front 1 what is the first branch of streptococci differentiation based on | back 1 shape (cocci vs. bacilli) |
front 2 after shape what is the main differentation of cocci | back 2 ability to grow in air |
front 3 after distinguishing which cocci grow in air, what is the differentiation based on between strep and staph | back 3 catalase
|
front 4 after distinguishing staph from strep what is the next step | back 4 bile soluble or optochin sensitive |
front 5 is s. pneumo bile solube or optochin sensitive | back 5 yes |
front 6 what coccus group grows on bile-esculin agar | back 6 group D strep/enterococcus |
front 7 how do you distinguish group D strep | back 7 growth in 6.5% NaCl |
front 8 what bacteria grows in 6.5% NaCl | back 8 enterococcus |
front 9 what bacteria doesn't grow in 6.5% NaCl | back 9 group D strep |
front 10 with respect to lack of growth on bile-esculin agar what is the next differentiative characteristic of streptococcus | back 10 hemolysis pattern on blood agar |
front 11 what hemolysis pattern indicates incomplete or partial lysis of RBCs | back 11 alpha/gamma |
front 12 what hemolysis pattern indicates complete lysis of RBCs | back 12 beta |
front 13 what is the beta hemolytic, bacitracin sensitive strep | back 13 group A |
front 14 what is the alpha/gamma hemolytic strep that does not grow on bile-esculin agar | back 14 viridans strep |
front 15 what is the bacitracin insensitive strep that is hippurate hydrolyzed or CAMP | back 15 group B |
front 16 what is the alpha hemolysis pattern | back 16 green zone around colonies growin on blood agar plate due to incomplete lysis of red blood cells |
front 17 what is the beta hemolysis pattern | back 17 clear zone around the colonies due to complete lysis of RBCs |
front 18 what is the gamma hemolysis pattern | back 18 no lysis and therefore no change in agar appearance |
front 19 what are the indications for different Lancefield groupings | back 19 carbohydrate on cell walls |
front 20 what are the main clinical indications of s. pneumo | back 20 respiratory tract infections
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front 21 what are the two respiratory tract infections from s. pneumo | back 21 pneumonia
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front 22 what is the most common cause of pneumonia in adults | back 22 s. pneumo |
front 23 when does incidence increase in s. pneumo pnemo | back 23 over 40 |
front 24 what is the s. pnemo pneumonia case fatality rate | back 24 5% but higher in elderly |
front 25 how can there be estra pulmonary sites of infection from s. pneumo pneumonia | back 25 bacteremia |
front 26 how do the abrupt symptoms usually start in s. pneumo pnsumo | back 26 severe shaking chills |
front 27 what are the symptoms of s. pneumo pneumo | back 27 high fever in most
|
front 28 what is an uncommon complication with effective antibiotic treatment | back 28 empyema |
front 29 how many children will have otitis media at least once by age 6 | back 29 75-95% |
front 30 how many cases of penumococci account for otitis media | back 30 50% |
front 31 what could meningitis result from in s. pneumo pneumo | back 31 bacteremia
|
front 32 how many people will have s. pneumo colonize the upper respiratory tract | back 32 5-50% of population |
front 33 how is s. pneumo transmitted | back 33 respiratory droplets (coughing) |
front 34 what are the virulence factors of s. pneumo | back 34 polysaccharide capsule
|
front 35 how many antigenic types have been detected of s. pneumo | back 35 85 |
front 36 what is the role of the polysaccharide capsule | back 36 retards phagocytosis |
front 37 what types of infection predispose for s. pneumo lung infection | back 37 viral respiratory infections |
front 38 how do viral respiratory infections help s. pneumo to invade the lungs | back 38 mucociliary clearnace |
front 39 what type of thing favors the development of bacteremia and sepsis from s. pneumo | back 39 splenectomy or functional splenectomy |
front 40 what does s. pneumo look like in the lab | back 40 gram stain smear and culture shows lancet shaped cocci in pairs (diplococci) |
front 41 what is the hemolysis pattern of s. pnemo | back 41 alpha hemolytic |
front 42 what inhibits s. pnemo | back 42 optochin |
front 43 what is the treatment for s pneumo | back 43 penicillin, 3rd gen cephalosporin and second antibiotic (vancomycin) in case of resistance for menintgitis |
front 44 what is the mechanism for resistance to penicillin for s. pneumo | back 44 mutation of transpeptidase enzymes (PBP: penicillin binding proteins) |
front 45 what are preventive measures of s. pneumo | back 45 23 valent vaccine against capsular polysaccharide for anyone with increased risk of s. pneumo infection and all adults over 65
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front 46 what are the clinical infections involved with s. pyogenes (group A) | back 46 pharyngitis
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front 47 what is pharyngitis called | back 47 strep throat |
front 48 what are the immediate complications of pharyngitis due to s. pyogenes | back 48 peritonsillar abscess, otitis media, mastoiditis |
front 49 what are the s. pyogenes sicknesses that are infections plus prominent manifestations of toxins | back 49 scarlet fever
|
front 50 what are the nonsuppurative diseases of s. pyogenes | back 50 acute glomerulonephritis
|
front 51 what happens in acute glomerulonephritis | back 51 immune complexes bound to glomeruli (type III hypersens) |
front 52 who does rheumatic fever usually afflict after sore throat | back 52 6-15 aged children |
front 53 what is ARF | back 53 immunologic reaction against host tissue (heart and joint tissue primiarliy) induced by cross-reacting antigens on the streptococci and human tissue |
front 54 how long after pharyngitis does ARF affect children | back 54 1-5 weeks |
front 55 what usually prevents ARF | back 55 early antibiotic treatment |
front 56 what are the "major" criteria for ARF | back 56 carditis
|
front 57 what are the "minor" criteria for ARF | back 57 previous rheumatic fever or HD
|
front 58 how much of population is genetically predisposed to ARF | back 58 10% |
front 59 where does s. pyogenes live | back 59 on throat and skin |
front 60 how is s. pyogenes transmitted | back 60 droplets and direct contact |
front 61 what are the virulence factors of s. pyogenes | back 61 LTA
|
front 62 what is LTA | back 62 polymmer of 25 glycerolphosphate subunits boudn to palmitate (lipid) |
front 63 what does LTA do | back 63 sticks to fibronectin (a host protein that coats epithelial cells of oropharynx) and allows organism to adhere to epithelial surfaces |
front 64 what does streptokinase do | back 64 dissolves clost by activating plasminogen (forms plasmin) which breaks down fibrin in clots |
front 65 what is streptokinase used to do | back 65 dissolve unwanted clots like in heart attack patients |
front 66 what is the role of M protein | back 66 binds fibrinogen, fibrin, and their degradation products to form a dense coating on the organism's surface
|
front 67 how many different M protein serotypes are there | back 67 80 |
front 68 what are two important M protein type categories | back 68 rheumatogenic and nephritogenic |
front 69 what does hyaluronidase do | back 69 hydrolyzes the ground substance of CT to aid spread |
front 70 what does C5a peptidase do | back 70 leaves C5a and destroys its chemotactic signal |
front 71 what are streptolysins S and O | back 71 S- oxygen stabile
|
front 72 is streptolysin S antigenic | back 72 no |
front 73 what is the ASO titer | back 73 antibody vs. streptolysin O, important in diagnosing streptococcal infection |
front 74 what can streptolysins be important for | back 74 lysing cells, tissue necrosis |
front 75 what are the types of SPE | back 75 a, b, c |
front 76 what produces the red rash of scarlet fever | back 76 SPE (erythrogenic toxin) |
front 77 what is SPE A associated with | back 77 shock-inducing strep infections (TSS) by stimulation of TNF and IL-1 release |
front 78 what is SPE A's TSS similar to | back 78 staphylococcal TSS |
front 79 what does streptococcal DNase do | back 79 depolymerizes DNA in necrotic tissues |
front 80 is streptococcal DNase antigenic | back 80 yes |
front 81 what does exotoxin B do | back 81 protease that rapidly destroys tissue |
front 82 what produces exotoxin B | back 82 strains of s. pyogenes that cause necrotizing fasciitis |
front 83 what is inolved in the lab diagnosis for s. pyogenes | back 83 gram stained
|
front 84 what is the treatment for pyogenes | back 84 penicillin |
front 85 is there a vaccine for pyogenes | back 85 nope |
front 86 what ar ethe clinical symptoms of s. agalactiae | back 86 endometritis and postpartum sepsis in mother
|
front 87 how is s. agalactiae (grou B strep) transmitted | back 87 flora of vagina, transmission to newborn at time of birth |
front 88 what are the virulence factors of s. sgalactiae | back 88 none ided |
front 89 what are the lab findings and diagnosis | back 89 beta hemolysis on blood agar
|
front 90 what is the treatment of s. agalactiae | back 90 penicillin, no vaccine available |
front 91 what is the prevention of s. agalactiae | back 91 culture pregnant women and treat mother and newborn if culture positive |
front 92 what are the two groups of group D strep | back 92 nonenterococci (s. bovus) and enterococcus |
front 93 what is S. bovus normal flora of | back 93 GI and GU tracts |
front 94 what is nonenterococcus a rare cause of | back 94 endocarditis and UTI |
front 95 what is s. bovus associated with | back 95 colon cancer |
front 96 what are members of the enterococcus family | back 96 s. faecalis
|
front 97 what types of infections are associated with enterococcus | back 97 UTI
|
front 98 why are enterococcus infections difficult to treat | back 98 antibiotic resistance |
front 99 how are enterococcal infections often acquired | back 99 nosocomially with weakened host defenses and chronic illness |
front 100 how is enterococcus transmitted | back 100 normal flora of the colon
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front 101 how can antibiotic resistant enterococcus transmitted | back 101 contact and environmental suraces in hospitals, most from endogenous flora |
front 102 what are the toxins and VFs of eneterococcus | back 102 none
|
front 103 what is involved in the lab diagnosis involved in enterococcus | back 103 grows in 6.5% NaCl and hydrolyzes esculin in presence of 40% bile |
front 104 how is enterococcus treated | back 104 penicillin+aminoglycoside
|
front 105 what type of resistanct is very important to enterococcus | back 105 vancomycin |
front 106 what is the resistant move that enterococcus made | back 106 substitute for D-ala-D-ala so it is not in peptidoglycan |
front 107 what is anaerobic streptococci called | back 107 peptostreptococcus |
front 108 where does peptostreptococcus reside normally | back 108 GI and female genital tract |
front 109 what is peptostreptococcus sometimes involved in | back 109 intra-abdominal absecesses |
front 110 what is part of the viridans group | back 110 s. sanguis
|
front 111 what are the clinical manifestations of s. viridans | back 111 endocarditis
|
front 112 how many of bacterial endocarditis are accounted for by s. viridans | back 112 50% |
front 113 what does s. viridans most commonly occur in | back 113 people with abnormal heart valve |
front 114 what are the primary symptoms of endocarditis | back 114 fever and heart murmur |
front 115 what are secondary manifestations of endocarditis | back 115 septic emboli
|
front 116 what are s. viridans normal flora of | back 116 oropharynx |
front 117 how do s. viridans enter the bloodstream | back 117 irritation of oral mucsa, then infect heart valves |
front 118 what are the virulence vactors of s. viridans | back 118 some make dextrans that enhance adherence to heart valves and increase risk factor for endocarditis |
front 119 how is lab diagnosis for s. viridans made | back 119 alpha/gamma hemolytic on blood agar
|
front 120 what is treatment of s. viridans | back 120 penicllin plus aminoglycoside
|