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Step 1 DIT > 7. Micro > Flashcards

7. Micro Flashcards

1
Q

What bacterial structure mediates adherence of bacteria to the surface of a cell?

A

fimbria

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2
Q

What bacterial structure protects against phagocytosis

A

capsule

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3
Q

What bacterial structure provides rigid support to bacterial cell and protects against osmotic pressure

A

peptidoglycan

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4
Q

What bacterial structure is the space b/w the inner and outer cellular membranes in gram negative bacteria?

A

periplasmic space

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5
Q

What bacterial structure allows motility?

A

flagella

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6
Q

What is the bacterial form which provides resistance to dehydration, heat, and chemicals?

A

spore

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7
Q

what forms attachment b/w two bacteria during transfer of DNA material (aka conjucation)

A

pilus

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8
Q

What is the name of independent pieces of genetic material within bacteria that may contain genes for abx resistance?

A

plasmid

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9
Q

What stain is required to see Cryptococcus neoformans?

A

india ink

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10
Q

What stain is required to see PCP?

A

silver stain

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11
Q

What stain is required to see Chlamydia?

A

Giemsa stain

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12
Q

Which organisms are not well visualized with Gram stain? (4)

A
  • treponema
  • legionella
  • mycoplasma (b/c no cell wall)
  • mycobacteria (b/c of high lipid content)
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13
Q

Which bacteria are encapsulated?

A
  • Strep pneumo
  • H. influenzae type B
  • Neisseria meningitidis
  • E. coli
  • Salmonella
  • Klebsiella pneumoniae
  • GBS
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14
Q

By what method are plasmids exchanged b/w bacteria?

A

conjugation (via pilus)

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15
Q

What exotoxin matches each of the following characteristics?

  • inhibits ACh release –> flaccid paralysis
A

botulinum toxin (clostridium botulinum)

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16
Q

What exotoxin matches each of the following characteristics?

  • phospholipase that causes gas gangrene
A

alpha toxin (clostridium perfringens)

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17
Q

What exotoxin matches each of the following characteristics?

  • inhibits the inhibitor of adenylate cyclase –> increased cAMP –> impairing phagocytosis; whooping cough
A

Pertussis toxin (Bordetella pertussis)

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18
Q

What exotoxin matches each of the following characteristics? (2)

  • stimulates adenylate cyclase –> increasing Cl and water secretion into gut –> diarrhea
A 
Heat-labile ETEC toxin  
Cholera toxin (Vibrio cholerae)
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19
Q

What exotoxin matches each of the following characteristics? (2)

  • destroys leukocytes
A
  1. gamma-hemolysin (S. aureus)

2. Panton-Valentine leukocidin (tissue destruction with MRSA)

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20
Q

What exotoxin matches each of the following characteristics?

  • composed of edema factor, lethal factor, and protective antigen
A

Anthrax toxin (Bacillus anthracis)

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21
Q

What exotoxin matches each of the following characteristics?

  • enterotoxin causing rice-water diarrhea
A

Cholera toxin

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22
Q

What exotoxin matches each of the following characteristics?

  • causes Scarlet fever
A

pyogenic/exotoxin A (GAS)

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23
Q

What exotoxin matches each of the following characteristics?

  • causes toxic shock syndrome
A

TSST-1 (S. aureus)

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24
Q

What exotoxin matches each of the following characteristics?

  • inactivates EF-2 –> pseudomembranous pharyngitis
A

Diphtheria toxin (Corynebacterium diphtheriae)

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25
Q

What exotoxin matches each of the following characteristics?

  • blocks release of inhibitory neurotransmitter (GABA and glycine)
A

tetanospasmin (Clostridium tetani)

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26
Q

What 6 bacteria secrete enterotoxins (exotoxins that causes water and electrolyte imbalances of intestinal epithelium resulting in diarrhea)?

A
  1. Vibrio cholerae
  2. ETEC
  3. S. aureus
  4. Shigella
  5. Yersinia
  6. C. diff
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27
Q

What is the function of catalase?

A

Hydrogen peroxide –> water + o2

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28
Q

One hour after eating potato salad at a picnic, an entire family began to vomit. After 10 hrs, they were better. What is the organism?

A

S. aureus

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29
Q

What very common aerobic skin colonizer is responsible for many indwelling foreign device infections?

A

S. epidermidis

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30
Q

What types of disease processes are caused by Strep pyogenes? (3)

A
  1. Pyogenic (pharyngitis, cellulitis, impetigo, erysipelas)
  2. Toxin-mediated (scarlet fever, toxic shock-like syndrome, necrotizing fasciitis)
  3. Immune mediated (rheumatic fever, glomerulonephritis)
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31
Q

Which gram positive organism causes scalded skin syndrome?

A

S. aureus (exfoliative toxin)

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32
Q

Which gram positive organism cause gray-white membrane in the posterior pharynx of an unvaccinated child?

A

Corynebacterium diphtheriae

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33
Q

Which gram positive organism cause pharyngitis resulting in glomerulonephritis

A

GAS

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34
Q

Which gram positive organism is the most common cause of meningitis?

A

Strep. pneumo

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35
Q

Which gram positive organism is the most common cause of osteomyelitis?

A

S. aureus

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36
Q

Which gram positive organism cause serious newborn infections

A

GBS, listeria, E.coli

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37
Q

Which gram positive organism cause infants with poor muscle tone?

A

Clostridium botulinum

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38
Q

Which gram positive organism cause resp distress in a postal worker?

A

Bacillus anthracis

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39
Q

Which gram positive organism cause otitis media in children

A

strep. pneumo

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40
Q

Which gram positive organism cause cellulitis? (2)

A

s. aureus, GAS

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41
Q

Which pts are susceptible to Listeria monocytogenes?

A

old, young, pregnant, immunocompromised

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42
Q

Which bacteria are spore formers? (3)

A

Bacillus, clostridium, coxiella burnetti

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43
Q

A culture reveals gram negative, oxidase positive diplococci. What is the likely organism? (3)

A
  1. Moraxella catarrhalis (COPD)
  2. Neisseria gonorrhoeae (urethral discharge from college student)
  3. N. meningitidis (CSF)
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44
Q

A 50 yo male smoker presents with a new cough and flu-like symptoms. Gram stain of the sputum shows no organisms but silver stain shows rods. What is the diagnosis?

A

legionella pneumophila

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45
Q

What gram-negative organism cause sepsis, DIC, adrenal hemorrhage?

A

N. meningitidis (Waterhouse-Friderichsen syndrome)

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46
Q

What gram-negative organism cause 5 yo with pharyngitis, drooling, and x-ray revealing thumb sign?

A

H. influenzae type B

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47
Q

What gram-negative organism cause burn wound infection?

A

pseudomonas

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48
Q

What gram-negative organism cause life-threatening meningitis + purpura?

A

N. meningitidis

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49
Q

What gram-negative organism cause septic arthritis in young, sexually active patients?

A

N. gonorrhoeae

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50
Q

Which form of E.coli causes HUS?

A

EHEC (0157:H7)

51
Q

What infectious agent cause diarrhea caused by gram-negative, non-motile organism that does NOT ferment lactose?

A

Shigella

52
Q

What infectious agent cause rice-water stools (2)

A

Vibrio cholerae, ETEC

53
Q

What infectious agent cause diarrhea caused by S-shaped organism?

A

Campylobacter

54
Q

What infectious agent cause diarrhea transmitted from household pet?

A

Yersinia (pet feces)

55
Q

What infectious agent cause diarrhea caused by gram-negative motile organism that does not ferment lactose

A

Salmonella

56
Q

Most common cause of traveler’s diarrhea

A

ETEC

57
Q

What infectious agent cause bloody diarrhea after eating undercooked hamburger meat?

A

EHEC (O157:H7)

58
Q

What infectious agent cause diarrhea and RLQ pain mimicking appendicitis?

A

Yersinia

59
Q

What infectious agent cause diarrhea after consuming eggs or handling raw chicken? (2)

A

Salmonella, campylobacter

60
Q

What infectious agent cause osteo in sickle cell patient?

A

Salmonella

61
Q

What organism cause LAD with new kitten?

A

Bartonella

62
Q

What organism is associated with dog bite?

A

Pasturella

63
Q

What organism is associated with ixodes tick?

A

Borrelia burgdorferi

64
Q

What organism is associated with rabbit hunter?

A

Francisella tularensis

65
Q

What organism is associated with pet prairie dog?

A

Yersenia pestis

66
Q

What is the treatment for latent TB?

A

Isoniazid alone for 9 months (+B6)

67
Q

What ist he treatment for active TB?

A

RIPE for first 2 months

Just rifampin+isoniazid for next 4 months

68
Q

What abx is used for ppx of MAC in AIDS patients? When should this begin?

A

Azithromycin

when CD4+

69
Q

What is the distinction b/w Ghon complex and Ghon focus? Are these seen in primary or reactivated TB?

A

Ghon focus: lung lesion from primary TB

Ghon complex: Ghon focus + hilar LAD

70
Q

What is the Rickettsial triad of symptoms?

A
  1. HA
  2. Fever
  3. Rash
71
Q

25 yo with mycoplasma atypical pneumonia exhibits ANEMIA due to cold agglutinins. What type of immunoglobulins is responsible for the anemia?

A

IgM antibodies

note: cold agglutinins are non-specific IgM ab to erythrocytes. can agglutinate (lyse) RBCs in cold environments

72
Q

Which abx should be used to treat mycoplasma pneumoniae?

A

tetracycline or macrolide (azithromycin)

73
Q

Which abx should be used to treat rocky mountain spotted fever

A

doxy

74
Q

Which abx should be used to treat bacterial vaginosis?

A

metronidazole

75
Q

Which penicillin drug would you use given the following infection?
- syphilis

A

penicillin G (IV)

76
Q

Which penicillin drug would you use given the following infection?
- UTI

A

aminopenicillins, like amoxicillin (better gram (-) coverage)

77
Q

Which penicillin drug would you use given the following infection? (3)
- pseudomonas

A
  • ticarcillin
  • carbenicillin
  • piperacillin
78
Q

What extended coverage do ampicillin or amoxicillin have? (7)

A

HEELPSS

  • H. influenzae
  • E coli
  • Enterococci
  • Listeria
  • Proteus mirabilis
  • Salmonella
  • Shigella
79
Q

What are the 2 diff. mechanisms of resistance bacteria use against penicillin agents?

A
  • production of beta-lactamase

- alteration of penicillin-binding protein (ex. MRSA)

80
Q

What are the beta-lactamase inhibitors? (3)

A
  • clavulanic acid
  • sulbactam
  • tazobactam
81
Q

Which generation of cephalosporin would you choose to use for each of the following infections?

  • UTI prevention
A

1st

82
Q

Which generation of cephalosporin would you choose to use for each of the following infections?

  • Serratia UTI
A

2nd (remember, HENS PEcK)

83
Q

Which generation of cephalosporin would you choose to use for each of the following infections?

  • N. meningitidis
A

3rd

84
Q

Which generation of cephalosporin would you choose to use for each of the following infections?

  • Pseudomonas
A

4th (cefepime)

or ceftazidime (3rd)

85
Q

Which generation of cephalosporin would you choose to use for each of the following infections?

  • resistant otitis media
A

cefdinir (oral 3rd gen)

86
Q

What side effect would you be concerned about if a patient is receiving both ceftriaxone and gentamicin?

A

nephrotoxicity

87
Q

Classify the following cephalosporins in their generation: cefepime

A

4th

88
Q

Classify the following cephalosporins in their generation: cephalexin

A

1st

89
Q

Classify the following cephalosporins in their generation: cefuroxime

A

2nd

90
Q

Classify the following cephalosporins in their generation: ceftazidime

A

3rd

91
Q

Classify the following cephalosporins in their generation: ceftaroline

A

5th

92
Q

What is the MoA of cephalosporins?

A

Binds to penicillin-binding protein –> inhibition of synthesis and cross-linking of peptidoglycans

93
Q

What cell wall inhibitor matches each of the following statements?

  • aminoglycoside pretender
A

Aztreonam (monobactam)

94
Q

What cell wall inhibitor matches each of the following statements?

  • broad-spec coverage for appendicitis
A

imipenem + cilastin OR

meropenem

95
Q

How does an organism develop resistance to vancomycin?

A

amino acid modification; D-ala D-ala –> D-ala D-lac

96
Q

A patient is receiving an IV infusion of an abx and the nurse calls you when his face becomes flushed 15 min after the infusion started. What is the treatment for this patient?

A
  • stop vanco
  • antihistamines
  • restart @ slower infusion
97
Q

What are the side effects of aminoglycosides?

A

NOT

  • nephrotoxicity
  • ototoxicity
  • teratogenic
98
Q

What drugs have photosensitivity reactions?

A

SAT for photo

  • Sulfonamides
  • amiodarone
  • tetracyclines
99
Q

What causes gray baby syndrome? Gray man syndrome? Red man syndrome?

A

a. Chloramphenicol
b. amiodarone
c. vanco

100
Q

What are the clinical uses for macrolides?

A

PUS

  • pneumonia (atypical)
  • URI
  • STD: chlamydia, gonorrhea
101
Q

What agent is used for ppx of gonorrhea

A

ceftriaxone

102
Q

What agent is used for ppx of syphilis

A

penicillin G

103
Q

What agent is used for ppx of recurrent UTIs (3)

A
  • TMP-SMX or
  • nitrofurantoin or
  • cephalexin
104
Q

What agent is used for ppx of PCP pneumonia

A

TMP-SMX

105
Q

What agent is used for ppx of exposure to H. influenzae type B meningitis

A

rifampin

106
Q

What agent is used for ppx of endocarditis prevention in pt with turbulent flow heart disease?

A

amoxicillin

107
Q

What are the major side effects of the IV polymyxins? (2)

A
  • neurotoxicity

- nephrotoxicity

108
Q

What is the MoA of sulfamethoxazole (SMX)?

A

inhibits dihydropteroate synthase

109
Q

What is the MoA of trimethoprim?

A

inhibits dihydrofolate reductase

110
Q

What is the MoA of levofloxacin?

A

inhibits DNA gyrase (topoisomerase III)

111
Q

What is the MoA of nitrofurantoin

A

inhibits bacterial ribosomes (only effective in urine)

112
Q

What is the MoA of metronidazole

A

forms toxic free radicals that damage DNA

113
Q

What is the MoA of polymyxin B?

A

cation detergent

114
Q

What 2 organisms are important causes of pneumonia and meningitis in neonates?

A

GBS

e. coli

115
Q

A group of picnic goers develop vomiting 2 hrs after eating. What is the most likely cause?

A

S. aureus

116
Q

What infection matches each of the following descriptions?

  • green frothy vaginal discharge with flagellated cells on wet prep
A

Trichomonas vaginalis

117
Q

What infection matches each of the following descriptions?

  • koilocytes on biopsy of lesion
A

HPV

118
Q

What infection matches each of the following descriptions?

  • multiple tender vesicles which becomes shallow ulcers
A

Herpes simplex virus

119
Q

What infection matches each of the following descriptions?

  • painless genital ulcer followed by rash on palms and soles
A

syphilis

120
Q

What infection matches each of the following descriptions?

  • mucopurulent cervical discharge with cervical motion tenderness
A

PID

121
Q

Which TORCHeS infections is the most likely cause?

chorioretinitis, hydrocephalus, intracranial calcifications

A

toxo

122
Q

Which TORCHeS infections is the most likely cause?

hydrops fetalis

A

parvo virus B19

123
Q

Which TORCHeS infections is the most likely cause?

PDA, cataracts, deafness

A

rubella

124
Q

Which TORCHeS infections is the most likely cause?

saddle nose, snuffles, Hutchinson teeth, saber shins

A

syphilis

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