Micro 4 USMLE Flashcards Preview

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Flashcards in Micro 4 USMLE Deck (170):
1

this is an enveloped, single stranded RNA virus with a segmented genome, with a vaccine, that commonly causes illness every winter

influenza virus

2

what 2 antigens does the influenza virus contain?

hemagglutinin and neuraminidase

3

the influenza virus is responsible for worldwide influenza epidemics. It has rapid genetic changes and puts pts at risk for a fatal ________ superinfection.

bacterial.

4

this type of viral influenza vaccine is the major mode of protection. It is reformulated yearly and offered in the fall to health care workers and the elderly

killed

5

this type of genetic change involves teh reassortment of viral genome (such as when human flu A virus combines with the swine flu A virus)

genetic shift

6

this type of genetic change involves minor changes based on random mutation

genetic drift.

7

what is more deadly a genetic shift or drift.

mneu: Sudden Shift is more deadly than a graDual Drift

8

give two Rxs for tx and prophylaxis of influenza A

Amantidine & Rimantadine

9

Give 2 neuraminidase inhibitors that are useful to tx both influenza A & B

Zanamivir and oseltamivir

10

pt presents with strange behavior, seizures, and fear of water, 2 mo after being bit by racoon. He dies quickly of fatal encephalitis. What is the bullet shaped virus that travels to the CNS by migrating in a retrograde fashion up nerve axons

rabies

11

what are the characteristic cytoplasmic inclusions in neurons infected by the rabies virus

negri bodies

12

these viruses are transmitted by arthropods (mosquitoes, ticks). Classic examples are dengue fever (aka break bone fever) & yellow fever. Note: A varient of dengue fever in Southeast Asia is hemorrhagic shock syndrome

Arboviruses

mneu: ARBOvirus - ARthropod-BOrne virus.

13

Give 2 arboviruses

flavivirus, togavirus, and bunyavirus

14

pt presents with a high fever and juandice. Wife reports he has been vomiting black stuff. His dz is caused by the flavivirus, and arbovirus transmitted by the Aedes mosquito with a monkey or human resevior.

Yellow Fever

15

flavi=______

yellow

16

what charicteristic acidophilic inclusions would you expect to see in the liver of a pt with yellow fever

councilman bodies

17

Name the herpesviruses

CMV
HSV1,2
EBV
VZV

mneu: get herpes in a CHEVrolet

18

this herpes virus causes gingivostomitis, keratoconjunctivitis, temporal lobe encephalitis, herpes labiales via respiratory secretion and saliva

HSV-1

19

this herpes virus causes herpes genitalis and neonatal herpes via sexual contact and perinatal transmission

HSV-2

20

this herpes virus causes shingles, encephalitis, and pneumonia via respiratory secretions

VZV

21

this herpes virus causes infectious mononucleosis & Burkitt's lymphoma via respiratory secretions and saliva

EBV

22

this herpes virus causes congenital infection, mononucleosis (negative monospot), and pneumonia via congenital, transfusion, sexual contact, saliva, urine, or transplant transmission

CMV

23

this herpes virus causes Kaposi's aarcoma in HIV pts via sexual contact

HHV-8

24

18 y/o female presents wtih fever, hepatosplenomegaly, pharyngitis, and posterior auricular lymphadenopaty. What virus and what dz?

EBV (herpes virus)
Mononucleosis

25

what test should you do to detect mononucleosis and what antibody does it detect

Monospot test

tests for heterophil antibodies by agglutination of sheep RBCs

26

what atypical lymphocytes are circulating in the blood of a pt with mononucleosis.

cytotoxic T cells

27

what viruses does a Tzank test detect

HSV-1,2, & VZV

mneu: Tzank heavens I do not have herpes or varicella

28

In a tzank test you take a smear of an opened skin vesicle to detect this

multiniucleated giant cell.

29

what hepatitis virus:
this RNA picornavirus is transmitted primarily by fecal-oral route. There is a short incubation period (usually 3 weeks) and No carrieres.

Hep A

mneu: Hep A-Asymptomatic (usually), Acute, Alone (no carriers; naked ssRNA)

30

what hepatitis virus: This DNA hepadnavirus is transmitted primarily by parenteral, sexual, and maternal-fetal routs. It has a long incubation (3 mo). There are carriers. Reverse transcription occurs; however, the virion enzyme is a DNA-dependent DNA polymerase

Hep B

mneu: hep B is Blood borne

31

what hepatitis virus: This RNA flavivirus is transmitted primarily via blood and resembles HBV in its course and severity. Carriers. Common cause of IV drug use hepatitis in the US

Hep C

mneu: Hep C: Chronic, Cirrhosis, Carcinoma, Carieres

32

what hepatitis virus:
this delta agent is a defective virus that requires HBsAg as its envelope. Carriers.

Hep D

mneu: Hep D: Defective, Dependent on HBV

33

what hepatitis virus:
this RNA calicivirus is transmitted enterically and causes water-borne epidemics. It resembles HAV in course, severity, incubation. There is a high mortality rate in pregnant women

Hep E

mneu: Hep E: enteric, expectant mothers, epidemics

34

Hep ___ & ____ are spread via the fecal-oral route

A & E

mneu: the vowels hit your bowels.

35

Hep ___ & ____ predispose a pt to chronic active hepatitis, cirrhosis, and hepatocellular carcinomai

B & C

36

Hepatitis serologic markers:
best test to detect active hep A

IgM HAV Ab

37

Hepatitis serologic markers: continued presence indicates carrier state of hep B

HBsAg (Ag found on surface of HBV)

38

Hepatitis serologic markers: PROVIDES IMMUNITY to hep B

HBsAb (Ab to HBs Ag)

39

Hepatitis serologic markers: Ag assoc. w/ core of HBV

HBcAg

40

Hepatitis serologic markers: positive during WINDOW PERIOD of Hep B infection

HBcAb

41

Hepatitis serologic markers: A second different antigenic determinant in the HBV core. Important indicator of transmissibility

HBeAg

mneu: BEware

42

Hepatitis serologic markers: Antibody to e antigen. Indicates low transmissibility of hep B

HBeAb

43

HBsAg will be + if pt is either in ______ or _______ Hepatitis B

acute or chronic (carrier)

44

HBsAb is + only when pt has _________ from hep B

completely recovered

45

this test rises about 2 mo after hep B exposure and remains + after complete recovery

HBcAg

46

HIV has a ______ genome (2 molecules of RNA)

diploid

47

HIV capsid is made of ______ (a rectangular nucleocapsid protein)

p24

48

HIV surface has these 2 envelope proteins

gp41 & gp120

49

image p 159 HIV

--

50

1st test given for HIV is this. It is a sensitive test with a high false positive rate and a low threshold (RULE OUT TEST).

ELISA

51

After pt tests + with the ELISA test dx of HIV is confirmed by this test. This test is more specific, it has a high false - rate and a high threshold (RULE IN TEST)

Western blot assay

52

these test allows the physician to monitor the effect of drug therapy on viral load.

HIV PCR/ viral load tests

53

Elisa/Western blot tests look for antibodies to viral proteins. These tests are often falsy negative when?

first 1-2 mo of HIV infections

54

Elisa/Western blot tests look for antibodies to viral proteins. These tests are often falsy positive when?

babies born to infected mothers (anti-gp120 crosses the placenta0

55

when is someone considered as having AIDS (3)

1) =/< 200 CD4 count
2) HIV+ w/ indicator conditon (e.g., PCP
3) CD4/CD8 ratio <1.5

56

1% of caucasions are homozygous for this mutation granting them immunity from HIV virus (20% are heterozygous leading to slower course)

CCR5 mutation

57

this mutation is associated with a rapid progression to AIDS

CXCR1

58

image 160-time course of HIV infection

--

59

give 3 opportunistic infections or dzs that attack the brain in AIDS

cryptococcal meningitis, toxoplasmosis, CMV encephalopathy, AIDS dementia, PML

60

PML is associated with what virus

JC virus

61

give 1 opportunistic infection or dz that attacks the eyes in AIDS

CMV retinitis

62

give 3 opportunistic infections or dzs that attack the mouth and throat in AIDS

Thrush, HSV, CMV, oral hairy leukoplakia

63

what organism causes thrush

candida albicans

64

what virus causes oral hairly leukoplakia

EBV

65

give 3 opportunistic infections or dzs that attack the lungs in AIDS

pneumocystis carinii pneumonia (PCP), TB, histoplasmosis

66

give 3 opportunistic infections or dzs that attack the GI system in AIDS

cryptosporidosis, mycobacterium avium-intracellulare complex, CMV colitis, non-hodgkins lymphoma

67

what virus can cause non-Hodgkin's lymphoma in AIDS

EBV

68

give 2 opportunistic infections or dzs that attack the skin in AIDS

shingles, kaposi sarcoma

69

what virus causes shingles

VZV

70

what virus causes Kaposi's sarcoma

HHV-8

71

give 3 opportunistic infections or dzs that attack the genitals in AIDS

genital herpes, warts, and cervical cancer

72

what virus can lead to cervical cancer

HPV

73

these are infectious agents that do not contain RNA or DNA (consist only of proteins). They are encoded by cellular genes.

PRions

74

give 3 examples of diseases caused by prions

Creutzfeldt-Jakob dz (CJD)
Kuru
Scrapie
"Mad cow dz"

75

this dz caused by prions results in rapid progressive dementia

CJD

76

Prions are associated with this brain damage

spongiform encephalopathy.

77

normal prions have this type of conformation; pathologic prions (like CJD) are this conformation.

alpha helix
Beta pleated sheets

78

Give the dominant normal fora for the body location: skin

staphylococcus epidermidis

79

Give the dominant normal fora for the body location: nose

S. aureus

80

Give the dominant normal fora for the body location: oropharynx

viridans streptococci

81

Give the dominant normal fora for the body location: dental plaque

streptococcus mutans

82

Give the dominant normal fora for the body location: colon

bacteroides fragilis> e. coli

83

Give the dominant normal fora for the body location: vagina

lactobacillus, colonized by E. coli and group B strep

84

T or F: Neonates delivered by cesaerean section have no flora but are rapidly colonized after birth

T

85

Give the dominant normal fora for the body location: vagina

lactobacillus, colonized by E. coli and group B strep

86

T or F: Neonates delivered by cesaerean section have no flora but are rapidly colonized after birth

T

87

common causes of pneumonia in children 6 wks -18 yrs

viruses (RSV)
mycoplasma
Chlamydia pneumoniae
Streptococcus pneumoniae

88

common causes of pneumonia in adults (18-40 y/o)

mycoplasma
C. pneumoniae
S. pneumoniae

89

common causes of pneumonia in adults (40-65 y/o)

S. pneumoniae
H. influenzae
Anaerobes
Viruses
Mycoplasma

90

common causes of pneumonia in the elderly

S. pneumoniae
Viruses
Anaerobes
H. influenzae
gram negative rods

91

common causes of pneumonia in the hospital

Staphylococcus, gram-negative rods

92

common causes of pneumonia in immunocompromized

staphylococcus, G- rods, fungi, viruses, PCP (HIV)

93

common causes of pneumonia after aspiration

anaerobes

94

common causes of pneumonia in alcoholics or IV drug users

S. pneumoniae, Klebsiella, Staphylococcus

95

common causes of pneumonia in alcoholics or IV drug users

S. pneumoniae, Klebsiella, Staphylococcus

96

common causes of pneumonia in postviral infections

staphylococcus, H. influenzae

97

common causes of pneumonia in the neonate

Group B streptococci, E. coli

98

common causes of atypical pneumonia

mycoplasma, legionella, chlamydia

99

Common causes of meningitis in the newborn (0-6mo)

GROUP B STREPTOCOCCI
E. COLI
Listeria

100

Common causes of meningitis in children (6 mo- 6yrs)

Streptococcus pneumoniae
Neisseria meningitidis
H. influenzae type B
Enteroviruses

101

Common causes of meningitis in ages 6-60 y/o

N. MENINGITIDIS
Enteroviruses
S. Pneumoniae
HSV

102

Common causes of meningitis in 60 + y/o

S. PNEUMONIA
G - rods
Listeria

103

Common causes of meningitis in HIV

cryptococcus
CMV
toxoplasmosis (brain abscess)
JC virus (PML)

104

incidence of this type of meningitis has greatly decreased after the introduction of the vaccine within the last 10-15 years

H. influenzae

105

On LP pt has increased PMNs, increased, protein, and decreased sugar. CSF pressure is increased. What kind of meningitis is this?

bacterial

106

On LP pt has increased lymphocytes, increased, protein, and decreased sugar. CSF pressure is increased. What kind of meningitis is this?

fungal or TB

107

On LP pt has increased lymphocytes, normal protein, and normal sugar. CSF pressure is normal. What kind of meningitis is this?

viral

108

osteomylitis is usually caused by what bug

S. aureus

109

osteomylitis in sexually active pts is rearely caused by this organism but they may be infected with this bug and have septic arthritis.

N. gonorrheae

110

osteomylitis usually occurs in this age group

children

111

osteomylitis in diabetics and drug addics is often due to this bug

pseudomonas aeruginosa

112

osteomylitis in pts with sickle cell anemia is often due to this bug

salmonella

113

osteomyelitis in pts with sickle cell often presents with this elevated lab value

ESR

114

osteomylitis in pts with prosthetic replacement is often due to these bugs

S. aureus & S. epidermis

115

vertebral osteomylitis (Potts dz) is due to this bug

Mycobacterium tuberculosis

116

urinary tract infections in ambulatory pts is most often due to this bug

E-coli (50-80%)
Klebsiella (10%)

117

2nd most common urinary tract infection young ambulatory women after E. Coli

Staphylococcus saphrophyticus

118

urinary tract infections in hospitalized pts

E. coli, proteus, klebsiella, serratia, pseudomonas

119

ratio of UTIs: women to men

10:1 (short urethra colonized by fecal flora)

120

urinary tract infections are usually caused by ascending infections. T or F

T

121

male baby presents with UTI what do you suspect

congenital defect

122

elderly male presents with UTI. what do you suspect

enlarged prostate

123

symptoms of UTI

dysuria, frequency, urgency, suprapubic pain

124

pt presents with fever, chills, flank pain, and CVA tenderness. What do you suspect?

pyelonephritis

125

some strains of this bug that causes UTI result in a red pigment. Often these infections are nosocomial and Rx resistant.

Serratia marcescens

126

this is the leading cause of UTI. Colonies show a metalic sheen on EMB agar

E. coli.

127

This UTI bug is often nosocomial and drug resistant

Enterobacter cloacae

128

this bug that causes UTIs has a large mucoid capsule and viscous colonies

Klebsiella pneumoniae

129

this bug that causes UTIs has motility and causes "swarming" on agar. It produces urease and is associated with struvite stones

Proteus mirabilis

130

this bug that causes UTIs produces a blue green pigment and a fruity odor. It is usually nosocomial and drug resistant

Pseudomonas aeruginosa

131

If the nitrite test is postitive what kind of bacteria are you looking at

G-

132

if the leukocyte esterase test is + what type of bug are you looking at

bactreial

133

UTI bugs can be memorized by the mneumonic--SSEEK PP

Serratia marcescens
Staphylococcus
Escherichia coli
Enterobacter cloacae
Klebsiella pneumoniae
Proteus mirabilis
Pseudomonas aeruginosa

134

pt presents with urethritis, cervicitis, PID, prostitis, epididymitis, arthritis, and a creamy purulent discharge. What is the dz and the organism?

Gonorrhea
Neisseria gonorrheae

135

Pt presents with a painless chancre. What is the dz and the organism?

Treponema pallidum
primary syphilis

136

pt presents with fever, lymphadenopathy, skin rashes, condylomata lata. What is the dz and the organism?

treponema pallidum
secondary syphilis

137

pt presents with gummas, tabes dorsalis, general paresis, aortitis, and argyll robertson pupil. What is the dz and the organism?

treponema pallidum
tertiary syphilis

138

pt presents with painful penile, vulvar or cervical ulcer. What is the dz and the organism?

genital herpes
HSV-2

139

Pt presents with urethritis, cervicitis, conjunctivitis, Reiter's syndrome, PIDWhat is the dz and the organism?

Chlamydia trachomatis (D-K)
chlamydia

140

pt presents with ulcers, lymphadenopathy and rectal strictures What is the dz and the organism?

lymphogranuloma venerium
C. trachomatis (L1-L3)

141

Pt presnts with vaginitis and strawberry colored mucosa. What is the dz and the organism?

trichomoniasis
trichomonas vaginalis

142

pt presents with opportunistic infections, Kaposi's sarcoma, lymphoma. What is the dz and the organism?

AIDS
HIV

143

Pt presents with genital warts and koiocytes. What is the dz and the organism?

condylomata acuminata
HPV 6 & 11

144

Pt presents with juandice What could the STD be and the organism?

HBV
hepatitis B

145

pt presents with a painful genital ulcer and inguinal adenopathy. What is the dz and the organism?

Haemophilis ducreyi
Chancroid

146

Pt preents with a noninflammatory, malodorous discharge; positive whiff test, and clue cells. What is the dz and the organism?

bacterial vaginosis
gardnerella vaginalis

147

this organism is most likely to cause a subacute undiagnosed pelvic inflammatory dz

chlamydia trachomatis

148

this bug can often causes an acute high fever PID

Neisseria gonorrhea

149

this cause of PID is the most common STD in the US (3-4 million cases per year).

C. trachomatis

150

pt presents with cervical motion tenderness (chandelier sign) purulent cervical discharge. Pt may have salpingitis, endometritis, hydrosalpinx, and tubo-ovarian abscess

PID

151

salpingitis is a risk factor for the following (give 2)

ectopic pregnancy, infertility, chronic pelvic pain, and adhesions

152

see clue cells on a prep what STD do you think

Gardnerella

153

see motile on wet prep what STD do you think

Trichomonas

154

2 most common nosocomial infections are:
UTI due to ______
Wound infection due to ______

E.coli
S.aureus

155

most common pathogens causing nosocomial infections in the newborn nursery are (2)

CMV & RSV

156

most common pathogens causing nosocomial infections in urinary catheterization are

E. coli, Proteus mirabilis

157

most common pathogen causing nosocomial infections in respiratory therapy equiptment is?

pseudomonas aeruginosa

mneu: presume pseudomonas AIruginosa when AIR or burns are involved

158

most common pathogens causing nosocomial infections in renal dialysis unit

HBV

159

most common pathogens causing nosocomial infections in hyperalimentation

candida albicans

160

most common pathogens causing nosocomial infections in water aerosols

legionella

mneu: legionella when water source is involved

161

Infections dangerous in pregnancy--ToRCHeS

Toxoplasma
Rubella,
CMV
HSV/HIV
Syphilis

162

If all else fails think this if dealing with pus, empyema, or an absess

S. aureus

163

If all else fails think this if dealing with a pediatric infection

H. influenzae

164

If all else fails think this if dealing with pneumonia in CF or a burn infection

pseudomonas aeruginosa

165

If all else fails think this if dealing with branching rods in oral infection

actinomyces israelii

166

If all else fails think this if dealing with a traumatic open wound

Clostridium perfringes

167

If all else fails think this if dealing with a surgical wound

S. aureus

168

If all else fails think this if dealing with dog or cat bite

pasteurella muticocida

169

If all else fails think this if dealing with currant jelly sputum

klebsiella

170

If all else fails think this if dealing with spesis/meningitis in newborn

group B strep