Goljan High Yield Microbiology EC

Question 1

Mechanism of action of Strep agalactiae (group B strep)

Answer 1

Inhibits phagocytosis

Question 2

Cause of an immunodeficiency with high IgM

Answer 2

Defect in isotype switching

Question 3

Cyclosporine necessary in identical twin transplant, why?

Answer 3

Still some difference in MHC sites from crossover of chromosomes during meiosis

Question 4

Receptor for HIV

Answer 4

CD4 molecule on helper T cells (also macrophages and dendritic cells)

Question 5

Tetany at birth

Answer 5

DiGeorge syndrome

Pure T cell deficiency due to absence of the third and fourth pharyngeal pouches, absent thymic shadow

Question 6

GVH reaction

Answer 6

Common in T cell deficiencies

must irradiate the donor blood to destroy lymphocytes (also destroys CMV)

Question 7

CD common to both B and T cells

Answer 7

CD45 is present in all leukocytes

Question 8

Hanta virus

Answer 8

Carried in rodents

ARDS, hemorrhage, renal failure, viral RNA in lung tissue (PCR test)

Question 9

Staph aureus

Answer 9

Protein A attaches to Fc receptor of macrophages (blocks opsonization)

Question 10

Proteus mirabilis

Answer 10

Moves with flagella

Urease +

Question 11

C. diphtheria

Answer 11

Toxin inhibits elongation factor 2 by ADP-robisylation (blocks protein synthesis)

Question 12

Mycoplasma pneumoniae

Answer 12

requires sterols

Question 13

Pneumonitis (larval transmigration) + ova in stools

Answer 13

Ascaris or hookworm (not strongyloides)

Question 14

Latex agglutination reaction

Answer 14

Antibody to capsular antigens is attached to the beads

Question 15

Locations of cells in lymph nodes

Answer 15

B=follicles
T=paracortex
Histiocytes=sinuses

Question 16

Cells that attack protozoans

Answer 16

CD4 T cells

Question 17

What gives bacteria their shape

Answer 17

peptidoglycan layer in cell wall

Question 18

Tumbling motility, gram positive rod

Answer 18

Listeria monocytogenes
invades mononuclear cells, beta hemolysis
Transplacental infection
Renal transplant patients
Contracted from eating unpasteurized cheese

Question 19

Gray membrane that bleeds when removed

Answer 19

Diphtheria

Question 20

Dengue

Answer 20

Transmitted by Aedes mosquito (same as yellow fever)
“Breakbone fever”
May be hemorrhagic

Question 21

Infection associated with premature rupture of the membrane

Answer 21

Group B strep

CAMP test

Question 22

IL-1 function

Answer 22

Activates B cells

Question 23

Location for staph aureus carriers

Answer 23

Anterior nares

Question 24

River blindness

Answer 24

Onchocera (blackfly)
Do skin biopsy
Ivermectin

Question 25

Rhinovirus

Answer 25

``` Common cold (fall and winter) Droplet infection and hands Acid labile (does not cause gastroenteritis) ```

Question 26

Virus responsible for a cold in spring and summer

Answer 26

Adenovirus

Question 27

Lactobacillus in vagina

Answer 27

responsible for the acid of pH

Question 28

Pruritic skin lesion in Gulf War veteran

Answer 28

cutaneous leishmaniasis | tsetse sandfly

Question 29

Hib vaccine

Answer 29

Antibody against capsular polysaccharide

Question 30

In addition to the normal childhood immunizations, what additional immunizations are recommended in sickle cell disease and CF

Answer 30

Pneumococcus and influenza

Question 31

Which live vaccine can be given to patient with AIDS

Answer 31

MMR

Question 32

List the live vaccines

Answer 32

MMR, varicella, OPV, BCG, smallpox, yellow fever

Question 33

List the polysaccharide vaccines

Answer 33

Pneumococcus and Hib (also meningococcal)

Question 34

List the killed virus vaccines

Answer 34

Flu, rabies, SALK

Question 35

List the immunizations that are contraindicated in patients with anaphylactic reactions against eggs

Answer 35

Flu MMR Yellow fever

Question 36

List the immunizations that are contraindicated in patients with anaphylactic reactions against neomycin

Answer 36

MMR, varicella (neomycin used as preservative)

Question 37

Verrucoid lesion in lower extremity in a patient returning from South America

Answer 37

South American blastomycosis (pseudoblastomycosis) | Yeast with a ships-wheel appearance

Question 38

AIDS patient with 2 peaks in the natural history of his disease

Answer 38

p24 antigen

Question 39

ELISA test for HIV

Answer 39

anti-gp 120 antibodies | Confirm with Western blot

Question 40

Best test for detecting HIV viral burden in blood

Answer 40

HIV RNA by PCR

Question 41

Newborn baby in HIV positive mother

Answer 41

Newborn has Anti-gp 120 in the serum (IgG) | Prevent HIV in newborn by giving mother AZT

Question 42

Animal association with toxoplasmosis

Answer 42

Cat

Question 43

Most common cause of diarrhea in children

Answer 43

Rotavirus

Question 44

E. coli

Answer 44

``` attaches to the urogenital epithelium #1 cause of UTIs ```

Question 45

Bruton's agammaglobulinemia

Answer 45

Defect in pre-B to B cells Prone to respiratory infections Need IV gamma globulin

Question 46

SCID

Answer 46

Adenosine deaminase deficiency

Question 47

Wiskott Aldrich

Answer 47

Sinopulmonary infections, eczema, thrombocytopenia, B and T cell deficiency, Increased leukemia/lymphoma

Question 48

Part of a vaccine that is antigenic

Answer 48

Polysaccharide capsule

Question 49

Person working with animal hides develops lung disease

Answer 49

Bacillus anthracis

Question 50

Cryptococcus

Answer 50

Evades host destruction via its polysaccharide capsule

Question 51

Child with anemia with diarrhea . . what parasite?

Answer 51

Hookworm (produces iron deficiency) (N. americanus A. duodenale)

Question 52

Lymphocutaneous nodules in a rose gardener

Answer 52

Sporotrichosis | treat with potassium iodide

Question 53

Elderly male smoker with non-productive cough, bacteria fails to grow on ordinary media (must be supplemented with iron and cysteine) need Dieterle silver stain to identify.

Answer 53

Legionella pneumophila | Treat with erythromycin

Question 54

Macrophage activation

Answer 54

interferron-gamma secreted from Th1 cell

Question 55

IgA deficiency

Answer 55

Sinopulmonary disease (most common genetic immunodeficiency)

Question 56

On what chromosome is the HLA system coded?

Answer 56

6

Question 57

Hyperacute rejection of a transplant

Answer 57

ABO incompatibility or patient had anti-HLA antibodies against an HLA antigen in the graft Type II hypersensitivity

Question 58

HLA-A,B,C code for the class I antigens

Answer 58

CD8 cytotoxic T-cells recognize

Question 59

HLA-DR, DQ, DP code for class II antigens

Answer 59

CD4 helper T cells and macrophages recognize

Question 60

GVH reaction

Answer 60

NK cell mediated Common in bone marrow and liver transplants Rash, jaundice, diarrhea, Danger in T cell deficient patients

Question 61

Receptor for EBV

Answer 61

CD21 on B cells Polyclonal stimulator causing increased synthesis of immunoglobulins (reason for hypergammaglobulinemia in aids) Increased divisions increase risk for t(8;14) Burkitt's lymphoma

Question 62

CD type for histiocyte

Answer 62

CD1 | Positive in patients with histiocytosis X (Hand-Schuller-Christian: Letterer-Siwe, eosinophilic granuloma)

Question 63

Destroy C. difficile in bedpans

Answer 63

autoclave

Question 64

Blastomycosis

Answer 64

Spored associated with beaver dams and inland water ways | Broad-Based-Bud

Question 65

Impetigo

Answer 65

Most commonly cause by Group A strep

Question 66

CD3

Answer 66

antigen recognition site for T cells

Question 67

Antigen that binds CD4 on T cells in HIV

Answer 67

gp120

Question 68

Risk for HIV if accidental needle stick from an HIV positive patient

Answer 68

1/330 | Treat with triple therapy for 6 months and get ELISA test at repeated intervals

Question 69

Fever in malaria

Answer 69

Coincides with rupture of RBCs

Question 70

Malaria

Answer 70

Treat with primaquine and develop acute intravascular hemolysis in G6PD deficiency