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STEP > ID 5 > Flashcards

ID 5 Flashcards

1
Q

what is emetic type of b cereus usually caused by? characteristics?

A

1) rice and pasta

2) nausea and vomiting within 1-5 hours

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2
Q

what causes emetic type of food poisoning caused by b cereus?

A

Cereulide, a preformed toxin

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3
Q

characteristics of diarrheal type of food poisoning caused by b cereus?

A

watery, non bloody diarrhea + GI pain within 8-18 hours

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4
Q

rises sardonicus presentation

A

Raised eyebrows and open grin

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5
Q

tetanus treatment

A

1) antitoxin +/- vaccine booster
2) diazepam (for muscle spasm)
3) wound debridement

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6
Q

tetanus prophylaxis

A

tetanus vaccine

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7
Q

floppy baby syndrome?

A

botulism in babies

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8
Q

what are local botox injections used for?

A

1) focal dystonia
2) achalasia
3) muscle spasms

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9
Q

sources of botulism

A

juice and honey

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10
Q

stability of c perfringens toxin?

A

spores can survive in undercooked food

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11
Q

c perfringens toxin

A

heat-labile enterotoxin

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12
Q

AB structure of c diff

A 
A = enterotoxin that binds to brush border of the gut
B = cytotoxin that causes cytoskeletal disruption via actin depolymerization
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13
Q

what else is c diff associated with?

A

PPI use

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14
Q

How do you diagnosis c diff?

A

Detection of one or both toxins in stool by PCR.

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15
Q

diphtheria toxin encoded by…

A

beta-prophage

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16
Q

other symptoms of diphtheria…

A

1) myocarditis

2) arrhythmias

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17
Q

appearance of diphtheria on culture?

A

Black colonies on cystine-tellurite agar

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18
Q

diphtheria diagnosis

A

1) metachromatic (blue and red) granules

2) elek ttest positive

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19
Q

listeria causes…

A

1) amnionitis
2) septicemia
3) spontaneous abortion in pregnant women
4) granulomatosis infantiseptica
5) neonatal meningitis
6) meningitis in immunocompromised
7) gastroenteritis in healthy

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20
Q

where is nocardia found?

A

soil

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21
Q

TB mimic?

A

nocardia

22
Q

Nocardia causes

A

1) pulmonary infection in immunocompromised similar to TB presentation
2) cutaneous infections after trauma in immunocompetent

23
Q

nocardia treatment

A

sulfonamides (TMP-SMX)

24
Q

where is actinomyces found?

A

Normal oral, reproductive, and GI flora

25
Q

what else can actinomyces cause?

A

PID with IUDs

26
Q

actinomyces treatment

A

penicillin

27
Q

Negative PPD means..

A

1) no infection

2) *sarcoidosis

28
Q

other TB test?

A

Interferon-gamma release assay (IGRA)

29
Q

characteristic findings with secondary TB?

A

1) caseating granulomas with central necrosis

2) Langerhans giant cells

30
Q

ghon complex =

A

Hilar nodes + Ghon focus

31
Q

what happens after primary TB?

A

1) over 90% heal by fibrosis and calcification. BUT can reactivate to secondary TB
2) 10% progress (usually in AIDS patients or malnourished people)

32
Q

Presentation of secondary/reactivated TB?

A

Fibrocaseous cavitary lesion (usually upper lobes)

33
Q

what can secondary TB progress to?

A

1) localized destructive disease with *caseation in kidneys or lungs.
2) OR bacteremia

34
Q

Where does bacteremic TB infect?

A

1) meninges
2) vertebra
3) lymph nodes
4) lungs
5) liver
6) spleen
7) adrenal gland
8) joints and long bones

35
Q

When do you need M avid prophylaxis?

A

CD4 less than 50

36
Q

m scrofulaceum causes…

A

cervical lymphadenitis in children

37
Q

cord factor appearance

A

“serpentine cord” appearance

38
Q

cord factor MOA

A

Inhibits macrophage maturation + induces release of TNF-alpha

39
Q

other virulence factor of TB

A

sulfatides

40
Q

sulfatides MOA

A

Inhibit phagolysosomal fusion.

41
Q

lepromatous leprosy presentation

A

1) diffuse over skin
2) leonine (lion-lake) facies
3) can be lethal

42
Q

lepromatous immune response

A

humoral Th2

43
Q

tuberculoid immune response

A

High cell-mediated immunity with a largely Th1-type response

44
Q

what do you add for lepromatous form?

A

clofazimine

45
Q

tuberculoid treatment

A

dapsone + rifampin

46
Q

comma-shaped rods?

A

1) campylobacter
2) cholera
3) h pylori

47
Q

coccobacilli?

A

1) h flu
2) pasteurella
3) brucella
4) b pertussis
5) francisella

48
Q

maltose utilization characteristic of…

A

n meningitidis

49
Q

fast lactose fermenters?

A

1) klebsiella
2) e coli
3) enterobacter

50
Q

H2S production on TSI agar?

A

1) salmonella

2) *proteus

51
Q

mycobacterium leprae characteristics

A

acid-fast bacillus that likes cool temperatures

STEP (85 decks)

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