Microbiology Flashcards
1
Q
What is the gram stain?
A
Gram + is purple, and Gram - is red or pink
2
Q
What is Giemsa stain?
A
1) Chlamydia
2) Borrelia
3) Rickettsia
3
Q
What is the periodic acid-schiff stain?
A
Diagnose Whipple disease
4
Q
What is the Ziehl-Neelsen Stain?
A
1) Acid fast bacteria
2) Mycobacteria
5
Q
What is the India ink stain?
A
Cyptococcus
6
Q
what is the Silver Stain?
A
Fungi
7
Q
What is the selective media?
A
1) Favors growth of particular organisms (and prevents others)
8
Q
What is an indicator media?
A
1) Color change in response to metabolism of certain organism.
9
Q
What is the media fo H influenzae?
A
Chocolate agar
10
Q
Culture for gonorrhea?
A
Thayer-Martin
11
Q
Culture for pertusis?
A
Bordet-gengou
12
Q
Culture for c, diptheriae?
A
Tellurite agar
13
Q
Culture media for tuberculosis?
A
Lowenstein-Jensen
14
Q
Culture for pneumonia?
A
Eaton agar
15
Q
Culture for lactose-fermenting enterics?
A
MacConkey agar
16
Q
What is culture media for e coli?
A
Eosin-methylene blue
17
Q
What is culture for legionella?
A
Charcoal yeast
18
Q
What is the culture for fungi?
A
Sabouraud agar
19
Q
Why are anaerobes difficult to culture?
A
They produce gas in tissue (CO2 and H2)
20
Q
What are the obligate intracellular bugs?
A
Stay inside cells when it`s really chilly and cold
Ricketsettsia, Chlamydia, Coxiella
21
Q
What are the facultative intracellular bugs>
A
Some Nasty Bugs May live Faculatatively Salmonella Neisseria Brucella Mycobacterium Listeria Francisella Legionella Yersina pestis
22
Q
What are examples of encapsulated bacteria?
A
1) Pesudonomas
2) Stretocoocus
3) E coli
4) Salmonella
5) Klebsiella
23
Q
What are the encapsulated bacteria vaccine?
A
1) Pneumococcal vaccine
2) H influenzae
3) Meningococcal vaccine
24
Q
What are urease postive organisms?
A
They hydrolze urea and release ammonia
1) Proteus
2) Cryptococcus
3) H. Pylori
4) Ureaplasma
5) S. epidermis
25
What are catalase-postive organisms?
Catalase degrades H2O2 into H20 and bubbles of O2
26
What are pigment producing bacteria?
1) Actinomyces: yellow
2) S. Aureus: yellow
3) P. aeruginosa: blue-green
4) Serratia: red
27
Which bacteria produce biofilm, and what is the likely cause?
1) S epidermis: catheter and prosthetic device
2) Viridens : dental plaques, infective endocarditis
3) P aeruginosa: respiratory tree
4) H influenza: ottis media
28
What are bacterial virulence factors?
1) Protein A (binds Fc region of IgG and prevents opsonization)
2) IgA protease (cleves Iga)
3) M protein (prevent phagocytosis)
29
What is transformation of a bacteria?
Can take up new DNA (S. Pneumonae, H. influenxae, Neisseria
30
What is transposition?
A segment of DNA can jump to another (can have excision and reintergration) even to another type of bacteria
31
What are spores?
Bacteria can form spores at the end of stationary phase, when nutrients are limited.
Highly resistant to heat, can be killed by steaming to 121 C
32
What are examples of bacteria that
1) Antracis
2) Bacillus cereus (food poisoning)
3) Botulism
4) C. Difficile (pseudomembrane colitis)
5) Perfingens: gangrene
6) Tetani: tetanus
33
What are key characteristics of exo vs endotoxin?
| What are the typical diseases?
Exotoxin
1) Very fatal
2) Heat destroys art 60 degrees
3) Typical disease Tetanus, botulism, diptheria
Endotoxin
1) Fever shock and hypotension
2) Stable at 100 degress
3) Meinococemia
34
What disease are caused by corynebacterium?
Pharyngitis
Pseudomonas
Lympadenopathy
(diptheria endotoxin)
35
What is pseudomonas cause?
Host cell death (exotoxin A)
36
What diseases caused by Shigella?
1) Shiga toxin
| 2) GI mucosa damage, dysentry (Hemolytic uremic syndrome)
37
What disease caused by Enterohemorraghic e Coli?
1) Shiga-like toxin
2) Causes hemolytic uremic syndrome)
3) Does not invade cells.
38
What causes enterotoxigenic e-choli?
water diarrhea
39
What toxin is released by bacillus anthracis?
1) edema toxin
| 2) Causes black eschar around cutaneous
40
What does vibrio cholera cause?
1) Voluminous rice-water diarrhea
| 2) Cholera toxin
41
What does bordella pertusis cause?
1) whooping cough
42
How does the clostridium tetani cause?
1) Toxin is tetanospasmin
| 2) Causes paralysis , lockjaw ( prevents release of inhibtatory GABA)
43
How does clostridium botulism cause>
1) Botulism toxin
| 2) Prevents release of ACh stimulatory (flaccid paralysis)
44
How does clostridium perfringens cause disease?
1) Alpha toxin
| 2) Myonecrosis (gas gangrene) with hemolysis
45
How does streptococcus pyogenes cause disease?
1) Streptolysin O
| 2) Lysis of RBC with B-hemolysis
46
How does staph aureus work?
1) TSST-1 toxin
| 2) Toxic shock that causes fever, rash, shock
47
What are the 3 mechanisms of endotoxins?
1) Macrophage activation
2) Complement activation
3) Tissue factor activation
48
What are the symptoms caused by macrophage activation?
1) Fever
| 2) Fever and hypotension
49
What symptoms are caused by complement activation?
1) Hypotension
| 2) edema
50
What symptoms are caused by tissue factor activation?
DIC
51
What bacteria are susceptible to novobiocin? (Staph)
1) Saprophyticus resistant
| 2) Epidermis is sensitive
52
What bacteria are sensitive to optochin? (strep)
1) Virdens is resistant
| 2) Pneumonia is senstive
53
What is sensitive to bacitracin?
1) Group B is resistant
| 2) Group A is sensitive
54
What are the characteristics of staphlococus spaorphyticaus?
What part of normal flora?
What does it cause?
1) Gram +
2) Catalase +
3) Coagulase -
4) Genital and perineum flora
5) Second cause of uncomplicated UTI
55
What are characteristics of staph pneumonae?
| What diseases does it cause?
1) Gram +
2) Diplococci
3) encapsulated
```
Disease caused:
Meningitis
Otitis Media
Pneumonia
Sinusitis
```
56
What medical procedure is associated with strep pneumonae?
1) Patients with sickle cell disease and splenectomy
| 2) No virulence without the capsule.
57
What are the characteristics of step. viridens?
| Broadly called viridens
1) Gram +
2) alpha hemolytic
3) Strep viridens sanguinis (produces fibrin aggregates on damaged heart valves
4) Viridens in the mouth (dental procedures)
58
What are some diseases that streptococcus pyrogenes produce?
1) Pharyngitits, cellulitis, impetigo,
2) Toxigneic-scarlet fever, toxic shock, necrotizing pharyngitis
3) Immunologic, rheumatic fever
59
What are critieria for acute rheumatic fever?
1) Joints-polyarthritis
2) Carditis
3) Nodules (subcutaneous)
4) Erythemia
5) Sydenham chorea
6) Pharyngitis
60
What are signs of scarlet fever?
1) Blanching, sandpaper-like rash
| 2) Strawberry like tongue
61
What are characteristics of streptococus agalactia?
1) Gram +
2) Cocci
3) Bacitracin resistent
4) B hemolytic
5) Colonizes the vagina
62
What are the clinical implications of agalactae?
1) Meningitis and sepsis in babies
2) Hippurate test +
3) Screen pregnent woman at 35-37 weeks
4) If are +, then give penicciline prophylaxis
63
Where is streptococcus bovis found?
| What are the properties of the organism?
1) Gram + Cocci
2) Boivis found in the blood
3) Linked to cancer of the colon.
64
What are the properties of enterococci?
| What do they cause?
1) Gram + coci
2) Enterococci are normal colonic flora
Pen G persistent
UTI
Bilary tract ingections
Suacute endocarditis
NOTE:
Entero: intestinal
Faecalis: feces
65
What are the characteristics of antracis?
1) Gram +
2) Spore forming
3) Have a polypeptide capsule that contains D-glutamate
66
What are the characteristic lesions of cutaneous anthrax?
1) Painless papule surrounded by vesicles
2) Ulcer with black eschar
3) Painless and necrotic
4) Leads to bacteremia and death
67
What are the signs of pulmonary anthrax?
1) Inhalation of spores
| 2) Flu-like symptoms that are fever, and pulmonary hemorrhage, mediastinitis and shock
68
What are characteristics of Bacillus cerus?
| What is the clinical picture associated with it?
1) Gram + rods
2) Reheating rice (spores aren't killed by cooking rice(
3) Cause nausea and vomiting within 1-5 hours
4) Caused by cereulide (preformed toxin)
5) Causes diarrehea, nonbloody, and GI pain within 8018 hours.
69
How does C tetani cause symptoms?
1) Blocks the release of GABA neurotransmittors from Renshaw cells in the spinal cord
70
What are the signs of C. Tetani?
1) Paralysis
2) Trismus *lockjaw*
3) Sardonicus (raised eyebrow and open grin)
71
How to treat the C. tetani?
1) Antitoxin
2) Vaccine + booster
3) Diazepam for muscle spasm
4) Wound debridement
72
What does C perfringens cause?
1) Produces alpha lecithinase
2) Give gas gangrene
3) Enterotoxi can survive undercooked food
73
What are the types of toxin secreted by C didficile?
1) Two types: toxin A, and enterotoxin (binds to border of gut)
74
what is the cause of C difficile?
1) After taking clindamycin
| 2) Can be associated with PPI
75
How is C. difficile diagnosed?
1) Detecting the toxins in stool by PCR
76
How to treat the C.Difficile diarrhea?
1) Metronidazole
2) Vancomycin
3) Fidaxomicin
4) Fecal microbiota transplant.
77
What is the effect of corynebacterium diptheriae?
1) Gram + rod
2) Cause pseudomembraneous (grayish-white membrane)
3) Elek test of toxin
78
What are the properties of listeria monocytogens?
1) They are gram + intracellular rods
| 2) They can be acquired by ingestion of dairy products transplacental transmission, or vaginal transmission
79
What are the diseases associated with listeria?
1) Amnionitis
2) Speticemia
3) Spontaneous abortion
4) Meninggitis (immunocompromised)
5) Gastroenteritis
80
How is listeria treated?
Ampicilline within infants
81
What are the differences between the no cardia and the actinomyces?
```
Nocardia:
1) Aerobe
2) Acid fast
3) Found in soil
Cause pulmonary inection in immunocompromised
```
Actinomyces:
1) Anaerobe
2) Not acid fast
3) Found in oral, reproductive and GI flora
4) Cause oral, and facial abcesses that drain through the sinus tract
82
How are infections with Nocardia treated?
1) With septra
83
How are actinomyces treated with?
1) Penicillin
84
what is the difference in PPD test, if have primary vs secondary tuberculosis?
1) PPD + (current infection or past exposure)
| 2) PPD- if no infection, and in sarcoidosis
85
What is the physiopathology of primary tubercuosis?
1) exposure to the mycobacterium
2) Presence of hilar nodes
3) Presence of Ghon focus
(infection)
There are then two pathways:
Pathway A:
a) > 90% Healig by fibrosis , calcification, and are tuberculin +
b) then you have reactivation
c) Secondary tuberculosis (fibrocaseous cavitary lesions, in the upper lobes)
c) Leads to localized, destructive disease
Pathway B:
1) There is no healing of the fibrosis or calcification
2) There is progressive, primary tuberculosis (AIDS/malnutrition)
3) Results in bacteremia, miliary tuberculosis
86
What are characteristics of miliary tuberculosis?
1) Lungs
2) Liver
3) Spleen
4) Adrenal glands
5) Joints and long bones
87
What are the different types of Mycobacteria (and what diseases do they cause)
1) Mycobacterium tuberulosis (often resistant to multiple drugs)
2) M avium-intracellulaire: dessiminated non-TB in aids (often resistant to multiple drugs)
3) Mycobacterium scrofulaceum: cervical lyphadenitis in children
4) Mycobactrium marinum: hand infection within handlers
88
What bacteria causes leprosy?
1) Mycobacterium leprae (acid fast bacillus)
89
What are the two form of leprosy?
1) Lepromatous: Presents diffusely over the skin, with lion-like facies
2) Tuberculoid: hairless plaques with high cell mediated immunity
90
What is the treatment for different types of leprosy?
1) Lepromatous form: clofazimine
| 2) Tuberculoid: rifampin and dapsone
91
What are examples of lactose producing bacteria?
1) Klebsiella
2) E coli
3) Eneterobacteria
4) Serratia
92
What type of agar should lactose bacteria grow on?
```
MacConKee (k=kelb, e=Ecoli, E=entero)
OR
EMB Agar (this turns purple, while E Coli in this agar, turnsgreen)
```
93
What are the differences between nesseria gonococci and meningococci?
Gonocci:
No polysaccaride capsule
No vaccine
Causes gonorrhea, septic arthritis, pelvic inflammatory disease and Fitz-Hugh syndrome
Meninococci
1) Polysccaride capsule
2) Maltose fermentaion
3) Causes meningococcemia with petechial hemorrahe and gangrene of toes
Waterhouse-friderichsen syndrome: adrenal insufficiency, fever, DIC
94
What is the treatment for gonococi vs meningococci?
1) Gonococci: Ceftriazone, azithromycine (eye ointment in new borns prevents blindness)
2) Meningococci:
Rifampin, ceftriaxone, ciprofloxacin
95
What gram is H.Influenzae?
1) Gram -
96
What type of infection does H. Influenzae cause?
1) Ottitis media
2) Conjunctivitis
3) Bronchitis
4) Epiglottis (cherry red in children)
5) Penumonia
6) Meningitis
97
What is the agar for H. influenzae?
1) Chocolate agar
98
What is used to treat H. influenzae?
1) Amoxicilline
| 2) Clavuline
99
When is the H. Infulenzae vaccine given?
| what does it consist of?
1) Capsular polysaccharide
| 2) 2-18 months of age
100
What are the characteristics of bordella pertusis?
1) Gram -
| 2) Aerobic cocobacillus
101
What disease is caused by bordella pertusis?
1) The whopping cough
102
What type of medium does legionella grow on?
| What gram and shape is it?
1) Uses silver, and grows on charchol
103
How is legionella transmitted?
1) Not by person to person
| 2) Aerosol transmission, from water source habitat
104
What are the 2 diseases that are caused by legionelle pneumophila?
1) Legionnaires disease: severe, lobar pneumonair (unilateral), fever, GI
- common in smokers and chronic lung disease
2) Pontiac fever: mild-flu like syndrome
105
What are microbiological characteristics of pseydonomas?
1) Gram -
2) Rod
3) Produce blue-green pigment
4) Endotoxin (fever, shock)
5) exotoxin A (inactivates EF2)
106
What are diseases of pseudomonas?
1) Pneumonia
2) Sepsis
3) UTI
4) Diabetes
5) OSteomyletis
6) Otits externa (swimmers ear)
7) Nosocomial infections (Catheter)
107
What are possible treatments of pseudomonas?
1) Carbapenems
2) Aminoglycosides
3) Monobactams
4) Fluoroquinolones: cipro and leve
Aeruginosa -aerobic
108
what is Ecthyma gangrenosum?
1) Caused by pseudomonas gangrenosum
| 2) Necrotic cutaneous lesion, seen in immunocompromised patients
109
Name all the strains of E.Coli, and the presentation?
1) EIEC: I (invasive dysentry), invades intestinal mucosa and causes necrosis and inflammation)
2) ETEC: traveler's diarrhea
3) EPEC: Pediatrics (watery diarrhea)
4) EHEC: O157: H7 (usually in leafy vegetales of uncooked meat)
110
What are the microbiological characteristics of Klebsiella?
1) Gram -
| 2) Rods
111
What are the diseases caused by Klebseilla?
1) Apiration pneumonia
2) Abcess of the lungs
3) Alcoholics
4) Diabetes
(tends to have currant Jelly sputum)
112
What are the microbiological characteristics of campylobacter jejuni?
1) Gram -
113
How is campylobacter jejuni transmitted?
1) Fecal oral contraimination
2) Person to person contact
3) Undercooked poultry or meat
4) Contact with infected animals: dog, cats
114
What disease is associated to Campylobacter jejuni?
1) Guilliain Barre syndrome
| 2) Reactive arthritis
115
What are the different characteristics between salmonella typhi and salmonella and shigella
Salmonella typhi vs salmonella species vs shigella
1) Reservoir: Human only vs. human and animal. vs human only
2) Infectious dose: high ve highvs low
3) GI manifestations: Constiptation followed by diarrhea vs. Diarrhea vs. Bloody diarrhea
4) Vaccine: oral vaccine with attenuated S.Thyphi vs no vaccine vs no vaccine
5) Unique properties: causes typhoid fever (treat ceftriaxone or fluoroquinone vs. poultry, eggs, pets, vs. fingers, food, feces and flies
116
What are the microbiological characteristics of cholerae?
1) Gram -
| 2) Flagellated
117
What are the clinical symptoms?
1) Rice water diarreha through enterotoxin
2) Sensitive to acid bile
3) Requires prompt rehydration
118
Where is Yersina enterocolitica usually found?
1) Transmitted from pet feces
| 2) Contaminated pork
119
What does Yersina enterolitica cause?
1) Acute diarrhea
| 2) Pseudoappnedicitis (mesenteric adenitis or ileitis)
120
What are characteristics of H. pylori?
1) Gram - rod
121
How is H. pylori diagnosed?
Urease breath test, or fecal antigen test
122
What does H pylori cause (disease)?
1) Ulcer disease
| 2) gastric adenocarcinoma
123
How is H. Pylori treated?
1) Clarithromycin
| 2) Proton pump inhibitor
124
What do leptospira interrogans?
1) Myalgias
2) Jauedice
3) Photophobia
4) Weil disease: severe jaunedice, and kidney dysfunction, fever, hemorrhage
125
What disease does Borrelia burgdorferi?
Lyme disease
126
What is the natural resevoir of borrelia burgdorfei?
1) Resevoir is the mouse
| 2) The vector is the ixodes deer tick
127
What are the stages of Lyme disease?
Stage 1: localized erythema, flu like symptoms
Stage 2: Early dessiminated carditis, AV block, facial nerve palsy
Stage 3: late encephalopathies, chronic arthritis.
128
What bacteria causes syphilis?
Treponema pallidum.
129
What are the symptoms of primary syphilis?
| How to diagnose?
1) Painless chancre
2) Dark field microscopy will see treponemes
3) Will be VDRL +
130
What are the signs of secondary syphilis?
1) constitutional symptoms
2) Condylomata lata (looks like a wart on genitals)
(Systemic)
131
How to diagnose secondary syphilis?
1) VDRL/RPR
| 2) FTA-ABS to confirm the diagnosis
132
What are the characteristics of tertiary syphilis?
1) Chronic granulomas
2) Aortitis (vasa vasorum destruction)
3) Neurosyphilis (protitute sign with pupil that accomodates but doesn't react)
133
What are tests that are positive (clinically for neurosyphilis)?
1) Broad based ataxia
2) Romberg +
3) Charcot joint
4) Stroke and HTN
134
How to test for neurosyphilis?
1) Spinal fluid with VDRL
2) FTA-ABS
3) PCR
135
What are signs of congenital syphilis?
1) Facial abnormalities such as rhagades (linear scars at angle of the mouth)
2) Saddle teeth (gap between the two front teeth)
3) Nasal discharge
4) Short maxilla
5) Saber shins
6) CN VII deafness
136
How to prevent congenital syphilis?
Treat in the first trimester (has placental transmission)
137
What are causes of false postsitive VDRL?
1) Viral infection (EBV, hepatitis)
2) Drugs
3) Rheumatic fever
4) Lungs and leprosy
138
What is a Jarisch-Herxheimer reaction?
1) Flu-like syndrome (fever, chills, headache, myalgia) after antibiotics have killed bacteria (usually spirochetes) and it releases toxins.
139
For the following bacteria (zoonosis: transmission between animals and humans) name the disease and the animal?
1) Anaplasma
2) Bartonella
3) Borrlia burgdorferi
4) Borelia recurrentis
5) Brucella recurrentis
6) Campylobacter
7) Chlamdophila psottaci
8) Coxiella burnetii
9) Ehrlichia chaffeensis
10) Francisella tularensis
11) Leptospira
12) Mycobacterium leprae
13) Pasturella multicoda
14) Rickettsia prowazekii
15) Ricketsettia typhi
16) Salmonella
17) Yersina Pestis
1) Anaplasma: Anaplasmosis, Ixodes ticks on deer and mice
2) Batonella: Cat scratch, bacillary angiomatosis, cat
3) Borrelia burgdorferi, Lyme disease, Ixodes ticks (deer and mice)
4) Borrelia recurrentis: relapsing fever, Louse
5) Brucella: Brucellosis/undulant fever (unpasterized dairy)
6) Campylobacter: bloody diarrehea, feces from infected pets, or contaiminated meat/foods/hands
7) Chlamydophilia psittaci: Psittacosis, parrots and other birds
8) Coxiella burnetil: Q fever, aerosols and sheep amniotic fluid
9) Ehrilichia chaffeenis: Ehrlichiosis, Lone star Tick
10) Francisella tularensis: Tularemia, Ticks, Rabbits, deer flies
11) Leptospira: Leptospirosis, animal urine in water
12) Mycobacterium leprae: Leprosy, humans with lepromatous leprosy
13) Pasterella mutlocida: cellulitis, osteomylitis, animal bites, cats and dogs.
14) Rickesettia prowazekii: endemic typhus, human to human via body louse
15) Rickettsia rickettsii: Rocky Mountain spotted fever, Dog tick
16) Rickettsia typhi: endemic typhus, fleas
17) Salmonella: Diarrhea, reptiles and poultry
18) Yersina Pestis: Plague, rats
140
What are characteristics of gardneralla vaginalis?
1) Gram variable rod
2) Presents as gray, vaginal discharge with fishy smell
3) Associated with sexual activity (but not sexually transmitted)
4) Fishy smell, grey discharge
141
How is gardneralla vaginalis diagnosed and treated?
1) Metronidazole or clindamycin
142
What are the characteristics of Rocky Mountain Spotted fever?
1) Rash on palms and soles
| 2) INfection (hand, foot, mouth)
143
What are clinical characteristics of typhus?
Rickettsia Typhi
| The rash starts centrally and spreads out
144
What are characteristics of Q fever?
1) Coxiella burneii
2) Present as pneumonia
3) Common cause of culture negative endocarditis.
145
What are the two types of Chlamydia?
1) Chlamydia tachomatis: Reactive arthritis (Reiter syndrome), follicylar conjunctivitis, non gonococcal arthritis
2) Chlamydophilia pneumoniae: pneumonia
146
How to treat Chlamydia?
1) Azithromycine, and doxycylcine
147
What are the different chlamydia serotypes, and what do they cause?
1) A, B, C : chronic infection, and blindness, follicular conjunctivitis
2) Types D-K: Urethritis,PID, eosinophilia, neonatal conjunctivitis
3) Type L1, L2, L3: lymphgranuloma venereum
(painless, swollen ulcers)
148
What are the clinical presentation of mycoplasma pneumonia?
1) Insidious onset
2) Headache
3) Non-productive cough
4) Patchy or diffuse infiltate
5) X-ray looks worst then the patient
149
What happens with the mycoplasma cold agglutinins?
1) High titers which can agglutinate or cause lysis of RBC
150
What are the characteristics of systemic mycoses?
1) Caused by dimorphic fungi mold, and yeast
151
How to treat systemic mycosis?
1) Local: flucanozole or itraconozole
| 2) Systemic: amphotercin B
152
Where is histoplasmosis found?
1) Ohio and Mississippi Valley
| 2) Bird or bat droppings
153
What does Blastomycosis cause?
| Where can it be found?
1) Eastern United States and Central America
2) Inflammatory lung disease (desiminate to skin and bone)
Forms granulomatous nodules
154
Where is coccidoidomycosis found?
| What does coccidomycosis cause?
1) Pneumonai and meningitis
2) Diseeminate to skin and bone
3) Spores thrown up after earthquakes
4) Found in San Joaquin Valley Fever
5) Cause erythem nodosum
6) Can cause arthralgias
155
How does paracocidiomycosis look on microscopy?
| Where does it come from?
1) Resembles a captain's wheel
| 2) Comes from Latin America
156
What does Tinea dermatophyte cause?
| How to diagnose?
1) Cutaneous fungi
| 2) KOH stain
157
What is tinea capitis?
Fungus on the head, can cause alopecia and scaling
158
What is tineas corporis?
On torso, and scaling ringworms
159
What is tinea curis?
Inguinal area
160
What are the 3 types of Tinea pedis?
1) Interdigital
2) Mocassin
3) Vesicular type
161
What is Tinea unguium?
Onychomycosis occurs on the nail
162
What is tinea versicolor?
1) Causes pale patches of the skin (damages malanocytes)
2) Usually occurs in hot, humid weather
3) Treatement: selenium sulfide, or antifungal medication
4) On microscopy looks like spagetthis and meatball.
163
What can candida albicans cause?
1) Systemic or superficial fungal infection
2) Diaper rash
3) endocarditis
4) Disseminated candidas
164
How to treat candida albicans?
1) Nystatin
2) Flucanozole
3) Caspofungin
4) Amphotericin B
165
What does apergillus fumigatus cause?
1) Invasive aspergillosis in immunocomporomised with chronic granulomatous disease
2) Especially susceptible if have chronic lung disease (such as tuberculosis)
166
What substance secreted by the aspergillus is associated with heptocellular carcinoma?
Alfatoxins
167
What is allergic bronchopulmonary aspergillos?
Hypersensitivity response associated with asthma and cystic fibrosis (can have bronchiectasis and eosinophilia)
168
Where is cryptococcus neoformans found? What disease does it cause?
1) Found in the soil and in pigeon droppings
2) Acquired through inhalation with hematological spread
3) Causes crytococcus meningitis, encephalities, usually in immunocompromised patient
169
Who does Mucor and Rhizopus attack? What does it cause?
1) Usually in ketoacidotic diabetic or neutropenic patients (leukemia)
2) Cause abcess in the brain and sinus thrombosis
3) Can lead to headache, facial pain, and black eschar on face
170
What is the treatment for Mucor and Rhizpus attack?
Surgical debridement and amphotericin B
171
What disease does pneumocystitis jirovecii cause?
1) Pneumocyctis pneumonia (diffuse, intersitital)
2) Yeast-like
3) Diffuse ground glass on chest or CT scan
4) Diagnosis by lung biopsy or lavage
172
What is the treatment for pneumocystitis?
1) TMP-SMX
2) Pentamidine
3) Dapsone
173
In HIV, when should prophylaxis of pneumocytitis start?
When cells drop
174
What disease does sporothrix scheneckii cause?
| How is the diease treated
1) Usually caused by a rose thron
2) Causes a pustule or an ulcer
3) Treated with itraconazole
175
The parasite Giardia lambia, disease, transmission, diagnnosis?
1) Giardiasis: bloating, flatulence, foul smelling diarrhea
2) Transmission: Cysts in the water
3) Diagnosis: trophozoites or cysts in the stool
4) Treatement: Metronidazole
176
What are the disease, transmission, diagnosis, treatment of Entamoeba histolytica?
1) Amebiasis: bloody diarrhea, lover abcess and pain
2) Transmission: cysts in water
3) Trophozoites in the RBC
4) Treatment: metronidazole, iodoquinol for assymptomatic cysts
177
What does cryptosporidium cause, transmission, diagnosis, and treatment?
1) Severe diarrhea in patients with AIDS
2) Mild watery in immunocompetent hosts
3) Transmission: oocysts
4) nitazonxanide
178
What does toxoplasma cause, transmission, diagnosis, and treatment?
1) Congenital toxoplasmosis: chorioetinitis, hydrocephalus, intracranial calcifications, reactivation of AIDS, brain abcess
2) Transmission: cysts in mean, oocysts in cat feces, crosses placenta
3) Diagnosis: serology and biopsy
4) Treatment: Sulfadiazine
179
What does Naegleria fowleri cause, transmission, diagnosis, and treatement?
1) Rapidly fatal meningoencephalitis
2) Transmission: freshwater lakes
3) How to diagnosis: Amoebas in the spinal fluid
4) Treatement: ampotericin B
180
What does Trypanosoma brucei cause, transmission, diagnosis, and treatment?
1) African sleeping sickness (recurring fever, coma)
2) Transmission: Tsetse fly
3) Trypomastigote in blood smear
4) How to treat: Suramin for blood borne disease
5) Melarsoprol for CNS penetration.
181
What disease are caused by Plasmodium? Transimission, diagnosis, and treatment?
1) Disease is malaria: fever, headache, anemia, splenomegaly
2) Transmision: mosquito
3) Diagnosis: Trophozoite ring within the RBC
4) Treatment: Chloroquine, Plasmodium heme, IV mefloquine, atovauone, if life threatening artesunate
182
What are the different species of plasmodium, and what is the effect clinically?
1) Vivax/ Ovale48 hour cycle of fevers
2) Falcipurum: irregular patterns (parasitized RBC occlude capillaries in the brain
3) Malariae: 72 hour cycle
183
What are cause, transmission, and treatment of Babesiosis?
1) Causes fever an hemolytic anemia in northwestern United States
2) Transmission: Ixodes tick
3) Diagnosis: blood smear
4) Treatment: Atovaquone + azithromycin.
184
What does trypanosoma cruzi cause, transmission, diagnosis, treatment?
1) Chagas disease (dilated cardiomyopathy, megacolon, megaesophagus, in South America)
PERIOMBILICAL swelling is characteristics
2) transmission: Eduviid bug (kissing), feces, painless bite
3) Diagnosis: Trypomastigot blood smear
4) Treatment: Benznidazole, nifirtimox,
185
What are characteristics of leishmanias, transmission, diagnosis, and treatment?
1) Spiking fevers
2) Heptaosplenomagealy, pancytopenia
3) Cutaneous leishmaniasis (skin ulcers)
4) Diagnosis: macrophages with amastigotes
5) Treatement: Amphotericin B (sodium stiboglucose)
186
What are causes, transmission and diagnosis of Trichmonas vaginalis?
1) Vaginitis: foul smelling and greenish discharge with itching and burning
2) Sexual transmission
3) Diagnosis: trophozoites
4) Treatment: metronidazole
187
What are the nematode method of infection?
1) Usually through ingestion (enterobius, ascaris, toxocara, trichinella)
2) Cutaneous: stronyloides, ancylostoma
3) Bites: loa, onchocerca volvulus
188
What type of immune response to helminths?
1) Esonopilstype 1 or type 2 hypersensitivity
2) Type 1: neutralize of histamines and leukotrienes
Type 2: esonophils attach to surface of helaminths via IgE
189
What disease enterobius vermicularis cause, transmission, and treatment?
1) Infection that causes pruritis
2) Diagnosis with seeing the egg,and via the tape test
3) Transmitted by fecal-oral
4) Trreatment with bendazoles
190
Disease, transmission, and treatment of ascaris lumbridoides?
1) Intestinal infection with obstruction of ileocecal valve
2) Fecal-oral in feces
3) Bendazoles
191
What is disease, treatment, and transmission of stronguloides stercoralis?
1) Intestinal infection causing vomiting, diarrhea, and epigastric pain
2) Transimission: larvae in the soil, penetrate the skin
3) Treatment: lvermectin or bendazoles
192
What disease, transmission,caused by Ancylostoma duodenale, necator americanus (hookworms)?
1) Intestinal infection causing anemia and sucking blood
2) Transmission by walking barefoot in the beach
3) Larvae penetrate the skin
4) Benzaoles nad pyrantel
193
What is the disease, transmission, and treatment of trichinella spirais?
1) Intestinal infection with larvae, that encyst withing the muscle cells and cause inflammation
2) Sympoms of fever, vomiting, nausea, and myalgia
3) Transmission: fecal-oral and undercooked meat
4) Treatment: Benzaoles
194
What is disease, transmission, and treatment of toxocara canis?
1) Nematodes migrate through blood, and cause inflammation and damage
2) Organs affected inclode heart, liver, and CBS (seizures)
3) Fecal-oral transmission
4) Bendazoles (treatment)
195
What is disease, transmission, for onchocera volvulus?1)
1) river blindness
2) Skin changes
3) Allergic reaction to microfilaria
4) Transmission by the female blackfly
5) Treatment by ivermectin)for liver blindness)
196
What is disease of loa loa?
1) Swelling of skin, and worms in conjunctiva
2) Transmission by deer fly, horse fly, and mango fly
3) Treatment by diethylcarbamazine
197
What disease by Wuchereria bancrofti?
1) Elephantiasis (worms imvade the lymph nodes and cause inflammation)
2) Transmission: female mosquito
3) Treatment:dietylcarbamzine
198
What are the 3 types of cestodes? (Tapeworms)
1) Taenia Solium
2) Diphyllobothrium latum
3) Echinococcus granulosus
199
What is disease of Taenia solium?
1) Intestinal tapeworm
2) Transmission by larvae encysted in undercooked pork
3) Treatement: Praziquntel
200
what is the disease of cestode diphyllobothrium latum?
1) Vitamin B deficinecy, the tapeworm competes for B12 in the intestine causing megaloblastic anemia
2) Treatment: praziquantel
201
What is the disease and treatment ofechinococcus granulosus?
1) Hyatid cysts in the liver
2) Can have anaphylaxis if antigen is released
3) Need to inject the cyst with ethanol or hypertonic saline to kill daughter cysts.
4) Transmission: ingestion of eggs from dog feces
202
What are the two types of trematodes?
1) Schistosoma
| 2) Clonorchis sinensis
203
What are the disease, transmission, and treatment of schistoma?
1) liver and spleen enlargement, fibrosis and inflammation
2) Transmission by snails
3) Treatement: praziquantel
204
What can S. Haematobium cause?
Squamous cell carcinoma of the bladder and pulmonary hypertension
205
What does clonorchis sinesis cause?
1) Bilary tract inflammation
2) Pigmented gallstones
3) Cholangiocarcinoma
206
What do scabis cause ? (sarcoptes scabiei)?
1) Mites that burrow into the stratum corneum and cause pruritis
2) Usually in webspace of the hands and feet
3) Treatment: permthrin cream (washing the bedding)
207
What does lice (pediculus humanus cause)?
1) Blood sucking insects that live in clothing (puritis, pink macules and papules)
2) Treatment: pyrethroids, malathion or ivermectin lotion and combing
208
Viral genetics, meaning of recombination?
exchange of genes between 2 chromosomes with significant sequence homology
209
Viral genetics, reassortement?
Virus with segmented genome (influenza virus) exchange of genetic material (H1NI influenzae)
210
Viral genetics, complementation?
Have two viruses.
1 infects the cell with a non-functioning gene
The second has that gene functioning, and produces the missing protein
211
Viral genetics, phenotypic mixing?
When have simultaneous infection of a cell with 2 viruses. GenomeA, then coated with virus B antigens
212
What are the examples of the live, attenuated virus?
1) Small pox
2) Yellow fever
3) Chicken pox
4) Sabin
5) MMR (measles, mumps, rubella)
6) Influenza (intranasal)
213
Who should not be given live vaccine?
1) Immunocompromized patients
| 2) HIV can be given if no signs of immunocompromised patient.
214
Which vaccines are dead?
1) Rabies
2) Influenza
3) Salk, polio
4) Hepatitis A
215
Which are subunit vaccines?
Hepatitis B
216
Which DNA virus is NOT double stranded?
Parvovirus
217
Which RNA virus are NOT single stranded?
Reoviridae
218
Which viral genome is infective?
Purified nucleic acid of most doublestranded DNA (except HBV) is infectious
Naked ssRNA and dsRNA are usually not infectious
219
Where do DNA virus replicate?
In the nucleus
220
Where do RNA virus replicate?
In the cytoplasm
221
What are some general rules about DNA virus?
1) HHAPPY (hepna, herpes, adeno, pox, parvo, papilloma, plyoma
2) Doubles stranded except parvo
3) Have linear genomes
4) Are icosahedral
5) Replicate in the nucleus
222
What do the following viruses cause?
1) Poxvirus
2) Hepadnavirus
3) Adenovirys
4) Papillomavirus
5) Polyomavirus
6) Parvovirus
1) Poxvirus: small pox, molluscum contagiosum (flesh coloured papule)
2) Hepadnavirus: Acute or chronic hepatitis
3) Adenovirus: febirl pharyngitits, pneumonia, conjunctivitis
4) Papillomsvirus: HPV warts
5( Polyomaviurs: leuckoencephalopathy in HIV
6) Parvovirus: Aplastic crisis in sickle cell disease, RBC desturction leading to hydrops fetalis, and rheumatoid arthritis and aplastic anemia in adults.
223
What are the types of herpes virus?
| What diseases do they cause?
1) Herpes simplex 1: giniovstomatitis, keratoconjuntivitis, can cause sporadic encephalitis
2) Herpes simplex 2: herpes genitalis, remains latent in sacral gaglia
3) Varicella Zoster (chicken box, shingles, encephalitis), latent in dorsal root or trigeminal ganglia
4) Epsetien Barr (kissing disease) mono (heptosplenomegaly and lymphadenopathy), associated with lymphoma, Burkitts and nasopharyngeal lymphoma
5) Cytomegalovirus (Mono) in patients, and causes retinitis inHIV patients
6) Human herpes virus 6 and 7 (Roseola infantum( high fevers with seizures
7) Herpes virus 8: Kaposi sarcoma ( HIV, transplant patients), can affect GI and lungs
224
What is the monospot test?
Heterophile antiboddies are detected by agglutination of sheep or horse RBC
225
How is HSV identification done?
1) Viral culture for skin/genitilia
| 2) CSF or PCR for herpes encephalitis
226
Disease for coltivirus?
Colorado tick fever
227
Disease for rotavirus?
Most common cause of fatal diarrhea in children
228
Disese for norovirus?
viral gastroenteritis
229
Diseases for flavivirus?
1) HCV
2) Yellow fever
3) Dengue
4) St-Louis encephalitis
5) West nile virus
230
Diseases for togavirus?
1) Rubella
2) Eastern equine encephalitis
3) Western equine encephalitis
231
Diseases for reterovirus?
1) HIV
| 2) HTLV
232
Diseases for coronovirus?
common cold
233
Disease for orhomyoxovirus?
influenzae
234
Disease for paramyxovirus?
1) Paraninfluenzae
2) respiratory virus
3) Measles, mumps
235
Disease with Rhabdovirus?
Rabies
236
Disease Filovirus?
1) Ebola
2) Marburg
Hemorraghic fever
237
Disease arenavirus?
1) LCMV (lymphocytic choriomeningitis)
| 2) Lassa fever
238
Disease Bunyavirus?
1) California encephalitis
2) Sandfly/Rift Valley
3) Crimean-Congo hemorraghic fever
4) Hantavirus : hemorraghic fever, pneumonia
239
Disease associated with Rhinovirus?
1) Runny nose
| 2) Acid labile, destroyed by the stomach acid
240
What is the mosquito for yellow fever?
| What are the symptoms?
1) Aedes mosquito
| 2) High fever, black vomit, jaunedice
241
What does the rotavirus due to intestinal?
1) Villous destruction which leads to atrophy and decreased absorption of Na+ and loss of K+
242
What are the two types of influenza virus?
1) Live attenuated vaccine (intra-nasal)
| 2) Killed vaccine
243
what does the flu shot contain?
Viral strains
244
What phenomenon causes pandemics?
Genetic / antigenic shift (reassortment of the viral genome)
245
What phenomen causes epidemics?
Antigenic drift (compared to SHIFT) for pandemics
246
What are the characteristics of rubella virus?
1) Fever
2) Postauricular and lymphadenopathy
3) Arthalgias
4) Starts at the face and trunk and moves outward.
247
What types of diseases does the paramyxovirus cause?
1) Mumps
2) Measles
3) Parainfluenza croup (seal like barking)
4) Respiratory tract infection (bronchiolitis and pneumonai)
248
What does croup (acute laryngotracheobronchitis) cause?
1) Narrowing of the upper trachea that is seen onx-ray
| 2) Can have pulsus paradoxus due to airway obstruction
249
What are the clinical sign of rubeola?
1) Cough
2) Coryza
3) Conjunctivitis
4) Usually starts with Koplik spots (bright spots on the buccal mucosa) and then followed by maculipapular rash
5) Can cause encephalitis, and giant cell pneumonia
250
What are signs of mumps?
1) Paroitis: (swelling of paritid gland..neck)
2) Inflammation of testes
3) Orchitisi
251
What are characteristics of rabies?
1) Found in Purkinje cells of cerebellum
2) Long incubation
3) Prophylaxis: wound cleaning and immunization with vaccine
4) Has passive-active immunity
252
What is progression of the disease of rabies?
1) Fever, malaise
2) Agitation
3) Photphobia
4) Excessive hypersalivation
5) Paralysis
6) Coma
7) Death
253
Which animals can transmit rabies?
1) Bats
2) Raccons
3) Skunks
4) Dogs
254
Hoe does Ebola virus work?
1) Targets endothelial cells, phagocytes, heptocytes
2) Incubation is 21 days
3) Flu symptoms, DIC, and hemorrage
255
How is Ebola transmitted?
1) Direct contact with bodily fluids, fomits, and primates, and bats
256
How is Ebola treated?
Supportive care (isolation)
257
What are signs of hepatitis?
Fever
Jaunedice
Increased ALT and AST
258
What is the transmission, incubation, clinical course, prognosis, hepato caricnoma risk, liver biopsy and carrier state of Hep A
1) Fecal-oral shellfish transmission
2) Short incubation (only a few weeks)
3) Asymptomatic clinical course
4) Prognosis: good
5) No carcinoma risj
6) Liver biopsy: have heptocyte swelling, infiltation
7) There is no carrier state
259
What is the transmission, incubation, clinical course, prognosis, hepato caricnoma risk, liver biopsy and carrier state of Hep B?
1) DNA virus
2) Blood transmission, sexual, and mother to child
3) Long incubation
4) Fever, rash, and may progress to carcinoma
5) Prognosis: most adults have full resolution, minority have chronic infection
6) There is HCC risk
7) Liver biopsy has ground glass appearnace, cytotoxic T cells
8) Carrier state uncommon
260
What is the transmission, incubation, clinical course, prognosis, hepato caricnoma risk, liver biopsy and carrier state of Hepatitis C?
1) Primarily after blood transfusion
2) Long incubation
3) May progress to cirrhosis and carcinoma
4) Majority have stable, chronic hep C
5) Have carcinoma risk
6) Liver biospsy: lymphoid aggregates with macrovesicular steatosis
7) Carrier state is common
261
What does Anti-HAV (IgM) and Anti-HAV (IgG) show?
1) IgM antibody to HAV, best to detect acute hepatitis A
| 2) Anti-HAV (IgG) prior HAV infection, or prior vaccination (protects against reinfection)
262
What does HBsAg show?
Antigen found on surface of HBV, indicates hepatitis B infection
263
What does Anti-HB show?
Antibody to HBsAg, indicates immunity to hepatitis B
264
What does HBcAg show?
Antigen associated with core HBV
265
What does Anti-Hbc show?
1) Antiody to HBcAg IgM (acute infection)
| 2) Antibody to HBcAg IgG: prior exposure or chronic infection
266
What does HbeAg show?
1) (envelope) secreted by the infected hepatocyte into circulation.
2) Indicates active viral replication
267
What does anti-HBe show?
Antibody to HBeAg indicates low transmissbility
268
How is the HIV diagnosis made?
1) ELISA (sensitive but high false positive rate RULE OUT)
| 2) Results are confirmed with Western blot assay (specific, low false positive)
269
For ELISA/Western blot, why are there false negatives in the beginning?
1) 1-2 months false positive, because they look for antibodies to the viral proteins
2) Can be falsely negative in first few months
3) Can be falsely + in new born babies (anti gp120 crosses the placenta)
270
What is the criteria for AIDS diagnosis?
271
What are the 4 stages of untreated infection?
1) Flu-like (acute)
2) Feeling fine (latent) .......during latent phase, virus replicates in lymph
3) Falling count
4) Final crisis
272
What are the results of decreasing CD4 count?
1) Reactivation of TB. HSV, shingles
2) Bacterial infection
3) Non-hodgekin's
273
What are infections associated with CD 4 less then 500?
1) Candida albicans (oral thrush)
2) EBV (oral hairy leukoplakia), white plaque on lateral tongue
3) Bartonella (bacillary angiomatosis, neutrophillic
4) HHV-8; kaposi sarcoma
5) Cryptosporidium: diarrhea
6) HPV: squamous cell carcinoma
274
What are infections after CD4
1) Dementia
2) JC virus (reactivation) multifocal leukoencephalopathy (signs of demylination)
3) Pneumocystis jirovecii: ground glass opacities
275
What are infections after CD 4
1) Apergillos (hemoptysis and pleuritic pain, infiltrates and cavities on chest x-ray)
2) Cryptococcus neoformans: meningitis (encapsulated yeast on india ink stain)
3) Candida albicans:esophalitis (white plaque on endoscoy)
4) CMV: retinitis, esophagitis, colitis, penumoitis, encephalitis (linear ulcers on endoscopy, cotton wool on fundascopy)
5) EBV (B cell lymphoma)
6) Histolasma capsulatuym: fever, weight loss, cough, dyspnea
7) Mycobacterium avium: fever, night sweats
8) Toxoplasma gondii: brain abcess (seen on MRI)
276
What is prion disease? Transmission?
1) Prion protien PrPc
2) Transmitted through CNS related tissue or contaminated BSE (varient of CJD)
3) Resistant to sterilizing procedures and standard autoclaving
277
What are the 3 varients of CJD?
1) CJD: rapidly progressing demntia (familial)
2) Boivine spongiform encephalopathy: mad cow disease
3) Kuru: acquired prion disease by tribal populations practicing human cannibalsim.
278
What is the normal flora for the following human areas?
1) Skin
2) Nose
3) Oropharynx
4) Dental plaque
5) Colon
6) Vagina
1) S. epidermis
2) S epidermis colonized by S.Aureus
3) Oropharynx viridans
4) Dental plaque : S. mutans
5) Colon: B. Fragilis
6) Vagina: lactobacillus
279
What are bugs that cause food poisoning? And where do they come from?
1) B cereus: reheated rice,
2) C. Botulinum: improperly canned food toxins, raw honey
3) C. perfringens: reheated meat
4) E Coli: undercooked meat
5) Salmonella: poultry, meath and eggs
6) S. Aureus: meats, mayo, and custard
7) S parahaemolyticu and vulnificus: contaminated seafood.
280
What are the bugs that cause bloody diarrhea? And defining characteristics?
1) Cambylobacter: S or comma shaped, growth at 42 degrees
2) E. Histolytica: Protozoan, amebic dysentry, liver abcess
3) Enterohemorraghic E Choli: Causes HUS, Shiga-like
4) Eneroinvasive E choli: traveler's diarrhea
5) Salmonella: Lactose -, has animal resevoir (poulty and eggs)
6) Shigella: shiga toxin
7) Y. Enterocolitica: day care outbreak, pseudo olympics
281
what are the bacteria responsible for watery diarrhea?
1) C. Difficile: pseudomembraneous colitis, caused by antibiotics
2) C perfrinegens: also causes gas gangrene
3) Enterotoxigenic ecoli: Travellers diarreha (heat labelled and heat stabile toxins)
4) Protozoa: Giardia, Cryptosporidium
5) V Cholera: Comma shaped organism, rice watr diarrhea
6) Viruses: Rotavirus, norovirus, adenovirus
282
What are common cause of pneumonia in neonates
1) Group B stretococi
| 2) E Choli
283
Most common cause of pneumonia children 4 weeks o 18 years old?
1) RSV virus
2) Mycoplasma
3) C. Trachomatis
4) C. Pneumoniae
5) S penumonaie
284
What are main causes of pneumonae 18-40 years old?
1) Mycoplasma
2) C. Pneumonaie
3) S. Pneumonaie
285
What are main causes of pneumonae 40-65 years?
1) S. pneumonia
2) H. Influenzae
3) Anaerobes
4) Virus
286
What are main causes of pneumoniae in the elderly?
1) S. pneumoniae
2) Influenza virus
3) Anaerobes
4) H. Influenzae
287
Main cause of pneumonia ETOH?
1) Klebsiella, anaerobes
288
Main cause of pneumonia IV drug user?
1) S. pneumonaie, S. Aureus
289
Main cause of pneumonia Aspiration?
1) Anaerobes
290
Main cause of pneumonia atypical?
1) Mycoplasma, legionella
291
Main cause in cystic fibrosis?
1) Pseudomonas
2) S. aureus
3) S. pneumonaie
292
Main cause of pneumonia in immunocompromised?
1) S. Aurus
| 2) Gram -
293
Main cause of pneumonia in hospitalized?
1) S. Aureus
| 2) Pseudomonas, gram -
294
Main cause of post viral pneumonia?
1) S. Pneumonia
| 2) S. Aureus
295
Cause of meningitis newborn?
1) Strep B
2) E choli
3) Listeria
296
Mengitis 6 months-6 years?
1) S. Pneumonia
2) N. Meningitiidis
3) H. Influenzae
297
Meningtitis: 6- 60 years old
1) S. penumonaia
| 2) N meningitidis (#1 in teens)
298
Meniningitis in 60 year olds and older?
1) S. pneumoniae
299
What is the emperical treatment for the meningitis?
1) Ceftriaxone and vanco
| 2) If suspect literia : add ampicilline
300
What are the viral cause of meningitis?
1) enterovirus (coxsackie virus)
301
What are the findings in CSF?
Opening pressure Cell type Protein Sugar
Bact. high incre PMN Increase dec
Fungal high inc. lymhocyte inc. dec
Viral normal inc. lymphp incre normal
302
What are infections that cause brain abcesses?
1) Strep viridens
| 2) Staph aureus
303
what are common pathways from the brain abcess?
Otitis media--- to mastoiditis ----- temporal cerebellum
OR:
Dental infection---frontal lobe
304
Most common cause of osteomyelitis?
Most common: S. Aureus
305
Cause ostromyelitis if sexually active?
Nesseria gonorrheae
306
Cause osteomyltis if sickle cell disease?
Salmonell and S. Aureus
307
Cause osteomyelitis if prosthetic joint replacement?
S. Aurues
| S. Epidermis
308
Cause osteomyletis if vertebral involved?
S. Aureus
309
Cause osteomyelitis if cat/dog bites?
Pasteurella multicida
310
Osteomyletis if IV drug abuse?
Pseudomonas, Candida
311
What are some clinical signs of osteomyletitis?
1) Elevated CRP and ESR
2) MRI
3) x ray good for chronic osteo but not acute.
312
What are risks for UTI?
1) women have shorter urethera
2) Kidney surgery
3) GU malformation
4) Diabetes
5) Pregnancy
313
What dipstick tests show the presence of UTI?
1) Leucocyte esterase
2) Nitrite positive
3) Urease test
314
What are common bugs causing UTI, what characteristics do they have?
1) E choli: green on EMB agar
2) Staphulococcus saprophyticus: second cause in women
3) Klebsiella pneumonaie: large mucoid capsules
4) Serratia Marceans: Red pigment, and often resistant
5) Enterococcus: nosocomial and drug resistant
6) Proteus mirabilis: swarming on agar
7) Pseudomonas: blue green, and fruity. Nosocimal and drug resistant
315
Symptoms, labs, treatment of vaginosis?
1) Thin white discharge with fishy odor
2) Clue cells with pH > 4. 5
3) Metronidazole
316
Symptoms, labs, treatment of trichomonas vaginitis?
1) Strawberry cervix
2) Mobile trichomonads
3) Ph > 4.5
4) Metronidazole (and treat sexual partners)
317
Symptoms, labs, treatment of candida vulvaginitis?
1) Inflammation + cottage cheese discharge
2) Pseudohyphe ph 4.0-4.5
3) Treatment: azoles.
318
What are TORCHES infections?
1) Microbes passed on from mother to fetus
2) Transplacental
3) Toxoplasma gondii, Rubella, Cytomegalovirus, HIV, Herpes Simplex Virus 2, Syphilis
319
What are the viruses responsible for rashes in children?
1) Coxsakievirus (Hand-foot-mouth disease)
2) Human herpesvirus 6 (Roseola exanthem subitum)
3) Measles virus (Measles rubeola)
4) Parvovirus b19: erythema infectiosum
5) Rubella virus (rubella)
6) Streptococcus pyrogenes: Scarlet fever
7) Varicelle Zoster: Chicken pox
320
What is the clinical presentation of Coxsakie?
Oval shaped vesicles on palms and soles (vesicles and ulcers in the oral mucosa)
321
What is clinical presentation of human herpesvirus 6?
Rose colored macules appear on the body after several days of high fever (can have febrile seizures)
322
What are characteristics of meseles virus?
1) Have a rash starting at the head
| 2) Koplik spots on the mucosa
323
What are the characteristics of parvovirus B19?
1) Slapped cheek rash on the face
| 2) Hydrops fetalis in pregnent women
324
What are the characteristics of rubella?
1) Pink macules at the head and then move down
2) Fine desquamating truncal rash
3) Post auricular lymphadenopathy
325
What are streptococcus pyogenes?
1) Sandpaper like rash
| 2) Fever and sore throat.
326
What does the varicella zoster virus clinical?
1) Vesicular rash on the trunk
| 2) Spreads to the extremities
327
What are clinical features of HIV?
1) Opportunistic infections
2) Kaposi sarcoma
3) Lymphoma
328
Clinical features of Chancroid?
1) Genital ulcer with exudate
| 2) Inguinal adenopathy
329
Clinical features of chlamydia?
1) Uretitis
2) Cervicitis
3) Epididymitis
4) Conjunctivitis
330
Clinical features of condylomata acuminata?
1) Genital warts, koilocytes
| 2) Organizime: HPV-6 and 11
331
Clinical features of genital herpes?
Painful penile, vulvar, or cervical vesicles and ulcers. Can cause systemic symptoms such as fever, headache, mylagia
332
Clinical features of gonorrhea?
1) Urethritis, cervivitis, epididymitis, conjunctivitis, reactive arthritis
2) Caused by Chylamydia trachomatis
333
Clinical features of hepatitis B?
1) Jaunedice
334
Clinical features of lymphogranuloma venereum?
1) Infection of lymphatics
2) Painless genital ulcers
3) Painful lymphadenopathy
335
What are the clinical of primary syphilis?
Painless chancre
336
What are clinical signs of secondary syphilis?
Fever, lympadenopathy, skin rash
337
what are clinical signs of secondary syphilis ?
1) Fever
2) Lymphadenopathy
3) Skin rashes
338
Clinical signs of tertiary syphilis ?
1) Gummas
2) Tabes dorsalis
3) General paresis
339
What is the Fitz-High Curtis syndrome?
1) Infection of the liver capsule and violin string
340
What are the main nosocimial infections?
E Coli and Staph aureus (wound infection)
341
Main bugs associated with aspiration?
Polymicrobial
| Gram negative
342
Bug associated with surgical wounds and decubitus ulcer?
S. Aureus
343
Infection of catheter?
S. Aureus
344
Pneumonia after endothracheal intubation ?
1) Pseudonomas aeruginsosa, Klebsiella
345
What are clinical features of legionella?
1) Signs of pneumonia
2) GI symptoms
3) Neurological abnormalities
346
Which bugs affect unvaccinated children?
Rubella, and Measles
347
Which bug causes epiglottis and pharyngitis?
1) H. influenzae
| 2) Cornyebacterium diphtheriae
348
What bugs affect asplenic patients?
SHIN
S. pneumonae
H. influenzae
N meningitis
349
What has branching rods in oral infections? and sulfur granules?
actinomyces
350
BUg for chronic granulomatous disease?
Catalase microbes
351
Bug for currant jelly sputam?
Klebsiella
352
What are dog or cat bite bugs?
Pasterlle multicoida
353
What are causes for facial nerve palsy?
Borrelia burgdorferi
354
Bug for fungal infection in diabetic?
Mucoror Rhizopus
355
Bugs associated with neutropenic patients?
Candida albicans
356
Bugs associated with organ transplant ?
CMV
357
Bugs associated with clostridium perfringens?
Clostridium perfringens
358
What are categories of penicillin?
1) Pen G (IV and IM form), and pen V (oral)
359
What is the clinical use of penicillin?
1) Usually gram +
| 2) Gram - cocci (N. meningitidis)
360
What are the adverse effects of Penicillin?
1) Hypersentitivty reactions
2) Direct coombs +
3) Hemolytic anemia
361
How is resistence to penicillin occur?
Penicillinase in bacteria (B-lactamase destroyed)
362
What are examples of penicillinase-sensitive penicillins?
1) Amoxcillin
2) Ampicllin
3) Aminopenincillines
363
what is the difference between penicillinase-sensitive penicillins?
They have a wider spectrum.
| Combine with Clavulanic acid to protect against destruction of B-lactamase
364
What are the clinical use of amped-up penicillins?
1) H. Influenzae
2) H. Pylori
3) e. Coli
4) Listeria monocytogens
5) Proteus mirabilis
6) Salmonella
7) Shigella
8) Enterococci
365
What are the adverse effects of amped-up penincillinase ?
1) Hypersensitivity
| 2) Pseudomembraneous colitis
366
What is penicillinase?
1) Produce by the bacteria and cleves the B lactam ring, which renders the penicillin useless
367
What are penicillinase resistant penicillins?
1) Dicloxacillin
2) Nafcillin
3) Oxacillin
368
Which are the penicillinase-resistant penicillin used for?
S. Aureus except for MRSA resistant
369
What is the spectrum of penicillinase resistant penicillin?
More narrow then regular penicillin
370
What are possible reactions to penicillinase-resistant penicillins?
1) Hypersensitivity
| 2) Interstitial Nephritis
371
What are the antipseudomonal penicillins?
1) Piperacillin
| 2) Ticarcillin
372
What are anti-pseudomonal penicillins used for?
Pseudomonas and gram -
373
What are B-lactamase inhibitors?
1) Clavulanic acid
2) Tazobactam
3) Sulbactam
374
What is the mechanism of cephalopsporins?
B-lactam drugs that inhibit cell wall synthesis
375
Which organisms are covered by cephalosporins?
```
1) LAME
Listeria
Atypicals (chlamydia)
Mycoplasma
MRSA (5th generation)
Enterococci
```
376
What are examples of 1st, 2nd, 3rd, 4th and 5th generation cephalosporin?
1) Cephalexin, Cefazolin (Proteus,E Coli, Klebsiella)
2) Cefacir, Cefoxtin, Cefuroxime: Gram + cocci (H. Influenzae, Enterpbacter, Neisseria, Serratia)
3) Ceftraixone, Cefotaxime, Ceftazidine: gram -
4) Cefepime: gram -
5) Ceftaroline: Broad gram + (MRSA) but NOT pseudomonas
377
What are the adverse effects of cepahlosporins?
1) Hypersensitivity
2) Autoimmune anemia
3) Dislfiriam-like reasction
4) Vitamin K deficiency
5) Nephortoxicity
378
What are examples of carbopenems?
1) Imipenem, meopenem, ertapenem, doripenem.
379
What compound is the imipenem adminstered with?
Cilastin, to prevent inactivation of the drug in the renal tubules
380
What is an example of Monobactams?
Aztreonam
381
What is specific about Monobactams?
1) No crosssensitivity to penicilline
2) Less susceptible to B-lactamases.
3) Only acts on gram - NOT grams +
382
Side effects of Monobactams?
1) Occasional GI upset.
383
What is the property of vancomycin?
1) Inhibits cell wall peptidogycan formation
| 2) Not susceptible to B-lactamases
384
What are the clinical uses of vancomycin?
Gram + bugs only (serious, multi drug resistance)
| MRSA, S epidermis, enterococcus, C.Dif
385
What are side effects associated with vancomycin?
1) Nephrotoxicity
2) Ototoxicity
3) Thrombophlebitis
4) Flushing- red man syndrome
386
What are examples of aminoglycosides?
1) Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin
387
What is the mechanism of aminoglycosides?
Inhibitiono of RNA, blocks transolcation.
388
What are the uses for the aminoglycosides?
Gram - infections
| Synergistoc B-lactam
389
What are the side effects of aminoglycosides?
1) Nephrotoxicity
2) Neurotoxicity
3) Ototoxicity
4) Teratogen
390
What are some examples of tetracyclines?
1) Tetracycline
2) Doxycycline
3) Minocycline
391
What conditions are treated by tetracyclines?
1) Borrelia burgdorfei
| 2) M. Pneumoniae
392
What are side effects of tetracyclines?
1) GI distress
2) Discolartion of teeth
3) Photosensitivity
4) Contraindicated in pregnancy
393
What is chloramphenicol uses?
1) Meningitis treatment (H. Influenzae, N. Meninigitis, Strep Pneumonae.
394
What are some adverse effects?
1) Anemia (dose dependent)
| 2) Aplastic anemia
395
What are mechanisms of Clindamycin?
Block translocation of ribosomal subunit
396
What are the uses of Clindamycin?
```
Anaerobic infections (Clostridium perfringens)
Aspiration pneumonia
Lung abcess
Oral infections
Strep A
```
397
What are side effects on clindamycin?
Pseudomonas colitis
Fever
Diarrhea
398
What are oxazolidinones?
Linezolids
399
What is the use for linezolid?
Gram + including MRSA and VRE
400
What are examples of macrolides?
1) Azithromycin
2) Clarithormycin
3) Erythromycin
401
What are the clinical uses of macrolides?
1) Mycoplasma
2) Chlamydia
3) Legionella
402
What are the adverse effects of macrolides?
GI motility
Arrythmia due to long QT syndrome
Rash
Eosinophilia
403
What are sulfonamides?
Sulfamethoxazole (SMX)
404
What are the bacteria it is used for?
Gram + and gram - (No cardia, Chlmydia) SMX for UTI
405
What are side effects of sulfonamides?
1) Nephrotoxicity
2) Photosensitivty
3) Kernicterus
406
What to use Dapsone for?
Similar to sulfonamides but structurally distinct
| Used for leprosy
407
What is trimethorpim for?
Used in combination with TMP-SMX
1) Shigella
2) Salmonella
3) Pneumocyctis jiroveceii
408
What are side effects of Trimethorpim?
1) Megaloblastic anemia
2) Leulopenia
3) Granulocytopenia
* TMP treats marrow poorly*
409
What are examples of fluroquinones?
1) Cipro
2) Norfloxacin
3) Levofloxacin
4) Ofloxacin
410
What are the clinical uses of fluoroquinones?
1) Gram - rods for urinary
| 2) Psuedomonas
411
What are the adverse effects of fluroquinones?
1) GI upset
2) Skin rashes
3) Myalgias
4) Not for pregenent women
5) May prolong QT interval
412
What are the diseases treated by metronidazle?
1) Giardia
2) Entamoeba
3) Trichomonas
413
What drugs are used to treat tuberculosis?
1) M. Tuberculosis: rifampin, isoniazid, Pyraziminde, Ethambutol
414
What is used to treat M. Avium-intracellulaire?
Azithromycin, rifabutin
415
What is used to treat M. Leprae?
1) Rifampin if tuberculoid form
| 2) Clofaszimine for lepromatous form.
416
What are examples of rifamycins?
1) Rifampin, rifabutin
417
What are the clinical uses of rifamycins?
1) M. Tuberculosis: delay resistance of dapson when used with leprosy
2) Used for meningococcal prohylaxis and chemoprophylaxis with H. Influenzae
418
What are the 4 R's of Rifampin?
1) RNA polymerase
2) Red/orange body fluids
3) Rapidresistance if used alone
419
What are the adverse effects of rifampin?
1) Hepatotoxicity
2) Orange body fluids
3) Rifabutin over rifampin isbetter for HIV infection.
420
What is the isoniazid used to treat?
1) TB (solo prophylaxis or monotherapy to treat)
421
What are the sideffects of isoniazid?
1) Hepatoxicity
2) Drug induced SLE
3) Vitamin B deficiency
GIVE pyridoxine B6
422
What is Pyrazinamide used for?
1) Mycobacterium tuberculosis
423
What are side effects of pyrazinamide?
1) Hyperuricemia
| 2) Hepatoxicity
424
What is ethambutol used for?
Mycobacterium tuberculosis
425
What are adverse effect of ethambutol?
Optic neuropathy
426
What are the adverse effects of streptomycin?
1) Tnnitus
2) Vertigo
3) Ataxia
4) Nephorttoxicity
427
What is the prophylaxis for endocarditis?
Amoxacillin
428
Prophylaxis for gonorrhea?
Ceftriaxone
429
Prophylaxis for reccurent UTI?
TMP-SMX
430
Prohpylaxis for meningococcal infection ?
Ceftriaxone, cirpofloxacin, rifampin
431
Prophylaxis for pregnent woman carrying group B strep ?
1)Penicillin G or ampicillin
432
Prevention gonoccal conjuntivitis in newborn?
erythromycin ointment on the eyes
433
What to do about post surgical infection due to S aureus?
Cefazolin
434
Prohylaxis for strep pharyngitis prior rheumatic fever?
Pen G or oral Pen V
435
Exposure to syphilis?
Pen G
436
When to do prophylaxis for HIV?
1) CD4
437
What is treament of MRSA?
1) Vancomycin
2) Linezoid
3) Tigecycline
4) ceftraoline
438
Treatement of VRE?
1) Linezolid, steptogramins
439
Treament of multi drug resistant P. Aeruginosa?
1) Polymyxins B
| 2p[-=) Colistins
440
What are cellular mechanisms of antifungal therapy?
1) Lanosterol synthesis: terbinafine
2) Ergisterol syntheis:
Clotrimazole
Flucanozole
Itracanazole
Ketoconazole
Miconazole
Voricanozole
3) Cell wall synthesis:
Anidulafungins
Caspofungin
Micafungin
4) Nucleic acid synthesis
flycytosine
441
When should amphotericin be used? Sideeffects?
1) Serious, systemic mycosis
2) Side-effects ares: K+ Nad MG decreased
3) Fever and chills
4) Hypotension
5) Nephortoxicity
442
When is nystatin used?
Topical only
| swish and swallow (oral, or vaginal )
443
When is flucytosine used? Side-effects
1) Systemic infection (fungus) cryptococcus
444
What are examples of azoles? What are they used for? Sideeffects?
1) Clotrimazole, flucanozole, itaraconazole, voricanazole
2) For local and less systemic mycoses
3) Chronic suppression of cryptococcal meningitis in AIDS patients with candidal infections
4) Sideeffects include gynecomastia, and liver dysfunction
445
What is terbinafine used for? What are the sideeffects?
1) Onchymosis (fungal infection of finger or toe nails)
| 2) Adverse effects include GI upset, hepatotoxicity, taste disturbance.
446
When are echinocandins used? What are the sideeffects?
1) Examples include anidulafungin, caspofungin, micafungin
2) Treat invasive aspergillos
2) GI upset, flushing (histamine release)
447
What are examples of grisofulvin?
1) They interfere with microtuble function and disrupt mitosis
2) Superficial infections and inhibits growth of dermatophytes
3) What are the adverse effects: teratogenic, carcinogenic, confusion and headaches.
448
What is used to treat mite and louse? What are the side effects?
1) Permethrin, Malathion, Lindane
| 2) Neurotoxicity
449
What is chloroquine used to treat?
1) Plasmodium falciparum (by blocking detoxification of heme) heme is toxic to plasmodia
2) Sideeffects include retinopathy,purtis
450
What is antihelminthic therapy?
1) Mebendazole (microtibule inhibitor)
451
What is used to treat influenzae A and B?
1) Oseltamivir
| 2) Zanamivir
452
What is used to treat HSV and VZV? What are the side effects of these drugs?
1) Acyclovir, famiciclovir, valacylovir
| 2) Nephropathy
453
What is used to treat CMV? what are the sidffects
1) Ganiciclovir
| 2) Adverse effects: leukopenia, neutropenia, and thrombocytopenia
454
What is foscarnet used to treat? And side effects?
1) DNA and RNA polymerase inhibitos
2) Used to treat CMV retinitis in immunocompomised patients (HIV)
3) Sideffects include nephortoxicity, electrolyte abnormalities
455
What is Cidofovir used to treat? what are the adverse effects?
1) CMV retinitis in immunocompromised patients
2) Long half life
3) Adverse effects include nephrotoxicity
456
When is HIV therapy started?
1) At the time of HIV diagnosisn
| 2) Strongest indication is for patients with AIDS defining illness (Low CD4+ cell count
457
What are examples of NRTI? What are they used for? What are side effects?
1) Abacavir (ABC)
2) Didanosine (ddl)
3) Emtricitabine (FTC)
4) Lamivudine (3TC)
5) Stavudine (d4t)
6) Tenofovir (TDF)
7) Zidovudine
Used as of the triple therapy for HIV
458
What are examples of NNRTI? what are the side effects?
1) Delavirdine
2) Efavirenz
3) Nevirapine
Bind reverse transcriptase at site different from NRTI
4) Can cause rash and heptatoxicity
459
What are protease inhibitors? what are they used to treat? What are the sideeffects?
1) Atazanavir
2) Darunavir
3) Fosamprenavir
4) Indinavir
5) Lopinavir
6) Ritonavir
7) Saquinavir
Sideeffects: nephropathy
460
What are integrase inhibitors? what is it used to treat? What are the sideffects?
1) Raltegravir
2) Elvitegravir
3) Dolutegravir
4) For HIV
5) Will increase the creatine kinase
461
What are the fusion inhibitors?
1) Enfuvirtide
2) Maraviroc
Can cause skin reaction at the injection site
462
What are interferons? what are they used to treat?
1) Have antiviral and anti-tumor properties
2) IFN - alpha chronic hepatits B and hepatitis C
3) IFN B: multiple sclerosis
4) IFN- gamma: Chronic granulomatous disease
463
What are the treatments for Hepatitis C therapy?
1) Ribavirin: inhibits synthesis of guanine nucleotides
2) Sofosbuvir
3) Simeprevir
464
What is autoclave?
Steam at > 120 degrees C, may be sporicidal
465
What do alcohols do for infection control?
Denature proteins and disrypt cell membranes (not sporicidal)
466
What does chlorhexidine do?
1) Denautre proteins, and disrupts cell membranes. Not sporicidal
467
What are antimicrobials to avoid during pregnancy?
1) Sulfonamides: kernicterus
2) Aminoglycosides: ottotoxicity
3) Fluoroquinlones: cartilage damage
4) Clarithromycin: embryotoxic
5) Tetracycline: discolored teeth, inhibition of bone growth
6) Ribavirin: teratogenic
7) Grisoflulvin: teratogenic
8) Chloramphenicol: gray baby
