XI - Other Bacteria Flashcards

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1
Q

Zoonoses

A

Brucella abortus, Francisella tularensis, Yersinia pestis, Pasteurella multocida

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2
Q

Small gram (-) rods without a capsule, contaminated dairy, direct contact, undulating fever

A

Brucellosis

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3
Q

Brucellosis: Cow

A

B. abortus

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4
Q

Brucellosis: Dog

A

B. canis

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5
Q

Brucellosis: Goat/Sheep

A

B. melitensis

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6
Q

Brucellosis: Sheep

A

B. ovis

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7
Q

Brucellosis: Treatment

A

Doxycycline + Rifampin

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8
Q

Small gram (-) rods, reservoir - rabbits, deer, rodents, transmission - ticks (Dermacentor), aerosols, contact, ingestion

A

Francisella tularensis (Tularemia)

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9
Q

Francisella tularensis: Treatment

A

Streptomycin, Gentamicin

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10
Q

Most virulent bacteria

A

Yersinia pestis

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11
Q

Small gram (-) rods with bipolar (safety pin) staining, reservoir - rodents, transmission - flea bite, inhalation

A

Yersinia pestis

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12
Q

Buboes, cutaneous hemorrhage

A

Yersinia pestis

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13
Q

Bubonic, Pneumonic and Septicemic Plague

A

Yersinia pestis

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14
Q

Yersinia pestis: Treatment

A

Streptomycin, Tetracycline

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15
Q

Short encapsulated gram (-) rod that exhibits bipolar staining, buttery colonies with musty odor due to indole production, osteomyelitis, reservoir - cats and dogs, transmission - animal bites

A

Pasteurella multocida

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16
Q

Pasteurella multocida: Treatment

A

Penicillin G

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17
Q

Aerobic, acid-fast rods, Ziehl-Neelsen (hot), Kinyoun (cold), high lipid content, mycolic acids, wax D, produces catalase and niacin, slow-growing on Löwenstein–Jensen medium (1 mo.), luciferase assay for drug resistance

A

Mycobacterium tuberculosis

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18
Q

Mycobacterium tuberculosis: Location

A

lungs

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19
Q

Mycobacterium tuberculosis: Transmission

A

respiratory droplets from coughing

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20
Q

TB Virulence Factors: Prevents phagosome-lysosomal fusion

A

Exported Repetitive Protein (Sulfatides)

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21
Q

TB Virulence Factors: Most important VF, prevents leukocyte migration

A

Cord Factor

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22
Q

TB Virulence Factors: Elicits delayed hypersensitivity

A

Tuberculin Surface Protein (Purified Protein Derivative - PPD)

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23
Q

Mycobacterium tuberculosis: Lesions

A

exudative, granulomatous

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24
Q

Central area of Langhan’s giant cells surrounded by a zone of epithelioid cells, tubercle is a granuloma surrounded by fibrous tissue that has undergone central caseation

A

Mycobacterium tuberculosis Granulomatous Lesions

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25
Q

TB Phase of Infection: Middle-lower lobes, subpleural granuloma, CLAD, radiologically detectable calcification

A

Primary Complex

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26
Q

TB: Subpleural Granuloma

A

Ghon’s Focus

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27
Q

TB: Subpleural Granuloma + Associated LN

A

Ghon’s Complex

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28
Q

TB: Radiologically Detectable Calcification

A

Ranke’s Complex

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29
Q

TB Phase of Infection: Apices (Simon’s Focus), cicatricial changes, subpleural blebs, cavitation, fibrosis, nodules, secondary colonization with A. fumigatus (fungus ball), pneumothorax

A

Reactivation TB

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30
Q

Reactivation TB: X-ray Findings

A

apices (Simon’s Focus), cicatricial changes, subpleural blebs, cavitation, fibrosis, nodules

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31
Q

PPD: HIV (+), AIDS, old TB, immunosuppressed

A

> 5 mm

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32
Q

PPD: High-risk Population

A

> 10 mm

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33
Q

PPD: Low-risk Population

A

> 15 mm

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34
Q

TB: Spectrum of Disease

A

pulmonary TB, miliary TB, scrofula (CLAD), erythema nodosum, TB meningitis, spondylitis (Pott’s), GI TB (ileocecal), renal TB, abdominopelvic TB

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35
Q

Cough ≥ 2 weeks ± local/constitutional symptoms

A

PTB Suspect

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36
Q

PTB: Local Symptoms

A

hemoptysis, chest pain, dyspnea

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37
Q

PTB: Constitutional Symptoms

A

night sweats, weight loss, anorexia, fever, chills, fatigue, malaise

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38
Q

Specimen: PTB

A

sputum AFB x 3

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39
Q

Specimen: TB Lymphadenitis

A

excisional biopsy

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40
Q

Specimen: TB Effusion

A

pleural fluid studies

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41
Q

Specimen: Genitourinary TB

A

urine AFB (PCR)

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42
Q

Specimen: Spinal TB (Pott’s)

A

tissue biopsy

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43
Q

Specimen: Abdominal TB

A

barium studies (intestinal), CT (extraintestinal), peritoneal fluid studies (AFB, Q/Q)

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44
Q

Specimen: TB Meningitis

A

CSF studies (AFB, Q/Q)

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45
Q

Specimen: TB Pericarditis

A

pericardial fluid studies (AFB, Q/Q)

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46
Q

PTB Treatment: New smear (+), new smear (-) with extensive disease, new severe extrapulmonary TB

A

Category I - Initiation: 2 HRZE, Continuation: 4 HR

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47
Q

PTB Treatment: Sputum smear (+), relapse, treatment failure, defaulter

A

Category II - Initiation: 2 HRZES + 1 HRZE, Continuation: 5 HRE

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48
Q

PTB Treatment: New smear (-) other than Cat. I, new less severe extrapulmonary TB

A

Category III - Initiation: 2 HRZE, Continuation: 4 HR

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49
Q

Mycobacterium tuberculosis: Prevention

A

droplet precautions, BCG vaccine limits extent of disease

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50
Q

Uses of BCG (Bacillus Calmette-Guerin) Vaccine

A

TB prevention, urinary bladder CA treatment (intravesicular infusion)

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51
Q

Cause pulmonary disease in immunocompromised hosts (CD4 < 50)

A

Mycobacterium Avium-Intracellulare Complex (MAI/MAC)

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52
Q

Mycobacterium Avium-Intracellulare: Treatment

A

Azithromycin

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53
Q

Aerobic acid-fast rods, can’t becultured in vitro (mouse footpad, armadillo)

A

Mycobacterium leprae (Hansen’s coccus spirilly)

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54
Q

Mycobacterium leprae: Location

A

humans, armadillos

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55
Q

Mycobacterium leprae: Transmission

A

prolonged exposure to nasal secretion of patients with the lepromatous form

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56
Q

Leprosy: One or few lesions

A

Tuberculoid

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57
Q

Leprosy: Little tissue destruction

A

Tuberculoid

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58
Q

Leprosy: Few acid-fast bacilli

A

Tuberculoid

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59
Q

Leprosy: Low transmission rate

A

Tuberculoid

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60
Q

Leprosy: Cell-mediated response to M. leprae

A

Tuberculoid

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61
Q

Leprosy: Lepromin skin test (+)

A

Tuberculoid

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62
Q

Leprosy: Many lesions

A

Lepromatous

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63
Q

Leprosy: Marked tissue destruction

A

Lepromatous

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64
Q

Leprosy: Many acid-fast bacilli

A

Lepromatous

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65
Q

Leprosy: High transmission rate

A

Lepromatous

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66
Q

Leprosy: Reduced/Absent cell-mediated response to M. leprae

A

Lepromatous

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67
Q

Leprosy: Lepromin skin test (-)

A

Lepromatous

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68
Q

Hypopigmented plaques, thickened superficial nerves, significant anesthesia

A

Tuberculoid

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69
Q

Leonine facies, erythema nodosum leprosum

A

Lepromatous

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70
Q

Tender red nodules, humps on both shins, signals acute lepromatous leprosy flare-ups

A

Erythema Nodosum Leprosum

71
Q

Leprosy: Treatment for Tuberculoid Form

A

Dapsone, Rifampin

72
Q

Leprosy: Treatment for Lepromatous Form

A

Dapsone, Rifampin, Clofazimine

73
Q

Leprosy: Treatment for Erythema Nodosum Leprosum

A

Thalidomide → Phocomelia

74
Q

Anaerobe, normal oral flora, local trauma (broken jaw, dental extraction), hard, non-tender swelling, sinus tracts draining sulfur granules

A

Actinomyces israelii

75
Q

Actinomyces israelii: Treatment

A

Penicillin G, drainage

76
Q

Actinomycete, aerobic, filamentous gram (+) rods with aerial hyphae, weakly acid-fast (Fite-Faraco stain), inhalation of particles from soil, mycetomas, lung and brain abscesses (orange colonies)

A

Nocardia asteroides

77
Q

Nocardia asteroides: Treatment

A

TMP-SMX, drainage

78
Q

Smallest free-living organisms

A

Mycoplasma pneumoniae

79
Q

No cell wall, only bacteria with cholesterol in cell membrane, Eaton’s medium

A

Mycoplasma pneumoniae

80
Q

Mycoplasma pneumoniae: Location

A

respiratory tract

81
Q

Mycoplasma pneumoniae: Transmission

A

respiratory droplets

82
Q

M. pneumoniae Virulence Factors: Attachment, inhibition of ciliary motion, necrosis

A

Toll-Like Receptor 2 Protein (P1 Adhesin)

83
Q

M. pneumoniae Virulence Factors: Contributes to the damage to the respiratory tract cells

A

Hydrogen Peroxide

84
Q

M. pneumoniae Virulence Factors: Autoantibodies against red cells and brain, lung and liver cells

A

Cold Agglutinins

85
Q

Most common type of atypical pneumonia

A

Mycoplasma pneumoniae

86
Q

“Walking Pneumonia” (clinical findings not compatible with x-ray), hemolysis, Stevens-Johnsons Syndrome, Raynaud’s, Guillain-Barré Syndrome

A

Mycoplasma pneumoniae

87
Q

Most common infectious cause of Stevens-Johnsons Syndrome

A

Mycoplasma pneumoniae

88
Q

Mycoplasma pneumoniae: Treatment

A

Macrolides (Erythromycin, Azithromycin)

89
Q

Mycoplasma pneumoniae: Resistance

A

Penicillins and Cephalosporins - does not have a cell wall

90
Q

Coiled spirochete, too thin for Gram-stain, cannot be cultured in vitro due to absence of TCA cycle, microaerophilic

A

Treponema pallidum

91
Q

Treponema pallidum: Location

A

genital tract

92
Q

Treponema pallidum: Transmission

A

sexual contact, transplacental

93
Q

Syphilis: Within hours, enters lymphatics and multiplies, local non-tender ulcer (chancre) in 2-10 weeks

A

Primary Syphilis

94
Q

Syphilis: Condyloma lata, maculopapular rash (palms, soles), fever, headache, malaise, anorexia, lymphadenopathy, after 1-3 months from inoculation

A

Secondary Syphilis

95
Q

Syphilis: Many years after inoculation, granulomas (gummas), neurosyphilis (tabes dorsalis, dementia paralytica), aortitis

A

Tertiary Syphilis

96
Q

Tabes dorsalis presents with _____ which _____ but does not react.

A

Argyll Robertson pupil, accomodates

97
Q

Obliterative invasion of small blood vessels and vasa vasorum by Treponema pallidum causing endarteritis

A

Syphilitic Aortitis

98
Q

Syphilis: Snuffles, saddle nose, mulberry molars, Hutchinson triad, saber shins, rhagades (angle of mouth), Higoumenakis sign, Clutton’s joints (synovitis), pulmonary hemorrhage

A

Congenital Syphilis

99
Q

Syphilis: Hutchinson teeth, deafness, keratitis

A

Hutchinson Triad

100
Q

Syphilis: Unilateral enlargement of the sternoclavicular portion of the clavicle → detachment

A

Higoumenakis sign

101
Q

Most important diagnostic test for Primary Syphilis

A

dark-field microscopy

102
Q

Secondary/Tertiary Syphilis: Diagnostic Tests

A

Screening - Rapid Plasma Reagin/Venereal Disease Research Laboratory (RPR/VDRL), Confirmatory - Fluorescent Treponemal Antibody-Absorption (FTA-ABS)

103
Q

Causes for False (+) VDRL Results

A

Viruses (EBV, Hepatitis), Drugs (Marijuana), Rheumatic fever, Rheumatic arthritis, Lupus, Leprosy

104
Q

Syphilis Diagnostic Test: Most specific, earliest positive, remains positive longest

A

Fluorescent Treponemal Antibody-Absorption (FTA-ABS)

105
Q

Syphilis: Treatment

A

Benzathine Penicillin G

106
Q

Influenza-like symptoms a few hours after receiving penicillin due to lysis of treponemes

A

Jarisch-Herxheimer Reaction

107
Q

Syphilis: Prevention

A

condoms, post-exposure antibiotics, serologic follow-up

108
Q

Weakly staining gram (-) spirochetes, largest medically important bacteria, aniline dye (Giemsa or Wright), BSK medium

A

Borrelia burgdorferi

109
Q

Borrelia burgdorferi: Location

A

white-footed mouse, white-tailed deer

110
Q

Borrelia burgdorferi: Transmission

A

bite from deer ticks (Ixodes scapularis)

111
Q

Borrelia burgdorferi: Disease

A

Lyme Disease

112
Q

Lyme Disease Stages: Erythema Chronicum Migrans (target lesion)

A

Stage 1

113
Q

Lyme Disease Stages: Myocarditis (AV block), meningitis, Bell’s palsy

A

Stage 2

114
Q

Lyme Disease Stages: Autoimmune migratory polyarthritis (onion skin lesions), acrodermatitis chronica atrophicans (skin atrophy - hands)

A

Stage 3

115
Q

Borrelia burgdorferi: Treatment for Early Localized or Disseminated Disease

A

Doxycycline, Amoxicillin, Cefuroxime

116
Q

Borrelia burgdorferi: Treatment for Late Disease

A

IV Penicillin, IV Ceftriaxone

117
Q

Borrelia burgdorferi: Prevention

A

insecticides, insect repellants on clothing, protective clothing that reduces exposure of skin to insects

118
Q

Relapsing fever from rapid antigenic changes due to programmed rearrangements of surface protein DNA

A

Borrelia recurrentis

119
Q

Borrelia recurrentis: Transmission

A

human body louse (Pediculus humanus)

120
Q

Borrelia recurrentis: Diagnostic Test

A

microscopy

121
Q

Borrelia recurrentis: Treatment

A

Tetracycline, Erythromycin

122
Q

Thin, coiled spirochetes, hook at one or both ends (Shepherd’s crook), obligate aerobe (only aerobic spirochete), Ellinghausen-McCullough-Johnson-Harris (EMJH) or Fletcher’s medium

A

Leptospira interrogans

123
Q

Leptospira interrogans: Location

A

wild and domestic animals

124
Q

Leptospira interrogans: Transmission

A

animal urine (dogs, livestock, rats), wading in floodwaters

125
Q

Leptospires penetrate intact mucous membranes or skin through small cuts or abrasions, multiply rapidly and damage endothelium of small blood vessels, early - blood & CSF, late - urine, immune complex-mediated meningitis and glomerulonehritis

A

Leptospira interrogans

126
Q

Leptospira interrogans: Diagnostic Tests

A

EMJH/Fletcher’s medium (+) after 2 weeks, Leptospire Microscopic Agglutination Test (Lepto-MAT) - gold standard

127
Q

Leptospira interrogans: Incubation Period

A

2-20 days

128
Q

Leptospirosis Phases: Fever, chills, intense headache, calf tenderness, conjunctival suffusion

A

Acute Leptospirosis

129
Q

Leptospirosis: Cause of Calf Tenderness

A

rapid multiplication of leptospires in muscles with high oxygen

130
Q

Leptospirosis: Cause of Conjunctival Suffusion

A

damaged and leaky conjunctival vessels, painful and itchy but with minimal tearing

131
Q

Leptospirosis Phases: Aseptic meningitis, pulmonary involvement, hepatic necrosis, glomerulonephritis

A

Immune Leptospirosis

132
Q

CSF pleocytosis ± meningeal symptoms, coincides with appearance of leptospire antibody titers

A

Aseptic Meningitis (Leptospira interrogans)

133
Q

Snow-flake lesion on CXR

A

Leptospira interrogans

134
Q

Leptospirosis: Cause of Glomerulonephritis

A

immune-complex deposition

135
Q

Most severe form of leptospirosis

A

Weil Syndrome

136
Q

Leptospirosis Phases: Jaundice, bleeding, uremia, orange cast skin (severe jaundice)

A

Weil Syndrome

137
Q

Weil Syndrome: Triad

A

bleeding, uremia, orange cast skin (severe jaundice)

138
Q

Weil Syndrome: Most common cause of death

A

respiratory failure from massive pulmonary hemorrhage

139
Q

Leptospirosis: Treatment

A

Penicillin G

140
Q

Leptospirosis: Prevention

A

Doxycycline chemoprophylaxis, vaccination of domestic livestock and pets, rat control

141
Q

Obligate intracellular bacteria, energy parasites that use host ATP, cell wall lacks muramic acid, grows in cyclohexamide culture, cytoplasmic inclusion bodies (Giemsa)

A

Chlamydia trachomatis

142
Q

Chlamydia trachomatis Forms: Inactive, extracellular, enters cells by endocytosis, infectious

A

Elementary Body

143
Q

Chlamydia trachomatis Forms: Metabolically active, intracellular, seen microscropically, replicates via binary fission

A

Reticulate Body

144
Q

Chlamydia trachomatis: Location

A

genital tract, eyes

145
Q

Chlamydia trachomatis: Transmission

A

Sexual contact, passage through birth canal, hand-eye contact

146
Q

Most common STD overall

A

Chlamydia trachomatis

147
Q

Balance reached between host and parasite resulting in prolonged persistence of infection despite high antibody titers

A

Chlamydia trachomatis

148
Q

C. trachomatis types A-C, chronic keratoconjunctivitis leading to scarring and blindness, Halberstädter-Prowazek inclusion bodies

A

Trachoma

149
Q

Most common infectious cause of blindness

A

Chlamydia trachomatis

150
Q

Round to oval cytoplasmic inclusion bodies near the nuclei of conjunctival epithelial cells in trachoma

A

Halberstädter-Prowazek inclusion bodies

151
Q

C. trachomatis types D-K, NGU (Non-gonococcal Urethritis) in males, PID in females, co-infection with gonorrhea, neonatal conjunctivitis and pneumonia, Reiter’s Syndrome

A

Chlamydia GUT Infection

152
Q

C. trachomatis types D-K, late-onset (2-4 weeks), striking tachypnea, paroxysmal cough (staccato cough), absence of fever, eiosinophilia

A

Chlamydia Neonatal Pneumonia

153
Q

C. trachomatis types L1-L3, papule or vesicular which ulcerates and leads to suppurative inguinal lymphadenitis (buboes), (+) Frei test (intradermal injection of antigen)

A

Lymphogranuloma Venereum

154
Q

Atypical pneumonia similar to Mycoplasma pneumoniae, associated with atherosclerosis

A

Chlamydia pneumoniae

155
Q

Bird exposure (bird fancier’s disease - parrots, parakeets, macaws, cockatiels), sudden onset pneumonia, malaise fever, anorexia, sore throat, photophobia, severe headache

A

Chlamydia psittaci

156
Q

Chlamydia: Treatment for STD

A

Azithromycin

157
Q

Chlamydia: Treatment for Conjunctivitis

A

Erythromycin

158
Q

Chlamydia: Treatment for Lymphogranuloma Venereum

A

Doxycycline

159
Q

Chlamydia: Treatment for Psittacosis

A

Azithromycin

160
Q

Cell wall resembles that of gram (-) rods, stain poorly with Gram-stain, obligate intracellular parasites (unable to produce sufficient energy to replicate extrecellularly), grown in cell culture, embryonated eggs, experimental animals, divide by binary fission within host cell

A

Rickettsiae

161
Q

Detected using Weil Felix reaction (cross-reaction with antigens of OX strains of Proteus vulgaris)

A

Rickettsiae

162
Q

Rickettsiae: Treatment

A

Doxycycline

163
Q

Rocky Mountain Spotted Fever: Rash starts in _____ and spreads _____

A

wrist, centripetally

164
Q

Rickettsia Typhus: Rash starts in _____ and spreads _____

A

trunk, centrifugally

165
Q

Rickettsia: Q fever is Queer because

A

no rash, no vector, (-) Weil-Felix reaction, not obligate intracellular, does not have Rickettsia in genus name (Coxiella burnetti)

166
Q

Diseases with Palm and Sole Rash

A

Coxsackievirus Type A (hand, foot & mouth disease), Rocky Mountain Spotted Fever, Syphilis

167
Q

Cat-scratch disease, gram (-) rod, normal oral flora of cats, cat bite/scratch, cat-scratch fever (immunocompetent), bacillary angiomatosis (immunocompromised)

A

Bartonella henselae

168
Q

Dogs, morulae in cytoplasm of monocytes, dog tick (Dermacentor) bite

A

Ehrlichia chaffeensis

169
Q

Facultative gram-variable rod, clue cells (squamous cells attahced to bacteria, (+) whiff test (fishy odor with KOH), malodorous vaginal discharge (white, milk-splattered)

A

Gardnerella vaginallis

170
Q

Small gram (-) rod, culture on chocolate agar with heme (factor X), painful genital ulcer (chancroid)

A

Haemophilus ducreyi

171
Q

Mesenteric adenitis (pseudoappendicitis), gram (-) rods, domestic animals, oro-fecal transmission

A

Yersinia enterolitica

172
Q

Granuloma inguinale (Donovanosis), encapsulated, pleomorphic, gram (-) bacillus, bipolar densities (Donovan bodies) that look like closed safety pins, small painless papule ulcerates to form beefy red ulcer with velvety surface, pseudobuboe formation

A

Klebsiella granulomatis

173
Q

Klebsiella granulomatis: Treatment

A

Azithromycin