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NBME Micro > Microbiology: Microbiology Systems > Flashcards

Microbiology: Microbiology Systems Flashcards

1
Q

How is Toxoplasma gondii characteristically transmitted?

A

Through cat feces or ingestion of undercooked meat

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2
Q

What organism causes both watery diarrhea and gas gangrene?

A

Clostridium perfringens

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3
Q

What are the sensitivity and specificity, respectively, of the ESR and CRP laboratory assays in the work-up for osteomyelitis?

A

Elevated values are sensitive for osteomyelitis, but not specific

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4
Q

What pathogen is associated with infection related to water aerosols?

A

Legionella

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5
Q

What virus is associated with genital herpes?

A

Herpes simplex virus-2, less commonly herpes simplex virus-1

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6
Q

What pathogens are likely responsible for infection related to intravascular catheters?

A

Staphylococcus aureus (including MRSA), Staphylococcus epidermidis (from long-term intravascular catheter use), Enterobacter

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7
Q

What pathogen is higher risk in unvaccinated individuals and presents with postauricular lymphadenopathy and a descending rash?

A

Rubella virus

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8
Q

What causes of pneumonia are associated with alcoholism?

A

Klebsiella and anaerobes secondary to aspiration (eg, Fusobacterium, Peptostreptococcus, Prevotella, Bacteroides)

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9
Q

What cause of pneumonia is associated with “currant jelly” sputum?

A

Klebsiella

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10
Q

When does chemical conjunctivitis present?

A

1-2 days after birth

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11
Q

Name the organisms that cause condylomata acuminata.

A

Human papillomavirus 6 and 11

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12
Q

Name the 6 organisms/agents that cause the ToRCHeS infections.

A

ToRCHeS: Toxoplasma gondii, Rubella, Cytomegalovirus, HIV, Herpes simplex virus type 2, Syphilis

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13
Q

What virus is responsible for chickenpox?

A

Varicella-zoster

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14
Q

How does conjunctivitis caused by chlamydia present?

A

Mild to severe hyperemia and thick, possibly bloody, mucopurulent discharge

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15
Q

What microorganism is associated with a food-borne illness from poultry, meat, and eggs?

A

Salmonella

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16
Q

When does neonatal conjunctivitis from gonorrhea present?

A

2-5+ days after birth

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17
Q

What UTI-causing organism is associated with a fruity odor and blue-green tint?

A

Pseudomonas aeruginosa, often acquired nosocomially

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18
Q

What pathogens are likely responsible for a nosocomial infection caused by decubitus ulcers, surgical wounds, or drains?

A

Staphylococcus aureus (including MRSA) or gram ⊖ anaerobes (eg, Bacteroides, Prevotella, Fusobacterium)

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19
Q

What STI presents with a painless, beefy red ulcerative genital lesion that bleeds on examination?

A

Donovanosis (or granuloma inguinale) caused by Klebsiella [Calymmatobacterium] granulomatis

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20
Q

Why is MRI better than radiographs for the diagnosis of osteomyelitis?

A

MRIs detect acute infection and detail anatomic involvement; radiographs are insensitive in early detection of osteomyelitis, although may be useful for chronic cases

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21
Q

What is the pathophysiology of lymphogranuloma venereum?

A

Infection of the lymphatics caused by Chlamydia trachomatis

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22
Q

What physical exam findings may be seen in Legionella infections?

A

Signs of pneumonia, neurologic abnormalities, and gastrointestinal symptoms (eg, diarrhea, nausea, vomiting)

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23
Q

Patients with chronic granulomatous disease are prone to infection by which organisms?

A

Catalase ⊕ microbes, especially Staphylococcus aureus

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24
Q

What virus is responsible for rubeola?

A

Measles

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25
Q

Watery diarrhea caused by which organism presents with rice-water stools in which you see comma-shaped organisms?

A

Vibrio cholerae infection

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26
Q

What microorganism is associated with a food-borne illness from reheated meat?

A

Clostridium perfringens

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27
Q

What microorganism is associated with a food-borne illness from deli meats or soft cheeses?

A

Listeria monocytogenes

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28
Q

What aspects of Enterococcus infections make them particularly difficult to treat?

A

They are often drug-resistant and nosocomial

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29
Q

What bacteria is typically found in dental plaques?

A

Streptococcus mutans

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30
Q

What bacteria are considered normal flora in the vagina?

A

Lactobacillus, Escherichia coli, and group B streptococcus

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31
Q

How might the mother of an infant diagnosed with Toxoplasma gondii infection present?

A

The mother is usually asymptomatic, with lymphadenopathy only in rare circumstances

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32
Q

In the absence of any further information, which organism is most likely involved in a traumatic open wound infection?

A

Clostridium perfringens

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33
Q

What are the 2 most common causes of nosocomial infections?

A

Escherichia coli (UTIs) and Staphylococcus aureus (wound infections)

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34
Q

What physical exam findings are seen in infections associated with wound infections, decubitus ulcers, or drains?

A

Erythema, tenderness, drainage, and induration

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35
Q

Which 2 organisms most frequently cause osteomyelitis of the vertebrae?

A

Staphylococcus aureus and Mycobacterium tuberculosis

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36
Q

What organism is associated with pediatric epiglottitis?

A

Haemophilus influenzae

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37
Q

A patient with meningitis has an ↑ opening pressure on lumbar puncture. CSF analysis shows ↑ protein, ↓ glucose, and a neutrophilic pleocytosis. Diagnosis?

A

Bacterial meningitis

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38
Q

When does neonatal conjunctivitis caused by chlamydia present?

A

5-14 days after birth

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39
Q

Name the most common causes of pneumonia in patients who are 4 weeks to 18 years of age.

A

Viruses (RSV), Mycoplasma, Chlamydia trachomatis, Chalmydia pneumoniae, Streptococcus pneumoniae (Runts May Cough Chunky Sputum)

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40
Q

What 2 microorganisms are associated with a quick onset and a quick resolution of food poisoning?

A

Staphylococcus aureus and Bacillus cereus cause food poisoning that is quick to start and brief in duration

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41
Q

What is the likely source of multiple brain abscesses?

A

Bacteremia

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42
Q

What vaginal infection presents with inflammation termed “strawberry cervix” and frothy, foul-smelling, green-yellow discharge?

A

Trichomonas vaginitis

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43
Q

What organism is associated with puncture wounds and lockjaw?

A

Clostridium tetani

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44
Q

Name 7 organisms that can cause bloody diarrhea.

A

Campylobacter, Entamoeba histolytica, enterohemorrhagic and enteroinvasive Escherichia coli, nontyphoidal Salmonella, Shigella, Yersinia enterocolitica

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45
Q

Why are UTIs 10 times more likely to occur in women than in men?

A

Women have a shorter urethra colonized by fecal flora

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46
Q

What allows for the motility of Salmonella?

A

Salmonella has flagella that allow it to move (Salmon swim)

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47
Q

What bacterial species is the leading cause of UTIs?

A

Escherichia coli

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48
Q

How does chemical conjunctivitis present?

A

Watery, nonpurulent discharge

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49
Q

What microscopy findings do you expect to see in a patient with Candida vulvovaginitis?

A

Pseudohyphae; infection characterized by thick, white vaginal discharge that resembles cottage cheese

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50
Q

What is the pH in Candida vulvovaginitis?

A

Normal (4–4.5)

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51
Q

In sexually active individuals, which pathogen rarely causes osteomyelitis but more commonly causes septic arthritis?

A

Neisseria gonorrhoeae

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52
Q

What organism is associated with pseudomembranous colitis and watery diarrhea?

A

Clostridium difficile

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53
Q

What is the most likely cause of meningitis in teenagers?

A

Neisseria meningitidis

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54
Q

A patient with meningitis has a normal opening pressure on lumbar puncture. CSF analysis shows normal protein and glucose with a lymphocytic pleocytosis. Diagnosis?

A

Viral meningitis

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55
Q

What is the mode of transmission of a ToRCHeS infection?

A

Caused by transmission of a microbe from mother to fetus, usually transplacental, but can also occur during delivery (eg, HSV-2)

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56
Q

What is the likely source of a single brain abscess?

A

Spread of infection from contiguous sites

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57
Q

What is another name for neonatal conjunctivitis?

A

Ophthalmia neonatorum

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58
Q

What is the most common source of Vibrio cholerae diarrhea?

A

Infected seafood

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59
Q

What exposures are associated with a Clostridium difficile infection?

A

Antibiotics and proton pump inhibitors

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60
Q

What are 3 congenital infections that present with dermal erythropoeisis and extravascular bleeding?

A

Toxoplasmosis, CMV, Rubella

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61
Q

How does cytomegalovirus infection present in the mother?

A

It is usually asymptomatic; rare cases may have mononucleosis-like symptoms

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62
Q

What is the mechanism of cytomegalovirus transmission?

A

Sexual contacts or organ transplantation

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63
Q

How does herpes simplex virus conjunctivitis present?

A

Conjunctival injection, nonpurulent discharge, vesicular skin lesions, keratitis, and disseminated infection

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64
Q

What pathogen is higher risk in unvaccinated individuals and presents with fever, drooling, dysphagia, difficulty breathing, and a swollen cherry-red throat?

A

Haemophilus influenzae type b causing epiglottitis (can affect immunized and unimmunized children)

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65
Q

How does gonorrheal conjunctivitis present?

A

Marked conjunctival injection, profuse purulent discharge, and lid swelling; corneal involvement can lead to blindness

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66
Q

What STI may present with urethritis, cervicitis, pelvic inflammatory disease, creamy purulent discharge, prostatitis, epididymitis, or arthritis?

A

Gonorrhea from Neisseria gonorrhoeae

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67
Q

What STI may result in jaundice?

A

Hepatitis caused by hepatitis B virus

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68
Q

What gastrointestinal complication may be seen in untreated PID?

A

Perihepatitis, or Fitz-Hugh–Curtis syndrome, characterized by “violin string” adhesions of the peritoneum to the liver capsule due to inflammation of the liver capsule

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69
Q

What does a urine sample testing positive for leukocyte esterase indicate?

A

WBC Activity

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70
Q

What STI presents with painless genital ulcers and painful inguinal lymphadenopathy resembling buboes?

A

Lymphogranuloma venereum

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71
Q

Which of the ToRCHeS infections often results in stillbirth or hydrops fetalis?

A

Syphilis

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72
Q

Which organism causing oral infections is associated with sulfur granules and branching rods?

A

Actinomyces israelii

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73
Q

Which 3 viruses cause watery diarrhea?

A

Rotavirus, enteric adenovirus, and norovirus

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74
Q

Which species of Chlamydia causes pneumonia in children younger than 3 years of age, and which causes it in school-aged children?

A

Chlamydia trachomatis in children younger than 3 years of age; Chlamydia pneumoniae in school-aged children

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75
Q

What are feared complications of gonorrhea conjunctivitis?

A

Blindness due to rapid corneal involvement, systemic dissemination

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76
Q

What are the dermatological manifestations of a congenital cytomegalovirus infection?

A

Petechial rash, “blueberry muffin” rash

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77
Q

What part of the body does Staphylococcus aureus normally colonize?

A

The Nose

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78
Q

What is the name of the condition when there is tuberculosis osteomyelitis involving the vertebrae?

A

Pott disease

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79
Q

Why does Staphylococcus aureus cause food poisoning quickly?

A

The toxins that cause the food poisoning are preformed

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80
Q

What organism causes chlamydia?

A

Chlamydia trachomatis (D-K)

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81
Q

What constellation of findings may be seen in a congenital Rubella infection?

A

Classic triad: eye abnormalities (eg, cataracts), ear issues (eg, deafness), congenital heart disease (eg, PDA) ± a “blueberry muffin” rash (“I [eye] ♥ ruby [rubella] earrings”)

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82
Q

What are the CSF protein levels in bacterial, fungal, and viral meningitis, respectively?

A

↑, ↑, normal to ↑

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83
Q

What pathological cells might be seen on a biopsy of a HPV-induced genital warts lesion?

A

Koilocytes

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84
Q

What risk factors predispose a patient to Clostridium difficile infection?

A

Recent antibiotic use

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85
Q

Pelvic inflammatory disease is most often caused by which 2 organisms?

A

Chlamydia trachomatis and Neisseria gonorrhoeae

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86
Q

What UTI-causing organism is associated with the formation of struvite stones?

A

Proteus mirabilis

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87
Q

What are the CSF opening pressure levels in bacterial, fungal, and viral meningitis, respectively?

A

↑, ↑, normal to ↑

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88
Q

What STI presents with exudative, painful genital ulcers and inguinal lymphadenopathy?

A

Chancroid

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89
Q

What organisms commonly cause osteomyelitis in IV drug users?

A

Staphylococcus aureus (most common), Pseudomonas, Candida

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90
Q

Name some of the common predisposing factors for UTIs.

A

Female sex, obstruction (eg, kidney stones, enlarged prostate), catheterization, kidney surgery, congenital genitourinary malformation (eg, vesicoureteral reflux), pregnancy, diabetes

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91
Q

What 2 protozoa are most likely to cause watery diarrhea?

A

Giardia and Cryptosporidium

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92
Q

What childhood rash presents with cough, conjunctivitis, coryza, and bluish spots on the buccal mucosa followed by a descending confluent rash?

A

Measles (rubeola); the blue-white spots on the buccal mucosa are known as Koplik spots

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93
Q

What is the most common route of transmission for microbes that cause UTIs?

A

Bacteria from the urethra ascends to the bladder

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94
Q

What pathogens are associated with infection related to urinary catheterization?

A

Proteus spp, Escherichia coli, or Klebsiella (infections in your PEcKer)

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95
Q

Which childhood rash can present with febrile seizures, especially in affected infants?

A

Human herpesvirus 6, which causes roseola (exanthem subitum)

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96
Q

What is the most common cause of neonatal conjunctivitis?

A

Chlamydia

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97
Q

What physical exam findings may be seen in infections caused by urinary catheterization?

A

Dysuria, leukocytosis, costovertebral tenderness, or flank pain

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98
Q

What stage of syphilis presents with a painless chancre?

A

Primary syphilis

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99
Q

What is the pH in bacterial vaginosis?

A

> 4.5

100
Q

What organism is likely responsible for a brain abscess in a patient with AIDS and a CD4+ count <100 cells/mm3?

A

Toxoplasma

101
Q

What STI presents with vaginitis and a strawberry-colored cervix?

A

Trichomoniasis caused by Trichomonas vaginalis

102
Q

What pathogen is higher risk in unvaccinated individuals and presents with cough, runny nose, conjunctivitis, a diffuse rash, and blue-white spots in the mouth?

A

Measles virus (the mouth lesions are called Koplik spots)

103
Q

Which settings are associated with hepatitis B and hepatitis C nosocomial infections?

A

Renal dialysis units, needlesticks

104
Q

What finding on urinalysis can help to distinguish a UTI from pyelonephritis?

A

Detection of WBC casts (absent in a UTI, present with pyleonephritis)

105
Q

What class of virus is responsible for German measles?

A

Togavirus (causative agent: Rubella virus)

106
Q

Sinus and CNS infections in patients with diabetes are associated with which fungal organisms?

A

Mucor or Rhizopus spp

107
Q

What characteristic radiographic exam findings may be seen after aspiration?

A

Infiltrates in the right lower lobe (or right upper or middle lobe if the patient is recumbent)

108
Q

Which infectious agents are the most common causes of pneumonia in the immunocompromised?

A

Staphylococcus aureus, Pneumocystis jirovecii (with HIV), enteric gram ⊖ rods, fungi, and viruses

109
Q

What organism is responsible for granuloma inguinale?

A

Klebsiella granulomatis

110
Q

What organism leads to chancroid?

A

Haemophilus ducreyi

111
Q

When does neonatal conjunctivitis from herpes simplex virus present?

A

Days-6 weeks after birth

112
Q

Which organism is the most likely cause of infection in individuals with burn injuries?

A

Pseudomonas aeruginosa

113
Q

What physical exam findings may be seen with aspiration pneumonia?

A

Purulent malodorous sputum

114
Q

What organism presents with bloody diarrhea and pseudoappendicitis?

A

Yersinia enterocolitica

115
Q

What cause of bloody diarrhea presents with liver abscesses?

A

Entamoeba histolytica, a protozoa that causes amebic dysentery

116
Q

Name the 3 organisms that cause rashes on the hands and feet.

A

Coxsackie A virus, Treponema pallidum, and Rickettsia rickettsii

117
Q

Which white blood cell type predominates in the CSF in bacterial, fungal, and viral meningitis, respectively?

A

PMN, lymphocyte, lymphocyte

118
Q

In general, what organism is the most common cause of osteomyelitis?

A

Staphylococcus aureus (assume this cause if information is limited)

119
Q

Which organism is commonly involved in surgical wound infections in postoperative patients?

A

Staphylococcus aureus

120
Q

What 2 toxins are produced by enterotoxigenic Escherichia coli?

A

LT (heat-labile) and ST (heat-stable) toxins

121
Q

What is the mechanism of syphilis maternal transmission?

A

Sexual contact

122
Q

What pathogen is higher risk in unvaccinated individuals, resides in the nasopharynx, and causes meningitis in unvaccinated children?

A

Haemophilus influenzae type b

123
Q

What characteristic sign may be seen on x-ray in Haemophilus influenzae epiglottitis?

A

Thumbprint sign

124
Q

What infectious organism is associated with bilateral facial nerve palsy?

A

Borrelia burgdorferi (causes Lyme disease)

125
Q

What organism is associated with bloody diarrhea caused by a lactose-negative bacterium with a low median infective dose (ID50)?

A

Shigella

126
Q

What pathogens are associated with atypical causes of pneumonia?

A

Mycoplasma, Legionella, Chlamydophila, and viruses (RSV, CMV, influenza, adenovirus)

127
Q

Which 2 organisms are likely causes of osteomyelitis in patients with prosthetic joint replacements?

A

Staphylococcus aureus and Staphylococcus epidermidis

128
Q

Name the most common causes of pneumonia in adults 18-40 years of age.

A

Mycoplasma, Chlamydia pneumoniae, Streptococcus pneumoniae, viruses (eg, influenza)

129
Q

Name 5 viral causes of meningitis.

A

Enteroviruses (particularly coxsackievirus), herpes simplex virus-2 (HSV-2), HIV, West Nile virus (which can result in encephalitis), varicella-zoster virus (VZV)

130
Q

What cause of bloody diarrhea presents with a comma- or S-shaped bug that grows at 42°C?

A

Campylobacter

131
Q

What are the most likely causes of meningitis in children 6 months to 6 years of age?

A

Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae type B, or enteroviruses

132
Q

Osteomyelitis from cat or dog bites is most frequently caused by which organism

A

Pasteurella multocida

133
Q

What physical exam findings are seen in infections associated with intravascular catheters?

A

Erythema, tenderness, induration, drainage from access sites

134
Q

How does a rubella infection typically present in a mother?

A

Rash, polyarthritis, polyarthralgia, and lymphadenopathy

135
Q

Which organisms are higher risk of causing infections in patients with asplenia?

A

Any of the encapsulated bacteria; think SHiN: Streptococcus pneumoniae > > Haemophilus influenzae type b > Neisseria meningitidis

136
Q

What pathogen is higher risk in unvaccinated individuals and presents with meningitis, myalgia, and paralysis?

A

Poliovirus

137
Q

What is the cause of chemical conjunctivitis?

A

Irritation from antibiotic ointments

138
Q

What are the common signs and symptoms of pyelonephritis?

A

Fevers, chills, costovertebral angle tenderness, flank pain, hematuria, WBC casts

139
Q

What microscopy finding is seen in bacterial vaginosis?

A

Clue cells; infection characterized by thin, white discharge and fishy odor

140
Q

A neonate delivered via cesarean section is colonized with bacteria at the time of birth?

A

No bacteria; neonates delivered by cesarean section are born without any flora but are colonized quickly after birth

141
Q

What is the treatment of choice for bacterial vaginosis?

A

Metronidazole or clindamycin

142
Q

Which 2 bacteria are considered part of the normal flora in the colon?

A

Bacteroides fragilis and, to a lesser extent, Escherichia coli

143
Q

What UTI-causing organism is associated with “swarming” on agar due to motility?

A

Proteus mirabilis

144
Q

What microorganism is associated with a food-borne illness from raw honey?

A

Clostridium botulinum (spores)

145
Q

Staphylococcus epidermidis is part of the normal flora of what 2 parts of the body?

A

The skin and the nose

146
Q

What stage of syphilis presents with gummas, tabes dorsalis, aortitis, general paresis, and an Argyll Robertson pupil?

A

Tertiary syphilis

147
Q

How does congenital syphilis infection present if the baby survives?

A

Facial abnormalities (notched teeth, saddle nose, short maxilla), CN VIII deafness, saber shins

148
Q

What organism is associated with neonatal meningitis or sepsis?

A

Group B streptococcus

149
Q

How has the incidence of meningitis caused by Haemophilus influenzae changed over time?

A

↓ as a result of vaccination

150
Q

What organism causes pneumonia in patients with HIV?

A

Pneumocystis jirovecii

151
Q

What organism is the second most common cause of UTIs in sexually active females?

A

Staphylococcus saprophyticus

152
Q

What causes of brain abscesses are associated with preceding dental infection or extraction?

A

Oral anaerobes

153
Q

What microorganism is associated with a food-borne illness from reheated rice?

A

Bacillus cereus; “Food poisoning from reheated rice? Be serious!”

154
Q

What causes of pneumonia are associated with IV drug use?

A

Streptococcus pneumoniae, Staphylococcus aureus

155
Q

Which UTI-causing organisms are urease positive?

A

Proteus mirabilis, Klebsiella pneumoniae, and Staphylococcus saprophyticus

156
Q

What are the most likely causes of meningitis in patients greater than 60 years of age?

A

Streptococcus pneumoniae, Listeria, and gram ⊖ rods

157
Q

What microorganism is associated with a food-borne illness from contaminated seafood?

A

Vibrio parahaemolyticus and Vibrio vulnificus

158
Q

What organism is associated with infection in transplant patients?

A

Cytomegalovirus

159
Q

What causes of pneumonia are associated with aspiration?

A

Anaerobes

160
Q

What is the maternal presentation of HIV infection?

A

Mother’s presentation varies depending on the CD4+ count

161
Q

What pathogen is higher risk in unvaccinated individuals and presents with low-grade fever and coryza progressing to cough with post-tussive emesis?

A

Bordetella pertussis

162
Q

What complications may be seen with a congenital herpes simplex virus-2 infection?

A

Meningoencephalitis and herpetic vesicular lesions

163
Q

What UTI-causing bacterial species grows with strong, pink lactose fermentation on MacConkey agar?

A

Escherichia coli

164
Q

What virus is responsible for roseola?

A

Human herpesvirus 6

165
Q

What microorganism is associated with a food-borne illness from consumption of improperly canned foods?

A

Clostridium botulinum (toxins)

166
Q

What pathogen is higher risk in unvaccinated individuals and presents with a sore throat and gray oral exudates that may cause airway obstruction?

A

Corynebacterium diphtheriae

167
Q

Name the 4 types of infectious process that make up pelvic inflammatory disease.

A

Salpingitis, endometritis, hydrosalpinx, and tubo-ovarian abscess

168
Q

What is the mechanism of transmission of herpes simplex virus-2?

A

Contact with skin or mucous membranes

169
Q

How does maternal herpes simplex virus-2 infection present?

A

Either asymptomatic or herpetic (vesicular) lesions

170
Q

What is seen on wet prep in a patient with trichomoniasis?

A

Motile trichomonads

171
Q

Name the 4 bacterial organisms that can cause watery diarrhea.

A

Clostridium difficile, Clostridium perfringens, enterotoxigenic Escherichia coli, and Vibrio cholerae

172
Q

What complication during pregnancy can result from exposure to parvovirus B19?

A

Hydrops fetalis

173
Q

What causes of pneumonia are associated with hospitalization?

A

Staphylococcus aureus, Pseudomonas, and enteric gram ⊖ rods

174
Q

A patient with meningitis has an ↑ opening pressure on lumbar puncture. CSF analysis shows ↑ protein, ↓ glucose, and a lymphocytic pleocytosis. Diagnosis?

A

Fungal or TB-induced meningitis

175
Q

What childhood rash presents with a high fever for several days followed by diffuse rose-colored macules?

A

Roseola (exanthem subitum) caused by human herpesvirus-6 infection; can present with febrile seizures

176
Q

What microorganism is associated with a food-borne illness from meats, mayonnaise, and custards?

A

Stapylococcus aureus, which produces preformed toxins

177
Q

What STI leads to high risk for opportunistic infections, Kaposi sarcoma, and lymphoma?

A

AIDS from HIV

178
Q

What are the 3 congenitally acquired infections in which the mother is usually asymptomatic?

A

Toxoplasma gondii, cytomegalovirus, and herpes simplex virus type 2

179
Q

What pathogen is higher risk in unvaccinated individuals and presents with muscle spasms and spastic paralysis?

A

Clostridium tetani

180
Q

What food poisoning microorganism may also cause wound infections from interactions with contaminated shellfish or water?

A

Vibrio vulnificus

181
Q

What are some of the ways that the spastic paralysis of Clostridium tetani infection may present?

A

Lockjaw, opisthotonus

182
Q

What reservoir is associated with Shigella?

A

Humans are its only reservoir

183
Q

What organisms are associated with postviral causes of pneumonia?

A

Staphylococcus aureus, Haemophilus influenzae, and Streptococcus pneumoniae

184
Q

What organism causes syphilis?

A

Treponema pallidum

185
Q

What is the pH in Trichomonas vaginitis?

A

> 4.5

186
Q

In addition to painful genital lesions, herpes simplex virus type 2 commonly causes what systemic symptoms?

A

Headaches, fevers, myalgias (herpes simplex virus-1 may also cause these symptoms, but not as commonly)

187
Q

How is rubella typically acquired?

A

Respiratory droplets

188
Q

A patient in the intensive care unit who has been intubated for a week shows ↑ sputum production on suctioning. A chest x-ray shows new infiltrates. Likely diagnosis?

A

Ventilator- associated pneumonia from Pseudomonas aeruginosa, Klebsiella, Acinetobacter, or Staphylococcus aureus (late onset)

189
Q

What virus is responsible for hand-foot-mouth disease?

A

Coxsackievirus type A

190
Q

What constellation of findings are seen in congenital cytomegalovirus infection?

A

Hearing loss, seizures, chorioretinitis, “blueberry muffin” rash, petechial rash, and periventricular calcifications

191
Q

What food sources are commonly associated with a Salmonella infection?

A

Most likely poultry or eggs

192
Q

What pathogens are associated with infections related to mechanical ventilation or endotracheal intubation?

A

Pseudomonas aeruginosa, Klebsiella, Acinetobacter, or Staphylococcus aureus

193
Q

In a child with aToxoplasma gondii infection, what might be the other findings besides the classic triad of manifestations?

A

A “blueberry muffin” rash (the rash may accompany the triad of hydrocephalus, chorioretinitis, and intracranial calcifications)

194
Q

What is the most likely cause of meningitis in patients aged 6-60 years?

A

Streptococcus pneumoniae, Neisseria meningitidis, enteroviruses, and herpes simplex virus

195
Q

What behaviors might precede HIV infection?

A

Unsafe sexual practice, use of needles/needlesticks

196
Q

What unique signs are seen with Clostridium difficile infection?

A

Watery diarrhea and leukocytosis

197
Q

Which UTI-causing organism is characterized by producing a red pigment?

A

Serratia marcescens

198
Q

What are the common signs and symptoms of cystitis from a UTI?

A

Dysuria, suprapubic pain, urinary frequency and urgency, urinalysis positive for WBCs

199
Q

What organism is associated with cat or dog bites?

A

Pasteurella multocida

200
Q

What UTI-causing organism is associated with a large mucoid capsule and viscous colonies?

A

Klebsiella pneumoniae

201
Q

In which patient population would you suspect Haemophilus influenzae meningitis?

A

In unimmunized children

202
Q

What microorganism is associated with a food-borne illness from undercooked meat?

A

Escherichia coli O157:H7

203
Q

What 2 organisms commonly cause osteomyelitis in patients with sickle cell disease?

A

Salmonella and Staphylococcus aureus

204
Q

What is the treatment of choice for Candida vulvovaginitis?

A

Azoles

205
Q

What organism is responsible for causing lymphogranuloma venereum

A

Chlamydia trachomatis serotypes L1–L3

206
Q

What organism causes meningitis and is associated with HIV

A

Cryptococcus spp

207
Q

What reservoir is associated with Salmonella infections?

A

Animal reservoirs

208
Q

What stages of syphilis may result in congenital infection?

A

The 1st (chancre) or 2nd (disseminated rash) stages

209
Q

What STI is characterized by genital warts and koilocytes?

A

Condyloma acuminata

210
Q

What pathogens are associated with nosocomial infection caused by aspiration?

A

Polymicrobial, gram ⊖ bacteria (often anaerobes)

211
Q

How does genital herpes present?

A

Painful penile, vulvar, or cervical vesicles and ulcers

212
Q

In which part of the body are viridans streptococci considered normal flora?

A

The oropharynx

213
Q

What are some of the complications of salpingitis?

A

Adhesions, ectopic pregnancy, infertility, chronic pelvic pain

214
Q

Which 2 organisms are common causes of pneumonia in neonates?

A

Group B streptococci and Escherichia coli are the most likely causes in newborns younger than 4 weeks of age

215
Q

When will a urease test be positive in a patient with a UTI?

A

When the infection is due to a urease-producing organism (eg, Staphylococcus saprophyticus, Proteus, Klebsiella)

216
Q

What organism is associated with PAS positivity?

A

Tropheryma whipplei (Whipple disease)

217
Q

What microscopy findings do you expect to see in a patient with Trichomonas vaginitis?

A

Motile trichomonads (pear-shaped); infection characterized by frothy, foul-smelling vaginal discharge with a yellow-green hue

218
Q

What is the test of choice for the diagnosis of acute osteomyelitis?

A

MRI (details sites that are involved)

219
Q

What STI may present with conjunctivitis, urethritis, cervicitis, epididymitis, pelvic inflammatory disease, and reactive arthritis?

A

Chlamydia

220
Q

Patients with neutropenia are highly susceptible to which 2 opportunistic fungal infections?

A

Candida albicans (often causes a systemic infection) or Aspergillus

221
Q

Which organism is the most likely cause of pneumonia in individuals with cystic fibrosis?

A

Pseudomonas aeruginosa

222
Q

Infection by which 2 organisms is most commonly linked to brain abscesses?

A

Viridans streptococcus and Staphylococcus aureus

223
Q

What are the most likely causes of pneumonia in the elderly (>65 years of age) population?

A

Streptococcus pneumoniae, influenza virus, anaerobes, Haemophilus influenzae, and gram ⊖ rods

224
Q

Name the most common causes of pneumonia in adults 40-65 years of age.

A

Strpetococcus pneumoniae, Haemophilus influenzae, Mycoplasma, anaerobes, viruses

225
Q

What physical exam findings are seen in infection caused by mechanical ventilation or endotracheal intubation?

A

Increased sputum production (with a sweet odor if due to Pseudomonas)

226
Q

What are the most common agents causing meningitis in newborns and infants up to 6 months of age?

A

Group B streptococci, Escherichia coli, and Listeria

227
Q

Where in the CNS does abscess from sinusitis and dental infections typically present?

A

Frontal lobe

228
Q

What virus is responsible for erythema infectiosum?

A

Parvovirus B19 (causes fifth disease)

229
Q

What feature of enterohemorrhagic Escherichia coli causes bloody diarrhea and hemolytic-uremic syndrome?

A

Shiga-like toxin, produced by enterohemorrhagic E coli O157:H7

230
Q

How does enteroinvasive Escherichia coli cause diarrhea?

A

By invasion of the colonic mucosa

231
Q

A baby is born with hydrocephalus, chorioretinitis, and intracranial calcifications. What infection is the likely culprit?

A

Toxoplasma gondii

232
Q

Where in the CNS does abscess from otitis media and mastoiditis typically present?

A

Temporal lobe and cerebellum

233
Q

What is the cutaneous manifestation of erythema infectiosum (fifth disease)?

A

The classic “slapped cheek” rash that appears on the face (this is parvovirus B19 infection)

234
Q

Which organism is most commonly associated with pus, empyema, and abscess formation?

A

Staphylococcus aureus

235
Q

What are the initial steps in management in a patient with suspected meningitis?

A

Administer ceftriaxone and vancomycin empirically; if Listeria is suspected, add ampicillin

236
Q

What is the most common sexually transmitted bacterial infection in the United States?

A

Chlamydia trachomatis

237
Q

What are the CSF glucose levels in bacterial, fungal, and viral meningitis, respectively?

A

↓, ↓, normal

238
Q

Which organisms cause pneumonia in patients with cystic fibrosis?

A

Pseudomonas, Burkholderia cepacia, Staphylococcus aureus, Steptococcus pneumoniae

239
Q

What does a positive urine nitrite test indicate?

A

Nitrate reduction in urine by gram ⊖ bacteria such as Escherichia coli

240
Q

How does congenital HIV infection present?

A

Recurrent infections or chronic diarrhea

241
Q

What is the pathophysiology behind pyelonephritis?

A

Ascension of bacteria to the kidneys from the bladder

242
Q

What childhood rash presents with fever, sore throat, and a red sandpaper-like rash in the neck, trunk, and extremities along with flushed cheeks and circumoral pallor?

A

Scarlet fever (Streptococcus pyogenes)

243
Q

What stage of syphilis presents with fever, skin rashes, lymphadenopathy, and condyloma lata?

A

Secondary syphilis

244
Q

What common vaginal infection presents without inflammation?

A

Bacterial vaginosis (inflammation is found with Trichomonas vaginitis [“strawberry cervix”] and Candida vulvovaginitis)

245
Q

What childhood rash presents with pink macules and papules that start on the head and spread to the body and postauricular lymph nodes?

A

Rubella (caused by the rubella virus); the rash eventually desquamates

NBME Micro (36 decks)

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