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Dr. Mel - Microbiology > First Aid > Flashcards

Flashcards in First Aid Deck (222):
1

Triad of Rocky Mountain spotted fever

Headache
Fever
Rash (wrists, ankles then trunk, palms, soles) (vasculitis)

2

3 diseases with palms and soles rash

Coxsackievirus A
Rocky Mountain spotted fever
Secondary syphilis

3

Penicillin G (IV/IM) and Penicillin V (oral) used against

Gram +
Gram - cocci (N. meningitidis)
Spirochetes

4

Penicillinase-sensitive penicillins

Penicillin G, penicillin V
Ampicillin
Amoxicillin (greater oral bioavailability)

5

Ampicillin and amoxicillin used against

Many G- rods (HHEELPSS)

6

Penicillinase-resistant penicillins

Oxacillin
Nafcillin
Dicloxacillin

7

Penicillinase-resistant penicillins used against

S. aureus except MRSA

8

Antipseudomonal penicillins

Piperacillin
Ticarcillin

9

Antipseudomonal penicillins used against

Pseudomonas spp.
Gram - rods

10

Beta-lactamase inhibitors

Clavulanic acid
Sulbactam
Tazobactam

11

4 organisms not covered by 1-4th gen of Cephalosporins

Listeria
Atypicals (chlamydia, mycoplasma)
MRSA
Enterococci

12

1st gen Cephalosporins (cefazolin, cephalexin)

Gram + cocci
Proteus mirabilis
E. Coli
Klebsiella pneumoniae

13

2nd gen Cephalosporins (cefaclor, cefoxitin, cefuroxime)

Gram + cocci
H. Influenzae
Enterobacter aerogenes
Neisseria spp.
Serratia marcescens
Proteus mirabilis
E. Coli
Klebsiella pneumoniae

14

3rd gen cephalosporins (ceftriaxone, cefotaxime, ceftazidime)

Ceftriaxone: meningitidis, gonorrhea, disseminated Lyme ds
Ceftazidime: pseudomonas

15

4th gen cephalosporins (cefepime)

Gram -
Pseudomonas
Gram +

16

5th gen cephalosporins (ceftaroline)

Gram +
Gram -
MRSA
(NOT pseudo)

17

Carbapenems

Imipenem
Meropenem
Ertapenem
Doripenem

18

Carbapenems used against

Gram + cocci
Gram - rods
Anaerobes

19

Monobactams (Aztreonam) used against

Gram - rods ONLY
(If penicillin allergy or renal insuff who cannot tolerate aminoglycosides)

20

Vancomycin (glycopeptide)

Gram + ONLY
(Including MRSA, sensitive enterococcus, C. difficile)

21

Protein synthesis inhibitors

50S: chloramphenicol, clindamycin, linezolid, macrolides, streptogramins
30S: aminoglycosides, tetracyclines

22

Aminoglycosides

Gentamincin
Neomycin
Amikacin
Tobramycin
Streptomycin

23

Aminoglycosides used against

Severe Gram - rod infections

24

Tetracyclines

Tetracycline
Doxycycline
Minocycline

25

Tetracyclines used against

Borrelia burgdorferi
Mycoplasma pneumoniae
Rickettsia
Chlamydia

26

Chloramphenicol used against

Meningitis (H. Influenzae, Neisseria meningitidis, Strepto pneumoniae)
Rocky mountain spotted fever (Rickettsia rickettsii)

27

Clindamycin used against

Anaerobic infections (Bacteroides spp., Clostridium perfringens)
Invasive group A strepto infection

28

Clindamycin vs Metronidazole

Clindamycin: anaerobic infections above the diaphragm
Metronidazole: anaerobic infections below the diaphragm

29

Oxazolidinones (Linezolid) used against

Gram + (including MRSA and VRE)

30

Macrolides

Azithromycin
Clarithromycin
Erythromycin

31

Macrolides used against

Atypical pneumonias (Mycoplasma, Chlamydia, Legionella)
STIs (Chlamydia)
Gram + cocci (Strepto infections if allergy to penicillin)
Bordetella pertussis

32

Acid folic synthesis and reduction inhibitors

Sulfonamides (sulfamethoxazole, sulfisoxazole, sulfadiazine)
Trimethoprim

33

Sulfonamides used against

Gram +
Gram -
Nocardia
Chlamydia
Sulfamethoxazole for simple UTIs

34

Dapsone (similar to sulfonamides)

Leprosy
Pneumocystis jirovecii prophylaxis

35

Trimethoprim used against

Combined with SMX for:
UTIs
Shigella
Salmonella
Pneumocystis jirovecii
Pneumonia ttt and prophylaxis
Toxoplasmosis prophylaxis

36

Gyrase inhibitors

Fluoroquinolones (ciprofloxacin, norflo, levoflo, oflo, moxiflo, gemiflo, enoxacin)
Quinolone (Nalidixic acid)

37

Fluoroquinolones used against

Gram - rods of urinary and GI tracts (+ pseudomonas)
Neisseria
Some Gram +

38

Daptomycin used against

Staph aureus skin infections (+ MRSA)
Bacteremia
Endocarditis
VRE

39

Metronidazole used against

Giardia
Entamoeba
Trichomonas
Gardnerella vaginalis
Anaerobes (bacteroides, C. diff)
H. Pylori (with Clarithromycin + PPI)

40

Prophylaxis against Mycobacterium

M. Tuberculosis: Isoniazid
M. Avium and M. Intracellulare: azithromycin, rifabutin
M. Leprae: -

41

Mycobacterium treatments

M. Tuberculosis: Rifampin, Isoniazid, Pyrazinamide, Ethambutol
M. Avium - M. Intracellulare: Azithromycin or Clarithromycin + Ethambutol. Can add Rifabutin or Ciprofloxacin
M. Leprae: for tuberculoid, long-term Dapsone + Rifampin. For lepromatous, add Clofazimine

42

Rifamycins (mRNA synthesis inhibitors): Rifampin - Rifabutin
Used against

M. Tuberculosis
M. Leprae
Meningococcal prophylaxis
Chemoprophylaxis in contacts of children with H. Influenzae B

43

Isoniazid (mycolic acid synthesis inhibitor) used against

M. Tuberculosis (monotherapy for latent TB, monotherapy for prophylaxis, combined for treatment)

44

Treatments of MRSA, VRE, multidrug-resistant P. aeruginosa and multidrug-resistant Acinetobacter baumannii

MRSA: vancomycin, daptomycin, linezolid, tigecycline, ceftaroline
VRE: linezolid and streptogramins (quinupristin, dalfopristin)
MDR P. aeruginosa and MDR A. baumannii: polymyxins B and E (colistin)

45

Amphotericin B (acts on cell membrane integrity) used against

Serious, systemic mycoses
Cryptococcus
Blastomyces
Coccidioides
Histoplasma
Candida
Mucor

46

Nystatin (acts on cell membrane integrity)

Topical use only for diaper rash, vaginal candidiasis
For oral candidiasis

47

Flucytosine (nucleic acid synthesis inhibitor) used against

Systemic fungal infections with Amphotericin B (especially meningitis by Cryptococcus)

48

Azoles (ergosterol synthesis inhibitors)

Clotrimoxazole
Fluconazole
Itraconazole
Ketoconazole
Miconazole
Voriconazole

49

Azoles used against

Local and less serious systemic mycoses
Fluconazole: chronic suppression of cryptococcal meningitis in AIDS patients + candidal infections
Itraconazole: Blastomyces, coccidioides, histoplasma
Clotrimoxazole and Miconazole: topical infections

50

Terbinafine (lanosterol synthesis inhibitor) used against

Dermatophytoses (especially onychomycosis)

51

Echinocandins (cell wall synthesis inhibitors)

Anidulafungin
Caspofungin
Micafungin

52

Echinocandins used against

Invasive aspergillosis
Candida

53

Griseofulvin used against

Oral treatment of superficial infections
Inhibits growth of dermatophytes

54

Antiprotozoan therapy

Pyrimethamine (toxoplasmosis)
Suramin and melarsoprol (trypanosoma brucei)
Nifurtimox (T cruzi)
Sodium stibogluconate (leishmaniasis)

55

Anti-mite/louse therapy: for scabies (Sarcoptes scabei) and lice (Pediculus and Phthirus)

Permethrin
Malathion
Lindane

56

Chloroquine used against

Plasmodial species (other than P. falciparum)

P. falciparum: artemether/lumefantrine or atovaquone/proguanil

Life-threatening malaria: quinidine (quinine) or artesunate

57

Antihelminthic therapy

Mebendazole (microtubule inhibitor)
Pyrantel pamoate
Ivermectin
Diethylcarbamazine
Praziquantel

58

Neuraminidase inhibitors (inhibition of progeny virus release)

Oseltamivir
Zanamivir

59

Oseltamivir and zanamivir used against

Treatment and prevention of Influenza A and B

60

Nucleic acid synthesis inhibitors (antiviral): 3 mechanisms

Guanosine analogs (Acyclovir, Famciclovir, Valacyclovir and Ganciclovir)
Viral DNA polymerase inhibitors (Cidofovir, Foscarnet)
Guanine nucleotide synthesis (Ribavirin)

61

Acyclovir, Famciclovir, Valacyclovir used against

HSV
VZV
Weak activity against EBV
No effect on latent forms of HSV ans VZV
For herpes zoster: Famciclovir

62

Ganciclovir (Valganciclovir) used against

CMV

63

Foscarnet used against

CMV retinitis in immunocompromised patients when ganciclovir fails
Acyclovir-resistant HSV

64

Cidofovir used against

CMV retinitis in immunocompromised patients
Acyclovir-resistant HSV

65

Protein synthesis inhibitors (antiviral)

Interferon-alpha: against chronic HBV and HCV, Kaposi sarcoma, hairy cell leukemia, condyloma acuminatum, renal cell carcinoma, malignant melanoma
Interferon-beta: against multiple sclerosis
Interferon-gamma: chronic granulomatous disease

66

Uncoating inhibitors (antiviral)

Amantadine
Rimantadine
No longer used for Influenza (high resistance)

67

HIV therapy drugs

NRTIs
NNRTIs
Protease inhibitors
Integrase inhibitors
Fusion inhibitors (on attachment or penetration)

68

7 NRTIs

Abacavir (CI if HLA-B*5701 mutation)
Didanosine
Emtricitabine
Lamivudine
Stavudine
Tenofovir (nucleotide/ others nucleosides)
Zidovudine (for general prophylaxis and during pregnancy)

69

3 NNRTIs

Delavirdine (CI in pregnancy)
Efavirenz (!!! Vivid dreams and CNS symptoms) (CI in pregnancy)
Nevirapine

70

7 Protease inhibitors

Atazanavir
Darunavir
Fosamprenavir
Indinavir (!!! Nephropathy, hematuria)
Lopinavir
Ritonavir
Saquinavir

71

3 Integrase inhibitors

Raltegravir
Elvitegravir
Dolutegravir

72

2 Fusion inhibitors

Enfuvirtide (binds gp41, inhibits penetration) (! Skin reaction)
Maraviroc (binds CCR-5 on host cell, inhibits attachment)

73

Hepatitis C therapy: 3 drugs

Ribavirin: against chronic HCV, RSV (Palivizumab in children)
Sofosbuvir: against chronic HCV with Ribavirin +/- peginterferon alfa
Simeprevir: against chronic HCV with Ledipasvir

74

Giemsa stain (5 organisms)

Chlamydia
Borrelia
Rickettsia
Trypanosomes
Plasmodium

75

PAS stain (glycogen) (1 organism)

Trophyrema whipplei (Whipple ds)

76

Silver stain (3 organisms)

Fungi (Coccidioides, Pneumocystis jirovecii)
Legionella
Helicobacter pylori

77

Thayer-Martin agar (selective media)

Neisseria

Vancomycin (against G+)
Trimethoprim and Colistin (against G-)
Nystatin (fungi)

78

Mac-Conkey agar

Lactose-fermenting enterics (acid, pink)

79

Anaerobes

Nocardia
Pseudomonas aeruginosa
Mycobacterium tuberculosis

80

Anaerobes (lack catalase and/or superoxide dismutase)

Clostridium
Bacteroides
Fusobacterium
Actinomyces

81

3 obligate Intracellular bugs

Rickettsia
Chlamydia
Coxiella

82

8 facultative intracellular bugs

Salmonella
Neisseria
Brucella
Mycobacterium
Listeria
Francisella
Legionella
Yersinia pestis

83

7 encapsulated bacteria

Pseudomonas aeruginosa
Streptococcus pneumoniae
Haemophilus influenzae type B
Neisseria meningitidis
E. Coli
Salmonella
Group B Strep

84

2 pneumococcal vaccines

Pneumococcal conjugate vaccine (Prevnar)
Pneumococcal polysaccharide vaccine with no conjugated protein (Pneumovax)

85

8 urease-positive organisms (struvite stones)

Proteus
Cryptococcus
H. Pylori
Ureaplasma
Nocardia
Klebsiella
Staph epidermidis
Staph saprophyticus

86

10 catalase-positive organisms

Nocardia
Pseudomonas
Listeria
Aspergillus
Candida
E. Coli
Staphylococci
Serratia
B. Cepacia
H. Pylori

87

Chronic granulomatous disease (NADPH oxidase deficiency) recurrent infections with

Catalase-positive organisms

88

In vivo biofilm-producing bacteria
1- Catheter + prosthetic devices
2- Dental plaques + infective endocarditis
3- Respiratory tree colonization in Cystic fibrosis + Contact lens
4- Otitis media

1- Staph epidermidis
2- Strepto viridans (mutans, sanguinis)
3- Pseudomonas aeruginosa
4- Nontypeable (unencapsulated) H. Influenza

89

1- Protein A
2- IgA protease
3- M protein

1- prevents opsonization + phagocytosis (Staph Aureus)
2- colonizes respiratory mucosa (Strep pneumo, H influenzae type B, Neisseria)
3- prevents phagocytosis (group A Streptococci)

90

6 spore-forming bacteria

Bacillus anthracis
Bacillus cereus
Clostridium botulinum
Clostridium difficile
Clostridium perfringens
Clostridium tetani

91

6 functions of exotoxins

1- Inhibit protein synthesis (4)
2- Increase fluid secretion (3)
3- Inhibit phagocytic ability (1)
4- Inhibit release of neurotransmitter (2)
5- Lyse cell membrane (2)
6- Superantigens causing shock (2)

92

4 bugs with exotoxins that inhibit protein synthesis

Corynebacterium diphteriae (Diphtheria toxin: EF-2)
Pseudomonas aeruginosa (Exotoxin A: EF-2)
Shigella spp. (Shiga toxin: 60S)
Enterohemorrhagic E. coli (Shiga-like toxin: 60S)

93

3 bugs with exotoxins that increase fluid secretion

Enterotoxigenic E. coli (Heat-labile toxin: cAMP / Heat-stable toxin: cGMP)
Bacillus anthracis (Edema toxin: cAMP)
Vibrio cholerae (Cholera toxin: cAMP)

94

1 bug with exotoxin that inhibits phagocytic ability

Bordetella pertussis (Pertussis toxin: cAMP)

95

2 bugs with exotoxins that inhibit release of neurotransmitter

Clostridium tetani (Tetanospasin: SNARE)
Clostridium botulinum (Botulinum toxin: SNARE)

96

2 bugs with exotoxins that lyse cell membranes

Clostridium perfringens (Alpha toxin: lecithinase)
Streptococcus pyogenes (Streptolysin O: protein lyses RBCs)

97

2 bugs with exotoxins / superantigens causing shock

Staphylococcus aureus (Toxic shock syndrome toxin: binds to MHCII/TCR, releases IL1 IL2 IFNg TNFa)
Streptococcus pyogenes (Exotoxin A: binds to MHCII/TCR, releases IL1 IL2 IFNg TNFa)

98

3 main effects of endotoxin

Macrophage activation (TLR4)
Complement activation
Tissue factor activation

99

Only bacterium with a polypeptide capsule (D-glutamate)

Bacillus anthracis

100

Treatment of Clostridium tetani infection

Antitoxin +/- vaccine booster
Diazepam
Wound debridement

Prevention with tetanus vaccine (inactivated bacterial toxoid)

101

Treatment of Clostridium botulinum infection

Antitoxin

102

Treatment of Pseudomembranous colitis

Metronidazole or Oral Vancomycin
If recurrent: repeat ttt or Fidaxomicin or Fecal microbiota transplant

103

Treatment of Corynebacterium diphtheriae

1- Diphtheria antitoxin (passive immunization)
2- Penicillin or Erythromycin
3- DPT vaccine (active immunization)

104

Treatment of Tuberculoid form of Leprosy

Dapsone + Rifampin

105

Treatment of Lepromatous form of Leprosy

Dapsone + Rifampin + Clofazimine

106

Treatment of N. gonorrhoeae infection

Ceftriaxone
+/- Azithromycin or Doxycycline (for possible Chlamydia coinf.)

107

Treatment of N. meningitidis infection

Ceftriaxone or Penicillin G

108

Treatment of H. Influenzae infection

Mucosal inf: Amoxicillin +/- clavulanate
Meningitis: Ceftriaxone
Prophylaxis for close contacts: Rifampin

109

Difference between EHEC and other forms of E. coli

EHEC does not ferment sorbitol

110

Treatment of typhoid fever

Ceftriaxone or Fluoroquinolone

111

Gram - rod that is triple +

Helicobacter pylori
Catalase +
Oxidase +
Urease +

112

Initial treatment of H. pylori

Triple therapy: Amoxicillin (metronidazole if allergy) + Clarithromycin + PPI

113

Prevention of congenital syphilis

Treat mother early in pregnancy (placental transmission after first trimester)

114

4 cases of VDRL false positives

Viral infections (EBV, hepatitis)
Drugs
Rheumatic fever
Lupus / Leprosy

115

Treatment of Rickettsial diseases and vector-borne illnesses

Doxycycline

116

Infection where rash spares palms and soles

Rickettsia typhi (endemic)
Rickettsia prowazekii (epidemic)

117

4 symptoms of Chlamydia trachomatis infection + treatment

Reactive arthritis (Reiter syndrome)
Follicular conjunctivitis
Nongonococcal urethritis
PID

Azithromycin (one-time) or Doxycyclin

118

Cold agglutinins (IgM) seen in 3 conditions

EBV infection
Mycoplasma pneumoniae infection
Hematologic malignancies

119

Treatment of Mycoplasma pneumoniae infection

Macrolides, Doxycyclin or Fluoroquinolone

120

Treatment for systemic mycoses

Fluconazole or Itraconazole (local infection)
Amphotericin B (systemic infection)

121

Treatment of Pityriasis versicolor infection

Selenium sulfide
Topical and/or oral antifungal medications

122

Treatment of candida albicans infection

Topical azole (vaginal)
Nystatin, Fluconazole or Caspofungin (oral/esophageal)
Fluconazole, Caspofungin, Amphotericin B (systemic)

123

3 presentations of Cryptococcal infection

Cryptococcosis (lung ds)
Meningitis
Encephalitis

124

Treatment + prophylaxis of Cryptococcal infection

Amphotericin B + Flucytosine (acute meningitis)

Fluconazole for lifelong prophylaxis

125

Treatment of Mucor/Rhizopus infection

Surgical debridement
Amphotericin B

126

Treatment and prophylaxis of Pneumocystis jirovecii

TMP-SMX
Pentamidine
Atovaquone

Dapsone (when CD4+ <200 in HIV ptts)

127

2 clinical presentations of Sporothrix schenckii

Local pustule or ulcer + nodules in ascending lymphangitis
Disseminated disease in immunocompromised

128

Treatment of sporotrichosis (Sporothrix schenckii)

Itraconazole or Potassium iodide

129

Triad of congenital toxoplasmosis

Chorioretinitis
Hydrocephalus
Intracranial calcifications

130

Treatment of Toxoplasma gondii infection

Sulfadiazine + Pyrimethamine + Leucovorin
Or
Pyrimethamine + Clindamycin (if sulfa hypersensitivity)

131

Treatment of Trypanosoma brucei infection

Suramin (blood-borne ds)
Melarsoprol (CNS penetration)

132

Treatment of Plasmodium infections

Sensitive: Chloroquine
Resistant: Mefloquine or Atovaquone/Proguanil
Life-threatening: IV Quinidine or Artesunate
For P. vivax/ovale: add Primaquine for hypnozoite

133

Treatment of Babesia infection

Atovaquone + Azithromycin

134

Treatment of Trypanosoma cruzi infection (Chagas)

Benznidazole or Nifurtimox

135

Treatment of Leishmania donovani infection

Amphotericin B
Sodium stibogluconate

136

Treatment of Trichomonas vaginalis

Metronidazole for patient and partner

137

Transmission + Treatment of Enterobius, Ascaris, Toxocara, Trichinella

Fecal-oral

Bendazoles

138

Treatment of Strongyloides stercoralis

Ivermectin or Bendazoles

139

Treatment of Ancylostoma and Necator

Bendazoles or Pyrantel pamoate

140

Treatment of Onchocerca volvulus

Ivermectin

141

Treatment of Loa loa and Wuchereria bancrofti

Diethylcarbamazine

142

3 presentations and treatment of Taenia solium

Intestinal tapeworm (Praziquantel)
Cysticercosis (Praziquantel)
Neurocysticercosis (Albendazole)

143

Presentation + Treatment of Diphyllobothrium latum

Megaloblastic anemia

Praziquantel

144

Presentation + Treatment of Echinococcus granulosus

Hydatid cyst in liver

Albendazole

145

Presentation + Treatment of Schistosoma

S. mansoni (lateral spine): fibrosis, inflammation and enlargement of liver and spleen
S. haematobium (terminal spine): chronically, squamous cell carcinoma of bladder + pulmonary HTN

Praziquantel

146

Presentation + Treatment of Clonorchis sinensis

Pigmented gallstones
Ass. w/ cholangiocarcinoma

Praziquantel

147

Treatment of Sarcoptes scabiei

Permethrin cream
Washing/drying all clothing/bedding
Treat close contacts

148

Treatment of Lice (Pediculus humanus/Phthirus pubis)

Pyrethroids, Malathion or Ivermectin lotion
Nit combing
Head lice treated at home

149

9 live attenuated vaccines

Smallpox
Yellow fever
Rotavirus
Chickenpox (VZV)
Sabin polio (oral)
MMR
Influenza (intranasal)

150

4 killed/inactivated vaccines

Rabies
Influenza (injected)
Salk polio (injected)
HAV

151

7 positive-stranded RNA viruses

Retrovirus
Togavirus
Flavivirus
Coronavirus
Hepevirus
Calicivirus
Picornavirus

152

4 naked DNA and 4 naked RNA viruses

Papillomavirus
Adenovirus
Parvovirus
Polyomavirus

Calicivirus
Picornavirus
Reovirus
Hepevirus

153

3 diseases from Poxvirus infection

Smallpox (eradicated by vaccine)
Cowpox (milkmaid blisters)
Molluscum contagiosum (papule w/ central umbilication)

154

Presentation + characteristic of Hepadnavirus

HBV:
Acute or chronic hepatitis B
Has reverse transcriptase (even if Not retrovirus)

155

4 presentations of Adenovirus infection

Febrile pharyngitis
Acute hemorrhagic cystitis
Pneumonia
Conjunctivitis

156

3 presentations of Papillomavirus

HPV:
Warts = Condyloma acuminata (serotypes 1, 2, 6, 11)
Cervical intraepithelial neoplasia
Cervical cancer (serotypes 16, 18)

157

2 viruses + presentations of Polyomavirus

JC virus: progressive multifocal leukoencephalopathy in HIV
BK virus: transplant patients, targets kidney

158

4 presentations of Parvovirus infection

B19:
Aplastic crises in Sicke cell ds
Erythema infectiosum = fifth ds (children)
Hydrops fetalis + death (fetus)
RBC aplasia + rheumatoid arthritis-like symptoms (adults)

159

5 presentations of HSV-1

Gingivostomatitis
Keratoconjunctivitis
Herpes labialis
Herpetic whitlow on finger
Temporal lobe encephalitis

160

3 presentations of HSV-2

Herpes genitalis
Neonatal herpes
Meningitis (> HSV-1)

161

4 presentations of HHV-3 (VZV)

Varicella (chickenpox)
Zoster (shingles)
Encephalitis
Pneumonia

162

Presentation + 2 associations of HHV-4 (EBV) infection

Mononucleosis w/ positive monospot test
Ass w/ lymphomas and nasopharyngeal carcinoma

163

4 presentation of HHV-5 (CMV) infection

Immunocompetent: mononucleosis w/ negative monospot test
Immunocompromised: many infections esp. pneumonia in transplant ptt
AIDS: retinitis
Congenital CMV

164

Presentation of HHV-6 and HHV-7 infections

Roseola infantum (exanthem subitum): high fevers several days then diffuse macular rash (trunk then extremities)
HHV-6 > HHV-7

165

Presentation of HHV-8 infection

Kaposi sarcoma (in HIV/AIDS and transplant ptt)

166

2 Reoviruses + presentations

Coltivirus: Colorado tick fever
Rotavirus: #1 fatal diarrhea in children

167

5 Picornaviruses + presentation

Poliovirus
Echovirus: aseptic meningitis
Rhinovirus: "common cold"
Coxsackievirus: 5 diseases
HAV: acute viral hepatitis

168

5 diseases of Coxsackievirus

Aseptic meningitis
Herpangina (mouth blisters + fever)
Hand + foot + mouth ds
Myocarditis
Pericarditis

169

1 Hepevirus

HEV

170

1 Calicivirus + presentation

Norovirus: viral gastroenteritis

171

5 presentations of Flaviviruses

HCV
Yellow fever
Dengue
St. Louis encephalitis
West Nile virus

172

3 presentations of Togaviruses

Rubella
Eastern equine encephalitis
Western equine encephalitis

173

2 Retroviruses + presentations

HTLV: T-cell leukemia
HIV: AIDS

174

3 presentations of Coronaviruses

"Common cold"
SARS (Sudden Acute Respiratory Syndrome)
MERS (Middle East Respiratory Syndrome)

175

1 Orthomyxovirus

Influenza virus

176

4 Paramyxoviruses + presentations

Parainfluenza: croup
RSV: bronchiolitis (babies) (ttt: Ribavirin) (prevention in premature infants: Palivizumab)
Measles
Mumps

177

1 Rhabdovirus

Rabies

178

1 Filovirus

Ebola/Marburg hemorrhagic fever

179

2 Arenaviruses + presentations

LCMV (Lymphocytic ChorioMeningitis Virus)
Lassa fever encephalitis

180

4 Bunyaviruses + presentations

California encephalitis
Sandfly/Rift Valley fevers
Crimean-Congo hemorrhagic fever
Hantavirus: hemorrhagic fever, pneumonia

181

1 Deltavirus

HDV

182

All Picornaviruses are enteroviruses except 1 Acid-labile

Rhinovirus

183

3 characteristics + 4 symptoms of Yellow fever virus

Flavivirus
Aedes mosquitoes
Monkey + human reservoir

High fever
Black vomitus
Jaundice
Councilman bodies on liver biopsy

184

3 characteristics of Rotavirus

#1 infantile gastroenteritis (day care centers, kindergartens)
Villous destruction + atrophy (loss of Na+ and K+)
Routine vaccination of all infants

185

5 characteristics of Influenza viruses

Hemagglutinin Ag + Neuraminidase Ag
Bacterial superinfection: S. aureus, s. pneumoniae, H. influenzae
Reformulated vaccine (season) - rapid genetic change
Killed vaccine (frequently used)
Live attenuated vaccine (intranasally)

186

4 symptoms of Rubella + 5 of Congenital rubella

Fever, postauricular + other lymphadenopathy, arthralgias, fine rash on face then trunk + extremities

Blueberry muffin rash (dermal extramedullary hematopoiesis), deafness, cataracts, cardiac defects (PDA), microcephaly/mental retardation

187

6 characteristics of Croup

Parainfluenza virus
Barking cough
Inspiratory stridor
Narrowing of upper trachea + subglottis
Steeple sign on XRay
If severe, pulsus paradoxus

188

6 symptoms + 3 complications + reduction of morbi/morta of Measles

Prodromal fever, cough, coryza, conjunctivitis, Koplik spots, maculopapular rash (1-2 days later): head/neck then downward

SSPE (years later), encephalitis, giant cell pneumonia (immunodepressed)

Vitamin A supplementation

189

4 symptoms + 1 complication of Mumps

Parotitis, orchitis, aseptic meningitis, pancreatitis

Sterility

190

4 findings + 7 symptoms of Rabies

Negri bodies
Long incubation period
Travels to CNS (retrograde) then to salivary glands
Postexposure prophylaxis: wound cleaning + killed vaccine + Ig

Fever, agitation, hydrophobia, photophobia, hypersalivation, ascending flaccid paralysis, coma (then death)

191

8 findings in Ebola virus infection

Endothelial cells, phagocytes, hepatocytes
Incubation period of 21 days
Abrupt flu-like sympt., diarrhea, vomiting, high fever, myalgia
Progression: DIC, diffuse hge, shock
Dg: RO-PCR in 48h of sympt.
Supportive care
Strict isolation
High mortality

192

4 general findings in Hepatitis viruses

Fever, jaundice, high ALT and AST
Naked (HAV + HEV) not destroyed by gut
HBV DNA-polymerase has DNA+RNA dependent activities
HCV lacks 3'-5' exonuclease (variation in antigenic env prot)

193

5 differential diagnosis for HIV brain lesions w/ ring enhancing on head MRI

1- Cerebral toxoplasmosis
2- CNS lymphoma
3- Primary brain tumors (glioblastoma multiforme)
4- Metastatic carcinoma
5- Fungal or bacterial abscesses

194

4 stages of untreated HIV infection

1- Acute, flu-like syndrome
2- Clinical latency (replication in lymph nodes)
3- Constitutinal symptoms (falling count) - CD4+<400
4- Opportunistic diseases (final crisis) - CD4+<200

195

3 diseases w/ elevated risk when CD4+ count diminishes in HIV

Reactivation of past infections (TB, HSV, shingles)
Dissemination of bacterial + fungal infections
Non-Hogdkin lymphomas

196

6 infections in HIV when CD4+<500

Candida albicans (oral thrush)
EBV (oral hairy leukoplakia)
Bartonella henselae (bacillary angiomatosis)
HHV-8 (Kaposi sarcoma)
Cryptosporidium spp. (chronic, watery diarrhea)
HPV (squamous cell carcinoma)

197

3 infections in HIV w/ CD4+<200

HIV (dementia)
JC (reactivation: PML)
Pneumocystis jirovecii (pneumocystis pneumonia)

198

8 infections in HIV w/ CD4+<100

Aspergillus fum. (hemoptysis, pleuritic pain)
Cryptococcus neof. (meningitis)
Candida alb. (esophagitis)
CMV (retinitis, esophagitis, colitis, pneumonitis, encephalitis)
EBV (B-cell lymphoma)
Histoplasma caps. (F*, weight loss, fatigue, cough, dyspnea, N/V, diarrhea)
Mycobacterium av.-intrac. (systemic sympt./focal lymphadenitis)
Toxoplasma gondii (brain abscesses)

199

4 symptoms + 3 diseases of Prions

Spongiform encephalopathy
Dementia
Ataxia
Death

Creutzfeldt-Jacob ds (rapidly prog., sporadic, rarely familial)
Bovine spongiform encephalopathy
Kuru (acquired, in human cannibalism)

200

Food poisoning that starts quickly + ends quickly

S. aureus
B. Cereus

201

7 bugs causing bloody diarrhea

Campylobacter
E. histolytica
Enterohemorrhagic E. coli
Enteroinvasive E. coli
Salmonella
Shigella
Y. enterocolitica

202

6 bugs causing watery diarrhea

C. difficile
C. perfringens
Enterotoxigenic E. coli
Protozoa (Giardia, Cryptosporidium)
V. cholerae
Viruses (Rotavirus, Norovirus, Adenovirus)

203

Causes of pneumonia in alcoholics, IV drug users, aspiration

Alcoholics: Klebsiella, anaerobes (peptostreptococcus, fusobacterium, prevotella, bacteroides)

IV drug: S. pneumoniae, S. aureus

Aspiration: anaerobes

204

Causes of atypical pneumonia and pneumonia in cystic fibrosis

Atypical: Mycoplasma, Legionella, Chlamydia

Cystic fibrosis: Pseudomonas, S. aureus, S. pneumoniae, Burkholderia cepacia

205

Causes of pneumonia in immunocompromised, nosocomial, postviral

I.compromised: S. aureus, enteric gram - rods, fungi, viruses, P. jirovecii (HIV)

Nosocomial: S. aureus, Pseudomonas, enteric gram - rods

Postviral: S. pneumoniae, S. aureus, H. influenzae

206

Most common causes of meningitis according to age + ttt

0-6 mo: group B Strep, E coli, Listeria
6 mo - 60 yo: S pneumo, N meningitidis
Teens: N meningitidis

Ceftriaxone + Vancomycin (empirically)
Add Ampicillin (if Listeria suspected)

207

Causes of osteomyelitis

S aureus
Sickle cell ds: Salmonella, S aureus
Prosthetic joint: S aureus, S epidermidis
Vertebral: S aureus, Mycobacterium tuberculosis
IV drug: Pseudomonas, Candida, S aureus
Sexually active: N gonorrhoeae (septic arthritis)

208

3 leading causes of UTI

E coli
Staph saprophyticus
Klebsiella pneumo

209

3 vaginal infections

Bacterial vaginosis (Gardnerella vaginalis)
Trichomonas vaginitis (Trichomonas vaginalis)
Candida vulvovaginitis (Candida albicans)

210

5 characteristics of Bacterial vaginosis

No inflammation
Thin, white discharge + pruritus
Fishy odor
Clue cells / Whiff test +
Ttt: Metronidazole or Clindamycin

211

4 characteristics of Trichomonas vaginitis

Inflammation (strawberry cervix)
Yellow-green, foul-smelling discharge
Motile trichomonads
Ttt: Metronidazole + ttt partner

212

5 characteristics of Candida vulvovaginitis

Inflammation
Thick, white discharge
Pruritus + erythema
Pseudohyphae
Ttt: Fluconazole

213

3 findings in ToRSHeS infections

Toxoplasma g, Rubella, CMV, HIV, HSV-2, Syphilis
Transplacental (or via delivery for HSV-2)
Hepatosplenomegaly, jaundice, thrombocytopenia, growth retardation

214

Maternal transm., maternal manif., neonatal manif. for Toxoplasma gondii

Cat feces / undercooked meat

Asymptomatic / rarely lymphadenopathy

Triad: chorioretinitis, hydrocephalus, intracranial calcifications
+/- blueberry muffin rash

215

Maternal transm., maternal manif., neonatal manif. for Rubella

Respiratory droplets

Rash, lymphadenopathy, polyarthritis, polyarthralgia

Triad: cataract, deafness, PDA
+/- blueberry muffin rash

216

Maternal transm., maternal manif., neonatal manif. for CMV

Sexual contact / organ transplant

Asymptomatic / mononucleosis-like illness

Hearing loss, seizures, petechial rash, periventricular calcifications, blueberry muffin rash

217

Maternal transm., maternal manif., neonatal manif. for HIV

Sexual contact / needlestick

Presentation depending on CD4+ count

Recurrent infections, chronic diarrhea

218

Maternal transm., maternal manif., neonatal manif. for HSV-2

Skin-mucous membrane contact

Asymptomatic / herpetic lesions

Encephalitis, herpetic lesions

219

Maternal transm., maternal manif., neonatal manif. for Syphilis

Sexual contact

Chancre (1*), disseminated rash (2*)

Stillbirth, hydrops fetalis
If child survives: facial abnl (notched teeth, saddle nose, short maxilla), saber shins, CN VIII deafness

220

7 Red rashes of childhood

Coxsackievirus A (Hand-foot-mouth ds)
HHV-6 (Roseola)
Measles virus (Rubeola)
Parvovirus B19 (Erythema infectiosum)
Rubella virus (Rubella)
Streptococcus pyogenes (Scarlet fever)
VZV (Chickenpox)

221

6 genital lesions sexually transmitted

Chancroid - Haemophilus ducreyi (painful ulcer w/ exudate + inguinal adenopathy)
Condylomata acuminata - HPV-6/11 (genital warts)
Genital herpes (painful vesicles/ulcers)
Lymphogranuloma venerum - Chlamydia trachomatis L1-L3 (painless genital ulcers + painful lymphadenopathy)
1* syphilis (painless chancre)
2* syphilis (condylomata lata)

222

Causes + signs/symptoms + complications of PID

Chlamydia trachomatis (subacute)
Neisseria gonorrhoeae (acute)

Cervical tenderness, purulent discharge
Salpingitis, endometritis, hydrosalpinx, tubo-ovarian abscess

Salpingitis (ectopic pregnancy, infertility, chronic pelvic pain, adhesions)
Fitz-Hugh-Curtis sd