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605 Cards in this Set
- Front
- Back
Peptidoglycan:
1. Function 2. chemical composition |
1. Support, protection against osmotic pressure
2. Sugar backbone with cross linked peptide side chains |
|
Cell Wall (gram positive):
1. function 2. chemical composition |
1. major surface antigen
2. peptidoglycan for support. Teichoic acid induces TNF and IL-1 |
|
Outer membrane (gram negative):
1. Function 2. Chemical composition |
1. Site of endotoxin (lipopolysac), major surface antigen.
2. Lipid A induced TNF and IL-1, polysacc is the antigen. |
|
Plasma membrane:
1. function 2. chem composition |
1. site of oxidative and transport enzymes
2. lipoprotein bilayer |
|
Periplasm
1. function 2. chem composition |
1. space between cytoplasmic membrane and outer membrane in gram negative bacteria.
2. contains beta-lactamases |
|
Capsule
1. function 2. chem composition |
1. protects against phagocytosis
2. polysaccharide (except Bacillus anthracis, which contains D-glutamate) |
|
1. Pilus- composition?
2. Flagellum- composition? |
1. glycoprotein
2. protein |
|
Spore
1. function 2. chem composition |
1. resistance to dehydration, heat, chemicals
2. keratin-like coat, dipicolinic acid |
|
plasmid
1. function 2. chem composition |
1. genes for antibiotic resistance, enzymes, toxins
2. DNA |
|
Glycocalyx
1. function 2. chem composition |
1. adherence to surfaces, especially foreign (catheters)
2. polysaccharide |
|
Circular bacteria, gram positive
(2) |
Staph
Strep |
|
Circular bacteria, gram negative
(1) |
Neisseria
|
|
Rods, gram positive
(5) |
Clostridium
Corynebacterium Bacillus Listeria Mycobacterium (acid fast) |
|
Rods, gram negative enterics
(13) |
E Coli
Shigella Salmonella Yersinia Klebsiella Proteus Enterobacter Serratia Vibrio Campylobacter Helicobacter Pseudomonas Bacteriodes |
|
Rods, gram negative, non enterics
(9) |
Haemophilus
Legionella (silver) Bordetella Yersinia Francisella Brucella Pasteurella Bartonella Gardnerella |
|
Branching filamentous
(2) |
Actinomyces
Nocardia (weakly acid fast) |
|
Pleomorphic bacteria
(2) |
Rickettsiae
Chlamydiae (giesma) |
|
Spirochetes
(3) |
Leptospira
Borrelia (giesma) Treponema |
|
Bacteria without a cell wall
(1) |
Mycoplasma (sterols)
|
|
Bacteria with abnormal cell membrane/wall content:
(2) |
1.Mycoplasma- sterols, no wall
2.Mycobacteria- mycolic acid, high lipid content |
|
Poor gram staining bacteria:
These Rascals May Microscopically Lack Color |
1.Treponema (too thin, darkfield and flourescent antibody staining)
2. Rickettsia (intracellular parasite) 3. Mycobacteria (high lipid = needs acid fact stain) 4. Mycoplasma (no wall) 5. Legionella pneumophila (intracellular, silver stain) 6. Chlamydia (intracellular, lacs muramic acid in wall) Mycoplasma |
|
Giesma stain
(4) |
Borrelia
Plasmodium Trypanosomes Chlamydia |
|
PAS (periodic acid-Schiff)
(1) |
Whipple's
(stains glycogen, mucopolysaccharides) |
|
Ziehl-Neelsen
|
Acid-fast bacteria
|
|
India Ink
|
Cryptococcus neoformans
|
|
Silver stain
|
Legionella
Fungi |
|
Media used to isolate:
H. influenzae |
Chocolate agar with factors V (NAD) and X (hematin)
|
|
Media used to isolate:
N. gonorrhoeae |
Thayer Martin media
|
|
Media used to isolate:
B. pertussis |
Bordet-Gengou (potato) agar
|
|
Media used to isolate:
C. diphtheriae |
Tellurite plate
Loffler's media |
|
Media used to isolate:
M. tuberculosis |
Lowenstein-Jensen agar
|
|
Media used to isolate:
M. pneumoniae |
Eaton's agar
|
|
Media used to isolate:
E. coli |
Eosin-methylene blue agar
|
|
Media used to isolate:
lactose fermenting enterics |
MacConkey's agar - pink colonies
|
|
Media used to isolate:
Legionella |
Charcoal yeast extract agar buffered with iron and cysteine
|
|
Media used to isolate:
Fungi |
Sabouraud's agar
|
|
Obligate aerobes:
Nagging Pests Must Breathe |
Nocardia, Pseudomonas, Mycobacterium tuberculosis, Bacillus
(M. tb has a predilection for the apices of the lungs, which have the highest P02). |
|
Obligate anaerobes:
Can't Breathe Air |
Clostridium
Bacteroides Actinomyces (lack catalase and/or superoxide dismutase) |
|
Obligate Intracellular bacteria:
Really Cold |
Rickettsia
Chlamydia (can't make own ATP) |
|
Intracellular bacteria:
Some Nasty Bugs May Live FacultativeLY |
Salmonella
Neisseria Brucella Mycobacterium Listeria Francisella Legionella Yersinia |
|
Encapsulated bacteria:
Some Nasties Have Kapsules |
Streptococcus pneumoniae
Neisseria meningitidis Haemophilus influenzae Klebsiella pneumoniae (positive quellung reaction, polysaccharide capsule is antiphagocytic) |
|
Urease positive bugs:
Particular Kinds Have Urease |
Proteus
Klebsiella H. pylori Ureaplasma |
|
Pigment producing bacteria
|
Staph aureus- yellow
Pseudomonas- blue green Serratia marcescens- red |
|
S. aureus virulence factor
|
Protein A
binds Fc region of Ig disrupts opsonization and phagocytosis |
|
S. pneumoniae virulence factor
|
IgA protease
cleaves IgA |
|
H. influenzae virulence factor
|
IgA protease- cleaves IgA
|
|
Neisseria virulence factor
|
IgA protease- cleaves IgA
|
|
Strep pyogenes (Group A) virulence factor
|
M protein- prevents phagocytosis
|
|
Source of exotoxin
|
Certain gram positive and gram negative
|
|
Source of endotoxin
|
Outer cell membrane of most gram neg and Listeria
|
|
Secreted from cell:
Exotoxin or endotoxin? |
Exotoxin
|
|
Exotoxin composition
|
polypeptide
|
|
Endotoxin composition
|
Lipopolysaccharide (structural part of bacteria, released when lysed)
|
|
Location of exotoxin genes
|
Plasmid or bacteriophage
|
|
Location of endotoxin genes
|
bacterial chromosome
|
|
endotoxin clinical effects
|
fever, shock through release of TNF and IL-1
|
|
which is more toxic? endotoxin or exotoxin
|
exotoxin- fatal dose on the order of 1 microgram vs. endotoxin- 100 micrograms
|
|
which is more antigenic? endotoxin or exotoxin
|
exotoxin- induces high titer antibodies called antitoxins
(endotoxin is poorly antigenic) |
|
Vaccines: endotoxin vs exotoxin
|
Endotoxin: no vaccine
Exotoxin: toxoid used as vaccine |
|
which is more heat stable? endotoxin vs exotoxin
|
endotoxin
|
|
Typical diseases caused by exotoxin?
(3) |
Tetanus
Diphtheria Botulism |
|
Typical diseases caused by endotoxin?
|
Meningococcemia, sepsis by gram-negative rods
|
|
What do superantigens do?
|
Bind directly to MHC II and T cell receptor simultaneously, activating T cells to release IFN-gamma an IL-2
|
|
S. aureus superantigen
|
TSST-1 causes toxic shock syndrome (fever, rash, shock)
|
|
Other S. aureus toxins (besides superantigen)
(2) |
enterotoxin (food poisoning)
exfoliatin (scalded skin syndrome) |
|
S. pyogenes superantigen
|
Scarlet fever-erythrogenic toxin (toxic shock)
|
|
Explain ADP ribosylating A-B toxins
|
Interfere with host cell function. B (binding) component binds to a receptor on surface of host cell, enabling endocytosis. A (active) component that attaches an ADP-ribosyl to a host cell protein, altering protein function
|
|
Exotoxin examples
|
Superantigens
ADP ribosylating AB toxins |
|
What has ADP ribosylating AB toxins?
(4) |
1. Corynebacterium
2. Vibrio cholerae 3. E coli 4. Bordetella pertussis |
|
C. diptheriae exotoxin
|
adp ribosylation inactivates elongation factor 2, causes pharyngitis and pseudomembrane
|
|
Vibrio cholerae exotoxin
|
adp ribosylates G protein which stimulates adenylyl cyclase, increases Cl- into gut and decreases Na+ absorption.
|
|
E coli exotoxin:
Labile like the Air Stabile like the Ground |
1. heat labile toxin stimulates adenylate cyclase
2. heat stable toxin stimulates guanylate cyclase * both cause watery diarrhea. |
|
Bordetella pertussis exotoxin
|
increases cAMP, causes whooping cough, inhibits chemokine receptor, causing lymphocytosis
|
|
Clostridium perfringens toxins
|
alpha toxin causes gas gangrene, get double zone of hemolysis on blood agar
-also beta toxin |
|
C. tetani toxin
|
blocks the release of inhibitory neurotransmitters GABA and glycine
|
|
C. botulinum toxin
|
blocks the release of acetylcholine- causes anticholinergic symptoms, CNS symptoms, etc
|
|
Bacillus anthracis toxin
|
Edema factor is an adenylate cyclase
|
|
Shigella toxin
|
Shiga toxin cleaves host cell rRNA, enhances cytokine release, causing HUS
|
|
S. pyogenes toxin
|
Streptolysin O is a hemolysin
Antigen for ASO antibody, used to dx rheumatic fever |
|
cAMP inducers
(4) |
1. Vibrio- activates Gs, turns the "on" on.
2. Pertussis- inactivates Gi, turns the "off" off. 3. E coli heat labile toxin 4. B anthracis edema factor is an adenylate cyclase which increases cAMP. |
|
1. What is endotoxin?
2. What does endotoxin activate (3 main things)? |
1. A Lipopolysaccharide found in cell wall of gram neg bacteria
2. activates macs, activates complement, activates hageman factor |
|
Endotoxin activates macrophages, which release what?
|
IL-1: fever
TNF: fever, hemorrhagic tissue necrosis Nitric oxide: hypotension (shock) |
|
Endotoxin activates complement, which release what?
|
C3a: hypotension, edema
C5a: neutrophil chemotaxis |
|
Endotoxin activates hageman factor, which activates what?
|
Coagulation cascade -> DIC
|
|
The Bacterial growth curve:
What is going on in the lag phase? |
metabolic activity without division
|
|
The bacterial growth phase:
What's going on in the log phase? |
Rapid cell division
|
|
Aaaaggghhhh!
|
I'm bored of micro already and I have at least 30 more pages of First Aid. Help :(
|
|
The bacterial growth phase:
What is going on in the stationary phase? |
Nutrient depletion slows growth. Spore formation in some bacteria.
|
|
What is transformation?
|
DNA is taken up directly from environment by prokaryotic and eukaryotic cells.
|
|
What is F+ x F- conjugation?
|
F+ plasmid contains genes required for conjugation process. Bacteria without plasmid are termed at F-. Plasmid is replicated and transferred through pilus from F+ cell. No transfer chromosomal genes.
|
|
What is Hfr x F- conjugation?
|
F+ plasmid can be incorporated into bacterial chromosomal DNA, termed Hfr. Replciation of incorporated plasmid DNA may include some of the flanking chromosomal DNA. Transfer of plasmid and chromosomal genes.
|
|
What is generalized transduction?
|
Lytic phage infects bacterium, leading to cleavage of bacterial DNA and synthesis of viral proteins.
|
|
What is specialized transduction?
|
Lysogenic phage infects bacterium, viral DNA is incorporated into bacterial chromosome. When phage DNA is excised, flanking bacterial genes may be excised with it.
|
|
What is transposition?
|
Segment of DNA can jump from one location to another, can transfer genes from plasmid to chromosome and vice versa.
|
|
Genes for which 5 bacterial toxins are encoded in a lysogenic phage?
ABCDE |
Shig-A
Botulinum Cholera Diphtheria Erythrogenic toxin of S. pyogenes |
|
Gram positive cocci, catalase +
|
Staphylococcus
|
|
Gram positive cocci, catalase -
|
Streptococcus
|
|
Gram positive rods
|
Clostridium (anaerobe)
Corynebacterium Listeria Bacillus |
|
Gram positive cocci, catalase +, coagulase +
|
S aureus
|
|
Gram positive cocci, catalase +, coagulase -, novobiocin sensitive
|
S epidermidis
|
|
Gram positive cocci, catalase +, coagulase -, novobiocin resistant
|
S saprophyticus
|
|
Gram positive cocci, catalase -, complete hemolysis (beta), bacitracin sensitive
|
S. pyogenes (group A)
|
|
Gram positive cocci, catalase -, complete hemolysis (beta), bacitracin resistant
|
S. agalactiae (group B- babies)
|
|
Gram positive cocci, catalase -, partial hemolysis (alpha, green), positive quellung, optochin sensitive, bile soluble
|
S pneumoniae
|
|
Gram positive cocci, catalase -, partial hemolysis (alpha, green), optochin resistant, not bile soluble
|
Viridans streptococci
(S mutans) |
|
Gram positive cocci, catalase -, no hemolysis/gamma hemolysis
|
Enterococcus (E. faecalis)
Peptostreptococcus (anaerobe) |
|
alpha hemolytic bacteria -green
|
s pneumoniae
viridans streptococci |
|
beta hemolytic bacteria -clear
|
s aureus
s pyogenes s agalactiae listeria monocytogenes (tumbling motility) |
|
What does catalase do?
|
degrades H2O2, an antimicrobial product of PMNs. Staphylococci make catalase, streptococci do not.
|
|
S. aureus virulence factor
|
Protein A
binds Fc IgG, inhibiting complement fixation and phagocytosis |
|
S. aureus inflammatory diseases
|
skin infections
abscesses pneumonia |
|
S. aureus toxin-mediated diseases
|
1. toxic shock (TSST-1)
2. scalded skin syndrome (exfoliative toxin) 3. rapid onset food poisoning (enterotoxins) |
|
MRSA infection
|
Resistant to beta lactams due to altered penicillin binding protein
|
|
S. epidermidis
|
prosthetics
catheters normal skin flora |
|
Streptococcus pneumoniae causes what?
(MOPS) |
Meningitis
Otitis media (kids) Pneumonia Sinusitis others: rusty sputum, sepsis in sickle cell anemia and splenectomy |
|
Streptococcus pneumoniae characteristics
|
encapsulated
IgA protease |
|
Viridans group stretococci causes what?
|
dental caries
subacute bacterial endocarditis |
|
Viridans group stretococci characteristics
|
alpha hemolytic
normal flora of oropharynx optochin resistant |
|
S. pyogenes: pyogenic causes
|
pharyngitis
cellulitis impetigo |
|
S. pyogenes: toxigenic causes
|
scarlet fever
toxic shock syndrome |
|
S. pyogenes: immunologic causes
|
rheumatic fever
acute glomerulonephritis |
|
S pyogenes characteristics
|
bacitracin sensitive
M protein (host antibodies to M protein can cause rheumatic fever) |
|
How do you detect a recent S pyogenes infection?
|
ASO titer
|
|
Rheumatic fever:
PECCS |
Polyarthritis
Erythema marginatum Chorea Carditis Subcutaneous nodules |
|
S. agalactiae (group B) characteristics
|
Bacitracin resistant
Beta hemolytic |
|
S. agalactiae (group B) causes what?
|
pneumonia
meningitis sepsis (mainly in babies) |
|
Enterococci characteristics:
E. faecalis E. faecium |
penicillin G resistant
grows in 6.5% NaCl lives in intestine variable hemolysis |
|
Enterococci causes what?
|
UTI
subacute endocarditis VRE cause nosocomial infections |
|
Lancefield group D
|
includes enterococci and nonenterococcal group D streptococci.
grouping is based on differences in C carbohydrate cell wall. |
|
Streptococcus bovis
|
associated with colon cancer
a group D streptococci |
|
Corynebacterium diphtheriae exotoxin
|
encoded by beta prophage
inhibits protein synth via ADP ribosylating EF-2 |
|
C. diphtheriae causes what?
|
pseudomembranous pharyngitis (grayish white membrane)
lymphadenopathy |
|
How is C. diph. diagnosed?
|
Gram positive rods with metachromatic granules,
Loffler's media tellurite plate |
|
Bacterial spores: characteristics
|
formed by certain gram pos rods
at end of stationary phase dipicolinic acid in their core no metabolic activity killed by autoclave |
|
Which bacteria produce spores found in the soil?
|
B. anthracis
C. perfringens C. tetani |
|
What other bacteria produce spores (not found in soil)?
|
B. cereus
C. botulinum |
|
Clostridia characteristics
|
gram pos
spore forming obligate anaerobes |
|
C. tetani exotoxin
|
blocks glycine release (inhibitory neurotransmitter) from Renshaw cells in spinal cord
|
|
C botulinum toxin
|
heat-labile, preformed
inhibits ach release at nm junction (adults: ingestion of preformed toxin, babies: spores from honey) |
|
C. perfringens toxin
|
alpha toxin (lecithinase)
causes myonecrosis (gas gangrene) causes hemolysis |
|
C difficile toxin
|
cytotoxin (exotoxin)
kills enterocytes causes pseudomembranous colitis (secondary to clindamycin or ampicillin) |
|
C diff treatment
|
metronidazole
|
|
Bacillus anthracis characteristics
|
gram positive
spores rod produces anthrax toxin protein capsule (D-glutamate) |
|
B. antracis causes what?
|
1. Contact->
Black skin lesion: malignant papule (painless ulcer) covered by black eschar, can lead to bacteremia and death 2. Inhalation of spores-> Woolsorter's disease: flu-like that progresses to fever, pulm hemorrhage, mediastinitis, shock |
|
Listeria monocytogenes characteristics
|
1. ingest unpasteurized milk/cheese, deli meat
2. vaginal transmission during birth 3. form "actin rockets" = tumbling motility 4. gram pos bacteria with endotoxin! |
|
Listeria monocytogenes causes what in pregnant women?
|
amnionitis
septicemia spontaneous abortion |
|
Listeria monocytogenes causes what?
|
granulomatosis infantiseptica
neonatal meningitis meningitis in immunocompromised, elderly |
|
Actinomyces:
A. israelii |
gram pos
branching filaments yellow sulfur granules anaerobe normal oral flora |
|
A. israelii causes what?
|
oral/facial abscesses that drain through sinus tracts in the skin
|
|
Nocardia asteroides
|
gram pos
weakly acid fact aerobe found in soil |
|
Nocardia causes what?
|
pulmonary infection in immunocomp. patients
|
|
Treatment: Nocardia vs. Actinomyces
|
SNAP:
Sulfa for Nocardia Actinomyces uses Penicillin |
|
Primary TB (nonimmune host, usually child)
|
Hilar nodes
Ghon focus, lower lobes = Ghon complex |
|
Secondary TB (partially immune hypersensitized host, usually adult)
|
fibrocaseous cavitary lesion, upper lobes
|
|
Primary TB --> heals by fibrosis --> ?
|
immunity and hypersensitivity --> tuberculin positive
|
|
Primary TB --> ? (in cases of HIV or malnutrition)
|
progressive lung disease --> death
|
|
Primary TB --> severe bacteremia--> ?
|
miliary TB --> death
|
|
Primary TB --> preallergic lymphatic or hematogenous dissemination -->?
|
dormancy in several organs --> reactivation as adult -->extrapulmonary TB
|
|
Extrapulmonary TB
|
1. CNS- parenchymal tuberculoma or meningitis
2. Pott's disease (vertebral body) 3. Lymphadenitis 4. Renal 5. GI |
|
Secondary TB --> ?
|
Reactivation in lungs --> extrapulmonary TB
|
|
PPD+ means what?
|
current infection
past exposure BCG vaccinated |
|
PPD- means what?
|
no infection
anergic (steroids, malnutrition, immunocompromised, sarcoidosis) |
|
Mycobacterium tuberculosis causes what symptoms?
|
fever
night sweats weight loss hemoptysis |
|
M. kansasii
|
pulmonary TB-like symptoms
|
|
M. avium-intracellulare
|
resistant to multiple drugs
disseminated disease in AIDS |
|
Characteristics of Mycobacterium
|
acid-fast
|
|
Mycobacterium leprae characteristics
|
acid-fact
bacillus likes cold temps (superficial nerves, skin) cannot be grown in vitro armadillos |
|
Leprosy treatment
|
long term oral dapsone
toxicity: hemolysis, methemoglobinemia other treatment: rifampin, clofazimine/dapsone |
|
M. leprae causes what symptoms?
|
loss of eyebrows
nasal collapse lumpy earlobe |
|
Hansen's disease
|
2 forms:
1. lepromatous (worse, failed cell mediated immunity) 2. tuberculoid (self limited) |
|
Gram - cocci
|
Neisseria meningitidis
N. gonorrhoeae |
|
Gram - cocci, maltose fermenter
|
N. meningitidis:
IgA protease capsule vaccine |
|
Gram - cocci, maltose nonfermenter
|
N. gonorrhoeae
IgA protease neonatal conjunctivitis |
|
Gram -, coccoid rods
|
Haemophilus influenzae
Pasteurella- animal bites Brucella Bordetella pertussis |
|
Gram - rods, lactose fermenters, fast fermenters:
(3) |
Klebsiella
E Coli Enterobacter |
|
Gram - rods, lactose fermenters, slow fermenters:
(2) |
Citrobacter
Serratia |
|
Gram - rods, lactose fermenters:
CEEKS |
Citrobacter
E Coli Enterobacter Klebsiella Serratia |
|
Gram - rods, lactose NON fermenters, oxidase -:
(4) |
Shigella
Salmonella Proteus Yersinia |
|
Gram - rods, lactose NON fermenters, oxidase +:
(1) |
Pseudomonas
|
|
Gram - rods, lactose NON fermenters, oxidase -:
ShYPS |
Shigella
Yersinia Proteus Salmonella |
|
lactose fermenting enteric bacteria
|
grow pink colonies on MacConkey's agar
|
|
Gram - bugs: resistance
|
benzylpenicillin G
vancomycin ** outer membrane layer inhibits entry (may be susceptible to ampicillin) |
|
Neisseria characteristics
|
gram - cocci
ferment glucose IgA protease Nm ferments maltose Ng ferments glucose |
|
N. gonorrhoeae
|
no capsule
no maltose ferm no vaccine |
|
N. gonorrhoeae causes what?
|
gonorrhea
septic arthritis neonatal conjunctivitis PID |
|
N. meningitidis
|
polysacc capsule
maltose ferm vaccine resp and oral secretions |
|
N. meningitidis causes what?
|
meningitis
Waterhouse-Friderichsen syndrome |
|
H. influenzae causes what?
EMOP |
epiglottitis
meningitis otitis media pneumonia |
|
H. influenzae
|
small gram neg coccobacillus
aerosol transmission capsular type B in most invasive IgA protease |
|
H. influenzae vaccine
|
type B capsular polysacc conjugated to diptheria toxoid or other protein to promote class switching
(between 2 and 18 months) |
|
How is H. influenzae cultured?
|
chocolate agar
factor V (NAD) factor X (hematin) |
|
H. influenzae treatment:
|
Ceftriaxone for meningitis
Rifampin for prophylaxis |
|
Legionella pneumophila
|
gram neg rod
poor gram stain silver stain no person to person transmission aerosol transmission from water source |
|
How is legionella cultured?
|
charcoal yeast extract/iron/cysteine
|
|
Legionnaire's disease
|
severe pneumonia
Pontiac fever = mild |
|
Legionella treatment
|
erythromycin
|
|
Pseudomonas causes what?
PSEUDO |
pneumonia (CF)
sepsis (black lesions on skin) External otitis (swimmers ear) UTI Drug use/Diabetic Osteomyelitis (also hot tub folliculitis) |
|
Pseudomonas characteristics
|
wound and burn infections
aerobic gram neg rod oxidase pos non lactose ferm produces pyocyanin (blue green) grapelike oder |
|
Pseudomonas toxin
|
endotoxin- fever, shock
exotoxin A- inactivates EF2 |
|
Pseudomonas treatment
|
aminoglycoside
plus extended spectrum penicillin (piperacillin, ticarcillin) |
|
Enterobacteriaceae
|
COFFEe:
Capsular K antigen- (virulence) O antigen- (somatic, polysacc of endotoxin) Flagellar H antigen (motility) Ferments glucose **oxidase negative!! |
|
Enterobacteriaceae:
CEEKS SHYPS |
Citrobacter
E Coli Enterobacter Klebsiella Serratia Shigella Yersinia Proteus Salmonella |
|
Klebsiella: 4 As
|
Aspiration pneumonia
Abscess in lungs alcoholics di-A-betics (also nosocomial UTIs) |
|
Klebsiella characteristics
|
gram neg rod
enterobacteriaceae glucose oxidase negative red current jelly sputum!! |
|
Salmonella
|
gram neg rod
non lactose ferm oxid negative glucose invade intestinal mucosa -> bloody diarrhea flagella = motile produces H2S animal reservoir |
|
Shigella
|
gram neg rod
non lactose ferm oxidase neg glucose invades intestinal mucosa -> bloody diarrhea more virulent than salmonella no flagella propels through actin polymerization |
|
Salmonella typhi
|
typhoid fever:
fever diarrhea headache rose spots on abdomen remains in gallbladder |
|
Yersinia enterocolitica
|
pet feces (puppies)
contaminated milk, pork day care outbreaks symptoms like crohns, appendicitis |
|
H. pylori
|
gastitis
duodenal ulcers gastric adenocarcinoma B cell lymphoma urease positive creates alkaline environment |
|
Test for H pylori?
|
urease breath test
|
|
treat H pylori?
|
bisumuth
metronidazole tetracycline or amoxicillin (or met, omeprazole, clarithromycin) |
|
Spirochetes: characteristics and types (3):
BLT |
axial filaments
spiral shaped Borrelia (big) Leptospira Treponema |
|
Borrelia is visualized with:
|
analine dyes (wright or giesma stain)
in LM |
|
Treponema is visualized with:
|
dark field microscopy
|
|
Leptospira interrogans
|
question mark shaped
water w/animal urine tropics |
|
Leptospira symptoms
|
flulike
fever headache abdominal pain jaundice Weil's disease |
|
Weil's disease
|
leptospira
isterohemorrhagic leptospirosis: severe jaundice and azotemia from liver and kidney dysfunction, fever, hemorrhage, anemia |
|
Borrelia burgdorferi
|
Ixodes tick
Lyme disease mice and deer reservoir summer NE US |
|
Lyme disease
|
stage 1- erythema migrans (bulls eye rash), flulike
stage 2- CNS, cardiac stage 3- chronic monoarthritis, migratory polyarthritis |
|
Lyme disease:<BR>BAKE a key Lyme pie
|
bilateral Bell's palsy<BR>arthritis<BR>kardiac<BR>erythema migrans
|
|
Treponema pallidum
|
causes syphillus
|
|
Treponema pertenue
|
causes yaws; infection of skin/bone/joints --> healing with keloids--> limb deformity
disease of tropics VDRL positive |
|
Primary syphilis
|
painless chancre
|
|
Secondary syphilis
|
disseminated disease:
maculopapular rash (palms, soles) condylomata lata |
|
Tertiary syphilis
|
Gumma (chronic granuloma)
aortitis (vasa vasorum destruction) neurosyphilis (tabes dorsalis) argyll robertson pupils signs: ataxia, pos romberg, charcot joints, stroke w/o HTN |
|
Congenital syphilis
|
Saber shins
saddle nose CN VIII deafness Hutchinson's teeth |
|
Argyll Robertson pupil
|
constricts with accomodation but not reactive to light.
|
|
Test for Treponema
|
FTA-ABS is specific, early positive, postive the longest
VDRRL is nonspecific, lots of false positives |
|
VDRL +, FTA +
|
active syphilis
|
|
VDRL +, FTA -
|
false pos
|
|
VDRL -, FTA +
|
successfully treated
|
|
VDRL has false positives for:
|
Viruses
Drugs Rheumatic fever Lupus and Leprosy |
|
Bartonella henselae
|
cat scratch fever
|
|
Borrelia burgdorferi
|
Lyme disease
Ixodes tick deer/mice |
|
Brucella
|
undulent fever
dairy goats |
|
Francisella
|
tularemia
rabbits tick bite deer |
|
Yersinia pestis
|
plague
flea bite rodents, prairie dogs |
|
Pasteurella multocida
|
cellulitis
cat bite |
|
Zoonotic bacteria:
Big bad bugs from your pet ella |
bartonella
brucella borrelia francisella yersinia pasteurella |
|
Gardnerella vaginalis
|
gram variable rod
vaginosis- gray/white fishy discharge not an STD clue cells- vaginal epithelial cells w/bacteria positive whiff test |
|
Treat gardnerella
|
metronidazole
|
|
Rickettsiae
|
oligate intracellular
need CoA and NAD arthropod vector (except coxiella) |
|
Rickettsiae symptom triad
|
fever
headache rash/vasculitis |
|
Treat Rickettsiae
|
tetracycline
|
|
Rickettsia rickettsii
|
Rocky mt spotted fever
-rash starts on hands/feet, spreads in (Rickettsia on the rists, typhus on the trunk) |
|
R typhi
|
Endemic typhus
fleas rash starts centrally and spreads out (Rickettsia on the rists, typhus on the trunk) |
|
R prowazekii
|
epidemic typhus
human body louse rash starts centrally and spreads out |
|
Ehrlichia
|
Ehrlichiosis
tick |
|
Coxiella burnetii
|
Q fever
inhaled aerosols no rash no vector negative Weil-Felix a Rickettsia |
|
Palm and sole rashes:
CARS |
Coxsackievirus A
Rocky Mountain spotted fever Syphilis |
|
Weil-Felix reaction
|
assays for antirickettsial antibodies, which cross react with proteus antigen
Positive for typhus and Rocky Mt, negative for Q fever |
|
Chlamydiae
|
Cell wall lacks muramic acid
Obligate intracellular- can't make own ATP cause mucosal infections 1. Elementary body (small, dense) enters cells via endocytosis 2. Reticulate/Initial body, replicates in cell by fission |
|
C. trachomatis
|
reactive arthritis
conjunctivitis nongonococcal urethritis PID |
|
C. pneumoniae
|
atypical pneumonia
transmitted by aerosol |
|
C. psittaci
|
atypical pneumonia
transmitted by aerosol |
|
lab diagnosis for chlamydia
|
cytoplasmic inclusions on Giesma or fluorescent antibody
|
|
Treatment for chlamydia
|
erythromycin or tetracycline
|
|
Chlamydia trachomatis serotypes A, B, C
|
chroinic infection
Africa Blindness |
|
Chlamydia trachomatis serotypes D-K
|
urethritis
PID ectopic preg neonatal pneumonia, conjunctivitis |
|
Chlamydia trachomatis serotypes L1, L2, L1
|
lymphogranuloma venereum
positive Frei test |
|
Chlamydia neonatal disease is acquired how?
|
passage through the birth canal
|
|
Mycoplasma pneumoniae
|
atypical walking pneumonia
X ray looks worse than patient no cell wall, membrane contains cholesterol military, prisons |
|
Mycoplasma pneumoniae is grown on?
|
Eaton's agar
|
|
fungal spores
|
Most fungal spores are asexual
Coccidioidomycosis and histoplasmosis are transmitted by inhalation of spores Conidia = asexual fungal spores (blastoconidia, arthroconidia) |
|
Histoplasmosis: where?
|
Mississippi and Ohio River Valleys
|
|
Histoplasmosis: What?
|
pneumonia
from bird/bat droppings intracellular, inside macs |
|
Blastomycosis: where?
|
East of Miss River and Central America
|
|
Blastomycosis: what?
|
Big, broad-based budding
lung, skin, bones granulomatous nodules cold = mold heat = yeast |
|
How is blastomycosis cultured?
|
On sabouraud's agar
|
|
Coccidioidomycosis: where?
|
SW US, California
|
|
Coccidioidomycosis: what?
|
Spherule filled with endospores
not dimorphic Valley fever/desert bumps: pneumonia meningitis bone skin |
|
Paracoccidioidomycosis: where?
|
Rural Latin America
|
|
Paracoccidioidomycosis: what?
|
captain's wheel appearance
budding yeast |
|
Dimorphic fungi (mold in soil at cool temps, yeast at higher temps in tissue):
(3) |
Histoplasmosis
Blastomycosis Paracoccidioidomycosis (NOT coccidioidomycosis) |
|
Treat systemic mycoses
(histo, blasto,coccid, paracoccid) |
fluconazole
ketoconazole amphotericin B for systemic |
|
Cutaneous mycoses
|
Tinea versicolor
tinea pedis, cruris, corporis, capitis |
|
Malassezia furfur
|
causes tinea versicolor:
hot humid spaghetti and meatball appearance KOH prep |
|
Treat tinea versicolor
|
topical miconazole
selenium sulfide |
|
Tinea pedis, cruris, corporis, capitis
|
pruritic lesions with central clearing (ring)
not dimorphic, mold hyphae KOH prep |
|
Tinea pedis, cruris, capitis, corporis caused by:
|
Microsporum, Trichophyton, Epidermophyton
|
|
Treatment for Tinea pedis, cruris, capitis, corporis
|
topical azoles
|
|
Candida albicans
|
yeast with pseudohyphae at 20 deg C
germ tubes at 37 deg C oral thrush in immunocompromised, endocarditis, disseminated infection, |
|
Treat Candida
|
nystatin for superficial
amph B for systemic |
|
Aspergillus fumigatus
|
mold with septate hyphae, 45 deg angle
lung cavity fungus ball |
|
Cryptococcus neoformans
|
encapsulated yeast
soil, pigeon droppings sabouraud's agar india ink latex agglutination test detects cap meningitis |
|
Mucor and Rhizopus
|
mold with irregular nonseptate hyphae
wind angle branching ketoacidotic diabetic patients leukemic patients frontal lobe abscesses blood vessel/tissue necrosis |
|
Pneumocystis jiroveci
|
yeast
inhaled interstitial pneumonia methanamine silver stain immunosuppressed |
|
Treatment for pneumocystis jiroveci
|
TMP-SMX
pentamidine dapsone |
|
Sporothrix schenckii
|
dimorphic
rose gardeners cigar shaped budding yeast local pustule or ulcer on skin nodules along draining lymphatics |
|
Treat Sporothrix
|
Itraconazole
potassium iodide |
|
Giardia lamblia transmission
|
cysts in water
|
|
Giardia diagnosis
|
trophozoites or cysts in stool
|
|
Giarda disease
|
bloating
foul smelling watery diarrhea campers, hikers |
|
Giardia treatment
|
metronidazole
|
|
Trichomonas vaginalis disease
|
greenish discharge
itching burning strawberry colored mucosa |
|
Trichomonas vaginalis transmission
|
sexual
|
|
Trichomonas vaginalis diagnosis
|
trophozoites (motile) on wet mount
|
|
Trichomonas vaginalis treatment
|
metronidazole
|
|
Trypanosoma cruzi disease
|
Chagas disease:
DCM megacolon megaesophagus South America |
|
Trypanosoma cruzi transmission
|
Reduviid "kissing" bug
|
|
Trypanosoma diagnosis
|
blood smear
|
|
Trypanosoma cruzi treatment
|
Nifurtimox
|
|
Trypanosoma gambiense and rhodesiense: disease
|
African sleeping sickness:
enlarged lymph nodes recurring fever (antigenic variation) coma |
|
Trypanosoma g. and r. transmission
|
Tsetse fly
|
|
Trypanosoma g and r treatment
|
Suramin for bloodborne disease
Melarsoprol for CNS disease |
|
Leishmania donovani disease
|
Visceral leishmaniasis (kala-azar):
spiking fevers HSM pancytopenia |
|
Leishmania transmission
|
Sandfly
|
|
Leishmania dx
|
macrophages with amastigotes
|
|
Leishmania tx
|
Sodium stibogluconate
|
|
Plasmodium
|
Malaria:
cyclic fever headache anemia splenomegaly |
|
Relapsing malaria
|
P. vivax
P. ovale -due to dormant hypnozoites in liver |
|
Severe (cerebral) malaria
|
P. falciform
|
|
Plasmodium transmission
|
Anopheles mosquito
|
|
Plasmodium dx
|
blood smear
|
|
Plasmodium tx
|
Cholorquine
Primaquine prevents relapsing Sulfadoxine + pyrimethamine Mefloquine quinine |
|
Babesia disease
|
fever
hemolytic anemia NE US |
|
Babesia transmission
|
ixodes tick
|
|
Babesia dx
|
maltese cross on blood smear,
no RBC pigment |
|
Babesia tx
|
quinine
clindamycin |
|
Cryptosporidium disease
|
severe diarrhea w/AIDS
mild in others |
|
Crytposporidium transmission
|
cysts in water
|
|
Cryptosporidium dx
|
cysts on acid fact stain
|
|
Cryptosporidium tx
|
none
|
|
Toxoplasma gondii disease
|
Brain abscess in HIV
birth defects (ring enhancing lesion) |
|
Toxoplasma transmission
|
cysts in meat, cat feces
crosses placenta |
|
Toxoplasma dx
|
serology
biopsy |
|
Toxoplasma tx
|
Sulfadoxine + pyrimethamine
|
|
Entamoeba histolytica disease
|
bloody diarrhea
liver abscess |
|
Entamoeba transmission
|
cysts (with 4 nuclei) in water
|
|
Entamoeba dx
|
serology
trophozoites or cysts in stool RBCs in cytoplasm of entamoeba |
|
Entamoeba tx
|
metronidazole
iodoquinol |
|
Naegleria fowleri disease
|
Rapidly fatal meningoencephalitis
|
|
Naegleria fowleri transmission
|
freshwater lakes
enter through cribiform plate |
|
Naegleria fowleri dx
|
amoebas in spinal fluid
|
|
Giardia: what type of organism?
|
protozoan
|
|
Trichomonas vaginalis: what type of organism?
|
protozoan
|
|
Trypanosoma: what type of organism?
|
protozoan
|
|
Leishmania: what type of organism?
|
protozoan
|
|
Plasmodium : what type of organism?
|
protozoan
|
|
Babesia: what type of organism?
|
protozoan
|
|
Cryptosporidium: what type of organism?
|
protozoan
|
|
Toxoplasma: what type of organism?
|
protozoan
|
|
Entamoeba: what type of organism?
|
protozoan
|
|
Naegleria fowleri: what type of organism?
|
protozoan
|
|
what is a helminth?
|
multicellular organism
parasitic worm |
|
what is a nematode?
|
roundworm
|
|
what is a cestode?
|
tapeworm
|
|
what is a trematode?
|
fluke
|
|
Enterobius vermicularis: what type of organism?
|
nematode
|
|
Ascaris lumbricoides: what type of organism?
|
nematode/roundworm
|
|
Trichinella spiralis:what type of organism?
|
nematode/roundworm
|
|
Strongyloides stercoralis: what type of organism?
|
nematode/roundworm
|
|
Ancylostoma duodenale, necator americanus (hookworm):what type of organism?
|
nematode/roundworm
|
|
Dracunculus medinensis: what type of organism?
|
nematode/roundworm
|
|
Onchocerca volvulus: what type of organism?
|
nematode/roundworm
|
|
Loa loa: what type of organism?
|
nematode/roundworm
|
|
Wuchereria bancrofti: what type of organism?
|
nematode/roundworm
|
|
Toxocara canis: what type of organism?
|
nematode/roundworm
|
|
Taenia solium: what type of organism?
|
Cestode/tapeworm
|
|
Diphyllobothrium latum: what type of organism?
|
cestode/tapeworm
|
|
Echinococcus granulosis: what type of organism?
|
cestode/tapeworm
|
|
Schistosoma: what type of organism?
|
trematode/fluke
|
|
Clonorchis sinensis: what type of organism?
|
trematode/fluke
|
|
paragonium westermani: what type of organism?
|
trematode/fluke
|
|
Enterobius vermicularis
|
pinworm
food with eggs intestinal infection anal pruritus (scotch tape test) |
|
Enterobius vermicularis tx
|
mebendazole/pyrantel pamoate
|
|
Ascaris lumbricoides
|
A scary giant roundworm
eggs in feces intestinal infection |
|
Ascaris tx
|
mebendazole/pyrantel pamoate
|
|
Trichinella spiralis
|
undercooked pork
muscle inflammation (larvae) periorbital edema |
|
Trichinella tx
|
thiabendazole
|
|
Strongyloides stercoralis
|
larvae in soil
penetrate skin intestinal infection -> anemia |
|
Strongyloides tx
|
Ivermectin/thiabendazole
|
|
Ancylostoma duodenale/necator americanus
|
hookworms
larvae penetrate feet intestinal infection -> anemia |
|
Ancylostoma and Necator tx
|
mebendazole/pyrantel pamoate
|
|
dracunculus medinensis
|
drinking water
skin inflammation skin ulceration |
|
Dracunculus tx
|
niridazole
|
|
Onchocerca volvulus
|
female blackflies
river blindness skin nodules "lizard skin" |
|
Onchocerca tx
|
Ivermectin (Iver eye, Iver rIVER)
|
|
Loa Loa
|
deer fly, horse fly, mango fly
skin swelling eye worm- ick! |
|
Loa loa tx
|
diethylcarbamazine
|
|
toxocara canis
|
food w/eggs
granulomas if in retina -> blindness visceral larva migrans |
|
toxocara tx
|
diethylcarbamazine
|
|
Wuchereria bancrofti
|
female mosquito
blocks lymph vessels elephantitis |
|
Wuchereria tx
|
diethylcarbamazine
|
|
Taenia solium
|
ingest larvae in undercooked pork
ingest eggs -> cysticercosis and neurocysticercosis "swiss cheese" appearance |
|
Taenia solium tx
|
prazaquentel for intestinal worms
albendazole for neurocysticercosis |
|
Diphyllobothrium latum
|
ingest larvae from freshwater fish
Vit B12 def -> anemia |
|
Diphyllobothrium tx
|
praziquental
|
|
Echinococcus granulosas
|
eggs in dog feces
hydatid cysts in liver can cause anaphylaxis |
|
Echinococcus tx
|
Albendazole
|
|
Schistosoma
|
snails host
penetrate skin granulomas fibrosis inflammation of spleen, liver SCC of bladder! |
|
Schistosoma tx
|
praziquantel
|
|
Clonorchis sinensis
|
undercooked fish
inflammation of biliary tract pigmented gallstones cholangiocarcinoma |
|
Clonorchis tx
|
praziquantel
|
|
Paragonimus westermani
|
undercooked crab
infection of lung |
|
Paragonimus tx
|
praziquantel
|
|
Nematodes with ingested routes of infection:
EAT |
Enterobius
Ascarcis Trichinella |
|
Nematodes with cutaneous routes of infection:
SANd |
Strongyloides
Ancylostoma Necator |
|
Brain cysts, seizures
parasite |
Taenia solium
|
|
liver cysts
parasite |
echinococcus granulosus
|
|
b12 deficiency
parasite |
Diphyllobothrium latum
|
|
biliary tract disease
parasite |
Clonorchus sinensis
|
|
Hemoptysis
parasite |
Paragoniums westermani
|
|
Portal HTN
parasite |
Schistosoma haematobium
|
|
Hematuria, bladder cancer
|
Schistosoma
|
|
Microcytic anemia
|
hookworms
Ancylostoma Necator |
|
Perianal pruritis
|
Enterobius
|
|
Typhoid fever
|
Salmonella typhi
|
|
Typhus
|
Rickettsia prowazekii (epidemic)
R. typhi (endemic) R. tsutsugamushi (scrub typhus) |
|
Nematodes:
EAT SAND TOWEL |
Enterobius, Ascaris, trichinella
strongyloides, ancylo, necator toxocara, onchocerca, wuchereria, loa |
|
Cestodes:
TED has a tapeworm |
Taenia
echinococcus diphyllobothrium (pigs, dog, fish) |
|
Trematodes:
PSC |
paragonium
schistosoma clonorchis (lung, bladder, gb) (crab, snail, fish) |
|
Recombination
|
exchange of genes between 2 chromosomes by crossing over within regions of significant base sequence homology
|
|
Reassortment
|
Viruses with segmented genomes exchange segments. High freq recombination. Causes worldwide flu pandemics
|
|
Complementation
|
1 of 2 viruses that infect the cell has a mutation that results in nonfunctional protein. Nonmutated virus complements the mutated one by making a functional protein that serves both
|
|
Phenotypic mixing
|
Simultaneous infection of cell with 2 viruses. Genomes of A can be partially or completely coated with surface proteins of B. Type B determines infectivity. Type A's genetic material make progeny
|
|
Live attenuated vaccines
|
induce humoral and cell mediated immunity
no booster needed |
|
Killed vaccines
|
induce only humoral immunity
|
|
Live attenuated vaccine examples
|
MMR
Sabin polio VZV yellow fever smallpox |
|
Killed vaccine examples:
RIP Always |
Rabies
Influenza Polio- salk HAV |
|
Recombinant vaccine
|
HBV
HPV |
|
Which DNA virus is single stranded?
|
Parvoviridae
("part of a virus") |
|
Which DNA viruses are NOT linear?
|
papilloma
polyoma hepadnavirus (rest are linear) |
|
Which RNA virus is double stranded?
|
Reoviridae
("repeato-virus") |
|
Which is infectious?
+ strand or - strand ssRNA |
+
(- strand and dsRNA are not infectious) |
|
Which virus is not haploid?
|
Retrovirus has 2 identical ssRNA molecules
|
|
Which DNA virus does NOT replicate in the nucleus?
|
pox
|
|
Which RNA virus does NOT replicate in the cytoplasm?
|
Influenza virus
retrovirus |
|
Naked viruses:
CPR and PAPP |
Calci, Picornavirus, Reo, Parvo, Adeno, Papilloma, Polyoma
|
|
DNA enveloped viruses
|
Herpes
HBV Pox |
|
DNA nucleocapsid viruses
|
Adeno
papillo parvo |
|
RNA enveloped viruses
|
influenza
parainfluenza RSV MMR rabies HTLV HIV |
|
RNA naked viruses
|
Enteroviruses (polio, coxsackie, echo, HAV)
rhino reo |
|
DNA viruses:
HHAPPPPy |
hepadna
herpes adeno pox parvo papilloma polyoma |
|
Almost all DNA viruses are:
|
double stranded
linear icosahedral replicate in nucleus |
|
Which DNA virus is not icosahedral?
|
Pox (complex)
|
|
Herpesvirus family:
names envelope? dna structure |
HSV
VZV EBV CMV HHV6, 7, 8 (envelope, linear) |
|
Hepadnavirus
disease envelope? dna structure |
HBV
Envelope ds, partial circular |
|
Adenovirus:
disease envelope? dna structure |
pharyngitis
pneumonia conjunctivities (pink eye) no env ds linear |
|
Parvovirus
disease envelope? dna structure |
B19 virus- aplastic crises in sickle cell
slapped cheek rash- erythema infectiosum (5th disease) hydrops fetalis no env ss linear |
|
Papillomavirus
disease envelope? dna structure |
HPV- warts, CIN, cervical cancer
no env ds circular |
|
Polyomavirus
disease envelope? dna structure |
JC- PML in HIV
no env ds circular |
|
Poxvirus
disease envelope? dna structure |
smallpox
vaccinia- cowpox molluscum contagiosum envelope ds linear largest dna virus |
|
HSV-1:
what does it cause how is it transmitted |
Herpesvirus
gingivostomatitis keratoconjunctivitis temp lobe encephalitis *respiratory secretions, |
|
HSV-2
what does it cause how is it transmitted |
herpes genitalis
neonatal herpes sexual contact, perinatal |
|
VZV
what does it cause how is it transmitted |
shingles
encephalitis pneumonia *respiratory secretions |
|
EBV
what does it cause how is it transmitted |
infectious mononucleosis
burkitt's lymphoma nasopharyngeal carcinoma *respiratory, saliva |
|
CMV
what does it cause how is it transmitted |
Congenital infection
mono (negative monospot) pneumonia congenital, transfusion, sexual, saliva, transplant, urine ***cells have owl's eye appearance*** |
|
HHV-8
what does it cause how is it transmitted |
Kaposi's sarcoma in HIV patients
sexual contact |
|
HSV identification
|
Tzanck test- smear of open skin vesicle to detect multinucleated giant cells
Intranuclear Cowdry A inclusions |
|
EBV characteristics
|
infects B cells
abnormal T cells postive monospot test- heterophil antibodies detected by agglutination of sheep RBCs |
|
EBV symptoms
|
fever
HSM pharyngitis lymphadenopathy (posterior cervical nodes) |
|
Reovirus:
env? structure? capsid symmetry? |
RNA
no envelope ds linear icosahedral |
|
Reo diseases
|
reovirus- colorado tick fever
rotavirus- diarrhea in kids |
|
Picornaviruses
env? structure? capsid symmetry? |
no env
ss + linear icosahedral |
|
Pico diseases
|
polio
echovirus- aseptic meningitis rhinovirus- common cold coxsackievirus- asceptic meningitis, herpangina- febrile pharyngitis, hand/foot/mouth disease, myocarditis HAV- acute viral hepatitis |
|
Hepevirus
env? structure? capsid symmetry? |
no envelope
ss + linear icosahedral |
|
Caliciviruses
env? structure? capsid symmetry? |
no envelope
ss + linear icosahedral |
|
Calcivirus disease
|
Norwalk virus- viral gastroenteritis
|
|
Flaviviruses
env? structure? capsid symmetry? |
envelope
ss + linear icosahedral |
|
Flavivirus diseases
|
HCV
Yellow fever Dengue St Louis encephalitis West Nile c yellow dengue west of st louis |
|
Togavirus
env? structure? capsid symmetry? |
envelope
ss + linear icosahedral |
|
Togavirus diseases
|
Rubella
EEE WEE |
|
Retroviruses
env? structure? capsid symmetry? |
envelope
ss + linear icosahedral |
|
Retroviruses
|
HIV
HTLV- T cell leukemia |
|
Coronavirus
env? structure? capsid symmetry? |
envelope
ss + linear helical |
|
Coronavirus diseases
|
common cold
SARS |
|
Orthomyxoviruses
env? structure? capsid symmetry? |
envelope
ss - linear, 8 segments helical |
|
Orthomyxovirus disease
|
influenza
|
|
Paramyxoviruses
env? structure? capsid symmetry? |
envelope
ss - linear nonsegmented helical |
|
Paramyxoviruses diseases
|
PaRaMyxovirus:
P- parainfluenza-croup R-RSV- bronchiolitis in babies M- measles/rubeola M- mumps |
|
Rhabdovirus
env? structure? capsid symmetry? |
envelope
ss - linear helical |
|
Rhabdovirus disease
|
rabies
|
|
Filovirus
env? structure? capsid symmetry? |
envelope
ss - linear helical |
|
filovirus diseases
|
Ebola
Marburg hemorrhagic fever |
|
Arenavirus
env? structure? capsid symmetry? |
envelope
ss - linear 2 segments helical |
|
Arenavirus diseases
|
LCMV- lymphocytic choriomeningitis
lassa fever encephalitis (mice) |
|
Bunyaviruses
env? structure? capsid symmetry? |
envelope
ss - circular 3 segments helical |
|
Bunyaviruses diseases
|
California encephalitis
Sandfly/Rift Valley fevers Crimean-Congo hemorrhagic fever Hantavirus- hemorrhagic fever, pneumonia |
|
Deltavirus
env? structure? capsid symmetry? |
envelope
ss - circular helical |
|
Negative stranded viruses:
Always Bring Polymerase Or Fail Replication |
Arena
Bunya Paramyxo Orthomyxo Filo Rhabdo |
|
Segmented viruses:
BOAR |
all are RNA viruses:
Bunya Orthomyxo Arena Reo |
|
Name all the picornaviruses:
PERCH on a peak |
Poliovirus
Echovirus Rhinovirus Coxsackievirus HAV |
|
Rhinovirus
|
nonenveloped RNA
common cold > 100 serologic types |
|
Yellow fever virus characteristics
|
flavivirus
Aedes mosquito with human/monkey reservoir Councilman bodies (acidophilic) in liver |
|
Yellow fever symptoms
|
fever, black vomitus, jaundice
|
|
Rubella virus
|
Togavirus
German 3 day measles fever, lymphadenopathy, arthralgias fine truncal rash congenital disease |
|
Rotavirus
|
segmented dsRNA
infantile gastroenteritis winter day care *villous destruction with atrophy leads to decreased absorption of Na+ and water |
|
Orthomyxovirus characteristics
|
enveloped
ssRNA segmented genome hemaglutinin (promotes viral entry) neuraminidase (progeny release) |
|
Genetic shift
|
pandemic
reassortment of viral genome (like swine flu) |
|
Genetic drift
|
epidemic
minor changes based on random mutation |
|
Measles/Rubeola
|
Koplik spots (red with blue/white center on buccal mucosa)
SSPE encephalitis giant cell pneumonia rash from head to toe (cough, coryza, conjunctivitis, koplik) |
|
Mumps:
POM |
Parotitis
Orchitis asceptic meningitis |
|
Rabies
|
Negri bodies-cytoplasmic inclusion bodies in neurons
Bullet shaped capsid fatal encephalitis, hyrdophobia, hypersalivation, pharyngeal spasm (travels up CNS retrograde) bat, raccoon, skunk bites |
|
Arboviruses:
Fever Transmitted by Bites |
mosquitos, ticks
Flavivirus Togavirus Bunya |
|
Variola
|
pox
|
|
HAV
|
asymptomatic
acute alone (no carriers) RNA picornavirus |
|
HBV
|
Blood borne
DNA hepadna 3 mo incubation carriers RNA polymerase |
|
HCV
|
Chronic
Cirrhosis Carcinoma Carriers IV drug users, post tranfusion |
|
HDV
|
defective, dependent on HBV
coinfects or superinfects |
|
HEV
|
Enteric
Expectant mothers- high mortality Epidemic- water borne |
|
IgG HAVAb
|
prior infection
|
|
IgM HAVAb
|
active hep A
|
|
HBsAg
|
active
continued = carrier |
|
HBsAb
|
immunity to hep B
surface antibody |
|
HBcAg
|
core antigen
|
|
HBcAb:
IgM IgG |
postive during window period
IgM HBcAb = recent disease IgG = chronic |
|
HBeAg
|
indicates high infectivity
active viral replication |
|
HBeAb
|
low transmissibility
|
|
HBsAg +, HBsAb -, HBcAb+
|
acute disease
|
|
HBsAg -, HBsAb -, HBcAb +
|
window phase
|
|
HBsAg -, HBsAb +, HBcAb +
|
complete recovery
|
|
HBsAg +, HBsAb -, HBcAb +
|
chronic carrier
|
|
HBsAg -, HBsAb +, HBcAb -
|
Immunized
|
|
HIV:
1. p24 = ? 2. gp41 = ? 3. gp120 = ? 4. p17 = ? |
1. capsid protein
2. envelope protein 3. envelope protein 4. matrix protein |
|
HIV binds which receptors on T cells?
|
CXCR4
CD4 |
|
HIV binds which receptors on macs?
|
CCR5
CD4 |
|
homozygous CCR5
|
immunity
|
|
heterozygous CCR5
|
slower HIV course
|
|
HIV diagosis
|
1. ELISA
2. Western blot 3. PCR- viral load |
|
ELISA
|
first test for HIV
sensitive high false positive RULE OUT test |
|
Western Blot
|
second test for HIV
specific high false negative high threshold RULE IN test |
|
AIDS diagnosis is made when?
|
equal to or > than 200 CD4+
with AIDS indicator condition (PCP) or CD4/CD8 ratio < 1.5 |
|
Babies born to mothers with HIV:
positive or neg ELISA? positive or neg Western? |
positive:
anti-gp120 crosses placenta |
|
Time course of HIV:
4 stages |
1. Flu like
2. Feel fine- latent 3. falling count 4. final crisis |
|
Opportunistic infections in AIDS:
brain |
cryptococcal meningits
toxoplasmosis CMV encephalopathy AIDS dementia PML (JC virus) |
|
Opportunistic infections in AIDS:
eyes |
CMV retinitis
|
|
Opportunistic infections in AIDS:
mouth and throat |
thrush-candida
HSV CMV oral hairy leukoplakia (EBV) |
|
Opportunistic infections in AIDS:
lungs |
Pneumocystis jiroveci pneumonia
TB Histoplasma |
|
Opportunistic infections in AIDS:
GI |
Cryptosporidiosis
MAC CMV colitis non-Hodgkin's lymphoma (EBV) |
|
Opportunistic infections in AIDS:
Skin |
shingles
kaposi |
|
Opportunistic infections in AIDS:
Genitals |
Herpes
warts cervical cancer |
|
Infections at < 400 CD4
|
thrush, VZV reactivation, TB reactivation,
|
|
infections at < 200 CD4
|
reactivation HSV, crypto, coccidiod., Pneumocystis
|
|
infections at <100 CD4
|
candida, toxoplasma, histoplasma
|
|
infections at < 50 CD4
|
MAC, CMV retinitis, crypto meningitis
|
|
HIV encephalitis
|
late in the course
gains CNS access via macs microglial nodules with multinucleated giant cells |
|
Prions
|
infectious proteins
spongiform encephalopathy normal prions have alpha helix confirmation, these are beta pleated sheet that cant be digested |
|
Prion diseases
|
CJD- rapid progressive dementia
kuru mad cow scrapie (sheep) |
|
Skin normal flora
|
S. epidermidis
|
|
Nose normal flora
|
S. epidermidis
|
|
Oropharynx normal flora
|
Viridans group streptococci
|
|
Dental plaque normal flora
|
S. mutans
|
|
Colon normal flora
|
bacteroides fragilis
E coli |
|
vagina normal flora
|
lactobacillus
|
|
Contaminated seafood bugs
|
Vibrio
|
|
Reheated rice bug
|
B cereus
|
|
Meat, mayo, custurd
|
S aureus
|
|
reheated meat
|
C. perfringens
|
|
canned foods
|
C botulinum
|
|
undercooked meat
|
E coli O157:H7
|
|
meat, poultry, eggs
|
Salmonella
|
|
bloody diarrhea bugs
|
Camplylobacter
Salmonella Shigella Enterohemorrhagic E coli Enteroinvasive E coli Yersinia enterocolitica C diff |
|
Watery diarrhea bugs
|
Enterotoxigenic E coli
Vibrio cholerae C perfringens C diff Giardia Crytosporidium Rotavirus Adenovirus Norwalk virus |
|
Pneumonia in neonates
|
Group B strep
E coli |
|
Pneumonia in children:
Runts May Cough Sputum |
RSV
Mycoplasma C. pneumoniae S. pneumoniae |
|
Pneumonia in adults 18-40
|
Mycoplasma
C. pneumoniae S. pneumoniae |
|
Pneumonia in adults 40-65
|
S. pneumoniae
H influenzae Mycoplasma |
|
Pneumonia in elderly
|
S pneumoniae
H influenzae |
|
Pneumonia in alcoholics
|
S. pneumoniae
Klebsiella Staph |
|
Pneumonia in Cystic Fibrosis
|
Pseudomonas
|
|
Meningitis in newborn
|
group B streptococci
E coli Listeria |
|
Meningitis in children 6 mo - 6 yrs
|
S. pneumoniae
Neisseria meningitidis H. influenzae Enterovirus |
|
Meningitis in 6-60 yrs
|
N. meningitidis
Enteroviruses S. pneumoniae HSV |
|
Meningitis 60 +
|
S pneumoniae
Gram neg rods Listeria |
|
Viral causes of meningitis
|
Coxsackievirus
HSV HIV West Nile virus VZV |
|
CSF findings in meningitis:
high pressure high PMNs high protein low sugar |
bacterial cause
|
|
CSF findings in meningitis:
high pressure high lymphocytes high protein low sugar |
fungal/tb
|
|
CSF findings in meningitis:
normal/high pressure high lymphocytes normal/high protein normal sugar |
Viral cause
|
|
Osteomyelitis in most people
|
S aureus
|
|
Osteomyelitis in sexually active
|
N. gonorrhaeae (rare)
|
|
Osteomyelitis in diabetics and drug addicts
|
Pseudomonas aeruginosa
|
|
Osteomyelitis in Sickle cell
|
Salmonella
|
|
Osteomyelitis in prosthetic replacement
|
S aureus and S epidermidis
|
|
Vertebral Osteomyelitis
|
Pott's disease- TB
|
|
Osteomyelitis and animal bites
|
Pasteurella
|
|
Ambulatory UTIs
|
E coli
Klebsiella S saprophyticus (2nd most common in young sexually active women) (most are ascending) |
|
Hospital acquired UTIs
|
E coli
Proteus Klebsiella Serratia Pseudomonas |
|
UTI bugs:
SSEK PP |
Serratia
S saprophyticus E coli Klebsiella Proteus Pseudomonas |
|
Serratia marcescens
|
red pigment
nosocomial and drug resistant |
|
UTI diagnostic markers
|
Leukocyte esterase positive:
bacterial Nitrite test positive: gram negative |
|
Enterobacter UTIs
|
nosocomial
drug resistant |
|
Klebsiella pneumoniae
|
large mucoid capsule
viscous colonies |
|
Proteus mirabilis
|
swarming motility on agar
produces urease associated with struvite stones |
|
ToRCHeS infections
|
Toxoplasma gondii
Rubella CMV HIV HSV 2 Syphilis **others: listeria, E coli, group B strep |
|
Toxoplasma gondii congenital problems
|
chorioretinitis
intracranial calcifications hydrocephalus |
|
Rubella congenital problems
|
deafness
cataracts heart- PDA, pulmonary artery stenosis |
|
CMV congenital problems
|
petechial rash
intracranial calcifications mental retardation HSM microcephaly jaundice |
|
HIV congenital problems
|
HSM
neurologic infections |
|
HSV 2 congenital problems
|
encephalitis
conjunctivitis vesicular skin lesions ***most transmitted during birth through infected maternal genital tract |
|
Syphilis congenital problems
|
cutaneous lesions
HSM jaundice saddle nose saber shins Hutchinson teeth CN VIII deafness rhinitis |
|
Childhood rashes
|
Measles
Rubella HHV 6 (roseola) scarlet fever (group A strep) parvovirus B19- slapped cheek |
|
H. ducreyi
|
painful chancre
("do cry" = ducreyi) |
|
Pelvic Inflammatory disease:
causes and symptoms |
C. trachomatis
N. gonorrhea Cervical motion tenderness (chandelier sign) discharge Fitz-Hugh-Curtis syndrome |
|
Fitz-Hugh-Curtis syndrome
|
PID
infetion of liver capsule and "violin string" adhesions of parietal peritoneum to liver |
|
Newborn nursery bugs
|
CMV
RSV |
|
Urinary catheters bugs
|
E coli
Proteus |
|
Respiratory therapy equipment bug
|
Pseudomonas
|
|
Hyperalimentation
|
Candida albicans
|
|
Water aerosols bug
|
Legionella
|
|
Pus, empyema, abscess
bug? |
S aureus
|
|
Pediatric infection
most likely bug? |
H influenzae
|
|
Traumatic open wound
bug? |
C perfringens
|
|
Currant jelly sputum
bug? |
Klebsiella
|
|
Sepsis/meningitis in newborn
bug? |
group B strep
|