Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
254 Cards in this Set
- Front
- Back
|
TNF and IL-1 are induced by what gram + molecule? gram -?
|
1) teichoic acid
2) Lipid A (polysaccarhide) |
|
|
Where is a gram - bacteria are the beta-lactamases? What is a spore made out of?
|
1) periplasm
2) keratin-like coat with dipicolinic acid |
|
|
Which bacteria has D-glutamate capsule and not a polysaccharide capsule?
|
1) B anthracis
|
|
|
what are examples of gram+ cocci? What is an example of gram- cocci?
|
1) Staph and strep
2) neiserria |
|
|
What are examples of gram+ rods?
|
1) clostridium
2) corynebacterium 3) bacillus 4) listeria 5) mycobacterium (acid fast) |
|
|
What are examples of gram+ branching filamentous bacteria?
|
1) actinomyces
2) nocardia (weakly acid fast) |
|
|
What are examples of enteric gram- rods?
|
1) E. coli
2) Shigella 3) Salmonella 4) Yersinia 5) Klebsiella 6) Proteus 7) Enterobacter 8) Seratia 9) Vibrio 10) Campylobacter 11) Helicobacter 12) Pseudomonas 13) Bacteroides |
|
|
What are example of non-enteric gram- rods?
|
1) haemophilus
2) legionella 3) bordetella 4) Francisella 5) brucella 6) pasteurella 7) bartonella 8) gardenella |
|
|
Which bacteria gram variable? What are pleomorphic gram- organisms?
|
1) gardenella
2) rickettsiae and chlamydiae (giemsa) |
|
|
Which bacteria are spirochetes?
|
1) leptospira
2) bartonella 3) treponema |
|
|
Which bacteria has no cell wall but has sterols? Which has mycolic acid and high lipid content?
|
1) mycoplasma
2) mycobacteria |
|
|
which bacteria are intracellular and therefore do not gram stain well?
|
1) rickettsia
2) legionella pneumophilia 3) chlamydia Note: treponema is too thin to visualized with gram staining |
|
|
How are treponemas stained?
|
darkfield microscopy and fluorescent antibody staining
|
|
|
Giemsa is good for staining which organisms?
|
1) borrelia
2) plasmodium 3) trypanosomes 4) chlamydia |
|
|
What is the PAS stain active against? What organisms?
|
1) stains glycogen and mucopolysaccharides
2) Whipple's disease (tropheryma whippelii) |
|
|
Ziehl-Neelsen stain is used for what? India Ink is used for? Sivler stain is also good for what?
|
1) acid-fast organisms
2) C neoformans 3) fungi and legionella |
|
|
H. influezae grows well on what media?
|
chocolate agar with factors V (NAD+) and X (hematin)
|
|
|
N. gonorrhoeae is grown on what media? What is in the media
|
1) thayer-martin
2) a. vancomycin - to kill gram+ b. polymxin - inhibit gram- c. nystatin - inhibits fungi |
|
|
Potato agar is used for what organism? What else is it called?
|
1) B pertussis
2) Bordet-Gengou |
|
|
Tellurite plate and Lofflers media are used to grow what?
|
M tuberculosis
|
|
|
Eatons agar is used to culture what? Sabouraud's agar is for what?
|
1) M. pneumoniae
2) fungi |
|
|
Lactose fermenting enterics are grown on what? How do they appear?
|
1) MacConkey's agar
2) appear pink from acid produced |
|
|
If E. coli is grown on eosin-methylene blue (EMB) agar how do they appear?
|
blue-black colonies with metallic sheen
|
|
|
Legionella can be grown on what media?
|
charcoal yeast extract agar buffered with cysteine
|
|
|
What obligate aerobes are seen in burn wounds, nosocomial pneumonia and pneumonias of CF?
|
1) nocardia
2) pseudomonas 3) M tuberculosis 4) Bacillus |
|
|
What enzymes do obligate anaerobes lack that they can't be near oxygen?
|
1) catalase
2) superoxide dismutase |
|
|
What are general characteristics of obligate anaerobes?
|
1) foul smelling (short chain fatty acids)
2) difficult to culture 3) produce CO2 and H2 |
|
|
Are aminoglycosides effective against obligate aerobes or anaerobes? Why is it not effective against the other?
|
1) effective against aerobes
2) anaerobes grow in low O2 environments 3) O2 is required for aminoglycosides to enter cells |
|
|
Which bacteria are obligate intracellular? Why?
|
1) Rickettsia
2) Chlamydia 3) They can't make own ATP |
|
|
Which bacteria are facultative intracellular?
|
1) Salmonella
2) Neisseria 3) Brucella 4) Mycobacterium 5) listeria 6) Francisella 7) Legionella |
|
|
What does a positive quellung reaction indicate? What occurs during the reaction?
|
1) that a bacteria is encapsulated
2) capsule swells when specific anticapsular antisera are added |
|
|
What are examples of bacteria that are positive for the quelling reaction? What does this property help these organisms do in the body?
|
3) Klebsiella pneumoniae
4) Salmonella 5) S pneumoniae 6) HIB 7) N meningitidis 8) capsules are virulence factors that prevent phagocytosis |
|
|
Which organisms produce an IgA protease? what other features do they have?
|
1) S pneumoniae
2) HIB 3) N meningitidis 4) all also cause meningitis and can take up DNA from environment |
|
|
What are urease positive bacteria?
|
1) proteus
2) klebsiella 3) H pylori 4) ureaplasma |
|
|
Which bacteria produce a pigment? What color does each produce?
|
1) Actinomyces israelli - yellow sulfur granules
2) S aureus - yellow pigment 3) P aeruginosa -- blue-green pigment 4) Serratia marcescens - red pigment |
|
|
Which bacteria produces protein A? What is its function/
|
1) S aureus
2) binds Fc region of Ig preventing opsonization |
|
|
Which bacteria produces M protein? what is its function?
|
1) group A strep
2) prevents phagocytosis |
|
|
Do gram+ or gram- bacteria produce exotoxins? Are exotoxins secreted?
|
1) certain species of each
2) yes |
|
|
Where in the bacteria are the genes for exotoxins located? endotoxins?
|
1) exotoxins - plasmid/bacteriophage
2) endotoxins - bacterial chromosome |
|
|
Are exotoxins or endotoxins more fatal? which is more antigenic?
|
1) exotoxin (1ug can kill)
2) exotoxin induces high-titer antibodies called antitoxins while endotoxins are poorly antigenic |
|
|
Are vaccines available for both exotoxins and endotoxins? Which more heat stable?
|
1) just exotoxins (toxoids used as vaccine
2) a. exotoxins destroyed at rapidly at 60 C b. endotoxins stable at 100 C for 1 hour |
|
|
What is the MOA of superantigens? What do they bind?
|
1) Bind MHC II and T cell receptors simultaneously
2) activates large numbers of T cells 3) T cells release IFN-gamma and IL-2 |
|
|
What bacteria produces TSST-1? What does it lead to? What are other toxins of this bacteria?
|
1) S aureus
2) superantigen causes toxic shock syndrome 3) enterotoxins and exfoliatin |
|
|
How is toxic shock syndrome characterized? What have if exfoliatin is also present?
|
1) fever, rash, shock
2) get staphylococcal scalded skin syndrome |
|
|
What do the superantigens of S pyogenes cause?
|
1) scarlet fever - erythrogenic toxin that causes toxic-shock like syndrome
|
|
|
How are ADP-ribosylating A-B toxins taken up?
|
1) B component binds to receptor on host surface
2) toxin is endocytosed 3) A component attaches ADP-ribosyl to a host cell protein altering it function |
|
|
What toxin does C diptheriae have? What is its function? What disease findings?
|
1) ADP-ribosylating A-B toxins
2) inactivates EF2 3) pharyngitis and pseudomembrane in throat |
|
|
What toxin does V cholerae have? what is its function? What are findings?
|
1) ADP ribosylating A-B toxin
2) activates adenylyl cyclase 3) increased pumping of Cl- into gut and decreased Na+ reabsorption 4) H2O moves into lumen causing rice-water diarrhea |
|
|
what is the function of E. coli heat labile toxin? Heat stable toxin? What results?
|
1) heat-labile stimulates adenylate cyclase
2) heat-stable stimulates gaunylate cyclase 3) both produce water diarrhea |
|
|
What does the B pertussis ADP ribosylating A-B toxin do? What are symptoms?
|
1) increases cAMP by inhibiting Galpha1
2) causes whooping cough 3) inhibits chemokine receptor causing lymphocytosis |
|
|
what organism has a double zone of hemolysis on blood agar? What toxin does it produce?
|
1) Clostridium perfringens
2) alpha toxin causes gas gangrene |
|
|
How does C tetani toxin work? What results?
|
1) blocks release of GABA and glycine
2) causes lockjaw |
|
|
How does the C botulinum toxin work? What results?
|
1) blocks release of ACh
2) anticholinergic symptoms 3) CNS paralysis, esp cranial nerves 4) found in canned food and honey |
|
|
What causes floppy baby syndrome?
|
botulinum toxin
|
|
|
Edema factor is released from what bacterium? What is its function?
|
1) B anthracis
2) it is an adenylate cyclase and increases cAMP |
|
|
what other organism has shiga toxin? What is the toxins function? What does it cause?
|
1) E coli and shigella
2) cleaves host 60S ribosome 3) enhances cytokine release leading to HUS |
|
|
What is the function of streptolysin O? Clinically what is it used for?
|
1) hemolysin
2) it is antigen for ASO antibody used in diagnosis of rheumatic fever |
|
|
Which bacteria produce ADP ribosylating A-B toxins?
|
1) C diptheriae
2) V cholerae 3) E coli 4) B pertussis |
|
|
Which bacteria are cAMP inducers?
|
1) cholera
2) pertussis 3) E coli Note: these activate host adenylate cyclase 4) antrax edema factor Note: this is an adenylyl cyclase |
|
|
What is the only gram+ bacteria that produces endotoxin? Is endotoxin heat stable or labile?
|
1) listeria monocytogenes
2) stable |
|
|
How does endotoxin effect macrophages? What results?
|
1) IL-1 increased = fever
2) TNF increased = fever and hemorrhagic tissue necrosis 3) NO increased = hypotension and shock |
|
|
Which complement pathway does endotoxin activate? Which factors? What results?
|
1) alternate pathway
2) C3a = hypotension and edema 3) C5a = neutrophil chemotaxis |
|
|
How does endotoxin induce DIC?
|
1) activates hageman factor
2) causes coagulation cascade |
|
|
What are the phase of the bacterial growth curve? What occurs in each?
|
1) lag = metabolic activity with out division
2) Log = rapid division 3) Stationary = nutrient depletion, slowed growth and SPORE formation 4) Death |
|
|
Which bacteria are particularly adept at transformation?
|
1) S pneumoniae
2) Hib 3) Neisseria |
|
|
If a bacteria is Hfr what does this mean? What is transposition?
|
1) F+ plasmid was inserted into bacterial chromosome
2) Segment of DNA that jumps from one location to another transferring genes from chromosome to plasmid and vice versa |
|
|
What is generalized transduction? What is specialized transduction?
|
1) lytic phage infects bacteria and cleaves bacterial DNA. Parts of bacterial chromosome are packaged into viral capsid
2) lytic phage infects bacteria and viral DNA is inserted into bacterial DNA. Phage DNA is later excised with some bacterial DNA and put in viral capsid |
|
|
which toxin genes are obtained via lysogeny?
|
1) Shiga-like toxin
2) botulinum toxin 3) Cholera toxin 4) Diptheria toxin 5) Erythrogenic toxin of S pyogenes |
|
|
What are features that distinguish strep and staph?
|
1) a. staph = catalase +
b. strep = catalase - 2) a. staph = gram+ clusters b. strep = gram + chains 3) a. staph = coagulase + b. strep = coagulase - |
|
|
How is staph aureus distinguished from S epidermidis and S saprophyticus?
|
1) S aureus = only coagulase +
2) others are coagulase - |
|
|
How are S epidermidis and S saprophyticus distinguished?
|
1) both coagulase -
2) S epidermidis = novobiocin sensitive 3) S saprophyticus = novobiocin resistant |
|
|
what type of hemolysis does enterococcus have?
|
either alpha or gamma but mostly GAMMA which is no hemolysis
|
|
|
Strep species are distinguished based on hemolysis. which species are alpha hemolytic? How are they further distinuished?
|
1) S pneumonaie = capsule (+quelling), optochin sensitive, bile soluble
2) viridans strep = No capsule (-quelling), optochin resistant, not bile soluble |
|
|
How are beta hemolytic strep species differentiated?
|
1) Group A = S pyogenes, bacitracin sensitive
2) Group B = S agalactiae, bacitracin resistant |
|
|
What are gamma hemolytic bacteria?
|
1) Enterococcus (E. faecalis)
2) Peptostreptococcus (anaerobe) |
|
|
Where is L monocytogenes found? what does it cause in new borns? Is it motile?
|
1) unpasteurized milk
2) meningitis in newborns 3) tumbling motility |
|
|
What is the virulence factor of S aureus? Is it catalase -/+? coagulase -/+? Is it aerobic or anearobic?
|
1) protein A = binds Fc-IgG to inhibit complement fixation
2) catalase + 3) coagulase - 4) facultative aerobe |
|
|
S aureus can cause what?
|
1) inflammatory disease of skin, organs and cause abecesses, pneumonia
2) Toxin mediated disease = TSST-1, exfoliative toxin, rapid onset enterotoxin 3) endocarditis, osteomyelitis |
|
|
What is structurally altered in MRSA to allow resistance?
|
resistant to beta-lactams via altered penicillin binding protein
|
|
|
where does staph epidermidis reside to cause infection? What does this organism commonly contaminate?
|
1) prosthetic devices and IV catheters via biofilm
2) normal skin flora 3) can contaminate blood cultures |
|
|
What is S pneumoniae the most common cause of?
|
1) meningitis
2) otitis media (in children) 3) pneumonia 4) sinusitis |
|
|
What are distinuishing features of S pneumoniae?
|
1) catalase -
2) optochin sensitive 3) alpha hemolytic 4) +quelling from capsule 5) bile soluble 6) IgA PROTEASE |
|
|
rusty sputum is associated with what? This organism also causes sepsis in people with what disease?
|
1) S pneumoniae
2) Sickle cells anemia |
|
|
Which viridans species causes dental caries? subacute bacterial endocarditis?
|
1) Strep mutans
2) Strep sanguis |
|
|
which group of strep is S pyogenes? What are its pyogenic effects?
|
1) Group A
2) Pyogenic Causes: a. pharyngitis b. cellulitis c. impetigo |
|
|
What are the toxigenic effects of S pyogenes? Is it bacitracin sensitive or resistant?
|
1) scarlet fever
2) toxic shock syndrome 3) sensitive |
|
|
What immunulogic conditions does S pyogenes elicit? What protein are host antibodies directed against? what do the antibodies give rise to?
|
1) rheumatic fever
2) acute glomerulonephritis 3) M protein 4) rheumatic fever |
|
|
How is rheumatic fever caused by S pyogenes characterized?
|
1) subcutaneous plaques
2) polyarthritis 3) erythema marginatum 4) Chorea 5) carditis |
|
|
Which group of strep is S agalactaie in? Are they bacitracin sensitive or resistant? What type of hemolysis do they induce?
|
1) Group B
2) resistant 3) beta hemolytic |
|
|
S agalactiae causes what diseases and in who?
|
1) pneumonia
2) meningitis 3) sepsis 4) mainly effects BABIES |
|
|
Enterococci are which group of strep? what are two bacteria in this group? Which antibiotic are they resistant to?
|
1) group D
2) E faecalis and E faecium 3) penicillin G |
|
|
What do they diseases do enterococci cause?
|
1) UTI
2) subacute endocarditis |
|
|
What are the three group D strep? What media can be used to distinguish them?
|
1) enterococci and nonenterococci and Streptococcus bovis
2) enterococci can grow on 6.5% NaCl |
|
|
Streptococcus bovis is in what group? Where is does colonize? What can it cause and in who?
|
1) Group D
2) colonize gut 3) bacteremia and subacute endocarditis in colon cancer patients |
|
|
where is the diptheria exotoxin coded? How do the bacteria look? What is the vaccine composed of? What kind of media are they grown on?
|
1) encoded on beta-prophage
2) gram + clubbed shaped rods with metachromatic (blue and red) granules 3) tellurite agar |
|
|
What molecule is found in the core of a gram + bacterial spore? What method is used to kill spores in hospitals?
|
1) dipicolnic acid
2) autoclave |
|
|
Which gram+ bacteria can form spores?
|
Found in soil:
1) B anthracis 2) C perfringens 3) C tetani Others: 4) B cereus 5) C botulinum |
|
|
How are clostridial species characterized?
|
1) gram +
2) spore forming 3) obligate anaerobic bacilli |
|
|
What does the tetanus toxin block the release of and from what cells?
|
1) blocks glycine release from Renshaw cells in spinal cord
Causes: 1) spastic paralysis 2) trismus 3) risus sardonicus - characteristic abnormal grin |
|
|
What does C perfringens produce? What does it cause?
|
1) alpha toxin = lecithinase
2) myonecrosis (gas gangrene) 3) hemolysis |
|
|
What does C difficile exotoxin destroy? If generally occurs in patients treated with which antibiotics?
|
1) enterocytes leading to pseudomembraneous colitis
2) clindamycin and ampicillin |
|
|
which bacteria has D-glutamate capsule? Who is most at risk for contracting it?
|
1) B anthracis
2) woolsorters |
|
|
How is cutaneous anthrax characterized? which toxins cause it?
|
1) black eschar (painless) surround by edematous ring
2) leads to bacteremia and death 3) lethal factor and edema factor |
|
|
le fumet
|
aroma
|
|
|
How is L monocytogenes acquired?
|
1) unpasteurized milk
2) deli meats 3) vaginal during birth |
|
|
What can L monocytogenes cause in pregnant women?
|
1) amnionitis
2) septicemia 3) abortion |
|
|
What can L monocytogenes cause in children? immunocompromised people? healthy people?
|
children:
1) granulomatosis infantseptica 2) neonatal meningitis others: 3) immuncompromised meningitis 4) mild gastroenteritis in healthy adults |
|
|
How is A isreali characterized? Where is it normally found?
|
1) gram+ rod
2) long branching filaments 3) anearobe 4) oral cavity |
|
|
what can A ireali cause? what is characteristic feature?
|
1) oral and facial abcess
2) yellow sulfur granules 3) sinus tracts |
|
|
How is nocardia treated? Actinomyces?
|
1) sulfa drugs
2) penicillin |
|
|
How is N asteroides characterized? What does it cause and in who?
|
1) gram+
2) weakly acid fast 3) aerobe 4) pulmonary infection in immunocompromised |
|
|
What is the Ghon complex? What does it reflect?
|
1) TB granulomas (ghon focus) with lobar and perihilar lymph node involvement
2) primary infection or exposure |
|
|
What are the 4 outcomes of primary TB?
|
1) heals by fibrosis
2) progressive lung disease a. autoimmune patients 3) severe bacteremia leading to a. miliarly TB b. death 4) preallergic lymphatic or hematogenous dissemination pg. 150 |
|
|
If someone has preallergic lymphatic or hematogenous dissemination of TB what happens? What organ systems involved
|
1) dormant tubercles form in many organs
2) reactivate in: a. CNS b. vertebral body (potts disease) c. lymphadenitis d. renal e. GI |
|
|
fibrocaseous necrosis in TB is seen with primary or secondary TB?
|
secondary TB
|
|
|
What can give a false negative PPD? What is the process by which this occurs?
|
1) steroids
2) malnutrition 3) immunocompromised 4) SARCOIDOSIS 5) process is called ANERGY |
|
|
What does M. kansaii cause? What feature do all mycobacterium have in common?
|
1) pulmonary TB-like symptoms
2) gram+ acid fast organisms |
|
|
What are symptoms of TB?
|
1) fever
2) night sweats 3) weight loss 4) hemoptysis |
|
|
Leprosy is also known as? What are presenting features?
|
1) hansens disease
Features: 1) loss of eyebrows 2) nasal collapse 3) lumpy earlobe 4) leonine facies of lepromatous leprosy |
|
|
Does M leprae grow in warm or cold environments? What does it infect? What is reservoir in US?
|
1) cool temps
2) infects skin and superficial nerves 3) armadillos |
|
|
What is longterm treatment of M leprae? What are toxicities of the drug?
|
1) dapsone
2) hemolysis 3) methemoglobinemia |
|
|
What are alternate treatments for M leprae?
|
1) rifampin and combination of clofazime and dapsone
|
|
|
What are the two types of leprosy?
|
1) lepromatous: diffusely over skin
2) tuberculoid: limited to a few hypesthetic nodules |
|
|
Which part of immune system fails with lepromatous Leprosy?
|
1) cell mediated immunity resulting in diffuse lesions
Note: tuberculoid is confined to a few areas |
|
|
How can the gram- cocci N meningitidis and N gonorrheae be distinguished?
|
1) N meningitidis = maltose fermenter
2) N gonorrheae = non-maltose fermenter |
|
|
What are examples of coccoid rods?
|
1) H influenzae
2) pasteurella 3) brucella 4) B pertusis |
|
|
How are gram negative non-lactose-fermenting bacteria further distinguished? What are examples of bacteria in each class?
|
Oxidase +:
1) pseudomonas Oxidase -: 1) Shigella 2) Salmonella 3) proteus |
|
|
What media are lactose fermenting bacteria grown on? What color are they?
|
1) MacConkeys
2) pink |
|
|
le carrefour
|
hub, junction, intersection
|
|
|
Lactose fermenting rods can further be divided based on how quickly they ferment. What are fast fermenters?
|
1) Klebsiella
2) E. coli 3) enterobacter |
|
|
Lactose fermenting rods can further be divided based on how quickly they ferment. What are some slow fermenters?
|
1) citrobacter
2) serratia |
|
|
Does N gonorrhea have capsule? ferment lactose? available vaccine? Compare to N meningitidis?
|
N gonorrhea:
1) no capsule 2) no maltose fermentation 3) no vaccine N meningitidis: 1) polysaccarhide capsule 2) maltose fermenter 3) vaccine |
|
|
What does N gonorrheae cause?
|
1) gonorrhea
2) spetic arthritis 3) neonatal conjunctivitis 4) PID 5) Fitz-hugh-curtis syndrome |
|
|
What does N meningitidis cause?
|
1) meningococcemia
2) meningitis 3) waterhouse-friderichsen syndrome |
|
|
What does H influenzae cause?
|
1) epiglottitis (cherry red)
2) meningitis 3) otitis media 4) pneumonia |
|
|
Which H inluenzae is most invasive? Waht does it produce?
|
1) type B capsule (Hib)
2) produces IgA protease |
|
|
How is meningitis caused by H influenzae treated? What drug is used for prophylaxis?
|
1) ceftriaxone
2) rifampin |
|
|
What is Hib vaccine conjugated to? why? What age is it first given?
|
1) diptheria toxin
2) increases immune response and Ig class switching 3) 2-18 months old |
|
|
How is Legionares disease characterized? How does it compare to pontiac fever?
|
legionnaires:
1) severe pneumonia 2) fever Pontiacs: 1) mild flulike syndrome |
|
|
What are features of L pneumophila? What stain is used? What media is needed?
|
1) gram- rod
2) gram stains poorly (use silver stain) 3) charcoal yeast extract with iron and cysteine |
|
|
How is L pneumophilia detected? transmitted? treated?
|
1) antigen in urine
2) areosol from water environment 3) erythromycin |
|
|
What is P aeruginosa infection associated with?
|
1) pneumonia (CF patients)
2) sepsis (black skin lesions) 3) external otitis media (swimmers ear) 4) UTI 5) Drug use 6) Diabetic osteomyelitis |
|
|
What does P aeruginosa cause in diabetics?
|
1) malignant otitis externa
2) osteomyelitis |
|
|
What causes swimmers ear? What does this same organism do in CF patients?
|
1) P aeurginosa
2) pneumonia |
|
|
What are features of P aeruginosa?
|
1) aerobic
2) gram- rod 3) non-lactose fermenting 4) oxidase positive 5) produces blue-green pigment 6) GRAPLIKE odor |
|
|
Does P aeruginosa produce an endo or exotoxin? How is it treated?
|
1) endoxin
2) aminoglycoside + extended spectrum penicillin (piperacillin or ticarcillin) |
|
|
Which bacteria are found in the enterobacteriaeceae group?
|
1) E. coli
2) Salmonella 3) Shigella 4) klebsiella 5) enterobacter 6) serratia 7) proteus |
|
|
What do all species of enterobacteriaceae have in common?
|
1) somatic (O) antigen = polysaccharide of endotoxin
2) capsular (K) antigen = virulence 3) all ferment glucose 4) oxidase negative 5) SOME have flagellar (H) antigen |
|
|
Aside from GI problems what can E. coli cause?
|
1) cystitis
2) pyelonephritis 3) pneumonia 4) neonatal meningitis 5) septic shock |
|
|
What is the virulence factor of enteroinvasive E coli (EIEC)? What does it produce? What is pathogenic process?
|
1) shiga-like toxin
2) dysentary 3) invades and toxin causes necrosis and inflammation |
|
|
What is the virulence factor of enterohemorrhagic E coli (EHEC)? What does it cause?
|
1) shiga-like toxin
2) dysentary 3) toxin alone causes necorsis and inflammation |
|
|
What is the toxin in travelers diarrhea caused by E coli?
|
labile toxin/stable toxin
|
|
|
How does E coli induce diarrhea usually in children without a virulence factor?
|
1) adheres to apical surface
2) flattens villi 3) prevents absorption |
|
|
The enterohemorrhagic type of E coli can cause hemolytic uremic syndrome which is characterized how?
|
Triad:
1) anemia 2) thrombocytopenia 3) acute renal failure Note- endothelium swells, narrows lumen, causes hemolysis and platelet consumption |
|
|
Who does Klebsiella infect?
|
1) alcholics
2) diabetics 3) nosicomial UTIs |
|
|
What are signs of klebsiella?
|
1) red currant jelly sputum
2) lung abcess |
|
|
What features do Salmonella and Shigella have in common?
|
1) non-lactose fermenters
2) both invade intestinal mucosa 3) both cause bloody diarrhea |
|
|
What features differentiate salmonella from shigella?
|
Salmonella:
1) flagella (H) antigen 2) spreads hematogenously 3) produces H2S |
|
|
Is salmonella or shigella more virulent?
|
1) shigella (10^1 organisms)
2) salmonella (10^5 organisms) |
|
|
What does Salmonella typhi cause? How is the disease characterized?
|
Typhoid fever
1) fever 2) diarrhea 3) headache 4) ROSE SPOTS on abdomen 5) Can REMAIN in gallbladder chronically |
|
|
All salmonella species have an animal reservoir except? Does shigella have a flagella?
|
1) S typhi
2) no flagella 3) propel via host cell actin polymerization |
|
|
How is yersinia enerocolitica transmitted? where are outbreaks common?
|
1) pet feces
2) contaminated milk 3) pork 4) outbreaks in Day Care centers |
|
|
What can yersinia enterocolitica mimic and in who?
|
1) Chron's
2) appendicitis 3) in adolescents |
|
|
Where does H pylori cause ulcers? What else does it cause? What are people at risk for?
|
1) 90% of all ulcers in duodenum
2) gastritis 3) predisposes to adenocarcinoma of stomach and lymphoma |
|
|
What are some characteristics of H pylori?
|
1) gram- rod
2) urease positive 3) creates alkaline environment |
|
|
What unusual test can be done to check for H pylori? What is cheap way of treating? More expensive?
|
1) urease breath test
2) Cheap: metronidazol, bismuth, and tetracycline or amoxicllin 3) Expensive: metronidazole, omeprazole, clarithromycin |
|
|
Which of the 3 spirochetes can be visualized? How are they seen?
|
1) Borrelia and Treponema
2) borrelia = aniline dyes, Wrights or Giemsa 3) Treponema = dark-field microscopy (NOT stained) |
|
|
Which bacteria is question mark-shape? How is it acquired? Where is it prevalent?
|
1) leptospira interrogans
2) water contaminated with animal urine 3) tropics |
|
|
How does leptospirosis present clinically?
|
1) flulike symptoms
2) fever 3) headache 4) abdominal pain 5) jaundice 6) PHOTOPHOBIA 7) conjunctivitis |
|
|
What is another name for Weil's disease? How does it present?
|
1) icterohemorrhagic leptospirosis
Symptoms: 2) sever jaundice and azotemia from liver damage and kidney dysfunction 3) fever 4) hemorrhage 5) anemia |
|
|
What causes lyme disease? what is vector? what other organism can this vector transmit?
|
1) B burgdoferi
2) ixodes tick 3) Babesia |
|
|
What are important reservoirs for B burgdoferi? What host is required for its life cycle?
|
1) mice
2) ixodes tick |
|
|
How is lyme disease treated? Where is it prevalent?
|
1) doxycycline, ceftriaxone
2) named after lyme Connecticut, disease is common in NE US |
|
|
How are the 3 stages of lyme disease characterized?
|
1) Stage 1 = erythema chronicum migrans (bulls eye red rash with central clearing)
2) Stage 2 = neurologic (Bells palsy) and cardiac (AV nodal block) 3) Stage 3 = chronic monoarthritis and migratory polyarthritis |
|
|
What Treponema pertenue cause? What tissues are effected? How does it heal?
|
1) Yaws
2) infection of skin and bone and joints 3) heals with keloids causing limb deformities |
|
|
Where does Treponema pertenue occur geographically? Is it an STD? What test will be positive?
|
1) tropics
2) NOT and STD 3) VDRL will be positive |
|
|
How is primary syphilis characterized? How is syphilis treated?
|
1) painless chancre
2) Penicillin G |
|
|
How does secondary syphilis present?
|
1) disseminated disease with constitutional symptoms
2) maculopapular rash on palms and soles 3) chonylomata lata |
|
|
Where can treponemes be obtained from in an infected person?
|
1) primary chancres
2) secondary chonylomata lata |
|
|
What are pathologic findings in tertiary syphilis characterized?
|
1) gummas (chronic granulomas)
2) aortitis (vasa vasorum destruction) 3) tabes dorsalis (neurosyphilis) 4) argyll robertson pupil |
|
|
What are signs of tertiary syphilis?
|
1) broad-based ataxia
2) positive romberg 3) Charcot joints 4) stroke without HTN 5) argyll robertson pupil |
|
|
What are deficits in congenital syphilis?
|
1) saber shins
2) saddle nose 3) CN VIII deafness 4) Hutchinsons teeth 5) mulberry molars |
|
|
describe argyll robertson pupil? What stage of syphilis is it associated with?
|
1) constricts with accomodation
2) unreactive to light 3) tertiary syphilis |
|
|
Why is FTA-ABS better than VDRL?
|
1) most specific
2) positive earliest 3) remains positive longer |
|
|
Does VRDL or FTA detect active infection? What does it mean if VDRL is positive but FTA is negative? What about negative VDRL and positive FTA?
|
1) active infection
2) probably false positive 3) successfully treated |
|
|
VDRL is a nonspecific antibody that reacts with what? What conditions produce false positive?
|
1) reacts with beef cardiolipin
False +: 1) mono 2) hepatitis 3) some drugs 4) rheumatic fever 5) SLE 6) leprosy |
|
|
What causes cat-scratch fever? What results? What is it confused with?
|
1) bartonella
2) bacillary angiomatosis in immunocompromised 3) confused with Karposi sarcoma |
|
|
What does brucella cause? where is found?
|
1) brucellosis has undulant fever
2) dairy products, animal contact |
|
|
Francisella tularensis is transmitted how? What is reservoir? What is disease?
|
1) tick bite
2) rabbits 3) deer 4) tularemia |
|
|
What is vector for Y pestis? What is reservoir? What is disease?
|
1) flea bite
2) rodents, prairie dogs |
|
|
What does pasturella multocida cause? Hos is it transmitted? What is reservoir?
|
1) cellulitis
2) animal bite 3) cats and dogs |
|
|
How is gardnerella vaginalis characterized? how is vaginosis characterized? is it painful?
|
1) pleomorphic rod that is gram variable
2) gray vaginal discharge 3) fishy order 4) painless |
|
|
What organism is commonly seen with G vaginalis infection? How is vaginosis treated?
|
1) mobiluncus an anaerobe
2) metronidazole |
|
|
What activity is associated with Gardnerella infection? What cell type is seen? How does it appear undermicroscope?
|
1) sex but it is not an STD
2) clue cells are vaginal epithelial cells covered with bacteria |
|
|
What is the classic triad for ricketsial infections? Which species is exception? How is transmitted and what does it cause:?
|
1) headache
2) fever 3) rash (vasculitis) 4) Coxiella areosolized to cause pneumonia |
|
|
What are rickettsiae dependent on? Which species is not transmitted via a vector?
|
1) intracellular bacteria dependent on CoA and NAD+ from host
2) coxiella |
|
|
how are all rickettsial species treated? where does the rickettsia rickettsii rash begin? Where does R. typhi rash begin?
|
1) tetracycline
2) begins on hands and feet 3) centrally and spreads outward never involving palms or soles |
|
|
Rocky mountain spotted fever is caused by? Endemic typhus is caused by? Epidemic typhus is caused by? How is each transmitted?
|
1) R rickettsii (tick)
2) R typhi (fleas) 3) R prowazekii (human body louse) |
|
|
What are the ricketsial species?
|
1) R rickettsia (tick)
2) R typhi (flea) 3) R prowazekii (human body louse) 4) Ehrlichia (tick) 5) Coxiella burnetii (Q fever) |
|
|
Where is R ricketsii endemic? What are symptoms?
|
1) rash on palms and soles that migrate to wrist and ankles
2) headache 3) fever 4) US east coast |
|
|
Which organisms cause palm and sole rash?
|
1) Coxsackievirus A (hand, foot and mouth disease)
2) R ricketsii 3) syphilis |
|
|
What is the Weil-Felix reaction used for? How does it work? Which species gives false negative results?
|
1) used for ricketsial species
2) patients serum mixed with proteus antigens and anti-ricketsial antibodies cross-react and agglutinate 3) coxiella is negative |
|
|
Is chlamydiae obligate or faculatative intracellular? What are the 2 forms and function of each? How do they replicate?
|
1) obligate because they can't make own ATP
Forms: 1) elementary bodies are released and infect via endocytosis 2) reticulate bodies replicate in cell by fission |
|
|
What does C trachomatis cause in general?
|
1) reactive arthritis
2) conjunctivitis 3) nongonoccocal urethritis 4) PID |
|
|
Which species of chlamydia cause atypical pneumoniae? How are they treated?
|
1) C pneumoniae and C psittaci
2) erythromycin or tetracycline |
|
|
What is the reservoir for C psittaci? Why is Chlamydia unusual for a bacteria? how the diagnosis of chlamydia made under microscope?
|
1) avain
2) cell wall lacks muramic acid 3) cytoplasmic inclusions seen on Giemsa or flourescent antibody stained smear |
|
|
What do C trachomatis types A, B, C cause? what country?
|
1) chronic infection causing blindness
2) africa |
|
|
C trachomatis types D-K cause what?
|
1) urethritis/PID
2) ectopic pregnancy 3) neonatal pneumonia 4) neonatal conjunctivitis |
|
|
C trachomatis tyeps L1, L2, L3 cause what? Test is positive? How is neonatal chlamydia treated?
|
1) lymphogranuloma venereum
2) acute lymphadenitis - positive Frei Test 3) oral erythromycin |
|
|
What can lymphogranuloma venereum be confused with? what causes the disease?
|
1) lymphogranuloma venereum = C trachomatis L1, L2, L3
2) granuloma inguinale (donovanosis) = Calymmatobacterium granulomatis |
|
|
How does classic atypical pneumonia present? What is cause?
|
1) insidious onset
2) headache 3) nonproductive cough 4) mycoplasma pneumoniae |
|
|
What is seen on x-ray in someone with mycoplasma pneumoniae? What media is it grown on? What specific blood test is used?
|
1) diffuse interstitial infiltrates
2) x-rays look worse than patients 3) eatons agar 4) cold agglutinins (IgM) can lyse RBCs |
|
|
How is mycoplasma pneumoniae treated? How is it different from other bacteria? What age group is usually infected? Where do outbreaks occur?
|
1) tetracycline or erythromycin
Note: penicillins won't work 2) cholesterol membrane 3) people <30 4) military bases and prisons |
|
|
Which two fungi are transmitted by inhaling asexual spores?
|
1) coccidioidomycosis
2) histoplasmosis |
|
|
What are conidia? Which 2 fungi use this mode?
|
1) asexual fungal spores
2) blastoconidia 3) arthroconidia |
|
|
where is histoplasmosis found in US? what does it cause? What is it found in?
|
1) Missippi and ohio river valleys
2) causes pneumonia 3) bird and bat droppings |
|
|
How does histoplasmosis compare to RBC size? What cell do they live in?
|
1) smaller than RBC
2) live in macrophages |
|
|
Where is blastomycosis found? what does it cause? Where does it disseminate? What structures does it form in tissues?
|
1) South east of mississippi river and central america
2) causes inflammatory lung disease and can disseminate to skin and bone 3) forms granulomatous nodules |
|
|
How does blastomycosis bud? Are they bigger or smaller than an RBC?
|
1) broad based budding
2) same size as RBC |
|
|
Where is Coccidioidomycosis found? What does it cause? Where can it disseminate? What environmental conditions increase transmission?
|
1) SW US, california, San Joaquin Valley or desert
2) pneumonia and meningitis 3) spreads to bone and skin 4) earthquakes increase rates when spherules are aerosolized |
|
|
A spherule that is filled with endospores indicates what? Is it larger or smaller than an RBC?
|
1) coccioidomycosis
2) larger than RBC |
|
|
Where is paracoccidiomycosis found? What are characteristic features?
|
1) budding yeast with captains wheel formation
2) much larger than RBC 3) Found in Latin America |
|
|
What are examples of dimorphic fungi? what does it mean to be dimorphic?
|
1) histoplasmosis
2) blastomycosis 3) coccidioidomycosis 4) paracoccidioidomycosis 5) mold in cool temp and yeast in heat (in body) a. coccidioidomycosis is exception = spherule (not yeast) in body |
|
|
How are all systemic mycoses treated locally? Systemically? What can systemic mycoses mimic?
|
1) fluconazole or ketoconazole locally
2) amphotericin B systemically 3) TB because of granuloma formation |
|
|
Tinea versicolor is caused by what? What is pathogenesis? What areas does it occur in?
|
1) malassezia furfur
2) degradation of lipids produces acids that damage melanocytes and cause hypopigmented patches 3) hot humid climates |
|
|
How is tinea versicolor treated? What is seen on KOH prep?
|
1) topical miconazole
2) selenium sulfide (selsun) 3) spaghetti and meatball appearance |
|
|
Tinea pedis, cruris, corporis, and capitis are caused by? How does lesion present?
|
1) dermatophytes (microsporum, trichophyton, epidermatophyton)
2) pruritic lesions with central clearing resembling a ring |
|
|
Are dermatophytes dimorphic yeast? What is a reservoir for microsporium? How are they treated?
|
1) no
2) pets 3) dermatophytes treated with topical azoles |
|
|
Candida can cause systemic or superficial fungal infections. How does the yeast appear at 20C and at 37C? which is diagnostic form
|
1) 20C = pseudohyphae
2) 37C = germ tube formation (diagnostic) |
|
|
Who does candida affect and what does it cause?
|
1) oral and esophageal thrush in immunocompromised
2) vulvovaginitis in normal pH, diabetes and with antibiotc 3) diaper rash 4) endocarditis in IV drug users 5) disseminated candidiasis (to any organ) 6) chronic mucocutaneous candidiasis |
|
|
How is superficial candida treated? How is it treated systemically?
|
1) nystatin
2) amphotericin B |
|
|
What does aspergillus fumigatus cause? who does it infect?
|
1) allergic bronchopulmonary aspergillosis
2) lung cavity aspergilloma (fungus ball) 3) invasive aspergillosis 4) mostly in immunocompromised and people with chronic granulomatous disease |
|
|
How is aspergillus fumigatus seen under microscope? Is it dimorphic?
|
1) mold with septate hyphae that branch at acute angle (<45)
2) Not dimorphic |
|
|
What does cryptococcus neoformans cause? does it have capsule?
|
1) meningitis
2) cryptococcosis 3) heavily capsulated |
|
|
Where is crytpococcus found in environment? How is it cultured? What is it stained with?
|
1) found in soil, pigeon droppings
2) culture on Sabourards agar 3) stains with india ink |
|
|
How is cryptococcus detected? what type of lesion appears in brain?
|
1) latex agglutination detects polysaccharide capsular antigen
2) soap bubble appearance in brain |
|
|
What do mucor and rhizopus cause? How do they appear under microscope? Who does it occur in?
|
1) mucormycosis
2) mold with irregular nonseptate hyphae branching at wide angles 3) ketoacidotic diabetics and leukemic patients |
|
|
Where in body does mucor infect and proliferate? how do they effect CNS?
|
1) proliferate in walls of blood vessels
2) cause infarction and necrosis of distal tissue 3) rhinocerebral and frontal lobe abcesses |
|
|
A yest is grown at 20C and shows pseudohyphae and budding yeasts. What is it?
|
candida
|
|
|
A yeast is grown at 37C and germ tubes are seen. What is it?
|
candida
|
|
|
A yeast is seen in under microscope and shows fruiting body with acute angle septate hyphae. What is it?
|
apergillus
|
|
|
A yeast is seen under microscope and shows wide capsular halo with narrow based unequal budding. What is it?
|
1) crytococcus
|
|
|
How is pneumocystis jiroveci seen on chest xray? How is it diagnosed? What stain identifies it?
|
1) diffuse b/l interstitial pneumonia
2) diagnose with lung biopsy or lavage 3) stain with methenamine silver stain |
|
|
What are symptoms of p. jiroveci in a healthy person? When should prophylaxis be given to someone that is immunocompromised? How is it treated?
|
1) asymptomatic usually in heatlhy
2) <200 cells/mL in HIV patients 3) a. TMP-SMX b. pentamidine c. dapsone |
|
|
where is sporothrix schenkii found? Is it mono or dimorphic? What are other cell features?
|
1) grows on vegetation
2) dimorphic cigar shaped yeast with unequal budding |
|
|
How is rose gardners disease treated? what causes it? Is it a systemic disease? What are local findings?
|
1) itraconazole or potassium iodide
2) sporthrix schenkii is introduced via trauma 3) it has little systemic effect 4) causes local pustule or ulcer with nodules along draining lymphatics (ascending lymphangitis) |
|
|
What are features of giardiasis?
|
1) bloating
2) flatulence 3) foul-smelling fatty diarrhea 4) seen in campers and day care |
|
|
What is infective form of giardia lamblia? How is it diagnosed and treated?
|
1) cysts in water
2) trophozoites or cysts in stool 3) metronidazole |
|
|
what are features of amebiasis? What color are liver abscesses? What does histology show in colon?
|
1) bloody diarrhea (dysentery)
2) liver abscess (reddish brown) 3) RUQ pain 4) histology = flask-shaped ulcers if submucosal abcess of colon ruptures |
|
|
How is entamoeba hystolytica transmitted? What are features of cysts? How is it diagnosed and treated?
|
1) cysts in water
2) cysts have 4 nuclei 3) a. serology and/or trophozoites or cysts in stool. b. also look for RBCs in cytoplasm of entamoeba 4) metronidazole and iodoquinol |
|
|
How does cryptosporidium parvum affect both AIDs and healthy people? How is it transmitted, diagnosed and treated?
|
1) AIDS= severe diarrhea
2) healthy = mild watery diarrhea 3) transmitted by cysts in water 4) cysts with acid-fast stain 5) treatment is prevention |
|
|
How T gondii affect CNS? What is the toxo congenital triad?
|
1) ring-enhancing brain lesions
2) triad: a. chorioretinitis b. hydrocephalus c. intracranial calcifications |
|
|
how is toxplasmosis gondii transmitted? What should pregnant women avoid? How is it treated?
|
1) cysts in meat and cat feces
2) pregnant women should avoid cats 3) sulfadiazine and pyrimethamine |
|
|
What protozoa causes a rapidly fatal meningoencephalitis after swimmin in freshwater lakes? How does organsim enter CNS? How is it diagnosed and treated?
|
1) Naegleria fowleri
2) enters via cribiform plate 3) amoebas in spinal fluid 4) no treatment |
