Infectious Diseases COPY Flashcards

1
Q

Criteria for Fever of Unknown Origin (FUO)

A

rectal T ≥ 38° C
cause could not be identified
3 weeks - OPD
1 week - hospital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

FUO in Neonates

A

7% risk of having serious bacterial infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

FUO at 1-3 mos.

A

pyelonephritis - most common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

FUO at 3 mos. - 3 y.o.

A

viral infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

_____ are connective tissue diseases most commonly associated with FUO.

A

JIA, SLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Empirical treatment for FUO should be avoided except in _____.

A

anti-TB drugs for the critically ill

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

_____ is an aerobic, G (+), coagulase (+) bacteria that grows in pairs or clusters.

A

Staphylococcus aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

_____ is the most common cause of pyogenic infection of the skin and soft tissue

A

S. aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Adhesion of S. aureus to mucosal cells is mediated by _____ in the cell wall.

A

teichoic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Staphylococci produce a _____ which may interfere with opsonophagocytosis.

A

slime layer

loose polysaccharide capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

_____ is present in S. aureus and absorbs serum Ig, preventing antibacterial antibodies from acting as opsonins.

A

Protein A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Enzymes Elaborated by Staphylococci

A

catalase

penicillinase or β-lactamase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

_____ is a protein than S. aureus combines with phospholipid in the leukocytic cell membrane, producing increased permeability and eventual death of the cell.

A

Panton-Valentine Leukocidin (PVL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

S. aureus with _____ is associated with more severe and invasive skin disease, pneumonia and osteomyelitis.

A

Panton-Valentine Leukocidin (PVL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

_____ in S. aureus produce dermatologic manifestations by splitting the desmosome and altering the intracellular matrix in the stratum granulosum.

A

Exfoliatins A and B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

S. aureus can produce _____ distinct enterotoxins.

A

≥ 20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

_____ are the most common causes of food poisoning from S. aureus.

A

Enterotoxin A and B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

_____ is associated with TSS related to menstruation and focal staphylococcal infection.

A

Toxic Shock Syndrome Toxin 1 (TSST-1)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

_____ is a superantigen from S. aureus that induces the production of IL-1 and TNF, resulting in hypotension, fever and multisystem involvement.

A

Toxic Shock Syndrome Toxin 1 (TSST-1)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

An altered _____ is responsible for the methicillin resistance of MRSA isolates.

A

PBP-2A

protein binding proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

_____ that complicates viral croup may be caused by S. aureus.

A

Membranous Tracheitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

S. aureus often causes _____ that may be associated with empyem, pneumatocoeles, pyopneumothorax and bronchopleural fistulas.

A

necrotizing pneumonitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Localized staphylococcal abscesses in muscle is called _____.

A

pyomyositis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

_____ is the most common cause of osteomyelitis and suppurative arthritis in children.

A

S. aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

_____ is an acute and potentially severe illness caharcterized by fever, hypotension, erythematous rash with dezquamation of the hands and feet, vomiting, diarrhea, neurologic abnormalities, myalgia, conjuctival hyperemia, and strawberry tongue.

A

Toxic Shock Syndrome (TSS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

TSS occurs most commonly in _____

A

menstruating women 15-25 y.o.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Diagnostic Criteria of Staphylococcal TSS

A

Major Criteria (all are required)

  • acute fever (> 38.8°C)
  • hypotension
  • rash (erythroderma with convalescent desquamation)

Minor Criteria (≥ 3)

  • thrombocytopenia (≤ 100,000)
  • mucus membrane inflammation
  • vomiting, diarrhea
  • liver abnormalities
  • renal abnormalities
  • muscle abnormalities
  • CNS abnormalities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q
Diagnostic Criteria of Staphylococcal TSS:
Major Criteria (all are required)
A

acute fever (> 38.8°C)
hypotension
rash (erythroderma with convalescent desquamation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q
Diagnostic Criteria of Staphylococcal TSS:
Minor Criteria (≥ 3)
A
thrombocytopenia (≤ 100,000)
mucus membrane inflammation
vomiting, diarrhea
liver abnormalities
renal abnormalities
muscle abnormalities
CNS abnormalities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Toxic Shock Syndrome (TSS) Treatment

A

β-lactamase-resistant antistaphylococcal antibiotic (Nafcillin, Oxacillin, 1st generation Cephalosporin)
Vancomycin (MRSA)
Clindamycin (reduces toxin production)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

_____ infections are common in patients with indwelling foreign devices.

A

Coagulase Negative Staphylococci (CoNS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

_____ are the most common cause of nosocomial infection, especially in NICU.

A

CoNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

_____ is the most common and persistent species of CoNS.

A

S. epidermidis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

CoNS, specifically S. epidermidis, are the most common cause of nosocomial bacteremia associated with _____.

A

central venous catheter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

CoNS is a common cause of _____ endocarditis.

A

prosthetic valve.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

_____ is the most common pathogen found in CSF shunt meningitis.

A

CoNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

_____ is a common cause of primary UTI in sexually active females.

A

S. saprophyticus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

True bacteremia with CoNS is considered when there is _____.

A

growth within 24 hours
≥ 2 cultures with same strain
both peripheral and line sites are (+)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Most CoNS strains are resistant to _____.

A

Methicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

_____ is a G (+), lancet-shaped, bile soluble, optochin sensitive, polysaccharide encapsulated diplococcus, occurring as individual cocci or in chains.

A

Streptococcus pneumoniae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

_____ is the most common cause of bacteremia, bacterial pneumonia, otitis media and bacterial meningitis in children.

A

S. pneumoniae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Encapsulated strains cause most serious diseases because _____ impede phagocytosis.

A

capsular polysaccharides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

S. pneumoniae is a common cause of secondary bacterial pneumonia in children with _____.

A

influenza

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Patients with _____ are susceptible to encapsulated organisms because of deficient opsonization and clearance of bacteria.

A

asplenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

A _____ should be performed when a pneumococcus is resistant to Erythromycin but sensitive to Clindamycin.

A

D-test

induce Clindamycin resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Immunologic responsiveness and efficacy following administration of pneumococcal polysaccharide vaccines is unpredicaatable in children _____.

A

< 2 y.o.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

_____ prophylaxis is recommended for children at high risk of invasive pneumococcal disease, including children with asplenia or sickle cell disease.

A

Penicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Group A Streptococcus (GAS) is also known as _____.

A

Streptococcus pyogenes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

_____ causes distinct clinical entities such as scarlet fever and erysipelas.

A

S. pyogenes (GAS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

S. pyogenes (GAS) causes 2 nonsuppurative complications:

A

Rheumatic Fever

Acute Glomerulonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

_____ are G (+) coccoid-shaped bacteria that grow in chains.

A

S. pyogenes (GAS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Virulence of S. pyogenes (GAS) depends on the _____ which resists phagocytosis.

A

M protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Streptococcal pyoderma occurs most frequently in _____ temperatures.

A

warmer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Streptococcal _____ are responsible for the rash of scarlet fever.

A

pyrogenic exotoxins A, B and C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

_____ is an URTI associated with a characteristic rash which begins around the neck and spreads over the trunk and extremities.

A

Scarlet Fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

The rash of scarlet fever appears within _____ after onset of symptoms.

A

24-48 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

After _____, the rash of scarlet fever begins to fade and is followed by desquamation starting with the _____.

A

3-4 days

face progressing to the trunk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

A diffuse, finely papular rash with erythematous eruption which blanches on pressure is characteristic of _____.

A

Scarlet Fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

A _____ tongue is usually seen in Scarlet Fever.

A

strawberry tongue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

_____ is a GAS infection which involves the deeper layer of skin and connective tissue with a sharply defined slightly elevated border.

A

Erysipelas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

The gold standard for the confirmation of GAS pharyngitis is _____.

A

throat swab culture on a sheep blood agar plate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

S. pyogenes (GAS) is very sensitive to _____.

A

Penicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

_____ is a superficial S. pyogenes (GAS) skin infection that appears as an erythematous papulovesicular lesion which becomes purulent and covered with an amber-colored crust which appears to be stuck onto the skin.

A

Non-bullous Impetigo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

_____ is a S. pyogenes (GAS) skin infection with flaccid, transparent bullae < 3 cm in diameter.

A

Bullous Impetigo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

S. pyogenes (GAS) is a common cause of vaginitis in _____.

A

prepubertal girls

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Criteria for Streptococcal TSS

A

Hypotension plus ≥ 2 of the ff.:

  • renal impairment
  • coagulopathy
  • hepatic involvement
  • adult respiratory distress syndrome
  • generalized erythematous macular rash
  • soft-tissue necrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Severe Invasive GAS Infections

A

Streptococcal TSS

Necrotizing Fasciitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

_____ is characterzized by the onset of acute arthritis following an episode of GAS pharyngitis in a patient whose illness does not fulfill the Jones criteria.

A

Poststreptococcal Reactive Arthritis (PSRA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

_____ is a group of neuropsychiatric disorders (OCD, tic disorder, Tourette Syndrome) for which a possible relationship with GAS infections has been hypothesized.

A

Pediatric Autoimmune Neuropsychiatric Disorders Associated with S. Pyogenes (PANDAS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

When therapy against GAS is given within _____ of onset, acute rheumatic fever is prevented.

A

9 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

_____ is the most common form of acquired heart disease.

A

Rheumatic Heart Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

_____ is most closely associated with the incidence of acute rheumatic fever.

A

Crowding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

A property of GAS that has been associated with rheumatogenicity is the formation of _____.

A

highly mucoid colonies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Children _____ are at greatest risk for GAS pharyngitis.

A

5-15 y.o.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Cytotoxic Theory of the Pathogenesis of ARF and RHD

A
GAS toxin
Streptolysin O (direct cytotoxic effect on cells)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Immunologic Theory of the Pathogenesis of ARF and RHD

A

common antigenic determinants shared between GAS and mammalian tissue (M protein ↔ tropomyosin, myosin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Criteria for Acute Rheumatic Fever

A
Jones Criteria
5 Major Criteria
 - migratory polyarthritis
 - carditis
 - subcutaneous nodules
 - erythema marginatum
 - Sydenham chorea

4 Minor Criteria

  • arthralgia
  • fever
  • elevated ESR and CRP
  • prolonged PR interval

*2 major, 1 major + 2 minor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

_____ is the most serious manifestation of ARF.

A

Carditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

_____ is a universal finding in ARF.

A

Endocarditis (Valvulitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

_____ is the earliest manifestation of ARF and has an inverse relationship with the severity of cardiac involvement.

A

Migratory Polyarthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

In ARF< there is a correlation between the presence of subcutaneous nodules and significant _____.

A

Rheumatic Heart Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Clinical Maneuvers for Chorea

A
  • Milkmaid’s Grip (irregular contractions while squeezing examiner’s hand)
  • spooning and pronation of hands when extended
  • wormian darting movements of tongue on protrusion
  • handwriting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Absolute Requirements for Evidence of GAS Infection

A

(+) throat culture or rapid streprococcal antigen test

elevated or increasing streptococcal antibody titer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

ARF without adherence to Jones Criteria can be made when there is _____

A

Chorea as the only manifestation
Indolent Carditis as the only manifestation
Recurrent ARF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Treatment for ARF

A

Oral Penicillin or Erythromicin x 10 days

IM Benzathine Penicillin as single dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Anti-inflammatory agents should be withheld if arthralgia or atypical arthritis is the only clinical manifestation. _____ may be used instead

A

Acetaminophen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

ARF patients with typical migratory polyarthritis and those with carditis without cardiomegaly or CHF should be given _____

A

oral salicylates

Aspirin:
100 mkday q6 x 3-5 days then
75 mkday q6 x 4 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

ARF patients with carditis and cardiomegaly or CHF should be given _____.

A

corticosteroids

Prednisone:
2 mkday q6 x 2-3 weeks then
tapered by 5 mg/day ever 2-3 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

_____ is the treatment of choice for Sydenham chorea.

A

Phenobarbital 16-32 mg q6-8 PO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

_____ is the regimen of choice for ARF antibiotic prophyhlaxis.

A

IM Benzathine Penicillin every 4 weeks
600,000 IU - ≤ 60 lbs
1.2 M IU - > 60 lbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

ARF Antibiotic Prophyhlaxis:

RF without carditis

A

5 years or until 21 y.o.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

ARF Antibiotic Prophyhlaxis:

RF with carditis but without residual heart disease

A

10 years or until 21 y.o.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

ARF Antibiotic Prophyhlaxis:

RF with carditis and residual heart disease

A

10 years or until 40 y.o. or lifelong

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Group B Streptococcus (GBS) is also known as _____.

A

Steptococcus agalactiae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

S. agalactiae (GBS) is a major cause of _____.

A

neonatal sepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

_____ are facultative anaerobic G (+) cocci that form chains or diplococci in broth and small gray-white colonies on solid medium.

A

S. agalactiae (GBS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Presumptive Identification of S. agalactiae (GBS)

A

β-hemolysis on blood agar
resistance to Bacitracin and TMP-SMX
lack of hydrolysis of bile esculin
elaboration of CAMP factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

Early Onset GBS Disease:

Age at Onset

A

0-6 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

Early Onset GBS Disease:

Increased Risk after Obstetric Complication

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

Early Onset GBS Disease:

Clinical Manifestations

A

sepsis, pneumonia, meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Early Onset GBS Disease:

Common Serotypes

A

Ia, Ib, II, III, V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

Early Onset GBS Disease:

Case Fatality Rate

A

4.7%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Late Onset GBS Disease:

Age at Onset

A

7-90 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Late Onset GBS Disease:

Increased Risk after Obstetric Complications

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

Late Onset GBS Disease:

Clinical Manifestations

A

bacteremia, meningitis, focal infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

Late Onset GBS Disease:

Common Serotypes

A

III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

Late Onset GBS Disease:

Case Fatality Rate

A

2.8%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

GBS Treatment:

Bacteremia without a Focus

A

10 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

GBS Treatment:

Meningitis

A

2-3 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

GBS Treatment:

Ventriculitis

A

4 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

GBS Treatment:

Septic Arthritis or Osteomyelitis

A

3-4 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

A major risk factor for the development of early-onset GBS infection is _____.

A

maternal vaginal or rectal colonization by GBS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

The foremost risk factor implicated in the pathophysiology of invasive GB disease is the _____.

A

type-specific capsular polysaccharide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

The _____ component of the GBS capsular polysaccharide prevents activation of the alternative pathway in the absence of type-specific antibody.

A

sialic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

GBS Virulence Factors:

adhesion to host cells

A

GBS Surface Protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

GBS Virulence Factors:

inhibit the recruitment of PMN cells

A

C5a Peptidase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

GBS Virulence Factors:

associated with cell injury

A

β-Hemolysin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

GBS Virulence Factors:

spreading factor in host tissue

A

Hyaluronidase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

The _____ of the GBS cell wall are potent inducers of the TNF-α release.

A

Group B Antigen

Peptidoglycan Component

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

Invasive GBS disease in children beyond early infancy is uncommon and manifests as _____.

A

bacteremia

endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

Severe apnea, easly onset of shock, abnormalities in WBC count and greater lung compliance may indicate infants with _____ rather than RDS.

A

GBS disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

_____ is the recommended treatment for GBS disease.

A

Penicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

Interruption of neonatal colonization is achievable if antibiotics are given to the mother during _____.

A

labor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

Intrapartum antibiotics should be given to women with _____.

A
(+) prenatal screening
GBS bacteriuria
previous infant with GBS disease
unknown culture status
delivered prematurely
PROM (> 18 hours)
intrapartum fever (≥ 38°C)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

_____ are G (+), catalase (-) facultatice anaerobes that grow in pairs or short chains.

A

Enterococci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

_____ accounts for 80% of enterococcal infections.

A

E. faecalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

Diptheria is an acute toxic infection caused by _____.

A

Corynebacterium diphtheriae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

_____ are aerobic, nonencapsulated, non-spore-forming, mostly non-motile, pleomorphic, G (+) bacilli.

A

Corynebacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

The virulence of C. diphtheriae lies in its ability to produce the potent _____ which inhibits protein synthesis and causes local tissue necrosis.

A

65kd polypeptide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

Within the first few days of diphtheria, a dense necrotic coagulum of organisms, epithelial cells, fibrin, leukocytes, and erythrocytes forms and becomes a gray-brown leather-like adherent _____.

A

psudomembrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

The primary focus of respiratory tract diphtheria is the _____.

A

tonsils or pharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

_____ causes shallow ulceration of the external nares and upper lip in infants as well as soft tissue edema creating a bull-neck appearance.

A

respiratory tract diphtheria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

_____ presents as a superficial, ecthymic, non-healing ulcer with a gray-brown membrane.

A

cutaneous diphtheria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
134
Q

_____ causes 50-60% of deaths from diphtheria.

A

Toxic Cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

Toxic cardiomyopathy in diphteria presents as tachycardia which is _____.

A

disproportionate to fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
136
Q

Cranial neuropathies caused by diphtheria occur in the _____ leading to _____.

A

5th week

oculomotor and ciliary paralysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
137
Q

In diphtheria, muscle weakness progresses _____.

A

distal → proximal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

_____ is the mainstay treatment for diphtheria.

A

Anti-Toxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

The role of anti-microbial therapy in diphtheria is to _____.

A

halt toxin production
treat localized infection
prevent transmission of the organism to contacts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

Antibiotics for Diphtheria

A

Erythromycin

Penicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
141
Q

Antibiotics for Diphtheria:

Erythromycin Dose

A

40-50 mkday q6 PO/IV

*max. 2 g/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
142
Q

Antibiotics for Diphtheria:

Penicillin G Dose

A

100,000-150, 000 ukday q6 IV/IM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q

Antibiotics for Diphtheria:

Procaine Penicillin Dose

A

300,000 u/day IM - < 10 kg

600,000 u/day IM - > 10 kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
144
Q

Household contacts of diphtheria should be monitored for illness through the _____.

A

7-day incubation period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
145
Q

Prophylactic Antibiotics for Diphtheria

A

Benzathine Penicillin G

Erythromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
146
Q

Prophylactic Antibiotics for Diphtheria:

Benzathine Penicillin G Dose

A

600,000 u IM - < 6 y.o.

1.2 M u - > 6 y.o.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
147
Q

Prophylactic Antibiotics for Diphtheria:

Erythromycin Dose

A

40-50 mkday QID PO x 10 days

*max. 2 g/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
148
Q

Diphtheria toxoid vaccine is given to immunized individuals who _____.

A

have not received a booster dose within 5 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
149
Q

_____ is a facultatively anaerobic,non-spore-forming, motile, catalase (+), G (+) bacilli

A

Listeria monocytogenes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
150
Q

_____ are anaerobbic, non-sporulating, g(+) bacteria that are part of the endogenous oral flora in humans and have filamentous and branching structure.

A

Actinomyces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
151
Q

_____ are G (+) filamentous bacilli which form a beaded pattern along portions of its branching filaments.

A

Nocardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
152
Q

_____ is a G (-), fastidious, encapsulated, oxidase (+), aerobic diplococcus occuring in kidney shaped pairs.

A

Neisseria meningitidis (Meningococcus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
153
Q

The Meningococcus strains responsible for almost all cases of human disease are _____

A

A, B, C, W-135, X, Y

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
154
Q

N. meningitidis is transmitted via _____.

A

aerosol droplets

respiratory secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
155
Q

Risk Factors for Meningococcal Infection

A
viral respiratory infections
tobacco smoke
marijuana use
binge drinking
night clubs/bars
dormitories
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
156
Q

_____ are specific bacteria adhesins which mediate the attachment of N. meningitidis to nasopharyngeal mucosal cells.

A

pili

opacity-associated proteins (Opa, Opc)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
157
Q

The most important virulence determinant of N. meningitidis is the presence of a _____ which enhances resistance to opsonophagocytic killing.

A

capsular polysaccharide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
158
Q

_____ is essential in stmulating cytokines and activating coagulation and bleeding which are hallmarks of severe meningococcal sepsis.

A

Endotoxin (lipopolysaccharide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
159
Q

The _____ portion of the meningococcal lipopolysaccharide is responsible for the toxicity of the molecule.

A

Lipid A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
160
Q

Diffuse adrenal hemorrhage in fulminant meningococemia is called _____.

A

Waterhouse-Friderichsen Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
161
Q

Persons with inherited deficiencies of _____ are 1000x more susceptible to meningococcal infections.

A

properdin
factor D
terminal complement components

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
162
Q

Fulminant meningococcemia progresses rapidly over several hours from fever with non-specific signs to spetic shock with prominent petechiae and purpura called _____.

A

purpura fulminans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
163
Q

Definitie diagnosis of meningococcal disease is established by _____.

A

isolation of N. meningitidis from a normally sterile body fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
164
Q

_____ are the drugs of choice for N. meningitidis.

A

β-lactam antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
165
Q

_____ is the most frequent neurologic sequela of meningococcal meningitis.

A

Deafness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
166
Q

Poor Prognostic Factors for Meningococcal Infections

A
hypothermia or severe hyperpyrexia
hypotension
purpura fulminans
seizures
leukopenia
thrombocytopenia (DIC)
acidosis
↑endotoxin and TNF-α
petechiae < 12 hrs before admission
absence of meningitis
low or N ESR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
167
Q

Antibiotic prohylaxis for N. meningitidis is indicated for persons in contact with the patient’s oral secretions _____.

A

7 days before onset of illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
168
Q

Antibiotics for N. meningitidis Prophhylaxis

A

Rifampin
Ceftriaxone
Ciprofloxacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
169
Q

N. meningitidis Prophhylaxis:

Rifampin Dose

A

< 1 mo. 5 mkdose PO q12 x2 days
≥ 1 mo. 10 mkdose PO q12 x 2 days

*max. 600 mg PO q12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
170
Q

N. meningitidis Prophhylaxis:

Ceftriaxone Dose

A

< 15 y.o. 125 mg IM

≥ 15 y.o. 250 mg Im

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
171
Q

N. meningitidis Prophhylaxis:

Ciprofloxacin Dose

A

20 mg/kg PO

  • max. 500 mg PO
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
172
Q

Meningococcal vaccination is recommended for _____.

A

11-21 y.o.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
173
Q

Antibody titers for N. meningitidis peak after _____ from vaccination.

A

4-6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
174
Q

A N. meningitidis antibody titer of _____ is considered protective.

A

≥ 1:4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
175
Q

Gonorrhea is transmitted via _____.

A

sexual contact

perinatal transmission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
176
Q

_____ is a non-motile, aerobic, non-spore forming, G (-) intracellular diplococcus with flattened adjacent surfaces.

A

Neisseria gonorrhoeae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
177
Q

Gonococcal species are differentiated from other Neiseria species by the _____.

A

fermentation of glucose but not maltose, sucrose or lactose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
178
Q

2 systems used to characterize gonococcal strains are _____.

A

auxotyping

serotyping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
179
Q

_____ is based on genetically stable requirements of strains for specific nutrients or cofactors.

A

Auxotyping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
180
Q

The most widely used Gonococcal serotyping system is based on a porin called _____.

A

Por1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
181
Q

_____ is the most common STI in sexually abused children.

A

Gonorrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
182
Q

N. gonorrhoeae primarily affects the _____.

A

columnar apithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
183
Q

Gonorrhea can cause endometritis, salpingitis and peritonitis which is collectively known as _____.

A

pelvic inflammatory disease (PID)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
184
Q

Dissemination of N. gonorrhoeae from the fallopian tubes through the peritoneum to the liver capsule results in perihepatitis called _____.

A

Fitz-Hugh-Curtis Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
185
Q

Women are more prone to disseminated gonoccocal infection during _____.

A

mentruation
pregnancy
postpartum period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
186
Q

The most common initial symptom of disseminated gonoccocal infection is _____.

A

acute polyarthralgia with fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
187
Q

Clinical Syndromes of Disseminated Gonoccocal Infection

A

Tenosynovitis-Dermatitis Syndrome

Suppurative Arthritis Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
188
Q

Clinical Syndromes of Disseminated Gonoccocal Infection:

more common, fever, chills, skin lesions, polyathralgia, (+) blood CS

A

Tenosynovitis-Dermatitis Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
189
Q
Clinical Syndromes of Disseminated Gonoccocal Infection:
monoarticular arthritis (knee), (-) blood CS
A

Suppurative Arthritis Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
190
Q

In _____, typical necrotic pustules on an erythematous base is distributed evenly over the extremities usually sparing the face and scalp.

A

disseminated gonoccocal infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
191
Q

Acute endocarditis leading to rapid destruction of the _____ is an uncommon but fatal manifestation of disseminated gonoccocal infection.

A

aortic valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
192
Q

In males, presumptive diagnosis of gonorrhea can be made by _____.

A

identification of G (-) intracellular diplococci in urethral discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
193
Q

All patients with gonorrhea should be tested for concomitant _____.

A

syphilis
hepatitis B
HIV
C. trachomatis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
194
Q

_____ is recommended as the initial therapy for gonorrhea.

A

Ceftriaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
195
Q

For gonorrheal PID, the recommended treatment therapy is _____.

A

Cefoxitin + Doxycucline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
196
Q

Gonococcal ophthalmia neonatorium can be prevented by instilling _____ into each conjunctiva shortly after birth.

A

1% solution of silver nitrate

erythromycin or tetracycline ophthalmic ointment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
197
Q

_____ is the most common etiology of joint and bone infections in children.

A

Kingella kingae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
198
Q

_____ is a fastidious, facultative anaerobic, β-hemolytic member of the Neisseriaceae family that appears as pairs or short chains of G (-) coccobacilli with tapered ends.

A

Kingella kingae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
199
Q

_____ is a fastidious, G (-), pleomorphic coccobacillus that requires factor X (hematin) and factor V (phosphorydine nucleotide) for growth.

A

Haemophilus influenzae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
200
Q

H. influenzae requires _____. for growth.

A
factor X (hematin)
factor V (phosphorydine nucleotide)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
201
Q

In the pre-vaccine era, _____ was a major cause of serious disease among children.

A

Hib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
202
Q

In Hib meningitis, _____ given shortly before or concurrent with the initiation of antimicrobial therapy decreases the risk of hearing loss.

A

Dexamethasone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
203
Q

Children with H. influenzae cellulitis have an antecedent _____ due to the seeding of organisms during bacteremia.

A

URTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
204
Q

H. influenzae usually affects the _____.

A

head
neck
cheek
preseptal region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
205
Q

_____ are the most common causes of otitis media.

A

H. influenzae
S. pneumoniae
Morazella catarrhalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
206
Q

_____ is the drug of choice for H. influenzae.

A

Ampicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
207
Q

_____ is used when H. influenzae is resistant to Ampicillin.

A

Ceftriaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
208
Q

_____ is preferred for non-invasive H. influenzae infections.

A

Amoxicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
209
Q

_____ is used as antibiotic prophylaxis for H. influenzae.

A

Rifampin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
210
Q

_____ is an STD characterized by painful genital ulceration and inguinal lyphadenopathy (buboes).

A

Chancroid (Haemophilus ducreyi)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
211
Q

_____ is an unencapsulated, G (-) diplococcus and is a human specific pathogen that colonizes the respiratory tract beginning in infancy.

A

Moraxella catarrhalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
212
Q

_____ is the sole cause of epidemic pertussis and the usual cause of sporadic pertussis.

A

Bordatella pertussis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
213
Q

_____ is a small, fastidious, G (-) coccobacilli that colonize only ciliated epithelium.

A

Bordatella pertussis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
214
Q

Pertussis is highly contagious with infection rates as high as _____.

A

100%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
215
Q

Protection against typical pertussis begins to wane _____ after vaccination.

A

3-5 years.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
216
Q

The major virulence protein of B. pertussis is the _____.

A

pertussis toxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
217
Q

The Pertussis Toxin causes lymphocytosis by _____.

A

rerouting lymphocytes to remain in the circulationg blood.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
218
Q

Incubation period of Pertussis

A

3-12 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
219
Q

Stages of Pertussis

A

Catarrhal - 1-2 weeks
Paroxysmal - 2-6 weeks
Convalescent - ≥ 2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
220
Q

Stages of Pertussis:

non-specific symptoms, congestion, rhinorrhea

A

Catarrhal - 1-2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
221
Q

Stages of Pertussis:

cough begins as a dry, intermittent, irritative hack and evolves into inexorable paroxysms

A

Paroxysmal - 2-6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
222
Q

Stages of Pertussis:

the number, severity and duration of coughing episodess diminish

A

Convalescent - ≥ 2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
223
Q

Infants _____ do not display the classic stages of pertussis.

A

< 3 mos.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
224
Q

Pertussis is characterized by cough ≥ 14 days plus _____>

A

paroxysms
whooping
post-tussive vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
225
Q

Leukocytosis due to absolute lymphocytosis is characteristic of the _____ of pertusis.

A

catarrhal stage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
226
Q

Severe course and death from pertussis are correlated with extreme _____.

A

leukocytosis

thrombocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
227
Q

_____ is the gold standard for diagnosing pertussis.

A

Isolation of B. pertussis in culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
228
Q

The preferred culture media for B. pertussis are _____.

A

Regan-Lowe Charcoal Agar

Stainer-Scholte Media

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
229
Q

_____ are the antibiotic of choice for pertussis.

A

Macrolides (Azithromycin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
230
Q

Oral erythromycin increases the risk for _____ 7-10x in neonates.

A

hypertrophic pyloric stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
231
Q

Exposure Prophylaxis for Pertussis:

< 7 y.o. with < 4 doses of pertussis vaccine

A

complete DTaP series

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
232
Q

Exposure Prophylaxis for Pertussis:

< 7 y.o. with 3rd dose of pertussis vaccine 6 mos. before exposure

A

DTaP booster

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
233
Q

Exposure Prophylaxis for Pertussis:

< 7 y.o. with 4th dose of pertussis vaccine 3 years before exposure

A

DTaP booster

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
234
Q

Exposure Prophylaxis for Pertussis:

≥ 9 y.o. without Tdap

A

Tdap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
235
Q

Antibiotics for Pertussis

A

Azithromycin
Erythromycin
Clarithromycin
TMP-SMX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
236
Q

Antibiotics for Pertussis:

Azithromycin Dose

A

0-5 mos. - 10 mkday OD x 5 days
≥ 6 mos. - 10 mkday OD on D1, 5 mkday OD on D2-5
adults - 500 mg OD on D1, 250 mg OD on D2-5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
237
Q

Antibiotics for Pertussis:

Erythromycin Dose

A

children - 40-50 mkday QID x 14 days

adults - 2 g/day QID x 14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
238
Q

Antibiotics for Pertussis:

Clarithromycin Dose

A

children > 1 mo. - 15 mkday BID x 7 days

adults - 1 g/day BID x 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
239
Q

Antibiotics for Pertussis:

TMP-SMX Dose

A

children > 2 mos. - TMP 8 mkday + SMX 40 mkday BID x 14 days

adults - TMP 320 mg/day + SMX 1600 mg/day BID x 14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
240
Q

_____ are motile, nonsporulating, nonencapsulated, G (-) rods that grow aerobically and are capable of facultative anaerobic growth.

A

Salmonellae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
241
Q

Sallmonella is resistant to many agents but can be killed by _____.

A

heating to 130°F for 1 hour or 140°F for 15 min.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
242
Q

Salmonella Antigens

A

Somatic O

Flagellar H

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
243
Q

_____ are the most important serotypes for salmonellosis transmitted from animals to humans.

A

Salmonella enteritidis

Salmonella typhimurium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
244
Q

_____ Salmonella organisms must be ingested to cause symptomatic disease.

A

10^6 - 10^8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
245
Q

Gastric acidity inhibits multiplication of the salmonellae and most organisms are killed at _____.

A

gastric pH ≤ 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
246
Q

Intestinal Salmonella infection results in a localized enteritis that is associated with a _____ response from the intestinal epithelium.

A

secretory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
247
Q

Intestinal Salmonella infection induces secretion of _____ and other chemoattractants from the apical surface, directing recruitment and transmigratioon of neutrophils into the gut lumen and thus preventing systemic spread.

A

IL-8 - basolateral surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
248
Q

The most common clinical presentation of salmonellosis is _____.

A

acute enteritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
249
Q

In Salmonella enteritis, stool typically contains _____.

A

PMNs

occult blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
250
Q

High rates of Salmonella in Africa suggests an association with _____.

A

HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
251
Q

The most common sites of focal Salmonella infection are _____.

A

skeletal system
meninges
intravascular sites
sites of preexisting abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
252
Q

_____ are not recommended for uncomplicated Salmonella gastroenteritis because suppression of normal gut flora can prolong infection and induce a chronic carrier state.

A

Antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
253
Q

S. typhimurium phage type DT104 is resistant to _____.

A
Ampicillin
Chloramphenicaol
Streptomycin
Sulfonamides
Tetracycline
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
254
Q

Salmonella Gastroenteritis Treatment

A

Cefotaxime
Ceftriaxone
Ampicillin
Cefixime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
255
Q

Salmonella Gastroenteritis Treatment:

Cefotaxime Dose

A

100-200 mkday q6-8 x 5-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
256
Q

Salmonella Gastroenteritis Treatment:

Ceftriaxone Dose

A

75 mkday OD x 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
257
Q

Salmonella Gastroenteritis Treatment:

Ampicillin Dose

A

100 mkday q6-8 x 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
258
Q

Salmonella Gastroenteritis Treatment:

Cefixime Dose

A

15 mkday x 7-10 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
259
Q

Typhoid Fever is caused by _____ which is G (-).

A

Salmonella typhi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
260
Q

_____ is a virulence factor present in 90% of S. typhi and has a protective effect against the host’s immune system.

A

Polysaccharide Capsule Vi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
261
Q

_____ found in S. typhi interferes with phagocytosis by preventing the binding of C3 to the surface of the bacteria.

A

Polysaccharide Capsule Vi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
262
Q

Salmonella typhi is resistant to _____.

A

Ampicillin
Chloramphenicol
TMP-SMX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
263
Q

It takes _____ S. typhi to manifest clinical symptoms.

A

10^5 - 10^9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
264
Q

The incubation period of S. typhi is _____.

A

7-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
265
Q

Primary S. typhi bacteremia results from _____.

A

lymphatic spread from intestinal mucosa and mesenteric LNs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
266
Q

Secondary S. typhi bacteremia occurs when bacteria are shed into the blood after a period of replication within the _____.

A

macrophages in the RES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
267
Q

Secondary S. typhi bacteremia coincides with _____.

A

onset of clinical symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
268
Q

Typhoid Fever Pattern

A

stepladder rise (gradual rise)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
269
Q

S. typhi causes a macular or maculopapular rash called _____ may be visible around the 7-10th day of illness.

A

Rose Spots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
270
Q

Risk Factors for Typhoid Carrier Status

A

gallbladder disease
advanced age
antibiotic resistance of prevalent strains

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
271
Q

S. typhi forms a biofilm in the _____ of a carrier.

A

gallbladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
272
Q

The mainstay of the diagnosis of Typhoid Fever is _____.

A

(+) culture result

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
273
Q

Typhoid Fever Culture Studies:

Blood

A

(+) early in the disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
274
Q

Typhoid Fever Culture Studies

Stool

A

(+) after 1 week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
275
Q

Typhoid Fever Culture Studies\Urine

A

(+) after 1 week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
276
Q

The _____ measures antibodies against O and H antigens of S. typhi.

A

Widal Test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
277
Q

Typhoid Fever Treatment:

uncomplicated, fully sensitive

A

Chlorampphenicol 50-75 mkday x 14-21 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
278
Q

Typhoid Fever Treatment:

uncomplicated, multidrug-resistant

A

Amoxicillin 75-100 mkday x 14 days
Fluorouinolone 15 mkday x 5-7 days
Cefixime 15-20 mkday x 7-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
279
Q

Typhoid Fever Treatment:

uncomplicated, quinolone-resistant

A

Azithromycin 8-10 mkday x 7 days

Ceftriaxone 75 mkday x 10-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
280
Q

Typhoid Fever Treatment:

uncomplicated, quinolone-resistant

A

Azithromycin 8-10 mkday x 7 days

Ceftriaxone 75 mkday x 10-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
281
Q

Typhoid Fever Treatment:

severe, fully sensitive

A

Fluoroquinolone 15 mkday x 10-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
282
Q

Typhoid Fever Treatment:

severe, multidrug-resistant

A

Fluoroquinolone 15 mkday x 10-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
283
Q

Typhoid Fever Treatment:

severe, quinolone-resistant

A

Ceftriaxone 60 mkday x 10-14 days

Cefotaxime 80 mkday x 10-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
284
Q

Individuals who excrete S. typhi for _____ after infection are considered chronic carriers

A

≥ 3 mos.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
285
Q

_____ is used to describe the syndrome of bloody diarrhea with fever, abdominal cramps, rectal pain and mucoid stools.

A

Dysentery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
286
Q

_____ causes bacillary dysentery.

A

Shigella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
287
Q

The basic virulence trait of Shigella is _____.

A

the ability to invade epithelial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
288
Q

_____ is a potent exotoxin in Shigella that inhibits protein synthesis.

A

Shiga Toxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
289
Q

The Shiga Toxin is found in _____

A

S. dysenteria serotype 1

Shiga Toxin-ProducingE. Coli (STEC) → HUS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
290
Q

The target organ of Shigella is the _____.

A

colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
291
Q

_____ are among the most common extraintestinal manifestations of bacillary dysentery.

A

Neurologic findings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
292
Q

The most common complication if shigellosis is _____.

A

dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
293
Q

_____ is a rare syndrome caused by Shigella which manifests as severe toxicity, convulsions, extreme hyperpyrexia, and headache followed by brain edema.

A

Ekiri Syndrome

Lethal Toxic Encephalopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
294
Q

Presumptive data supporting the diagnosis if bacillary dysentery include _____.

A

fecal leukocytes
fecal blood
leukocytosis with left shift

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
295
Q

_____ is the recommended drug for bacillary dysentery.

A

Ciprofloxacin 20-30 mkday BID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
296
Q

_____ supplementation may be given for children with bacillary dysentery.

A

Vit. A 200,000 IU as single dose - lessen severity

Zinc 20 mg x 14 days - decrease duration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
297
Q

_____ immunization can reduce the incidence and severity of diarrheal diseases including shigellosis.

A

Measles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
298
Q

_____ is a facultatively anaerobic G (-) bacilli that usuali ferments lactose.

A

Escherichia coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
299
Q
E. coli Strains:
> 1 y.o. and travelers
watery +++
bloody -
acute
colonization factor (CF)
E. coli common pilus (ECP
heat-labile enterotoxin (LT)
heat-stable enterotoxin (ST)
A

Enterotoxigenic E. coli (ETEC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
300
Q

E. coli Strains:

“Traveler’s DIarrhea”

A

Enterotoxigenic E. coli (ETEC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
301
Q

The LT in ETEC stimulates _____.

A

adenylate cyclase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
302
Q

The ST in ETEC stimulates _____.

A

guanylate cyclase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
303
Q
E. coli Strains:
> 1 y.o.
watery +
bloody ++
acute
invasion plasmid antigen (ipaABCD)
(-) toxins
A

Enteroinvasive E. coli (EIEC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
304
Q

E. coli Strains:

symptoms resemble bacillary dysentery because they share virulence genes with Shigella

A

Enteroinvasive E. coli (EIEC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
305
Q
E. coli Strains:
< 2 y.o.
watery +++
bloody +
acute, prolonged, persistent
A/E lesion, intimin/Tir, EspABD, Bfp
EspF, Map, EAST1, SPATEs (EspC)
A

Enteropathogenic E. coli (EPEC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
306
Q

E. coli Strains:

major cause of acute and persistent diarrhea in children < 2 y.o. in developing countries

A

Enteropathogenic E. coli (EPEC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
307
Q

E. coli Strains:

breastfeeding is protective against diarrhea

A

Enteropathogenic E. coli (EPEC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
308
Q

E. coli Strains:

induces a characteristic attaching and effacing (A/E) histopathologic lesion

A

Enteropathogenic E. coli (EPEC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
309
Q
E. coli Strains:
6 mos. - 10 y.o., elderly
watery +
bloody +++
acute
A/E lesion, intimin/Tir, EspABD
Shiga toxins (Stx1, Stx2)
A

Shiga Toxin Producing E.coli (STEC)
Enterohemorrhagic E. coli (EHEC)
Verotoxin Producing E. Coli (VTEC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
310
Q

STEC differs from shigellosis or EIEC because _____ is uncommon.

A

fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
311
Q

E. coli Strains:

5-10% develop complications like HUS

A

Shiga Toxin Producing E.coli (STEC)
Enterohemorrhagic E. coli (EHEC)
Verotoxin Producing E. Coli (VTEC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
312
Q

_____ are the key virulence factors for EHEC/VTEC.

A

Shiga toxins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
313
Q
E. coli Strains:
< 2 y.o., HIV, travelers
watery +++
bloody +
acute, prolonged, persistent
aggregative adherence fimbriae (AAF)
SPATEs (Pic,Pet), ShET1, EAST1
A

Enteroaggregative E. coli (EAEC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
314
Q

E. coli Strains:
associated with acute and persistent diarrhea in children < 2 y.o. in developing countries as well as chronic diarrhea in HIV (+) individuals

A

Enteroaggregative E. coli (EAEC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
315
Q

E. coli Strains:
forms a characteristic biofilm on the intestinal mucosa and induce shortening of the villi, hemorrhagic necrosis, and inflammatory responses

A

Enteroaggregative E. coli (EAEC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
316
Q
E. coli Strains:
> 1y.o., travelers
watery ++
bloody -
acute
Afa/Dr, AIDA-I
SPATES (Sat)
A

Diffusely Adherent E. coli (DAEC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
317
Q

E. coli Strains:

produces acute watery diarrhea in children after the first 1-2 years that is not dysenteric and often prolonged

A

Diffusely Adherent E. coli (DAEC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
318
Q

_____ is the most virulent STEC serotype and most frequently associated with HUS.

A

O157:H7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
319
Q

STEC O157:H7 is suggested by isolation of E. coli that fails to ferment _____ on _____.

A

sorbitol

MacConkey agar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
320
Q

The cornerstone of management of E. coli diarrhea is _____.

A

fluid and electrolyte therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
321
Q

EIEC infections can be treated with _____.

A

TMP-SMX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
322
Q

______ is a G (-) comma-shaped bacillus.

A

Vibrio cholerae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
323
Q

Vibrio cholerae is divided into serogroups by its _____.

A

somatic O antigen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
324
Q

Cholera epidemics are cause by _____.

A

V. cholerae O1 and O139

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
325
Q

The most extensive cholera pandemic was caused by _____.

A

V. cholerae O1 El Tor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
326
Q

V. cholerae is transmitted through _____.

A

contaminated water and undercooked shellfish

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
327
Q

Risk Factors for Severe Cholera

A
blood type O
↓gastric acidity
malnutrition
immunodeficiency
↓intestinal immunity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
328
Q

Large inocula of bacteria, _____ of organisms, is needed for severe cholera to occur.

A

> 10^8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
329
Q

The cholera toxin consists of _____ subunits.

A

5 binding B subunits

1 active A subunit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
330
Q

The _____ of the cholera toxin binds to the GM1 ganglioside receptors in the intestine.

A

B subunit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
331
Q

The _____ of the cholera toxin stimulates adenylate cyclase.

A

A subunit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
332
Q

The hallmark of _____ is painless purging of profuse rice-water stools (suspended flecks of mucus) with a fishy smell.

A

cholera

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
333
Q

_____ is the most severe form of cholera where purging rates of 500-1000 ml/hour occur.

A

Cholera Gravis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
334
Q

_____ is the gold standard for diagnosing cholera.

A

Microbiologic isolation of V. cholerae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
335
Q

V. cholerae can be cultured on _____.

A

Thiosulfate Citrate Bile Salts Sucrose (TCBS) Agar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
336
Q

Dark-field microscopy may be used for rapid identification of typical _____ motility in wet mounts of rice-water stools.

A

darting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
337
Q

_____ is the mainstay therapy of cholera.

A

Rehydration.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
338
Q

_____ should be used during rehydraion for cholera.

A

Rice-based ORS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
339
Q

Antiobiotics in cholera are used to _____.

A

shorten duration of illness
decrease fecal excretion of vibrios
decrease volume of diarrhea
reduce the fluid requirement during rehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
340
Q

For cholera, single dose antibiotics such as _____ are recommended to increase compliance.

A

Doxycycline 2-4 mg/kg PO
Ciprofloxacin 20 mg/kg PO
Azithromycin 20 mg/kg PO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
341
Q

_____ are G (-), curved, thin, non-spore-forming rods that have tapered ends.

A

Campylobacter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
342
Q

Campylobacter are motile with a _____.

A

flagellum at 1 or both poles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
343
Q

_____ are microaerophilic, partially anaerobic, oxidase (+) and do not oxidize or ferment carbohydrates.

A

Campylobacter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
344
Q

Campylobacter differ from oterh enteric bacterial pathogens in that they have both _____.

A

N- and O-linked glycosylation capacities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
345
Q

_____ are a classic source of Campylobacter.

A

Chickens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
346
Q

C. jejuni has strong association with _____.

A

Guillain-Barre Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
347
Q

_____ infection should be considered when evaluating Inflammatory bowel disease.

A

Campylobacter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
348
Q

the most common presentation of Campylobacter is _____.

A

enteritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
349
Q

Campylobacter is treated with _____ if necessary.

A

Erythromycin

Azithromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
350
Q

_____ is an acute demyelinating disease of the peripheral nervous system characterized by acute flaccid paralysis and is the most common cause of neuromuscular paralysis worldwide.

A

Guillain-Barre Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
351
Q

_____ is the most common Yersinia species causing human disease.

A

Yersinia enterocolitica

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
352
Q

_____ causes fever, diarrhea and abdominal pain that can mimic appendicitis.

A

Yersinia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
353
Q

_____ causes acute febrile lymphadenitis seen in the bubonic plague.

A

Yersinia pestis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
354
Q

_____ is a large, G (-) coccobacillus that exhibit little or no bipolarity when stained with methylene blue and carbol fuchsin.

A

Yersinia enterocolitica

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
355
Q

_____ ferments glucose and sucrose but not lactose, is an oxidase (-) facultative anaeerobe and reduces nitrate to nitrite.

A

Yersinia enterocolitica

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
356
Q

Yersinia enterocolitica are motile at _____

A

22°C but not at 37°C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
357
Q

_____ are the major reservoir of Yersinia enterocolitica.

A

Pigs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
358
Q

Risk Factors for Yersinia enterocolitica Infection

A

iron overload
hemochromatosis
thalassemia
sickle cell disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
359
Q

Yersinia enterocolitica has been associated with _____ disease.

A

Kawasaki

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
360
Q

_____ is recommended as empirical treatment for Yersinia enterocolitica.

A

TMP-SMX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
361
Q

_____ is a G (-) facultative anaerobe that is a pleomorphic non-motile, non-spore-forming coccobacillus and is a potential agent for bioterrorism.

A

Yersinia pestis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
362
Q

The most common mode of transmission of Yersinia pestis is _____

A

flea bite (Xenopsylla cheopis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
363
Q

3 Principal Clinical Presentations of Plague

A

Bubonic
Septicepmic
Pneumonic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
364
Q

Clinical Presentations of Plague:

most common form

A

Bubonic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
365
Q

In the bubonic plague, lymphadenitis (buboes) develop most commonly in the _____ area.

A

inguinal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
366
Q

In the Black Death, ______ of the extremities can develop as a result of intravascular coagulation.

A

purpura and gangrene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
367
Q

Clinical Presentations of Plague:

systemic infection without buboes

A

Septicemic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
368
Q

Clinical Presentations of Plague

least common but most dangerous and lethal form

A

Pneumonic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
369
Q

______ is the drug of choice for the bubonic plague.

A

Steptomycin 30 mkday q12 IM x 10 days

  • max. 2 g/day
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
370
Q

Postexposure prophylaxis using _____ should be given to those exposed to pneumonic plague.

A

Tetracycline
Doxycycline
TMP-SMX

*7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
371
Q

_____ is a strictly aerobic, oxidase (+), G (-) rod that does not ferment lactose and may produce β-hemolysis on blood agar.

A

Pseudomonas aeruginosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
372
Q

_____ is capable of chronic persistence due to the formation of biofilms, organized communities of bacteria encased in an extracellular matrix that protects the organism from the host immune response and the effects of antibiotics.

A

Pseudomonas aeruginosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
373
Q

_____ infection causes ecthyma gangrenosum which begins as pink macules and progress to hemorrhagic nodules and eventually to ulcers with ecchymotic and gangrenous centers with eschar formation surrounded by an intense red areola.

A

Pseudomonas aeruginosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
374
Q

A frequent focus preceding Pseudomonas aeruginosa bacteremia in newborns is _____.

A

conjunctivitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
375
Q

_____ of fluid or gram of tissue is evidence suggestive of Pseudomonas aeruginosa.

A

≥ 100,000 CFU/ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
376
Q

Antibiotics for P. aeruginosa

A

Ceftaziidime 150-250 mkday q6-8 IV (max. 6 g/day)
Piperacillin-Tazobactam 300-450 mkday q6-8 IV (max. 12 g/day)
Cefepime
Ticarcillin-Clavulanate

± Gentamicin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
377
Q

_____ is an acute, spastic, paralytic illness (lockjaw) that is caused by the neurotoxin produced by _____.

A

Tetanus

Clostridium tetani

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
378
Q

_____ is a motile, G (+), spore-forming obligate anaerobe whose spores produce a drumstick or tennis racket appearance.

A

Clostridium tetani

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
379
Q

The tetanus toxin is also called _____.

A

tetanospasmin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
380
Q

_____ is the 2nd most poisonous substance known surpassed only by botulinum toxin.

A

Tetanospasmin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
381
Q

The most common form of tetanus is _____.

A

neonatal or umbilical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
382
Q

Tetanus occurs after spores germinate, multiply and produce tetanus toxin in the _____ of an infected injury site.

A

↓oxidation-reduction potential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
383
Q

Tetanus toxin binds at the _____.

A

neuromuscular junction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
384
Q

Tetanus toxin initiallly enters the _____ by endocytosis.

A

motor nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
385
Q

In the sciatic nerve, tetanus transport rate was found to be _____.

A

3.4 mm/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
386
Q

The tetanus toxin exits the motor neuron in the spinal cord and enters the adjacent spinal inhibitor interneurons where it prevents release of _____.

A

glycine

GABA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
387
Q

The incubation period of C. tetani is _____.

A

2-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
388
Q

The presenting symptom of 50% of tentanus cases is _____.

A

trismus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
389
Q

_____ results from intractable spasms of facial and buccal muscles.

A

Risus Sardoniucus (sardonic smile)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
390
Q

When paralysis from tetanus extends to the abdominal, lumbar, hip and thigh muscles, the patient may assume a hyperextension of the body called _____.

A

opisthotonos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
391
Q

Fever is common in tetanus because of _____.

A

the menergy consumed by spastic muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
392
Q

Neonatal tetanus manifests within _____.

A

3-12 days from birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
393
Q

_____ results in painful spasms of the muscles adjacent o the wound site.

A

Localized Tetanus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
394
Q

Tetanus toxin cannot be inhibited by TIG after it hasbegun its _____.

A

axonal ascent to the spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
395
Q

_____ is the antibiotic of choice for tetanus.

A

Penicillin G

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
396
Q

The treatment of generalized tetanus requites _____.

A

muscle relaxants

neuromuscular blockade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
397
Q

Favorable Prognosis for Tetanus

A

long incubation period
absence of fever
localized disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
398
Q

Poor Prognosis for Tetanus

A

trismus < 7 days after injury

generalized tetanic spasms < 3 days after trismus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
399
Q

Diphtheria Toxoid-Tetans Toxoid-Acellular Pertussis (DTaP) should be given at _____.

A

2-4-6 mos.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
400
Q

Diphtheria Toxoid-Tetans Toxoid-Acellular Pertussis (DTaP) booster should be given at _____.

A

4-6 y.o.

10 year intervals thereafter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
401
Q

Maternal immunization of at least _____ is recommended to eliminate neonatal tetanus.

A

2 doses of tetanus toxoid

402
Q

Tetanus Prophylaxis:

clean, minor wound, uncertain or < 3 doses of tetanus toxoid

A

Tdap

403
Q

Tetanus Prophylaxis:

clean, minor wound, ≥ 3 doses of tetanus toxoid

A

none

404
Q

Tetanus Prophylaxis:

major wound, uncertain or < 3 doses of tetanus toxoid

A

Tdap and TIG

405
Q

Tetanus Prophylaxis:

major wound, ≥ 3 doses of tetanus toxoid

A

none

406
Q

A tetanus toxoid booster is given to those who completed primary immunization when _____.

A

clean, minor wound, ≥ 10 years since last booster

serious wound, ≥ 5 years since last booster

407
Q

_____ are non-spore-forming, non-motile, pleiomorphic, obligately aerobic, weakly G (+) bacilli.

A

Mycobacterium tuberculosis

408
Q

_____ grow in synthetic media containing glycerol as the carbon source and ammonium salts as the nitrogen source (Lowenstein-Jensen).

A

Mycobacterium tuberculosis

409
Q

_____ is the hallmark of TB.

A

Acid Fastness

  • the capacity to form stable mycolate complexes with arylmethane dyes and resist decoloration with ethanol and ydrochloric acids
410
Q

A reactive TST without clinical or radiographic manifestations is the hallmark of _____

A

latent TB

411
Q

The primary complex (Ghon complex) of TB includes _____.

A

local parenchymal infecction

lymphadenopathy

412
Q

Bacterial replication of TB is more likely to occur in the _____.

A

lung apices
brain
kidneys
bones

413
Q

The most common result of female genital tract TB is _____.

A

infertility

414
Q

A TST _____ is positive for any age.

A

≥ 10 mm

415
Q

The hallmark of PTB is _____.

A

large lymphadenitis

small lung focus

416
Q

Sequence of PTB

A

hilar lymphadenopathy → focal hyperinflation → atelectasis → collapse-consolidation (segmental tuberculosis)

417
Q

Calcification in TB lesions implies that an infection has been there for _____.

A

6-12 mos.

418
Q

Most Common Symptoms of TB

A

non-productive cough

mild dyspnea

419
Q

Reactivation TB is more common in those who acquire the infection at _____.

A

> 7 y.o.

420
Q

The most common CXR findings in reactivation TB are _____ in the upper lobes.

A

extensive infiltrates

thick-walled cavities

421
Q

Pleural Fluid Findings in TB

A
yellow
SG 1.012-1.025
protein 2-4 g/L
↓glucose
↑WBCs (lymphocytic)
422
Q

The most common cause of cardiac TB is _____.

A

pericarditis

423
Q

The most clinically significant form of disseminated TB is _____.

A

miliary TB

424
Q

_____ is the most common extrapulmonary TB in children.

A

Scrofula

425
Q

The _____ is often the site of greatest involvement in CNS TB.

A

brainstem (CN III, VI, VII)

426
Q

Stages of TB:

non-specific symptoms, no focal neurologic signs

A

Stage 1

427
Q

Stages of TB:

lethargy, nuchal rigidity, seizures, (+) Kernig and Brudzinski signs, hypotonia, vomiting, CN palsies

A

Stage 2

428
Q

Stages of TB:

coma, hemiplegia, paraplegia, hypertension, decerebrate posturing, deterioration of vital signs, death

A

Stage 3

429
Q

CSF findings in TB

A

↑WBC 10-500 cell/mm3 (lymphocytic)
↓glucose < 40 mg/dl
↑protein 400-5000 mg/dl

430
Q

CT Scan MRI FIndings in TB

A

basilar enhancement
communicating HCP
focal ischemia (arteritis)

431
Q

Tuberculomas in children are often found in the _____.

A

infratentorial area

432
Q

The classic manifestation of tuberculous spondylitis is progression to _____.

A

Pott’s Disease

433
Q

TB enteritis usually involves the _____.

A

jejunum
ileum near Peyer patches
appendix

434
Q

Anti-TB Drugs:

optic neuritis, decreased red-green discrimination, GI disturbances, hypersensitivity

A

Ethambutol

435
Q

Anti-TB Drugs:

mild hepatic enzyme elevation, hepatitis, peripheral neuritis, hypersensitivity

A

Isoniazid

436
Q

Anti-TB Drugs:

hepatotoxic effects, hyperuricemia, arthralgias, GI tract upset.

A

Pyrazinamide

437
Q

Anti-TB Drugs:
orange discoloration of body fluids, vomiting, hepatitis, flu-like symptoms, thrombocytopenia, pruritus, ineffectve oral contraceptives

A

Rifampicin

438
Q

TB osteomyelitis, arthritis, meningitis and disseminated TB should be treated for _____.

A

9-12 mos.

439
Q

Corticosteroids are used for _____ TB.

A

meningitis
endobronchial
pericardial effusion
miliary

440
Q

_____ should be given to partients with latent TB.

A

Isoniazid x 9 mos.

441
Q

_____ have been associated with the ability of virulent TB strains to produce disease.

A
trehalose dimycolate (cord factor)
sulfatides
442
Q

_____ is responsible for the morphologic appearance of serpentine cords of TB bacilli in cllose, parallel arrangements.

A

Cord Factor

443
Q

_____ are peripherally located glycolipids that inhibit fusion of secondary lysosomes with bacilli-containing phagosomes within a macrophage, promoting intracellular survival of TB

A

Sulfatides

444
Q

The gold standard for diagnosing TB is _____.

A

TB Culture

445
Q

_____ is a long, motile spirochete with finely tapered ends.

A

Treponema pallidum

446
Q

Treponema pallidum Subspecies:

venereal syphilis

A

pallidum

447
Q

Treponema pallidum Subspecies:

yaws

A

pertenue

448
Q

Treponema pallidum Subspecies:

bejel, endemic syphilis

A

endemecium

449
Q

Treponema pallidum Subspecies:

pinta

A

carateum

450
Q

Detection of T. pallidum requires _____.

A

dark-field microscopy
phase contrast microscopy
direct immunofluorescence staining

451
Q

Acquired Syphilis is transmitted through _____.

A

vaginal, anal and oral exposure

452
Q

Primary syphilis is characterized by _____.

A

chancre

regional lymphadenitis

453
Q

In syphilis, a painless papule appears at the site of entry _____ after inoculation and develops into a clean, painless, highly contagious ulcer (chancre).

A

2-6 weeks

454
Q

Untreated patients develop secondary syphilis _____ after the chancre heals.

A

2-10 weeks

455
Q

Manifestations of secondary syphilis include generalized non-pruritic maculopapular rash involving th _____.

A

pals and soles.

456
Q

_____ are gray-white erythematous wart-like plaques which occur in moist areas around the anus and vagina of those infected wih syphilis.

A

Condyloma lata

457
Q

Syphilis meningitis is characterized by _____.

A

CSf pleocytosis

elevaated protein

458
Q

Secondary syphilis infection becomeas latent withiin _____.

A

1-2 mos. after onset of rash

459
Q

_____ is marked by neurologic, cardiovascular and gummatous lesions.

A

Tertiary Syphilis

460
Q

_____ are non-suppurative granulomas of the skin and muskuloskeletal system resulting from the host’s hypersensitivity reaction to syphilis.

A

Gummas

461
Q

All cstages of congenital syphilis are characterized by _____.

A

vasculitis with progression to necrosis and fibrosis

462
Q

_____ anemia is characteristic of syphilis.

A

Coomb’s negaive hemolytic anemia

463
Q

_____ causes osteochondritis, periostitis and a mucocutaneous rash manifesting with erythematous macules followed by desquamation involving hands and feet.

A

Syphilis

464
Q

Mucus patches, persistent rhinitis (snuffles) and condylomatous lesions are highly characteristis fetues of mucus membrane involvement in _____.

A

syphilis

465
Q

X-rays showing Wimberger lines, osteochondritis aand periostitis of the long bones are suggestive of _____.

A

syphilis

466
Q

Manifestations of Syphilis:

metaphyseal demineralization of the medial aspect of the proximal tibia

A

Wimberger lines

467
Q

Manifestations of Syphilis:

bony prominence of the forehead due to persistent or recurrent periostitis

A

Olympian brow

468
Q

Manifestations of Syphilis:

painful osteochondritis resulting in irritability and refusal o move the involved extemity

A

pseudoparalysis of Parrot

469
Q

Manifestations of Syphilis:

thickening of the sternoclavicular third of the clavicle

A

Higoumenakia sign

470
Q

Manifestations of Syphilis:

anterior bowing of the midportion of the tibia

A

Saber shins

471
Q

Manifestations of Syphilis:
peg-shaped upper central incisors, erupt during the 6th year of life with abnormal enamel, notched along the biting surface

A

Hutchinson teeth

472
Q

Manifestations of Syphilis:

abnormal 1st lower molars (6 y.o.) characterized by small biting surface and excessive number of cusps

A

Mulberry molars

473
Q

Manifestations of Syphilis:

depression of the nasal root resulting from destruction of the adjacent bone and cartilage

A

Saddle nose

474
Q

Manifestations of Syphilis:

linear scars that extend in a spoke-like pattern from previous mucocutaneous fissures of the mouth, anus and genitalia

A

Rhagades

475
Q

Manifestations of Syphilis:
latent meningovascular infection, occurs in adolescence, behavioral changes, focal seizures, loss of intellectual function

A

Juvenile paresis

476
Q

Manifestations of Syphilis:

rare spinal cord involvement and cardiovascular involvement with aortitis

A

Juvenile tabes

477
Q

Manifestations of Syphilis:

Hutchinson teeth, interstitial keratitis, CN VIII deafness

A

Hutchinson triad

478
Q

Manifestations of Syphilis:
painless joint swelling (knees) due to synovitis with sterile synovial fluid, spontaneous remission occurs after several weeks

A

Clutton joint

479
Q

Manifestations of Syphilis:
manifests with intense photophobia and lacrimation, followed within weeks or months by corneal opacification and complete blindness

A

Interstitial keratitis

480
Q

Manifestations of Syphilis:

appears at any age, manifests initially as vertogo and high-tone hearing loss, progresses to permanent deafness

A

CN VIII deafness

481
Q

_____ are sensitive nontreponemal tests that detect antibodies against phospholipid antigen on the treponeme surface that crossreact with mammalian cardio-lipid-lecithin-cholesterol antigens

A

VDRL, RPR

482
Q

_____ is the drug of choice for syphilis.

A

Penicillin

483
Q

_____ is the drug of choice for congenital syphilis.

A

Penicillin G 200,000-300,000 ukday IV q4-6 x 10 days

484
Q

_____ is the drug of choice for primary, secondary and early latent syphilis.

A

Penicillin G 50,000 u/kg IM as single dose

*max. 2.4 M u

485
Q

_____ is the drug of choice for late latent syphilis or syphilis of unknown duration.

A

Penicillin G 50,000 u/kg IM x 3 doses 1 week apart

*max. 2.4 M u

486
Q

_____ is the drug of choice for neurosyphilis.

A

Penicillin G 200,000-300,000 ukday IV q4-6 x 10 days

487
Q

Persons exposed within _____ of diagnosis of syphilis in a sex partner should be treated.

A

≤ 90 days

488
Q

Persons exposed within _____ of diagnosis of syphilis in a sex partner should be treated.

A

≤ 90 days

489
Q

_____ are aerobic motile spiral bacteria with a terminal hook at 1 or both ends.

A

Leptospora

490
Q

_____ are the principal source of Leptospira.

A

Rats

491
Q

Leptospirosis follows a _____ course.

A

biphasic

Initial/Septicemic
Immune/Leptospiruric

492
Q

The initial or septicemic phase of leptospirosis lasts _____ during which leptospires can be isolated from the _____.

A

2-7 days

blood, CSF, other tissue

493
Q

Abrupt onset of flu-like illness including severe debilitating myalgia most prominent in the lower extemities, lumbosacral spine and abdomen occurs during the _____.

A

Initial/Septicemic Phase of Leptospirosis

494
Q

Conjunctival suffusion with photophobia and orbital pain, generalized lymphadenopathy and hepatosplenomegaly occur during the _____.

A

Initial/Septicemic Phase of Leptospirosis

495
Q

Appearance of circulating antibody, disappearance of organisms from the blood and CSF, recurrence of fever, aseptic meningitis and localization of leptospires in the tissues occur during the _____.

A

Immune/Leptospiruric Phhase of Leptospirosis

496
Q

_____ is severe Leptospirosis characterized by jaundice, renal failure, thrombocytopenia, hemorrhage and cardiovascular collapse.drug of choice for leptospirosis is _____.

A

Weil SyndromePenicillin G 60-8 M u/m2/day q4

497
Q

The principal cause of death in Weil Syndrome is _____.

A

acute renal failure

498
Q

Use of Warthin-Starry silver staining, PCR, IF and immunohistochemical methods permits diagnosis of _____.

A

Leptospirosis

499
Q

The gold standard diagnostic method for leptospirosis is _____.

A

microscopic agglutination test (LeptoMAT)

500
Q

Leptospires can be isolated from the blood or CSF during the _____ of illness.

A

first 10 days

501
Q

Leptospires can be isolated from the urine during the _____ of illness.

A

2nd week

502
Q

The drug of choice for leptospirosis is _____.

A

Penicillin G 6-8 M u/m2/day q4 IV x 7 days

503
Q

_____ is used for leptospirosis patients who are allergic to Penicillin.

A

Doxycycline 2 mkday BID

*max. 100mg

504
Q

_____ is used as prophylaxis for leptospirosis.

A

Doxycycline 200 mg PO

505
Q

_____ is an obligate intracellular pathogen which has a G (-) envelope without a detectable peptidoglycan.

A

Chlamydia pneumoniae

506
Q

Chlamydiae are characterized by a unique developmental cycle with morpholigically distinct infectious and reproductive bodies namely _____

A
Elementary Body (EB) - infectious
Reticulate Body (RB) - reproductive
507
Q

Chlamydial _____ attach to the host cell by a process of electrostatic binding and taken by endocytosis.

A

elementary bodies

508
Q

Chlamydial _____ undergo binary fission then differentiate into elementary bodies after 36 hours which are released by cytolysis or exocytosis.

A

reticulate bodies

509
Q

_____ usually occurs as a classic atypical (non-bacterial) pneumonia characterized by mild constitutional symptoms.

A

Chlamydial pneumonia

510
Q

CXR findings which appear worse than the patient’s clinical status is characteristic of _____.

A

Chlamydial pneumonia

511
Q

Diagnosis of C. pneumoniae is based on _____

A

posterior nasopharyx tissue culture

512
Q

Acute chlamydial infection using the microimmunofluorescence (MIF) test is defined by a _____.

A

↑4x in IgG titer

≥ 16 IgM titer

513
Q

Antibiotic therapy for chlamydial pneumonia lasts for _____.

A

≥ 2 weeks

514
Q

Treatment for Chlamydia pneumoniae

A

Erythromycin 40 mkday PO BID x 10 days
Clarithromycin 15 mkday PO BID x 10 days
Azithromycin 10 mkday PO on D1 then 5 mkday PO on D2-5

515
Q

_____ is the most important preventable cause of blindness worldwide.

A

Trachoma

516
Q

_____ begins as a follicular conjunctivitis which heals leading to conjunctival scarring that result in entropion causing corneal ulceration, scarring and blindness.

A

Trachoma

517
Q

Criteria for Trachoma

A

conjunctival scarring
vascular pannus
limbal follicles
lymphoid vesicles on the upper tarsal conjunctivae

*at least 2

518
Q

_____ is given as treatment for trachoma.

A

Azithromycin 20mg/kg as single dose

*max. 1g

519
Q

_____ is a major cause of epididymitis and non-gonococcal urethritis.

A

Chlamydia trachomatis

520
Q

Around 50% of men with gonorrhea are co-infected with _____.

A

Chlamydia trachomatis

521
Q

Perinatally acquired Chlamydia trachomatis can persist for _____.

A

≥ 3 years

522
Q

Definitive diagnosis of genital chlamydial infection is accomplished by _____.

A

tissue culture

inclusions in fluorescent antibody staining

523
Q

Culture specimens for genital chlamydia should be taken from _____.

A

males - urethra

females - endocervix

524
Q

Chlamydia trachomatis is treated with _____.

A

Azithromycin 1 g PO as single dose

Doxycycline 100 mg PO BID x 7 days

525
Q

Sex partners of chlamydia patients should be treated if the last sexual contact was within _____ from onset of symptoms.

A

60 days

526
Q

30-50% if infants born to mothers with active, untreated chlamydial infections develop _____.

A

conjunctivitis

527
Q

_____ occurs at 1-3 mos. presenting as persistent cough, tachypnea, (-) fever, rales, (-) wheezing, eosinophilia (> 400 cells/mm3).

A

C. trachomatis pneumonia

528
Q

The most consistent CXR finding in C. trachomatis pneumonia is _____,

A

hyperinflation

minimal interstitial or alveolar infiltrates

529
Q

The recommended treatment for C. trachomatis conjunctivitis or pneumonia is _____.

A

Erythromycin 50 mkday QID PO x 14 days

Azithromycin 20 mkday OD PO x 3 days

530
Q

Pregnant women with C. trachomatis should be treated with _____.

A

Azithromycin 1 g PO as single dose

Amoxicillin 500 mg PO TID x 7 days

531
Q

_____ is a systemic STD caused by the L1, L2 and L3 serotype of the LGV biovar of C. trachomatis.

A

Lymphogranuloma Venereum

532
Q

LGV strains of C. trachomatis have a predilection for _____.

A

lynphoid tissue

533
Q

LGV Stages:

painless transient papule in the genitals

A

1st stage

534
Q

LGV Stages:

unilateral, femoral or inguinal lymphadenitis with enlarging painful buboes

A

2nd stage

535
Q

LGV Stages:

genitoanorectal syndrome with rectovaginal fistulas, rectal strictures and urethral destruction

A

3rd stage

536
Q

The recommended treatment for LGV is _____.

A

Doxycycline 100 mg PO ID x 21 days

537
Q

Invasive candidiasis is a leading cause of mortality in _____.

A

hospitalized immunocompromised patients

538
Q

Morphologic Forms of Candida

A

blastospores or yeast cells
chlamydospores
pseudomucelium

539
Q

Morphologic Forms of Candida:

ocal to round, 3-6 mm

A

blastospores or yeast cells

540
Q

Morphologic Forms of Candida:

double-walled, 7-17 mm, at the terminal end of a pseudohypha

A

chlamydospores

541
Q

Morphologic Forms of Candida:

a mass of pseudohyphae, tissue phase

A

pseudomycelium

542
Q

Morphologic Forms of Candida:

Among Candida species, _____ accounts for most human infectiona.

A

Candida albicans

543
Q

_____ forms a germ tube when suspended in rabbit or human serum and incubated for 1-2 hours.

A

C. albicans

544
Q

Amphotericin B deoxycholate is inactive against 20% of strains of _____.

A

C. lusitaniae

545
Q

Fluconazole is inactive against all strains of _____ and 5-25% of strains of _____.

A

C. krusei

C. glabrata

546
Q

Candida is a common cause of _____ in newborn infants.

A

oral thrush

diaper dermatitis

547
Q

_____ is the 3rd mostc ommon cause of sepsis in preterms.

A

Candida

548
Q

Risk Factors for Candidiasis

A
prematurity
low birthweight
broad-spectrum antibiotics
abdominal surgery
central line
549
Q

_____ is the treatment of choice for congenital cutaneous candidiasis in full-term infants.

A

Topical Antifungal Therapy

550
Q

_____ is the treatment of choice for congenital cutaneous candidiasis in full-term infants.

A

Systemic Antifungal Therapy

551
Q

Systemic antifungal therapy should be admnistered for _____ from the last (+) Candida culture.

A

21 days

552
Q

_____ is the mainstay treatment fot systemic candidiasis and is active against both yeast and mycelial forms.

A

Amphoteriicin B deoxycholate

553
Q

_____ is a superficial mucous membrame infection caused by candida.

A

Oral Thrush

554
Q

_____ is the drug of choice for oral thrush.

A

Nystatin

555
Q

_____ is the drug of choice for recalcitrant of recurrent oral thrush.

A

Fluconazole as single dose

556
Q

_____ is the most common infection caused by Candida and is characterized by a confluent erythematous rash with satellite pustules.

A

Siaper Dermatitis.

557
Q

Diaper rash should be treated when it has been present for _____.

A

> 3 days

558
Q

The topical antifungal drugs of choice for diaper dermatitis are _____.

A

nystatin
clotrimazole
miconazole

559
Q

Candida paronychia may be treated with _____.

A

topical antifungals

560
Q

Ungual Candida infections may require _____.

A

systemic azoles

561
Q

_____ is a common Candida infection of pubertal and postpubertal females.

A

Vulvovaginitis

562
Q

Candida vulvovaginitis may be treated with _____.

A

vaginal creams
nystatin
clotrimazole
miconazole

563
Q

_____ is the most common cause of invasive candidiasis in immunocompromised patients.

A

C. albicans

564
Q

_____ are the most common Candida infections in HIV (+) patients.

A

oral thrush

diaper dermatitis

565
Q

Oral Candidiasis in HIV:

fiery erythema of the mucosa or loss of papillae of the tongue

A

atrophic candidiasis

566
Q

Oral Candidiasis in HIV:

oral symmetric white plaques

A

chronic hyperplastic candidiasis

567
Q

Oral Candidiasis in HIV:

erythema and fissuring of the angles of the mouth

A

angular chelitis

568
Q

_____ is usually necessary for oral candidiasis in HIV (+) patients.

A

systemic fluconazole or itraconazole

569
Q

_____ decreases the incidence of candidemia in bone marrow transplant recipients.

A

Fluconazole prophylaxis

570
Q

_____ is a group of heterogenous immune disorders with a primary defect of T-lymphocyte responsiveness to Candida.

A

Chronic Mucocutaneous Candidiasis

571
Q

_____ risk factors associated with chronic mucocutaneous candidiasis.

A
hypoparathyroidism
Addison disease
hyperimmunoglobulin E syndrome (Job syndrome)
HIV
inhaled corticosteroids
572
Q

_____ are necessary to treat chronic mucocutaneous candidiasis.

A

topical antifungal therapy

systemic azoles

573
Q

_____ is an invasive fungal disease caused by a monomorphic, encapsulated yeast.

A

Cryptococcosis

574
Q

_____ is the most common etiologic agent causing cryptococcosis and is the predominant pathogenic fungal infection among persons with HIV.

A

Cryptococcus neoformans

575
Q

C. neoformans is acquired by _____.

A

inhalation of fungal spores (5-10 um) which are engulfed by alveolar macrophages

576
Q

_____ is the 3rd most common invasive fungal infection after candidiasis and aspergillosis in organ transplant patients.

A

Cryptococcosis

577
Q

_____ is the most important host defense for producing granulomatous inflammation and thus containing cryptococcal infection.

A

Cell-Mediated Immunity

578
Q

_____ is the most common form of cryptococcosis.

A

Pneumonia

579
Q

_____ is the most common predisposing factor for disseminated cryptococcosis.

A

Advanced HIV Infection

580
Q

_____ is the most common clinical manifestation of disseminated cryptococcal infection.

A

Meningitis (subacute or chronic)

581
Q

The definitive diagnosis of cryptococcosis is made by _____.

A

culture

histology

582
Q

_____ is the most useful diagnostic test for cryptococcosis.

A

Latex Agglutination Test

583
Q

Immunocompetent patients with asymptomatic or mild cryptococcal pneumonia may be observed or given _____.

A

Fluconazole - 6-12 mkday (max. 200-400 mg/day)
Itraconazole - 5-10 mkday q12 (max. 200-400 mg/day

*for 3-12 mos.

584
Q

Patients with cryptococcemia, severe cryptococcosis, with antigen titers of > 1:8 should be treated in a staged approach using _____.

A

Induction - Amphotericin B + Flucytosine (min. 2 weeks)
Consolidation - oral Fluconazole or Itraconazole (6-12 mos.)
Maintenance

585
Q

Anti-Fungal Dose:

Amphotericin B deoxycholate

A

1 mkday

586
Q

Anti-Fungal Dose:

Amphotericin B lipid complex

A

5 mkday

587
Q

Anti-Fungal Dose:

Liposomal Amphoericin B

A

5 mkday

588
Q

Anti-Fungal Dose:

Amphotericin B colloidal dispersion

A

5 mkday

589
Q

Anti-Fungal Dose:

Fluconazole

A

12 mkday

590
Q

Anti-Fungal Dose:

Voriconazole

A

8 mkdose q12

591
Q

Anti-Fungal Dose:

Micafungin

A

2-4 mkday

592
Q

Anti-Fungal Dose:

Capsofungin

A

50 mg/m2/day

593
Q

Anti-Fungal Dose:

Anidulafungin

A

1.5 mkday

594
Q

_____ is a single-stranded, lipid-enveloped RNA virus in the family Paramyxoviridae and genus Morbillivirus

A

Measles

595
Q

Of the 6 major structural proteins of measles, the 2 most important in terms of induction of immunity are _____

A

hemaglutinin (H) protein

fusion (F) protein

596
Q

Measles is transmitted through _____.

A

contact with large droplets or small-droplet aerosols

597
Q

Measles patients are infectious from _____.

A

3 days before up to 4-6 days after onset of rash.

598
Q

The histology of _____ rash and exanthem reveals intracellular edema and dyskeratosis associated with formation of epidermal syncytial giant cells with up to 26 nuclei.

A

measles

599
Q

In lyphoreticular tissue of measles patients, _____ is prominent.

A

lyphoid hyperplasia

600
Q

Fusion of infected cells results in multinucleated giant cells, _____ that are pathognomonic for measles, with up to 100 nuclei and intracytoplasmic and intranuclear inclusions.

A

Warthin-Finkeldey giant cells

601
Q

Phases of Measles

A

incubation period
prodromal illness
exanthematous phase
recovery

602
Q

In primary measles viremia, the virus is disseminated to the _____.

A

reticuloendothelial system

603
Q

In secondary measles viremia, the virus is spread to the _____.

A

body surfaces

604
Q

_____ are enanthem which are pathognomonic for measles.

A

Koplik Spots

605
Q

Koplik spots appear _____ before onset of rash.

A

1-4 days

606
Q

A measles rash appears after _____ as _____ starting at the _____.

A

3-5 days from onset of symptoms
erythematous macules
facespreading to the trunk and extremities

607
Q

The symptoms of measles intensify for_____ until the 1st day of the rash.

A

2-4 days

608
Q

With the onset of _____, measles symptoms begin to subside.

A

rash

609
Q

The measles rash fades over _____ in the same progression it appeared, leaving behind a _____.

A

7 days, fine desquamation

610
Q

Of the major symptoms of measles, _____ lasts the longest, often up to 10 days.

A

cough

611
Q

Children who had received the original formalin-inactiated measles vaccine at times demostrate a more severe form called _____.

A

atypical measles

612
Q

Measles is serologically confirmed by the identification of _____ in the serum.

A

Measles IgM

613
Q

Measles IgM appears _____ and remains detectable for about _____.

A

1-2 days after onset of rash

1 mo.

614
Q

There is _____ rise in measles IgG in acute and convalescent specimens collected 2-4 weeks later.

A

4x rise

615
Q

Morbidity and mortality from measles are greatest in patients _____.

A

< 5 y.o.

> 20 y.o.

616
Q

_____ is the most common cause of death from measles.

A

Pneumonia

617
Q

The most common pathogens causing secondary pneumonia in measles are _____.

A

S. pneumoniae
H. influenzae
S. aureus

618
Q

Following severe measles pneumonia, the final common pathway to a fatal outcome is often the development of _____.

A

bronchilotis obliterans

619
Q

_____ is the most common complication of measles.

A

Otitis Media

620
Q

A severe form of measles manifesting with hemorrhagic skin eruption and causing death was called _____.

A

hemorrhagic measles

“black measles”

621
Q

Indications for Vit. A in Measles

A

6 mos.- 2 y.o. hospitalized patients with complications
immunodeficiency
vitamin A deficiency
impaired intestinal absorption
moderate-severe malnutrition
immigration from areas with high measles mortality

622
Q

Vit. A Dose for Measles

A

< 6 mos. - 50,000 IU
6 mos.-1 y.o. - 100,000 IU
≥ 1 y.o. - 200,000 IU

623
Q

Patients shed measles virus from _____ to _____.

A

7 days after exposure

4-6 days after onset of rash

624
Q

The measles vaccine is effective in preventio or modification of measles if given within _____ of exposure.

A

72 hours

625
Q

The measles immunoglobulin may be given up to _____ after exposure.

A

6 days

626
Q

Measles immunoglobulin is recomnded for _____.

A

household contacts
infants < 6 mos.
pregnant wommen
immunocompromised patients

627
Q

_____ is a chronic complication of measles with a delayed onset and an outcome that is nearly always fatal.

A

Subacute Sclerosing Panencephalitis (SSPE)

628
Q

The clinical manifestations of SSPE begin _____ after primary measles infection.

A

7-13 years

629
Q

The hallmark of the 2nd stage of SSPE in _____ which coincides with the involvement of the deeper structures of the brain including the basal ganglia.

A

massive myoclonus

630
Q

In the 3rd stage of SSPE, involuntary movements disappear and are replaced by _____ that result from the destruction of deeper centers in the basal ganglia

A

choreoathetosis
immobility
dystonia
lead pipe rigidity

631
Q

The 4th stage of SSPE is characterized by the loss of critical centers that support _____.

A

breathing, HR, BP

632
Q

CSF Findings in SSPE

A

elevated IgG and IgM titers (> 1:8)

633
Q

EEG Findings in SSPE

A

suppression-burst pattern in myoclonic phase

634
Q

SSPE patients die within _____ of onset from infection.

A

1-3 years

635
Q

_____ is also known as German Measles or 3-day Measles.

A

rubella

636
Q

_____ is a member of the family Togaviridae and the only species of genus Rubivirus.

A

Rubella

637
Q

_____ is a single-stranded RNA virus wih a lipid envelope and 3 structural proteins.

A

Rubella

638
Q

Followinig rubella infection, the virus replicates in the _____ then spreads to the _____.

A

respiratory epithelium

regional lymph nodes

639
Q

Rubella viremia is most intense at _____ after infectio.

A

10-17 days

640
Q

Viral shedding of rubella from the nasopharynx begins _____ and may be detected up to _____.

A

10 days after infection

2 weeks after onset of rash

641
Q

The period of highest communicability of rubella is _____ the appearance of the rash.

A

5 days before to 6 days after

642
Q

Maternal rubella infection during the _____ results in the most severe and widespread defects.

A

first 8 weeks of gestation

643
Q

The most distinct features of congenital rubella is _____.

A

chronicity

644
Q

The incubation period of rubella is _____.

A

14-21 days

645
Q

The prodrome of rubella presents as _____.

A
low-grade fever
sore throat
red eyes
eye pain
headache
malaise
anorexia
lymphadenopathy
646
Q

The first manifestation of rubella in children is _____.

A

rash

647
Q

_____ may cause tiny, rose-colored lesions in the oropharynx called Forchheimer spots.

A

Rubella

648
Q

Rubella rash lasts for _____.

A

3 days

649
Q

The most common test for Rubella is _____,

A

IgM enzyme immunosorbent assay

650
Q

_____ is the most serious complication of postnatal rubella.

A

Encephalitis

651
Q

_____ is a rare complication of rubella thaat is similar to SSPE.

A

Progressive Rubella Panencephalitis (PRP)

652
Q

_____ is the single most common finding among infants with congenital rubella.

A

Nerve Deafness

653
Q

Retinal Findings in Rubella

A

salt and pepper retinopathy

654
Q

_____ are the most common eye finding in rubella.

A

Cataracts

655
Q

Late Onset Symptoms of Congenital Rubella

A
diabetes mellitus (20%)
thyroid dysfunction (5%)
galucoma
656
Q

treatment for rubella is _____.

A

supportive

657
Q

_____ is of special importance to congenital rubella syndrome because early intervention may improve outcomes.

A

Hearing Screening

658
Q

Patients with rubella must be isolated for _____.

A

7 days

659
Q

_____ is characterized by fever, bilateral or unilateral parotid swelling and tenderness and the frequent occurrence of meningoencephalitis and orchitis.

A

Mumps

660
Q

_____ is in the family Paramyxoviridae and the genus Rubulavirus.

A

Mumps

661
Q

_____ is a single stranded pleomorphic RNA virus encapsulated in a lipoprotein envelope and possessing 7 astructural proteins.

A

Mumps

662
Q

Mumps Surface Glycoproteins

A

hemagglutitnin-neuraminidase (HN)

fusion (F)

663
Q

Mumps Surface Glycoproteins:

absorption of the virus into the host cells

A

hemagglutitnin-neuraminidase (HN)

664
Q

Mumps Surface Glycoproteins:

penetration into cells

A

fusion (F)

665
Q

The mumps virus appears in the saliva from _____.

A

7 days before to 7 days after parotid swelling appears

666
Q

The period of maximum infectiousness of mumps is _____.

A

1-2 days before to 5 days after onset of paotid swelling

667
Q

The incubation period of mumps is _____.

A

12-25 days (usually 16-18 days)

668
Q

Mumps presents with a prodrome lasting _____ presenting as _____.

A

1-2 days

fever, headache, vomiting, achiness

669
Q

The parotid swelling in mumps peaks at _____ and subsides at _____.

A

3 days, 7 days

670
Q

The mumps virus can be isolated from _____.

A

upper airway secretions
CSF
urine

671
Q

Confirmation of the presence of parotitis is demonstrated by increased _____ levels.

A

amylase

672
Q

_____ is usually caused by S. aureus and is unilateral, extemely tender, associated with inc. WBC and may have purulent drainage from the Stensen duct.

A

Purulent Parotitis

673
Q

The most common complications of mumps are _____.

A

meningitis

gonadal involvement

674
Q

Maternal infection with mumps results in _____.

A

fetal wastage

675
Q

The mumps virus enters the CNS through the _____.

A

choroid plexus

676
Q

_____ has been found in 40-60% of patients with mumps parotitis.

A

CSF pleocytosis

677
Q

In males, _____ is 2nd only to parotitis as a common finding in mumps.

A

orchitis

678
Q

Pancreatitis may occur in mumps with or without _____.

A

parotitis

679
Q

Mumps Immunization Schedule and DOse

A

MMR x 2 doses
1st dose - 12-15 mos.
2nd dose - 4-6 y.o.

680
Q

Presumptive Evidence of mumps Immunity

A
  1. documentation of adequate vacccination
  2. labortory evidence
  3. birth before 1957
  4. documentation of diagnosed mumps
681
Q

_____ are non-enveloped, singele-stranded, positive-sense viruses in the Picornaviridae family .

A

Enteroviruses

682
Q

_____ are the only known reservoir for enteroviruses.

A

humans

683
Q

The incubatiojn period for enteroviruses in _____.

A

3-6 days

684
Q

The incubation period for acute hemorrhagic conjunctivitis is _____.

A

3 days

685
Q

Development of _____ is the most important immune defense against enteroviruses.

A

type-specific antibodies

686
Q

_____ are the most common sypmtomatic manifestations of enteroviruses.

A

Non-Specific Febrile illnesses

687
Q

Hand-foot-and-mouth disease is caused by _____.

A

coxsackievirus A16

688
Q

_____ is characterized by sudden onset fever, sore throat, dysphagia and lesions in the posterioir pharynx.

A

Herpangina

689
Q

_____ is characterized by paroxysmal thoracic pain due to myositis involving the chest and abdominal wall muscles.

A

Pleurodynia (Bornholm Disease)

690
Q

Pleurodynia is caused by _____.

A

coxsackievirus 1, 3, 5

enterovirus 1, 6

691
Q

Acute hemorrhagic conjunctivitis is caused by _____.

A

coxsackie A24/A24

enterovirus 70

692
Q

Acute hemorrhagic conjunctivitis is spread through _____.

A

eye-hand-fomit-eye transmission

693
Q

Enteroviruses account for 25-35% of _____.

A

myocardiitis

pericarditis

694
Q

_____ are 2nd only to mumps as causes of orchitis.

A

Coxsackie B viruses

695
Q

_____ are the most common cause of viral meningitis in mumps-immunized populations.

A

Enteroviruses

696
Q

_____ is the gold standard for confirming enterovirus infection.

A

Viral Culture (cell line combinations)

697
Q

_____ is the mainstay therapy for enteroviruses.

A

Supportive Therapy

698
Q

_____ is cused by the human parvovirus B19, a single-stranded DNA virus.

A

Erythema Infectiosum (5th Disease)

699
Q

The affinity of parvovirus to red blood celll progenitor cells makes it an important cause of _____.

A

aplastic crisis

700
Q

Maternal parvovirus infection causes _____.

A

fetal anemia

hydrops fetalis

701
Q

The cell receptor for parvovirus B19 is the _____ which is a glycolipid present on erythroid cells.

A

erythrocyte P antigen

702
Q

Parvovirus replicates in actively dividing erythroid cells ealding to cell death that results in _____.

A

erythroid aplasia

anemia

703
Q

Parvovirus B19 is transmitted by _____.

A

respiratory secretions

blood transfusions

704
Q

The incubation period of parvovirus B19 is _____.

A

4-14 days

705
Q

The characteristic rash of erythema infectiosum is the _____ which is seen with _____

A

“slapped cheek” rash

circumoral pallor

706
Q

Erythema infectiosusm causes an erythematous symmetric, maculopapular, truncal rsh which appears _____ later but fades into a _____.

A

1-4 days

lacy reticulated rash (2-40 days)

707
Q

The reticulocyte count in a patient in aplastic crisis from parvovirus is _____.

A

low or 0 (7010 days)

708
Q

_____ may be used in immunodeficient patients with severe anemia caused by parvovirus.

A

IVIg

709
Q

Maternal parvovirus infection causes _____.

A

fetal heart failure, hydrops fetalis, fetal death

710
Q

Maternal parvovirus infection causes _____.

A

fetal heart failure
hydrops fetalis
fetal death

711
Q

Parvovirus B19 causes a syndrome with fever, pruritus and edema and erythema localized to the distal extremities called _____.

A

papular purpuric “gloves and socks” syndrome (PPGSS)

712
Q

_____ occurs in individuals previously infected with 1 type of HSV and has been infected by another.

A

on-primary 1st Infection

713
Q

HSV establishes latent infection in _____.

A

regional sensory ganglion neurons

714
Q

_____ contains a double-stranded DNA genome of 152 kb that encodes 84 proteins.

A

Herpes Simplex Virus (HSV)

715
Q

The _____ DNA is contained in an icosadeltahedral capsid which is surrounded by an outer envelope composed of a lipid bilayer containing at least 12 glycoproteins.

A

HSV

716
Q

HSV glycoproteins are major targets for _____.

A

humoral immunity

717
Q

Non-structural proteins of HSV are targeted by _____.

A

cellular immunity

718
Q

_____ are encoded proteins in HSV which are targets for antiviral drugs.

A

viral DNA polymerase

thymidine kinase

719
Q

HSV-1 has a greater propensity to cause _____.

A

oral infections

720
Q

HSV-2 has a greater propensity to cause _____.

A

genital infecitions

721
Q

_____ is a leading cause of sporadic, fatal viral encephalitis.

A

HSV

722
Q

The hallmarks of HSV infections are _____.

A

skin vesicles

shallow ulcers

723
Q

_____ infections manifest as 2-4 mm vesicles that are surrounded by an erythematous base.

A

HSV

724
Q

Herpes gingivostomatitis in children _____.

A

6 mos.-5 y.o.

725
Q

Herpes gingivostomatitis resolves in _____.

A

7-14 days

726
Q

_____ are the most common manifestation of recurrent HSV-1 infection.

A

fever blisters or cold sores

727
Q

The most common site for herpes labialis is the _____.

A

vermillion border of the lip

728
Q

Cutaneous HSV infections usually occur in contact sports such as _____.

A

wrestling (herpes gladiatorum)

rugby (scrum pox)

729
Q

_____ is HSV infection of the fingers and toes.

A

Herpes Whitlow

730
Q

_____ presents as local burning and tenderness followed by vesicles on the genital mucosal surface or keratinized skin around the anus, buttocks or thighs.

A

Genital Herpes

731
Q

The course of classic primary genital herpes is _____.

A

2-3 weeks

732
Q

HSV keratoconjunctivitis is usually unilateral and is associated with _____.

A

blepharitis

tender preauricular lymphadenopathy

733
Q

HSV encephalitis is an acute necrotizing infection involving the _____.

A

frontal and temporal lobes

734
Q

HSV is a common cause of recurrent aseptic meningitis called _____.

A

Mollaret meningitis

735
Q

Infants infected with HSV can present with _____.

A
  1. skin, eyes, mouth involvement (SEM disease)
    2, enncephalitis
  2. disseminated infection
736
Q

Infants with HSV encephalitis present at _____.

A

8-17 daysof life

737
Q

HSV infection is confirmed with _____.

A

PCR

738
Q

The gold standard for diagnosing HSV infection is _____.

A

viral culture

739
Q

Treatment for HSV

A

Acyclovir
Valacyclovir
Famiciclovir

740
Q

HSV Gingivostomatitis Treatment

A

Oral Acyclovir 15mkdose 5x/day PO x 7 days

*max. 1 g/day

741
Q

Herpes Labialis Treatment

A

Valacyclovir 2 g BID PO x 1 day
Acyclovir 200-400 mg 5x/day PO x 5 days
Famciclovir 1.5 g OD PO x 1 day

742
Q

Herpes Gladiatorum Treatment

A

Acyclovir 200 mg 5x/day PO x 7-10 days

Valacyclovir 500 mg BID PO x 7-10 days

743
Q

Herpetic Whitlow Treatment

A

Acyclovir 1.6-2 g mg/day BID/TID PO x 10 days

744
Q

Eczema Herpeticum Treatment

A

Acyclovir 200 mg 5x/day PO x 5 day

745
Q

Teatment Options for Recurrent HSV Infections

A

1 - no therapy
2 - episodic therapy
3 - long-term suppressive therapy

746
Q

Herpes encephalitis should be treated with _____.

A

Acyclovir 10 mkdose q8 x 1h x 14-21 days

747
Q

HSV limited to skin, eyes and mouth should be treated for _____.

A

14 days

748
Q

Disseminated or CNS HSV should be treated for _____.

A

21 days

749
Q

Pregnant women with active genital herpes should deliver via CS within _____.

A

4-6 hours of rupture of membranes

750
Q

_____ infection results in establishment of of a lifelong latent infection of sensory ganglion neurons.

A

Varicella

751
Q

Reactivation of latent varicella infection causes _____.

A

herpes zoster (shingles)

752
Q

_____ ias n enveloped virus with double-stranded DNA genomes that encode 70 proteins.

A

Varicella

753
Q

Primary varicella infectionresults from inoculation of the virus onto the _____.

A

upper respiratory tract mucosa

tonsillar lymphoid tissue

754
Q

The incubation period of varicella is _____.

A

10-21 days

755
Q

Varicella is contagious _____ before the appearance of rash.

A

1-2 days

756
Q

Chickenpox manifests _____ after exposure.

A

14-16 days

757
Q

The initial exanthem of _____ consists of intensely pruritic erythematous macules that evolve through the papular stage to form clear, fluid-filled vesicles.

A

varicella

758
Q

Clouding and umbilication of varicella lesions begin in _____.

A

24-48 hours

759
Q

While the initial varicella lesions are crusting, new crops form on the _____.

A

trunk then extemities

760
Q

The distribution of varicella rash is _____.

A

central or centripetal

761
Q

Varicella in vaccinated individuals is called _____ and is caused by _____.

A

Breakthrough Varicella

wild-type VZV

762
Q

Breakthrough varicella is _____ than wild-type infection.

A

less contagious

763
Q

_____ is a severe complication of primary VZV infection which manifests with visceral organ involvement, coagulopathy, severe hemorrhage and continued vasicular lesion development.

A

Progressive Varicella

764
Q

Infants whose mothers demonstrate varicella in the period from _____ are at high risk for severe varicella.

A

5 days before to 2 days after delivery

765
Q

Newborns from mothers with varicella should be given _____.

A

1 vial of VZIG

766
Q

_____ is characterized by cicatricial skin scaring in a zoster-like distribution, limb hypoplasia, neurologic, renal and autonomic nervous system abnormalities.

A

Congenital Varicella

767
Q

The characteristic cutaneous lesion of _____ has been called cicatrix, a zigzag scarring, in a dermatomal distribution associated with atrophy of the affected limb.

A

congenital varicella

768
Q

Herpes zoster manifests as vesicular lesions in a _____ pattern.

A

dermatomal

769
Q

The most common complication of herpes zoster is _____, a painful condition that affects the nerves despite resolution of the shingles skin lesions.

A

postherpetic neuralgia

770
Q

In Varicella, multinucleated giant cells can be detected through _____.

A

Tzanck Smear

771
Q

A _____ increase in varicella IgG is confirmatory of acute infection.

A

4x

772
Q

The drug of choice for varicella is _____.

A

Acyclovir 20 mkdose QID x 5 days

*max. 800mg/dose

773
Q

_____ is the only drug available for acyclovir-resistant VZV infections.

A

Foscarnet 120 mkday q8 x 3 weeks

774
Q

The most common fatal complication of varicellla is _____.

A

pneumonia

775
Q

Varicella is contagious for _____.

A

24-48 hours before rash

776
Q

Varicella Vaccine Schedule

A

1st dose - 12-15 mos.

2nd dose - 4-6 y.o.

777
Q

Postexposure varicella prophylaxis is given within _____ after exposure.

A

3-5 days

778
Q

_____ is the best known clinical syndrome caused by the Epstein-Barr Virus.

A

Infectious Mononucleosis

779
Q

Infectious Mononucleosis is also known as _____.

A

glandular fever

780
Q

_____ derives its name from the mononuclear lymphocytosis wih atypical appearing lymphocytes

A

Infectious Mononucleaosis

781
Q

Infectious Mononucleosis-like illnesses can be caused by _____.

A
CMV
Toxoplasma gondii
adenovirus
viral hepatitis
HIV
rubella
782
Q

EBV affects _____ of the world’s population.

A

95%

783
Q

EBV is shed in _____ for _____ after acute infection then intermittently for life.

A

oral secretions, 6 mos.

784
Q

Triad of EBV

A

fatigue
pharyngitis
generalized lymphadenopathy

785
Q

The atypical lymphocytes that are characteristic of infectious mononucleosis are _____ which exhibit suppressor and cytotoxic functions that develop response to infeced B lymphocytes.

A

CD8+ T lymphocytes

786
Q

____ was the first virus to be associated with malignancy

A

EBV.

787
Q

EBV infection increases risk for _____ by 2-4x.

A

Hodgkin’s Disease

788
Q

____ is an X-linked recessive disorder of the immune system associated with severe, persistent and sometimes fatal EBV infection.

A

X-Linked Lymphoproliferative Syndrome

Duncan Syndrome

789
Q

The incubation period of Infectious Mononucleosis is _____.

A

30-50days

790
Q

Classic PE of Infectious Mononucleosis

A

generalized lymphadenppathy (90%)
splenomegaly (50%)
hepatomegaly (10%)

791
Q

80% of infectious mononucleosis patients experience _____ when treated wtih ampicillin or amoxicillin.

A

ampicillin rash

792
Q

EBV is associated with _____, a symmetric rash on the cheeks with multiple erythematous papules which may coalesce into plaques, and persists for 15-50 days.

A

Gianotti-Crosti syndrome

793
Q

The culture method for EBV is _____.

A

transformation assay

794
Q

_____ is performed by co-cultivation of oropharyngeal or genital secretions, peripheral blood (10-390 ml) or tumor with human umbilical cord lymphocytes.

A

Transformation Assay

795
Q

EBV cultures are observed for 6 weeks for signs of _____.

A

cell transformation

796
Q

EBV immortalizes the _____.

A

umbilical cord cells

797
Q

In EBV infection, there is eukocytosis at _____ with _____ atypical lymphocytes.

A

10,000-20,000 cells/mm3

20-40%

798
Q

Heterophile Antibody Test is useful for diagnosisng _____.

A

EBV infection

799
Q

Paul-Bunnell-Davidson Test is used to detect Paul-Bunnell Antibodies to diagnose _____.

A

EBV

800
Q

Because of risk for splenic rupture in EBV, strenuous activities must be avoided for _____.

A

2-3 weeks or while with splenomegaly

801
Q

The most feared complication of EBV is _____.

A

subcapsular splenic hemorrhage or splenic rupture

802
Q

Splenic hemorrhage or rupture in EBV is most likely to happen during the _____ of disease.

A

2nd week

803
Q

_____ is associated with EBV and presents with perceptual distortions of sizes, shapes and spatial relationships.

A

Alice in Wonderland Syndrome (metamorphopsia)

804
Q

_____ is the most common cause of congenital infection.

A

Cytomegalovirus (CMV)

805
Q

CMV causes _____ which causes hepaatosplenomegaly, jaundice, petechia, purpura and microcephaly in neonates.

A

Cytomegalic Inclusion Disease

806
Q

_____ is the largest of the herpesviruses and has a diameter of 200 nm with double-stranded DNA viral genome of 240 kb in a 64 nm core enclosed by an icosahedral capsid composed of 162 capsomers.

A

CMV

807
Q

_____ causes SGA, microcephaly, thrombocytopenia, hepatosplenomegaly, hepatitis, intracranial calcifications, chorioretinitis, hearing abnormalities and blueberry muffin appearance.

A

CMV

808
Q

HHV-6 is responsible for _____.

A

Roseaola Infantum
Exanthema Subitum
6th Disease

809
Q

_____ are the sole members of the Roseolovirus genus in the Betaherpesviridae subfamily of human herpesviruses.

A

HHV 6 and 7

810
Q

_____ are composed of a protein-dense tegument, lipid envelope and icosahedral nucleocapsid containing large linear double-stranded DNA genomes with > 80 unique proteins

A

HHV 6 and 7

811
Q

95% of children are infected with HHV 6 by _____.

A

2 y.o.

812
Q

HHV 6 is traansmitted through _____.

A

transplacental infection

chromosomal integration

813
Q

HHV 6 is unique among the human herpesviruses in that it is integrated in the _____ of the human chromosome.

A

telomere end

814
Q

_____ viremia is demonstrated by co-culture of the patient’s peripheral blood mononuclear cells (PBMCs) with mitogen-stimulated cord blood mononuclear cells.

A

HHV 6

815
Q

_____ has a cytopathic effect consisting of appearance of large refractile mononucleated or multinucleated cells with intracytoplasmic and/or intranuclear inclusions.

A

HHV 6

816
Q

_____ is characterized by the abrupt onset of high fever which may be accompanied by fussiness.

A

Roseola

817
Q

_____ presents with fever lasting 72 hours with a faint pink or rose-colored, non-pruritic, 2-3 mm morbilliform rash on the trunk.

A

Roseola

818
Q

In Asian counties, ulcers at the uvulopalatoglossal junction called _____ are commonlu seen in roseola.

A

Nagayama Spots

819
Q

_____ is the most consistent finding in HHV 6 infection.

A

High Fever (39.7° C)

820
Q

The most common laboratory findings in HHV 6 infeections are _____.

A

↓WBC 8900/mm3
↓lymphocytes 3400/mm3
↓neutrophils 4500/mm3

821
Q

_____ presents as 3 days of high fever in an otherwise non-toxic (10 mo.) infant with blanching maculopapular rash on the trunk.

A

Roseola

822
Q

_____ is the gold standard for diagnosisng roseola.

A

Viral Culture

823
Q

_____ are the most common complication of roseola.

A

Convulsions

824
Q

_____ is the major cause of bronchiolitis and viral pneumonia in children < 1 y.o. and is the most important respiratory tract pathogen of early childhood.

A

Respiratory Syncytial Virus (RSV)

825
Q

_____ is an enveloped RNA virus with a single-stranded negative-sense genome that replicates entirely in the cytoplasm of infected cells and matures by budding from the apical surface of the cell membrane,

A

RSV

826
Q

Because RSV has a non-segmented genome, it can undergo _____.G glycoprotein.

A

antigenic shift

827
Q

Breastfeeding is protective against RSV in _____ infants.

A

female

828
Q

RSV if the lower respiratory tract have the highest incidence during _____ of age.

A

6 weeks-7 mos.

829
Q

_____ is caused by obstruction and collapse of the small airways during expiration

A

Bronchiolitis

830
Q

Airway Resistance is proportional to _____.

A

1/radius^4

831
Q

The first sign of RSV infection is _____.

A

rhinorrhea

832
Q

RSV CXR Findings

A

normal (30%)
hyperexpansion
peribronchial thickening
interstitial infiltrates

833
Q

Definitive diagnosis of RSV infection is based on the detection of _____.

A

live virus in respiratory secretions by cell culture

834
Q

_____ is an antiviral agent delivered through an oxygen hood, face masks or ET tube that can be used for RSV infection.

A

Ribavirin

835
Q

Immunoprophylaxis for RSV

A

Palivizumab 15 mg/kg IM 1x/mo.

836
Q

_____ is a neutralizing humanized murine monoclonal antibody against RSV.

A

Palivizumab

837
Q

Canditates for RSV Immunoprophylaxis

A

lung disease
preterm
< 2 y.o. with CHD

838
Q

_____ are non-enveloped viruses with an icosahedral capsid containing double-stranded DNA.

A

Adenoviruses (AdV)

839
Q

Adenoviruses can be shed from the _____ for prolonged periods and can establish chronic infection of the _____.

A

GI tract

tonsils and adenoids

840
Q

An important factor in adenovirus transmission is its ability to _____.

A

survive on inanimate objects in the environment

841
Q

Hemorrhagic cystitis with sudden onset hematuria, dysuria, frequency, urgency and (-) urine bacterial culture can be caused by _____.

A

adenovirus

842
Q

In early childhood, the single most important cause of severe dehydrating diarrhea is _____.

A

rotavirus

843
Q

Medically Important Pathogens of Viral Gatroenteritis

A

Rotavirus
Astrovirus
Calicivirus (Norwalk Agent)

844
Q

_____ are wheel-like, triple-shelled icosahedrons containing 11 segments of double-stranded RNA.

A

Rotaviruses

845
Q

_____ are in the Reoviridae family and cause disease in virtually all mammals and birds.

A

Rotaviruses

846
Q

Viruses that cause human diarrhea selectively infect and destry _____.

A

villus tip cells of the small intestines

847
Q

Viral infection of intestinal villus tip cells leads to decreased absorption of _____ leading to an imbalance in the ratio of the intestinal fluid absorption to secretion.

A

salt and water

848
Q

Viral infection of intestinal villus tip cells leads to dminished _____ acctivity and malabsorption of complex carbohydrates particularly _____.

A

disaccharidase, lactulose

849
Q

Rotavirus has an incubation period of _____.

A

< 48 hours

850
Q

Adenovirus enteritis causes diarrhea lasting _____.

A

10-14 days

851
Q

_____ is the most common finding in severe viral enteritis.

A

Isotonic Dehydration with acidosis

852
Q

Children may be infected with rotavirus each year during the _____.

A

first 5 years

853
Q

Trivalent rotavirus vaccine has been linked to increased incidence of ______.

A

intussusception

854
Q

_____ is characterized by biphasic fever, myalgia or arthraalgia, rash, leukopenia and lymphadenopathy.

A

Dengue Fever

855
Q

Dengue viruses have _____ distinct antigenic types.

A

4

856
Q

Dengue is transmitted bby _____, a daytime biting mosquito.

A

Aedes aegypti

857
Q

_____ is the strongest risk facor for developing severe dengue.

A

Infection-Enhancing Antibodies

858
Q

The incubation period of dengue is _____.

A

1-7 days

859
Q

In dengue, severe back pain can precede fever. this is called _____.

A

breakback fever

860
Q

A generalized, blanching, macular rash may be seen in the first _____ of dengue fever.

A

24-48 hours

861
Q

_____ after defervescence from dengue, a generalized, morbiliform, maculopapular rash appears that spares the palms and soles.

A

1-2 days

862
Q

WHO Criteria for Dengue Hemorrhagic Fever

A
fever - 2-7 days, biphasic
hemorrhagic manifestations
thrombocytopenia (< 100,000/mm3)
increased capillary permeability
≥ 20% increase in hemetocrit
pleuraleffusion or ascites
hypoalbuminemia
863
Q

Criteria for Dengue Shock Syndrome

A

hypotension
tachycardia
narrow pulse pressure (≤ 20 mmHg)
poor perfusion

864
Q

Dengue IgM disappears after _____.

A

6-12 weeks

865
Q

In dengue fever, pancytopenia may occur after the _____ of illnesss.

A

3-4 days

866
Q

Most Common Hematologic Abnormalities in Dengue

A

≥ 20% increase in hemetocrit
thrombocytopenia
prolonged bleeding time
decreased prothrombin level

867
Q

Most Frequent Complications of Dengue

A

fluid and electrolyte losses
hyperpyrexia
febrile convulsions

868
Q

The _____ virus is a bullet-shaped, negative-sense, single-stranded, enveloped RNA virus from the family Rhabdoviridae, genus Lyssavirus.

A

rabies

869
Q

After inoculation, the rabies virus replicates slowly and at low levels in the _____.

A

muscle

skin

870
Q

The rabies virus enters the _____, utilizing the _____.

A

peripheral motor nerve

nicotinic acetylcholine receptor

871
Q

Oncein the nerve, the rabies virus travels by _____, crossing synapses roughly every _____.

A

fast axonal transport, 12 hours

872
Q

Rabies infection concentrates in the _____, accounting for autonomic dysfunction and sparing of cognition.

A

brainstem

873
Q

The pathologic hallmark of rabies, the _____, is composed of clumped viral nucleocapsids that create cytoplasmic inclusions on histology.

A

Negri body

874
Q

After infection of the CNS, the rabies virus travels _____ throug the peripheral nervous system.

A

anterograde

875
Q

The incubation period of rabies is _____.

A

1-3 mos.

876
Q

Forms of Rabies

A

Encephalopathic/Furious

Paralytic/Dumb

877
Q

_____ are cardinal signs of rabies.

A

hydrophobia

aerophobia

878
Q

_____ is the most sensitive available assay for the diagnosis if rabies.

A

RT-PCR

879
Q

Rabies post-Exposure prophylaxis

A
  1. cleanse wound
  2. Human RIG 20 IU/kg
  3. inactivated vaccine
880
Q

_____ is a single-stranded RNA virus of the retrovirus family that produces a reverse transcriptase enabling the viral RNA to act as a template for DNA transcription and integration into the host gene.

A

Human Immunodeficiency Virus (HIV)

881
Q

HIV infects _____.

A

helper T cells

cells of the monocyte-macrophage lineage

882
Q

HIV infects cells via interaction of _____ with _____.

A

viral protein gp120, CD4 and chemokines

883
Q

HIV causes _____ immunodeficiency.

A

combined (B and T cell)

884
Q

HIV is transmitted through _____.

A

sexual contact
IV drug use
birth
breastfeeding

885
Q

Perinatal transmission of HIV can be decreased from 25% to 8% with _____.

A

maternal antiretrovirals before and during delivery

postnatal treatment of the infant

886
Q

Incubation Period of HIV:

Vertical Transmission

A

5 mos. (1-24 mos.)

887
Q

Incubation Period of HIV:

Horizontal transmission

A

7-10 years

888
Q

Primary HIV infection results in the _____ which develops after 2-6 weeks and consists of fever, malaise, weight loss, pharyngitis, lymphadenopathy and maculopapular rash.

A

Acute Retroviral Syndrome

889
Q

Manifestations of HIV in Children

A
recurrent bacterial infection
lymphoid hyperplasia
chronic parotid swelling
lymphocytic interstitial pneumonitits
early onset of progressive neurologic deterioration
890
Q

HIV can be diagnosed by _____.

A

1-6 mos.

891
Q

Diagnostic HIV testing should be done at _____.

A

48 hours
1-2 mos.
3-6 mos.

892
Q

The preferred test for HIV is _____.

A

HIV DNA PCR

893
Q

Persistence of a (+) HIV antibody test beyond _____ indicates hIV infection.

A

18 mos.

894
Q

There is rapid increase of HIV risk as CD4 counts declines to _____.

A

< 15%

895
Q

Initiation of antiretroviral therapy is recommended for _____.

A

infants < 12 mos. with clinical or immunologic symptoms of HIV, > 12 mos. with AIDS or severe immunosupression, HIV RNA levels > 100,000 copies/ml, adolescents with CD4< 200-350/mm3 or HIV RNA levels > 55,000 copies/ml

896
Q

Antiretroviral Drugs

A

nucleoside analogue
nucleoside reverse transcriptase inhibitors
non-nucleoside reverse transcriptase inhibitors
protease inhibitors
fusion inhibitors

897
Q

Combination therapy with _____ is recommended for HIV.

A

Highly Active Antiretroviral Therapy (HAART)

898
Q

Infants born to HIV (+) mothers should be given prophylaxis for P. jirovecii (carinii) pneumonia with _____ given at _____.

A

TMP-SMX, 4-6 weeks to 1 y.o.

899
Q

TMP-SMX prophylaxis for P. jirovecii (carinii) should be given to older children with _____.

A

CD4 < 200/mm3

oropharyngeal candidiasis

900
Q

HIV (+) individuals are prone to Non-Hodgkin Lymphoma most commonly found at the _____.

A

GI tract

901
Q

_____ are the 2nd most common tumors among HIV-infected children.

A

Leiomyosarcomas

902
Q

Maternal HIV Prophylaxis

A

Zidovudine 100 mg 5x/day PO starting at 4 weeks AOG to delivery (2 mg/kg IV as LD then 1 mg/kg/h)

903
Q

Neonatal HIV Prophylaxis

A

Zidovudine 2 mg/kg q6 for the first 6 weeks

904
Q

Most Commen Diseases caused by E. histolytica

A

amebic colitis

amebic liver abscess

905
Q

Amebiasis is acquired through ingestion of _____ which measure 10-18 mm in diameter in contain 4 nuclei.

A

parasite cysts

906
Q

The most common finding in amebic liver abscess is _____.

A

single abscess in the right hepatic lobe

907
Q

Invasive amebiasis is treated with _____.

A

Nitriimidazole (Metronidazole, Tinidazole)

Luminal Amebicide

908
Q

Giardia lamblia infects humans after ingestion of _____ which measure 8-10 mm in diameter.

A

10-100 cysts

909
Q

The incubation period of Giardia is _____.

A

1-2 weeks

910
Q

_____ infection causes stools which are initiallly watery then later becomes greasy and foul smelling and may float.

A

Giardia

911
Q

The diagnostic tests of choice for Giardia are _____.

A

stool enzyme immunoassay (EIA)

direct fluorescent antibody tests

912
Q

Drug of Choice for Giardia

A

Tinidazole
Nitazoxanide
Metronidazole

913
Q

Major Phases of the Life Cycle of Plasmodium

A

Asexual (Schizogony)

Sexual (Sporogony)

914
Q

The _____ of Plasmodium asexual development begins when the merozoites released from exoerythrocytic schizonts in the liver penetrate erythrocytes.

A

Erythrocytic Phase

915
Q

When inside the erythrocyte, plasmodium transforms into _____ which enlarges to become a _____.

A

ring form, trophozoite.

916
Q

Trophozoites can be identified via _____ which is the primary means of confirminf the diagnosis of malaria.

A

Giemsa Stain of blood smear

917
Q

Malaria is primarily transmitted by _____.

A

female Anopheles mosquitoes

918
Q

_____ is the most important cause of fever and morbidity in the tropical world.

A

Malaria

919
Q

The incubation period of plasmodium is _____ depending on the species.

A

6-30 days

920
Q

The most characteristic clinical feature of malaria is _____.

A

febrile paroxysms

921
Q

Classic Symptoms of Febrile Paroxysms in Malaria

A

high fever
rigors
sweats
headache

922
Q

Febrile paroxysms coincide with the rupture of _____.

A

schizonts

923
Q

Plasmodium with Tertian Periodicity (48 hours)

A

P. vivax, P. ovale

924
Q

Plasmodium with Quartan Periodicity (72 hours)

A

P. malariae

925
Q

_____ is the recurrence of malarial symptoms after a primary attack that is due to the survival of erythrocyte forms in the bloodstream.

A

Short-Term Relapse

926
Q

_____ is the renewal of malarial symptoms long after the primary attack, usually due to release of merozoites from an exoerythrocytic source in the liver.

A

Long-Term Relapse

927
Q

Malaria Diagnostics:

scan large numbers of erythrocytes quickly

A

thick blood smear

928
Q

Malaria Diagnostics:

identification of malaria species

A

thin blood smear

929
Q

_____ is the recommended treatment for malaria.

A

Chloroquine

930
Q

_____ is a complication of P. falciparum and a frequent cause of death.

A

Cerebral Malaria

931
Q

Severe hemolysis caused by malaria is called _____.

A

blackwater fever

932
Q

_____ is a sepsis syndromewith vascular collapse caused by malaria.

A

Algid Malaria

933
Q

Malaria prophylaxis should be given _____.

A

1-2 weeks before until 4 weeks after travel

934
Q

Doxycycline can be given as malaria prophylaxis _____ before travel.

A

1-2 days

935
Q

In areas where chloroquine-resistant P. falciparum exists, _____ is recommended.

A

Mefloquine

936
Q

Exoerythroxytic Cycle:

P. falciparum

A

5.5-7 days

937
Q

Exoerythroxytic Cycle:

P. vivax

A

6-8 days

938
Q

Exoerythroxytic Cycle:

P. ovale

A

9 days

939
Q

Exoerythroxytic Cycle:

P. malariae

A

12-16 days

940
Q

Exoerythroxytic Cycle:

P. knowlesi

A

8-9 days

941
Q

Erythrocytic Cycle:

P. falciparum

A

48 hours

942
Q

Erythrocytic Cycle:

P. vivax

A

42-48 hours

943
Q

Erythrocytic Cycle:

P. ovale

A

49-50 hours

944
Q

Erythrocytic Cycle:

P. malariae

A

72 hours

945
Q

Erythrocytic Cycle:

P. knowlesi

A

24 hours

946
Q

Incubation Period:

P. falciparum

A

12 days (9-14 days)

947
Q

Incubation Period:

P. vivax

A

13 days (12-17 days)

948
Q

Incubation Period:

P. ovale

A

17 days (16-18 days)

949
Q

Incubation Period:

P. malariae

A

28 day (18-40 days)

950
Q

Incubation Period:

P. knowlesi

A

~12 days

951
Q

Erythrocyte Preference:

P. falciparum

A

young erythrocytes

952
Q

Erythrocyte Preference:

P. vivax

A

reticulocytes

953
Q

Erythrocyte Preference:

P. ovale

A

reticulocytes

954
Q

Erythrocyte Preference:

P. malariae

A

older erythrocytes

955
Q

Erythrocyte Preference:

P. knowlesi

A

older erythrocytes

956
Q

Parasite Load:

P. falciparum

A

1-5

957
Q

Parasite Load:

P. vivax

A

1-2

958
Q

Parasite Load:

P. ovale

A

1-2

959
Q

Parasite Load:

P. malariae

A

1-2

960
Q

Parasite Load:

P. knowlesi

A

variable

961
Q

Secondary Exoerythrocytic Cycle and Relapses:

P. falciparum

A

absent

962
Q

Secondary Exoerythrocytic Cycle and Relapses:

P. vivax

A

present

963
Q

Secondary Exoerythrocytic Cycle and Relapses:

P. ovale

A

present

964
Q

Secondary Exoerythrocytic Cycle and Relapses:

P. malariae

A

absent

965
Q

Secondary Exoerythrocytic Cycle and Relapses:

P. knowlesi

A

absent

966
Q

Duration of Untreated Infection:

P. falciparum

A

1-2 years

967
Q

Duration of Untreated Infection:

P. vivax

A

1.5-4 years

968
Q

Duration of Untreated Infection:

P. ovale

A

1.5-4 years

969
Q

Duration of Untreated Infection:

P. malariae

A

3-50 years

970
Q

Duration of Untreated Infection:

P. knowlesi

A

unknown

971
Q

Severity of Primary Attack:

P. falciparum

A

severe

medical emergency

972
Q

Severity of Primary Attack:

P. vivax

A

mild to severe
splenic rupture
relapse

973
Q

Severity of Primary Attack:

P. ovale

A

mild
splenic rupture
relapse

974
Q

Severity of Primary Attack:

P. malariae

A

chronic
subclinical
nephritis

975
Q

Severity of Primary Attack:

P. knowlesi

A

variable

can be fatal

976
Q

Periodicity of Febrile Attacks:

P. falciparum

A

none

977
Q

Periodicity of Febrile Attacks:

P. vivax

A

48 hours (tertian)

978
Q

Periodicity of Febrile Attacks:

P. ovale

A

48 hours (tertian)

979
Q

Periodicity of Febrile Attacks:

P. malariae

A

72 hours (quartan)

980
Q

Periodicity of Febrile Attacks:

P. knowlesi

A

24 hours

981
Q

Duration of Febrile Paroxysm:

P. falciparum

A

16-36 hours

982
Q

Duration of Febrile Paroxysm:

P. vivax

A

8-12 hours

983
Q

Duration of Febrile Paroxysm:

P. ovale

A

8-12 hours

984
Q

Duration of Febrile Paroxysm:

P. malariae

A

8-10 hours

985
Q

Duration of Febrile Paroxysm:

P. knowlesi

A

unknown

986
Q

Toxoplasmosis is a zoonosis caused by _____ an intracellular protozoan parasite.

A

Toxoplasma gondii

987
Q

T. gondii is acquied by ingesting _____.

A

oocysts - cats

cysts - unndercooked meat

988
Q

_____ is characterized by heterophil (-) mononucleosis syndrome that includes lymphadenopathy, fever and hepatosplenomegaly

A

Toxoplasmosis

989
Q

Serologic diagnosis is established by (+) PCR for T. gondii in _____.

A

peripheral WBCs
CSF
serum
amniotic fluid

990
Q

Toxoplasmosis is treated with _____.

A

Pyrimethrine
Sulfadiazine

*folic acid inhibitor, should be given with folinic acid

991
Q

Ascariasis is caused by _____, a large nematode.

A

Ascaris lumbricoides

992
Q

_____ is the most prevalent helminthiasis.

A

Ascariasis

993
Q

After humans ingest ascaris eggs, larvae are released and penetrate the _____.

A

intestines → lungs → trachea → reswallowed

994
Q

_____ occurs as ascaris larvae migrate through the lung, producing cough, blood-stained sputum, eosinophilia and transient infiltrates on CXR.

A

Pulmonary Ascariasis

995
Q

_____ is diagnostic for ascariasis.

A

Fecalysis

996
Q

Pinworm is caused by _____, a nematode that is distributed worldwide.

A

Enterobius vermicularis

997
Q

Enterobius eggs hatch in the _____. and the larvae migrate to the _____.

A

stomach, cecum

998
Q

The most common symptoms of enterobasis are _____.

A

nocurnal anal pruritus (pruritus ani)

sleeplessness

999
Q

Enterobius eggs are detected by _____.

A

presssing cellophane tape over the anus to collect eggs

1000
Q

Enterobiasis is treated with_____.

A

Albendaole 400 mg
Mebendazole 100 mg
Pyrantel pamoate 11 mg/kg (max. 1 g)

*single dose, q2 weeks