Infectious II Exam Flashcards

1
Q

Most Common TB treatment

A

isoniazid (INH)
rifampin (RIF)
ethambutol (EMB)
pyrazinamide (PZA)

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2
Q

What drugs not to use with Multi-Drug Resistant TB

A

don’t use isoniazid (INH) and Rifampin

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3
Q

Leprosy Tx

A

Dapsone, rifampin, clofazimine

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4
Q

Two types of Leprosy

A

Tuberculoid: more nerve involvement, less skin lesions
Lepromatous: more skin, less nerve involvement

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5
Q

What disease is a AIDS defining disease

A

MAC (Mycobacterium avium complex )

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6
Q

What bacteria are the atypical cause of pneumonia?

A

Mycoplasma pneumonia
Legionairres’ disease
Chlamydia pneumoniae

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7
Q

How is mycoplasma pneumonia transmitted?

A

person-to-person via respiratory droplets

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8
Q

What is an appropriate antibiotic choice for empiric treatment in an assumed Mycoplasma pneumonia?

A

Azithromycin 500 mg on day 1, 250mg once daily on days 2-5

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9
Q

What is the drug of choice for Chlamydia pneumonia?

A

Doxycycline

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10
Q

How is Legionnaires’ Disease spread?

A

contaminated water

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11
Q

What test do you order to diagnose Legionella?

A

Urinary antigen test and sputum culture

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12
Q

What is the drug of choice for Legionnaire’s disease

A

Ciprofloxacin (Fluoroquinolone)

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13
Q

What step/chemical is the “mordant” in the gram stain?

A

iodine; fixes crystal violet

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14
Q

What does the result of a Catalase test tell you?

A

Pos: Staph
Neg: Strep

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15
Q

What does a Coagulase test tell you?

A

Pos: confirm Staph. aureus
Neg: Staph. epidermidis

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16
Q

What does a blood agar characteristic tell you?

A

Hemolysis;
Alpha-hemolytic: Strep. mitis
Beta: Strep. pyogenes
Gamma: Strep faecalis

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17
Q

What are the toxins produced by S. aureus?

A

enterotoxins, Exfoliatin, toxic shock syndrome toxin, alpha-toxin

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18
Q

How can you get Toxic Shock Syndrome?

A

extended tampon use; NOT BACTEREMIA

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19
Q

What can exfoliatin cause?

A

Staph Scalded Skin Syndrome (“Ritter’s disease”) –> usually pediatric

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20
Q

Toxic Shock Syndrome characteristics

A
  • Temp ≥ 101 F BP<90
  • Rash with desquamation (peeling skin)
  • Involvement of three or more of the following organ systems: GI, Muscular, Renal, CNS, Liver
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21
Q

What antibiotics to treat S. aureus (non-resistant)?

A

PCN (Nafcillin, Oxacillin), Cephalosporins (1st, 2nd gen: Cephalexin, Cefazolin, Cefuroxime), Erythromycin

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22
Q

How to treat MRSA?

A

Bactrim, Clindamycin, Doxycycline x7-10 days

Vancomycin for inpatient (7-14 days)

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23
Q

What does Staph. saprophyticus cause?

A

UTI, esp young women

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24
Q

What is S. epidermidis associated with?

A

intravascular devices, osteomyelitis

break in skin from procedures, IV

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25
Q

What species of Strep is Group A, B-hemolytic and what infection does it cause?

A

Strep. pyogenes –> strep throat

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26
Q

What genus causes gamma hemolysis?

A

Enterococcus

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27
Q

What species causes alpha hemolysis?

A

S. pneumonia

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28
Q

What species of Strep is Group B, B-hemolytic?

A

Strep. agalactiae

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29
Q

What kind of membrane does Streptococcus live on?

A

mucous membrane

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30
Q

Where in the respiratory system does Streptococcus live on?

A

upper respiratory tract

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31
Q

What is the morphology of S. pneumoniae

A

encapsulated diplococci

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32
Q

What sequelae can accompany strep pharyngitis?

A

Scarlet fever

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33
Q

Patient presents with “strawberry tongue” and strep throat, what is the diagnosis

A

Scarlet fever

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34
Q

What organisms can cause toxic shock syndrome?

A

Staph. aureus

Strep. pyogenes

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35
Q

“Honey-color crust”

A

Impetigo

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36
Q

What is the leading cause of bacterial disease and death in newborns and in maternal infections?

A

Strep. agalactiae

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37
Q

Where does Strep. agalactiae reside?

A

vagina

also upper resp tract

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38
Q

What part of the body does Strep. pyogenes primarily affect?

A

Larynx

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39
Q

What part of the body does Strep. pneumoniae primarily affect?

A

Lungs (respiratory)

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40
Q

What enzyme does Strep. pneumoniae produce?

A

IgA protease

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41
Q

Who should be vaccinated for Strep. pneumoniae?

A

> 65, <5

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42
Q

What respiratory infections does Strep. pneumoniae cause?

A

Pneumonia
Otitis Media
Sinusitis

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43
Q

What bacteria can cause endocarditis?

A

Strep. Viridans, Strep. Bovis, Enterococcus

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44
Q

What does ASO titers test?

A

Antibody to Group A Strep –> tests for HISTORY of strep

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45
Q

What antibiotic to treat Streptococcal infection in PCN allergic patient?

A

Erythromycin

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46
Q

Enterococcus treatment

A

Ampicillin

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47
Q

Vancomycin-resistant Enterococci treatment

A

Linezolid

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48
Q

S. pyogenes and S. pneumoniae treatment

A

PCN

pneumonia: increased resistance

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49
Q

Gram positive bacilli bacteria

A

Clostridium tetani and botulinum
Corynebacterium diphtheriae (Diphtheria)
Listeria monocytogenes
Bacillus anthracis

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50
Q

What bacteria produces “Lockjaw”

A

Clostridium tetani (tetanus)

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51
Q

What are the characteristics of “Lockjaw”

A

spasms and rigidity of voluntary muscles

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52
Q

What infection does C. diff cause?

A

pseudomembranous colitis

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53
Q

Gas Gangrene

A

Clostridium perfringens

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54
Q

Pseudomembrane on tonsils is characteristic of what disease?

A

Diphtheria

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55
Q

What gram positive bacillus bacteria grows intracellularly?

A

Listeria monocytogenes (Listeriosis)

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56
Q

Listeriosis

A

food-borne illness

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57
Q

What gram positive bacillus bacteria is primarily a disease of domesticated and wild animals, cows, sheep

A

Anthrax

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58
Q

What cell structures are unique to gram negative bacteria

A

periplasmic space and lipopolysaccharide (LPS)

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59
Q

What is the most severe strain of E. coli?

A

Enterohemorrhagic E. coli

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60
Q

What severe pathology can Enterohemorrhagic E. coli cause?*

A

hemorrhagic colitis and hemolytic uremia syndrome

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61
Q

Which strain of E. coli causes Traveler’s Diarrhea

A

Enterotoxigenic E. coli

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62
Q

How to treat E. coli

A

nothing; usually self-limiting and goes away in a few days

only treat bloody, invasive infections

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63
Q

What’s the leading cause of bacterial gastroenteritis worldwide?

A

Campylobacter

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64
Q

What gram negative bacteria can survive at low temperatures?

A

Yersenia enterocolitica

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65
Q

What gram negative bacteria caused the plague?

A

Yersenia pestis

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66
Q

Which manifestation of Y. pestis has the highest mortality rate?

A
Pneumonic plague (90%)
fast spread, respiratory failure
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67
Q

What gram negative bacteria live in coastal waters and can be transmitted through seafood?

A

Vibrio cholera

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68
Q

What gram negative bacteria causes Typhoid Fever?

A

Salmonella typhi

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69
Q

What bacteria causes “currant jelly” sputum

A

Klebsiella pneumonia

70
Q

What bacteria associated with staghorn calculi (very large kidney stones)? (also UTI and indwelling catheters)

A

Proteus mirabilis

71
Q

If you smell fruity grape scent from a wound or breath of a patient, what bacteria caused the infection?

A

Pseudomonas aeruginosa

72
Q

What is the model organism for resistance?

A

Pseudomonas

73
Q

What causes “Rabbit Fever”

A

Tularemia

74
Q

Most common STD

A

Chlamydia

75
Q

2nd most common STD

A

Neisseria gonorrhoeae

76
Q

Most common MRSA colonization site

A

anterior nares

77
Q

Most common nasal MRSA treatment

A

Mupirocin (topical ointment) in the nose

aka Bactroban

78
Q

Hear “spider bite”, what do you consider

A

CA-MRSA

79
Q

What is Ascaris lumbricoides known as

A

roundworm

80
Q

What is Necator americanus known as

A

hookworm

81
Q

What parasite can be transmitted from undercooked pork?

A

Trichinella spiralis

82
Q

What is Enterobius vermicularis known as

A

pinworm

83
Q

Which helminth does not cause eosinophilia?

A

pinworm (Enterobius vermicularis)

84
Q

Katayama fever, Swimmer’s itch, flukes

A

Schistosomiasis

85
Q

look like “old man with glasses”; flagellated protozoa; traveler’s diarrhea; “Beaver Fever”

A

Giardia

86
Q

“Walking pneumonia”

A

Mycoplasma pneumoniae

87
Q

Stevens Johnson Syndrome

A

skin sloughing off/lesions, affects mucosal membranes

88
Q

What organism causes “Parrot Disease”?

A

Chlamydia psittaci

89
Q

Ziehl-Neelsen Stain

A

stains Acid Fast bacteria

primary stain: carbolfuschin

90
Q

What are the 3 phases of TB

A

Primary
Latent
Reactivated

91
Q

What are the characteristics of the Latent phase of TB

A

No symptoms
Non-infectious
(+) PPD

92
Q

Give 2 examples of Non-Tuberculosis Mycobacterium

A

M. avium (complex)

M. scrofula

93
Q

What is a characteristic of acid fast bacteria cell structure that prevents easy staining

A

high cell wall lipid content (wax-like)

94
Q

Ghon lesion

A

granuloma of macrophages and mycobacterium

95
Q

Miliary TB

A

disseminated TB

CXR: snow storm

96
Q

Pott’s disease

A

Spinal TB (curved spine)

97
Q

What’s the initial symptom of TB

A

fever

98
Q

What is a positive PPD result for immunocompromised, higher risk people, and immunocompetent (very rarely tested)?

A

≥ 5mm induration
≥ 10mm
≥ 15mm
,respectively

99
Q

What are the diagnostic tests for TB?

A
PPD
Quantiferon
CXR
AFB Smears
Culture: gold standard
NAA
100
Q

What are diseases caused by acid fast bacteria

A

Tuberculosis
Leprosy
MAC

101
Q

Tx for MAC

A

Macrolides (e.g. erythromycin, azithromycin)

102
Q

What type of fungus causes Tinea and onycholysis

A

Dermatophytes

103
Q

Tx for Candida

A

Polyene (amphotericin B, nystatin)

Azoles

104
Q

Diagnose dermatophytes

A

KOH skin scrapings

wood light

105
Q

Aspergillomas

A

“fungus balls” in healed lung scars from previous disease

106
Q

Tx for aspergillosis

A

amphotericin B

107
Q

What fungal/yeast infections are caused by bird feces?

A

Histoplasmosis and Cryptococcosis

108
Q

Biggest nutritional deficiency in the world

A

iron

109
Q

What is the primary cause of immunodeficiency worldwide?

A

Protein-energy malnutrition

110
Q

Sources of iron

A

red meat, poultry, fish, egg yolks, dark green vegetables, legumes, dried fruit

111
Q

Kwashiokor

A

protein malnutrition

112
Q

Marasmus

A

protein and calorie deficiency

113
Q

Which antibody does not cross placenta?

A

IgM

114
Q

Which antibody is best for diagnosing acute Hep A?

A

HAV-IgM

115
Q

Which antibody is best for detecting vaccinated Hep A?

A

HAV-IgG

116
Q

Which antibody is best for detecting past Hep A infection?

A

HAV-total

117
Q

prion

A

infectious protein

118
Q

Which viruses have DNA

A

Adenovirus (ds)
HSV (ds)
Varicella Zoster Virus (ds)
CMV (ds)

119
Q

What is croup caused by

A

Parainfluenza Type I

120
Q

What is the most frequent cause of pediatric bronchiolitis and pneumonia?

A

RSV

121
Q

What is Fifth Disease, what virus is it caused by, and what is the classic presentation?

A

Erythema Infectiosum
Parvovirus B19
reticular (lacey) rash

122
Q

What virus causes Mono?

A

Epstein Barr Virus (EBV)

123
Q

What disease is EBV also associated with?

A

cancer

124
Q

CMV IV treatment for immunocompromised patients

A

ganciclover

125
Q

What is the common cause of blindness in HIV patients?

A

CMV retinitis

126
Q

What infection is associated with warts?

A

HPV (Human Papilloma Virus)

127
Q

How are viruses with lipid envelopes transmitted?

A

respiratory, parenteral, sexual routes (easier to sterilize)

128
Q

How are non-enveloped viruses transmitted?

A

fecal-oral (stable to harsh conditions)

129
Q

Horizontal transmission

A

one host to another in the same generation

130
Q

Vertical transmission

A

host to offspring

131
Q

Direct horizontal transmission

A

contact, aerosolized droplets

132
Q

Indirect horizontal transmission

A

vector mediated

133
Q

Who do you not give aspirin to?

A

people under 18 years old

134
Q

What virus causes the common cold and SARS?

A

Coronavirus

135
Q

What is the most common cause of the common cold?

A

Rhinovirus

136
Q

What virus can survive outside the body for up to 2 weeks?

A

Adenovirus

137
Q

What virus causes “dew drops on rose petal” rash?

A

Varicella (chicken pox)

138
Q

What virus causes parotitis (hallmark)

A

Mumps

139
Q

What virus is the leading cause of gastroenteritis in children?

A

Rotavirus

140
Q

What is the hand-foot-and-mouth disease? (visible vesicles)

A

Coxsackievirus A (Enterovirus)

141
Q

What virus presents with Koplik spots on oral mucosa and a non-pruritic macolopapular rash?

A

Measles (Rubeola)

142
Q

What virus causes cold sores?

A

Herpes labialis

143
Q

Ramsay Hunt Syndrome

A

Herpes Zoster Oticus (ear)

144
Q

Which virus is resistant to most disinfectants and highly contagious?

A

Norovirus

145
Q

Which class of viruses can cause viral meningitis, encephalitis, percaditis, and myocarditis?

A

Enteroviruses

146
Q

What viruses are enteroviruses?

A

Poliovirus
Coxsackievirus
Echovirus
Enterovirus

147
Q

What are the 3 C’s of the Prodromal phase of Measles

A

cough, coryza (nose), conjunctivitis

148
Q

Classic signs of Measles

A

Koplik spots on oral mucosa

Rash

149
Q

Which Herpes Simplex Virus causes genital herpes? (majority)

A

HSV-2

150
Q

What are the CNS involvement in HSV-1 and HSV-2?

A

HSV-1: common for infectious Encephalitis

HSV-2: Viral Meningitis

151
Q

What is neonatal HSV encephalitis caused by?

A

HSV-2 during vaginal delivery

152
Q

What bacteria causes the hemolytic uremic syndrome?

A

Enterohemorrhagic E. coli

153
Q

What are the 3 symptoms of hemolytic uremic syndrome?

A

hemolysis, thrombocytopenia, renal failure

154
Q

What does enteroinvasive E. coli cause?

A

fever, severe abdominal pain

155
Q

Which virus should you avoid aspirin?

A

Varicella Zoster Virus

156
Q

What virus is associated with the “Slapped Cheek Appearance”?

A

Fifth Disease of Parovirus B19

157
Q

Tx for Parovirus B19

A

supportive unless complications (then IV Ig)

158
Q

Which virus should you not treat with amoxicillin/ampicillin bc can develop non-allergic maculopapular rash?

A

EBV

159
Q

Which virus can you develop splenomegaly in up to 50% of patients?

A

EBV

160
Q

Which virus is particularly harmful during pregnancy, leading to congenital infection/defects/hearing loss?

A

CMV

161
Q

What virus occurs in over 40% solid organ transplant patients (immunocompromised)?

A

CMV

162
Q

What is the most common sexually transmitted virus?

A

HPV

163
Q

Give an example of a prion virus

A

Creutzfelt-Jakob Disease

164
Q

Tropical disease that causes conjunctivitis

A

Zika

165
Q

What virus can cause congenital microcephaly?

A

Zika

166
Q

What virus causes severe joint pain with primary Tx of pain management? (spread through mosquitoes)

A

Chikungunya

167
Q

Most common mosquito viral illness in humans

A

Dengue Fever

168
Q

Which virus should you NOT treat with NSAIDs due to risk of hemorrhage?

A

Dengue Fever

169
Q

What is can example of acid fast bacteria?

A

Mycobacterium:
M. tuberculosis
M. Leprae
M. avium complex

170
Q

Erythromycin is D.O.C. for which diseases?

A

Pertusis
Diphtheria
Mycoplasma pneumoniae
Chlamydia