Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
409 Cards in this Set
- Front
- Back
|
Diphtheria toxin works by?
|
intracellular protein ribosylation inactivating EF-2
|
|
|
Clostridium perfringens toxin works by?
|
Lecithinase and cell membrane destruction and cell death. Causes gas gangrene
|
|
|
Pertussis toxin works by?
|
increased intracellular Gproteins - increases cAMP, insulin, lymphocyte, neutrophil dysfunction. Sensitivity to histamine
|
|
|
EHEC and Shigella toxin work by?
|
inactivating 60s ribosomal subunits
|
|
|
Group A strep toxin works by?
|
molecular mimicry leads to rheumatic fever
|
|
|
Agent associated with custard
|
S aureus
|
|
|
Agent associated with mayo
|
S aureus
|
|
|
Agent associated with undercooked beef
|
E coli
|
|
|
Agent associated with fried rice
|
B cereus
|
|
|
Agent associated with eggs/raw chicken
|
Salmonella
|
|
|
Agent associated with canned food
|
C botulinum
|
|
|
Mech of action of Zidovudine (AZT) and zalcitabine
|
NRTI
|
|
|
Mech of action for Ritonavir
|
HIV protease inhibitor
|
|
|
Mech of action for Nevirapine and side fx
|
NNRTIs (non- nucleoside); SJS, TEN, hepatotoxicity
|
|
|
Mech of action for Enfuviratide
|
Binds gp41 and blocks HIV fusion
|
|
|
What diseases does Pentamidine treat?
|
PCP prevention/treatment. Also Leishmaniasis and African sleeping sickness
|
|
|
What does Mebendazole treat?
|
Ascariasis, trichuriasis, hookworm, pin worm
|
|
|
What does nifurtimox treat?
|
Chagas
|
|
|
What does Ivermectin treat?
|
Onchocerciasis
|
|
|
What does Metronidazole treat?
|
Giardia, E histolytica, Trich
|
|
|
How do you treat GC?
|
Ceftriaxone
|
|
|
How do you treat Chlamydia?
|
Azithromycin or doxy
|
|
|
What does maculopapular rash, auricular lymphadenopathy, fever and then polyarthritis sound like?
|
Rubella
|
|
|
What can fetal rubella cause?
|
deafness, cataracts, PDA
|
|
|
Rx for Treponema?
|
Penicillin
|
|
|
Rx for Strep?
|
B lactam
|
|
|
Rx for Legionella? Mechanism?
|
Erythromycin. Blocks 50S ribosomal subunit.
|
|
|
Rx for Mycoplasma?
|
Erythromycin. Blocks 50S ribosomal subunit.
Tetracycline. blocks 30S subunit. |
|
|
What does long, branched lipids make you think of for organism?
|
Mycobacterium
|
|
|
Method of action of Isoniazid? Toxicity?
|
like B6 (pyridoxine). Blocks mycolic acid synthesis. Leads to neuropathy, hepatotoxicity
|
|
|
Causes of acute otitis media?
|
H flu and strep pneumo
|
|
|
What percent of otitis media is typeable hep flu?
|
10%
|
|
|
Vaccines against toxin?
|
tetanus, diphtheria
|
|
|
Vaccine for pertussis has?
|
purified bordetella and detoxified toxin
|
|
|
Vaccine for Hep B has?
|
inactivated HBsAg
|
|
|
Vaccine with live attenuated viruses?
|
measles, mumps, rotavirus, Sabin polio, Varicella
|
|
|
Vaccine against Tb (BCG)?
|
live attenuated M bovis
|
|
|
Vaccine against polio in the US is?
|
Salk killed virions
|
|
|
Vaccines with capsular polysaccharides are for?
|
Strep pneumo, Neisseria meningitidis, H flu
|
|
|
5yo boy with PRP antibodies is protected against?
|
H flu
|
|
|
ASO in the blood suggests infection by what?
|
Group A Strep. Rheumatic Fever.
|
|
|
spherules in the lungs?
|
Coccidio
|
|
|
What is an example of a virus that is polycistrionic? It can take a stretch and make different proteins out of it?
|
A Single strand + sense, linear, nonsegmented. Like echovirus.
|
|
|
What type of virus is CMV?
|
enveloped double stranded DNA virus
|
|
|
What interesting fact about mycoplasma makes treating it with PCN pointless?
|
No cell wall!
|
|
|
What can a group A strep skin infection lead to?
|
post strep glomeruloneophritis
|
|
|
What is Waterhouse Friderchsen syndrome?
|
Meningococcemia that leads to adrenal gland destruction, DIC, shock
|
|
|
What levels are associated with meningococcus morbidity and mortality?
|
Cell wall lipooligosaccharide
|
|
|
How does ether influence virii?
|
can get rid of envelope
|
|
|
What is applying an aniline dye like carbolfuchsin then adding HCL and EtOH testing?
|
acid fast. Mycolic acid retains the red dye
|
|
|
How does S. aureus resistance to Beta lactams other than penicillin (like methicillin) work?
|
altered penicillin binding protein
|
|
|
How does resistance to tetracycline and sulfonamides work?
|
Drug transport out
|
|
|
How does resistance to RNA polymerase help against what drug?
|
Helps against Rifampin
|
|
|
What is ecthyma gangrenosum?
|
From pseudomonas sepsis in neutropenic, hospitalized, burn, or catheter patients.
From vascular destruction then subsequent skin necrosis. Toxins = Exotoxin A - protein synthesis inhibited Elastase - PLC - degrades cell membrane Pyocyanin - generates ROS |
|
|
What is strep pyogenes skin manifestations?
|
Impetigo - golden crust
Erysipelas - well demarcated painful plaque |
|
|
What is the protection conferred by tetanus vaccine?
|
Against tetanus toxin
|
|
|
What is the primary virulence factor for pneumococcus?
|
Capsule. Prevents phagocytosis.
|
|
|
What is quellung reaction?
|
Seeing capsule swell in vitro when exposed to antibodies to pneumococcus capsule
|
|
|
What mediates C diff destruction?
|
Toxin A - neutrophil attractant, water loss, diarrhea
Toxin B - actin depolymerization leading to cytoskeleton loss of integrity |
|
|
What mediates damage by C perfringens?
|
Toxin to cell membrane = alpha toxin lectithinase
|
|
|
Is C diff part of gut flora?
|
Yes can be. 2-3% adults. 70% babies
|
|
|
Is Shiga producing bacteria normal gut flora?
|
No
|
|
|
What does Shiga toxin do?
|
Ribosomal protein synthesis inhibition
|
|
|
IgA deficiency can lead to?
|
URIs and giardiaisis.
|
|
|
Where is secretory IgA found between mothers and fetus?
|
Colostrum
|
|
|
What helps mediate immunity to reinfection by influenza?
|
antibodies to hemiagglutinin. IgA and IgG.
|
|
|
What are the most common causes for acute orchitis?
|
Young - GC and chlamydia
Old - E coli |
|
|
What is the major surface antigen on gram positive?
|
Teichoic acid - made of peptidoglycan. Teichoic acid induces TNF and IL-1.
|
|
|
What is the major surface antigen on gram negative outer membrane?
|
LPS. Lipid A induces TNF and IL-1. Polysaccharide is the antigen.
|
|
|
What is the periplasm?
|
Space between the cytoplasmic membrane and outer membrane in gram-negative bacteria. Has beta-lactamases.
|
|
|
Function of bacterial capsule?
|
protects against phagocytosis. Made of polysaccharide.
|
|
|
What is poilus/fimbria made of?
|
Glycoprotein
|
|
|
What is spore made of?
|
Keratin-like. MAde from dipicolinic acid.
|
|
|
Function of glycocalyx? Made of?
|
Mediates adherence to surfaces, especially foreign surfaces.
Polysaccharide |
|
|
What are gram positive rods?
|
clostridium, corynebacterium, bacillus, listeria
|
|
|
Gram negative coccus?
|
Neisseria and moraxella
|
|
|
What bugs don't stain well (bacteria)?
|
Mycoplasm - no wall
Chlamydia - IC Legionella - use silver- IC Mycobacteria - high lipids Rickettsia - IC Treponema - too thin |
|
|
Giemsa stains work with?
|
Borrelia, plasmodium, trypanosomes, chlamydia
|
|
|
PAS stains are for?
|
Whipple's disease
|
|
|
Ziehl-Neesen stains are for?
|
acid fast
|
|
|
India ink diagnoses?
|
Cryptococcus neoformans.
Also mucicarmine for red stain |
|
|
Silver stains?
|
Fungi, Legionella
|
|
|
What is VPN mediat (Thayer Martin) for?
|
Vancomycin - kills gram +
Polymyxin - kills gram-negative Nystatin - kills fungi for Neisseria |
|
|
H flu media?
|
Chocolate agar with factors V (NAD+) and X (hematin)
|
|
|
B pertussis media?
|
Bordet-Gengou agar (Bordet for Bordetella)
|
|
|
M penumoniae agar?
|
Eaton's agar
|
|
|
M tuberculosis agar?
|
Lowenstein-Jensin
|
|
|
Legionella agar?
|
charcoal yeast extract agar buffered with cysteine
|
|
|
Fungi agar?
|
sabouraud's agar
|
|
|
Obligate aerobes?
|
Use O2 dpt system for ATP
Nocardia, Pseudomonas, Myco tb, Bacillus |
|
|
Obligate aerobes?
|
Bacteroides, actinomyes, clostridium
No catalase or superoxide dismutase - foul smelling |
|
|
Examples of encapsulated bacteria?
|
Positive quellung
Vaccines = capsule Klebsiella, Salmonella, Strep pneumo, Hib, meningococcus |
|
|
What are urease positive bugs?
|
Proteus, klebsiella, h pylori, ureaplasma
|
|
|
Color of actinomyces?
|
Yellow sulfur
|
|
|
Color of pseudomonas?
|
Blue-green
|
|
|
Color of serratia marescens?
|
red
|
|
|
What from Staph aurerus allows it to avoid immune system?
|
Binds Fc region of Ig. Prevents opsonization and phagocytosis.
|
|
|
What bacteria produce IgA protease?
|
Strep pneumo, Hib, Neisseria meningitidis
|
|
|
What does group A strep use to evade immune system?
|
M protein - prevents phagocytosis
|
|
|
Features of exotoxins?
|
secreted, polypeptide, from plasmid or bacteriophage, high toxicity.
Induces high titer antibodies called antitoxins |
|
|
Typical diseases associated with exotoxins?
|
tetanus, botulism, diphtheria
|
|
|
Features of endotoxin?
|
Lipopolysaccharide composition from bacterial chromosome, low toxicity, makes fever and shock from TNF and IL-1
Seen with gram negative rods and meningococcemia |
|
|
What do superantigens do?
|
bind directly to MHC II and TCR simultaneously and activate large number of T cells to stimulate release of IFN-gamma and IL-2
|
|
|
What exotoxins associated with staph aureus?
|
TSST-1 = Toxic shock
Enterotoxin = food poisoning Exfoliatin = staph scalded skin |
|
|
Which toxins are ADP-ribosylatin?
|
A component atatches an ADP-ribosyl to a host cell protein, altering protein function
Vibrio cholera - binds Gs - leads to Cl exit Coryne diphtheria - inhibits Elongation factor - 2; pharyngitis and pseudomembrane E coli - stimulation of AC, heat stable = GC. Both = diarrhea Bordetella Pertussis - inhibit Gi, whopping cough; inhibits chemokine receptor = lymphocytosis |
|
|
Other bacterial exotoxins?
|
C perfringens - alpha toxin causes gas gangrene
C tetani - blocks release of GABA and glycine C botulinum - blocks release of ACh. B anthracis - edema factor = adenylate cyclase Shigella - shig A topxin = cleaves rRNA (60S), also causes HUS S pyogenes = ASO |
|
|
Which toxins are cAMP inducers?
|
E coli
B anthracis Cholera B pertussis |
|
|
Actions of endotoxin?
|
Activates macrophages
IL-1 TNF - fever, hemorrhagic tissue necrosis Nitric oxide Activates complement alternate pathway C3a- hypotension, edema C5a - neutrophil chemotaxis Activates Hageman factor (Coag - DIC) |
|
|
What is bacterial transformation?
|
Feature of Strep pneumo, Hib, meningococcus
pick up DNA from environment |
|
|
What is bacterial conjugation?
|
F+ x F = f plasmid sending plasmid through pilus from F + cell to another
Hfr x F = F plasmid incorporated into bacterial chromosomal DNA. Some flanking DNA might get out with replication. Transfer plasmid and chromosomal. |
|
|
Differnece between generalized and specialized transduction?
|
Generalized transduction - packaging event, lytic phage infects bacterium - cleavage of bacterial DNA. Parts of bacterial chromosomal DNA may become packaged in viral capsid. Phage infects another bacterium, transferring those genes.
specialized - exicition event. Lygogenic phage infects bacterium. Viral DNA incorporated. DNA phage excised, gets some flanking DNA. Infect another. |
|
|
What is transposition?
|
Segments of DNA that can jump from one location to another. Excision may get some other flanking DNA that can be incorporated into a plasmid.
|
|
|
What 5 toxins are encoded in lysogenic phage?
|
ABCDE
Shig A Botulinum Cholera Diphtheria Erythrogenic Strep pyogenes |
|
|
What bacteria are novobiocin resistant coagulase negative, catalase positive?
|
Staph Saprophyticus
|
|
|
Bacteria novobiocin sensitive, coag negative, catalase positive?
|
Staph Epidermidis
|
|
|
Which bacteria are catalase negative, alpha hemolytic, optochin sensitive?
|
Strep pneumo also bile soluble
|
|
|
Which bacteria are catalase negative, alpha hemolytic, optochin resistant?
|
Step viridans group. not bile soluble
|
|
|
Which bacteria are beta hemolytic, bacitracin sensitive, catalase negative?
|
Group A = s pyogenes
|
|
|
Which bacteria are beta hemolytic, bacitracin resistant, catalase negative?
|
Group B strep
|
|
|
B hemolytic bacteria?
|
Strep pneumo, Staph aureus, Group B strep (step agalactiae),
Listeria monocytogenes |
|
|
Profile of Staph aureus?
|
causes skin infections, organ abscesses, pneumonia
acute bacterial endocarditis, osteomyelitis |
|
|
How is MRSA resistant to methicillin?
|
Alteration in PBP
|
|
|
Staph epidermidis does?
|
normal skin flora
infects prosthetic devices and IV catheters by producing adherent biofilms |
|
|
Step pneumo most common causes of?
|
MOPS
Meningitis Otitis media Pneumonia Sinusits sepsis in sickle cell, splenectomy. Rust colored sputum from pneumonia. |
|
|
Viridans group strep?
|
Part of oral flora
Sanguis - subacute bacterial endocarditis Mutans - dental caries |
|
|
Strep pyogenes (group A beta hemolytic bacitracin sensitive)?
|
pharyngitis, cellulitis, impetigo
Toxigenic - scarlet fever, toxic shock Immunologic - rheumatic fever, acute GN |
|
|
Rheumatic fever pentad?
|
Subq plaques
Polyarthritis Erythema marginatum Chorea Carditis |
|
|
What can strep agalactiae do?
|
Remember Beta hemolytic, bacitracin resistant.
group B strep! pneumonia, meningitis, sepsis in babies. |
|
|
What are enterococci? What do they do?
|
Enterococci - normal colonic flora. Cause UTI and subacute endocarditis.
Hardier than nonenterococcal group D. Lancefiled grouping based on differences in C carbohydrate on cellw all. |
|
|
What is group D nonenterococcal strep?
|
S bovis.
Can do subacute endocarditis in colon cancer patients. Also bacteremia. |
|
|
Describe Diphtheria?
|
ABCDEFG
ADP ribosylation Beta=prophage Corynebacterium Diphtherium Elongation factor 2 Granules Makes pseduomembranous pharyngitis with lymphadenopathy. toxoid vaccine prevents |
|
|
What form bacterial spores?
|
B anthracis, C perfringens, C tetani
B cereus, C botulinum |
|
|
Clostridia profile?
|
Gram positive, spore forming, obligate anaerobes.
|
|
|
How does c diff mediate pseudomembranous colitis?
|
producing cytotoxin, exotoxin that kills enterocytes.
|
|
|
C perfringens produces what toxin?
|
alpha toxin, a lecithinase (a phospholipase) that can cause myonecrosis (gas gangrene) and hemolysis.
|
|
|
What cells does tetanospasmin affect?
|
Renshaw cells in spinal cord. Causes spastic paralysis, trismus, and risus sardonicus.
|
|
|
Anthrax profile?
|
B anthracis - gram positive, spore-forming rod that produces anthrax oxin.
ONLY BACTERIUM WITH A POLYPETPTIDE CAPSULE (contains D-glutamate) skin form - black eschar with edematous ring pulm anthrax - mediastinitis, shock, fever, pulm hemorrhage, flulike symptoms |
|
|
Listeria monocytogenes profile?
|
Facultative intracellular microbe.
Unpasteurized milk/cheese and deli meats or vaginal transmission. Cx tumbling motility from actin rockets. Gram positive with endotoxin. Cause - amnionitis, septicemia, spontaneous abortion in women; neonatal meningitis; meningitis in IC patients; mild gastroenteritis in healhty |
|
|
Actinomyces vs nocardia?
|
Both gram positive rods forming long branching filaments resembling fungi
Actino -- anaerobe, oral/facial abscesses Nocardia - weakly acid fast; pulm infection in IC. |
|
|
treatment for actinomyces vs nocardia?
|
SNAP
Solfa = nocardia Actinomyces = PCN |
|
|
What is a Ghon complex?
|
TB granulomas (Ghon focus) with lobar and perihilar lymph node involvement. Reflects primary infection or exposure.
|
|
|
M. avium-intracellulare profile?
|
Disseminated disease in AIDS. Multi drug resistant.
|
|
|
Leprosy profile?
|
M leprae. Likes cool temperatures and armadillos.
rx: long term dapsone Leprematous form = failed cell mediated immunity. Vs tuberculoid form. |
|
|
Differentiate N meningitidis from N gonorrhoeae?
|
Maltose fermenter = meningococcus
Maltose nonfermenter = gonorrhea |
|
|
Lactose fermenting enteric bacteria?
|
Citrobacter, Klebsiella, E coli, Enterobacter, serratia
|
|
|
Which bugs are gram negative coccoid rods?
|
H flu, B pertussis
|
|
|
Why are gram negative not sensitive to vancomycin or regular penicillin?
|
Gram negative outer membrane inhibits entry of penicillin G and vancomycin
|
|
|
What is important about neisseria?
|
both ferment glucose.
Meningococcus -polysaccharide capsule, maltose, vaccine, Waterhouse-Friderichsen syndrome Gonococci - STD, gonorrhea, septic arthritis, neonatal conjunctivitis, PID, Fitz-Hugh-Curtis |
|
|
What is Fitz-Hugh-Curtis syndrome?
|
Infection of the liver capsule and "violin string" adhesions of parietal peritoneum to liver
|
|
|
H flu profile?
|
Epiglottitis, Meningitis, Otitis media, Pneumonia.
IgA protease. Meningitis = Ceftriaxone Rifampin prophylaxis in close contacts |
|
|
Legionella pneumophila profile?
|
Legionnaire's = severe pneumonia and fever
Pontiac fever = mild flulike syndrome Gram negative rod. Detected by presence of antigen in urine!!! No p2p tranmission. Rx: erythromycin |
|
|
Pseudomonas profile?
|
Associated with wound and burn infections.
CYSTIC FIBROSIS pneumonia Sepsis External otitis - swimmer's ear UTI Drug use DIABETIC osteomyelitis Aerobic gram-negative, non lactose-fermenting, oxidase positive. Grapelike odor Endotoxin, exotoxin A - inactivates EF-2 Rx: aminoglycoside + extended-spectrum penicillin |
|
|
Which gram negative rods don't ferment lactose and aren't oxidase positive?
|
Salmonella, Shigella, Proteus
|
|
|
E coli differential profile?
|
Invade mucosa: EIEC - Shiga like toxin - dysentery -invasion and toxin
Not invade EHEC - shiga alone destroys ETEC - labile toxin/stable toxin EPEC - no toxin - diarrhea - prevents absorption; adheres to apical surface |
|
|
Klebsiella profile?
|
Lactose fermenter.
Pneumonia in ALCOHOLICS. DIABETICS. Red currant jelly sputum. Nosocomial UTIs. |
|
|
Salmonella vs Shigella differential?
|
Both invade intestinal mucosa and can cause bloody diarrhea.
Salmonella - flagella, hematogenous dissemination, produces H2S, prolonged symptoms with antibiox, monocytic response Shigella - more virulent. move within cell by actin polymerization. no flagella. |
|
|
Typhoid fever description?
|
Fever, diarrhea, headache, rose spots on abdomen
can remain in gallbladder chronically |
|
|
Yersinia enterocolitica profile?
|
Usu transmitted from pet feces, contaminated milk, or PORK.
Can mimic crohn's or appendicits. Outbreaks in day care centers |
|
|
H pylori profile?
|
Gram negative rod.
Creates alkaline environment. Rx: metronidazole, bismuth, either tetracycline or amoxicillin OR Metronidazole, omeprazole, clarithromycin |
|
|
Three spirochetes?
|
BLT
Borrelia - only one to be seen - Wright's or Giemsa Leptospiroris Treponema. |
|
|
Leptospira interrogans profile?
|
Question mark shaped. Water with animal urine.
Flulike sx, fever, HA, abdominal pain, jaundice, photophobia with conjunctivitis. |
|
|
What is Weil's disease?
|
Severe form of leptospirosis with jaundice, azotemia from the liver, kidney dysfunction; fever, hemorrhage, and anemia
|
|
|
What is the pathogenesis for Lyme disease?
|
Caused by Borrelia burgdorferi - transmitted by Ixodes
Present with erythema chronicum migrans, an expanding bull's eye red rash with central clearing. Mice are important reservoirs. Deer required for life cycle. rx: doxy, ceftriaxone |
|
|
Stages of Lyme disease?
|
1 = erythema chronicum migrans, flulike symptoms
2= neurologic and cardiac manifestations 3= chronic monoarthritis, and migratory polyarthritis |
|
|
Treponemal pertenue?
|
Yaws. Infection of skin, bones, joints --> healing with keloids. Leading to severe limb deformities.
Disease of the tropics. Not an STD, but VDRL positive. |
|
|
What is t pallidum?
|
primary syphilis - painless shancre
2ndary - disseminated disease with palms and soles rash, condyloma lata. Tertiary - gummas, aortitis, neurosyphilis = tabes dorsalis, Argyll Robertson (accomodates but doesn't react) |
|
|
VDRL vs FTA?
|
Both test for syphilis.
FTA is much more specific. Positive if acitve or successfuly treated. Antibody test. VDRL = nonspecific antibody reacting with beef cardiolipin. |
|
|
VDRL false positives?
|
VDRL
Viruses (mono,hepatitis) Drugs Rheumatic fever Leprosy and lupus |
|
|
Bartonella profile?
|
Zoonotic.
Cat scratch fever. Bacillary angiomatosis in IC patients (looks like Kaposis) |
|
|
Borrelia profile?
|
Lyme disease.
Zoonotic. Tick bite - Ixodes |
|
|
Brucella profile?
|
Brucellosis/undulant fever
Symptoms include profuse sweating and joint and muscle pain. from dairy products, contact wiht animals |
|
|
Tularemia profile?
|
Francisella tularensis
Tick bite; rabbits ulceroglandular (the most common type representing 75% of all forms), glandular, oropharyngeal, pneumonic, oculoglandular, and typhoidal |
|
|
Yersinia pestis disease?
|
Plague
from flea bite, rodents, prairie dogs bubonic - with buboes pneumonic septicemic |
|
|
Pasteurella disease?
|
Cellulitis!
from animal bite |
|
|
What is Gardnerella vaginalis like?
|
Pleomorphic, gram-variable rod = vaginosis with fishy smell; nonpainful. Mobiluncus, an anaerobe, is also involved.
Associated with sexual activity, but not an STD. Bacterial vaginosis cx by overgrowth of certain bacteria in vagina. rx: Metronidazole Look for clue cells |
|
|
Rickettiae genus profile?
|
OBLIGATE INTRACELELULAR ORGANISMS
need CoA and NAD+. All except Coxiella = arthropod vector. = headache, fever, rash Coxiella = atypical - aeorosol and pneumonia ALL TREATMENT = TETRACYCLINE |
|
|
Contrast ricketssial diseases and profiles?
|
Typhus - rash on trunk spreads
Ricketssia - hands and feet and spreads ROMSF tick- Rickettsia ricketsii Endemic typhus flea - R typhi Endemic typhus with louse - R prowazekii Erlichiosis Q fever - Coxiella burnetti - inhaled aerosol |
|
|
What diseases have palm and sole rashes?
|
Coxsackievirus A (hand, foot, and mouth)
RMSF Syphilis Small pox |
|
|
What is Weil-Felix reaction?
|
Pts with rickettsial antibodies presented to Proteus - cross react and agglutinate.
NOT COXIELLA |
|
|
Chlamydia profile?
|
CANNOT MAKE OWN ATP.
Obligate intracellular organisms causing mucosal infections. 2 forms: 1) elementary body is infectious and enters cell 2) Reticulate body replicates in cell by fission |
|
|
Chlamydia trachomatis?
|
reactive arthritis, conjunctivitis, nongonococcal urethritis, PID
A-C = africa, blindness, chronic infection D-K = urethritis, neonatal pneumonia/conjunctivitis L = lymphangranuloma venereum Rx: erythromycin |
|
|
Mycoplasma pneumoniae background?
|
atypical pneumonia
X ray looks bad high titer of cold agglutinins (IgM) Eaton's agar MEMBRANE HAS CHOLESTEROL Eaton's agar |
|
|
Donovanosis?
|
Granuloma inguinale from Calymmatobacterium granulomatis.
Small, painless nodules appear after about 10–40 days of the contact with the bacteria |
|
|
Name a bacteria also oxidase positive and sensitive to gastric pH that isn't pseudomonas?
|
V cholera
|
|
|
Causes for chlamydia pneumoniae and c psittaci?
|
atypical pneumonia. transmitted by aerosol. C psittaci - notable for an avian reservoir.
|
|
|
Which fungi are transmitted by inhalation of asexual spores?
|
Coccidio and histo
|
|
|
Histoplasmosis profile?
|
Mississippi and Ohio river valleys. Pneumonia.
In macrophage filled with it. From bird or bat droppings. |
|
|
Blastomycosis profile?
|
Inflammatory lung disease. See in skin and bone.
Forms granulomatous nodules. Broad-base budding |
|
|
Coccidiomycosis profile?
|
Pneumonia and meningitis; can disseminate to bone and skin.
Spherules. |
|
|
Paracoccidiomycoseis?
|
Budding yeast with captain's wheel formation
|
|
|
Systemic mycoses non opportunistic cx?
|
Dimorphic
cold = mold hot = yeast (coccidio = spherule) Rx: fluconazole/ketoconazole = local Amp B = systemic |
|
|
What is tinea versicolor?
|
Malassezia furfur. Degradation of lipids produces acids that damage melanocytes and cause hypopigmented patches.
tx: topical miconazole, selenium sulfide Spaghetti and meatballs look |
|
|
Tinea pedis, cruris, corporis, capitis profile?
|
Pruritic lesions with central clearing resembling a ring, caused by dermatophytes.
See mold hyphae, not dimorphic. Rx: topical azoles |
|
|
Candida albicans profile?
|
Yeast with pseudohyphae. Germ tube formation at 37 degrees = dx.
Oral thrush, vulvovaginitis - higher with DM, diaper rash, endocarditis in IVDU, disseminated candidiasis. rx: nystatin for superficial infection; amp B for serious sytemic infection |
|
|
Aspergillus profile?
|
Allergic bronchopulmonary aspergillosis, lung cavity aspergilloma (fungus ball)
esp CGD and IC pts Acute angle branches Not dimorphic |
|
|
Cryptococcus neoformans profile?
|
Cryptococcal meningitis, cryptococcus
Narrow based budding Heavily encapsulated yeast. Not dimorphic. Found in soil, pigeon droppings. Soap bubble lesions in brain |
|
|
Mucor and Rhizopus profile?
|
Mucormycosis. Mold with irregular nonseptate hyphae wide angles.
DKA pts and leukemic. Fungi also prolif in blood wessels. Rhinocerebral, frontal lobe abscesses |
|
|
Pneumocystis jiroveci profile?
|
Yeast. Inhaled.
Diffuse bilateral CXR appearance. Dx by lung biopsy or lavage Identified by methenamine silver stain of lung tissue Rx: bactram, pentamidine, dapsone |
|
|
Sporothrix schenkii profile?
|
Yeast forms, unequal budding
dimorphic fungus Rose gardeners Ascending lymphangitis rx: itraconazole or potassium iodide |
|
|
Giardia profile?
|
Bloating, flatulence, foul-smelling, fatty diarrhea
Cysts in water = transmission Dx = trophozoites or stool Rx: Metronidazole |
|
|
Entameoba histolytica profile?
|
Amebiasis: bloody diarrhea, liver abscess, RUQ pain,
cysts in water = transmission dx: serology, stool, RBCs in cytoplasm of entamoeba rx: metronidazole and iodoquinol |
|
|
Cryptosporidium profile?
|
Diarrhea in AIDS
Cysts in water = transmission dx = cysts on acid fast rx: prevention with water filtering in cities |
|
|
Toxoplasma gondii profile?
|
Brain abscess in HIV (ring enhancing)
congenital = chorioretinitis, hydrocephalus, intracranial calcifications Cysts in meat or cat feces. dx: serology, bx rx: sulfadiazine + pyrimethamine |
|
|
Naegleria fowleri profile?
|
Rapidly fatal meningoencephalitis
Transmission - swimming in freshwater lakes, enter via cribriform plate Dx: amoebas in spinal fluid |
|
|
Trypanosoma gambiense/rhodesiense/brucei profile?
|
African sleeping sickness
Transmitted: tsetse fly, painful bite dx: blood smear |
|
|
T cruzi profile?
|
Chagas disease
Periorbital edema, dilated cardiomyopathy, megacolon, megaesophagus transmission: reduviid bug dx: blood smear tx: nifurtimox |
|
|
Leishmania donovani?
|
Visceral leishmaniasis, hepatosplenomegaly
transmission: sandfly dx: macrophages containing "amastigotes" rx: sodium stibogluconate |
|
|
Difference between p vivax and ovale and falciparum?
|
Malaria - cyclic fever, HA, anemia, splenomegaly
Vivax/ovale - cycles occur every other day falciparum - parasitized RBCs can occlude capillaries in brain (cerebral malaria) transmission - anopheles dx - blood smear |
|
|
Babesia profile?
|
Babesiosis - fever and hemolytic anemia
transmission: ixodes dx: blood smear, no RBC pigment like maltese cross rx: quinine, clindamycin |
|
|
Trichomonas vaginalis?
|
vaginitis; foul smelling, greenish discharge, itching and burning, strawberry cervix
transmission: STD dx: trophozoites on wet mount rx: metronidazole |
|
|
Enterobius vermicularis (pin worm)?
|
food contaminated with eggs. intestinal infection. Anal pruritus.
dx: scotch tape test rx: bendazoles or pyrantel pamoate |
|
|
Ascaris lumbricoides?
|
Roudnworm.
Eggs visible in feces. Intestinal infection Rx: bendazoles or pyrantel pamoate |
|
|
Trichinella spiralis?
|
undercooked meat, pork; inflammation of muscle (larvae encyst in muscle), periorbital edema
rx: bendazoles |
|
|
What is Romana's sign?
|
Eyelid infammation with Chagas
|
|
|
Strongyloides background?
|
Larvae penetrate skin; intestinal infections; vomiting diarrhea, and anemia
tx: bendazoles or ivermectin |
|
|
Hookworks (ancylostoma duodenale, necator americanus)?
|
Larvae penetrate feet skin; intestinal infection can cause anemia.
rx: bendazoles or pyrantel pamoate |
|
|
Dracunculus medinensis?
|
drinking water; skin inflammation and ulceration
rx: niridazole |
|
|
Onchocerciasis?
|
transmitted by female blackflies; hyperpigmented skin and river blindness. Possible allergy to microfilaria.
|
|
|
Loa loa infection?
|
transmitted by deer fly, horse fly, and mango fly;
causes swelling in skin (can see worm crawling in conjunctiva) rx: diethylcarbamazine |
|
|
Wuchereria bancrofti?
|
Female mosquito; causes blockage of lymphatic vessels (elephantiasis)
9mo-1yr for elephantiasis Diethylcarbamazine |
|
|
Toxocara canis?
|
Food contaminated with eggs; causes granulomas (blindness in retina) and visceral larva migrans.
rx: diethylcarbamazine |
|
|
Taenia solium profile?
|
Ingestion of larvae from undercooked pork = intestinal tapeworm
Eggs = cysticercosis and neurocysticercosis (swiss cheese brain) rx: praziquantel or bendazoles for neurocysticercosis |
|
|
Echinococcus granulosus?
|
Eggs in dog feces when ingested can cause cysts in liver; causes anaphylaxis if echinococcal antigens are released from cysts (surgeons inject ethanol before removal to neutralize antigens)
rx: bendazoles |
|
|
Diphyllobothrium latum?
|
ingestion of larvae in raw freshwater fish. Vitamin B12 deficiency, resulting in anemia
|
|
|
Schistosoma profile?
|
Snails = host; cercariae penetrate skin of humans; causes granulomas, fibrosis, and inflammation of spleen and liver.
s mansoni = portal hypertension Infection from s hematobium - hematuria/bladder squamous cell cancer Rx: praziquantel |
|
|
Clonorchis sinensis organism?
|
undercooked fish; causes inflammation of the biliary tract --> pigmented gallstones. Also associated with cholangiocarcinoma.
rx: praziquantel |
|
|
Paragonimus vestermani?
|
Undercooked crab meat, inflammation and 2ndary bacterial infection of the lung, hemoptysis.
rx: praziquantel |
|
|
What does recombination mean?
|
Exchange of genes between 2 chromosomes by crossing over within regions of significant base sequence homology.
|
|
|
What does reassortment mean?
|
When viruses with segmented genomes (influenza) exchange segments. High frequency recombination. Cause of worldwide flue pandemics.
|
|
|
What does complementation mean?
|
When 1 of 2 viruses that infect the cell has a mutation that results in a nonfunctional protein. The nonmutated virus "complements" the mutated one by making a functional protein that serves both proteins.
|
|
|
What is phenotypic mixing?
|
Simultaneous infection of a cell with 2 viruses. Genome of virus A can be covered by virus B redetermining infectivity. But progeny will have type A coat encoded by its type A genetic material.
|
|
|
Difference between live and attenuated vaccines?
|
Live - induce humoral and cell-mediated immunity; no booster needed; only MMR can be given to HIV +
Killed - only humoral, but stable |
|
|
Which vaccines are live attenuated?
|
smallpox, yellow fever, chicken pox, Sabin's polio virus, MMR
|
|
|
Vaccines are killed viruses?
|
Rabies, influenza, salk Polio, HAV
|
|
|
Recombinant virus vaccines?
|
HBV, HPV
|
|
|
DNA virus that isn't double strand?
|
Parvoviridae
|
|
|
DNA virus that isn't linear?
|
Papilloma and polyoma and hepadna.
These are circular and supercoiled except hepadna is incomplete. |
|
|
What is the double strand RNA virus?
|
Reovirus
|
|
|
What viruses are infectious purified? Which ones aren't?
|
Purified nucleic acids of most dsDNA and +strand ssRNA (mRNA) = infxs
exception: HBV and poxviruses Naked - strand ssRNA and dsRNA = not. Need enzymes from the complete virion. |
|
|
Which viruses aren't haploid?
|
ALL ARE HAPLOID
except retroviruses = two copies of ssRNA |
|
|
Where do virii replicate?
|
DNA - nucleus
except - pox RNA - cytoplasm except - influenza and retro |
|
|
What are the naked/noneveloped viruses?
|
CPR PAPP
Calcivirus, Picorna, Reo, Parvo, Adeno, Papilloma, Polyoma |
|
|
Where do enveloped viruses acquire envelopes? Exception?
|
Plasma membrane
Hepadna virus = nuclear membrane |
|
|
Which are the DNA enveloped viruses?
|
Herpesviruses, HBV, Pox virus
|
|
|
Which DNA viruses have nucleocapsid?
|
Adenovirus, Polyomavirus, Papilloma
|
|
|
DNA viruses list?
|
HHAPPPPy
Hepadna, Herpes, adeno, polyoma, pox, papilloma, parvo |
|
|
Why doesn't pox replicate in the nucleus?
|
Carries its own DNA-dependent RNA polymerase
|
|
|
Which DNA virus isn't icosahedral?
|
Pox. It's complex.
|
|
|
Adenovirus profile?
|
Not enveloped.
Causes febrile pharyngitis, pneumonia, and pink eye |
|
|
Parvovirus profile?
|
No envelope. SS-linear negative strand.
B19 virus - aplastic crises in SCD. Slapped cheeks rash - erythema infectiosum (fifth disease). RBC destruction in fetus leads to hydrops fetalis and death. |
|
|
Papillomavirus?
|
Causes HPV - warts, CIN, cervical cancer.
warts = 6 and 11 cancer = 16 and 18 |
|
|
Polyomavirus profile?
|
Not enveloped. DS-circular
JC virus - PML in HIV |
|
|
Poxvirus profile?
|
Largest DNA virus.
Causes smallpox Vaccinia - cowpox Molluscum contagiosum |
|
|
HSV-1 profile?
|
Gingivostomatitis, keratoconjunctivitis, temporal lobe encephalitis, herpes labialis.
Transmission - respiratory secretions, saliva |
|
|
HSV-2 profile?
|
Herpes genitalis, neonatal herpes.
From sexual contact, perinatal. |
|
|
VZV profile?
|
Shingles, encephalitis, pneumonia.
From respiratory secretions reamins dormant in trigeminal and dorsal root ganglia |
|
|
EBV profile?
|
Causes infxs mono, Burkitt's lymphoma, nasopharyngeal carcinoma
Infects B cells. See atypical lymphocytes (T cells) from respiratory secretions, saliva Positive Monospot = sheep agglutination |
|
|
CMV profile?
|
Congenital infection, mononucleosis (negative monospot), pneumonia.
Infected cells = owl's eye route - congenital, transfusion, sexual contact, saliva, urine, transplant |
|
|
HHV-6 profile?
|
Roseola: high fevers for several days that can cause szs, followed by diffuse macular rash
|
|
|
HHV-8 profile?
|
Kaposi's sarcoma (HIV pts)
from sexual contact |
|
|
What is the Tzanck test used for?
|
smear from an opened vesicle to detect multinucleated giant cells. Used for HSV-1, HSV-2, VZV.
Also Cowdry A infections. |
|
|
Reovirus profile?
|
No envelope. DS linear. Icosahedral (double).
Reovirus = colorado tick fever Rotavirus |
|
|
Rotavirus profile?
|
A reovirus.
#1 cause of fatal diarrhea in children segmented dsRNA villous destruction with atrophy leads to decreased absorption of Na and water |
|
|
Picornavirus profile?
|
No envelope. SS+ linear. Icosahedral.
PERCH Polio Echo - aseptic meningitis Rhino Coxsackievirus - aspetic meningitis, herpangina, hand-foot-mouth disease, myocarditis HAV |
|
|
Hepevirus profile?
|
No envelope.
SS + linear Icosahedral HEV |
|
|
Calicivirus profile?
|
No envelope. SS + linear. Icosahedral.
Norwalk virus - viral gastroenteritis |
|
|
Flaviviruses profile?
|
Yes envelope. SS + linear. Icosahedral.
HCV Yellow fever Dengue St. Louis encephalitis West Nile |
|
|
Yellow fever profile?
|
Transmitted by Aedes mosquitos.
Symptoms: high fever, black vomitus, and jaundice. Councilman bodies (acidophilic inclusions) may be seen in liver. |
|
|
Togavirus profile?
|
Yes Envelope. SS+ linear. Icosahedral.
Rubella Eastern equine encephalitis Western equine encephalitis |
|
|
Rubella profile?
|
Togavirus. German (3-day) measles. Fever, lymphadenopathy, arthralgias, fine truncal rash.
Mild dz in children serious TORCH infection |
|
|
Retrovirus profile?
|
Yes envelope. SS + linear. Icosahedral.
Reverse transcriptase HIV - AIDS HTLV - T cell leukemia |
|
|
Coronavirus profile?
|
envelope. SS + linear. Helical.
Coronavirus = common cold and SARS |
|
|
Orthomyxoviruses?
|
Envelope. SS negative!! linear.
8 segments. Helical structure. Influenza |
|
|
Influenza profile?
|
Contain hemagglutinin (viral entry)
Neuraminidase (promotes progeny virion release) Pts at risk for fatal bacterial superinfection. killed viral vaccine = major mode of protection |
|
|
Paramyxovirus profile?
|
Envelope. SS - linear, nonsegmented. Helical.
Parainfluenza = croup RSV = bronchiolitis in babies Rubeola (Measles) Mumps all contain surface F (fusion proteins) that cause respiratory epithelial cells to fuse and form multinucleated cells. Palivizumab used in RSV to neutralize F protein. |
|
|
Rubeola/measles virus profile?
|
Paramyxovirus that causes measles.
Dx: Koplik spots - red spots with blue-white center on buccal mucosa SSPE = subacute sclerosing panencephalitis years later. Encephalitis Giant cell pneumonia (immunosuppressed) Rash spreads head to two cough, coryza, conjunctivitis!!! |
|
|
Mumps profile?
|
Paramyxovirus
Symptoms: Parotitis, Orchitis, aseptic Meningitis. Sterility possible after puberty. |
|
|
Rhabdovirus profile?
|
Envelope. SS negative linear. Helical.
Rabies |
|
|
Rabies profile?
|
Negri bodies are cx cytoplasmic inclusions in neurons infected by rabies. Bullet-shaped capsid.
Progression: fever, malaise --> agitation, photophobia, hydrophobia --> paralysis, coma --> death Bat, raccoon, skunk |
|
|
Filoviruses profile?
|
Envelope. ss negative linear. Helical. Ebola/marburg hemorrhagic fever.
|
|
|
Arenavirus profile?
|
Envelope. Single strand negative sense. Circular. 2 segments. Helical.
LCMV = lymphocytic choriomeningitis virus Lassa fever encephalitis = mice |
|
|
Bunyavirus profile?
|
Envelope. sS-. circular. 3 segments. Helical.
California encephalitis Sandfly/Rift Valley fevers Crimean-Congo hemorrhagic fever Hantavirus - hemorrhagic fever, pneumonia |
|
|
Deltavirus profile?
|
Envelope. SS negative. Circular. Helical.
HDV. |
|
|
Arboviruses?
|
Transmitted by arthropods
Dengue Yellow fever Flavivirus, Togaviurs, Bunyavirus |
|
|
Hepatitis viruses differential?
|
Signs: fever, jaundice, elevated AST and ALT
HAV = RNA picornavirus. Fecal-oral HBV = DNA hepadna. Sexual, parental, maternal. Long incubation. Carriers. HCV = RNA flavivirus. Primarily transmitted via blood. HDV = delta agent = defective virus requiring HBsAg as envelope. Can coinfect with HBV or superinfect (with worse prognosis) HEV (RNA hepevirus) = transmitted enterically and causes water-borne epidemics. Resembles HAV in course. High mortality in PREGNANT WOMEN. Epidemics. |
|
|
How does HBV replicate?
|
Cellular RNA polymerase transcribes RNA from DNA template. Reverse transcriptase transcribes DNA genome from RNA intermediate.
But the virion enzyme is a DNA-dependent DNA polymerase |
|
|
What does HBeAg signify? What does HBeAb signify?
|
HBeAg signifies infectivity. Anti-HBe signifies low transmissibility.
|
|
|
Differences in liver enzymes between hepatitis from virus and EtOH?
|
EtOH = high AST
viral = high ALT |
|
|
What are some features of HIV?
|
What are the envelope proteins - gp41 and gp120
p24= capsid Reverse trasncriptase = pol p17 = matrix protein |
|
|
What does HIV bind on T cells? Macrophages?
|
T cells - CD4 and CXCR4
Macrophages - CD4 and CCR5 |
|
|
Replication of HIV?
|
Reverse transcriptase synthesizes dsDNA from RNA; dsDNA integrates into host genome
|
|
|
How do you diagnose HIV?
|
presumptive = ELISA
Rule in = Western Blot |
|
|
AIDS diagnosis?
|
<200 CD4
HIV with AIDS indicator condition CD4/CD8 ratio < 1.5 |
|
|
What are the four stages of HIV infection?
|
Flulike
Feeling fine Falling count Final crisis in latent phase, virus replicates in lymph nodes |
|
|
Why are babies positive born to infected HIV mothers when they're actually not?
|
anti-gp120 crosses the placenta
|
|
|
What are neoplasms associated with HIV?
|
Kaposi's, invasive cervical carcinoma (HPV), primary CNS lymphoma, non-Hodgkin's
|
|
|
How does HIV encephalitis happen?
|
late in HIV course. Virus gains CNS access via infected macrophages. Microglial nodules with multinucleated giant cells.
|
|
|
What is the structure of prions that causes messing up?
|
Beta pleated form
|
|
|
What are normal flora in the body?
|
Skin - staph eidermidis
Nose - staph epidermidis, S aureus Oropharnyx- viridans group strep Dental plaque - strep mutans Colon - B fragilis > e coli Vagina - lactobacillus, colonized by e coli and group B strep |
|
|
Which bugs cause food poisoning?
|
vibrio parahaemolyticus and v vulnificus - contaminated seafood. V vulnificus - also cause wound infections from contact with contaminated water or shell fish
b cereus = reheated rice S aureus = mayonnaise, custard, meat C perfringens = reheated meat C botulinum = improper canned food E coli O157:H7 = undercooked meat Salmonella - poultry, meat, eggs |
|
|
Which pneumoniac agents are associated with postviral pneumonia?
|
Staph, H flu
|
|
|
Pneumonia agent with cystic fibrosis?
|
Pseudomonas
|
|
|
Sickle cell and osteomyelitis?
|
Salmonella
|
|
|
Prosthetic replacement and osteomyelitis?
|
S aureus and S epidermidis
|
|
|
What are diagnostic markers of UTIs?
|
positive leukocyte esterase test = bacterial UTI
positive nitrite test = gram-negative bacterial UTI |
|
|
Serratia marescens features?
|
UTI. some strains produce a red pigment. Often nosocomial and drug resistant.
|
|
|
Enterobacter cloacae?
|
Often nosocomial and drug resistant
|
|
|
Klebsiella pneumoniae features for UTI?
|
large mucoid capsule and viscous colonies.
|
|
|
Proteus mirabilis features for UTI?
|
motility causes swarming on agar; produces urease; associated with struvite stones
|
|
|
What are the Torch infections?
|
Toxo
Rubella CMV HIV Herpes simplex virus Syphilis |
|
|
Toxo neonatal manifestations?
|
Chorioretinitis, hydrocephalus, intracranial calcifications
|
|
|
Rubella neonatal manifestations?
|
PDA (or pulmonary artery hypoplasia), cataracts, deafnes +/- blueberry muffin rash
|
|
|
CMV neonatal manifestations?
|
Hearing loss, seizures
|
|
|
HIV neonatal manifestations?
|
Recurrent infxns, diarrhea
|
|
|
HSV neonatal manifestations?
|
Encephalitis, herpetic lesions
|
|
|
Syphilis neonatal manifestations?
|
Often results in stillbirth; hydrops fetalis. If child survives, presents with facial abnormalities (notched teeth, saddle nose, short maxilla), saber shins
|
|
|
Rash begins at head and moves down. Postauricular lymphadenopathy?
|
Rubella virus
|
|
|
Rash beginning at head and moving down; rash preceded by cough, coryza, conjunctivitis, and blue-white (Koplik) spots on buccal mucosa?
|
Measles virus - paramyxovirus
|
|
|
No rash. Can present with parotitis, meningitis (orchitis or oophoritis in young adults)?
|
Mumps virus
|
|
|
Rash begins on trunk; spreads to face and extremities with lesions of different age?
|
VZV
|
|
|
A macular rash over body appears after several days of high fever; usually affects infants?
|
HHV-6 / roseola
|
|
|
"Slapped cheek" rash on face later appears over body in reticular, "lace-like" pattern. (Can casue hydrops fetalis in pregnant women)
|
Parvovirus B19 = erythema infectiosum
|
|
|
Erythematous, sandpaper-like rash with fever and sore throat.
|
Strep pyogenes. Scarlet fever.
|
|
|
Vesicular rash on palms and soles; ulcers in oral mucosa?
|
Coxsackievirus type A. Hand-foot-mouth disease.
|
|
|
Noninflammatory, malodorous discharge (fishy smell); positive whiff test, clue cells?
|
Gardnerella vaginalis
|
|
|
Nosocomial risk factors?
|
Newborn nursery - CMV, RSV
Urinary cath - E coli, Proteus, mirabilis Respiratory therapy equipment - Pseudomonas Work in renal unit - HBV |
|
|
HIV - Dermatologic - superficial vascular proliferation - bx neutrophilic inflammation?
|
Bartonella hensalae and bacillary angiomatosis
|
|
|
HIV - Superficial - lymphocytic inflammation?
|
Kaposi's
|
|
|
HIV - neurologic - encephalopathy - reactivation of latent virus; resulting in demyelination?
|
JC virus (cause of PML)
|
|
|
HIV - neurologic - many ring-enhancing lesions on imaging?
|
Toxoplasma gondii
|
|
|
HIV - neurologic - retinitis - cotton-wool spots on funduscopic exam?
|
CMV
|
|
|
HIV - oncologic - hairy leukoplakia - often on lateral tongue?
|
EBV
|
|
|
HIV - non-hodgkins lymphoma - often on oropharynx?
|
EBV
|
|
|
HIV - respiratory - interstitial pneumonia - bx reveals cells with intranuclear and cytoplasmic inclusion bodies?
|
CMV
|
|
|
HIV - respiratory - pleuritic pain, hemoptysis, inifiltrates on imaging?
|
Aspergillus
|
|
|
When to think of MAC with HIV?
|
CD4 < 50
|
|
|
Positive PAS stain?
|
Whipple's disease
|
|
|
Bacteria associated with protein M?
|
Group A strep
|
|
|
What property allows hep c not to confer immunity to host?
|
Changing envelope structure of its envelope
|
|
|
Which bacteria can grow in bile and 6.5% NaCl?
|
enterococci and E faecium
|
|
|
Organisms associated with Reiter's syndrome?
|
Chlamydia, shigella, salmonella, yersinia, campylobacter
|
|
|
What are the invasive gut bacteria?
|
Salmonella, Shigella, Yersinia enterocolitis, EIEC, Campylobacter jejuni
|
|
|
Which bacteria produce exotoxin after ingestion?
|
ETEC, EHEC, shigella, vibrio cholera.
|
|
|
Bacteria with preformed exotoxin?
|
B cereus, S aureus. No P2p.
|
|
|
Primary focus of crypto infection is where?
|
Lungs
|
|
|
Pathogen responsible a lot of the times for aseptic meningitis?
|
Enterovirus, a picornavirus
|
|
|
Is staph epidermidids associated with skin infections?
|
No
|
|
|
Virulence factor of Group B strep?
|
resists ingestion by phagocytes
|
|
|
Pathogen responsible for chancroid?
|
haemophilus (coccobacillus) ducreyi
|
|
|
Skin findings with cocccidio?
|
Red nodules on shins with lung findings
|
|
|
Pathogen associated with osteomyelitis and SCD?
|
salmonella
|
|
|
P falciparum can be visualized on blood smear with what?
|
Giemsa stain
|
|
|
NRTIs cause anemia how?
|
decrease erythrocyte production
|
|
|
Cause of molluscum contagiosum?
|
Pox virus (MC)
|
|
|
Cause for endometritis?
|
Usu post delivery. Usu bacteroides. Foul smelling
|
|
|
Most common viral encephalitis?
|
HSV-1
|
|
|
Most common bacterial meningitis?
|
S pneumo
|
|
|
Best method for sterilizing C diff bedpan?
|
121C steam for 15 min (saturated)
|
|
|
Coagulase can be detected by beads coated with?
|
Fibrinogen and IgG
|
|
|
Antibodies against measles would be against what antigen?
|
Hemagglutinin
|
|
|
Fremitus can suggest?
|
Lobar pneumonia
|
|
|
HIV related renal finding?
|
FSGS (also SCD, heroin)
|
|
|
Entameba findings?
|
Bloody diarrhea, liver abscess
|
|
|
Aspergillus spreads by?
|
Vascular invasion
|
|
|
Virulence factor for group A strep?
|
strep pyogenes has M protein - inhibits phagocytosis and complement activation
|
|
|
Sputum culture and candida?
|
Probably a mouth contaminant!
|
|
|
Hep C envelope and immunogenicity?
|
Antigenic structure changes so it's wily!
|
|
|
What is susceptible to optochin and bile?
|
S pneumo
|
|
|
Risk factors for candida?
|
antibiotics, DM, steroids, contraception, immunocompromise
|
|
|
What HIV product is glycosylated?
|
env - gp160 cleaved to...
120 - for absorption 41 - fusion backbone |
|
|
HiB pathogenicity?
|
PRP capsule
|
|
|
What grows on blood agar with bile and salt?
|
Enterococci. Group D strep like s bovis can't grow on the salt
|
|
|
MacConkey agar grows?
|
Enteric bacteria
|
|
|
What grows on cysteine-tellurite agar?
|
C diphtheria
|
|
|
Important factor for Shiga infection?
|
Mucosal invasion
|
|
|
Difference between reassortment and recombination?
|
segmented, ssRNA can reassort (like flu)
recombination seems to be more common with crossing over |
|
|
Hep B infant prognosis?
|
Increased risk for chronic infection, increased viral rate, milder liver injury
|
|
|
Mucor typically affects?
|
DKA. DM.
see sinuses |
|
|
E coli virulence factor for neonatal meningitis?
|
Capsule
|
|
|
E coli O antigen? Heat labile toxin? Fimbria?
|
O = cell wall polysaccharide = gram neg identification
ETEC = heat labile Fimbria = virulence factor for UTI |
|
|
BK virus is what?
|
A Papova virus, causes hemorrhagic cystitis and nephropathy
|
|
|
HIV pts big risk of what type of malignancies?
|
EBV lymphoma (non-Hodgkins)
|
|
|
C perfringens toxin does what?:
|
Lecithinase. Degrades phospholipid
|
|
|
Thayer Martin media has?
|
for gonococcus
Vanco Colistin (polymyxin) Bactram |
|
|
Hep B prodrome presents as?
|
Joint pain, serum sickness like with fever
|
|
|
TB infection presents with what immunologic response?
|
Type IV hypersensitivity
|
|
|
HbsAg looks like what?
|
envelope - has spheres and tubules 22nm
|
|
|
Number one cause of meningitis?
|
Strep pneumo
|
|
|
C perfringens can cause what issues?
|
Gas gangrene and toxin like diarrhea
|
|
|
H flu gets to meninges how?
|
Pharynx, lymphatics, meninges
|
|
|
N meningitis path to meninges?
|
Pharynx, blood, choroid plexus, meninges
|
|
|
ETEC toxins?
|
Labile toxin - cAMP - activates Gs
Stable toxin - cGMP |
|
|
MMR vaccine is live or killed?
|
Live
|
|
|
What vaccines are killed?
|
rabies and HepA
|
|
|
What allows for TB intracellular proliferation?
|
Sulfatide virulence factor
|
|
|
Dx aspergillus?
|
Serologic
|
|
|
Dx mucor?
|
biopsy
|
|
|
Treating lyme disease?
|
Ceftriaxone, PCN, doxy
|
|
|
How does Flu vaccine mediate resistance?
|
Hemagluttinin - preventing viral entry; humoral
|
|
|
Staph Aureus major virulence factor?
|
Protein A. Inhibits binding of Fc portion of Ig. Not allowing opsonization and phagocytosis
|
|
|
S pyogenes major virulence factor?
|
Prevents phagocytosis
|
|
|
Number 2 cause of UTI?
|
Staph saprophyticus
|
|
|
Mycoplasma can cause what blood reaction?
|
cold agglutinin
|
|
|
What can cause hemorrhagic cystitis?
|
Adenovirus -normal
BK virus - a polyoma virus in transplant pts |
|
|
Tetanosplamin action?
|
Prevents release of nts inhibiting inhibitory neurons.
|
|
|
Most important discriminating prognostic factor for PSGN?
|
Age
|
|
|
Segmented viruses?
|
Rota. Orthomyxo
|
|
|
EHEC specific factos?
|
Doesn't ferment sorbitol. Doesn't produce glucuronidase.
|
|
|
Mechanism of C diff toxin?
|
exotoxin disrupting the cytoskeleton
|
