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STEP 1 > High Yield Topics-Microbiology > Flashcards

High Yield Topics-Microbiology Flashcards

1
Q

What STI presents with a painless genital ulcer followed several weeks later by a diffuse maculopapular rash involving the palms and soles

A

syphilis (Treponema pallidum)

  • spirochete
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2
Q

First-line treatment for syphilis

A

penicillin

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3
Q

MOA of penicillin

A

binds to bacterial transpeptidase and interferes with bacterial cell wall synthesis through the inhibition of peptidoglycan cross-linking

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4
Q

spread by respiratory droplets and present with an erythematous rash, “arthralgias”, “postauricular lymphadenopathy”, and fever

A

Rubella infection

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5
Q

An infection during pregnancy –> infant manifests with cataracts, sensorineural deafness, and congenital heart disease (patent ductus arteriosus), and microcephaly

A

congenital rubella infection

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6
Q

Rubella infection can be prevented by

A

measles-mumps-rubella (MMR) vaccination

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7
Q

what kind is MMR vaccination?

A

live-attenuated vaccine

  • contraindicated during pregnancy!
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8
Q

Presents with a fever, cough, “conjunctivitis”, and a maculopapular rash; no postauricular lymphadenopathy or arthralgias

A

Measles virus

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9
Q

An infection during pregnancy –> infant presents with increases the risk for fetal demise and low birth weight

A

congenital measles

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10
Q

An infection during pregnancy –> infant presents with localized lesions of the skin, eyes, and mouth + encephalitis and multiorgan dysfunction

A

Herpes simplex virus (HSV)

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11
Q

An infection during pregnancy –> infant presents with intrauterine growth restriction, hepatosplenomegaly, petechiae, jaundice, thrombocytopenia, microcephaly, and chorioretinitis

A

Cytomegalovirus

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12
Q

Neurocysticercosis (calcified nodules and some cysts of brain) is caused by

A

pork tapeworm (aka.Taenia solium)

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13
Q

Source of pork tapeworm Taenia solium

A

raw or undercooked, infected pork

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14
Q

Azoles (-conazole) inhibits the production of ergosterol (part of the fungal cell membrane) by

A

inhibiting the cytochrome P450-dependent demethylation reaction that synthesizes ergosterol from lanosterol.

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15
Q

Prevention of cross-linking of β-glucans in the cell wall is the mechanism of action of

A

echinocandins

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16
Q

Pore formation in the fungal cell membrane is the mechanism of action of

A

amphotericin B and nystatin

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17
Q

Inhibition of DNA and RNA synthesis is the mechanism of action of what fungal tx?

A

flucytosine

  • tx for cryptococcal meningitis
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18
Q

Prevention of tetrahydrofolic acid synthesis is the mechanism of action of

A

Sulfonamides and trimethoprim

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19
Q

antibody that indicates immunity to hepatitis B due to vaccination or recovery from infection.

A

Anti-HBs

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20
Q

Mnemonic for Viral hepatitis B markers

A

SpECiES

S: HBsAg
E: HBeAg
C: HBcAg

E: Anti-HBe
S: Anti-HBs

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21
Q

antibody that indicates low transmissibility of hepatitis B

A

Anti-HBe

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22
Q

the sole ⊕ marker of viral hepatitis B infection during window period

A

Anti-HBc (IgM)

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23
Q

Three genes encoded by HIV RNA (diploid genome = two ssRNAs)

A
  1. env
  2. gag
  3. pol
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24
Q

What structural proteins are encoded by env gene?

A

glycoprotein 160 (later cleaves into gp120 and gp41)

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25
Q

Function of gp 120

A

attachment to host CD4+ T cell

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26
Q

Function of gp 41

A

fusion and entry

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27
Q

What structural proteins are encoded by gag gene?

A

p24 and p17

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28
Q

Function of p24

A

capsid protein

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29
Q

Function of p17

A

matrix protein

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30
Q

What structural proteins are encoded by pol gene?

A

Reverse transcriptase
Integrase
Protease

*STUDY AID: RIP Pol

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31
Q

Function of Reverse transcriptase

A

synthesizes dsDNA from viral RNA

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32
Q

Function of Integrase

A

integrates dsDNA into host genome

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33
Q

Function of Protease

A

Cleaves protein formed from dsDNA

34
Q

HIV binds to what co-receptor on CD4 T cells?

A

CXCR4

35
Q

HIV binds to what co-receptor on macrophages?

A

CCR5

36
Q

What does HIV acquire through budding from host cell plasma membrane?

A

envelope glycoproteins and envelope

37
Q

HIV is diagnosed using

  • know this cold!
A

HIV-1/2 Ag/Ab testing

  • It detects viral p24 “antigen” capsid protein + IgG “antibodies” to HIV 1 and HIV 2
38
Q

HIV-1/2 Ag/Ab immunoassays has _____ sensitivity/specificity

A

high

39
Q

What test is used to confirm HIV in case of indeterminate HIV-1/2 Ag/Ab immunoassays?

A

Nucleic acid test (NAT)

  • aka. viral load test (measure the amount of the genetic material (RNA) of HIV in the blood)
40
Q

High viral load is used to monitor effect of

A

drug therapy

41
Q

HIV genotyping is used to determine

A

appropriate therapy

42
Q

AIDS can be diagnosed by what two criteria?

A
  1. low CD4+ T cell count

OR

  1. HIV ⊕ with AIDS-defining condition (Pneumocystis pneumonia)
43
Q

What CD4+ T cell count is used to diagnose AIDS?

A

≤ 200 CD4+ cells/mm3

44
Q

Since HIV-1/2 Ag/Ab testing is not recommended in babies with suspected HIV due to maternally transferred antibody, what is used instead?

A

HIV viral load

45
Q

What are the four stages of untreated infection?

  • HINT: 4 F’s
A
  1. Flu-like (acute)
  2. Feeling fine (latent)
  3. Falling count
  4. Final Crisis
46
Q

Amount of HIV RNA (viral load) is inversely proportional to

A

CD4+ T cell count

47
Q

Describe amount of HIV RNA and CD4+ T cell count during four stages of untreated infection

A
  1. Flu-like (acute)
    - high HIV RNA
    - CD4+ T cell count drops
  2. Feeling fine (latent)
    - relatively low HIV RNA
    - CD4+ T cell count increases
  3. Falling count
    - progressive increase of HIV RNA
    - progressive decrease of CD4+ T cell count
  4. Final Crisis
    - high HIV RNA
    - very low CD4+ T cell count (<200) –> death
48
Q

HIV RNA is relatively low during latency phase b/c

A

Virus replicates in lymph nodes during latency phase

49
Q

What pathogen is responsible for oral hairy leukoplakia on tongue in HIV patients?

A

EBV

50
Q

How to distinguish oral thrush (by candida) vs. oral hairy leukoplakia (by EBV)

A

oral thrush is scrapable vs. oral hairy leukoplakia is unscrapable

51
Q

A condition that presents with loss of memory, difficulty thinking, concentrating, speaking clearly, etc. due to HIV virus spreading to the brain

A

HIV dementia

52
Q

Imaging findings of HIV dementia

A

cerebral atrophy on neuroimaging

53
Q

What pathogen is responsible for progressive multifocal leukoencephalopathy (brain white matter disease) and areas demyelination on MRI in HIV patients?

A

John Cunningham virus

aka. JC virus

54
Q

What pathogen is responsible for pneumonia in HIV patients with CD4+ cell count <200?

A

Pneumocystis jirovecii

55
Q

Chest imaging finding of Pneumocystis jirovecii pneumonia

A

“Ground-glass” opacities

56
Q

What pathogen is responsible for pleuritic pain and hemoptysis?

A

Aspergillus

57
Q

Chest imaging finding of Aspergillus fumigatus

A

Cavitation or infiltrates

58
Q

What pathogen is responsible for bacillary (rod-shaped) angiomatosis in HIV patients?

A

Bartonella spp

59
Q

Biopsy findings of bacillary (rod-shaped) angiomatosis

A

neutrophilic inflammation

60
Q

What pathogen is responsible for esophagitis in HIV patients?

A

Candida albicans

61
Q

What endoscopy finding is associated with esophagitis caused by Candida albicans?

A

White plaques on endoscopy

62
Q

What biopsy finding is associated with esophagitis caused by Candida albicans?

A

yeast and PSEUDOHYPHAE on biopsy

63
Q

What pathogen is responsible for Colitis, Retinitis, Esophagitis, Encephalitis, and Pneumonitis in HIV patients?

A

CMV

  • STUDY AID: CMV causes CREEP
64
Q

What pathogen is responsible for linear ulcers on endoscopy?

A

CMV

65
Q

What pathogen is responsible for cotton-wool spots on fundoscopy?

A

CMV

66
Q

What biopsy finding is associated with CMV infections?

  • HINT: same as in all CMV infections
A

cells with intranuclear inclusion bodies (owl eyes)

67
Q

What pathogen is responsible for meningitis in HIV patients?

A

Cryptococcus neoformans

68
Q

What pathogen is responsible for encapsulated yeast on india ink stain or capsular antigen +?

A

Cryptococcus neoformans

  • STUDY AID: sketchyMicro
69
Q

What pathogen is responsible for chronic, watery diarrhea in HIV patients?

A

Cryptosporidium spp

70
Q

What pathogen is responsible for Acid-Fast oocysts in stool

A

Cryptosporidium spp

71
Q

What pathogen is responsible for B-cell lymphoma (diffuse large b cell lymphoma, non-Hodgkin lymphoma, and CNS lymphoma) in HIV patients?

A

EBV

72
Q

What pathogen is responsible for nonspecific symptoms such as fever, night sweats, weight loss or focal lymphadenitis in HIV patients?

A

Mycobacterium avium

73
Q

What pathogen is responsible for brain abscesses in HIV patients?

A

Toxoplasma gondii

74
Q

How to distinguish CNS lymphoma (EBV) vs. Toxoplasma gondii on brain MRI

A

Toxoplasma gondii: MULTIPLE ring-enhancing lesions

CNS Lymphoma by EBV: SOLITARY ring-enhancing lesion

75
Q

Faulty nucleo”sides” that halt reverse transcriptase’s activity of converting ssRNA to dsDNA –> early chain termination

A

NRTIs

  • Lamivudine
  • Zidovudine
  • Stavudine
  • Didanosine
  • Emtricitabine
  • Abacavir
  • STUDY AID: “Dine” with my “nuclear (nucleosides)” family
76
Q

NRTIs are missing what on its nucleoside?

A

3’OH

77
Q

NRTIs must be _____ to be activated b/c they are nucleosides

A

phosphorylated

78
Q

The only NRTI that is a nucleo”tide”

A

“T”enofovir

79
Q

Tenofovir must be phosphorylated a total of ___ times to be active

A

3

already phosphorylated but must be phosphorylated two times more to be active

80
Q

Which NRTI has an adverse effect of myelosuppression (bone marrow suppression), leading to anemia and neutropenia (agranulocytosis)?

A

Zidovudine

81
Q

Tx to reverse bone marrow suppression caused by Zidovudine?

A
  • G-CSF (granulocyte colony-stimulating factor)

- Erythropoietin

82
Q

Allele that increased the risk of Type 4 hypersensitivity with Abacavir

A

HLA-B 57:01

  • STUDY AID:
  • Book: HLA-B
  • Page: 57
  • Line: 1

STEP 1 (19 decks)

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