Nath Microbio Oneliners Sti Subset

Front 1

247. Genital chancre begins as a papule, ulcerates to form a single, painless, clean-based ulcer. TOW?

Back 1

primary syphilis

Front 2

248. Cause of genital chancre, begining as a papule, ulcerating to form a single, painless, clean-based ulcer.

Back 2

Treponema pallidum

Front 3

249. A pen-allergy, non-pregnant, female pt w/ fever, "copper penny" macular lesions on the palms or soles; RPR(+) should be

Back 3

Doxycycline (secondary syphilis)

Front 4

250. Management choice of tabes dorsalis (10-20yrs), iritis, uveitis, or Argyll-Robertson pupils in a pregnant woman w/ pen allergy; RPR(+) is

Back 4

Desensitization

Front 6

251. Hx of painful clustered vesicles with an erythematous base; urinary retention in a woman w multiple sex partners. TOW?

Back 6

HSV-2 >> 1

Front 8

252. Giemsa stain of fluid from a herpetic lesion should reveal

Back 8

Multinucleated giant cells

Front 10

253. Patient with genital herpes does not respond to acyclovir because pt is infected with

Back 10

thymidine kinase deficient HSV

Front 12

254. A pregnant woman with 1o symptomatic HSV-2 infection is at risk of her baby developing

Back 12

neonatal (congenital) herpes

Front 14

255. Cause of painful genital ulcers; purulent, grey base; painful inguinal adenitis, in a sexually promiscuous man

Back 14

Haemophilus ducreyi

Front 16

256. Fastidious organism in the infiltrate of the penile ulcer, co-localized with neutrophils and fibrin, in a pt w/ chancroid is

Back 16

Haemophilus ducreyi

Front 18

257. All sex partners of pt with chancroid, regardless of symptoms, should be examined and treated with

Back 18

Azythromycin > ceftriaxone

Front 20

258. Most common cause of mucopurulent endocervical exudate (Gram stain non revealing) in a woman w multiple sex partners

Back 20

Chlamydia trachomatis D-K

Front 22

259. Dx of mucopurulent urethral discharge, dysuria, penile pruritis is based on

Back 22

NAAT of urethral specimen or urine (+)

Front 24

260. DOC of most frequent cause of nongonococcal urethritis

Back 24

Azythromycin > doxycycline

Front 26

261. Cause of rare genital ulcers, inguinal lymphadenopathy [cytology(-) for multi-nucleated giant cells; RPR (-)] in men is

Back 26

Chlamydia trachomatis L1-L3

Front 28

262. Hx of systemic Sx/Sn w/ cervical motion tenderness in a woman with turbo-ovarian abscess. TOW?

Back 28

PID

Front 30

263. Cause of mucopurulent urethritis, dysuria, penile pruritis [Smear (+):Gram-negative diplococci co-populated w/ PMNs] is

Back 30

Neisseria gonorrhoeae

Front 32

264. Deficiency in serum factors in a female pt w/ frequent gonorrhea and DGIs is

Back 32

C6-C9

Front 34

265. Immune evasion of Neisseria gonorrhoeae in frequent mucosal infection is due to

Back 34

Antigenic variation of pili.

Front 35

266. Auxotrophic strains of N. gonorrhoeae with serum (complements) resistance are likely to cause

Back 35

Septic arthritis (aka: DGI)

Front 37

267. Most frequent complication of gonococcal (GC) infection in men

Back 37

Epididymitis

Front 39

268. Cause of "bull headed clap", urethral stricture, prostatitis is

Back 39

Neisseria gonorrhoeae

Front 41

269. Urethritis is treated with ceftriaxone + azythromycin because

Back 41

Concurrent GC + Chlamydia

Front 43

270. An older woman with PID and tubo-ovarian abscess receives ceftriaxone, azythromycin, and metronidazole because

Back 43

Polymicrobic (endogenous) infection

Front 45

271. Cause of anogenital warts w/ histology (+): koilocytes is

Back 45

HPV 6 and 11

Front 47

272. Cause of atypical squamous cells of undetermined significance (ASCUS) on pap smear w/ no clinical signs of infection is

Back 47

HPV 16 and 18

Front 49

273. Cause of koilocytotic cells and possible progression to squamous cell carcinoma

Back 49

HPV 16 and 18

Front 51

274. Next step to identify viral cause of ASCUS on pap smear w/ and further management in a woman of age > 29 years is

Back 51

Colposcopy > HPV DNA in bpsy

Front 53

275. Wet prep of vaginal discharge from a pt w/ vaginal pruritis; ectocervical erythema ("strawberry cervix") should reveal

Back 53

motile tissue flagellate

Front 55

276. Gram stain of vaginal discharge w/ fishy odor from a pt w/ vaginal pruritis but no erythema and normal cervix should reveal

Back 55

SECs stippled with Gram- variable organisms.

Front 57

277. Pathology of bacterial vagisnosis is overgrowth (in vagina) of anaerobic Mobiluncus species and

Back 57

Gardnerella vaginalis

Front 59

278. DOC of bacterial vaginosis is

Back 59

metronidazole

Front 61

279. Wet prep of curdy discharge (no odor), adhering to vaginal walls, from a pregnant woman w/ recent UTI, who now has severe vaginal pruritis; vulvovaginal area - erythematous should reveal

Back 61

budding yeasts with pseudohyphae

Front 63

280. Normal commensal of skin, GI & GU tracts; endogenous overgrowth of budding yeast, capable of >10 diseases. TOW?

Back 63

Candida albicans

Front 65

281. Mechanism of action of a po DOC of vulvovaginal candidiasis is

Back 65

blocks C14α-lanosterol demethylase

Front 67

282. Hx of flu-like illness, lymphadenopathy, maculopapular rash in a bisexual man. Lab: lymphopenia and transaminase elevations; monospot/all serology (-). TOW?

Back 67

Acute retroviral syndrome

Front 69

283. Time from infection (acquisition) to acute seroconversion detected by HIV serology (ELISA/ WBlot) is

Back 69

6-12 weeks.

Front 70

284. Hx of mononucleosis-like illness and lymphadenopathy in a man who has sex w men. Serology (-). What is HIV viral load?

Back 70

>10,000 copies/ml

Front 72

285. Host-cell receptor for HIV-1 infection

Back 72

CD4

Front 74

286. Homozygous for deletions in what gene renders resistance to infection and some protection against progression.

Back 74

CCR5

Front 76

287. Host cells that trap HIV and mediate the efficient transinfection of CD4+ T cells are

Back 76

Dendritic cells

Front 78

288. A man, who practices “sex with another man”, has antibodies to HIV (ELISA and WB) but asymptomatic. TOW?

Back 78

Clinical latency

Front 80

289. What happens to HIV-1 virus when acute retroviral syndrome progresses to clinical latency?

Back 80

Virus continues to replicate low level.

Front 81

Progressive multifocal leukoencephalopathy Wasting syndrome due to HIV infection"

Back 81

CD4+ < 200/μL

Front 82

291. A man with HIV infection has chronic diarrhea, oral thrush + toxoplasma encephalitis. Most likely CD4+ count is

Back 82

< 50 cells/μL.

Front 84

292. Most common cause of HIV- associated peripheral skin or mucosal ulcers

Back 84

HSV-1 (>> Histo > CMV > VZV > Syphilis)

Front 86

293. Most common cause of HIV- associated nodules (neoplasia)?

Back 86

HHV-8 (aka KSHV)

Front 87

294. Hx of fatigue, nausea, abdominal pain, diarrhea, fever, chills, night sweats, dry persistent cough w/ SOB and weight loss in a man with AIDS. Lab: PPD (-); blood culture (+) for AFB. TOW?

Back 87

Mycobacterium avium- intracellulare (MAI) complex (aka: MAC)

Front 89

295. Common cause of retinitis, viral pneumonitis or esophagitis in AIDS

Back 89

CMV

Front 91

296. Cases of CMV disease occur with immunosuppression level

Back 91

CD4< 50

Front 93

297. Cytopathology of CMV infected tissue is characterized by large cells with these features

Back 93

nuclear (Cowdry owl’s eye) and cytoplasmic inclusions

Front 95

298. Hx of progressive CNS dz in a pt w/ AIDS: hemiparesis, visual, ataxia, aphasia, cranial nerves, sensory. Head MRI: ring- enhancing lesions. Toxo antibody (-). TOW?

Back 95

JC virus

Front 97

299. Definitive indication for initial HAART is CD4+ count?

Back 97

350/mm3.

Front 99

300. Objective of ARV Tx is to reduce viremia to what level of genomic RNA/mL

Back 99

< 50 copies RNA/mL.

Front 101

301. Initial regimen of anti-retroviral therapy is

Back 101

Emtricitabine + Tenofovir + Efavirenz

Front 103

302. Abacavir, emtricitabine, lamivudine, zidovudine, tenofovir belong to what class of antiretrovirals?

Back 103

NRTIs

Front 105

303. Efavirenz, nevirapine belong to what class of antiretrovirals?

Back 105

NNRTIs

Front 107

304. Atazanavir, Lopinavir, Saquinavir belong to what class of antiretrovirals?

Back 107

Protease inhibitors

Front 109

305. This drug binds to gp41 and prevents conformational change required for viral fusion and entry into cells.

Back 109

enfuvirtide

Front 111

306. This drug inhibits integrase, responsible for insertion of HIV proviral DNA into the host genome.

Back 111

raltegravir

Front 113

307. A man has AIDS and CD4 <200cells/μL or thrush. Antibacterial prophylaxis needed besides HAART is

Back 113

TMP-SMX (for PCP)

Front 115

308. A man has AIDS and CD4 <100 + pos toxo IgG. Chemoprophylaxis needed besides HAART is

Back 115

TMP-SMX (for Toxoplasma encephalitis)

Front 117

309. A man has AIDS and CD4 <100 + PPD >5mm induration. Antibacterial prophylaxis needed besides HAART is

Back 117

INH + pyridoxine

Front 119

310. A man has AIDS and CD4 <50. Antibacterial prophylaxis needed besides HAART is

Back 119

azithromycin (for MAC)

Front 121

311. Hx of fever, a pustule at a cat scratch site, adenopathy, hepatosplenomegaly in a pt w/ AIDS. Warthin-Starry stain tissue (+). TOW (clue: bacillary angiomatosis)?

Back 121

Bartonella henselae

Front 123

312. Leading causes of congenital infections are

Back 123

"ToRCH3eS-List

Front 125

313. Cause of severe CNS sequelae, chorioretinitis, systemic disease in a neonate (mom at pregnancy had mono-like illness after eating undercooked beef or pork or exposure to oöcysts in cat feces) is

Back 125

Toxoplasma gondii

Front 127

314. Drug for pregnant woman in first trimester to prevent transmission if mother seroconverts is

Back 127

Spiramycin

Front 129

315. Hx of deafness, cataracts, heart defects, or microcephaly in a child (of a seronegative, caregiver mom, exposed to “Blueberry muffin baby” in 1st trimester). TOW?

Back 129

congenital rubella syndrome (CRS)

Front 131

316. Dx of CRS usually with positive anti-rubella antibody type?

Back 131

IgM

Front 133

317. Microcephaly, seizures, sensorineural hearing loss, feeding difficulties, petechial rash, hepatosplenomegaly, or jaundice in a neonate. PCR of any body fluid should yield

Back 133

CMV

Front 135

318. After primary infection, CMV, characterized as enveloped dsDNA betaherpesvirus; establishes

Back 135

lifelong latency

Front 137

319. Hepatosplenomegaly, neurologic abnormalities, frequent infections in a neonate w/ low CD4+ counts. Woman before birthing should have received

Back 137

Nevirapine

Front 139

320. Cause of vesicular skin lesions + conjunctivitis in a child (asymptomatic at birth)

Back 139

HSV-2

Front 141

321. Hx of cutaneous lesions, hepatosplenomegaly, jaundice, saddle nose, and saber shins. Hutchinson teeth, + CN VIII deafness in a neonate (mom is a prostitute). TOW?

Back 141

3o syphilis

Front 143

322. Neonatal septicemia or meningitis (mom had flu-like Sx and ate imported cheese during pregnancy). TOW?

Back 143

Listeria monocytogenes

Front 144

247. Genital chancre begins as a papule, ulcerates to form a single, painless, clean-based ulcer. TOW?

Back 144

primary syphilis

Front 145

248. Cause of genital chancre, begining as a papule, ulcerating to form a single, painless, clean-based ulcer.

Back 145

Treponema pallidum

Front 146

249. A pen-allergy, non-pregnant, female pt w/ fever, "copper penny" macular lesions on the palms or soles; RPR(+) should be

Back 146

Doxycycline (secondary syphilis)

Front 147

250. Management choice of tabes dorsalis (10-20yrs), iritis, uveitis, or Argyll-Robertson pupils in a pregnant woman w/ pen allergy; RPR(+) is

Back 147

Desensitization

Front 148

251. Hx of painful clustered vesicles with an erythematous base; urinary retention in a woman w multiple sex partners. TOW?

Back 148

HSV-2 >> 1

Front 149

252. Giemsa stain of fluid from a herpetic lesion should reveal

Back 149

Multinucleated giant cells

Front 150

253. Patient with genital herpes does not respond to acyclovir because pt is infected with

Back 150

thymidine kinase deficient HSV

Front 151

254. A pregnant woman with 1o symptomatic HSV-2 infection is at risk of her baby developing

Back 151

neonatal (congenital) herpes

Front 152

255. Cause of painful genital ulcers; purulent, grey base; painful inguinal adenitis, in a sexually promiscuous man

Back 152

Haemophilus ducreyi

Front 153

256. Fastidious organism in the infiltrate of the penile ulcer, co-localized with neutrophils and fibrin, in a pt w/ chancroid is

Back 153

Haemophilus ducreyi

Front 154

257. All sex partners of pt with chancroid, regardless of symptoms, should be examined and treated with

Back 154

Azythromycin > ceftriaxone

Front 155

258. Most common cause of mucopurulent endocervical exudate (Gram stain non revealing) in a woman w multiple sex partners

Back 155

Chlamydia trachomatis D-K

Front 156

259. Dx of mucopurulent urethral discharge, dysuria, penile pruritis is based on

Back 156

NAAT of urethral specimen or urine (+)

Front 157

260. DOC of most frequent cause of nongonococcal urethritis

Back 157

Azythromycin > doxycycline

Front 158

261. Cause of rare genital ulcers, inguinal lymphadenopathy [cytology(-) for multi-nucleated giant cells; RPR (-)] in men is

Back 158

Chlamydia trachomatis L1-L3

Front 159

262. Hx of systemic Sx/Sn w/ cervical motion tenderness in a woman with turbo-ovarian abscess. TOW?

Back 159

PID

Front 160

263. Cause of mucopurulent urethritis, dysuria, penile pruritis [Smear (+):Gram-negative diplococci co-populated w/ PMNs] is

Back 160

Neisseria gonorrhoeae

Front 161

264. Deficiency in serum factors in a female pt w/ frequent gonorrhea and DGIs is

Back 161

C6-C9

Front 162

265. Immune evasion of Neisseria gonorrhoeae in frequent mucosal infection is due to

Back 162

Antigenic variation of pili.

Front 163

266. Auxotrophic strains of N. gonorrhoeae with serum (complements) resistance are likely to cause

Back 163

Septic arthritis (aka: DGI)

Front 164

267. Most frequent complication of gonococcal (GC) infection in men

Back 164

Epididymitis

Front 165

268. Cause of "bull headed clap", urethral stricture, prostatitis is

Back 165

Neisseria gonorrhoeae

Front 166

269. Urethritis is treated with ceftriaxone + azythromycin because

Back 166

Concurrent GC + Chlamydia

Front 167

270. An older woman with PID and tubo-ovarian abscess receives ceftriaxone, azythromycin, and metronidazole because

Back 167

Polymicrobic (endogenous) infection

Front 168

271. Cause of anogenital warts w/ histology (+): koilocytes is

Back 168

HPV 6 and 11

Front 169

272. Cause of atypical squamous cells of undetermined significance (ASCUS) on pap smear w/ no clinical signs of infection is

Back 169

HPV 16 and 18

Front 170

273. Cause of koilocytotic cells and possible progression to squamous cell carcinoma

Back 170

HPV 16 and 18

Front 171

274. Next step to identify viral cause of ASCUS on pap smear w/ and further management in a woman of age > 29 years is

Back 171

Colposcopy > HPV DNA in bpsy

Front 172

275. Wet prep of vaginal discharge from a pt w/ vaginal pruritis; ectocervical erythema ("strawberry cervix") should reveal

Back 172

motile tissue flagellate

Front 173

276. Gram stain of vaginal discharge w/ fishy odor from a pt w/ vaginal pruritis but no erythema and normal cervix should reveal

Back 173

SECs stippled with Gram- variable organisms.

Front 174

277. Pathology of bacterial vagisnosis is overgrowth (in vagina) of anaerobic Mobiluncus species and

Back 174

Gardnerella vaginalis

Front 175

278. DOC of bacterial vaginosis is

Back 175

metronidazole

Front 176

279. Wet prep of curdy discharge (no odor), adhering to vaginal walls, from a pregnant woman w/ recent UTI, who now has severe vaginal pruritis; vulvovaginal area - erythematous should reveal

Back 176

budding yeasts with pseudohyphae

Front 177

280. Normal commensal of skin, GI & GU tracts; endogenous overgrowth of budding yeast, capable of >10 diseases. TOW?

Back 177

Candida albicans

Front 178

281. Mechanism of action of a po DOC of vulvovaginal candidiasis is

Back 178

blocks C14α-lanosterol demethylase

Front 179

282. Hx of flu-like illness, lymphadenopathy, maculopapular rash in a bisexual man. Lab: lymphopenia and transaminase elevations; monospot/all serology (-). TOW?

Back 179

Acute retroviral syndrome

Front 180

283. Time from infection (acquisition) to acute seroconversion detected by HIV serology (ELISA/ WBlot) is

Back 180

6-12 weeks.

Front 181

284. Hx of mononucleosis-like illness and lymphadenopathy in a man who has sex w men. Serology (-). What is HIV viral load?

Back 181

>10,000 copies/ml

Front 182

285. Host-cell receptor for HIV-1 infection

Back 182

CD4

Front 183

286. Homozygous for deletions in what gene renders resistance to infection and some protection against progression.

Back 183

CCR5

Front 184

287. Host cells that trap HIV and mediate the efficient transinfection of CD4+ T cells are

Back 184

Dendritic cells

Front 185

288. A man, who practices “sex with another man”, has antibodies to HIV (ELISA and WB) but asymptomatic. TOW?

Back 185

Clinical latency

Front 186

289. What happens to HIV-1 virus when acute retroviral syndrome progresses to clinical latency?

Back 186

Virus continues to replicate low level.

Front 187

290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is:
Candidiasis, esophageal, bronchi, trachea, or lungs Cervical cancer, invasive
Coccidioidomycosis, extrapulmonary Cryptococcosis, extrapulmonary Cryptosporidiosis, chronic intestinal Cytomegalovirus retinitis (with vision loss) Encephalopathy, HIV-related
Herpes simplex - Chronic ulcers
Histoplasmosis, disseminated or extrapulmonary Isosporiasis, chronic intestinal (duration >1 mo) Kaposi sarcoma
Lymphoma, Burkitt
Lymphoma, primary, of the brain
Mycobacterium avium complex or Mycobacterium kansasii infection, extrapulmonary Mycobacterium tuberculosis infection, any site (pulmonary or extrapulmonary)
Pneumocystis pneumonia
Progressive multifocal leukoencephalopathy Wasting syndrome due to HIV infection

Back 187

CD4+ < 200/μL

Front 188

291. A man with HIV infection has chronic diarrhea, oral thrush + toxoplasma encephalitis. Most likely CD4+ count is

Back 188

< 50 cells/μL.

Front 189

292. Most common cause of HIV- associated peripheral skin or mucosal ulcers

Back 189

HSV-1 (>> Histo > CMV > VZV > Syphilis)

Front 190

293. Most common cause of HIV- associated nodules (neoplasia)?

Back 190

HHV-8 (aka KSHV)

Front 191

294. Hx of fatigue, nausea, abdominal pain, diarrhea, fever, chills, night sweats, dry persistent cough w/ SOB and weight loss in a man with AIDS. Lab: PPD (-); blood culture (+) for AFB. TOW?

Back 191

Mycobacterium avium- intracellulare (MAI) complex (aka: MAC)

Front 192

295. Common cause of retinitis, viral pneumonitis or esophagitis in AIDS

Back 192

CMV

Front 193

296. Cases of CMV disease occur with immunosuppression level

Back 193

CD4< 50

Front 194

297. Cytopathology of CMV infected tissue is characterized by large cells with these features

Back 194

nuclear (Cowdry owl’s eye) and cytoplasmic inclusions

Front 195

298. Hx of progressive CNS dz in a pt w/ AIDS: hemiparesis, visual, ataxia, aphasia, cranial nerves, sensory. Head MRI: ring- enhancing lesions. Toxo antibody (-). TOW?

Back 195

JC virus

Front 196

299. Definitive indication for initial HAART is CD4+ count?

Back 196

350/mm3.

Front 197

300. Objective of ARV Tx is to reduce viremia to what level of genomic RNA/mL

Back 197

< 50 copies RNA/mL.

Front 198

301. Initial regimen of anti-retroviral therapy is

Back 198

Emtricitabine + Tenofovir + Efavirenz

Front 199

302. Abacavir, emtricitabine, lamivudine, zidovudine, tenofovir belong to what class of antiretrovirals?

Back 199

NRTIs

Front 200

303. Efavirenz, nevirapine belong to what class of antiretrovirals?

Back 200

NNRTIs

Front 201

304. Atazanavir, Lopinavir, Saquinavir belong to what class of antiretrovirals?

Back 201

Protease inhibitors

Front 202

305. This drug binds to gp41 and prevents conformational change required for viral fusion and entry into cells.

Back 202

enfuvirtide

Front 203

306. This drug inhibits integrase, responsible for insertion of HIV proviral DNA into the host genome.

Back 203

raltegravir

Front 204

307. A man has AIDS and CD4 <200cells/μL or thrush. Antibacterial prophylaxis needed besides HAART is

Back 204

TMP-SMX (for PCP)

Front 205

308. A man has AIDS and CD4 <100 + pos toxo IgG. Chemoprophylaxis needed besides HAART is

Back 205

TMP-SMX (for Toxoplasma encephalitis)

Front 206

309. A man has AIDS and CD4 <100 + PPD >5mm induration. Antibacterial prophylaxis needed besides HAART is

Back 206

INH + pyridoxine

Front 207

310. A man has AIDS and CD4 <50. Antibacterial prophylaxis needed besides HAART is

Back 207

azithromycin (for MAC)

Front 208

311. Hx of fever, a pustule at a cat scratch site, adenopathy, hepatosplenomegaly in a pt w/ AIDS. Warthin-Starry stain tissue (+). TOW (clue: bacillary angiomatosis)?

Back 208

Bartonella henselae

Front 209

312. Leading causes of congenital infections are

Back 209

ToRCH3eS-List
To = Toxoplasma gondii
R = Rubella C = CMV H = HSV-2 H = HIV
H = HBV
S = Syphilis
List = Listeria monocytogenes

Front 210

313. Cause of severe CNS sequelae, chorioretinitis, systemic disease in a neonate (mom at pregnancy had mono-like illness after eating undercooked beef or pork or exposure to oöcysts in cat feces) is

Back 210

Toxoplasma gondii

Front 211

314. Drug for pregnant woman in first trimester to prevent transmission if mother seroconverts is

Back 211

Spiramycin

Front 212

315. Hx of deafness, cataracts, heart defects, or microcephaly in a child (of a seronegative, caregiver mom, exposed to “Blueberry muffin baby” in 1st trimester). TOW?

Back 212

congenital rubella syndrome (CRS)

Front 213

316. Dx of CRS usually with positive anti-rubella antibody type?

Back 213

IgM

Front 214

317. Microcephaly, seizures, sensorineural hearing loss, feeding difficulties, petechial rash, hepatosplenomegaly, or jaundice in a neonate. PCR of any body fluid should yield

Back 214

CMV

Front 215

318. After primary infection, CMV, characterized as enveloped dsDNA betaherpesvirus; establishes

Back 215

lifelong latency

Front 216

319. Hepatosplenomegaly, neurologic abnormalities, frequent infections in a neonate w/ low CD4+ counts. Woman before birthing should have received

Back 216

Nevirapine

Front 217

320. Cause of vesicular skin lesions + conjunctivitis in a child (asymptomatic at birth)

Back 217

HSV-2

Front 218

321. Hx of cutaneous lesions, hepatosplenomegaly, jaundice, saddle nose, and saber shins. Hutchinson teeth, + CN VIII deafness in a neonate (mom is a prostitute). TOW?

Back 218

3o syphilis

Front 219

322. Neonatal septicemia or meningitis (mom had flu-like Sx and ate imported cheese during pregnancy). TOW?

Back 219

Listeria monocytogenes