Microbiology

Question 1

What is the transformation route for shigella?

Answer 1

Fecal-oral

Question 2

What Vitamin and element deficiency predict the pt to have a worse prognosis when infected with shigella?

Answer 2

Vitamin A and zinc

Question 3

What are the 2 complications of shigella?

Answer 3

Reactive arthritis and HUS

Question 4

Does shigella has siderophores?

Answer 4

Yes

Question 5

What is passed through the type III secretion system from shigella?

Answer 5

Protein (shiga toxin)

Question 6

What does IpaB (virulence factor) of shigella do?

Answer 6

Induce macrophage apoptosis

Question 7

Pt with HUS would present with increase or decrease lactate dehydrogenase?

Answer 7

Increase

Question 8

Antibiotic treatment for Shigella or E. Coli would increase the risk for HUS?

Answer 8

E. Coli (antibiotic treatment for Shigella would decrease the risk)

Question 9

Should you give anti diarrhea drugs for enteric infection?

Answer 9

No, let it flush

Question 10

Which enterotoxin of ETEC is responsible for the watery diarrhea?

Answer 10

LT

Question 11

What is the diagnostic hallmark for noninfectious toxigenic gastroenteritis?

Answer 11

Happens very fast (a couple of hours after ingestion)

Question 12

Can Salmonella cause reactive arthritis?

Answer 12

Yes

Question 13

What is Salmonella’s infectious process (similar to Shigella) and what is its virulence factors?

Answer 13

Invade through M cell of Peyer’s patches—>survive in macrophages and induce apoptosis of macrophage—>reentry of inner side of epithelial cells/fimbriae and type 3 secretion system

Question 14

What virulence factor does Salmonella typhi use to evade immune system?

Answer 14

Vi antigen (capsule)

Question 15

What is the infection route for Salmonella typhi and paratyphi?

Answer 15

Fecal oral

Question 16

Which allele is protective against typhoid fever/cholera/TB?

Answer 16

CFTR

Question 17

Where is the ideal location to identify typhoid fever?

Answer 17

Bone marrow aspirate

Question 18

How to treat Salmonella enterica infection?

Answer 18

Self limited and rehydrate

Use antibiotic only for very young or old

Question 19

Yersinia enterocolitica and pseudoTB urease + or -? and do they have high or low infectious dose?

Answer 19

Urease +/high infectious dose

Question 20

What is the underlying cause of fake appendicitis from yersinia infection?

Answer 20

Mesenteric LAD

Question 21

What complication does Yersinia enterocolitica predispose the pt to?

Answer 21

Reactive arthritis?

Question 22

Izumi fever is caused by?

Answer 22

Yersinia pseudoTB

Question 23

What is the treatment for Yersinia enterocolitica infection?

Answer 23

Replace fluid and electrolyte

Question 24

What virulence factor does Listeria use to escape endosome?

Answer 24

Listerolysin

Question 25

Where dose Listeria proliferate in a pregnant woman?

Answer 25

Placenta

Question 26

CNS infection of listeria can be identified using a ___ test?

Answer 26

Wet mount

Question 27

Which antibiotic does Listeria resistant to and is Listeria a reportable disease?

Answer 27

Cephalosporin/yes

Question 28

What are the 2 hosts of cholera?

Answer 28

Human and the plankton in Indian Ocean

Question 29

Pts who are on ___ are more susceptible to cholera infection?

Answer 29

Anti acid

Question 30

How does cholerae toxin work?

Answer 30

A-B subunit structure--->B binds to the wall and A goes in--->activation of adenylate cyclase (Gs)

Question 31

Is it painful and is there blood and neutrophil in the stool from cholerae infection?

Answer 31

No pain, no blood nor neutrophil

Question 32

What is the complication associated with cholerae?

Answer 32

Acidosis and hypokalemia

Question 33

What does cholerae grow on?

Answer 33

Bile salts (halophile)

Question 34

Treatment for cholerae?

Answer 34

Rehydrate and correct electrolyte imbalance (Ringer solution)

Question 35

What is the antibiotic's affect on cholerae?

Answer 35

Shorten disease course/reduce shedding

Question 36

Is there a vaccine for cholerae?

Answer 36

Yes--->killed vaccine--->50% effective for 3-6 mo

Question 37

Do you see blood/leukocytes/bacteria in stool for V. parahaemolyticus?

Answer 37

Yes

Question 38

Treatment for V. parahaemolyticus?

Answer 38

Self limited | Use antibiotics for complication or high fever

Question 39

What does V. vulnificus cause? what toxins does it produce?

Answer 39

Cellulitis from working with shellfish | Hemolysin like the other two vibrio/protease exotoxin/siderophores

Question 40

How is V. vulnificus fatal?

Answer 40

Immunocompromised pt eating shellfish--->septicemia--->progress rapidly Can also progress to necrotizing fasciitis

Question 41

Is Campylobacter catalase + or -? and is it motile or immotile?

Answer 41

Catalase +/motile

Question 42

What is the disease process for campylobacter?

Answer 42

Start with watery foul smelling diarrhea--->bloody stools with fever

Question 43

What appearance might you see on campylobacter culture?

Answer 43

"seagull"

Question 44

Treatment for campylobacter?

Answer 44

Self limited | Antibiotics if the child is getting worse

Question 45

How does urea breath test work?

Answer 45

Pt swallow radiolabeled urea--->if infected-->exhale radiolabeled CO2

Question 46

Virus that has segmented genome has what ability that could enhance genetic diversity?

Answer 46

Reassortment

Question 47

What part of the GI tract does rotavirus and norovirus infect?

Answer 47

Small intestinal villi

Question 48

Which virus is more strongly associated with vomiting, rotavirus or norovirus?

Answer 48

Norovirus--->change in gastric motility and delayed gastric emptying

Question 49

Do rotavirus and norovirus cause fever?

Answer 49

Yes--->low fever

Question 50

Which virus is more likely cause dehydration, rotavirus or norovirus?

Answer 50

Rotavirus

Question 51

What is primary and secondary viremia, and which one does piconavirus have?

Answer 51

Primary--->small amount of virus go through GI and into blood--->look for a replication site Secondary--->replication site release large amount of viruses into the blood for shedding Piconavirus has both

Question 52

Which virus can enter the CNS during primary viremia?

Answer 52

Poliovirus

Question 53

What other reservoir does poliovirus has besides human?

Answer 53

NOTHING

Question 54

Why don't we use Sabin vaccine anymore?

Answer 54

Cuz Sabin vaccine can give polio to other ppl

Question 55

What receptor does poliovirus bind and infect?

Answer 55

CD155 (found in gray matter of CNS cells)

Question 56

Can polio pt recover from movement dysfunction? and what happens down the road?

Answer 56

Yes--->dennervated neurons reestabolish connection with adjacent neurons---->these adjacent neurons eventually wear out in decades and polio symptoms come back

Question 57

Exams for polio?

Answer 57

LP MRI of spinal cord Isolation is needed

Question 58

What is herpangina and what causes it? and what is the treatment?

Answer 58

Small vesicular lesions in the back of the throat--->coxsackie A Self limited

Question 59

What symptoms do coxsackie virus start with?

Answer 59

Mild gastroenteritis--->secondary viremia--->herpangina

Question 60

What family of virus is enterovirus 71 and what does it cause?

Answer 60

Picornavirus | Herpangina/polio like/meningitis

Question 61

Can the family member of the a kid with coxsackie A gets hand-foot-mouth disease as well?

Answer 61

Yes-->mild form

Question 62

What virus causes acute hemorrhagic conjunctivitis? and how does it present? and what shouldn't you give for that?

Answer 62

Coxsackie A Rapid onset--->painful--->early teen years NO topical steroids

Question 63

What 3 conditions do coxsackie A cause?

Answer 63

Herpangina/hand foot mouth disease/acute hemorrhagic conjunctivitis

Question 64

What population does coxsackie B virus target and what conditions does it cause?

Answer 64

Neonate and children | Myocarditis (dilated cardiomyopathy)/pleurodynia/aseptic meningitis

Question 65

Why do we admit pt with viral myocarditis?

Answer 65

Bedrest and observation

Question 66

What causes the pleurodynia? and how does it present?

Answer 66

Coxsackie B infect muscle around the lungs--->muscle necrosis and spasm Sudden severe chest pain--->reoccur--->dull pain in between

Question 67

What would you find in physical exam with pleurodynia? and why do we need to keep tap on the kids once he/she is recovered?

Answer 67

Pleural friction rub | It is associated with immune-mediated sequale

Question 68

When does pleurodynia life threatening?

Answer 68

When the pt is a newborn

Question 69

Tx for aseptic meningitis?

Answer 69

Self limited

Question 70

Infants can develop into ___ from aseptic meningitis from enteroviruses and HSV

Answer 70

Shock

Question 71

What is Giardia's reservoir?

Answer 71

Beaver!

Question 72

Symptoms of giardia?

Answer 72

Gas/weight lost

Question 73

Can symptoms of Giardia reappear?

Answer 73

Yes, hard to get rid of it

Question 74

What animals do crytosporidium come from? and can you kill it with chlorine?

Answer 74

Young animals like calf/No, water need to be filtered

Question 75

What animal is the definitive host of S. Saginata and S. Solium?

Answer 75

YOU

Question 76

Which parasite do you usually get neurocysticersosis, S Saginata or S. Solium ?

Answer 76

S. Solium

Question 77

For D. latum, do you ingest the cyst/egg or the worm itself?

Answer 77

Worm itself

Question 78

What is the most common parasite in the US?

Answer 78

Pinworm

Question 79

What is the whipworm? what does it cause?

Answer 79

Trichuris Trichiura/rectal prolapse

Question 80

What population of pt does strongyloidiasis affect?

Answer 80

Immunocompromised

Question 81

If you get Hep A once, can you get it again?

Answer 81

Nope

Question 82

Are Hep A/B/C/D directly hepatotoxic?

Answer 82

A/B/C are not--->it is immune mediated hepatoxicity | D is the exception

Question 83

Does Hep A usually progress into chronic state?

Answer 83

No

Question 84

What is the color of urine and stool with Hep A pt?

Answer 84

Dark urine/pale feces

Question 85

What to give for Hep A and E prophylaxis?

Answer 85

Immune serum globulin for A | No prophylaxis for E

Question 86

Hep E is prevalent in ___ country and what are its 2 phases?

Answer 86

China/Asia | Prodrome and then icteric

Question 87

Do pt with Hep E need to be put to bed rest?

Answer 87

No--->need light activity

Question 88

Which one has higher mortality, Hep A or E?

Answer 88

E

Question 89

What is the most efficient way of transmitting Hep B?

Answer 89

Injection of contaminated blood

Question 90

What are the 4 stages of Hep B?

Answer 90

Immune tolerance--->immunogenic symptoms (if not cleared--->cirrhosis)--->clearing the virus--->virus cleared

Question 91

Rate the severity of acute symptoms of HepA/B/C/E from most severe to mildest

Answer 91

A/E--->B--->C

Question 92

What is given with needle stick exposing one to Hep B?

Answer 92

Antibody prophylaxis (HBsAB) + vaccine booster

Question 93

Tx for chronic Hep B?

Answer 93

1 year of polymerase inhibitor (lamivudine) + 4 months of interferon alpha (bad bad side effects)

Question 94

The virus that enables the viriod (Hep D) to survive is called?

Answer 94

Helper virus

Question 95

Hep D encode ___ antigen?

Answer 95

delta

Question 96

What is superinfection with Hep D?

Answer 96

Hep D infect a liver that is already infected by Hep B

Question 97

How does Hep B immune evade?

Answer 97

Produce decoys

Question 98

What are the confirmatory tests for Hep C?

Answer 98

EIA followed by RIBA

Question 99

What is the current best tx options for chronic Hep C

Answer 99

2 combos of drugs that can induce SVR w/o IFN

Question 100

What is congenital infection? what is worse, acute/chronic/early/late?

Answer 100

Acquired during gestation | Acute and early are worse

Question 101

What is the definitive diagnosis of congenital infection?

Answer 101

Sample the baby | CSF/saliva and etc.

Question 102

Manifestations of congenital syphilis?

Answer 102

Puffy placenta/sniffles/rash/LAD

Question 103

Some risk factors for congenital CMV?

Answer 103

First pregnancy/new sex partner during pregnancy/contact with little kids

Question 104

Can you also see eye problem with congenital CMV?

Answer 104

Yes

Question 105

How to diagnose congenital CMV?

Answer 105

PCR on urine or blood

Question 106

What drug is used for infant for HSV infection and how to avoid it?

Answer 106

Acyclovir/C section

Question 107

What is perinatal infection? how to avoid it?

Answer 107

Infection during or after birth | Don't kiss the baby! and don't put baby in the corner!

Question 108

How to minimize HIV perinatal transmission?

Answer 108

Zidovudine for both mom and baby

Question 109

Does Hep B cause congenital or perinatal infection?

Answer 109

Perinatal

Question 110

What are the difference of early and late onset disease with group B strep?

Answer 110

Early onset--->pneumonia | Late---->meningitis