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STEP1 > Micro > Flashcards

Micro Flashcards

1
Q

Classic signs of leprosy

A

Loss of sensation on the cool parts of the body associated with granuloma formation from acid fast bacilli

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2
Q

To what would a patient be susceptible if they wre deficient in the C5 complement protein?

A

Gram-negative bacteria, especially Neisseria species

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3
Q

gram-positive, catalase-negative, alpha-hemolytic diplococcus

A

streptococcus pneumoniae

viridans streptococci

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4
Q

atypical fungus

A

pneumocystis jiroveci

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5
Q

gram-negative, catalase-positive bacillus

A

pseudomonas aeruginosa

gram negative
rod (bacillus)
lactose nonfermenter
oxidase positive

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6
Q

gram-positive, catalase-positive, beta-hemolytic coccus in clusters

A

staphylococcus aureus

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7
Q

What is a common cause of pneumonia in patients with cystic fibrosis?

A

pseudomonas

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8
Q

gram + cocci
catalase +
coagulase +

A

s. aureus

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9
Q

gram+ cocci
catalase +
coagulase -

A

s. epidermidis (novobiocin sensitive)

s. saprophyticus (novobiocin resistant)

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10
Q

gram + cocci
catalase -
alpha-hemolytic

A 
s. pneumoniae (capsule, optochin sensitive, bile soluble)
viridans streptococci (no capsule, optochin resistant, bile insoluble)
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11
Q

gram + cocci
catalase -
beta-hemolytic

A

s. pyogenes (bacitracin sensitive) (group A)

s. agalactiae (bacitracin resistant) (group B)

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12
Q

gram + cocci
catalase -
gamma-hemolytic

A

group D (enterococcus, e.g., E. faecalis) - growth in bile and 6.5% NaCl

Nonenterococcus (S. bovis) - growth in bile, not in 6.5% NaCl

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13
Q

gram + bacilli

A 
clostridium (anaerobic)
bacillus (aerobic)
corynebacterium
mycobacterium tuberculosis (acid fast)
listeria monocytogenes (beta-hemolytic)
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14
Q

gram + branching filaments

A

nocardia - aerobic, acid fast

actinomyces - anaerobic, not acid fast

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15
Q

gram - diplococci

A 
Neisseria meningitidis (maltose fermenter)
Neisseria gonorrhoeae (maltose nonfermenter)

Both produce IgA protease and ferment glucose

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16
Q

gram - “coccoid” rods

A

Haemophilus influenza

Bordatella pertussis

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17
Q

gram - rods

lactose fermenters

A

Fast:
Klebsiella
E. Coli
enterobacter

Slow:
citrobacter
serratia

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18
Q

gram - rods

lactose nonfermenters

A 
oxidase (-):
shigella
salmonella
proteus
yersinia

oxidase (+)
pseudomonas

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19
Q

gram (-) comma-shaped

oxidase +

A 
campylobacter jejuni (grows in 42 degrees)
helicobacter pylori (produces urease)
vibrio cholerae (grows in alkaline media)
20
Q

Characteristics of Salmonella

A
  • has flagella
  • hematogenous spread
  • produces hydrogen sulfide
  • intestinal epithelial invasion –> monocytic response
  • may cause bloody diarrhea
  • has many animal reserviors
  • antibiotics may prolong duration fecal excretion of organism
  • does not ferment lactose
21
Q

Characteristics of shigella

A
  • no flagella
  • cell-to-cell transmission (no hematogenous spread)
  • does not produce hydgrogen sulfide
  • intestinal epithelial invasion –> neutrophilic response
  • often causes bloody diarrhea
  • only found in humans and primates
  • antibiotics shorten duration of fecal excretion of organism
  • does not ferment lactose
22
Q

Characteristics of N. gonorrhoeae

A

(1) no pollysaccharide capsule
(2) does not ferment maltose
(3) sexually transmitted
(4) no vaccine (due to rapid antigenic variation in pilus protein
(5) leads to: gonorrhea, septic arthritis, pelvic inflammatory disease, neonatal conjunctivitis, Fitz-Hugh_Curtis Syndrome
(6) condoms prevent sexual transmission; erythromycin ointment prevent neonatal transmission
(7) treatment: ceftriaxone (+ doxycycline or azithromycin for possible chlamydia infection)
(8) often intracellular (in neutrophils)

23
Q

Characteristics of N. meningitidis

A

(1) polysaccharide capsule
(2) ferments maltose
(3) respiratory and oral secretions
(4) vaccine available (except for type B)
(5) leads to: meningococcemia, meningitis, Waterhouse-Friderichsen syndrome
(6) rifampin, ciprofloxacin, or ceftriaxone prophylaxis for close contacts
(7) treatment: ceftriaxone or penicillin G

24
Q

Common characteristics of Neisseria

A
  • -gram negative
  • -diplococci
  • -ferment glucose
  • -produce IgA proteases
25
Klebsiella characteristics
Four As: (1) Aspiration pneumonia (lobar) (2) Abscess formation in lungs and liver (3) Alcoholics (4) diAbetics Patients often produce "red currant jelly" sputum due to abundant polysaccharide capsules
26
Whats the relationship between penicillin and gram-negative bugs?
Gram (-) bacilli are resistant to penicillin G but may be susceptible to penicillin derivatives such as ampicillin and amoxicillin. The gram negative outer membrane layer inhibits entry of penicillin G and vancomycin
27
Beta-hemolytic bacteria
Form a clear area of hemolysis on blood agar streptococcus pyogenes streptococcus agalactiae staphylococcus aureus listeria monocytogenes
28
What microorganism causes syphilis?
Treponema pallidum
29
Describe primary syphilis. | presentation, serology/diagnosis
- -localized disease - -presents with painless, non-itchy, nodule (chancre) - -screen with: VDRL, RPR - -confirm diagnosis with FTA-ABS - -can use dark-field microscopy to visualize treponemes in fluid from chancre
30
What do VDRL, RPR and FTA-ABS stand for?
VDRL - venereal disease research laboratory RPR - rapid plasma reagin FTA-ABS - fluorescent treponemal antibody absorption
31
Describe secondary syphilis. | presentation, screening/diagnosis
--disseminated disease that presents with: - fever - lymphadenopathy - maculopapullar rash, often including palms and soles - condylomata lata - whitish, wart-like lesion on genitals VDRL/RPR for screening, FTA-ABS for confirmation Dark field microscopy to visualize treponemes *Followed by latent syphilis - (+) serology, asymptomatic
32
Describe tertiary syphilis | presentation, screening/diagnosis
(1) gummatous syphilis (chronic granulomas) (2) cardiovascular syphilis (aortitis, vaso vasorum destruction --> increased risk of aortic aneurysm) (3) late neurosyphilis (tabes dorsalis, Argyll-Robertson pupil) - ->presents with broad-based ataxia, (+) Romberg sign, stroke without hypertension, Charcot joint For neurosyphilis: test CSF with VDRL or RPR
33
What is VDRL?
venereal disease research laboratory - -detects nonspecific antibody that reacts with beef cardiolipin - -screening test for syphilis, sensitive, nonspecific, many false positives
34
Causes of false positives in VDRL test
VDRL: Viruses (hepatitis, mononucleosis [EBV]) Drugs Rheumatic fever Lupus and leprosy
35
What is congenital syphilis?
syphilis present in utero and at birth occurs when a child is born to a mother with syphilis
36
What are the clinical manifestations of neonatal syphilis?
``` Saber shins Hutchinson teetch (notched incisors) Mulberry molars Saddle nose CNVIII deafness Often results in stillbirth, hydrops fetalis ```
37
How should you treat neonatal syphilis?
Treat the mother early in pregnancy, as placental transmission typically occurs after the first trimester.
38
What are the serological tests for HIV diagnosis?
--ELISA - highly sensitive test used for screening; has a high false positive rate; a positive must be confirmed with: --Western Blot - specific test; high false negative rate, used to "rule in"
39
What test is used to monitor HIV prognosis and effect of therapy
- -HIV PCR/viral load - used to determine the amount of viral RNA in plasma. - -High viral load is associated with a poor prognosis - -Used to also monitor effect of drug therapy
40
What defines an AIDS diagnosis?
<14% of all lymphocytes
41
What do the ELISA and Western Blot tests look for?
antibodies produced to viral proteins
42
Why should ELISA and Western Blot tests be interpreted with caution?
These tests can be falsely negative in the first 1-2 months after HIV infection. These tests can also be falsely positive initially in babies born to HIV positive mothers because the anti-gp120 antibody (IgG) crosses the placenta
43
Where does HIV replicate during the latent phase of the infection?
In the lymph nodes (where the CD4+ cells would normally be found)
44
What are the four general stages of untreated HIV infection?
(1) Flu-like symptoms (2) Feeling fine (latent) (3) Falling count (CD4+) (4) Final crisis
45
How would you diagnose diphyllobothrium latum?
diagnost by finding operculated eggs or proglottids in feces

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