Usmle Step 1 Bacteriology/ Virology

Front 1

Mycoplasma cell wall?

Back 1

contain sterols and have no cell wall

Front 2

alpha hemolysis

Back 2

partial hemolysis (green)
-S. pneumoniae
-Viridans

Front 3

beta hemolysis cocci and catalase neg?

Back 3

complete hemolysis (clear)
Group A (S. pyogenes)
Group B (S. agalactiae)

Front 4

Catalase (-) cocci with gamma hemolysis

Back 4

-No hemolysis
-enterococcus
-peptosteptococcus (anaerobe)

Front 5

Catalase (+) and Coagulase negative bugs?

Back 5

S. epidermidis
S. Saphrophyticus (UTI's)

Front 6

Catalase (+) and Coagulase (+) bugs?

Back 6

Staph aureus

Front 7

How do you identify saprophyticys vs epidermidis?

Back 7

within the staph there was NO StRES

Novobiocin= saprophyticus is resistant; epidermidis is sensitive

Front 8

How do you identify Viridins vs pneumo?

Back 8

OVRPS

Optochin: Viridins is Resistant and Pneumo is Sensitive

Front 9

How do you identify group B strep from group A strep?

Back 9

B-BRAS

Bacitacin: group B strep are Resistant and group A are Sensitive

Front 10

Beta hemolytic bacteria

Back 10

S. aureus
S. pyogenes
S. agalactiea
listeria

B-PAAL

Front 11

What does catalase do?

Back 11

degrades H2O2 before it can be converted to microbicidal products by the enzyme myeloperoxidase

Front 12

Staph. Aureus toxin mediated dz

Back 12

1) TSST (they were shocked to see him)
2) Scalded skin syndome: exfoliative toxin ("X-foly pours hot tar on baby")
3) rapid-onset food poisoning: enterotoxin "toxic enty"

Front 13

Virulence factor of Staph. Aureus?

Back 13

Protein A (binding to Fc-IgG inhibiting complement fixation and phagocytosis

Front 14

Describe TSST in Staph. Aureus

Back 14

a superantigen that binds to MHC II and T-cell receptor, resulting in polyclonal T-cell activation.

Front 15

Clinical signs of Staph. Aureus?

Back 15

-pus, empyema, abscess, acute bacterial endocarditis, osteomyelitis, menigitis

Front 16

MC of meningitis in adults?

Back 16

Strep. pneumo

Front 17

MC of otitis media in children?

Back 17

Strep. pneumo

Front 18

MC of pneumonia in adults?

Back 18

Strep. pneumo

Front 19

MC of Sinusitis in adults?

Back 19

Strep. pneumo

Front 20

Virulence of Strep. pneumo

Back 20

capsule, IgA protease

Front 21

Bug a/w rusty sputum, sepsis in sickle cell anemia and splenectomy

Back 21

Strep. pneumo

"His wife wears a red dress"

Front 22

Tx for Strep. pneumo?

Back 22

-Capsule vaccine for children against meningitis and pneumonia
-cephtriaxone, Penicillin

Front 23

Lancet shaped bug?

Back 23

Strep. pneumo

Front 24

Viridans

Back 24

-viridans live in the mouth bc they are not afraid of the chin (op-to-chin resistant)
-produce polysaccarides (dextrans) which uses sucrose as a substrate

Front 25

tx of Viridans?

Back 25

Penicillin

Front 26

Clinical manifestations of Strep pyogenes?

Back 26

1) pyogenic -pharyngitis, Cellulitis, impetigo ("the pirate was fat with a thick neck and sun-burned skin")
2) Toxigenic- scarlet fever, tss ("scarlet was shocked when she found out he was cheating")
3) Immnologic- rheumatic fever, acute glomerulonephritis ("rheuma and gomerula were his other lovers")

Front 27

Rheumatic fever

Back 27

-caused by Strep pyogenes
-type II hypersensitivity
-antibodies cross react w/ heart and damage tissue
-FEVERSS Fever, Erythema marginatum, Valvular damage, ESR incrased, Red-hot joints (migratory poly arthritis), Subcutaneous noduel (Aschoff bodies), St. Vitus's dance
-Mitral valve

"at the aschoff dance: lots of bodies John Travolta, dancing, hot, heart pumps, down on knees. Oh my!

Front 28

Glomerulonephritis

Back 28

-Strep pyogenes
-Glomulera type III hypersensitivity (immune complexes, lumpy bumpy, nephritic, IF- granular)

Front 29

virulence factor in strep. pyogenes?

Back 29

M protein

Front 30

What do you use to detect a recent Strep pyogenes infection?

Back 30

ASO titer

Front 31

tx for Strep pyogenes?

Back 31

penicillin

Front 32

neonatal meningitis

Back 32

e. coli, listeria, strep B

Front 33

Tx for strep B?

Back 33

Ampicillin, Penicillin, Cephalosporin

Front 34

What does strep agalactiae cause?

Back 34

-pneumonia, meningitis and sepsis in babies
-can also affect pregnant women
-normal flora of vaginal mucosa

Front 35

Enterococci (group D streptococci)

Back 35

-Cock: UTIs
-Men enter (menigitis)
-"heart races" (valve endocarditis)
-"come in your nose"(nosocomal VRE)
"might have babies" (neonatal infx)

Front 36

What test do you use for Enterococcu?

Back 36

can grow on 6.5% NaCl

Front 37

Strep bovis

Back 37

-Colonizes the gut, Can cause bacteremia and subacute endocarditis in colon cancer pt.
-most pt do not have pre-existing valve lesion

Front 38

Diptheria

Back 38

ABCDEFG:
ADP ribosylation, Beta-prophage, C. Diptheria, Elongationg factor, Elek, Granules

"Corey has a club, and a blue and red shirt (red and blue metachromatic granules). He has a bull neck, plays in front of pseudo gray stand (pseudomembranous pharygitis) he's chinese (chinese letters on stain)

Front 39

explain the toxin in Diptheria

Back 39

exotoxin encoded by B-prophage. Potent exotoxin inhibits protein synthesis via ADP ribosylation of EF. The toxin is not invasive, goes systemic and has effects on heart and nerves. Toxin inhibits elongation.

Front 40

Spore formers

Back 40

Bacillus anthracis, Clostridium, and B. cereus

Front 41

treatment of Diptheria

Back 41

-Toxoid vaccine
-erythromycin

Front 42

C. tetani

Back 42

-causes tetanospasmin an exotoxin causing tetanus
-blocks glycine release (inhibitory transmitter) from renshaw cells in spinal cord
-Causes spastic paralysis, trismus, lockjaw and risus sardonicus

Front 43

MCC of tenanus in developing countries?

Back 43

incompletely removed placentas and in newborns, infected umbilical cord stumps

Front 44

When is the vaccine started for tetanus?

Back 44

-2 months after birth. Not given at birth bc infant doesn't have proper memory or immune system

Front 45

C. botulinum

Back 45

-Heat labile toxin that inhibits Ach release at the neuromuscular junction.
-infant will present with poor feeding, lethargy. do not use antibiotics in babies
-diplopia, dysphagia, dyphonia, nausia, dry mouth,

Front 46

C. perfringens

Back 46

-produce alpha toxin (lectinase which degrades membrane, phopholipids)
-gas gangrene, hemolysis (double zone on blood agar) myonecrosis
-milk media culture
-cytolysin

"Clyde is an alpha male who lectures and has gas. He poisons the food giving the other pigs transient watery diarrhea. His leg is broken an necrosed. He also drinks milk"

Front 47

C. Difficile toxin

Back 47

-cytotoxin, an exotoxin that kills enterocytes causing pseudomembranous colitis.

Front 48

First step in management of C. difficile?

Back 48

toxin assay of stool, not gram stain

Front 49

tx of C. difficile

Back 49

metronidazole or oral vancomycin

Front 50

Capsule of Anthrax?

Back 50

D-glutamate

Front 51

Athrax toxin?

Back 51

lethal factor (kills cells) and edema factor. Edema factor is a CAMP toxin, adenlyate cyclase similar to bordatella

Front 52

Symptoms of Anthrax?

Back 52

-black eschar, a painless ulcer which can progress to bacteremia and death
-pulmonary= flulike symptoms: rapidly progress to fever, pulmonary hemorrhage, mediastinitis and shock

Front 53

Who is at high risk for Anthrax?

Back 53

Wool sorters

Front 54

Only gram positive bacteria with an endotoxin?

Back 54

listeria

Front 55

What can listeria cause?

Back 55

amnionitis, septicemia, and spontaneous abortion, granulomatosis infantiseptica; neonatal meningitis, meningitis in immunocompromised (kidney transplant pts), mild gastroenteritis in healthy individuals

Front 56

treatment for listeria?

Back 56

penicillin, ampicillin, gentamycin

Front 57

what does listeria look like?

Back 57

b-hemolytic rods, forms L and V formations, cold growth

Front 58

Norcardia

Back 58

-weakly acid fast areobe in soil. -Causes pulmonary infection in immunocompromised pts.
-CNS multi-focal lesions
-cough, fever, dyspnea and cavitary lesions

Front 59

tx for norcardia and Actinomyces?

Back 59

SNAP
Sulfa for Nordardia and Actinomyes uses Penicillin

Front 60

Actinomyces

Back 60

-solitary lesions in CNS
-lumpy jaw
-forms abcess which drain = sulfur granules

Front 61

Ghon complex?

Back 61

-TB granulomas (Ghon focus) with lobar and perihilar lymph node involvement
-usually in lower lobes

Front 62

Cord factor

Back 62

-in TB
-inactivates neutrophils. Damages mitochondria and induces release of TNF

Front 63

What type of hypersensitivity is TB?

Back 63

type IV T cell mediated

Front 64

Extra pulomonary TB?

Back 64

-CNS
-Vertebral body (pott's disease)
-Lymphadenitis
-Renal
-GI

Front 65

Which is more severe? Tuberculoid leprosy or lepromatous leprosy?

Back 65

-lepromatous, presents diffusely over skin and is communicable. Pts cannot mount cell-mediated immune response

Lepromatous can be LEthal

Front 66

Mycobacterium leprae

Back 66

-likes cool temp
-infects skin and superficial nerves
-cannot be grown in vitro
-reservoir in US is armadillos
-toxicity is hemolysis and methemoglobinemia

Front 67

tx for leprosy?

Back 67

long-term oral dapsone; or rifampin and combination of clofazimine and dapsone

Front 68

Fast lactose fermenting gram neg rods?

Back 68

-Will turn pink on mcKonkey agar
-Klebsiella
-E.coli
-Enterobacter

EEK! thats fast

Front 69

Slow lactose fermenting gram neg rods

Back 69

-Will grow pink on mckonkey agar
-Citrobacter, serratia

"the serology was slow in the city"

Front 70

Lactose non-fermenting gram neg rods?

Back 70

Shigella, Salmonella, Proteus and Pseudomonas

Front 71

Lactose non-fermenting gram neg rods oxidase (+)

Back 71

Pseudomonas

Front 72

Lactose non-fermenting gram neg rods oxidase (-)

Back 72

Shigella, Salmonella, Proteus

The Salmon was Only negative and SHruged PROfusely

Front 73

Main differences btwn Neisseria gonococci and meningococci?

Back 73

G-No polysaccharide capsule, no maltose fermentation, no vaccine, Sexually transmitted

M-Polysaccharide capsule, Maltose fermentation, Vaccine, Respiratory and oral secretions

"MeninGococci ferment Maltose and Glucose. Gonococci ferment Glucose"

Front 74

What dzs does Neisseria gonococci cause?

Back 74

-gonorrhea, septic arthritis, neonatal conjunctivitis, PID and Fitz-Hugh-Curtis syndrome
-yellowish green discharge

Front 75

What dzs does Neisseria meningococci cause?

Back 75

meningococcemia and meningitis, Waterhouse-Friderichsen syndrome

Front 76

Tx for Neisseria meningococci?

Back 76

Cepholosphorins, B is the most common serotype but there is no vaccine.

Front 77

Tx for Neisseria gonococci?

Back 77

Ceftriaxone

Front 78

Whats in Thayer martin?

Back 78

-chocolate blood agar
-vancomycin
-colistin (polymyxin)
-trimethoprim
-nyastatin

Front 79

H. Influenza vaccine?

Back 79

contains type B capsular polysaccharide conjugated to diptheria toxoid or other protein to improve immune system recognitin of polysaccharide and promote class switching

Front 80

What can H. influenza cause?

Back 80

HAEMOPHILuS

-Hematin
-Acute conjunctivitis
-Epiglotttitis, encapsulated
-Meningitits
-Otitis media, obligate human parasite
-Pneumonia, polytibitol ribose phosphate
-Haemophilis
-IgA protease
-Lyses blood, little kids
-Septic arthritis, Satallite infections with staph aureus.

Front 81

prophylaxis for H influenza?

Back 81

Rifampin

Front 82

Obligate anaerobes?

Back 82

Clostridium, Bacteroides, Actinomyces (ABC)

-lack catalase and/or superoxide dismutase and are thus susceptble to oxidative damage.
-generally foul smelling
-difficult to culture and produce gas in tissue (CO2 and H2)

Front 83

Obligate aerobes

Back 83

Nocardia, Pseudomonas, Mycobacterium tuberculosis, and Bacillus

Nagging Pest Must Breathe

-Cars are outside
-Mona is everywhere in the air
-Mike the boss is everywhere
-Bacillus Bob the alien pops up from under the ground (wants air)

Front 84

Obligate intracellular

Back 84

Rickettsia and Chlamydia (can't make own ATP)

"Really Cold"

"Rick should have stayed at home and Chlamydia has sex with ppl inside"

Front 85

Facultative intracellular

Back 85

Salmonella, Neisseria, Brucella, Myobacterium, Listeria, Francisella, Legionella

"Some Nasty Bugs May Live FacultativeLy"

Front 86

Encapsulated bactera

Back 86

Salmonella
Klebs
H. influenza
Pseudomonas
Neisseria meningitidis
Cryptococcus

"Some Killers Have Pretty Nice Capsules"

Front 87

Urease-positive bugs

Back 87

Proteus, Klebs, H. Pylori, Ureaplasma

Front 88

IgA Protease

Back 88

-Step pneumo, H influenza B, Neisseria (SHiN)
-Enyme that cleaves IgA
-helps colonize respiratory mucosa

Front 89

Giemsa stain?

Back 89

Borrellia, Plasmodium, trypanposomes, Chlamydia

Front 90

Legonaires dz

Back 90

-pontiac fever (mild flu-like) or atypical pneumonia. Silver stain, grows on charcol yeast extract, culture with iron and cystein, detect clinically by presence of antigen in urine. Aerosol transmission from Water source, not person to person

The french legionare (a smoker over 55), makes a camp fire (charcol) with his SILVER helmet and IRON dagger--he's no cissy (cysteine). He URINATES in the bushes and has a MISTER set up for when its too hot. He misses his GRANDMA (granulosa formation). Before he attacks he says EEEE (eyrthromycin). There's not much salt around the camp (hyponatremia)

Front 91

Pseudomonas: my story

Back 91

MONA is in the air (Aerobic) she lives on an island (swimmer's ear), She's BLACK (black lesions on skin), she visits ppl in HOT TUBS (hot tub folliculitis). She wears FRUIT on her head (fruit odor). She's the water goddess so she doesn't like burn victims. Her hair is in fibrils (cystic fibrosis). She an old lady so she has diabetic osteomyletis

Front 92

Pseudomonas: First aid mnemonic

Back 92

PSEUDO
Pneumonia in cystic fibrosis
Sepsis
UTI
External otitis
Diabetic Osteomyelitis

Front 93

What gives pseudomonas the grape-like odor?

Back 93

pyocyanin

Front 94

Enterobacteriaceae?

Back 94

COFFEe
Capsular
O antigen
Flagellar antigen
Ferment glucose
Enterobacteriaceae

Front 95

E. Coli: general

Back 95

-causes cystits, pyelonephritis, pneumonia, neonatal menigitis and septic shock
-endogenous transmission
- in EMB agar has a metallic green sheen

Front 96

EIEC

Back 96

-Shiga-like toxin
-Dysentery (microbe invades and causes necrosis and inflammation)
-immune mediated rxn w/ fever
-diarrhea is bloody with WBCs

"I for Inflammation and Immune mediated"

Front 97

EHEC

Back 97

-sHiga-like toxin
-interferes with ribosome. Toxin inhibits protein synthesis and binds to kidneys. No fever, pus or PMNs in stool
-Causes HUS (anemia, thrombocytopenia and acute renal failure)
-also causes Dysentery (microbe invades and causes necrosis and inflammation)
-Bloody diarrhea, severe abdominal cramps
-Does not produce glucuronidase (other stains do)

Front 98

ETEC

Back 98

-Labile toxin/stable toxin
-Traveler's diarrhea no blood
-increase cGMP so watery diarrhea. Similar to cholera toxin
-rice-water stools
-toxin doesn't invade

Front 99

EPEC

Back 99

-no toxin produces; adheres to apical surface, flattens villi, prevents absorption
-Usally in children, causes failure to thrive
-"P for Pediatrics"

Front 100

klebsiella

Back 100

-intestinal flora
-pneumonia in alcoholics and diabetes when aspirated
-Red currant jelly sputum
-nosocomial UTI
-destroys lung tissue producing cavities

"4 A's:
Aspiration pneumonia
Abscess in lungs
Alchoholics
di-A-betics

Front 101

Salmonella and Shigella: which one produces H2S?

Back 101

Salmonella

"Salmon produce bubbles in the water"

Front 102

Salmonella and Shigella: Which one is more virulent?

Back 102

Shigella (response with 10^1 organisms vs Salmonella which is 10^5)

"salmon aren't very threatening"

Front 103

Salmonella and Shigella: Which one has flagella?

Back 103

Salmonella

"salmon swim"

Front 104

Salmonella and Shigella: which one may be prolonged with antibiotic tx?

Back 104

Salmonella

"salmon are slippery

Front 105

How are Salmonella and Shigella alike?

Back 105

both are non-lactose fermenters, both invade intestinal mucosa and cause bloody diarrhea.

Front 106

Salmonella and Shigella: which one has an animal resivoir

Back 106

Salmonella (not typhi tho)

"it is a salmon..."

Front 107

Salmonella and Shigella: which one are sickle cell anemia pts prone to osteomylelitis?

Back 107

Salmonella

Front 108

Salmonella and Shigella: which one propell's itself by actin polymerization?

Back 108

Shigga

Front 109

Salmonella typhi?

Back 109

-enteric fever, diarrhea, headache, rose spots on abdomen. Can remain in gallbladder chronically
-spleen may enlarge
-

Front 110

tx for salmonella typhi?

Back 110

Ciprofloxacin, Ceftriaxone

Front 111

tx for Salmonella?

Back 111

flud and electrolytes

Front 112

Shiga toxin?

Back 112

-cleaves host cell rRNA (inactivates 60 S ribosome) also enhances cytokine release causing HUS
-invades GI through M cells located in peyer's patches

Front 113

Yersinia enterocolitica

Back 113

-usually transmitted from feces (puppies) contanimated milk or pork
-day care center out breaks
-can mimic Crohn's appendicitis especially in adolescents
-can survive the cold

Front 114

H. Pylori

Back 114

-Causes gastritic and up to 90% of duodenal ulcers
-Risk factors for peptic ulcer: gastric adenocarcinoma, and lymphoma.
-Urease positive (urease breath test)
-Creates alkaline environment

Front 115

treatment for H. pylori?

Back 115

1) Metronidazole, bismuth (pepto-bismol), and either tetracycline or amOxicillin

"for an stomach ache: take the metro home, take pepto bismol, drink FOUR glasses of water Orally

2) metronidazole, omeprazole, and clarithromycin

Another way to feel better: first take the metro home, Clear your thoughts and say "ommmm"

Front 116

How is borrelia visualized?

Back 116

w/ aniline dyes (Wright's or Giemsa stain)

Front 117

Leptospira interrogans

Back 117

-found in water contaminated with animal urine, flulike symptoms, fever, headache, abdominal pain, jaundice, and photophobia w/ conjunctivits. Prevalent in the tropics
Weil's disease: severe form jaundice, azetomia from liver and kidney dysfunction, fever, hemorrhage and anemia

"flood in tropics, weil the rat with a spiral rail rides a kidney shaped yellow boat, he hits his head, and has red eyes. He has a cut which it bleeding"

Front 118

tx for leptospira

Back 118

penicillin or doxycyclin

Front 119

What transmits Borrelia burgdorferi

Back 119

the tick Ixodes (also vector for babesia)

Front 120

reservoir for lyme's?

Back 120

Mice. Deer are required for tick life cycle

Front 121

tx lyme's?

Back 121

doxycyclin, ceftriaxone

Front 122

stage 1 of lyme's disease?

Back 122

erythemia, chronicum migrans, flulike symptoms

Front 123

stage 2 of lyme's disease?

Back 123

neurologic (Bell's palsy) and cardiac (AV nodal block) manifestations

Front 124

stage 3 of lyme's disease?

Back 124

Chronic monoarthritis and migratory polyarthritis

Front 125

mnemonic for Lymes?

Back 125

BAKE a key Lyme pie
-Bell's palsy
-Arthritis
-Kardiac block
-Erythema migrans

Front 126

Treponemal pertenue

Back 126

causes yaws; injection of skin bone and joints --> healing with keloids--> sever limb deformities. Disease of the tropics. Not an STD but VDRL posititive

"its PERTInant you watch out! Yaws attacks in the tropics, eats your skin, bones a joins leaving your limbs severely deformed."

Front 127

sign of tertiary syphilis?

Back 127

broad-based ataxia, positive Romberg, Charcot joints, stroke without hypertension

Front 128

Congenital syphilis

Back 128

Saber shins (anterior bowing of tibia), saddle nose, CN VIII deafness, Hutchinson's teeth mulberry molars (rounded rudimentary cusps on the permanent first molars)

Front 129

treatment of syphilis?

Back 129

penicillin G

Front 130

FTA-ABS vs VDRL

Back 130

FTA-ABS = Fine The Antibody-Absolutely
1) most specific
2) Earliest positive
3) Remains positive the longest

Front 131

VDRL false positives?

Back 131

-VDRL detects nonspecific antibody that reacts with beef cardiolipin
-Viral infx (mono, hepatitis)
-Rhematic fever, SLE, leprosy

"VDRL"
Viruses, Drugs, Rheumatic fever, Lupud and leprosy"

Front 132

Bartonella

Back 132

-Cat scratch fever
-can cause bacillary angiomatosis in immunocompromised patients (often confused with Kaposi's sarcoma)

Front 133

Brucella

Back 133

-Undulant fever
-Dairy products, contact with animals (domestic livestock, massive profuse sweating, HSM)

"Unpasteurized dairy products give you Undulant fever"

Front 134

Fancisella tularensis

Back 134

-Tularemia
-Tick bite; rabbits, deer
-necrosis at bite if aerosoled can get pneumonia, ingestion of undercooked rabbit meat

Front 135

Yersinia pestis

Back 135

-plague
-flea bite; rodents, expecially prarie dogs

Front 136

pasturella multocida

Back 136

-cellulitis
-animal bite; cats dogs

Front 137

descibe discharge in Gardnerella vaginalis?

Back 137

gray with fishy smell, nonpainful

Front 138

What other bug is nvolved in the vaginosis caused by gardnerella?

Back 138

Mobiluncus

Front 139

What is visible the microscope for Garnerella vaginalis?

Back 139

clue cells

Front 140

tx of gardnerella vaginalis?

Back 140

metronidazole

Front 141

mnemonic for gardnerella vaginalis?

Back 141

I don't have a clue why I smell fish in the vagina garden near the metro!

Front 142

tx for rickettsiae?

Back 142

tertacycline

Front 143

What do rickettsiae need to survive?

Back 143

CoA and NAD+

Front 144

Q fever

Back 144

-coxiella burnetti (rickettsial dz)
- has an endospore
-can survive outside host cell
-grows in ticks and cattle (dried tick feces deposit on cow hides and can be aersolized)
-causes mild pneumonia w/ no rash

"Q fever is queer bc it has no rach, no vector and has a negative weil-felix and can survive outside for a long time

Front 145

Palm and sole rashes?

Back 145

Coxasackie A, Rocky mountain spotted fever and Syphilis

"you drive CARS using your palms and soles"

Front 146

lab diagnosis of Chlamydiae?

Back 146

cytoplasmic inclusions seen on Giemsa or fluorecent antibody-stained smear

Front 147

describe the Chlamydiae cell wall

Back 147

lacks muramic acid

Front 148

two forms of Chlamydiae?

Back 148

1) elementary body (small, dense) is Enfectious and Enters cell via endocytosis
2) Reticulate body Replicates in cell by fission

Front 149

Chlamydia trachomatis

Back 149

-causes reactive arthritis, conjunctivitis, nongonococcal urethritis, and pelvic inflammatory disease

Front 150

tx of chlamydiae?

Back 150

-erythromycin or tetracyclin

Front 151

c. trachomatic serotypes A, B and C

Back 151

chronic infection
cause blindness in Africa

"ABC = Africa/Blindness/Chronic infection"

Front 152

c. trachomatic serotypes D-K

Back 152

urethritis/PID, ectopic pregnancy, neonatal pneumonia, or neonatal conjunctivitis.

Front 153

c. trachomatic serotypes L1, L2 L3

Back 153

Lymphogranuloma venereum (acute lymphadenitis--positive frei test)

Front 154

only bacterial membrane that contains cholesterol?

Back 154

Mycoplasma pneumoniae

Front 155

Mycoplasma pneumonia

Back 155

-atypical/walking pneumonia (insidious onset, headache, nonproductive cough, diffuse interstitial infiltrate)
-cold agglutinins
-grows on eaton's agar

Front 156

What are cold agglutinins

Back 156

IgM. At lower temperature antibodies bring blood cells close together or will lyse them

Front 157

treatment of mycoplasma pneumonia?

Back 157

tetracycline or eythromycin (bugs are penicillin resistant bc they have no cell wall

Front 158

live attenuated vaccines

Back 158

smallpox, yellow fever, chickenpox, sabin's polio virus, MMR

"Live! one night only! See small yellow chickens get vaccinated with Sabin's and MMR"

Front 159

Killed vaccine

Back 159

Rabies, Inluenza, Salk Polio and HAV vaccines

SalK= Killed
R.I.P. Always

Front 160

Recombinant vaccine

Back 160

HBV (antigen= recominant HBsAg), HPV (types 6,11,16 and 18)

Front 161

nonenveloped viruses

Back 161

Calcicivirus, Picornavirus, Reovirus, Parvovirus, Adenovirus, Papilloma and Polyoma

Naked CPR and PAPP smear

Front 162

Herpes viruses

Back 162

Get herpes in the CHEVrolet

CMV
HSV, HHV
EBV
VZV

Front 163

HSV-1

Back 163

-gigivostomatitis, keratoconjunctivitis, temporal lobe encephalitis (MCC of sporatic encephalitis in US) herpes labialis
-contacted through respiratory secretions and saliva

Front 164

HSV-2

Back 164

-Herpes genitalis, neonatal herpes
-sexual contant or perinatal

Front 165

VSV

Back 165

shinges, ecephalitis, pneumonia.

Front 166

EBV

Back 166

infectious mononucleosis, Burkitt's lymphoma, nasopharyngeal carcinoma

Front 167

CMV

Back 167

-congenital infection, mononucleosis (negative monospot), pneumonia.
-transfered congenitally, sexual contact, saliva, urine or transplant

Front 168

HHV-6

Back 168

Roseola: high fevers for several days that can cause seizures, followed by a diffuse macular rash

Front 169

HHV-8

Back 169

Karposi's sarcoma (HIV pts)

Front 170

Tzanck test

Back 170

a smear of an opened skin vesicle to detect multinucleated giant cells. Used to assay for HSV-1 HSV-2 and VZV.

"Tzanck heavens I don't have herpes"

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dx of EBV

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-positive monospot test: heterophil antibodies detected by agglutination of sheep RBCs
-abnormal circulating cytotoxic T cells

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Picornaviruses

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Poliovirus, Echovirus, Rhinovirus, Coxasackievirus, HAV

"PIC a PERCH"

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Calcivirus

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Norwalk virus

"the calico cat went on a cruise"

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Flaviviruses

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HCV, yellow fever, Dengue, St leouis Encephalitis, West nile virus (all caused by mosquitos)

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Togaviruses

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Rubella (German measles)
Eastern equine encephalitits
Western equine encephalititis

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Retroviruses

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have reverse transcriptase
HIV
HTLV

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Orthomyxoviruses

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Influenza virus

"O" you have the flu

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Paraamyxovirus

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PaRaMycovirus:
Parainfluenza-croup
RSV-bronchiolitis in babies
Rubeola (measles)
Mumps

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Filoviruses

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Ebola/Margburg hemorrhagic fever

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Arenaviruses

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LCMV (lymphocytic choriomeningitis virus)
Lassa fever encephalitis

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Bunyaviruses

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California encephalitis
sandfly/rift valley fevers
Crimean-Congo hemorrhagic fever
Hantavirs

"the Bunny was deciding where to go on his trip: California, the Rift Valley, the Congo or a Haunted House?"

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Segmented viruses

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All Are RNA viruses
Eat a segment of "BOAR"
-Bunyaviruses
-Orthomyxoviruses
-Arenaviruses
-Reoviruses

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Yellow fever virus

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-a flavivirus (also an arbovirus). -Transmitted by Aedes mosquito
-Human/monkey reservoirs
Sx: high fevers, black vomitus and jaundice. Councilman bodies (acidophilic inclusions) may be seen in liver

The Black and Yellow monkey was a councilman in the faraway land called Aedes. In Aedes, they eat liver (they love the flavor), include everyone and like hot temperatures (fever)

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Most important cause of infantile gastroenteritis

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rotavirus

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MCC of sporadic encephalitis

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HSV-1 (mostly affects teenagers and young adults)

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Rotavirus

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-segmented dsRNA
-acute diarrhea during winter in daycare centers
-Villous destruction with atrophy leads to decreased absorption of Na+ and water

ROTA = Right Out The Anus

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Influenza virus

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-Segmented genome
-Has hemagglutinin and neuraminidase antigens
-pts at risk for fatal bacterial superinfection
-Rapid genetic change
-

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hemagglutinin

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promotes viral entry

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neuraminidase

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promotes progency viron release

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Genetic shift vs Genetic drift

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shift= pandemic. Reassortment of viral genome (such as when human flu A virus recombines with swine flue A vrius)
Drift= epidemic. minor (antigenc drift) changes based on random mutation

"Sudden shift is more deadly than graDual Drift"

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Influenza vaccine

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Killed viral vaccine

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Rubella virus

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Togavirus
German (3 day) measles
Fever, lymphadenopathy, arthralgias, fine truncal rash. Causes mild dz in children but serious congenital disease (TORCH infx) Causes cataracts, sensory hearing loss, growth retardation, thrombocytopenia and jaundice.

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What viral family uses the F protein

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-Paramyxoviruses
-F protein (surface fusion protein) causes respiratory epithelial cells to fuse and form multinucleated cells

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Palivaizumab

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used in RSV to neutralize F protein

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Rubeola (measles)

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-Koplik spots
-SSPE
-encephalitis
-giant cell pneumonia
-rash spreads from head to toe
MC sequela = polyarthralgia and polyarthritis
Fetal infx= deafness, cataracts and cardiac defects

"3 C's of measles: Cough, Coryza (acute inflam of nose), Conjunctivits"

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Mumps virus

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-Parotits, Orchitis, Meningits
-Can cause sterility (especially after puberty)

"mumps make your parotid glands and testes as big as POM-poms"

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Rabies

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-Negri bodies (cytoplasmic inclusions in neurons)
-bullet-shaped capsid
-prgression of dz: fever, malaise--> agitation, photophobia, hydrophobia--> paralysis, coma--> death
-Travels to the CNS by migrating in a retrograde fashion up nerve axons

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tx of rabies?

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killed virus vaccine

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Klebsiella granulomatis

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STD
granuloma inguale and donavan bodies

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Karposi sarcoma

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-painless red-violet lesions caused by ENDOTHELIAL proliferation
-herpes virus
-enveloped
-DS-linear
-a/w body cavity fluid B-cell lymphoma

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C1, C2, C3, C4

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n the classical pathway these proteins are involved in viral neutralization.

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C1 esterase

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is an enzyme that breaks down C1 which leads to further production and activation of C2, C3, and C4. Therefore, a deficiency in C1 esterase can cause hereditary angioedema and a defect in the complement immune response.

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C3b

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along with IgG are the major opsonization proteins. Opsonization involves applying a “flag” to the pathogen that codes for degradation.

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C3a and C5a:

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function primarily to attract neutrophils to the site of injury, thus they are known as inflammatory mediators. Each of the three complement pathways converge on the complement protein C5 which continues the cascade of proteins leading to the formation of the membrane attack complex.

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C5b-C9

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The membrane attack complex involves the combination of complement proteins which form "pores" in the cell membrane resulting in lysis of the cell. It is especially effective against gram-negative bacteria.