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Board Prep > Micro > Flashcards

Micro Flashcards

1
Q

8 year old boy presents w/

  • behavioral changes, mild intellectual deterioration, and laziness
  • develops progressive clumsiness and frequent involuntary jerky movements
  • CSF shows increased IgG
  • he dies 2 years later

Dx?
Infection d/t?

A

Subacute sclerosing panencephalitis (SSPE)

infection: measles
- nml infected by age 2 but takes about 6 years for symptoms to occur

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2
Q

Pt presents w/

  • raised lesions on finger and toes
  • white spots on retina surrounded by hemorrhage
  • small non-tender, painless, erythematous lesions on palm or sole
  • clots under fingernails
  • new onset heart murmur
  • fever

Dx
Cause
Staining

A

Subacute bacterial endocarditis

  • osler nodes
  • roth spots
  • janeway lesions
  • splinter hemorrhages

Causes:

  • strep viridans : gram positive cocci in chains
  • staph aureus: gram positive cocci in clusters
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3
Q

Pt presents w/

  • pain that is relieved when leaning forward and worsens w/ inspiration
  • scratchy leathery sound upon auscultation
  • admitted to having flu-like illness about 2 weeks ago

Dx
EKG findings
MC cause

A

Dx: pericarditis (friction rub)

EKG: diffuse ST segment elevations and depression of PR

Cause:

  • coxsackie B is MC
    • picornavirus: positive, single stranded, naked, icosahedral, RNA virus
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4
Q

What lab test help determine MAC from TB in AIDs pt?

A

MAC presents w/

  • anemia
  • elevated alk phos
  • elevated lactate dehydrogenase
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5
Q

S. Pyogenes toxic shock like syndrome vs s aureus toxic shock like syndrome

A

S pyogenes: release of exotoxin A causes activation fo T cells

  • shock, fever, multi-organ failure
  • painful, pre-existing skin infections and positive blood cultures

S. Aureus

  • no pre-existing skin infections
  • negative blood cultures
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6
Q

Causes endocarditis in pts w/ carcinoma of colon or pre-existing valvular lesions

Dx
Tx

A

Strep bovis

Tx: penicillin and ceftriaxone
-vanco for beta-lactam allergery

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7
Q

What 5 pathogens cause pharyngitis?

A

GrACED

  • group A strep
  • adenovirus
  • coxsackie A
  • EBV
  • corynebacterium dipthetheriae
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8
Q

Mycoplasma pneumonia tx and MOA

A

Macrolide = 23s ribosomal RNA inhibitor

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9
Q

3 stages of bordetella pertussis

A

Catarrhal stage: 1-2 wks
-URI: fever, nasal congestion, rhinorrhea

Paroxysmal stage: 2-8 wks
-paroxysmal coughing followed by inspiratory whoop

Convalescent stage: wks-months
-subsiding cough

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10
Q

Types of E coli (who they infect / s/s)

  • ETEC
  • EIEC
  • EPEC
  • EHEC
A

ETEC = T: traveler diarrhea
-non inflammatory diarrhea d/t LT (AC) and ST (GC)

EIEC = I: inflammatory diarrhea
-bloody diarrhea d/t actin formation

EPEC = P: pediatric diarrhea
-non inflammatory d/t adherence of M cells on brush border

EHEC = H: Hamburger
-bloody diarrhea, nonfermentor of sorbitol d/t verotoxin (shigella like toxin) -> lead to HUS and hemorrhagic colitis

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11
Q

Which two microbacteria inhibit ptn synthesis by ADP-ribosylation of eER-2

A

Pseudomas = ecythyma gangrenosum

Diptheria = heart and nerve

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12
Q

Elementary bodies vs reticulate bodies

A

Chlamydia

  • elementary: extracellular, inert, transmission form
  • reticulate: intracellular, replicating form
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13
Q

Thin/gray malodorous discharge from vagina vs thin frothy yellow green

A

Gray: Gardnerella

Yellow/green: trichomonas

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14
Q

Pt presents w/ progressive weakness of his legs and arms

  • has noticed it since childhood: no vaccination history available
  • shows: flaccid paralysis, ms atrophy, fasciculations, areflexia

Dx
Where is the lesion

A

Polio -> poliovirus (+, single stranded RNA, picornavirus)

Attacks ventral horn -> LMN

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15
Q

Pt presents w/

  • loss of conscious proprioception and vibration sensation
  • areflexia
  • pain, temp and ms strength are preserved
  • sexually active w/ multiple partners

Dx
Where is the lesion

A

Tabes dorsalis -> tertiary syphillis

Dorsal columns affected

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16
Q

HIV Pt presents with

  • CD4 count of 150
  • weakness, disturbance of speech, congnitive abnml, HA, gait disorder, visual impairment and sensory loss
  • MRI: shows multiple non enhancing multifocal white matter lesions

Dx
Infectious agent

A

Dx: progressive multifocal leukoencephalopathy

  • circle, double stranded, naked, DNA virus
  • CD4 <200

Infectious agent: JC virus -> destruction of myelinating oligodendrocytes

17
Q

42 year old man returning from vacation in Honduras presents w/

  • grandmal seizure accompanied by HA, n/v, and some visual changes
  • CT of the brain shows multiple punctate calcifications and two cystic lesions with surrounding edema (swiss cheese)
  • tx is began w/ albendazole and praziquantel

Dx
Infectious agent
How did the patient occur this condition

A

Dx: neurocysticercosis

Infectious agent: taenia solium (tapeworm/cestode)

Acquired infection via: ingestion of eggs (feces contaminated water) or autoinfection (perianal area -> mouth via contaminated fingers)
-oncosphere crosses the intestinal wall -> enters circulation -> gains access to tissues

18
Q

54 year old pt from Ecuador comes in complaining of

  • recurrent HA, n, fatigue, nuchal rigidity for the past year
  • CSF shows: increased lymphocytes, plasma cells, macrophages, and fibroblast ; ptn and pressure are also elevated while glucose in decreased

Dx
MC cause

A

Dx: chronic meningitis

Cause: Mycobacterium tuberculosis
-others: syphilis, brucellosis, fungal infection

19
Q

CSF fluid in pts w/

  • bacterial (purulent)
  • aseptic (viral)
  • granulomatous (fungal)

*cells, glucose, ptns, and pressure levels

A

Bacterial: increased neutrophils, ptns, and pressure; decreased glucose

Viral: increased lymphocytes, ptn erythrocytes, nml glucose, and pressure

Granulomatous: increased all cell types, decreased glucose, increased ptn and pressure

20
Q

33 year old man with AIDs develops multifocal encephalitis

  • u/l, vesicular, painful rash on the left side of his back, mid chest, left side of chest and upper abdomen that appeared one month ago
  • tx w/ acyclovir began but he died 4 days later

Dx
Infectious agent

A

Herpes zoster encephalitis

Infectious agent: varciella zoster virus
-d/t its reactivation (rash)

21
Q

Multinucleated giant cells w/ intranuclear inclusion bodies seen in patients w/ encephalitis

Infectious agent

A

Herpes simplex virus

22
Q
  • MC cause of sporadic encephalitis in US
  • CSF: elevated ptn, lymphocytes, erythrocytes and nml glucose
  • MRI: u/l temporal lobe hypointense lesions

Dx
Tx
What would be seen on microscopic exam of the brain
What might be seen on ocular exam

A

HSV-1 encephalitis
Tx: acyclovir
Brain: cowdry type A inclusions: intranuclear viral inclusion bodies
Ocular: serpignous (snake-like) corneal ulcers

23
Q

Toxoplasma IgG vs IgM antibodies

A

IgG: have been infected with it but no s/s
IgM: active infection

24
Q

What are the 3 most common neonatal pathogens associated with meningitis

A

Group B strep

E coli

Listeria monocytogenes

25
Q

What are the 2 MC causes of botulism toxicity in adults

A
  • canned alkaline vegetables
  • preserved fish

*both have preformed toxins

26
Q

In HIV positive pts what is the most common cause of a ring-enhancing brain lesion?

  • what would you see on biopsy?
  • what cell type would be deficient
A

Toxoplasmosis

Biopsy: crescentic microorganisms and necrosis

Th-1 helper cells would be deficient d/t cell-mediated immune response
- intracellular organism

27
Q

Pt presents w/

  • excitability, agitation, hypersalivation, sweating, pupillary dilation
  • hydrophobia, aerophobia (pharyngeal spasm triggered by air drafts)
  • facial ms spasticity

Pt is diagnosed with rabies
-what would you see on histology ?

A

Negri bodies: elongated eosinophilic intracytoplasmic inclusions w/in the pyramidal neurons of the hippocampus and purkinje neurons of cerebellum

28
Q

Elderly pt presents w/

  • urinary incontinence
  • new onset confusion
  • gait disturbances

Dx

  • what would be seen on CT and CSF
  • tx
A

nml pressure hydrocephalus: “wet, wacky, and wobbly”

  • CT: dilated ventricles
  • CSF: nml pressure

Tx: ventricular shunt

29
Q

MC cause of meningitis in AIDs pts

-how to dx it

A

Cryptococcus neoformans

-dx: latex particle agglutination (india ink misses 50%)

30
Q

Pt presents w/

  • facial rash (in children)
  • arthropathy : acts like RA but remits in 7 days
A

Parvovirus B19

31
Q

Pt presents w/

  • aphasia, hemiparesis, cortical blindness, ataxia, homonymous. Hemianopia
  • MRI: abnml T2 signal in white matter
  • electroencephalogram: slowing over both cerebral hemispheres
  • biopsy: demyelination w/ abnml giant oligodendrocytes that contain eosinophilic intranuclear inclusions

Dx
Infectious agent
What pt condition occurs most commonly in assoc w/ this disease
Treatment

A

Progressive multifocal leukoencephalopathy

JC virus

AIDs patients

Not effective treatment

32
Q

Pt w/

  • bloody diarrhea
  • weakness in legs that is ascending
  • CSF: increased ptn but nml cell counts

Dx
What cell is involved in dz process

A

Guillain barre syndrome
- campylobacter jejuni

Schwann cell

Board Prep (7 decks)

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