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1
Q

2 most common cause of hematogenous osteomyelitis

A
  1. S. aureus

2. S. pyogenes

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2
Q

Osteomyelitis in DM

A

polymicrobial (contiguous spread from infected foot ulcer)

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3
Q

Diptheria toxin - gene

Diptheria - treatment

A

Tox gene

treatment: active + passive immunization, antibiotics (penicillin or erytrhomycin)

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4
Q

MC eye related complication of CMV

A

chorioretinitis

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5
Q
  1. Enrichment media
  2. reducing media
  3. synthetic media
A
  1. contains special growth factors required for some organisms (example is H. inf)
  2. remove oxygen (for anareobics)
  3. Al chemical contains are known
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6
Q

MMR vaccination - pregnancy

A

avoid pregnancy for 4 weeks

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7
Q

Sporotrichosis - biopsy

A

granuloma

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8
Q

Lactobacilli - characteristics

A

gram (+) - major part of normal vagianl flora in balacne with other colonizers at normal vaginal pH 3.8-4.5

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9
Q

causes of primary ovarian insuficiency

A
  1. smoking
  2. radiation
  3. chemotherapy
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10
Q

hydrop fetalis - symptoms

A

severe anemia, heart failure, pleural effusion, pericardial effusion, ascitis

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11
Q

Extrapulmonary manifesations of M. pneumonia

A
  1. anemia 2. Steven-Johnoson syndrome 3. Joint pains 4. encephalitis 5. cardiac rhythm disturbances 6. Bullous myringitis
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12
Q

S. aureus meningitis is common in

A

neurosurgical patients

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13
Q

Listeria - temperature

A

tumbling motility at 22 C

can be calture at temperature as low as 4 C

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14
Q

chanchroid - treatment

A

ceftriaxone

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15
Q

Fever + anaphylaxis

A

no fever in anaphylaxis (low il-1)

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16
Q

causes of common flue (by frequency, and season)

A
  1. Rhinovirus (esp winter)
  2. Coronovirus (esp winter)
  3. Adenovirus (MC in children)
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17
Q

CMV retinitis –>

A

cooton wood exudates, perivascular hemorrhage + necrotizing vasculitis –> Retinal detachment

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18
Q

special feature of adenovirus and orthomyxovirus as common flu

A

adeno –> similar to A strep (exudate tonslis + cervical adenopathy)
orthomyxo –> high fever

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19
Q

HSV 1 - primary vs reactivation

A

1ry: gingiva tongue, palate, pharynx involvement along with systemic symptoms
reactivation: mild perioral vesicles

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20
Q

Latent TB - transmission

A

no

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21
Q
  1. diagnostic test for gonorrhea

2. diagnostic test for chlamydia

A

both PCR

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22
Q

Mucormycosis is caused by

A
  1. Rhizopus
  2. Mucor
  3. Absidia
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23
Q

pneumonia with retoorbital headaches

A 
Q fever (also increasd liver enzymes, thrombocytopenia etc) 
NORMAL LEUKOCYTES
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24
Q

Dengue fever - mechansim

A

transmitted by Aedes (4 serotypes) –> 1ry infection leads to lifelong immunity agaisnt the same serotype
–> 2ry infection with different viral serotype can cause sever illness due to antibody depended enhancement of infection, enhanced IC formation, and/or accelerated T cells responses–> can cause hemorrhagic fever

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25
Q

mouse-like odor - microbe?

A

Pasteruella multocida (also indole (+)

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26
Q

EBV vs CMV mediated infectious mononucleosis according to clinical presentation

A

pharyngitis + lymphadenopathy are seen less commonly than EBV

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27
Q

2 examples of preforemed enterotoxin

A

B. cereus

S. aureus

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28
Q

diarrhea with monocytes

A

salmonela typhi

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29
Q

viral infectivity is often destroyed by heating to

A

50-60 C for 30 mins (with a few exceptions)

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30
Q

infant botulism - diagnosis

A

elisa or PCR of toxins

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31
Q

Tetanospasim travels within the ….. to reach the spinal cord

A

motor neuron (retrograde)

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32
Q

torticolis?

A

cervical dystonia of the sternocleidomastoid muscle

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33
Q

West Nile also causes

A

neuroinvasive diseae that can present as encephalitis, meningitis, or flaccid paralysis (anti WNV antibodies)

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34
Q

Candida in sputum

A

not indicate disease –> Candida is normal inhabitant of GI (including oral cavity)

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35
Q

abortive infection

A

vrirus enter the cell but does not produce new virus

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36
Q

Roseola - pattern of rash

A

start in trank –> goes to face + extremities (vs measles + rubella)

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37
Q

Taenia solium is endemic in

A

Central + South america

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38
Q

mucormycosis - how to diagnose

A

biopsy

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39
Q

HBV treatment

A
  1. IFN-α
  2. entecavir
  3. tenofovir
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40
Q

pneumonia by pseudomonas - treatment

A

gentamycin

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41
Q

UTI treatment in sulfa allergy

A

nitrofurantoin

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42
Q

nitrofurantoin in pregnancy

A

safe

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43
Q

pneumonia - fist line of treatment

A

azyththromycin

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44
Q

katayaam fever - mechanism and manifestation

A

Schistosomiasis:

1. fever 2. hepatosplenomegaly 3. eosinophilia

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45
Q

Gold standard of M. pneumonia detection

A

PCR

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46
Q

aspiration pneumonia vs pneumonitis according to onset

A

pneumonia: days after aspiration
pneumonitis: hours after aspiration

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47
Q

Schistosoma diagnosis

A

eggs is stool

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48
Q

WBC in CSF in meningitis (viral vs bacterial)

A

viral –> less than 500

bacterial –> more than 1000

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49
Q

How listeria survive in the cell

A

listeriolysin 0 (a preformed toxin) selectively activated within acidified phagosomes –> escape from phagosome

50
Q

EBV protein that binds CD21

51
Q

lepromatous vs tuberculoid leprosy according to skin test, immunity, bacterial load

A

lepromatous: increased load, (-) lepromin test, Th2
tuberculoid: decreased load, (+) lepromin test, Th1

52
Q

Increased risk of osteomyelitis in increased age - mechanism

A

nutritient arteries develop a corkscrew anatomy –> allows bacteria more easily to penetrate the marrow cavity + cause local infection

53
Q

staphyloccoci according to mannitol fermentation

A

only S. aureus

54
Q

MCC of oppurstunistic mycosis

55
Q

Defnitive treatment of biofil producing orgnaism

A

remove the foreign body

56
Q

an example that increases the risk for S. epidermidis meningitis

A

ventriculoparietal shunt placement for meningitis

57
Q

histoplasma in immunocompromised

A
  1. systemic symptoms
  2. painful oral ulcers
  3. lymphadenopathy
  4. hepatosplenomegaly
58
Q

Pertussis phases

A
  1. Catarrhal phase (like URI)
  2. Paroxysmal phase - severe coughing spells with clasic inspiratory whoop or post-tussive emesis
  3. Convalescent phase - cough improves
59
Q

C. neoformans - extraCNS manifestations

A

rare:
Lungs: cough with scant sputum production, dyspnea, or pleuritic chest pain
Skin: papules, pustules, nodules, ulcers (less than 10%)

60
Q

bacterial pneumonia 2ry to viral infection - mechanism

A

virally induced damaged to the mucociliary clearance

–> S. pneumonia, S. aureus, H. infl

61
Q

infectious dose of shigella, C. jejuni, E. hemolytica, Giardia

A

shigella –> 10-500 : depending on age, comditio of host, species of shigella
C. jejuni –> 500
E. histolytica –> 1-10
Giardia 1-10

62
Q

drugs that increased the risk of parotitis (also other risk factors)

A

anticholinergics

other risk factors: intubation. dehydration, obstruction

63
Q

babesiosis also causes

A
  1. flu-like
  2. thrombocytopenia
  3. abdominal liver function test
64
Q

virus that causes Steven Johnson

65
Q

how to distinguish E. coli from Enterobacter

A

E.coli is indole (+)

66
Q

CMV in HIV - spasticity?

A

radiculopathy –> trouble in walkin, spasticity, not able to urinate

67
Q

physiologic leukorrhea

A

women have 1-4 ml of white to yellow, mostly odorless discharge daily

68
Q

bug that produce DNAase

A

S. pyogenes

69
Q

trichomonas vaginalis in men

A

urethritis

MC asymptomatic

70
Q

pathognomonic histology for hepatic schistosomiasis

A

periportal “pipestem” fibrosis

71
Q

Inactivated (killed) bacteria vaccines

A
  1. virbrio cholera

2. Yersinia pestis

72
Q

B. burgdorferi vaccine contains

A

recombinant bacterial outer surface protein

73
Q

Bacteria - how to survive intracellulary

A
  1. by blocking the fusion of phagosomes with lysosome (salmonela + TB)
  2. by inhibiting phagolysosome acidification (TB)
  3. Escaping from phagosome into the cytpsol (Listeria, Shigella)
74
Q

Both toxins of C difficile inactivates

A

Rho regulatory proteins

75
Q

warm reaction agglutination - treatment

76
Q

actinomyces - sulfur granules - colour

A

yellow –> become basophilic under the microscope with the hematoxilin eosin

77
Q

other virulence factor of S. pneumonia, beside capsule

A

IgA protease, adhensins, pneuomolysin (cytotoxin that causes pores in cell membrane + cell lysis)

78
Q

Intraabdominal infections are polymcrobial, with ……. being the most prominent

A
  1. B. fargilis

2. E.coli

79
Q

cellulitis associated with freshwater or seawater exposure

A
  1. Aeromonas hydrophila

2. Vibrio vulnificus

80
Q

B19 virus protein binds to

A

erythrocyte P antigen

81
Q

Dracunculus medinensis - transmission / causes

A
  • Drink water with lavrae

- skin + soft tissue infection

82
Q

H. inf - satellite phenomenon

A

grows around S. aureus due to NAD supplementation

83
Q

scabie rash - due to / worse when

A
  • due to delayed IV hypersensitivity to the mite, mite feces, mite egss
  • worse at nights
84
Q

necrotizing fascitis - course / treatment

A

severe pain + swelling at the site of trauma or recent surgery –> quickly become hypotensive + develop septic shock
treatment: aggressive surgical debridement of all necrotic tissue along with empiric broad spectrum antibiotcs due to high incidence of polymicrobial infection

85
Q

C. difficile - necessary before examining the patient

A

Nonsterile gloves + gown

86
Q

B. henselae is visuable in

A

Warthin-starry stain

87
Q

findaxomicin - group?

88
Q

Chikungunya

A
  • a febrile illness with flulike, polyarthralgia/arthritis, rash
  • AEDES mosquito (like Yellow + Dengue)
89
Q

neurocisticercosis image

A

fluidfilled larval cyst with minimal enhancement + no associated edema

90
Q

Septic abortion - presentation / due to / treatment

A

presentation: fever, abd pain, uterine tenderness, foul-smelling discharge after pregnancy termination
due to: S. aureus, E. coli due to seeding of the uterine cavity during instrumentation
treatment: antibiotics, surgical evacuation to remove the nidus
long term complication –> Asherman syndrome

91
Q

urease breath test for H. pylori

A

consume (13)C labeled urea + his breath is then (after 30 mins) monitored for the presence of (13)C labeled C13
(antibiotics or PPI during 2-4 wks pior the test may cause FN)

92
Q

Isosporal belli causes

A

produce diarrhea in HIV (+)

93
Q

Strongyloides stercolaris infection - diagnosis

A

rhabditiform (noninfectious) larvae in the stool

94
Q

Strongyloides stercolaris - HYPERINFECTION SYNDROME

A

rhabditiform (noninfectious) larvae –> mature in filariform larva in the GI –> autoinfection cycle –> Hyperinfection syndrome (dissemination + multiorgan dysfunction/septic shock) (esp in immunospressants or HTLV infection)

95
Q

microscopic appearance of b. anthracis in media

A

serpentine or medusa head

96
Q

aspergillus has been associated with contaminated ….. preparations

A

glucocorticoid

97
Q

Bromoacetycholine - mechanism of action

A

inhibits choline acetyltrasferaase, blocking the sysnthesis of Ach from acetate + choline

98
Q

Granuloma inguinale

A
  • donovanosis
  • caused by Klebsiella granulomatis
  • painless progressive red serpiginous ulcerative lesions without lymphadenopathhy
  • diagnosis: gram (-) culture / biopsy (Donovan bodies: deeply staining gram (-) intracytoplasmic cysts)
  • if left untreated –> scarring + strictures –> lymphatic obstruction –> lymphadema (elephantiasis)
99
Q

LPS vs LOS

A

LOS (on Neisseria) lacks the 0 antigen

–> lipooligosaccharide –> sometimes also refereed as LPS

100
Q

mechanism of mycoplasma induced anemia

A

similarity between antigens in the cell membranes of Mycoplasma + the cell membrane of erythrocytes
(I-antigen)

101
Q

hyaluronate - bacteria

A 
present in the capsule of S. pyogenes + has antiphagocytic activity 
not immunogenic (vs M protein)
102
Q

Most important steps for prevention of central venous catherter infections

A
  1. proper hand hygiene
  2. full barrier precautions during insertions
  3. Chlorhexidine skin disinfection
  4. Avoidance of femoral insertion site
  5. Removal of the catheter when it is no longer needed
    (catheter replacement, oral antibiotics and topical atnimicrobial oitments do not prevent,
103
Q

initial of empiric therapy coag (-) staph infection

A

vancomicin (due to widespread methicillin resistance, esp in nosocomial infections)
- if methicillin sensitive –> switch to nafcillin or oxacillin

104
Q

Type III secretion system (injectisome) type of bacteria

105
Q

cutaneous anthrax

A

painless papule surrounded by vesicle –> ulcer with black eschar (painless, pencrotic)

106
Q

Bacilluls cereus - types and causes

A 
emetic type (preformed heat labile toxin, cerulide, like cholera) --> in 5 h
diarrheal type (heat sable) --> watery nonbloody in 8-18 h
107
Q

Cord Factor

A

cell wall of Mycobacterium –> surpentine cords –> inhibits macrophage maturation + induces TNF-a secretion (virulence)

108
Q

Mycobacterium - sulfatides

A

surface glycolipids –> inhibit phagolysosomal fusion

109
Q

salmonela vs shigella according to immune response

A

salmoneal typhi –> monocytes
other salmonela –> PMN
shigella –> PMN

110
Q

sporothrix schenckii - treatment

A

intraconazole or potassium iodide

111
Q

T. cruzi - map / treatment

A

S. america

Benzidazole or nifurtimox

112
Q

vaccine - eggs

A

inf, measles , mumps, yello

113
Q

close contacts of immunocompromised - vaccines

A

not live polio or infl

114
Q

HSV-2, VZV, CMV - latent state

A

sacral ganglion
dorsal root or trigeminal ganglia
mononuclear cells

115
Q

CMV receptor

Rhinovirus receptor

A

integrins (heparan sulfate)

ICAM-1

116
Q

simeprevir - clinical use

A

chronic HCV in combination with Ledipasvir (NS5A inhibitor)

not monotherapy

117
Q

Clindamycin - clinical use

A
  1. anaerobic upper diaphragm
  2. Gardenella vaginalis
  3. invasive A strep infection
118
Q

Macrolides - clinical use

A

atypicals pneuonia
chlamydia
pertusis
GRAM + cocci (STREP INFECTION IF ALLERGIC TO PENICILLINS)

119
Q

Bunyaviridae - virus

A
  1. california encephalitis
  2. Rift valley
  3. Crimean congo hemorrhagic fever
  4. Hantavirus
120
Q

flavivirus - virus

A
  1. Yellow
  2. HCV
  3. dangue
  4. west nile
  5. st Louis encephalitis

Microbiology (25 decks)

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