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STEP1 2015 > Micro > Flashcards

Micro Flashcards

1
Q

Test for capsule on bacteria

A

Quellung leads to swelling if there is a capsule

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2
Q

Even Some Pretty Nasty Killers Have Shiny Bodies

Also SHiN

A 
encapsulated bacteria
E.Coli
Strep pneumoniae
Pseudomonas aeruginosa
Neisseria meningitidis
Klebsiella pneumoniae
Haemophilus influenza type B
Salmonella typhi
Group B Streptoccocus
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3
Q

SHiN organisms

A

These are unique in ability to undergo transformation, or DNA- uptake from lysed bacteria. Also they are all encapsulated and have vaccines available that you should give to asplenics

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4
Q

Mycoplasma- unique membrane

A

sterols, no cell wall (abx often target cell wall so this is a challenge)

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5
Q

Mycobacteria- unique outer layer

A

mycolic acid in membrane, rish in lipis so resistant to gram stain and resilient in many environments

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6
Q

bacteria that can form spores (dipicolinic acid core) when resources are limited. highly resistant to heat, cold, disinfectants, lack of nutrients

A

bacillus and clostridium

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7
Q

bacillus anthracis

A

anthrax

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8
Q

bacillus cereus

A

food poisoning

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9
Q

c. botulinum

A

botulism

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10
Q

c. diff

A

antibiotic- associated colitis

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11
Q

c. perfringens

A

gas gangrene

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12
Q

c. tetani

A

tetanus

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13
Q

coxiella burnetii

A

q fever

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14
Q

giemsa stain

A 
chlamydia
borrelia
rickettsia
trypanosomes
plasmodium

and histoplasma
certain bugs really try my patience

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15
Q

PAS

A

stains glycogen, mucopolysccharides, used to fiagnose Whipple disease (tropheryma whipplei), PASs the sugar

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16
Q

Ziehl- Neelson (carbol fuschin)

A

acid- fast bacteria (nocardia, mycobacteria), protozoa (cryptospordium oocysts)

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17
Q

India ink

A

for fungus. cryptococcus neoformans (mucicarmine can also be used to stain thick polysaccharide capsule red)

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18
Q

silver stain

A

fungi (pneumocystis, such as PCP which is pneumocystis jirovecii), legionella, helicobacter pylori

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19
Q

organisms that do not gram stain well: These Microbes May Lack Real Color

A

Treponema (too thin, dark- field microscopy and fluorescent antibody staining instead), mycobacteria (high lipid content, mycolic acids in cell wall detected by carbolfuchsin in acid- fast stain), mycoplasma (no cell wall), legionella (silver stain instead, primarily intracellular), rickettsia (intracellular parasite), chlamydia (intracellular parasite; lacks classic peptidoglycan because of low muramic acid)

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20
Q

lipopolysaccharide endotoxin in outer membrane of gram negative bacteria, released upon cell lysis

A 
ENDOTOXIN
edema
nitric oxide
DIC/Death
Outer membrane
TNFa
O- antigen
eXtremely heat stable
IL1
Neutrophil chemotaxis
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21
Q

Hemolytic uremic syndrome

A

subsequent to Enterohemorrhagic E. Coli O157:H7 EHEC, which causes bloody diarrhea and damage to renal and endothelial cells

Syndrome= hemolytic anemia, thrombocytopenia, acute renal failure

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22
Q

enterotoxigenic E. coli

A

heat- labile (LT), overactive adenylate cyclase leads to increased cAMP and subsequent chloride secretion into gut, H2O efflux.
heat stable toxin (ST), overactivates cGMP, leading to decreased resoprtion of NaCl and H2O in the gut.

Watery diarrhea either way “labile in the air (adenylate cyclase), stable on the ground (guanylate cyclase)”

aka montezuma’s revenge, jelly belly, traveler’s diarrhea

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23
Q

Bacillus anthracis exotoxin

A

anthrax toxin: edema factor (adenylyl cyclase; causes edema), lethal factor, protective antigen

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24
Q

yersinia enterocolitis

A

heat- stable toxin activates guanylyl cyclase, increased cGMP, pseudoappendicitis

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25
Q

vibrio cholerae

A

choleragen (cholera toxin) stimulates adenylyl cyclase, increasing cAMP, chloride and water cross into lumen of intestine –> “rice water stools”

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26
Q

Jones criteria for RF which is a type 3 hypersensitivity reaction

A 
Joint arthalgia
pancarditis
nodules
erythema marginatum
sydenham chorea
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27
Q

organisms associated with subacute endocarditis

A 
viridans
s bovis
enterococci
coag negative staph
HACEK (haemophilus aphrophilus, actinobacillus actinomycetan comitans, cardiobacterium hominis, eikenella corrodens, kingella kingae)
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28
Q

obligate anaerobes

A

fusobacterium
clostridium
bacteroides
actinomyces
frankly can’t breathe air
suseptible to ROS since they lack catalase and SOD. smelly, difficult to culture, gas producint.
ABX: metronidazole, clindamycin, NOT aminoglycosides

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29
Q

Waterhouse Friederichson Syndrome of N. meningitidis

A

sepsis, adrenal hemorrhage, DIC

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30
Q

5 yr old with pharyngitis, drooling, xray shows thumbprint sign

A

Haemophilus influenzae type B

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31
Q

Burn wound infection

A

pseudomonas aeruginosa

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32
Q

life- threatening meningitis + purpura

A

n. meningitidis

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33
Q

septic arthritis in young, sexually active patients

A

n. gonorrhoeae

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34
Q

infections associated with animal urie

A

leptospira

hantavirus

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35
Q

maculopapular rash on hands and feet

drive kawasaki cars with your hands and feet

A

Kawasaki
Coxsackie A
Rocky mountain spotted fever
Secondary Syphilis

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36
Q

False positive results on VDRL

A 
VDRL:
viruses (EBV)
drugs 
Rheumatic fever
lupus/ leprosy/other autoimmune
pregnancy
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37
Q

Bartonella spp

A

cat scratch disease, with lymphadenopathy proximal to the scratch site, and bacillary angiomatosis that looks like Kaposi in immunocompromised patients

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38
Q

borrelia burgdorferi

A

Lyme disease:

rodents to humans via ixodes scapularis

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39
Q

borrelia recurrentis

A

pathogensis due to varying surface antigens: relapsing fever

transmitted from rodents and lice

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40
Q

brucella spp

A

brucellosis: cattle, sheep, goats, unpasteurized dairy products

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41
Q

campylobacter

A

diarrhea from birds, pigs

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42
Q

chlamydophila psittaci

A

fever, dry cough, birds (parrots)

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43
Q

coxiella burnetti

A

Q fever: flu-like symptoms, fever for several weeks, transmitted by aerosols from infected placenta or contaminated fluid on coats of newborn farm animals

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44
Q

Ehrlichia chaffeensis

A

headaches, muscle aches, fatigue known as ehrlichiosis. transmitted by the lone star tick

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45
Q

francisella tularensis

A

tularemia- rabbit, squirrel, tick, high risk for use in bioterrorism

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46
Q

mycobacterium leprae

A

armadillo

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47
Q

pasteurella multocida

A

introduced into wounds from cat or dog bite leading to cellulitis, osteomyelitis

48
Q

rickettsia prowazeckii

A

epidemic typhus (lice)

49
Q

rickettsia typhi

A

endemic (murine) typhus (fleas)

50
Q

rickettsia rickettsii

A

RMSF, tickborn illness, fever, headache, rash on palms and soles

51
Q

yersinia peptis

A

bubonic plague, fleas, prairie dogs

52
Q

inactivates EF2

A

corynebacterium diphteriae, pseudomonas (exotoxin A)

53
Q

activates Gs

A

vibrio cholerae, e. coli (ETEC heat- labile toxin)

54
Q

disables Gi

A

pertussis toxin

55
Q

bacterial adenylate cyclase (no G protein involved)

A

bacillus anthracis

56
Q

blocks GABA and glycine

A

c. tetani

57
Q

passive immunity is possible

A

tetanus toxin, botulinum toxin, HBV, Varicella, rabies come as preformed antibodies (To Be Healed Very Rapidly)

58
Q

Attenuated live virus vaccines: Attention! Please Vaccinate Young Infants with MMR Regularly

A 
Attenuated virus vaccines
Polio vaccine (Sabin, oral)
Varicella
Yellow fever
Intranasal influenza
MMR
Rotavirus

Attention! Please Vaccinate Young Infants with MMR Regularly

59
Q

vaccines that can be given to HIV patients with CD4> 200

A

MMR, varicella, yellow fever as long as the patient has a CD4> 200

60
Q

inactivated or killed vaccine

A

rabies, influenza (injection), polio (Salk), hepatitis A (RIP Always)

61
Q

Egg- based vaccines

A

influenza, yellow fever vaccines

62
Q

Anti- IgG antibodies

A

RA

63
Q

Anti- citrullinated protein antibodies (ACPA)

A

RA

64
Q

Antinuclear antibodies (ANA)

A

SLE

65
Q

Anti- Smith

A

SLE

66
Q

Anti- dsDNA

A

lupus renal disease

67
Q

Anti- histone

A

Drug- induced lupus

68
Q

Anti- centromere

A

CREST scleroderma

69
Q

Anti- scl-70

A

diffuse scleroderma

70
Q

anti- jo-1

A

polymyositis, dermatomyositis

71
Q

Anti- SSA (anti-Ro)

A

Sjogren syndrome

72
Q

Anti- SSB (anti- La)

A

Sjogren syndrome

73
Q

Anti- U1- RNP

A

Mixed connective tissue disease

74
Q

Anti- desmoglein

A

pemphigus vulgaris

75
Q

Anti- acetylcholine receptor

A

myasthenia gravis

76
Q

Anti- endomysial (anti- tissue transglutaminase)

A

celiac disease

77
Q

anti-gliadin

A

celiac disease

78
Q

anti- mitochondrial

A

primary biliary cirrhosis

79
Q

anti- smooth muscle

A

autoimmune hepatitis

80
Q

anti- glutamate decarboxylase

A

type 1 DM

81
Q

anti- thyrotropin receptor

A

Graves disease, binds TSH receptor

82
Q

Anti- thyroid peroxidase (anti- TPO)

A

Hashimoto thyroiditis

83
Q

Anti- thyroglobulin

A

Hashimoto thyroiditis, Graves disease

84
Q

Anti- basement membrane

A

Goodpasture disease

85
Q

c- ANCA

A

Wegener (granulomatosis with polyangiitis), affecting kidney and lungs

86
Q

p-ANCA

A

Churg- Struass, microscopic polyangiitis, pauci- immune crescentic GN

87
Q

What makes coxiella burnetti different from other rickettsial organisms

A 
negative Weil- Felix test
no vector
transmitted by aerosolized droplets
endospore
does not cause rash; causes interstital PNA
88
Q

obligate intracellular bacteria

A

rickettsia
coxialle
chlamydia

89
Q

proteus vulgaris renal stones

A

ammonium magnesium phosphate stone

staghorn calculus

90
Q

causes cervical lymphadenitis in children

A

mycobacterium scrofulaceum

91
Q

causes disseminated disease in AIDS patients

A

mycobacterium avium intracellulare (MAI)

mycobacterium avium complex (MAC)

92
Q

causes pulmonary TB- like symptoms in COPD patients

A

mycobacterium kansasii

93
Q

obligate aerobes:nagging pests must breath

A

nocardia
pseudomonas
mycobacterium tb
bacillus

94
Q

small intestinal mucosa laden with distended macrophages in the lamina propria

A

Whipple disease

95
Q

defect in chylomicron exportation

A

abetalipoproteinemia

96
Q

crampling associated with milk products

A

lactase deficiency

97
Q

chlamydia trachomatis types A, B, C

A

trachoma eye infections mainly in Africa

98
Q

Chlamydia trachomatis types D through K

A

STDs and PID, also neonatal conjunctivitis, urethritis

99
Q

Chlamydia trachomatis types L1, L2, L3

A

lymphogranuloma venereum, looks like IBD with primary ulcer and then lymphadenopathy of the inguinal nodes

100
Q

Chlamidophila psittaci

A

PNA in patients who are exposed to birds

101
Q

Chlamidophila pneumoniae

A

walking PNA

102
Q

treatment for most chlamydia and chlamydophila

A

macrolides or tetracyclines

103
Q

What can cause acute pancreatitis

A

autodigestion of pancreas by pancreatic enzymes
PANCREATITIS

hyperParathyroidism (increased calcium)
Alcohol 
Neoplasm (blocks the ducts)
Cholelithiasis (gallstones!)
Rx (drugs)
ERCP (reverse flow through pancreatic ducts)
Abdominal surgert
hyperTriglyceridemia
Infection (mumps)
Trauma
Idiopathic
Scorpion sting
104
Q

Chronic pancreatitis

A

chronic inflammation, atrophy, calcification of the pancreas p.376

105
Q

Pancreatic adenocarcinoma

tumor markers, risk factors, presentation- Trousseau

A

average surgical of about 1 year after diagnosis, very aggressive tumor arising from pancreatic ducts
CA19-9 and CEA tumor markers

RF:tobacco use, chronic pancreatitis >20yrs, dm, age>50, Jewish, black

trousseau syndrome:
hypercoagulability, venous thrombosis, mogratory thrombophlebitis

other sx: abd pain radiating to back, weighloss, malabsorption, anorexia

Treat with Whipple, chemo, rads

106
Q

chorioretinitis+hydrocephalus+intracranial calcifications

A

toxoplasma gondii

107
Q

hydrops fetalis (fluid accumulations in the body such as ascites, pleural effusion)

A

Parvovirus B19

108
Q

PDA+cataracts+deafness

+/- blueberry muffin rash

A

congenital rubella

109
Q

saddle nose, snuffles, Hutchinson teeth, saber shins

A

late manifestations of congenital syphilis

110
Q

hepatomegaly, sniffles, skeletal abnormalities, desquamating hands and feet

A

early manifestations of congenital syphilia

111
Q

recurrent infections, chronic diarrhea

A

SCID, congenital HIV

112
Q

encephalitis, herpetic skin lesions, meningoencephalitis, sepsis- like picture if disseminated

A

HSV2

113
Q

sensorineural hearing loss, seizures, petechial rash, blueberry muffin rash, periventricular calcifications

A

CMV

114
Q

what toxins are associated with GAS

A
  1. streptolysin O
    -hemolysis on blood agar plates
    -oxygen labile
  2. Streptolysin S
    -oxygen stable
  3. Streptococcal pyrogenic exotoxins A, B, C
    -erythrogenic toxins (superantigens), scarlet fever, also
    leading to toxic shock syndrome
115
Q

bloody diarrhea, hemolytic anemia, thrombocytopenia, acute renal failure

A

hemolytic uremic syndrome

STEP1 2015 (30 decks)

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