Shared Flashcard Set

Details

Microbiology
USMLE studying
1079
Medical
Graduate
06/23/2014

Additional Medical Flashcards

 


 

Cards

Term

Peptidoglycan

(Function and Chemical Composition)

Definition

Function = Rigid support; protects against osmotic pressure

 

Composition = Sugar backbone with peptide side chains cross-linked by transpeptidase

Term
Enzyme that crosslinks Peptidoglycan side chains
Definition
Transpeptidase
Term

Cell Wall/Cell Membrane (Gram +)

(Function and Chemical Composition)

Definition

Function = Major surface antigen

 

Composition = Peptidoglycan for support; Lipotechoic acid induces inflammation

Term
Inflammatory reaction for Lipotechoic acid
Definition
TNF and IL-1
Term

Outer Membrane (Grame -)

(Function and Chemical Composition)

Definition

Function = Site of endotoxin (LPS); major surface antigen

 

Composition = Lipid A (induces inflammation); O polysaccharide (antigen)

Term

Plasma Membrane

(Function and Chemical Composition)

Definition

Function = site of oxidative and transport enzymes

 

Composition = Phospholipid bilayer

Term

Ribosome

(Function and Chemical Composition)

Definition

Function = protein synthesis

 

Composition = 50S and 30S subunits

Term

Periplasm

(Function and Chemical Composition)

Definition

Function = Space between cytoplasmic membrane and outer membrane in G-neg bacteria

 

Composition = Contains many hydrolytic enzymes (including B-lactamases)

Term

Capsule

(Function and Chemical Composition)

Definition

Function = protects against phagocytosis

 

Composition = Polysaccharide (except Bacillus anthracis - D-glutamate)

Term

Pilus/Fimbria

(Function and Chemical Composition)

Definition

Function = Mediate adherence to cell surface; sex pilus forms attachments between bacteria during conjugation

 

Composition = Glycoprotein

Term

Flagellum

(Function and Chemical Composition)

Definition

Function = motility

 

Composition = protein

Term

Spore

(Function and Chemical Composition)

Definition

Function = Resistant to dehydration, heat, and chemicals

 

Composition = Keratin-like coat; dipicolinic acid; peptidoglycan

Term

Plasmid

(Function and Chemical Composition)

Definition

Function = Contains genes for antibiotic resistance, enzymes, and toxins

 

Composition = DNA

Term

Glycocalyx

(Function and Chemical Composition)

Definition

Function = adherence to surfaces, especially foreign surfaces (indwelling catheters)

 

Composition = Polysaccharide

Term
Unique to Gram + organisms?
Definition
Lipotechoic acid
Term
Unique to Gram - organisms?
Definition

Endotoxin (LPS)

 

Periplasm

Term
Gram Positive Cocci
Definition

Staphylococcus

Streptococcus

Term
Gram Negative Cocci
Definition
Neisseria
Term
Gram (+) Bacilli
Definition

Clostridium

Corynebacterium

Bacillus

Listeria

Mycobacterium (acid fast)

Gardnerella (gram variable)

Term

Gram (-) Bacilli

(Enterics)

Definition

Vibrio

Yersinia

Klebsiella

E. coli

Enterobacter

Proteus

Salmonella

Helicobacter

Psuedomonas

Shigella

Bacteroides

Campylobacter

Serratia

Term

Gram (-) Bacilli

(Respiratory)

Definition

Haemophilus (pleomorphic)

Legionella (silver)

Bordetella

Term

Gram (-) Bacilli

(Zoonotic)

Definition

Pasteurella

Brucella

Francisella

Bartonella

Term
Gram (+) Branching Filaments
Definition

Actinomyces

Nocardia (weakly acid fast)

Term
Gram (-) Pleomorphic
Definition

Rickettsiae (Giemsa)

Chlamydiae (Giemsa)

Term
Gram (-) Spirochetes
Definition

Borrelia (Giemsa)

Treponema

Leptospira

Term
Gram (+) with no Cell Wall
Definition
Mycoplasma (no gram stain)
Term
Mycoplasma cell membrane/wall
Definition
Sterolds and no cell wall
Term
Mycobacteria cell membrane/wall
Definition
Mycolic acid and high lipid content
Term
Bugs that don't Gram stain well
Definition

(These Microbes May Lack Real Color)

 

Treponema (dark-field microscopy and fluorescent antibody staining)

 

Mycobacteria (high lipid content detected by acid-fast stain)

 

Mycoplasma (no cell wall)

 

Legionella pneumophila (primarily intracellular)

 

Rickettsia (intracellular parasite)

 

Chlamydia (intracellular parasite; lacks muramic acid in cell wall)

Term
Giemsa stain
Definition

(Certain Bugs Really Try my Patience)

 

Chlamydia

Borrelia

Rickettsia

Trypanosomes

Plasmodium

Term

Anaplasma spp.

 

(Disease and Transmission)

Definition

Anaplasmosis

 

Ixodes ticks

(live on deer and mice)

Term

Bartonella spp.

 

(Disease and Transmission)

Definition

Cat Scratch Disease

Bacillary Angiomatosis

 

Transmission = Cat scratch

Term

Borrelia Burgdorferi

 

(Disease and Transmission)

Definition

Lyme Disease

 

Ixodes ticks

(live on deer and mice)

Term

Borrelia recurrentis

 

(Disease and Transmission)

Definition

Relapsing Fever

 

Louse

(recurrent due to variable surface antigens)

Term

Brucella spp.

 

(Disease and Transmission)

Definition

Brucellosis

Undulant fever

 

Transmission = Unpasteurized dairy

Term

Campylobacter

 

(Disease and Transmission)

Definition

Bloody diarrhea

 

Transmission = Puppies, Livestock

(fecal-oral, ingestion of undercooked meat)

Term

Chlamydophila psittaci

 

(Disease and Transmission)

Definition

Psittacosis

 

Transmission = Parrots/birds

Term

Coxiella burnetii

 

(Disease and Transmission)

Definition

Q Fever

 

Transmission = Aerosols of cattle/sheep amniotic fluid

Term

Ehrlichia chaffeensis

 

(Disease and Transmission)

Definition

Ehrlichiosis

 

Transmission = Lone Star ticks

Term

Francisella tularensis

 

(Disease and Transmission)

Definition

Tularemia

 

Transmission = Ticks, rabbits, deer fly

Term

Leptospira spp.

 

(Disease and Transmission)

Definition

Leptospirosis

 

Transmission = Animal urine

Term

Mycobacterium leprae

 

(Disease and Transmission)

Definition

Leprosy

 

Transmission = Humans with lepromatous leprosy; Armadillos (rare)

Term

Pasteurella multocida

 

(Disease and Transmission)

Definition

Cellulitis
Osteomyelitis

 

Transmission = Animal bite (cats/dogs) 

Term

Rickettsia prowazekii

 

(Disease and Transmission)

Definition

Epidemic Typhus

 

Transmission = Louse

Term

Rickettsia rickettsii

 

(Disease and Transmission)

Definition

Rocky Mountain Spotted Fever

 

Transmission = Dermacentor ticks

Term

Rickettsia typhi

 

(Disease and Transmission)

Definition

Endemic Typhus


Transmission = Fleas

Term

Yersinia pestis

 

(Disease and Transmission)

Definition

Plague

 

Transmission = Fleas

Reservoir = Rats/Prairie dogs

Term
Jarisch-Herxheimer Reaction
Definition

Flu-like syndrome after antibiotics are started

 

Cause = killed bacteria release pyrogens

Term
Argyll Robertson Pupil
Definition

Constricts with accommodation, but non-reactive to light

 

Association = Tertiary Syphilis

 

(Prostitute Pupil - accomodates, but does not react)

Term

Lyme Disease

(Cause, Transmission, Reservoir)

Definition

Borrelia Burgdorferi

 

Transmission = Ixodes tick

Reservoir = Mouse

Term

Lyme Disease

(location)

Definition
Northeastern United States
Term

Lyme Disease

(Treatment)

Definition

Doxycycline

Ceftriaxone

Term

Lyme Disease

(Symptoms)

Definition
  • Initial:
    • Erythema chronicum migrans
    • Flu-like symptoms
    • +/- facial nerve palsy
  • Late:
    • Monoarthritis (large joints)
    • Migratory polyarthritis
    • Cardiac (AV node block)
    • Neurologic (Encephalopathy, Facial nerve palsy, Polyneuropathy)
  • FAKE a Key Lyme pie:
    • Facial nerve palsy
    • Arthritis
    • Kardiac block
    • Erythema migrans
Term

Syphilis

(Cause)

Definition
Treponema pallidum
Term

Syphilis

(Treatment)

Definition
Penicillin G
Term

Syphilis

(Symptoms)

Definition
  • Primary:
    • Painless genital chancre
  • Secondary = Systemic
    • Constitutional symptoms
    • Maculopapular rash (palms and soles)
    • Condylomata lata (confirmable with dark-field microscopy)
  • Latency
  • Tertiary:
    • Gummas (chronic granulomas)
    • Aortitis (vasa vasorum destruction)
    • Neurosyphilis (Tabes Dorsalis, "general paresis")
    • Argyll Robertson pupil
    • Broad-based ataxia
    • + Romberg
    • Charcot joint
    • Stroke without HTN
  • Congenital:
    • Saber shins
    • Saddle nose
    • CN VIII deafness
    • Hutchinson teeth
    • Mulberry molars
Term

Syphilis

(Testing)

Definition
  • Primary:
    • VDRL/RPR (non-specific)
    • Confirmation = FTA-ABS
  • Secondary:
    • VDRL/RPR (non-specific)
    • Confirmation = FTA-ABS
  • Latent:
    • Positive serology without symptoms
  • Tertiary:
    • Test spinal fluid with VDRL/RPR
Term

Congenital Syphilis

(Symptoms and Treatment)

Definition

Symptoms:

- Saber Shins

- Saddle nose

- CN VIII deafness

- Hutchinson teeth

- Mulberry molars

 

Treatment:

Treat in early pregnancy, since placental transmission happens after first trimester

Term
VDRL
Definition

Detects nonspecific antibody that binds beef cardiolipin

 

Inexpensive, widely available, quantitative, sensitive but not specific

 

Many False positives

(Viral infection [Mono, Hepatitis], Drugs, SLE)

 

VDRL:

Viruses (mono, hepatitis)

Drugs

Rheumatic fever

Lupus and Leprosy

Term

Gardnerella vaginalis

(Appearance)

Definition
Pelomorphic gram-variable rod
Term

Gardnerella vaginalis

(Disease)

Definition
Vaginosis
Term

Gardnerella vaginalis

(Presentation)

Definition

Gray vaginal discharge with fishy smell

 

Nonpainful (vs. vaginitis)

 

Overgrowth of anaerobic bacteria in vagina

 

Clue cells

(vaginal epithelium covered with Gardnerella bacteria)

 

I don't have a clue why I smell fish in my vagina garden!

Term

Gardnerella vaginalis

(Treatment)

Definition

Metronidazole

 

Clindamycin

(treats anaerobic bacteria)

Term
Rickettsial disease treatment
Definition
Doxycycline
Term
Rickettsial diseases
Definition
  • Rash Common:
    • RMSF (R. rickettsii)
    • Typhus (R. typhi)
  • Rash Rare:
    • Ehrlichiosis (Ehrlichia)
    • Anaplasmosis (Anaplasma)
    • Q fever (Coxiella burnetii)
Term

RMSF

(Cause, Vector)

Definition

Rickettsia rickettsii

 

Vector = tick

Term

RMSF

(Location)

Definition

South Atlantic states

(North Carolina)

Term

RMSF

(Presentation)

Definition

Rash at wrists/ankles > trunk, palms, soles

(Vasculitis)

 

Headache

 

Fever

Term
Palms/Soles rashes
Definition

You drive CARS with your palms and soles


Coxsackievirus A

RMSF

Syphilis (2)

Term

RMSF

(Organism Characteristics)

Definition

Intracellular

(require CoA and NAD+ because they can't synthesize ATP)

Term

Typhus

(Cause)

Definition

Endemic (fleas) = R. typhi

 

Epidemic (human body louse) = R. prowazekii

Term

Typhus

(Presentation)

Definition
Rash starts central > spreads out (spares palms/soles)
Term
Typhus vs. RMSF rashes
Definition
Rickettsii on wRists, Typhus on Trunk
Term

Ehrlichiosis

(Cause, Vector)

Definition

Ehrlichia

 

Vector = tick

Term

Ehrlichiosis

(Presentation)

Definition
Monocytes with morulae (berry-like inclusions) in cytoplasm
Term

Anapalsmosis

(Cause, Vector)

Definition

Anaplasma

 

Vector = tick

Term

Anaplasmosis

(Presentation)

Definition
Granulocytes with morulae in cytoplasm
Term

Q Fever

(Cause, Transmission)

Definition

Coxiella burnetii

 

No vector

 

Transmission = Tick feces and cattle placenta > spores > inhaled

 

Q Fever is Queer because it has no rash/vector and causative organisms survives outside in endospore form

Term

Q Fever

(Presentation)

Definition
Atypical Pneumonia
Term

Chlamydiae

(Organism Characteristics)

Definition

Obligate Intracellular

(cannot make their own ATP)

 

Cell wall lacks muramic acid

Term

Chlamydiae

(Forms)

Definition
  • Elementary body (small, dense)
    • Enfectious
    • Enters cell via Endocytosis
    • Transforms into Reticulate
  • Reticulate body
    • Replicates by fission
    • Reorganizes into Elementary bodies
Term

Chlamydiae

(Types and Presentations)

Definition
  • C. Trachomatis
    • Reactive arthritis
    • Follicular conjunctivitis
    • Nongonococcal urethritis
    • PID
  • C. Pneumoniae and C. Psittaci
    • Atypical pneumonia (aerosol transmission)
Term

Chlamydiae

(Diagnosis)

Definition
Cytoplasmic inclusions seen on Giemsa or Fluorescent antibody-stained smear
Term

Chlamydiae

(Treatment)

Definition

Azithromycin

(one-time treatment)

 

or

 

Doxycycline

Term
Chlamydiae trachomatis serotypes
Definition

Types A, B, C

 

Types D-K

 

Types L1, L2, L3

Term

Chlamydiae Trachomatis

(Types A, B, C presentations)

Definition

Chronic infection > blindness (Follicular conjunctivitis) in Africa

 

ABCAfrica/Blindness/Chronic infection

Term

Chlamydiae Trachomatis

(Types D-K presentation)

Definition

Urethritis/PID

 

Ectopic Pregnancy

 

Neonatal pneumonia

(Staccato cough)

 

Neonatal conjunctivitis

Term
Neonatal Chlamydiae transmission
Definition
Acquired during passage through infected birth canal
Term

Chlamydiae Trachomatis

(Types L1, L2, L3 presentation)

Definition
Lymphogranuloma Venereum
Term

Lymphogranuloma Venereum

(Cause, Presentation, Treatment)

Definition

Cause = Chlamydiae Trachomatis (types L1-L3)

 

Small, painless ulcers on genital > swollen, painful inguinal lymph nodes that ulcerate (buboes)

 

Treatment = Doxycycline

Term

Mycoplasma Pneumoniae

(Presentation)

Definition

Atypical pneumonia

(insidious onset, headache, nonproductive cough, patchy/diffuse interstitial infiltrate)

Term

Mycoplasma Pneumoniae

(Labs)

Definition

X-ray looks worse than patient

 

High titer of cold agglutinins (IgM) > agglutinate/lyse RBCs

 

Grown on Eaton agar

Term

Mycoplasma Pneumoniae

(Treatment)

Definition

Macrolide, Doxycycline, or Fluoroquinolone

 

(No cell wall = Penicillin not effective)

Term

Mycoplasma Pneumoniae

(Characteristics)

Definition

No cell wall

 

Not seen on gram stain

 

Membrane has sterols (stability)

Term

Mycoplasma Pneumoniae

(Epidemiology)

Definition

More common in patients < 30 years old

 

Frequent outberaks in military recruits and prisons

Term

Systemic Mycoses

(Organisms, Characteristics, Presentation, Treatment)

Definition
  • Organisms:
    • Histoplasmosis
    • Blastomycosis
    • Coccidiomycosis
    • Paracoccidiomycosis
  • Characteristics:
    • Dimorphic fungi (Cold = Mold, Heat = Yeast)
    • Exception = Coccidiodomycosis (spherule in tissue)
  • Presentation:
    • Pneumoniae (can disseminate)
    • Mimic TB (granuloma formation) but no person-person transmission
  • Treatment:
    • Local = Fuconazole or Itrazonazole
    • Systemic = Amphotericin B
Term

Histoplasmosis

(Location)

Definition
Mississippi and Ohio River valleys
Term

Histoplasmosis

(Presentation)

Definition

Pneumoniae

 

Macrophages filled with Histoplasma

(Histo Hides)

Term

Histoplasmosis

(Source)

Definition
Bat droppings, Birds
Term

Blastomycosis

(Location)

Definition
Mississippi River and Central America
Term

Blastomycosis

(Presentation)

Definition

Inflammatory lung disease

 

Can disseminate > Skin/Bone

 

Granulomatous nodules

 

Broad-base budding

(Blasto buds broadly)

Term

Coccidiomycosis

(Location)

Definition
Southwestern United States, California
Term

Coccidiomycosis

(Presentation)

Definition

Pneumonia

 

Meningitis

 

Disseminate > Bone/Skin

(Desert Bumps = erythema nodosum

Desert Rheumatism = arthralgias)

 

Spherule filled with endosphores

(Coccidio crowds)

Term

Paracoccidiomycosis

(Location)

Definition
Latin America
Term

Paracoccidiomycosis

(Presentation)

Definition

Budding yeast with "captain's wheel" formation

(Paracoccidio parasails with the captain's wheel all the way to Latin America)

Term
Cutaneous Mycoses
Definition
Tinea Versicolor, other Tinea
Term

Tinea Versicolor

(Cause)

Definition
Malassezia furfur
Term

Tinea Versicolor

(Pathophysiology/Presentation)

Definition

Degradation of lipids > acid > damage melanocytes > Hypo/Hyperpigmented patches

 

Occurs in hot, humid weather

Term

Tinea Versicolor

(Microscopy)

Definition
Spaghetti and meatball appearance
Term

Tinea Versicolor

(Treatment)

Definition

Topical miconazole

 

+

 

Selenium sulfide

(Selsun)

Term
Tinea Pedis
Definition
Foot ringworm
Term
Tinea Cruris
Definition
Groin ringworm
Term
Tinea corporis
Definition
Ringworm on body
Term
Tinea capitis
Definition
Head, scalp ringworm
Term
Tinea unguium
Definition
Onychomycosis, on fingernails
Term

Tinea appearance

(not Versicolor)

Definition
Pruritic lesions with central clearing resembling a ring
Term

Tinea microscopy

(not Versicolor)

Definition

Mold hyphae in KOH prep

 

Not dimorphic

Term

Tinea cause

(not Versicolor)

Definition

Dermatophytes

(Microsporum, Trichophyton, Epidermophyton)

Term

Candida albicans

(Presentation)

Definition

Systemic or superficial infection

 

Oral/Esophageal thrush in immunocompromised

(neonates, steroids, diabetes, AIDS)

 

Vulvovaginitis

(diabetes, antibiotic use)

 

Diaper rash

 

Endocarditis in IV drug users

 

Disseminated

(to any organ)

 

Chronic mucocutaneous candidiasis

Term

Candida albicans

(Treatment)

Definition

Vaginal = Topical azole

 

Oral/Esophageal = Fluconazole or Caspofungin

 

Systemic = Fluconazole, Amphotericin B, or Caspofungin

Term

Candida albicans

(Microscopy)

Definition

Dimorphic yeast

 

Pseudohyphae and budding yeasts at 20 C

 

Germ tubes at 37 C

Term

Aspergillus fumigatus

(Presentation)

Definition

Invasive aspergillosis, especially in immunocompromised and CGD

 

Allergic Bronchopulmonary aspergillosis

 

Aspergillomas in lung cavities

(especially at TB infection)

 

Hepatocellular carcinoma

(aflatoxins)

Term

Allergic Bronchopulmonary Aspergillosis

(ABPA)

Definition

Associated with asthma and cystic fibrosis

 

Can cause bronchiectasis and eosinophilia

Term

Aspergillus fumigatus

(Microscopy)

Definition

Not dimorphic

 

Septate hyphae that branch at 45 degree angle

(Acute Angles in Aspergillus)

 

Conidophore with radiating chains of spores

 

 

Term

Cryptococcus neoformans

(Presentation)

Definition

Meningitis

(hematogenous dissemination)

 

Cryptococcosis

Term

Cryptococcus neoformans

(Source, Transmission)

Definition
Soil and Pigeon droppings > inhaled
Term

Cryptococcus neoformans

(Transmission)

Definition
Term

Cryptococcus neoformans

(Labs)

Definition

Culture on Sabouraud agar

 

Stains with India ink and mucicarmine

 

Latex agglutination test detects polysaccharide capsular antigen

(more specific)

 

"Soap bubble" lesions in brain imaging

Term

Cryptococcus neoformans

(Microscopy)

Definition

Heavily encapsulated yeast; not dimorphic

 

5-10 um yeasts with wide capsular halos and unequal budding in India ink stain

Term

Mucor and Rhizopus spp.

(Disease)

Definition
Mucormycosis
Term

Mucor and Rhizopus spp.

(Presentation)

Definition

Rhinocerebral, frontal lobe abscesses

 

Headache, facial pain

 

Black necrotic eschar on face

 

Possible CN involvement

Term

Mucor and Rhizopus spp.

(Epidemiology)

Definition
Disease mostly in ketoacidotic diabetic and leukemic patients
Term

Mucor and Rhizopus spp.

(Pathophysiology)

Definition
Fungi proliferate in blood vessel walls when there is excess ketone and glucose > penetrate cribriform plate > enter brain
Term

Mucor and Rhizopus spp.

(Treatment)

Definition
Amphotericin B
Term

Mucor and Rhizopus spp.

(Microscopy)

Definition
Irregular, broad, nonseptate hyphae branching at wide angles
Term

Pneumocystic jirovecii

(Disease)

Definition

Pneumocystic pneumonia (PCP) in immunocompromised patients

 

Usually asymptomatic

Term

Pneumocystic jirovecii

(Transmission)

Definition
Inhalation
Term

Pneumocystic jirovecii

(Labs)

Definition

Methenamine silver stain

 

Diffuse, bilateral CXR appearance

Term

Pneumocystic jirovecii

(Diagnosis)

Definition
Lung biopsy or lavage
Term

Pneumocystic jirovecii

(Microscopy)

Definition
Disc-shaped (cups) yeast forms on methenamine silver stain of lung tissue
Term

Pneumocystic jirovecii

(Treatment)

Definition

Treatment:

TMP-SMX

Pentamidine

 

Prophylaxis:

Dapsone

Atovaquone

 

Start prophylaxis when CD4 count drops < 200 in HIV patients

Term

Sporothrix schenckii

(Disease)

Definition

Sporotrichosis

("Rose Gardner's Disease")

Term

Sporothrix schenckii

(Microscopy)

Definition
Dimorphic, cigar-shaped budding yeast
Term

Sporothrix schenckii

(Source, Transmission)

Definition

Spores traumatically introduced into skin by a thorn

(rose gardener's disease)

Term

Sporothrix schenckii

(Presentation)

Definition

Local pustule or ulcer with nodules along draining lymphatics

(Ascending lymphangitis)

 

Little systemic illness

Term

Sporothrix schenckii

(Treatment)

Definition

Itraconazole or Potassium Iodid

 

(Plant a rose in the pot)

Term

Giardia lamblie

(Disease)

Definition
Giardiasis
Term

Giardia lamblia

(Presentation)

Definition

Bloating, flatulence

 

Foal-smelling, fatty diarrhea

 

Often seen in campers/hikers

 

(Fat-rich Ghiradelli chocolates for fatty stools of Giardia)

Term

Giardia lamblia

(Transmission)

Definition
Cysts in water
Term

Giardia lamblia

(Diagnosis)

Definition
Trophozoites or cysts in stool
Term

Giardia lamblia

(Treatment)

Definition
Metronidazole
Term

Entamoeba histolytica

(Disease)

Definition
Amebiasis
Term

Entamoeba histolytica

(Presentation)

Definition

Bloody diarrhea (dysentery)

 

Liver abscess (anchovy paste exudate)

 

RUQ pain (flask-shaped ulcer if submucosal abscess of colon ruptures)

Term

Entamoeba histolytica

(Transmission)

Definition
Cysts in water
Term

Entamoeba histolytica

(Diagnosis)

Definition

Serology

 

and/or

 

Trophozoites (with RBC's in the cytoplasm) or Cysts (with up to 4 nuclei) in stool

Term

Entamoeba histolytica

(Treatment)

Definition

Metronidazole

 

Iodoquinol for asymptomatic cyst passers

Term

Cryptosporidium

(Presentation)

Definition

Severe diarrhea in AIDS

 

Mild disease (watery diarrhea) in nonimmunocompromised

Term

Cryptosporidium

(Transmission)

Definition
Oocysts in water
Term

Cryptosporidium

(Diagnosis)

Definition
Oocysts on acid-fast stain
Term

Cryptosporidium

(Treatment)

Definition

Prevention

(filtering city water supplies)

 

Nitazoxanide

(immunocompetent hosts)

Term
Protozoal GI infections
Definition

Giardia lamblia

 

Entamoeba histolytica

 

Cryptosporidium

Term
Protozoal CNS infections
Definition

Toxoplasma gondii

 

Naegleria fowleri

 

Trypanosoma brucei

Term

Toxoplasma gondii

(Presentation)

Definition

Brain abscess in HIV

(ring-enhancing brain lesions on CT/MRI)

 

Congenital triad

(Chorioretinitis, hydrocephalus, intracranial calcifications)

Term

Toxoplasma gondii

(Transmission)

Definition

Cysts in meat

 

Oocysts in cat feces

 

Crosses placenta

(pregnant women should avoid cats)

Term

Toxoplasma gondii

(Diagnosis)

Definition

Serology

 

Biopsy

(tachyzoite)

Term

Toxoplasma gondii

(Treatment)

Definition
Sulfadiazine and Pyrimethamine
Term

Naegleria fowleri

(Presentation)

Definition
Rapidly fatal meningoencephalitis
Term

Naegleria fowleri

(Transmission)

Definition

Swimming in freshwater lakes > enters cribriform plate

 

(Nalgene bottle filled with fresh water and Naegleria)

Term

Naegleria fowleri

(Diagnosis)

Definition
Amoebas in spinal fluid
Term

Naegleria fowleri

(Treatment)

Definition

Amphotericin B

(effective for few survivors)

Term

Trypanosoma brucei

(Disease)

Definition
African Sleeping Sickness
Term

Trypanosoma brucei

(Presentation)

Definition

Enlarged lymph nodes

 

Recurring fever

(antigenic variation)

 

Somnolence

 

Coma

Term

Trypanosoma brucei

(Species)

Definition

Trypanosoma brucei rhodesiense

 

Trypanosoma brucei gambiense

Term

Trypanosoma brucei

(Transmission)

Definition

Tetse fly

(painful bite)

Term

Trypanosoma brucei

(Diagnosis)

Definition
Blood smear
Term

Trypanosoma brucei

(Treatment)

Definition

Blood-borne disease = Suramin 

 

CNS penetration = Melarsoprol

 

(it sure is nice to go sleep; melatonin helps with sleep)

Term
Protozoal Hematologic infections
Definition

Plasmodium (Vivax, Ovale, Falciparum, Malariae)

 

Babesia

Term

Plasmodium

(Disease)

Definition
Malaria
Term

Plasmodium

(Presentation)

Definition
  • General:
    • Headache
    • Fever
    • Anemia
    • Splenomegaly
  • P. vivax/ovale:
    • 48 hr cycle (Tertian; 1st day and 3rd day)
    • Dormant form in liver (Hypnozoite)
  • P. falciparum:
    • Severe
    • Irregular fever patterns
    • Parasitized RBC's occlude capillaries in brain (cerebral malaria), kidneys, and lungs
  • P. malariae
    • 72 hr cycle (Quartan)
Term

Plasmodium

(Transmission)

Definition

Mosquito

(Anopheles)

Term

Plasmodium

(Diagnosis)

Definition

Blood smear

(Trophozoite ring form within RBC;

Schizont containing merocoites)

Term

Plasmodium

(Treatment)

Definition

Begin = Chloroquine

(blocks Plasmodium heme polymerase)

 

Resistant = Mefloquine or Atovaquone/Proguanil

 

Life-threatening = IV Quinidine

(test for G6PD deficiency)

 

Vivax/Ovale = add Primaquine for hypnozoite

(test for G6PD deficiency)

Term

Babesia

(Disease)

Definition
Babesiosis
Term

Babesia

(Presentation)

Definition

Fever

 

Hemolytic anemia

 

Severe disease = Asplenia

Term

Babesia

(Location)

Definition
Northeastern US
Term

Babesia

(Transmission)

Definition

Ixodes tick

(same as Lyme disease; can coinfect!)

Term

Babesia

(Diagnosis)

Definition

Blood smear

(Ring form; Maltese cross)

 

PCR

Term

Babesia

(Treatment)

Definition
Atovaquone and Azithromycin
Term

Trypanosoma cruzi

(Disease)

Definition
Chagas disease
Term

Trypanosoma cruzi

(Presentation)

Definition

Dilated cardiomyopathy

 

Megacolon

 

Megaesophagus

Term

Trypanosoma cruzi

(Location)

Definition
South America
Term

Trypanosoma cruzi

(Transmission)

Definition

Reduviid bug feces, deposited in painless bite

(kissing bug)

Term

Trypanosoma cruzi

(Diagnosis)

Definition
Blood smear
Term

Trypanosoma cruzi

(Treatment)

Definition

Benznidazole

 

or

 

Nifurtimox

Term

Leishmania donovani

(Disease)

Definition

Visceral Leishmaniasis

(Kala-azar)

Term

Trypanosoma cruzi

(Presentation)

Definition

Spiking fevers

 

Hepatosplenomegaly

 

Pancytopenia

Term

Trypanosoma cruzi

(Transmission)

Definition
Sandfly
Term

Trypanosoma cruzi

(Diagnosis)

Definition
Macrophages containing amastigotes
Term

Trypanosoma cruzi

(Treatment)

Definition

Amphotericin B

 

Sodium Stibogluconate

Term

Trichomonas vaginalis

(Disease)

Definition
Vaginitis
Term

Trichomonas vaginalis

(Presentation)

Definition

Foul-smelling, greenish discharge

 

Itching and burning

 

DON'T CONFUSE WITH GARDNERELLA!

(Gram-variable bacteria associated with bacterial vaginosis)

Term

Trichomonas vaginalis

(Transmission)

Definition

Sexual

(cannot exist outside human because it cannot form cysts)

Term

Trichomonas vaginalis

(Diagnosis)

Definition

Trophozoites on wet mount

(motile)

 

Strawberry cervix

Term

Trichomonas vaginalis

(Treatment)

Definition
Metronidazole for patient AND partner (prophylaxis)
Term

Enterobius vermicularis

(Disease)

Definition
Pinworm
Term

Enterobius vermicularis

(Transmission)

Definition
Fecal-oral
Term

Enterobius vermicularis

(Presentation)

Definition
Intestinal infection causing anal pruritus
Term

Enterobius vermicularis

(Diagnosis)

Definition
Scotch Tape test
Term

Enterobius vermicularis

(Treatment)

Definition
Bendazoles or Pyrantel pamoate
Term

Ascaris lumbricoides

(Disease)

Definition
Giant Roundworm
Term

Ascaris lumbricoides

(Transmission)

Definition

Fecal-oral

(eggs visible in feces under microscope)

Term

Ascaris lumbricoides

(Presentation)

Definition
Intestinal infection
Term

Ascaris lumbricoides

(Treatment)

Definition
Bendazoles or Pyrantel pamoate
Term

Strongyloides stercoralis

(Transmission)

Definition
Larvae in soil penetrate the skin
Term

Strongyloides stercoralis

(Presentation)

Definition
Intestinal infection > Vomiting, diarrhea, epigastric pain (similar to ulcer)
Term

Strongyloides stercoralis

(Treatment)

Definition
Ivermectin or Albendazole
Term
Hookworm cause
Definition

Ancylostoma duodenale

 

Necator americanus

Term

Hookworm

(Transmission)

Definition
Larvae penetrate skin
Term

Hookworm

(Presentation)

Definition
Intestinal infection > Anemia (sucking blood from intestinal walls)
Term

Hookworm

(Treatment)

Definition
Bendazoles or Pyrantel pamoate
Term
Nematode tissue infections
Definition

Onchocerca volvulus

 

Loa loa

 

Wuchereria bancrofti

 

Toxocara canis

Term
Nematode intestinal infections
Definition

Enterobius vermicularis

 

Ascaris lumbricoides

 

Strongyloides stercoralis

 

Ancylostoma duodenale

 

Necator americanus

Term

Onchocerca volvulus

(Transmission)

Definition
Female blackfly bite
Term

Onchocerca volvulus

(Presentation)

Definition

Hyperpigmented skin and River blindness

(black flies, black skin nodules, black sight)

 

Allergic reaction to microfilaria

Term

Onchocerca volvulus

(Treatment)

Definition

Ivermectin

(Ivermectin for river blindness)

Term

Loa loa

(Transmission)

Definition
Deer fly, Horse fly, Mango fly
Term

Loa loa

(Presentation)

Definition

Swelling in skin

 

Worm in conjunctiva

Term

Loa loa

(Treatment)

Definition
Diethylcarbamazine
Term

Wuchereria bancrofti

(Transmission)

Definition
Female mosquito
Term

Wuchereria bancrofti

(Presentation)

Definition

Blocks lymphatic vessels

(Elephantiasis)

 

Takes 9 months to become symptomatic

Term

Wuchereria bancrofti

(Treatment)

Definition
Diethylcarbamazine
Term

Toxocara canis

(Transmission)

Definition
Fecal-oral
Term

Toxocara canis

(Presentation)

Definition
Visceral larva migrans
Term

Toxocara canis

(Treatment)

Definition
Albendazole or Mebendazole
Term
Nematode routes of infection
Definition

Ingested = Enterobius, Ascaris, Toxocara

(You'll get sick if you EAT these!)

 

Cutaneous = Strongyloides, Ancylostoma, Necator

(These get into you feet from the SANd)

 

Bites = Loa loa, Onchocerca, Wuchereria

(Lay LOW to avoid getting bit)

Term

Cestodes

(Tapeworms)

Definition

Taenia solium

 

Diphyllobothrium

 

Echinococcus granulosus

Term

Taenia solium

(Disease)

Definition
Cysticercosis or Neurocysticercosis
Term

Taenia solium

(Transmission)

Definition

Ingestin of larvae encysted in undercooked pork

 

Ingestion of eggs

Term

Taenia solium

(Presentation)

Definition

Intestinal infection

 

Seizures (neuro)

Term

Taenia solium

(Treatment)

Definition

Praziquantel

 

Neuro = Praziquantel or Albendazole

Term

Diphyllobothrium latum

(Transmission)

Definition
Ingestion of larvae from raw freshwater fish
Term

Diphyllobothrium latum

(Presentation)

Definition
Vitamin B12 deficiency (tapeworm competes for B12 in intestine) > anemia
Term

Diphyllobothrium latum

(Treatment)

Definition
Praziquantel
Term

Echinococcus granulosus

(Transmission)

Definition
Ingestion of eggs from dog feces
Term

Echinococcus granulosus

(Presentation)

Definition

Hydatid cysts in liver > anaphylaxis if antigens released

(surgeons preinject with ethanol > kills cysts before removal)

Term

Echinococcus granulosus

(Treatment)

Definition
Albendazole
Term

Trematodes

(Flukes)

Definition

Schistosoma

 

Clonorchis sinensis

Term

Schistosoma

(Transmission)

Definition

Host = snails

 

Cerceriae penetrate skin of humans

Term

Schistosoma

(Presentation)

Definition

Liver and spleen granulomas, fibrosis, and inflammation

 

Chronic infection with S. haematobium > Squamous Cell Carcinoma of bladder

(Painless hematuria)

Term

Schistosoma

(Treatment)

Definition
Praziquantel
Term

Clonorchis sinensis

(Transmission)

Definition
Undercooked fish
Term

Clonorchis sinensis

(Presentation)

Definition

Biliary tract inflammation > pigmented gallstones

 

Associated with cholangiocarcinoma

Term

Clonorchis sinensis

(Treatment)

Definition
Praziquantel
Term

Biliary tract disease, Cholagiocarcinoma

(Parasite Hints)

Definition
Clonorchis sinensis
Term

Brain cysts, Seizures

(Parasite Hints)

Definition

Taenia solium

(cysticercosis)

Term

Hematuria, Bladder cancer

(Parasite Hints)

Definition
Schistosoma haematobium
Term

Liver (hydatid) cysts

(Parasite Hints)

Definition
Echinococcus granulosus
Term

Microcytic anemia

(Parasite Hints)

Definition
Ancylostoma, Necator
Term

Perianal pruritus

(Parasite Hints)

Definition
Enterobius
Term

Portal HTN

(Parasite Hints)

Definition

Schistosoma mansoni

Schistosoma japonicum

Term

Vitamin B12 deficiency

(Parasite Hints)

Definition
Diphyllobothrium latum
Term

PAS stain

(Periodic Acid-Schiff)

Definition

Stains glycogen, mucopolysaccharides

(PASs the sugar)

 

 

Used to diagnose Whipple disease

(Tropheryma whipplei)

Term

Ziehl-Neelson stain

(Carbol Fuchsin)

Definition

Acid-fast organisms

(Nocardia, Mycobacterium)

Term
India Ink stain
Definition

Cryptococcus neoformans

(mucicarmine can also be used to stain thick polysaccharide capsule red)

Term
Silver stain
Definition

Fungi (Pneumocystis)

Legionella

Helicobacter Pylori

 

(The silver helicopter legion are fun guys)

Term

H. influenzae

(Special Culture Requirements)

Definition

Chocolate agar with factors V (NAD+) and X (hematin)

 

(Blood and chocolate)

Term

N. gonorrhoeae/meningitidis

(Special Culture Requirements)

Definition

Thayer-Martin (VPN) media

 

Vancomycin = inhibits G+

Polymyxin = inhibits G- except Neisseria

Nystatin = inhibits fungi

 

(To connect to Neisseria, please use your VPN client)

Term

B. pertussis

(Special Culture Requirements)

Definition

Bordet-Gengou (potato) agar

 

Bordet for Bordetella

Term

C. diphtheriae

(Special Culture Requirements)

Definition
Tellurite agar, Loffler medium
Term

M. tuberculosis

(Special Culture Requirements)

Definition
Lowenstein-Jensen agar
Term

M. pneumoniae

(Special Culture Requirements)

Definition
Eaton agar, requires cholesterol
Term

Lactose-fermenting enterics

(Special Culture Requirements)

Definition

MacConkey agar > Pink colonies

(fermentation produces acid)

Mac for Lac

 

E. coli grown on EMB agar with green metallic colonies

E. coli is green on EMB

Term

Legionella

(Special Culture Requirements)

Definition
Charcoal yeast extract agar buffered with cysteine and iron
Term

Fungi

(Special Culture Requirements)

Definition

Sabouraud agar

(Sab's a fun guy)

Term
Obligate Aerobes
Definition

Use O2-dependent system to generate ATP

 

(Nagging Pests Must Breathe) 

Nocardia

Psuedomonas aeruginosa

Mycobacterium tuberculosis

Bacillus

 

P. aeruginosa is an aerobe in burn wounds, diabetes complications, nosocomial pneumonia, cystic fibrosis pneumonia

 

TB reactivation > apices of lung (highest PO2)

Term
Obligate Anaerobes
Definition

Can't Breathe Air

Clostridium

Bacteroides

Actinomyces

 

Lack catalase and/or SOD > susceptible to oxidative damage

 

Foul smelling (short-chain FAs), hard to culture, produce gas in tissue (CO2 and H2)

 

Normal flora in GI tract, pathogenic elsewhere

 

AminO2glycosides don't work (need O2 to enter cell)

Term
Obligate Intracellular
Definition

Stay inside cells when it's Really Cold

Rickettsia

Chlamydia

 

Can't make own ATP

Term
Facultative Intracellular
Definition

Some Nasty Bugs May Live FacultativeLY

Salmonella

Neisseria

Brucella

Mycobacterium

Listeria

Francisella

Legionella

Yersinia

Term
Encapsulated Bacteria
Definition

SHiNE SKiS

Strep. pneumo

Hinfluenzae type B

Neisseria

E. coli

Salmonella

Klebsiella

Group B Strep

 

Capsules are antiphagocytic virulence factor

Capsule + protein conjugate > vaccine antigens

(H. flu, N. meningitidis, S. pneumo)

 

Opsonized and cleared by spleen

Asplenia > more risk for inefction

Term
Catalase-Positive Organisms
Definition

Catalase degrades H2O2 before it can be used by MPO

 

CGD (NADPH oxidase deficiency) > recurrent infections

 

You need PLACESS for your cats

Pseudomonas

Listeria

Aspergillus

Candida

E. coli

Staph. aureus

Serratia

Term

Encapsulated Bacteria Vaccines

(Mechanism, Vaccines)

Definition

Contain polysaccharide capsule antigens > conjugated to carrier protein > enhances immunogenicity (promotes T-cell activation > class-switching)

 

Polysaccharide alone can't be presented to T-cells

 

Vaccines:

PCV/Prevnar (pneumococcal conjugate)

PPSV/Pneumovax (pneomococcal polysaccharide)

H. flu (conjugate)

Meningococcal (conjugate)

Term
Urease-Positive Bugs
Definition

CHuck Norris hates PUNKSS

Cryptococcus

H. pylori

Proteus

Ureaplasma

Nocardia

Klebsiella

S. epidermidis

S. saprophyticus

Term

Actinomyces israelii

(Pigment)

Definition

Yellow sulfur granules composed of bacterial filaments

 

Israel has yellow sand

Term

S. aureus

(Pigment)

Definition

Yellow pigment

 

Aureusgold

Term

Pseudomonas aeruginosa

(Pigment)

Definition

Blue-green pigment

 

Aerugula is green

Term

Serratia marcescens

(Pigment)

Definition

Red pigment

 

Think red maraschino cherries

Term
Protein A
Definition

Binds Fc region of IgG > prevents opsonization and phagocytosis

 

S. aureus

Term
IgA protease
Definition

Cleaves IgA > helps colonize respiratory mucosa

 

Secreted by SHiN

S. pneumoniae

H. influenzae type B

Neisseria

 

 

Term
M Protein
Definition

Helps prevent phagocytosis

 

Goup A Strep.

Term

Exotoxin

(Source)

Definition
Certain species of some G+ and G- bacteria
Term

Exotoxin

(Secreted?)

Definition
Yes
Term

Exotoxin

(Chemistry)

Definition
Polypeptide
Term

Exotoxin

(Location of Genes)

Definition
Plasmid or bacteriophage
Term

Exotoxin

(Toxicity)

Definition

High

(fatal dose on the order of 1 ug)

Term

Exotoxin

(Antigenicity)

Definition
Induces high-titer antibodies called antitoxins
Term

Exotoxin

(Vaccines)

Definition
Toxoids used as vaccines
Term

Exotoxin

(Heat Stability)

Definition

Destroyed rapidly at 60 C

(except Staph enterotoxin)

Term

Exotoxin

(Typical Diseases)

Definition
Tetanus, Botulism, Diphtheria
Term

Endotoxin

(Source)

Definition
Outer cell membrane of most G- bacteria
Term

Endotoxin

(Secreted?)

Definition
No
Term

Endotoxin

(Chemistry)

Definition

Lipopolysaccharide

(structural part of bacteria; released when lysed)

Term

Endotoxin

(Location of Genes)

Definition
Bacterial chromosome
Term

Endotoxin

(Toxicity)

Definition

Low

(fatal dose on the order of hundreds of micrograms)

Term

Endotoxin

(Clinical Effects)

Definition
Fever, shock (hypotension), DIC
Term

Endotoxin

(Mechanism)

Definition
Induces TNF, IL-1, and IL-6
Term

Endotoxin

(Antigenicity)

Definition
Poorly antigenic
Term

Endotoxin

(Vaccine)

Definition
No toxoids formed and no vaccine available
Term

Endotoxin

(Heat Stability)

Definition
Stable at 100 C for 1 hr
Term

Endotoxin

(Typical Diseases)

Definition

Meningococcemia

 

Sepsis by G- rods

Term
Exotoxins that inhibit protein synthesis
Definition

Diphtheria toxin

(Corynebacterium diphtheriae)

 

Exotoxin A

(Pseudomonas aeruginosa)

 

Shiga toxin

(Shigella spp.)

 

Shiga-like toxin

(EHEC; O157:H7)

Term

Corynebacterium diphtheriae Exotoxin

(Toxin)

Definition
Diphtheria toxin
Term

Corynebacterium diphtheriae Exotoxin

(Mechanism)

Definition
Inactivate EF-2
Term

Corynebacterium diphtheriae Exotoxin

(Manifestation)

Definition
Pharyngitis with pseudomembranes in throat and severe lymphadenopathy (bull neck)
Term

Pseudomonas aeruginosa Exotoxin

(Toxin)

Definition
Exotoxin A
Term

Pseudomonas aeruginosa Exotoxin

(Mechanism)

Definition
Inactivates EF-2
Term

Pseudomonas aeruginosa Exotoxin

(Manifestation)

Definition
Host cell death
Term

Shigella spp. Exotoxin

(Toxin)

Definition
Shiga Toxin
Term

Shigella spp. Exotoxin

(Mechanism)

Definition
Inactivates 60S ribosome by removing adenine from rRNA
Term

Shigella spp. Exotoxin

(Manifestation)

Definition

GI mucosal damage > dysentery

 

Toxin also enhances cytokine release > HUS

Term

EHEC E. coli Exotoxin

(Toxin)

Definition
Shiga-like Toxin
Term

EHEC E. coli Exotoxin

(Mechanism)

Definition
Inactivate 60S ribosome by removing adenine from rRNA
Term

EHEC E. coli Exotoxin

(Manifestation)

Definition

Toxin enhances cytokine release > HUS

 

Does not invade host cells

Term
Exotoxins that increase fluid secretion
Definition

Heat-labile Toxin

(ETEC)

 

Heat-stable Toxin

(ETEC)

 

Edema factor

(Bacillus anthracis)

 

Cholera toxin

(Vibrio cholera)

Term

ETEC

(Toxin)

Definition

Heat-labile Toxin

 

Heat-stable Toxin

Term

ETEC

(Mechanism)

Definition

HLT = Overactivates AC > increased cAMP > increased Cl- secretion in gut and H2O efflux

 

HST = Overactivates GC > increased cGMP > decreased resorption of NaCL and H2O in gut

 

Labile in the Air; Stable on the Ground

Term

ETEC

(Manifestation)

Definition
Watery diarrhea
Term

Bacillus anthracis Exotoxin

(Toxin)

Definition
Edema factor
Term

Bacillus anthracis Exotoxin

(Mechanism)

Definition
Mimics AC > increased cAMP
Term

Bacillus anthracis Exotoxin

(Manifestation)

Definition
Characteristic edematous borders of black eschar in cutaneous anthrax
Term

Vibrio cholera Exotoxin

(Toxin)

Definition
Cholera toxin
Term

Bacillus anthracis Exotoxin

(Mechanism)

Definition
Permanently activates Gs > overactivates AC > increased cAMP > increased Cl- secretion in gut and H2) reflux
Term

Bacillus anthracis Exotoxin

(Manifestation)

Definition
Voluminous rice-water diarrhea
Term
Exotoxin that inhibits phagocytic ability
Definition

Pertussis toxin

(Bordetella pertussis)

Term

Bordetella pertussis Exotoxin

(Toxin)

Definition
Pertussis toxin
Term

Bordetella pertussis Exotoxin

(Mechanism)

Definition

Disables Gi > overactivation of AC > increased cAMP

 

Impairs phagocytosis > permits survival of microbe

Term
Exotoxins that inhibit release of neurotransmitter
Definition

Tetanospasmin

(Clostridium tetani)

 

Botulinum toxin

(Clostridium botulinum)

Term

Clostridium tetani Exotoxin

(Toxin)

Definition
Tetanospasmin
Term

Clostridium tetani Exotoxin

(Mechanism)

Definition

Protease > cleaves SNARE protein required for NT release

 

Prevents release of inhibitory (GABA/Glycine) NTs from Renshaw cells in spinal cord

Term

Clostridium tetani Exotoxin

(Manifestation)

Definition

Spasticity

Risus sardonicus ("rictus grin")

Lockjaw

Term

Bordetella pertussis Exotoxin

(Manifestation)

Definition

Whooping Cough

Child = coughs on exspiration, whoops on inspiration

 

Adult = 100 day cough

Term

Clostridium botulinum Exotoxin

(Toxin)

Definition
Botulinum toxin
Term

Clostridium botulinum Exotoxin

(Mechanism)

Definition

Protease > cleaves SNARE protein required for NT release

 

Prevents release of stimulatory (ACh) signals at NMJ

Term

Clostridium botulinum Exotoxin

(Manifestation)

Definition

Flaccid paralysis

(Floppy baby)

Term

ADP Ribosylating A-B toxins

(Mechanism, Toxins)

Definition

B components binds host cell surface receptor > enables endocytosis

 

A component attaches ADP-ribosyl to disrupt host cell proteins

 

Toxins:

SAD Little Puddy Cat

Shiga(-like) toxin

exotoxin A

Diphtheria toxin

Heat Labile toxin

Pertussis toxin

Cholera toxin

 

Term
Exotoxins that lyse cell membranes
Definition

Alpha toxin

(Clostridium perfringens)

 

Streptolysin O

(Streptococcus pyogenes)

Term

Clostridium perfringens Exotoxin

(Toxin)

Definition
Alpha toxin
Term

Clostridium perfringens Exotoxin

(Mechanism)

Definition
Phospholipase (lecinthinase) > degrades tissue/cell membranes
Term

Clostridium perfringens Exotoxin

(Manifestation)

Definition

Myonecrosis

("gas gangrene")

 

Hemolysis

("double zone" of hemolysis on blood agar)

Term

Streptococcus pyogenes Exotoxin

(Toxin)

Definition

Streptolysin O

 

Exotoxin A

Term

Streptococcus pyogenes Exotoxin

(Mechanism)

Definition

Streptolyson O = Degrades cell membrane > lyses RBC

 

Exotoxin A = Superantigen

(Brings MHC II and TCR together with antigen binding site > overwhelming release of IFN-y and IL-2 > shock)

Term

Streptococcus pyogenes Exotoxin

(Manifestation)

Definition

Streptolysin O

RBC lysis

(contributes to B-hemolysis)

 

Host antibodies against toxin (ASO) used to diagnose Rheumatic Fever

(NOT antibodies in poststreptococcal glomerulonephritis)

 

Exotoxin A

Toxic Shock Syndrome

(fever, rash, shock)

Term
Exotoxins that are superantigens (shock)
Definition

Toxic Shock Syndrome Toxin (TSST-1)

(Staphylococcus aureus)

 

Exotoxin A

(Streptococcus pyogenes)

Term

Staphylococcus aureus Exotoxin

(Toxin)

Definition

TSST-1

 

Exfoliative toxin

 

Enterotoxin

Term

Staphylococcus aureus Exotoxin

(Mechanism)

Definition

TSST-1 = Superantigen

(Bring MHC II and TCR together with antigen binding site > overwhelming release of IFN-y and IL-2 > shock)

 

Exfoliative = Targets desmoglein of epidermal squamous cells

Term

Staphylococcus aureus Toxin

(Manifestation)

Definition

TSST-1 = Toxic Shock Syndrome

(fever, rash, shock)

 

Exfoliative = Scalded Skin Syndrome

 

Enterotoxin = Food poisoning

Term
Endotoxin Symptoms
Definition
  • Activates Macrophages
    • IL-1 > Fever
    • TNF > Fever and Hypotension
    • NO > Hypotension
  • Activates Complement
    • C3a > Hypotension and Edema
    • C5a > Neutrophil chemotaxis
  • Activates Tissue Factor
    • Coagulation cascade > DIC

ENDOTOXIN

Edema

Nitric Oxide

DIC/Death

Outer membrane

TNF-a

O-antigen

eXtremely heat stable

IL-1

Neutrophil chemotaxis

Term

Transformation

(Definition, Common organisms)

Definition

Ability to take up naked DNA (from cell lysis) from environment. Any DNA can be used. Also called "competence".

 

Common organisms: (SHiN)

S. pneumo

Hinfluenzae

Neisseria

Term
What can stop Transformation?
Definition
Add deoxyribonuclease > degrades naked DNA in medium > no transformation
Term

Conjugation

(Types, Definitions)

Definition

F+ x F-

(F+ plasmid has genes for sex pilus/conjugation. F+ bacteria > transfers plasmid to F-. No chromosomal gene transfer)

 

Hfr x F-

(F+ plasmid incorporated into bacterial chromosome = High frequency recombination. Replication of plasmid in DNA includes flanking chromosomal DNA. Transfer of plasmid AND chromosomal genes.)

Term

Transposition

(Definition)

Definition

Transposon = segment of DNA that jumps (excision/reintegration). Can go between plasmid and chromosome

 

Excision > includes flanking chromosomal DNA > incorporated into plasmid > transferred to other bacteria

 

Example = antibiotic resistance genes of R plasmid

Term
Generalized Transduction
Definition
Lytic phage infects bacteria > cleavage of bacterial DNA > parts of chromosome can be repackaged into viral capsid > phage infects other bacteria > transfers genes
Term
Specialized Transduction
Definition
Lysogenic phage infects bacteria > viral DNA incorporated into bacteria chromosome > phage DNA is excised + flanking bacterial genes > DNA packaged into phage viral capside > infects other bacteria
Term
Examples of bacterial toxins with lysogenic phage coding
Definition

ABCD'S

 

ShigA-like toxin

Botulinum toxin

Cholera toxin

Diphtheria toxin

Streptolysin O

Term

Gram Positive

(branching filaments)

Definition

Actinomyces

(anaerobe; not acid fast)

 

Nocardia

(aerobe; acid fast)

Term

Gram Positive

(Rods)

Definition

Clostridium
(anaerobe)

 

Corynebacterium

 

Listeria

 

Bacillus

(aerobe)

 

Mycobacterium

(acid-fast) 

Term

Gram Positive

(Catalase + Cocci)

Definition
Staphylococcus
Term

Gram Positive

(Catalase - Cocci)

Definition
Streptococcus
Term

Gram Positive

(Coagulase + Staphylococcus)

Definition
S. aureus
Term

Gram Positive

(Coagulase - Staphylococcus)

Definition

Novobiocin Sensitive = S. epidermidis

 

Novobiocin Resistant = S. saprophyticus

 

NO StRESs on the staph retreat

 

NOvobiocin

Saprophyticus Resistant, Epidermidis Sensitive

 

Term

Gram Positive

(a-hemolytic Streptococcus)

Definition

S. pneumoniae

(Capsule +, Optochin sensitive, Bile soluble)

 

Viridans streptococci [S. mutans]

(Capsule -, Optochin resistant, Bile insoluble)

 

OVRPS (overpass)

Optochin

Viridans Resistant, Pneumoniae Sensitive

Term

Gram Positive

(B-hemolytic Streptococcus)

Definition

Group A Strep [S. pyogenes]

(Bacitracin sensitive)

 

Group B Strep [S. agalactiae]

(Bacitracin resistant)

 

B-BRAS

Bacitracin

Group B Resistant, Group A Sensitive

Term

Gram Positive

(y-hemolytic Streptococcus)

Definition

Group D [Enterococcus; E. faecalis]

(Growth in bile and 6.5% NaCl)

 

Nonenterococcus [S. bovis]

(Growth in bile, NOT in 6.5% NaCl)

Term
a-hemolytic bacteria
Definition

Form green ring around colonies on blood agar

 

Strep. pneumoniae

(Catalase - and Optochin sensitive)

 

Viridans streptococci

(Catalase - and Optochin resistant)

Term
B-hemolytic bacteria
Definition

Form clear area of hemolysis on blood agar

 

Staph. aureus

(Catalase and Coagulase +)

 

Strep. pyogenes [GAS]

(Catalase - and Bacitracin sensitive)

 

Strep. agalactiae [GBS]

(Catalase - and Bacitracin resistant)

 

Listeria monocytogenes

(tumbling motility, meningitis in newborns, unpasteurized milk)

Term

Staph. aureus

(Appearance)

Definition
Gram+ cocci in clusters
Term

Staph. aureus

(Virulence Factor)

Definition

Protein A

(binds Fc-IgG > inhibits complement activation/phagocytosis)

Term

Staph. aureus

(Presentations)

Definition

Inflammatory disease

(skin infections, organ abscesses, pneumoniae [after flu virus infection], endocarditis, osteomyelitis)

 

Toxin-mediated disease

Toxic shock Syndrome (TSST-1)

Scalded Skin Syndrome (exfoliative toxin)

Rapid-onset food poisoning (enterotoxin)

 

MRSA infection

Important cause of serious nosocomial/community-acquired infections. Resistant to methicillin and nafcillin (altered PBP)

Term

Staph. aureus

(TSST)

Definition

Superantigen > binds MHC II and TCR > polyclonal T-cell activation

 

Presentation = fever, vomiting, rash, desquamation, shock, end-organ failure

 

Use of vaginal/nasal tampons predisposes to TSS

Term

Staph. aureus

(Food Poisoning)

Definition

Ingestion of preformed toxin > short incubation period (2-6 hrs)

 

Enterotoxin = heat stable > not destroyed by cooking

Term

Staph. aureus

(Biochemistry)

Definition

Catalase +

 

Coagulase +

(forms fibrin clot around self > abscess)

Term

Staph. aureus

(Location)

Definition
Commonly colonizes the nose
Term
Staphylococcus epidermidis
Definition

Infects prosthetic devices and intravenous catheters by producing an adherent biofilm.

 

Location = normal skin flora

(contaminates blood cultures)

 

Novobiocin sensitive

Term
Staphylococcus saprophyticus
Definition

Second most common of uncomplicated UTI in young women (E. coli #1)

 

Novobiocin resistant

Term

Streptococcus pneumoniae

(Presentation)

Definition

Most common cause of MOPS

Meningitis

Otitis media (in children)

Pneumoniae

Sinusitis


Pneumococcus = "rusty" red sputum

 

Sepsis in sickle cell anemia and splenectomy

Term

Streptococcus pneumoniae

(Virulence, Appearance, Biochemistry)

Definition

Virulence:

Secretes IgA protease

Encapsulated

(no virulence without capsule)

 

Appearance = Lancet-shaped, Gram+ diplococci

 

Biochemistry = Optochin Sensitive

Term

Viridans group streptococci

(Location)

Definition
Normal flora of the oropharynx
Term

Viridans group streptococci

(Presentation)

Definition

Streptococcus mutans = Dental caries

 

Streptococcus sanguinis = Subacute bacterial endocarditis at damaged valves

(Makes dextrans > bind to fibrin-platelet aggregates on damaged valves)

Term

Streptococcus pyogenes [GAS]

(Presentation)

Definition

Pyogenic = Pharyngitic, Cellulitis, Impetigo

 

Toxigenic = Scarlet fever, Toxic Shock-like Syndrome, Necrotizing fasciitis

 

Immunologic = Rheumatic fever, Acute glomerulonephritis

 

Pharyngitis > Rheumatic phever and Glomerulonephritis!

 

Impetigo precedes Glomerulonephritis more than pharyngitis

Term

Streptococcus pyogenes [GAS]

(Virulence)

Definition
M protein
Term

Streptococcus pyogenes [GAS]

(Immunologic Response)

Definition

Antibodies to M protein enhance host defense, but can cause Rheumatic Fever

 

ASO titer detects recent infection

Term

Streptococcus pyogenes [GAS]

(Scarlet Fever)

Definition

Scarlet rash with sandpaper-like texture

 

Strawberry tongue

 

Circumoral pallor

Term
Rheumatic Fever Criteria
Definition

JONES Criteria

 

Joints (polyarthritis)

<3 (carditis)

Nodules (subcutaneous)

Erythema marginatum

Sydenham chorea

Term

Streptococcus agalactiae [GBS]

(Location)

Definition
Vagina
Term

Streptococcus agalactiae [GBS]

(Presentation)

Definition

Causes pneumoniae, meningitis, and sepsis - mainly is babies!

 

Group B for Babies

Term

Streptococcus agalactiae [GBS]

(Biochemistry)

Definition

Produces CAMP factor

(enlarges area of hemolysis formed by S. aureus)

 

Hippurate +

Term

Streptococcus agalactiae [GBS]

(Screening)

Definition

Screen pregnant women at 35-37 weeks

 

Positive cultures = Intrapartum penicillin prophylaxis

Term

Enterococci [Group D Strep]

(Location)

Definition
Normal colonic flora
Term

Enterococcus [Group D Strep]

(Presentation)

Definition

UTI

 

Biliary tract infections

 

Subacute endocarditis

(after GI/GU procedures)

 

Nosocomial infection

(VRE)

Term

Enterococcus [Group D Strep]

(Species)

Definition

E. faecalis

 

E. faecium

Term
Nonenterococcal Group D Strep
Definition

Included in Lancefield grouping

(based on differences in C carbohydrate on bacterial cell wall)

 

Variable hemolysis

 

Not as hardy as Enterococci

(cannot grow in 6.5% NaCl or Bile)

Term

Streptococcus bovis [GDS]

(Location)

Definition
Gut
Term

Streptococcus bovis [GDS]

(Presentation)

Definition

Bacteremia and subacute endocarditis in colon cancer patients

 

Bovis in the blood = cancer in the colon

Term

Corynebacterium diphtheriae

(Virulence)

Definition

Diphtheria exotoxin

(Encoded by B-prophage. Inhibits protein synthesis via ADP-ribosylation of EF-2)

 

Term

Corynebacterium diphtheriae

(Presentation)

Definition

Pseudomembranous pharyngitis

(grayish-white membrane)

 

Lymphadenopathy

 

Myocarditis

 

Arrhythmias

Term

Corynebacterium diphtheriae

(Diagnosis, Labs)

Definition

Diagnosis = Gram+ rods with metachromatic (blue and red) granules + Elek test for toxin

 

Black colonies on cystine-tellurite agar

Term

Corynebacterium diphtheriae

(Mnemonic)

Definition

ABCDEFG

ADP-Ribosylation

B-prophage

Corynebacterium

Diphtheria

Elongation Factor 2

Granules

Term
When are spores formed?
Definition
End of stationary phase when nutrients are limited
Term
Spores
Definition

Highly resistant to heat/chemicals

 

Have dipicolinic acid in core

 

No metabolic activity

Term
How to kill spore-forming bacteria?
Definition
Autoclave at 121 C for 15 min
Term
Spore-forming Bacteria
Definition

Bacillus anthracis

Clostridium perfringens

Clostridium tetani

B. cereus

C. botulinum

Coxiella burnetii

Term
Clostridia
Definition
Gram+ spore-forming obligate anaerobic bacilli
Term
Clostridium tetani
Definition

Produces Tetanospasmin

(Cleaves SNARE proteins > prevents GABA/Glycine release from Renshaw cells in spinal cord)

 

Presentation:

Spastic paralysis

Trismus (Lockjaw)

Risus sardonicus

 

Term
Clostridium botulinum
Definition

Produces Botulinum toxin

(Heat-labile. Cleaves SNARE protein > inhibits ACh release at NMJ)

 

Adults = ingestion of preformed toxin

Babies = ingestion of spores in honey

 

Presentation = flaccid paralysis (floppy baby syndrome)

 

 

Term
Clostridium perfringens
Definition

Produces Alpha toxin

(Lecithinase, a phospholipase)

 

Presentation = Myonecrosis (gas gangrene) and Hemolysis

 

Perfringens perforates a gangrenous leg

Term

Clostridium difficile

(Virulence)

Definition

Exotoxins:

Toxin A

(Enterotoxin. Binds brush border of gut)

 

Toxin B

(Cytotoxin. Causes actin depolymerization > cytoskeletal disruption > pseudomembranous colitis > diarrhea)

 

Term

Clostridium difficile

(Cause)

Definition

Usually secondary to antibiotic use

(Clindamycin and Ampicillin)

 

Term

Clostridium difficile

(Diagnosis)

Definition
Toxin detection in stool
Term

Clostridium difficile

(Presentation)

Definition
Diarrhea
Term

Clostridium difficile

(Treatment)

Definition

Metronidazole or oral Vancomycin

 

Recurring cases = Fecal transplant can prevent relapse

Term

Anthrax

(Cause)

Definition

Bacillus anthracis

(Gram+ spore-forming rod)

 

Produces Anthrax toxin

(Edema factor)

 

Only bacteria with polypeptide capsule

(contains D-glutamate)

Term

Anthrax

(Cutaneous)

Definition
Boil-like lesion > ulcer with black eschar (painless, necrotic) > uncommonly progresses to bacteremia and death
Term

Anthrax

(Pulmonary)

Definition

Inhalation of spores > flu-like symptoms > rapidly progress to:

- Fever

- Pulmonary hemorrhage

- Mediastinitis

- Shock

 

Woolsorter's Disease = inhalation of spores from contaminated wool

Term
Dominant normal flora of the skin?
Definition
S. epidermidis
Term
Dominant normal flora of the nose?
Definition

S. epidermidis

 

S. aureus

Term
Dominant normal flora of the oropharynx?
Definition
Viridans group streptococci
Term
Dominant normal flora of dental plaque?
Definition
S. mutans
Term
Dominant normal flora of the colon?
Definition
B. fragilis > E. coli
Term
Dominant normal flora of the vagina?
Definition

Lactobacillus

 

(Colonized by E. coli and GBS)

Term

Food poisoning source

(B. cereus)

Definition
Reheated rice
Term

Food poisoning source

(C. botulinum)

Definition

Improperly canned foods

(sign = bulging cans)

Term

Food poisoning source

(C. perfringens)

Definition
Reheated meat dishes
Term

Food poisoning source

(E. coli O157:H7)

Definition
Undercooked meat
Term

Food poisoning source

(Salmonella)

Definition
Poultry, meat, and eggs
Term

Food poisoning source

(S. aureus)

Definition

Meats, mayonnaise, custard

(preformed toxin)

Term

Food poisoning source

(V. parahaemolyticus)

Definition
Contaminated seafood
Term

Food poisoning source

(V. vulnificus)

Definition

Contaminated seafood

 

(Contaminated water or shellfish > wound infections)

Term
Food poisoning that starts and ends quickly
Definition

S. aureus

 

B. cereus

Term
Bugs that cause bloody diarrhea
Definition

Campylobacter

 

E. histolytica

 

EHEC

 

EIEC

 

Salmonella

 

Shigella

 

Y. enterocolitica

Term

Bloody diarrhea

(Campylobacter)

Definition

Comma- or S-shaped organisms

 

Growth at 42 C

Term

Bloody diarrhea

(E. histolytica)

Definition

Protozoa

 

Amebic dysentery

 

Liver abscess

Term

Bloody diarrhea

(EHEC)

Definition

O157:H7

 

Can cause HUS

 

Makes Shiga-like toxin

Term

Bloody diarrhea

(EIEC)

Definition
Invades colonic mucosa
Term

Bloody diarrhea

(Salmonella)

Definition

Lactose -

 

Flagellar motility

 

Animal reservoir

(especially poultry and eggs)

Term

Bloody diarrhea

(Shigella)

Definition

Lactose -

 

Very low ID50

 

Produces Shiga toxin

(only in human reservoir)

 

Bacillary dysentery

Term

Bloody diarrhea

(Y. enterocolitica)

Definition

Day-care outbreaks

 

Pseudoappendicitis

Term
Causes of watery diarrhea
Definition

C. difficile

 

C. perfringens

 

ETEC

 

Protozoa

 

V. cholera

 

Viruses

Term

Water Diarrhea

(C. difficile)

Definition

Pseudomembranous colitis

 

Caused by antibiotics

 

Sometimes bloody diarrhea

Term

Water Diarrhea

(C. perfringens)

Definition
Also causes gas gangrene
Term

Water Diarrhea

(ETEC)

Definition

Traveler's diarrhea

 

Produces heat-labile (LT) and heat-stable (ST) toxins

Term

Water Diarrhea

(Protozoa)

Definition

Giardia

 

Crytosporidium

(immunocompromised)

Term

Water Diarrhea

(V. cholera)

Definition

Comma-shaped organisms

 

Rice-water diarrhea

 

Often from infected seafood

Term

Water Diarrhea

(Viruses)

Definition

Rotavirus

 

Norovirus

(cruises)

Term
Causes of pneumonia in neonates
Definition

GBS

 

E. coli

Term
Causes of pneumonia in children (4 wk-18 yrs)
Definition

Runts May Cough Chunky Sputum

 

Viruses (RSV)

Mycoplasma

C. trachomatis (infants-3yrs)

C.pneumoniae (school-aged)

S. pneumoniae

Term
Causes of pneumonia in adults
Definition

Mycoplasma

 

C. pneumoniae

 

S. pneumoniae

Term
Causes of pneumonia in alcoholic/IV drug user
Definition

S. pneumoniae

 

Klebsiella

 

Staphylococcus

Term
Causes of pneumonia in aspiration
Definition
Anaerobes
Term
Causes of pneumonia in cystic fibrosis
Definition

Pseudomonas

 

S. aureus

 

S. pneumoniae

Term
Causes of pneumonia in immunocompromised
Definition

Staphylococcus

 

Enteric Gram- rods

 

Fungi

 

Viruses

 

P. jirovecii

(HIV)

Term
Causes of pneumonia in nosocomial
Definition

Staphylococcus

 

Pseudomonas

 

Other enteric Gram- rods

Term
Causes of pneumonia in postviral
Definition

Staphylococcus

 

H. flu

 

S. pneumo

Term
Causes of meningitis in newborns (0-6 months)
Definition

GBS

 

E. coli

 

Listeria

Term
Causes of meningitis in children (6 months-6 yrs)
Definition

S. pneumo

 

N. meningitidis

 

H. flu type B

 

Enteroviruses

Term
Causes of meningitis in 6-60 yrs
Definition

S. pneumo

 

N. meningitidis (#1 in teens)

 

Enteroviruses

 

HSV

Term
Causes of meningitis in 60+ yrs
Definition

S. pneumo

 

Gram- rods

 

Listeria

Term
Meningitis Treatment
Definition

Ceftriaxone and Vancomycin

 

Add Ampicillin if Listeria

Term
Viral causes of Meningitis
Definition

Enteroviruses

(especially Coxsackievirus)

 

HSV-2

(HSV-1 = encephalitis)

 

HIV

 

West Nile

 

VZV

Term
Causes of meningitis in HIV
Definition

Cryptococcus

 

CMV

 

Toxoplasmosis

(brain abscess)

 

JC virus

(PML)

Term
H. flu in meningitis
Definition

Incidence greatly reduced with immunization

 

Cases usually seen in unimmunized children

Term

CSF in Meningitis

(Bacterial)

Definition

Opening pressure = increased

Cell type = PMNs

Protein = increased

Sugar = decreased

Term

CSF in Meningitis

(Fungal/TB)

Definition

Opening pressure = increased

Cell type = Lympocytes

Protein = increased

Sugar = decreased

Term

CSF in Meningitis

(Viral)

Definition

Opening pressure = normal/increased

Cell type = Lymphocytes

Protein = normal/increased

Sugar = normal

Term

Osteomyelitis Causes

(No risk factors)

Definition
Staph. aureus
Term

Osteomyelitis Causes

(Sexually active)

Definition

Neisseria gonorrhoea

(Rare. Septic arthritis more common)

Term

Osteomyelitis Causes

(Diabetics and IV drug users)

Definition

Pseudomonas aeruginosa

 

Serratia

Term

Osteomyelitis Causes

(Sickle cell)

Definition
Salmonella
Term

Osteomyelitis Causes

(Prosthetic Joints)

Definition

S. aureus

 

S. epidermidis

Term

Osteomyelitis Causes

(Vertebral involvement)

Definition

TB

(Pott disease)

Term

Osteomyelitis Causes

(Cat/Dog bites)

Definition
Pasteurella multocida
Term
Osteomyelitis usually occurs in... ?
Definition
Children
Term

Osteomyelitis

(Labs)

Definition

Elevated CRP and ESR

(nonspecific)

 

Subtle on radiographs, more easily seen on MRI

 

 

Term

Cystitis

(Presentation)

Definition

Dysuria

 

Frequency

 

Urgency

 

Suprapubic pain

 

WBCs in urine

(no casts)

Term

Cystitis/Pyelonephritis

(Cause)

Definition

Ascension of microbes from urethra to bladder/kidney

 

 

Term

UTI/Cystitis/Pyelonephritis

(Predisposing Factors)

Definition

Males = infants with congenital defects, vesicoureteral reflux

 

Elderly = enlarged prostate

 

Female gender (shorter urethras)

 

Other = Obstruction, Kidney surgery, Catheterization, GU malformation, Diabetes, Pregnancy

Term

Pyelonephritis

(Presentation)

Definition

Fever, Chills

 

Flank pain

 

Costovertebral angle tenderness

 

Hematuria

 

WBC casts

Term
UTI Diagnostic Markers
Definition

Leukocyte esterase +

(Bacterial UTI)

 

Nitrite +

(Gram- bacterial UTI)

Term
Leading cause of UTI
Definition

E. coli

 

Colonies show green metallic sheen on EMB agar

Term
Second leading cause of UTI in sexually active women
Definition
Staph. saprophyticus
Term
Third leading cause of UTI
Definition

Klebsiella pneumoniae

 

Large mucoid capsule and viscous colonies

Term
Nosocomial causes of UTI
Definition

Serratia marcescens

(Produces a red pigment)

 

Enterobactera cloacae

 

Pseudomonas aeruginosa

(Blue-green pigment. Fruity odor)

 

All usually drug resistant

Term
Cause of UTI associated with struvite stones
Definition

Proteus mirabilis

 

Motility > "swarming" on agar

 

Produces urease

Term
Common vaginal infections
Definition

Bacterial vaginosis

 

Trichomoniasis

 

Candida vulvovaginitis

Term

Common Vaginal Infections

(Bacterial Vaginosis)

 

[Symptoms, Labs, Treatment]

Definition

Symptoms:

No inflammation

Thin, white discharge with fishy odor

 

Labs:

Clue cells

pH > 4.5

 

Treatment:

Metronidazole

Term

Common Vaginal Infections

(Trichomoniasis)

 

[Symptoms, Labs, Treatment]

Definition

Symptoms:

Inflammation

Frothy, grey-green, foul-smelling discharge

 

Labs:

Motile trichomonads

pH > 4.5

 

Treatment:

Metronidazole

Treat sexual partner

Term

Common Vaginal Infections

(Candida Vulvovaginitis)

 

[Symptoms, Labs, Treatment]

Definition

Symptoms:

Inflammation

Thick, white, cottage cheese discharge

 

Labs:

Pseudohyphae

pH normal (4-4.5)

 

Treatment:

-azoles

Term
Infections that pass from mother to fetus
Definition

ToRCHeS


Toxoplasma gondii

Rubella

CMV

HIV

Herpes Simplex Virus-2

Syphilis

Term
Normal mode of transmission for ToRCHeS infections?
Definition

Transplacental

 

During delivery

(HSV-2)

Term
Common nonspecific signs of ToRCHeS infections
Definition

Hepatosplenomegaly

 

Jaundice

 

Thrombocytopenia

 

Growth retardation

Term

Important infectious agents with mother > baby transmission

(besides ToRCHeS)

Definition

GBS

E. coli

Listeria

(all causes of meningitis in neonates)

 

Parvovirus B19

(hydrops fetalis)

Term

ToRCHeS Infections

(Toxoplasma gondii)

 

[Mode of Transmission]

Definition
Cat feces or ingestion of undercooked meat
Term

ToRCHeS Infections

(Toxoplasma gondii)

 

[Maternal Manifestations]

Definition

Usually asymptomatic

 

Sometimes lymphadenopathy

Term

ToRCHeS Infections

(Toxoplasma gondii)

 

[Neonatal Manifestation]

Definition

Classic Triad:

Chorioretinitis

Hydrocephalus

Intracranial calcifications

 

(all stays on the head)

Term

ToRCHeS Infections

(Rubella)

 

[Transmission]

Definition
Respiratory droplets
Term

ToRCHeS Infections

(Rubella)

 

[Maternal Manifestations]

Definition

Rash

 

Lymphadenopathy

 

Arthritis

Term

ToRCHeS Infections

(Rubella)

 

[Neonatal Manifestations]

Definition

Classic Triad:

PDA (or Pulm. artery hypoplasia)

Cataracts

Deafness

 

May have blueberry muffin rash

Term

ToRCHeS Infections

(CMV)

 

[Transmission]

Definition

Sexual contact

 

Organ transplants

Term

ToRCHeS Infections

(CMV)

 

[Maternal Manifestations]

Definition

Usually asymptomatic

 

Sometimes mononucleosis-like illness

Term

ToRCHeS Infections

(CMV)

 

[Neonatal Manifestations]

Definition

Hearing loss

Seizures

Petechial rash

Blueberry muffin rash

Term

ToRCHeS Infections

(HIV)

 

[Transmission]

Definition

Sexual contact

 

Needlestick

Term

ToRCHeS Infections

(HIV)

 

[Maternal Manifestations]

Definition
Variable presentation depending on CD4+ count
Term

ToRCHeS Infections

(HIV)

 

[Neonatal Manifestations]

Definition

Recurrent infections

Chronic diarrhea

Term

ToRCHeS Infections

(HSV-2)

 

[Transmission]

Definition
Skin or mucous membrane contact
Term

ToRCHeS Infections

(HSV-2)

 

[Maternal Manifestations]

Definition

Usually asymptomatic

 

Herpetic (vesicular) lesions

Term

ToRCHeS Infections

(HSV-2)

 

[Neonatal Manifestations]

Definition

Encephalitis

Herpetic (vesicular) lesions

Term

ToRCHeS Infections

(Syphilis)

 

[Transmission]

Definition
Sexual contact
Term

ToRCHeS Infections

(Syphilis)

 

[Maternal Manifestations]

Definition

Primary = Chancre

 

Secondary = Disseminated rash

 

Two stages likely to result in fetal infection

Term

ToRCHeS Infections

(Syphilis)

 

[Neonatal Manifestations]

Definition

Stillbirth

Hydrops fetalis

 

If child survives:

Hutchinson's teeth

Saddle nose

Short maxilla

Saber shins

CN VIII deafness

Term

Red Rashes of Childhood

(Coxsackievirus A)

 

[Disease]

Definition
Hand-foot-mouth Disease
Term

Red Rashes of Childhood

(Coxsackievirus A)

 

[Presentation]

Definition

Vesicular rash on palms/soles

 

Vesicles and ulcers in oral mucosa

Term

Red Rashes of Childhood

(HHV-6)

 

[Disease]

Definition
Roseola
Term

Red Rashes of Childhood

(HHV-6)

 

[Presentation]

Definition

Several days of higher fever > macular rash over body

 

Febrile seizures

 

Usually affects infants

Term

Red Rashes of Childhood

(Measles Virus)

 

[Disease]

Definition

Measles

(Rubeola)

Term

Red Rashes of Childhood

(Measles Virus)

 

[Presentation]

Definition

Paramyxovirus

 

Begins at head > moves down

 

Rash preceded by by 4 C's

Cough

- Coryza

Conjunctivitis

Koplik spots on buccal mucosa

Term

Red Rashes of Childhood

(Parvovirus B19)

 

[Disease]

Definition

Erythema Infectiosum

(Fifth Disease)

Term

Red Rashes of Childhood

(Parvovirus B19)

 

[Presentation]

Definition

"Slapped cheek" rash

(Begins on head > moves down to fine truncal rash)

 

Postauricular lymphadenopathy

 

Can cause Hydrops Fetais in pregnant women

 

Term

Red Rashes of Childhood

(Strep. pyogenes)

 

[Disease]

Definition
Scarlet Fever
Term

Red Rashes of Childhood

(Strep. pyogenes)

 

[Presentation]

Definition

Erythematous, sandpaper-like rash

 

Fever

 

Sore throat

Term

Red Rashes of Childhood

(VZV)

 

[Disease]

Definition
Chickenpox
Term

Red Rashes of Childhood

(VZV)

 

[Presentation]

Definition

Vesicular rash

(begins on trunk > spreads to face/extremities with lesions of different ages)

Term

STDs

(AIDS)

 

[Organism]

Definition
HIV
Term

STDs

(Chancroid)

 

[Organism]

Definition

Haemophilus ducreyi

 

It's so painful, you cry

Term

STDs

(Chlamydia)

 

[Organism]

Definition

Chlamydia trachomatis

(D-K)

Term

STDs

(Condylomata acuminata)

 

[Organism]

Definition
HPV-6 and 11
Term

Red Rashes of Childhood

(Rubella Virus)

 

[Disease]

Definition
Rubella
Term

Red Rashes of Childhood

(Rubella Virus)

 

[Presentation]

Definition

Rash begins at head > moves down > fine truncal rash

 

Postauricular lymphadenopathy

Term

STDs

(Genital Herpes)

 

[Organism]

Definition

HSV-2

(less commonly HSV-1)

Term

STDs

(Gonorrhea)

 

[Organism]

Definition
Neisseria gonorrhoeae
Term

STDs

(Hepatitis B)

 

[Organism]

Definition
HBV
Term

STDs

(Lymphogranuloma Venereum)

 

[Organism]

Definition

C. trachomatis

(L1-L3)

Term

STDs

(Syphilis)

 

[Organism]

Definition
Treponema pallidum
Term

STDs

(Trichomoniasis)

 

[Organism]

Definition
Trichomonas vaginalis
Term

STDs

(AIDS)

 

[Clinical Features]

Definition

Opportunistic infections

Kaposi sarcoma

Lymphoma

Term

STDs

(Chancroid)

 

[Clinical Features]

Definition

Painful genital ulcer

Inguinal adenopathy

Term

STDs

(Chlamydia)

 

[Clinical Features]

Definition

Urethritis

Cervicitis

Conjunctivitis

Reactive arthritis

PID

Term

STDs

(Condylomata Acuminata)

 

[Clinical Features]

Definition

Genital warts

Koilocytes

Term

STDs

(Genital Herpes)

 

[Clinical Features]

Definition

Painful penile, vulvar, or cervical vesicles and ulcers

 

Can cause systemic symptoms such as fever, headache, myalgia

Term

STDs

(Gonorrhea)

 

[Clinical Features]

Definition

Urethritis

Cervicitis

PID

Prostatitis

Epididymitis

Arthritis

Creamy purulent discharge

Term

STDs

(Hepatitis B)

 

[Clinical Features]

Definition
Jaundice
Term

STDs

(Lymphogranuloma Venereum)

 

[Clinical Features]

Definition

Infection of lymphatics

 

Painless genital ulcers

Painful lymphadenopathy (buboes)

Term

STDs

(Syphilis)

 

[Clinical Features]

Definition

Primary = Painless chancre

 

Secondary = Fever, Lymphadenopathy, Skin rashes, Condylomata lata

 

Tertiary = Gummas, tabes dorsalis, general paresis, aortitis, Argyll Robertson pupil

Term

STDs

(Trichomoniasis)

 

[Clinical Features]

Definition

Vaginitis

Strawberry cervix

Motile in wet prep

Term

Pelvic Inflammatory Disease

(Top bugs)

Definition

Chlamydia trachomatis

(subacute, often undiagnosed)

 

Neisseria gonorrhoeae

(acute)

 

C. trachomatis

Term

Pelvic Inflammatory Disease

(Clinical Signs)

Definition

Cervical motion tenderness

(Chandelier sign)

 

Purulent cervical discharge

Term

Pelvic Inflammatory Disease

(Complications)

Definition

Salpingitis

 

Endometritis

 

Hydrosalpinx

 

Tubo-ovarian abscess

 

Fitz-Hugh-Curtis Syndrome

Term
Fitz-Hugh-Curtis Syndrome
Definition

Infection of liver capsule > "violin string" adhesions of peritoneum to liver

 

Can occur after PID

Term
Salpingitis is a risk factor for ____?
Definition

Ectopic pregnancy

 

Infertility

 

Chronic pelvic pain

 

Adhesions

Term

Nosocomial Infections

(Candida)

 

[Risk Factor]

Definition
Hyperalimentation
Term

Hyperalimentation

(Nosocomial Infections)

Definition
Candida albicans
Term

Nosocomial Infections

(CMV, RSV)

 

[Risk Factor]

Definition
Newborn nursery
Term

Newborn nursery

(Nosocomial Infections)

Definition

CMV

 

RSV

Term

Nosocomial Infections

(E. coli, Proteus Mirabilis)

 

[Risk Factor]

Definition
Urinary catheterization
Term

Urinary catheterization

(Nosocomial Infections)

Definition

E. coli

 

Proteus mirabilis

Term
2 most common causes of nosocomial infections
Definition

E. coli

(UTI)

 

S. aureus

(wound infection)

Term

Nosocomial Infections

(HBV)

 

[Risk Factor]

Definition
Work in renal dialysis unit
Term

Work in renal dialysis unit

(Nosocomial Infections)

Definition
HBV
Term

Nosocomial Infections

(Legionella)

 

[Risk Factor]

Definition
Water aerosols
Term

Water aerosols

(Nosocomial Infections)

Definition
Legionella
Term
Nosocomial infection when water source is involved
Definition
Legionella
Term

Nosocomial Infections

(Pseudomonas aeruginosa)

 

[Risk Factor]

Definition
Respiratory therapy equipment
Term

Respiratory therapy equipment

(Nosocomial Infections)

Definition

Pseudomonas aeruginosa

 

(think airuginosa when air or burns are involved)

Term
Bugs that affect unimmunized children
Definition

Rubella virus

 

Measles virus

 

H. flu type B

 

Poliovirus

 

Corynebacterium diphtheriae

Term

Rash in unimmunized children

 

(begins at head and moves down + postauricular lymphadenopathy)

Definition
Rubella virus
Term

Rash in unimmunized children

 

(begins at head and moves down + preceded by cough, coryza, conjunctivitis, and Koplik spots)

Definition
Measles
Term

Meningitis in unimmunized children

(Findings/Labs)

Definition

Microbe colonizes nasopharynx

 

Can lead to myalgia/paralysis

Term

Meningitis in unimmunized children

(Pathogens)

Definition

HiB

 

Poliovirus

Term

Epiglottitis in unimmunized children

(Findings/Labs)

Definition

Fever with dysphagia, drooling, and difficulty breathing

(edematous "cherry red" epiglottis)

 

"Thumbprint sign" on x-ray

Term

Epiglottitis in unimmunized children

(Pathogen)

Definition

HiB

(can also cause epiglottitis in immunized children)

Term

Pharyngitis in unimmunized children

(Findings/Labs)

Definition

Grayish oropharyngeal exudate

(pseudomembranes may obstruct airway)

 

Painful throat

Term

Pharyngitis in unimmunized children

(Pathogen)

Definition

Corynebacterium diphtheriae

(exotoxin > necrosis in pharynx, cardiac, and CNS tissue)

Term

Unimmunized children

(Corynebacterium diphtheriae)

Definition

[Pharyngitis]

 

Grayish oropharyngeal exudate

(pseudomembranes obstruct airway)

 

Painful throat

Term

Unimmunized children

(HiB)

Definition

[Epiglottitis]

 

Fever with dysphagia, drooling, difficulty breathing

(edematous cherry red epiglottis)

 

Thumbprint sign on x-ray

 

[Meningitis]

 

Microbe colonizes nasopharynx

 

Can lead to myalgia + paralysis

Term

Unimmunized children

(Rubella)

Definition

Rash at head > moves down

 

Postauricular lymphadenopathy

Term

Unimmunized children

(Measles)

Definition

Rash begins at head > moves down

 

Rash preceded by cough, coryza, conjunctivitis, and Koplik spots on buccal mucosa

Term

[Bug Hints]

 

Asplenic patient

(due to surgical splenectomy or autosplenectomy in chronic Sickle Cell)

Definition

Encapsulated microbes

 

SHiN SKiS

S. pneumo

HiB

N. meningitidis

Salmonella

Klebsiella

Strep (Group B)

 

(Strep. pneumo >> HiB > N. meningitidis)

Term

[Bug Hints]

 

Branching rods in oral infection, Sulfur granules

Definition
Actinomyces israelii
Term

[Bug Hints]

 

Chronic granulomatous disease

Definition

Catalase + microbes

(especially S. aureus)

Term

[Bug Hints]

 

"Currant jelly" sputum

Definition
Klebsiella
Term

[Bug Hints]

 

Dog or cat bite

Definition
Pasteurella multocida
Term

[Bug Hints]

 

Facial nerve palsy

Definition

Borrelia burgdorferi

(Lyme disease)

Term

[Bug Hints]

 

Fungal infection in diabetic or immunocompromised patient

Definition
Mucor or Rhizopus spp.
Term

[Bug Hints]

 

Health care provider

Definition

HBV

(from needle stick)

Term

[Bug Hints]

 

Neutropenic patients

Definition

Candida albicans

(systemic)

 

Aspergillus

Term

[Bug Hints]

 

Organ transplant recipient

Definition
CMV
Term

[Bug Hints]

 

PAS +

Definition

Tropheryma whipplei

(Whipple Disease)

Term

[Bug Hints]

 

Pediatric infection

Definition

HiB

(including epiglottitis)

Term

[Bug Hints]

 

Pneumonia in cystic fibrosis

Burn infection

Definition
Pseudomonas aeruginosa
Term

[Bug Hints]

 

Pus, empyema, abscess

Definition
S. aureus
Term

[Bug Hints]

 

Rash on hands and feet

Definition

Coxsackie A virus

 

Rickettsia rickettsii

 

Syphilis

(Treponema pallidum)

Term

[Bug Hints]

 

Sepsis/Meningitis in newborn

Definition
GBS
Term

[Bug Hints]

 

Surgical wound

Definition
S. aureus
Term

[Bug Hints]

 

Traumatic open wound

Definition
Clostridium perfringens
Term

Bacillus cereus

(Disease)

Definition
Food poisoning
Term

Bacillus Cereus

(Pathogenesis)

Definition

"Reheated Rice Syndrome"

 

Spores survive cooking rice. Keeping rice warm > germination of spore > enterotoxin formation

Term
Reheated Rice Syndrome
Definition
Bacillus Cereus food poisoning
Term

Bacillus Cereus

(Types)

Definition

Emetic = rice and pasta

(N/V within 1-5 hrs; caused by cereulide, a preformed toxin)

 

Diarrheal

(watery, nonbloody diarrhea and GI pain within 8-18 hrs)

Term

Listeria Monocytogenes

(Characteristics)

Definition

Gram positive facultative intracellular microbe

 

Only gram positive to make LPS

 

Term

Listeria Monocytogenes

(Route)

Definition

Ingestion of unpasteurized dairy products and deli meats

 

Transplacental transmission

 

Vaginal transmission during birth

Term
Only gram positive microbe to make LPS?
Definition
Listeria Monocytogenes
Term

Listeria Monocytogenes

(Immune Evasion)

Definition

Form "rocket tails" (actin polymerization) > move through cytoplasm into cell membranes > avoids antibody

 

Tumbling motility

Term

Listeria Monocytogenes

(Features in Pregnant Women)

Definition

Amnionitis

Septicemia

Spontaneous abortion

Term

Listeria Monocytogenes

(Features in Immunocompromised)

Definition
Meningitis
Term

Listeria Monocytogenes

(Features in Babies)

Definition

Granulomatosis infantiseptica

Neonatal meningitis

Term

Listeria Monocytogenes

(Features in Healthy Individuals)

Definition
Mild gastroenteritis
Term

Listeria Monocytogenes

(Treatment)

Definition

Gastroenteritis = self-limited

 

Ampicillin for infants, immunocompromised, and elderly

(empirical treatment for meningitis)

Term

Actinomyces

(Characteristics)

Definition
Gram positive anaerobe
Term

Actinomyces

(Stain)

Definition
Not acid fast
Term

Actinomyces

(Location)

Definition
Normal oral flora
Term

Actinomyces

(Clinical)

Definition

Causes oral/facial abscesses that drain through sinus tracts

 

Forms yellow "sulfur granules"

Term

Actinomyces

(Treatment)

Definition
Penicillin
Term

Nocardia

(Characteristics)

Definition
Gram positive aerobe
Term

Nocardia

(Stain)

Definition

Acid fast

(weak)

Term

Nocardia

(Location)

Definition
Found in soil
Term

Nocardia

(Clinical)

Definition
Causes pulmonary infections in immunocompromised and cutaneous infections after traums in immunocompetent
Term

Nocardia

(Treatment)

Definition
Sulfonamides
Term
Positive PPD
Definition

Current infection

 

Past exposure

 

BCG vaccinated

Term
Negative PPD
Definition

No infection

 

Anergic

(steroids, malnutrition, immunocompromise)

 

Sarcoidosis

Term
More specific test for Tuberculosis
Definition

Interferon-y Release Assay

(IGRA)

 

Fewer false positives from BCG vaccination

Term

Primary Tuberculosis

(Pathogenesis)

Definition
Infection with Mycobacterium tuberculosis > nonimmune host (usually child) > Primary tuberculosis
Term

Primary Tuberculosis

(Ghon Complex)

Definition

Hilar nodes

 

Ghon focus

(usually in mid zone of lung)

Term

Primary Tuberculosis

(Clinical Consequences)

Definition

Heals by fibrosis > immunity and hypersensitivity > Tuberculin positive

 

Progressive lung disease (HIV, malnutrition) > Death (rare)

 

Severe bacteremia > Miliary tuberculosis > Death

 

Preallergic lymphatic or hematogenous dissemination > Dormant tubercle bacilli in several organs > Reactivation in adult life

Term

Secondary Tuberculosis

(Pathogenesis)

Definition
Infection with Mycobacterium tuberculosis > partially immune hypersensitized host (usually adult) > reinfection > reactivation tuberculosis of the lungs
Term

Secondary Tuberculosis

(Clinical Feature)

Definition

Fibrocaseous cavitary lesion

(usually upper lobes)

Term

Secondary Tuberculosis

(Extrapulmonary Sites)

Definition

CNS

(parenchymal tuberculoma or meningitis)

 

Vertebral body

(Pott Disease)

 

Lymphadenitis

 

Renal

 

GI

 

Adrenals

Term
Caseating Granuloma
Definition
Central necrosis (pinkish region) with multinucleated Langerhans giant cells
Term
Mycobacterium tuberculosis
Definition

TB

 

Often resistant to multiple drugs

Term

Tuberculosis

(Pathogen)

Definition
Mycobacterium tuberculosis
Term
Mycobacterium kansasii
Definition
Pulmonary TB-like symptoms
Term

Pulmonary TB-like symptoms

(Mycobacterium)

Definition
M. kansasii
Term

Mycobacterium avium-intracellulare

(Clinical)

Definition

Disseminated, non-TB disease in AIDS

 

Often resistant to multiple drugs

Term

Mycobacterium avium-intracellulare

(Treatment)

Definition
Prophylactic treatment with Azithromycin
Term

Mycobacteria

(Staining)

Definition
Acid-fast
Term

Tuberculosis

(Symptoms)

Definition

Fever

 

Night sweats

 

Weight loss

 

Hemoptysis

Term

Tuberculosis

(Virulence)

Definition

Cord factor > inhibits macrophage maturation + induces release of TNF-a

 

Sulfatides (surface glycolipids > inhibit phagolysosomal fusion

Term

Leprosy

(Hansen Disease)

 

[Pathogen]

Definition
Mycobacterium leprae
Term

Mycobacterium Leprae

(Characteristics)

Definition

Acid-fast bacillus that likes cool temperatures

 

Cannot be grown in vitro

Term

Mycobacterium Leprea

(Infection Site)

Definition

Skin and superficial nerves

("glove and stocking" loss of sensation)

Term

Mycobacterium Leprea

(Reservoir in US)

Definition
Armadillos
Term

Hansen Disease

(Forms)

Definition

Lepromatous:

Presents diffusely over skin

Leonine facies

Communicable

Low cell-mediated immunity with humoral Th2 response

 

Tuberculoid:

Limited to few hypoesthetic, hairless skin plaques

High cell-mediated immunity with largely Th1-type immune response

Term

Hansen Disease

(Leprosy)

 

[Treatment]

Definition

Multidrug therapy

 

Tuberculoid = Dapsone + Rifampin for 6 months

 

Lepromatous = Dapsone, Rifampin, Clofazimine for 2-5 years

Term

Gram Negative

 

(Oxidase +, Comma Shaped)

Definition

Campylobacter Jejuni

(grows in 42C)

 

Vibrio Cholerae

(grows in alkaline media)

 

Helicobacter Pylori

(produces urease)

Term

Gram Negative

 

(Fast Lactose fermenting Rods)

Definition

Klebsiella

 

E. coli

 

Enterobacter

Term

Gram Negative

 

(Slow Lactose fermenting Rods)

Definition

Citrobacter

 

Serratia

Term

Gram Negative

 

(Non-Lactose Fermenting, Oxidase + Rods)

Definition
Pseudomonas
Term

Gram Negative

 

(Non-Lactose Fermenting, Oxidase - Rods)

Definition

Shigella

 

Salmonella

 

Proteus

 

Yersinia

Term

Gram Negative

 

("Coccoid" Rods)

Definition

Haemophilus influenzae

(requires factors V and X)

 

Pasteurella

(animal bites)

 

Brucella

(brucellosis)

 

Bordetella pertussis

Term

Gram Negative

 

(Diplococci)

Definition

Neisseria meningitidis

(Maltose fermenter)

 

Neisseria gonorrhoeae

(Non-Maltose fermenter)

 

MeninGococci ferment Maltose and Glucose

Gonococci ferment Glucose

Term
Lactose Fermenting Enteric bacteria
Definition

MacConkey Agar = Grow pink colonies

 

EMB agar = Grow purple/black colonies

(E. coli = purple colonies with green sheen)

 

Test with MacConKEE'S Agar

Citrobacter

Klebsiella

E. coli

Enterobacter

Serratia (weak fermenter)

 

 

Term

E. coli

(Lactose fermentation)

Definition
Produces B-galactosidase > breaks down Lactose > Glucose + Galactose
Term
Penicillin and Gram-Negative bugs
Definition

Gram Neg bacilli resistant to Penicillin G, but may be susceptible to Penicillin derivatives (Ampicillin/Amoxicillin)

 

Outer membrane layer > inhibits entry of Penicillin G + Vancomycin

Term

Gonococci

(Capsule)

Definition
No polysaccharide capsule
Term

Gonococci

(Fermentation)

Definition
Glucose
Term

Gonococci

(Vaccine)

Definition

No vaccine

(due to rapid antigenic variation of pilus proteins)

Term

Gonococci

(Transmission)

Definition
Sexually transmitted
Term

Gonococci

(Disease)

Definition

Gonorrhea

 

Septic arthritis

 

Neonatal conjunctivitis

 

PID

 

Fitz-Hugh-Curtis Syndrome

Term

Gonococci

(Prophylaxis)

Definition

Condoms prevent sexual transmission

 

Erythromycin outment prevents neonatal transmission

Term

Gonococci

(Treatment)

Definition
Ceftriaxons + Azithromycin or Doxycycline (possible chlamydia coinfection)
Term

Meningococci

(Capsule)

Definition
Polysaccharide capsule
Term

Meningococci

(Fermentation)

Definition
Maltose and Glucose
Term

Meningococci

(Vaccine)

Definition
Vaccine (none for type B)
Term

Meningococci

(Transmission)

Definition
Respiratory and oral secretions
Term

Meningococci

(Disease)

Definition

Meningococcemia

 

Meningitis

 

Waterhouse-Friderichsen Syndrome

Term

Meningococci

(Prophylaxis)

Definition
Rifampin, Ciprofloxacin, or Ceftriaxone prophylaxis in close contacts
Term

Meningococci

(Treatment)

Definition
Ceftriaxone or Penicillin G
Term

Haemophilus Influenzae

(Characteristics)

Definition

Small gram negative (coccobacillary) rod

 

Produces IgA protease

 

Culture on chocolate agar requires factors V (NAD+) and X (hematin) for growth

(Mom goes to the five and dime store to buy some chocolate when her child has the flu)

 

Can also be grown with S. aureus, which provides factor V

Term

Haemophilus Influenzae

(Transmission)

Definition
Aerosol
Term

Haemophilus Influenzae

(Types)

Definition

Most invasive disease = Type B

 

Nontypeable strains > mucosal infections

(Otitis Media, Conjunctivitis, Bronchitis)

Term

Haemophilus Influenzae

(Diseaes)

Definition

HaEMOPhilus

Epiglottitis ("cherry red" in kids)

Meningitis

Otitis Media

Pneumonia

 

Does NOT cause the flu

(that's influenzae virus)

Term

Haemophilus Influenzae

(Treatment)

Definition

Mucosal infections = Amoxicillin +/- Clavulanate

 

Meningitis = Ceftriaxone

 

Rifampin prophylaxis in close contacts

Term

Haemophilus Influenzae

(Vaccine)

Definition

Contains type B capsular polysaccharide (polyribosylribitol phosphate) conjugated to diphtheria toxoid or other protein

 

Given between 2-18 months of age

Term

Legionella pneumophila

(Characteristics)

Definition

Gram-negative rod

 

Grows on charcoal yeast extract culture with iron and cysteine

(a French legionnaire with his silver helmet sits around a charcoal campfire with his iron dagger - he is no sissy)

 

 

Term

Legionella pneumophila

(Stain)

Definition
Gram stains poorly - use Silver stain
Term

Legionella pneumophila

(Findings/Labs)

Definition

Hyponatremia

 

Presence of antigen in urine

Term

Legionella pneumophila

(Transmission)

Definition

Aerosol from environmental water source

 

NO person-to-person transmission

Term

Legionella pneumophila

(Disease)

Definition

Legionnaires' Disease

Severe pneumonia

Fever

GI/CNS symptoms

 

Pontiac Fever

Mild flu-like syndrome

Term

Legionella pneumophila

(Treatment)

Definition
Macrolide or Quinolone
Term

Pseudomonas aeruginosa

(Characteristics)

Definition

Aerobic gram-negative rod

Aeruginosa = aerobic

 

Non-lactose fermenting, oxidase +

 

Produces pyocyanin (blue-green pigment)

 

Grape-like odor

Term

Pseudomonas aeruginosa

(Source)

Definition
Water
Term

Pseudomonas aeruginosa

(Virulence)

Definition
Produces endotoxin (fever, shock) and exotoxin A (inactivates EF-2)
Term

Pseudomonas aeruginosa

(Disease)

Definition

Associated with wound and burn infections

 

PSEUDOmonas

Pneumonia (especially cystic fibrosis)

Sepsis

External otitis (Swimmer's ear)

UTI

Drug use and Diabetic Osteomyelitis

 

Hot tub folliculitis

Malignant otitis externa in Diabetics

Ecthyma gangrenosum

Term
Ecthyma Gangrenosum
Definition

Rapid progressive necrotic cutaneous lesions caused by Pseudomonas bacteremia

 

Typically seen in immunocompromised patients

Term

Pseudomonas aeruginosa

(Treatment)

Definition
Aminoglycoside + extended-spectrum Penicillin (Piperacillin, Ticarcillin, Cefepime, Imipenem, Meropenem)
Term
E. coli virulence factors
Definition

Fimbriae

(cystitis and pyelonephritis)

 

K capsule

(pneumonia, neonatal meningitis)

 

LPS endotoxin

(septic shock)

Term

EIEC

(Toxin and Mechanism)

Definition

Microbe invades intestinal mucosa > causes necrosis and inflammation

 

Clinical manifestation similar to shigella

Term

ETEC

(Toxin and Mechanism)

Definition

Produces heat-labile and heat-stable enterToxins

 

No inflammation or invasion

Term

EPEC

(Toxin and Mechanism)

Definition
No toxin produced. Adheres to apical surface > flattens vili > prevents absorption
Term

EHEC

(Toxin and Mechanism)

Definition

O157:H7 = most common serotype

Produces shiga-like toxin > HUS

(triad of anemia, thrombocytopenia, acute renal failure)

Also called STEC

(Shiga toxin-producing E. coli)

 

Toxin damages endothelium > microthrombi form on it > mechanical hemolysis (schistocytes) + decreased renal blood flow

 

Microthrombi consume platelets > thrombocytopenia

Term

EIEC

(Presentation)

Definition

Invasive

 

Dysentery

Term

ETEC

(Presentation)

Definition
Travelers' diarrhea (watery)
Term

EPEC

(Presentation)

Definition

Diarrhea usually in children

(Pediatrics)

Term

EHEC

(Presentation)

Definition

Dysentery

(toxin alone causes necrosis and inflammation)

 

Does not ferment sorbitol

(distinguishes it from other E. coli)

Term
Klebsiella
Definition

Intestinal flora > lobar pneumonia in alcoholics and diabetics

(aspiration)

 

Abundant polysaccharide capsules > very mucoid colonies

 

Red "currant jelly" sputum

 

Can also cause nosocomial UTIs

 

4 A's:

Aspiration pneumonia

Abscess in lungs and liver

Alcoholics

- diAbetics

Term

Salmonella

(Flagella)

Definition

Have flagella

(salmon swim)

Term

Salmonella

(Dissemination)

Definition
Hematogenously
Term

Salmonella

(Reservoir)

Definition
Many animal reservoirs
Term

Salmonella

(Hydrogen Sulfide)

Definition
Produce hydrogen sulfide
Term

Salmonella

(Antibiotics)

Definition
May prolong fecal excretion of organism
Term

Salmonella

(Invasion)

Definition
Invades intestinal mucosa > monocytic response
Term

Salmonella

(Diarrhea)

Definition
Can cause bloody diarrhea
Term

Salmonella

(Fermentation)

Definition
Does not ferment lactose
Term

Shigella

(Flagella)

Definition
None
Term

Shigella

(Dissemination)

Definition

Cell to cell transmission

 

No hematogenous spread

Term

Shigella

(Reservoir)

Definition
Humans and primates
Term

Shigella

(Hydrogen Sulfide)

Definition
Does not produce
Term

Shigella

(Antibiotics)

Definition
Shorten duration of fecal excretion of organism
Term

Shigella

(Invasion)

Definition
Invades intestinal mucosa > PMN infiltration
Term

Shigella

(Diarrhea)

Definition
Often causes bloody diarrhea
Term

Shigella

(Fermentation)

Definition
Does not ferment lactose
Term
Typhoid Fever
Definition

Caused by both Salmonella and Shigella

 

Found only in humans

 

Characterized by:

- Rose spots on the abdomen

- Fever

- Headache

- Diarrhea

 

Can remain in gallbladder and cause a carrier state

Term

Campylobacter Jejuni

(Clinical Features)

Definition

Major cause of bloody diarrhea, especially in children

 

Common antecedent to Guillain-Barre syndrome and Reactive Arthritis

Term

Campylobacter Jejuni

(Transmission)

Definition
Fecal-oral transmission through foods like poultry, meat, unpasteurized milk
Term

Campylobacter Jejuni

(Characteristics)

Definition

Comma or S-shaped

 

Oxidase +

 

Grows at 42C

(Campylobacter like the hot campfire)

Term

Vibrio Cholerae

(Clinical Features)

Definition
Profuse rice-water diarrhea
Term

Vibrio Cholera

(Pathogenesis)

Definition
Enterotoxin > permanently activates Gs > increased cAMP
Term

Vibrio Cholera

(Characteristics)

Definition

Comma-shaped

 

Oxidase +

 

Grows in alkaline media

Term

Vibrio Cholera

(Location)

Definition
Endemic to developing countries
Term

Vibrio Cholera

(Treatment)

Definition
Prompt oral rehydration is necessary
Term

Yersinia Enterocolitica

(Transmission)

Definition

Pet feces

(puppies)

 

Contaminated milk

 

Pork

Term

Vibrio Cholera

(Clinical Features)

Definition
Mesenteric adenitis that can mimic Crohn disease or appendicitis
Term

Helicobacter Pylori

(Clinical Features)

Definition

Gastritis

 

Peptic ulcers

(especially duodenal)

Term

Helicobacter Pylori

(Risk Factor for?)

Definition

Peptic Ulcer

 

Gastric adenocarcinoma

 

Lymphoma

Term

Helicobacter Pylori

(Characteristics)

Definition

Curved gram-negative rod

 

Catalase, oxidase, and Urease +

Term

Helicobacter Pylori

(Diagnosis)

Definition

Urea breath test

 

Fecal antigen test

Term

Helicobacter Pylori

(Treatment)

Definition

Triple Therapy:

PPI + Clarithromycin + Amoxicillin or Metronidazole

Term
Spirochetes
Definition

Spiral-shaped bacterial with axial filaments

 

BLT

Borrelia (big size)

Leptospira

Treponema

 

Only Borrelia visualized using aniline dyes (Wright or Giemsa) in light microscopy

 

Treponema visualized by dark-field microscopy

Term

Leptospira Interrogans

(Source)

Definition

Water contaminated with animal urine

(prevalent among surfers and in tropics, i.e. Hawaii)

Term

Leptospira Interrogans

(Disease)

Definition

Leptospirosis

 

Weil Disease

Term
Leptospirosis
Definition

Flu-like symptoms

Jaundice

Photophobia with conjunctival suffusion

(erythema without exudate)

Term
Weil Disease
Definition

Icterohemorrhagic Leptospirosis

(severe form)

 

Liver/Kidney dysfunction > Jaundice and Azotemia

 

Fever

Hemorrhage

Anemia

Term
Viral Structure
Definition

3 Types:

 

1) Naked virus with icosahedral capsid

2) Enveloped virus with icosahedral capsid

3) Enveloped virus with helical capsid

 

Envelope = lipid bilayer with surface protein

Term

Viral Genetics

(Recombination)

Definition
Exchange of genes between 2 chromosomes by crossing over within regions of significant base sequence homology
Term

Viral Genetics

(Reassortment)

Definition

When viruses with segmented genomes (influenza virus) exchange segments. High-frequency recombination

 

Cause of world-wide influenza pandemics

Term

Viral Genetics

(Complementation)

Definition
When 1 of 2 viruses that infect the cell has a mutation that results in a nonfunctional protein. The nonmutated virus "complements" the mutated one by making a functional protein that serves both viruses.
Term

Viral Genetics

(Phenotypic Mixing)

Definition

Occurs with simultaneous infection of a cell with 2 viruses.

 

Genome of virus A can be partially or completely coated (forming pseudovirion) with the surface proteins of virus B. Type B protein coat determines the tropism (infectivity) of the hybrid virus. However, progeny from this infection have a type A coat encoded by type A genetic material.

Term

Viral Vaccines

(Inactivated/Killed vs. Live Attenuated)

Definition

Induce humoral and cell-mediated immunity but have reverted to virulence on rare occasions.

 

Killed/Inactivated vaccines induce only humoral immunity but are stable

 

No booster needed for live attenuated. Dangerous to give to immunocompromised patients or close contacts.

Term

Viral Vaccines

(Live Attenuated)

Definition

"Live! One night only! See small yellow chickens get vaccinated with Sabin and MMRIt's incredible!"

 

- Smallpox

Yellow fever

Chickenpox (VZV)

Sabin polio virus

MMR

Influenza (intranasal)

Term
MMR Vaccine
Definition

Measles, Mumps, Rubella

 

Live attenuated vaccine

 

Can be given to HIV-positive patients who do not show signs of immunodeficiency

Term

Viral Vaccines

(Killed)

Definition

RIP Always

Rabies

Influenza (injected)

- Salk Polio

- HAV

 

SalKKilled

Term

Viral Vaccines

(Recombinant)

Definition

HBV

(antigen = recombinant HBsAg)

 

HPV

(types 6, 11, 16, 18)

Term
DNA Viral Genomes
Definition

Parvoviridae = only dsDNA genome

(part-of-a-virus)

 

All linear except: (circular)

- Papilloma

- Polyoma

- Hepana

Term
RNA Viral Genomes
Definition

Reoviridae = only dsRNA virus

 

(All are ssRNA like our mRNA except "repeato-virus" is dsRNA)

Term
Positive-Stranded RNA viruses
Definition

I went to a retro toga party, where I drank flavored Corona and ate hippy California pickles

 

- Retrovirus

- Togavirus

- Flavivirus

- Coronavirus

- Hepevirus

- Calicivirus

- Picornavirus

Term
Naked viral genome infectivity
Definition

Purified nucleic acids of most dsDNA (except poxviruses and HBV) and Positive-strand ssRNA viruses are infectious.

 

Naked nucleic acids of Negative-strand ssRNA and dsRNA viruses are not infectious. They require polymerases contained int he complete virion.

Term

Viral Replication

(DNA viruses)

Definition

All replicate in the nucleus

 

(except Poxvirus)

Term

Viral Replication

(RNA viruses)

Definition

All replicate in the cytoplasm

 

(except Influenza and Retroviruses)

Term
Naked (Nonenveloped) Viruses
Definition

Give PAPP smears and CPR to a naked Heppy

 

- Papillomavirus

- Adenovirus

Parvovirus

- Polyomavirus

Calicivirus

Picornavirus

Reovirus

Hepevirus

 

(DNA = PAPP; RNA = CPR and hepevirus)

Term
Envelope Development
Definition

Enveloped viruses acquire their enveloped from plasma membrane when they exit from the cell.

 

Exceptions = Herpesviruses (acquire envelopes from nuclear membrane)

Term
DNA Viruses
Definition

DNA viruses are HHAPPPPy viruses

Hepadna

- Herpes

Adeno

Pox

Parvo

Papilloma

Polyoma

Term

DNA Viruses

(Characteristics)

Definition

Double stranded

(except Parvo)

 

Linear

(except Papilloma and Polyoma [circular, supercoiled] and Hepadna [circular, incomplete])

 

Icosahedral

(except Pox [complex])

 

Replicate in the nucleus

(except Pox [carries own DNA-dependent RNA polymerase])

Term

Herpesviruses

(Envelope)

Definition
Yes
Term

Herpesviruses

(DNA Structure)

Definition
DS and linear
Term

Herpesviruses

(Medical Importance)

Definition

HSV-1

HSV-2

VZV (HHV-3)

EBV (HHV-4)

CMV (HHV-5)

HHV-6

HHV-7

HHV-8

Term

HSV-1

(Clinical Features, Location, Transmission)

Definition

Clinical:

- Oral (and some genital) lesions

 - Spontaneous temporal lobe encephalitis

 - Keratoconjunctivitis

- Gingivostomatitis

 

Latent in trigeminal ganglia.

 

Transmitted by respiratory secretions + saliva

Term

HSV-2

(Clinical Features, Location, Transmission)

Definition

Clinical:

- Genital (and some oral) lesions

- Neonatal herpes

 

Latent in sacral ganglia

 

Transmitted by sexual contact + perinatally

Term

VZV [HHV-3]

(Clinical Features, Location, Transmission)

Definition

Clinical:

- Chickenpox

 - Zoster (Shingles)

[most common complication = post-herpetic neuralgia]

- Encephalitis

- Pneumonia

 

Latent in dorsal root or trigeminal ganglia

 

Transmitted by respiratory secretions

 

Vaccine available!

 

Term

EBV [HHV-4]

(Clinical Features)

Definition

Mononucleosis

- Fever

- Hepatosplenomegaly

- Pharyngitis

- Lymphadenopathy

(especially posterior cervical nodes)

 

Associated with: 

- Burkitt lymphoma 

- Hodgkin lymphoma

- Nasopharyngeal Carcinoma

Term

CMV [HHV-5]

(Clinical Features, Location, Transmission)

Definition

Clinical:

- Congenital defects

("sightomegalovirus")

- AIDS retinitis

- Mononucleosis (Monospot Negative)

- Pneumonia

 

Infected cells have "owl eye" inclusions

 

Latent in mononuclear cells

 

Transmission:

- Congenital

- Transfusion

- Sexual contact

- Saliva

- Urine

- Transplant

Term

HHV-6

(Medical Importance)

Definition

Roseola

(exanthem subitum)

- High fevers for several days that can cause seizures

- Diffuse macular rash follows fever

 

Transmission = Saliva

 

 

Term

HHV-7

(Medical Importance)

Definition
Less common cause of Roseola
Term

HHV-8

(Clinical Featuers, Transmission)

Definition

Kaposi Sarcoma

- Neoplasm of endothelial cells

- Seen in HIV/AIDS and transplant patients

- Dark/violaceous flat and nodular skin lesions (endothelial growths)

- Can also affect GI/lungs

 

Transmission = sexual contact

Term

Hepadnavirus

(Envelope)

Definition
Yes
Term

Hepadnavirus

(DNA structure)

Definition
Partially DS and circular
Term

Hepadnavirus

(Medical Importance)

Definition

HBV

- Acute or Chronic hepatitis

- Vaccine available (contains HBV surface antigen)

- Not a retrovirus but has reverse transcriptase

Term

Adenovirus

(Envelope)

Definition
No
Term

Adenovirus

(DNA structure)

Definition
DS and linear
Term

Adenovirus

(Medical Importance)

Definition

Febrile pharyngitis

(sore throat)

 

Acute hemorrhagic cystitis

 

Pneumonia

 

Conjunctivitis

("Pink eye")

Term

Parvovirus

(Envelope)

Definition
No
Term

Parvovirus

(DNA structure)

Definition

SS and linear (-)

(smallest DNA virus)

Term

Parvovirus

(Medical Importance)

Definition
B19 virus 
Term
Parvovirus B19
Definition

Aplastic crises in sickle cell disease

 

"Slapped cheek" rash in children

(Erythema Infectiosum/Fifth Disease)

 

RBC destruction in fetus > hydrops fetalis and death

 

Pure RBC aplasia and rheumatoid arthritis-like symptoms in adults

Term

Papillomavirus

(Envelope)

Definition
No
Term

Papillomavirus

(DNA structure)

Definition
DS and circular
Term

Papillomavirus

(Medical Importance)

Definition

HPV

- Warts (1, 2, 6, 11)

- CIN

- Cervical cancer (16, 18)

- Vaccine available

Term

Polyomavirus

(Envelope)

Definition
No
Term

Polyomavirus

(DNA structure)

Definition
DS and circular
Term

Polyomavirus

(Medical Importance)

Definition

JC Virus = Progressive Multifocal Leukoencephalopathy (PML) in HIV

 

BK Virus = Transplant patients, commonly targets kidney

 

(JC Junky Cerebrum; BKBad Kidney)

Term

Poxvirus

(Envelope)

Definition
Yes
Term

Poxvirus

(DNA structure)

Definition

DS and linear

(largest DNA virus)

Term

Poxvirus

(Medical Importance)

Definition

Smallpox, although eradicated, could be used in germ warfare

 

Cowpox

(milkmaid blisters)

 

Molluscum Contagiosum

(flesh-colored dome lesions with central umbilicated dimple)

Term

EBV [HHV-4]

(Transmission)

Definition

Respiratory secretions and Saliva

(called the "kissing disease")

Term

EBV [HHV-4]

(Epidemiology)

Definition
Commonly seen in teens, young adults
Term

EBV [HHV-4]

(Pathogenesis)

Definition
Infects B cells
Term

EBV [HHV-4]

(Labs/Diagnosis)

Definition

Atypical lymphocytes on peripheral blood smeal

(NOT infected B cells, just reactive cytotoxic T-cells)

 

Monospot Test

(heterophile antibodies detected by agglutination of sheep or horse RBCs)

Term
HSV Identification
Definition

Skin/Genital Herpes = viral culture

 

Herpes Encephalitis = CSF PCR

 

Genital Herpes = Tzanck test

(smear of an opened skin vesicle > detect multinucleated giant cells)

Tzanck heavens I do not have herpes!

 

Infected cells also have intranuclear Cowdry A inclusions

Term

Reoviruses

(Envelope)

Definition
No
Term

Reoviruses

(RNA Structure)

Definition

DS linear

10-12 segments

Term

Reoviruses

(Capsid Symmetry)

Definition

Icosahedral

(double)

Term

Reoviruses

(Medical Importance)

Definition

Coltvirus = Colorado Tick Fever

 

Rotavirus = #1 cause of fatal diarrhea in children

Term

Picornaviruses

(Envelope)

Definition
No
Term

Picornaviruses

(RNA Structure)

Definition
SS (+) linear
Term

Picornaviruses

(Capsid Symmetry)

Definition

PERCH

Poliovirus = polio-Salk/Sabin vaccines - IPV/OPV

Echovirus = asaeptic meningitis

Rhinovirus = "common cold"

Coxsackievirus = aseptic meningitis; herpangina (mouth blisters, fever); hand, foot, and mouth disease; Myocarditis; Pericarditis

- HAV = acute virus hepatitis

Term

Hepevirus

(Envelope)

Definition
No
Term

Hepevirus

(RNA Structure)

Definition
SS (+) linear
Term

Hepevirus

(Capsid Symmetry)

Definition
Icosahedral
Term

Hepevirus

(Medical Importance)

Definition
HEV
Term

Caliciviruses

(Envelope)

Definition
No
Term

Caliciviruses

(RNA Structure)

Definition
SS (+) linear
Term

Caliciviruses

(Capsid Symmetry)

Definition
Icosahedral
Term

Caliciviruses

(Medical Importance)

Definition
Norovirus = viral gastroenteritis
Term

Flaviviruses

(Envelope)

Definition
Yes
Term

Flaviviruses

(RNA Structure)

Definition
SS (+) linear
Term

Flaviviruses

(Capsid Symmetry)

Definition
Icosahedral
Term

Flaviviruses

(Medical Importance)

Definition

HCV

 

Yellow Fever

 

Dengue

 

St. Louis Encephalitis

 

West Nile virus

Term

Togaviruses

(Envelope)

Definition
Yes
Term

Togaviruses

(RNA Structure)

Definition
SS (+) linear
Term

Togaviruses

(Capsid Symmetry)

Definition
Icosahedral
Term

Togaviruses

(Medical Importance)

Definition

Rubella

 

Eastern Equine Encephalitis

 

Western Equine Encephalitis

Term

Retroviruses

(Envelope)

Definition
Yes
Term

Retroviruses

(RNA Structure)

Definition
SS (+) linear
Term

Retroviruses

(Capsid Symmetry)

Definition

Icosahedral

(HTLV)

 

Complex and Conical

(HIV)

Term

Retroviruses

(Medical Importance)

Definition

Have reverse transcriptase

 

HTLV = T-cell leukemia

 

HIV = AIDS

Term

Coronaviruses

(Envelope)

Definition
Yes
Term

Coronaviruses

(RNA Structure)

Definition
SS (+) linear
Term

Coronaviruses

(Capsid Symmetry)

Definition
Helical
Term

Coronaviruses

(Medical Importance)

Definition
Coronavirus = "common cold" and SARS
Term

Orthomyxoviruses

(Envelope)

Definition
Yes
Term

Orthomyxoviruses

(RNA Structure)

Definition

SS (-) linear

8 segments

Term

Orthomyxoviruses

(Capsid Symmetry)

Definition
Helical
Term

Orthomyxoviruses

(Medical Importance)

Definition
Influenza virus
Term

Paramyxoviruses

(Envelope)

Definition
Yes
Term

Paramyxoviruses

(RNA Structure)

Definition

SS (-) linear

Nonsegmented

Term

Paramyxoviruses

(Capsid Symmetry)

Definition
Helical
Term

Paramyxoviruses

(Medical Importance)

Definition

PaRaMyxovirus

Parainfluenza = croup

RSV = bronchiolitis in babies; Rx - ribavirin

Measles

Mumps

Term

Rhabdoviruses

(Envelope)

Definition
Yes
Term

Rhabdoviruses

(RNA Structure)

Definition
SS (-) linear
Term

Rhabdoviruses

(Capsid Symmetry)

Definition
Helical
Term

Rhabdoviruses

(Medical Importance)

Definition
Rabies
Term

Filoviruses

(Envelope)

Definition
Yes
Term

Filoviruses

(RNA Structure)

Definition
SS (-) linear
Term

Filoviruses

(Capsid Symmetry)

Definition
Helical
Term

Filoviruses

(Medical Importance)

Definition

Ebola/Marburg hemorrhagic fever

 

Often fatal!

Term

Arenaviruses

(Envelope)

Definition
Yes
Term

Arenaviruses

(RNA Structure)

Definition

SS (-) circular

2 segments

Term

Arenaviruses

(Capsid Symmetry)

Definition
Helical
Term

Arenaviruses

(Medical Importance)

Definition

LCMV = Lymphocytic choriomeningitis virus

 

Lassa Fever Encephlitis = spread by mice

Term

Bunyaviruses

(Envelope)

Definition
Yes
Term

Bunyaviruses

(RNA Structure)

Definition

SS (-) cicular

3 segments

Term

Bunyaviruses

(Capsid Symmetry)

Definition
Helical
Term

Bunyaviruses

(Medical Importance)

Definition

California encephlitis

 

Sandfly/Rift Valley fevers

 

Crimeon-Congo Hemorrhagic fever

 

Hantavirus = hemorrhagic fever, pneumonia

Term

Delta virus

(Envelope)

Definition
Yes
Term

Delta virus

(RNA Structure)

Definition
SS (-) circular
Term

Delta virus

(Capsid Symmetry)

Definition
Uncertain
Term

Delta virus

(Medical Importance)

Definition
HDV is a "defective" virus that requires HBV co-infection
Term
Negative-stranded Viruses
Definition

Must transcribe (-) strand to (+). Virion brings its own RNA-dependent RNA polymerase.

 

Always Bring Polymerase OFail Replication

- Arenaviruses

Bunyaviruses

Paramyxoviruses

Orthomyxoviruses

Filoviruses

Rhabdoviruses

Term
Segmented Viruses
Definition

All are RNA viruses

 

BOAR

Bunyaviruses

Orthomyxoviruses (influenza viruses)

Arenaviruses

Reoviruses

Term
Picornaviruses
Definition

RNA translated into 1 large polypeptide > cleaved by proteases into functional viral proteins

 

Can cause Aseptic (viral) Meningitis (not HAV/Rhinovirus)

 

All are enteroviruses (fecal-oral spread) except Rhinovirus

 

PERCH on a peak (pico)

Poliovirus

Echovirus

Rhinovirus

Coxsackievirus

HAV

 

PicoRNAvirus = small RNA virus

 

Term
Rhinovirus
Definition

Noneveloped RNA Picornavirus

 

Cause of common cold

 

> 100 serologic types

 

Acid labile - destroyed by stomach acid > does not infect GI tract

 

Rhino has a runny nose

Term
Yellow Fever Virus
Definition

Flavivirus (and arbovirus)

 

Transmission = Aedes mosquitoes

 

Reservoir = monkeys or humans

 

Symptoms:

- High fever

- Black vomitus

- Jaundice

(Flavi = yellow)

Term
Rotavirus
Definition

Most important global cause of infantile gastroenteritis

 

Segmented dsRNA Reovirus

 

Major cause of acute diarrhea in the US in winter

(especially in day-care, kindergarten)

 

Villous destruction with atrophy > decreased absorption of Na+ and loss of K+

 

ROTAvirus = Right Out The Anus

 

CDC recommends routine vaccination of all infants

Term

Influenza Viruses

(Characteristics)

Definition
Enveloped (-) ssRNA Orthomyxoviruses with 8-segment genome
Term

Influenza Viruses

(Virulence)

Definition

Contain hemagglutinin (promotes viral entry) and neuraminidase (promotes progeny virion release) antigens

 

Rapid genetic changes

 

Patients at risk for fatal bacterial superinfection

Term

Influenza Viruses

(Vaccine)

Definition

Reformulated vaccine ("the flu shot") contains viral strains most likely to appear during the flu season

 

Killed viral vaccine is most frequently used

 

Live, attenuated (temperature-sensitive mutant) vaccine that replicates in the nose but not in the lung, administered intranasally

Term
Genetic/Antigenic Shifts
Definition

Causes pandemics

 

Reassortment of viral genome; segments undergo high-frequency recombination, such as when human flu A virus recombines with swin flu A virus

 

Sudden Shift is more deadly than gradual drift

Term
Genetic Drift
Definition

Causes epidemics

 

Minor (antigenic drift) changes based on random mutation

Term
Rubella Virus
Definition

Togavirus

 

Causes Rubella (German 3-day measles)

- Fever

- Postauricular/other lymphadenopathy

- Arthralgias

- Fine rash

 

Mild disease in children; serious congenital disease (ToRCHeS)

 

Congenital Rubella = Blueberry muffin appearance

(indicates extramedullary hematopoiesis)

Term

Paramyxovirus

(Clinical)

Definition

Causes disease in children

- Parainfluenza (Croup)

- Mumps

- Measles

- RSV (Bronchiolitis, Pneumonia) in infants

Term

Paramyxovirus

(Virulence)

Definition
All contain surface F (fusion) protein > respiratory epithelial cells fuse and form multinucleated cells
Term

Paramyxovirus

(Treatment)

Definition

Palivizumab

(monoclonal antibody against F protein)

 

Prevents pneumonia caused by RSV infection in premature infants

Term
Measles Virus
Definition

Paramyxovirus

 

4 C's:

Cough

Coryza

- Conjunctivitis

- Koplik spots

 

Descending maculopapular rash

 

Possible Sequelae:

- SSPE (Subacute Sclerosing Panencephalitis) occurs years later

- Encephalitis

- Giant cell pneumonia (rarely, in immunosuppressed)

 

Vitamin A prevents severe exfoliative dermatitis in malnourished children

Term
Mumps Virus
Definition

Paramyxovirus

 

Mumps makes your parotid glands and testes as big as POM-poms

Symptoms:

- Parotitis

Orchitis

Meningitis (aseptic)

 

Can cause sterility (especially after puberty)

Term

Rabies Virus

(Appearance, Location)

Definition

Bullet-shaped virus

Negri bodies

(characteristic cytoplasmic inclusions in infected neurons)

 

Commonly found in Purkinje cells of cerebellum and in hippocampal neurons

 

Travels to CNS by migrating in a retrograde fashion up nerve axons

 

Term

Rabies Virus

(Clinical Course)

Definition

Long incubation period (weeks to months) before symptom onset

 

Progression of disease:

1) Fever, Malaise

2) Agitation, Photophobia, Hydrophobia

3) Paralysis, Coma

4) Death

Term

Rabies Virus

(Treatment)

Definition
Postexposure treatment = wound cleaning and vaccination +/- rabies immune globulin
Term

Rabies Virus

(Transmission)

Definition
More commonly from bat, raccoon, and skunk bites than from dog bites in the US
Term

HAV

(Virus)

Definition
RNA Picornavirus
Term

HBV

(Virus)

Definition
DNA Hepadnavirus
Term

HCV

(Virus)

Definition
RNA Flavivirus
Term

HDV

(Virus)

Definition
RNA Delta Virus
Term

HEV

(Virus)

Definition
RNA Hepevirus
Term

HAV

(Transmission)

Definition
Fecal-oral
Term

HBV

(Transmission)

Definition

Parenteral

Sexual

Maternal-Fetal

Term

HCV

(Transmission)

Definition

Primarily blood

(IVDU, post-transfusion)

Term

HDV

(Transmission)

Definition

Parenteral

Sexual

Maternal-Fetal

Term

HEV

(Transmission)

Definition

Fecal-oral

(especially with waterborne epidemics)

Term

HAV

(Carrier)

Definition
No
Term

HBV

(Carrier)

Definition
Yes
Term

HCV

(Carrier)

Definition
Yes
Term

HCV

(Carrier)

Definition
Yes
Term

HDV

(Carrier)

Definition
Yes
Term

HEV

(Carrier)

Definition
No
Term

HAV

(Incubation)

Definition

Short

(weeks)

Term

HBV

(Incubation)

Definition

Long

(months)

Term

HCV

(Incubation)

Definition
Long
Term

HDV

(Incubation)

Definition

Superinfection = short

(HDV after HBV)

 

Co-infection = long

(HDV with HBV)

Term

HEV

(Incubation)

Definition
Short
Term

HAV

(HCC Risk)

Definition
No
Term

HBV

(HCC Risk)

Definition
Yes - integrates into host genome, acts as oncogene
Term

HCV

(HCC Risk)

Definition
Yes - from chronic inflammation
Term

HDV

(HCC Risk)

Definition
Yes
Term

HEV

(HCC Risk)

Definition
No
Term

HAV

(Notes)

Definition

Asymptomatic (usually)

Acute

Alone (no carriers)

Term

HCV

(Notes)

Definition

Chronic

Cirrhosis

Carcinoma

Carrier

Term

HDV

(Notes)

Definition

Defective virus Dependent on HBV

 

Superinfection > poor prognosis

Term

HEV

(Notes)

Definition

High mortality in pregnant women

 

Enteric

Expectant mothers

Epidemic

Term
Signs and Symptoms of all Hepatitis viruses
Definition

Episodes of fever

 

Jaundice

 

Increased ALT and AST

Term
HAV and HEV transmission
Definition

Fecal-oral

(the vowels hit your bowels)

 

Naked viruses do not rely on an envelope > not destroyed by the gut

Term
HBV DNA Polymerase
Definition

Has both DNA and RNA dependent activities

 

Entry into nucleus > completes the partial dsDNA > host RNA polymerase transcribes mRNA from viral DNA > viral proteins

 

DNA polymerase > reverse transcribes viral RNA to DNA > form new viral particles

Term

Hepatitis Serologic Markers

(Anti-HAV IgM)

Definition

IgM antibody to HAV

 

Best test to detect active Hep A

Term

Hepatitis Serologic Markers

(Anti-HAV IgG)

Definition

IgG antibody indicates prior HAV infection and/or prior vaccination

 

Protects against reinfection

Term

Hepatitis Serologic Markers

(HBsAg)

Definition

Antigen found on surface of HBV

 

Indicates Hep B infection

Term

Hepatitis Serologic Markers

(Anti-HBs)

Definition

Antibody to HBsAg

 

Indicates immunity to Hep B

Term

Hepatitis Serologic Markers

(HBcAg)

Definition
Antigen associated with core of HBV
Term

Hepatitis Serologic Markers

(Anti-HBc)

Definition

Antibody to HBcAg

 

IgM = acute/recent infection

IgG = prior exposure or chronic infection

 

Positive during window period

Term

Hepatitis Serologic Markers

(HBeAg)

Definition

A second, different antigenic determinant in the HBV core

 

Indicates active viral replication and therefore high transmissibility

Term

Hepatitis Serologic Markers

(Anti-HBe)

Definition

Antibody to HBeAg

 

Indicates low transmissibility

Term
LFTs in Hepatitis
Definition

Viral = ALT > AST

 

Alcoholic = AST > ALT

Term

Hepatitis Timeline

(Diagnostic Tests)

Definition

SECES

(Sky, Earth, Core, Earth, Sky)

 

- HBsAg (1-5 weeks)

- HBeAg (1 1/2-4 weeks)

- Anti-HBc (2 weeks and on)

- Anti-HBe (5 weeks and on)

- Anti-HBs (6 weeks and on)

 

Window Period = 5-6 weeks

 

Incubation Period = HBsAg (1-2 weeks)

Prodrome/Acute Disease = HBsAg > Anti-HBc (2-5 weeks)

Early Convalescence = Anti-HBc (5-7 weeks)

Late Convalescence = Anti-HBs and Anti-HBc (6 weeks and on)

Term

Acute HBV

(Hepatits Titers)

Definition

HBsAg

HBeAg

Anti-HBc IgM

Term

Window Period

(Hepatitis Titers)

Definition

Anti-HBe

Anti-HBc IgM

Term

Chronic HBV [High Infectivity]

(Hepatitis Titers)

Definition

HBsAg

HBeAg

Anti-HBc IgG

Term

Chronic HBV [Low Infectivity]

(Hepatitis Titers)

Definition

HBsAg

Anti-HBe

Anti-HBc IgG

 

Term

Recovery

(Hepatitis Titers)

Definition

Anti-HBs

Anti-HBe

Anti-HBc IgG

Term

Immunized

(Hepatitis Titers)

Definition

Anti-HBs

 

Term

Docking Glycoprotein

(HIV)

Definition
gp120
Term

Transmembrane Glycoprotein

(HIV)

Definition
gp41
Term

Capsid Protein

(HIV)

Definition
p24
Term

Envelope Proteins

(HIV)

Definition
Acquired through budding from host cell plasma membrane
Term

Genome Structure

(HIV)

Definition

Diploid genome

(2 molecules of RNA)

Term

3 Structural Genes

(HIV)

Definition

env


gag


pol

Term

env

(HIV)

Definition

gp120 and gp41

 

Formed from cleavage of gp160 to form envelope glycoproteins

Term
gp120
Definition
Attachment of HIV to host CD4+ T-cell
Term
gp41
Definition
Fusion and entry of HIV to CD4+ T-cell
Term

gag

(HIV)

Definition
p24 = capsid protein
Term

pol

(HIV)

Definition

Reverse transcriptase

 

Aspartate protease

 

Integrase

Term

Reverse Transcriptase

(HIV)

Definition
Synthesizes dsDNA from RNA; dsDNA integrates into host genome
Term

Receptors

(HIV)

Definition

T-cells = CCR5 (early) or CXCR4 (late) co-receptor and CD4

 

Macrophages = CCR5 co-receptor and CD4

 

 

Term

Homozygous CCR5 Mutation

(HIV)

Definition
Immunity
Term

Heterozygous CCR5 Mutation

(HIV)

Definition
Slower Course
Term

Matrix Protein

(HIV)

Definition
p17
Term
HIV Diagnosis
Definition

Presumptive diagnosis made with ELISA

(sensitive; low threshold with high false-positive rate = rule out test)

 

Positive results confirmed with Western Blot assay

(specific; high threshold with high false-negative rate = rule in test)

 

Look for antibodies to viral proteins

 

Tests often falsely negative in first 1-2 months of HIV infection and falsely positive initially in babies born to infected mothers (anti-gp120 crosses placenta)

Term

Viral Load

(HIV)

Definition

PCR determines the amount of viral RNA in plasma

 

High viral load = poor prognosis

 

Used to monitor effect of drug therapy

Term
AIDS Diagnosis
Definition

< 200 CD4+ cells/mm3

 (normal = 500-1500)

 

HIV-positive with AIDS-defining condition (Pneumocystis pneumonia) or CD4 percentage < 14% 

Term

Untreated Infection

(HIV)

Definition

Four Stages:

Flu-like (acute)

Feeling Fine (latent)

Falling count

Final crisis

Term
Acute HIV Syndrome
Definition

Months 0-2

 

Wide dissemination of virus; Seeding of lymphoid organs

 

Viral Load climbs to over 1000

 

CD4+ count drops to 500

 

 

Term
Clinical Latency in HIV
Definition

2 months to years later

 

Virus replicates in lymph nodes

 

Viral Load drops to below 400, then slowly climbs above it

 

CD4+ count climbs to 700, then slowly drops to 200

Term
Risk of decreased CD4+ count in HIV
Definition

Reactivation of past infections

(TB, HSV, Shingles, etc.)

 

Dissemination of bacterial infections and fungal infections

(Coccidioidomycosis, etc.)

 

Non-Hodgkin lymphomas

Term

Histoplasma capsulatum

(HIV)


[Clinical Presentation]

Definition

Causes only pulmonary symptoms in immunocompetent hosts

 

HIV:

- Low-grade fevers

- Cough

- Hepatosplenomegaly

- Tongue ulcer

Term

Low-grade fevers, Cough, Hepatosplenomegaly, and Tongue Ulcer

(HIV)


[Pathogen]

Definition
Histoplasma capsulatum
Term

Histoplasma capsulatum

(HIV)


[Findings/Labs]

Definition

Oval yeast cells within macrophages

 

CD4+ < 100 cells/mm3

Term

Fluffy white cottage-cheese lesions

(HIV)

 

[Pathogen]

Definition
C. albicans
Term

Hairy leukoplakia

(HIV)

 

[Pathogen]

Definition
EBV
Term

Superficial vascular proliferation

(HIV)

 

[Pathogen]

Definition
Bartonella henselae
Term

Chronic, watery diarrhea

(HIV)

 

[Pathogen]

Definition
Cryptosporidium spp.
Term

Brain abscesses

(HIV)

 

[Pathogen]

Definition
Toxoplasma gondii
Term

Dementia

(HIV)

 

[Pathogen]

Definition
Directly associated with HIV
Term

Encephalopathy

(HIV)

 

[Pathogen]

Definition
JC virus reactivation
Term

Meningitis

(HIV)

 

[Pathogen]

Definition
Cryptococcus neoformans
Term

Retinitis

(HIV)

 

[Pathogen]

Definition
CMV
Term

Non-Hodgkin lymphoma, large cell type

(HIV)

 

[Pathogen]

Definition
May be associated with EBV
Term

Primary CNS lymphoma

(HIV)

 

[Pathogen]

Definition
Often associated with EBV
Term

Squamous cell carcinoma

(HIV)

 

[Pathogen]

Definition
HPV
Term

Superficial neoplastic proliferation of vasculature

(HIV)

 

[Pathogen]

Definition

HHV-8

(Kaposi Sarcoma)

 

Do NOT confuse with bacillary angiomatosis caused by B. henselae

Term

Interstitial pneumonia

(HIV)

 

[Pathogen]

Definition
CMV
Term

Invasive aspergillosis

(HIV)

 

[Pathogen]

Definition
Aspergillus fumigatus
Term

Pneumocystic pneumonia

(HIV)

 

[Pathogen]

Definition
Pneumocystic jirovecii
Term

Pneumonia

(HIV)

 

[Pathogen]

Definition
S. pneumoniae
Term

Tuberculosis-like disease

(HIV)

 

[Pathogen]

Definition

Mycobacterium avium-intracellulare

(also known as Mycobacterium avium complex or MAC)

Term

C. albicans

(HIV)

 

[Clinical Presentation]

Definition

Causes oral thrush and esophagitis

 

Fluffy white cottage-cheese lesions

Term

EBV

(HIV)

 

[Clinical Presentation]

Definition

Hairy leukoplakia

 

Often on lateral tongue

Term

Bartonella henselae

(HIV)

 

[Clinical Presentation]

Definition

Causes Bacillary angiomatosis

 

Superficial vascular proliferation

Term

Cryptosporidium spp.

(HIV)

 

[Clinical Presentation]

Definition
Chronic, watery diarrhea
Term

Toxoplasma gondii

(HIV)

 

[Clinical Presentation]

Definition
Brain abscesses
Term

JC virus reactivation

(HIV)

 

[Clinical Presentation]

Definition

Progressive multifocal leukoencephalopathy

(Virus > Demyelination)

Term

Cryptococcus neoformans

(HIV)

 

[Clinical Presentation]

Definition
Meningitis
Term

CMV

(HIV)

 

[Clinical Presentation]

Definition

Retinitis

 (May also occur with esophagitis)

 

Interstitial pneumonia

Term

May be associated with EBV

(HIV)

 

[Clinical Presentation]

Definition
Non-Hodgkin Lymphoma (large cell type), often on oropharynx (Waldeyer Ring)
Term

Often associated with EBV

(HIV)

 

[Clinical Presentation]

Definition

Primary CNS lymphoma

 

Focal or multiple

 

Differentiate from Toxoplasmosis!

Term

HPV

(HIV)

 

[Clinical Presentation]

Definition

Squamous cell carcinoma

 

Often in anus (MSM) or cervix

Term

HHV-8

(HIV)

 

[Clinical Presentation]

Definition

Kaposi Sarcoma

(Superficial neoplastic proliferation of vasculature)

 

Do NOT confuse with Bacillary Angiomatosis from Bartonella Henselae!

Term

Aspergillus fumigatus

(HIV)

 

[Clinical Presentation]

Definition
Invasive aspergillosis
Term

Pneumocystic jirovecii

(HIV)

 

[Clinical Presentation]

Definition
Pneumocystic pneumonia
Term

S. pneumoniae

(HIV)

 

[Clinical Presentation]

Definition
Pneumonia
Term

Mycobacterium avium-intracellulare/complex

(HIV)

 

[Clinical Presentation]

Definition
Tuberculosis-like disease
Term

C. albicans

(HIV)

 

[Findings/Labs]

Definition

Pseudohyphae

 

Commonly oral if CD4+ < 400

 

Esophageal if CD4+ < 100

Term

Bartonella henselae

(HIV)

 

[Findings/Labs]

Definition
Biopsy reveals neutrophilic inflammation
Term

Cryptosporidium spp.

(HIV)

 

[Findings/Labs]

Definition

Acid-fast cysts seen in stool

(especially when CD4+ < 200)

Term

Toxoplasma gondii

(HIV)

 

[Findings/Labs]

Definition

Many ring-enhancing lesions on imaging

 

CD4+ < 100

Term

JC virus reactivation

(HIV)

 

[Findings/Labs]

Definition
CD4+ < 200
Term

Cryptococcus neoformans

(HIV)

 

[Findings/Labs]

Definition

India ink stain reveals yeast with narrow-based budding and large capsule

 

CD4+ < 50

Term

CMV

(HIV)

 

[Findings/Labs]

Definition

Retinitis:

- Cotton-wool spots on fundoscopic exam

- CD4+ < 50

 

Interstitial Pneumonia:

- Biopsy reveals cells with intranuclear (owl eye) inclusions

Term

HHV-8

(HIV)

 

[Findings/Labs]

Definition
Biopsy reveals lymphocytic inflammation
Term

Aspergillus fumigatus

(HIV)

 

[Findings/Labs]

Definition

Pleuritic pain, hemoptysis

 

Infiltrates on imaging

Term

Pneumocystic jirovecii

(HIV)

 

[Findings/Labs]

Definition

Especially with CD4+ < 200

 

Ground-glass appearance on imaging

Term

S. pneumonia

(HIV)

 

[Findings/Labs]

Definition
Generally with CD4+ > 200
Term

MAC/Mycobacterium avium-intracellulare

(HIV)

 

[Findings/Labs]

Definition
Especially with CD4+ < 50
Term

Prion Disease

(Pathogenesis)

Definition

Conversion of normal (a-helical) protein called prion protein (PrPc) to a B-pleated form (PrPSC), which is transmissible.

 

PrPSC resists protease degradation > facilitates conversion of more prion > accumulation > spongiform encephalopathy and dementia, ataxia, and death

Term

Prion Disease

(Types)

Definition

Sporadic

(Creutzfeldt-Jakob Disease - rapidly progressive dementia)

 

Inherited

(Gerstmann-Straussler-Scheinker Syndrome)

 

Acquired

(Kuru)

Term

Antimicrobials that affect

Folic Acid Synthesis

Definition

Sulfonamides

 

Trimethoprim

Term

Antimicrobials that affect

DNA Topoisomerases

Definition

Fluoroquinolones

 

Quinolones

Term

Antimicrobials that

Damage DNA

Definition
Metronidazole
Term

Antimicrobials that affect

mRNA Synthesis

Definition
Rifampin
Term

Antimicrobials that affect

Protein Synthesis

(50S Subunit)

Definition

Chloramphenicol

 

Clindamycin

 

Linezolid

 

Macrolides

 

Streptogramins

Term

Antimicrobials that affect

Protein Synthesis

(30S Subunit)

Definition

Aminoglycosides

 

Tetracyclines

Term

Antimicrobials that affect

Cell Wall Synthesis

(Peptidoglycan Synthesis)

Definition
Glycopeptides
Term

Antimicrobials that affect

Cell Wall Synthesis

(Peptidoglycan Cross-Linking)

Definition

Penicillinase-Sensitive Penicillins

 

Penicillinase-Resistant Penicillins

 

Antipseudomonals

 

Cephalosporins (I-V)

 

Carbapenems

 

Monobactams

Term
Penicillin G vs. Penicillin V
Definition

Penicillin G = IV and IM

 

Penicillin V = oral

Term

Penicillin G, V

(Mechanism)

Definition

Bind penicillin-binding proteins (transpeptidases)

 

Block transpeptidase cross-linking of peptidoglycan

 

Activate autolytic enzymes

Term

Penicillin G, V

(Clinical Use)

Definition

Mostly Gram+ organisms

( S. pneumoniae, S. pyogenes, Actinomyces)

 

Also used for:

- N. meningitidis

- T. pallidum

 

Bactericidal for Gram+ cocci, Gram+ rods, Gram- cocci, and spirochetes.

 

Penicillinase sensitive

Term

Penicillin G, V

(Toxicity)

Definition

Hypersensitivity reactions

 

Hemolytic anemia

Term

Penicillin G, V

(Resistance)

Definition
Penicillinase in bacteria (a type of B-lactamase) cleaves B-lactam ring
Term
Sulfonamides
Definition

Sulfamethoxazole

 

Sulfisoxazole

 

Sulfadiazine

Term
Fluoroquinolones
Definition

Ciprofloxacin

 

Levofloxacin

 

Norfloxacin

 

Ofloxacin

 

Sparfloxacin

 

Moxifloxacin

 

Gemifloxacin

 

Enoxacin

Term
Quinolone
Definition
Nalidixic acid
Term
Glycopeptides
Definition

Vancomycin

 

Bacitracin

Term
Penicillinase-sensitive Penicillins
Definition

Penicillin G, V

 

Ampicillin

 

Amoxicillin

Term
Penicillinase-resistant Penicillins
Definition

Oxacillin

 

Nafcillin

 

Dicloxacillin

Term
Antipseudomonals
Definition

Ticarcillin

 

Piperacillin

Term
Carbapenems
Definition

Imipenem

 

Meropenem

 

Ertapenem

 

Doripenem

Term
Monobactam
Definition
Aztreonam
Term
Macrolides
Definition

Azithromycin

 

Clarithromycin

 

Erythromycin

Term
Streptogramins
Definition

Quinupristin

 

Dalfopristin

Term
Aminoglycosides
Definition

Gentamicin

 

Neomycin

 

Amikacin

 

Tobramycin

 

Streptomycin

Term
Tetracyclines
Definition

Tetracycline

 

Doxycycline

 

Minocycline

Term
Aminopenicillins
Definition

Ampicillin

 

Amoxicillin

(AmOxicillin has greater Oral bioavailability)

Term

Aminopenicillins

(Mechanism)

Definition

Same as Penicillin:

- Bind penicillin-binding proteins (transpeptidases)

- Block transpeptidase cross-linking of peptidoglycan

- Activate autolytic enzymes 

Term

Aminopenicillins

(Clinical Use)

Definition

Extended-spectrum penicillin


HELPSS kill enterococci:

 - Haemophilus influenzae

E. coli

Listeria monocytogenes

Proteus mirabilis

Salmonella

Shigella

- Enterococci

Term

Aminopenicillins

(Toxicity)

Definition

Hypersensitivity reactions

 

Rash

 

Pseudomembranous colitis

Term

Aminopenicillins

(Resistance)

Definition

Penicillinase in bacteria (a type of B-lactamase) cleaves B-lactam ring

 

Combine with Clavulanic acid to protect against B-lactamase

Term

Oxacillin, Nafcillin, Dicloxacillin

(Mechanism)

Definition

Same as Penicillin:

- Bind penicillin-binding proteins (transpeptidases)

- Block transpeptidase cross-linking of peptidoglycan

- Activate autolytic enzymes

Term

Oxacillin, Nafcillin, Dicloxacillin

(Clinical Use)

Definition

Narrow spectrum

 

S. aureus

(NOT MRSA - altered PBP target site)

 

Use naf to kill staph

Term

Oxacillin, Nafcillin, Dicloxacillin

(Toxicity)

Definition

Hypersensitivity reactions

 

Interstitial nephritis

Term

Oxacillin, Nafcillin, Dicloxacillin

(Resistant)

Definition

Penicillinase resistant

(bulky R group blocks access of B-lactamase to B-lactam ring)

Term

Ticarcillin, Piperacillin

(Mechanism)

Definition

Same as Penicillin:

- Bind penicillin-binding proteins (transpeptidases)

- Block transpeptidase cross-linking of peptidoglycan

- Activate autolytic enzymes

Term

Ticarcillin, Piperacillin

(Clinical Use)

Definition

Extended Spectrum

 

Pseudomonas spp. and Gram- rods

Term

Ticarcillin, Piperacillin

(Toxicity)

Definition
Hypersensitivity reactions
Term

Ticarcillin, Piperacillin

(Resistance)

Definition

Susceptible to penicillinase

 

Use with B-lactamase inhibitors

Term
B-lactamase inhibitors
Definition

CAST

Clavulanic Acid

Sulbactam

Tazobactam

 

Added to penicillin antibiotics to protect against destruction by B-lactamase (penicillinase)

Term

Cephalosporins

(Mechanism)

Definition

B-lactam drugs that inhibit cell wall synthesis

 

Less susceptible to penicillinases

 

Bactericidal

Term
Organisms NOT covered by Cephalosporins
Definition

They're LAME

Listeria

Atypicals (Chlamydia, Mycoplasma)

MRSA

Enterococci

 

(Exception = Ceftaroline covers MRSA)

Term
1st Gen Cephalosporins
Definition

Drugs:

- Cefazolin

- Cefalexin

- Cefalothin

- Cefadroxil

- Cefaparin

- Cefradine

 

Covers Gram+ Cocci and PEcK

Proteus mirabilis

Ecoli

Klebsiella

 

Cefazolin used prior to surgery to prevent S. aureus wound infections

Term
2nd Gen Cephalosporins
Definition

Drugs:

- Cefoxitin

- Cefaclor

- Cefuroxime

 

Covers Gram+ Cocci and HEN PEcKS

Haeumophilus influenzae

Enterobacter aerogenes

Neisseria spp.

Proteus mirabilis

Ecoli

Klebsiella

Serratia marcescens

Term
3rd Gen Cephalosporins
Definition

Drugs:

- Ceftriaxone

- Cefotaxime

- Ceftazidime

 

Covers serious Gram- infections resistant to other B-lactams

 

Ceftriaxone = Meningitis and Gonorrhea

Ceftazidime = Pseudomonas

Term
4th Gen Cephalosporins
Definition

Drug = Cefepime

 

Increased activity against Pseudomonas and Gram+ organisms

Term
5th Gen Cephalosporins
Definition

Drug = Ceftaroline

 

Broad Gram+ and Gram- organism coverage, including MRSA

 

Does NOT cover Pseudomonas

Term

Cephalosporins

(Toxicity)

Definition

Hypersensitivity reactions

 

Vitamin K deficiency

 

Low cross-reactivity with penicillins

 

Increases nephrotoxicity of aminoglycosides

Term

Aztreonam

(Mechanism)

Definition

Monobactam; resistant to B-lactamases

 

Binds PBP3 > prevents peptidoglycan cross-linking

 

Synergistic with aminoglycosides

Term

Aztreonam

(Clinical Use)

Definition

Gram- rods only

 

No activity against Gram+ or Anaerobes

 

Good for penicillin-allergic patients and those with renal insufficiency who cannot tolerate Aminoglycosides

Term

Aztreonam

(Toxicity)

Definition

Usually nontoxic

(occasional GI upset)

 

No cross-allergenicity with penicillins

Term

Carbapenems

(Drugs)

Definition

DIME

Doripenem

Imipenem

Meropenem

Ertapenem

Term

Carbapenems

(Mechanism)

Definition

Imipenem = broad-spectrum, B-lactamase-resistant Carbapenem.

 

Always administered with Cilastatin (inhibits renal dehydropeptidase I) to decrease inactivation of drug in renal tubules

 

(The kill is lastin' with cilastatin)

Term

Carbapenems

(Clinical Use)

Definition

Gram+ Cocci

 

Gram- Rods

 

Anaerobes

 

Side effects > limited to life-threatening infections or after other drugs have failed

 

Meropenem = decreased risk of seizures and is stable to dehydropeptidase I

 

Ertapenem = limited Pseudomonas coverage

Term

Carbapenems

(Toxicity)

Definition

High plasma levels:

- GI distress

- Skin rash

- CNS toxicity (seizures)

Term

Vancomycin

(Mechanism)

Definition

Inhibits cell wall peptidoglycan formation by binding D-ala D-ala potion of cell wall precursors

 

Bactericidal

Term

Vancomycin

(Clinical Use)

Definition

Gram+ only; serious multi-drug resistant organisms

- MRSA

- Enterococci

- C. difficile

(PO for pseudomemranous colitis)

Term

Vancomycin

(Toxicity)

Definition

Well tolerated in general - NOT trouble free

Nephrotoxicity

Ototoxicity

Thrombophlebitis

 

Red Man Syndrome = diffuse flushing (largely prevented by pretreatment with antihistamines and slow infusion rate)

Term

Vancomycin

(Resistance)

Definition

Occurs in bacteria via amino acid modification of D-ala D-ala to D-ala D-lac

 

"Pay back 2 D-ala's for vandalizing"

Term
Protein Synthesis Inhibitors
Definition

Specifically target smaller bacterial ribosome (70S = 30S and 50S), leaving human ribosome 80S unaffected.

 

"But AT 30CCEL at 50"

 

30S Inhibitors:

Aminoglycosides (bactericidal)

Tetracyclines (bacteriostatic)

 

50S Inhibitors:

Chloramphenicol (bacteriostatic)

Clindamycin (bacteriostatic)

Erythromycin [Macrolides] (bacteriostatic)

- Linezolid (variable)

 

Term

Aminoglycosides

(Drugs)

Definition

"Mean GNATS"

Gentamicin

Neomycin

Amikacin

Tobramycin

Streptomycin

Term

Aminoglycosides

(Mechanism)

Definition

Inhibits formation of initiation complex > misreading of mRNA

 

Blocks translocation

 

Requires O2 for uptake > ineffective against anaerobes

 

("Mean GNATS caNNOT kill anaerobes")

Term

Aminoglycosides

(Clinical Use)

Definition

Severe Gram- rod infections

 

Synergistic with B-lactam antibiotics

 

Neomycin = bowel surgery

Term

Aminoglycosides

(Toxicity)

Definition

Mean GNATS caNNOT kill anaerobes

Nephrotoxicity (especially with cephalosporins)

Neuromuscular blockade

Ototoxicity (especially with loop diuretics)

Teratogen

Term

Aminoglycosides

(Resistance)

Definition
Bacterial transferase enzymes inactivate drug by acetylation, phosphorylation, or adenylation
Term

Tetracyclines

(Drugs)

Definition

Tetracycline

 

Doxycycline

 

Minocycline

Term

Tetracyclines

(Mechanism)

Definition

Bacteriostatic

 

Bind to 30S > prevent attachment of aminoacyl-tRNA

 

Limited CNS penetration

 

Doxycycline = fecally eliminated > can be used in patients with renal failure

 

Do not take with milk (Ca+), antacids (Ca+ or Mg+), or iron-containing preparations because divalent cations inhibits its absorption in the gut

Term

Tetracyclines

(Clinical Use)

Definition

Borrelia burgdorferi

 

M. pneumoniae

 

Rickettsia and Chlamydia

(drug accumulates intracellularly)

 

Acne

Term

Tetracyclines

(Toxicity)

Definition

GI distress

 

Discoloration of teeth + Inhibition of bone growth in children

 

Photosensitivity

 

Contraindicated in pregnancy

Term

Tetracyclines

(Resistance)

Definition
Decreased uptake or increased efflux out of bacterial cells by plasmid-encoded transport pumps
Term

Macrolides

(Drugs)

Definition

Azithromycin

 

Clarithromycin

 

Erythromycin

Term

Macrolides

(Mechanism)

Definition

(Macroslides)

 

Inhibit protein synthesis by blocking translocation; bind to 23S rRNA of the 50S ribosomal subunit

 

Bacteriostatic

Term

Macrolides

(Clinical Use)

Definition

Atypical pneumonias

(Mycoplasma, Chlamydia, Legionella)

 

STDs

(Chlamydia)

 

Gram+ Cocci

(Streptococcal infections in patients allergic to penicillin)

Term

Macrolides

(Toxicity)

Definition

MACRO

- GI Motility issues

Arrhythmia caused by prolonged QT

- acute Cholestatic hepatitis

Rash

- eOsinophilia

 

Increases serum concentration of theophyllines and oral anticoagulants

Term

Macrolides

(Resistance)

Definition
Methylation of 23S rRNA-binding site prevents binding of drug
Term

Chloramphenicol

(Mechanism)

Definition

Blocks peptidyltransferase at 50S ribosomal subunit

 

Bacteriostatic

Term

Chloramphenicol

(Clinical Use)

Definition

Meningitis

(H. influenzae, N. meningitidis, S. pneumoniae)

 

Rocky Mountain Spotted Fever

(Rickettsia rickettsii)

 

Limited use due to toxicty, but often used to developing countries because of low cost

Term

Chloramphenicol

(Toxicity)

Definition

Anemia

(dose dependent)

 

Apalstic anemia

(dose independent)

 

Gray baby syndrome

(premature infants = lack liver UDP-glucuronyl transferase)

Term

Chloramphenicol

(Resistance)

Definition
Plasmid-encoded acetyltransferase inactivates the drug
Supporting users have an ad free experience!