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Step 1 > Microbiology > Flashcards

Microbiology Flashcards

1
Q

Staphylococcus characteristics:

A

Gram+
Cocci arranged in clusters
Catalase+

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2
Q

Streptococcus characteristics:

A

Gram+
Chains or pairs of cocci
Catalase-

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3
Q

Lyme disease is caused by:

A

Borrelia burgdorferi

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4
Q

Syphilis is caused by:

A

Treponema pallidum

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5
Q

Q fever is caused by:

A

Coxiella burnetii

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6
Q

Rocky Mountain spotted fever is caused by:

A

Rickettsia rickettsii (transmitted by ticks)

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7
Q

Chlamydiae infection is treated with:

A

Azithromycin or doxycycline (tetracycline for C. pisttaci)

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8
Q

Toxoplasmosis is caused by:

A

Toxoplasma gondii

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9
Q

Chagas disease is caused by:

A

Trypanosoma cruzi

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10
Q

Kaposi sarcoma is caused by:

A

HHV8

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11
Q

The most important global cause of infantile gastroenteritis is:

A

Rotavirus

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12
Q

Name three symptoms of measles:

A

3C’s

Cough
Coryza (rhinitis)
Conjuntivitis

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13
Q

Drugs that inhibit folic acid synthesis (DNA methylation):

A

Sulfonamides (SULFAdiazine)

Trimethoprim

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14
Q

Drugs that inhibit DNA tropoisomerases 2 and 4:

A

Fluoroquinolones (ciproFLOXACIN)

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15
Q

Antibiotic that damages DNA by making free radicals:

A

Metronidazole

Bleomycin has also this mechanism

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16
Q

Antibiotic that inhibits mRNA synthesis (RNA polymerase):

A

Rifampin

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17
Q

Antibiotics that inhibit protein synthesis inhibiting 50s subunit:

A

Macrolides (aziTHROmycin) and Clindamycin: block translocation

Linezolid: blocks initiation

Streptogramims (DalfoPRISTIN, QuinuPRISTIN): block extrusion

Chloramphenicol: blocks peptidyltransferase

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18
Q

Antibiotics that inhibit protein synthesis inhibiting 30s subunit:

A

Aminoglycosides (amikaCIN, gentamiCIN): block 30s binding to Shine Dalgano sequence

Tetracyclines (doxyCYCLINE): block tRNA to bind the ribosome A site

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19
Q

Antibiotics that inhibit cell wall synthesis inhibiting peptidoglycan cross-linking:

A

Penicillins (AmoxiCILIN, piperaCLIN)
Cephalosporins (CEFazolin, CEFtaroline)
Carbapenems (doriPENEM)
Monobactams (aztreonam)

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20
Q

Antibiotics that inhibit cell wall synthesis inhibiting peptidoglycan synthesis:

A

Glycopeptides (bacitraCIN, vancomyCIN)

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21
Q

Cephalosporins with high activity against Pseudomonas:

A

4th generation (cefepime) and 3rd generation (ceftazidime)

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22
Q

5th generation cephalosporins (ceftaroline) spectrum:

A

Broad gram-positive and gram-negative including methicillin resistant staphylococcus aureus

Does not cover Pseudomonas

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23
Q

Antibiotics that treats anaerobic infections above the diaphragm:

A

Clindamycin

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24
Q

Antibiotics that treats anaerobic infections below the diaphragm:

A

Metronidazole

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25
Q

Treatment of Methicillin-resistant Staphylococcus aureus:

A

Non beta-lactams because mecA decreases PBP affinity for beta lactams

Vancomycin
Clindamycin
Linezolid
TMP-SMX
Doxycyclin
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26
Q

Treatment of Vancomycin-Resistant Enterococci:

A

Linezolid

Streptogramins (quinuPRISTIN)

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27
Q

Antibiotics to avoid in pregnancy:

A 
Sulfonamides
Aminoglycosides
Fluoroquinolones
Clarithromycin
Tetracyclines
Ribavirin (antiviral)
Griseofulvin (antifungal)
Chloramphenicol

SAFe Children Take Really Good Care

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28
Q

Streptococcus pyogenes (group A streptococci), characteristics, diseases and treatment:

A

Characteristics: Group A, beta hemolytic and bacitracin sensitive, hyaluronic acid capsule, Protein M

Diseases: Pharyngitis, scarlet fever and pyoderma/impetigo. Sequelae: Rheumatic fever and acute glomerulonephritis (+ streptozyme test)

Treatment: Beta-lactam or erythromycin

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29
Q

Staphylococcus aureus, characteristics, diseases and treatment:

A

Characteristics: Beta hemolytic, yellow, gram + cocci (clusters), catalase and coagulase +

Diseases: Gastroenteritis, endocarditis, abscesses and mastitis, toxic shock, impetigo, pneumonia, surgical infection and osteomyelitis

Treatment: Methicillin or vancomycin and fusidic acid if resistant

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30
Q

Streptococcus agalactiae (group B streptococci), characteristics, diseases and treatment:

A

Characteristics: Group B, beta hemolytic, bacitracin resistant and hydrolyzes hippurate

Diseases: Neonatal septicemia and meningitis, the meningitis starts a few weeks after birth vs Listeria that starts a few days after birth

Treatment: Ampicillin (Listeria) with cefotaxime

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31
Q

Streptococcus pneumoniae, characteristics, diseases and treatment:

A

Characteristics: Alpha!! partially hemolytic, gram+, catalase-, encapsulated, lancet-shaped, diplococcus, bile soluble (unable to be cultured in bile) and optochin sensitive

Diseases: Bacterial pneumonia, adult meningitis, otitis media and sinusitis in children

Treatment: Penicillin G, start with macrolides!! for community acquired pneumonia. Vancomycin+-rifampin!! if meningitis

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32
Q

Viridians streptococcus, characteristics, diseases and treatment:

A

Characteristics: Alpha hemolytic, bile and optochin resistant, s. sanguinis makes dextrans

Diseases: Dental caries and endocarditis

Treatment: Penicillin G (with aminoglycoside if endocarditis)

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33
Q

Enterococcus characteristics:

A

Gram+
Catalase-
PYR (pyrrolidonyl arylamidase)+
Grows on salt and bile

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34
Q

Enterococcus faecalis, characteristics, diseases and treatment:

A

Characteristics: Gram+, group B, bile esculin+, grows in 6.5% salt

Diseases: Urinary, biliary track infections and subacute endocarditis (damaged valve)

Treatment: All strains carry some drug resistance

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35
Q

Bacillus characteristics:

A

Gram+ rods
Spore-forming
Aerobic

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36
Q

Bacillus anthracis, characteristics, diseases and treatment:

A

Characteristics: Large gram+ spore-forming rods with poly-D-glutamate capsule

Diseases: Antrax, cutaneous antrax and pulmonary Wool Sorter’s Disease

Treatment: Ciprofloxacin or doxycycline

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37
Q

Listeria characteristics:

A 
Gram+
Nonspore-forming rods
Facultative intracellular
Tumbling motility!!
Cold growth 🍦
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38
Q

Mycobacterium characteristics:

A

Acid fast rods with waxy cell wall

Obligate aerobes

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39
Q

Mycobacterium tuberculosis, characteristics, diseases and treatment:

A

Characteristics: Auramine-rhodamine staining bacilli, acid fast, aerobic, slow growing on Lowenstein-Jensen, produce niacin and heat sensitive catalase

Diseases: Tuberculosis

Treatment:
First 2 months(isoniazid+rifampin+pyrazinamide)
Next 4 months (isoniazid+rifampin)
+ ethambutol or streptomycin

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40
Q

Clostridium characteristics:

A

Gram+ rod
Spore forming
Anaerobic

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41
Q

Neisseria characteristics:

A

Gram-
Diplococci with flattened sides
Oxidase+

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42
Q

Neisseria meningitidis, characteristics, diseases and treatment:

A

Characteristics: Gram-, kidney/bean shape cocci in pairs, large capsule, grows on chocolate agar and ferments maltose

Diseases: Meningitis and meningococcemia

Treatment: Penicillin G or ceftriaxone

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43
Q

Neisseria gonorrhoeae, characteristics, diseases and treatment:

A

Characteristics: Gram- diplococci, culture on Thayer-Martin medium

Disease: Gonorrhea

Treatment: Ceftriaxone + macrolide

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44
Q

Pseudomonas characteristics:

A

Gram- rod
MOTILE (twitching motility thanks to type IV pili and flagellum)
Oxidase+, catalase+
Aerobic
Make slime glycocalix (avoids phagocytosis)
Nonfermenting (grows in McConkey agar but doesn’t turn it pink)

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45
Q

Pseudomonas aeruginosa, characteristics, diseases and treatment:

A

Characteristics: Gram- rods, motile, oxidase+, aerobic, non-fermenting, pyocyanin pigment (blue-green), grape-like odor, MOTILE

Diseases: GI track colonization, folliculitis and eye ulcers in normal people. Pneumonia, septicemia, ectyma gangrenosum, malignant otitis externa… on diabetic, burn, neutropenic, chronic granulomatous disease…

Polysaccharide capsule forms biofilm so causes chronic pneumonia in CF!

Treatment: Antipseudomonal penicillin, 3g cephalosporins, fluoroquinolones

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46
Q

Legionella characteristics:

A

Weakly gram-
Requiere cysteine and iron
Water organisms

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47
Q

Legionella pneumophila, characteristics, diseases and treatment:

A

Characteristics: Gram- but stain poorly, require cysteine and iron, facultative intracellular

Disease: legionnaires disease (pneumonia, hyponatremia, mental confusion and diarrhea with no bug in GI tract)

Treatment: Levofloxacin + rifampin in immunodeficiency

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48
Q

Bordetella characteristics and main illness:

A

Gram- small rods
Strict aerobes

B. Pertussis: Whooping cough, unvaccinated with lymphocytosis and hypoglycemia

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49
Q

Francisella characteristics and main illness:

A

Gram- small cocobacilli
Facultative intracellular: needs Th1 and gives type 4 hypersensitivity
Zoonotic: 🐇 🦌 🐁 hunters (dermacentor tick)

F. Tularensis: tularemia, black ulcer due to tick bite, lymphadenopathy, atypical pneumonia (skinning rabbit), septicemia, diarrhea form eating undercooked rabbit

Tto: streptomycin (aminoglycosides)

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50
Q

Brucella characteristics and main illness:

A

Gram- rods
Aerobic
Zoonotic: 🐂 🐐 farmers, vets, unpasteurized 🥛 in Mexico
Facultative intracellular

Brucellosis: undulant fever, sweating a lot; can last years

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51
Q

Yersinia characteristics and main illness:

A

Gram- rods
Coagulase positive
Facultative intracellular
Bipolar 🧷 staining

Y. Pestis; Plague: Bubonic (fever, buboes-lymphadenopathies-, conjunctivitis) Pneumonic (hemoptisis, chests pain, dyspnea)
Zoonotic: southwest dessert flea from🐀🐿 and prairie dogs

Y. Enterocolitica: 🐶 mesenteric adenitis +- ileitis (pseudoappendicitis, discarded in CT or sx)
Zoonotic: raw pork, unpasteurized 🥛 in clod climates (Y. enteroCOLDitica), unfiltered water or pet feces

Tto: aminoglycosides

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52
Q

Bartonella characteristics and main illness:

A

Gram- rods + with warthin-starry
Transmission: 🐱 🐶 scratch/bite (in bite you clean and give amoxicillin-clavulanic for pasteurella if stays think bartonella)

B. Henselae: papule+ lymphadenopathy+- fever +- headache. Bacillary angiomatosis in AIDS
Stellate granulosis with central necrosis in lymph nodes

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53
Q

Campylobacter characteristics:

A

Gram-curved rod with polar flagella

Microaerophilic

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54
Q

Campylobacter jejuni, characteristics, diseases and treatment:

A

Characteristics: Gram- curved motile rods (seagull appearance) microaerophic (grows on Campy or Skirrow’s agar)

Disease: self limited enteritis that can lead to guillain-Barré

Treatment: Fluoroquinolones, erythromycin

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55
Q

Helicobacter pylori, characteristics, diseases and treatment:

A

Characteristics: Gram- spiral with flagella, microaerophilic, 37deg, oxidase+

Diseases: Chronic gastritis and duodenal ulcers, associated with stomach cancer

Treatment: Omeprazole+amoxicillin+clarithromycin

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56
Q

Escherichia characteristics:

A

Gram- rod, enterobacteriaceae, ferments lactose

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57
Q

Toxins that increase cAMP

A

Cholera
Antrax
E.Coli (M,E)
Pertussis

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58
Q

Escherichia coli, characteristics, diseases and treatment:

A

Characteristics: Gram- rod, motile, anaerobic, oxidase-, ferments lactose

Diseases: Urinary tract infection, neonatal septicemia and meningitis, septicemia

Treatment: Depends, trimethoprim-sulfamethoxazole for traveler’s diarrhea, fluoroquinolones for bloody diarrhea with pus and fever

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59
Q

Major encapsulated organisms:

A

Some Killers Have Pretty Nice Capsules:

Strep pneumoniae
Klebsiella pneumoniae
Haemophilus influenzae Type b
Pseudomonas aeruginosa
Neisseria meningitidis
Cryptococcus neoformans
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60
Q

Klebsiella characteristics:

A

Gram- rod, enterobacteriaceae, major capsule

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61
Q

Klebsiella pneumoniae, characteristics, diseases and treatment:

A

Characteristics: Gram-, larger capsule, mucous, lactose-fermenting, oxidase-

Diseases: Pneumonia, urinary tract infections, septicemia

Treatment: test antibiotic sensitivity

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62
Q

Salmonella characteristics:

A

Gram- rod (enterobacteriaceae), non-lactose fermenter, flagellated and motile (flagella contributes to hematogenous spread)

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63
Q

Salmonella typhi, characteristics, diseases and treatment:

A

Characteristics: Gram- rods, Vi capsule, non-lactose fermenting, produces H2S

Disease: Typhoid fever

Treatment: Ciprofloxacin or ceftriaxone

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64
Q

Yersinia characteristics:

A

Gram- rod, enterobacteriaceae (oxidase-)

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65
Q

Enterobacteriaceae characteristics:

A

Gram- rods
Non-sporing
Ferment glucose
Reduce nitrate to nitrite

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66
Q

Enterobacteriaceae bacteria with clinical significance:

A

Highly pathogenic:
Yersinia
Salmonella
Shigella

Facultatively pathogenic:
E. Coli
Klebsiella
Enterobacter
Proteus
Serratia
Citrobacter
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67
Q

Proteus characteristics:

A

Gram- rod (enterobacteriaceae), with flagella, non-lactose fermenting, urease+, oxidase -
Alkalinizes the urine! and smells like ammonia

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68
Q

Vibrio characteristics:

A

Gram- curved rod with polar flagella, oxidase+

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69
Q

Haemophilus characteristics:

A

PLEOMORPHIC Gram NEGATIVE COCCOBACILLI!!! that requires growth factors X (hematin) and V (nicotinamide) so grows in chocolate agar or co-culture with S. Aureus

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70
Q

Haemophilus influenzae, characteristics, diseases and treatment:

A

Characteristics: Gram- rods, requires factors X and V (chocolate agar)

Diseases: Meningitis in unvaccinated, otitis media, bronchitis, pneumonia, epiglottitis, conjuntivitis

Treatment: Cefotaxime or ceftriaxone for meningitis (rifampin for prophylaxis!!)

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71
Q

Treponema characteristics and others of that type:

A

Spirochetes (spiral, axial filament) poor gram stain (Gram-but very thin to see)

Other spirochetes: Borrelia and Leptospira

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72
Q

Treponema pallidum, characteristics, diseases and treatment:

A

Characteristics: Poor gram stain (gram-), thin spirochete, obligate pathogen

Disease: Syphilis

Treatment: Penicillin G

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73
Q

Borrelia characteristics:

A

Large spirochetes, gram- and microaerophilic

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74
Q

Borrelia burgdorferi, characteristics, diseases and treatment:

A

Characteristics: Poorly seen in gram stain, spirochete

Disease: Lyme disease

Primary treatment: Doxycycline, amoxicillin or azithromycin, clarithromycin

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75
Q

Rickettsia characteristics and diseases:

A

Obligate intracellular, gram-

Rocky Mountain spotted fever (rickettsii; tick; flu like + centripetal rash)
Typhus epidemic (prowazekii; louse) endemic (typhi; flea)
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76
Q

Chlamydia characteristics:

A

Obligate intracellular, not seen in gram but you can see iodine or giemsa-staining intraepithelial inclusion bodies, cannot make ATP, cell wall lacks muramic acid

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77
Q

Chlamydia trachomatis, characteristics, diseases and treatment:

A

Characteristics: Obligate intracellular, cannot make ATP, found in metabolically active cells, not seen in gram, no muramic acid

Diseases: STD, lymphogranuloma venereum, trachoma

Primary treatment: Doxycycline or azithromycin

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78
Q

Mycoplasma characteristics:

A

Smallest extracellular bacteria, no cell wall, sterols in membrane

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79
Q

Mycoplasma pneumoniae, characteristics, diseases and treatment:

A

Characteristics: extracellular, no cell wall, not seen in gram, requires colesterol in vitro culture! (Eaton agar)

Disease: Pneumonia

Primary treatment: macrolides

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80
Q

Gram+ bacteria are stained in:

A

Purple/blue

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81
Q

Gram- bacteria are stained in:

A

Red/pink

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82
Q

Antiphagocytic bacterial components:

A

Capsule
Pili of Neisseria gonorrhoeae
M-protein of Streptococcus pyogenes
A proteins of Staphylococcus aureus

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83
Q

Mechanism of action of both diphtheria toxin and pseudomonas exotoxin A:

A

Inhibition of protein synthesis trough inactivation of EF2

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84
Q

Gram- diplococcus, oxidase+ and does not ferment lactose

A

Neisseria

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85
Q

Gram+ coccus, catalase+ and coagulase-

A

Staphylococcus saprophyticus (UTI in newly active adolescent women)

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86
Q

Gram+ coccus, optochin-resistant and catalase-

A

Steptococcus viridians (subacute infective endocarditis and caries)

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87
Q

The oxidation-reduction requirement of anaerobes is:

A

Low

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88
Q

Filarial worm maturing in the lymphatics and causing elephantiasis

A

Wucheria bancrofti

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89
Q

Carrier of epidemic typhus and Trench Fever

A

Pediculus humanus

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90
Q

Two causative agents of elephantiasis are:

A

Wuchereria

Brugia

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91
Q

What do reduviid bugs transfer? How does it present?

A

American trypanosomiasis or Chagas disease

Periorbital edema+ myocarditis+ meningoencephalitis if acute dilation of organs if chronic

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92
Q

What do Tsetse flies transfer? How does it present?

A

African trypanosomiasis or sleeping sickness

Axially lymph node+ fever + flagellated trypomastigotes in blood or CSF

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93
Q

HPV 6 and 11 cause and are considered:

A

Anogenital condyloma acuminatun and laryngeal papillomas

Considered benign

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94
Q

HPV 16, 18 and 31 cause and are considered:

A

Cervical intraepithelial neoplasia

Considered malignant: most common cause of neoplasia

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95
Q

The leading cause of deaths AIDS is:

A

Pneumonia

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96
Q

Viral vaccines types and examples:

A

Recombinant: HepB and HPV

Killed: Rest In Peace Always (Rabies!!! Influenza, Polio Salk, HepA)

Live not attenuated:
Adenovirus

Live attenuated:
All the rest 
Ex: MMR
Mumps 
Measles or rubeola
Rubella or german measles
Rotavirus only live attenuated given in 👦
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97
Q

The window period in hepatitis is:

A

Between the end of the detectable HBsAg and the beginning of antibody to HBsAg

HBc antibody and HBeAg are present (HBcAg is not detectable in plasma)

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98
Q

Indicates carrier state in hepatitis:

A

HBsAg the past 6 months

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99
Q

Indicates viral production in hepatitis:

A

HbeAg

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100
Q

Grows in alkaline medium and the isolate is oxidase+

A

Vibrio cholerae

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101
Q

Owl’s eyes are and are caused by:

A

Basophilic intranuclear inclusions with smaller eosinophilic cytoplasmatic inclusion bodies

Caused by Cytomegalovirus (herpes virus, dsDNA)

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102
Q

Bacteria that require cysteine for growth:

A

Four Sisters Ella of the Cysteine Chapel:

Francisella
Legionella
Brucella
Pasteurella

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103
Q

Rheumatic fever occurs only after:

A

Pharyngitis with Group A streptococcus (s. pyogenes)

  • Not after Group C streptococcus
  • Not after group A skin infections
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104
Q

A key characteristic of Neisseria is that:

A

Is a facultative intracellular organism often seen within neutrophils

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105
Q

Mechanism of toxicity related to gram- bacteria:

A

EnDotoxin release

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106
Q

Achalasia, megacolon or megaureter could be caused by:

A

Trypanosoma cruzi (Chagas disease)

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107
Q

Common bacteria isolated in intraabdominal infections:

A

Bacteroides fragilis

Escherichia coli

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108
Q

Species that can cause disease with little amount of organisms:

A 
Giardia lamblia (1 organism)
Entamoeba histolytica (1 organism)
Shigella  (10-200 organisms)
Campylobacter jejuni (500 organisms)
Clostridium perfringens (500 organisms)
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109
Q

Vibrio cholerae, characteristics, diseases and treatment:

A

Characteristics: Gram-, oxidase+, comma-shaped rod, grows on alkaline but not on acidic media

Disease: cholera

Treatment: fluids, electrolytes and doxycycline/ciprofloxacin

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110
Q

Bugs with eXotoxins that inhibit translation or protein synthesis:

A

Corynebacterium diphtheriae

Pseudomona aeruginosa

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111
Q

Bugs with eXotoxins that increase fluid secretion:

A

Enterotoxigenic E. coli
Bacillus anthracis
Vibrio cholerae

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112
Q

Bugs with eXotoxins that inhibit release of neurotransmitters:

A 
Clostridium tetani 
Clostridium botulinum (blocks fusion of Ach vesicles to the mb cleaving SNAP-25, synaptobrevin and syntaxin)
113
Q

Bugs with eXotoxins that lyse cell membranes:

A

Clostridium perfringens
Staphylococcus aureus
(both have alpha toxin)

114
Q

Bugs with eXotoxins that are superantigens causing shock:

A

Staphylococcus aureus

Streptococcus pyogenes

115
Q

Corynebacterium diphtheriae, characteristics, diseases and treatment:

A

Characteristics: Gram+ rod, non-motile, unencapsulated, clustered resembling letters, cytoplasmic granules that stain with aniline dyes, cultured on cysteine-tellurite agar

Disease: diphtheria

Treatment: antitoxin (passive immunization), erythromycin, DTP (active immunization)

116
Q

Classic clinical manifestations of congenital rubella:

A

Congenital cataracts
Sensory-neural deafness
Patent ductus arteriosus, pulmonary stenosis
Blue berry muffin baby

117
Q

Examples of heterophile antibody tests:

A

Monospot test for Epstein-Bar virus
Weil-Felix test for Rickettsia
VDRL for syphilis

118
Q

A frequent cause of anaerobic lung abscesses is:

A

Oral bacterial flora (specially in elderly, alcoholic, demetria and depressed cough)

119
Q

Most common cause of self-limited EXTERNAL otitis:

A

Pseudomonas aeruginosa (but it can become malignant and cause osteomyelitis of temporomandibular joint and base of the skull in diabetics)

Otitis media is due to:
S.pneumo
Haemophilus
Moraxella

120
Q

Molluscum contagiosum genome:

A

DNA, double-stranded, linear, enveloped

121
Q

Poliovirus genome:

A

RNA, naked, single-stranded positive, part of the picornavirus (PERCH: polio, echo, rhino, coxakie, hep A)

122
Q

Schistosoma haematobium is a risk factor of:

A

Bladder disease (including cancer)

123
Q

Helicobacter pylori eradication treatment:

A

Triple therapy:
Amoxicillin (Metronidazole if allergy)
Clarithromycin
PPI

Quadruple therapy:
Metronidazole
Tetracycline
Bismuth subsalicylate
PPI
124
Q

Gram-, non-lactose fermenting, oxidase+ rod

A

Pseudomonas aeruginosa

125
Q

Causative agents of congenital infections:

A

TORCH:

Toxoplasmosis 
Other (syphilis)
Rubella 
Cytomegalovirus 
Herpes simplex virus
126
Q

Name 4 bacteria that require cysteine:

A

Francisella
Legionella
Brucella
Pasteurella

127
Q

Tumbling motility is associated with:

A

Listeria monocytogenes

128
Q

Lactose fermenting, gram- bacillus that generates jelly sputum, tissue necrosis and abscess formation:

A

Klebsiella pneumoniae (encapsulated)

129
Q

How can we identity a lactose fermenting bug?

A

It turns MacConkey agar pink

130
Q

C. tetani’s exotoxin blocks the release of:

A

GABA and glycine

131
Q

C. botulinum exotoxin blocks the release of:

A

Ach

132
Q

Pseudomona and diphtheria toxin mechanism:

A

ADP-ribosilate and inactivate elongation factor 2, so block translation

133
Q

Only DNA viruses that can replicate on the cytoplasm:

A

Poxviridae (smallpox and molluscum contagiosum)

134
Q

Only RNA virus type that needs the nucleus to replicate:

A

Orthomyxovirus (influenza)

135
Q

Organism that causes LOBAR pneumonia after aspiration

A

Klebsiella pneumoniae

136
Q

The presence of cord factor in M. Tuberculosis correlates with:

A

Virulence

137
Q

Mayor virulence factor and vaccine target for S. Pneumoniae:

A

Polysaccharide!!!! capsule

138
Q

Laboratory abnormality very specific of legionella in pneumonia:

A

Hyponatremia

139
Q

Cold agglutinin formation is characteristic of which microorganisms?

A

Mycoplasma pneumoniae

140
Q

What is the most common cause of aseptic meningitis?

A

Enterovirus

141
Q

Major virulence factor for C. difficile:

A

Toxin A: enteroroxic—>diarrhea
Toxin B: cytotoxic—>necrosis
They disrupt the actin cytoskeletal structure and intracellular signaling

142
Q

What are the most important pathogens in bacterial meningitis?

A

Capsules

143
Q

Main transmission of Campylobacter jejuni:

A 
Undercooked poultry 
Domesticated animals (kennels)
144
Q

What difference Staphylococcus aureus form the other staphylococci?

A

It is coagulase positive and the others (s. epidermidis, s.saprophyticus) are coagulase negative

145
Q

Most frequent cause of meningitis in neonates:

A

B strep agalactiae (vaginal canal)
E. coli (vaginal canal)
Listeria: crosses the placenta and causes granulomatosis infantiseptica

The meningitis from B strep starts a few weeks after birth vs Listeria that starts a few days after birth

146
Q

Most frequent cause of meningitis in children and teenagers:

A

N. meningitidis (trough nose)

147
Q

Most frequent cause of meningitis in adults/elderly:

A

S. pneumoniae

148
Q

Most frequent cause of meningitis in non vaccinated kid:

A

H. influenza

149
Q

Gram - oxidase + curved rod is:

A

Campylobacter

150
Q

Gram - oxidase - nonmotile non-lactose fermenter rod is:

A

Shigella

151
Q

Gram - oxidase - very motile rod that produces H2S gas is:

A

Salmonella

152
Q

If they tell you gram-negative, oxidase positive nonfermenting bacillus think about:
Other characteristics:

A

Pseudomona aeruginosa

Blue-green pigments and grape-like odor

153
Q

If they tell you gram-negative, pleomorphic rod think about:

Other characteristics:

A

Haemophilus influenzae

Requires factors X and V

154
Q

What is the major protection factor of C. difficile?

A

Ability to form spores when there is high antibiotic concentration

155
Q

Transformation definition:

A

Uptake of naked DNA from the environment. They will refer to lysate (note that supernatant is just the media, does not contain DNA)

156
Q

Conjugation definition:

A

Gene transfer from one bacteria to another trough direct cell-to-cell contact, when you see a transfer of a big drug resistance plasmid think conjugation

157
Q

Transduction definition:

A

Transfer of DNA by a phage vector (bacteriophage)

Generalized: lytic phage, package problem, can’t keep his cycle and can’t cause productive infection, efficient, different new traits for different bacteria, just ONE phage is able to transduce

Specialized: lysogenic phage, just flanking genes transmitted so less efficient, same traits for different bacteria, all phages are able to trasduce, ABCD’S toxins: group A stept, Botulinum, Cholera, Diphtheria, Shiga, Salmonella O

158
Q

Bacteria that can bind fibrinogen and IgG:

A

S. aureus

Because of it’s coagulase activity it binds fibrinogen and because of prot A it binds IgG

159
Q

What fungi is endemic form the east coast?

Form characteristics:

A

Blastomyces

Forms broad based budding yeast in tissue. Alone

160
Q

What fungi is endemic from California?

Form characteristics:

A

Coccidioidomyces

Archeology, earthquakes

Forms arthroconium in soil and biggest SPHERULES and endoSPORES in tissue

161
Q

What fungi is endemic from Mississippi and Ohio?

Form characteristics:

A

Histoplasma

Spelunking (cave exploring): 🐦 🦇 💩

Forms tuberculated macroconidia and microconidia in culture and intracellular narrow based budding yeast inside the macrophages. Histoplasma hides within macrophages, smallest

162
Q

What fungi is endemic from Latin America?

Form characteristics:

A

Para-coccidioidomyces

Big thick yeast with multiple buds, Capitain’s wheel

163
Q

Name gram + cocci species:

A

Staphylococcus
Streptococcus
Enterococcus

164
Q

Name gram + rod species:

A

Spore formers N’ CLAM

Bacillus 
Clostridium 
Nocardia 
Corynebacterium 
Listeria 
Actinomyces 
Mycobacterium
165
Q

Name gram - cocci species:

A

Neisseria
Moraxella!!!
Veillonella

166
Q

How do I differentiate between bacillus anthracis and clostridium tetani on culture?

A

Both are gram + spore forming rods

Bacillus is aerobic and clostridium is anaerobic

167
Q

Which organism presents with stormy fermentation in milk media and double zone of hemolysis?

A

Clostridium perfringens

168
Q

Pathogens associated to colon ca:

A 
Clostridium septicum (sepsis)
Steptococcus group D!! Gallolyticus -bovis- (endocarditis)
169
Q

How do I differentiate between actinomyces and nocardia on culture? How do I treat them?

A

Both are gram + branching rods

Actinomyces is anaerobic and nocardia is aerobic and partially stains with acid fast

Actinomyces is treated with penicillin and nocardia with TMP-SMX

170
Q

Thayler Martin (a variant of chocolate agar) is used to culture which organism? Which antibiotics contains?

A

Neisseria

It has antibiotics to select neisseria (Very Typically Cultures Neisseria: Vanco, Trimethoprim, Colistin and Nystatin)

171
Q

What do we use to confirm syphilis in the different phases?

A

Primary: biopsy of the lesion and dark field microscopy, FTA-ABS or MNSTP
Secondary: non-treponemal RPR o VDRL (look for abs that bind to cardiolipin; screening then you do treponemal)
Tertiary: treponemal FTA-ABS or MNSTP

172
Q

Tests that indicate that the ineffective organism has a capsule:

What organism have a capsule?

A

Quellung reaction (swelling)
Latex particle agglutination
India ink

Think meningitis. Some Killers Have Pretty Nice Big And Elaborated Capsules: Strep. Pneumo, Klebsiella, Haemophilus, Pseudomona, Neisseria meningitidis, Bacillus, Strep. Agalactiae, E. Coli (K1 neonatal disease), Crypto

173
Q

What do we use to diagnose Lyme?

A

ELISA (a lot of false negatives) then, Western blot

174
Q

Classic clinical manifestations of congenital toxoplasmosis:

A

1st trimester:
Microcephaly
Intracranial calcifications (periventricular en CMV)
Hydrocephalus

2nd trimester:
Chorioretinitis
Strabismus

175
Q

Chocolate agar is used to culture:

A 
Neisseria
Haemophilus influenzae (needs X and V)
176
Q

Charcoal yeast extract agar is used to culture:

A

The one that need cysteine and iron:

Legionella (causes hyponatremia)
Brucella
Francisella
Pasteurella

177
Q

Most common cause of meningitis in unvaccinated children:

A

Haemophilus influenzae

178
Q

What are common causes of bloody diarrhea outbreak at a day care?

A

Shigella (leukocytosis)

Others:
EHEC (no leukocytosis because non invasive)
Yersinia enterocolitica (leukocytosis)

179
Q

Surfactant-rich exudate and SILVER-staining cysts in lung biopsy indicates:

A

Pneumocystis jirovecii

180
Q

Name important urease positive organisms:

A 
KiSS PUNCH
Klebsiella 
Staphylococcus epidermidis 
Staphylococcus saprophyticus
Proteus
Ureaplasma 
Nocardia 
Cryptococcus 
Helicobacter
181
Q

B12 deficiency after eating raw fish:

A

Diphyllobothirium latum

182
Q

Name examples of lysogenic conversion:

A 
CO-BEDS (share beds)
Cholera toxin
O antigen of salmonella 
Botulinum toxin
Erythrogenic toxin of S. pyogenes 
Diphtheria toxin 
Shiga toxin
183
Q

Predominant cells in CSF of meningitis depending on the agent:

A

Bacteria: neutrophils=PNMs

Virus, fungi or mycobacterium: lymphocytes (fungi and mycobacterium will have low glucose)

184
Q

Bugs that can be used in bioterrorism and how to diagnose:

A 
Yersinia pestis: 🧷 bipolar staining 
The rest serology 
Francisella
Brucella 
Bacillus anthracis
Coxiella
Smallpox
185
Q

Intracellular organisms:

A

Obligate: Stay inside when it’s Really CHilly and COld. Hard to grow in the lab
Rickettsia
Chlamydia
Coxiella

Facultative: Some Nasty Bugs May Live FacultativeLY
Salmonella typhi
Neisseria gonorrheae, Nocardia
Brucella 
Mycobacterium 
LISTERIA
Francisella
LEGIONELLA
Yersinia

Toxoplasma
Leishmania
Babesia, plasmodium

Criptococcus
Histoplasma

Require Th1, INFgamma, IL2 (activates CD8) and you make granulomas

186
Q

Which illnesses can be transmitted by dermacentor tick:

A

Rocky Mountain: rickettsia
Tularemia: francisella!!!
Colorado tick!!! fever: Colorado tick fever virus

187
Q

Pathology and complications associated with Entamoeba histolytica:

A

Bloody diarrhea with inverted flask-shaped deep ulcers.

Can lead to fulminant colitis and liver abscesses

188
Q

Thiosulfate citrate bile salt sucrose (TCBS) medium is used to culture:

A

Vibrio

189
Q

Name important oxidase positive bacteria:

A 
Pseudomona
Vibrio 
Neisseria
Helicobacter 
Campylobacter
190
Q

Name the three dermatophytic fungi:

A

Tricophyton: hair, nails, skin
Microsporum: hair, skin (fluorescent)
Epidermophytum: nails, skin

191
Q

Pathology and staining associated with Malassezia furfur:

A

Tinea versicor: hypopigmented spots

KOH shows🍝 yeast clusters with curved septate hyphae

192
Q

Causative organism and hallmarks of cat scratch disease:

A

Bartonella henselae

Papule+- lymphadenopathy (biopsy: stellate ⭐️ granulomas) +- bacillary angiomatosis (nodular lesion following blood vessel distribution)

DD. Pasteurella. Pasteurella is due to bites and healed with amoxi-clavulanic

193
Q

Acid fast oocysts in stools indicate:

How does it cause the symptoms?

A

Cryptosporidium

Causes diarrhea in AIDS due to intracellular multiplication within intestinal epithelium

194
Q

Which illnesses can be transmitted by the ixodes scapularis tick:

A

Lyme: borrelia
Babesiosis (spiky fever + maltese cross on RBSs): babesia
Human granulocytic anaplasmosis (flu-like + low leukocytes + low platelets + morulae inside granulocytes): Anaplasma

195
Q

Bugs associated with raw oysters 🦪?

A 
Hep A
Vibrio parahaemolyticus (watery diarrhea)
Vibrio vulnificus (watery diarrhea +-septicemia +-cellulitis
196
Q

Candida morphology:

A

At 37deg: germ tubes, germinating hyphae

Also:
Pseudohyphae (constricted at septi)
Oval budding yeasts
True hyphae

197
Q

What antibodies need to be used to detect neonatal infection?

A

IgM (1st produced) or IgA (mucosa)

IgG crosses the placenta

198
Q

What parasite is associated with liver hydatid cysts?

A

Echinococcus granulosus

DD. With Entamoeba that causes liver abscess

199
Q

What parasite is associated with pigmented gallstones?

A

Clonorchis sinensis

Can evolve to cholangiocarcinoma

200
Q

What parasite is associated with brain cysts?

A

Taenia solium (neurocysticercosis)

201
Q

Pneumocystis morphology:

A

Extracellular atypical

Dx: Cysts in silver (methenamine) staining of the lavage

202
Q

Segmented viruses:

A 
ROBA
Reovirus (Rotavirus)
Orthomyxovirus (Influenza)
Bunyavirus (Hantavirus)
Arenavirus (LCMV, Lassa fever)

If they are talking about any of those viruses think REASSORTMENT
‘Robar en un resort’

203
Q

What parasite is associated with acid-fast oocysts in stools?

A

Cryptosporidium parvum

204
Q

Bacterial vaccines types and examples:

A

Conjugated (conjugate the meninges) ->T activation:
Neisseria meningitidis
Strep pneumoniae 13 serotypes 👦
Haemophilus influenza B

Polisaccharide:
Strep pneumoniae 23 serotypes 👴

Toxoid:
DTaP: diphtheria, tetanus, acellular pertussis

205
Q

Heterophile negative mononucleosis:

A

CMV (can be transmitted by blood transfusion, less risk if irradiated)
Toxoplasmosis
HIV
HVS 6

206
Q

What is the difference between gram + and gram -?

A

Gram - have an outer membrane covering the peptidoglycan

207
Q

Which bug causes hyponatremia?

A

Legionella

208
Q

Differential diagnosis of vaginal discharge:

A

Gardnerella: gray thin and odorous, clue cells, +Whiff, high pH, endogenous→ metronidazole
Trichomona: frothy green-yellow, trophozoite with corkscrew motility, STD→ metronidazole
Candida: cottage cheese, pseudohyphae, germ tubes→, topical or oral azole

209
Q

Differential diagnosis of genital lesions and treatment:

A

Treponema pallidum, syphilis: painless chancre and painless lymphadenopathy. Micro: corkscrew. Tto: Penicillin 0

Klebsiella granulomatis: granuloma inguinale or donovanosis: painless nodule that ulcerates (beefy red) and can bleed (PSEUDObubon) WITHOUT lymphadenopathy. In Africa. Giemsa, intraCYTOPLASMATIC bipolar ~🧷 staining. Tto: doxy/macrolide 0

Clamydia trachomatis (L): painless ulcers→ tender painful lymphadenopathies that ulcerate (buboes) lymphogranuloma venereum. In Latin America and Africa. Micro: Giemsa, intraCYTOPLASMATIC. Tto: Doxy 1

Haemophilus ducreyi: chancrOID, deep purulent painful ulcers (papule→ pustule→ ulcer→ BLEEDING) with ragged borders, GRAY base and SUPPURATIVE inguinal lymphadenitis. Micro: clumping, school of fish. Tto: ceftriaxone/macrolide 2

HSV2: superficial ITCHY painful vesicles or ulcers w erythematous base (but do not bleed) and tender lymphadenopathy (but not suppurative) ± discharge ± constitutional symptoms (FEVER, malaise). Heal in 10 days. Easier to get AIDS. Micro: intraNUCELAR and multinucleated cells. Tto: acyclovir 2

210
Q

Antibodies against nonstructural protein 1 indicate:

A

Dengue, transmitted by the Acedes mosquito

211
Q

Where does JC virus remains latent?

A

In kidney and lymphoid organs

212
Q

Bugs associated with hemochromatosis:

A

Listeria
Yersinia enterocolitica
Vibrio vulnificus

213
Q

Which drugs can be a RF for oral thrush? How can you prevent it?

A

Inhaled corticosteroids for asthma

Prevent it by washing the mouth with water after use

214
Q

Which parasites are transmitted by flies and what is their treatment?

A

Tsetse fly: trypanosoma brucei->suramin, melarsoprol
Sandfly: leishmania->sodium stibogluconate (ampho B for visceral)
Black fly: onchocerca->ivermectin
Deer/horse/mango fly: loa loa->diethylcarbamazine

215
Q

Which are the natural transformers? Bacteria that tend to transfer DNA by transformation:

A 
They have at least the enz. RecA for transformation
Think meningitis:
S. Pneumoniae
H. Influenza type B
Neisseria species
Those 3 also have IgA protease

Other natural transformers:
Bacillus species
H. Pylori

216
Q

Organisms associated with bites:

A

Cat/Dog bite: Pasteurella multocida. Treat with amoxiclavulanic

If does not heal:
Human: Eikenella corrodens (Cepha 3rd)
Dog: Capnocytophaga canimorsus (Cepha 3rd)
Cat scratch: Bartonella henselae (azithromycin)

217
Q

Which are the dimorphic yeasts?

A 
Body Heat Changes Shape:
Blastomyces
Histoplasma
Coccidioidomyces
Sporothrix

Mold in the cold and yeast in the beast (yeast more imp for dx)

218
Q

What can give you chronic meningitis?

A

M. tuberculosis
Syphilis
Brucella
Fungi

219
Q

How can pseudomonas cause chronic pneumonia even if they are treated?

A

Polysaccharide capsule forms biofilm so causes chronic pneumonia in CF!

220
Q

How do you treat cestodes (tapeworms) and trematodes (flukes)?
How does it work?

A

Praziquantel (albendazole for echinococcus)

Increases permeability of cell mb. to Ca

221
Q

How do you treat menatodes (roundworms)?

How does it work?

A

Bendazoles (but ivermectin for onchocerca and diethylcarbamazine for loa loa and wuchereria)

Bind to β-tubulin and inhibit its assembly into microtubules

222
Q

Which bugs need to be cultured in live tissue?

A

Mycobacterium leprae

Pneumocystis jirovecii

223
Q

What is the capsule composition of S. pyogenes, S. pneumonia, H. influenza, Pseudomona, B. anthracis and Salmonella?

A

S. pyogenes: Hyaluronic acid
S. pneumonia: Polysaccharide
H. influenza: Polysaccharide, polyribosylribitol phosphate!!!
Pseudomona: Polysaccharide that can form biofilm
B. anthracis: Polypeptide poly D!!!!-glutamate
Salmonella typhi: Vi

224
Q

Which pathogenic factors get transferred by specialized transduction:

A

A lysogenic phage transfer flanking DNA; ALSO CALLED LYSOGENIC CONVERSION

ABCD'S tOxins:
Group A stept (pyogenes) exotoxins A-C
Botulinum toxin
Cholera toxin
Diphtheria toxin (presence tested by ELEK)
Shiga toxin
Salmonella O antiges
225
Q

What is the ELEK test? what does it test?

A

Presence of diphtheria toxin. If they are crossing lines there is toxin!

Diphtheria toxin is acquired by a lysogenic/temperate phage!!!!

Diphtheria toxin ADP-ribosilates and inactivates elongation factor 2 blocking translation

226
Q

How do you treat community acquired pneumonia in adults?

A

Macrolides or doxycycline

227
Q

Histological hallmarks of HIV encephalopathy and progressive multifocal leukoencephalopathy:

A

HIV: microglial nodules, multinucleate giant cells, p24+ cells
JC: multifocal non-enhancing lesions, demyelination in white matter, intranuclear inclusions

228
Q

Which bacteria causes lymphocytosis and why?

A

Bordetella pertussis (produces lymphocytosis promoting factor that prevents lymphocytes to enter the lymph node)

229
Q

What are the different causes of endocarditis?

A

Acute IV drugs: Staph aureus
Subacute dentist: Strept viridians
Subacute urologist: Enterococci
Subacute prostatic valve or IV drugs: Staph epidermidis
Subacute gram negative: HACEK (Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, Kingella)

230
Q

Name all the spirochetes:

A

Borrelia (the biggest and the only one that can be seen in Giemsa)
Leptospira
Treponema

231
Q

Infections associated with 🐦 and their treatments:

A

Both cause pneumonia
C. psittaci; tetracycline
Histoplasma; fluconazole

Flaccid paralysis
West Nile

Meningitis in HIV
Cryptococcus (pigeons)

232
Q

Which fungal infection can present as lobar consolidation?

A

Aspergillus

233
Q

How do hep C and plasmodium enter the cell?

A

CD81 is used by hep C and plasmodium to enter and infect the cell

234
Q

HACEK examples, presentation and treatment:

A 
Haemophilus
Aggregatibacter
Cardiobacterium
Eikenella
Kingella

Endocarditis in normal patient with a new murmur; very mild symptoms so hard to dx; they are mouth flora (maybe got it by punching someone on the face)

Two: 3rd cefalosporin

235
Q

Define MIC and MBC:

A

MIC: minimal inhibitory concentration (color change in test tube)
MBC: minimal bactericidal concentration needed for immunocompromised (bacteria in agar)

236
Q

Name 4 bacteria that secrete IgA protease:

A

Neisseria meningitidis and gonorrhoeae
Stept pneumo
Haemophilus influenzae

It cleaves IgA at the hinge region

237
Q

How do you get rid of proteins, spores, RNA and lipid bilayer envelopes?

A

Proteins, naked viruses and spores: autoclave and chlorine-based solutions (such as bleach -sodium hypochlorite-)
RNA and DNA: ionizing Radiation (radiotherapy causes DNA double strand breaks and free radicals)
DNA: aldehydes and iodine
Lipid bilayer envelope, destroy cell membranes: alcohol, heating at 60 deg for 30 min

Other mechanism:
Destroy intracelular constituents: chlorhexidine
Cross-link DNA and proteins: aldehydes
Halogenation of DNA: iodine
Free radicals formation: hydrogen peroxide

238
Q

Which is the most common cause of non-purulent celulitis? and of purulent celulitis?

A

Non-purulent: Strep pyogenes

Purulent: Staph aureus

239
Q

Fungi that are budding yeasts:

A

Candida at 20 deg
Cyptococcus, narrow
Blastomyces, broad
Paracoccidioides

240
Q

Acid fast stains: other names, color of acid-fast positive organism and change of color:

A

Other names: Kinyoun, Fite and Ziehl-Neelsen
Acid fast organism look pink

Carbon Fuchsin enters the cell at high temperature making all pink, then you go back to normal temperature and add Methylene Blue, acid fast will remain pink and the rest will become blue

241
Q

Which illness is associated with serratia osteomyelitis?

A

Chronic granulomatous disease

242
Q

Bugs for which the most important mechanism for presentation is molecular mimicry:

A

Chagas
Lyme
GAS=S. pyogenes (rheumatic fever)

243
Q

Big joint artritis that moves:

A

Lyme
Rheumatic fever
Gonorrhea

244
Q

Which pneumonias can form and abscesses?

A

Anaerobes
Staph aureus
Klebsiella

Because they are caused by aspiration abscesses are normally on the lower lobes of the right lung!

245
Q

Main virulence factors of S.pyogenes and S.aureus:

A

S. pyogenes: Protein M (binds to factor H and prevents opsonization and complement destruction)

S. aureus: Protein A (binds Fc of IgG and prevents opsonization)

246
Q

Bugs that are observed in Giemsa stain:

A 
Rickettsia
Chlamydia
Trypanosomes
Plasmodium
Borrelia
Helicobacter

RICKy got CHLAMYDIA as he TRIed to PLease the BORred Hot Geisha

247
Q

Genetic causes of genetic shift and drift:

A

Drift: point mutation; yearly mutations human to human
Shift: genetic reassortment; species to species

248
Q

Define the following mechanisms of viral interaction: Recombination, Phenotypic mixing, Reassortment and Interference

A

Recombination: gene exchange between two dsDNA viruses with homologous regions

Phenotypic mixing: genes are form one strain and capsid/envelope from another

Reassortment: exchange of whole genome segments, just happens in segmented viruses

Interference: one virus stops another virus that is infecting the same cell

249
Q

What is the characteristic appearance of the chickenpox rash?

A

dewDROP on a rose petal

250
Q

Peeling erythematous rash resembling a sunburm is characteristic of which infection?

A

Desquamating rash in toxic shock syndrome

251
Q

Schüffner’s dots are characteristic of which malaria species? What are they?

A

P. vivax (maybe also ovale)

Schüffner stippling: red granules inside the cytoplasm of big RBCs

252
Q

Main virulence factors of M. tuberculosis

A

Sulfatides: inhibit phagosome-lysosome fusion. The 1st week of exposure to TB in healthy patient there is intracellular bacteria proliferation

Cord factor=trehalose dimycolate: paralyzes the host cells, induces TNFα release and leads to granulomas. Correlates with virulence.

Tuberculin= surface protein: leads to granulomas

253
Q

DD. salt tolerant gram positive cocci:

A

Enterococcus

Staphylococcus

254
Q

Which is the main pathogenic factor of Giardia?

A

Ventral sucking disk (can be identified because it has a falling leaf motility)

255
Q

Neonatal conjuntivitis causes and timing:

A

Gonococcal conjuntivitis. In 2 days old. Prevented with erythromycin prophylaxis

Chlamydia conjuntivitis. In 2 weeks old. Chlamydia is calm and goes slow!

256
Q

Where does Parvovirus B19 bind?

A

P antigen in RBCs also called globoside

257
Q

DD between HSV’s gingivomastitis and coxakie’s hand foot and mouth disease:

A

Both have vesicular lesions but HSV involves gums and hard palate and coxakie does not

258
Q

What protects you from influenza virus infection after previous exposure or immunization?

A

Serum antibodies against hemagglutinin, prevent the virus from entering the host cells

259
Q

Live cycle of plasmodium:

A

SSant Thomas Medical Group:

Sporozoite (enters the body)
Schizont (infect liver and then rupture)
Trophozoite (infects RBCs)
Merozoites (free in blood and cause fever)
Gametocyte (in mosquito)
260
Q

What defines viral tissue tropism?

A

Surface glycoproteins

261
Q

Cause of apendicitis:

A

E. coli

262
Q

DD for epiglottis, croup and whooping cough:

A

H. influenza type B: epiglottis, tripod position, inspiratory stridor, thumb sign👍, unvaccinated

Parainfluenza: croup, laryngitis and tracheal edema of the SUBGLOTTIC LARYNX below the vocal folds, barking cough, inspiratory stridor, steeple sign )( unvaccinated

Pertussis: whooping COUGH, inspiratory whoop!!, vomiting, long illness with phases, lymphocytosis, unvaccinated, 3 toxins (Adenylate cyclase, Gi, tracheal)

263
Q

Phase variation:

A

Method for dealing with rapidly varying ENVIRONMENTS without requiring random mutation. It involves the variation of protein expression within different parts of a bacterial population

264
Q

What is the gram, shape and Os requirement of lactobacillus?

A

Gram positive! anaerabic rod. The vagina is positive!

265
Q

How do you confirm PCP?

A

Direct fluorescent antibody test

266
Q

DD of roseola, rubella and measles rashes:

A

Roseola: maculopapular from trunk to face, postauricular lymphadenopathy

Rubella: maculopapular rash from the head down, postauricular lymphadenopathy, forheimers spots on the soft palate

Measles (rubeola): maculopapular rash from the head down, koplik spots on buccal mucosa

267
Q

What is the only positive marker during window period?

A

Hep B core antibody

268
Q

Hoe does cryptosporidium cause watery diarrhea?

A

Multiplies intracellularly, within the intestinal epithelium

269
Q

By which mechanism bacteria exchange multi-drug resistant plasmids? And single drug resistant genes?

A

Multi drug: transposition

Single drug: Conjugation, takes longer time and is less efficient

270
Q

Which organism grows on fried egg colonies?

A

Mycoplasma

271
Q

Which organism grows mucoid gray-white colonies?

A

Klebsiella

It also turns ‘eosin methylene blue agar’ purple because acidifies the medium

272
Q

What do the different HIV genes encode for?

A

gag: p24 (inner capsid membrane, dx) and p17 (outer membrane)
pol: reverse transcriptase, integrase, protease
env: envelop made of gp160 that divides into gp120 (antigenic variation, attaches, maraviroc) and gp41 (fusion, enfuvirtide)
tat: transcription! regulatory protein, to initiate HIV transcription
rev: transport! regulatory protein that allows virus to progress
nef: decreases CD4s and MHCI

273
Q

Which animals are the natural reservoir for lyme?

A

Mice (larvae) and deer (adult)

The white-footed mouse is the host of Ixodes tick larvae and the white-tailed deer is the obligatory host of adult Ixodes ticks

274
Q

What is the main difference in presentation of hepatitis B in adults vs neonates?

A

Transaminases do not go up a lot in babies because they do not have a lot of CD8+ that are the ones that cause the cell damage, they also do not have symptoms for the same reason but the hepatitis very frequently becomes chronic

275
Q

How do you get resistance to aminoglycosides?

A

By enzymes transferases that inactivate the antibiotic via phosphorylation, acetylation, or adenylation

276
Q

How do you differentiate between gonococcal and chlamydial conjunctivitis?

A

Gonococcal conjunctivitis: baby is 2 days old. Prophylaxis: erythromycin drops

Chlamydia conjunctivitis: baby is 1-2 weeks old, watery discharge. Tto: oral erythromycin

277
Q

What is used to diagnose strep on a patient that comes with pharyngitis?

A

Swab immunoassay for strep group A antigens!

278
Q

Which are the only 3 DNA and the 3 RNA viruses with circular genomes?

A

DNA: Papilloma, Polyoma and Hepadna (gets envelope form RER)

RNA: BAD; Bunya, Arena, Delta

279
Q

Why MMR (measles, mumps, rubella) need to be a live vaccine

A

They form syncitia, you need a vigorous cell mediated response to kill them

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