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USMLE > Micro > Flashcards

Micro Flashcards

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USMLE® Step 1 flashcards
1
Q

Encapsulated bacteria

“SHiNE SKiS”

A

Strep pneumo, Hib, Neisseria meningiditis, E coli, Salmonella, Klebsiella, and gBs
+ Pseudomonas!

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2
Q

What yeast has a capsule?

What are 2 stains for the organism?

A 
Cryptococcus neoformans (meningitis in AIDS pts)
India ink and mucicarmine
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3
Q

What is transformation?

What is transduction?

A

Transformation - when a live bacterium takes up free DNA released from nearby lysed cells and incorporates it into their genome
Transduction - when a bacteriophage brings along bacterial DNA with it’s viral genome. Once it infects another bacteria, it will gain the donor bacterial DNA

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4
Q

What bacteria can undergo transformation?

A

“SHiN”

Strep pneumo, Hib, and Neisseria meningiditis

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5
Q

What is transposition?

A

When a small part of DNA is self-exiled from it’s chromosome and moves to a new location (i.e. a plasmid)

Genetic material isn’t actually exchanged between bacteria, BUT this would allow an ax-resistance gene to move to a plasmid where it would be shared via conjugation

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6
Q

What 3 species can form spores?

A

Bacillus, clostridium, and Coxiella burnetii (Q fever)

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7
Q

Giemsa stain

“Certain Bugs Really TRY my Patience”

A

Chlamydia, Borielal, Rickettsiae, TRYpanosomes (african sleeping sickness), and Plasmodium

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8
Q

What molecule does PAS stain?

What organism is detected with a PAS stain?

A

Stains glycogen.

Detects Tropheryma whipplei (Whipple disease)

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9
Q

India ink

A

Cryptococcus neoformans (AIDS meningitis)

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10
Q

Silver stain (3)

A

Legionella, H pylori, and fungi (PCP)

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11
Q

Ziehl-Neelsen stain

A

Acid fast = Mycobacterium and norcadia

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12
Q

Food poisoning (vomiting) associated with potato salad

A

Staph aureus

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13
Q

Food poisoning (vomiting) associated with reheated rice

A

Bacillus cereus

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14
Q

What does Protein A do?

What bacterium expresses it?

A

Binds Fc region of host IgG (expressed on PM)

Staph aureus

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15
Q

Bacteria associated with the pigment:
Gold
Yellow
Green

A

Gold - Staph aureus “Au = gold”
Yellow - Actinomyces isrelii
Green - Pseudomonas

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16
Q

Pneumonia with rust colored sputum - what is the organism?

A

Strep pneumo

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17
Q

What type of infection can Staph saprophytic cause?

A

UTI - especially in young, sexually active women

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18
Q

What bacteria have IgA protease?

What other 2 characteristics do these bacteria all have in common?

A

“SHiN” - Strep pneumo, Hib, and Neisseria meningiditis

They are also all encapsulated and are capable of transformation

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19
Q

Sandpaper-like rash + strawberry tongue

A

Scarlet fever - toxin mediated (pyro- and erythro-genic toxins)

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20
Q

What bacteria causes necrotizing fasciitis?

A

Strep species (especially strep pyogenes)

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21
Q

What are the 3 most common causes of neonatal meningitis?

A

GBS, E coli, and Listeria

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22
Q

What are 3 causes of strawberry tongue?

A

Scarlet fever, kawasaki disease, and vitamin B12 deficiency

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23
Q

What 3 bacteria are associated with subacute endocarditis?

A

Viridans strep, enterococcus, and Strep bovis

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24
Q

Cystine-tellurite agar

A

Corynebacterium

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25
Q

What two toxins can be made by Clostridium perfringens and what diseases do they cause?

A

Gas gangrene - a toxin (a phospholipase)

Food poisoning - enterotoxin (reheated meat)

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26
Q

What 2 abs could b e used to treat diphtheria?

A

Penicillin or erythromycin

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27
Q

What infection is associated with people that work with goat hair?

A

Bacillus anthrasis

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28
Q

What are 3 obligate anaerobes?

What two antibiotics can be used?

A

Clostridium tetani, Actinomyces, and Bacteroides

Clindamycin or metronidazole

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29
Q

Gram+ rod that grows at cold temperature (room temp) + narrow zone of B hemolysis

A

Listeria

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30
Q

What is the treatment for Actinomyces isrelii?

A

Penicillin

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31
Q

Headache + fever + rash

What is the treatment?

A 
Rickettsial infection (RMSF, typhus, ehrlichiosis, anaplasma, and Q fever)
All are treated with Doxycycline
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32
Q

What 4 infections can cause a rash on the palms and soles?

“drive Kawasaki CARS with your hands and feet”

A

Kawasaki disease, Coxsackie A, RMSF, and secondary Syphillis

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33
Q

Headache + fever + rash that spares palms/soles
What vector transmitted the bacteria:
Rickettsia typhi
Rickettsia prowazekii

A

Rickettsia typhi - fleas (“thyphi = thyFLEA”)

Rickettsia prowazekii - lice (“prowasekII = lIIce”)

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34
Q

Nonspecific flu-like illness (with fever) + inclusions in monocytes or granulocytes
What is the treatment?

A

Monocytes - Ehrlichiosis
Granulocytes - Anaplasma
Tx - Doxycycline (a rash-rare rickettsial subtype)

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35
Q

Risk factor includes birthing farm animals

A

Q fever (Coxiella burnetii)

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36
Q

What 3 organisms can be spread through unpasteurized milk?

A

Listeria, Coxiella burnetii (Q fever - pneumonia), and Brucella (recurrent fever)

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37
Q

What are 2 presentations of Coxiella burnetii (Q fever)?

A

Acute pneumonia (fever lasting several weeks) or chronic endocarditis

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38
Q

What are 3 presentations of Chlamydia?

A 
Follicular conjunctuvitis ("ABC = africa, blindness, chronic infection")
Urethritis/PID
Lymphogranuloma venerium (painless genital ulcers + unilateral ulcerative LAD)
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39
Q

What is the treatment for suspected sexually transmitted Chlamydia?

A

Azithromycin (chlamydia) + Ceftriaxone (gonorrhea)

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40
Q

What bacteria are associated with reactive arthritis?

A

Chlamydia and diarrhea bugs (shigella, salmonella, campylobacter, and yersinia)

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41
Q

Pet parrot + pneumonia

Treatment?

A

Chlamydia psittaci

Tx - azithromycin (all Chlamydia bugs)

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42
Q

What 3 bacteria can cause atypical pneumonia (nonproductive cough + flu-like, Xray looks worse than the pts feels)?

A

Legionella pneumophila, Chlamydia pneumoniae, and Mycoplasma pneumoniae

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43
Q

What is the treatment for atypical pneumonia?

A

Macrolide (azithromycin)

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44
Q

What non-pneumonia phenomonon is associated with Mycoplasma infection?

A

IgM cold agglutinins (also with CLL and EBV)

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45
Q

What organisms of transmitted by animal urine?

A

Leptospira interrogans and Hantavirus

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46
Q

What is Weil disease?

A

Severe Leptospira infection = liver and kidney dysfunction

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47
Q

What 2 symptoms characterize each stage of Lyme disease?
Stage 1 - early localized
Stage 2 - early disseminated
Stage 3 - late disseminated

A

Stage 1 - flu-like + erythemia migrans
Stage 2 - fluctuating AV block + bilateral Bells palsy
Stage 3 - migratory arthritis + encephalopathy

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48
Q

What is the treatment for Lyme disease?

A

Doxycycline

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49
Q

What symptoms characterize secondary (2 sxs) and tertiary (3 sxs) syphillis?

A

Secondary - rash on palms/soles + condyloma lata

Tertiary - gummas + aortitis + neurosyphillis (general paresis dementia, tabes dorsalis, and argyll-robertson pupil)

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50
Q

What is used to screen for syphillis?

A

VDRL (sometimes also called RPR) - tests for serum reactivity against a cardiolipin (non-specific, happens to be in all pts with syphillis)

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51
Q

What can cause a false + on VDRL?

“Suspicious Positive VDRL”

A

SLE, Pregnancy, Visuses (EBV), iv Drug users, Rheumatic fever, and Leprosy

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52
Q

What organism causes Bacillary angiomatosis (confused with Kaposi sarcoma)?

A

Bartonella (also Cat Scratch Disease)

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53
Q

2 bacterial causes of recurrent fever

A

Borriella recurrentis and Brucella

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54
Q

Transmitted via rabbits

A

Francisella tularensis “rabbits eat tulips”

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55
Q

Transmitted via armadillos

A

Leprosy

56
Q

Cellulitis/osteomyelitis from a cat/dog bite

A

Pasteurella multocida

57
Q

Transmitted via prairie dogs

A

Boubonic plague (painful inflamed lymph nodes) - Yersinia pestis

58
Q

What RNA viruses are naked?

“my REal HEavy PICture of CALIfornia was Ruined without an envelope”

A

REovirus (rota), HEpevirus (HEV), PICornavirus (PERCH), CALIcivirus (noro) = Rna

59
Q

What DNA viruses are naked?

“PA PA and Aunt POLY Didn’t have an envelope”

A

PApilloma (HPV), PArvovirus (B10), Adeno, POLYoma (JC) = Dna

60
Q

What is reassortment?

Which viruses can participate?

A

Co-infection allows viruses to exchange segments of DNA

Reovirus (rota), influenza, and hantavirus

61
Q

What is recombination?

A

Co-infection allows non-homologous recombination of chromosomes in areas with similar sequences - progeny is a completely new virus
Only occurs in DNA viruses and retro viruses (RNA virus with DNA phase)

62
Q

What is the only ssDNA virus?

A

Parvovirus (“parvo = small”)

63
Q

Child with diarrhea in winter months

A

Rotavirus

64
Q

Aseptic meningitis in summer months

A

Echovirus

65
Q

What are the 3 most common presentations of Coxsackie virus infection?

A

Hand/foot/mouth disease (papules/ulcers), myocarditis, and pericarditis

66
Q

How would Coltivirus present?

A

“COLorodo TIck fever = COL TI virus”

Self-limited flu-like in a hiker (outdoorsy person)

67
Q

What virus is most active in the winter? In the summer?

A 
Winter = rotavirus (diarrhea in kids)
Summer = echovirus (aseptic meningitis)
68
Q

What 2 viruses cause the common cold?

A

Rhinovirus and coronavirus

69
Q

What 2 viruses cause aseptic meningitis?

A

Echovirus and coxsackievirus

70
Q

High fever + hemorrhage + jaundice

A

Yellow fever

71
Q

Severe musculoskeletal pain + retro-orbital headache + fever

A

Dengue fever

Complication = hemorrhagic fever

72
Q

How does West Nile virus spread?

How does it present?

A

Birds to mosquitos to humans

Flu-like. Some progress to meningitis/encephalitis

73
Q

What family do each of the hepatitis viruses (except HDV) belong?

A

HAV - picornavirus (+ ssRNA, PERCH)
HBV - hepadnavirus (partial dsDNA circular)
HCV - flavivirus (+ ssRNA)
HEV - hepevirus (+ ssRNA)

74
Q

What drug is used as prophylaxis for vertical transmission of HIV?

A

Zidovudine (NRTI)

75
Q

What are the side effects for the following protease inhibitors:
Ritonavir
Indinavir
Atazanavir

A

Ritonavir - P450 inhibitor, pancreatitis
Indinavir - nephrolithiasis
Atazanavir - nephrolithiasis, increased bilirubin (“AtAzanavir

76
Q

What are 2 side effects of protease inhibitors as a class?

A

GI upset and lipdystrophy/hyperTG

77
Q

What are the side effects for the following NRTIs:
Abacavir
Didanosine
Zidovudine

A

Abacavir - life-threatening hypersensitivity reaction
Didanosine - pancreatitis, peripheral neuropathy, hepatic steatosis (“Dan Died = we should wear PPH”)
Zidovudine - bone marrow suppression (EX megaloblastic anemia) (“Zidovudine Zaps the marrow”

78
Q

What are the side effects of NRTIs as a class?

A

Lactic acidosis

79
Q

What are 2 side effect of NNRTIs as a class?

A

Rash and hepatotoxicity

80
Q

What are 3 side effects specific to Efevirenz?

A

Neuro-psych changes (dizziness, depression), marajuiana false positive test, teratogen

81
Q

What is the mechanism of:
Raltegravir
Enfuvertide
Miraviroc

A

Raltegravir - integrase inhibitor
Enfuvertide - gp41 fusion inhibitor (cannot enter cell)
Miraviroc - binds CCR5 to prevent gp120 binding

82
Q

What is the treatment for cryptococcus meningitis?

A

Amphoteracin B + flucytosine (converted to 5FU by fungal enzymes) followed by fluconazole

83
Q

Recent travel to Latin America + severe pneumonia + granulomas in mucus membranes

A

Paracoccidioides = dimorphic fungi with captains wheel appearance on imaging
“PARAcocco PARAsails with the captains wheal all the way to latin america”

84
Q

Where do systemic mycoses generally disseminate to?

What additional place does coccidioidomycoses disseminate to?

A

Skin and bone

Cocco - also to CNS (meningitis)

85
Q

What 2 fungi are transmitted via bird/bat droppings?

A

Histomycoses (dimorphic, endemic fungus) and cryptococcus neoformans (meningitis in AIDS pts)

86
Q

Treatment for sporothrix schenckii

A

Itraconazole or potassium iodide

“Transmitted by planting roses in your POT = treat with POTassium iodide”

87
Q

What is the most common side effect of amphoteracin B?

Azoles?

A

Nephrotoxicity

Hepatotoxicity (increases LFTs)

88
Q

What is used for prophylaxis in AIDS pts for:

Candida (CD4

A

Candida - Itraconazole

Cryptococcus - Fluconazole

89
Q

What is the treatment for endemic mycoses (Histo, blast, cocoa, paracocco)?

A

Itraconazole

90
Q

What is the mechanism of terbinafine?

What is it used to treat?

A 
Inhibits squalene epoxidase
Dermatophyte infecitons (Tineas)
91
Q

In addition to the flask-shaped ulcer and bloody diarrhea, what other finding is seen with Entamoeba histolytica infection?

A

Liver abscess

92
Q

What do entamoeba histolytica cysts look like on light microscopy?

A

Round with multiple nuclei

93
Q

What is the treatment for toxoplasma?

A

Sulfadiazine + pyramethamine (DHFR inhibitor)

94
Q

What parasite is transmitted through freshwater lakes?

A 
Naegleria fowleri (rapidly fatal meningo-encephalitis) 
"Naegleria sounds like Nalgene"
95
Q

What causes Chagas disease?

A

Trypanosoma cruzi

96
Q

What parasite is transmitted by the sandfly?

A

Leishmania donovani

97
Q

Spiking fevers + hepatosplenomegaly + pancytopenia + macrophages containing small amastigoes

A

Visceral leishmaniasis

98
Q

Slow healing ulcerative papules

A

Cutaneous leishmaniasis

99
Q

How can you differentiate the gametocyte of Plasmodium falciparum from other subtypes?

A

It’s banana shaped

100
Q

What is the treatment for malaria?
What do you add if it’s vivid or oval?
What do you use if it’s falciparum (likely resistant)?

A

Chloroquine
+ primaquine
Atovaquone/proguanil or mefloquine

101
Q

Metrozoite cross in RBC

A

Babesia

102
Q

What 3 organisms are transmitted via the Ixodes tick?

A

Borellia burdorferi (lyme disease), anaplasma (chlamydiophila bacteria), and babesia (protozoan hemolytic anemia)

103
Q

What is the presentation of the following roundworms:

  1. Enterobius vermicularis
  2. Ascaris lumbricoides
  3. Strongyloides stercoralis
  4. Ancylostoma/Necator
A
  1. Anal pruritis
  2. Loffler eosinophilic pneumonitis (gut-lung-gut)
  3. Peptic ulcer-like pain, vomiting (skin-lung-gut)
  4. Anemia (skin-lung-gut)
104
Q

Treatment for roundworms (except strongyloides)

A

Bendazoles or pyrantel pamoate

105
Q

Myositis + periorbital edema + eosinophilia

A

Trichinella spiralis (from undercooked game meat)

106
Q

What roundworms are transmitted by ingestion?

Which roundworms are transmitted by skin penetration?

A

“EAT” - Enterobius (anal pruritis), Ascaris (loffler eosinophilic pneumonitis), and Trichinella (game meat)
“SANd” - Strongyloides (peptic ulcer-like), Ancyclostoma and Necator (anemia)

107
Q

What is the treatment for strongyloides?

A

Ivermectin

108
Q

What is the consequence of ingesting Taenia solium larvae?

Ingesting Taenia sodium eggs?

A 
Larvae = tapeworm
Eggs = cysticercosis (muscle) or neurocysticercosis (brain)
109
Q

What does praziquantel treat?

A

Tapeworms (taenia solim, diphyllobothrium) and flukes (schistosoma, clonorchis)

110
Q

Treatment for neurocysticercosis

A

Albendazole

111
Q

Biopsy procedure of liver mass results in anaphylaxis - what is the mass?

A

Echinococcus granulosus cysts (transmitted via dogs)

112
Q

Eosinophilia + megaloblastic anemia

A

Diphyllobothrium latum (fish tapeworm)

113
Q

Eosinophila + portal HTN

A

Schistosoma mansoni (invades the mesenteric vasculature and can cause vascular obstruction)

114
Q

Egyptian immigrant with bladder squamous cell CA

A

Schistosoma haematobium

115
Q

Eosinophila + pigmented gallstones

A

Clonorchis sinensis - increases risk for cholangioCA

116
Q

What is the presentation of Wuchereria bancrofti?

A

Elaphantitis (transmitted via mosquito)

117
Q

What parasite can be treated with Amphoteracin B?

A

Leishmania donovani - visceral leishmaniasis

118
Q

Prophylaxis against N meningiditis

Treatment for N meningiditis

A

Prophylaxis - Rifampin (also for Hib)

Treatment - Ceftriaxone

119
Q

What is the first step in treatment for H influenza epiglottis?

A

Secure the airway (if you do anything else first they may cry and lose their airway)

120
Q

Chocolate agar + factors 5 and 10

A

Hib

“when you’re sick with the FLU, mom runs to the 5 and DIME store to get some CHOCOLATE”

121
Q

Severe atypical pneumonia + GI symptoms + CNS changes

A

Legionnaires disease (legionella pneumophila)

122
Q

What lab abnormality is associated with Legionnaires disease?

A

HypoNa

123
Q

How is legionella transmitted?

A

Contaminated water (air conditioner, sprinkler system, history of cruise or hotel)

124
Q

What is the triple and quadruple therapy for H pylori?

A 
Triple = PPI + metronidazole/amoxacillin + clarithromycin (macrolide)
Quadruple = PPI + Bismuth + metronidazole + tetracycline
125
Q

IF you chose to treat Gram - diarrhea, what 3 antibiotics could be used?

A

Fluoroquinolone, TMP-SMX, or azithromycin

126
Q

Fever + salmon colored spots on the abdomen

A

Salmonella typhi

127
Q

Diarrhea + pet turtle

A

Salmonella

128
Q

What bacteria are associated with reactive arthritis?

A

Salmonella, shigella, campylobacter

129
Q

Pseudoappendicitis

A

Yersinia enterocolitica

130
Q

“Currant jelly sputum”

A

Klebsiella pneumonia

131
Q

Who is at high risk for Klebsiella pneumonia?

A

Alcoholics and diabetics

132
Q

“Swarming motility” + urease positive

A

Proteus (UTI with strive stones)

133
Q

Lowenstein-jensen agar

A

TB

134
Q

What antibiotic is used to treat latent TB?

A

Isoniazid

135
Q

What is the mechanism of the TB drugs?

A

Rifampin - RNApol inhibitor
Isoniazid - block mycolic acid synthesis
Pyrazinamide - acidify phagolysosomes
Ethambutol - block other cell wall carb synthesis

136
Q

Side effects for TB drugs

R (2), I (3), P (2), E (1)

A

Rifampin - hepatotoxicity, Ramps up P450s and Red/orange body fluids
Isoniazid - hepatotoxicity, peripheral neuropathy (vitB6 deficiency), and drug-induced lupus
Pyrazinamide - hepatotoxicity and gout
Ethambutol - red/green color blindness (ONLY one that’s non-hepatotoxic)

137
Q

What is the presentation of Mycobacterium kansasii?

A

TB-like illness

USMLE (12 decks)

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