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USMLE > Microbiology Superset RidEZ - Part 4 > Flashcards

Microbiology Superset RidEZ - Part 4 Flashcards

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USMLE® Step 1 flashcards
1
Q

Medical importance of HSV-1

A
  1. Oral (and some genital) lesions (Gingivostomatitis)
  2. Keratoconjunctivitis
  3. Temporal lobe encephalitis
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2
Q

Medical importance of HSV-2

A

Genital (and some oral) lesions

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3
Q

Medical importance of VZV

A
  1. Chickenpox
  2. Shingles
  3. Encephalitis
  4. Pneumonia
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4
Q

Medical importance of EBV

A
  1. Mononucleosis

2. Burkitt’s lymphoma

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5
Q

Medical importance of CMV

A
  1. Infection in immunosuppressed (especially transplant)
  2. Congenital defects
  3. Mononucleosis (negativie Monospot)
  4. Pneumonia
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6
Q

Medical importance of HHV-6

A

Roseola (exanthem subitum):

  1. High fever lasting 3 to 5 days which resolves and is followed by a…
  2. Rash: mostly on trunk, lasting a day or two
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7
Q

Medical importance of HHV-8

A

Kaposi’s sarcoma-associated herpesvirus

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8
Q

List of important Herpesviruses

A

HSV 1 and 2, VZV, EBV, CMV, HHV 6 and 8

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9
Q

Medical importance of Adenovirus

A
  1. Febrile pharyngitis (sore throat)
  2. Pneumonia
  3. Conjunctivitis (pink eye)
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10
Q

Medical importance of Parvovirus

A

B19 virus causes:

  1. Aplastic crises in sickle cell disease
  2. “slapped cheeks” rash—erythema infectiosum (fifth disease)
  3. Hydrops fetalis
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11
Q

List of Papova viruses

A
  1. PApilloma
  2. POlyoma (human BK and JC)
  3. Simian VAcuolating virus (does not affect humans)
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12
Q

Medical importance of Papilloma virus

A

causes warts and cervical cancer, including CIN (cervical intraepithelial neoplasia)

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13
Q

Medical importance of JC virus

A

Progressive multifocal leukoencephalopathy in HIV

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14
Q

List of Pox viruses

A
  1. Smallpox
  2. Vaccinia (cowpox “milkmaid’s blisters”)
  3. Molluscum contagiosum
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15
Q

List of Picornaviruses

A

Mnemonic: PERCH on a “peak”

  1. Poliovirus
  2. Echovirus
  3. Rhinovirus
  4. Coxsackievirus
  5. HAV
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16
Q

Medical importance of Poliovirus

A

Fecal-oral transmission

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17
Q

What is IPV?

A

Inactivated polio vaccine (Salk)

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18
Q

What is OPV?

A

Oral Polio vaccine (Sabin)

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19
Q

Medical importance of Echovirus

A

Aseptic meningitis

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20
Q

Medical importance of Rhinovirus

A

“common cold”

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21
Q

Medical importance of Coxsackie virus

A
  1. Aseptic meningitis
  2. herpangina-febrile pharyngitis
  3. hand, foot, and mouth disease
  4. myocarditis
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22
Q

List of Caliciviruses

A

HEV, Norwalk virus

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23
Q

Medical importance of Norwalk virus

A

viral gastroenteritis

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24
Q

List of Reoviruses

A

Reovirus, Rotavirus

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25
Q

Medical importance of Reovirus sp.

A

Colorado tick fever

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26
Q

Medical importance of Rotavirus

A

1 cause of fatal diarrhea in children

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27
Q

Medical importance of Flavivirus

A
  1. HCV
  2. Yellow fever
  3. Dengue
  4. St. Louis encephalitis
  5. West Nile virus
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28
Q

List of Arboviruses

A

Arboviruses are ARthropod BOrne viruses

  1. Togaviridae
  2. Flaviviridae
  3. Bunyaviridae
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29
Q

Medical importance of Togaviruses

A
  1. Rubella (German measles)
  2. Eastern equine encephalitis
  3. Western equine encephalitis
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30
Q

List of Retroviruses

A
  1. HIV

2. HTLV

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31
Q

Medical importance of Coronavirus

A
  1. common cold

2. SARS

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32
Q

Medical importance of Orthomyxovirus

A

Influenza

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33
Q

List of Paramyxoviruses

A

PaRaMyxovirus

  1. Parainfluenza
  2. RSV
  3. Measles
  4. Mumps
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34
Q

Medical importance of Parainfluenza

A

croup

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35
Q

Medical importance of RSV

A

Bronchiolitis in babies. Treat with Ribavirin.

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36
Q

Medical importance of Rhabdoviruses

A

Rabies

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37
Q

Medical importance of Filoviruses

A

Ebola or Marburg hemorrhagic fever, both are often fatal

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38
Q

Medical importance of Arenaviruses

A
  1. LCV (lymphocytic choriomeningitis)

2. Meningitis (spread by mice)

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39
Q

Medical importance of LCV

A

lymphocytic choriomeningitis

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40
Q

Medical importance of Hantavirus

A

hemorrhagic fever, pneumonia

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41
Q

Medical importance of Bunyaviruses

A
  1. California encephalitis
  2. Sandfly/Rift Valley fevers
  3. Crimean-Congo hemorrhagic fever
  4. Hantavirus
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42
Q

Characterize Picornaviruses

A
  1. 1 large polypeptide that is cleaved by proteases into functional viral proteins
  2. All except Rhino and HAV can cause aseptic meningitis
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43
Q

How many serotypes of Rhinovirus?

A

100

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44
Q

Mechanism of rotavirus diarrhea

A

Villous destruction with atrophy leads to decreased absorption of Na and water

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45
Q

How many serotypes of Paramyxovirus?

A

all viruses have 1 except parainfluenza which has 4

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46
Q

Signs and symptoms of mumps

A

Mnemonic: Mumps make your parotid glands and testes as big as POM-poms

  1. Parotitis
  2. Orchitis (inflammation of testes, can cause sterility especially after puberty)
  3. Meningitis
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47
Q

Signs and symptoms of measles

A
  1. Koplik spots (bluish-gray spots on buccal mucosa) diagnostic
  2. Subacute sclerosing panencephalitis (child, many years after measles infection, slowly progressing)
  3. Encephalitis
  4. Giant cell pneumonia (in immunosuppressed)
  5. 3 Cs: (Cough, coryza, conjunctivitis)
  6. Head to toe rash lasting 6 days (slowly dripping bucket of paint)
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48
Q

Antigens in influenza virus

A

Hemaglutinin and Neuraminidase

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49
Q

Difference between genetic drift and shift

A

Drift: Minor changes based on random mutation

Shift: Reassortment of viral genome (such as when flu A virus recombines with swine flu A virus)

Sudden Shift is more deadly than graDual Drift

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50
Q

Treatment for influenza

A

A only: Amantadine and rimantadine

A and B: Zanamivir and Oseltamivir (neuraminidase inhibitors) for both influenza A and B

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51
Q

What are negri bodies?

A

Characteristic cytoplasmic inclusions in neurons infected by rabies virus.

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52
Q

What shape is the rabies capsid?

A

Bullet shaped.

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53
Q

Mechanism of rabies disease

A
  1. Animal bite
  2. Virus travels to CNS in retrograde fashion up nerve axons
  3. Incubates for weeks to 3 months
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54
Q

What does rabies cause?

A

Fatal enchephalitis with seizures and hydrophobia

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55
Q

How is rabies acquired?

A

US: Skunk, raccoon and bat bites

Abroad: Dog bites

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56
Q

What is dengue fever?

A

break-bone fever, caused by flaviviruses. A variant in Southeast Asia is hemorrhagic shock syndrome.

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57
Q

How is yellow fever transmitted?

A

Arbovirus, by Aedes mosquitos, from monkey or human reservoir

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58
Q

Signs and symptoms of yellow fever

A
  1. High fever
  2. Black vomitus
  3. Jaundice
  4. Councilman bodies in liver (nonspecific)
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59
Q

How is HSV-1 transmitted?

A

Respiratory secretions and saliva

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60
Q

How is HSV-2 transmitted?

A

Sexual contact and perinatally

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61
Q

How is VZV transmitted?

A

Respiratory secretions

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62
Q

How is EBV transmitted?

A

Respiratory secretions, saliva

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63
Q

How is CMV transmitted?

A
  1. Congenital
  2. Transfusion
  3. Sexual contact
  4. Saliva
  5. Urine
  6. Transplant
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64
Q

How is HHV-8 transmitted?

A

Sexual contact

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65
Q

Treatment for CMV

A

Ganciclovir or Foscarnet

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66
Q

What kind of cell does Epstein Barr virus infect?

A

B cells

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67
Q

How does mononucleosis present?

A
  1. Fever
  2. Hepatosplenomegaly
  3. Pharyngitis
  4. Lymphadenopathy (especially posterior auricular nodes)
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68
Q

Peak incidence of mononucleosis

A

15-20 years old (peak kissing years)

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69
Q

Laboratory diagnosis of mononucleosis

A
  1. Monospot test: Heterophil antibodies detected by agglutination of sheep RBCs. In EBV, positive. In CMV, negative.
  2. Abnormal circulating CD8 cells.
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70
Q

Tzanck test

A

Smear of opened skin vesicle to detect multinucleated giant cells. Used to assay for HSV-1, HSV-2, VZV

Mnem: Tzanck heavens I do not have herpes. (helps if you do it in an eastern european accent)

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71
Q

HAV: Virus family, nucleic acid type, envelope, incubation period, transmission, carriers

A 
Virus family: ssRNA picornavirus
Envelope: no
Incubation period: Short (3 weeks)
Transmission: Fecal-oral
Carriers: No
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72
Q

HBV: Virus family, nucleic acid type, envelope, incubation period, transmission, carriers

A 
Virus family: dsDNA hepadna virus
Envelope: yes
Incubation period: Long (3 months)
Transmission: Parenteral, sexual, in utero
Carriers: Yes
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73
Q

HCV: Virus family, nucleic acid type, envelope, incubation period, transmission, carriers

A 
Virus family: ssRNA flavivirus
Envelope: yes
Incubation period: Variable (2 weeks to 5 months)
Transmission: Blood
Carriers: Yes
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74
Q

HDV: Virus family, nucleic acid type, envelope, incubation period, transmission, carriers

A

Virus family: ssRNA deltavirus
Envelope: yes
Incubation period: Variable (2 weeks to 2 months)
Transmission: Parenteral, sexual, in utero
Carriers: Yes

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75
Q

HEV: Virus family, nucleic acid type, envelope, incubation period, transmission, carriers

A 
Virus family: ssRNA calicivirus
Envelope: no
Incubation period: Variable (2 weeks to 2 months)
Transmission: Fecal-oral
Carriers: No
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76
Q

Characterize Hepatitis A

A
  1. Asymptomatic (usually)
  2. Acute
  3. Alone (no carriers; naked ssRNA)
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77
Q

Characterize Hepatitis B

A

Blood borne

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78
Q

Characterize Hepatitis C

A
  1. Chronic
  2. Cirrhosis
  3. Carcinoma
  4. Carriers
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79
Q

Characterize Hepatitis D

A
  1. Defective

2. Dependent on HBV

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80
Q

Characterize Hepatitis E

A
  1. Enteric
  2. Expectant mothers (high mortality rate)
  3. Epidemics
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81
Q

What does IgM HAVAb measure?

A

IgM antibody to HAV. Best test to detect active Hepatitis A.

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82
Q

What does HBsAg measure?

A

HBV surface antigen. Continued presence indicates carrier state.

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83
Q

What does HBsAb measure?

A

Antibody to HBsAg. Provides immunity to hepatitis B.

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84
Q

What does HBcAg measure?

A

Antigen associated with core of HBV, doesn’t seem to be measured.

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85
Q

What does HBcAb measure?

A

Antibody to core antigen. Positive during window period (no HBsAg or HBsAb detected). IgM HBcAb is an indicator of recent disease.

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86
Q

What does HBeAg measure?

A

A second different antigenic determinant in the HBV core. Important indicator of transmissibility. (BEware!)

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87
Q

What does HBeAb measure?

A

Antibody to e antigen; indicates low transmissibility.

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88
Q

Characterize this patient:
HBsAg is positive;
HBsAb is negative;
HBcAb is positive;

A

Acute disease. (HBcAb is IgM in acute stage, and IgG in chronic or recovered stage.)

89
Q

Characterize this patient:
HBsAg is negative;
HBsAb is negative;
HBcAb is positive;

A

Window phase, follows acute infection.

90
Q

Characterize this patient:
HBsAg is negative;
HBsAb is positive;
HBcAb is positive;

A

Complete recovery.

91
Q

Characterize this patient:
HBsAg is positive;
HBsAb is negative;
HBcAb is positive;

A

Chronic carrier. (Surface antibody is present, but bound to surface antigen.)

92
Q

What is gag?

A

Gene that encodes for p24 capsid, the nucleocapsid in HIV

93
Q

What is env?

A

Gene that encodes for gp41 and gp120 proteins, the envelope proteins in HIV.

94
Q

What is p17?

A

Interior envelope protein in HIV

95
Q

What is p24?

A

Nucleocapsid protein in HIV, coded for by gag gene.

96
Q

What is gp41?

A

Envelope protein which traverses bilayer. If it is a mushroom stalk, then gp120 is the head. Both coded for by env.

97
Q

What is gp120?

A

Envelope protein that serves as mushroom cap to gp41 stalk. Both coded for by env.

98
Q

What is pol?

A

Gene which codes for HIV reverse transcriptase

99
Q

HIV diagnostic tests

A

Presumptive diagnosis: ELISA (sensitive, high false-positive rate, and low threshhold)

Confirmation: Western blot assay (specific, high false-negative rate, and high threshold)

PCR viral load used to monitor drug therapy on viral load

100
Q

Timeframe for HIV diagnosis

A

ELISA/Western blot often:

Falsely negative in first 1-2 months of HIV infection
Falsely positive initially in babies born to infected mothers (anti-gp120 crosses placenta)

101
Q

AIDS diagnosis

A

One of the following:

  1. less than 200 CD4 cells
  2. HIV positive with AIDS indicator condition (eg pneumocystis infection)
  3. CD4/CD8 ratio less than 1.5
102
Q

CCR5 mutation: What does it mean?

A

HIV susceptibility.

Homozygous means immunity, heterozygous means slower course (long-term non production)

103
Q

CXCR1 mutation

A

HIV susceptibility. Rapid progression to AIDS.

104
Q

What is the likelihood of CCR5 mutation?

A

% of US caucasians
Homozygous: 1
Heterozygous: 20

105
Q

Relative HIV-related levels aproximately 1.5 months after infection

A

In descending order:

  1. CD4 lymphocytes (initial trough)
  2. Virus p24 antigen (initial peak)
  3. Anti-p24 Ab
  4. Anti-gp120 Abs

Highest period of acute symptoms

106
Q

Relative HIV-related levels aproximately 2 months after infection

A

In descending order:

  1. CD4 lymphocytes (rise from initial trough back to near pre-infection levels before leveling out [the mark of end of acute symptoms])
  2. Anti-p24 Ab (Reaching peak [not reached until approximately 3 years])
  3. Anti-gp120 Abs (Reaching peak [not reached until approximately 3 years])
  4. Virus p24 antigen (very low levels)
107
Q

Relative HIV-related levels more than 3 years after infection: Early phase

A

In descending order:

  1. CD4 lymphocytes (begins linear descent)
  2. Anti-p24 Ab (descent begins at faster rate than CD4)
  3. Anti-gp120 Abs (slow descent begins)
  4. Virus p24 antigen (slow rise)
108
Q

Relative HIV-related levels more than 3 years after infection: First middle phase

A

In descending order:

  1. CD4 lymphocytes (continues linear descent)
  2. Anti-gp120 Abs (slow descent continues)
  3. Anti-p24 Ab (having dropped below Anti-gp120, descent continues at slower rate)
  4. Virus p24 antigen (fast rise begins)
109
Q

Relative HIV-related levels more than 3 years after infection: Second middle phase

A

In descending order:
1. CD4 lymphocytes (continues linear descent)
AND
1. Virus p24 antigen (already passed gp-120 Abs and about to pass CD4 lymphocytes)
3. Anti-gp120 Abs (slow descent continues)
3. Anti-p24 Ab (approximately 1/3 amount of p24 antigen, slow descent continues)

110
Q

Relative HIV-related levels more than 3 years after infection: Third middle phase

A

In descending order:

  1. Virus p24 antigen (already passed gp-120 Abs and about to pass CD4 lymphocytes)
  2. CD4 lymphocytes (continues linear descent, about to drop below anti-g120 Abs)
  3. Anti-gp120 Abs (slow descent continues)
  4. Anti-p24 Ab (approximately 1/3 to 1/4 amount of p24 antigen, slow descent continues)
111
Q

Relative HIV-related levels more than 3 years after infection: Late phase

A

In descending order:
1. Virus p24 antigen (leveled out at nearly 20x anti-p24 antibody)
2. Anti-gp120 Abs (little less than half p24 antigen)
3. Anti-p24 Ab (1/20 amount of p24 antigen)
AND
3. CD4 lymphocytes

112
Q

Opportunistic infections and disease in AIDS attacking the brain

A
  1. Cryptococcal meningitis
  2. Toxoplasmosis
  3. CMV encephalopathy
  4. AIDS dementia
  5. PML (JC virus)
113
Q

Opportunistic infections and disease in AIDS attacking the eyes

A

CMV retinitis

114
Q

Opportunistic infections and disease in AIDS attacking the mouth and throat

A
  1. Thrush (Candida albicans)
  2. HSV
  3. CMV
  4. Oral hairy leukoplakia (EBV)
115
Q

Opportunistic infections and disease in AIDS attacking the lungs

A
  1. Pneumocystis pneumonia (PCP)
  2. TB
  3. Histoplasmosis
116
Q

Opportunistic infections and disease in AIDS attacking the GI tract

A
  1. Cryptosporidiosis
  2. Mycobacterium avium-intracellulare complex
  3. CMV colitis
  4. non-Hodgkin’s lymphoma (EBV)
117
Q

Opportunistic infections and disease in AIDS attacking the skin

A
  1. Shingles (VZV)

2. Kaposi’s sarcoma (HHV-8)

118
Q

Opportunistic infections and disease in AIDS attacking the genitals

A
  1. Genital herpes
  2. Genital warts
  3. Cervical cancer (HPV)
119
Q

When does HIV encephalitis occur?

A

Late in the course of HIV infection

120
Q

Mechanism of HIV encephalitis

A

Virus gains CNS access via infected macrophages

121
Q

Pathologic presentation of HIV encephalitis

A

Microglial nodules with multinucleated giant cells

122
Q

What are prions?

A

Infectious agents that do not contain RNA or DNA, only proteins, that are encoded by cellular genes.

123
Q

Diseases caused by prions

A
  1. Creutzfeldt-Jakob disease
  2. Kuru
  3. Scrapie (in sheep)
  4. Mad cow disease (association with human spongiform encephalopathy)
  5. Fatal familial insomnia
124
Q

What is Creutzfeldt-Jakob disease

A

Prion caused disease with rapid progressive dementia

125
Q

Mechanism of prion pathology

A

Normal proteins (alpha-helices) become pathologic (beta-pleated sheets)

126
Q

Dominant normal flora of dental plaque

A

Streptococcus mutans

127
Q

Dominant normal flora of the skin

A

Staphylococcus epidermidis

128
Q

Dominant normal flora of the nose

A

Staphylococcus aureus

129
Q

Dominant normal flora of the colon

A
  1. Bacteroides fragilis

2. E. coli

130
Q

Dominant normal flora of the vagina

A
  1. Lactobacillus
  2. E. coli
  3. Group B strep
131
Q

Dominant normal flora in neonates

A

When delivered by cesarean section, none, but are rapidly colonized after birth.

132
Q

Most common causes of pneumonia in people 6 weeks to 18 years old.

A
  1. Viruses (RSV)
  2. Mycoplasma
  3. Chlamydia pneumoniae
  4. Streptococcus pneumoniae
133
Q

Most common causes of pneumonia in people 18 to 40 years old.

A
  1. Mycoplasma
  2. Chlamydia pneumoniae
  3. Streptococcus pneumoniae
134
Q

Most common causes of pneumonia in people 40 to 65 years old.

A
  1. Streptococcus pneumoniae
  2. Haemophilus influenzae
  3. Anaerobes
  4. Viruses
  5. Mycoplasma
135
Q

Most common causes of pneumonia in people over 65 years old.

A
  1. Streptococcus pneumoniae
  2. Anaerobes
  3. Viruses
  4. Haemophilus influenzae
  5. Gram negative rods
136
Q

Most common causes of nosocomial pneumonia

A
  1. Staphylococcus

2. Gram negative rods

137
Q

Most common causes of immunocompromised pneumonia

A
  1. Staphylococcus
  2. Gram negative rods
  3. Fungi
  4. Viruses
  5. Pneumocystis jirovecii (with HIV)
138
Q

Most common causes of aspiration pneumonia

A

Anaerobes

139
Q

Most common causes of pneumonia in alcoholics or IV drug users

A
  1. Streptococcus pneumoniae
  2. Klebsiella
  3. Staphylococcus
140
Q

Most common causes of postviral pneumonia

A
  1. Staphylococcus

2. Haemophilus influenzae

141
Q

Most common causes of neonatal pneumonia

A
  1. Group B streptococci

2. E. coli

142
Q

Most common causes of atypical pneumonia

A
  1. Mycoplasma
  2. Legionella
  3. Chlamydia
143
Q

Causes of bacterial meningitis in: people 0-6 months old

A
  1. Group B streptococci
  2. E. coli
  3. Listeria

All from birth canal

144
Q

Causes of bacterial meningitis in: people 6 months to 6 years old

A
  1. Streptococcus pneumoniae
  2. Neisseria meningitidis
  3. Haemophilus influenzae type B
  4. Enteroviruses
145
Q

Causes of bacterial meningitis in: people 6 years to 60 years old

A
  1. Neisseria meningitidis
  2. Enteroviruses
  3. Streptococcus pneumoniae
  4. HSV
146
Q

Causes of bacterial meningitis in: people greater than 60 years old

A
  1. Streptococcus pneumoniae
  2. Gram negative rods
  3. Listeria
147
Q 
What is the cause of meningitis with the following findings?:
Pressure: Increased
Cell type: Increased PMNs
Protein: Increased
Sugar: Decreased
A

Bacterial (not TB)

148
Q 
What is the cause of meningitis with the following findings?:
Pressure: Increased
Cell type: Increased lymphocytes
Protein: Increased
Sugar: Decreased
A

Fungal or TB

149
Q 
What is the cause of meningitis with the following findings?:
Pressure: Normal/Increased
Cell type: Increased lymphocytes
Protein: Normal
Sugar: Normal
A

Viral

150
Q

Common causes of osteomyelitis in most people.

A

Staphylococcus aureus

151
Q

Common causes of osteomyelitis in sexually active people.

A

Neisseria gonorrhoeae (rare), septic arthritis more common

152
Q

Common causes of osteomyelitis in diabetics.

A

Pseudomonas aeruginosa

153
Q

Common causes of osteomyelitis in drug addicts.

A

Pseudomonas aeruginosa

154
Q

Common causes of osteomyelitis in people with sickle cell disease.

A

Salmonella

155
Q

Common causes of osteomyelitis in people with prosthetic replacement

A

Staphylococcus aureus and Staphylococcus epidermidis

156
Q

Common causes of vertebral osteomyelitis

A

Mycobacterium tuberculosis (Pott’s disease)

157
Q

Common causes of urinary tract infections in ambulatory people

A

Mostly ascending infections

  1. E. coli (50-80%)
  2. Staphylococcus saprophyticus (10-30%) in young amubulatory women
  3. Klebsiella (8-10%)
158
Q

Common causes of urinary tract infections in the hospital

A

Mostly ascending infections

  1. E. coli
  2. Proteus
  3. Klebsiella
  4. Serratia
  5. Pseudomonas
159
Q

Epidemiology of urinary tract infections

A

Mostly ascending infections. Ratio of women:men is 10:1. (short urethra colonized by fecal flora)

Males:

  1. Babies: Congenital defects.
  2. Elderly: Enlarged prostates
160
Q

Predisposing factors to urinary tract infections

A
  1. Flow obstruction
  2. Kidney surgery
  3. Catheterization
  4. Gynecologic abnormalities
  5. Diabetes
  6. Pregnancy
161
Q

Signs and symptoms of urinary tract infections

A
  1. Dysuria
  2. Frequency
  3. Urgency
  4. Suprapubic pain
162
Q

Signs and symptoms of pyelonephritis

A
  1. Fever
  2. Chills
  3. Flank pain
  4. Costovertebral angle tenderness
163
Q

What disease states does Serratia marcescens cause?

A

Nosocomial (4th most common) and drug-resistant urinary tract infection

164
Q

What bug: metallic sheen on EMB agar

A

E. coli

165
Q

What disease states does Enterobacter cloacae cause?

A

Nosocomial and drug-resistant urinary tract infection

166
Q

What disease states does Proteus mirablis cause?

A

Urinary tract infection. Urease positive, and associated with struvite stones. Motility causes “swarming” on agar.

167
Q

List of bugs that cause UTI

A

SSEEK PP

  1. Serratia marcescens (nosocomial/drug-resistant)
  2. Staphylococcus saprophyticus (2nd most common cause in ambulatory young women)
  3. E. coli (Most common cause. Metallic sheen on EMB agar)
  4. Enterobacter cloacae (nosocomial and drug resistant)
  5. Klebsiella (thick viscous colonies)
  6. Proteus mirablis (urease positive, struvite stones, swarming on agar)
  7. Pseudomonas Aeruginosa (blue-green pigment, fruity odor)
168
Q

Most common causes of bronchitis/bronchiolitis

A
  1. RSV
  2. Influenza A
  3. Coronavirus

All RNA viruses with envelope

169
Q

How does gonorrhea present?

A
  1. Urethritis
  2. Cervicitis
  3. PID
  4. Prostatitis
  5. Epididymitis
  6. Arthritis
  7. Creamy purulent discharge (mmm!)
170
Q

What organism causes gonorrhea?

A

Neisseria gonorrheae aka Gonococcus

171
Q

What organism causes syphilis?

A

Treponema pallidum

172
Q

How does genital herpes present?

A

Painful ulcers on the:

  1. Penis
  2. Vulva
  3. Cervix
173
Q

What disease states does HPV 6 cause?

A

Condylomata acuminata: Genital warts and koilocytes

same as HPV 11

174
Q

What disease states does HPV 11 cause?

A

Condylomata acuminata: Genital warts and koilocytes

same as HPV 6

175
Q

What causes condylomata acuminata?

A

HPV 6 and 11

176
Q

What causes condylomata lata?

A

Treponema pallidum

177
Q

Condylomata lata vs Condylomata acuminata

A

Condyloma (plural: “Condylomata”, from Greek “knob”) refers to an infection of the genitals. The two subtypes are:

“condylomata acuminata”, another term for genital warts - caused by human papilloma virus
“condylomata lata”, white lesions associated with secondary syphilis

(copied from Wikipedia)

178
Q

What disease states does Haemophilus ducreyi cause?

A

Chancroid:

  1. Painful genital ulcer (red papule with yellow-gray exudate)
  2. Inguinal adenopathy
179
Q

How does Chancroid present?

A
  1. Painful genital ulcer (red papule with yellow-gray exudate)
  2. Inguinal adenopathy
180
Q

What causes chancroid?

A

Haemophilus ducreyi

181
Q

What is the Whiff test?

A

Several drops of a potassium hydroxide (KOH) solution are added to a sample of vaginal discharge to see whether a strong fishy odor is produced. A fishy odor on the whiff test usually means bacterial vaginosis is present.

182
Q

How does bacterial vaginosis present?

A

Caused by Gardnerella vaginalis

  1. Greenish vaginal discharge with fishy smell
  2. Noninflammatory (nonpainful)
  3. Mobiluncus (anaerobe) is also seen
  4. Clue cells are visible (vaginal epithelium covered with bacteria)
  5. Positive Whiff test
183
Q

Top causes of PID

A
  1. Chlamydia trachomatis (subacute, often undiagnosed)
  2. Neisseria gonorrhoeae (acute, high fever)
  3. Gardnerella
  4. Trichomonas
184
Q

Most common STD in the US

A

Chlamydia trachomatis (3-4 million cases per year)

185
Q

Clinical presentation of PID

A
  1. Cervical motion tenderness (chandelier sign)
  2. Purulent cervical discharge
  3. Possibly salpingitis, endrometritis, hydrosalpinx, or tubo-ovarian abscess
186
Q

What is the chandelier sign?

A

Colloquial term referring to severe pain elicited during pelvic examination of patients with pelvic inflammatory disease in which the patient responds by reaching upwards towards the ceiling for relief.

Retrieved from “http://www.biology-online.org/dictionary/Chandelier_sign”

187
Q

What is salpingitis a risk factor for?

A
  1. Ectopic pregnancy
  2. Infertility
  3. Chronic pelvic pain
  4. Adhesions
188
Q

Risk factor for nosocomial CMV infection.

A

Newborn nursery

189
Q

Risk factor for nosocomial RSV infection.

A

Newborn nursery

190
Q

Risk factor for nosocomial E. coli infection.

A

Urinary catheterization

191
Q

Risk factor for nosocomial Proteus mirablis infection.

A

Urinary catheterization

192
Q

Risk factor for nosocomial Pseudomonas aeruginosa infection.

A

Respiratory therapy equipment

193
Q

Risk factor for nosocomial HBV infection.

A

Work in renal dialysis unit

194
Q

Risk factor for nosocomial Candida albicans infection.

A

Hyperalimentation

195
Q

Risk factor for nosocomial Legionella infection.

A

Water aerosols

196
Q

2 most common causes of nosocomial infections

A
  1. E. coli (UTI)

2. S. aureus (wound infection)

197
Q

Infections dangerous in pregnancy

A

ToRCHeS

  1. Toxoplasma
  2. Rubella
  3. CMV
  4. HSV/HIV
  5. Syphilis
198
Q

What bugs: Hyaluronidase

A
  1. Staphylococcus
  2. Streptococcus pyogenes
  3. Clostridium dificile
199
Q

What bug: Pus

A

Staphylococcus aureus

200
Q

What bug: Empyema

A

Staphylococcus aureus (means pus in a natural body cavity, not an abscess)

201
Q

What bug: Abscess

A

Staphylococcus aureus

202
Q

What bug: Pediatric infection

A

Haemophilus influenzae

203
Q

Most common causes of pneumonia in people with cystic fibrosis.

A

Pseudomonas aeruginosa

204
Q

What bug: Branching rods in oral infection

A

Actinomyces israelii

205
Q

What bug: Traumatic open wound infection

A

Clostridium perfringens

206
Q

What bug: Surgical wound

A

Staphylococcus aureus

207
Q

What bug: Dog or cat bite

A

Pasteurella multocida

208
Q

What bug: Sepsis in a newborn

A

Group B Strep

209
Q

What bug: Meningitis in a newborn

A

Group B Strep

210
Q

Antimicrobial class with mechanism: Block cell wall synthesis by inhibition of peptidoglycan cross-linking

A

Mnemonic: It’s forming its cell wall. ACT PAPI!

  1. Aztreonam
  2. Cephalosporins
  3. Ticarcillin
  4. Penicillin
  5. Ampicillin
  6. Piperacillin
  7. Imipenem
211
Q

Antimicrobial class with mechanism: Block peptidoglycan synthesis

A
  1. Bacitracin
  2. Vancomycin
  3. Cycloserine
212
Q

Antimicrobial class with mechanism: Disrupt bacterial cell membranes

A

Polymyxins

213
Q

Antimicrobial class with mechanism: Disrupt fungal cell membranes

A
  1. Amphotericin B
  2. Nystatin
  3. Fluconzaole/azoles
  4. Polymyxins
214
Q

Antimicrobial class with mechanism: Block nucleotide synthesis

A
  1. Sulfonamides

2. Trimethprim

215
Q

Antimicrobial class with mechanism: Block DNA topoisomerases

A

Quinolones

216
Q

Antimicrobial class with mechanism: Block mRNA synthesis

A

Rifampin

217
Q

Antimicrobial class with mechanism: Block protein synthesis at 50S ribosomal subunit

A
  1. Chloramphenicol
  2. Erythromycin/macrolides
  3. Lincomycin
  4. Clindamycin
  5. Streptogramins (quinupristin, dalfopristin)
  6. Linezolid
218
Q

Antimicrobial class with mechanism: Block protein synthesis at 30S ribosomal subunit

A
  1. Aminoglycosides

2. Tetracyclines

219
Q

Bactericidal antibiotics

A

Mnemonic: Am I Safe using a Metropolitan Pen in a Van, Flo?

  1. Aminoglycosides
  2. Cephalosporins
  3. Metronidazole
  4. Penicillin
  5. Vancomycin
  6. Fluoroquinolones

USMLE (13 decks)

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