Micro Cheat Sheet #3

Micro Cheat Sheet #3 (PASS Videos)

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Shigella o Causes gastroenteritis associated with daycare outbreaks o Most immunogenic bacteria o Has an exotoxin (shiga toxin) which causes seizures o S. sonneii: common in the US o S. dysentery: common outside the US

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Salmonella o Encapsulated o Loves to attack people with sickle cell anemia (causes osteomyelitis) o Causes gastroenteritis associated with raw chicken or raw eggs o Runs and hides in the gallbladder if you treat it with antibiotics  Can precipitate cholecystitis o Causes a biotin deficiency o Causes monocytosis o S. enteritidis: most common strain in US o S. dysentery: common outside the US o S. typhi  Cause of typhoid fever  Traid: fever, rose spots, and intestinal fire (stomach feels like it is burning)  Causes heart block  Associated with contaminated water  Tx: ciprofloxacin

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Bordatella o B. pertussis  Causes whooping cough  Prodromal stage – fever, runny nose  Catarrhal stage – increase mucus

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 Paroxysmal stage – cough Has an exotoxin that ADP-ribosylates Gi subunit of the G-protein Exotoxin is intracellular  kills cells High cAMP increases mucus in the lungs Causes extreme lymphocytosis ( should be PMN’s but lymphocytes instead) MCC of death was suffocation Vaccination - DtaP Diagnosis: ELIZA on nasopharyngeal washings TX: erythromycin; also treat close contacts (>25hrs) with erythromycin

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Pasturella o P. multocida  Causes cellulitis associated with an infected cat or dog bite  Found in the saliva of cats and dogs  Mix up with Bartonella henselae – cat scratch – Bart Simpson  Tx: Amoxacillin

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Brucella o Causes undulating fever (5-7 fever spikes a day) o Seen primarily in veterinarians and farmers who deliver animals o Attaches to placenta

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Bartonella o B. henselae  Silver stain  H. pylori, B. henselae, and Legionella  Causes cat scratch fever  Carried by kittens

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Francisella o F. Tularensis  Causes tularemia or oculo-glandular fever

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Vibrio o V. cholera  Curved rod 

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Transmitted by rabbits (90%) and deer (10%) Tularemia cause Tx: streptomycin  Cannot give to a pregnant woman  teratogenic

Has an exotoxin that ADP-ribosylates Gs and elevates cAMP

 “Rice water” diarrhea (also ETEC) o V. parahemolyticus  Diarrhea associated with raw fish o V. vulnificus  Diarrhea associated with raw oysters Campylobacter Jejunii o Curved rod o Attackes the jejunum; causing copious blood diarrhea o Causes diarrhea associated with raw chickens or raw eggs o Tx: Erythromycin Yersinia o Likes the Southwest o Vector: prairie dog o Y. Pestis  Bubonic plague  Pneumonic plague o Y. Enterocolitica  Likes to attack the ileum causing ileitis or mesenteric adenitis (mimic’s appendicitis in symptoms  Causes Reiter’s syndrome- any post infection arthritis o HLA-B27 diseases  Reiter’s syndrome-any post infection arthritis  Ankylosing spondilytis-shoeberg test, bamboo spine  Psoriasis-silver plaque on extensor surfaces  Tx: methaltrexate, and UV light (sunlight)  cells don’t rapidly divide  Psoriasis w/o arthritis- HLA B13 Atypicals

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have no cell wall granulomatous inflammation covered by Quinalones, Macrolides, and tectracyclines causes interstitial pneumonia symptoms out of proportion to physical findings  walking pneumonia labs do not coincide with what you can see  consider: if adult: Chlamydia Pneumonia  Teen: Mycoplasma pneumonia Chlamydia o Parasites: depend on the host for ATP o Eosinophilia o Has two forms:  Elementary body (infectious)  Reticulate body (dormant form) o Granulomatous inflammation o C. Trachomatis  Causes trachoma: Mcc #1 of neonatal blindness in the world  -trachoma: destruction of the cornea from scarring  -Prevention: apply erythromycin to eyes  Mcc of lymphogranuloma venereum  Mcc of STDs (90% are asymptomatic)  Mcc of infertility in WOMEN  Mcc of ectopic pregnancy (from scarring)  No cilia to move egg along  Most common location for ectopic pregnancy is ampulla  Hcg is low  Diagnosis:  ELIZA with all pap smears  Tx: one-dose :azithromycin  Old Tx: doxycycline for 7 days o C. Pneumonia  Mcc of atypical pneumonia (0-2 mo)  Eosinophilia  Interstitial pneumonia  Symptoms out of proportion to physical findings  Steccato coughing (*a—hoo—a—hoo* hard time breathing)  Found to be connected to Alzheimer’s disease and coronary artery disease (CAD)  Abs from C. Pneumonia for plaque and such for Alzheimers

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o IF PT PRESENTS with Walking Pneumonia:  Adults: choose Chlamydia  Teens: mycoplasm o C. Psitacii  KEY: Pet shop  Associated with parrots and parakeets  Causes interstitial pneumonia or nonbacterial endocarditis Mycoplasma o No cell wall o NO epithelial lining o Look like a jellyfish o Mcc of atypical pneumonia from ages 10 to 30 o Cold agglutinins (cryoglobulinemia)  IgM Abs attracted to RBCs cause them to clump o Causes “walking pneumonia” o Interstitial pneumonia with symptoms out of proportion to physical findings o M. Hominis  An occasional cause of vaginitis Legionella Penumonphilia o Mcc of atypical pneumonia age 40yrs o Interstitial pneumonia o Silver stain  H. pylori, Bartonella Hensli, and Legionella o Grows on CYAE (charcoal, Yeast agar) “3 sisters Ella in the Cysteine chapel” o Likes standing water on heating and air conditioning systems (**vegetable and fruit sprayersmists) o Causes high rise building syndrome or hotel/motel syndrome o Pontiac Fever: fever and nonspecific symptoms o Legionnaire’s disease: full blown pneumonia o Granulomatous inflammation o Causes Heart Block  First degree: fixed prolonged PR interval  Tx: do nothing, asymptomatic  Second degree:  Mobitz 1: progressively prolonged PR interval until a QRS complex is dropped o Winki Bauck Mcc from DRUGS o D/c offending drug

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Mobitz 2: normal PR interval; erratic dropping of QRS complexes o Tx: D/c the drug and if needed PACE THEM  Third degree: NO relationship between P waves and QRS complexes  Tx: put in a permanent pacemaker  INFECTIONS THAT CAUSE:  Legionella  Lyme  Diptheria  Chaga’s  Typhoid fever Ureoplasma Urolyticum o An occasional cause of vaginitis o Has NO cell wall or epithelial lining like mycoplasma o Urease (+) o Case: little girl who has this; assume sexual abuse

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Like warmth and moisture (skin folds, groin, axilla, vagina) Like to eat sugar- DIABETICS MOST COMMON To prevent fungal infections, keep cool and dry Have a unique lipid in their membrane called ergesterol Antifungals: o Bind to ergestrol  Amphotericin B- IV for systemic fungal infections  Get confused with cholesterol  Pokes holes in your cells—releasing K+  EKG changes: Peaked T waves  True hyperkalemia  Nystatin- PO wash, does not cross intact membrane  Mycostatin- topical: athletes foot, jock itch, oral thrush, ring worms, vaginitis  Miconazole  Clotrimazole: topical: inhibits P450 of fungus  Tolnaftate: over the counter: spray or topical cream  Terbenafine: Lamisil for Nail infections (more than 1 nail affected otherwise will take the 1 nail off) @5:30

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Flucytosine (5FC)-inhiits mitosis (acts like pyramadine analog) inhibits the DNA fungal synthesis  Inhibits erg sterol synthesis  Fluconazole- best CNS penetration (cross BBB)  Itraconazole  Ketoconazole- inhibits the P450s, blocks 5α reductase more effective  Inhibits microtubules  Griseofulvin o Superficial Fungi infections  Piedre- blk balls on the hair shaft  Tx: cut hair  Microsporum Beigeii- white balls on the hair shafter  Tx: cut hair