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USMLE Step 1 Quick Notes > Microbiology > Flashcards

Microbiology Flashcards

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USMLE® Step 1 flashcards
1
Q

What is Tellulrite agar used to detect?

A

C. diphtheriae

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2
Q

What is Loeffler medium used to detect?

A

C. diphtheriae

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3
Q

What is lowenstein-Jensen agar used to detect?

A

Mycobacterium TB

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4
Q

How do you stain for H. pylori?

A

Silver Stain

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5
Q

How do you stain for Legionella?

A

Silver Stain

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6
Q

Where can you get listeria from?

A

Unpasteurized milk, deli meats or by vertical transmission/vaginal delivery

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7
Q

What is carbol fuschin?

A

Acid fast stain

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8
Q

What is the charcoal yeast extract with cysteine and iron?

A

Legionella

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9
Q

What is MacConkey agar used for?

A

Lactose fermenting (such as E.coli); will form pink colonies

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10
Q

What is EMB (eosin-methylene blue) agar used for?

A

E. coli (forms green metallic sheen)

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11
Q

What are the aerobes?

A

Nocardia, Pseudomonas, Mycobacterium

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12
Q

What are obligate intracellular pathogens?

A

Rickettsia, Chlamydia

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13
Q

What are the catalase positive organisms?

A

S. aureus, E.coli, Candida, Serratia, Pseudomonas, Aspergillus, Listeria, Burkholderia, Nocardia

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14
Q

How does Pertussis toxin work?

A

Increases cAMP b displaying Gi, impairing phagocytosis. Its an ADP-ribosylating toxin.

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15
Q

How does C. perfringens toxin work?

A

It is a phospholipase (lecithinase) that degrades cell membranes

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16
Q

Transformation vs Transduction?

A

Transformation: naked DNA transfer
Transduction: Generalized - lytic phage
Trasnduction: Specialized - lysogenic phage

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17
Q

What does Protein A do and what pathogen is it a virulence factor of?

A

Virulence factor of S. aureus. Binds Fc portion of IgG inhibiting complement activation and phagocytosis

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18
Q

If you get influenza infection, what pathogen can give you pneumonia after?

A

S. aureus (especially in elderly) or S. pneumo/Hib

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19
Q

What produces dextrans from glucose?

A

S. sanguis (viridans strep)

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20
Q

What are the toxins of S. pyogenes?

A

Exotoxin A and Streptolysin O

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21
Q

What is PYR Test positive?

A

S. pyogenes

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22
Q

What produces CAMP factor?

A

S. agalactiae

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23
Q

What causes subacute endocarditis following GI/GU procedures?

A

Group D enterococci

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24
Q

What encodes the diptheria toxin?

A

Beta-prophage

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25
Q

What else can diphtheria cause besides pharyngitis?

A

Myocarditis, arrhythmia, lymphadenopathy

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26
Q

What does Elek test do?

A

Tests for diphtheria toxin

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27
Q

What has metachromatic granules (blue and red)?

A

Diphtheria

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28
Q

What forms spores?

A

Bacillus (anthrax, cereus), clostridium, Coxiella burnetti

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29
Q

What else does C. perfringens cause besides gas gangrene?

A

Late onset food poisoning causing watery diarrhea; from undercooked meat

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30
Q

What looks like serpentine or medusa head?

A

Anthrax

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31
Q

What is the only gram positive bacteria to make endotoxin?

A

Listeria

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32
Q

Which bug causes spontaenous abortion?

A

Listeria

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33
Q

What cause vertebral osteomyelitis?

A

Myocbacterium TB (Pott’s Disease)

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34
Q

What is the prophylactic treatment of MAC?

A

Azithromycin

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35
Q

What does cord factor do?

A

Inhibits macrophage maturation and induces release of TNF-alpha

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36
Q

What do sulfatides (in TB) do?

A

inhibit phagolysosomal fusion

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37
Q

What does Lepromin test show?

A

Positive for tuberculoid due to Th1 response but negative for lepromatous due to Th2 response (no cell immunity)

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38
Q

What presents as hypopigmented hairless plaques with focal decreased sensation?

A

Tuberculoid Leprosy

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39
Q

What strain of Hib causes conjunctivitis, otitis media, bronchitis?

A

Nontypable

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40
Q

How do you treat Hib meningitis?

A

Ceftriaxone

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41
Q

How do you treat Hib mucosal infections?

A

Amoxicillin +/- clavulanate?

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42
Q

What do labs show for for legionella?

A

Hyponatremia

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43
Q

What is a non lactose fermenting gram negative rod that produces H2S?

A

Salmonella

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44
Q

What is a non lactose fermenting gram negative rod that does not produce H2S?

A

Shigella

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45
Q

What is the diagnosis? Travel to endemic area, faint rose colored spots on the abdomen, fever, abdominal pain, intestinal perforation.

A

Salmonella Typhi

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46
Q

How does Salmonella typhi cause a carrier state?

A

Remain in gallbladder

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47
Q

What enteric infection do you get from puppies’ feces?

A

Campylobacter of Yersinia

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48
Q

What is urease, oxidase, and catalase positive?

A

H. Pylori

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49
Q

Treatment for H. pylori?

A

PPI + clarithromycin + amoxicillin or metronidazole

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50
Q

What does leptospira cause?

A

Flu-like symptoms, jaundice, photophobia, conjunctival suffusion

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51
Q

Where do you get leptospira from?

A

Water contaminated with animal urine; seen among surfers and tropics?

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52
Q

What is Weil disease?

A

Severe form of Leptospirosis (jaundice, azotemia, fever, hemorrhage, anemia)

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53
Q

How do you treat Lyme Disease?

A

Doxycycline or Ceftriaxone

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54
Q

What causes Francisella?

A

Ticks, rabbits, deer fly

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55
Q

How do you treat Rickettsial disease (rocky mountain etc)

A

Doxycycline

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56
Q

What bug do you get from cattle placenta and tick feces?

A

Coxiella Burnetti (Q fever aka pneumonia)

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57
Q

What has cytoplasmic inclusions seen on Giemsa?

A

Chlamydia

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58
Q

What grows on Eaton agar?

A

Mycoplasma (cholesterol enriched media)

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59
Q

What is a disc shaped yeast on methenamine silver stain?

A

Pneumocystis Jirovecii

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60
Q

What is a cigar shaped budding yeast?

A

Sporothrix schenkii

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61
Q

What is the treatment for entaemoba histolytica?

A

Metronidazole; Iodoquinol for asymptomatic

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62
Q

What causes bloody diarrhea, liver abscess with anchovy paste exudate, RUQ pain?

A

Entamoeba Histolytica

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63
Q

What is the classic triad of congenital toxoplasmosis?

A

Intracranial calcifications, chorioretinitis, hydrocephalus

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64
Q

How do you treat toxoplasmosis?

A

Sulfadiazine, pyrimethamine

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65
Q

What is the treatment for African sleeping sickness?

A

Suramin for blood borne disease; Melasoprol for CNS penetration

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66
Q

What is the treatment for Babesia?

A

Atovaquone + azithromycin

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67
Q

Which bugs cause dilated cardiomyopathy?

A

Coxsackie B and T. cruzi (Chagas Disease)

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68
Q

What is the treatment for T. cruzi?

A

Benzinidazole or nifurtimox

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69
Q

What disease is it if you see macrophages with amastigotes?

A

Leishmniasis

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70
Q

What is Leishmaniasis

A

Spiking fevers, hepatosplenomegaly, pancytopenia

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71
Q

What is associated with a strawberry cervix?

A

Trichomonas vaginalis

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72
Q

What do you treat Trichomonas with?

A

Metronidazole (both bacterial vaginosis and this is metronidazole)

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73
Q

What is the treatment for Strongyloides?

A

Ivermectin or albendazole

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74
Q

How do you treat enterobius, ascaris, and ancytoplasma/necator?

A

Pyrantel pamoate or bendazole

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75
Q

What is it if you see rhabtidiform larvae in stool?

A

Strongyloides

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76
Q

What are the symptoms of strongyloides?

A

Pruritc streak (larva currens), GI sx (diarrhea, vomiting, epigastric pain - may resemble peptic ulcer)

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77
Q

What bug is a snail the host of?

A

Schistosoma

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78
Q

What forms hyatid cysts in the liver?

A

Echinococcus

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79
Q

Which hepatitis virus causes risk of fulminant hepatitis in pregnancy women?

A

HEV

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80
Q

What bug do you get from shellfish?

A

HAV

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81
Q

Which two viruses are exceptions to this rule: all dsDNA and + RNA are infectious?

A

HBV, Poxvirus

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82
Q

What virus is an exception to this rule: all enveloped viruses acquire their envelopes from plasma membrane?

A

Herpesvirus: acquires envelopefrom nuclear membrane

83
Q

What are the polyomaviruses?

A

JC and BK viruses

84
Q

Which DNA virus is partially double stranded?

A

Hepadnavirus

85
Q

Where do you get norovirus from?

A

Cruise ships, nursing homes, schools

86
Q

Who gets rotavirus?

A

Children. It is the #1 cause of fatal diarrhea in children

87
Q

What is the reservoir for yellow fever?

A

Monkeys or humans

88
Q

What are the symptoms of yellow fever?

A

Jaundice, black vomitus, high fever

89
Q

What is Pavlizumab?

A

It is a monoclonal antibody against F protein that prevents pneumonia caused by RSV in premature infants

90
Q

How do paramyxoviruses cause infection?

A

They express F protein (surface protein) causing respiratory epithelial cells to fuse and form and multinucleated cells?

91
Q

Which receptor does HIV bind early?

A

CCR5

92
Q

Which receptor does HIV bind late?

A

CXCR4

93
Q

Antibody to which of the HIV proteins crosses the placenta and creates a false positive result in the baby?

A

GP120

94
Q

What causes hairy leukoplakia in AIDS patients?

A

EBV

95
Q

What causes acid fast cysts in the stool?

A

Cryptosporidium

96
Q

How do you differentiate superficial vascular proliferations in HIV caused by HHV-8 (Kaposi) from Bartonella henslae (bacillary angiomatosis)?

A

HHV-8 has lymphocytic infiltrate

B. henslae has neutrophilic infiltrate

97
Q

What does P. jirovecii look like on imaging?

A

Ground glass appearance

98
Q

How do you tell Haemophilus ducreyi and primary syphilis apart?

A

H. ducreyii you see a painFUL chancroid; primary syphilis you see a painLESS chancre.

99
Q

What do you use for pneumocystis and pneumocystis plus toxoplasma (if severe) prophylaxis?

A

TMP- SMX

100
Q

How does chloroquine work?

A

Blocks detoxification of heme into hemozoin

101
Q

Which of the NRTI’s is a nucleotide instead of a nucleoside?

A

Tenofovir

102
Q

Which NRTI for general HIV prophylaxis and transmission to baby?

A

Zidovudine

103
Q

What is the toxicity of cephalosporins?

A

Increases nephrotoxicity of aminoglycosides, vitamkin K deficiency, hypersensitivity reactions

104
Q

What is lepromin test positive for?

A

Tuberculoid leprosy because of Th1 response (would see IFN-gamma and IL-2 in induration)

105
Q

What do you give for acute diphtheria?

A

Antitoxin (passive immunization) then give erythromycin/penicillin, DPT vaccine

106
Q

How does Daptomycin work?

A

Membrane depolarization, inactivated by surfactant. Associated with CKP increase and myopathy

107
Q

What is unique about spores?

A

They are heat resistant so you must autoclave

108
Q

What causes noninflammatory diarrhea?

A

Cholera, Giardia, ETEC, S. aureus, B. cereus

109
Q

What would you see in the stool if you had cholera?

A

Mucus and epithelial cells in stool

110
Q

How do Nystatin and Amphotericin B work?

A

Create pores in cell membrane

111
Q

What is Amphotericin B’s toxicity?

A

Arrhythmias (hypokalcemia, hypomagnesia), nephrotoxicity, anemia, IV phlebitis, fevers/chills

112
Q

Is Aspergilloma colonizing or invasion?

A

Colonizing

113
Q

How does Flyctosine work?

A

Inhibits DNA & RNA synthesis

114
Q

How does Griseofulvin work?

A

Inhibits microtubule function

115
Q

What does HCV progress to?

A

Chronic stable hepatitis

116
Q

How does lyme disease present?

A

Facial nerve palsy, arthralgias, cardiac block, erythema migrans (annular rash with central clearing)

117
Q

What organs does mumps cause inflammation in?

A

Pancreas, testes, parotid gland

118
Q

What does anthrax look like on blood agar?

A

Nonhemolytic, rough gray colonies

119
Q

What is the classic presentation of congenital syphilis?

A

Desquamating rash, cleft palate, rhinitis, RPR+

120
Q

What else can ascaris cause besides intestinal infection?

A

Pneumonia; it posses one of the most potent allergens so cause type 1 hypersensitivity

121
Q

What infections are CF patients most likely to get?

A

Pseudomonas

122
Q

What is the diagnosis? Caseating granulomatous disease from ingestion of unpasteurized milk?

A

Brucella Abortis

123
Q

What does Brucella abortis?

A

Abortions, endocarditis (aortic), mostly mild fevers

124
Q

How does Fluconazole work?

A

Blocks lanosterol demethylase

125
Q

What do you think of if you have HIV and see ring enhancing lesions?

A

Primary CNS lymphoma and to toxoplasma

126
Q

What is the life cycle of strongyloides?

A

Get into feet from sand –> hematogenous spread to lungs –> coughed up and swallowed –> develop into adults –> lay eggs in intestinal mucosa –> hatch into rhabtidiform larvae –> excreted in stool

127
Q

What is larva currens and what do you see it with?

A

It is pruritic, erythematos linear streaks on thighs and buttocks seen with strongyloides (due to larvae migrating away from perianal region)

128
Q

How does diphtheria toxin work?

A

Inhibits protein synthesis via ADP ribosylation of EF-2

129
Q

What virulence factor does E. coli use to cause meningitis and pneumonia?

A

K1 capsule

130
Q

What virulence factor does E. coli use to cause pyelonephritis and cystitis?

A

Fimbriae

131
Q

What does LPS endotoxin cause?

A

Septic shock

132
Q

What part of LPS causes shock?

A

Lipid A

133
Q

What do you give measles?

A

Vitamin A

134
Q

What is a nonenterococcus group D bug?

A

S. bovis

135
Q

What can you get enterococcus bacterial endocarditis?

A

GU instruments or cath

136
Q

How does C. Diff toxin work?

A

Disrupts cytoskeleton via actin depolymerization

137
Q

What is the MCC of infections associated with foreign bodies?

A

S. epidermis

138
Q

What is the most likely organism if you have pneumonia, GI symptoms (diarrhea), high fever especially if neutrophisl but no bacteria?

A

Legionella

139
Q

What do you get Legionella from?

A

Contaminated water exposure (cruise ships, recent travels, AC, hot tub)

140
Q

What is ribavrin used for?

A

RSV and HCV

141
Q

What should someone who develops septic shock or severe pulmonary disease from SW US be evaluated for?

A

Plague

142
Q

Why is MRSA resistant to all beta lactams?

A

It has penicillin binding protein so drug can’t find it easily

143
Q

How does acyclovir work?

A

Inhibits viral DNA synthesis by incorporating into viral DNA

Needs to be phosphorylated first (only in infected cells so few adverse effects)

144
Q

What is the major pathogenesis of Salmonella and Shigella?

A

Mucosal invasion

145
Q

What is a small focus of fibrotic tissue in TB?

A

Ghon complex (calcification is immune system walling off granuloma)

146
Q

What is a cavitary lesion in TB?

A

Latent TB

147
Q

What makes a cholera infection more likely?

A

PPI

148
Q

What kills latent malaria infection with vivax and ovale?

A

Primaquin

149
Q

What type of medium is Thayer Martin?

A

Selective

150
Q

What does env in HIV make?

A

Glycosylated to make gp41 (invading) and gp120 (attaching)

151
Q

When does T helper cell response to TB occur?

A

2-4 weeks after infection

152
Q

What presents with prodrome, then agitation, disorientation, hydrophobia, hypersalivation, progressing to death or coma?

A

Rabies

153
Q

What do you get rabies from?

A

Bats, raccoon, skunk bites

154
Q

What transmits campylobacter?

A

Cattle, sheep, dogs, chicken

155
Q

What has granular eosinophilic appearance resembling ground glass?

A

HBV (HBsAg in hepatocellular cytoplasm)

156
Q

What is the host for schistosoma?

A

Snail

157
Q

What does parvovirus cause in adults?

A

RA like symptoms

158
Q

What is the diagnosis? Dysphagia, diplopia, dysphonia.

A

Botulinum

159
Q

Why does HDV need HBV?

A

For coating of viral particles

160
Q

What does MAC grow at?

A

41deg and has more widespread involvement in body

161
Q

How does HBV replicate?

A

Produces positive RNA template from DNA template but DNA progeny

162
Q

What is the only DNA viruses in the hepatitis family?

A

HBV

163
Q

Why is there no vaccine to HCV?

A

Huge antigenic variation

164
Q

What is one way CMV be transmitted?

A

Blood transfusions

165
Q

What is an indurated genital ulcer?

A

Gumma (from syphilis)

166
Q

What type of hypersensitivity does TB damage through?

A

Type 4

167
Q

How do you tell if someone has risk for chronic HepB

A

HbeAg and HbsAg positive

168
Q

How doe shigella invade the GI tract?

A

By first gaining access to M cells

169
Q

What do you use to treat most coagulase negative straph?

A

Vancomycin

170
Q

What is this: progency has capsid of one and genome of another but no change in genome so next generation of virions revert back to normal.

A

Phenotyping mixing

171
Q

What do gram negative organisms that ferment lactose look like on agar?

A

Pink on MacConkey

172
Q

What are the segmented viruses?

A

BOAR: bunya, orthomyxo, arena, reo

173
Q

What has one large polypeptide that is cleaved by proteases into functional viral proteins?

A

Picronavirus

174
Q

How does tetanus toxin infect?

A

Wound –> motor neurons –> spinal cord

175
Q

How do you prevent HSV reactivation?

A

Daily valaycyclovir. Acyclovir during 1st episode is just for that episode (it doesn’t affect latent)

176
Q

How does HCV have so much genetic variability?

A

3-5 exonuclease

177
Q

What has cutaneous black eschar?

A

Antrhax

178
Q

What has black eschar from the nose?

A

Mucormycosis

179
Q

What is pustular skin lesions that form thick scabs?

A

Impetigo

180
Q

If you do gastric biopsy and put in urea solution. If it turns pink then what does that mean?

A

Positive urea test indicative of H. pylori (urease converts urea to ammonia)

181
Q

What would isoniazid monotherapy in TB result in?

A

Selective survival of bacterial cells secondary to gene mutation (either of catalase peroxidase enzyme or binding site of isoniazid)

182
Q

What can be cultured at refrigeration temperatures and is beta hemolytic?

A

Listeria

183
Q

What is most useful for making a tetanus diagnosis?

A

History and physical (there is no serum toxin assay)

184
Q

What is the MC outcome of hepatitis infection?

A

Complete resolution

185
Q

Which E. coli does not ferment sorbitol on MacConkey agar?

A

EHEC

186
Q

What are the MCC of intraabdominal infections?

A

B. fragilis, E. coli

187
Q

What causes abscess around appendix?

A

B. fragilis

188
Q

How can HAV be killed?

A

Boiling, chlorination, bleach, formalin

189
Q

What most likely happened if baby is born and gets oral thrush, interstitial pneumonia, and lymphopenia?

A

Mom transmitted HIV to baby

190
Q

What do you treat Giardia with?

A

Metronidazole

191
Q

What causes disulfiram like reaction with alcohol?

A

Metronidazole

192
Q

What presents with intensely pruritic rash (excoriation with small crusted red papules) worse at night and on hands/palms?

A

Scabies

193
Q

What is raltegavir?

A

Integrase inhibitor: prevents viral DNA integration and therefore inability to synthesize mRNA

194
Q

Why do you use primaquine for vivax and ovale?

A

To kill hypnozoites (those inside hepatocytes)

195
Q

Why do hepatocytes get destroyed when HBsAg present?

A

Viral antigens displayed on cell surface stimulate cytotoxic CTLs

196
Q

What else besides BPH can also have difficulty starting a stream and maintaining?

A

Diabetic neuropathy leading to overflow incontinence

197
Q

What causes liver abscess?

A

Echinococcus, Entameoba

198
Q

What are councilman bodies a result of?

A

These eosinophilic globules are a result of hepatocyte apoptosis

199
Q

What is reassortment?

A

When viruses with segmented genomes exchange segments. Responsible for influenza pandemics

200
Q

What has trophozoites with phagocytosed RBC or cysts in stool?

A

Entamoeba histolytica

201
Q

What is CMV colitis?

A

Common cause of colitis in immunocormpromised.
Reactivation of CMV after retinitis in HIV: GI sx, colonoscopy shows erythema, erosions, ulcerations.
Biopsy shows large cells with large ovioid nuclei containing basophilic depossits (intranuclear inclusions)

202
Q

What would the HSV DNA of three different vesicular lesions look like?

A

The same!

203
Q

What does Hep B infection lead to?

A

Most completely resolve

204
Q

How do you kill anaerobic spores?

A

Autoclave (exposure to steam at 121 celsius for 15 minutes)

USMLE Step 1 Quick Notes (17 decks)

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