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Unit 4 JG > Micro > Flashcards

Micro Flashcards

1
Q

systemic mycoses: (coccidioides/histoplasma/blastomyces/paracoccidioides) thermally dimorphic (mold-spherule), endemic to US southwest, mold grows in wet weather

A

coccidioides

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2
Q

systemic mycoses: (coccidioides/histoplasma/blastomyces/paracoccidioides) thermally dimorphic (mold-multibud yeast), endemic to rural Latin America

A

paracoccidioides

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3
Q

systemic mycoses: (coccidioides/histoplasma/blastomyces/paracoccidioides) thermally dimorphic (mold-yeast), endemic to eastern US

A

blastomyces

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4
Q

systemic mycoses: (coccidioides/histoplasma/blastomyces/paracoccidioides) thermally dimorphic (mold-yeast), endemic to Ohio, Missouri, Mississippi river valleys, soil-based

A

histoplasma (infectious microconidia can be kicked up by construction projects)

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5
Q

systemic mycoses: (coccidioides/histoplasma/blastomyces/paracoccidioides) releases infectious arthrospores in dry weather, spores are inhaled then they change form

A

coccidiodes

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6
Q

systemic mycoses: (coccidioides/histoplasma/blastomyces/paracoccidioides) 60% Mild: asymptomatic or flulike clearance by innate or containment by CMI, moderate: valley fever/ desert rheumatism: pulmonary+EN, severe: major pneumonia or dissemination (either bare or in macrophages).

A

coccidioides

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7
Q

systemic mycoses: (coccidioides/histoplasma/blastomyces/paracoccidioides) Risk factors: age, race, pregnancy, immunocompromise, occupational high exposure. Diagnose by exam, history, PPD, biopsy for spherules, culture for dimorphism, serology for dissemination.

A

coccidioides

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8
Q

systemic mycoses: (coccidioides/histoplasma/blastomyces/paracoccidioides) Treat if predisposed to complications (oral azoles), meningitis (fluconazole), pregnant or disseminated (Amphotericin B).

A

coccidioides

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9
Q

systemic mycoses: (coccidioides/histoplasma/blastomyces/paracoccidioides) causes pulmonary symptoms, previously-healthy usually clear or contain in granulomas, higher-dose infection produces TB mimic, CMI-deficient host disseminates in macrophages (yeast survive lysosomal fusion)

A

histoplasma

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10
Q

systemic mycoses: (coccidioides/histoplasma/blastomyces/paracoccidioides) look for pancytopenia and ulcerations on tongue. Also for diagnosis: history (birds, bats, endemic area, immunocompromised, occupation), biopsy for yeast in macrophages, cultures for dimorphism, ELISA for antigen.

A

histoplasma

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11
Q

systemic mycoses: (coccidioides/histoplasma/blastomyces/paracoccidioides) Treat serious lung w/ itraconazole, meningitis w/ fluconazole, disseminated w/ Amphotericin B.

A

histoplasma

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12
Q

systemic mycoses: (coccidioides/histoplasma/blastomyces/paracoccidioides) Innate immunity clears most cases, destroys conidia easily, yeasts are harder to kill (BAD1), graulomatous response contains most, immunosuppression predisposes to hematogenous spread.

A

blastomyces

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13
Q

systemic mycoses: (coccidioides/histoplasma/blastomyces/paracoccidioides) Moderate acute: pneumonia w/ purulent sputum, Moderate chronic: mimics TB, Severe acute: ARDS. May include EN or ulcerating skin lesions.

A

blastomyces

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14
Q

systemic mycoses: (coccidioides/histoplasma/blastomyces/paracoccidioides) Diagnose by sputum microscopy for yeast, culture for hyphae w/ pear-shaped conidia, biopsy for yeast w/ supperating (not caseating) granulomas. Treat w/ itraconazole, fluconazole if meningitis, Amphotericin B if severe.

A

blastomyces

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15
Q

systemic mycoses: (coccidioides/histoplasma/blastomyces/paracoccidioides) severe in children/immunocompromised, moderate in adults, usually men in agriculture or construction. Adult form has very long latency, skin&mucous lesions.

A

paracoccidioides

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16
Q

systemic mycoses: (coccidioides/histoplasma/blastomyces/paracoccidioides) Diagnose by pus or tissue KOH mount for yeast with multiple buds, culture. Treat w/ itraconazole, Amphotericin B if severe, combine with healthier lifestyle (semi-opportunistic).

A

paracoccidioides

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17
Q

opportunistic fungi: (fusarium/mucormycosis/cryptococcosis/aspergillosis) is widespread environmental, enabled by reduced CMI, suppresses host inflammatory response. Infection originates in lung but usually either clears or progresses to meningitis.

A

cryptococcosis

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18
Q

opportunistic fungi: (fusarium/mucormycosis/cryptococcosis/aspergillosis) . Patient presents late in disease with meningitis and skin nodules or pulmonary symptoms. Diagnose by biopsy, CSF, crag. Treat with combinations of azoles and Amphotericin B.

A

cryptococcosis

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19
Q

opportunistic fungi: (fusarium/mucormycosis/cryptococcosis/aspergillosis) presents as ABPA, aspergilloma, CNPA, or Invasive.

A

aspergillosis

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20
Q

opportunistic fungi: (fusarium/mucormycosis/cryptococcosis/aspergillosis) caused by Rhizopus is a very rare deadly invasive vasculitis by environmental mold, causes infarction, invades brain from sinuses.

A

mucormycosis (also caused by mucor)

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21
Q

opportunistic fungi: (fusarium/mucormycosis/cryptococcosis/aspergillosis) Predisposition by uncontrolled diabetes, iron overload, immunosuppression.

A

mucormycosis

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22
Q

opportunistic fungi: (fusarium/mucormycosis/cryptococcosis/aspergillosis) Diagnose by biopsy for histo, treat with amphotericin B and aggressive surgical removal of diseased tissue, prognosis poor.

A

mucormycosis

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23
Q

opportunistic fungi: (ABPA/aspergilloma/CNPA/Invasive) hypersensitivity rxn to infection complicating asthma or CF, diagnose on exam, tx with itraconazole, sinus surgery, Xolair

A

ABPA

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24
Q

opportunistic fungi: (ABPA/aspergilloma/CNPA/Invasive) colonizing aspergillosis, fungus ball complicating cavitary lung dz, diagnose by air crescent on scan, treat with itraconazole or surgery

A

aspergilloma

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25
Q

opportunistic fungi: (ABPA/aspergilloma/CNPA/Invasive) presents as respiratory distress with history of profound immunosuppression, diagnose by halo sign on scan, needle or tissue biopsy for histo

A

invasive

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26
Q

opportunistic fungi: (ABPA/aspergilloma/CNPA/Invasive) mimics TB; try to diagnose by air crescent on scan, needle-aspirate lung fluid for microscopy

A

CNPA

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27
Q

opportunistic fungi: Treat (ABPA/aspergilloma/CNPA/Invasive) (2) with voriconazole+AmphotericinB, but prognosis is poor.

A

CNPA and invasive

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28
Q

opportunistic fungi: (fusarium/mucormycosis/cryptococcosis/aspergillosis) a ubiquitous environmental mold, infection is rare overall but frequently fatal in predisposed population.

A

fusarium

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29
Q

opportunistic fungi: (fusarium/mucormycosis/cryptococcosis/aspergillosis) May cause mycotoxicosis (contaminated grain), local infection (burns, prosthetic implants, contaminated contact lens solution), or deadly disseminated infection (prolonged neutropenia, HSCT recipients).

A

fusarium

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30
Q

opportunistic fungi: (fusarium/mucormycosis/cryptococcosis/aspergillosis) Diagnose by blood culture, histo, treat aggressively with surgery, amphotericin B, voriconazole, prognosis poor.

A

fusarium

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31
Q

opportunistic fungi: (fusarium/mucormycosis/cryptococcosis/aspergillosis) Enters from sinus or wound site, circulates in blood, symptoms in skin, eye, lung.

A

fusarium

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32
Q

TB: how does transmission occur

A

inhalation (then to elsewhere by hematogenous spread, to GI by swallowing infected sputum)

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33
Q

TB: Hematogenous spread by intracellular infection of naive macrophages; activated ones clear it, (CD4/CD8) cells kill infected macrophages and establish caseating granulomas in which infection is contained.

A

CD8

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34
Q

TB: what factor is important for containment

A

TNF alpha

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35
Q

TB: (classic pulmonary/extrapulmonary/pediatric) scrofula (fine needle aspirate), genitourinary (intravenous urography, urine culture), CNS (MRI, spinal tap), skeletal (MRI, joint fluid culture), GI (Xray, CT of abdomen), miliary (chest Xray w/ bright spotlight, lateral Xray, chest CT)

A

extrapulmonary

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36
Q

TB: (classic pulmonary/extrapulmonary/pediatric) must have been recently acquired (trace source), watch for miliary&meningitis, culture from gastric lavage

A

pediatric

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37
Q

TB: (classic pulmonary/extrapulmonary/pediatric) (75%): cough, weight loss (“consumption”), fever, night sweats, hemoptysis, and chest pain, check sputum and chest Xray

A

classic pulmonary

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38
Q

Determine _____ (disease) exposure by TST and/or IGRA, perform antibiotic resistance testing as soon as cultures grow (~2wks for cultures, another 3wks for resistance tests)

A

TB

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39
Q

BCG vaccine (live attenuated M. bovis) is used abroad for ___ (disease), not cost-effective here, can create weak-moderate false positive TST.

A

TB

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40
Q

Atypical mycobacterial infection in an immuno (compromised/competent) adult is usually cutaneous; scrofula in children

A

competent

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41
Q

____ (disease) has no in vitro culture system, slowest growing human pathogen, prefers 30C to 37C

A

M leprae

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42
Q

____ (disease) has an extremely long incubation period, doesn’t transmit easily, only 5-10% of humans believed susceptible to disease

A

M leprae

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43
Q

_____ (disease) presents on a range from Tuberculoid (paucibacillary, vigorous CMI both contains infection and damages nerves, PPD+) to Lepromatous (multibacillary, weak CMI, extensive cutaneous symptoms, PPD-)

A

Hansen’s Disease (leprosy)

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44
Q

Hansen’s: (tuberculoid/lepromatous) easily tested by skin smear, biopsy, molecular probe, serology

A

lepromatous

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45
Q

Hansen’s: (tuberculoid/lepromatous) may be detected by biopsy or serology but sensitivity is low – physical exam, history, &PPD

A

tuberculoid

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46
Q

Lepromin PPD tests anti-leprosy (immunocompetence/exposure)

A

immunocompetence!

47
Q

_____ (disease) treatment is 2 years of dapsone and rifampin

A

M leprae

48
Q

(tuberculoid/lepromatous) patients when treated may develop erythema nodosum; severe cases can require immunomodulant treatment like thalidomide (teratogen!)

A

lepromatous

49
Q

Pseudomonas: (aeruginosa/B cepacia/B pseudomallei/B mallei) rare in US but can be lethal (2)

A

B pseudomallei and B mallei

50
Q

Pseudomonas: (aeruginosa/B cepacia/B pseudomallei/B mallei) a common and serious nosocomial pathogen

A

aeruginosa

51
Q

Pseudomonas: (aeruginosa/B cepacia/B pseudomallei/B mallei) common, serious in context of CF

A

B cepacia

52
Q

Pseudomonas: Gram (-/+), strict (anaerobes/aerobes)

A

gram - aerobes

53
Q

Pseudomonas: oxidase (-/+), nonfermenters, grow easily in culture

A

oxidase +

54
Q

Pseudomonas: (aeruginosa/B cepacia/B pseudomallei/B mallei) produces green pyocyanin in culture, extreme antibiotic resistance

A

aeruginosa (all have antibiotic resistance, from combo of low permeability outer membrane and efflux pumps)

55
Q

Pseudomonas: (aeruginosa/B cepacia/B pseudomallei/B mallei) have minimal growth requirements –> contaminate hospital solutions (2)

A

P aeruginosa and B cepacia

56
Q

Pseudomonas: (aeruginosa/B cepacia/B pseudomallei/B mallei) has a few community-acquired presentations: endocarditis in IV drug addicts, Otitis externa in underchlorinated hot tubs, Osteochondritis in sneaker punctures, corneal infections under contact lenses

A

aeruginosa

57
Q

Pseudomonas: (aeruginosa/B cepacia/B pseudomallei/B mallei) MC presents in hospitals

A

aeruginosa

58
Q

Pseudomonas: (aeruginosa/B cepacia/B pseudomallei/B mallei) MC presents in CF centers

A

B cepacia

59
Q

Pseudomonas: (aeruginosa/B cepacia/B pseudomallei/B mallei) presents in previously-ill travelers/immigrants or Vietnam veterans

A

B pseudomallei

60
Q

Pseudomonas: (aeruginosa/B cepacia/B pseudomallei/B mallei) presents in previously-ill travelers/immigrants with animal handling history.

A

B mallei

61
Q

Pseudomonas: two ways to make the diagnosis

A

culture and gram stain

62
Q

Pseudomonas: treat with antibiotics, test ____ sensitivity both before and during treatment

A

antibiotic

63
Q

Chlamydia: small, (intra/extra) cellular bacterium

A

intra (must use drugs that penetrate the human cell membrane)

64
Q

Chlamydia: replicate in a unique manner beginning with tiny, infectious, rugged, (reticulate/elementary) bodies which “unpack” into (elementary/reticulate) bodies after infection.

A

replicate in a unique manner beginning with tiny, infectious, rugged, elementary bodies which “unpack” into reticulate bodies after infection.

65
Q

Chlamydia: (Elementary/Reticulate) bodies form intracellular inclusions that are visible on microscopy; within the inclusions they multiply by binary fission, forming new reticulate bodies and later new elementary bodies.

A

reticulate

66
Q

Chlamydia: known virulence factor

A

T3SS

67
Q

Chlamydia: what complicates research

A

unusual life cycle

68
Q

C. pneumoniae, C. psittaci, and C. trachomatis can all cause ______ (disease)

A

PNA

69
Q

Chlamydia: treat with _____ except pregnant/pediatric/allergic patients, who get erythromycin

A

tetracyclines (doxy)

70
Q

Bacterial PNA: (C burnetti/mycoplasma/legionella) Opportunistic facultative intracellular pathogen with variable infection outcome, exposure is from aspiration or inhalation of contaminated water

A

legionella

71
Q

Bacterial PNA: (C burnetti/mycoplasma/legionella) survives endocytosis by monocytes&macrophages by altering endosomes so that it can multiply in them and then escape

A

legionella

72
Q

Bacterial PNA: (C burnetti/mycoplasma/legionella) disease outbreaks trace back to contaminated locations, NOT people

A

legionella

73
Q

Bacterial PNA: (C burnetti/mycoplasma/legionella) Optimal diagnosis is by BOTH urine antigen test and culture of respiratory secretions (fastidious, special media required)

A

legionella

74
Q

Bacterial PNA: (C burnetti/mycoplasma/legionella) For geriatric community-acquired pneumonias in general, take samples for culture/ELISA first, start treatment w/ levofloxacin second, get labs back third

A

legionella

75
Q

Bacterial PNA: (C burnetti/mycoplasma/legionella) Outbreaks in healthcare are common: vulnerable individuals exposed to bad plumbing

A

legionella

76
Q

Bacterial PNA: (C burnetti/mycoplasma/legionella) is a small coccus to short rod, zoonotic infection from ruminants.

A

C burnetti

77
Q

Bacterial PNA: (C burnetti/mycoplasma/legionella) transmitted by aerosols, grows in alveolar monocyte/macrophages

A

C burnetti

78
Q

Bacterial PNA: (C burnetti/mycoplasma/legionella) survives endolysosomal fusion, extremely infectious, long-lived in environment

A

C burnetti

79
Q

Bacterial PNA: (C burnetti/mycoplasma/legionella) causes pneumonia+hepatitis = Q Fever.

A

C burnetti

80
Q

Bacterial PNA: (C burnetti/mycoplasma/legionella) Diagnose by immunohistochemistry, treat with tetracyclines or fluoroquinolones.

A

C burnetti

81
Q

Bacterial PNA: (C burnetti/mycoplasma/legionella) are unique among bacteria in lacking a cell wall and including cholesterol in their cell membrane.

A

mycoplasma

82
Q

Bacterial PNA: (C burnetti/mycoplasma/legionella) causes walking PNA, mild and self limited

A

mycoplasma

83
Q

Bacterial PNA: (C burnetti/mycoplasma/legionella) CARDS exotoxin-induced ciliostasis, local inflammation, local tissue destruction

A

mycoplasma

84
Q

Bacterial PNA: (C burnetti/mycoplasma/legionella) Immunopathology: antibodies against mycoplasma cross-react with red blood cells (cold agglutinins) → anemia during infection.

A

mycoplasma

85
Q

Bacterial PNA: (C burnetti/mycoplasma/legionella) Persistence through slow growth and intracellular hiding, treat with tetracyclines or macrolides

A

mycoplasma

86
Q

(Haemophlius/Bordetella/both) human restricted, fastidious in culture, require factors X and V in vitro.

A

both

87
Q

(Haemophlius/Bordetella/both) Transmitted by respiratory droplets, mostly-pediatric contagious respiratory infection, vaccines available, treat with antibiotics and supportive care

A

both

88
Q

(Haemophlius/Bordetella/both) Gram(-) pleomorphic – may appear as cocci, rods, mixture on microscopy.

A

Haemophlius

89
Q

Haemophlius: (encapsulated/unencapsulated) H. influenzae (Hib) are more pathogenic, covered by vaccination, cause lethal meningitis. Bacteremia quickly follows upper respiratory infection and underlies all invasive disease: meningitis, cellulitis, epiglottitis, septic arthritis

A

encapsulated

90
Q

Haemophlius: (encapsulated/unencapsulated) H. influenzae (NTHi) are less pathogenic but not covered by vaccination. May be normal flora. Cause neonatal and postpartum sepsis, CF pneumonia, systemic complications after untreated local mucosal infections, particularly with respiratory or immune predisposition.

A

unencapsulated (lack capsule but still have IgA protease, pili, adhesins)

91
Q

________ is a highly contagious short Gram(-) rod, incidence and mortality increasing because of inadequate vaccine coverage. Acellular vaccine used in US has shorter-lived protection than killed-cell, used abroad.

A

Bordetella pertussis

92
Q

_____ (disease): Filamentous hemagglutinin attaches, exotoxin causes ciliary stasis and death of ciliated cells → cough for contagion. No bacteremia, prognosis good.

A

pertussis (pertussis toxin)

93
Q

______ (disease) is prolonged (~3mo) even with drug treatment, dangerous with underlying conditions, leukocytosis on bloodwork.

A

whooping cough

94
Q

viruses: (coronavirus/influenza/paramyxovirus/adenovirus) +ssRNA, cold like symptoms, SARS, MERS

A

coronavirus

95
Q

viruses: 2 modes of transmission for viral respiratory infections

A

fomites, aerosol

96
Q

viruses: which cells in the body are the first site of virus/host interaction

A

epithelial cells

97
Q

viruses: rhinovirus replicate preferentially where?

A

upper respiratory tract (temperature difference!)

98
Q

viruses: (upper/lower) resp tract infections: parainfluenza, resp syncytial virus, influenza, adenovirus affecting the trachea, bronchi, bronchioles

A

lower

99
Q

viruses: (upper/lower) resp tract infections: rhino, corona, parainfluenza, resp syncytial, influenza, adeno, HSV, EBV

A

upper

100
Q

viruses: (acute infection with replication confined to resp mucosal surface/persistent replication on resp mucosal surface/systemic replication-dissemination): EBV, adenovirus, papillomavirus

A

persistent replication on respiratory mucosal surface

101
Q

viruses: (acute infection with replication confined to resp mucosal surface/persistent replication on resp mucosal surface/systemic replication-dissemination): paramyxovirus (mumps, measles), HSV, rubella, picornavirus (polio)

A

systemic replication/dissemination

102
Q

viruses: (acute infection with replication confined to resp mucosal surface/persistent replication on resp mucosal surface/systemic replication-dissemination): rhinovirus=picornavirus, coronavirus, paramyxovirus=parainfluenza and resp syncytial, orthomyxovirus=influenza

A

acute infection with replication confined to resp mucosal surface

103
Q

virus: what does myxo mean

A

mucus (Greek)–these viruses bind to mucin protein on RBCs

104
Q

virus: (orthomyxoviridae/paramyxoviridae): influenzavirus A, B, and C

A

ortho

105
Q

virus: (orthomyxoviridae/paramyxoviridae): nuclear replication

A

ortho

106
Q

virus: (orthomyxoviridae/paramyxoviridae): segmented genome, (-)ssRNA

A

ortho

107
Q

virus: (orthomyxoviridae/paramyxoviridae): enveloped

A

both! syke

108
Q

virus: (orthomyxoviridae/paramyxoviridae): mumps, measles, pneumovirus-resp syncytial virus

A

paramyxo

109
Q

virus: (orthomyxoviridae/paramyxoviridae): cytoplasmic replication, non segmented genome (-)ssRNA

A

paramyxo

110
Q

virus: parainfluenza virus + RSV =

A

Croup=laryngotracheobronchitis

111
Q

virus: peak incidence in winter, starts like a cold, infants with a barking cough, treat at home with steam

A

croup. complications: PNA, resp distress

112
Q

viruses: (coronavirus/influenza/paramyxovirus/adenovirus) most infections are asymptomatic, or involve the resp/GI tracts, eye. persists in lymphoid tissue

A

adenovirus

113
Q

virus: who gets the adenovirus vaccine

A

military personnel

Unit 4 JG (5 decks)

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