topnotch generalities Flashcards
1
Q
microorganisms
enumerate
A
bacteria
protozoa
microscopic algae
fungi
2
Q
acellular infections agents enumerate
A
viruses
viroids
prions
3
Q
mobile genetic elements enumerate
A
bacteriophages
plasmids
transposons
4
Q
animal parasites enumerate
A
nematodes
trematodes
cestodes
5
Q
roundworms
A
nematodes
6
Q
flukes
A
trematodes
7
Q
tapeworms
A
cestodes
8
Q
Non-SI unit for sedimentation rate
A
Svedberg unit
9
Q
is the rate at which particles of a given size and shape travel to the bottom of the tube under centrifugal force
A
svedberg unit
10
Q
this reflects at which a molecule sediments under the centrifugal force
A
svedberg unit
11
Q
svedberg is a measure of time defined exactly
A
10^-13 s (100 fs)
12
Q
replicates through binary fission
A
bacteria
13
Q
how does fungi replicate
A
budding or mitosis
14
Q
how does protozoa and helminths replicate
A
mitosis
15
Q
protein capsid
A
viruses
16
Q
rigid wall containing peptidoglcan
A
bacteria
17
Q
rigid wall contaning chitin
A
fungi
18
Q
flexible membrane
A
protozoa and helminths
19
Q
Which of the following microorganisms lack membrane sterols
A
bacteria
20
Q
Which organism has abundant sterols in membrane, 10% of dry weight
A
yeast
21
Q
mobile genetic elements
A
transposons
22
Q
Jumping genes
A
transposons
23
Q
obligate intracellular parasites of plants
acellular
with naked RNA
no human diseases known
A
viroids
24
Q
Transposons are DNA pieces that move readily from one site to another between DNA of what type of organisms
A
bacteria
plasmids
bacteriophages
25
code for drug-resistant enzymes , toxins or metabolic enzymes
transposons
26
cause mutations in gene into which they insert or alter expression of nearby genes
transposons
27
Which of the following infectious agents lack nucleic acids?
a. viruses
b. bacteria
c. viroids
d. prions
d. prions
| protein only
28
noncellular infectious proteins
prions
29
naked proteins that have the same amino sequence as certain human cell surface proteins but folded differently
prions
30
prions are resistant to
nucleases
proteases
many chemicals and
normal autoclaving
31
prions are associated with what condition
spongiform encephalopathies
| Creutzfeldt- Jakob’s disease, kuru, fatal familial insomnia
32
What is the pathogenic mechanism of prions
dysfunction due to protein misfolding
33
appearance of the VACUOLATED NEURONS with loss of function and the lack of an immune response or inflammation
spongiform encephalopahies
34
Human prior diseases
```
Creutzfeldt- Jakob disease
Kuru
Variant CJD
Gertsmann- Straussler- Scheinker (GSS Syndrome)
Fatal Familial Insomnia
Sporadic fatal insomnia
```
35
etiology of CJD
infection
36
etiology of Kuru
cannibalism
37
difference of manifestation of CJD and Kuru
CJD - higher cortical dysfunction-> dementia
| Kuru - cerebellar manifestation -> dysdiadochokinesia, ataxia, myoclonic jerks
38
Kuru means
kuria or guria -> to shake
39
clinical features of kuru
cerebellar ataxia
voluntary tremor
involuntary movements ( choreoathetosis, myoclonic jerks, fasciculations)
Euphoria, dementia, emotional liability, loss of grasp of reflexes
40
the most infectious organ
brain
41
enumerate animal prion diseases
scrapie (sheep and goats)
Transmissible mink encephalopathy
Bovine spongigorm encephalopathy (BSE) - mad cow disease
Chronic wasting disease (Mule, deer, elk)
42
susceptible population to prion diseases
women and children of the Fore tribe in New Guinea
neurosurgeons and brain surgery patients
transplant surgeons and transplant patients
43
manifestations of human prion disease
```
loss of muscle control
shivering
myoclonic jerks and tremors
loss of coordination
rapidly progressive dementia
death
```
44
Treatment and prevention of prion diseases
no tx available
cessation of ritual cannibalism
elimination of animal products from livestock field
45
3 shapes of bacteria
cocci (sphere)
bacilli (rods)
spirochete (spirals)
46
cocci are arranged in 3 patterns
pairs (diplococci)
chains (streptococci)
clusters (staphylococci)
47
all bacteria have a cell wall composed of peptidoglycan except
mycoplasma - no cell wall
48
peptidoglycan is composed of glycan and peptide side chains cross-linked by
transpeptidase
49
structures in bacterial cell wall the facilitate passage of small, hydrophilic molecules into the cell
porin proteins
50
in the outer membrane of gram - bacteria this allow entry of essential substances such as sugars, amino acids and vitamins
channels
51
lysozymes are enzymes that kill bacteria by cleaving which part of cell wall
The link between the N-acetylglucosamine and N-acetylmuramic acid is cleaved by lysozyme.
52
thicker, multilayer of peptidoglycan in cell wall
| presence of teichoic acids
gram + cells
53
presence of thinner peptidoglycan
no teichoic acids
(+) lipopolysaccharide
(+) periplasmic space
gram -
54
what is the endotoxin that forms the outer membrane of gram (-) bacteria
lipopolysaccharide
55
All gram (+) bacteria have no exotoxin except
LISTERIA MONOCYTOGENES
56
procedure for gram staining
| steps 1 -4
primary stain - crystal violet
mordant - iodine
decolorizing agent - acetone
counterstain 0 safranin
VIAS
57
enumerate all bacteria not seen in gram stain
Treponema
Rickettsiae
Mycobacteriae
Mycoplasma spp
Legionella spp
Chlamydiae
Spirochetes
These Rascals May Microscopically lack color S
58
why is this bacteriae not seen on gram stain and alternative approach
mycobacteria
too much lipid in cell wall so dye cannot penetrate
59
why is this bacteriae not seen on gram stain and alternative approach
spirocheres
too thin to see
darkfield microscopy
60
why is this bacteriae not seen on gram stain and alternative approach
mycoplasma
no cell wall
very small
none
(serologies)
61
why is this bacteriae not seen on gram stain and alternative approach
legionella
poor uptake of counterstain
silver stain
62
why is this bacteriae not seen on gram stain and alternative approach
chlamydiae
intracellular
very small
giemsa stain -> inclusion bodies
63
why is this bacteriae not seen on gram stain and alternative approach
rickettsiae
intracellular, very small
giemsa/ tissue stains
64
which component of the gram negativecell wall is responsible for its nonspecific endotoxin activity
Lipopolysaccharide
65
which of the following is the OLDEST acid- fast staining method which requires heating the specimen during procedure
Ziehl-Neelsen method- hot plate method
66
method of Ziehl-Neelson
Primary dye - Carbol fuchsin
Decolorizer- acid alcohol
Count stain - methylene blue / malachite green
67
structure of bacteria that protects against phagocytosis
capsule (polysaccharide)
68
space between the plasma membrane and outer membrane of bacteria
periplasm
69
essential components of bacteria
```
cell wall
cytoplasmic membrane
ribosome
nucleiod
mesosome
periplasm
```
70
non essential components of bacteria
```
capsule
pilus or fimbria
glycocalyx
flagellum
spore
plasmid
granule
```
71
component of bacteria for attachment and conjugation
pilus or fimbria
72
structure in bacteria that mediates adherence to surfaces
glycocalyx
73
protein in bacteria that mediates motility
flagellum
74
structure in bacteria with keratin like coat and dipicolinic acid that provides resistance to head, and chemicals
spore
75
structure in bacteria that provides genes for antibiotic resistance and toxins
plasmid
76
structure in bacteria that is site of nutrients in cytoplasm
granule
77
extrachromosomal, double stranded, circular DNA capable of replicating independently of the bacterial chromosome
plasmids
78
when plasmids are integrate into the bacterial chromosome, it is called
episomes
79
ALL bacterial capsules are composed of polysaccharide except
bacillus anthracis ( polypeptide of D-glutamate)
80
spore forming bacteria are
gram (+) rods such as bacillus and clostridium
81
can plasmids replicate independent of bacterial
chromosome
T/F
T
82
toxic proteins produced by certai bacteria that are lethal for other bacteria
bacteriocins
83
Which of the bacterial structures necessitate the use of soap-based products over the alcohol rubs?
spores
84
Alcohol based hand sanitizers may be effective against the ff organisms, except
Spore forming bacteria such as clostridium and bacillus
85
is a coordinated process of increase in individual cell mass and size and duplication of chromosome, followed by cell division
bacterial growth
86
bacterial reproduction occurs via
binary fission
87
bacterial growth phase
zero growth rate
adaptation to new environment
vigorous metabolic activity without binary fission
Phase 1 - lag phase
88
bacterial growth phase
rapid cell division
constant growth rate
Phase 2- log or exponential phase
89
bacterial growth phase affected by beta lactam antibiotics
Phase 2- log or exponential phase
90
bacterial growth phase
exhaustion of nutrients or accumulation of toxic products
zero growth rate
spores are formed
phase 3 - stationary phase
91
most of the cells die because nutrients have been exhausted
| negative growth phase
phase 4 - decline or death phase
92
bacterial oxygen metabolism generates toxic products such as
superoxide and hydrogen peroxide
93
what enzymes are needed for bacteria to survive in aerobic environments
superoxide dismutase
peroxidase
catalase
94
aerobic metabolism
| types of bacteria
obligate aerobes
| microaerophiles
95
anaerobic metabolism
| types of bacteria
facultative anaerobe
aerotolerant anaerobes
obligate anaerobes
96
completely dependent on oxygen for ATP generation
obligate aerobes
97
use fermentation but can tolerate low amounts of oxygen because they have SOD
microaerophiles
98
utilize oxygen if it is present, but can use fermentation in its absence
facultative anaerobes
99
exclusively anaerobic but is insensitive to presence of oxygen
aerotolerant anaerobes
100
cannot grow in presence of oxygen because they lack SOD, peroxidase, catalase
obligate anaerobes
101
enumerate obligate anaerobes
actinomyces
bacteroides
clostridium
102
enumerate aerotolerant anaerobes
propionibacterium
| lactobacillus
103
bacterial oxygen metabolism
| nocardia
obligate aerobes
104
bacterial oxygen metabolism
| streptococcus
microaerophiles
105
bacterial oxygen metabolism
| staphylococcus
facultative anaerobic
106
bacterial oxygen metabolism
| Neisseria
Obligate aerobes
107
bacterial oxygen metabolism
| Bacillus cereus
obligate aerobes
108
bacterial oxygen metabolism
| pseudomonas
Obligate aerobes
109
bacterial oxygen metabolism
| Bordetella
Obligate aerobes
110
bacterial oxygen metabolism
| spirochetes (Borrelia, Treponema)
microaerophiles
111
bacterial oxygen metabolism
| Campylobacter
Microaerophiles
112
bacterial oxygen metabolism
| Legionella
Obligate aerobes
113
bacterial oxygen metabolism
| Brucella
Obligate aerobes
114
bacterial oxygen metabolism
| Mycobacterium
obligate aerobes
115
bacterial oxygen metabolism
| Leptospira
Obligate aerobes
116
bacterial oxygen metabolism
| Mycoplasma pneumoniae
Obligate aerobes
117
bacterial oxygen metabolism
| Helicobacter
microaerophiles
118
bacterial oxygen metabolism
| Bacillus anthracis
facultative anaerobes
119
bacterial oxygen metabolism
| Corynebacterium
Facultative anaerobes
120
bacterial oxygen metabolism
| Listeria
Facultative anaerobes
121
bacterial oxygen metabolism
| Mycoplasma in general
Facultative anaerobes
122
Obligate aerobes
| enumerate
Nosy and Nagging Pests Must Breathe Lots of Oxygen
```
Nocardia
Neisseria
Pseudomonas
Mycobacteria
Bordetella/ Brucella/ B. cereus
Legionella
```
123
Obligate anaerobes
| enumerate
ABC
Actinomyces
Bacteroides
Clostridium
124
DNA transferred from one bacterium to another
Conjugation
125
DNA transferred by a virus from one cell to another
transfuction
126
Purified DNA taken up by cell
transformation
127
Bacterial DNA transfer procedure for prokaryotes
Conjugation
Transduction
Transformation
128
Eukaryotic cells DNA transfer procedure
transformation
129
microorganisms that are permanent residents of the body
normal flora
130
are low virulence organisms in their usual anatomic site
normal flora
131
occurs when normal flora occupy receptor sites preventing pathogens from binding
colonization resistance
132
normal flora
| skin
Staphylococcus epidermidis
133
normal flora
| nose
Staphylococcus aureus
134
normal flora
| Mouth
Viridans Streptococci
135
normal flora
| mouth
viridans streptococci
136
normal flora
| Dental plaque
Streptococcus mutans
137
normal flora
| Colon
Bacteroides
| Escherichia coli
138
normal flora
| Vagina
Lactobacillus vaginalis
E. coli
Streptococus agalactiae
139
are microbes that can cause disease
pathogens
140
are microbes that cause disease in immunocompromised people only
opportunistic pathogens
141
is a measure of a microbe’s ability to cause disease determined by virulence factors such as capsules, exotoxins, or endotoxins
virulence
142
is the number of organisms required to cause disease in 50% of population
ID50
143
2 meanings of infection
presence of microbes in the body
| symptoms of disease
144
mechanisms of bacterial disease
production of toxins
| induction of inflammation
145
mediates strong adherence to surface of human cells
glycocalyx
146
surface proteins called ___ mediate binding to endothelium and to extracellular proteins such as fibronectin
curli
147
enzymes in bacterial invasion
```
collagenase
hyaluronidase
coagulase
IgA protease
Leukocidin
```
148
enzyme to spread through subcutaneous tissue
collagenase
| and hyaluronidase
149
bacterial enzyme to accelerate formation of a fibrin clot coating the organisms with a layer of fibrin
coagulase
150
bacterial enzyme that allows adherence to mucous membranes
IgA protease
151
bacterial enzyme that destroys both neutrophilic leukocytes and macrophages
leukocidin
152
which enzyme is primarily responsible for development of cellulitis from a small furuncle
hyaluronidase
153
Prophage coded bacteria
ABCDE
shigA- like toxin: EHEC
botulinum
Cholera Diphtheria
Erythrogenic Strain
154
Bacteria with IgA protease
```
SHiNe My Gong
Streptococcus pneumoniae
Haemophilus influenzae
Neisseria meningitidis
Neisseria Gonorrhoeae
```
155
the toxic component of LPS
lipid A
156
this virulence factor protect against phagocytosis
polysaccharide capsule
157
this process involves anticapsular antibodies more effective phagocytosis to occur
opsonization
158
cell wall protein S. pyogenes that protects against phagocytosis
M protein
159
cell wall protein of S. aureus prevents complement activation
protein A
160
exotoxin is produced by
gram + and gram - bacteri
161
endotoxin is found in
gram - bacteria
162
which toxin is secreted by bacteria
exotoxin
163
exotoxin is made up of
polypeptide
164
endotoxin is made up of
lipopolysaccharide
165
location of genes of exotoxin
plasmid or bacteriophage
166
location of genes
| endotoxin
bacterial chromosome
167
which is more toxic
| exotoxin vs endotoxin
exotoxin
168
which is more antigenic
| exotoxin vs endotoxin
exotoxin
169
what vaccine is used for exotoxin
toxoids
170
heat stability of exotoxin
60 C - destroyed rapidly
171
what exotoxin is heat stable
staphylococcal enterotoxin
172
typical diseases of exotoxin
tetanus
| botulism
173
heat stabilty of endotoxin
stable at 100 C for 1 hour
174
typical diseases of endotoxin
meningococcemia
175
is the toxic component of LPS
Lipid A
176
Lipid A induces cytokines such as
TNF and IL-1
177
Lipid A effect
overproduction of cytokines
activates complement cascade
activates the coagulation cascade resulting in DIC
178
all bactyeria have cell walls composed of peptidoglycan except
Mycoplasma pneumoniae
179
All gram-positive bacteria have no endotoxin except
listeria monocytogenes
180
all bacterial capsules are composed of polysaccharide except
bacillus anthracis
181
all exotoxins are heat-labile except
staphylococcal enterotoxin
182
use of high or rising titer of specific IgG antibodies or the presence of a specific IgM antibodies may suggest or confirm a diagnosis
serodiagnosis
183
Microorganisms particularly bacteria, are tested in vitro to determien whether they are susceptible to antimicrobial agents
Antimicrobial suspceptibility
184
propagation of microorganisms in media conducive to their growth
culture
185
a nutritive substance in which cultures of microorganisms are grown
culture medium
186
specialized media for
| clostridium perfringens
egg yolk
187
specialized media for
| corynebacterium diphtheriae
tellurite
188
specialized media for
| group D streptococci
bile esculin
189
specialized media for
| staphylococci
mannitol salts
190
specialized media for
| N. meningitidis
chocolate
191
specialized media for
| N. gonorrhoeae from sterile sites
chocolate
192
specialized media for
| N. gonorrhoeae from nonsterile sites
Thayer-martin
193
specialized media for
| Haemophilus influenzae
Chocolate + Factors X and V
194
Bacteria isolated in this agar:
| Lowenstein -Jensen
Mycobacterium tuberculosis
195
Bacteria isolated in this agar:
| Thiosulfate citrate bile salts
Vibrio cholerae
196
Bacteria isolated in this agar:
| Border- Gengou
Bordetelli pertussis
197
Bacteria isolated in this agar:
| Charcoal-yeast extract
Legionella pneumphila
198
Bacteria isolated in this agar:
| skirrows
Campylobacter, helicobacter
199
Bacteria isolated in this agar:
| Barbour-stoenner-kelly
Borrelia burgdorferi
200
Bacteria isolated in this agar:
| eaton
Mycoplasma pneumoniae
201
Bacteria isolated in this agar:
| cetrimide
Pseudomonas aeruginosa
202
Bacteria isolated in this agar:
| Xylose-lysine-deoxycholate (XLD)
Salmonella, Shigella
203
Bacteria isolated in this agar:
| Ellinghausen-McCullough-Johnson-Harris (EMJH)/ Fletcher’s
Leptospira interogans
204
Working Dx: TB Lymphadenitis -
| what should be requested to RAPIDLY identify mycobacterial species
PCR
205
highly specific, quite sensitive, much faster than culture, especially useful for those bacteria that are difficult to culture such as chlamydia and mycobacterium species
Molecular Tests
206
enumerate Antigen detection immunodiagnostics
Immunofluorescent antibody tests
| EIAs, ELISA, agglutination tests
207
enumerate antibody detection immunodiagnostics
Western blot immunoassays
Lepto MAT
COPT
208
Serologic tests is used for iagnosis of viral infections with long incubation period prior to appearance of clinical manifestations
such as
Epstein-Barr, Hepatitis, HIV
209
Immunofluorescent Antibody staining is commonly used for these strains of bacteria
Bordetella pertussis, Legionella pneumophila
210
in this type of fluorescent antibody test, the fluorescent dye is attached directly to the antibody that is interacting with the antigen
direct fluorescent antibody test
211
in this type of fluorescent antibody test, the fluorescent dye is attached to the antibody that is made against human IgG
indirect fluorescent antibody test
212
the rabies antibody used for dFA test is primary directed against ____
nucleoprotein (antigen) of the virus
213
What are serologic tests or syphilis
Nontreponemal-
-VDRL- Venereal disease research laboratory
-RPR - Rapid plasma reagin
-Antigen- cardiolipin, cholestrol, purified lecithin
-Unheated serum reagin (USR), toluine red unheated serum test (TRUST)
Treponemal antibody tests - T pallidium enzyme immunoassay (TPEIA)
214
screening for HIV
ELISA
215
ELISA procedure
Coat wells with antigen
- > add specimen -> incubate
- > wash wells
- > add enzyme labelled antibodies -> wash
- > add substrate
- > color change
- > analyze using spectyrophotometer
216
difference of RIA with ELISaA
uses radio-labeled antibodies
| uses gamma counter to measure radioactive signal
217
immunoassay primarily directed at the detection of carbohydrate antigens of encapsulated micoorganisms
Latex agglutination
218
STEPS of Latex aggltination
1. antigen-specific antibody (either polyclonal or monoclonal) that is fixed to latex beads
2. add specimen
antibodies present -> bind to antigens -> lattice structure -> agglutination of the beads
219
uses of latex agglutination assay
diagnosis of group A streptococcal pharyngitis
detection of cryptococcal antigen (CALAS)
bacterial meningitis
220
performed to detect antibodies against specific antigens
western blot immunoassays
221
based upon the electrophoretic separation of major proteins of the organism in question in a 2-dimentional agarose gel
western blot assays
222
is a method used in molecular biologyto detect a specific DNA sequence
Souther blot
223
lab method to detect specific RNA
nothern blot
224
In the diagnosis of HIV, which technique employs strips that are incubated with patient serum and anti-human IgG conjugated with an enzyme and chromagen
Western blot
225
An 18 year old ale presents with ureththral discharge. You suspect he has gonococcal infection. What is the gold standard for diagnosis?
CULTURE on Thayer-Martin medium
226
which molecular techniques represents a variation of the PCR involving the use of an enzyme to convert viral RNA or messenger RNA to DNA prior to amplification
Reverse transcriptase PCR
227
Also known as McClung-Toabe agar, this agar is a differential medium useful in the detection of lecithinase activity such as _____
Clostridium perfringens
228
Also known as McClung-Toabe agar, this agar is a differential medium useful in the detection of lecithinase activity such as Clostridium perfringens. This culture medium is also known asa
Egg yolk agar,
| Anaerobic lecithin lipase agar
229
toxoplasma gondii is
a. tissue protozoan
b. blood protozoan
c. blood and tissue protozoan
a. tissue protozoan
230
trypanosoma cruzi is a
a. tissue protozoan
b. blood protozoan
c. blood and tissue protozoan
c. blood and tissue protozoan
231
4 forms of Trypanosoma cruzi
amastigote, promastigote, epimastigote, typomastigote
232
trypanosoma crui is transmitted by
reduviid bug
233
transmission of trypanosoma cruzi is via
reduviid bug (Triatoma ) bite
234
infective stage of trypanosoma cruzii
metacyclic trypomastigotes
235
diagnostic stage of trypanosoma cruzi
trypomastigotes in blood
236
which are frequent sites affected by trypanosoma cruzi
myocardial
glial
reticuloendothelial cells
237
most frequently and severely affected tissue of trypanosoma cruzi
cardiac muscle
238
how to diagnose trypanosoma cruzi
stained BMA or muscle biopsy
culture of the organism on special medium
xenodiagnosis - allowing an uninfected lab raised reduviid bug to feed on the patient
239
allowing an uninfected, lab raised reduviid bug to feed on patient
xenodiagnosis
240
Spectrum of diseases caused by trypanosoma cruzi
Acute Chagas’ disease
| Chronic disease-myocarditis, megacolon, megaesophagus
241
s and sx of Acute Chagas’ diseaseaa
```
periorbital edema (Romana sign)
nodule near bite (chagoma)
fever
LAD
hepatosplenomegaly
```
242
tx for trypanosoma infection
nifurtimox
243
trypanosom brucei is
a. tissue protozoan
b. blood protozoan
c. blood and tissue protozoan
c. blood and tissue protozoan
244
what are the forms of trypanosoma brucei
trypanosoma brucei gambiense
| trypanosoma brucei rhodesiense
245
transmission by trypanosoma brucei
tsetse fly (Glossina ) bite
246
infective stage by trypanosoma brucei
metacyclic trypomastigotes
247
diagnostic stage of trypanosoma brucei
trypomastigotes in blood
248
how does trypanosoma spread in the body
spread from the skin through the blood to the lymphnodes and brain -> somnolence -> coma (demyelinating encephalitis) ARAS and brainstem
249
fever spike in trypanosoma brucei
cyclical fever spike every 2 weeks due to antigenic variation
250
which is more rapid and fatal antigenic variation of trypanosoma brucei
rhodesian > gambian
251
spectrum of disease
| trypanosoma brucei
indurated skin ulcer (trypanosomal chancre)
intermittent weekly fever and LAD
enlargement of posterior cervical LN (Winderbottom sign)
excessive somnolence - demyelinating encephalitis
hyperesthesia (Kerandel sign)
encephalitis - mott cells
252
plasma cells with cytoplasmic immunoglobulin globules
Mott cells
253
hyperesthesia due to trypanosoma brucei
kerandel sign
254
enlargement of posterior cervical LN due to trypanosoma cruzei
winterbottom sign
255
West african sleeping sickness
| antigenic variation
gambian
WaGER
West - Gambian
East- Rhodesian
256
east african sleeping sickness
| antigenic variation
rhodesian
WaGER
West - Gambian
East- Rhodesian
257
early west african sleeping sickness tx
1st line: pentamidine
alt: suramin , eflornithine
258
CNS involvement west african sleeping sickness tx
1st : eflornithine
alt: melasorprol
eflornithine-nifurtimox
259
early east african sleeping sickness tx
suramin
alt: pentamidine
260
CNS involvement west african sleeping sickness tx
melasoprol
261
causes Granulomatous Amebic encephalitis
Acanhamoeba castellani
262
Primary amebic meningoencephalitis
Naegleria fowleri
263
causes Balantidium dysentery
Balantidium coli
264
only ciliated protozoa to cause human disease
Balantidium coli
265
Balantidium coli is associated with this animal
pig
266
causes round-based, wide-necked intestinal ulcers
Balantidium coli
267
Babesiosis is caused by
Babesia microti
268
Babesia microti is transmitted by the bite of
Ixodes tick
269
intraerythrocytic ring-shaped trophozoites in tetrads in the form of a maltese cross
Babesia microti
270
Leishmaniasis is transmitted by
sandfly (Phlebotomus)
271
infective stag of Leishmania spp.
promastigotes
272
spectrum of disease caused by leishmania spp.
cutaneous - Leishmania tropica
Visceral / kala-azar - Leishmania donovani
Mucocutaneous - Leishmania braziliensis
273
coccidial sporozoa
| cause diarrhea in immunocompromised patients
Cyclospora Cayetanensis
| Isospora belli
274
Intestinal nematodes
```
Ascaris
Ancyclostoma and Necator
Trichuris
Enterobius
Strongyloides
Capillaria
```
275
Tissue nematodes
Wuchereria
Brugia
Trichinella
276
Hookworms
Ancyclostoma
| Necator
277
Whipworm
Trichuris
278
Pinworm
Enterobius
279
Strongyloidiasis
Strongyloides
280
transmission of ascaris
ingestion of eggs
281
transmission of hookworm (Ancylostoma and Necator)
Larval penetration of skin
282
transmission of trichuris
ingestion f eggs
283
transmission of Enterobius
Ingestion of eggs
284
transmission of Strongloides
Larval penetration of skin
285
transmission of Capillaria
Eggs in undercooked fish
286
transmission of Wuchereria and Brugia
mosquito bite
287
transmission of Trichinella
Larvae in undercooked meat
288
DOC for ascaris
albendazole
289
DOC for Ancylostome and necator
Albendazole
290
DOC for trichuris
Mebendazole
291
DOC for Enterobius
Pyrantel pamoate
292
DOC for Strongyloides
Ivermectin
293
DOC for Capillaria
Albendazole
294
DOC for Wuchereria and Brugia
DEC
295
DOC for Trichinella
Thiabendazole
296
A barrel shaped egg with bipolar plugs was found in stool examination
Trichuris (Whipworm)
297
most common and largest intestinal nematode
| soil-transmitted helminth
Ascaris lumbricoides
298
giant roundworm
ascaris lumbricoides
299
infective stage of ascaris
embyonated egg
300
diagnostic stage of ascaris
unembryonated egg
301
diagnosis of ascaris
direct fecal smear
| kato-katz technique
302
major damage in ascaris happens during
larval migration
303
principal site of tissue reaction by ascaris is the
lungs - inflammation with an eosinophilic excudate occurs
304
ascaris heavy worm burden may lead to this condition
malnutrition
305
spectrum of disease ascaris
```
hypersensitivity pneumonitis (Loeffler syndrome)
acute intestinal obstruction
hepatobiliary ascariasis
pancreatitis
malabsorption syndromes
nutrient deficiencies
```
306
soil-transmitted helminth
| blood-sucking nematodes
hookworms - Necator americanus, ancylostoma duodenale
307
infective stage of Hookworms
filariform larvae
308
diagnostic stage of hookworms
eggs in feces
309
diagnosis of hookworms
direct fecal smear
| kato-katz smear
310
major damag occurs with necator and ancylostoma due to
blood loss at site of attachment - anticoagulant made by worm -> microcytic anemia
311
spectrum of hookworm
Acute disease
| Chronic disease
312
ground itch at site of entry
serpiginous tracts - cutaneous larva migrans
eosinophilic pneumonia during transpulmonary passage
mild GIT symptoms
Acute disease of Hookworms
313
Chronic disease hookworm manifestation
microcytic anemia
| hypoalbuminemia
314
infective stage of trichuris trichuria
embryonated egg
315
diagnostic stage of trichuris
unembryonated egg
316
diagnosis of trichuris trichuria
direct fecal smear
| kato-katz technique - barrel shaped eggs with bipolar plugs
317
burrow their hairlike anterior ends into the intestinal mucosa
do not cause significant anemia
trichuris trichuria
318
spectrum of disease caused by trichuris trichuria
diarrhea
| rectal prolapse- inc peristalsis to expel hookworms
319
seatworm
Pinworm, enterobius vermicularis
320
enterobius vermicularis
| life cycle is confined to
humans
321
most common soil transmitted helminth in developed countries
enterobius vermicularis
322
infective stage of enterobius vermicularis
embryonated eggs
323
diagnostic stage of enterobius vermicularis
eggs on perianal folds
324
enterobius vermicularis dx technique
Graham scotch tape technique - D shaped eggs
| eggs rarely found in stools
325
D shaped eggs
Enterobius vermicularis
326
perianal pruritus
enterobius vermicularis
327
pathogenesis of enterobius vermicularis
female releases thousands of fertilized eggs on perianal skin-> eggs develop into larvae -> perianal pruritus-> autoinfection
328
spectrm of enterobiasis
pruritus ani
eosinophilic enterocolitis
vulvovaginitis
appendicitis (oxyuriasis)
329
tx enterobius vermicularis
pyrantel pamoate
330
soil transmitted heminth
| facultative parasites
Strongyloides stercolaris
331
transmission Strongyloides stercoralis
larvae penetrate skin
332
infective stage Strongyloides stercoralis
filariform larvae
333
diagnostic stage transmission Strongyloides stercoralis
rhabditiform larvae
334
pathogenesis of Strongyloides stercoralis
larvae penetrate intestinal wall directly -> lungs (autoinfection)
hyperinfection in immunocompromised patients
335
acute disease
Strongyloides stercoralis
ground itch at site of entry
mild watery diarrhea
eosinophilic pneumonia
336
Strongyloides stercoralis
| chronic disease
serpiginous track (larva currens)
duodenitis
paradoxicavl asthma
hyperinfection syndrome
337
tx for Strongyloides stercoralis
ivermectin
338
intestinal nematode
| only nematode whose life cycle involves a migratory bird
Capillaria philippinensis
339
transmission of Capillaria philippinensis
undercooked fish
340
Capillaria philippinensis
| infective stage
infective larvae
341
Capillaria philippinensis
| diagnostic stage
unembryonated egg
342
diagnosis of capillaria philippinensis
direct fecal smear
| kato-katz smear - peanut-shaped eggs with flattened bipolar plugs
343
kato-katz smear - peanut-shaped eggs with flattened bipolar plugs
capillaria philippinensis
344
intestinal nematode
only nematode whose life cycle involves a migratory bird
capillaria philippinensis
345
Pathogenesis of capillaria philippinensis
embryonated eggs can cause autoinfection and reinfection
leads to ulcerative and compressive degeneration of enterocytes
resulting in severe malabsorption
346
acute disease of capillaria philippinensis presents with
borborygmus
fever
abominal pain
eosinophilia
347
chronic disease of capillaria philippinensis presents with
```
chronic watery diarrhea
edema
wasting
protein losing enteropathy
hypogammaglobulinemia
```
348
tx of capillaria philippinensis
albendazole
349
blood and tissue nematode
| most debilitating nematode infection
Wuchereria bancrofti
| Brugia malayi
350
farmer from abaca plantation
| most -> adenolymhangitis, fever
Wuchereria and brugia
351
smoothly curved nematode
| absent terminal nuclei
Wuchereria
352
kinky shaped blood and tissue nematode
| present terminal nuclei
Brugia
353
which is more widespread
| Wuchereria vs Brugia
Wuchereria
Brugia- South East Asia
354
mosquito vectors of Wuchereria
Culex, Aedes, Anopheles
355
preference organ affected by wuchereria
scrotal lymphatics
356
preference organ affected by brugia
limb lymphatics
357
mosquito vectors of brugia
mansonia
358
more severe
a. wuchereria
b. brugia
a. wuchereria
359
transmission of Wuchereria and brugia
mosquito bite
360
infective stage of Wuchereria and brugia
3rd stage larvae
361
diagnostic stage of Wuchereria and brugia
microfilariae
362
diagnosis of Wuchereria and brugia
thick blood smear- curved or kinky microfilariae
363
Specimen collected for wuchereria and brugia best done between
8 pm and 4 am (nocturnal periodicity)
364
test used in diagnosis of lymphatic filariasis in cases it is not possible to obtain night blood specimens
DEC provocation test
365
how to do DEC provocation test
50-100 mg DEC given to a patient
blood sample is taken 30-45 minutes after
to find presence of microfilariae
DEC -flushes out microfilariae into peripheral circulation
366
Which form of Wuchereria and brugia cause inflammation that causes lymphedema
adult worms
| microfilariae do not cause symptoms
367
acute disease of wuchereria and brugia presents with
acute adenolymphangitis
filarial fever
tropical pulmonary edema - small epihtelioid granulomas (Meyes-Kouvenaar bodies)
expariate syndrome
368
small epithelioid granulomas
Meyers- Kouvenaar bodies
369
Meyers- Kouvenaar bodies is seen in
acute infection of wuchereria and brugia
370
chronic disease of wuchereria and brugia presents with
hydrocele
elphantiasis
milky urine (chyluria)
371
a new filarialsyndrome has been descibed as clinical and immunologic hyper-responsiveness found in expatriate visitors to regions endemic for loiasis
expatriate syndrome
372
Bancroftian filariasis is found in this regions
Sorsogon, Samar, Leyte, Palawan, Camarines, Albay, Mindoro, Marinduque, Romblon, all of Mindanao
373
Malayan Filariasis is found in
Eastern Samar, Agusan del sur, Palawan, Sulu
374
Treatment for filariasis
Diethylcarbamazine
375
trichinella spiralis
a. tissue nematode
b. blood nematode
c. both
a. tissue nematode
376
intermediate host of trichinella spiralis is
pigs
377
transmission of trichinella spiralis is
undercooked pork
378
infective stage of trichinella spiralis is
encysted larvae
379
diagnostic stage of trichinella spiralis is
encysted larvae
380
diagnosis of trichinella spiralis
muscle biopsy - larvae w/in striated muscle
elevated CPKs (creatinine phosphokinase)
xenodiagnosis
381
pathogenesis of trichinella spiralis
intestinal stage - liberated from pork by gastric juices
muscle stage- disseminated hematogenously into striated skeletal muscle ; encysted within a host-derived cell (nurse cell)
382
tx for trichinella spiralis
thiabendazole
383
mild disease of trichinella spiralis
| will present with
```
fever
muscle pain
periorbital edema
eosinophilia
hemorrhagic phenomena (subconjunctival, splinter)
```
384
severe disease of trichinella spiralis
myocarditis, encepalitis, pneumonia, respiratory myositis
385
Treatment for Trichinella spiralis
thiabendazole
386
Onchocerca volvulus is transmitted by
female blackfly (Simulium)
387
clinical findings of Onchocerca volvulus
dermal nodules
hanging groin
lizard skin
river blindness
388
A 30 year old FIlipino male working in Sudan is being treated for Onchocerca volvulus infection. He then develops fever, headache, dizziness, rashes, pruritus, pain in joints, muscles and lymph glands
The physician suspects that he had Mazzotti reaction. Which is due to the following
Inflammatory reaction to lysis of the worms
389
How is paragonimiasis transmitted
ingestion of raw crab meat
390
transmissio of S. japonicum
penetrate skin
391
S. japonicum transmission
penetrate skin
392
P. westermani
| transmission
ingested with raw crab
393
transmission
| C. sinensis
ingested with raw fish
394
site affected by S. japonicum
liver
395
sites affected by P. westermani
lung
396
sites affected by C. sinensis
liver
397
intermediate hosts of S. japonicum
Snail
398
intermediate hosts of P. westermani
snail and crab
399
intermediate hosts of C. sinensis
snail and fish
400
treatment of S. japonicum
praziquantel
401
Treatment of P. westermani
Praziquantel
402
Treatment of C. sinensis
praziquantel
403
A 50 year old seaport carrier complains of cough for more than 1 month, with hemoptysis. TB work up was negative. Further history revealed he is fond of eating pickled crab (burong talangka) when binge-drinking in his town.
A repeat CXR revealed a ring-shadowed opacity and sputum examination was positive for eggs.
Which is the most appropriate treatment
praziquantel
404
Schistosoma japonicum oriental blood fluke reside in these areas
mesenteric and portal veins
405
intermediate host of S. japonicum
snail (Oncomelania hupensis quadrasi)
406
transmission of S. japonicum
cercariae penetrate skin
407
infective stage of S. japonicum
cercariae
408
diagnostic stage of S. japonicum
eggs in feces
409
Diagnosis of S. japonicum
Kato-katz technique
| Circumoval precipitin test - ovoid egg with small hook
410
pathogenesis of S. japonicum
presence of eggs cause granuloma formation
| -> liver granuloma -> presinusoidal obstruction, hepatomegaly, portal hypertension
411
how S. japonicum evade immune system
by coating themselves with host antigens
412
acute disease of S. japonicum presents as
itching and dermatitis (swimmer’s itch)
| Katayama fever - systemic hypersensitivity, resembling serum sickness
413
chronic disease of s. japonicum presents as
chronic liver disease, portal hypertension
| colonic, pulmonary, cerebral
414
lung fluke
| hermaphrodite
paragonimus westermani
415
intermediate hosts of P. westermani
```
snail (Antemelania asperata)
mountain crab (Sundathelphusa philippina)
```
416
infective stage of paragonimus westermani
metacercariae
417
diagnostic stage of unembryonated egg
P. westermani
418
diagnosis of P. westermani
3% NaOH preparation
419
a fluke that develops a fibrous wall that provokes a granulomatous reaction
secondary bacterial infection frequently occurs
P. westermani
420
chronic cough with bloody sputum
chest xray : ring-shadowed opacity
closely resemble TB
Paragonimiasis
421
Asian liver flukes
Clonorchis sinensis
| Opistorchis viverrini
422
intermediate hosts of clonorchis sinensis
snail (Parafossarulus)
| Fish (Cyprinidae)
423
Clonorchis sinensis
| transmission
undercooked/ raw fish
424
infected stage of clonorchis sinensis
metacercariae
425
diagnostic stage of C. sinensis
embryonated egg
426
Diagnosis of Clonorchis sinensis
direct fecal smear
| Potassium permanganate stain - ovoid with melon-like ridges and abopercular protuberance
427
inflammatory response to this fluke can caus hyperplasia and fibrosis of biliary tract
C. sinensi
428
Acute disease of C. sinensis presents with
fever
eosinophilia
LAD
tender hepatomegaly
429
Chronic disease of C. sinensis
hepatobiliary disease
pancreatitis
cholangiocarcinoma
neurocirculatory dystonia
430
tx, c. sinensis
praziquantel
431
enumerate cestodes
T. solium
T. saginata
D. latum
E. granulosus
432
tranmission of T. solium
eggs/ larvae in undercooked pork
433
tranmission of T. saginata
larvae in undercooked beef
434
tranmission of D. latum
larvae in undercooked fish
435
tranmission of E. granulosus
eggs in food contaminated with dog feces (sarap naman nito)
436
intermediate host of T. solium
pigs
437
intermediate host of T. saginata
cattle
438
intermediate host of D. latum
fish
439
intermediate host of E. granulosus
sheep
440
site affected by T. solium
intestine
441
site affected by T. saginata
intestine
442
site affected by D. latum
intestine
443
site affected by E. granulosus
Liver
444
tx for T. solium
praziquantel
445
tx for T. saginata
praziquantel
446
tx for D. latum
praziquantel
447
tx for E. granulosus
albendazole
448
Taenia spp differentiated based on
```
scolex
gravid proglottids (GP)
```
449
a knob-like protrusion at the extreme anterior end of the tapeworm, an extension of the tegument
rostellum
450
has 4 suckes, rostellum, and 5-10 primary UB in GP
T. solium
451
has 4 suckes, no rostellum, and 15-25 primary UB in GP
T. saginata
452
transmission of Taenia spp.
undercooked pork/ meat
453
infective stage of taenia
cysticerci (both)
| eggs (T. solium)
454
diagnostic stage of Taenia spp.
gravid proglottids
455
signs and symptoms of taenia saginata
abdominal pain
weight loss
pruritus ani
intestinal obstruction
456
taenia solium signs and symptoms
mild intestinal symptoms
small infective eggs cross the BBB -> seizures (neurocysticercosis)
worms in vitreous humour
457
small infective eggs of Taenia solium cross the BBB causing seizures
neurocysticercosis
458
Living cysticerci will not cause inflammation
| T/F
T
459
cestodes with operculated eggs
| 2 elongated sucking grooves for attachment
diphyllobothrium latum
460
intermediate hosts of diphyllobothrium latum
fish
| copepods
461
transmission of diphyllobothrium latum
undercooked fish
462
diphyllobothrium latum
| infective stage
plerocercoid larvae
463
diagnostic stage of diphyllobothrium latum
unembryonated egg
464
D. latum
| spectrum of disease
abdominal pain
diarrhea
megaloblastic anemia - Vit B 12 deficiency
465
Composed of a scolex and 3 proglottids
Echinococcus granulosus
466
one of the smalles tapeworms
Echinococcus granulosus
467
intermediate hosts of Echinococcus granulosus
sheep / man
468
definitive host of Echinococcus granulosus
dog
469
pathogenesis of E. granulosus
cysts act as space occupying lesions
| if cyst ruptures -> life-threatening anaphylaxis can occur
470
spectrum of E. granulosus
hydatid cysts in liver
pulmonary cysts
cerebral cysts
471
tx of E. granulosus
surgical resection
albendazole
PAIR procedure - puncture, aspiration, injection, respiration
472
A 23 year old homeless man with a history of IVDA is brought to the ER because of a sudden onset of high -grade fever, dyspnea and malaise
One hour later, he develops progressive respiratory distress and supplemental oxygen is provided
His CD4 count is 178/ microL
Examination of BAL showed predominant organism when staiend with methenamine
Which is the most likely etiology
Pneumocystis
473
hat shaped cysts
pneumocystitis
474
2 basic forms of fungi
yeast
| molds
475
single fungal cells, budding
yeast
476
hyphae, and mycelia, mitosis
molds
477
transverse walls fungi
septate hyphae
478
multinucleated hyphae
nonseptate hyphae
479
thermally dimorphic fungi are
molds on artificial culture medium at room temp
yeast in infected tissue
480
2 types of host response vs fungi
granulomatous or
| pyogenic response
481
reduced cell mediated immunity vs fungi may cause
disseminate disease
482
liver necrosis due to these 2 toxins produced by amanita mushrooms
amanitin
| phylloidin
483
aspergillus toxin
aflatoxin
484
amanitin and phylloidin cause
liver necrosis
485
aflatoxin cause
liver cancer
486
aflatoxin B1 cause this muratio
G:C-> T:A in codon 249 of p53
487
inhalation of spores causes allergic bronchopulmonary aspergillosis (IgE-mediated)
(IgE mediated)
Aspergillus fumigatus
488
lab technique to dissolve human cells allowing visualization of fungi
microscopy of KOH preparation
489
this medium has low pH inhibits growth of bacteria
sabouraud agar
490
to detect early infection with fungi
DNA probes
491
yeasts - single or multiple buds
```
blastomycosis
histoplasmosis
paracoccidioidomycosis
penicilliosis
sporotrichosis
```
492
yeasts with capsules
cyrtococcosis
493
Hyphae- septate
Hylohypomycosis (Aspergillus, Fusarium, Geotrichum, Trichosporon)
494
hyphae-septate in skin or nail specimens
dermatophytosis
495
Hyphae - non septate
mucormycosis - species of Rhizopus, Lichtheimia, Cunninghamella
496
Hyphae septate
| brownish cell wallls
Phaohyphomycosis - bipolaris, cladosporium, curvularia,exserohilum
497
yeasts and pseudohyophae
candidiasis
498
yeasts and hyphae in skin scrapings
pityriasis versicolor
499
spherules
coccidiomycoses
500
Sclerotic cells- brownish cell walls
chromoblastomycosis
501
sulfur granules
mycetoma
502
conidia in pulmonary artery
hyalohyphomycosis - species of aspergillus and Fusarium
503
Cysts (asci) in pulmonary segments
Pneumocystitis
504
stain binds to complex carbohydrate cell wall of fungi and lights up a bright blue white color
calcofluor white
505
Which group of antifungal agents pertain to a novel highly selective class of semiynthetic peptides that inhibit important constituents of the fungal cell wall
echinocandins
506
ring worms
dermatophytoses
507
fungal pathogen that can infecty only superficial keratinized structures
dermatophytoses
508
3 important dermatophytes
microsporum canis
trichophyton tonsurans
epidermophyton floccosum
509
is an inflammatory reaction to dermatophyosis at a cutaneous site distant from the primary infection
dermatophytid reactions
510
spectrum of dermatophytoses
```
Tinea pedis
Tinea unguium
Tinea corporis
Tinea cruris - jock itch
Tinea manum
Tinea capitis
Tinea barbae
```
511
dermatophytoses on feet
Tinea pedis
512
dermatophytoses on nails
Tinea unguium
513
dermatophytoses on body
Tinea corporis
514
dermatophytoses on groin and inner thighs
Tinea cruris
515
dermatophytoses on hand
Tinea manum
516
dermatophytoses on scalp
Tinea capitis
517
dermatophytoses on beard
Tinea barbae
518
diagnosis of dermatophytoses
10% KOH - septate hyphae
sabouraud agar - hyphae and conidia
green fluorescence on Wood lamp
519
tx for dermatophytoses
local angtifungal creams
| keep skin dry
520
A 10/M with 2 weeks pruritic scalp with patchy hair loss.
PE: three scaly and circular patches about 3 cm in diameter;
alopecia
black dots in the areas of hair loss
cervical lymphadenopathy
Trichophyton tonsurans
521
disease caused by superficial fungal infection of the skin of scalp, eyebrows, and eyelashes
tinea capitis
