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Micro 2 USMLE Flashcards

1
Q

dermatophyte has a reservoir in pets

A

microsporum

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2
Q

this obligate anaerobic bacilli is gram positive, spore forming

A

clostridia

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3
Q

this clostridium species produces an exotoxin

A

clostridium tetani

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4
Q

C tetani exotoxin works by blocking ________ release [inhibitory neurotransmitter] from Renshaw cells in the spinal cord

A

glycine

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5
Q

this clostridia bacilli forms a preformed, heat-labile toxin that inhibits ACh release

A

C. botulinum

mneu: BOTulinum is from bad BOTtles of food (causes a flacid parralysis)

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6
Q

this clostridia bacilli produces an alpha toxin (lethinasse) that causes myonecrosis, gas gangrene, or hemolysis.

A

C. Perfringes

mneu: PERFringes PERForates a gangrenous leg

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7
Q

this clostridia bacilli produces a cytotoxin, an exotoxin that kills enterocytes, causing psudomembranous colitis. It is often secondary to antibiotic use, especially clindamycin or ampicillin.

A

C. difficile

mneu: DIfficile causes DIarrhea.

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8
Q

how do you tx C. difficile

A

metronidazole.

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9
Q

Diptheria is caused by _________ via exotoxin encoded by a Beta-prophage.

A

Corynebacterium diptheriaee

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10
Q

the potent diptheria exotoxin works by inhibiting what via ADP ribosylation of EF-2

A

Protein synthesis

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11
Q

coryne=______

A

club shaped

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12
Q

Symptoms of infection with this bug include pseudomembranous pharyngitis (grayish-white membrane) with lymphadenopathy)

A

C. diptheriae.

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13
Q

C diptheriae identified in the lab as a Gram ___, _____ with metachromatic ranules.

A

G+, rod

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14
Q

C diptheriae grows on a ______ agar

A

tellurite

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15
Q

What are the ABCDEG of diptheria and its exotoxin

A 
ADP ribosylation
Beta-prophage
Corynebacterium
Diphtheriae
Elongation Factor 2
Granules
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16
Q

pt presents with painless black skin lesions (vesicular papules covered by black eschar). He developes sepsis and dies. What G+ sporeforming rod that produces a toxin do you suspect

A

Bacillus anthracis

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17
Q

Inhalation of anthrax spores from contaminated wool can lead to flulike symptoms that rapidly progress to fever, pulmonary hemorrhage, and shock. what is the name of this dz.

A

woolsorters dz.

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18
Q

these two bugs are both gram + rods forming long branching filaments resembling fungi

A

actinomyces v. nocardia.

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19
Q

this bug forms yellow “sulfur granules’ in sinus tracts

A

A. israelii

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20
Q

this bug is a G+ ANAEROBE, that causes oral/facial abscesses with “sulfur granules” that may drain through sinus tracts in the skin. It is part of the normal oral flora.

A

Actinomyces israelii

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21
Q

this bug is a gram + and weakly acid fast aerobe in the soil taht causes pulmonary infection in immunocompromized pts

A

Nocardia asteroides

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22
Q

How do you tx nocardia? actinomyces?

A 
mneu:  SNAP
Sulfa for 
Nocardia;
Actinomyces use
Penicillin
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23
Q

Gram negative outer membrane layer inhibits entry of these 2 AB. Therefore G - bugs are resistant to these 2 drugs

A

Penicillin G

Vancomycin

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24
Q

T or F. G- bugs are resistant to all derivitives of penicillin such as ampicillin

A

F–just resistant to PCN & Vanco.

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25
Q

Neisseria is a gram ___, ____

A

neg, cocci

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26
Q

Neisseria Gonococci or Meningococci?

Polysaccharide capsule

A

Meningococci

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27
Q

Neisseria Gonococci or Meningococci?

No Polysaccharide capsule

A

Gonococci

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28
Q

Neisseria Gonococci or Meningococci?

No maltose fermintation

A

Gonococci

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29
Q

Neisseria Gonococci or Meningococci?

maltose fermintation

A

Meningococci

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30
Q

Neisseria Gonococci or Meningococci?

No Vaccine

A

Gonococci

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31
Q

Neisseria Gonococci or Meningococci?

Vaccine

A

Meningococci

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32
Q

Neisseria Gonococci or Meningococci?

causes gonorrhea, septic arthritis, neonatal conjunctivitis, PID

A

Gonococci

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33
Q

Neisseria Gonococci or Meningococci?

causes meningococcemia and meningitis, Waterhouse-Friderichsen syndrome

A

Meningococci

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34
Q

this bug is a small gram negative (coccobacillary) rod spread via aerosol transmission.

A

Haemophilus influenzae

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35
Q

HaEMOPhilus Influenzae causes (4)

A

Epiglottis, Meningitis, Otitis media & Pneumonia.

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36
Q

Most invasive form of H. influenzae is caused by capsular type ___

A

B.

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37
Q

H. influenzae produces ____ protease.

A

IgA.

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38
Q

how do you culture H. influenzae

A

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

mneu: when child has “flu” mom goes to five(V) & dime (X) to buy some chocolate.

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39
Q

H. flu vaccine contains type B capsular polysaccharide conjugated to diptheria toxoid or other protien. It is given between ____ and _____ mo of age.

A

2 and 18

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40
Q

this group is a diverse family including E. coli, salmonella, shigella, klebsiella, enterobacter, serratia, porteus

A

enterobacteriaceae.

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41
Q

all enterobacteriaceae have somatic (__) Ag (polysaccharide of endotoxin. The capsular (__)Ag related to virulence of the bug. The flagellar (__) Ag is found in motile species

A

O
K
H

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42
Q

enterobacteriaceae ferment ____ and are oxidase ____

A

glucose

negative

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43
Q

with enterobacteriaceae think COFFEe.

A 
Capsular
O Ag
Flagellar Ag
Ferment glucose
Enterobacteriaceae
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44
Q

these bacteria grow pink colonies on MacConkey’s agar. Examples include Klebsiella, E. coli, Enterobacter, and Citrobacter

A

Lactose fermenters

Lactose is KEE

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45
Q

These 2 organisms are similar in that both are non-lactose fermenters. Both invade intestinal mucosa and can cause bloody diarrhea

A

Salmonella v. Shigella

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46
Q

Salmonella v. Shigella:
Only _______ is motile and can invade further and disseminate hematogenously. Symptoms may be prolonged with AB treatments, and there is typically a monocyte response.

A

Salmonella

mneu: Salmon swim (motile and disseminate

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47
Q

_____ has an animal reservoir

A

salmonella.

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48
Q

Shigella is transmitted via the 4 Fs

A

Food, fingers, feces, & fliies

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49
Q

usually transmitted from pet feces (e.g., puppies), contaminated milk, or pork. Outbreaks are common in day-care centers. Can mimic Crohn’s or appendicitis, can disseminate to produce lymphadenitis.

A

Yersinia enterocolitica.

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50
Q

Bugs causing food poisoning:

contaminated seafood

A

Vibrio parahaemolyticus & V. vulnificus

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51
Q

Bugs causing food poisoning:

reheated rice

A

Bacillus cereus

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52
Q

Bugs causing food poisoning:
meats, mayonaise, custard

s/s starts quickly and ends quickly

A

S. aureus

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53
Q

Bugs causing food poisoning: reheated meat dishes

A

clostridium perfringes

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54
Q

Bugs causing food poisoning: undercooked meat

A

E. Coli O157:H7

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55
Q

Bugs causing food poisoning: poultry, meat, & eggs

A

Salmonella

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56
Q

Pt presents with bloody diarrhea. culture shows comma or S- shaped, oxidase positive organisms that grow at 42*C. What is the species

A

Campylobacteria

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57
Q

Pt presents with bloody diarrhea. culture shows motile organisms What is the species

A

Salmonella

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58
Q

Pt presents with bloody diarrhea & dysentery. Culture shows nonmotile species with very low ID50. What is the species

A

Shigella.

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59
Q

What is more virulent Shigella or Salmonella

A

Shigella (only 100 organisms causes dz)

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60
Q

Pt presents with bloody diarrhea which progresses to HUS. culture shows shiga-like toxin. What is the species

A

Enterohemorrhagic E. coli

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61
Q

Pt presents with bloody diarrhea. culture shows O157:H7 which has invaded the colonic mucosa What is the species

A

Enteroinvasive E. coli

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62
Q

child at day care center presents with bloody diarrhea and pain that mimicks appendicitis. What is the bug?

A

Yersinia enterocolitica

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63
Q

Pt presents with bloody diarrhea & pseudomembranous colitis. What is the species

A

C. dificile

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64
Q

Pt presents with bloody diarrhea. culture shows protozoa. What is the species

A

entamoeba histolytica

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65
Q

Pt presents with watery diarrhea. Hx of traveling out of the country. No preformed toxin. What is the species

A

Enterotoxigenic E. coli (ETEC)

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66
Q

Pt presents with rice watery diarrhea . culture shows comma shaped organisms. What is the species

A

V. cholerae

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67
Q

Pt presents with watery diarrhea and gas gangrene. What is the species

A

C. perfringes

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68
Q

Immunocompromized pt presents with watery diarrhea. what do you suspect.

A

protazoa (e.g., giardia, cryptosporidium)

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69
Q

Pt presents with watery diarrhea . What viruses could cause this

A

Rotavirus, adenovirus, Norwalk virus

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70
Q

This toxin acts via ADP ribosylation that perminantly activates adenyl cyclase (increase cAMP). It perminantly activates G(s)causing rice-water diarrhea.

A

Vibrio cholerae toxin

Cholera turns the “on” on

71
Q

This toxin acts via ADP ribosylation that perminantly activates adenyl cyclase (increase cAMP). It perminantly disables G(i)causing whooping cough. It also promotes lymphocytosis by inhibiting chemokine receptors

A

Pertussis toxin

Pertussis turns the “off” off

72
Q

This bug is a gram neg. rod that gram stains poorly. It is spread via aerosol transmission from enviornmental water source hapitat. It is not spread person to person.

A

Legionella pneumophelia

73
Q

How do you cx & stain Legionella pneumophelia

A

grow on charcoal yeast extract culture with iron and cysteine

stain with silver stain.

mneu: Think of French legionnaire (ssoldier) with his silver hlmet, sitting around a campfire (charcoal) with is iron dagger–he is no sissy (cysteine)

74
Q

How do you tx Legionnaires’ dz

A

erythromycin

75
Q

this bug is associated with wound and burn infections. It is an aerobic gram negative rod. It is non lactose fermenting, oxidase positive. it produces pyocyanin which is a blue green pigment and is usually associated with a water source.

A

Pseudomonas aeruginosa.

mneu: AERuginosa–AERobic. think water connnection & blue green pigment.

76
Q

Pseudomonas aeruginosa causes pneumonia in these patients

77
Q

Pseudomonas aeruginosa causes black lesions on the skin when this happens

78
Q

When pseudomonas aeruginosa causes external otitis, it is also known as

A

swimmers ear

79
Q

Pseudomonas aeruginosa produces an endotoxin which causes (2)

A

fever & shock

80
Q

Pseudomonas aeruginosa produces an exotoxin (A) which does this to EF-2

A

inactivates it

81
Q

how do you tx Pseudomonas aeruginosa

A

aminoglycoside plus extended-spectrum penicillin (e.g., Piperacillin, ticarcillin.

82
Q

this gram - rod causes gastritis and up to 90% of duodenal ulcers.

A

Helicobacter pylori

83
Q

Is H. pylori urease + or -

A

+ think the urease breath test.

84
Q

what other bug is urease +

A

Proteus

cleaves urea to amonia

85
Q

H. pylori is a risk factor for (2)

A

peptic ulcer and gastric carcinoma

86
Q

H. pylori creates this kind of envirnment (acid or alkaline)

87
Q

tx H. pylori w/ triple therapy-what is it

A

1) bismuth (pepto-bismol)
2) metronidazole
3) tetracycline or amoxycillin

or (more expensive)

1) metronidazole
2) omeprazole
3) clarithromycin

88
Q

this zoonotic bacteria causes lyme dz and is transmitted by the bite of the Ixodes tick that live on deer and mice

A

Borrelia Burgdorferi

89
Q

this zoonotic bacteria causes Undulant fever and is transmitted by dairy products and contact with animals

A

Brucella species

90
Q

this zoonotic bacteria causes Tularemia and is transmitted by ticks that live on rabbits & deer

A

Francisella tularensis

91
Q

this zoonotic bacteria causes plague and is spread via flease that live on rodents, especially prarie dogs

A

Yersinia pestis

92
Q

this zoonotic bacteria causes cellulitis and is spread via bites from cats and dogs

A

pasteurella multocida

93
Q

On pelvic exam you note a greenish vaginal discharge with a fishy smell. Pt reports no pain. Smear shows clue cells and cx grows out a pleomorphic, gram variable rod. What is the dx and the bug.

A

Bacterial Vaginosis

Gardnerella vaginalis

94
Q

What anaerobe is also involved with B.V

A

Mobiluncus.

95
Q

How do you tx B.V.

A

metronidazole

96
Q

what are clue cells

A

vaginal epithelial cells covered with bacteria, visable under microscope

97
Q

TB granulomas with lobar and perihilar lymph node involvement. Reflects primary infection or exposure

A

Ghon complex

98
Q

pt presents with fever, night sweats, weight loss & hemoptysis. What mycobacterium do you suspect

A

mycobacterium tuberculosis

99
Q

pt presents with TB like symptoms but it is not mycobacterium tuberculosis, what other mycobacterium could it be

A

M. kansasii

100
Q

child presents with cervical lymphadenitis. What mycobacterium?

A

M. scrofullaceum

101
Q

AIDS pt presents with disseminated dz. Bug is resistant to multilple drugs. What mycobacteria

A

M. avium-intracellulare

102
Q

all mycobacteria should be stained this way

103
Q

what dz involves loss of eyebrows, nasal collapse, lumpy earlobe, and “leonine facies”

A

Leprosy (Hansen’s dz)

104
Q

This bug is an acid fast bacillus that likes cool temperatures (infects skin and superficial nerves) and cannot be grown in vitro.

A

Mycobacterium leprae

105
Q

What is the reservoir in US for M. leprae

A

armadillos.

106
Q

TB granulomas with lobar and perihilar lymph node involvement. Reflects primary infection or exposure

A

Ghon complex

107
Q

pt presents with fever, night sweats, weight loss & hemoptysis. What mycobacterium do you suspect

A

mycobacterium tuberculosis

108
Q

pt presents with TB like symptoms but it is not mycobacterium tuberculosis, what other mycobacterium could it be

A

M. kansasii

109
Q

child presents with cervical lymphadenitis. What mycobacterium?

A

M. scrofullaceum

110
Q

Hansen’s dz (Leprosy) has 2 forms: lepromatous & tubberculoid. Which is worse?

A

Lepromatous is worse–it involves failed cell mediated immunity; tuberculoid is self limited

mneu: LEpromatous=LEthal.

111
Q

these are obligate intracellular parasites that cause mmucosal infections

112
Q

chlamys=_______

A

cloak (intracellular

113
Q

Chlamydiae exists in 2 forms What are they?

A

1) Elementary body (small, dense) Enters cell via Endocytosis
2) Reticuliate body, which Replicates in cell by fission

114
Q

This chlamydia species causes reactive arthritis, conjunctivitis, and nongonococcal urethritis

A

Chlamydia trachomatis

115
Q

These 2 chlamydia species cause atypical pneumonia, and is transmitted via aerosol droplets

A

C. pneumoniae & C. psittaci

116
Q

C. psittaci is notable in that it has an ____ reservior

117
Q

The clamydial peptidoglycan wall is unusual in that it lacks ______

A

muramic acid

118
Q

Dx of clamydia is made by cytoplasmic incusions seen on _______ or fluorescent Ab stained smear

119
Q

how do you tx clamydia

A

erythromycin or tetracylcine

120
Q

Clamydia trachomatis serotypes:

A,B,C

A

ABC=Africa/Blindness/Chronic infection

121
Q

Clamydia trachomatis serotypes:

D-K

A

urethritis/PID, ectopic pregnancy, neonatal pneumonia, or neonatal conjunctivitis

D-K=everything else

122
Q

Clamydia trachomatis serotypes:

L1-L3

A

Lymphogranuloma venerium

123
Q

Neonate develops conjunctivits via passage through infected birth canal. How do you tx his chlamydia

A

erythromycin eye drops

124
Q

Name 3 spirochetes

A

Borrelia (Big-can be visualized under light microscopy using aniline dyes (Wright’s or Giemsa stain))
Leptospira
Treponema

mneu: BLT

125
Q

pt presents with erythema chronicum migrans, an expanding “bull’s eye” red rash with central clearing. Dz may progress to affect joints CNS, & heart.

126
Q

Lyme dz caused by what spirochete and what vector

A

Borrelia burgdorferi, transmitted by the tick Ixodes

127
Q

important reservoir for Lymme dz

128
Q

animal required for tick life cycle

129
Q

lyme dz transmission is most common during this season

130
Q

3 stages of Lyme dz

A

1) erythema chronicum migrans, flulike symptoms
2) neurologic and cardiac manifestations
3) autoimmune migratory polyarthritis

mneu: BAKE a Key LYME pe:
Bells palsy, Arthritis, Kardiac block, Erythema chronicum migranes.

131
Q

treponemes are ______

A

spirochetes

132
Q

________ causes syphilis

A

Treponema pallidum

133
Q

_______ causes yaws (a tropical infxn that is not an STD, although VDRL test is +.

A

T. pertenue

134
Q

describe primary syphilis

A

localized dz-painless chancre

135
Q

describe secondary syphilis

A

disseminated dz w/ constitutional symptoms, maculopapular rash (palms & soles) condylomata lata

mneu: Secondary syphilis=Systemic

136
Q

pt preents w/ broad-based ataxia positive Romberg, charcot joints, stroke without hypertension

A

tertiary syphilis

137
Q

describe tertiarry syphilis

A

gummas, aortitis, neurosyphalis (tabes dorsalis), argyl Robertson pupil

138
Q

child presents with deafness, saber shins, sadddle nose. what dx

A

congenital syphilis

139
Q

describe primary siphilis

A

localized dz-painless chancre

140
Q

describe secondary syphilis

A

disseminated dz w/ constitutional symptoms, maculopapular rash (palms & soles) condylomata lata

mneu: Secondary syphilis=Systemic

141
Q

pt preents w/ broad-based ataxia positive Romberg, charcot joints, stroke without hypertension

A

tertiary syphilis

142
Q

describe tertiarry syphilis

A

gummas, aortitis, neurosyphalis (tabes dorsalis), argyl Robertson pupil

143
Q

child presents with deafness, saber shins, sadddle nose. what dx

A

congenital syphilis

144
Q

constricts with accomodation but is not reactive to light. Pathognomonic for tertiary syphilis

A

Argyll Robertson Pupil

“prostitute’s pupil” – accommodates but does not react.

145
Q

FTA-ABS is specific for these. It turns + earliest in dz & remains positive for longest

A

treponemes

mneu: FTA-ABS=Find The Antibody-ABSolutely:
1) Most specific
2) earliest positive
3) remains positive the longest

146
Q

VDRL or FTA interpretation:

Active infection

147
Q

VDRL or FTA interpretation:

Probably false positive

148
Q

VDRL or FTA interpretation: positive after successful treatment

149
Q

this test detects a nonspecific Ab that reacts with beef cardiolipin

150
Q

VDRL false positive

A 
VDRL
Viruses (mono, hepatitis)
Drugs
Rheumatic fever & arthritis
Lupus & leprosy
151
Q

coccidiomycosis and histoplasmosis are fungus transmitted by _______

A

inhalation of conidia (asexual fungal spores)

152
Q

this fungus can cause a systemic of superficial fungal infection. It is dimorphic forming budding yeast with psudohyphae in cx at 20C and germ tube formation at 37C

A

Candida albicans

153
Q

alba=_____

154
Q

causes thrush esophagitis with immunocompromized pts (neonates, steroides, diabetes, AIDS), endocarditis in IV drug users, vaginitis (post-antibiotic), diaper rash

A

Candida albicans

155
Q

Tx of candida for superfical infxn

156
Q

Tx of candida for systemic infxn

A

amphotercin B

157
Q

this dz causes San Joaquin Valley or desert “valley fever.” It is known as desert bumps and on cx you may see a spherule filled with endospores

A

Coccidiomycosis

158
Q

this dz is spread by bird or bat droppings in Mississippi and Ohio river valleys. Characterized by tiny yeast inside macrophages

A

Histoplasmosis

159
Q

This organism endemic in rural Latin America and is characterized by a “Captain’s wheel” appreance.

A

PARACOCCIDIOMYCOSIS

160
Q

This fungis is endemic to states east of Mississippi River & Central America, it is characterized by Big, Broad-Based Budding yeasts

A

Blastomycosis.

161
Q

histo, paracoxie, and blastomycoisis are all caused by _______ fungi, which are mold in soil (low temp) adn yeast in tissue (higher temp)

162
Q

coxie is the exception in that it is a ______ in tissue

163
Q

tx coxie, histo, paracoxie, and blastomycoisis locally with

A

fluconazole or ketoconazole

164
Q

tx coxie, histo, paracoxie, and blastomycoisis systemically

A

amphotericin

165
Q

systemic mycosis can form granulomas and mimick this dz

166
Q

this dz causes hypopigmented skin lesion and occurs in hot, humid weather.

A

tinea versicolor

167
Q

tinea versicolor is caused by

A

malassezia furfur

168
Q

tx tinea versicolor with topical

A

miconazole or selenium sulfide (Selsun)

169
Q

this dz is an infxn of keratinized leyer of skin. It appears as a brownish spot.

A

tinea nigra

170
Q

tinea nigra is caused by this fungus

A

Cladosporium wernecki.

171
Q

tx tinea nigra with topical______

A

salycylic acid

172
Q

pruritic lesions with central clearing resembling a ring

A

Tinea (pedis, cruris, corporis, capitis)

173
Q

Tinea (pedis, cruris, corporis, capitis) caused by

A

dermatophytes (microsporum, trichophyton, and epidermophyton)

Step 1 Complete (29 decks)

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