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Test q's Flashcards

1
Q

How does meningococci enter the blood?

A

from the pharynx- via pilus-mediated adherence to and penetration of the mucosal epithelium

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2
Q

What is n meningitidis’ virulence factor?

A
  • sex pilus

- produces an IgA protease that facilitates survival by destroying antibodies

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3
Q

sputum gram stain shows many neutrophils but few or no organisms

A

Legionella pneumonia

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4
Q

very high fever in a smoker with diarrhea, confusion, and cough

A

Legionella pneumonia

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5
Q

Why cant legionella gram stain?

A

bc they have unique lipopolysaccharide chains on the outer membrane that inhibit gram staining

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6
Q

What is staph aureus’ virulence factor that is bound to the peptidoglycan wall?

A

Protein A: binds to the Fc portion of IgG at the complement binding site thus preventing activation of complement
= decreased opsonization

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7
Q

What substance is SECRETED by staph?

A

Hemolysin: can produce hemolysis and destruction of neutrophils, macs, and platelets

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8
Q

Which bacteria have the ability to take up free DNA from the environment (transformation)

A

Strep pneumo
H influ
Neisseria meningitidis

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9
Q

What bacteria are responsible for secondary bacterial pneumonia?

A
  1. Strep pneumo
  2. Staph aureus
  3. H influenzae
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10
Q

What organism has a lipooligosaccharide

A

N meningitidis

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11
Q

What is significant about N meningitidis’ LOS?

A
  1. It correlates with the outcome of the disease
  2. It causes sepsis by induction of inflammatory response (interacts with toll like receptor 4)
  3. Cause of cutaneous petechiae and hemorrhagic bullae
  4. Causes Waterhouse-Friderichsen syndrome
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12
Q

What is the major virulence factor of Group A strep?

A

Protein M: inhibits phagocytosis and inactivates complement

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13
Q

Streptolysin O MOA?

A
  • found on group A strep- strep pyogenes

- lyses erythrocytes and PMNs but does not convey resistance to phagocytosis

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14
Q

budding yeast with a thick capsule

A

Cryptococcus

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15
Q

What does the DPT vaccine target?

A

the binding component (B subunit) of Diptheria’s exotoxin

- antibody binding prevents the exotoxin from attaching to host cell membrane and preventing disease

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16
Q

In a pt with bronchial asthma and CBC with eosinophilia, what do you suspect?

A
  • Aspergillus
  • Allergic Bronchopulmonary Aspergillus
  • seen in steroid dependent asthmatics
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17
Q

How does typhoid fever cause death?

A
  • causes inflammation within Peyer’s patches leading to intestinal hemorrhage and gut perforation
  • polymicrobial peritonitis and sepsis
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18
Q

Pt presents with abdominal cramping, low fever, constipation and salmon colored rose spots on the abdomen, plus hepatosplenomegaly

A

Salmonella typhi

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19
Q

What do the different HIV structural genes encode:

  1. Gag
  2. Pol
  3. Env
A
  1. Gag = nucleocapsid proteins p24 & p7
  2. Pol = reverse transciptase
  3. Env = envelope glycoproteins ie gp120 and gp41
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20
Q

What is the only gram + bug with an endotoxin?

A

Listeria

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21
Q

Stain with carbolfuschin = what bugs?

A

Acid fast stain = Ziehl neelsen: Nocardia and Mycobacteria

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22
Q

Giemsa stain?

A
  1. Chlamydia
  2. Borrelia
  3. Rickettsia
  4. Trypanosomes
  5. Plasmodium
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23
Q

mucicarmine = ?

A

Cryptococus, stains the thick polysaccharid capsule red

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24
Q

Catalase positive organisms?

A 
PLACESS:
pseudomonas
listeria
aspergillus
candida
e coli
s aureus
serratia
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25
Q

What are the conjugated vaccines and why are they conjugated?

A 
for capsular antigens- a protein is conjugated to the polysaccharide antigen to promote T cell activation and subsequent class switching- a polysaccharide antigen alone cannot be presented to T cells (only IgM would be produced)
ex) H influenza type B and Meningococcal
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26
Q

What are the urease positive bugs?

A
  1. Cryptococcus
  2. H pylori
  3. Proteus
  4. Ureaplasma
  5. Nocardia
  6. Klebsiella
  7. Staph epidermidis
  8. Staph saprophyticus
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27
Q

Protein A: who has it and what does it do?

A

Staph aureus

- Binds to Fc portion of Ig, prevents opsonization and phagocytosis

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28
Q

IgA protease: who has it and what does it do?

A
  • enzyme that cleaves IgA in hinge region, secreted by SHiN: s pneumo, h influ, neisseria
  • used to colonize resp mucosa
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29
Q

M protein: who has it and what does it d?

A
  • Group A strep

- prevents phagocytosis

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30
Q

How do ST and SLT from shigella and EHEC cause HUS?

A

their exotoxins: binding to 60S ribosome and enhances cytokine release

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31
Q

how do shigella and EHEC differ?

A

EHEC does not invade host cells

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32
Q

Genes for what 5 toxins can be encoded in a lysogenic phage?

A 
ABCDE
shigA like toxin
Botulinum toxin
Cholera toxin
Diptheria toxin
Erythrogenic toxin
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33
Q

which bugs are beta hemolytic?

A
  1. Staph aureus
  2. Strep pyogenes
  3. Strep agalactiae
  4. Listera monocytogenes
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34
Q

What is the MOA of exfoliative toxin?

A
  • seen in staph aureus

- acts as a protease and cleaves desmoglenin desmosomes

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35
Q

How does staph epidermidis protect itself?

A

Producing adherent biofilms

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36
Q

how does vviridans group strep adhere to surfaces of teeth and valves?

A
  • makes dextrans from glucose that aid organisms in colonizing = glycocalyx
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37
Q

rash that spares the face

A

scarlet fever

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38
Q

Which bacteria are hippurate test positive?

A
  1. Group B strep
  2. Gardnerella vaginosis
  3. Listeria
  4. Campylobacter
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39
Q

cytoplasm contains metachromatic granules hat stain with aniline dyes

A

Cornybacterium

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40
Q

What is the preformed toxin seen in bacillus cereus?

A

cereulide!

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41
Q

Which bug is able to multiply on cold enrichment culture?

A

Listeria

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42
Q

What is Fitz-Hugh Curtis syndrome?

A

infection of liver capsule from ascending infection

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43
Q

What factor does staph aureus provide w H influe?

A

factor V: niacin

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44
Q

When do you give rifampin prophylaxis?

A

H flu and meningococcal

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45
Q

Which bug’s antigen is preset in the urine?

A

Legionella

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46
Q

which bug has a grape like odor?

A

pseudomonas

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47
Q

What are E coli’s virulence factors and what do they cause?

A
  1. Fimbriae: cystitis and pyelonephritis
  2. K capsule: pneumonia and nonatal meningitis
  3. LPS endotoxin: septic shock
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48
Q

How do you distinguish EHEC 0157:H7 from other strains?

A

It doesnt ferment sorbitol

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49
Q

Where does salmonella typhii remain in carrier state?

A

in gallbladder

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50
Q

what happens when you give someone with salmonella antibiotics?

A

it prolongs the excretion in the stool

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51
Q

3 stages of Lyme disease?

A

Stage 1: erythema chronicum migrans, flu like sx
Stage 2: neurologic (facial n palsy) and AV nodal block
Stage 3: MSK, migratory polyarthrtitis and neurological (encephalopathy) and cutaneous manifestations

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52
Q

how does congenital syphillis transmission happen?

A

usually after the first trimester

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53
Q

False positives of VDRL?

A

Viruses- mono and hepatitis
Drugs
Rheumatic fever
Lupus and leprosy

54
Q

Rickettsiae are obligate intracellular organisms that need what?

A

CoA and NAD+

55
Q

cattle placenta

A

Coxiella burnetti

56
Q

2 forms of chlamydia:

A
  1. Elementary body: small, dense, infectious, and enters cell via endocytosis
  2. Reticulate body: replicates in cell by fission , form seen in culture
57
Q

Serotypes of Chlamydia and assoc disease:

A

ABC: chronic infection, cause blindness in Africa
D-K: urethritis/PID, ectopic pregnancy, neonatal diseases
L1, L2, L3: lymphogranuloma venereum

58
Q

Systemic mycoses: ltretment for local vs systemic infections

A

Local: itraconazole or fluconazole
Systemic: ampho B

59
Q

conidiophore with radiating chains of spores

A

Aspergillus fumigatus

60
Q

How do Mucor and rhizopus cause infection?

A
  • fungi proliferate in blood vessel walls when there is excess ketone and glucose, penetrate cribriform plate and enter brain
  • has enzyme ketone reductase
61
Q

trophozoites have RBCs in cytoplasm

A

entamoeba histolytica

62
Q

flask shaped ulcer in submucosa of colon

A

entamoeba histolytica

63
Q

cysts on acid fast stain

A

Cryptosporidium- severe diarrhea in AIDS

64
Q

enterobius vermicularis

A

pinworm

65
Q

strongyloides stercoralis

A

penetrates the skin- roundworm

66
Q

what nematodes can cause iron deficiency anemia and how?

A
  • Ancylostoma duodenale and Necator americanus: penetrate skin and suck blood from intestinal wall
67
Q

onchocerca volvulus

A
  • from female blackfly bite

- hyperpigmented skin and river blindness (black fly, black skin, black sight)

68
Q

wuchereria bancrofti

A
  • causes elaphantitis over 9 years bc of blocked lymphatics, transmitted by female mosquito
69
Q

Loefflers eosinophilic pneumonitis

A

ascaris lumbricoides

70
Q

cestode: ingestion of larvae encysted in undercooked pork or ingestion of eggs

A

Taenia solium

71
Q

cestode: ingestion of larvae from raw freshwater fish, bug and disease?

A

Diphyllobothrium latum- vitamin B12 deficiency -> anemia

72
Q

cestode: ingestion of eggs from dog feces

A

echinococcus granulosus (surgeons preinject cysts in liver with ethanol to kill bc could cause anaphylaxis)

73
Q

fluke: snails are host, cercarieae penetrate skin

A

Schistosoma, liver and spleen granlomas leading to protal hypertension and splenomegaly

74
Q

Fluke: undercooked fish, assoc with cholangiocarcinoma

A

clonorchis sinesis

75
Q

Fluke: undercooked crab meat

A

paragonimus westermani

76
Q

What two worms are associated with cancers?

A
  1. Schistosoma: squamous cell carcinoma of bladder

2. Clonorchis: cholangiocarcinoma

77
Q

Parasite: brain cysts, seizures: bug and transmission

A

taenia solium, ingestion of eggs

78
Q

Parasite: liver cysts, bug and transmission

A

Echinococcus granulosus, ingestion of eggs from dog feces

79
Q

Parasite: vit B12 deficiency, bug and transmission

A

Diphyllobothrim latum, ingestion of larvae from raw freshwater fish

80
Q

Parasite: biliary tract disease, cholangiocarcinoma, bug and transmission

A

clonorchis sinensis, undercooked fish

81
Q

Parasite: hemptysis, bug and transmission

A

paragonimus westermani, undercooked crab meat

82
Q

Parasite: portal hypertension, bug and transmission

A

schsitosoma mansoni, snails are host- penetrate skin

83
Q

parasite: hematuria and bladder cancer, bug and transmission

A

Schistosoma haematobium, snails are host, penetrates skin

84
Q

parasite: Microcycit anemia: bug and transmission

A

Ancylostoma, Necator

85
Q

Parasite: perianal pruiritus, bug and transmission

A

Enterobius, fecal oral

86
Q

Viral reassortment- who can do it and why is it improtant

A
  • Segmented viruses only
  • BOAR: bunya, orthamyxo, arena, reovirus
  • the reason for genetic shifts -> pandemics
87
Q

Live attenuated viruses?

A
  1. Smallpox
  2. Yellow fever
  3. Chicken pox/ Shingles
  4. Sabins polio
  5. MMR
  6. Influenza- intranasal
88
Q

type of immunity w:

  1. Live
  2. Killed/inactivated
A

Live = cell and humoral

Killed: humoral only

89
Q

Killed viruses

A
  • Rabies
  • Influenza (injected)
  • Salk Polio
  • HAV vaccine
90
Q

Recombinant vaccines - 2

A

HPV and HBV

91
Q

Which virus is not a retrovirus but carries its own reverse transcriptase?

A

HBV

92
Q

what is exanthem subitum and who causes it?

A

another name for roseola- HHV-6

93
Q

high fevers for several days followed by a diffuse macular rash

A

HHV-6 = roseola

94
Q

Picornaviruses and assoc disease

A
  • PERCH: polio, echo, rhino, coxsackie, HAV
  • all can casue aseptic meningitis except HAV and rhino
  • all are enteroviruses (fecal oral) except rhino
95
Q

All paramyxoviruses contain what?

A
  • surface F protein which causes respiratory epithelial cels to fuse and form multinucleated cells
96
Q

Palivizumab

A
  • monoclonal antibody against F protein in paramyxoviruses

- prevents pneumonia caused by RSV infection in premature infants

97
Q

3 C’s of measles

A

cough coryza conjunctivitis

98
Q

Where do you find rabies virus?

A

Purkinje cells of cerebellum

99
Q

hydrophobia

A

rabies!

100
Q

How do you treaet HCV?

A

Alpha interferon and Ribaviron

101
Q

What ratio of CD4:CD8 determines AIDS?

A

<1.5

102
Q

Why is an ELISA typically falsely positive in babies born to infectd mothers?

A

Anti-gp120 crosses the placenta

103
Q

Where does HIV virus replicate in latent phase?

A

lymph nodes

104
Q

superficial vascular proliferation in AIDS pt, non neoplastic, see neutrophilic infiltration

A

Bartonella henselae- bacillary angiomatosis

105
Q

chronic watery diarrhea in AIDS patient

A

Cryptosporidium

106
Q

Neoplastic superficial proliferation of vasculature, see lymphocytic infilatration

A

HHV-8, causing Kaposis sarcoma

107
Q

source of food poisoning of vibrio vulnificus food poisoning

A

Contaminated seafood

108
Q

What bugs cause osteomyelitis in IV drug users and diabetics?

A

Pseudomonas and Serratia

109
Q

+ leukocyte esterase test in uti

A

bacterial cause

110
Q

+ nitrite test in uti

A

gram negative

111
Q

+ urease test in uti

A

proteus or klebsiella

112
Q
  • urease test in uti
A

e coli or enterococcus

113
Q

How does rubella manifest in baby?

A 
Triad of 
1. PDA
2. Cataracts
3. Deafness
\+/- blueberry muffin rash
114
Q

How does CMV appear in baby?

A

blueberry muffin rash, hearing loss, seizures

115
Q

baby born with hemorrhagic rhinitis

A

syphilis

116
Q

what are the ToRCHeS infections?

A 
Toxoplasma
Rubella
CMV
HIV
HSV-2
Syphilis
117
Q

Baby of an IV drug user presents with oral thrush, interstitial pneumonia and secere lymphopenia

A

HIV-1 vertical transmission

118
Q

What is malignant otitis externa?

A
  • a severe infection most commonly seen in elderly diabetic patients
  • caused by Pseudomonas aeruginosa
  • present with excruciating ear pain and drainage
119
Q

What vitamin shouldnt a pt on Levodopa take and why?

A

Vitamin B6- bc it increaes the peripheral metabolism of levodopa and decreases its effectiveness

120
Q

What drugs can cause serotonin syndrome?

A
  1. Antidepressants: SSRIs, SNRIs, MAO, TCA
  2. Tramadol
  3. 5-HT3 receptor antagonists
  4. Linezolid
  5. Triptans
121
Q

Where is the lowest pH found along the nephron?

A

the distal tubules and collecting ducts- whythe reason why uric acid recipitates here

122
Q

What does CD95 do?

A

its the Fas ligand that activates extrinsic apoptotic pathway

123
Q

what activates the caspases?

A

Ca influx!

124
Q

Pale infarcts occur in what types of tissue?

A

heart
kidney
spleen

125
Q

What are the acute phase inflammatory cytokines?

A

IL-1, IL-6 and TNFalpha- they signal endothelial cells to put out selectins to attract neutrophils!

126
Q

Vasodilation and increased vascular permeability in acute inflammation is due to…

A

serotonin, histamine, and bradykinin

requires Vitamin C

127
Q

What are metalloproteinases?

A

remodel after inflammation, require zinc

128
Q

what is the result of chronic iron poisoning?

A

metabolic acidosis

129
Q

what is dialysis related Amyloidosis?

A
  • fibrils composed of Beta2-microglobulin
  • in pt with ESRD or dialysis
  • presents as carpal tunnel syndrome and joint issues
130
Q

what is the gene mutation in hereditary Amyloidosis?

A

transthyretin (prealbumin)

131
Q

amyloid deposits seen in DBM and Medullary thyroid CA?

A

DBM type II: Amyloid

Med thyroid: Calcitonin

132
Q

which drugs follow a zero order elimination?

A

phenytoin
aspirin
alcohol

FA notes (11 decks)

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