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USLME Kiss my ass and pray > DIT Micro Bacteria > Flashcards

DIT Micro Bacteria Flashcards

1
Q

lipoteichoic acid is found where and leads to what?

A

found in gram + cell walls and leads to, IL1 IL6, TNF alpha

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2
Q

Lipopolysacharide is found where and causes what?

A

found in gram -

Contains lipid A - lysed ->
and leads to IL1, IL6, and TNF alpha

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3
Q

Transpeptidase is?

A

an enzyme that is targeted that links peptide side chains together to make peptidylglycan wall

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4
Q

Ribosomal sub units of prokaryotes

A

30s and 50s -> 70s

s refers to sedimentation not units

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5
Q

Bacterial w/ capsules (8+1)

A

Even Some Nasty Killers Have Pretty Shiny Bodies

E Coli -some
Streptococcus pneumonia*
Nisseria meningitis*
Klebsiella
Hamophelis influenza*
Pseudomonas aerugenosa
Salmonella typhi
Group B strep

SHiN

Cryptococcus neoformis - fungi

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6
Q

Splenectomy leads to what concerns?

A

Of encapsulated bugs

Make sure vaccinated agains SHiN bugs

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7
Q

Only fungus that is encapsulated ?

Stain?

Causes?

A

Cryptococcus neoformis

India ink

meningitis in AIDS

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8
Q

Bacteria w/out a cell wall

A

myocplasma

  • high sterol count
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9
Q

Bacteria w. high lipid count in cell wall making it difficult to gram stain

A

Mycobacteria

contains mycolic acid

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10
Q

6 bugs that do not gram stain well

A 
Treponema - too thin - dark field instead
Ricketsia - intracellular
Chlamydia - intracellular
Mycobacteria - high lipid content
Mycoplasma - no cell wall
Legionella - intracellular
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11
Q

Silver stain useful for which 2 organisms

A

Legionella

Pneumocystis

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12
Q

Zeil neelsen positive organisms?(2)

A

Acid fast stain

Mycobacteria
Norcardia

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13
Q

Giemsa stain useful for? (5)

A 
Chlamydia
Borrelia
Ricketsia
Trypanosomes
Plamodium
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14
Q

Positive Quelleng Test in

A

Bugs w/ capsules

E Coli -some
Streptococcus pneumonia*
Nisseria meningitis*
Klebsiella
Hamophelis influenza*
Pseudomonas aerugenosa
Salmonella typhi
Group B strep
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15
Q

3 organisms capable of taking in naked DNA from the environment

A

SHiN can do Transformation

Streptococcus pneumonia
Hamophelous influenza
Nesseria meningitis

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16
Q

Spore forming bacteria (2 families)

A

gram +

Bacillus

  • anthacis
  • cereus

Clostridium

  • perfinges
  • botulinum
  • tetani
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17
Q

Lipid A endotoxin found where?

Leads to activation of what 3 pathways

A

in the LPS wall of gram -

Macrophage activation

  • IL1, IL6 -> fever
  • TNF alpha -> fever and hypotension
  • Nitric Oxide -> vasodialation

Complement

  • C3a -> hypotension/edema (histamine)
  • C5a -> PMN chemotaxis

Activates tissue factor -> coag + DIC

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18
Q

Macrophage activation post Lipid A encounter leads to (3)

A

Septic shock

  • IL1, IL6 -> fever
  • TNF alpha -> fever and hypotension
  • Nitric Oxide -> vasodialation

Also have complement and tissue factor activation

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19
Q

Complement activation in septic shock gram -

A
  • C3a -> hypotension/edema (histamine)
  • C5a -> PMN chemotaxis

Macrophage activation and tissue factor as well

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20
Q

Why is gram - septic shock lead to DIC?

A

Activates tissue factor -> coag + DIC

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21
Q

Two gram + bacteria associated w/ super antigens and their respective antigen

A

Staph aureous
-TSST1

Streptococaal pyrogenes
- pyrogenic toxin A-C

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22
Q

Superantigens binds to (2)

leads to?

A

MHC II and TCR

leads to polycolonal T cel activation

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23
Q

2 toxins associated w/ inactivation of E2F

A

Diptheria on Corynebacterium dipheriae

Exotoxin A on Pseudomonas aerugunosa

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24
Q

2 toxins that inactivate 60s ribosome leading to HUS

A

Shiga toxin in shigella

Shiga like toxin in EHEC

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25
Q

Hemolytic uremic syndrome is characterized by what 3 symptoms and found w/which 2 bugs

A

thrombocytopenia
hemolytoc anemia
acute renal failure

Shigella and EHEC (O157:H70

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26
Q

2 toxins -> Over activates adenylate cyclase -> increased cAMP -> Cl secretion and diarrhea

A

Cholera toxin in vibrio Toxin

heat labile toxin in ETEC

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27
Q

heat stable toxin is found where and leads to what

A

found in ETEC also

leads to diarrhea due to increase of guanate cyclase action and increasing cGMP and decreased NaCL reabsorbtion

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28
Q

Edema factor, lethal factor and protective antigen make up?

A

Bacillus anthra toxin -> edemotous border and black eschar

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29
Q

Activation of Gs via this toxin leads to 12-20 L of fluid loss per day

A

Cholera
overactivationof adenylate cyclase -> increased cAMP and Cl excretion

~ HL toxin in ETEC

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30
Q

activation of Gi by this toxin leads to

A

Pertussis

100 day cough in adults and wooping in kids

inactivation of Gi leads to increase adenylate cyclase and increased cAMP

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31
Q

Neurotoxins are secreted by which family.

What are their 2 toxin and MOA

A

Clostridium, both cleave SNARE proteins holding vesicles of NT near the synapse

Clostriudum tetani -> tetanospasim toxin, blocks GABA and glycine release (spasm)

Clostridium botulinum -> butulinum toxin, blocks release of ACh (flaccid)

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32
Q

Clostridium botulinum has 2 food borne associations w/ dif mechanisms of action

A

spores in honey -> floppy baby

Eneterotoxins in canned foods -> diarrhea in adults

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33
Q

Alpha toxin is found where and leads to what 2 problems

A

Clostridum perfinges

degradation of phospholipid C ->

  • myonecosis
  • gas gangrene
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34
Q

Streptolysin O and S are associated w/ what organism and leads to what

A

Streptococcal pharynges

hemolysis

O being oxygen labile -ASO titre
S being stable

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35
Q

Scarlet fever is due to

differs from rheumatic fever how?

A

Streptococcal pyrogenes -> erythrogenic and pyrogenic toxins

Rheumatic fever is an immune response weeks later due to cross reactivity to the M antigen

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36
Q

Spores are formed during what part of the bacterial graph

A

Stationary, plateau

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37
Q

Penicillins and cephasporins work best at what stage of infection

A

exponential growth phase

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38
Q

7 bugs that secrete enterotoxins(watery diarrhea/ electrolyte imbalances)

A 
Staph aureus
Vibrio cholera
ETEC
Shigella
Yessernia enterolita
Clostridium perfinges
Clostridium difficle
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39
Q

Enterotoxin producing bacteria that may mimic appendicitis

Prefers what environment

A

Yessernia enterocolitica

colder temps - fridge, do not kill it

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40
Q

Leukocodin is what and found where

A

exotoxin made by Staph aureus that kills leukocytes

2 types - delta and panton valentine

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41
Q

Protein A is found where and responsible for what? (2)

A

Found in Staph aureus and associated w/ hemolysis

also binds to Fc-IgG inhibiting opsonization and phagocytosis

type of hemolysin along w/ Protein B

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42
Q

3 main branches of gram +

A

Cocci
-Staph and Strep

Rods

  • Clostridium
  • Bacillus
  • corynebacterium
  • Listeria
  • Mycobacterium

Branching filaments

  • actinomyces
  • Nocardia
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43
Q

Catalase test is what and used to seperate

A

Breaks down H2O2 into CO2 and H20

Separates cocci Staph (+) and Strep (-)

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44
Q

Coagulase test is what and used to separate which 3 organisms

how do you differentiate the last 2?

A

Whether gram + bunches together blood or not, also used to coat w/ fibrin to protect itself

S. aurous is (+)

S. epidermidis (-)
-(novobiocin sensitive)
S. straphrolyticus (-)
-novobiocin resistant

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45
Q

S. saphrolyticus is known for causing

A

UTIS

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46
Q

common aerobic bug found complicating prosthetic valves and joints

A

S. epidermidis

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47
Q

Partial hemolysis streptococcus (2)

differentiate how?

A

S pneumonia

  • Optochin +
  • Capsule (quelleng)

S. mutans

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48
Q

Complete beta hemolysis strep (2)

Differentiate how?

A

Group A -S pyrogenes
-bacitracin sensitive

Group B -S Agalactiae
-bacitracin resistant

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49
Q

gamma hemoysis gram + organisms (3)

A

Enterococcus Group D
E. faeceium
E. faecalis

S bolvis

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50
Q

Branching Filament Gram Positive organisms (2)

differ how?

A

Actinomyces
-anaerobic

Nocardia
-aerobic
acid fast

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51
Q

Gram + rods (5)

A

Spore formers

  • Clostridium
  • Bacillus

Nonspore

  • listeria
  • corynebacterium

Mycobacteria - acid fast

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52
Q

Bug forming yellow sulfur ganules

A

Actinomyces israleii

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53
Q

Bug staining the bandages blue-green

A

Pseudomonas aergunosa

Remember pseudo loves water

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54
Q

S aureous creates what colored pigment?

A

Yellow

Au = gold

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55
Q

Serratia marcescens is associated w/ what pigment?

A

Red

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56
Q

Toxin mediated Staph aureous infections?(3)

A

Enterotoxin - fast food poisoning
TSS1T - toxic shock syndrome
exfolotoxin - scalded skin syndrome

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57
Q

Staph virulence factor that binds to Pc-Ig inhibiting obsinization

A

Protein A

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58
Q

Gram + dipplococci think

A

Strep pneumonia

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59
Q

Streptococcus pneumonia most commonly causes (4)

A

MOPS

Meningitis - community aquired, elderly

Otitis media - kids

Pneumonia

Sinusitis

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60
Q

IgA protease is found in ?

A

Staph aureus
Nesseria meningitis
H influenza

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61
Q

2 virulence factors of strep pneumo

A

Encapsulated

IgA protease

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62
Q

Rusty colored suptum

A

Pneumonia w/ Strep pneumo

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63
Q

Concern of sepsis w/ these 2 patients w/ S pneumonia

A

Splenectomy

Sickle cell

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64
Q

3 classifications of diseases due to Strep pyrogenes- total of (8)

A

Pyrogenic

  • Impetigo
  • cellulitis
  • pharyngitis

Toxin mediated

  • scarlet fever
  • Toxic shock
  • necrotizing fascitiis

immunologic

  • rheumatic heart disease
  • glomerulonephritis
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65
Q

Cellulitis and impetigo most often due to(2)

A

S. pyrogenes

S. aures

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66
Q

Glomerulonephritis can be seen a week after this infection

A

Strep pneumonia

either pharyngitis or cellulite/impetigo

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67
Q

Rheumatic fever due to ?

Diagnosed by?

A

Molecular mimicry to the M antigen of Strep pyrogens

J - joints, polyarthritis
O - heart - pancarditis
N - nodules - sub Q
E - Erythema migratans
S - sydenhams Chorea
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68
Q

ASO titer preformed to check for

A

S pyogenes

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69
Q

3 main worries w/ Group B in babies

Test what?

A

Meningitis #1
Pneumonia
Sepsis

CAMP factor

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70
Q

Strep bovis in the blood be concerned w?

Strep bovis also causes

A

Colon cancer

Sub acute endocarditis

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71
Q

Enterococci Group D causes

A

UTI and sub acute endocarditis

resisitant to treatment when found where it shouldn’t be

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72
Q

grows in 6.5% NaCl and bile

A

Enterococci Grop D

  • E facecalis
  • E Faecum
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73
Q

Grows in 6.5% NaCl but NOT bile

A

S bolvi

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74
Q

ADP ribosylation of EF2 is due to?

A

dyptheria exotoxin or pseudomonas exotocin A

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75
Q

Rx for dyptherisa(3)

A

ABx

  • erythromycin/penicillin
  • anti toxin
  • Vaccine
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76
Q

Club shaped baceria

A

corynebacterium

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77
Q

Obligate anaerobic bacteria (3)

A

Clostridium
Bacteriodes
Actinomyes

lack catalase and/or superoxide dismutase

Rx - metronidazole and clindamycin

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78
Q

Rx for obligate anaerobic bacteria(2)

A

Rx - metronidazole and clindamycin

Clostridium
Bacteriodes
Actinomyes

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79
Q

Toxin A enterotoxin and Toxin B

causing cytotoxin destruction(kills enterocytes)

A

C difficile

  • leading to psudomembranous colitis due to binding
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80
Q

small papule leading to bleach eschar surrounded by edema due to?

A

Bacillus anthacis

- cutaneous

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81
Q

Woolsorter w/ flu like symptoms that rapidly progress to fever, pulmonary hemorrhage and shock caused by?

CXR shows ?

A

Pulmonary bacillus anthacis

->mediastinal widening

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82
Q

Only bacterium w/ a polypeptide (D glutamate) capsule?

A

B anthracsis

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83
Q

B cereus cause what pathology(2)?

A

Emetic type
- w/ rice and pasta w/in 1-5 hrs -due to a toxin

diarrheal type
-non bloody w/in 8-18 hrs

Spores survive heating and -> toxin production

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84
Q

Neonatal disease bugs biggest concern (3)

A

Step B
E coli
listeria

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85
Q

listeria affects who (4)

A

Neonates
inmmuncompromised
elderly
pregnant women -> neonatal death

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86
Q

Listeria monocytogens can reside in what cell?

A

Monocytes
faculative intracellular

move by actin rockets

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87
Q

Gram + anaerobe that has large branching filaments that cause oral/fascial abscesses?

Characteristic color?

A

Actinomyces israllii

yellow sulfur granules

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88
Q

Partially acid fast positive bacteria w/ large branching filaments that is aerobic?

Causes?(2)

A

Nocardia

pulmonary infection and cutaneous infection in the immune compromised

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89
Q

Gram - dipplocci

A

Nesseria

Urease +

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90
Q

Gram - coccii (3)

A

Nesseria meningitidis,
Nesseria gonorrhoeea
Morallela catarrlis

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91
Q

Cocciod Rod (gram -)

4

A

Haemophilus influnezae
Bordetella pertussis
Pasturella
Brucella

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92
Q

Gram - rods (10)

Broken up by

A

Lactose fermenters- FAST

  • Klebsiella
  • E Coli
  • Enterococcii

Lactose femermenters -SLOW
-Citrobacter
Serratia

Lactose NON fermentors

  • Shigella
  • Salmonella
  • Protease
  • Pseudomonas*
  • H pylori*
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93
Q

Gram - rods Lactose nonfermentors(5)

broken up by?

A

Oxidase -

  • Shigella
  • Salmonella
  • Proteus

Oxidase +

  • Psuedomonas
  • H pylori
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94
Q

Gram - rods Lactose fermentors (5)

Broken up by

A

Fast

  • Klebsiella
  • E coli
  • Enterobacter

Slow

  • Citrobacter
  • Serratia
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95
Q

Gram - comma shaped (2)
-Oxidase +

Unique characteristic of each?

A

Camplobacter jejuni
-grows at 42 degrees C

Vibrio Cholera
-grows in alkaline material

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96
Q

Nesseria that does not have a capsule?

A

gonococci and thus no vaccine

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97
Q

Prophylactiv Rx for N meningitidis (3)

Definitive (2)

A

Prophylactic

  • rifampin
  • cipro
  • ceftriaxone

Ceftriaxone definitive

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98
Q

Adrenal hemorrhage is due to this bug,

Called?

A

waterhouse friderichsen syndrome

due to N meningitis

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99
Q

sniffing dog position and thumb sign on CXR may indicate what by what organism?

A

Epiglotitis

by Haemophilus influenza

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100
Q

Haemophilus influenza causes (5)

A 
Epiglottis - Cherry red
Meningitis 
Otisis media
sinusitis
Pneumonia

IgA protease
chocolate agar w/ V and X

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101
Q

Culturing requires a chocolate agar w/ factors V and X

A

Haemophilus influenza

Vaccine avaialable

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102
Q

Small painful lesion, solitary, on the genitalia?

A

Haemophilus ducreyi

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103
Q

Legionella can be detected through what 2 tests?

A

Silver stain

antigen in urine

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104
Q

Legionella pneumophila spreads via

A

aerosolized water

NOT person to person

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105
Q

Grows on a charcoal yeast extract culture w/ iron and cysteine

A

Legionella pneumophilia

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106
Q

atypical pneumonia w/ fever and GI symptoms that does not gram stain

A

legionella

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107
Q

Erythema gangreosum (black escar) seen w/ a sepsis think of?

  • may be a burn patient
A

PSeudomonas

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108
Q

Special victims of pseudomonas (3)

A

Burn victims
CF
Diabetics

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109
Q

Pseudomonas causes

A 
Pneumonia- CF
Spepsis
External otitis - swimmer
UTI
Diabetic Osteomylitis
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110
Q

Triple Therapy in gram - nonlactose fermentor causing increased risk for Lymphoma and gastric adenocarcinoma

A

Helicobacter pylori

Use

  • PPI
  • Clarithromycin
  • Amoxicillin/metronidazole
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111
Q

Breath test for gastric ulcer takes advantage of what feature of this organism

A

Urease + -> alkaline environment

H pylori

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112
Q

osteromyolitis in sickle cell disease

maybe after a diarrheal illness

A

Salmonella

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113
Q

diarrhea caused by gram - non motile organism that does not ferment lactose

A

shigella

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114
Q

diarrhea caused by gram - motile organism that doesn’t ferment lactose

A

Salmonella

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115
Q

MacConkey agar turns pink w/ this enzyme

A

lactose fermenters

- like E coli, klebsiella etc

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116
Q

Heat labile and heat stabile toxin are produced by this bacteria and lead to the same result by different mech

Rx

A

ETEC e coli -
- floroquinolones

Heat labile increase cAMP
~cholera

Heat stabile increases cGMP

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117
Q

Has a shigella like toxin leading to HUS but is lactose fermenting

A

EHEC O157-H7

Does not ferment sorbitol

HUS - anemia, thrombocytopenia and acute renal failure
(mech hemolysis, low renal flow and platelet consumption)

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118
Q

Diarrhea seen in kids due to adherence, no invasion

A

EPEC

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119
Q

Diarrhea due to invasion causing necrosis and inflammation similar to shigella

A

EIEC

Rx floroquinilones, TMP/SMX

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120
Q

Shigella presentation progression

A

Starts as water diarrhea that becomes bloody as the toxn does its work and then have invasion leading to fever

No flagella, very virulent
- food to water spread

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121
Q

produces hydrogen sulfide and has a flagella causing diarrhea

A

Salmonella

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122
Q

Picinic and egg salad or chicken was consumed causing diarrhea 1-3 days later

A

salmonella

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123
Q

Reactive arthritis seen it 2 GI bugs

A

Salmonella and Shigella

In addition to Chlamydia

124
Q

Salmonella typhi differs in that(3)

A

typhoid fever

  • rose spots on the abdomen
  • fever
  • HA
  • Nausea

gallbladder is a carrier state

125
Q

diarrhea w/ rose colored spots on the abdomen

A

salmonella typhi

126
Q

Major cause of bloody diarrhea found in poultry, meat and unpasturized milk?

2 unique features?

A

camplobacter jejuni

S shaped
grows at 42 degrees C

127
Q

Sequllea associated w/ camplobacter jejuni?

A

Guillain Barre

128
Q

Grows in alkaline media and has a flagella to move around. Slight comma shape

A

Vibrio cholera

activates Gs

129
Q

Diarrhea associated w/ puppies

also found in?(2)

A

yersernia enterocolitica

contaminated milk or pork

130
Q

Turtles can harbor

A

salmonella

131
Q

mesenteric adenitis epidemic found in a daycare due to

A

yersernia enterocolitica
- mimics appendicitis

Found in cooler climates as well

132
Q

Aspiration pneumonia in someone that is immune compromised

may see on sputum

A

Klebsiella, especially in alcoholics and diabetics

red current jelly from lobar pneumonia

133
Q

oral vancomycin really only ever used for?

another Rx if that does not work

A

C dif
- no nephrotoxicity due to no oral absorption

metronidazole

134
Q

Post clindamycin or ampicillin Rx worry about

How would you diagnose this disorder if suspected?

A

C dif

C dif Toxin A or B

A - enterotoxin
B - cytotoxic to enterocytes

135
Q

Contaminated seafood or shellfish due to

A

vibrio parahemolyticus and vulificans

136
Q

Clostridium perfengiens enterotoxin can be found in?

A

reheated meat dishes

137
Q

bulging food can may indicate contamination w.

A

C botulinum

138
Q

Dysurea, increased frequency urgency and suprapubic pain, WBCs are all seen in

139
Q

WBC casts are seen when and why?

A

Seen in pylonephritis or anytime the renal tubules are involved. Need the compression of the tubules to lead to cast formation

140
Q

Positive leukocyte esterase test indicates in urine

A

bacterial UTI, enzyme is being expeller but can also just beinflammation

141
Q

positive nitrite test in urine is indicative of

A

gram - bacteria UTI

enterobacteriacea

142
Q

4 most common causes of UTIs

A

E coli
Staph saprophyticus
Klebsiella pneumonia
Proteus mirabilis

others
- Pseudomonas
Serratia macescens
-enterobacter cloacae

143
Q

Urease is found in (2)

What does it do?

A

Found in H pylori and Proteus mirabillis

Splits urease into NH3 and Co2 to make the environment more hospitable

144
Q

Motility causes swarming when trying to culture this UTI

Associated feature?

A

Proteus mirabilis

causes struvite stones

145
Q

Green metallic sheen on EMB agar

146
Q

Rx for UTIs

A

TMP-SMX*
Aminopenicillins
Floquinolines*
Nitrofurantoin

147
Q

Spirochetes are defined by?(2)

3 examples

A

spiral shape
axial location of flagella (axial filaments)

BLT

Borrelia
Leptospira interrogans
Treponema

148
Q

Weils Disease characterized by

A

Severe Leptospira interrogans infection - tropical disease

jaundice, azotemia, kidney dysfunction, hemorrhage, fever and anemia

149
Q

animal urine think of 2 organisms

A

leptospira interrogans

rats - hanta virus

150
Q

Leptospirosis symptoms (6)

A

1st -flu like

2nd - jaundice, photophobia, meningitis, liver damage and renal failure

Severe form - Weil disease

151
Q

question mark shaped organism

A

leptospira interogans

152
Q

Tick carrying borrelia burdorferi

Also carries?

A

Ixodes

babesia microti -> babesiosis

153
Q

3 Stages of lyme Disease

2 symptoms for 1st 2
3 for the last

A

1

  • erythema migraines,
  • flu like symptoms

2

  • neurologic (bi lateral bells palsy)
  • cardiac - AV block

3

  • migratory polyarthritis
  • chronic monoarthritis (knee)
  • encephalopathy/polyneuropathy
154
Q

Bilateral bells palsy think of

155
Q

Diseases w/ bells palsy associated?(5)

A 
Lymes
Herpes Zoster
Sarcoidosis
Tumors
Diabetes
156
Q

2 tests looking for syphilis antibodies

False positives due to (5)

Confirm w?

A

RPR or VDRL

V- viruses (EBV, mono, hepatitis)
D- drugs
R- Rheumatic fever
L- Lupes, leprosy

FTA-ABS

157
Q

condylomata lata

A

wart like lesion in moist areas associated w/ secondary syphilis

158
Q

1st stage of syphilis

A

solitary painless ulcer

159
Q

secondary stage of sphyilis has (3)

A

Maculopapular rash (hands/feet)
conylomata lata
fever/malaise/chills

160
Q

3rd stage of syphilis has (4)

A

tabes dorsales/neurosyphilis
gummas - anywhere
aoritis - tree barking
argyll robertson pupil

161
Q

Congenital syphillis one may see? (4)

A

saber shins - anterior bowing
hutchingsons teeth - notched incisors
saddle nose - frontal bossing
hearing loss

162
Q

Argyll Robertson pupil is seen in what and defined by

A

tertiary syphilis

defined by pupils that accommodate but do not react to light

163
Q

tabes dorsales is ?

signs and symptoms (3)

associated w

A

degeneration of the dorsal column and roots leads to loss of pain and sensation

leads to wide ataxic gait
charcots joints
positive rhomberg

tertiary syphilis

164
Q

Charcot joints found in (2)

A

Tabes dorsales in tertiary syphilis

Diabetic neuropathy

165
Q

bartonella causes?

Found in?

A

cat scratch fever - regional LAD and angiomitosis in immune compromised

cat scratch

166
Q

borrelia burgdorferi causes?

Found in

A

Lymes disease

Ixodes ticks

167
Q

Borreila recurrentis causes?

Found in?

A

recurrent fever

louse

168
Q

brucella spp causes?

found in

A

brucellosis/undulant fever (granulomatous caseating)

unpasturized dairy (vets and ranchers)

169
Q

Chlamydophila psittaci causes?

found in?

A

psittacosis - severe pneumonia

parrots/birds

170
Q

coxiella burnetti causes?

found in?

A

Q fever - severe flu, abrupt fever

aerosols of cattle sheep amniotic fluid

171
Q

erlichia caffeenis causes?

Found in

A

ehrlichiosis (HA, muscle ache, fever)

lone star tick

172
Q

Francisella tularensis causes?

Found in?

A

tularemia (LAD, ulcer and granuloma formation)

Dermacator tick (rickettsia); rbabits and deer

173
Q

Mycobacertium leprae causes?

Found in

A

leprosy

Armadillos

174
Q

Pasteurella multocida causes?

Found in?

A

Cellulitis, osteomyolitis

Dog and Cat bites

175
Q

Rickettsia prowazekki causes?

Found in?

A

epidemic typhus

louse

176
Q

Rickettsia rickettsii causes?

Found in

A

Rocky mountain spotted fever

Dermencetor tick (franciella tularensis)

177
Q

Rickettsia typhi causes?

Found in

A

endemic typhus

fleas

178
Q

Yersernia pestis causes?

Found in?

A

plague

Fleas (rats/ praiare dogs)

179
Q

Gohn complex

A

combination of hilar LAD
and john focus - calcified lung scar mid to low lung lobe

Primary TB

180
Q

Gohn focus

A

Calcified lung scar in the mid to bottom lobe in primary TB

181
Q

Primary TB most often becomes

Complications of Primary TB (3)

A

healed by fibrosis leading to immunity and hypersensitivity, Tuberculin +

progressive lung disease (HIV or malnutrition) -> infection/death

bacteremia w/ hematogenous spread -> milady TB and death

reactivation later in life leading to secondary TB

182
Q

Secondary TB characterized by?

Location of lesion?

A

fibrocasious cavitary lesion in the upper lobes

Symptomatic w/ fever hemoptysis, weight loss and night sweats

183
Q

lower back pain, nigh sweats, fever, hemoptysis think of?

A

Potts disease

extra pulmonary TB

184
Q

extra pulmonary TB locations(5)

A

CNS -> parenchymal tuberculoma or meningitis

Vertebral bodies -> Potts disease

Lymphadenitis

Renal

GI

185
Q

PPD + test means (3)

A

Current infection
past infection
BCG vaccine

186
Q

PPD - test means (2)

A

No infection

Immune compromised to the point of anergic response (steroids,HIV, sarcoidosis, malnutrition)

187
Q

Diagnosis of TB (2)

A

3 sputum cultures over 3 days
-any one can be positive

Culture takes 2-4 wks and should be done regardless

188
Q

Acid fast + bacteria that causes pulmonary TB like symptoms in chronic bronchitis and emphysema

189
Q

disseminated TB in AIDS patients w/ fever diarrhea, and malabsorbtion

Prophylactic treatment w/ what, when?

A

M. avium

Prophylactic treat Azythromycin when CD4 <50

190
Q

Aquatic associated TB, seen in those that work at shipyard and aquarium workers

191
Q

Rx for active TB(4)

A

RIPE

Rifampin
Isoniazid - B6 pyradoxine
Pyrazinamide
Ethambutol

192
Q

Rx for latent TB (2)

A

6-9 months of Isonizid

193
Q

some virulence factors of mycobacterium tuberculosis(2)

A

cord factor - inhibits macrophage maturation, induces TNF alpha release

sulfatides - inhibit phagolysosomal fusion

194
Q

mycobacterium that prefers cool temperatures of skin and superficial nerves

causes?

A

mycobacterium leprae

Causes

  • lepramatous leprosy
  • tuberculoid leprosy
195
Q

Lepramatous leprosy is due to?

A

m leprae

communicable form of leprosy is due to an improper Th2 stimulation(humoral), Th1 response is low(cell mediated)

diffuse skin involvement

196
Q

Tuberculoid leprosy is due /

A

m leprae

same pathogena as in lepromatous but immune response is primarily Th1 cell mediates and the disease is limited to few hypesthetic hairless plaques

197
Q

Rx of lepromatous leprosy vs tuberculoid leprosy

A

lepromatous (2-5 yrs)
-dapsone
-rifambin
clofazimine

tuberculoid (12 months)

  • dapsone
  • rifampin
198
Q

Dapsone is used in? (2)

Concern?

A

leprosy - tuberculoid and lepromatous

pneumocystis pneumonia prophylaxis (2nd line)

Concern in G6PD patients

199
Q

fishy nonpainful vaginal discharge (gray)

Rx?

A

Gardenella vaginosis

metronidazole

200
Q

Clue cells are ?

associated w?

A

Gardenella vaginosis

vaginal epithelial cells covered in bacteria

201
Q

Rickettisia triad?

A

Fever
HA
Rash

202
Q

Rash starting at the wrists and ankles making its way to the trunk?

A

Rickettsia rickettsii

  • obligate intracellular
203
Q

some obligate intracellular organisms(2)

A

Chlamydia

rickttsia

204
Q

tick born rash that develops centrally and spreads out sparing the palms and soles (2)

A

R typhi - endemic

R. prowazekii - rpidemic

205
Q

Monocytes w/ morula (berry like inclusions) in cytoplasm - tick borne

A

Ehlichiosis - in Ehlichia

NO rash

206
Q

Granulocytes w. morula in cytoplasm tick born

A

Anaplasmosis w/ anaplasma

NO rash

207
Q

Coxiella burnetti causes?

transmitted by?

A

Q fever

  • NO rash,
  • fever and interstital pneumonia

aerosolized spores in tick feces and cattle placenta release

208
Q

Weil felix reaction is?

what is positive, what is negative

A

Test for rickettsia and tick borne illness

Coxiella is negative

the rest: rickettsia etc are positive

209
Q

atypical pneumonia w/ a person that has a pet parrot

A

Chlamydophilia psittaci

210
Q

pneumonia in a 20 something that presents w/ low grade fever, tachypnea, crackles/wheezing

A

chlamydia pneumonia

or mycoplasma pneumonia

211
Q

Chronic infection leading to blindness in Africa

A

Types A, B, C chlamydia trachomatis

212
Q

neonatal pneumonia and conjunctivitis found in a subclinical mother w/ reticulate bodies

Prevention and Rx?

A

Chlamydia D-K
- May also cause PID/Urethritis

Rx w/ azithromycin, Prevent w/ erythromycin eye drops

213
Q

solitary painless chancre on the penis that may progress to rectal disease that is confused for IBD

A

Chlamydia tachmomatis L1, L2 L3

Painful LAD

214
Q

Walking pneumonia due to (3)

Rx for each

A

Mycoplasma pneumonia - (macrolide)

Chlamydia pneumonia (azithromycin)

Liegenella (macrolide or quinolone)

215
Q

bacteria characterized by high sterol content in bacterial membrane

A

mycoplasma pneumonia

leads to atypical pneumonia in <30s especially in prisons/military recruits

216
Q

Cold agglutinin anemia seen sometimes w/ atypical m pneumonia is to what antibody?

217
Q

Where is the major mode of resistance to penicillin located in gram -?

what is another mech of resistance

A

Penicillinase is located in the periplasm

Alteration of the penicillin binding protein also a mech of resistance

218
Q

What drug given to a patient w/ mono leads to inappropriate assumption of allergy

A

Amoxicillin leads to rash when given to EBV + patients

not a hypersensitivity reaciton

219
Q

What are the concerns w/ penicillin (3)

A

hypersensitivity

Rarely

  • thrombocytopenia
  • hemolytis uremia
220
Q

ampicillin and amoxicllin spectrum?

A

Extended
Gram +
HELPSS

Haemophilus
E Coli
Listeria
Proteus mirabilis
Salmonella
Shigella

URI, UTIs and neonatal

221
Q

Penicillins used in pseudomonal infections (3)

A

Ticarcillin
piperacillin
Carbenicillin

222
Q

MRSA reisistance due to ?

A

Changing of the penicillin binding protein target of Staph Aureus

Use methicillin to test for not used clinically

223
Q

Oral penicillin vs IV

A

Oral - Penicillin V

IV - G

224
Q

Organisms not covered by cephalsporins

A

LAME

Listeria
Atypical pneumonia - chlamydia, mycoplasma
MRSA
Enterococci

225
Q

1st generation Cephalosporins(2)

Coverage(4)

A

Cefazolin
Cephalexin

gram + and PEcK

Proteus mirabilis
E Coli
Klebiella

226
Q

2 Generation Cephalosporins (4)

Coverage (8)

A

cefoxitin
cefaclor
cefuroxime
cefprozile

gram + and HEN PEcKS

Haemophilus
Enterobacter
nesseiria (not gon)
Proteus mirabilis
E Coli
Klebsiella
Serratia
227
Q

3rd gen Cephalosporins(4)

Coverage(10)

A

cefTriaxone* (Nesseria go to)
cefoTaxime
cefdinir
cefTazidime * (anti pseudo)

only gram + is strep pneumo

serious gram -

Haemophilus
Enterobacter
nesseiria 
Proteus mirabilis
E Coli
Citrobacter (new)
Klebsiella
Serratia
228
Q

4th Gen Cephalosporin(1)

Coverage

A

Cefepime

Pseudomonals and gram +
- broad spectrem

229
Q

Antipseudomonals Cephalosporins (2)

A

Ceftazidime

Cefepime

230
Q

Increased nephrotoxicity is seen when these 2 ABx classes are paired together

A

Aminoglycocides and cephalosporins

231
Q

Go to neisseria ABx

Excreted?

A

Ceftriaxone

Excreted in bile so safe for kidneys

232
Q

UTI prevention prophylactically give

A

1st or 2nd gen cephalosporin

233
Q

Cell wall inhibitor w/ No cross reactivity w/ penicillin allergies

Spectrum

A

Aztreonam

Gram -

234
Q

Great drug to use in those w/ a gram - infection and have renal insufficiency

235
Q

Imipenem is always coadministed w/ what

why?

A

cilastatin to prevent renal degradation of imipenem by renal dehydroppeptidase I

236
Q

Broad spectrum beta lactamase inhibitor for maybe appendicitis?(2)

Not used all the time why?

A

Carbapenems

  • Imipenem/cilastatin
  • meropenem

not used to concern w/ serious side effects like seizures (imipenem), GI and skin rash

237
Q

What is the one bug carbapenems do not hit

238
Q

Antipseudomonial drugs in general (4)

A

Cefepime
Ceftiazdime
Aztreonam
Carbapenems

239
Q

Red man syndrome w/ vancomycin Rx

A

pause the treatment, give an antihistamine and run again at a slower rate

not an IgE mediated hypersensitivity; nonspecific mast cell degranulation

240
Q

Protein synthesis inhbitors
2 acting on 30 s

5 on 50 s

A

buy AT 30 CCEL at 50

30s

  • Aminoglycoside
  • Tetracycline
50s
Clindamycin
Choramphenicol
Erythromycin (macrolides)
Linezolid
241
Q

Situation of Linezolid use?

A

When you want to oral outpatient Rx for MRSA instead of Vanco (IV)

also used for VRE

binds to 23s (50s) and interacts w/ bacterial initiation complex

242
Q

Tetracyclines indicated for (9)

A

VACUUM THe BedRoom

Vibrio cholera
Acne
Clamydia
Ureaplasma Ureayticum
Mycoplasma
Tularemia
Helicobacter pylori
e
Borrelia urgdorferi
ed
Rickettsia Ricketsii
243
Q

Why don’t we give tetracycline to Kids?

A

teeth discoloration - yellow

premature epiphyseal plate closing

244
Q

Taking a tetracycline can cause upset stomach. Why is this a bad coinicidence

What other adverse effects are there?

A

because taking an antacid (Ca, Mg Fe, vitamins) will limit the effectiveness of the drug and lower absorption

Photo toxicity, teratogen,

245
Q

Chronic use of minocycline can lead to what unique toxicity

A

blue tinged skin

246
Q

Clinical use of macrolides

A

Azithromycin, Erythromycin, Clindamycin

Used in PUS - atypical Pneumonia, URIs( Strep pneumo and pyrogenes); STDs (Chlamydia)

247
Q

Concern w/ macrolides w

A

prolonged QT

acute cholestatic hepatitis - rare w/ erythromycin

Rash

p450 inhibitor (CRACK AMIGOS) -> increased concentrations of Warfarin and theophylline

248
Q

Synergistic drug for a neonatal infection w/ ampicillin

A

aminoglycoside

aminoglycosides used severe gram - infections

Streptomycin, Amikacin, Gentamycin, Neomycin, Tobramycin

249
Q

Toxicity of aminoglycosides(3)

A

Different kind of NOT vs vanco

Nephrotoxicity
Ototoxicity
Teratogen*

250
Q

Which drug class requires O2 limiting its effectiveness in anaerobes to 0

Indicated for what bacteria?

A

Aminoglycosides

Severe gram - rods

251
Q

Old drug used primarily for meningitis - very toxic but still used in developing countries

Biggest concern (2)

A

Grey baby syndrome

Anemia (aplastic, dose dependent)

252
Q

Grey baby syndrome casued by what drug and why?

Symptoms

A

Chloramphenicol - bacteriostatic

due to decreased UDP gycouronyl transferase activity in neonates to take care of the toxic metabolites

ashen grey colored baby, flaccid, cyanotic, refuse to suckle, abdominal distention

253
Q

Go to drug for anaerobes w/ metronidazole

Indicated for what else (3)

A

Clindamycin - bacteriostatic

anaerobes but also MRSA(skin abcesses), protozoal infections, acne

254
Q

Toxicity associated w/ Clindamycin

A

C dif infection w/ a psuedomembranous overgrowth

255
Q

drug used topically more than iv due to sever nephrotoxic and neurotoxic effects

Used for?

A

Polymyxin

Used for severe last resort gram - infections

256
Q

prophylaxis in meningococcal infection

A

Ciprofloxacin in adults

rifampin in kids

257
Q

gonorrhea prophylaxis

A

ceftriaxone

258
Q

syphillis prophylaxis

A

penicillin G

259
Q

History of UTIs prophylaxis

A

TMP-SMX, nitrofurantoine, 1st and 2nd gen cephalosporins, amoxicillin

260
Q

endocarditis w/ surgical or dental procedure prophilaxis

A

penicllins - aminopenicllins, cephalexins

261
Q

Pregnant woman that is group B positive give

A

ampicillin

262
Q

Prevention of gonorrhea and chlamydia conjunctivitis in newborns

A

erythromycin drops

263
Q

H infleunzae meningicoccal exposure give

264
Q

Pneumocystis jiroveci prophylaxis w/ CD4 <200

A

TMP-SMX

if allergic - pentamidine, dapsone

265
Q

Most common causes of pneumonia in neonates(2)

A

Group B strep

E coli

rx ampicillin w/ gentimicin

266
Q

Pneumonia in 8wks -18yrs (5)

A

RSV

Mycoplasma
Chlamydia trachimonas- (infant -3)
Chlamydophila pneumonia

Strep pneumo

267
Q

common cause of pneumonia in adults 18-40 (3)

A 
Strep pneumo (older)
Mycoplasma (younger)

Chlamydophila pneumonia

268
Q

Common Cause of pneumonia in adults 40-65 (5)

A

Strep Pneumo

H influenza
anaerobes
viruses
mycoplasma

269
Q

Pneumonia in the elderly >65

A 
Strep pneumonia
Influenza 
Anerobes
H influenza
gram - rods (new)
270
Q

Nocosomial pneumonia (2)

A

staph aureus and enteric gram - rods

271
Q

Immunocompromised pneumonia

A

pneumocystis jirovecii

272
Q

Aspiration pneumonia

273
Q

pneumonia in alcoholics

A

klebsiella

274
Q

Cystic fibrosisi pneumonia

A

pseudomonas

S aureus
S pneumonia

275
Q

Atypical pneumonia (3)

A

Mycoplasma
Chlamydiophila
legionella

276
Q

Common cause of meningitis in neonates

A

Group B strep #1
E coli
Listeria

277
Q

Causes of meningitis in children 6 months to 6 yrs (4)

A

Strep pneumonia #1
Nesseria Meningitidis - serious

Hamophelous influenza type B
Enteroviruses (echo and coxsackie)

278
Q

Causes of meningitis ages 6 -60(4)

A

Strep pneumona

N meningitidis (#1 in teens)
enterovirus
HSV (tempora encephalitis)

279
Q

Causes of meningitis in elderly

A

S pneumonia
Gram - rods
Listeria

280
Q

Rx for meningitis empirically? (2)

A

Vancomycin and ceftriaxone

Dexamethosine to reduce inflammation

281
Q

Most common cause of osteomyolitis

A

Staph aureous

282
Q

Most common cause of osteomyolitis in a sickle cell patient

A

Salmonella

283
Q

Most common cause of vertebral disease (infectious)

A

Mycobacterium tuberculosis (Potts)

284
Q

Cat and dog bites that go deep to the bone worry about

A

Pateurella multocida - osteomyolitis

285
Q

R/o osteomyolitis if you have negative what?

A

ESR or CRP

can get MRI, plain radiographs, Bone biopsy = gold standard

286
Q

Most common fungal infection of the lung in Texas/gulf

A

histoplamosis

287
Q

Mist common fungal infection of the lung in SW Cali, Arizona, NM, Texas

288
Q

Osteomyolitis concerns in an IV drug user(2)

A

Staph aureous and pseudomonas

289
Q

painful indurates, ulcerated genital lesion w/ exudate

A

chancroid due to Haemophilus ducreyi

290
Q

Stippled vaginal epithelial cells on a wet prep of vaginal discharge

A

clue cells

291
Q

strawberry cervix

A

trichimonoa

292
Q

infection of lymphatics, genital ulcers (painless) and rectal strictures (mimics IBD)

A

lymphogranuloma vereum due to chlamydia L1 - L3

293
Q

Fitzs Hugh Curtis syndrome

A

infection of the liver capsule in PID ascending infection-> violin string adhesions of parietal peritoneum to liver

294
Q

risks of exposure in a newborn nursery (2)

295
Q

Risks w/ urinary catheterization (4)

A

E coli
proteous mirabilis
MRSA
pseudomonas

296
Q

Respiratory therapy equipment use linked to what infection

A

pseudomonas

297
Q

Working in a renal dialysis unit and w/ sharps

298
Q

Hyperalimentation (total parental feeding) have increased risk of what infection

A

Candida albicans

299
Q

TORCHeS infections

A 
Toxoplasma gondii
O- other like parvovirus B19
R- Rubella
C - CMV
H- Herpes and HIV
e
S -syphilis
300
Q

Congenital toxoplasmosis infection

Risk

Symptoms(3)

A

due to maternal exposure to cat feces or undercooked meat

Choriorectinitis
hydrocephalus
intracranial calcifications

301
Q

Congenital Rubella infection symptoms (3)

A

PDA
Cataracts
deafness

+/- blueberry muffin appearance

302
Q

Congenital CMV infection (3)

A 
Hearing loss (unilateral)
Seizures
petechial rash (blueberry muffin)
303
Q

Herpes simplex 2 congenital infection (2)

A

encephalitis - temporal lobe

herpetic lesions

304
Q

Congenital syphilis infection complications

  • 5 early
  • 4 late
A

early

  • snuffles
  • hemolytic anemia
  • rash/desquamation
  • jaundice
  • radiographic changes(metatarsal dystrophy)

late

  • saber shins (tibial bowing)
  • hutchingson’s teeth (notched incisers)
  • Saddle nose
  • Frontal bossing
305
Q

Congenital Parvo B19 exposure

A

Hydrops fetalis

USLME Kiss my ass and pray (33 decks)

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