MICRO/PATH

Question 1

Name the 7 respiratory pathogen vaccines

Answer 1

1	Pneumococcal pneumonia
2	Flu A and Flu B
3	Haemophilus influenze
4	Whooping cough
5	TB (not in US)
6	Adenovirus 4 and 7 (military only)
7	Anthrax (emergency personnel only)

Question 2

what is the second most common cause of otitis media?

Answer 2

H. influenzae

Question 3

OMP38 is found in which pathogen?

Answer 3

acinetobacter

Question 4

what does OMP38 do

Answer 4

releases cytochrome C and an apoptosis-inducing factor which enter the epithelial cell nucleus and causes the degradation of DNA and other apoptotic phenomena

Question 5

what is the world’s leading preventable cause of blindness?

Answer 5

Trachoma infection of conjunctiva by Chlamydia

Question 6

which disease is prevented by giving erythromycin eye drops at birth?

Answer 6

neonatal inclusion conjunctivitis (baby gets it from mom as baby moves through birth canal)

Question 7

what is the most common sexually transmitted disease in industrialized countries?

Answer 7

chlamydia trachomatis

Question 8

where does legionella replicate?

Answer 8

in macrophages after inhalation (facultative intracellular aerobe)

Question 9

what does cord factor do?

Answer 9

toxic to mammalian cells

inhibits PMNs

Question 10

who makes cord factor?

Answer 10

MTB

nocardia

Question 11

what are the special mechanism for cell entry for MTB?

Answer 11

directly bind mannose receptors on mphages via cell wall-associated mannosylated glycolipid, LAM, or indirectly via certain complement receptors or Fc receptors

Question 12

which bug has high cold agglutin titer?

Answer 12

mycoplasma

Question 13

foamy macrophages are characteristic of ___________bacterial pneumonia

Answer 13

subacute

Question 14

Name the bug!
Smoker w/ acute onset of fever, rigors, cough, dyspnea, diarrhea, confusion, pulmonary crackles, bronchopneumonia, leukocytosis, hyponatremia and non diagnostic sputum

Answer 14

Legionella

Question 15

which pneumonia has the highest mortality even if treated?

Answer 15

pseudomonas

Question 16

Name the bug!
Intubated hospital pt w/ acute onset of fever, chills, confusion purulent sputum, tachycardia, tachypnea, hypotension, pulmonary crackles, bilateral bronchopeneumonia, neutropenia, and gram-negative rods in sputum

Answer 16

pseudomonas

Question 17

Name the bug:
Middle aged male that’s immunocompromised, insidious onset of dyspnea, dry cough, low fever, tachycardia, tachypnea, elevated LDH and bilateral reticular infiltrates

Answer 17

pneumocystis

Question 18

_______________pneumonia is the prototype subacute or chronic interstitial pneumonia in an immunocompromised pt.

Answer 18

Pneumocystis

Question 19

Name the bug!
Adult w/ neutropenia, acute onset of fever, pleuritic chest pain, hemoptysis, tachycardia, tachypnea, pulmonary crackles and nodular infiltrates

Answer 19

Aspergillosis

Question 20

Name the pathology

Late middle aged female smoker w/ insidious onset of persistent cough, anorexia, weight loss and peripheral lung mass

Answer 20

adenocarcinoma of the lung

Question 21

Name the pathology:
Late middle aged black male smoker w/ insidious onset of persistent cough, dyspnea, anorexia, wt loss, hemoptysis and central endobronchial lung mass

Answer 21

Squamous cell lung cancer

Question 22

Name the pathology:
Late middle aged black male smoker w/ insidious onset of persistent cough, dyspnea, anorexia, wt loss, hemoptysis and central endobronchial lung mass

Answer 22

Squamous cell lung cancer

Question 23

Name the pathology:
Late 60’s male heavy smoker w/ insidious onset of wt loss, cough, dyspnea weakness, central parabronchial lung mass w/ hilar LAD

Answer 23

Small cell carcinoma of the lung

Question 24

what is the most aggressive type of lung cancer?

Answer 24

small cell carcinoma

Question 25

which lung cancer has SIADH

Answer 25

small cell lung cancer

Question 26

where are the neuroendocrine cells derived from in small cell carcinoma of the lung?

Answer 26

neural crest cells

Question 27

where are the neuroendocrine cells derived from in small cell carcinoma of the lung?

Answer 27

neural crest cells

Question 28

Name the pathology: Late middle aged pt w/ insidious onset of anorexia, wt loss, malaise, fatigue, and numerous small rounded lung nodules (more in lower lobes)

Answer 28

metastases to the lung

Question 29

which bug has no cell wall?

Answer 29

mycoplasma (explains why it has a need for cholesterol in media to grow)

Question 30

which bug has no peptidoglycan in its cell wall?

Answer 30

chlamydia

Question 31

what are the classic immunostains for adenocarcinoma of the lung?

Answer 31

CK7 | TTF1

Question 32

what are the classic immunostains for small cell lung cancer?

Answer 32

Synaptophysin | Chromogranin

Question 33

what is a Ghon complex?

Answer 33

primary TB lesion + hilary lymph node involvement

Question 34

what is one way you can differentiate histoplasmosis from old TB microscopically?

Answer 34

do a methenamine silver stain

Question 35

what are the 3 forms of aspergillus disease

Answer 35

allergy colonization invasion

Question 36

Name the pathogen! Adult black pt that’s immunocompromised, insidious onset of fever, cough, dyspnea, headache, tachycardia, tachypnea, stiff neck and nodular infiltrates

Answer 36

cryptococcus

Question 37

what is the histologic confirmation for cryptococcus?

Answer 37

mucicarmine stain

Question 38

what is the most common chronic occupational disease?

Answer 38

silicosis

Question 39

what are the 2 genes that predispose a pt to getting sarcoidosis?

Answer 39

macrophage HLA, BTLN2 (butyrophillin-like2)

Question 40

what kinds of cells are characteristically found in sarcoidosis?

Answer 40

CD4 T-helper cells

Question 41

what kinds of cells are characteristically found in asthma?

Answer 41

eosinophils (inflammatory), CD4 TH2 helper cells that secrete cytokines IL-4, IL-5

Question 42

what does the diabetic pt in ketoacidosis get if he is has an infection?

Answer 42

mucormycosis

Question 43

what is bacillus anthracis capsule made of?

Answer 43

Poly D Glutamic acid (it is nonantigenic and prevents phagocytosis)

Question 44

which bug requires lysogenic conversion to make an exotoxin that could really kill a sick kid?

Answer 44

Corynebacterium diptheriae

Question 45

which bug charactistically makes sulfur granules?

Answer 45

actinomyces

Question 46

what is one way you can distinguish actinomyces from nocardia?

Answer 46

nocardia stains AFB+ weakly and actinomyces is AFB-

Question 47

how do you get actinomyces?

Answer 47

part of normal flora, can become infected when mucosa is disrupted and can lead to abscess (sulfur granules)

Question 48

how can you get nocardiosis?

Answer 48

inhalation (can lead to lung abscess)

Question 49

which bug smells like grapes and has procyanin?

Answer 49

pseudomonas

Question 50

name the bug. has DOT, ICM, intracellular and has a urine antigen test?

Answer 50

legionella

Question 51

describe the epidemiology of coronavirus?

Answer 51

children get this in the winter (strongly seasonal)

Question 52

what is Reye's syndrome?

Answer 52

noninflamm. Cerebral edema, fatty infiltration of liver, hepatic dysfunction (↑LFTs), seen in children that have the flu

Question 53

how do you get the hantavirus?

Answer 53

breathe in aerosolized rodent urine, saliva, feces in the four corners region of the US

Question 54

if you have a pt with a history of fatigue and fever leading to dyspnea with rodent exposure, what do they have?

Answer 54

hantavirus

Question 55

what is the tetrad of lab tests that will help diagnose hantavirus pulmonary syndrome?

Answer 55

1. thrombocytopenia 2. leukocytosis w/ bandemia 3. ↑ hematocrit levels (b/c ultrafiltration by lungs) 4. immunoblasts in peripheral blood smear Serology is useful b/c long incubation period before onset of disease

Question 56

Name the bug! Presentation: child 2-8 months october to march begins w/ URT symptoms (cough, low fever)LRT symptoms in 2 days, can prog. to severe cases of wheezing and coughing

Answer 56

RSV

Question 57

whats the name of the virulence factor for paramyxoviridae that causes cells to fuse together?

Answer 57

Fusion protein (F protein) forms syncytia

Question 58

whats the name of the virulence factor in adenovirus that has a toxic effect on cells?

Answer 58

Penton protein (which are attachment proteins)

Question 59

what is the classic triad of aspergillosis in neutropenic patients?

Answer 59

1. fever 2. pleuritic chest pain 3. hemoptysis

Question 60

which pneumonia characteristically has a high LDH in serum?

Answer 60

pneumocystis

Question 61

name the bug! | chubby safety pin gram negative rods

Answer 61

yersinia pestis

Question 62

whats the name of the virulence factor in yersinia pestis that paralyzes phagocytes upon ingestion?

Answer 62

F1 antigen capsule

Question 63

what are the immunostains for squamous cell lung cancer?

Answer 63

p63 | p40

Question 64

what is an aspergillum?

Answer 64

fruiting body producing conidia in aspergillus

Question 65

what is the most common presenting ymptoms of pulmonary thromboembolism?

Answer 65

dyspnea

Question 66

what is the classic triad for fat embolism?

Answer 66

1. mental status change 2. thrombocytopenia 3. petechiae

Question 67

what is the microscopic pathological hallmark of ILD?

Answer 67

fibroblast foci of immature fibrosis bulging into alveoli from interstitium

Question 68

what is the histologic hallmark of cryptogenic organizing pneumonia?

Answer 68

Masson bodies= plugs of fibrosing granulation tissue in the alveoli

Question 69

Name the pathology: adult with recent surgery, central venous catheterization, malignancy, long haul travel obesity and smoking with sudden onset of dypsnea associated with chest pain, leg pain and swelling tachypnea, hypoxemia and normal chest xray.

Answer 69

pulmonary thromboembolism

Question 70

name the pathology: elderly black male with insidious onset of fatigue, anorexia, weight loss, low grade fever, chills, nightsweats, ild cough, mucopurulent sputum, apical cavitary nodules and acid fast bacilli in sputum.

Answer 70

MTB

Question 71

Name the pathology: pt with trauma surgery and vascular catheter insertion or removal with sudden onset of dyspnea, single gasp or cough, lightheadedness, tachypnea, tachycardia hypotension, hypoxemia and mill wheel heart murmur

Answer 71

air embolism

Question 72

Name the pathology: middle aged male smoker with the insidiuos onset of dyspnea and persistent dry cough bibasilar dry velcro pulmonary crackles and bilateral reticular lung opacities in periphery and at the bases

Answer 72

usual interstitial pneumonia

Question 73

name the pathology: hospital pt with shock sepsis pneumonia acute onset of rapidly worsening dypsnea, respiratory distress, tachypnea, diffuse pulmonary crackles and progressive pulmonary infiltrates

Answer 73

ARDS

Question 74

Name the pathology: male smoker with acute onset of single strong rigor, high fever, productive cough, rusty sputum, tachypnea, pulmonary crackles, tubular breath sounds, lobar consolidation, leukocytosis and gram-positive diplococci in sputum.

Answer 74

pneumococcus

Question 75

name the pathology: hospital pt with acute onset of fever cough dyspnea, tachycardia tachypnea, hypotension, pulmonary crackles, abscessing bronchopneumonia leukocytosis and gram positive cocci in sputum

Answer 75

staph aureus pneumonia

Question 76

name the pathology: young pt in winter with insidious onset of malaise, low fever, persistent intractable dry cough, normal wbc count, cold agglutinins and bronchopneumonic reticulor or reticulonodular infiltrates that look worse than the pt.

Answer 76

mycoplasma pneumonia

Question 77

name the pathology: pt with long bone fraction 1-3 days ago or black pt with sickle cell crissis now with acute onset of dyspnea, confusion, tachypnea hypoxemia, and petechiae and thrombocytopenia

Answer 77

fat embolism

Question 78

name the pathology: tall thin yung male smoker with sudden onset of dyspnea associated with unilateral chst pain and decreased breath sounds on the same side and ocllapsed lung on cxr

Answer 78

pneumothorax