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241 Cards in this Set

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Do not gram stain well
Treponema, Rickettsia, Mycobacteria, Mycoplasma, Legionella pneumophila, Chlamydia (These Rascals May Microscopically Lack Color)
Gram positive organism that produces endotoxin
Listeria monocytogenes
Capsule has D-glutamate (not polysaccharide)
Bacillus anthracis
What does Corynebacterium diphtheriae exotoxin do?
Inactivates EF2 and causes pharyngitis and pseudomembrane in throat (so does Pseudomonas exotoxin A)
How does vibrio cholerae exotoxin work?
ADP ribosylation of G protein stimulates adenylate cyclase which increases pumping of Cl and H20 into the gut= voluminous rice water diarrhea
How does E. coli heat stable exotoxin work?
stimulates guanylate cyclase causing inhibition of resorption of NaCl= watery diarrhea
How does E. coli heat labile exotoxin work?
stimulates adenylatecyclase causing inhibition of resorption of NaCl= watery diarrhea
How does Bordetella pertussis exotoxin work?
Stimulates adenylate cyclase which increases cAMP and impairs chemotaxis and phagocytosis like Bacillus anthracis. Also causes whooping cough and inhibits chemokine receptor causing lymphocytosis. Exotoxin is release into cells of bronchi!
Common causative agents for acute pyelonephritis and treatment
Proteus, Klebsiella, E. coli and Enterobacter (Tx: Ampicillin and Gentamicin)
Widespread granulomas in neonate
Listeria monocytogenes
Acute bacterial endocarditis-causative agent and etiology
Staph aureus and IV drug use. Note: Septic emboli from infective endocarditis causes multiple small parietal lobe abscesses.
Epiglottitis (difficulty swallowing and unable to speak clearly- leaning forward with neck hyperextended and chin protruding, drooling) causative agent
H. influenza (also common cause of otitis media in children)
Ear pain and drainage of pus from the ear canal. Also swelling and tenderness over mastoid bone and external auditory meatus. (Otitis externa)
Pseudomonas aeruginosa
LYMPHADENOPATHY with or without low fevers and headaches. Numerous granulomas filled with neutrophils and necrotic debris. Patients have multiple skin lesions and extracutaneous manifestations involving liver and bone.
Bartonella henselae (cat scratch) Tx with macrolide (ie erythromycin or azithromycin)
Treatment for simple urinary tract infections (gram negative rods in urine)
E. coli so treat with ampicillin
Spontaneous abortion
Listeriosis- Listeria monocytogenes (soft cheeses). Can also give meningitis and septicemia in children.
Interstitial lung infiltration. Cold agglutins present.
Mycoplsma pneumoniae (Tx Erythromycin)
Produces struvite (magnesium ammonium phosohate) kidney stones
Proteus mirabilis
What medication can produce hemolytic anemia in G6PD deficient patient?
SMX/TMP (Sulfamehoxazole/trimethoprim) ie sulfonamide
PAS positive macrophages
Whipples disease (Tropheryma Whippeli)
Associated with tropical sprue
Enterotoxigenic E. coli (ETEC)
Septic arthritis in sexually active adult(swollen knee, painful)
Neisseria gonorrheoea (note: can live within neutrophils and macrophages)
Can mimic appendicitis or Crohns disease (right lower quadrant pain). Spreads in day cares. Fecal oral route.
Yersinia enterocolitica. (most patients who develop joint pain have HLA B27)
Yellow discharge from eye. Conjunctivitis. Hyperemia. Gram negative bacilli. Etiology and how do you culture organism with whole blood agar?
Hemophilus. Must lyse RBC to expose organism. Done with beta hemolytic organism (ie Staph aureus)= satellite phenomenon
UTI in pregnant woman (gram negatives)
Most are bacterial and most common organism is E. coli (70% are P pili postitive organisms)
Flu like symptoms and cavitary lesion. (Bacterial pneumonia with lung abscess.
Staph aureus and H. influ
UTI with indwelling catheter
Pseudomonas aeruginosa
UTI in poorly controlled DM (because glucose in the urine enhances its growth)
Candida albicans and Klebsiella pneumoniae
Gram positive coccus that causes UTI in elderly men with prostate problems
Enterococcus faecalis
MOST common cause of community acquired UTI
E. coli
Which organism would be isolated from the vagina of a 5 year old?
Staphylococcus (epidermidis)- prepubertal girls and postmenopausal women
Alcoholic with bloody sputum
Klebsiella pneumoniae
Greenish sputum
Pseudomonas aeruginosa (especially with CF or alcoholism)
Lobar pneumonia
Strep pneumo
Black skin lesions
Bacillus anthracis
Rat bite fever
Spirillium minus
GI infection. Increase BUN. Anemia and thrombocytopenia. Schistocytes in blood. Etiology?
HUS which is complication of Shiga-like toxin. Ie in Shigella or EHEC.
The fastest and most reliable assay specific for diagnosis of gonorrhea is?
DNA probe assays of endocervical exudates (Thayer-Martin agar is secondary choice-slower results)
Explosive watery diarrhea with blood after eating chicken that was improperly cooked. Comma shaped organisms.
Campylobacter jejuni.
An abscess is formed (think Staph aureus) at surgical site. Does not improve with cephalosporin but does respond to nafcillin. What enzyme is produced by the infecting organism?
B lactamase(penicillinase)
Causes scalded skin syndrome in children
exfoliative toxin (s. aureus)
Kills leukocytes and causes gas gangrene
alpha toxin (C. perfringens)
Painful penile vesicle with inguinal lymphadenopathy. Extracellular and intracellular forms. What is pathogen?
Chlamydia trachomatis (L1, 2,3). Recall the painless ulcer is syphilis.
Purulent penile discharge. Gram negative diplococci.
Neiserria gonorrhoeae.
Gram negative rod. Soft, painful penile chancre. First appears as papule with erythematous base and eventually becomes ulcerated and painful. Inguinal adenopathy presetnt. Most common in tropics (ie Asian immigrant). What is pathogen?
Haemophilus ducreyi (pleomorphic gram negative rods in school of fish pattern)
Alcohol abuse and periodontal disease brought to ER for spiking fever and chills. Cavity in right lower lobe. What is pathogen?
Anaerobic bacteria
Urinary retention secondary to prostatic hyperplasia. Intercostal muscle retractions and bilateral inspiratory crackles. CXR shows bilateral interstitial and alveolar infiltrates. What is the pathogen?
E. coli is most common cause of cystitis. Cystitis can develop bacteremia and subsequent septic shock and ARDS. (Gram negative rod)
Acute epididymitis and orchitis with prominent nuetrophils in sexually active male?
Neisseria gonorrhoeae or Chlamydia trachomatis.
Nonspecific epdidymitis and orchitis in older men
Pseudomonas sp.
Nonspecific epdidymitis and orchitis in children with congenital genitourinary abnormalities and in older men.
E. coli
Most common cause of CAP?
Strep. pneumo
Abdominal pain, vomiting, nausea, diarrhea 6 hours after eating rice and seafood. What is the pathogen?
Bacillus cereus
Foods such as potato salad, custard, milk shakes, and mayonnaise. Abdominal pain, nausea, diarrhea 1-6 hours after ingestion of enterotoxin.
Staph aureus
Meats cooked, allowed to cool and then warmed. Allows germination of what spores?
Clostridium perfringens. Causes necrotizing enterocolitis
Pneumonia in CF patients. Pathogen? The function of which of the following proteins is most likely inhibited by the bacteria responsible?
Pseudomonas aeruginosa. A GTP-binding protein involved in the elongation step of protein synthesis (inactivates EF2).
Common opportunist in burn patients. Blue-green pigment on growth media and grape-like odor. Pathogen?
Pseudomonas aeruginosa
Aspiration pneumonia and pulmonary abscesses in alcoholics and patients with COPD. Pathogen?
Klebsiella pneumoniae (gram negative, highly encapsulated rod). Lactose fermenter so MacConkey agar.
In a patient with purulent sputum, mild hemoptysis, CXR with infiltrate in lower lobe and blunting of the right costophrenic angle. Pathogen?
Think pneumonia so most common cause in Strep pneumo. Strep pneumo is rich in teichoic acids and peptidoglycan which elicit the neutrophilic exudate. This causes pus.
Drug used for penicillin-allergic patients and those with renal insufficiency who cannot tolerate aminoglycosides.
Aztreonam
Peptic ulcer disease, gastritis and possibly gastric carcinoma and gastric lymphoma are strongly associated with which pathogen?
H. pylori
Patients with this pathogen produce one or two heterophile antibodies during the course of the infection: one agglutinates human O+ RBCs in the cold and the other agglutinates a strain of Strep. salivarius termed strain MG
Mycoplasma pneumoniae (walking pneumonia). Mycoplasa are susteptible to macrolide family of antibiotics (erythromycin, clarithromycin)- penicillin resistant because lack cell wall
Child with headache and weakness and gram negative diplococci at summer camp of college. What pathogen?
Neisseria meningitidis. Associated with DIC and Waterhouse-Friderichsen syndrome
Dairy farmer with headache, rash and spirochetes. Increased alkaline phosphatase, elevated BUN and creatinine, dark colored urine.
Leptospira interrogans
Treatment with antibiotics and then develop nausea, vomiting, abdominal pain and diarrhea. What pathogen do you think of?
C. difficile causing pseudomembranous colitis. Antibiotic that causes it is clindamycin or ampicillin.
Antibiotic that causes aplastic anemia and gray baby syndrome (abdominal distention/pallid cyanosis)?
Chloramphenicol (inhibits peptidyl transferase- binds 50s subunit of ribosomes)
Used to treat pseudomembranous colitis and anaerobic infections?
Metronidazole
Should be restricted in pregnancy since newborns have a decreased ability to metabolize this medication. With decreased metabolism you can get peripheral neuropathy, seizures, irritability, and profound gastrointestinal disturbances.
Abx that caues ototoxicity and nephrotoxicity?
Gentamicin
Oral cavity of dogs and cats (from bites)
Pasteurella multocida
Eating dog
Brucella canis
Vomiting. anorexia, high fever and bulging fontanel. What is etiology and pathogen?
Neonatal meningitis. Strep agalactiae (Group B Strep)
Amoxicillin given to child for earache (otitis media) but it is unsuccessful. What is likely pathogen and what medication should be tried?
Strep pneumo and H. influ are commonly responsible for pediatric otitis media. Treat with second-generation cephalosporin like cefaclor.
Otitis media in infant. What is the likely virulence factor absent in H. flu the produce otitis media, compared to those that produce epiglottis or meningitis.
95% of all cases of invasive diesease (epiglottitis, meningitis) due to H. influ are caused by type B organisms that possess a polyriboitol phosphate capsule. Not so for otitis media.
Mediators of attachment to the epithelium and colonization of the oropharynx
Nonpilus adhesions
Important causes of post-gonococcal urethritis
Chlamydia, Mycoplasma, Ureaplasmsa (not effectively treated by penicillin and cephalosporin)
CAP with cavitation?
Klebsiella pneumoniae
What two organisms are the most likely causes of cervicitis and PID?
Neisseria gonorrhoeae and Chlamydia trachomatis. (both induce endocytosis by epithelial cells)
Contact with sheep and goats.
Brucella melitensis
Contact with cows and pigs.
Brucella abortus and Brucella suis. Recall brucella causes undulating fever, LAD and hepatosplenomegaly.
Human bites.
Eikenella corrodens
Rabbit Fever
Francisella tularensis
Prarie dog (vector is a rat flea)
Yersinia pestis (bubonic plague). Any previously healthy person in the Southwestern US who develops septic shock or severe pulm disease should be evaluated for plague.
Bordet-Gengou (potato) agar
B. pertussis
Travelers diarrhea pathogen and treatment?
E. coli, Shigella species, Campylobacter jejuni. Fluoroquinolones (Ciprofloxacin, Ofloxacin, Norfloxacin). Trimethoprim/sulfamethoxazole most commonly used in treatment of children.
Teeth mottling (discoloration) when children exposed to what Abx? What mechanism does it inhibit?
Tetracycline inhibits aminoacyl-tRNA binding.
Septicemia from eating raw oysters. Most at risk if you have chronic renal insufficiency, liver disease, hematopoietic disorders and past history of alcoholism.
Vibrio vulnificus
Contaminated water sources such as air conditioning systems.
Legionella and Pseudomonas
The triad of cutaneous peticheal hemorrhages (blueberry muffin baby, deafness and periventricular CNS calcifications suggest what? (Also include microcephaly and hepatoslenomegaly)
Congenital CMV infection (Tx: Ganciclovir)- may also show mom having flulike episode during first trimester
Flesh colored papules on trunk?
Poxvirus
MR, heart abnormalities, blindness, encephalitis, and motor abnormalities
Congenital rubella
Vesicles on skin and mucous membranes, encephalities or disemminated disease.
Neonatal herpes
Often death in utero (or abnormal teeth, bones, CNS)
Congenital syphilis
Stillbirth, chorioretinitis, intracerebral calcifications, and hydro- or microcephaly
Toxoplasmosis
Transmitted via birth canal and causes opthalmia neonatorum
Neisseria gonorrhoeae
Branching septate hyphae (cross walls)
Tenia pedis, Aspergillus
Hyphae with rosettes of conidia
Sporothrix schenckii
Budding yeasts
Sporotrichosis
Short curved hyphae and round yeasts (shagetti and meatball)
Malassezia furfur (Pityriasis versicolor)
AIDS patient with low grade fever, diarrhea and malabsorption.Oocytes in stool?
Isospora belli (tx: trimethoprim-sulfamethoxazole)or Cryptosporidium parvum (no tx)
Africa- massive unilateral enlargement of face in the vicinity of the mandible. Sheets of medium sized blast cells and admixed larger macrophages on bx. What kind of tumor? What virus is it associated? Translocation?
Burkitts lymphoma (high grade B cell lymphoma)Associated with EBV t(8;14)
Virus associated with HCC and translocation?
Hepatitis B t(9;22) (this translocation is also seen in CML and AML-philadelphia chromosome)
Vertebral tuberculosis can lead to abscess where if masses are noted over lateral lumbar back and in ipsilateral groin?
psoas major
Ring enhancing lesion in brain. Necrosis of brain parenchyma.
Toxoplasma gondii (cat feces, cysts in meat)
Numerous small infarcts due to vascular occlusion as this parasite adheres to endothelial cells of small cerebral vessels?
Plasmodium falciparum (cerebral malaria)- Anopheles moSquito
Bird droppings
Cryptococcus (meningoencephalitis), histoplasmosis (rarely affects brain)
cooling systems
Legionella pneumophilia.
washbasins
pseudomonas aeruginosa
Presentation of 5th disease?
Adults do not get facial rash- get arthralgias and arthritis. Children get slapped cheek appearance.
Localizes mainly in the heart and nerve cells of myenteric plexus leading to myocarditis and dysmotility of hollow organs, such as the esophagus, colon, and ureter. Cardiac involvement manifests with ventricular dilatation and congestive heart failure secondary to myocyte necrosis and fibrosis. Can cause achalasia and megacolon. Note: in early cases you will see romanas sign (eyelid swollen shut) and retroauricular and cervical LAD
T. cruzi (chagas)
Brain cysts
Taenia solium (pork)
Cold like illness. Pleuritis, myocarditis, manifesting with fever, chest pain and if myocarditis is severe, CHF.
Coxsackievirus
An erythematous rash beginning on the head which spreads downward to involve the the trunk lasting for approximately 3 days. Fever, posterior cervical LAD and arthralgias.
Rubella (German measles)- 40% asymptomatic
Febrile preiod for 3-5 days with rapid defervescence followed by erythematous maculopapular rash lasting 1-3 days.
Roseola- HHV 6 (Exanthem subitum or 6th disease)
Upper resp prodrome and characteristic oral lesions (Koplik's spots) that precede the non-pruritic maculopapular rash. Rash begins on face and spreads to trunk and extremities including palms and soles. Also posterior and cervical LAD.
Measles (Rubeola)
What parasite causes megaloblastic anemia (B12 deficiency)
Diphyllobothrium latum
Causes aplastic crisis in individuals with chronic hemolytic diseases (sickle cell)
Parvovirus
Tick bite or handling animal carcasses such as rabbits, squirrels, beavers, muskrats, and deer.
Francisella tularensis
Rash that spread centripetally
Rocky mountain spotted fever (Rickettsia rickettsii) Recall: centriPHugal is rickettsia tyPHus
Pulmonary symptoms from spores in the soil in Arizona
Coccidiodomycosis immitans
Pulm and CNS dz (meningitis) in immunocompromised from pigeon droppings.
Cryptococcus neoformans
Fever, cough and sweats in Ohio-Mississipi river valley from bird/bat droppings
Histoplasma capsulatum
Acute lymphocytic meningitis (markedly increased lymphocytes)
mumps, herpes, EBV, echovirus, coxsackie virus
Acute pyogenic meningitis (markedly increased neutrophils as well as lymphocytes)
E. coli, N. meningitidis, S. pneumonia
Chronic meningitis (increased plasma cells, lymphocytes, macrophages and fibroblasts)
M. TB, Treponema pallidum
Patients developing iron overload because of mulitiple transfusions (ie thalassemia patients) are at increased risk of ___ because some strains are unable to synthesize bacterial iron chelators called siderophores.
Yersinia
Associated with reactive arthritis follwoing an infection with an enteropathogenic organism (express HLA B27)
Yersinia enterocolitica
Budding yeast and pseudohyphae
Candida albicans
Encapsulated yeast
Cryptococcus neoformans
Molds with nonseptate hyphae
Mucor and Rhizopus
College student with difficulty swallowing. Exudative tonsillitis, palatal petechaie, cervical lymphadenopathy, tender hepatosplenomegaly. Pathogen? Likely complication?
infectious mononucleosis from EBV. Splenic rupture requiring splenectomy can result from splenomegaly and capsular swelling.
Blister like lesions on glans of the penis. No crusting, drainage or bleeding. Similar episodes over the past 2 years. Pathogen? During the asymptomatic periods where would the causative agent likely have been found?
HSV 2. Neurons of the sacral or lumbar ganglion.
Perioral lesions. Pathogen? During asymp periods between outbreaks where would the causative agent likely be found?
HSV 1. Neurons of the trigeminal ganglion.
Fibroblasts may be infected with which virus?
CMV. This produces a distinctive mononucleosis like syndrome in most normal individuals.
Involvement of palms and soles is unusual. What pathogen should come to mind?
Treponema pallidum
anal pruritis, scotch tape test
Enterobius vermicularis (pinworm)
Protozoa in erythrocytes, incubation period of 1 week, Eatern seaboard- fever, chills, fatigue, myalgia and arthralgia. Hemolytic anemia and hepatosplenomegaly are features.
Babesia microti
Depends on ability to bind D-ala D-ala which is vital in the synthesis of peptidoglycan peptide bridges.
Vancomycin
Vancomycin-resistant enterococi utilize what?
Formation of novel cell wall peptide bridges (D-lactic acid in their peptide bonds)
Acetylation of antibiotic is used for resistance to what antibiotic?
Aminoglycosides
Altered drug binding protein confers resistance to what antibiotic?
Penicillin (Penicillin binding protein (PBP)
B lactamases confer resistance to?
Penicillins and cephalosporins
Modified ribosomes with decreased antibiotic affinity confer resistance to what antibiotic?
Protein synthesis inhibiting antibiotics- ie tetracycline, minocycline, doxycycline, and macrolide antibiotics.
Liver abscesses with diarrhea.
Entamoeba histolytica
Trauma to cribriform plate predisposes to this infection (found in lake water)- causes meningoencephalitis
Naegleria (young, always fatal) and Acanthamoeba (older, immunocompromiosed and spontaneously recover)
#1 cause of fatal diarrhea in children
Rotavirus (Reovirus)
Which infection is most specifically associated with Schistosoma haematobium?
Squamous cell carcinoma of the bladder
AIDS patient with history of shingles develops multifocal encephalitis. Acyclovir tried and did not work, patient dies. Pathogen?
Herpes zoster-varicella
Cause pharyngoconjunctivitis that affects children and sometimes adults living in same household. Contaminated swimming pool. Can also cause watery non bloody diarrhea. Associated with local epidemics. Does not affect visual acuity. Photophobia
Adenovirus
Important cause of travelers diarrhea, causes intestinal epithelium to overproduce CAMP because activates intestinal adenylate or guanylate cyclase
ETEC
Multiple small vesicular lesions on an erythematous base. Some lesions are fluid filled and some are crusted. Pathogen?
Stress activated secondary disease caused by reactivation of herpes zoster- shingles!
3 major viral causes of neonatal encephalitis?
HSV1, HSV2, CMV
Pulmonary edema, renal failure, with or without hemoglobinuria, shock, hypoglycemia, and cerebral malaria. Which type of plasmodium?
Plasmodium falciparum (only malaria associated with high mortality.)
Naked RNA virus which is not inactivated by lipid solvents such as ether. All vacinated infants will shed the virus for a period of time after immunization with OPV.
Poliovirus
Iodine staining intracellular inclusion bodies with nonpainful lymphogranuloma venereum. Odorless cervical discharge. No rash on genitalia. (PID)
Chlamydia trachomatis. Most common bacterial cause of STD in this country.
Hard and nontender chancre
Syphilis
A budding encapsulated yeast grows on Sabourauds agar. What is the morphology of the infectious form of the organism?
Encapsulated budding yeast. These are monomorphic cryptococcus
SSPE (subacute sclerosing panencephalitis) is associated with what pathogen? Presents with clumsiness, jerky movements, vision deterioration, white matter lesions, cerebral atrophy
Measles
pilots wheel
Paracoccoides brasiliensis
4 nuclei in most of the cysts. spherical thin walled cysts. 10-20 um in diameter
Entamoeba histiolytica
small cysts 4-5 um with arc-shaped merozoites
Cryptosporidium parvum
oval or elliptical cysts 8-14 nm
Giardia
almond shaped 30x15nm
isospora belli
Most common atypical pneumonia in AIDS patients. Next most common pool of at risk individuals consist of premature infants.
PCP
White spots on bright red background on buccal mucosa (Kopliks spots). Rash begins around the hairline and spreads to the trunk and extremities. One week later the child begins to convulse and loses consciousness. Pathogen? What is on CNS bx?
Measles. Perivenous microglial encephalitis with demyelination
Demyelinating of white matter of cerebral hemispheres with abnml giant oligodendrocytes.
PML with JC virus
Phagocytosis of motor neurons in the spinal cord
Poliomyolities- ventral horns of the spinal cord and motor cortex (enterovirus-poliovirus)
Severe hemorrhagic and necrotizing encephalitis of the temporal lobe with eosinophilic Cowdry type A inclusion in neurons and glia.
Herpes encephalitis affects temporal lobes and orbitofrontal gyri
Small granulomas with central ceseation in the meninges
M. TB
Which type of Hepatitis can cause an epidemic and high mortality in pregant women?
Hepatitis E
Most common outcome of Hep B from needle stick?
Subclinical disease followed by recovery
Acute pyogenic meningites (fever, headache, nuchal rigidity, low glasgow coma score and increased neutrophils, increased protein, reduced glucose)
Strep pneumo in older population (Also Listeria monocytogenes in older)(Neisseria meningitis in adolescents and young adults) (in neonates E. coli and Group B strep) (in infants and children H. influ)
Encephalitis (lymphocytic infiltrate of brain parenchyma and leptomeninges)with increased lymphocytes and normal glucose?
Arboviruses, Herpesviruses
Chronic meningoencephalitis- prolonged clinical course- dense granulomatous infiltrate of base of brain. Associated CSF include increased lymphocytes and normal or slightly decreased glucose.
M. TB
During asymptomatic latent phase of AIDS the virus is actively proliferating and can be found in association with?
follicular dendritic cells in germinal centers of lymph nodes- reserviors of HIV
oligodendrocytes are affected in
JC virus, and measles virus
Generalized myositis and flaccid paralysis. Causes herpangina and hand-foot and mouth disease.
Coxsackie A group
Lesions of heart, pancreas, and CNS. Causes pleurodynia, myocarditis and pericarditis.
Coxsackie B group
Genetic shift causes pandemics with which pathogens?
Influenza A and Rotavirus (Reovirus)- segmented
Predisposing factors for Candida albicans
diabetes, high vaginal pH, use of antibiotics
Deepening cough, dyspnea, history of fever. Chest xray with multiple intersitial infiltrates and hyperinflation of the lungs. Multinucleated giant cells with cytoplasmic inclusion bodies on nasal wash. Pathogen. and tx
RSV infection is the most common cause of penumonia and bronchiolitis in children under 1 year of age. Ribavirin is used to treat.
Treat otitis media (tympanic membrane) pathogen and treatment
Strep pneumo, H. influ. Treat with amoxicillin and then try second generation cephalosporin (cefaclor)
Characteristics of neurosyphilis?
PARESIS- Personality, Affect, Hyperactive Reflexes, Eyes- argyll-robertson pupils, defects in Sensorium, Intellectual decline & deficient Speech
Rash confined to a dermatome
Shingles (Varicells is the primary form and affects face and trunk diffusely)
The electron transport system of Neisseria is located in what structure?
cytoplasmic membrane
Anogenital warts
HPV
Malodorous, cheesy exudate and erythema of external genitalia
Pear shaped flagellated protozoa- Trichomonas vaginalis
Fever, myalgia, rapid development of respiratory failure leading to death. Most common in New Mexico, Arizona, Colorado and Utah. Pathogen and cause of pathogen? Hiking in rodent infested areas.
Hantavirus, (Bunyaviridae). Inhalation of aerosolized secretions from the common deer mouse. Note: in addition to the pulmonary syndrome of Hanta you can also get Hemmorrhagic fever in Korean patients
Arbovirus transmitted by infected mosquitos. Most cases are children less than 10 years old. Most causes in Midwestern US. Photophobia, vomiting, myalgias and arthralgias.
California encephalitis (arbovirus)
Veternarian who is pregnant presents with LAD. Her child is born with classic triad of chorioretinitis, hydrocephalus and cerebral califications. what is the pathogen?
Toxoplasma gondii
Chronic granulomatous disease with caseating granulomas. Endocarditis (AV>MV). Occupational contact with cattle.
Brucella abortus
Rickettsial group spread by rat feces.
Endemic typhus (Rickettsia typhi)
During times of war spread by body louse
Epidemic typhus (Rickettsia prowazekii)
Inhaling dust contaminated by animals with asymptomatic infetions (goat, sheep, cattle)
Q fever (Coxiella burnetti)
diabetic patient with unresolved skin lesion on food. black necrotic center and raised red edges. (Ecthyma gangrenosum)pathogen?
pseudomonas aeruginosa (same mechanism as diphtheria)
18 year old has erythematous red sunburn like skin rash. Using super absorbant tampons. Pathogen?
TSS- Staph aureus
Virulence factor for strep pneumo.
carbohydrate capsule (acidic polysaccharide)- So antibody to this specific capsule type is necessary to overcome the infection.
The alternative pathway is important in clearing what pathogen?
Neisseria (so deficiency in C5-C8 increases risk of the infection)
Antibody against M type protein will prevent what infection?
Staph pyogenes (but raising Ab to M proteins can lead to rheumatic fever)
Carried in poultry, turtles, cattles, pigs and sheep. Incubation is 8-48 hours.
Salmonella
interstitial pneumonitis, hacking cough, macular rash on trunk (Horder's spots)- pidgeon handlers
Chlamydia psittaci
Produce yellow sulfur granules. Gram positive rods that grow as branching filaments. Yellow colonies found in low oxygen niches like the tonsils. In patients with history of surgery or trauma in mouth (ie removal of tonsils or tooth extraction. Tx: Ampicillin
Actinomyces israelii
Envelope with large amounts of lipid and true waxes that prevent acid fast stain from leaking out.
Mycobacteria
What causes cholangitis (dark urine, pale fecer, jaundice)
Roundworm (Ascaris lumbricoides) and liver flukes (clonorchis sinensis and Fasciola hepatica)
Neonate encephalitis- sepsis, skin vesicles, conjunctivitis, seizures, cranial nerve palsies.
Herpes simplex II
non-immunosuppressed adult herepes encephalitis
Herpes simplex I
Cystic lesions in brain . Seizures are most common presentation.
Cysticercosis (Taenia solium)
Which virus is associated with severe infection if occurs at an early age?
Hepatitis B virus (associated with chronic infection and development of HCC if get at young age)
What organisms can undergo natural transformation?
Haemophilus, Strep species, Neisseria gonorrhoeae, Helicobacter pylori
Rash, menstrual period...
Think TSS- Staph aureus
Meningitis in 14 yr old. Pathogen? By what mechanism does this organism mediate its attachement to resp mucosa?
Strep pneumo- IgA protease
What produces hyaluronic acid capsule to inhibit phagocytosis?
Strep pyogenes
Spore formation occurs during what phase?
Stationary phase
Stains on India ink. Encapsultaed organismm. HIV positive person with meningitis. Pathogen? Tx?
Cryptococcus neoformans. Amphotericin B.
Lobar pneumonia. Pathogen?
Strep pneumo
Centrally spreading rash. Pathogen and tx?
RMSF. Tx with doxycycline
Influenza like virus that resolves in a few days. Less than a week later get muscle pain, spasms and sensory disturbances and then flaccid paralysis? Pathogen? Most common cause of death?
Poliovirus. Paralysis of resp muscles.
Most common cause of shunt infection in child>
Staph epidermidis
Otitis externa (swimmers ear)
Pseudomonas aerginosa
Croup (barking cough)
Parainfluenza virus in paramyxovirus family
rat bite fever
Streptobacillus moniliformis
Colonize foreign bodies such as IV, catheters, prosthetic valves and ventricular shunts
Candida albicans
Inhibit DNA gyrase (topoisomerase II) and affective against gram negative rods like Pseudomonas
Fluoroquinolones(ie Ciprofloxacin and norfloxacin)
Inhibition of Dihydrofolate reductase
Trimethoprim (note: sulfonamides inhibit an earlier step in folate synthesis and can be used with TMP to treat shigella, salmonella, recurrent UTIs and PCP.
Inhibition of DNA dependent RNA polymerase
Rifampin
Inhibition of 30s
tetracyclines (tetracycline, doxycycline, demoeclocycile) and aminoglycosides (gentamicin, tobramycin, streptomycin)- Tetracyclines inhibit the attachment of aminoacyl-tRNA to the ribosome while the aminoglycosides inhibit the formation of the initiation complex.
Inhibition of 50s
Macrolides bind reversibly (ie erythromycin), lincosamides bind irreversibly (clindamycin, lincomycin), chloramphenicol- cloramphenicol inhibits 50s peptidyl transferase while erythromycin blocks translocation
Inhibition of bacterial cell wall synthesis
Cefuroxime (2nd generation cephalosporin) used to treat infections in the lower respiratory and urinary tracts and otitis media
Competitive inhibition of para-aminobenzoic acid (PABA)
Sulfonamide - inhibiting folic acid biosynthesis required for bacterial growth
Post strep glomerulonephritis
Strep pyogenes (group A)
Replicate in cytoplasm>
Picornaviridiae (Poliovirus)
Child who eats soil. Microcytic, hypochromic anemia, eosinophilia?
Ancylostoma duodenale or Necator americanus- hookworm
Patient with bloody diarrhea and purpuric skin rash and oliguria 2-3 days after eating a hamburger at a fast food restaurant. Thombi are seen in afferent arterioles and glomerular capillaries. Etiology? Pathogen?
HUS (Hemolytic-Uremic Syndrome) EHEC (Serotype 0157:H7)
Transmitted by tsetse fly. Winterbottom's sign (supraclavicular and posterior neck lymphadenopathy)
Trypanosoma gambiense (W) or rhodesience (E). Sleeping sickness.
Eye irritation, photopobia. In young children in dirty areas.
Trachoma (C. trachomatis) Type A, B and C- chronic infection via eye to hand. Major cause of blindness in endemic areas.
Most common cause of pneumonia and death in bone marrow transplant patients? (also in AIDs patients)
CMV pneumonitis
Important causes of blindness in AIDS patients?
CMV, Toxoplasmosis, PML.
acute diarrhea in malnourished children and severe diarrhea in immunocompromised?
Cryptosporidium parvum
Liver cyst
Echinococcus granulosus
Middle east and western china. reservoirs are wild and domesticated sheep, cattle, goats and hares. Tick vector (usually ixodid) Severe thrombocytopenia.
Hemorrhagic fever-crimean-congo
Hemmorrhagic fever. Mosquito born. Thailand. Stagnant water.
Hemorrhagic fever- Dengue. (flavivirus)
Southern africa. massive hemorrhage of GI tract. Watery diarrhea with measles like skin rash.
Hemorrhagic fever- Ebola virus
Conjunctivitis in infants with permiscuous mothers.
Neisseria gonorrhea (corneal inflammation) and Chlamydia trachomatis serotype D through K (inclusion conjunctivitis and pneumonia in infants)