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244 Cards in this Set

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What is the main gram negative cocci?
Neisseria
Name the seven major gram positive bac
Circular- staph, strep

Rods- clostridium, corynebacterium, bacillus, listeria and mycobacterium(acid fast)
Name the two branching filamentous gram positives
Actinomyces, nocardia
what are the three major gram neg spirochetes?
Treponema, leptospira, borrelia
Which bac have membranes with high lipid content and mycolic acid?
Mycobacteria
What is the special stain for legionella?
Silver stain
Which stain is used for tropheryma whippelii
PAS
Which stain is used for acid fast organisms?
Ziehl-Neelsen
What special stain is used for cryptococcus neoformans?
India ink
Which bac is grown on eosin methylene blue agar as blue black colonies?
E. coli
Which organism is cultured on a charcoal yeast agar?
Legionella
Which orgsnisms form pink ocolonies on macConkey's agar?
Lactose fermenting enterics
What are the main obligate anaerobes?
"Nagging Pests Must Breathe"

Nocardia, Pseudomonas aeruginosa, Mycobacterium tuberculosis and Bacillus
What are the three main obligste anaerobes?
"Cant Breath Air"

Clostridium, Bacteroides, Actinomyces
What are the two main intracellular bugs?
Rickettsia, Chlamydia
What are the eight main facultative anaerobes?
"Some Nasty Bugs May Live FacultativeLY"

Salmonella, Neisseria, Brucella, Mycobacterium, Listeria, Francisella, Legionella, Yersinia pestis
What are the six main examples of encapsulated bac?
SHiN SKiS

Strep. pneumo, H. influenzae, Neisseria meningitidis, Salmonella, Klebsiella pneumoniae, grp B Strep
What are the five major catalase positive bugs?
S. aureus, Serratia, Pseudomas, Candida, E. coli
Why are conjugated vaccines superior to polysaccharide only vaccines?
Conjugated protein promotes T cell acitvation and class switching. Only IgM produced by polysaccharide vaccines
Is pneumovax conjugated?
Negatron
What are the six main urease positive bugs?
Proteus, Ureaplasma, Nocardia, Cryptococcus, H. pylori, Klebsiella
What is the function of protein A and which organism produces it?
Binds Fc region of Ig--> prevention of opsonization and phagocytosis

Produced by S. aureus
What is the function of IgA protease and which organisms produce it?
Enzyme that cleaves IgA --> colonization of respiratory mucosa

Produced by SHiN S. pneumoniae, H. Influenzae, Neisseria
Which organism produces M protein?
Grp A Strep
What is the mode of action of endotoxins?
Induces TNF and IL-1 --> fever and shock
Are endotoxins or exotoxins heat stable?
Endotoxins
Which bac produces shiga-like toxin?
EHEC (O157:H7)
What exotoxin is produced by Yersinia enterocolitica?
Heat-stable toxin (ST)
Which bac produces Exotoxin A?
Pseudomonas aeruginosa, Strep. pyogenes
Which exotoxin acts by preventing the release of GABA and glycine NTs in the spinal cord?
Tetanospasmin
Which exotoxin overactivates cGMP --> decreased resorption of NaCl in the gut --> watery diarrhea
Heat stable toxin (ETEC and Yersinia enterocolitica)
What is the MOA of shiga and shiga-like toxin?
Inactivate 60S ribosome by cleaving rRNA --> HUS
Which bac produce toxic shock syndrome toxin?
S. aureus
What exotoxin is produced by Clostridium perfringens and what is its MOA?
Alpha toxin --> degrades tissues and cell membranes --> gas gangrene
Catalase positive, coagulase positive gram positive is what organism?
S. aureus
Which organisms are catalase negative and exhibit no hemolysis?
Enterococci
Which strains of strep are resistant/sensitive to optochin?
OVRPS

Viridans is resistant pneumoniae is sensitive
Which strains of strep are bacitracin sensitive/resistant?
B-BRAS

Grp B is resistant, grp A is sensitive
Which strains of Staph are novobiocin resistant/sensitive?
Saprophyticus is sensitive, epidermidis is resistant
Name the four main beta hemolytic bacteria
Staph. aureus, Strep. pyogenes, Strep. agalactiae, Listeria monocytogenes
What are the two main alpha hemolytic bacteria?
Strep. viridans, Strep. pneumoniae
Strep pneumo is the most common etiology for what diseases?
Meningitis, Otitis media in peds, Pneumonia, Sinusitis
Which facultative intracellular anaerobe is transmitted by unpasteurized milk or birth
Listeria monocytogenes
Are ghon complexes seen in primary or secondary TB.
Primary
What is the prophylactic treatment for mycobacterium avium in AIDS pts?
Azithromycin
What is the causative organism of leprosy?
Mycobacterium leprae
What are the physical characteristics of H. influenzae?
little gram negative coccoid rods (tiny)
What are the physical characteristics of Bordetella pertussis?
little gram negative coccoid rods (tiny)
What are the two main lactose fermenting gram negative rods?
Klebsiella, E. coli
What are the 3 main gram neg, oxidase neg, lactose nonfermenters?
Shigella, Salmonella, Proteus
What are the two most important gram neg lactose fermenters?
Klebsiella and E. coli
Which type of fermentation is used to differentiate gram neg cocci? rods?
cocci --> maltose

rods --> lactose
Which gram neg cocci are maltose fermenters?
N. meningitidis = maltose fermenter

N. gonorrhoeae = maltose nonfermenter
What special culturing is done for lactose fermenters?
grow pink colonies on macconkey's agar
Which org is grown on chocolate agar and requires factors V and X?
H. influenzae
What diseases are caused by H. influenzae?
HaEMOPhilus

Epiglottitis, Meningitis, Otitis media, Pneumonia
What diseases are caused by Pseudomonas aeruginosa?
PSEUDOmonas

Pneunomonia, Sepsis, External otitis, UTI, Drug use (associated infection), Osteomyelitis (diabetic)
How is EHEC distinguished from other E. coli on culture?
EHEC does not ferment sorbitol
What are the two comma shaped, oxidase pos gram negatives?
Vibrio cholerae and Campylobacter jejuni
What is the only spirohcete visualized in light microscopy?
Borrelia
What is the disease and source of Yersinia pestis?
Flea bite --> Plague
What is the disease and source of Rickettsia typhi?
flea bite --> endemic typhus
What is the disease and source of Rickettsia rickettsii?
dermacentor tick bite --> Rocky Mountain spotted fever
What is the disease and source of Rickettsia prowazekii?
louse --> epidemic typhus
What is the disease and source of Pastuerella multocida?
animal bite --> cellulitis, osteomyelitis
What is the disease and source of Leptospira?
Animal urine --> Leptospirosis
What is the disease and source of Francisella tularensis?
ticks, rabbits, deer flies --> tularemia
What is the disease and source of Ehrlichiosis chaffeensis?
Lone star tick --> Ehrlichiosis
What is the disease and source of Coxiella burnetii?
spores from tick feces and cattle placenta --> Q fever
What is the disease and source of Chlamydophila psittaci?
bird shit --> Psittacosis
What is the disease and source of Campylobacter?
Puppies, livestock --> dysentery
What is the disease and source of Brucella?
Unpasteurized dairy --> undulant fever (Brucellosis)
What is the disease and source of Borrelia recurrentis?
Louse --> reccurrent fever
What is the disease and source of Bartonella?
cat scratch --> cat scratch disease
Fishy gray vaginal discharge. What is the Rx?
Gardnerella vaginalis --> Rx w/ metronidazole
How do you distinguish between Rickettsia species clinically?
rickettsii --> starts on hands and feet

typhi and prowazekii --> starts on trunk
What is the infectious form of Chlamydiae?
elementary bodies
What is the Rx for Chlamydiae infections?
azithromycine or doxycycline
What organism is the classic cause of atypical pneumonia? What is the Rx?
Mycoplasma pneumoniae

Rx = doxy or erythromycin
Which fungus grows as a spherule in tissue?
coccicioidomycosis
What is the Rx for systemic fungal infections?
Amp B
Which fungus is found in Mississippi and Ohio river valleys and found in bat/bird shit?
Histoplasma
Which fungus is found in states east of the Mississippi and in Central America and has Broad-based budding
Blastomyces
Which fungus produces San Joaquin fever?
Coccidioides
Which fungus is found in Latin America and has a "captain's wheel" formation on light microscopy?
Paracoccidioides
What are the signs and causative organism of Tinea versicolor?
hypo/hyperpigmented patches of skin and "spaghetti and meatball" on KOH prep

caused by Malassezia furfur
What is the organism and Rx for oral thrush?
Candida albicans --> fluconazole or caspofungin
Which fungi have wide angle septal hyphae? acute angle?
Wide angle = Mucor and Rhizopus

Acute Angle = Aspergillus
Which fungus, found in soil and pigeon shit, produces heavily encapsulated yeast ("soap bubble" lesions in brain)?
Cryptococcus neoformans
What fungal prohylaxis should be started when an AIDS pt drops below 200 CD4?
TMP-SMX for Pneumocystis jiroveci
What is the appearance of the organism that causes "rose gardener's dz"
Dimorphic, cigar-shaped budding yeast (Sporothrix schenckii)
What is the Rx for giardia?
metronidazole
How would you dx/rx amebiasis?
Entamoeba histolytica infection --> dysentery, liver abscess, RUQ pain --> trophozoites w/RBCs in cytoplasm or cysts found in stool --> Rx w/ metronidazole and iodoquinol
What fungal organism would you suspect in a pt w/ severe diarrhea and AIDS?
Cryptosporidium
Which protozoan causes brain abscesses in HIV pts?
Toxoplasma gondii
Chorioretinitis, hydrocephalus and intracranial calcifications are the classic triad of what congenital infection?
Toxoplasmosis
What is the Rx for Toxoplasmosis?
Sulfadiazine + pyrimethamine
A child swimming in a freshwater pond for a week comes down with meningioencephalitis and dies shortly after. What is the likely causative organism?
Naegleria fowleri (protozoan)
Which organism, transferred from the Tsetse fly causes African sleeping sickness?
Trypanosoma brucei
Which malarial species has dormant form in liver?
Plasmodium vivax/ovale
Which malarial species is most severe and occludes capillaries in the brain, kidneys and lungs?
Plasmodium falciparum
Which rx should be added to mefloquine to rx P. vivax/ovale?
add primaquine for dormant form in liver
What is the Rx for babaesiosis?
Quinine, clindamycin
What is the vector for Babesia?
Ixodes tick
What is the rx for Chaga's disease?
Trypanosoma cruzi --> Rx w/ nifurtimox
What organism produces foul-smelling, greenish discharge with itchy vag? Rx?
Trichonomas vaginalis --> Rx w/ metronidazole
A pt bit by a sandfly has spiking fevers, hepatosplenomegaly and pancytopenia. Dx?
Leishmaniasis (Leishmania donovani)
What is used to treat intestinal nematodes?
bendazoles
What is used to treat trematodes?
Praziquantel
What is used to treat cestodes?
Praziquantel (except use bendazoles in Echinococcus granulosus)
Which helminthes are treated with Diethylcarbamazine?
Loa loa, Wuchereria bancrofti, Toxocara canis (Tissue nematodes)
Which hemlminthes are treated w/ Ivermectin?
Onchocerca volvulus (rIVER blindness), Strongyloides stercoralis (nematodes)
What is the transmission/disease of Enterobius vermicularis?
pinworms, eggs found in food --> anal pruritis
What is the transmission/disease of Trichenella spiralis?
undercooked meat (pork) --> muscle inflammation and periorbital edema
What is the transmission/disease of Strongyloides stercoralis?
Larvae in soil penetrate skin --> intestinal infection
What is the transmission/disease of Onchocerca volvulus?
blackflies --> river blindness
What is the transmission/disease of Wuchereria bancrofti?
female mosquito --> elephantiasis
Which nematodes penetrate skin/are ingested?
EAT --> Enterobius, Ascaris, Trichinella

feet in the SANd --> Strongyloides, Ancylostoma, Necator
What are the sources of flukes?
Trematodes --> Schistosoma (snails), Clonorchis sinensis (undercooked fish), Paragonimus westermani (undercooked crab)
Which hemlminth --> B12 deficiency?
Diphyllobothrium latum
Which helminths cause microcytic anemia?
Ancylostoma, Necator
Which vaccines are killed?
RIP Always

Rabies, Influenza, salk Polio, hAv
What type of vaccine is the sabin vaccine?
Live attenuated
Which DNA virus is single stranded?
Parvoviridae
Which RNA virus is double stranded?
Reoviridae
What are the seven main DNA viruses?
Hepadna, Herpes, Adeno, Pox, Parvo, Papilloma, Polyoma
What are the seven naked viruses?
CPR and PAPP smears

Calicivirus, Picornavirus, Reovirus, Parvovirus, Adenovirus, Papilloma and Polyoma
Which DNA virus does not replicate in the nucleus?
Pox
JC and BK viruses are what classification?
DNA viruses, polyomaviruses
How is VZV transmitted?
respiratory droplets
Which virus causes Kaposi's sarcoma?
HHV-8
What are the 5 major Picornaviruses?
Poliovirus, Echovirus, Rhinovirus, Coxsackievirus, HAV
What is the #1 cause of fatal diarrhea in kids?
Rotavirus
What are the 3 C's of measles?
Cough, Coryza, Conjunctivitis
What organism causes Koplik spots, and rash moving from head to toe?
Measles (rubeola) virus
Which virus causes fifth's diseae?
'slapped cheeks', and aplastic crisis in sickle cell --> Parvo B19
What ate the three major symptoms of mumps?
Parotitis, Orchitis, aseptic Meningitis
What is the organism and presentation of roseola?
high fevers for several days followed by diffuse macular rash --> HHV-6
Negri bodies found in CNS autopsy in what dz?
Rabies
Which hepatitis strain is a DNA virus?
HBV
What are the two serologic markers for Hep A?
Anti-HAVAb IgM (active) and IgG (prior infection)
What serologic makers are found in acute Hep B infection?
HBsAg, HBeAg, IgM Anti-HBcAb
When is the window period for Hep B infections?
5-6 months post-exposure
What serologic markers are present during Hep B Window period?
IgM and IgG Anti-HBsAb
Which serologic marker indicates high transmissibility of Hep B?
HBeAg
Which serologic marker indicates low transmissibility of Hep B?
Anti-HBeAb
Which serologic markers are present in Hep B immunized individual?
Anti-HBsAb
What are the two diagnostic tests for HIV?
ELISA followed by Western Blot confirmatory
Which organism is a/w daycare outbreaks, pseudoappendicitis and dysentery?
Yersinia enterocolitica
What is the major CSF finding differentiating Bacterial meningitis from viral and fungal?
Bac --> increased PMNs and decreased glucose -->

Viral --> increased lymphocytes and normal glucose

Fungal --> increased lymphocytes, decreased glucose
What is the #1 cause of meningitis in teens?
Neisseria meningitidis
What is the empiric therapy for meningitis?
Ceftriaxone + vancomycin
What is the leading cause of UTI?
E. coli
What are the three dx markers of UTI and what do the positives mean?
Leukocyte esterase --> bacterial

Nitrite Test --> gram neg (except S. saprophyticus)

Urease test --> Proteus, Klebsiella
What are the six ToRCHeS infections?
Toxoplasma gondii, Rubella, CMV, HIV, HSV-2, Syphilis
What is the classic triad of congenital Rubella infection?
PDA, cataracts, deafness +/- "blueberry muffin rash"
Which TORCH infection manifests neonatally as hearing loss, seizures and blueberry muffin rash?
CMV
Hutchinson's teeth, saddle-nose, saber shins. Which TORCH?
Syphilis
Rash begins at head and moves down; --> fine truncal rash

Which red rash of childhood?
Rubella
Rash begins at head and moves down; preceded by cough, coryza, conjunctivitis, koplik spots.

Which red rash of childhood?
Rubeola --> Measles virus
Vesicular rash begins on trunk; spreads to face and extremities with lesions of different age

Which red rash of childhood?
Chickenpox --> VZV
A macular rash over body appears after several days of high feverl usually in infants

Which red rash of childhood?
Sixth disease --> HHV-6 and 7
"Slapped Cheek" rash on face

Which red rash of childhood?
Fifth disease --> Parvo B19
Erythematous, sandpaper-like rash with fever and sore throat

Which red rash of childhood?
Scarlet fever --> Strep. pyogenes
Vesicular rash on palms and soles, ulcers in oral mucosa

Which red rash of childhood?
Hand-foot-mouth --> Coxsackie A
Which STD has the following clinical features:

Urethritis, cervicitis, PID, prostatitis, epididymitis, arhtritis, creamy purulent discharge?
Neisseria gonorrhoeae --> Gonorrhea
Which STD has the following clinical features:

Painless chancre?
Treponema pallidum --> Primary syphilis
Which STD has the following clinical features:

Fever, lymphadenopathy, skin rashes, condylomata lata?
Treponema pallidum --> secondary syphilis
Which STD has the following clinical features:

Painful genital ulcer, inguinal adenopathy?
H. ducreyi --> Chancroid
Which STD has the following clinical features:

Urethritis, cervicitis, conjunctivitis, Reiter's syndrome, PID?
Chlamydia trachomatis --> Chlamydia
Which STD has the following clinical features:

Vaginitis, strawberry mucosa, corkscrew motility on wet prep?
Trichomonas vaginalis --> Trichonomiasis
Which STD has the following clinical features:

Malodorous fishy vagina, clue cells?
Gardnerella vaginalis --> bacterial vaginosis
What is the most common bacterial STD?
Chlamydia
Which ABX block peptidoglycan synthesis?
Bacitracin and vancomycin
Which ABX block cell wall synthesis by inhibition of peptidoglycan cross-linking?
cillins, cephalosporins, aztreonam, imipenem
Which ABX block nucleotide synthesis?
TMP-SMX
Which ABX block DNA topoisomerases?
FQs
Which ABX block mRNA synthesis?
Rifampin
Which ABX damage DNA?
Metronidazole
which ABX block protein synthesis at 30S ribosomal subunit?
AGs, Tetracyclines
What is the DOC for syphilis?
pen G
What is the DOC for S. aureus?
"Mean Old Dick Naf killed all the Staf"

Methicillin, Oxacillin, Dicloxacillin, Nafcillin
What is the clinical use of Ampicillin and amoxicillin?
HELPSS kill enterococci

H. influenzae, E. coli, Listeria monocytogenes, Proteus mirabilis, Salmonella, Shigella
What is the main clinical use for Ticarcillin and Pipercillin?
Pseudomonas
What is the spectrum for 1st gen cephalosporins?
PEcK

Proteus mirabilis, E. coli, Klebsiella
What is the spectrum for 2nd gen cephalosporins?
HEN PEcKS

H. influenzae, Enterobacter aerogenes, Neisseria, Proteus mirabilis, E. coli, Klebsiella, Serratia marcescens
What is the clinical use for ceftriaxone?
meningitis and gonorrhea
What is the clinical use for ceftazidime?
Pseudomonas
What is the clinical use for cefepime?
Pseudomonas
What is the clinical use for Aztreonam?
Rx gram negs in pts with pen allergy or renal insufficiency who can't tolerate AGs
What is the clinical use for imipenem/cilastin?
Life threatening drug resistant infections (last resort)
What is the clinical use for vancomycin?
Gram positive serious infections, MRSA, C. dif
What are the vancomycin toxicities?
Nephrotoxicity, Ototoxicity (reversible), Thrombophlebitis, red man
Which protein synthesis inhibitors are bactericidal?
AGs, sometimes linezolid
What is the clinical use for AGs?
gram neg rod aerobes
What are the side effects of AGs?
Nephrotoxicity, Ototoxicity (irreversible), teratogenic
What is the clinical use of tetracylcines?
Borrelia burgdorferi, M. pneumoniae, Rickettsia and Chlamydia
Which ABX cause discoloration of teeth, photosensitivity and are contraindicated in preggo?
Tetracyclines
Which ABX treats Atypical Pneumonia (Mycoplasma, Chlamydia, Legionella) gram positives in pts allergic to pens?
Macrolides
Which ABX causes prolonged QT?
Macrolides
What is the main clinical use of Chloramphenicol?
meningitis
Which ABX causes gray-baby?
Chloramphenicol
What is the main clinical use of clindamycin?
Anaerobic infections (lung abscess)
What is the main toxicity of clindamycin?
Pseudo colitis
Which ABX is known to cause hemolysis in G6PD def pts?
Sulfas
What are the two main organisms treated by SMX?
Chlamydia, Nocardia
Which ABX are known to cause tendon rupture?
FQs
What are the 6 main organisms treated by Metronidazole?
anaerobes below the diaphragm

GET GAP

Giardia, Entamoeba, Trichomonas, Gardnerella, Anaerobes, h. Pylori
What is the main side effect of metronidazole?
disulfiram-like rxn
What drug is used for TB prophylaxis?
INH
What are the four TB drugs?
Rifampin, Isoniazid, Pyrazinamide, Ethambutol
Which TB drug is a P450 inducer?
Rifampin
What is Rifampin used for besides TB?
H. influenzae prophylaxis
Which ABX causes red-green colorblindness?
Ethambutol
What the DOC for meningococcal prophylaxis?
Ciprofloxacin
What is the DOC for gonorrhea prophylaxis?
Ceftriaxone
What is the DOC for recurrent UTIs?
TMP-SMX
What is the empiric therapy of outpatient CAP?
macrolides
What is the empiric therapy for inpatient CAP?
FQs
What is the empiric therapy for CAP in ICU setting?
beta lactam + FQ or azithromycin
Which antifungal blocks membrane function?
Amp B
Which antifungal inhibits nucleic acid synthesis?
5-Fluorocytosine
Which antifungals (2) block lanosterol synthesis?
Naftifine, Terbinafine
Which antifungals (3) block ergosterol synthesis?
Fluconazole, Itraconazole, Voriconazole
Which antifungal blocks cell wall synthesis?
Caspofungin
Which antifungal is used for serious systemic infections?
Amp B
Which antifungal is ised for swish and swallow candidiasis?
Nystatin
Which antifungal is used for cryptococcal meningitis in AIDS pts?
fluconazole
Which antifungal is used for Blastomyces, Coccidioides, Histoplasma, and Candida albicans?
Ketoconazole
Which antifungal is used for invasive Aspergillosis?
Caspofungin
Which antifungal is used for onychomycosis?
Terbenafine
Which antifungal is an oral Rx for ringworm?
Griseofulvin
Which antiviral is used in parkinson's dz?
Amantidine
Which antivirals treat both influenza A and B?
Zanamivir and oseltamivir
Which antiviral is used for RSV and chronic hep C?
Ribavirin
Which viruses are treated with Acyclovir?
HSV, VZV, EBV
Which viruses are treated with Ganciclovir?
CMV
Which drug is used to treat CMV retinitis in immunocompromised pts when ganciclovir fails?
Foscarnet
When is HAART initiated?
CD4 < 350 or high viral load
What classes make up the AIDS cocktail?
2 NRTIs + 1 NNRTI or 1 protease inhibitor or 1 integrase inhibitor
Which AIDS drugs must by phosphorylated by thymidine kinase to be active?
NRTIs
Which AIDS drugs are the protease inhibitors?
navirs
Which AIDS drugs are the NNRTIs?
neVIRapine, efaVIRenz, delaVIRdine
What are the main drugs to avoid in preggo pts?
"Countless SAFe Moms Take Really Good Care"

Clarithromycin - embryotoxic
Sulfonamides - kernicterus
AGs - ototoxicity
FQs - cartilage damage
Metronidazole - mutagenesis
Tetracyclines - teeth
Ribavarin - teratogen
Griseofulvin - teratogen
Chloramphenicol - "gray baby"