XI - Other Bacteria Flashcards Preview

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Flashcards in XI - Other Bacteria Deck (173):
1

Zoonoses

Brucella abortus, Francisella tularensis, Yersinia pestis, Pasteurella multocida

2

Small gram (-) rods without a capsule, contaminated dairy, direct contact, undulating fever

Brucellosis

3

Brucellosis: Cow

B. abortus

4

Brucellosis: Dog

B. canis

5

Brucellosis: Goat/Sheep

B. melitensis

6

Brucellosis: Sheep

B. ovis

7

Brucellosis: Treatment

Doxycycline + Rifampin

8

Small gram (-) rods, reservoir - rabbits, deer, rodents, transmission - ticks (Dermacentor), aerosols, contact, ingestion

Francisella tularensis (Tularemia)

9

Francisella tularensis: Treatment

Streptomycin, Gentamicin

10

Most virulent bacteria

Yersinia pestis

11

Small gram (-) rods with bipolar (safety pin) staining, reservoir - rodents, transmission - flea bite, inhalation

Yersinia pestis

12

Buboes, cutaneous hemorrhage

Yersinia pestis

13

Bubonic, Pneumonic and Septicemic Plague

Yersinia pestis

14

Yersinia pestis: Treatment

Streptomycin, Tetracycline

15

Short encapsulated gram (-) rod that exhibits bipolar staining, buttery colonies with musty odor due to indole production, osteomyelitis, reservoir - cats and dogs, transmission - animal bites

Pasteurella multocida

16

Pasteurella multocida: Treatment

Penicillin G

17

Aerobic, acid-fast rods, Ziehl-Neelsen (hot), Kinyoun (cold), high lipid content, mycolic acids, wax D, produces catalase and niacin, slow-growing on Löwenstein–Jensen medium (1 mo.), luciferase assay for drug resistance

Mycobacterium tuberculosis

18

Mycobacterium tuberculosis: Location

lungs

19

Mycobacterium tuberculosis: Transmission

respiratory droplets from coughing

20

TB Virulence Factors: Prevents phagosome-lysosomal fusion

Exported Repetitive Protein (Sulfatides)

21

TB Virulence Factors: Most important VF, prevents leukocyte migration

Cord Factor

22

TB Virulence Factors: Elicits delayed hypersensitivity

Tuberculin Surface Protein (Purified Protein Derivative - PPD)

23

Mycobacterium tuberculosis: Lesions

exudative, granulomatous

24

Central area of Langhan's giant cells surrounded by a zone of epithelioid cells, tubercle is a granuloma surrounded by fibrous tissue that has undergone central caseation

Mycobacterium tuberculosis Granulomatous Lesions

25

TB Phase of Infection: Middle-lower lobes, subpleural granuloma, CLAD, radiologically detectable calcification

Primary Complex

26

TB: Subpleural Granuloma

Ghon's Focus

27

TB: Subpleural Granuloma + Associated LN

Ghon's Complex

28

TB: Radiologically Detectable Calcification

Ranke's Complex

29

TB Phase of Infection: Apices (Simon's Focus), cicatricial changes, subpleural blebs, cavitation, fibrosis, nodules, secondary colonization with A. fumigatus (fungus ball), pneumothorax

Reactivation TB

30

Reactivation TB: X-ray Findings

apices (Simon's Focus), cicatricial changes, subpleural blebs, cavitation, fibrosis, nodules

31

PPD: HIV (+), AIDS, old TB, immunosuppressed

> 5 mm

32

PPD: High-risk Population

> 10 mm

33

PPD: Low-risk Population

> 15 mm

34

TB: Spectrum of Disease

pulmonary TB, miliary TB, scrofula (CLAD), erythema nodosum, TB meningitis, spondylitis (Pott's), GI TB (ileocecal), renal TB, abdominopelvic TB

35

Cough ≥ 2 weeks ± local/constitutional symptoms

PTB Suspect

36

PTB: Local Symptoms

hemoptysis, chest pain, dyspnea

37

PTB: Constitutional Symptoms

night sweats, weight loss, anorexia, fever, chills, fatigue, malaise

38

Specimen: PTB

sputum AFB x 3

39

Specimen: TB Lymphadenitis

excisional biopsy

40

Specimen: TB Effusion

pleural fluid studies

41

Specimen: Genitourinary TB

urine AFB (PCR)

42

Specimen: Spinal TB (Pott's)

tissue biopsy

43

Specimen: Abdominal TB

barium studies (intestinal), CT (extraintestinal), peritoneal fluid studies (AFB, Q/Q)

44

Specimen: TB Meningitis

CSF studies (AFB, Q/Q)

45

Specimen: TB Pericarditis

pericardial fluid studies (AFB, Q/Q)

46

PTB Treatment: New smear (+), new smear (-) with extensive disease, new severe extrapulmonary TB

Category I - Initiation: 2 HRZE, Continuation: 4 HR

47

PTB Treatment: Sputum smear (+), relapse, treatment failure, defaulter

Category II - Initiation: 2 HRZES + 1 HRZE, Continuation: 5 HRE

48

PTB Treatment: New smear (-) other than Cat. I, new less severe extrapulmonary TB

Category III - Initiation: 2 HRZE, Continuation: 4 HR

49

Mycobacterium tuberculosis: Prevention

droplet precautions, BCG vaccine limits extent of disease

50

Uses of BCG (Bacillus Calmette-Guerin) Vaccine

TB prevention, urinary bladder CA treatment (intravesicular infusion)

51

Cause pulmonary disease in immunocompromised hosts (CD4 < 50)

Mycobacterium Avium-Intracellulare Complex (MAI/MAC)

52

Mycobacterium Avium-Intracellulare: Treatment

Azithromycin

53

Aerobic acid-fast rods, can't becultured in vitro (mouse footpad, armadillo)

Mycobacterium leprae (Hansen's coccus spirilly)

54

Mycobacterium leprae: Location

humans, armadillos

55

Mycobacterium leprae: Transmission

prolonged exposure to nasal secretion of patients with the lepromatous form

56

Leprosy: One or few lesions

Tuberculoid

57

Leprosy: Little tissue destruction

Tuberculoid

58

Leprosy: Few acid-fast bacilli

Tuberculoid

59

Leprosy: Low transmission rate

Tuberculoid

60

Leprosy: Cell-mediated response to M. leprae

Tuberculoid

61

Leprosy: Lepromin skin test (+)

Tuberculoid

62

Leprosy: Many lesions

Lepromatous

63

Leprosy: Marked tissue destruction

Lepromatous

64

Leprosy: Many acid-fast bacilli

Lepromatous

65

Leprosy: High transmission rate

Lepromatous

66

Leprosy: Reduced/Absent cell-mediated response to M. leprae

Lepromatous

67

Leprosy: Lepromin skin test (-)

Lepromatous

68

Hypopigmented plaques, thickened superficial nerves, significant anesthesia

Tuberculoid

69

Leonine facies, erythema nodosum leprosum

Lepromatous

70

Tender red nodules, humps on both shins, signals acute lepromatous leprosy flare-ups

Erythema Nodosum Leprosum

71

Leprosy: Treatment for Tuberculoid Form

Dapsone, Rifampin

72

Leprosy: Treatment for Lepromatous Form

Dapsone, Rifampin, Clofazimine

73

Leprosy: Treatment for Erythema Nodosum Leprosum

Thalidomide → Phocomelia

74

Anaerobe, normal oral flora, local trauma (broken jaw, dental extraction), hard, non-tender swelling, sinus tracts draining sulfur granules

Actinomyces israelii

75

Actinomyces israelii: Treatment

Penicillin G, drainage

76

Actinomycete, aerobic, filamentous gram (+) rods with aerial hyphae, weakly acid-fast (Fite-Faraco stain), inhalation of particles from soil, mycetomas, lung and brain abscesses (orange colonies)

Nocardia asteroides

77

Nocardia asteroides: Treatment

TMP-SMX, drainage

78

Smallest free-living organisms

Mycoplasma pneumoniae

79

No cell wall, only bacteria with cholesterol in cell membrane, Eaton's medium

Mycoplasma pneumoniae

80

Mycoplasma pneumoniae: Location

respiratory tract

81

Mycoplasma pneumoniae: Transmission

respiratory droplets

82

M. pneumoniae Virulence Factors: Attachment, inhibition of ciliary motion, necrosis

Toll-Like Receptor 2 Protein (P1 Adhesin)

83

M. pneumoniae Virulence Factors: Contributes to the damage to the respiratory tract cells

Hydrogen Peroxide

84

M. pneumoniae Virulence Factors: Autoantibodies against red cells and brain, lung and liver cells

Cold Agglutinins

85

Most common type of atypical pneumonia

Mycoplasma pneumoniae

86

"Walking Pneumonia" (clinical findings not compatible with x-ray), hemolysis, Stevens-Johnsons Syndrome, Raynaud's, Guillain-Barré Syndrome

Mycoplasma pneumoniae

87

Most common infectious cause of Stevens-Johnsons Syndrome

Mycoplasma pneumoniae

88

Mycoplasma pneumoniae: Treatment

Macrolides (Erythromycin, Azithromycin)

89

Mycoplasma pneumoniae: Resistance

Penicillins and Cephalosporins - does not have a cell wall

90

Coiled spirochete, too thin for Gram-stain, cannot be cultured in vitro due to absence of TCA cycle, microaerophilic

Treponema pallidum

91

Treponema pallidum: Location

genital tract

92

Treponema pallidum: Transmission

sexual contact, transplacental

93

Syphilis: Within hours, enters lymphatics and multiplies, local non-tender ulcer (chancre) in 2-10 weeks

Primary Syphilis

94

Syphilis: Condyloma lata, maculopapular rash (palms, soles), fever, headache, malaise, anorexia, lymphadenopathy, after 1-3 months from inoculation

Secondary Syphilis

95

Syphilis: Many years after inoculation, granulomas (gummas), neurosyphilis (tabes dorsalis, dementia paralytica), aortitis

Tertiary Syphilis

96

Tabes dorsalis presents with _____ which _____ but does not react.

Argyll Robertson pupil, accomodates

97

Obliterative invasion of small blood vessels and vasa vasorum by Treponema pallidum causing endarteritis

Syphilitic Aortitis

98

Syphilis: Snuffles, saddle nose, mulberry molars, Hutchinson triad, saber shins, rhagades (angle of mouth), Higoumenakis sign, Clutton's joints (synovitis), pulmonary hemorrhage

Congenital Syphilis

99

Syphilis: Hutchinson teeth, deafness, keratitis

Hutchinson Triad

100

Syphilis: Unilateral enlargement of the sternoclavicular portion of the clavicle → detachment

Higoumenakis sign

101

Most important diagnostic test for Primary Syphilis

dark-field microscopy

102

Secondary/Tertiary Syphilis: Diagnostic Tests

Screening - Rapid Plasma Reagin/Venereal Disease Research Laboratory (RPR/VDRL), Confirmatory - Fluorescent Treponemal Antibody-Absorption (FTA-ABS)

103

Causes for False (+) VDRL Results

Viruses (EBV, Hepatitis), Drugs (Marijuana), Rheumatic fever, Rheumatic arthritis, Lupus, Leprosy

104

Syphilis Diagnostic Test: Most specific, earliest positive, remains positive longest

Fluorescent Treponemal Antibody-Absorption (FTA-ABS)

105

Syphilis: Treatment

Benzathine Penicillin G

106

Influenza-like symptoms a few hours after receiving penicillin due to lysis of treponemes

Jarisch-Herxheimer Reaction

107

Syphilis: Prevention

condoms, post-exposure antibiotics, serologic follow-up

108

Weakly staining gram (-) spirochetes, largest medically important bacteria, aniline dye (Giemsa or Wright), BSK medium

Borrelia burgdorferi

109

Borrelia burgdorferi: Location

white-footed mouse, white-tailed deer

110

Borrelia burgdorferi: Transmission

bite from deer ticks (Ixodes scapularis)

111

Borrelia burgdorferi: Disease

Lyme Disease

112

Lyme Disease Stages: Erythema Chronicum Migrans (target lesion)

Stage 1

113

Lyme Disease Stages: Myocarditis (AV block), meningitis, Bell's palsy

Stage 2

114

Lyme Disease Stages: Autoimmune migratory polyarthritis (onion skin lesions), acrodermatitis chronica atrophicans (skin atrophy - hands)

Stage 3

115

Borrelia burgdorferi: Treatment for Early Localized or Disseminated Disease

Doxycycline, Amoxicillin, Cefuroxime

116

Borrelia burgdorferi: Treatment for Late Disease

IV Penicillin, IV Ceftriaxone

117

Borrelia burgdorferi: Prevention

insecticides, insect repellants on clothing, protective clothing that reduces exposure of skin to insects

118

Relapsing fever from rapid antigenic changes due to programmed rearrangements of surface protein DNA

Borrelia recurrentis

119

Borrelia recurrentis: Transmission

human body louse (Pediculus humanus)

120

Borrelia recurrentis: Diagnostic Test

microscopy

121

Borrelia recurrentis: Treatment

Tetracycline, Erythromycin

122

Thin, coiled spirochetes, hook at one or both ends (Shepherd's crook), obligate aerobe (only aerobic spirochete), Ellinghausen-McCullough-Johnson-Harris (EMJH) or Fletcher's medium

Leptospira interrogans

123

Leptospira interrogans: Location

wild and domestic animals

124

Leptospira interrogans: Transmission

animal urine (dogs, livestock, rats), wading in floodwaters

125

Leptospires penetrate intact mucous membranes or skin through small cuts or abrasions, multiply rapidly and damage endothelium of small blood vessels, early - blood & CSF, late - urine, immune complex-mediated meningitis and glomerulonehritis

Leptospira interrogans

126

Leptospira interrogans: Diagnostic Tests

EMJH/Fletcher's medium (+) after 2 weeks, Leptospire Microscopic Agglutination Test (Lepto-MAT) - gold standard

127

Leptospira interrogans: Incubation Period

2-20 days

128

Leptospirosis Phases: Fever, chills, intense headache, calf tenderness, conjunctival suffusion

Acute Leptospirosis

129

Leptospirosis: Cause of Calf Tenderness

rapid multiplication of leptospires in muscles with high oxygen

130

Leptospirosis: Cause of Conjunctival Suffusion

damaged and leaky conjunctival vessels, painful and itchy but with minimal tearing

131

Leptospirosis Phases: Aseptic meningitis, pulmonary involvement, hepatic necrosis, glomerulonephritis

Immune Leptospirosis

132

CSF pleocytosis ± meningeal symptoms, coincides with appearance of leptospire antibody titers

Aseptic Meningitis (Leptospira interrogans)

133

Snow-flake lesion on CXR

Leptospira interrogans

134

Leptospirosis: Cause of Glomerulonephritis

immune-complex deposition

135

Most severe form of leptospirosis

Weil Syndrome

136

Leptospirosis Phases: Jaundice, bleeding, uremia, orange cast skin (severe jaundice)

Weil Syndrome

137

Weil Syndrome: Triad

bleeding, uremia, orange cast skin (severe jaundice)

138

Weil Syndrome: Most common cause of death

respiratory failure from massive pulmonary hemorrhage

139

Leptospirosis: Treatment

Penicillin G

140

Leptospirosis: Prevention

Doxycycline chemoprophylaxis, vaccination of domestic livestock and pets, rat control

141

Obligate intracellular bacteria, energy parasites that use host ATP, cell wall lacks muramic acid, grows in cyclohexamide culture, cytoplasmic inclusion bodies (Giemsa)

Chlamydia trachomatis

142

Chlamydia trachomatis Forms: Inactive, extracellular, enters cells by endocytosis, infectious

Elementary Body

143

Chlamydia trachomatis Forms: Metabolically active, intracellular, seen microscropically, replicates via binary fission

Reticulate Body

144

Chlamydia trachomatis: Location

genital tract, eyes

145

Chlamydia trachomatis: Transmission

Sexual contact, passage through birth canal, hand-eye contact

146

Most common STD overall

Chlamydia trachomatis

147

Balance reached between host and parasite resulting in prolonged persistence of infection despite high antibody titers

Chlamydia trachomatis

148

C. trachomatis types A-C, chronic keratoconjunctivitis leading to scarring and blindness, Halberstädter-Prowazek inclusion bodies

Trachoma

149

Most common infectious cause of blindness

Chlamydia trachomatis

150

Round to oval cytoplasmic inclusion bodies near the nuclei of conjunctival epithelial cells in trachoma

Halberstädter-Prowazek inclusion bodies

151

C. trachomatis types D-K, NGU (Non-gonococcal Urethritis) in males, PID in females, co-infection with gonorrhea, neonatal conjunctivitis and pneumonia, Reiter's Syndrome

Chlamydia GUT Infection

152

C. trachomatis types D-K, late-onset (2-4 weeks), striking tachypnea, paroxysmal cough (staccato cough), absence of fever, eiosinophilia

Chlamydia Neonatal Pneumonia

153

C. trachomatis types L1-L3, papule or vesicular which ulcerates and leads to suppurative inguinal lymphadenitis (buboes), (+) Frei test (intradermal injection of antigen)

Lymphogranuloma Venereum

154

Atypical pneumonia similar to Mycoplasma pneumoniae, associated with atherosclerosis

Chlamydia pneumoniae

155

Bird exposure (bird fancier's disease - parrots, parakeets, macaws, cockatiels), sudden onset pneumonia, malaise fever, anorexia, sore throat, photophobia, severe headache

Chlamydia psittaci

156

Chlamydia: Treatment for STD

Azithromycin

157

Chlamydia: Treatment for Conjunctivitis

Erythromycin

158

Chlamydia: Treatment for Lymphogranuloma Venereum

Doxycycline

159

Chlamydia: Treatment for Psittacosis

Azithromycin

160

Cell wall resembles that of gram (-) rods, stain poorly with Gram-stain, obligate intracellular parasites (unable to produce sufficient energy to replicate extrecellularly), grown in cell culture, embryonated eggs, experimental animals, divide by binary fission within host cell

Rickettsiae

161

Detected using Weil Felix reaction (cross-reaction with antigens of OX strains of Proteus vulgaris)

Rickettsiae

162

Rickettsiae: Treatment

Doxycycline

163

Rocky Mountain Spotted Fever: Rash starts in _____ and spreads _____

wrist, centripetally

164

Rickettsia Typhus: Rash starts in _____ and spreads _____

trunk, centrifugally

165

Rickettsia: Q fever is Queer because

no rash, no vector, (-) Weil-Felix reaction, not obligate intracellular, does not have Rickettsia in genus name (Coxiella burnetti)

166

Diseases with Palm and Sole Rash

Coxsackievirus Type A (hand, foot & mouth disease), Rocky Mountain Spotted Fever, Syphilis

167

Cat-scratch disease, gram (-) rod, normal oral flora of cats, cat bite/scratch, cat-scratch fever (immunocompetent), bacillary angiomatosis (immunocompromised)

Bartonella henselae

168

Dogs, morulae in cytoplasm of monocytes, dog tick (Dermacentor) bite

Ehrlichia chaffeensis

169

Facultative gram-variable rod, clue cells (squamous cells attahced to bacteria, (+) whiff test (fishy odor with KOH), malodorous vaginal discharge (white, milk-splattered)

Gardnerella vaginallis

170

Small gram (-) rod, culture on chocolate agar with heme (factor X), painful genital ulcer (chancroid)

Haemophilus ducreyi

171

Mesenteric adenitis (pseudoappendicitis), gram (-) rods, domestic animals, oro-fecal transmission

Yersinia enterolitica

172

Granuloma inguinale (Donovanosis), encapsulated, pleomorphic, gram (-) bacillus, bipolar densities (Donovan bodies) that look like closed safety pins, small painless papule ulcerates to form beefy red ulcer with velvety surface, pseudobuboe formation

Klebsiella granulomatis

173

Klebsiella granulomatis: Treatment

Azithromycin