1: Step 1 Micro

Front 1

techoic acid? what does it induce?

Back 1

part of cell wall in gram (+) org.
induces IL-1 and TNFalpha

Front 2

what IL makes acute phase ptoteins, and what cells secrete it?

Back 2

IL-1, secreted by macrophages, also causes growth/differentiation

Front 3

what function does capsule play in bacteria? what bacteria have capsules?

Back 3

protects against phagocytosis. Encapsulated:
Sarah Pleads, HI No More Killing People Enterococcus

Strep pneumo
H Influenzae
Neisseria Meningitidis
Klebsiella pneumonia
enterococcus

Front 4

what are capsules made of?

Back 4

polysaccharide, except bacillus anthracics which contains D-gluatmate

Front 5

in bacteria, where are oxidative and transport enzymes located?

Back 5

in plasma membrane

Front 6

who has periplasm, and what's in it?

Back 6

gram (-), it is between two cell membranes.
it has hydrolytic enzymes, incldueing B-lactamases

Front 7

what aids adherence of bacteria?

Back 7

pilus, made of glycoprotien

Front 8

what expresses "H" antigen

Back 8

flagellum

Front 9

what is spore made of?

Back 9

keratin like coat of DIPICOLINIC ACID

Front 10

glycocalyx function?

Back 10

aids adherence to surfaces, esp. foreign surfaces (eg. indwelling catheters).
note: glycocalyx is made of POLYSACCHARIDE and pilus is made of GLYCOPROTEIN

Front 11

who has endotoxin, and what does it stimulate?

Back 11

gram (-) have LPS endotoxin and it sitmulates release of IL-1, IL-6, and TNF

Front 12

gram (-) coccus (only one we learned)

Back 12

neisseria

Front 13

what shape/ID is neisseria

Back 13

gram (-) coccus

Front 14

name two gram (+) cocci we learned

Back 14

staph and strep

Front 15

how do you distinguish between staph and strep?

Back 15

staph is catalase + coagulase + and strep is catalase (-)

staph is never sensitivie to penicillin (except staph saprophyticus) and strep is commonly sensitive to penisillin

Front 16

what is difference between alpha and beta hemolytic bacteria?
name two alpha, four beta.

Back 16

alpha: form green ring around colonies on blood agar
1. strep pneumo (catalase negative, optichin sensitive)
2. viridans strep (catalase negative and optichin resistant)

Beta: clear area of hemolysis on blood agar.
1. S aureus: catalase and coag +
2. Strep pyogenes: group A strep (catalase negative, bacitracin senstiive)
3. strep agalactiae group B strep (catalase negative, bacitrasin resistnatn)
4. listeria monocytogenes (meningitis in newborns, unpasteurized milk)

Front 17

.meningitis in newborns, unpasteurized milk

Back 17

listeria monocytogenes

Front 18

catalase (-) bacitracin sensitive
B hemolytic

Back 18

Group A strep (strep pyogenes)

Front 19

B hemolytic
catalase (-) bacitracin resistant

Back 19

group B strep (strep agalactaie)

Front 20

what does catalase do?

Back 20

degrades H2O2 from PMNs
H2O2 is substrate for myeloperoxidase

Front 21

Who makes coagulase?

Back 21

staph aureus makes coagulase, staph epidermidis and staph saprophyticus do not!

Front 22

Who makes Protein A as a virulence factor? how does it work?

Back 22

staph aureus makes Protein A.
it prevents opsonization by binding to Fc-IgG, inhibiting complement and phagocytosis

Front 23

name 3 toxin mediated diseases caused by s. aurus

Back 23

1. Toxic shock syndrome
2. scalded skin syndrome
3. rapid onset food poisoning

Front 24

mayonaise makes you sick. what organism?

Back 24

staph aureus

Front 25

Why is MRSA dangerous

Back 25

it is resistant to B lactams due to altered penicillin binding protein.

Front 26

asplenia puts you at risk for what?

Back 26

infxn by encapsulated bacteria

Front 27

strep pneumo... MOPS (what does that stand for?)

Back 27

M: meningitis'
O: otitis media(in kids)
P: pneumonia
S: sinusitis

also, MOPS =
Most OPtochin Sensitive

Front 28

how do you treat strep pneumo

Back 28

amoxicillin or vancomycin

Front 29

"rusty sputum" and sepsis in sickle cell anemia... what organism?

Back 29

pneumococcus (strep pneumo)

Front 30

Who has IgA protease?

Back 30

strep pneumo

Front 31

what are 3 most common newborn meningitis?

Back 31

1. group B strep
2. listeria
3. e coli

Front 32

ASO titer reflects recent infxn with what?

Back 32

strep pneumo

Front 33

diabetic gets osteomyelitis... what is mechanism, what organism caused it?

Back 33

diabetics get diabetic foot ulcers that are prone to infection by PSEUDOMONAS aeriginosa

Front 34

hot tub folliculitis organism

Back 34

pseudomonas

Front 35

wound infection in burn patients

Back 35

pseudomonas: can lead to gram (-) sepsis. THe moist invironment of burn surface is good breeding ground for pseudonmoas.

Front 36

pneumonia in CF patients. organism?

Back 36

pseudomonas!

Front 37

pneumonia in pt that had prior therapy on broad spectrum antibiotics. organism?

Back 37

pseudomonas

Front 38

name 6 things caused by pseudomonas

Back 38

P = pneumonia
S = sepsis/skin infections
E = endocarditis
U = urinaty tract infection, corneal ulcers
D = diabetic infections
O = osteomyelitis

Front 39

what organism is associated with guillan barre?

Back 39

Camyplobacter jejuni

Front 40

what causes hemolytic uremic syndrome?

Back 40

Enterohemorrhagic E. Coli
(found in ground beef)
HUS is usually in kids < 10
you will see renal failure, thrombocytopenia, hemolytic anemia, and bloody diarrhea. Very serious.

hemorrhagic colitis, no fever, HUS can be fatal
expresses SHIGA toxin, ingibiting protein synthesis and causing enterocyte death.

Front 41

what organisms produce H2S gas but does not ferment lactose? How do you distinguish them?

Back 41

Shigella; no animal reservoir ;
bloody stools, NONMOTILE:
Shiga toxin (A-B toxin)

Salmonella: MOTILE, also invades M cells of peyers patches (similar to Shigella); ingest contaminated chicken, egg or dairy products.
S,Typhi is able to live in macrophages so it can travel and cause typhoid fever

Front 42

what causes typhoid fever?

Back 42

Salmonella Typhi.
typhoid fever appears 1-3 wks after infection and mimicks appendicitis. It has rash with ROSE SPOTS

Front 43

what viruses cannot complete life cycle without their own polymerase?

Back 43

Reovirus (dsRNA)
all (-) strand RNA viruses
Pox virus (DNA replicates in cytoplasm)
all Retroviruses

Front 44

what type of virus is adenovirus?

Back 44

dsDNA linear

Front 45

what virus can cause
febrile pharyngitis (sore throat)
pneymonia
conjuctivitis (Pink Eye)

Back 45

Adenovirus
dsDNA, no envelope

Front 46

what does HSV-1 cause? HSV-2?

Back 46

HSV -1 = ORAL and some genital lesions, keratoconjuctivitis

HSV - 2 = GENTIAL and some oral lesions

Front 47

varicella zoster virus causes (3 things)

Back 47

shingles
chicken pox
zoster

Front 48

mononucleosis and burkitts?

Back 48

EBV (dsDNA linear)

Front 49

roseola (exanthem subitum)

Back 49

HHV -6

Front 50

karposis sarcoma

Back 50

HHV - 8

Front 51

HBV? what does it cause? what is general viral category?

Back 51

aucte or chronic hepatitis
hepadnavirus (dsDNA)

Front 52

"slapped cheek rash".. caused by what?

Back 52

parvovirus (b19)

Front 53

aplastic crisis in sickle cell disease caused by what virus?

Back 53

parvovirus B19

Front 54

erythema infectiosum (fifth disease) caused by what virus

Back 54

parvovirus b19

Front 55

what does JC virus cause? who does it infect?

Back 55

infects HIV patients
it causes progressive multifocal leukoencephalopathy (PML)

Front 56

what virus causes molluscum contagiosum

Back 56

pox virus - also causes small pox and cow pox

Front 57

what test do you do to ID herpes?

Back 57

tzanck test

Front 58

what is the tzanck test?

Back 58

used to ID herpes... get smear from open lesion and look for multinucleated giant cells; infected cells also have nuclear inclusions Cowdry Type A bodies.

Front 59

name this autoimmune demyelinating disease in which TH1 cells stimulate macrophages to attack myelin. what type of hypersensitivity?

Back 59

multiple sclerosis
type IV hypersensitivity

Front 60

negri bodies? what disease and in what kind of matter are they found?

Back 60

rabies
found in grey matter

Front 61

agent that causes cat scratch disease

Back 61

bartonella hensleae; pustule forms at site followed by local tender regional adenopathy. usually benign and self limiting, but can be treated with ccipro and pregnant people with macrolides (azithromycin)
microscopically: stellate granulomas with central necrosis.pu

Front 62

what orgnism:
found in dust/dirt/soil in arizona
causes pulmonary disease in immunocompromised and eryethema nodosum (in normal pts).

Back 62

coccidiodomycosis

Front 63

found in caves due to bat droppings

Back 63

histpolasmosis capsulatum;
fever, cough, night sweats, may be brief or self limiting;
foudn esp. in ohio river valleys.

Front 64

what organism can you get gardening/

Back 64

sporothrix schenckii; can manifest as single cutaneous lesoion or may follow lymph drainage patterns

Front 65

travel outside US could cause exposure to what cutaneous orgnaism?

Back 65

cutaneous leishmaniasis

Front 66

chinese restaurant, rice, rapid onset of vomiting

Back 66

bacillus cereus

Front 67

truck driver with burns, blue green exudate, hemorrhagic lesions develop. what are these lesions called? what organism and what mechanism is responsible?

Back 67

erythema gangrenosum, caused by
pseudomonas. These lesions caused by ELASTASES (las A and las B) which degrade elastin and inhibit neutrophil migration

pseudomonas capsule will enable adnerence and avoidance of phagocytosis

endotoxin is compnent of all gram (-) bacteria and will cause macrophages to release IL 1, IL 6 and TNF which will cause endotoxin shock

pili are also helpful in adnerence

pyocyanin is blue green pigment and causes IL 8 release (neutrophil chemotaxis) and also catalyzes production of oxygen radicals...

Front 68

what causes PID and stains on Giemsa stain with cytoplasmic inclusions?

Back 68

chlamydia trachomatis... most common
bacterial STD;
does not make ATP so it is obligate intracellular parasite.
uses elementary body to invade cells and reticular body to replicate inside cells.

Front 69

what is ergosterol

Back 69

it is found in membranes of fungi. it is unique to fungi and is the target of nystatin and imidazoles

Front 70

what organisms have sterols in theirm membranes?

Back 70

mycoplasmas

Front 71

what is unique to fungi in their membranes?

Back 71

ergosterol

Front 72

how do you confirm trichinosis?

Back 72

muscle biopsy showing cysts. usually comes from eating raw or undercooked pork

Front 73

most common parasitic infection in the US

Back 73

toxoplasma gondii; once acquired, do not cause symptoms in normal individual ut in those with lowered immmune systems (cancer AIDS will reinitiate prolifereation and cause symptoms (ring ehhancing lesion)

Front 74

non-septate ribbon like hyphae at 90 degrees. who gets this?

Back 74

mucor, seen in diabetics.

Front 75

anthroconidia (environmental form) and sphereules (yeast form) of what orgnism> what does it cause?

Back 75

coccidioidies immitus, causes san juaquine valley fever

Front 76

septate hyphae at 45 degrees describes...

Back 76

aspergillus

Front 77

monomorphic, encapsulated yeast?

Back 77

cryptococcus (pigeons!!!)

Front 78

gram negative rod, oxidase positive, non-fermenter, catalase (+)

Back 78

pseudomonas

Front 79

what is ergosterol

Back 79

it is found in membranes of fungi. it is unique to fungi and is the target of nystatin and imidazoles

Front 80

what organisms have sterols in theirm membranes?

Back 80

mycoplasmas

Front 81

what is unique to fungi in their membranes?

Back 81

ergosterol

Front 82

how do you confirm trichinosis?

Back 82

muscle biopsy showing cysts. usually comes from eating raw or undercooked pork

Front 83

most common parasitic infection in the US

Back 83

toxoplasma gondii; once acquired, do not cause symptoms in normal individual ut in those with lowered immmune systems (cancer AIDS will reinitiate prolifereation and cause symptoms (ring ehhancing lesion)

Front 84

non-septate ribbon like hyphae at 90 degrees. who gets this?

Back 84

mucor, seen in diabetics.

Front 85

anthroconidia (environmental form) and sphereules (yeast form) of what orgnism> what does it cause?

Back 85

coccidioidies immitus, causes san juaquine valley fever

Front 86

septate hyphae at 45 degrees describes...

Back 86

aspergillus

Front 87

monomorphic, encapsulated yeast?

Back 87

cryptococcus (pigeons!!!)

Front 88

gram negative rod, oxidase positive, non-fermenter, catalase (+)

Back 88

pseudomonas

Front 89

hepatosplenomegaly, hyperpigmentation, from india, transmitted by sand fly... what is it?

Back 89

leishmania donovani
macrophages contain amastigotes

hyperpigmentation is called "Kala Azar" which means "black fever"

Tx: antimonials, or amphoteracin B or paromomycin

Front 90

meningitis, orchitis, parotid gland enlargement in 7 yo

Back 90

mumps

Front 91

seizures, severe encephalitis, bullet shaped crystals and negri bodies

Back 91

RABIES... racoon, rat, dog, bat bite

Front 92

fevers, headache, vomiting black stuff, just came from S. AMerica, jaundice and bradycardia
what is it and how transmitted?

Back 92

Yellow fever.

Flavivirus which is type of arbovirus transmitted by Aedes mosquito

Front 93

47 yo japanese male 2 mo history fever, night sweats, weight loss, hemoptysis.
what does he have
what media to culture it?

Back 93

M. Tuberculosis

culture on Lowenstein- Jensen agar

Front 94

6 yo hispanic boy with persistent cervical lymphandenitis. tx with cephalexin had no improvement. You see "red snappers" on your acid fast bacillus stain. WHat is it?

Back 94

mycobacterium SCROFULACEUM

think "red snappers" ... kathy dated a guy who sold lobster tanks and was scruffy...

Front 95

37 yo woman who works at chinese restaurant has rash on R arm. her job is to clean four fish tanks. what does she have?

Back 95

mycobacterium marinum

Front 96

desert bumps

Back 96

coccidiomycosis; causes "valley fever" or San Juaquin valley fever

Front 97

46 yo spelunker returned from trip to ohio river basin. persistent cough for 3 weeks plus fever. what is it and how is it transmitted?

Back 97

Histoplasmosis
bat guano

Front 98

35 yo white male with AIDS and CD count of 75 has 1 wk history of headache, nausea and vomiting. What is going on and how will you confirm diangosis?

Back 98

cryptococcus meningitis
do an india ink on his CSF after you confirm that CAT scan is normal. You can aso do cryptococcal antigens (latex agglutination test that detects polysaccharaide capsular antigen on serum and CSF but this takes 3-5 days)

Front 99

65 yo grandmother with RA hsa red pustule on index finger and red stripe up arm to axilla. gardening. WHat is organism and what does it look like in microscope?

Back 99

sporothrix schenckii
looks like cigar shaped budding yeast

Front 100

33 yo aids pt with 4 wk history of nonproductive cough; CD 4 count is 136; pt has fevers, SOB, no orthopnea or paroxysmal nocturanal dyspnea.

Back 100

Pneumocystics pneumonia caused by pneumocystiss carinii

Front 101

24 yo hispnic male has diarrhea and R upper quadrant pain. bloody diarhea. ultraxound showsl multiple liver absecess and stool has cysts. dx? tx?

Back 101

entamoeba histolytica
tx = metronidazole

Front 102

stomach pain, watery diarrhea, bloating, weight loss, drank mt water

Back 102

giardia
tx = metronidazole

Front 103

38 yo hispanic with HIV and CD 4 count of 38 has watery diarrhea; lost 5 pounds. most likely cause of diarrhea in aids pt is?

Back 103

cryptosporidium

Front 104

54 yo white male with AIDS and CD 4 of 74 has slurred speech. ring enhanced lesions in brain; around basal ganglia and corticomedulalary junction. What is dx and tx?

Back 104

toxoplasmosis;
tx is sulfadiazine and pyrimethamine

Front 105

chagas disease:
cause and organism?

Back 105

trypanosoma cruzi
Reduvvid bug

Front 106

tsetse fly and organism can be seen on blood smear

Back 106

tripanosoma gambiense or rhodesiense; "African sleeping sickness"

Front 107

15 yo female with fever fatige, sore throuat, bumps on neck. erythematous pharynx and hepatomegaly. heterophil antibodies are positive. atypical lymphocytes. what is it and what caused it?

Back 107

mononucleosis
EBV

Front 108

TORCH in infants and causes retitinis in immune compromised hosts?

Back 108

CMV

Front 109

shift vs drift?

Back 109

shift = reassortmnet of viral genome (eg. viral genome of Influenza A recombines with swine flu A virus)

drift = random minor changes based on random mutations

Front 110

HIV is retrovirus. how does it replicate?

Back 110

reverse transcribed into dsDNA from RNA via reverse transcriptase. dsDNA incorporated into host genome. When cell turns over, the viral DNA will be replicated along with cellular DNA

Front 111

anitschkow cells? what disease?

Back 111

activated histiocytes seen in rheumatic heart disease

Front 112

roth's spots

Back 112

pale retinal spots surrounded by hemorrhage seen in endocarditis

Front 113

concentric calcified laminated shpherules? what disease?

Back 113

psamomma bodies;
papillary carcinoma of thyroid

Front 114

progressive blindness, diminshed responsiveness, seizures; ashkenazi jew. what disease and what enzyme is deficient?

Back 114

Tay Sachs disease
deficiency in Hexosaminidase A; leads to an accumulation of ganglioside GM2 in neurons, producing a dengerative neurological disease. kid looks normal at birth, but then gets sick. You will see cherry red spots on macula. death occurs by 4-5 years. NO HEPATOSPLENOMEGALY

Front 115

how do you differentiate Tay Sachs from Nemann Pick disease in infants?

Back 115

Tay Sachs has No hepatomegaly or splenomegaly.

Front 116

deficiency in galactosidase A will cause what?

Back 116

galactosidase A is a lysosomal enxyme and will cause Fabry disease (x linked) in which ceramide trihexoside accumulates; corneal changes, heart problems, rnal failure and GI symptoms

Front 117

deficiency of glucocerebrosidase will cuase what disease?

Back 117

Gaucher disease; most common lysosomal storage disorder. Most cases present in adulthood. hepatomegaly and splenomegaly and mobne marrow involvement. Lipid laden enlarged macrophages with fibrillary appearance seen in bone marrow and other tissues

Front 118

deficieny of sphingomyelinase in lysosomes willl cause what disease?

Back 118

Niemann Pick disease is accumulation of sphingomyelin in lysosomes of CNS and reticuloendothelial systems. Also more common in ashkenazi jews. You will also see cherry red spots in macula region (like Tay Sachs) BUT you will see HEPATOSPLENOMEGALY in niemann pick but NOT in tay sachs. You will see distended cells with foamy vacuolization and on EM, these cells have lamellar bodies called "zebra bodies"

Front 119

what nerve does knee flexion?

Back 119

sciatic

Front 120

what nerve does knee extension?

Back 120

femoral

Front 121

what nerve does foot dorsiflexion?

Back 121

deep perineal (think foot drop)

Front 122

what nerve does hip ADDuction?

Back 122

obturator

Front 123

what nerve does hip ABDuction?

Back 123

superior gluteal (stabilize pelvis)

Front 124

aspergillosis has tropism for what?

Back 124

blood vessels.

Front 125

anti centromere antibodies seen in what disease?

Back 125

crest

Front 126

what does CREST stand for? what antibodies does it have?

Back 126

calcinosis, raynauds, esophageal dysmotility, scerodactyly, telangectasia;

ANTI-CENTROMERE ANTIBODIES

Front 127

alzheimers affects what part of brain first? what does it do to this part of brain?

Back 127

affects hippocampus (learning and memory). it causes deposition of B-amyloid in senile plaques and also causes neurofibrillary tangles with abnormal deposition of Tau protein

Front 128

Neurofibrillary tangles. What are these made of and what disease?

Back 128

made of Tau protein deposits;
seen in Alzheimers

Front 129

what malaria is found in latin america?

Back 129

P. vivax

Front 130

what is tx for P. vivax and P. Ovale?

Back 130

give chloroquine, mefloquine or Atovaquone-proguanile.
also
must give PRIMAQUINE to eliminate the liver form of the disease.

Front 131

what is most common malaria found in africa?

Back 131

p. falciparum (most deadly and most common) no liver form

Front 132

what malaria has fevers every 3 days? every other day?

Back 132

every three days (quartan) = malariae


every two days (tertian) = vivax and ovale

(falciparum has no cycle)

Front 133

what antidepressant can trigger onset of narrow angle glaucoma?

Back 133

amitriptyline; (tricyclic antidepressant with anticholinergic side effects) narrow angle glaucoma can be precipitated by anticholinergic drugs bc the muscarinic receptors on the pupillary constrictor muscle of the iris are blocked, thereby causing dilation of the iris and increased narrowing of the angle in the anterior chamber of the eye

Front 134

what kind of drug is cimetidine? what is it used for?

Back 134

H2 antagonist used to decrease gastric acid secretion

Front 135

poison ivy is what type of hypersensitivity rxn?
what IL will inhibit it? who makes that IL?

Back 135

type IV hypersensitivity rxns are mediated by TH1 cells. IL-10 will INHIBIT TH1 cells. (IL-10 is made by TH2 cells)

Front 136

strawberry tongue, 5 day fever, rash on fingers and toes... young child.
what disease?
what are they at risk for developing?

Back 136

kawasaki disease; strong association with Asians, affects small and medium vessels; necrotizing vasculitis;

may develop CORONARY ANEURYSMS

Front 137

what are Koplick's spots?

Back 137

pathognomonic for early stage MEASLES; seen on buccal and oral mucosa,
small irregular red spots with bluish white speck in the center;
measles begins with infection for 3 days, then erythematous rash that starts at head and spreads to rest of body

Front 138

what is dressler's syndrome?

Back 138

autoimmune pericarditis that develops 6-8 weeks post MI (variant of fibrinous pericardiits)

Front 139

fracture of surgical neck of humerous produces what deficit?

Back 139

injury to axillary nerve, loss of abduction of arm, loss of sensation of lateral upper arm

Front 140

injury to axillary nerve, loss of abduction of arm, loss of sensation of lateral upper arm... damage to what part of humerus?

Back 140

surgical neck

Front 141

damage to lateral epicondyle of humerus produces what deficit?

Back 141

injury to radial nerve => wrist drop

Front 142

injury to what part of humerus and what nerve will cause wrist drop?

Back 142

lateral epicondyle; damage to radial nerve

Front 143

wrist drop is what nerve?

Back 143

radial nerve

Front 144

injury to medial epicondyle of humerus produces what deficit and affects what nerve?

Back 144

injury to ulnar nerve; claw hand

Front 145

injury to what nerve and which part of humerus will cause "claw hand"

Back 145

medial epicondyle

Front 146

claw hand is what nerve?

Back 146

ulnar nerve

Front 147

damage to midshaft of humerus produces damage to what nerve with what deficit?

Back 147

damage to radial nerve, causing wrist drop

Front 148

wrist drop is associated with what nerve and damage in what two places of humerus?

Back 148

it is associated with RADIAL nerve; damage to midshaft or lateral epicondyle of humerus

Front 149

psoriatic arthritis is associated with what HLA?

Back 149

HLA B27, and it is rheumatoid factor negative

Front 150

name three conditions that are HLA-B27 but are rheumatoid factor negative?

Back 150

ankylosing spondylitis
psoriatic arthritis
reiter syndrome (Triad: arthritis, conjunctivitis - redness of eyes, UTI; usually men ages 20-40)

Front 151

what is reiters syndrome

Back 151

HLA B27 Rheumatoid factor negative;
usually after infection with chlamydia trachomatis;
affects men ages 20-40
triad = arthritis, conjunctivitis (redness, blurry vision), and urinary tract infection. may also have lesions on penis called "balanitis circinata"

Front 152

increased PR interval without changes to QRS complex is what type of heart block?

Back 152

first degree AV node block

Front 153

preogressive elongation of PR interval until there is a missed beat

Back 153

second degree AV block MObitz Type I (Wenkebach)

Front 154

non-conductive p waves without preceeding prolongation of PR interval

Back 154

second degree AV block Mobitz Type II

Front 155

no relationship between p wave and qrs complex

Back 155

third degree heart block

Front 156

progressive muscle weakness at shoulders and pelvic girdles, calf pseudohypertrophy, resp insufficiency, pulmonary infections...
what disease and what gene?

Back 156

duchenne muscular dystrophy; may be genetic or due to frameshift mutation that leads to untranslatable mRNA

Front 157

what organism will grow germ tubes in animal serum?

Back 157

candida

Front 158

encapsulated yeasts; cause meningitis in AIDS patients and HOdgkins

Back 158

Cryptococcus neoformans

Front 159

hyphae with rosettes of microconidia

Back 159

sporothrix schenckii "rose gardeners disease"

Front 160

atypical pneumonia in ohio river valley; MACROCONIDIA

Back 160

histoplasmosis capsulatum

Front 161

top 3 causes of meninigitis in babies

Back 161

1. strep (group B) eg. strep agalactiae give mom penicillin before delivery if she is (+)

2. listeria

3. E. coli

Front 162

M protein is in what bacteria?

Back 162

s. pyogenes (causes rheumatic fever)

Front 163

ASO titer is what bacteria

Back 163

s. pyogenes

Front 164

what bacteria is stongly associated with colon cancer?

Back 164

streptococcus bovis

Front 165

exotoxin of diptheria works how?

Back 165

exotoxin inhibits protein synthesis via ADP ribosylation of Elongageion Factor 2 (EF-2)

corny grows on tellurite agar (think corn is grown in telluride colorado)

sx are pseudomembranous pharyngitis (grey white membrane) with lymphadenopathy

Front 166

what causes scarlet fever?

Back 166

strep pyogenes

white exudate on tonsils, fever, pain, sandpaper rash spreads outward sparing palms, soles face

Front 167

white exudate on tonsils, fever, pain, sandpaper rash spreads outward sparing palms, soles face

what disease and what organism?

Back 167

scarlet fever, s. pyogenes

Front 168

rheumatic fever follws what?

Back 168

strep pharyngitis ONLY. strep pyogenes...diagnose with jones criteria.
subQ nodules, polyarthritis, erythema arginatum, chorea, carditis

Front 169

post strep glomerulonephritis can follow what?

Back 169

strep pharyngitis OR skin infection.

Front 170

what is the acid found in the core of bacterial spores?

Back 170

diplicolinic

Front 171

what is diplicolinic acid?

Back 171

found in center of spores.

Front 172

name the gram (+) spores

Back 172

clostridium perfringes
clostridium tetani
bacillus anthracis
also:
b. cereus
clostridium botulinum

Front 173

what causes lock jaw

Back 173

clostridium tetani. binds peripheral nerves then travels in axons to CNS. Toin binds presyntaptic neurons and inhibits release of GABA and glycine, so you have constant stimulation aka tetani

Front 174

how does c. botulinim work?

Back 174

releases preforemd toxin that blocks ACH release at neuromuscular jxn.

Front 175

what causes gas gangrene, and waht is the toxin called?

Back 175

c. perfringens
alpha toxin

Front 176

what causes pseudomembranous collitis?

Back 176

c. difficile, often second to antibiotic use esp. clindamycin or ampicillin.

to tx, stop antibiotics and give metronidazole or vancomycin

Front 177

what is only orgnism with polypeptide capsule?

Back 177

bacillus antrhacis...capsule is protein and contains d-glutamate.

Front 178

what are sx of anthrax? tx?

Back 178

black skin lesions, woolsorters disease (inhalation of spores from wool)

tx = cipro

Front 179

soft cheese and milk, or vaginal during delivery.
what bug and what is tx?

Back 179

listeria

resistant to cephalosporins so give penicillin or ampicillin with gentamycin

Front 180

reheated fried rice?

Back 180

bacillus cereus

Front 181

neontatal meningitis 2-3 weeks after birth?

Back 181

listeria

Front 182

only gram + with endotoxin?

Back 182

listeria; has "tumbling motility"

Front 183

yellow sulfur granules in sinus tracts?

Back 183

actinomyces israellii
tx is penicillin

"SNAP"
sulfa for norcardia
actinomyces use penicillin

Front 184

SNAP?

Back 184

"SNAP"
sulfa for norcardia
actinomyces use penicillin

Front 185

what is pott's disease?

Back 185

tuberculosis of vertebral bodies

Front 186

if you have TB, why might PPD be negative?

Back 186

anergic:
steroids, immunocompromised, sarcoidosis, malnutrition

Front 187

what are the 2 forms of leprosy?

Back 187

1. lepromatous (lethal)
2. tuberculoid

tx is long term oral dapsone

loss of eyebrows, nasal collapse, lumpy earlobe, leonine faces

Front 188

lactose fermenters grow what color on what medium?

Back 188

pink on MacConckey agar

Front 189

neisseria subtypes: which ferments glucose only and which fermetns glucose and maltose?

Back 189

N. meningitidis does maltose and glucose

N. gonorreha does glucose only

Front 190

what causes waterhouse friedrichson syndrome?

Back 190

N. meningitidids. (has polysaccharide capsule)

Front 191

chocolate agar, factor V and factor X

Back 191

H.influenzae

Front 192

H influenzae needs what medium?
what is tx?

Back 192

chocolate, with factor V and factor X
tx for hflu meningitis = ceftiriaxone plus rifampin as propyhlaxis

Front 193

wwhat causes epigotitis?

Back 193

h flu

Front 194

legionnaires disease, what is bug? what is tx? what do you grow it on

Back 194

bug = legionella
disease is pneumonia
gram (-) rod
tx is erythromycin
grow it on charcoal yeast with iron and cysteine

Front 195

main cause of pul. infections in CF?

Back 195

pseudomonas

Front 196

hot tub follicultitis bug?

Back 196

pseudomonas

Front 197

diabetic osteomylitis bug?

Back 197

pseudomonas

Front 198

endotoxin and exotoxin A, inhibits EF-2. what is tx?

Back 198

pseudomonas

tx = aminoglycoside plus penicillin eg. piperacillin or ticarcillin

Front 199

malignant otitis externa bug?

Back 199

pseudomonas

Front 200

UTI after catheter placement caused by what bug?

Back 200

pseudomonas

Front 201

name the two bugs that inhibit EF 2

Back 201

cornybacterium diphteria

A toxin from pseudomonas

Front 202

what is the #1 cause UTI and a major cause of neonatal meningitis?

Back 202

e coli

Front 203

what is O antigen

Back 203

polysaccharide of endotoxin

Front 204

what is K antigen

Back 204

related to virulence of but

Front 205

what is H antigen

Back 205

found in motilie speces

Front 206

what bugs have KOH?

Back 206

enterobacteria (klebsiella, e coli, serratia, proteus, salmonella, shigella

Front 207

pneumonia in alcoholics and diabetics

Back 207

klebsiella

Front 208

currant gelly sputum

Back 208

klebsiella

Front 209

salmonella vs. shigella. both have bloody diarrhea and invade intestinal mucosa. which produces H2S? which is more virulent? which have flagella?

Back 209

salmonella: have flagella, make H2S

shigella: more virulent

Front 210

most common cause of PSEUDOappendicities. where do you get it from?

Back 210

Yersinia enterocolitica. common in day care centers, from pet feces (eg. puppies) or contaminated meat or pork

Front 211

what is viewed using dark field microscopy?

Back 211

treponema.

Front 212

causes bloody diarrhea, assoc, with guillan barre and reactive arthiritsi

Back 212

campylobacter jejuni

Front 213

weils disease (jaundice and azotemia from liver and kidney dysfxn). what causes it?

Back 213

leptospira interrogans. shaped like question mark

Front 214

what is shaped like question mark?

Back 214

leptospira interrogans

Front 215

migrating rash with concentric rings, "erythema chronicum migrans"
what bug, how transmitted, what is tx?

Back 215

lyme disease
borrelia burgdorferi, Ixodes tick

"BAKE a key LYME pie"
Bells palsy
Arthritis
Kardiac sx
Erythema migrans

Front 216

ixodes tick carries what 2 bugs?

Back 216

borrelia burdgorfori

babesia microti (malaria like sx)

Front 217

what caues syphilis

Back 217

treponema pallidium
tx is penicillin G
REMEMBER THE G PART!@@!!

Front 218

painless chancre

Back 218

primary syphilis

Front 219

maculopapular rash on palms and soles, condylomata lata

Back 219

secondary syphilis

Front 220

gummas (chronic granulomas) aortiis (vasa vasorum destruction), neurosyphileis (tabes dorsalis), argyll robertson pupil

Back 220

tertiary syphilis; broad based ataxia, positive rhomberg, charcot joints, stroke without HTN

Front 221

saber shins, saddle nose, CN 8 deafness, hutchinsons teeth

Back 221

congenitial syphilis

Front 222

VRDL vs. FTA-ABS?

Back 222

both test for treponems
VRDL = active infection,

FTA = most specific, earliest positive, remanisn postivie longer

Front 223

what causes the plague?

Back 223

yersina pestis; from flea bite, rodents, prarie dogs

chills, fever, headache, cough bloody sputum, diff. breathing.

cxr shows patchy infiltrates and segmental consolidation

Front 224

cat scratch fever

Back 224

bartonella henselae

Front 225

tularemia

Back 225

francisella tularensis

Front 226

what does pasturella multocida cause?

Back 226

cellulitis; get it from animal bite (cat, dog)

Front 227

grey white vaginal discharge with fishy smell, nonpainful, not an STD, wht type of cells do you see, what is bug, what is tx?

Back 227

gardenerlla vaginosis

you see CLUE CELLS covered with bacteria
tx is metronidazole

Front 228

obligate intracellular bug that needs NAD and CoA, arthropod vector
- cause triad of rash, fever, and headache
- what is bug and what is tx?

Back 228

rickettsia

tx = tetracycline

Front 229

rockymtn spotted fever

Back 229

rickettsia rickettsii

Front 230

rash of typhus vs. rockymtn spotted fever?

Back 230

Ricketsia on the wRists, Typhus on the Trunk

rickettsia rash starts on hands and feet and moves inward vs. typhus which starts on trunk and moves out

Front 231

R prowazekii causes what? R. typhi?

Back 231

R prowazekii = epidemic typhus

R typhi = endemic typhus

Front 232

Q fever

Back 232

coxiella burnetti

Front 233

name 3 diseases where you will see rash on palms and soles

Back 233

1. ricketsia rocky mtn spotted fever

2. coxsackievirus A infection (hand foot mouth disease)

3. Syphilis

Front 234

weil felix reaction

Back 234

used to look for ricketsia

(+) in rocky mtn spotted fever and in typhus but NEGATIVE IN Q fever (coxiella burnetti)

Front 235

obligate intracellular bug, cant make own ATP causes; mucosal infection. there are 2 forms.

Back 235

chlamydia

forms
1. elementary body that enters cell through endocytosis
2. retiuclate body which replicates in cell via fission

Front 236

bug whose cell wall LACKS MURAMIC ACID

Back 236

chlamydia

Front 237

reactive arthitis, conjuctivitis, nongonococcal urethritis, and PID

Back 237

chalmydia thrachomoatis

Front 238

cytoplamsic inculsions seen on giemsa or fluorescent antibody stain

Back 238

chlamydia

Front 239

tx for chlamydia?

Back 239

erythromycin or tetracycline

Front 240

what is mechanism of chlamydia infection?

Back 240

causes TH1 lymphosyte response and CD8 (+) effector cells. (cell mediated immune resonse is stimulated)

Front 241

subtypes ABC of chlamydia cause what?

Back 241

Africa
Blindness
Chronic infection

Front 242

tx for neonatal chlamydia after delivery through birth canal?

Back 242

eryhtromycin

Front 243

atypical walking pneumonia

Back 243

mycoplasma pneumonia
insidious onset, heandache, nonproductive cough, diffuse interstitial infiltrate; x ray looks worse than patient

Front 244

grown on Eatons agar
high titer of COLD AGGLUTININS (IgM)
bacterial membrane has cholesterol
no cell wall, not seen on gram stain

Back 244

mycoplasma pneumonia

Front 245

pneumonia common in military camps and prisons

Back 245

mycoplasma pneumoniae
tx. erythro or tetracycline

Front 246

how do you view chlamydia?

Back 246

giemsa stain
iodine
fluorescent ab

remember its intracellular bc cant make its own ATP

Front 247

most common overal STD? most common bacterial STD?

Back 247

overall = HPV
bacterial = Chlamydia trach.

Front 248

intraneutrophilic gram (-) diplococci, dysuria and neutrophilic exudate

Back 248

N gonorrhea

Front 249

intranuclear inclusions with owl eyes?

Back 249

CMV - causes Std but not PID

Front 250

lactose fermenting gram (-) bacilli

Back 250

E. Coli - causes UTI but not PID

Front 251

pear shaped flagellated protozoa only protazoal STD, smelly cheezy exudate

Back 251

Trichomonas vaginalis

Front 252

pleomorphic gram (-) rods

Back 252

hemophylis ducreyi

Front 253

mississippi and ohio river valleys

Back 253

histo

Front 254

bird or bat droppings, tiny yeasts INSIDE macrophages

Back 254

histo

Front 255

east of mississippi and central america; inflammatory lund disease and can disseminate to skin and bone
forms GRANULOMATOUS nodules

Back 255

blastomycosis

Front 256

what determines if blastomycosis is yeast or mold?

Back 256

cold = Mold
heat = yeast

culture on sabouraud's agar

Front 257

southwest US, california; causes pneumonia and meningitis; desert valley fever

Back 257

coccidiodomycosis

Front 258

spherule filled with endospores

Back 258

coccidiodomycosis

Front 259

rural latin america; captains wheel appearance

Back 259

paracoccidiodomycosis "budding yeast"

Front 260

treatmetn for all systemic mycosis?

Back 260

amphteracin B for systemic infxns

fluconazole or ketaconazole for local infection

Front 261

what causes tinea versicolor

Back 261

malassexia furfur; occurs in hot and humid weather; "spaghetti and meatball aperance" on KOH prep

Front 262

vulvovaginitis at
HIGH pH
diabetics
use of antibiotics

tx for local vs systemic infxns?

Back 262

candida albicans

systemic tx = amphoteracin B
local tx = NYSTATIN

Front 263

mold with septate hypahe at 45 degree angle

Back 263

aspergillus fumigatus (MOLD!!)

Front 264

found in soil and PIGEON droppings; stains with INDIA INK; has polysacccharide capsular antigen that is detected with LATEX AGGLUTINATION

Back 264

cryptococcus neoformans (heavily encapsulated yeast) NOT DIMORPHIC

causes SOAP BUBBLE lesions in brain

Front 265

mold with wide branching non-septate hyphae > 90 degrees; proliferate in walls of blood vessels and cause infarction and necrosis of distal tissue

Back 265

mucor and rhizopus; mucormycosis

seen in DIABETICS AND LEUKEMIA PTS

Front 266

rhinocerebral, frontal lobe abascess due to what opportunistic fungal infection?

Back 266

mucormycosis

Front 267

budding yeast at 20 degrees, germ tubes at 37 degrees

Back 267

candida albicans

Front 268

yeast with wide capsular halo, narrow based unequal budding

Back 268

cryptococcus

Front 269

identified via methenamine silver stain of lung tissue?

what is tx?
who gets it?

Back 269

pneumocystis jiroveci - causes diffuse interstitial pneumonia, yeast; tx is TMP-SMX or dapsone;

seen in AIDS pts
start prophylaxis when CD4 < 200

Front 270

aids pt with atypical pneumonia and cyanosis

Back 270

pneumocystis jiroveci

Front 271

rose gardeners disease

Back 271

sporothrix schenchii

Front 272

premature neonate with resp distress, silver staining cysts and surfactant rich exudate. what are you thinking?

Back 272

pneumocystis jiroveci
you have surfactant rich exudate due to replicaiton of type II pneumocytes

Front 273

most common cause of otitis media and pneumonia

Back 273

strep pneumo

Front 274

otitis media, epiglottitis, meningitis in unvaccinated kids

Back 274

h influenzae

Front 275

giardia tx

Back 275

metronidazole

Front 276

trichomonas vaginitis tx

Back 276

metronidazole

Front 277

p. vivax is found where? how do you treat?

Back 277

latin america, asia, some africa
tx i cholorquine or mefloquine or atovaquione -proguanil

Front 278

p. ovale is foudn wehre?

Back 278

W africa, philippines, papua new guinea

Front 279

vivax and ovale will persist in liver and cause relapse unless you treat with what?

Back 279

PRIMAQUINE

Front 280

Chagas disease

Back 280

trypanosoma cruzi

Front 281

reduviid bug?

Back 281

chagas disease;
trypanosoma cruzi

Front 282

tsetse fly

Back 282

trypanosoma gambiense or rhodiesiense;
african sleeping sickness, enlarged lymph nodes, somnolence, coma, recurring fever

Front 283

leishmania donovanni

Back 283

leishmaniasis from sandfly; spiking fevers, hepatosplenomegaly, pancytopenia;
tx is sodium stibogluconate or amphoteracin B or pentamidine

Front 284

which plasmodium persists in liver

Back 284

vivax and ovale

Front 285

most severe malaria

Back 285

P falciparum

Front 286

which plasmodium uses DUFFY ANTIGEN to enter RBCs

Back 286

vivax

Front 287

most common type of malaria

Back 287

vivax

Front 288

heterozygotes with sickle cell trait are resistant to what?

Back 288

malaria

Front 289

how is malaria transmitted (what type of mosquito)

Back 289

anopheles mosquito

Front 290

maltese cross in RBC

Back 290

babsia
"babsiosis" is fever and hemolytic anemia mainly NE US.

from Ixodes tick (same as lyme disease)
tx is clindamycin or quinie

Front 291

cysts on acid fast stain, cause diarrhea (watery) in healthy people, severe in AIDS Pts.

Back 291

cryptosporidium
think ACID FAST CYSTS

Front 292

brain abscess in HIV and ring enhancing lesions; cyst are in meat or cat feces, can cross placenta and cuase birth defects.
bug and tx?

Back 292

toxoplasma gondii

tx is sulfadiazine and pyrimethamine

Front 293

amebiasis, bloody diarrhea, liver abscess, RUQ pain

Back 293

entamoeba histolydica - invades colonic mucosa and makes shallow ulcers

tx is metronidazole

Front 294

rapidly fatal meningoencephalitis; enter through cribriform plate; get from swimming in freswhater lake; you willl see amoebas in CSF

bug?

Back 294

naegleria fowleri

Front 295

what is definitive host of toxoplasma gondii?

Back 295

cat

Front 296

cystercircosis bug

Back 296

taenia solium (tape worm)
tx is praziquantel for intestinal worms and cistercircosis

Front 297

eat undercooked fish, causes vitamin B12 defieicney (megaloblastic anemia)

Back 297

diphyllobothrim latum

Front 298

hytadid cyst; eggs in dog feces when ingested cause cysts in liver

Back 298

echinococcus granulosus; think BRAIN invovlement and dogs

Front 299

chronic infection with schistosoma haematobium will lead to what kind of cancer

Back 299

squamous cell carcinoma of bladder

Front 300

you see SHISTOSOMA HAEMATOBIUM, what do you think?

Back 300

BLADDER ==> invades pelvic veins and causes squamous cell ca of bladder

Front 301

oriental liver fluke; undercooked fish, pigmented gallstones due to inflammation of billary tree
associated with cholangiocarcinoma

Back 301

clonorchis siensis

Front 302

Parnoimus WESTERMANI, what do you think?

Back 302

undercooked CRAB meat, LUNG involvment (cough, bronchiectasis)

Westermani ==> Crabs and Lung

Front 303

parasite hintbrain cysts and seizures

Back 303

taenia solium

Front 304

parasite hint
liver cysts

Back 304

echinococcus granulosus

think CHINA?

Front 305

parasite hint
B12 deficiency

Back 305

Diphyllobothrium latum

B12 deficiency from PHYLLO dough?

Front 306

parasite hint
billary tract disease

Back 306

clonorchis sinensis

SINUS of bilary tract?

Front 307

parasite hint
hemoptysis

Back 307

Paragoniums WESTERMANI (remember, lungs and crabs)

Front 308

parasite hint
bladder cancer

Back 308

SCHISTOSOMA HAEMATOBIUM

Front 309

parasite hint
microcytic anemia

Back 309

anclosytoma, necator

Front 310

parasite hint
perianal pruitis

Back 310

enterobius