Micro

Question 1

Gram - coccobacilli?

Answer 1

Haemophilus influenza 
Bordetella Pertussis
Pasteurella
Brucella
Francisella

Question 2

What do the toxins in Bordetella do?

Answer 2

Pili filamentous hemagglutinin, pertactin - allowto strongly attach to resp. epithelium. After binding it releases exotoxins -
Tracheal cytotoxin - damages and destroys ciliated epithelial cells
Pertussis toxin - activates adenylate cyclase and inhibits phagocyte activity and causes lymphocytosis

Question 3

Endotoxins are ass. with what

Answer 3

Outermembrane of gram - and cause septic shock when released into blood stream

Question 4

Sequelae of Measles (rubeola)

How does measles spread in body

Answer 4

Subacute sclerosing panencephalitis (SSPE) - personaility changes, dementia, autonomic dysfunction, death (years later)

Encephalitis - sx appear w/in few days of rash

Giant cell pneumonia

-Pneumonia is MCC of death in measles

begins in resp. epithelium and spreads via blood stream to reticuloendothelial cells

Question 5

Congenital rubella features

Answer 5

Classic triad of
Eye problems (cataracts, glaucoma)
Ear problems (deafness)
Heart disease (PDA)
\+/- blueberry muffin rash 

I (eye) <3 (heart) ruby (rubella) earrings (ears)

Question 6

Rubella presentation in young children:

Answer 6

Fever, POST AURICULAR lymphadenopathy, arthralgias, fine, maculopap rash that starts on face and spreads to trunk and extremities.

Question 7

Actinomyces presentation

Answer 7

slowly progressive disease. Bacteria colonizes in the mouth, colon, and vagina. Also found in dental caries and margins of gums in patients with poor dentition.

Pulmonary actinomycosis caused by aspiration which leads to lower lobe consolidation with air bronchograms.
Diagnosis is by identifying branching patterns and the characteristic sulfur granules.

tx: Penicillin G

Question 8

Treatment for toxoplasma gondii

Answer 8

combination of pyrimethamine and sulfadiazine (or pyrimethamine and clindamycin in case of sulfa drug hypersensitivity) along with leucovorin (folinic acid)

Question 9

Facultative intracellular bugs have what virulence factor?

What cytokines are involved in the cellular response

Answer 9

Mycobacterium, Listeria, Legionella have virulence factor that prevent bacteria from being destroyed by the phagolysosome of macrophages
Bc these bugs are so tiny and intracell. they come into cell by phagosome and stay there, MCH II molecules display this and naive CD4 cells release interferon gamma (which activate macros) and IL-2

Question 10

What is the immune response to extracellular pathogens>

Answer 10

mediated by neutrophils and then by humoral antibody response (lymphocytes, immunoglobulins, complement)

Question 11

congenital syphillis

Answer 11

rinorrhea
skeletal abnormalities (shaber shin)
desquamating rash

Question 12

congenital CMV

Answer 12

periventricular calcifications
microcephaly
sensorineural hearing loss

Question 13

congenital HSV

Answer 13

vesicular/ulcerative rash

Question 14

Most common causes of meningitis in 6 mo-6 years

Answer 14

S. pneumo
N. meningitis
H. influenza type B
Group B strep
Enterovirus (echo, polio, coxsackie)

Question 15

most common causes of meningitis in 6-60 yo

Answer 15

S. pneumo
N. meningitis
HSV-2
Enterovirus

Question 16

most common causes of meningitis in 60+

Answer 16

S. pmeumo
N. meningitis
H. influenzae type B
Group B Strep
Listeria

Question 17

newborn causes of meningitis

Answer 17

GEL
Group B Strep
E. Coli
Listeria

Question 18

newborns MCC of pneumonia under 4 weeks baby

Answer 18

Group B Strep

E.coli

Question 19

children 14-18 yo MCC of pneumonia

Answer 19

RSV
Mycoplasma
S. pneumo
Chlamydia

Question 20

adults 18-40 yo MCC of pneumonia

Answer 20

Mycoplasma

S. pneumo

Question 21

MCC of otitis media

Answer 21

H. influenzae
Moraxella catarrhalis
Strep pneumo

Question 22

Most common infections that can exacerbate COPD

Answer 22

Viral: rhinovirus, influenza, parainfluenza
Bacterial: H. influenzae
Moraxella catarrhalis
Strep pneumo

Question 23

what is intraceullular polyphosphate granules characteristic of?

Answer 23

Diphtheria - what we see on microscopy after growing this organism on Loeffler and staining it with methylene blue (club shaped granules)

Question 24

what are Peritrichous flagella and where is it present

Answer 24

flagella that are evenly distributed over the entire surface of bacteria. Highly motile organisms such as proteus contain this.

Question 25

vascular manifestations with Hep B vs Hep C

Answer 25

Hep B can present with polyarteritis nodosa (painful purple lesions)
Hep C can have leukocytoclastic vasculitis (non blanching petechiae or palpable purpura without significant bleeding)

Question 26

What is a bacteria that causes ecthyma gangrenosum

Answer 26

Pseudomonas.

Perivascular bacterial invasion of arteries and veins in the dermis and subcutaneous tissue, with subsequent release of exotoxins destructive to human tissue, leads to characteristic skin patches exhibiting necrosis and ulceration as a result of insufficient blood flow.

Question 27

How does Diptheria become toxigenic?

Answer 27

normally diphtheria is non-toxic. but then a lysogenic bacteriophage called Corynephage beta inserts the tox gene inside diphtheria genome. Now diphtheria will contain the AB toxin.
(which then leads to protein synth inhibition bc of ADP ribosylation of Elongation factor 2)

Question 28

what bacteria are only toxic under environmental influences?

Answer 28

spore forming bacteria (Bacillus/clostridium) are dormant until there is warming up to 37 C. then there is more CO2 and proteins and the spores can germinate and synthesize toxin.
For C. tetanii, spores only germinate and produce toxin when in anaerobic environments like necrotic wounds.