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1
Q

what do Lipid A (outer mem of g-) and Lipoteichoic acid (outer layer of g+ cell wall) induce?

A

both serve as major surface antigens and induced TNF and IL-1.

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2
Q

where are b-lactamases found?

A

Periplasmic space

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3
Q

define Glycocalyx

A

network of polysachharides that mediates adherence to surface, i.e. as a biofilm to cathether

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4
Q

G+ rods

A

Bacillus, Clostridium, Corynebacterium diptheria, Lactobacillus, Propionibacterium, Listeria, Mycobacterium

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5
Q

Camplyobacter classification

A

G- enteric

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6
Q

Giemsa stain organisms

A

Chlamydia, Rickettsia, Borrelia, Plasmodium. these are pleomorphic.

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7
Q

Chlamydia: high or low muramic acid?

A

low

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8
Q

carbol-fuchsin aka Ziehl-Neelsen stain

A

Acid fast: bacteria = Nocardia, Mycobacterium. protozoa = cryptosporidium.

auramine-rhodopsin is an alternative

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9
Q

silver stain organismis

A

PCP, Legionella, H Pylori

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10
Q

PAS

A

Whipples: Cardiac sx, Arthralgias, and Neuro sx + malabsorption. Foamy macrophages in intestinal LP.

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11
Q

describe Thayer-Martin agar

A 
Chocolate agar + antibiotics. 
AKA VPN (p =polymyxin). But we know it cantains Very Nice Chocolate Treats. 
Vanco (G+), 
Nystatin (fungi), 
Colistatin (G- except Neisseria), 
Trimethoprim .
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12
Q

Sabourad agar

A

Fungi. Sab is a fun guy!

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13
Q

Anaerobic bacteria lack___________and are susceptible to __________damage

A

lack Catalase/SOD. oxidative damage. they are foul smelling.

Clostridium, Actinomyces, Bacteroides, Fusobacterium.

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14
Q

________ ineffective against clostridium

A

Aminoglycosides are ineffective against Anaerobic organisms

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15
Q

keep nocardia and actinomyces 02 req straigth

A

nocardia: the air bellow even though inside. its Aerobe

actinomyces

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16
Q

how do conjugate vaccines enhance immunogenicity

A

Promote t cell activation and class switching

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17
Q

urease positive organisms (list)

A

Cryptococcus, H pylori, Proteus, Klebsiella, Straph epidermidis/saprophyticus, Nocardia!, Ureaplasma

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18
Q

Stones from organisms such as Crptococcus, Klebsiella, Nocardia

A

Urease + organisms cause struvite aka ammonium magneisum phosphate kidney stones –> staghorn calculi

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19
Q

people with recurrent catalase + infections (dont forget serratia)

A

Chronic granulomatous disease (NADPH oxidase deficiency)

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20
Q

f(x) of protein A (dont confuse with IgA protease)

A

expressed by staph aureus. binds Fc of IgG.

Prevents opsonization/complement/phagocytosis

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21
Q

organisms that express IgA protease

A

Strep pneumo, H flu, Neisseria –> helps to colonize respiratory mucosa (SHiN)

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22
Q

f(x) of M protein

A

prevent phagocytosis (strep pyo aka GAS)

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23
Q

Type 3 injectisome secretion system

A

Shigella, Salmonella, E coli, Pseudomonas

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24
Q

Exotoxin vs Endotoxin

A

Exo: polypeptide, secreted from cell, genes on plasmid/bacteriophage. low ID50 = highly fatal/toxic. Destroyed with heat.

Endo: polysachharadie, no secreted, released upon lysis, low toxicity, induces TNF, IL-1, IL6, can cause DIC, stable at 100 C heat.

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25
Q

extoxins that inhibit protein synthesis

A

Inactivate EF-2: Diptheria and Exotoxin A(PSEUDOmonas)

Inactivate 60S by removing adenine from rRNA = Shiga and Shiga-like toxin (EHEC)

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26
Q

difference btwn Shiga and Shiga-like toxin (E coli)

A

both inactivate protein synthesis by removing adenine from 60S rRNA. “60$ for A # 9 HUS burger”

EHEC does NOT invade host cells
Shigella DOES INVADE

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27
Q

whats does 60$ for A #9 HUS burger remind us of?

A

that shigella and shiga-like toxin remove adenine from the 60S ribosome (rRNA) = inhibit protein synthesis.

burgers = protein

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28
Q

ETEC toxins

A

heat labile: aL Agua –>increase cAMP = INCREASED Cl secretion

heat stable: San Gabriel–>increase cGMP = DECREASED NaCl and H20 resorption

LAS SG

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29
Q

edema toxin

A

Bacillus anthracis –> increased cAMP (edematous borders of black eschar)

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30
Q

cholera toxin

A

increase cAMP = increase Cl secretion = rice water diarrhea

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31
Q

exotoxin that inhibits phagocytic ability

A

Impairs Gi–>increase cAMP —–>impairs phagocytosis. My nigga Pertussis .Pertussus blocks phagocytosis. (4-5 week hx of cough “100 day cough”)

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32
Q

prevents release inhibitory nt’s (GABA/Glycine)

A

Tetanospasmin

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33
Q

prevents release of stimulatory signals (ACH) @ NMJ

A

Botulinum

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34
Q

What bug degrades phospholipids to lyse cell membranes?

A

C perfrigens. Alpha toxin = lecithinase

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35
Q

double zone of hemolysis on blood agar

A

alpha toxin c perfringens

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36
Q

Exotoxins that lyse cell membranes

A

alpha toxin (c perf) and streptolysin O

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37
Q

antibodies against oxin used to dx rheumatic fever

A

streptolysin o… = ASO

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38
Q

Superantigen releases:

A

Il-1, Il-2, IFN gamma, TNF alpha. binds MHC II and TCRj

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39
Q

which of the systemic mycoses is not a yeast in the heat (tissue)

A

Coccioidomycosis is a spherule in the tissue –> filled with endospores

40
Q

Mississippi and Ohio river valleys and within macrophages

A

Histoplasmosis hides. bird or bat droppings dont be a peasant and go for crypto

41
Q

Histo and Cocci and blasto compared to rbc

A

Histo is much smaller; cocci and paracocci is much bigger. blasto is the same size as rBc

42
Q

broad base budding

A

blasto. forms granulomatous nodules granuloma). can disseminate from lung to skin and bone.

43
Q

pneumonia and meningitis, can disseminate to bone and skin.

A

Coccidioidomycosis

44
Q

spherules within endospores

45
Q

captains wheel budding yeast

46
Q

severe diarrhea in AIDS

A

Cryptosporidium–> oocysts on acid-fast stain

47
Q

tx and triad for toxoplasmosis

A

Sulfadiazine and Pyrimethamine. Triad = yellow spots on fundus (chorioretinis), hydrocephalus, and intracranial calcifications (ring-enhancing lesions–>abscess)

48
Q

Ixodes tick

A

Babesia and Borrelia

49
Q

Maltese cross + hemolytic anemia (indirect bilirubinemia, increased LDH, decreased haptoglobin, abnormal liver tests)

A

Babesiosis. Tx with Azithromycin + Atovoquone

50
Q

Tx for chagas (t cruzi)

A

Nifurtimox or Benznidazole. I like to Cruz around in a benz or new ferrari (ni fur raari)

51
Q

Sx of T. cruzi

A

Chagas disease: DCM + ACHALASIA, megacolon/megaesophagas.

UNILATERAL PERIORBITAL SWELLING = ROMANA SIGN = ACUTE STAGE

52
Q

Kala-azar: spiking fever, pancytopenia, heaptosplenomegaly

A

Sandly: Leishmania donovania. Treat with STIBOGLUCONATE, Amphotericin B

53
Q

rash that starts on face and moves down

A

Parvovirus (slapped cheek), Rubella, Measles

54
Q

rash that starts on the trunk and moves up

A

Rosela (hhv-6)

55
Q

febrile seizure or just high ass fever, later develops rash

A

Roseola - HHV-6

56
Q

hydrops fetalis

A

Parvo and Syphilis = torch.

alpha thalassemia

57
Q

nonbacterial thrombotic endocarditis (NBTE)

A

sterile thrombi attached to mitral valve (noninfectious endocarditis). Associated with: Advanced malignancy, chronic inflam disorders (SLE, antiphospholipid syndrome), and sepsis

58
Q

Rapidly fatal meningoencephalitis, swimming in freshwater, enters via Cribiform plate

A

Naegleria Fowleri

59
Q

Dermatophytes = branching septate hyphae visible on _________

A

KOH preparation

Microsporum, Trichophyton, Epidermophyton (malessezia is different even though same name)

60
Q

Malassezia = tinea versicolor = yeast-like fungus. Degradation of lipids produces acids that damage _______ and cause ____ patches. Common in summer. Spaghetti and meatballs on microscopy. Tx:

A

melanocytes; hypopigmented; selenium sulfide

61
Q

fungal infection with germ tubes/pseudohyphae/budding

A

Candida (looks like meth pipe)

62
Q

causes Bronchiectasis and eosinophilia, associated with asthma and cystic fibrosis

A

Aspergillus

63
Q

Acute angled branching septate hyphae vs broad nonseptate hyphae at wide angles

A

Acute angle = aspergillus

nonseptate hphae = mucor/rhizopus

64
Q

cryptococcus latex agglutination teset detects _______

A

polysachharide capsular antigen. MORE SPECIFIC THAN india ink or mucicarmine technically

65
Q

Cryptococcus (“Budding yeast”) infects:

A

inhalation so first infects lungs. then hematogenous dissemination to meninges = CNS.

66
Q

Bactrim
Pentamidine
Dapsone (also for leprosy)
Atovaquone

67
Q

budding yeast is traumatically introduced, causes a local pustule/ulcer, and spreads along lymphatics

A

Sporothrix schenkii: ascending lymphangitis

68
Q

Major defense against Giardia infection

A

Its a GI infection so secretory IgA impairs its adherence (so don’t be a peasant and pick eosinophils because its a protozoa)

69
Q

bloody diarrhea, liver abcess, RUQ pain. Flask-shaped ulcer seen on histology

A

Entamoeba histolytica (amebiasais). Tx with Iodoquinol or metronidazole

70
Q

Toxoplasma: tell me the triad and treatment

A

Yellow/white retinal spots (chorioretinitis), hydrocephalus, intracranial lesions.

Reactivated in AIDS = ring-enhancing lesions = abscess

Tx= sulfadiazine + pyrimethamine. PS: ring-enhancing lesions in AIDS reactivation

71
Q

Name the protozoa in which you see a recurring fever due to antigenic variation

A

Trypanosoma brucia –> TseTse fly.

Tx = Suramin and Melarsoprol

72
Q

what are you dx with scotch tape test?

A

Enterobius vermicularis –> Pinworm

73
Q

Nematodal infection at ileocecal valve

A

Ascaris lumbricoides

74
Q

Diethylcarbamazine used for

A

Loa loa and Wucheria bancrofti(elephantiasis)

75
Q

Ingestion of larvae from freshwater causes megaloblastic anemia

A

Diphyllobothrium: vit b12 deficiency (tape worm competes for b12 in the intestine)

76
Q

Biliary tract inflammation (pigmented gallstones) and cholangiocarcinoma

A

Clonorchis sinensis: Liver fluke

77
Q

HDV is an example of ____________ because this is when 1 of 2 viruses infecting the cell has a mutation that results in a ___________ protein

A

Complementation; nonfunctional.

–>the nonmutated virus “complements” the mutated one by making a functional protein that serves both viruses

78
Q

Live vaccines (dangerous to give to immunocompromised or their contacts. Can give MMR to HIV+ pt with no signs of immunodef)

A 
MMR
Smallpox
Yellow fever
Chickenpox (VZV)
Sabin polio
Influenza (intranasal)

Sabin the small yellow chicken FLUE IN (influenza) my nose

79
Q

Killed Vaccines

A

RIP Always: Rabies, Influenza, Polio (salk), HAV

80
Q

dsRNA and ssDNA

A

dsRNA: Reo
ssDNA: Parvo

81
Q

Naked nucleic acids of __________ are not infectious and require _____

A
  • strand ssRNA and dsRNA; require polymerases in virion
82
Q

Viral replication rules (nucleus/cytoplasm)

A

DNA: all in nucleus (except Pox)
RNA: all in cytoplasm (except Influenza and Retro)

83
Q

enveloped viruses acquire their envelopes from ________, except for ___________

A

Plasma membranes as the exit the cell

exception = Herpesviruses, acquire from nuclear mem

84
Q

what does Pox carry so that it can replicate in cytoplasm

A

DNA-dep RNA polymerase

85
Q

non-retro virus that has a reverse transcriptase

86
Q

Sx of Adenovirus

A

Febrile pharyngitis (sore throat)
Hemorrhagic cystitis (acute)
Pneumonia
Conjunctivitis (close quarters)

87
Q

Molluscum contagiosum

A

flesh-colored papule with central umbilication –> Poxvirus

88
Q

Intranuclear acidophilic inclusions:

Intranuclear basophilic inclusions:

A 
acidophilic = HSV
basophilic = CMV
89
Q

Latent in trigeminal ganglion

A

VZV, HSV 1

90
Q

which LN does EBV attack

A

Posterior Cervical

91
Q

Pharyngitis +

  • —Tenosynovitis
  • —Glomerulonephritis
  • —Endocarditis
A

P and T: Neisseria Gonnorhea
P and G: Strep Pyo
P and E: Corynebacterium Diptheria

92
Q

G- Lactose Fermenter: Indole + vs Indole -

A

Indole+: E coli
Indole-: Enterobacter

both = common cause UTI

93
Q

Treatment for bacterial (Gardnerella) vaginalis

A

Metronidazole or CLINDAMYCIN

94
Q

cat scratch vs dog bite

A

Cats: Pasteurella (more common); Bartonella henslae (self-limiting lymphadeno)

Dogs: Pasteurella , Strep, Staph

95
Q

Facial pain, headache, black necrotic eschar

A

Mucormycosis (not anthrax fool). Seen in DKA pt

Need to do histology aka Mucosal BIOPSY –>will show broad non-septate hypae with R-angle branching

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