Micro Bio Flashcards
Presence of microoorganisms in a normally sterile site is called ________
Infection
Cultivatable bacteria in the bloodstream is called ______
Bacteremia
Temp >38, H.R. >90, R.R. >20 WBC> 12,000, PaCO2
SIRS
Systemic inflammatory response syndrome
The whole-body inflammatory response to an infection is called _______
sepsis
Sepsis associated with organ dysfunction distant from the site of infection is called _____
severe sepsis
Sepsis with hypotension that despite adequate fluid, requires vasopressor therapy is called _____
septic shock
The presence of microorganisms on an epithelial surface is called ______
colonization
The TLR4 recognizes _____ on gram _______ bacteria
LPS on gram - bacteria
A massive release of the endotoxin LPS can result in _____ _____ _____
gram negative shock
A primary BSI is (intravasular/extravascular) while a secondary BSI is (intravasular/extravascular)
Primary is intraascular
Secondary is Extravascular
TLR2 recognizes Gram _______ bacteria
positive
The most common sites of entry for secondary bacteremia are (3)
- Lungs
- Abdomen
- UTI
a condition in which blood clots form throughout the body’s small blood vessels is called ____
DIC
This blood substance inhibits thrombin production as well as by binding and inhibiting thrombin directly
Antithrombin
This blood protien blocks the coag cascade at multiple steps helping to prevent DIC
Activated protein C
You are confident your patient is septic, but when you draw cultures you don’t see anything. What might be the infection?
intermitant bacteremia or gram (-) sepsis
What is the most common source of bacterial endocarditis?
mouth flora, dental work
The 3 most common organisms for catheter-related infections are:
- coag (-) staphylococci
- Stapylocaccus Aureus
- Candida species
a marker of inflammatory response, stimulated by bacterial products (endotoxins/LPS) and cytokines (IL-1,IL-2, IL-6, TNFα)
Procalcitonin
the predominant organism that causes malaria is __ _______
Plasmodia falciparum
The 5 parasites that cause malaria in humans are:
- P. vivax
- P. ovale
- P. malariae
- P. falciparum
- P. knowlesi
malaria transmission is exclusively through the _______ mosquito
Anopheles (about 20 species)
a major reason why malaria is endemic to Africa is due to this anopheles characteristic ______ ______
longer lifespan
which plasmodia are most common (2)
P. falciparum
P. vivax
which plasmodia is the most deadly
P. falciparum
With P. vivax, P. ovale and P. falciparum Paroxysm occurs periodically every ___ hours
48 hours
With P. malariae Paroxysm occurs periodically every ___ hours
72 hours
The three stages of the malaria paroxysm are:
- cold stage: RBC lysis
- Hot stage: immune response
- Sweating stage: immune turns off, exhaustion
Malaria relapse occurs with which two species?
P. vivax
P. ovale
When Malaria parasitemia falls below detectable levels and later increases to a detectible parasitemia is called _________
recrudescence
Chagas disease is caused by ________ ________
Trypanosoma cruzi
Swelling of the eyelid due to Chagas infection is called ______ sign
Romana’s sign
Trypanosoms can be carried by the insects, ________ in S. America or the ______ in Africa
Triatomine, a Reduviidae bug in S. Amer
Tsetse fly in Africa
Which malaria plasmodia species predominates sub-saharan Africa and south America?
P. falciparum
Which malaria plasmodia species predominates western Africa, west pacific and south Asia?
P. ovale
Which malaria plasmodia species occur everywhere EXCEPT sub-saharan Africa?
P. Vivax
Erythrocytes lacking the ____ ____ are resistant to P. vivax merozoite invasion
Duffy Antigen
incubation of malaria so that it may relapse happens in the _____ (organ)
the liver
When Malaria sporozoites invade hepatocytes, and are not observed in the circulation may be asymptomatic is called ______
relapse
P. falciparum modifies the RBC to allow further infection using the _______ receptor
PfEMP-1
The two quinols for malaria treatment are:
chloroquine
paraquinine
Which is intracellular and which is not? (Malaria/Chagas)
Malaria: intracellula
Chagas, T. cruzi: NOT
Chagas, T cruzi causes damage and dilation to which 3 organs?
Megaesophagus
Cardiomyopathy
Megacolon
Leishmaniasis is transmitted by the _____ _____
sand fly
Toxoplasmosis come primarily from ______ and ______
undercooked food and cat poop
toxoplasmosis (can/cannot) be passed congenitally
can, congenital infection can be severe
the most common cause of posterior uveitis is infection with _______
toxoplasmosis
white fluffy cotton lesions in the back of the eye could indicate ______
toxoplasmosis infection
Lyme disease is caused by the spirochete ________ _______
Borrelia Burgdorfi
The 3 spirochetes are
- Treponema (syphilis)
- Borellia (lyme and relapsing fever)
- Leptospira
Which can you see with regular microscopy (Treponema / Borellia)
Borellia
The biology name for the deer tick is __ _______
I. scapularis, on the east coast
Mild Lyme can be treated with ________ or ________
Doxycycline or Amoxicillin if pregnant 20-30 days
Severe Lyme can be treated with ________
Ceftriaxone
Patient had lyme and was treated with doxy for the past 30 days. They ask for more doxy, what to do?
DON’T give more than 30 days of Doxycycline
this is enough to kill the Borellia
What are the Labs for Borrelia Burgdorfi?
ELISA or IF, neither is very useful
Borellia recurrentis is carried by the _____ ______ and reservoir is _______
Borellia Recurrentis, pediculus coRpoRis, Reservoir humans
Borellia hermsii is carried by _____ _____ and reservoir is _______
Borellia Hermsii, soft ticks, small Huggable mammals
As the spirochete present different surface antigens, fevers will spike, fall, spike, fall known as ______ ______
relapsing fever
What two spirochetes cause relapsing fever?
- Borellia Recurrentis
2. Borellia Hermsii
Which 2 diseases gets transmitted by “scratch and crush” w/ poop
- Relapsing fever w/ Borellia Recurrentis
2. Endemic Typhus w/ R. prowazkii
Dx: Relapsing fever w/ Borellia Recurrentis or Borellia Hermsii
Rx:?
tetracyclines
- doxycycline
- erythromycin
- penicillin G
Rocky mountain spotted fever is caused by _______ ______
Rickettsia ricketsii
Rocky mountain spotted fever is vectored by _________
Ticks!
Dermacentor variabilis, dog tick, on east coast
Dermacentor andersoni on west coast
What is the host for Rocky mtn spotted fever, Rickettsia ricketsii?
mice AND ticks, humans are accidental
How do Rickettsia, especially RMSF, cause their characteristic spotted petechia?
invades + breaks out of vascular endothelium
–>Vasculitis!
What is the Biology name for a dog tick?
Dermacentor variabilis
Dx: spotted fever
Rx: ________
Doxycycline
The infectious agent of endemic typhus is __ ________
Rickettsia prowazekii
Rickettsia prowazekii of endemic typhus is vectored by ______
the louse, head or pubic
Recrudescent Typhus is called _____ _____ diesease
Brill-Zinsser disease
Treatment for all 3 types of Typhus is _______ or ________
Doxycycline or chloramphenicol
Human monocytic ehrlichiosis (HME) is caused by ______ ______
Erlichia chaffeensis
Human granulocytic ehrlichiosis (HGE) is caused by _______ ______
Anaplasma phagocytophilum
Rickettsia, Ehrlichia and Anaplasma are all (obligate intracellular / facultative intracellular)
obligate intracellular!
Anaplasma and Ehrlichia live in _____ cells and form ______ in phagocytic vacuoles
white cells,
black berries = morulae
In relapsing fever Borellia, there is a strong IL__ response
IL10
What is the shape for Rickettsia, Ehrlichia and Anaplasma?
small cocci to short rods
How do you visualize Rickettsia, Ehrlichia and Anaplasma?
microimmunofluorescents
Dx: Rickettsia
Hx: currently pregnant
Rx: _________
chloremphenicol
Dx: Rickettsia, Ehrlichia OR Anaplasma
Rx _______
tetracycline:
doxycycline
Dx: Erlichia or Anaplasma
Hx: currently pregnant
Rx: _________
fluoroquinolones
group of viruses that are transmitted by arthropod vectors are called ________
Arboviruses
All the arboviruses we discussed are (RNA/DNA)
RNA
All Arboviruses are transmitted by either _____ or _______
ticks or mosquitoes
when the arbovirus lives in an animal it is called the _______ phase
zoonotic
EEE is of the ________ virus family
togaviridae
Hx: walking in cicero swap
CBC: elevated white count
Swelling in midbrain on T2 MRI
Dx: _____
EEE
Which viral family can cause:
- Systemic febrile illness
- Fever w/ arthritis
- Encephalitis
- Hemorrhagic fever
Arboviruses
For EEE humans are (resident hosts/ dead end hosts)
dead end hosts
Hx: Hiking in Thailand
CBC: elevated white count
Swelling in midbrain on T2 MRI
Dx: _____
Japanese Encephalitis
Japanese encephalitis and dengue are of the _______ virus family
Flaviviridea
Yellow fever is spread by the insect _______
mosquitoes
Yellow fever and dengue fever both cause (Fever with arthritis/ Encephalitis/ Hemorrhagic fever)
hemorrhagic fever
Which is thermally dimorphic? (Sporotrichosis/ Chromomycosis)
Sporotrchosis
Type I hypersensitivity is mediated by (IgE/ IgG/ T- cells)
IgE
Type II and III hypersensitivity is mediated by (IgE/ IgG/ T- cells)
IgG
Type IV hypersensitivity is mediated by (IgE/ IgG/ T- cells)
T-cells (Th1, Th2 or CTL cells)
Mast cells are activated only in Type (I/ II/ III/ IV) hypersensitivity
Type I
IgG bind FcR on phagocytes in type (I/ II/ III/ IV) hypersensitivity
Type II
penicillin drug allergic reaction is typically a type (I/ II/ III/ IV) hypersensitivity
Type II
serum sickness and arthus rxn are type (I/ II/ III/ IV) hypersensitivity
Type III
Contact dermatitis is usually a type (I/ II/ III/ IV) hypersensitivity
Type IV
Mismatched blood transfusions can lead to hemolytic anemia, at type (I/ II/ III/ IV) hypersensitivity
Type II
all herpes viruses are (enveloped/naked)
enveloped
During the acute phase of chagas, ______ can be seen in the blood with microscopy
trypomastigotes
The triad of congenital toxoplasmosis is:
- chorioretinitis
- hydrocephalus
- intracranial calcifications
In healthy people, Toxoplasmosis is the most common cause of what eye condition?
posterior uveitis
In immunocompromised people, esp. HIV, toxoplasmosis can lead to (Gastrotoxoplasmosis/ Neurotoxoplasmosis/ Reprotoxoplasmosis)
neurotoxoplasmosis
the others are made up
The detection of toxoplasmosis is primarily through ________
antibodies, directed against toxo
Serology for Borellia burgdorfi will not become positive until (24 hours/ 2 days/ 2 weeks/ 2 months) post initial infection
2 weeks
Erythema chronicum migrans, macular rash, bull’s eye pattern, flu like symptoms is Lyme stage (I/ II/ III)
Stage I
Cardiac involvement, heart block, aseptic meningitis, Bell’s palsy possibly bilateral is Lyme state (I/ II/ III)
Stage II
Lingering fatigue post treatment, joint pain, mental status change is Lyme stage (I/ II/ III)
Stage III
Rheumatic fever is a post-_______ condition
post streptococcal
The treatment for streptococcal pharyngitis is:
- Penicillin G or others:
- amoxicillin
- erythromycin
Rheumatic fever is an (alloimmune/ autoimmune) disease
autoimmune
The diagnosis of Rheumatic fever is based on the clinical features of fever, polyarthritis, mitral heart murmur and the antibody ________
IgM against streptolysin O
In Rheumatic fever there (is/ is not) bacteremia
IS NOT, it is an autoimmune condition
Rheumatic fever increases the risk of which heart condition?
endocardidits, due to damaged mitral valve
Dental caries are caused by Streptococcus ________
viridians
A child with a questionable vaccine history presents to the ED with systemic muscle paralysis. In the child’s mouth you see a pharyngeal mucus membrane. Lab culture shows gram (+) rods with clubbed ends
Dx:?
Diphtheria infection with diphtheria toxin
How do you prevent diphtheria disease?
DTaP: diphtheria, pertussis, and tetanus vaccine
Patient presents to your PCP office. Hx of rheumatic fever. Splinter hemorrhages in fingernails and conjunctival hemorrhages are seen on exam. Your EKG shows widened PR intervals.
Dx:?
Bacterial Endocarditis
What organism causes endocarditis post rheumatic fever? post-IV drug use?
post rheumatic: Strep viridans
post IV drugs: Staph aureus
What two bug genus cause impetigo?
Streptococci and staphylococci
A child present to your PCP office. She has a yellow crusted lesion around her mouth. culture shows gram (+) cocci, coagulase (+), beta-hemolytic, salt resistant.
The infective organism is ______
S. aureus, impetigo infection
A child present to your PCP office. She has a yellow crusted lesion around her mouth. culture shows gram (+) cocci, coagulase (-), beta-hemolytic and bacitracin sensitive
The infective organism is ______
S. pyogenes
Treatment for impetigo is ________
mupirocin ointment
Infected piercing.
Infective organism is _________
staphylococcus epidermidis
linear lesions especially on wrists or genitals. microscopy shows 8 legged mite.
Infectious organism _____ ______
Sarcoptes scabei
treatment for Sarcoptes scabei is _______
permethrin
facial acne is caused by the organism _____________ ______
propionobacterium acnes
Skin abscess, Scalded Skin Syndrome and Toxic Shock syndrome are most commonly caused by ____ _____
staph aureus
Which is more superficial (Erysipelas/ Cellulitis)
Erysipelas
Necrotizing faciiitis is useually caused by __ ______
C. perfringens
Ringworm type Tinea is caused by (Cladosorium weneckii/ Malassezia furfur/ dermatophytes)
dermatophytes
Tinea Versicolor is caused by (Cladosorium weneckii/ Malassezia furfur/ dermatophytes)
Malassezia furfur
Tinea Nigra is caused by (Cladosorium weneckii/ Malassezia furfur/ dermatophytes)
Cladosporium werneckii
Which Tinea causes hypopigmented spots? (dermatophyte tinea/ tinea versicolor, furfur / tinea nigra, werneckii)
tinea versicolor= Malassezia furfur
Which tinea only infects superficial keratinized structures (dermatophyte tinea/ tinea versicolor, furfur / tinea nigra, werneckii)
dermatophyte tinea
Which type of tinea has the 3 major genera of 1. epidermophyton, 2. trichphyton, 3. microsporum? (dermatophyte tinea/ tinea versicolor, furfur / tinea nigra, werneckii)
dermatophyte tinea
Which type of tinea can be viewed on microscopy with 10% KOH?
(dermatophyte tinea/ tinea versicolor, furfur / tinea nigra, werneckii)
Diagnostic for all of them!
dermatophyte tinea/ tinea versicolor, furfur / tinea nigra, werneckii
Which type of tinea can be treated with oral griseofulvin? (dermatophyte tinea/ tinea versicolor, furfur / tinea nigra, werneckii)
dermatophyte tinea
Which type of tinea can be treated with topical miconazole? (dermatophyte tinea/ tinea versicolor, furfur / tinea nigra, werneckii)
tinea versicolor = Malassezia furfur
Which type of tinea should be treated with salacyclic acid and topical azole? (dermatophyte tinea/ tinea versicolor, furfur / tinea nigra, werneckii)
tinea nigra = cladosporium werneckii
Which type of tinea generates brown pigments and appears as brown spots? (dermatophyte tinea/ tinea versicolor, furfur / tinea nigra, werneckii)
tinia nigra
dermatophyte tinea, tinea versicolor and tinea nigra are all (cutaneous mycosis/ subcutaneous mycosis)
cutaneous, superficial
Which is thermally dimorphic (Sporotrichosis/ Chromomycosis/ Mycetoma)
Sporotrichosis
Sporotrichosis, Chromomycosis and Mycetoma are all (superficial cutaneous/ subcutaneous)
subcutaneous
Which associated with roses and thorn puncture wounds (Sporotrichosis/ Chromomycosis/ Mycetoma)
Sporotrichosis
On biopsy, this fungus has cigar shaped yeast, cultured at room temp it ha hyphea with oval conidia clusters (Sporotrichosis/ Chromomycosis/ Mycetoma)
Sporotrichosis
Which causes dark, wart-like lesions, especially on the legs and feet? (Sporotrichosis/ Chromomycosis/ Mycetoma)
Chromomycosis
Which might you get walking barefoot in a tropical location? (Sporotrichosis/ Chromomycosis/ Mycetoma)
Chromomycosis
Which do you treat with itraconazole? (Sporotrichosis/ Chromomycosis/ Mycetoma)
Sporotrichosis
Which do you treat with flucytosine of thiabendazole? (Sporotrichosis/ Chromomycosis/ Mycetoma)
Chromomycosis
Which forms abscesses with pus containing colored granules and may require surgical excision? (Sporotrichosis/ Chromomycosis/ Mycetoma)
Mycetoma
Which are you most likely to see on a patient in the US? (Dermatophytosis/ Chromomycosis/ Mycetoma)
Dermatophytosis
Which of the following are Candidiasis virulence factors? (adhesion/ acid proteases/ phenotype switching/ intracellular evasion)
adhesion, acid proteases and phenotype switching
Candidiasis is not intracellular
Which cell type is primarily responsible for killing tumors in the body? (NK cell/ CD4+ T cells/ CD8+ cytotoxic T cells)
CD8+ cytotoxic T cells
List the 3 types of Typhus and their vectors
- Epidemic typhus - louse
- Murine Typhus - fleas
- Scrub Typhus - chiggers
Which is more likely with a cat bite (Pasturella multocida/ Capnocytophaga species)
Pasturella multocida
Which is more likely with a dog bite (Pasturella multocida/ Capnocytophaga canimorsus)
Capnocytophaga canimorsus
Which can you pick up from lawn mowing and running over a rabbit? (Anthrax/tuleremia/brucellosis/plague/cat scratch fever/ leptospirosis)
Tularemia: Francisella tularensis
which can be carried by cattle? (Anthrax/tuleremia/brucellosis/plague/cat scratch fever/ leptospirosis)
Anthrax: bacillus anthracis and
Brucellosis: Brucella species
Which can cause a cyclic fever in the acute form of the disease (Anthrax/tuleremia/brucellosis/plague/cat scratch fever/ leptospirosis)
Brucellosis: Brucella species
Which has gram (-) rods? (Anthrax/tuleremia/brucellosis/plague/cat scratch fever/ leptospirosis)
- Plague: Yersinia Pestis
- Tularemia
- Brucella
- Cat scratch disease: Bartonella henselae
Which makes gram (+) endospores?(Anthrax/tuleremia/brucellosis/plague/cat scratch fever/ leptospirosis)
Antrax: Bacillus anthracis
Which can lead to icterus with Weil disease? (Anthrax/tuleremia/brucellosis/plague/cat scratch fever/ leptospirosis)
leptospirosis
