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1
Q

Chocolate Agar

- Factors V (NAD+) and X (hematin)

A

H. influenzae

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2
Q

Thayer-Martin Agar

A

Neisseria gonorrhoeae and meningitidis

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3
Q

Bordet Gengou Agar (potato) or Regan Lowe Medium (charcoal, blood, Abx)

A

Bordatella pertusssis

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4
Q

Tellurite Agar, Loffler Medium

A

C. diptheriae

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5
Q

Lowenstein-Jensen Agar

A

M. tuberculosis

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6
Q

Eaton Agar (requires cholesterol)

A

M. pneumoniae

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7
Q

MacConkey Agar

- Fermentation –> acid –> pink colonies

A

Lactose-fermenting enterics (E. coli, Klebsiella)

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8
Q

EMB Agar

A

E. coli

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9
Q

Charcoal yeast extract agar buffered with cysteine and iron

A

Legionella

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10
Q

Sabouraud Agar

A

Fungi

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11
Q

Yellow “sulfur” granules

A

Actinomyces israelii

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12
Q

Yellow pigment

A

Staph aureus

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13
Q

Blue-green pigment

A

Pseudomonas aeruginosa

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14
Q

Red pigment

A

Serratia marcescens

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15
Q

Protein A

- S. aureus

A

Binds Fc region of IgG –> prevents opsonization and phagocytosis

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16
Q

IgA Protease

- S. pneumo, H. flu type B, Neisseria

A

Cleaves IgA to colonize respiratory mucosa

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17
Q

M Protein

- Group A Strep

A

Prevents phagocytosis

  • Molecular mimicry
  • AI response in rheumatic fever
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18
Q

Type III Secretion System (Injectisome)

- Pseudomonas, Salmonella, Shigella, E. coli

A

Needle-like protein appendage facilitating direct delivery of toxins from certain gram negative bacteria to eukaryotic host cell

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19
Q

Transformation

- S. pneumo, Hib, Neisseria

A

Take up naked DNA from environment

- Add deoxyribonuclease –> degrades naked DNA –> no transformation seen

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20
Q

Conjugation

A 
F+ = sex pilus, conjugation
F- = no plasmid
Hfr = F+ plasmid incorporated into bacterial chromosomal DNA (can bring flanking DNA)
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21
Q

Transposition

A

Segment of DNA jumps from one location to another (can bring flanking DNA)
- Ex. vanA gene from vancomycin-resistant Enterococcus to S. aureus

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22
Q

Generalized Transduction

A

Lytic phage infects bacterium –> cleavage of bacterial DNA –> parts of bacterial chromosomal DNA may become packaged in phage capsid –> phage infects another bacterium –> transfers genes

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23
Q

Specialized Transduction

A

Lysogenic phage infects bacterium –> viral DNA incorporates into bacterial chromosome –> phage DNA excised with some flanking bacterial genes –> DNA packaged into phage capsid –> infects another bacterium

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24
Q

Spore Forming Bacteria

  • highly resistant to heat and chemicals
  • dipicolinic acid in core
  • must autoclave to kill
A
  • Bacillus anthracis (anthrax)
  • Bacilus cereus (food poisoning)
  • C. botulinum (botulism)
  • C. difficile (pseudomembranous colitis)
  • C. perfringens (gas gangrene)
  • C. tetani (tetanus)
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25
C. diphtheriae | - Diphtheria toxin
ADP-ribosylation --> inactivates EF-2 --> no protein synthesis - Pharyngitis with pseudomembranes in through and severe LAD (bull neck)
26
Pseudomonas aeruginosa | - Exotoxin A
ADP-ribosylation --> inactivates EF-2 --> no protein synthesis - Host cell death
27
Shigella spp. | - Shiga toxin
Inactivates 60S ribosome by removing adenine from rRNA - GI mucosal damage --> dysentery - Enhances CK release --> HUS - INVADES host cells
28
EHEC | - Shiga-like toxin
Inactivates 60S ribosome by removing adenine from rRNA - Enhances CK release --> HUS (O156:H7) - Does NOT invade host cells
29
ETEC | - Heat labile and heat stable toxin
Heat LABILE: overactivates adenylate cyclase --> increased cAMP --> increased Cl- secretion in gut and H2O efflux Heat STABLE: overactivates guanylate cyclase --> increased cGMP --> decreased reabsorption of NaCl and H2O in gut - Watery diarrhea
30
Bacillus anthracic | - Edema toxin
Mimics adenylate cyclase enzyme --> increased cAMP | - Edematous borders of black eschar in cutaneous anthrax
31
Vibrio cholerae | - Cholera toxin
Permanently activates Gs --> overactivates adenylate cyclase --> increased cAMP --> increased Cl- secretion in gut and H2O efflux - Voluminous rice-water diarrhea
32
Bordatella pertussis | - Pertussis toxin
Disables Gi --> overactivates adenylate cyclase --> increases cAMP --> impairs phagocytosis --> permits survival of microbe - Whooping cough
33
Clostridium tetani | - Tetanospasmin
Protease that cleaves SNARE --> inhibits vesicular fusion --> no NT release - Spastic paralysis, risus sardonicus, "lockjaw" - Prevents release of inhibitory (GABA and glycine) NT from Renshaw cells in spinal cord
34
Clostridium botulinum | - Botulinum toxin
Protease that cleaves SNARE --> inhibits vesicular fusion --> no NT release - Flaccid paralysis, floppy baby - Prevents release of stimulatory (ACh) at NMJ
35
Clostridium perfringens | - Alpha toxin
Phospholipase (lecithinase) --> degrades tissue and cell membranes - Myonecrosis (gas gangrene) - Hemolysis ("double zone" of hemolysis on blood agar)
36
Streptococcus pyogenes - Streptolysin O - Exotoxin A
Streptolysin O: degrades cell membrane --> Lyses RBC --> contributes to beta-hemolysis - Host Ab against toxin (ASO) used to dx rheumatic fever Exotoxin A: binds to MHC II and TCR outside of Ag binding site --> overwhelming release of IL-1, IL-2, IFN-gamma, TNF-alpha --> toxic shock syndrome
37
Staph aureus - Toxic shock syndrome toxin (TSST-1) - Exfoliative toxin - Enterotoxin
- TSST-1: binds to MHC II and TCR outside of Ag binding site --> overwhelming release of IL-1, IL-2, IFN-gamma, TNF-alpha --> toxic shock syndrome - Exfoliative toxin: scalded skin syndrome - Enterotoxin: food poisoning
38
Endotoxin
- Macrophage activation --> IL-1/6 (fever), TNF-alpha (fever and hypotension), NO (hypotension) - Complement activation --> C3a (HA release --> hypotension, edema), C5a (neutrophil chemotaxis) - Tissue factor activation --> coagulation cascade --> DIC
39
Catalase positive
Staph
40
Coagulase positive
Staph aureus
41
Novobiocin resistant
Staph saprophyticus
42
Novobiocin Sensitive
Staph epidermidis
43
Catalase negative
Strep
44
Alpha hemolytic | - Partial reduction --> greenish/brown w/o clearing around growth
Strep viridians, Strep pneumo
45
Optochin resistant
Strep viridans
46
Optochin sensitive
Strep pneumo
47
Beta hemolytic | - Complete lysis of RBCs --> clear area surrounding colony on blood agar
Strep agalactiae (Group B), Strep pyogenes (Group A), Staph aureus
48
Bacitracin resitatnt
Group B strep
49
Bacitracin sensititve
Strep pyogenes (Group A)
50
Staph aureus
- Protein A | - TSST-1 (superantigen), exfoliative toxin, enterotoxin
51
Most common cause of septic arthritis in adults
Staph aureus
52
Most common cause of osteomyelitis
Staph aureus
53
R sided (tricuspid) endocarditis in IV drug user
Staph aureus
54
Secondary pneumonia after influenza infection
Staph aureus
55
Staph epidermidis
Normal flora of skin Prosthetic devices and IV catheters BIOFILMS
56
Staph saprophyticus
Uncomplicated UTI in young sexually active women (2nd to E. coli)
57
Strep pneumo
Lancet-shaped diplococci Encapsulated IgA protease No virulence without capsule
58
Most common cause of meningitis
Strep pneumo
59
Most common cause of otitis media in children
Strep pneumo
60
Most common cause of pneumonia
Strep pneumo | - Rusty sputum
61
most common cause of sinusitis
Step pneumo
62
Strep pneumo vaccine
- Adults: polysaccharide w/o protein (23 valent) --> T cell independent --> IgM - Kids: conjugated to protein (7 valent) --> robust response of T cells and B cells --> IgG
63
Strep viridans
``` Dental caries (mutans and mitis) Subacute bacterial endocarditis at DAMAGED heart valves (sanguinis) Makes dextrans --> bind to fibrin-platelet aggregates on damaged heart valves ```
64
Strep pyogenes (Group A Strep)
``` PYR + M protein --> rheumatic fever ASO titer detects infection Pharyngitis --> rheumatic fever and PSGN Scarlet fever ```
65
Most common cause of erysipelas (rash)
Strep pyogenes
66
Acute Rheumatic Fever | - Strep pyogenes
Polyarthritis, carditis, subcutaneous nodules, erythema marginatu, sydenham chorea
67
Scarlet Fever | - Strep pyogenes
Blanching, sandpaper-like body rash Strawberry tongue Circumoral pallor Erythrogenic toxin +
68
Strep agalactiae (Group B Strep)
- Pneumonia, meningitis, & sepsis in babies - CAMP factor --> enlarges area of hemolysis formed by S. aureus - Hippurate test + - PYR+
69
Most common cause of neonatal meningitis
Strep agalactiae
70
Strep bovis
Subacute endocarditis | COLON CANCER
71
Enterococci
UTI, biliary tract infections, subacute endocarditis PYR + VRE --> nosocomial infections Ca grow in 6.5% NaCl and bile
72
Bacillus anthracis
Spore-forming rod Anthrax toxin Polypeptide capsule (D-glutamate) Cutaneous anthrax --> black eschar Pulmonary anthrax --> pulmonary hemorrhage, mediastinitis, shock (WOOL, GOAT HAIR) Edema factor --> increases cAMP --> inhibits phagocytosis Lethal factor --> protease --> cleaves MAPK --> tissue necrosis
73
Bacillus cereus
Reheated rice syndrome Spores Cereulide (preformed toxin)
74
Clostridium tetani | - PUNCTURE WOUND
Tetanospasmin --> blocks release of inhibitory GABA And glycine from Renshaw cells in spinal cord --> spastic paralysis Rx: antitoxin +/- vaccine booster, diazepam, wound debridement
75
Clostridium botulinum - Adults: improper food canning (preformed toxin) - Babies: honey (spores)
Produces heat-labile toxin (protease) that inhibits ACh release --> flaccid paralysis Rx: antitoxin
76
Clostridium perfringens - Motorcycle accidents - Penetrating wound form military combat
``` Alpha toxin (lecithinase) --> myonecrosis and hemolysis Spores in undercooked food --> heat-labile enterotoxin --> food poisoning (late onset) ```
77
Clostridium difficile - Clindamycin or ampicillin use - PPI use
Toxin A: enterotoxin --> binds to brush border of gut Toxin B: cytotoxin --> actin depolymerization --> cytoskeletal disruption --> diarrhea --> pseudomembranous colitis Dx: stool toxins via PCR Rx: metronidazole or oral vancomycin
78
Corynebacterium diptheriae
Exotoxin encoded by beta-prophage --> ADP-ribosylation of EF-2 --> inhibits protein synthesis Psuedomembranous pharyngitis Dx: metachromatic (blue and red) granules, Elek test+ (toxin) Black colonies on cystine-tellurite agar
79
Diphtheria vaccine
Toxoid | IgG response against exotoxin B
80
Listeria monocytogenes
Pregnant women Rocket tails - actin polymerization --> IC movement and cell-to-cell spread Tumbling motility Rx: ampicillin
81
Nocardia
Aerobe Acid fast Pulmonary infections (IC), cutaneous infections after trauma Rx: sulfonamides
82
Actinomyces
``` Anaerobe Oral/facial abscess Yellow sulfur granules PID w/ IUDs Rx: penicillin ```
83
Mycobacterium tuberculosis
Caseating granulomas with central necrosis and Langerhans giant cells Cord factor --> serpentine cord --> inhibits mac maturation, induces release of TNF-alpha Sulfatides --> inhibit phagolysosomal fusion Acid fast (mycolic acid) Lowenstein Jensen medium
84
Mycobacterium leprae
Cool temperatures Armadillo reservoir Lepromatous: low cell-mediated immunity, humoral Th2 response, numerous acid fast bacilli Tuberculoid: high cell-mediated immunity, largely Th1-type immune response, rare acid fast bacilli Rx: dapsone, rifampin, clofazimine
85
Utilizes maltose
N. meningitidis
86
Doesn't utilize maltose
N. gonorrhoeae | Moraxella
87
Grows in 42 C
Campylobacter jejuni
88
Grows in alkaline media
Vibrio cholerae
89
Produces urease
H. pylori
90
Fast lactose fermenter
Klebsiella E. coli Enterobacter
91
Slow lactose fermenter
Citrobacter | Serratia
92
H2S production on TSI agar
Salmonella | Proteus
93
Neisseria
VPN agar (Thayer Martin) Metabolize glucose Produce IgA protease Gonococci: IC (within neutrophils), no vaccine (Ag variation of pilus), Fitz-Hugh-Curtis Syndrome Meningococci: polysaccharide capsule, maltose fermenter, vaccine, Waterhouse-Friderichsen syndrome
94
Haemophilus influenze
IgA protease | Chocolate agar - V (NAD+), X (hematin)
95
Most common cause of mucosal infections (otitis media, conjunctivitis, bronchitis)
Nontypeable (unencapsulated) H. flu
96
Cause of epiglottitis | - drooling, inspiratory stridor
H. flu
97
Hib vaccine
Type b capsular polysaccharide + PRP conjugated to diptheria toxoid - Given between 2 and 18 mo
98
Bordatella pertussis
Pertussis toxin (disables Gi) Tracheal cytotoxin (cleaves cilia epi of resp tract) Whooping cough Vaccine (Tdap, DTap) Lymphocytic infiltrate from immune resopnse
99
Legionella pneumophila
``` Gram stains poorly - use silver stain Charcoal yeast extract medium with iron and cysteine Dx: Ag in urine HYPONATREMIA Water sources (AC) Pneumonia + diarrhea + hyponatremia ```
100
Legionnaires' Disease | - Legionella pneumophila
Sever pneumonia, fever, GI, and CNS sx | Smokers, chronic lung DZ
101
Pontiac Fever | - Legionella pneumophila
Mild flu-like syndrome
102
Pseudomonas aeruginosa
``` Non-lactose fermenting Pyocyanin (blue-green) Grape-like odor Endotoxin (fever, shock) Exotoxin A (inactivates EF-2) Phospholipase C (degrades cell membranes) Pyocanin (generates ROS) Mucoid polysaccharide capsule --> biofilm formation ```
103
Malignant otitis externa
Pseudomonas Can spread to mastoid, temporal bones Increased risk in elderly, IC, DM
104
Ostemyelitis in diabetics and IV drug users
Pseudomonas
105
Most common cause of respiratory failure in CF patients
Pseudomonas | Mucoid polysaccharide capsule --> biofilm formation
106
Burn patients
Pseudomonas
107
Hot tub folliculitis
Pseudomonas
108
Ecythema gangrenosum
Pseudomonas Rapidly progressive necrotic cutaneous lesion Seen in IC
109
Proteus mirabilis
Swarming motility Urease + --> staghorn struvite stones Fish odor
110
Helicobacter pylori
Flagellated Catalase +, oxidase +, urease + Dx: urea breath test, fecal antigen test Produces ammonia --> alkaline environment Colonizes stomach antrum Risk of gastric adenocarcinoma and MALT lymphoma
111
Leptospira interrogans
Spirochete | Water contaminated with animal urine
112
Leptospirosis | - Leptospira interrogans
Flue-like sx, myalgias (CALVES), jaundice, photphobia with conjunctival suffusion (erythema w/o exudate) Surfers and in tropics (Hawaii)
113
``` Weil Disease (Icterohemorrhagic Leptospirosis) - Leptospira interrogans ```
severe form with jaundice and azotemia from liver and kidney dysfunction, fever, hemorrhage, anemia
114
Borrelia burdorferi
``` Lyme DZ Vector: Ixodes deer tick Reservoir: mouse NE US Erythema migrans AV block Bells palsy Encephalopathy Chronic arthritis ```
115
Treponema pallidum
``` Painless chancre Dark field microscopy VDRL + Maculpapular rash on palms and soles Condyloma lata VDRL/RPR+, confirm with FTA-ABS Gummas Aortitis (vasa vasorum destruction) Neurosyphilis (tabes dorsalis) Argyll Robertson pupil Broad-based ataxia, + Romberg, Charcot joints ```
116
Congenital Syphilis
rhagades, snuffles, saddle nose, notched teeth, mulberry molars, short maxilla, saber shins, CNIII deafness
117
VDRL false positives
Viral infection Drugs Rheumatic fever Lupus and leprosy
118
Anaplasma spp.
``` Anaplasmosis Ixodes tick (live on deer and mice) ```
119
Bartonella spp.
Immunocompetent --> Cat scratch DZ --> fever, LAD (stellate granulomas w/ central necrosis) IC --> bacillary angiomatosis --> raised red vascular lesions
120
Borrelia recurrentis
Relapsing fever | Louse (variable surface Ag)
121
Brucella spp.
Brucellosis undulant fever --> organomegaly, osteomyelitis | Unpasteurized dairy, vets, ranchers, slaughter houses
122
Campylobacter
Bloody diarrhea | Feces from infected pets/animals, contaminated meats/foods/hands
123
Chlamydiophila psittaci
Psittacosis | Parrots, other birds
124
Coxiella burnetii
``` Q fever (no rash) Aerosols of cattle/sheep amniotic fluid ```
125
Eherlichia chaffeensis
Ehrlichiosis | Amblyomma (Lone Star tick)
126
Francisella tularensis
Tularemia Rabbits, ticks, deer flies Type IV HSN
127
Pasteurella multocida
Cellulitis, osteomyelitis Animal bite, cats, dogs Mouse like odor

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