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Uworld > Micro > Flashcards

Micro Flashcards

1
Q 
Isolate in medium of:
vanc
colistin
nystatin
TMP
A

N. gonorrhoeae

(Thayer-Martin medium - chocolate agar based)

Abx inhibit other growth:
vanc - gram +
colistin (polymyxin) - gram -
nysatin - yeast
tmp - proteus (GN)
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2
Q

unexplained oral thrush otherwise health person

A

think HIV

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3
Q

life cyle of Hep B

A
  • entry into host cell
  • capsid released into cytoplasm
  • nuclear import of viral genome
  • partially dsDNA repaired (full ds)
  • transcription
    (out to cytosol)
  • translation of proteins
  • reverse transcription of RNA template into partially dsDNA in new capsid
  • envelope aquired via budding into endoplasmic reticulum (contains virally-coded proteins)
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4
Q

HiB vaccine composition

A

cell wall polysaccharide conjugated with protein toxoid (diptheria or tetanus)

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5
Q

HiB vaccine prevents

A

meningitis
pneumonia
sepsis
epiglottitis

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6
Q

salmonella virulence factor

A

Vi antigen

  • capsular protein
  • protects it from opsonization/phagocytosis

(note: some salmonella can produce exotoxin –> typhoid fever not osteomyelitis)

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7
Q

main virulence factor of staph aures in osteomyelitis

A

adhesion to collagen

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8
Q

HAV decontam

A
  • water chlorination
  • bleach (1:100 dilution)
  • formalin
  • UV irradiation
  • boiling to 85 degC for one minute
  • autoclave (120degC for 20 min)

NOT:

  • drying (stable for weeks)
  • diethyl either, choroform, trichloroethane (no lipid soluble env)
  • acid (can withstand acidic gastric env)
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9
Q

Mother:
HBsAg+, HBeAg+

Infant…

A

(high risk for tranmission during delivery during active infection)

neonate:

  • high levels of HBV replication
  • mildly elevated liver enzymes
  • high risk for chronic infx (90%)

Hep B vaccine given at birth; if HBV+ mom, give anti HBV IgG to newborn

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10
Q

Increased risk of HepB to baby…

A

HBeAg+ (90% vs 20%)

Acute infx in 3rd trimester

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11
Q

streptococcal antibodies

A

anti- streptolysin
anti - DNaseB
anti- hyaluronidase

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12
Q

MCC of E.coli bactermia

A

UTI

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13
Q

dx of mucormycosis

A

bx

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14
Q

MaConkey agar restricts grown of most…

A

gram positive

contains bile salt

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15
Q

Bordet-Gengou medium

A

bordetella pertussis

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16
Q

Post strep GN follows ___

Rhumatic fever follows ____

A

GN - either skin or throat GAS

Rhumatic fever - only throat GAS

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17
Q

major pathogenic mechanism of shigella

A

mucosal invasion
- invades M cells that overlie Peyer’s patches

(not all shigella have shiga toxin)

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18
Q

host inflammatory response to shigella

A

neutrophils

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19
Q

neisseria gonorrhea often seen w/in

A

neutrophils

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20
Q

mechanism of acquiring virulence in cornyebacterium

A

lysogenization by a phage

phage conversion
–> tox gene –> AB exotoxin production

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21
Q

major virulence factor of s. pneumo?

how is it aquired?

A

capsule

via transformation

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22
Q

e.coli acquire the ability to form pili via..

A

conjugation

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23
Q

toxin synthesis under environmental influence

which bacteria

A

bacillus

clostridium

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24
Q

trigger for b.anthracis to make toxin

A
  • warming to 37deg

- presence of appropriate concentration of protein and CO2

25
Q

trigger for C. tetani to germinate/make toxin

A

anaerobic env

e.g. necrotic wounds

26
Q

exquisite ear pain
drainage
granulation tissue in ear canal

A

malignant otitis externa

pseudomonas

27
Q

MCC of death w/diphteria

A

cardiomyopathy

myocarditis?

28
Q

major virulence factor for Strep pyogenes (A)

A

Protein M

  • inhibits phagocytosis and the activation of complement
  • cytotoxic for neutrophils in serum
  • mediator for bacterial attachment
29
Q

streptolysin O

A

produced by most GAS
oxygen-labile
immunogenic
extracellular

lyses erythrocytes and polymorphonuclear leukocytes

does not convey resistance to phogocytosis

30
Q

DNase

A
  • produced by stretococcus
  • depolymerizes viscous DNA in pus and
  • disintegrates polymorphonuclear leukocytes

(allows it to move more freely in tissue)

31
Q

vaginal pH during candida vaginitis

A

normal (3.8-4.2)

32
Q

initial empiric tx of coag-neg staph should include…

A

vancomycin
(due to widespread resistance, esp in nosocomila infx)

can be switched to naf or oxacillin if tests sens

33
Q

dextrans

A

prod by viridans strep

facilitate adherence to fibrin –> form valvular veg

34
Q

why do viridans strep require prior damage to valves

A

w/o endothelial damage –> no platelets or fibrin –> viridans unable to adhere

35
Q

Abx tx of strep throat decreases risk of…

A

rhumatic fever

NOT glomerular nephritis

36
Q

risk of more severe form of hansen disease

A

weak Th1 (cell mediated) immune response –> lepromatous leprocy

macrophages are told to kill mycobacteria–> disseminates widely

37
Q

m. leprae growth conditions

A

temp slighly lower than core body temp –> extremities, skin, superficial nerves, eyes, testes

38
Q

mild form of hansen

A

tuberculoid leprosy

infx limited by cell-med immune –> mild skin plaques (hypopig, hair loss, focally decreased sensation)

39
Q

neutropenia (ANC

A

gram negative

eg pseudomonas

40
Q

p. aeruginosa virulence factors that contribute to EG

A
  • exotoxin A (protein synth inhib)
  • elastase (–> blood vessle destruction)
  • phospholipase c (degrades cell membranes)
  • pyocyanin (gen reactive ox species)
41
Q

bacillary angiomatosis

A

bartonella henselae in immunocompromised pts –>

  • red-purple papular skin lesions
  • vascular prolif also w/in viscera
  • fatal if left untreated
42
Q

triad of HUS

A
  • microangiopathic hemolytic anemia
  • thrombocytopenia
  • renal unsuff
43
Q

Bartonella causes…

A
  • cat scratch disease
  • bacillary angiomatosis
  • culture-neg endocarditis
44
Q 
Kills spores out of:
etoh
chlorohxidine
H2O2
iodine
A

H2O2

Iodine

45
Q

sterilization of hospital instruments that cannot withstand autoclave

A

alklyating agents cross-link DNA and proteins

  • formaldhyde
  • glutaraldehyde
46
Q

Antipseudomonals

A

some pens:

  • ticar
  • piper

some cephs:

  • ceftazidime (3rd)
  • cefepime (4th)

some aminos:

  • amikacin
  • gent
  • tobra

some fluor:
- cipro
- levo
(NOT moxy)

Aztreonam

Carbapenems

47
Q

dx of strongloides

A

rhabditiform larvae in stool

48
Q

rhabditiform vs filariform larvae

A

rhab = less mature; found in stool

filariform - infect through skin or go to lung through large intestine

49
Q

tx for strongloides

A

ivermectin

50
Q

ETEC enterotoxins

A

heat labile (LT)

  • choleragen-like
  • activates adenylate cyclase
heat stabile (ST)
- activates guanylate cyclase
51
Q

tx for recurrent c.diff (or an increased risk of recurrence)

A

fidaxomicin

52
Q

what is seen in stool of cholera

A

mucus and some sloughed epithelial cells

NO leukocytes or RBCs b/c non inflammatory

53
Q

tx for giardia

A

metronidazole

54
Q

mebendezole use

A

roundworms

  • anclyostoma
  • ascaris
  • enterobius
55
Q

albendazole use

A

echinoccos granulosus
[tapeworm/cestode that causes cysts in liver]

**will also need surgery! – first cysts killed w/ etoh injection to prevent anaphalaxis if leak out)

56
Q

immune rx to shistosoma

A

Th2 mediated granulomatous response against eggs –> Th2, eosinophils, macrophages –> ulceration and scarring of bowel or bladder/ureters

57
Q

B. anthracis produce what type of capsule

A

antiphagocytic D-glutamate capsule

instead of polysaccharide

58
Q

lecinthinase mech

A

aka phospholipase C
aka alpha toxin

catalyzes the splitting of phospholipid molecules –> cell lysis (inc RBCs –> tissue necrosis and edema

59
Q

Protein A on Staph aureus

A
  • binds Fc portion of IgG (at complement binding site)–> impairs complement activation, opsonization, and phagocytosis

(on peptidoglycan cell wall)

Uworld (9 decks)

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