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225 Cards in this Set

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What induces TNF and IL-1 on Gram + and Gram - bacteria?
Teichoic Acid (Gram +)
Lipid A of LPS (Gram -)

TNF - released by macrophages, mediates sepsis, cachexia
IL-1 - released by macrophages, causes acute inflam, fever
What bacteria have adherence pili?
N meningitidis, Pertussis, Cholera, urinary/GI E coli
What are most bacterial capsules made of?
What bacteria has a capsule made of D glutamate
polysaccharides

Bacillus anthracis (like anthrax glu)
What mediates adherence to surfaces, like indwelling catheters?
Glycocalyx
Layers of Gram + bacteria from outside in?
- Capsule (sometimes)
- cell wall (peptidoglycan) with teichoic acid
- cytoplasmic membrane
Layers of Gram - bacteria from outside in?
- capsule (sometimes)
- LPS/endotoxin - use O Ag to classify bact
- thin peptidoglycan layer
- periplasmic space
- cytoplasmic membrane
why is mycoplasma weird?
no cell wall, cell membrane has sterols
why is mycobacteria weird?
cell membrane contains mycolic acid (long saturated fatty acid - makes it acid fast).

btw, Nocardia is a weakly acid fast gram +
What bugs don't gram stain well?
These Rascals May Microscopically Lack Color.

Treponema (too thin, use dark field and fluor)
Ricketssia, Chlamydia, Legionella (intracel)
Mycobact (use acid fast)
Mycoplasma (no cell wall)
What bugs stain with silver stain?
Fungi
Legionella
Bartenella henslae
H pylori
PCP
Special culture requirements for
H flu
Fungi
Legionella
H flu : chocolate agar with factor V (NAD+) and X (hematin)
Fungi: Sabouraud
Legionella: charcoal yeast agar with Cys
Special culture requirements for
N gonorrhoeae
M pneumoniae
C diphth
N gonorrhoeae: Thayer-Martin/VPN (vanco inhibits gram +, Polymyxin inhibits gram - , Nystatin inhibits fungi)

M pneumoniae: Eaton's agar

C diphth - cysteine tellurite medium - grows dark black colonies
Special culture requirements for lactose fermenting enterics
pink colonies on MacConkey's agar (= lactose + bile... bile prevents most gram + growth)

E coli: EMB agar with blue/black colonies w/ metallic sheen

(btw, lactose fermenting enterics are Klebsiella, E coli, Enterobacter and Serratia). * lactose fermenting enterics like to give a KEES
Pseudomonas commonly seen in...
burn wounds
CF/ nosocomial pna
chronic catheters
neutropenic patients
obligate aerobes
Mycobact, Nocardia, Pseudomonas, Bacillus
obligate anaerobes
Clostridium
Bacteroides
Actinomyces
What bacteria have a positive quelling reaction (swollen capsule when anticapsular antisera added) ?
Strep pneumo
H flu
N meningitidis
Klebsiella
Salmonella

btw, E coli with K1 antigen have capsule - cause neonatal meningitis

- capsule impaires opsonization
- high inf risk if asplenic
How are vaccines using capsular polysaccharides made?
Conjugate with protein (only things with protein can be presented on MHC) - this increases the T cell response and immunity
Urease + bacteria
H pylori
Proteus
Klebsiella
What do S pneumo, H flu and N meningitidis (SHiN) have in common?
have IgA protease
cause meningitis
transform (take up DNA from env)
have capsules
group A strep - virulence factor

and antibodies to it can cause...
M protein: prevents phago

btw, antibodies to M protein can cause rheumatic fever (FEVERSS - Fever, Erythema marginatum, Valvular damage, ESR elevation, Red hot joints - migratory polyarthritis, Subcutaneous nodules, Sydenham's chorea

(btw, Group A strep toxin = streptolysin..look for ASO antibodies to check for strep infection)
What bacteria have endotoxins?
most gram - and Listeria
What is the intracellular location for exotoxin and endotoxin genes?
exotoxin: Plasmid/bacteriophage
endotoxin: bacterial chromosome
What is more toxic, exotoxin or endotoxin?
exotoxin

these toxoids are used to make vaccines (tetanus, botulism, dipth)
What do superantigens do?
bind lots of MHC II and TCR -
activate lots of T cells -
release IFN-gamma (by Th, stim macro) and IL-2 (by Th, stim Tc and more Th) and then macrophages release IL-1, IL-6 and TNF-alpha
S aureus virulence factor and toxins
virulence factor:
Protein A : binds Ig Fc - prevents opsonization

toxins:
TSST - fever, rash, shock
enterotoxin - food poisoning
exfoliatin - SSSS
S pyogenes toxins
scarlet fever - erythrogenic toxin

Streptolysin O - lyses RBCs
(antigen for ASO Ab - used to diagnose recent Strep inf)
How does the V cholerae ADP ribosylating toxin work?
ADP ribosylate Gs ptn -
stim AC -
increase Cl secretion and decrease Na reabs in gut -
voluminous RICE WATER diarrhea
What do the ETEC toxins do?
"Labile like the Air"

these are ADP ribosylating toxins
Heat Labile toxin - stim AC
Heat stable toxin - stim GC
What does the B pertussis toxin do?
ADP ribosylating toxin:
inhibits Gi
increase cAMP
whopping cough
also inhibits chemokine receptors so causes lymphocytosis
What does the C perfringens toxin do?
alpha toxin (lecithinase) degrades membrane phospholipids - gas gangrene AKA myonecrosis and hemolysis
What does the C tetani toxin do?
blocks inhib neurotransmitters like GABA and glycine - causes lockjaw
What does the C botulinum toxin do?
blocks Ach release -
anti-cholinergic symptoms like CNS paralysis, floppy baby

DDD - diplopia, dysphagia, dysphonia
What does the B anthracis toxin do?
Edema factor (adenylate cyclase)

increases cAMP
inhibit PMN function, edema
What bacteria produce ADP ribosylating toxins?
C diptheriae
V cholerae
E coli
B pertussis
What does the C diphtheriae toxin do?

What is distinctive about this organisms appearance?
ADP ribosylating toxin that inactivates EF-2 (like Pseudomonas exotoxin A)

causes cardiomyopathy and neuropathy

has blue and red granules
What bacteria induce cAMP?
V cholerae
Pertussis
E coli
B anthracis
What are the two types of conjugation?
F+ with F- transfer plasmid DNA

Hfr with F- transfer plasmid and chromosomal genes
What are the two types of transduction?
genes that virus has picked up from previous bacterial host can be transferred to new bacterial host.

generalized: parts of bact chr accidently get PACKAGED into LYTIC virus.

specialized - when LYSOGENIC phage EXCISES itself, takes flanking bacterial genes with it
These bacterial toxins are encoded in a lysogenic phage
shigA - like toxin
Botulinum
Cholera
Diphtheria
Erythrogenic toxin of Strep pyogenes (scarlet fever toxin)
What does the Lipid A component of endotoxin activate?
macrophages (IL-1, TNF)

Hageman factor (factor 12) - DIC !!!

complement - C3a/C5a - anaphylaxis. (C5a PMN chemotaxis)
Name the Gram + rods
Bacillus
Clostridium
Corynebacterium
Listeria

Actinomyces
Nocardia
What bacteria are
optochin sensitive
novobiocin resistant
grow in bile and 6.5 NaCl
bacitracin resistant?
optochin sensitive - Strep pneumo
novobiocin resistant - Staph sapro
grow in bile and 6.5 NaCl - Enterococci
bacitracin resistant - S agalactiae
what color are Gram + things
purple/blue
What Gram + bacteria are B hemolytic?
S aureus, Group A/B strep, Listeria
intracellular bugs
Rickettsia, Chlamydia, Legionella, Listeria, Salmonella, Neisseria, Mycobact,
What does coagulase do?
It joins forces with prothrombin
Converts fibrinogen to fibrin
fibrin coats the bacteria
resistant to phagocytosis!
(in S aureus)
What does catalase do?
Catalase degrades hydrogen peroxide before myeloperoxidase can convert it to bleach

so CGD (NADPH oxidase deficient) people susceptible to coagulase positive bacteria
What does S pneumo cause?
MOPS
Meningitis (esp in alcoholics, HbS and asplenics)
Otitis media
Pna w/ rusty sputum
Sinusitis
What does S pneumo look like?
lancet shaped
encapsulated
What do Viridans strep cause?
dental caries
subacute bacterial endocarditis post dental work (usu in people with previous valve problems)

(produces dextrans from glucose - helps colonize teeth and heart valves)
What does S aureus cause?
- abscess
- skin infections - impetigo
- toxin mediated dx - Toxic shock (TSST), SSSS (exfoliative toxin), rapid onset food poisoning (enterotoxins)
- MRSA
- osteomyelitis
- endocarditis in IVDA
What do these bacteria cause
Enterococci/E faecium
S bovis
Enterococci/E faecium -
endocarditis post GU procedure

S bovis -
endocarditis assoc with colon malignancy
C diff
- toxins
- causes disease secondary to what
- tx
- toxin A : attract PMN, mucosal death
- toxin B: decrease cytoskeleton function, fibrin deposition (makes pseudomembrane)

- secondary to clindamycin/ampillin

- tx metronidazole
What does Strep agalactiae cause?
B is for Babies!

pna, meningitis and sepsis in babies

prevent transmission with intrapartum antibiotics (PCN/ampicillin)
What does anthrax cause?
Cutaneous anthrax - black eschar painless ulcer

Pulmonary anthrax - inhale spores - fever, pulm hem, mediastintis, shock, DIE!
(Woolsorters' disease)
What has a tumbling motility?
Listeria (in unpasteurized milk/cheese)
Trichomonas vaginalis
What does anthrax look like microscopically?
long serpentine chains, medusa head style
What is a ghon complex?
TB granuloma (Ghon focus) calcified in lower lobe with hilar lymphadenopathy
Mycobacterium virulence factors
Sulfatide - inhib lysosome phagosome fusion. allows for survival in macrophage

Mycoside cord factor - correlates with virulence
What make up a caseating granuloma?
Langerhans giant cells - multiple peripheral nuclei in horseshoe shape
epithelioid cells, fibroblasts and collagen
What cells induce the formation of a granuloma?
Th1 and macrophages..

this is important!!!!
Where can TB spread to?
meninges
vertebral bodies (Pott's disease)
miliary TB - little foci everywhere

(lots of other areas also)
Where does reactivation TB manifest?
usually in upper lobe cuz mycobact are obligate aerobes
What is tuberculoid leprosy?
Th1 response - cell mediated immunity - granuloma formation - damage skin/nerves but it's contained
What is lepromatous leprosy?
Th2 response - dev antibody that's not protective to antigen (causes hypergammaglobinemia) - bacteria multiply in macrophage - disseminated/disfiguring inf

summary: HIGH Ab/ HIGH infection
Leprosy treatment and toxicity
dapsone

toxicity: hemolysis in G6PD def and methemoglobinemia (tx is methylene blue)
Leprosy appearance
lose eyebrows
lumpy earlobe
nasal collapse
leonine facies with lepromatous leprosy
areas of skin anesthesia
What are the gram negative coccoid rods?
H flu
B pertussis
What are the gram negative lactose nonfermenters?
oxidase + pseudomonas
oxidase - shigella, salmonella, proteus
What do the different kinds of Neisseria ferment?
N meningitidis - maltose and glucose
N gonorrhea - glucose
The only meningitis with petechial lesions is caused by what bacteria?
N meningitidis
What is Waterhouse-Friderichsen syndrome and what causes it?
acute adrenocortical insufficiency due to adrenal hem

N meningitidis
H flu causes...
haEMOPhilus

Epiglottitis (inspir stridor, thumbprint sign, drooling, dysphagia)
Meningitis
Otitis media
Pna

(and bronchitis) btw, the vaccine only protects against Type B
What is the most invasive strand of H flu?

tx?
prophylaxis?
type B (cuz capsule, made out of polyribosyl ribitol phosphate)

tx: ceftriaxone
prophylaxis: rifampin
What are the S/S of diseases caused by Legionella
Legionnaires dx - SEVERE pna, HIGH fever (confusion), GI sympt, hyponatremia cuz kidney problems.... esp in smokers

Pontiac fever- mild flu-like sympt
Where does Legionella like to grow (in vivo and in vitro)
in vivo - natural bodies of water like A/C, humidifier systems

in vitro - charcoal yeast agar with cysteine
What does Pseudomonas cause?
PSEUDOmonas
Pna (nosocomial, esp if on respirator)
Sepsis (black lesions on skin)
External otitis (swimmers ear)
UTI
Drug use and Diabetic Osteomyelitis

also hot tub folliculitis
What does Staph epidermidis cause?

tx?
prosthetic valve endocarditis
IV catheter related injury
prosthetic joint septic arthritis

vanco (w/ or w/o rifampin/gentamycin)
What things cause anterior uveitis (iris inflammation)
Herpes
Syphilis
Lyme disease
Reiter's syndrome
Sarcoid
What are the steps of staining an acid fast organism?
Use aniline dye (like carbolfuchsin)
Decolorize with acid alcohol

acid fast bacteria = red
What does Actinomyces cause?
oral/facial abscesses that can drain through skin!
What are the symptoms of Toxic Shock Syndrome?
fever, vomit, diarrhea, muscle pain, erythroderma

can progress to hypotension, desquamation and multi-system failure

(caused by S aureus and S pyogenes)
Why does snoop dogg carry an umbrella around?
Fo drizzle
What organisms can cause impetigo?
S aureus and Strep pyogenes
What diseases cause joint pain and red eyes?
Sjogrens, lupus and Reiters
What are differences/similarities between rashes caused by Rubeola, Roseola, Rubella and Varicella?
Rubeola(measles)/Rubella - rash starts on face and spreads to body
(diferentiate with Rubella's post auricular lymphadenopathy)

Roseola/Varicella - rash starts on trunk and moves outwards
What diseases result in rashes that are also present on palms and soles?
Syphilis, Rocky Mountain Spotted fever and Coxsackie A (hand foot mouth disease)

also, other palms things are janeway lesions and osler's nodes (both bact endocarditis)
What organisms cause gastroenteritis with a very small inoculum?
Campy, E histolytica, Giardia, Shigella
What organisms colonize the vagina?
Gram + lactobacilli, Group B Strep, and E coli
What are risk factors for getting a yeast infection?
broad spectrum anti-biotics
steroids
uncontrolled DM
immunocomp
contraceptives (change vaginal pH)
What does Klebsiella cause?
Aspiration pna (red current jelly sputum)
Abscess in lungs
Alcoholics
diAbetes

also UTIs
What are the symptoms of Salmonella typhi
fever, diarrhea, headache and rose spots on belly
How does Salmonella invade?
(Shigella invades the same way, but also has Shiga toxin)

enter M cells in Peyer's patches, escape phagolysosome - inflam Peyer's patches - bloody diarrhea
What is HUS and what causes it?
Hemolytic anemia (microangiopathic)
Acute renal failure
Thrombocytopenia

caused by EHEC and Shigella whose toxins damage endothelium and activate platelet aggregation
What are the risks of having H pylori?
duodenal ulcer, gastric adenocarcinoma, lymphoma
Tx for H pylori infection?
metronidazole, bismuth (Pepto-Bismol), tetracycline/amoxicillin

OR

metronidazole, omeprazole, clarithromycin
How do you diagnose an H pylori infection
urease breath test.
Describe the various stages of Lyme disease
1. erythema migrans rash, flu-like symptoms

2. neuro (bilat Bell's palsy) and cardic (AV block)

3. arthritis
What is lyme disease caused by?
Borrelia burgodorferi who hangs out on mice, transmitted to Ixodes tick (which also carries Babesia) who hangs out on deer.
Lyme disease treatment?
doxy, ceftriaxone
What are the different stages of syphilis?
primary - painLESS chancre

secondary - rash (including palms/feet), condylomata LATA

tertiary - gummas (chronic granulomas on skin, organs, bones), tabes dorsalis (degen dorsal colums and dorsal roots, broad-based ataxia, positive Romberg), Argyll Robertson pupil (accomodate but don't react)
What is the screening test for Syphilis?
screen: VDRL
used to follow disease and monitor for re-infection
false positives with lupus and others

confirm: fluor treponemal Ab (FTA) - this stay positive for life
What is Cat Scratch fever caused by?
Bartonella henselae, which also causes bacillary angiomatosis in immunocomp
What are the S/S of Gardenerella vaginalis?
I don't have a CLUE why I smell FISH in the vagina garden.

gray discharge
fishy smell (Whiff test with KOH)
clue cells- vaginal epithelial cells covered with bacteria
Treatment of Gardnerella vaginalis?
Metronidazole
What causes Rocky Mountain Spotted Fever and what are the S/S
Ricketssia rickettsii

high fever, rash that starts on hands/feet
What is a Weil-Felix reaction?
Mix patient serum with Proteus Ag.

if agglutinates, patient has Rickettsial infection
What is the Chlamydiae life cycle?
Elementary body is Enfectious and Enters cell via endocytosis

develops into Reticulate body which Replicates in cell by fission. Reorganizes into elementary bodies
What are the different Chlamydia serotypes and what do they cause?
A, B, C : blindness

D-K : urethritis/PID, neonatal PNA/conjunctivitis

L1, L2, L3: lymphogranuloma venereum : small papule - painful inguinal nodes - rupture - fibrosis - anogenital/lymphatic strictures
What does Mycoplasma pneumoniae cause?
atypical walking pna:

insidious onset
NON productive cough
CXR looks much worse than patient appears
see cold agglutinins (also seen in EBV mono) which causes anemia
Tx for Mycoplasma pneumoniae
Tetracycline or erythromycin

(no cell wall, so resistant to penicillin)
What microorganisms are related to birds?
Cryptococcus - pigeons
Histoplasmosis - bird/bat droppings
Chlamydiaa psittaci - avian reservoir
Who is susceptible to giardia?
low IgA (cuz this normally inhibits giardia adherence to GI mucosa)

so, selective IgA deficiency, CVID, Hyper IgM syndrome and Bruton's agammaglobulinemia
What does Entamoeba histolytica cause?
drill into mucosa (flask shaped ulcers) - bloody diarrhea - portal vein - anchovy paste liver abscess
What is characteristic of Entamoeba histolytica's appearance?
has RBCs in cytoplasm
What does Toxolasma gondii cause?
ring abscess in HIV

in neonate: chorioretinitis, hydrocephalus and intracranial calcifications
Why should pregnant women avoid cats?
Toxoplasma gondii is in cat poo
Tx for toxoplasma gondii
Sulfadiazine + pyrimethamine
What causes Chagas disease and what are the S/S?
Trypanosoma cruzi transmitted by Reduviid AKA kissing bug

-dilated cardiomyopathy, heart block
- destroys PS myenteric plexi: megacolon, megaesophagus, megaureter, achalasia
What disease is transmitted by a sandfly and what are the S/S?
Visceral leishmaniasis (Leishmania donovani) -

spiking fevers, pancytopenia
What is the tx for the different kinds of malaria?
chloroquine. if resistant, mefloquine

for P vivax/ovale - add primaquine for dormant liver forms
(these have fever spikes every 48 hrs)
What causes Babesiosis and what does it look like microscopically?
Ixodes tick (same as Lyme dx), but this causes a malaria-like illness

RBCs have maltese cross
What are the S/S of Trichomonas vaginalis infection?
green, smelly discharge with itching/burning

look for trophozoites on wet mount
What parasite has visible eggs in feces?
Ascaris lumbricoides (giant roundworms)
What causes elephantiasis and how is it transmitted?
Wuchereria bancrofti, transmitted by female mosquito
What parasite causes brain cysts and seizures?
Taenia solium (cysticercosis) - in undercooked pork

(brain = sol)
What parasite causes liver cysts?
Echinococcus granulosus

(cysts = granulosus)
What parasite causes B12 deficiency?
Diphyllobothrium latum

(latum licks B12)
What parasite causes biliary tract disease?
Clonorchis sinesis
What parasite causes hemoptysis?
Paragonius westermani
What parasite causes portal hypertension?
Schistosoma manisoni

(portal vein filled with shit-so)
What parasite causes hematuria or bladder cancer?
Schistosoma haematobium

(bladder filled with shit-so)
What parasite causes microcytic anemia?
Ancylostoma and Necator

both are hookworms
What parasite causes perianal itching?
Enterobius (pinworm)
Define reassortment
when viruses with SEGMENTED genomes (influenza) exchange segments - causes pandemics
define complementation
2 viruses infect a cell. A nonmutated virus makes a functional protein that the mutated virus needs
What kind of immunity do live and killed vaccines induce?
live - humoral and cell mediated

killed - humoral
What viral vaccines are live?
smallpox, yellow fever, chicken pox, Sabin's polio and MMR

(Live! see SMALL YELLOW CHICKENS get vaccinated with SABINS and MMR)

btw. MMR is the only live vaccine that can be given to immunocomp.
purified nucleic acid of what dsDNA viruse are NOT infectious?
Poxviruses and HBV
What RNA viruses DON'T replicate in the cytoplasm?
influenza and retroviruses
What viruses are naked ?
Adeno
Parvo
Papilloma
Polyoma

Reo
Picorna
Hepe
Calci
Which enveloped viruses gets their coats from the host nuclear membrane?
Herpesviruses
Are DNA viruses single or double stranded?
all are double except parvo
What DNA viruses are not linear?
circular - papilloma, polyoma
circular, incomplete - hepadna
Name all viruses in herpes fam
HSV 1
HSV 2
VZV -
EBV -
CMV - infections in immunocomp
HHV6 - roseola
HHV8 - Kaposi's sarcoma
What does adenovirus cause?
sore throat
PNA
pink eye
outbreaks of acute hem cystitis in kids
What is the human receptor for parvovirus and what does this virus cause?
P antigen on RBCs - replicates in marrow

erythema infectiosum - slapped cheek
hydrops fetalis
chronic arthritis
aplastic crisis in HbS
What are the viruses in the polyomavirus family?
JC - progressive multifocal leukoencephalopathy
What are the viruses in the poxvirus family?
Smallpox
Vaccinia
Molluscum contagiosum - volcano like lesions with sandy crater
What does HSV-1 cause?
primary: sick, gum lesions, cervical lymphadenopathy
secondary: oral lesions
keratoconjunctivitis
temporal lobe encephalitis
What is EBV associated with?
nasopharyngeal carcioma
endemic Burkitt's lymphoma
development of Hodgkins

btw, EBV uses B cell CD 21 as a receptor and immortalizes B cells
What viruses cause mono?
EBV (monospot positive)
CMV (monospot negative)
HHV6 - roseola

btw, monospot = IgM heterophil antibodies detected by agglutination of sheep RBCs
What virus commonly causes problems in transplants?
CMV
How to identify HSV lesions
Tzank test - detect multinuc giant cells

infected cells also have intranuc Cowdry A inclusions
What RNA viruses are - ss and linear?
Orthomyxo
Paramyxo
Rhabdo
Delta
What viruses are members of the Picornavirus family?
Polio
Echo
Rhino
Coxsakie
HAV

PickanOrange on the PERCH
What is the #1 cause of fatal diarrhea in children?
Rotavirus

belongs to Reovirus family

problems with this virus in daycare and kindergarten
What is special about Reoviruses?
they are ds RNA
What does the Norwalk virus cause and what family does it belong to?
gastroenteritis epidemics.

Calcivruses

(think Indian food in NORWALK - gives diarrhea - Indos need to eat CALCIUM)
What virus family does HEV belong to?
Hepevirus
What viruses give the common cold?
Rhino - naked RNA
Corona
Adenom
What are the viruses in the Flavivirus family?
HCV
Yellow Fever
Dengue
West Nile
St Louis encephalitis
What virus families do mumps, measles and rubella fall under?
Mumps - Paramyxo
measles - paramyxo
rubella - Toga
What viruses are retroviruses?
HIV
HTLV (causes T cell leukemia - esp in Japanese)
What viruses are in the Paramyxo family?
PaRaMyxo

Parainfluenza - croup
RSV - bronchiolitis
rubeola AKA Measles
Mumps
What RNA viruses are segmented?
Ortho (influenza)
Reo (rotavirus)
Describe the influenza virus
Orthomyxovirus. - ss RNA segmented.

hemagglutinin promotes entry
(immunity from anti-hemagglutinin IgGs which prevent virus binding to host cells)
neuraminidase promotes progeny release
What causes croup and what are the S/S?
parainfluenza virus (ss - RNA, Paramyxo family)

seal-like barking cough, steeple sign, laryngiotracheobronchitis
S/S of rubeola
AKA measles

Cough
Coryza (runny nose)
Conjunctivitis
Koplik's spots (red spots with blue/white center on buccal mucosa)
S/S of mumps
Parotitis
Orchitis
Meningitis

Mumps makes your parotids and testis as big as POM-poms
S/S Rabies
Rhabdovirus family

Negri bodies (eosino neuronal inclusions)

fever - agitation, dysphagia, photophobia - paralysis, coma - death
Which Hepatitis viruses are naked?
A/E

(these are fecal oral, acute)
Which Hepatitis viruses have parenteral transmission?
B, C, D

(these are enveloped, chronic)
How are hepatocytes damaged in hepatitis and what does it look like histologically?
CMI

ballooning degeneration with mononuclear infiltrate
Hep A associations
(Picorna +ss RNA)

Asymptomatic (usually)
Acute
Hep B associations
(Hepadna ds DNA, partically circular)

- long, insidious incubation
- has reverse transcriptase
(dsDNA - template + RNA - ds DNA progeny)
- high risk of vertical transmission if Mom has high e Ag

polyarteritis NODOSAAAAA
Hep C associations
(Flavivirus +ss RNA)

Cirrhosis
Carcinoma

post transfusion and IV hepatitis

unstable cuz no 3' to 5' exonuclease and env glycoptn has hypervariable region
Hep E associations
Expectant mothers
Epidemics
Are Hep A antibodies protective?

Are Hep C antibodies protective?
Yes

No - cuz Hep C is an unstable virus!
What is the marker for the window period in Hep B infection?
core Ab IgM
what do these tell you about a patients Hep B infection?
- S Ab
- E antigen
- Core Ab
anti S = immune or not

E antigen = high/low infectivity (e for enfectivity)

anti C = acute (IgM) vs chronic (IgG)
What antibodies does a person have after recovering from Hep B?
anti-S
anti-e
anti-C IgG
What does HIV bind to?
it's gp120 binds host CD4/CXCR4 and CD4/CCR5

(CCR5 mutations in host give partial/total immunity to HIV)
What do the env and gag genes of HIV do?
env makes gp160 which is cleaved into gp120 (binding), gp 41 (fusion)

gag makes p24 (capsid)
What is the screening and confirmatory tests for HIV?
screening - ELIZA
confirmatory - Western
What bacteria colonize the colon?
Bacteroides fragilis > E coli
What sort of foods cause S aureus food poisoning?
mayo, custard
What sort of foods cause C perfringens food poisoning?
reheated meat

(this is late onset food poisoning)
What diseases does Coxsackie cause?
aseptic meningitis
herpangina (mouth blisters)
febrile pharyngitis
hand foot mouth disease
myocarditis
What microorganisms frequently infect diabetics?
Klebsiella
Mucor/Rhizopus
What fungi ...
has broad based buds
macrophages filled with fungi
spherules with endospores
broad based buds - Blasto
macrophages with fungi - Histo
spherules with endospores - Coccidio
What fungi form
narrow based buds
wide branched nonseptate hyphae
pseudohyphae and germ tubes
V shaped septate hyphae w/ coronas
narrow based buds - Crypto

wide branched nonseptate hyphae - Mucor

pseudohyphae and germ tubes - Candida

V shaped septate hyphae w/ coronas - Aspergillus
What does dimorphic fungi mean and what fungi are dimorphic?
cold = mold, heat = yeast
(except coccidio.. cold = spherule, heat = yeast)

Blasto, Histo, Coccidio, Sporothrix schenckii
What are the causes of bronchitis and bronchiolitis?
RSV (paramyxo env - ssRNA)
Influenza (ortho env - ssRNA)
Corona (corona env, + ssRNA)
MCC of pneumonia in

newborns
6 mo - 6 years
6-60 years
newborns - Group B strep
6 mo - 6 years N meningitidis
6-60 years S pneumo
What levels cell type, protein and sugar do you see in bact, fungal/TB, viral meningitis?
Bacterial
high PMNs, high ptn, low sugar

Fungal/TB
high lympho, high ptn, low sugar

Viral
high lympho, normal/high ptn, normal sugar
In what conditions does Strep bovis grow?
bile without 6.5% NaCl
What is the MCC of diarrhea transmitted from domestic animals?
Campy

(MCC of diarrhea in industrialized nations)

Can lead to Guillan Barre - ascending, symmetric LMN demyelination by T cells and macros. see albuminocytologic dissocation (high ptn CSF with normal cell count)
What microorganisms cause black necrotic lesions?
Bacillis anthracis
Pseudomonas
Leishmaniasis
Mucor/Rhizopus
What are cryoglobulins and what diseases have them?
Proteins that become insoluble at low temps

HCV
Multiple myeloma
What is a latex agglutination test?
Latex beads covered with antibodies.

Mix in sample.

If sample has antigen, latex beads will clump.
How does the Shiga toxin function?
Inhibits the 60S ribosomal subunit
What fungi causes a TB-like disease?
Histo

has calcified granulomas in lungs with weight loss
What kinds of people does Aspergillus commonly cause disease in?
- immunocomp
- CF
- TB cavities (aspergilloma)
- asthmatics (allergic bronchopulm aspergillosis -- high IgE, eosinophilia, leads to bronchiectasis)
What is the function of interferons?
INF alpha/beta - inhibit viral ptn synthesis
(can be used at treatment in Hep and MS)

INF gamma - stim macrophages, Th1 and inhibit Th2
What bacteria adhere onto previously damaged heart valves and how?
Strep viridans

adhere to fibrin on previously damaged valves by making dextrans from glucose
What disease causes a painful genital ulcer?
Hemophilus ducreyi causes chancroids

see yellow/grey exudate on ulcer
What is a koilocyte?
Seen in HPV -

dysplastic squamous cell with clear halo around nucleus and vacuoles

seen in HPV 6, 11 (condyloma acuminata) and HPV 16, 18 (CIN)
What is Gram - oxidase + curved rod ?
Vibrio cholera
During what process in malaria do fevers spike?
RBC lysis
Whats the treatment for giardia?
metronidazole
What is the treatment for pinworms?
Mebendazole
What is phenotypic mixing?
Viruses coinfect.
Virus A uses Virus B coat.
But virus A progeny won't have B coat.
Name the spirochetes
Leptospira

Treponema

Borrelia
What is the tx for strep pneumo?
PCN
Does Blasto disseminate?
Yes, to skin and bones
Where is the primary focus of Cryptococcus?
lungs
What are the S/S of adult Rubella?
rash
post auricular lymphadenopathy
polyarthralgia
What are the S/S of congenital Rubella?
sensorineural deafness
cataract
PDA

"blueberry muffin baby"
What organisms stain with Geimsa?
Borrelia
Plasmodium
trypanosome
chlamydia
What organisms stain with Ziehl Neelsen?
acid fast organisms

mycobact
nocardia
Gram - curved rod that survives alkaline env
V cholera
Gram - rod, urease +
H pylori
Gram - rod, curved, cannot survive alkaline env
Campy