Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Step 1 > Microbiology > Flashcards

Microbiology Flashcards

1
Q

What is the toxic component of LPS?

A

Lipid A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does the pilus/fimbria do and give an example

A

Mediates adherence of bacteria to cell surface as in meningococcus colonizing the pharyngeal surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Bacteria with unusual cell membranes/walls

A

Mycoplasma - membrane contains sterols, no cell wall. Mycobacteria - contain mycolic acid, high lipid content

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Bugs that do not gram stain well

A

These Rascals May Microscopically Lack Color. Treponema, Rickettsia, Mycobacteria, Mycoplasma, Legionella, Chlamydia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Stain for legionella

A

Silver stain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Organisms seen with giemsa stain

A

Borrelia, plasmodium, trypanosomes, chlamydia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Organisms seen with PAS stain

A

Stains glycogen and mucopolysaccharides. Use to diagnose Whipples disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Organisms seen with silver stain

A

Fungi and legionella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Culture requirements of h flu

A

Chocolate agar. Factor V (NAD) and Factor X (hematin). If grown with staph they will provide the needed NAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Culture requirements of n gonorrhoeae

A

Thayer-Martin (VPN). Vancomycin, Polymyxin, Nystatin. Or Vanco, Colistin, Nystatin, Trimethoprim

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Culture requirements of b pertussis

A

Bordet-Gengou (potato) agar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Culture requirements of c diphtheriae

A

Tellurite plate, Lofflers media

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Culture requirements of m tb

A

Lowenstein-Jensen agar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Culture requirements of m pneumoniae

A

Eatons agar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Culture requirements of lactose-fermenting enterics

A

Will be pink on MacConkey. E coli also grown on Eosin-Methylene Blue (EMB) and will be green with metallic sheen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Culture requirements of legionella

A

Charcoal yeast extract agar buffered with cysteine and iron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Culture requirements of fungi

A

Sabourauds agar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is another name for polymixin?

A

Colistin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What allows e coli to spread hematogenously and cause meningitis?

A

K-1 capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Encapsulated bacteria (6)

A

Strep pneumo, H flu type b, N meningitidis, Salmonella, Klebsiella, group B strep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What vaccines should you give an asplenic patient?

A

S pneumo, H flu, N meningitidis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Test of choice for encapsulated bacteria

A

Quellung (will see capsular swelling)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Catalase-positive organisms (5)

A

S aureus, Serratia, Pseudomonas, Candida, E coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the antigen in the N meningitidis vaccine?

A

Capsular polysaccharide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Urease positive bugs (8)

A

Proteus, Ureaplasma, Nocardia, Cryptococcus, H pylori, Klebsiella, Staph saprophyticus, Staph epidermis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Protein A virulence factor

A

Staph aureus. Binds Fc of Ig. Prevents opsonization and phagocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

IgA protease

A

Cleaves IgA. Secreted by s. pneumoniae, h flu type b, and neisseria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

M protein

A

Group A streptococcus. Helps prevent phagocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Where are exotoxin and endotoxin genes respectively located?

A

Exotoxins - plasmid or bacteriophage, endotoxin - bacterial chromosome (remember that endotoxins are part of bacterial wall, thus part of bacteria themselves. Similarly the gene is in with bacterial genes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Heat stability of exotoxins and endotoxins respectively

A

Exotoxins destroyed rapidly at 60 C (except staph enterotoxin), endotoxins stable at 100 C for 1 hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Diseases caused by exotoxins and endotoxins respectively

A

Exotoxins - tetanus, botulism, diphtheria. Endotoxins - meningococcemia, gram negative sepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Diphtheria toxin

A

Inactivates EF-2 and thus inhibits protein synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Exotoxin A

A

Pseudomonas. Inactivates EF-2 (like diphtheriae toxin) and thus inhibits protein synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Shiga Toxin

A

Shigella. Inactivates 60S ribosome by cleaving rRNA (like EHEC toxin). Causes GI mucosal damage and triggers HUS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Shiga-like Toxin

A

EHEC (including O157H7). Inactivates 60S ribosome by cleaving rRNA. Enhances cytokine release, causes HUS but EHEC does not invade host cells (unlike shigella)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are the properties of EHEC in culture?

A

Does not ferment sorbitol, does not produce glucuronidase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Heat-labile (cholera-like) toxin

A

ETEC. Overactivates adenylate cyclase increasing Cl secretion. Watery diarrhea.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Heat-stable diarrhea

A

ETEC and Yersinia enterocolitica. Overactivates guanylate cyclase. Decreases reabsorption of NaCl and water in gut. Watery diarrhea in ETEC, bloody in y entocolitica (invades)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Edema factor

A

Bacillus anthracis. Mimics adenylate cyclase (similar to pertussis toxin). Black eschar of cutaneous anthrax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Cholera toxin

A

Vibrio cholerae. Overactivates adenylate cyclase by permanently activating Gs. Increased Cl secretion. Rice-water diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Pertussis toxin

A

Bordatella pertussis. Overactivates adenylate cyclase by disabling Gi. Impairs phagocytosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Tetanospasmin

A

Clostridium tetani. Cleaves SNARE (required for NT release). Prevents release of inhibitory NTs in spinal cord (GABA and glycine). Rigidity and lockjaw

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Botulinum toxin

A

Clostridium botulinum. Cleaves SNARE (required for NT release). Prevents stimulatory (Ach) signals at neuromuscular junction. Flaccid paralysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Botulinum toxin

A

Clostridium botulinum. Cleaves SNARE (required for NT release). Prevents stimulatory (Ach) signals at neuromuscular junction. Flaccid paralysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Alpha toxin

A

Clostridium perfringens. A phospholipase that degrades tissue and cell membranes. Causes gas gangrene and hemolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Streptolysin O

A

Strep pyogenes. Protein that degrades cell membranes. Lyses RBCs (beta hemolysis). Use ASO in diagnosis of rheumatic fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Exotoxin A

A

Strep pyogenes. Superantigen (MHC 2 and TCR linking). Toxic shock syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Toxic shock syndrome toxin (TSST-1)

A

Staph aureus. Superantigen (MHC 2 and TCR linking). Toxic shock syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Transformation (including bacteria capable of it)

A

Ability to take up DNA from environment. Strep pneumo, h flu type b, neisseria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Conjugation

A

F+ to F- (plasmid DNA only) or Hfr to F- (plasmid and chromosomal genes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Transposition

A

Transfer of genes between plasmids or between chromosome and plasmid. Plasmid DNA may then move between bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Generalized transduction

A

Lytic phage infection with accidental packing of bacterial chromosome into viral capsid. Viral transfer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Specialized transduction

A

Lysogenic phage incorporates and takes bacterial DNA with it when it excises

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What toxins are encoded in lysogenic phages (specialized transduction)?

A

Shiga-like toxin, Botulinum toxin, Cholera toxin, Diphtheria toxin, Erythrogenic toxin of strep pyogenes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Branching gram positive bacteria and what separates them

A

Actinomyces (anaerobe and not acid fast), Nocardia (aerobe, acid fast)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Catalase positive and negative gram positive cocci

A

Positive - Staph (clusters), Negative - Strep (chains)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Coagulase positive, catalase positive gram positive cocci

A

S aureus (beta hemolytic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Coagulase negative, catalase positive, gram positive cocci

A

Novobiocin sensitive - staph epidermis, novobiocin resistant - staph saprophyticus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What do staph epidermis tend to infect?

A

Teflon coated surfaces (due to biofilm formation) such as IVs and other artifical surfaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Alpha hemolytic catalase negative gram positive cocci

A

Optochin sensitive - strep pneumo (bile soluble - does not grow in bile). Optochin resistant - Viridans strep (eg strep mutans, insuluble in bile)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Beta hemolytic catalase negative gram positive cocci

A

Group A (Bacitracin sensitive) - Strep pyogenes (impetigo). Group B (bacitracin resistant) - Strep agalactiae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Gamma hemolytic catalase negative gram positive cocci

A

Enterococci (e faecalis) - grow in 6.5 pct NaCl and bile. Nonentercocci (strep bovis) - grow in bile but not 6.5 pct NaCl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Gram positive mnemonics

A

Staph (novobiocin) - On offices STAPH retreat there was NO StRES. Strep (optochin) - OVRPS. Strep (bacitracin) - B-BRAS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Hemolysis of listeria monocytogenes

A

Beta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What is the most common site of staph aureus colonization?

A

Anterior nares

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What is strep pneumo the most common cause of?

A

Meningitis, Otitis media in children, Pneumonia, Sinusitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Color of sputum in strep pneumo infection

A

Rust colored

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Strep viridans infections

A

Dental caries (strep mutans), subacute bacterial endocarditis of damaged valves (strep sanguis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What infection precipitates rheumatic fever?

A

Group A strep (strep pyogenes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What is done to prevent group B strep infection in newborns?

A

Pregnant women screened at 35-37 weeks. Positive patients receive intrapartum penicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What do enterococci cause?

A

UTI and subacute endocarditis. Are normal colonic flora. Are penicillin G resistant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Strep bovis

A

Normal gut bacteria. Can cause bacteremia and subacute endocarditis in colon cancer patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Gram positive rods with metachromatic (blue and red) granules and Elek test for toxin

A

Cornyebacterium diptheriae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Gram positive rods with metachromatic (blue and red) granules and Elek test for toxin

A

Cornyebacterium diptheriae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What is seen in diphtheriae pharyngitis

A

Grayish-white pseudomembrane and lymphadenopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What is needed to prevent clostridium tetani infection and what is the implication of this?

A

IgG. Breastmilk will not cut it. Vaccinate early

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Path tetanospasmin travels

A

Wound to motor neuron axon to spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Toxin A and Toxin B

A

C difficile. A (enterotoxin) - binds brush border of gut. B (cytotoxin) - destroys enterocyte cytoskeleton, causing pseudomembranous colitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

How do you diagnose C difficile colitis?

A

Detection of Toxin A and/or B in the stool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Cause and treatment of C difficile

A

Commonly caused by clindamycin or ampicillin. Treat with metronidazole or oral vanco

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

What is given to prevent neonatal tetanus?

A

A maternal vaccine during pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Only bacterium with a polypeptide capsule (contains D-glutamate)

A

Bacillus anthracis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Fever, pulmonary hemorrhage, mediastinitis, shock

A

Pulmonary anthrax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Microscopy of anthrax infection

A

Long chains (medussa head appearance)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

People in what profession are susceptible to anthrax infection?

A

Woolsorters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Culture appearance of listeria monocytogenes

A

Narrow zone of beta hemolysis on sheep blood agar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Where does listeria monocytogenes live?

A

Facultative intracellular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Amnioitis, septicemia, and spontaneous abortion. Or granulomatosis infantiseptic. Or neonatal meningitis. Or meningitis in immunocompromise. Or mild gastroenteritis (healthy adult)

A

Listeria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Treatment for listeria

A

Usually self-limited. Ampicillin in infants and immunocompromised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Treatment for branching gram positive rods

A

SNAP. Sulfa for Nocardia, Actinomyces use Penicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Prophylactic treatment for MAIC in AIDS patients

A

Azithromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Fevers, weight loss, weakness, hepatosplenomegaly

A

MAI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Treatment for leprosy

A

Dapsone (toxicity is hemolysis and methemoglobinemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Outcomes of leprosy

A

Lepromatous (Th2 response), tuberculoid (Th1 response)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Gram negative cocci

A

Maltose fermenter - N meningitidis. Maltose nonfermenter - N gonorrhoeae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Gram negative coccoid rods

A

H flu, pasteurella, brucella, bordatella pertussis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Gram negative comma shaped (oxidase positive)

A

Grows at 42 C - campylobacter jejuni. Grows in alkaline media - vibriocholerae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

Gram negative lactose fermenting rods

A

Fast fermenters - klebsiella, e coli, enterobacter. Slow fermenters - citrobacter, serratia, others

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

Gram negative non lactose fermenting rods

A

Oxidase negative - shigella (no H2S production), salmonella and proteus (H2S production). Oxidase positive - pseudomonas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

Why dont you get lasting imunity from gonoccocal infection?

A

Due to rapid antigenic variation of pilus proteins (which is also why we dont have a vaccine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

What does meningococcus cause?

A

Meningococcemia, meningitis, and Waterhouse-Friderichsen syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

What does gonococcus cause?

A

Gonorrhea, septic arthritis, neonatal conjuctivitis, PID, and Fitz-Hugh-Curtis syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

What does meningococcus have that is analogous to LPS of enteric gram negatives?

A

LOS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Prophylaxis of meningococcus close contacts

A

Rifampin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

Treatment of gonococcus and meningococcus respectively

A

Gonococcus - cetriaxone, meningococcus - ceftriaxone or penicillin G

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

What does h flu cause?

A

Epiglottitis (cherry red), Meningitis, Otitis media, and Pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

Transmission of h flu

A

Aerosol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

Treatment and prophylaxis for h flu

A

Ceftriaxone (treatment) and rifampin (close contact prophylaxis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

What is contained in the HiB vaccine?

A

PRP component of the HiB capsule conjugated to diphtheria toxoid (give between 2 and 18 months of age)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

Test of choice for legionella

A

Urine assay for antigen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

Transmission and habitat of legionella

A

Aerosol. Water source habitat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

Treatment for legionella

A

Erythromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

What presentation in a pneumonia case would suggest legionella over strep pneumo?

A

Pneumonia + GI + Neuro symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

High fever in smoker with diarrhea, confusion, cough, and chest pain

A

Legionella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

Erythema gangrenosum

A

Necrotic skin condition due to pseudomonas exotoxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

What is pseudomonas associated with

A

Wound and burn infection, pneumonia (esp in CF), sepsis (black lesions on skin), swimmers ear, UTI, drug users and diabetic osteomyelitis, hot tub folliculitis, malignant otitis externa in diabetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

Smell of pseudomonas

A

Grape like odor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

Treatment for pseudomonas

A

Aminoglycoside plus extended-spectrum penicillin (piperacillin, ticarcillin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

Most important virulence factor in e coli UTI

A

Fimbriae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

E coli diarrhea in children

A

EPEC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

Which e coli does not ferment sorbitol?

A

EHEC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

Red currant jelly sputum

A

Klebsiella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

Contrast DIC with TTP-HUS

A

1) Pts bleed in DIC. 2) Only platelets activated in TTP-HUS. 3) PTT and PT prolonged in DIC, 4) Low fibrinogen and increased FDP in DIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

Which populations are more common in TTP and HUS respectively

A

TTP - pts with mainly CNS symptoms. HUS - children with renal failure and mild CNS symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

Main differences betweeon salmonella and shigella

A

Salmonella have flagella and can disseminate hematogenously and produce H2S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

What may prolong symptoms in salmonella infection?

A

Antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

Rose spots on abdomen, fever, headache, diarrhea.

A

Salmonella typhi (typhoid fever). May remain in gallbladder in carrier state

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

How do shigella enter our cells?

A

They first enter antigen sample M (microfold) cells, then spread to epithelial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

How do Shigella move?

A

Actin polymerization (they do not have flagella like salmonella do)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

Most common cause of bloody diarrhea

A

Campylobacter jejuni. This is especially true in children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

Transmission of campylobacter

A

Fecal-oral through poultry, meat, unpasturized milk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

Common antecedent to Guillain-Barre

A

Pet feces (puppies), contaminated milk, or pork

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

Diarrhea outbreaks in day care centers. Can also cause mesenteric adenitis which can mimic Crohns or appendicits

A

Yersinia entercolitica

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
134
Q

Spirochetes

A

Borrelia, Leptospira, Treponema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

Flulike symptoms, jaundice, photophobia with conjunctivitis.

A

Leptospirosis. Found in water contaminated with animal urine, prevalent among surfers and in the tropics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
136
Q

Severe jaundice and azotemia, fever, hemorrhage, anemia

A

Weils disease (icterohemorrhagic leptospirosis) - liver and kidney dysfuntcion from severe leptospira infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
137
Q

Stages of lyme disease

A

1 - erythema migrans, flulike symptoms. 2 - Bells palsy, AV nodal block. 3 - chronic monoarthritis and migratory polyarthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

Treatment for lyme

A

Doxycycline, ceftriaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

Stages of syphilis

A

1 - painless chancre, 2 - rash, condylomata lata. 3 - Gummas, aoritis, neurosyphilis, argyll-robertson pupil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

Saber shins, saddle nose, CN 8 deafness, Hutchinsons teeth, mulberry molars

A

Congenital syphilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
141
Q

Argyll-Robertson pupil

A

Reactive to accomodation but not light

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
142
Q

Causes of VDRL false positives

A

VDRL. Viruses (mono, hepatitis), Drugs, Rheumatic fever, Lupus and leprosy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q

Histologic appearance of brucellosis and what is the source?

A

Chronic caseating granulomas similar to Tb endocarditis. Unpasteurized dairy (common in cattle ranchers)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
144
Q

Source and organism of Q fever

A

Coxiella burnetii. Spores from tick feces and cattle placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
145
Q

Source and organism of ehrlichiosis

A

Ehrlichiosis chaffeensis. Lone star tick

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
146
Q

Vector for francisella tularensis

A

Ticks, rabbits, deer fly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
147
Q

Vector for pasteurella multocida

A

Animal bite, cats, dogs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
148
Q

Organism and vector for epidemic typhys

A

Rickettsia prowazekii. Louse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
149
Q

Vector and organism for endemic typhyus

A

Rickettsia typhi. Flease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
150
Q

Characteristic finding in garnderella vaginalis infection

A

Fishy odor on addition of kOH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
151
Q

What infection is associated with sexual activity but is not an STD?

A

Garnerella overgrowth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
152
Q

Clue cells

A

Gardnerella overgrowth. Vaginal epithelial cells covered with bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
153
Q

Treatment for gardnerella

A

Metronidazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
154
Q

Where do Rickettsia live and what do they need to survive?

A

Intracellularly. Need CoA and NAD+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
155
Q

Rash starting centrally and spreading out sparing palms and soles

A

Epidemic typhys. R prowazekii carried by human body louse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
156
Q

Headache, fever, rash (vasculitis) starting on palms and soles

A

Rickettsia (but not typhus type. Typhus rash starts on trunk and spreads out)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
157
Q

Rickettsial pneumonia with no rash, no vector, and negative Weil-Felix

A

Q fever (coxiella burnetti). Organism can survive outside for a long time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
158
Q

Weil-Felix

A

Mixing pts serum with proteus antigens and antirickettsial antibodies will cross react with Proteus O antigen and agglutinate (if they have had a rickettsial infection)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
159
Q

Rash on palms and soles migrating to wrist, ankles, then trunk, headache, fever

A

Rocky mountain spotted fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
160
Q

In what infections is palm and sole rash seen?

A

Coxsackie A (hand foot and mouth), RMSF, Syphilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
161
Q

Two main forms in chlamydia life cycle

A

Elementary body (infectious), and Reticulate body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
162
Q

Lab diagnois of chlamydiae

A

Cytoplasmic inclusions on Giemsa or floresecent antibody stained smear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
163
Q

Chlamydia trachomatis serotypes

A

ABC - blindness, africa, chronic. D-K - urethritis, PID, ectopic, neonatal pneumonia and conjunctivitis. L1L2L3 - Lymphogranuloma venerum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
164
Q

Cause of atypical pnuemonia, high titer of cold aggultinins (IgM), grown on Eatons agar

A

Mycoplasma pneumoniae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
165
Q

Treatment for mycoplasma pneumoniae

A

Tetracycline or erythromycin (do not use penicillins as they have no cell wall)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
166
Q

Atypical pneumonia outbreak in military recruits or prisons

A

Mycoplasma pneumoniae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
167
Q

Main fungus in New England and mid-atlantic

A

Blastomyces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
168
Q

Main fungus in midwest

A

Histoplasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
169
Q

Main fungus in southwest

A

Coccidiodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
170
Q

Main fungus in latin america

A

Paracoccidiodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
171
Q

Symptoms of histoplasmosis

A

pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
172
Q

Dimorphic fungus in bird or bat droppings

A

Histoplasmosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
173
Q

Treatment for systemic mycoses

A

Fluconazole or ketoconazole (local), amphotericin B (systemic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
174
Q

Dimorphic broad based buds

A

Blastomyces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
175
Q

Symptoms of blastomycosis

A

Inflammatory lung disease, can disseminate to skin and bone. Granulomatous nodules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
176
Q

Symptoms of coccidiodomycosis

A

Pneumonia and meningitis, can disseminate to bone and skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
177
Q

Dimorphic fungus which looks like a ball of grapes

A

Coccidiodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
178
Q

Which systemic mycoses can become a spherule filled with endospores (much larger than an RBC)?

A

Coccidiodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
179
Q

Dimorphic fungus with captains wheel appearance

A

Paracoccidiodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
180
Q

How does malassezia furfur affect skin pigment?

A

Degrades lipids, which produces acids that damage melanocytes and cause hypopigmentation or hyperpigmented patches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
181
Q

What kind of weather is conducive to malassezia furfur?

A

Hot, humid weather

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
182
Q

Treatment for tinea versicolor

A

Topical miconazole, selenium sulfide

183
Q

Histologic appearance of malassezia furfur

A

Spaghetti and meatball look on KOH prep

184
Q

What cells are responsible for preventing candidiasis?

A

Th cells suppress superficial candidiasis. Neutrophils prevent hematogenous spread

185
Q

Forms of candida

A

Dimorphic. Psuedohyphae and budding at 20C, Germ tubes at 37C

186
Q

Treatment for candidiasis

A

Topical azole (vaginal), fluconazole or caspofungin (oral/esophageal), amphotericin B, fluconazole, caspofungin (systemic)

187
Q

Acute angle hyphae

A

Aspergillus

188
Q

How do aflatoxins cause cancer?

A

They cause a GC to TA mutation in p53

189
Q

Which opportunistic fungal infections are not dimorphic?

A

Aspergillus, cryptococcus, mucor and rhizopus (I think), PCP (I think)

190
Q

Histologic appearance of cryptococcus

A

Heavily encapsulated yeast. Little balls with smaller balls in them

191
Q

How is cryptococcus acquired?

A

Inhalation (which results in hematogenous dissemination) from yeast in soil and pigeon droppings

192
Q

Characteristic brain lesion from cryptococcus

A

Soap bubble lesions

193
Q

What patients tend to get mucor and rhizpus infections?

A

DKA pts and leukemia pts

194
Q

Headache, facial pain, black necrotic eschar on face, possible cranial nerve involvement

A

Mucor and rhizopus infections

195
Q

How is PCP acquired?

A

Inhalation of yeast

196
Q

Treatment for PCP

A

TMP-SMX, pentamidine, dapsone. Prophylax at CD4 less than 200

197
Q

Dimorphic, cigar-shaped budding yeast that lives on vegetation

A

Sporothrix schenkii

198
Q

Treatment for sporothrix schenkii

A

Itraconazole or KI

199
Q

Bloating, flatulence, foul-smelling fatty diarrhea in campers and hikers

A

Giardiasis

200
Q

How are giardia, entamoeba, and cryptosporidum respectively transmitted?

A

All are cysts in water

201
Q

Treatment for giardia

A

Metronidazole

202
Q

Treatment for entamoeba histolytica

A

Metronidazole and iodoquinol

203
Q

Treatment for cryptosporidium

A

Prevention (water treatment), nitazoxanide

204
Q

Bloody diarrhea, liver abscess, RUQ pain, flask-shaped colonic ulcers

A

Entamoeba

205
Q

Chorioretinitis, hydrocephalus, intracranial calcifications

A

Toxoplasmosis (usually in HIV)

206
Q

Transmission of toxoplasma

A

Cysts in meat or cat feces

207
Q

Treatment for toxoplasma

A

Sulfadiazine and pyrimethamine

208
Q

Rapidly fatal meningoencephalitis in someone who swam in a fresh water pool

A

Naegleria fowleri

209
Q

Where do you look for the amoeba in naegleria infection?

A

CSF

210
Q

Organism and vector for sleeping sickness

A

Trypanosoma brucei, gambiense, rhodesiense. Tsetse fly (painful bite)

211
Q

Treatment for sleeping sickness

A

Suramin (blood-borne), melarsoprol (CNS protection)

212
Q

Cycle length of the various malarias

A

Vivax/Ovale - 48 hours, Falciparum - irregular, Malariae - 72 hours

213
Q

Which malaria has a dormant form in the liver?

A

Vivax-ovale

214
Q

Which malaria causes cerebral malaria and how?

A

Falciparum. Parasitized RBCs occlude capillaries in brain (also kidney and lungs)

215
Q

Malaria treatment

A

Start with chloroquine (blocks plasmodium heme polymerase). If resistant, use mefloquine. Vivax/ovale - add primaquine for hypnozoites

216
Q

Fever and hemolytic anemia, northeastern United States, asplenia in severe disease

A

Babesia

217
Q

Treatment for babesia

A

Quinine, clindamycin

218
Q

Organism and vector in Chagas disease

A

Trypanosoma cruzi. Reduviid bug (kissing bug, painless bite)

219
Q

Treatment for Chagas disease

A

Nifurtimox

220
Q

Dilated cardiomyopathy, megacolon, megaesophagus

A

Chagas disease (mostly in S america)

221
Q

Spiking fevers, hepatosplenomegaly, pancytopenia

A

Visceral leishmaniasis

222
Q

Organism and vector of leishmaniasis

A

Leishmania donovani. Sandfly

223
Q

Treatment for leishmaniasis

A

Sodium stibogluconate

224
Q

Treatment for trichomonas vaginalis

A

Metronidazole (for patient and partner)

225
Q

Organism and treatment for pinworm

A

Enterobius vermicularis. Bendazoles or pyrantel pamoate

226
Q

Transmission of pinworm

A

Food contaminated with eggs

227
Q

Nematode that encysts in muscle, causes periorbital edema

A

Trichinella spiralis

228
Q

Nematode that penetrates the skin, causes vomiting, diarrhea, anemia

A

Strongyloides stercoralis

229
Q

Nematode that penetrates skin of feet, causes anemia

A

Ancylostoma duodenale and Necator americans (hookworms)

230
Q

Transmission and treatment of dracunculus medinensis

A

Drinking water, niridazole

231
Q

Loa Loa

A

Transmitted by deer flies, causing skin swelling. Treat with DEC

232
Q

Wuchereria bancrofti

A

Transmitted by female mosquito. Causes elephantiasis. Treat with DEC

233
Q

Toxocara canis

A

Food contaminated with eggs, causes granulomas (can cause blindness) and visceral larva migrans. Treat with DEC

234
Q

Treatment for taenia solium

A

Praziquantel (use bendazoles for neurocysticercosis)

235
Q

Appearance of t solium lesions in the brain

A

Swiss cheese appearance

236
Q

Treatment for diphyllobothrium latum

A

Praziquantel

237
Q

Cysts in the liver that can cause anaphylaxis if antigens are released during removal

A

Echinococcus granulosus. Acquired from eggs in dog feces. Treat with bendazoles

238
Q

Treatment for trematodes (flukes)

A

Praziquantel

239
Q

Trematodes (flukes) (3)

A

Schistosoma, clonorchis sinesis (pigmented gallstones, cholangiocarcinoma), paragonimus westermani (crab meat, hemoptysis)

240
Q

Routes of nematode infection and the worms that use each (6 total)

A

Ingestion - Enterobius, Ascaris, Trichinella. Cutaneous - Strongyloides, Ancylostoma, Necator

241
Q

Parasite of brain cysts and seizures

A

T solium

242
Q

Parasite of liver cysts

A

Echinococcus granulosus

243
Q

Parasite of B12 deficiency

A

Diphyllobothrium latum

244
Q

Parasite of biliary tract disease, cholangiocarcinoma

A

Clonorchis sinesis

245
Q

Parasite of hemotypsis

A

Paragonimus westermani

246
Q

Parasite of portal hypertension

A

Schistosoma mansoni

247
Q

Parasite of hematuria, bladder cancer

A

Schistosoma haematobium

248
Q

Parasite of microcytic anemia

A

Ancylostoma, necator

249
Q

Complementation and the requirement for it

A

When one virus uses another viruses protein product. Both viruses have to be infecting the same cell at the same time

250
Q

Phenotypic mixing

A

Coating of a progeny virus of virus A with surface proteins of virus B. Have to be infecting the same cell at the same time. Surface protein determines infectivity, but progeny carry virus A genetic material

251
Q

Live attenuated vaccines (5)

A

Lead to longer production of mucosal IgA than killed vaccines. Smallpox, yellow fever, chickenpox, Sabins polio, MMR

252
Q

Killed vaccines (4)

A

Rabies, influenza, salk polio, HAV

253
Q

Recombinant vaccines (2)

A

HBV, HPV

254
Q

All DNA viruses are what and what is the exception?

A

Double stranded, except the parvoviruses

255
Q

What are all RNA viruses and what is the exception?

A

Single stranded except Reoviruses

256
Q

RNA viruses

A

I went to a RETRO (retrovirus) TOGA (togavirus) party where I drank FLAVored (flavivirus) CORONA (coronavirus) and ate HIPPY (hepevirus) CALIfornia (Calcivirus) PICKLES (picornavirus)

257
Q

What naked viruses are infectious?

A

dsDNA (except pox and HBV) and +strand ssRNA

258
Q

Where do viruses replicate

A

DNA viruses - nucleus (except pox). RNA - cytoplasm (except influenza and retroviruses)

259
Q

Naked viruses (7)

A

Calcivirus, Picornavirus, Reovirus, Parvovirus, Adenovirus, Papilloma, Polyoma

260
Q

Which viruses acquire their envelops from nuclear membrane?

A

Herpesviruses (other get them from the PM)

261
Q

DNA viruses (7)

A

Hepadna, Herpes, Adenoa, Pox, Parvo, Papilloma, Polyoma

262
Q

All DNA viruses are icosehedral except which?

A

Pox (complex)

263
Q

HHV-6

A

Roseola (exanthem subitum)

264
Q

Which hepatitis virus is a DNA virus?

A

Hep B (it is a hepadnavirus)

265
Q

What virus is not a retrovirus but has reverse transcriptase?

A

HBV

266
Q

Most common viral cause of acute cystitis (dysuria, hematuria) in kids

A

Adenovirus

267
Q

Febrile pharyngitis, sore throat, acute hemorrhagic cystitis, pneumonia, conjunctivitis

A

Adenovirus

268
Q

Erythema infectiosum (fifth disease)

A

Parvo B19. Slapped cheek rash, hydrops fetalis in utero, RBC aplasia and RA-like symptoms in adults

269
Q

Causes of pure red cell aplasia

A

Parvo B19 and thymoma

270
Q

Histology of VZV infection

A

Intranuclear inclusions, multinucleate giant cells

271
Q

Tzanck test

A

Smear to detect HSV-1, HSV-2 and VZV

272
Q

Fever, hepatosplenomegaly, pharyngitis, lymphadenopathy (especially posterior cervical nodes). 15-20 years of age

A

Mononucleosis

273
Q

Family and symptomology of norwalk virus

A

Calcivirus. Viral gastroenteritis

274
Q

Which Hepatitis viruses are RNA viruses and what is the family of each?

A

HAV - Picorna, HCV - Flavi, HDV - Delta, HEV - Hepe

275
Q

Picornaviruses (5)

A

Polio, Echo (aseptic meningitis), Rhino, Coxsackie (aseptic meningitis, herpangina, febrile pharyngitis, hand foot mouth disease), HAV

276
Q

Paramyxoviruses (4)

A

Parinfluenza (croup), RSV (briochilitis in babies, treat with ribavirin), Rubeola (Measles), Mumps

277
Q

Negative stranded RNA viruses (6)

A

Always Bring Polymerase Or Fail Replication. Arenaviruses, Bunyaviruses, Paramyxoviruses, Orthomyxoviruses, Filoviruses, Rhabdoviruses

278
Q

Segmented viruses (4)

A

BOAR. All are RNA viruses. Bunyaviruses, Orthomyxoviruses, Arenaviruses, Reoviruses

279
Q

Protein synthesis in picornaviruses

A

RNA translated into 1 large polypeptide that is cleaved by proteases into functional viral proteins

280
Q

Spread of picornaviruses

A

Fecal oral (except rhinovirus)

281
Q

Why doesnt rhinovirus affect the GI tract?

A

It is acid labile

282
Q

High fever, black vomitus, jaundice

A

Yellow fever (a flavivirus)

283
Q

Diarrhea in day care centers due to villous destruction with atrophy. A segmented RNA virus.

A

Rotavirus (a reovirus)

284
Q

Fever, postauricular adenopathy, lymphadenopathy, arthralgias, fine truncal rash that starts at head and moves down.

A

Rubella (a togavirus, also called german measles). Mild in children but serious if congenital

285
Q

What do paramyxoviruses have, what does it do, and how does this relate to treatment?

A

F (fusion) protein. Causes respiratory epithelial cells to fuse and form multinucleated cells. Palivizumab is a monoclonal antibody against F protein

286
Q

Palivizumab

A

Monoclonal antibody against F protein (paramyxoviruses). Prevents pneumonia in premature infants

287
Q

Descending maculopapular rash including hands and feet, koplik spots.

A

Measles (rubeola, a paramyxovirus)

288
Q

Difference between the rashes in rubella and rubeola

A

Rubeola (measles) rash includes hands and feet. Rubella (german measles) rash stays on trunk. Both spread down from head

289
Q

Potential sequelae of measles (rubeola)

A

SSPE (many years later), encephalitis, giant cell pneumonia (typically only in immunosuppressed)

290
Q

Cough, cold like symptoms, conjunctivitis

A

Measles

291
Q

Parotitis, aseptic meningitis, orchitis

A

Mumps (a paramyxovirus)

292
Q

Between measles (rubeola) and german measles (rubella), which contains hemagglutinin?

A

Measles (rubeola), as it is a paramyxovirus

293
Q

Fever, malaise, agitation, photophobia, hydrophobia, paralysis, coma, death

A

Rabies (progresses in that order)

294
Q

Histology of hepatitis A infection

A

Hepatocyte ballooning degeneration and apoptosis

295
Q

Histology of Hep B infection

A

Fine, eosinophilic, cytoplasmic granules of HBsAg are visible, giving ground glass appearance

296
Q

Transmission of HBV

A

Parenteral, sexual, maternal-fetal

297
Q

Symptoms of HBV prodromal period

A

Serum-sickness like

298
Q

What viral hepatitises predispose to cancer and which cancer?

A

HCC. HBV and HCV

299
Q

Best test for active HAV infection

A

Anti-HAVAb (IgM)

300
Q

Best test for prior HAV infection

A

Anti-HAVAb (IgG). Can also indicate prior vaccination

301
Q

What Hep B serologic marker indicates high transmissibility?

A

HBeAg

302
Q

HIV structural genes

A

Env (gp120 for attachment, gp41 for fusion and entry), Gag (p24 capsid), Pol (reverse transcriptase)

303
Q

What receptors does HIV use for entry?

A

CXCR4 or CCR5 (CD4 cells), CCR5 and CD4 (macrophages)

304
Q

Why are HIV tests initially falsely positive in babies born to infected mothers?

A

Anti-GP120 crosses placenta

305
Q

Where does the HIV virus replicate during the latent phase?

A

Lymph nodes

306
Q

What fungal infection is commonly picked up by spelunkers?

A

Histoplasma capsulatum (from bats)

307
Q

Low-grade fever, cough, hepatosplenomegaly, tongue ulcer, only pulmonary symptoms if CD4 count greater than 100

A

Histoplasma

308
Q

Encephalopathy and demyelination in pt with CD4 count below 200

A

JC virus reactivation

309
Q

Ring-enhancing brain abscesses with CD4 count below 100

A

Toxoplasma

310
Q

CD4 count for cryptococcus meningitis

A

Below 50

311
Q

CD4 count for CMV retinitis

A

Below 50. Will see cotton-wool spots

312
Q

CD4 ranges for PCP and MAI infections respectively

A

PCP - below 200, MAI - below 50

313
Q

Bugs that can mimic appendicits (3)

A

Yersinia enterocolitica, campylobacter jejuni, non-typhoidal salmonella. Mimic appendicits by causing mesenteric adenitis

314
Q

Bugs causing bloody diarrhea (7)

A

Campylobacter, salmonella, shigella, EHEC, EIEC, Yersinia enterocolitica, Entamoeba histolytica

315
Q

Bugs causing watery diarrhea (4)

A

ETEC, Vibrio choleraea, C diff, C perfringens. Also protozoa - giardia, cryptosporidium, viruses - rota, adeno, norwalk

316
Q

Most common causes of pneumonia (in order with most common first) in neonates

A

Group B strep, E coli

317
Q

Most common causes of pneumonia (in order with most common first) in children 4 weeks to 18 years

A

Viruses (RSV), Mycoplasma, Chlamydia trachomatis, Strep pneumo

318
Q

Most common causes of pneumonia (in order with most common first) in adults (18-40)

A

Mycoplasma, C pneumoniae, Strep pneumo

319
Q

Most common causes of pneumonia (in order with most common first) in adults (40-65)

A

Strep pneumo, H flu, Anaerobes, Viruses, Mycoplasma

320
Q

Most common causes of pneumonia (in order with most common first) in elderly

A

Strep pneumo, Influenza, Anaerobes, H flu, Gram negative rods

321
Q

Most common causes of nosocomial pneumonia

A

Staph, enteric gram negative rods

322
Q

Most common causes of aspiration pneumonia and treatment

A

Anaerobes. Clindamycin

323
Q

Most common causes of pneumonia in alcoholics and IV drug users

A

Strep pneumo, Klebsiella, Staph

324
Q

Most common causes of pneumonia in CF

A

Pseudomonas

325
Q

Most common causes of atypical pneumonia

A

Mycoplasma, Legionella, Chlamydia

326
Q

CSF findings in bacterial meningitis

A

WBC high (over 1000) predominantely neutrophils. Glucose low (below 70), protein high

327
Q

Most common causes of meningitis (in order with most common first) in newborn

A

Group B strep, E Coli, Listeria

328
Q

Most common causes of meningitis (in order with most common first) in children (6 mos to 6 years)

A

Strep pneumo, N meningitidis, HiB, Enteroviruses

329
Q

Most common causes of meningitis (in order with most common first) in 6 to 60 years

A

Strep pneumo, N meningitidis (number 1 in teens), Enteroviruses, HSV

330
Q

Most common causes of meningitis (in order with most common first) in elderly

A

Strep pneumo, GNRs, Listeria

331
Q

Enteroviruses

A

Coxsackie, Echo, Polio, others

332
Q

CSF findings in viral meningitis

A

WBC below 500 predominantely lymphocytes, glucose normal or near normal, protein elevated but below 70

333
Q

Treatment of meningitis

A

Cetriaxone and vanco empirically. Add ampicillin if Listeria suspected

334
Q

Fever, headache, photophobia, nuchal rigidity, painful extraocular movements

A

Meningitis

335
Q

CSF findings in fungal/Tb meningitis

A

Very similar to bacterial except WBC predominance is lymphocytes instead of PMNs

336
Q

Fever with positive gallium scan

A

Osteomyelitis

337
Q

Most common causes of osteomyelitis in: all comers, sexually active, DM and IVDU, sickle cell, prosthetics, vertebral, animal bite

A

All - S aureus, Sexually active - N gonorrhoeae (rare), DM and IVDU - pseudomonas, Sickle - Salmonella, Prosthetics - S aureus and s epidermis, Vertebral - M Tb (potts disease), Animal bite - Pasteurella

338
Q

Where in the bone does osteomyelitis typically occur

A

Metaphysis of long bones

339
Q

Features seen in pyelonephritis but not cystitis

A

Fever, chills, flank (vs suprapubic) pain, CVA tenderness, hematuria, WBC casts (vs WBCs)

340
Q

Predisposing factors to UTI

A

Female, obstruction, kidney surgery, catheterization, GU malformation, DM, pregnancy

341
Q

Markers for UTI agents

A

Positive leukocyte esterase test - bacterial UTI, Positive nitrite test - gram negative bacterial UTI

342
Q

Urease producing bugs that cause UTIs

A

Proteus, Klebsiella. Negative urease test suggests E coli, Strep, Enterococcus

343
Q

ToRCHHeS

A

Toxoplasma, Rubella, CMV, HIV, HSV-2, Syphilis

344
Q

Hepatosplenomegaly, jaundice, thrombocytopenia, growth retardation in newborn

A

Common features of ToRCHHeS infections

345
Q

Which TORCHES infection often includes poor feeding?

A

Toxoplasma

346
Q

Maternal symptoms for each of the ToRCHHeS infections

A

Toxo - asymptomatic or lymphadenopathy. Rubella - Rash, postauricular lymphadenopathy, polyarthritis. CMV - Asymptomatic or mono-like. HIV - variable. HSV-2 - Asymptomatic or herpetic lesions. Syphilis - Chancre, rash, or cardiac/neuro disease

347
Q

PDA, cataracts, deafness, blueberry muffin rash (may or may not be present)

A

Congenital rubella

348
Q

Hearing loss, seizures, petechial rash, blueberry muffin rash

A

Congenital CMV

349
Q

Recurrent infections, chronic diarrhea in newborn

A

Congenital HIV

350
Q

Temporal encephalitis, herpetic lesions in newborn

A

Congenital HSV-2

351
Q

Stillbirth or facial abnormalities, saber shins, and CN 8 deafness

A

Congenital syphillis

352
Q

Slapped cheek rash

A

Parvo B19

353
Q

Vesicular rash on palms and soles. Ulcers in oral mucosa

A

Coxsackie Type A (hand-foot-mouth disease)

354
Q

Urethritis, cervicitis, PID, prostatitis, epididymitis, arthritis, creamy purulent discharge

A

Gonorrhea

355
Q

Painful genital ulcer, inguinal adenopathy

A

Chancroid (haemophilus ducreyi)

356
Q

Painful penile, vulvar, or cervical vesicles and ulcers. With or without fever, headache, myalgia

A

HSV-2

357
Q

Noninflammatory, malodorous discharge, positive whiff test, clue cells

A

Gardnerella vaginosis

358
Q

Two most common causes of PID

A

Chlamydia trachomatis and N gonorrhoeae

359
Q

Cervical motion tenderness, purulent cervical discharge

A

PID. May progress to salpingitis, endometritis, hydrosalpinx, and tubo-ovarian abscess

360
Q

Fitz-Hugh-Curtis

A

Infection of the liver capsule and violin string adhesions of parietal peritoneum to liver. Caused by ascending PID (esp N gonorrhoeae)

361
Q

Causes of meningitis in unimmunized children

A

HiB and polio

362
Q

What bug should you associate with sulfur granules?

A

Actinomyces israelii

363
Q

Action of penicillin and its dervitives

A

Block cell wall synthesis by inhibition of peptidoglycan cross linking

364
Q

Drugs that block peptidoglycan synthesis

A

Bacitracin, vancomycin

365
Q

Drugs that block nucleotide synthesis

A

Sulfonamides, trimethoprim

366
Q

Drugs that block DNA topoisomerases

A

Fluoroquinolones

367
Q

Drugs that block mRNA synthesis

A

Rifampin

368
Q

How does metronidazole work?

A

Damages DNA

369
Q

Dicloxacillin

A

A penicillin derivative related to methicillin and nafcillin

370
Q

Which has greater oral bioavailability, amoxicillin or ampicillin?

A

Amoxicillin

371
Q

Main uses of ampicillin and amoxicillin

A

H flu, E coli, Listeria, Proteus, Salmonella, Shigella, enterococci

372
Q

Most important use of ticarcillin, carbenicillin, and piperacillin

A

Pseudomonas. Also covers GNRs

373
Q

Clavulanic Acid, Sulbactam, Tazobactam

A

B-lactamase inhibitors

374
Q

What do cephalosporins block?

A

Transpeptidases (also called penicillin binding proteins)

375
Q

Organisms not covered by cephalosporins are LAME

A

Listeria, Atypicals (chlamydia, mycoplasma), MRSA, Enterococci

376
Q

Toxicities of cephalosporins

A

Hypersensitivity reactions, Vitamin K deficiency, Disulfiram-like reaction

377
Q

Aztreonam

A

Monobactam resistant to B-lactamases. Binds PBP3, no cross-allergenicity with penicillins. GNR coverage only.

378
Q

Main use of aztreonam

A

Penicillin-allergic pts and those with renal insufficiency who cannot tolerate aminoglycosides

379
Q

Imipenem/cilastatin and meropenem

A

Limited by side effects, use in life-threatening infections after other options exhausted.

380
Q

Cilastatin

A

Inhibits renal dehydropeptidase to decrease inactivation of imipenem

381
Q

What are penicillins structural analogs of in bacteria?

A

The D-Ala-D-Ala sequence (which vancomycin binds)

382
Q

Toxicities of vancomycin

A

Nephrotoxicity, Ototoxicity, Thrombophlebitis, red man syndrome

383
Q

What causes vancomycin resistance?

A

Change of D-ala-D-ala to D-ala-D-lac

384
Q

Protein synthesis inhibitor targets

A

buy AT 30, CCEL at 50. 30S - Aminoglycosides, Tetracyclines. 50S - Chloramphenicol, Clindamycin, Erythromycin (macrolides), Linezolid

385
Q

Aminoglycosides (5)

A

Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin

386
Q

Action of aminoglycosides

A

Inhibit formation of initiation complex and cause misreading of mRNA (bactericidal)

387
Q

What type of bacteria are aminoglycosides ineffective against and why?

A

Anaerobes, because they require O2 for uptake

388
Q

Main use of aminoglycosides

A

Severe GNR infections

389
Q

Toxicities of aminoglycosides

A

Nephrotoxicity, Ototoxicity, Teratogenic

390
Q

Resistance of aminoglycosides

A

Transferase enzymes inactivate drug by acetylation, phosphorylation, or adenylation

391
Q

Tetracyclines (4)

A

Tetracycline, doxycycline, demeclocycline, minocycline

392
Q

Which tetracycline is used in a renal disorder and which disorder?

A

Demeclocycline (ADH antagonist) is used in SIADH

393
Q

Action of tetracyclines

A

Bind 30S, prevent aminoacyl-tRNA attachment

394
Q

Instructions for patients taking tetracyclines

A

Do not take with milk, antacids, or iron-containing preparations as these will inhibit tetracycline absorption

395
Q

What makes tetracyclines so effective against Rickettsia and Chlamydia

A

They accumulate intracellularly

396
Q

Action of macrolides

A

Bind 50S (23S rRNA subsubunit) and prevent translocation

397
Q

Main uses of macrolides

A

Atypical pneumonias, URIs, STDs, gram positive cocci, Neisseria

398
Q

Toxicities of macrolides

A

Prolonged QT, GI discomfort (most common cause of noncompliance), acute cholestatic hepatitis, eosinophilia, skin rashes

399
Q

What drugs are increased in plasma concentration by macrolides?

A

Theophyllines and oral anticoagulants

400
Q

Action of chloramphenicol

A

Binds 50S - blocks peptide bond formation

401
Q

Resistance to chloramphenicol

A

Plasmid-encoded acetyltransferase inactivates drug

402
Q

Action of clindamycin

A

Binds 50S - blocks peptide bond formation

403
Q

Main uses of clindamycin

A

Anaerobic infections in aspiration pneumonia or lung abscesses

404
Q

General principle for treating anaerobes

A

Above the diaphragm - clindamycin, Below the diaphragm - metronidazole

405
Q

Sulfonamides (3)

A

Sulfamethoxazole (SMX), sulfisoxazole, sulfadiazine

406
Q

Action of sulfonamides

A

Inhibit dihydropteroate synthase (needed for DNA synthesis). Are PABA antimetabolites

407
Q

Fluoroquinolones (9)

A

Ciprofloxacin, norfloxacin, levofloxacin, ofloxacin, sparfloxacin, moxifloxacin, gatifloxacin, enoxacin, nalidixic acid (a quinolone)

408
Q

Uses for metronidazole

A

Giardia, Entamoeba, Trichomonas, Gardnerella, Anaerobes.

409
Q

Toxicities of metronidazole

A

Disulfiram-like reaction, headache, metallic taste

410
Q

Prophylaxis for Tb, MAI, and M leprae respectively

A

Tb - INH, MAI - Azithromycin, M leprae - None

411
Q

What is responsible for acid fastness?

A

Mycolic acids

412
Q

What is needed to activate INH?

A

Bacterial catalase-peroxidase (KatG)

413
Q

Toxicities of INH

A

Neurotoxic, hepatotoxic, lupus. Pyridoxine (B6) can prevent neurotoxicity and lupus

414
Q

What causes different INH half life in different individuals

A

Fast vs slow acetylators

415
Q

4 Rs of Rifampin

A

RNA polymerase inhibitor, Revs up P-450, Red/orange body fluids, Rapid resistance if used alone

416
Q

Pyrazinamide

A

Anti-tb. Inhibits mycolic acid production by blocking pyrazanamidase

417
Q

Ethambutol

A

Anti-tb. Decreases carbohydrate polymerization of cell wall by blocking arabinosyltransferase. Can cause optic neuropathy (red-green color blindness)

418
Q

Prophylaxis for each of the following: meningococcus, gonorrhea, syphilis, recurrent UTIs, endocarditis with surgical or dental procedures

A

Meningococcus - Cipro, rifampin or minocycline. Gonorrhea - Cetriaxone, Syphilis - Benzathine penicillin G, Recurrent UTI - Bactrim, Endocarditis - Penicillins

419
Q

HIV prophylaxis at CD4 below: 200, 100, and 50

A

200 - Bactrim (PCP), 100 - Bactrim (PCP and Toxo), 50 - Above and Azithryomycin (MAI)

420
Q

Treatment for VRE

A

Linezolid and quinupristin/dalfopristin

421
Q

Empiric therapy for community-acquired pneumonias

A

Outpatient - macrolides, Inpatient - fluoroquinolones, ICU - B-lactam + (fluoroquinolone or azithromycin)

422
Q

What antifungals affect each of the following: membrane function, cell wall synthesis, ergosterol synthesis, lanosterol synthesis, nucleic acid synthesis

A

Membrane - Amphotericin B, Cell wall - Caspofungin, Ergosterol - fluconazole, itraconazole, voriconazole, terbinafine, Lanosterol - naftitine, Nucleic Acids - 5-fluorocytosine

423
Q

Action of amphotericin B

A

Binds ergosterol and forms pore that allow leakage of electrolytes

424
Q

What do you have to supplement in amphotericin treatment and why?

A

K and Mg because of altered renal tubule permeability

425
Q

Action and delivery of nystatin

A

Same as amphotericin (binds ergosterol and makes pores). Topical only because too topic systemically

426
Q

Action of caspofungin

A

Inhibits cell wall synthesis by inhibiting synthesis of B-glucan

427
Q

Action of terbinafine

A

Inhibits fungal enzyme squalene epoxidase (necessary for ergosterol synthesis)

428
Q

Action of griseofulvin

A

Inhibits MT function, disrupting mitosis

429
Q

Antiprotozoals (5)

A

Pyrimethamine (toxo and falciparum), suramin and melarsoprol (sleeping sickness), nifurtimox (Chagas), Sodium stibogluconate (leishmaniasis)

430
Q

Action of chloroquine

A

Blocks plasmodium heme polymerase

431
Q

Antihelminthic drugs

A

Mebendazole, pyrantel pamoate, ivermectin, DEC, praziquantel. They all immobilize helminths

432
Q

Amantadine

A

Blocks viral penetration and uncoating (M2 protein). Causes release of dopamine from nerve terminals

433
Q

Use and toxicity for amantadine

A

Influenza A, Parkinsons disease. Causes ataxia, dizziness, slurred speech. 90 pct of influenza A resistant to amantadine

434
Q

Zanamivir and oseltamivir

A

Inhibit neuraminidase, decreasing release of progeny viruses. Use in both Influenza A and B

435
Q

Ribavirin

A

Inhibits synthesis of guanine nucleotides by competitively inhibiting IMP dehydrogenase. Use in RSV and Hep C. Can cause hemolytic anemia, is teratogenic

436
Q

Activation and Action of Acyclovir

A

Monophosphorylated by HSV/VZV thymidine kinase. Guanosine analog

437
Q

Uses of acyclovir

A

HSV, VZV, EBV. Use famciclovir for herpes zoster

438
Q

Toxicities of acyclovir

A

Can cause crystalline nephropathy if adequate hydration not provided

439
Q

Uses of ganciclovir

A

CMV

440
Q

Toxicities of gancicyclovir

A

Leukopenia, neutropenia, thrombocytopenia, renal toxicity. Much more toxic than acyclovir

441
Q

Foscarnet

A

Viral DNA pol inhibitor (binds pyrophosphate-binding site, no activatoin required).

442
Q

What effect does foscarnet have on electrolyte levels

A

Can chelate Ca and promote Mg wasting (leads to low Ca and Mg levels)

443
Q

Cidofovir

A

Inhibits viral DNA pol. Does not require phosphorylation. Nephrotoxic (give with probenecid)

444
Q

HAART regimens

A

2 NRTIs with 1 NNRTIs or 1 PI or 1 Integrase inhibitor

445
Q

Lopinavir, atazanavir, darunavir, fosamprenavir, saquinavir, ritonavir, indinavir

A

Protease inhibitors

446
Q

Toxicities of protease inhibitors

A

Hyperglycemia, GI intolerance, lipodystrophy (fat redistribution similar to Cushings)

447
Q

NRTIs (7)

A

Tenofovir, Emtricitabine, Abacavir, Lamivudine, Zidovudine, Didanosine, Stavudine

448
Q

Toxicities of NRTIs

A

Bone marrow suppression, peripheral neuropathy, lactic acidosis, rash, megaloblastic anemia

449
Q

NNRTIs (3)

A

Nevirapine, Efavirenz, Delaviridine

450
Q

Raltegravir

A

Integrase inhibitor. Inhibits HIV genome integration. Can cause hypercholesterolemia

451
Q

Uses for each of the interferons

A

Alpha - Chronic Hep B and C, Kaposi sarcoma. Beta - MS. Gamma - NADPH oxidase deficiency

452
Q

Toxicities of the interferons

A

Neutropenia

453
Q

Antimicrobials to avoid in pregnancy

A

Countless SAFe Moms Take Really Good Care. Clarithromycin, Sulfonamides, Aminoglycosides, Fluoroquinolones, Metronidazole, Tetracyclines, Ribavirin, Griseofulvin, Chloramphenicol

454
Q

What bacterium likes the gallbladder?

A

Salmonella typhi

Step 1 (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions