FA Micro II Flashcards
1
Q
Which kind of neisseria is sexually transmitted
A
gonococci
2
Q
What does gonococi cause
A
gonorrhea, septic arthritis, neonatal conjunctivitis, PID, fitz-hugh curtis
3
Q
What does meningococci cause
A
meningitis, waterhouse friderichsen,
4
Q
What drug is give as prophylaxis for close contacts of of meningococci
A
rifampin
5
Q
haEMOPhilus causes….
A
epiglottitis (cherry-red in kids) meningitis, otitis media and pneumonia
6
Q
what is the most invasive H flu disease caused by and what virulence factor does it produce
A
type B protease IgA
7
Q
What are the laboratory findings for H Flu
A
gram neg coccobacillary rods, cultured on chocolate agar with factors V and X NAD+ and hematin OR with S. aureus
8
Q
What is the treatment for meningitis from H flue
A
ceftriaxone, rifampin for close contacts
9
Q
What is the H flu vaccine
A
type B capsular polysaccharide conjugated to diptheria toxoid or other protein
10
Q
When is H flu vaccine give
A
between 2 and 18 months
11
Q
What is legionnaires disease
A
severe pneumonia
12
Q
What is pontiac fever
A
mild flulike symptoms with legionella
13
Q
What are the laboratory findings of legionella
A
gram neg rod, poor gram stain, use silver stain, grow on charcoal yeast extract with iron and cysteine
14
Q
How is legionella detected clinically
A
antigen in urine
15
Q
How is legionella transmitted
A
aerosal, from environmental water source
16
Q
Is there person to person transmissino of legionella and what is the TX
A
no, erythromycin
17
Q
What are the assiaction of pseudomonas and what can it cause
A
wound and burn infectinos - Pneumonia in CF, sepsis, external otitis (swimmer’s ear), UTI, drug use and diabetic osteomyelitis and hot tub follculitis
18
Q
What malignancy is pseudomans associated with in diabetics
A
malignant otitis externa
19
Q
What are the lab findings of pseudomonas
A
aerobic gram pos rod, non lactose fermenting, oxidase pos, blue-green pigment, grapelike odor
20
Q
What is the source of pseudomonas and what does virulence factors does it have
A
water source, endotoxin causing fever and shock, exotoxin A (inactivates EF-2)
21
Q
What is the TX for pseudomonas
A
aminoglycoside plus extended spectrum pen (pipercillin, ticarcillin)
22
Q
what are the different virulence factors in E. coli and what do they cause
A
fimbriae- cystitis and pyelonephritis; K capsule - pneumonia, neonatal meningitis, LPS endotoxin - septic shock
23
Q
What is the presentation of EIEC and what is the mechanism of the toxin
A
invasive, dysentary - shiga like toxin; microbe invades mucosa and toxin causes necrosis and inflammation
24
Q
What is the presentation of ETEC and what is the mechanism of the toxin
A
traveler’s diarrhea -labile toxin/stable toxin - no inflammatino or invasion
25
What is the presentation of EPEC and what is the mechanism
diarrhea in children - no toxin, adheres to apical surface, flattens villi, prevents absorption
26
What is the presentation and mechanism of toxin in EHEC
dysentery from shiga like toxin, O157:H7 is common serotype, produces HUS
27
What is the triad of HUS
anemia, thrombocytopenia, acute renal failure
28
What is the mechanism of renal failure and thrombocytopenia in HUS
endothelium swells and narrows lumen, leading to mechanical hemolysis and reduced renal blood flow - damaged endothelium consumes platelets
29
How do you distinguish EHEC from other kinds of E. Coli
does not ferment sorbitol
30
Intestinal flora that causes lobar pneumonia in alcoholics and diabetics when aspirated
klebsiella
31
What color is the sputum in klebsiella infxn an besides pneumonia, what else can it cause
red current jelly, nosocomial UTI
32
What features are common to both salmonella and shigella
both are lactose fermenters, both invade intestinal mucosa and can cause blood diarrhea
33
What features are unique to salmonella
have flagella, disseminate hematogenously, produce H2S, symptoms can be prolonged with Abx, typically a monocytic response
34
What feature is unique to shigella
more virulent - 10^1 vs 10^5 organisms
35
What does salmonella typhi cause
fever diarrhea, headache, rose spots on abdomen
36
Where can salmonella typhi remain chronically
gallbladder
37
What is the resevoir of salmonella
animal, except typhi - only in humans
38
How do shigella propel themselves without flagella
actic polymerization
39
What is the mode of transmission of salmonella and shigella
food, fingers, feces, flies
40
This bacteria is a majore cause of bloody diarrhea, esp in children, fecal-oral transmission through mean (poultry, met unspasteurized milk
campylocobacter jejuni
41
What shape are campylobacter and what are the lab findings
comma shaped, s-shaped, oxidase positive, grows at 42 C
42
Campylobacter is a common antecedent to what neurologic disorder
guillain barre
43
What does infxn with vibrio cholerae produce and how does it produce it
profuse rice water diarrhea via toxin that permantnely activates Gs inc cAMP
44
What are the lab findings for cholera
comma shaped, oxidase positive, grows in alkaline media
45
What treatment is required for cholera
prompt oral rehydration
46
this bacteria is usually transmitted from pet feces, contaminated milk or pork - what does it cause
yersinia, enterocolitica - diarrhea (in day care centers), causes mesenteric adenitis
47
What other disease can mesenteric adenitis mimic
crohns or appendicitis
48
This bacteria causes gastritis and up to 90% of duodenal ulcers, risk factor for peptic ulcer, gastric adenocarcinoma, lymphoma
H. pylori
49
What are the lab findings for H pylori
gram neg rod, urease pos, creates alk envrionment
50
What is the TX for h pylori
triple therapy - metronidazole, bismuth, either tetracycline or amoxicillin OR metro, omeprazole and clarithromycin
51
Which bacteria are spirochetes
Borrelia, leptospira, treponema
52
Which spirochete can be visulized using aniline dyes in light microscopy
only borrelia
53
How is treponema visualized
dark field microscopy
54
What question mark shaped bacteria is found in water contaminated with animal urine and what does it cause
leptospira interrogans - flulike symptoms, fever, HA, abdominal pain, jaundice, and photophobia with conjuctivitis
55
Who mostly gets infected with leptospira
surfers in the tropics
56
What is weil's disease
icterohemorrhagic leptospriosis - sever form with jaundice and azotemia from liver and kidney dysfxn, ; fever hemorrhage and anemia
57
What bacteria causes Lyme disease, how is transmitted, how does it present, and what other systems does it effect
borrelia burgdorferi, transmited by Ixodes, erythema chronicum migrans (bulls eye rash with central clearing) effects joints, CNS and heart
58
What are important resevoirs for borrelia and what animal is required for tick life cycle
mice, deer
59
How do you treat lyme disease
doxycycline and ceftriaxone
60
What happens in stage 1 of lyme disease
bulls eye rash, flulike symptoms
61
What happens in stage 2 of lyme disease
neurologica like bell's palsy and cardiac AV block
62
What happens in stage 3 of lyme disease
chronic monoarthritis and migratory polyarthritis
63
What organism causes syphillis and what happens in primary syphillis
treponema palladium, painless chancre
64
What happens in secondary syphillis
disseminated disease with constintutional symptoms including maculopapular rash on palms and soles, condylomata lata
65
What is present in the condylomata and chancres in primary and secondary syphillis
many treponemas
66
What happens in tertiary syphillis
gummas (chronic granulomas), aortitis (vasa vasorum destruction) neurosyphillis (tabes dorsalis), argyll robertson pupils
67
What are the signs of neurosyphillis
broad based ataxia, positive ataxia, charcot joint, stroke without HTN
68
What test screens for syphillis and what test confirms it
VDRL screens and FTA-ABS
69
What are agryll roberston pupils
accommodate but does not react, associated with tertiary syphillis
70
What is the treatment for syphillis
pen
71
What does VDRL detect, what it is used for and what are the limitations
nonspecific antibody test that reacts with beef cardiolipin, used for screening of syphillis but many biologic false pos including viral infection (mono or hepatitis) some drugs, rheumatic fever, SLE and leprosy (V=viruses, D =drugs R = rheum fever L = leprosy and lupus
72
Cat scratch disease, can cause bacillary angiomatosis in immuncoCised patients, can be confused with KS
bartonella sp
73
lyme dz, ixodes tick that lives on deer and micd
borrelia burgdorferi
74
recurrent fever from variable surface antigen, transmitted by louse
borrelia recurrentis
75
undulant fever, transmitted in dairy products, contact with animals
brucella sp
76
tularemia, tick bite, rabbits and deer
francisella tularenis
77
plague, flea bite, rodents esp prarie dogs
yersinia pestis
78
cellulitis, osteomyelitis from animal bite: cats and dogs
pasteurella multocida
79
pleomorphic gram variable rod that causes vaginosis presenting as gray vaginal discharge with a fishy smell; non painful
gardnerella vaginalis
80
What other organism is involved in vaginosis from gardnerella
mobiluncus, an anaerobe
81
What are the lab findings in gardnerella
clue cells, or vaginal epithelial cells covered with bacteria visible under the microscope
82
What is the TX for gardnerella
metronidazole
83
What is gardnerella associated with
sexual activity, but not an STI
84
What is the classic triad of infxn with rickettsia and what requirements do they need to grow
headache, fever, rash (vasculitis) - obligate intracellular that need CoA and NAD+
85
How are rickettsiae transmitted
all except coxiella are via arthropod
86
How is atypical rickettsiae transmitted
aerosal and causes pneumonia
87
What is the treatment for rickettsiae
doxycycline
88
what is the organism for rocky mountain spotted fever (tick)
rickettsia rickettsii
89
what is the organism for endemic typhus (fleas)
R. typhi
90
What is the organism for endemic typhus (human body louse)
R. prowazekii
91
What is the organism and histological findings for ehrliciosis
Ehrlichia: no rash, granulocytes with berry cluster organisms
92
What is the organism and vector for Q fever
tick feces and cattle placenta release spores that are inhaled as aerosols - coxiella burnetti
93
What is the TX for rickettsiae
doxycycline
94
Where does the rickettsiae rash start and where does the typhus rash start
rickettsiae starts on hands and feet, typhus starts centrally and spreads outwards without involving palms or soles
95
What kind of result is expected from the Weill Felix test in Q fever
negative
96
Patient serum mixed with proteus antigen, and anti-rickettsial antibodies cross react to proteus O antigen and agglutinate
Weil Felix test
97
What are the symptoms of Rocky Mountain spotted fever
rash on palms and soles migrating to wrists, ankles and then trunk, headach fever - endemic to east coast
98
What 3 things cause rash on palms and soles
coxsackie A, rocky mountain spotted fever and syphillis (CARS)
99
Why are chlamydiae obligate intracellular
can't make their own ATP - cause mucosal infections
100
What are the two forms for chlamydiae
elementary body - small dense is infectious and enters via endocytosis,; reticulate body replicates in cell by fission, seen in tissue culture
101
what chlamydiae cause reactive arthritis, conjunctivitis, nongonococcal urethritis, PID
chlamydia trachomatis
102
atypical pneumonia, transmitted by aerosal - two organisms chlamydiae
pneumoniae and psittaci
103
In the chlamydiae replication cycle, what is released from a lysed host cell
elementary body
104
In the chlamydiae replication cycle, what undergoes binary fission and where
reticulte body, in cytoplast of host
105
What is the resevoir for chlamydiae psittaci
avain resevoir
106
what does the chylamidial cell wall lack
muramic acid
107
How is chlamydia DX is lab
cytoplasmic inclusions seen on giemsa stain or fluorescent antibody-stained smear
108
Of the serotypes of chlamidyia trachomatis, which cause chronic infection and blindness due to follicular conjunctivitis in Africa
ABC
109
Of the sereptypes of chlamydia trachomatis, which cause urethritis/PID ectopic pregs, neonatal pneumonia with staccato cough, or neonatal conjunctivitis
D-K
110
Of the serotypes of chlamydia trachomatis, which cause lymphogranuloma venereum
L1, L2, L3
111
What causes granuloma inguinale (donovanosis)
klebsiella granulomatis
112
What is the TX for chlamydia
azithromycin
113
What is the classical presentation of mycoplasma pneumonia
insidious onset, HA, non productive cough, diffuse interstitial infiltrate
114
What tod the lab studies show for mycoplasma pneumonia
bad xray, worse than pt, high titer of cold agglutinins (IgM) which can agglutinate or lyse RBCs - grown on Eaton's agar
115
Why aren't myccolasma seen on gram stain
no cell wall
116
Mycoplasma pneumoniae is the only bacterial membrane containing what substance
cholesterol
117
In what age group is mycoplasma seen, and what groups are outbreaks common
<30, military, prisons
118
What is the TX for mycoplasma pneumonia
tetracycline or erythromycin
119
What are the key features of systemic mycoses
can cause pneumonia and disseminate - all are dimorphic fungi except coccidiodomycosis which is a spherule in tissue - tx is fluconazole/ketoconazole for local and amphotericin B for systemic - can mimic TB except no person to person infxn
120
This fungi can be found in bird/bat droppings or within macrophages and causes pneumonia - where is it endemic
histoplasmosis - mississippi and ohio river valley
121
This fungi forms broad based buds, causes inflammatory lung diease and can disseminate to skin and bone - forms granulomatous nodules - where is endemic
blastomycosis - states east of mississippi river and central america
122
This fungi causes pneumonia and meningitis can disseminate to bone -cases inc after earthquakes - name of dz, classic histo finding and endemic area
coccidiodiomycosis, southwestern US, CA, San Joaquin Valley valley fever, spherules
123
Latin american, captain wheel appearance
paracoccidioidomycosis
124
Spaghetti and meatball appearance on KOH prep- dz, organism
tinea versicolor, malassezia furfur
125
What is the pathophys of tinea versicolor
degradation of lipids produces acids that damage melancytes and cause hypopigmented and or hyperpigmented patches - occurs in hot humid weather
126
What is the treatment for tinea versicolor
topocal miconazole, selenium sulfide
127
pruritic lesions with central clearing resembling ring - dz and organism
tinea pedis, cruris, corporis, capitis - dermatophytes: microsporum, trichophyton, epidermophyton
128
What is seen on with the dermatophytes with KOH prep
mold hyphae, not dimorphic
129
What is the resevoir for Microsporum and what is the management
pets, treat with topical azoles
130
What are the lab findings for candida albicans
dimorphic: yeast with pseudohyphae in culture at 20C, germ tube formation at 37C (diagnostic)
131
What does candida result in with immunoCised pts
oral and esophageal thrush
132
What does candida result in with diabetic pts and Abx usage
vulvuvaginitis
133
Other than thrush and vaginitis, what are the other clinical manifestations or candidiasis
diaper rash, endocarditis in IVDU, disseminated candidiasis, chronic mucocutanous candidiasis
134
What is the TX for candidiasis
nystatin for superficial, ampho B for systemic
135
What do lab diagnostics show for aspergillus
mold with septate hyphae that branch at acute angles
136
What does aspergillus cause
allergic bronchopulmonary aspergillosis, lung cavity aspergilloma "fungus ball" invasice aspergillosis in immunoCised pts and those with chronic granulomatous disease
137
How is cryptococcus diagnosed in the lab and where is it found
heavily encapsulate yeast, not dimorphic culture on saboouraud's agar, india ink stain, found in soil pigeon droppings - latex agglutination test detects polysaccharide capsular antigen
138
What does cyrptococcus result in clinically
cryptococcal meningitis, cryptococcosis, soap bibble lesions in brain
139
How are mucor and rhizopus diagnosed in the lab
mold with irregular nonseptate hyphae branching at wide angles
140
How does mucomycosis present clinically
mostly in DKA pts and leukemic pts, rhinocerebral, frontal lobe abscesses, HA, facial pain, black necrotic eschar on face, cranial nerve involvement
141
What is the pathophys of mucor
fungi proliferate in blood vessel walls when there is excess ketone and glucose, penetrate cribiform plate, and enter
142
What does pneumocystis jeroveci cause, how is it diagnosed, and in who do you see it in
interstitial pneumonia, AIDS, diffuse bilateral CXR appearance, dx by lung biopsy or lavage, ID-ed by methanamine silver stain of lung tissue
143
What is the TX for pneumocystis jerovici
TMP-SMX, pentamidine, dapsone - start proph when CD4 drops below 200
144
Is pneumocystis a fungus or a protazoan
yeast - protazoan
145
Dimorphic fungus that lives on vegetation - traumatically introduced into the skin causes local pustule or ulcer with nodules along draining lymphatics - little systemic illness
sporothrix schenckii
146
Who typically gets sporothrix
rose gardner's
147
What is the TX for sporthrix
itraconazole or potassium iodide
148
How do sporothrix appear on microscopically
cigar shaped yeast
149
How do pneumocystis appear microscopically
saucer shaped yeast forms
150
bloating, flatulence, foul-smelling fatty diarrhea seen in campers/hikers - infection, transmission, dx, and tx
giardia, cysts in water, trophozoites or cysts in stool, metronidazole
151
bloody diarrhea, reddish brown liver abcess, RUQ pain - flask shaped ulcer; dz, transmission, dx, and tx
entamoeba his, cysts in water, serology/trophozoites or cysts in stool/RBC in cytoplasm of entamoeba, metronidazole and iodquinol
152
sever diarrhea in AIDS, mild disease with watery diarrhea in immunoCtent - dz, transmission, dx, and tx
cryptosporidium, cysts in water, cysts on acid-fast stain, prevention (clean water) no tx
153
brain abscesses in HIV - classic triad of chorioretinitis, hydrocephalus, intracranial calcifications - dz, transmission, dx, and tx
toxoplasma, cysts in meat or cat feces, serology/biopsy, sulfadiazine + pyrimethamine
154
How does toxoplasmosis appear on CT/MRI in HIV pts
ring enhancing brain lesions
155
Why are pregnant women told to avoid cats
toxo crosses the placenta
156
rapidly fatal meningoencephalitis after swimming- dz, transmission, dx and tx
naegleria fowleri, freshwater lakes through cribiform plate, amoebas in spinal fluid, amphotericin for survivors
157
African sleeping sickness: enlarged lymph nodes, recurring fever - organism, transmission, dx, tx
trypanosoma bruceii, tsetse fly (painful bite), blood smear, suramin for blood borne, melarsoprol for CNS infxn
158
what species of trypanosoma other than bruceii cause african sleeping sickness
gambiense, rhodesiense
159
dilated cardiomyopathy, megacolon, megaesophagus in south america - dz, organism, transmission, dx and tx
chagas dz, trypanosoma cruzi, reduviid bug, blood smear, nifurtimox
160
protozoa causing spiking fevers, hepatosplenomegaly, pancytopenia - dz, org, transmission, dx, tx
visceral leishmaniasis, donovani, sandly, macrophages containing amastigotes (lack flagella), sodium stibogluconate
161
48 hr cyclic fever, HA, splenomegaly - dz, organism, transmission, dx and tx
malaria, plasmodium, anopheles, blood smear, cholorquine -resistant use mefloquine and for vivax/ovale add primaquine for dormant forms
162
what is the fever cycle for p. vivax/ovale
cycles occur every other day: dormant form in liver
163
what is the fever cycle for p. falciparum
severe, daily cycles - parasitized RBCs occlude capillaries in the brain, kidneys and lungs
164
Cyst with four nuclei
entamoeba hisotlytica
165
trophozoite ring form in RBC
plasmodium
166
fever, hemolytic anemia, northeastern US, maltese cross (and ring) - dz, transmission, dx and tx
babesiosis, ixodes, blood smear, quinine and clindamycin
167
foul-smelling greenish vaginal discharge, itching, burning - protozoa, transmission, dx and tx
trichomonas, sexual, motile trophozoites on wet mount, metronidazole
168
intestinal nematode causing anal pruritis, scotch tape test - org, transmission, tx
enterobius verniculum (pinworm, nematode), food contaminated with eggs, bendazoles or pyrantel pamoate
169
intestinal nematode causing infection, eggs are visible in feces - org, tx
acsaris lumbricoides (giant roundworm), bendazole or pyrantel pamoate
170
intestinal nematode causing inflammation of muscle, periorbital edema - org, transmission, dx, tx
trichinella spiralis, undercooked meat usually pork, larvae encyst in muscle, bendazoles
171
nematode causing intestinal infection, vomiting, diarrhea, anemia - org, transmission, tx
strongyloides stercoralis, larvae penetrate skin, bendazoles or ivermectin
172
intestinal nematode can cause anemia by sucking blood from the intestinal walls - orgs, transmission, tx
ancylostoma duodenale, necator americanus, larvae penetrate skin of feet, bendazoles or pyrantel pamoate
173
tissue nematode causing skin inflammation and ulceration - org, transmission, tx
dracunculus medinensis, in drinking water, niridazole
174
tissue nematode causing hyperpigmented skin and river blindess, allergic reaction to microfiliria - org, transmission, tx
onchocerca volvulus, female blackfies, ivermectin
175
tissue nematode that causes swelling in the skin and can see worms crawling in the conjunctiva - org, transmission, tx
loa loa, deer/horse/mango fly, diethylcarbamazine
176
tissue nematodes tha causes blockage of the lymphatic vessels (elphantitis) - org, transmission, clinical course, tx
wuchereria bancrofti, femile mosquito, 9 months to 1 year after bite to develop symptoms, diethylcarbmazine
177
tissue nematode causing granulomas (blindness if in the retina) and visceral larva migrans - org, transmission, tx
toxocara canis, food contaminated with eggs, diethylcarbamazine
178
cestode causing intestinal tapeworms - org, transmission, tx
taenia solium, ingestion of larvae encysted in undercooked pork, praziquantel
179
cestode causing cysticercosis - org, transmission, tx
taenia solium, ingestion of eggs, praziquantal
180
cestode causing neurocysticercosis - org, transmission, tx
taenia solium, ingestion of eggs, bendazole
181
cestode causing B12 deficiency and anemia - org, transmission, tx
diphyllobothrium latum, ingestion of larvae in raw freshwater fish, praziquantel
182
cestode causing cysts in liver, anaphylaxis when released from cysts - org, transmission, pre-surgical tx, and tx
echinococcus granulosus, ingested eggs in dogs feces, surgeons inject ethanol before removal to kill daughter cysts, bendazoles
183
trematodes causing granulomas, fibrosis, inflammation of spleen and liver - org, host, transmission, tx
schistosoma, snail, cercariae penetrate skin of humans, praziquantrl
184
What schistosoma species is associated with squamous cell carcinoma, and of what organi
haematobium, bladder
185
trematode causing inflammation of the biliary tract leading to pigmented gallstones - org, transmission, associated cancer, tx
clonorchis sinensis, undercooked fish, cholangiocarcinoma, praziquantel
186
trematode causing inflammation and 2ndary bacterial infection of the lung with hemoptysis - org, transmission, tx
paragonimus westermani, undercooked crab meat, praziquantel
187
Which nematodes are ingested
enterobius, ascaris, trichinella
188
Which nematodes infect through the skin
strongyloides, ancylostoma, necator
189
brain cysts, seizures - parasite
taenia solium, cysticercosis
190
liver cysts - parasite
echinococcus granulosus
191
B12 def - parasite
diphyllobothrium latum
192
biliary tract disease, cholangiocarcinoma - parasite
clonorchis sinensis
193
hemoptysis - parasite
paragonimus westermani
194
portal HTN - parasite
schistosoma mansori
195
hematuria, bladder cancer - parasite
schistosoma haematobium
196
microcytic anemia - parasite
ancylostoma, necator
197
perianal pruritis - parasite
enterobius
198
What causes typhoid fever - tricky Ts
salmonella typhi
199
What causes typhus - tricky Ts
caused by bacteria Rickettsia prowazekki, rickettsia typhi, rickettsia tsutsugamushi
200
What is chlamydia trachomatis - tricky Ts
bacteria, STD
