Micro High Yield Flashcards

1
Q

6 bugs that don’t gram stain well

A
Treponema palladium (visualize on darkfield microscopy)
Rickettsia (intracellular)
Mycobacteria (acid fast)
Mycoplasma (no cell wall)
Legionella (sliver stain)
Chlamydia (intracellular)
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2
Q

Bugs that stain with Giemsa stain

A

Chlamydia, Borrelia, Rickettsia, Trypanosomes, Plasmodium

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3
Q

Ziehl Neeson is a stain that correlates with what type of bacteria

A

Acid fast bacteria

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4
Q

Typical bug that stains with India Ink

A

Cryptococcus neoformans

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5
Q

Bugs that stain with silver stain

A

fungi, Legionella, H. pylori

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6
Q

What makes up Thayer-Martin Agar and what grows on it?

A

VPN (vancomycin, polymixin, nystatin) and it grows Neisseria

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7
Q

Agar that grows Clostridium diptheriae

A

Tellurite Lofflers

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8
Q

Fungi grow on this type of agar

A

Sabaroud dextrose

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9
Q

Legionella grows on this type of agar

A

Charcoal yeast with cysteine and iron

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10
Q

These bugs grow on Hektoen Enteric agar

A

Salmonella, Shigella, E. coli, Klebsiella

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11
Q

Vibrio cholera grows on

A

TCBS

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12
Q

Aminoglycosides are ineffective against these types of organisms

A

obligate anaerobes (AG’s need O2 to work)

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13
Q

Organisms that are catalase positive

A

Pseudomonas, Listeria, Aspergillus, Candida, E. coli, Staph A, Serratia

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14
Q

Toxins that inhibit protein synthesis

A

C. diptheria, Pseudomonas (both inactivate IL2); Shigella, EHEC (both inactivate 60s ribosome)

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15
Q

Toxins that increase cAMP

A
Vibrio cholera (increase Cl secretion-"rice water")
Bacillus anthracis (edema)
ETEC (labile-increases Cl secretion; stabile- decreases NaCl absorbtion)
Bordetella pertussis (disables Gi, impairs phagocytosis)
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16
Q

Toxins that affect nerve transmission (cleave SNARE)

A

C. tetani- rigidity, lockjaw, no release of GABA or glycine

C. botulinum- flaccid paralysis, inhibits release of Ach.

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17
Q

toxins that lyse membranes

A

C. perfringens: alpha toxin, myonecrosis

Strep pyogenes: streptolysin O lyses RBC

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18
Q

Superantigens of Strep pyogenes and Staph A causing TSS.

A

Strep: Exotoxin A
Staph: TSST1

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19
Q

How to differentiate Beta hemolytic strep

A

Sensitive to Bacitracin: Strep pyogenes

Resistant to Bacitracin: Strep agalacticae

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20
Q

How to differentiate Alpha hemolytic strep

A

Sensitive to Optochin: Strep pneumo

Resistant to Optochin: Viridians strep

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21
Q

How to differentiate Coagulase negative strep

A

Sensitive to Novobiocin: Staph Epidermis

Resistant to Novobiocin: Staph Saprophyticis

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22
Q

Strep pneumo is the most common cause of these 4 diseases

A

MOPS: meningitis, otitis media, pneumonia, sinusitis

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23
Q

Strep bovis has a high association with

A

colon cancer

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24
Q

Common infections caused by and characteristics of Pseudomonas

A
Acronym: PSEUDOmonas
Pneumonia (CF patients)
Sepsis
External otitis
UTI
Drug use
Osteomyelitis (in diabetics)
(hot tub folliculitis)
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25
Q

Differentiate between Salmonella and Shigella

A

Salmonella: H2S +
Shigella: H2S -

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26
Q

E. coli strain responsible for Traveler’s diarrhea (watery)

A

ETEC; labile and stable toxins. No mucosa invasion.

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27
Q

E. coli strain responsible for Hemolytic uremic syndrome (anemia, thrombocytopenia and renal failure)

A

EHEC O157:H7 virulence factor is the Shiga-like toxin (doesn’t ferment sorbitol unlike other E. colis!)

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28
Q

Most common cause of bloody diarrhea in kids, temperature it grows in and high yield clinical sequelae

A

Campylobacter jeujeni, grows at 42 degrees C, can cause Guillian Barre syndrome

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29
Q

H. pylori is the predominant cause of ulcers located where?

A

duodenum

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30
Q

Clinical consequence of Leptospira infection

A

Weil disease: jaundice, renal failure, liver and kidney shutdown, fever, hemorrhage, anemia

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31
Q

Sign of primary syphillis

A

painless chancre (tx: penicillin)

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32
Q

Signs of secondary syphillis

A

maculopapular rash on palms and soles, condyloma lata

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33
Q

Signs of tertiary syphillis

A

CNS manifestations: tabes dorsalis, ataxia, Argyll Robertson pupil
gummas (chronic granulomas), charcot joints

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34
Q

Description of Argyll Robertson pupil

A

Accommodates but doesn’t react (prostitute pupil)…GET IT???

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35
Q

Signs of congenital syphillis

A

Saber shins, saddle nose, CN VIII deafness, mulberry molars, “hutchinson teeth” (notched)

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36
Q

3 infections causing rash on palms and soles

A

Coxsackie A, Rickettsia (RMSF) and syphillis

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37
Q

4 fungal pneumonias in immunocompetent patients

A
  1. Histoplasmosis
  2. Blastomyces
  3. Coccioides
  4. Paracoccioides
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38
Q

Histoplasmosis is found in this geographic area and is associated with exposure to…

A

Mississippi/Ohio river valley, assoc with caves, bats, demolition projects. The fungi hides in the macrophages

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39
Q

Blastomyces is found in this geographic area, characteristics of what you see on microscopy

A

Mississippi and eastward, on microscopy you see broad based budding yeast.

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40
Q

Coccioides is associated with this geographical area and has what characteristic on microscopy?

A

Desert SW, especially after an earthquake. Microscopy shows Spherules containing endospores

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41
Q

Paracoccioides looks like this and is found where?

A

Captains wheel and found in Latin America

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42
Q

This cutaneous fungi looks like “spaghetti and meatballs” on KOH prep

A

Tinea Versicolor (Malasezzia furfur)

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43
Q

cigar-shaped fungi associated with vegetation, causes pustule/ulcer

A

Sporothrix -“rose gardener” disease

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44
Q

Protozoa causing malabsorption, flatulence, diarrhea, associated with campers and hikers.

A

Giardia Lambia: treated with metronidazole

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45
Q

Parasite causing bloody diarrhea, RUQ pain, liver abcess. Contains multinucleated cysts

A

Entamoeba histolytica

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46
Q

aka pinworm

A

Enterobius vermicularis

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47
Q

Nematode causing intestinal infections, knobby looking eggs

A

Ascaris lumbricoides

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48
Q

Trichuris trichuria (whipworm) causes what type of infection?

A

Intestinal: bloody diarrhea, football shaped eggs w/ operculated ends

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49
Q

Cestode responsible for neurocystisarcosis and intestinal infection from undercooked pork.

A

Taenia solium (tx: praziquantel)

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50
Q

Cestode that competes for B12 in intestines and causes anemia

A

Diphyllobothrium- from raw fish

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51
Q

Schistosome that causes portal HTN and liver issues

A

Schistosome mansoni

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52
Q

Schistosome that causes bladder CA

A

Schistosome hematobilium

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53
Q

Protozoa causing rapidly fatal meningioencephalitis. Found in freshwater lakes, enters cribiform plate.

A

Neigleria fowleri

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54
Q

Congenital toxoplasmosis infection triad found in babies

A

chorioretinitis, hydrocephalus, intracranial calcifications

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55
Q

Trypanosoma brucei is transmitted by what

A

tse tse fly (no amastigotes-those are only cruzi)

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56
Q

T. brucei causes this disease

A

African sleeping sickness: swollen lymph nodes, recurring fever, somnolence, coma.
Tx: suramin

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57
Q

Mode of Plasmodium transmission

A

Anopheles mosquito

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58
Q

Transmission of Babesiosis

A

Ioxodes tick (coinfects with Borellia)

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59
Q

What you see on microscopy in Babesiosis infection

A

Ring form (ddx: malaria) and Maltese cross (rules out malaria)

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60
Q

Tx for Babesiosis

A

Atovaquone and azithromycin

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61
Q

Transmission of Trypanosome cruzii

A

reduvid bug (amastigotes seen)

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62
Q

Clinical signs/sx of T. cruzi infection

A

Chagas disease: dilated cardiomyopathy, megacolon, megaesophagus

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63
Q

Paragnomius westermani causes

A

lung inflammation, TB like sx, hemoptysis (lung fluke)

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64
Q

Clinical sign of infection with Paragnomius westermani

A

“coffee bean shape” operculated eggs, “rusty” color.
recent ingestion of undercooked seafood/crab
Tx: praziquantel

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65
Q

List of live vaccines

A

VZV, smallpox, yellow fever, Sabin’s polio, MMR, Intranasal influenza, rotavirus

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66
Q

only DNA virus that is single stranded

A

parvovirus (part-of-virus -silly mnemonic)

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67
Q

only RNA virus that is double stranded

A

reovirus

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68
Q

RNA viruses:

A

Retrovirus, Togavirus, Flavivirus, Coronavirus, Hepevirus, Calicivirus, Picornavirus, Orthomyxovirus, Paramyxovirus, Rhabdovirus, Bunyavirus

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69
Q

7 DNA viruses:

A

Herpesvirus, Hepadnavirus, Adenovirus, Parvovirus, Papillomavirus, Polyomavirus, Poxvirus

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70
Q

High fever then when fever stops you get a rash

A

Roseola

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71
Q

Roseola is caused by what virus?

A

HHV6

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72
Q

How can you identify Herpes Simplex virus for diagnostic purposes? (just HSV1 and HSV2)

A

Tszank test and visualization of cowdry bodies

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73
Q

Hepadnavirus causes what disease?

A

Hepatitis B

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74
Q

Virus responsible for aplastic crisis in sickle cell patients, “slap cheek fever”/erythema infectiosum (5th disease) in kids

A

Parvovirus B19

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75
Q

Subtypes of HPV responsible for cervical cancer

A

HPV 16 and 18

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76
Q

Virus responsible for Progressive multifocal leukoencephaly in HIV patients

A

JC virus (polyomavirus)

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77
Q

Poxvirus is responsible for these diseases

A

smallpox and molluscum contagiosum

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78
Q

Reovirus (the only DS RNA virus) is responsible for what disease?

A

Rotavirus infection: gastroenteritis/diarrhea in children usually in winter months

79
Q

4 viruses belonging to Picornavirus family

A

Poliovirus, Rhinovirus, Coxsackie virus, Hepatitis A (all fecal-oral)

80
Q

The norwalk (norovirus) belongs to what family?

A

Calicivirus

81
Q

What is the Norwalk virus responsible for?

A

viral gastroenteritis

82
Q

5 Diseases caused by Flaviviruses

A

Hepatitis C, Yellow Fever, Dengue fever, West Nile and St. Louis encephalitis

83
Q

Yellow fever is transmitted by

A

Aedes mosquito (fever, black vomit, jaundice)

84
Q

Rubella belongs to what family of viruses?

A

Togavirus

85
Q

Rubella infection (German measles) causes what?

A

Infant cataracts, lymphadenopathy, arthralgias, truncal rash starting at head and moving down

86
Q

4 diseases caused by paramyxoviruses

A
  1. Parainfluenza: croup
  2. RSV: bronchiolitis in babies (tx: ribavirin)
  3. Measles
  4. Mumps
87
Q

Clinical signs and most important sequelae of Measles

A

Cough, coryza, conjunctivitis, Koplik spots, Descending rash, biggest complication: subacute sclerosing panencephalitis

88
Q

biggest concern of Mumps infection

A

orchitis–>sterility

89
Q

Most high yield disease coming from the Rhabdovirus family

A

Rabies

90
Q

Microscopic appearance of Rabies infection

A

“bullet shaped viruses”, Negri bodies in purkinje cells of cerebellum.

91
Q

Clinical characteristics of Rabies

A

Photophobia, hydrophobia, paralysis, coma. Associated with animal bites. Virus migrates retrograde up the axons.

92
Q

Negative stranded viruses: (Always Bring Polymerase Or Fail Replication)

A

Arenavirus, Bunyavirus, Paramyxovirus, Orthomyxovirus, Filovirus, Rhabdovirus

93
Q

Process responsible for pandemics; Animal-human recombination

A

Antigenic shift

94
Q

Process responsible for epidemics; minor changes based on mutations

A

Antigenic drift

95
Q

Hepatitis type: Picornavirus, fecal/oral, Acute infection

A

HAV

96
Q

Hepatitis type: DNA hepadnavirus, long incubation, acts as oncogene and predisposes to Hepatocellular carcinoma

A

HBV

97
Q

Hepatitis type: Flavivirus, long incubation, increases risk for hepatocellular carcinoma, chronic infection, can cause cirrhosis

A

HCV

98
Q

Hepatitis type: deltavirus, needs HBV to coinfect with.

A

HDV

99
Q

Hepatitis type: Hepevirus, fecal/oral waterborne, high mortality in pregnant women

A

HEV

100
Q

Marker that indicates Hep B infection

A

HBsAg

101
Q

Marker that indicates immunity to Hep B

A

Anti-HBsAg

102
Q

First antibody made to Hep B infection

A

Anti-HBcAg

103
Q

Anti-HBcAg in acute/recent infection

A

IgM

104
Q

Anti-HBcAg in prior exposure/chronic infection

A

IgG

105
Q

Marker indicating active viral replication of HBV

A

HBeAg

106
Q

Marker indicating low transmissibility of HBV

A

Anti-HBeAg

107
Q

Serology profile for Acute HBV infection

A

HBsAg+, HBeAg+, Anti-HBc IgM

108
Q

Serology profile for the “window period” of HBV

A

Anti-HBe+, Anti-HBc IgM+

109
Q

Serology profile for chronic HBV, active

A

HBsAg+, HBeAg+, Anti-HBc IgG+

110
Q

Serology profile for chronic HBV, inactive

A

HBsAg+, Anti-HBeAg+, Anti-HBc IgG+

111
Q

Serology profile for Recovery of HBV

A

Anti-HBsAg+, Anti-HBeAg+, Anti HBc IgG+

112
Q

Serology profile for vaccinated HBV

A

Anti-HBsAg+ ONLY

113
Q

In viral hepatitis, which liver enzyme is greater?

A

ALT > AST

114
Q

In alcoholic hepatitis, which liver enzyme is greater?

A

AST > ALT

115
Q

Mutation in this cell surface protein can make one immune to HIV infection

A

CCR5 (T cell co-receptor)

116
Q

Cause of bacillary angiomatosis in HIV patients (vascular proliferation, neutrophils)

A

Bartonella henslae

117
Q

GI infection seen in AIDS patients with a CD4 < 200

A

Cryptosporidium parvum

118
Q

CNS infection showing up when CD4 < 100

A

Toxoplasma gondii

119
Q

CNS infection showing up with CD4<50

A

Cryptococcus neoformans

120
Q

Infection causing retinitis, cotton wool spots, esophagitis, interstitial pneumonia, CD4<50

A

CMV

121
Q

HHV8 causes this manifestation in AIDS pts

A

Kaposi sarcoma, (looks similar to bacillary angiomatosis but lymphocytes instead of neutrophils)

122
Q

Diseases showing up at CD4 <200

A

Cryptosporidium, JC virus, Pneumocystis jirovechi

123
Q

Diseases showing up at CD4 < 50

A

CMV, MAC, Cryptococcus

124
Q

9 bugs causing food poisoning

A

Vibrio parahemolyticus, Vibrio vulnificans, Bacillus cereus, Staph A toxin, Clostridium perfringens, Clostridium botulinum, EHEC, Salmonella, Campylobacter jeujeni

125
Q

Causes of bloody diarrhea

A

C. jeujeni, Salmonella, Shigella, EHEC, EIEC, Yersinia, Entamoeba histolytica

126
Q

Causes of watery diarrhea

A

ETEC, Vibrio cholerae (rice water), C. diff, C. perfringens, Giardia, Cryptosporidia, Rotavirus, Norwalk virus

127
Q

Pneumonia in neonates <4 wk

A
  1. Group B strep (agalacticae) and 2. E. coli
128
Q

Pneumonia in children (1 mo-18 years)

A

RSV, Mycoplasma, Chlamydia, Strep pneumo

129
Q

Pneumonia in ages 18-40

A

Mycoplasma, Chlamydia pneumoniae, Strep pneumo

130
Q

Pneumonia in adults 40-65

A

Strep pneumo, H. influenza, Anaerobes (aspiration), viruses

131
Q

Pneumonia in elderly >65

A

Strep pneumo, influenza

132
Q

Nosocomial pneumonia causes

A

Staph A, Gram negative rods, pseudomonas (ventilator)

133
Q

Pneumonia in IVDU

A

S. pneumo, Klebsiella pneumo, Staph A

134
Q

Pneumonia in CF patients

A

Pseudomonas and Staph A

135
Q

Post viral pneumonia

A

1: Staph A

136
Q

Newborn meningitis

A

Strep agalactiae, E. coli, Listeria

137
Q

Childhood meningitis

A

Strep pneumo, Neisseria meningitidis, H. inf type B, enteroviruses

138
Q

Meningitis in young adults

A

Teens: #1 is Neisseria meningiditis

strep pneumo, coxsackie virus

139
Q

Meningitis in elderly

A

Strep pneumo, Gram negative rods, Listeria

140
Q

CSF profile in bacterial meningitis

A

Pressure increased, PMN’s, Protein increased, Glucose decreased

141
Q

CSF profile in viral meningitis

A

normal pressure, lymphocytes, normal to decreased protein, normal glucose

142
Q

CSF profile in fungal meningitis

A

increased pressure, lymphocytes, increased protein, decreased glucose

143
Q

1 cause of osteomyelitis

A

Staph A

144
Q

Osteomyelitis in sickle cell

A

Salmonella

145
Q

Osteomyelitis in IVDU

A

Pseudomonas

146
Q

1 cause of UTI

A

E. coli

147
Q

UTI in sexually active young girls (still 2nd to E. coli)

A

Staph saprophyticus

148
Q

UTI associated with struvite stones (staghorn calculi)

A

Proteus

149
Q

UTI associated with catheters

A

Staph Epi

150
Q

vesicular rash on palms, soles and buttocks, in children

A

Coxsackie A (hand/foot/mouth)

151
Q

Painful penile chancre and lymphadenopathy

A

Haemophilus ducreyi

152
Q

most common bacterial STD in US

A

Chlamydia serotypes D-K

153
Q

HPV subtypes associated with genital warts

A

HPV 6 and 11

154
Q

Strongyloides stercoralis, AKA Threadworm is transmitted how? Where does it go from there?

A

Transmitted by penetration of the skin and from there it goes to infect the pulmonary system, gets coughed back in and ingested and infects GI. Therefore sx are: local itching at feet, cough, diarrhea, vomiting etc.

155
Q

What type of HS reaction is Grave’s disease?

A

Type II non cytotoxic

156
Q

typically presents in crowded conditions, in the webs of hands and feet, and has linear burrows accompanied by excoriation

A

Sarcoptes scabeii

157
Q

DOC for Giardia

A

Metronidazole

158
Q

Active TB likes what part of the lung?

A

apex (the Ghon complex primary infection is assoc with the base)

159
Q

DOC for Lyme disease in kids <8

A

Amoxicillin (Doxy is the DOC older than this…remember Doxy is used in kids ONLY in RMSF)

160
Q

Intracellular finding in Klebsiella granulomatous infections (genital ulcers)

A

Donovan bodies

161
Q

Resistant Pasteurella is treated by the combo of Impinem/cilastatin. What are their MOA’s?

A

Imipinem is a carbapenem beta lactam that is beta lactamase resistant.Cilastatin inhibits renal dehydropeptidase I which by doing that decreases the excretion rate of Impinem.

162
Q

4 gram positive rods

A

Bacillus, Corneybacterium, Listeria, Clostridium

163
Q

type of hemolysis that is green

A

alpha (strep viridians and strep pneumo)

164
Q

MOA of C. tetani toxin

A

prevents release of glycine from Renshaw cells in the spinal cord

165
Q

2 bacterial toxins that act by inhibiting EF-2

A

Pseudomonas and C. diphtheriae

166
Q

capsule is encoded by what bacterial structure?

A

K antigen

167
Q

virulence factors of H. influenzae?

A

capsule and IgA protease

168
Q

Lab test for anti-rickettsial antibodies

A

Weil-Felix (this can cross react with proteus)

169
Q

what 5 things can give false positive VDRL test?

A

Viral infections (mono and hepatitis), Drugs (narcotics), Rheumatoid arthritis, Lupus, Leprosy

170
Q

antimicrobial that inhibits 50s peptidyl transferase

A

chloramphenicol

171
Q

antimicrobial that binds 50s and inhibits translocase

A

macrolides

172
Q

antimicrobial that blocks 50s peptide bond formation

A

clindamycin

173
Q

antimicrobial that blocks entry of aa-tRNA to the 30s complex

A

Tetracyclines

174
Q

antimicrobial that bind to 30s and block initiation complex formation

A

Aminoglycosides

175
Q

MOA of Rifampin

A

inhibits DNA dependent RNA polymerase

176
Q

6 uses for Metronidazole

A

Giardia, BV (gardenella), Trichomonas, C. diff, H. pylori, Entamoeba

177
Q

6 DNA viruses

A

Herpesvirus, Hepadnavirus, Adenovirus, Poxvirus, Polyomavirus, Parvovirus

178
Q

Only DNA virus that is single stranded

A

Parvovirus (also naked)

179
Q

only RNA virus that is double stranded

A

Reovirus (rotavirus)

180
Q

4 families of segmented viruses

A

Arenavirus, Orthomyxovirus, Bunyavirus, Reovirus

181
Q

only diploid virus class

A

Retrovirus

182
Q

virus causing councilman bodies to show up in liver

A

yellow fever virus (aedes mosq)

183
Q

Virus associated with Dane particles

A

Hep B

184
Q

virus that can cause intussusception due to hyperplasia of Peyer patches

A

Adenovirus

185
Q

induction of this TF during immune response leads to activation of transcription of HIV proviral DNA

A

nuclear factor kappa B

186
Q

symptoms of prion disease

A

rapidly progressing dementia, psych disturbance, cerebellar symptoms

187
Q

MOA of acyclovir

A

activated by thymidine kinase, inhibits viral DNA polymerase

188
Q

MOA of foscarnet

A

pyrophosphate analog, inhibits viral DNA polymerase

189
Q

rose gardener disease with ascending lymphadenitis

A

sporothrix schenkii, tx: potassium iodide

190
Q

transmitted by tsetse, shows antigenic variation

A

Trypanosoma bruceii

191
Q

macrophages containing amastigotes, aka kala-azar

A

Leishmania donovani

192
Q

bloody diarrhea with flask shaped ulcers, liver abcesses and trophozoites in stool

A

entamoeba histolytica

193
Q

fever, periorbital edema, myositis after ingesting raw pork

A

Trichenella spiralis (tx thiabendazole)

194
Q

undercooked pork larval worm, causes mass lesions in brain

A

Taenia solium (praziquantel, albendazole)