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Bac

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what mediates adherence to catheters? what is it made out of?
glycocalyx, polysaccharide
what spore made out of
keratin-like coat, dipicolinic acid
mediates adherence to another cell? what is it made of?
pilus/fimbrae, glycoprotein
where is endotoxin? what is it made of?
outer mem of gram negative, made of lipopolysaccharide
unique substance to gram -
endotoxin/LPS
unique substance to gram +
teichoic acid
structure of peptidoglycan
sugar backbone with crosslinked peptide side chains
describe the cell wall gram -
outside capsule, outer mem with endotoxin, space called periplasm with a thin layer of peptidoglycan and then a cytoplasmic mem
T/F Gram positive do not have peptidoglycan
F, both + and - has peptidoglycan
name stages of bac growth curve
lag, log, stationary, death
what are clinical effects of endotoxin? hormones released in response?
fever, shock
TNF, IL1
which exotoxin is not heat labile
staph enterotoxin
describe periplasm. what's in it?
layer in gram - cells bw outer and inner mem.
contains hydrolytic enzymes ie beta lactamases
what's major surface Ag for gram +? gram -?
what does ea induce in the host
gram +=teichoic, induces TNF, IL1
gram -=endotoxin (LPS), lipid A induces TNF, IL1
what's special about Anthrax's spore
it has D glutamate (most capsules are made of pollysaccharide
how do endo and exotoxin differ as far as genetic origin
exotoxin comes from plasmid or bacteriophage, endotoxin is made from bac chromosome
compare toxicity endo v exotoxin
how does this apply to vaccines
exo is high! can use toxoid for vaccine. endo is low, there are not very antigenic and can't be used in vaccines
what are the three general pathways that endotoxin induces
activated macro
activated complement (by alternate)
activates Hageman factor
describe endotoxin-macrophage pathway: mediators, what symptoms they cause
IL1-fever
TNF-fever, hemorrhagic tissue necrosis
NO-hypotension (shock)
describe endotoxin complement path: mediators? symptoms?
C3a=hypotension, edema
C5a=neutro chemotaxis
what does activating hageman factor do
activated coag cascade, leads to DIC
describe cholera toxin actions. what is most similar to this?
cholera + Gs, ADP ribo leads to cAMP.
bordetella pertusis is similar (opposite) it - Gi.
describe C. Diph toxin
similar?
ADP ribo - EF2
Pseudo exo A does exact same thing
Pseudo toxin. similar?
2 toxins!!
exo A ADP ribo - EF2 (just like Diph)
exoS ADP ribo
describe E Coli toxins. compare to similar toxins
LT= +ADP ribos to cAMP (like cholera)
ST= + ADP ribos to Gcmp leads to excrete Na, Cl (Y pestis also has this)
describe Shiga toxin. similar?
EF - ribosome
Y ent has Shiga EF toxin
describe Salmon toxin.
enterotoxin + cAMP
which are AB toxins? which aren't?
Lots are AB-cholera, pertussis, diph, pseudo, E Coli LT, Shiga, tetanus, botulinum, bacillus
NOT AB=E coli ST, Salmon, Perfringes, Staph and Strep
which two have toxins equiv to cholera. what is that mech
ADP leading to cAMP
-E Coli LT
-C Jejuni
describe C perfringens toxin
alpha toxin= phospholipase C, lecithinase causes gas gangrene
describe toxins of bacillus
PA=B
EF=an AC
LF=kill
describe Staph toxins.
what do they induce?
TSS (superAg binds MHCII and Tcell R inducing IL1,2 in toxic shock)
exfoliatin
entero
describe S pyo toxins
LOTS!
-toxins A-F
-erythro (superAg, rash scarlet F)
-hemo Strep O (ASO of rheum F)
which toxins use ADP ribos to + AC
-E Coli heat labile toxin
-cholera exotoxin
-pertussis exotoxin
(anthrax IS an AC)
which bugs can't gram stain. what can you use?
-Syph (Treponema, use dark light)
-Mycobac (acid fast)
-Intracellulars: Rickettsia, Chlamydia (Giemsa), Legionella (use Ag stain)
culture for H FLu
choc agar + V (NAD) and X (hematin)
culture for N gonorrhea
Thayer-Martin (VCN)
culture N mening
choc agar
culture B pertussis
Bordet-Gengou (potato agar)
culture C Diphtheria
tellurite, Loefflers, blood agar
culture TB
Lowenstein-Jensen
culture Legionella
Charcoal yeast w iren and cysteine
culture fungi
Sabarouds
can survive 6.5% NaCL
Entero, S Aureus, V parahemo
"viable even in salt"
culture Mycoplasma
Eaton's agar
microaerophils
Camp, Helio, Borrelia
"can hardly breathe"
Prussian blue stain for
Fe
Ziehl Nelson stain
for AFB (incl mycobac)
Silver stain or "methanamine Ag"
Fungi, PCP, Legionella
name inactivated vaccines
-H Flu
-V Cholera
-hep A
-rabies
-Salk polio
name activ/other vaccines
-adeno
-MMR
-varicella
-variola
-Sabin polio
-(Francisella, Yellow Fever)
name Lactose ferment gram -
Klebsiella, Ecoli, Enterobac (fast ferment)
Citobacter, Serratia (slow ferment)
=Pink on McConkey's
what are gram - rods don't ferment lactose
Pseudo (ox +)
Shigella, Salmonella, Proteus (all ox -)
name some gram - that are non cocci, non rod
-H Pylori, Borrelia (spirochetes)
-Comma shape: Vibro, Camp
-Yersinia-safety pin
-branch-Nocardia
name obligate aerobes
Nocardia
Pseudo
Bacillus
TB
name obligate anaerobes
Clost
Actino
Bacteroides
which have IgA proteases
S Pneu
both Neisseria
H Flu
difft Staph and Strep
catalase+=Staph
alpha hemo
S Pneu (opt sensitive)
S Viridians (opt R)
beta hemo
grp A=S Pyo (bac sensit)
grp B=S aglaictae (bac R)
color alpha hemo? beta? gamma?
alpha=green (partial)
beta=clear (complete)
gamma=no hemolysis
name qualities of S Pne
alpha hemo, optochin sensitive
what's grp A Strep
S Pyo (beta hemo)
what grp B Strep
S Aglaictae (beta hemo)
name qualities S Pyo
beta hemo, grp A, bacitracin sensitive
bacitracin difft
grp A and B (under beta hemo)
optochin difft
S Pneu, Viridians (under alpha hemo)
name gram + rods
Clostridium
Corynebac
Listeria
Bacillus
how difft within Staph
Aureus is coag +
Coag -=
S epidermis (novobiocin S)
S sapro (novobiocin R)
Remember all are catalase +
name facultative intracell
Salmonella, Brucella, Pasteurella, Legionella, Listeria, Yersinia, Mycobac
which can mutliple at 4 degrees
Yersinia, Pseudo, Listeria
which bac encapsulated
Strep
Neisseria
H FLu
Klebsiella
which form spores
Bacillus
C Perfringen
C tetani
beta hemo besides Strep
(Strep pyo, aglactiae)
Staph Aureus
Listeria
virulence of Staph comes from
Protein A-which binds Fc-IgG inhibiting complement fix and phago
transmission Francisella
(causes Tularemia)
tick bite; rabbits, deeer
transmission Brucella
(undulating fever)
dairy products
contact animals (farm?)
transmission Bartonella
cat scratch dz--cat!
transmission Borrelia
(Lyme)
Ixodes tick bite, ticks live on deer and mice
transmission Yersinia
flea bite, rodents esp praire dogs
transmission Pasteurella
(cause cellulitis)
animal bite, cats, dogs
oral/facial abscess with sulfur granules draining thru skin
actinomyces
tx actinomyces
SNAP
sulfa for Nocardia, Actinomyces use Penicillin
where find C perfringens
in reheated meat dishes
where find Salmonella
poultry, meat, eggs
O antigen? what are other of these antigens?
Applies to Enterobactericae family
O antigen=somatic (polysacc of endotoxin)
K antigen=virulence
H antigen=flagellar
what qualities all enterobactericae share? ie ferment lactose...
all ferment glucose and oxidase -
dzs for H Influ
HEMOP
Epiglottitis
Meningitis
Otitis Media
PNA
tx Legionella
erythro
tx Pseudo (per 1st Aid)
AG + piperacillin
tx H Flu meningitis
Ceftriaxone, and rifampin for close contacts
dzs of Pseudo
burn infxn
PNA in CF
PNA in hospital
-UTI
-external otitis
-hot tub
-sepsis (black skin lesions)
what mycobac causes LAD in kids
M Scropulaceum causes cervical LAD
Mycobac Kansaii causes
pulmonary TB like symptoms
what rxn to determine if Rickettsia? what does this involve
Weil Felix
checks for anti-rickettsia Ab that cross react with Proteus Ag
tx Mycoplasma Pneu
tetracycline or Erythro
congenital CMV
blueberry muffin baby+ deafness + periventricular Ca
congenital rubella
MR, heart, blindness, encephalitis, motor problems
congenital Syph
can cause death or abnormal teeth, bone, CNS
congenital Toxo
can be aquired on delivery (mild) or severe congenital
still birth, chorioretinitis, intracerebral Ca, hydo or microcephaly
what unusual in composition Chlamydia's wall
the peptidoglycan contains no muramic acid
describe Chlamydia life cycle
Elementary body (small dense) enters cell via endocytosis, then Reticulate body replicates by fission, reorganized into EB and released
Chla A,B,C
ABC=Africa, blindness, chronic infxn
Chla L1, L2, L3
lymphogranuloma venereum (acute lymphadenitis). positive Frei test
Chla D-K
urethritis/PID, ectopic preg, neonatal PNA, or neonatal conjunctivitis (tx with erythro eye drops)
Spirochetes histol
BLT
Borrelia big (aniline dye=Wright/Giemsa)
Leptospira
Treponema (dark field)
VDRL false positives
VDRL
Viruses (mono, hep)
Drugs
Rheumatic Fever and RA
Lupus and leprosy
describe VDRL test
nonspecific Ab reacts w cardiolipin
epidemic v endemic typhus
endemic (fleas)-Ricekttsia typhi
epidemic (human body louse)-R prowazekii
palm and sole rash seen...
RMSF, syph, cox A
how differentiate typhus and RMSF rash
typhus spreads outward, RMSF spreads inward
name of skin mainfest of Lyme
erythema chronicum migrans=expanding bull's eye (w flu-like symptoms)
tx Lyme
tetracycline
qualities of Plasmodium vivax/ovale, tx
LATENT in LIVER
oval shape host cells w Schuffer's granules, ragged cell wall, only effects RE
tx=chloroquine + primaquine
qualities of Plasmodium malarie, tx
bar and band forms, rosette schizonts, only affects mature RBC
tx=chloroquine
qualities P. falciarum, tx
mltp ring forms and crescents (gametocytes) rarely see schizonts. affects RBC of all ages. Assoc with cerebral dz
tx chloroqune resistant with quinine and doxycycline
life cycle plasmodium
mosquito ingests gametocytes.
inject sporozoites into humans, they infect liver
(hypnozoites=resting form of ovale and vivax use primaquine)
merozoites released infect RBC (tx chloroquine)
where asexual phase of malaria? sexual phase?
asexual (schizogeny) in liver and RBC
sexual (sporogony) in mosquito

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