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213 Cards in this Set

  • Front
  • Back
toxins: inactivate elongation factor EF-2
diphtheria toxin, exotoxin A (P. aeruginosa)
toxins: inactivate 60S ribosome by cleaving rRNA
shiga toxin (Shigella spp.), shiga-like toxin (EHEC O157:H7)
toxins: increase cAMP --> Cl- secretion, H2O efflux in gut
heat-labile toxin (ETEC), cholera toxin. LT binds adenylyl cyclase, cholera toxin binds Gs
toxin: increases cGMP --> decreased reabsorption of NaCl, H2O in gut
heat-stable toxin (ETEC and Y. enterolytica)
toxin: mimics adenylyl cyclase enzyme, increasing cAMP and causing edema
edema factor (B. anthracis)
toxin: increases cAMP by disabling Gi, thus impairing phagocytosis
pertussis toxin
toxin: cleaves SNARE required for release of GABA and glycine
tetanospasmin
toxin: cleaves SNARE required for release of ACh
botulinum toxin
toxin: phospholipase that degrades tissue and cell membranes, aka lecithinase
alpha toxin (C. perfringens)
toxin: binds brush border and destoys cytoskeleton
A toxin and B toxin (C. difficile)
toxin: protein that degrades cell membrane
streptolysin O (S. pyogenes)
toxins: superantigens
exotoxin A (S. pyogenes), TSST-1 (S. aureus)
shigA-like toxin, Botulinum toxin, Cholera toxin, Diphtheria toxin, Erythrogenic toxin (ABCDE)
lysogenic toxins (encoded by phage)
PUNCH-K: Proteus, Ureaplasma, Nocardia, Cryptococcus, H. pylori, Klebsiella
urease +
S. pneumo, Hib, Neisseria
encapsulated and IgA protease positive
virulence factor: binds Fc region of Ig, preventing opsonization and phagocytosis
protein A (S. aureus)
dipicolinic acid
component of spores
Giemsa stain
for intracellular organisms like Chlamydia, Borrelia, Rickettsia, Trypanosoma, Plasmodium
periodic acid-Schiff (PAS) stain
Tropheryma whippelii
Ziehl-Neelsen stain =
acid fast stain! - mycobacteria, nocardia
DAPI/Hoechst stain for DNA
Mycoplasma
Silver stain
Legionella pneumophila, fungi
India ink
Cryptococcus neoformans
growth on chocolate agar with factors V (NAD+) and X (hematin)
H. influenzae
Thayer-Martin (VPN) media
N. gonorrhoeae
potato agar
B. pertussis (Bordet-Gengou agar)
Tellurite plate/Loffler's media
C. diphtheriae
Lowenstein-Jensen agar
M. tuberculosis
Eaton's agar
M. pneumoniae
charcoal yeast extract agar with cysteine and iron
L. pneumophila
major cytokine leading to shock 2/2 gram negative sepsis
TNF
cat scratch disease
Bartonella spp.
recurrent fever and its vector
Borrelia recurrentis, louse
undulant fever and exposure that causes it
Brucella spp., unpasteurized dairy
Q fever and 2 vectors/exposures
Coxiella burnetti, spores from tick feces and cattle placenta (vets)
ehrlichiosis vector
Lone Star tick (carries Ehrlichosis chaffeensis)
tularemia and its vectors (3)
Francisella tularensis, ticks, rabbits, deer fly
exposure leading to leptospirosis
drinking animal urine-contaminated water
dog or cat bite
Pasturella multocida
epidemic typhus and its vector
Rickettsia prowazekii, louse
endemic typhus and its vector
Rickettsia typhi, fleas
granulocytes with berry cluster organisms
Ehrlichiosis chaffeensis
Weil-Felix reaction
patient serum cross-reacts with Proteus antigens --> agglutination; positive for Rickettsiae, Coxiella, Ehrlichiosis
treatment for Weil-Felix reaction positive organisms
doxycycline
yeast within macrophages
Histoplasmosis
broad-based budding yeast
Blastomycosis
spherule filled with endospores
Cocci
budding yeast with "captain's wheel"
Paracocci
mold hyphae on KOH prep
dermatophytes (Microsporum, Trichophyton, Epidermophyton)
cause of tinea versicolor
Malassezia furfur (spaghetti & meatballs on KOH prep)
pseudohyphae and budding yeasts at 20 degrees; germ tubes at 37 degrees
Candida albicans
septate hyphae branching at <45 degree angles, conidiophore with rare fruiting bodies
Aspergillus fumigatus
5-10 um yeasts with wide capsular halos and unequal budding ("soap bubbles")
Cryptococcus neoformans, stain with India ink
irregular, broad, nonseptate hyphae branching at wide angles
Mucor and Rhizopus
disk-shaped yeast on methenamine silver stain
Pneumocystis jirovecii
dimorphic, cigar-shaped budding yeast
Sporothrix schenkii
flask-shaped ulcers in colon
Entamoeba histolytica
acid-fast cysts in stool
Cryptosporidium
72-hour (quartan) malaria
P. malariae
48-hour (tertian) malaria
P. vivax, P. ovale; can remain dormant in liver so tx with primaquine, too
macrophages containing amastigotes
Leischmania donovani
treatment for nematodes
mebendazole
treatment for all cestodes and trematodes except Echinococcus granulosus (mebendazole)
praziquantal
worm causing brain cysts, seizures
Taenia solium (cysticercosis)
worm causing liver cysts
Echinococcus granulosus (dog tapeworm)
worm causing B12 deficiency
Diphyllobothrium latum (fish tapeworm)
worm causing biliary disease and possibly cholangiocarcinoma
Clonorchis sinensis (Oriental river fluke)
worm causing hemoptysis
Paragonimus westermani
Worm causing portal hypertension
Schistosoma mansoni
worm causing hematuria and bladder cancer
Schistosoma hematobium
worm causing microcytic anemia
Ancylostoma, Necatur (hookworms)
polysaccharide-only vaccine
Pneumococcus
vaccine with polysaccharide conjugated to diphtheria toxin (2)
H. influenzae type B, N. meningitidis
ssDNA virus
Parvovirus
linear DNA viruses (4)
Herpes, Adeno, Pox, Parvo
partial circular dsDNA virus
Hepadna
complete circular dsDNA viruses (2)
Papilloma, Polyoma
mnemonic for + strand viruses
I went to a RETRO TOGA party, drank FLAVored CORONA, and ate HIPPY CALIfornia PICKles. (retro, toga, flavi, corona, hepe, calici, picorna)
dsRNA virus
Reovirus (=Rotavirus)
enveloped DNA viruses (3)
Pox, Hepadna, Herpes
naked DNA viruses (3)
Papova (=Papilloma + Polyoma), Adeno, Parvo. NAKED for a PAP smear.
+ Tzank test
multinucleated giant cells seen in HSV1, HSV2, VZV
Owl's eye inclusions
CMV
vector for yellow fever virus (symptoms: high fever, jaundice, black vomitus)
Aedes mosquito
function of influenza's hemagglutinin
promotion of viral entry
function of influenza's neuraminidase
progeny virion release
function of paramyxovirus's surface F protein
fusion of respiratory epithelial cells to form multinucleated giant cells (think respiratory SYNCITIAL virus)
mab that prevents RSV pneumonia in preemies
palivizumab (mab to F protein)
bullet-shaped capsid and Negri bodies (hippocampus, Purkinje cells)
Rhabdovirus
HbsAg +, HBeAg +, anti-HBcAb + (IgM)
acute HBV
anti-HBcAg + (everything else negative)
HBV window period
HBsAg +, HBeAg +, anti-HBcAg + (IgG)
chronic HBV infection, highly infectious (bc of HBeAg)
HBsAg +, anti-HBeAg +, anti-HBcAg + (IgG)
chronic HBV infection, less infectious (bc of anti-HBeAg)
anti-HBsAg +, anti-HbeAb +, anti-HBcAg +
full recovery from HBV infection
anti-HBsAg + only
immunized against HBV
function of HIV's gp120
attachment to host T cell
function of HIV's gp41
fusion and entry
function of HIV's p24 (gag)
capsid protein
function of HIV's pol
reverse transcriptase
function of HIV's env
env = gp160, which is cleaved to gp120 and gp41
low-grade fever, cough, HSM, and tongue ulcers in HIV+
Histoplasma capsulatum, disseminated
superficial vascular proliferation with neutrophilic inflammation in HIV+
Bartonella henselae (NOT Kaposi sarcoma!)
superficial vascular proliferation with lymphocytic inflammation in HIV+
Kaposi sarcoma
demyelinating encephalopathy in HIV+
JC virus reactivation --> progressive multifocal leukoencephalopathy
brain abscesses in HIV+
T. gondii
meningitis in HIV+
Cryptococcus neoformans
retinitis in HIV+, with cotton-wool spots and possibly esophagitis
CMV
type of NHL seen in HIV+
large cell NHL, often oropharyngeal
interstitial pneumonia in HIV+
could be CMV (look for owl's eyes)
pleuritic pain, hemoptysis, infiltrates on imaging in HIV+
Aspergillus fumigatus, invasive
MCC pneumonia in neonates (2)
Group B strep (agalactiae), E. coli
MCC pneumonia in children 4 wk - 18 yr (4)
viruses (esp. RSV), Mycoplasma, C. trachomatis, S. pneumo
MCC pneumonia in adults 18-40 yo (3)
Mycoplasma, C. pneumoniae, S. pneumo
MCC pneumonia in adults 40-65 (5)
S. pneumo, H. influenzae, anaerobes, viruses, Mycoplasma
MCC pneumonia in adults >65 (5)
S. pneumo, influenza, anaerobes, H. influenzae, gram negative rods
MCC nosocomial pneumonia (2)
Staph, enteric gram negative rods
MCC aspiration pneumonia (1)
anaerobes
MCC pneumonia in an alcoholic (3)
S. pneumo, Klebsiella, Staph
MCC pneumonia in cystic fibrosis (1)
Pseudomonas
MCC postviral pneumoniae
Staph, H. influenzae
MCC atypical pneumonia
Mycoplasma, Legionella, Chlamydia
MCC meningitis in children <6 mos (3)
Group B strep (S. agalactiae), E. coli, Listeria
MCC meningitis in children 6 mos - 6 yr (4)
S. pneumo, N. meningitidis, Hib, enteroviruses (including coxsackie, HSV-2, HIV, West Nile, VZV)
MCC meningitis in people 6 - 60 yr
S. pneumo, N. meningitidis, Enteroviruses, HSV
MCC meningitis in adults > 60 yr
S. pneumo, gram negative rods, Listeria
empiric treatment for meningitis
vancomycin + ceftriaxone (+ ampicillin if you suspect Listeria)
MCC osteomyelitis in general population
S. aureus
MCC osteomyelitis in person with sexual risk factors
N. gonorrhoeae
MCC osteomyelitis in diabetics and IVDU
Pseudomonas
MCC osteomyelitis in sickle cell anemia
Salmonella
MCC osteomyelitis in prosthetic joint
S. aureus, S. epidermidis
MCC vertebral osteomyelitis
TB (Pott's dz)
MCC osteomyelitis secondary to dog/cat bite
Pasteurella multocida
MCC urease + UTI (2)
Proteus, Klebsiella
what does it mean to have a leukocyte esterase + UTI?
it's bacterial
what does it mean to have a nitrite + UTI?
it's gram negative bacterial
neonate with chorioretinitis, hydrocephalus, intracranial calcifications
congenital toxoplasmosis
neonate with PDA/PA hypoplasia, cataracts, deafness, and possibly a rash
congenital rubella
neonate with hearing loss, seizures, and petechiae
congenital CMV
neonate with recurrent infections and chronic diarrhea
congenital HIV
neonate with temporal encephalitis and herpetic lesions
congenital HSV2
neonate stillborn or with hydrops fetalis
congenital syphilis (parvo B19 can also cause hydrops fetalis)
child with saddle nose, short maxilla, notched teeth, saber shins, and CNVIII deafness
congenital syphilis
fine, descending rash most pronounced on the trunk; assoc. with postauricular lymphadenopathy
Rubella
descending rash preceded by cough, coryza, conjunctivitis, Koplik's spots
Measles
vesicular rash beginning on trunk and spreading peripherally
chickenpox
macular rash over the body appearing several days after a high fever, MC in infants
HHV-6 (roseola)
"slapped cheek" rash on face
parvo B19
erythematous, sandpaper-like rash with fever and sore throat
scarlet fever (S. pyogenes)
vesicular rash on palms and soles with ulcers on the oral mucosa
coxsackie A virus (hand-foot-mouth disease)
cause of chancroid (a painful chancre)
Haemophilis ducrei
cause of lymphogranuloma venereum (genital ulcers, inguinal lymphadenopathy, possibly rectal strictures)
C. trachomatis (L1-L3)
STD with corkscrew motility on wet prep
Trichomoniasis (if on dark-field, think syphilis)
MCC acute PID
N. gonorrhoeae
MCC subacute/undiagnosed PID
C. trachomatis
MCC nosocomial UTI (2)
E. coli, Proteus
MCC pneumonia associated with respiratory therapy equipment
Pseudomonas
MCC infection in hemodialysis worker
HBV
binds 30S; inhibits formation of initiation complex leading to misreading of mRNA
aminoglycosides (GNATS)
binds 30S; prevents attachment of aminoacyl-tRNA
tetracyclines
binds 50S; blocks peptide bond formation
chloramphenicol, clindamycin
binds 50S; binds 23S rRNA and blocks translocation
macrolides (ACE)
protein synthesis inhibitors mnemonic
buy AT 30 (aminoglycocides, tetracyclines), CCEL at 50 (chloramphenicol, clindamycin, erythromycin/macrolides, linezolid, also streptogramins)
anti-pseudomonal B-lactams (3)
piperacillin, ticarcillin, carbenicillin
what is aztreonam?
a monobactam resistant to all B-lactamases, but only useful lin gram negative rods
another toxicity of vancomycin (besides neph/oto and flushing)
thrombophlebitis
DOC for severe gram negative rod infections
aminoglycosides
DOC for Borrelia, Chlamydia, other intracellulars
tetracyclines, specifically doxycycline, or azithromycin
DOC for atypical pneumonias
macrolides, specifically erythromycin
DOC for life-threatening meningitis
chloramphenicol
DOC for anaerobic infections above the diaphragm
clindamycin
DOC for anaerobic infections below the diaphragm
metronidazole
DOC for Giardia, Entamoeba, Trichomonas, Gardnerella
metronidazole
mechanism of sulfonamides
inhibit dihydropteroate synthase
mechanism of trimethoprim
inhibit dihydrofolate reductase
DOC for meningococcal prophylaxis
fluoroquinolones, rifampin
cause of bacterial vaginosis
Gardnerella
4 drugs for TB
RIPE: rifampin, isoniazid, pyrazinamide, ethambutol
mechanism of rifampin
inhibits mRNA synthesis (DNA-dependent RNA polymerase)
mechanism of isoniazid and pyrazinamide
inhibit mycolic acid synthesis
mechanism of ethambutol
inhibits arabinosyltransferase, which polymerizes the carbohydrates of mycobacterial cell wall
TB drug causing optic neuropathy (red/green color blindness)
ethambutol
TB drug that's a CYP450 inducer
rifampin
TB drug that's a CYP450 inhibitor
isoniazid
DOC for TB prophylaxis
isoniazid
DOC for leprosy
rifampin (does not cure, just treats)
vitamin you have to give with isoniazid
B6
TB drug causing hyperuricemia
pyrazinamide
DOC for VRE
linezolid, streptogramins (quinupristin, dalfopristin)
DOC for outpatient atypical pneumonia
erythromycin
DOC for inpatient pneumonia (non-ICU)
fluoroquinolones
DOC for ICU pneumonia
B-lactam + fluoroquinolone or azithromycin
mechanism of amphotericin B and nystatin
bind ergosterol, form cell membrane pore causing electrolyte disturbance
mechanism of azole antifungals
inhibit enzyme that converts lanosterol to ergosterol, a component of fungal cell membrane
mechanism of caspofungin
inhibits synthesis of B-glucan, a component of fungal cell wall
mechanism of terbinafine
inhibits squalene epoxidase (antifungal)
DOCs for dermatophytoses
terbinafine (esp onychomycosis), griseofulvin
mechanism of griseofulvin
microtubule inhibitor that disrupts mitosis (antifungal)
mechanism of antiretroviral raltegravir
inhibits inTEGRAtion into host chromosome
mechanism of antiretroviral protease inhibitors
prevent maturation of new viruses
suffix for antiretroviral protease inhibitors
-navir
common stem for NNRTIs
-vir-, e.g. nevirapine, efavirenz, delaviridine
mechanism of action of tenofovir, abacavir, zidovudine, lamivudine, emtricitabine, didanosine, stavudine
NRTIs
DOC for HIV prophylaxis in pregnancy
zidovudine
mechanism of amantadine
blocks viral penetration/uncoating (M2 protein), influenza A now resistant
mechanism of zanamivir and oseltamavir
inhibits neuraminidase, preventing release of progeny (all influenzas)
mechanism of action of ribavirin
inhibits synthesis of guanine nucleotides by competitively inhibiting viral IMP dehydrogenase
DOC for RSV and chronic Hep C
ribavirin
DOC for VZV
famciclovir
DOC for CMV
ganciclovir
mechanism of the antivirals ending in -cyclovir
guanine analogues phosphorylated by viral TK that inhibit transcription
mechanism of action of foscarnet
binds binding site of viral DNA polymerase
DOCs for CMV retinitis (2)
foscarnet, cidofovir