What is the most common cause of UTI?
E. Coli
Most common cause of infant meningitis?
E. Coli
What infection is caught from raw milk and is especially dangerous for pregnant women and newborns?
Listeria
What is the route of transmission of Yersinia Pestis?
Rat-Flea-man
What bacteria is associated with buboes?
Yersinia Petis
What bacteria(s) causes severe gastroenteritis and can be caught from shellfish?
Yersinia enterocolitica, Vibrio parahemolyticus, and salmonella typhi
What bacteria causes pneumonia in immuno-compromised patients?
Klebsiella pneumoniae
What red colored organism causes UTI in debilitated patients?
Serratia
Which of the following is NOT a lactose fermenter? Proteus, E. Coli, Klebsiella, Enterobacter, or Serriatia?
Proteus
Which bacteria that produces urease is often associated with UTI especially after catherization?
Proteus
Which species causes thyphoid fever?
Salmonella typhi
What species causes thyphus?
Rickettsia Prowazeki
What organism can exist chronically in the gallbladder?
Salmonella typhi
What organism causes rose colored spots on the abdomen, high fever, and possible perforation of the abdomen?
Salmonella typhi
What organism, having many animal reservoirs produces endotoxin and is a common cause of food poisoning in the US?
Salmonella enterides
Salmonella choleosius carries what 3 things?
pneumonia, osteomyelitis, and meningitis
What causes bacillary dysentry?
Shigella dysenteriae
What gram + cocci is catalase +?
Staph Aureus
What gram + cocci is catalase - ?
Strep
Compare salmonella and staph food poisoning in terms of incubation and explain why?
Staph: 4-8 hours b/c it produces exotoxin.
Salmonella: 10-28 hours b/c the cells have to die and start producing endotoxin.
What organism causes boils, carbuncles, and impetigo?
Staph Aureus
Two possible organisms of impetigo are?
Staph Aureus, Strep Pyogenes (group A, Beta hemolytic)
What type of toxin is responsible for the scalded skin syndrome of staph aureus infection?
Exfoliatin
True or False: Staph aureus can be killed with penicilin, if not why?
False, b/c it secretes penicillinase which destroys penicillin
What organism is associated with toxic shock syndrome? (TSS)
Staph Aureus
The calalase test is diagnostic for what organism?
Staph Aureus
What organism has hemolysis as a diagnostic feature?
Streptococcus
What organism is responsible for scarlet fever?
Strep pyogenes
What is an important sequelae to know about strep?
Rheumatic fever and acute glomerulonephritis
What is the Jones criteria for rheumatic fever?
J: joints–polyarthritis
How do we know if someone has had a recent S. pyogenes infection?
ASO titer will be increased
True or false: Strep pyogenes is Bacitracin sensitive?
True
What antibodies are produced in S. pyogenes infection?
antibodies to protein M. (enhances the host’s defense but can give rise to rheumatic fever)
Glomerulonephritis can follow what infection?
Strep.
In what type of strep infection is the the capsule pathogenic?
Strep pneumonaie
How does gonorrhea usu. present in males?
urethritis, purulent discharge
how does gonnorrhea present in females and what are the complications?
Usu. asx, complications are PID or salpingitis (leads to scarring and infertility)
What STI grows on Thayer-Martin agar in CO2?
Neisseria gonorrhea
Which STI is oxidase positive?
Neisseria gonorrhea
Patient comes in with a fever, N/V, stiff neck, and petichiae what is the likely dx?
Neisseria meningitidis infection
What disease can you get from home canned products?
Clostridium botulinum
What type of paralysis is associated with C. Botulinum?
Descending flaccid paralysis
What organism causes gas gangrene?
Clostridium perfringens
People who handle livestock are susceptible to what kind of infection?
Bacillus anthracis
What is a complication of diptheria
Respiratory paralysis and death
Corynebacterium diptheriae has what kind of throat infection? (what do you see?)
pseudomembranous pharyngitis- gray-ish white membrane.
Clostridium tetani causes what kind of paralysis?
spastic paralysis
Rice water stools is associated with what type of infection?
Vibrio cholera
What organism is associated with hot tubs and can cause folliculitis?
Pseudomonas
What is a common cause of OM in children, and can cause meningitis and pneumonia?
Hemophilus influenza
What causes a chancroid?
hemophilus ducreyi
What SDT has a painful ragged ulcer?
hemophilus ducreyi
what can be diagnosed with clue cells from a wet prep?
Gardnerella (H. vaginalis)
What organism grow around staph aureus on agar plate?
Hemophilus influenza
what causes whooping cough?
Bordatella pertussis
Rabbit fever is caused by what organism?
Francisella tularensis
What is tularemia spread?
Infected ticks
what disease is walled off in the body by granulomas?
mycobacterium tuberculosis
what is the skin test for TB called?
Mantoux skin test
what is the immunization of TB called
BCG
how is brucella transmitted?
Raw milk (unpasteurized dairy products)
How is TB transmitted
by respiratory droplets
what kind of immune response does the body have to TB?
cell mediated response, no antibodies are involved.
what is the TB infection that has spread to the blood called?
Milary TB
what are the two types of leprosy?
Lepromatous (diffuse over skin- low humoral Th2 response) and tuberculoid (limited patches, Th1 response) leprosy
What type of leprosy is less infectous and has lost of bacteria present?
Lepromatous leprosy
Which type of leprosy is associated with defective cellular immunity?
Lepromatous leprosy
What organism is cultured in armadillos?
mycobacterium leprae
The chancre, a bulls eye lesion, is associated with what disease?
Syphillis - Treponema pallidum
what kind of organism causes Lyme disease and syphilis?
a spirochete
when is syphilis infectious?
primary and esp. secondary infections
the mucocutaneous lesion of syphlilis is found in what phase?
secondary
the gummas (chronic granulomas) are found in what stage of syphilis?
tertiary
what is Hutchinson’s triad and what is it caused by?
Congenital syphilis and has impaired vision, notched teeth, and impaired hearing.
Yaws is caused by what?
Treponema pallidum pertenue (a tropical infection of the skin, bones and joints )
What are some of the lab tests done for syphillis?
serological (non-speicific–i.e screening) VDRL/RPR, specific/dx: FTA-abs,
what does treponema vincentii cause?
Trench mouth
what organism causes “glue” ear
hemophilus influenza
what organism has a blue-green pigment and is associated with skin and esp. burn infections?
Pseudomonas aeriginoas
what is the vector for lyme disease?
deer tick
what disease has a spreading circular lesion called erythema chronicum migrans?
lyme disease
Lyme disease closely parallels what other disease in its 1, 2, and 3 sx?
syphilis
what organism causes infectious jaundice?
leptospira interrogans
what causes rate bite fever?
spirillum
what organism contrated from raw milk causes bloody diarrhea and can mimic appendicitis? (esp in children)
Campylobacter jejuni
what organism is implicated in causing gastritis and peptic ulcers?
helicobacter pylori
what organisms is a common antecedent to Guillain-Barre syndrome and reactive arthritis?
Campylobacter jejuni (fecal-oral, transmission through food)
what causes walking pneumonia?
mycoplasma pneumonia
What is special about mycoPLASM species?
They have no cell wall and are therefore resistant to penicillin.
what sexually transmitted organism requires cholestrol and urea?
ureaplasma
Ureaplasma causes what type of infection?
non-gonoccocal urethritis
what species of organisms are transmitted by arthropods?
Rickettsiae (obligate intracellular organism)
what causes epidemic typhus?
Rickettsiae prowazeki
what causes endemic typhus?
Rickettsiae typhi
Ricketsiae typhi affect which types of cell?
endothelial cells
what is the vector for Rickettsiae prowazeki?
the louse
what is the vector for rickettsiae typhi?
the flea
what is the only rickettsial disease with no vector?
Q-fever- Coxiella burnetti
What are some sx of typhus?
macular rash, high fever, acute bacteremia
What is the organism responsible for rocky mountain fever?
Rickettsia Rickettsii
How is Rocky mountain spotted fever transmitted?
the tick
What STI is associated with conjunctivitis and blindness?
Chlamydia trachomatis
what disease is associated with standing water, e.g. air condition systems?
Legionella pneumophila
what disease is associated with birds?
Chlamydia psittici
What fungus-like bacteria can mimic TB?
Norcardia
What causes lumpy jaw?
Actinomyces
What is the common name for Coccidodies immitis
Valley fever
what does chlamydia cause?
conjunctivitis, urethritis, cervicitis, salpingitis, lymphogranuloma venerum
What is the most common cause of epididymitis in men?
chlamydia trachomatis
Parrot fever is the common name for what disease?
Chlamydia Psittici
What is the name for trench fever?
Rochalimaea quintana
how do yeast reproduce?
budding
how do molds reproduce?
by forming tubular structures. Dormant as spores.
what fungi is associated with bat and bird feces?
histoplasma capsulatum — > histoplasmosis
what large encapsulated yeast is commonly found in soil and pigeon droppings?
cryptococcus neoformans
what type of lesions are associated with cryptococcus neoformans? where are they?
“soap bubble” lesions in the brain
C. Neoformans stains with India ink, what is it cultured on?
Sabouraud agar
what organism causes status asthmaticus, associated with asthma and cystic fibrosis?
Aspergilus fumigatus
what is the medical name for ring worm?
Tinia corporis
how is tinea diagnosed?
KOH wet mount
What causes jock itch?
tinea cruris
what opportunistic yeast commonly affects immunocompromised patients?
Candida albicans
what causes amoebic dysentry?
entamoeba histolytica
what causes beaver disease?
giardia lamblia
which of the following do NOT cause bloody diarrhea?
- Shigella dysenteriae
- Campylobacter jejuni
- Giardia Lamblia
- Entamoeba
giardia lamblia
which parasite interferes with fat absorption?
Giardia lamblia
True or false: trichomonas has NO cysts?
true
pneumocystis carnii is a problem for what kind of patient?
immunocompromised
who is as risk for an infection of toxoplasma gondii
pregnant women
what parasite is associated with cats?
toxoplasma gondii
what is the common name for Ascaris lumbricoides?
human round worm
what is the common name for Necato americanus
hookworm
what parasite causes spoon nails, anemia and stunted growth?
hookworm
what parasite can be contracted from pork or bear meat?
trichinella spiralis
what is the vector for malaria?
mosquito
what does plasmodium species of parasites cause?
malaria
how is filariasis transmitted?
mosquito
what causes elephantitis?
filariasis
schistosomata is associated with what reservoir?
snails
taenia is associated with what animals?
pigs and cows
what type of parasite is taenia solium
tapeworm (ingestion of larvae from under cooked pork)–can cause brain cysts and seizures (cysticercosis)
Clonorchis is what type of parasite?
liver fluke– from undercooked fish– biliary tract inflammation, associated with cholangiocarcinoma
Diphyllobothrium latum is what kind of parasite?
fish tapeworm (ingestion of larvae from freshwater fish– depletes Vitamin B12)
What type of parasite is a schistosome
a blood fluke
what population is most affected by pneumocystis jirovecii?
immunosuppressed–eg. AIDs pts
what does pneumocystis jirovecii cause?
pneumocystis pneumonia, a diffuse interstitial pneumonia
What types of stools are seen in giardiasis?
fatty stools (other sx: bloating, flatulence, foul-smelling fatty diarrhea)
What type of discharge is seen in trichomonas vaginalis?
foul-smelling greenish discharge, also itching and burning
what does Wuchereria bancrofti cause?
blocks lymphatic vessels– elephantitis. Transmitted by a female mosquito.
Major cause of acute diarrhea in the US during winter, and most important global cause of infantile GE?
Rotavirus: dsRNA virus.
German measles is caused by what virus?
Rubella virus- togavirus. (3 day measles) mild children’s disease by serious congenital dz.
Myocardial dz is most commonly caused by what type of organism?
Virus: Coxsackie-B, Flu, CMV, ECHO
What bacteria can cause myocarditis?
Staph, strep, corynebacterium diptheria.
What parasites can cause myocarditis?
toxoplasmosis, trypansosoma cruzi, trichinosis
What is Rickettsial myocarditis?
Typhus, rocky mountain spotted fever, flabby ventricular myocardium, 4 chamber dilation, endocardium and valves unaffected, mb asx or get CHF.
what happens when salicylates are given during viral illness?
Reye’s syndrome (link to aspirin)
What are the most common potential complications of Reyes syndrome?
encephalopathy and liver damage
what age group is most affected by HAV?
children
how is HAV transmitted?
fecal oral route
what immunoglobulin arises early in HAV infection?
IgM
what is the incubation period for HAV?
3-4 weeks
what sx are common in early HAV?
fever, jaundice, nausea
What are some other signs of HAV infection
dark colored urine, clay colored stools, elevation of liver serum enzymes
what are the 3 known methods for contracting HBV?
blood, perinatally, sexual contact
what is the incubation period for HBV?
10-12 days
what sx commonly occur ins HBV?
fever, fatigue, nausea, jaundice w/hepatomegally, arthralgia, arthritis
what serum antigen tends to rise 1-6 weeks before clinical sx of HBV?
HBsAg (surface antigen)
what serum antigen of HBV occurs during active infection?
HBeAg (e antigen)
what serum antibody against HBV appears weeks after recovery?
Anti-HBsAb (anti-surface antibody)
What serum antibody against HBV appears at onset of clinical sx or suggests a past infection?
Anti-HBcAb (anti-core antibody)
what serum antibody against HBV suggests low risk of infectivity and shows good chance of avoiding chronic liver disease?
Anti-HBeAb (anti-e-antibody)
why does HBV have a potential carrier state?
viral DNA is integrated in the chromosome of host cells
what population has a high rate of hepatitis C infection?
IV drug users and transfusion/blood product recipients prior to 1992.
the delta particle is associated with what disease?
Hepatitis D
What is the transmission route for each type of viral hepatitis?
HAV: fecal oral (food and water) HBV: sexual, parenteral, blood HCV: blood (major), sex (low risk) HDV: need to have hep B, blood, sex, needles, parenteral HEV: fecal oral (contaminated water)
what type of hepatitis virus occurs with another hep infection
hep D requires concurrent infection with hep B
what types of hepatitis may progress to chronic hepatitis?
hep B and C
what is the most common cause of transfusion mediated hepatitis?
hep C
alcoholic hepatitis involves what changes in the liver
infiltration of neutrophils, focal liver cell necrosis, presence of mallory bodies, fatty changes in the liver, fibrosis leading to central venous obstruction
what is the most common cause of opportunistic infections?
candida albicans
what pathologies is candida responsible for?
diaper rash, oral thrush, candidal esophagitis, “yeast infections” and endocarditis of tricuspid valve (in drug users)
Does candida change the pH of the vaginal secretions?
No, remains normal at
what factors predispose someone to a candidal infection?
being diabetic, antibiotic use, oral contraceptive use, IV drug use, AIDs/immunocomp, sterroid use, heat and humidity.
what is the geographical location associated with histoplasmosis?
midwest, central US, mississippi -ohio river valley
what is the geographical location associated with blastomycosis?
southern and eastern US, great lakes, ohio river valley, extends to the east coast
what is the geographical location associated with coccidiomycosis?
southwest US
Bird, bad droppings, cave or chicken coup (farmers) are associated with what systemic fungi?
histoplasmosis
What unique feature of histoplasmosis is found in the immunocomp?
hepatosplenomegly
how does blastomycosis present in the immunocomp?
pneumonia that spreads to skin (ulcers) and bones (osteomyelitis)
how does coccidiomycosis present in the immunocomp?
in the skin, lungs (pneumonia), bones, and meningitis
Erythema nodosum is a major feature of what fungi?
Coccidiomycosis (major) also histoplasmosis
what is the geographical location associated with paracoccidiomycosis?
south america
what are the unique features of paracoccidiomycosis?
Lymphadenopathy and mucocutaneous lesions (ulcers of the mouth and lungs)…also granulomas (not unique)
In general fungi are dimorphic… what are their forms?
Mold in the cold , Yeast in the heat
Candida is catalase neg?
False, it is catalase +
Aspergillus fumigatus is catalase +?
True, it is catalase +
What toxin is associated with Aspergilus flavus?
Aflatoxin, it is carcinogenic: Hepatocellular carcinoma
How is infection of aspergillus fumigatus transmitted?
forms conidophores w/fruiting bodies that are released into the air–> inhaled
what 3 infections are associated with aspergillus fumigatus?
Allergic bronchopulmonary aspergillosis, Aspergillomas (associated w/TB cavities), and Angioinvasive aspergillosis (in immunocomp)
What is the main virulence factor for cryptococcus neoformans?
heavy encapsulation: repeating polysaccharide capsule, helps it avoid phagocytosis
Where would you find cryptococcus neoformans?
in soil and pigeon droppings
How is cryptococcus neoformans transmitted?
inhalation–> lungs–> desseminates
What is unique feature of cryptococcus neoformans?
Urease + (minor detail but distinguishes it from other fungi)
What is the most common cause of fungal meningitis?
cryptococcus neoformans
what is most fungi cultured on ?
Sabourad agar (this method takes a long time so not used often for dx)
cryptococcus neoformans causes what gross pathology in the brain?
soap bubble lesions in the gray matter
what stain is used for CSF with cryptococcus neoformans?
India ink – see wide capsular halos
what 3 things might you see with a cryptococcus neoformans infection?
fever, pneumonia, meningitis
what is the major predisposing factor for a mucormycosis infection?
Diabetic ketoacidosis (DKA)
Where does mucormycosis proliferate once the spores have been inhaled?
in blood vessel walls
what type of branching does mucormycosis hyphae have?
non-septate and wide angle branching (90 deg)
what type of branching does aspergillus fumigatus have?
septate acute angle branching
what severe pathology is associated with mucormycosis?
frontal cortex abscesses, necrosis of eye and nose tissue ( invades the cribiform plate and penetrates the brain)
what population is at risk of mucormycosis infection?
Immunocomp: especially: diabetics, leukemia, and neutropenia
A pt with HIV, pneumonia, and CD4 count under 200 is likely to have
pneumocystis pneumonia
Pneumocystis pneumonia is caused by what?
pneumocystis jiroveci
what stain is used to diagnose pneumocystis pneumonia
methanamine silver stain
what are some of the AIDS defining fungal infections
Candida (CD4
Name the 3 types of dermatophytes?
Trichophyton, epidermophyton, microsporum
Where do dermatophytes live?
on the skin, rarely invade other tissues
Where do you find tinea capitis?
head and scalp
where do you find tinea corporis
the body
where do you find tinea cruris
groin, aka jock itch
where do you find tinea pedis?
feet, akak athletes foot
what is it called when dermatophytes invade the nails?
onychomycosis
how are dermatophytes dx?
hyphae on KOH skin scraping
What can woods lamp detect?
only microsporum type
what fungi causes hypo or hyper pigmented patches and is non pruristic (usu on the back and chest)?
Malassezia furfur– causes pityriasis versicolor
what layer of the skin does malassezia furfur invade?
stratum corneum
how does mycobacterum tuberculosis stain?
acid fast (dt mycolic acids in cell wall)
what medium is used for culturing mycobacterium tuberculosis?
Lowenstein-Jensen medium
how is TB transmitted?
respiratory droplets
What are the two main virulence factors for TB?
cord factor (elicits granuloma formation by inc TNFa), and sulfatides (prevent phagolysosome fusion allowing TB to survive in macrophages)
Where in the lungs would a primary TB infection be?
middle or lower lobes
where in the lungs would a reactivated TB infection be?
upper lobes
what type of granulomas does TB make/
caseating granulomas
T/F: TB is an obligate aerobe
true
that 3 things would cause a + TB skin test?
primary infection, latent infection, or having had the BCG vaccine
what is the name of the calcified tissue and hilar LNs after a primary TB infection?
Ghon complex
what is the most lethal type of TB?
Miliary TB- spread to blood and can affect any organ
In what population is TB reactivated?
immunocomp, only in 5-10% of latent infections
What is the method of TB reactivation?
by down regulation of TNFa (which is proinflammatory- maintains the containment of TB in granulomas)
what are the classic sx of reactivation of TB?
cough, night sweats, hemoptysis
What are some systemic pathologies of reactivated TB?
skeletal: POTS (damage to bones), CNS: meningitis or tuberculoma (cavitating lesion)
Klebsiella, enterobacter, and serratia cause what pathologies?
pneumonia and UTI, **cause nosocomial infections
Klebsiella, enterobacter, and serratia use what culture medium? what color are they?
Pink on MacConkey agar
of Klebsiella, enterobacter, and serratia, which ones are motile?
Enterobacter and Serratia are motile. Klebsiella is immotile
What color is serratia when cultured?
Red
What population is associated with klebsiella?
alcoholics
What bacteria causes a currant jelly sputum?
klebsiella
what does klebsiella cause?
Pneumonia, UTI, abscesses and aspirations
What are the virulence factors for klebsiella?
Urease + and polysac capusule
What agar is a Salmonella cultured on, what color is it?
Black colonies on Hektoen agar (H2S +)
is salmonella mobile?
yes
What kind of person is suscetible to salmonella?
those with low stomach acid- salmonella is acid labile so normally would not survive (would need low stomach acid or high dose)
What is the #1 cause of osteomyelitis in sickle cell dz?
Salmonella typhi
What is the main reservoir of salmonella enteritidis?
Chickens- eating undercooked chickens
main virulence factor for salmonella enteritidis?
Type III secretion system
Is Salmonella an intracellular aerobe?
no its a facultative intracellular but in macrophages only.
What medium is used to culture shigella, what color are the colonies?
Green colonies on Hektoin agar
what type of bacteria is shigella?
gram negative, acid stable, immobile, causing bloody diarrhea, facultative intracellular
What pathology can Shigella dysenteriae cause in children?
Shiga toxin –>HUS (hemolytic uremic syndrome)–acute renal failure, endothelial injury leading thrombocytopenia (thrombi in microcirculation)
what is the mechanism of Shigga toxin?
binds to 60S subunit of ribosome and inhibits translation
What toxin causes necrosis in an C. Perfingens infections?
alpha toxin (causes hemolysis)
Infection of C. perfringens is associated with what accidents?
motorcycle and military (exposure to dirt and soil in wounds- spore former)
Can C. Perfringens cause late onset infection?
yes, from ingested spores can germinate and create toxin that causes watery diarrhea
c. perfringens is an obligate aerobe?
No, it isn an obligate anaerobe, likes the non -oxygenated environment of wounds.
how is C. diptheriae transmited?
respiratory droplets
what major pathology can C. diptheriae cause if it enters the blood ?
life threatening Myocarditis. cardiotoxic (myocarditis, arrhythmias, heart block )
what media is used to culture C. diptheraie?
Tellurite and loeffler’s media
what type of response is seen with the toxoid vaccine for diptheria, tetanus and pertussis?
IgG (inactive exotoxin bound to a protein to increase immunogenicity)
What gram + bacteria causes “bulls neck”?
clostriudium Diptheriae
how does C. diptheriae stain?
metachomatic granules, stain with anilline dyes
Main virulence factors for C. diptheriae?
Exotoxin A and B: inhibits elongation factor 2 to inhibit protein synthesis.
what type of infeciton does C. Difficle cause?
nosocomial diarrhea (infects those with disrupted flora- i.e taking antbiotics or immunocomp…in hospitals)
all clostridium species are obligate anaerobes?
True! (spore formers)
what bacteria causes pseudomembranous colitis?
C. Difficile
what bacteria causes rust-colored sputum?
Strep pneumoniae (lobar pneumonia of the lower lobes)
What clinical infections can Strep pneumo cause?
most common for all MOPS: meningitis, otitis media, pneumonia, sinusitis
what inhibits the growth of strep pneuo on culture?
optochin (sensitive)
what is the main virulence factor for strep pneumoniae?
poly sac capsule
Strep Agalactiae is part of what group of strep?
Group B strep
what population does Strep agalactiae (GBS) infect?
newbornes, babies
what test distinguishes Strep agalactiae (GBS) from other species of strep?
CAMP Test
what test distinguishes strep pneumo from strep viridans?
Strep agalactiae (GBS) is beta hemolytic, viridans is alpha hemolytic (partial)
what is the number 1 cause of meningitis in neonates?
strep agalactiae (GBS)
Would bacitracin stop Strep agalactiae (GBS) from growing on culture?
no , it is bacitracin resistant
what bacteria is associated with dental caries?
Strep viridans
What can strep viridans cause in those with damaged heart valves?
Subacute endocarditis is mitral valves. (mitral valves are most likely to be damaged)
what bacteria grow on chocolate agar?
Haemophilus influenzae and Neisseria meningitidis
