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Micro - Systems Flashcards

1
Q

A neonate gets an infection in utero and develops notched teeth, saddle nose, short maxilla, and saber shins. Diagnosis?

A

Syphilis

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2
Q

A patient has vesicular rashes on the palms and soles and ulcers in the oral mucosa. What caused this?

A

Coxsackie A virus

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3
Q

What causes Prion diseases?

A

Prion protein (PrPc: a normal cellular protein) gets converted into a -pleated form (PrPsc), which destroys normal tissue

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4
Q

What clinical manifestations does prion accumulation cause?

A

Spongiform encephalopathy, ataxia, dementia, and death

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5
Q

Why does the β-pleated form of Prion protein cause encephalopathy?

A

Because it is resistant to degradation and facilitates conversion of more prion
protein to the β-pleated (pathologic) form

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6
Q

_____ is an example of an inherited prion disease; _____ is an example of an
acquired prion disease; _____ is an example of a sporadic prion disease.

A

Gerstmann-Sträussler-Scheinker syndrome; kuru; Creutzfeldt-Jakob disease

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7
Q

Staphylococcus epidermidis is considered normal flora of what parts of the body?

A

The skin and nose

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8
Q

Staphylococcus aureus normally colonizes what part of the body?

A

The nose

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9
Q

In which part of the body are viridans streptococci considered normal flora?

A

The oropharynx

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10
Q

Where in the body is Streptococcus mutans part of the normal dominant flora?

A

The dental plaque

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11
Q

Which bacteria are considered part of the normal dominant flora of the colon?

A

Bacteroides fragilis and to a lesser extent, Escherichia coli

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12
Q

Which three bacteria are considered dominant flora in the vagina?

A

Lactobacillus, Escherichia coli, and group B Streptococcus

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13
Q

What two organisms that causes food poisoning are found in contaminated
seafood?

A

Vibrio parahaemolyticus and Vibrio vulnificus

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14
Q

What gram-positive rod causes food poisoning associated with reheated rice?

A

Bacillus cereus (remember: Food poisoning from reheated rice? Be serious!)

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15
Q

Given that symptoms of Staphylococcus aureus food poisoning can begin within
an hour, symptoms are caused by what?

A

Preformed toxins

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16
Q

Which two organisms cause food poisoning that starts quickly and ends quickly?

A

Staphylococcus aureus and Bacillus cereus

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17
Q

Staphylococcus aureus preformed toxin is found in what types of foods?

A

Meats, mayonnaise, and custard

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18
Q

Which bacteria are associated with food poisoning after consumption of reheated
meat dishes?

A

Clostridium perfringens

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19
Q

Which bacteria are associated with food poisoning after consumption of
improperly canned foods (ie, bulging cans)?

A

Clostridium botulinum

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20
Q

Which gram-negative rod causes food poisoning in undercooked meat?

A

Escherichia coli

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21
Q

What bacteria cause food poisoning that is associated with contaminated poultry,
meat, and eggs?

A

Salmonella

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22
Q

In addition to causing food poisoning, what other type of infection can Vibrio
vulnificus cause?

A

Wound infections (after contact with shellfish or contaminated water)

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23
Q

Name eight organisms that can cause bloody diarrhea.

A

Campylobacter jejuni, Salmonella, Shigella, enterohemorrhagic Escherichia coli,
enteroinvasive Escherichia coli, Yersinia enterocolitica, Clostridium difficile,
and Entamoeba histolytica

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24
Q

Name eight organisms (bacteria, protozoa and viruses) that can cause watery
diarrhea.

A

Enterotoxigenic Escherichia coli, Vibrio cholerae, Clostridium perfringens,
Giardia, Cryptosporidium(in immunocompromised patients), rotavirus,
adenovirus, and Norwalk virus

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25
Q

What comma- or S-shaped organisms cause bloody diarrhea, grow at 42°C, and are
oxidase positive?

A

Campylobacter jejuni

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26
Q

What nonlactose-fermenting, motile, gram-negative rod causes bloody diarrhea?

A

Salmonella

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27
Q

What nonlactose-fermenting, nonmotile, gram-negative rod has a low ID50 and
causes dysentery?

A

Shigella

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28
Q

Infection with what organism can cause hemolytic uremic syndrome and a bloody
diarrhea that is caused by a Shiga-like toxin?

A

Enterohemorrhagic Escherichia coli

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29
Q

How does enterohemorrhagic Escherichia colicause bloody diarrhea?

A

By the invasion of the colonic mucosa

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30
Q

What organism causes bloody diarrhea and pseudoappendicitis and is associated
with outbreaks in day-care centers?

A

Yersinia enterocolitica

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31
Q

Pseudomembranous colitis is caused by which organism?

A

Clostridium difficile

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32
Q

Which protozoan causes blood diarrhea as well as liver abscesses?

A

Entamoeba histolytica

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33
Q

Enterotoxigenic Escherichia colicauses travelers diarrhea by producing what two
toxins?

A

Labile toxins and stabile toxins

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34
Q

What comma-shaped organisms cause watery diarrhea characterized by “rice-
water” stools?

A

Vibrio cholerae

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35
Q

Which gram-positive bacillus that causes gas gangrene also causes watery
diarrhea?

A

Clostridium perfringens

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36
Q

Which two protozoa cause significant diarrhea in immunocompetent individuals?

A

Giardia and Cryptosporidium

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37
Q

Which protozoan can cause significant watery diarrhea in immunocompromised
patients but mild disease in immunocompetent hosts?

A

Cryptosporidium

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38
Q

Which viruses can cause watery diarrhea?

A

Rotavirus, adenovirus, and Norwalk virus

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39
Q

What are the two most common causes of pneumonia in neonates?

A

Group B streptococci and Escherichia coli

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40
Q

What are the four most common causes of pneumonia in children 4 weeks to 18
years old?

A

Viruses (Respiratory syncytial virus), Mycoplasma, Chlamydia pneumoniae,
and Streptococcus pneumoniae(remember: Runts May Cough Sputum)

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41
Q

What are the three most common causes of pneumonia in adults 18-40 years of
age?

A

Mycoplasma, Chlamydia pneumoniae, and Streptococcus pneumoniae

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42
Q

What are the five most common causes of pneumonia in adults 40-65 years of age?

A

Streptococcus pneumoniae, Haemophilus influenzae, anaerobes, viruses
and Mycoplasma

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43
Q

What are the most common causes of pneumonia among the elderly?

A

Streptococcus pneumoniae, Haemophilus influenzae, gram-negative rods,
anaerobes, and viruses

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44
Q

Which pathogens are usually acquired as a nosocomial pneumonia?

A

Staphylococci and enteric gram-negative rods, which are rarely acquired in the
community

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45
Q

In addition to common causes, which organisms should be considered in
immunocompromised patients with pneumonia?

A

Staphylococci, gram-negative rods, fungi, viruses, and (in patients with HIV
infection) Pneumocystis jiroveci

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46
Q

In aspiration pneumonia, one would expect to see what type of organisms?

A

Anaerobes

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47
Q

Which three pathogens commonly cause pneumonia among alcoholics and
intravenous drug users?

A

Streptococcus pneumoniae, Klebsiella, and Staphylococcus

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48
Q

Postviral pneumonia is commonly caused by what pathogens?

A

Staphylococcusand Haemophilus influenzae

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49
Q

Which three pathogens commonly cause atypical pneumonia?

A

Mycoplasma, Legionella, and Chlamydia

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50
Q

Which bacterium often causes pneumonia in patients with cystic fibrosis?

A

Pseudomonas

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51
Q

In newborns up to 6 months of age, what three pathogens are most commonly
responsible for meningitis?

A

Group B streptococcus, Escherichia coli, and Listeria monocytogenes

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52
Q

In children between 6 months and 6 years of age, what four pathogens are most
commonly responsible for meningitis?

A

Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae type
B, and enteroviruses

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53
Q

In people 6 to 60 years old, what four pathogens are most commonly responsible
for causing meningitis?

A

Neisseria meningitidis, enteroviruses, Streptococcus pneumoniae, and herpes
simplex virus

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54
Q

In people 60 years of age and older, what three pathogens are most commonly responsible for causing meningitis?

A

Streptococcus pneumoniae, Listeria, and gram-negative rods

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55
Q

What five viruses are common causes of meningitis?

A

Enteroviruses (especially coxsackievirus), herpes simplex virus, HIV, West Nile
virus, and varicella zoster virus

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56
Q

What four pathogens commonly cause central nervous system disease in HIV-
positive patients?

A

Cryptococcus, cytomegalovirus, toxoplasmosis (brain abscess), and JC virus
(progressive multifocal leukoencephalopathy)

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57
Q

How has the incidence of bacterial meningitis changed in the past 20 years?

A

It has decreased due to the use of the Haemophilus influenzaevaccine

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58
Q

What cerebrospinal fluid findings are indicative of bacterial meningitis?

A

Increased pressure, polymorphonuclear leukocyte predominance, increased protein,
and decreased sugar

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59
Q

What cerebrospinal findings are indicative of fungal or tubercular meningitis?

A

Increased pressure, lymphocyte predominance, increased protein, and decreased
sugar

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60
Q

What cerebrospinal findings are indicative of viral meningitis?

A

Normal or increased pressure, lymphocyte predominance, normal or elevated
protein and normal sugar

61
Q

What is the difference in cerebrospinal fluid findings between bacterial and
fungal/tubercular meningitides?

A

Both show increased pressure and protein and decreased sugar; however,
polymorphonuclear leukocytes are found with bacterial causes, whereas
lymphocytes are found with fungal/tubercular causes

62
Q

In general, what is the most common cause of osteomyelitis?

A

Staphylococcus aureus (assume this cause if there is no other information)

63
Q

In sexually active people, what pathogen can rarely cause osteomyelitis and, more
commonly, septic arthritis?

A

Neisseria gonorrhoeae

64
Q

Osteomyelitis in diabetic and drug-addicted individuals may be caused by what
organism?

A

Pseudomonas aeruginosa

65
Q

Which otherwise unlikely organism can cause osteomyelitis in patients with sickle
cell disease?

A

Salmonella

66
Q

Which otherwise unlikely organism can cause osteomyelitis in patients with
prosthetic replacement?

A

Staphylococcus aureus and Staphylococcus epidermidis

67
Q

What is vertebral osteomyelitis caused by tuberculosis called?

A

Potts disease

68
Q

In what age group does osteomyelitis most frequently occur?

A

Children

69
Q

What two nonspecific laboratory findings are classically found in osteomyelitis?

A

Elevated erythrocyte sedimentation rate and C-reactive protein

70
Q

What organism is implicated in osteomyelitis resulting from dog bites or cat
scratches?

A

Pasteurella multocida

71
Q

Why are urinary tract infections 10 times more likely to occur in women than in
men?

A

Women have a short urethra that can be colonized by fecal flora

72
Q

Name seven factors that can predispose patients to urinary tract infections.

A

Flow obstruction, kidney surgery, catheterization, genitourinary abnormalities,
diabetes, and pregnancy

73
Q

Elderly males with what condition are predisposed to urinary tract infections?

A

Enlarged prostate

74
Q

What is the most common route of urinary tract infection?

A

Ascent of bacteria from the urethra to the bladder

75
Q

What are the symptoms of urinary tract infection?

A

Dysuria, frequency, urgency and suprapubic pain

76
Q

What are the symptoms of pyelonephritis?

A

Fever, chills, flank pain, and costovertebral angle tenderness

77
Q

What is found on urinalysis of a patient with cystitis?

A

White blood cells but not white blood cell casts, which would indicate kidney
pathology

78
Q

What is found on urinalysis of a patient with pyelonephritis?

A

White blood cell casts and red blood cells (hematuria)

79
Q

How does pyelonephritis develop from a lower urinary tract infection?

A

Further ascent of bacteria from the bladder to the kidneys

80
Q

Infants with what conditions are more prone to urinary tract infections?

A

Vesicoureteral reflux and other congenital anomalies of the urinary tract

81
Q

What does a positive leukocyte esterase test indicate on urinalysis?

A

Bacterial urinary tract infection

82
Q

What does a positive nitrite test indicate on urinalysis?

A

Gram-negative bacterial urinary tract infection

83
Q

Name seven bacteria that cause UTIs.

A

Serratia marcescens, Staphlococcus saprophyticus, Escherichia coli, Enterobacter
cloacae, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas
aeruginosa(remember: SSEEK PP)

84
Q

What organism causes nosocomial, drug-resistant urinary tract infection and
produces a red pigment?

A

Serratia marcescens

85
Q

The colonies of what leading cause of urinary tract infection show a metallic sheen
in eosin methylene blue agar?

A

Escherichia coli

86
Q

Enterobacter cloacae often causes _____ (community-acquired/nosocomial)
urinary tract infection, and it is often _____ (drug susceptible/drug resistant).

A

Nosocomial; drug resistant

87
Q

What organism, which is characterized by a large mucoid capsule and viscous
colonies, causes urinary tract infection and pneumonia in humans?

A

Klebsiella pneumoniae

88
Q

The production of what enzyme by Proteus mirabilisis associated with struvite
stones?

A

Urease; the enzyme makes urine more basic, which promotes struvite stone
formation

89
Q

Blue-green pigment and fruity odor characterize which organism that causes
urinary tract infection?

A

Pseudomonas aeruginosa

90
Q

In sexually active women, what is the second leading cause of community acquired
urinary tract infections?

A

Staphlococus saphrophyticus

91
Q

What are the ToRCHeS infections?

A

Toxoplasmosis, Rubella, Cytomegalovirus, Herpes simplex virus and HIV,
and Syphilis

92
Q

What is the classic triad found in many neonatal Toxoplasma gondii infections?

A

Chorioretinitis, intracranial calcifications, and hydrocephalus

93
Q

An neonate is found to have deafness, cataracts, a patent ductus arteriosus, and
pulmonary artery stenosis. What infection did his mother most likely have while
the neonate was in utero?

A

Rubella

94
Q

An infant presents with encephalitis and vesicular skin lesions. What infection did
this infant likely contract during vaginal birth?

A

Herpes simplex virus type 2

95
Q

What are the three congenitally acquired infections in which the mother is usually
asymptomatic with the infectious agent?

A

Cytomegalovirus, toxoplasmosis, and herpes simplex virus type 2

96
Q

What rash is commonly associated with neonatal rubella?

A

A “blueberry muffin” rash

97
Q

How does HIV commonly present in neonates?

A

Chronic diarrhea, recurrent infections, and failure to thrive

98
Q

If a neonate survives in utero infection of syphilis, how does s/he commonly
present?

A

Notched teeth, saddle nose, short maxilla, and saber shins

99
Q

What physical findings of the neonate are common to most ToRCHeS infections?

A

Jaundice, hepatosplenomegaly, growth retardation, and thrombocytopenia

100
Q

Aside from the infections in the ToRCHeS mnemonic, what are three other
important infectious agents that can pass from mother to fetus?

A 
Streptococcus agalactiae (group B strep), Escherichia coliand Listeria 
monocytogenes; all are common causes of meningitis in neonates
101
Q

How does a pregnant woman with rubella infection commonly present?

A

With rash, arthritis, and lymphadenopathy

102
Q

How does a pregnant woman with syphilis commonly present?

A

If primary, with chancres; if secondary, with disseminated rash; if tertiary, with
cardiac and neurologic symptoms

103
Q

Name eight diseases that can cause red rashes in childhood.

A

Measles, mumps, rubella, roseola (human herpesvirus type 6), scarlet fever (group
A strep), parvovirus B19, varicella zoster virus, Coxsackie A

104
Q

Describe the rash associated with scarlet fever.

A

Red and sandpaper-like (accompanied by fever and sore throat)

105
Q

What is hand-foot-and-mouth disease?

A

Vesicular lesions on the extremities and oral mucosa caused by coxsackie A virus

106
Q

How does gonorrhea present in men and women?

A

In both, urethritis with creamy purulent discharge; in women, cervicitis, pelvic
inflammatory disease; in men, prostatitis, epididymitis; disseminated disease can
cause migratory arthritis and skin pustules

107
Q

How do the lesions of chickenpox differ from those of smallpox?

A

In chickenpox the lesions are in various stages of healing; in smallpox all lesions
are of the same age

108
Q

A 2-year-old patient has a high fever for 3 days. On the fourth day, the temperature
returns to normal, but the child develops a body-wide red rash. What is the
diagnosis?

A

Human herpesvirus type 6

109
Q

Characterize the disease caused by Chlamydia trachomatis(serotypes D-K).

A

Urethritis, cervicitis, pelvic inflammatory disease; neonates can develop
conjunctivitis; susceptible individuals can develop reactive arthritis (Reiter
syndrome)

110
Q

How does the presentation of measles differ from that of rubella?

A

Measles is preceded by cough, coryza, conjunctivitis and Kopliks spots whereas
rubella has a notable postauricular lymphadenopathy

111
Q

What organism causes lymphogranuloma venereum?

A

Chlamydia trachomatisserotypes L1 through L3

112
Q

What are the findings of lymphogranuloma venereum?

A

Ulcers, lymphadenopathy, and rectal strictures

113
Q

What spirochete causes a painless chancre?

A

Treponema pallidum (primary stage)

114
Q

What are the findings of secondary syphilis?

A

Fever, lymphadenopathy, condyloma lata, and skin rashes

115
Q

What are the clinical findings in tertiary syphilis?

A

Tabes dorsalis, gummas, aortitis, Argyll Robertson pupil

116
Q

What disease is caused by Haemophilus ducreyi?

A

Chancroid, characterized by painful, genital ulcers and inguinal lymphadenopathy
(remember: Haemophilus ducreyi so painful, you do cry)

117
Q

In addition to painful genital lesions, herpes simplex virus type 2 commonly causes
what systemic symptoms?

A

Headaches, fevers, myalgias

118
Q

Trichomonas vaginaliscauses what condition in women?

A

Vaginitis; unlike other etiologies of vaginitis, trichomonas is sexually transmitted

119
Q

What causes condyloma acuminata?

A

Human papillomavirus types 6 and 11

120
Q

Which viral hepatitis can be sexually transmitted?

A

Hepatitis B

121
Q

What three findings are indicative of bacterial vaginosis?

A

Noninflammatory discharge, fishy odor (positive whiff test), and clue cells on
microscopy

122
Q

Pelvic inflammatory disease is most often caused by what two organisms?

A

Chlamydia trachomatis and Neisseria gonorrhoeae

123
Q

What is the most common sexually transmitted disease in the United States?

A

Chlamydia trachomatis; unlike gonorrhea it can be an asymptomatic infection and
therefore has higher prevalence

124
Q

Cervical motion tenderness is most commonly associated with what disease?

A

Pelvic inflammatory disease due to ascending chlamydial or gonorrheal infection

125
Q

What is the chandelier sign?

A

Cervical motion tenderness; said to be so painful that the patient jumps up to the
ceiling (the chandelier)

126
Q

Name four possible sequelae of pelvic inflammatory disease.

A

Salpingitis, endometritis, hydrosalpinx, and tubo-ovarian abscess

127
Q

Salpingitis is a risk factor for which complications?

A

Adhesions, which lead to ectopic pregnancy, infertility, and chronic pelvic pain

128
Q

What cause of vaginitis shows motile organisms on wet preparations?

A

Trichomonas vaginalis

129
Q

How does the presentation of urethritis due to gonorrhea differ from that due to
chlamydia?

A

Neisseria gonorrhoeae often causes acute disease with high fevers

130
Q

What is Fitz-Hugh-Curtis syndrome?

A

Ascending gonorrheal or chlamydial infection causing inflammation of the liver
capsule and “violin string” adhesions of the parietal peritoneum to the liver

131
Q

Cytomegalovirus and respiratory syncytial virus are often associated with
transmission in what nosocomial setting?

A

The newborn nursery

132
Q

Which two pathogens are most likely to cause nosocomial infections associated
with urinary catheterization?

A

Escherichia coli and Proteus mirabilis

133
Q

Which nosocomial infection can cause blue-green pus to develop in burn wounds?

A

Pseudomonas aeruginosa

(remember:
presume Pseudomonas AIRuginosa when AIR or burns are involved)

134
Q

What etiology of pneumonia, uncommon outside of cystic fibrosis patients, can be
acquired from respiratory therapy equipment?

A 
Pseudomonas aeruginosa(remember: 
presume Pseudomonas AIRuginosa when AIR or burns are involved)
135
Q

Hepatitis B virus is associated with nosocomial infections in what setting?

A

The renal dialysis unit, due to the frequency of venipuncture in that setting

136
Q

What organism is associated with infection of intravenous lines used for
hyperalimentation?

A

Candida albicans

137
Q

Water aerosols that lead to nosocomial infections often involve which organism?

A

Legionella(remember: think Legionella when water sources are mentioned)

138
Q

What are the two most common causes of nosocomial infections?

A 
Escherichia coli(urinary tract infection) and Staphylococcus aureus (wound 
infections)
139
Q

How do HIV-positive adults with Histoplasma capsulatuminfection present?

A

Low-grade fever, cough and hepatosplenomegaly; immunocompetent individuals
would have only pulmonary symptoms, if any

140
Q

How do HIV-positive adults with Candida albicans infection commonly present?

A

With fluffy, cottage-cheese lesions on the buccal mucosa (thrush)

141
Q

What is bacillary angiomatosis?

A

Vascular proliferation with neutrophilic inflammation seen in HIV-positive
individuals infected with Bartonella

142
Q

What is Kaposi sarcoma?

A

A malignant neoplasm of superficial vascular endothelial cells caused by human
herpesvirus type 8 in HIV-positive individuals

143
Q

How does the superficial vascular proliferation of Kaposi sarcoma differ from
bacillary angiomatosis histologically?

A

Bacillary angiomatosis is marked by neutrophilic inflammation whereas Kaposi
sarcoma is a malignant neoplasm with lymphocytic inflammation

144
Q

How does an HIV-positive adult with Cryptosporidiuminfection commonly
present?

A

With chronic, watery diarrhea

145
Q

What finding in the stool suggests Cryptosporidiuminfection?

A

Acid-fast cysts

146
Q

Which yeast commonly causes meningitis and encephalitis in adults who are HIV
positive?

A

Cryptococcus neoformans

147
Q

What causes progressive multifocal leukoencephalopathy?

A

In AIDS patients, latent JC virus reactivates and causes demyelination

148
Q

What diagnosis should be considered in an HIV-positive patient found to
have cotton wool spots on fundoscopic exam?

A

Cytomegalovirus retinitis

piggy (83 decks)

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