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Micro 1 USMLE Flashcards

1
Q

alcoholic vomits gastric contents and develops foul smelling sputum. What organisms are most likely

A

anaerobes

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2
Q

middle age male presents w/ acute onset monoarticular joint pain and bilateral bell’s plalsy. What is the likely dz and how did he get it

A

lyme dz; bite from Ixodes tick

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3
Q

Pt w/ mycoplasma pneumoniae exhibits cryoagglutins during recovery phase. What types of immunoglobulins are reacting

A

IgM

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4
Q

UA of pt shows WBC casts. What is the dx?

A

pyelonephritis

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5
Q

young child presents w/ tetany and candidiasis. Hypocalcemia and immunosuppression are found. What cell is deficient?

A

T cell (DiGeorge)

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6
Q

pt presente w/ “rose gardener’s” scenerio (thorn prick w/ ulcers olong lymphatic drainage. What is the infectious bug.

A

sporothrix schencki

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7
Q

25 y/o medical student has a burning feeling in his gut after meals. bx of gastric mucosa shows gram negative rods. what is the likely organism?

A

H pylori

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8
Q

32 yo male has “cauliflower” skin lesions. Tissue bx shows broad based budding yeast. What organism is most likely?

A

blastomyces

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9
Q

breast feeding woman suddenly develops redness and swelling of her right breast. On examination it is found to be afluctuant mass. What is the dx?

A

mastitis caused by S. aureus

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10
Q

Young child has recurrent lung infections and granulomatous lesions. What is the defect in neutrophils?

A

NADPH oxidase (chronic granulomatous dz)

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11
Q

20 y/o college student presents w/ lymphadenopathy, fever, and hepatosplenomegaly. His serum agglutinates sheep RBCs. What cell is infected?

A

B cell (EBV; infectious mononucleosis)

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12
Q

One hour after eating custard at a picnic, a whole family began to vomit. After 10 hours, they were better. What is the organism?

A

S. aureus (produces preformed enterotoxin)

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13
Q

infant becomes flaccid after eating honey. What organism is implicated, and what is the mechanism of action.

A

Clostridium botulinum; inhibited release of ACh.

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14
Q

Man presents with squamous cell carcinoma of the penis. He has exposure to what virus?

A

HPV

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15
Q

Pt develops endocarditis three weeks after receiving a prosthetic heart valve. What organism is suspected?

A

S. aureus or S. epidermidis

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16
Q

55 y/o man who is a smoker and heavy drinker presents with a new cough and flulike symptoms. Gram stain shows no organisms; silver stain of sputum shows gram-negative rods. What is the dx?

A

legionella pneumonia

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17
Q

after taking clidamycin, pt develops toxic megacolon and diarrhea. What is the mechanism of diarrhea

A

C. difficile overgrowth

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18
Q

this bacterial structure is composed of a sugar backbone with cross linked peptide side chains. It functions to give the bacterium rigid support, and to protect against osmotic pressure

A

peptidoglycan

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19
Q

This bacterial structure is composed of teichoic acid which induces TNF and IL-1. It functions as a major surface antigen.

A

cell wall/membrane in gram postitives

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20
Q

this bacterial structure is composed of lipid A which induces TNF & IL-1. Polysaccharide is the antigen. It functions as a major surface Ag and a site of endotoxin.

A

outer membrane of gram negative

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21
Q

what is the endotoxin of Gram negative bacteria

A

lipopolysaccaride

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22
Q

this bacterial structure is composed a plasma bilayer. It fxs as a site of oxidative and transport enzymes.

A

Plasma membrane

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23
Q

This bacterial structure is composed RNA and protein in 50S and 30S subunits. It functions as the site of protein synthesis.

A

ribosome

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24
Q

this bacterial structure is composed of many hydrolytic enzymes, including B-lactamases. It is the space between the cytoplasmic membrane and outer membrane in gram negative bacteria.

A

Periplasm

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25
Q

this bacterial structure is composed polysaccaride and protects against phagocytosis.

A

capsule.

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26
Q

the capsule of bacillus anthracis is unique in that it contains _________ instead of polysaccharide.

A

D-glutamate

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27
Q

This bacterial structure is composed of glycoprotein. It functions to mediate adherence of bacteria to cell surface.

A

pilus/fimbrae

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28
Q

sex pilus forms attachment between 2 bacteria during _______

A

conjugation

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29
Q

this bacterial structure is composed of protein and fxs in motility

A

flagellum

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30
Q

this bacterial structure is composed of a keratin-like coat and dipicolinic acid. It provides resistance to dehydration, heat, and chemicals.

A

spore

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31
Q

this bacterial structure is composed DNA. It contains a variety of genes for antibiotic resistance, enzymes, and toxins.

A

plasmid

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32
Q

This bacterial structure is composed of polysaccharide. It mediates adherence to surfaces, especially foreign surfaces (e.g., indwelling catheters).

A

Glycocalyx

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33
Q

in the bacterial growth curve this is the part where there is metabolic activity without division

A

lag

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34
Q

in the bacterial growth curve this is the part where there is rapid cell division

A

log

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35
Q

in the bacterial growth curve this is the part where nutrient depletion slows growth

A

stationary

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36
Q

in the bacterial growth curve this is the part where there is prolonged nutrient depletion and buildup of waste products.

A

death

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37
Q

what is the source of exotoxins

A

some G+ & G- bacteria

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38
Q

what is the source of endotoxins

A

cell wall of most G- bacteria and listeria

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39
Q

are exotoxins secreted from the cell

A

yes

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40
Q

are endotoxins secreted from the cell

A

no

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41
Q

exotoxins are made of _______

A

polypeptides

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42
Q

endotoxins are made of _____

A

lipopolysaccharides

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43
Q

genes for exotoxins are located where?

A

plasmid or bacteriophage

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44
Q

genes for endootoxins are located where?

A

bacterial chromosomes

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45
Q

how toxic are exotoxins

A

high (fatal dose is on the order of 1 ug)

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46
Q

What is the toxicity of endotoxins?

A

low (fatal dose is on the order of hundreds of micrograms)

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47
Q

what are the clinical effects of endotoxins?

A

fever & shock

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48
Q

what is cytokines are involved in the mode of action of endotoxins

A

TNF & IL1

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49
Q

high-titer antibodies called antitoxins can be used against these toxins

A

exotoxins

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50
Q

this toxin poorly antigenic

A

endotoxins

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51
Q

these are used as vaccines for exotoxins

A

toxoids

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52
Q

is there a vaccine available for endotoxins

A

no

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53
Q

what is more heat stable, endotoxins or exotoxins

A

endotoxins

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54
Q

what is the only exotoxin that is heat stable

A

staphylococcal enterotoxin

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55
Q

tetanus, botulism, & diphtheria typically cause problems due to ________ (exotoxin or endotoxins)

A

exotoxins

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56
Q

meningococcemia, causes sepsis by G- rods. Toxicity is due to ________ (exotoxin or endotoxins)

A

endotoxins

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57
Q

these binds directly to MHC II and T-cell receptor, activating large numbers of T cells to stimulate release of IL-1 & IL-2

A

superantigens

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58
Q

TSST-1 from this bug causes toxic shock syndrome (fever, rash, shock).

A

S. Aureus

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59
Q

Enterotoxins from this bug cause food poisoning.

A

S. Aureus

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60
Q

Scarlet fever-strain SPE SPE toxin from this bug causes toxic shock-like syndrome.

A

S. pyogenes

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61
Q

this exotoxin interferes with host cell fx. It has a B component and an A component.

A

ADP ribosylating A-B toxins.

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62
Q

tell me about the B component of ADP ribosylating A-B toxins

A

B (binding) component binds to receptor on surface of host cell, enaboling endocytosis)

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63
Q

tell me about the A component of ADP ribosylating A-B toxins

A

A (active) component attaches an ADP-ribosyl to a host cell protien (ADP ribosylation), altering protein fx.

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64
Q

What bugs have ADP ribosylating A-B toxins (4)

A

Corynebacteria diptheria
Vibrio cholerae
E. Coli
Bordetella Pertussis

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65
Q

What bugs have superantigins (2)

A

S. aureus

S. pyogenes

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66
Q

this bug has an ADP ribosylating A-B toxin that inactivatess elongation factor (EF-2) causing a pharyngitis and a “pseudomembrane” in the throat

A

Corynebacterium diptheriae

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67
Q

This bugs ADP ribosylating A-B toxin acts on the G protein to stimulate adenylyl cyclase, increasing pumping of Cl- & H2O in the gut causing voluminous rice-water diarrhea.

A

Vibrio cholerae

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68
Q

This bug has a heat-labile ADP ribosylating A-B toxin, that stimulates adenylyl cyclase (cholera-like mechanism), causing watery diarrhea. Heat stabile toxin stimulates guanylate cyclase.

A

E. Coli

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69
Q

This bug has an ADP ribosylating A-B toxin that stimulates adenylate cyclase, causes whooping cough, inhibits chemokine receptor causing lymphocytosis.

A

Bordetella pertussis

70
Q

This bug has an alpha toxin that causes gas gangrene. You will see a double zone of hemolysis on blood agar.

A

Clostridium perfringes.

71
Q

This bug blocks the release of inhibitory neurotransmitter glycine. Causing “lockjaw”

A

C. Tetani

72
Q

This bug blocks the release of Ach, causing anticholinergic symptoms such as CNS paralysis. Spores can be found in canned food and honey causing floppy baby.

A

C. botulinum

73
Q

this bug has a toxin in which 1 toxin in the toxin complex is adenylate cyclases.

A

B. anthracis

74
Q

This bug produces the shiga toxin which cleaves host cell rRNA and also enhances cytokine release causing HUS.

A

Shigella

75
Q

what other bug produces the Shiga toxin

A

E. Coli O157:H7

76
Q

This bug produces streptolysin O, a hemolysin and antigen for ASO antibody in rheumatic fever

A

S. pyogenes

77
Q

this is a lipopolysaccharide found in the cell wall of gram negative bacteria

A

endotoxin

mneu: N-dotoxin is an integral part of gram-Negative cell wall.

78
Q

endotoxins are heat ______ (stable or labile)

A

stable)

79
Q

these bugs do not gramstain well

A

Treponema (too thin)
Rickettsia (intracellular
Mycobacteria (high lipid content of cell wall)
Mycoplasma (no cell wall)
Legionella pneumophila (primarily intracellular)
Chlamydia (intracellular)

mneu:These Rascals May Microscopically Lack Color

80
Q

how do you I.D. Treponema

A

darkfeild microscopy and fluorescent Ab staining

81
Q

How do you I.D. Mycobacteria

A

acid fast stain

82
Q

How do you I.D. Legionella

A

silver stain

83
Q

pathogenic Neisseria species are differentiated on the basis of sugar ________

A

fermentation

84
Q

MeninGococci ferment ________ & __________

Gonococci ferment _______

A

Maltose & Glucose

Glucose

85
Q

S. aureus produces a ________ pigment

A

yellow

mneu: Aureus (latin)=gold

86
Q

Pseudomonas Aeruginosa produces a ________ pigment

A

blue green

87
Q

Serratia marcescens produces ____ pigment

A

red

mneu: marcescens = maraschino cherries are red

88
Q

______ proteases allows these organisms to colonize mucosal surfaces: Streptococcus pneumoniae, Neisseria meningitidis, N. gonorrheae, H. influenzae.

A

IgA proteases

89
Q

special media cx requirements for isolation:

H. influenzae

A

chocolate agar w/ factors V (NAD) & X (hematin)

90
Q

special media cx requirements for isolation:

N. gonorrheaeae

A

Thayer-Martin (VCN) media

91
Q

special media cx requirements for isolation:

B. pertussis

A

Bordet-Gengou (potato) agar

92
Q

special media cx requirements for isolation:

C. diptheriae

A

Tellurite plate, Loffler’s medium, blood agar

93
Q

special media cx requirements for isolation:

M. Tuberculosis

A

Lowenstein-Jensen agar

94
Q

special media cx requirements for isolation:

Lactose-fermenting enterics

A

pink colonies on MacConkey’s agar

95
Q

special media cx requirements for isolation:

Legionella

A

Charcoal yeast exxtract agar buffered with increased iron and cysteine

96
Q

special media cx requirements for isolation:

Fungi

A

Sabouraud’s agair

97
Q

Give the appropriate stain–

Amyloid; apple-green bifringence in polarized light because of Beta pleated sheets

A

Congo red

98
Q

Give the appropriate stain–

Borrelia, Plasmodium, trypanosomes, Chlamydia

A

Giemsa’s

99
Q

Give the appropriate stain–

stains glycogen, mucopolysaccharides, used to diagnose Whipple’s dz

A

PAS (periodic acid-Schiff)

100
Q

Give the appropriate stain–Acid-fast bacteria

A

Ziehll-Neelsen

101
Q

Give the appropriate stain–Cryyptococcus neoformans

A

India ink

102
Q

Give the appropriate stain–Fungi, PCP, Legionella

A

Silver stain

103
Q

DNA transfered from 1 bacterium to another (Conjugation, transduction, or transformation)

A

conjugation

104
Q

DNA transferred by a virus from 1 cell to another (Conjugation, transduction, or transformation)

A

Transduction

105
Q

Purified DNA taken up by a cell. (Conjugation, transduction, or transformation)

A

Transformation

106
Q

Conjugation, transduction, & transformation. The only transfer process done in eukaryotic (e.g., human) cells

A

transformation

107
Q

Conjugation transfers these 2 types of DNA

A

chromosomal or plasmid

108
Q

this classification of bacteria use an O2 dependent system to generate ATP

A

Obligate Aerobes.

109
Q

Examples of obligate aerobes

A

Nocardia, Pseudomonas Aeruginosa, Mycobacterium tuberculosis, & Bacillus

mneu: Nagging Pests Must Breath.

110
Q

This bug is an Aerobe seen in burn wounds, nosocomial pneumonia, and pneumonias in cystic fibrosis patients

A

P. Aeruginosa

mneu: P. AERuginosa is an AERobe

111
Q

__________ HAS A PREDILECTION FOR THE APICES OF THE LUNG, WHICH HAVE THE HIGHEST PO2

A

M. TUBERCULOSIS

112
Q

Examples of this category of bacterium include Clostridium, Bacteroides, and Actinomyces.

A

Obligatee anaerobes

113
Q

Obligatee anaerobes lack ________ and/or ________ and thus are susceptible to oxidative damage.

A

catalase

superoxide dismutase

114
Q

Obligatee anaerobesare generally foul smelling due to _________

A

short chain fatty acids

115
Q

Obligatee anaerobes are difficult to culture, and produce ______ in tissue

A

gas (CO2 & H2)

116
Q

anaerobes are normal flora in _____ but are pathogenic elsewhere.

A

GI tract

117
Q

_________ are ineffective against anaerobes because these antibiotics require O2 to enter into bacterial cell

A

AminO2glycosides

118
Q

These 2 bugs are obligate intracellular bugs because they can’t make own ATP

A

Rickettsia, Clamydia

mneu: Stay inside (cells) when it is Really Cold

119
Q

These 8 bugs are facultative intracellular bugs.

A

Salmonela, Neisseria, Brucella, Mycobacterium, Listeria, Francisella, Legionella, Yersinia

mneu: Some Nasty Bugs May Live FacultativeLY

120
Q

Give 2 examples of encapsulated bacteria

A

Streptococcus pneumoniae, H. influenzae, N. meningitidis, K. pneumoniae

121
Q

in encapsulated bacteria the _______ capsule is an antiphagocytic virulence factor

A

polysaccharide

122
Q

this positive test tells you if an encapsulated bug is present–the capsule swells when specific anticapsular antiserra are added

A

positive quellung reaction

mneu: Quellung = capsular “swellung”

123
Q

in encapsulated bacteria ______ is necessary for immune response

A

IgG2

124
Q

In pneumovax, H. influenzae, & B. meningococcii, this serves as the Ag in vaccines

A

capsule

125
Q

these are highly resistant to destruction by heat and chemicals. They have no metabolic activity and dipicolinic acid in their core.

A

spores

126
Q

You must do this in order kill spores (what is done to surgical equipment)

A

autoclave

127
Q

Only this type of bug forms spores when nutrients are limited

A

G+ rods

128
Q

gram + soil bugs (aka spore formers) are (3)

A

B. anthracis, C. perfringes, C. tetani

129
Q

give the 2 alpha hemolytic bacteria

A

1) streptococcus pneumoniae

2) Viridans streptococci

130
Q

this alpha hemollytic bacteria is catalase negative and optochin sensitive

A

streptococcus pneumonia

131
Q

this alpha hemolytic bacteria is catalase negative and optochin resistance

A

viridans streptococci

132
Q

Give the 4 Beta hemolytic bacteria

A

1) Staphylococcus Aureus
2) Streptococcus Pyogenes
3) Streptococcus agalactiae
4) Listeria moncytogenes

133
Q

this beta hemolytic bacteria is catalase and coagulase positive

A

Staphylococcus Aureus

134
Q

this beta hemolytic bacteria is catalase negative and bacitracian sensitive

A

Streptococcus Pyogenes

135
Q

this beta hemolytic bacteria is catalase negative and bacitracian resistant

A

Streptococcus agalactiae

136
Q

this beta hemolytic bacteria exists in unpasteurized milk has tumbling motility and causes meningitis in newborns

A

Listeria moncytogenes

137
Q

This degrades H2O2, an antimicrobial prodct of PMNs. H2O2 is a substrate for myeloperoxidase

A

Catalase.

138
Q

_____cocci make catalase, whereas streptococci do not

A

staphylo-

mneu: STAPH make catalase because they have more “staph”.

139
Q

________ makes coagulase, whereas Staph epidermidis and Staph saphrophyticus do not

A

Staph Aureus

mneu: Bad staph (aureus, because epidermidis is skin flora) makes coagulase and toxins)

140
Q

this virulence factor of S. Aureus binds Fc-IgG, inhibiting compliment fixation and phagocytosis

A

Protein A

141
Q

S. Aureus causes these 2 things

A

1) Inflammatory dz- skin infxns, organ abscesses, pneumonia

2) Toxin-mediated dz- toxic shock syndrome, scalded skin syndrome, rapid onset food poisoning

142
Q

Give the toxin responsible for toxic shock syndrome?

A

TSST-1

143
Q

Give the toxin responsible for scalded skin syndrome

A

exfoliative toxin

144
Q

Give the toxin responsible for rapid-onset food poisoning

A

enterotoxins

145
Q

This is a superantigen that binds to MHC II and T-cell receptor, resulting in polyclonal T-cell activation

A

TSST

146
Q

S. Aureus food poisoning is due to ingestion of a preformed ________

A

toxin

147
Q

this causes ACUTE bacterial endocarditis

A

S. Aureus

148
Q

Streptococcus pyogenes (group A Beta hemolytic streptococci causes three sequelae what are they?

A

1) Pyogenic-pharyngitis, cellulitis, impetigo
2) Toxigenic - scarlet fever, toxic shock syndrome
3) Immunologic - rheumatic fever, acute glomerulonepritis

mneu: PHaryngitis gives you rheumatic “PHever” and glomerulonepHritis”
mneu2: No “RHEUM” for SPECCulation: Subcutaneous nodules, Polyarthritis, Erythema marginatum, Chorea, Carditis.

149
Q

Streptococcus pyogenes is bacitratian _______.

A

sensitive.

150
Q

Ab to ________ enhances host defences against Streptococcus pyogenes

A

M protein

151
Q

______ titer detects recent Streptococcus pyogenes infection

A

ASO

152
Q

Streptococcus pnemonia is the most common cause of (4 )

A 
MOPS
Meningitis
Otitis media
Pneumonia
Sinusitis
153
Q

Streptococcus pnemonia ia optochin ______

A

sensitive

mneu: Streptococcus pnemonia MOPS are Most OPtochin Sensitive

154
Q

Pt presents with rusty sputum, sickle cell anemia sepsis, and splenectomy. He has a bug that is encapsulated & has an IgA protease.

A

Streptococcus pneumonia

155
Q

these bugs are bacitracin resistant & B hemolytic. They cause pneumonia, meningitis, and sepsis, mainly in babies.

A

Group B streptococci

156
Q

this virulence factor of S. Aureus binds Fc-IgG, inhibiting compliment fixation and phagocytosis

A

Protein A

157
Q

S. Aureus causes these 2 things

A

1) Inflammatory dz- skin infxns, organ abscesses, pneumonia

2) Toxin-mediated dz- toxic shock syndrome, scalded skin syndrome, rapid onset food poisoning

158
Q

Give the toxin responsible for toxic shock syndrome?

A

TSST-1

159
Q

Give the toxin responsible for scalded skin syndrome

A

exfoliative toxin

160
Q

Give the toxin responsible for rapid-onset food poisoning

A

enterotoxins

161
Q

enterococci (2 bugs)

A

E. faecalis & E. faecium.

162
Q

enterococci are resistant to this AB

A

penicillin G

163
Q

enterococci cause these 2 dz

A

UTIs & subacute endocarditis

164
Q

this lancefield group includes enterococci

A

D

165
Q

Lancefield grouping is based on differences in the ___ carbohydrate on the bacterial cell wall.

A

C

166
Q

enterococci grow in 6.5% ______

A

NaCl

167
Q

entero=______
faecalis=_______
strepto=_______
coccus=_______

A

intestine
feces
twisted (chains)
berry

168
Q

viridans streptococci are _____ hemolytic

A

alpha.

169
Q

viridans streptococci are normal flora of the oropharynx and cause dental caries (________) and subacute bacterial endocarditis (_________)

A

streptococcus mutans
streptococcus sanguins

mneu: sanguis=blood. There is lots of blood in the heart.

170
Q

viridans streptococci are optochin ______ which differentiates them from S. pneumoniae, which is also alpha hemolytic but is optochin _______

A

resistant

sensitive

mne: viridians group strep live in the mouth because they are not afraid OF-THE-CHIN (OPTOCHIN RESISTANT)

step 1 complete (29 decks)

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