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USMLE Step 1 Random Facts > Micro > Flashcards

Micro Flashcards

1
Q

characteristic tumbling motility

A

Listeria monocytogenes

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2
Q

transmitted via respiratory droplets

A

N.meningitidis, RSV, H.influenzae, M.tuberculosis

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3
Q

arthropod bites

A

leishmaniasis (sandfly)
malaria (Anopheles mosquito)
Chagas (reduviid bug)
Lyme dz (Ixodes tick bite)

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4
Q

needle stick transmission

A

HBV, HCV, HIV

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5
Q

H.influenzae

A

small, gram neg coccobacilliary rod
epiglottis, meningitis, otitis media, pneumonia
“haEMOPhilus”

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6
Q

causes a palm & sole rash?

A

2ndary syphilis
Rocky mountain spotted fever
coxsackievirus A
Kawasaki dz

“you drive KAWASAKI CARS w/ your HANDS AND FEET”
(CA = cox A, R = RMSF, S = syphilis)

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7
Q

can cross placenta and allow infection from mother to fetus?

A 
TORCHES:
TOxoplasma gondii
Rubella
Cytomegalovirus
HErpes, HIV (HSV-2 transmitted VIA DELIVERY)
Syphilis
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8
Q

2 obligate intracellular parasites (require host ATP for energy)

A

Chlamydia

Ricketssiae

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9
Q

common causes of atypical pneumonia (class types)

A

Mycoplasma
Legionella
Chlamydia
Viruses

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10
Q

5 pediatric diseases w/ rash

A 
Measles
Rubella
Scarlet fever (S.pyogenes)
Roseola (HHV-6)
Erythema infectiosum (parvovirus B19) - "slapped cheeks"
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11
Q

5 causes of common cold

A 
rhinovirus
coronavirus
adenovirus
influenze C virus
coxsackievirus
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12
Q

3 common causes of conjunctivitis

A

H.influenzae
Adenovirus
S.pneumoniae

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13
Q

most common viral cause of mental retardation in US

A

CMV

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14
Q

cancers caused by EBV

A 
Burkitt's lymphoma
nasopharyngeal carcinoma (in East Asians)
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15
Q

HBV, HCV, HDV 4 characteristics:

A

Blood transmission
Chronic carrier state
Cirrhosis
HCC

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16
Q

smallpox eradicated bc of?

A

1) only ONE serotype existed
2) NO CARRIER state
3) NO ANIMAL RESERVOIRS

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17
Q

enveloped viruses?

A

susceptible to anything capable of destroying lipids (ex. bile acids)

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18
Q

use host cell TRANSLATION machinery

A

ssDNA viruses

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19
Q

use host cell TRANSCRIPTION machinery

A

dsDNA viruses

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20
Q

Parvovirus B19 =

A

ssDNA linear, nonenveloped

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21
Q

HPV =

A

nonenveloped, dsDNA circular

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22
Q

HPV uses what 2 factors to grow?

A

E6 (blocks p53), E7 (blocks Rb)

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23
Q

JC virus =

A

dsDNA circular, nonenveloped

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24
Q

adenoviruses =

A

dsDNA linear, nonenveloped

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25
adenoviruses can cause?
resp tract infection conjunctivitis hemorrhagic cystitis gastroenteritis
26
adenoviruses remain latent where?
tonsillar adenoids following infection
27
adenoviruses contain what factor?
hemagglutinin fibers in each of 12 vertices of capsid
28
HSV-1, HSV-2, VZV =
enveloped, dsDNA linear
29
HSV, CMV, EBV envelope?
only virus that obtains envelope by budding from nuclear membrane
30
HSV-1 can cause?
gingivostomatitis keratoconjunctivitis (recurrence of --> common cause of blindness in U.S) cold sores **temporal lobe encephalitis (focal necrosis)
31
HSV-1 dormant in?
trigeminal ganglion
32
HSV-2 dormant in?
lumbosacral ganglion
33
HSV-2 passed from mother to fetus can cause?
congenital defects abortion neonatal encephalitis
34
most common cause of encephalitis in U.S
``` HSV-1 = adults HSV-2 = neonates ```
35
"dew on a rose petal"
VZV
36
VZV dormant in?
DRG
37
CMV =
dsDNA linear, enveloped
38
CMV causes?
``` cytomegalic inclusion dz [deafness, hepatosplenomegaly, microcephaly in newborns) heterophil-NEGATIVE mononucleosis retinitis (esp in AIDS pt) pneumonia (esp in transplant pts) esophagitis ```
39
cancers ass w/ EBV?
Burkitt's lymphoma, nasopharyngeal carcinoma (East Asians)
40
EBV dormant in?
B cells bind and infect B cells via C3d complement receptor
41
atypical lymphocytes charact of?
EBV infection cytotoxic T-lymphocytes react against infected B cells
42
HBV =
enveloped, dsDNA circular
43
HBV and weak immune response =
chronic state
44
HBV tx?
alpha-IFN or pegylated alpha-IFN | lamivudine
45
smallpox =
enveloped, dsDNA linear
46
smallpox presentation?
start as macules --> evolve to pus-filled vesicles --> crust over in 2-3 wks --> infectious particles released
47
molluscum contagiosum =
enveloped, dsDNA linear
48
unlike HSV or VZV, molluscum contagiosum is?
limited to epidermis | NO latent state
49
Molluscum contagiosum presentation?
flesh-colored pearly nodules/papules w/ central crater "dome-like"
50
features of acid-fast bacilli?
cell wall w/ mycolic acid (a lipid) --> makes wall hydroPHOBIC after stained, retains stain!
51
spirochetes shape/motility?
``` corkscrew bc flexible/thin cell walls periplasmic flagella (b/w outer membrane and cell wall) --> corkscrew motility ```
52
mycoplasma distinguishing feature?
no cell wall
53
chlamydia/rickettsiae species are?
obligate intracellular bacteria
54
mycolic acid cell wall protects from?
phagocytosis, germicides, dryness
55
M.tuberculosis cell wall contains?
sulfatides - inhib phagosome from fusing lysosome
56
M.tuberculosis =
thin RODS, non-motile obligate aerobes | linear growth
57
acid-fast staining bacteria?
mycobacteria, nocardia
58
live-attenuated vaccines for bacteria?
BCG and F.tulerensis vaccines
59
Mycobacterium avium complex consists of?
M.avium, M.intracellulare | major opportunistic inf in AIDS pts
60
M.bovis seen w/?
GI tuberculosis; unpasteurized milk
61
M.leprae =
same as M.tuberculosis but also grows at low temps, phenolase positive
62
M.leprae infect?
cells of nerve sheaths
63
tuberculoid leprosy =
strong immune response granulomas formed thickened palpable nerves and 1-2 anesthethized lesions that are hypopigmented and hairless
64
lepromatous leprosy =
weak immune response inflamm damage --> sensory loss at face, extremities loss of eyebrows, saddle-nose deformity (thick nose), leonine facies (thick cheeks), infertility
65
tx of leprosy SE?
type 1 = DTH response --> intensified tuberculoid-like sympt; tx w/ prednisone type 2 = immune-complex dep --> erythema nodosum leprosum; tx w/ thalidomide
66
T.pallidum =
spirochete microaerophilic sensitive to high temps
67
T.pallidum contains?
endoflagellum (b/w cell wall and outer membrane)
68
Giemsa stain
``` Chlamydia Borrelia Ricketssiae Trypanosomes Plasmodium ``` "Certain Bugs Really Try My Patience"
69
PAS stain
stains GLYCOGEN, mucopolysaccharides | dx Whipple's Dz (Tropheryma whipplei)
70
Ziehl-Neelson stain (carbolfuchsin)
acid-fast organisms (Nocardia, Mycobacteria)
71
India Ink
C.neoformans (stains CLEAR)
72
mucicarmine stain
C.neoformans (stains capsule RED)
73
Silver stain
Fungi (Pneumocystis) Legionella H.pylori
74
chocolate agar w/ factors V (_____), X (________) media for?
H.influenzae NAD+;hematin ENRICHMENT MEDIA
75
Thayer-Martin media contains?
Vancomycin (inhib Gram + org) Polymyxin (inhib Gram - org except Neisseria) Nystatin (inhib fungi) SELECTIVE MEDIA!
76
Thayer-Martin media for?
N.gonorrheae/meningitidis
77
Bordet-Gengou (_______) agar for?
B.pertussis | potato!
78
cystine-tellurite plate
C.diphtheriae --> forms black colonies
79
Loffler's media
C.diphtheriae
80
Lowenstein-Jensen agar for?
M.tuberculosis
81
pink colonies on MacConkey's agar?
lactose-fermenting enterics! fermentation prod acid --> turns colony pink DIFFERENTIAL MEDIA
82
eosin-methylene blue agar?
E.Coli (colonies w/ green metallic sheen)
83
charcoal yeast extract agar buffered w/ _________ and used for?
cysteine and iron Legionella!
84
Sabouraud's agar
Fungi "Sab's a FUN Guy"
85
obligate aerobes
Nocardia Pseudomonas aeruginosa M.tuberculosis Bacillus (some are facultative anaerobes) "Nagging Pests Must Breathe"
86
obligate anaerobes
Clostridium Bacteroides Actinomyces "anaerobes Can't Breathe Air" foul smelling, difficult to culture, produce gas in tissue
87
what drug class is ineffective against anaerobes?
Aminoglycosides (req O2 to enter)
88
obligate intracellular
Rickettsiae Chlamydia can't make own ATP
89
facultative intracellular
``` Salmonella Neisseria Brucella Mycobacterium Listeria Francisella Legionella Yersinia pestis ``` "Some Nasty Bugs May Live FacultativeLY"
90
catalase + organisms
``` Pseudomonas Listeria Aspergillus Candida E.Coli S.aureus Serratia ``` "you need PLACESS for your CATS"
91
urease + bugs
``` Cryptococcus H.pylori Proteus Ureaplasma Nocardia Klebsiella S.epidermidis S.saprophyticus ```
92
yellow "sulfur" granules prod by?
Actinomyces israelii | composed of filaments of bacteria
93
yellow pigment
S.aureus
94
blue-green pigment
Pseudomonas aeruginosa
95
red pigment
Serratia marcescens
96
Protein A virulence factor?
S.aureus | binds Fc region of Ig --> prevents opsonization/phagocytosis
97
IgA protease virulence factor?
S.pneumo, H.flu B, Neisseria ("SHiN") | cleaves IgA --> colonize respiratory mucosa
98
M protein virulence factor?
group A strep | prevent phagocytosis and activation of complement!
99
features of exotoxin
genes located for in plasmid or bacteriophage; made of polypeptide; induces high-titer Ab (antitoxins) ONLY staph enterotoxin not destroyed at 60 degrees C
100
features of endotoxin
located in outer cell membrane of Gram -; made of LPS; causes fever, shock by release of TNF, IL-1
101
superantigen cause what?
overwhelming release of IFN-gamma and IL-2
102
3 effects of endotoxin
``` activates macrophages (TNF, IL-1, NO) activates complement (C3a, C5a) activates tissue factor (coag cascade --> DIC) ```
103
transformation?
take up naked DNA from environement (form recomb organism) | SHiN organisms!!
104
what inhibits transformation from occurring?
adding deoxyribonuclease (degrades naked DNA)
105
what contains genes for sex pilus and conjugation?
F+ plasmid
106
transposition?
segment of DNA that can jump (excision, reintegration) from one location to another can carry AB resistance or virulence factors
107
transduction uses?
phages!
108
5 bacterial toxins encoded in lysogenic phage?
``` shigA-like toxin Botulinum toxin Cholera toxin Diphtheria toxin Erythrogenic toxin of Strep pyogenes ``` "ABCDE"
109
beta-hemolytic bacteria
S.aureus S.pyogenes S.agalctiae Listeria monocytogenes "forms clear area"
110
classic drugs used to tx anaerobic infections
metronidazole | clindamycin
111
branching, filamentous Gram (+) rods w/ sulfur granules
Actinomyces israelii
112
spore forming bacteria
B.cereus B.anthracis Clostridrium botulinum/tetani/perfringens
113
see "picnics" and egg salad or chicken salad, think?
S.aureus - immed (1-6 hrs) vomiting/diarrhea | Salmonella - occurs 1-3 days later
114
transmission from turtle
Salmonella
115
traveller's diarrhea
ETEC
116
staghorn calculi are what stones?
ammonium-magnesium-phosphate stones (struvite stones)
117
what bug causes staghorn calculi?
Proteus
118
hemolysis color for alpha-hemolytic
green
119
hemolysis color for beta-hemolytic
clear
120
water contaminated w/ rodent urine =
hantavirus
121
Borrelia burgdorferi transmitted by, and, natural reservoir =
transmit by Ixodes tick (also holds Babesia) | reservoir = mouse
122
BILATERAL Bell's palsy ass w/?
stage 2 Lyme dz
123
stage 2 Lyme dz manifestations?
bilateral bell's palsy (w involved forehead); | AV nodal block
124
3 biggies in atypical (interstital) pneumonia
Legionella pneumophila Chlamydophila pneumoniae Mycoplasma pneumoniae
125
MRSA resistant to beta-lactams by?
altering penicillin-binding protein
126
S.pneumo is _______ sensitive or resistant and causes?
optochin sensitive Meningitis Otitis media (in children) Pneumonia Sinusitis MOPS
127
normal flora of oropharynx and causes dental caries
S.mutans
128
causes subacute bacterial endocarditis at damaged valves, and by doing what?
S.sanguis - sticks to damaged valves by making glycocalyx
129
most commonly precedes acute PSGN
impetigo > pharyngitis
130
S.viridans are ________ resistant or sensitive?
optochin resistant
131
S.pyogenes is __________ sensitive or resistant?
bacitracin sensitive
132
other S.pyogenes virulence factors
hyaluronate in capsule (antiphagocytic activity) Streptolysin O DNase (depolymerize viscous DNA in pus + disintegrate PML) streptokinase (catalyze plasminogen --> plasmin)
133
S.agalactiae is _________ resistant or sensitive and prod what factor?
``` bacitracin resistant CAMP factor (enlarge area of hemolysis formed by S.aureus) ```
134
S.agalactiae positive culture requires what prophylaxis?
penicillin
135
Enterococci (Group D strep) are resistant to what drug and grow in what?
resistant to penicillin G | grow in 6.5% NaCl and bile
136
S.bovis causes what?
subacute endocarditis in COLON CANCER PTS
137
C.diphtheriae acquires virulence via? has a toxin similar to? appearance in microscope?
bacteriophage-mediated infection w/ Tox gene --> codes for AB exotoxin; P.aeruginosa Gram positive rods w/ metachromatic (blue/red) granules resembling chinese letters
138
spores have what in their core?
dipicolinic acid
139
describe Clostridria species
Gram (+), spore-formers, obligate anaerobic bacilli | oxidase (-)
140
C.difficile toxins
Toxin A --> enterotoxin (binds to brush border of gut --> intestinal fluid secretion and inflamm) Toxin B --> cytotoxin (destroys cytoskeletal structure of enterocytes = kills enterocytes)
141
DOC for C.difficile
metronidazole | 2nd = oral vanco
142
drugs against C.diphtheriae
erythromycin, penicillin; vaccine
143
B.anthracis unique feature
polypeptide capsule containing D-glutamate
144
3 toxins of anthrax
edema factor lethal factor protective antigen
145
wool, goat's hair contain spores for?
Anthrax
146
widened mediastinum and pulm hemorrhage seen in?
Woolsorter's dz (B.anthracis)
147
reheated rice synd + cause/toxin
B.cereus --> cereulide (preformed toxin)
148
able to multiply at 4 degrees C
L.monocytogenes
149
L.monocytogenes is a ? and tx = ?
facultative intracellular microbe (taken up by monocytes) acquired by ingestion of unpasteurized milk/cheese and deli meats + passed on during vaginal birth tx = ampicillin in infants/elderly/immunocomp
150
Actinomyces 4 defining features
Gram (+) anaerobe Not acid-fast oral/facial abscesses (usually of mandible) draining through sinus tracts [bc part of normal oral flora] yellow "sulfur" granules
151
tx for actinomyces?
penicillin
152
Nocardia 4 defining features
Gram (+) aerobe Acid-fast in soil, dust, vegetation pulmonary infections in immunocompromised; cutaneous infections after trauma in immunocompetent
153
Nocardia tx?
sulfonamides
154
congenital toxoplasmosis classic triad?
chorioretinitis hydrocephalus intracranial calcifications
155
cell types rich in smooth ER?
hepatocytes | steroid hormone-producing cells of adrenal cortex
156
formation of spiral septum?
truncoconical swellings fuse + turn 180 degrees | neural crest cell derivative!
157
underlying cause of transposition of great vessels
180 degree spin didn't take place
158
underlying cause of persistent truncus arteriosus
failure of neural crest cell migration
159
congenital defects with present shunts
``` persistent truncus arteriosus - VSD tricuspid atresia - REQ BOTH ASD + VSD TAPVR - ASD + sometimes PDA ToF - VSD transposition of great vessels - REQ ASD, VSD, OR PFO ```
160
2 common causes of osteomyelitis in otherwise healthy children
``` #1 = S.aureus #2 = S.pyogenes ```
161
osteomyelitis in sickle cell dz
Salmonella
162
E.Coli virulence factor for UTIs?
fimbriae
163
E.Coli virulence factor for pneumonia/neonatal meningitis?
K capsule
164
E.Coli virulence factor for shock?
LPS
165
organisms that use fimbriae/pili to attach to tissues/cause infection
N.meningitidis UTI/diarrhea-causing E.coli B.pertussis V.cholera
166
common cause of Acute otitis externa
swimmer's ear! P.aeruginosa S.aureus
167
common cause of Acute otitis media
S.pneumo nontypable H.influenzae M.catarrhalis
168
difference seen b/w bacterial and fungal/TB meningitis?
bacterial - increased PMNs! | fungal/TB - increased lymphocytes!
169
parvoviridae
non enveloped, ssDNA
170
what do Cowdry type A bodies look like?
intranuclear eosinophilic droplets (seen in HSV, CMV)
171
conjugated vaccines are what?
polysaccharide antigen + protein
172
exotoxin not destroyed at 60 degrees C is made by
S.aureus
173
conjugation w/ F+ plasmid will
NOT transfer chromosomal genes
174
conjugation w/ high-freq recombination cell (Hfr) will
transfer plasmid AND chromosomal genes
175
toxins w/ genes encoded in a lysogenic phage
``` shigA-like toxin Botulinum toxin Cholera toxin Diphtheria toxin Erythrogenic toxin of S.pyogenes ``` "ABCDE"
176
alpha-hemolysis produces what area
green ring around colonies
177
DOC for C.perfringens
metronidazole | 2 - oral vanco
178
DOC for GBS prophylaxis
intrapartum penicillin
179
cutaneous anthrax
``` black eschar (painless ulcer) lethal factor and edema factor ```
180
pulmonary anthrax
pulm hemorrhage, mediastinitis (widened, hemorrhagic mediastinum), shock
181
B.cereus
diarrhea cereulide (preformed toxin) reheated rice
182
L.monocytogenes
tumbling motility (actin) able to multiply @4 degrees C (cold) ampicillin for empirical meningitis tx listeriolysin - activated in acidified phagosomes in monocytes; can lyse vacuolar membrane
183
Actinomyces
oral/facial abscesses draining thru sinus tracts | tx = penicillin
184
Nocardia
pulm infections in immunosupp cutaneous infections after trauma in immunocompetant tx = sulfonamides
185
Mycobacterium 2 factors in virulent strains
cord factor - inhib macrophage maturation + induce release of TNF-alpha; "serpentine" looking sulfatides (surface glycoproteins) - inhib phagolysosomal fusion
186
tx for leprosy
tuberculoid - dapsone + rifampin 6 mo. | lepromatous - dapsone, rifampin, clofazimine 2-5 yrs
187
Gram neg bacteria resistant to?
penicillin G and vancomycin
188
N.gonorrheaoe vs. N.meningitidis
N.Meng - has polysacch capsule; nasopharyngeal colonization (resp/oral transmission)
189
HiB vaccine unique in that
it contains pentose monosacch (polyribosylribitol phosphate) conjugated to diphtheria toxoid or other protein
190
which bug shows up w/ hyponatremia on labs
L.pneumophila
191
otitis externa distinguishing feature
granulation tissue w/in ear canal
192
EHEC unique from other E.Coli in that it doesn't
ferment sorbitol
193
Salmonella vs Shigella
``` Sal: flagella dissem hematogenously prod hydrogen sulfide causes monocytic response animal reservoir (turtles) ``` Shigella: cell-to-cell trans (P2P, contaminated food/water) AB shorten duration of fecal excretion causes PMN response
194
can be transmitted from domestic animals to humans
C.jejuni
195
V.cholerae can benefit from what state
achlorhydia (from PPI use, ex)
196
triple therapy for H.pylori
PPI, clarithromycin, amoxicillin/metronidazole
197
H.pylori mainly colonizes where
gastric antrum (duodenal bulb)
198
spirochetes disting factor
axial filaments (flagella located in diff location than others)
199
leptospira
jaundice photophobia w/ conjunctivitis "question-mark" shaped
200
DOC for stage 1/2 of Lyme dz
``` doxycycline azithromycin (in children) ```
201
DOC for later stages of Lyme dz
ceftriaxone (for 28 days)
202
stage 3 lyme dz
chronic monoarthritis/migratory polyarthritis | encephalopathy/polyneuropathy
203
tertiary syphilis physical signs
broad-base ataxia | argyll-robertson pupil
204
early sign of cong syphilis
snuffles (blood tinged nasal secretions)
205
DOC for/cause of bacterial vaginosis
metronidazole | from overgrowth of certain bacteria in vagina
206
R.typhi, R.prowazekii cause
typhus; rash starts centrally + spreads out, sparing palms/soles
207
sign of Ehrlichiosis
granulocytes w/ berry-like inclusions in cytoplasm
208
DOC for LGV
doxycycline
209
chlamydial cell wall unique bc it
lacks muramic acid
210
unique sequelae of Mycoplasma pneumo
mild anemia due to high titer of COLD agglutinins (IgM)
211
histoplasmosis
mississippi and ohio river valleys | w/in macrophage - smaller than RBC
212
blastomycosis
east of Mississippi river and central america granulomatous nodules broad-based budding yeast - same size as RBC
213
coccidioidomycosis
southwestern US, California; San Joaquin valley fever | spherules - larger than RBC
214
Tinea versicolor caused by
M.furfur | degrad of lipids --> prod acids --> damage melanocytes --> hypo/hyperpigmented patches (not pruritic)
215
other tinea lesions usually show what histo
pruritic lesions w/ central clearing resembling ring
216
tx for vaginal/localized candidiasis
nystatin (topical med)
217
disseminated candidiasis predisposition =
decreased neutrophils
218
superficial/localized candidiasis predisposition =
decreased T-lymphocytes
219
Aspergillus can produce
aflatoxins (ass w/ HCC) | conidophore w/ radiating chains of spores
220
C.neoformans causes what sign in brain; also, found where?
soap-bubble lesions; | found in soil, pidgeon droppings
221
mucor/rhizopus features
HA, facial pain (periorbital pain) black necrotic eschar on face (palate or nose usually) have ketone reductase (therefore prolif in excess glucose/ketone)
222
DOC for PCP
TMP-SMX | pentamidine, dapsone (if sulfa allergy)
223
DOC for sporothrix schenckii
itraconazole or K iodide
224
DOC for Giardia lamblia
metronidazole | tinidazole
225
tx for asympt E.histolytica cyst passers
iodoquinol
226
sympt of E.histolytica
bloody, mucous-y diarrhea liver abscess RUQ pain flask-shaped ulcer if colon ruptures
227
tx for Toxoplasmosis
sulfadiazine + pyrimethamine
228
features/tx for Trypanosoma brucei gambiense/rhodesiense
LAD, RECURRING FEVER (due to antigenic variation), coma (late) suramin (if blood-borne dz) melarsoprol (for CNS penetration)
229
Babesiosis features
fever | hemolytic anemia
230
loa loa features
worm in conjunctiva | tx = diethylcarbamazine
231
river blindness caused by
onchocerca volvulus; hyperpigmented skin + blindness tx = ivermectin
232
Elephantiasis caused by/tx
Wuchereria bancrofti; blocks lymphatic vessels tx = diethylcarbamazine
233
Taenia solium ingested from eggs causes
cysticercosis | neurocysticercosis ("swiss-cheese" appearance in brain) - tx w/ -bendazoles + dexamethasone
234
diphyllobothrum latum causes
vit B12 def
235
before removing E.granulosus cysts what do you do?
preinject w/ ethanol to kill cysts
236
S.hematobium ass w/?
SCC of bladder
237
C.sinenis ass w/?
``` pigmented gallstones (from biliary tract inflamm) cholangiocarcinoma ```

USMLE Step 1 Random Facts (35 decks)

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