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STEP1 2014 > Micro (and some renal) > Flashcards

Micro (and some renal) Flashcards

1
Q

Bacteria that secrete enterotoxins

A

c. perfringens, c. difficile
s. aureus
shigella
yersinia
enterotoxigenic e. coli
vibrio cholera

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2
Q

subacute endocarditis

A

viridans strep
enterococci
coagulase- negative staphylococci such as staph epidermidis

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3
Q

penicillinase- sensitive extended spectrum PCNs

A

h. influenzae
e.coli, enteroccoci
listeria
proteus
salmonella
shigella

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4
Q

causes a rash on the hands and feet

A

Drive Kawasaki CaRS with hands and feet

Kawasaki
Coxsackie A
RMSF
Secondary syphilis

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5
Q

Signs of congenital syphilis

A 
saber shins
saddle nose
CN 8 deafness
Hutchinson teeth
mulberry molars
snuffles (blood snot)
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6
Q

WAGR complex

A

Wilms tumor
Aniridia
Genitourinary malformation
mental Retardation (intellectual disability)

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7
Q

Risk factors in transitional cell carcinoma development

A 
PeeSAC
Phenacetin
Smoking
Aniline dyes
Cyclophosphamide
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8
Q

Acute interstitial nephritis

A 
fever
rash
eosinophilia
azotemia
1-2 wks following drug administration
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9
Q

most common tumor of the urinary tract

A

Transitional cell carcinoma

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10
Q

BMP changes in a patient with renal failure

A

BUN, Cr, potassium increase. hypocalcemia

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11
Q

most common renal tumor of early childhood

A

Wilm’s tumor, associated with WT1, WT2 loss of function (these are tumor suppressor genes).
contains embryonic glomerular structures and presents with huge palpable flank mass and/or hematuria

May present with WAGR (beckwith- weidemann)

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12
Q

bacterial casts

A

pyelonephritis

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13
Q

WBC casts

A

pyelonephritis, transplant rejection, tubulostitial inflammation

WBCs in the urine (pyuria) may occur with acute cystitis. Casts only come from the distal convoluted tubule or collecting duct and are indicative of kidney infection.

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14
Q

Epithelial cell cast

A

ATN, toxic ingestion

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15
Q

Muddy brown cast

A

ATN

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16
Q

hyaline cast

A

nonspecific, may be normal with dehydration, formed of epithelial secretions

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17
Q

granular (muddy brown) casts

A

acute tubular necrosis

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18
Q

waxy casts

A

advanced renal disease/ chronic renal failure, 2/2 breakdown of cellular casts/ aggregates/ albumin/ light chains

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19
Q

fatty casts

A

nephrotic syndrome

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20
Q

RBC casts

A

glomerulonephritis, ischemia, malignant hypertension, appears yellow- brown with ragged edges

bladder cancer, kidney stones might produce hematuria without casts. indeed, hematuria can come from anywhere and RBC casts come only from the kidney, specifically the distal convoluted tubule or collecting duct

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21
Q

Drugs associated with drug- induced interstitial nephritis

A 
NSAIDs (this can take months to show up)
PCN/cephalosporins, especially methicillin
sulfonamides: TMP/SMX, furosemide, etc.
ciprofloxacin
cimetadine
allopurinol
PPIs
indinavir
mesalamine

presentation: fever, eosinophilia, azotemia, rash
Tx: corticosteroids

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22
Q

eosinophilia

A

DNAAACP

Drugs (NSAIDs, PCN/ cephalosporins)
Neoplasm
Allergis, asthma (Churg- Strauss), allergic bronchopulmonary aspergillosis
Adrenal insufficiency (Addison disease)
Acute interstitial nephritis
Collagen vascular disease (PAN, dermatomyositis)
Parasites (Strongyloides, Ascaris –> Loeffler eosinophilic pneumonitis)
Other: HIV, hyper IgE, hypereosinophilic syndrome, coccidioidomycosis, numerous other potential causes)

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23
Q

helminth that causes the most infections in the US

A

enterobius vermicularis

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24
Q

one quarter of the world is infected with this helminth

A

ascaris lumbricoides

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25
Q

helminth with a snail host that causes swimmer’s itch

A

schistosoma species

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26
Q

helminth that is the most common predisposing factor for bladder cancer in developing countries

A

schistosoma hematobium

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27
Q

helminth that is contracted by eating undercooked fish and causes an inflammation of the biliary tract

A

clonorchis sinensis (liver fluke)

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28
Q

soil to skin to venous blood to lungs coughed to pharynx then swallowed to the intestines where they reside

A

strongyloides (skin)

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29
Q

ingested to venous blood to lungs, coughed to pharynx then swallowed into the intestine where it resides

A

ascaris lumbricoides

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30
Q

helminth that is contracted by eating undercooked crabmeat and causes inflammation of the lung

A

paragonimus westermani

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31
Q

pork tapeworm

A

taenia solium

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32
Q

responsible for lymphatic filariasis

A

wuchereria bancrofti

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33
Q

adult patient from mexico with new onset seizures and brain calcifications (helminth)

A

neurocystercercoma (Schistosoma)

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34
Q

hookworm

A

ancylostoma duodenale, necator americanus

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35
Q

giant roundworm

A

ascaris lumbricoides

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36
Q

helminth hematuria in a patient from a developing country

A

schistosoma hematobium

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37
Q

What medications for giardia, entamoeba, trichomonas

gardnerella, anaerobic bacteria, h. pylori

A

metronidazole

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38
Q

how to treat most malarias

A

chloroquine

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39
Q

how to treat plasmodium vivax or ovale

A

chloroquine plus primaquine (check G6PD status)

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40
Q

how to treat almost all flukes and tapeworms

A

praziquantel

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41
Q

how to treat hookworm, pinworm, roundworm

A

benzimadazole or pyrantel pamoate

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42
Q

how to treat chagas

A

benzimidazole or nfurtimox

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43
Q

how to treat roundworms

A

mostly benzymidazoles or pyrantel pamoate

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44
Q

how to treat leishmaniasis

A

cutaneous- sodium stibogluconate

visceral- liposomal amphotericin B

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45
Q

how to treat pediculosis capitis and pubis

A

permethrin, pyrethrin

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46
Q

nematodes- roundworms that cause intestinal infections

A 
enterobius vermicularis (pinworm)
ascaris lumbricoides (giant roundworm)
strongyloides stercoralis
ancylostoma duodenale, necator americanus (hookworm)
trichinella spiralis
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47
Q

nemotodes- roundworms that infect tissue

A

onchocerca colculus, loa loa, wuchereria bancrofti (lymphatic filariasis), toxocara canis

48
Q

transmission- pinworm enterobius vermicularis

A

fecal- oral

dx scotch tape test
sx anal pruritis
tx bendazoles, pyrantel

49
Q

ascaris lumbricoides (giant roundworm) transmission

A

200,000 eggs or more released daily, human ingests the eggs (even just a little bit), and the worm goes to the lungs, trachea, oropharynx, is then swallowed into the intestine where it matures.

hypersensitivity to ascaris at the lungs can lead to loffler eosinophilic pneumonitis (dyspnea, eosinophilic PNA)

eggs in feces visible under microscope

Tx bendazole or pyrantel pamoate

50
Q

strongyloides stercoralis transmission

A

larvae in soil penetrate the skin, travel to lungs, trachea, swallow, GI tract, intestinal infection. Tx ivermectin, albendazole

51
Q

ancylostoma duoenale, necatur americanus (hookworm) transmission

A

larvae penetrate skin, travel to lungs, trachea, swallow, mature at GI tract where they hook into the intestinal wall and suck blood out. abdominal discomfort, anemia. Tx. bendazoles, pyrantal pamoate

52
Q

trichonella spiralis transmission

A

undercooked meat, meat of wild game, larvae migrate from GI tract to muscles causing myositis, fever, eosinophilia, perorbital edema. Tx: Benzimidazole

53
Q

Feco- orally transmitted nematodes

A

EAT (enterobius, ascaris in fecal contamination and trichonella spiralis in meat)

54
Q

skin- transmitted nematodes

A

strongyloides, ancylostoma, and necator, which all penetrate bare feet. Strongyloides is in the soil.
SANd

55
Q

Bites

A

LOW
loa loa
oncherocerca volvulus
wuchereria bancrofti

56
Q

Cestodes (tapeworms)

A

taenia solium
diphyllobrothrium latum
echinococcus granulosus

57
Q

Trematodes (flukes)

A 
schistosoma (blood fluke)
clonorchis sinensis (liver fluke)
paraconimus westermani (lung fluke)
58
Q

Schistosoma

A

eggs into snails, then they penetrate skin to enter into humans (swimmer’s itch), in which the schistosomes migrate to lungs or liver and mature.

s. mansoni matures at mesenteric vessels, portal htn
carribean, s. america

s. hematobium goes to the lower urinary tract, leading to scc of bladder (painless hematuria)
western hemisphere, including egypt

embolized eggs may get stuck in the portal system leading to splenomegaly

tx: praziquantel

59
Q

chlonorchis sinensis (liver fluke)

A

comes from eating undercooked fish. biliary inflammation results in pigmented gallstones, cholangiocarcinoma

tx. praziquantel

60
Q

paragonimus westermani (lung fluke)

A

sx- chronic bronchitis, hemoptysis, undercooked crab meat

tx: praziquantel

61
Q

taenia solium (pork tapeworm)

A

ingested larvae that are encysted in undercooked pork lead to intestinal infection, leading to cystercercosis and neurocysticercosis

cysticercosis= larval infection resulting from cyst ingestion leads to myositis at muscles, neurocystercercosis in the brain

tx: praziquantel, albendazole for neurocysticercosis

62
Q

echinococcus granulosus (dog tapeworm)

A

ingestion of eggs from dog feces.
mature larval cysts occur in the host parenchyma

hydatid cysts in the liver cause anaphylaxis if antigens released (surgeons preinject with ethanol to kill cysts before removal)

tx: albendazole

63
Q

biliary tract disease, cholangiocarcinoma

A

clonorchis sinensis

64
Q

brain cysts, seizures

A

taenia colium (cysticercosis)

65
Q

hematuria, bladder cancer

A

schistosoma haematobium

66
Q

liver (hydatid cysts)

A

echinococcus granulosus

67
Q

microcytic anemia

A

anculostoma, necator

68
Q

perianal pruritis

A

enterobius

69
Q

portal hypertension

A

schistosoma mansoni, schistosoma japonicum

70
Q

B12 deficiency

A

diphyllobothrium latum

71
Q

found in SW US including w Texas and CA

A

coccidiomycosis immitus

72
Q

Mississippi and OH river basin

A

histoplasma capsulatum

73
Q

San Joaquin valley fever

A

coccidiomycosis immitus

74
Q

rural Latin America

A

paracoccidiuides brasiliensis

75
Q

associated with plant thorns and cutaneous injury

A

sporothrix schenki

76
Q

found in states east of the mississippi river

A

blastomycosis dermatotiditis

77
Q

found in bird and bat droppings

A

histoplasmosis capsulatum

78
Q

mold form contains barrel= shaped arthroconidia

A

cocidioides immitus

79
Q

associated with dust storms

A

coccidiomycosis immitus

80
Q

broad- based budding of yeast

A

blastomycosis dermatididis

81
Q

multiple budding of yeast form

A

paracoccidiomycosis brasiliensis

82
Q

infections associated with birds

A 
H5N1 (avian influenza)
cryptococcus neoformans- pigeon poop
chlamydia psittaci- parrots
WNV- crows
histoplasma capsulatum
83
Q

treatment for sporothrix

A

potassium iodid, itroconazole is newer (plant a rose in a pot)

84
Q

treatment fo oral candidiasis

A

fluconazole, nystatin swish and swallow

85
Q

mc opportunistic infection in HIV patients

A

PCP

86
Q

ppx for cryptococcus in AIDS

A

fluconazole

87
Q

ppx for PCP in AIDS

A

TMP-SMX when CD4<200

88
Q

treatment for systemic candidiasis

A

fluconazole, amphotericin B, echinocandin

89
Q

4 molds that are considered dermatophytes (fungal species invading only superficial layers of skin

A

trichophyton
microsporum
epidermophyton
malassezia furfur

90
Q

ringworm

A

tinea corporis, tinea capitis (looks round with a central clearing but there is no actual worm)

91
Q

DNA virus and erythema infectiosum

A

parvovirus B19

92
Q

heterophile- positive mono

A

EBV

93
Q

can cause conjunctivitis or diarrhea

A

adenovirus

94
Q

enlarged cell with owl’s eye inclusions

A

CMV

95
Q

identified with PAP

A

papillomavirus 16, 18 are high risk

96
Q

milkmaid blsters

A

vaccinia poxvirus

97
Q

Burkitt lymphoma

A

EBV

98
Q

gingivostomatitis

A

HSV1

99
Q

hides in sensory ganglia of S2 and S3

A

HSV2

100
Q

hides in trigeminal ganglia

A

HSV1

101
Q

hides in dorsal root ganglia

A

VZV

102
Q

viral family of JC virus

A

polyomavirus

103
Q

Downey cells

A

EBV T cells that target B cells

104
Q

human progressive multifocal leukoencephalopathy

A

JC Virus polyomavirus

105
Q

oral hairy leukoplakia

A

EBV

106
Q

multinucleate giant cells on Tzanck test

A

HSV1,2, VZV

107
Q

only DNA virus that is not double stranded

A

HBV

108
Q

roseola

A

HHV6

109
Q

heterophile negative mononucleosis

A

CMV

110
Q

SCC penis

A

HPV 16, 28

111
Q

aplastic anemia in SCD

A

parvovirus B19

112
Q

child with a fever and slapped cheek rash on the face that spreads to the body

A

parvovirus B19 5th disease

113
Q

where does herpes virus acquire its envelope?

A

most enveloped viruses get their envelope from plasma membrane when they exit the cell but herpes gets its envelope from the nuclear membrane

114
Q

viral families that are naked

A

DNA:
parvovirus, adenovirus, papillomavirus, polyoma virus

RNA: calicivirus, picornivirus, reovirus, hepevirus

115
Q

Loffler syndrome

A

Ascaris lumbricoides
eosinophilic pulmonary infiltrates
most common worldwide cause
Symptoms develop when larvae are within the lungs, approximately 9-12 days after ingesting the ascaris eggs but then subside after about 5-10 days depending on the severity.
symptoms and signs:
- irritating, nonproductive cough, burning substernal discomfort
-dyspnea, blood- tinged sputum
-urticaria for the first few days
-fever over 38.3 (101)
-crackles, wheezing, no consolidation
-hepatomegaly
-CXR: round or oval infiltrates that range in size from millimeters to centimeters in both lung fields
-migratory infiltrates, confluent on perihilar areas, usually clear completely after several weeks

STEP1 2014 (26 decks)

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