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Microbio Flashcards

1
Q

peptidoglycan function and structure

A
  • protects against osmotic pressure

- sugar backbone with peptide side chains cross-linked by transpeptidase

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2
Q

periplasm is the location for what?

A

hydrolytic enzymes, including b-lactamases

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3
Q

Unique to gram (-) or gram (+)

A

gram (+): lipoteichoic acid

gram (-): porins, endotoxin/LPS (outer membrane), periplasmic space

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4
Q

Special cultures (H. flu, N. gonorrhoeae, Legionella)

A

H flu - chocolate agar (requires factors X hematin and V NAD+)
N gonorrhoeae - Thayer-Martin ( Very Typically Cultures Neisseria - vanc + trimethoprim + colistin + nystatin)
Legionella - charcoal yeast

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5
Q

Aerobes - Nagging Pests Must Breathe

A

Require O2 to generate ATP

Nocardia, Pseudomonas, MycoBacterium tb

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6
Q

Anaerobes - Frankly Can’t Breathe Air

A

normal in GI tract, can’t use aminoglycosides (which require O2 to enter cell)

Fusobacterium, Clostridium, Bacteroides, Actinomyces

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7
Q

Encapsulated bacteria (SHiNE SKiS)

A

Strep pneumo, H. flu, N. meningitidis, E. coli, Salmonella, Klebsiella, group b Strep

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8
Q

Bacterial virulence proteins - Protein A, IgA protease, Protein M

A

Protein A - binds Fc region of IgG, Staph aureus
IgA protease - cleaves IgA, SHiN (S. pneumo, H. flu, N.m)
Protein M - prevent phagocytosis by decreased activation of alternate complement pathway, group A strep

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9
Q

ENDOTOXIN

A 
Edema
Nitric Oxide
DIC/Death
Outer membrane
TNF-a
O-antigen
eXtremely heat stable
IL-1
Neutrophil chemotaxis
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10
Q

Gram-positive algorithm

A

bacilli vs. cocci
catalase + (clusters) –> coagulase
catalase - (chains) –> hemolysis
then sensitivities (coag -: novobiocin, cat -/a-hemolytic: optochin, cat-/B-hemolytic: bacitracin)

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11
Q

Strep bovis (bovis in the blood = ?)

A

Group D strep

Bovis in the blood = cancer in the colon

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12
Q

Diphtheria ABCDEFG

A 
ADP-ribosylation
B-prophage
Corynebacterium
Diphtheriae
Elongation Factor-2
Granules (intracellular, polyphosphate)

Gram positive rod

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13
Q

Clostridia toxins (Gram positive rod)

A

tetani - cleave SNARE proteins, block release of NTs (spastic paralysis)
botulinum - block Ach release (floppy baby)
perfringens - alpha toxin = lecithinase - phospholipid breakdown (also, myonecrosis by collagen breakdown)
dificile - toxin A: enterotoxin. Toxin B: cytotoxin (depolymerizes actin filaments) (pseudomembranous colitis)

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14
Q

Listeria bacteria features

A

facultative intracellular Gram positive rod
rocket tails - actin polymerization, rapid movement
neonatal meningitis!
grows at 4 degrees (contaminates refrigerated food, food = most common transmission)

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15
Q

Leprosy (mycobacterium)

A
  • cool temperature distribution (glove and stocking)
  • tx: dapsone and rifampin
  • lepromatous: low immunity (Th2)
  • tuberculoid: high immunity (Th1)
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16
Q

Gram-negative algorithm

A

diplocoi vs. coccoid rods vs. cocci

  • maltose fermentation vs. not
  • lactose fermentation or not
  • oxidase + (pseudomonas) vs. not
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17
Q

Lactose fermenters (Klebsiella and E. coli)

A

MacConkey’s agar

Lactose is key with MacConKEY’s agar

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18
Q

Neisseria gono vs. mening

A

GoNO - no polysaccharide capsule, no maltose fermentation, no vaccine, FHC syndrome
Mening - maltose fermentation, W-F syndrome

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19
Q

H. flu leads to what?

hEMOPhilus

A 
haEMOPhilus causes:
Epiglottitis
Meningitis
Otitis media
Pneumonia
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20
Q

Legionella

A

use silver stain on charcoal culture with iron and cysteine (silver helmet over campfire with iron dagger - not a sissy!)

aerosol transmission

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21
Q

Pseudomonas is associated with what?

A 
PSEUDDO
Pneumonia
Sepsis
otitis Externa
UTIs
Drugs/Diabetes
Osteomyelitis

think pseudomonas in burn victims!
exotoxin A -

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22
Q

E. coli subtypes (I, T, P, H)

A

EIEC: invasive
ETEC: enteroToxins, Traveler’s (watery, heat-stable vs. heat-labile)
EPEC: Pediatrics
EHEC: O157:H7, Shiga-toxin, HUS (anemia, thrombocytopenia, renal failure due to damaged endothelium)

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23
Q

Klebsiella (4A’s)

A

Aspiration pneumonia
Abscesses (lung/liver)
Alcoholics
diAbetics

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24
Q

Campylobacter

A

Bloody diarrhea
Gullain-Barre
reactive arthritis (arthritis, conjunctivitis, urethritis)
Undercooked meat!

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25
Cholera mechanism
Enterotoxin that permanently activates Gs, causing increased cAMP activity
26
Leptospirosis (surfers, tropics)
flu-like symptoms myalgias (calves!) jaundice photophobia
27
Lyme symptom progression (FACE)
early - flu-like, classic rash, facial nerve palsy (bilateral) later - arthritis, AV nodal block, neurologic Lyme pie to the FACE: Facial nerve palsy, Arthritis, Cardiac block, Erythema migrans
28
False positives on VDRL
Viruses Drugs Rheumatic fever Lupus/leprosy
29
Animal transmission
cat scratch - Bartonella armadillo - leprosy dog tick - rickettsia (RMSF) sheep amniotic fluid - Coxiella (Q fever)
30
Gardnerella
bacterial vaginosis clue cells KOH whiff test
31
Palms and soles rash
CARS Coxsackie A RMSF Syphillis
32
E's and R's of chlamydia
Elementary body is enfectious, enters cell through Endocytosis Reticulate body Replicates in cell by fission, Reorganizes into elementary bodies for spread to other cells Reactive arthritis - uveitis/conjunctivitis, arthritis, urethritis
33
Chlam subtypes
ABC - Africa, blindness, chronic infection | D-K - everything else!
34
High titer of cold agglutinins (IgM)
Mycoplasma pneumoniae X-ray is worse than patient antigenic similarity with RBCs, so immune response destroys RBCs! no cell wall
35
Systemic Mycoses (HBCP)
Histo - hides within macrophages Blasto bus broadly Coccidio crowds (spherule filled with spores) Paracoccidio parasails with captain's wheel to Latin America
36
Tinea versicolor mechanism
degradation of lipids produces acids that damage melanocytes and cause hypopigmentation
37
Opportunistic fungal infections (6 total)
Candida - superficial or systemic (no pulm involvement) Aspergillus - invasive; ABPA (asthma and CF, look for eosinophilia); aspergilloma (post-TB infection). A for Acute Angles in Aspegillus. Cryptococcus - heavily encapsulated, latex agglutination (polysaccharide capsular antigen test) Mucor/Rhizopus - rhinocerebral, frontal lobe abscess, CST Pneumocystis - diffuse ground-glass opacities, disc-shaped yeast Sporothrix - ascending lymphangitis (rose in the pot)
38
GI protozoa
Giardia - foul-smelling, fatty Entamoeba - liver abscess (anchovy paste), RBCs in cytoplasm, cysts with 4 nuclei Cryptosporidium - severe diarrhea in AIDS
39
CNS protozoa
Toxo - congenital (chorioretiniti, calcifications, hydrocephalus), AIDS (brain abscess) Naegleria - rapidly fatal, freshwater lakes Trypanosoma brucei (African sleeping) - lymph nodes, recurring fever, somnolence. "Sure is nice to sleep with Melatonin" tx = suramin, melarsoprol
40
Heme protozoa
Malaria (Plasmodium) - fevers are 48 hrs apart in vivax/ovale, look for spots in RBCs, quinidine = watch for G6PDH def.! Babesia - same tick as Lyme, hemolytic anemia, Maltese cross in RBC, predilection for asplenia!
41
Other protozoa
``` Chagas dz (trypanosoma cruzi) - dilated cardiomyopathy + achlasia/megacolon + unilateral periorbital swelling, kissing bug feces Leishmaniasis - sandfly, fevers/HSM/pancytopenia ```
42
Trichomonas (what does cervix look like?)
strawberry cervix, foul-smelling, treat pt and partner!
43
roundworm treatment (pinworms, hookworms, etc.)
Bendazoles are bendy for intestinal infection
44
Biliary tract dz -cholangiocarcinoma (parasite)
Clonorchis sinensis (undercooked fish), pigmented gallstones
45
Brain cysts/seizures (parasite)
Taenia solium (cysticercosis) when eggs are ingested
46
Hematuria, bladder SCC (parasite), less likely =
Schistosoma haematobium, lives in snails!
47
Liver hydatid cysts (parasite)
Echinococcus (dog feces, sheep, kill daughter cysts before removal with ethanol)
48
Microcytic anemia (parasite)
Ancylostoma (blood sucker!)
49
Myalgias (parasite)
Trichinella (undercooked meat)
50
Perianal pruritis (parasite)
Enterobius (pinworm)
51
Portal hypertension (parasite)
Schistosoma mansoni, schistosoma japonicum
52
Vitamin B12 deficiency (parasite)
Diphyllobothrium latum (raw freshwater fish)
53
``` Match the food to the bug Rice Canned food/honey Undercooked meat Poultry/meat/eggs Meats/mayonnaise Seafood ```
``` Rice - bacillus cereus Canned food/honey - C. botulinum Undercooked meat - E. coli Poultry/meat/eggs - Salmonella, Campylobacter Meats/mayonnaise - Staph aureus Seafood - Vibrio ```
54
HIV + diseases
<100: Aspergillus (pleuritic pain), Crypto (meningitis), Candida (esophagitis), CMV (retinitis, colitis, enceph), EBV (oral hairy leukoplakia, B-cell lymphoma), Histo (const. sx), MAC (non-specific sx)
55
Three prion diseases
CJD: rapidly progressive dementia Bovine spongiform encephalopathy: mad cow disease Kuru: human cannibalism
56
Diarrhea etiologies
Bloody: Campy, Enteamoeba, EHEC, EIEC, E. coli, Salmonella, Shigella, Yersinia Watery: Clostridium (diff/perf), ETEC, Giardia/Crypto, Vibrio, Rota/Noro/Adeno
57
Special pneumonia groups (alcoholics, atypical, CF)
Alcoholics: Klebsiella Atypical: Mycoplasma, Legionella, Chlam CF: Pseudomonas, S. aureus
58
Brain abscess
Viridans strep Staph aureus Toxo reactivation
59
Osteomyelitis special risk factors (generally S. aureus, except...)
Sickle cell - Salmonella, S. aureus Vertebral involvement - M. tuberculosis Cat/dog bites - Pasteurella
60
UTI bugs
E. coli - green metallic sheen on EMB agar Staph sapro Klebsiella - + urease test
61
Congenital infections (ToRCHeS)
Toxo - chorioretinitis, hydrocephalus, intracranial calcs Rubella - PDA, cataracts, deafness CMV - hearing loss, seizures, petechial rash HSV-2 - encephalitis Syphilis - facial abnormalities
62
Red rashes of childhood
Coxsackie Type A - HFM dz HHV-6 (roseola) - fever followed by rash Measles (rubeola) - 3 C's, descending rash Rubella - post-auricular adenopathy, descending rash Strep pyogenes - scarlet fever, sandpaper-like rash VZV - lesions of different ages
63
Random bug hints asplenia, branching rods, chronic granulomatous dz, currant jelly sputum, dog/cat bite, health care provider, neutropenia, organ transplant, PAS +, palms/soles rash, surgical wound, traumatic open wound
``` SHiN - strep pneumo, H. flu, Neisseria Actinomyces (oral infections) catalase + (S. aureus, Burkholderia) Klebsiella Pasteurella HBV Candida, Aspergillus CMV Tryponema Whipplei CARS: coxsackie A, Rickettsia, Syphillis Staph aureus Pseudomonas ```

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