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Dr. Mel - Microbiology > First Aid > Flashcards

First Aid Flashcards

1
Q

Triad of Rocky Mountain spotted fever

A

Headache
Fever
Rash (wrists, ankles then trunk, palms, soles) (vasculitis)

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2
Q

3 diseases with palms and soles rash

A

Coxsackievirus A
Rocky Mountain spotted fever
Secondary syphilis

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3
Q

Penicillin G (IV/IM) and Penicillin V (oral) used against

A

Gram +
Gram - cocci (N. meningitidis)
Spirochetes

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4
Q

Penicillinase-sensitive penicillins

A

Penicillin G, penicillin V
Ampicillin
Amoxicillin (greater oral bioavailability)

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5
Q

Ampicillin and amoxicillin used against

A

Many G- rods (HHEELPSS)

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6
Q

Penicillinase-resistant penicillins

A

Oxacillin
Nafcillin
Dicloxacillin

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7
Q

Penicillinase-resistant penicillins used against

A

S. aureus except MRSA

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8
Q

Antipseudomonal penicillins

A

Piperacillin

Ticarcillin

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9
Q

Antipseudomonal penicillins used against

A

Pseudomonas spp.

Gram - rods

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10
Q

Beta-lactamase inhibitors

A

Clavulanic acid
Sulbactam
Tazobactam

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11
Q

4 organisms not covered by 1-4th gen of Cephalosporins

A

Listeria
Atypicals (chlamydia, mycoplasma)
MRSA
Enterococci

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12
Q

1st gen Cephalosporins (cefazolin, cephalexin)

A

Gram + cocci
Proteus mirabilis
E. Coli
Klebsiella pneumoniae

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13
Q

2nd gen Cephalosporins (cefaclor, cefoxitin, cefuroxime)

A 
Gram + cocci
H. Influenzae
Enterobacter aerogenes
Neisseria spp.
Serratia marcescens
Proteus mirabilis
E. Coli
Klebsiella pneumoniae
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14
Q

3rd gen cephalosporins (ceftriaxone, cefotaxime, ceftazidime)

A

Ceftriaxone: meningitidis, gonorrhea, disseminated Lyme ds
Ceftazidime: pseudomonas

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15
Q

4th gen cephalosporins (cefepime)

A

Gram -
Pseudomonas
Gram +

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16
Q

5th gen cephalosporins (ceftaroline)

A

Gram +
Gram -
MRSA
(NOT pseudo)

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17
Q

Carbapenems

A

Imipenem
Meropenem
Ertapenem
Doripenem

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18
Q

Carbapenems used against

A

Gram + cocci
Gram - rods
Anaerobes

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19
Q

Monobactams (Aztreonam) used against

A

Gram - rods ONLY

If penicillin allergy or renal insuff who cannot tolerate aminoglycosides

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20
Q

Vancomycin (glycopeptide)

A

Gram + ONLY

Including MRSA, sensitive enterococcus, C. difficile

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21
Q

Protein synthesis inhibitors

A

50S: chloramphenicol, clindamycin, linezolid, macrolides, streptogramins
30S: aminoglycosides, tetracyclines

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22
Q

Aminoglycosides

A 
Gentamincin
Neomycin
Amikacin
Tobramycin
Streptomycin
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23
Q

Aminoglycosides used against

A

Severe Gram - rod infections

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24
Q

Tetracyclines

A

Tetracycline
Doxycycline
Minocycline

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25
Q

Tetracyclines used against

A

Borrelia burgdorferi
Mycoplasma pneumoniae
Rickettsia
Chlamydia

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26
Q

Chloramphenicol used against

A

Meningitis (H. Influenzae, Neisseria meningitidis, Strepto pneumoniae)
Rocky mountain spotted fever (Rickettsia rickettsii)

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27
Q

Clindamycin used against

A 
Anaerobic infections (Bacteroides spp., Clostridium perfringens)
Invasive group A strepto infection
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28
Q

Clindamycin vs Metronidazole

A

Clindamycin: anaerobic infections above the diaphragm
Metronidazole: anaerobic infections below the diaphragm

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29
Q

Oxazolidinones (Linezolid) used against

A

Gram + (including MRSA and VRE)

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30
Q

Macrolides

A

Azithromycin
Clarithromycin
Erythromycin

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31
Q

Macrolides used against

A

Atypical pneumonias (Mycoplasma, Chlamydia, Legionella)
STIs (Chlamydia)
Gram + cocci (Strepto infections if allergy to penicillin)
Bordetella pertussis

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32
Q

Acid folic synthesis and reduction inhibitors

A

Sulfonamides (sulfamethoxazole, sulfisoxazole, sulfadiazine)

Trimethoprim

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33
Q

Sulfonamides used against

A 
Gram +
Gram -
Nocardia
Chlamydia
Sulfamethoxazole for simple UTIs
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34
Q

Dapsone (similar to sulfonamides)

A

Leprosy

Pneumocystis jirovecii prophylaxis

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35
Q

Trimethoprim used against

A 
Combined with SMX for:
UTIs
Shigella
Salmonella
Pneumocystis jirovecii
Pneumonia ttt and prophylaxis
Toxoplasmosis prophylaxis
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36
Q

Gyrase inhibitors

A

Fluoroquinolones (ciprofloxacin, norflo, levoflo, oflo, moxiflo, gemiflo, enoxacin)
Quinolone (Nalidixic acid)

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37
Q

Fluoroquinolones used against

A

Gram - rods of urinary and GI tracts (+ pseudomonas)
Neisseria
Some Gram +

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38
Q

Daptomycin used against

A

Staph aureus skin infections (+ MRSA)
Bacteremia
Endocarditis
VRE

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39
Q

Metronidazole used against

A 
Giardia
Entamoeba
Trichomonas
Gardnerella vaginalis
Anaerobes (bacteroides, C. diff)
H. Pylori (with Clarithromycin + PPI)
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40
Q

Prophylaxis against Mycobacterium

A

M. Tuberculosis: Isoniazid
M. Avium and M. Intracellulare: azithromycin, rifabutin
M. Leprae: -

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41
Q

Mycobacterium treatments

A

M. Tuberculosis: Rifampin, Isoniazid, Pyrazinamide, Ethambutol
M. Avium - M. Intracellulare: Azithromycin or Clarithromycin + Ethambutol. Can add Rifabutin or Ciprofloxacin
M. Leprae: for tuberculoid, long-term Dapsone + Rifampin. For lepromatous, add Clofazimine

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42
Q

Rifamycins (mRNA synthesis inhibitors): Rifampin - Rifabutin

Used against

A

M. Tuberculosis
M. Leprae
Meningococcal prophylaxis
Chemoprophylaxis in contacts of children with H. Influenzae B

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43
Q

Isoniazid (mycolic acid synthesis inhibitor) used against

A

M. Tuberculosis (monotherapy for latent TB, monotherapy for prophylaxis, combined for treatment)

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44
Q

Treatments of MRSA, VRE, multidrug-resistant P. aeruginosa and multidrug-resistant Acinetobacter baumannii

A

MRSA: vancomycin, daptomycin, linezolid, tigecycline, ceftaroline
VRE: linezolid and streptogramins (quinupristin, dalfopristin)
MDR P. aeruginosa and MDR A. baumannii: polymyxins B and E (colistin)

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45
Q

Amphotericin B (acts on cell membrane integrity) used against

A 
Serious, systemic mycoses
Cryptococcus
Blastomyces
Coccidioides
Histoplasma
Candida
Mucor
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46
Q

Nystatin (acts on cell membrane integrity)

A

Topical use only for diaper rash, vaginal candidiasis

For oral candidiasis

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47
Q

Flucytosine (nucleic acid synthesis inhibitor) used against

A

Systemic fungal infections with Amphotericin B (especially meningitis by Cryptococcus)

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48
Q

Azoles (ergosterol synthesis inhibitors)

A 
Clotrimoxazole
Fluconazole
Itraconazole
Ketoconazole
Miconazole
Voriconazole
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49
Q

Azoles used against

A

Local and less serious systemic mycoses
Fluconazole: chronic suppression of cryptococcal meningitis in AIDS patients + candidal infections
Itraconazole: Blastomyces, coccidioides, histoplasma
Clotrimoxazole and Miconazole: topical infections

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50
Q

Terbinafine (lanosterol synthesis inhibitor) used against

A

Dermatophytoses (especially onychomycosis)

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51
Q

Echinocandins (cell wall synthesis inhibitors)

A

Anidulafungin
Caspofungin
Micafungin

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52
Q

Echinocandins used against

A

Invasive aspergillosis

Candida

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53
Q

Griseofulvin used against

A

Oral treatment of superficial infections

Inhibits growth of dermatophytes

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54
Q

Antiprotozoan therapy

A

Pyrimethamine (toxoplasmosis)
Suramin and melarsoprol (trypanosoma brucei)
Nifurtimox (T cruzi)
Sodium stibogluconate (leishmaniasis)

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55
Q

Anti-mite/louse therapy: for scabies (Sarcoptes scabei) and lice (Pediculus and Phthirus)

A

Permethrin
Malathion
Lindane

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56
Q

Chloroquine used against

A

Plasmodial species (other than P. falciparum)

P. falciparum: artemether/lumefantrine or atovaquone/proguanil

Life-threatening malaria: quinidine (quinine) or artesunate

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57
Q

Antihelminthic therapy

A 
Mebendazole (microtubule inhibitor)
Pyrantel pamoate
Ivermectin
Diethylcarbamazine
Praziquantel
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58
Q

Neuraminidase inhibitors (inhibition of progeny virus release)

A

Oseltamivir

Zanamivir

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59
Q

Oseltamivir and zanamivir used against

A

Treatment and prevention of Influenza A and B

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60
Q

Nucleic acid synthesis inhibitors (antiviral): 3 mechanisms

A 
Guanosine analogs (Acyclovir, Famciclovir, Valacyclovir and Ganciclovir)
Viral DNA polymerase inhibitors (Cidofovir, Foscarnet)
Guanine nucleotide synthesis (Ribavirin)
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61
Q

Acyclovir, Famciclovir, Valacyclovir used against

A 
HSV
VZV
Weak activity against EBV
No effect on latent forms of HSV ans VZV
For herpes zoster: Famciclovir
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62
Q

Ganciclovir (Valganciclovir) used against

A

CMV

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63
Q

Foscarnet used against

A

CMV retinitis in immunocompromised patients when ganciclovir fails
Acyclovir-resistant HSV

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64
Q

Cidofovir used against

A

CMV retinitis in immunocompromised patients

Acyclovir-resistant HSV

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65
Q

Protein synthesis inhibitors (antiviral)

A

Interferon-alpha: against chronic HBV and HCV, Kaposi sarcoma, hairy cell leukemia, condyloma acuminatum, renal cell carcinoma, malignant melanoma
Interferon-beta: against multiple sclerosis
Interferon-gamma: chronic granulomatous disease

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66
Q

Uncoating inhibitors (antiviral)

A

Amantadine
Rimantadine
No longer used for Influenza (high resistance)

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67
Q

HIV therapy drugs

A 
NRTIs
NNRTIs
Protease inhibitors
Integrase inhibitors
Fusion inhibitors (on attachment or penetration)
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68
Q

7 NRTIs

A

Abacavir (CI if HLA-B*5701 mutation)
Didanosine
Emtricitabine
Lamivudine
Stavudine
Tenofovir (nucleotide/ others nucleosides)
Zidovudine (for general prophylaxis and during pregnancy)

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69
Q

3 NNRTIs

A

Delavirdine (CI in pregnancy)
Efavirenz (!!! Vivid dreams and CNS symptoms) (CI in pregnancy)
Nevirapine

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70
Q

7 Protease inhibitors

A 
Atazanavir
Darunavir
Fosamprenavir
Indinavir (!!! Nephropathy, hematuria)
Lopinavir
Ritonavir
Saquinavir
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71
Q

3 Integrase inhibitors

A

Raltegravir
Elvitegravir
Dolutegravir

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72
Q

2 Fusion inhibitors

A

Enfuvirtide (binds gp41, inhibits penetration) (! Skin reaction)
Maraviroc (binds CCR-5 on host cell, inhibits attachment)

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73
Q

Hepatitis C therapy: 3 drugs

A

Ribavirin: against chronic HCV, RSV (Palivizumab in children)
Sofosbuvir: against chronic HCV with Ribavirin +/- peginterferon alfa
Simeprevir: against chronic HCV with Ledipasvir

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74
Q

Giemsa stain (5 organisms)

A 
Chlamydia
Borrelia
Rickettsia
Trypanosomes
Plasmodium
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75
Q

PAS stain (glycogen) (1 organism)

A

Trophyrema whipplei (Whipple ds)

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76
Q

Silver stain (3 organisms)

A

Fungi (Coccidioides, Pneumocystis jirovecii)
Legionella
Helicobacter pylori

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77
Q

Thayer-Martin agar (selective media)

A

Neisseria

Vancomycin (against G+)
Trimethoprim and Colistin (against G-)
Nystatin (fungi)

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78
Q

Mac-Conkey agar

A

Lactose-fermenting enterics (acid, pink)

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79
Q

Anaerobes

A

Nocardia
Pseudomonas aeruginosa
Mycobacterium tuberculosis

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80
Q

Anaerobes (lack catalase and/or superoxide dismutase)

A

Clostridium
Bacteroides
Fusobacterium
Actinomyces

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81
Q

3 obligate Intracellular bugs

A

Rickettsia
Chlamydia
Coxiella

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82
Q

8 facultative intracellular bugs

A 
Salmonella
Neisseria
Brucella
Mycobacterium
Listeria
Francisella
Legionella
Yersinia pestis
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83
Q

7 encapsulated bacteria

A 
Pseudomonas aeruginosa
Streptococcus pneumoniae
Haemophilus influenzae type B
Neisseria meningitidis
E. Coli
Salmonella
Group B Strep
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84
Q

2 pneumococcal vaccines

A

Pneumococcal conjugate vaccine (Prevnar)

Pneumococcal polysaccharide vaccine with no conjugated protein (Pneumovax)

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85
Q

8 urease-positive organisms (struvite stones)

A 
Proteus
Cryptococcus
H. Pylori
Ureaplasma
Nocardia
Klebsiella
Staph epidermidis
Staph saprophyticus
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86
Q

10 catalase-positive organisms

A 
Nocardia
Pseudomonas
Listeria
Aspergillus
Candida
E. Coli
Staphylococci
Serratia
B. Cepacia
H. Pylori
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87
Q

Chronic granulomatous disease (NADPH oxidase deficiency) recurrent infections with

A

Catalase-positive organisms

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88
Q

In vivo biofilm-producing bacteria
1- Catheter + prosthetic devices
2- Dental plaques + infective endocarditis
3- Respiratory tree colonization in Cystic fibrosis + Contact lens
4- Otitis media

A

1- Staph epidermidis
2- Strepto viridans (mutans, sanguinis)
3- Pseudomonas aeruginosa
4- Nontypeable (unencapsulated) H. Influenza

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89
Q

1- Protein A
2- IgA protease
3- M protein

A

1- prevents opsonization + phagocytosis (Staph Aureus)
2- colonizes respiratory mucosa (Strep pneumo, H influenzae type B, Neisseria)
3- prevents phagocytosis (group A Streptococci)

90
Q

6 spore-forming bacteria

A 
Bacillus anthracis
Bacillus cereus
Clostridium botulinum
Clostridium difficile
Clostridium perfringens
Clostridium tetani
91
Q

6 functions of exotoxins

A 
1- Inhibit protein synthesis (4)
2- Increase fluid secretion (3)
3- Inhibit phagocytic ability (1)
4- Inhibit release of neurotransmitter (2)
5- Lyse cell membrane (2)
6- Superantigens causing shock (2)
92
Q

4 bugs with exotoxins that inhibit protein synthesis

A

Corynebacterium diphteriae (Diphtheria toxin: EF-2)
Pseudomonas aeruginosa (Exotoxin A: EF-2)
Shigella spp. (Shiga toxin: 60S)
Enterohemorrhagic E. coli (Shiga-like toxin: 60S)

93
Q

3 bugs with exotoxins that increase fluid secretion

A 
Enterotoxigenic E. coli (Heat-labile toxin: cAMP / Heat-stable toxin: cGMP)
Bacillus anthracis (Edema toxin: cAMP)
Vibrio cholerae (Cholera toxin: cAMP)
94
Q

1 bug with exotoxin that inhibits phagocytic ability

A

Bordetella pertussis (Pertussis toxin: cAMP)

95
Q

2 bugs with exotoxins that inhibit release of neurotransmitter

A 
Clostridium tetani (Tetanospasin: SNARE)
Clostridium botulinum (Botulinum toxin: SNARE)
96
Q

2 bugs with exotoxins that lyse cell membranes

A 
Clostridium perfringens (Alpha toxin: lecithinase)
Streptococcus pyogenes (Streptolysin O: protein lyses RBCs)
97
Q

2 bugs with exotoxins / superantigens causing shock

A 
Staphylococcus aureus (Toxic shock syndrome toxin: binds to MHCII/TCR, releases IL1 IL2 IFNg TNFa)
Streptococcus pyogenes (Exotoxin A: binds to MHCII/TCR, releases IL1 IL2 IFNg TNFa)
98
Q

3 main effects of endotoxin

A

Macrophage activation (TLR4)
Complement activation
Tissue factor activation

99
Q

Only bacterium with a polypeptide capsule (D-glutamate)

A

Bacillus anthracis

100
Q

Treatment of Clostridium tetani infection

A

Antitoxin +/- vaccine booster
Diazepam
Wound debridement

Prevention with tetanus vaccine (inactivated bacterial toxoid)

101
Q

Treatment of Clostridium botulinum infection

102
Q

Treatment of Pseudomembranous colitis

A

Metronidazole or Oral Vancomycin

If recurrent: repeat ttt or Fidaxomicin or Fecal microbiota transplant

103
Q

Treatment of Corynebacterium diphtheriae

A

1- Diphtheria antitoxin (passive immunization)
2- Penicillin or Erythromycin
3- DPT vaccine (active immunization)

104
Q

Treatment of Tuberculoid form of Leprosy

A

Dapsone + Rifampin

105
Q

Treatment of Lepromatous form of Leprosy

A

Dapsone + Rifampin + Clofazimine

106
Q

Treatment of N. gonorrhoeae infection

A

Ceftriaxone

+/- Azithromycin or Doxycycline (for possible Chlamydia coinf.)

107
Q

Treatment of N. meningitidis infection

A

Ceftriaxone or Penicillin G

108
Q

Treatment of H. Influenzae infection

A

Mucosal inf: Amoxicillin +/- clavulanate
Meningitis: Ceftriaxone
Prophylaxis for close contacts: Rifampin

109
Q

Difference between EHEC and other forms of E. coli

A

EHEC does not ferment sorbitol

110
Q

Treatment of typhoid fever

A

Ceftriaxone or Fluoroquinolone

111
Q

Gram - rod that is triple +

A

Helicobacter pylori
Catalase +
Oxidase +
Urease +

112
Q

Initial treatment of H. pylori

A

Triple therapy: Amoxicillin (metronidazole if allergy) + Clarithromycin + PPI

113
Q

Prevention of congenital syphilis

A

Treat mother early in pregnancy (placental transmission after first trimester)

114
Q

4 cases of VDRL false positives

A

Viral infections (EBV, hepatitis)
Drugs
Rheumatic fever
Lupus / Leprosy

115
Q

Treatment of Rickettsial diseases and vector-borne illnesses

A

Doxycycline

116
Q

Infection where rash spares palms and soles

A 
Rickettsia typhi (endemic)
Rickettsia prowazekii (epidemic)
117
Q

4 symptoms of Chlamydia trachomatis infection + treatment

A

Reactive arthritis (Reiter syndrome)
Follicular conjunctivitis
Nongonococcal urethritis
PID

Azithromycin (one-time) or Doxycyclin

118
Q

Cold agglutinins (IgM) seen in 3 conditions

A

EBV infection
Mycoplasma pneumoniae infection
Hematologic malignancies

119
Q

Treatment of Mycoplasma pneumoniae infection

A

Macrolides, Doxycyclin or Fluoroquinolone

120
Q

Treatment for systemic mycoses

A 
Fluconazole or Itraconazole (local infection)
Amphotericin B (systemic infection)
121
Q

Treatment of Pityriasis versicolor infection

A

Selenium sulfide

Topical and/or oral antifungal medications

122
Q

Treatment of candida albicans infection

A

Topical azole (vaginal)
Nystatin, Fluconazole or Caspofungin (oral/esophageal)
Fluconazole, Caspofungin, Amphotericin B (systemic)

123
Q

3 presentations of Cryptococcal infection

A

Cryptococcosis (lung ds)
Meningitis
Encephalitis

124
Q

Treatment + prophylaxis of Cryptococcal infection

A

Amphotericin B + Flucytosine (acute meningitis)

Fluconazole for lifelong prophylaxis

125
Q

Treatment of Mucor/Rhizopus infection

A

Surgical debridement

Amphotericin B

126
Q

Treatment and prophylaxis of Pneumocystis jirovecii

A

TMP-SMX
Pentamidine
Atovaquone

Dapsone (when CD4+ <200 in HIV ptts)

127
Q

2 clinical presentations of Sporothrix schenckii

A

Local pustule or ulcer + nodules in ascending lymphangitis

Disseminated disease in immunocompromised

128
Q

Treatment of sporotrichosis (Sporothrix schenckii)

A

Itraconazole or Potassium iodide

129
Q

Triad of congenital toxoplasmosis

A

Chorioretinitis
Hydrocephalus
Intracranial calcifications

130
Q

Treatment of Toxoplasma gondii infection

A

Sulfadiazine + Pyrimethamine + Leucovorin
Or
Pyrimethamine + Clindamycin (if sulfa hypersensitivity)

131
Q

Treatment of Trypanosoma brucei infection

A

Suramin (blood-borne ds)

Melarsoprol (CNS penetration)

132
Q

Treatment of Plasmodium infections

A

Sensitive: Chloroquine
Resistant: Mefloquine or Atovaquone/Proguanil
Life-threatening: IV Quinidine or Artesunate
For P. vivax/ovale: add Primaquine for hypnozoite

133
Q

Treatment of Babesia infection

A

Atovaquone + Azithromycin

134
Q

Treatment of Trypanosoma cruzi infection (Chagas)

A

Benznidazole or Nifurtimox

135
Q

Treatment of Leishmania donovani infection

A

Amphotericin B

Sodium stibogluconate

136
Q

Treatment of Trichomonas vaginalis

A

Metronidazole for patient and partner

137
Q

Transmission + Treatment of Enterobius, Ascaris, Toxocara, Trichinella

A

Fecal-oral

Bendazoles

138
Q

Treatment of Strongyloides stercoralis

A

Ivermectin or Bendazoles

139
Q

Treatment of Ancylostoma and Necator

A

Bendazoles or Pyrantel pamoate

140
Q

Treatment of Onchocerca volvulus

A

Ivermectin

141
Q

Treatment of Loa loa and Wuchereria bancrofti

A

Diethylcarbamazine

142
Q

3 presentations and treatment of Taenia solium

A

Intestinal tapeworm (Praziquantel)
Cysticercosis (Praziquantel)
Neurocysticercosis (Albendazole)

143
Q

Presentation + Treatment of Diphyllobothrium latum

A

Megaloblastic anemia

Praziquantel

144
Q

Presentation + Treatment of Echinococcus granulosus

A

Hydatid cyst in liver

Albendazole

145
Q

Presentation + Treatment of Schistosoma

A

S. mansoni (lateral spine): fibrosis, inflammation and enlargement of liver and spleen
S. haematobium (terminal spine): chronically, squamous cell carcinoma of bladder + pulmonary HTN

Praziquantel

146
Q

Presentation + Treatment of Clonorchis sinensis

A

Pigmented gallstones
Ass. w/ cholangiocarcinoma

Praziquantel

147
Q

Treatment of Sarcoptes scabiei

A

Permethrin cream
Washing/drying all clothing/bedding
Treat close contacts

148
Q

Treatment of Lice (Pediculus humanus/Phthirus pubis)

A

Pyrethroids, Malathion or Ivermectin lotion
Nit combing
Head lice treated at home

149
Q

9 live attenuated vaccines

A 
Smallpox
Yellow fever
Rotavirus
Chickenpox (VZV)
Sabin polio (oral)
MMR
Influenza (intranasal)
150
Q

4 killed/inactivated vaccines

A

Rabies
Influenza (injected)
Salk polio (injected)
HAV

151
Q

7 positive-stranded RNA viruses

A 
Retrovirus
Togavirus
Flavivirus
Coronavirus
Hepevirus
Calicivirus
Picornavirus
152
Q

4 naked DNA and 4 naked RNA viruses

A

Papillomavirus
Adenovirus
Parvovirus
Polyomavirus

Calicivirus
Picornavirus
Reovirus
Hepevirus

153
Q

3 diseases from Poxvirus infection

A

Smallpox (eradicated by vaccine)
Cowpox (milkmaid blisters)
Molluscum contagiosum (papule w/ central umbilication)

154
Q

Presentation + characteristic of Hepadnavirus

A

HBV:
Acute or chronic hepatitis B
Has reverse transcriptase (even if Not retrovirus)

155
Q

4 presentations of Adenovirus infection

A

Febrile pharyngitis
Acute hemorrhagic cystitis
Pneumonia
Conjunctivitis

156
Q

3 presentations of Papillomavirus

A 
HPV:
Warts = Condyloma acuminata (serotypes 1, 2, 6, 11)
Cervical intraepithelial neoplasia
Cervical cancer (serotypes 16, 18)
157
Q

2 viruses + presentations of Polyomavirus

A

JC virus: progressive multifocal leukoencephalopathy in HIV

BK virus: transplant patients, targets kidney

158
Q

4 presentations of Parvovirus infection

A

B19:
Aplastic crises in Sicke cell ds
Erythema infectiosum = fifth ds (children)
Hydrops fetalis + death (fetus)
RBC aplasia + rheumatoid arthritis-like symptoms (adults)

159
Q

5 presentations of HSV-1

A 
Gingivostomatitis
Keratoconjunctivitis
Herpes labialis
Herpetic whitlow on finger
Temporal lobe encephalitis
160
Q

3 presentations of HSV-2

A

Herpes genitalis
Neonatal herpes
Meningitis (> HSV-1)

161
Q

4 presentations of HHV-3 (VZV)

A

Varicella (chickenpox)
Zoster (shingles)
Encephalitis
Pneumonia

162
Q

Presentation + 2 associations of HHV-4 (EBV) infection

A

Mononucleosis w/ positive monospot test

Ass w/ lymphomas and nasopharyngeal carcinoma

163
Q

4 presentation of HHV-5 (CMV) infection

A

Immunocompetent: mononucleosis w/ negative monospot test
Immunocompromised: many infections esp. pneumonia in transplant ptt
AIDS: retinitis
Congenital CMV

164
Q

Presentation of HHV-6 and HHV-7 infections

A 
Roseola infantum (exanthem subitum): high fevers several days then diffuse macular rash (trunk then extremities)
HHV-6 > HHV-7
165
Q

Presentation of HHV-8 infection

A

Kaposi sarcoma (in HIV/AIDS and transplant ptt)

166
Q

2 Reoviruses + presentations

A

Coltivirus: Colorado tick fever
Rotavirus: #1 fatal diarrhea in children

167
Q

5 Picornaviruses + presentation

A 
Poliovirus
Echovirus: aseptic meningitis
Rhinovirus: "common cold"
Coxsackievirus: 5 diseases
HAV: acute viral hepatitis
168
Q

5 diseases of Coxsackievirus

A 
Aseptic meningitis
Herpangina (mouth blisters + fever)
Hand + foot + mouth ds
Myocarditis
Pericarditis
169
Q

1 Hepevirus

170
Q

1 Calicivirus + presentation

A

Norovirus: viral gastroenteritis

171
Q

5 presentations of Flaviviruses

A 
HCV
Yellow fever
Dengue
St. Louis encephalitis
West Nile virus
172
Q

3 presentations of Togaviruses

A

Rubella
Eastern equine encephalitis
Western equine encephalitis

173
Q

2 Retroviruses + presentations

A

HTLV: T-cell leukemia
HIV: AIDS

174
Q

3 presentations of Coronaviruses

A

“Common cold”
SARS (Sudden Acute Respiratory Syndrome)
MERS (Middle East Respiratory Syndrome)

175
Q

1 Orthomyxovirus

A

Influenza virus

176
Q

4 Paramyxoviruses + presentations

A

Parainfluenza: croup
RSV: bronchiolitis (babies) (ttt: Ribavirin) (prevention in premature infants: Palivizumab)
Measles
Mumps

177
Q

1 Rhabdovirus

178
Q

1 Filovirus

A

Ebola/Marburg hemorrhagic fever

179
Q

2 Arenaviruses + presentations

A

LCMV (Lymphocytic ChorioMeningitis Virus)

Lassa fever encephalitis

180
Q

4 Bunyaviruses + presentations

A

California encephalitis
Sandfly/Rift Valley fevers
Crimean-Congo hemorrhagic fever
Hantavirus: hemorrhagic fever, pneumonia

181
Q

1 Deltavirus

182
Q

All Picornaviruses are enteroviruses except 1 Acid-labile

A

Rhinovirus

183
Q

3 characteristics + 4 symptoms of Yellow fever virus

A

Flavivirus
Aedes mosquitoes
Monkey + human reservoir

High fever
Black vomitus
Jaundice
Councilman bodies on liver biopsy

184
Q

3 characteristics of Rotavirus

A 
#1 infantile gastroenteritis (day care centers, kindergartens)
Villous destruction + atrophy (loss of Na+ and K+)
Routine vaccination of all infants
185
Q

5 characteristics of Influenza viruses

A

Hemagglutinin Ag + Neuraminidase Ag
Bacterial superinfection: S. aureus, s. pneumoniae, H. influenzae
Reformulated vaccine (season) - rapid genetic change
Killed vaccine (frequently used)
Live attenuated vaccine (intranasally)

186
Q

4 symptoms of Rubella + 5 of Congenital rubella

A

Fever, postauricular + other lymphadenopathy, arthralgias, fine rash on face then trunk + extremities

Blueberry muffin rash (dermal extramedullary hematopoiesis), deafness, cataracts, cardiac defects (PDA), microcephaly/mental retardation

187
Q

6 characteristics of Croup

A 
Parainfluenza virus
Barking cough
Inspiratory stridor
Narrowing of upper trachea + subglottis
Steeple sign on XRay
If severe, pulsus paradoxus
188
Q

6 symptoms + 3 complications + reduction of morbi/morta of Measles

A

Prodromal fever, cough, coryza, conjunctivitis, Koplik spots, maculopapular rash (1-2 days later): head/neck then downward

SSPE (years later), encephalitis, giant cell pneumonia (immunodepressed)

Vitamin A supplementation

189
Q

4 symptoms + 1 complication of Mumps

A

Parotitis, orchitis, aseptic meningitis, pancreatitis

Sterility

190
Q

4 findings + 7 symptoms of Rabies

A

Negri bodies
Long incubation period
Travels to CNS (retrograde) then to salivary glands
Postexposure prophylaxis: wound cleaning + killed vaccine + Ig

Fever, agitation, hydrophobia, photophobia, hypersalivation, ascending flaccid paralysis, coma (then death)

191
Q

8 findings in Ebola virus infection

A 
Endothelial cells, phagocytes, hepatocytes
Incubation period of 21 days
Abrupt flu-like sympt., diarrhea, vomiting, high fever, myalgia
Progression: DIC, diffuse hge, shock
Dg: RO-PCR in 48h of sympt.
Supportive care
Strict isolation
High mortality
192
Q

4 general findings in Hepatitis viruses

A

Fever, jaundice, high ALT and AST
Naked (HAV + HEV) not destroyed by gut
HBV DNA-polymerase has DNA+RNA dependent activities
HCV lacks 3’-5’ exonuclease (variation in antigenic env prot)

193
Q

5 differential diagnosis for HIV brain lesions w/ ring enhancing on head MRI

A 
1- Cerebral toxoplasmosis
2- CNS lymphoma
3- Primary brain tumors (glioblastoma multiforme)
4- Metastatic carcinoma
5- Fungal or bacterial abscesses
194
Q

4 stages of untreated HIV infection

A

1- Acute, flu-like syndrome
2- Clinical latency (replication in lymph nodes)
3- Constitutinal symptoms (falling count) - CD4+<400
4- Opportunistic diseases (final crisis) - CD4+<200

195
Q

3 diseases w/ elevated risk when CD4+ count diminishes in HIV

A

Reactivation of past infections (TB, HSV, shingles)
Dissemination of bacterial + fungal infections
Non-Hogdkin lymphomas

196
Q

6 infections in HIV when CD4+<500

A

Candida albicans (oral thrush)
EBV (oral hairy leukoplakia)
Bartonella henselae (bacillary angiomatosis)
HHV-8 (Kaposi sarcoma)
Cryptosporidium spp. (chronic, watery diarrhea)
HPV (squamous cell carcinoma)

197
Q

3 infections in HIV w/ CD4+<200

A

HIV (dementia)
JC (reactivation: PML)
Pneumocystis jirovecii (pneumocystis pneumonia)

198
Q

8 infections in HIV w/ CD4+<100

A

Aspergillus fum. (hemoptysis, pleuritic pain)
Cryptococcus neof. (meningitis)
Candida alb. (esophagitis)
CMV (retinitis, esophagitis, colitis, pneumonitis, encephalitis)
EBV (B-cell lymphoma)
Histoplasma caps. (F*, weight loss, fatigue, cough, dyspnea, N/V, diarrhea)
Mycobacterium av.-intrac. (systemic sympt./focal lymphadenitis)
Toxoplasma gondii (brain abscesses)

199
Q

4 symptoms + 3 diseases of Prions

A

Spongiform encephalopathy
Dementia
Ataxia
Death

Creutzfeldt-Jacob ds (rapidly prog., sporadic, rarely familial)
Bovine spongiform encephalopathy
Kuru (acquired, in human cannibalism)

200
Q

Food poisoning that starts quickly + ends quickly

A

S. aureus

B. Cereus

201
Q

7 bugs causing bloody diarrhea

A 
Campylobacter
E. histolytica
Enterohemorrhagic E. coli
Enteroinvasive E. coli
Salmonella
Shigella
Y. enterocolitica
202
Q

6 bugs causing watery diarrhea

A 
C. difficile
C. perfringens
Enterotoxigenic E. coli
Protozoa (Giardia, Cryptosporidium)
V. cholerae
Viruses (Rotavirus, Norovirus, Adenovirus)
203
Q

Causes of pneumonia in alcoholics, IV drug users, aspiration

A

Alcoholics: Klebsiella, anaerobes (peptostreptococcus, fusobacterium, prevotella, bacteroides)

IV drug: S. pneumoniae, S. aureus

Aspiration: anaerobes

204
Q

Causes of atypical pneumonia and pneumonia in cystic fibrosis

A

Atypical: Mycoplasma, Legionella, Chlamydia

Cystic fibrosis: Pseudomonas, S. aureus, S. pneumoniae, Burkholderia cepacia

205
Q

Causes of pneumonia in immunocompromised, nosocomial, postviral

A

I.compromised: S. aureus, enteric gram - rods, fungi, viruses, P. jirovecii (HIV)

Nosocomial: S. aureus, Pseudomonas, enteric gram - rods

Postviral: S. pneumoniae, S. aureus, H. influenzae

206
Q

Most common causes of meningitis according to age + ttt

A

0-6 mo: group B Strep, E coli, Listeria
6 mo - 60 yo: S pneumo, N meningitidis
Teens: N meningitidis

Ceftriaxone + Vancomycin (empirically)
Add Ampicillin (if Listeria suspected)
207
Q

Causes of osteomyelitis

A

S aureus
Sickle cell ds: Salmonella, S aureus
Prosthetic joint: S aureus, S epidermidis
Vertebral: S aureus, Mycobacterium tuberculosis
IV drug: Pseudomonas, Candida, S aureus
Sexually active: N gonorrhoeae (septic arthritis)

208
Q

3 leading causes of UTI

A

E coli
Staph saprophyticus
Klebsiella pneumo

209
Q

3 vaginal infections

A 
Bacterial vaginosis (Gardnerella vaginalis)
Trichomonas vaginitis (Trichomonas vaginalis)
Candida vulvovaginitis (Candida albicans)
210
Q

5 characteristics of Bacterial vaginosis

A 
No inflammation
Thin, white discharge + pruritus
Fishy odor
Clue cells / Whiff test +
Ttt: Metronidazole or Clindamycin
211
Q

4 characteristics of Trichomonas vaginitis

A

Inflammation (strawberry cervix)
Yellow-green, foul-smelling discharge
Motile trichomonads
Ttt: Metronidazole + ttt partner

212
Q

5 characteristics of Candida vulvovaginitis

A 
Inflammation
Thick, white discharge
Pruritus + erythema
Pseudohyphae
Ttt: Fluconazole
213
Q

3 findings in ToRSHeS infections

A

Toxoplasma g, Rubella, CMV, HIV, HSV-2, Syphilis
Transplacental (or via delivery for HSV-2)
Hepatosplenomegaly, jaundice, thrombocytopenia, growth retardation

214
Q

Maternal transm., maternal manif., neonatal manif. for Toxoplasma gondii

A

Cat feces / undercooked meat

Asymptomatic / rarely lymphadenopathy

Triad: chorioretinitis, hydrocephalus, intracranial calcifications
+/- blueberry muffin rash

215
Q

Maternal transm., maternal manif., neonatal manif. for Rubella

A

Respiratory droplets

Rash, lymphadenopathy, polyarthritis, polyarthralgia

Triad: cataract, deafness, PDA
+/- blueberry muffin rash

216
Q

Maternal transm., maternal manif., neonatal manif. for CMV

A

Sexual contact / organ transplant

Asymptomatic / mononucleosis-like illness

Hearing loss, seizures, petechial rash, periventricular calcifications, blueberry muffin rash

217
Q

Maternal transm., maternal manif., neonatal manif. for HIV

A

Sexual contact / needlestick

Presentation depending on CD4+ count

Recurrent infections, chronic diarrhea

218
Q

Maternal transm., maternal manif., neonatal manif. for HSV-2

A

Skin-mucous membrane contact

Asymptomatic / herpetic lesions

Encephalitis, herpetic lesions

219
Q

Maternal transm., maternal manif., neonatal manif. for Syphilis

A

Sexual contact

Chancre (1), disseminated rash (2)

Stillbirth, hydrops fetalis
If child survives: facial abnl (notched teeth, saddle nose, short maxilla), saber shins, CN VIII deafness

220
Q

7 Red rashes of childhood

A 
Coxsackievirus A (Hand-foot-mouth ds)
HHV-6 (Roseola)
Measles virus (Rubeola)
Parvovirus B19 (Erythema infectiosum)
Rubella virus (Rubella)
Streptococcus pyogenes (Scarlet fever)
VZV (Chickenpox)
221
Q

6 genital lesions sexually transmitted

A

Chancroid - Haemophilus ducreyi (painful ulcer w/ exudate + inguinal adenopathy)
Condylomata acuminata - HPV-6/11 (genital warts)
Genital herpes (painful vesicles/ulcers)
Lymphogranuloma venerum - Chlamydia trachomatis L1-L3 (painless genital ulcers + painful lymphadenopathy)
1* syphilis (painless chancre)
2* syphilis (condylomata lata)

222
Q

Causes + signs/symptoms + complications of PID

A 
Chlamydia trachomatis (subacute)
Neisseria gonorrhoeae (acute)

Cervical tenderness, purulent discharge
Salpingitis, endometritis, hydrosalpinx, tubo-ovarian abscess

Salpingitis (ectopic pregnancy, infertility, chronic pelvic pain, adhesions)
Fitz-Hugh-Curtis sd

Dr. Mel - Microbiology (3 decks)

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