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546 Cards in this Set
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How is Gardnerella vaginalis histologically characterized?
|
Presence of clue cells, vaginal epithelial cells covered with bacteria, seen on a Pap smear
|
11.2
|
|
How is Gardnerella vaginalis tested for?
|
Pap smear
|
11.2
|
|
This organism is detected as PAS+ rods withing the macrophages of the lamina propria of the small intestine
|
Tropheryma whippelii
|
29.1
|
|
What is the cause and the symptoms (5) of Whipple's Disease?
|
Tropheryma whippelii; ab pain, malabsorption with diarrhea and weight loss, and migratory polyarthritis
|
29.2
|
|
Endemic to tropical nations, this sexually transmitted organism results in granulomatous genital ulcers (pseudobuboes) with the potential for autoamputation of genitalia
|
Calymmatobacterium granulomatis
|
34.1
|
|
What are diagnostic findings of Calymmatobacterium granulomatis infection?
|
Based on finding intracellular organism aggregated as "Donovani Bodies"
|
34.2
|
|
This organism is transmitted through the bite of a domestic cat or dog and can result in an abscess, cellulitis, and osteomyelitis
|
Pasteurella multocida
|
52.1
|
|
What are growth characteristics of P. multocida and location of normal flora?
|
Short, encapsulated, bipolar staining organism; part of the nasopharyngeal flora of domestic dogs and cats
|
52.2
|
|
A normal inhabitant of the oral cavity, infection can be associated with dental procedures, with formation of lesions that erupt through the face with a purulent discharge
|
Actinomycetes israelii
|
1.1
|
|
Diagnosis is by finding sulfur granules= tangles of filaments of organisms wrapped in a matrix of calcium phosphate, with a yellow (sulfur) color to the abscess and discharge
|
Actinomycetes israelii
|
1.2
|
|
The most severe form of this disease results from the inhalation of spores with mediastinitis, pulmonary edema, and hemorrhage (Woolsorter's disease)
|
Bacillus anthracis
|
2.1
|
|
Can occur as an occupational disease of textile or agricultural personnel resulting from contact with infected hides or wool; recently used as bioweapon
|
Bacillus anthracis
|
2.2
|
|
Causes gastroenteritis and is typically associated with the consumption of reheated rice
|
Bacillus cereus
|
3.1
|
|
What are the symptoms and molecular transmission of B. cereus?
|
Rapid emesis or diarrhea is associated with an exotoxin that increases cAMP and is produced by the organism as it germinates
|
3.2
|
|
Disease can be due to the ingestion of preformed toxin in home-canned foods or by the ingestion of spores in honey by an infant
|
Clostridium botulinum
|
4.1
|
|
Produces an exotoxin that blocks the release of Ach at the neuromuscular junction
|
Clostridium botulinum
|
4.1
|
|
What are the symptoms of C. botulinum?
|
Flaccid paralysis, dry mouth, diplopia, dysphagia, and respiratory failure
|
4.2
|
|
Associated with the use of broad-spectrum antibiotics and the overgrowth of toxin-producing bacteria
|
Clostridium difficile
|
5.1
|
|
What disease is associated with C. difficile and where is it usually acquired?
|
Pseudomembranous colitis, major nosocomial disease
|
5.2
|
|
Causes gas gangrene and is often associated with automobile and motorcycle accidents
|
Clostridium perfringens
|
6.1
|
|
What is source and pathology of C. perfringens?
|
Spores are abundant in soil and germinate in wounds
|
6.2
|
|
What is the treatment of C. difficile?
|
Surgical debridement, antibiotics, and hyperbaric oxygen
|
6.2
|
|
Infection is associated with traumatic inoculation of spores that germinate and produce a toxin that causes a spastic paralysis
|
Clostridium tetani
|
7.1
|
|
What is the morphology of C. tetani?
|
Organism looks like a long rod with a dilated terminal end containing a spore that resembles a tennis racquet
|
7.2
|
|
Can cause risus sardonicus, the characteristic grimace of lockjaw
|
Clostridium tetani
|
8.1
|
|
What is the treatment of C. tetani?
|
Antitoxins produced in horses or hyperimmunized humans, and antispasmodics such as benzodiazepines
|
8.2
|
|
Causes gray pseudomembranes on the back of the throat
|
Corynebacterium diphtheriae
|
9.1
|
|
Organisms viewed with Chinese-letter" configuration"
|
Cornyebacterium diphtheriae
|
9.2
|
|
A common cause of nosocomial infections, this organism is often resistant to many antibiotics, including vancomycin
|
Enterococcus spp.
|
10.1
|
|
Common cause of gram (+) UTIs, sepsis, meningitis, and endocarditis
|
Enterococcus spp.
|
10.2
|
|
Causes a fishy smelling vaginal discharge
|
Gardnerella vaginalis
|
11.1
|
|
As the dominant organism of normal vaginal flora, its metabolism helps maintain the low pH of the vagina
|
Lactobacillus spp.
|
12.1
|
|
Lactobacillus spp. have what effect in the vagina?
|
Lactic acid produced helps prevent the overgrowth of potentially pathogenic organisms
|
12.2
|
|
What causes Lactobacillus acid producing flora to diminish in the vagina and allow for overgrowth of pathogenic species?
|
Broad-spectrum antibiotic use
|
12.2
|
|
This cause of late onset neonatal sepsis is a facultative intracellular parasite that spreads from cell to cell via actin rockets
|
Listeria monocytogenes
|
13.1
|
|
This gram positive organism can be detected as short non-spore-forming rods with tumbling end-over-end" motility"
|
Listeria monocytogenes
|
13.2
|
|
As well as being gram positive, this organism is also weakly acid fast and causes a pneumonia predominantly in immuno-compromised patients
|
Nocardia asteroides
|
14.1
|
|
This aerobic gram postive bacteria with filamentous growth is a common soil organism
|
Nocardia asteroides
|
14.2
|
|
What type of growth is associated with Nocardia?
|
Filamentous growth
|
14.2
|
|
Part of the microbial flora of the skin, this bacilli contributes to the development of acne
|
Propionibacterium acnes
|
15.1
|
|
This gram positive organism produces lipases that split fatty acids that cause inflammation, resulting in the formation of comedones
|
Propionibacterium acnes
|
15.2
|
|
A major cause of acute bacterial endocarditis, especially in IV drug users
|
Staphylococcus aureus
|
16.1
|
|
How is S. aureus endocarditis unlike subacute bacterial endocarditis?
|
Can cause infection of undamaged heart valves, typically on the right side (tricuspid) in IV drug users
|
16.2
|
|
A major cause of abscesses, furuncles, carbuncles, and other skin infections such as impetigo
|
Staphylococcus aureus
|
17.1
|
|
What are the growth patterns of S. aureus?
|
Beta-hemolytic cocci grows like grape-like clusters, coagulase positive, and yellowish colonies in culture
|
17.2
|
|
Part of the normal flora of the skin, it causes infection of IV lines and catheters; it is a major cause of endocarditis in patients with prosthetic heart valves
|
Staphylococcus epidermidis
|
18.1
|
|
How is S. epidermidis different from S. aureus?
|
White colonies, NO coagulase, NO Protein A, does NOT ferment mannitol
|
18.2
|
|
The second leading cause of urinary tracct infection in sexually active women
|
Staphylococcus saprophyticus
|
19.1
|
|
How is S. saprophyticus differentiated from S. epidermidis?
|
Ferment mannitol and resistance to novobiocin
|
19.2
|
|
An important cause of neonatal sepsis and meningitis
|
Streptococcus agalactiae (Group B)
|
20.1
|
|
What are the growth characteristics of Group B Strep?
|
Beta-hemolytic, bacitracin-resistant cocci
|
20.2
|
|
Where is Group B Strep a normal inhabitant and how can it be acquired?
|
Female genital tract, during vaginal delivery
|
20.2
|
|
A major cause of dental caries
|
Streptococcus mutans (of viridans group)
|
21.1
|
|
What are the growth characteristics of S. viridans?
|
Alpha-hemolytic, optochin resistant cocci
|
21.2
|
|
What are the growth characteristics of Strep mutans?
|
Member of the viridans group, alpha-hemolytic and optochin-resistant
|
21.2
|
|
Lancet-shaped diplococci found in a rusty brown sputum
|
Streptococcus pneumoniae
|
22.1
|
|
What is the cause of over 90% of all cases of lobar pneumonia?
|
Streptococcus pneumoniae
|
22.2
|
|
The use of a quellung reaction helps differentiate between the 85 different capsular subtypes
|
Streptococcus pneumoniae
|
23.1
|
|
What are the growth characteristics of S. pneumoniae?
|
Alpha-hemolytic, optochin sensitive bile soluble coccus, grows on sheep blood agar
|
23.2
|
|
What is significant about the Strep pneumo vaccine?
|
Contains at least 23 subtypes
|
23.2
|
|
Infection results in rheumatic fever
|
Streptococcus pyrogenes (Group A)
|
24.1
|
|
What is cause of rheumatic fever and what are the symptoms?
|
Streptococcus pyogenes (Group A); migratory polyarthritis, erythema marginatum, pancarditis, Sydenham chorea, and subcutaneous nodules (PECSS/FEVERSS)
|
24.1
|
|
A major cause of pharyngitis, infection can also result in other suppurative symptoms such as erypsipelas, cellulitis, and impetigo
|
Streptococcus pyrogenes (Group A)
|
25.1
|
|
How can Strep pyogenes be diagnosed?
|
Serodiagnosed with the detection of host antibodies to bacterial DNase B and ASO
|
25.2
|
|
What are other suppurative symptoms of Group A Strep?
|
Erysipelas, cellulitis, and impetigo
|
25.2
|
|
What are the growth characteristics of Group A Strep?
|
Beta-hemolytic, bactitracin-sensitive cocci
|
25.2
|
|
Infection can lead to the development of acute glomerulonephritis and mitral and aortic stenosis
|
Streptococcus pyrogenes (Group A)
|
26.1
|
|
How is Group A Strep infection related to heart valves?
|
Cross-reactive antibodies to the bacteria result in autoimmune destruction of the valves
|
26.2
|
|
How is Group A Strep infection visualized in the kidney?
|
Immunocomplex deposition in the kidney visualized by "lumpy bumpy" immunofluorescence
|
26.2
|
|
Leading cause of subacute bacterial endocarditis
|
Streptococcus viridans
|
27.1
|
|
Where is S. viridans part of normal flora?
|
Human pharynx
|
27.2
|
|
Chronic exposure to this group of organisms leads to the development of hypersensitivity pneumonitis, including Farmer's Lung, Pigeon breeder's Lung, and Humidifier Lung
|
Thermophilic Actinomycetes
|
28.1
|
|
Exposure to Thermophilic actinomycetes causes what symptoms (5)?
|
Immunologically mediated interstitial fibrosis, bronchiolitis, and granuloma formation with progressive respiratory failure and cyanosis
|
28.2
|
|
Predominant organism in the human colon
|
Bacteroides fragilis (2nd is E. coli)
|
30.1
|
|
Most often the cause of serious anaerobic infection
|
Bacteroides fragilis
|
30.2
|
|
Transmitted by the bite, scratch, or lick of an infected cat, resulting in low grade fever and a characteristic enlargement of lymph nodes for several weeks
|
Bartonella henselae
|
31.1
|
|
What is the causitive agent of Cat Scratch disease?
|
Bartonella henselae
|
31.2
|
|
Which group is Cat scratch disease more severe and what are the symptoms?
|
Immunocompromised patients can result with Bacillary angiomatosis, cranberry-like pustules resembling Kaposi sarcoma
|
31.2
|
|
Transmitted by contaminated livestock and unpasteurized dairy products, infection results in a fever that rises in the morning and falls at night (Undulant fever)
|
Brucella spp.
|
33.1
|
|
What is pathogenesis of Brucella infection?
|
Granulomatous infection invades the reticulo-endothelial cells of the lymph nodes, liver, spleen, and bone marrow
|
33.2
|
|
A common cause of bloody diarrhea, particularly in children in close contact with puppies and kittens, which serve as reservoirs
|
Campylobacter jejuni
|
35.1
|
|
What are growth characteristics of C. jejuni?
|
Gram (-) rod shaped organisms appear as gull wing" -shaped colonies with a single flagellum"
|
35.2
|
|
Causes a bloody diarrhea and is associated with the consumption of undercooked meat and dairy products
|
Enterohemorrhagic Escherichia coli (E. coli 0157:H7)
|
36.1
|
|
What are molecular pathogenesis of Enterhemorrhagic E. coli?
|
This dysentery-like condition is due to the elaboration of verotoxins similar to Shiga toxins that causes cytotoxicity to the colonic mucosa
|
36.2
|
|
Infection may result in hemorrhagic colitis progressing to the hemolytic uremic syndrome (HUS)
|
Enterohemorrhagic Escherichia coli (E. coli 0157:H7)
|
37.1
|
|
What causes HUS and how is it characterized?
|
EHEC; acute renal failure, microangiopathic hemolytic anemia, and thrombocytpenia in kids
|
37.2
|
|
Leading cause of urinary tract infections
|
Escherichia coli
|
38.1
|
|
What are other major causes of UTIs other than E. coli?
|
Proteus, Serratia, Enterococcus, Klebsiella, Pseudomonas, S. saprophyticus (PPEKSS)
|
38.2
|
|
Causes "traveler's diarrhea" and is also a major cause of death in children of developing nations
|
Escherichia coli (ETEC)
|
39.1
|
|
What is molecular pathogenesis and symptoms of ETEC?
|
Heat stable and heat labile toxin that causes explosive watery diarrhea with cramping, ab discomfort, and dehydration
|
39.2
|
|
This zoonotic organism can be transmitted by the bite of a deerfly or tick, or through handling or consuming rabbit products, which are the reservoir
|
Francisella tularensis
|
40.1
|
|
What is the disease pattern of F. tularensis infection?
|
Necrotic ulcers at the site of entry: conjunctiva (oculoglandular), mouth (typhoidal), or lungs (pneumonic tularemia) with disseminated granulomatous lesions of the lung, spleen, and liver
|
40.2
|
|
Organisms closely associated with chronic gastritis and peptic ulcer disease
|
Helicobacter pylori
|
41.1
|
|
H. pylori is associated with an increase in development of what types of cancer?
|
Gastric carcinoma and MALToma
|
41.2
|
|
Major cause of aspiration pneumonia in alcoholics
|
Klebsiella pneumoniae
|
45.1
|
|
What are the growth characteristics of K. pneumoniae
|
Large antiphagocytic capsule, giving it a mucoid appearance and producing a thick, bloody, currant-jelly" sputum"
|
45.2
|
|
What is most characteristic of K. pneumoniae infections?
|
Currant-jelly sputum
|
45.2
|
|
Paired, kidney bean-shaped diplococci within leukocytes in a urethral dishcarge
|
Neisseria gonorrhoeae
|
46.1
|
|
How is N. gonorrhoeae differentiated from N. meningitidis?
|
N.m. ferments glucose AND maltose whereas N.g. ONLY ferments glucose
|
46.2
|
|
Leading cause of septic arthritis
|
Neisseria gonorrhoeae
|
47.1
|
|
How does N. gonorrhoae arthritis present?
|
Monoarticular arthritis of the knee, ankle, or wrist afte a bout of urethritis
|
47.2
|
|
Infection of a neonate passing through an infected birth canal results in ophthalmia neonatorum and purulent conjuncitivits
|
Neisseria gonorrhoeae
|
48.1
|
|
How are Neisseria gonorrhoeae eye infections prevented in babies in the U.S.?
|
Receive required administration of tetracycline, erythromycin, or SILVER NITRATE drops
|
48.2
|
|
Sexually transmitted disease that can lead to pelvic inflammatory disease that then predisposes to ectopic pregnancy
|
Neisseria gonorrhoeae
|
49.1
|
|
What is the the second most notifiable disease in the United States?
|
PUD from Neisseria gonorrhoeae infection
|
49.2
|
|
Leading cause of meningtis among military recruits and dormitory settings
|
Neisseria meningitidis
|
50.1
|
|
Patients with what immune deficiencies are particularly susceptible to N. meningitidis infection?
|
Complement components C6-9 membrane attack complex""
|
50.2
|
|
Septicemia resulting from this organism can result in progressive hypotension, disseminated intravascular coagulation (DIC), widespread vascular purpura, and bilateral adrenal hemorrhage
|
Neisseria meningitidis
|
51.1
|
|
What N. meningitidis disease process is rapidly fatal without antibiotic treatment?
|
The shock and adrenocortical insufficiency of Waterhouse-Friderichsen Syndrome
|
51.2
|
|
Urease-positive organism that causes an alkaline urine predisposing to the formation of urinary calculi
|
Proteus spp. (P. mirabilis and P. vulgaris)
|
53.1
|
|
Significant treatment factors of Proteus spp.
|
These highly motile organisms are often refractory to antibiotic treatment because they often become trapped within stones
|
53.2
|
|
Major cause of pneumonia in burn patients and Cystic fibrosis patients
|
Pseudomonas aeruginosa
|
54.1
|
|
What is the etiology of P. aeruginosa infection?
|
Major cause of nosocomial infections; colonizes aspirators, water and ice dispensers, CATHETERS, IV lines, and even dilute disinfectant solutions!
|
54.2
|
|
Infection can result in folliculitis, swimmer's ear, pneumonia, and sepsis with the development of characteristic skin lesions (Ecthyma gangrenosum)
|
Pseudomonas aeruginosa
|
55.1
|
|
What are the growth characteristics of P. aeruginosa?
|
Obligate aerobe requires only trace elements (cysteine/iron on charcoal yeast extract), blue-green colonies (pyoverdin/pyocyanin), and characteristic fruity odor
|
55.2
|
|
Where is P. aeruginosa especially good at growing in?
|
Inadequately chlorinated HOT TUBS
|
55.2
|
|
Causes a self-limiting enterocolitis associated with the consumption of contaminated eggs and poultry
|
Salmonella enteritidis
|
56.1
|
|
What is significant with Salmonella enteritidis infection?
|
This highly motile organism requires a LARGE infectious dose, which distinguishes it from Shigella spp.
|
56.2
|
|
Causes an enteric fever with the development of characteristic "rose spots" on the abdomen
|
Salmonella typhi
|
57.1
|
|
What happens to a small percentage of people after recovery from S. typhi infection?
|
Become carriers due to colonizing the gallbladder; may require cholecystectomy
|
57.2
|
|
This organism is a common cause of nosocomial infections; some strains produce a red pigment
|
Serratia marcescens
|
58.1
|
|
What infections are caused by Serratia marcescens?
|
Pneumonia, bacteremia, endocarditis, and is often multidrug-resistant
|
58.2
|
|
Infection with a small dose of organisms results in dysentery that is only transmitted among humans with no animal reservoir
|
Shigella dysenteriae
|
59.1
|
|
S. dysenteriae infection is characterized by what symptoms?
|
Bloody, mucoid, low-volume diarrhea that can result in life-threatening dehydration and acidosis
|
59.2
|
|
What is Shigella infection often associated with?
|
Insanitary conditions
|
59.2
|
|
Major cause of secretory diarrhea with life-threatening dehydration, particularly in developing nations
|
Vibrio cholerae
|
60.1
|
|
What is pathogenesis of V. cholerae infection?
|
Comma-shaped rods with polar flagellum adhere to the intestinal mucosa and elaborate an exotoxin, but never invade the wall
|
60.2
|
|
Causes nausea, cramping, and is associated with the consumption of raw shellfish (and what are the bugs characteristics?)
|
Vibro parahemolyticus: free-living salt bacteria (Sx milder than V. cholerae)
|
61.1
|
|
Rodents are the reservoir for this organism, transmitted by the bite of a flea, resulting in the plague
|
Yersinia pestis
|
62.1
|
|
What is the cause and transmission of pneumonic plague?
|
Y. pestis; human to human (aerosol)
|
62.2
|
|
Infection can result in pustules and enlargement of draining lymph nodes that rupture through the skin to form buboes
|
Yersinia pestis
|
63.1
|
|
What are the visual (staining) characteristics of Y. pestis?
|
Bipolar staining resulting in a safety pin appearance
|
63.2
|
|
Late stages of infection may lead to a severe autoimmune arthritis, life threatening heart block, and facial palsy
|
Borrelia burgdorferi
|
64.1
|
|
Late stages of infection may lead to a severe autoimmune arthritis, life-threatening heart block, and facial nerve palsy
|
Borrelia burgdorferi (Lyme disease)
|
64.1
|
|
Is there a vaccine available for Lyme disease?
|
Yes, recently available
|
64.2
|
|
Transmitted by the Ixodes tick bite that results in a characteristic bull's eye lesion (Erythema chronicum migrans)
|
Borrelia burgdorferi (Lyme disease)
|
65.1
|
|
Transmitted by the Ixodes tick bite that results in a characteristic bull's eye" lesion (Erythema chronicum migrans)"
|
Borrelia burgdorferi
|
65.1
|
|
Where and when are most B. burgdorferi cases?
|
Northeast during the summer months (ticks)
|
65.2
|
|
Transmitted by the human body louse, this organism causes Relapsing Fever
|
Borrelia recurrentis
|
66.1
|
|
Transmitted by the human body louse, this organism causes Relapsing fever
|
Borrelia recurrentis
|
66.1
|
|
What is the pathogenesis of B. recurrentis?
|
Febrile disease that fades as antibodies develop and RELAPSES as the organism undergoes ANTIGENIC VARIATION of its variable major protein
|
66.2
|
|
Previously known as the TWAR agent, it is a common cause of sore throats and intestitial pneumonia
|
Chlamydia pneumoniae
|
67.1
|
|
What are the cycle forms of the Chlamydia family?
|
Elementary bodies, the infectious form, or intracellular reticular bodies, the metabolically active form
|
67.2
|
|
Causes an interstitial type of pneumonia and is associated with exposure to contaminated parrots adn parakeets and other domestic birds
|
Chlamydia psittaci
|
68.1
|
|
What are the two diseases caused by C. psittaci?
|
Psittacosis, transmitted by birds of the psittacine family; Ornithosis, exposure to pigeons, ducks, and chickens
|
68.2
|
|
The cause of chronic keratoconjunctivitis results in corneal scarring and is the most common cause of blindness worldwide
|
Chlamydia trachomatis
|
69.1
|
|
How are the strains of C. trachomatis distinguished?
|
Divided into SEROVARS based on serology and symptomology; with keratoconjunctivitis C. trachomatis A, B, C
|
69.2
|
|
This organism is the leading cause of sexually transmitted bacterial disease, resulting in urethritis, cervicitis, salpingitis, and neonatal conjuctivitis
|
Chlamydia trachomatis
|
70.1
|
|
Infection in a female can progress to pelvic inflammatory disease, resulting in the potential for ectopic pregnancy and sterility
|
Chlamydia trachomatis
|
70.2
|
|
This organism is closely associated with the development of conjunctivitis, urethritis, and arthritis (Reiter's Syndrome)
|
Chlamydia trachomatis
|
71.1
|
|
What is the association of C. trachomatis and Reiter's Syndrome?
|
AUTOIMMUNE phenomenon resulting from cross-reactive antigens between the organism and affected tissues, associated with HLA-B27 (PAIR)
|
71.2
|
|
Causes Lymphogranuloma venereum, characterized by nodules and vesicles on the genitals, venereal buboes, and elephantiasis of the genitals with rectal strictures
|
Chlamydia trachomatis
|
72.1
|
|
Which strains of Chlamydia trachomatis cause Lymphgranuloma venereum?
|
Most invasive SEROVARS L1, L2, and L3; this STD progresses through primary, secondary, and tertiary stages
|
72.2
|
|
Causes Q fever, an interstitial pneumonia, resulting from the inhalation of the organism
|
Coxiella burnetii
|
73.1
|
|
How is C. burnetii different from the other Rickettsia diseases?
|
NOT transmitted by the bite of an arthropod, does NOT cause a rash, and CANNOT be detected by the Weil-Felix Test (classic serologic Rickettsia test)
|
73.2
|
|
Associated with overcrowding and transmitted by the human body louse, this organism causes Epidemic typhus
|
Rickettsia prowazekii
|
84.1
|
|
What causes the less severe form of disease, Endemic typhus?
|
Rickettsia typhi
|
84.2
|
|
What symptoms characterize Epidemic typhus?
|
Extreme fever, myalgias, and rash (R. prowazekii)
|
84.2
|
|
Transmitted by ticks, infection results in a petechial rash wit involvement of the palms and soles
|
Rickettsia rickettsii - Rocky Mountain Spotted Fever
|
85.1
|
|
Transmitted by ticks, infection results in a petechial rash with involvement of the palms and soles
|
Rickettsia prowazekii
|
85.1
|
|
How is Rocky Mountain spotted fever diagnosed?
|
R. rickettsii is an OBLIGATE INTRACELLULAR organism seen with GIEMSA staining
|
85.2
|
|
Where is Rocky Mountain Spotted Fever endemic?
|
Eastern United States
|
85.2
|
|
Transplacental infection can result in a triad of interstitial keratitis, Hutchinson teeth, and 8th cranial nerve deafness
|
Treponema pallidum (syphilis)
|
86.1
|
|
Transplacental infection can result in a triad of interstitial keratitis, Hutchinson teeth, and 8th cranial nerve deafness
|
Treponema pallidum
|
86.1
|
|
What bone deformities are caused by T. pallidum infection (5)?
|
Osteochondritis, periostitis, destruction of the VOMER leading to SADDLE NOSE; SABER SHIN and MULBERRY MOLARS
|
86.2
|
|
Long-term consequences of untreated disease include tabes dorsalis and aneurysms of the ascending aorta
|
Treponema pallidum (syphilis)
|
87.1
|
|
Long-term consequences of untreated disease include tabes dorsalis and aneurysms of the ascending aorta
|
Treponema pallidum - tertiary syphilis
|
87.1
|
|
The disease can manifest with a maculopapular rash on the palms and soles, and condyloma lata
|
Treponema pallidum (syphilis)
|
88.1
|
|
The disease can manifest with a maculopapular rash on the palms and soles, and condyloma lata
|
Treponema pallidum - secondary syphilis
|
88.1
|
|
What are condyloma lata of T. pallidum often confused with?
|
Condyloma ACUMINATUM seen with HPV infection
|
88.2
|
|
What disease patterns are caused by secondary syphilis?
|
CONDYLOMA LATA are gray flattened WART-LIKE LESIONS on the anogenital, axillary, and oral areas; rash also present
|
88.2
|
|
What late stage disease patterns are caused by tertiary syphilis?
|
Leading cause of aneurysms of the ASCENDING AORTA with characteristic TREE-BARK appearance; can also lead to paresis
|
88.2
|
|
Initial infection presents with a painless ulcer on the genitals known as a chancre
|
Treponema pallidum (syphilis)
|
89.1
|
|
How is primary syphilis diagnosed?
|
Numerous SPIROCHETES viewed by DARK FIELD or IMMUNOFLURESCENT microscopy
|
89.2
|
|
What is signigicant concerning Treponema pallidum transmission and spread?
|
HIGHLY CONTAGIOUS!!
|
89.2
|
|
Patient with SLE are often positive for serologic tests for this organism even if not infected (biologic false positive)
|
Treponema pallidum (syphilis)
|
90.1
|
|
Patients with SLE are often positive for serologic tests for this organism even if not infected (biologic false positive)
|
Treponema pallidum - SLE patients make antibodies to cardiolipin
|
90.1
|
|
What are the sensitivity screening tests utilized for Treponema pallidum infection?
|
RAPID PLASMA REAGIN or Venereal Disease Research Laboratory (VDRL); tests for antibodies to cardiolipin
|
90.2
|
|
What is the most specific test for Treponema pallidum infection?
|
Fluorescent treponemal antibody (FTA-Abs) test
|
90.2
|
|
The organism is exquisitely sensitive to penicillins; treatment can result in rash, fever, and hypotension (Jarisch-Herxheimer reaction)
|
Treponema pallidum (syphilis)
|
91.1
|
|
This STD organism is exquisitely sensitive to penicillins; treatment can result in a rash, fever, and hypotension (Jarisch-Herxheimer reaction)
|
Treponema pallidum
|
91.1
|
|
What is the pathogenesis of the Jarisch-Herxheimer reaction?
|
Tx results in rapid death of T. pallidum with RELEASE OF TOXIC PRODUCTS that cause symptoms that can be relieved by anti-inflammatory agents
|
91.2
|
|
This organism that lacks a cell wall is the cause of recurrent UTIs
|
Ureaplasma urealyticum
|
92.1
|
|
What organism is Ureaplasma related and infection is associated with what obstructive disease?
|
Mycoplasma pneumoniae; development of URINARY CALCULI
|
92.2
|
|
Produces a trivalent exotoxin composed of protective antigen, edema factor, and lethal factor
|
Bacillus anthracis
|
93.1
|
|
Produces a trivalent exotoxin composed of protective antigen, edema factor, and lethal factor
|
Bacillus anthracis
|
93.1
|
|
What are the components and functions of the B. anthracis trivalent exotoxin?
|
Protective antigen CELL BINDING; edema factor is a secreted ADENYLATE CYCLASE; lethal factor causes CNS DEPRESSION
|
93.2
|
|
One of the virulence factors of this organism is an anti-phagocytic capsule composed of D-glutamic acid
|
Bacillus anthracis
|
94.1
|
|
One of the virulence factors of this organism is an anti-phagocytic capsule composed of D-glutamic acid
|
Bacillus anthracis
|
94.1
|
|
Produces a trivalent exotoxin composed of protective antigen, edema factor, and lethal factor
|
Clostridium botulinum
|
96.1
|
|
What is the treatment for C. botulinum?
|
ANTITOXIN produced in HORSES, with the possibility of SERUM SICKNESS
|
96.2
|
|
The toxin produced by this organism can be used in minute amounts to treat dystonias, strabismus, and wrinckles
|
Clostridium botulinum
|
97.1
|
|
The toxin produced by this organism can be used in minute amounts to treats dystonias, strabismus, and wrinkles
|
Clostridium botulinum - causes FLACCID PARALYSIS of the injected muscles
|
97.1
|
|
Produces an AB toxin that ADP-ribosylates the small GTP binding protein Rho
|
Clostridium difficile
|
98.1
|
|
Produces an AB toxin that ADP-ribosylates the small GTP binding protein Rho
|
Clostridium difficile
|
98.1
|
|
What is the pathogenesis of C. difficile's AB toxin
|
Depolymerization of the cytoskeleton with NECROSIS of the COLONIC EPITHELIUM
|
98.2
|
|
Produces a lecithinase and hyaluronidase that results in cellulitis and myonecrosis
|
Clostridium perfringens
|
99.1
|
|
Produces a lecithinase and hyaluronidase that results in cellulitis and myonecrosis
|
Clostridium perfringens
|
99.1
|
|
What are the growth characteristics of C. perfringens?
|
Lecithinase can be demonstrated by culturing on egg YOLK AGAR; normally the organism produces a DOUBLE ZONE of HEMOLYSIS on blood agar
|
99.2
|
|
The toxin elaborated by this organism inhibits the release of the inhibitory neurotransmitters, GABA, and glycine, resulting in a spastic paralysis
|
Clostridium tetani
|
100.1
|
|
The toxin elaborated by this organism inhibits the release of the inhibitory neurotransmitters, GABA and glycine, resulting in a spastic paralysis
|
Clostridium tetani
|
100.1
|
|
When is the highly immunogenic tetanus toxoid (DaPT) vaccine recommended?
|
Booster every 10 years and after a PUNCTURE WOUND
|
100.2
|
|
A virulence factor produced by these two organisms is a typical AB toxin that catalyzes the transfer of ADP-ribose from NAD+ to EF-2
|
Corynebacterium diphtheria and Pseudomonas aeruginosa; results in the INHIBITION of PROTEIN SYNTHESIS and death of the cell
|
101.1
|
|
Produces a heat stable toxin Sta, that stimulates the production of cGMP, with similar effects to those of increased cAMP
|
Enterotoxigenic Eshcerichia coli
|
102.1
|
|
Produces a heat stable toxin Sta, that stimulates the production of cGMP, with similar effects to those of increased cAMP
|
Enterotoxigenic E. coli (ETEC) also produces STb toxin this is cyclic nucleotide independent
|
102.1
|
|
What are toxins similar to Shiga toxin?
|
Verotoxins produced by EHEC
|
102.2
|
|
Virulence factor found in the outer leaflet of the cell wall of gram-negative organisms
|
Lipopolysaccharide (LPS)
|
103.1
|
|
What immunogenic effects and disease states does LPS cause?
|
Activation of macrophages with release of IL-1; development of DIC and septic shock
|
103.2
|
|
What is the composition of LPS?
|
Lipid A, a core polysaccharide, and O antigen
|
103.2
|
|
Produces a toxin that irreversibly inactivates the 60S ribosomal subunit with the cesation of protein synthesis and cell death
|
Shigella dysenteriae
|
105.1
|
|
Produces a toxin that irreversibly inactivates the 60S ribosomal subunit with the cessation of protein synthesis and cell death
|
Shigella dysenteriae - Shiga toxin
|
105.2
|
|
Produces exfoliant toxin
|
Staphylococcus aureus
|
106.1
|
|
What is Scalded skin syndrome and its cause?
|
S. aureus; toxin mediated exfoliative dermatitis that appears as a sunburn-like rash
|
106.2
|
|
Produces Toxic shock syndrome toxin
|
Staphylococcus aureus
|
107.1
|
|
What is TSS?
|
Toxic Shock Syndrome (staph); Associated wtih superabsorbent tampons in 80s, results from the production of TSST, causing POLYCLONAL ACTIVATION of T CELLS through antigen-independent activation of the T-cell recepter (betaTCR/alphaMHCII)
|
107.2
|
|
Protein A is a major virulence factor
|
Staphylococcus aureus
|
108.1
|
|
Protein A is a major virulence factor (and function)
|
Staphylcoccus aureus - binds the Fc region of the antibody, preventing complement fixation and phagocytosis
|
108.1
|
|
The three major pyogens for which a polysaccharide capsule is the major virulence factor
|
S. pneumoniae, H. influenzae, N. meningitidis; prevents opsonization by host cell immunoglobulins
|
109.1
|
|
Produces erythrogenic toxin, resulting in Scarlet fever
|
Streptococcus pyogenes (Group A)
|
110.1
|
|
Produces erythrogenic toxin, resulting in Scarlet fever (And what is the function of this toxin?)
|
Streptococcus pyogenes (Group A); phage-encoded superantigen that causes the rash often accompanying pharyngitis
|
110.1
|
|
M antigen is the most importan virulence factor (and what is M antigen funtion)
|
Streptococcus pyogenes (Group A); prevents phagocytosis and Abs lead to CHRONIC RHEUMATIC HEART DISEASE
|
111.1
|
|
Produces and AB toxin that transfers AdP-ribose from NAD+ to the stimulatory G protein subunit (Gs)
|
Vibrio cholerae
|
112.1
|
|
Produces an AB toxin that transfers ADP-ribose from NAD+ to the stimulatory G protein subunit (Gs)
|
Vibrio cholerae
|
112.1
|
|
What is the function of V. cholerae's AB toxin?
|
Similar to LT of ETEC; results in increase of cAMP with hypersecretion of Cl- and HCO3- with the OSMOTIC REFLUX of up to 30L of water/day
|
112.2
|
|
Major STDs in the U.S. (Bacterial, Protozoal, Viral)
|
B- C. trachomatis, N. gonorrhoeae; P- T. vaginalis; V- HSV-2, HIV, HPV
|
239.1
|
|
Major causes of meningitis (Newborns, kids, young adults, Elderly over 60 years, AIDS patients)
|
N- S. agalactiae, E. coli; K- H. influ; YA- N. meningitidis; E- S. pneumoniae; AIDS- C. neoformans
|
240.1
|
|
Major causes of pneumonia (Neonates, kids 6wks-18 years, Adults, Elderly over 60, Alcoholics, postviral, CF patients)
|
N- S. agalactiae, E. coli; K- RSV; A- Mycoplasma; EtOH- K. pneumo; P.V.- H. influ; CF- P. aeruginosa
|
241.1
|
|
Common nosocomial infections associated with (Newborns, Urinary caths, Renal dialysis units, Resp therapy equip, Water aerosols)
|
N- RSV, CMV; U- E. coli, Proteus; RDU- HBV; RTE- P. aeruginosa; WA- L. pneumophila
|
242.1
|
|
Major causes of endocarditis (Subacute, Acute, IVDA, Prosthetic valves)
|
Sub- S. viridans; Acute- S. aureus; IVDA- S. aureus; Pros- S. epidermidis
|
243.1
|
|
Major causes of osteomyelitis (Gen. pop., Sexually active, Drug users, Sickle cell anemia)
|
GP- S. aureus; Sex- N. meningitidis; DU- P. aeruginosa; SCA- Salmonella spp.
|
244.1
|
|
Major causes of UTIs (8)
|
E. coli (most common), Enterococcus faecalis, K. pneumo, Proteus mirabilis/vulgaris, P. aeruginosa, Serratia marcescens, S. saprophyticus
|
245.1
|
|
Organisms causing WATERY diarrhea (6)
|
C. parvum, E. coli, V. cholerae, G. lamblia, Norwalk Agent, Rotavirus
|
246.1
|
|
Organisms causing BLOODY diarrhea (dysentery) (6)
|
C. jejuni, EHEC, EIEC, Salmonella, S. dysenteriae, E. histolytica
|
247.1
|
|
Major causes of food poisoning (4)
|
B. cereus, C. perfringens, S. aureus, V. parahaemolyticus
|
248.1
|
|
Major causes of transcervical neonatal infections (acquired by vaginal delivery) (4)
|
C. albicans, E. coli, L. monocytogenes, S. agalactiae
|
250.1
|
|
What are the poorly staining organisms (9)?
|
Borrelia, Chlamydia, Coxiella, Legionella, Mycobacterium, Mycoplasma, Rickettsia, Treponema, Ureaplasma
|
|
|
What three organisms have unique capsular components and what do they consist of?
|
B. anthracis - D-glutamic acid; S. agalactiae - sialic acid; P. multocida - hyaluronic acid
|
|
|
Causes a paroxysmal cough ending with an inspiratory whoop" as air rushes over the swollen glottis"
|
Bordetella pertussis
|
32.1
|
|
What is included with the pertussis vaccine, when is it administered, and with what other vaccines?
|
Purified virulence factors filamentous hemagluttin (FHA) and pertussis toxoid; administered 2, 4, 6, and 18 months; Diphtheria/tetanus in DaPT vaccine
|
32.2
|
|
A sexually transmitted disease, results in painful necrotizing genital ulcers (Chancroid)
|
Haemophilus ducreyi, painless ulcer= T. pallidum
|
42.1
|
|
Where do H. ducreyi infections geographically occur?
|
Rare in US, mostly in tropics
|
42.2
|
|
Infections with this coccobacillus causes epiglottitis, otitis media in kids, sinusitis, meningitis, and pneumonia in older patients with chronic respiratory disease
|
HaEMOPhilus influenzae
|
43.1
|
|
What are the growth characteristics of H. influenzae?
|
Growth requires Factor V (hemin) and Factor X (NAD), found in chocolate agar media
|
43.2
|
|
Formerly a leading cause of infection in children, the incidence of infection has dramatically decreased with the introduction of a vaccine
|
HaEMOPhilius influenzae
|
44.1
|
|
What is the H. influenzae vaccine composed?
|
Capsular material, polyribitol phosphate (PRP); conjugated to diphtheria toxin
|
44.2
|
|
This poorly staining organism grows in warm, moist environments (contaminated air conditioner systems) and causes a potential life-threatening pneumonia in patients with lung disease
|
Legionella pneumophilia
|
74.1
|
|
How is L. pneumophila visualized?
|
Dieterle silver stain
|
74.2
|
|
What is another less severe form of pneumonia caused by L. pneumophilia?
|
Pontiac fever
|
74.2
|
|
One of the most common opportunistic bacterial infections in AIDS patients
|
Mycobacterium avium-intercellulare
|
75.1
|
|
How does M. avium-intercellulare present?
|
Similarly to TB and is acquired from soil, birds, or other animals
|
75.2
|
|
Infection results in the destruction of skin and cartilage, resulting in a leonine facies and limb deformities
|
Mycobacterium leprae
|
76.1
|
|
How does Hansen's disease present?
|
Spectrum between two extremes- TUBERCULOID associated with good prognosis to LEPROMATOUS
|
76.2
|
|
What does Mycobacterium leprae cause?
|
Leprosy, Hansen's disease
|
76.2
|
|
What is the significance of Lepromatous leprosy?
|
Numerous acid-fast bacilli are stuffed in macrophages= LEPRA CELLS
|
76.2
|
|
Infection results in the destruction of peripheral nerves, resulting in anesthesia followed by atrophy and autoamputation
|
Mycobacterium leprae
|
77.1
|
|
What is generation time of M. leprae?
|
Acid-fast bacilli has a LONG GENERATION TIME, approximately 13 days, and CANNOT be cultivated in the laboratory
|
77.2
|
|
Primary infection results in subpleural parenchymal lesions and enlarged caseous lymph nodes (Ghon complex) and reactivation can result in cavitary lesions in the upper lung lobes
|
Mycobacterium tuberculosis
|
78.1
|
|
How is Mycobacterium tuberculosis diagnosis confirmed?
|
Finding ACID-FAST BACILLI in the sputum or in cultures that take several weeks to grow
|
78.2
|
|
The classic presentation of infection with this organism includes fever, night sweats, fatigue, adn weight loss
|
Mycobacterium tuberculosis
|
79.1
|
|
What other GRANULOMATOUS infections does Mycobacterium tuberculosis present similarly to?
|
Histoplasmosis or Coccidiodomycosis
|
79.2
|
|
Infection can result in the involvement of vertebrae (Pott disease) with spread to form a psoas abscess
|
Mycobacterium tuberculosis
|
80.1
|
|
M. tuberculosis can cause what liver disease in immunocompromised patients?
|
Overwhelming miliary dissemination
|
80.2
|
|
Where and in whom are M. tuberculosis infections increasing?
|
Although rare in U.S., incidences are increasing in IMMUNOCOMPROMISED patients adn urban populations, with high incidence of MDRS
|
80.2
|
|
Immunization employees the use of Bacillus Calmette Guerin (BCG), one of the only live attenuated bacterial vaccines available
|
Mycobacterium tuberculosis
|
81.1
|
|
What it the test for TB and what does it involve?
|
Injection of partially purified derivative (PPD) or tuberculin and detecting DELAYED TYPE HYPERSENSITIVITY Reaction
|
81.2
|
|
Why is the TB vaccine not utilized within the U.S.?
|
Recipients of the vaccine (an ATTENUATED STRAIN OF M. BOVIS) have a positive PPD
|
81.2
|
|
A prominent cause of community-acquired pneumonia, symptoms normally include a hacking, nonproductive cough (atypical pneumonia)
|
Mycoplasma pneumoniae
|
82.1
|
|
What characteristics are unique to Mycoplasma pneumoniae?
|
One of the SMALLEST FREE-LIVING BACTERIA, has NO CELL WALL, and causes an INTERSTITIAL INFLAMMATION rather than intra-alveolar exudates
|
82.2
|
|
Causes Walking pneumonia" with the potential to develop a self-limiting hemolytic anemia"
|
Mycoplasma pneumoniae
|
83.1
|
|
What to untreated patients with Mycoplasma pneumoniae infection develop immunologically?
|
IgM AUTOANTIBODIES to RBCs, termed ACUTE COLD AGGLUTININS (mononucleosis also a cause)
|
83.2
|
|
Produces a typical AB toxin that catalyzes the transfer of ADP-ribose from NAD+ to the inhibitory G protein subunit (Gi)
|
Bordetella pertussis
|
95.1
|
|
What are the virulence factors utilized by B. pertussis?
|
ADP ribosylation protein, filamentous hemagglutinin, and tracheal cytotoxin
|
95.2
|
|
What does interference of G protein-coupled receptors, as utilized by B. pertussis effect and cause?
|
Effects chemokines with G protein-coupled receptors and causes LYMPHOCYTOSIS
|
95.2
|
|
The virulence factors associated with this organism include the ability to grow intracellularly and the production of cord factor
|
Mycobacterium tuberculosis
|
104.1
|
|
What is the function of M. tuberculosis cord factor?
|
Thought to contribute to formation of GRANULOMAS
|
104.2
|
|
The three major pyogens for which a polysaccharide capsule is the major virulence factor
|
S. pneumoniae, H. influenzae, N. meningitidis; prevents opsonization by host cell immunoglobulins
|
109.1
|
|
Produces a toxin that results in liver damage upon ingestion of wild mushrooms
|
Amanita spp.
|
113.1
|
|
What happens with ingestion of Amanita spp.?
|
Life-threatening FULMINANT HEPATITIS, requiring liver transplant
|
113.2
|
|
Produces the carcinogen aflatoxin and is a common contaminant of moldy nuts and grains
|
Aspergillus favus
|
114.1
|
|
What diseases to aflatoxins contribute?
|
Hepatocellular carcinoma and synergistically with HBV to promote carcinogenesis
|
114.2
|
|
Proliferation of this organism within the lung causes a fungus ball" that must be removed surgically"
|
Aspergillus fumigatus
|
115.1
|
|
What is characteristic of Aspergillus fumigatus growth?
|
SEPTATE HYPHAE, branching at 45 degree angles
|
115.2
|
|
Although an opportunistic mycosis, it can cause hypersensitivity pneumonitis such as Farmer's Lung
|
Aspergillus fumigatus; resulting from inhalation of MOLDY HAY
|
116.1
|
|
Systemic mycosis that begins as lower RTI and may disseminate to cause warty-like skin lesions
|
Blastomyces dermatitidis
|
117.1
|
|
What are the manifestations of Blastomyces dermatitidis infection?
|
Granulomatous lung lesions similar to TB, also skeletal and genitourinary
|
117.2
|
|
Systemic mycosis endemic to the southeastern United States
|
Blastomyces dermatitidis
|
118.1
|
|
What is specific growth pattern of Blastomyces dermatitidis?
|
Appears as YEAST with BROAD-BASED BUDDING
|
118.2
|
|
Causes a cottage cheese-like vaginal discharge
|
Candida albicans
|
119.1
|
|
What are predisposing factors to C. albicans infection?
|
Immunosuppression, diabetes, obesity, broad-spectrum antibiotics
|
119.2
|
|
Causes white curd-like patches on the mucocutaneous membranes of the mouth and extend downward to cause esphagitis in immunocompromised patients
|
Candida albicans
|
120.1
|
|
What are three common causes of C. albicans infection?
|
THRUSH, tinea unguium (fungal infection of nails), and DIAPER RASH
|
120.2
|
|
Most common mycotic pathogen
|
Candida albicans
|
121.1
|
|
What are the growth characteristics of Candida albicans?
|
Although a YEAST, can form PSEUDOHYPHAE; form GERM TUBES at 37degrees under lab conditions
|
121.2
|
|
Systemic mycosis endemic to the San Joaquin Valley in southern California
|
Coccidioides immitis; inhalation of ARTHROSPORES in sand and soil
|
122.1
|
|
Coccidioides immitis causes what unique infection?
|
Valley Fever; "characterized by arthralgias, cough, and fever"
|
122.2
|
|
Found within infected tissue as spherules that rupture to release endospores
|
Coccidioides immitis
|
123.1
|
|
The only mycotic pathogen with a capsule
|
Cryptococcus neoformans
|
124.1
|
|
How is C. neoformans visualized?
|
INDIA INK TEST; capsule EXCLUDES ink, providing CONTRAST
|
124.2
|
|
Causes meningitis in patients with underlying immunodeficiency,especially AIDS
|
Cryptococcus neoformans
|
125.1
|
|
What is Cryptococcus neoformans associated with and where does it grow?
|
Pigeon droppings; FUNGUS grows in Virchow-Robin spaces of brain resulting in SOAP BUBBLE LESIONS""
|
125.2
|
|
What is unique characteristic finding of Cryptococcus neoformans infections
|
SOAP BUBBLE LESIONS""
|
125.2
|
|
Causes cutaneous infections such as tinea corporis, tinea cruris (jock itch), and tinea pedis (athlete's foot)
|
Dermatophytes
|
126.1
|
|
What dermatophyte genera can cause hypo- or hyperpigmented ANNULAR PRURITIC LESIONS?
|
Trichophyton spp.
|
126.2
|
|
Associated with the inhalation of spores in the Ohio and Mississippi River Valley
|
Histoplasma capsulatum
|
127.1
|
|
How is Histoplasma capsulatum histologically characterized?
|
Macrophages stuffed with numerous YEAST cells
|
127.2
|
|
Most common pulmonary mycotic infection with symptoms ranging from asymptomatic to TB-like symptoms
|
Histoplasma capsulatum
|
128.1
|
|
How does Histoplasma capsulatum resolve in immunocompromised patients?
|
Calcification of hilar lymph nodes
|
128.2
|
|
Causes tinea versicolor, which manifests as patches of hyper- and hypopigmentation on the trunk
|
Malassezia furfur; found in skin scales
|
129.1
|
|
Malassezia furfur has what characteristics?
|
Spaghetti and meatballs appearance (YEAST clusters and short, curved SEPTATE HYPHAE)
|
129.2
|
|
Most common cause of tinea capitis, ringworm of the scalp (and commom patients)
|
Microsporum canis; common in PREPUBESCENT KIDS WITH PETS
|
130.1
|
|
Why is Microsporum spp. a problem of only Prepubescent kids?
|
Natural inhibitor of growth, UNDECYLENIC ACID, is produced in the sebum of POSTpubertal individuals
|
130.2
|
|
Results in rhinocerebral disease, primarily in patients wtih diabetic ketoacidosis or leukemia
|
Mucor and Rhizopus spp.
|
131.1
|
|
What distinction exists between Mucor and Rhizopus spp. and other human fungal pathogens?
|
Cause disease in their SEXUAL LIFE CYCLE and display NONSEPTATE HYPHAE BRANCHING at 90 degree angles or wider
|
131.2
|
|
This organism grows as multiple budding yeasts that appear as a captain's wheel" and causes disease almost exclusively in MEN"
|
Paracoccidioides braziliense
|
132.1
|
|
Where does Paracoccidioides braziliense occur and in whom?
|
GRANULOMATOUS LUNG disease in C. and S. America; greater than 90% in men
|
132.2
|
|
Causes an alveolar pneumonia, typically in AIDS patients
|
Pneumocystis carinii; FUNGUS NOT PROTOZOA
|
133.1
|
|
What is pathogenesis and visualization of Pneumocystis carinii infection?
|
Foamy, amorphous alveolar exudate; CUP- or BOAT-SHAPED CYSTS on staining with SILVER METHENAMINE
|
133.2
|
|
Causes the most common subcutaneous mycosis; Rose handler's disease
|
Sporothrix schenckii
|
134.1
|
|
How is Sporothrix schenckii transmitted and treated?
|
Prick of contaminated thorn; dilute solution of potassium iodide (KI) in milk
|
134.2
|
|
Transmitted by the same tick as that which carries Lyme Disease, infection results in similar manifestation as malaria
|
Babesia microti
|
135.1
|
|
What is Babesia microti often mistaken for and how differentiated?
|
P. falciparum; detected in RBCs as Maltese cross""
|
135.2
|
|
Causes a self-limiting diarrhea in immuncompetent individuals orlife-threatening intractable diarrhea in AIDS patients (etiology)
|
Cryptosporidium parvum; consumption of water contaminated with INFECTED ANIMAL FECES
|
136.1
|
|
Dissemination to the liver can result in abscess formation with a characteristic ANCHOVY PASTE aspirate
|
Entamoeba histolytica
|
137.1
|
|
What are serious complications of Entamoeba histolytica infection?
|
Amoeboma with potential for penetration of serosa adn peritonitis
|
137.2
|
|
Common cause of amebic dysentery, infection leads to the formation of flask-shaped ulcers in the colonic mucosa (lab findings)
|
Entamoeba histolytica; TROPHOZOITES with ingested RBCs is pathognomonic
|
138.1
|
|
The onlly common pathogenic protozoa of the small intestine
|
Giardia lamblia
|
139.1
|
|
What are lab findings for Giardia lamblia?
|
HEART-SHAPED symmetrical TROPHOZOITE with TWO nuclei, FOUR pairs of FLAGELLA, and a LARGE SUCKING DISK for adherence
|
139.2
|
|
Causes flatulence and diarrhea with steatorrhea and the production of bulky greasy foul-smelling stool
|
Giardia lamblia
|
140.1
|
|
What are common places for Giardia lamblia transmission?
|
Day-care kids, campers drinking from contaminated stream, homosexuals engaging in ORAL-ANAL contact
|
140.2
|
|
Infection with different species results in dermal, mucocutaneous, and visceral forms of the disease
|
Leishmania spp.
|
141.1
|
|
What are the types of Leishmania spp. and disease manifestations (3)?
|
L. tropica - DERMAL; L. braziliensis - MUCOCUTANEOUS; L. donovani - VISCERAL
|
141.2
|
|
What is characteristic of Leishmania donovani infection?
|
Most severe form of Leishmaniasis resulting in skin hyperpigmentation or KALA-AZAR
|
141.2
|
|
Transmitted by the sandfly, the amastigote stage survives and multiplies within macrophages
|
Leishmania spp.
|
142.1
|
|
What is unique with Leishmania replication?
|
The only protozoan parasite capable of REPLICATION WITHIN the PHAGOLYSOSOMES of reticuloendothelial cells
|
142.2
|
|
Free-living flagellated amoeba, acquired by swimming in freshwater ponds, causing a fulminant meningoencephalitis with death within a week
|
Naegleria fowleri
|
143.1
|
|
What organism causes less severe form of disease similar to Naegleria fowleri and symptoms?
|
Acanthamoeba castellani; limited to CORNEAL ULCERATION and keratitis
|
143.2
|
|
Blackwater fever
|
Plasmodium falciparum
|
144.1
|
|
What is pathology of P. falciparum malaria?
|
Infected cells are ABNORMALLY ADHERENT and cause THROMBOSIS and ISCHEMIA with HEMOLYSIS, resulting in HEMOGLOBULINURIA
|
144.2
|
|
Transmitted by the female Anopheles mosquito, with infection of RBCs and hepatocytes
|
Plasmodium spp.; OBLIGATE INTRACELLULAR PARASITE
|
145.1
|
|
How is Plasmodium diagnosed?
|
Typically RING- or CRESCENT-shaped forms within RBCs on a Giemsa-stained peripheral blood smear
|
145.2
|
|
Some resistance to infection is provided to patients with sickle cell disease/trait, G6PD deficiency, and thalassemia
|
Plasmodium spp.
|
146.1
|
|
What are the symptoms of malaria?
|
CYCLIC FEVERS (every 48 hr= P. falciparum, every 72 hr= P. malariae), headache, anemia
|
146.2
|
|
Exposure of nonimmune mothers results in fetal transmission with the potential for stillbirth and intracerebral calcifications
|
Toxoplasma gondii
|
147.1
|
|
How may T. gondii be acquired?
|
Cysts in raw or undercooked meat; aerosolization of infected cat feces from litter boxes
|
147.2
|
|
Usually asymptomatic in immunocompetent individuals, infection in an AIDS patient can result in fulminant, life-threatening encephalitis
|
Toxoplasma gondii
|
148.1
|
|
How is T. gondii visualized?
|
RING-ENHANCING MASS on CT
|
148.2
|
|
What other ring-enhancing masses are confused with T. gondii infection?
|
Cerebral abscess and Glioblastoma multiforme
|
148.2
|
|
A common cause of vaginitis, it often presents with vulvo-vaginal pruritus, with a profuse frothy discharge
|
Trichomonas vaginalis
|
149.1
|
|
What is are the symptoms of Trichomonas vaginalis infection?
|
Strawberry mucosa, spotty reddening and edema of the affected mucosa
|
149.2
|
|
Identified as pear-shaped, flagellated trophozoites with undulating movements on a wet-mount slide of vaginal or urethral discharge
|
Trichomonas vaginalis
|
150.1
|
|
What is etiology of Trichomonas vaginalis?
|
Typically STD, growth associated with abnormal ALKALINE pH of the Vagina
|
150.2
|
|
Transmitted by the tsetse fly, this protozoa causes African sleeping sickness, characterized by cyclic fevers, encephalitis, slurred speech, and somnolence
|
Trypanosoma brucei
|
151.1
|
|
How does T. brucei evade the immune system?
|
GENETIC rearrangement of its VARIABLE SURFACE GLYCOPROTEIN (VSG)
|
151.2
|
|
What are the symptoms of African sleeping sickness?
|
Characterized by cyclic fevers, encephalitis, slurred speech, and somnolence
|
151.2
|
|
Can destroy the myenteric plexus, resulting in mega-esophagus and megacolon
|
Trypanosoma cruzi
|
152.1
|
|
How is T. cruzi transmitted?
|
Droppings of reduviid bug (kissing bug)
|
152.2
|
|
What is the initial symptom of T. cruzi infection?
|
Unilateral swelling of the eyelids (Romana's sign)
|
152.2
|
|
A major cause of heart disease in Central and South America
|
Trypanosoma cruzi; Chagas disease
|
153.1
|
|
What are the types of Chagas disease and pathogenesis?
|
Acute- direct INVASION OF THE MYOCARDIUM with inflammation; Chronic- AUTOIMMUNE DESTRUCTION with development of DILATED CARDIOMYOPATHY with life-threatening arrhythmias
|
153.2
|
|
Migration of larval nematodes below the skin results in serpiginous urticarial trails on the skin (Creeping eruptions)
|
Ancyclostoma braziliense and other animal hookworms
|
154.1
|
|
How is Ancyclostoma acquired?
|
Sand-containing feces of dogs and cats
|
154.2
|
|
Chronic infection with this hookworm constitutes an important cause of anema worldwide
|
Ancyclostoma duodenale
|
155.1
|
|
Why does Ancyclostoma duodenale infection lead to anemia?
|
Each worm consumes as much as 0.25ml blood/day
|
155.2
|
|
Most common helminth infection in humans worldwide
|
Ascaris lumbricoides
|
156.1
|
|
What is incidence of Ascaris worldwide and symptoms
|
25% of world population; GI OBSTRUCTION, granulomas of biliary tree, liver abscesses, and HYPERSENSITIVITY PNEUMONITIS
|
156.2
|
|
Infection is associated with damage to the biliary tract and the development of cholangiocarcinoma
|
Clonorchis sinesis
|
157.1
|
|
How is C. sinesis acquired?
|
Consumption of infected freshwater fish
|
157.2
|
|
Infection can be associated with megaloblastic anemia
|
Diphyllobothrium latum; fish tapeworm that absorbs vit. B12
|
158.1
|
|
Removal of this nematode is traditionally accomplished by slowly twisting it around a stick to remove it from beneath the skin
|
Dracunculus medinensis
|
159.1
|
|
How is Dracunculus acquired?
|
Consuming water contaminated by the INTERMEDIATE HOST, the CYCLOPS (microscopic crustacean)
|
159.2
|
|
Larvae form large space-occupying hydatid cysts in the liver and lung, and leakage of fluid can result in anaphylaxis
|
Echinococcus granulosus (dog tapeworm)
|
160.1
|
|
How is Echinococcus granulosus acquired?
|
Sheep an intermediate host; presents in context of a SHEEP FARMER with many SHEEPDOGS
|
160.2
|
|
Causes perianal pruritis, with diagnosis confirmed by the recovery of the eggs from the anus with scotch tape
|
Enterobius vermicularis (pinworm)
|
161.1
|
|
What is unique with Enterobius infection?
|
Most common helminth infection in U.S.; associated with DAY-CARES
|
161.2
|
|
Infection results in subcutaneous "caliber" swellings and can be seen migrating across the eye beneath the conjuntiva"
|
Loa loa
|
162.1
|
|
How is Loa loa acquired?
|
Bite of the mango fly, Chrysops
|
162.2
|
|
Endemic to Africa, especially along river basins, infection can result in River blindness
|
Oncocerca volvulus - nematode
|
163.1
|
|
How is Oncocerca acquired?
|
Blackfly
|
163.2
|
|
What are is another significant symptom of Oncocerca volvulus?
|
Loss of elasticity of the skin with significant dependent edema (HANGING GROIN)
|
163.2
|
|
Infection of the bladder is associated with the development of squamous cell carcinoma of the bladder
|
Schistosoma hematobium
|
164.1
|
|
How and where is S. hematobium acquired?
|
Endemic to Egypt and Sudan; wading through moist soil while barefoot
|
164.2
|
|
How is Schistosoma hematobium diagnosis confirmed?
|
Finding SPHERICAL EGGS with a TERMINAL SPINE in the URINE
|
164.2
|
|
The smallest of all intestinal nematodes, high worm burden is possibly the result of autoinfection
|
Strongyloides steracoralis
|
165.1
|
|
What is unique with Strongyloides?
|
Only intestinal NEMATODE capable of completing its life cycle WITHIN THE HUMAN HOST
|
165.2
|
|
One of the most common CESTODE infections in the U.S. and associated with the consumption of improperly cooked contaminated beef
|
Taenia saginata (BEEF tapeworm)
|
166.1
|
|
What is significant with T. saginata infection?
|
Vague ab pain; grow to SEVERAL METERS IN LENGTH
|
166.2
|
|
Infection with the larval form of this tapeworm from feces-contaminated water can lead to CYSTICERCOSIS
|
Taenia solium (PORK tapeworm)
|
167.1
|
|
What is the result of T. solium infection?
|
Growth of larvae in the brain, resulting in a SWISS CHEESE APPEARANCE of the cerebral hemispheres
|
167.2
|
|
Accidental transmission of these NEMATODES from pet feces (sandboxes/sandy beaches) results in Visceral larva migrans
|
Toxocara canis and Toxocara cati
|
168.1
|
|
What are the symptoms of Toxocara (3)?
|
Eosinophilia, pneumonitis, and VISION LOSS
|
168.2
|
|
Infection is acquired by consuming cysts in under-cooked contaminated pork
|
Trichinella spiralis
|
169.1
|
|
What are the symptoms of Trichinella spiralis (4)?
|
Flu-like, diarrhea, MYALGIAS, and PERIORBITAL EDEMA
|
169.2
|
|
Rectal prolapse is a potential complication in children resulting from straining during defecation with the infection of this NEMATODE
|
Trichuris trichiura (whipworm)
|
170.1
|
|
How is Trichuris diagnosed?
|
Bile-stained BARREL-SHAPED EGGS with POLAR PLUGS
|
170.2
|
|
What is the cause and symptoms of Filariasis (Elephantiasis)?
|
Wucheria bancrofti; obstruction of lymph vessels resulting in EDEMA with swelling of the LEGS and GENITALIA
|
171.1
|
|
Opportunistic infections common in AIDS patients (Bacterial, Fungal, Protozoal, Viral)
|
B- M. avium-intracellulare; F- P. carinii; P- T. gondii, Cryptosporidium parvum; V- CMV, Kaposi Sarcoma virus (HSV-8)
|
238.1
|
|
Opportunistic infections common in AIDS patients: Bacterial? Fungal? Protozoal? Viral?
|
Bacterial: Mycobacterium avium-intracellulare; Fungal: Pneumocystis carinii; Protozoal: Toxoplasma gondii, Cryptosporidium parvum; Viral: Cytomegalovirus (CMV), Kaposi sarcoma virus
|
238.1
|
|
Major STDs in the U.S. (Bacterial, Protozoal, Viral)
|
B- C. trachomatis, N. gonorrhoeae; P- T. vaginalis; V- HSV-2, HIV, HPV
|
239.1
|
|
Major causes of meningitis (Newborns, kids, young adults, Elderly over 60 years, AIDS patients)
|
N- S. agalactiae, E. coli; K- H. influ; YA- N. meningitidis; E- S. pneumoniae; AIDS- C. neoformans
|
240.1
|
|
Major causes of pneumonia (Neonates, kids 6wks-18 years, Adults, Elderly over 60, Alcoholics, postviral, CF patients)
|
N- S. agalactiae, E. coli; K- RSV; A- Mycoplasma; EtOH- K. pneumo; P.V.- H. influ; CF- P. aeruginosa
|
241.1
|
|
Common nosocomial infections associated with (Newborns, Urinary caths, Renal dialysis units, Resp therapy equip, Water aerosols)
|
N- RSV, CMV; U- E. coli, Proteus; RDU- HBV; RTE- P. aeruginosa; WA- L. pneumophila
|
242.1
|
|
Major causes of UTIs (8)
|
E. coli (most common), Enterococcus faecalis, K. pneumo, Proteus mirabilis/vulgaris, P. aeruginosa, Serratia marcescens, S. saprophyticus
|
245.1
|
|
Organisms causing WATERY diarrhea (6)
|
C. parvum, E. coli, V. cholerae, G. lamblia, Norwalk Agent, Rotavirus
|
246.1
|
|
Organisms causing BLOODY diarrhea (dysentery) (6)
|
C. jejuni, EHEC, EIEC, Salmonella, S. dysenteriae, E. histolytica
|
247.1
|
|
Major causes of food poisoning (4)
|
B. cereus, C. perfringens, S. aureus, V. parahaemolyticus
|
248.1
|
|
Major causes of transplacental neonatal infections (6)
|
TORCH group - T. gondii, T. pallidum, Rubella, CMV, HSV, HIV (congenital defects if in utero)
|
249.1
|
|
Major causes of transcervical neonatal infections (acquired by vaginal delivery) (4)
|
C. albicans, E. coli, L. monocytogenes, S. agalactiae
|
250.1
|
|
What are the poorly staining organisms (9)?
|
Borrelia, Chlamydia, Coxiella, Legionella, Mycobacterium, Mycoplasma, Rickettsia, Treponema, Ureaplasma
|
|
|
Major cause of epidemic conjunctivitis (Pink eye)
|
DNA - Adenovirus
|
172.1
|
|
What symptoms are associated with Adenovirus (3)?
|
conjunctivitis, pharyngitis, gastroenteritis
|
172.2
|
|
Major cause of retinitis, leading to blindness, in an immunocompromised patient
|
DNA - Cytomegalovirus (CMV)
|
173.1
|
|
What disease can CMV cause in immunocompetent individuals?
|
Heterophil-negative infectious mononucleosis
|
173.2
|
|
What life-threatening disease can CMV cause in immunocompromised patients?
|
Interstitial pneumonia
|
173.2
|
|
Most common viral cause of congenital abnormalities in the U.S.
|
DNA - CMV
|
174.1
|
|
Infected CMV cells display what characteristic finding?
|
OWL EYE" intranuclear viral inclusions"
|
174.2
|
|
Infection results in the production of heterophil antibodies
|
DNA - Epstein-Barr virus (EBV)
|
175.1
|
|
What is pathogenesis and testing for EBV?
|
POLYCLONAL activation of B cells with the production of Antibodies to SHEEP RBCs (heterophil Abs); detected with MONOSPOT test
|
175.2
|
|
Major cause of infectious mononucleosis (kissing diseae)
|
DNA - EBV
|
176.1
|
|
How is EBV infectious mononucleosis characterized?
|
WEEKS of fever, malaise, lymphadenopathy; peripheral blood contains abundance of atypical lymphs (T cells that recognize EBV-infected cells)
|
176.2
|
|
Infection is associated with Burkitt lymphoma and Nasopharyngeal carcinoma
|
DNA - EBV
|
177.1
|
|
What are the geographic etiologies of carcinomas caused by EBV?
|
Burkitt lymphoma - Africa; Nasopharyngeal carcinoma - Asia
|
177.2
|
|
DNA virus that encodes an RNA-dependent DNA polymerase (reverse transcriptase)
|
Hepatitis B virus (HBV)
|
178.1
|
|
How does HBV produce it's DNA genome?
|
Single mRNA transcript, requiring Reverse Transcriptase
|
178.2
|
|
Appear in the serum as Dane particles and as large amounts of filaments of excess surface antigen
|
DNA - Hepatitis B virus
|
179.1
|
|
What is the compositon of the Hep B vaccine?
|
Surface antigen (HBsAg) now produced by recombinant DNA technology
|
179.2
|
|
A major cause of Hepatocellular carcinoma worldwide
|
Hepatitis B virus - especially Africa; less likely to progress to cirrhosis or carcinoma than HCV
|
180.1
|
|
Major cause of sexually transmitted and vertically transmitted hepatitis
|
DNA - HBV
|
181.1
|
|
How is HBV diagnosed histologically?
|
Ground glass" appearing hepatocytes (presence of EXCESS SURFACE ANTIGEN within the cytoplasm)"
|
181.2
|
|
Infection with this virus is a leading cause of corneal blindness in the U.S.
|
DNA - Herpes Simplex Virus-1 (HSV-1)
|
182.1
|
|
What are symptoms of HSV-1 and how is it diagnosed?
|
Keratoconjunctivitis resulting in DENDRITIC ULCERS; Fluorescein staining
|
182.2
|
|
Infection results in COWDRY type A intranuclear inclusions and multinucleated giant cells
|
HSV-1; one of the most common human viral infections
|
183.1
|
|
What is pathogenesis of HSV-1 infection?
|
Enters broken skin, remains latent in trigemial ganglion; spontaneous reactivation triggered by axonal injury, STRESS, or UV LIGHT
|
183.2
|
|
Leading cause of sporadic encephalitis in the U.S.
|
DNA - HSV-1 (commonly the temporal lobe)
|
184.1
|
|
Most common cause of vesiculo-ulcerativ lesions on the penis or vagina
|
DNA - Herpes simplex virus-2 (HSV-2)
|
185.1
|
|
Why is HSV-2 REACTIVATION common?
|
Remains LATENT in the LUMBAR and SACRAL GANGLIA
|
185.2
|
|
How is HSV-2 detected?
|
Tzanck test
|
185.2
|
|
Infection causes Roseola infantum or Sixth disease
|
DNA - Herpes virus 6
|
186.1
|
|
How is HSV-6 characterized?
|
Mild kid disease; HIGH FEVER, SKIN RASH
|
186.2
|
|
Causes cranberry-pigmented lesions on AIDS patients
|
DNA - HSV-8
|
187.1
|
|
What is Kaposi sarcoma?
|
TUMOR of BLOOD VESSELS; DISARRAY of VASCULAR channels filled with RBCs
|
187.2
|
|
How is HSV-8 characterized?
|
Kaposi sarcoma
|
187.2
|
|
Infection is linked to premalignant lesions on the vulva, cervix, penis, and anus
|
DNA - Human papilloma virus (HPV)
|
188.1
|
|
What is the pathogenesis of HPV?
|
Viral oncoprotein E6 binds p53 and E7 binds Rb; stimulates UNCONTROLLED CELL GROWTH
|
188.2
|
|
Infection of keratinized tissue results in the formation of warts on the hands and feet
|
DNA - HPV 1-4; hands (Verruca Palmaris) feet (Verruca Plantaris)
|
189.1
|
|
Infection causes cauliflower-like lesions on the external genitals or perianal areas
|
DNA - HPV
|
190.1
|
|
What is HPV genital infection called and how is it characterized?
|
Condyloma acuminatum, presence of vacuolated infected cells (KOILOCYTES)
|
190.2
|
|
Reactivation of latent viral infection in immunocompromised patients can result in Progressive multifocal leukoencephalopathy (PML)
|
DNA - JC virus
|
191.1
|
|
How is JC virus characterized?
|
Polyomavirus causing foci of DEMYELINATION, surrounded by oligodendrocytes with viral inclusions
|
191.2
|
|
This contagious virus causes benign epithelial tumors that appear as pearly, umbilicated nodules with a central caseous plug
|
Molluscum contagiosum
|
192.1
|
|
What causes molluscum contagiosum, symptoms, and transmission?
|
DNA - POXVIRUS; CLUSTERS on trunk, genitalia, extremities; towels, barbers, swimming pools, sex
|
192.2
|
|
Causes aplastic crisis in patients with sickle cell anemia, thalassemias, and acquired hemolytic anemias
|
DNA - PARVO B19 virus
|
193.1
|
|
How does Parvo B19 replicate?
|
Best in rapidly dividing ERYTHROBLASTS, resulting in cell lysis
|
193.2
|
|
Infection of a child results in a slapped cheek" appearance"
|
Parvovirus B19 - ssDNA; Fifth Disease or Erythema infectiosum
|
194.1
|
|
The ONLY DNA virus that replicates solely in the cytoplasm and that carries its own DNA-dependent polymerases
|
DNA - POXVIRUS; Largest of all viruses
|
195.1
|
|
How is Poxvirus characterized?
|
Brick-shaped on EM; Guarnieri inclusion bodies when replicating in cells
|
195.2
|
|
Found as a contaminant in preparations of polio vaccines produced in monkey cell culture
|
DNA - SV40
|
196.1
|
|
What is SV40?
|
Polyoma virus (Simian virus); cause tumors in MICE; no path reported in humans
|
196.2
|
|
Causes chickenpox upon initial infection, and shingles upon reactivation
|
DNA - Varicella-Zoster virus (VZV)
|
197.1
|
|
Where does VZV reactivation most commonly occur?
|
Dermatomal distribution of ophthalmic division of trigeminal nerve
|
197.2
|
|
What is unique to VZV vaccine?
|
ONLY herpes virus with a LIVE ATTENUATED VACCINE
|
197.2
|
|
Infection results in the successive appearance of macules, papules, vesicles, and crusts all seen SIMULTANEOUSLY
|
DNA - VZV
|
198.1
|
|
What can severe VZV infection lead towards?
|
Pneumonia with multinucleated giant cells
|
198.2
|
|
Associated with REYE Syndrome when the accompanying fever is treated with aspirin
|
VZV (Reye's is acute encephalopathy with fatty liver; often fatal)
|
199.1
|
|
Group of Togaviruses transmitted by mosquitoes leading to encephalitis
|
RNA - Alphavirus
|
200.1
|
|
Alphavirus genus includes what strains?
|
RNA - Eastern, Western, Venezuelan Equine Encephalitis (EEE, WEE, VEE)
|
200.2
|
|
A group of viruses that are transmitted by mosquitoes and ticks
|
RNA - Arboviruses
|
201.1
|
|
Arbovirus group contains?
|
RNA - Flavivirus, Togavirus, and Bunyavirus
|
201.2
|
|
Only bunyavirus member causing diseases endemic to the U.S.
|
RNA - California encephalitis virus (including La Crosse virus); mild encephalitis, sometimes ONLY meningitis
|
202.1
|
|
Causes pleurodynia (Bornholm disease)
|
RNA - Coxsackie B virus
|
203.1
|
|
What are Coxsackie B virus symptoms?
|
SUDDEN ONSET of STABBING CHEST PAIN with waxing and waning Sx
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203.2
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Most common cause of viral myocarditis
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RNA - Coxsackie B virus
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204.1
|
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What are implications of myocardial Coxsackie B infection?
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Usually self-limiting, but may cause FATAL ARRHYTHMIAS or lead to Dilated Cardiomyopathy
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204.2
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Causes herpangina
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RNA - Coxsackievirus; descrete VESICLES on the THROAT and tongue with pain and dysphagia
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205.1
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Infection may result in destruction of the pancreas with resultant insulin-dependent diabetes mellitus
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RNA - Coxsackieviruses B3/B4
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206.1
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What may Cocksackievirus destruction of pancreas leading to IDDM arise from?
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Molecular mimicry owing to shared antigens between virus and pancreatic beta cells
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206.2
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Causes a severe hemorrhagic fever with outbreaks in Zaire and Sudan
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RNA - Ebola virus (filovirus)
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207.1
|
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What is another filovirus and associated infection?
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RNA - Marburg virus; associated with infection of lab personnel working with MONKEY TISSUE
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207.2
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Infection leads to severe hemorrhage and renal failure
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RNA - Hantavirus; member of Bunyavirus; THREE SEGMENTS of RNA
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208.1
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Infection is associated with ingestion of raw shellfish from fecally contaminated water
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RNA - Hepatitis A (HAV)
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209.1
|
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How is HAV transmitted?
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Fecal/oral route; causes acute hepatitis with NO CHRONIC CARRIER STATE
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209.2
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Major cause of post-transfusion hepatitis
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RNA - Hepatitis C virus (HCV) (Flavivirus)
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210.1
|
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How does HCV infection initially present?
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Initially SUBCLINICAL although can lead to chronic hepatitis and cirrhosis to hepatocellular carcinoma
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210.2
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What is the major cause of CHRONIC hepatitis and cirrhosis in the U.S.?
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RNA - HCV
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210.2
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Which hepatitis virus will most likely result in hepatocellular carcinoma?
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RNA - HCV
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210.2
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Replication-deficient virus requiring the presence of HBV for productive infection
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RNA - Hepatitis D virus (HDV)
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211.1
|
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What is the HDV viral particle known as?
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Dane particle
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211.2
|
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What replication characteristic is unique with HDV?
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Viral particle (Dane particle), requires packaging into HBsAg to be infectious
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211.2
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Infection is associated with a high mortality rate in infected pregnant women
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RNA - Hepatitis E virus (HEV) (Calicivirus)
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212.1
|
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How is HEV transmitted and location of prevalence?
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Fecal/oral route, like HAV; most prevalent in DEVELOPING nations
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212.2
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Infection leads to the destruction of T cells, with the development of life-threatening opportunistic infections
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RNA - HIV
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213.1
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What are the life-threatening opportunistic infections related to HIV infection (5)?
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CMV, Kaposi sarcoma, P. carinii, T. gondii, M. avium-intracellulare
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213.2
|
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Virus binds to CD4+ cells via viral glycoprotein gp120
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RNA - HIV
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214.1
|
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What is HIV entry into cells specifically dependent upon?
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Chemokine receptors; CCR5 on MACs/monocytes; CXCR4 on T cells
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214.2
|
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Retrovirus that causes oncogenic transformation of CD4+ T cells?
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RNA - Human T-cell Lymphotropic virus-1 (HTLV-1)
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215.1
|
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What virus is HTLV-1 related, where is it endemic, and what other disease does it cause?
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HIV, Japan and the Caribbean basin, Tropical spastic paraparesis
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215.2
|
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Treatment with salicylates for this viral cause of respiratory symptoms may result in Reye Syndrome in kids
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RNA - Influenza virus (Orthomyxovirus)
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216.1
|
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Which viruses are the ONLY RNA viruse to replicate in the NUCLEUS?
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Influenza and Retroviruses
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216.2
|
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What does Influenza cause in children?
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Croup, otitis media, muscle aches, and high fever
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216.2
|
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Changes in the viral surface proteins resulting from POINT MUTATIONS; REASSORTMENT of genome segments result in epidemics and pandemics
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RNA - Influenza virus (Orthomyxovirus)
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217.1
|
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What is the replication strategy of Influenza virus?
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POINT mutations in viral hemagglutinin (HA) or neuraminidase (NA) resulting in antigen DRIFT; REASSORTMENT of genes resulting in antigenic SHIFTS
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217.2
|
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Major viral cause of pneumonia, and infection typically predisposes to secondary bacterial pneumonia
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RNA - Influenza virus (Orthomyxovirus)
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218.1
|
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What is the pathogenesis of Influenza virus?
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Decrease in resp. mucosal viscosity by viral NA and destruction of resp. epithelium; LOWER THE RESISTANCE to BACTERIAL SUPERINFECTION
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218.2
|
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What are the most common secondary bacterial causes of pneumonia in Influenza pneumonia (3)?
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Staphylcoccus spp., Strep spp., HaEMOPhilus spp.
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218.2
|
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Infection has been associated with subacute sclerosing panencephalitis (SSPE)
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RNA - Measles virus
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219.1
|
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How does Measles virus cause SSPE?
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Defective virus encoding a DEFECTIVE M PROTEIN
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219.2
|
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Infection leads to an immune-mediated maculopapular rash on the head, trunk, and limbs
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RNA - Measles virus
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220.1
|
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What is the diagnostic pattern of Measles virus infection?
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Koplik spots (small bluish-white ulcerations) on the ORAL MUCOSA are pathognomonic
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220.2
|
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Giant-cell pneumonia and encephalomyelitis are potential complications
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RNA- Measles virus
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221.1
|
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What is the vaccine for measles?
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MMR, along with mumps and rubella viruses
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221.2
|
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Infection can result in orchitis, which can lead to sterility
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RNA - Mumps virus
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222.1
|
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What does mumps infected orchtis complicate?
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Parotiditis in 20% of infected males
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222.2
|
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Infection results in swelling of one or both parotids
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RNA - Mumps virus
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223.1
|
|
What severe complications can arise from Mumps infection?
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Aseptic meninigitis and pancreatitis
|
223.2
|
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Major agent of epidemic gastroenteritis in adults
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RNA - Norwalk Agent (Calicivirus)
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224.1
|
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Where do Norwalk Agent outbreaks usually occur?
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Institutional settings, CRUISE SHIPS
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224.2
|
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Leading cause of croup
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RNA - Parainfluenza
|
225.1
|
|
What is another name for Parainfluenza croup and characteristic feature?
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Laryngotracheobronchitis; obstruction of larynx results in SEAL-BARK" COUGH"
|
225.2
|
|
Infection leads to the destruction of the cells of the anterior horn of the spinal cord
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RNA - Polio virus (Picornavirus)
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226.1
|
|
What is pathogenesis of Polio infection?
|
DENERVATION ATROPHY of innervated muscles with FLACCID paralysis
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226.2
|
|
Infection is associated with an aversion to water, foaming at the mouth, and choking (hydrophobia)
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RNA - Rhabdovirus/Rabies virus
|
227.1
|
|
What is histologically characteristic of Rabies virus?
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BULLET-SHAPED" virion by EM; NEGRI BODIES (intracellular inclusions)"
|
227.2
|
|
ONLY virus for which postexposure vaccination is indicated
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RNA - Rhabdovirus/Rabies virus
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228.1
|
|
What will happen without speedy vaccination following rabies exposure?
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CNS symptoms lead invariably to DEATH
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228.2
|
|
Why can rabies be vaccinated after exposure?
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LONG INCUBATION PERIOD allows for development of protective immune response
|
228.2
|
|
Infection is associated with symptoms of sympathetic over-reactivity (i.e. salivation)
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Rabies virus; binds to NICOTINIC Ach Receptor
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229.1
|
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Most important cause of lower RTIs in infants
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RNA - Respiratory Syncytial virus (RSV); infected cells form multinucleated syncytia
|
230.1
|
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Virion contains two identical strands of positive RNA (diploid-like genome)
|
Retrovirus; also carries RNA-dependent RNA polymerase, RT, and integrase for placement into the host cell genome
|
231.1
|
|
Major cause of upper RTIs in humans
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RNA - Rhinovirus (Picornavirus)
|
232.1
|
|
What is the pathogenesis of Rhinovirus?
|
Enters epithelial cells via attachment to ICAM-1; replicates best at 33 degrees, explaining predilection for MUCOSA of the NASOPHARYNX
|
232.2
|
|
Major cause of diarrhea (gastroenteritis) in young kids
|
RNA- Rotavirus (Reovirus)
|
233.1
|
|
What is unique in Rotavirus genetic materials?
|
Contains 10-12 segments of dsRNA within TWO concentric capsids
|
233.2
|
|
Teratogenic virus leading to congenital defects of the heart, brain, and eye
|
RNA - Rubella virus
|
234.1
|
|
What group is Rubella virus a member?
|
TORCH group, agents capable of CROSSING THE PLACENTA and infecting developing fetus
|
234.2
|
|
This newly emerging cause of mosquito-borne encephalitis can also be transmitted via blood transfusions and organ transplants
|
RNA - West Nile Virus (Flavivirus)
|
235.1
|
|
WNV can cause life-threatening symptoms in which populations?
|
Elderly and immunocompromised patients
|
235.1
|
|
History of West Nile Virus?
|
First reported in Africa in 1930's, U.S. in 1999; large outbreaks with thousands of cases and nearly 200 deaths
|
235.2
|
|
What family does WNV belong?
|
Flavivirus
|
235.2
|
|
Arbovirus that causes severe hepatitis with jaundice and severe gastrointestinal hemorrhage with black vomit
|
RNA - Yellow Fever virus (Flavivirus)
|
236.1
|
|
How is Yellow Fever transmitted and prevented?
|
Aedes mosquito; vaccine developed from 17D STRAIN
|
236.2
|
|
A unique and recently discovered class of infectious agents that can result in Spongiform encephalitis
|
Prions - resistant to most forms of sterilization; transmitted IATROGENICALLY (surgical instruments, cadaveric material), or from consuming contaminated meats
|
237.1
|
|
Opportunistic infections common in AIDS patients (Bacterial, Fungal, Protozoal, Viral)
|
B- M. avium-intracellulare; F- P. carinii; P- T. gondii, Cryptosporidium parvum; V- CMV, Kaposi Sarcoma virus (HSV-8)
|
238.1
|
|
Opportunistic infections common in AIDS patients: Bacterial? Fungal? Protozoal? Viral?
|
Bacterial: Mycobacterium avium-intracellulare; Fungal: Pneumocystis carinii; Protozoal: Toxoplasma gondii, Cryptosporidium parvum; Viral: Cytomegalovirus (CMV), Kaposi sarcoma virus
|
238.1
|
|
Major STDs in the U.S. (Bacterial, Protozoal, Viral)
|
B- C. trachomatis, N. gonorrhoeae; P- T. vaginalis; V- HSV-2, HIV, HPV
|
239.1
|
|
Common nosocomial infections associated with (Newborns, Urinary caths, Renal dialysis units, Resp therapy equip, Water aerosols)
|
N- RSV, CMV; U- E. coli, Proteus; RDU- HBV; RTE- P. aeruginosa; WA- L. pneumophila
|
242.1
|
|
Organisms causing WATERY diarrhea (6)
|
C. parvum, E. coli, V. cholerae, G. lamblia, Norwalk Agent, Rotavirus
|
246.1
|
|
Major causes of transplacental neonatal infections (6)
|
TORCH group - T. gondii, T. pallidum, Rubella, CMV, HSV, HIV (congenital defects if in utero)
|
249.1
|