Micro 1 Flashcards
1
Q
peptidoglycan structure
A
sugar backbone with peptide side chains cross linked with transpeptidase
2
Q
lipoteichoic acid in what organisms and activity
A
Gram positives, induces TNG and IL-1
3
Q
Lipopolysaccharide in what and does what
A
Endotoxin of gram negatives. Induces TNF and IL-1. O polysaccharide is the antigen.
4
Q
Space between cytoplasmic membrane and outer membrane in gram negatives
A
Periplasm: contains hydrolytic enzymes including Beta-lactamases
5
Q
what is a capsule made of
A
polysccharide
6
Q
exception to polysaccharide capsule
A
Bacillus anthracis, contains D-glutamate
7
Q
sex pilus for what process
A
conjugation
8
Q
pilus and fimbria made of
A
glycoprotein
9
Q
spore made of
A
keratin-like coat; dipicolinic acid; peptidoglycan
10
Q
dipicolinic acid??
A
????
11
Q
glycocalyx structure and function
A
polysaccharide, adheres to surfaces (biofilms)
12
Q
capsules in what organisms
A
both gram positives and negatives
13
Q
Name the gram + cocci
A
staph and strep
14
Q
gram - cocci
A
neisseria (gram - diplococci)
15
Q
What are the branching filamentous bacteria
A
actinomyces and nocardia (weakly acid fast) Gram positives!!!
16
Q
What are the pleomorphic bacteria
A
Rickettsiae (Giemsa) and Chlamydiae (Giemsa) Gram negatives!!!!
17
Q
What are the spiral bacteria
A
Spirochetes (gram negatives): Borrelia (Giemsa), Leptospira, Treponema
18
Q
No cell wall bacteria
A
Mycoplasma (does not Gram stain)
19
Q
Mycoplasma cell membrane
A
Contain sterols and have no cell wall
20
Q
Mycobacteria cell wall
A
Contains mycolic acid with high lipid content.
21
Q
Name the gram positive rods
A
Clostridium, corynebacterium, bacillus, listeria, mycobacterium (acid fast), gardnerella (gram variable)
22
Q
The gram-negative rods
A
There are a ton.
23
Q
Make a table of the different kinds of bacteria, at least be able to recognize what each one is.
A
…………………….If you know all the gram-positives (there are only a few), you can know what all the gram negatives are!!!!!
24
Q
Everything is gram negative except for
A
Staph, strep, clostridium, corynebacterium, bacillus, listeria, gardnerella, actinomyces, nocardia, (not sure about nocardia)
25
Is mycoplasma gram +?
??????????????
26
What is in acid fast stain
Carbolfuchsin to stain the high lipid content of mycobacteria
27
Legionella is found where
Priarmily intracellular
28
Legionella staining
silver stain
29
Rickettsia gram stain?
Intracellular parasite (doesn't gram stain)
30
Chlamydia stain?
IC parasite; lacks muramic acid in cell wall
31
Muramic acid?
???
32
What is Giemsa stain?
?????
33
What bugs stain with Giemsa???
Chlamydia, Borrelia, Rickettsia, Trypanosomes, Plasmodium (these sound intracellular, but are all of them?....nope..fuck)
34
What is PAS stain
Periodic acid-Schiff: stains glycogen!!!!, mucopolysaccharides. PASs the sugar.
35
PAS stain for what
Tropheryma whipplei (Whipple disease)
36
Ziehl-Neelsen stain
Carbolfuchsin (Acid fast: nocardia, mycobacterium)
37
India ink stain
Cryptococcus
38
Other way of staining cryptococcus
Mucicarmine to stain thick polysaccharide capsule red
39
Silver stain for what
Fungi (pneumocystis), legionella, helicobacter
40
Special culture requirements....Know them???
?????????
41
Growing neisseria gonorrheae or meningitidis
Thayer-Martin or VPN media (Vancomycin, Polymyxin, and Nystatin.
42
Growing Bordetella pertussis
Bordert-Gengou (potato) agar (Bordet for Bordertella)
43
Growing E. coli
Eosin-Methylene blue (EMB) agar as colonies with green metallic sheen
44
Growing Fungi
Sabouraud agar. "Sab's a fun guy!"
45
What are the obligate aerobes
Pseudomonas, Mycobacterium tuberculosis, and Nocardia! All lung infections
46
What part of lung has the highest PO2
Apices of lung, where M. tuberculosis goes after reactivation from immune compromise or TNF-alpha inhibitor.
47
Bacteria in burn wounds
P. aeruginosa
48
Where do you see P. aeruginosa
Burn wounds, complications of diabetes, nosocomial PNA, and pneumonias in cystic fibrosis patients.
49
What are the obligate anaerobes
Clostrium, bacteroides, and actinomyces (actinomyces and nocardia are at opposite ends)
50
What do obligate anaerobes lack
Catalase and/or superoxide dismutase
51
Characteristics of obligate anaerobes
Smell bad (short-chain fatty acids), difficult to culture, and produce gas in tissue (CO2 and H2).
52
What ABx can't be used against anaerobes
Aminoglycosides because they require O2 to enter.
53
Obligate intracellular bugs
Rickettsia, Chlamydia (can't make own ATP)
54
Facultative intracellular bugs
Salmonella, neisseria, brucella, mycobacterium, listeria, francisella, legionella, yersinia pestis
55
Mnemonic for facultative intracellular bugs
Some Nasty Bugs May Live FacultativeLY
56
Encapsulated Bacteria
SHiNE SKiS: Strep pneumo, HiB, N. meningitidis, E. coli, Salmonella, Kleb, group B Strep
57
How to kill encapsulated bacteria
Opsonized and cleared by spleen
58
What vaccines to give aplenics
S. pneumo, H. flu, and N. meningitidis
59
Catalase-positive organisms
Pseudomonas, Listeria, Aspergillus, Candida, E.coli, S. aureus, Serratia (You need PLACESS for your CATs)
60
What kind of vaccine activates T-cells
Conjugated vaccine (to protein), polysaccharide antigen cannot be presented to T cells.
61
Pneumovax kind of vaccine
Pneumococcal Polysaccharide Vaccine (PPSV) with no conujugated protein
62
Prevnar is what kind of vaccine
Pneumococcal Conjugate Vaccine (PCV)
63
HiB vaccine
Conjugate
64
Meningococcal vaccine
Conjugate vaccine
65
Urease-positive bugs
Cryptococcus, H. pylori, Proteus, Ureaplasma, Nocardia, Klebsiella, S. epidermidis, S. saprophyticus
66
Pigment-producing bacteria
Actinomyces israelii (Yellow), S. aureus (Yellow), Pseudomonas aeruginosa (blue-green), Serratia marcescens (red)
67
What does Protein A do?
Binds Fc region of IgG. Prevents opsonization and phagocytosis. Expressed by S. aureus.
68
What does IgA protease do?
Cleaves IgA. Secreted by S. pneumo, HiB, and Neisseria (SHiN)
69
What does M protein do?
Helps prevent phagocytosis. Expressed by group A strep.
70
Compare exotoxin and endotoxin..
.............
71
Basics of endotoxin
Outer cell membrane of most gram-negative bacteria, is not secreted, is made out of LPS (released when lysed), made by bacterial chromosome, low toxicity, creates fever, chock (hypotension), and DIC, induces TNF,IL-1, and IL-6, poorly antigenic, no toxoids formed and no vaccine avaialble, stable at 100 degrees celsius for 1 hr. Found in meningococcemia, sepsis by gram negative rods
72
What is a toxoid?
Toxoid is the toxin that has been inactivated chemically or with heat but still has its immunogenicity and is used as vaccine.
73
Basics of exotoxin
Certain species of gram + and gram - bacteria, secreted from cell, polypetide, from plasmid or bacteriophage, high toxicity, induces hihg-titer antibodies called antitoxins, toxoids used as vaccines, destroyed rapidly at 06 degrees celsius (except staph enterotoxin), causes tetanus, botulism, and diphtheria.
74
Write out a table of bugs with exotins
........
75
Dysentery from what bacteria
Shigella
76
ETEC toxins mnemonic
Labile int he Air, Stable on the Ground (cAMP and cGMP)
77
ENDOTOXIN mnemonic
Edema, nitrix oxide, DIC/Death, Outer membrane, TNF-alpha, O-antigen, eXtremely heat stable, IL-1, Neutrophil chemotaxis
78
What are endotoxins
A LPS in outer membrane of gram negatives
79
What does Lipid A do
It is an endotoxin, activates macrophages, complement, and tissue factor.
80
What activated macrophages do
IL-1, TNF, and NO
81
What activated complement does
C3a and C5a
82
What activated tissue factor does
Coagulation cascade and subsequent DIC
83
What is competence
The ability to take up naked DNA from environment for Transformation
84
What bacteria are known for transformation
SHiN: S. pneumo, HiB, and Neisseria
85
What is optochin
Optochin is used to distinuish alpha-hemolytic strep. Strep pneumo is optochin sensitive but strep viridans is resistant.
86
Example of Viridans strep
S. mutans
87
F+ conjugation
From a F+ plasmid which contains genes for sex pilus and conjugation. no chromosomal genes. The entire plasmid is shuttled through sex pilus.
88
Hfr conjugation
Incorporated into bacterial chromosome. Transfers plasmid and chromosome genes.
89
Transposition in bacteria
Transposons between plasmid and chromosome. Abx resistance genes on R plasmid.
90
Generalized transduction
Lytic phage gets DNA incorporated into the virion.
91
Specialized transduction
Lysogenic phage gets flanking DNA from bacteria
92
5 bacterial toxins encoded in a lysogenic phage
ABCDE: ShigA-like toxin, Botulinum, Cholera, Diphtheria, Erythrogenic of Strep pyogenes.
93
Do strep have catalase?
No, all strep lack catalase, staph has catalase
94
Is staph aureus hemolytic?
Yes, beta-hemolytic
95
Is listeria hemolytic
Yes
96
Listeria describtion
Tumbling motion, newborn meningitis, unpasteurized milk
97
Where to find Staph aureus
The nose.
98
What is protein A
Virulence factor of staph aureus binding Fc-IgG, inhibits complement activation and phagocytosis.
99
Bacterial superinfection after flu
Staph aureus
100
Staph aureus toxins
TSST-1 (toxic shock syndrome), scalded skin syndrome (exfoliative toxin), rapid-onset food poisoning (enterotoxins)
101
MRSA (methicillin-resistant S. aureus infection) MOA of resistance
Altered penicillin binding protein
102
What is TSST and what does it do
Superantigen activating a huge percentage of T-cells with MHCII. Presents with fever, vomiting, rash, desquamation, shock, end-organ failuire, use of vaginal or nasal tampons predisposes to toxic shock syndrome.
103
Incubation period of s. aureus food poisoning
2-6 hrs. Enterotoxin is heat stable, not destroyed by cooking
104
What does coagulase do
Forms fibrin clot around self to lead to an abscess
105
Staph epidermidis blurb
Biofilms on prosthetics and catheters. Contaminates blood cultures. Novobiocin sensitive.
106
Staph saprophyticus blurb
Second MCC of uncomplicated UTI in young women (1. is E. coli). Novobiocin resistant
107
Strep pneumo MCC of what diseases
MOPS: meningitis, otitis media (children), pneumonia, and sinusitis.
108
Morphology of strep pneumo
Lancet-shaped, gram-positive diplococci, encapsulated. IgA protease
109
Pneumococcus sputum
Rusty sputum
110
Pneumocccus causes sepsis in what
Sickle cell and splenectomy
111
What happens if you remove pneumococcus capsule
No virulence without it!
112
Pneumococcus and optochin
Sensitive
113
Name the viridans group strep and description
S. mutans in mouth (caries), cause subacute bacterial endocarditis at damaged valves (S. sanguinis). Resistant to optochin. Alpha-hemolytic.
114
Strep pyogenes infections
Scarlet fever is toxin induced (rheumatic fever is immunologic), can cause cellulitis, impetigo, necrotizing fasciitis.
115
Strep pneumo description
Group A beta-hemolytic strep. Bacitracin sensitive. Antibodies to M protein enhance host defense but give rise to rheumatic fever. .
116
Recent strep pyo infection dx
ASO titer (anti-streptolysin O antibodies)
117
JONES criteria for rheumatic fever
Joints (polyarthralgias), carditis, nodules (subQ), Erythema marginatum, sydenham chorea.
118
What strep pyo infections can cause rheumatic fever and glomerulonephritis
Pharyngitis can do both. Impetigo more commonly precedes glomerulonephritis than pharyngitis.
119
Scarlet fever sxs
Scarlet rash with sandpaper-like texture, strawberry tongue, circumoral pallor.
120
What does erythema marginatum look like
it looks like pink rings
121
Strep agalactiae description
beta-hemolytic (Group B strep), in vagina. Bacitracin resistant. Causes PNA, meningitis, sepsis in babies.
122
What is CAMP factor
Made by strap agalactiae, enlarges the area of hemolysis formed by S. aureus
123
What to diagnose strap agalactiae with
CAMP test (named after authors). It turns hippurate test positive.
124
Screening and management for strep agalactiae
Screen pregnant women at 35-37 weeks. patients with positive culture receive intrapartum penicillin ppx.
125
Enterococci cause what infections
UTI, biliary tract infections, and subacute endocarditis after GI/GU procedures.
126
Enterococci tx
Resistant to penicillin G
127
Nonenterococcal group D strep
Can't grow in 6.5% NaCl and bile (enterococci can)
128
Where to find strep bovis
In the gut, can cause bacteremia and subacute endocarditis in colon cancer patients.
129
What kind of strep is strep bovis
gamma-hemolytic group D strep
130
What is pseudomembranous mean?
For diphtheria, it is gray-white exudative layer of necrotic epithelium and debris, fibrin, bacteria, and neutrophils. Removing it causes hemorrhage.
131
Diphtheria presentatin
Pseudomembranous pharyngitis, bull neck lymphadenopathy, myocarditis, and arrythmias.
132
Diphtheriae dx
Gram-positive rods with metachromatic (blue and red) granules and Elek test for toxin.
133
What does diphtheria look like on agar
Black colonies on cystine-tellurite agar.
134
Diphtheriae mnemonic
ADP-ribosylation, beta-prophage, corynebacterium, diphtheriae, elongation factor 2, granules
135
Diphtheriae path
Exotoxin encoded on Beta-prophage. Potent exotoxin hibits protein synthesis via ADP-ribosylation of EF-2
136
What do spores have??
Dipicolinic acid in their core with nometabolic activity.
137
What bacteria form spores
Bacillus anthracis, clostridium perfringens, C. tetani. SPORE FORMING GRAM POSITIVES IN SOIL.
other spore formers are B. cereus, C. botulinum, and Coxiella botulinum
138
Full name for B. cereus
Bacillus cereus
139
What is a bacteroides species?
Bacteroides fragilis
140
What are the clostridia
Gram-positive, spore-forming, obligate anaerobic bacilli.
141
What does tetanospasmin do
Blocks glycine and GABA release from REnshaw cells in spinal cord.
142
What is floppy baby syndrome?
Caused by Botulinum toxin.
143
What does C. perfringens make?
Alpha toxin ("lecithinase" a phospholipase) that causes myonecrosis (gas gangrene) and hemolysis.
144
C. difficile toxins
Toxin A, enterotoxin, binds to the brush border of the gut. Toxin B, cytotoxin, causes cytoskeletal disruption via actin depolymerization leading to pseudomembranous colitis and diarrhea.
145
C. diff most commonly due to what Abx
clindamycin and ampicillin.
146
What is bacillus anthracis
Gram-positive, spore forming rod that produces anthrax toxin. The ONLY bacterium with a polypeptide capsule (contains D-glutamate)
147
Cutaneous anthrax presentation
Painless, necrotic black eschar that starts out as a boil-like lesion. Does not lead to bacteremia and death.
148
Pulmonary anthrax presentation
Inhalation of spores causes flu-like sxs that progresses to fever, pulm. hemorrhage, mediastinitis, and shock.
149
What is woolsorters' disease
Pulm. anthrax from breathing in spores from contaminated wool.
150
What causes Reheated Rice Syndrome
Bacillus cereus
151
How can Bacillus cereus cause disease in boiled rice?
Spores!!!
152
Types of bacillus cereus infections
Emetic type: rice and pasta. n/V within 1-5 hrs. Caused by cereulide, a preformed toxin.
Diarrheal type: Water, nonbloody diarrhea and GI pain within 8-18 hr
153
Listeria monocytogenes description
Facultative intracellular microbe, from unpasteurized dairy products and deli meats, via transplacental transmission, or from vagina during birth.
154
How does listeria get around
Rocket tails from actin polymerization. Characteristic tumbling motility; is only gram positive organism to produce LPS
155
The only gram positive to produce LPS
Listeria
156
What can listeria cause
Amnionitis, septicemia, and spontaneous abortion in pregnant women; granulomatosis infantiseptica; neonatal meningitis; meningitis in immunocompromised patients; mild gastroenteritis in healthy individuals.
157
Treating listeria
Gastroenteritis is self-limited. Ampicillin in infants, immunocompromised patients, and elderly in empirical treatment of meningitis
158
Distinguish actinomyces from nocardia
Make a table to compare......
159
Nocardia infections
Pulm. infections in immunocompromised and cutaneous infections after trauma in immunocompetent
160
Actinomyces infections
oral/facial abscesses that drain through sinus tracts, forms yellow "sulfur granules"
161
What to treat Nocardia with
Sulfonamides
162
What to treat Actinomyces with
Penicillin
163
What is primary tuberculosis
The Ghon complex (hilar lymph nodes and Ghon focus in mid-lung field). Occurs in infection naive people, usually children. Can proceed to several endpoints like death or heals.
164
What can happen to primary tuberculosis
1. Heal by fibrosis with hypersensitivity and immunity and tuberculin +
2. Progressive lung disease and death (malnutrition, HIV)
3. Severe bacteremia, miliary tuberculosis leading to death.
4. Preallergic lymphatic or hematogenous dissemination leading to dormant tubercle bacilli in several organs and reactivation in adult life.
165
How does secondary tuberculosis happen?
Partially immune hypersensitized host gets reinfected or patient with latent TB gets reactivation.
166
How does secondary tuberculosis present?
Fibrocaseous cavitary lesion (usually upper lobes)
167
Examples of extrapulmonary tuberculosis
CNS (parenchymal tuberculoma or menigitis), vertebral body in Pott's disease), lymphadenitis, Renal, GI, and adrenal infection.
168
BCG + on PPD?
Yes
169
When is PPD negative?
steroids, malnutrition, immunocompromise leading to anergy AND SARCOIDOSIS
170
What does a caseating granuloma have?
Central necrosis with multinucleated Langhans giant cells.
171
More specific test than PPD?
Interferon-gamma release assay IGRA is more specific. Fewer false positives than BCG.
172
TB symptoms
Fever, night sweats, weight loss, and hemoptysis.
173
Mycobacterium kansasii presentation
Pulmonary TB like symptoms
174
Mycobacterium avium-intracellulare presentation
Disseminated, non-TB dsiease in AIDS; often resistant to multiple drugs. Prophylactic treatment with azithromycin.
175
Which mycobacterium is not acid fast?
All are acid fast
176
What is cord factor
For M. tuberculosis that inhibits macrophage maturation and induces release of TNF-alpha. Sulfatides (surface glycolipids) inhibit phagolysosomal fusion.
177
Other name for leprosy
Hansen disease
178
Agar media for Mycobacterium leprae
Cannot be grown in vitro. Reservoir is armadillos.
179
M. leprae does what path
Likes cool temps (skin and superficial nerves, glove and stocking loss of sensation)
180
Forms of leprosy
Lepromatous and Tuberculoid
181
Lepromatous leprosy presentation
Presnts diffusely over the skin with leonine facies, communicable, characterized by low cell-mediated immunity with a humoral TH2 response.
182
Tuberculoid leprosy presentation
Limited to a few hypoesthetic, hairless skin plaques; characterized by high cell-mediated immunity with a largely Th1-type immune response.
183
Treating leprosy
Multidrug therapy with dapsone and rifampin for 6 months for tuberculoid form; and dapsone, rifampin, and clofazimine for 2-5 years for lepromatous form.
184
Is lepromatous leprosy lethal?
It can be!
185
Know the gram-negative lab algorithm
What are the gram negative diplococci
186
What grows pink colonies on MacConkey agar
Lactose fermenting enteric bacteria. Citrobacter, Klebsiella, E. coli, Entergoacter, and Serratia (weak fermenter).
187
What enzyme does E. coli produce
Beta-galactosidase which breaks down lactose into glucose and lactose
188
EMB agar grows what
Lactose fermenters grow as purple/black colonies. E. coli is purple colonies with a green sheen.
189
Penicillin and gram-negative bugs.
Gram negative bacilli are resistant to penicillin G but may be susceptible to ampicillin and amox. Gram neg. outer lmembrane inhibits penicillin G and vancomycin entry.
190
Neisseria general description
Gram-negative diplococci.
| Both ferment glucose and produce IgA proteases. N. gonorrhoeae is often intracellular (within neutrophils)
191
Neisseria mnemonics
MeninGococci ferment Maltose and Glucose.
| Gonococci ferment Glucose.
192
Compare gonococci to meningococci in a table
....
193
Mnemonic for Haemophiluis
HaEMOPhilus (epiglottitis, meningitis, otitis media, and PNA.
194
H. flu tx
mucosal infection with augmentin.
Meningitis with ceftriaxone.
Rifampin ppx in close contacts.
195
H flu characteristics
small gram-negative coccobacillary rod. Aerosol transmission.
196
Nontypeable strains cause what
Mucosal infections (otitis media, conjunctivitis, bronchitis)
197
What does Hib vaccine contain
Type B capsular polysaccharide (polyribosylribitol phosphate) conjugated to diphtheria toxoid or other protein. Given between 2-18 months of age.
198
Legionella description
Gram negative rod stained with silver stain.
199
Legionella growth
Charcoal yeast extract culture with iron and cysteine.
200
legionella dx
Urine antigen
201
Legionella transmission
Aerosol around water sources. No person to person transmission
202
Legionella tx
Macrolide or quinolone
203
Legionnaires' disease presentation
Severe PNA, fever, GI and CNS sxs
204
Pontiac fever presentation
Mild flu-like syndrome
205
Legionella bloodwork
Hyponatremia.
206
Pseudomonas description
Aerobic gram-negative rod. non-lactose fermenting, oxidase positive. Produces pyocyanin (blue green); grade like odor. Water source. Produces endotoxin (fever, shock) and exotoxin A (inactivates EF-2).
207
Pseudomonas mnemonic
PSEUDOmonas: associated with wound and burn infections, PNA (cystic fibrosis), Sepsis, External otitis (swimmer's ear), UTI, Drug use and Diabetic Osteomyelitis, and hot tub folliculitis. Malignant otitis externa in diabetics
208
Ecthyma gangrenosum
Rapidly progressive, necrotic cutaneous lesions caused by Pseudomonas bacteremia. Typically seen in immunocompromised patients.
209
Ecthyma tx
Aminoglycoside plus extended-spectrum penicillin (e.g. piperacillin, ticarcillin, cefepime, imipenem, meropenem.
210
E. coli virulence factors
Fimbriae: cystitis and pyelonephritis
K capsule: PNA, neonatal meningitis
LPS endotoxin: septic shock
211
4 A's of Klebsiella
Aspiration PNA, Abscess in Lungs and Liver, Alcoholics, di-A-betics
212
Typhoid fever presentation
Only in humans. Rose spots on the abdomen, fever, headache, and diarrhea. Can remain in gallbladder and cause a carrier state.
213
Campylobacter jejuni
Major cause of bloody diarrhea, especially in children.
214
Campylo transmission
Fecal-oral through poultry, meat, unpasteurized miolk.
215
Campylo morph.
s-shaped, oxidase +, grows at 42 degrees (campylobacter likes the hot CAMPfire)
216
Extraintestinal findings of Campylobacter
Guillain-Barre and reactive arthritis
217
Vibrio cholerae morph.
comma shaped, oxidase +, grows in alkaline media. Endemic to developing countries.
218
Yersinia enterocolitica transmission
From puppy feces, contaminated milk, or pork. Causes mesenteric adenitis that can mimic Crohn disease or appendicitis.
219
What does H. pylori increase the risk of
Peptic ulcer, gastric adenocarcinoma, and lymphoma
220
H. pylori morph
Catalase, oxidase, and urease + (can use urea breath test or fecal antigen test for diagnosis).
221
H. pylori tx
Triple therapy: Proton pump inhibitor + clarithromycin + either amoxicillin or flagyl
222
Name the spirochetes
Borrelial (big size), Leptospira, Treponema (BLT).
223
Imaging spirochetes
Only Borrelia can be visualized with aniline dyes (Write or Giemsa stain) in light microscopy. Treponema is dark-field microscopy.
224
Leptospira disease
Leptospira interrogans causes leptospirosis from water contaminated with animal urine: flu-like sxs, jaundice, photophobia with conjunctival suffusion (erythema without exudate). Prevalent among surfers and in tropics (i.e. Hawaii)
225
What is Weil disease
Icterohemorrhagic leptospirosis: severe form with jaundice and azotemia from liver and kidney dysfunction; fever, hemorrhage, and anemia
226
Lyme disease mnemonic
FAKE a Key Lyme pie: Facial nerve palsy (bilateral), Arthritis, Kardiac block, Erythema migrans
227
VDRL false positives
VDRL: viruses (mono, hepatitis), drugs, rheumatic fever, lupus and leprosy
228
Treatment for all Rickettsial diseases and vector-borne illness
Doxycycline!!!!
229
Where do you seen rash on palms and soles
CARS: Coxsackievirus A (hand food mouth), RMSF, and Secondary Syphilis
230
Difference in rash between Typhus and RMSF
Typhus starts centrally, RMSF starts peripherally
231
Cause of Q fever
Coxiella burnetii
