Infectious Disease Flashcards
During bacterial DNA replication, ________ functions to remove RNA primers via 5’-3’ exonuclease activity and replace them with DNA via 5’-3’ polyermase activity
______ binds dsDNA at origin or replication and unwinds it
_______ or topoisomerase II relieves tension created during unwinding by introducing negative supercoils in DNA
_______ synthesizes RNA primers
________ binds Okazaki fragments together
_________ has 5’ to 3’ polymerase activity and 3’ to 5’ exonuclease activity
DNA polymerase I
Helicase
gyrase
primase
ligase
DNA polymerase III
the key structural feature that enables _______ to undergo rapid genetic shifts through reassortment is the segmented nature of their genomes. Segmented viruses include orthomyxoviruses, rotaviruses, reoviruses, bunyaviruses, and arenaviruses
influenza
sexually active female with verrucous, skin colored genital lesion =
caused by
type of virus
types that result in warts
can infect stratified squamous epithelium, found in the anal canal, vagina, cervix, and __________
condylomata acuminatum
HPV
dsDNA
6 and 11
true vocal cords
encephalitis with hemorrhagic lymphocytic pleocytosis with increase protein and normal glucose, abnormal MRI signal in bilateral temporal lobes =
treatment
competes with dGTP for _______
Herpes simplex virus encephalitis
acyclovir
viral DNA polymerase
4 year old, tender perioral papules and pustules, covered with golden yellow crusts =
bugs =
treatment is topical abx like =
major complication =
ARF usually follows =
Nonbullous impetigo
S aureus, Grp A Beta hemolytic Strep (S pyogenes)
mupirocin
PSGN
untreated Strep Pharyngitis
low grade fever, high serum ALT and AST, +HBsAg =
most likely outcome =
chronic hepatitis with or without cirrhosis and risk of hepatocellular carcinoma, fulminant hepatitis with massive liver necrosis are
Hepatitis B infection
acute hepatitis with complete resolution
much less likely
boy with rapid and irregular movements of hands, funny faces, trouble controlling voice, new systolic murmur, circular faintly erythematous lesions on abdomen =
most likely mechanism for condition is cross reactivity of antibodies directed against GAS antigens, _______, and __________ subsequently attack myosin and lysoganglioside
ARF
M protein
N-acetyl-beta-D-glucosamine
_______ is a topical antifungal used for oral candidiasis and is a polyene antifungal like _________ that act by binding ergosterol in the fungal cell membrane
Nystatin
Amphotericin B
facial pain (eye pain), fever, headache, and black nasal eschar in patient with DKA are highly suggestive of _______ caused by _________. Most cases are rhinocerebral. These fungi appear as broad, ribbon like nonseptate hyphae with right angle branching
how to confirm
if narrow septate hypahe with sharp angle branching?
mucormycosis
Mucor or Rhizopus
mucosal biopsy
Aspergillus
Type I (a and B) ______ are synthesized in response to viral infections, resulting in transcription of antiviral enzymes that ________. These enzymes only become active in the presence of ________ in order to selectively inhibit virally infected cells
Interferons
halt protein synthesis
dsRNA
urethritis (dysuria with discharge) in a young man is likely due to _______ or _______. The standard treatment for the first presumes infection by both organisms. Therefore, ___________ is given for the first, and doxycycline or __________ is given for the second.
The first is a G- intracellular diplococci, the second is an obligate intracellular organism that does not gram stain well
Neisseria gonorrhoeae
Chlamydia trachomatis
ceftriaxone
azithromycin
most cases of IM (fever myalgias malaise, fatigue, splenomegaly) are due to _______ and associated with serum heterophile antibodies that agglutinate horse or sheep erythrocytes. This test is negative in the beginning and positive later. Negative on two separate occasions =
EBV
CMV
erythema infectiosum = red flushed cheeks (slapped cheeks)
virus can also cause aplastic crises in patients with SCD and hydrops fetalis in fetus
Parvovirus B19
IC patient with hemiparesis, visual field defects, and cognitive impairment =
caused by
Progressive multifocal leukoencephalopathy
JC virus
the -navirs (lopinavir) are ______ used in antiretroviral therapy that can cause metabolic complications such as _______
Protease inhibitors
insulin resistance, lypodystrophy, and inhibit p450
South Asia, cough for months, hemoptysis, 15 lb weight loss, acid fast bacilli =
Isoniazid monotherapy would most likely result in ________, so drug regimens with rifampin, streptomycin, ethambutol, and pyrazinamide are used
TB
selective survival of bacterial cells secondary to gene mutation
TB treatment
inhibition of bacterial RNA polymerase =
adverse effects are _____ and _____
inhibition of mycolic acid synthesis =
adverse effects are __________, give ________
unknown mechanism
adverse effect is hepatotoxicity and hyperuricemia
Inhibition of arabinosyl transferase =
adverse effect is
Rifampin
rash, red body fluids
Isoniazid
Neurotoxicity, give VitaminB6/pyridoxine
Pyrazinamide
Ethambutol
optic neuropathy
HIV in prison for 3 years, has TB meningitis, but TB shows significantly decreased activity of intracellular catalase peroxidase. Exhibits resistance to ________, which must be processed by mycobacterial catalase peroxidase to become active
Isoniazid (INH)
infection with Neisseria gonorrhoeae dose not appear to provide lasting protective immunity to reinfection due to the ___________ of microbial antigenic structure
high variability
malaise, fever, painful genital thin walled vesicles on erythematous base with shallow ulcers on labia and tender inguinal lymphadenopathy, Tzanck smear with multinucleated giant cells =
antiviral drugs = nucleoside analogs such as ______, which incorporate into the newly replicating viral DNA and ultimately terminate viral DNA chain synthesis
primary genital herpes, HSV2
acyclovir
2 day history of target rash, not painful, low grade fever, generalized myalgias, intermittent headaches, no LAD or other skin lesions =
rash called =
recent history of =
vector =
Lyme Disease: Borrelia burgdoferi
Erythema migrans
Camping
Ixodes tick
Vancomycin blocks _______ polymerization and can cause red man syndrome and ________
Daptomycin __________ by creating channels and can cause __________, but is inactivated by pulmonary surfactant
Linezolid inhibits _________ by binding the _____ subunit and can result in ________ and optic neuritis
all treatments for
glycopeptide polymerization; nephrotoxicity
depolarizes the cell membrane; myopathy and CK elevation
bacterial protein synthesis, 50S, serotonin syndrome
MRSA
Pt from Kazakhstan as a child, dog at home, hepatomegaly, US shows large liver mass with cystic lesions, dies during surgery to resect the mass
bug =
cyst type =
spilling of cyst contents can cause =
Echinococcus granulosus
hydatid cysts (eggshell calcification)
anaphylaxis
patient, HIV + from Botswana, painful single ulcer on penis, ragged borders, grey exudate, no penile discharge, tender enlarged inguinal lypmh node in right groin =
bug = curved G- rod in clumping pattern
Chancroid
Haemophilus ducreyi
the presence of ________ in a mother greatly increases the risk of vertical transmission to infant in Hepatitis B infection
HBeAg
INFy release assays test for latent _____ by measuring the amount of IFNy released by _________ when exposed to antigens unique to TB
TB
T cells
dental manipulation, hard mass under jaw, drains yellowish push through the overlying skin, sulfur granules, slow growing
treatmetn
Actinomyces israelii
penicillin treatment and surgical debridement
out break of hepatitis in New Delhi characterized by high incidence of fulminant hepatitis in pregnant women=
type of virus =
spread =
HepE
ssRNA unenveloped
Fecal oral
multiple episodes of diarrhea in a single night during hospital stay =
need appropriate hand hygiene (___________), ________gloves, ________, private room
C diff
soap and water
nonsterile
gown
missionary to Latin America, fever, HA, abdominal pain, 1 week history of watery diarrhea that recently became bloody, fever, HSM, several faint erythematous (salmon colored) maculopapular lesions on chest and abdomen =
transmission
risk of
typhoid fever, Salmonella typhi
fecal oral
bowel perforation
outdoor exposure in northeastern US, flue like symptoms, severe fatigue, coarse crackles bilateraly on lungs, soft and mildly tender abdomen with palpable splenomegaly, peripheral blood smear shows intraerythrocytic ring forms or Maltese cross with short incubation period=
vector
area
Babesia microti
Ixodes tick
NE US
______ commonly infects B cells, stimulating them to proliferate continuously while maintaining the capacity to secrete Igs. The _______ test is sensitive and highly specific
EBV
heterophile Antibody
sore on shoulder, ulcer with central black eschar surrounded by edema, exudate reveals chains of large G+ rods =
helpful in diagnosis =
Cutaneous Anthrax: Bacillus anthracis
occupation with livestock
young girl with fever, HA, seizures, aphasia, personality changes
autopsy of brain shows edema and hemorrhagic necrosis of the temporal lobe =
from primary oropharyngeal infection and travels from olfactor nerve or from _______
HSV1 encephalitis
reactivation of latent virus
IgA protease is produced by Neisseria meningitidis, gonorrhoeae, S pneumo, and H influenza, and cleaves IgA at its hinge region. This enzyme facilitates
mucosal adherence of bacteria
Raltegravir is an ______ that disrupts HIV genome integration, preventing synthesis of ________
Integrase inhibitor
viral mRNA
the presence of a central vascular catheter and receipt of parenteral nutrition are risk factors for _______, which display the morphology of branching pseudohyphae with blastoconidia
Candida
azoles inhibit _______, changing the composition of the fungal cell membrane. They suppress human and fungal _______, resulting in many drug drug interactions
ergosterol synthesis
cytochrome P450 enzymes
polyarthritis, synovial fluid analysis notable for neutrophilic predominance and intracellular organisms =
prevented with
Neisseria gonorrhoeae
condom use
patient grew up in Guatemala with no underlying IC conditions had a seizure and is found to have a cystic lesion on MRI that is not ring enhancing is most consistent with __________ caused by ________ and ingestion of eggs from the stool of the bug. In the brain they form cysticeri, which are fluid filled larval cysts surrounding the invaginated scolex
neurocysticercosis
Taenia solium: pork tapeworm
_________ is characterized by gastroeteritis, septicemia, and meningocenphalitis. It most commonly affects patients with depressed cell mediated immunity (chemo, post op, hospital), and outbreaks have been associated with contaminated dairy products
examination of CSF would show
Listeria monocytogenes
intracellular gram + bacilli
______ refers to gene exchange that occurs through the crossing over of 2 dsDNA molecules. _______ describes the mixing of genome segments in segmented viruses that infect the same host
Recombination
Reassortment
superficial Candida infection (oral/esophagus, cutaneous) is prevented by _______, while hematogenous spread or disseminated candidiasis is prevented by _______
T cells
neutrophils
thin, off white discharge with fishy odor in vaginitis =
labs?
Treatment?
thin, yellow green, malodorous, frothy discharge =
labs
treat?
thick, cottage cheese discharge =
lab
treat?
gardnerella vaginalis, clue cells, positive KOH whiff test, metronidazole or clindamycin
Trichomonas vaginalis, motile trichomonads, metronidazole
candida albicans, pseudohyphae, fluconazole
Patient with HIV, duration of pain, itching, rectal bleeding with visible ulcerative mass =
due to
anal squamous cell carcinoma
HPV types 16 and 18
G(-) sepsis (septic shock) results from release of LPS. The toxic component of LPS is ______, which causes activation of macrophages leading to widespread release of IL1, TNF-a, which causes fever, hypotension, diarrhea, oliguria, vascular compromise, and DIC
Lipid A endotoxin
the presence of anti-hepatitis A virus IgG suggest this patient is _________
individuals who are successfully immunized against hepatitis B virus develop protective ________. Individuals who recover from HepB infection however, have _______ and ___________ antibodies. The presence of circulating __________ indicates active infection
protected from acute HAV
anti-HBsAb
anti-HBsAb and anti-HBcAb
HBeAb
penicillins and cephalosporins function by irreversibly binding to penicillin-binding proteins such as _______
transpeptidases
a change in _________ that prevents cephalosporin binding is one mechanism of bacterial resistance to cephalosporins
penicillin binding proteins
__________ of children against HBV would likely cause a steep decline in the worldwide incidence of -_________
Universal vaccination
hepatocellular carcinoma
small shallow ulcers, large painful, coalesced inguinal lymph nodes (buboes), intracytoplasmic inclusion bodies in epithelial cells and leukocytes =
due to =
lymphogranuloma venereum
Chlamydia trachomatis
hypersensitivity reaction that develops in patients with HLA-B*57.01 and HIV, which drug
Abacavir
Clavulanic acid, subactam, and tazobactam are ________ administered concurrently with amoxicillin in order to include strains of Beta-lactamase synthesizing bacteria that are resistant to amoxicillin alone
beta-lactamase inhibitors
skin and soft tissue infection at the site of a dog or cat bite within 24 hours and a characteristic mouse like odor
Pasteurella multocida
_________ is the most important virulence factor that uropathogenic (UTI) E. coli express
Fimbrial antigen
the aminoglycoside _________ used in TB therapy inhibits protein synthesis by inactivating the _______ ribosomal subunit
streptomycin
30S
_______ classically presents with fever for 3-5 days, seizure, followed by a truncal rash =
HHV6 infection: roseola
Thayer-Martin agar that contains, vancomycin, colistin, nystatin, and trimethoprim used to isolate
Neisseria species
a virion that buds through and acquires their envelope from the host cell nuclear envelope most likely belongs to the _______ family, including ______
herpesviruses
CMV
______ is a highly contagious disease that presents with an intensely pruritic rash worse at night in the flexor surfaces of the hands and wrist. Patients have excoriations with small crusted red papules scattered around the affected areas. Diagnosis by skin scrapings that show mites, ova, and feces under LM
Sarcoptes Scabies
_______ inhibits mycolic acid synthesis, which is required for the unique mycobacterial peptidoglycan cell wall
Isoniazid
painless ulcer near the glans penis with no surrounding erythema and no inguinal LAD, college student =
sensitive to ______ which are structurally similar to D alanine D alanine
chancre due to primary syphillis
penicillin
many children in close quarters with acute onset fever, cough, congestion, pharyngitis, conjunctivitis; disease is self limiting and year round
Adenovirus
patients with profound and prolonged neutropenia (100/mm3 in this case), dense infiltrate right upper lobe, unaffected by broad spectrum abx, bronchoscopy grows mold, most likely ___________. __________ respiratory infections are very uncommon, while bloodstream infections can occur in patients who have an indwelling central venous catheter.
_____________ is a fungus that most frequently causes opportunistic infections in patients with immunosuppression especially in HIV/AIDs. The most common presentation is meningoencephalitis while pneumonia is rare
__________ can present in patients with HIV/AID with fulminant respiratory failure and chest radiographs reveal diffuse, bilateral interstitial infiltrates
___________ can lead to mucormycosis which common presents with a sinus infection that spreads rapidly to orbits and brain (patients with diabetes)
Aspergillus fumigatus
Candida
Crytopcoccus neoformans
Pneumocystis jiroveci
Rhizopus oryzae
multiple painful ulcers and constitutional symptoms in a sexually active patient is highly suggestive of _________. Diagnosis can be established by ______, direct fuorescence antibody testing, viral culture, or Tzanck smear
HSV
PCR
H influenza type b is the most invasive strain of H influenzae and can causes _________, pneumonia, ________, and sepsis
the PRP capsule serves as an important ________ factor, facilitating invasion by _________
meningitis
epiglottitis
virulence
evading mucosal immunity
optic neuropathy after TB treatment due to
Ethambutol
white oral plaques that can be easily scraped off revealing and erythematous mucosal surface underneath =
in an otherwise healthy individual, this is suggestive of immunosuppession and is a common presentation of ______
oral thrush, Candida yeast
HIV infection
___________ is a combination of extended spectrum penicilin with Beta lactamase inhibitor. It is effective against most G(-) enteric rods (including P aeruginosa) and against _______________
case presented was diabetic foot ulcer with infection
piperacillin-tazobactam
Bacteroides fragilis
Gram negative cocci, patient with meningitis =
brother shares a room, should be given =
vaccination is important, but not useful for post exposure prophylaxis
N. meninigitidis
prophylactic rifampin
If ________ persists for several months and host antibodies to this antigen remain low or undetectable, suspect chronic HepB infection with ______ infectivity
HBeAg
high
clavulanic acid, sulbactam, tazobactam are all
beta lactamase inhibitors
70% isopropanol antiseptic properties lie in its ability to ___________, it ______ sporicidal
chlorhexidine does the same, along with _____ of the cytoplasm, it ________ sporicidal
Hydrogen peroxide produce destructive _______ and is sporicidal
Iodine _________ proteins and nucleic acids and is sporicidal
disrupt cell membranes, is not
coagulates the cytoplasm, is
free radicals
halogenates
gardnernella vaginalis shows _________ covered with Gram _____ rods on microscopy
epithelial cells
variable
Zidovudie (AZT) is an NRTI used to treat HIV. It competitively binds to reverse transcriptase and is incorporated into the viral genome as a _______ analog. AZT dose not have a 3’-OH group, making ____________ bond formation impossible
thymidine
3’-5’ phosphodiester
fever, chills, night sweats that occur every 48 hours after trip to India
RBC inclusions on ______ smear
_______ is the treatment of choice, while ________ is added in the treatment of infections with P vivax and P ovale to eradicate the intrahepatic stages (hypnozoites) of these malarial species, which are responsible for relapses
tertian malaria
Giemsa
Chloroquine
Primaquine
4 year old with fever, irritability, oral lesions, refusal to eat or drink, painful ulcers on tongue, gingiva, swollen gums, cervical LAD, multinucleated giant cells on Tzanck smear =
this a _________ that results in gingivostomatitis
incontrast, reactivation of latent infection in the trigeminal ganglia results in mild _______ vesciles
HSV-1
primary infection
perioral
Oseltamivir is a __________ inhibitor useful in the treatment and prevention of both Influenza A and B virus infections. It impairs _________ from infected host cells
neuraminidase inhibitor
release of newly formed virions
Amphotericin B binds ______ in the fungal cell membranes to form holes. It is notorious for _______ toxicity and severe _________ and _________ are commonly seen during treatment
ergosterol
renal toxicity
hypokalemia, hypomagnesemia
Trimethoprim, __________, and pyrimethamine inhibit dihydrofolate reducatase. Trimethoprim works well in conjunction with ________ which inhibits an earlier step in the bacterial folic acid pathway
methotrexate
sulfonamide
vague chest pain, cough, from Taiwan, decresendo type diastolic murmur over RSB, normal breath sounds, treponemal antibody absorption test is positive, CXR shows medialstinal widening =
murmur from =
widening suggest =
pathologic process of widening
tertiary syphilis
aortic regurg
aortic aneurysm
vasa vasorum endarteritis and obliteration
guanosine analog anti viral =
EBV or CMV infected cells do not produce the same virally encoded thymidine kinase, and cannot easily convert the drug to its _________ because of a much lower phosphorylation rate
acyclovir
active form
stuporous after trip to Mexico, high grade fever, HA, severe myalgias and joint pain, developing shock, marked thrmbocytopenia, leukopenia, elevated liver aminotransferases =
due to ______, a ssRNA _________ with 4 different serotypes
bone break fever, retro orbital pain, rash of white islands on a sea of red =
Dengue hemorrhagic fever
Dengue virus, flavivirus
Classic Dengue fever
Step _______ is bile soluble and optochin susceptible
Strep ______ is beta hemolytic, bacitracin susceptible, and pyrrolidonyl arylamidase +
Streptococci are catalase _____, Staphylococci are catalase _______
pneumo
pyogenese
negative, positive
the overrall increase in staphylococcal bloodstream infections over the last 30 years is most likely related to the increased use of
intravascular devices
HBV +, liver mass with increased AFP =
preceded by
__________ triggers neoplastic changes
hepatocellular carcinoma
liver cirrhosis
integration of viral DNA into the genome of host hepatocytes
Immunosuppressed with thin, sharp branching hyphae =
can cause
Aspergillus
invasive aspergillosis (Amph B to treat), aspergillomas (surgery to treat), and allergic pulmonary aspergillosis(patients with asthma and migratory pulmonary infiltrates, treat corticosteroids)
elderly patient with fever, hypotension, altered mental status, and E coli bacteremia has ________ most likley due to ________
septic shock
UTI
__________ is a comma shaped oxidase + G(-) bacillus that causes watery diarrhea and is endemic in southern Asia, parts of Africa, and Latin America. It grows well on highly alkaline selective media such as TCBS agar, hence it is very sensitive to gastric acidity. Patients who have been on chronic _______ therapy would likely require the smallest infectious dose to initiate infection
Vibrio cholerae
omeprazole
Hepadna, Herpes, Pox are all _________
Adenovirus, Papova(HPV), and Polyoma (JC, BK) are all _______
dsDNA enveloped
dsDNA nonenveloped
Traveler’s diarrhea is often self resolving and is characteristic of ______, due to the LT enterotoxin that is similar to _______ in mode of action, increases intracellular cAMP in gut mucosa
ETEC
cholera toxin
_______ is a replication defective RNA virus that is only capable of causing infection when encapsulated with HBsAg
Hepatitis D
Recurrences of gential herpes (HSV2) can be reduced through daily treatment with oral __________
valacyclovir, acyclovir, famciclovir
_______ work by interfering with the 30S ribosomal subunit. An important mechanism of resistance is the methylation of the _________ binding portion of the ribosome, which inhibits the ability of aminoglycoside to interfere with protein translation
Aminoglycosides
aminoglycoside
unvaccinated child with fever, cough congestion, conjunctivitis followed by maculopapular rash is consistent with =
type of virus
the classic exanthema starts on the face and spreads cephalocaudal and centrifugal
_______ is recommended, especially in patients with deficiency, as this acute infection depletes vitamin A stores resulting in a risk of keratitis and corneal ulceration
Measles
paramyxovirus
Vitamin A
7 year old girl with lace like erythematous rash after first developing red flushed cheeks with congestion, HA, and low grade fever, last week her younger brother had similar symptoms that resolved spontaneously =
caused by
replicates in the _________ in the bone marrow
Erythema infectiosum
Parvovirus B19, ssDNA
erythrocyte precursors
the HCV is genetically unstable because it lacks ________ in its RNA polymerase. Its enveloped glycoprotein sequences also contain a hypervariable region prone to frequent genetic mutation
proofreading 3’-5’ exonuclease activity
changes in host range are most commonly caused by mutation in the viral encoded _______ that mediates virion attachment to target host cell plasmalemma receptors
surface glycoprotein
a _______ response with antibodies directed against ______ is generally the most important source of protection against Influenza A outbreak
humoral
hemagglutinin
vomiting and watery diarrhea outbreak in a school/cruiseship/nursing home most likely =
in undeveloped or unvaccinated areas, could be
Norovirus, nonenveloped, ssRNA
Rotavirus
virus with ds circular DNA =
Hepatitis B
lesion in primary syphilis
secondary syphilis
tertiary syphilis
chancre painless
condylomata lata, large wart like growth, diffuse macular rash
painless gumma, neurosyphilis, ascending aortic aneurysms, aortic valve insufficience
severe pharyngitis with exudates and cervical LAD, neck swelling, difficulty swallowing, one died from severe heart failure, unknown vaccination status indicates =
this toxin acts in a similar manner to exotoxin A, which is produced by
Diphtheria
Pseudomonas aeruginosa
Mosquitos transmit the viruses that cause ______ and _________
dengue fever
chikungunya
infants of HBeAg positive mothers have high levels of HBV replication but are usually _______
asymptomatic
the presence of antiHBc and antiHBs Abs in the serum without detectable viral Ags indicates _________
recovery from acute HepB infection
intense perianal itching at night, presence of eggs on cellulose adhesive tape that are asymmetrically flattened on one side =
treatment?
in pregnant patients?
Enterobius vermicularis (pinworm)
Albenazole
pyrantel pamoate
_________ is a nonmotile non lactose fermenting organism that does not produce H2S when grown on triple sugar iron agar. ________ of the M cells that overlie Peyer’s patches is an essential pathogenic mechanism for this bug. It escapes the phagosome and spreads laterally to other epithelial cells via _________
Shigella
mucosal invasion
actin polymerization
NNRTIs such as ______ are antiretroviral drugs that due not require activation via intracellular phosphorylation and are structurally unrelated to nucleosides. These drugs act within the cytoplasm of infected cells to inhibit the synthesis of viral DNA.
Adverse effects
Nevirapine, efavirenz
Hepatic failure
fetal infection with _____ can lead to profound anemia, ascites, fetal hydrops, and still birth. This virus is a __________ with an increased incidence in children and teachers during school outbreaks. Infections in adults can present with acute symmetric ________ without rash
Parvovirus
nonenveloped ssDNA
arthralgias/arthritis
nephrotoxicity of AmphB is due to its binding to human
cell membrane cholesterol
echinocandins such as _________ are antifungal medications that inhibit synthesis of polysaccharide glucan, an essential component of the fungal cell ______
caspofungin, micafungin
wall
patient develops tinnitus and hearing loss attributed to this type of antibiotic
affects
aminoglycoside (ototox and nephrotox)
mRNA genetic code reading (30S ribosomal subunit)
young sexually active male with dysuria and yellow penile discharge with intracellular diplococci =
treat with __________ like azithromycin for coinfection with _____________ and a 3rd gen cephalosporin like ceftriaxone
Gonorrhea
macrolide
Chlamydia
fever, CSF pleocytosis, irritability in an infant suggestive of ________, which is resistant to cephalosporins like cefotaxime, but is susceptible to ________
Listeria monocytogenes
ampicillin
alcoholic with cavitary lesion and foul smelling sputum =
most common cause =
Lung abscess aspiration pneumonia
anaerobic bacteria from gingivodental sulcus
elderly post op patient that was intubated and dehydrated, swelling that extends to the mandible with fever and right jaw pain =
bug =
lab =
suppurative parotitis
S aureus
elevated serum amylase w/o pancreatitis because parotid gland secretes amylase
growth of _________ on sheep blood agar can be achieved by cross streaking the medium with S aureus because the latter actively secretes V factor (____) into the medium and facilitate the release of X factor hematin from B hemolysis induced erythrocyte lysis
H influenzae
NAD+
UTI in older women that is lactose fermenting, indole positive G(-) rod
E coli
trismus, spasms, clenched fists, dorsiflexed feet, arched back in a 6 day old infant exposed to dirt with unknown vaccination status mother most likely
prevented by _________ and hygenic delivery and cord care
neonatal tetanus
immunization of pregnant women
fever, cough, rhinorrhea, conjunctivitis, Koplik spots (small white, blue, gray specks on erythematous base in mouth) in unvaccinated child =
these symptoms procede the
transmission
Measles virus (rubeola), enveloped RNA paramyxovirus
maculopapular rash
airborne person to person
meningitis in IC patient with G- rods and tumbling motility at room temperature =
due to
Listeria monocytogenes
contaminated food (unpasteurized milk)
aminoglycoside resistance such as _______ develops through the bacterial production of aminoglycoside modifying enzymes that transfer different chemical groups (acetyl) to the aminoglycoside molecule outside of the bacterium, thereby decreasing the ability of the antibiotic to bind the ribosomes
gentamicin
______ infection caused by an RNA picornavirus with acute onset of malaise, fatigue, anorexia, nausea, and aversion to smoking after a 30 day incubation period
vector
HAV
contaminated water/food, raw or steamed shellfish
fever, vomiting, diarrhea, muscle pains, and erythroderma (macular rash resembling a sunburn) are manifestations of _______ associated with ______. S aureus strains producing TSST are responsible for most cases. TSST acts as a super antigen that activates large numbers of Th cells and macrophages, who release IL2 and IL1/TNFa respectivley
TSS
tampons
_______ is responsible for almost half of all UTIs in sexually active young women. This bug is catalase positive, gram positive, coagulase negative, ______ resistant
Staph saprophyticus
novobiocin
extended spectrum beta lactamases can be produced by G- bacteria, rendering cephalosporins inactive. These drug resistant genes are transmitted between organisms in
plasmid vector conjugation
African american with osteomyelitis, nonlactose fermenting, oxidase negative, motile organisms =
virulence mechanism contributing to the current presentation
underlying condition
Salmonella
capsule resistant to opsonization and phagocytosis
SCD
fusion inhibitors such as ________ inhibit HIV fusion with target cell membrane by binding to HIV gp41
Enfuvirtide
genetic variations created during _____ replication result in a marked variety of _______ of the envelope protein. THe production of host Abs lags behind that of new mutant strains, preventing infected individuals from mounting an effective immune response
HCV
antigenic structure
severe retroorbital headaches, myalgias, pneumonia, elevated liver enzymes, thrombocytopenia, dairy farm waste =
due to
chronically can cause
Acute Q fever
Coxiella burnetii
endocarditis and valvular disease
patient with latent TB started on isoniazid therapy now has fever, anorexia, and nausea due to
INH hepatotoxicity
Diphtheria exotoxin inhibits ________ by catalyzing the ADP ribosylation of host cell EF2
cell protein synthesis
17 year old boy, lots of contacts with different animals, recent onset insomnia, HA, periodic agitation, dysphagia, develops painful spasms, progressive paralysis, and coma and dies =
intervention that would have prevented this illness
Human Rabies virus (bat cave)
postexposure prophylaxic INACTIVATED vaccine
antecedent nasal congestion/discharge, and cough, wheezing/crackles, respiratory distress (tachypnea, retractions, nasal flaring) before the age of 2 =
due to
viral bronchiolitis
RSV
C diphtheriae is cultured on ________ agar and results in black colonies
cysteine tellurite
only the HIV gene polyprotein product _____ is glycosylated to gp160 and proteolytically cleaved within the ER and Golgi apparatus to from the envelope glycoproteins ______ and ________
env
gp120 and gp41
________, known as woolsorters disease is caused by inhalation of spores. Patients present with fever, chest pain, hemoptysis, widened mediastinum, large gram + rods that form _______ colonies on standard media. These bacteria produce an _______ that is required for pathogenicity that contains _____ instead of polyaccharide
Pulmonary anthrax
medusa head
antiphagocytic capsule
D glutamine
patient with untreated HIV (CD4 38/mm3) fever, abdominal pain, explosive diarrhea, erosions and ulcerations, viral intranuclear and intracytoplasmic inclusions treated with a drug that inhibits DNA polymerase and reverse transcrpitase, administered via IV in patients who are acyclovir resistant. The drug used does not require intracellular activation
condition?
drug?
CMV induced colitis
Foscarnet
elderly patient who recently underwent GU procedure (cystoscopy) with a UTI caused by______ which is a G+ cocci in pairs and chains and when grown on blood agar reveals no hemolysis (called ______). It is PYR + and grows in bile and in 6.5% NaCl
Enterococcus
gamma hemolysis
Babesiosis and Lyme disease are transmitted by the _____ and coinfection is common
Ixodes tick
