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Step 1 > Micro High Yield > Flashcards

Micro High Yield Flashcards

1
Q

Toxins that increase cAMP

A

ETEC Heat-Labile toxin, Bacillus Anthracis Edema factor, Cholera toxin, and pertussus toxin

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2
Q

Inflammatory component of gram negative LPS

A

Lipid A Note: Lipoteichoic acid induces TNFa and IL-1 from G+

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3
Q

Novobiocin–

A

Sensitive: Staph epidermidisResistant: Staph saprophyticus

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4
Q

Quellung Reaction

A

Strep Pneumo Note: Strep pneumo capsule swells when bound by Ab (specific); Lancet shaped diplococci

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5
Q

Bacitracin:

A

Sensitive: Strep PyogenesResistant: Strep agalactiae

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6
Q

Endocarditis following GI/GU procedures

A

Enterococcus Note: Can grow in bile and 6.5% NaCl

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7
Q

Gram Positive Rods with Metachromatic (blue and red) granules

A

Corynebacterium diptheriae Note: Black colonies on cystine-tellurite agar; ADP Ribosulates EF-2; ELEK test for toxin

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8
Q

tetanospasmin block GABA and glycine release from?

A

Renshaw cells in the spinal cord Note: trismus (lockjaw), Risus Sardonicus, and Opisthonotos (eyes locked)

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9
Q

Serpentine chains of G+ rods

A

Bacillus anthracis Note: spore forming; edema factor inc cAMP; + lethal toxin

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10
Q

Only G+ that produces LPS

A

Listeria Note: Tumbling motility and can grow at 4 degrees celcius (cold enrichment)

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11
Q

Acid fast+ and G+, causes pulmonary infections

A

Nocardia Note: weakly acid fast (carbolfuschin); TX with sulfonamides

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12
Q

Oxidase+, G- that grows at 42 degrees

A

Camplyobacter Note: Comma shaped, undercooked chicken; Guillane-Barre and Reactive Arthritis

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13
Q

Oral abscess or facial abscess (draining through sinus tract) with yellow sulfur granules

A

Actinomyces Note: Branched G+ bacteria; TX with penecillin

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14
Q

Asthma and CF pts at risk for this infection causing bronchiectasis and Eosinophilia

A

Allergic Bronchopulmonary Aspergillosis (ABPA) Note: Can lead to bronchiectasis

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15
Q

Bacteria that causes Lymptocytic Leukocytosis

A

Bordetella pertussis Note: Produces lymphocytosis promoting factor that blocks lymphocytes from leaving blood for lymph node

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16
Q

Grows in both bile and 6.5% NaCl (G+ coccus)

A

Enterococcus

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17
Q

Only bacteria with a polypeptide capsule

A

Bacillus anthracis Note: D-glutamate; Cutaneous- ulcer with black eschar

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18
Q

Gonorrhea immune evasion

A

Rapid Ag variation of Pilus proteins Note: also often intracellular in neutrophils (culture negative UTI)

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19
Q

Chlamydia/Gonorrhea Tx regimen

A

Ceftriaxone + Azithromycin/doxycycline

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20
Q

G- coccobacillus causing otitus media, bronchitis, conjunctivitis

A

Nontypable Haemophilus influenze Note: No capsular Ag

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21
Q

Pneumonia with Hyponatremia, watery diarrhea, heachahe and GI pain

A

Legionella Note: can cause SIADH and decreased tubular reabsorption; Charcoal Yeast Extract

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22
Q

Key E coli virulence factor for: UTI? Pneumonia? Neonatal Meningitis? Sepsis?

A

UTI- Fimbrae/P-pili; Shock-LPSPneumonia/Meningitis- K Capsule

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23
Q

E. Coli strain that does not ferment sorbitol or produce glucuronidase

A

EHEC Note: O157:H7, Shiga-like/Verotoxin causes microthrombi to form on toxin-damaged endothelium–>HUS

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24
Q

Woolsorter’s disease

A

Bacillus anthracis Note: inhalation of SPORES from contaiminated wool; flu-like with rapid progression to fever, hemorrhage, mediastinitis and shock

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25
Q

Two toxins that inhibit EF-2

A

Diptheria toxin and Pseudomonas Exotoxin A

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26
Q

Gardener with skin ulcer on arm and nodules traced up the arm; CIGAR-shaped budding yeast

A

Sporothrix Schenkii Note: Ascending Lymphangitis

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27
Q

Optochin-

A

Sensitive: Strep Pneumo (bile solube);Resistant: viridans strep (bile insoluble) Note: Strep pneumo also has a capsule and is bile soluble (lysed by bile)

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28
Q

Bacteria grown in culture w/ Staph aureus (which provides Factor V/NAD+

A

Haemophilus influenza Note: otherwise grown on chocolate agar–>NAD/Factor V and Hemitin/Factor X

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29
Q

Bloody diarrhea w/ bacteria that invades @ M cells in Peyer’s patch and spreads cell to cell (not hematogenous spread)

A

Shigella Note: does not produde H2S; Invasion of intestinal mucosa is the most important virulence factor

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30
Q

Diarrhea after eating raw oysters

A

Vibrio vulnificus

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31
Q

Appendicitis-like mesenteric adenitis from a puppy

A

Yersinia enterocolitica Note: bloody diarrhea with puppy may also be campylobacter

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32
Q

Flu, Jaundice, and Photophobia after contact with animal urine in Hawaii

A

Leptospira interrogans Note: Can cause Weil disease–>severe jaundice with azotemia, anemia, fever and hemorrhage

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33
Q

Screen and confirm tests for Syphilis

A

VDRL/RPR screen; FTA-ABS confirms Note: Can also try to visualize the spirochete on Darkfield microscopy; CSF for VDRL/RPR for tertiary

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34
Q

Bacteria that causes Kaposi like purpura after cat scratch

A

Bartonella (Bacillary angiomatosis)

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35
Q

Deer hides/pelts in Arkansas/Missouri, Rabbits

A

Francisella tularensis

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36
Q

Osteomyelitis/cellulitis after a dog/cat bite

A

Pasteurella multocida

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37
Q

Dermacentor tick spreads these bacteria

A

Ricketsia and Francisella

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38
Q

Monocytes with morulae

A

Erlichiosis Note: blue, berry like inclusions

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39
Q

Granulocytes with morulae

A

Anaplasmosis Note: Ixodes tick with Borrelia and Babesia

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40
Q

Infectious form of Chlamydia? Intracellular form?

A

Elemenatary is infectious, Reticulate is intracellular Note: Cannot make own ATP; Visualized on Giemsa stain

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41
Q

Atypical pneumonia with bird exposure

A

Chlamydophila psittaci Note: C. pneumoniae also causes atypical pneumonia

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42
Q

Cold agglutinin Immune hemolytic anemia

A

Mycoplasma, infectious mononucleosis

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43
Q

Dimorphic fungus intracellular in Macrophages

A

Histoplasmosis Note: Immunocomprimised patients can have hepatosplenomegaly and ulcerated tongue lesions

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44
Q

Spaghetti and Meatball appearence, damage melanocytes

A

Malassezia furfur Note: Tinea Versicolor, spot that does not tan

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45
Q

Yeast that branch at 45deg? 90deg?

A

45-Aspergillus; 90-Mucor/Rhizopus

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46
Q

Germ Tubes at 37 deg

A

Candida

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47
Q

Key immune cell to prevent Candida superficial vs systemic

A

Superficial–T lymphocyte; Systemic-Neutrophils

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48
Q

Pt in North Carolina with rash that starts at wrists

A

Rocky Mountain Spotted Fever/Rickettsia Note: Starts are wrists and ankles then spreads to the palms/soles and trunk; Dermacentor Tick

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49
Q

This is the site of cryptococcus initial infections

A

Lungs (not nasopharynx) Note: inhalation of yeast, pidgeon droppings

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50
Q

Most specific test for Cryptococcus

A

Latex Agglutination Note: detects polysaccharide capsular Ag; India Ink is also characteristic but a shittier test, Mucicarmine stains red

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51
Q

Fungus that causes frontal lobe abscesses after penetrating cribiform plate in Ketoacidotic diabetic or leukemia pt

A

Mucor/Rhizopus Note: Black, necrotic eschar on face; Branch at 90, nonseptate;

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52
Q

Fungal infection that can be treated with Potassium Iodide

A

Sporothrix Schenkii Note: Also with itraconazole–>Rose Gardener’s disease

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53
Q

Liver abscess w/ anchovy paste exudate and flask shaped ulcer

A

Entamoeba histolytica Note: Metronidazole/Iodoquinol; RBC in entamoeba

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54
Q

AIDS pt with amoeba infection in brain causing focal deficits, dementia and coma; no lake exposure

A

Ancanthamoeba

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55
Q

IgE mechanisms to block/kill parasites

A

Antibody-Dependent Cellular Cytotoxicity via Eosinophils Note: binds FcER1 on eosinophils causing Major Basic Protein release

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56
Q

Green nasal discharge after jumping in a lake

A

Naeglaria fowleri Note: enters cribiform plate causing rapidly fatal meningoencephalitis w/ amoeba in CSF

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57
Q

African Sleeping Sickness/Trypanosoma brucei TX

A

Suramin (Blood) and Melarsoprol (CNS) Note: Winterbottom’s sign–>swollen lymph nodes on back of the neck

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58
Q

Chorioretinitis, Hydrocephalus, and intracranial calcifications

A

Toxoplasma gondii Note: tachyzoite on biopsy; Sulfadiazine and Pyrimethamine

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59
Q

Hemolytic anemia with “Maltese cross” in RBC on smear

A

Babesia Note: Ixodes tick with Lyme/Borrelia and Anaplasma–>Atovaquone+azithromycin

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60
Q

Trophozoites with RBC in cytoplasm or Cysts w/ 4 nuclei

A

Entamoeba histolytica Note: Metronidazole/Iodoquinol; Entamoeba is the only amoeba that phagocytizes RBC

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61
Q

Chagas Tx

A

Nifurtimox Note: mega colon, megaesophagus, dilated cardiomyopathy

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62
Q

Macrophage with Amastigotes

A

Leishmania donovani Note: Sandfly bite; spiking fever, hepatomegaly, pancytopenia

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63
Q

TX for Leishmania

A

Sodium Stibogluconate

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64
Q

TX for anal pruritis/Scotch tape test +

A

Mebendazole or Pyrantel Pamoate Note: Enterobius vermincularis/Pinworm (nematode)

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65
Q

Filiform larvae in soil penetrate skin after rhabdiform larve lost in stool

A

Strongyloides Note: Can have autoinfection if rhabdiform becomes filiform in the gut

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66
Q

TX for Strongyloides

A

Ivermectin or Albendazole

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67
Q

Black skin nodules and blindness

A

Onchocerca volvulus Note: “River” blindness due to RXN to bacteria in onchocerca (Wolbachia)

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68
Q

TX for Riverblindness

A

Ivermectin

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69
Q

Elephantiasis organism and TX

A

Wucheria bancrofti; Diethycarbamazine Note: takes 9mo-1year; blocks lymphatics

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70
Q

Scabes (skin lesions on hand) TX

A

Permethrin or Ivermectin

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71
Q

Forms cysts in liver than require ethanol injection prior to surgery to prevent anaphylaxis

A

Echinococcus Note: Hydatid cyst; Ingestion of eggs from dog feces; TX with albendazole; sheep Dog is definitive host

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72
Q

TX for Taenia solium

A

Praziquantel Note: Albendazole for neurocystacercosis–>ingestion of eggs (not cysts in pork–>tapeworm)

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73
Q

Organism that causes Squamous Cell carcinoma of bladder and can lead to bilateral hydronephrosis

A

Schistosoma Note: Cercariae leave snails and penetrate skin; Egypt and China; Praziquantel

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74
Q

Cholangiocarcinoma and pigment gallstone association

A

Clonorchis sinensis Note: China, undercooked fish, liver fluke, Praziquantel

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75
Q

Pt with brain cysts and Seizures

A

Neurocystacercosis

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76
Q

Parasite causing Microcytic Anemia? Macrocytic?

A

Microcytic: Hookworm (Necator americanus/AncylostomaMacrocytic: Diphyllobothrium latum Note: larvae penetrate skin (Bendazole or pyrantel pamoate)Undercooked fish (Praziquantel)

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77
Q

Parasites treated with Ivermectin

A

Strongyloides and Onchocerca

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78
Q

Undercooked crabmeat

A

Paragonimus Westernmanii

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79
Q

Inflammation of the liver capsule by Neisseria gonorrhea

A

Fitz-Hugh Curtis Syndrome Note: due to ascention of the gonorrhea, can also cause salpingitis/PID leading to infertility

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80
Q

Comma shaped bacteria that grows in alkaline medium

A

Vibrio cholera

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81
Q

Rabies binds to this recepter to cause infection

A

Nicotinic Ach Receptor Note: Replicates initially in muscle and connective tissue–>Retrograde transport in axons to CNS

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82
Q

Bartonella TX

A

Azithromycin Note: G- but very fastidious (difficult to grow and test for susceptability)

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83
Q

Live Vaccines

A

VZV, Polio, MMR Note: small pox and yellow fever; Live polio vaccine allows production of gut IgA against polio (unlike killed)

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84
Q

DNA virus with reverse transcriptase

A

HepB Note: Circular partially dsDNA; can cause HCC via integration into host genome (no cirrhosis first)

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85
Q

RNA viruses that do not replicate in the cytoplasm

A

influenza and HIV

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86
Q

Killed Vaccines

A

Rabies, Influenze, HAV

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87
Q

Herpes virus envelope are from?

A

nuclear membrane

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88
Q

Pts immune to HepB will not have what Ab if vaccinated

A

Anti-HBcAg

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89
Q

Recombinant vaccines

A

HepB (HbsAg) and HPV

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90
Q

Pt has punch out lesions in the esophagus

A

HSV-1 Note: CMV also causes esophageal lesions–>linear ulcers

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91
Q

Most common cause of acute hemorrhagic cystitis in kids

A

Adenovirus Note: dsDNA linear, also causes pink eye, febrile pharyngitis, and pneumonia

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92
Q

Temporal lobe encephalitis with acute mood, memory, and behavioral changes and Cowdry Type A Inclusions

A

HSV-1

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93
Q

JC viurs genome type

A

dsDNA circular (Polyomavirus) Note: similar to BK virus that infects the kidney in transplant patients

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94
Q

Pts with infectious mononucleosis are at risk for rupture of what organ

A

spleen Note: hepatosplenomegaly with fever, pharyngitis, and lymphadenopathy (poster cervical especially)

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95
Q

EBV receptor

A

CD21 Note: Infects B cells and blood smear shows atypical CD8+ T cells (Downey cells)

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96
Q

Virus that can cause high fevers/febrile seizures followed by a diffuse macular rash on the body after several days

A

Roseola Note: HHV6; Febrile SEIZURES key for differentiating from other Rashes of Childhood

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97
Q

Where is VZV latent

A

Dorsal root or trigeminal ganglia Note: Single dermatome, transmitted by respiratory secretions

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98
Q

Characteristic test for genital herpes

A

Tzanck test Note: detects multinuclear giant cells in opened skin vesicle

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99
Q

Immature Squamous cell with Dense pink cytoplasm and a perinuclear halo

A

Koilocyte Note: HPV, Nucleus may be enlarged with undulating membrane

100
Q

dsRNA with linear, segmented genome

A

Reovirus (rotavirus) Note: Most common cause of fatal diarrhea in children, more common in winter

101
Q

Hepatitis with high mortality in pregant women

A

Hep E Note: Hepevirus->ssRNA+ linear

102
Q

4 virus in Paramyxovirus (ssRNA- linear)

A

Parainfluenza, RSV, Measles, Mumps

103
Q

Key TX for RSV

A

Ribavirin Note: Inhibits duplication of viral genome via inhibiting IMP dehydrogenase; #1 cause of respiratory death in infants, causes fusion of respiratory epithelial cells and giant cells via Fusion (F) protein

104
Q

Rabies virus genome

A

Rhabdovirus–ssRNA (-) linear

105
Q

Hepatitis B vaccination protects against what additional virus

A

HepD/Delta agent Note: HepD must use HBsAg to replicate/spread

106
Q

Picornaviruses that cause meningitis

A

Echovirus, Poliovirus, Coxsackievirus

107
Q

Main virulence factor of rhinovirus (common cold)

A

> 100 serotypes

108
Q

Segmented viruses

A

Orthomyxovirus, reovirus, bunyavirus, hantavirus

109
Q

black vomit, high fever, jaundice

A

Yellow fever virus Note: SS+RNA

110
Q

Post Auricular lymphadenopathy in a child with a fine rash on body that started at head and moved down

A

Rubella Note: Deafness, PDA, blindness, blueberry muffin rash in neonate

111
Q

mAb that blocks F protein in RSV

A

Palivizumab Note: prevents fusion of respiratory epithelial cells to for multinucleated cells

112
Q

Child with white spots with erythematous background on buccal mucosa with maculopapular rash

A

Measles Note: Koplik Spots; Vitamin A used to prevent severe exfoliation

113
Q

Pt is delirious with hypersalivation and laryngeal spasms

A

Rabies

114
Q

What determines the incubation period length in rabies

A

Distance of inoculation site from CNS Note: Bites near head and neck progress rapidly

115
Q

Postexposure TX of rabies

A

Wound cleansing + Active and Passive immunization Note: rabies immune globulin injected

116
Q

What causes HepC immune evasion?

A

RNA-dependent-RNA-Polymerase has No 3’-5’ exonuclease proofreading function Note: hypervariable envelope glycoprotein

117
Q

Positive serology in the window period of HepB

A

Anti-HBc IgM

118
Q

What HepB Ag indicates active infection/high transmissability

A

HBeAg/HBV DNA Note: Also indicated likelihood of a mother passing to a child–>95% chance with high HBeAg

119
Q

Progression of Ag&Ab in HepB

A

SECES Note: SE Ag, CES Ab

120
Q

Pol gene in HIV genome contains:

A

Reverse Transcriptase, aspartate Protease, Integrase Note: raltegravir blocks integrase, which prevents production of HIV mRNA by host enzymes

121
Q

Homozygous mutation of what surface molecule provides HIV immunity

A

CCR5 Note: bound by gp120; Blocked with Maraviroc

122
Q

HIV Screen and Confirmatory Tests

A

Screen: ELISA; Confirm: Western Blot (+ for 3 proteins) Note: AIDS when CD4

123
Q

Child develps progressive dementia, ataxia, myoclonus, and visual problems; had a rash on body about 6 years ago; Oligoclonal bands in CSF

A

Subacture Sclerosing Panencephalitis Note: Occurs about 6 years after having measles

124
Q

Vesicular lesion on trunk with lesions of different ages in child

A

VZV Chickenpox Note: “Dew on a Rose”

125
Q

How can newborns of HIV mothers be falsely positive for HIV?

A

IgG against HIV cross the placenta Note: ELISA and Western Blot test for HIV Ab, confirm exposure to actual virus w/ HIV PCR

126
Q

During the latent phase of HIV, why is blood level of HIV low?

A

Replication in the lymph nodes

127
Q

Tongue ulcer and hepatosplenomegaly in AIDS pt

A

Histoplasma capsulatum Note: No pulmonary symptoms; Oval yeast IN macrophages

128
Q

White material on lateral tongue that can’t be scraped off, HIV

A

Hairy Leukoplakia/EBV

129
Q

Visual Impairment in HIV pt with cotton wool spots on fundoscopic exam

A

CMV Retinitis Note: TX with ganciclovir/Foscarnet (Foscarnet can cause seizures–chelates Ca2+ and Mg2+)

130
Q

Spongiform Encephalopathy with rapid dementia and ataxia

A

Prions/Creutzfedt-Jakob

131
Q

Characteristic finding in HIV CNS invasion

A

Microglial nodules with Multinucleated Microglial cells

132
Q

Primary CNS Lymphoma in AIDS associated with what

A

EBV Note: B lymphocytes, can be focal or multiple periventricular ring enhancing lesions

133
Q

Pt with AIDS has purple papules diffuse across skin (give 2)

A

Bacillary Angiomatosis- Bartonella–Neutrophil infiltrateKaposi Sarcoma- HHV-8-Lymphocyte infiltrate

134
Q

Key normal flora bacterium of the vagina

A

Lactobacillus

135
Q

Pseudoappendicitis associated with daycare

A

Yersinia enterocolitica

136
Q

Gas gangrene and watery diarrhea organism

A

Clostridium perfringens Note: spore forming G+ rod, Alpha toxin=lecithinase

137
Q

Osteomyelitis most common

A

Staph Aureus

138
Q

Osteomyelitis in Diabetic/IV drug user

A

Pseudomonas or Serratia Note: Serratia ferments lactose

139
Q

Signs you went from cystitis/UTI to acute pyelonephritis

A

WBC Casts, Fever, flank pain, CVA tenderness Note: UTI has WBC in urine but NOT casts

140
Q

Urease positive UTI

A

Proteus, Klebsiella Note: E. coli is urease negative; staph saprophyticus is nitrite negative

141
Q

Newborn with PDA, cataracts, and deafness, what infection

A

Rubella

142
Q

Seizures and hearing loss in a newborn

A

CMV Note: Often with blueberry muffin rash and petechial rash

143
Q

Meningitis with a petechial rash

A

Neisseria meningitidis Note: LOS mediated (meningococcus has LOS instead of LPS); Purpura Fulminans

144
Q

Chronic Diarrhea and recurrent infections in a newborn

A

HIV Note: If HIV negative and infections are viral, bacterial, and fungal, think SCID

145
Q

Congenital Syphilis findings

A

Notched/Hutchinson teeth, saber shins, saddle nose, short maxilla, CN8 deafness Note: often results in still birth or hydrops fetalis

146
Q

Possible cause of infertility in women with HX of PID

A

Failure to TX both Gonorrhea and Chlamydia in co-infected pt Note: Look out for Infertility Questions where the woman had PID and was only tx with Ceftriaxone OR doxycycline/Azithromycin

147
Q

Pt with purulent cervical discharge and adhesion from peritoneum to liver

A

Fitz-Hugh Curtis Syndrome

148
Q

Child with sickle cell at risk for what infection(s)

A

Strep pneumo, Haemophilus and Salmonella osteomyelitis Note: Autosplenectomy in SCD makes susceptable to encapsulated microbes

149
Q

In osteomyelitis, what is the devitalization of bone called

A

sequestra

150
Q

In osteomyelitis, reactive bone formation in the periosteum

A

Involucrum

151
Q

Muscle pain with calcified cyst in skeletal muscle, splinter hemorrhages in nails and periorbital edema, Eosinophilia

A

Trichinella spiralis Note: Due to eating undercooked pork; Tx with albendazole, larvae encyst in striated muscle and often have dystrophic calcification

152
Q

Does the rash in Measles or Rubella become confluent

A

Measles

153
Q

Erythematous rash that begins on the cheeks then extends to trunk and proximal extremities

A

Parvovirus B19–Erythema infectosum Note: Arthritis in adults

154
Q

When are children with VZV/Chickenpox infectious

A

1 week BEFORE the rash appears Note: Macules, vesicles and pustules all present at the same time

155
Q

How must you treat onychomycosis/tinea unguium

A

Oral agents–terbinafine or itraconazole

156
Q

What technique can be used to help identify tinea versicolor

A

Wood’s Lamp Note: Fungus derived acids inhibit tyrosinase (hypopigmentation) –> does not tan

157
Q

Newborn with “cradle cap” seborrheic dermatitis, what tx

A

shampoo (selenium sulfide, zinc pyrithione Note: Malassezia furfur

158
Q

Kid plays in sandbox with cat/dog, Serpiginous tunnels in skin with intense pruritis and eosinophilia

A

Cutaneous Larval Migrans Note: Ancylostoma –> dog/cat hookworm, larvae migrate in skin; TX with Ivermectin

159
Q

Intensely pruritis lesion inbetween fingers

A

Scarptes scabiei Note: Intense pruritis caused by the EGGS; TX with permethrin cream

160
Q

Bedbug organism

A

Cimex lectularius Note: feed on human blood, active just before dawn, intensely pruritic

161
Q

Hepatitus C is associated with what dermatologic condition

A

Lichen Planus Note: Polygonal Purple Planar papules and plaques + Wickham’s Striae + Sawtooth Dermal-Epidermal junction

162
Q

Infections associated with Erythema Multiforme

A

Mycoplasma and HSV Note: Targetoid rashes on palms soles and extensor surfaces

163
Q

Infections associated with Erythema Nodosum

A

Coccidioidomycosis, Histoplasma, TB, Strep pharyngitis, Yersinia Enterocolitica

164
Q

Hepatitis B has a prodrome including what type of rash

A

Uticaria Note: Type 3 Hypersensitivity –> Serum Sickness-like prodrome

165
Q

Pt with sinopulmonary infection also has eczema and thrombocytopenia

A

Wiscott Aldrich Syndrome Note: X linked progressive deletion of B and T cells; Dec IgM and G; Inc Ig A and E

166
Q

Hepatitis B is associated with what Vasculitis

A

Polyarteritis nodosa Note: typically effects the renal and mesenteric arteries–>Transmural inflammation w/ fibrinoid necrosis

167
Q

What is the major virulence factor for Strep pyogenes

A

M Protein Note: Inhibits phagocytosis and complement activation, cytotoxic for neutrophils, and mediates adhesion

168
Q

TB growth in parallel chains/sepentine cords signifies:

A

Cord Factor + Note: Cord factor is TB’s key virulence factor and is needed for infection

169
Q

Toxin produced by Listeria to exit phagosome in macrophage

A

Listerolysin O Note: facultatice intracellular G+ rod; tumbling motility and growth at 4 deg C

170
Q

Child with a Pink upper body and Cyanotic lower body had what infection transmitted from the mother

A

Rubella Note: Rubella associated with PDA, which causes differential cyanosis when the shunt reverses

171
Q

Most common cause of myocarditis and pericarditis

A

Coxsackie virus Note: also dilated cardiomyopathy (via myocarditis)

172
Q

Metachromatic granules in a clustered Gram +

A

Corynebacterium diptheriae Note: Red and Blue granules, toxin inhibits EF-2 (protein synthesis), ELEK test for toxin

173
Q

Most common infection transmitted by blood transfusion (currently)

A

CMV Note: In the past HepC was the big one, but now PCR makes that rare; CMV in donor lymphocytes

174
Q

Most common extrapulmonary site for Miliary TB

A

Kidney

175
Q

Inspiratory stridor and brassy cough in a child

A

Parainfluenza virus/Croup Note: Steeple sign on X-ray, Brassy=barking

176
Q

Transplant pt or AIDS pt with pneumonia; Histology shows enlarged macrophages w/ inclusions and surrounded by halo

A

CMV

177
Q

Staccato (choppy) cough in a newborn with pneumonia 2 weeks after birth

A

Chlamydia trachomatis

178
Q

Dairy Farmer/Veternarian has atypical pneumonia

A

Coxiella burnetii Note: associated with livestock birthing process

179
Q

Yellow sputum in pt w/ pneumonia 5 days after viral pneumonia

A

Staph Aureus

180
Q

Hypersensitivity Pneumonitis is a restrictive lung disease caused by thermophilic actinomyces; What type of Hypersensitivity

A

Type III hypersensitivity (IgG mediated) Note: Farmer’s Lung; Silo Filler’s Disease is due to inhalation of N2O from silo’s, also causes restrictive disease

181
Q

Inhalation of bacterial endotoxin in cotton, linen, and hemp cause what disease that improves over the weekend

A

Byssinosis Note: Workers feel better over the weekend then dyspnea reoccurs during the week

182
Q

Pt presents with diarrhea 3 hours after a picnic, what do you culture and what do you give for TX

A

Culture: Food – especially if mayo containingTX: Supportive

183
Q

Foamy, PAS+ macrophages in the GI lamina propria

A

Tropheryma whippelii

184
Q

“Healthy” vs Infective Chronic carrier of HepB

A

Infective is HBeAg/HBV DNA positive Note: Both are HBsAg positive

185
Q

Fever, Jaundice, and RUQ pain

A

Ascending Cholangitis (charcots triad) Note: If septic shock and AMS–> Reynold’s Pentad

186
Q

How is clonorchis contracted

A

encysted larvae in undercooked fish Note: high risk of cholangiocarcinoma; Chinese liver fluke

187
Q

Responsible for the green pigment of sputum in lobar pneumonia

A

Myeloperoxidase Note: from neutrofils

188
Q

Epididymitis/Orchitis/Prostatitis bacteria by age

A

35: E. coli or Pseudomonas Note: In epididymitis, elevation of the scrotum Relieves the pain (Prehn’s sign)

189
Q

Red Inclusions in cervical metastatic squamous cells

A

Reticulate bodies of Chlamydia trachomatis

190
Q

Yeast with germ tubes

A

Candida

191
Q

TX for oral thrush

A

Nystatin Note: Same mechanism as amphotericin B; swish and swallow because not absorbed

192
Q

Classic Galactosemia is associated with what infection in neonate

A

E. coli Sepsis Note: Deficiency of Galactose-1-P Uridyltransferase

193
Q

previously healthy person in the Southwest US who develops rapid septic shock and/or severe pulmonary disease

A

Yersinia pestis Note: Prarie dogs and rats; Plague; (Coccidioides would not cause disease this severe in immunocompetant person)

194
Q

Thayer Martin contains Vancomycin, Polymyxin/Colistin (g-) and nystatin, used to isolate what

A

Neisseria meningitidis and gonorrhea Note: Used for carrier screening from pharyngeal samples

195
Q

Obligate Intracellular bacteria

A

Rickettsia and Chlamydia Note: Cannot produce ATP

196
Q

In toxic shock syndrome, what is released by the TH1 cell?

A

INF-gamma Note: That induces cytokine release from the APC

197
Q

Specialized transduction involves what type of virus

A

Lysogenic bacteriophage Note: General transduction is lytic phage; Specialized: Shiga-like, Botulinum, Cholera, Diptheria toxins

198
Q

Strep viridans endocarditis mediated by binding what on valves

A

Bind fibrin-platelet aggregates Note: produces dextrans from sucrose to facilitate binding

199
Q

Palor around the mouth with a sandpaper type rash in a kid

A

Scarlet Fever Note: Step Pyogenes, toxin mediated

200
Q

Prevention of Tetanus in newborns

A

Vaccination of the mother (IgA/G in breastmilk/placenta) Note: Or on a large scale, vaccinate young adults

201
Q

Mechanism of Gram neg resistance to penecillin G and Vanco

A

Outer membrane layer inhibits entry

202
Q

Neisseria meningitidis contains what instead of LPS

A

Lipo-oligosaccharide (LOS) Note: Levels of LOS in plasma corrolated with severity of disease, essentially the same as LPS

203
Q

Rifampin monotherapy is used for prophylaxis in contacts for what

A

Meningococcus (N. meningitidis) or Haemophilus Note: never used alone for TB

204
Q

Gray vaginal discharge, fishy smell, clue cells

A

Gardnerella vaginalis “Bacterial vaginosis” Note: Tx w/ metronidazole or clindamycin; KOH “whiff test” worsens fishy smell

205
Q

Treatment for all vector borne bacterial diseases

A

Doxycycline

206
Q

Painless ulcers on genitals with painful, ulcerated inguinal nodes

A

Lymphogranuloma venereum Note: Chlamydia trachomatis serotypes L1, L2, and L3

207
Q

TX for Toxoplasmosis

A

Sulfadiazine + pyramethamine +/- leucovorin

208
Q

Green vaginal discharge with itching and burning

A

Trichomonas vaginalis Note: Metronidazole for pt and partner

209
Q

Used to prevent severe exfoliative dermatitis in measles infection

A

Vitamin A

210
Q

Organisms for AIDS Encephalitis vs Meningitis

A

Enceph: JC virus; Meningitis: Cryptococcus

211
Q

Pneumonia in an AIDS pt with CD4 count >200

A

Strep Pneumoniae Note: presents as normal community acquired lobar streph pneumo

212
Q

Nucleoside Reverse Transciptase inhibitor used in pregnancy

A

Zidovudine

213
Q

C. diff toxin causes pseudomembranous colitis via what action

A

Actin Depolymerization Note: Damages cytoskeletal integrity

214
Q

Gastric Biopsy shows a positive urease test (becomes more basic when urea added to biopsy

A

Helicobacter pylori infection Note: H. pylori converts urea to CO2 and NH3–>NH3 increases pH, changing the color of the indicator

215
Q

Measured in serum to test for Anaphylaxis

A

Tryptase

216
Q

Main manifestation of Parvovirus in adults

A

Arthralgia Note: symmetric in PIPs, wrists, knees, and ankles

217
Q

G- oxidase +, lactose non-fermenter

A

Pseudomonas

218
Q

Reassortment can only occur in what type of virus

A

Segmented Virus

219
Q

How does Silicosis (pneumoconiosis) increase TB risk

A

Silica impairs phagolysosome formation by macrophages

220
Q

Bacteria that release toxins that lyse cell membranes

A

Clostridium perfringens and Step pyogenese (streptolysin O)

221
Q

Flu-like symptoms after onset of Syphilis tx

A

Jarish-Herxheimer reaction Note: killed bacteria release pyrogens

222
Q

Person presents w/ erythemia migrans after camping and fever/hemolytic anemia

A

Borrelia/Lyme Disease AND Babesiosis Note: Babesia is parasite that causes hemolytic anemia and fever; Maltese cross on blood smear

223
Q

Cephalosporins active against Pseudomonas

A

Ceftazidime (3rd) and cefepime (4th) Note: Ceftaroline (5th) is active against MRSA

224
Q

Antibiotic class contraindicated in Myasthenia gravis–>neuromusclular blockade

A

Aminoglycosides Note: Drug inactivated via acetylation, phosphorylation, and adenylation

225
Q

Used to treat strep infections in pts allergic to penecillin

A

Macrolides Note: Prolong QT, acute cholestatic hepatitis, increase serum concentration of theophyllines and anticoagulants

226
Q

Abx that can cause kernicterus in newborns

A

Sulfonamides Note: displace bilirubin from albumin

227
Q

Needed to convert isoniazid to active form

A

Catalase-peroxidase Note: Chemically similar to Pyridoxine/vitamin B6; Neurotoxicity (dec w/ B6 supp), hepatotoxicity, Drug-Lupus

228
Q

TB drug effective in the acidic pH of Phagolysosome

A

Pyrazinamide Note: works in macrophages where intracellular TB is

229
Q

TX for Schistosomiasis, Clonorchis, and Taenia solium

A

Praziquantel Note: Increases permability to Ca, causing muscle paralysis

230
Q

Pts w/ late compliment (C5-9) deficiency are susceptable to

A

Neisseria meningitidis infections

231
Q

Resistance to aminoglycosides is via:

A

conjugation of the drug at the bacteria surface Note: acetylation, adenylation, phosphorylation

232
Q

Abx that prolong QT

A

Macrolides and fluoroquinolones

233
Q

Tetracycline derivative that is effective against MRSA

A

Tigecycline

234
Q

Main side effect of acyclovir? Ganciclovir?

A

Acyclovir can crystallize in urine–>NephrotoxicGanciclovir causes myelosuppresion

235
Q

What two drugs are associated w/ Fanconi Syndrome

A

Tenofovir and expired Tetracyclines Note: also Wilson’s disease can cause Fanconi syndrome

236
Q

Nephrogenic strains of Strep Pyogenes cannot cause rheumatic fever because they lack:

A

M protein Note: RF is type 2 hypersensitivity against M protein (molecular mimicry)

237
Q

Treatment for Rheumatic Fever

A

Penicillin, aspirin and corticosteroids (if murmur present)

238
Q

Non-caseating granulomas in the axillary lymph nodes

A

Cat Scratch disease (Bartonella hensae)

239
Q

Splinter hemorrhages & dystrophic calcification in striated muscle

A

Trichinosis (Trichinella spiralis) Note: from eating undercooked pork

240
Q

Swollen, painful apocrine glands in axilla and groin infected w/ Staph aureus

A

Hidradenitis supperativa Note: hallmark is presence of sinus tracts

241
Q

Pharyngitis w/ erythematous rash the spares circumoral region, sandpaper feeling

A

Scarlet Fever (Strep pyogenes w/ erythrogenic toxin)

242
Q

Dermatophytes by location

A

Tinea Capitis: Blacks-Trichophyton tonsurans,Tinea Capitis: Whites-Microsporum canis/audouiniiCorporis/pedis/cruris-Trichophyton rubrumUnguium-Trichophyton rubrum

243
Q

Organisms at risk in Chronic Granulomatous Disease

A

Staph aureus, Pseudomonas cepacia, Nocardia, Serratia, Aspergillus Note: Nitroblue tetrazolium test; Nocardia is a branched gram positive

244
Q

Infection associated w/ non-caseating granulomas

A

Bartonella henselae–cat scratch disease Note: often in axillary lymph nodes due to scratches on arms

245
Q

Pts who undergo splenectomy should be vaccinated against

A

Strep Pneumo (most important) Note: Haemophilus influenza and Neisseria vaccination is also important but Strep pneumo is #1

246
Q

Most common bacteria in aspiration pneumonia

A

Oral anaerobes- Bacteroides, Fusobacterium, Peptococcus Note: Right lower lobe abscess; Think Klebsiella if currant jelly sputum

247
Q

Potential Complication of lymphogranuloma venereum

A

Rectal stricture Note: Chlamydia trachomatis L1-L3

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