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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
oral anal sex puts you at risk of
salmonella
26
carriers are females over 50
salmonella
27
salmonella incubation
1-2 weeks
28
salmonella pathogenesis
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
29
Gallbladder carriage
salmonella
30
signs and symptoms of salmonella
``` 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 ```
31
children under 5 have weird s and S
salmonella
32
intestinal perforation
salmonella
33
diagnose salmonella
1-3 weeks - blood 4+ weeks - feces > urine 2 weeks - serology for vi antigen
34
tx for salmonella
ampicillin, tmp smx, ciprofloxacin
35
vaccine for salmonella
vivotif Ty21a - oral live with boosters every 5 years | Typhim vi - parenteral recombinant with boosters every 2 years
36
Seen in macrophages
salmonella
37
fruits/vegetables
salmonella
38
Rat pee in water
Leptospirosis
39
Weil's dz is a form of
Leptospirosis
40
dark field microscopy
leptospirosis, borrelia miyamotoi, lyme
41
chronic in kidney
leptospirosis
42
CNS type 3 vasculitis
leptospirosis
43
biphasic
leptospirosis
44
sispecial media
leptospirosis
45
s and s of leptospirosis
rash, aseptic meningitis, tibial tenderness, hemoptysis
46
spirochete with hooked ends
leptospira
47
multiple serovars for different animals
leptospira
48
tropical climates
leptospira
49
transmission of leptospira
water contact through skin abrasion | vertical transmission by placenta and breast milk
50
Pathogenesis of leptospira
endothelial damage resulting in vasculitis and persisting in kidney without renal impairment
51
Anicteric and icteric forms
leptospirosis
52
which form of lepto is most common
anicteric
53
acute leptospiremic phase
fever, headache, conjuncitval suffusion
54
immune leptospiruric phase
aseptic meningitis from immunopathology vasculitis
55
Abx are not effective when
immune phase of lepto
56
Weil's dz is known as what and is characterized as what
icteric leptospirosis (anicteric signs of conjunctival suffusion and aseptic meningitis + JAUNDICE)
57
what causes weils
vascular dyfunction
58
Humoral immunity
leptospirosis, anthrax, borrelias
59
Binds DC SIGN to induce dendritic cell maturation
Humoral immunity in lepto
60
rats peei n water
lepto
61
diagnosis for lepto
Week 1 - blood and csf culture Week 2 - urine culture serology for ab's
62
tx for lepto
penicillin doxy tetracycline
63
jarisch herxheimer
lepto
64
doxy chemoprophylaxis
lepto | yersinia
65
Spring seasonality
brucella
66
brucella morphology
gram - rod
67
abortus suis melitensis canis
brucella
68
most common zoonotic dz
brucella
69
bangs dz
brucella
70
unpasteurized milk
brucella
71
transmission of brucella
ingestion contact with skin abrasions or conjunctiva inhalation
72
pathogenesis of brucella
enters skin or mucous membranes and spreads by lymphatics. Multiplies in macrophages preventing their apoptosis
73
brucella virulence factors
5' GMP and AMP - suppress myeloperoxidase | Atypical LPS - doesn't activate complement
74
signs and symptoms for 2-8 weeks
brucella
75
signs and symptoms of brucella
night sweats, fever, weight loss, malodorous perspiration
76
acute, undulant, and chronic form
brucella
77
tx for brucella
tetracycline with streptomycin for 6 weeks
78
spore forming
bacillus anthracis
79
GI, pulmonary, cutaneous
bacillus anthracis
80
boxcar shaped
bacillus anthracis
81
bacillus anthrasis morphology
encapsulated gram positive rod
82
virulence factors for bacillus anthracis
Poly D glutamic acid capsule (PXO2) Protective antigen toxin Lethal factor toxin Edema factor toxin
83
LF fxn
Cleaves mitogen activated protein kinase kinases causing macrophage lysis Targets cardiomyocytes and vascular smooth muscle cells
84
EF fxn
calcium calmodulin dependent adenylate cyclase Acts on hepatocytes
85
herbivores
bacillus anthracis
86
WMD
bacillus anthracis, tularemia
87
WMD anthrax form
pulmonary
88
transmission of bacillus anthracis
excreted in feces, urine, and saliva with spores in soil
89
toxemia
bacillus anthracis
90
forms of anthrax
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
91
whcih form of anthrax is immune to abx pretty much
pulmonary
92
mediastinal widening
pulmonary anthrax
93
increase in vascular permeability causing respiratory deistress, hemorrhage, shock, and death
pulmonary anthrax
94
Target of immunity in anthrax
PA antigen
95
Tx for bacillus anthracis
penicillin, doxy, cipro
96
vaccine for anthrax
PA purified vaccine with small amounts of LF and EF
97
tularemia agent
francisella tularensis
98
morphology of francisella
Encapsulated G- coccobacillus
99
intracellular in macrophages, endothelial cells, and hepatocytes
francisella
100
virulence factor for francisella
lipoprotein encoded by FTT1103
101
ocurs in all states except hawaii
francisella
102
rabbis
francisella
103
no P2P ever documented
Francisella, trench fever
104
transmission of francisella
contact with animal carcasses cat or tick bite aerosol ingestion (high ID)
105
warmer months
francisella, RMSF, Spotted fever group
106
multiplies in macrophages and amoebae
francisella
107
signs and symptoms of francisella
uleceroglandular form - papule at entry site, enlarged lymph nodes, granulomatous nodules Inhalation form GI form
108
detected by visualizing antibodies with a 4 fold increaase
francisella
109
tx for francisella
streptomycin, tetracycline, chloramphenicol
110
yersinia morphology
gram - coccobacillus
111
wide temperature range for growth
yersinia
112
virulence factors of yersinia
``` YOPS OMP VW F1 Coagulase (28 degrees C) ``` Top 3 control survival in macrophages. 3 and 4 form capsule
113
location of yersinia
asia, brazil, west coast
114
domestic and sylvatic cycles
yersinia
115
1 microorganism is enough
yersinia
116
may spread by droplet nuclei
yersinia
117
form of yersinia that results in epidemic
droplet nuclei spread resulting in pneumonic plague
118
transmission of yersinia
droplet nuclei | flea bite
119
type 3 secretion
salmonella and francisella
120
bubonic plague
yersinia
121
3 forms of yersinia
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
diagnosis for yersinia
serology for F1 antigen
123
Tx for yersinia
doxycycline
124
strict quarantine
yersinia
125
vaccine for yersinia
F1 and VW ag
126
obligate intracellular and target endothelial
rickettsia
127
do not produce their own ATP
rickettsia
128
arthropod borne ONLY
ricketsia
129
mites and ticks are reservoir
rickettsia
130
transovarial transmission
rickettsia, endemic relapsing fever
131
pathogenesis for rickettsia
arthropod bites. infects endothelial cells causing vasculitis
132
rickettsia signs and syptoms
triad of fever, headache, and rash
133
both humoral and CMI and gamma interferon
Rickettsia
134
rickettsia tx
doxy
135
diagnosis for rickettsia
FA of lesion | Weil felix agglutination reaction
136
Southeastern US
RMSF, SPotted fever group
137
people under 10
RMSF
138
agent of RMSF
R. rickettsia
139
Enters endothelial cells of larger vessels and smooth muscle
RMSF
140
Binds to Ku70 via OMP to enter cells
RMSF
141
Fever with conjunctivitis and photophobia
RMSF
142
RMSF signs and symptoms
Prodrome of fever, conjunctivitis, photophobia followed by rash on palms and soles that spreads
143
highly cytotoxic
RMSF
144
RMSF diagnosis
Thrombocytopenia, hyponatremia, LFTs elevated | PCR of rash site
145
Spotted fever group agent
Rickettsia parkeri
146
eschar
bacillus anthracis, SFGR, rickettsial pox, scrub typhus
147
difference between RMSF and SFGR
eschar
148
urban setting
rickettsial pox
149
rickettsial pox agent
r akari
150
spread by mouse mite
rickettsial pox
151
rickettsial pox signs and symptoms
eschar, prodorome, lymphadenopathy, rash that spreads centrifugally
152
epidemic typhus agent
r prowazekii
153
crowded conditions
epidemic typhus
154
Epidemic typhus signs and symptoms
centrifugally spreading rash
155
brill zinsser
recrudescent epidemic typhus with IgG
156
agent of murine endemic tyhus
r typhi
157
rat fleas and cat fleas in LA spread
murine endemic typhus
158
Raash that remains centraly located
murine endemic typhus
159
agent of scrub typhus
orientia tsutsugamushi
160
lacks peptidoglycan and LPS
Rickettsia and orienta
161
Chiggers
scrub typhus
162
endemic in asia india and pakistan
scrub typhus
163
rainy season with river banks and grassy areas
scrub typhus
164
what are you at risk of when lying in the grass
scrub typhus
165
scrub typhus signs and symptoms
Week 1 - fever, eschar, rash | Week 2 - hearing loss
166
coinfxn with lepto
scrub typhus
167
lymphopenia followed by lymphocytosis and a decreased CD4:CD8 ration
scrub typhus
168
Weil felix
Ricketsia and scrub typhus
169
White foot mouse and deer
Anaplasmosis, babesia, lyme
170
Ixodes
Anaplasmosis, Ehrlichiosis, babesia, lyme
171
Leukopenia/Neutropenia
Anaplamsmosis
172
Inclusions in neutrophils
Anaplasmosis
173
Doxy treats
rickettsia, anaplasma, ehrlichiosis, bartonellas
174
Infects monocytes
Ehrlichiosis
175
Rash from coinfxn
Anaplasma and ehrlichiosis
176
Mostly asymptomatic unless transfused
ehrlichiosis
177
Agent of babesiosis
babesia microti
178
can't donate blood
babesia
179
In Rbc's
babesia
180
anemia risk
babesia
181
nymph most important stage
babesia, lyme
182
persistent fever
babesia
183
dark urine
babesia
184
protozoan
babesia
185
lymphadenopathy absent
babesia
186
misdiagnosed as malaria
babesia
187
Most common complication of babesia
ards
188
hemolytic anemia
babesia, bartonellosis
189
maltese crosses in RBCs
babesia
190
tx for babesia
quinine and clindamycin atovaquone and azithromycin
191
trench fever agent
bartonella quintana
192
cat scratch dz agent
bartonella henselae
193
bacillary angiomatosis agent
bartonella henselae and bartonella quintana
194
bartonellosis agent
bartonella bacilliformis
195
occurs in immunocompetent
trench fever
196
homeless
trench fever
197
cat flea, cat urine spread it
trench fever
198
shin bone fever
trench fever
199
humans and cats are reservoirs
trench fever
200
bone pain
trench fever, lepto
201
cat scratch dz age
children mainly | elderly and immunocompromised
202
wartin starry silver stain
cat scratch
203
doesn't respond to abx
cat scratch dz
204
higher in kittens
cat scartch dz
205
fever, scratch, lymphadenopathy
cat sratch dz
206
resolves spontaneously in 3 months
cat scratchz
207
blood filled lsions
bacilary angiomatosis
208
looks like kaposis
bacilary angiomatosis
209
peliosis if involves organs
bacilary angiomatosis
210
jarich herxheimer oddly even though not spirochete
bacilary angiomatosis
211
cat contact can spread
bacillary angiomatosis
212
Vasoproliferative dz of the skin
bacillary angiomatosis
213
titer greater than 1:64 indicates infxn
bacillary angiomatosis
214
tx for bacillary angiomatosis
doxy with rifampin
215
Immunocompromised should avoid cats
bacillary angiomatosis
216
Western slopes of andes
bartonellosis
217
affects RBCs and endothelium
Bartonellosis
218
sandfly
bartonellosis
219
Verruga peruana
bartonellosis
220
lesions for months to years that are indictative of endothelial hyperplasia and up to 4cm on the head and limbs
bartonellosis
221
Relapsing fever agents
borrelia recurrentis borellia hermsii borella myamotoi
222
colder months
epidemic relapsing fever
223
Spirochete thick enough to be seen on blood smear
borellia recurrentis, borellia hermsii
224
agent of epidemic relapsing fever
borellia recurrentis
225
human body louse is crushed during scratching causing infxn
epipdemic relapsing fever
226
wearing the same clothes and crowding puts you at risk for
epidemic relapsing fever
227
agent of endemic relapsing fever
borellia hermsii
228
difference between epidemic and endemic relapsing fever
louse vs tick
229
west coast
endemic relapsing fever
230
soft bodied tick transmits
endemic relapsing fever
231
tick only active at night
endemic relapsing fever
232
May- september seasonality
Endemic relapsing fever
233
replicates in blood
borellia relapsing fevers
234
antigenic variation
borellia relapsing fevers
235
high fevers with 5 day break between
borellia relapsing fevers
236
antibodies immobilize organism and enhance PMN phagocytosis against
borellia relapsing fevers
237
lyme dz without rash
Borellia miyamotoi
238
East coast
borrelia miyamotoi, lyme (pretty much everywhere now)
239
Dementia
borellia miyamotoi
240
hard bodied ticks
borrelia miyamotoi and lyme dz
241
diagnosed via PCR
borrelia miyamotoi
242
coinfxn with lyme
borrelia miyamotoi
243
how does lyme differe from borrelia miyaotoi
Gi symptoms, no rash
244
tx for borrelia
tetracycline
245
juvenile arthritis
lyme
246
affects 1 joint
lyme
247
most common vector born dz
lyme
248
S and S of lyme
erythema migrans, bells palsy, encephaopathy
249
tick transmission is vital to maintain cycle
lyme
250
lyme dz ticks
ixodes and dermacentor
251
adults feed on larger things like deer
lyme
252
multiplies in skin before spreading everywhere
lyme
253
3 stages of lyme
acute - rash disseminated - arthritis, multiple rashes, bells palsy, cardiac, conjunctivitis, hepatitis chronic - arthritis (HLA DR4 possibly) Alzheimers
254
Alzheimers
Chronic Lyme
255
complication includes coinfxn with other ixodes agents
lyme
256
2 tiered testing with ELISA and IgG
Lyme
257
Tx for lyme
doxy, amoxicillin, cefuroxime Cefrtriaxone/penicillin if neurologic or cardiac
258
post treatment syndrome that is unaffected by abx
lyme
259
which heaptitises cause jaundice
all
260
which heps are chronic
B, C, D
261
which heps can be fulminant
all
262
which hep ha the longest incubation
hep B (2-6 months)
263
what are the s and s of acute viral hepatitis
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
PicoRNA
Hep A
265
Noneveloped SSRNA
Hep A, HEV
266
Only replicates in hepatocytes
Hep A
267
inactivated by chlorination (not heating)
Hep A
268
Virus enters via GI and leaves via feces
Hep A
269
when does peak HAV infxn occur
2 week period before juaundice or elevation of liver enzymes
270
what causes damage in Hep A
Immune response CD8 killing liver
271
Neutralizing IgG provide long term protection from infxn
Hep A
272
Jaundice indicates halting of prodoromal symptoms
hep A
273
Complications of HAV
vasculitis of butt, prolonged PR and QT
274
how do you diagnose HAV
IgM and symptoms
275
IgM presetnts 5 days beofee symptoms
HAV
276
Post exposure prophylaxis for HAV
HAV vaccine if 12 months to 40 y/o otherwise Ig
277
Prevention of HAV
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
How long does active HAV vaccine last
20 years
279
TwinRix
Mix of havrix and energix used as active immunization for both hep a and b
280
Fecal oral in pregnant peeps
HEV
281
Enveloped DNA virus
HBV
282
Hepadnaviridae
HBV
283
Reverse transciptase
HBV
284
Partially double stranded
HBV
285
More infectious than HIV by a lot
HBV
286
No integrase activity
HBV
287
C gene
Encodes HBcAg and HBeAG
288
P gene
reverse transciptase in HBV
289
S gene
HBsAg
290
Dane particle
Complete HBV virus with postive sense DNA
291
first serologic marker for HBV
HBsAg
292
How do you diagnose chronic HBV infxn
HBsAg and total anti HBc present in two specimens 6 months apart HBsAg and total anti HbC but no IgM anti HbC
293
Complication of Hep B
hepatocellular carcinoma and cirrhosis
294
what are the preventions for Hep B
HBIG passively | Recombinant Surface antigen made in yeast (energix and Recombivax)
295
Give babies Ig within 12 hours of birth
HBV
296
which hep virus is enveloped
B and D and E
297
what are the serology markers for HDV
total anti HDV IgM anti HDV HDVag
298
which form of HDV is preventable
coinfxn
299
leading cause of cirrhosis and liver failure and hepatocelluar carcinoma in the west
chronic HCV
300
most people with which hep progress to chronic infxn
HCV

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