1 Flashcards
1
Q
Zika is transmitted through
A
Sex
2
Q
Zika during pregnancy causes
A
Defect of brain called microcephaly
3
Q
Zika causes
A
Miscarriage Still birth Defects Guillian barre syndrome (rare nervous system sickness) Microcephaly
4
Q
Pathogenesis of dengue hemorrhagic shock syndrome is distinguished from that of uncomplicated dengue
A
Immune enhancement of infection
5
Q
Exfoliative toxins a & b cause
A
Ritter disease
6
Q
Suprantigen (stimulates proliferation of T cells and release of cytokines )
Release inf mediators in mast cells
Increasing intestinal peristalsis and fluid loss (nausea and vomiting)
A
Enteritoxins
7
Q
Produces leakage or cellular destruction of endothelial cells
Suprantigen
A
Toxic shock syndrome toxin 1
8
Q
Toxic for blood cells (erythro, fibro, platelets, macrophages, leukocytes)
A
Cytotoxins
9
Q
Serine protease that split the intercellular bridges in the sternum granulosum epidermis
A
Exfoliative toxins (ETA, ETB)
10
Q
Staphylococcus scalded skin syndrome
A
Ritter disease
11
Q
…characterized by inset of local perioral erythema (redness and inf around the MOUTH) then spreads within 2 days
A
Ritter disease (staphylococcal scalded skin)
12
Q
Large bullae or cutaneous blisters form in ritter disease, followed by
A
Desquamation of epithelium
13
Q
If slight pressure displases the skin in ritter disease this is called (picture)
A
Positive nikolskys sign
14
Q
- A 20 year old patient comes to the homeless clinic with a skin abscess on the right arm. A swab from the intact skin overlying this abscess grows coagulase negative staphylococci. An aspirate obtained sterilely with a needle and syringe grows Staphylococcus aureus. About these 2 organisms in this patient you can say:
A
The staph aureus is a a pathogen and the coagulase negative staph isn’t
15
Q
requiring of vasopressors to maintain a mean arterial pressure and lactate level is a sign of
A
Septic shock
16
Q
Risk factors for sepsis
A
ICU Bacteremia Over 65 yrs old Immunosuppression Diabetes and obesity Cancer Genetic Community acquired pneumonia
17
Q
most prevalent virus that cause viral myocarditis
A
enterovirus— cocksackie A, B (mainly B)
18
Q
high level lactate means patient goes into s
A
septic shock
19
Q
initial differential test is
A
catalase test
20
Q
streptococci is catalase
A
Negative
21
Q
Blood cultures from a man with infect
A
22
Q
An 8-year-old boy develops a severe sore throat. On examination, a grayish-white exudate is seen on the tonsils and pharynx. The cause of the boy’s pharyngitis is most likely
A
Catalase negative gram positive coccus that grows in chains
23
Q
Which following statements
Regarding s bovis group is correct
A
Possess lancefeild group D antigen
24
Q
4 yrs old boy, honey clustered region behind ear, simple test to determine genus of bacteria responsible
A
Catalase test
25
Enterococci are distinguished from nonentercoccal group D stertococci on the basis of which characteristic
Growth in 6.5% NaCl
26
60 yr old woman hospitalized following a stroke and develops a high grade fever with chills, she is catherized to to incontinence, blood cultures and gram stain are preformed by the lab. Organisms isolated are gram postitive cocci that are catalase negative and capable of growing in 6.5 sodium chloride.which is most likely casual agent
Enterococcus faecalis
27
A 12year-old girl woke up saying it hurt to swallowHer mother took her to physician who said it looked like a viral pharyngitis and performed a rapid strep antigen test which was negative. Three weeks later she became listless and irritablePhysical examination revealed a febrile girl with arthritis two joints and a heart murmurHer antistreptolysin titer was elevated. Her cardiac findings are most likely due to antibody directed against:
Sarcolemmal membrane
28
An 8-year-old girl develops Sydenham's chorea (St. Vitus dance) with rapid uncoordinated facial tics and involuntary purposeless movements of her extremities , strongly suggestive of acute rheumatic fever. She has no other major manifestations of rheumatic fever carditis, arthritis, subcutaneous nodules, skin rash). The patient's throat culture is negative for pyogenes (group A streptococci)However, she, her brother, positive would indicate recent pyogenes infections is
ASO antibody titer
29
All of the following statements regarding the hyaluronic acid capsule of S. pyogenes are correct except
A vaccine against the capsule is currently available
30
An 8-year-old boy has been listless and irritable for a week. The mother says he had a sore throat 3 weeks ago but did not see a physician Examination reveals arthritis in two joints and a heart murmur. His antistreptolysin (ASO) titer is elevated. His cardiac findings are most likely due to antibody stimulated by:
M protein
31
A 10-year-old child develops glomerulonephritis a week after he was treated for a sore throat. The causal agent is identified by serotyping of the
M proteins
32
A -year-old girl has a sore throat. She is febrile and has a scant exudate on one tonsillar pillar. The most sensitive way to detect whether this infection is due to group A streptococci is:
Throat culture
33
A 19 yr old female asks if she can discontinue penicillin prophylaxis at age 12she was diagnosed with with acute rheumatic fever
She should continue on penicillin indefinitely as she had a precious recurrance
34
Which is the most common clinical presentation of acute rheumatic fever
Poly arthritis
35
A 30-year-old hospitalized patient with an intravenous (IV) catheter developed fever and systemic infection. The source of the infection was bacteria that contaminated the catheter during its insertion. The IV catheter had to be removed because the bacteria grew within the catheter forming a biofilm. Biofilm development depends on the ability of the bacteria to produce which of the following?
Polysaccharides
36
Which kinds of primary bacteremia attributed to the central line require that the line be pulled immediately and antibiotic therapy be initiated ?
Tunnel infection and septic phlebitis (B&D)
37
A SS-year-old man presented with fever and feeling generally unwell. His wife reported he had complained of shortness of breath and coughing up brown sputum the day before. He had no past medical history and was not taking any regular medication. He worked as an engineer. On examination, he had a gSOFA score of 2 respiratory rate >22/min and BP What does SOFA stand for?
Sepsis related organ failure assessments
38
Which of the following is correct concerning the pathogenesis of catheter related bloodstream infection ?
Thrombus around catheter facilitates bacterial growth
39
A cancer chemotherapy patient has to have her intravenous port revised after it becomes blocked and the catheter is found to contain bacterial contaminants. Which of the following attributes is most likely to be a factor in this pathogenesis?
Biofilm production
40
What type of bacteria is most common cause of cathedrals related bloodstream infection?
Staphylococci
41
Tye followin features are severe sepsis except
Hypertension
42
Presence of 2/3 qSOFA criteria predicts?
Increased risk of death
43
An elderly man with an enlarged prostate has frequent and painful urinationSuddenly he develops fever and chillsExamination reveals hypotension (blood pressure 55/10 mm Hg) and a blood culture is positive for Klebsiella pneumoniae. The fever, chills, and hypotension likely derive from the bacterial:
Polysaccharide capsule
44
Which of the following lesions is associated with infective endocarditis (painful, red, raised lesions on hand and feet)
Osler lesion
45
A 55-year-old woman had her rheumatic heart valve replaced with a prosthetic valveSix blood cultures became positive after 3 days of incubation. An optochin-resistant, catalase-negative gram-positive coccus that was alpha-hemolytic was isolated. What was the most likely causal agent? Streptococcus viridans A 55-year-old woman had her rheumatic heart valve replaced with a prosthetic valveSix blood cultures became positive after 3 days of incubation. An optochin-resistant, catalase-negative gram-positive coccus that was alpha-hemolytic was isolated. What was the most likely causal agent? Streptococcus viridans
Streptococcus viridans
46
Which of the following demographics has the highest prevalence of infective endocarditis at the present time?
Newborn babies
47
Which of the following causes of infective endocarditis is not a member of the HACEK group ?
Chlamydia
48
A 68-year-old woman on chemotherapy for leukemia has developed sepsis due to an infection with Escherichia coli. The following day the patient develops septic shock and dies. The structure on the bacterium most likely responsible for causing septic shock in this patient is
Lipopolysaccaride
49
All of the following statements regarding the HACEK organisms are true EXCEPT:
A. HACEK-associated endocarditis tends to occur in younger patients than non-HACEK endocarditis
B. HACEK organisms require an oxygen- enriched environment for growth
C. Most cultures that ultimately yield a HACEK organism become positive within the first week
D.The most common clinical manifestation of the HACEK organisms is endocarditis
E. They are fastidious slow- growing organism
The most common clinical manifestation of the HACEK organisms is endocarditis
50
A 68-year-old man is found to have infective endocarditis 2 weeks after heart valve replacement surgeryWhat is the most likely etiology?
Staphylococcus species
51
Risk factors for isolated right side native valve infective endocarditis
Intravenous drug use
52
Best definition of janeway lesions
Small hemorrhagic lesions on the palms or soles caused by septic emboli from endocarditis
53
Which is more likely to cause infective endocarditis with negative blood cultures
Coxiella burnetii
54
Which of the following signs is least likely to be associated with infective endocarditis
Decreased deep tendon reflexes
55
Which of the following is present in all cases of infective endocarditis regardless of etiology
Cardiac endothelial damage
56
What is non bacterial thrombotic endocarditis mainly composed of
Fibrin and platelet matrices
57
Which of the following organisms is not a common cause of early or late prosthetic valve endocarditis
Neisseria gonirrhoae
58
Blood cultures from a man with infective endocarditis grow streptococcus bovis, a workup for which of the following conditions is indicated
Colon cancer
