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UWorld > Micro > Flashcards

Micro Flashcards

1
Q

What is the MOA of sulbactam, tazobactam, clavulinic acid?

A

beta lactamase inhibitors

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2
Q

What causes a mono-spot negative mono-like syndrome?

A

CMV

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3
Q

What type of leprosy has a TH1 response?

A

Tuberculin

  • IL-2, TNF-g, IL-12
    • induration with lepromin skin test
  • Limited disease
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4
Q

What type of leprosy has a TH2 response?

A

Lepromatous

  • IL-4, IL-5, IL-10
  • No reaction to lepromin skin test
  • Disseminated disease, weak immune system
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5
Q

How does Hep B help Hep D infet?

A

Hep B is required to COAT the HDAg

“hey BuDdy, I’ll get to your COAT”

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6
Q

What part of the spinal cord does neurosyphilis affect?

A

Dorsal columns, hence Tabes Dorsalis

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7
Q

What are some symptoms of Tabes Dorsalis?

A 
A-R pupils
Paresthesia
Lack of proprioception
Ataxia
\+ Romberg
Bladder incontinence
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8
Q

How does integration of HBV into the genome of hepatocytes stimulate HCC?

A

Viral product of HBV increases insulin-like growth factor > proliferation

HBV suppresses Rb

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9
Q

What symptoms characterize the measles prodrome?

A

CCCK

Cough
Coryza
Conjunctivitis
Koplik spots

Rash begins in 1-2 days

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10
Q

What forms of malaria have fevers at 48 hour intervals?

A

Vivax and Ovale

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11
Q

What are the forms of malaria (vivax and ovale) in the:

  • Liver (active)
  • Blood
  • Liver (latent)
A
  • Liver (active): trophozoites
  • Blood: merozoites
    Liver (latent): hypnozoites
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12
Q

What is the treatment for malaria (vivax and ovale)?

A

Chloroquine for acute + Primaquine for hypozoites

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13
Q

HIV structural proteins encoded by:

gag

A

p24 + p7: nucleocapsid proteins

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14
Q

HIV structural proteins encoded by:

pol

A

Reverse transcriptase

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15
Q

HIV structural proteins encoded by:

env

A

gp120 + gp41: envelope glycoproteins

Bind CD4
Mediate viral absorption

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16
Q

Temporal lobe aphasia, olfactory hallucination caused by reactivation of a virus on the trigeminal ganglion

A

Herpes encephalitis

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17
Q

Caused by point mutations in viral genome

Genetic drift or shift?

A

Drift

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18
Q

Caused by exchange of genome by segmented virus

Genetic drift or shift?

A

Shift

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19
Q

What viruses can undergo genetic shift?

A

Influenza, orthomyxoviruses, rotavirsues

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20
Q

What are the names and functions of the Diphtheria toxins?

A

B: binding (esp. heart and neuronal tissue)

A: active (EF2 > stops host cell protein synth)

Note: A stains with Aniline dye

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21
Q

What is the most common cause of retinitis in AIDS patients?

A

CMV

CD4

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22
Q

What is the treatment for CMV retinitis?

A

Gancyclovir

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23
Q

Cause of hydrocephalus + intracranial calcifications + chorioretinitis in newborns

A

Congenital Toxoplasmosis

Avoid cat poop while pregnant.

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24
Q

Congenital toxoplasmosis is acquired…

  • Transplacental
  • Intrapartum
  • Breast milk
A

Transplacental (in utero)

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25
Q

What happens when you mix Metronidazole and alcohol?

A

Disulfuram-like reaction: flushing, headache, N/V, cramps

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26
Q

What is the MOA of cord factor in TB?

A

Inhibits neutrophils
Destroys mitochondria
Releases TNF

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27
Q

What does the presence of cord factor indicate in TB infection?

A

Virulence

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28
Q

How does this intracellular organism survive in macros?

Salmonella

A

Blocks phagolysosome fusion

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29
Q

How does this intracellular organism survive in macros?

Tuberculosis

A

Blocks phaglysosome fusion and acidification

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30
Q

How does this intracellular organism survive in macros?

Listeria

A

Escapes phagolysosomes into the cytosol

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31
Q

How does this intracellular organism survive in macros?

Shigella

A

Escapes phagolysosomes into the cytosol

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32
Q

Intracellular organisms require what kind of immune response to kill them?

A

Cell-mediated immunity. Complement or Abs will not do it.

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33
Q

Morphology of Hep E

A

Unenveloped ssRNA virus

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34
Q

Spread of Hep E

A

Fecal oral

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35
Q

What population is affected by Hep E?

A

Pregnant women

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36
Q

What virus causes pharyngoconjunctivitis?

A

Adenovirus

  • Pharyngitis
  • Conjunctivitis
  • Cervical LAD

Seen in close quarters

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37
Q

What are some nucleoside analogues?

A

Acyclovir
Valacyclovir
Gancyclovir
Famicyclovir

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38
Q

What enzyme do the nucleoside analogues require?

A

Viral kinase to activate

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39
Q

What are the nucleotide analgoues?

A

Cidofovir, Tenofovir

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40
Q

What enzyme do the nucleotide analogues requrie?

A

None!

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41
Q

What is the Rx for VZV, CMV, and EBV–nucleoside or nucleotide inhibitors?

A

Nucleotide (Cidofovir, Tenofovir) because they lack thymidine kinase to activate nucleoside inhibitors

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42
Q

What part of the brain is damaged in Tabes Dorsalis?

A

Midbrain (tectum)

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43
Q

What are the adverse effects of protease inhibitors?

A

Lipodystrophy
Hyperglycemia (increased insulin resistance)
Inhibition of p450

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44
Q

Antigen that is released during division or bacteriolysis of Gram negatives and causes sepsis

A

LPS

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45
Q

Angiten released from Gram negatives that causes shock by activating the inflammatory cascade

A

Lipid A

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46
Q

Antigen that is an outer membrane polysaccharide in the cell wall of Gram negatives

A

O antigen

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47
Q

What are some means of inactivating HAV?

A 
Chlorination of water
Bleach
Formalin
UV
85 degrees C for 1 min
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48
Q

Bacterial cause of meningitis with this pattern of invasion:

pharynx > lymphatics > meninges

A

H flu

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49
Q

Bacterial cause of meningitis with this pattern of invasion:

middle ear > contiguous tissue > meninges

A

S pneumo

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50
Q

Bacterial cause of meningitis with this pattern of invasion:

traumatic wound leaking CSF > meninges

A

S aureus

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51
Q

Bacterial cause of meningitis with this pattern of invasion:

pharynx > blood > choroid plexus > meninges

A

Neisseria

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52
Q

Bacterial cause of meningitis with this pattern of invasion:

primary lung focus > blood > meninges

A

TB

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53
Q

HIV + seizures + ring enhancing lesions think..

A

Toxoplasmosis

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54
Q

Rx for Toxoplasmosis

A

Pyrimethamine and Sulfadiazine

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55
Q

Cause of HIV esophagitis with:

Gross–gray pseudomembranes
Histo–yeast cells, pseudohyphae

A

Candida

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56
Q

Cause of HIV esophagitis with:

Gross–punched out lesions, vesicles
Histo–eosinophilic intranuclear inclusions

A

HSV

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57
Q

Cause of HIV esophagitis with:

Gross–linear ulcerations
Histo–intranuclear and cytoplasmic inclusions

A

CMV

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58
Q

Aerobic, serpentine bacteria with medusa heads

A

Bacillus anthracis

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59
Q

Bacterial cause of wool-sorter’s disease

A

Bacillus anthracis

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60
Q

Bacterial cause of mediastinal hemorrhage

A

Bacillus anthracis

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61
Q

Virulence factors of Bacillus anthracis

A

3 part anthrax toxin

Antiphagocytic capsule

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62
Q

Drugs for MRSA

A

Vancomycin
Linezolid
Daptopmycin

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63
Q

What is a strain of E coli that does not ferment sorbitol or make glucuronidase?

A

EHEC O157:H7

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64
Q

What is the pathogenicity of E Coli O157:H7

A

Shiga like toxin inactivates 60S ribosomal subunit, ceasing protein synthesis > death

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65
Q

What food is EHEC associated with?

A

Undercooked beef

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66
Q

Barrier to antibiotic penetration and host defenses synthesized by Staph epidermidis

A

Biofilm

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67
Q

What organisms produce biofilm?

A 
Staph epi
Strep viridans
Strep mutans + sanguis
Pseudomonas
H flu
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68
Q

5 catalase + organisms by which Chronic Granulomatous Disease NABSS you:

A 
Noardia
Aspergillus
Burkholderia
Serratia
Staph aureus
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69
Q

MOA of Raltegravir

A

Integrase inhibitor

Stops mRNA transcription by stopping HIV genome from integrating into the host

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70
Q

What cofactors does H flu require in growth medium?

A 
Factor V (NAD): remember 5, nickel, NAD
Factor X (hematin): remember hemaTEN
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71
Q

Can grow on sheep’s blood agar with Staph aureus

A

H Flu

Staph aureus makes Factor V and lyses the RBCs to release Factor X

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72
Q

Rash moving from face to trunk + post-auricular cervical LAD

A

Rubella (German measles)

- Togavirus

73
Q

Rash moving from face to trunk that darkens and coalesces

A

Rubeola (measles)

- Paramyxovirus

74
Q

Papulovesicular rash from the trunk moving out

A 
Varicella Zoster (chicken pox)
- Herpesvirus
75
Q

Rash moving from trunk out, transient with fever

A

Roseola

- Herpesvirus

76
Q

What are the side effects of Amphotericin?

A

Renal toxicity

Severe hypokalemia, hypomagnesemia

77
Q

How does meningococcus attach to epithelial surfaces like the nasopharynx?

A

Pilus

78
Q

What are 3 non TB uses for Rifampin?

A

Meningitis (prophylaxis for contacts)
Leprosy
Staph endocarditis

79
Q

What is the most common cause of aseptic meningitis?

A

Enteroviruses

80
Q

Why are enteroviruses named such?

A

They replicate in the GI tract

Do not cause gastroenteritis! Instead:

  • Polio
  • Cocksackie
  • Echo
81
Q

What is the treatment for H Pylori?

A

Triple Therapy

2 antibiotics: metronidazole, tetracycline, amoxicillin, clarithromycin + 1 PPI (omeprazole +/- bismuth)

14 days

82
Q

What antigen does the influenza vaccine target?

A

Hemagluttinin

83
Q

What is the MOA of hemagluttinin of influenza virus?

A

Mediates viral entry into cells

84
Q

What is the MOA of Oseltamivir against influenza virus?

A

Prevents neuraminidase cleavage of sialic acid, thereby preventing release of viral progeny

85
Q

How do IFN-a and IFN-b combat influenza virus?

A

They are released by infected cells to induce antiviral synthesis in neighboring cells, thereby preventing spread by suppressing viral replication and assembly

86
Q

What is the most common viral cause of aplastic crisis?

A

Parvovirus B19

  • Non-enveloped ss DNA virus
  • Infects erythrocyte precursors in bone marrow
87
Q

Gram - bacillus, anaerobe, part of intestinal flora

Common cause of intra-abdominal infections and abscess formation, as well as appendicitis

A

Bacterioides fragilis

88
Q

What is the rx for B fragilis?

A

Piperacillin-tazobactam

89
Q

N/V and cramps within 6 hours after eating mayo at a picnic. Diagnosis?

A

Staph aureus

90
Q

What toxin is responsible for Staph food poisoning?

A

Pre-formed heat stable enterotoxin

91
Q

What are 3 diseases caused by Staph “exotoxin” release?

A

1) Toxic Shock
2) Scalded Skin
3) Gastrotenteritis

92
Q

What is the most common cause of viral encephalitis in both immunocompetent and compromised?

A

HSV

93
Q

What part of the brain does HSV encephalitis affect?

A

Temporal lobe, causing seizure, personality change, and psychosis along with more general fever, headache, and malaise

94
Q

What are non-specific screening tests for syphilis?

A

RPR and VDLR

95
Q

What is the definitive test for syphilis?

A

FTA-ABS

96
Q

What syphilis test involves adding patient serum to cardioplipin, lecithin, and cholesterol, looking for flocculation?

A

RPR–will see flocculation if patient has serum Abs against destroyed cell products

97
Q

Name the type of viral exchange:

when 2 viral strains infect 1 cell and the product involves surface proteins of one virus and the genome of the other

A

Phenotypic Mixing

  • Note: if neither original organism was cytopathic, the new arrangement will not be either
98
Q

Name the type of viral exchange:

uptake of DNA that changes genetics of host but not progeny virions

A

Transformation

99
Q

Name the type of viral exchange:

genetic exchanges between 2 virus strains with non-fragmented ds DNA

A

Recombination

100
Q

Name the type of viral exchange:

host cells co-infected with 2 strains that exchagne whole genome segements, altering capsule proteins of progency

A

Reassortment

101
Q

Pharyngitis (gray exudate) + strawberry tongue + sandpaper rash starting in the axilla, groin, and neck that generalizes. Diagnosis?

A

Scarlet fever

102
Q

What is the causal organism of Scarlet Fever?

A

GAS

103
Q

Because Scarlet Fever is caused by GAS, what are possible sequelae?

A

Glomerulonephritis

Acute Rheumatic Fever

104
Q

URI followed by red, flushed cheeks in a child. Diagnosis?

A

Erythema infectiosum/Fifth Disease, caused by Parvo B19

105
Q

What type of cell does Parvo B19 infect preferentially?

A

Erythroid precursors

106
Q

Where does Parvo B19 replicate?

A

Bone marrow

107
Q

Dimorphic fungus that lives intracellularly in macrophages

A

Histoplasma capsulatum

108
Q

Metronidazole + alcohol causes…

A

Disufuram-like effect

Metronidazole is an acetaldehyde dehydrogenase inhibitor

109
Q

“Mold in the cold, yeast in the heat”
Name the dimorphic fungus:

Branching hyphae
Cigar-shaped yeast

A

Sporothrix

110
Q

“Mold in the cold, yeast in the heat”
Name the dimorphic fungus:

Thick walled spherules with endospores

A

Coccidioides

111
Q

“Mold in the cold, yeast in the heat”
Name the dimorphic fungus:

Branching hyphae
Yeast within macros

A

Histoplasma

112
Q

“Mold in the cold, yeast in the heat”
Name the dimorphic fungus:

Branching hyphae with doubly refractile wall
Single, broad based bud

A

Blastomyces

113
Q

“Mold in the cold, yeast in the heat”
Name the dimorphic fungus:

Blastoconidia

A

Paracoccidioides

114
Q

Which hepatitis on biopsy looks like:

  • Cytoplasm full of spheres and tubules
  • Finely granular eosinophilic appearance (“ground glass”)
A

Hep B

115
Q

Which hepatitis on biopsy looks like:

  • Lymphoid aggregates in portal tracts
  • Focal areas of microvesicular stenosis
A

Hep C

116
Q

Why doesn’t infection confer immunity to Neisseria Gonorrhea?

A

Antigenic variation in membrane proteins

117
Q

E. Coli Virulence Factors:

Name the disease caused by….

LPS

A

Septic shock + bactemia

Through macrophage activation of IL-1, IL-6, TNF-a

“will that Like Produce Shock?”

118
Q

E. Coli Virulence Factors:

Name the disease caused by….

K1 Capsular Polysaccharide

A

Neonatal meningitis

Through preventing phagocytosis and complement mediated lysis

“K for kids”

119
Q

E. Coli Virulence Factors:

Name the disease caused by….

Verotoxin (Shiga-like toxin)

A

Bloody diarrhea (Gastroenteritis)

Through inactivating 60S, stopping protein synthesis

120
Q

E. Coli Virulence Factors:

Name the disease caused by….

Heat-stable/labile enterotoxins

A

Watery diarrhea (Gastroenteritis)

Through fluid and electrolyte secretion

“Lose water in the heat”

121
Q

E. Coli Virulence Factors:

Name the disease caused by….

P fimbriae/pili

A

UTI

Through adhesion to urothelium

“P for pee”

122
Q

Desquamative illness + hypotension + multisystem dysfunction caused by Staph aureus

A

Toxic Shock Syndrome

123
Q

What is the immune cascade that causes Toxic Shock Syndrome

A 
Superantigens interact with MHC on APC and variable region on T cell >
Widespread T cell activation >
IL-2 release > 
Macros > IL-1 + TNF >
Immune cascade continues
124
Q

Gram + anaerobic spore forming bacillus that releases toxin by autolysis

A

Clostridium botulinum

125
Q

Used as rx for focal dystonia, achalasia, spams

A

Botulinum toxin

126
Q

Gram + bacillus found in soil that causes gas gangrene and gastroenteritis

A

Clostridium perfringens

127
Q

What is the MOA of Staph aureus’ Protein A?

A

Binds Fc of IgG, preventing complement activation

Found on cell wall

128
Q

Non motile, non lactose fermenting, oxidase - gram - rod that does not produce H2S on triple sugar iron agar

A

Shigella

129
Q

Invades M cells

A

Shigella

130
Q

Escapes phagolysosome and spreads via actin polymerase

A

Shigella

131
Q

Only fungus with polysacharide capsule

A

Cryptococcus

This makes it stain red with mucicarmine, clear with unstained zone on India ink

132
Q

What is the transmission of Campylobacter and common vectors?

A

Fecal oral, from

Domestic animals: cattle, sheep, chickens, dogs

Contaminated food: poultry, milk

133
Q

On what agar is Cryptococcus cultured?

A

Sabouraud’s

134
Q

What stains are good for Cryptococcus on CSF? Or tissue?

A

CSF: India ink and latex agglutination
Tissue: Methenamine silver (GMS), Mucicarmine

135
Q

Viral cause of:

  • Hemorrhagic cystitis in children
  • Tonsilitis
  • Conjunctivitis
A

Adenovirus

136
Q

What is the vector for Schistosomiasis?

A

Freshwater snail (not found in US)

137
Q

What type of schistosomiasis does S. hematobium cause?

A

Urinary

  • Hematuria, dysuria
  • Hydropherosis, pyelonephrosis, SCC bladder
138
Q

What type of schistosomiasis does S. mansoni cause?

A

Intestinal: diarrhea, ab. pain, iron def. anemia
&
Hepatic: HSM, periportal “pipestem” fibrosis, portal HTN

139
Q

What type of schistosomiasis does S. japonicum cause?

A

Intestinal: diarrhea, ab. pain, iron def. anemia
&
Hepatic: HSM, periportal “pipestem” fibrosis, portal HTN

140
Q

What is the MOA of Zidovudine aka AZT?

A

NRTI

Binds reverse transcriptase and is integrated into genome
Doesn’t have 3’ - OH, so can’t make 3-5’ phosphodiester bond

141
Q

What are two antibiotics that are paired with another drug to prevent renal secretion?

A

Imipenem/Cilastatin

Penecillin/Probenecid

142
Q

What is the Rx for HCV and CMV?

A

Ribavarin

143
Q

What are the causes of Impetigo?

A

Staph aureus & GAS (pyogenes, viridans, pneumo)

144
Q

What viruses use host DNA + RNA polymerases to replicate in the nucleus?

A

Papovaviruses (Papilloma, polyoma)

145
Q

HBV Protein Sequences

Nucleocapsid core protein that assembles virion

A

HBcAg

146
Q

HBV Protein Sequences

Core + precore, assembles + secretes, indicates infectivity

A

HBeAg

147
Q

HBV Protein Sequences

Non-infectious envelope glycoprotein
Spheres + tubules in structure
Huge quantity secreted

A

HBsAg

148
Q

HBV Protein Sequences

Uses reverse transcriptase to replicate genome

A

DNA polymerase

149
Q

HBV Protein Sequences

Transcription transactivator necessary for replication
De-regulation of hepatocyte replication
Causes HCC

A

HBx

150
Q

Hepatitis transmission:

HAV

A

Fecal oral

151
Q

Hepatitis transmission:

HBV

A

Sex >

Drugs, blood transfusion

152
Q

Hepatitis transmission:

HCV

A

Drugs (IV)

153
Q

Hepatitis transmission:

fecal oral

A

HAV

154
Q

Hepatitis transmission:

Sex

A

HBV

155
Q

Hepatitis transmission:

Drugs

A

HCV > HBV

156
Q

Bloody Diarrhea is caused by…

A

SECSEY

Salmonella
Ecoli (invasive)
Campylobacter
Shigella
Entamoeba
Yersinia
157
Q

Watery Diarrhea is caused by…

A

Vibrio
Ecoli (toxogenic)
B cereus
Staph aureus

Giardia
Cryptosporidium
Cylcospora
Microsporidia

158
Q

Name the pathogen:

Paroxysmal cough
Toxin that converts ATP > cAMP, disturbing cell signalling and preventing neutrophil chemotaxis
Increased lymphos in circ, but not clearing infection

A

Bordatella Pertussis

159
Q

Non-lactose fermenting oxidase (-) organism with capsule that prevents opsonization

Common cause of what in Sickle Disease?

A

Osteomyelitis

Salmonella

160
Q

Main cause of acute airway obstruction in infants

A

RSV causing viral bronciolitis

Rx: Ribavarin

161
Q

What is a toxin that cleaves IgA at the hinge region, thereby increasing mucosal adhesion and penetration?

A

IgA protease

162
Q

What organisms have IgA protease?

A

N gonorrhea
N meningitidis
Strep pneumo
H flu

163
Q

What organism is the cause of malignant otitis externa?

A

Pseudomonas: non-lactose fermenting Gram - ox + rod

- Ear pain and granulation tissue in ear canal

164
Q

What is the mechanism of drug resistance in E coli?

A

Acquired plasmid R via conjugation

165
Q

What receptors mediate HIV entry?

A

CD4

CCR5 chemokine co-receptor

166
Q

What accounts for the variability of HCV (quasi species)?

A

No 3-5 exonuclease, so no proofreading

Leads to genetic variability

167
Q

Strep pyogenes virulence factors:

Stops phagocytosis + complement

A

Protein M (Major!)

168
Q

Strep pyogenes virulence factors:

lyses RBCs (beta hemolysis) + PMNs

A

Streptolysin O

169
Q

Strep pyogenes virulence factors:

depolymerizes DNA in pus, dissolves PMNs, allows spread

A

DNAse

170
Q

Strep pyogenes virulence factors:

Plasminogen > plamin > decreased fibrin, allows spread

A

Streptokinase

171
Q

Strep pyogenes virulence factors:

Capsular antigen, antiphagocytic

A

Hyaluronate

172
Q

Selective medium, chocolate agar + vanco, polymixin, nystatin, and TMP, grows…

A

Neisseria Meningitidis

Thayer Martin medium

173
Q

Strep pneumo, N meningitidis, and H flu all have vaccines directed against…

A

Capsular polysaccharides

174
Q

Influenza vaccine is a killed vax against….

A

HA: hemagluttinin

175
Q

What bacteria causes chronic infection in CF patients because of its biofilm in the LRT?

A

Pseudomonas

  • Has tolerance to antibiotics
  • Decreased phagocytosis
176
Q

Mycobacterium that prefers cool temps

Stocking glove distribution of loss of sensation

A

Mycobacterium leprae

177
Q

What type of cancer does EBV cause?

A

Nasopharyngeal carcinoma

178
Q

Inhibits cell wall synthesis by inhibiting B-glucan carbohydrates

A

Caspofungin

UWorld (15 decks)

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