Tricky SOB's II

Question 1

The Fitz-Hugh-Curtis syndrome is characterized and most often caused by what?

Answer 1

Characterized by right upper quadrant pain also referred to as perihepatitis. Most of these are due to chlamydial infection.

Question 2

Esterase nitrate is a screening tool for what?

Answer 2

Screens for pyuria in urine which means a lack of less than 10 wbc per cubic millilimeter of urine. 90% of UTIs are identified as polyuria.

Question 3

What is the number one causitive agent of urinary tract infections?

Answer 3

Escherichia coli followed closely by staphylcoccus saprophyticus.

Question 4

Enterobacteriaceae are known to ferment … reduce …

Answer 4

Ferment glucose with a reduction in nitrate.

Question 5

Are enterobactericae oxidase negative or positive?

Catalase?

Answer 5

Oxidase negative

Catalase positive.

Question 6

Enterobactericeae K and H antigens are responsible for what?

Answer 6

These are virulence factors and are consistently alterated to protect themselves from host antibodies.

Question 7

E. coli contain a virulence factor known as hemolysin (HlyA). This factor does what?

Answer 7

This factor lyses eryhrocytes and other cell types leading to induction of an inflammatory respons.

Also have adhesins (p pili) and endotoxin.

Question 8

Type 1 pilli expressed by E. coli perform what function?

where do p. pilli bind?

Answer 8

Bind to mannose residues.
Think Type 1 = mannose
The number one MANnose.

P. pilli specifically bind to sugar residues found on uroepithelial cells.

Question 9

Which microbe is most commonly found to be the cause of cystitis in sexually active young women?

Answer 9

Staphylococci saprophyticus.

Question 10

Proteus s most noticibly know to produce what specific odor and uses what unqiue enzyme?

Answer 10

Produces ureas and an unusual fishy odor.

Question 11

What is Proteus treated with

Answer 11

TMP-SMX works excellently against proteus.

Question 12

In patients with very long periods of time with indwelling catheders and being treated with multiple treatments of antibiotics you would suspect what bacterium?

Answer 12

Pseudomonas aeruginosa.

Question 13

Which types of bacteria are considered type D strep?]

What distinguishes it from other Strep?

Answer 13

Enterococcus species.
Gram + with a group D carbohydrate
Extremely tolerant to high salt and bile content without being sensitive to optochin.

Question 14

If a patient has had prolonged hospitalization and has been treated with a broad selection of antibacterials what would you suspect them to be infected with?

Answer 14

Enterococcus species as these guys are extremely resistant.

Question 15

Breakbone fever is most commonly related to what pathogen?

Answer 15

Dengue fever!

Question 16

Dengue hemorrhagic fever presents in what manner?

Answer 16

After the degue fever subsides the pt then becomes restless or lethargic and the pt begins to show circulatory failure, skin hemorrhages, bleeding gums etx.

Question 17

Toxic phase Yellow fever is distinguished by what?

Answer 17

Toxic phase occurs within 24 hours of acute phase yellow fever and causes the patient to rapidly develop jaundice.

Question 18

Of the viruses spread by mosquitos, which has a vaccine available?

Answer 18

Yellow fever has a vaccine available that provides immunity within the week and provides protection for up to a year.

Question 19

What virus is known to cause “Dengue-Like fever”

Answer 19

Zika virus!

Question 20

what are the complications of Zika virus?

Answer 20

Microcephally, guillain Barre syndrome, sexaual transmission.

Question 21

Hemorrhagic fever with renal syndrome (HFRS) is caused by what viral infection?

Answer 21

Caused by Hantavirus, a virus spread through dead mice/ excrement from rodents mostly in asia and parts of europe.

Question 22

Hantavirus pulmonary syndrome is caused by what virus?

Answer 22

Hantavirus - Sin Nombre.

Question 23

An illness characterized as febrile illness that develops into an acute pulmonary edema stimulating acute respiratory distress syndrome (ARDS) refers to what virus?

Answer 23

Hantavirus!

Question 24

What vrus infects and replicates within erythroid precursor cells?

Answer 24

Colorado Tick fever virus which can be found within red blood cells or in the progenitor cells resuting in leukopenia and thrombocytopnia.
Leukopeia is considered the hallmark of this disease!

Question 25

What is the treatment for Bacillus anthracis?

Answer 25

Amoxicillin for topical

Doxycycline and fluoroquinone for inhilation/ digestion with 2 additional antibiotics.

Question 26

What is the hallmark feature of brucella infections?

Answer 26

An alternating fever that begins at night and goes down in the morning specifically around cows pigs or sheep.

Question 27

What is Brucella treated with?

Answer 27

6 week course of tetracycline (doxycycline) and rifampin.

Question 28

Cellulitis and lymphadenopathy within 12-24 hours of a dog or cat bite is indicitive of what sort of infection?

Answer 28

Pasteurella mutocida.

Question 29

A person swimming in the tropics who ends up with influenzae like sickness slowly leading into jaundice, meningitis, or renal failure most likely contracted what?

Answer 29

Leptospirosis interrogans.

Question 30

What can leotispira interrogans be treated with

Answer 30

Penicillin.

Question 31

What is the well known vector for Francisella?

Answer 31

Hard shelled ticks found within rabbits!

Typically seen in the summer during tick season or winter during small game season.

Question 32

Pt comes in after being bit with tick, says within 48 hours had red painful papule at bite. Pt also has regional lymphnnode swelling full of pus that ulcerate. What is the Dx and the Perscription?

Answer 32

Francisella tularensis

Treatment: Gentamicin

Question 33

Histological geimsa stains reveal a rod with bipolar staining appearing safety pin like. What is the Dx?

Answer 33

Yersinia pestis.

Question 34

The three plasmids Yersinia carries code for what specifcially?

Answer 34

Biofilm to resist phagocytosis
Enhanced resistance to macrophage killing
Resistance to complement mediated lyses.

Question 35

What is the treatment for bubonic plague?

Answer 35

Streptomycin or gentamicin / fluoroquinones.