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School > Micro Exam 11 > Flashcards

Micro Exam 11 Flashcards

1
Q

toxemia

A

Bacillus anthracis

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2
Q

non arthropod vector transmission

A 
s typhi
leptospira
bacillus anthracis
brucella
p multocida
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3
Q

louse transmission

A

r prowazekii
bartonella quintana
borellia recurrentis

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4
Q

tick transmission

A

francisella
r rickettsii
borellia burgdorferi

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5
Q

flea transmission

A

yersinia pestis
bartonella quintana
bartonella henselae

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6
Q

fly transmission

A

francisella tularensis

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7
Q

ticks and mites are vector and reservoir in all except

A

ehrlichia

lyme dz

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8
Q

extracellular

A

borellia

leptospira

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9
Q

facultative intracelllular

which target endothelial as opposed to macrophages/epithelial

A 
bacillus anthracis
brucella
francisella
salmonella
yersinia
bartonella quintana (endothelial)
bartonella henselae (endothelial)
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10
Q

encapsulated

A

bacillus anthracis
yersinia pestis
salmonella typhi

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11
Q

high infectious dose

A

salmonella typhi
babesia
francisella (ingestion route)

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12
Q

obligate intracellular?….

A

rickettsia
ehrlichia
anaplasma
babesia

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13
Q

human spread only important in

A

yersinia pneumonic plague

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14
Q

humans are sole reservoir

A

salmonella
ricketsii prowazekii
b recurrentis

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15
Q

vaccine preventable

A 
antrhax
typhoid fever
yersinia
HAV
HBV
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16
Q

salmonella morphology

A

encapsulated non coliform gram - rod

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17
Q

motile and invaive

A

salmonella

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18
Q

vi antigen

A

salmonella

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19
Q

fxns of vi antigen

A

antiphagocytic for pmns

prevents intracellular killing by type 3 secretion

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20
Q

reportable dz

A

salmonella, francisella, rickettsia, HAV, HBV

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21
Q

asia, africa, latin america

A

salmonella

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22
Q

main transmission of salmonella

A

ingestion of food and water with fecal contmaination

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23
Q

year round seasonality

A

salmonella

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24
Q

age group for salmonella

A

under 30

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25
Q

oral anal sex puts you at risk of

A

salmonella

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26
Q

carriers are females over 50

A

salmonella

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27
Q

salmonella incubation

A

1-2 weeks

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28
Q

salmonella pathogenesis

A

multiplies in peyers patches in SI then spreads to liver, spleen, bone marrow where it is phagocytized by macrophages (NOT PMNS). Multiplies intracellularly. Spreads again to gallbladder where it stays

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29
Q

Gallbladder carriage

A

salmonella

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30
Q

signs and symptoms of salmonella

A 
4 weeks of dz
1 - bacteremia with fever and flu signs
2 - bacteremia with fever and maculopapular rash
3 - ulceration of peyers patches
4 - cholecystitis
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31
Q

children under 5 have weird s and S

A

salmonella

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32
Q

intestinal perforation

A

salmonella

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33
Q

diagnose salmonella

A

1-3 weeks - blood
4+ weeks - feces > urine
2 weeks - serology for vi antigen

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34
Q

tx for salmonella

A

ampicillin, tmp smx, ciprofloxacin

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35
Q

vaccine for salmonella

A

vivotif Ty21a - oral live with boosters every 5 years

Typhim vi - parenteral recombinant with boosters every 2 years

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36
Q

Seen in macrophages

A

salmonella

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37
Q

fruits/vegetables

A

salmonella

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38
Q

Rat pee in water

A

Leptospirosis

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39
Q

Weil’s dz is a form of

A

Leptospirosis

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40
Q

dark field microscopy

A

leptospirosis, borrelia miyamotoi, lyme

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41
Q

chronic in kidney

A

leptospirosis

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42
Q

CNS type 3 vasculitis

A

leptospirosis

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43
Q

biphasic

A

leptospirosis

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44
Q

sispecial media

A

leptospirosis

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45
Q

s and s of leptospirosis

A

rash, aseptic meningitis, tibial tenderness, hemoptysis

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46
Q

spirochete with hooked ends

A

leptospira

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47
Q

multiple serovars for different animals

A

leptospira

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48
Q

tropical climates

A

leptospira

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49
Q

transmission of leptospira

A

water contact through skin abrasion

vertical transmission by placenta and breast milk

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50
Q

Pathogenesis of leptospira

A

endothelial damage resulting in vasculitis and persisting in kidney without renal impairment

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51
Q

Anicteric and icteric forms

A

leptospirosis

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52
Q

which form of lepto is most common

A

anicteric

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53
Q

acute leptospiremic phase

A

fever, headache, conjuncitval suffusion

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54
Q

immune leptospiruric phase

A

aseptic meningitis from immunopathology vasculitis

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55
Q

Abx are not effective when

A

immune phase of lepto

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56
Q

Weil’s dz is known as what and is characterized as what

A

icteric leptospirosis (anicteric signs of conjunctival suffusion and aseptic meningitis + JAUNDICE)

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57
Q

what causes weils

A

vascular dyfunction

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58
Q

Humoral immunity

A

leptospirosis, anthrax, borrelias

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59
Q

Binds DC SIGN to induce dendritic cell maturation

A

Humoral immunity in lepto

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60
Q

rats peei n water

A

lepto

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61
Q

diagnosis for lepto

A

Week 1 - blood and csf culture
Week 2 - urine culture
serology for ab’s

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62
Q

tx for lepto

A

penicillin
doxy
tetracycline

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63
Q

jarisch herxheimer

A

lepto

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64
Q

doxy chemoprophylaxis

A

lepto

yersinia

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65
Q

Spring seasonality

A

brucella

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66
Q

brucella morphology

A

gram - rod

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67
Q

abortus
suis
melitensis
canis

A

brucella

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68
Q

most common zoonotic dz

A

brucella

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69
Q

bangs dz

A

brucella

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70
Q

unpasteurized milk

A

brucella

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71
Q

transmission of brucella

A

ingestion
contact with skin abrasions or conjunctiva
inhalation

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72
Q

pathogenesis of brucella

A

enters skin or mucous membranes and spreads by lymphatics. Multiplies in macrophages preventing their apoptosis

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73
Q

brucella virulence factors

A

5’ GMP and AMP - suppress myeloperoxidase

Atypical LPS - doesn’t activate complement

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74
Q

signs and symptoms for 2-8 weeks

A

brucella

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75
Q

signs and symptoms of brucella

A

night sweats, fever, weight loss, malodorous perspiration

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76
Q

acute, undulant, and chronic form

A

brucella

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77
Q

tx for brucella

A

tetracycline with streptomycin for 6 weeks

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78
Q

spore forming

A

bacillus anthracis

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79
Q

GI, pulmonary, cutaneous

A

bacillus anthracis

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80
Q

boxcar shaped

A

bacillus anthracis

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81
Q

bacillus anthrasis morphology

A

encapsulated gram positive rod

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82
Q

virulence factors for bacillus anthracis

A

Poly D glutamic acid capsule (PXO2)
Protective antigen toxin
Lethal factor toxin
Edema factor toxin

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83
Q

LF fxn

A

Cleaves mitogen activated protein kinase kinases causing macrophage lysis

Targets cardiomyocytes and vascular smooth muscle cells

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84
Q

EF fxn

A

calcium calmodulin dependent adenylate cyclase

Acts on hepatocytes

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85
Q

herbivores

A

bacillus anthracis

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86
Q

WMD

A

bacillus anthracis, tularemia

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87
Q

WMD anthrax form

A

pulmonary

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88
Q

transmission of bacillus anthracis

A

excreted in feces, urine, and saliva with spores in soil

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89
Q

toxemia

A

bacillus anthracis

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90
Q

forms of anthrax

A

cutaneous - most common. eschar with edematous ridge (malignant pustule)
pulmonary (wool sorters dz) - inhale spores. multipy in lungs causing hemorrhage and necrosis.
GI - eat infected meatt which invades GI causing N/V/ bloody diarrhea and ascites

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91
Q

whcih form of anthrax is immune to abx pretty much

A

pulmonary

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92
Q

mediastinal widening

A

pulmonary anthrax

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93
Q

increase in vascular permeability causing respiratory deistress, hemorrhage, shock, and death

A

pulmonary anthrax

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94
Q

Target of immunity in anthrax

A

PA antigen

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95
Q

Tx for bacillus anthracis

A

penicillin, doxy, cipro

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96
Q

vaccine for anthrax

A

PA purified vaccine with small amounts of LF and EF

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97
Q

tularemia agent

A

francisella tularensis

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98
Q

morphology of francisella

A

Encapsulated G- coccobacillus

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99
Q

intracellular in macrophages, endothelial cells, and hepatocytes

A

francisella

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100
Q

virulence factor for francisella

A

lipoprotein encoded by FTT1103

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101
Q

ocurs in all states except hawaii

A

francisella

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102
Q

rabbis

A

francisella

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103
Q

no P2P ever documented

A

Francisella, trench fever

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104
Q

transmission of francisella

A

contact with animal carcasses
cat or tick bite
aerosol
ingestion (high ID)

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105
Q

warmer months

A

francisella, RMSF, Spotted fever group

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106
Q

multiplies in macrophages and amoebae

A

francisella

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107
Q

signs and symptoms of francisella

A

uleceroglandular form - papule at entry site, enlarged lymph nodes, granulomatous nodules
Inhalation form
GI form

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108
Q

detected by visualizing antibodies with a 4 fold increaase

A

francisella

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109
Q

tx for francisella

A

streptomycin, tetracycline, chloramphenicol

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110
Q

yersinia morphology

A

gram - coccobacillus

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111
Q

wide temperature range for growth

A

yersinia

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112
Q

virulence factors of yersinia

A 
YOPS
OMP
VW
F1
Coagulase (28 degrees C)

Top 3 control survival in macrophages. 3 and 4 form capsule

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113
Q

location of yersinia

A

asia, brazil, west coast

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114
Q

domestic and sylvatic cycles

A

yersinia

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115
Q

1 microorganism is enough

A

yersinia

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116
Q

may spread by droplet nuclei

A

yersinia

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117
Q

form of yersinia that results in epidemic

A

droplet nuclei spread resulting in pneumonic plague

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118
Q

transmission of yersinia

A

droplet nuclei

flea bite

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119
Q

type 3 secretion

A

salmonella and francisella

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120
Q

bubonic plague

A

yersinia

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121
Q

3 forms of yersinia

A

bubonic plague - pustule at bite site, femoral and inguinal lymphadenopathy, gangrene of extremities
pneumonic - cervical buboes, lung pathology
septicemia - internal buboes w/ bacteremia before buboes

122
Q

diagnosis for yersinia

A

serology for F1 antigen

123
Q

Tx for yersinia

A

doxycycline

124
Q

strict quarantine

A

yersinia

125
Q

vaccine for yersinia

A

F1 and VW ag

126
Q

obligate intracellular and target endothelial

A

rickettsia

127
Q

do not produce their own ATP

A

rickettsia

128
Q

arthropod borne ONLY

A

ricketsia

129
Q

mites and ticks are reservoir

A

rickettsia

130
Q

transovarial transmission

A

rickettsia, endemic relapsing fever

131
Q

pathogenesis for rickettsia

A

arthropod bites. infects endothelial cells causing vasculitis

132
Q

rickettsia signs and syptoms

A

triad of fever, headache, and rash

133
Q

both humoral and CMI and gamma interferon

A

Rickettsia

134
Q

rickettsia tx

A

doxy

135
Q

diagnosis for rickettsia

A

FA of lesion

Weil felix agglutination reaction

136
Q

Southeastern US

A

RMSF, SPotted fever group

137
Q

people under 10

A

RMSF

138
Q

agent of RMSF

A

R. rickettsia

139
Q

Enters endothelial cells of larger vessels and smooth muscle

A

RMSF

140
Q

Binds to Ku70 via OMP to enter cells

A

RMSF

141
Q

Fever with conjunctivitis and photophobia

A

RMSF

142
Q

RMSF signs and symptoms

A

Prodrome of fever, conjunctivitis, photophobia followed by rash on palms and soles that spreads

143
Q

highly cytotoxic

A

RMSF

144
Q

RMSF diagnosis

A

Thrombocytopenia, hyponatremia, LFTs elevated

PCR of rash site

145
Q

Spotted fever group agent

A

Rickettsia parkeri

146
Q

eschar

A

bacillus anthracis, SFGR, rickettsial pox, scrub typhus

147
Q

difference between RMSF and SFGR

A

eschar

148
Q

urban setting

A

rickettsial pox

149
Q

rickettsial pox agent

A

r akari

150
Q

spread by mouse mite

A

rickettsial pox

151
Q

rickettsial pox signs and symptoms

A

eschar, prodorome, lymphadenopathy, rash that spreads centrifugally

152
Q

epidemic typhus agent

A

r prowazekii

153
Q

crowded conditions

A

epidemic typhus

154
Q

Epidemic typhus signs and symptoms

A

centrifugally spreading rash

155
Q

brill zinsser

A

recrudescent epidemic typhus with IgG

156
Q

agent of murine endemic tyhus

A

r typhi

157
Q

rat fleas and cat fleas in LA spread

A

murine endemic typhus

158
Q

Raash that remains centraly located

A

murine endemic typhus

159
Q

agent of scrub typhus

A

orientia tsutsugamushi

160
Q

lacks peptidoglycan and LPS

A

Rickettsia and orienta

161
Q

Chiggers

A

scrub typhus

162
Q

endemic in asia india and pakistan

A

scrub typhus

163
Q

rainy season with river banks and grassy areas

A

scrub typhus

164
Q

what are you at risk of when lying in the grass

A

scrub typhus

165
Q

scrub typhus signs and symptoms

A

Week 1 - fever, eschar, rash

Week 2 - hearing loss

166
Q

coinfxn with lepto

A

scrub typhus

167
Q

lymphopenia followed by lymphocytosis and a decreased CD4:CD8 ration

A

scrub typhus

168
Q

Weil felix

A

Ricketsia and scrub typhus

169
Q

White foot mouse and deer

A

Anaplasmosis, babesia, lyme

170
Q

Ixodes

A

Anaplasmosis, Ehrlichiosis, babesia, lyme

171
Q

Leukopenia/Neutropenia

A

Anaplamsmosis

172
Q

Inclusions in neutrophils

A

Anaplasmosis

173
Q

Doxy treats

A

rickettsia, anaplasma, ehrlichiosis, bartonellas

174
Q

Infects monocytes

A

Ehrlichiosis

175
Q

Rash from coinfxn

A

Anaplasma and ehrlichiosis

176
Q

Mostly asymptomatic unless transfused

A

ehrlichiosis

177
Q

Agent of babesiosis

A

babesia microti

178
Q

can’t donate blood

A

babesia

179
Q

In Rbc’s

A

babesia

180
Q

anemia risk

A

babesia

181
Q

nymph most important stage

A

babesia, lyme

182
Q

persistent fever

A

babesia

183
Q

dark urine

A

babesia

184
Q

protozoan

A

babesia

185
Q

lymphadenopathy absent

A

babesia

186
Q

misdiagnosed as malaria

A

babesia

187
Q

Most common complication of babesia

A

ards

188
Q

hemolytic anemia

A

babesia, bartonellosis

189
Q

maltese crosses in RBCs

A

babesia

190
Q

tx for babesia

A

quinine and clindamycin

atovaquone and azithromycin

191
Q

trench fever agent

A

bartonella quintana

192
Q

cat scratch dz agent

A

bartonella henselae

193
Q

bacillary angiomatosis agent

A

bartonella henselae and bartonella quintana

194
Q

bartonellosis agent

A

bartonella bacilliformis

195
Q

occurs in immunocompetent

A

trench fever

196
Q

homeless

A

trench fever

197
Q

cat flea, cat urine spread it

A

trench fever

198
Q

shin bone fever

A

trench fever

199
Q

humans and cats are reservoirs

A

trench fever

200
Q

bone pain

A

trench fever, lepto

201
Q

cat scratch dz age

A

children mainly

elderly and immunocompromised

202
Q

wartin starry silver stain

A

cat scratch

203
Q

doesn’t respond to abx

A

cat scratch dz

204
Q

higher in kittens

A

cat scartch dz

205
Q

fever, scratch, lymphadenopathy

A

cat sratch dz

206
Q

resolves spontaneously in 3 months

A

cat scratchz

207
Q

blood filled lsions

A

bacilary angiomatosis

208
Q

looks like kaposis

A

bacilary angiomatosis

209
Q

peliosis if involves organs

A

bacilary angiomatosis

210
Q

jarich herxheimer oddly even though not spirochete

A

bacilary angiomatosis

211
Q

cat contact can spread

A

bacillary angiomatosis

212
Q

Vasoproliferative dz of the skin

A

bacillary angiomatosis

213
Q

titer greater than 1:64 indicates infxn

A

bacillary angiomatosis

214
Q

tx for bacillary angiomatosis

A

doxy with rifampin

215
Q

Immunocompromised should avoid cats

A

bacillary angiomatosis

216
Q

Western slopes of andes

A

bartonellosis

217
Q

affects RBCs and endothelium

A

Bartonellosis

218
Q

sandfly

A

bartonellosis

219
Q

Verruga peruana

A

bartonellosis

220
Q

lesions for months to years that are indictative of endothelial hyperplasia and up to 4cm on the head and limbs

A

bartonellosis

221
Q

Relapsing fever agents

A

borrelia recurrentis
borellia hermsii
borella myamotoi

222
Q

colder months

A

epidemic relapsing fever

223
Q

Spirochete thick enough to be seen on blood smear

A

borellia recurrentis, borellia hermsii

224
Q

agent of epidemic relapsing fever

A

borellia recurrentis

225
Q

human body louse is crushed during scratching causing infxn

A

epipdemic relapsing fever

226
Q

wearing the same clothes and crowding puts you at risk for

A

epidemic relapsing fever

227
Q

agent of endemic relapsing fever

A

borellia hermsii

228
Q

difference between epidemic and endemic relapsing fever

A

louse vs tick

229
Q

west coast

A

endemic relapsing fever

230
Q

soft bodied tick transmits

A

endemic relapsing fever

231
Q

tick only active at night

A

endemic relapsing fever

232
Q

May- september seasonality

A

Endemic relapsing fever

233
Q

replicates in blood

A

borellia relapsing fevers

234
Q

antigenic variation

A

borellia relapsing fevers

235
Q

high fevers with 5 day break between

A

borellia relapsing fevers

236
Q

antibodies immobilize organism and enhance PMN phagocytosis against

A

borellia relapsing fevers

237
Q

lyme dz without rash

A

Borellia miyamotoi

238
Q

East coast

A

borrelia miyamotoi, lyme (pretty much everywhere now)

239
Q

Dementia

A

borellia miyamotoi

240
Q

hard bodied ticks

A

borrelia miyamotoi and lyme dz

241
Q

diagnosed via PCR

A

borrelia miyamotoi

242
Q

coinfxn with lyme

A

borrelia miyamotoi

243
Q

how does lyme differe from borrelia miyaotoi

A

Gi symptoms, no rash

244
Q

tx for borrelia

A

tetracycline

245
Q

juvenile arthritis

A

lyme

246
Q

affects 1 joint

A

lyme

247
Q

most common vector born dz

A

lyme

248
Q

S and S of lyme

A

erythema migrans, bells palsy, encephaopathy

249
Q

tick transmission is vital to maintain cycle

A

lyme

250
Q

lyme dz ticks

A

ixodes and dermacentor

251
Q

adults feed on larger things like deer

A

lyme

252
Q

multiplies in skin before spreading everywhere

A

lyme

253
Q

3 stages of lyme

A

acute - rash
disseminated - arthritis, multiple rashes, bells palsy, cardiac, conjunctivitis, hepatitis
chronic - arthritis (HLA DR4 possibly) Alzheimers

254
Q

Alzheimers

A

Chronic Lyme

255
Q

complication includes coinfxn with other ixodes agents

A

lyme

256
Q

2 tiered testing with ELISA and IgG

A

Lyme

257
Q

Tx for lyme

A

doxy, amoxicillin, cefuroxime

Cefrtriaxone/penicillin if neurologic or cardiac

258
Q

post treatment syndrome that is unaffected by abx

A

lyme

259
Q

which heaptitises cause jaundice

A

all

260
Q

which heps are chronic

A

B, C, D

261
Q

which heps can be fulminant

A

all

262
Q

which hep ha the longest incubation

A

hep B (2-6 months)

263
Q

what are the s and s of acute viral hepatitis

A

Prodrome (preicteric phase) with dull right UQ pain
Icteric phase about a week later with jaundice, vasculitis (Hep B), and glomerulonephritis (Hep B and C)
Convalescent phase - jaundice clears but prodrome stuff may stay

264
Q

PicoRNA

A

Hep A

265
Q

Noneveloped SSRNA

A

Hep A, HEV

266
Q

Only replicates in hepatocytes

A

Hep A

267
Q

inactivated by chlorination (not heating)

A

Hep A

268
Q

Virus enters via GI and leaves via feces

A

Hep A

269
Q

when does peak HAV infxn occur

A

2 week period before juaundice or elevation of liver enzymes

270
Q

what causes damage in Hep A

A

Immune response CD8 killing liver

271
Q

Neutralizing IgG provide long term protection from infxn

A

Hep A

272
Q

Jaundice indicates halting of prodoromal symptoms

A

hep A

273
Q

Complications of HAV

A

vasculitis of butt, prolonged PR and QT

274
Q

how do you diagnose HAV

A

IgM and symptoms

275
Q

IgM presetnts 5 days beofee symptoms

A

HAV

276
Q

Post exposure prophylaxis for HAV

A

HAV vaccine if 12 months to 40 y/o otherwise Ig

277
Q

Prevention of HAV

A

post exposure prophylaxis with HAV vaccine or immune globulin

Passive immunization with generic HSIG before or within 2 weeks

Active - Killed accine havrix and vaqta within 2 weeks IM

278
Q

How long does active HAV vaccine last

A

20 years

279
Q

TwinRix

A

Mix of havrix and energix used as active immunization for both hep a and b

280
Q

Fecal oral in pregnant peeps

A

HEV

281
Q

Enveloped DNA virus

A

HBV

282
Q

Hepadnaviridae

A

HBV

283
Q

Reverse transciptase

A

HBV

284
Q

Partially double stranded

A

HBV

285
Q

More infectious than HIV by a lot

A

HBV

286
Q

No integrase activity

A

HBV

287
Q

C gene

A

Encodes HBcAg and HBeAG

288
Q

P gene

A

reverse transciptase in HBV

289
Q

S gene

A

HBsAg

290
Q

Dane particle

A

Complete HBV virus with postive sense DNA

291
Q

first serologic marker for HBV

A

HBsAg

292
Q

How do you diagnose chronic HBV infxn

A

HBsAg and total anti HBc present in two specimens 6 months apart

HBsAg and total anti HbC but no IgM anti HbC

293
Q

Complication of Hep B

A

hepatocellular carcinoma and cirrhosis

294
Q

what are the preventions for Hep B

A

HBIG passively

Recombinant Surface antigen made in yeast (energix and Recombivax)

295
Q

Give babies Ig within 12 hours of birth

A

HBV

296
Q

which hep virus is enveloped

A

B and D and E

297
Q

what are the serology markers for HDV

A

total anti HDV
IgM anti HDV
HDVag

298
Q

which form of HDV is preventable

A

coinfxn

299
Q

leading cause of cirrhosis and liver failure and hepatocelluar carcinoma in the west

A

chronic HCV

300
Q

most people with which hep progress to chronic infxn

A

HCV

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