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Microbiology > Exam 2: Master Deck > Flashcards

Exam 2: Master Deck Flashcards

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1
Q

What percent of people infected with TB become ill?

A

10%

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2
Q

Inadequate tx of TB has what 2 effects worldwide?

A
  1. patients remain infectious

2. drug resistance

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3
Q

TB co-infection with HIV and improper therapy have allowed what to occur in TB?

A

abx resistance (MDR, XDR)

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4
Q

What makes TB difficult to eradicate?

A

long term tx

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5
Q

T/F? Humans are the only reservoir for TB.

A

True

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6
Q

This is a cutaneous manifestation of TB that is common in healthcare workers who are exposed to TB in lab conditions…

A

prosector’s warts

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7
Q

TB is transmitted via…

A

aerosol droplet nuclei

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8
Q

TB has a bimodal age distribution that sees peaks in what two ages?

A
  1. infants

2. older adults

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9
Q

The spread of TB in the blood (hematogenous dissemination) can result in what serious complication for what populations?

A

meningitis

infants and immunocompromised

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10
Q

What is a complication of older age that can lead to reactivation of a latent TB infection?

A

immune failure

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11
Q

What are three factors that influence the probability of being infected with TB?

A

Crowded Conditions

Prolonged Exposure

Virulent strain

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12
Q

Who is the vector for TB in infants?

A

caregivers

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13
Q

What chronic disorder confers a 30% increase in risk of developing TB?

A

DM

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14
Q

What lifestyle factors contribute to increased risk for developing TB? (4)

A
  1. long-term care
  2. EtOH/IVDU
  3. Malnutrition
  4. low income housing
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15
Q

What three medical disorders confer increased risk for TB?

A
  1. DM
  2. silicosis
  3. immunosuppression
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16
Q

What three species produce human tuberculosis?

A

m. tuberculosis
m. bovis
m. africanum

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17
Q

Which species of TB?

  • consumption of unpasteurized milk
  • contact w/ infected animals
  • source of BCG vaccine
A

m. bovis

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18
Q

Which species of TB?

  • west african countries
  • especially hits HIV
  • Spread by food
  • No animal reservoirs
A

M. africanum

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19
Q

This bacteria has the following characteristics:

  • obligate aerobe
  • slender, curved bacillus
  • non-motile
  • intracellular growth
A

m. tuberculosis

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20
Q

Where does m. tuberculosis like to grow?

A

alveolar macrophages

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21
Q

M. Tuberculosis is heat sensitive, meaning it is killed by what?

A

pasteurization

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22
Q

Zeihl-Neelsen or Kinyoun stains are used to identify which acid fast bacillus?

A

MTB

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23
Q

What are the two layers in the MTB cell wall?

A

peptidoglycan, mycolic acid

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24
Q

This portion of the MTB cell wall contains LCFA, which makes up 60% of the lipid content in the cell wall.

A

mycolic acid

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25
Q

This structural feature of MTB cell wall prevents dehydration and resists hydrogen peroxide

A

mycolic acid

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26
Q

Does MTB have classic virulence factors or toxins?

A

no

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27
Q

What causes pathogenicity of MTB?

A

structural features

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28
Q

What three features of MTB cause sxs for patients?

A

mycolic acid, cord factor, LAM

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29
Q

This MTB structure is a mycoside… aka mycolic acid+disaccharide

A

cord factor

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30
Q

This MTB structure inhibits cell mediated immunity, scavenges reactive oxygen intermediates

A

LAM

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31
Q

What causes caseous lesions in patients infected with MTB?

A

granuloma formation

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32
Q

The following describes what clinical manifestation of MTB?

  • surrounded by macrophages, multi-nucleated giant cells, fibroblases, collagen fibers.
  • harbors viable MTB cells
  • Evident 2-6 weeks after infx
A

granuloma

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33
Q

What allows a granuloma to be seen on x-ray?

A

calcification and fibrotic tubercle formation

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34
Q

What stage of TB infection?

insidious onset of sxs

cough, weight loss, fatigue, fever, night sweats, CP

caseous lesions with necrosis

A

reactivation/secondary tuberculosis

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35
Q

What is responsible for causing infection due to secondary TB?

A

erosion and discharge of TB

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36
Q

this results from lymphohematogenous spread of primary infection or a latent lesion with subsequent spread…

A

miliary tuberculosis

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37
Q

a _______ stain and _______ culture can be used to detect acid fast bacteria

A

sputum stain

broth culture

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38
Q

The rapid blood test for TB is based on the release of ______

A

IFN-y

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39
Q

IFN-y is produced by what isolated cell line?

A

T cells

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40
Q

GenXpert tests for ______ and _______ resistance

A

MTB and rifampin resistance

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41
Q

What three factors need to be controlled in order to prevent TB outbreak?

A
  1. correct dx
  2. isolation
  3. tx
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42
Q

_______ and ______ infection can give false positives on a TST…

A

BCG receptors and NTM infx

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43
Q

Prophylaxis for MTB can be given to exposed subjects. It is dependent on HIV status and requires which drug for how long?

A

RIF x 9 mo

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44
Q

What is a weakly gram-positive aerobic, acid fast bacillus common in the environment, water, soil and plants?

A

MAC

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45
Q

Are MAC fast or slow growing

A

slow

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46
Q

How is is MAC transmitted?

A

ingestion of contaminated food/water

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47
Q

What distinguishes MAC from TB regarding transmission?

A

no person-to-person transmission

no isolation required

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48
Q

This is the leading cause of NTM infx in HIV pts, and is an opportunistic human pathogen

A

MAC

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49
Q

What two populations of immunocompetent patients can be at risk for MAC?

A

middle-aged/older males with hx of smoking

elderly female non-smokers

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50
Q

Patchy or nodular apparance on X-Ray and Lady Windermere’s syndrome are associate with MAC infx in what population?

A

elderly female non-smokers

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51
Q

Cavitary lesions resembling TB is associated with MAC infx in what population?

A

middle-aged/older male smokers

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52
Q

Disseminated disease with MAC infx occurs with multisystem organ involvement and immune collapse in what population?

A

AIDS

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53
Q

What therapeutics can be used for MAC prophylaxis in HIV positive patients?

A

HAART and abx

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54
Q

What are two essential components to diagnosing MAC?

A

Acid Fast microscopy/culture

exclusion of fungi/tb

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55
Q

What does treatment for MAC look like for HIV positive and negative?

A

combination abx

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56
Q

When can tx stop for MAC in HIV negative patients?

A

negative sputum cultures x 1 year

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57
Q

When can prophylaxis for MAC stop in HIV positive patients?

A

CD4 > 100

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58
Q

When should prophylaxis be considered for MAC in HIV positive patients?

A

CD4 < 50

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59
Q

When can abx tx for MAC stop in HIV positive patients?

A

lifelong if continued immunocomplromised

or

2 weeks then HAART

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60
Q

Measles is also called…

A

rubeola

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61
Q

This disease is one of the classic childhood exanthems and can be severe in malnourished/vitamin A deficiency

A

Measles

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62
Q

What is the incubation period for measles?

A

10-14 days

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63
Q

Where does measles replication occur in the body?

A

respiratory epithelium and lymph

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64
Q

Measles can disseminate from respiratory epithelium and lymph nodes to other tisseus via what cell type?

A

monocytes

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65
Q

What stage of measles?

1-12 days post-infx

high fever

Coryza, cough, conjunctiitis

Koplik Spots

A

Prodromal stage

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66
Q

Koplik spots are pathognomonic for…

A

measles

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67
Q

When does the onset of the measles rash occur?

A

3-4 days after prodrome initiation

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68
Q

What stage of measles?

  • highest fever
  • rash spreading from ears, downward to rest of body
A

Rash phase

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69
Q

In the resolution phase, antibodys are produced which stop the viremia. The measles rash will fade in what order?

A

same order it appeared

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70
Q

What are three broad complications of measles?

A

PNA

Diarrhea

CNS involvement

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71
Q

What measles complication…

  • responsible for most measles deaths
  • risk if malnourished
  • can be result of bacterial superinfx
A

Pneumonia

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72
Q

Which measles complication?

-high fatality rate (15%)

A

acute symptomatic encephalitis

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73
Q

What type of encephalitis is rare, but a dangerous CNS complication of measles?

A

subacute sclerosing panencephalitis

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74
Q

Who are the two known hosts for measles?

A

humans and monkeys

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75
Q

Does measles have a healthy carrier state?

A

no

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76
Q

Immunity to measles typically occurs by…

A

10 yo

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77
Q

Measles is rare in patients below the age of _____ and why?

A

6 mo due to maternal immunity

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78
Q

How is measles transmitted?

A

respiratory droplet

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79
Q

Measles dx is confirmed by what three diagnostics?

A

rash and koplik spots

serology

FA test of mucosal swab

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80
Q

Swab of the pharynx, nasal, and buccal mucosa show what, which aids in dx of measles?

A

multinucleated giant cells

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81
Q

Which vaccines are indicated for measles prevention in exposed, non-immune subjects?

A

MMR and immune globulin (BayGam)

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82
Q

Describe the vaccination schedule for MMR

A

15 mo

4-6 yrs

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83
Q

Which MMR vaccine type does the US use, what makes it not-suitable for all patients?

A

MMR II, live attenuated

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84
Q

What percent of the population must be vaccinated to stop measles persistence?

A

95%

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85
Q

in 2015, the largest outbreak since eradication in 2000 occurred. how many cases

A

668

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86
Q

What infection?

nicknamed “little red”

mild exanthemous disease

resembles measles

children often escape infx

A

rubella (german measles)

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87
Q

Rubella requires _______ contact for infection

A

close and prolonged

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88
Q

This complication of rubella…

  • occurs via maternal infection in 1st trimester
  • may lead to placental/fetal infection
A

congenital rubella syndrome

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89
Q

What three organ systems are affected by congenital rubella syndrome?

A

cardiac, eye, hearing

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90
Q

Congenital Rubella Syndrome (CRS) can cause what two cardiac malformation?

A

pulmonary artery stenosis, PDA

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91
Q

What eye defects can occur due to Congenital Rubella Syndrome (CRS)?

A

glaucoma, cataracts

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92
Q

What ear manifestations can occur due to Congenital Rubella Syndrome (CRS)?

A

hearing loss

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93
Q

the risk of CRS is highest in the 1st trimester. What percentages are associated with the months of the 1st trimester?

A

1st month: 50%

2nd month: 30%

3rd month: 20%

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94
Q

What nearly eliminated congenital rubella syndrome in the united states?

A

vaccination

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95
Q

If a mother is exposed to rubella, what is the last line prophylaxis you can administer during the 1st trimester?

A

IVIG

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96
Q

The following are two unique properties of what pathogen?

  1. invade and replicate in CNS
  2. establish latent infx
A

HSV

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97
Q

Is there a vaccine for HSV?

A

no

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98
Q

After primary HSV infection resolves, it establishes a latency where via what type of transport?

A

CNS dorsal root ganglia

retrograde transport

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99
Q

can latent HSV reactivate?

A

yes

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100
Q

A patient presents with:

  • shallow vesicles on an erythematous base
  • ballooning vesicles that crust over
A

HSV

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101
Q

How is HSV transmitted to children?

A

caregivers/close contacts

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102
Q

Does the presence of active humoral and cellular immunity prevent the reactivation of HSV?

A

no

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103
Q

The probability of HSV recurrence is greater in individuals who…

A

have more severe initial outbreaks

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104
Q

Asymptomatic shedding means that HSV can be transmitted when?

A

without current outbreak

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105
Q

what three ways is HSV spread?

A

vesicle fluid

saliva

secretions

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106
Q

Which HSV type?

  • occurs early in life
  • 90% oral
  • common
  • 90% seropositive
A

HSV-1

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107
Q

Which HSV type?

  • infx occurs later in life
  • 90% genital
  • correlated to sexual activity
A

HSV-2

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108
Q

HSV dx is accomplished by using…

A

direct sample of tissue

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109
Q

what two drugs are:

  • most prescribed HSV agent
  • Stops viral DNA replication by blocking viral thymidine kinase
  • can suppress HSV recrudesence
A

acyclovir, valacyclovir

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110
Q

A patient presents with the following, which is concerning for…

  • asymmetrical vesicular rash
  • fever, malaise, headache, neuralgia
  • pruritic leesions
A

varicella

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111
Q

The varicella virus infects through what tissues?

A

conjunctiva or respiratory mucosa

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112
Q

Where does varicella replicate in the 4-6 days after infection?

A

regional lymph nodes

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113
Q

Where does varicella replicate during secondary viremia (rash phase) 10-14 days after infection?

A

liver and spleen

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114
Q

Varicella peaks in what seasons?

A

winter-spring

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115
Q

90% of all varicella cases occur between years…

A

1-14

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116
Q

When is a patient most contagious with varicella?

A

1-2 days before lesions and 4-5 days after

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117
Q

prodromal sxs of varicella are absent in what age group?

A

younger children

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118
Q

What medication should be avoided with varicella infection and why?

A

aspirin, reyes syndrome

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119
Q

What two drugs can be given to treat chickenpox?

A

acyclovir

VariZig

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120
Q

What vaccine is available for varicella?

A

varivax

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121
Q

Are chickenpox cases occurring in vaccinated children?

A

yes, often due to incomplete courses

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122
Q

What prevention therapy is available for high-risk peole exposed to varicella?

A

VariZig

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123
Q

infection of varicella can produce significant disease and damage, this is called

A

congenital/neonatal VZV

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124
Q

These lesions are painful, described as searing, burning, stabbing. Pain may precede the rash by days/weeks

A

Shingles

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125
Q

Varicella Zoster (shingles) presents in what pattern?

A

unilateral dermatomal distribution

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126
Q

What percent of shingles cases have involvement of ophthalmic branch of CN V?

A

10%

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127
Q

What is an absolute prerequisite for shingles infection?

A

varivax vaccination or hx of chickenpox

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128
Q

What vaccine for shingles is…

  • adjuvanted, recombinant
  • recommended for prior zostavax recipients
  • DOC
A

shingrix

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129
Q

What vaccine for shingles

  • pts over 50 yo
  • high potency VZV vaccination to boost immunity
  • same virus as varivax, but higher potency
A

zostavax

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130
Q

This disease…

  • called Roseola infantum, 6ths disease, or exanthem subitum
  • fever followed by rose-colored rash
  • prevalent and unrecognized until culture system was available
A

human herpes virus 6

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131
Q

this is one of the most regularly acquired viral infections of childhood.

30% of children 6mo-3yo have had this.

A

HHV-6

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132
Q

A patient presents with sustained fever of unknown origin for 2-5 days, but is otherwise well appearing

A

Roseola infantum (HHV-6)

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133
Q

What 2 methods of HHV-6 diagnosis are available?

A

Ab detection via EIA

DNA sequence detection via PCR

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134
Q

Is treatment required for HHV-6?

A

no

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135
Q

This disease is called “Fifths Disease” or erythema infectiosum.

it often appears in children with a “slapped cheek” rash

A

parvovirus B19

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136
Q

A patient presents with:

Prodrome of mild fever, HA, malaise, myalgia, respiratory sxs +/- NV

Post-prodromal skin rash with circumoral sparing which resolves in 1-2 weeks

A

parvovirus b19

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137
Q

the rash of parvovirus B19 commonly affects…

A

limbs and trunk

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138
Q

What connective tissue manifestations can be present with parvovirus B19?

A

arthralgia, arthritis

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139
Q

Parvovirus B19 has a worldwide distribution among school age children, and is epidemic in what seasons?

A

late winter and spring

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140
Q

What three things aid in Parvovirus B19 diagnosis?

A

facial rash

anti B19 IgM

epidemic outbreak

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141
Q

What tx can be given to relieve sxs of parvovirus B19?

A

NSAIDs

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142
Q

What tx for Parvovirus B19 can be given to anemic patients?

A

immunoglobulin

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143
Q

What two HPV types are correlated with cervical dysplasia and cancer?

A

HPV 16 and 18

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144
Q

What two types of HPV are associated with anogenital warts?

A

HPV 6 and 11

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145
Q

Gardasil 9 protects against which 5 types of HPV?

A

6, 11, 16, 18 and 5 others

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146
Q

For whom is gardisil vaccine indicated?

A

ages 9-45

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147
Q

Erysipelas, Impetigo, Folliculitis all infect what layer of the skin?

A

epidermis

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148
Q

Ecthyma, furunculosis, carbunculosis infect what layer of the skin?

A

dermis

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149
Q

Cellulitis infects what tissue layer?

A

superficial fascia

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150
Q

Necrotizing fascitis infects what tissue layer?

A

subcutaneous tissue

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151
Q

Myonecrosis infects what layer of tissue?

A

muscle

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152
Q

If the following factors are present, then a skin infection can be considered…

  • pre-existing wound
  • deeper tissue involvement
  • needs surgery
  • refractor/recurrent
  • associated with underlying dz
A

Complicated

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153
Q

Recurrent skin infection should raise concern for what

A

MRSA or underlying issues

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154
Q

If a foreign body is present in the skin, what happens to the infectious dose?

A

drops dramatically

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155
Q

This skin infection:

  • disease of sebaceous follicles
  • noninfectious folliculitis
  • teens/young adults
  • androgen trigger
A

acne vulgaris

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156
Q

The following are characteristics of what cause of acne vulgaris?

  • G+
  • Anaerobic Rod
  • Normal Skin flora
  • colonize skin, sebaceous glands
A

propionibacterium acnes

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157
Q

When follicular contents rupture in the dermis, what is the infection now known as?

A

inflammatory acne vulgaris

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158
Q

folliculitis is usually caused by what two bacteria

A

staph. aureus

pseudomonas aeruginosa

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159
Q

if folliculitis doesn’t respond to topical tx, what should be done?

A

gram stain to r/o G- or MRSA

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160
Q

What causes hot-tub folliculitis?

A

pseudomonas aeruginosa

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161
Q

This pathogen which causes folliculitis has the following characteristics:

  • majority of abscess-type infx
  • G+
  • Coagulase +
A

staph aureus

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162
Q

This pathogen which causes folliculitis has the following characteristics:

G- rod

opportunistic

ubiquitous

produces pyocyanin and pyoverdin

A

pseudomonas aeruginosa

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163
Q

carbuncles and furuncles are more common in what 4 populations?

A

obese

immunocompromised

DM

elderly

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164
Q

What is the primary tx for furuncles?

A

incision and drainage

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165
Q

when should abx be considered for furuncles/carbuncles?

A

> 5mm
don’t resolve w/ drainage
evidence of spread
immunocompromised

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166
Q

Abx for carbuncles/furuncles must be able to cover what pathogen?

A

MRSA

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167
Q

A pt. has multiple carbuncle/furuncles, and has a fever. What aggressive therapy can be administered?

A

rifampin

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168
Q

What can prevent recurrence of furuncles?

A

chlorhexidine/isopropyl alcohol soap

maintenance abx

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169
Q

impetigo is caused by what two agents?

A

staphylococci, streptococci

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170
Q

This is a deeper, ulcerative form of impetigo

A

ecthyma

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171
Q

What are the 2 types of impetigo?

A

non-bullous and bullous

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172
Q

What two agents can cause non-bullous impetigo?

A

staph aureus

strep. pyogenes

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173
Q

this type of impetigo has the following characteristics:

  • MC in infants and younger children
  • specific strains of S. aureus only
  • bacterial colonized fluid-filled bullae formed
A

bullous

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174
Q

What causes the formation of bullae in bullous impetigo

A

exfoliative toxin

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175
Q

This is a severe form of impetigo characterized by a deep invasion of the dermis.

hard crust that is deeper, thicker than impetigo

A

ecthyma

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176
Q

when should you consider cx of impetigo/ecthyma?

A

if no response to tx/topical abx

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177
Q

This is a skin disease characterized by the following:

  • acute, extensive epidermolysis
  • nicolsky positive
  • presence of sterile bullae
  • MC children < 6, infants especially
A

staphylococcal scalded skin syndrome (Ritter’s Disease)

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178
Q

What causes the formation of bullae in ritter’s disease?

A

staphylococcal toxin

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179
Q

What abx can be used for scalded skin syndrome?

A

penicillinase resistant penicillan

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180
Q

what should scalded skin syndrome be treated similarly to if extensive disease?

A

tx like burns

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181
Q

describe the mortality rate for scaled skin disease…

A

low, due to 2ry infx

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182
Q

Erysipelas or cellulitis?

  • superficial
  • caused by GAS
  • focal dermal lymphatic involvement
  • well demarcated border
A

erysipelas

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183
Q

What are two severe complications of erysipelas

A

septicemia, meningitis

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184
Q

What three populations are at risk for erysipelas?

A

young children, immunocompromised, older adults

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185
Q

what are the most common sites for erysipelas infx?

A

legs and face

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186
Q

what is the best treatment for erysipelas?

A

PO or IV abx for most-likely agent

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187
Q

Erysipelas or cellulitis?

  • unilateral infection, deeper dermis/subQ tissue
  • indistinct borders
  • localized vesicles, bullae or abscess
  • caused by staph aureus and s. pyogenes
A

cellulitis

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188
Q

What can help monitor the spread of cellulitis?

A

mark borders of rash

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189
Q

Where is cellulitis most common?

A

lower extremety

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190
Q

Cellulitis may result from infected skin breakage or endogenous seeding. This means that a ______ may not be evident

A

wound may not be evident

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191
Q

What are 3 complications from cellulitis

A

sepsis

local gangrene

necrotizing fasciitis

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192
Q

Cellulitis can be characterized by HEET… which stands for…

A

heat, erythema, edema, tenderness

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193
Q

What to things cause sxs in cellulitis?

A

bacterial toxin

inflammatory response

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194
Q

cellulitis infection is commonly of a ______ etiology

A

mixed

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195
Q

What drugs must be avoided in cellulitis for fear of myonecrosis pain masking?

A

NSAIDs

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196
Q

This common cellulitis pathogen is associated with…

cat bites

A

pasteurella multocida

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197
Q

This common cellulitis pathogen is associated with…

dog bite

A

capnocytphaga

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198
Q

This common cellulitis pathogen is associated with…

fresh water injury

A

aeromonas hydrophilia

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199
Q

This common cellulitis pathogen is associated with…

salt water injuries

A

vibrio vulnificus

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200
Q

This common cellulitis pathogen is associated with…

previous trauma/surgery

A

acinetobacter baumannii

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201
Q

What is the carriage ratae of MRSA?

A

2% in general population

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202
Q

What genes confer resistance that cause MRSA?

A

MEC/MEC-A

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203
Q

A patient presents with a kin infx with the following features…

  • fluctuance
  • yellow/white center
  • central point
  • pus drainage
A

MRSA

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204
Q

What two tests can detect the presence mecA and help dx MRSA

A

PCR and latex agglutination assay

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205
Q

A patient presents with:

  • HEET sxs
  • Pain out of proportion to apparent issue
  • no true pus anywhere, think brown exudate
  • rapid progression
  • pink/purple bullae
  • red/purple patches-blue gray
A

necrotizing fasciitis

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206
Q

What helps dx necrotizing fasciitis?

A

tissue bx

imaging

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207
Q

What differentiates necrotizing fasciitis from cellulitis?

A

failure to respond to abx

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208
Q

what is the tx for necrotizing fasciitis?

A

surgical debridement/amputation

IV abx

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209
Q

Gas gangrene primarily infects muscle tissue and is called…

A

clostridial myonecrosis

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210
Q

What spore forming, G+, anaerobic bacillus accounts for 90% of gas gangrene cases?

A

clostridium perfringens type A

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211
Q

a patient presents with…

rapid onset of pain

bronze skin

edema, tender, crepitant skin

bullae

A

gas gangrene

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212
Q

what causes the crepitus skin in gas gangrene?

A

H2 gas production splitting tissue layers

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213
Q

A gram stain and biopsy in gas gangrene would show…

A

gram variable rods

muscle necrosis

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214
Q

How do you treat gas gangrene?

A

IV abx
hyperbaric oxygen
surgery

215
Q

A patient presents with a fever and sunburn-like whole body rash.

began as soft-tissue inflammation at site of apparent infection

A

toxic shock syndromes

216
Q

What two conditions often occur alongside toxic shock syndrome?

A

bacteremia

necrotizing fasciitis

217
Q

What toxin from staph aureus can cause sxs in toxic shock syndrome?

A

enterotoxin type b - superantigen

218
Q

toxic shock syndrome can occur in what patient population

A

otherwise healthy, no pre-existing skin infx

219
Q

the toxic shock syndrome superantigen causes what?

A

extensive immune response

220
Q

What are the three important genera of dermatophytes?

A

microsporum
trichopyton
epidermophyton

221
Q

______ is the infectious state of dermatophyte disease and can be visualized in 10% KOH prep

A

arthroconidium

222
Q

What laboratory test allows early detection of dermatophyte infection?

A

dermatophyte test medium

223
Q

What dermatophyte antigen is described by:

  • galactomannan peptide antigen
  • crude antigen of dermatophytes
  • CHO component causes immediate response
  • Peptide component causes delayed response
A

Trichopytin

224
Q

This diagnostic for dermatophyte infection has the following characteristics:

  • uses a red color change to indicate positive
  • selective and differential based on CHO fermentation
A

dermatophyte test medium

225
Q

What are the three classifications of dermatophytes?

A

zoophilic
antrophophilic
geophilic

226
Q

Were do dermatophytes like to live on the body?

A

moist areas

227
Q

dermatophyte infection is common worldwide, but most prevalent where?

A

tropics

228
Q

arthrospores are fragment hyphal elements found where on the body?

A

hair, nails, outer skin

229
Q

hair, nails, outer skin can exhibit infx by arthrospores and what other three types of fungal infx?

A

microconidia, macroconidia, sexual spores

230
Q

This is an allergic dermal reaction to fungal antigens in areas devoid of the organism

MC in tinea pedis

A

dermatophytid

231
Q

These fungal species have the following characteristics…

  • not often fluorescent
  • pencil shaped macroconidia with thin walls

PRODUCE:
-spindle shaped hypae

  • microconidia
  • macroconidia
A

trichopyton

232
Q

These fungal species have the following characteristics…

MC cause of tinea capitis

fluoresce under wood’s lamp

PRODUCE:

  • hyphae
  • microconidia
  • large, spindle shaped, multicellular, thick walled macroconidia
A

microsporum

233
Q

MC causative agent of tinea capitis is…

A

M. canis

234
Q

What is the most prevalent dermatophyte infection?

A

tinea pedis

235
Q

How is tinea corporis and tinea cruris transmitted?

A

towels, clothing, linens

236
Q

tinea unguinum is often mistaken for…

A

psoriasis

237
Q

what works better at treating tinea unguium infection, topical or systemic antifungals?

A

systemic

238
Q

tinea unguium causes…

A

onychomycosis

239
Q

This is the most commonly encountered opportunistic mycosis worldwide

A

candidiasis

240
Q

The following are common causes of…

  • absence of competing flora
  • introduction to abnormal site
  • pathologic change in microenvironment
  • inborn/acquired immune defect
  • use of broad spectrum abx
A

candidiasis

241
Q

does candida albicans have virulence factors?

A

not many

242
Q

is the candida germ tube or yeast cell more adhesive?

A

germ tube

243
Q

Under direct microscopy, you notice large G+ cells showing yeast cells, pesudohyphae and true hyphae. What is this indicative of?

A

candida

244
Q

On culture, the presence of what feature helps diagnose candida?

A

germ tubes

245
Q

Tinea versicolor is caused by what?

A

malassezia furfur

246
Q

This fungal species…

  • spaghetti and meatballs arrangement
  • has lipophilic growth factor
  • forms yeast like colonies
A

malassezia furfur

247
Q

this fungal species…

  • extreme halotolerant
  • dimporphic, grows as yeast or mold
  • tropical disease
  • produces bron lesion due to fungus produced melanin
A

hortaea merneckii

248
Q

This ectoparasitic infection:

  • burrowing mite
  • relative to ticks
  • small mite with short legs
A

sarcoptes scabiei

249
Q

Does the male or female scabiei mite lay eggs under the skin?

A

male mite

250
Q

The adult scabies mite develops _____ after hatching

A

2 weeks

251
Q

how long does scabies pruritis/allergic response take to develop with first infection?

A

weeks

252
Q

scabies reinfection can see symptoms how quickly?

A

< 24 hrs

253
Q

What scabies disease?

  • 1 mo incubation
  • crusted, pruritic lesions
  • observed in HIV
  • lesions teeming with mites
A

crusted scabies

254
Q

a patient presents with sxs similar to crusted (norwegian) scabies, but lesions are blood filled/red…

A

pediatric scabies

255
Q

What is applied to the lesion in order to scrape off and capture scabies mites, mite parts, eggs, or feces?

A

mineral oil

256
Q

does ivermectin kill scabies eggs?

A

no

257
Q

What is the preferred tx for scabies?

A

5% permethrine

258
Q

What causes pediculosis?

A

pediculus humanus

259
Q

How long is the egg-to-egg cycle in pediculus humanus?

A

3 weeks

260
Q

vagabond’s disease is a result of pediculosis infection for ______ and manifests with ____

A

years long infestation

darkened, thick skin

261
Q

pediculus humanus causes sxs via…

A

bloodsucking bite irritation

262
Q

What tx for pediculosis?

A

permethrin, OTC

263
Q

Which ectoparasite?

  • 1-4 mm length, laterally compressed
  • blood parasite
  • inject allergic saliva during blood meal
  • short spikes on legs that allow host attachment
A

pulex irritans (flea)

264
Q

Flea or scabies?

  • bites in groups of 3-4, linear
  • raised bumps, halo surrounding site
  • rash on different parts of body
  • non-contagious rash
A

flea

265
Q

Flea or scabies?

  • pimple like rash
  • intense itch at nighttime
  • restricted to one body region due to slow crawl
  • appearance of tunnels
A

scabies

266
Q

What tick species carries rickettsia rickettsii?

A

brown doc tick

267
Q

This is a G-, obligate intracellular, pleomorphic pathogen responsible for RMSF

A

rickettsia rickettsii

268
Q

sxs of RMSF appear how quickly?

A

2-14 days

269
Q

the 1st rash in RMSF appears 2-5 days post-infection and looks like..

A

small, flat, non-pruritic macules

270
Q

The 2nd rash in RMSF appears 6 days post infx and can be described as…

A

red-purple spotted petechial rash

271
Q

development of a petechial rash in RMSF indicates…

A

severe, late infx

272
Q

What is the gold standard for dx of RMSF and at what intervals?

A

indirect immunofluoresence

2 samples 2-4 weeks apart

273
Q

in pregnant patients with mild RMSF, what can be used?

A

chloramphenicol

274
Q

This genera causes african sleeping sickness, chagas and leishmaniasis…

A

trypanosomatids

275
Q

what is the vector for Chagas (american trypanosomiasis)?

A

triatomine bug (kissing bug)

276
Q

What parasitic protozoan is carried on the triatomine bug and responsible for chagas?

A

trypanosoma cruzi

277
Q

What phase of the T. cruzi life cycle:

  • passed in feces at night
  • enter cells near inoculation site and differentiate to amastigotes
A

trypomastigotes

278
Q

This stage of the T. cruzi life cycle sees replication by binarry fission, and differentiation to trypomastigotes to be released to circulation

A

amastigotes

279
Q

What two signs are characteristic of acute chagas?

A

Chagoma

romanas sign (swelling of eyelid)

280
Q

Chronic chagas can see heart and intestinal complications. which is more common?

A

cardiac

281
Q

Presence of trypomastigotes in blood smear indicate what phase of chagas?

A

acute

282
Q

presence of amastigotes on biopsy indicates what phase of chagas?

A

chronic

283
Q

What two lab tests are available for chagas?

A

serology

PCR

284
Q

the antiparasitic drug Benzidazole is only available thru…

A

CDC

285
Q

what type of cancer is linked to EBV infection?

A

burkitt’s lymphoma

286
Q

how long is the incubation period of EBV?

A

1-2 months

287
Q

EBV is an infection of what lymphocytes?

A

B cells

288
Q

Primary EBV viral replication occurs in the _____ and eventually reaches what tissue?

A

primary: oropharynx

reaches lymph nodes

289
Q

how long is the prodrome of flu-like sxs with EBV?

A

3-5 days

290
Q

A patient presents with:

  • ST
  • symmetrical LAD
  • fever

+/- hepatomegaly, increased LFTs, jaundice

A

EBV

291
Q

Atypical lymphocytes called _____ appear in circulation with EBV infection.

A

downey cells

292
Q

What cell type controls EBV infx, but also generates most sxs?

A

T cells

293
Q

What is the peak incidence of EBV infx?

A

17-25

294
Q

how long can EBV be found in saliva?

A

1 mo

295
Q

the presence of ___ antibodies and patient age are keys to EBV dx…

A

heterophile Abs

296
Q

What patient population may not have a strong heterophile Ab response to EBV, therefor making monospot inaccurate?

A

pre-teens

297
Q

how can you confirm EBV infection?

A

Monospot

Serology showing IgM anti capsid antigen and anti-VCA

298
Q

CMV is similar to EBV, except it doesn’t produce what?

A

heterophile antibodies

299
Q

for whom is CMV infection most problematic?

A

immunocompromised and pregnancy

300
Q

Can vaccinated people still get mumps?

A

yes

301
Q

Lyme disease is caused by infection by…

A

borrelia burgdorferi

302
Q

Which disease progresses through stages in a pattern similar to syphilis?

A

lyme disease

303
Q

Which stage of lyme disease?

  • erythema migrans which fades within a month
  • flu-like sxs
A

acute localized (stage 1)

304
Q

Which stage of lyme disease?

  • flu-like sxs
  • assymetric arthritis attacks
  • annular skin lesions
  • +/- hepatitis, meningitis, facial palsy
  • 2 weeks to months after infx
A

subacute disseminated (stage 2)

305
Q

Which stage of lyme disease?

  • longer, persistant arthritis attacks
  • MSK manifestations
  • second-third year after infx
A

Chronic (stage 3)

306
Q

what are the reservoirs for lyme disease

A

rodents, rats, mice, birds

307
Q

Which disease is associated with forest edge locations (i.e. mouse habitat)

A

lyme disease

308
Q

A substantial portion of human lyme infections are transmitted by…

A

nymphal stage ticks, deer tick or black legged tick

309
Q

What serological testing sequence confirms lyme?

A

EIA, if positive, western blot

310
Q

patients infected with lyme are testing positive by what week?

A

4th week

311
Q

Syphilis, EBV, SLE, RA, oral spirochete infx can cause false positives for what disease?

A

lyme disease

312
Q

Patients with symptomatic lyme disease can be treated with…

A

amoxicillin or doxy x 10-21 days

313
Q

Is prophylactic abx for lyme typically done

A

no

314
Q

10-20% of abx treated lyme patients have lingering pain and joint problems. This is called…

A

post-tx lyme disease syndrome

315
Q

What is the main way to prevent lyme infection?

A

control and avoidance of vectors

tick checks

DEET

316
Q

PrEP for lyme is now being done with…

A

monoclonal Ab

vaccine

317
Q

Redmeat allergy is associated with…

A

lone-star tick

318
Q

Which hepatitis?

  • fecal oral route
  • not chronic
A

A/E

319
Q

Which hepatitis?

  • blood/body fluids
  • percutaneous permucosal transmission
  • can be chronic
A

B/C/D

320
Q

HCV is also called…

A

transfusion associated

321
Q

Chronic hepatitis is only possible for which types?

A

B,C,D

322
Q

type D hepatitis is only in patients with what active infx?

A

HBV

323
Q

The subclinical, anticteric course of hepatitis can be recognized by…

A

seroconversion

324
Q

Which course of hepatitis has a high fatality rate?

A

fulminant hepatitis

325
Q

Which hepatitis causes infectious hepatitis?

A

HAV

326
Q

HAV is diagnosed via what laboratory test?

A

Presence of IgM Ab via ELISA

327
Q

What is the treatment for HAV?

A

supportive

328
Q

Is vaccine available for HAV?

A

yes

329
Q

What can be used for HAV PrEP?

A

immunoglobulin

330
Q

What are three major prevention mechanisms for HAV?

A

handwashing

avoid contaminated food

education

331
Q

This hepatitis:

  • infectious cause of 80% of primary hepatocellular carcinoma
  • common cause of chronic hepatitis
A

HBV

332
Q

What is the infectious form of HBV?

A

Dane particle

333
Q

What are three antigens present on the dane particle?

A

HBsAg (surface antigen)

HBcAg (core antigen)

HBeAg (surface antigen)

334
Q

The presence of which HBV antigen is the best indication of an infectious patient?

A

HBeAg

335
Q

What is the major reservoir of HBV?

A

chronic hepatitis patients

336
Q

Who poses the greatest risk for perinatal congenital HBV infx?

A

HBeAg POS mother

337
Q

Who are two populations that are at risk for HBV infection?

A

healthcare workers

IVDU

338
Q

Why do we vaccinate newborns for HBV?

A

90% of HBV infx in newborns become chronic

339
Q

How long is the incubation period for HBV?

A

50-180 days

340
Q

A patient presents with insidious onset of a self-limited infx:

  • fever
  • urticarial rash
  • semetrical arthralgia
A

HBV

341
Q

What percent of HBV infx in adults become chronic?

A

5-10%

342
Q

Which HBV antigens are secreted into the blood stream during infection? The presence of these without Abs to them indicates…

A

HBsAg, HBeAg

presence w/o Abs = chronic state

343
Q

What is the hallmark of initial ongoing HBV infection if present alongside HBsAg?

A

IgM anti-HBc + HBsAg

344
Q

A patient was tested for HBV and has the following results. What does this indicate?

-POS IgG anti-HBc

A

past infx

345
Q

A patient was tested for HBV and has the following results. What does this indicate?

  • POS IgG anti-HBc
  • POS HBsAg
A

chronic infx

346
Q

Detection of which antigen is the best indication of infectious HBV virus?

A

HBeAg

347
Q

A patient was tested for HBV and has the following results. What does this indicate?

POS HBeAg
POS HBsAg

A

chronic infx

348
Q

What test is available to detect HBV Surface antigen?

A

rapid hepatitis tests

349
Q

How is HBV treated?

A

no specific cure, mostly self-limiting

350
Q

How are chronic cases of HBV treated?

A

PEG-Interferon plus antivirals

non curative tx

351
Q

This type of hepatitis requires presence of HBV and is a viral parasite of another virus…

A

HDV

352
Q

HDV can occur under what 2 conditions

A
  1. HBV coinfection

2. Superinfx with chronic HBV

353
Q

Fluminant hepatitis is more likely with…

A

HDV

354
Q

How is HDV diagnosed?

A

ELISA for delta antigen or Abs

355
Q

Does the HBV vaccine also prevent HDV?

A

yes

356
Q

How is HDV treated?

A

PEG-interferon

357
Q

What is the hallmark of HCV?

A

chronic infx (70-85%)

358
Q

Chornic HCV occurs despite the presence of what?

A

high anti-HCV

359
Q

What is the most common cause of HCV?

A

idiopathic

360
Q

What is used for screening for HCV?

A

enzyme immunoassay detectio of HCV Ab

361
Q

Seroconversion occurs when after HCV infection?

A

24 weeks

362
Q

Chronic state and acute phase viremic patients with HCV can escape Ab Enzyme Immonoassay screening. What can be used to confirm HCV?

A

direct assay for virus

363
Q

What is a revolutionary and possible cure for HCV?

A

direct acting antivirals (protease or polymerase inhibiter)

364
Q

In HBV/HCV coinfection, treatment of HCV with DAAs may cause…

A

activation of HBV

365
Q

HCV tends to ____ HBV

A

suppress

366
Q

What is making a new approach to liver transplant in hepatitis patients?

A

new generation drugs

367
Q

What are the two leading causes of liver transplant for hepatitis?

A

cirrhosis and hepatocellular carcinoma

368
Q

Transplant may be the only curative option for which hepatitis viruses?

A

HBV, HCV

369
Q

Can an HCV positive patient donate their liver?

A

yes, due to new therapy

370
Q

HIV often mimics which virus?

A

EBV

371
Q

When is HIV most easily transmitted?

A

early stage, unaware of HIV status

372
Q

AIDS is diagnosed when?

A

severe immune system damage

CD4 < 200

373
Q

The presence of the following indicate HIV or AIDS?

kaposi's sarcoma
pneumocystitis PNA
MAC infx
CMV
crypto
Candidiasis
A

AIDS

374
Q

What are the 4 HIV course classes?

A

fast (3 years to AIDS)

intermediate ( 10 years to AIDS)

Long-term slow progressors (> 10 years years to AIDS)

elite controllers

375
Q

Sequencing of HIV genome has revealed what?

A

entry of HIV to humans several times (early as 1950s)

376
Q

What three cell types are commonly infected with HIV

A

T-helpers, monocytes, macrophages

377
Q

What two receptors must be present on cells for HIV infection?

A

CD4 and chemokine co-receptor

378
Q

What enzyme allows for integration of viral genome to host chromosome?

A

viral integrase

379
Q

HIV mutates quickly, making what method of treatment manditory?

A

multi-drug/combo therapy

380
Q

What is more common worldwide, HIV-1 or HIV-2?

A

HIV-1

381
Q

Which HIV type?

  • slower progression
  • less easily transmitted
  • resistant to NNRTIs
A

HIV-2

382
Q

What is responsible for clinical latency in HIV progression?

A

antibody production

383
Q

HIV is diagnosed via what to Ab tests?

A

EIA + Western blot confirmation

384
Q

Donated blood undergoes direct testing, what tests are used?

A

NAT

385
Q

Donated blood is screened for what two substances?

A

antigen p24 or RNA genome

386
Q

How many people are estimated to be infected with HIV in the US, but not know it?

A

280k

387
Q

Is there a rapid test for HIV?

A

yes

388
Q

What are the three main classes of HIV antivirals?

A

reverse transcriptase inhibitors

protease inhibitors

fusion penetration inhibitors

389
Q

Combo of which two antiviral classes has made a huge difference in managing HIV?

A

reverse transcriptase inhibitors + protease inhibitors

390
Q

viral load under ____ means it is suppressed, and viral load virtually undetectable..

A

< 50

391
Q

viral load over ____ means HIV is reproducing

A

1000

392
Q

How often should HIV patients have viral load testing done?

A

every 90 days

393
Q

HIV has major impacts on which organ system?

A

CNS

394
Q

Are patients in viral suppression contagious?

A

no

395
Q

What are the 5 types of malaria?

A 
vivax
falciparum
malariae
ovale
knowlesi
396
Q

Which two types of malaria are most common?

A

vivax and falciparum

397
Q

The malaria life cycle has two broad phases…what are they

A

mosquito phase and human phase

398
Q

upon injection into humans, plasmodium ______ are transmitted

A

sporozoites

399
Q

Sporozoites travel to what tissue for asexual division?

A

liver

400
Q

sporozoite reproduction in the liver is known as the ______ cycle

A

schizogony

401
Q

What type of life-forms are released during the schizogony cycle of plasmodia?

A

merozoites

402
Q

what form of plasmodium is a vaccine target?

A

sporozoite

403
Q

This phase of plasmodia can infect liver cells or RBCs, initiating the erythrocytic cycle

A

merozoites

404
Q

Once merozoites enter the RBC, they differentiate to a uninucleate cell called a…

A

ring trophozoite

405
Q

Mature trophozoites can become ______ trophozoites which are capable of reinfecting other cells

A

amoeboid trophozoite

406
Q

When the single nucleus of a trophozoite divides, it can form a multinucleated cell called a

A

schizont

407
Q

________ are multinucleated cells that produce erythrocytic merozoites

A

erythrocytic schizonts

408
Q

When an RBC lyses, merozoites escape and what two reproductive cycles can occur?

A

schizogony or gametogony

409
Q

Do plasmodia gametocytes cause RBC lysis?

A

no

410
Q

What is the fate of gametocytes in RBC?

A

uptake during mosquito blood meal, sporozoite production, changes within mosquito, resistance

411
Q

The release of what substance intensifies symptoms of malaria?

A

tumor necrosis factor

412
Q

fever and chills in malaria correspond to the release of what substance after RBC lysis?

A

pyrogen

413
Q

Does malaria have local or systemic effects?

A

systemic

414
Q

What is the only malaria vaccine? what is it effective against? What is the half life

A

mosquirix, falciparum, t1/2 = 5 years

415
Q

What two host resistance factors confer resistance to malaria?

A

duffy antigen

sickle cell

416
Q

which type of malaria?

  • seldom fatal
  • infects young erythrocytes
  • fever paroxysms every 48 hours
  • chills, shaking for 15 minutes plus systemic sxs
A

vivax

417
Q

Fever and chills in vivax infection are due to…

A

RBC schizonts

418
Q

Relapse can occur in vivax due to the activation of…

A

liver hynozoites

419
Q

Where is vivax most common?

A

carribean, latin america

420
Q

What is the reservoir for vivax?

A

humans

421
Q

What type of malaria?

Giemsa stain showing:

-Schuffner’s dots

A

vivax

422
Q

Which type of malaria?

  • high grade parasitemia
  • very high fever due to high parasite load
  • assoc. w/ blackwater fever
  • fast moving
  • targets all RBCs
A

falciparum

423
Q

A patient presents with:

high Hb in urine

dark/black urine

autoimmune destruction of kidney

chillds, fever, rigor

A

blackwater fever, falciparum

424
Q

Falciparum can lead to capillary obstruction. This occurs why?

A

RBC destruction leads to sticking in endothelium

425
Q

this falciparum complication results in:

  • occlusion of capillaries with parasitized RBCs
  • necrosis, hemorrhage, fever, mania, convulsions and possibly death
A

cerebral malaria

426
Q

this falciparum complication results in:

frequent vomiting

A

gastric falciparum malaria

427
Q

this falciparum complication results in:

cool skin but high internal temperature

sign of serious disease

A

algid malaria

428
Q

Does falciparum have a hynozoite stage?

A

no

429
Q

Which plasmodium species?

double or multiple ring stages

crescent shaped gametocyte

maurers clefts

young tophozoites and gametocytes

A

falciparum

430
Q

What type of malaria?

  • infects older RBCs
  • 4th day paroxysms
  • primate reservoir
  • basket/band shaped trophozoites
  • rosette shaped schizonts
A

malariae

431
Q

which type of malaria?

similar to vivax

forms hynozoite

common to west africa

A

ovale

432
Q

What type of malaria?

zoonotic

can be fatal

southeast asia

A

knowlesi

433
Q

What geologic characteristic has made malaria worse?

A

climate change

434
Q

What is the main mechanism for increased malaria resistance?

A

efflux pumps

435
Q

What is the causative agent of babesiosis/nantucket island fever?

A

babesia microti

436
Q

This disease:

  • prevalent in new england during warm months
  • increasing issues with blood donation
  • deer tick vector
A

bebesia microti

437
Q

The sxs of babesiosis are clinically similar to…

A

malaria

438
Q

What is typical on the skin for babesiosis?

A

pinpoint lesions

439
Q

Babesiosis is often coinfected with…

A

lyme disease

440
Q

The following morphology/symptomatology suggests…

cross like structure in RBCs

sxs similar to falciparum

A

babesiosis

441
Q

This is the destruction of motor neurons in the spinal cord resulting in asymmetric flaccid paralysis…

A

poliomyelitis

442
Q

Polio is a ______ virus

A

picorna

443
Q

What clinical syndromes can be present in polio infection? (5)

A
  1. inapparent infection
  2. abortive illness
  3. nonparalytic poliomyelitis
  4. paralytic poliomyelitis
  5. Post-polio syndrome
444
Q

This is the most common clinical syndrome of poliovarus. It often appears asymptomatic or with minor malaise

A

inapparent infx

445
Q

The presence of antibodies in HIV indicates a good/bad prognosis?

A

bad, will eventually die of HIV or related infx

446
Q

this clinical syndrome of polio virus has the following characteristics:

  • flaccid paralysis from lower motor neuron damage
  • effects less than 1%
  • rarest
A

paralytic poliomyelitis

447
Q

This polio virus syndrome has the following characteristics:

  • muscle weakness, pain, fatigue in polio patients
  • can occur 30+ years after acute case of paralyzing polio
A

post-polio syndrome

448
Q

What causes failure of remaining CNS motor units in post-polio syndrome?

A

overuse

449
Q

Salk discovered which polio vaccine?

A

inactivated polio vaccine

450
Q

Which polio vaccine has the following characteristics?

  • injected, virus killed
  • prevents disease/paralysis but not infection
A

inactivated polio vaccine

451
Q

Which polio vaccine is a trivalent oral polio vaccine, discovered by Sabin

A

Live polio vaccine

452
Q

Which polio vaccine has the following characteristics?

  • live-attenuated
  • multiplies, infects, immunizes community
  • back mutation to a wild type of polio is known, and 10 US cases per year
A

live polio vaccine

453
Q

does rabies vaccine occur before or after infx?

A

after

454
Q

Which vaccine is used in the US?

A

IPV

455
Q

What are the usual vectors for arboviruses?

A

mosquitos and ticks

456
Q

What are the animal reservoirs for arboviruses in the US?

A

birds and small mammals, often unapparent infx

457
Q

Which type of arbovirus?

  • alphaviruses
  • Eastern, Western, Venezuelan Equine Encephilitis
A

togaviridae

458
Q

Which type of arbovirus?

  • st. louis encephalitis
  • wet nile virus
  • dengue
A

flaviviridae

459
Q

Which arbovirus type?

-california encephalitis

A

bunyaviridae

460
Q

A patient presents with the following manifestations. what type of virus is responsible?:

  • often subclinical
  • fever, HA, vertigo, NV, Photophobia
  • AMS, focal/general seizure
A

Arboviruses

461
Q

Which virus is a flavivirus, closely related to yellow fever and St. Louis encephalitis?

A

west-nile

462
Q

There is an antigenic cross reaction between west-nile and what two viruses?

A

yellow fever

st. louis encephalitis

463
Q

Describe the change in distribution of west-nile virus since 2000?

A

more widespread

464
Q

What are 4 important historical clues that can point you towards west-nile?

A

travel hx, time of year, location, age

465
Q

Which tests for WNV test for specific IgM Ab in the CSF or serum?

A

MAC-ELISA

466
Q

MAC-ELISA for WNV may show antigenic cross reactions with what 4 other diseases?

A

yellow fever
dengue
japanese encephalitis
st. louis encephalitis

467
Q

are people with post-polio syndrome infectious?

A

no

468
Q

What may induce long-lasting positive IgM titers for WNV?

A

yellow fever, japanese encephalitis vaccine

469
Q

How is west nile treated?

A

supportive care

470
Q

During arbovirus infections, days 0-5 after onset can sometimes be detected/dx with… is this reliable?

A

acute serum, RT-PCR

not reliable

471
Q

diagnosis of arbovirus infx is most reliably made with what test?

A

convalescent serum, IgM ELISA

472
Q

Positive IgM ELISA for arbovirus indicates…

A

infection

473
Q

What are the dead end hosts of arboviruses?

A

horses, humans

474
Q

Immunization of horses and non-human amplifying hosts can help control ____virus infection

A

arbovirus

475
Q

What are two major ways to prevent arbovirus infection?

A

eradicate vector

avoid exposure

476
Q

What are 2 ways of Zika transmission?

A

mosquito bite, STI

477
Q

What prevents zika infection? (2)

A

mosquito avoidance, education

478
Q

Diagnosis of Zika is made using what two tests?

A

nucleic acid test/PCR

MAC ELISA

479
Q

Zika shows antigenic cross reaction with flaviviruses such as…

A

dengue

480
Q

A major concern of zika virus is___

A

teratogenic

481
Q

This disease is considered invariably fatal once symptoms become overt…

A

Rabies

482
Q

Describe the incubation period of rabies…

A

2-16 weeks to years

483
Q

How long does it take for death to occur when rabies symptoms appear?

A

5-6 days

484
Q

A patient presents with the following, concerning for…

  • mild fever
  • pharyngitis
  • HA
  • pain/burning at site of inocculation
  • increased sensory sensitivity
A

Rabies

485
Q

Rabies diagnosis depends on what two factors?

A

exposure to bite plus symptoms

486
Q

What test should be used on the suspected rabid animal vector?

A

FA test

487
Q

What animal contact should be immediately suspicious of rabies?

A

bats

488
Q

This virus is an enveloped, bullet shaped virus in the rhabdovirus family…

A

rabies

489
Q

Negri Bodies are eosinophilic inclusion bodies that are pathognomonic for…

A

rabies

490
Q

What are the rabies reservoirs in US, Canada and Europe?

A

skunks, raccoons, foxes, bats

491
Q

What is the number 1 cause of viral encephalitis in the US yearly?

A

WNV

492
Q

a retrospective study showed that majority of human rabies cases have/haven’t been linked to bites

A

haven’t, simple contact

493
Q

How successful is the Milwaukee protocol in rabies tx?

A

fails as often as succeeds

494
Q

What are the 3 ways to prevent rabies?

A

avoidance

prophylactic vaccination of animals

post exposure vaccination

495
Q

The rabies vaccine is given with______ after contact with a reservoir…

A

hyperimmune serum

496
Q

The quadrivalent vaccine for meningococcal meningitis is a ______ conjugate that covers which serotypes?

A

polysaccharide-protein

A,C,Y, W135

497
Q

Which media is selective for menigococcal meningitis, containing sheep RBCs and antibiotics?

A

Thayer-Martin Agar

498
Q

Menigococcemia will present with what characteristic lesions?

A

petechial lesions

499
Q

What two diagnostic tests detect capsular polysaccharide of menigococcal meningitis in CSF?

A

PCR, agglutination

500
Q

A non-blanching (tumblr test positive) petechaial and pink macular rash can indicate what infection?

A

meningococcemia

501
Q

DIC and gram negative shock can occur in what condition?

A

meningococcemia

502
Q

Who is the only reservoir for menigococcus?

A

humans

503
Q

Meningococcus infx requires what kind of contact?

A

close contact

504
Q

What pathogen is the causative agent of meningococcal meningitis?

A

N. meningitidis

505
Q

This is a fastidious, G-, kindey bean shaped diplococcus…

A

n. meningitidis

506
Q

What two factors have significantly declined the incidence of meningitis?

A
  1. vaccine

2. universal GBS screening of pregnant women

507
Q

S. Pneumoniae
H. Flu
N. Meningitidis

these pathogens colonize the respiratory tract and are responsible for _____ acquired meningitis

A

community acquired

508
Q

What is the most common way that pathogens gain access to the CNS to cause meningitis?

A

bacteremia and seeding to CNS

509
Q

Fever, HA, Neck stiffness indicates…

A

meningitis

510
Q

Comparing serum glucose to CSF glucose should show a decreased level in which fluid?

A

CSF

511
Q

A pediatric patient presents with the following. These sxs are concerning for…

bulging fontanelle
high pitched cry
hypotonia
paradoxic irritability
hyperthermia
A

neonatal bacterial meningitis

512
Q

Which three pathogens are common causes of neonatal meningitis?

A

S. agalactiae (G+), MC
Listeria (G+)
E. Coli (G-)

513
Q

Vaginal and rectal screening should occur for all pregnant women between 35 and 37 weeks gestation for what?

A

GBS (s. agalactiae)

514
Q

This is a G+ coccus with narrow zone of beta-hemolysis.

A

S. agalactiae

515
Q

Capsular Polysaccharide
Hyaluronidase
Collagenase
Hemolysin

These are virulence factors on which organism?

A

S. agalactiae

516
Q

Early or Late onset neonatal GBS ifx?

maternal obstetric complication

sxs in 1st 5 days of life

bacteremia, pneumona, meningitis

A

early onset

517
Q

Early or Late onset neonatal GBS ifx?

maternal obstetric complications uncommon

sxs 7 days to 3 mo of age

severe

bone/joint infx, bacteremia, fulminant meningitis

A

Late onset

518
Q

Lab tests for s. agalactiae can look for ______ factor, which shows accentuation of hemolysis due to interaction with staph beta lysin

A

CAMP factor

519
Q

What offers definitive diagnosis of S. agalactiae?

A

isolation from blood, CSF

520
Q

AccuProbe DNA probe can give a presumptive dx of …

A

s. agalactiae

521
Q

E. Coli is an important cause of neonatal meningitis whose source is…

A

not endogenous

rectal colonization of mother’s vagina

522
Q

What is the MC cause of bacterial meningitis?

A

s. pneumo

523
Q

Acute purulent meningitis following PNA, other infection, or no apparent infection describes the etiology of…

A

S. pneumo

524
Q

This meningitis causing pathogen has the following characteristics:

  • non-motile, G- coccobacillus
  • contains LOS, which is similar to LPS
  • associated with URI or AOM
A

H. Flu

525
Q

This meningitis agent has the following pattern:

  • several days of mild antecedent infx
  • following deterioration, signs, sxs of meningitis
A

H. flu

526
Q

This pathogen is a G+ motile coccobacillus. It is non-fastidious and growth between 0-50 degrees C.

It is a facultative intracellular pathogen

A

Listeria

527
Q

What are two main virulence factors on listeria?

A

LPS like surface component

Listeriolysin O

528
Q

Which listeria virulence factor has the following characteristics?

  • antiphagocytic
  • responsible for complement dependent hemolytic abs
A

LPS like surface component

529
Q

Which listeria virulence factor has the following characteristics?

disrupts phagolysosome membrane

inhibits antigen processing

induces apoptosis

A

listeriolysin O

530
Q

What are 2 main manifestations of listeriosis?

A

sepsis, meningitis

531
Q

Listeria grows on what media?

A

blood agar

532
Q

You see “tumbling” motility on culture. This indicates what infection?

A

listeriosis

533
Q

What is the test of choice for diagnosing listeriosis?

A

DNA probe (accuprobe)

Microbiology (13 decks)

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