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USMLE Step 1 > Microbiology > Flashcards

Microbiology Flashcards

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1
Q

Functions of bacterial cell wall

A
  1. Resist osmotic stress
  2. primer for own synthesis
  3. shape
  4. Protection
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2
Q

Encapsulated bacteria

A 
Strep pneumoniae
Klebsiella pneumoniae
H. influenzae
N. meningitidis
Salmonella
Group B strep
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3
Q

Bacterial capsules

A

Composed of glycocalyx (except b. anthracis)

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4
Q

Gram positive bacteria

A

Thick cell wall with lots of PG. Assoc with techoic and lipoteichoic acids

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5
Q

Gram negative bacteria

A

Thin PG layer and outer membrane. LPS.

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6
Q

Phases of bacterial growth

A

Lag, Log, Stationary, Decline

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7
Q

Obligate aerobes

A

Require O2. Nocardia, pseudomonas, mycobacterium tuberculosis, bacillus. (“Nagging pests must breathe”)

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8
Q

Obligate anaerobes

A

Cannot grow in presence of O2. Clostridium, bacteroides, actinomyces. (“Can’t breathe air”)

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9
Q

Microaerophilic

A

Requires very little levels of O2 for growth

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10
Q

Conjugation

A

One-way transfer of DNA from a donor cell to a recipient cell through sex (F) pilus. Donor bacterium must carry F plasmid (F+, male) and other must not (F-, female)

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11
Q

Spores

A

Dehydrated, multicelled structure that allows bacteria to survive when nutrients are limited. Only autoclaving will kill. Only certain gram positive rods can form spores.

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12
Q

Transformation

A

Bacteria take up fragments of naked DNA and incorporate them into their genomes if recipient is sufficiently homologous for recomb to occur

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13
Q

Transduction

A

Genetic transfer mediated by bacteriophages

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14
Q

Pigment producing bacteria

A 
S aureus (yellow)
P aeruginosa (blue-green)
Serratia marcescens (red)
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15
Q

Bacteria that carry IgA proteases

A

S pneumoniae
N meningitidis
N gonorrhoeae
H influenzae

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16
Q

alpha hemolysis

A

Green darkening of blood agar. S pneumoniae, viridans strep

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17
Q

beta-hemolysis

A

Complete clearing of blood agar. S pyogenes, agalactiae, aureus. Listeria.

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18
Q

Gamma-hemolysis

A

no hemolysis. Enterococcus

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19
Q

Endotoxin

A

LPS. Outer cell membrane of gram neg bacteria. Can cause fever and shock

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20
Q

Exotoxin

A

Polypep secreted by bacteria that harm host by altering cellular structure or fn. Very potent and potentially lethal.

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21
Q

Enterotoxins

A

Act on gut.

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22
Q

Bacteria not amenable to Gram staining

A

Mycobacteria. mycoplasma, rickettsia, chlamydia, treponema, legionella

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23
Q

MacConkey agar

A

Inhibits Gram+. Lactose fermenters: red. Non-lactose fermenters: white.

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24
Q

Chocolate agar

A

Good for H influenzae. Contains X, V factors.

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25
Q

Bordet-Gengou medium

A

Good for B pertussis

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26
Q

Bile esculin agar

A

Good for Group D streptococci

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27
Q

Silver stain

A

Good for Legionella pneumophilia

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28
Q

Hemolysis on blood agar

A

Differentiates streptococci

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29
Q

Streptococcus pyogenes

A

Pyogenic. B hemolysis. Causes wide variety diseases

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30
Q

Streptococci

A

Catalase negative, grm positive

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31
Q

Rheumatic fever

A

Caused by cross rxn of Abs raised against streptococcus bacteria with antigens in heart, causing pancarditis initially and potentially later-onset valvular disease.

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32
Q

Streptococcal pharyngitis

A

Odynophagia, high fever, regional lymphadenopathy, and most notably, erythema and frank white exudate on palatine tonsils. Scarlet fever is a complication from lysogenized pyrogenic exotoxin.

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33
Q

Impetigo

A

Common childhood colonization of upper epidermis. Perioral vesicular/blistered lesions that eventually develop honey-colored crust. Can be caused by streptococcus or S aureus.

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34
Q

Necrotizing fasciitis

A

Rapidly progressive infection of deep subcutaneous tissue. Purple-blue bullae on overlying skin following cellulitis-like picture, overt gangrene, systemic sxs, MOF.

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35
Q

Erysipelas

A

Acute skin infection-erythema, edema, warmth, systemic sxs. Streptococcus or other orgs like s aureus if immunocompromised

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36
Q

Cellulitis

A

Acute skin infection-erythema, edema, warmth, systemic sxs. Streptococcus or other orgs like s aureus if immunocompromised

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37
Q

Strep agalactiae

A

Common cause UTIs in pregnant women, comm cause neonatal infection. Indistinguishable from strep pyogenes on microscopy. B hemolysis. High rate of asymptomatic carriage in pregnant women.

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38
Q

Yellow fever

A

Flavivirus

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39
Q

Poliovirus

A

RNA enterovirus. Acute flaccid paralysis in <1%

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40
Q

Cat scratch disease

A

Bartonella henselae

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41
Q

Lyme disease

A

Borrelia burgdorferi, by Ixodes tick

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42
Q

EBV

A

Assoc with Burkitt lymphoma

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43
Q

S saprophyticus

A

5-20% cystitis

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44
Q

K pneumoniae

A

Community acquired pneumonia or secondary infections in COPD patients
Currant-jelly sputum
Alcoholics and aspirators at risk

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45
Q

WBC casts

A

Only if in kidney

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46
Q

Pyelonephritis

A

Costovertebral angle tenderness, fever, chills, with or without sxs UTI. In kids, may ascend to kidneys through incompetent ureterovesical sphincters

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47
Q

Histoplasma

A

Can live intracellularly

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48
Q

Blastomyces

A

Big, Broad Based, Budding

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49
Q

Mississippi River Basin

A

Histoplasmosis, blastomycosis

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50
Q

Central and S America-fungi

A

Paracoccidioidomycosis

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51
Q

Paracoccidioidomycosis

A

Captains wheel/Mickey Mouse appearance

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52
Q

Atypical pneumonia

A

Mycoplasma pneumoniae, legionelle pneumoniae, chlamydia pneumoniae

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53
Q

IgM cold agglutinin production

A

Only seens with mycoplasma infection

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54
Q

Legionella pneumoniae

A

Cultured on charcoal yeast extract medium
OR SILVER STAIN
Gram -
Severe community acq pneumonia, mostly affecting elderly with pre-existing lung disease

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55
Q

Reticulate bodies

A

Intracellular form of chlamydia species

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56
Q

Progressive multifocal leukoencephalopathy

A

Immunodef. pts. Caused by JC virus

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57
Q

CMV encephalitis

A

Uncommon except in HIV, homeless

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58
Q

Toxoplasmosis

A

Most comm cause cerebral mass lesions in HIV infected pts. Ring enhancing lesions on head CT.

TORCH infection.

Cat feces.

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59
Q

Rubeola

A

Measles. Koplik spots (red oral lesions with blue-white centers).

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60
Q

Diptheria

A

membraous pharyngitis

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61
Q

Rubella

A

German measles

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62
Q

Roseola

A

HHV6. V young kids, Rash, high fever

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63
Q

Rocky Mtn Spotted Fever

A

Petechial rash beginning around ankles and wrists

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64
Q

Eczema herpeticum

A

Vesicular rash. Pruritic. HSV-1 with disrupted skin barrier.

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65
Q

Impetigo

A

Honey colored crusting. Itchy btu not painful. S aureus or sometimes S pyogenes

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66
Q

P. malariae

A

72 hr cycle

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67
Q

P ovale

A

24 hr cycle

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68
Q

P vivax

A

24 hr cycle

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69
Q

P knowlensi

A

Macaques

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70
Q

Viral meningitis

A

Normal or raised ICP, high lymphos, normal protein, sugar

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71
Q

HPV

A

Inactivates p53, Rb

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72
Q

Influenza

A

Hemagglutinin and neuraminidase on surface allow absorption and penetration of host cells

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73
Q

Antigenic shift

A

New virus, can cause pandemics

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74
Q

Guillan Barre

A

Assoc with campylobacter jejuni

Symmetrical ascending paralysis

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75
Q

Neurocysticercosis

A

Pork tapeworm. Most comm parasitic infxn CNS worldwide. Brain, muscles, skin, heart.

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76
Q

B. Pertussis-stages

A

Incubation: 7-10 days
Catarrhal stage: URTI sxs. Max infectivity
Paroxysmal-single deep breath then whooping
Convalescent stage: decrease in intensity

Macrolides only work in incubation, catarrhal stages.

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77
Q

H influenzae

A

Chocolate agar + factor V, X
Does not cause influenza! (But can be post-influenza pneumonia)
Hib vaccine covers serotype B
Epiglottitis, meningitis, otitis media, pneumonia, eye infections, sinusitis

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78
Q

Corynebacterium diptheriae

A

Loeffler medium

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79
Q

N gonorrhoeae

A

Thayer-Martin medium

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80
Q

C botulinum

A 
fresh honey (babies).  Babies-unable to swallow, general weakness.  Heat labile toxins that inhibit ACh release into NMJ.
Home-canned or preserved food in adults.
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81
Q

Exotoxin A

A

TSS, Scarlet fever

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82
Q

Rose thorns

A

Sporothrix schenkii

83
Q

TORCH infections

A 
Diseases transmitted transplacentally and thus tested for at birth.
Toxoplasmosis
Other: Syphilis
Rubella
CMV
Herpes/HIV
84
Q

Congenital rubella

A

Deafness, cataracts, CV abnormalities (esp PDA)

85
Q

Listeria monocytogenes

A

Gram +ve bacilli, B hemoysis. Meningitis and sepsis in neonates and immunocompromised
Soft cheeses

86
Q

Group B strep

A

Most comm cause neonatal meningitis

87
Q

Listerosis in immunocomp

A

Ingestion poorly pasteurized milk, soft cheeses, cole slaw, ready to eat turkey/pork products

88
Q

Sarcoidosis

A

Lympadenopathy (enlarged, nontender). CXR-bilat hilar lymphadenopathy. Non caseating granulomas. Tx with systemic corticosteroids

89
Q

Malaria

A

Fever, sweat, chills, myalgia. if jaundiced, most likely falciparum.

90
Q

Test for malaria

A

Thick and thin blood films (parasites and species), giemsa stained.

91
Q

Hodgkins lymphoma

A

Reed Sternberg cells (binucleate)

92
Q

Typhoid fever

A

Enteric fever. High fever unresponsive to paracetamol. Gram neg bacilli. Fever increases in step wise manner til 39-41. Bradycardia, rose spots, 3rd gen cephalosporin

93
Q

E. histolytica

A

Diarrhea withuot blood or mucus.

94
Q

Erythema nodosum

A

Tender warm red nodules nuder skin from inflamm adipocytes, Strep, HCV, TB, M. pneumoniae, Yersinia, EBV, coccidioides, AI, sarcoid, preg, cancers….

95
Q

Blackwater fever

A

Complication of malaria due to hemolysis and release Hb into urine. Freq–> renal failure

96
Q

EBV + ampicillin

A

maculopapular pattern rash

97
Q

Risus sardonicus

A

“Sardonic smile”. Tetanus

98
Q

Trismus

A

Decreased jaw opening, oft due to muscle spasms. Tetanus

99
Q

Opisthotonos

A

State of severe hyperextaneion, spasticity. Tentanus

100
Q

Cholera toxin

A

Stimulates adenylate cyclase

101
Q

Thayer-Martin agar

A

X, V factors + abx/antifungals that suppress normal flora in vaginal, rectal, and pharyngeal specimens.

Neisseria.

102
Q

Tellurite agar

A

Corynebacterium. Pos=black

103
Q

LPS

A

Potent activator of immune syst. Il-1, IL-6, TNF

104
Q

Catalase

A

Differentiates G+ cocci

105
Q

Coagulase

A

Differentiates S aureus from other staph

106
Q

Superantigens

A

Scarlet fever toxin (S pyogenes), TSST-1 (S aureus), staph enterotoxins

107
Q

IgA proteases

A 
Cleave IgA (1st line defense against pathogens).  Prevents opsonization so not noticed by immune system
S. pneum, Neisseria, H. influenzae
108
Q

Viridans strep

A

Ungroupable. alpha hemolyitc, optochin resistant

109
Q

S mutans

A

Dental caries

110
Q

Strep bovis

A

Assoc w/ GI malignancies

111
Q

S pneumoniae

A

1 cause bacterial pneumonia in adults

Pyogenic immune response-highly immunogenic capsule
#1 cause meningitis in adults
Tx: ceftriaxone and/or vanco

112
Q

S aureus

A

B hemolysis, producing gold pigment
Contains coagulase
Scalded skin syndrome, TSS, cellulitis, impetigo, folliculitis, dirty wounds w/ foreign matter, osteomyelitis

113
Q

Osteomyelitis in Sickle cell

A

Salmonella

114
Q

S epidermis

A

Novobiocin sensitive
Mechanical prostheses, indwelling catheters
Often a contaminant

115
Q

C. tetani

A

anaerobic G+.
Neurotoxin prevents release GABA, glycine–sustained contractions, risus sardonicus.
Vaccine: TDaP. Immunity fleeting-need boosters.

116
Q

C. perfringens

A

Gas gangrene. Soil. Necrotizes tissue, blood, vasculature. High mortality.

117
Q

C. diff

A

Anaerobic. Antibiotic-assoc colitis. Most severe=pseudomembranous colitis.

118
Q

B anthracis

A

Cutaneous-black eschar
Pulm-woolsorters disease.
Also GI version.

119
Q

B. cereus

A

Reheated fried rice. Emetic form and diarrheal forms. Resolve on own.

120
Q

Corynebacterium diphtheriae

A

G+ rods
Metachromatic (red/blue) granules
Diphtheria-exudative pharyngitis-dysphagia, fever, malaise. Pseudomembrane on post oropharynx and tonsils that cannot be scraped off (dislodges +1 week)
DTaP vaccine

121
Q

Actinomycetes

A

G+ rods. Fungus like morphology. Nocardia and actinomycetes israelii.

122
Q

Nocardia

A

Strictly aerobic. Bronchopulm infxns, esp if decreased T cell immunity.

123
Q

Actinomycetes israelii

A

Anaerobic. Oral/facial abscesses with underlying yellow color (sulfur). Surgical drainage and penicillin/ampicillin.

124
Q

Neisseria

A

G- cocci. Differentiate gonorrhoeae and meningitidis: N men can ferment maltose.

125
Q

N. meningitidis

A

Most cases meningitis in adolescents.
Meningococcemia: multiorgan disease with small vessel thrombolysis and overwhelming consumptive coagulopathy–petechiae/purpura

126
Q

Waterhouse-Friderichsen syndrome

A

Fulminant meningococcemia–septic shock and bilat hemorrhagic destruction of adrenal glands.

127
Q

N. gonorrhoeae

A 
Opthalmia neonatorum if pass through infected birth canal.
Gon=2nd most comm STI.
Req's Thayer-Martin media.
Males-acute purulent urethritis
Females-acute cervicitis or asymptomatic
128
Q

PID

A

Polymicrobial but usually gonococcus and/or C thrachomatis involved. Spreads to inner lady bits causing bad things like ovarian abscess, increased risk ectopic preg, infertility

129
Q

H ducreyi

A

Causes chancroid (STI). Tender perianal nodule that eventually ulcerates. Inguinal lympahdenopathy.

130
Q

Genital herpes

A

Multiple painful ulcers

131
Q

Lymphogranulum venereum

A

STI. Single painless ulcer, but painful lymphadenopathy.

132
Q

Gardnerella vaginalis

A

Coccobacillary Gram -.

Asymptomatic or bacterial vaginosis.

133
Q

Bacterial vaginosis

A 
G. vaginalis and/or other anaerobes.
Intense pruritis, fishy odor, and copius frothy secretions when mixed with KOH.
Clue cells (=epith surrounded by bacteria)

Metronidazole

134
Q

Shigella

A 
Gram- rod
Fecal-oral route
Invasive gastroenteritis-bloody diarrhea +pus, fever, abdo pain
Shiga toxin
Severe=dysentery
135
Q

Salmonella

A

G- rod
Chicken, eggs, dairy
S. typhi=typhoid fever (pain mimics appendicitis, splenomegaly, rose spots). Cipro, even for carriers.

136
Q

E. coli

A 
G- rod.
Infectious diarrhea, HUS
#1 cause UTIs
#2 cause neonatal meningitis
Shiga-like toxin causes enterocyte death
EHEC, incl O157:H7 most common in US
137
Q

Proteus miribalis

A

Urease. Comm cause UTIs.

138
Q

V cholerae

A

Exotoxin (choleragen) increases cAMP

Rice water stools. Oral rehydration. Doxy, TMP-SMX can shorten course.

139
Q

C jejuni

A

G- rod
Undercooked chicken, unpast. milk
Single most comm cause invasive diarrhea
Assoc with Guillain Barre and reactive arthritis

140
Q

H pylori

A

G- rod.
Duod ulcers, chronic gastritis.
Urease enzyme
Increases risk gastric adenocarcinoma, gastric lymphoma.

141
Q

Pseudomonas

A

Opportunistic.
*Skin infections in burn patients

P. aeruginosa has blue-green tint and sweet grape odor.

142
Q

Yersinia pestis

A

Plague. Dissem by macrophages. Rats and rodents in rural areas (SW US)-bite or fleas.
Bubonic plague-buboes.
Pneumonic plague-constit and resp sxs

143
Q

Francisella tularensis

A

Tularemia. Rabbits. Central plains.

Lesions-bubo formation at site infxn

144
Q

Brucella

A 
Cows, goats, pigs.  Spread by infected meat, aborted placentas, unpast milk.
Intermitt fever (worse in day, better at night).
145
Q

Pasteurella multocida

A

Mouths of cats and dogs. Local wound infx, lymphadenopahty, cellulitis.
Doxy or penicillin.

146
Q

Bartonella

A

B. henselae-Cat scratch fever. Chronic lymphadenitis. Mostly in kids.
B quintana-trench fever

147
Q

Mycobacterium tuberculosis

A

TB. 1/3 world. Caseous granulomas. Ghon complex-perihilar LNs by calcified granuloma.
In vertebrae=Pott disease
Apices of lungs (high O2)
Fever, night sweats, weight loss, hemoptysis
Miliary-distal seeding

148
Q

M. leprae

A

Hansen disease (former: leprosy)
Armadillos.
Tuberculoid and lepromatous forms.

149
Q

Mycoplasma. pneumoniae

A

Comm cause atypical pneumonia in young adults.

150
Q

Treponema pallidum

A

Type of spirochete.
SYPHILIS
Primary-single nonpainful lesion
Tertiary-neurosyph. Argyl-Robertson.

151
Q

Spirochetes

A

Borrelia, tremponema, leptospira

152
Q

Nonvenereal treponema

A

Yaws, pinta, bejel. All tx’d with penicillin

153
Q

Borrelia recurrentis

A

Relapsing fever.
Louse.
Sudden onset shaking chilld, fever, myalgias, headache, delirium, cough, lethargy, hepatosplenomegaly

Penicillin, tetracycline

154
Q

Leptospira interrogans

A

Aerobic, two flagella.
Fecal-oral through contaminated water (puddle jumping)

Flu-like, photophobia. Mild-aseptic meningitis. Severe-Weil disease

155
Q

Weil disease

A

Severe complication leptospirosis.
Hemorrhagic vasculitis.
High mortality.

156
Q

Dimorphic fungi

A

Coccidiodes immitis
Histoplasma capsulatum
Blastomyces dematiditis
Paracoccidioides brasiliensis

157
Q

Pseudomonacea

A

Wound infections in burns patients. Opportunistic. G- rods, oxidase positive, do not ferment lactose..

158
Q

Rocky Mountain Spotted Fever

A

Rickettsial infection (arthropod vector)

159
Q

Lyme disease

A

Borrelia burgdoferi
Ixodes scapularis tick bite
Erythema chronicum migrans and constitutional sxs. Can later cause heart conduction problems

162
Q

Coccidiodes

A

SW US. Desert rheumatic fever.

163
Q

Herpesviruses

A 
HSV-1, HSV-2
ZVZ
EBV
CMV
HHV-6
HHV-8
164
Q

HBV

A

Blood/sex transmission.
Partially double stranded hepadna (DNA) virus. Requires RNA-dependent DNA polymerase.
Vaccine is recombinant

165
Q

Adenovirus

A

ds DNA virus. Febrile pharyngitis, pneumonia, conjunctivitis (“pink eye”).

166
Q

Parvovirus

A

ss DNA. Most important is B19-aplastic crises in sickle cell, “slapped cheeks” (fifth disease)-erythema infectiosum in kids, RBC destruction in fetus leading to hydrops fetalis and death.

167
Q

Papillomavirus

A

ds DNA. Main disease=HPV.
Warts: 1, 2, 6, 11
Cervical cancer: 16, 18

Vaccine recombinant.

168
Q

Polyomavirus

A

ds DNA.
JC virus-progressive multifocal leukoencephalopathy in HIV
BK virus-transplant patients, commonly affects kidney

169
Q

Poxvirus

A

ds DNA.

Smallpox, vaccinia (cowpox), molluscum contagiosum

170
Q

Live attenuated vaccines

A

MMR, polio (Sabin), typhoid, BCG, chickenpox, yellow fever, smallpox

171
Q

Killed vaccines

A

Rabies, Influenza, Pertussis, Polio (Salk), HAV

172
Q

Recombinant vaccines

A

HBV, HPV

173
Q

HSV identification

A

Tzanck test. Detects multinucleated giant cells.

174
Q

Reoviruses

A

*Only class of RNA viruses that are ds

Colitvirus
Rotavirus

175
Q

Picornaviruses

A 
HAV
Polio
Echo
Rhino
Coxsackie
176
Q

Hepevirus

A

HEV

177
Q

Calicivirus

A

Norwalk

178
Q

Flavivirus

A 
Yellow fever
Dengue fever
HCV
St. Louis encephalitis
West Nile virus

All are arboviruses except HCV

179
Q

Togaviruses

A

Rubella
Eastern equine encephalitis
Western equine encephalitis

180
Q

Retroviruses

A

HIV-1, HIV-2
HTLV-1

Requires reverse transcriptase

181
Q

Coronavirus

A

Common cold, SARS

182
Q

Orthomyxoviruses

A

Influenza

183
Q

Paraorthomyxoviruses

A

Parainfluenza-croup
RSV
Measles (Rubeola)
Mumps

184
Q

Rhabdovirus

A

Rabies

185
Q

Filovirus

A

Ebola/Marburg

186
Q

Bunyavirus

A

Hanta
California encephalitis
Sandfly/Rift Valley Fever
Crimean-Congo hemorrhagic fever

187
Q

Delta virus

A

HDV

188
Q

Negative stranded viruses

A 
"Always Bring Polymerase Or Fail Replication"
Arena
Bunya
Paramyxo
Orthomyxo
Filo
Rhabdo
189
Q

Segmented viruses

A 
All RNA.
BOAR.
Bunya
Orthomyxo
Arena
Reo
190
Q

Yellow fever

A

Aedes mosquito.

High fever, black vomitus, jaundice (hence “yellow”)

191
Q

Rotavirus

A

“ROTA: Right Out The Anus”

Most important global cause infantile gastroenteritis.

192
Q

HBeAg

A

Marker of HBV replication and infectivity.

193
Q

Anti-HBeAg

A

Antibody. Low transmissability.

194
Q

HBsAg

A

Have HBV :(

195
Q

Anti-HBcAg

A

Antibody to HBcAg.
IgM=acute infection
IgG=chronic disease

196
Q

Anti-HBsAg

A

Immunity to HBV

197
Q

HIV diagnosis

A

“Rule out” with ELISA

“Rule in” with Western blot

198
Q

Bugs mimicking appendicitis

A

Yersinia enterocolitica, C jenuni, non-typhoidal Salmonella. Mimicks by causing mesenteric adenitis.

199
Q

Congenital toxoplasmosis

A

Chorioretinitis, hydrocephalus, intracranial calcifications

200
Q

Congenital rubella

A

PDA/pulm artery hypoplasia
Cataracts
Deafness
Possibly “blueberry muffin rash”

201
Q

Congenital CMV

A

Hearing loss
Seizures
petechial rash
“Blueberry muffin” rash

202
Q

Congenital HIV

A

Recurrent infections

Chronic diarrhea

203
Q

HSV-2

A

Termporal encephalitis

Herpetic lesions

204
Q

Congenital syphilis

A

Often results in stillbirth, hydrops fetalis.

If survives:
Facial abnormalities-notched teeth, saddle nose, short maxilla
Saber shins
CN VIII deafness

205
Q

Hand-foot-mouth disease

A

Coxsackievirus type A

206
Q

Erythema infectiosum

A

Parvo B19.

“Slapped cheek syndrome”

USMLE Step 1 (15 decks)

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