MICROBIOLOGY Flashcards
What type of microbes stained with giemsa (5)?
Chlamydia Borrelia Rickettsia Trypanosome Plasmodium
What type of microbes stained with PAS?
Whipple disease tropheryma whipple
What type of microbes stained with Ziehl-Neelsen (carbon fushin) (3) ?
Acid fast nocardia. Mycobacteria
Cryptosporidium oocysts
What type of microbes stained with India ink?
Cryptococcus neoformans
What type of microbes stained with Silver stain (3) ?
Fungi (pneumocystis)
Legionella
Helicobacter pylori
Type of special culture used for H.influenzae?
Chocolate agar
Type of special culture used for N.gonorrhoeae and N.meningitidis ?
Thayer-Martin
Type of special culture used for B.pertussis?
Border
Type of special culture used for C. Diphtheria?
Loffler medium , tellurite agar
Type of special culture used for M. Tuberculosis?
Lowestein-Jensen agar
Type of special culture used for M. Pneumoniae?
Eaton agar
Type of special culture used for lactose-fermenting ?
MacConkey agar
Type of special culture used for E.coli?
EMB agar
Type of special culture used for legionella?
Charcoal yeast
Type of special culture used for fungi?
Sabouraud agar
What are the anaerobic microorganisms (4)?
Fusobacterium
Clostridium
Bacteroides
Actinomyces
What are obligated intracellular bugs (3)?
Rickettsia
Chlamydia
Coxiella
What are facultative intracellular bugs (8)?
Neisseria Mycobacterium Salmonella Brucella Francisella Legionella Listeria Yersinia
What are encapsulated bugs (7)?
Streptococcus pneumoniae Haemophilus influenzae Neisseria meningitidis Escherichia Coli Salmonella Klebsiella Streptococcus group B
What are urease positive bacteria (8)?
Cryptococcus H. Pylori Proteus Ureaplasma Nocardia Klebsiella S. Epidermidis S. Saprophyticus
What are catalase positive bacteria (8)? cats Need PLACESS
Nocardia Pseudomonas Listeria Aspergillus Candida E. Coli Staphylococcus Serratia l
What are gram positive bacillus?
Bacillus Clostridium Corynebacterium Gardnerella Lactobacillus Listeria Mycobacterium Propionibacterium
What are the difference between N.meningitides and N.gonorrhoeae?
N.meningitides —- maltose fermenter
N.gonorrhoeae —- non- maltose fermenter
What are oxidase positive bacterium?
Gram negative bacteria!!!
Comma shape (campylobacter jejuni, Vibrio Cholerae, H. pylori)
Pseudomona ( lactose non fermenter)
What type of bacterium is linked with production bro not of sulfidric acid?
Bacillus gram neg ⏩lactose non fermenter⏩oxidase negative ⏩H2S make salmonella, proteus yersinia
Non make Shigella
What are lactose fermenters? MacConKEES!!!!
FAST klebsiella E.coli. Enterobacter
SLOW. Citrobacter Serratia
haEMOPhilus influenzae
Epiglottis
Meningitis
Otitis media
Pneumonia
PSEUDDOmona
Pneumonia Sepsis Externa otitis Uti Drug use Diabetes Osteomyelitis
4 As of klebsiella?
Aspiration pneumonia
Abscess in lung and liver
Alcoholics
diAbetes
Principal feature of salmonella typhi ?
Constipation⏩diarrhea
Principal feature of yersinia?
Pseudoappendicitis
What are spirochetes (3)?
Borrelia
Lepstospira
Treponema
False positive VDRL
Viral infection hepatitis
Drugs
Rheumatic fever
Lupus or Leprosy
What’s the toxoplasmosis triada?
Chorioretinitis
Hydrocephalus
Intracranial calcifications
What are the nematodes which use ingested route (4)?
EATT Enterobius Ascaris Toxocara Trichinella
What are the nematodes which use cutaneous route (3)?
Strongylodes
Ancylostoma
Necator
What are the nematodes which use vector bites route(3)?
Loa loa
Onchocerca Volvulus
Wuchereria bancrofti
What is the Cestode (tapeworm) linked with megaloblastic anemia?
Diphilobothrium Latum
Competes for B12 in the intestine
What type of trematodes are linked with squamous cell carcinoma of the bladder?
Schistosoma haematobium
Egg whit terminal spine
What is the differential feature of schistosoma mansolin I?
Lateral spine
Hepatic splenomegaly
What trematode is associated whit cholangiocarcinoma?
Clonorchis sinensis
What are live attenuated vaccines (7)?
Smallpox Chickenpox Rotavirus Yellow fever Sabin polio MMR Influenza intranasal
What are killed vaccines?
Rabies
Influenza infected
Salk polio
HAV
What are RNA virus ➕(7) ➖ (6) stranded
POSITIVE Retrovirus Togavirus Flavivirus Coronavirus Hepevirus Calicivirus Picornavirus
NEGATIVE Paramixovirus Rhabdovirus Folio virus Orthomixovirus Bunyavirus Arenavirus
What are naked virus(8)?
Papillomavirus Adenovirus Parvovirus Polyomavirus Calicivirus Picornavirus Reovirus Hepevirus
Rubella triada
Patent ductus arteriosus - pulmonic stenosis
Cataracts
Deafness
What are non linear DNA viruses(3)?
Papilloma virus
Polyoma
Hepadna
What are picornaviruses?
PERCH Poliovirus Echovirus Rhinovirus Coxsackievirus HAV
How is the differential diagram of gram negative rods enteric bacteria?
⬛️LACTOSE FERMENTER
▪️Fast fermenter: klebsiella,E.coli (indol➕),Enterobacter(indol➖)
▪️Slow fermenter: Citrobacter,Serratia
⬛️LACTOSE NON- FERMENTER
▪️ Oxidase positive: Pseudomona Aeruginosa
▪️ Oxidase negative:
🔺No H2S production: Shigella
🔺H2S production: salmonela , Protesis
CMV in fetus
Hearing loss
Seizures
Petechia like rash
Peri ventricular calcifications
What are negative stranded virus (6) ?
Arenavirus Bunyavirus Paramyxovirus Orthomixovirus Filovirus Rhabdovirus
What is a characteristic feature of parvovirus B19 virus infection?
“Slapped cheek” rash
What is the essential pathogenic mechanism of Shigella infection?
Mucosal invasion of the M cells that overlie peyer’s patches
What are a microscopical feature of corynebacterium diphtheria(2)?
Chinese characters
Methacromatic granules that stains whit aniline (methylene blue)
What are catalase-positive organisms (5) ? They can infect patients with CGD.
S. Aureus Burkholderia Cepacia Serratia marcenses Nocardia Aspergillus
What is the feature in the blood agar for listeria?
very narrow zone of Beta-hemolysis
What bacteria inhibit phagosome-lysosomal fusion(3)?
Listeria
Salmonella
Tuberculosis
What is the major process of listeria immune -elimination?
Cell-mediated immunity
What is the process by corynebacterium acquired the toxins gene?
By bacteriophage mediated infection which TOX gene by lisogenization ( oh ago transmits the gene and this will incorporate to the bacterial genome)
What is the process in S.pnumoniae acquire its major virulent factor?
CAPSULE by transformation
What is the process by E.coli acquire its major virulent factor?
PILI is acquire by conjugation
What is the process which lead to endotoxins production?
Chromosomal mutations
What are the diferent serotypes of chlamydia (3)?
Serotypes A–C. Cause ocular infect. Trachoma
Serotypes D–K urogenital infections
Serotypes L1—L3 lymphogranuloma venereum
What structure of salmonella protects it from opsonization?
Vi antigen in the capsule
What is the main virulence factor is S. Aureus?
Adhesion to collagen
What vaccines are indicated in the asplenic patient(3)?
S. Pneumoniae
Haemophilus influenzae
Neisseria meningitidis
What are the requirements for H. Influenzae to grow in a culture?
X factor (hematina) V factor (NAD+)
Agar chocolate
Whit S.Aureus because it has beta hemolytic action -satellite phenomenon
What is the function of lac operon in E.coli?
lac operon encode for enzymes necessaries for lactose fermentation , it is a inducible enzyme
What are the type of meningococcal vacine(2)?
Polysaccharide quadrivalent
Conjugate (diphtheria toxoid)
What is the H.influenzae vaccine ?
Polysaccharide capsule conjugated with meningococcal carrier protein
What is the best medium for vibrio Cholera to grow??
Very alkaline medium like bile salts (TCBS)
People how take omeprazol are in high risk
What are the different E.coli toxins?
Heath labile(LT) ✅ cAMP Heath sable (ST) ✅cGMP
What is Waterhouse-Friderichsen syndrome?
Is a bilateral adrenal hemorrhage cause by N.meningitides infection lead to adrena insufficiency
What are the bacteria which produce necrotizing fasciitis?
Streptococcus pyogenes PYR-positive Staphylococcus aureus Clostridium perfringens Streptococcus agalactiae Aeromonas hydrophila
Which bacteria produces a double zone of beta hemolysis?
Clostridium perfringes
What is a positive CAMP test?
Narrow zone of beta hemolysis when culture whit S.aureus … That means The presence of S. Agalactiae.
What bacteria cannot be seen in gram stain (6)?
Mycoplasma Legionella Mycobacteria Treponema Rickettsia Chlamydia
Pneumonia + diarrhea+ high fever+ relative Bradicardia + headache =?
Legionella !!!!!!
Cruise ships,spa, air-conditioned
How adults and infants are affected by botulism?
Adults — canned food ingest preformed toxins
Baby—– spores from honey
What type of vaginal disease is linked with pH> 4.5?
Trichomona vaginitis
What are the empiric therapy for coagulate negative staphylococcus ( S. Epidermidis, S. Saprophyticus)?
VANCOMYCIN because all of them are methicillin resistant
What fungus are dimorphic (5)? Hyphae 25-30 grades or Yeast 37grades
Sporothrix schenckii Coccidiodes immitis Histoplasma capsulatum Blastomyces dermatidities Paracoccidiodes brasiliensis
Major features of dimorphic fungus
Sporothrix schenckii ———–cigar shaped budding yeast
Coccidiodes immitis————thick walled spherules fill endoscopes
Histoplasma capsulatum——–oval yeast within macrophages
Blastomyces dermatidities——double refractory wall broad based budding
Paracoccidiodes brasiliensis—-captain’s wheel
What are nontreponemal test?
RPR rapid plasma reagin
VDRL venereal disease research laboratory
What is the features of enterococcus?
Gram positive coccus
Gamma hemolytic
PYR positive
Grow in bile and 6.5% sodium
Important etiology for UTI infections by medical cystoscopy
What is the reason there is no effective antibodies against hepatitis C virus?
RNA-dependent RNA polymerase has no proofreading
Leads to resulted in marked variety of antigenic structure of HCV envelope
Why in the mycoplasma infection there are anemia?
hemolytic anemia is because the body generate cold agglutinins ( aBs against M proteins which cross link whit erythrocytes membranes)
What are the features of mycoplasma infection?
Hemolytic anemia Stevens-Johnson syndrome Join pains Encephalitis Cardiac rhythm disturbance Bullous myringitis
What is the mechanisms of Shiga like toxin?
Subunit B make a Canal for
Subunit A takes off a adenine from tRNA
And tRNA cannot interact whit 60s ribosomal subunit
What is the response of HIV virus to long time antiretroviral treatment?
Increase in pol gene mutations
What is characteristic in type B H. Influenzae?
It’s capsule contains polyribitol phosphate PRP
PRP contains pentose monophosphate rather hexose
PRP prevent phagocytosis
H. Influenzae cause (4)
Epiglottis
Bacteremia
Arthritis
Meningitis
How can stain cryptococcus neoformans (2)?
India ink
Mucicarmine (red)
Methenamine
What type of vaccine is pneumococcus vaccine?
Outer polysaccharide covering
Pneumococcal conjugated
What is the microscopic characteristic of mucormycosis?
90 grades angle nonseptate hyphae
What is the microscopic feature of aspergillus?
45 grades septa the hyphae
What are the major microscopic characteristics of Histoplasmosis ,coccidiosis,cryptococcosis,candidiasis,aspergillosis?
Histoplasmosis —macrophages whit intracellular oval bodies
coccidiosis—- spherules packed whit endospores
cryptococcosis— budding yeast whit a thick capsule
candidiasis—-yeast that form pseudo hyphae
aspergillosis—- septa the hyphae V shape
Anal cell squamous cell carcinoma , ulceral mass in VIH positive patient indicates?
Human papilloma virus infection
What’s the first line treatment for blastomyces dermatitidis?
ITRACONAZOL!!!
What pneumonia cause HYPONATREMIA and elevated transaminases?
LEGIONELLOSIS !!!!!
What surface is used to adherence for Viridans streptococcus?
Fibrin-platelet aggregates in Heart valves
What GI infections cause fecal mononuclear leukocytes?
SALMONELLA TYPHI!!!!
Elderly whit Flaccid paralysis + encephalitis =
West Nile Virus
Flavivirus transmitted by mosquitos
What is the function of nucleolus?
Synthesis of rRNA!!!!!
Exposure in the deferents fungus infections Cryptococcosis,Coccidiomicosis,Histoplasmosis Mississippi Aspergillosis - Candida- A.fumigatus, Mucor, Rhizopus A. Fumigatus .
Cryptococcosis pigeon drooping
Coccidiomicosis Arizona west UEA
Histoplasmosis Mississippi - Ohio river bird and bat droopings
Aspergillosis - historic of TB old lung cavities
Candida- A.fumigatus, Mucor, Rhizopus NEUTROPENICS
A. Fumigatus - ASTHMA patients
What is the agent which cause croup?
PARAINFLUENZA !!!!
What are the toxins implied en pseudomembran colitis ?
C. Difficile secrete
Toxin A enterotoxin
Toxin B cytotoxin
Inactive Rho-regulatory proteins
❎transduction and actin cytoskeletal structure maintenance
What are the virulent factors of E.coli (5)
LPS K1 capsular polysaccharide NEONATAL MENINGITIS!!!! Verotoxin (Shiga like toxin) Heat stable/labile enterotoxin P fimbriae UTI!!!!
Clinical findings in CMV infection in Immunossuppresed patients (3)
Retinitis
Esophagitis
Pneumonia
What is the second cause of ring-enhancing lesions with mass effect in HIV patients after toxoplasmosis?
PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA
B- cell origin !!!!
EPSTEIN BARR VIRUS IS IDENTIFY
Explain the virus of rubella and rubeola
Rubella or German measles TOGAVIRUS posauricular lymphadenopathy
Rubeola measles. PARAMIXOVIRUS
Why gram negative bacteria cause septic shock?
Lipopolysacharides or lopooligosaccharides
Induce
TNF-alpha, IL-1betta , IL-6, IL-8
What antibiotics are in Thayer Martin medium?
To isolate NEISSERIA
vancomycin to ❎ gram positive
Colistin ❎ gram negative (less Neisseria)
Nystatin❎.yeast
TMP❎ proteus
How act anthrax exotoxin and borderlands pertussis toxin?
⬆️cAMP by ⬆️ Adenylate Cyclase
Phagocyte dysfunction and edema
What’s the major virulent factor of streptococcus pyogenes ?
Protein M
Inhibit phagocytosis and complement activation
What is the virulence factor of mycobacterium tuberculosis?
Cord Factor
Inactivate neutrophils
Mitochondrial damage
TNF release
How differentiate gram positive coccus?
CATALASE ✅ Coagulase ✅. S.Aureus Coagulase ❎ 🔹novobiocin sensible S.epidermidis 🔹novobiocin resistant S. Saprophyticus
CATALASE ❎
Alpha hemolytic PARTIAL
🔹opotchin sensible bile insoluble. S.pneumiae
🔹opotchin resistant bile soluble S. Viridans mutants
Beta hemolytic COMPLETE
🔹bacitracin sensitive PYR ✅S.pyogenes
🔹bacitracin resistant PYR ❎ S.agalactiae
Gamma hemolytic NO !!!
🔹Growth in bile and 6.5% NaCl enterococcus
🔹Growth in bile NOT in 6.5% NaCl S. Bovis l
What are the Two forms of leprosy and which kind of immune is related whit which one?
TUBERCULOID LEPROSY good cell response Th-1 mediated
LEPROMATOUS LEPROSY bad cell response Th-2 mediated WORST
What antibiotic has minimal absorption and is so good for recurrent pseudomembranous colitis ?
FIDAXOMICIN!!!!!
What is the requirement to herpes zoster infection to appear ? And what is its principal complication ?
Previous varicella Zoster Virus infection in single dorsal root sensory ganglion !!
POSTHERPETIC NEURALGIA !!!!!
What are the single strain DNA virus
And the double strain RNA virus?
single strain DNA virus PARVOVIRUS
double strain RNA virus ROTAVIRUS
What is the most common agent which cause viral gastroenteritis in developed countries?
NOROVIRUS!!!!
What is the most common cause of diarrhea in developing countries (travelers diarrhea )
Enterotoxigenic E. Coli !!!
Watch are the Symptoms of strongyloidiasis?
Cough
Asthma like bronchospasm
Hemoptysis
What is the difference between mononucleosis illness by CMV and EBV?
CMV monospot test (-) heterophilic antibodies
EVB monospot test(+) heterophilic antibodies
Alteration of bordetella pertussis in second messengers ?
⬆️AMPc
Pertussis toxin ADP ribosylate Gi
How works Shiga like toxin?
Inactivate 60s ribosomal subunit
How P. Falciparum is declined in the gram stained blood?
Dalicate ring-like intraeritocyte parasite
How plasmodium species can return infection?
P.falciparum. Trophozoite into the RBC RECRUDECENSE
P. Vivax and P. Ovale. From Hypnozoites from the liver
How bunyavirus is transmitted?
By inhalation of shit of rodents
What. Virus cause hydrocephalus in fetus?
Cytomegalovirus!!!!
Which infections tend to develop rheumatic fever and which post-streptococcal glomerulonephritis?
rheumatic fever PHARYNGITIS
post-streptococcal glomerulonephritis IMPETIGO
What is the mechanism of oncogenesis of Burkitt lymphoma?
TRNASLOCATION!!!
c-myc oncogene to site of antibody synthesis
How echinococcus Granulosus is transmitted?
Dog feces
Which parasites can be transmitted by ingestion of water plants?
Fasciolopsis burky
Facsiola hepatica
Which patients are vulnerable to pneumocystis jiroveci infection?
IMMUNOCOMPROMISED
PREMATURES
Renal transplant patients are vulnerable to ….
CYTOMEGALOVIRUS PNEUMONITIS
What bacterial component can survive to autoclave?
Endotoxins -LPS
What’s the most common cause of pericarditis in U.S.A.?
COXSACKIEVIRUS B
What kind of genome has rotavirus?
Double strained RNA
Agent which cause endocarditis in drug abusers?
CANDIDA!!!
Microscopic features of Blastomyces dermatitis ?
Broad based
Double shelled budding yeast
From OLD ROOTING WOOD
Say the family of the different kind of hepatitis virus?
PICORNAVIRUS. HEPATITIS A
HEPADNAVIRUS. HEPATITIS B
FLAVIVIRUS. HEPATITIS C
CALICOVIRUS. HEPATITIS E
After lymphocytes CD4 drop under 200 what kind of Igs can be produced?
Ig M against gp120
Experiments genetic drift
Which kind of plague is necessary for generalized transduction and which kind to specialized transduction?
VIRULENT PHAGUE generalized transduction
LYSOGENIC OR TEMPERATE PHAGUE specialized transduction
What are phosphatetransferases and where are its gene located?
Enzymes which inactivate drugs
It’s gene is located in BACTERIAL PLASMIDS
What is episome?
A plasmid that has been stabilized inside the chromosome of a cell by site -specific recombination
What are the microscopic features of infectious form of fungus ?
Aspergillosis dichotomously branching hyphae
Coccidiodes. Hypha with arthroconidia
Blastomyces hypha whit nondescript conidia
Sporothrix schenckii Hypha whit rosettes and sleeves of conidia
Histoplasma Hyphae whit microconidia and macroconidia
What is the drug of choice of esophagitis candidiasis and Coccidiomicosis?
FLUCONAZOL!!!
Drug of choice of blastomycosis and Sporothrichosis?
ITRACONAZOL!!!
Drug of choice of paracoccidiomicosisand back up for Blastomyces and histoplasmosis?
KETOCONAZOLE !!!
Which antiparasitary agent is contraindicated in glaucoma?
CHLOROQUINE!!!!
Which drugs can develope hemolysis in G-6PD deficiency patient?
Sulfanilamide Nitrofurantoine Dapsone Primaquine Quinine
What’s palivizumab?
Monoclonal antibody to treat rspiratory syncytial virus RSV
Dermatologic finding in hepatitis B
URTICARIAL DERMATITIS
How pork tapeworm (Taenia solium) can cause neurocysticercosis or taeniasis (tapeworm infestation).
neurocysticercosis = ingestion of eggs from stool
taeniasis = ingestion larval cyst from infected uncooked pork
Mechanism of action of penicillin?
Covalently binding to and inhibiting transpeptidase ( cros-linking step in peptidoglican cell formation
What is the antibiotics for vaginitis?(3)
Grardnerella METRONIDAZOLE OR CLINDAMICIN
trichomona METRONIDAZOLE (treat the partner)
Candida. FLUCONAZOLE
Which bacteria does not need to be In big quantities to cause gastroenteritis?
SHIGUELLA!!!!
Dysentery
Tenesmus
Important considerations of malaria treatment?
Cloroquine sensitive
Chloroquine resistant ➡️ MEFLOQUINE
P. Vivax and P. Ovale ➡️ PRIMAQUINE ( Hypnozoites )
Treatment for Chagas’ disease?
NIFURTIMOX
How is the prophylaxis and treatment form P. Jirovecii?
PENTAMIDINE
What’s are MRSA? ABs resistance.
RESISTANCE TO…
oxacillin
Nafcillin
Methicillin
ALTERACION IN PENICILIN BINDING PROTEINS PBPs
Mechanism of tetracycline and sulfunylurea resistance?
Active drug transport out of the cell
Mechanism of quinolone resistance?
DNA Gyrase mutation
Mechanism of rifampin resistance ?
RNA polymerase mutation
What is the most important side effect of amphotericn B ?
RENAL TOXICITY
SEVERE HYPOKALEMIA AND HYPOMAGNESEMIA
How non segmented double-stranded DNA virus exchange genetic information?
RECOMBINATION!!!
How segmented virus exchange genetic information?
REASSORTMENT
Influenza virus
Side effects of RIPE treatment for TB?
Rifampin : GI, rash, red orange body fluids
Isoniazid : neurotoxicity (give B6) Hepatotoxicity
Pirazinamide: Hepatotoxicity, hyperuricemia
Ethambutol: óptic neuropathy
What is the immunology finding strongly linked whit ABACAVIR hypersensitivity reaction?
HLA-B*57:01 allele of HLA
Different segments actions of antiviral therapy (8)
🔹VIRAL ABSORTION ⬇ 🚫 enfuvirtide 🔹PENETRATION ⬇🚫amantadine 🔹UNCOATING ⬇ 🔹EARLY PROTEIN SYNTHESIS ⬇ purine pyrimidine analogs. RTIs 🔹NUCLEIC ACID SYNTHESIS ⬇ 🚫protease 🔹LATE PROTEIN SYNTHESIS AND PROCESING ⬇ 🔹PACKAGING AND ASSEMBLY ⬇ 🚫neuraminidase 🔹VIRAL RELEASE
Most common cause of endocarditis in patients whit prosthetic valves and septic arthritis in patients whit prosthetic joints?
S. EPIDERMIDIS!!!
How schistosomiasis is transmitted?
Freshwater snails 🐌🐌🐌🐌
Pathognomonic Histologic finding of hepatic schistosomiasis?
Periprotal “pipestem” fibrosis
How human is infected by diphyllobothrium latum?
Ingestion of larvae from raw freshwater fish 🐡
what organs (3) and what kind of patients are infected by NOCARDIA? and what is the treatment?
lungs
brain
skin
IMMUNOCOMPROMISED AND PATIENTS
TRIMETHOPRIM/SULFAMETHOXAZOLE
what is teh principal cause of viral meningitis in children?
GROUP B COXSACKIEVIRUS
what type of virus is Cytomegalovirus?
ENVELOPED double-stranded DNA virus
What are the inteGRAse inhibitors ?
DoluteGRAVIR
ralteGRAVIR
What are the protease inhibitors?
indiNAVIR
RitoNAVIR
Technic to visualized Treponema pallidum…
DARK-FIELD MICROSCOPY!!!!!!
Which type of human papilloma virus can result in genital warts?
Type 6 and 11
Attacks stratified squamous epithelium
Advantage of interferon gamma release assay (IGRAs)over tuberculin skin test?
Tuberculin skin test can has an falsely positive result whit BCG vaccine
IGRAs does not
What are the dermatological lesions of 1-2-3 syphilis ?
PRIMARY chancre
SECUNDARY condylomata late
TERTIARY gumma
Color of lactose fermenters and non-lactose fermenters in MacConkey agar ….
FERMENTERS. PINK!!!!!!
NON FERMENTERS WHITE !!!!!!
When can be seen cold agglutinins?(3)
mycoplasma pneumoniae
Epstein Barr virus
Hematologic malignancy
Management for pinworm (enterobius vermicularis)
ALBENDAZOL!!!!
Or pyrantel pamoate
Actions of Rivavirin and clinical use
INHIBIT DUPLICATION OF VIRAL GENETIC MATERIAL
🚫IMP dehydrogenase
🚫RNA dependent RNA polymerase
⬆️Th1 ⬇️Th2
🔹Hepatitis C
🔹VSR
Use of ketoconazole (450 inhibitor) will increase the serum concentrations of what antibiotics?
MACROLIDS Eritromicin Claritromycin
What is the toxins of C. Perfringes (gangrene) and Diphteria?
C. Perfringes lecithinase or phospholipase C ( phospholipid splitting )
Diphtheria ribosylation of Elongation Factor-2
Mechanism of action of C.difficile toxin?
Actin depolymerization
What are the antibiotics used to Neisseria meningitides prophylaxis?(3)
Rifampin
Ciprofloxacin
Ceftriaxone IM
What gram positive coccus can produce dextrans from sucrose?
S. VIRIDANS !!!
What are transpeptidases in bacteria?
There are PENICILIN-BINDING PROTEINS
which cross-link peptidoglican in bacterial cell wall
Which microorganism cause cat-scratch disease?
BARTONELLA HENSELAE!!!!
Can cause bacillary angiomatosis
What type of patients cannot receive primaquine?
G6PDH deficiency patients
Pathogenesis of prion disease?
Protein change from Alpha helix chance to beta-plated sheet (stand to proteases)
Spongiform Change
Which virus obtain its envelope from the host cell nucleus?
HERPERVIRUS!!!!
Principal adverse effects of anti HIV drugs (4)
NRTI lactic acidosis
NNRTI SJS Hepatotoxicity neuropsychiatric teratogenic
PI Dibetes
Integrase inhibitor myopathy
In gram stain how gram+ and gram- are seen?
Gram+. BLUE!!!!
GRAM - RED!!!!
What is the diagnostic test for gonorrhea?
And treatment?
Nucleic acid amplification test NAAT!!!!!
Ceftriaxone+ azithromycine
What’s the diagnostic test for chlamydia and gonorrhea? The first and second most common sexually transmitted disease in U.S.?
NAAT
Nuaclear acid amplification testing
Management for chlamydia?
AZITHROMYCINE!!!
Which agent cause scrofula and where is taken?
Mycobacterium scrofulaceum
WATER SOURCES PONDS
Which agent in the capsule of Haemophilus Influenzae bacteria facilitate it invasion and cause meningitis?
Poluribosyl ribitol phosphate PRP
What kind of vaccine is rabies vaccine?
Inactivated vaccine
Risk factors to suppurative parotid in adults?(3)
⬇️salivary flow
Anthicholinergic
Dehydration INTUBATION!!!!
⬆️AMILASE!!!!
What are the CMV-related complications of inutero infected patients?
Chorioretinitis Sensorineural deafness Seizures Jaundice Hepatosplenomegaly Microcephaly
What are the complications of diphtheria?(3)
Obstruction of respiratory tract
Myocarditis/ heart failure
Neurological toxicity
The diphtheria vaccine (in DPT vaccine) produce ….
IgG against the DIPHTHERIA TOXIN
Which virus has serum heterophile antibodies? (Agglutination of horse erithrocytes in monopost test)
What means positive?
And what if has the mononucleosis-like symptoms but is negative?
➕Epstein-Barr!!!
➖CYTOMEGALOVIRUS!!!!
Or HHV-6 , HIV, toxoplasma
Listeriosis a cause of meningitis in elderly and babies < 3 months can be transmitted in…
Milk products
Raw fruits and vegetables
Clinical findings of tabes dorsalis in syphilis tertiaria? (4)
Sensory ataxia
Lancinating pains
Neurogenic urinary incontinence
Argyll Robertson pupils ( non react but accommodated 👯)
Which type of hepatitis has high mortality rate in pregnancy?
And it’s virus characteristics …
HEPATITIS E!!!!
Unenveloped single-stranded RNA virus
Fecal-oral route
Transformation cause genomic changes in progeny virions?
NO!!!!!!!!
How is call the bacteria who exert TRANSFORMATION?
Naturally competent
Germ tubes resulted after incubated at 37C are pathognomonic of…
CANDIDA ALBICANS!!!!
enveloped virus with partially double -stranded circular DNA ?
HEPATITIS B VIRUS!!!!
complications of Measles virus (rubeola)
- pneumonia
- Neurologic:
- Encephalitis (days)
- Acute disseminated encephalomyelitis (weeks)
- Subacute sclerosing panencephalitis (years)
treatment of acute C. diphtheriae infection in order of importance?
- Diphtheria antitoxin
- Penicillin of Erythromycin
- DPT vaccine
function of protein A located in the staphylococcus peptidoglycan wall
prevents its opsonization and complement activation
binding the Fc portion of IgG (complement binding site)
bacteria which produce IgA protease? (2)
Streptococcus pneumoniae
Neisseria gonorrhoeae
principal antibiotics used in MRSA infection?(3)
VANCOMYCIN like penicilin but binding D-alanyl-D-alanine r– red man Sd.
DAPTOMYCIN transmembrane channels– myopathy
LINEZOLID inhibit 50s ribosomal subunit– optic neuritis , thrombocytopenia, serotonin syndrome
managment for chorioretinitis by cytomegalovirus?
GANCICLOVIR!!!!!
What is the target of EBV?
B cells
EBV has gp350 which attach CD21 (CR2)
What are the infectious form and non infectious form of strongyloidiasis?
Filariform (infectious) penetrate the skin
Rhabditiform (non infectious) excreted in stool for DIAGNOSIS
Most common sites of serious infection by cryptococcus, Aspergillus,candida?
Cryptococcus: Meningitis
Candida: Candidemia
Aspergillus: pneumonia
Culture medium to legionella?
BCYE
Buffered Charcoal Yeast Extract ( L-cysteine)
SILVER STAIN!!!!
Agent which cause tinea Capitis and tinea corporis?
Microsporum
Where betalactamase genes are Encoding?
plasmids!!!
Gram negative rods , lactose fermenter indol ➕ and indol ➖
indol ➕ E. COLI!!!!
indol ➖ ENTEROBACTER!!!!!
What is the major virulence factor of Haemophilus influenzae type b?
Capsule- PRP ( polyrobosylribitol phosphate)
Which bind the factor H.
How streptococcus prevent complement activation?
M PROTEIN bind factor H prevents opsonization
Major virulence factor of mycobacterium tuberculosis?
Trehalose dimycolat
protects from macrophages
Viruses which replicate into red blood cells precursors and lymphocytes?(2)
RBCs. Parvovirus B19
Lymphocytes HHV-6 roseola
Hypovitaminosis of Vit A is related with bad prognosis in which viral infection?
MEASLES!!!! Rubeola
Which microorganisms produce a toxin which inactivate the elongation factor 2? (2)
Diphtheria - diphtheria toxin
P. Aeruginosa - Exotoxin A
Difference between toxins of B. Pertussis and V. Cholera ?
B. Pertussis ⬆️cAMP by ❎Gi ADP
V. Cholera ⬆️cAMP by ✅Gs ADP
Clinical findings In perinatal hepatitis B infection ?(3)
No symptoms (immune tolerant)
90% chronic infection
High viral load & HBeAg ➕
How does amphotericin B works ? And principal side effects? (5)
Fungal cell lysis by ergosterol binding but bind cholesterol in high doses
- Acute : fever hypotension , rigidity
- nephrotoxicity
- ⬇️magnesium ⬇️potassium
- Anemia. By ⬇️EPO
- Thrombophlebitis
What viruses are non responsive to acyclovir action and why?
Epstein-Barr virus
Cytomegalovirus
Lack of thymidine to phosphorylate acyclovir
What’s QUELLUNG. Reaction?
Dx S. P. Neumoniae
Capsular swelling blue stain bacterial
Specific anti-capsule antibody
Methylene blue dye
Most important virulence factor of S. Pneumoniae?
Polysaccharide capsule
What’s D- glutamic acid capsule ?
Is a residue in capsule of B. Anthrax
Mechanism of action of Daptomicin?
And side effects ? (2)
Create transmembrane channels
Side effect myopathy and rhabdomyolysis
Explain the prophylaxis for opportunistic infections in HIV according CD4+ count. (4)
<200 P. Jirovecci ⏩ TMP-SMX
<150 Histoplasma ⏩ Itraconazol
<100 T. Gondii. ⏩ TMP-SMX
<50 M. Avium - Intracellulare ⏩ Azithromycin
Principal characteristics of Micobacterium Avium Complex ( avium+Intracellulare) infection in HIV+ <50 CD4+? (5)
Anemia Hepatosplenomegaly ⬆️ Alkaline phosphatase ⬆️ Lactato Dehydrogenase Grow 41 grades
Function of O antigen?
Outermost in LPS
To classify gram (-) bacteria
Risk of patients after cystoscopy ,colonoscopy and obstetric procedures and agent?
ENDOCARDITIS by Enterococcus: 🔹Grow in bile 🔹grow in 6.5% NaCl 🔹PYR ➕
Goups of antibiotics which inhibit bacterial 50s ribosomal subunit?
MACROLIDE CHLORAMPHENICOL LINEZOLID CLINDAMICIN ESTREPTOGRAMINS
What antibiotics Inhibit the bacterial 30s ribosomal subunit? (4)
DoxyCYCLINE
tetraCYCLINE
minoCYCLINE
AMINOGLYCOSIDES
How enterotoxigenic E. Coli and Yersinia enterocolitica produce watery diarrhea and electrolyte loss?
⬆️Intracellular cGMP
How Clostridiun difficile enterotoxin A and cytotoxin B works?
And diagnosis of pseudomembranous colitis ?
Enterotoxin A Watery diarrhea
Cytotoxin B Disrupting the cytoskeleton
Depolymerixing actin
PCR of toxin genes
Explain echinococcus Granulosum infection and How it’s can cause dead in surgery ?
Tape worm transmitted from dogs and sheep
HYDATID CYSTS in liver,lungs and muscles eggshell calcification
full of monocytes and eosinophilis manipulation can cause ANAPHYLACTIC SHOCK!!!!
How acetaminophen, NSAIDS and corticosteroids can decrease fever?
⬇️PGE2 reducing the thermoregulatory set point in the hypothalamus
What kind of drugs increase the serum levels of Azoles?
Cytochrome oxidase inducers
Rifampin
Carbamazepine
Phenytoin
Phenobarbital
Mechanism of action of Flucytosine?
Inhibit DNA and RNA fungal synthesis
✅cryptococcosis
Food linked with salmonella?(2)
🐣Raw egg
🐔Raw chicken
Two principal infectious agents linked with ectopic pregnancy?
Neisseria Gonorrhoeae
Chlamydia Trachomatis
Time to presentation of Sydenham chorea?
1-8 months!!!!!
Localization and etiology of Janeway lesions and Osler nodes in infectious endocarditis?
Janeway lesions: Palms & Soles septic 🔹microembolism
Osler nodes: pulp of fingers and toes 🔹immunocomplex
Why biofilms are resistant to antibiotics?
Intermicrobial communication induces exopolysacaride production
Family of streptomycin?
AMINOGLYCOSIDE!!!!!
Principal mycobacterium tuberculosis resistance to Izoniazid?
⬇️catalase-peroxidase activity
Principal mycobacterium tuberculosis resistance to Ethambutol?
⬆️cell wall polysaccharide synthesis
After influenza A outbreak elderly patients are in high risk of pneumonia for which pathogens?
- Streptococcus pneumoniae
- Staphylococcus Aureus
- Haemophilus influenzae
Explain the antyfungal targets of antimucotics. (4 targets)
CELL WALL Caspofungin
CELL MEMBRANE amphotericin B, nystatin; Azoles,terbinafine
DNA RNA SYNTHESIS Flucytosine
MITOSIS Griseofulvin
Which culture mediums can be used to corynebacterium diphtheria grow?
Cysteine- tellurine agar
Loffler’s médium
Microscopic features of listeria?(3)
Gram+ rods
Tumbling motility ate room temp
Specific feature of Gardnerella Vaginalis ?
ANAEROBIC GRAM-VARIABLE ROD!!!!!!
What are segmented viruses , which permits reassortment, to enhance epidemic features?(5)
Rotavirus Orthomixovirus Reovirus Bunyavirus Arenavirus
Important features of B. Anthracis.
ANTIPHAGOCYTIC D GLUTAMATE CAPSULE
Gram - rods
woolstortes disease 🐏
Culture media with medusa head appearance
HEMORRHAGIC MEDIASTINITIS !!!!
Intracellular polyphosphate granules are characteristic in?
Orynebacterium diphtheriae
Important findings of Q fever and agent?
Coxiella burnetti
ZOONOSIS animal waste
Headache retroorbital
Fever
Pneumonia consolidation
Thrombocytopenia
which infections needs the use of face -masks in health workers?
droplets > 5 microns
N. meningitides influenza B.pertussis M. pneumoniae RSV
How bacteria develope resistance against aminoglycosides?
By aminoglycoside-modifying enzymes
transfer acetyl-adenyl-phosphate groups
which antibiotics acts in 50S RNA and 30S RNA subunits?(4-3)
50S chloramphenicol, clindamycin, linezolid, macrolides
30S tetracycline, doxycycline, aminoglycosides
what type of patients are more susceptible for Babesia infection?
Asplenic patients!!!!
How is the differencial clinical presentation and Diagnosis of Syphilis, Genital herpes, Chancorid, Granuloma inguinale (donovanosis)?
Syphilis: painless ulcer VDRL/RPR , Dark feild
Genital herpes:Painfull ulcers PCR ,Tzanck smear
Chancorid: Painfull deep supurative ulcers Limphadenitis PCR, Gram.
Granuloma inguinale (donovanosis) painless serpenginous ulcers no Lymphadenopathy , Gram - Biopsy
How Micobacterium tuberculosis is Isoniazid resistant ?
⬇️intracellular catalase peroxidase activity
what bacteria is transmitted from domestic animals to humans and is the most common cause of acute gastroenteritis in industrialized countries?
CAMPILOBACTER JEJUNI !!!!!!!
Explain different drugs which interact with tetrahydrofolate reductase.(3)
TMP bacteria
MTX human
Pyrimethamine Protozoa
Mechanism of action of metronidazole ?
Binds bacterial-Protozoa DNA
Unraveling helical structure
Breaking its strands
strategies to decreas central venous catheter infections?(5)
Hand hygiene Maximal barrier precautions chlorexidine antiseptic subclavian or internal jugular insertion prompt removal
mechanism of action of Terbinafine, Caspofungine, Griseofulvine.
Terbinafin 🚫squalene epoxidase so 🚫ergosterol synthesis
Caspofungine 🚫 beta-d glucan Aspergillus Candida
Griseofulvine 🚫 microtubules polimerization so 🚫 mitosis