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