Micro Random Flashcards
composition flagellum vs pilus
proteins-flagellum
pilus-glycoprotein
composition spore
dipicolinic acid
resist dehydration, heat, chemicals
capsule
inhibits against phagocytosis
polysaccharide (poly D glutamate in B anthracis)
location endotoxin
outer leaflet (LPS/LOS)
lipid A
induces TNF and IL-1
sugar backbone with peptide side chains cross linked by peptidase
cell wall
lipoteichoic acids
gram positive only
extend from membrane to exterior
can induce TNF-alpha and IL-1
Giemsa stain
chlamydia, borrelia, rickettsia, trypanosomes, plasmodium
PAS
stains glycogen, mucopolysaccharides
used to diagnose Whipple disease
carbol fuchsin
stains mycolic acid in cell wall
current standard-auramine-rhodamine stain
chocolate agar
contains factor V (NAD) and X (hematin)
grows H flu
Thayer Martin
contains vanco, trimethoprim and colistin and nystatin
grows neisseria
Bordet-Gengou
potato extract for pertussis
Regan-Lowe
charcoal, blood and antibiotics
grows pertussis
grow diptheria
tellurite, Loeffler
grow TB
Lowenstein-Jensen
grow M pneumo
Eton agar
contains cholesterol
MacConkey agar
produces acid in fermentation-turns pink
for lactose fermenting enterics
eosin-methylene blue agar
gree metallic sheen for E. coli
charcoal years with cysteine and iron
legionella
sabouraud agar
fungi
obligate aerobes
nocardia, psuedonomas, mycobacterium TB
obligate anaerobes
clostridium, bacteroides, fusobacterium, actinomyces
lack catalse
foul smell in anaerobes
short chain fatty acids
facultative anaerobes
make ATP through nonoxygen dependent pathways
not killed by O2
obligate intracellular
rickettsia, chlamydia, coxiella
rely on host ATP
facultative intracellular
salmonella, neisseria, brucella, mycobacterium, listeria, francisella, legionella, yersinia
encapsulated
pseudomonas, strep pneumo, h flu, neisseria, e. coli, salmonella, klebsiella, group B strep
encapsulated bacteria vaccines
conjugate protein
promote T cell activation
pneumo, h flu, meningitis
urease positive
proteus, cryptococcus, h pylori, ureaplasma, nocardia, klebsiella, s epidermidis, s saprophyticus
catalase positive
nocardia, pseudonomas, listeria, aspergillus, candida, e coli, staph, serratia, B cepacia, h pylori
ventilator associated pneumonia
p aeruginosa
also contact lens-associated keratitis
binds Fc portion of IgG to prevent opsonization and phagocytosis
staph protein A
cleaves IgA to adhere and colonize membranes
s pneumo, h flu, neisseria
type III sec
pseudonomas, salmonella, shigella, e coli
uptake naked bacteria
transformation
bacteria that use transformation
s pneumo, h flu, neisseria (ones with IgA protease)
no transfer of chromosomal DNA
F+xF-
transfer part of plasmid and flanking chromosomal genes
Hfr x F-
recipient remains F- but has new bacterial genes
generalized transduction
lytic cleaves bacterial DNA and packages in phage capsid
specialized transduction
excision-lysogenic infects bacterium
flanking DNA may be packaged into capsid
toxins encoded in lysogenic phage with specialized
GAS, botulism, cholera, diptheria, shiga toxin
example of transposon
vanA in VRE
formation of spores
at end of stationary phase when nutrients are limited
kill spore
autoclave
steam at 121C for 15 min
exotoxin
polypeptide on plasmid or bacteriophage that are highly toxic
exotoxin examples
tetanus, botulism, diptheria
endotoxin
lipid A of LPS
induces TNF, IL-1 and IL-6
destruction exotoxin
at 60C
destruction endotoxin
at 100C for 1 hr
enhances cytokine release
shiga toxin and SLT
labile vs stable ETEC
labile cAMP (increase Cl secretion) stable cGMP (decrease NaCl resorption)
pertussis toxin
overactivates AC by disabling Gi
location botulism toxin
NMJ
AB toxin
B binding
A active
alpha toxin C perfringes
phospholipase degrades tissue and cell membranes
strep degrades cell membrane
streptolysin O
binds MHC II and TCR
exotoxin A-strep
TSST-staph
food poisoning
heat stable enterotoxin staph
exfoliative toxin
scalded skin syndrome
composition LPS
O antigen+core polysaccharide+ lipid A
endotoxin-not secreted actively
effects endotoxin
macrophage activation (TLR4), complement activation, tissue factor activation (edema and NO)
common sites of staph colonization
nares, axilla, groinlabs TSS
increase AST, ALT and bilirubin
labs in TSS
no virulence without capsule
strep pneumo
makes dextrans which bind fibrin-platelet aggregates
s sanguinis
PYR+
GAS
impetigo
precedes glomerulonephritis
pharyngitis can be before either
CAMP factor GBS
enlarges area of hemolysis formed by staph
hippurate + PYR-
GBS
intrapartum penicillin prophylaxis
GBS
strep bovis
associated with colon cancer
catalase - PYR+
enterococci
medusa head appearance
anthrax
cause cereus food poisoning
cereulide
preformed toxin
treatment tetanus
antitoxin+booster
diazepam and wound debridement
babies c diff
spores in honey
treat with anti-toxin
causes C diff
antibiotics-clinda or ampicillin
PPI use
treatment c diff
metronidazle, vancomycin, fidaxomicin
encoded by beta prophage
exotoxin diptheria
stain diptheria
metachromatic (blue and red) granules and Elek + for toxin
black colonies on cystine-tellurite agar
manifestations listeria
amnionitis, septicemia, spontaneous abortion, granulomatosis infantiseptica, neonatal meningitis, meningitis in immunocompromised
PID with IUDs
actinomyces
mimic TB but -PPD and acid fast
nocardia
fewer false positives from BCG vaccination
interferon gamma release assay
prophylaxis MAI
azithromycin
M scrofulaceum
cervical lymphadenitis in children
M marinum
hand infection in aquarium handlers
cord factor
activates macropahges and induces release of TNF-alpha
sulfatides
inhibit phagolysosomal fusion
lepromatous
Th2-low response
tuberculoid
Th1
lactose fermenters
klebsiella, e coli, enterobacter, serratia
breaks down lactose into glucose and galactose
beta galactosidase in e coli
EMB agar
lactose-purple/black
e coli green
ferment maltose and glucose
meningococci
capsule neisseria
none in gonococci
polysaccharide capsule in meningococci
conjunctivitis 2-5 days after birth
neisseria
prevents neonatal blindness
erythromycin
most common cause of mucosal infection h flu
nontypable
unencapsulated
thumb sign
epiglottitis
vaccine h flu
type b capsular polysaccharide (polyribosylribitol phosphate)
conjugated to diptheria toxoid
given between 2-18 months of age
stages pertussis
catarrhal-low grade fever
paroxysmal
convalescent
lymphocytic infiltate
bordatella
confused as viral frequently
treatment legionella
macrolides or quinolone
Legionnaires disease
pneumonia, fever, GI, and CNS symptoms
toxins pseudomonas
endotoxin-fever, shock
exotoxin A-inactivates EF2
phospholipase C-degrades membranes
pyocyanin-generates reactive oxygen species
treatments pseudonomas
carbapenems, aminoglycosides, monobactams, polymyxins, FQN, third and fourth gen cephalosporins, extended penicillins
mucoid polysaccharide capsule
contribute to chronic pneumonia in CF
patients with ecthyma gangenosum
seen in immunocompromised
K capsule e coli
pneumonia, neonatal meningitis
fimbriae e coli
cystitis, pyelonephritis
EIEC
invasive, dysentery
similar manifestations similar to shigella
ETEC
heat labile and heat stable enterotoxins causing travelers diarrhea
EPEC
adheres to apical surfaces and prevents absorption in peds
e coli that does not produce sorbitol
EHEC
lobar pneumonia in alcoholics and diabetics
klebisella
no hematogenous spread
shigella
Vi capsule
salmonella typhi
prolongs duration
antibiotics and salmonella
primarily monocyte response
salmonella typhi
vaccine salmonella typhi
Vi capsular polysaccharide in IM
live attenuated in oral
treatment typhoid fever
ceftriaxone or FQN
carrier state typhoid
gallbladder colonization
decreasing severity shigella
dysenteriae
flexneri
boydii
sonnei
grows in alkaline media
vibrio cholera
acid vibrio
acid labile
pseudoappendicitis
yersinia due to mesenteric adenitis and/or terminal ileitis
main location pylori
antrum stomach
treatment pylori
amoxicillin
clarithromycin
PPI
visualization with aniline dyes spirochete
borrelia
myalgia lepto
calves
also jaundice, photophobia
conjunctiva suffusion
erythema without exudate
Weil disease
jaundice and azotemia from liver and kidney dysfunction
ixodes vector
anaplasma
babesia
borrelia
natural reservoir borrelia
mouse
DOC lyme
doxycycline
amoxicillin and cefuroxime in children and pregnant
condylomomata lata
white lesions, smooth
from syphilis
neurosyphilis
test spinal fluid with VDRL, FTA-ABS, PCR
VDRL
nonspecific antibody that reacts with beef cardiolipin
sensitive but not specific
false + VDRL
viral infection
drugs
rheumatic fever
lupus and leprosy
borrelia louse
relapsing fever from variable surface antigens
Lone star tick
ehrlichiosis
rickettsia louse
prowazekii
dermacentor rickettsia
rocky mountain spotted fever
endemic typhus
fleas
typhi
epidemic typhus
louse
prowazekii
monocytes with morulae
mulberry like inclusions
ehrlichiosis
anaplasma
granulocytes with morulae
no rash or vector
endospore
Q fever
coxiella
elementary body
enters via endocytosis
treatment chlamydia
azithromycin
or doxy and ceftriaxone
A-C chlamydia
blindness
especially in Africa
D-K
everything else
neonatal conjunctivitis-weeks
treatment lymphogranuloma venereum
doxycycline
treatment mycoplasma
macrolides, doxy, or FQN
fungal palatal/tongue ulcers
splenomegaly
histoplasmosis
fungal simulate SCC
blastomycosis
tinea characteristics
branching septate hyphae
varieties tinea pedis
interdigital
moccasin distribution
vesicular type
degeneration of lipids produces acids that damage melanocytes
malasseiza
candida vulvovaginitis
diabetes and ABX
disseminated candidiasis
neutropenic patients
cause invasive aspergillosis
immunocompromised
chronic granulomatous disease
ABPA
associated with asthma and CF
may cause bronchiectasis and eosinophilia
latex agglutination
detects polysaccharide capsular antigen
fungal cavernous sinus thrombosis
mucor and rhizopus
prophylaxis PCP count
<200
ascending lymphangitis
nodules along draining lymphatics
sporothrix schenckii
treatment sporothrix
itraconazole or potassium iodide
cysts with up to 4 nuclei in stool
E histolytica
treatment E histolytica
metronidazole, paromomycin, iodoquinol for asymptomatic cyst
transmission cryptosporidium
oocytes in water
treatment cryptosporidium
nitazoxanide
congenital toxo
chorioretinitis, hydrocephalus, intracranial calcifications
biopsy toxo
tachzoite seen
spinal fluid naegleria
amoebas
blood smear trypanosoma
trypomastigote
treatment trypanosoma
suramin for blood
melarsoprol for CNS
48 hr cycle
p vivax/ovale
72 hr cycle
p malariae
chloroquine MOA
blocks heme polymerase
life threatening malaria
quinidine or artesunate (test for G6PD)
primaquine
for hypnozoite for vivax/ovale
fever and hemolytic anemia
babesia
unilateral periorbital swellin
Romana sign
acute stage Chagas
blood smear chagas
trypomastigote
treatment chagas
benznidazole or nifurtimox
visceral leishmaniasis
spiking fevers, hepatosplenomegaly, pancytopenia
cutaneous leishmaniasis
skin ulcers
diagnosis leishmania
macrophages containing amastigotes
wet mount trichomonas
trophozoites moving
type I HSR to helminths
neutralization of histamine and leukotrienes
type II HSR to helminths
eosinophils attach to surface of helminths via IgE and release cytotoxins (major basic protein)
treatment pinworm
pyrantel pamoate or bendazoles
ascariasis
fecal-oral
cutaneous larva migranse
serpiginous rash from ancylostoma (hook worm)
trichuris
whipworm that causes rectal prolapse in children
visceral larva migrans
migrate to blood through intestinal wall
affects heart, liver, eyes, CNS
transmission onchocerca
female blackfly
transmission loa loa
deer fly, horse fly, mango fly
transmission wuchereria
female mosquito
treatment neurocysticercosis
albendazole
cysticercosis
ingestion of eggs
transmission echinococcus
ingestion of eggs
treatment echinococcus
albendazole
squamous cell carcinoma of bladder
s haematobium (terminal spine)
biliary tract inflammation
leads to pigmented gallstones
clonorchis sinensis
cancer clonorchis
cholangiocarcinoma
from undercooked fish
pruritus worse at night
scabies
transmission through skin to skin contact
treatment scabies
permethrin cream
lice
pediculus, blood suckling
can transmit prowazekii, borrelia recurrentis, bartonella quintana
treatment lice
pyrethroids, malathion, or ivermectin
can be treated at home without interrupting school attendance
recombination
exchange between 2 chromosomes by crossing over in regions with homology
reassortment
segmented genomes exchange genetic material
antigenic shift
complementation
nonmutated complements mutated one by making functional proteins
hepB makes envelope for HDV
live attenuated vaccines
MMR, Yellow fever, Rotavirus, influenza, chickenpox, smallpox, sabin
killed vaccines
rabies, influenza, salk polio, HAV
induce only humoral immunity
subunit vaccines
HBV, HPV
circular DNA
papilloma, polyoma, hepadnaviruses
infectivity naked viral genome
require polymerases in virion to be infectious
membrane herpes
from nuclear membrane
febrile pharyngitis, hemorrhagic cystitis, pink eye
adenovirus
cause PML
JC virus in HIV
virus targets kidneys
BK polyomavirus
pure RBC aplasia and rheumatoid arthritis in adult
parvo
most common cause of sporadic encephalitis
HSV1
herpes zoster ophthalmicus
V1 varicella HHV3
lymphoproliferative disease in transplant patients
EBV HHV4
hemorrhage, cotton-wool exudates, vision loss
CMV in AIDS retinitis
latency CMV
mononuclear cells
owl eye inclusions
intranuclear eosinophilic Cowdry A inclusions
HSV and VZV
receptor CMV
integrins
receptor parvo
P antigen on RBC
receptor rabies
nicotinic AChR
chikungunya
togavirus
HTLV
T celll leukemia
icosahedral capsid
croup
parainfluenza
LCMV
lymphocytic choriomeningitis virus
an arenavirus
segmented ambisense
arenavirus
rhino and acid
acid labile
Councilman bodies
eosinophilic apoptotic globules in liver seen in Yellow fever virus
binds sialic acid and promotes viral entry
hemagglutinin
location replication live attenuated influenza vaccine
in nose and not in lung
blueberry muffin appearance from rubella
due to dermal extramedullary hematopoiesis
fusion protein
causes respiratory epithelial cells to fuse and form multinucleated cells
promotes virion release
neuraminidase
steeple sign
narrowing upper trachea and subglottis
from parainfluenza
severe croup
pulsus paradoxus secondary to upper airway obstruction
prodrome measles
cough, coryza, and conjunctivitis, Koplik spots
Warthin-Finkeldey giant cells
fused lymphocytes seen in measles
sequelae measles
SSPE, encephalitis, and giant cell pneumonia
reduce morbidity and mortality from measles
vitamin A
particularly in malnourished children
negri bodies
cytoplasmic inclusions
purkinje and hippocampal neurons
postexposure rabies
killed vaccine and rabies immunoglobulin
transport rabies
retrograde via dynein after binding to Ach receptors
target cells ebola
endothelial cells, phagocytes, hepatocytes
Zika
flavivirus from Aedes mosquito
Zika in pregnant womane
congenital microcephaly and miscarriage
naked viruses hepatitis
A and E
lacks exonuclease activity
HCVHCV
leads to variation in envelope proteins
macrovascular steatosis
HCV
ground glass and cytotoxic T cell mediated damage liver
HBV
hepatocyte swelling, Counsilman bodies
HAV
leukocytoclastic vasculitis
seen in HepC
porphyria cutanea tarda and lichen planus
hepC
renal HepC
membranous
renal HepB
membranoproliferative
endocrine HepC
increase risk for DM and autoimmune hypothyroidism
anti HBs
from vaccination or recovery
env
gp 120 and 41 for attachment and fusion
gag
p24 and p17 for capsid and matrix proteins
pol
reverse trasncriptase, aspartate protease, integrase
early infection HIV receptor
CCR5 on macrophages
receptor late HIV
CXCR4
diagnosis HIV
ELISA-sensitive
Western Blot-specific
AIDS diagnosis
<200
HIV and AIDS defining condition
problems with diagnosis HIV
falsely negative 1-2 months
falsely positive in babies due to anti-gp120 crossing placenta
detecting viral lode in babies HIV
PCR
location replication HIV latent phase
lymph nodes
oval yeast cells within macrophages
histoplasma capsulatum
seen inHIV patients less than 200
nonenhancing areas of demyelination on MRI
PML from JC reactivation
acid fast oocysts in stool
cryptosporidium
CNS lymphoma
ring enahncing from EBV
usually solitary
special infections CF
burkholderia cepacia
staph aureus
strep pneumo
pseudomonas
post viral infection
strep pneumo
staph aureus
h flu
most common to cause abscess
viridans and staph aureus
otitis and mastoiditis abscess
temporal lobe and cerebellum
sinusitis or dental infection abscess
frontal lobe
osteomyelitis involving vertebra
staph and TB
best test for osteomyelitis
MRI
elevated CRP and ESR
predisposing factors UTI
obstruction, kidney surgery, catheterization, GU malformation, diabetes, pregnancy
+nitrite
E coli
thin white vaginal discharge
bacterial vaginosis
nonspecific TORCH infection signs
hepatosplenomegaly, jaundice, thrombocytopenia, growth retardation
meningoencephalitis in baby
HSV-2
oval shaped vsicles on palms and soles
hand foot mouth
fine desquamating truncal rash
Rubella
clinical features gonorrhea
urethritis, cervicitis, PID, prostatitis, epidymitis, arthritis
granuloma inguinale
red ulcer that bleeds on contact
from Klebsiella
most common bacterial STI
chlamydia
can cause PID
risk factor for ectopic preganncy
salpingitis
Fitz-Hugh-Curtis syndrome
infection of liver capsule and violin string adhesions of peritoneum to liver
bacteria from ventilators and intubation
pseudomonas, klebsiella, acinetobacter, staph aureus
penicillin G vs V
G IV or IM
V oral
greater oral availability than ampicillin
amoxicillin
bulky R group penicillin
diclox, naf, oxacillin
beta lactamase inhibitors
clavulanic acid
avibactam
sulbactam
tazobactam
organisms not covered in cephalospoins 1-4
listeria
atypicals
MRSA
Enterococci
ABX prior to surgery
cefazolin
ceftazidime
pseudomonas coverage
adverse cephalosporins
disulfiram like reaction
vitamin K def
cilastin
inhibitor of renal dehydropeptidase I
decrease risk of seizures carapenem
meropenem
MOA aztreonam
binds BPB3
synergistic with aminogylcosides
prevent red man
antihistamines
resistance to van
d-ala to d-lac
ABX cause neuromuscular blockade
aminoglycosides
resistance to aminoglycosides
acetylation, phosphorlation, adenylation
tigecycline MOA
binds 30S
gray baby
lack UDP-glucuronyltransferase
resistance to chloramphenicol
plasmid encoded acetyltransferase
resistance to macrolides
methylation of 23s rRNA
macrolides inhibit p450
clarithromycin
erythromycin
MOA sulfonamides
inhibit dihdropteroate synthase
MOA trimethoprim
inhibits bacterial dihydrofolate reductase
FQN inhibit p450
cipro
resistance to FQN
mutation in gyrase, plasmid resistance, efflux pumps
delay resistance to dapsone in leprosy
rifamycins
rifabutin
less p450 stimulation
formation of active metabolite isoniazie
catalase peroxidase (KatG)
pyrazinamide
acidic pH
results in hyperuricmia
blocking arabinosyltransferase
ethambutol
prophylaxis exposure to syphilis
benzathine penicillin G
use colistin
multidrug resistant pseudomonas and acinetobacter
supplement with ampho
K and Mg
adverse flucytosine
bone marrow suppression
gynecomastia from azole
ketoconazole
neuronal membrane depolarization via Na
permethrin
AchE inhibitor
malathione
blocks GABA
lindane
leads to neurotoxicity
blocks detox heme into hemozoin
chloroquine
inhibit neuraminidase
oseltamivir
drug for zoster
famciclovir
adverse acyclovir
obstructive crystalline nephropathy
MOA ganciclovir
5’ monophosphate guanosine analog that inhibits DNAP
foscarnet
DNA/RNAP inhibitor
does not require activation
cidofovir
inhibits viral DNAP, does not require phosphorylation by viral kinase
adverse cidofovir
nephrotoxicity
preferential HIV treatment
2 NRTIs and an integrase inhibitor
NRTI pancreatitis
didanosine
abacavir
hypersensitivity in B5701
do not require phosphorylation
delavirdine, efavirenz, nevirapine
vivid dreams
efavirenz
contraindicated NNRTI in pregnancy
delavirdine and efavirenz
ritonavir
boost other drug concentrations by inhibiting p450
adverse indinavir
nephropathy, hematuria, thrombocytopenia
uses IFN alpha
hep B, C, kaposi sarcoma, hairy cell leukemia, condyloma acuminatum, RCC, malignant melanoma
uses IFN-beta
MS
use IFN-gamma
chronic granulomatous disease
MOA ribavirin
inhibits synthesis of guanine nucleotides by inhibiting inosine monophosphate dehydrogenase
adverse ribavirin
hemolytic anemia
sofosbuvir
inhibits RNA dependent RNAP
simeprevir
HCV protease inhibitor
causes photosensitivity
ledipasvir
NS5A inhibitor
chlorhexidine
denatures proteins and disrupts cell membranes
hydrogen peroxide
sporicidal
iodine and iodophors
halogenation of RNA, DNA, and proteins
may be sporicidal
