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Micro Flashcards

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1
Q

Branching filamentous rods

A

Nocardia (acid fast, urease +)

actinomyces (anaerobe)

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2
Q

Use of PAS

A

Whipple’s disease

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3
Q

Chocolate agar growth

A

H. influenza

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4
Q

Thayer-Martin growth (has vanco/polymyxin/nystatin)

A

N. gonorrhea or N. menigitidis

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5
Q

Bordet-Genau growth

A

Bordatella pertussis

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6
Q

Tellurite/Loffler growth

A

C. diphtheria

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7
Q

Lowenstein-Jensen growth

A

Mycobacterium tuberculosis

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8
Q

Eaton’s agar growth

A

Mycoplasma pneumonia

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9
Q

Charcoal yeast extract with cysteine/iron growth

A

Legionella

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10
Q

Assc with burn wounds

A

Pseudomonas

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11
Q

Encapsulated organisms (7)

A 
H. flu
Strep pneumo
N. meningitidis
E. coli
Salmonella
Klebsiella
Strep group B
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12
Q

Catalase (+) bugs (7)

A 
pseudomonas
listeria
aspergillus
candida
E. coli
S. aureus
serratia
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13
Q

Sulfur granules on microscopy

A

Actinoyces israelii

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14
Q

Bug that produces red pigment

A

Serratia marcescens

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15
Q

Pharyngitis/pseudomembrane

bull neck

A

C. diphtheria

inactivates EF2

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16
Q

Dysentery
GI mucosal damage
toxin caused

A

Shigella, shiga toxin
inactivates 60s ribosome
also seen in E. coli 0157:H7

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17
Q

Rice water diarrhea

A

cholera toxin

increases cAMP by adenylate cyclase

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18
Q

Whooping cough toxin

A

Pertussis toxin

disables Gi, increases cAMP

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19
Q

Tetanus MOA

A

toxin inhibits GABA/glycine release

muscle rigidity

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20
Q

Botulinum MOA

A

toxin prevents release of ACh at NMJ

paralysis

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21
Q

Toxins with A/B type MOA

A

Cholera toxin and pertussis toxin

B enters cell, A activates

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22
Q

Staph species differentiation

A

S. aureus-coagulase +
S. epidermidis-novobiocin sensitive
S. saprophyticus-novobiocin resistant

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23
Q

Strep species differentiation

A

S. pneumo-optochin sensitive, alpha hemolytic
Viridans strep-otpochin resistant, alpha
Group A strep-bacitracin sensitive, beta
Group B strep-bacitracin resistant, beta

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24
Q

S. aureus toxins

A

TSST-1 toxic shock
scalded skin syndrome
food poisoning

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25
Bug seen on prosthetic heart valves
Staph epidermidis | biofilm
26
Pneumonia otitis media sinusitis IgA protease (+)
Strep pneumo rusty sputum sepsis with sickle cell/splenectomy optochin sensitive
27
Dental caries endocarditis normal flora
Viridans strep Strep mutans-caries S. sanguis-heart valves resistant to optochin
28
Arthritis carditis nodules sub q post infection
Strep pyogenes bacitracin sensitive ASO titer to detect also see erythema marginatum and syndenham's chorea with Rheumatic fever
29
Rash over the body red tongue and throat post infection
Strep pyogenes Scarlet fever bacitracin sensitive toxic shock like syndrome
30
1 yr/o Pneumonia meningitis
Strep agalactia (group B) seen in babies bacitracin resistant Hippurate (+)
31
Subacute endocarditis | bacteremia
Strept bovis | colon cancer pts
32
Grayish-white on pharynx lymphadenopathy of neck (+) cystine-tellurite growth
C. diphtheria bullneck/pseudomembrane EF2 inhibiting toxin (+) Elek's test
33
lecithinase (alpha toxin) gas gangrene hemolysis
C. perfringens | causes myonecrosis
34
Black eschar bacteremia edema
cutaneous anthrax poly D glutamate capsule lethal factor and edema factor cause eschars
35
Flu like sx progresses quickly mediastinitis pulmonary hemorrhage
pulmonary anthrax | Woolsorter's disase-from contaminated wool
36
Rice and pasta diet N/V for 5 hrs watery diarrhea
Bacillus cereus food poisoning reheated rice syndrome
37
High dairy diet spontaneous abortion in pt gastroenteritis
``` Listeria monocytogenes unpasteurized milk/cheese, deli meats tumbling motility moves cell to cell via actin rockets neonatal meningitis ```
38
Oral abscess | sulfur granules on microscopy
Actinomyces normal flora anaerobic branching filaments
39
Pneumonia in immunosuppressed pt | found in soil
nocardia acid fast branching filamentous rods
40
TB virulence factors
cord factor-inhibit Macrophage maturation | sulfatides-inhibit lysosomal fusion
41
Loss of sensation on feet and hands no growth on agar hairless skin plaques
mycobacterium leprae US armadillos lepromatous-communicable (Th2), diffuse tuberculoid-Th1
42
Differentiation b/t neisseria strains
N. meningitidis- maltose fermenter | N. gonorrhea- maltose nonfermenter
43
Adrenal gland failure shock maltose fermentation
N. meningitidis | rapid necrosis of adrenals
44
Epiglottitis otitis media meningitis
H. influenza otitis media from nontypeable cultured on chocolate agar
45
Elderly man pneumonia GI and CNS sx hx of hotel stay
``` Legionella pneumophilia gram (-) rod charcoal yeast growth (iron/cystein) water source caused (AC unit) intracellular in macrophages ```
46
Folliculitis after in hot tub also external otitis exotoxin A
``` Pseudomonas green/blue pigment smells like grapes cystic fibrosis/hot tub/swimmer's ear/burn assc toxin inactivates EF2 ```
47
Homeless alcoholic pneumonia MacConkey growth
Klebsiella red currant jelly sputum diabetics/alcoholics
48
Rose spots on abd fever diarrhea
Slamonella typhi | typhoid fever
49
Bloody diarrhea in a kid arthritis S shaped lower extremity weakness
Campylobacter jejuni deli meat/milk grows at 42 degrees, oxidase (+) Guillain-Barre syndrome (ascending paralysis)
50
Rice water diarrhea | dehydration
vibrio cholerae activates Gs protein oxidase (+) dehydration risk
51
Sx of Crohn's disease | has new puppy
Yersinia entercolitica mimics Crohn's/appendicitis assc with pet feces/milk/pork
52
Duodenal ulcers | dx with gastric adenocarcinoma
Helicobacter pylori urease (+) tx with PPI, clarithromycin, amoxicillin
53
Just got back from Hawaii has jaundice photophobia proteinuria
Leptospira interrogans | Weil's disease (jaundice/azotemia/anemia)
54
Facial n. palsy AV block migratory arthritis erythema migrans
Lyme disease-borrelia burgdoferi NE U.S. bull's eye rash encephalopathy can develop
55
Pupil does not react to light ataxia Hx of maculopapular rash on palms/soles
Syphilis-treponema pallidum VDRL screen, FTA-ABS confirm painless chancre/maculopapular rash/tabes dorsalis (neurosyphilis)
56
Child born with deafness notched teeth abnormal molars
``` Congenital syphilis (treponema) Saber shins/CN VIII/Hutchinson's teeth/mulberry molars ```
57
Dairy products fever muscular pain/swelling migratory arthralgia
Brucella spp | Brucellosis
58
Bloody diarrhea | works at pet shop
Campylobacter | puppies/livestock/undercooked meat
59
Bitten by a cat swelling around the area bone pain
Pasteurella multocida animal bite cellulitis/osteomyolitis
60
Overcrowded area Rash on trunk, spreads out (no palms/soles) fever/headache
Rickettsia prowazekii epidemic typhus body louse vector
61
Hiker rash on limbs that spread to trunk headache/fever
Rickettsia ricketssii | needs CoA and NAD+
62
Farmer | presents with pneumonia sx
Coxiella burnetii | cattle placenta spores
63
African immigrant Recurrent conjunctivitis irritation of the cornea no bugs seen on microscopy
Chlamydia trachomatis serotypes A,B,C follicular conjunctivitis can lead to blindness
64
Sexually active female tenderness/inflammation in pelvis no bugs seen on microscopy What serotype?
Chlamydia trachomatis serotypes D-K urethritis/PID ectopic pregnancy/neonatal penumonia
65
Reactive arthritis urethritis sexually active
Chlamydia elementary body enters cell reticulate body replicates in cell tx with azithromycin/doxycycline
66
Pneumonia pt is mobile and walking (+) cold agglutinins grows on Eaton's agar
Mycoplasma pneumonia walking pneumonia, contains sterols in membrane military recruits/prisons tx with fluoroquiolone or macrolides
67
Pt lives in Ohio presents with pneumonia Has been cave diving in the last month
Histoplasmosis intracellular in macrophages bird/bat droppings
68
Pt lives in Mississippi granulomatous nodules in bone/skin pneumonia
Blastomycosis | broad base budding yeast seen
69
Pt lives in Arizona Presents with meningitis and pneumonia Bone/skin involvement
Coccidioidomycosis Spherules seen San Joaquin valley/desert
70
Immigrant recently moved from South America Captain's wheel appearance on microscopy Pneumonia
Paracoccidioidomycosis
71
In Florida hypopigmented patches spaghetti and meatball appearance on KOH prep
Tinea versicolor | Malassezia furfure causes
72
Pt has asthma sx sputum production (sometimes blood) recurrent pulmonary infections
Aspergillus fumigatus 45 degree branching hyphae type IV HS rxn can also can Aspergillomas (ball in lung)
73
AIDS pt presents with meningitis (+) latex agglutination test recently camping
Cryptococcus neoformans meningitis in AIDS pts bird droppings Soap bubble test in brain
74
Diabetic pt has acidosis headaches necrosis around the nose
``` Mucor and rhizopus spp keotacidotic diabetics cribriform plate/enters brain black necrotic eschar on face hyphae branching at 90 degrees ```
75
AIDS pt below CD4 count of 200 | pneumonia, but mobile
Pneumocystis jirovecii binds alveolar macrophage receptors methenamine silver stained
76
Gardner area of ucler with nodules on finger ascending lymphangitis
Sporothrix schenckii cigar shaped budding yeast vegetation, trauma of skin (rose needles)
77
Dysentery(bloody diarrhea) sx | rectal prolapse
Trichuris trichuria whipworm football eggs with plugged ends
78
Explosive watery diarrhea pig farmer ciliate cysts
balantidium coli
79
Steatorrhea hx of camping no blood in stool
Giardia lamblia steams/lakes/beavers assc falling leaf motility bilobed nuclei
80
Bloody diarrhea RUQ pain hx of camping
Entamoeba histolytica liver abscess flask shaped ulcer
81
AIDS pt severe watery diarrhea acid fast (+)
Cryptosporidium | severe in AIDS pts
82
AIDS pt thrombocytopenia chronic watery diarrhea
microsporidia
83
Explosive watery diarrhea Florida blue fluorescence under UV
cyclospora cayetanensis tropical disease acid fast
84
Cerebral abscess on MRI with ring enhancement calcifications of brain cats
Toxoplasma gondii crosses placenta in pregnancy AIDS pts
85
Recurring fever African immigrant hx of chancre somnolence/anemia
Trypanosoma brucei African sleeping sickness Tstse fly vector antigenic variation
86
Recurrent fevers anemia hx of Middle East trip splenomegaly
Plasmodium vivax/ovale malaria anopheles mosquito vector tx with cholorquine + primaquine for relapsing hypnozoites
87
Young male fever stroke anemia/jaundice
``` Plasmodium falciparum malaria anopheles mosquito vector infected RBC's occlude brain tx severe with quinidine/quinine ```
88
Hemolytic anemia fever asplenia NE U.S.
Babesia ixodes tick vector (same as Lymes) maltese cross
89
Trip to Japan alternating constipation/diarrhea waterchest nuts consumed
Fasciolopsis buski | intestinal fluke in bile duct
90
Megacolon Dilated cardiomyopathy edema around the eye
Trypannosoma cruzi Chaga's disease reduviid bug vector Romana's sign periorbital edema
91
``` Pancytopenia hepatosplenomegaly fevers dark pigment over some areas of body Tx with Na+ stibogluconate ```
Leishmania donovani visceral leishmaniasis female sandfly vector cutaneous (L. braziliense) causes volcano eruptions on skin
92
Greenish vaginal discharge strawberry cervix itching/burning
Trichomonas vaginalis | sexual transmission
93
Gray vaginal discharge Fishy smell Clue cells
Gardnerellla vaginalis | assc with sexual activity
94
Perianal itching | sticky eggs
Enterobius vermicularis (pinworm)
95
Epigastric pain Coughing rural SE
Ascaris lumbricoides intestinal infection migrate through lungs in development
96
Anemia diarrhea/vomiting AIDS pt
Strongyloides stercoralis seen in immunocompromised pneumonitis
97
Anemia due to blood loss | intestinal infection
Ancylostoma duodenale/necator americanus hookworms anemia by sucking blood from GI walls
98
Black skin nodules African immigrant ocular problems
Onchocera volvulus female blackfly vector River blindness
99
Worm seen in conjunctiva | skin swelling
Loa loa | deer/horse/mango fly vectors
100
Elephantiasis bug
Wuchereria bancrofti female mosquito bector blockage of lymph
101
Diarrhea myalgias/edema heart/lung/brain involvement
Tichinella spiralis undercooked bear/fox/pork travel to muscle via blood
102
Pork eater neuro sx scolex seen on microscopy
Taenia solium (pork tapeworm) cysticercosis/neurocysticerosis caused by eggs only calcifications of tissue result
103
Eater of raw fish from Great Lakes increased methylmalonyl-Coa and homocysteine anemia
Diphyllobothrium latum Vit B12 deficiency raw freshwater fish
104
Pt owns dog cysts seen in lung and liver lives in Nevada
Echinococcus granulosus Hydatid cyst disease in western US from dog feces
105
Fibrosis of liver/spleen dx with bladder cell carcinoma hematuria
Schistosoma haematobium terminal spine assc with bladder cancer
106
Clay pipestem fibrosis around portal vein bloody diarrhea eats snails
Schistosoma mansoni lateral spine Katayoma syndrome
107
Dx with cancer of the bile duct eats sushi epigastric pain/jaundice
Clonorchis sinensis assc with cholangiocarcinoma pigmented gallstones/bile duct inflammation undercooked fish
108
Eats crab pneumonia/hemoptysis other bacterial infection also present
Paragonimus westermani coffee bean shaped/crab meat assc secondary bacterial infection
109
Live attenuated vaccines for virus (6)
``` Smallpox Yellow fever VZV Sabin's polio virus MMR Influenza (intranasal) ```
110
Killed virus vaccines (4)
Rabies Influenza (injected) Salk Polio HAV
111
Recombinant virus vaccines (2)
HBV | HPV (6,11,16,18)
112
Only ssDNA virus
parvovirus
113
Only circular DNA virus
hepadnaviruses
114
Only dsRNA virus
Reoviridae
115
Only diploid virus
retroviruses
116
Only enveloped virus using nuclear membrane
herpesviruses
117
DNA viruses
``` HHAPPPPy Hepadna Herpes Adenoa Pox Parvo Papilloma Polyoma ```
118
Only DNA virus replicating in cytosol
Poxvirus
119
Only RNA viruses replicating in nucleus
Influenza | Retroviruses
120
Temporal lobe encephalitis | keratoconjunctivitis
HSV-1
121
Assc with Burkitt's Lymphoma and Hodgkin's Lymphoma | fatigue
EBV (HHV-4) | mononucleosis
122
AIDS pt retinitis most common virus causing
CMV | seen in immunocompromised pts
123
Cause of roseola
HHV-6 | Exanthem subitum
124
Ass with Kaposi's sarcoma | AIDS pts
HHV-8
125
Circular DNA virus | has reverse transcriptase
HBV
126
Pharyngitis pneuumonia conjunctivitis
Adenovirus dsDNA acut hemorrhagic cystitis assc
127
Apastic crisis with sickle cell disease | slapped cheek fever
Parvovirus B19 ssDNA 5th disease in kids (erythema infectiosum)
128
Cervical cancer assc virus
Papillomavirus 16 and 18
129
AIDS pt circular dsDNA mental deterioration
JC virus progressive multifocal leukoencephalopathy also BK targets kidney in transplant pts both are polyomaviruses
130
Replicates in cytosol DNA virus flesh colored dome lesions with central dimple
Poxvirus molluscum contagiosum only on replicating in cytosol
131
``` Locations of latency in Herpes viruses: HSV-1 HSV-2 VZV EBV CMV ```
``` HSV1-trigeminal ganglia HSV2-sacral ganglia VZV-dorsal root or trigeminal ganglia EBV-B cells CMV-mononuclear cells ```
132
Characteristic of CMV infection
Owl's Eyes inclusions
133
Diffuse macular rash in kids high fever/seizures
HHV-6 | roseola
134
AIDS pt papular purple lesions on mouth/GI/respiratory tracts
Kaposi's sarcoma | assc with HHV-8
135
ID of herpes virus
Tzanck test | Cowdry bodies
136
Picornoviruses (5)
``` Polio Echovirus rhinovirus coxsackievirus HAV all RNA viruses ```
137
(-) stranded RNA viruses (6)
``` all have RNA-dependent RNA pol Arenavirus bunyavirus paramyxovirus orthomyxovirus filovirus rhabdovirus ```
138
Common cold no GI sx naked virus
Rhinovirus acid labile RNA virus
139
Black vomit jaundice in South America/Africa
Yellow fever | Aedes mosquito vector
140
1 y/o segmented dsRNA virus acute diarrhea others in daycare also have
Rotavirus infantile gastroenteritis villous atrophy
141
Enveloped (-) ssRNA neuraminidase and hemagglutinin cough/cold
Influenza | genetic shift/drift seen
142
Postauricular adenopathy arthralgia descending rash from head down
Rubella virus (togarvirus) German measles TORCH infection
143
Seal like barking cough
Parainfluenza (croup)
144
Paramyxoviruses (4)
Parainfluenza mumps measles RSV
145
Red spots on buccal mucosa descending maculopapular rash (head down) paramyxovirus
Measles Koplick spots (buccal mucosa) subacute sclerosing panencephalitis years later
146
Swollen parotids and testes | meningitis with not bugs seen in CSF
Mumps (paramyxovirus) parotitis/orchitis can cause sterility Bull neck
147
Negri bodies found in cerebellum (Purkinje cells) long incubation period photophobia/agitation
``` Rabies virus bullet shaped CNS retrograde migration hydrophobia/paralysis/death animal bites ```
148
HAV source
oysters/clams/mussels fecal oral acute infection
149
Dane particles | ground glass hepatocytes seen
HBV Dane particles=active infection hepatocellular carcinoma risk
150
Increased HCC risk cryoglobulinemia chronic infection
HCV | HCC with or w/o cirrhosis
151
delta agent | needs HBV to infect
HDV | causes fulminant liver failure with HBV
152
HEV danger
pregnant women
153
Dx of HCV
EIA for screen | RIBA II for confirmation
154
``` Significance of hepatitis B Ags/Abs in blood HBsAg HBsAb HBcAg HBcAb HBeAg HBeAb ```
sAg-hep B infection sAb-immunity to hep B cAg-core of HBV cAb-prior exposure/chronic infection (if IgG) eAg-high transmissibility/active viral replication eAb-low transmissibility
155
Genes of HIV
env (gp120/gp41)-attach to T cells/entry gag (p24)-capsid pol-reverse transcriptase
156
HIV binding to WBC's
CD4 +CCR5/CXC4 on T cells | CD4 + CCR5 on macrophages
157
Bugs that can mimic appendicitis
Yersinia entercolitica Nontyphoidal salmonella Campylobacter jejuni
158
Lg cause of pneumonia infant-3y/o
Chlamydia trachomatis
159
Cause of meningitis in young children
N. meningitidis | H. influenza type B
160
Sx or Rubella
``` PDA cataracts deafness blueberry muffin rash (descending) postauricular lymphadenopathy ```
161
Peptidoglycan cell wall synthesis inhibitors (8)
``` penicillin nafcillin (resistant to penicillanse) ampicillin/amoxicillin ticarcillin/piperacillin (pseudomonas use) cephalsporins (resistant) aztreonam (monobactm resistant) imipenem vanycomycin (D-ala D-ala) ```
162
30s subunit RNA bacterial inhibitors
aminoglycosides (inhibits initiation) | tetracyclines (prevents attachment of tRNA)
163
50s subunit RNA bacterial inhibitors
macrolides (blocks translocation) chloramphenicol (blocks peptidyltransferase) clindamycin (blocks peptide transfer)
164
Folic acid pathway inhibitors on bacteria
Sulfonamides (PABA analog) | TMP (inhibits dihydrofolate reductase)
165
DNA inhibitors on bacteria
fluoroquinolones (DNA gyrase) | metronidazole (ROS damage DNA)
166
Tx for vancomycin resistant enterococci
linezolid | streptogramins (quinupristin/dalfopristin)
167
Antifungal meds
Amphotericin B (binds ergosterol) Azoles (inhibits ergosterol synthesis) Flucytosine (5-FU conversion)
168
Tx for toxoplasmosis
pyrimethamine
169
Tx for T brucei (sleeping sickness)
suramin (heme stage) | melarsoprol (CNS stage)
170
Tx for T. cruzi (Chagas)
nifurtimox
171
Tx for Leishmaniasis (volcano eruptions/visceral necrosis)
Na+ stibogluconate
172
Tx for plasmodium
cholorquine-nonsevere quinine/quinidine-severe primaquine-hypnozoites (vivax/ovale)
173
Tx for flukes (trematodes ie Schistosoma)
Praziquantel
174
Tx for hemiliths
Mebendazole pyrantel pamoate ivermectin diethylcarbamazine
175
MOA of zanamivir/oseltamivir
inhibits influenza neuraminidase | for influenza A and B
176
MOA of ribavirin
inhibits guanine nucleotide synthesis
177
MOA of acyclovir
HSV/VZV thymidine kinase needed, inhibits DNA pol by guanosine analog not for CMV
178
MOA of ganciclovir
CMV viral kinase needed Guanosine analog, inhibits DNA pol for CMV
179
MOA of foscarnet
DNA pol inhibitor | for CMV retinitis in AIDS pt
180
MOA of HIV protease inhibitors
end in -navir depend on HIV-1 protease (pol gene) prevent maturation of viruses Ritonavir boosts others
181
MOA of NRTI's in HIV
inhibit reverse transcriptase binding
182
MOA of NNRTI's in HIV
bind reverse transcriptase
183
MOA of raltegravir
inhibits HIV intregration into host cell chromosome | inhibits HIV integrase
184
Use of interferon alpha in disease
chronic Hep B/C | Kaposi's sarcoma
185
Use of interferon beta in disease
Multiple sclerosis
186
Use of intereferon gamma in disease
NADPH oxidase deficiency

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