Bacterial Growth
Growth curve antimicrobials that attack single target of bacteria to cause death is reflected as this
Exponential growth phase transferred to another medium; ideal to transfer bacteria
30 to 37 0C optimum growth temperature for most organisms
Viral Growth
Capsid viral component most important to facilitate attachment & entry into host cells
Interferon acts like circulating phagocyte to digest viral particles
Cell multiplication in viruses exemplifies growth
Downey cells atypical epithelial cells infected by a virus
Virus causes disease by altering the growth properties of the cell
10-fold increased risk for a 2nd dengue infection
Immunology
Basic Principles
Application of occlusive dressing significantly modifies microbial flora
Diarrhea bacterial content of the bowel expected to diminish
Acne Propionibacterium
> 25 PMNs/lpf & < 10 squamous cells/lpf good sputum smear
Cord factor tihexa
Aflatoxin commonly contaminated food: peanuts
Washing might be expected to reduce skin flora by 90 % but normal return by 16 hours
Spirochetes considered prokaryotic cells because they contain both RNA & DNA in their nucleus
Normal bowel flora most common source of organisms that cause urinary tract infection
Air conditioning most common source of hospital acquired infections
Resistant organism inhibited but not killed by Penicillin
Culture Medium
Glucose, lactose, sucrose important component of Triple Sugar Iron Agar aside from ferrous sulfite
Obligate anaerobe large nodule on right jaw oozing a yellowish grainy material described as sulfur granules
Peptostreptococcus strictly aerobic & microaerophilic
Exceptions
Staphylococcus aureus
Staphylococcus epidermidis
Streptococcus pyogenes
Diphosphopyridine nucleotidase factor responsibly for the ability of S. pyogenes to kill leukocytes
Fibronectin lipotechoic ligand of S. pryogenes
Dicks test necessary for confirming the diagnosis of scarlet fever
Streptococcus pneumonia
Streptococcus pneumonia patient w/ pneumonia showed gram (+) cocci in pairs & alpha hemolysis on BAP
Streptococcus viridians
Streptococcus mutans
Corynebacterium dipththeria
Restricted blood flow to affected area responsible for cgaracteristic appearance of gray-white membrane
over the tonsils of Corynebacterium diphtheria infected patient
Mycobacterium tuberculosis
Psychrophilic not a characteristic of Mycobacterium tuberculosis (acid-fast, bacilli, shape, obligate aerobe)
Hematuria usual manifestation of tuberculosis of the kidney
Neisseria
Opacity associated proteins adherent factors of N. gonorrheae enhancing invasion of host target cells
Gonococcus non-motile, oxidase positive, gram (-) coccus, usually in pairs, facultative anaerobe, focus is the
urethralepithelium in male
Latent syphilis absence of clinical lesions, negative darkfield examination, normal CSF, (+) treponemal
serologic test
Nocardia
Nocardia asteroids stains pink at the end of modified acid fast staining method
Clostridia
Bacillus
Salmonella
Shigella
Shigella dysenteriae does not produce an enterotoxin impairing absorption of Na & Cl in the large intestine
Shigella dysenteriae yellowish-green, mucoid & blood-streaked stool, numerous pus cells & 15-20 RBC/hpf
Vibrio
Vibrio cholera non-0139 curved, gram (-) rods, transmitted by fecal contamination of water & food, human is
the usual carrier & watery diarrhea in large volume is the clinical picture of this incurable strain
Acidic pH of stomach most effective in preventing Vibrio cholerae from establishing infection
Cholera toxins yields increased levels of intracellular cAMP
Helicobacter pylori
Haemophilus
Bacteroides
Bacteroides fragilis accidental spillage of colonic contents into peritoneal cavity during surgery causing
abscess formation
Bacteroides species most frequent isolates in anaerobic infections
Bordetella
Chocolate agar with X & V factors not a culture medium for B. pertussis
Chlamydia
Very thick capsule surrounding the cell makes Chlamydia difficult to visualize after G/S
Treponema
Gumma seen during tertiary stage of syphilis
Penicillin drug of choice for sexually transmitted syphilis
Most accurate of Treponema pallidum despite of therapeutic use of penicillin for many years, no
penicillin-resitant strains of Treponema pallidum have been isolated
Leptospirae
Pseudomonas aeruginosa
Pseudomonas aeruginosa wounds smell like rotting fruit & oozing greenish-yellow pus; gram (-), non-lactose
Fermenting bacilli grown on McConkey Agar.
Yersinia
Gardnerella
Gardnerella vaginalis many epithelial cells w/ numerous adhering bacteria (clue cells)
Blood agar culture medium for pneumococcal organism causing lobar pneumonia
Ethylene oxide chemical agents most suitable for sterilization of heat-sensitive surgical instruments
such as those used by ophthalmologists
Quinolones inhibit bacterial DNA synthesis by blocking DNA gyrase
Clindamycin induces pseudomembranous enterocolitis if taken chronically
Tetracycline drug of choice in a px who developed bloody diarrhea, presence of Clostridium difficile toxin
was detected, after 10-day course of Clindamycin & Gentamicin following repair of perforated
colon secondary to diverticulitis
Cephalosporin resembles Nalidixic acid inhibiting both gram negative & gram positive organism by binding
to DNA gyrase thereby inhibiting DNA replication
Chloramphenicol aplastic anemia (idiosyncratic effect); gray-baby syndrome
Cotrimoxazole Steven-Johnsons Syndrome
Rifampicin hepatotoxicity
Penicillin In px w/ UTI, resistance to cephalosporins, least rational antibiotic to cause antibiotic resistance
Metronidazole antiprotozoal & active against most anaerobes
INH & Ampicillin + Gentamicin household prophylactic treatment most appropriate to prevent spread of
meningococcemia
Preventive Measures
Viral
Rubella vertically transmited congenital infection most preventable by vaccination of the mother
Rubella caused by Togavirus
Molluscum contagiosum diagnosis can be made clinically
Killed (inactivated) virus vaccines stimulate secretory AB at portals of entry most important concept of viral
vaccine preparation
Amantadine most useful for preventing Influenza A infection
Cytomegalic inclusion disease caused by Human Herpesvirus
Poliomyelitis affects only humans, not animals
Aedes mosquito vector for virus causing dengue fever
Respiratory Syncytial Virus : croup not correct ( EBV IM, Coxsackie pleurodynia, Paramyxovirus Mumps)
Subacute sclerosing panencephalitis fatal sequel of measles causing CNS symptoms
Rotavirus less likely to cause pneumonia, px developing persistent cough & fever
Epstein Barr Virus associated w/ thymic carcinoma, B-cell lymphoma, Human Herpesvirus 4
Epstein barr - would not provide lifelong immunity
Herpes Zoster
Paramyxovirus
HIV/AIDS
Rabies Infection
Rabies bullet-shaped
Incubation period shorter in adults than in children not an accurate statement regarding rabies
Neuraminidase - In H5N1, N stands for
CCR5 - predominant co-receptor for macrophage-tropic strains of HIV-1
SARS coronaviridae
Hepatitis Infection
Fungal
Pneumocystis jirovecii - fungi
Dextrose sugar incorporated in Sabourauds agar for growth of fungi
Amphotericin IV drug of choice for systemic fungal infections
Amphotericin B disrupts cell membrane by binding at the site of ergosterol in the membrane
Azoles inhibit ergosterol synthesis
Capsulated blastospheres Crptococcal subacute meningitis
Candida albicans an opportunistic fungus
Aspergillosis cavitary tuberculosis w/ chest x-ray showing cottony infiltrates in the area of cavity (fungus ball)
Malassezia furfur - most common cause of mild chronic superficial skin mycoses
Cryptococcus fungal species with wide CHO capsule
SDA for primary isolation & replication of fungi
Candidiasis erythematous vesioco-pustules w/ some area of maceration involving genito-crural areas, satellite
lesions