pneumonia, nosocomial UTI )

"5 A's" aspiration pneumonia (air space consolidation involving much of RUL) -alcoholics -diAbetics -abscess (lungs- progression causes large abscess cavity with air fluid level) -currAnt jelly sputum

CD4 <500

candida (oral thrush) EBV (oral hairy leukoplakia HPV (SCC anus/cervix) HHV8 (kaposi)

what causes pneumocystis pneumonia "dented helmet cells on Gomori methenamine silver stain"

PJP

micro vesicular steatosis without inflammation. tiny fat vacuoles surround hepatocytes

reye syndrome

cigar shaped fungi

sporothrix schenckii

name 3 infections reactivated in AIDS

shingles TB HBV

examples of fungi include

mold yeast mushrooms

HUS disease manifests as triad of

anemia thrombocytopenia acute renal failure

all dna viruses are double stranded except for

parvovirus b19

TACHY hypotension AMS warm extremities

septic shock

what part of gram neg bacterial wall contributes to sepsis

Lipopolysaccharide

chorioretinitis, intracranial calcifications, hydrocephalus, hepatosplenomegaly in babies

Congenital toxoplasmosis

gram variable pleomorphic rod

gardner vaginalis (BV)

dimorphic

mold in cold 20 c AND IN yeast in heat 37 c