Steve Martin's Manic Micro Material Flashcards

Question

Encapsulated Bacteria Vaccines

Answer 1

``` Some vaccines have polysaccharide capsule antigens that are conjugated to a carrier protein, enhancing immunogenicity by promoting T-cell activation and subsequent class switching A polysaccharide antigen alone cannot be present to T-Cells so you won't get class switching ```

Answer 2

CHuck norris hates PUNKSS | Cryptococcus, H pylori, Proteus, Ureaplasma, Norcardia, Klebsiella, S. epidermidis, S saprophyticus

Answer 3

Actinomyces isrelii makes yellow sulfur granules which are composed of filaments of bacteria (israel has yellow sand) S. aureus makes yellow pigment (aureus latin for gold) Pseudomonas aeruginosa makes blue green pigment (aerugula is green) Serrratia marcescens makes a red pigment - after a cat serrates your face you bleed red

Answer 4

binds Fc region of IgG prevents opsonization and phagocytosis Expressed on S aureus

Answer 5

Enzyme that cleaves IgA secreted by S. pneumoniae, H. influenza type B, Neisseria in order to colonize respiratory mucosa SHiN

Answer 6

Helps prevent phagocytosis Expressed by group A streptococci meromysin in heart

Answer 7

``` Secreted from cell Polypeptide Highly toxic induces high antitoxin antibody response toxoids used as vaccines destroyed rapidly at 60 degrees C examples: tetanus, botulism, diphtheria ```

Answer 8

``` secreted from cell membrane of gram negative cells is a lipopolysaccharide low level of toxicity, poorly antigenic fever, shock (hypotension), DIC Induces TNF, IL-1, IL-6 Stable at 100 degrees C No antitoxin vaccines Example: meningococcoemia, sepsis by gram negative rods ```

Answer 9

releases diphtheria toxin, inactivating elongation factor EF-2 Causes pharyngitis with pseudomembranes (fibrinous) in throat and severe lymphadenopathy positive ELEK test LICK test for blue and red corn chips

Answer 10

realeases Exotoxin A, inactivating elongation factor EF-2 | Causes host cell death

Answer 11

releases shiga toxin causing inactivation of 60s ribosome by removing adenine from rRNA causes GI mucosal damage leading to dysentery, also enhances cytokine release causing hemolytic-uremic syndrome

Answer 12

releases Shiga like Toxin causing inactivation of 60s ribosome by removing adenine from rRNA SLT enhances cytokine release causing hemolytic-uremic syndrome, but does not invade host cells

Answer 13

Heat labile toxin: overactivates cAMP causing increase Cl secretion in gut and efflux Heat stabile toxin: overactivates cGMP causing decreased reaborption of NaCl and H2O in gut Both cause watery diarrhea "Liable in the Air, Stable on the Ground"

Answer 14

Edema factor toxin mimics the cAMP enzyme likely responsible for characteristic edematous borders of black eschar in cutaneous anthrax

Answer 15

cholerae toxin overactivates cAMP by permanently activating Gs leading to increase Cl secretion with H2O following Voluminous "rice-water" diarrhea Vibrate the G-Spot Vibrio Gs

Answer 16

Pertussis toxin overactivates cAMP by disabling Gi, impairing phagocytosis to permit survival of microbe Whooping cough: child coughs on expiration and whoops on inspiration

Answer 17

tetanospasmin toxin protease that cleave SNARE proteins required for neurotransmitter release Symptoms: spasticity, rusis sardonicus, lockjaw, prevents release of inhibitory neurotransmitters (GABA, glycine) from Renshaw cells in spinal cord get tetanus from a rusty wrench-saw (Renshaw)

Answer 18

Botulinum toxin Proteases that cleave SNARE proteins required for neurotransmitter release Flaccid paralysis, floppy baby toxin prevents release of stimulatory ACh signals at neuromuscular junctions leading to flaccid paralysis

Answer 19

Alpha toxin phospholipase (lecithinase) that degrades tissue and cell membranes degradation of phospholipids leading to myonecrosis (gas gangrene) and hemolysis (double zone of hemolysis on blood agar)

Answer 20

streptolysin O Protein that degrades cell membrane Lyses RBCs, contributes to Beta-hemolysis, host antibodies against toxin (ASO) used to diagnose rheumatic fever (do not confuse with immune complexes of poststreptococcal glomerulonephritis) Exotoxin A bring MHC II and TCR in proximity to outside of antigen binding site to cause overwhelming release of IFN-gamma and IL-2 leading to shock Toxic shock syndrome: fever, rash, shock

Answer 21

Toxic shock syndrome toxin (TSST-1) bring MHC II and TCR in proximity to outside of antigen binding site to cause overqhelming release of IFN-gamma and IL-2 leading to shock also protein A binds Fc portion of IgG

Answer 22

Ability to take up naked DNA (i.e. from cell lysis) from environment (aka competence) a feature of many bacteria any DNA can be used

Answer 23

High frequency recombination (Hfr) replication of incorporated plasmid DNA may include flanking chromosomal genes transfer of plasmid and chromosomal genes

Answer 24

segment of DNA (e.g. transposon) that can "jump" from one location to another, can transfer genes from plasmid to chromosome and vice versa when excision occurs, may include some flanking chromosomal DNA which can be incorporated into a plasmid and transferred to another bacterium examples include antibiotic resistance genes on R plasmid

Answer 25

A packaging event lytic phage infects bacterium, leading to cleavage of bacterial DNA Parts of bacterial chromosomal DNA may become packaged in viral capsid phage infects another bacterium, transferring these genes

Answer 26

an excision event lysogenic phage infects bacterium viral DNA incorporates into bacterial chromosome when phage DNA is excised, flanking bacterial genes may be excised with it DNA is packaged into phage viral capsid phage infects another bacterium, transferring these genes

Answer 27

Form green ring around colonies on blood agar Streptococcus pneumoniae viridans streptococci

Answer 28

``` Capsule Optochin sensitive Bile soluble Catalase negative alpha hemolytic gram positive Cocci diplococci lancet shaped IgA protease natural transformer ```

Answer 29

``` No capsule optochin resistant bile insoluble alpha hemolytic Gram positive cocci Catalase negative ```

Answer 30

``` Group A Bacitracin sensitive Beta hemolytic catalase negative gram positive cocci ```

Answer 31

``` Group B Bacitracin resistant gram positive cocci in chains Beta hemolytic catalase negative CAMP test positive ```

Answer 32

``` Group D gram positive cocci Catalase negative gamma hemolytic Growth in bile and NaCl ```

Answer 33

novobiocin resistant Gram positive cocci catalase positive coagulase negative

Answer 34

``` Novobiocin sensitive Gram positive cocci catalase negative coagulase negative Makes biofilm(which is why it can adhere to medical implants and cause infections) ```

Answer 35

gram positive cocci catalase positive coagulase positive beta-hemolytic

Answer 36

``` Clostridium corynebacterium listeria bacillus mycobacterium ```

Answer 37

Gram positive branching filaments anaerobe not acid fast

Answer 38

Gram positive branching filaments aerobe mildly acid fast

Answer 39

Protein A- binds Fc-IgG Inflammatory disease Toxin-mediated disease- toxic shock syndrome (TSST-1), scalded skin syndrome (exfoliative toxin), rapid onset food poisoning (enterotoxins) MRSA- altered penicillin-binding protein makes it resistant

Answer 40

``` MOPS meningitis Otitis media in kids Pneumonia Sinusitis Rusty sputum (alpha hemolytic) causes sepsis in sickle cell anemia and splenectomy ``` S. pneumoniae MOPS are Most OPtochin Sensitive.

Answer 41

Streptococci mutans

Answer 42

Streptococci sanguinis sanguis=blood makes dextrans which bind to fibrin-platelet aggregates on damaged heart valves

Answer 43

``` release pyrogenic exotoxin in scarlet fever rheumatic fever (antibodies against M protein, type II hypersensitivity) acute glomerulonephritis (type III hypersensitivity) ```

Answer 44

B is for babies (group B), shortly after birth babies get symptoms causes pneumonia, meningitis, and sepsis Colonizes vagina Produces CAMP factor which enlarges area of hemolysis cause by strep aureus) Hippurate test positive screen pregnant women and give positive ones intrapartum penicillin prophylaxis

Answer 45

normal colonic flora that are penicillin G resistant cause UTI, biliary infections, subacute endocarditis following GI/GU procedures VRE= Vanco resistant enterococci

Answer 46

Colonizes the gut | can cause bacteremia and subacute endocarditis in COLON CANCER

Answer 47

causes diphtheria via exotoxin encoded by beta prophage Potent exotoxin inhibits protein synthesis via ADP-ribosylation of EF-2 lab diagnosed

Answer 48

Spores are highly resistant to heat and chemicals Need to autoclave to kill Have dipicolinic acid in their core If you DIP your COLON in ACID, only the spores will be left (like clostridium)

Answer 49

preformed heat labile toxin that inhibits ACh release at the neuromuscular junction causing botuism Adults ingest the toxin babies ingest the spores in honey causing floppy baby syndrome

Answer 50

produce alpha toxin lecithinase which is a phospholipase can cause myonecrosis (gas gangrene) and hemolysis

Answer 51

Produces 2 toxins Toxin A, enterotoxin, binds brush border of gut Toxin B, cytotoxin, cases cytoskeletal disruption via actin depolymerization causing pseudomembranous colitis leading to diarrhea usually secondary to antibiotic use. especially clindmycin or ampicillin diagnose by detecting one of the toxins in stool

Answer 52

caused by bacillus anthracis gram positive spore forming rod only bacterium with a *polypeptide capsule* (contains D-glutamate)

Answer 53

boil-like lesion ulcer with black eschar (painless and necrotic) uncommon for it to progress to bacteremia and death

Answer 54

inhalation of spores | flu-like symptoms that progress to fever, pulmonary hemorrhage, mediastinitis and shock

Answer 55

inhalation of anthrax spores from contaminated wool......weird

Answer 56

causes food poisoning spores survive cooking rice, keeping rice warm results in germination and enterotoxin formation emetic type usually seen with rice and pasta (nausea and vomiting within 1 to 5 hrs, caused by cerculide, a preformed toxin) Diarrheal type causes watery, nonbloody diarrhea and GI pain within 8 to 18 hrs Cereus - cereal Rice - warm rice krispies cereal

Answer 57

Facultative intracellular microbe ingestion of unpasteurized dairy products, deli meats, transplacental transmission, or vaginal during birth form "rocket tails" from actin polymerization, help it move, tumbling motility *Only gram positive to produce LPS* can cause amnionitis, septicemia, spontaneous abortion, neonatal meningitis goes away in adults usually ampicillin in kids, immunocompromised, elderly

Answer 58

gram positive anaerobe long, branching filaments resembling fungi not acid fast normal oral flora causes oral/facial abscesses that drain through sinus tracts, forms yellow sulfur granules treat with penicillin

Answer 59

Gram positive aerobe weakly acid fast long, branching filaments resembling fungi found in soil causes pulmonary infections in immune compromised and cutaneous infections after trauma in normal patients treat with sulfonamides

Answer 60

Ghon complex | usually in mid zone of lung

Answer 61

fibrocaseous cavitary lesion usually in upper lobe pott disease when in the vertibrae

Answer 62

acid fast M. tuberculosis M. kansasii (pulmonary TB-like symptoms) M. avium (intracellular, causes disseminated non-TB disease in AIDS patients), prophylactic treatment with azithromycin

Answer 63

fever, night sweats, weight loss, hemoptysis cord factor in virulent strains inhibits macrophage maturation and induces release of TNF-alpha. sulfatides inhibit phagolysosomal fusion

Answer 64

Caused by mycobacterium leprae 2 forms lepromatous and tuberculoid

Answer 65

causes leprosy acid fast bacillus likes cool temperatures (infects skin, superficial nerves) can't be grown in vitro reservoir in US is in armadillos dapsone, rifampin and clofazimine for 2 to 5 years

Answer 66

presents diffusely over skin with leonine facies, no granulomas, communicable low cell-mediated immunity with humor Th2 response

Answer 67

limited to a few hypoesthetic, hairless skin plaques, go after superficial surface and nerves, slow growth high cell-mediated immunity with Th1 type immune response, will see granulomas on biopsy dapsone and rifampin treats in 6 months

Answer 68

Acid fast bacillus produces niacin mycolic acids make it resistant to gram staining Auramine- rhodamine stain of sputum will be positive

Answer 69

``` Gram negative oxidase positive comma shaped grows at 42 degrees polar flagella microaerophilic ```

Answer 70

Gram negative oxidase positive comma shaped grows in alkaline media

Answer 71

Gram negative oxidase positive comma shaped produces urease

Answer 72

gram negative coccoid rod require factors V and X

Answer 73

gram negative rod coccoid rods from animal bites

Answer 74

Gram negative coccoid rod causes brucellosis

Answer 75

gram negative | coccoid rod

Answer 76

gram negative diplococci maltose fermenter

Answer 77

``` gram negative diplococci maltose nonfermenter Can be grown on chocolate agar, but not on blood agar Pili are its pathogenic feature ```

Answer 78

gram negative rod | fast lactose fermenter

Answer 79

gram negative rod fast lactose fermenter produces beta galactosidase which breaks down lactose into glucose and galactose

Answer 80

gram negative rod | fast lactose fermenter

Answer 81

gram negative rod | slow lactose fermenter

Answer 82

gram negative rod | slow lactose fermenter

Answer 83

Gram negative rod lactose non fermenter oxidase negative

Answer 84

Gram negative rod lactose non fermenter oxidase negative

Answer 85

Gram negative rod lactose non fermenter oxidase negative

Answer 86

Gram negative rod lactose non fermenter oxidase negative

Answer 87

Gram negative rod non fermenter Oxidase positive

Answer 88

Lactose is KEE Test with macConKEE'S agar, turns pink from acid Citrobacter, Klebsiella, E. coli, Enterobacter, and Serratia EMB agar- lactose fermenters grow as purple/black colonies E. coli grows purple with green sheen

Answer 89

gram negative bacilli are resistant to penicillin G but may be susceptible to penicillin derivatives such as ampicillin or amoxicillin gram negative outer membrane blocks penicillin and vanco entry

Answer 90

Gram negative diplococci (only circular gram negative) ferments glucose Produces IgA proteases Has pili Mostly found intracellularly in neutrophils but not an intracellular organism No capsule No maltose fermentation No vaccine due to rapid antigenic variation of pilus proteins Sexually transmitted Causes gonorrhea, septic arthritis, neonatal conjunctivitis, pelvic inflammatory disease, Fitz-hugh curtis syndrome Condoms prevent transmission treat with ceftriaxone (add azithromycin or doxy for possible chlamydia co infection) Capsule is immunogenic

Answer 91

``` Gram negative diplococci ferments glucose Produces IgA proteases Polysaccharide capsule maltose fermentation Vaccine but not for type B Transmitted by respiratory and oral secretions Causes meningiococcemia and meningitis, waterhouse-Friderichsen syndrome prophylaxis with rifampin, ciprofloxacin, or ceftriaxone Treat with ceftriaxone or penicillin G Type B capsule is not immunogenic GIVE AWAY MENINGITIS IS PETECHIAL RASH! ```

Answer 92

Small gram negative coccobacillary rod aerosol transmission Produces IgA proteases culture on chocolate agar with Nad (V) and hematin (X) or with staph aureus which provides factor X haEMOPhilus causes: Epiglottitis, Meningitis, Otitis media, Pneumonia Treat mucosal with amoxicillin +/- clavulanate treat meningitis with ceftriaxone rifampin for prophylaxis

Answer 93

thumbprint sign- thickening of epiglottis on lateral neck radiograph

Answer 94

``` Gram negative rod, stains poorly-use silver stain Grow on charcoal yeast extract with iron and cysteine clinically detected by antigen in urine aerosol transmission from water no person to person transmission treat with macrolide or quinolone labs show hyponatremia pontiac fever= mild flu like symptoms ```

Answer 95

severe pneumonia fever GI CNS symptoms

Answer 96

Aerobic gram negative rod non lactose fermenting oxidase positive produces pyocyanin (blue green pigment) grape like odor from a water source produces endotoxin (fever, shock) and exotoxin A (inactivates EF-2) PSEUDOmonas is associated with burn infections, Pneumonia (especially cystic fibrosis), Sepsis, External otitis, UTI, Drug use, and Diabetic Osteomyelitis, and hot tub folliculitis treat with aminoglycosides plus extended spectrum penicillin (piperacillin, ticarcillin, cefepime, imipenen, meropenum)

Answer 97

rapidly progressive necrotic cutaneous lesions caused by pseudomonas bacteremia usually in immune compromised patients treat with aminoglycosides plus extended spectrum penicillin (piperacillin, ticarcillin, cefepime, imipenen, meropenum)

Answer 98

Gram negativem oxidase negative lactose fermenting rod grows pink on MacConkey agar virulence factors: fimbriae- cystitis and pyelonephritis, K capsule- pneumonia, neonatal meningitis, LPS endotoxin- septic shock

Answer 99

Microbe invades intestinal mucosa and causes necrosis and inflammation clinically similar to shigella Invasive; dysentery

Answer 100

produces heat-labile and heat-stabile enterToxins. no inflammation or invasion Travelers' diarrhea (watery)

Answer 101

no toxin produced adheres to apical surface, flattens villi, prevents absorption Diarrhea usually in Peds patients

Answer 102

O157:H7 is the most common serotype produces Shiga-like toxin causing hemolytic-uremic syndorme (triad of anemia, thrombocyopenia, acute renal failure) also called STEC (shiga toxin producing E coli) Microthrombi form on endothelium damaged by toxin leading to mechanical hemolysis (schistocytes) and decreased renal blood flow; microthrombi consume platelets leading to thrombocytopenia Dysentery (toxin alone causes necrosis and inflammation) Does not ferment sorbitol (which other E coli do)

Answer 103

Gram negative, oxidase negative, bacillus, fast lactose fermenting, urease positive MacConkeys agar an intestinal flora that causes lobar pneumonia in alcoholics and diabetics when aspirated very mucoid, abundant polysaccharide capsules red currant jelly sputum, x ray shows lobar cavitation nosocomial UTIs 4 A's Aspiration pneumonia, Abscess in lungs and liver, Alcoholics, di-A-betics treat with 3rd gen cephalosporin +/- aminoglycoside

Answer 104

``` has flagella can disseminate hematogenously have animal reservoirs produces hydrogen sulfide antibiotics may prolong fecal excretion of organism invades intestinal mucosa and causes a monocytic response can cause blood diarrhea does not ferment lactose ```

Answer 105

no flagella cell to cell transmission no hematogenous spread only reservoirs are humans and primates does not produce hydrogen sulfide antibiotics shorten duration of fecal excretion of organism invades intestinal mucosa and causes PMN infiltration often causes blood diarrhea does not ferment lactose

Answer 106

Causes typhoid fever found only in humans characterized by rose spots on the abdomen, fever, headache, and diarrhea can remain in gallbladder and cause a carrier state

Answer 107

Group B strep (agalactae) E coli Listeria monocytogenes

Answer 108

major cause of bloody diarrhea, especially in kids fecal oral transmission through foods (pork, meat, unpasteurized milk) Comma or S shaped oxidase positive, grows at 42 Celcius Look for RBCs and WBCs in stool (invasive bug causing immune response and bleeding) common antecedent to Guillain-Barre syndrome and reactive arthritis

Answer 109

produces profuse rice-water diarrhea via enterotoxin that permanently activates Gs, increasing cAMP comma shaped, oxidase positive, grown in alkaline media endemic to developing countries oral rehydration necessary

Answer 110

Usually transmitted from pet feces, contaminated milk, or pork causes mesenteric adenitis that can MIMIC Crohns disease or appendicitis (find micro abscesses in lymph nodes when they think they have appendicitis

Answer 111

Causes gastritis and peptic ulcers (especially duodenal) risk factor or peptic ulcer, gastric adenocarcinoma, lymphoma curved gram negative rod catalase positive, oxidase positive, urease positive Use urea breath test or urine antigen test to diagnose creates alkaline environment most common initial treatment is triple therapy: proton pump inhibitor, clarithromycin, and amoxicillin or metronidazole

Answer 112

spiral shaped bacteria with axial filaments includes Borrelia (big size), Leptospira, Treponema only borrelia can be visualized using aniline dyes (wright or Giemsa stain) in light microscopy Treponema is visualized by dark-field microscopy

Answer 113

Found in water contaminated with animal urine, causes leptospirosis: fly like symptoms, jaundice, photophobia with conjuctival suffusion (erythema w/o exudate) prevalent among surfers and in tropics (i.e. Hawaii)

Answer 114

Icterohemorrhagic leptospirosis severe form of leptospirosis jaundice, azotemia from liver and kidney dysfunction, fever, hemorrhage, anemia

Answer 115

Cause by Borrelia burgdorferi, from tick Ixodes Natural reservoir is mice Common in Northeastern US Initial symptoms- erythema chromicum migrans, flu like, +/- facial palsy (bell palsy) Later symptoms- monoarthritis (knee, hips) due to type III hypersensitivity, migratory polyarthritis, AV nodal block, encephalopathy, facial nerve palsy, polyneuropathy treat: doxy, ceftriaxone

Answer 116

Lymes, Babesia, Anaplasmosis

Answer 117

spirochete Treponema pallidum | treat: penicillin G

Answer 118

Localized disease with painless chancre | use dark field microscopy to visualize treponemes in fluid from chancre

Answer 119

secondary=systemic bronze colored maculopapular rash (palms and soles); condylomata lata: gray to white flat wart like lesions of the mouth and perineal area; constitutional symptoms serologic testing: VDRL/RPR (nonspecific), confirm diagnosis with FTA-ABS (fluorescent treponenal antibody absorption test) latent syphilis follows (no symptoms, but still positive tests)

Answer 120

gumma (chronic granulomas), aortitis (vasa vasorum destruction), neurosyphilis (tabes dorsalis), argyll robertson pupils broad-based ataxia, romberg, charcot joint, stroke without hypertension for neurosyphilis test spinal fluid with VDRL or RPR

Answer 121

saber shins, saddle nose, CN VIII deafness, Hutchinson teeth, mulberry molars to prevent, treat mom early, placental transmission usually occurs after first trimester

Answer 122

Pupil constricts with accommodation but is not reactive to light associated with tertiary syphilis "prostitute pupil" accommodates but does not react

Answer 123

VDRL detects nonspecific antibody that reacts with beef cardiolipin inexpensive, widely available test for syphilis sensitive, not specific many false positives due to VDRL: Viruses, Drugs Rheumatic Fever, Lupus/Leprosy

Answer 124

Flu-like symptoms after antibiotics are started | due to killed bacteria releasing pyrogens

Answer 125

causes Anaplasmosis, | transmitted via Ixodes ticks (live on deer and mice)

Answer 126

causes Cat scratch disease, bacillary angiomatosis | get from cat scratches

Answer 127

causes lyme disease | Transmitted via ixodes tick (live on deer and mice)

Answer 128

causes relapsing fever transmitted via Louse recurrent due to variable surface antigens

Answer 129

causes Brucellosis/undulant fever from unpasteurized dairy faculative intracellular

Answer 130

causes bloody diarrhea | from puppies, livestock (fecal oral, or uncooked meat)

Answer 131

cause psittacosis | from parrots, other birds

Answer 132

causes Q fever from Aerosols of cattle/sheep amniotic fluid BURN the cattle and sheep on the bbQ

Answer 133

causes Ehrlichiosis from lone star ticks you get ehrlich from the lone star tick

Answer 134

gram negative coccobacillus, slow growing, aerobic, require cystine to grow involvement of regional lymph nodes rupture of pustules causes ulcers causes Tularemia from ticks, rabbits, deer fly, dermacentor tick, (think mid western hunter)

Answer 135

causes leptospirosis get it from animal urine surfers in the leper colony in hawaii surf on a spiral of urine

Answer 136

causes leprosy from humans with lepromatous leprosy or armadillos which are the reservoir in the US (lepromaTWOs is a Th2 response) (tubercuLLOYD christmas - all that ONE in a million talk is Th1)

Answer 137

causes cellulitis and osteomyelitis get it form animal bites, cats, dogs animals in a pasture chewing on skin and bones

Answer 138

causes epidemic typhus get it from Louse epidemic typhus is on the PROWL

Answer 139

causes rocky mountain spotted fever from dermacentor ticks obligate intracellular (endothelial cells) organisms that need CoA and NAD because they cannot synthesize ATP

Answer 140

causes Endemic typhus | from fleas

Answer 141

``` causes plague from fleas (rats and prairie dogs are reservoirs) ```

Answer 142

``` causes babesiosis from the ixodes tick protozoan parasite, intraerythrocytic fever headache and chills splenectomy patients get severe hemolytic anemia ```

Answer 143

pleomorphic gram variable rod causes vaginosis Presents as a gray vaginal discharge with a fishy smell, nonpainful (vs. vaginitis) associated with sexual activity, but not sexually transmitted Clue cells or vaginal epithelial cells covered with Gardnerella bacteria are visible under the microscope Treat with metronidazole or clindamycin if anaerobic vaginosis (other gram negative bacteria can cause vaginosis) I don’t have a clue why I smell fish in the vagina garden!

Answer 144

Rickettsia rickettsii (lives in endothelial cells), vector is Dermacentor ticks Rash usually at wrists and ankles, spreads to trunk, palm, and soles Classic triad are headache, fever, rash (vasculitis)

Answer 145

Endemic (fleas)- R. typhi Epidemic (human body Louse) R. prowazekii rash starts centrally and spreads out, sparing palms and soles Rickettsii on the wRists, Typhys on the Trunk

Answer 146

Ehrlichia: vector is tick monocytes with morulae (berry like inclusions) in cytoplasm ehrlich is from the lone star tick

Answer 147

Anaplasma, vector is tick, granulocytes with morulae (berry like clusters) in cytoplasm (intracellular): Leukopenia, thrombocytopenia, increased transaminases.

Answer 148

Coxiella burnetti no arthropod vector tick feces and cattle placenta release spores that are inhaled as aerosols. presents as pneumonia Q fever is Queer: no rash, no vector, causative organism can survive outside in its endospore form

Answer 149

Chlamydie in obligate intracellular organism that causes mucosal infections; non gram staining Elementary body (small, dense) is infectious and enters cell via endocytosis; transforms into reticulate body (what you would culture) Reticulate body replicates in cell by fission; reorganizes into elementary body Diagnose in lab: cytoplasmic inclusions seen on Giemsa iodine, or fluorescent antibody- stained smear cell wall lacks muramic acid treat with azithromycin (one time treatment) or doxy reiter's = arthreitis

Answer 150

``` reactive arthritis (reiter syndrome) follicular conjuctivitis, nongonococcal urethritis and PID treat with azithromycin (one time treatment) or doxy ```

Answer 151

cause atypical pneumonia; transmitted via aerosol | treat with azithromycin (one time treatment) or doxy

Answer 152

Chronic infection, causes blindness due to follicular conjunctivitis in africa ABC= Africa/Blindness/Chronic infection

Answer 153

Urethritis/PID, ectopic pregnancy, neonatal pneumonia (staccate cough, neonatal infection D-K=everything else neonatal disease can be acquired passing through infected birth canal: why we give erythromycin eye drops

Answer 154

Lymphogranuloma Venereum: small painful ulcers on genitals leading to swollen, painful inguinal lymph nodes that ulcerate ("buboes") and drain through the skin. treat with doxy

Answer 155

not seen on gram stain, no cell wall membrane has sterols for stability young people in close quarters Causes atypical "walking" pneumonia insidious onset, headache, nonproductive cough, patchy or diffuse interstitial infiltrate X ray looks worse than patient higher titer of cold agglutinins (IgM) grown on Eaton agar treatment: macrolide, doxy, or fluoroquinolone penicillin does not work because it has no cell wall

Answer 156

IgM: IgM isohemagglutinins that agglutinate autologous erythrocytes at 4 degrees C Strep MG agglutinins: agglutinates streptococcus salivaries termed MG

Answer 157

local infection: fluconazole or intraconazole | systemic infection: amphotericin B

Answer 158

``` Looked for a macrophage filled with histoplasms (the histoplasma is smaller than RBC, 2-5 micrometers) thin capsule, no true cell wall Mississippi and ohio river valleys causes pneumonia *Birds or bat droppings* ```

Answer 159

States east of Mississippi river and central US Causes inflammatory lung disease can disseminate to bones and skin, joints, and genitourinary forms granulomatous nodules Broad based budding (same size as RBCs) Blasto Buds Broadly a dog rolling around in a rotting wood pile

Answer 160

Southwestern US, California, Desert areas Causes pneumonia and meningitis can disseminate to bone and skin increased cases after earthquakes (spores go into air, become spherules in lungs) Spherule is much larger than an RBC, filled with endospores Valley fever, desert humps (erythema nodosum), Desert rheumatism (arthralgias)

Answer 161

Latin America Budding yeast with captians wheel formation way bigger than RBC Paracoccidio parasails with the captian's wheel all the way to latin america paraguay is in south america, and you can sail there with your captain wheel

Answer 162

caused by malassezia furfur degradation of lipids produces acids that damage melanocytes and cause hypopigmented and or hyperpigmented patches occurs in hot humid weather treat: topical miconazole, selenium sulfide, spaghetti and meatball appearance Furry meatballs look green under a woods lamp

Answer 163

KOH the skin scraping, detects arthroconida and hyphae

Answer 164

alba=white systemic or superficial infections Oral and esophageal in immunocompromised or steroid asthma user who doesn't wash out mouth Vulvovaginits, diaper rash, endocarditis in IV drug user, disseminates to any organ, chronic mucocutaneous candidiasis treat: topical azole for vagina, fluconazole or caspofungin for oral/esophageal; systemic is fluconazole, amphotericin B, or caspofungin Diagnosed by gram tube test, budding yeast with short true hyphae catalase positive

Answer 165

Invasive aspergillosis, especially in immunocompromised or chronic granulomatous disease Allergic bronchopulmonary aspergillosis (ABPA): associated with asthma and cystic fibrosis, may cause bronchiectasis and eosinophilia Aspergillomas in lung cavities, especially after TB infection Some species produce aflatoxins which are associated with hepatocellular carcinoma think A's for Acute Angles in Aspergillus. not dimorphic the aflac duck eats liver and asparagus (aflatoxin of aspergillus causes hepatocellular carcinoma) fumigatus = fumes = lungs Catalase positive

Answer 166

Cryptococcal meningitis, cryptococcus Heavily encapsulated yeast not dimorphic found in soil, *pigeon droppings* get it from inhalation with hematogenous spread to meninges culture on Sabouraud agar, stain with india ink and mucicarmine *latex agglutination test detects polysaccharide capsular antigen and is most specific* "Soap Bubble" legions in brain Most common cause of meningitis in AIDS patients in US Sab is a cryptic guy when he visits india because he has a latex soap bubble fetish fetish, he also raises pigeons

Answer 167

Mucormycosis Disease mostly in ketoacidotic diabetic and leukemic patients fungi proliferate in blood vessel walls when there is excess ketone and glucose penetrate cribriform plate and enter brain rhinocerebral, frontal lobe abscesses Symptoms: headache, facial pain, black necrotic eschar on face, may have CN involvement treat: amphotericin B Ribbon form hypae branching at 90 degrees

Answer 168

Causes Pneumocystis pneumonia, diffuse interstitial pneumonia (increased surfactant due to activation of type II pneumocytes leading to death by asphyxiation) Yeast Inhaled Get this if immunosuppressed (AIDS, newborn) X ray shows diffuse bilateral CXR appearance Lung biopsy or lavage confirms *Disc shaped yeast forms on methenamine silver stain* TMP-SMX to treat atovaquone, dapsone to prevent when CD4 count less than 200 pneumodiscus

Answer 169

Sporotrichosis Dimorphic cigar shaped budding yeast that lives on vegetation thorn prick introduces yeast to skin causes local pustule or ulcer with nodules along draining lymphatics little systemic illness treat with itraconazole or potassium iodide ITRy to plant a Rose in a Pot, pot=potassium ITRaconazome

Answer 170

Giardiasis: blotting, flatulence, foul-smelling, fatty diarrhea often seen in campers/hikers and may be in water supply think fat-rich Ghirardelli chocolates for fatty stools of Giardia, may be asymptomatic comes from cysts in water Look for trophozoites or cysts in stool to diagnose Treat with metronidazole

Answer 171

``` Amebiasis: bloody diarrhea (dysentery), liver abscess (anchovy paste exudate), abdominal abscesses before liver affected RUQ pain (histology shows flask like ulcer if submucosal abscess of colon ruptures comes from cysts in water diagnose by doing serology and or trophozoites (with RBCs in cytoplams) or cysts in stool treat with metronidazole or iodoquinol for asymptomatic cyst passers ```

Answer 172

Causes severe diarrhea in AIDS Mild disease with watery diarrhea in healthy people get it from Oocysts in water Diagnose by seeing oocysts on acid fast stain treat by prevention (city water filters), nitazoxanide in healthy people Diarrhea caused by bug lysing brush boarder cells (bug replicates in brush border cells) Nita is Sabs cryptic sister who has oocytes and does so much butt stuff that she has severe diarrhea with her AIDS

Answer 173

brain abscess in HIV (ring enhancing lesions on CT/MRI) Congenital Toxoplasmosis= triad of *chorioretinitis, hydrocephalus, and intracranial calcifications* "bright periphery and dark core" due to necrosis Transmitted as cysts in meat, uncooked pork, or oocytes in cat feces, cross placenta (pregnant stay away form cats) diagnose by serology treat with sulfadiazine and pyrimethamine 15-20% of population is infected but immune system makes it go dormant until immune compromised then they get the infection Most common brain infection in HIV patients causing seizures, altered mental status, focal neurologic defects

Answer 174

Rapidly fatal meningoencephalitis flagellated trophozoite Get it from swimming in freshwater lakes (Naegleria-Nalgene) enters body via cribiform plate forming necrotic lesions spreading from olfactory lobes Diagnose by amoebas in spinal fluid Treat: amphotericin B, but most still die

Answer 175

African sleeping sickness: enlarged lymph nodes, recurring fever ( due to antigenic variation), somnolence, coma two subtypes: rhodesiense and gambiense get it from Tsetse fly that has a painful bite diagnose by blood smear Suramin for blood borne disease or melarsoprol for CNS penetration (“it sure is nice to go to sleep”; melatonin helps with sleep)

Answer 176

Causes malaria: headache, fever, anemia, splenomegaly vivax and ovale-get 48 hour cycle (tertian; fever on first and third day, thus fevers are 48 hours apart) dormant in liver Falciparum-sever; irregular fever pattern; parasites in RBCs occlude capillaries in brain (cerebral malaria), kidney, lungs malariae- 72 hour cycle (quartan) transmitted via misquito (anopheles) diagnosed by blood smear showing trophoziote ring from within RBC, schizont containing merozoites

Answer 177

AKA treatment of malaria Begin with chlorquine, which blocks plasmodium heme polymerase; if resistant use mefloquine or atovaquone/proguanil If life threatening use IV quinidine (test for G6PD deficiency) if Vivax/ovale add primaquine for hypnozoite (test for G6PD deficiency)

Answer 178

Babesiosis: fever and hemolytic anemia; predominantly in Northeastern US, if asplenic you get increase risk of severe disease Transmitted via ixodes tick (same as borrelia burgdorferi of Lymes, so many are co infected) Diagnose via blood smear, see ring form "maltese cross' or PCR Treat with atovaquone + azithromycin

Answer 179

causes chagas' disease: dilated cardiomyopathy, megacolon, megaesophagus, predominantly in south america Transmitted via Reduciid bug (kissing bug) feces, deposited in a painless bite (much like a kiss) diagnose via blood smear treat with benznidazole or nifurtimox romana sign - unilateral periorbital edema a MEGA-BENZ-MOX-Cruz ship takes you to the other hemisphere (unilateral edema)

Answer 180

Visceral leishmaniasis: spiking fevers, hepatosplenomegaly, pancytopenia transmitted via sandfly (beachmaniasis) Diagnose via macrophages containing amastigotes Treat with amphotericin B, sodium stibogluconate DONOVANI, the world famous SAND volleyball player SPIKES the volleyball so hard that it goes down your throat and gives you a huge belly (HEPATOSPLENOMEGALY) the mascot goats are there (amastigotes)

Answer 181

Vaginitis: foul-smelling, yellow-greenish discharge; foul smelling and burning; do not confuse with Gardnerella vaginalis (gram variable bacterium associated with baterial vaginosis) transmitted via sex (cannot exist outside humans, has no cysts) diagnose with trophozoites (motile) on wet mount; see a strawberry cervix Treat with metronidazole for patient and partner (prophylaxis)

Answer 182

roundworm/nematode Transmitted fecal ora causes intestinal infection causing anal pruritus (diagnosed via scotch tape test) treat: bendazoles (BENDy worms) or pyrantel pamoate WA had the scotch tape test done. He is a vermin (vermicularis)

Answer 183

roundworm/nematode AKA giant roundworm, it is HUGE! 8 inches human fecal-oral; eggs visible in feces under microscope get intestinal infection and some lung, can cause bowel obstruction treat: bendazoles (BENDy worms) or pyrantel pamoate

Answer 184

roundworm/nematode hookworms larvae penetrate skin get intestinal infection causing anemia by sucking blood from intestinal walls

Answer 185

nematode/roundworm Larvae in soil pentrate the skin get intestinal infection causing vomiting, diarrhea, epigastic pain (like a peptic ulcer) treat with ivermectin or albendazole

Answer 186

nematode/roundworm transmitted via the female blackfly that bites you get hyperpigmented skin and river blindness (blackflies, black skin nodules, "black sight", allergic reaction to microfilaria is possible Treat with ivermectin (ivermectin for iver blindness)

Answer 187

roundworm/tapeworm transmitted via Deer fly, horse fly, mango fly get swelling in skin, worm in conjunctiva treat with Diethylcarbamazine

Answer 188

roundworm/nematode get it from female misquito it blocks lympatic vessels: elephantaisis; takes 9 months to a year after bite to get symptoms treat with diethylcarbamazine

Answer 189

nematode/roundworm get it from fecal oral transmission causes visceral larva migrans (go to a ton of organs and cause inflammation and damage) treat with Albendazole or mebendazole

Answer 190

ingestion is Enterobius, Ascaris, Toxocara Cutaneous is Strongyloides, Ancylostoma, Necator Bites is Loa loa, Onchocerca volvulus, Wuchereria bancrofti "you'll get sick if you EAT these! these get into your ffet from the SANd. lay LOW to avoid getting bitten."

Answer 191

Tapeworm transmission: ingestion of larvae encysted in undercooked port, ingestion of eggs Intestinal infection, cysticerosis, neurocystericerosis (focal calcifying brain lesions w/ seizures) Treat: praziquantel (Add albendazole for neurocystericerosis)

Answer 192

Tapeworm transmission: ingestion of larvae form raw freshwater fish Causes B12 deficiency (tapeworm competes for B12), get anemia treat with praziquantel

Answer 193

Tapeworm Get it from ingestion of eggs from dog feces Causes hydatid (containing tape worm) cysts in liver, causing anaphylaxis if antigens released, surgeons pre-inject w/ ethanol to kill cysts before removal Treat w/ albendazole

Answer 194

Trematode (flukes) get it from snails, cercariae (larval stage) penetrate skin of human causes: liver and spleen granulomas, fibrosis and inflammation: if chronic infection w/ S. haematobium can lead to squamous cell carcinoma of the bladder (painless hematuria) Treat w/ praziquantel

Answer 195

treamatode (flukes) get it from undercooked fish causes biliary tract infection causing pogmented gallstons. Associated with *cholangiocarcinoma* treat w/ praziquantel

Answer 196

exchange of genes between 2 chromosomes by crossing over within regions of significant base sequence homology

Answer 197

When viruses with segmented genomes exchange segments. High frequency recombination. Cause of world wide influenza pandemics

Answer 198

When 1 of 2 viruses that infect the cell has a mutation that results in a nonfunctional protein the nonmutated virus "complements" the mutated one by making a functional protein that serves both viruses

Answer 199

occurs w/ simultaneous infection of a cell with 2 viruses. genome of virus A can be partially or completely coated (forming pseudovirion) with the surface proteins of virus B. Type B protein coat determines the tropism (infectivity) of the hybrid virus. However, the progeny from this infection have a type A coat that is encoded by its type A genetic material.

Answer 200

induce humoral and cell-mediated immunity but have reverted to virulence on rare occasions killed/inactivated vaccines induce only humoral immunity but are stable no boosters needed Dangerous to give live viruses to immunocompromised patients or those w/ close contacts

Answer 201

smallpox, yellow fever, chickenpox, sabian polio virus, MMR, influenza

Answer 202

Rabies, influenza, Salk polio, and HAV vaccines

Answer 203

HBV (antigen=recombinant HBsAg), HPV (types 6, 11, 16, 18)

Answer 204

All DNA viruses except parvoviridae are dsDNA | all are linear except papilloma, polyoma, and hepadnaviruses (circular)

Answer 205

All RNA viruses except reovirdae are ssRNA

Answer 206

purified nucleic acids of most dnDNA (except poxviruses and HBV) and positive strand ssRNA viruses are infectious. Naked nucleic acids of negative strand of ssRNA and dsRNA are not infectious, they require polymerases contained in the complete virion.

Answer 207

nucleus (Except poxvirus)

Answer 208

cytoplasm | except influenza and retrovirus

Answer 209

DNA- (PAPP)Papillomavirus, Adenovirus, Parvovirus, Polyomavrius RNA- (CPR-H) Calicivirus, picornavirus, Reovirus, and Hepevirus

Answer 210

the plasma membrane of the cell | except for herpesvirus which gets it from the nuclear membrane

Answer 211

Enveloped dsDNA and linear genome HSV-1: oral lesions, temporal lobe encephalitis, keratoconjunctivitis HSV-2: genital lesions VZV(HHV-3): chickenpox, shingles EBV (HHV-4): mononucleosis, Burkitt lymphoma, Hodgkin lymphoma CMV(HHV5): infection in immunocompromised patients (AIDS retinitis), especially transplant patients, congenital defects (sightomegalovirus) HHV-6 roseola (exanthem subitum) HHV-7: less common cause of roseola HHV-8 causes kaposi sarcoma

Answer 212

Enveloped Partially dsDNA and circular HBV: acute or chronic hepatitis, vaccine has HBV surface antigens not a retrovirus but has reverse transcriptase

Answer 213

``` not enveloped dsDNA and linear Febrile pharyngitis, sore throat acute hemorrhagic cystitis pneumonia conjunctivitis "pink eye" Contaminated swimming pools can transmit it to many people ```

Answer 214

not enveloped ssDNA (-) and linear: smallest DNA virus B19 virus: aplastic crises in sickle cell disease, slapped cheeks rash in kids-erythema infectiosum (fifths disease), RBC destruction in fetus leads to non-immune hydrops fetalis and death (aplastic anemia), pure RBC aplasia and rheumatoid arthritis-like symptoms in adults

Answer 215

``` not enveloped dsDNA and circular HPV-warts from 1, 2, 6, 11 CIN, cervical cancer from 16 and 18 vaccine available ```

Answer 216

Not enveloped dsDNA and circular JC virus: progressive multifocal leukoencephalopathy (PML) in HIV (JC=Junky Cerebrum) BK virus: transplant patients, commonly targets kidney (BK=bad kidney)

Answer 217

"brick shaped" (only DNA not icosahedral) enveloped does not use nucleus to make DNA (only DNA virus to do that) dsDNA and linear (largest DNA virus) smallpox Cowpox (milkmaid blisters) molluscum contagiosum: flesh colored dome lesions with central umbilicated dimple

Answer 218

Herpes encephalitis: hypodensity of temporal and frontal lobes on CT, increase lymphocytes in csf cowdry type A inclusion in neurons and glia in encephalitis gingivostomatitis, keratoconjunctivits, herpes labialis latent in trigeminal ganglia transmitted by respiratory secretions and saliva

Answer 219

herpes genitalis, neonatal herpes; small tender nodules with inguinal lymph node involvement latent in sacral ganglia transmitted by sexual contact, perinatally

Answer 220

varicella-zoster, encephalitis, pneumonia latent in dorsal roots or trigeminal ganglia most common complication of shingles is post-herpetic neuralgia. transmitted by respiratory droplets

Answer 221

Mononucleosis: fever, hepatosplenomegaly, pharyngitis, and lymphadenopathy (posterior cervical lymph nodes) Transmitted by secretions and saliva infects B cells: atypical lymphocytes seen on peripheral blood smear are not infected B cells but rather reactive cytotoxic T cells Detect by monospot test: heterophile antibodies detected by agglutination of sheep or horse RBCs Associated w/ hodgkin lymphoma, endemic burkitts lymphoma, and nasopharyngeal carcinoma (cytokeratin positive)

Answer 222

Congenital infection, mononucleosis (negative monospot though), pneumonia, retinitis. infected cells have Owl eye inclusions latent in mononuclear cells transmitted congenitally and by transfusion, sexual contact, saliva, urine, transplant

Answer 223

Roseola: high fevers for several days that can cause seizures, followed by a diffuse macular rash transmitted by saliva

Answer 224

Kaposi sarcoma: neoplasm of endothelial cells, seen in HIV/AIDS and transplant patients Dark/violaceous flat and nodular skin lesions representing endothelial growths. can also affect GI tract and lungs transmitted by sexual contact

Answer 225

1. HSV1 2. HSV2 3. CMV

Answer 226

viral culture for skin/genitalia CSF PCR for herpes encephalitis Tzanck test (genital herpes)- a smear of an open skin vesicle to detect multinucleated giant cells Infected cells also have Cowdry A inclusions

Answer 227

``` not enveloped dsRNA linear 10-12 segments iscosahedral coltivurs- colorado tick fever rotalvirus- #1 cause of fatal diarrhea in children ```

Answer 228

``` no envelope ssRNA positive, linear icosahedral PERCH viruses Poliovirus: polio-Salk/Sabin-IPV/OPV Echovirus- aseptic meningitis Rhinovirus: common cold Coxsackievirus: aseptic meningitis; herpangina, hand, foot and mouth disease; myocarditis; pericarditis HAV- acute viral hepatitis Fecal oral spread except rhinovirus ```

Answer 229

No envelope ssRNA positive linear icosahedral causes HEV

Answer 230

not enveloped ssRNA positive linear icosahedral norovirus: viral gastroenteritis

Answer 231

enveloped ssRNA positive, linear Icosahedral HCV, yellow fever, Dengue, St. Louis encephalitis, West nile virus

Answer 232

Enveloped ssRNA positive, linear icosahedral Rubella, eastern and western equine encephalitis

Answer 233

``` Enveloped ssRNA positive linear icosahedral have reverse transcriptase HTLV- T-cell leukemia HIV-AIDS ```

Answer 234

enveloped ssRNA positive and linear helical coronavirus- common cold and SARS

Answer 235

``` enveloped ssRNA negative and linear 8 segments helical influenza replicates in nucleus only (only RNA virus that needs nucleus) ```

Answer 236

``` enveloped ssRNA linear Helical PaRaMyxovirus: Parainfluenza: croup Rsv: bronchiolitis in babes (treat with ribavirin) Measles, Mumps ```

Answer 237

enveloped ssRNA negative linear helical Rabies

Answer 238

enveloped ssRNA negative linear helical ebola/marburg hemorrhagic fever- often fatal

Answer 239

``` Enveloped ssRNA negative circular 2 segments helical LCMV: lymphocytic choriomeningitis virus Lassa fever encephalitis: spread by mice ```

Answer 240

``` enveloped ssRNA negative 3 segments helical California encephalitis Sandfly/Rift valley fever Crimean-COngo hemorrhagic fever Hantavirus- hemorrhagic fever, pneumonia ```

Answer 241

enveloped SS negative circular unknown capsid HDV is a defective virus that requires HBV co-infection

Answer 242

must transcribe negative strand to positive. viron brings its own RNA-dependent RNA polymerase Always Bring Polymerase Or Fail Replication Arenavirus, Bunyavirus, Paramyxovirus, Orthomyxovirus, Filovirus, Rhabdovirus

Answer 243

all RNA, no segmented DNA viruses Bunyavirus, Orthomyxovirus, Arenavirus, Reovirus BOAR!

Answer 244

``` a picornavirus nonenveloped RNA virus causes of common cold (rhino runny nose) over 100 serologic types acid labile- destroyed by stomach acid- so it does not infect GI tract (all other picornaviruses do) ```

Answer 245

``` a flavivirus (and an arbovirus) transmitted by Aedes mosquitoes Virus has a monkey or human reservoir High fever, black vomitus, and jaundice Flavi=yellow ```

Answer 246

the most important cause of global infantile gastroenteritis segmented dsRNA virus (reovirus) major cause of acute diarrhea in the US during winter, especially in day care settings, kindergartens villous destruction with atrophy leads to decreased absorption of Na and loss of K ROTAvirus=Right Out The Anus CDC recommend vaccine for all infants

Answer 247

Orthomyxovirus enveloped, negative ssRNA, 8 segments contain hemagglutinin (promotes viral entry) and neuraminidase (promotes progeny virion release) antigens. patients at high risk for fatal bacterial superinfection rapid genetic changes

Answer 248

causes pandemics reassortment of viral genome; segments undergo high-frequency recombination such as when human flu A virus recombines with swine flu A virus

Answer 249

causes epidemics | minor changes based on random mutation

Answer 250

Togavirus AKA german measles fever, postauricular and other lymphadenopathy, arthralgias, fine rash causes mild disease in children but serious congenital disease (ToRCHes) Congenital rubella findings include blueberry muffin appearance, indicative of extramedullary hematopoiesis, cataracts, deafness, PDA

Answer 251

parainfluenza (croup), mumps, measles, as well as RSV, which causes respiratory tract infection (bronchiolitis, pneumonia) in infants (fever, labored breathing, expiratory wheezes, tachypnea, tachycardia) all contain surface F (fusion) protein which causes respiratory epithelia cells to fuse and form multinucleated cells Palivizumab is treatment

Answer 252

monoclonal antibody against F protein | prevents pneumonia caused by RSV infection in premature infants

Answer 253

a paramyxovirus koplik spots and descending maculopapular rash are characteristic SSPE (subacute sclerosing panencephalitis) giant cell pneumonia (rare, in immune suppressed) 3 C's of measles: Cough Coryza (swelling of mucous membranes in nose) Conjunctivitis Vitamin A used to prevent severe exfoliative dermatitis in malnourished children

Answer 254

subacute sclerosing panencephalitis occurs 6 or more years after measles virus (Get measles before 2 years of age) spasticity, ataxia, coma, behavior changes, increased immunoglobulins in CSF

Answer 255

Paramyxovirus Parotitis, Orchitis, aspectic Meningitis Can cause sterility Mumps makes your parotid glands and tests as big as POM-poms.

Answer 256

giant multi nucleated cells will show up from viruses of paramyxovirus and herpesvirdae viruses is a mechanism of immune system

Answer 257

bullet shaped virus get negri bodies in purkinje cells of cerebellum and in hippocampal neurons weeks to months incubation period Give rabies immune globulin travels to CNS by migrating retrograde fashion up axons Progression of disease: fever, malaise, agitation, photophobia, hydrophobia, paralysis, coma, then death SKUNKS, raccoon, bat

Answer 258

``` hep A RNA picornavirus fecal oral transmission no carrier weeks of incubation usually asymptomatic ```

Answer 259

Hep B DNA hepadnavirus parenteral, sexual, maternal-fetal spread there are carriers months of incubation increased risk of HCC (hepatocellular carcinoma), integrates into host DNA and acts as oncogene

Answer 260

Hep C (Chronic, Cirrhosis, Carcinoma, Carrier) RNA flavivirus Primarily blood transmission There are carriers long incubation increased HCC risk from chronic inflammation

Answer 261

Hep D (Defective, Dependent on HBV) RNA delta virus Parenteral, sexual, maternal-fetal spread there are carriers co infected (long incubation) or super infected (short incubation, bad prognosis) increased HCC risk

Answer 262

RNA hepevirus (Enteric, Expectant mothers, Epidemic) spread Fecal-oral, especially with waterborne epidemics there are no carriers short incubation no increased HCC risk High mortality in pregnant women

Answer 263

IgM antibody to HAV; best test to detect active Hep A

Answer 264

IgG antibody to detect prior HAV infection and/or prior vaccination; protects against reinfection

Answer 265

antigen found on surface of HBV; indicates hep B infection

Answer 266

antibody to HBsAg; indicates immunity to hep B

Answer 267

antigen associated with core of HBV

Answer 268

antibody to HBcAg; IgM=acute/recurrent infection; IgG= prior exposure or chronic infection. positive during window period

Answer 269

A second, different antigenic determinant in the HBV core. HBeAg indicates active viral replication and therefore high transmissibility

Answer 270

antibody to HBeAg; indicates low transmissibility

Answer 271

ectopic pregnancy with tubular rupture. The infection caused inflammation and scarring due to type 4 hypersensitivity and all that damage can lead to ectopic pregnancy. Eventually ectopic pregnancy leads to rupture

Answer 272

``` Diploid genome (2 RNA molecules) env gene (codes for gp120 and pg41): formed from the cleavage of gp160 to form envelope glycoproteins, gp120 is for attachment to the host CD4+ t cell, gp41 is for fusion and entry gag gene (codes for p24): for capsid protein pol gene (reverse transcriptase, asparate protease, integrase): RT synthesizes dsDNA from RNA; dsDNA integrates into host genome. Virus binds CCR5 (early) or CXCR4 (late) co receptor and CD4 on T cells; binds CCR5 and CD4 on macrophages. U ```

Answer 273

Presumptive diagnosis made with ELISA (sensitive, high false positive rate and low threshold, rule out test); + results are confirmed with western blot assay (specific, high false negative rate and high threshold, rule in test). Viral PCR load will give you prognosis AIDS is confirmed HIV with

Answer 274

are caused by conversion of a normal (usually alpha helix) protein termed prion protein (PrPc) to a beta pleated form (PrPsc), which is transmissible. PrPsc resists protease degradation and facilitates the conversion of still more PrPc to PrPsc. Accumulation of PrPsc results in spongiform encephalopathy and dementia, ataxia, and death. It can be sporadic (creutzfeldt-jakob disease) or inherited (Gerstmann-Straussler-Scheinker syndrome), or acquired, (kuru).

Answer 275

S epidermidis

Answer 276

S epidermidis and S. aureus

Answer 277

Viridans strep

Answer 278

B fragilis > e coli

Answer 279

Lactobacillus, colonized by E coli and group B strep

Answer 280

Reheated rice. "Yes, and B. serious about it, it sucks."

Answer 281

Improperly canned foods (bulging cans is a sign...haha...bulging cans.....haha...C her BODulium...haha) Also alkaline canned foods like veggies

Answer 282

reheated meat dishes

Answer 283

Undercooked meat

Answer 284

Poultry, meat and eggs

Answer 285

Meats, mayonnaise, custard; preformed toxin

Answer 286

contaminated seafood | vulnificus can also cause wound infections just by touching contaminated food with open cut

Answer 287

campylobacter, E. histolytica, Enterohemorrhagic E coli, enteroinvasice E. coli, salmonella, shigella, Y enterocolitica

Answer 288

C diff, C perfringens, Enterotoxigenic e coli, protozoa, v cholerae, some viruses.

Answer 289

Group B strep (S. agalactiae) | E. coli

Answer 290

Virus (RSV), Mycoplasma, C. trachomatis (infants to 3 years old), C. pneumoniae (school age), S. pneumoniae, (Runts May Cough Chunky Sputum)

Answer 291

Mycoplasma, C. pneumoniae, S. pneumoniae

Answer 292

S. pneumoniae, H. influenzae, Anaerobes, Viruses, Mycoplasma

Answer 293

S. pneumoniae, Influenza virus, Anaerobes, H. influenzae, Gram-negative rods

Answer 294

S. pneumoniae, Klebsiella, Staphylococcus

Answer 295

Anaerobes (bacteriodes, peptococcus, fusobacterium), will be foul smelling sputum that is rust colored (these are the normal flora being thrown up and getting into the lung. Look for patient who goes unconscious.

Answer 296

Mycoplasma, Legionella, Chlamydia

Answer 297

Pseudomonas, S. aureus, S. pneumoniae

Answer 298

Staphylococcus, enteric gram negative rods, gungi, virsuses, P jirovecii (HIV)

Answer 299

staph, pseudomonas, other enteric gram negative rods

Answer 300

Staph, H. influenzae, S. pneumoniae

Answer 301

Group B strep, E coli, Listeria

Answer 302

S pneumoniae, N meningitids, H influenzae type B, Enteroviruses

Answer 303

S. Pneumoniae, N meningitidis (#1 in teens), Enteroviruses, HSV

Answer 304

S. pneumoniae, gram negative rods, listeria

Answer 305

Give ceftriaxone, vancomycin, and add ampicillin if listeria is suspected

Answer 306

enterociruses, HSV-2, HIV, West nile virus, VZV,

Answer 307

Cryptococcus, CMV, toxoplasmosis (brain abscess), JC virus (PML)

Answer 308

Increase opening pressure Increase PMNs increased protein decreased sugar

Answer 309

Increased opening pressure increased lymphocytes increased protein decreased sugar

Answer 310

normal to increased opening pressure increased lymphocytes Normal to increased proteins normal sugar

Answer 311

assume S. aureus

Answer 312

Neisseria gonorrhoeae (rare), septic arthritis more common

Answer 313

Pseudomonas aeruginosa, Serratia

Answer 314

Pseudomonas aeruginosa, Serratia

Answer 315

Salmonella

Answer 316

S. aureus and S epidermidis

Answer 317

Mycobacterium tuberculosis (Pott disease)

Answer 318

Pasteurella multocida

Answer 319

dysuria, frequency, urgency, suprapubic pain, and WBCs (but not WBC casts) in urine.

Answer 320

Leukocyte esterase test + means bacterial UTI; nitrite test + means gram negative bacterial UTI

Answer 321

proteus or klebsiella

Answer 322

Leading cause of UTI, colonies show green metallic sheen on EMB agar, negative urease test, positive nitrite test

Answer 323

2nd leading cause of UTI, in sexually active women, urease test negative, nitrite test negative

Answer 324

3rd leading cause of UTI, large mucoid capsule and viscous colonies Urease test +

Answer 325

some strains produce a red pigment; often nosocomial and drug resistant

Answer 326

often nosocomial and drug resistant

Answer 327

motility causes "swarming" on agar; produces urease; associated with struvite stones.

Answer 328

blue-green pigment and fruity odor; usually nosocomial and drug resistant.

Answer 329

No inflammation, thin, white discharge with fishy odor See clud cells and a pH > 4.5 Treat: metronidazole

Answer 330

Inflammation, frothy, grey-green foul smelling discharge Motile trichomonads with a pH > 4.5 treat: metronidazole and make sure you treat sexual partner

Answer 331

Inflammation, thick, white, "cottage cheese" discharge Pseudohyphae pH is normal (4 to 4.5) treat with -azoles Factors that increase chance of getting this infection: diabetes (Increase sugar in secretions), antibiotic use, increase estrogen levels, immune compromised

Answer 332

microbes that may pass from mother to fetus. Transmission is tranplacental in most cases, or via delivery (especially HSV-2). nonspecific signs common to many ToRCHeS infections include hepatosplenomegaly, jaundice, thrombocytopenia, and growth retardation. Other agents: Strep Agalactiae, E coli, Listeria monocytogenes, all cause meningitis in neonates. Parvovirus B19 causes hydrops fetalis.

Answer 333

get it from Cat feces or ingestion of undercooked meat Mom's manifestions: usually none, rarely lymphadenopathy Neonatal manifestions: Classic triad: chorioretinitis, hydrocephalus, and intracranial calcifications

Answer 334

Transmission: respiratory droplets mom symptoms: rash, lymphadenopathy, arthritis Neonatal symptoms: Classic triad: PDA (or pulmonary artery hypoplasia), cataracts, and deafness +/- blueberry muffin rash

Answer 335

Transmitted via sexual contact or organ transplant Mom symptoms: Rash, lymphadenopathy, arthritis Neonatal symptoms: Hearing loss, seizures, petechial rash, blueberry muffin rash (lots of cutaneous hemorrhages), calcifications in periventricular calcifications

Answer 336

Transmitted via sexual contact or needle stick Maternal symptoms: Cariable presentation depending on CD4+ count Neonatal manifestions: recurrent infections, chronic diarrhea

Answer 337

transmitted via skin or mucous membrane contact mom symptoms: usually asymptomatic; herpetic vesicular lesions Neonatal symptoms: encephalitis, herpetic vesicular rash

Answer 338

transmitted via sexual contact Maternal manifestations: chancre (primary) and disseminated rash (secondary) are the two stages likely to result in fetal infection Neonatal manifestations: often results in stillbirth, hydrops fetalis; if child survives, presents with facial abnormalities (notched teeth, saddle nose, short maxilla), saber shins, CN VIII deafness

Answer 339

gram negative, comma, oxidase positive, rod, sensitive to acid Causes: gastroenteritis, cellulitis treat: tetracycline, 3rd generation cephalasporin

Answer 340

Hand foot mouth disease | Vesicular rash on palms and soles; vesicles and ulcers in oral mucosa

Answer 341

Roseola A macular rash over body appears after several days of high fever; can present with febrile seizures; usually affects infants

Answer 342

Measles (Rubeola) A paramyxovirus; beginning at head and moving down; rash is preceded by cough, coryza, conjunctivitis, and blue-white Koplik spots on buccal mucosa

Answer 343

``` Erythema infectiosum (fifths disease) Slapped cheek rash on face; can cause hydrops fetalis in pregnant women; adults get swollen joints mostly in hands and wrists ```

Answer 344

Rubella | Rash begins at head and moves down; leads to fine truncal rash; postauricular lymphadenopathy

Answer 345

Scarlet fever | Erythematous, sandpaper like rash with fever and sore throat

Answer 346

Chickenpox | Vesicular rash begins on trunk; spreads to face and extremities with lesions of different ages

Answer 347

spread by HIV | leads to opportunistic infections, Kaposi sarcoma, lymphoma

Answer 348

from Haemophilus ducreyi (so painful you do cry) | Painful genital ulcer, inguinal adenopathy, starts as papule then painful genital ulcer;

Answer 349

From chlamydia trachomatis (D-K) | causes urethritis, cervicitis, conjunctivitis, reactive arthritis, Pelvic inflammatory disease

Answer 350

From HPV-6 and 11 | Causes genital warts and koilocytes

Answer 351

from HSV-2, less commonly HSV-1 | Painful penile, vulvar, or cervical vesicles and ulcers; can cause systemic symptoms such as fever, headache, myalgia

Answer 352

from neisseria gonorrhoeae | Causes Urethritis, cervicitis, PID, prostatitis, edidiymitis, arthritis, creamy purulent discharge

Answer 353

from HBV | causes jaundice

Answer 354

Caused by C. trachomatis (l1-l3) | infectino of lymphatics; painless genital ulcers, painful lymphadenopathy (i.e. buboes)

Answer 355

From Treponema pallidum | Painless chancre

Answer 356

From Treponema pallidum | fever, lymphadenopathy, skin rashes, condylomata lata

Answer 357

From Treponema pallidum | Gummas, tabes dorsalis, general paresis, aortitis, Argyll Robertson pupils

Answer 358

From Trichomonas vaginalis | Causes vaginitis, strawberry cervix, motile in wet prep

Answer 359

Chlamydia trachomatis (subacute, often undiagnosed, the most common bacterial STD in the US), Neisseria gonorrhoeae (acute),

Answer 360

Cervical motion tenderness (chandelier sign), purulent cervical discharge. PID may include salpingitis, endometritis, hydrosalpinx, and tubo-ovarian abscess. Can lead to Fitz-High-Curtis syndrome- infection of the liver capsule and violin string adhesions of peritoneum to liver Salpingitis is a risk factor for ectopic pregnancy infertility, chronic pelvic pain and adhesions.

Answer 361

hyperalimentation

Answer 362

CMV and RSV

Answer 363

E. coli, Proteus mirabilis, the second most common causes of nosocomial infections are E coli and S aureus

Answer 364

Legionella

Answer 365

Pseudomonas aeruginosa, presume pseudomonas "airuginosa" when air or burns are involved

Answer 366

Encapsulated microbes, especially SHiN (S. pneumoniae >> H. influenzae type B > N. Meningitidis)

Answer 367

actinomyces israelii

Answer 368

Catalase positive mucrobies, especially S. aureus

Answer 369

Klebsiella, see lobar cavitation on x ray

Answer 370

Pasteurella multocida

Answer 371

Borrelia burgdorferi (lymes disease)

Answer 372

Mucor or Rhizopus spp.

Answer 373

HBV from needlestick (I guess you just assume the stuck themselves......)

Answer 374

Candida albicnas (Systemic), Aspergillus

Answer 375

Tropheryma whippleu (whipple disease)

Answer 376

Haemophilus influenzae (including epiglottitis)

Answer 377

Coxsackie A virus, Treponema pallidum, Rickettsia rickettsii

Answer 378

Group B strep

Answer 379

Clostridium perfringens

Answer 380

G is IV and IM, V is oral Binds penicillin-binding proteins (transpeptidases). Block transpeptidase cross-linking of peptidoglycan. Activate autolytic enzymes Used: mostly used for gram positive bugs (S. pneumoniae, S. pyogenes, Actinomyces), N. Meningitids, T. pallidum. Bactericidal for gram + cocci, gram + rods, gram - cocci, and spiorchetes. Toxicity: hypersensitivity reactions, hemolytic anemia Resistance: penicillinase in bacteria cleaves beta lactam ring

Answer 381

Ampicillin , amoxicillin Mechanism: same as penicillin, wider spectrum Use: H. influenzae, E coli, Listeria monocytogenes, Proteus mirabilis, Salmonella, Shigella, enterococci Toxicity: hypersensitivity reactions; rash; pseudomembranous colitis (C. diff) Resistance: penicillinase

Answer 382

Oxacillin, nafcillin, dicloxacillin Mechanism: same as penicillin, narrow spectrum, resistant because due to bulky R group Clinical use: S. aureus (except MRSA; resistant because o faltered penicillin-binding protein target site) Toxicity: hypersensitivity reactions, interstitial nephritis

Answer 383

Ticarcillin, piperacillin Mechanism: same as penicillin. Clinical: Pseudomonas spp. and gram negative rods, susceptible to penicillinases

Answer 384

Clavulanic Acid, Sublactam, Taxobactam | Added to penicillin antibiotics to prevent destruction from penicillinase.

Answer 385

Used for serious infections, given IV For gram - bacilli, Pseudomonas aeruginosa, klebsiella Binds LPS on membrane, acts as catatonic detergent, alters osmotic barrier Nephrotoxicity

Answer 386

Beta-lactam drugs that inhibit cell wall synthesis but are less susceptible to penicillinases. Bactericidal Organisms NOT covered by cephalosporins are LAME: Listeria, Atypicals (chlamydia, mycoplasma), Mrsa, and Enterococci

Answer 387

Cefazolin, cephalexin gram + cocci for PEcK: Proteus mirabilis, E coli, Klebsiella pneumoniae Cefazolin used prior to surgery to prevent S. aureeus wound infections

Answer 388

Cefoxitin, cefaclor cefuroxime for gram + cocci (HEN PEcKS) Haemophilus influenza, Enterobacter aerogenes, Neisseria spp., Proteus mirabilis, E. coli, Klebsiella pneumoniae, Serratia marcescens

Answer 389

ceftriaxone, cefotaxime, ceftazidime serious gram - infections resistant to other beta lactams Ceftriaxone- for meningitis and gonorrhea Ceftazidime- for Pseudomonas

Answer 390

cefepime | increases activity against Pseudomonas and gram + organisms

Answer 391

Ceftaroline Broad gram + and gram - organism coverage including MRSA; does not cover pseudomonas

Answer 392

Hypersensitivity reactions, vitamin K deficiency, low cross-reactivity with penicillins. Increase nephrotoxicity of aminoglycosides

Answer 393

Monobactum penicillin Resistant beta lactamases. Prevent peptidoglycan cross-linking by binding to penicillin-binding protein 3. Synergistic with aminoglycosides. No cross-allergenicity with peniciliins Uses: gram - rods, no activity against gram + or anaerobes. For penicillin allergic patients and those with renal insufficiency who cannot tolerate aminoglycosides Toxicity: usually nontoxic; occasional GI upset

Answer 394

Works on gram + treat skin/skin structure infectinos given IV no toxicity usually rapid cell death, binds to membrane causes rapid depolarization Gram postive only (MRSA and Vanco resistant) REsistance is from positive charged lysines repelling drup

Answer 395

Imipenem, meropenem, ertapenem, doripenem imipenem is broad spectrum, beta lactamase resistant carbapenem. Always administered with cilastin (inhibitor of renal dehydropeptidase I) to decrease inactivation of drug in renal tubules Uses: Gram + cocci, gram - rods, and anaerobes. wide spectrum but significant side effects so use when patient is about to die. Meropenem has a decreased risk of seizures and is stable to dehydropeptidase I. Toxicity: GI distress, skin rash, and CNS toxicity (seizures) at a high plasma levels)

Answer 396

Inhibits cell wall peptidoglycan formation by binding D-ala D-ala portion of cell wall precursors. Bactericidal. Clinical use: gram + only, serious, multi-drug resistant organisms, including MRSA, enterococci, and C diff Toxicity: well tolerated in general but NOT trouble free. Nephrotoxicity, Ototoxicity, Thrombophlebitis, diffuse flushing- red man syndrome (can largely prevent by pretreatment with antihistamines and slow infusion rate) Resistance: D-ala D-ala switches to D-ala D-lac

Answer 397

``` Topical or IM Pain at IM, nephrotoxicity Cell wall inhibitor, prevent incorporation of peptidoglycans and lipopolysaccharides Used for gram + and gram - Not beta lactam ```

Answer 398

Ham, potato salad, and pastries | has exotoxin A which produces nausea and vomiting in a few hours (3-6), with little to no diarrhea

Answer 399

gentamicin neomycin, amikacin, tobramycon, streptomycin Mechanism: bactericidal; binds 30s, inhibits formation of initiation complex and cause misreading of mRNA. Also block translocation. Require 02 for uptake; therefore ineffective against anaerobes. Uses: severe gram - rod infections. synergistic with beta lactam antibiotics Toxicity: Nephrotoxicity (especially when used with cephalosporins), Neuromuscular blockade, Ototoxicity (especially when used with loop diuretics), Teratogen, ototoxic to fetus

Answer 400

Tetracycline, doxycycline, minocycline Bacteriostatic: binds 30s, prevetns attachment of aminoacyl-tRNA' limited CNS penetration, doxy is fecally excreted and can be used during renal failure. Do not take with Ca or Mg, or iron because divalent cations block absorption. Uses:Borrelia burgdorferi, M pneumoniae, drugs ability to accumulate intracellularly makes it very effective against Rickettsia and Chlamydia, also used to treat acne. Toxicity: Gi distress, discoloration of teeth and inhibition of bone growth in children, photosensitivity, contraindicated in pregnancy

Answer 401

Azithromycin, clarithromycin, erythromycin Mechanism: inhibits protein synthesis by blocking translocation; binds to the 23s subunit of the 50s ribosomal subunit: bacteriostatic Uses: atypical pneumonias (Mycoplasma, Chlamydia, Legionella), STDs (Chlamydia), gram + cocci (Strep infections in penicillin allergic patients) Toxicity: MACRO: gastrointestinal Motility issues, Arrhythmia caused by prolonged QT, acute Cholestatic hepatitis, Rash, eOsinophilia, increases serum concentrations of theophyllines-oral anticoagulants, Clarithromycin is embryotoxic

Answer 402

Blocks peptidyltransferase at 50s subunit: bacteriostatic Uses: meningitis (H. flu, N. meningitidis, S. pneumoniae) and rocky mountain spotted fever (rickettsia rickettsii) Limited use owing to toxicities but often still used in developing countries cause it's cheap. Toxicity: anemia (dose dependent), aplastic anemia (dose independent), gray baby syndrome (premature infants because they lack liver UDP-glucuronyl transferase) Resistance arises from: plasmid encoded acetyltransferase inactivates the drug

Answer 403

Blocks peptide transfer at 50s: bacteriostatic Uses: anaerobic infections (e.g. bacteroides spp. Clostridium perfringens) in aspiration pneumonia, lung abscesses, and oral infections. also effective against invasive group A strep infections. Toxicity: Pseudomembranous colitis (C diff overgrowth), fever, diarrhea

Answer 404

Clindamycin: treats anaerobes above the diaphragm vs metronidazole which treats below diaphragm

Answer 405

Sulfamethoxazole (SMX), sulfisoxazole, sulfadiazine Mechanism: inhibit folate synthesis, para-aminobenzoic acid antimetabolites inhibit dihydripteroate synthase. bacteriostatic Uses: gram +, gram -, Nocardia, chlamydia, triple sulfas or SMX for simple UTI Toxicity: hypersensitivity, if G6PD then hemolysis, nephrotoxic (tubulointerstitial nephritis), photosensitivity, kernicterus in infants, displaces other drugs from albumin Resistance arises from: altered enzyme (bacterial dihydropteroate synthase), decrease uptake, or increase PABA synthesis.

Answer 406

inhibits bacterial dihydrofolate reductase, bacteriostatic Used in wombo combo with SMX, causing sequential blocking of folate synthesis. combination used for UTIs, Shigella, salmonella, pneumocystis jirovecii pneumonia treatment and prophylaxis, toxoplasmosis prophylaxis. Toxicity: megaloblastic anemia, leukopenia, granulocytopenia, (may alleviate with supplemental folinic acid)

Answer 407

-floxacin (like ciprofloxacin, moxifloxacin), and enoxacin, nalidixic acid Inhibts DNA gyrase (topo 2) and topo 4, bactericidal. Do not take with antacids cause the bind and prevent absorption Uses: gram - rods in urinary and GI tracts, pseudomonas, Neisseria, some gram + Toxicity: GI upset, superinfections, skin rashes, headache, dizziness, less commonly: tendonitis and rupture, leg cramps, myalgia. Can't use in pregnant or breast feeding women due to potential cartilage damage. can prolong QT, tendon rupture mostly in old people on prednisone

Answer 408

Forms free radical toxic metabolites in the bacterial cell that damage DNA, bactericidal, antiprotozoal uses: treats GET GAP: Giardia, Entamoeba, Trichomonas, Gardnerella vaginalis, Anaerobes (bacteriodes, c diff). part of triple therapy for h pylori. toxicity: disulfiram-like reactions(severe flushing, tachycardia, hypotension) w/ alcohol; headache, metallic taste

Answer 409

Prophylaxis: Isoniazid Treatment: RIPE (rifampin, Isoniazid, Pyrazinamide, Ethambutol)

Answer 410

Prophylaxis: azithromycin or rifabutin Treatment: Azithromycin or clarithromycin + ethambutol, can add rifabutin or ciprofloxacin More drug resistant than M tuberculosis

Answer 411

No prophylaxis Treatment: Jesus daps you on the head or Dapsone and rifampin for tuberculoid form but add clofazimine for lepromatous form

Answer 412

Mechanism: decreased synthesis of mycolic acids, bacterial catalase-peroxide (encoded by KatG) need to convert INH to active metabolite Uses: M. tuberculosis, and the only agent used in prophylaxis for TB Toxicity: Neurotoxicity, Hepatotoxicity, Pyridoxine (B6) can prevent neurotoxicity, lupus

Answer 413

Rifampin, rifabutin Inhibits DNA-dependent RNA polymerase uses: M tuberculosis, delays resistance to dapsone in leprosy, meningococcal prophylaxis and chmoprophylaxis in contacts of children with H influenzae type B Toxicity: minor hepatotoxicity and increase p450, orange body fluids, Rifabutin used over rifampin in patients with HIV infection due to less cytochrome p450 stimulation.

Answer 414

mechanism: uncertain, thought to acidify intracellular environment via conversion to prazinoic acid. effective in acidic pH of phagolysosomes, where TB engulfed macrophages is found Clinical use: mycobacterium tuberculosis Toxicity: Hyperuricemia, hepatotoxicity

Answer 415

Mechanism: decrease polymerization of mycobacterium cell wall by blocking arabinosyltransferase Uses: mycobacterium tuberculosis Toxicity: optic neuropathy (red-green color blindness)

Answer 416

penicillins

Answer 417

Ceftriaxone

Answer 418

Ciprofloxacin is choice drug, rifampin for kids

Answer 419

Ampicillin

Answer 420

Erythromycin ointment

Answer 421

oral penicillin

Answer 422

Benzathine penicillin G

Answer 423

TMP-SMX to prevent pneumocystis pneumonia

Answer 424

TMP-SMX to prevent pneumocystis pneumonia and toxoplasmosis

Answer 425

Azithromycin to prevent mycobacterium avium complex

Answer 426

Vancomycin, daptomycin, linezolid, tigecycline, ceftaroline

Answer 427

serotonin syndrome

Answer 428

Linezolid and streptogramins (quinupristin/dalfopristin)

Answer 429

Mechanism: binds ergosterol (unique to fungi) and form membrane pores that allow leakage of electrolytes Uses: serious systemic mycoses, cryptococcus, blastomyces, coccidioides, histoplasma, candida, mucor. Intrathecally for fungal meningitis. Give with K+ and Mg2+ because of altered renal tubule permeability Toxicity: fever, chills, hypotension, nephrotoxicity, arrhythmias, anemia, IV phlebitis. Hydration decreases nephrotoxicity, liposomal amphotericin decreases toxicity.

Answer 430

Mechanism: same as amphotericin B. Topical for because it is too toxic for systemic use Use: swish and swallow for oral candidiasis; topical for diaper rash or vaginal candidiasis

Answer 431

-azoles (fluconazole, ketoconazole, itraconazole.....) Mechanism: inhibit fungal sterol (ergosterol) synthesis by inhibiting p-450 that converts lanosterol to ergosterol UsesL local and serious systemic mycoses, fluconazole for chronic suprresion of cryptococcal meningitis in AIDS patients and candidal infections of all types. Itraconazole for blastomyces, Coccidioides, Histoplasma. Clotrimazole and miconazole for topical fungal infections. Voriconazole for aspergillus in immunocompromised. Toxicity: testosterone synthesis inhibitor (gynecomastia, esp. w/ ketoconazole, liver dysfunction (inhibits p450)

Answer 432

Mechanism: inhibits DNA and RNA biosynthesis by conversion to 5-fluorouracil by cytosine deaminase Use: systemic fungal infections (esp. meningitis caused by cryptococcus) in combination with amphotericin B Toxicity: bone marrow suppression

Answer 433

-fungin (Caspofungin, micafungin, anidulafungin) Mechanism: inhibits cell wall synthesis by inhibiting synthesis of beta-glucan. Uses: invasive aspergilloisis, candida Toxicity: GI upset, flushing (by histamine release)

Answer 434

Mechanism: inhibits the fungal enzyme squalene epoxidase Use: Dermatophytoses (especially onychomycosis- finger and toe nails) Toxicity: GI upset, headaches, hepatotoxicity, taste disturbance

Answer 435

Mechanism: interferes with microtubule function; disrupts mitosis/ Deposits in keratin-containing tissues (e.g. nails) Uses: oral treatment of superficial infections; inhibits growth of dermatophytes (tinea, ringworm), Teratogenic

Answer 436

Pyrimethamine

Answer 437

Suramin and melarsoprol

Answer 438

nifurtimox

Answer 439

sodium stibogluconate

Answer 440

Mechanism: blocks detoxification of heme into hemozoin. Heme accumulates and is toxic to plasmodia. Uses: treatment of plasmodial species other than P. falciparum. For life threatening malaria, use quinidine in US or artesunate Toxicity: Retinopathy; prurititus (Especially in dark-skinned individuals)

Answer 441

do not use chloroquine (frequency of resistance in P falciparum is too high). resistance due to membrane pump. Treat falciparum with artemether/lumefantrine or atovaquone/proguanil.

Answer 442

Mebendazole, pyrantel pamoate, ivermectin, diethylcarbamazine, prazinquantel Works to immobilize helminths. Use praziquantel against flukes (trematodes) such as Schistosoma

Answer 443

antiviral Mechanism: inhibit influenza neuraminidae leading to decreases in the release of progeny virus Uses: treatment and prevention of influenza A and B

Answer 444

antiviral Inhibits synthesis of guanine nucleotides by competitively inhibiting inosine monophosphate dehydrogenase toxicity: hemolytic anemia, severe teratogen

Answer 445

Mechanism: monophosphorylated by HSV/VZV thymidine kinase and not phosphorylated in uninfected cells (so less side effects). Guanosine analog. Triphosphate formed by cellular enzymes. Preferentially inhibits viral DNA polymerase by chain termination Toxicity: Obstructive crystalline nephropathy and acute renal failure if not hydrated

Answer 446

Mechanism: 5' monophosphate formed by a CMV viral kinase. Guanosine analog. Triphosphate formed by cellular kinases. Preferentially inhibits viral DNA polymerase Uses: CMV, especially in immunocompromised patients. Valganciclovir, a prodrug of ganciclovir, has better oral bioavailability Toxicity: leukopenia, neutropenia, thrombocytopenia, renal toxicity. more toxic to host enzymes than acyclovir Resistance comes from mutated CMV DNA polymerase or lack of viral kinase

Answer 447

Mechanism: viral DNA polymerase inhibitor that binds the pyrophosphate-binding site of the enzyme. Does not require activation by viral kinase Uses: CMV retinitis in immunocompromised patients when ganciclovir fails; acyclovir resistant HSV Toxicity: nephrotoxicity Resistance comes from mutated DNA polymerase

Answer 448

Mechanism: preferentially inhibits viral DNA polymerase. Does not require phosphorylation by viral kinase. Uses: CMV retinitis in immunocompromised patients; acyclovir resistant HSV. long half life Toxicity: nephrotoxic (given with probenecid and IV saline to decrease toxicity)

Answer 449

HAART: highly active antiretroviral therapy: given when patient presents with AIDS-defining illness, low CD4 count(

Answer 450

-Navir tease a protease Mechanism: assembly of virions depends on HIV-1 protease (pol gene), which cleaves the polypeptide products of HIV and mRNA into their functional parts. Thus, protease inhibitors prevent maturation of new viruses. Ritonavir can boost other drugs concentrations because it blocks p450 Toxicity: hyperglycemia, GI intolerance, lipodystrophy, Nephropathy, hematuria (indinavir)

Answer 451

Abacavir, emtricitabine, lamivudine, stavudine, tenofovir, Zidovudine, and Didanosine The magician did all the tricks and voodoo for the ten people

Answer 452

Competitively inhibit nucleotide binding to reverse transcriptase and terminate the DNA chain (lack a 3' OH). Tenofovir is a NucleoTide and all the others are nucleosides and need to be phosphorylated. Zidovudine is used for general prophylaxis and during pregnancy to decrease risk of fetal transmission

Answer 453

Bone marrow suppression (reversed w/ granulocyte colony stimulating factor and erythropoietin), peripheral neuropathy, lactic acidosis (nucleosides), rash (nucleosides), anemia (zido), pancreatitis (didanosine)

Answer 454

Efavirenz, Nevirapone, Delavirdine | Do a nerdy a favor and travel to Nevada and Delaware.

Answer 455

bind reverse transcriptase at site different from NRTIs. Do not require phosphorylation to be active or compete with nucleotides.

Answer 456

Rash and hepatotoxicity. Vivid dreams and CNS symptoms are common with efavirenz. Delaviridein and efavirenz are contraindicated in pregnancy.

Answer 457

Raltegravir (tegra) Inhibits HIV genoma integration into host cell chromosome by reversibly inhibiting HIV integrase Toxicity is hypercholesterolemia

Answer 458

Enfuvirtide (ENFUsion inhibitor), Maraviroc (CCR is a rock band) Mechanism: enfuvirtide binds gp41 inhibiting entry, maraviroc is a CCR-5 binder on the surface of t cells/monocytes, inhibiting interaction with gp120 Toxicity: skin reaction at injection site

Answer 459

Mechanism: glycoproteins normally synthesized by virus-infected cells, exhibiting a wide range of antiviral and antitumoral properties Uses: IFN-alpha-chronic hepatitis B and C, Kaposi sarcoma, hairy cell leukemia, condyloma acuminatum, renal cell carcinoma, malignant melanoma. IFN-beta: Multiple sclerosis IFN-gama: chronic granulomatous disease Toxicity: Neutropenia, myopathy

Answer 460

SAFe Children Take Really Good Care | Sulfonamides, Aminoglycosides, Fluoroquinolones, Clarithromycin, Tetracycline, ribavirin, Griseofulvin, Chloramphenicol

Answer 461

E coli, shigella, campylobacter are the most common cause | treat with fluoroquinolone (most ciprofloxacin)

Answer 462

Cat scratch fever; Only affects immune compromised and pregnant; regional lymphadenopathy with stellate granulomas on biopsy of lymph nodes; fever alternating with chills is commona

Answer 463

Poxvirus family

Answer 464

Poxvirus family

Answer 465

is part of the LPS of gram negative bacteria. It is the most toxic portion of LPS. Causes release of IL-1 and 6, TNF.

Answer 466

pseudomonas aeruginosa (gram negative rod, oxidase positive, has exotoxin A that inhibits EF-2 like diphtheria)

Answer 467

lysogenic conversion makes it so exotoxins of bacteria can cause their symptoms. Only certain bacteria need to do this. COBEDS is the way to remember: Cholera toxin, O antigen of Salmonella, botulinum toxin, Strep pyogenes toxin, Diphtheria toxin, Shiga toxin

Answer 468

Get undulant fever (spiking high fevers with sweats that come and go); chronic infection in nature; think unpasteurized milk and cheese or people who work with cattle.

Answer 469

Actinomyces israelli; gram positive rod anaerobic rod, makes yellow sulfur granules, causes cerviocfacial, female reproductive and GI infections.

Answer 470

think SW USA, exposure to rodent poop, and has acute respiratory distress

Answer 471

Strep Pyogenes (honey crusted lesions) or Staph aureus (blister like lesions)

Answer 472

Rickettsia (RMSF) and tularemia

Answer 473

Plasmodium Vivax or Ovale malaria; they are round bodies inside of infected erythrocytes.

Answer 474

Likely a gram negative rod so give them some clindamycin (50s inhibitor)

Steve Martin's Manic Micro Material Flashcards

(506 cards)