Micro Cheat Sheet #3

(PASS Videos)

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

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

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

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 PMNs but lymphocytes instead) MCC of death was suffocation Vaccination - DtaP Diagnosis: ELIZA on nasopharyngeal washings TX: erythromycin; also treat close contacts (>25hrs) with erythromycin

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

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

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

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

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

Vibrio o V. cholera Curved rod 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 (mimics appendicitis in symptoms Causes Reiters syndrome- any post infection arthritis o HLA-B27 diseases Reiters syndrome-any post infection arthritis Ankylosing spondilytis-shoeberg test, bamboo spine Psoriasis-silver plaque on extensor surfaces Tx: methaltrexate, and UV light (sunlight) cells dont rapidly divide Psoriasis w/o arthritis- HLA B13 Atypicals

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 (*ahooahoo* hard time breathing) Found to be connected to Alzheimers 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 sprayersmists) o Causes high rise building syndrome or hotel/motel syndrome o Pontiac Fever: fever and nonspecific symptoms o Legionnaires 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

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 Chagas 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

FUNGI 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 cellsreleasing 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

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 5 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