Block 2 Flashcards
The following are true for non-trepanomal test in the detection of syphilis, except:
A. RPR test can serum to determine and evaluate neurosyphilis
B. Can have false positive result due to other infections
c.can be used to determine for evaluation of titers of antibodies
d. it can be used to monitor efficacy of therapy
RPR test can serum to determine and evaluate neurosyphilis
When visualized under darkfield microscopy, it is characterized as tightly coiled, thin, flexible spirochetes, with very fine spirals and one end is often bent, forming a hook.
Leptospira interrogans
Erythema migrans is the characteristics skin lesion of this disease.
Lyme Disease
True for the Treponomal test in the detection of syphilis.
a. It is persistently positive in Latent Syphilis
b. It detects the presence of treponomal antigen in the specimen
c. It utilizes cardiolipin as reagent
d. It detects the presence of anti-treponemal antibodies in the specimen
It detects the presence of anti-treponemal antibodies in the specimen
W/c of the ff is true for relapsing fever?
a. can be caused by borrelia burgdorferi (recurrentis)
b. Abrupt rise in the temperature after 1 week incubation
c. In the febrile phase, the organism is found in the spleen
d. antibodies appear during afebrile phase
Abrupt rise in the temperature after 1 week incubation
W/c of the ff statement is true?
a. Spirochetes do not contain peptidoglycan w/c defers from gram + bacteria
b. Leptospira and Borellia are the only known pathogens of family spirochetaceae
c. Borellia sp. belongs to the family spirochetaceae
d. The flagella is invested above the outer membrane
Borellia sp. belongs to the family spirochetaceae
W/c of the ff organism can be seen in the blood as a specimen w/ the use of aniline dyes?
Borrelia burgdorferi
A 24yr old man was wading in floodwater since yesterday up to today after heavy rain, he sought consultation at the SHH OPD. WHat prophylaxis should be given?
a. Doxycycline 100mg/cap, 2 capsule to be given daily w/in 72 hrs of exposure
b. Doxycycline 100mg.cap, 1 capsule to be given daily within 72 hrs of exposure
c. Doxycycline 200mg/cap, 1 capsule to be given daily w/in 72hrs of exposure
d. Doxycycline 100mg/cap, 2 caps to be given once a week until the end of exposure, 72 hrs within exposure
Doxycycline 100mg/cap, 2 caps to be given once a week until the end of exposure, 72 hrs within exposur
W/c of the ff is correctly paired according to the epidemiology of Lyme Disease?
a. Ixodes pacificus = Eastern US (West Coast)
b. Ixodes scapularis= Europe (damini)
c. Ixodes ricinus- West cost US (Europe)
d. Ixodes dammini=Northeast US (and Midwest)
Ixodes dammini=Northeast US (and Midwest)
A px from Connecticut, USA came in at the emergency room due to facial paralysis associated w/ painful radiculopathy. History showed he was a deer hunter & was treated & completed the oral antibiotic due to fever w/c happened 2 weeks ago. In this case, what antibiotic should be given? (B burgdorferi)
a. Doxycycline
b. Cetriazone (refractory cases)
c. Amoxicilin
d. Penicillin
(B burgdorferi)
Cetriazone (refractory cases)
W/c of the ff is true for the stages of syphilis?
a. Tertiary syphilis is high infectious
b. Primary syphilis is characterized by conylomata lata
c. Secondary syphilis is characterized by localized chancre and regional lymphadenopathy
d. Majority of latent syphilis will not progress to tertiary syphilis
Majority of latent syphilis will not progress to tertiary syphilis
W/c of the ff can be strained best w/ Silver impregnation technique for visualization of the organism?
a. Leptospira interogans
b. Borelia burgdorferi
c. Borelia recurrentis
d. Borelia vincentti
e. Treponema palilidum
Treponema palilidum
Sodoku is caused by spirochete:
a. Borelia buccalis
b. Spirilium minor (minus)
c. Borellia burgdorferi
d. Borelia refringes
Spirilium minor (minus)
Jarisch-Herxheimer reaction is characterized by the ff manifestations, except:
a. Purpura
b. Urticaria
c. Fever
d, Lymphadenopathy
Purpura
In Two-tiered test for lyme Disease, w/c test is used for Screening?
Enzyme immunoessay
The stage of Lyme Disease is characterized by arthalgia and neurologic manifestations.
Stage 2
A man came in w/ fever and neurologic deficit & seizure. HIstory revealed he has been wading in flood water 7 days prior. W/c statement is true to support your dx?
a. Doxycycline 100mg/tab, to be taken 1/day is the treatment modality
b. Agglutination test is the confirmatory test for such case
c. Urine is the specimen of choice for this case
c. There is good prognosis for this case
Agglutination test is the confirmatory test for such case
Liptospiroses
W/c of the ff sp is Louse-borne?
a. Borelia hermsii
b. Borelia vincenti
c. Borelia burgdoferi
d. Borelia recurrentis
Borelia recurrentis
Lyme disease is caused by these spirochete
a. Borelia burgdoferi
b. Borelia hermsii
c. Borelia recurrentis
Borelia burgdoferi
MATCH
- Bubo formation
- Groove sign
- Henderson
- Painless ulce
- Pseudobubo
Chancroid Lympogranuloma venereum Molluscum contagiosum Chancre Donovanosis
- Bubo formation- Chancroid
- Groove sign- Lympogranuloma venereum
- Henderson-Patterson bodies-Molluscum contagiosum
- Painless ulcer-Chancre
- Pseudobubo-Donovanosis
A woman complained of vaginal discharge ass w/ inguinal lymph node enlargement. McCoy cells culture of the cytobrush showed positive for inclusion bodies. What is the causative serovariant?
LGV 1
A determinant of the pathogenicity of Mycoplasma.
Adhesion factor
When the Chlamydias are stained w/ routine gram staining procedure, they will look like?
Gram-Negative Pleomorphic
True for Chlamydia, except:
a. Multiple intracellularly
b. the sp w/c infects human have common group antigens?
c. obligate intracellarly pathogens
d. Are gram negative bacteria
Multiple intracellularly
A 17yr old boy who works at cebu safari as caretaker of Moluccan, Major mitchell and Bared eye cocatoo. When he developed fever, chills and flu-like illness after 10 days. What is the drug of choice?
Doxycycline
W/c Chlamydial serotype is/are invlived in a px presenting w/ a painful inflammation & enlargement of the inguinal lymph nodes above the inguinal ligament?
a. L2
b. L3
c. D
d. L1
e. F
f. E
(LGV)
a. L2
b. L3
d. L1
A woman who had just gien birth had an onset of fever and body malaise after she got discharged from the hospital. Ultrasound showed tubo-ovarian abscess. The OBgyne specialist ordered culture of the abscess w/c showed a friend egg colony appearance. What is the causative organism?
Mycoplasma hominis
MATCH
- Gram negative intracellular bacteria
- donovan bodies-
- school of fish-
- clue cells-
- koilocytes-
N. gonorrheae Klebsiella granulomatis H. ducreyi Gardnerlla vaginalis HPV
- Gram negative intracellular bacteria- N. gonorrheae
- donovan bodies- Klebsiella granulomatis
- school of fish- H. ducreyi
- clue cells- Gardnerlla vaginalis
- koilocytes- HPV
W/c of the ff organism can spread through vertical route of transmission (Mother to fetus)?
a. C. trachomatis
b. M pneumoniae
c. Chlamydia psittaci
d. C. pneumoniae
C. trachomatis
W/c of the ff organism’s inclusion bodies will be stained dark with Iodine?
a. C. pneumoniae
b. C. psittaci
c. None
d. C trachomatis
C trachomatis
True for Mycoplasma organisms
a. Ability to grow in cell line culture media
b. can reproduce in cell media
c. resistant to penicillin and erythromycin
d. Obligate intracellular pathogens
can reproduce in cell media
T/F
Chlamydia infection is the most common sexually transmitted bacterial pathogen.
TRUE
T/F
To treat bacterial vaginosis among pregnant px, metronidazole administration is restricted to the 1st & 2nd trimester.
FALSE
A woman who had sexual contact w/ a man whom she met in a club a week ago is now complaining of vaginal discharge & dysuria. Gynecological findings showed cervical motion tenderness & non-foul smelling whitish discharge. The culture of the discharge in A8 agar showed growth w/ a change in the color of the medium after 2 days of incubation. What is the causative organism?
Ureaplasma urealyticum
A woman complained of vaginal discharge & dysuria, cytobrush culture on cell McCoy cell culture showed + for inclusion bodies. What is the serovariant?
C.t serovar E
The DNA & RNA content is equally distributed in EB. The reason why Elementary bodies are colored purple w/ Giemsa stain is?
a. The nucleiod has more DNA than the cytoplasm
b. The cytoplasm has more RNA than the nucleiod
c. The DNA is more concentrated in the nucleoid
d. The RNA is more concentrated in the nucleoid
The DNA is more concentrated in the nucleoid
A 6yr old child has lacrimation & mucopurelent discharge of the eye. The older sibling also got the same condition a few days ago. What is the causative agent?
C trachomatis serovar C
W/c of the ff antimicrobial is known to be the tx of choice for ehrlichae?
a. Fluoroquinolones
b. Trimethoprim-sulfamethoxazole
c. Penicillin G
d. Doxycycline
e. Chloramphenicol
Doxycycline
A mountaineer from Costa Rica, took a hoke through a forested & brushy area near his home. The next morning he noticed & removed a large insect from his tigh. About 7 days later, he experienced an abrupt onset of fever & malaise. He now seeks medical attention because he is concerned about a possible infection transmitted by the tick. W/c of the ff is known to the vector of the disease process?
a. Human body louse
b. Lone star tick
c. Chigger
d. Wood tick
e. Rat flea
(RMSF)
Wood tick
Rickketsial organisms are recovered in blood. What is the ideal time of collection for testing?
Convalescent period
All of the ff statements regarding R. akari are correct except:
I. It causes ricketsial pox
II. Ticks of the genus Amblyomma are responsible for transmission
III. The disease is mild
IV. Disease is more common in urban than in rural areas
Ticks of the genus Amblyomma are responsible for transmission
W/c of the ff bacteria is named after an investigator of typhus who was a victim of this disease?
a. Rickettsia akari
b. Ehrlichia ewingii
c. Rickettsia prowazekii
d. Erlichia chaffeensis
Rickettsia prowazekii
W/c of the ff diagnostic tests is most widely used in diagnosing rickketsial infections?
a. Weil Felix test
b. Polymerase Chain reaction
c. Complement fixation
d. Indirect immunofluorescence & enzyme immunoassay
e. Cell culture using lines
Indirect immunofluorescence & enzyme immunoassay
All of the ff are true about the Rickketsia except:
I. Fastidious & obligate extracellular bacteria (intracellular)
II. Cannot be culture using cell-free media
III. Multiply via transverse fission (binary)
IV. Humans are only accidental host except R. prowazekii
I & III
Why is it necessary to process suspected specimens w/ C. burnetii at BSL-3?
a. It’s acquired via inhalation
b. The treatment is difficult due because it’s dependent on the phase of infection
c. It can cause severe pneumonia
d. ALL
ALL
Observing typical morulae in granulocytic leukocytes confirm that that px is infected w/?
A. phagocytophilum
All of the ff statements are truue about C burnetii, except:
a. Small obligate organisms similar to GN bacteria
b. It’s the causative agent of Q fever
c. It’s transmitted primarily by arthropod-bites
d. Doxycycline is the drug of choice for acute infection
e. The organism multiplies w/in vacuoles
It’s transmitted primarily by arthropod-bites
W/c of the ff antimicrobials should not be used in treating RMSF?
a. doxycylcine
b. chloramphenicol
c. fluoroquinolones
d. trimethoprim-sulfamethoxazole
trimethoprim-sulfamethoxazole
W/c of the ff is considered as reservoir host of rickketsialpox causative agent?
a. humans
b. hard ticks
c. dogs
d. none
c. wild rodents
none (mice)
Q fever is characterized by both acute and chronic infections. Endocarditis is the most common form of chronic infections w/c is associated w/ w/c antigenic phase of the organism?
a. Phase 2
b. phase 4
c. Phase 3
d. Phase 1
Phase 1
W/c of the ff is the principal vector of endemic typhus infection?
a. Dermacentor andersonii
b. Leptotombidium delicense
c. Xenopsylla cheopsis
d. Pediculus humanus corporis
Xenopsylla cheopsis
Identify the presumptive organism based on. the Weil-Felix reaction. [OX-1: negative; OX-2: negative; OXK: positive].
a. R. prowazekii
b. O. tsutsugamushi
c. C. burnetii
d. R. akari
e. R. rickettsia
C. burnetii
All of the ff lab tests can be employed in diagnosising HME and HGE, except:
a. platelet
b. CBC w/ WBC differential count
c. Urinalysis
d. None
e. SGPT/ALT
None
W/c specific structure is responsible for the ability of Rickettsia to adhere endothelial cells?
outer membrane protein A (Omp A & B)
W/c of the ff infections exhibits a small ulcer covered w/ a black crust at the site of a tick bite?
a. Brill-Zinsser disease
b. Rickettsialpox
c. Mediterranean spotted fever
d. Murine typhus
e. Rocky mountain spotted fever
Mediterranean spotted fever
W/c of the ff is histopathologic cell is common in px with RMSF?
a. Morulae w/in neutrophils
b. Bacteria located intracellularly
c.Morulae w/in monocytes
d Intracellular vacuoles
e. Perivascular lymphocytes
Perivascular lymphocytes
Ehrlichiae & chlamydiae resembles each other, however they differ in:
ATP synthesis
Scrub typhus develops suddenly after a 10-day incubation period w/ severe headache, fever, & body pain. W/c of the ff vector can caused the above mentioned disease?
a. Human louse
b. Chiggers
c. Rat fleas
d. Soft ticks
e. Hard ticks
Chiggers
W/c of the ff statement is not true about prowazekii life cycle?
a. Scratching the area of the bite allows the rickketsia excreted in the feces to penetrate the skin
b. Whenever a louse bites, it defecates at the same
c. Rickketsia are transmitted from one generation of lice to another
d. The louse obtains the organism by biting infected human beings & transmits the agent by fecal excretion on the surface of the skin of another person
Rickketsia are transmitted from one generation of lice to another
All of the ff infections manifest the presence of eschar, except:
a. Ricketsialpox
b. Endemic typhus
c. Flea-borne spotted fever
d. Boutonneuse fever
Endemic typhus
All of the ff statements are of the host immune response to rickettsial infection, except:
a. None
b. Antibody response to OmpA
c. Clearance by cytotoxic CD8 lymphocytes
d. Cytokine mediated intracellular killing
e. Opsonization of bacteria during their extracellular phase
Opsonization of bacteria during their extracellular phase
This disease is a recrudescence of an typhus infection
Brill-Zinsser disease
Since C burnetii can be transmitted by milk when animals like cows & goats are infection, what is the best sterilization method to destroy viable organisms?
High temperature, short-time pasteurization
Identify the presumptive disease based on the Weil-Felix reaction: [OX-19: positive, OX2-negative, OXK: negative].
Endemic typhus
W/c of the ff is a virus infection involving the presence of a noninfectious from of the virus?
Latent
A 36yr old father complained of rash on his torso. HIs children had been diagnosed w/ chickenpox & confined to their home. the father had experienced chickenpox as a child & knew he did not have the same rash as his children. What is the most likely cause of the father’s rash?
Varcella-zoster
A 3rd yr med student complained of sore throat & extreme fatigue. The resident physician noted lymphodenopathy & ordered a rapid test for infectious mononucleosis antibodies that was negative. Bacterial cultures were negative, as were serological tests for influenza a & b, HIV-1, CMV, hep B & anti-streptolysin O. What would be the next line of viral testing to establish a dx?
Epstein-Barr
W/c of the ff has not been successfully used to detect viruses in clinical specimens?
a. growth on selective media
b. ELISA
c. Immunofluorescent antibody test
d. Cytopathic effect
growth on selective media
From w/c part of the virus is the enveloped acquired?
Nuclear or cytoplasmic membrane
A very small, single0stranded DNA virus that causes a febrile illness with a rash & it is called the 5th childhood disease after rubella, rubeola, varcella & roseola is:
Parvovirus B19
A cervival papanicolaou, smear is taken from a woman with a vaginal papilloma (wart). Certain types of papillomas have been ass. w/ cervical carcinoma. What method would be used to detect & identify the type of papilloma in the cervical smear?
PCR analysis
A 5yr old girl was admitted to the hospital ff a 2day visit w/ relative over new York Holidays. Vomiting & diarrhea left the child severely dehydrated. No other members of the family were affected. Bacterial cultures proved negative. A stool sample should be tested for w/c virus?
Rotavirus
A female became pregnant after 1month of having MMR vaccine, though was advised to avoid pregnancy. What advice the doctor should give to the px?
wait & watch
The most common viral syndrome of pericarditis, myocarditis & pleurodynia is caused by:
Coxsackie B virus
W/c virus ass w/ venereal & respiratory warts & produce lesions of skin & mucous membranes?
Papilloma virus
A child is presented w/ fever, conjunctivitis, & bluish-white spot-on bucial mucosa. 4 days later, she developed rashes. What is the characteristics feature of the virus that is responsible for this condition?
ss-enveloped RNA virus
The serological test of a px shows HBsAg negative, IgM anti HBc negative, HBV DNA not detectable, anti HBc IgA antibody positive and anti HBs antibody positive. What is the most probable diagnosis?
Recovery from previous infection of Hep B
An 8yr old boy was admitted to SWUMC w/ a diagnosis of viral encephalitis. History revealed that the boy harbored stray cat from a nearby parks. What is the best method to determine if the boy has contracted rabies?
a. Request immunofluorescent test for antigen in cutaneous nerve obtain by nuchial biopssy of the px
b. Remove the brain stem from the cat & examin cytopathic effects
c. Isolate the virus from the saliva of both the cat and the px
d. Request immunofluorescent test for antibody on the saliva from the cat
Request immunofluorescent test for antibody on the saliva from the cat
Mumps is characterized by an infection of the
Parotid
The Sabin Polio vaccine uses w/c of the ff?
a. Attenuated virus
b. Formalin-inactivated virus
c. DNA
d. Recombinant viral antigens
Attenuated virus
W/c of the ff is not ass w/ HSV?
a. Encephalitis
b. Genital herpes
c. Cold sores
d. Thrush
Thrush
A mature virus particle containing a nucleic acid core surrounded by a protein coat with/without envelope is called a:
Virion
W/c of the ff statements about Hep C is true?
a. DNA virus
b. Doesn’t cause liver chirrosis
c. Most common indication for liver transplant
d. Doesn’t cause coinfection w/ Hep B
Most common indication for liver transplant
Owl’s eye appearance inclusions are seen in?
CMV infections
W/c of the ff influenza virus binds to the cell surface receptors to initiate infection of the cell?
a. Hemagluttins
b. Neurminidase
c. Gp 120 & 40
d. Fusion spikes
Hemagluttins
W/c of the ff of viral hepatitis infection in pregnancy, the maternal mortality is highest?
a. Hep C
b. Hep A
c. Hep B
d. Hep E
Hep E
W/c of the ff oportunisticdisease is not closely ass w/ AIDS?
a. Cryptococcus
b. Cryptosporidiosis
c. Tuberculosis
d. Malaria
Malaria
A mother delivers a bay 3 days after developing chickenpox. W/c of the ff is true?
a. Give antiviral tx to mother
b. Give no tx to mother and give antiviral tx to baby
c. No risk to both mother & baby
d. Baby has a risk of congenital varicella infection
Baby has a risk of congenital varicella infection
Culex tritaeniorhynchus is vector of which viral disease?
Japanese Encephalitis
All of the ff are cardinal signs of measles, except:
a. Diarrhea
b. Conjuctivitis
c. Cough
d. Coryza
Diarrhea
The appearance of Koplik spots in the oral mucosa of px is characteristic of infection w/ viral what agent?
Robeola
W/c of the ff terms refers to the exchange of homologous segments of RNA bet. 2 different influenza type A virus?
a. Phenotypic making
b. Complimentation
c. Genetic reassortment
d. Phenotypic mixing
Genetic reassortment
Which of the following pair of viruses are the most common cause of viral pneumonia in adults?
a. Herpes simplex and Cytomegalovirus
b. Influenza and adenovirus
c. Hepatitis A and B viruses
d. Coxsackie A and B viruses
Influenza and adenovirus
Which of the following statement is/are true of all paramyxoviruses?
a. All of the choices
b. They have a cytoplasmic site of replication
c. Envelope is derived from the host cells plasma membrane
d. None of them
ALL
Which specimen should be collected from a patient suspected with enteroviral meningitis?
a. Stool
b. All of the choices
c. Throat swab
d. CSF
ALL
All are correct statement about Hepatitis A, except:
a. Chronicity is the hallmark of the disease
b. It is difficult to culture
c. Vaccines are available
d. It belongs to enterovirus
Chronicity is the hallmark of the disease
A 10-month-old baby was hospitalized with respiratory infections. The baby was diagnosed with apnea and bronchiolitis. Further testing revealed congenital heart disease. Bacterial cultures were negative for S. pneumoniae and H.influenzae. Which further testing should be done?
a. Norwalk virus
b. Rotavirus
c. HIV
d. RSV
RSV
Which of the following statements of clinical viral disease is true?
a. It is associated with target organs in most disseminated viral disease
b. It is most frequently due to toxin production
c. It can result without infection of host cells
d. It usually follows viral infection
It is associated with target organs in most disseminated viral disease
The purpose of adding 5-fluorouracil in culturing Leptospira organism
a. To eliminate of fungal growth
b. ALL
c. To supress the growth of non-pathogenic serovars
d. To prevent the growth of treponema
To supress the growth of non-pathogenic serovars
The hallmark feature of Hemolytic anemia in Mycoplasma pneumoniae infections?
a. The cross reactivity of the organism’s specific antibodies w/ that of the RBC
b. The production of cold agglutins w/c are autoantibodies that targets RBC
c. the production of cytokines w/c triggers a hightened immune response against RBC
d. RBC hemolysis due to intracellular parasitism
The production of cold agglutins w/c are autoantibodies that targets RBC
Characteristic feature of pneumonia caused by Chlamydia pneumoniae.
a. Eosinophilia
b. Monocytosis
c. Neutrophilia
d. Basophilia
Monocytosis
A disease characterized by malaise, rigors & fever developed in members of several family living in an unheated was-damaged house in an Eastern Europe country. Erhtematous 2-6mm macular red rashes appeared on the people’s trunk & later their extremities. Some of the people had coughs. The presumptive diagnosis is epidemic typhus. What is the hallmark of infection of rickettsial infections?
a. ALL
b. Low-grade fever
c. Headache & body malaise
d. Vasculitis
e. Contact dermatitis
Vasculitis
A 47-year-old woman who has rheumatoid arthritis and treated with a tumor necrosis factor (TNF) antagonist notice many umbilicated papules on the skin of her upper thighs. What is the most likely causative agent?
MCV
The type of cell culture that best supports the growth of CMV is:
a. Hep-2 cells
b. HeLa cells
c. Primary monkey kidney cell
d. Human fibroblast cells
Human fibroblast cells
W/c of the ff is an RNA virus that has nuclear phase to its replication process?
a. Coronavirus
b. Retrovirus
c. Rhabdovirus
d. Togavirus
Retrovirus
