Rapid Review 1 Flashcards
(200 cards)
1
Q
what bug is this and what does it transmit
A
Reduviid bug
kissing bug
Trypanosoma cruzi aka Chagas
2
Q
what is this & what does it cause (via what mechanism)
A
brown recluse
Loxosceles reclusa
Phospholipase/Sphingomyelinase D causes dermonecrosis
3
Q
what is this
A
head louse
4
Q
what is this
A
body louse
5
Q
what is this
where is its anal groove
what does it transmit
A
Dermacentor
anal groove BELOW anus
Francisella
Rickettsia
6
Q
what is this
what does it transmit
A
DERMACENTOR (variabilis) aka American dog tick
Francisella tularensis (tularemia) [also Amblyomma]
Rickettsia rickettsii (RMSF)
7
Q
what is this
what does it transmit
A
DERMACENTOR (variabilis) aka American dog tick
Francisella tularensis (tularemia) [also Amblyomma]
Rickettsia rickettsii (RMSF)
8
Q
what is this
where is its anal groove
what does it transmit
A
amblyomma americanum
anal groove BELOW anus
Ehrlichia
Francisella
9
Q
what’s the scientific name for the lone star tick?
A
amblyomma americanum
10
Q
what’s the scientific name for the american dog tick
A
dermacentor (variabilis)
11
Q
what’s this & what does it transmit?
A
AMBLYOMMA AMERICANUM aka THE LONE STAR TICK
Ehrlichia chafeensis (human monocytic ehrlichiosis)
Francisella tularensis (tularemia) [also Dermacentor]
12
Q
what’s the scientific name for a blacklegged deer tick?
A
ixodes
13
Q
clinical specificity
A
value obtained when the number of true negatives is divided by the sum of the true negatives and false positives
14
Q
clinical sensitivity
A
value obtained when the number of true positives is divided by the sum of the true positives and the false negatives
15
Q
how do you calculate false negative rate?
A
1 minus clinical sensitivity
16
Q
the formula for THIS relates instrument response to analyte concentration
A
calibration curve
17
Q
analytical specificity
A
the performance of the assay when measuring an analyte in the presence of an interfering substance
18
Q
analytical sensitivity
A
lowest possible concentration of an analyte that is accurately & reproducibly measured by an assay
19
Q
what is this
A
dientamoeba fragilis
(1-2 nuclei, 3-5 granules of chromatin)
20
Q
Dense granules
A
CAAMPS
Calcium
ADP
ATP
Magnesium
Pyrophosphate
Serotonin
21
Q
Alpha granules
A
PPPvBFF
PDGF
P-selectin
PF4
vWF
β-thromboglobulin
factor V
fibrinogen
“other proteins”
22
Q
what’s this
A
cyclospora cayetanensis
23
Q
what’s this
A
Giardia
24
Q
what’s this
A
entamoeba histolytica
25
what's this
entamoeba histolytica
26
what's this
chilomastix mesnili
(oral groove)
27
Dubin-Johnson
type of bili & gene
CONJUGATED
MRP2 mutation
28
Rotor syndrome
type of bili & gene
CONJUGATED
SLCO1B1and SLCO1B3 mutations
29
Crigler-Najjar
type of bili & gene
UNconjugated
UGT1A1 mutation
30
Gilbert's syndrome
type of bili & gene
UNconjugated
UGT1A1 mutation
31
liver cirrhosis lab values
hypoalbuminemia
hypergammaglobulinemia (high total protein)
32
most important prognostic factor in CML
response to tyrosine kinase inhibitors
33
tube & preservative for coag studies
light blue top
sodium citrate 3.2%
34
tube & preservative for serum determinations in chemistry & serology
gold top serum separator tube
clot activator & gel
35
tube & preservative for serum determinations in chemistry and serology PLUS drug/tox testing
red top
clot activator
36
tube & preservative for plasma determinations in chemistry
green or tan top
sodium heparin or lithium heparin
37
tube & preservative for lead determinations
lavender top
sodium heparin (glass)
K2 EDTA (plastic)
38
tube & preservative for whole blood hematology, immunohematology, ABO grouping, Rh typing, antibody screening, etc
royal blue top
K2 EDTA
(dipotassium ethylenediaminetetra acetic acid)
39
tube & preservative for trace-element, tox, nutritional determinations
gray top
sodium heparin
Na2 EDTA
40
tube & preservative for glucose determinations
gray top
potassium oxalate/sodium fluoride
sodium fluoride/Na2 EDTA
41
blood tube draw order
blue (jan)
red (feb)
gold (march)
green (april)
purple & blue (may)
gray (june)
42
convex, smooth colonies w/ musty odor
gram negative rod
won't grow on MacConkey
susceptible to penicillin
Pasteurella multocida
43
major hCG @ 3-5 weeks of gestation
hyperglycosylated hCG
44
major hCG in choriocarcinoma
hyperglycosylated hCG
45
major hCG past 5 weeks gestation
intact hCG
46
major hCG in postgestational choriocarcinoma or after removal of hydatidiform mole
nicked hCG
(inactivated)
47
sensitive marker for testicular cancer (blood)
free beta-hCG levels
48
pathogenesis of TRALI
anti-human neutrophil antigen antibodies (HNA-Abs) [CLASS II] {or HLA class I Abs} bind to marginated neutrophils in pulmonary vasculature \> neutrophil activation \> pulmonary leak
49
newborn screening for cystic fibrosis
measure immunoreactive trypsinogen
+
DNA analysis
50
whose egg is this
paragonimus westermani
(opercular shoulders)
51
whose egg is this
clonorchis sinensis
(abopercular knob)
(v smol)
52
whose egg is this
Diphyllobothrium latum
(NO shoulders on its operculum)
(tiny abopercular knob)
53
whose egg is this?
fasciola hepatica
(no shoulders, no knob)
(rather lorge)
54
whose egg is this?
fasciolopsis buski
(transparent, no shoulders)
55
sensitive to tyrosine kinase inhibitors (EGFR)
L858R
(you die L8R if you have this mutation cause the drugs work)
56
resistance to tyrosine kinase inhibitors (EGFR)
T790M
57
troponin complex components
troponin C (smallest)
troponin I
troponin T (biggest)
58
which troponin binds calcium?
troponin C
c = calcium
59
which troponin is an actomyosin-ATP–inhibiting protein?
troponin I
i = inhibit
60
which troponin binds tropomyosin?
troponin T
t = tropomyosin
61
gene for Duffy antigen
DARC
[Fy(a-b-) is commonest in DARC-skinned pts]
62
Duffy Fy(a-b-) is most likely what race?
black
63
what does a DARC mutation do?
in Duffy antigen Fy(a-b-) phenotype
**disrupts binding site for erythroid specific GATA-1 transcription factor**
usu you get Duffy on other tissues, but not RBCs
if no Duffy on tissues OR RBCs, you can make Anti-Fy3 Abs
64
vector for Lyme
Ixodes tick
65
White footed mouse & white tailed deer are vectors for what bacteria?
Borrelia burgdorferi
66
When do Lyme/Borrelia IgG Abs peak?
after 4-6 months of illness
67
gold standard for enumerating reticulocytes
new methylene blue (NMB) or brilliant cresyl blue
[supravital dyes]
68
normal frequency for CAP inspections
every 2 years
69
hypoparathyroidism
PTH & Ca
both low
70
hyperparathyroidism
PTH & Ca
primary & tertiary: both high
secondary has low-normal Ca with high PTH
71
pseudohypoparathyroidism
PTH & Ca
high PTH
low Ca
(peripheral PTH resistance)
you know what else you see this in? Rickets
72
pseudopseudohypoparathyroidism
PTH & Ca
both normal!
73
Fanconi anemia
inheritance & defect
autosomal recessive (mostly)
abnormal chromosome breakage studies
74
most helpful lab in evaluation of primary amenorrhea
FSH
75
hematopoietic progenitor cell transport shipper requirements
portable liquid nitrogen "dry" shippers
must maintain a temp of **-150 C or less for at least 48 hours past the time of delivery** to the facility
76
what needs to be on the HIV Western blot for it to be positive?
p160/120
OR
p41 env + p24 gag
77
what is the HIV window period
6 weeks
(time of exposure til the time Abs show up)
78
what do you do if you have discrepant HIV screening? (positive EIA but negative Western blot)
HIV qualitative nucleic acid test
(can also be used before Abs are detectable)
79
deferral period for toxoids; synthetic or killed viral, bacterial, or rickettsial vaccines; recombinant vaccines; intranasal live attenuated flu vaccine
NONE
includes anthrax, cholera, diphtheria, hep A, hep B, flu, Lyme, paratyphoid, pertussis, plague, pneumococcal polysaccharide, polio/Salk/injection, rabies, RMSF, tetanus, typhoid (injection, NOT oral), HPV
80
deferral period after live attenuated viral and bacterial vaccines for:
measles/rubeola
mumps
polio/Sabin/oral
typhoid/oral
yellow fever
2 weeks
81
deferral period after smallpox vaccine without complications OR after the vax scab has spontaneously separated
21 days
whichever is later between the OR
82
deferral period following unlicensed vaccines
A YEAR
83
deferral period after live attenuated viral and bacterial vaccines for:
German measles/rubella
chickenpox/VZV
4 weeks
84
deferral after smallpox if the scab was removed before separating spontaneously
2 months
85
deferral after vaccination with complications (smallpox)
2 weeks after resolution of complications
86
what's this
Fusarium
septate hyphae with canoe-shaped macroconidia having 3-5 septations
87
what's this?
Fusarium
88
what's this?
Fusarium
89
what's this?
Alternaria
PIGMENTED large brown conidia with transverse & longitudinal septations
90
what's this?
Exophiala
PIGMENTED with single-celled conidia aggregated at apex of conidiophore
91
what's this?
Geotrichum
hyphae break into segmented cells \> arthroconidia
92
what does this transmit?
Mansonella perstans
(biting midge)
93
what is this & what does it transmit?
IXODES
Borrelia burgdorferi(Lyme)
Anaplasmaphagocytophilum (anaplasmosis)
Babesia microti
94
what is this & what does it transmit?
IXODES
Borrelia burgdorferi (Lyme)
Anaplasmaphagocytophilum (anaplasmosis)
Babesia microti
95
what is this & what does it transmit?
IXODES
Borrelia burgdorferi (Lyme)
Anaplasmaphagocytophilum (anaplasmosis)
Babesia microti
96
what is this & what does it transmit?
ixodes
anal groove ABOVE anus
Borrelia burgdorferi
Anaplasma phagocytophilum
Babesia microti
97
what is this & what does it transmit?
ixodes
anal groove ABOVE anus
Borrelia burgdorferi
Anaplasma phagocytophilum
Babesia microti
98
what's this
Blastomyces dermatitidis
99
what's this?
Blastomyces dermatitidis
100
what's this
coccidioides
101
what's this
coccidioides
102
what's this
histoplasma capsulatum
103
what's this
histoplasma capsulatum
104
what's this
histoplasma capsulatum
105
what's this
Paracoccidioides brasiliensis
106
what's this
Paracoccidioides brasiliensis
107
what's this
sporothrix schenkii
108
what's this
sporothrix schenkii
109
what's this
sporothrix schenkii
110
what's this
talaromyces (penicillium) marneffei
111
what's this
talaromyces (penicillium) marneffei
112
what's this
aspergillus fumigatus
113
what's this
aspergillus fumigatus
114
what's this
aspergillus niger
115
what's this
aspergillus niger
116
what's this
aspergillus flavus
117
what's this
aspergillus flavus
118
what's this
aspergillus terreus
119
what's this
aspergillus terreus
120
what's this
aspergillus terreus
121
what's this
aspergillus terreus
122
what's this
aspergillus flavus
123
what's this
aspergillus fumigatus
124
what's this
aspergillus niger
125
what's this
talaromyces (penicillium) marneffei
126
what's this
Proteus
127
what's this
balantidium coli
128
which aspergillus species are biseriate?
niger & terreus
sometimes flavus
129
which aspergillus species are uniseriate?
fumigatus
sometimes flavus
130
what's this
chromoblastomycosis
131
what's this?
what is it frequently associated with?
scopulariopsis brevicaulis
onychomycosis
132
what is birdseed agar for?
cryptococcus neoformans
produces melanin
(will also grow crypto gattii - use CGB)
133
what is CGB agar for?
cryptococcus gattii
C G B
crypto - gattii - blue
134
what agar grows talaromyces (penicillium) marneffei?
sabouraud (dextrose) agar
also grows Nocardia
135
what's going on here & who is doing it?
positive germ tube test
candida albicans
136
what's this?
Chlamydoconidia on pseudohyphae and spherical collections of blastoconidia at regular intervals when grown on cornmeal agar
137
what color is candida albicans on CHROMagar?
blue-green
138
what color is candida tropicalis on CHROMagar?
dark blue
139
what's this?
random blastoconidia on cornmeal
candida tropicalis
140
what color are candida krusei and candida glabrata on CHROMagar?
pink or violet
141
what is this
candida krusei
oval to elongated blastopores found at the tip of pseudohyphae on cornmeal
"cross-matchsticks" appearance
142
what is this
candida glabrata
single oval & terminal budding
NO pseudohyphae
cornmeal
143
what's this
pneumocystis jirovecii
usu in **vacuolated foamy casts** in BAL of symptomatic HIV pts
GMS: crushed ping pong balls
144
what's this
trichophyton rubrum
micro & macroconidia
macroconidia have thin walls
145
what's this
trichophyton tonsurans
micro & macroconidia
macroconidia have thin walls
146
what's this & what is the most common causative bug?
scalp ringworm (tinea capitis)
d/t trichophyton tonsurans (in the US)
147
what's this
microsporum canis
148
what's this
microsporum canis
149
what's this
epidermophyton floccosum
150
which mycobacterial species are rapid growers?
abscessus
chelonae
fortuitum + parafortuitum
mucogenicum
FORTunately, ABSCESSes and MUCOus CHEL (chill out) fast!
151
which mycobacterial species are photochromogens?
simiae
szulgai at 24
asiaticum
marinum
kansasii
SIMon SZULGAI, age 24, took PHOTOs of the ASIATIC SEA (marinum) in KANSASii
152
which mycobacterial species are scotochromogens?
gordonae
szulgai at 37
scrofulaceum
xenopi
(simon's brother) GORDON SCOT SZULGAI, age 37, is a SCROFUL (awful) XENOphobe
153
which mycobacterial species are nonchromogens?
MAC (avium + intracellulare)
TB
ulcerans
leprae
haemophilum
MAC got TB, leprosy, and an invisible (nonchromo) ulcer in his blood (haemophilum)
154
which biochemical tests can you use to tell some mycobacteria apart?
[photo]
marinum: niacin +, nitrate -, catalase -
kansasii: niacin -, nitrate +, catalase +
simiae: niacin +, nitrate -, catalase +
[scotochromogens]
scrofulaceum: niacin -, nitrate -, catalase +
xenopi: niacin -, nitrate -, **arylsulfatase +**
[nonchromo]
TB: niacin +, nitrate +, catalase -
[rapid]
fortuitum: only rapid that is nitrate +
chelonae: citrate +
abscessus: citrate -
155
which mycobacteria is arylsulfatase positive?
xenopi
156
which is the only rapid-growing mycobacterial species that is nitrate test positive?
fortuitum
157
what is the gold standard for subtyping strains of mycobacteria?
IS6110 restriction length polymorphism analysis
158
which mycobacteria have an ERM gene & what does it do?
fortuitum & abscessus (both rapid)
ERM = erythromycin ribosomal methyltransferase
confers resistance to macrolides (clarithromycin, erythromycin)
159
**SZULGAI @ 24**
choose from photo, scoto, nonchromo, or rapid
photochromogen
pigmented when exposed to light
160
**SIMIAE**
choose from photo, scoto, nonchromo, or rapid
photochromogen
pigmented when exposed to light
161
**ASIATICUM**
choose from photo, scoto, nonchromo, or rapid
photochromogen
pigmented when exposed to light
162
**MARINUM**
choose from photo, scoto, nonchromo, or rapid
photochromogen
pigmented when exposed to light
163
**KANSASII**
choose from photo, scoto, nonchromo, or rapid
photochromogen
pigmented when exposed to light
164
**SZULGAI @ 37**
choose from photo, scoto, nonchromo, or rapid
schotochromogen
| (pigmented all the time)
165
**XENOPI**
choose from photo, scoto, nonchromo, or rapid
schotochromogen
| (pigmented all the time)
166
**SCROFULACEUM**
choose from photo, scoto, nonchromo, or rapid
schotochromogen
| (pigmented all the time)
167
**GORDONAE**
choose from photo, scoto, nonchromo, or rapid
schotochromogen
| (pigmented all the time)
168
**HAEMOPHILUM**
choose from photo, scoto, nonchromo, or rapid
nonchromogen
slow
169
**LEPRAE**
choose from photo, scoto, nonchromo, or rapid
nonchromogen
slow
170
**ULCERANS**
choose from photo, scoto, nonchromo, or rapid
nonchromogen
slow
171
**TB COMPLEX**
choose from photo, scoto, nonchromo, or rapid
nonchromogen
slow
172
**MAC (AVIUM + INTRACELLULARE)**
choose from photo, scoto, nonchromo, or rapid
nonchromogen
slow
173
**MUCOGENICUM**
choose from photo, scoto, nonchromo, or rapid
rapid (colonies in 5 days)
174
**FORTUITUM (+ PARAFORTUITUM)**
choose from photo, scoto, nonchromo, or rapid
rapid (colonies in 5 days)
175
**CHELONAE**
choose from photo, scoto, nonchromo, or rapid
rapid (colonies in 5 days)
176
**ABSCESSUS**
choose from photo, scoto, nonchromo, or rapid
rapid (colonies in 5 days)
177
what does CLSI (clinical & laboratory standards institute) say you should do your McFarland inoculum at for antimicrobial susceptibility testing of aerobic nonfastidious bacteria?
0.5 McFarland inoculum
178
what component of MacConkey inhibits the growth of gram positive organisms?
bile salts & crystal violet dye
| (selective media)
179
MoA: beta-lactam Abx
"Inhibit cross-linking of N-acetylglucosamine to N-acetylmuramic acid in the bacterial cell wall"
Inhibit cross-linking of NAG to NAM
(-cillins, cephalosporins, carbapenems, monobactams)
180
MoA: beta-lactam resistance
1. _ESBLs_ inactivate the beta lactam ring via hydrolysis (encoded on a **plasmid** so they can be transferred)
2. decreased penetration to target site d/t _porin mutations_ and _efflux pumps_
3. alteration of target site PBPs that cause decreased binding of drug to PBP (MRSA: mecA: PBP2a transpeptidase protein)
1 ESBLs, 2 decreased penetration, 3 decreased binding
181
which Abx interfere with folic acid metabolism/folate synthesis?
sulfonamides
&
trimethoprim
182
MoA: sulfonamides
block dihydropteroate synthase
prevent p-aminobenzoic acid (PABA) from turning into dihydropteroic acid
first step in pathway
183
MoA: trimethoprim
block dihydrofolate reductase
prevent dihydrofolic acid from turning into tetrahydrofolic acid
2nd to last step I think in the pathway
184
MoA: quinolones
inhibit topoisomerase II/gyrase & topoisomerase IV
Gram NEG target: DNA gyrase-A subunit
Gram POS target: topoisomerase IV
185
MoA: vancomycin
binds to D-Ala-D-Ala end of peptide
blocks transglycosylase & transpeptidase activity \> prevents transpeptidation linking
stops bacterial cell wall construction/maturation
186
MoA: polymyxin
polymyxin (+) binds to lipopolysaccharide (-) @ phosphate residues on outer membrane of gram negatives
displaces membrane-stabilizing Mg & Ca ions that cross-bridge adjacent lipids & stabilize outer membrane
187
MoA: metronidazole
enters organism \> undergoes reduction \> concentration gradient formed & more drug is pumped in \> free radicals \> death
only works in ANAEROBES
188
MoA: macrolides
50S ribosomal subunit, specifically 23S ribosomal RNA strand in the 50S subunit
this prevents protein synthesis
189
MoA: rifampin
binds to DNA-dependent RNA polymerase
190
MoA: tetracyclines
reversibly bind to 30S subunit
prevent attachment of aminoacyl-tRNA to ribosomal acceptor site (ribosome can't bind to RNA)
191
what's sarecycline and why is it better than its predecessors?
tetracycline antibiotic
larger C7 moiety overcomes the efflux pump resistance mechanism
so it can stay inside the cell and bind to the 30S subunit to block tRNA-ribosome binding
192
MoA: aminoglycosides
bind to aminoacyl site of 16S ribosomal RNA within the 30S subunit
Misread genetic code \> inhibit translocation
do NOT work with anaerobes!!!
193
virus associated with Merkel cell carcinoma
polyomavirus
| (MCPyV or MCV)
194
what causes Q fever & what's the characteristic histo finding?
Coxiella burnettii
RING GRANULOMAS
195
bacillary angiomatosis causative organism
Bartonella
196
what are the clinical & histo findings of bacillary angiomatosis?
peliosis hepatis (blood lakes in liver)
dense aggregates of bacilli with warthin starry
dotty skin rash (epithelioid angiomatosis)
197
what bacteria is associated with rheumatic heart disease?
strep pyogenes
198
if thrombi are positive for CD62p, then what does the patient have?
TTP
CD62p is a plt marker
199
when should you use a chi square test
to determine if a test is more often positive in pts WITH the disease than without it
200
when should you use a paired t-test?
to compare the performance of 2 analyzers (compare means)
