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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
Yellow (sulfur) pigment producer
Actinomyces israelii
26
Dental procedure ->
Viridans Group Strep
27
Dental caries
S. mutans
28
Lipoteichoic acid
Capsule of G(+) induces TNF-alpha & IL-1
29
Acute Phase Cytokines
IL-1, IL-6, TNF-alpha
30
Fimbriae
mediates adherence
31
Pilus
Sexual conjugation (DNA transfer)
32
Capsule
elusion of phagocytosis
33
Quellung Reaction
capsule (+) --> swelling (+ anti-capsule serum)
34
Encapsulated bacteria
``` E. coli *S. pneumoniae Pseudomonas aeruginosa *Neisseria meningitidis Klebsiella pneumoniae *Haemophilus influenzae type B Salmonella typhi Group B Streptococcus ```
35
Meningitis in AIDS pts
Cryptococcus neoformans
36
Recombinant bacteria is made via
Transformation (DNA released by lysed cell -> picked up by another bacterium & incorporated in chromosomal DNA)
37
Transduction
phage infects bacterium (dirty - may pick up other DNA fragments)
38
Doesn't Gram stain d/t high sterol composition & no cell wall
Mycoplasma
39
Doesn't Gram stain d/t high Mycolic Acid composition
Mycobacteria
40
Spore-formers
Bacillus, Clostridium
41
Dark-Field Microscopy
Treponema
42
Atypical pneumonia d.t broken Air conditioner
Legionella pneumophila
43
PAS stain
Whipple Disease Dx (Tropheryma whipplei)
44
Ziehl-Neelson Stain (Carbolfuchsin AKA Acid-Fast)
Mycobacterium, Nocardia
45
India Ink Stain
Cryptococcus neoformans
46
Silver Stain
Pneumocystis jiroveci, Legionella pneumophila, Helicobacter pylori
47
Giemsa Stain
Chlamydia, Borrelia, Rickettsiae, Plasmodium, Trypanosomes, Histoplasma
48
Lipid A
G(-) outer membrane component that induces TNF-alpha & IL-1
49
Endotoxin
G(-) LPS
50
Transpeptidase
enzyme that cross-links the peptidoglycan layer of the cell wall
51
"O" antigen
LPS/Lipid A of G(-) Outer Membrane
52
Periplasm contains
b-lactamases
53
"H" antigen
Flagella
54
"K" antigen
Capsule
55
Capsule containing D-glutamate
B. anthracis
56
PAS stains which moclecules
glycogen & mucopolysaccharides
57
Chocolate agar + factors 5 (NAD+) & 10 (hematin)
Haemophilus influenzae
58
Thayer-Martin (or VPN) agar
Neisseria spp.
59
Charcoal yeast medium w/ Fe & cysteine
Legionella
60
Sabouraud agar
Fungi
61
pneumonia in Cystic Fibrosis pts
Pseudomonas aeruginosa
62
Anaerobes lack
catalase &/or dismutase -> oxidative damage
63
Which ABX is ineffective against anaerobes?
AminO2glycosides :)
64
Common ABX for anaerobic infections
Metronidazole or Clindamycin
65
Ventilator-associated pneumonia
Pseudomonas aeruginosa
66
Gamma hemolysis
Enterococcus
67
Beta Hemolysis
Group A Strep (S. pyogenes) | Group B Strep (S. agalactiae)
68
Alpha Hemolysis
Strep Viridans Group | S. pneumoniae
69
Endocarditis w/ _______________ warrants evaluation for Colon Cancer
S. bovis
70
Impetigo
S. aureus
71
What type of pt is at risk for severe infections by encapsulated bacteria?
Asplenics (opsonization is required for clearing infection)
72
People w/ Chronic Granulomatous Disease have recurrent infections w/ ______________ d/t a deficiency of ____________
Catalase (+) organisms; | NADPH oxidase deficiency
73
Facultative Intracellular organisms
``` Salmonella Neisseria Brucella Mycobacterium Listeria Francisella Legionella Yersinia pestis ```
74
Obligate Aerobes
Nocardia Pseudomonas aeruginosa MycoBacterium tuberculosis
75
Gram Stain Limitations
``` Treponema -> Dark-Field Mycoplasma -> no cell wall Mycobacterium -> Acid-Fast Legionella pneumophila -> Silver stain Rickettsia -> Giemsa stain Chlamydia -> Giemsa stain ```
76
GNR Lactose Fermenters
``` Citrobacter – Fast Lactose Fermenter Klebsiella – Slow Lactose Fermenter E. coli - Slow Lactose Fermenter Enterobacter - Slow Lactose Fermenter Serratia - Fast Lactose Fermenter ```
77
Catalase (+) organisms
``` Pseudomonas Listeria Aspergillus Candida E. coli S. aureus Serratia ```
78
Catalase (+) organisms
``` Pseudomonas Listeria Aspergillus Candida E. coli S. aureus Serratia ```
79
Urease (+) organisms
``` Cryptococcus H. pylori Proteus Ureaplasma Nocardia Klebsiella S. epidermidis S. saprophyticus ```
80
Protein A is expressed by _________ & has what MOA
S. aureus; | binds Fc of IgG to prevent opsonization & phagocytosis
81
What structure protects against phagocytosis?
capsule
82
Plasmids are exchanged by?
Conjugation
83
Superantigen MOA
bind MHC class II -> activate TCR -> polyclonal T-cell expansion -> huge release of cytokines
84
What organisms secrete superantigens?
S. aureus & S. pyogenes
85
Diptheria toxin MOA
inactivates EF-2 -> cell death
86
Pseudomonas aeruginosa toxin
Exotoxin A
87
Exotoxin A of Pseudomonas aeruginosa MOA
inactivates EF-2 -> cell death
88
Shiga toxin MOA
cleaves host rRNA at Adenine base in 60S subunit -> prevents protein synthesis -> cell death
89
Shiga Toxin is expressed by
EHEC 0157:H7 & Shigella
90
Hemolytic Uremic Syndrome Sx
thrombocytopenia, hemolytic anemia, acute renal failure
91
HUS is caused by what organism
EHEC 0157:H7
92
ETEC heat-labile toxin MOA
activates adenylate cyclase -> increase cAMP
93
ETEC heat-stabile toxin MOA
activates guanine cyclase -> increase cGMP
94
Pseudoappendicitis
Yersinia enterocolitica
95
Anthrax toxin
3 components: - Edema Factor (activates a.c. -> increase cAMP) - Lethal Factor - Protective Factor
96
Diptheria toxin MOA
inactivates EF-2
97
Heat-stabile toxin MOA; expressed by?
activates guanine cyclase -> increase cGMP; | ETEC & Yersinia entercolitica
98
Anthrax toxin
3 components: - Edema Factor (activates a.c. -> increase cAMP) - Lethal Factor - Protective Factor
99
Traveler's Diarrhea
E. coli
100
TSST-1 MOA
(S. aureus) causes release of cytokines -> TSS
101
"rice water" stools
Vibrio cholera
102
Botulinum toxin MOA
inhibits ACh release at NMJ -> flaccid paralysis
103
Tetanospasm toxin MOA
blocks release of GABA/glycine inhibitory NTs from Renshaw cells -> muscle contraction
104
Cholera toxin MOA
activates a.c. -> increase cAMP
105
Pertussis toxin MOA
inactivates the inhibitor of adenylate cyclase -> increase cAMP
106
Phospholipase causing gas gangrene (organism/toxin?)
C. perfringens - alpha toxin
107
Panton-Valentine Leukocidin MOA (organism?)
S. aureus - tissue destruction w/ MRSA, killing macrophages & neutrophils
108
Exfoliative toxin MOA (organism?)
S. aureus - disrupts zona granulosa -> flaccid bullae -> Scalded Skin Syndrome (newborns)
109
Woman on period using super-absorbent tampon-->
Toxic Shock Syndrome d/t S. aureus & TSST-1
110
Streptolysin O
S. pyogenes - O2-labile -> hemolysis
111
Streptolysin S
S. pyogenes - O2-stabile -> hemolysis
112
Scarlet Fever
S. pyogenes - pyrogenic exotoxins (A, B, C)
113
Biofilm production is esp pronounced in
S. epidermidis
114
IgA protease producers
(SHiN) S. pneumo HiB Neisseria
115
M protein is produced by ______________ and has what MOA?
S. pyogenes; | helps prevents phagocytosis
116
Bull Neck
C. diptheriae
117
HUS is caused by what organism
EHEC 0157:H7 & Shigella
118
ETEC heat-labile toxin MOA
activates adenylate cyclase -> increase cAMP | -> increased Cl- secretion in GIT
119
Heat-stabile toxin MOA; expressed by?
activates guanine cyclase -> increase cGMP -> decreased NaCl resorption in GIT; ETEC & Yersinia entercolitica
120
Botulinum toxin MOA
inhibits ACh release at NMJ (cleaves SNARE protein) -> flaccid paralysis
121
Tetanospasm toxin MOA
blocks release of GABA/glycine inhibitory NTs from Renshaw cells (cleaves SNARE protein) -> muscle contraction
122
Pertussis toxin MOA
inactivates the (Gi) inhibitor of adenylate cyclase -> increase cAMP
123
Bull Neck (severe LAD)
C. diptheriae
124
Painless black eschar
Cutaneous Bacillus Anthracis
125
Whooping cough
Bordetella pertussis
126
Impetigo
S. aureus & S. pyogenes
127
Superantigen MOA
bind MHC class II -> activate TCR -> polyclonal T-cell expansion -> huge release of IFN-gamma & IL-2
128
Diptheria toxin MOA
inactivates EF-2 (ADP ribosylator)
129
Whooping cough
Bordetella pertussis
130
"double zone" of hemolysis on blood agar
C. perfringens
131
ASO
(anti-Streptolysin O Ab) used to diagnose Rheumatic Fever (S. pyogenes)
132
LPS/Endotoxin activates (6)
- > macrophages ->TNF-alpha, IL-1, NO - > complement -> C3a, C5a - > tissue factor -> Coag cascade -> DIC
133
"rust-colored" sputum & lobar pneumonia
S. pneumoniae
134
Otitis Media
S. pneumoniae
135
Bacterial Toxins encoded by Lysogenic Phages
``` shigA toxin Botulinum toxin Cholera toxin Diptheria toxin Erythrogenic toxin of S. pyogenes ```
136
Organism associated w/ Acute Post-Strep Glomerulonephritis
S. pyogenes
137
Mediastinal widening
Bacillus anthracis (Inhalation Anthrax)
138
Which Streptococcus strain is susceptible to Optochin?
S. pneumo
139
Which Streptococcus strain is resistant to Optochin?
Viridans group
140
Cervicofacial Disease w/ draining sinus tracts
Actinomyces israelii
141
Contaminant of deli meats & unpasteurized milk products
Listeria
142
Obligate Anaerobes
Clostridium Bacteroides Actinomyces
143
Superantigen
``` TSST-1 (S. aureus) Exotoxin A (S. pyogenes) ```
144
Superantigen
``` TSST-1 (S. aureus) Exotoxin A (S. pyogenes) ```
145
2nd most common cause of UTI in young women
S. saprophyticus
146
Novobiocin Resistance
S. saprophyticus
147
Novobiocin Sensitivity
S. epidermidis
148
Sepsis in Sickle Cell pts or Asplenics
S. pneumoniae
149
S. pneumo is the MOST COMMON CAUSE OF
Meningitis Otitis Media Pneumonia Sinusitis
150
MOST common cause of osteomyelitis
S. aureus
151
"Thumb Sign" on X-ray
Epiglottitis (H. influenzae type B)
152
Neonatal conjunctivitis
N. gonorrhoaea
153
Meningitis in young adults & children
N. meningitidis
154
Purpura Fulminans
N. meningitidis
155
Pontiac Fever
Legionella pneumophila
156
Hot Tub Folliculitis
P. aeruginosa
157
Burn victim wound infection
P. aeruginosa
158
GN diplococci, Oxidase (+) organism in COPD sputum sample
Moraxella catarrhalis
159
Diarrhea 1-3d following handling turtles
Salmonella
160
Osteomyelitis in a Sickle Cell pt
Salmonella
161
42C Culture
Campylobacter
162
Common cause of gastroenteritis & Guillain-Barre Syndrome
Campylobacter
163
Pneumonia in Alcoholics or COPD pts
Klebsiella pneumoniae
164
"Currant-jelly" sputum
Klebsiella pneumoniae
165
"Swarming" motility
Proteus
166
Struvite stones -> Staghorn Calculi
Proteus
167
E. coli causing HUS
EHEC O157:H7
168
Diarrhea d/t GN, non-motile, lactose nonfermenter
Shigella
169
Diarrhea d/t "S-shaped" organisms
Campylobacter jejuni
170
Diarrhea from household pets
Yersinia enterocolitica or Salmonella
171
Diarrhea d/t GN, motile, lactose nonfermenter
Salmonella
172
Traveler's Diarrhea
ETEC
173
Diarrhea from undercooked hamburger meat
EHEC
174
Diarrhea mimicking appendicitis
Yersinia
175
Diarrhea after handling raw chicken or eggs
Salmonella or Campylobacter
176
Osteomyelitis in Sickle Cell pts
Salmonella
177
Osteomyelitis in Sickle Cell pts
Salmonella
178
"Comma" shaped GNR
Vibrio
179
"S" shaped GNR
Campylobacter
180
Which E. coli invades the intestinal wall?
EIEC
181
Infection caused by animal urine?
Leptospira (water contaminated w/ urine) | Hantavirus (rodent urine)
182
"Target" shaped lesion is associated w/ what disease
Lyme's Disease
183
Lyme's Disease is transmitted by what vector
Ixodes tick
184
Lyme's Disease is caused by what organisms
Borrelia burgdorferi
185
B/L facial n. palsy
Lyme's Disease (disseminated)
186
Causes of rashes on palms & soles
Kawasaki Disease Coxsackie A Rocky Mountain Spotted Fever Secondary Syphilis
187
External Otitis (Swimmer's Ear)
Pseudomonas aeruginosa
188
Ecthyma Gangrenosum in immunocompromised
Pseudomonas aeruginosa
189
What allows S. sanguinis to bind to damaged heart valves?
Dextrans -> bind fibrin-platelet aggregates on damaged heart valves
190
S. pyogenes pyrogenic conditions
pharyngitis, cellulitis, impetigo
191
S. pyogenes toxigenic conditions
Scarlet fever, TSS-like, necrotizing fasciitis
192
S. pyogenes Immunologic conditions
Rheumatic Fever & Acute Post-Strep Glomerulonephritis
193
Ab to what S. progenies virulence factor gives rise to Rheumatic Fever?
Antibodies to M protein
194
Ab to what S. progenies virulence factor is used in the Dx of Rheumatic Fever?
Anti-Streptolysin Antibodies (ASO) - confirms prior S. pyogenes infection
195
"Strawberry tongue"
Scarlet fever d/t S. pyogenes
196
"Sandpaper-like" Rash
Scarlet fever d/t S. pyogenes
197
CAMP test or Hippurate Test is an important diagnostic test for?
S. agalactiae
198
Important cause of Biliary Tract Infections & UTIs?
Enterococci
199
Which Strep strain is resistant to Bacitracin?
group B Strep
200
Which Strep strain is sensitive to Bacitracin?
group A Strep
201
Lung abscess in aspiration pneumonia
Klebsiella pneumo
202
"rose-spots" on abdomen + fever + HA + diarrhea
Salmonella typhi
203
Salmonella typhi carrier state in which organ?
Gallbladder
204
Puppy poop
Yersinia enterocolitica
205
Weil's Disease
Severe Leptospirosis - fever, hemorrhage, and anemia
206
Flu-like Sx in surfer
Leptospira interrogans
207
Flu-like Illness contracted from birds (parrots)
Chlamydophila psittaci
208
Flu-like Illness contracted from infected placenta or newborn farm animals
Coxiella burnetti
209
LAD + new kitten
Bartonella henslae
210
Recurrent Fever
Borrelia recurrentis
211
Spread by prairie dogs
Yersinia pestis
212
Spread by rabbits, squirrels, ticks
Francisella tularensis
213
Spread by armadillos
Mycobacterium leprae
214
Cat or Dog bite -> Cellulitis
Pasteurella multocida
215
Spread by the Dermacentor tick
Rickettsia rickettsii
216
Epidemic typhi
Rickettsia prowazekii (Lice)
217
Endemic typhi
Rickettsia typhi (fleas)
218
Spread by RABBITS, squirrels, ticks
Francisella tularensis
219
Endemic typhi
Rickettsia typhi (fleas)
220
Fish tank cellulitis
mycobacterium marinum
221
gray discharge + fishy odor
gardnerella vaginosis
222
Q fever Sx
acute flu-like Sx w pneumonia | Chronic --> endocarditis
223
Q fever agent
coxiella burnetti
224
Unpasteurized milk
Brucella or Coxiella burnetti
225
Animal placent
Coxiella burnetti
226
farm animal urine/feces --> air borne spread
Coxiella burnetti
227
Spread by Ixodes scapulars ticks
Anaplasma phagocytophilum & Borrelia burgdorferi
228
Spread by Lone Star tick
Ehrlichia chaffensis
229
Epidemic Typhus
Rickettsia prowazekii spread by lice
230
Endemic Typhus
Rickettsia typhi spread by flea
231
Chlamydia trachomatis A-C
Trachoma (eye infection -> blindness)
232
Chlamydia trachomatis D-K
Urethritis, cervicitis, PID
233
Reactive Arthritis
Chlamydia trachomatis, Campylobacter, Salmonella, Shigella, Yersinia
234
Pet parrot
chlamydophila psittaci
235
Common atypical pneumonia agents
legionella pneumoniae, chlamydophila pneumoniae, mycoplasma pneumoniae
236
Rickettsial triad of Sx
HA, fever, rash
237
Cold agglutinins
IgM
238
Mycoplasma pneumoniae Tx
Azithromycin
239
Bacterial vaginosis Tx
Metronidazole
240
Rocky Mountain Spotted Fever Tx
Doxycycline
241
Rocky Mountain Spotted Fever Sx
HA, fever, rash on palms/soles!!
242
Agents that cause rash on palms & soles
Coxsackie A, Rocky Mountain Spotted Fever, Meningocococcus, Secondary Syphilis
243
Rocky Mountain Spotted Fever agents
Rickettsia rickettsiae
244
Bird & bat droppings
Histoplasmosis
245
Broad-based fungus found near MS, OH river basins
Blastomycoses
246
HSV-1 may cause
Temporal lobe encephalitis Gingivostomatitis Oral herpes labialis Keratoconjunctivitis
247
HSV-2 may cause
Genital Herpes Multiple, painful vesicles latent infection in sacral n. root
248
HSV-2 spread
sexual contact, genital-oral contact (mucosa)
249
HSV-2 to neonate
through canal | primary inf. increases risk of spread to neonate
250
ZVZ
primary: chickenpox, encephalitis, pneumonia Secondary: latent in dorsal root ganglia -> shingles (U/L single dermatome rash)
251
ZVZ spread
contant, respiratory, direct contact to active lesions, airborne if disseminated in immunodeficient
252
Tzanck smear
open vesicle sample, multinucleate giant cell, HSV-1, -2, VZV; low specificity
253
Intranuclear eosinophilic inclusions
Cowdry A inclusions
254
EBV
infectious mononucleosis
255
EBV spread
oral secretions, 15-24yo, kissing disease
256
EBV infects
B cells, T-cell response
257
Downey cells
atypical lymphocytes seen in EBV (reactive T-cells)
258
infectious mononucleosis
fever, sore throat, posterior cervical LAD, exudative pharyngitis
259
When you give Amoxicillin to infectious mononucleosis pt -->
maculopapular rash (trunk, ext) NOT ALLERGIES
260
infectious mononucleosis complications
splenomegaly, rupture (no contact sports)
261
infectious mononucleosis Dx
``` Monospot test (heterophile Ab) IgG IgM Ab to EBV ```
262
Heterophile negative mononucleosis
CMV > HIV > Toxoplasmosis
263
EBV is assoc. w/ what malignancies?
Hodgkin, Burkitt, Nasopharyngeal carcinoma, Diffuse Large B cell, Hairy leukoplakia
264
CMV spread
congenital, close contact
265
CMV cuases
Heterophile negative mononucleosis | Transplant pts
266
AIDS w/ CMV
retinitis, GI ulcers, Candida esophagitis
267
CMV infects
mononuclear cells & polynuclear cells infected for life
268
HHV-6 causes
roseola in children, 6th Ds, exanthum rubitum
269
HHV-6 Sx
3-5d Fever, maculopapular rash, +/- Febrile seizures
270
HHV-7
Roseola-like virus, almost all ppl are infected by 5
271
HHV-8
Kaposi Sarcoma, MSM, HIV
272
Acyclovir
guanosine analog (activated by thymidine kinase) inhibits DNA polymerase; useful for HSV-1, -2, VZV
273
Parvovirus B19
ssDNA
274
Sickle cell pts + Parvo
Transient aplastic crisis
275
Parvo B19 in children
Slapped cheek! erythema infectiosum
276
Adults w/ Parvo B19
inflammatory arthritis
277
Parvo B19 in utero
Hydrops fetalis & miscarriage
278
HPV-1, -2
common warts
279
HPV-6, -11
genital warts
280
HPV-16, -18
genital cancer
281
Adenovirus
dsDNA, URI -> conjunctivitis + diarrhea; hemorrhagic cystitis, pneumonia,
282
Smallpox
enveloped variola virus
283
Cowpox
Milkmaid's blisters, | provides immunity to smallpox
284
Molluscum contagiosum
benign umbilicalized flesch-colored lesins
285
JC virus
PML in HIV pts
286
Hepatitis B virus (Hepadnavirus)
partial dsDNA, circular enters nucleus, makes RNA, uses RT to make DNA
287
Rotavirus
fatal diarrhea in children -> severe diarrhea, electrolyte imbalance
288
Rotavirus case
infant, winter mos, daycare child
289
Coltivirus
CO tick fever in west US, spread by wood tick
290
Picornavirus
small RNA virus
291
Enterovirus
Poliovirus, Coxsackie, Echovirus
292
Poliovirus
infects gray matter of anterior horn & motor horns
293
Salk vaccine
injected, killed Polio vaccine
294
Sabin vaccine
Oral, live Polio vaccine
295
Echovirus
Aseptic meningitis, myocarditis, URIs
296
Echovirus
Summer outbreaks, detected by PCR of CSF
297
Coxsackie virus
Aseptic meningitis, myocarditis, Hand-foot-mouth disease, pericarditis
298
Hepatitis A virus transmission
fecal-oral
299
Rhinovirus
common cold (Coronavirus too)
300
Norwalk Virus
Calcivirus; viral gastroenteritis - vomiting, diarrhea; outbreak on ships & nursing homes
301
Hepatitis C is in which viral family
Flavivirus
302
Yellow Fever
Flavivirus, Aedes mosquitoes spread, sub-saharan Africa
303
Yellow Fever Sx
High fever, hemorrhagic ds, jaundice, coffee-ground emesis, gum bleeding, purpura
304
Dengue Virus Sx
break bone fever, severe HA, retro-orbital pain
305
Dengue hemorrhagic fever
Tourniquet Test -> excess petechiae = increased vascular wall fragility
306
West Nile Virus
spread from birds -> mosquitoes -> humans
307
West Nile Virus Sx
flu-like illness
308
West Nile Virus complications
meningitis, encephalitis, flaccid paralysis (ant. horn infection like polio)
309
West Nile Virus Dx
IgM anti-WNV Ab
310
St. Louis Encephalitis virus
Arbovirus (arthropod vector)
311
Rubella virus
mild fever, rash, arthralgias
312
Congenital Rubella syndrome
cardiac defects, cataracts, deafness, PDA, pulmonic stenosis
313
Coronavirus
common cold (rhinovirus)
314
HTLV-1 is a
RNA RT
315
Influenza virus
orthomyxovirus, enveloped, ssRNA, hemagluttinin, neuraminidase
316
Influenza Sx
Viral pneumonia, secondary bacterial infection (S. pneumo, S. aureus)
317
Genetic shift
reassortment of viral genome, exchange genetic material -> complete shift -> pandemic
318
Genetic drift
mutated or rearranged -> seasonal epidemics
319
Influenza vaccine
trivalent (2 A & 1 B) quadravalent (2A & 2B) injectable or live intranasal
320
Recommendations for flu vaccine
everyone > 6mo
321
Avian influenza
H5N1, bird-to-human
322
Avian influenza Sx
URI, GI sx, pancytopenia, fever, ALT & AST elevated
323
Swine Influenza
H1N1
324
Neuraminidase inhibitors
Zanamivir, Oseltamivir for influenza pts at high risk, must be used w/in first 24h
325
Parainfluenza virus
Croup -> barking seal cough, steeple sign (laryngo-tracheo-bronchitis)
326
Parainfluenza virus Tx
cold air, mist, Epi, steroids, O2
327
RSV
Bronchiolitis +/- pneumonia in winter in premature infants | URI, brassy cough
328
RSV Px
palivizumab for premature infants
329
Ribavirin
guanosine analog RSV, Hep C (IFN-alpha) S/E Hemolytic anemia, teratogen
330
Measles aka
Rubeola
331
Measles Sx
Coryza, cough, conjunctivitis, Koplik Spots (buccal mucosa) -> maculopapular rash (head down)
332
Measles Complications
Fetal loss, premature delivery, encephalitis, giant cell pneumonia
333
Subacute Sclerosing Pnacephalitis
Complication of Measles
334
Mumps
Parotitis, Orchitis, Aseptic Meningitis
335
Rabies virus
bitten by infected animal -> peripheral nn. to CNS
336
Negri bodies
Rabies Virus
337
Bullet-shaped capsid
Rabies
338
Rabies Sx
fever, malaise, n/v, strange behavior, hallucinations, hydrophobia, coma, death
339
Hantavirus
hemorrhagic fever, pulmonary syndrome, respiratory failure
340
Hantavirus
aerosolized mouse urine (deer mouse)
341
Hemorrhagic fever
Ebola, Marburg
342
Ebola
spread through infected blood, secretions
343
Ebola Sx
fever, HA, myalgias, v/n, diarrhea, fluid-loss, shock, death
344
Ebola prevention
sweat, tears, urine, feces - ISOLATION!!
345
Screening HIV test
ELISA (high Sens)
346
Confirmatory Test for HIV
Western (high Spec)
347
Viral Load HIV testing
PCR, quantifies HIV RNA, monitor effectiveness, confirm diagnosis (early detection 1-2mo in window period)
348
Most common opportunistic infection in HIV pts
pneumocystic jiroveci pneumonia
349
Pneumocystic jiroveci (PCP) in AIDS pts
interstitial infiltrates on CXR
350
Opportunistic infection in HIV pts
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
Progressive Multifocal Leukoencepalopathy
reactivation of JC virus
352
HIV pts are at risk for what malignancies
``` Kaposi sarcoma (purple lesions), Primary CNS lymphoma (ring lesions) Large B cell EBV Squamous Cell Carcinoma cervix/anus ```
353
Bacillary angiomatois
purple lesions
354
Prophylaxis for AIDS pts
TMP-SMX for PCP at CD4
355
Causes cat scratch fever
Bartonella henslae
356
Causes lyme disease
Borrelia burgdorferi
357
Causes recurrent fever from variable surface antigens
Borrelia recurrentis
358
Causes bloody diarrhea
Campylobacter (puppies, livestock, fecal-oral)
359
Causes Q fever
Coxiella burnetii (livestock placenta, tick feces)
360
Cause tularemia
Francisella tularensis (Rabbits)
361
Causes leptospirosis
Leptospira (animal urine)
362
Causes cellulitis and osteomyelitis from cat or dog bites
Pasteurella multocida
363
Tx for CMV retinitis
Ganciclovir > Foscarnet
364
Oral hairy Leukoplakia
EBV
365
Aplastic anemia in a sickle cell pt
Parvovirus B19
366
Child w/ fever + slapped cheek rash
Parvovirus B19
367
Congenital Rubella Cardiac Defects
PDA, aortic stenosis
368
Coryza, cough, conjunctivitis
Measles
369
blue-gray spots on buccal mucosa surround by a base of red
Koplik spots w/ Measles
370
Travel to Africa + fever, vomiting, diarrhea
Ebola
371
Can cause conjunctivitis or diarrhea
Adenovirus
372
Can cause fever + jaundice + black vomit
Yellow Fever
373
Can cause enlarged cell w/ "owl's eye" inclusions
CMV
374
Can cause "barking seal" cough
Parainfluenza virus
375
Can cause bronchiolitis w/ cough/wheezing in babies
RSV
376
Can cause negri bodies
Rabies
377
Hides in trigeminal ganglia
HSV-1
378
Diarrhea in child during winter months
Rotavirus
379
2 most common causes of the common cold
Rhinovirus > Coronavirus
380
Downey Cells are seen w/
EBV
381
Common cause of aseptic meningitis
Enterovirus
382
gag gene in HIV encodes
p24 capsid protein
383
pol gene in HIV encodes
RT & integrase
384
env gene in HIV encodes
gp120, gp41
385
Meningitis in AIDS pt
Cryptococcus neoformans
386
Pseudoappendicitis
Yersinia colitis
387
C. albicans - oral thrush Sx
white, cottage-cheese like patches on tongue
388
C. albicans - oral thrush is seen in
AIDS, immunodeficient, asthmatics w/ inhaled steroids, neonates
389
C. albicans - oral thrush vs oral hairy leukoplakia
oral thrush can be scraped off
390
C. albicans - Vuvlovaginitis
acidic pH, severe itching, cottage cheese discharge
391
Diaper rash
C. albicans
392
C. albicans - Intertrigo
skin infections in folds
393
C. albicans - Bloodstream infections are seen in
pts w/ central lines, drug users, immunocompromised
394
C. albicans - complications in immunocompromised
Endopthalmitis, Endocarditis
395
C. albicans - Dx
germ tubes, budding yeast
396
C. albicans - Tx
Topical Nystatin, Clotrimazole, Fluconazole
397
Cryptococcus neoformans is seen mostly in
Aids pts as meningitis
398
Cryptococcus neoformans Dx
Sabouraud's agar, narrow-based budding yeast
399
Cryptococcus neoformans is found in what environment
soil & in pigeon droppings
400
India ink stain
Cryptococcus neoformans
401
Soap-bubble lesion in the brain
Cryptococcal meningeal encephalitis
402
Pneumocystis jiroveci is most commonly seen
in AIDS pts as atypical pneumonia
403
Pneumocystis jiroveci - pneumonia
Diffuse interstitial
404
Pneumocystis jiroveci Dx
Silver stain or CXR w/ "ground-glass" appearance
405
Pneumocystis jiroveci Tx
TMP-SMX
406
Aspergillus fumigatus is found
ubiquitous in food, soil, air
407
Aspergillus fumigatus Dx
narrow-septate branching at acute angles
408
Mucor & Rhizopus Dx
Broad, irregularly shaped, non-septate hyphae branching at right angles
409
Mucor & Rhizopus in Diabetics
Rhinocerebral mucormycosis: facial pain, HA, necrotic lesions
410
"Ringworm" aka
Tinea capitis or Tinea corpora
411
Thickened, discolored nails
Tinea unguium (Onychomycosis)
412
Malassezia furfur Sx
hypo pigmented spots on trunk
413
Malassezia furfur Tx
Topical azole, topical selenium sulfide
414
Malassezia furfur Dx
KOH prep - "spaghetti & meatball" appearance
415
Organism assoc. w/ cat feces
Toxoplasma
416
Organism assoc. w/ dog feces
Yersinia entercolitica
417
Organism assoc. w/ bird or bat poop
Histoplasma capsulatum
418
Organism assoc. w/ OH & MS river valley
Histoplasma capsulatum
419
Histoplasma capsulatum enters lung and is engulfed by
macrophages
420
Blastomyces dermatitidis is found
MS, OH river basins & Central America (East of River)
421
Blastomyces dermatitidis Dx
broad-based yeast forms
422
Coccidioides immitis in environment
dimorphic -> mycelial or arthroconidia in soil
423
Coccidioides immitis in human lung
Spherules - larger than a RBC
424
Coccidioides immitis is found
SW US & increased in incidence after windstorms
425
What organism is assoc w/ rose thorns?
Sporothrix schenckii
426
What organism is assoc w/ SW US
Coccidioides immitis
427
Paracoccidioides brasiliensis is found
Latin America
428
What organism is assoc w/ East of the MS River
Blastomyces dermatitidis
429
Barrel-shaped arthroconidia
Coccidioides immitis
430
Amphotericin B MOA
binds ergosterol -> permeability
431
Cryptosporidium - Sx
chronic watery diarrhea in AIDS pts
432
Giardia lamblia in found
in nature in fresh-water streams
433
Giardia lamblia Sx
gas, bloating, acute fatty & foul-smelling diarrhea
434
Giardia lamblia Dx
pear-shaped trophozoite or oocyte
435
Giardia lamblia Tx
Metronidazole, Tinidazole
436
Entamoeba histolytica Sx
amoeba dysentery invades colon +/- liver cysts
437
Flask-shaped lesions in GIT
Entamoeba histolytica
438
Entamoeba histolytica Dx
trophozoites or cysts in stools
439
Entamoeba histolytica Tx
Metronidazole & Iodoquinol to kill cysts
440
Trichomonas vaginalis Sx
greenish, foul-smelling discharge
441
Trichomonas vaginalis Dx
trophozoites w/ flagella
442
Toxoplasma gondii is found
cat feces or undercooked cysts in meat
443
Toxoplasma gondii Sx
ring-enhancing lesions on MRI in AIDS pts
444
Congenital Toxoplasma gondii
Chorioretinitis, hydrocephalus, intracranial calcifications
445
Naegleria fowleri - Sx
meningoencephalitis
446
Naegleria fowleri is found
swimming in freshwater lakes
447
Naegleria fowleri Tx
Amphotericin B
448
Trypanosoma brucei Sx
Fever, LAD, somnolence ---> encephalitis, coma, death
449
Trypanosoma brucei are found
Africa
450
Trypanosoma cruzi is found
S. America
451
Trypanosoma cruzi is transmitted by
reduvid bug
452
Trypanosoma brucei is transmitted by
Tsetse fly
453
Chagas Disease
Trypanosoma cruzi --> dilated cardiomyopathy, megacolon, megaesophagus
454
Leishmania donovani - Visceral
fevers, HSM, pancytopenia
455
Leishmania donovani - Cutaneous
ulcerating papules slow to heal
456
Malaria vector
Anopheles mosquito
457
Malaria Sx
cyclin fever (48h ovale & vivax, 72h malaria)
458
Most severe form of Malaria
p. falciparum
459
Banana-shaped gametocyte
p. falciparum
460
Babesia Sx
ring-form trophozoite | maltese cross merozoite
461
Babesia vector
Ixodes tick
462
Most common helminthic inf. in the US
Enterobius vermicularis
463
Ascaris lumbricoides Life cycle
ingest egg -> larvae hatch -> penetrate bowel -> lung -> migrate up trachea to oropharynx -> swallowed & mature in colon
464
Ascaris lumbricoides - Sx
Loffler eosinophilic pneumonitis
465
Ascaris lumbricoides - Tx
Mebenzdazole, Albendazole, Pyrantel pamoate
466
Undercooked game meat (bear)
Trichinella spiralis
467
Trichinella spiralis life cycle
larvae migrate from GIT to muscles
468
Trichinella spiralis Sx
myositis, fever, eosinophilia, periorbital edema
469
Strongyoides stercoralis infect humans via
infactive larvae penetrate skin from soil
470
Strongyoides stercoralis life cycle
larvae migrate to lung -> swallowed -> GI inf
471
Strongyoides stercoralis Tx
Ivermectin, Mebendazole
472
Ancylostoma & Necator infect humans via
penetrate skin of feet
473
Ancylostoma & Necator cause
abd discomfort (hookworm sucks blood) -> anemia
474
Ancylostoma & Necator Tx
Albendazole, Mebendazole, Pyrantel pamoate
475
Undercooked pork
Taenia solium
476
Taenia solium Sx
GI Sx or Myositis, Neurocysticercosis
477
Taenia solium infects humans via
adult tapeworm infects GIT or | ingestion of eggs -> larvae invasion of tissues (myositis, neurocysticercosis)
478
Neurocysticercosis
black ring lesion on CT
479
Immigrant presents w/ new CNS Sx (AMS, confusion, etc)
neurocysticercosis
480
Taenia solium Tx
Praziquantel, Albendazole + Dexamethasone (Neurocysticercosis)
481
Diphyllobothrium latum -> deficiency of
Vitamin B12 -> megaloblastic anemia
482
Ingestion of raw fish (tapeworm)
Diphyllobothrium latum
483
Tapeworm spread in dog feces
Echinococcus granulosus
484
Echinococcus granulosus Sx
cysts in liver or lung
485
Schistosoma life cycle
eggs ingested by snails -> cercaria penetrate skin of humans -> "swimmers itch" -> migrate to lungs or liver
486
Which parasite resides in the lower GU?
Schistosoma haematobium
487
Which parasite resides in Mesenteric vessels?
Schistosoma mansoni
488
Helminths + portal HTN + splenomegaly
Schistosoma eggs stuck in portal v.
489
Schistosoma haematobium can cause what malignancy?
Squamous cell carcinoma of bladder
490
Paragonimus westermani Sx
chronic bronchitis, hemoptysis
491
Undercooked crabmeat
Paragonimus westermani
492
Clonorchis sinensis - Sx
lives in biliary tract -> inflammation, pigmented gallstones, cholangiocarcinoma
493
Undercooked fish - fluke
Clonorchis sinensis
494
Wuchereria bancrofti Sx
elephantiasis, hydrocele "filariasis"
495
Scabies are found typically
interdigital webs

DIT (22 decks)

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