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Pharmacology > microbiology > Flashcards

microbiology Flashcards

1
Q

spore

A

gram + only

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2
Q

capsule

A

polysaccahride (except bacillus anthracis which is poly d glutamate)

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3
Q

pleomorphic

A

means no cell wall

anaplasma, ehrlichia

chlamydiae (giemsa)
rickettsiae (giemsa)
mycoplasma (has sterols which dont gram stain)

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4
Q

borrelia

A

(giemsa)

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5
Q

coccus

A

spherical

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6
Q

streptococcus

A

chains or pairs

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7
Q

entercoccus

A

pairs or short chains

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8
Q

moraxella catarrhalis taxonomy/morphology

A

gram negative spherical (coccus)

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9
Q

corynebacterium morp

A

gram + rod

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10
Q

clostridium morph

A

gram + rod

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11
Q

gardnerella morph

A

gram variable rod

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12
Q

lactobacillus

A

gram + rod

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13
Q

listeria morph

A

gram + rod

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14
Q

mycobacterium morph

A

acid fast rod

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15
Q

propionibacterium morph

A

gram + rod

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16
Q

fusobacterium morph

A

gram - rod

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17
Q

bordetella

A

respiratory gram negative coccobacillius

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18
Q

burkholderia cepacia

A

gram negative rod respiratory

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19
Q

haemophilus

A

gram negative coccibacillus (pleomorphic) respiratory

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20
Q

legionella

A

silver stain rod (gram negative?) respiratory

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21
Q

bartonella

A

gram negative zoonotic

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22
Q

brucella

A

gram negative coccobcaillus zoonotic

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23
Q

francisella

A

gram - zoonotic coccobcaillus

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24
Q

pasteurella

A

gram - zoonotiv coccobcaillus

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25
Q

poor gram stain

A

these little microbes may unfortunately lack real color but are everywhere

treponema, leptospira (too thin), mycobacteria (lipid content), mycoplasma, ureaplasma (no cell wall), legionella, rickettsia, chlamydia, bartonella, anaplasma, enrlichia (primarily intracellular, plus chlamydia lacks classic peptidiglygan due to decreased muramic acid)

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26
Q

giemsa stain

A

certain bugs really try my patience

chlamydia, borrelia, rickettsia, trypanasomes, plasmodium

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27
Q

ziehl neelsen stain (carbol fuchsin)

A

protozoa (eg cryptosporidium cysts)

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28
Q

cryptococcus neoformans detection

A

culture on sabouraud agar, india ink (clear halo), mucicarmine (red inner capsule). latex agglutination assay detects polysaccharide capusle and is more specific.

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29
Q

silver stain

A

fungi eg (coccidioides, pneumocystis), legionella, helicobacter

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30
Q

n meningitidis culture

A

thayer martin

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31
Q

thayer martin contents

A

vancomycin against gram +, trimethoprim and colistin and fungi with nystatin

Very typically cultures neisseria

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32
Q

c diptheriae culture

A

tellurite and loffler (enhances metachromasia)

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33
Q

m pneumoniae

A

eaton with cholesterol

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34
Q

e coli culture

A

eosin methylene blue agar, colone with green metalic sheen

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35
Q

fungi culture

A

sabouraud

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36
Q

aerobe examples

A

nocardia, pseudomonas, mycobacteria,

naggin pests must breath

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37
Q

anaerobes examples

A

clostridium, bacteroides, fusobacterium, actinomyces

cant breath fresh air

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38
Q

why are anaerobes susceptible to oxidative damage?

A

lack catalase and or superoxide dismutase

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39
Q

anaerobes general features

A

foul smelling (short chain fatty acids), difficult to culture, and produce gas in tissue (co2 and h2)

normal flora in the gi tract, pathogenic elsewhere

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40
Q

facultative anaerobes examples

A

streptococci, staphylocci, and eneteric gram +

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41
Q

obligate intracellulars

A

rockettsia, chlamydia, coxiella. rely on host atp. stay inside cells when its Really CHIlly and Cold

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42
Q

faculatative intracellulars

A

salmonella, neisseria, brucella, mycobacterium, listeria, francicella, legionella, yersinia pestis

Some nasty bugs may live FacultativeLY

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43
Q

encapsulated bacteria

A

pseudomonas, streptococcus, haemophilus, influenza type b, neisseria meningitidis, e coli, salmonella, klebsiella, groub B strep

please SHINE my SKiS

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44
Q

pneumococcal vaccines

A

pcv13 conjugate. ppsv23 not conjugated

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45
Q

h influenza vaccine

A

conjugate

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46
Q

meningococcaly vaccine

A

conjugate

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47
Q

urease positive organisms

A

proteus, ctryptococcus, h pylori, ureaplasma, nocardia, klebsiella, s epidermis, s saprophyticus.

Pee CHUNKS

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48
Q

catalase +

A

nocardia, pseudomonas, listeria, aspergillus, candida, e coli, staphylocci, serratia, b cepacia, h pylori

CATs need placess to Belch their Hairballs

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49
Q

s aureus pigment

A

yellow

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50
Q

pseudomonas pgiment

A

blue green (pyocyanin and pyoverdin)

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51
Q

serratia marcescens

A

red pigment

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52
Q

biofilm makers

A

s epidermididis, viridans (s mutans and s sanguinis), p aeruginosa, nontypeable (unencapsulated) h influenza

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53
Q

s epidermidis charch

A

catheter and prostehtic devices

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54
Q

viridans (s mutans and s sanguinis)

A

dental plaques and infective endocarditis

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55
Q

p aeruginosa

A

respiratory tree colonization in CF pts, ventilator assisted pneumonia, contact lens associated keratitis.

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56
Q

type 3 secretion system

A

also known as the injectisome. needle like appedage faciliatating direct delivery of toxins from certain gram - to eukaryote cells.

psudomonas, salmonella, shigella, e coli.

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57
Q

transformation bugs

A

ShIN

s pneumoniae, h influenza, neisseria

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58
Q

lysogenic phage toxins

A

ABCD’S

group A strep erythrogenic toxin, botulinum toxin, cholera toxin, diphteria toxin, shiga toxin

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59
Q

endotoxin/exotoxin feature: source

A

exotoxins are made by gram + and - endotoxin gram - only

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60
Q

endotoxin/exotoxin feature: chemistry

A

exotoxins are polysaccharide

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61
Q

endotoxin/exotoxin feature: location of genes

A

exotoxin plasmid or bacteriphage

endotoxin bacterial chromosome

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62
Q

endotoxin/exotoxin feature: adverse affects

A

exotoxin

high (fatal dose 1 uq)

endotoxin low 100s uq

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63
Q

endotoxin/exotoxin feature: clinical affects

A

exotoxin various

endotoxin fever, shock (hypotension), dic

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64
Q

endotoxin/exotoxin feature: mode of action

A

exotoxin various

endotoxin induce tnf il1 il6

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65
Q

endotoxin/exotoxin feature: antigeniticty

A

exotoxin induces high titers called antitoxins

endotoxin is poorly antigenic

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66
Q

endotoxin/exotoxin feature: vaccines

A

exotoxin toxoids used as vaccines

endotoxin no toxoids

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67
Q

endotoxin/exotoxin feature: heat stability

A

exotoxin destroyed rapidly at 60 degrees c (except staph enterotxin and ecoli heat stable toxin)

endotoxin

stable at 100 degree c for 1 hour

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68
Q

endotoxin/exotoxin feature: typical diseases

A

exotoxin tetanus, botulism diptheria,

meningococcemia; sepsis by gram - rods

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69
Q

diptheria toxin

A

(inhibit protein synthesis)

inactivates ef-2 (vs e2f) sounds like blocks peptide elongation

adp

ab

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70
Q

exotoxin A

A

(inhibit protein synthesis)

pseudomonas

inactivation of ef-2 vs e2f, results in host cell death

adp

ab

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71
Q

shiga toxin (ST)

A

(inhibit protein synthesis)

inactivate 60s ribosome by removing adenine from rRNA

mucosal dmage -> dystenery

enhances cytokine release -> HUS

ab

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72
Q

shiga-like toxin (verotoxin)

A

(inhibit protein synthesis)

unlike shigella, ehec does not invade

cytokine release -> HUS

a

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73
Q

heat labile toxin (LT)

A

(increase fluid secretion)

etec

activates camp -> increased CL secretion and water efflux

adp

ab

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74
Q

heat stable (ST)

A

(increase fluid secretion)

etec

overactivates guanylate cyclase -> increased cgmp - decreased nacl reabsorbtion and water

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75
Q

edema toxin

A

(increase fluid secretion)

B anthracis

minis adenylate cylase (increased camp)

likely responsbile for the charateris edematous borders of black eshcar in cutaneous anthrax

ab

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76
Q

Cholera toxin

A

(increase fluid secretion)

overativates adynalte cyclase by permenately activating gs. increased cl sectiona nd h20 elffux.

voluminous rice water stools

ab

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77
Q

pertussis toxin

A

(inhibit phagocytic activity)

overativates adynalte cyclase by impairing gi -> increased camp. impairs phagocytosis to improve survival of microbe.

ab

adp

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78
Q

tetanospasmin

A

ab

is a protease. works on snare (soluble NSF attachment protein receptor)

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79
Q

botulinmu toxin

A

protease working on snare (soluble nsf attachment protein receptor)

ab

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80
Q

Alpha toxin

A

(lyse cell membranes)

C perfingens

Phospholipase (lecithinase) that degrades tissue and cell membranes

degradtion of phospholipids -> myonecrosis (gas gangrenes) and hemolysis (double sone of hemolysis on blood agar)

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81
Q

Streptolysin O

A

(lyse cell membrane)

protein that degrades cell membranes

lyses RBS, contributes to the B hemolysis. Host abs agaisnts ABOs used to diagnosis rheumatic fever.

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82
Q

toxic shock syndrome toxin (TSST-1)

A

super antigen

binds mhc2 and tcr and causes il1 il2 ifn g tnf a release -> shock

toxic shock syndrome: fever, rash, shock

exfoliative toxin causes scalded skin syndrome and bullous impetigo.

heat stable enterotixin.

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83
Q

erythrogenic toxins a and b (spea and speb)

A

strep pyogenes

binds mhc2 and tcr and causes il1 il2 ifn g tnf a release -> shock

toxic shock like syndrome; fever rash shock

scarlet fever

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84
Q

endotoxin tlr4 activation

A

il 1, il-6, -> fever
tnf a -> fever and hypotension
nitric oxide -> hypotension

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85
Q

endotoxin complement activation

A

c3a and c5a histamine release and hyptension

c5a nutrophil chemotaxis

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86
Q

tissue factor activation by endotoxin

A

coagulation cascade -> dic -> renal failure

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87
Q

catalase postive respiratotion

A

anaerobic/facultative

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88
Q

gram positive color

A

purple/blue

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89
Q

gram + bacilli aerobic

A

LBC

listeria, bacillus, corynebacterium

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90
Q

gram + bacilli anaerobic

A

clostridium propionibacterium

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91
Q

B hemolytic PYR positive

A

group a strep

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92
Q

viridans 2 species and characteristic

A

s mutans and s mitis (unencapsulated)

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93
Q

a hemolytic description

A

greenish or brownish colow without clearing

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94
Q

b hemolysis

A

shows clear area

includes:
Staph
strep pyogenes
strep b
listeria
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95
Q

protein A of staph inhibits?

A

compliment activation and phagocytosis

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96
Q

s aureus colonizes

A

nares, axilla, groin

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97
Q

2 inflammatory s aureus

A

septic arhtisis and osteomyelitis

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98
Q

toxic shock syndrome

A

fever, vomiting, rash, desquamation, shock, end organ failure

increased ast, aslt , bilirubin

Can also be caused by nasal packing

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99
Q

cause of toxic shock like syndrome?

A

painful skin lesion

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100
Q

s aureus enteroxin feature

A

heat stable, not destroyed by cooking

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101
Q

coagulase of staph

A

helps it form a fibrin clot around itself

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102
Q

staph aureus ferments

A

manitol

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103
Q

s epidermidis infects

A

iv catheters, heart valves, prosthetic devices by forming biofilms

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104
Q

strep pneumoniae otitis media

A

in children

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105
Q

viridans group that cause dental caries

A

strep mutans and s mitis

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106
Q

viridans that causes endocarditis

A

s sanguinis

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107
Q

s sanguinis virulence

A

makes dextrans that allow binding to fibrin platele aggregates

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108
Q

group b strep causes

A

pneumonia, sepsis, and meningitis in babies

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109
Q

fxn of group b camp factor

A

enhances area of hemolysis by s aureus

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110
Q

strep bovis and extra name and one thing it can cause

A

S gallolyticus (s bovis biotype 1)

bactermia and subacute endocardits in colon cancer

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111
Q

entercocci

A

subacute endocarditis

pyr +

variable hemoylysis

VRE are important nosocominal bugs

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112
Q

bacillus anthracis

A

spore forming

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113
Q

bacillus anthracis morphology

A

colonies show a medusa head which is a halo of projections around themselves

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114
Q

cutaneous anthrax

A

classically hide of goat (craftsmen)

painless papule surrounded by vesicles -> ulcer with black eschar (painless, necrotic)

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115
Q

pulomnary anthrax

A

inhalation of spores -> flu like symptoms -> rapidly fever, pulmonary hemmorhage mediastinitis (macs took them) and shock.

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116
Q

b cerueus causes

A

food poisoning

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117
Q

b cerueus pathogenesis

A

keeping rice warm results in germination of the sporesand enterotoxin formation called (cereulide)

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118
Q

b cerueus emetic type associated with?

A

rice and pasta n/v within 1-5 hours, cereulide involved

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119
Q

diarrhea type b cerueus

A

watery and gi pain within 8-18 hrs

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120
Q

c tetani causes

A

trismus (lockjaw), risus saronicus (raised eyebrows and open grin), opisthotonos (spasms of spinal extensors)

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121
Q

c tetani treatment

A

prevent with vaccine. treat with antitoxin +/- booster, diazepam for spasms, wound debridement

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122
Q

c botulinum toxin feature and mech

A

heat labile prevents ach from being released -> flaccid paralysis

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123
Q

fourd d’s of botulinum

A

dysphagia, diplopia, dysathria, dyspnea.

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124
Q

c botulinum how adults get

A

ingesting preformed toxin

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125
Q

c botulinum kids

A

floppy baby syndrome from ingesting spores in honey

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126
Q

c botulinum can treat

A

dystonia, achalasia, muscle spasms and facial wrinkles

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127
Q

c perfingens toxin

A

alpha toxin (lechithinase, a phospholipas) that causes myonecrosis (gas gangrene) and hemoylsis

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128
Q

other thing c perfingens can do

A

spores survive in undercooked food and whn ingested bacter release heat labile entertoxin -> food poisoning

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129
Q

c diff toxins

A

toxin a -> binds bursh border and alters gut fluid secretion

toxin b -> a cytotoxin, disrupts cytoskeletan by actin depolymerization

both lead to diarrhea -> pseudomembranous colitis

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130
Q

c diff can be causes by?

A

clindamycin, ampicillin, ppi

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131
Q

c dfif diagnosis?

A

one or more toxins in the stool by PCR

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132
Q

c dip agars

A

cystine-tellurite agar grows black colonies

i think lofflers causes the blue and red metachromatic granules

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133
Q

c dip lab test

A

elek test positive for toxin

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134
Q

c dip exotoxin encoded by?

A

b prophage

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135
Q

c dip toxin mech

A

inhibits protein synthesis by adp ribosylation of ef 2

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136
Q

c dip clinical

A

bull neck, myocarditis, arrythmias, neuro symptoms

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137
Q

listeria living

A

facultative intracellular

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138
Q

c dip transmission

A

respiratory droplets

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139
Q

listeria get from?

A

unpasteruizeddairy products and cold deli meats, via placental transfer, vaginal transmission during birth

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140
Q

listeria growth

A

grows well at refrigeration temps ( 4 - 10 degree cold enrichment)

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141
Q

listeria movement

A

“rocket rails” from actin polymerization that allow cell to cell and intracellular movement

saying intracellular it avoids abs

tumbling motility in broth

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142
Q

listeria clinical

A

amnionitis, septicemia, and spontaenous abortion in pregnant women

meningitis in immunocompromised

self limited gastroenterits in immunocompotent adults

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143
Q

nocardia vs actino where found?

A

soil vs normal oral, reproductive, and gi flora

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144
Q

nocardia clinical

A

pulmonary infection in immunocompromised (can mimic tb but negative ppd), cuteaneous infection in immmunocompotent after trauma, can spread to cna

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145
Q

actino clinical

A

causes oral/facial abscess that drain through sinus ttracts.

associated with gental caries/extraction.

forms yellow sulfur granules

PID with IUDs

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146
Q

PPD +

A

current infection or past exposure

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147
Q

IGRA advantage

A

fewer false positive

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148
Q

what is a ghon complex

A

ghon focus + hilar lymph nodes

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149
Q

where can miliary TB spread to?

A

meningitis, vertebrae (pott disease), lymph nodes, spleen, liver, adrenal glands

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150
Q

cord factor

A

creates a serpitine cord appearence where virulent m tuburculosis strains line up

activates macs (promoting granuloma formation) and induces release of TNFa

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151
Q

sulfatides (surface glycolipids)

A

inhibit phagolysosome formation

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152
Q

m scrofulaceum

A

cervical lymphadenitis in children

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153
Q

m marinum

A

hand infection in aquarium handlers

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154
Q

all mycobacteria are acid fast, which means?

A

they stain pink

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155
Q

m leprae infects

A

skin and peripheral nerves, likes cook temps

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156
Q

m leprae sensation loss?

A

glove and stocking

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157
Q

m leprae labs

A

cannot be grown in vitro

diagnosed via skin biopsy or tissue PCR

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158
Q

m leprae resevori in US

A

armadillos

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159
Q

lepromatous form

A

presents iffusely over the skin, with leonine (lion like faces), and is communicable.

low cell mediated immunit with humoral th2 response

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160
Q

tuberculoid form

A

limited to a few hypoesthetic (decreased sensatoin), hairless sking plaques

high th1 response

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161
Q

gram negative diplococcis aerobic with maltose utilization

A

n mengitidis

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162
Q

gram negative diplococcis aerobic without maltose utilization

A

n gonnorhea or moraxella

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163
Q

gram negative stains?

A

pink

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164
Q

gram negative coccobacilli

A

h influenza
bordetalla pertusiss

pasteurella
brucella
franscilla

(all zoonotic, bartonella also a zoonotic but not coccobacilli gram - rod)

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165
Q

coma shaped oxidase positive

A

campylobacter jejuni (42 degree growth)
vibrio (grows in alkaline media)
helico (produces urease)

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166
Q

b henslae

A

gram - rod

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167
Q

b fragilis

A

gram - rod

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168
Q

gram - baccili lactose fermentation +

A

fast
kleb
e coli
entero

slow
citrobacter
serratia

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169
Q

gram - baccili lactose - oxidase +

A

pseudomonas

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170
Q

gram - baccili lactose - h2s production on TSI agar +

A

salmonella, proteus

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171
Q

gram - baccili lactose - h2s production on TSI agar -

A

shigella yersinia

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172
Q

how does e coli ferment lactose?

A

with b galactosidase that break lactose inro glucose and galactose

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173
Q

EMG agar

A

lactose fermenters grow as purple/black colonies

e coli grows colonies with a green sheen

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174
Q

neisseria fermentation

A

both ferment glucose

only meningoccis ferments maltose

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175
Q

conococci shape

A

kidney bean shaped

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176
Q

does gonococcis have a capsule?

A

no

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177
Q

menigigoccia causes

A

causes meningococcemia with petechial hemmorahges and gangrene of toes, meningitis, waterhouse frerichsen sydnrome (fever, adrenal inusfficiency, DIC, shock)

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178
Q

h influ how transmitted?

A

aerosol

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179
Q

h influ non typeable (unencapsulated causes)

A

mucosal infections (otitis media, conjunctivits, bronchitis) as well as invasive disease since vaccine agaisnt type b.

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180
Q

h influ virulence

A

iga protease

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181
Q

h influ grows on?

A

chocalate agar (contains 5 and 10) and can also be grown with s aureus which provides factor 5 through hemolysis

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182
Q

h influ can also cause?

A

pneumonia

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183
Q

h influ vaccine?

A

polyribosylribitol phosphate conjugated to diphteria toxoid

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184
Q

when to give h flu vaccine?

A

2 and 18 onths

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185
Q

signs of epiglottis

A

stridor, thumbprint sign, cherry red appearence

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186
Q

bordetella pertussis virulence factors

A

pertussis toxin (diasbles Gi increasing camp) and tracheal cytotoxin

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187
Q

bordetella pertussis stages

A

catarrhal - low grade fevers, corza (rhinits, runny nose)

paroxysmal stage (100 day cough) - paroxysms of intense cough follow by whoop, posttussive vomiting

convalescet phase - gradual recover of cough

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188
Q

pertussis toxin can causes

A

lymphocytosis, hypoglycemia

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189
Q

vaccines for bordetella

A

Tdap, DTaP

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190
Q

bordetella what can it be mistaken for?

A

a viral infection due to lymphocytic infiltrate resulting from immune response

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191
Q

bordetella agar

A

bordet gengou

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192
Q

legoinella culture

A

charcoal yeast extract with iron and cysteine

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193
Q

legoinella detection?

A

antigen in urine

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194
Q

legoinella transmission

A

aerosol from encrionmental sources (ac systems, hot water tanks)

no person to person transmisson

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195
Q

legionnaires disease pneumonia type

A

often lobar and unilateral

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196
Q

legionnaires disease symptoms

A

fever, gi, and cns symptoms

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197
Q

legionnaires disease common in?

A

smokers and in chronic lung disease

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198
Q

pontiac fever

A

mild flu like syndrome

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199
Q

pseudomonas morphology

A

aerobic and motile

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200
Q

pseudomonas produces?

A

pyocyanin which is a blue green pigment and has a graplike odor

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201
Q

pseudomonas virulence

A

produces endotoxin (fever, shock), exotoxin A (inactivates ef-2), phospholipase C (degrades cell membrane), pyocyanin (generates ROS)

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202
Q

pseudomonas causes

A

PSEUDOMONAS

P - pyocyanin, pneumonia
S - sepsis
E - ecthyma gangrenosum
U -UTIs
D - diabetes, drug use
O - osteomyelities (puncture wounds)
M - mucoid polysaccharide capsulre
O - otitis externa (most common overall)
N - Nosocominal infections (catheters, equipment)
A - Exotoxin A
S - skin infections - hot tub folliculits
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203
Q

pseudomonas and IV drug users

A

right sided endocarditis

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204
Q

pseudomonas psteomyelitits

A

daiabetic foot ulcers, moist shoe puncture

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205
Q

pseudomonas feared complications of burns

A

burns are good environment, worry about sepsis

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206
Q

sepsis in?

A

neutropenia, diabetics, extensive burns, leukemia

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207
Q

why do cycstic fibrosis patients get chronic penumonia?

A

because of the mucoid polysacharide capsulre forms biolfilms

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208
Q

pseudomonas think andy

A

corneal ulcers/keratitis in contact lens wearers /minor eye trauma

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209
Q

ecthyma gangrenosum

A

rapidly progressive necrotic cutaneous lesioin, caused by pseudomonas bactermia, typically in immnocompromised

fever prior

single or multiple lesions

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210
Q

e coli virulence factors

A

fimbriae - cystitis and pyelonephritis (p pili); k capsule - oneumonia and neonatal meningitis; LPS endotoxin - septic shock

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211
Q

EIEC

A

invades intestinal mucosa, causes necrosis and inflammation

invasive; dysentery. clinically similar to shigella

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212
Q

ETEC

A

produces heat labiile and heat stable toxin; no inflammatin of invasion

travelers diarrhea

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213
Q

EPEC

A

no toxin produced. adheres to apical surface, flattens villi, prevents absorption.

diarrhea in children

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214
Q

EHEC serotype

A

O157:H7 most common serotype in us

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215
Q

EHEC transmission

A

undercooked meat and raw leafy veggies

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216
Q

EHEC clinical

A

dysentery (toxin alone produces necrosis and inflammation)

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217
Q

EHEC labs

A

does not ferment sorbitol vs other e coli

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218
Q

EHEC toxin and what does it causes?

A

shiga like toxin and causes HUS

causes decreased renal blood flow

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219
Q

klebsiella flora?

A

intestinal

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220
Q

klebsiella causes?

A

lobar pneumonia in alcoholics and diabetics when aspirated

also noscocominal UTI

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221
Q

klebsiella morphology

A

mucoid colonies caused by abundant polysaccharide capsule

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222
Q

klebsiella sputum

A

dark red “currant jelly” sputum blood and mucous

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223
Q

kelbsiella 5 A’s

A

Aspiration pneumonia
Abscess in lung and livers
Alcoholics
diAbetics

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224
Q

campylobacter mmorphology

A

common or s shaped with polar flagella

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225
Q

campylobacter causes

A

bloody diarrhea, espiecally in children

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226
Q

campylobacter transmission

A

fecal oral from person to person, or ingestion of undercooked poultry or meat, unpastruerized milk.

contact with infected animals (dogs, cats, pigs)

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227
Q

campylobacter can causes

A

gullian barre and reactive arhtirits

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228
Q

how do salmonella and shigella invade?

A

via m cells of th epeyer’s patches

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229
Q

what do salmonella typhi, salmonella spp, and shigella infect?

A

humans, humans and animals, humans

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230
Q

what do salmonella typhi, salmonella spp, and shigella h2s productions

A

yes, yes, no

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231
Q

what do salmonella typhi, salmonella spp, and shigella flagella

A

yes, yes, not

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232
Q

what do salmonella typhi, salmonella spp, and shigella virulence

A

endotoxin; Vi capsule, endotoxin, endotoxin, shiga toxin (enterotoxin)

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233
Q

what do salmonella typhi, salmonella spp, and shigella id50

A

high (large incoulum required because gastric acid inacivates), high, low (very small inovulum required bc resistant)

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234
Q

what do salmonella typhi, salmonella spp, and shigella efftcs of antibiotics on fecal excretion

A

prolongs, prolongs, shortens

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235
Q

what do salmonella typhi, salmonella spp, and shigella immune response

A

monocytes, pmns, pmns

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236
Q

what do salmonella typhi, salmonella spp, and shigella gi manifestations

A

constipation; followed by diarrhea, diarrhea (possibly bloody), bloody diarrhea (bacillary dysentery)

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237
Q

what do salmonella typhi, salmonella spp, and shigella vaccine

A

only for s typhi, oral vaccine is live attenuated s typhi and IM vaccine contains Vi capsular polysaccharide

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238
Q

typhoid fever (enteric fever) cilnical manifestations

A

rose spots, constipation, abdominal pain, fever

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239
Q

s typhi unique property

A

can be carried in the gall bladder

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240
Q

salmonella non typhoidal species

A

poultry, eggs, pets, and turtles

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241
Q

salmonella non typhoidal usually causes?

A

gastroenteritis

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242
Q

salmonella non typhoidal antibiotics to treat

A

not indicated

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243
Q

shigella sources

A

fingers, flies, food, feces

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244
Q

shigella in order of decreasing severity

A

s dysenteriae (bacillary dysenteriae), f flexneri, s boydii, s sonnei (shigellosis)

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245
Q

shigella key fact

A

invasion of M cells is key to pathogencity and organisms froduce little toxin can cause disease

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246
Q

vibrio morphology

A

flagellated and comma shaped

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247
Q

vibrio culture

A

grows in alkaline media

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248
Q

vibrio infectvity?

A

sensitive to stomach acid, requires a large incodulum (high id50) unless host has decreased acid

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249
Q

vibrio transmission

A

transmitted by contaminated water or uncooked food (eg raw shellfish)

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250
Q

vibrio treatment

A

oral rehydration

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251
Q

yersinia enterocolitis tranmission

A

pet feces (eg puppies), contaminated milk, or pork

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252
Q

yersinia enterocolitis manifestations

A

acute diarrhea or pseudoappendicitis (right lower abdominal pain due to mesenteric adenitis and/or terminal ileitis)

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253
Q

h pylori moprhlogy

A

curved, flagellated

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254
Q

h pylori lab

A

triple positive cat, ox, urease

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255
Q

h pylori diagnosis

A

urea breath test or fecal antigen test

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256
Q

spriochetes visualization

A

only borrelia can be visulized by aniline dyes (wright or giemsa) due to its large size

treponema is visulzed by dark field microscopy or direct furescent ab (dfa)

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257
Q

leptospira interrogans morphology

A

hook shaped ends

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258
Q

leptospira interrogans transmission

A

water contamited with animal urine

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259
Q

leptospirosis

A

flu like symptoms, myalgias (especially calves), jaundice, photophobia with conjuntival suffusion (erythema without exudate). prevelant in surfers and in tropics (hawaii)

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260
Q

weil disease and aka

A

(icterohemorrhagic leptospirosis)

sever form of jaundice and azotemia from liver and kidney dysfxn, fever, hemorrhage, and anemia

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261
Q

lyme disease vector and also transmits?

A

ixodes tick deer tick (also transmits anaplasma and protozoa babesia)

262
Q

lyme disease natural resevoir

263
Q

lyme disease stage 1

A

erythema migrans (not always present), and flu like symptoms

264
Q

lyme disease stage 2

A

early disseminated, secondary lesions, carditis, av block, facial nerve palsy, migratory arhtirits/transient arthritis

265
Q

lyme disease stage 3

A

late disseminated: encephalopathies, chronic arthritis

266
Q

primary syphillis

A

localized disease presenting with painless chancre.

use darkfield microscopy if avaiable

vdrlr + in 80 percent (rpr?)

267
Q

secondary syphillis

A

disseminated disease with contitutional symptoms, with maculopapular rash. condyloma lata (smooth most painless wart like lesions on the genitals), lymphadenopathy, pathcy hairy loss,

also can be confirmed using dark field microscopy

serologic testing (vdrlr/rpr are non sepcific, confirm with specific test fta-abs/mha)

latent syphillis may follow (early latent is less than 1 year and late latent is grreater than 1 year)

268
Q

tertiary syphillis

A

gummas (chronic granulomas), aortitis (vasa vasorum destruction), neutrosyphillis (tabes dorsalis, general paresis), argyll robertson pupil (constricts with accomdation but is not reactive to light), alsoknown as prostitues pupil

signs: broad based ataxia, + romberg, charcot joints, stroke without hypertension

for neurosyphillis: test spinal fluid with vdrlr, fta abs, and pct

269
Q

congenital syphillis

A

facial abnomralityes like rhagades (linear scars at angle of mouth), snuffles (nasal discharge), saddle nose, notched (hutchinson teeth), mulberry molars, and short maxilla, saber shins, and cn viii damage

prevent by trreating mom early aas transmission usually occurs in first trimester

270
Q

vdrl false positives

A

viral infectoin (ebv, hepatitis)
drugs
rheumatic fever
lupus and leprosy

271
Q

j herxhemier rxn

A

flu like syndrome (fever chillls, headache, myalgia) after antibitoics are started, due to killed bacteria (uslaly trepnema) relasing toxins

272
Q

anaplasma table

A

zoonotic, ixodes tick (live on deer and mice)

273
Q

bartonella spp table

A

zoonotic, cat scratch disease and bacillary angiomatosis, get from cat scartch

274
Q

borrelia reccurentis table

A

zoonotic, relapsing fever, louse (recurrentdue to variable antigens)

275
Q

brucella table

A

brucellosis/undulant fever, from unpastrurized dairy like (milk, cheese, cattle), endocarditis of the aortic valve, granulomatosis

276
Q

campylobacter table

A

bloody diarrhea, from infected pets/animals; contaminated meats/foods/hands

277
Q

c psittacosis get from?

A

parrots and other birds

278
Q

c burnetti table

A

q fever, from aerosols of cattle/sheep aminiotic fluid

279
Q

ehrlichia chaffeensis table

A

ehrlichiosis, transmission by amblyomma (lone star tick)

280
Q

f tularensis table

A

tularemia, ticks, rabbits, deer flies

281
Q

p multocida table

A

cellulits, osteomyelitis from animal bites, cats and dogs

282
Q

salmonella spp except typhi table

A

diarrhea (which may be bloody), vomiting, fever, abdominal cramps

283
Q

yersinia pestis table

A

plague, comes from fleas (rats and prarie dogs are resevoirs)

284
Q

garnerella vag presentation

A

gray vaginal discharge with a fishy smell

285
Q

garnerella vag also characterized by?

A

certain anaerobic bacteria in the vagina

286
Q

clue cells

A

have stippled apperance

287
Q

amine whiff test

A

mix with 10 percent koh enhances fishy odor

288
Q

rock mountain spotted fever vector

A

dermacentor tick

289
Q

rock mountain spotted fever classic triad

A

headache, fever, rash (vasculitis)

290
Q

palms and soles rashes

A

drive CARS with your palms and soles

Coxsackievirus A infection (hand, foot, and mouth disease), rocky mountain spotted fever, 2n syphhilis)

291
Q

typhus rash?

A

typhus on the Trunk spreads out but spares palms and soles

292
Q

endemic typphus

A

fleas, r ryphi

293
Q

epidemic typhus

A

human body louse, r prowazekii

294
Q

ehrlichia chaffeensis

A

ehrlichiosis, amblyomma (lone star tick), monocytes with morulae (mulberry like inclusions) in cytoplasm, rash rare

295
Q

anaplasma

A

anaplasmosis (ixodes tick), live on deer and mice, granulocytes with morulae in cytoplasm

296
Q

q fever cause

A

c burnetti

297
Q

q fever transmission

A

spores inhaled as aersols from cattle/sheep aminotic fluid

298
Q

q fever presentation

299
Q

q fever commonly causes?

A

culture negative endocarditis

300
Q

q fever is queer because?

A

no rash or vector, can survive outside host in endospore. closele related to rickettsia though

301
Q

what can chlamydiae not make?

302
Q

how does the reticulate body replicate?

303
Q

4 syndromes of c trachmomatis

A

reactive arthritis (reiter syndrome), follicular conjunctivitis, nongonnoccal urethritis, and PID

304
Q

how are c pneumoniae and psittaci transmitted?

305
Q

lab diagnosis

A

PCR, nucleic acid amp, cytoplasmic inclusions (reticulate bodies) can also be seen on giemsa stain or flurescent antibody stained smear

306
Q

c trachomatis types abd

A

african blindness chronic infection (ABC)

307
Q

types d-k

A

urethritis/pid, ectopic pregnancy, neonatal pneumonia (staccato cough) with eosionophilia, neonatal conjunctivitis (1-2 weeks after birth)

308
Q

type l1-l3 cause and how to treat?

A

lymphogranuloma venereum - small painless ulcers on genitals -> swollen painful inguinal lymph nodes that ulcerate (buboes)

treat with doxycyline

309
Q

m pneumoniae, what does the cell wall have?

310
Q

m pneumoniae more common in what age group?

A

people less than 30

311
Q

m pneumoniae common where?

A

military recruits and prisons

312
Q

systemic mycoses general principles

A

all can cause pneumonia and dessiminate

all are dimorphic: cold at 20 C and yeast at 37 C (exception coccioides, which iss a spherule with endospores) in tissue

they can form granulomas like TB but can not be transmitted from person to person (unlike TB)

313
Q

systemic mycoses treatment

A

fluconazole or itraconazole for local infection

amphoterricin B for systemic infection

314
Q

histo location

A

mississippi and ohio river valleys

315
Q

histo path feature

A

smaller than rbc

inside macs

316
Q

histo unique things

A

palatal/tongue ulcers, splenomegaly

317
Q

histo get from?

A

bird (starlings) or bat droppings

318
Q

histo diagnosis?

A

serum or urine antigen

319
Q

blastomycosis location

A

eastern and central US

320
Q

blastomycosis path

A

broad based budding

same sized as RBC

321
Q

blastomycosis unique

A

inflammatory lung disease, can disseminate to skin/bone,

verroucous skin lession can simulate SCC

forms granulomatous nodules

322
Q

coccidoiomycosis location

A

southwestern us, california

323
Q

coccidoiomycosis path

A

spherule (much larger than RBC) filled with endospores of coccidies

324
Q

coccidoiomycosis unique

A

dissimnates to skin/bone

erythema nodosum (desert bumps) or multiforme, arthrlagias (desert rheumatism), can cause meningitis

325
Q

paracocciiomycosis location

A

latin america

326
Q

paracocciomycosis path

A

budding yeast with captains wheel formation (much larger than RBC)

327
Q

paracocciomycosis unique

A

similar to cocioimycosys

males > females

328
Q

what does tinea mean?

A

its the clinical name given to a dermatophyte (cutaneous fungal) infectoin

329
Q

what are the dermatophytes?

A

microsporum, trichophyton, epidermophyton

330
Q

dermatophytes microscope

A

branching septate hypahe visble on KOH preparation with blue fungal stain

331
Q

dermaopthye infection assocaited with?

332
Q

tinea capitis

A

occurs on head/scalp, associated with lymphadenopahty, alopecia, scaling

333
Q

tinea corporis

A

occurs on torso. characterized by erythematous scaling rings (ringworm) and central clearing. can be acquired from cat or dog

334
Q

tinea cruris

A

occurs in inguinal area. often does not show central clearing seen in tinea corporis

335
Q

tinea pedis

A

three varieties:

  • interdigital (most common)
  • moccasin distribution
  • vesicular type
336
Q

tinea unguium/onychomycosis

A

occurs on nails

337
Q

tinea (pityriasis) vericolor caused by

A

malassezia spp (pityrosporum), a yeast like fungus (not a dermatophyte)

338
Q

tinea (pityriasis) vericolor pathogenesis

A

degradation of lipids produces acids that damage melanocytes and cause hypopigmented, hyperpigmented, and/or pink patches

339
Q

tinea (pityriasis) vericolor less of what than dermatophytes?

A

less pruitis

340
Q

tinea (pityriasis) vericolor occurs most often?

A

anytime but most comon in summer

341
Q

tinea (pityriasis) vericolor appearence under microscope

A

meatballs and spaghetti (hypahe and yeasts)

342
Q

tinea (pityriasis) vericolor treatment

A

selenium sulfide, topical and/or oral antifungal medications

343
Q

candida moprhology

A

dimorphic, forms pseduhypahe and budding yeast at 20 and germ tubes at 37

344
Q

candida clinical manifestations

A

causes oral and esophageal thrush in immunocompromised (neonates, steroids, diabetes, aids), vulvovaginitis (diabtes, use of antibitoics), diaper rash, endocariditis (iv drug users), disseminated candidiasis (especially in neutropenic patients), chronic mucocutaneous candidiasis

345
Q

aspergillus fumigatus morphology

A

septate hypahe that branch at 45 degrees (acute), produces conidia at the end of conidiophore

346
Q

aspergillus fumigatus clinical

A

invasive asperigillosis in immunocompromised, chronic granulomatis disease.

aspergillomas in preexisting lung cavities, especially after TB

some species make aflatoxins

ABPA: hypersensitivity response associated with asthma and cystic fibrosis; may cause bronchiectasis and eosinophilia

347
Q

crptococcus morphology

A

5-10 um narrow budding. heavily encapsulated yeast. not dimorphic

348
Q

crptococcus found where?

A

soil, pigeon droppings

349
Q

crptococcus how do you get?

A

inhlation with hematgenous spread to meninges

350
Q

crptococcus causes

A

cryptococcosis, cryptococcal meningitis, cryptococcal encephalitis (soap bubble lesions), primarily in immunocompromised

351
Q

crptococcus diagnosis

A

culture on sabouraud agar

high lighted with india ink (clear halo) and mucicarmine (red inner capsule)

latex aggultination assay detects plysaccharide capsule and is more specific

352
Q

mucor and rhizopus spp. morphology

A

irregular, broad, nonseptate hyphae branching at wide angles

353
Q

mucor and rhizopus spp. who does it bother?

A

diabeteic ketoacidosis, and or neutropenic patients (eg leukemia patients).

354
Q

mucor and rhizopus spp. pathogenesis

A

proliferate in blood vessels, penetrate cribiform plate, and enter brain.

rhinocerebral, frontal lobe absccess, cavernous sinus thrombosis.

headache, facial pain, black necrotic eschar on face; may have cranial nerve involvement

355
Q

pneumocystis jirovecii causes?

A

a diffuse interstitial pneumonia

356
Q

pneumocystis jirovecii morphology

A

yeast like fungus (originally thought to be protozoan)

357
Q

pneumocystis jirovecii most infections result in?

A

asymptomatic

358
Q

pneumocystis jirovecii cxr/ct

A

diffuse, bilateral ground glass opacities

359
Q

pneumocystis jirovecii diagnosed by?

A

lung biopsy or lavage

disc shaped yeast seen on methenamine silver stain of lung tissue

360
Q

sporothrix schenckii morphology

A

dimorphic, cigar shaped budding yeast grows in branching hyphae with rosettes of conidia

361
Q

sporothrix schenckii lives where?

A

on vegetation

362
Q

sporothrix schenckii how do you get and manifestations?

A

introduced into skin, typically by thorn (“rose gardeners disease”), causes local pustule or ulcer with nodules along the draining lymphatics (ascending lymphangitis)

disseminated siease possible in immunocompromised

363
Q

giardia diagnosis

A

nultinucleated trophozoiites or cysts in stool, antigen detection

364
Q

e hysticolytica diagnosis

A

serology and or trophozoites (with engulfed RBCs) or cysts up to 4 nuclei in stool. antigen detection

365
Q

cryptosporidium parvum disease

A

sever diarrhea in aids

mild disease (watery diarrhea) in immunocompotent

366
Q

cryptosporidium parvum transmission and of giardia and e histo

A

oocysts, and cycst for later 2

367
Q

cryptosporidium parvum diagnosis

A

oocysts on acid fast stain

368
Q

congenital toxo

A

triad of chorioretinitis, hydrocephalus, and intracranial calcifications

369
Q

toxo diagnosis

A

serology, biopsy (tachyzoiites)

370
Q

naegleria fowleri causes

A

meningoencephalitis

371
Q

naegleria fowleri diagnosis

A

amoebas in spinal fluid

372
Q

t brucei disease

A

african sleeping sickness - enlarged cervical lymph nodes, recurring fever (antigenic variation), somnolence, coma.

373
Q

t brucei transmission

A

tsetse fly, a painful bite

374
Q

t brucei diagnosis

A

trypomastigote in blood smear

375
Q

clinical of malaria

A

fever, headache, anemia, spenomegaly

376
Q

vivax/ovale

A

48 hr (tertian) 1st and 3rd day fever

dormant form (hypnozoite)

377
Q

falciparum

A

sever irregular fever patterns. parasitized RBCs oclude capillaries in brain (cerebral malaria), kidneys, lungs

378
Q

p malriae

A

72 hr cycle (quaartan)

379
Q

malaria transmission

380
Q

malaria diagnosis

A
  1. trophozoite ring form with RBC
  2. shizont containg merozoites
  3. red granules (schuffner stippling) seen throught RBC cytoplasm in vivax/ovale
381
Q

babesia causes

A

fever and hemolytic anemia in the northeastern US

382
Q

babesia who is at increased risk

383
Q

babesia transmission

A

ixodes tick (often coinfects with lyme disease)

384
Q

babesia diagnosis

A

blood smear ring form and maltese cross. PCR

385
Q

trypanosoma cruzi clinical

A

chagas disease

dilates cardiomyopathy with apical atrophy

megacolon

megaesophagus

found in south america

unilateral perioribital swelling (romana sign) is seen in acute

386
Q

trypanosoma cruzi transmission

A

reduviid bug (kissing bug)

feces deposited in a painless bite

387
Q

trypanosoma cruzi diagnosisq

A

trypomastigote in blood smear

388
Q

visceral leishmaniasis (kala azar)

A

spiking fevers, hepatosplenomegaly, pancytopenia

389
Q

cutaneous leishmaniasis

A

skin ulcers

390
Q

lesihmania transmission

391
Q

lesihmania diagnosis

A

macs containing amastigotes

392
Q

trichomonas clinical feature

A

itching burning and fould smelling discharge

393
Q

trichomonas diagnosis

A

tophozoites (motile) on wet mount “strawberry cervix”

394
Q

immune response to helminths

A

type 1 - neutralization by histamine and leukotrienes

type 2 - eosinophils attach and release major basic protein

395
Q

enterobius (pinworm)

A

anal pruitis

diagnosis via egg on scotch tape

fecal oral

396
Q

asaris (giant roundworm)

A

ileocecal obstruction at ileoceal valve

bilary obstruction

intestinal perforation

migrates from nose/mouth

fecal oral

knobby oval eggs seen in feces

397
Q

strongyloides (threadeorm)

A

causes vomiting, diarrhea, epigatric pain (may mimic peptic ulcer disease)

larvae in soil penetrate skin, rhabditiform larvae seen in feces under microscope

398
Q

ancyclostoma/necator (hookworms)

A

causes anemia by sucking blood form intestine

cutaneous larva migrans - pruitic serpiginous rash from waling barefoot on the beach

larvae penetrate the skin

399
Q

t spiralis

A

larvae enter blood stream and encyst in striated muscle -> muscle inflammation

trichinosis - fever, vomiting, nausea, periorbital edmea, myalagia

undercooked meat (especially pork); fecal oral is less likely

400
Q

trichuris trichuria (whipworm)

A

often asymptomatic; loose stooks/anemia, rectal prolapse in children (heavy infection)

fecal oral

401
Q

t canis

A

visceral larva migrans - nematodes migrate to blood through intestinal wall
-> inflammation and damage

often effects heart (myocarditis), liver, eyes (visual impairement, blidness), and CNS (seizures, coma)

fecal oral

402
Q

onchocerca volvulus -

A

skin changes, loss of elastic fibers and river blindness

allergic reaction to microfilaire possible

femal blackfly

403
Q

loa loa

A

sweeeling in skin, worm in conjunctiva

deer fly, horse fly, mango fly

404
Q

w bancrofti

A

lymphatic filriasis (elephantiasis) - worms invade lymph nodes -> inflammation -> lymphedma

1 year latent period

female mosquito

405
Q

t solium

A

intestinal tape worm ingestion of larvae encysted in undercooked pork

cystiecercosis, neurocystercercosis - ingestion of eggs in food contaminated with human feces

406
Q

d latum

A

b12 -> megaloblastic anemia

ingestion of larvae in raw freshwater fish

407
Q

e granulosis

A

hydatid cysts (eggshell calcifications) in liver; cysts can rupture and cause anaphylaxis

ingestion of eggs in food contaminted with dog feces
sheep are intermediate host

408
Q

schistosoma mansonia

A

liver and spleen enlargement

eggs have lateral spine

fibrosis, inflammation, portal hypertension

snails are host; cercariea penetrate skin of humans

409
Q

s hematobium

A

chronic infection (egg with terminal spine), can lead to SCC of the bladder and pulmonary hypertension

410
Q

clnorchis sinesis

A

biliary tract infection -> pigemented gallstones

associated with cholangicarcimoa

undercooked fish

411
Q

ingested helminths

A

you EATT these

enterobius, ascaris, toxocara, trichinella

412
Q

cutaneous helmenths

A

get them from the SANd

strongyloides, ancyclostoma, necator

413
Q

helminths from bites

A

loa loa, onchocerca volvulus, wucheria bancfrotis

stay LOW to avoid these

414
Q

sarcoptes scabei

A

mites burrown into the stratum corneum and cause scabies - pruitis (worse at night) and serpiginous burrowns (lines) in the webspace of hands and feet

common in children, crowded populations (jails, nursing homes)

transmission by skin to skin and less commonly via fomites

415
Q

pediculus humanus/phthirus pubis

A

blood sucking lice that causes intense pruitis with asssociated excoriations, commonly on the scalp and neck (head lice) or waistband and axilla (body lice)

can transmit rickesttsia prowazekii (epidemic typhus), borelia recurrentis (relapsing fever), bartonella quintana (trench fever)

416
Q

schistosoma japonicum

A

portal hypertension

417
Q

ancyclostoma and necator can cause?

A

microcytic anemia

418
Q

viral recombination

A

just like medels recombinatoin

419
Q

reassortment viral

A

flu stuff (antigenic shift)

420
Q

complementation

A

hbsag is the envelope protein for hep d because its own is defective

421
Q

phenotypic mixing

A

forms a pseudovirion

422
Q

live attenuated vaccines viral

A

MMR, yellow fever, rotavirus, influenza (intranasal), chickenpox (VZV), small pox, sabin polio virus

Musci and lYRICSS are best enjoyed Live

can be given to HIV positive who do not show signs of immunodifiency

423
Q

Killed vaccines viral

A

Rabies, influenza (injected), salk polio, and HAV vaccines

only humoral immunity but are stable

424
Q

subunit viral vaccines

A

HBC (ag = hbsag), HPV (6 11 16 18)

425
Q

naked virion genome infectivity

A

purified nucleic acids of most dsDNA (except pox and HBV) and + strand ssRNA (smae thing as mRNA) are infectious

  • strand ssRNA and dsRNA viruses are not infectious and require polymerases brought with the complete virion
426
Q

dna viral replication location

A

al replicate in the nucleus except pox (carries its own dna-dependent rna polymerase)

427
Q

rna replication virus

A

all in the cytoplasm (except influenza virus and retro virus)

428
Q

complex dna capsid

429
Q

draw your rna/dna charts

A

good luck!

430
Q

poxvirus

A

smallpox eliminated due to live atteunated

cowpox “milkmaid blisters”

molluscum contagiosum

431
Q

adenovirus causes?

A

febrile pharygitis - sore throat
acute hemmorhagic cystitis
pneumonia
conjunctivitis - pink eye

432
Q

hpv warts

433
Q

bk virus

A

transplant patients, commonly targets the kidney

434
Q

parvovirus b19

A

in children slapped cheek diseae, 5th disease, erythema infectiosum

in fetus -> hydrops fetalis
adults can cause pure red cell aplasia and arthirtis like symptoms

435
Q

were is hsv2 latent?

A

sacral ganglia

436
Q

vzv latent were and what can reactivation cause?

A

latent in the doral root or trigeminal ganglia

cn v1 involvement can cause herpes zoster ophthalmicus

437
Q

mono symptoms

A

fever, hepatosplenomegaly, pharygitis, and lymphadenopathy (especially posterior cervical lymph nodes)

438
Q

cmv in transplants?

A

causes penumonia

439
Q

cmv retinits in aids

A

hemmorhage, cotton wool exudates, vision loss

440
Q

where is cmv latent?

A

mononulcear cells

441
Q

roseola infantum also called?

A

exanthem subitum

442
Q

roseola infantum clinical

A

high fever for days that cause cause seizures followed by diffuse macular rash

443
Q

hhv 8 transmission

A

sexual contact

444
Q

hhv 8 can also affect?

A

gi tract and lungs

445
Q

chsv identification

A

tzanck smear shows multinucleated giant cells seen in hsv 1 2 and vzv

intranuclear eosinophillic cowdry A inclusions also seen with 1 2 vzv

446
Q

cmv attachment

A

integrins (heparan sulfate)

447
Q

ebv attachment

448
Q

p b19 attachment

A

p antigen on RBCs

449
Q

attachment for rabies

A

nicotinic achr

450
Q

rhinovirus attachment

451
Q

sabin vaccine route?

452
Q

salk route?

453
Q

echovirus causes

A

aseptic meningitis

454
Q

rhinovirus casues

A

common cold

455
Q

coxsackie syndromes

A

aspetic meningitis, herpangian (mouth blisters and fever), hand foot and mouth disease, myocarditis and pericarditis

456
Q

chikungunya virus family

457
Q

coronaviruses cause

A

common cold, sars, mers

458
Q

arenavirus members

A

LCMV - lymphocytic choriomeningitis virus

lassa fever encephalitis - spread by rodents

459
Q

hantavirus causes

A

hemorrhagic fever, pneumonia

460
Q

enteroviruses

A

all of perch except rhinovirus

461
Q

picornavirus replication

A

all are made from i large polypeptide that is cleaved by proteases

462
Q

rhinovirus tid bits

A

> 100 serologic variants

acid labile - destroyed in stomach and does not infect GI tract , unlike other picornaviruses

463
Q

yellow fever trnamission

A

aedes mosquito

464
Q

yellow fever resevoir

A

human or monkey

465
Q

yellow fever symptoms

A

high fever, black vomitus, and jaundice

466
Q

yellow fever histology

A

liver biopsy may show councilman bodies (eosinophilic apoptotic bodies)

467
Q

rotavirus causes gastro where?

A

in day care centers and kindergartens

468
Q

rotavirus pathology

A

villous destruction with atrophy leads to decreased absortion of na and loss of k

469
Q

roata virus who should be vaccinated?

A

all infants by CDC

470
Q

influenza superinfection

A

s aureus, s pneumo, h influ

471
Q

most used flu vaccnie

A

killed vaccine

472
Q

live attenuated vaccine features

A

temp sensitive

replicates in nose but not lungs

473
Q

genetic shift is due to?

A

minor random mutations in hemagllutinin or neuramidase

474
Q

when do you need knew flu vaccines?

A

from genetic drift

475
Q

rubella also known as?

A

3 day german measles

476
Q

rubella symptoms

A

fever, postauricular and other lymphadeonpathy, arthlagias, and fine confluent rash that starts on face and spread centrifigullay to onvolve trunk and extremities.

477
Q

what causes blueberry muffin rash in congenital rubella?

A

dermal extramedullary hematopoiesis

478
Q

all paramyxovirsus have?

A

f or fusion protein which causes epithelial cells to fuse and form multinucleated giant cells

479
Q

croup also called

A

`acute laryngotracheobronchitis

480
Q

croup surface proteins

A

hemmaglutin and neuramidase

481
Q

croup caused by

A

parainfluenza

482
Q

croup clinical signs

A

results in seal like barking cough and inspiratory stridor

483
Q

croup xray sign

A

steeple sign

484
Q

croup sever can cause

A

pulsus paraoxus

485
Q

measles also called

486
Q

measles clinical

A

prodromal fever with cough, corzya, conjunctivitis and then koplik spots

then the maculopapular rash 1-2 days later

487
Q

measles histology

A

lymphadenitis with warthin finkeldey giant cells (fused lymphocytes) in a background of paracortical hyperplasia

488
Q

measles sequale

A

SSPSE years later, ecephalitis, and giant cell pneumonia (rarely, in immunosupressed)

489
Q

mumps clinical

A

parotitis, orchitis, aseptic meningitis, pancreatitis.

can cause steritly (especially after puberty)

490
Q

rhabies histopath

A

negri bodies, cytoplasmic inclusions found in the purkinje cells of the cerebellum and the hippocampal neurons

491
Q

rhabies clinical

A

incubations period of weeks to months

fever mailaise -> agitation, photophobia, hyrdophobia -> hypersaliavation -> paralysis, coma -> death

492
Q

rhabies trip to cns

A

binds ach receptors and the retrograde transport via dynein motors

493
Q

rhabies transmission

A

bat, raccon, and skunk bites, than from dog bites in US

aersol transmission in bat caves also possible

494
Q

rhabies tretament

A

wound cleaning, killed vaccine, immunoglobin

495
Q

ebola virus targets

A

targets endothelial cells, phagocytes, hepatocytes.

496
Q

ebola virus clinical

A

up to 21 day incubatino period, abrupt onset of flu like symptoms, diarrhea/vomiting, high fever, myalgia.

can progress to DIC, diffuse hemmorhage, shock

497
Q

ebola virus transmision

A

requires direct contact with bodily fluids, fomites (including dead bodies), infected bats or primates (apes/monkeys)

high incidence of nosocominal infections

498
Q

zika virus family?

A

flavivirus

499
Q

zika virus trnamission

A

aedes mosquito and outbreaks more common in tropical and subtropical communities

sexual and vertical transmission possible

500
Q

zika virus clinical

A

20 percent get low grade pyrexia, itchy rash, conjuntivits

can lead to congenital microcephaly or misccariages

501
Q

nonenveloped hepatitis viruses do?

A

hit your gut

502
Q

hepatitis signs and symptoms

A

fever, jaundice, alt and ast,

503
Q

HBV completion of DNA and of reverse transciptions

A

by hbv dna that has dna and rna depedent activities

504
Q

transcription of HBV mrna

A

by host rna polymerase

505
Q

HCV lacks?

A

3 to 5 prime exonuclaese activity so get variation in the envelop proteins and host antibodies lag behind

506
Q

HAV transmission

A

fecal oral (shellfish, travelers, day care)

507
Q

HAV incubation

A

short (weeks)

508
Q

HAV clinical course

A

asymptomatic (usually), acute

509
Q

HAV biopsy

A

hepatocyte sweling, monocyte infiltation, councilmen bodies

510
Q

HBV transmission

A

parenteral (blood), sexual (baby making), perinatal (birthing)

511
Q

HBV incubatino

A

long (months)

512
Q

HBV clinical

A

intially like serum sickness (fever, arthlagias, rash) may progress to carcinoma

513
Q

HBV prognosis

A

mostly full resoution for adults. neonates have a worse prognosis

514
Q

HBV histology

A

granular eosinophilic “ground glass” appearence; cytotoxic T cells mediate damage

515
Q

common hepatitis carrier states

A

HBV and HBC

516
Q

HCV transmission

A

primarily blood (IVDU, post transfusion)

517
Q

HCV incubation

518
Q

HCV histology

A

lymphoid aggregates with focal areas of macrovesicular steatosis

519
Q

HDV transmission

A

parenteral, sexual, perinatal

520
Q

HEV transmission

A

fecal oral, especially waterborne

521
Q

HEV incubation

522
Q

HEV clinical

A

fmulminant hepatitis in Expactant pregnant women

523
Q

HEV histo

A

patchy necrosis

524
Q

hep b hematologic

A

aplastic anemia

525
Q

hep b renal

A

mebranous gn -> membranoproliferative gn

526
Q

hep b vascular

A

polarteritis nodasa

527
Q

hep c hematologic

A

essential mixed cryoglubulinemia, increased risk for b cell NHL, ITP, autoimmune hemolytic anemia

528
Q

cryoglobulinemia

A

increased protein, usually igm
precipitate at lower temps
toes and fingers gangrene

529
Q

hep c renal

A

membranoproliferative gn -> membranous Gn

530
Q

hep c vascular

A

leukocytoclastic vasculitis

531
Q

hep c dermatologic

A

sprodic porphyria cutanea tarda, lichen planus

532
Q

hep c endocrine

A

increased risk of diabetes mellitus, autoimmune hypohyroidism

533
Q

Anti HAV (IgM)

A

best to detect acute hepatitis a

534
Q

anti HAV (IgG)

A

prior HAV infection and or prior vaccination; protects agaisnts reinfection

535
Q

HbSag

A

what you need to know is persistance of this represents chronic infection

536
Q

HBcAG`

A

never found in serum

537
Q

HbEAg

A

secreted by infected hepatocyte into circulation. not part of mature virion.

538
Q

hiv env gene

A

gp 41 and gp 120

539
Q

gag gene

A

p24 (capsid) and p17 (matrix)

540
Q

pol gene

A

reverse transcriptase (tavels in virus), aspartate protease, integrase

541
Q

what confers immuntiy?

A

ccr5 mutations

542
Q

hiv testing

A

elisa (rule out) western blot (rule in)

543
Q

aids diagnosis

A

less than or equal to 200, aids defining illness, cd4 percentage lss than 14 percent

544
Q

aids diagnosis in neonates

A

us PCR in neonates

545
Q

draw hiv time course chart

546
Q

acute hiv infection clinical

A

fever, myalgias, maculopapular rash, mono like, sore throat, cervical adenopathy

547
Q

less than 400 general symptoms

A

constituional symptoms, skin, mucous membrane infections

548
Q

less than 200 general symptoms

A

systemic/aids defining illnesses

549
Q

less than 500 disease

A

oral thrush, pral hairy leukoplakia, bacillary angiomatosis, kaposi sarcoma, HPV (squamous cell carcinoma comonly of anus or cervix

550
Q

less than 500 candida

A

scrapbale white plague, psuedohypahe

551
Q

less than 500 oral hairy leukoplakia

A

unscaplble plague on lateral tongue

552
Q

less than 500 bartonella

A

bopsy shows neutrophils

553
Q

less than 500 hhv8

A

biopsy shows lymphocytic infiltrate

554
Q

less than 200 cd4 disease

A

histo, hiv, jc, pneumocystis

555
Q

less than 200 histo

A

fever, weightl loss, fatigue, cough, dyspnea, nausea,vomiting, dirrhe

oval yeast cells within macrophages

556
Q

less than 200 HIV

557
Q

less than 200 jc

A

PML

nonenhancing areas of demylination on MRI

558
Q

hive disease less than 100

A

aspergillus, candida esophagitis, CMV, cryptococcus, cryptosporidium, EBV b cell lymphoma, MAC, toxo

559
Q

less than 100 aspergillus

A

hemoptysis, pluretic pain cavitation or infiltrates on chest imaging

560
Q

less than 100 candida

A

esophagitis white plagues on endoscopy

561
Q

less than 100 CMV

A

retinitis, esophagitis, colitis, pneumonitis, encephalitis

linear ulcers on endoscopy, cotton wool spots on fundoscopy

intranuclear owleye inclusions

562
Q

c neoformans less than 100

A

meningitis

563
Q

less than 100cryptosporidium less than 100

A

chronic watery diarrhea

564
Q

less than 100 ebv

A

primary b cell lymphoma

565
Q

less than 100 MAC

A

nonspecific systemic symptoms (fever, night sweats, weight loss) or focal lymphadenitis

566
Q

less than 100 toxo

A

brain abscesses

567
Q

prions are usually predominatly?

A

alpha helical but get turned to beta

568
Q

prions are resistant too?

A

standard sterilization and autoclaving

569
Q

normal flora: skin

570
Q

nose: normal flora:

A

s epi and colonized by s aureus

571
Q

oropharynx normal flora:

572
Q

dental plague normal flora:

573
Q

normal flora: colon

A

b fragilis > e coli

574
Q

vagina normal flora:

A

lactobacillus, colonized by e coli and group b strep

575
Q

c perfingens whats it on?

A

reheated meat

576
Q

s aureus food poisoning food in

A

meats, mayonaise, custard

577
Q

v vulnifus and v parahaemolyticus

A

get from contamiated seafood

usually infects those with liver disease (alcoholic cirrhosis, hepatitis, hemochromatsis)

Can get both VV and VP from eating shellfish, and only VV from wound infection from contaminated water or shellfish

both can cause septicemia

fluid fille dblisters

578
Q

enteroinvasive e coli

A

causes bloody diarrhea and invades colonic mucosa

579
Q

y entercolitica assoicated with what kind of outbreaks?

A

day care outbreaks

580
Q

often get vibrio cholera frm where?

A

infected seafod

581
Q

pneumonia neonates less than 4 wks

A

group b strep or e coli

582
Q

pneumonia children 4wk to 18 yr

A

RSV, mycoplasma, c trachomatis (infants), c pneumoniae (school aged children), s pneumoniae

583
Q

adults 18 to 40 yers pneumonia

A

mycoplasma pneumoniae, c pneumoniae, s pneumoniae, viruses (influenza)

584
Q

adults 40 to 65 yrs pneumonia

A

s pneumoniae, h influenza, anaerobes, viruses, mycoplasma

585
Q

elderly pneumonia

A

s pneumoniae, influenza, anaerobes, h influenza gram neg rods

586
Q

alcoholic pneumonia

A

klebsiella, anaerobes due to aspiration (peptostreptococcus, fusobacterium, prevotella, bacteroides)

587
Q

iv drugs users pneumonia

A

s pneumoniae, s aureus

588
Q

cystic fibrosis pneumonia

A

pseudomonas, s aureus, s pneumoniae, burkholder cepacia

589
Q

postviral pneumonia

A

s pneumoniae, s aureus, h influenza

590
Q

newborm meningitis (0-6 wks)

A

group b strep, e coil, listeria

591
Q

children meningitis (6 months to 6 yrs)

A

s pneumonia, n meningitidis, h influenza type b, enteroviruses

592
Q

6 yrs to 60 yrs meningitis

A

s pneumo, n meningitidis, enteroviruses, hsv

593
Q

60+ meningitis

A

s pneumo, gram - rods, listeria

594
Q

viral causes of meningitis

A

enterovirsusu (especially coxsackie), hsv2 (hsv-1 = encephalitis), HIV, west nile virus (also causes encephalitis), VZV

595
Q

bacterial meningitis findings

A

opening pressure increased, increased PMNs, increased protein, decreased glucose

596
Q

fungal/tb meningitis findings

A

increased pressure, increased lymphocytes, increassed protein, decreased glucose

597
Q

viral meningitis findings

A

normal to increased opening pressure, increased lymphocytes, normal to increased protein, normal glucose

598
Q

infections causing brain abscesses

A

most commonly viridans strep or staph aureus. if dental infection or extraction procedes abscess, anaerobes commonly invovled.
multiple abscesses are sually from bacterimia; single lesions from cintigious sites; otitis media and mastoiditis -> temporal lobe and cerebellum; sinusitus or dental infection -> frontal lobe
toxoplasma in aids

599
Q

osteomyelitis if no other info

600
Q

sexually active osteomyelitis

A

n gonorrhea

601
Q

sickle cell osteomyelitis

A

salmonella and s aureus

602
Q

osteomyelitis prosthetic joint replacement

A

s aureus and s epidermidis

603
Q

osteomyelitis vertebral involvement

A

s aureus, mycobacterium tb (pott disease)

604
Q

cat and dog bites osteomyelitis

A

pasteurella multocida

605
Q

iv drug abuse osteomyelitis

A

pseudomonas, candida, s aureus

606
Q

osteomyelitis findings

A

elevated CRP and ESR

MRI best in early

607
Q

kelbsiella UTI

A

3rd leading cause of UTI. large mucoid capsule and viscous colonies

608
Q

serratia UTI

A

some strains produce red pigment, often nosocomnial and drgu resistant

609
Q

enterococcus UTI

A

often nosocominal and drug resistant

610
Q

proteus mirabalis UTI

A

motility causes swarming on agar; produces urease; assoicated with struviite stones

611
Q

pseudomonas UTI

A

blue green pigment and fruity odor; usually nosocominal and drug resistant

612
Q

bacterial vaginosis

A

thin, white discharge with fishy odor, no inflammatin

613
Q

trichomonas

A

inflamation, frothy yellow green foul smelling discharge

motile trichomonads

614
Q

candida vulvovaginitis

A

inflammation, thich white cottage cheese discharge

615
Q

nonspecific torches signs

A

hepatosplenomegaly, jaundice, thrombocytopenia, and growth retardation

616
Q

tocoplasma in mom

A

usually asymptomatic, can cause lymphadenopathy

617
Q

toxo in baby

A

triad of chorioretinitis, hydrocephalus, and intracrnial calcifications and could have blueberry muffin rash

618
Q

rubella transmission

A

respiratory droplets

619
Q

rubella mom manifestations

A

rash, lymphadenopathy, polyarthirtis, polyarthlagias

620
Q

rubella baby

A

triad: eye (cataracts) and ear (deafness) and congenital heart porblems (PDA).

621
Q

cmv mom transmission

A

sexual contact, transplants

622
Q

cmv baby

A

hearing loss, seizures, petehcial rash, blueberry muffine rash, periventricular calcifications

623
Q

HIV in baby

A

reccurrent infetions, chronic diarrhea

624
Q

HSV2 in baby

A

meningoencephalitis or herpetic lesions

625
Q

syphillis in baby

A

often still birth, hydrops fetalis; if child survives, presens with facial abnormalities (eg notched teeth, saddle nose, short maxilla, saber shins, cn 8 deafness

626
Q

red rashes of childhood: handfoot and mouth disease

A

ovalshaped vesicles on palms and soles; vesicles and ulcers in oral mucosa

627
Q

red rashes of childhood: roseola aka

A

eanthem subitum

628
Q

red rashes of childhood: p b19 in pregnant

A

hydrops fetalis

629
Q

red rashes of childhood: vzv

A

vesicular rash begins on trunk, spreads to face and extremities with lesions of different stages

630
Q

chancroid

A

painful genital ulcer with exudates, inguinal lymphadenopathy

631
Q

chlamydia as an std

A

urethritis, cervicitis, epididymitis, conjunctivitis, reative arthiritis, PID

types d-k

632
Q

condyloma acuminata

633
Q

granuloma inguinale (donovanosis)

A

painless beefy red ulcer that bleeds readily on contact
not common in us

Klebsiella (calymmatobacterium) granulomatis; cytoplasmic donovan bidies (bipolar staining) seen on microscopy

634
Q

PID top bugs an clinical

A

c trachmoatis (subacute and often undiagnosed), Neiserria gonorhea (acute)

c trach most common

cervical motion tenderness (chadilier signs), purulent cervical discharge

PID may include salpingitis, endometritis, hydrosalpinx, and tuboovarian abscess

635
Q

PID salpingitis risk factor

A

ectopic pregnancy, infertility, chronic pelvic pain, adhesions

636
Q

PID can lead to

A

fitz hugh curtis syndrome - infection of the liver capsule and violin strong adhesions to the peritoneum

637
Q

two most common nosocominal infections

A

e coli (uti) and s aureus (wound infection)

638
Q

aspiration pneumonia is

A

foul smelling

639
Q

debubitis ulcers, surgical wounds, drains

A

s qureus (including mrsa), gram - anaerobes (bacteroides, prevotella, fusobacterium)

640
Q

intravascuar catheters

A

s aureus (including mrsa), s epidermidis (long term), enterobacter

641
Q

mechanical ventilation, endotracheal intubation

A

late onset: pseudomonas, klebsiella, acinetobacter, s aureua

sweet odor for pseudomonas

642
Q

renal dialysis unit, needle stick

643
Q

urinary catherterization

A

e coli, klebsiella, proteus

644
Q

meningitis that can colonize the nasopharynx

A

h influenza type b

645
Q

meningitis that can lead to myagias and paralysis

A

poliovirus

646
Q

epiglottis can cause what ?

A

epiglottis even in fully immunized kids

647
Q

chronic granulomatis disease susceptible to?

A

cat + especially s aureus

648
Q

fungal infection in diabetic or immunocompromised?

A

mucor or rhizopus

649
Q

needle stick?

650
Q

neutropnenic patients

A

candida albicans (systemic), aspergilus

651
Q

organ transplant

652
Q

traumatic open wound

A

c perfingens

Pharmacology (33 decks)

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