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Elliot Step 1 > Micro Cards > Flashcards

Micro Cards Flashcards

1
Q

Cellulitis?

A

Pasteurella

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2
Q

undulant fever?

A

Brucella

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3
Q

Unpasteurized dairy?

A

Brucella; listeria; campylobacter

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4
Q

Dairy products and dogs? treat with?

A

Yersenia– aminoglycosides with tetracycline; bipolar staining

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5
Q

Puppies and bloody diarrhea?

A

Campylobacter

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6
Q

Cat scratch disease? Treatment?

A

Bartonella; macrolides and doxycycline

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7
Q

Casseating granulomas and painful ulcers?

A

Francisella– from rabbits (think of radishes underground in video)

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8
Q

Aerosols of cattle; no rash; fever; pneumonia

A

Q fever; Coxiella

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9
Q

Osteomyelitis and cellulitis?

A

Pasteurella

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10
Q

Gray vaginal discharge

A

Gardnerella

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11
Q

Clue cells

A

Gardnerella

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12
Q

Gray discharge– pH?

A

Between 5-6.5

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13
Q

Treatment of gray discharge?

A

Gardnerella– metronidazole

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14
Q

+ whiff test plus clue cells?

A

Gardnerella

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15
Q

Patchy infiltrates on X ray but patient not in bad shape?

A

Mycoplasma pneumonia

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16
Q

IgM cold agglutinins?

A

Mycoplasma pneumonia

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17
Q

Bacteria with no cell wall+ eatons agar?

A

Mycoplasma pneumonia

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18
Q

Treatment of bacteria that causes patchy infiltrates on xray in patient with fever, headache, non productive cough?

A

Mycoplasma pneumonia required macrolides or fluoroquinolones

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19
Q

Only bacteria with cholesterol in cell membrane?

A

Mycoplasma

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20
Q

Rash that starts at wrist treatment?

A

Rickettsia rickettsii– RMSF– doxycycline (Rickets tires)

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21
Q

Weil felix agglutination test- this bacteria requires what cofactors

A

CoA(ch) and NAD+ (name of drink)

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22
Q

Causes vasculitis– treatment?

A

Rocky mountain spotted fever– doxycycline

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23
Q

Rash that starts on wrist– spread via?

A

Dermatick–RMSF (dermacenter)

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24
Q

Spread by louse?

A

Rickettsia prowazekii (throwing around louse football)

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25
Q

Rash starts out centrally and spread out sparing face, palms and soles- requires what substances to proliferate?

A

R. prowazekii– NAD+ (name of drink) and CoA (CH)

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26
Q

Palm sole rash Ddx: 3?

A

CARS: Coxsackie a infection; RMSF; Syphilis– drive CARS using palms and soles

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27
Q

Myalgias, pneumonia, centrally located rash– requires?

A

Prowazekii; NAD+ and CoA

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28
Q

Berry like inclusions in cytoplasm?

A

Ehrlichiosis (monocytes with morula)

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29
Q

Monocytes with morula

A

Ehrlichiosis (berry like inclusions)

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30
Q

Histology of Ehrlichiosis?

A

Monocytes with morula

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31
Q

Histology of Anaplasmosis?

A

Granulocytes with morula in cytoplasm

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32
Q

Granulocytes with morula in cytoplasm?

A

Anaplasmosis

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33
Q

No arthropod vector, no rash, fever, hepatitis

A

Coxiella (Curly Q)– think of cow with liver painted on

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34
Q

Cannot make own ATP; STD?

A

Chlamydia

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35
Q

Chlamydia replication?

A

Replicate in reticulate body; and infect via elementary body

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36
Q

Elementary body?

A

Chlamydia’s enfectious form

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37
Q

Joint pain; sexually active; conjunctivitis– treatment?

A

Chlaymydia– treat with macrolide (favored due to one time dose) or doxycycline (ceftriaxone to cover gonorrhaea)

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38
Q

Leading cause of blindness world wide?

A

Chlamydia A-C (blind pirate)

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39
Q

Chlamydia is missing what in cell wall?

A

Muramic acid– so treat with macrolide

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40
Q

Cytoplasmic inclusion seen on giemsa stain? Treatment?

A

Chlamydia– macrolides or doxy

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41
Q

lacks Muramic acid in cell wall– blindness?

A

Chlamydia

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42
Q

Short sudden bursts of coughing, watery discharge from vagina– ?

A

Chlamydia D-K– staccato cough

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43
Q

Enlarged lymph nodes in groin area– start off painless and become painful?

A

Lymphogranuloma venereum L1-L3

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44
Q

Variable gram stain?

A

Gardnerella–treat with KOH prep

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45
Q

Stages 1,2,3 of lyme disease?

A

1) erythema chronicum migrans (bulls eye)– flu like sx2) Cardiac block with bells palsy3) Musculoskeletal (arthritis) and neurologic (encephalitis and polyneuropathy)

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46
Q

Host of child tick lyme disease?

A

Mouse

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47
Q

Host of adult tick in Lyme disease?

A

Deer

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48
Q

Central clearing rash– tick? what else uses this tick?

A

Ixode; Babesia is also carried by Ixode tick

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49
Q

AV nodal block after camping trip a few months ago–? Treatment?

A

Doxy (Robbin hood on cycle shooting bow)Lyme disease

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50
Q

Stain for lyme disease?

A

Wright stain (Sir Wright) and Giemsa

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51
Q

Reddening of eyes but no exudate?– found in?

A

Leptospira interrogans– water contaminated with animal urine (Think surfer)

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52
Q

Jaundice, fever, question mark shaped bacteria?

A

Leptospira

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53
Q

Leptospira looks like on histology?

A

Question mark– duh it’s a spirochete

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54
Q

Bug that can cause kidney dysfunction; found in urine contaminated water?

A

Leptospira

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55
Q

Jaundice, azotemia, fever, hemorrhage, and anemia?

A

Leptospira– Weil’s disease (think Whale) (surfer, with kidney, RBCs)

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56
Q

Weil’s disease?

A

icterohemorrhagic leptospirosis– severe form of jaundice and azotemia associated with leptospira infection

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57
Q

Painless genital ulcer? screen with? confirm with?

A

Syphilis; screen with VDRL; confirm with FTA-ABS

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58
Q

Immune response of syphilis?

A

Th1 even though Treponema is extracellular

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59
Q

Condyloma lata

A

Treponema

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60
Q

Condyloma accumulata

A

HPV

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61
Q

Hallmark of tertiary syph?

A

Gummas (chronic granulomas)

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62
Q

Tabes dorsalis causes neuro issues in wha tpart of spinal cord?

A

Dorsal column

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63
Q

Tertiary syphilis may have what cardiac affect?

A

Aortitis dt vaso vasorum destruction

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64
Q

Charcot joints

A

Tertiary syph– degeneration of weight bearing joints

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65
Q

Positive Romberg test + funny acting pupils

A

Tertiary syphilis

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66
Q

Rash in syphilis is?

A

Palms and soles (also seen in coxsackie A, rickettsia)– drive CARS with palms and soles

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67
Q

Anterior convexing tibia in newborn?

A

Congential syph– saber shins

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68
Q

Saddle nose?

A

Congenital syph

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69
Q

Teeth in congenital syph (2)?

A

mulberry molars and hutchinson teeth

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70
Q

Placental transmission of syph usually occurs when?

A

First trimester

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71
Q

Tree barking aorta?

A

Tertiary syphilis– vaso vasorum destruction leads to aortitis

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72
Q

Causes false positive in VDRL syph test?

A

Viruses (mono, hep); Drugs; Rheumatic fever; Lupus, leprosy

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73
Q

Another screening test for syph other than VDRL?

A

RPR

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74
Q

Cause of reaction that begins after treatment of syphilis?

A

Killed bacteria releases pyrogens– Jarisch Herxheimer reaction

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75
Q

Maculopapular rash (5)

A

Measles, Rubella, Scarlet fever, Syphilis, Parvo B19

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76
Q

Rash caused by Rubella?

A

Maculopapular

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77
Q

Rash caused by Scarlet fever?

A

Maculopapular

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78
Q

Rash caused by Syphilis?

A

Maculopapular

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79
Q

Cranial nerve defect in congenital syph?

A

Deafness (8)

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80
Q

Baby born with weird teeth and deaf?

A

Syph

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81
Q

Gram positive abscess formation?

A

Staph aureus

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82
Q

Protein A virulence factor?

A

Staph aureus

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83
Q

Virulence factor of Staph?

A

Protein A

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84
Q

Mechanism of protein A

A

binds Fc-IgG inhibiting complement fixation and phagocytosis— STAPH

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85
Q

Treatment of resistant strains of gm+ organism with protein A virulence factor?

A

Vancoymycin (staph)

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86
Q

Mech of TSST superantigen?

A

binds MHCII and TCR resulting in polyclonal t cell activation (Staph)

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87
Q

Widespread formation of fluid filled blisters with formation of blisters within minutes of rubbing skin?

A

Staph– caused by exfoliative toxin (scalded skin)

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88
Q

Bunch of people at picnic get sick from potato salad– toxin?

A

Staph– Enterotoxin

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89
Q

Fever, vomiting, desquamating rash, dec blood pressure?

A

TSST superantigen found in Staph- binds mhcII and TCR resulting in polyclonal t cell activation

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90
Q

Pneumonia with patchy infiltrates

A

M. pneumonia or Staph

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91
Q

staph is resistant to ?

A

Beta lactams because of altered penicillin binding protein

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92
Q

Beta hemolytic coagaulase and catalase+?

A

Staph

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93
Q

Causes acute bacterial endocarditis in IV drug users?

A

staph

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94
Q

Staph aureus food poisoning is caused by ingestion of?

A

preformed toxin

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95
Q

Common cause of osteomyelitis; gm+

A

staph

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96
Q

Post viral bacterial pneumonia?

A

Staph

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97
Q

Bug that infects prosthetic devices– MOA?

A

Produces adherent biofilms

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98
Q

Novobiocin sensitive?

A

staph epi

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99
Q

novobiocin resistant?

A

staph saprophyticus

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100
Q

Staph saprophyticus can cause?

A

UTIs in sexually active women

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101
Q

Treatment of staph epi

A

Vancomycin (think Van behind plumber)

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102
Q

alpha hemolytics?

A

pneumoniae and viridans

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103
Q

Optochin sensitive?

A

strep pneumo

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104
Q

Quellung positive group A

A

strep pneumo

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105
Q

Optochin resistant?

A

strep viridans

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106
Q

Can cause dental carries?

A

Strep mutans which is part of viridan group

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107
Q

Can cause subacute bacterial endocarditis at damaged valves?

A

Viridans–s. sanguis

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108
Q

MOA of sanguis?

A

Sticks to damaged valves by making glycocalyx

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109
Q

Susceptible in sickle cell disease to what bacteria?

A

Strep pneumo

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110
Q

Strep pneumo causes?

A

MOPS; meningitis, otitis media, pneumonia, sinusitis

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111
Q

Lancet shaped diploccoi

A

strep pneumo

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112
Q

Rusty sputum

A

strep pneumo

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113
Q

Strep pneumo virulence?

A

Capsule– NOT VIRULENT WITHOUT CAPSULE

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114
Q

Treatment of strep pneumo?

A

Cetriaxone and macrolides (axes and birds at knight tournament)

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115
Q

Strep pneumo vaccine in adults produces?

A

IgM response

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116
Q

Strep pneumo vaccine in children produces?

A

IgG response

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117
Q

Virulence factor of rheumatic fever? MOA?

A

M protein (m on bakers hat)– inhibits phagocytosis and creates molecular mimicry against mitral valve

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118
Q

Bacitracin sensitive?

A

strep pyogenes

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119
Q

Detection of recent pyogenes infection?

A

ASO titer

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120
Q

Widspread rash sparing the face; pharyngitis?

A

Scarlet fever

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121
Q

Honey crusted lesions?

A

strep pyogenes– impetigo

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122
Q

Causes lyses of RBC, gm+ catalase negative

A

Streptolysin O in strep pyogenes

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123
Q

Jones criteria of rheumatic fever?

A

Joints (first thing); heart (shape); nodules (subcutaneous); erythema marginatum; sydenhams chorea

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124
Q

Strep pyogenes causes 3 main things and subtypes

A

1) pyogenic: pharyngitis; cellulitis; impetigo2) Toxigenic: scarlet fever; toxic shock like syndrome; necrotizing fasciitis3) Immunologic: rheumatic fever; acute glomerulonephritis (cola colored urine)

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125
Q

Capsule in strep pyogenes is made of ?

A

Hyaluronic acid

126
Q

Impetigo in strep pyogenes generally preceeds?

A

Glomerulonephritis

127
Q

Job of streptokinase?

A

Activates circulating plasminogen to plasmin to degrade clots

128
Q

Superantigen in strep pyogenes?

A

exotoxin A

129
Q

Bacitracin resistant?

A

Strep agalactiae

130
Q

Strep agalactiae produces what?

A

CAMP factor– enlarges area of hemolysis formed by s. aureus

131
Q

CAMP factor

A

strep agalactiae

132
Q

1 cause of neonatal meningitis?

A

strep agalactiae

133
Q

when do we screen for group B strep

A

35 weeks

134
Q

Pregnant mom with strep agalactie– what do you do?

A

treat with penicillin

135
Q

Test for strep agalactiae?

A

hippurate (think of hippo on ground in galactic baby scene)

136
Q

Hippurate positive

A

strep agalactiae

137
Q

Penicillin G resistant and cause UTIs

A

Enterococcus

138
Q

Biliary tract infections– bug?

A

Enterococcus– salmonella typhi also causes gallbladder problems I believe

139
Q

grow in bile and NaCl

A

Enterococcus

140
Q

Growth in bile and not NaCl

A

Strep bovis

141
Q

Enteroccus faecalus is ?

A

More common and less dangerous

142
Q

Enterococcus faecium

A

Less common more dangerous (think of scary guy carrying sign that says No more FEES)

143
Q

Patient presents with biliary tract infection– what can we grow his bug sample on?

A

enterococcus– grow on bile and nacl

144
Q

Treatment of enterococcus resistant to Vanco?

A

Tigecycline and Linezolid (think TIGer police tape and LINE around parameter)

145
Q

Osteomyelitis in sickle cell disease?

A

salmonella

146
Q

Osteomyelitis in teens

A

Neisseria–sexually active

147
Q

Osteomyelitis in diabetics of IV drugs users

A

Pseudomonas

148
Q

Osteomyelitis leading to vertebral body problems

A

Pott disease– tuberculosis

149
Q

Virulence of C. diptheriae

A

exotoxin inhibits ADP riBOWsalation of EF-2

150
Q

psuedomembranous pharyngitis

A

corynbacterium diptheriae

151
Q

Myocarditis and arrhythmias gm+ rod

A

Corynebacterium diptheria

152
Q

Metachromatic blue and red granules

A

Corynebacerium diptheriae

153
Q

Eleks test

A

Corynebacterium diptheriae

154
Q

Test for toxin in corynebacterium diptheriae?

A

Eleks

155
Q

How is diptheria spread?

A

through respiratory droplets (think bull with droplets coming out of nose and eyes)

156
Q

Club shaped

A

corynebacterium (think morracas in bull fight)

157
Q

Chinese character bacteria?

A

Corynebacterium

158
Q

Teleuride and loughlers medium

A

Corynbacterium (Tele and Laughing)

159
Q

Spores are composed of what?

A

dipicolinic acid at the core

160
Q

Clostridia specias are…bacilli?

A

obligate anaerobic bacilli

161
Q

MOA of tetanus toxin?

A

Protease that cleaves releasing proteins (SNARES) for neurotransmitters

162
Q

Protease that cleaves snares?

A

Tetanus or botulinum

163
Q

Tetanus blocks which two NT?

A

GABA and glycine (inhibitory neurotransmitters)

164
Q

Two inhibitor neurotransmitters? Vaccine binds?

A

GABA and glycine– blocked in c. tetani

Vaccine binds toxoid

165
Q

GABA and glycine are released from which cells?

A

Renshaw (monkey with wrench)

166
Q

Renshaw cells?

A

C. tetani– renshaw cells release gaba and glycine which are inhibitory neurotransmitters

167
Q

Risus sardonicus

A

C. tetani

168
Q

Opisthonos

A

Overarching of back seen in C tetani

169
Q

C. botulinum inhibits?

A

ACh release at neuromuscular junction

170
Q

Adult disease in c botulinum is caused by

A

preformed toxin!

171
Q

Child disease in c botulinum is caused by?

A

spores

172
Q

2 month old presents with paralysis of arms that started in face, drooping eyes

A

C. botulinum caused by the spore of honey or canned goods

173
Q

Lymphadenopathy, myocarditis, membranous stuff on pharynx

A

corynebacteria

174
Q

Produced alpha toxin? whats in alpha toxin

A

C perfringens– lecithinase (a phospholipase)

175
Q

Toxin produced by c perfringens? whats in toxin?

A

Alpha toxin–lecithinase (phospholipase)

176
Q

Myonecrosis and hemolysis?

A

C perfringens

177
Q

Double zone of hemolysis on blood agar?

A

C perfringens

178
Q

Person working on a farm develops myonecrosis

A

C. perfringens–spore found in soil

179
Q

Where is C. perfringens found?

A

soil

180
Q

C perfringens associated with what type of accident?

A

motorcycle accidents

181
Q

Two toxins of C. diff and functions of toxins

A

Toxin A= enterotoxin; binds to brush border (think choc. factory brushing choc on apples (a)) of gutToxin B= Cytotoxin; destroys cytoskeletal structure of enterocytes–>pseudomembranous colitis

182
Q

pseudomembranous colitis

A

C diff

183
Q

C diff usually secondary to use of which antibiotic?

A

Clindamycin or ampicillin

184
Q

How do we detect C. diff?

A

Toxins in stool (NOT BACTERIA)

185
Q

Treatment of C. diff?

A

Vanco or metronidazole (think Van and metro in chocolate factory)

186
Q

Bacteria with polypeptide capsule? what does it contain?

A

Anthrax– contains D glutamate (poly D symbol on viking chest)

187
Q

D glutamate capsule?

A

Anthrax

188
Q

Black painless eschar?

A

Anthrax

189
Q

Rods and chains bacteria?

A

Anthrax

190
Q

Pulmonary hemorrhage, fever– what else would we see? How does one get this?

A

Anthrax– see mediastinitis (think shape of ax with blood on it); transmitted via spores from contaminated wool (wool on armor)

191
Q

Edema factor–>?

A

Increased cAMP (via Ca2+)–> increase in fluid–>helps bug evade phagocytosis– bacillas anthracis

192
Q

Lethal factor–>?

A

Snips off N-terminus of MAPK– bacillas anthrax

193
Q

Two enzymes of Anthrax?

A

Edema factor and Lethal factor

194
Q

Treatment of Anthrax?

A

Fluoroquinolones and doxycyline (think of flower on vikings shoulder along next to tire on boat)

195
Q

Toxin of bacillus cereus?

A

Cereulide– preformed toxin

196
Q

watery, nonbloody diarrheam GI pain, reheated food

A

B. cereius– cereulide toxin

197
Q

How does listeria move?

A

via actin rockets (rocket on christmas); tumbling motility (Santa tumbling down fireplace

198
Q

cat+; gm+ rod; beta hemolytic

A

Listeria

199
Q

Granulomatosis infantiseptica?

A

Listeria

200
Q

Treat Listeria with?

A

Ampicillin in infants (AMP with guitar for christmas)

201
Q

Actinomyces?

A

Gm+ aNaerobe (think soldier with gas mask); filamentous branching rods

202
Q

Nocardia?

A

gm+ aerobe (bellow

203
Q

Gm+ filamentous branching rods?

A

actinomyces and nocardia

204
Q

Oral and facial abscesses that form yellow sulfur granules

A

actinomyces (soldier with facial abscesses)– drain through sinus tracts

205
Q

Patient presents with oral abscess after dental work?

A

Actinomyces (yellow sulfur granules– yellow sand in israel)

206
Q

Treatment of actinomyces?

A

Penicillin G– think of israeli solider with pencilin against tree

207
Q

Pulmonary infection in cancer patient. bug is found in soil?

A

Nocardia (no card game for old men); acid fast (mycolic acids)

208
Q

HIV patient undergoes a bicycling accident and develops indurated lesions on the skin; bug is acid fast; how would we treat him?

A

Nocardia causes cutaneous infections in immunocompromised after trauma— TREAT with Sulfonamides (eggs on counter in no card game for old men contains lot of sulfonamides)

209
Q

6 causes of osteomyelitis

A

1) Staph
2) N. gonorrhaea
3) Salmonella–sickle cell disease
4) Pseudomonas
5) Pasteurella
6) TB

210
Q

Connection between sickle cell and osteomyelitis

A

Salmonella can cause osteomyelitis in sickle cell patient

211
Q

Budding yeast in macrophages?

A

Histoplasmosis– bird or bat droppings– mississippi ohio river valley

212
Q

Broad based bud

A

Blastomycosis– east of mississippi; forms granulomas; pneumonia; ulcerating pimple

213
Q

Patient from North Carolina presents with pneumonia and ulcerating pimple– fungi?

A

Blastomycosis

214
Q

HIV patient presents with pulmonary infection, arthralgias and rash. He’s from New mexico– describe the organism?

A

Coccidioidomycosis– thick walled spherule with endospores– southwestern US

215
Q

Thick walled spherules with endospores?

A

Coccidioidomycosis– cutaneous lesions; pulmonary infections

216
Q

Budding yeast with central circle

A

Paracoccidioidomycosis

217
Q

Patient complains of a rash that develops after she comes back from the beach. On KOH prep there is a stringy clumpy appearance– disease and process?

A

Malassezia furfur– degradation of fats produce acids that damage the melanocytes and cause hypopigmentation. The suntan made the hypopigmentation more noticeable

218
Q

Pseudohyphae and budding yeast at 20C

A

Aspergillas

219
Q

Drug user develops endocarditis on tricuspid valve. Organism exhibits germ tubes when grown at 37C–organism? Treatment?

A

Candida– amphotericin B for systemic disease; fluconazole for oral/esophageal.

220
Q

Candida– random facts

A

Increased risk of infection with candida in patient with neutropenia; pseudohypae at 20c; germ tubes at 37c

221
Q

Patient who is a farmer says he is deficient in NADPH oxidase and Asthma. He presents with wheezing, coughing, and shortness of breath– describe organism?

A

Aspergillus– 45 degrees; not dimorphic; Causes allergic bronchopulmonary aspergillosis; grown on vegitation
May cause aspergillomas in lung cavities
Aspergillus most common in immunocompromised and those with CGD

222
Q

45 degree branching and radiating chains of spores

A

Aspergillus– seen in farmers because grows on vegetables; looks like stalk with colorful round thing at the end

223
Q

Aspergillus produce aflatoxin which is associated with?

A

Hepatocellular carcinoma

224
Q

HIV patient living on the streets presents with meningitis. The organism stains with India ink. What agar would you use? What woudl latex agglutination test detect? What will you see in brain

A

Cryptococcus– Sabourauds agar; latex would show polysaccharide capsular antigen; has large capsule

See soap bubble lesions in brain

225
Q

Treatment of cryptococcus?

A

Flucanozole

226
Q

Patient presents with slow deep breaths, purulent discharge, black eschar on face, and orbital pain. Organism? Treatment?

A

Mucor and Rhizopus– branch at 90 degrees.
Most common in ketoacidotic diabetic (the fungi likes ketones and glucose)
Penetrates the cribriform plate and enters brain.
Treat with amphotericin b

227
Q

Fungi that affects paranasal sinuses?

A

Mucor Rhizopus

228
Q

HIV patient presents with interstitial pneumonia. How is the organism spread?

A

Pneumocystis jirovecii is spread via inhalation

229
Q

Disc shaped yeast forms on methenamin silver stain of lung?

A

Pneumocystis jirovecii

230
Q

Treatment of pneumocystis jirovecii

A

TMP SMX, pentamidine, dapsone

231
Q

Child dives into a bunch of bushes at home to catch a football. He develops reddish pinkish round nodules on his arm. Organism? Describe organism?Treatment

A

Sporothrix Schenckii– rose gardners disease; caused by prick from thorn. Grows on vegetation. Dimorphic cigar shaped budding yeast; forms subQ nodules
Treat with itraconazole or potassium iodide (Plant Rose in the pot)

232
Q

Dimorphic, budding yeast, skin rash; Lives on vegetation?

A

Sporothrix Schenckii

233
Q

Pseudohyphae and budding yeast; causes diaper rash in children?

A

Candida

234
Q

Differential for bird droppings?

A

Histoplasmosis (because lives in histiocytes) or cryptococcus

235
Q

Granulomas+ulcerating pimple?

A

Blastomycosis; broad based budding; Blasto buds broadly

236
Q

Chronic Granulomatous disease+ bug?

A

Aspergillus

237
Q

Bug associated with hepatocellular carcinoma?

A

Aspergillus– produced aflatoxin

238
Q

Patient presents with bloody diarrhea after a camping trip. The patients stool shows mobile bug with ingested RBC–what will histology show? Where did the bug come from? Treatment?

A

Entamoeba presents with dysentery, liver abscess. Can get it from cysts in the water. Histology will show flask shaped ulcer if submucosal abscess of colon ruptures. Treatment is with metronidazole (forms free radical toxic metabolites– causes disulfiram reaction sometimes)

239
Q

Serology shows trophozites with RBCs in cytoplasm?

A

Entameoba– cysts ingested and differentiate to trophozites in ileum (trophozites have 4 nuclei cysts)

240
Q

Differential for protozoal diarrhea?

A 
Bloody= entamoeba
Watery= cryptosporidium
Fatty= Giardia
241
Q

20yoF presents 2 weeks after a camping trip with foul smelling stools– what will trophozites look like?

A

2 nuclei with 4 pairs of moustache flagella

242
Q

2 nuclei, and 4 pairs of moustache flagella?

A

Giardia

243
Q

HIV patient presents with severe diarrhea that is non bloody. The patient had previously visited a farm. What diagnosis tool should be used for this trophozite?

A

Acid fast stain

244
Q

Patient with CF, from Iowa– works on a farm, presents with wheezing and coughing– bug?

A

Aspergillus (septa hyphae branches at 45 degrees); one long stick with bunch of tiny little round things at end (fruiting body). Can cause allergic bronchipulmonary aspergillosis in asthma and CF

245
Q

Patient presents with vaginal greenish, watery foul smelling discharge. How is organism spread? What does it look like on wet mount?

A

Spread through sexual contact. Cannot survive outside environment because it LACKS a CYST. Looks like a tear drop (5 flagella, 1 nucleus)

246
Q

Causes brain abscess in HIV patient?

A

Toxoplasmosis– seen as ring enhancing lesions– treat with sulfadiazine ad pyrimethamine

247
Q

Neonate presents with retinal inflammation, increased ICP, and intracranial calcifications. Where did mother get bug from? Treatment? What does it look like on histology?

A

Cysts in meat or cats; mother is asymptomatic
Sulfadiazine+pyrimethamine
Crescent shaped trophozites

248
Q

Patient presents with dilated cardiomyopathy, megaesophagus after visiting south america? Transmission? Treatment?

A

Trypnasoma cruzi; Chagas’ disease: megacolon and romanas sign can be seen also (causes achalasia).

Transmitted via the reduviid bug (kissing bug), painless bite much like a kiss

Treat with nifurtimox

249
Q

Treatment of trypnasoma cruzi?

A

Nifurtimox

250
Q

Trypnasoma transmited via?

A

Reduviid bug

251
Q

Pt from tropical country presents with weight loss and fever. PE revelas massive hepatosplenomegaly with edema and hyperpigmented skin patches. CBC shows thrombocytopenia, and anemia– bug? Transmission? Histology? Treatment?

A

Leishmania (kalazar– means black illness for hyperpigmented skin lesions): spiking fevers, hepatosplenomegaly, pancytopenia

Transmitted via sandfly
See macrophages containing amastigotes

Treat with sodium stibogluconate

252
Q

Macrophages with amastigotes?

A

Lesihmania; transmitted via sandfly

253
Q

Treatment of leishmania?

A

sodium stibogluconate

254
Q

Pt from Africa presents with chronic fatigue, enlarged lymph nodes, and recurrent fevers? Transmission? Treatment?

A

Trypansoma brucei: african sleeping sickness due to antigenic variation which allows protozoa to evade immune response
Transmitted via tsetse fly; painful bite

Treated with suramin for blood borne disease
Melarsoprol for CNS penetration

255
Q

Dormant form of malaria?

A

P. vivax/ovale– treatwith chloroquine which blocks heme polymerase– use mefloquine if resistant

256
Q

Worst form of malaria?

A

Falciparum (“Fal”ing fast”)

257
Q

Test patients for blank before giving malarial meds?

A

G6PD deficiency

258
Q

How is Listeria distinguished from beta hemolytic strep?

A

Listeria is catalase+

259
Q

These bacteria resemble fungi due to branching filaments?

A

Actinomyces and nocardia

260
Q

Sore throat and acute hemorrhagic cystitis?

A

Adenovirus (no envelope); conjunctivitis; and pneumonia as well

261
Q

Pink eye?

A

Adenovirus (“Adam NO! farting on your brother, you’ll give him pink eye”)

262
Q

causes aplastic crisis in sickle cell disease? What is special about this DNA virus?

A

Parvovirus (no envelope)– SINGLE STRANDED

RBC APLASIA AND RHEUMATOID ARTHRITIS IN ADULTS

263
Q

JC virus? BK?

A

Polyomavirus– JC: Junky cerebrum

BK: bad kidney

264
Q

Flesh colored dome lesions with central dimple?

A

Poxvirus

265
Q

Most common cause of sporadic encephalitis in us?

A

Temporal lobe encephalitis due to HSV 1

266
Q

Owl eye inclusion bodies on histology?

A

CeeMV

267
Q

1yo presents after having a seizure. The child has had a fever for the past several days. She now has a diffuse macular rash

A

HHV6 Roseola

268
Q

Pico viruses?

A

PERCH

Polio; Echo; Rhino; Coxsackie; HAV

269
Q

MCC of viral gastroenteritist in children?

A

Rota virus

270
Q

MCC of viral gastroenteritis in adults?

A

Norovirus– part of calicivirus family (people in California shit a lot)

271
Q

Influenza virus is part of what family?

A

Orthomyxovirus

272
Q

Paramyxoviruses? 3

A

Parainfluenza, RSV, Measles, Mumps

PaRaMyxo

273
Q

High fever, black vomitus, and jaundice?

A

Yellow fever causes black vomit (Flavivirus)

274
Q

Describe rotavirus?

A

dsRNA; segmented–>villous destruction with atrophy leads to dec absorption of Na and loss of K+

275
Q

Rash that starts at the head and moves down; postauricular adenopathy; deafness

A

Rubella virus– congenital rubella looks like blueberry muffin

276
Q

F protein?

A

Paramyxovirus– fusion protein causes respiratory epithelial cells to fuse and form multinucleated cells

277
Q

Palivizumab?

A

Prevents pneumonia caused by RSV infection in premature infants

278
Q

Koplick spots?

A

Measles– paraMyxo

279
Q

Cough, coryza, conjunctivitis?

A

Measles

280
Q

Rubella rash vs measles rash?

A

Rubella=truncal

Measles= involves hands and feet

281
Q

Severe pneumonia; fever; GI and CNS symptoms–bug? how do we detect?

A

Legionella; detect clinically by antigen in urine; silver stain; grows on charcoal extract with iron and cystein

282
Q

pericardial knock

A

constric. pericarditis

283
Q

bipolar staining

A

yersenia

284
Q

how is yersenia secreted?

A

via type III secretion system

285
Q

Swollen tender lymph nodes on skin

A

bubbos- yersenia

286
Q

seafood contaminated by?

A

vibrio subtypes

287
Q

Pt has difficulty urinating; swarming motility when plated?

A

Proteus– struvite stones– fishy odor

288
Q

anal pruritus

A

enterobius vermicularis treat with mybuttazole

289
Q

Intestinal infection leading to bilirubin stones– fecal oral

A

ascaris lumbricoides

290
Q

Larvae in soil penetrate the skin

A

Strongyloides; intestinal infection, vomiting diarrhea anemia– treat with IVermectin (ivan is a STRONG man)

291
Q

Black flies, black skin nodules, black sight

A

Onchorcer volvulus– black volvo drove into river000 treat with “iver”mectin for river

292
Q

brain cysts; seizures; intestinal infection; from undercooked pork

A

Taenia solium– treat with praziquantel

293
Q

b12 deficiency; tape worm; trasmitted from fresh water fish

A

Diphyllobothrium laktum– praziquantel

294
Q

liver and spleen granulomas; fibrosis and inflammation; squamous cell carcinoma of bladder

A

schistosoma– treat with praziquantel

295
Q

Biliary tract inflammation–>pigmented gallstones– cuased by undercooked fish

A

Clonorchis sinensis associated with cholangiocarcinoma

296
Q

undercooked crab meat; lung inflammation and HEMOPTYSIS

A

paragonimus westermani

297
Q

liver cysts parasite

A

Echinococcus

298
Q

parasite microcytic anemia

A

necator and ancylostoma

299
Q

Catalase +

A

PLACESS pseudomonas, listeria, aspergillus, candida, ecoli, staph serratia

300
Q

epiglottitis, meningitis, otitis media, pneumonia

A

HaEMOPhilus– caused by capsular type B

301
Q

Treat haemophilus with?

A

cephtriaxon; – vaccine contains b capsular polysaccharide conjugated to diptheria toxoid

302
Q

Carbol fuschin stain

A

TB

303
Q

Cord factor

A

Tb

304
Q

freshwater lakes– rapidly fatal meningioencepahlitis

A

naegleria fowleri

305
Q

All DNA are linear except

A

papilloma, polyoma and hepadna

306
Q

All RNA are SS except

A

REO

307
Q

Naked nucleic acids of negative strands

A

are not infectious

308
Q

All viruses are haploid except

A

retrovirus

309
Q

DNA viruses replicate in?

RNA viruses replicate in?

A

DNA= nucleus except pox (has own DNA dependent RNA polymerase)

RNA= cytoplasm except influenza and retro

310
Q

Segmented viruses

A

BOAR

Bunya, ortho, arena, reo

311
Q

H. influenza

A

gram negative coccobacillus that needs NAD and CoA

Elliot Step 1 (32 decks)

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