> For the complete documentation index, see [llms.txt](https://thisispiggy.gitbook.io/my-wiki/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://thisispiggy.gitbook.io/my-wiki/01-step-1/microbes/02-gm-positive-bacilli.md).

# 02 Gm Positive Bacilli

## Bacillus anthracis and cereus

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/Anthrax%20and%20cereus%20morphology,%20capsule?%20Aerobe/anaerobe/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/GZUB4xB.jpg)

* Air bellow : obligate aerobe
* Large ships in chain: Large gram positive rods in chains
* Leather armor with buckles:  Protein capsule composed of poly-D-glutamic acid

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/Anthrax%20demographics/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/GZUB4xB.jpg)

* Walnuts, like seeds: Spore forming
* Sheep: "Wool sorters disease"- classically causes pulmonary infection in those who work with wool. Spores stay in wools for long time

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/Anthrax%20symptoms/README.md)

* Black ground and flame: Most common manifestation of infection is cutaneous black eschar
* Large axe with blood: Pulmonary infection may lead to pulmonary hemorrhage
* Ship with wide mast: Widened mediastinum on chest x-ray if pulmonary infection.,

![](https://f001.backblazeb2.com/file/wikiFiles/GZUB4xB.jpg)

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/Anthrax,%20toxins%20and%20MOA/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/GZUB4xB.jpg)

* Shield with EF: Edema factor
* viking tent: Edema factor acts by causing elevation in cAMP
* LF shield: Lethal factor
* Burning map: Map kinase, burned and turned into eschar. Lethal factor responsible for tissue necrosis

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/Anthrax%20treatment/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/GZUB4xB.jpg)

* Pink flower: Flouroquinolone treatment
* Bicycle: Tetracycline treatment

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/B.%20cereus%20cause,%20symptoms)

* Viking reheating rice and vomiting: B.cereus classically causes vomiting after eating reheated rice.,

![](https://f001.backblazeb2.com/file/wikiFiles/GZUB4xB.jpg)

## Clostridium Tetani

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/Clostridium%20tetani%20morphology/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/cKwxCb9.jpg)

* purple color: gram positive
* Walnuts: Spore forming
* Gas mask: Obligate anaerobe

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/Clostridium%20tetani%20found%20in,%20transmission/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/cKwxCb9.jpg)

* Pots of earth on ground: Spores found in soil
* Nails: Endospores transmitted via puncture wound from rusty nail (construction zone)
* Barbed wire: Endospores transmitted via puncture wound from barbed wire (construction zone)

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/Clostridium%20tetani%20symptoms/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/cKwxCb9.jpg)

* Evil monkey smiling: Lock jaw symptoms and facial spasms (risus sardonicus (evil grin))
* Monkey extend back: Opisthotonus, muscle spasms cause arched back

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/Clostridium%20tetani%20vaccine/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/cKwxCb9.jpg)

* Orange syringe: Vaccine consists of deactivated toxin (same color orange), not the bacteria

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/Clostridium%20tetani%20pathogenesis/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/cKwxCb9.jpg)

* Scissors on pulley: Tetanus **toxin** (not the organism) migrates to CNS via retrograde axonal transport
* Snare trap: Tetanus toxin cleaves SNARE
* G and G labs: Tetanus toxin cleaves SNARE preventing release of inhibitory neurotransmitters GABA and Glycine, inhibit inhibitors = uncontrolled firing
* Wrench and saw: Tetanus toxin inhibits inhibitory neurotransmitter release from Renshaw cells in spinal cord

## Clostridium Botulinum

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/Clostridium%20botulinum%20morphology%20and%20features/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/m4RMRk0.jpg)

* violet color: gm +
* mechanical nuts: Spore forming
* gas mask: Obligate anaerobe

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/Clostridium%20botulinum%20transmission,%20classic%20case/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/m4RMRk0.jpg)

* Canned robot shape: Transmitted by improperly canned, insufficient heating of home canned food, allow spore survival and heat production (family developing neuro symptoms)

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/Clostridium%20botulinum%20symptoms/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/m4RMRk0.jpg)

* Robots heads and torso going limp: Descending flaccid paralysis (Guillian Barre ascending) (multiple people with symptoms = botulism)
* Only affects PNS, not CNS because can't cross BBB
* Droopy robot eyelids: Ptosis

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/Clostridium%20botulinum%20infantile%20transmission,%20symptoms,%20pathogenesis/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/m4RMRk0.jpg)

* Oil: Infantile bolulism transmitted via honey ingestion
* Baby robot flaccid: "Floppy baby"
* Adults ingest spores directly ok because anaerobes outcompete in GI. Babies have low GI anaerobe flora

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/Clostridium%20botulinum%20pathogenesis/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/m4RMRk0.jpg)

* Ach power supply: Botulism toxin prevents acetylcholine release (excitatory) at neuromuscular junction
* Scissor cutting: protease cutting SNARE

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/Clostridium%20botulinum%20adult%20vs%20children%20transmission/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/m4RMRk0.jpg)

* Adults symptoms by ingest toxins; baby symptoms by ingest spores  

## Clostridium Difficile

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/Clostridium%20difficile%20morphology/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/ASmwD4M.jpg)

* Gas mask: Obligate anaerobe
* Walnuts: Spore forming

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/C.%20difficile%20A%20toxin%20pathogenesis,%20symptoms,%20found%20in)..

![](https://f001.backblazeb2.com/file/wikiFiles/ASmwD4M.jpg)

* Apples: Exotoxin A
* Brushing apple: Exotoxin A attaches to brush border
* Chocolate syrup: Watery diarrhea
* Shoe from chocolate syrup: Toxin detected in stool 

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/C.%20difficile%20cause)..

![](https://f001.backblazeb2.com/file/wikiFiles/ASmwD4M.jpg)

* Clean hand sign: Clindamycin: C. Diff infection after antibiotic use 

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/C.%20difficile%20B%20toxin%20pathogenesis%20and%20symptoms)..

![](https://f001.backblazeb2.com/file/wikiFiles/ASmwD4M.jpg)

* B sign: Exotoxin B
* Kid picking apart actins: Exotoxin B disrupts cytoskeleton by depolymerizing actin. Inactivates Rho regulatory protein. Loss of intracellular tight junction = cell rounding
* Membrane on right: Pseudomembranous colitis

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/C.%20difficile%20treatment)..

![](https://f001.backblazeb2.com/file/wikiFiles/ASmwD4M.jpg)

* Tongue looking van: Oral vancomycin for treatment
* metro train: IV metronidazole for treatment

## Clostridium Perfringes

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/clostridium%20perfringes%20morphology,%20hemolysis/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/z4MLsJz.jpg)

* Gas mask: Obligate anaerobe
* double fine zone: Double zone of hemolysis when plated in anaerobe environment 

![](https://f001.backblazeb2.com/file/wikiFiles/rG6LKZz.jpg)

Anaerobic culture of Clostridium perfringens on blood agar. The characteristic double zone of clear beta-hemolysis around a colony is clearly seen (arrow).

![](https://f001.backblazeb2.com/file/wikiFiles/MOPXQ8c.jpg)

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/clostridium%20perfringes%20transmission/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/z4MLsJz.jpg)

* Walnut and pots : Spores found in soil
* Private fell of motorcycle: Infection associated with motorcycle accidents and other major trauma
* Private: Infection associated with deep penetrating **military** wounds

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/clostridium%20perfringes%20symptoms%20and%20pathogenesis/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/z4MLsJz.jpg)

* Slow sign in puddle: May cause slow onset diarrhea; spores have to germinate first before cause diarrhea, not preformed
* Gas from motor cycle: Causes "gas gangrene", causes crepitus when palpate. Metabolizes carbohydrates, producing the gas.

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/clostridium%20perfringes%20pathogenesis/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/z4MLsJz.jpg)

* alpha flag on bob pins: Alpha-toxin, lecithinase (phospholipase), disrupts cell membrane function
* tomatoes on ground smashed: Alpha-toxin also has hemolytic activity

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/clostridium%20perfringes%20treatment/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/z4MLsJz.jpg)

* Pencil: Penicillin treatment

  ​

## Cornyebacteria diptheria

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/diptheria%20morphology,%20shape,%20color/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/kOV6msd.jpg)

* purple hue: gram positive
* Guy playing with toys, zig zag lines: Metachromatic granules (red and blue). Club shaped rods in V or Y formation

![](https://f001.backblazeb2.com/file/wikiFiles/8KIjKMb.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/0HK4HOD.jpg)

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/diptheria%20pathogneesis/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/kOV6msd.jpg)

* Guy with **bow** tie playing **elongating** piano: ADP ribosylation of elongation factor 2, inhibits protein synthesis, cell death, pseudomembrane

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/diptheria%20symptoms/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/kOV6msd.jpg)

* Candy with plastic wrap: Pseudomembrane on throat and tonsils
* Bull: Bull neck
* Heart shaped cape block bull: Cardiotoxic effects: myocarditis, arrhythimia, heart block
* Guy eating sausages shaped like nerves: Demyelination causes nerve deficits starting in posterior oropharynx
* Fibrinous exudate → systemic circulation → cortical neurons:  This is the route that diphtheria toxin takes from the pseudomembranous exudate it forms in the pharynx to the bloodstream and subsequently to cardiac and cerebral cortical tissues.

![](https://f001.backblazeb2.com/file/wikiFiles/V7pvrgg.jpg)

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/diptheria%20transmission/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/kOV6msd.jpg)

* Droplets from bull's mouth: Transmitted by respiratory droplets

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/diptheria%20diagnosis%20agar%20and%20test/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/kOV6msd.jpg)

* Tele screen: Plated on Tellurite agar
* Kid watching and laughing: "Plated on Loeffler's medium"
* Bull licking: Elek's test, differentiate toxin variant

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/diptheria%20vaccine/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/kOV6msd.jpg)

* Syringes: Inactivated pertussis toxoid vaccine, IgG

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/diptheria%20treatment/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/kOV6msd.jpg)

* Treatment: administer IVIG

## Listeria monocytonegenes

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/listeria%20morphology,%20motility%20at%20different%20temp,%20hemolysis/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/dhYyrBq.jpg)

* Cat: Catalase positive
* Falling tree: Tumbling motility
* Beta bulb: Beta hemolytic
* Actin rocket half in and out: Facultative anaerobic bacterium
* Ice on window: Motile with flagella at 30 degrees and below
* Actin rocket: At body temperature, motile by actin polymerization, or "actin rockets"

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/listeria%20transmission%20and%20population%20at%20risk/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/dhYyrBq.jpg)

* Pregnant woman: May be acquired transvaginally- pregnant women may be advised not to eat soft cheese
* Milk: Transmitted from dairy products
* Cheese: Transmitted by consumption of certain of cheeses
* Santa: Infection also prevalent in elderly population
* Baby with helmet: Common cause of neonatal meningitis

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/listeria%20treatment/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/dhYyrBq.jpg)

* Amplifier: Treatment with ampicillin

## Actinomyces israeli

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/actinomyces%20morphology,%20color/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/XkRm0rN.jpg)

* gas mask: Obligate anaerobe, nocardia is aerobe
* Tree branching, violet wrap: Gram positive filamentous rod
* Yellow rocks: Yellow sulfur granules

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/actinomyces%20cause%20and%20symptoms/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/XkRm0rN.jpg)

* Canal draining: Formation of sinus tracts. Draining sinus tract
* Jaw wrap:  Infection associated with jaw trauma

![](https://f001.backblazeb2.com/file/wikiFiles/hSmHiGm.jpg)

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/actinomyces%20treatment/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/XkRm0rN.jpg)

* Pencil: Treat with penicillin

## Nocardia

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/Nocardia%20morphology,%20features/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/ftAzlC1.jpg)

* NH3 spray bottle: Urease positive
* Branching tree: Gram-positive branching filamentous rod. - Similar to actinomyces
* air bellow: Obligate aerobe
* Cow boy cloth with tails:  Mycolic acids with two tails 
* cat: Catalase positive, pts with CGD at increased risk
* Fast drawing of gun: Partially acid fast, carbo fuscia stain

![](https://f001.backblazeb2.com/file/wikiFiles/yAVAquI.jpg)

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/nocardia%20found%20in.%20Spores?)..

![](https://f001.backblazeb2.com/file/wikiFiles/ftAzlC1.jpg)

* Cactus pot broken: Found in soil

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/nocardia%20demographics/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/ftAzlC1.jpg)

* Cane: Immunocompromised especially affected

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/nocardia%20symptoms/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/ftAzlC1.jpg)

* Coughing: Pneumonia like symptoms
* Bullet hitting chest: Associated with cavitary lesions in lung
* Bullet leaving hole in hat: Brain abscess formation
* Cow print with red around: Cutaneous symptoms- indurated lesions and inflammatory reaction

![](https://f001.backblazeb2.com/file/wikiFiles/swrbI4k.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/aYN8EQd.jpg)

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Microbes/nocardia%20treatment/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/ftAzlC1.jpg)

* Rotten eggs: Treat with sulfonamides