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Flashcards in Micro Quiz Deck (98):
1

Naked, ico, dsDNA circular virus with STD

HPV

2

Intranuclear inclusions bodies surrounding by halos with STD

CMV Owl's eyes

3

Iodine staining intraepithelial inclusion bodies with STD

Chlamydia trachomatis

4

Lactose fermenting gram negative bacillus with GU symptoms

E. Coli

5

Pear shaped flagellated protozoa with GU symptoms

Trachoma vaginalis (strawberry red cervix)

6

Pleomorphic GNRs with GU symptoms

Haemophylis ducreyii with painful soft genital lesion (chancroid)

7

Spirochetes on dark field microscopy with GU symptoms

Treponema pallidum (syphilis) with chancre or rash

8

Motile trophozoites with GU symptoms

Trachoma vaginalis (strawberry red cervix with frothy green discharge)

9

Clue cells with GU symptoms

Bacterial vaginosis 2/2 to gardnerella vaginalis overgrowth (malodorous thin grey discharge worse after menses)

10

Gram - diplococci with GU symptoms

Neisseria gonorrhea (PMN rich discharge and mucosal erosions)

11

Obligate intracellular pathogens with GU symptoms

Chlamydia trachomatis (PID)

12

White cottage cheese in GU area

Candida albicans growing with germ tubes

13

Stellate granulomas in an arm lesion

Bartonella henselae (cat scratch disease). Gram - rod can disseminate in pregnant and immunocompromised. Give cipro or doxy normally and azithromycin macrocodes to pregnant.

14

Gram - coccobacillus with undulating fever

Brucella from unpasteurized cheese.

15

Exploring caves?

Histoplasma capsulatum disease in immunocompromised patients. This is an obligate IC parasite, living in histiocytes. Spores breathed in from bird and bat droppings. See it in Ohio and Mississippi River Valley.

16

Gardening?

Sporothrix schenkii with causes subQ nodules that track up lymphatic tracts. Dimorphic fungus grows as mold in humans.

17

Eyelid inflammation with pannus formation and IC inclusion bodies

Chlamydia trachomatis - Serotypes A-C causes trachoma. Leads to pannus formation, scarring, and distortion of eyelids. Grow in tissue culture to identify reticulate bodies )(IC). Elementary bodies are infective and EC.

Serotypes D-K - Conjunctivitis and genital infection

Serotypes L1-L3 - Lymphogranuloma venereum.

18

Conjunctivitis in a newborn with gram neg dipococci

Neisseria gonnorheae

19

Conjunctivitis with intranuclear inclusion bodies and naked capsid DNA virus

Adenovirus. Three Ps and a C. Pharyngitis, Pneumonia, Pink eye, and hemorrhagic cystitis. Uses HA to bind cells.

20

Large, box car shaped gram + cocci that forms spores that look like bamboo shoots.

Bacillus anthracis.
1) Malignant pustule which ruptures to form black eschar and surrounding edema
2) Bacteremia
3) Mening
4) Pneumonia

21

Cigar shaped yeast

Sporothrix schenkii.

22

Gram - rod that requires cysteine

Francisella Tularensis

23

GNR with bipolar staining

Yersinia pestis (bubonic plague) which black necrotic lymph nodes at site of bite

24

A large spirochete which forms a lesion on the extremity

Borrelia burgdorferi - Lyme disease erythema migrans, transmitted by Ixodes

25

Meningitis in AIDs

Cryptococcus neoformans. Polysaccharide coat. India ink and mucicarmine stain. Bird droppings. Sabouarud agar.

26

Broad based budding yeast

Blastomyces dermatiditis. Live EC. Skin and bone lesions and found in the Eastern US.

27

Budding yeast in pilot's wheel

Paracoccidiomycosis. Common in Central and South America. Primary pulmonary disease.

28

IC yeast in macrophages

Histoplasma capsulatum. Usually in immunocompromised, like AIDs. Cause pneumonia.

29

Septate hyphae at 45 degree angles

Aspergillus fumigatus. Acute angles, allergic BP aspergillosis, aspergilloma, invasive aspergillus, amphotericin B, aflatoxin.

30

Spherules

Coccidiodes immitus. Seen in SW US. Causes 1) desert rheumatism 2) desert nodules (erythema nodosum), 3) valley fever

31

GI disease in an AIDS patient

Cryptosporidum -- acid fast oocytes, treat with nitazoxanide.

32

Cavitated lung lesions in an alcoholic

Klebsiella pneumonia with 4 As.
1) Aspiration pneumonia
2) Abscess in lung
3) Alcoholics
4) DiAbetics.

Causes currant jelly sputum and mucoid colonies

33

Maculopapular rash with mono Tx?

Amoxicillin with CMV mononucleosis

34

dsDNA with complex lipid envelope

Poxvirus with smallpox and molluscum contagiosum.

35

Novobiocin distinguishes...

Staph epidermidis (sens) from saprophyticus

36

Optochin distinguishes...

Strep pneumo (sens) from viridans group strep

37

Bacitracin distinguishes...

Strep pygo (sens) from strep agalactiae

38

Coagulase production seen in which two organisms?

Staph aureus and yerisinia pestis

39

ELEK test

Distinguishes between diptheroid (diphtheria like flora in mouth) and corynebacterium diphtheria, which contains B prophage DNA, which creates exotoxin.
ADP ribosylation of EF2 by exotoxin
Beta prophage DNA which makes toxin, Black colonies
Corynenacterium on Cystine-tellurite agar
Diptheriae
EF2 is inhibited by ADP ribosylation, ELEK test
Granules are metochromatic on GNR

40

Reactive Reiter arthritis

HLAB27+
Ureaplasma
Cjejuni
Chlamydia
Shigella
Salmonella
Yersinia pestis

41

Knee infection that grows on chocolate agar

Nesseriae gonorrheae.
NO:
1) Capsule
2) Maltose fermentation
3) Vaccine (because of antigenically variable pili)

Causes:
1) STD with PID (cetriaxone)
2) Septic arthritis
3) Neonatal conjunctivitis (erythromycin)
4) Fitz-Hugh-Curtis syndrome

42

Two viruses with complementation?

Hep B and Hep D

43

Syncitial formation?

Herpes, Measles, Mumps, RSV

44

Ground beef

E Coli

45

Poultry

Campylobacter and Salmonella

46

Rice

Bacillus Cereus

47

Salad

E Coli

48

Bad bottling practices

Clostridium Botulinum (bottles)
Preformed heat labile toxin which blocks Ach at NMJ
Adult --> toxin
Baby --> spores

49

Cross in an RBC

Babesiosis with fever, hemolytic anemia. Asplenia increases risk.
Transmitted by Ixodes = Borrelia Bergdorferi, babesia, and anaplasma.
Smear: Maltese cross and rings in RBCs
Tx: Atovaquone + Azythro.

50

Tick bite with photophobia and retro-orbital pain

Dermacentor andersoni and Colorado Tick Fever Virus.
Dermacentor also transmits tularemia.

51

Culex tick

West nile virus mening and encephitis.

52

As patient with HIV becomes symptomatic, how does serology change?

Viral titer increases as virus overwhelms immune system
GP24 Ab falls as CD4 cells killed
GP41 and 120 may rise because they only require IgM

53

Genital lesion followed by rash on palms?

Syphilis (treponema pallidum).
Primary - painless chancre
Secondary - rash on palms and soles and condyloma lata
Tertiary - Gummas, aortitis, Argyll Robertson, Neurosyphilic with tabes dorsalis.

Dx VDRL and later FTA-ABS.

Congenital - Saber shin, mulberry molars, hutchinson's incisors, saddle deformity

Tx Penicillin G

54

+ Weil-Felix Rxn?

Rickettsia Ricketsii = Rocky Mtn Spotted Fever

Most commonly in NC

Rash on ankles spread to trunks, palms, and soles

Obligate IC organisms needing Coa and NAd+

55

Rash on the palms or soles?

CARS - use your palms to drive CARS
Coxscackie A (hand foot mouth)
Rocky Mtn Spotted Fever
Syphilis

56

Anthrax toxin?

Edema factor (adenylate cyclase fluid loss) and lethal factor (endoprotease apoptosis)

57

Organisms with toxins similar to cholera toxin?

Cholera toxin, E coli heat labile toxin, and a pertussis all activate Gs, increase camp, and increase fluid loss from intestine.

58

Organism with toxin similar diphtheria toxin?

Diptheria toxin and Pseudomona auriginosa both use the EF2 inhibiting toxins.

59

Clostridium perfringens toxin?

Alpha toxin which is a lecithinase

60

Tetanus toxin?

Inhibits release of GABA and glycine inhibitory neurotransmitters.

61

CAMP test?

Distinguishes Group B Strep from other streptococci.

62

Causes of PID?

Chlamydia trachomatis and Neisseria gonorrheae.

63

With hepatitis B, only the Anti HbS antigen?

Indicates immunization with HbSAg

64

With hepatitis B, what differentiates acute infection versus window?

With acute:
1) HepBsAg
2) HepBeAg
3) IgM against the core

With window:
1) No HepBsAg or Antibody against the surface
2) Antibody against the envelope
3) IgM against the core

65

What serologic markers indicate chronic HBV?

1) HepBsAg
2) IgG against the core

66

What indicates recovery?

Only antibodies and no antigens

67

Lyme disease signs, symptoms, Tx?

Borrelia bergdorferi -- Ixodes tick.

FANCEY
Flue +/- facial palsy
Arthritis (mono or migatory)
Neurologic (Enceph, Polyneur, Facial palsy)
Cardiac Block
Erythema Migrans
Y

Tx with Doxy or ceftriaxone

68

Short germinating, nonseptate hyphae?

Candida albicans. Only fungus to grow as germ tube.

69

What can give you glomerulonephritis with reduced complement?

1) SLE glomerulonephritis and
2) Post streptococcal glomerulonephritis (type III HS)

70

What is the toxic part of LPS which causes shock?

Lipid A. It stimulates release of IL1, IL6 and TNF.

71

Why does the window period happen in hepatitis?

Because antibody to the surface rises, binds the surface antigen, and removes it from the blood stream via precipitation of Antigen-antibody complexes. This results in neither being detected in the blood for a short period.

72

Cocci bacteria?

Gram + or Staph and Strep
Gram - are Neisseria

73

Pleomorphic bacteria?

All Gram -. Rickettsii and Chlamydia.

74

Filamentous bacteria?

Actinomyces and Nocardia

75

Spirochete bacteria?

All Gram -. Borrelia, Treponema, and Leptospira.

76

No CW and Sterols

Mycoplasma

77

CW of Mycobacteria?

Mycolic acid and lipid rich.

78

Bacteria that do not gram stain well?

These microbes may lack real color.
Treponema (too thin so use dark field microsopy with fluoresence)
Mycobacteria (mycolic acid detected with acid fast)
Mycoplasma (no cell wall)
Legionella (intracellular so use silver)
Rickettsia (intracellular)
Chlamydia (intracellular)

79

Giemsa Stain?

These bugs really try my patients
Treponema
Borrelia
Ricketsii
Trypanosomes
Plasmodium

80

Silver stain?

Fungi, Legionella, and H Pylori

81

Acid fast? (Zeels Neeson)

Nocardia and Mycobacteria

82

India ink?

Cryptococcus

83

PAS stain?

Pass the sugar. Stain glycogen for Whipple disease (Tropheryma Whipplei)

84

Chocolate wirth X heme and V nad?

H influenza

85

VPN?

Neisseria. V + P - and N fungi.

86

Charcoal?

Legionella

87

Tellurite?

Diptheria. Also grows on Loffler.

88

Bordet Gengou

Bordatella Pertussis.

89

TB grows on?

Lowenstein-Jensen

90

M. pneumonia grows on?

Eaton with cholesterol

91

E coli grows on?

Pink on macconkey and green on EMB.

92

If you see obligate aerobe?

Nagging pests must breathe.
Nocardia
Pseudomonas Auruginosa
MB

93

If you see obligate anaerobe?
What makes them anaerobic?
What antibiotic can't you use on them?

Anaerobes can't breathe air.
Clostridium
Bacteroides
Actinomyces

Lack catalase or SOD so susceptible to oxidative damage.

Can't use aminoglycosides because they require O2 to enter cell.

94

Obligate intracellular?

Real Cold.
Rickettsii and Chlamydia.

95

Facultative intracellular?

You lie low, be safe for now man.
Yersinia pestis
Legionella
Listeria
Brucella
Salmonella
Francisella
Neisseria
MB

96

Encapsulated bacteria?

SHiNESKiS.
Strep pneumo
Hi (H flu)
Neisseria mening
E coli
Salmonella
Klebsiella
Strep B

97

Protein A and Protein M

A is for S Aureus. Binds Fc portion of Ab to prevent opsonization.

M is for Strep Pyogenes to prevent phagocytosis.

98

Iga Protease?

Expressed by SHiN organisms.
Strep pneumo
Hi (h flu)
Neisseria