Micro One-Liners

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1. Nausea, vomiting (onset < 6 hr) after eating cold cuts, or potato salad, or mayonnaise, or custards is caused by

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Staphylococcus aureus

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2. Rapid-onset food poisoning mediated by staphylococcal

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Enterotoxin

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3. Tx of staphylococcal food poisoning

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Rehydration

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4. Nausea and vomiting, +/- diarrhea (onset < 6 hr) after eating reheated rice is caused by

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Bacillus cereus

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5. Bacterial spores are resistant to heat due to

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dipicolinic acid core

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6. Nausea, vomiting, watery diarrhea w/ rapid (onset >6 hr) after eating reheated meat or gravy is caused by

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Clostridium perfringens

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7. Peptic-ulcer dz (PUD) in a patient w/o NSAIDs use is caused by

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Helicobacter pylori

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8. Helicobacter pylori attaches to gastric cells inducing

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inflammation and cytokines

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9. Abx treatment and H. pylori eradication significantly impact

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PUD and MALT

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10. First-line, triple-drug regimen for PUD due to H. pylori is

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PPI + clarith + amox

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11. Acute, severe secretory diarrhea, vomiting, severe dehydration, during travel to tropics, is caused by

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Vibrio cholerae

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12. Cholera (A-B, subunit) toxin induces secretion of Na and bicarbonate-rich non-inflammatory fluid from

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Small intestine

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13. Vibrio cholerae is isolated from stool by culture on

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thiosulfate-citrate-buffered sucrose (TCBS) agar

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14. Aerobic, gram negative, comma-shaped bacilli of cholera are microscopically similar to

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Campylobacter

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15. Tx to avoid mortality of cholera is

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Ringer’s lactate with extra K+

Front 16

16. Besides rehydration, treat cholera as soon as vomiting ceases with

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doxycyline

Front 17

17. Secretory diarrhea, fever and vomiting during travel are caused by

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Enterotoxic E. coli

Front 18

18. Secretory diarrhea w/ fatty, foul-smelling stools in campers, hikers;also day-care outbreaks is caused by

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Giardia lamblia

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19. Following ingestion of 15-25 cysts, excysted trophozoites adhere at brush border of enterocytes and contribute to malabsorption. TOW?

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Giardiasis

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20. Dx of giardiasis is confirmed by

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Stool antigen (+)

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21. Giardiasis is specifically treated with

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Metronidazole

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22. Protracted, secretory diarrhea w/ large fluid loss in AIDS is caused by acid-fast protozoa

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Cryptosporidium >> Cyclospora > Isospora

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23. Frank bloody diarrhea, after drinking roadside fruits drinks, is caused by

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E. coli O157:H7

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24. Pathogenesis of hemorrhagic enterocolitis caused by E. coliinvolves

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Shiga toxin (a cytotoxin)

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25. Complication of hemorrhagic enterocolitis in children

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hemolytic uremic syndrome

Front 26

26. Profuse diarrhea, fever, vomiting, and dehydration in infants is caused by

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Rotavirus

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27. Mechanism of rotaviral diarrhea involves

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Villus destruction

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28. Infantile watery diarrhea and fever are caused by

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Adenovirus 40,41

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29. Outbreak of nausea, vomiting, fever in adults is caused by

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Norovirus

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30. Cause of nausea/vomiting, abdominal cramps, diarrhea +/- bloody12-48h after eating eggs or poultry or peanut butter?

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Non-typhoidal Salmonella

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31. Abx treatment of uncomplicated acute gastroenteritis due toSalmonella forces condition of

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carrier (in bile ducts) state

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32. Abx used only to treat septic phase of salmonella gastroenteritis is

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ciprofloxacin

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33. Cause of fevers (>103°), headaches; macular rash on torso (“rose spots”) abdominal pain and little diarrhea later in a pt with hx of travel (to tropics)?

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Salmonella typhi

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34. Cause of diarrhea w/ occult blood, abdominal cramping and fever,2d after ingestion of poultry-contaminated salad

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Campylobacter jejuni

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35. Abx to treat campylobacter enteritis with high fevers in pregnancy, and HIV is

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Erythromycin

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36. Cause of dysentery-like illness with fever + abdominal cramps, tenesmus + blood & mucus in children?

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Shigella sonnei

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37. Dysentery due to invasive Shigella spp. in elderly is treated with

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Ciprofloxacin

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38. Cause of dysentery-like illness (+/- pseudoappendicitis) in the northern region after eating cheese

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Yersinia enterocolitica

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39. Cause of dysentery-like illness in a patient w/ hx of broad-spectrum abx use

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Clostridium difficile

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40. Clostridium difficile-associated diarrhea (CDAD) is mediated by toxins

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A (enterotoxin) + B (cytotoxin).

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41. Lab confirmation of CDAD is based on

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stool toxins A or B positive

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42. Besides rehydration and cessation of inciting meds, CDAD is treated with

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Metronidazole (mild) or oral vancomycin (severe/relapse)

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43. Health-care associated (nosocomial) spread of Clostridium difficilediarrhea and protracted outbreak is due to

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Soiling/contact or spores in rooms

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44. Hx of abdominal pain, tenesmus, stools with mucus + blood in a patient, who recently traveled to tropics; CBC: eosinophilia. TOW?

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Amebic dysentery

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45. Stool microscopy to confirm amebic dysentery should reveal characteristic trophozoites of Entamoeba histolytica w/

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endocytosed RBCs (distinction from luminal ameba)

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46. Rx of amebic dysentery involves

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Metronidazole + iodoquinol

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47. Abscesses in liver or peritonitis in travelers w/ or w/o hx of amebic dysentery is confirmed by

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Serology for E. histolytica

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48. A boar hunter develops dysentery after eating meat at campsite; O& P test should reveal a ciliate parasite, known as

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Balantidium coli

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49. Most likely cause of chronic abdominal pain, diarrhea; intestinal obstruction; cholangitis; liver abscess, in children

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Ascaris lumbricides

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50. Ova & Parasite test using microscopy for oval eggs (with a thick coarse shell) in stool confirms

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ascariasis

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51. A child has stomach ache, distended abdomen, poor appetite. “Pearl-colored earthworm”-like organisms in the stool. Major immune response against this infection?

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IgE

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52. DOC of ascariasis is

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Mebendazole

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53. Vomiting, cramping, diarrhea, epigastric pain, weight loss in an immigrant from developing country is caused by

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Strongyloides stercoralis

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54. DOC of strongyloidosis is

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Ivermectin

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55. Pt w/ AIDS (low CD4+ counts) develops pulmonary infiltrates (+eosinophilia) and/or gram negative sepsis. TOW?

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Invasive strongyloidosis

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56. Weakness, fatigue, lightheadedness, dyspnea, pruritis; pallor; iron- deficiency anemia; eosinophilia (hx of outdoor activity). TOW?

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Hookworm (Necator americanas) infection

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57. Fever, periorbital edema, subconjunctival hemorrhages, muscle weakness, and rash, after eating undercooked pork (Lab: eosinophilia., ↑CPK, ↑LDH &). TOW?

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Trichinellosis

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58. Abdominal pain, bloating, altered appetite after ingestion of sushi.CBC: megaloblastic anemia; leukocytosis/eosinophilia. TOW?

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Diphyllobothriasis (fish tapeworm)

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59. Dx of tape worm infection is confirmed by

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Proglottids in stool

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60. Tape worm infections are treated with broad-spectrum agent

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Praziquantel

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61. Cause of fever, lymphadenopathy, hepatosplenomegaly in an immigrant from Africa or Orient; pt recalls wading in stagnant water. RUQ ultrasound (+); CBC: eosinophilia.

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Schistosoma mansoni (Africa)S. japonicum (Far East)

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62. Microscopy of stool in chronic stage of schistosomiasis reveals

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Large eggs with lateral spine.

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63. Chronic stage of schistosomiasis is treated with

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Praziquantel

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64. Patient with acute jaundice is HAV IgM (+); household contact should receive for prophylaxis

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Inactivated HAV vaccine

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65. Patient with jaundice for < 1 week has HBsAg (+), Anti-HBc IgM (+). TOW?

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Acute HBV infection

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66. Multiple sex partners, IDU, infants born to infected mothers are risk groups for which hepatitis virus

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HBV

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67. This is an enveloped, double stranded DNA virus w/ ss-break;transmitted by infective body fluids. TOW?

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HBV

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68. This asymptomatic man has hep serology profile of HBsAg (-), Anti-HBs (+), Anti-HBc IgG (+), Anti-HBc IgM (-). TOW?

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Resolved hepatitis B

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69. This man has jaundice and is HBsAg (+) > 6 months, Anti-HBs (-), HBeAg (+), Anti-HBc IgG (+), HBV DNA > 20,000 IU/ml. TOW?

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Chronic active hepatitis B

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70. This man has jaundice and is HBsAg (+) > 6 months, HBeAg (+)and evidence of necroinflammation. He should receive

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Peg-IFN 2a + lamivudine(or cidofovir)

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71. This man has no jaundice, but HBsAg (+) >6 months, Anti-HBs (-), Anti-HBc IgG (+), HBeAg (-), persistently normal ALT. TOW?

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Inactive HBsAg carrier

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72. This man, at the time of annual physical exam, reveals Anti-HBs (+) and other markers are (-). TOW?

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HBV immunized

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73. Virologic confirmation of chronic jaundice in a HBV-immunized pt w/ IDU or hemodialysis is based on

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HCV RNA > HCV IgG

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74. More chronicity of HCV (than HBV) is due to immune-evasive quasispecies generated during replication (in blood) of

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error-prone HCV RNA virus

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75. Fulminant hepatitis in a patient, who has multiple sexual partners and is HBsAg (+); HBcIgM (-), can be fatal due to what?

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HDV superinfection.

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76. Cause of acute onset of jaundice, nausea, right-upper quadrant pain, hepatomegaly in pregnant women in India

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HEV

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77. Fever, arthralgia, carditis, polyarthritis, chorea, erythema marginatum; elevated WBCs or ESR/CRP. Clinical Dx is confirmed by

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Rising ASO titer

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78. Type II hypersensitivity due to molecular mimicry in a immunological sequel of streptococcal pharyngitis causes

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Acute rheumatic fever (ARF)

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79. ARF is diagnosed and treated with

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Anti-streptolysin O (ASO) titer and benzathine penG.

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80. A man with IDU has flu-like symptoms; 1-3 minor peripheral signs: conjunctival hemorrhage, Janeway lesions, Osler nodes, Roth spots, plus vegetation in tricuspid valve. Blood Cx (BCx) should yield

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S. aureus

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81. A pt w/ hx of extraction of impacted tooth 3 weeks ago now has subacute (native, mitral-valve) endocardits. BCx should yield

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Viridans streptococci.

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82. A pt w/ hx of St. Jude bypass 2 months ago has now subacute bacterial endocarditis. BCx should yield

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Staphylococcus epidermidis

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83. A pt with AIDS and recent hx of UTI has now subacute, native mitral-valve endocarditis. BCx should yield

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Enterococcus faecalis (or faecium)

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84. DOC of acute endocarditis in patient with IDU due to sensitive S.aureus (MSSA)

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Nafcillin +gentamicin

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85. DOC of acute endocarditis in patient with IDU due to resistant S. aureus (MRSA).

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Vancomycin + rifampin

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86. DOC of subacute, native mitral-valve endocarditits due to viridansstreptococci.

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PenG +/- gentamicin

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87. DOC of subacute, prosthetic-valve endocarditis due toStaphylococcus epidermidis

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Vancomycin + gentamicin

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88. DOC of subacute, native mitral-valve endocardits due toEnterococcus faecalis (or faecium)

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High-dose ampicillin +gentamicin

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89. Patient with enterococcal bacteremia fails to respond tovancomycin. MOR of the organism

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D-Ala-D-Ala is changed to DAla-D-lac

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90. Hx of catheter-related endocarditis, involving prosthetic or nativevalves. BCx (+) for budding yeast. Pt does not respond to AmphoBor fluconazole; should receive

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Caspofungin

Front 91

91. Patient with colon cancer has bacteremia due to

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Streptococcus bovis

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92. Cause of febrile, malaise, arthralgia, dyspnea, edema, palpitations.ST/T wave change, heart block, dysrhythmias; CXR: cardiomegaly

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Coxsackievirus > echovirus >Trypanosoma cruzi (Chagas)

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93. Cause of runny nose, red throat, and nasal pus

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Rhinoviruses

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94. Rhinoviruses and enteroviruses belong to picornavirus family, butthe rhinoviruses differ from enteroviruses on

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Growth at 22oC/noninvasive

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95. Rhinovirus receptor in the nasal passages and uppertracheobronchial tree is

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ICAM-1

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96. Rhinovirus, influenza, parainfluenza, coronavirus, RSV,metapneumovirus, and adenovirus all cause

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Upper-respiratory infections(URIs)

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97. Sinusitis, otitis, laryngitis, exacerbations of bronchitis and asthmaare mostly secondary to

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Viral URIs

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98. In HEENT, Streptococcus pneumoniae, non-typable Haemophilus influenzae, Moraxella catarrhalis all cause

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Acute otitis media (AOM) &sinusitis

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99. AOM and sinusitis are empirically treated with amoxicillin +clavulanate. Why use clavulanate?

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Haemophilus and Moraxellaare beta-lactamase producers

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100. Cause of pharyngeal pain, dysphagia, fever; red throat +purulent exudate that responds to penicillin

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Streptococcus pyogenes (aka: Group-A Beta-hemolytic Streptococcus = GABHS)

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101. GABHS is differentiated from GBBHS by what?

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Bacitracin sensitivity

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102. Common mode of acquisition of URI due to Streptococcus pyogenes?

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Infective droplets

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103. Major virulence factor with anti-phagocytic function ofStreptococcus pyogenes

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M-protein fibrils

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104. Damage in posterior pharynx and tonsils due toStreptococcus pyogenes is associated with what host response?

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Pyogenic inflammation

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105. DOC of acute bacterial pharyngitis in a pt w/ Pen allergy

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Erythromycin > clindamycin

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106. Pyogenic complication of streptococcal pharyngitis

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Tonsillar abscess

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107. Toxigenic complication of streptococcal pharyngitis

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Scarlet fever >> TSS (rare)

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108. Immunologic complication of streptococcal pharyngitis

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Acute rheumatic fever (ARF)

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109. Cause of fever, red throat + purulent exudate - pseudomembrane with lymphadenopathy, in a pt w/ questionable immunization.

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Corynebacterium diphtheriae

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110. Gram/special stain of Corynebacterium diphtheriae should reveal

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Gram(+) rods in palisade arrangements/metachromatic granules.

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111. Virulence genotype of Corynebacterium diphtheriae is acquired by

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Transduction (phage mediated transfer of exotoxin gene)

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112. Isolate on tellurite agar culture of throat swab for a cause of diphtheria is confirmed by

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Immunodiffusion (ELEK)assay for toxin

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113. Mechanism of action of exotoxin of Corynebacterium diphtheriae

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ADP ribosylation of EF-2 (inhibits protein synthesis)

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114. Damage to pharynx and cardiac myosites due toCorynebacterium diphtheriae is mediated by

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Cytotoxicity of A-B toxin

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115. Virologic Dx of URI symptoms, fever; red throat + purulent exudate; hepato-splenomegaly, lymphadenopathy, in a teenager, is confirmed by

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heterophile antibody (+)

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116. Host cells preferentially infected by EBV are

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B cells

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117. EBV is biologically similar to what class of viruses?

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herpes viruses

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118. Host immune system controls the EBV infection, mediated by

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CD8+ T lymphocytes

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119. Rash occurs following which antibiotic(s) to treat infectious mononucleosis?

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amoxicillin

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120. Burkitt's lymphoma in some African population is a B-cell tumor due to oncogenesis by

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EBV

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121. B-cell tumor in the Oriental population that consumes preserved fish, is due to oncogenesis by

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EBV

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122. Heterophile-negative infectious mononucleosis syndrome is due to ?

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CMV

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123. Gram-positive bacteria that cause acute otitis media (AOM)

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Streptococcus pneumoniae

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124. Gram-negative diplococci bacteria that cause AOM

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Moraxellar catarrhalis

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125. Gram-negative coccobacilli bacteria that cause AOM

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Haemophilus influenzae

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126. > 7 days of nasal obstruction, rhinorrhea; purulent nasal drainage + frontal pain/tenderness is treated with

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Amoxicillin & Clavulanate

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127. DOC for acute mastoiditis in a young child is amoxicillin &clavulanate; why?

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Same etiology as AOM

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128. Cause of "seal-like barking" cough + episodic aphonia w/symptoms of URI in a child

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parainfluenza virus

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129. Gram-stain-nonreactive organism that causes redness; purulent discharge at lid margin/eye corners, in a newborn

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Chlamydia trachomitis

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130. Most common cause of redness; tenderness; hyperpurulent d/c; eye stuck shut in AM, lid edema. Gram stain (+)

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Staphylococcus aureus

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131. Cause of pharyngitis, conjunctivitis, fever with rhinitis, and cervical adenitis in a child.

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Adenovirus

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132. Cause of burning, gritty feeling in eyes; diffuse conjunctival injection & profuse tearing + preauricular LN.

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Adenovirus

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133. Cause of foreign body sensation, lacrimation, photophobia, conjunctival hyperemia, and ulceration

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HSV-2>>1

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134. Cause of severe pain and skin lesions in dermatomal pattern involving the ophthalmic division of the trigeminal nerve.

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VZV

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135. Cause of painful, swollen, red eyes, with conjunctival hemorrhaging and excessive tearing in an outbreak

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Enterovirus

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136. Cause of chorioretinitis in AIDS, but CMV antigen (-)

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Toxoplasma gondii

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137. Cause of painful keratitis, chronic corneal ulcers in contact

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Acanthamoeba spp.

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138. In an infant w/ ?immunization, 2 wks of paroxysmal coughs, inspiratory "whoop" + post-tussive emesis. TOW?

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Bordetella pertussis

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139. Pertussis toxin inhibits chemotaxis via downregulation of C3a/C5a receptor, resulting in?

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Lymphocytic leukocytosis in CBC

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140. Three major virulence factors of "whooping cough" pathogen?

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ADP-ribosylating toxin; tracheal cytotoxin; hemolysin

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141. Cause of fever + drooling, stridor, dyspnea in a child w/?immunization (pt appears septic)

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Haemophilus influenzae b

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142. Major virulence factor of Haemophilus influenzaeassociated with pneumonia and meningitis

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Capsular polysaccharide(antiphagocytic and anti-C3b)

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143. Since, absent spleen places host at increased risk for invasive H. influenzae infection, pre-exposure prophylaxis prior to elective splenectomy is ?

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Hib immunization

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144. Cause of acute exacerbation (cough, purulent sputum) in pt with chronic bronchitis (COPD); CXR: R/O pneumonia; Lab: sputum reveals Gram-negative coccobacilli.

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Haemophilus influenzae (non capsular types)

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145. Tx of AECB, caused by an organism that needs NAD +hematin for growth; -lactamase (+), is

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Ceftriaxone (severe) >. Amoxicillin-clavulanate (mild)

Front 146

146. Most common cause of lower-respiratory infections in neonates (babies < 4 wk)?

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Streptococcus agalactiae(aka: group B streptococcus)

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147. Complicated illness in a newborn of a GBS-colonized mother is

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Sepsis or meningitis

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148. A mother colonized (recto-vaginally) w/ GBS is at risk for preterm baby or premature membrane rupture. She should receive

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Ampicillin

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149. An elderly comes up with an abrupt-onset fever, myalgia, headache, malaise, dry cough, sore throat and rhinitis, in winter. Illness could have been prevented w/ ?

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annual influenza vaccine

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150. Annual influenza vaccine protects at-risk subpopulation w/60% immune protection, and is composed of what 3 viruses?

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A:H1N1 + A:H3N2 + B

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151. Secondary spread of influenza occurs in a crowded setting(within 6 feet of infected person) via

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respiratory droplets

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152. Annual vaccine to prevent influenza is needed due to antigenic drift. This occurs due to what genetic mechanism?

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Mutation

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153. Occasionally serious pandemic of influenza occurs due to antigenic shift. This occurs due to what genetic mechanism?

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Reassortment of 8 genomic segments

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154. DOC of pts with influenza <48 hours is

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Oseltamivir

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155. Bacterial superinfection, causing pneumonia, after influenza occurs in elderly (in LTCF) due to what?

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S. pneumoniae > S. aureus(common) (severe)

Front 156

156. A seriously ill young adult w/ necrotizing pneumonia, poorly responding to vancomycin, should get

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Linezolid

Front 157

157. Cause of febrile illness + bronchiolitis in an infant; BALviral culture (+).

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Respiratory syncytial virus(RSV)

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158. RSV causes seasonal, nosocomial pneumonia outbreaks in the pediatric units via

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Contact spread

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159. Pathophysiology of asthmatic Sx + Sn in bronchioles in high-risk infants due to RSV involves

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type III hypersensitivity

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160. Inhaled anti-viral drug used in the sickest infants with bronchiolitis is

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Ribavirin

Front 161

161. Insidious onset of fever, dry cough, malaise and sore throat in young adults. CBC: anemia; CXR: diffuse infiltrates. TOW?

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Mycoplasma pneumoniae

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162. Dx of “walking pneumonia” in older children and youngadults, while waiting for serology, is supported by

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cold agglutinin (IgM Ab against RBCs) titer 1:32

Front 163

163. Mycoplasma spp. is an atypical bacterial pathogen and is hard to grow because of fragility due to lack of

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Cell wall

Front 164

164. Beta-lactam abx is ineffective for Tx of mycoplasma pneumonia because

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Wall-less bacteria

Front 165

165. A male child with mycoplasma pneumonia now has systemic rash, covering 10% of his body. TOW?

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erythema multiforme (SJS)

Front 166

166. Cause of upper respiratory Sx, slow onset of cough(laryngitis) >2wks + CXR: patchy infiltrate, viral serology (+)

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Chlamydophila pneumoniae

Front 167

167. The most common cause of community-acquired pneumonia (CAP) is

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Streptococcus pneumoniae

Front 168

168. Cause of rapid onset of high fever, cough, & sputum, dyspnea; tachypnea in an elderly; CXR: lobar infiltrate; CBC: pronounced neutrophilic leukocytosis with left shift, is

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Streptococcus pneumoniae

Front 169

169. Gram-positive diplococci from sputum from a patient with lobar pneumonia yield α-hemolytic colonies and are confirmed by

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Capsular swelling (Quelling rxn)

Front 170

170. α-hemolytic colonies of Streptococcus pneumoniae is differentiated from viridans streptococci definitively confirmed by

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Optochin sensitivity

Front 171

171. Population w/ increased incidence of pneumococcal pneumonia is

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AIDS

Front 172

172. increased incidence of colonization of what organism is seen in very young and elderly, crowding, following viral URI (increased PAFreceptors), fall/winter season?

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Streptococcus pneumoniae

Front 173

173. Streptococcus pneumoniae is transmitted P2P by

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Respiratory droplets

Front 174

174. Nasopharyngeal mucosal colonization is facilitated by

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IgA protease

Front 175

175. Streptococcus pneumoniae reaches lungs after nasopharyngeal colonization via

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aspiration

Front 176

176. Major virulence factor, facilitating invasion and dissemination of Streptococcus pneumoniae is

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Polysaccharide capsule

Front 177

177. Pneumococcal cell wall peptidoglycans, teichoic acid elicit

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Inflammation

Front 178

178. Increased Lung cell injury in pneumococcal pneumonia is caused by virulence factor?

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Pneumolysin (alpha-hemolysin)

Front 179

179. Multiple myeloma, C3 deficiency, asplenia - Hg SS, COPD, diabetes, alcoholism, smokers are risk factors for mortality due to

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pneumococcal pneumonia

Front 180

180. Hematologic marker for poor prognosis of pneumococcal pneumonia is

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Leukopenia

Front 181

181. Emipiric DOC of CAP in pts at risk or w/ comorbidity is

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Azithromycin (or levofloxacin) + ceftriaxone

Front 182

182. Pneumonia due to highly penicillin-resistant Streptococcus pneumoniae (Pen MIC >8) should receive

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moxifloxacin or vancomycin

Front 183

183. Mechanism of penicillin resistance in Streptococcus pneumoniae is

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PBP alteration by mutation

Front 184

184. Pt w/ agammaglobulinemia or asplenia or sick-cell anemia or ↓C3 should be vaccinated with

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Pneumococcal polysaccharide vaccine (PPSV: 23-valent)

Front 185

185. Hx: a patient w/ serious CAD now on a ventilator, acquires bronchopneumonia >72 hrs after hospitalization. TOW?

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Pseudomonas aeruginosa(VAP)

Front 186

186. Cause of necrotizing pneumonia >72 hrs after hospitalization of complicated viral illness

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Staphylococcus aureus(assume MRSA)

Front 187

187. Patients that are aspiration prone have hx of

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dysphagia, decreased consciousness

Front 188

188. Hx of a patient w/ seizure illness has fever, cough evolving over 2-4 wks; CXR infiltrate (+).TOW?

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Aspiration pneumonia

Front 189

189. Community-acquired respiratory pathogens that cause aspiration pneumonia

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Streptococcus pneumoniae > Anaerobes

Front 190

190. Hospital-acquired respiratory pathogens that cause aspiration pneumonia

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Gram-negative bacilli > S. aureus +/- anaerobes

Front 191

191. Clinical Dx of sudden dyspnea +/- cyanosis, fever, wheezing, often ARDS-like picture is

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acid-related pneumonia

Front 192

192. Bacterial etiology and Tx of aspiration pneumonia are determined by

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Gram stain (polymicrobic)and culture of sputum

Front 193

193. Empiric DOC of necrotizing pneumonia in a patient with seizure illness

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clindamycin + levofloxacin

Front 194

194. Targeted Abx for anaerobic aspiration pneumonia is

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clindamycin

Front 195

195. Pneumonia in homeless/alcoholics; Gram-positive diplococci in sputum Gram smear. TOW?

Back 195

Streptococcus pneumoniae

Front 196

196. Pneumonia in homeless/alcoholics; Gram-negative rods in sputum smear. TOW?

Back 196

Klebsiella pneumoniae

Front 197

197. Cause of pulmonary embolism in a pt with IVDU

Back 197

Staphylococcus aureus

Front 198

198. Common cause of pneumonia in pts with CF

Back 198

Pseudomonas aeruginosa

Front 199

199. Sputum of a patient with hospital-acquired pneumonia yields a Gram-negative rod that is oxidase (+). TOW?

Back 199

Pseudomonas aeruginosa

Front 200

200. Common cause of external otitis due to hot tub use is

Back 200

Pseudomonas aeruginosa

Front 201

201. A patient with diabetes has osteomyelitis after penetrating foot injury. TOW?

Back 201

Pseudomonas aeruginosa

Front 202

202. The most widely used anti-pseudomonal penicillin

Back 202

Piperacillin > imipenem

Front 203

203. The most widely used anti-pseudomonal aminoglycoside

Back 203

Tobramicin > gentamicin

Front 204

204. This pt >50 years, smoking hx, CMI↓ has pneumonia; diarrhea, renal failure. Urine antigen (+) for pathogen. Pt responds to azithromycin. TOW?

Back 204

Legionella penumophila

Front 205

205. Penicillin is ineffective against Legionnaire’s dz because

Back 205

Intracellular organism

Front 206

206. Individuals with defective CMI response has poor prognosisof Legionnaire’s dz because

Back 206

Intracellular organism

Front 207

207. Asymptomatic patient with PPD (+)

Back 207

Latent tuberculosis infection(LTBI)

Front 208

208. Cough > 2 wks, fever, night sweats, weight loss, hemoptysis, SOB; CXR: upper lobe infiltrate. TOW?

Back 208

Active Mycobacterium Tuberculosisinfection

Front 209

209. Oral drug regimen of choice for treatment of active TB (aka: 1st line drugs) is

Back 209

INH+RIF+PZA+EMB (oral)+ Vit B6

Front 210

210. Pyridoxine is added to 4-drug therapy for TB to prevent

Back 210

neuropathy (due to INH)

Front 211

211. Pt w/ TB fails to respond to 4-drug regimen w/ INH+RIFresistance because

Back 211

Multiply drug-resistant(MDR) TB

Front 212

212. Pt w/ MDR-TB fails to respond to INH +RIF+FQ+an injectable drug (amikacin, capreomycin, or kanamycin) because

Back 212

Extremely-drug resistant(XDR) TB

Front 213

213. Cause of TB-like Dz that does not respond to 1o TB Tx regimen, in a pt. w/ AIDS

Back 213

Mycobacterium avium –intracellulare (aka: MAC)

Front 214

214. Cause of chronic pneumonia in a patient with cancer, receiving cytotoxic chemotherapy; lung-CT: halo/crescent sign (+)?

Back 214

Aspergillus fumigatus

Front 215

215. Microscopic observation of Aspergillus fumigatus in tissue biopsy sections depends on staining by

Back 215

Silver stain

Front 216

216. Hx of chronic pneumonia w/ lung bpsy histopathology (+)for hyphae 2-4µm wide, septate, acute- angle branching. TOW?

Back 216

Aspergillus fumigatus

Front 217

217. Cause of TB-like LRI in a pt with outdoor activity (Giemsa stain of bronchoscopy specimen: (+) for 2-5 μm yeasts) is

Back 217

Histoplasma capsulatum

Front 218

218. Pt with AIDS has blood culture (+) for histoplasmosis.DOC has effects on

Back 218

Ergosterol in fungal cell membrane

Front 219

219. TB-like Dz w/ ulcerative skin lesions. lung bpsy histopathology (+) for large yeast w/ broad-based bud. DOC?

Back 219

Intraconazole

Front 220

220. Hx of acute onset of cough, fever, infiltrate in a black male with CMI↓; histopathology of lung (+) for a large sac of endospores. DOC?

Back 220

Fluconazole (indefinite)

Front 221

221. Pt w/ aspiration pneumonia with cervico-facial lesion should respond to

Back 221

Penicillin G

Front 222

222. Granular specimen from draining fistulae from a pt withLRI on anaerobic culture should yield

Back 222

Actinomyces israelii

Front 223

223. Pt with AIDS or organ transplant has indolent pneumonia, w/ or w/o CNS abscess or granuloma. TOW?

Back 223

Nocardiosis

Front 224

224. Organism w/ characterization of Gram-positive branching, beaded, filamentous rod, weakly acid fast is

Back 224

Nocardia asteroids

Front 225

225. Hx of non-productive cough, fever and dyspnea evolving over 2-4 wks. CXR (+): bilateral interstitial infiltrates, hypoxemia;↑LDH, CD4 count <200/mm3 in a MSM. TOW?

Back 225

Pneumocystis pneumonia

Front 226

226. DOC of pneumocystis pneumonia (PCP)

Back 226

TMP-SMX

Front 227

227. Pt has urinary urgency, frequency, dysuria; lab: pyuria (+)or nitrite (+). TOW?

Back 227

Cystitis due to E. coli

Front 228

228. Significant UTI is confirmed by semiquantitative MSUculture based on the threshold of

Back 228

> 105 cfu/mL

Front 229

229. Mode of acquisition of uropathogen is

Back 229

Endogenous

Front 230

230. Microbial (structure) factor favoring bacterial persistence/colonization and UTI is

Back 230

bacterial binding via fimbriae

Front 231

231. Factor favoring bacterial persistence/colonization and UTIdespite high osmolarity and urea concentrations and low pH is

Back 231

high bacterial growth rates

Front 232

232. Host factor favoring bacterial persistence/colonization andUTI is

Back 232

Urinary stasis

Front 233

233. Bacterial persistence/colonization and UTI despite frequent voiding and high urinary flow is favored by

Back 233

lack of Tamm-Horsfall proteins

Front 234

234. Pyogenic inflammation in complicated UTI due to Gram- negative bacteria is due to

Back 234

Lipopolysaccharide (LPS)

Front 235

235. Empiric DOC to treat community-acquired UTI in adults is

Back 235

ciprofloxacin

Front 236

236. The abx class that inhibits DNA gyrase or topoisomerase IVand blocks with bacterial DNA replication is

Back 236

Fluoroquinolones

Front 237

237. DOC to treat UTI in pregnant women is

Back 237

Nitrofurantoin

Front 238

238. Gram-positive bacteria that cause uncomplicated UTI in sexually active, young women are

Back 238

Staphylococcus saprophyticus

Front 239

239. Differentiation of Staphylococcus saprophyticus from S. epidermidis (both coagulase negative) is based on

Back 239

novobiocin resistance

Front 240

240. In elderly or pt with risks of urinary stasis, fever, chills, flank pain, and CVA tenderness; Lab: pyuria, casts, nitrite+. TOW?

Back 240

Pyelonephritis due to E. coli

Front 241

241. Pt hospitalized > 72 h for comorbidity has urinaryfrequency, dysuria and foul-smelling urine; w/ flank pain, fever and chills, in the presence of a urinary catheter:Clue: GNR; fermenter; encapsulated; intrinsic ampicillin resistance) Clue: GNR; slow fermenter; red pigment; intrinsic drug resistance) Clue: GNR; swarming growth [very motile]; slow fermenter; intrinsic drug resistance)Clue: GNR; non fermenter; oxidase+, blue pigment; intrinsic drug resistance)Clue: GPC in chains; catalase-neg; grows in high salt; penicillin resistance)

Back 241

Klebsiella pneumoniae Serretia marcescens Proteus mirabilisPseudomonas aeruginosaEnterococcus faecalis

Front 242

242. If a patient with complicated UTI is severely ill or notimproving with therapy, do what rapid test next?

Back 242

renal ultrasound (to rule outurinary tract obstruction)

Front 243

243. For a patient with complicated UTI, once culture andsensitivity available, switch to what?

Back 243

Narrow-spectrum abx

Front 244

244. 2 or more of the following: fever (T>38°C) or hypothermia(T< 36°C), tachycardia (HR>90), tachypnea (RR>20), leukocytosis(WBC>12,000 or differential w/ >10% bands). TOW?

Back 244

SIRS

Front 245

245. SIRS + infection (e.g., positive blood culture) is

Back 245

Sepsis

Front 246

246. Sepsis + organ failure, decreased perfusion (lactic acidosis,oliguria, altered mental status) or low BP. TOW?

Back 246

Severe Sepsis

Front 247

247. Severe sepsis + hypotension despite fluids + lactic acidosis,oliguria, altered mental status.

Back 247

Septic Shock

Front 248

248. Septic shock due to Gram-negative bacteria (e.g., E. coli,Klebsiella spp., or Pseudomonas aeruginosa) is

Back 248

Endotoxic Shock

Front 249

249. Endotoxin that mounts pro-inflammatory cytokines,responsible for endotoxic shock, is

Back 249

Lipid A of LPS

Front 250

250. Genital chancre begins as a papule, ulcerates to form asingle, painless, clean-based ulcer. TOW?

Back 250

1o syphilis

Front 251

251. Cause of genital chancre, begining as a papule, ulcerating toform a single, painless, clean-based ulcer.

Back 251

Treponema pallidum

Front 252

252. A pen-allergy, non-pregnant, female pt w/ fever, "copperpenny" macular lesions on the palms or soles; RPR(+) should betreated with

Back 252

Doxycycline

Front 253

253. Management choice of tabes dorsalis (10-20yrs), iritis,uveitis, or Argyll-Robertson pupils of pen-allergy in a pregnantwoman w/ pen allergy; RPR(+) is

Back 253

Desensitization

Front 254

254. Hx of painful clustered vesicles with an erythematous base;urinary retention in a promiscuous woman. TOW?

Back 254

HSV-2 >> 1

Front 255

255. Giemsa stain of fluid from a herpetic lesion should reveal

Back 255

Multinucleated giant cells

Front 256

256. Patient with genital herpes does not respond to acyclovir because pt is infected with

Back 256

thymidine kinase deficientHSV

Front 257

257. A pregnant woman with 1o symptomatic HSV-2 infection is at risk of her baby developing

Back 257

neonatal (congenital) herpes

Front 258

258. Cause of painful genital ulcers; purulent, grey base; painful inguinal adenitis, in a man with multiple sexual partners is

Back 258

Haemophilus ducreyi

Front 259

259. Fastidious organism in the infiltrate of the penile ulcer, co- localized with neutrophils and fibrin, in a pt w/ chancroid is

Back 259

Haemophilus ducreyi

Front 260

260. All sex partners of pt with chancroid, regardless of symptoms, should be examined and treated with

Back 260

Azythromycin > ceftriaxone

Front 261

261. New episode of purulent or mucopurulent endocervical exudate visible in the endocervical canal or on endocervical swab. Friability and bleeding may be noted after gentle passage of swab though cervical os. Test for:

Back 261

Chlamydia trachomatis andNeisseria gonorrhoeae

Front 262

262. New episode of purulent or mucopurulent endocervical exudate visible in the endocervical canal or on endocervical swab. Friability and bleeding may be noted after gentle passage of swab though cervical os. Test is

Back 262

Nucleic acid amplification tests (NAAT)

Front 263

263. Most common cause of mucopurulent endocervical exudate(Gram stain non revealing) in a sexually promiscuous woman

Back 263

Chlamydia trachomatis D-K

Front 264

264. Chlamydia trachomatis is an intracellular parasite which lacks

Back 264

Muramic acid (cell wall)

Front 265

265. Dx of mucopurulent urethral discharge, dysuria, penile pruritis is based on

Back 265

NAAT of urethral specimen or urine (+)

Front 266

266. DOC of most frequent cause of nongonococcal urethritis

Back 266

Azythromycin > doxycycline

Front 267

267. Cause of rare genital ulcers, inguinal lymphadenopathy[cytology(-) for multi-nucleated giant cells; RPR (-)] in men is

Back 267

Chlamydia trachomatis L1-L3

Front 268

268. Hx of systemic Sx/Sn w/ cervical motion tenderness in a woman with turbo-ovarian abscess. TOW?

Back 268

PID

Front 269

269. Cause of mucopurulent urethritis, dysuria, penile pruritis[Smear (+):Gram-negative diplococci co-populated w/ PMNs] is

Back 269

Neisseria gonorrhoeae

Front 270

270. Deficiency in serum factors in a female pt w/ frequent gonorrhea and DGIs is

Back 270

C6-C9

Front 271

271. Immune evasion of Neisseria gonorrhoeae in frequent mucosal infection is due to

Back 271

Antigenic variation of pili.

Front 272

272. Auxotrophic strains of N. gonorrhoeae with serum(complements) resistance are likely to cause

Back 272

Septic arthritis (aka: DGI)

Front 273

273. Most frequent complication of gonococcal (GC) infection in men

Back 273

Epididymitis

Front 274

274. Cause of "bull headed clap", urethral stricture, prostatitis is

Back 274

Neisseria gonorrhoeae

Front 275

275. Urethritis is treated with ceftriaxone + azythromycin because

Back 275

Concurrent GC + Chlamydia

Front 276

276. Intra-amniotic infection syndrome, following rupture of membranes, without histological (neutrophilic inflammation of chorion, necrosis, micro-abscess formation, amnion basement membrane thickening) or microbiological confirmation, etiology is usually

Back 276

polymicrobial (2 or more)

Front 277

277. Intra-amniotic infection syndrome, following rupture of membranes, without histological (neutrophilic inflammation of chorion, necrosis, micro-abscess formation, amnion basement membrane thickening) or microbiological confirmation, Frequently recovered isolates from pre-term infant placentas(chorioamnionitis):

Back 277

Ureaplasma urealyticum, Gardnerella vaginalis.

Front 278

278. Along with gentamicin, a standard component of treatment for chorioamnionitis is

Back 278

Ampicillin

Front 279

279. Acute onset of intermenstrual bleeding in a non-pregnant woman, recent onset dyspareunia, lower abdominal pain or distension: crampy, fever, pain with bowel movements or constipation. Confirm by tests of

Back 279

Gram stain and culture of fluid from surgery (acute endometritis)

Front 280

280. Diagnosis of chronic endometritis is made by endometrial biopsy with histologic diagnosis based upon

Back 280

plasma cells, lymphocytes in endometrial infiltrate

Front 281

281. An older woman with PID and tubo-ovarian abscess receives ceftriaxone, azythromycin, and metronidazole because

Back 281

Polymicrobic (endogenous)infection

Front 282

282. Cause of anogenital warts w/ histology (+): koilocytes is

Back 282

HPV 6 and 11

Front 283

283. Cause of atypical squamous cells of undetermined significance (ASCUS) on pap smear w/ no clinical signs of infection is

Back 283

HPV 16 and 18

Front 284

284. Cause of koilocytotic cells and possible progression to squamous cell carcinoma

Back 284

HPV 16 and 18

Front 285

285. Next step to identify viral cause of ASCUS on pap smear w/and further management in a woman of age > 29 years is

Back 285

Colposcopy > HPV DNA in bpsy

Front 286

286. Wet prep of vaginal discharge from a pt w/ vaginal pruritis;ectocervical erythema ("strawberry cervix") should reveal

Back 286

motile tissue flagellate

Front 287

287. Clinical syndrome form replacement of normal peroxide- producing Lactobacillus spp. in the vagina with high concentrations of anaerobic bacterial (e.g., Mobiluncus sp and Prevotellasp), G. vaginalis, and Mycoplasma hominis is

Back 287

Bacterial vaginosis (BV)

Front 288

288. Gardnerella and/or Mobiluncus morphotypes in BV are seen with few or absent of

Back 288

Lactobacilli

Front 289

289. Gram stain of vaginal discharge w/ fishy odor from a pt w/ vaginal pruritis but no erythema and normal cervix (in BV) should reveal

Back 289

SECs stippled with Gram- variable organisms.

Front 290

290. DOC of bacterial vaginosis is

Back 290

metronidazole

Front 291

291. Wet prep of curdy discharge (no odor), adhering to vaginal walls, from a pregnant woman w/ recent UTI, who now has severe vaginal pruritis; vulvovaginal area - erythematous should reveal

Back 291

budding yeasts with pseudohyphae

Front 292

292. Normal commensal of skin, GI & GU tracts; endogenous overgrowth of budding yeast, capable of >10 diseases. TOW?

Back 292

Candida albicans

Front 293

293. Mechanism of action of a po DOC of vulvovaginal candidiasis is

Back 293

blocks C14 alpha-lanosterol demethylase

Front 294

294. Hx of flu-like illness, lymphadenopathy, maculopapular rash in a bisexual man. Lab: lymphopenia and transaminase elevations; monospot/all serology (-). TOW?

Back 294

Acute retroviral syndrome

Front 295

295. Time from infection (acquisition) to acute seroconversion detected by HIV serology (ELISA/ WBlot) is

Back 295

6-12 weeks.

Front 296

296. Hx of mononucleosis-like illness and lymphadenopathy in a man who has sex man. Serology (-). What is HIV viral load?

Back 296

>10,000 copies/ml

Front 297

297. Host-cell receptor for HIV-1 infection

Back 297

CD4

Front 298

298. Homozygous for deletions in what gene renders resistance to infection and some protection against progression.

Back 298

CCR5

Front 299

299. Host cells that trap HIV and mediate the efficient transinfection of CD4+ T cells are

Back 299

Dendritic cells

Front 300

300. A man, who practices “sex with another man”, hasantibodies to HIV (ELISA and WB) but asymptomatic. TOW?

Back 300

Clinical latency

Front 301

301. What happens to HIV-1 virus when acute retroviral syndrome progresses to clinical latency?

Back 301

Virus continues to replicate low level.

Front 302

302. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count isi. Candidiasis, esophageal, bronchi, trachea, or lungs ii. Cervical cancer, invasiveiii. Coccidioidomycosis, extrapulmonary iv. Cryptococcosis, extrapulmonaryv. Cryptosporidiosis, chronic intestinalvi. Cytomegalovirus retinitis (with vision loss)vii. Encephalopathy, HIV-related viii. Herpes simplex - Chronic ulcersix. Histoplasmosis, disseminated or extrapulmonary x. Isosporiasis, chronic intestinal (duration >1 mo) xi. Kaposi sarcomaxii. Lymphoma, Burkittxiii. Lymphoma, primary, of the brainxiv. Mycobacterium avium complex or Mycobacterium kansasii infection, extrapulmonaryxv. Mycobacterium tuberculosis infection, any site(pulmonary or extrapulmonary)xvi. Pneumocystis pneumoniaxvii. Progressive multifocal leukoencephalopathy xviii. Wasting syndrome due to HIV infection

Back 302

CD4+ < 200/microL

Front 303

303. A man with HIV infection has chronic diarrhea, oral thrush+ toxoplasma encephalitis. Most likely CD4+ count is

Back 303

< 50 cells/microL.

Front 304

304. Most common cause of HIV- associated peripheral skin or mucosal ulcers

Back 304

HSV-1 (>> Histo > CMV > VZV > Syphilis)

Front 305

305. Most common cause of HIV- associated nodules(neoplasia)?

Back 305

HHV-8 (aka KSHV)

Front 306

306. Hx of fatigue, nausea, abdominal pain, diarrhea, fever,chills, night sweats, dry persistent cough w/ SOB and weight loss in a man with AIDS. Lab: PPD (-); blood culture (+) for AFB. TOW?

Back 306

Mycobacterium avium- intracellulare (MAI) complex (aka: MAC)

Front 307

307. Common cause of retinitis, viral pneumonitis or esophagitis in AIDS

Back 307

CMV

Front 308

308. Cases of CMV disease occur with immunosuppression level

Back 308

CD4< 50

Front 309

309. cytopathology of CMV infected tissue is characterized by large cells with

Back 309

nuclear (Cowdry owl’s eye)and cytoplasmic inclusions

Front 310

310. Hx of progressive CNS dz in a pt w/ AIDS: hemiparesis, visual, ataxia, aphasia, cranial nerves, sensory. Head MRI: ring- enhancing lesions. Toxo antibody (-). TOW?

Back 310

JC virus

Front 311

311. Definitive indication for initial HAART is CD4+ count?

Back 311

350/mm3.

Front 312

312. Objective of ARV Tx is to reduce viremia to what level of genomic RNA/mL

Back 312

< 50 copies RNA/mL.

Front 313

313. Initial regimen of anti-retroviral therapy is

Back 313

Emtricitabine + Tenofovir + Efavirenz

Front 314

314. Abacavir, emtricitabine, lamivudine, zidovudine, tenofovirbelong to what class of antiretrovirals?

Back 314

NRTIs

Front 315

315. Efavirenz, nevirapine belong to what class of antiretrovirals?

Back 315

NNRTIs

Front 316

316. Atazanavir, Lopinavir, Saquinavir belong to what class of antiretrovirals?

Back 316

Protease inhibitors

Front 317

317. This drug binds to gp41 and prevents conformational change required for viral fusion and entry into cells.

Back 317

enfuvirtide

Front 318

318. This drug inhibits integrase, responsible for insertion ofHIV proviral DNA into the host genome.

Back 318

raltegravir

Front 319

319. A man has AIDS and CD4 <200cells/μL or thrush.Antibacterial prophylaxis needed besides HAART is

Back 319

TMP-SMX (for PCP)

Front 320

320. A man has AIDS and CD4 <100 + pos toxo IgG.Chemoprophylaxis needed besides HAART is

Back 320

TMP-SMX (for Toxoplasma encephalitis)

Front 321

321. A man has AIDS and CD4 <100 + PPD >5mm induration.Antibacterial prophylaxis needed besides HAART is

Back 321

INH + pyridoxine

Front 322

322. A man has AIDS and CD4 <50. Antibacterial prophylaxis needed besides HAART is

Back 322

azithromycin (for MAC)

Front 323

323. Hx of fever, a pustule at a cat scratch site, adenopathy, hepatosplenomegaly in a pt w/ AIDS. Warthin-Starry stain tissue (+). TOW (clue: bacillary angiomatosis)?

Back 323

Bartonella henselae

Front 324

324. Leading causes of congenital infections are

Back 324

ToRCH3eS-ListTo = Toxoplasma gondiiR = RubellaC = CMVH = HSV-2H = HIV H = HBVS = SyphilisList = Listeria monocytogenes

Front 325

325. Cause of severe CNS sequelae, chorioretinitis, systemic disease in a neonate (mom at pregnancy had mono-like illness after eating undercooked beef or pork or exposure to oöcysts in catfeces) is

Back 325

Toxoplasma gondii

Front 326

326. Drug for pregnant woman in first trimester to prevent transmission if mother seroconverts is

Back 326

Spiramycin

Front 327

327. Hx of deafness, cataracts, heart defects, or microcephaly ina child (of a seronegative, caregiver mom, exposed to “Blueberrymuffin baby” in 1st trimester). TOW?

Back 327

congenital rubella syndrome(CRS)

Front 328

328. Dx of CRS usually with positive anti-rubella antibody type?

Back 328

IgM

Front 329

329. Microcephaly, seizures, sensorineural hearing loss, feedingdifficulties, petechial rash, hepatosplenomegaly, or jaundice in aneonate. PCR of any body fluid should yield

Back 329

CMV

Front 330

330. After primary infection, CMV, characterized as envelopeddsDNA betaherpesvirus; establishes

Back 330

lifelong latency

Front 331

331. Hepatosplenomegaly, neurologic abnormalities, frequentinfections in a neonate w/ low CD4+ counts. Woman beforebirthing should have received

Back 331

Nevirapine

Front 332

332. Cause of vesicular skin lesions + conjunctivitis in a child(asymptomatic at birth)

Back 332

HSV-2

Front 333

333. Hx of cutaneous lesions, hepatosplenomegaly, jaundice,saddle nose, and saber shins. Hutchinson teeth, + CN VIII deafnessin a neonate (mom is a prostitute). TOW?

Back 333

3o syphilis

Front 334

334. Neonatal septicemia or meningitis (mom had flu-like Sx andate imported cheese during pregnancy). TOW?

Back 334

Listeria monocytogenes

Front 335

335. What are the SIX red rashes of childhood (acute, febrileexanthema illnesses)?(Clue1: maculopapular rash; off-white lesions on buccal mucosa,MMRV vaccine prevents)(Clue2: maculopapular rash starting on face moving to foot; MMRVprevents)(Clue3: scarlatina rash post pharyngitis)(Clue4: vesicular rash, moderate pain)(Clue5: maculopapular “slapped face” appearance in a young child)(Clue6: maculopapular rash and systemic Dz in immunocompromisedpt)

Back 335

MeaslesRubellaScarlet fever (GAS)Chicken pox (VZV)Parvovirus B19HHV-6

Front 336

336. Worldwide rubella infection, with only human reservoirsknown this infectious agent is a

Back 336

RNA togavirus

Front 337

337. >95% seropositive after MMRV if >12mos age and lifelongprotection against rubella is conferred with?

Back 337

Single dose

Front 338

338. Cause of single or multiple scaly and/or crusted patchesand/or plaques, affecting the scalp or beard area +/- inflammation.

Back 338

Dermatophytes

Front 339

339. KOH prep of scales from the scalp and plucked hairs fromcutaneous mycoses may reveal?

Back 339

hyphae and spores

Front 340

340. Most common cause of cutaneous mycoses

Back 340

Trichophyton spp.

Front 341

341. Common cause of cutaneous mycosis with animal contact

Back 341

Microsporum spp.

Front 342

342. Oral DOC of cutaneous mycoses

Back 342

itraconazole

Front 343

343. Topical DOC of cutaneous mycoses

Back 343

terbinafine

Front 344

344. Dz w/ subcutaenous lesions w/ slow spread by lymphatic system producing nodules in a gardener, or from rose-thorn injury.

Back 344

Sporotrichosis

Front 345

345. Cause of subcutaenous lesions w/ slow spread by lymphatic system producing nodules in a gardener, or from rose-thorn injury.

Back 345

Sporothrix schenckii

Front 346

346. Dimorphic fungus that grows at 37°C as cigar-shaped yeast, and produces septate hyphae and conidia (in daisy arrangement) at25°C is

Back 346

Sporothrix schenckii

Front 347

347. DOC of sporotrchosis

Back 347

itraconazole.

Front 348

348. Cause of deeper and wider lesions with interconnecting subcutaneous abscesses arising from infection of several neighboring hair follicles, in young children.

Back 348

Staphylococcus aureus(Curbuncle)

Front 349

349. Cause of superficial pustules progressing to erosionscovered by honey-colored crusts, surrounded by erythematous halo, in young children.

Back 349

Staphylococcus aureus >> Streptococcus pyogenes (non- bullous impetigo)

Front 350

350. Dz characterized by bullae and denuded areas after the blisters rupture, covered by thin, varnish-like light brown crusts; regional lymphadenopathy, in children.DOC if lab: gram stain and culture of pus or base of the lesions yieldsGPC in chains.DOC if lab: gram stain and culture of pus or base of the lesions yieldsGPC in clusters.

Back 350

Bullous impetigoPenicillin G Nafcillin

Front 351

351. mecA (SCC) genes which encode PBP2a, w/ low affinity for β-lactams; confers resistance in Staphylococcus aureus against what?

Back 351

Nafcillin

Front 352

352. Cause of spreading (butterfly-wing) erythema on the face that responds to empirical penicillin.

Back 352

Streptococcus pyogenes(Erysipelas)

Front 353

353. Cause of severe pain on his knee w/ site of injury is tender and erythematous. Blood culture may yield?

Back 353

Streptococcus pyogenes. (Cellulitis)

Front 354

354. What is the microbial factor that promotes degradation ofC3b by binding to factor H, the serum β globulin factor

Back 354

M protein

Front 355

355. Other epidemiologically linked or risk-associated causes of cellulitis are:Clue1: cat/dog bite. What?Clue2: Salt water exposure. What? Clue3: Fresh water exposure. What? Clue4: Neutropenia. What?Clue5: Human bite. What?

Back 355

Pasteurella multocida / Capnocytophaga canimorous Vibrio vulnificusAeromonas hydrophila Pseudomonas aeruginosa Eikenella corrodens

Front 356

356. Most likely cause of fever/chills/ night sweats, localizing pain/tenderness or swelling/erythema (lab: ↑ESR, ↑CRP; ↑WBC w/ left shift. Radiology: periosteal elevation.) is

Back 356

Staphylococcus aureus(Osteomyelitis)

Front 357

357. Major antiphagocytic virulence factor of drug-resistant organism that causes osteomyelitis is

Back 357

protein A

Front 358

358. Major neutrophil-damaging virulence factor of drug- resistant organism that causes osteomyelitis is

Back 358

Penton-Valentine leukocydin

Front 359

359. Cause of vertebral, sternoclavicular or pelvic bone infections (in pt w/ IVDU) or osteochondritis of foot (following penetrating injuries through tennis shoes)?

Back 359

Pseudomonas aeruginosa

Front 360

360. Cause of osteomyelitis in pt w/ underlying sickle cell Dz;blood culture +)?

Back 360

Salmonella typhimurium

Front 361

361. Cause of chronic, vertebral osteomyelitis (blood culture negative)?

Back 361

Mycobacterium tuberculosis

Front 362

362. Cause of osteomyelitis in pt. w/ hx of cat bites; GNSR;fastidious growth of wound culture?

Back 362

Pasteurella multocida

Front 363

363. Cause of fever, chills, malaise, joint pain, swelling. PE: tenderness, erythema, heat, swelling, decreased ROM. CBC: leukocytosis w/ neutrophils predominating; joint aspirate: no crystals.Clue1: sexually active; BLCx (-); responds to ceftriaxoneThink of other pathogens (BLCx negative): Clue2: Rheumatoid arthritis?Clue3: IVDU?Clue4: Unpasteurized dairy productsClue5: Diabetes

Back 363

Septic arthritisNeisseria gonorrhoeaeS. aureusS. aureus, P. aeruginosaBrucella spp.S. agalactiae (GBS)

Front 364

364. Dz is characterized by arthritis in up to 6 joints (especially knees, feet), low back pain/stiffness, irritable eyes w/ or w/o redness, conjunctivitis, iritis, malaise.Caused by:Clue1: sexually acquiredClue2: non-sexually acquired

Back 364

Reactive arthritisC. trachomatis, N. gonorrhoeae Campylobacter, Salmonella

Front 365

365. Cause of bacteremia in neutopenic pts with central line or pts with prosthetic devices and catheters; blood culture (+)

Back 365

Staphylococcus epidermidis

Front 366

366. Cause of intraabdominal abscess w/ putrid pus; anaerobicbacteremia in pt with trauma or solid GI tumor?

Back 366

Bacteroides fragilis.

Front 367

367. A woman with obstetric infection has fever > 102oF, SBP <90; diffuse sunburn-like rash or desquamation of palms and soles;multisystem Sx/Sns; vomiting, and diarrhea; BLCx (-). TOW?

Back 367

Staphylococcal Toxic shockSyndrome

Front 368

368. What is the toxin associated with staphylococcal toxicshock syndrome?

Back 368

TSST-1 (a superantigen)

Front 369

369. Cause of severe, watery diarrhea in a woman with toxicshock syndrome?

Back 369

Enterotoxin (coregulated withTSST-1)

Front 370

370. Cause of toxic shock syndrome, which responds tovancomycin and clindamycin?

Back 370

MRSA

Front 371

371. Hx of fever > 38.9oC, SBP < 90 ; diffuse sunburn-like rashor desquamation of palms and soles, in a man w/ necrotizingfasciitis or myositis; multisystem involvement; BLCx (+). TOW?

Back 371

Streptococcal toxic shocksyndrome

Front 372

372. What is the toxin associated with streptococcal toxic shocksyndrome?

Back 372

SpeA (superantigen)

Front 373

373. DOC for streptococcal toxic shock syndrome

Back 373

PenG + clindamycin

Front 374

374. Hx of fever, chills, and hypotension. Blood culture yields a GNR, oxidase (-), lactose fermenting organism on MacConkeyagar. Immunological mediators of sepsis.

Back 374

IL-1 and TNF

Front 375

375. DOC for a neutropenic pt w/ line-associated infection w/immune suppression (hematologic malignancy, organ orhematopoietic stem cell transplantation, chemotherapy); w/ positiveblood cultures and Beta-D-glucan antigenemia?

Back 375

Caspofungin

Front 376

376. DOC for a line-associated infection in a pt w/ GI tumor; lab:positive blood cultures and Beta-D-glucan antigenemia?

Back 376

Fluconazole

Front 377

377. Without prophylaxis with valganciclovir, D+/R- solid organtxp pts will develop

Back 377

CMV disease

Front 378

378. Cause of mononucleosis-like dz with fever, myalgia/arthralgia w/ lab: leukopenia, LFT abnls, in a pt w/ solid organtransplant?

Back 378

CMV

Front 379

379. Lung biopsy reveals large cells with nuclear inclusions(Cowdry owl's eyes inclusion bodies) in a pt with AIDS andinterstitial pneumonia. TOW?

Back 379

CMV

Front 380

380. DOC for CMV antigenemia in a febrile pt with solid organtansplant?

Back 380

valganciclovir

Front 381

381. Cause of hematuria, hemorrhagic cystitis, or uretericstenosis, or interstitial nephritis in a severly immunocompromisedpt?

Back 381

BK Virus

Front 382

382. What is the most common cause of bacteremia associatedw/ foreign device (prostheses, intravenous cathether, or centrallines) in co-morbid, hospitalized pts?

Back 382

Staphylococcus epidermidis

Front 383

383. What is the cause of infections associated w/ ventilatorsupport of respiration in co-morbid pts in the ICU?

Back 383

Pseudomonas aeruginosa

Front 384

384. DOC for a pt w/ travel hx (back from the tropics), who hasflu-like symptoms; splenomegaly; lab: CBC: anemia,thrombocytopenia, hypoglycemia. Blood smear: enlarged RBCsand Schuffner dots.

Back 384

mefloquine + primaquine

Front 385

385. Which drug is contraindicated in specific Tx of liver formof malaria in pts w/ G6PD deficiency?

Back 385

Primaquine

Front 386

386. DOC for a pt w/ travel hx (back from the tropics), who hasflu-like symptoms (fever > 103o F), seizure, hyperparasitemia(>2.5% of RBC), pulmonary edema, or renal failure, or severeanemia?

Back 386

Quinidine and doxycycline.

Front 387

387. Cause of malaria-like illness in an immunosuppressed ptw/o travel hx; lab: blood smear has cross-over rings in the RBCs?

Back 387

Babesia spp.

Front 388

388. A pt from S. America has a week-long fever, anorexia,lymphadenopathy, mild hepatosplenomegaly, and myocarditis; anodular lesion on the arm; blood smear should reveal

Back 388

Trypanosoma cruzi

Front 389

389. Cause of a chronic-stage systemic dz w/ cardiomyopathy,megaesophagus, megacolon, and weight loss in a pt from S.America, who does not respond to nifurtimox.

Back 389

Trypanosoma cruzi

Front 390

390. Cause of protracted fever and Crohn’s, celiac dz, ocularproblems, and lymphadenopathy; duodenal biopsy demonstratingfoamy macrophages in lamina propria?

Back 390

Tropheryma whipplei

Front 391

391. Painless papule (on arms, face, or chest), thenvesicles/bullae, then black eschar + edema evolving over 3-5d is

Back 391

Cutaneous anthrax

Front 392

392. Unique features of cutaneous anthrax include edema, lackof pain and bullous fluid that lacks

Back 392

PMNs

Front 393

393. Cutaneous anthrax can be treated in 7-10 days with

Back 393

Ciprofloxacin

Front 394

394. Fever, chills, sweats, GI sx, cough, malaise, chest pain (3-4d); CXR: wide mediastinum and bloody pleural effusion is

Back 394

Inhalation anthrax

Front 395

395. CT scan in inhalation anthrax may show hyperdense mediastinal nodes and

Back 395

pulmonary edema

Front 396

396. Cultures of blood and respiratory specimens from in inhalation anthrax should yield

Back 396

Bacillus anthracis

Front 397

397. DOC of Inhalation anthrax is

Back 397

Ciprofloxacin or levofloxacin> doxycycline

Front 398

398. Need to treat inhalation anthrax 60 days because

Back 398

Spores persist in lungs

Front 399

399. 60 d total course recommended for any presentation to avoid

Back 399

relapse or breakthrough of incubation of spores

Front 400

400. Post-exposure prophylaxis to prevent inhalation anthrax also requires

Back 400

Cipro for 60 days

Front 401

401. Exposure (time & place to environment) + papule progressing to black eschar on exposed area in 3-4d +/- local edema, often intensely pruritic is

Back 401

Cutaneous anthrax

Front 402

402. Ciprofloxacin, levofloxacin and doxycycline are equivalent to treat cutaneous anthrax. All other abx are

Back 402

less effective

Front 403

403. In the event of an index case of anthrax (although infectionis not P2P communicable), notify public health authorities and local

Back 403

infection control

Front 404

404. Infection control of all types of anthrax (based on non- communicability of the pathogen) warrants only

Back 404

Standard precautions

Front 405

405. Species of Clostridium that causes afebrile, systemic toxic diseases in infants (honey), and in adults foodborne (meat, canned vegetables), wound (injected), iatrogenic (cosmetic) is

Back 405

C. botulinum

Front 406

406. Differential diagnosis of botulism-like symptom/signs should include Myasthenia gravis, Stroke, Chemical Intoxications, Lambert-Eaton Dz, and

Back 406

Guillian-Barré

Front 407

407. Clostridia produces human pathogenic

Back 407

neurotoxins types A, B, E, Fand G

Front 408

408. Many pts w/ flaccid paralysis in the same geography without common food source may be

Back 408

Bioterrorism-associated botulism

Front 409

409. CSF examination in botulism is

Back 409

Normal profile (no pleocytosis)

Front 410

410. Post lab confirmation of food botulism, while waiting for antitoxin may give

Back 410

activated charcoal

Front 411

411. Infection control of all types of botulism (based on non- communicability of the pathogen or toxins) warrants only

Back 411

Standard precautions

Front 412

412. Aerobic slender gram-negative rod, which causes glanders in horses, associated with bioterrorism is

Back 412

Burkholderia mallei

Front 413

413. Acute glanders caused by Burkholderia mallei may produce a localized infection with ulceration following inoculation in the skin; lymphadenopathy; lung infections may present as pneumonia. Acute bloodstream infections can be

Back 413

rapidly fatal.

Front 414

414. If Burkholderia mallei isolated suspect bioterrorism; Quarantine pt & give antibiotics:

Back 414

TMP-SMX or Imipenem

Front 415

415. Multiple cases of glanders: must consider

Back 415

bioterrorism.

Front 416

416. Patients with glanders should be isolated, respiratory precautions. B. mallei spread by

Back 416

aerosol.

Front 417

417. In the DDx of bioterrorism-related pneumonia +pleuritis + hilar adenopathy, include anthrax, plague and

Back 417

tularemia

Front 418

418. Small, pleomorphic, aerobic Gram-neg rod that causes1) bite/abrasion (acquired from tick exposure or contact with rabbits) → nodule/ulcer → node → sepsis, or 2) inhalation (bioterrorism) → acute fever, dry cough. CXR: infiltrates + hilar adenopathy, is

Back 418

Francisella turlarensis

Front 419

419. DOC of tularemia is

Back 419

streptomycin

Front 420

420. For tularemia, if bioterrorism suspected, notify

Back 420

local public health

Front 421

421. Pathogen Francisella turlarensis does not have a person-to- person mode of transmission. Infection control does not require:

Back 421

Isolation

Front 422

422. Acute fever, myalgias, remorrhagic rash, conjunctivitis, pharyngitis, headache, diarrhea, and thrombocytopenia in bioterrorism indicates

Back 422

Viral hemorrhagic fever (e.g., Ebola, Marburg)

Front 423

423. For Lassa, Marburg, and Ebola, person-to-person transmission based infection control (respiratory) precautions and other measures must include:

Back 423

Patient isolation

Front 424

424. Endemic plague in the South West USA is acquired by bite of rodent flea carrying

Back 424

Yersinia pestis

Front 425

425. Aerobic, Gram-neg bipolar rod, which causes painfullymphadenitis (bubonic), fever, chills, headache (afterexposure to rodents, rabbits or fleas) is

Back 425

Yersinia pestis

Front 426

426. Three forms of plague: bubonic (lymph nodes),pneumonic and the third:

Back 426

septicemic

Front 427

427. DOC of plague is

Back 427

Doxycycline

Front 428

428. Pneumonic plague can be transmitted

Back 428

from person-person

Front 429

429. Sudden fever ≥ 102°F , homogeneous vesiculo-pustularrash (unlike common viral exanthems) in multiple pts (in timeand place) is

Back 429

Small pox, caused by variollamajor virus

Front 430

430. Sudden fever ≥ 102°F , homogeneous vesiculo-pustularrash in multiple pts (in time and place) is, main diagnosticdifferential is

Back 430

Varicella or zoster

Front 431

431. For small pox associated bioterrorism, person-to-persontransmission based infection control warrants isolation measuresand

Back 431

respiratory precautions

Front 432

432. No person-to-person transmission are observed (other thanstandard precautions) for the bioterrorism agents:

Back 432

Anthrax, botulism (noncommunicable)

Front 433

433. Fever, headache, neck stiffness, and altered mental status;Kernig's/Brudzinski's sign, rash; CSF: WBC > 2000 or PMNs >1200; glucose < 34, protein > 220CSF gram stain of the most likely pathogen of ABM in a 6 mos-6yr old(or adults > 50 years) should revealCSF gram stain of the most likely pathogen of ABM in an older childor young adult should reveal

Back 433

Acute bacterial meningitis(ABM)Gram-positive diplococciGram-negative diplococci

Front 434

434. Most common cause of sepsis/meningitis innewborns/neonates?

Back 434

Streptococcus agalactiae

Front 435

435. Cause of fever, headache, photophobia, nausea/vomiting, rash, diarrhea, meningeal signs, in older children in the summer months; CSF with 10-<1,000 WBC typical, mostly monos, moderately elevated protein?

Back 435

Aseptic meningitis(enteroviruses)

Front 436

436. Cause of aseptic meningitis in men with exposure to rodents?

Back 436

Leptospira interrogans

Front 437

437. Cause of aseptic meningitis with hx of tick bite and erythema migrans?

Back 437

Borrelia burgdorferi

Front 438

438. Cause of aseptic meningitis with hx of sex with multiple partners; CSF PCR(+):

Back 438

HSV-2 > 1

Front 439

439. Cause of fever, headache, photophobia, meningismus, in pts w/ solid organ transplant, malignancy, corticosteroid use. CSF glucose < 2/3 serum glucose, elevated protein, WBC > 5 withPMNs

Back 439

Listeria monocyotgenes

Front 440

440. How does Listeria monocytogenes differ from other - hemolytic bacteria

Back 440

Gram-positive rods; tumbling motility

Front 441

441. Cause of chronic meningoencephalitis in a pt, who uses infliximab or native from endemic region; PE: papilledema. CXR (+). Lab: elevated monocytes on differential, low CSF glucose?

Back 441

Mycobacterium tuberculosis

Front 442

442. Test to confirm subacute mengoencephalitis in a, immunocompromised pt (CD4 <100); vesicular skin lesions [CSF profile: protein 30-150mg/dl, monos 10-100]?

Back 442

CSF India ink

Front 443

443. Cause of meningoencephalitis after a hx of respiratory illness after travel to SW USA?

Back 443

Coccidioides immitis

Front 444

444. Test to confirm CNS pathology with fever, cognitive deficits, focal neurologic signs, seizures; temporal lobe involvement on MRI. Lab: no papilledema, CT (no brain lesion)?

Back 444

CSF PCR (+)

Front 445

445. Cause of fever, cognitive deficits, focal neurologic signs, seizures, abnormal mental status with ataxia, hemi-paresis, in a pt w/ AIDS?

Back 445

JC virus > HHV-6

Front 446

446. Cause of fever, cognitive deficits, focal neurologic signs, seizures or abnormal mental status with ataxia in an adult during outdoor activity?

Back 446

West-Nile virus > SLE

Front 447

447. Hx of fever, cognitive deficits, focal neurologic signs,seizures, in a pt w/ AIDS (CD4 < 50). MRI: multifocal (ringenhancing)lesions in basal ganglia. Rule out?

Back 447

Toxoplasma encephalitis (TE)

Front 448

448. HIV-infected Pt with TE should receive (for life)

Back 448

pyrimethamine + leucovorin +sulfadiazine

Front 449

449. Folinic acid (leucovorin) prevents bone marrow suppressiveeffect of

Back 449

Pyrimethamine

Front 450

450. Cause of confusion, stiff neck, irritability over wks tomonths, in immunocompromised pts; CT/MRI = multifocal lesionsin midbrain, brain stem, & cerebellum; wet mount CSF = motilemacrophage-like organisms

Back 450

Acanthamoeba spp. (GAE)

Front 451

451. Cause of severe headache and other meningeal signs, fever,vomiting, and focal neurologic deficits, frequently progressing tocoma, in a healthy boy (summer diving activity)?

Back 451

Naegleria fowleri (PAM)

Front 452

452. Cause of seizures, chronic headache, symptomatichydrocephalus, in immigrants; pt. successfully responds topraziquantel + anti-convulsant drug?

Back 452

Taenia solium(neurocysticercosis)

Front 453

453. Pt from Africa had fever, lymphadenopathy, chancre, andpruritus weeks ago; now has headaches, somnolence, neuro Sns;slowly responds to pentamidine isothionate or suramin. TOW?

Back 453

Sleeping sickness caused byTrypanosoma brucei

Front 454

454. Hx of rigidity, muscle spasm, and autonomic dysfunction.Trismus due to masseter spasm in an infant w/ umbilical stumpinfection. Neurotoxin interferes w/

Back 454

GABA and glycine

Front 455

455. Hx of afebrile illness w/ diplopia, dysarthria, dysphoria,dysphagia, in a pt w/ IDU skin poppers with black tar heroin.Neurotoxin blocks the release of

Back 455

Acetylcholine

Front 456

456. Immediate treatment of a male infant w/ constipation, aweak cry, and drooling, hypotonea and cranial neuropathy, afteringestion of home-processed honey.

Back 456

Equine immune globulin(infant botulism)

Front 457

457. Ingestion of a raw potato delivers a new vaccine protein toelicit an immune response. The immune structure to interact withthe vaccine protein?

Back 457

Lamina propria mucosae

Front 458

458. Inflammation and the resulting increase in vascularpermeability permit leakage into damaged or infected sites areeffected by

Back 458

Phagocytic cells and acutephase proteins

Front 459

459. The serum of a pt, who has IgG and IgM deficiency,appears to fix complement in an assay for tetanus antibodies. Whatis the explanation?

Back 459

Activation of the alternatepathway

Front 460

460. A 3-year-old boy with genetic C3 deficiency has recurrent ear and lung infections due to pyogenic bacteria. Deficiency of what?

Back 460

B lymphocytes

Front 461

461. A very young child, w/ recurrent infections due to Staphylococcus aureus, now has numerous granulomas. TOW?

Back 461

Chronic granulomatous dz

Front 462

462. Treatment with which protease enzyme causes decrease in avidity of IgG w/o changing the specificity of the antibody?

Back 462

Papain

Front 463

463. Cells activated by both γ-IFN and CD40 are

Back 463

Macrophages

Front 464

464. High-dose chemo has caused severe bone marrow suppression in a pt with hematologic malignancy. Reversal is plausible with what?

Back 464

GCSF

Front 465

465. Function of the T-lymphocyte receptor (CD3) complex of transmembrane proteins?

Back 465

Signal transduction

Front 466

466. The MHC class I pathway presents an antigen directly to what?

Back 466

CD8+ T lymphocytes

Front 467

467. HSV infection can block the transfer of antigenic peptides from the cytoplasm to the ER of the infected cells. As a result of this, action of what cell type is compromised?

Back 467

CD8+ T cells

Front 468

468. Infection of the thyroid gland can induce the expression of MHC II molecules. Which cell types would initiate an autoimmune response, leading to Hashimoto’s thyroiditis?

Back 468

CD4+ T cells.

Front 469

469. PPD skin test (+) in a pt , who was vaccinated against turberculosis in his native country, reflects response of what cell type?

Back 469

CD4+ T lymphocytes (Th1 response  γ-IFN)

Front 470

470. A man with hx of MI is given a morphine injection for a new episode of chest pain; 10 mins later, he has itching and urticaria. Mechanism of this reaction?

Back 470

mediators from sensitized mast cells

Front 471

471. Loss of skin pigments, sense of touch, inability to feel objects and pain in a pt from Africa, whose skin scraping contains AFBs, is caused by

Back 471

Th1-mediated DTH reactions

Front 472

472. A man with polycystic kidney dz, who receives a renal transplant and cyclosporine, develops a high temp and swelling and tenderness in the grafted kidney. TOW?

Back 472

Immunity to the donor MHCantigens.

Front 473

473. A man who now has progressive stupor and laryngeal spasms for 3 days after pt was being attacked by a wild bat in a cave a month ago should have received

Back 473

Inactivated rabies virus vaccine

Front 474

474. Alternative and lectin pathways of complements activated

Back 474

bacterial surfaces

Front 475

475. Classic complement pathway is activated by antibody- antigen complexes involving antibody class type

Back 475

IgM >> IgG

Front 476

476. Chemotactic and anaphylotoxic complements are

Back 476

C3a, C5a

Front 477

477. successful opsonization of all non-encapsulated bacteria are by complement

Back 477

C3b

Front 478

478. Defect or deficiency of which complements predisposes individuals to infections caused by Neisseria spp., the causative agents of gonorrhea and meningitis

Back 478

C6-C9

Front 479

479. Antimicrobial (immune) response important for intracellular bacterial infections involves cell type

Back 479

Th1 CD4 T cells

Front 480

480. Immune response important for viral infections involves cell type

Back 480

CD8 cytolytic T cells

Front 481

481. Major antibody in secretions and plays a significant role in first-line defense at the mucosal level is

Back 481

IgA

Front 482

482. Main antibody in the initial “primary” immune response andallows good complement activation is

Back 482

IgM

Front 483

483. Fc region of this immunoglobulin binds to eosinophils, basophils and mast cells and is significant mediator of allergic (hypersensitivity) reactions

Back 483

IgE

Front 484

484. What on macrophages enables them to sense that the material is microbial in origin, and must therefore be eliminated quickly?

Back 484

Toll-like receptor

Front 485

485. These oxygen-dependent enzymes: NADPH oxidase, superoxide dismutase, and myeloperoxidase are involved in killing of what?

Back 485

Gram-positive bacteria

Front 486

486. These oxygen-independent enzymes/proteins: lysosome, lactoferrin, defensins and other cationic proteins are involved in killing of what?

Back 486

Gram-negative bacteria

Front 487

487. Infections persist, because m activation is defective, leading to chronic stimulation of CD4+ T cells in what dz?

Back 487

Chronic granulomatous Dz

Front 488

488. Defective respiratory burst, predisposing chronic bacterial infection is associated with deficiency of what?

Back 488

Glucose-6-phosphate dehydrogenase (G6PD)

Front 489

489. All nucleated cells express MHC I antigens

Back 489

HLA-A, B, C

Front 490

490. Antigen-presenting cells express MHC II antigens

Back 490

HLA-DP, DQ, DR

Front 491

491. Lymphocyte proliferation (T, B) and NK → cytotoxicity are undertaken by what cytokine?

Back 491

IL-2

Front 492

492. B-cell activation, IgE and IgG4 switch, ↓ TH1 cells/ M (phi), ↓IFN-gamma, TH0 → TH2 are all undertaken by what cytokine?

Back 492

IL-4

Front 493

493. M activation; elevated expression of MHC and FcRs molecules on B cells, IgG2 class switching, increased IL-4 and TH2 are all undertaken by what cytokine?

Back 493

IFN gamma

Front 494

494. The Th1 response, driven primarily by IFN-gamma leads to the activation of

Back 494

macrophages

Front 495

495. The Th2 response, driven primarily by IL-4 and IL-5, leads to the production of IgE and IgG4 and to the activation of

Back 495

Mast cells and eosinophils

Front 496

496. Variable T and B cells in DiGeroge’s syndrome is associated with

Back 496

Thymic aplasia

Front 497

497. No B cells and immunoglobulins in X-linked agammaglobulinemia (Bruton’s) is associated with

Back 497

Loss of Btk tyrosine kinase

Front 498

498. Lack of anti-polysaccharide antibody and impaired T-cell activation causing Wiskott-Aldrich syndrome is associated with

Back 498

X-linked-defective WASP gene

Front 499

499. Inability to control B cell growth in X-linked lympho- proliferative syndrome is associated with

Back 499

SH2D1A mutant

Front 500

500. Glomerulonephritis, pulmonary hemorrhage inGoodpasture’s syndrome is caused by what autoantigen?

Back 500

basement membrane collagen type IV

Front 501

501. Hyperthyroidism in Grave’s Dz is caused by whatautoantigen?

Back 501

Thyroid-stimulating hormone

Front 502

502. Progressive muscle weakness in Myasthenia gravis iscaused by what autoantigen?

Back 502

Acetyl choline receptor

Front 503

503. Brain degeneration, paralysis in Multiple sclerosis (MS) iscaused by what autoantigen?

Back 503

Myelin basic protein,proteolipid protein

Front 504

504. Localized allergies (e.g., drug allergy, asthma, hay fever)and anaphylaxis (food, drug) w/ systemic inflammation throughoutcirculation are associated with reaction?

Back 504

Type I hypersensitivity

Front 505

505. Autoimmune hemolytic anemia: Ab’s produced vs RBCmembrane Ag’s, mismatched blood (transfusion rxn), and allergiesto antibiotics (e.g., penicillins, sulfa drugs) are associated withreaction?

Back 505

Type II hypersensitivity

Front 506

506. Grave’s Disease, Myasthenia Gravis, Goodpasture’ssyndrome are all associated with reaction?

Back 506

Type II hypersensitivity

Front 507

507. Post-streptococcal glomerulonephritis, serum sickness tohorse diphtheria anti-toxin, systemic lupus erythematosis (SLE),and rheumatoid arthritis are all associated with reaction?

Back 507

Type III hypersensitivity

Front 508

508. Poison ivy, erythematous induration in tuberculin skin test,and transplantation/graft rejection are all associated with reaction?

Back 508

Type IV hypersensitivity

Front 509

509. Periodic acid Schiff (PAS) stain targeted at glycogen andmucopolysaccharides is used to diagnose

Back 509

Whipple’s disease

Front 510

510. For microscopic visualization, mycobacteria with highlipid-contentcell wall requires

Back 510

Acid-fast stain

Front 511

511. Acid-fast bacteria (aka: mycobacteria) are visualized bymicroscopy using

Back 511

Ziehl-Neelsen stain

Front 512

512. Non-stainable bacteria that are considered atypical and intracellular may be detected by microscopy using

Back 512

Giemsa stain

Front 513

513. Rickettsia and chlamydia do not stain with Gram stain because they are

Back 513

Strictly intracellular

Front 514

514. Special culture medium required to grow Haemophilus influenzae is

Back 514

Chocolate agar w/ X (hematin) and V (NAD) factors

Front 515

515. Special culture medium required to grow Bordetella pertussis is

Back 515

Bordet-Gengou (potato) agar

Front 516

516. Special culture medium required to grow Corynebacterium diphtheriae is

Back 516

Tellurite or Loeffler’s agar

Front 517

517. Special culture medium required to grow Neisseria gonorrhoeae is

Back 517

Thayer-Martin (agar) media

Front 518

518. Special culture medium required to grow Mycoplasma pneumoniae is

Back 518

Eaton’s agar

Front 519

519. Special culture medium required to grow Mycobacterium tuberculosis is

Back 519

Lowenstein-Jensen agar

Front 520

520. Special culture medium required to grow Legionella pneumophila is

Back 520

Buffered charcoal-yeast- extract (BCYE) agar with iron and cysteine

Front 521

521. Growth/differential medium required to grow and differentiate Escherichia coli from non-sterile body fluid/tissue is

Back 521

MacConkey agar

Front 522

522. Growth/differential medium required to grow and differentiate Staphylococcus aureus from non-sterile body fluid/tissue (e.g., skin, abscesses) is

Back 522

Mannitol-salt agar

Front 523

523. Nutrient rich medium required to support growth of fastidious organisms (e.g., Streptococus pneumoniae, Neisseria meningitidis) from the sterile body fluid/tissue is

Back 523

Chocolate agar

Front 524

524. Special culture medium required to grow moulds or yeasts from a presumed fungal infection is

Back 524

Sabouraud’s dextrose agar

Front 525

525. Thee anaerobes, such as ABC (Actinomyces, Bacteroides, and Clostridium) organisms do not grow in presence of oxygen because they lack

Back 525

Catalase and superoxide dismutase

Front 526

526. The encapsulated bacteria (Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, Klebsiella pneumoniae, Streptococcus agalactae) are all virulent by virtue of the property of resistance to

Back 526

Phagocytosis

Front 527

527. Edema factor and lethal factor carried by protective antigen are associated with

Back 527

Bacillus anthracis

Front 528

528. A-B subunit toxin (plasmid encoded): ADP ribosylating activity is associated with

Back 528

Bordetella pertussis

Front 529

529. Neurotoxin toxin (prophage carrier) that caused flaccidparalysis is associated with

Back 529

Clostridium botulinum

Front 530

530. Enterotoxin A and cytotoxin B are syngerstically active in

Back 530

Clostridium difficile

Front 531

531. Phospholipase C and enterotoxin are non-synergistically (in different diseases) associated with various subspecies of

Back 531

Clostridium perfringens

Front 532

532. Peripheral neuro toxin causing spastic paralysis (carried in plasmid) is associated with

Back 532

Clostridium tetani

Front 533

533. A-B subunit toxin (carried in bacteriophage) causinginhibition of protein synthesis in target cells is associated with

Back 533

Corynebacterium diphtheriae

Front 534

534. Heat-labile toxin (LT, carried/coded in plasmid), heat-stabletoxin (ST, also carried/coded in plasmid), and Shiga-like toxin(carried/coded in bacteriophage) are non-synergistically associatedwith various toxic strains of

Back 534

Escherichia coli

Front 535

535. Exotoxin A is associated with a pyocyanin-producingGram-negative bacterial species:

Back 535

Pseudomonas aeruginosa

Front 536

536. Shiga toxin, an enterotoxin is associated with

Back 536

Shigella dysenteriae

Front 537

537. TSST-1, exfoliating toxin (carried in plasmid), alpha toxin

Back 537

Staphylococcus aureus

Front 538

538. Pyrogenic exotoxin SpeA, SpeC (carried in bacteriophage) and hemolysins O & S (general cytotoxins) are associated with

Back 538

Streptococcus pyogenes (know also: M proteins surface virulence factor)

Front 539

539. Gram-positive Cocci in pairs and chains are:

Back 539

o Streptococcus (“Lancetshaped”:Streptococcuspneumoniae)o Enterococcuso Peptostreptococcus(anaerobe)

Front 540

540. Gram-positive Cocci in Clusters are:

Back 540

o Bacillus (large; aerobe)o Clostridium (“Box carshaped”:Clostridiumperfringens)o Corynebacterium(palisading; aerobe)o Propionibacterium(pleomorphic; anaerobe)o Listeria (small) o Nocardia (branching,filamentous, aerobe)o Actinomyces (branching,filamentous, anaerobe)

Front 541

541. Gram-negative Cocci are

Back 541

o Neisseria (diplococci:“kidney bean-shaped”)o Moraxella catarrhalis(diplococci)o Veillonella (anaerobe)

Front 542

542. Gram-negative Rods are

Back 542

o Enterobacteriaceae(E.coli, Klebsiella,Salmonella; “Safety pinshaped”:Yersinia pestis)o Pseudomonaso Bacteroides (anaerobe)o Fusobacterium (anaerobe)o Haemophilus(pleomorphic)o Brucella (coccobacillus)o Vibrio (curved)o Campylobacter (“Seagull”appearance)o Helicobacter (curved)

Front 543

543. Facultative intracellular bacteria are non-susceptible toβ-lactam antibiotics and are commonly known species of :

Back 543

Brucella, Francisella,Legionella, Mycobacterium,Yersinia

Front 544

544. Non-envelope, icosahedral, smallest virus with linearsingle-stranded (ss-) DNA is

Back 544

parvovirus B19

Front 545

545. Non-envelope, icosahedral virus with circular doublestranded (ds-) DNA (super-coiled) is

Back 545

papilloma viruses; JC, BKviruses

Front 546

546. Enveloped, icosahedral virus with incomplete, circular dsDNAis

Back 546

hepatitis B virus

Front 547

547. Enveloped, icosahedral virus with linear, ds-DNA is

Back 547

herpes viruses (e.g., HSV 1,2;VZV; CMV; EBV; HHV-6;HHV-8 (KSHV))

Front 548

548. Enveloped (“Donut”-shaped), largest virus with helical,linear, ds-DNA is

Back 548

smallpox

Front 549

549. Non-enveloped, icosahedral virus with linear, positivepolarity,ss-RNA is

Back 549

polioviruses; rhinoviruses;echoviruses;coxsackieviruses;enteroviruses; HAV

Front 550

550. Non-enveloped, icosahedral ('Star of David') virus withlinear, positive-polarity, ss-RNA is

Back 550

noroviruses

Front 551

551. Enveloped, icosahedral virus with linear, positive-polarity,ss-RNA is

Back 551

HCV; dengue virus; yellowfever virus; West Nile virus;Japanese encephalitis virus

Front 552

552. Enveloped, icosahedral virus with linear, positive-polarity,ss-RNA is

Back 552

rubella virus; Eastern equineencephalitis (EEE) and WEEviruses

Front 553

553. Non-enveloped (“Rota” or wheel-shaped) icosahedral viruswith linear ds-RNA (10 segments) is

Back 553

rotaviruses

Front 554

554. Enveloped, helical virus with linear, negative polarity, ssRNA(8 segments) is

Back 554

influenza viruses types A, B,and C

Front 555

555. Enveloped, icosahedral virus with linear, positive-polarity,ss-RNA (diploid) is

Back 555

HIV-1 and 2; HTLV-1 and 2

Front 556

556. Enveloped, helical virus with linear, negative-polarity ssRNA(3 segments) is

Back 556

Hantaan (Sin Nombre) virus

Front 557

557. Enveloped (“crown”-shaped virus), helical virus with linear,positive-polarity, ss-RNA is

Back 557

SARS Corona virus type 4

Front 558

558. Enveloped (“bullet”-shaped virus), helical virus with linear,negative-polarity, ss-RNA is

Back 558

rabies virus

Front 559

559. Enveloped, complex virus with linear, negative-polarity, ssRNAis

Back 559

Marburg and Ebola viruses

Front 560

560. Enveloped (largest RNA viruses), helical virus with linear,negative-polarity, ss-RNA is

Back 560

Paraifluenza viruses, Mumps,Measles, RSV

Front 561

561. Outbreaks of Acinetobacter infections typically occur inintensive care units and healthcare settings housing:

Back 561

Very ill patients

Front 562

562. People with certain health conditions, like weakenedimmune systems or chronic lung diseases (particularly cysticfibrosis), may be more susceptible to infections with

Back 562

Burkholderia cepacia.

Front 563

563. Burkholderia cepacia bacteria are often resistant to

Back 563

common antibiotics

Front 564

564. Diarrhea and fever are the most common symptoms of

Back 564

Clostridium difficile infection

Front 565

565. The most important risk for getting Clostridiumdifficile infection in health-care settings is overuse of

Back 565

antibiotics

Front 566

566. A family of Gram-negative bacteria that are difficult to treathealth care-associated infections because they have high levels ofresistance to antibiotics.

Back 566

Carbapenem-resistantEnterobacteriaceae (CRE)

Front 567

567. Carbapenem-resistant Enterobacteriaceae are

Back 567

Klebsiella speciesand Escherichia coli

Front 568

568. Gram-negative bacteria cause pneumonia, bloodstreaminfections, wound or surgical site infections, and meningitis in

Back 568

healthcare settings

Front 569

569. In medical facilities, MRSA causes life-threateningbloodstream infections, pneumonia and

Back 569

surgical site infections

Front 570

570. Community-acquired CA-MRSA isolates contain thevirulence factor Panton-Valentine leukocidin (PVL) and carry

Back 570

staphylococcal cassettechromosome(SCC) mec genes

Front 571

571. Patients colonized (nare) with MRSA, in health-caresettings are advised to use chlorohexidine, gluconate scrub,povidone iodine, and

Back 571

mupirocin ointment for 5 days

Front 572

572. Products that are used to remove soil, dirt, dust, organicmatter, and germs (like bacteria, viruses, and fungi) are

Back 572

Cleaners or detergents

Front 573

573. Cleaners or detergents work by washing the surface to liftdirt and organisms off

Back 573

surfaces (so they can berinsed away with water)

Front 574

574. Products used to reduce organisms from surfaces but nottotally get rid of them (considered safe) are

Back 574

Sanitizers

Front 575

577. Chemical products that destroy or inactivate germs and preventthem from growing (also used after cleaning for surfaces thathave visible blood or drainage from infected skin) are

Back 575

Disinfectants

Front 576

578. Disinfectants are regulated by the

Back 576

Environmental ProtectionAgency (EPA).

Front 577

579.Pruritus is the most common symptom of head lice infestation andis caused by an allergic reaction to bites by

Back 577

Pediculus humanus capitis

Front 578

580.Lice infestations (pediculosis and pthiriasis) are spread mostcommonly by

Back 578

close person-to-person contact

Front 579

581.The life cycle of the head louse has three stages:

Back 579

egg,nymph, and adult

Front 580

582. Nits, heads lice eggs, are laid by the adult female and are cementedat the base of the

Back 580

hair shaft nearest the scalp

Front 581

583.The egg hatches to release a nymph. The nit shell then becomes amore visible dull yellow and remains attached to the

Back 581

hair shaft

Front 582

584. Nymphs mature after three molts and become adults about

Back 582

7 days after hatching

Front 583

585. The adult louse is tan to grayish-white, about the size of a sesame seed, and has legs numbering:

Back 583

6 (each with claws)

Front 584

586.Treatment for head lice is recommended for persons diagnosed with

Back 584

an active infestation

Front 585

587.Apply lice medicine, also called pediculicide, using prescription medication(s):

Back 585

Benzyl alcohol, 5% or ivermectin, 0.5% or malation,0.5% or spinosad 0.9%

Front 586

588.Body lice infestations (pediculosis) are spread most commonly by close person-to-person contact but are generally limited to persons who live under conditions of

Back 586

crowding and poor hygiene

Front 587

589.The only treatment needed for body lice infestations is

Back 587

Improved hygiene and regularchanges of clean clothes