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DIT > Micro > Flashcards

Micro Flashcards

1
Q

Ventilator-associated pneumonia

A

pseudomonas aeruginosa

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2
Q

septic arthritis in young adult

A

neisseria gonorrhoeae

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3
Q

Waterhouse-Freidrichsen Syndrome

A

neisseria meningitidis

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4
Q

Cellulitis

A

S. aureus or S. pyogenes

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5
Q

Scalded Skin Syndrome

A

S. aureus (exfoliative toxin)

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6
Q

Gray-white membrane in the posterior pharynx of an unvaccinated child

A

C. diptheriae

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7
Q

Most common cause of meningitis

A

S. pneumoniae

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8
Q

Most common cause of osteomyelitis

A

S. aureus

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9
Q

Serious newborn infection

A

Listeria, E. coli, Group B Strep

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10
Q

Infant w/ poor muscle tone

A

C. botulinum

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11
Q

Diarrhea after ABX use

A

C. difficile

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12
Q

Respiratory distress in a postal worker

A

B. anthracis

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13
Q

Otitis media in children

A

S. pneumo

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14
Q

Spore formers

A

Clostridium, Bacillus, Coxiella burnetti

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15
Q

Tx of C. difficile colitis

A

Metronidazole or ORAL Vancomycin

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16
Q

GPR branching filmentous w/ sulfur granules

A

Actinomyces israelii

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17
Q

Rheumatic Fever

A

S. pyogenes

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18
Q

Subacute Endocarditis

A

Viridans Group Strep, Enterococci, S. bovis, coag (-) Staph, HACEK organisms

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19
Q

GI Sx after eating potato salad

A

S. aureus

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20
Q

GI Sx after eating reheated rice

A

B. cereus

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21
Q

Infections of indwelling foreign devices

A

S. epidermidis

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22
Q

Red pigment producer

A

Serratia marcescans

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23
Q

Blue-Green pigment producer

A

P. aeruginosa

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24
Q

Gold pigment producer

A

S. aureus

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25
Q

Yellow (sulfur) pigment producer

A

Actinomyces israelii

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26
Q

Dental procedure ->

A

Viridans Group Strep

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27
Q

Dental caries

A

S. mutans

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28
Q

Lipoteichoic acid

A

Capsule of G(+) induces TNF-alpha & IL-1

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29
Q

Acute Phase Cytokines

A

IL-1, IL-6, TNF-alpha

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30
Q

Fimbriae

A

mediates adherence

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31
Q

Pilus

A

Sexual conjugation (DNA transfer)

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32
Q

Capsule

A

elusion of phagocytosis

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33
Q

Quellung Reaction

A

capsule (+) –> swelling (+ anti-capsule serum)

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34
Q

Encapsulated bacteria

A 
E. coli
*S. pneumoniae
Pseudomonas aeruginosa
*Neisseria meningitidis
Klebsiella pneumoniae
*Haemophilus influenzae type B
Salmonella typhi
Group B Streptococcus
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35
Q

Meningitis in AIDS pts

A

Cryptococcus neoformans

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36
Q

Recombinant bacteria is made via

A

Transformation (DNA released by lysed cell -> picked up by another bacterium & incorporated in chromosomal DNA)

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37
Q

Transduction

A

phage infects bacterium (dirty - may pick up other DNA fragments)

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38
Q

Doesn’t Gram stain d/t high sterol composition & no cell wall

A

Mycoplasma

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39
Q

Doesn’t Gram stain d/t high Mycolic Acid composition

A

Mycobacteria

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40
Q

Spore-formers

A

Bacillus, Clostridium

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41
Q

Dark-Field Microscopy

A

Treponema

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42
Q

Atypical pneumonia d.t broken Air conditioner

A

Legionella pneumophila

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43
Q

PAS stain

A

Whipple Disease Dx (Tropheryma whipplei)

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44
Q

Ziehl-Neelson Stain (Carbolfuchsin AKA Acid-Fast)

A

Mycobacterium, Nocardia

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45
Q

India Ink Stain

A

Cryptococcus neoformans

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46
Q

Silver Stain

A

Pneumocystis jiroveci, Legionella pneumophila, Helicobacter pylori

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47
Q

Giemsa Stain

A

Chlamydia, Borrelia, Rickettsiae, Plasmodium, Trypanosomes, Histoplasma

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48
Q

Lipid A

A

G(-) outer membrane component that induces TNF-alpha & IL-1

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49
Q

Endotoxin

A

G(-) LPS

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50
Q

Transpeptidase

A

enzyme that cross-links the peptidoglycan layer of the cell wall

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51
Q

“O” antigen

A

LPS/Lipid A of G(-) Outer Membrane

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52
Q

Periplasm contains

A

b-lactamases

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53
Q

“H” antigen

A

Flagella

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54
Q

“K” antigen

A

Capsule

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55
Q

Capsule containing D-glutamate

A

B. anthracis

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56
Q

PAS stains which moclecules

A

glycogen & mucopolysaccharides

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57
Q

Chocolate agar + factors 5 (NAD+) & 10 (hematin)

A

Haemophilus influenzae

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58
Q

Thayer-Martin (or VPN) agar

A

Neisseria spp.

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59
Q

Charcoal yeast medium w/ Fe & cysteine

A

Legionella

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60
Q

Sabouraud agar

A

Fungi

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61
Q

pneumonia in Cystic Fibrosis pts

A

Pseudomonas aeruginosa

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62
Q

Anaerobes lack

A

catalase &/or dismutase -> oxidative damage

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63
Q

Which ABX is ineffective against anaerobes?

A

AminO2glycosides :)

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64
Q

Common ABX for anaerobic infections

A

Metronidazole or Clindamycin

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65
Q

Ventilator-associated pneumonia

A

Pseudomonas aeruginosa

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66
Q

Gamma hemolysis

A

Enterococcus

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67
Q

Beta Hemolysis

A

Group A Strep (S. pyogenes)

Group B Strep (S. agalactiae)

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68
Q

Alpha Hemolysis

A

Strep Viridans Group

S. pneumoniae

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69
Q

Endocarditis w/ _______________ warrants evaluation for Colon Cancer

A

S. bovis

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70
Q

Impetigo

A

S. aureus

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71
Q

What type of pt is at risk for severe infections by encapsulated bacteria?

A

Asplenics (opsonization is required for clearing infection)

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72
Q

People w/ Chronic Granulomatous Disease have recurrent infections w/ ______________ d/t a deficiency of ____________

A

Catalase (+) organisms;

NADPH oxidase deficiency

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73
Q

Facultative Intracellular organisms

A 
Salmonella
Neisseria
Brucella
Mycobacterium
Listeria
Francisella
Legionella
Yersinia pestis
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74
Q

Obligate Aerobes

A

Nocardia
Pseudomonas aeruginosa
MycoBacterium tuberculosis

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75
Q

Gram Stain Limitations

A 
Treponema -> Dark-Field
Mycoplasma -> no cell wall
Mycobacterium -> Acid-Fast
Legionella pneumophila -> Silver stain
Rickettsia -> Giemsa stain
Chlamydia -> Giemsa stain
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76
Q

GNR Lactose Fermenters

A 
Citrobacter – Fast Lactose Fermenter
Klebsiella – Slow Lactose Fermenter
E. coli - Slow Lactose Fermenter
Enterobacter - Slow Lactose Fermenter
Serratia - Fast Lactose Fermenter
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77
Q

Catalase (+) organisms

A 
Pseudomonas
Listeria
Aspergillus
Candida
E. coli
S. aureus
Serratia
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78
Q

Catalase (+) organisms

A 
Pseudomonas
Listeria
Aspergillus
Candida
E. coli
S. aureus
Serratia
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79
Q

Urease (+) organisms

A 
Cryptococcus
H. pylori
Proteus
Ureaplasma
Nocardia
Klebsiella
S. epidermidis
S. saprophyticus
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80
Q

Protein A is expressed by _________ & has what MOA

A

S. aureus;

binds Fc of IgG to prevent opsonization & phagocytosis

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81
Q

What structure protects against phagocytosis?

A

capsule

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82
Q

Plasmids are exchanged by?

A

Conjugation

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83
Q

Superantigen MOA

A

bind MHC class II -> activate TCR -> polyclonal T-cell expansion -> huge release of cytokines

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84
Q

What organisms secrete superantigens?

A

S. aureus & S. pyogenes

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85
Q

Diptheria toxin MOA

A

inactivates EF-2 -> cell death

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86
Q

Pseudomonas aeruginosa toxin

A

Exotoxin A

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87
Q

Exotoxin A of Pseudomonas aeruginosa MOA

A

inactivates EF-2 -> cell death

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88
Q

Shiga toxin MOA

A

cleaves host rRNA at Adenine base in 60S subunit -> prevents protein synthesis -> cell death

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89
Q

Shiga Toxin is expressed by

A

EHEC 0157:H7 & Shigella

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90
Q

Hemolytic Uremic Syndrome Sx

A

thrombocytopenia, hemolytic anemia, acute renal failure

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91
Q

HUS is caused by what organism

A

EHEC 0157:H7

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92
Q

ETEC heat-labile toxin MOA

A

activates adenylate cyclase -> increase cAMP

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93
Q

ETEC heat-stabile toxin MOA

A

activates guanine cyclase -> increase cGMP

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94
Q

Pseudoappendicitis

A

Yersinia enterocolitica

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95
Q

Anthrax toxin

A

3 components:

  • Edema Factor (activates a.c. -> increase cAMP)
  • Lethal Factor
  • Protective Factor
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96
Q

Diptheria toxin MOA

A

inactivates EF-2

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97
Q

Heat-stabile toxin MOA; expressed by?

A

activates guanine cyclase -> increase cGMP;

ETEC & Yersinia entercolitica

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98
Q

Anthrax toxin

A

3 components:

  • Edema Factor (activates a.c. -> increase cAMP)
  • Lethal Factor
  • Protective Factor
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99
Q

Traveler’s Diarrhea

A

E. coli

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100
Q

TSST-1 MOA

A

(S. aureus) causes release of cytokines -> TSS

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101
Q

“rice water” stools

A

Vibrio cholera

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102
Q

Botulinum toxin MOA

A

inhibits ACh release at NMJ -> flaccid paralysis

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103
Q

Tetanospasm toxin MOA

A

blocks release of GABA/glycine inhibitory NTs from Renshaw cells -> muscle contraction

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104
Q

Cholera toxin MOA

A

activates a.c. -> increase cAMP

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105
Q

Pertussis toxin MOA

A

inactivates the inhibitor of adenylate cyclase -> increase cAMP

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106
Q

Phospholipase causing gas gangrene (organism/toxin?)

A

C. perfringens - alpha toxin

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107
Q

Panton-Valentine Leukocidin MOA (organism?)

A

S. aureus - tissue destruction w/ MRSA, killing macrophages & neutrophils

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108
Q

Exfoliative toxin MOA (organism?)

A

S. aureus - disrupts zona granulosa -> flaccid bullae -> Scalded Skin Syndrome (newborns)

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109
Q

Woman on period using super-absorbent tampon–>

A

Toxic Shock Syndrome d/t S. aureus & TSST-1

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110
Q

Streptolysin O

A

S. pyogenes - O2-labile -> hemolysis

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111
Q

Streptolysin S

A

S. pyogenes - O2-stabile -> hemolysis

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112
Q

Scarlet Fever

A

S. pyogenes - pyrogenic exotoxins (A, B, C)

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113
Q

Biofilm production is esp pronounced in

A

S. epidermidis

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114
Q

IgA protease producers

A

(SHiN)
S. pneumo
HiB
Neisseria

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115
Q

M protein is produced by ______________ and has what MOA?

A

S. pyogenes;

helps prevents phagocytosis

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116
Q

Bull Neck

A

C. diptheriae

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117
Q

HUS is caused by what organism

A

EHEC 0157:H7 & Shigella

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118
Q

ETEC heat-labile toxin MOA

A

activates adenylate cyclase -> increase cAMP

-> increased Cl- secretion in GIT

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119
Q

Heat-stabile toxin MOA; expressed by?

A

activates guanine cyclase -> increase cGMP -> decreased NaCl resorption in GIT;
ETEC & Yersinia entercolitica

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120
Q

Botulinum toxin MOA

A

inhibits ACh release at NMJ (cleaves SNARE protein) -> flaccid paralysis

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121
Q

Tetanospasm toxin MOA

A

blocks release of GABA/glycine inhibitory NTs from Renshaw cells (cleaves SNARE protein) -> muscle contraction

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122
Q

Pertussis toxin MOA

A

inactivates the (Gi) inhibitor of adenylate cyclase -> increase cAMP

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123
Q

Bull Neck (severe LAD)

A

C. diptheriae

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124
Q

Painless black eschar

A

Cutaneous Bacillus Anthracis

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125
Q

Whooping cough

A

Bordetella pertussis

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126
Q

Impetigo

A

S. aureus & S. pyogenes

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127
Q

Superantigen MOA

A

bind MHC class II -> activate TCR -> polyclonal T-cell expansion -> huge release of IFN-gamma & IL-2

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128
Q

Diptheria toxin MOA

A

inactivates EF-2 (ADP ribosylator)

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129
Q

Whooping cough

A

Bordetella pertussis

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130
Q

“double zone” of hemolysis on blood agar

A

C. perfringens

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131
Q

ASO

A

(anti-Streptolysin O Ab) used to diagnose Rheumatic Fever (S. pyogenes)

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132
Q

LPS/Endotoxin activates (6)

A
  • > macrophages ->TNF-alpha, IL-1, NO
  • > complement -> C3a, C5a
  • > tissue factor -> Coag cascade -> DIC
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133
Q

“rust-colored” sputum & lobar pneumonia

A

S. pneumoniae

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134
Q

Otitis Media

A

S. pneumoniae

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135
Q

Bacterial Toxins encoded by Lysogenic Phages

A 
shigA toxin
Botulinum toxin
Cholera toxin
Diptheria toxin
Erythrogenic toxin of S. pyogenes
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136
Q

Organism associated w/ Acute Post-Strep Glomerulonephritis

A

S. pyogenes

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137
Q

Mediastinal widening

A

Bacillus anthracis (Inhalation Anthrax)

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138
Q

Which Streptococcus strain is susceptible to Optochin?

A

S. pneumo

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139
Q

Which Streptococcus strain is resistant to Optochin?

A

Viridans group

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140
Q

Cervicofacial Disease w/ draining sinus tracts

A

Actinomyces israelii

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141
Q

Contaminant of deli meats & unpasteurized milk products

A

Listeria

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142
Q

Obligate Anaerobes

A

Clostridium
Bacteroides
Actinomyces

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143
Q

Superantigen

A 
TSST-1 (S. aureus)
Exotoxin A (S. pyogenes)
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144
Q

Superantigen

A 
TSST-1 (S. aureus)
Exotoxin A (S. pyogenes)
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145
Q

2nd most common cause of UTI in young women

A

S. saprophyticus

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146
Q

Novobiocin Resistance

A

S. saprophyticus

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147
Q

Novobiocin Sensitivity

A

S. epidermidis

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148
Q

Sepsis in Sickle Cell pts or Asplenics

A

S. pneumoniae

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149
Q

S. pneumo is the MOST COMMON CAUSE OF

A

Meningitis
Otitis Media
Pneumonia
Sinusitis

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150
Q

MOST common cause of osteomyelitis

A

S. aureus

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151
Q

“Thumb Sign” on X-ray

A

Epiglottitis (H. influenzae type B)

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152
Q

Neonatal conjunctivitis

A

N. gonorrhoaea

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153
Q

Meningitis in young adults & children

A

N. meningitidis

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154
Q

Purpura Fulminans

A

N. meningitidis

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155
Q

Pontiac Fever

A

Legionella pneumophila

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156
Q

Hot Tub Folliculitis

A

P. aeruginosa

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157
Q

Burn victim wound infection

A

P. aeruginosa

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158
Q

GN diplococci, Oxidase (+) organism in COPD sputum sample

A

Moraxella catarrhalis

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159
Q

Diarrhea 1-3d following handling turtles

A

Salmonella

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160
Q

Osteomyelitis in a Sickle Cell pt

A

Salmonella

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161
Q

42C Culture

A

Campylobacter

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162
Q

Common cause of gastroenteritis & Guillain-Barre Syndrome

A

Campylobacter

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163
Q

Pneumonia in Alcoholics or COPD pts

A

Klebsiella pneumoniae

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164
Q

“Currant-jelly” sputum

A

Klebsiella pneumoniae

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165
Q

“Swarming” motility

A

Proteus

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166
Q

Struvite stones -> Staghorn Calculi

A

Proteus

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167
Q

E. coli causing HUS

A

EHEC O157:H7

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168
Q

Diarrhea d/t GN, non-motile, lactose nonfermenter

A

Shigella

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169
Q

Diarrhea d/t “S-shaped” organisms

A

Campylobacter jejuni

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170
Q

Diarrhea from household pets

A

Yersinia enterocolitica or Salmonella

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171
Q

Diarrhea d/t GN, motile, lactose nonfermenter

A

Salmonella

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172
Q

Traveler’s Diarrhea

A

ETEC

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173
Q

Diarrhea from undercooked hamburger meat

A

EHEC

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174
Q

Diarrhea mimicking appendicitis

A

Yersinia

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175
Q

Diarrhea after handling raw chicken or eggs

A

Salmonella or Campylobacter

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176
Q

Osteomyelitis in Sickle Cell pts

A

Salmonella

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177
Q

Osteomyelitis in Sickle Cell pts

A

Salmonella

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178
Q

“Comma” shaped GNR

A

Vibrio

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179
Q

“S” shaped GNR

A

Campylobacter

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180
Q

Which E. coli invades the intestinal wall?

A

EIEC

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181
Q

Infection caused by animal urine?

A

Leptospira (water contaminated w/ urine)

Hantavirus (rodent urine)

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182
Q

“Target” shaped lesion is associated w/ what disease

A

Lyme’s Disease

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183
Q

Lyme’s Disease is transmitted by what vector

A

Ixodes tick

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184
Q

Lyme’s Disease is caused by what organisms

A

Borrelia burgdorferi

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185
Q

B/L facial n. palsy

A

Lyme’s Disease (disseminated)

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186
Q

Causes of rashes on palms & soles

A

Kawasaki Disease
Coxsackie A
Rocky Mountain Spotted Fever
Secondary Syphilis

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187
Q

External Otitis (Swimmer’s Ear)

A

Pseudomonas aeruginosa

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188
Q

Ecthyma Gangrenosum in immunocompromised

A

Pseudomonas aeruginosa

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189
Q

What allows S. sanguinis to bind to damaged heart valves?

A

Dextrans -> bind fibrin-platelet aggregates on damaged heart valves

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190
Q

S. pyogenes pyrogenic conditions

A

pharyngitis, cellulitis, impetigo

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191
Q

S. pyogenes toxigenic conditions

A

Scarlet fever, TSS-like, necrotizing fasciitis

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192
Q

S. pyogenes Immunologic conditions

A

Rheumatic Fever & Acute Post-Strep Glomerulonephritis

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193
Q

Ab to what S. progenies virulence factor gives rise to Rheumatic Fever?

A

Antibodies to M protein

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194
Q

Ab to what S. progenies virulence factor is used in the Dx of Rheumatic Fever?

A

Anti-Streptolysin Antibodies (ASO) - confirms prior S. pyogenes infection

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195
Q

“Strawberry tongue”

A

Scarlet fever d/t S. pyogenes

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196
Q

“Sandpaper-like” Rash

A

Scarlet fever d/t S. pyogenes

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197
Q

CAMP test or Hippurate Test is an important diagnostic test for?

A

S. agalactiae

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198
Q

Important cause of Biliary Tract Infections & UTIs?

A

Enterococci

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199
Q

Which Strep strain is resistant to Bacitracin?

A

group B Strep

200
Q

Which Strep strain is sensitive to Bacitracin?

A

group A Strep

201
Q

Lung abscess in aspiration pneumonia

A

Klebsiella pneumo

202
Q

“rose-spots” on abdomen + fever + HA + diarrhea

A

Salmonella typhi

203
Q

Salmonella typhi carrier state in which organ?

A

Gallbladder

204
Q

Puppy poop

A

Yersinia enterocolitica

205
Q

Weil’s Disease

A

Severe Leptospirosis - fever, hemorrhage, and anemia

206
Q

Flu-like Sx in surfer

A

Leptospira interrogans

207
Q

Flu-like Illness contracted from birds (parrots)

A

Chlamydophila psittaci

208
Q

Flu-like Illness contracted from infected placenta or newborn farm animals

A

Coxiella burnetti

209
Q

LAD + new kitten

A

Bartonella henslae

210
Q

Recurrent Fever

A

Borrelia recurrentis

211
Q

Spread by prairie dogs

A

Yersinia pestis

212
Q

Spread by rabbits, squirrels, ticks

A

Francisella tularensis

213
Q

Spread by armadillos

A

Mycobacterium leprae

214
Q

Cat or Dog bite -> Cellulitis

A

Pasteurella multocida

215
Q

Spread by the Dermacentor tick

A

Rickettsia rickettsii

216
Q

Epidemic typhi

A

Rickettsia prowazekii (Lice)

217
Q

Endemic typhi

A

Rickettsia typhi (fleas)

218
Q

Spread by RABBITS, squirrels, ticks

A

Francisella tularensis

219
Q

Endemic typhi

A

Rickettsia typhi (fleas)

220
Q

Fish tank cellulitis

A

mycobacterium marinum

221
Q

gray discharge + fishy odor

A

gardnerella vaginosis

222
Q

Q fever Sx

A

acute flu-like Sx w pneumonia

Chronic –> endocarditis

223
Q

Q fever agent

A

coxiella burnetti

224
Q

Unpasteurized milk

A

Brucella or Coxiella burnetti

225
Q

Animal placent

A

Coxiella burnetti

226
Q

farm animal urine/feces –> air borne spread

A

Coxiella burnetti

227
Q

Spread by Ixodes scapulars ticks

A

Anaplasma phagocytophilum & Borrelia burgdorferi

228
Q

Spread by Lone Star tick

A

Ehrlichia chaffensis

229
Q

Epidemic Typhus

A

Rickettsia prowazekii spread by lice

230
Q

Endemic Typhus

A

Rickettsia typhi spread by flea

231
Q

Chlamydia trachomatis A-C

A

Trachoma (eye infection -> blindness)

232
Q

Chlamydia trachomatis D-K

A

Urethritis, cervicitis, PID

233
Q

Reactive Arthritis

A

Chlamydia trachomatis, Campylobacter, Salmonella, Shigella, Yersinia

234
Q

Pet parrot

A

chlamydophila psittaci

235
Q

Common atypical pneumonia agents

A

legionella pneumoniae, chlamydophila pneumoniae, mycoplasma pneumoniae

236
Q

Rickettsial triad of Sx

A

HA, fever, rash

237
Q

Cold agglutinins

238
Q

Mycoplasma pneumoniae Tx

A

Azithromycin

239
Q

Bacterial vaginosis Tx

A

Metronidazole

240
Q

Rocky Mountain Spotted Fever Tx

A

Doxycycline

241
Q

Rocky Mountain Spotted Fever Sx

A

HA, fever, rash on palms/soles!!

242
Q

Agents that cause rash on palms & soles

A

Coxsackie A, Rocky Mountain Spotted Fever, Meningocococcus, Secondary Syphilis

243
Q

Rocky Mountain Spotted Fever agents

A

Rickettsia rickettsiae

244
Q

Bird & bat droppings

A

Histoplasmosis

245
Q

Broad-based fungus found near MS, OH river basins

A

Blastomycoses

246
Q

HSV-1 may cause

A

Temporal lobe encephalitis
Gingivostomatitis
Oral herpes labialis
Keratoconjunctivitis

247
Q

HSV-2 may cause

A

Genital Herpes
Multiple, painful vesicles
latent infection in sacral n. root

248
Q

HSV-2 spread

A

sexual contact, genital-oral contact (mucosa)

249
Q

HSV-2 to neonate

A

through canal

primary inf. increases risk of spread to neonate

250
Q

ZVZ

A

primary: chickenpox, encephalitis, pneumonia
Secondary: latent in dorsal root ganglia -> shingles (U/L single dermatome rash)

251
Q

ZVZ spread

A

contant, respiratory, direct contact to active lesions, airborne if disseminated in immunodeficient

252
Q

Tzanck smear

A

open vesicle sample, multinucleate giant cell, HSV-1, -2, VZV; low specificity

253
Q

Intranuclear eosinophilic inclusions

A

Cowdry A inclusions

254
Q

EBV

A

infectious mononucleosis

255
Q

EBV spread

A

oral secretions, 15-24yo, kissing disease

256
Q

EBV infects

A

B cells, T-cell response

257
Q

Downey cells

A

atypical lymphocytes seen in EBV (reactive T-cells)

258
Q

infectious mononucleosis

A

fever, sore throat, posterior cervical LAD, exudative pharyngitis

259
Q

When you give Amoxicillin to infectious mononucleosis pt –>

A

maculopapular rash (trunk, ext) NOT ALLERGIES

260
Q

infectious mononucleosis complications

A

splenomegaly, rupture (no contact sports)

261
Q

infectious mononucleosis Dx

A 
Monospot test (heterophile Ab)
IgG IgM Ab to EBV
262
Q

Heterophile negative mononucleosis

A

CMV > HIV > Toxoplasmosis

263
Q

EBV is assoc. w/ what malignancies?

A

Hodgkin, Burkitt, Nasopharyngeal carcinoma, Diffuse Large B cell, Hairy leukoplakia

264
Q

CMV spread

A

congenital, close contact

265
Q

CMV cuases

A

Heterophile negative mononucleosis

Transplant pts

266
Q

AIDS w/ CMV

A

retinitis, GI ulcers, Candida esophagitis

267
Q

CMV infects

A

mononuclear cells & polynuclear cells infected for life

268
Q

HHV-6 causes

A

roseola in children, 6th Ds, exanthum rubitum

269
Q

HHV-6 Sx

A

3-5d Fever, maculopapular rash, +/- Febrile seizures

270
Q

HHV-7

A

Roseola-like virus, almost all ppl are infected by 5

271
Q

HHV-8

A

Kaposi Sarcoma, MSM, HIV

272
Q

Acyclovir

A

guanosine analog (activated by thymidine kinase) inhibits DNA polymerase; useful for HSV-1, -2, VZV

273
Q

Parvovirus B19

274
Q

Sickle cell pts + Parvo

A

Transient aplastic crisis

275
Q

Parvo B19 in children

A

Slapped cheek! erythema infectiosum

276
Q

Adults w/ Parvo B19

A

inflammatory arthritis

277
Q

Parvo B19 in utero

A

Hydrops fetalis & miscarriage

278
Q

HPV-1, -2

A

common warts

279
Q

HPV-6, -11

A

genital warts

280
Q

HPV-16, -18

A

genital cancer

281
Q

Adenovirus

A

dsDNA, URI -> conjunctivitis + diarrhea; hemorrhagic cystitis, pneumonia,

282
Q

Smallpox

A

enveloped variola virus

283
Q

Cowpox

A

Milkmaid’s blisters,

provides immunity to smallpox

284
Q

Molluscum contagiosum

A

benign umbilicalized flesch-colored lesins

285
Q

JC virus

A

PML in HIV pts

286
Q

Hepatitis B virus (Hepadnavirus)

A

partial dsDNA, circular enters nucleus, makes RNA, uses RT to make DNA

287
Q

Rotavirus

A

fatal diarrhea in children -> severe diarrhea, electrolyte imbalance

288
Q

Rotavirus case

A

infant, winter mos, daycare child

289
Q

Coltivirus

A

CO tick fever in west US, spread by wood tick

290
Q

Picornavirus

A

small RNA virus

291
Q

Enterovirus

A

Poliovirus, Coxsackie, Echovirus

292
Q

Poliovirus

A

infects gray matter of anterior horn & motor horns

293
Q

Salk vaccine

A

injected, killed Polio vaccine

294
Q

Sabin vaccine

A

Oral, live Polio vaccine

295
Q

Echovirus

A

Aseptic meningitis, myocarditis, URIs

296
Q

Echovirus

A

Summer outbreaks, detected by PCR of CSF

297
Q

Coxsackie virus

A

Aseptic meningitis, myocarditis, Hand-foot-mouth disease, pericarditis

298
Q

Hepatitis A virus transmission

A

fecal-oral

299
Q

Rhinovirus

A

common cold (Coronavirus too)

300
Q

Norwalk Virus

A

Calcivirus; viral gastroenteritis - vomiting, diarrhea; outbreak on ships & nursing homes

301
Q

Hepatitis C is in which viral family

A

Flavivirus

302
Q

Yellow Fever

A

Flavivirus, Aedes mosquitoes spread, sub-saharan Africa

303
Q

Yellow Fever Sx

A

High fever, hemorrhagic ds, jaundice, coffee-ground emesis, gum bleeding, purpura

304
Q

Dengue Virus Sx

A

break bone fever, severe HA, retro-orbital pain

305
Q

Dengue hemorrhagic fever

A

Tourniquet Test -> excess petechiae = increased vascular wall fragility

306
Q

West Nile Virus

A

spread from birds -> mosquitoes -> humans

307
Q

West Nile Virus Sx

A

flu-like illness

308
Q

West Nile Virus complications

A

meningitis, encephalitis, flaccid paralysis (ant. horn infection like polio)

309
Q

West Nile Virus Dx

A

IgM anti-WNV Ab

310
Q

St. Louis Encephalitis virus

A

Arbovirus (arthropod vector)

311
Q

Rubella virus

A

mild fever, rash, arthralgias

312
Q

Congenital Rubella syndrome

A

cardiac defects, cataracts, deafness, PDA, pulmonic stenosis

313
Q

Coronavirus

A

common cold (rhinovirus)

314
Q

HTLV-1 is a

315
Q

Influenza virus

A

orthomyxovirus, enveloped, ssRNA, hemagluttinin, neuraminidase

316
Q

Influenza Sx

A

Viral pneumonia, secondary bacterial infection (S. pneumo, S. aureus)

317
Q

Genetic shift

A

reassortment of viral genome, exchange genetic material -> complete shift -> pandemic

318
Q

Genetic drift

A

mutated or rearranged -> seasonal epidemics

319
Q

Influenza vaccine

A

trivalent (2 A & 1 B)
quadravalent (2A & 2B)
injectable or live intranasal

320
Q

Recommendations for flu vaccine

A

everyone > 6mo

321
Q

Avian influenza

A

H5N1, bird-to-human

322
Q

Avian influenza Sx

A

URI, GI sx, pancytopenia, fever, ALT & AST elevated

323
Q

Swine Influenza

324
Q

Neuraminidase inhibitors

A

Zanamivir, Oseltamivir for influenza pts at high risk, must be used w/in first 24h

325
Q

Parainfluenza virus

A

Croup -> barking seal cough, steeple sign (laryngo-tracheo-bronchitis)

326
Q

Parainfluenza virus Tx

A

cold air, mist, Epi, steroids, O2

327
Q

RSV

A

Bronchiolitis +/- pneumonia in winter in premature infants

URI, brassy cough

328
Q

RSV Px

A

palivizumab for premature infants

329
Q

Ribavirin

A

guanosine analog
RSV, Hep C (IFN-alpha)
S/E Hemolytic anemia, teratogen

330
Q

Measles aka

331
Q

Measles Sx

A

Coryza, cough, conjunctivitis, Koplik Spots (buccal mucosa) -> maculopapular rash (head down)

332
Q

Measles Complications

A

Fetal loss, premature delivery, encephalitis, giant cell pneumonia

333
Q

Subacute Sclerosing Pnacephalitis

A

Complication of Measles

334
Q

Mumps

A

Parotitis, Orchitis, Aseptic Meningitis

335
Q

Rabies virus

A

bitten by infected animal -> peripheral nn. to CNS

336
Q

Negri bodies

A

Rabies Virus

337
Q

Bullet-shaped capsid

338
Q

Rabies Sx

A

fever, malaise, n/v, strange behavior, hallucinations, hydrophobia, coma, death

339
Q

Hantavirus

A

hemorrhagic fever, pulmonary syndrome, respiratory failure

340
Q

Hantavirus

A

aerosolized mouse urine (deer mouse)

341
Q

Hemorrhagic fever

A

Ebola, Marburg

342
Q

Ebola

A

spread through infected blood, secretions

343
Q

Ebola Sx

A

fever, HA, myalgias, v/n, diarrhea, fluid-loss, shock, death

344
Q

Ebola prevention

A

sweat, tears, urine, feces - ISOLATION!!

345
Q

Screening HIV test

A

ELISA (high Sens)

346
Q

Confirmatory Test for HIV

A

Western (high Spec)

347
Q

Viral Load HIV testing

A

PCR, quantifies HIV RNA, monitor effectiveness, confirm diagnosis (early detection 1-2mo in window period)

348
Q

Most common opportunistic infection in HIV pts

A

pneumocystic jiroveci pneumonia

349
Q

Pneumocystic jiroveci (PCP) in AIDS pts

A

interstitial infiltrates on CXR

350
Q

Opportunistic infection in HIV pts

A

PCP, TB, MAC –> pneumonia
Histoplasma capsulatum -> systemic disease, HSM, fever
Cryptococcal meningitis
Toxoplasmosis (ring-enhancing lesions)
Primary Lymphoma
CMV retinitis (cotton-wool spots)
PML JC virus
Cryptosporidiosis
C. albicans -> thrush, esophageal candidiasis
Oral hairy leukoplakia (can’t scrape off)- EBV
HSV, CMV oral infections

351
Q

Progressive Multifocal Leukoencepalopathy

A

reactivation of JC virus

352
Q

HIV pts are at risk for what malignancies

A 
Kaposi sarcoma (purple lesions),
Primary CNS lymphoma (ring lesions)
Large B cell 
EBV
Squamous Cell Carcinoma cervix/anus
353
Q

Bacillary angiomatois

A

purple lesions

354
Q

Prophylaxis for AIDS pts

A

TMP-SMX for PCP at CD4

355
Q

Causes cat scratch fever

A

Bartonella henslae

356
Q

Causes lyme disease

A

Borrelia burgdorferi

357
Q

Causes recurrent fever from variable surface antigens

A

Borrelia recurrentis

358
Q

Causes bloody diarrhea

A

Campylobacter (puppies, livestock, fecal-oral)

359
Q

Causes Q fever

A

Coxiella burnetii (livestock placenta, tick feces)

360
Q

Cause tularemia

A

Francisella tularensis (Rabbits)

361
Q

Causes leptospirosis

A

Leptospira (animal urine)

362
Q

Causes cellulitis and osteomyelitis from cat or dog bites

A

Pasteurella multocida

363
Q

Tx for CMV retinitis

A

Ganciclovir > Foscarnet

364
Q

Oral hairy Leukoplakia

365
Q

Aplastic anemia in a sickle cell pt

A

Parvovirus B19

366
Q

Child w/ fever + slapped cheek rash

A

Parvovirus B19

367
Q

Congenital Rubella Cardiac Defects

A

PDA, aortic stenosis

368
Q

Coryza, cough, conjunctivitis

369
Q

blue-gray spots on buccal mucosa surround by a base of red

A

Koplik spots w/ Measles

370
Q

Travel to Africa + fever, vomiting, diarrhea

371
Q

Can cause conjunctivitis or diarrhea

A

Adenovirus

372
Q

Can cause fever + jaundice + black vomit

A

Yellow Fever

373
Q

Can cause enlarged cell w/ “owl’s eye” inclusions

374
Q

Can cause “barking seal” cough

A

Parainfluenza virus

375
Q

Can cause bronchiolitis w/ cough/wheezing in babies

376
Q

Can cause negri bodies

377
Q

Hides in trigeminal ganglia

378
Q

Diarrhea in child during winter months

379
Q

2 most common causes of the common cold

A

Rhinovirus > Coronavirus

380
Q

Downey Cells are seen w/

381
Q

Common cause of aseptic meningitis

A

Enterovirus

382
Q

gag gene in HIV encodes

A

p24 capsid protein

383
Q

pol gene in HIV encodes

A

RT & integrase

384
Q

env gene in HIV encodes

A

gp120, gp41

385
Q

Meningitis in AIDS pt

A

Cryptococcus neoformans

386
Q

Pseudoappendicitis

A

Yersinia colitis

387
Q

C. albicans - oral thrush Sx

A

white, cottage-cheese like patches on tongue

388
Q

C. albicans - oral thrush is seen in

A

AIDS, immunodeficient, asthmatics w/ inhaled steroids, neonates

389
Q

C. albicans - oral thrush vs oral hairy leukoplakia

A

oral thrush can be scraped off

390
Q

C. albicans - Vuvlovaginitis

A

acidic pH, severe itching, cottage cheese discharge

391
Q

Diaper rash

A

C. albicans

392
Q

C. albicans - Intertrigo

A

skin infections in folds

393
Q

C. albicans - Bloodstream infections are seen in

A

pts w/ central lines, drug users, immunocompromised

394
Q

C. albicans - complications in immunocompromised

A

Endopthalmitis, Endocarditis

395
Q

C. albicans - Dx

A

germ tubes, budding yeast

396
Q

C. albicans - Tx

A

Topical Nystatin, Clotrimazole, Fluconazole

397
Q

Cryptococcus neoformans is seen mostly in

A

Aids pts as meningitis

398
Q

Cryptococcus neoformans Dx

A

Sabouraud’s agar, narrow-based budding yeast

399
Q

Cryptococcus neoformans is found in what environment

A

soil & in pigeon droppings

400
Q

India ink stain

A

Cryptococcus neoformans

401
Q

Soap-bubble lesion in the brain

A

Cryptococcal meningeal encephalitis

402
Q

Pneumocystis jiroveci is most commonly seen

A

in AIDS pts as atypical pneumonia

403
Q

Pneumocystis jiroveci - pneumonia

A

Diffuse interstitial

404
Q

Pneumocystis jiroveci Dx

A

Silver stain or CXR w/ “ground-glass” appearance

405
Q

Pneumocystis jiroveci Tx

406
Q

Aspergillus fumigatus is found

A

ubiquitous in food, soil, air

407
Q

Aspergillus fumigatus Dx

A

narrow-septate branching at acute angles

408
Q

Mucor & Rhizopus Dx

A

Broad, irregularly shaped, non-septate hyphae branching at right angles

409
Q

Mucor & Rhizopus in Diabetics

A

Rhinocerebral mucormycosis: facial pain, HA, necrotic lesions

410
Q

“Ringworm” aka

A

Tinea capitis or Tinea corpora

411
Q

Thickened, discolored nails

A

Tinea unguium (Onychomycosis)

412
Q

Malassezia furfur Sx

A

hypo pigmented spots on trunk

413
Q

Malassezia furfur Tx

A

Topical azole, topical selenium sulfide

414
Q

Malassezia furfur Dx

A

KOH prep - “spaghetti & meatball” appearance

415
Q

Organism assoc. w/ cat feces

A

Toxoplasma

416
Q

Organism assoc. w/ dog feces

A

Yersinia entercolitica

417
Q

Organism assoc. w/ bird or bat poop

A

Histoplasma capsulatum

418
Q

Organism assoc. w/ OH & MS river valley

A

Histoplasma capsulatum

419
Q

Histoplasma capsulatum enters lung and is engulfed by

A

macrophages

420
Q

Blastomyces dermatitidis is found

A

MS, OH river basins & Central America (East of River)

421
Q

Blastomyces dermatitidis Dx

A

broad-based yeast forms

422
Q

Coccidioides immitis in environment

A

dimorphic -> mycelial or arthroconidia in soil

423
Q

Coccidioides immitis in human lung

A

Spherules - larger than a RBC

424
Q

Coccidioides immitis is found

A

SW US & increased in incidence after windstorms

425
Q

What organism is assoc w/ rose thorns?

A

Sporothrix schenckii

426
Q

What organism is assoc w/ SW US

A

Coccidioides immitis

427
Q

Paracoccidioides brasiliensis is found

A

Latin America

428
Q

What organism is assoc w/ East of the MS River

A

Blastomyces dermatitidis

429
Q

Barrel-shaped arthroconidia

A

Coccidioides immitis

430
Q

Amphotericin B MOA

A

binds ergosterol -> permeability

431
Q

Cryptosporidium - Sx

A

chronic watery diarrhea in AIDS pts

432
Q

Giardia lamblia in found

A

in nature in fresh-water streams

433
Q

Giardia lamblia Sx

A

gas, bloating, acute fatty & foul-smelling diarrhea

434
Q

Giardia lamblia Dx

A

pear-shaped trophozoite or oocyte

435
Q

Giardia lamblia Tx

A

Metronidazole, Tinidazole

436
Q

Entamoeba histolytica Sx

A

amoeba dysentery invades colon +/- liver cysts

437
Q

Flask-shaped lesions in GIT

A

Entamoeba histolytica

438
Q

Entamoeba histolytica Dx

A

trophozoites or cysts in stools

439
Q

Entamoeba histolytica Tx

A

Metronidazole & Iodoquinol to kill cysts

440
Q

Trichomonas vaginalis Sx

A

greenish, foul-smelling discharge

441
Q

Trichomonas vaginalis Dx

A

trophozoites w/ flagella

442
Q

Toxoplasma gondii is found

A

cat feces or undercooked cysts in meat

443
Q

Toxoplasma gondii Sx

A

ring-enhancing lesions on MRI in AIDS pts

444
Q

Congenital Toxoplasma gondii

A

Chorioretinitis, hydrocephalus, intracranial calcifications

445
Q

Naegleria fowleri - Sx

A

meningoencephalitis

446
Q

Naegleria fowleri is found

A

swimming in freshwater lakes

447
Q

Naegleria fowleri Tx

A

Amphotericin B

448
Q

Trypanosoma brucei Sx

A

Fever, LAD, somnolence —> encephalitis, coma, death

449
Q

Trypanosoma brucei are found

450
Q

Trypanosoma cruzi is found

A

S. America

451
Q

Trypanosoma cruzi is transmitted by

A

reduvid bug

452
Q

Trypanosoma brucei is transmitted by

A

Tsetse fly

453
Q

Chagas Disease

A

Trypanosoma cruzi –> dilated cardiomyopathy, megacolon, megaesophagus

454
Q

Leishmania donovani - Visceral

A

fevers, HSM, pancytopenia

455
Q

Leishmania donovani - Cutaneous

A

ulcerating papules slow to heal

456
Q

Malaria vector

A

Anopheles mosquito

457
Q

Malaria Sx

A

cyclin fever (48h ovale & vivax, 72h malaria)

458
Q

Most severe form of Malaria

A

p. falciparum

459
Q

Banana-shaped gametocyte

A

p. falciparum

460
Q

Babesia Sx

A

ring-form trophozoite

maltese cross merozoite

461
Q

Babesia vector

A

Ixodes tick

462
Q

Most common helminthic inf. in the US

A

Enterobius vermicularis

463
Q

Ascaris lumbricoides Life cycle

A

ingest egg -> larvae hatch -> penetrate bowel -> lung -> migrate up trachea to oropharynx -> swallowed & mature in colon

464
Q

Ascaris lumbricoides - Sx

A

Loffler eosinophilic pneumonitis

465
Q

Ascaris lumbricoides - Tx

A

Mebenzdazole, Albendazole, Pyrantel pamoate

466
Q

Undercooked game meat (bear)

A

Trichinella spiralis

467
Q

Trichinella spiralis life cycle

A

larvae migrate from GIT to muscles

468
Q

Trichinella spiralis Sx

A

myositis, fever, eosinophilia, periorbital edema

469
Q

Strongyoides stercoralis infect humans via

A

infactive larvae penetrate skin from soil

470
Q

Strongyoides stercoralis life cycle

A

larvae migrate to lung -> swallowed -> GI inf

471
Q

Strongyoides stercoralis Tx

A

Ivermectin, Mebendazole

472
Q

Ancylostoma & Necator infect humans via

A

penetrate skin of feet

473
Q

Ancylostoma & Necator cause

A

abd discomfort (hookworm sucks blood) -> anemia

474
Q

Ancylostoma & Necator Tx

A

Albendazole, Mebendazole, Pyrantel pamoate

475
Q

Undercooked pork

A

Taenia solium

476
Q

Taenia solium Sx

A

GI Sx or Myositis, Neurocysticercosis

477
Q

Taenia solium infects humans via

A

adult tapeworm infects GIT or

ingestion of eggs -> larvae invasion of tissues (myositis, neurocysticercosis)

478
Q

Neurocysticercosis

A

black ring lesion on CT

479
Q

Immigrant presents w/ new CNS Sx (AMS, confusion, etc)

A

neurocysticercosis

480
Q

Taenia solium Tx

A

Praziquantel, Albendazole + Dexamethasone (Neurocysticercosis)

481
Q

Diphyllobothrium latum -> deficiency of

A

Vitamin B12 -> megaloblastic anemia

482
Q

Ingestion of raw fish (tapeworm)

A

Diphyllobothrium latum

483
Q

Tapeworm spread in dog feces

A

Echinococcus granulosus

484
Q

Echinococcus granulosus Sx

A

cysts in liver or lung

485
Q

Schistosoma life cycle

A

eggs ingested by snails -> cercaria penetrate skin of humans -> “swimmers itch” -> migrate to lungs or liver

486
Q

Which parasite resides in the lower GU?

A

Schistosoma haematobium

487
Q

Which parasite resides in Mesenteric vessels?

A

Schistosoma mansoni

488
Q

Helminths + portal HTN + splenomegaly

A

Schistosoma eggs stuck in portal v.

489
Q

Schistosoma haematobium can cause what malignancy?

A

Squamous cell carcinoma of bladder

490
Q

Paragonimus westermani Sx

A

chronic bronchitis, hemoptysis

491
Q

Undercooked crabmeat

A

Paragonimus westermani

492
Q

Clonorchis sinensis - Sx

A

lives in biliary tract -> inflammation, pigmented gallstones, cholangiocarcinoma

493
Q

Undercooked fish - fluke

A

Clonorchis sinensis

494
Q

Wuchereria bancrofti Sx

A

elephantiasis, hydrocele “filariasis”

495
Q

Scabies are found typically

A

interdigital webs

DIT (22 decks)

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