Fa - Micro Part 4

Front 1

ENDOTOXIN:

Back 1

Edema

N.O.

DIC

Outer memb.

TNF-a

O-antigen

Xtremely heat-stable (cGMP)

IL-1

N' chemotaxis

Front 2

GN's structure:

Back 2

Outer memb.

Peptide wall

Periplasm

Cytoplasmic (Inner) Memb

Front 3

3 features of C. diphtheria and its toxin:

Back 3

1. colonizes respiratory tract

2. AB toxin in granules within Corynebact.

3. developing countries

Front 4

3 complications of diphtheria:

Back 4

1. suffocation

2. myocarditis/HF

3. neuro toxicity

Front 5

unlike that of Clostridium, every other toxin:

Back 5

B subunit binds,

while A is the active part

Front 6

immunization against diphtheria is achieved by:

Back 6

IgG against the B subunit,

preventing attachment and thus maleffect

Front 7

difference b/w passive and active immunization:

Back 7

passive immunization = antitoxin/antidote,

active immunization = vaccine against future inf's/toxins

Front 8

the first step of viral inf. =

Back 8

attachment

- need glycoproteins to attach, then fuse

Front 9

Enteroviruses = RNA viruses of the GI tract that:

Back 9

commonly cause meningitis in children

(PERC)

Front 10

4 enteroviruses:

Back 10

1. polio

2. echo

3. rhino

4. coxsackie

(all (picornoviruses)

Front 11

try to eliminate certain bugs from the answer choices based on the part of the world the pt is coming from;

Back 11

e.g. if from America, probably vaccinated against MMR, diphtheria, etc.

Front 12

biofilm =

Back 12

extracellular polysaccharide matrix

Front 13

one bug notable for biofilm production =

Back 13

S. epidermis

- think catheters, tubes

Front 14

Adenovirus inf. ~~

Back 14

close quarters and fatigue/stress

- barracks, college dorm, summer camp

Front 15

2 classes of virus with segmented genomes:

Back 15

Orthomyxovirus, Rotavirus

~~ genetic shifts via reassortment

Front 16

remember that Clostridium botulim lives:

Back 16

in the ground

Front 17

hypervariable pili are characteristic of the:

Back 17

diplococci

(both)

- makes vaccines against pili impractical - too much antigenic variation

Front 18

Protein A is an outer memb. prot. that binds:

Back 18

the Fc portions of IgG,

thereby preventing phag.

- **expressed by Staph aureus**

Front 19

m.c.c. of catheter inf. =

Back 19

unwashed hands

Front 20

what does rabies virus bind to?

Back 20

Nicotinic ACH r's

- then travels retrograde to the CNS

Front 21

pts with CGD/NADPH oxidase deficiency are susceptible to inf. with:

Back 21

catalase+ org's (PLACENSS)

Front 22

dysphagia, drooling with microbe, think:

Back 22

epiglottitis,

=> H. influ

(~~ lack of vaccination against it)

- epiglottitis is exclusively caused by H. influ.

Front 23

remember that antimicrobials against malaria end in:

Back 23

"-quines"

- Primaquine, Mefloquine

Front 24

"walking pneumonia" ~~

Back 24

severe pneumonia on CXR, despite looking ok

~~ Mycoplasma pneumonia

Front 25

T. pallidum must be viewed with:

Back 25

darkfield microscopy

Front 26

H. influ type b vaccine is composed of:

Back 26

polyribosyl-RP, a component of its capsule

=> life-long immunity against Hib

Front 27

what does Chagas dz do?

Back 27

destroys myenteric plexi in esophagus, intestines, ureters

=> dysphagia, megacolon, megaureter

- caused by Trypanosoma cruzi

Front 28

Isospora belli causes:

Back 28

profuse watery diarrhea in imm-comp,

esp. AIDS

Front 29

tie-in b/w Micro and peripheral neuropathy:

Back 29

Campylobacter jejuni ppt's Guillain-Barre syndrome

Front 30

m.c.c. of opportunistic mycosis =

Back 30

Candida albicans

Front 31

"germ tubes" =

Back 31

true hyphae coming out of circular yeast, under microscope

~~ Candida albicans

Front 32

apart from mycosis/blood, Candida can show up in:

(3)

Back 32

1. oral thrush

2. vulvovaginal inf.
(thick white DC)

3. cutaneous
(e.g. diaper rash)

Front 33

remember that apart from mucopurulent DC, N. gonorrhea can cause:

Back 33

polyarthritis, if disseminated

- m.c.ly in young adults

Front 34

m.c.c. of septic arthritis in children and non-sexually-active adults =

Back 34

S. aureus

Front 35

Waterhouse-Freidrichson syndrome =

Back 35

DIC and bilateral, hemorrhagic destruction of adrenal glands,

due to sepsis from N. meningitidis

Front 36

Enterococci are colonic bact. that are frequently found near the:

Back 36

perineum and genital skin

=> can infect urethra with them via cystoscopy (seeing inside urethra/bladder)

Front 37

the m.c.c. of E. coli bacteremia is from:

Back 37

UTI

- colonic sepsis is infrequent; only bowel perforation could do it

Front 38

positive monospot test =

Back 38

red cells agglutinated in vitro by **heterophil AB's**

Front 39

cryoglobulins =

Back 39

cold-pp'd serum prots associated with Hep C

Front 40

m.c.c. of UTI in pt with cather =

Back 40

Pseudomonas aeruginosa

Front 41

barking cough or stridor in child (croup), think:

Back 41

parainfluenza virus

Front 42

wheezing inf. in child, think:

Back 42

RSV

Front 43

remember that N. meningitidis can cause:

Back 43

upper respiratory tract inf.

- spread is promoted through barracks, etc. like Adenovirus

Front 44

5 bugs that cause CGD:

Back 44

1. S. aureus

2. Pseudomonas cepacia

3. Serratia marcescens

4. Nocardia

5. Aspergillus

Front 45

remember that with a lack of NADPH oxidase, cells use:

Back 45

MPO

- catalase+ org's readily destroy H2O2, so MPO can't convert it to HOCl and is thereby ineffective

=> bugs have free rein over cells

Front 46

frothy, yellow-green DC w/ motile org's having a flagella =

Back 46

Trichomonas vaginalis

- sting-ray

Front 47

croup is most likely caused by parainfluenza virus, but also consider:

Back 47

diphtheria if un-vaccinated,

influenza virus,

measles,

RSV

Front 48

most antibiotics courses last:

Back 48

5-7 days

- except for TB, which is months, and UTI's, which req. only one dose

Front 49

giving antibiotics to Salmonella =>

Back 49

prolong excretion

Front 50

Giardia = trophozoite that infects:

Back 50

the SI

- IgA prevents adherence

(pear-shaped)

Front 51

hemagglutinin, e.g. of influenza virus, binds:

Back 51

sialic acid of host cell plasma membranes

Front 52

remember that a vaccine against N. gonorrhea is untenable b/c of:

Back 52

high antigenic variation of their membrane prot's

- there is NO lasting immunity, even naturally

Front 53

5 effects of IL-2:

Back 53

1. activates monocytes

2. activates NK's

3. CD4+ differentiation

4. Th1 IFN-y secretion

5. stimulation of B-cell division

Front 54

Misoprostol =

Back 54

PGE1 analogue

- uterine contraction, cervical dilation

Front 55

Mifepristone =

Back 55

anti-PROG

Front 56

tx for Chlamydia =

Back 56

Z-pak OR Doxycycline

Front 57

***primary mech. by which OCP's inhibit pregnancy is by:

Back 57

suppressing LH and FSH synth in the ant. pit.

=> lack of LH surge

=> lack of ovulation

Front 58

a positive VDRL in the CSF is diagnostic of:

Back 58

TERTIARY syphilis

Front 59

gummas =

Back 59

granulomas occurring almost anywhere,

via tertiary syphilis

Front 60

O and A of endotoxin:

Back 60

O-antigen = antigen part

Lipid A = part that causes shock, etc.

Front 61

mechanism of different toxins:

Back 61

diphtheria and exotoxin A of Pseudomonas inhibit EF-2 via ADP-ribosylation => prevent prot. synthesis => cell death

Shiga and Shiga-like toxin cleave rRNA 60S subunit of ribosomes => block prot. synthesis => cell death

cholera toxin permanently activates Gs (via AD-r) => Cl- secretion into gut

pertussis toxin disables Gi => inc. cAMP => impairs phagocytosis, inc. HIST sensitivity

alpha toxin/lecithinase of C. perfringens => degradation of memb => cell death/gas gangrene

anthrax => inc. cAMP

Streptolysin O => lysis of RBC's

Front 62

Which toxins are ADP-ribosylating A-B toxins?

(recall: A- active part, B- binding part)

(5)

Back 62

Diphtheria toxin,

Pseudomonas (exotoxin A),

ETEC LT,

Cholera toxin,

Pertussis toxin

Front 63

3 features of Viridans streptococci (mutans, sangui):

Back 63

1. responsible for dental caries

2. can attach to pre-existing valve defect following dental procedure

3. form dextrans out of glucose

Front 64

erythema nodosum is extremely:

Back 64

non-specific

Front 65

ss(+) viruses with can make:

Back 65

one big protein, then use protease to make the active parts

- think retro hippy toga etc. mnemonic

Front 66

acute bronchitis is almost always:

Back 66

VIRAL in etiology

Front 67

remember that the NONtypable (non-vaccinable) H. influ is the one that causes:

Back 67

OM

- Epiglottitis and Meningitis are caused by H. influ. type B

Front 68

"pleocytosis" =

Back 68

increased cell count

- esp. in CSF - meningitis

Front 69

Cryptococcus has a:

Back 69

polysaccharide capsule

- that's how it can cause meningitis in HIV+

Front 70

latex agglutination test detects:

Back 70

polysaccharide capsule of Cryptococcus

Front 71

India ink staining of Cryptococcus shows:

Back 71

round or oval BUDDING yeast

- soil or pigeon droppings

Front 72

"hot tub folliculitis" =

Back 72

self-limiting Pseudomonas inf. obtained from poorly-kept pools/hot tubs

=> diffuse pustules

Front 73

TSS has been associated with the use of:

Back 73

tampons

- fever, vomiting, diarrhea, muscle pain, and erythroderma ~~ TSS

Front 74

hallmark of superantigens =

Back 74

widespread activation of a LARGE number of T-cells

(nl antigens activate only a small amount)

Front 75

3 superantigens:

Back 75

1. enterotoxins
(e.g. GAS, S. aureus)

2. TSST-1
(S. aureus)

3. Exfoliative Toxin

Front 76

mech. of superantigens:

Back 76

bind MHC of mP's and TCR's of T-cells

=> TNF-a from mP's, IL-2 from T-cells

=> widespread immune cascade

Front 77

tetanus toxin (undesired muscle contractions) ~~

Back 77

entering at the wound, making its way to the SC

Front 78

Polymyxin is used against:

Back 78

GN's

Front 79

any UTI that leads to dysuria and hematuria = hemorrhagic cystitis; m.c. viral cause of hemorrhagic cystitis outbreaks in children =

Back 79

Adenovirus

Front 80

5 features of scarlet fever:

Back 80

1. strawberry tongue

2. fever

3. pharyngitis

4. sandpaper-like rash on chest and trunk

5. throat possibly covered with gray-white exudate (don't confuse with diphtheria)

Front 81

scarlet fever [via GAS] predisposes to:

(2)

Back 81

1. rheumatic fever

2. PSGN

Front 82

features of typhus:

(5)

Back 82

1. escalating fever

2. initial watery diarrhea that *becomes bloody*

3. followed by HSM

4. "rose spots" on abdomen

5. pot. bowel perforation (very inflammatory)

Front 83

remember that C. perfringens' alpha-toxin/lecithinase is a:

Back 83

phospholipid degrader

Front 84

to prevent GBS sepsis or transfer to neonate, mom is given:

Back 84

pen. or ampicillin INTRA-labor

- screened at 35-37 weeks

Front 85

measles = rubeola =

Back 85

CCCK

(cough, coryza, conjunctivitis, Koplik spots)

*these PREcede the diffuse rash [that starts on the face and works to trunk/E's]*

Front 86

diffuse non-Hodge lymphomas in HIV pts are the result of:

Back 86

REactivation of EBV

Front 87

not only are MRSA and VRE a problem, but:

Back 87

S. epidermis is also becoming R
(as are all Staph)

- treat empirically/prophylactically with VANCOMYCIN

Front 88

compared to measles, the rash of rubella does NOT:

Back 88

darken or coalesce

Front 89

**main differentiation b/w rubella and measles = **

Back 89

Cervical LAD in rubella

Front 90

ether and other organic solvents inactivate:

Back 90

viral envelopes

(cus they're made of lipids)

Front 91

rubella family =

Back 91

Togavirus

(includes equine encephalitis - both types)

Front 92

3 dz's caused by Bartonella henselae:

Back 92

1. cat-scratch dz
(self-limited)

2. bacillary angiomatosis
(HIV)

3. culture-negative endocarditis

Front 93

***3 features of congenital HIV:

Back 93

1. oral thrush

2. interstitial pneumonia

3. severe lymphopenia

- prophylactic = Zidovudine

Front 94

Nikolsky's sign =

Back 94

easy sloughing of skin with gentle pressure

(~~ SSSS)

Front 95

all neutropenic pts, as per leukemias and lymphomas, ~~

Back 95

invasive aspergillosis

Front 96

botulinum toxin can be preformed, as in canned foods, or:

Back 96

synthesized within a wound

- honey ~~ bot. SPORE

Front 97

"slow virus inf" ~~

Back 97

prolonged incubation

Front 98

HSV-1 ALSO shows:

Back 98

Cervical LAD

- like rubella

=> look for mouth ulcers/vesicles

Front 99

C. perfringens not only causes gas gangrene, but also:

Back 99

LATE-onset food poisoning (vs, SA, B. cereus)

=> *transient* watery diarrhea

Front 100

remember that ss(+) RNA is essentially:

Back 100

mRNA

- naked, ss(+) RNA viruses can immediately infect

- retro, toga, etc. + NAKED
- Rotavirus is dsRNA, not ss

Front 101

pityriasis versicolor = white patches when sunlight hits; caused by:

Back 101

Malassezia furfur

=> spaghetti and meatballs on KOH (like other dermatophytes, Candida)

Front 102

+ monospot test =

Back 102

AGGLUTINATION of sheep RBC's via heterophil AB's

Front 103

symps of mononucleosis:

(3)

Back 103

1. fever

2. myalgias

3. progressive fatigue

NO sore throat

Front 104

"tumbling motility" ~~

Back 104

Listeria

- via contaminated food/dairy in adults,
- vaginal tract or trans-placentally in neonates

- meningitis in neonates and imm-comp