Saturday, August 8, 2009

Microbiology

Entameoba histolytica: disease caused, action EntAmoeba causes Amoebic dysEntery.
Action: histo (cell) lytic (burst), so it bursts cells

Clostridium difficile: disease caused "Difficult to be in a Closet with someone having explosive foul smelling diarrhea, because it would smell and there would be no air in there.
Clostridium Difficile causes explosive foul smelling diarrhea and is an anaeorbe (no air)

Pneumonia: acute pneumonia infiltrates from different causes "Pyrogenic=PMN, Miscellaneous=Mononuclear":
Acute pneumonia caused by Pyogenic bacteria: PMN infiltrate.
Acute pneumonia caused by Miscellaneous microbes: Mononuclear infiltrate.

Klebsiella details You tell the patient: "Get UPS you fat alcoholic":
UTI
Pneumonia
Sepsis
Fat capsule
Get up=nonmotile since no flagella.
Alcoholic=commonly seen in alcoholic and nosocomial patients.

Pseudomonas details · See diagram of patient.
Patient: bug commonly infects nosocomial.
Oxygen tank: oxidase positive.
IV bag: has glucose and lactose, so its OK to give because its a nonlactose fermenter.
Why giving oxygen? Because it commonly caused pneumonia.
IV in the arm: supposed to signify sepsis.
The foley: UTI.
Burn on his foot: can infect burns

Leprosy: early signs diagnostic criteria "LEProsy":
Loss of sensation in affected skin/ Loss of function (paralysis)
Enlargement of affected superficial nerves (tender too)
Positive identification of M. leprae under microscope

Kidney transplant virus "Borrowed Kidney":
BK virus is associated with kidney transplants.

Endotoxin features ENDOTOXIN:
Endothelial cells/ Edema
Negative (gram- bacteria)
DIC/ Death
Outer membrane
TNF
O-antigen
X-tremely heat stable
IL-1
Nitric oxide/ Neutrophil chemotaxis

Mycobacterium tuberculosis: culture identification "Rough, Tough, Buff":
Rough: colony isn't smooth but rough like breadcrumbs.
Tough: colony stuck to plate well, and tough to remove.
Buff: buff is a color, a cream/coffee shade.

Gram+: bacterial cell wall · Gram+ has:
+hick pepidoglycan layer.
+eichoic acid in wall

Listeria: motility Istanbul sounds like Listambul = list + tumble.
Listeria has tumbling motility.

Staphylococci: novobiocin test to distinguish coagulase negative staphylococciepidermidis stays away from the novobiocin disc like an epidemic.
· Therefore, epidermidis is sensitive to novobiocin.
Staph saprophyticus, much friendlier, comes up to the disc and says, "'sap?'" [short for "whassup?", ie "what's up"].
· Therefore, saprophyticus is novobiocin resistant.

Acute post-streptococcal glomerulonephritis: classic presentation "Sore throat, Face bloat, Pi$$ coke":
Sore throat: 1 week ago
Face bloat: facial edema
Pi$$ coke: coke-coloured urine
· Alternatively, short version: "Throat, bloat and coke"

Streptococci: classification by hemolytic ability Gamma: Garbage (no hemolytic activity).
Alpha: Almost (almost lyse, but incomplete).
Beta: Best (complete lysis).

Streptococci: Quellung reaction: positive sign, Strep type confirmed "Quell-lung":
Quell: Capsules swell [+ve test].
Lung: S. pnuemonia [type confirmed].
· You get pneumonia in your lung.

E. coli: diseases caused in presence of virulence factors DUNG:
Diarrhea
UTI
Neonatal meningitis
Gram negative sepsis
· Dung, since contract E. coli from dung-contaminated water.

Streptococcus pyrogenes: antibody SPAM:
Streptococcus Pyogenes: Antibody to M protein.

Staphylococcus aureus: diseases caused SOFT PAINS:
Skin infections
Osteomyelitis
Food poisoning
Toxic shock syndrome
Pneumonia
Acute endocarditis
Infective arthritis
Necrotizing fasciitis
Sepsis

Gram staining: mechanism "Murein gets the red out" [Allusion to an old eye-wash slogan]:
Peptidoglycan (aka murein) remains purple during Gram staining. The Gram negatives, devoid of murein, are red.
Thus, murein prevents redness and are purple (positive).

HIV infection: high-risk groups HIV:
Homosexuals/ Hemophiliacs
IV drug abusers

Trichomaniasis: features · 5 F's:
Flagella
Frothy discharge
Fishy odor (sometimes)
Fornication (STD)
Flagyl (metronidazole) Rx

Nematodes: ones spreading by egg ingestion "ATE eggs":
Ascaris Lumbricoides
Trichuris trichuira
Enterobius vermicularis
spread by ingestion of eggs (vs skin invasion or insect bite)

Food poisoning: bugs inducing "Eating Contaminated Stuff Causes Very Big Smelly Vomit":
E. coli O157-H7 [undercooked meat, esp. hamburgers]
Clostridium botulinum [canned foods]
Salmonella [poultry, meat, eggs]
Vibrio parahaemolyticus [seafood]
Bacillus cereus [reheated rice]
Staphylococcus aureus [meats, mayo, custard]
Clostridium perfringens [reheated meat]
Vibrio vulnificus [seafood]

B19 virus: at-risk groups B19 affects 3 B's:
Babies (5th disease, infectiousum erythematosa)
Black Bleeders (sickle cell anemics - anaplastic anemic crisis)
Bearing Babies [pregnant women] (hydrops fetalis)

IgA protease-producing bacteria "Nice Strip of Ham":
Neisseria
Streptococcus pneumonia
Haemophilus influenza

Hemophilius: culture requirements Read Hemophilus as "HemoFive":
· Needs Heme with Factors Five and Ten.

DNA viruses: morphology rule of thumb DNA:
Double-stranded
Nuclear replication
'Anhedral symmetry
· Rule breakers: pox (cytoplasmic), parvo (single-stranded)

Streptococcus pyogenes: virulence factors SMASHED:
Streptolysins
M protein
Anti-C5a peptidase
Streptokinase
Hyaluronidase
Exotoxin
DNAses

Gram positive stain Gram Positives
Stain Purple (violet-blue)
because of their thick Peptidoglycan layer

Common cold: viral causes "Common cold (acute infectious rhinitis, coryza) is PRIMArily caused by":
Paramyxoviruses
Rhinoviruses
Influenza viruses
Myxoviruses
Adenoviruses

Streptococcus pyogenes: diseases caused NIPPLES:
Necrotising fasciitis and myositis
Impetigo
Pharyngitis
Pneumonia
Lymphangitis
Erysipelas and cellulitis
Scarlet fever/ Streptococcal TSS

Picornavirus: features PICORNAvirus:
Positive sense
ICOsahedral
RNA virus

Neisseria: fermentation of N. gonorrhoeae vs. N. meningitidis Gonorrhoeae: Glucose fermenter only.
MeninGitidis: Maltose and Glucose fermenter.
· Maltose fermentation is a useful property to know, since it's the classic test to distinguish the Neisseria types.

RNA viruses: negative stranded "Orthodox Rhabbi's Party Around Fine Bunnies":
Orthomyxo
Rhabdo
Paramyxo
Arena
Filo
Bunya

RNA viruses: positive stranded "Pico Called Flavio To Return Renzo's Corona":
Picorna
Calici
Flavi
Toga
Retro
Reo
Corona

Endocarditis: lab results suggesting it "High Tech Lab Results Point At Endocarditis":
Hematuria
Thrombocytopenia
Leukocytosis, -penia
Red blood cell casta
Proteinuria
Anemia
Elevated ESR

Endocarditis: causes of culture negative endocarditis "With Negative Tests, Investigators Should Focus Attention Somewhere Meaningful":
Wrong diagnosis
Noninfectious endocarditis
Timing (cultures drawn at end of chronic course)
obligate Intracellular organisms
Slow growing fastidious organisms
Fungal infection
Antibiotic used previously
Subacute right-sided endocarditis
Mural endocarditis

Endocarditis: indications for surgery PUS RIVER:
Prosthetic valve endocarditis (most cases)
Uncontrolled infection
Supporative local complications with conduction abnormalities
Resection of mycotic aneurysm
Ineffective antimicrobial therapy (eg Vs fungi)
Valvular damage (significant)
Embolization (repeated systemic)
Refractory congestive heart failure

Meningitis: risk factors "Can Induce Severe Attacks Of Head PAINS":
Cancer
Immunocompromised state
Sinusitis
Age extremes
Otitis
Head trauma
Parameningeal infection
Alcoholism
Infections (systemic, esp. respiratory)
Neurosurgical procedures
Splenectomy

Influenza infection: clinical manifestations "Having Flu Symptoms Can Make Moaning Children A Nightmare":
Headache
Fever
Sore throat
Chills
Myalgias
Malaise
Cough
Anorexia
Nasal congestion

UTI-causing microorganisms KEEPS:
Klebsiella
Enterococcus faecalis/ Enterobacter cloacae
E. coli
Pseudomonas aeroginosa/ Proteus mirabilis
Staphylococcus saprophyticcus/ Serratia marcescens

Psedomonas aeruginosa: features AERUGINOSA:
Aerobic
Exotoxin A
Rod/ Resistance
UTIs, burns, injuries
Green-blue dressings
Iron-containing lesions
Negative gram
Odor of grapes
Slime capsule sometimes (in CF pt)
Adherin pili

Toxoplasma gondii: manifestations "My Cat Eats Mice":
Mononucleosis-like illness
Chorioretinits/ Congenital infection
Encephalitis
Myocarditis

Chlamydia: elementary vs. initial body location Elementary: Extracellular
Initial: Intracellular

RNA enveloped viruses FORT ABC, Puerto Rico:
Flavivirus/ Filo
Orthomyxo
Retro
Toga
Arena
Bunya
Corona
Paramyxo
Rhabdo

Teratogens: placenta-crossing organisms ToRCHeS:
Toxoplasma
Rubella
CMV
Herpes simplex, Herpes zoster (varicella), Hepatitis B,C,E
Syphilis
· Alternatively: TORCHES: with Others (parvo, listeria), add HIV to H's, Enteroviruses.

E. coli: major subtypes, key point of each "HIT by E. coli outbreak":
EnteroHemorrhagic:
· HUS from Hamburgers
EnteroInvasive:
· Immune-mediated Inflammation
EnteroToxigenic:
· Traveller's diarrhea

Obligate anaerobes: members worth knowing ABC:
Actinomyces
Bacteroides
Clostridium

Urease positive organisms PUNCH:
Proteus (leads to alkaline urine)
Ureaplasma (renal calculi)
Nocardia
Cryptoccocus (the fungus)
Helicobacter pylori

Vaccines: types STARK:
Subunit
Toxoid
Attenuated [live]
Recombinant
Killed [inactivated]

AIDS pathogens (T-cell suppression) worth knowing "The Major Pathogens Concerning Complete T-Cell Collapse":
Toxoplasma gondii
M. avium intracellulare
Pneumocystis carinii
Candida albicans
Cryptococcus neoformans
Tuberculosis
CMV
Cryptosporidium parvum

Tetanus: treatment for infection SAD RAT:
Sedation
Antitoxin
Debridement
Relaxant
Antibiotic
Tracheostomy

Placenta-crossing organisms/ antenatal Infections STARCH:
Syphilis
Toxoplasmosis
AIDS (HIV)
Rubella
CMV
Herpes/ Hepatitis

Typhus: Epidemic Typhus: etiologic agent, vector ePidemic typhus:
Etiological agent: Rickettsia Prowazekii.
Vector: Pediculus corporis (human body louse).
· This is in contrast to Endemic typhus.

Capsulated bacteria "Some Bacteria Have An Effective Paste Surrounding Membrane Yielding Pseudo Fort, Bypassing Killing":
Strep pneumonia
Bacteroides
H. influenza
Anthrax (B. anthracis)
E. coli
Pasteurella
Salmonella
Menigitidis (N. Menigitidis)
Yersinia pestis
Pseudomonas
Francisella
Brucella
Klebsiella

Hepatitis: transmission routes "Vowels are bowels":
Hepatitis A and E transmitted by fecal-oral route.

Capsulated microbes "Some Nasty Killers Have Some Capsule Protection":
Streptococcus pneumoniae
Neisseria meningitidis
Klebsiella pnemoniae
Haemophilus influenzae
Salmonella typhi
Cryptococcus neoformans
Pseudomanas aerigenosa

Pneumonia: causes: gram negative vs. gram positive Gram Negatives (eg coliforms) are responsible mainly for Nosocomial pneumonia.
Gram positives (eg strep pneumonia, staph) are thus more responsible for community acquired pneumonia.

Meningitis: most common organisms NHS:
Neisseria meningitidis
Hemophilus Influenzae
Streptococcus pneumonia
·The cause of the most Severe meningitis is Streptococcus.
· Note: NHS is an acronym for National Health Service in several countries

Syphilis vs. H. ducreyi (chancroid): which ulcer is painful "In du-crey-i, you do cry
In H. ducreyi, the ulcer is painful, in syphilis the ulcer is painless.

Diphtheria toxin properties ABCDEF:
A/B-type toxin. Made by
Corynebacterium diphtheriae, which binds to
EF-2 (elongation factor 2).

RNA viruses: negative stranded "Always Bring Polymerase Or Fail Replication":
Arena
Bunya
Paramyxo
Orthomyxo
Filo
Rhabdo
· Note: Negative RNA viruses need there own polymerase.

Picorna viridae: members PEECoRnA (Picorna is pronounced 'pee-corna')
Poliovirus
Echovirus
Enterovirus
Coronavirus
"R'novirus" (Rhinovirus)
Hepatitis A

Streptococcus pneumoniae: diseases caused COMPS:
Conjunctivitis
Otitis media
Meningitis
Pneumonia
Sinusitis

Catalase positive organims SPACE:
Staphylococcus aureus
Pseudomonas
Aspergillus
Candida
Enterobacter
Staph (because it is painful)":

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