Amitha's Micro test 3
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- What is the major route of infection in UTIs?
- Retrograde ascent up the urethra/ureters
- What is the normal protective vaginal flora?
- Gram positive lactobacilli
- What are 3 things secreted by normal flora that deters the growth of other organisms?
- Hydrogen peroxide lactic acid to lower pH, and bacteriocins to prevent infection
- What hormone promotes growth of vaginal flora?
- estrogen
- What virulence factor promotes E. coli UTI's?
- pilus that binds epithelial cells
- What virulence factor promotes Staph saprophyticus infections of the urinary tract
- lipoteichoic acid
- What orgainsim accounts for 85% of UTI's?
- E. coli
- Which orgainsims are mainly responsible for hematogeous spread of UTI's?
- Staph aureus or candida
- What two things are tested for with a dipstick urinalysis?
- Leukocyte esterase levels (indicating neutrophils in the urine) and Nitrate reduction to Nitrate (performed only by enterobacteriaceae)
- In the microscopic examinationof urine, how many White cells/ high power field indicate pyuria?
- > 5 per high power field
- which anaerobic gram-positive spore-forming rod makes an enterotoxin produced in the small intestine which causes transport disturbances and secretory diarrhea?
- Clostridium perfringens
- What 3 syndromes are caused by Salmonella enterica?
- Enteric fever, enterocolitis, and bacteremia
- Are salmonella lactose positive or negative?
- lactose negative
- Campylobacter is a gram (neg/pos?) (cocci/rod?)
- Gram negative curved rod
- Gram negative bacilli, lactose positive, indole positive, sorbitol negative
- E. coli O157 (enterohemorrhagic)
- What lactose negative organism is closely related to E. coli
- Shigella
- What food borne pathogen causes an appendicitis-like syndrome and causes mucosal ulcerations in the terminal ileum?
- Yersinia enterocolitica
- What organism that is responsible for many duodenal and gastric ulcers will produce urea and thus an increase in pH in a urease media?
- Helicobacter pylori
- Which enterobacteriaceae does not causes GI symptomes but causes bubonic and pneumonic plague?
- Yersinia pestis
- What organism causes most of the cases of tuberculosis?
- Mycobacterium tuberculosis
- What is the major difference that distinguishes Mycobacterium tuberculosis from other bacteria?
- 60% of the dry wall weight is lipid--responsible for the acid fast stain specificity.
- What cell type ingests Mycobacteria tuberculosis in a non-immune host? What intracellular compartment do the bacteria reside in?
- pulmonary alveolar macrophages, reside intracellularly in phagosomes
- What is a Ghon focus?
- Local lung parenchymal infection caused by mycobacterium bacilli.
- What is a Ghon complex?
- Ghon focus (site of parenchymal infection plus intrathoracic lymphangitis with draining regional node involvement
- What makes up the TB granulomas?
- langhans giant cells, lymphocytes, and granulation tissue (fibroblasts and capillaries)
- What type of necrosis occurs in the tissue as a result of TB?
- caseation necrosis
- Can those with a latent infection of TB transmit the disease?
- No
- Which 4 drugs are given as initial first line theraphy in TB patients?
- Isoniazid, rifampin, pyrazinamide, and ethambutol
- What common fluroquinolone would not be given up front to treat UTIs because it is not excreted in the urine?
- Moxifloxacin. Other fluoroquinolones are commonly given to treat cystitis
- Which 3 organisms can cause food poisoning illness by ingestion of preformed toxins?
- S. Aureus, B. Cereus, C. botulinum.
- What is the most common cause of traveler's diarrhea?
- enterotoxigenic E. coli
- Vibrio cholerae causes diarrhea by what mechanism?
- irreversible activation of adenylate cyclase-> produces cAMP-> water and electrolyte secretion in gut -> secretory diarrhea
- What is the morphology of Borrelia?
- elongated, spiral shaped bacteria
- What is the natural reservoir of endemic relapsing feber caused byBorrelia? What vector is it transmitted by?
- Rodents, fly
- What is the natural reservoir of epidemic relapsing fever caused by Borrelia? What vector is it transmited by
- Humans, louse born
- How does Borrelia evade the immune system?
- Gets sequestered into organs of the reticuloendothelial system and re-emerges antigenically modified after a period of quiescence.
- What is the best way to diagnose relapsing fever? With what stain?
- blood films with arcidine orange stain you can see a small squigly organism
- What antibiotics can be used to treat relapsing fever caused by Borrelia?
- Tetracycline or erythromycin
- What is a Jarish herxheimer reaction?
- A reaction seen a few afters antibiotics are given to treat borrelial or spirochete organisms. It causes a febrile reaction because of the antigens released after the bacteria have been killed.
- What is Lyme disease?
- A systemic infection caused by Borrelia burgdorferi that is spread by the bite of Ixodes ticks. Has a life cycle similar to syphillis
- What is the primary reservoir of Borrelia burgdorferi
- white footed mouse
- At which stage in its life cycle is a tick most likely to transmit lyme disease to humans?
- small nymph stage
- What are the characteristics of the first stage or primary stage of lyme disease
- Erythema migrans and acute flu like or meningitis like symptoms
- What are the characteristics of the secondary stage of lyme disease?
- A disseminated infection that occurs weeks to months later, can present with arthritis, cardiac (prolonged P-R interval)or neurological symptoms (bells palsy)
- What are the characteristics of the chronic or persistent stage of lyme disease?
- chronic skin conditions, neurologic changes (encephalitis, dementia, spastic paraparesis, transverse myelitis)
- How are Rocky mountain spotted fever and erllichiosis transmitted?
- Ticks
- What is the hallmark of roky mountain spotted fever?
- small vessel vasculitis- porliferation of the organisms around the endothelium of small vessels with a large inflammatory response
- What is the clinical presentation of Rocky Mountain Spotted Fever?
- traid of fever, headache, and myalgias. A rash appears on the 3rd day of illness. May have hemmorhagic manifestations of petechia and ecymoses. Also thrombocytopenia
- What are the drugs of choice used for Rocky Mountain Spotted Fever
- tetracycline and chloramphenicol
- What organism causes Rocky Mountain Spotted Fever?
- R. rickettsii
- What is the organism, vector and host for epidemic typhus?
- Rickettsia prwazekii, louse, human
- What is the organism, vector, and host for endemic typhus?
- Ricketsia typhi, flea, rats and opossums
- What is Brill Zinsser disease?
- A recrudescence of typhus
- What is a morrula?
- A group of replicating bacteria in the white blood cells.
- What is the organism responsible for Q-fever?
- Coxiella burnetti
- How is Q-fever transmitted?
- Transmitted by inhalation-it is infectious for long periods outside the host.
- What is the treatment for Q fever?
- doxycyclin