microbiology Flashcards
(652 cards)
1
Q
spore
A
gram + only
2
Q
capsule
A
polysaccahride (except bacillus anthracis which is poly d glutamate)
3
Q
pleomorphic
A
means no cell wall
anaplasma, ehrlichia
chlamydiae (giemsa)
rickettsiae (giemsa)
mycoplasma (has sterols which dont gram stain)
4
Q
borrelia
A
(giemsa)
5
Q
coccus
A
spherical
6
Q
streptococcus
A
chains or pairs
7
Q
entercoccus
A
pairs or short chains
8
Q
moraxella catarrhalis taxonomy/morphology
A
gram negative spherical (coccus)
9
Q
corynebacterium morp
A
gram + rod
10
Q
clostridium morph
A
gram + rod
11
Q
gardnerella morph
A
gram variable rod
12
Q
lactobacillus
A
gram + rod
13
Q
listeria morph
A
gram + rod
14
Q
mycobacterium morph
A
acid fast rod
15
Q
propionibacterium morph
A
gram + rod
16
Q
fusobacterium morph
A
gram - rod
17
Q
bordetella
A
respiratory gram negative coccobacillius
18
Q
burkholderia cepacia
A
gram negative rod respiratory
19
Q
haemophilus
A
gram negative coccibacillus (pleomorphic) respiratory
20
Q
legionella
A
silver stain rod (gram negative?) respiratory
21
Q
bartonella
A
gram negative zoonotic
22
Q
brucella
A
gram negative coccobcaillus zoonotic
23
Q
francisella
A
gram - zoonotic coccobcaillus
24
Q
pasteurella
A
gram - zoonotiv coccobcaillus
25
poor gram stain
these little microbes may unfortunately lack real color but are everywhere
treponema, leptospira (too thin), mycobacteria (lipid content), mycoplasma, ureaplasma (no cell wall), legionella, rickettsia, chlamydia, bartonella, anaplasma, enrlichia (primarily intracellular, plus chlamydia lacks classic peptidiglygan due to decreased muramic acid)
26
giemsa stain
certain bugs really try my patience
chlamydia, borrelia, rickettsia, trypanasomes, plasmodium
27
ziehl neelsen stain (carbol fuchsin)
protozoa (eg cryptosporidium cysts)
28
cryptococcus neoformans detection
culture on sabouraud agar, india ink (clear halo), mucicarmine (red inner capsule). latex agglutination assay detects polysaccharide capusle and is more specific.
29
silver stain
fungi eg (coccidioides, pneumocystis), legionella, helicobacter
30
n meningitidis culture
thayer martin
31
thayer martin contents
vancomycin against gram +, trimethoprim and colistin and fungi with nystatin
Very typically cultures neisseria
32
c diptheriae culture
tellurite and loffler (enhances metachromasia)
33
m pneumoniae
eaton with cholesterol
34
e coli culture
eosin methylene blue agar, colone with green metalic sheen
35
fungi culture
sabouraud
36
aerobe examples
nocardia, pseudomonas, mycobacteria,
naggin pests must breath
37
anaerobes examples
clostridium, bacteroides, fusobacterium, actinomyces
cant breath fresh air
38
why are anaerobes susceptible to oxidative damage?
lack catalase and or superoxide dismutase
39
anaerobes general features
foul smelling (short chain fatty acids), difficult to culture, and produce gas in tissue (co2 and h2)
normal flora in the gi tract, pathogenic elsewhere
40
facultative anaerobes examples
streptococci, staphylocci, and eneteric gram +
41
obligate intracellulars
rockettsia, chlamydia, coxiella. rely on host atp. stay inside cells when its Really CHIlly and Cold
42
faculatative intracellulars
salmonella, neisseria, brucella, mycobacterium, listeria, francicella, legionella, yersinia pestis
Some nasty bugs may live FacultativeLY
43
encapsulated bacteria
pseudomonas, streptococcus, haemophilus, influenza type b, neisseria meningitidis, e coli, salmonella, klebsiella, groub B strep
please SHINE my SKiS
44
pneumococcal vaccines
pcv13 conjugate. ppsv23 not conjugated
45
h influenza vaccine
conjugate
46
meningococcaly vaccine
conjugate
47
urease positive organisms
proteus, ctryptococcus, h pylori, ureaplasma, nocardia, klebsiella, s epidermis, s saprophyticus.
Pee CHUNKS
48
catalase +
nocardia, pseudomonas, listeria, aspergillus, candida, e coli, staphylocci, serratia, b cepacia, h pylori
CATs need placess to Belch their Hairballs
49
s aureus pigment
yellow
50
pseudomonas pgiment
blue green (pyocyanin and pyoverdin)
51
serratia marcescens
red pigment
52
biofilm makers
s epidermididis, viridans (s mutans and s sanguinis), p aeruginosa, nontypeable (unencapsulated) h influenza
53
s epidermidis charch
catheter and prostehtic devices
54
viridans (s mutans and s sanguinis)
dental plaques and infective endocarditis
55
p aeruginosa
respiratory tree colonization in CF pts, ventilator assisted pneumonia, contact lens associated keratitis.
56
type 3 secretion system
also known as the injectisome. needle like appedage faciliatating direct delivery of toxins from certain gram - to eukaryote cells.
psudomonas, salmonella, shigella, e coli.
57
transformation bugs
ShIN
s pneumoniae, h influenza, neisseria
58
lysogenic phage toxins
ABCD'S
group A strep erythrogenic toxin, botulinum toxin, cholera toxin, diphteria toxin, shiga toxin
59
endotoxin/exotoxin feature: source
exotoxins are made by gram + and - endotoxin gram - only
60
endotoxin/exotoxin feature: chemistry
exotoxins are polysaccharide
61
endotoxin/exotoxin feature: location of genes
exotoxin plasmid or bacteriphage
endotoxin bacterial chromosome
62
endotoxin/exotoxin feature: adverse affects
exotoxin
high (fatal dose 1 uq)
endotoxin low 100s uq
63
endotoxin/exotoxin feature: clinical affects
exotoxin various
endotoxin fever, shock (hypotension), dic
64
endotoxin/exotoxin feature: mode of action
exotoxin various
endotoxin induce tnf il1 il6
65
endotoxin/exotoxin feature: antigeniticty
exotoxin induces high titers called antitoxins
endotoxin is poorly antigenic
66
endotoxin/exotoxin feature: vaccines
exotoxin toxoids used as vaccines
endotoxin no toxoids
67
endotoxin/exotoxin feature: heat stability
exotoxin destroyed rapidly at 60 degrees c (except staph enterotxin and ecoli heat stable toxin)
endotoxin
stable at 100 degree c for 1 hour
68
endotoxin/exotoxin feature: typical diseases
exotoxin tetanus, botulism diptheria,
meningococcemia; sepsis by gram - rods
69
diptheria toxin
(inhibit protein synthesis)
inactivates ef-2 (vs e2f) sounds like blocks peptide elongation
adp
ab
70
exotoxin A
(inhibit protein synthesis)
pseudomonas
inactivation of ef-2 vs e2f, results in host cell death
adp
ab
71
shiga toxin (ST)
(inhibit protein synthesis)
inactivate 60s ribosome by removing adenine from rRNA
mucosal dmage -> dystenery
enhances cytokine release -> HUS
ab
72
shiga-like toxin (verotoxin)
(inhibit protein synthesis)
unlike shigella, ehec does not invade
cytokine release -> HUS
a
73
heat labile toxin (LT)
(increase fluid secretion)
etec
activates camp -> increased CL secretion and water efflux
adp
ab
74
heat stable (ST)
(increase fluid secretion)
etec
overactivates guanylate cyclase -> increased cgmp - decreased nacl reabsorbtion and water
75
edema toxin
(increase fluid secretion)
B anthracis
minis adenylate cylase (increased camp)
likely responsbile for the charateris edematous borders of black eshcar in cutaneous anthrax
ab
76
Cholera toxin
(increase fluid secretion)
overativates adynalte cyclase by permenately activating gs. increased cl sectiona nd h20 elffux.
voluminous rice water stools
ab
77
pertussis toxin
(inhibit phagocytic activity)
overativates adynalte cyclase by impairing gi -> increased camp. impairs phagocytosis to improve survival of microbe.
ab
adp
78
tetanospasmin
ab
is a protease. works on snare (soluble NSF attachment protein receptor)
79
botulinmu toxin
protease working on snare (soluble nsf attachment protein receptor)
ab
80
Alpha toxin
(lyse cell membranes)
C perfingens
Phospholipase (lecithinase) that degrades tissue and cell membranes
degradtion of phospholipids -> myonecrosis (gas gangrenes) and hemolysis (double sone of hemolysis on blood agar)
81
Streptolysin O
(lyse cell membrane)
protein that degrades cell membranes
lyses RBS, contributes to the B hemolysis. Host abs agaisnts ABOs used to diagnosis rheumatic fever.
82
toxic shock syndrome toxin (TSST-1)
super antigen
binds mhc2 and tcr and causes il1 il2 ifn g tnf a release -> shock
toxic shock syndrome: fever, rash, shock
exfoliative toxin causes scalded skin syndrome and bullous impetigo.
heat stable enterotixin.
83
erythrogenic toxins a and b (spea and speb)
strep pyogenes
binds mhc2 and tcr and causes il1 il2 ifn g tnf a release -> shock
toxic shock like syndrome; fever rash shock
scarlet fever
84
endotoxin tlr4 activation
il 1, il-6, -> fever
tnf a -> fever and hypotension
nitric oxide -> hypotension
85
endotoxin complement activation
c3a and c5a histamine release and hyptension
c5a nutrophil chemotaxis
86
tissue factor activation by endotoxin
coagulation cascade -> dic -> renal failure
87
catalase postive respiratotion
anaerobic/facultative
88
gram positive color
purple/blue
89
gram + bacilli aerobic
LBC
listeria, bacillus, corynebacterium
90
gram + bacilli anaerobic
clostridium propionibacterium
91
B hemolytic PYR positive
group a strep
92
viridans 2 species and characteristic
s mutans and s mitis (unencapsulated)
93
a hemolytic description
greenish or brownish colow without clearing
94
b hemolysis
shows clear area
```
includes:
Staph
strep pyogenes
strep b
listeria
```
95
protein A of staph inhibits?
compliment activation and phagocytosis
96
s aureus colonizes
nares, axilla, groin
97
2 inflammatory s aureus
septic arhtisis and osteomyelitis
98
toxic shock syndrome
fever, vomiting, rash, desquamation, shock, end organ failure
increased ast, aslt , bilirubin
Can also be caused by nasal packing
99
cause of toxic shock like syndrome?
painful skin lesion
100
s aureus enteroxin feature
heat stable, not destroyed by cooking
101
coagulase of staph
helps it form a fibrin clot around itself
102
staph aureus ferments
manitol
103
s epidermidis infects
iv catheters, heart valves, prosthetic devices by forming biofilms
104
strep pneumoniae otitis media
in children
105
viridans group that cause dental caries
strep mutans and s mitis
106
viridans that causes endocarditis
s sanguinis
107
s sanguinis virulence
makes dextrans that allow binding to fibrin platele aggregates
108
group b strep causes
pneumonia, sepsis, and meningitis in babies
109
fxn of group b camp factor
enhances area of hemolysis by s aureus
110
strep bovis and extra name and one thing it can cause
S gallolyticus (s bovis biotype 1)
bactermia and subacute endocardits in colon cancer
111
entercocci
subacute endocarditis
pyr +
variable hemoylysis
VRE are important nosocominal bugs
112
bacillus anthracis
spore forming
113
bacillus anthracis morphology
colonies show a medusa head which is a halo of projections around themselves
114
cutaneous anthrax
classically hide of goat (craftsmen)
painless papule surrounded by vesicles -> ulcer with black eschar (painless, necrotic)
115
pulomnary anthrax
inhalation of spores -> flu like symptoms -> rapidly fever, pulmonary hemmorhage mediastinitis (macs took them) and shock.
116
b cerueus causes
food poisoning
117
b cerueus pathogenesis
keeping rice warm results in germination of the sporesand enterotoxin formation called (cereulide)
118
b cerueus emetic type associated with?
rice and pasta n/v within 1-5 hours, cereulide involved
119
diarrhea type b cerueus
watery and gi pain within 8-18 hrs
120
c tetani causes
trismus (lockjaw), risus saronicus (raised eyebrows and open grin), opisthotonos (spasms of spinal extensors)
121
c tetani treatment
prevent with vaccine. treat with antitoxin +/- booster, diazepam for spasms, wound debridement
122
c botulinum toxin feature and mech
heat labile prevents ach from being released -> flaccid paralysis
123
fourd d's of botulinum
dysphagia, diplopia, dysathria, dyspnea.
124
c botulinum how adults get
ingesting preformed toxin
125
c botulinum kids
floppy baby syndrome from ingesting spores in honey
126
c botulinum can treat
dystonia, achalasia, muscle spasms and facial wrinkles
127
c perfingens toxin
alpha toxin (lechithinase, a phospholipas) that causes myonecrosis (gas gangrene) and hemoylsis
128
other thing c perfingens can do
spores survive in undercooked food and whn ingested bacter release heat labile entertoxin -> food poisoning
129
c diff toxins
toxin a -> binds bursh border and alters gut fluid secretion
toxin b -> a cytotoxin, disrupts cytoskeletan by actin depolymerization
both lead to diarrhea -> pseudomembranous colitis
130
c diff can be causes by?
clindamycin, ampicillin, ppi
131
c dfif diagnosis?
one or more toxins in the stool by PCR
132
c dip agars
cystine-tellurite agar grows black colonies
i think lofflers causes the blue and red metachromatic granules
133
c dip lab test
elek test positive for toxin
134
c dip exotoxin encoded by?
b prophage
135
c dip toxin mech
inhibits protein synthesis by adp ribosylation of ef 2
136
c dip clinical
bull neck, myocarditis, arrythmias, neuro symptoms
137
listeria living
facultative intracellular
138
c dip transmission
respiratory droplets
139
listeria get from?
unpasteruizeddairy products and cold deli meats, via placental transfer, vaginal transmission during birth
140
listeria growth
grows well at refrigeration temps ( 4 - 10 degree cold enrichment)
141
listeria movement
"rocket rails" from actin polymerization that allow cell to cell and intracellular movement
saying intracellular it avoids abs
tumbling motility in broth
142
listeria clinical
amnionitis, septicemia, and spontaenous abortion in pregnant women
meningitis in immunocompromised
self limited gastroenterits in immunocompotent adults
143
nocardia vs actino where found?
soil vs normal oral, reproductive, and gi flora
144
nocardia clinical
pulmonary infection in immunocompromised (can mimic tb but negative ppd), cuteaneous infection in immmunocompotent after trauma, can spread to cna
145
actino clinical
causes oral/facial abscess that drain through sinus ttracts.
associated with gental caries/extraction.
forms yellow sulfur granules
PID with IUDs
146
PPD +
current infection or past exposure
147
IGRA advantage
fewer false positive
148
what is a ghon complex
ghon focus + hilar lymph nodes
149
where can miliary TB spread to?
meningitis, vertebrae (pott disease), lymph nodes, spleen, liver, adrenal glands
150
cord factor
creates a serpitine cord appearence where virulent m tuburculosis strains line up
activates macs (promoting granuloma formation) and induces release of TNFa
151
sulfatides (surface glycolipids)
inhibit phagolysosome formation
152
m scrofulaceum
cervical lymphadenitis in children
153
m marinum
hand infection in aquarium handlers
154
all mycobacteria are acid fast, which means?
they stain pink
155
m leprae infects
skin and peripheral nerves, likes cook temps
156
m leprae sensation loss?
glove and stocking
157
m leprae labs
cannot be grown in vitro
diagnosed via skin biopsy or tissue PCR
158
m leprae resevori in US
armadillos
159
lepromatous form
presents iffusely over the skin, with leonine (lion like faces), and is communicable.
low cell mediated immunit with humoral th2 response
160
tuberculoid form
limited to a few hypoesthetic (decreased sensatoin), hairless sking plaques
high th1 response
161
gram negative diplococcis aerobic with maltose utilization
n mengitidis
162
gram negative diplococcis aerobic without maltose utilization
n gonnorhea or moraxella
163
gram negative stains?
pink
164
gram negative coccobacilli
h influenza
bordetalla pertusiss
pasteurella
brucella
franscilla
(all zoonotic, bartonella also a zoonotic but not coccobacilli gram - rod)
165
coma shaped oxidase positive
campylobacter jejuni (42 degree growth)
vibrio (grows in alkaline media)
helico (produces urease)
166
b henslae
gram - rod
167
b fragilis
gram - rod
168
gram - baccili lactose fermentation +
fast
kleb
e coli
entero
slow
citrobacter
serratia
169
gram - baccili lactose - oxidase +
pseudomonas
170
gram - baccili lactose - h2s production on TSI agar +
salmonella, proteus
171
gram - baccili lactose - h2s production on TSI agar -
shigella yersinia
172
how does e coli ferment lactose?
with b galactosidase that break lactose inro glucose and galactose
173
EMG agar
lactose fermenters grow as purple/black colonies
e coli grows colonies with a green sheen
174
neisseria fermentation
both ferment glucose
only meningoccis ferments maltose
175
conococci shape
kidney bean shaped
176
does gonococcis have a capsule?
no
177
menigigoccia causes
causes meningococcemia with petechial hemmorahges and gangrene of toes, meningitis, waterhouse frerichsen sydnrome (fever, adrenal inusfficiency, DIC, shock)
178
h influ how transmitted?
aerosol
179
h influ non typeable (unencapsulated causes)
mucosal infections (otitis media, conjunctivits, bronchitis) as well as invasive disease since vaccine agaisnt type b.
180
h influ virulence
iga protease
181
h influ grows on?
chocalate agar (contains 5 and 10) and can also be grown with s aureus which provides factor 5 through hemolysis
182
h influ can also cause?
pneumonia
183
h influ vaccine?
polyribosylribitol phosphate conjugated to diphteria toxoid
184
when to give h flu vaccine?
2 and 18 onths
185
signs of epiglottis
stridor, thumbprint sign, cherry red appearence
186
bordetella pertussis virulence factors
pertussis toxin (diasbles Gi increasing camp) and tracheal cytotoxin
187
bordetella pertussis stages
catarrhal - low grade fevers, corza (rhinits, runny nose)
paroxysmal stage (100 day cough) - paroxysms of intense cough follow by whoop, posttussive vomiting
convalescet phase - gradual recover of cough
188
pertussis toxin can causes
lymphocytosis, hypoglycemia
189
vaccines for bordetella
Tdap, DTaP
190
bordetella what can it be mistaken for?
a viral infection due to lymphocytic infiltrate resulting from immune response
191
bordetella agar
bordet gengou
192
legoinella culture
charcoal yeast extract with iron and cysteine
193
legoinella detection?
antigen in urine
194
legoinella transmission
aerosol from encrionmental sources (ac systems, hot water tanks)
no person to person transmisson
195
legionnaires disease pneumonia type
often lobar and unilateral
196
legionnaires disease symptoms
fever, gi, and cns symptoms
197
legionnaires disease common in?
smokers and in chronic lung disease
198
pontiac fever
mild flu like syndrome
199
pseudomonas morphology
aerobic and motile
200
pseudomonas produces?
pyocyanin which is a blue green pigment and has a graplike odor
201
pseudomonas virulence
produces endotoxin (fever, shock), exotoxin A (inactivates ef-2), phospholipase C (degrades cell membrane), pyocyanin (generates ROS)
202
pseudomonas causes
PSEUDOMONAS
```
P - pyocyanin, pneumonia
S - sepsis
E - ecthyma gangrenosum
U -UTIs
D - diabetes, drug use
O - osteomyelities (puncture wounds)
M - mucoid polysaccharide capsulre
O - otitis externa (most common overall)
N - Nosocominal infections (catheters, equipment)
A - Exotoxin A
S - skin infections - hot tub folliculits
```
203
pseudomonas and IV drug users
right sided endocarditis
204
pseudomonas psteomyelitits
daiabetic foot ulcers, moist shoe puncture
205
pseudomonas feared complications of burns
burns are good environment, worry about sepsis
206
sepsis in?
neutropenia, diabetics, extensive burns, leukemia
207
why do cycstic fibrosis patients get chronic penumonia?
because of the mucoid polysacharide capsulre forms biolfilms
208
pseudomonas think andy
corneal ulcers/keratitis in contact lens wearers /minor eye trauma
209
ecthyma gangrenosum
rapidly progressive necrotic cutaneous lesioin, caused by pseudomonas bactermia, typically in immnocompromised
fever prior
single or multiple lesions
210
e coli virulence factors
fimbriae - cystitis and pyelonephritis (p pili); k capsule - oneumonia and neonatal meningitis; LPS endotoxin - septic shock
211
EIEC
invades intestinal mucosa, causes necrosis and inflammation
invasive; dysentery. clinically similar to shigella
212
ETEC
produces heat labiile and heat stable toxin; no inflammatin of invasion
travelers diarrhea
213
EPEC
no toxin produced. adheres to apical surface, flattens villi, prevents absorption.
diarrhea in children
214
EHEC serotype
O157:H7 most common serotype in us
215
EHEC transmission
undercooked meat and raw leafy veggies
216
EHEC clinical
dysentery (toxin alone produces necrosis and inflammation)
217
EHEC labs
does not ferment sorbitol vs other e coli
218
EHEC toxin and what does it causes?
shiga like toxin and causes HUS
causes decreased renal blood flow
219
klebsiella flora?
intestinal
220
klebsiella causes?
lobar pneumonia in alcoholics and diabetics when aspirated
also noscocominal UTI
221
klebsiella morphology
mucoid colonies caused by abundant polysaccharide capsule
222
klebsiella sputum
dark red "currant jelly" sputum blood and mucous
223
kelbsiella 5 A's
Aspiration pneumonia
Abscess in lung and livers
Alcoholics
diAbetics
224
campylobacter mmorphology
common or s shaped with polar flagella
225
campylobacter causes
bloody diarrhea, espiecally in children
226
campylobacter transmission
fecal oral from person to person, or ingestion of undercooked poultry or meat, unpastruerized milk.
contact with infected animals (dogs, cats, pigs)
227
campylobacter can causes
gullian barre and reactive arhtirits
228
how do salmonella and shigella invade?
via m cells of th epeyer's patches
229
what do salmonella typhi, salmonella spp, and shigella infect?
humans, humans and animals, humans
230
what do salmonella typhi, salmonella spp, and shigella h2s productions
yes, yes, no
231
what do salmonella typhi, salmonella spp, and shigella flagella
yes, yes, not
232
what do salmonella typhi, salmonella spp, and shigella virulence
endotoxin; Vi capsule, endotoxin, endotoxin, shiga toxin (enterotoxin)
233
what do salmonella typhi, salmonella spp, and shigella id50
high (large incoulum required because gastric acid inacivates), high, low (very small inovulum required bc resistant)
234
what do salmonella typhi, salmonella spp, and shigella efftcs of antibiotics on fecal excretion
prolongs, prolongs, shortens
235
what do salmonella typhi, salmonella spp, and shigella immune response
monocytes, pmns, pmns
236
what do salmonella typhi, salmonella spp, and shigella gi manifestations
constipation; followed by diarrhea, diarrhea (possibly bloody), bloody diarrhea (bacillary dysentery)
237
what do salmonella typhi, salmonella spp, and shigella vaccine
only for s typhi, oral vaccine is live attenuated s typhi and IM vaccine contains Vi capsular polysaccharide
238
typhoid fever (enteric fever) cilnical manifestations
rose spots, constipation, abdominal pain, fever
239
s typhi unique property
can be carried in the gall bladder
240
salmonella non typhoidal species
poultry, eggs, pets, and turtles
241
salmonella non typhoidal usually causes?
gastroenteritis
242
salmonella non typhoidal antibiotics to treat
not indicated
243
shigella sources
fingers, flies, food, feces
244
shigella in order of decreasing severity
s dysenteriae (bacillary dysenteriae), f flexneri, s boydii, s sonnei (shigellosis)
245
shigella key fact
invasion of M cells is key to pathogencity and organisms froduce little toxin can cause disease
246
vibrio morphology
flagellated and comma shaped
247
vibrio culture
grows in alkaline media
248
vibrio infectvity?
sensitive to stomach acid, requires a large incodulum (high id50) unless host has decreased acid
249
vibrio transmission
transmitted by contaminated water or uncooked food (eg raw shellfish)
250
vibrio treatment
oral rehydration
251
yersinia enterocolitis tranmission
pet feces (eg puppies), contaminated milk, or pork
252
yersinia enterocolitis manifestations
acute diarrhea or pseudoappendicitis (right lower abdominal pain due to mesenteric adenitis and/or terminal ileitis)
253
h pylori moprhlogy
curved, flagellated
254
h pylori lab
triple positive cat, ox, urease
255
h pylori diagnosis
urea breath test or fecal antigen test
256
spriochetes visualization
only borrelia can be visulized by aniline dyes (wright or giemsa) due to its large size
treponema is visulzed by dark field microscopy or direct furescent ab (dfa)
257
leptospira interrogans morphology
hook shaped ends
258
leptospira interrogans transmission
water contamited with animal urine
259
leptospirosis
flu like symptoms, myalgias (especially calves), jaundice, photophobia with conjuntival suffusion (erythema without exudate). prevelant in surfers and in tropics (hawaii)
260
weil disease and aka
(icterohemorrhagic leptospirosis)
sever form of jaundice and azotemia from liver and kidney dysfxn, fever, hemorrhage, and anemia
261
lyme disease vector and also transmits?
ixodes tick deer tick (also transmits anaplasma and protozoa babesia)
262
lyme disease natural resevoir
mouse
263
lyme disease stage 1
erythema migrans (not always present), and flu like symptoms
264
lyme disease stage 2
early disseminated, secondary lesions, carditis, av block, facial nerve palsy, migratory arhtirits/transient arthritis
265
lyme disease stage 3
late disseminated: encephalopathies, chronic arthritis
266
primary syphillis
localized disease presenting with painless chancre.
use darkfield microscopy if avaiable
vdrlr + in 80 percent (rpr?)
267
secondary syphillis
disseminated disease with contitutional symptoms, with maculopapular rash. condyloma lata (smooth most painless wart like lesions on the genitals), lymphadenopathy, pathcy hairy loss,
also can be confirmed using dark field microscopy
serologic testing (vdrlr/rpr are non sepcific, confirm with specific test fta-abs/mha)
latent syphillis may follow (early latent is less than 1 year and late latent is grreater than 1 year)
268
tertiary syphillis
gummas (chronic granulomas), aortitis (vasa vasorum destruction), neutrosyphillis (tabes dorsalis, general paresis), argyll robertson pupil (constricts with accomdation but is not reactive to light), alsoknown as prostitues pupil
signs: broad based ataxia, + romberg, charcot joints, stroke without hypertension
for neurosyphillis: test spinal fluid with vdrlr, fta abs, and pct
269
congenital syphillis
facial abnomralityes like rhagades (linear scars at angle of mouth), snuffles (nasal discharge), saddle nose, notched (hutchinson teeth), mulberry molars, and short maxilla, saber shins, and cn viii damage
prevent by trreating mom early aas transmission usually occurs in first trimester
270
vdrl false positives
viral infectoin (ebv, hepatitis)
drugs
rheumatic fever
lupus and leprosy
271
j herxhemier rxn
flu like syndrome (fever chillls, headache, myalgia) after antibitoics are started, due to killed bacteria (uslaly trepnema) relasing toxins
272
anaplasma table
zoonotic, ixodes tick (live on deer and mice)
273
bartonella spp table
zoonotic, cat scratch disease and bacillary angiomatosis, get from cat scartch
274
borrelia reccurentis table
zoonotic, relapsing fever, louse (recurrentdue to variable antigens)
275
brucella table
brucellosis/undulant fever, from unpastrurized dairy like (milk, cheese, cattle), endocarditis of the aortic valve, granulomatosis
276
campylobacter table
bloody diarrhea, from infected pets/animals; contaminated meats/foods/hands
277
c psittacosis get from?
parrots and other birds
278
c burnetti table
q fever, from aerosols of cattle/sheep aminiotic fluid
279
ehrlichia chaffeensis table
ehrlichiosis, transmission by amblyomma (lone star tick)
280
f tularensis table
tularemia, ticks, rabbits, deer flies
281
p multocida table
cellulits, osteomyelitis from animal bites, cats and dogs
282
salmonella spp except typhi table
diarrhea (which may be bloody), vomiting, fever, abdominal cramps
283
yersinia pestis table
plague, comes from fleas (rats and prarie dogs are resevoirs)
284
garnerella vag presentation
gray vaginal discharge with a fishy smell
285
garnerella vag also characterized by?
certain anaerobic bacteria in the vagina
286
clue cells
have stippled apperance
287
amine whiff test
mix with 10 percent koh enhances fishy odor
288
rock mountain spotted fever vector
dermacentor tick
289
rock mountain spotted fever classic triad
headache, fever, rash (vasculitis)
290
palms and soles rashes
drive CARS with your palms and soles
Coxsackievirus A infection (hand, foot, and mouth disease), rocky mountain spotted fever, 2n syphhilis)
291
typhus rash?
typhus on the Trunk spreads out but spares palms and soles
292
endemic typphus
fleas, r ryphi
293
epidemic typhus
human body louse, r prowazekii
294
ehrlichia chaffeensis
ehrlichiosis, amblyomma (lone star tick), monocytes with morulae (mulberry like inclusions) in cytoplasm, rash rare
295
anaplasma
anaplasmosis (ixodes tick), live on deer and mice, granulocytes with morulae in cytoplasm
296
q fever cause
c burnetti
297
q fever transmission
spores inhaled as aersols from cattle/sheep aminotic fluid
298
q fever presentation
penumonia
299
q fever commonly causes?
culture negative endocarditis
300
q fever is queer because?
no rash or vector, can survive outside host in endospore. closele related to rickettsia though
301
what can chlamydiae not make?
atp
302
how does the reticulate body replicate?
fission
303
4 syndromes of c trachmomatis
reactive arthritis (reiter syndrome), follicular conjunctivitis, nongonnoccal urethritis, and PID
304
how are c pneumoniae and psittaci transmitted?
aerosol
305
lab diagnosis
PCR, nucleic acid amp, cytoplasmic inclusions (reticulate bodies) can also be seen on giemsa stain or flurescent antibody stained smear
306
c trachomatis types abd
african blindness chronic infection (ABC)
307
types d-k
urethritis/pid, ectopic pregnancy, neonatal pneumonia (staccato cough) with eosionophilia, neonatal conjunctivitis (1-2 weeks after birth)
308
type l1-l3 cause and how to treat?
lymphogranuloma venereum - small painless ulcers on genitals -> swollen painful inguinal lymph nodes that ulcerate (buboes)
treat with doxycyline
309
m pneumoniae, what does the cell wall have?
sterols
310
m pneumoniae more common in what age group?
people less than 30
311
m pneumoniae common where?
military recruits and prisons
312
systemic mycoses general principles
all can cause pneumonia and dessiminate
all are dimorphic: cold at 20 C and yeast at 37 C (exception coccioides, which iss a spherule with endospores) in tissue
they can form granulomas like TB but can not be transmitted from person to person (unlike TB)
313
systemic mycoses treatment
fluconazole or itraconazole for local infection
amphoterricin B for systemic infection
314
histo location
mississippi and ohio river valleys
315
histo path feature
smaller than rbc
inside macs
316
histo unique things
palatal/tongue ulcers, splenomegaly
317
histo get from?
bird (starlings) or bat droppings
318
histo diagnosis?
serum or urine antigen
319
blastomycosis location
eastern and central US
320
blastomycosis path
broad based budding
same sized as RBC
321
blastomycosis unique
inflammatory lung disease, can disseminate to skin/bone,
verroucous skin lession can simulate SCC
forms granulomatous nodules
322
coccidoiomycosis location
southwestern us, california
323
coccidoiomycosis path
spherule (much larger than RBC) filled with endospores of coccidies
324
coccidoiomycosis unique
dissimnates to skin/bone
erythema nodosum (desert bumps) or multiforme, arthrlagias (desert rheumatism), can cause meningitis
325
paracocciiomycosis location
latin america
326
paracocciomycosis path
budding yeast with captains wheel formation (much larger than RBC)
327
paracocciomycosis unique
similar to cocioimycosys
males > females
328
what does tinea mean?
its the clinical name given to a dermatophyte (cutaneous fungal) infectoin
329
what are the dermatophytes?
microsporum, trichophyton, epidermophyton
330
dermatophytes microscope
branching septate hypahe visble on KOH preparation with blue fungal stain
331
dermaopthye infection assocaited with?
pruitis
332
tinea capitis
occurs on head/scalp, associated with lymphadenopahty, alopecia, scaling
333
tinea corporis
occurs on torso. characterized by erythematous scaling rings (ringworm) and central clearing. can be acquired from cat or dog
334
tinea cruris
occurs in inguinal area. often does not show central clearing seen in tinea corporis
335
tinea pedis
three varieties:
- interdigital (most common)
- moccasin distribution
- vesicular type
336
tinea unguium/onychomycosis
occurs on nails
337
tinea (pityriasis) vericolor caused by
malassezia spp (pityrosporum), a yeast like fungus (not a dermatophyte)
338
tinea (pityriasis) vericolor pathogenesis
degradation of lipids produces acids that damage melanocytes and cause hypopigmented, hyperpigmented, and/or pink patches
339
tinea (pityriasis) vericolor less of what than dermatophytes?
less pruitis
340
tinea (pityriasis) vericolor occurs most often?
anytime but most comon in summer
341
tinea (pityriasis) vericolor appearence under microscope
meatballs and spaghetti (hypahe and yeasts)
342
tinea (pityriasis) vericolor treatment
selenium sulfide, topical and/or oral antifungal medications
343
candida moprhology
dimorphic, forms pseduhypahe and budding yeast at 20 and germ tubes at 37
344
candida clinical manifestations
causes oral and esophageal thrush in immunocompromised (neonates, steroids, diabetes, aids), vulvovaginitis (diabtes, use of antibitoics), diaper rash, endocariditis (iv drug users), disseminated candidiasis (especially in neutropenic patients), chronic mucocutaneous candidiasis
345
aspergillus fumigatus morphology
septate hypahe that branch at 45 degrees (acute), produces conidia at the end of conidiophore
346
aspergillus fumigatus clinical
invasive asperigillosis in immunocompromised, chronic granulomatis disease.
aspergillomas in preexisting lung cavities, especially after TB
some species make aflatoxins
ABPA: hypersensitivity response associated with asthma and cystic fibrosis; may cause bronchiectasis and eosinophilia
347
crptococcus morphology
5-10 um narrow budding. heavily encapsulated yeast. not dimorphic
348
crptococcus found where?
soil, pigeon droppings
349
crptococcus how do you get?
inhlation with hematgenous spread to meninges
350
crptococcus causes
cryptococcosis, cryptococcal meningitis, cryptococcal encephalitis (soap bubble lesions), primarily in immunocompromised
351
crptococcus diagnosis
culture on sabouraud agar
high lighted with india ink (clear halo) and mucicarmine (red inner capsule)
latex aggultination assay detects plysaccharide capsule and is more specific
352
mucor and rhizopus spp. morphology
irregular, broad, nonseptate hyphae branching at wide angles
353
mucor and rhizopus spp. who does it bother?
diabeteic ketoacidosis, and or neutropenic patients (eg leukemia patients).
354
mucor and rhizopus spp. pathogenesis
proliferate in blood vessels, penetrate cribiform plate, and enter brain.
rhinocerebral, frontal lobe absccess, cavernous sinus thrombosis.
headache, facial pain, black necrotic eschar on face; may have cranial nerve involvement
355
pneumocystis jirovecii causes?
a diffuse interstitial pneumonia
356
pneumocystis jirovecii morphology
yeast like fungus (originally thought to be protozoan)
357
pneumocystis jirovecii most infections result in?
asymptomatic
358
pneumocystis jirovecii cxr/ct
diffuse, bilateral ground glass opacities
359
pneumocystis jirovecii diagnosed by?
lung biopsy or lavage
disc shaped yeast seen on methenamine silver stain of lung tissue
360
sporothrix schenckii morphology
dimorphic, cigar shaped budding yeast grows in branching hyphae with rosettes of conidia
361
sporothrix schenckii lives where?
on vegetation
362
sporothrix schenckii how do you get and manifestations?
introduced into skin, typically by thorn ("rose gardeners disease"), causes local pustule or ulcer with nodules along the draining lymphatics (ascending lymphangitis)
disseminated siease possible in immunocompromised
363
giardia diagnosis
nultinucleated trophozoiites or cysts in stool, antigen detection
364
e hysticolytica diagnosis
serology and or trophozoites (with engulfed RBCs) or cysts up to 4 nuclei in stool. antigen detection
365
cryptosporidium parvum disease
sever diarrhea in aids
mild disease (watery diarrhea) in immunocompotent
366
cryptosporidium parvum transmission and of giardia and e histo
oocysts, and cycst for later 2
367
cryptosporidium parvum diagnosis
oocysts on acid fast stain
368
congenital toxo
triad of chorioretinitis, hydrocephalus, and intracranial calcifications
369
toxo diagnosis
serology, biopsy (tachyzoiites)
370
naegleria fowleri causes
meningoencephalitis
371
naegleria fowleri diagnosis
amoebas in spinal fluid
372
t brucei disease
african sleeping sickness - enlarged cervical lymph nodes, recurring fever (antigenic variation), somnolence, coma.
373
t brucei transmission
tsetse fly, a painful bite
374
t brucei diagnosis
trypomastigote in blood smear
375
clinical of malaria
fever, headache, anemia, spenomegaly
376
vivax/ovale
48 hr (tertian) 1st and 3rd day fever
dormant form (hypnozoite)
377
falciparum
sever irregular fever patterns. parasitized RBCs oclude capillaries in brain (cerebral malaria), kidneys, lungs
378
p malriae
72 hr cycle (quaartan)
379
malaria transmission
anopholes
380
malaria diagnosis
1. trophozoite ring form with RBC
2. shizont containg merozoites
3. red granules (schuffner stippling) seen throught RBC cytoplasm in vivax/ovale
381
babesia causes
fever and hemolytic anemia in the northeastern US
382
babesia who is at increased risk
asplenia
383
babesia transmission
ixodes tick (often coinfects with lyme disease)
384
babesia diagnosis
blood smear ring form and maltese cross. PCR
385
trypanosoma cruzi clinical
chagas disease
dilates cardiomyopathy with apical atrophy
megacolon
megaesophagus
found in south america
unilateral perioribital swelling (romana sign) is seen in acute
386
trypanosoma cruzi transmission
reduviid bug (kissing bug)
feces deposited in a painless bite
387
trypanosoma cruzi diagnosisq
trypomastigote in blood smear
388
visceral leishmaniasis (kala azar)
spiking fevers, hepatosplenomegaly, pancytopenia
389
cutaneous leishmaniasis
skin ulcers
390
lesihmania transmission
sandfly
391
lesihmania diagnosis
macs containing amastigotes
392
trichomonas clinical feature
itching burning and fould smelling discharge
393
trichomonas diagnosis
tophozoites (motile) on wet mount "strawberry cervix"
394
immune response to helminths
type 1 - neutralization by histamine and leukotrienes
type 2 - eosinophils attach and release major basic protein
395
enterobius (pinworm)
anal pruitis
diagnosis via egg on scotch tape
fecal oral
396
asaris (giant roundworm)
ileocecal obstruction at ileoceal valve
bilary obstruction
intestinal perforation
migrates from nose/mouth
fecal oral
knobby oval eggs seen in feces
397
strongyloides (threadeorm)
causes vomiting, diarrhea, epigatric pain (may mimic peptic ulcer disease)
larvae in soil penetrate skin, rhabditiform larvae seen in feces under microscope
398
ancyclostoma/necator (hookworms)
causes anemia by sucking blood form intestine
cutaneous larva migrans - pruitic serpiginous rash from waling barefoot on the beach
larvae penetrate the skin
399
t spiralis
larvae enter blood stream and encyst in striated muscle -> muscle inflammation
trichinosis - fever, vomiting, nausea, periorbital edmea, myalagia
undercooked meat (especially pork); fecal oral is less likely
400
trichuris trichuria (whipworm)
often asymptomatic; loose stooks/anemia, rectal prolapse in children (heavy infection)
fecal oral
401
t canis
visceral larva migrans - nematodes migrate to blood through intestinal wall
-> inflammation and damage
often effects heart (myocarditis), liver, eyes (visual impairement, blidness), and CNS (seizures, coma)
fecal oral
402
onchocerca volvulus -
skin changes, loss of elastic fibers and river blindness
allergic reaction to microfilaire possible
femal blackfly
403
loa loa
sweeeling in skin, worm in conjunctiva
deer fly, horse fly, mango fly
404
w bancrofti
lymphatic filriasis (elephantiasis) - worms invade lymph nodes -> inflammation -> lymphedma
1 year latent period
female mosquito
405
t solium
intestinal tape worm ingestion of larvae encysted in undercooked pork
cystiecercosis, neurocystercercosis - ingestion of eggs in food contaminated with human feces
406
d latum
b12 -> megaloblastic anemia
ingestion of larvae in raw freshwater fish
407
e granulosis
hydatid cysts (eggshell calcifications) in liver; cysts can rupture and cause anaphylaxis
ingestion of eggs in food contaminted with dog feces
sheep are intermediate host
408
schistosoma mansonia
liver and spleen enlargement
eggs have lateral spine
fibrosis, inflammation, portal hypertension
snails are host; cercariea penetrate skin of humans
409
s hematobium
chronic infection (egg with terminal spine), can lead to SCC of the bladder and pulmonary hypertension
410
clnorchis sinesis
biliary tract infection -> pigemented gallstones
associated with cholangicarcimoa
undercooked fish
411
ingested helminths
you EATT these
enterobius, ascaris, toxocara, trichinella
412
cutaneous helmenths
get them from the SANd
strongyloides, ancyclostoma, necator
413
helminths from bites
loa loa, onchocerca volvulus, wucheria bancfrotis
stay LOW to avoid these
414
sarcoptes scabei
mites burrown into the stratum corneum and cause scabies - pruitis (worse at night) and serpiginous burrowns (lines) in the webspace of hands and feet
common in children, crowded populations (jails, nursing homes)
transmission by skin to skin and less commonly via fomites
415
pediculus humanus/phthirus pubis
blood sucking lice that causes intense pruitis with asssociated excoriations, commonly on the scalp and neck (head lice) or waistband and axilla (body lice)
can transmit rickesttsia prowazekii (epidemic typhus), borelia recurrentis (relapsing fever), bartonella quintana (trench fever)
416
schistosoma japonicum
portal hypertension
417
ancyclostoma and necator can cause?
microcytic anemia
418
viral recombination
just like medels recombinatoin
419
reassortment viral
flu stuff (antigenic shift)
420
complementation
hbsag is the envelope protein for hep d because its own is defective
421
phenotypic mixing
forms a pseudovirion
422
live attenuated vaccines viral
MMR, yellow fever, rotavirus, influenza (intranasal), chickenpox (VZV), small pox, sabin polio virus
Musci and lYRICSS are best enjoyed Live
can be given to HIV positive who do not show signs of immunodifiency
423
Killed vaccines viral
Rabies, influenza (injected), salk polio, and HAV vaccines
only humoral immunity but are stable
424
subunit viral vaccines
HBC (ag = hbsag), HPV (6 11 16 18)
425
naked virion genome infectivity
purified nucleic acids of most dsDNA (except pox and HBV) and + strand ssRNA (smae thing as mRNA) are infectious
- strand ssRNA and dsRNA viruses are not infectious and require polymerases brought with the complete virion
426
dna viral replication location
al replicate in the nucleus except pox (carries its own dna-dependent rna polymerase)
427
rna replication virus
all in the cytoplasm (except influenza virus and retro virus)
428
complex dna capsid
pox virus
429
draw your rna/dna charts
good luck!
430
poxvirus
smallpox eliminated due to live atteunated
cowpox "milkmaid blisters"
molluscum contagiosum
431
adenovirus causes?
febrile pharygitis - sore throat
acute hemmorhagic cystitis
pneumonia
conjunctivitis - pink eye
432
hpv warts
1,2,6,1
433
bk virus
transplant patients, commonly targets the kidney
434
parvovirus b19
in children slapped cheek diseae, 5th disease, erythema infectiosum
in fetus -> hydrops fetalis
adults can cause pure red cell aplasia and arthirtis like symptoms
435
were is hsv2 latent?
sacral ganglia
436
vzv latent were and what can reactivation cause?
latent in the doral root or trigeminal ganglia
cn v1 involvement can cause herpes zoster ophthalmicus
437
mono symptoms
fever, hepatosplenomegaly, pharygitis, and lymphadenopathy (especially posterior cervical lymph nodes)
438
cmv in transplants?
causes penumonia
439
cmv retinits in aids
hemmorhage, cotton wool exudates, vision loss
440
where is cmv latent?
mononulcear cells
441
roseola infantum also called?
exanthem subitum
442
roseola infantum clinical
high fever for days that cause cause seizures followed by diffuse macular rash
443
hhv 8 transmission
sexual contact
444
hhv 8 can also affect?
gi tract and lungs
445
chsv identification
tzanck smear shows multinucleated giant cells seen in hsv 1 2 and vzv
intranuclear eosinophillic cowdry A inclusions also seen with 1 2 vzv
446
cmv attachment
integrins (heparan sulfate)
447
ebv attachment
cd21
448
p b19 attachment
p antigen on RBCs
449
attachment for rabies
nicotinic achr
450
rhinovirus attachment
icam-1
451
sabin vaccine route?
oral OPV
452
salk route?
IPV
453
echovirus causes
aseptic meningitis
454
rhinovirus casues
common cold
455
coxsackie syndromes
aspetic meningitis, herpangian (mouth blisters and fever), hand foot and mouth disease, myocarditis and pericarditis
456
chikungunya virus family
togavirus
457
coronaviruses cause
common cold, sars, mers
458
arenavirus members
LCMV - lymphocytic choriomeningitis virus
| lassa fever encephalitis - spread by rodents
459
hantavirus causes
hemorrhagic fever, pneumonia
460
enteroviruses
all of perch except rhinovirus
461
picornavirus replication
all are made from i large polypeptide that is cleaved by proteases
462
rhinovirus tid bits
> 100 serologic variants
| acid labile - destroyed in stomach and does not infect GI tract , unlike other picornaviruses
463
yellow fever trnamission
aedes mosquito
464
yellow fever resevoir
human or monkey
465
yellow fever symptoms
high fever, black vomitus, and jaundice
466
yellow fever histology
liver biopsy may show councilman bodies (eosinophilic apoptotic bodies)
467
rotavirus causes gastro where?
in day care centers and kindergartens
468
rotavirus pathology
villous destruction with atrophy leads to decreased absortion of na and loss of k
469
roata virus who should be vaccinated?
all infants by CDC
470
influenza superinfection
s aureus, s pneumo, h influ
471
most used flu vaccnie
killed vaccine
472
live attenuated vaccine features
temp sensitive
replicates in nose but not lungs
473
genetic shift is due to?
minor random mutations in hemagllutinin or neuramidase
474
when do you need knew flu vaccines?
from genetic drift
475
rubella also known as?
3 day german measles
476
rubella symptoms
fever, postauricular and other lymphadeonpathy, arthlagias, and fine confluent rash that starts on face and spread centrifigullay to onvolve trunk and extremities.
477
what causes blueberry muffin rash in congenital rubella?
dermal extramedullary hematopoiesis
478
all paramyxovirsus have?
f or fusion protein which causes epithelial cells to fuse and form multinucleated giant cells
479
croup also called
`acute laryngotracheobronchitis
480
croup surface proteins
hemmaglutin and neuramidase
481
croup caused by
parainfluenza
482
croup clinical signs
results in seal like barking cough and inspiratory stridor
483
croup xray sign
steeple sign
484
croup sever can cause
pulsus paraoxus
485
measles also called
rubeola
486
measles clinical
prodromal fever with cough, corzya, conjunctivitis and then koplik spots
then the maculopapular rash 1-2 days later
487
measles histology
lymphadenitis with warthin finkeldey giant cells (fused lymphocytes) in a background of paracortical hyperplasia
488
measles sequale
SSPSE years later, ecephalitis, and giant cell pneumonia (rarely, in immunosupressed)
489
mumps clinical
parotitis, orchitis, aseptic meningitis, pancreatitis.
can cause steritly (especially after puberty)
490
rhabies histopath
negri bodies, cytoplasmic inclusions found in the purkinje cells of the cerebellum and the hippocampal neurons
491
rhabies clinical
incubations period of weeks to months
fever mailaise -> agitation, photophobia, hyrdophobia -> hypersaliavation -> paralysis, coma -> death
492
rhabies trip to cns
binds ach receptors and the retrograde transport via dynein motors
493
rhabies transmission
bat, raccon, and skunk bites, than from dog bites in US
aersol transmission in bat caves also possible
494
rhabies tretament
wound cleaning, killed vaccine, immunoglobin
495
ebola virus targets
targets endothelial cells, phagocytes, hepatocytes.
496
ebola virus clinical
up to 21 day incubatino period, abrupt onset of flu like symptoms, diarrhea/vomiting, high fever, myalgia.
can progress to DIC, diffuse hemmorhage, shock
497
ebola virus transmision
requires direct contact with bodily fluids, fomites (including dead bodies), infected bats or primates (apes/monkeys)
high incidence of nosocominal infections
498
zika virus family?
flavivirus
499
zika virus trnamission
aedes mosquito and outbreaks more common in tropical and subtropical communities
sexual and vertical transmission possible
500
zika virus clinical
20 percent get low grade pyrexia, itchy rash, conjuntivits
can lead to congenital microcephaly or misccariages
501
nonenveloped hepatitis viruses do?
hit your gut
502
hepatitis signs and symptoms
fever, jaundice, alt and ast,
503
HBV completion of DNA and of reverse transciptions
by hbv dna that has dna and rna depedent activities
504
transcription of HBV mrna
by host rna polymerase
505
HCV lacks?
3 to 5 prime exonuclaese activity so get variation in the envelop proteins and host antibodies lag behind
506
HAV transmission
fecal oral (shellfish, travelers, day care)
507
HAV incubation
short (weeks)
508
HAV clinical course
asymptomatic (usually), acute
509
HAV biopsy
hepatocyte sweling, monocyte infiltation, councilmen bodies
510
HBV transmission
parenteral (blood), sexual (baby making), perinatal (birthing)
511
HBV incubatino
long (months)
512
HBV clinical
intially like serum sickness (fever, arthlagias, rash) may progress to carcinoma
513
HBV prognosis
mostly full resoution for adults. neonates have a worse prognosis
514
HBV histology
granular eosinophilic "ground glass" appearence; cytotoxic T cells mediate damage
515
common hepatitis carrier states
HBV and HBC
516
HCV transmission
primarily blood (IVDU, post transfusion)
517
HCV incubation
long
518
HCV histology
lymphoid aggregates with focal areas of macrovesicular steatosis
519
HDV transmission
parenteral, sexual, perinatal
520
HEV transmission
fecal oral, especially waterborne
521
HEV incubation
short
522
HEV clinical
fmulminant hepatitis in Expactant pregnant women
523
HEV histo
patchy necrosis
524
hep b hematologic
aplastic anemia
525
hep b renal
mebranous gn -> membranoproliferative gn
526
hep b vascular
polarteritis nodasa
527
hep c hematologic
essential mixed cryoglubulinemia, increased risk for b cell NHL, ITP, autoimmune hemolytic anemia
528
cryoglobulinemia
increased protein, usually igm
precipitate at lower temps
toes and fingers gangrene
529
hep c renal
membranoproliferative gn -> membranous Gn
530
hep c vascular
leukocytoclastic vasculitis
531
hep c dermatologic
sprodic porphyria cutanea tarda, lichen planus
532
hep c endocrine
increased risk of diabetes mellitus, autoimmune hypohyroidism
533
Anti HAV (IgM)
best to detect acute hepatitis a
534
anti HAV (IgG)
prior HAV infection and or prior vaccination; protects agaisnts reinfection
535
HbSag
what you need to know is persistance of this represents chronic infection
536
HBcAG`
never found in serum
537
HbEAg
secreted by infected hepatocyte into circulation. not part of mature virion.
538
hiv env gene
gp 41 and gp 120
539
gag gene
p24 (capsid) and p17 (matrix)
540
pol gene
reverse transcriptase (tavels in virus), aspartate protease, integrase
541
what confers immuntiy?
ccr5 mutations
542
hiv testing
elisa (rule out) western blot (rule in)
543
aids diagnosis
less than or equal to 200, aids defining illness, cd4 percentage lss than 14 percent
544
aids diagnosis in neonates
us PCR in neonates
545
draw hiv time course chart
172
546
acute hiv infection clinical
fever, myalgias, maculopapular rash, mono like, sore throat, cervical adenopathy
547
less than 400 general symptoms
constituional symptoms, skin, mucous membrane infections
548
less than 200 general symptoms
systemic/aids defining illnesses
549
less than 500 disease
oral thrush, pral hairy leukoplakia, bacillary angiomatosis, kaposi sarcoma, HPV (squamous cell carcinoma comonly of anus or cervix
550
less than 500 candida
scrapbale white plague, psuedohypahe
551
less than 500 oral hairy leukoplakia
unscaplble plague on lateral tongue
552
less than 500 bartonella
bopsy shows neutrophils
553
less than 500 hhv8
biopsy shows lymphocytic infiltrate
554
less than 200 cd4 disease
histo, hiv, jc, pneumocystis
555
less than 200 histo
fever, weightl loss, fatigue, cough, dyspnea, nausea,vomiting, dirrhe
oval yeast cells within macrophages
556
less than 200 HIV
dementia
557
less than 200 jc
PML
nonenhancing areas of demylination on MRI
558
hive disease less than 100
aspergillus, candida esophagitis, CMV, cryptococcus, cryptosporidium, EBV b cell lymphoma, MAC, toxo
559
less than 100 aspergillus
hemoptysis, pluretic pain cavitation or infiltrates on chest imaging
560
less than 100 candida
esophagitis white plagues on endoscopy
561
less than 100 CMV
retinitis, esophagitis, colitis, pneumonitis, encephalitis
linear ulcers on endoscopy, cotton wool spots on fundoscopy
intranuclear owleye inclusions
562
c neoformans less than 100
meningitis
563
less than 100cryptosporidium less than 100
chronic watery diarrhea
564
less than 100 ebv
primary b cell lymphoma
565
less than 100 MAC
nonspecific systemic symptoms (fever, night sweats, weight loss) or focal lymphadenitis
566
less than 100 toxo
brain abscesses
567
prions are usually predominatly?
alpha helical but get turned to beta
568
prions are resistant too?
standard sterilization and autoclaving
569
normal flora: skin
s epi
570
nose: normal flora:
s epi and colonized by s aureus
571
oropharynx normal flora:
viridans
572
dental plague normal flora:
s mutans
573
normal flora: colon
b fragilis > e coli
574
vagina normal flora:
lactobacillus, colonized by e coli and group b strep
575
c perfingens whats it on?
reheated meat
576
s aureus food poisoning food in
meats, mayonaise, custard
577
v vulnifus and v parahaemolyticus
get from contamiated seafood
usually infects those with liver disease (alcoholic cirrhosis, hepatitis, hemochromatsis)
Can get both VV and VP from eating shellfish, and only VV from wound infection from contaminated water or shellfish
both can cause septicemia
fluid fille dblisters
578
enteroinvasive e coli
causes bloody diarrhea and invades colonic mucosa
579
y entercolitica assoicated with what kind of outbreaks?
day care outbreaks
580
often get vibrio cholera frm where?
infected seafod
581
pneumonia neonates less than 4 wks
group b strep or e coli
582
pneumonia children 4wk to 18 yr
RSV, mycoplasma, c trachomatis (infants), c pneumoniae (school aged children), s pneumoniae
583
adults 18 to 40 yers pneumonia
mycoplasma pneumoniae, c pneumoniae, s pneumoniae, viruses (influenza)
584
adults 40 to 65 yrs pneumonia
s pneumoniae, h influenza, anaerobes, viruses, mycoplasma
585
elderly pneumonia
s pneumoniae, influenza, anaerobes, h influenza gram neg rods
586
alcoholic pneumonia
klebsiella, anaerobes due to aspiration (peptostreptococcus, fusobacterium, prevotella, bacteroides)
587
iv drugs users pneumonia
s pneumoniae, s aureus
588
cystic fibrosis pneumonia
pseudomonas, s aureus, s pneumoniae, burkholder cepacia
589
postviral pneumonia
s pneumoniae, s aureus, h influenza
590
newborm meningitis (0-6 wks)
group b strep, e coil, listeria
591
children meningitis (6 months to 6 yrs)
s pneumonia, n meningitidis, h influenza type b, enteroviruses
592
6 yrs to 60 yrs meningitis
s pneumo, n meningitidis, enteroviruses, hsv
593
60+ meningitis
s pneumo, gram - rods, listeria
594
viral causes of meningitis
enterovirsusu (especially coxsackie), hsv2 (hsv-1 = encephalitis), HIV, west nile virus (also causes encephalitis), VZV
595
bacterial meningitis findings
opening pressure increased, increased PMNs, increased protein, decreased glucose
596
fungal/tb meningitis findings
increased pressure, increased lymphocytes, increassed protein, decreased glucose
597
viral meningitis findings
normal to increased opening pressure, increased lymphocytes, normal to increased protein, normal glucose
598
infections causing brain abscesses
most commonly viridans strep or staph aureus. if dental infection or extraction procedes abscess, anaerobes commonly invovled.
multiple abscesses are sually from bacterimia; single lesions from cintigious sites; otitis media and mastoiditis -> temporal lobe and cerebellum; sinusitus or dental infection -> frontal lobe
toxoplasma in aids
599
osteomyelitis if no other info
s aureus
600
sexually active osteomyelitis
n gonorrhea
601
sickle cell osteomyelitis
salmonella and s aureus
602
osteomyelitis prosthetic joint replacement
s aureus and s epidermidis
603
osteomyelitis vertebral involvement
s aureus, mycobacterium tb (pott disease)
604
cat and dog bites osteomyelitis
pasteurella multocida
605
iv drug abuse osteomyelitis
pseudomonas, candida, s aureus
606
osteomyelitis findings
elevated CRP and ESR
| MRI best in early
607
kelbsiella UTI
3rd leading cause of UTI. large mucoid capsule and viscous colonies
608
serratia UTI
some strains produce red pigment, often nosocomnial and drgu resistant
609
enterococcus UTI
often nosocominal and drug resistant
610
proteus mirabalis UTI
motility causes swarming on agar; produces urease; assoicated with struviite stones
611
pseudomonas UTI
blue green pigment and fruity odor; usually nosocominal and drug resistant
612
bacterial vaginosis
thin, white discharge with fishy odor, no inflammatin
613
trichomonas
inflamation, frothy yellow green foul smelling discharge
motile trichomonads
614
candida vulvovaginitis
inflammation, thich white cottage cheese discharge
615
nonspecific torches signs
hepatosplenomegaly, jaundice, thrombocytopenia, and growth retardation
616
tocoplasma in mom
usually asymptomatic, can cause lymphadenopathy
617
toxo in baby
triad of chorioretinitis, hydrocephalus, and intracrnial calcifications and could have blueberry muffin rash
618
rubella transmission
respiratory droplets
619
rubella mom manifestations
rash, lymphadenopathy, polyarthirtis, polyarthlagias
620
rubella baby
triad: eye (cataracts) and ear (deafness) and congenital heart porblems (PDA).
621
cmv mom transmission
sexual contact, transplants
622
cmv baby
hearing loss, seizures, petehcial rash, blueberry muffine rash, periventricular calcifications
623
HIV in baby
reccurrent infetions, chronic diarrhea
624
HSV2 in baby
meningoencephalitis or herpetic lesions
625
syphillis in baby
often still birth, hydrops fetalis; if child survives, presens with facial abnormalities (eg notched teeth, saddle nose, short maxilla, saber shins, cn 8 deafness
626
red rashes of childhood: handfoot and mouth disease
ovalshaped vesicles on palms and soles; vesicles and ulcers in oral mucosa
627
red rashes of childhood: roseola aka
eanthem subitum
628
red rashes of childhood: p b19 in pregnant
hydrops fetalis
629
red rashes of childhood: vzv
vesicular rash begins on trunk, spreads to face and extremities with lesions of different stages
630
chancroid
painful genital ulcer with exudates, inguinal lymphadenopathy
631
chlamydia as an std
urethritis, cervicitis, epididymitis, conjunctivitis, reative arthiritis, PID
types d-k
632
condyloma acuminata
6 and 11
633
granuloma inguinale (donovanosis)
painless beefy red ulcer that bleeds readily on contact
not common in us
Klebsiella (calymmatobacterium) granulomatis; cytoplasmic donovan bidies (bipolar staining) seen on microscopy
634
PID top bugs an clinical
c trachmoatis (subacute and often undiagnosed), Neiserria gonorhea (acute)
c trach most common
cervical motion tenderness (chadilier signs), purulent cervical discharge
PID may include salpingitis, endometritis, hydrosalpinx, and tuboovarian abscess
635
PID salpingitis risk factor
ectopic pregnancy, infertility, chronic pelvic pain, adhesions
636
PID can lead to
fitz hugh curtis syndrome - infection of the liver capsule and violin strong adhesions to the peritoneum
637
two most common nosocominal infections
e coli (uti) and s aureus (wound infection)
638
aspiration pneumonia is
foul smelling
639
debubitis ulcers, surgical wounds, drains
s qureus (including mrsa), gram - anaerobes (bacteroides, prevotella, fusobacterium)
640
intravascuar catheters
s aureus (including mrsa), s epidermidis (long term), enterobacter
641
mechanical ventilation, endotracheal intubation
late onset: pseudomonas, klebsiella, acinetobacter, s aureua
sweet odor for pseudomonas
642
renal dialysis unit, needle stick
HBV, HCV
643
urinary catherterization
e coli, klebsiella, proteus
644
meningitis that can colonize the nasopharynx
h influenza type b
645
meningitis that can lead to myagias and paralysis
poliovirus
646
epiglottis can cause what ?
epiglottis even in fully immunized kids
647
chronic granulomatis disease susceptible to?
cat + especially s aureus
648
fungal infection in diabetic or immunocompromised?
mucor or rhizopus
649
needle stick?
hbv
650
neutropnenic patients
candida albicans (systemic), aspergilus
651
organ transplant
cmv
652
traumatic open wound
c perfingens
