Micro Flashcards
Branching filamentous rods
Nocardia (acid fast, urease +)
actinomyces (anaerobe)
Use of PAS
Whipple’s disease
Chocolate agar growth
H. influenza
Thayer-Martin growth (has vanco/polymyxin/nystatin)
N. gonorrhea or N. menigitidis
Bordet-Genau growth
Bordatella pertussis
Tellurite/Loffler growth
C. diphtheria
Lowenstein-Jensen growth
Mycobacterium tuberculosis
Eaton’s agar growth
Mycoplasma pneumonia
Charcoal yeast extract with cysteine/iron growth
Legionella
Assc with burn wounds
Pseudomonas
Encapsulated organisms (7)
H. flu Strep pneumo N. meningitidis E. coli Salmonella Klebsiella Strep group B
Catalase (+) bugs (7)
pseudomonas listeria aspergillus candida E. coli S. aureus serratia
Sulfur granules on microscopy
Actinoyces israelii
Bug that produces red pigment
Serratia marcescens
Pharyngitis/pseudomembrane
bull neck
C. diphtheria
inactivates EF2
Dysentery
GI mucosal damage
toxin caused
Shigella, shiga toxin
inactivates 60s ribosome
also seen in E. coli 0157:H7
Rice water diarrhea
cholera toxin
increases cAMP by adenylate cyclase
Whooping cough toxin
Pertussis toxin
disables Gi, increases cAMP
Tetanus MOA
toxin inhibits GABA/glycine release
muscle rigidity
Botulinum MOA
toxin prevents release of ACh at NMJ
paralysis
Toxins with A/B type MOA
Cholera toxin and pertussis toxin
B enters cell, A activates
Staph species differentiation
S. aureus-coagulase +
S. epidermidis-novobiocin sensitive
S. saprophyticus-novobiocin resistant
Strep species differentiation
S. pneumo-optochin sensitive, alpha hemolytic
Viridans strep-otpochin resistant, alpha
Group A strep-bacitracin sensitive, beta
Group B strep-bacitracin resistant, beta
S. aureus toxins
TSST-1 toxic shock
scalded skin syndrome
food poisoning
Bug seen on prosthetic heart valves
Staph epidermidis
biofilm
Pneumonia
otitis media
sinusitis
IgA protease (+)
Strep pneumo
rusty sputum
sepsis with sickle cell/splenectomy
optochin sensitive
Dental caries
endocarditis
normal flora
Viridans strep
Strep mutans-caries
S. sanguis-heart valves
resistant to optochin
Arthritis
carditis
nodules sub q
post infection
Strep pyogenes
bacitracin sensitive
ASO titer to detect
also see erythema marginatum and syndenham’s chorea with Rheumatic fever
Rash over the body
red tongue and throat
post infection
Strep pyogenes
Scarlet fever
bacitracin sensitive
toxic shock like syndrome
1 yr/o
Pneumonia
meningitis
Strep agalactia (group B)
seen in babies
bacitracin resistant
Hippurate (+)
Subacute endocarditis
bacteremia
Strept bovis
colon cancer pts
Grayish-white on pharynx
lymphadenopathy of neck
(+) cystine-tellurite growth
C. diphtheria
bullneck/pseudomembrane
EF2 inhibiting toxin
(+) Elek’s test
lecithinase (alpha toxin)
gas gangrene
hemolysis
C. perfringens
causes myonecrosis
Black eschar
bacteremia
edema
cutaneous anthrax
poly D glutamate capsule
lethal factor and edema factor cause eschars
Flu like sx
progresses quickly
mediastinitis
pulmonary hemorrhage
pulmonary anthrax
Woolsorter’s disase-from contaminated wool
Rice and pasta diet
N/V for 5 hrs
watery diarrhea
Bacillus cereus
food poisoning
reheated rice syndrome
High dairy diet
spontaneous abortion in pt
gastroenteritis
Listeria monocytogenes unpasteurized milk/cheese, deli meats tumbling motility moves cell to cell via actin rockets neonatal meningitis
Oral abscess
sulfur granules on microscopy
Actinomyces
normal flora
anaerobic
branching filaments
Pneumonia in immunosuppressed pt
found in soil
nocardia
acid fast
branching filamentous rods
TB virulence factors
cord factor-inhibit Macrophage maturation
sulfatides-inhibit lysosomal fusion
Loss of sensation on feet and hands
no growth on agar
hairless skin plaques
mycobacterium leprae
US armadillos
lepromatous-communicable (Th2), diffuse
tuberculoid-Th1
Differentiation b/t neisseria strains
N. meningitidis- maltose fermenter
N. gonorrhea- maltose nonfermenter
Adrenal gland failure
shock
maltose fermentation
N. meningitidis
rapid necrosis of adrenals
Epiglottitis
otitis media
meningitis
H. influenza
otitis media from nontypeable
cultured on chocolate agar
Elderly man
pneumonia
GI and CNS sx
hx of hotel stay
Legionella pneumophilia gram (-) rod charcoal yeast growth (iron/cystein) water source caused (AC unit) intracellular in macrophages
Folliculitis after in hot tub
also external otitis
exotoxin A
Pseudomonas green/blue pigment smells like grapes cystic fibrosis/hot tub/swimmer's ear/burn assc toxin inactivates EF2
Homeless alcoholic
pneumonia
MacConkey growth
Klebsiella
red currant jelly sputum
diabetics/alcoholics
Rose spots on abd
fever
diarrhea
Slamonella typhi
typhoid fever
Bloody diarrhea in a kid
arthritis
S shaped
lower extremity weakness
Campylobacter jejuni
deli meat/milk
grows at 42 degrees, oxidase (+)
Guillain-Barre syndrome (ascending paralysis)
Rice water diarrhea
dehydration
vibrio cholerae
activates Gs protein
oxidase (+)
dehydration risk
Sx of Crohn’s disease
has new puppy
Yersinia entercolitica
mimics Crohn’s/appendicitis
assc with pet feces/milk/pork
Duodenal ulcers
dx with gastric adenocarcinoma
Helicobacter pylori
urease (+)
tx with PPI, clarithromycin, amoxicillin
Just got back from Hawaii
has jaundice
photophobia
proteinuria
Leptospira interrogans
Weil’s disease (jaundice/azotemia/anemia)
Facial n. palsy
AV block
migratory arthritis
erythema migrans
Lyme disease-borrelia burgdoferi
NE U.S.
bull’s eye rash
encephalopathy can develop
Pupil does not react to light
ataxia
Hx of maculopapular rash on palms/soles
Syphilis-treponema pallidum
VDRL screen, FTA-ABS confirm
painless chancre/maculopapular rash/tabes dorsalis (neurosyphilis)
Child born with deafness
notched teeth
abnormal molars
Congenital syphilis (treponema) Saber shins/CN VIII/Hutchinson's teeth/mulberry molars
Dairy products
fever
muscular pain/swelling
migratory arthralgia
Brucella spp
Brucellosis
Bloody diarrhea
works at pet shop
Campylobacter
puppies/livestock/undercooked meat
Bitten by a cat
swelling around the area
bone pain
Pasteurella multocida
animal bite
cellulitis/osteomyolitis
Overcrowded area
Rash on trunk, spreads out (no palms/soles)
fever/headache
Rickettsia prowazekii
epidemic typhus
body louse vector
Hiker
rash on limbs that spread to trunk
headache/fever
Rickettsia ricketssii
needs CoA and NAD+
Farmer
presents with pneumonia sx
Coxiella burnetii
cattle placenta spores
African immigrant
Recurrent conjunctivitis
irritation of the cornea
no bugs seen on microscopy
Chlamydia trachomatis serotypes A,B,C
follicular conjunctivitis
can lead to blindness
Sexually active female
tenderness/inflammation in pelvis
no bugs seen on microscopy
What serotype?
Chlamydia trachomatis serotypes D-K
urethritis/PID
ectopic pregnancy/neonatal penumonia
Reactive arthritis
urethritis
sexually active
Chlamydia
elementary body enters cell
reticulate body replicates in cell
tx with azithromycin/doxycycline
Pneumonia
pt is mobile and walking
(+) cold agglutinins
grows on Eaton’s agar
Mycoplasma pneumonia
walking pneumonia, contains sterols in membrane
military recruits/prisons
tx with fluoroquiolone or macrolides
Pt lives in Ohio
presents with pneumonia
Has been cave diving in the last month
Histoplasmosis
intracellular in macrophages
bird/bat droppings
Pt lives in Mississippi
granulomatous nodules in bone/skin
pneumonia
Blastomycosis
broad base budding yeast seen
Pt lives in Arizona
Presents with meningitis and pneumonia
Bone/skin involvement
Coccidioidomycosis
Spherules seen
San Joaquin valley/desert
Immigrant recently moved from South America
Captain’s wheel appearance on microscopy
Pneumonia
Paracoccidioidomycosis
In Florida
hypopigmented patches
spaghetti and meatball appearance on KOH prep
Tinea versicolor
Malassezia furfure causes
Pt has asthma sx
sputum production (sometimes blood)
recurrent pulmonary infections
Aspergillus fumigatus
45 degree branching hyphae
type IV HS rxn
can also can Aspergillomas (ball in lung)
AIDS pt
presents with meningitis
(+) latex agglutination test
recently camping
Cryptococcus neoformans
meningitis in AIDS pts
bird droppings
Soap bubble test in brain
Diabetic pt
has acidosis
headaches
necrosis around the nose
Mucor and rhizopus spp keotacidotic diabetics cribriform plate/enters brain black necrotic eschar on face hyphae branching at 90 degrees
AIDS pt below CD4 count of 200
pneumonia, but mobile
Pneumocystis jirovecii
binds alveolar macrophage receptors
methenamine silver stained
Gardner
area of ucler with nodules on finger
ascending lymphangitis
Sporothrix schenckii
cigar shaped budding yeast
vegetation, trauma of skin (rose needles)
Dysentery(bloody diarrhea) sx
rectal prolapse
Trichuris trichuria
whipworm
football eggs with plugged ends
Explosive watery diarrhea
pig farmer
ciliate cysts
balantidium coli
Steatorrhea
hx of camping
no blood in stool
Giardia lamblia
steams/lakes/beavers assc
falling leaf motility
bilobed nuclei
Bloody diarrhea
RUQ pain
hx of camping
Entamoeba histolytica
liver abscess
flask shaped ulcer
AIDS pt
severe watery diarrhea
acid fast (+)
Cryptosporidium
severe in AIDS pts
AIDS pt
thrombocytopenia
chronic watery diarrhea
microsporidia
Explosive watery diarrhea
Florida
blue fluorescence under UV
cyclospora cayetanensis
tropical disease
acid fast
Cerebral abscess on MRI with ring enhancement
calcifications of brain
cats
Toxoplasma gondii
crosses placenta in pregnancy
AIDS pts
Recurring fever
African immigrant
hx of chancre
somnolence/anemia
Trypanosoma brucei
African sleeping sickness
Tstse fly vector
antigenic variation
Recurrent fevers
anemia
hx of Middle East trip
splenomegaly
Plasmodium vivax/ovale
malaria
anopheles mosquito vector
tx with cholorquine + primaquine for relapsing hypnozoites
Young male
fever
stroke
anemia/jaundice
Plasmodium falciparum malaria anopheles mosquito vector infected RBC's occlude brain tx severe with quinidine/quinine
Hemolytic anemia
fever
asplenia
NE U.S.
Babesia
ixodes tick vector (same as Lymes)
maltese cross
Trip to Japan
alternating constipation/diarrhea
waterchest nuts consumed
Fasciolopsis buski
intestinal fluke in bile duct
Megacolon
Dilated cardiomyopathy
edema around the eye
Trypannosoma cruzi
Chaga’s disease
reduviid bug vector
Romana’s sign periorbital edema
Pancytopenia hepatosplenomegaly fevers dark pigment over some areas of body Tx with Na+ stibogluconate
Leishmania donovani
visceral leishmaniasis
female sandfly vector
cutaneous (L. braziliense) causes volcano eruptions on skin
Greenish vaginal discharge
strawberry cervix
itching/burning
Trichomonas vaginalis
sexual transmission
Gray vaginal discharge
Fishy smell
Clue cells
Gardnerellla vaginalis
assc with sexual activity
Perianal itching
sticky eggs
Enterobius vermicularis (pinworm)
Epigastric pain
Coughing
rural SE
Ascaris lumbricoides
intestinal infection
migrate through lungs in development
Anemia
diarrhea/vomiting
AIDS pt
Strongyloides stercoralis
seen in immunocompromised
pneumonitis
Anemia due to blood loss
intestinal infection
Ancylostoma duodenale/necator americanus
hookworms
anemia by sucking blood from GI walls
Black skin nodules
African immigrant
ocular problems
Onchocera volvulus
female blackfly vector
River blindness
Worm seen in conjunctiva
skin swelling
Loa loa
deer/horse/mango fly vectors
Elephantiasis bug
Wuchereria bancrofti
female mosquito bector
blockage of lymph
Diarrhea
myalgias/edema
heart/lung/brain involvement
Tichinella spiralis
undercooked bear/fox/pork
travel to muscle via blood
Pork eater
neuro sx
scolex seen on microscopy
Taenia solium (pork tapeworm)
cysticercosis/neurocysticerosis
caused by eggs only
calcifications of tissue result
Eater of raw fish from Great Lakes
increased methylmalonyl-Coa and homocysteine
anemia
Diphyllobothrium latum
Vit B12 deficiency
raw freshwater fish
Pt owns dog
cysts seen in lung and liver
lives in Nevada
Echinococcus granulosus
Hydatid cyst disease
in western US
from dog feces
Fibrosis of liver/spleen
dx with bladder cell carcinoma
hematuria
Schistosoma haematobium
terminal spine
assc with bladder cancer
Clay pipestem fibrosis around portal vein
bloody diarrhea
eats snails
Schistosoma mansoni
lateral spine
Katayoma syndrome
Dx with cancer of the bile duct
eats sushi
epigastric pain/jaundice
Clonorchis sinensis
assc with cholangiocarcinoma
pigmented gallstones/bile duct inflammation
undercooked fish
Eats crab
pneumonia/hemoptysis
other bacterial infection also present
Paragonimus westermani
coffee bean shaped/crab meat assc
secondary bacterial infection
Live attenuated vaccines for virus (6)
Smallpox Yellow fever VZV Sabin's polio virus MMR Influenza (intranasal)
Killed virus vaccines (4)
Rabies
Influenza (injected)
Salk Polio
HAV
Recombinant virus vaccines (2)
HBV
HPV (6,11,16,18)
Only ssDNA virus
parvovirus
Only circular DNA virus
hepadnaviruses
Only dsRNA virus
Reoviridae
Only diploid virus
retroviruses
Only enveloped virus using nuclear membrane
herpesviruses
DNA viruses
HHAPPPPy Hepadna Herpes Adenoa Pox Parvo Papilloma Polyoma
Only DNA virus replicating in cytosol
Poxvirus
Only RNA viruses replicating in nucleus
Influenza
Retroviruses
Temporal lobe encephalitis
keratoconjunctivitis
HSV-1
Assc with Burkitt’s Lymphoma and Hodgkin’s Lymphoma
fatigue
EBV (HHV-4)
mononucleosis
AIDS pt
retinitis
most common virus causing
CMV
seen in immunocompromised pts
Cause of roseola
HHV-6
Exanthem subitum
Ass with Kaposi’s sarcoma
AIDS pts
HHV-8
Circular DNA virus
has reverse transcriptase
HBV
Pharyngitis
pneuumonia
conjunctivitis
Adenovirus
dsDNA
acut hemorrhagic cystitis assc
Apastic crisis with sickle cell disease
slapped cheek fever
Parvovirus B19
ssDNA
5th disease in kids (erythema infectiosum)
Cervical cancer assc virus
Papillomavirus 16 and 18
AIDS pt
circular dsDNA
mental deterioration
JC virus
progressive multifocal leukoencephalopathy
also BK targets kidney in transplant pts
both are polyomaviruses
Replicates in cytosol
DNA virus
flesh colored dome lesions with central dimple
Poxvirus
molluscum contagiosum
only on replicating in cytosol
Locations of latency in Herpes viruses: HSV-1 HSV-2 VZV EBV CMV
HSV1-trigeminal ganglia HSV2-sacral ganglia VZV-dorsal root or trigeminal ganglia EBV-B cells CMV-mononuclear cells
Characteristic of CMV infection
Owl’s Eyes inclusions
Diffuse macular rash
in kids
high fever/seizures
HHV-6
roseola
AIDS pt
papular purple lesions
on mouth/GI/respiratory tracts
Kaposi’s sarcoma
assc with HHV-8
ID of herpes virus
Tzanck test
Cowdry bodies
Picornoviruses (5)
Polio Echovirus rhinovirus coxsackievirus HAV all RNA viruses
(-) stranded RNA viruses (6)
all have RNA-dependent RNA pol Arenavirus bunyavirus paramyxovirus orthomyxovirus filovirus rhabdovirus
Common cold
no GI sx
naked virus
Rhinovirus
acid labile
RNA virus
Black vomit
jaundice
in South America/Africa
Yellow fever
Aedes mosquito vector
1 y/o
segmented dsRNA virus
acute diarrhea
others in daycare also have
Rotavirus
infantile gastroenteritis
villous atrophy
Enveloped (-) ssRNA
neuraminidase and hemagglutinin
cough/cold
Influenza
genetic shift/drift seen
Postauricular adenopathy
arthralgia
descending rash from head down
Rubella virus (togarvirus)
German measles
TORCH infection
Seal like barking cough
Parainfluenza (croup)
Paramyxoviruses (4)
Parainfluenza
mumps
measles
RSV
Red spots on buccal mucosa
descending maculopapular rash (head down)
paramyxovirus
Measles
Koplick spots (buccal mucosa)
subacute sclerosing panencephalitis years later
Swollen parotids and testes
meningitis with not bugs seen in CSF
Mumps (paramyxovirus)
parotitis/orchitis
can cause sterility
Bull neck
Negri bodies
found in cerebellum (Purkinje cells)
long incubation period
photophobia/agitation
Rabies virus bullet shaped CNS retrograde migration hydrophobia/paralysis/death animal bites
HAV source
oysters/clams/mussels
fecal oral
acute infection
Dane particles
ground glass hepatocytes seen
HBV
Dane particles=active infection
hepatocellular carcinoma risk
Increased HCC risk
cryoglobulinemia
chronic infection
HCV
HCC with or w/o cirrhosis
delta agent
needs HBV to infect
HDV
causes fulminant liver failure with HBV
HEV danger
pregnant women
Dx of HCV
EIA for screen
RIBA II for confirmation
Significance of hepatitis B Ags/Abs in blood HBsAg HBsAb HBcAg HBcAb HBeAg HBeAb
sAg-hep B infection
sAb-immunity to hep B
cAg-core of HBV
cAb-prior exposure/chronic infection (if IgG)
eAg-high transmissibility/active viral replication
eAb-low transmissibility
Genes of HIV
env (gp120/gp41)-attach to T cells/entry
gag (p24)-capsid
pol-reverse transcriptase
HIV binding to WBC’s
CD4 +CCR5/CXC4 on T cells
CD4 + CCR5 on macrophages
Bugs that can mimic appendicitis
Yersinia entercolitica
Nontyphoidal salmonella
Campylobacter jejuni
Lg cause of pneumonia infant-3y/o
Chlamydia trachomatis
Cause of meningitis in young children
N. meningitidis
H. influenza type B
Sx or Rubella
PDA cataracts deafness blueberry muffin rash (descending) postauricular lymphadenopathy
Peptidoglycan cell wall synthesis inhibitors (8)
penicillin nafcillin (resistant to penicillanse) ampicillin/amoxicillin ticarcillin/piperacillin (pseudomonas use) cephalsporins (resistant) aztreonam (monobactm resistant) imipenem vanycomycin (D-ala D-ala)
30s subunit RNA bacterial inhibitors
aminoglycosides (inhibits initiation)
tetracyclines (prevents attachment of tRNA)
50s subunit RNA bacterial inhibitors
macrolides (blocks translocation)
chloramphenicol (blocks peptidyltransferase)
clindamycin (blocks peptide transfer)
Folic acid pathway inhibitors on bacteria
Sulfonamides (PABA analog)
TMP (inhibits dihydrofolate reductase)
DNA inhibitors on bacteria
fluoroquinolones (DNA gyrase)
metronidazole (ROS damage DNA)
Tx for vancomycin resistant enterococci
linezolid
streptogramins (quinupristin/dalfopristin)
Antifungal meds
Amphotericin B (binds ergosterol)
Azoles (inhibits ergosterol synthesis)
Flucytosine (5-FU conversion)
Tx for toxoplasmosis
pyrimethamine
Tx for T brucei (sleeping sickness)
suramin (heme stage)
melarsoprol (CNS stage)
Tx for T. cruzi (Chagas)
nifurtimox
Tx for Leishmaniasis (volcano eruptions/visceral necrosis)
Na+ stibogluconate
Tx for plasmodium
cholorquine-nonsevere
quinine/quinidine-severe
primaquine-hypnozoites (vivax/ovale)
Tx for flukes (trematodes ie Schistosoma)
Praziquantel
Tx for hemiliths
Mebendazole
pyrantel pamoate
ivermectin
diethylcarbamazine
MOA of zanamivir/oseltamivir
inhibits influenza neuraminidase
for influenza A and B
MOA of ribavirin
inhibits guanine nucleotide synthesis
MOA of acyclovir
HSV/VZV thymidine kinase needed, inhibits DNA pol by guanosine analog
not for CMV
MOA of ganciclovir
CMV viral kinase needed
Guanosine analog, inhibits DNA pol
for CMV
MOA of foscarnet
DNA pol inhibitor
for CMV retinitis in AIDS pt
MOA of HIV protease inhibitors
end in -navir
depend on HIV-1 protease (pol gene)
prevent maturation of viruses
Ritonavir boosts others
MOA of NRTI’s in HIV
inhibit reverse transcriptase binding
MOA of NNRTI’s in HIV
bind reverse transcriptase
MOA of raltegravir
inhibits HIV intregration into host cell chromosome
inhibits HIV integrase
Use of interferon alpha in disease
chronic Hep B/C
Kaposi’s sarcoma
Use of interferon beta in disease
Multiple sclerosis
Use of intereferon gamma in disease
NADPH oxidase deficiency