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1
Q

which component of LPS induces TNF/IL1? which is the antigen?

A

Lipid A induces TNF and IL1

O polysaccharide is antigenic

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2
Q

lipoteichoic acid is only in what kind of bacteria?

A

gram pos

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3
Q

what organisms should be giemsa stained? (5)

A

chlamydia, borrelia, rickettsiae, trypanosomes, plasmodium

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4
Q

PAS stain is used to dx which infectious dz?

A

Whipple’s dz (tropheryma whipplei)

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5
Q

india ink used for

A

cryptococcus neoformans

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6
Q

Ziehl-Neelsen stain good for

A

acid fast organisms (nocardia, mycobacteria)

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7
Q

silver stain used for

A

fungi, legionella, h pylori

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8
Q

tuberculosis agar

A

lowenstein jensen agar

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9
Q

obligate aerobes

A

Nagging Pests Must Breathe

nocardia, pseudomonas, m tb, bacillus

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10
Q

obligate anaerobes

A

Can’t Breathe Air

clostridium, bacteroides, actinomyces

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11
Q

2 obligate intracellular bugs

A

chlamydia, rickettsia

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12
Q

pts w/ CGD are vulnerable for what category of bugs?

A

catalase pos

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13
Q

catalase pos bugs

A

pseudomonas, listeria, aspergillus, candida, e coli, staph aureus, serratia

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14
Q

urease pos bugs

A

crytpo, h pylori, proteus, ureaplasma, nocardia, klebsiella, s epidermidis, s saprophyticus

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15
Q

sulfur granules

A

actinomyces israelii

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16
Q

protein A

A

binds Fc region of Ig to evade immune system. made by staph aureus

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17
Q

IgA protease expressed by which bugs?

A

strep pneumo, h flu, neisseria

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18
Q

M protein

A

helps prevent phagocytosis, expressed by strep pyogenes

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19
Q

bacteria that make toxins that inhibit protein synth (4)

A

corynebacterium diphtheriae
pseudomonas
shigella
EHEC O157:H7

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20
Q

bacteria that make toxins that inc fluid secretion (3)

A

ETEC (heat stabile and labile toxins)
bacillus anthracis
vibrio cholerae

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21
Q

rice water diarrhea

A

cholera

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22
Q

bacteria that make toxins that inhibit phagocytic activity (1)

A

bordetella pertussis

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23
Q

bacteria that make toxins that inhibit NT release (2)

A

clostridium tetani

clostridium botulinum

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24
Q

bacteria that make toxins that lyse cell membranes (2)

A 
c perfringens (alpha toxin)
strep pyogenes (streptolysin O)
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25
bacteria that make toxins that are superantigens and cause shock (2)
``` staph aureus (toxic shock syndrome toxin) strep pyogenes (exotoxin A) ```
26
bacteria: transformation vs conjugation vs transduction
transformation - uptake of naked DNA from env conjugation - bacteria sex transduction - injecting DNA via virus
27
phage encoded bacterial toxins (5)
``` ABCDE: shigA-like toxin Botulinum Cholera Diphtheria Erythrogenic toxin of strep pyogenes ```
28
alpha, beta, gamma hemolysis
alpha - partial, green. Strep pneumo and viridans | beta - complete, clear. Staph aureus, strep pyogenes, strep agalactiae, listeria
29
staph epidermidis - what does it cause
infections of prosthetic devices / catheters. also common blood culture contaminant
30
dental caries caused by
viridans strep (mutans)
31
subacute bacterial endocarditis (abnormal valve)
viridans strep (sanguis)
32
Jones criteria for rheumatic fever
``` Joints Heart Nodules Erythema marginatum Sydenham's chorea ```
33
main concern w/ enterococcus
combining / transferring abx resistances (penicillin resistance, VREs)
34
pseudomembranous pharyngitis
diphtheria
35
2 groups of bacteria that form spores
bacillus | clostridium
36
bacteria that blocks function of Renshaw neurons
c tetani
37
tx of c diff
metronidazole or oral vanc
38
reheated rice syndrome
bacillus cereus
39
nocardia causes
pulm infxn in immunocompromised and cutaneous infxns after trauma in immunocompetent
40
med condition that can make PPD negative
sarcoidosis
41
Pott's disease
extrapulm TB in vertebral bodies
42
prophylactic tx for MAC
azithromycin
43
reservoir for leprosy in US
armadillos
44
lepromatous vs tuberculoid leprosy
lepromatous - diffusely over skin, leonine facies, due to low cell mediated immunity and a mostly humoral Th2 response tuberculoid - hypoesthetic hairless skin plaques. high cell mediated immunity Th1 response
45
lactose fermenting gram negs
Citrobacter, Klebsiella, E coli, Enterobacter, Serratia
46
n. gonorrhoeae found inside what cells?
PMNs
47
how do you tell meningococcus vs gonococcus
meningococcus ferments maltose
48
which neisseria has a capsule
meningococcus
49
Fitz Hugh Curtis syndrome is a complication of
gonorrhea / PID
50
Waterhouse Friderichsen syndrome
complication of n. meningitidis infxn, causes bleeding of adrenals
51
epiglottitis caused by
h flu type b
52
hallmark lab finding in legionella infxn
hyponatremia
53
legionnaires dz
severe pna, fever, GI and CNS sx
54
pontiac fever
mild flu like syndrome caused by legionella
55
common cause of diabetic osteomyelitis
pseudomonas
56
two common manifestations of pseudomonas infxn in normal host
external otitis (swimmer's ear), hot tub folliculitis
57
tx of pseudomonas
aminoglycoside + extended spectrum pcn (ex piperacillin, ticarcillin)
58
MCC traveler's diarrhea
ETEC
59
EPEC manifestation
diarrhea in kids
60
triad of HUS
anemia, thrombocytopenia, renal failure
61
red currant jelly sputum
klebsiella
62
what organ does salmonella typhi hang out in in carriers?
gallbladder
63
rose spots on abdomen
typhoid fever (s typhi)
64
2 fairly common sequelae of campy
Guillian barre | reactive arthritis
65
bacteria that can mimic Crohn's or appendicitis
yersinia enterocolitica
66
3 spirochetes
borrelia, leptospira, treponema
67
leptospirosis sx
flu like sx, jaundice, photophobia w/ conjunctivitis
68
Weil's disease
severe for of leptospirosis w/ jaundice and azotemia from liver and kidney dysfunction, fever, hemorrhage, anemia
69
reservoir and vector for borrelia burgdorferi
mouse > ixodes tick
70
3 stages of lyme disease
stage 1 - erythema chronicum migrans, flu like sx stage 2 - facial nerve palsy and AV nodal block stage 3 - musculoskeletal (arthritis), encephalopathy and polyneuropathy, cutaneous manifestations
71
bull's eye erythema w/ central clearing
erythema migrans of lyme disease
72
screening and confirmation tests for syphilis
screening - VDRL | confirmation - FTA-ABS / MHA - TP
73
Argyll Robertson pupil
assoc w/ tertiary syphilis | pupil accomodates but does not react to light
74
which congenital disease? saber shins, saddle nose, CNVIII deafness, Hutchinson's teeth, mulberry molars
syphilis
75
VDRL tests ab for ____. Who gets false pos?
cardiolipin | viral infxn, drugs, rheumatic fever, SLE, leprosy
76
Jarisch Herxheimer reaction
flu like syndrome immediately after starting abx (seen in syphilis)
77
gardnerella vaginalis
bacteria causing vaginosis (not STD, but assoc w/ sexual activity). causes gray vaginal d/c w/ fish odor, painless.
78
classic triad of rickettsial diseases
HA, fever, rash
79
cause of typhus (endemic vs epidemic)
endemic - rickettsia typhi | epidemic - rickesttsia prowazekii
80
monocytes w/ morula (berry like inclusion) in cytoplasm AND granulocytes w/ same inclusion
ehrlichia in monocytes | anaplasma in granulocytes
81
Chlamydia trachomatis serotypes A,B,C
Africa Blindness Chronic infection other serotypes cause everything else
82
atypical PNA w/ inc cold agglutinins (IgM)
mycoplasma pneumoniae
83
histoplasma likes to hang out in (inside body)
macrophages
84
broad based budding fungus
blastomycosis
85
"captain's wheel" formation
paracoccidiomycosis
86
what causes all the tinea pedis / cruris / corporis / capitis?
Microsporum, Trichophyton, Epidermophyton
87
Tinea versicolor
caused by Malassezia furfur common in hot/humid weather causes hypo/hyperpigmented patches
88
specific disease that predsiposes to disseminated aspergillosis (not AIDS)
chronic granulomatous disease
89
fungus that branches at acute angles
aspergillus
90
"soap bubble" lesions in brain
cryptococcal meningitis
91
who gets mucormycosis (2)
DKA pts | leukemic pts
92
rose garderner's disease
sporothrix schenckii
93
parasite that causes severe diarrhea in AIDS but mild dz in normal pts
cryptosporidium
94
classic triad of congenital toxo
chorioretinitis, hydrocephalus, intracranial calcifications
95
causative organisms of african sleeping sickness
trypanosoma brucei, gambiense, rhodesiense
96
sx of malaria
fever, HA, anemia, splenomegaly
97
most severe causative agent of malaria
plasmodium falciparum
98
babesiosis
fever and hemolytic anemia, predominantly in NE US (ixodes tick like lyme disease)
99
causative agent of Chaga's dz
trypanosoma cruzi
100
sx of visceral leishmaniasis
spiking fevers, hepatosplenomegaly, pancytopenia
101
sx of trichomonas vaginalis
foul smelling greenish d/c, itching and burning
102
enterobius vermicularis infxn
pinworm, anal pruritis, dx w/ scotch tape test
103
cause of visceral larva migrans
toxocara canis
104
cause of cysticercosis
ingesting EGGS of taenia solium
105
diphyllobothrium latum
tapeworm that causes vit b12 def > anemia
106
echinococcus granulosus
tapeworm that causes cysts in liver > anaphylaxis if they burst
107
schistosoma
from snails liver and spleen granulomas s. haematobium causes hemorrhagic cystitis and inc risk of SCC of bladder
108
clonorchis sinensis
from undercooked fish | biliary tract inflammation > pigmented stones, inc risk of cholangioCA
109
paragonimus westermani
from undercooked crab | lung inflammation, hemoptysis
110
viral recombination vs reassortment
``` recombination = genetic drift reassortment = shift ```
111
live attenuated vaccines (6)
``` smallpox chicken pox yellow fever Sabin's polio virus MMR influenza (intranasal) ```
112
killed virus vaccines (4)
rabies influenza (injection) Salk polio HAV
113
only dsDNA virus
parvoviridae
114
circular DNA viruses (3)
papilloma polyoma hepadna
115
only dsRNA virus
reoviridae
116
pos sense RNA viruses (7)
``` retro toga flavi corona hepe calici picorna ```
117
which types of viruses (nucleic acid categories) are infectious as naked viral genomes?
``` most dsDNA (except pox and HBV) pos sense ssRNA ```
118
only diploid virus family
retroviruses
119
nonenveloped viruses (8)
PAPP: papilloma, adeno, parvo, polyoma CPR: calici, picorna, reo hepeviridae
120
DNA viruses
HHAPPPP | hepadna, herpes, adeno, pox, parvo, papilloma, polyoma
121
HHV6 causes
roseola (exanthem subitum)
122
HHV7 causes
less common cause of roseola
123
hepadnavirus example
HBV
124
adenoviruses can cause
febrile pharyngitis hemorrhagic cystitis PNA conjunctivitis
125
2 most important types of papillomavirus that cause cancer
16, 18
126
2 polyomaviruses and what they cause
JC - PML in HIV | BK - in transplant pts, commonly targets kidney
127
MCC sporadic encephalitis
HSV1
128
what type of cells do EBV and CMV stay latent in, respectively?
EBV - B cells | CMV - monocytes
129
Tzanck test
detects herpes from vesicular fluid
130
2 reoviruses
coltivirus, rotavirus
131
coltivirus causes
colorado tick fever
132
MCC fatal diarrhea in children
rotavirus
133
5 picornaviruses
polio, echo, rhino, coxsackie, HAV | PERCH
134
a calicivirus
norovirus
135
5 things caused by flaviviruses
``` HCV yellow fever dengue st louis encephalitis west nile ```
136
2 things caused by togaviruses
rubella | W/E equine encephalitis
137
influenza is part of what family
orthomyxoviridae
138
4 viruses in paramyxoviridae
parainfluenza RSV measles virus mumps virus
139
filoviruses cause
hemorrhagic fever - ebola/Marburg
140
arenaviruses cause (2)
LCMV (lymphocytic choriomeningitis virus) | Lassa fever encephalitis
141
most notable bunyavirus
hantavirus (hemorrhagic fever, PNA)
142
4 segmented viruses
bunya, orthomyxo, arena, reo
143
viral infection causing black vomit
yellow fever
144
fns of hemagglutinin and neuraminidase
hemagglutinin - helps w/ entry | neuraminidase - helps w/ new virus exiting cell
145
palivizumab
monoclonal ab against F protein on paramyxoviruses - given to prevent PNA in premies
146
Koplik spots
seen in measles | red spots w/ blue/white center on buccal mucosa
147
3 c's of measles
cough coryza conjunctivitis
148
3 sx of mumps
parotitis, orchitis, aseptic meningitis
149
negri bodies
rabies
150
Hep E affects
pregnant women (high mortality)
151
which hep B antibody indicated immunity?
anti-Hb surface
152
Hep B E antigen
indicates acute viral replication > high transmissibility
153
CD4 count for AIDS
<200
154
presentation of histo in AIDs pt
low fever, cough, hepatosplenomegaly, tongue ulcer
155
aids pt w/ superficial vascular proliferation, on biopsy shows neutrophilic inflammation
Bartonella henselae
156
cotton wool spots on fundoscopic exam
CMV retinitis
157
aids pt w/ superficial vascular proliferation, on biopsy shows lymphocytic inflammation
HHV8 (kaposi)
158
cause of interstitial PNA in AIDs pt
CMV
159
3 normal vaginal flora
lactobacillus e coli group b strep
160
3 MCC meningitis in newborns
group B strep E coli listeria
161
MCC of meningitis in non-newborns
strep pneumo
162
in sickle cell pt w/ osteomyelitis, what is likely cause?
salmonella
163
2nd MCC UTI in young sexually active women
staph saprophyticus
164
"swarming" colonies
proteus
165
classic presentation of congenital rubella
PDA (or pulm art hypoplasia), cataracts, deafness, +/- blueberry muffin rash
166
which congenital infection (ToRCHeS) most often causes stillbirth?
syphilis
167
rash of childhood that presents following high fevers (can cause febrile seizures)
roseola (HHV6)
168
cause of chancroid
haemophilus ducreyi
169
cause of condyloma acuminata
(genital warts) HPV 6 and 11
170
MC bacterial STD in US
chlamydia
171
Fitz Hugh Curtis syndrome
infxn of liver capsule and "violin string" adhesions of parietal peritoneum to liver
172
what step of cell wall synth do beta lactams block?
peptidoglycan cross linking
173
2 abx that block peptidoglycan synth
bacitracin, vanc
174
mech of rifampin
block mRNA synth
175
mech of metronidazole
damage DNA
176
abx that block protein synth at 50S subunit
chloramphenicol, macrolides, clindamycin, streptogramins, linezolid
177
abx that block protein synth at 30S subunit
aminoglycosides, tetracyclines
178
PCN - bactericidal/static? for what types of bugs?
cidal for gram pos cocci and rods, gram neg coci, spirochetes
179
oxacillin, nafcillin, dicloxacillin - mainly used for? important side effect?
``` staph aureus (non-MRSA) interstitial nephritis ```
180
2 wider spectrum penicilllins
ampicillin, amoxicillin
181
beta lactamase inhibitors (3)
clavulanic acid, sulbactam, tazobactam
182
what extra bugs do amoxicillin/ampicillin cover?
HELPSS - h flu, e coli, listeria, proteus, salmonella, shigella
183
ticarcillin and piperacillin
penicillins active against pseudomonas
184
which cephalosporin covers MRSA?
cephtaroline
185
organisms typically not covered by cephalosporins
LAME - listeria, atypicals, MRSA, enterococci
186
generations of cephalosporins - what do they cover
1st - gram pos cocci, proteus, e coli, klebsiella 2nd - 1st+ H flu, enterobacter, neisserias, serratia 3rd- serious gram neg infxns (meningitis, gonorrhea, pseudomonas) 4th- inc activity against pseudomonas and gram pos
187
aztreonam
monobactam, works on gram neg rods only, good for pts w/ PCN allergy or renal insufficiency that can't handle aminoglycosides
188
what is imipenem always given w/ and why?
cilastatin - dec inactivation of drug in renal tubules
189
when are -penems used?
life threatening infections or ones that have failed other options - must be worth risk of serious side effects
190
main side effect to worry about for -penems
seizures
191
vanc binds to
d-ala-d-ala portion of cell wall precursor
192
vanc spectrum
gram pos only, but gets even the really resistant ones like MRSA, enterococci and C diff
193
side effects of vanc
nephrotox, ototox, thrombophelbitis, diffuse flushing = red man syndrome can mostly be prevented by giving antihistamines first and slow infusion rate generally well tolerated
194
batericidal/static for the protein synth inhibitors
aminoglycosides are cidal | rest are static
195
which drugs are aminoglycosides
GNATS - gentamicin, neomycin, amikacin, tobramycin, streptomycin
196
spectrum/uses of aminoglycosides
severe gram neg rod infxns
197
aminoglycosides are synergistic w/
beta lactams
198
side effects of aminoglycosides
nephrotoxicity, neuromuscular blockade, ototox, teratogen
199
resistance to aminoglycosides
transferase enzymes inactivate drug
200
demeclocycline non-abx use
used as diuretic in SIADH
201
which tetracycline to use in pts w/ renal failure?
doxy
202
why are tetracyclines avoided in kids?
inhibit bone growth
203
resistance to tetracyclines
dec uptake or inc efflux from cells
204
3 macrolides
azithromycin, clarithromycin, erythromycin
205
what are macrolides good for
atypical PNA, STDs (chlamydia), gram pos cocci
206
side effects of macrolides
MACRO - motility issues, arrhythmias (prolong QT), cholestatic hepatitis, rash, eOsinophilia
207
resistance to macrolides
methylation of 23S rRNA binding site
208
serious side effect of chloramphenicol
aplastic anemia (dose independent)
209
clindamycin uses
anaerobic infxns above the diaphragm
210
spectrum of SMX
gram pos, gram neg, nocardia, chlamydia - good for simple UTIs
211
2 important side effects of SMX
hemolysis in G6PD def, nephrotox (tubulointerstitial nephritis)
212
resistance to SMX
altered enzyme, dec uptake, or inc PABA synth
213
enzyme blocked by TMP
dihydrofolate reductase
214
what is TMP/SMX used for?
UTIs, shigella, salmonella, PCP
215
side effects of TMP
megaloblastic anemia, leukopenia, granulocytosis
216
which type of abx cant be taken w/ antacids?
fluoroquinolones
217
spectrum of quinolones
gram neg rods of urinary and GI tracts, pseudomonas, neisseria, some gram pos
218
unique side effect of quinolones
tendon rupture
219
resistance to quinolones
altered DNA gyrase or efflux pumps
220
what is metronidazole used for
giardia, entamoeba, trichomonas, gardnerella vaginalis, anaerobes, part of triple therapy for h pylori
221
2 sorta weird side effects of metronidazole
disulfiram like reaction to alcohol | metallic taste
222
4 drugs used for active TB, 1 used for prophylaxis
rifampin, isoniazid, pyrazinamide, ethambutol | prophylaxis - isoniazid
223
4 abx given for MAC
azithromycin, rifampin, ethambutol, streptomycin
224
tx of m. leprae
dapsone + rifampin, add clofazimine for lepromatous form
225
rifampin is used as prophylaxis for
contacts of children w/ h flu type B
226
main side effect concern w/ rifampin
many drug interactions cuz inc P450 activity
227
side effect of ethambutol
optic neuropathy causing red green colorblindness
228
prophylaxis for endocarditis in surgical/dental procedures
penicillins
229
prevention of gonococcal or chlamydial conjunctivitis in newborn
erythromycin ointment
230
AIDS infxns prophylaxis schedule
CD4 <50 - add azithromycin for MAC
231
what do you use for VREs?
linezolid and streptogramins (-pristin)
232
-azoles mechanism
block ergosterol synth
233
ampho B mechanism
binds ergosterol and forms leaky holes in fungal membrane
234
side effects of ampho B
fever/chills "shake and bake", hypotension, nephrotox (better w/ hydration), arrhythmias, anemia, IV phlebitis
235
nystatin is
topical ampho B
236
when to use the azoles - fluconazole? itraconazole? clotrimazole/miconazole?
flucon - chronic suppression of cyrptococcal meningitis, any candidal infection itracon - blasto, cocci, histo (regional mycoses) clotrim/micon - topical infxns
237
side effects of azoles
gynecomastia (testosterone synth inhib), liver dysfunction
238
when is 5FU used for fungal infxns?
systemic infxns alongside ampho B
239
-fungins mech and use
mech - inhib cell wall synth by inhibiting synth of beta glucan used for invasive aspergillosis and candida
240
use of terbinafine
dermatophytoses
241
griseofulvin used for
oral tx of superficial infxns (deposits in keratin rich tissues) - dermatophytes but has lots of side effects
242
toxo tx
pyrimethamine
243
trypansoma brucei tx
suramin and melarsoprol
244
t. cruzi tx
nifurtimox
245
leishmaniasis tx
sodium stibogluconate
246
chloroquine used for
non-falciparum malaria (too much resistance in falciparum)
247
drugs that tx plasmodium falciparum
artemether/lumifantrine, atovaquone/proguanil, quinidine for life threatening or artisunate
248
drug for flukes
praziquantel
249
zanamavir and oseltamivir - mech and use
inhib influenza neuraminidase > dec release of new virus | tx and prevention of influenza A and B
250
ribavirin - mech, use, tox
mech - inhib IMP dehydrogenase to inhib synth of guanine nucleotides use - RSV, chronic hep C tox - hemolytic anemia, teratogen
251
acyclovir and valacyclovir- mech, use, tox
guanosine analog - chain terminator HSV and VZV (mucocutaneous and genital lesions, encephalitis) no significant tox
252
famciclovir used for
herpes zoster
253
ganciclovir - mech, use, tox
guanosine analog - inhibits viral DNA polymerase CMV leukopenia, neutropenia, thrombocytopenia, renal tox
254
foscarnet and cidofovir - mech, use, tox
viral DNA polymerase inhib (doesnt need to be activated) CMV retinitis, acyclovir resistant HSV nephrotox
255
3 conditions for starting HAART
AIDS defining illness, CD4<500, or high viral load
256
HAART regimen
2 NRTIs + (1 NNRTI OR 1 protease inhib OR 1 integrase inhib)
257
suffix for protease inhibitors
-navir
258
"booster" for protease inhibitors
ritonavir - inhibits cyt P450 to inc drug concentrations
259
toxicity of protease inhibitors
hyperglycemia, GI intolerance, lipodystrophy nephropathy and hematuria for just indinavir
260
list NRTIs (4 drugs and 1 suffix)
``` DATE- didanosine abacavir tenofovir emtricitabine ``` -vudine
261
which HIV drug is used during pregnancy to prevent vertical transmission?
ZDV - zidovudine
262
tox of NRTIs and NNRTIs (same)
``` bone marrow suppression (fix w/ GCSF and EPO) peripheral neuropathy lactic acidosis rash anemia (ZDV) ```
263
list NNRTIs (3)
NED - nevirapine efavirenz delavirdine
264
name integrase inhibitor
raltegravir
265
tox of integrase inhibitors
hypercholesterolemia
266
how do interferons work as antivirals?
block replication of both RNA and DNA viruses
267
tox of IFNs
neutropenia, myopathy
268
uses of IFN alpha, beta, and gamma respectively
alpha - chronic hep B/C, Kaposi's sarcoma beta - MS gamma - NADPH oxidase def
269
abx/virals/fungals/etc to avoid in pregnancy (8) and what they cause
SAFe Children Take Really Good Care ``` sulfonamides - kernicterus aminoglycosides - ototox fluoroquinolones - cartilage dmg clarithromycin - embryotoxic tetracyclines - discolored teeth, inhib bone growth ribavirin - teratogenic griseofulvin - teratogenic chloramphenicol - "gray baby" ```

EBSE (18 decks)

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