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498 Cards in this Set
- Front
- Back
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where on bacterial structure is endotoxin found?
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outer membrane of gram negatives
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where on bacterial structure is major surface antigen found?
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cell wall/cell membrane of gram positives
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where are beta-lactamases found in gram-negative bacteria?
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periplasm (space between cytoplasmic membrane and peptidoglycan wall)
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what is special about anthrax capsule?
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contains D-glutamate (all others are just polysaccharide)
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bacterial structure that mediates adherence to indwelling catheters?
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glycocalyx
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gram + cocci?
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staph
strep |
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gram - cocci?
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neisseria
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gram + rods?
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Listeria
Mycobacterium Bacillus Cornebacterium Clostridium |
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what is special about mycoplasma cell membrane/wall?
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contains sterols; has no cell wall
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what is special about mycobacteria cell membrane/wall?
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contains mycolic acid; high lipid content
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microbes that do not gram stain well?
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Treponema
Rickettsia Mycobacteria Mycoplasma Legionella Chlamydia |
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use of Giemsa stain?
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Borrelia, Plasmodium, trypanosomes, Chlamydia
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use of PAS stain?
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stains glycogen and mucopolysaccharides;
used to diagnose Whipple's disease |
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use of Ziehl-Neelsen stain?
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acid fast organisms
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use of India ink?
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cryptococcus neoformans
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use of silver stain?
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fungi, legionella
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Special media used to isolate H. influenza?
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chocolate agar with factors V (NAD+) and X (hematin)
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Special media used to isolate N. gonorrhoeae?
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Thayer-Martin (VPN) media (contains Vancomycin, Polymyxin, Nystatin)
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Special media used to isolateB. Pertussis?
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Bordet-Gengou (potato) agar
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Special media used to isolate C. diphtheriae?
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Tellurite plate, Loffler's media
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Special media used to isolate M. tuberculosis?
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Lowenstein-Jensen agar
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Special media used to isolate M. pneumoniae?
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Eaton's agar
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Special media used to isolate lactose-fermenting enterics?
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pink colonies on MacConkey's agar
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Special media used to isolate Legionella?
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charcoal yeast extract agar buffered with cysteine
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Special media used to isolate fungi?
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Sabouraud's agar
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reactivation tuberculosis has prediliction for what parts of lungs?
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apices (highest PO2, requirement for obligate aerobe)
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obligate anaerobes?
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Clostridium
Bacteroides Actinomyces |
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obligate intracellular?
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rickettsia
chlamydia |
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facultative intracellular?
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Salmonella
Neisseria Brucella Mycobacterium Listeria Francisella Legionella |
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positive quellung reaction?
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encapsulated bacteria
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encapsulated bacteria?
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Streptococcus pneumoniae
Neisseria meningitidis Haemophilus influenza type B --- GBS Klebsiella pneumoniae Salmonella |
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vaccines that use polysaccharide capsule antigens conjugated to protein?
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Pneumovax
H influenza type B Meningococcal vaccine |
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|
urease positive?
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Proteus
H. pylori Ureaplasma Klebsiella (PHUK... these cause staghorn calculi) |
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bacteria that produces yellow "sulfur" granules?
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Actinomyces israelii
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bacteria that produces yellow pigment?
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S. aureus
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bacteria that produces blue-green pigment?
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Pseudomonas aeruginosa
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bacteria that produces red pigment?
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Serratia marcescens
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role of virulence factor Protein A?
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S. aureus
binds Fc region of Ig; prevents opsonization and phagocytosis |
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role of virulence factor IgA protease?
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enzyme that cleaves IgA; secreted by:
S. pneumonia, H. influenzae, Neisseria (to colonize respiratory mucosa) |
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role of virulence factor M protein?
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Group A streptococcus; helps prevent phagocytosis
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what type of molecule makes up exotoxin?
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polypeptide
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examples of exotoxin?
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tetanus, botulism, diphtheria
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examples of endotoxin?
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meningococcemia, GNR sepsis
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clinical effects of endotoxin?
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fever, shock; mediated by TNF and IL-1
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examples of ADP ribosylating A-B toxins?
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Diptheria
Cholerae E. coli Bordetella pertussis |
|
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mechanism of cholera?
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ADP ribosylation of G protein stimulates adenylyl cyclase (activates Gs), causing increased pumping of Cl- into gut and decreased Na+ absorption; causes voluminous rice-water diarrhea
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mechanism of E. coli toxins?
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heat-labile toxin stimulates Adenylate cyclase
heat-stable toxin stimulates Guanylate cyclase |
|
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double zone of hemolysis on blood agar?
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result of alpha toxin from clostridium perfringens
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mechanism of C. tetani toxin?
|
blocks release of GABA and glycine; causes "lockjaw"
|
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mechanism of C. botulinum toxin?
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blocks release of acetylcholine, causing anticholinergic symptoms
(ingestion in honey causes floppy baby) |
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mechanism of shiga toxin?
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(produced by shigella and E. coli O157:H7)
cleaves host cell rRNA; also enhances cytokine release, causing HUS |
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mechanism of pertussis toxin?
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permanently inactivates Gi, inducing cAMP
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mechanism of bacillus anthracis toxin?
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includes edema factor which is bacterial adenylate cyclase (increasing cAMP)
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bacterial "competence"?
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ability to take up DNA from environment
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GPC, +/- catalase?
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catalase +: staph
catalase -: strep |
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how to determine type of staph?
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coagulase +: s. aureus
coagulase -: S. epidermidis (novobiocin sensitive) or S. saprophyticus (novobiocin resistent) |
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how to determine type of strep?
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Hemolysis:
partial hemolysis (green) - alpha complete hemolysis (clear) - beta no hemolysis - gamma |
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species in alpha-hemolytic strep?
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S. pneumoniae (capsule, optochin sensitive, bile soluble)
S. mutans/viridans (no capsule, optochin resistant, not bile soluble) |
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species in beta-hemolytic strep?
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GAS: S. pyogenes (bacitracin sensitive)
GBS: S. agalactiae (bacitracin resistant) |
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non-strep beta-hemolytic bacteria?
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s. aureus
listeria monocytogenes |
|
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cause of toxic shock syndrome?
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TSST-1 toxin from s. aureus; binds to MHC II and TCR, resulting in polyclonal T cell activation
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causes:
Meningitis Otitis media (in children) Pneumonia Sinusitis |
S. pneumoniae
|
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alpha-hemolytic bacteria that are normal flora in oropharynx?
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viridans strep
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causes scarlet fever?
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Strep pyogenes (group A strep)
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subcutaneous plaques, polyarthritis, erythema marginatum, chorea, cardidits?
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symptoms of rheumatic fever (caused by strep pyogenes)
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caused by GBS?
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pneumonia, meningits, sepsis (mostly in babies)
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group D strep?
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enterococci
streptococcus bovis (colonizes gut) |
|
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pseudomembranous pharyngitis with lymphadenopathy?
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corynebacterium diphtheria (symptoms caused by exotoxin)
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Elongation Factor 2 is involved in what bacterium/disease?
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Cornybacterium diphtheria
Pseudomonas aeruginosa |
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spore-forming gram positive bacteria found in soil?
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Bacillus anthracis, Clostridium perfringens, Clostridium tetani
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mechanism of C. perfringens toxin?
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alpha-toxin (lecithinase) is a phospholipase; causes myonecrosis and hemolysis
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mechanism of C. difficile toxin?
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toxin A: enterotoxin, binds to brush border of gut
toxin B: cytotoxin, destroys cytoskeletal structure of enterocytes, causing pseudomembranous colitis |
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only bacterium with polypeptide capsule?
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Anthrax
|
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black skin lesions (necrosis) surrounded by edematous ring?
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anthrax
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flulike symptoms that rapidly progress to fever, pulmonary hemorrhage, mediastinitis, shock
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anthrax
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Woolsorter's disease?
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inhallation of anthrax spores from contaminated wool
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characteristic tumbling motility?
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listeria monocytogenes
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amnionitis, septicemia, spontaneous abortion in pregnant women?
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listeria monocytogenes
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gram positive rod that causes pulmonary infection in immunocompromised patients; long branching filaments that resemble fungi?
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Nocardia asteroides
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Ghon complex?
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lower lobe granuloma with enlarged perihilar lymph nodes; primary tuberculosis in nonimmune host
|
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Pott's disease?
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extrapulmonary tuberculosis in vertebral body
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PPX against MAI?
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azithromycin
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United States reservoir for Mycobacterium leprae?
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armadillos
|
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Tx for mycobacterium leprae?
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long-term dapsone
|
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2 forms of Hansen's disease?
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1. lepromatous (diffusely over skin, communicable, patients with weak T-cell-mediated immunity)
2. tuberculoid (scattered hypoesthetic skin nodules; patients with intact T-cell response) |
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gram negative rods, lactose non-fermenters?
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Oxidase +: pseudomonas
Oxidase -: Shigella, Salmonella, Proteus |
|
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gram negative rods, fast fermenters?
|
Klebsiella
E coli Enterobacter |
|
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gram negatie cocci?
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maltose fermenter: N. meningitidis
maltose nonfermenter: N. gonorrhoeae |
|
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use of MacConkee's agar?
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to determine lactose-fermenting gram negative bacteria
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Fitz-Hugh-Curtis syndrome?
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PID associated infection of liver capsule and adhesions to peritoneum; caused by Neisseria gonorrhoeae
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what type of neisseria has polysaccharide capsule?
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meningococci
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cause of waterhouse-Friderichsen syndrome?
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Neisseria meningitidis
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what does Haemophilus influenzae cause?
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Epiglottitis
Meningitis Otitis media Pneumonia |
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treatment for H. influenza meningitis?
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ceftriaxone
|
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rifampin prophylaxis for?
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cose contacts of N. meningitidis and H. influenza meningitis
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Pontiac fever?
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mild flulike syndrome caused by Legionella pneumophila
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how to clinically test for legionella pneumophila?
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antigen in urine
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treatment for Legionella?
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erythromycin
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classic microbe for superinfection of burns?
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Pseudomonas aeruginosa
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virulence factors associated with E. coli?
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fimbriae: cystitis and pyelonephritis
K capsule: pneumonia, neonatal meningitis LPS endotoxin: septic shock |
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E. coli strain that produces Shiga-like toxin?
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EIEC: microbe invates intestinal mucosa, toxin causes necrosis and inflammation
EHEC: (O157:H7) |
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E. coli strain that does not produce toxin?
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EPEC (usually diarrhea in children. Think "P"ediatric)
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E. coli strain that usually causes traveler's diarrhea?
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ETEC
|
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E. coli strain that causes HUS?
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EHEC (O157:H7)
|
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anemia, thrombocytopenia, acute renal failure?
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hemolytic uremic syndrome caused by E. coli O157:H7
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|
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lobar pneumonia with red currant jelly sputum?
|
Klebsiella (usually seen in alcoholic and diabetics)
|
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where in body can Salmonella typhi hide out?
|
gallbladder
|
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common antecedent to Guillain-Barre?
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Campylobacter jejuni
|
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comma shaped, oxidase positive, grows at 42 degrees C, causes bloody diarrhea
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Campylobacter jejuni
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causes mesenteric adenitis that can mimic Crohn's or appendicitis?
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Yersinia enterocolitica
|
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spirochete visible with Geimsa stain in light field microscopy?
|
Borrelia
|
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question-mark shaped bacteria found in water contaminated with animal urine?
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Leptospira interrogans
|
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tropical surfer with liver and kidney dysfunction, fever, hemorrhage, anemia?
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Weil's disease caused by leptospirosis
|
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tick that transmits Lyme diseae?
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Ixodes
|
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treatment for lyme disease?
|
doxycycline, ceftriaxone
|
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cardiac manifestations of Lyme disease?
|
AV nodal block
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treatment for syphilis?
|
penicillin G
|
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in what stage of syphilis do you see painless chancre?
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primary
|
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in what stage of syphilis do you see maculopapular rash on palms and soles and condyloma lata?
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secondary
|
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in what stage of syphilis do you see gummas and aortitis?
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tertiary
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in what stage of syphilis do you see neurosyphilis and Argyll Robertson pupil?
|
tertiary
|
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testing for syphilis?
|
screen with VDRL
confirm with FTA-ABS |
|
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broad-based ataxia, positive Romberg, Charcot joint, stroke without hypertension?
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tertiary syphilis
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signs of congenital syphilis?
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Saber shins, saddle nose, CN VIII deafness, Hutchinson's teeth, mulberry molars
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pupil that constricts with accommodation but not reactive to light?
|
Argyll Robertson pupil; associated with tertiary syphilis
|
|
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VDRL false positives?
|
Viruses (mono, hepatitis)
Drugs Rheumatic fever Lupus and leprosy |
|
|
bacterial disease that presents similar to Kaposi's sarcoma?
|
Bartonella in immunocompromised host
|
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Borrelia species carried by lice?
|
Borrelia recurrentis; causes recurrent fever
|
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cellulitis or osteomyelitis following cat/dog bite?
|
Pasteurella multocida
|
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treatment for bacterial vaginosis?
|
metronidazole
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treatment for rickettsia?
|
doxycycline
|
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headache, fever, rash?
|
classic triad for rickettsiae (treat with doxycycline)
|
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rash involving palms and soles?
|
Coxsackievirus A (hand, foot, mouth disease)
Rocky Mountain Spotted Fever Syphilis |
|
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Q fever?
|
Coxiella burnetii; no rash, no vector; tick feces and cattle placenta release spores that are inhaled as aerosols
|
|
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Weil-Felix reaction?
|
serum from patients with anti-rickettsial antibodies cross-reacts to Proteus O antigens and causes clumping
|
|
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why is chlamydiae obligate intracellular?
|
cannot make own ATP
|
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treatment for chlamydia?
|
azithromycin or doxycycline
|
|
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type of chlamydia that can cause blindness?
|
Chlamydia trachomatis type A, B, C
(cause blindness due to follicular conjunctivitis, seen in Africa) |
|
|
lymphogranuloma venereum?
|
caused by chlamydia trachomatis type L1-L3
|
|
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granuloma inguinale (donovanosis)
|
caused by Klebsiella granulomatis
|
|
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treatment for chlamydia?
|
azithromycin
|
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"walking" pneumonia with headache, nonproductive cough, diffuse insterstitial infiltrate, high titer of IgM?
|
Mycoplasma pneumoniae
|
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treatment for M. pneumoniae?
|
tetracycline or erythromycin
|
|
|
only bacterial membrane containing cholesterol?
|
Mycoplasma pneumoniae
|
|
|
treatment for systemic mycosis?
|
Amphotericin B
|
|
|
Mississippi and Ohio river valleys; causes pneumonia; bird and bat droppings
|
Histoplasmosis
|
|
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Eastern US and central America; causes inflammatory lung disease and can disseminate to skin and bone; forms granulomatous nodules
|
Blastomycosis
|
|
|
Southwestern US, California (San Juaquin Valley); causes pneumonia and meningitis; can disseminate to bone and skin;
|
Coccidioidomycosis
|
|
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systemic mycosis with macrophage findings?
|
Histoplasmosis
|
|
|
systemic mycosis with budding?
|
Blastomycosis
|
|
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systemic mycosis with large spherule filled with endospores?
|
Coccidioidomycosis
|
|
|
systemic mycosis with budding yeast in "captain's wheel" formation?
|
Paracoccidioidomycosis
|
|
|
infectious disease associated with rural Latin America?
|
Paracoccidioidomycosis
|
|
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cause of tinea versicolor?
|
Malassezia furfur
|
|
|
spaghetti and meatball appearance on KOH prep?
|
tinea versicolor (caused by malassezia furfur)
|
|
|
treatment for candida?
|
superficial infection: nystatin
systemic: amphotericin B |
|
|
mold with septate hyphae that branch at acute angles?
|
Aspergillus fumigatus
|
|
|
lung cavity fungus?
|
Aspergillus fumigatus
|
|
|
soap bubble lesions in brain?
|
cryptococcus neoformans
|
|
|
mold with irregular nonseptate hyphae branching at wide angles?
|
mucor and rhizopus
|
|
|
headache, facial pain, black necrotic eschar?
|
mucor infection with cranial nerve involvement
|
|
|
when to start ppx for PCP in HIV patients?
|
when CD4 drops < 200
|
|
|
treatment for Pneumocystis jiroveci?
|
TMP-SMX, pentamidine, dapsone
|
|
|
cigar-shaped yeast forms with unequal budding?
|
sporothrix schenckii
|
|
|
rose gardener's disease? Treatment?
|
sporotrichosis (dimorphic fungi)
tx: itraconazole or potassium iodide |
|
|
treatment for giardia?
|
metronidazole
|
|
|
liver histology showing flask-shaped ulcer?
|
entamoeba histolytica
|
|
|
treatment for entamoeba histolytica?
|
metronidazole and iodoquinol
|
|
|
bloody diarrhea, liver abscess, RUQ pain?
|
entamoeba histolytica
|
|
|
severe diarrhea in AIDS?
|
cryptosporidium; no treatment!
|
|
|
brain abscess in HIV?
|
toxoplasma gondii
|
|
|
congenital toxoplasmosis?
|
classic triad: chorioretinitis, hydrocephalus, intracranial calcifications
|
|
|
tx for toxoplasmosis?
|
sulfadiazine and pyrimethamine
|
|
|
amoeba found in freshwater lakes that enters brain and causes rapidly fatal meningoencephalitis?
|
naegleria fowleri
|
|
|
African sleeping sickness?
|
caused by Trypanosoma spp. carried by Tsetse fly (painful bite)
|
|
|
Tx for trypanosoma brucei, gambiense, rhodesiense?
|
(African sleeping sickness)
Suramin or Melarsoprol |
|
|
Trypanosoma cruzi?
|
Chagas disease; carried by Reduviid bug (painless bite)
|
|
|
dilated cardiomopathy, megacolon, megaesophagus
|
Chagas disease; carried by Reduviid bug (painless bite)
|
|
|
Tx for Chagas disease?
|
Nifurtimox
|
|
|
Spiking fevers, hepatosplenomegaly, pancytopenia
|
Leishmania donovani; carried by sandfly
|
|
|
treatment for Leishmaniasis?
|
Sodium stibogluconate
|
|
|
fever cycle for malaria?
|
P. vivax/ovale: every other day
P. falciparum: daily |
|
|
cyclic fever, headache, anemia, splenomegaly
|
malaria
|
|
|
tx for malaria?
|
start with chloroquine; if resistant use mefloquine;
add primaquine for vivax/ovale dormant forms in liver |
|
|
fever and hemolytic anemia in northeastern US?
|
babesiosis (carried by Ixodes tick)
|
|
|
Maltese cross inside RBC?
|
babesiosis (carried by Ixodes tick)
|
|
|
tx for babesiosis?
|
Quinine, clindamycin
|
|
|
tx for trichomonas vaginalis?
|
metronidazole
|
|
|
treatment for intestinal roundworm infections?
|
-bendazoles or pyrantel pamoate
|
|
|
river blindness?
|
Onchocerca volvulus; roundworm infection transmitted by female blackflies; causes hyperpigmented skin; treated with ivermectin
|
|
|
worm crawling in conjunctiva?
|
Loa loa (roundworm); carried by deer fly, horse fly, mango fly; treat with Diethylcarbamazine
|
|
|
Elephantiasis?
|
Wuchereria bancrofti; carried by female mosquito; Tx diethylcarbamazine
|
|
|
Taenia solium?
|
intestinal tapeworm carried by larvae found in undercooked pork; associated with cystercercosis and neurocystercercosis
|
|
|
treatment for taenia solium?
|
Praziquantel
add -bendazoles for neurocysticercosis |
|
|
tapeworm transmitted in raw freshwater fish?
|
Diphyllobothrium latum; causes vitamin B12 deficency; tx Praziquantel
|
|
|
tapeworm transmitted in dog feces?
|
Echinococcus granulosus; liver cysts, can cause anaphylaxis; Tx -bendazoles
|
|
|
parasite that can cause squamous cell carcinoma of bladder?
|
chronic schistosoma haematobium infection
|
|
|
Schistosoma
|
fluke carried by snails; causes granulomas, fibrosis, inflammation of spleen and liver
|
|
|
Tx of all flukes?
|
Praziquantel
|
|
|
fluke transmitted in undercooked fish?
|
Clonorchis sinensis; can cause pigmented gallstones and cholangiocarcinoma
|
|
|
parasite associated with pigmented gallstones?
|
Clonorchis sinensis (fluke carried in undercooked fish)
|
|
|
fluke transmitted in undercooked crab meat?
|
Paragonimus westermani; causes inflammation and secondary bacterial infection of lung -> hemoptysis
|
|
|
parasite associated with hemoptysis?
|
Paragonimus westermani (fluke carried in undercooked crab meat)
|
|
|
nematodes transmitted via ingestion?
|
Enterobius, Ascaris, Trichinella
|
|
|
nematodes transmitted cutaneously?
|
Strongyloides, Ancylostoma, Necator
|
|
|
parasite associated with brain cysts, seizures?
|
Taenia solium (cysticercosis)
|
|
|
parasite associated with liver cysts?
|
Echinococcus granulosus
|
|
|
parasite associated with B12 deficiency?
|
Diphyllobothrium latum
|
|
|
parasite associated with cholangiocarcinoma?
|
Clonorchis sinensis
|
|
|
parasite associated with portal hypertension?
|
Schistosoma mansoni
|
|
|
parasite associated with hematuria, bladder cancer?
|
Schistosoma haematobium
|
|
|
parasites associated with microcytic anemia?
|
Ancylostoma; Necator
|
|
|
parasite associated with perianal pruritus?
|
enterobius
|
|
|
typhoid fever vs. typhus?
|
Typhoid fever: Salmonella typhi
Typhus: Rickettsia spp. |
|
|
exchange of genome segments between viruses?
|
Reassortment
|
|
|
exchange of genes between two chromosomes by crossing over?
|
Recombination
|
|
|
Live attenuated vaccines?
|
smallpox, yellow fever, chickenpox, Sabin's polio virus, MMR
|
|
|
Killed vaccines?
|
Rabies
Influenza salk Polio hep A |
|
|
recombinant vaccines?
|
HBV, HPV
|
|
|
ssDNA virus?
|
Parvo virus
|
|
|
circular DNA viruses?
|
papilloma
polyoma hepadnavirus |
|
|
dsRNA virus?
|
Reoviridae
Rotavirus |
|
|
(+) strand RNA viruses?
|
RETRO
TOGA FLAV CORONA HEPE CALIfornia PICOles |
|
|
which viruses are not infectious when purified?
|
(-) strand ssRNA
dsRNA |
|
|
diploid viruses?
|
retroviruses (2 identical ssRNA strands)
|
|
|
non-enveloped viruses?
|
Calicivirus
Picornavirus Reovirus Parvovirus Adenovirus Papilloma Polyoma |
|
|
virus that acquires envelope from nuclear membrane?
|
herpesviruses
|
|
|
viral cause of conjunctivitis?
|
adenovirus
|
|
|
virus that causes febrile pharyngitis, acute hemorrhagic cystitis, pneumonia?
|
adenovirus
|
|
|
viral cause of aplastic crisis in sickle cell disease?
|
parvovirus (B19 virus)
|
|
|
slapped cheek rash in children?
|
fifth disease (parvovirus/B19 virus)
|
|
|
viral cause of progressive multifocal leukoencephalopathy in HIV
|
JC virus (polyomavirus)
|
|
|
HPV types that cause warts? Cervical cancer?
|
Warts: 1, 2, 6, 11
Cancer: 16, 18 |
|
|
flesh-colored dome lesions with central dimple?
|
poxvirus (molluscum contagiosum)
|
|
|
lymphoma associated with EBV infection?
|
Burkitt's lymphoma (endemic form)
Hodgkin's disease |
|
|
high fevers for several days with seizures followed by diffuse macular rash?
|
HHV-6 causing roseola
|
|
|
virus associated with Kaposi's sarcoma?
|
HHV-8; sexually transmitted
|
|
|
Tzanck test?
|
used to determine type of HSV vs. VZV (uses smear of opened skin vesicle to detect multinucleated giant cells)
|
|
|
atypical lymphocytes seen in EBV infection?
|
normal T cells responding to EBV infected B cells
|
|
|
most common cause of fatal diarrhea in children?
|
Rotavirus
|
|
|
oral polio virus? (name and type)
|
Sabin (live attenuated)
|
|
|
hep A caused by what type of virus?
|
HAV is picornavirus (ssRNA)
|
|
|
Flaviviruses?
|
HCV
Yellow fever Dengue St. Louis encephalitis West Nile virus |
|
|
high fever, black vomitus, jaundice?
|
yellow fever, caused by flavivirus, transmitted Aedes mosquitoes
|
|
|
H and N proteins in influenza viruses?
|
Hemagglutinin: promotes viral entry
Neuraminidase: promotes progeny virion release |
|
|
fever, postauricular tenderness, lymphadenopathy, arthralgias, fine truncal rash?
|
German (3-day) measles
Rubella virus |
|
|
Koplik spots?
|
diagnostic for rubeola virus (measles)
|
|
|
cough, coryza, conjunctivitis?
|
measles (rubeola virus)
|
|
|
measles vs. German measles?
|
Measles: rubeola
German measles: rubella |
|
|
parotitis, orchitis, aseptic meningitis?
|
mumps (paramyxovirus)
|
|
|
Negri bodies?
|
cytoplasmic inclusions in neurons infected by rabies virus
|
|
|
fever, malaise leading to agitation, photophobia, hydrophobia?
|
rabies
|
|
|
most common causes of rabies in US?
|
bat, racoon, and skunk bites
|
|
|
most common location for Negri bodies?
|
(cytoplasmic inclusions in neurons infected by rabies virus)
most commonly found in Purkinje cells of cerebellum |
|
|
incubation period for Hep A?
|
3 weeks
|
|
|
incubation period for Hep B?
|
3 months
|
|
|
four C's of hep C?
|
Chronic
Cirrhosis Carcinoma Carriers |
|
|
hep D is found only with what other infection?
|
Hep B
|
|
|
three E's of hep E?
|
Enteric
Expectant mother (high mortality) Epidemics |
|
|
types of hepatidites that predispose to chronic infection, cirrhosis, hepatocellular carcinoma?
|
HBV, HCV
|
|
|
hepatitis viruses carried fecal-oral?
|
Hep A
Hep E |
|
|
HIV has what type of genome?
|
diploid (2 molecules of ssRNA)
|
|
|
HIV capsid protein?
|
p24
|
|
|
HIV envelope proteins?
|
gp41 and gp120
|
|
|
three structural genes in HIV?
|
env (gp 120 and gp 41)
gag (p24) pol (reverse transcriptase) |
|
|
what does HIV bind to on T cells?
|
CXCR4 and CD4
|
|
|
what does HIV bind to on macrophages?
|
CCR5 and CD4
|
|
|
mutation that conveys immunity to HIV?
|
CCR5 (homozygous yields immunity, herozygous yields slower course)
|
|
|
normal CD4 count?
|
500 to 1500
|
|
|
why is ELISA/Western blot often falsely positive in babies born to HIV+ mothers?
|
anti-gp120 crosses placenta, present right after birth
|
|
|
where is HIV virus found during latent phase of infection?
|
replicating in lymph nodes
|
|
|
timing of acute HIV symptoms?
|
first 1-2 months after infection
|
|
|
HIV-associated infections seen at CD4 <400?
|
oral thrush, tinea pedis, reactivation VZV, reactivation TB
|
|
|
HIV-associated infections seen at CD4 <200?
|
reactivations HSV, cryptosporidiosis, Isospora, disseminated coccidioidomycosis, PCP pneumonia
|
|
|
HIV-associated infections seen at CD4 <100?
|
candidal esophatitis, toxoplasmosis, histoplasmosis
|
|
|
HIV-associated infections seen at CD4 <50?
|
CMV retinitis and esophagitis, disseminated MAI, cryptococcal meningoencephalitis
|
|
|
neoplasms associated with HIV?
|
Kaposi's sarcoma (HHV-8)
invasive cervical carcinoma (HPV) primary CNS lymphoma non-Hodgkin's lymphoma |
|
|
mechanism of prion disease?
|
conversion of PrPc to beta-pleated form PrPsc
|
|
|
inherited prion disease?
|
Gerstmann-Straussler-Scheinker syndrome
|
|
|
normal dominant flora on skin?
|
Staph epidermidis
|
|
|
normal dominant flora in nose?
|
Staph epidermidis, colonized by Staph aureus
|
|
|
normal dominant flora in oropharynx?
|
viridans strep
|
|
|
normal dominant flora in dental plaque?
|
Streptococcus mutans
|
|
|
normal dominant flora in colin
|
bacteroides fragilis > E. coli
|
|
|
normal dominant flora in vagina?
|
Lactobacillus; colonized by E. coli and GBS
|
|
|
food poisoning from reheated rice?
|
Bacillus cereus
|
|
|
food poisoning from contaminated seafood?
|
Vibrio spp.
|
|
|
food poisoning from preformed toxin in meats, mayonaise, custard?
|
S. aureus
|
|
|
food poisoning from reheated meat dishes?
|
Clostridium perfringens
|
|
|
food poisoning from improperly canned foods?
|
Clostridium botulinum
|
|
|
food poisoning from undercooked meat?
|
E. coli O157:H7
|
|
|
food poisoning from poultry, meat, eggs?
|
Salmonella
|
|
|
common causes of pneumonia in neonates (<4 weeks)?
|
GBS
E. coli |
|
|
common causes of pneumonia in children?
|
Viruses
Mycoplasma Chlamydia pneumoniae Streptococcus pneumoniae |
|
|
common causes of pneumonia in adults (18-40)?
|
Mycoplasma
Chlamydia pneumoniae Strep pneumoniae |
|
|
common causes of pneumonia in adults (40-65)?
|
Strep pneumoniae
H. influenzae Anaerobes Viruses Mycoplasma |
|
|
common causes of pneumonia in elderly?
|
Strep pneumoniae
Influenza virus Anaerobes H. influenzae GNRs |
|
|
hospital acquired pneumonia?
|
Staph
enterics (GNRs) |
|
|
aspiration pneumonia?
|
anaerobes
|
|
|
pneumonia in alcoholic/IV drug user?
|
S. pneumoniae
Klebsiella Staphylococcus |
|
|
pneumonia in cystic fibrosis?
|
Pseudomonas aeruginosa
|
|
|
postviral pneumonia?
|
staph
H. influenza |
|
|
atypical pneumonia?
|
mycoplasma
legionella chlamydia |
|
|
common causes of meningitis in newborns (<6 mos)?
|
GBS
E. coli Listeria |
|
|
common causes of meningitis in children (6mos-6yrs)?
|
Strep pneumoniae
Neisseria meningitidis HiB enteroviruses |
|
|
common causes of meningitis in 6-60 yrs?
|
N. meningitidis
Enteroviruses Strep pneumoniae HSV |
|
|
common causes of meningitis in >60yrs?
|
Strep pneumoniae
GNRs Listeria |
|
|
primary cell type seen in CSF in bacterial meningitis?
|
increased PMNs
|
|
|
primary cell type seen in CSF in fungal/TB meningitis?
|
increased lymphocytes
|
|
|
primary cell type seen in CSF in viral meningitis?
|
increased lymphocytes
|
|
|
most common cause of osteomyelitis?
|
S. aureus
|
|
|
osteomyelitis in sexually active person?
|
Neissera gonorrhoeae
|
|
|
osteomyelitis in diabetics and drug addicts?
|
Pseudomonas aeruginosa
|
|
|
osteomyelitis in sickle cell patients?
|
salmonella
|
|
|
osteomyelitis in patients with prostheses?
|
S. aureus and S. epidermidis
|
|
|
osteomyelitis in the vertebra?
|
mycobacterium tuberculosis (Pott's disease)
|
|
|
osteomyelitis following cat/dog bite or scratch?
|
Pasteurella multocida
|
|
|
most common cause of UTI?
|
E. coli
|
|
|
UTI with struvite stones?
|
Proteus mirabilis
|
|
|
blueberry muffin rash?
|
congenital rubella
|
|
|
chorioretinitis and hydrocephalus?
|
congenital toxoplasmosis
|
|
|
patent ductus arteriosis, cataracts, deafness
|
classic triad for congenital rubella
|
|
|
hearing loss, seizures, petechial rash?
|
congenital CMV
|
|
|
neonatal manifestations of congenital HIV?
|
recurrent infections, chronic diarrhea
|
|
|
temporal encephalitis in neonate?
|
congenital HSV
|
|
|
stillbirth, hydrops fetalis?
|
congenital syphilis
|
|
|
saber shins?
|
congenital syphilis
|
|
|
notched teeth, saddle nose, short maxilla?
|
congenital syphilis
|
|
|
painful genital ulcer with inguinal adenopathy?
|
chancroid caused by Haemophilus ducreyi
|
|
|
systemic symptoms of genital herpes?
|
fever, headache, myalgias
|
|
|
Reiter's syndrome caused by?
|
chlamydia trachomatis (STD)
|
|
|
genital ulcers, lymphadenopathy, rectal strictures
|
lymphogranuloma venereum caused by C. trachomatis (L1-L3)
|
|
|
strawberry cervix?
|
trich
|
|
|
genital warts?
|
condylomata acuminata, caused by HPV 6 and 11
|
|
|
STD causing jaundice?
|
Hep B
|
|
|
nosocomial infection associated with newborn nursery?
|
CMV, RSV
|
|
|
nosocomial infection associated with respiratory therapy equipment?
|
Pseudomonas aeruginosa
|
|
|
nosocomial infection associated with working in renal dialysis unit?
|
HBV
|
|
|
nosocomial infection associated with hyperalimentation?
|
candida
|
|
|
nosocomial infection associated with aerosolized water?
|
legionella
|
|
|
HIV patient with low-grade fevers, cough, hepatosplenomegaly?
|
Histoplasma capsulatum
|
|
|
HIV patient with oral thrush?
|
candida
|
|
|
HIV patient with superficial vascular proliferation, neutrophilic inflammation on biopsy?
|
bartonella henselae
|
|
|
HIV patient withHIV patient with superficial vascular proliferation, lymphocytic inflammation on biopsy?
|
HHV-8 (causes Kaposi's sarcoma)
|
|
|
HIV patient with meningitis?
|
cryptococcus neoformans
|
|
|
HIV patient with encephalopathy?
|
JC virus (polyomavirus)
|
|
|
HIV patient with abscesses and many ring-enhancing lesions on imaging?
|
toxoplasma gondii
|
|
|
HIV patient with retinitis and cotton-wool spots on fundoscopic exam?
|
CMV
|
|
|
HIV patient with hairy leukoplakia on lateral tongue?
|
EBV
|
|
|
HIV patient with interstitial pneumonia?
|
CMV
|
|
|
HIV patient withpleuritic pain, hemoptysis, pulmonary infiltrates?
|
Aspergillus fumigatus
|
|
|
child with fever, dysphagia, drooling ,difficulty breathing?
|
epiglottitis due to HiB
|
|
|
health care provider?
|
think HBV from needle stick
|
|
|
asplenic patient at risk for?
|
Strep pneumonia
H. influenza Neisseria meningitidis |
|
|
patient with bilateral bell's palsy?
|
Lyme disease
|
|
|
patient with chronic granulomatous disease at risk for?
|
catalase-positive:
S. aureus Nocardia spp. Aspergillus spp. |
|
|
MOA of pyrimethamine?
|
(antiprotozoal)
selectively inhibits plasmodial dihydrofolate reductase |
|
|
MOA of nifurtimox?
|
(antiprotozoal)
forms intracellular oxygen radicals, toxic to organism |
|
|
MOA of sodium stibogluconate?
|
(antiprotozoal)
inhibits glycolysis at PFK reaction |
|
|
MOA of chloroquine?
|
(antiprotozoal)
blocks plasmodium heme polymerase, leading to accumulation of toxic hemeglobin breakdown products that destroy organism |
|
|
MOA of mebendazole?
|
(antihelminthic)
inhibits glucose uptake and microtubule synthesis |
|
|
MOA of pyrantel pamoate?
|
(antihelminthic)
stimulates nicotinic receptors causing paralysis |
|
|
MOA of ivermectin?
|
(antihelminthic)
intensifies GABA effects and causes immobilization |
|
|
MOA of praziquantel?
|
(antihelminthic)
increases membrane permeability to calcium, causin gcontraction and paralysis of tapeworms and flukes |
|
|
MOA of amantadine?
|
blocks viral penetration/uncoating (M2 protein) and causes release of dopamine from intact nerve terminals
|
|
|
clinical use of oseltamivir, zanamivir?
|
influenza A and B
|
|
|
clinical use of ribavirin?
|
RSV, chronic hep C
|
|
|
MOA of acyclovir?
|
guanosine analog that is monophosphorylated by HSV/VZV thymidine kinase; preferentially inhibits viral DNA polymerase by chain termination
|
|
|
treatment for herpes zoster?
|
famciclovir
|
|
|
treatment for CMV?
|
ganciclovir
|
|
|
toxicity of acyclovir? Ganciclovir?
|
acyclovir - generally well tolerated
ganciclovir - leukopenia, neutropenia, thrombocytopenia, renal toxicity |
|
|
foscarnet?
|
viral DNA polymerase inhibitor; used for CMV retinitis when ganciclovir fails
|
|
|
composition of HAART regimen?
|
two NRTIs and 1 protease inhibitor OR
2 NRTIs and 1 NNRTI |
|
|
NRTIs used in HAART?
|
Zidovudine
Didanosine Zalcitabine Stavudine |
|
|
MOA of NRTIs in HAART?
|
nucleoside reverse transcriptase inhibitors; competitively inhibit nucleotide binding to reverse transcriptase and terminate the DNA chain
|
|
|
NNRTIs used in HAART?
|
Nevirapine
Efavirenz Declaviridine |
|
|
use of enfuvirtide in HIV?
|
fusion inhibitor (binds viral gp41 subunit); used in patients with persistent viral replication despite antiretroviral therapy
|
|
|
length of triple therapy for H. pylori?
|
14 days
|
|
|
microscopic characteristics of Strep viridans?
|
gram-positive cocci, catalase-negative, beta hemolytic, bacitracin-sensitive
|
|
|
how to differentiate viral atypical pneumonia from Mycoplasma pneumoniae?
|
cold agglutinin titer in serum (positive in approx 50% of M. pneumoniae and 20% of adenovirus)
|
|
|
malaria type that causes cerebral involvement?
|
P. falciparum
|
|
|
causes of reactivation of HSV?
|
stress, menstruation, immunosuppression, exposure to ultraviolet light
|
|
|
what viral component can be detected in neurons infected with latent HSV?
|
dsDNA and latency-associated mRNAs (no proteins)
|
|
|
Split S2 heart sound with accentuated P2 component, bounding pulses and wide pulse pressure?
|
PDA
|
|
|
remnant of fetal ductus arteriosis?
|
ligamentum arteriosum
|
|
|
TORCHES infection that causes PDA?
|
rubella
|
|
|
most common viral cause of myocarditis?
|
Coxsackie B
|
|
|
general MOA of acyclovir, etc?
|
inhibits DNA polymerase
|
|
|
specific treatment for shingles?
|
famciclovir
|
|
|
"can't pee, can't see, can't climb a tree"
|
Reiter's syndrome; reactive arthritis following Chlamydia trachomatis, Neisseria gonorrohoeae, Salmonella, Shigella, Yersinia, Campylobacter, Ureaplasma
|
|
|
genotype associated with reactive arthritis?
|
HLA B27
|
|
|
hepatic abscess with bloody mucoid diarrhea and recent travel to developing country?
|
amebiasis (due to Entamoeba histolytica); treat with metronidazole
|
|
|
cause of dysdiadochokinesia, impaired saccadic eye movements, frontal release signs in late stage HIV patient? Finding in CSF?
|
HIV-associated dementia; see elevated levels of protein and IgG in CSF in many patients
|
|
|
air-crescent sign on CXR in immunocompromised patient with pulmonary symptoms?
|
Aspergillus infection
|
|
|
cardiovascular sequella of syphilis?
|
aortic arch or ascending aortic aneurysm leading to aortic insufficiency
|
|
|
thick, gray, tissue-like material covering tonsils in unimmunized person?
|
Diptheria
|
|
|
trismus?
|
lockjaw caused by clostridium tetani toxin
|
|
|
tenesmus?
|
sensation of need to empty bowel along with pain and cramping; associated with inflammatory diseases of bowel
|
|
|
primary ppx against tuberculosis?
|
Isoniazid
|
|
|
Isoniazid toxicity?
|
neurotoxicity, hepatotoxicity
|
|
|
CSF lymphocytosis vs. leukocytosis?
|
leukocytosis: seen in bacterial meningitis
lymphocytosis: seen in fungal/tubercular meningitis |
|
|
permanent inhibition of Gi?
|
pertussus toxin (causes whooping cough)
|
|
|
ADP ribosylation of elongation factor 2?
|
diptheria exotoxin (also pseudomonas)
|
|
|
permanent activation of Gs?
|
vibrio cholerae toxin
|
|
|
HbeAg?
|
cleavage product of viral core polypetide in hep B; indicates high levels of viral replication and high infectivity
|
|
|
late finding in CMV retinitis?
|
retinal detachment
|
|
|
most common infectious cause of congenital abnormalities in USA?
|
CMV
|
|
|
proliferation of blood and lympathic vessels with "mulberry" lesionin skin caused by Bartonella (seen in AIDS patients)
|
bacillary angiomatosis
|
|
|
tick-associated infection with berry-like cytoplasmic inclusions in macrophages or neutrophils?
|
Ehrlichiosis
|
|
|
long term serious sequella of measles (rubeola)?
|
Subacute sclerosing panencephalitis (SSPE)
1. dementia and personality changes (1 yr) 2. severe myoclonus (3-12 months) 3-4. worsening dementia and deterioration of autonomic nervous system with decorticate rigidity or flaccidity |
|
|
first line treatment for C. diff?
|
oral metronidazole
|
|
|
classic CXR finding in P. jiroveci pneumonia?
|
diffuse bilateral infiltrates resembling ground glass
|
|
|
treatment for P. jiroveci pneumonia?
|
TMP-SMZ
|
|
|
target of S. aureus exotoxins responsible for scalded skin syndrome?
|
desmosomes (desmoglein 1)
|
|
|
bacteria commonly responsible for cholangitis?
|
enteric GNRs
|
|
|
filamentous gram-positive organism that is weakly acid fast, often misdiagnosed as tuberculosis?
|
Nocardia asteroides
|
|
|
treatment for Nocardia?
|
sulfonamides
|
|
|
MOA of nystatin?
|
binds ergosterol to form pores in membranes
|
|
|
infectious cause of aplastic anemia in patients with sickle cell anemia and hereditary spherocytosis?
|
Parvovirus B19
|
|
|
structure of rabies virus?
|
(rhabdovirus)
ssRNA, enveloped, helical |
|
|
Councilman bodies?
|
condensed nuclar chromatin seen in hepatocellular damage due to yellow fever (flavivirus)
|
|
|
viral hepatitis with AST>ALT?
|
yellow fever (flavivirus)
|
|
|
gram positive organisms with branching filaments?
|
actinomyces (anaerobe, not acid fast)
nocardia (aerobe, weakly acid fast) |
|
|
gram positive rods?
|
Listeria
Mybacterium - Bacillus Clostridium Corynebacterium (diphtheria) |
|
|
GPC, catalase +, coagulase +
|
S. aureus
|
|
|
GPC, catalase +, coagulase -, novobiocin resistant?
|
S. saprophyticus
|
|
|
GPC, catalase +, coagulase -, novobiocin sensitive?
|
S. epidermidis
|
|
|
alpha-hemolytic strep, optochin sensitive?
|
S. pneumoniae
|
|
|
alpha-hemolytic strep, optochin resistant?
|
Strep viridans
|
|
|
beta-hemolytic strep, bacitracin sensitive?
|
GAS, S. pyogenes
|
|
|
beta-hemolytic strep, bacitracin resistant?
|
GBS, S. agalactiae
|
|
|
gamma-hemolytic strep?
|
Enterococcus and Peptostreptococcus
|
|
|
GNR, oxidase +, grows in 42C?
|
Campylobacter jejuni
|
|
|
GNR, oxidase +, grows in alkaline media?
|
Vibrio cholera
|
|
|
gram negative, coccoid rods?
|
Haemophilus influenzae
Pasteurella Brucella Bordetella |
|
|
GNR, lactose nonfermenter, oxidase (-)
|
Shigella
Salmonella Proteus |
|
|
GNR, lactose nonfermenter, oxidase (+)
|
Pseudomonas
|
|
|
GNR, lactose fast fermenter
|
Klebsiella
E. coli Enterobacter |
|
|
gram negative cocci, maltose fermenter?
|
Neisseria meningitidis
|
|
|
gram negative cocci, maltose non-fermenter?
|
Neisseria gonorrhoeae
|
|
|
Structure of herpes viruses?
|
dsDNA enveloped
|
|
|
Structure of HBV?
|
dsDNA enveloped
|
|
|
Structure of smallpox virus?
|
dsDNA enveloped
|
|
|
Structure of adenovirus?
|
dsDNA nucleocapsid
|
|
|
Structure papillomaviruses?
|
dsDNA nucleocapsid
|
|
|
Structure of parvovirus?
|
ssDNA nucleocapsid
|
|
|
Structure of influenza virus, parainfluenza virus, RSV?
|
ssRNA enveloped
|
|
|
Structure of measles, mumps, rubella viruses?
|
ssRNA enveloped
|
|
|
structure of rabies virus?
|
ssRNA enveloped
|
|
|
structure of HIV?
|
ssRNA enveloped
|
|
|
structure of poliovirus?
|
ssRNA nucleocapsid
|
|
|
structure of coxsackievirus?
|
ssRNA, non-enveloped, nucleocapsid
|
|
|
structure of HAV?
|
ssRNA nucleocapsid
|
|
|
structure of rhinovirus?
|
ssRNA nucleocapsid
|
|
|
structure of rotavirus (reovirus family)
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dsRNA nucleocapsid
|
|
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which toxins permanently activate adenylate cyclase to increase sAMP?
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cholera, pertussis, E. coli
|
|
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toxin that permanently activates Gs?
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cholera
|
|
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toxin that permanently disables Gi?
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pertussis
|
|
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heat-labile toxin that increases cAMP?
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E. coli (ETEC) (also has heat-stable toxin that stimulates guanylate cyclase)
|
|
|
toxin that increases cAMP by including a bacterial adenylate cyclase?
|
anthrax
|
|
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toxin that cleaves host cell rRNA?
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shiga toxin (shigella and E. coli O157:H7)
|
|
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toxin that is hemolysis and antigen for ASO antibody?
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Streptolysis O from strep pyogenes (used to diagnose rheumatic fever)
|
|
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gene transfer resulting from uptake of DNA from culture medium?
|
transformation
|
|
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gene transfer via bacteriophage?
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transduction
|
|
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when are serology tests useful in diagnosing lyme disease?
|
later in disease (delay in developing antibodies)
|
|
|
most likely cause of acute bacterial endocarditis?
|
S. aureus
|
|
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organisms associated with tricuspid valve endocarditis (2/2 IV drug use)
|
S. aureus
Pseudomonas Candida |
|
|
culture yields "viscous colonies"
|
Klebsiella
|
|
|
Thayer-Martin agar?
|
VCN agar used for Neisseria gonorrhoeae
|
|
|
culture medium used to differentiate between Salmonella and Shigella?
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Hektoen enteric agar; only Salmonella produces hydrogen sulfide, which makes colonies appear light green with black centers
|
|
|
Gram positive cocci that causes nosocomial UTIs?
|
enterococcus
|
|
|
toxin responsible for crepitus in soft tissue infection?
|
alpha toxin (lecithinase) from Clostridium perfringens
|
|
|
treatment for lyme disease?
|
oral doxycycline
|
|
|
toxin that blocks release of acetylcholine at spinal synapses?
|
Clostridium botulinum (causes flaccid paralysis)
|
|
|
Ataxia, urinary incontinence, seizures in HIV+ patient?
|
AIDS complex dementia
|
|
|
Gram-positive cocci, coagulase-negative?
|
Staph epidermidis
|
|
|
cause of osteomyelitis in sickle cell patients?
|
Salmonella (susceptible to encapsulated organisms because of autosplenectomy)
|
|
|
macrophages containing amastigotes?
|
leishmaniasis, carried by sand fly; symptoms include hepatsplenomegaly, malaise, anemia, leukopenia, weight loss
|
|
|
HPV types associated with warts?
|
6 and 11
|
|
|
treatment for all rickettsial illnesses?
|
doxycycline
|
|
|
vaginal pH range associated with candidiasis?
|
normal (<4.5)
|
|
|
normal CVP?
|
2-8 mm Hg
|
|
|
normal pulmonary capillary wedge pressure?
|
2-15 mm Hg
|
|
|
normal cardiac output?
|
4-8 L/min
|
|
|
normal SVR?
|
700-1600 dyn*sec/cm-5
|
|
|
what viral illness predisposes to subsequent bacterial pneumonia in an otherwise healthy individual?
|
influenza
|
|
|
appearance of E. coli on MacConkey agar?
|
pink (lactose fermenting)
|
|
|
microscopic characteristics of Bartonella henselae?
|
gram negative bacilli
|
|
|
treatment for bartonella?
|
often self-limiting, but short course of azithromycin generally prescribed
|
|
|
rapidly progressing meningoencephalitis associated with freshwater lakes? Microscopic finding?
|
Naegleria fowleri
amebas seen in CSF |
|
|
treatment for pinworms?
|
-bendazoles
|
|
|
clinical use of ivermectin?
|
Strongyloides stercoralis, Onchocerca volvulus (river blindness)
|
|
|
clinical use of niridazole?
|
Dracunculus medinensis (roundworm)
|
|
|
serum marker elevated in acute phase of HIV infection?
|
viral RNA (can only diagnose by measuring viral load)
|
|
|
where is acetylcholine synthesized?
|
basal nucleus of meynert
|
|
|
transient hypothyroidism following viral illness
|
De Quervain's thyroiditis (etiology unknown, numerous viral agents implicated)
|
|
|
jaundice and elevated liver enzymes in a pregnant woman?
|
Hep E (ssRNA virus)
|
|
|
cause of croup?
|
parainfluenza virus (paramyxo virus; ssRNA, negative sense)
|
