- Shuffle
Toggle OnToggle Off
- Alphabetize
Toggle OnToggle Off
- Front First
Toggle OnToggle Off
- Both Sides
Toggle OnToggle Off
Front
How to study your flashcards.
Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key
Up/Down arrow keys: Flip the card between the front and back.down keyup key
H key: Show hint (3rd side).h key
PLAY BUTTON
PLAY BUTTON
250 Cards in this Set
- Front
- Back
|
What induces TNF and IL1 in Gram +? How about Gram -?
|
Gram + = Techoic acid
Gram - = Lipid A |
|
What is the location in the Gram - bacteria structure where many of the beta-lactamases are found?
|
Periplasmic space
|
|
What reaction is used to identify encapsulated bugs?
|
Quellung reaction = capsule swells when anticapsular Ab are added
|
|
Which bugs are encapsulated?
|
"Some Killers Have Nice Shiny Bodies"
S = Strep pneumoniae K = Klebsiella pneumoniae H = Haemophilus influenza type B N = Neisseria meningitidis S = Salmonella B = group B strep |
|
Which vaccines use conjugated polysaccharide capsules?
|
Pneumovax
H. influenzae type B Meningococcal vaccines |
|
Which bugs can produced spores?
|
only certain Gram + rods, when neutrients are limited (when they are dying..)
|
|
Which bugs are spore formers?
|
Gram + rods found in soil:
Bacillus anthracis Clostridium perfringens Clostridium tetani Clostridium botulinum B. cereus Coxiella burnetii (causes Q fever) |
|
Which bug is the ONLY Gram + with endotoxin?
|
Listeria
|
|
Which cytokine causes degranulation of mast cells & basophils?
|
C3a = hypotension & edema
|
|
Which cytokine causes causes neutrophil chemotaxis?
|
C5a
|
|
What are the 3 responses that body has for endotoxin (Lipid A)
|
Activate macrophages (makes IL1, TNF & Nitric oxide)
Activate compliment (alternate) = C3a & C5a Activate Hageman factor = DIC |
|
What are the three main exotoxins of S. aureus, what what dz do they cause?
|
All are superantigens:
TSST-1 = toxic shock syndrome Enterotoxins = food poisoning Exfoliatin = scalded skin syndrome |
|
What are the three main exotoxins of S. aureus, what what dz do they cause?
|
Streptolysin O = Oxygen labile
Streptolysin S = oxygen Stable Erythrogenic/pyrogenic toxin/EXOTOXIN A = scarlet fever |
|
What is the MOA of the toxin of Corynebacterium diphtheriae?
|
Inactivates elongation factor (EF-2) = interferes with protein synthesis = pharyngitis and "pseudomembrane" in throat
|
|
Which bug?
ADP ribosylation of G protein stimulates adenylyl cyclase |
Vibrio cholerae = "rice-water" diarrhea"
- Gs protein! - Increases Cl secretion & Na/H20 follow |
|
E. coli have a heat-labile toxin and a heat-stabile toxin...which one of them stimulates adenylate cyclase & which one stimulates gyanylate cyclase?
|
"Labile like the Air, stable like the Ground"
Heat-labile toxin = stimulates Adenylate cyclase Heat-stabile toxin = stimulates Guanylate cyclase |
|
Which bug:
Increases cAMP by inhibiting Gi Whooping cough |
Bordetella pertussis
|
|
What are the 4 cAMP inducer bugs and what do they do?
|
All increase cAMP by either turning the "on" (Gs) on...or turning the "off" (Gi) off.
Vibrio cholerae toxin = permanently activates Gs = rice-water diarrhea Pertussis toxin = permenantly disables Gi = whooping cough E. coli (ETEC = travelers) = heat-labile toxin which stimualtes Adenylyl cyclase (Gs) Bacillus anthracis toxin = induces EDEMA FACTOR = which itself is an adenylyl cyclase = increase cAMP (does NOT work though G protein) V. Cholera, Pertussis & ETEC act via ADP ribosylation of GTP binding protein = increase cAMP |
|
Which toxin causes gas gangrene?
|
alpha-toxin in C. perfringens (get a double zone of hemolysis)
|
|
MOA of C. tetani
|
tetanospasmin toxin = blocks release of inhibitor neurotransmitters GABA & glycine = "lockjaw"
|
|
MOA of C. botulinum
|
blocks release of Ach (canned foods, honey)
|
|
Which two bugs have the O157:H7 strain?
|
Shigella
EHEC |
|
What is the MOA of the Shiga toxin?
|
cleaves host cell rRNA (inactivates 60S ribosome)
Also enhances cytokine release = HUS!! |
|
Exotoxin:
Inhibits ACh release --> flaccid paralysis |
botulinum toxin
|
|
Exotoxin:
Lecithinase that causes gas gangrene |
alpha toxin (C. perfringens)
|
|
Exotoxin:
inhibits the inhibitor of adenylate cyclase --> whooping cough |
pertussis toxin
|
|
Exotoxin:
stimulates adenylate cyclase --> Cl- and water into gut --> diarrhea |
cholera toxin (Vibrio) & heat labile toxin (ETEC)
|
|
Exotoxin:
Destroys leukocytes |
leukocydin (staph aureus)
|
|
Exotoxin:
Composed of edema factor, lethal factor and protective Ag |
Bacillus anthracis exotoxin
|
|
Exotoxin:
Enterotoxin causing rice-water diarrhea |
Cholera toxin (Vibrio) & heat labile toxin (ETEC)
|
|
Exotoxin:
causes scarlet fever |
pyrogenic/erythrogenic/Exotoxin A (group A strep)
|
|
Exotoxin:
Causes toxic shock syndrome |
TSST-1 (Staph)
|
|
Exotoxin:
Inactivates EF-2 --> pseudomembranous pharyngitis |
Diptheria toxin
- can be LETHAL if you scrape it and it goes systemic!! |
|
Exotoxin:
blocks the release of the inhibitory NT glycine |
tetanospasmin
|
|
Which two bugs are obligate intracellular?
|
"Stay inside when it is Really Cold"
- Rickettsia - Chlamydia Stay inside cells because they can't make their own ATP!! Intracellular = don't stain well |
|
Main facultative intracellular bug to know
|
Legionella
- intracellular, so also doesn't stain well! |
|
Which has NO cell wall, mycobacteria or mycoplasma?
|
mycoplasma ("plasma is exposed!")
|
|
Legionella cannot be gram stained...which stain CAN be used to visualize it?
Which other bug/s need to use this stain? |
Silver stain!
Fungi such as Pneumocystis jiroveci use silver stain |
|
What's another name for acid-fast stain?
What 3 main bugs are stained with acid-fast? |
Ziehl-Neelsen stain
Mycobacterium nocardia cryptosporidium (severe diarrhea in AIDS pts) |
|
India ink is used for what?
|
Cryptococcus neoformans - stains the background, so the organism can be seen since it doesn't take up the ink
|
What stain is this?
What bug? |
India ink
Cryptococcous neoformans |
|
What does congo red stain?
|
amyloid
|
What stain is used here?
What does it stain? |
Congo Red stain
Stains amyloids |
|
Which culture medium is needed for H. influenza?
|
Chocolat agar with factors V (NAD) & factor X (hematin)
"When a child has "flu," mom goes to five (V) and dime (X) store to buy some chocolate." |
|
A bacteria grows on Lowenstein-Jensen agar..which bacteria is it?
How long does it take to culture? |
Mycobacterium tuberculosis!
3-4 weeks to culture!!!...so ANYone with suspected TB should be in AIRBORNE ISOLATION while waiting for culture results |
|
Colonies are pink on MacConkey's agar means what?
Colonies that are not pink on MacConkey's agar means what? |
Gram - bugs that ferment lactose
Gram - bugs that do not ferment lactose |
|
Colonies are grown on Eosin-methylene blue (EMB) agar as blue-black colonies with metallic sheen. Bug?
|
E. coli
|
|
A bug is grown on Sabourad's agar. What class of bug is it?
|
fungus!
|
|
Pigment-producing bacteria:
Yellow "sulfur" granules Yellow pigment Blue-green pigment Red pigment |
Yellow "sulfur" granules - actinomyces israelii ("Israel has yellow sand")
Yellow pigment - S. aureus (Au is the elemental symbol for GOLD!) Blue-green pigment - pseudomonas aeruginosa Red pigment - serratia marcescens ("think red maraschino cherries") |
|
Spore formation takes place during which bacterial growth phase?
|
Stationary phase = nutrient depletion slows growth (but bugs aren't dying yet); Spore formation in some bacteria occurs!
|
|
What is transformation?
Which bacteria use this method? |
ability to take up DNA from environment
SHiN = S. pneumoniae, H. influenza type B, Neisseria |
|
What's the role of conjugation in bacterial DNA exchange?
|
exchange plasmid DNA only...NOT chromosomal genes
|
|
What's the role of transduction in bacterial DNA exchange?
|
exchange of DNA via use of bacteriophage (lytic phage infects bacterium = cleavage of bacterial DNA and synthesis of viral proteins, which are packaged into viral capsid & infect other bacterium
|
|
What's the role of transposition in bacterial DNA exchange?
|
segments of DNA that can "jump" from one location to anther, and can transfer genes from plasmid to chromosome and vice versa
|
|
What stain for Chlamydia?
|
Giemsa stain
|
What stain is this?
Bug? |
Silver stain
- pneumocystis jiroveci/carinii - Legionella also uses this stain |
|
Protein A is a virulence factor for which bug?
What is it's MOA? |
- binds Fc-IgG...which hides it from causing obsonization = inhibits complement fixation and phagocytosis!
|
|
IgA protease is virulence factor for which bugs?
MOA? |
SHiN bugs: S. pneumoniae, H. influenzae type B, Neisseria
Cleaves IgA..which is found in mucous membranes...so it's easy for these bugs to invade areas that contain mucous (sinusitis, bronchitis, etc) |
|
M protein is a virulence factor in which bug?
MOA? |
Group A Strep (Strep. pyogenes)
- helps prevent phagocytosis!!!! |
|
What 1 bug is the MOST COMMON cause of meningitis in adults, otitis media in kids, pneumonia (typical; lobar consolidation) and sinusitis?
Why? |
Strep pneumoniae (alpha hemolytic, capsule, lancet-shaped diplococci gram +)
It has IgA protease, which cleaves IgA (found in mucous/fluid membranes) |
|
Pt presents with pneumonia sx and is coughing up "blood-tinged" or "rusty" sputum. CXR shows lobar consolidation. Which bug?
|
Strep pneumoniae = RUSTY SPUTUM + LOBAR CONSOLIDATION (typical pneumonia) !!!!!!!!!!
|
|
Why do pt's who have sickle cell anemia or have had a splenectomy need the pneumovax (Step. pneumonia) vaccine?
|
Because Strep pneumo is capsulated and is very virulent in a person w/o a spleen!! If you have sick cell anemia, your get autosplenectomy, so the spleen is there but not working..so need the vaccine
|
|
What group of people should get the pneumococcal vaccine?
|
>65yo
Aslpenia Sickle cell anemia HIV + Hx of chronic lung dz |
|
Which bacteria can cause subacute endocarditis in pts with turbulent flow heart problems (pre-existing endothelial damage)?
|
Strep. mutans (a viridans strep)
|
|
Strep. mutans (a viridans strep) causes subacute endocarditis in who?
|
pts with PRE-EXISTING heart damage!!!
|
|
What 3 skin infections can be caused by BOTH Staph aureus & Strep. pyogenes?
|
-Folliculitis
-Cellulitis (DEEP skin infections through all layers of the skin) -Impetigo** - "thick, yellow weeping crusted lesions" - common the face, esp around mouth |
|
A pt has lesions on the face. They look red, but the center is yellow and crusty looking. Dx? What 2 bugs can cause this?
|
Impetigo
- Staph aureus or Strep. pyogenes (group A strep) |
|
Pt has a "strawberry" or "beefy red" tongue. Dx? Bug?
|
Scarlet fever
- Strep pyogenes (group A strep) |
|
ASO titer detects which strep type (specifically)
|
Group A strep = Strep pyogenes
|
|
In which weeks of pregnancy does a pregnant woman need to get a Group B Strep (GBS) swab done?
|
35-37 weeks
|
|
Enterococci (Group D strep) are normal gut flora bugs which can cause which 3 common dz's?
|
UTI
Subacute endocarditis Biliary tract infections (can occur after GI/GU surgery) |
|
What are the 3 obligate anaerobes?
Why is air bad for them? |
"anaerobes Can't Breathe Air"
- Clostridium - Bacteroides - Actinomyces These lack catalase and/or superoxide dismutase, which decrease ROS. Accumulation of ROS kills these bugs. - they produce gas in tissues (CO2 and H2) |
|
Which class of antibiotics are NOT effective against anaerobes?
|
AminOglycosides!
|
|
Which 2 antibiotics are used for anaerobes?
|
Metronidazole
Clindamycin |
|
Which 4 bugs are obligate aerobes?
|
Nocardia
Pseudomonas AERuginosa ("air") Mycobacterium TB (loves lungs) Bacillus (must inhale anthrax) |
|
Most common bacteria in burn wounds?
|
Pseudomonas aeruginosa
|
|
Most common bacteria in nosocomial pneumonia?
|
Pseudomonas aeruginosa
|
|
Most common bacteria causing pneumonia in cystic fibrosis?
|
Pseudomonas aeruginosa
|
Pt presents with a black eschar (necrosis) on the skin, surrounded by edematous ring.
Which bug caused this? What are the two main virulence factors of this bug? |
Bacillus anthracis (gram +, spore forming rod) causing cutaneous anthrax
- lethal factor - edema factor |
|
A pt presents with pneumonia and lymphadenitis. CXR shows widening of the mediastinum, hemorrhage of the lungs on bronchoscopy. The pt works at a factory which processes animal hides.
Which bug, and which two virulence factors cause this? |
Bacillus antracis (gram + spore-forming rod = "box-car" like) causing Woolsorters' dz (also seen in Postal workers)
- lethal factor - edema factor |
|
A pregnant woman at A LOT OF refrigerated foods like goat cheese, coalslaw, unpasturized milk and deli meats. Her kid ended up being stillborn.
Which bacteria was she infected with? |
Listeria monocytogenes (G + rod) - commonly found in refrigerated foods.
|
|
The MOST COMMON cause of meningitis in renal transplant pt's & adults with cancer
|
Listeria monocytogenes (G + rod)
|
|
This bacteria can cause meningitis and has a "tumbling motility"
|
Listeria monocytogenes
|
|
Pt has an oral/facial abscess. What is the mc bug?
|
Actinomyces israelii (Gram + rod)
|
|
Put has an abscess on the face. culture of the push shows sulfur granules which grow in anaerobic gram + bacteria. Will this bug stain with acid-fast?
|
NO...this is actinomyces israelii...which is anarobic and does NOT stain with acid fast (nocardia is the other gram + branching rod, but it is aerobic and does stain in acid-fast!)
|
|
What 3 organisms are the most commonly implicated bugs in SUBACUTE endocarditis?
|
Coag - staph = staph epidermidis
Viridans strep Enterocci |
|
A woman is breast-feeding develops redness and swelling of her right breast over a period of 24 hours. Examination reveals a warm, fluctuant mass. Dx & bug?
|
Mastitis...caused by S. aureus
|
|
What is the most common AEROBIC skin flora?
|
Staph epidermidis
|
|
These 6 bacteria DO NOT gram stain well
|
"These Rascals May Microscopically Lack Color"
Treponema (syphilis) - use a darkfield microscope + fluoresecent Ab stain Rickettsia - intracellular Mycobacteria - high lipid content cell wall requires ACID-FAST! Mycoplasma - no cell wall = can't stain! Legionella pneumophilia = intracellular Chlamydia = intracellular; no muramic acid in cell wall = use SILVER stain for your silvery chlamydia |
|
Which gram negatives ferment lactose? (enterics)
|
"macConKEE'S" agar
Citrobacter Klebsiella E.coli Enterobacter Serratia |
|
What is Fitz-High-Curtis syndrome and what bug causes it?
|
N. gonorrhea infection which starts in the lower genital tract & ascents through upper genital tract = ultimately infects the LIVER CAPSULE
|
|
Young sexually active male who presents with a swollen, red knee. You aspirate the fluid and you get pus (a lot of neutrophil's). What is the most common bug causing this?
|
This is Septic Arthritis...mc bug is N. gonorrhea ("sexually active!")
|
|
Which bug that causes meningitis can cause a petechial rash?
|
N. meningitis
|
|
Which bug causes Waterhouse-Friderichsen syndrome?
|
N. meningitis
|
|
What drug is used to prophylax close contacts of those infected with N. meningitis?
|
Rifampin
|
|
Intracellular gram - diplococci in PMN's described which bug?
|
Neisseria
|
|
Which drug is used to tx meningitis associated with H. influenzae?
|
ceftriaxone
|
|
Which drug is used to prophylax people against people who have H. influenzae infection?
|
Rifampin
|
|
Rifampin prophylaxis is used with which bugs?
|
N. meningitis
H. influenzae |
|
H. influenzae vaccine contains type B capsulse polysaccharide conjugated to __________ toxoid
|
diptheria
|
|
If I say silver stain, charcoal yeast, iron and cysteine...you say which bug?
|
Legionella pneumophila!
Stains with silver stain Grown on CHARCOAL EXTRACT culture with IRON and CYSTEINE |
|
Dx for legionelle pneumophila?
Tx for legionella pneumophila? |
Dx: by urinary Ag test for legionella
Tx: Erythromycin |
|
Pneumonia in cystic fibrosis pt's is cause by
|
pseudomonas aeruginosa
|
|
When I say "blue-green" pigment, + water...you should think what bug?
|
pseudomonas aeruginosa
|
|
Common cause of swimmers eat (external otitis media)
|
pseudomonas aeruginosa
|
|
Kid eats a hamburger and now has bloody diarrhea. Stool culture shows colorless colonies that do not ferment sorbitol. Bug?
|
EHEC O157:H7
|
|
Virulence factors for E. coli
|
Fimbriae = cystitis (mc cause!!), pyelonephritis
K capsule - pneumonia, neonatal meningitis, LPS endotoxin - septic shock |
|
This bug can cause lobar pneumonia in alcoholics and diabetics when aspirated.
|
Klebsiella "thick & bloody" sputum
|
|
Osteomyelitis in sickle cell pt
Osteomyelitis in a diabetic pt |
salmonella
Pseudomonas aergunosa |
|
This bug causing bloody diarrhea can propel itself within the cell by actin polymerization
|
Shigella
|
|
Why must you avoid antibiotics in pts with salmonella infection?
|
may prolong the carrier state in salmonella
|
|
Picnic, ingestion of poultry, handling pet turtles
|
salmonella
|
|
A pt had a salmonella infection. They then had diarrhea, headaches, rose spots on the abdomen. What is this called? What is the sequella?
|
Salmonella typhi = typhoid fever
can remain the gallbladder chronically! |
|
What is the common anticident bug to Guillain-Barre syndrome?
|
campylobacter jejuni
|
|
This bug grows at 42*C!
|
Campylobacter jejuni (may need to be cultured in CO2)
|
|
#1 cause of blood diarrhea in the US
|
Campylobacter jejuni
|
|
Transmitted from pet feces (puppies), contaminated milk or pork
|
Yersinia enterocolitica
- can mimic Crohn's (LQ pain) or appendicitis |
|
This bus tests positive on Urease breath test
|
Helicobacter pylori
|
|
What is the triple therapy for H. pylori infection?
|
PPI + 2 antibiotics:
PPI + clarithromycin + amoxicillin OR metronidazole (if allergic to penicillins) |
|
Name the animal associations with these bugs:
Bartonella henselae Pasturella multocida Toxoplasmosis Yersinia enterocolitica Leptospira Spirillum minus |
Bartonella henselae - cat SCRATCH
Pasturella multocida - dog/cat BITE Toxoplasmosis - CAT feces Yersinia enterocolitica - PUPPY feces Leptospira - animal URINE Spirillum minus - rat bites |
|
Bartonella spp. can cause what dz in immunocompromised pt's?
|
bacillary angiomatosis (often confused with Kaposi's sarcoma)
- get "regional lymphadenopathy" with cat scratch fever!! |
|
Borrelia burgdorferi lives on what?
|
deer & mice = LYME dz = erythema MIGRANS (not multocida!!)
|
|
A pt has recurrent fevers. He was dx with having borrelia recurrentis infections. What vector carries this infection?
|
Louce!!
|
|
A pt has increasing and falling fever episodes. He went to visit a farm yesterday, petted some animals, and drank their awesome unpasteurized milk.
Bug? |
Brucella spp = Brucellosis/undulant fever
"UNpasteurized dairy products give you UNdulant fever" |
|
A hunter has ulcers on his hands. He was skinning rabbits and deer (he's good) earlier from his hunting trip. What bug did he get?
|
Francisella tularensis ("imagine a rabbit eating a tulip") = Tularemia
- commonly in Arkansas and Missouri!!! |
|
Contact with prairie dogs can cause which infection?
|
Yersinia pestis = buboes
|
|
Kid got bitten by a dog. What treatment would you do?
|
Prophylaxis tx with penicillin, sulfa's, OR doxy if allergic! (QB question!)
|
|
What is the mc bug in the colon?
|
bacteroides fragillis = can cause peritonitis is colon is perforated
|
|
A guy was involved in a knife fight and got stabbed in the abdomen, which perforated his descending colon. Other than bleeding all over the place, which infection is possible now that his colon is perforated?
|
Peritonitis d/t Bacteroides fragillis (mc organism in the colon!)
|
|
Legionella is common in which 3 population groups?
|
elderly SMOKER (usually MALE)
heavy DRINKER (usually MALE) immunocompromised Ie. "56 yo male smoker presents with new cough and flu-like sx. Gram stain = no organisms, but silver stain shows rods" |
|
54yo homeless alcoholic male presents to the ER with productive cough. CXR shows lobar pneumonia. Bug?
|
Klebsiella pneumo
|
|
Corneal infections in contact lens wearers
|
pseudomonas!
|
|
Difference between Ghon focus and Ghon complex
|
Ghon focus = calcified scar in the lung
Ghon complex = ghon focus + hilar nodes! |
|
What are the 3 DDx for a pt who presents with an apical lung lesions?
|
1) 2* TB
2) Fungus ball (aspergillus) 3) Pancoast tumor = Horner's syndrome |
|
You think your pt has TB. What culture is used to grow the bug which causes TB?
|
Mycobacterium is VERY slow to grow, and thus takes 2-4weeks to culture.
Cultured on Lowenstein-Jensen Agar! |
|
What bug has it's reservoir in Armadillos?
|
Mycobacterium leprae!
|
|
Which leprosy type is communicable, the lepromatous or tuberculoid type?
|
lepromatous type (it's d/t a weak T-cell mediated immunity)
|
|
What are the two main uses of Dapsone?
|
Pneumocystic carinii
Mycobacterium leprae |
|
What is the tx for leprosy?
|
long-term oral dapsone....or tri-tx method with rifampin, clofazimine and dapsone
|
|
Which bacteria is associated with water contaminated with animal urine?
Which virus is associated with water contaminated with animal urine? |
Leptospira interrogans (one of the few bugs that causes JAUNDICE!!!!)
Hanta virus (rodent/mice urine) |
|
What is the tx for early early Lyme dz (stages I and II?
What is the tx for late Lyme dz (stage 3)? |
early = doxycycline
late = ceftriaxone |
|
What is the tx for syphilis? What if allergic to this drug?
|
DOC = pen G
if allergic to penicillins = doxy! |
|
What is the tx for early early Lyme dz (stages I and II?
What is the tx for late Lyme dz (stage 3)? |
early = doxycycline
late = ceftriaxone |
|
What is the tx for syphilis? What if allergic to this drug?
|
DOC = pen G
if allergic to penicillins = doxy! |
What is this image showing?
What dz is it associated with? |
Tabes dorsalis (neurosyphilis) - associated with 3* Syphilis!
= degeneration of bilateral dorsal columns = loss of touch, pain & proprioception |
|
What are the three bugs that can cause a rash on the palms and soles?
|
"CARS" mnemonic = you drive a car with your PALMS and SOLES
Coxsackie A virus Rickettsia (Rocky mountain spotted fever) Syphilis (2*) |
|
"tree barking" of the aorta described what? What's it due to?
|
3* Syphilis
- d/t vasa vasorum destruction |
|
Pupils that constricts on accommodation but does not react to light. Should make you think of which dz?
|
3* Syphilis (Argyll Robertson pupil) = like a prostitute...which accommodates but doesn't react!
|
|
What does the Romberg test measure? Which bug causes a dz that causes a + Romberg test?
|
3* syphilis!
Your body has 3 things which assess where your body is in space so you don't fall = vision, vestibular apparatus & proprioception (from dorsal column). You need 2 of these to be intact to functions. Tabes dorsalis causes destruction of the dorsal columns...so now you only have 2 things intact: vision and vestibular apparatus. For the Romberg test, the pt closes their eyes, so the only thing left is the vestibular apparatus...so they would fall over. So the test measures intactness of the proprioceptive info and vestibular info (after vision is taken away) |
What is this xray showing?
What dz is this associated with? |
"Saber shin" - anterior bowing of the tibia
- associated with congenital syphilis! |
|
Screen syphilis with this test:
Confirm a + syphilis test with this: |
VDRL
FTA-ABS |
|
VDRL is a test used to screen for syphilis. It's also a mnemonic for the false VDRL positives...what are they?
|
Viruses (mono = EBV; Hepatitis)
Drugs Rheumatic fever (S. pyogenes) Lupus and leprosy (M. leprae) |
What is this image of?
What is it associated with? What is DOC to tx this? |
Clue cells
Gardnerella vaginalis (gray/thin vaginal discharge with FISHY smell; nonpainful!) Tx: Metronidazole (get Gap on the Metro) |
|
What are almost all of the Rickettsiae dz's treated with?
|
Doxycycline
|
|
Rickettsia typhi causes what? What's the vector?
Rickettsia prowazekii causes what? What's the vector? |
R. typhi = ENdemic typhus (FLEAS)
R. Prowazekii = ePIdemic typhus (human body louse) |
|
Q fever is Queer. Why?
|
Q fever is caused y Coxiella burnetti...which is a type of Rickettsial bug.
It's Queer because unlike the rest of the Ricketssial bugs, it has: no fever no vector negative Weil-Felix rxn Can survive a long time outside (d/t being a spore former) does not have Rickettsia as its genus name |
|
Which rickettsial bug is the ONLY rickettsial bug that does NOT have a positive Weil-Felix reaction?
|
Coxiella burnetii (Q fever!)
|
|
+ Weil-Felix reactions test for which bugs?
|
Rickettsial bugs (except Coxiella burnetii)
|
|
Rickettsia rickettsii causes RMSF...it's carried by which tick?
|
Dermacentor tick
|
|
A pt presents with a severe lung dz. Hx reveals that sx began a month ago after he bought a pet parrot. Dx?
|
Chlamydia psittaci
- causes psittacosis! |
|
Which 3 bacteria are known to cause atypical/walking/interstitial pneumonia?
|
MC is mycoplasma pneumo
chlamydia pneumonia legionella pneumophilia |
|
Tx for chlamydia?
|
azithromycin/erythromycin
doxycycline |
|
Pt presents with ulcers on his skin and inguinal lymphadenitis for 6 weeks now. Culture of the ulcers shows basophilic inclusion bodies w/in the epithelial cells. Dx?
|
Chlamydia tachomatis types L1, L2, L3
|
|
An infant is born and has red eyes. PE shows new blood vessel growth in the eyes. Culture shows basophilic inclusion bodies w/in the epithelial cells. Dx?
|
Chlamydia tachomatis (D-K) - causes neonatal conjunctivitis...so that's why newborns all get erythromycin/azithromycin put into their eyes
|
|
How is Mycoplasma pneumoniae treated?
|
tetracyclines or azithromycin/erythromycin
|
|
The ONLY backteria containing cholesterol.
|
Mycoplasma pneumoniae
|
|
Which E. coli produces Shiga-like toxin?
|
EHEC (O157:H7) = causes HUS (anemia, thrombocytopenia and ARF!)
|
|
Most common causes of meningitis in
0 - 6 mos 6 mos - 6 yrs 6 yrs - 60 yrs >60yrs |
0 - 6 mos = GBS, E. coli, Listeria
6 mos - 6 yrs = S. pneumoniae, N. meningitidis, H. inf type B, enteroviruses 6 yrs - 60 yrs = S. pneumoniae, N. meningitidis, enteroviruses, HSV >60yrs - S. pneumoniae, G - rods, Listeria |
|
This fungus exists as yeast with speudohyphae at 20*C, and forms a GERM TUBE at 37*C.
|
Candida albicans
|
|
What are the two possible tx for Candida?
|
superficial infections = nystatin (swish and swallow)
serious systemic infections = amphotericin B |
|
Meningitis in AIDS or Hodgkin pts...which fungi should you immediatley think of?
|
Cryptococcus neoformans
|
|
Pt has AIDS. Brain imaging shows a "soap bubble" lesion in the brain. Dx?
|
Cryptococcus neoformans
|
|
This fungus is a MOLD with septate hyphae that branch at ACUTE angles (45* or less).
This fungus is a MOLD with irregular NONSEPTATE hyphae branching at WIDE angles (90* or more) |
Aspergillus fumigatus
Mucor and Rhizopus |
|
"fungus ball"
|
Aspergillus fumigatus
|
|
Ketoacidotic diabetic pt or leukemic pt with rhinocerebral infection
|
Mucor or Rhizopus spp.
|
|
Frontal lobe abscesses and black necrotic eschar on face...
|
Mucor or Rhizopus spp.
|
|
"spaghetti and meatball" appearance on KOH prep
|
Tinea versicolor, caused by Malassezia furfur
"yeast clusters & short curved septate hyphae" |
|
This fungus can cause areas of hypopigmented and/or hyperpigmented patches d/t melanocyte damage
|
Tinea vesicolor d/t Malassezia furfur infection
|
|
What three species of fungi cause tinea pedis, cruris, corporis, capitis, unguium, etc?
|
Microsporum
Trichophyton Epidermophyton |
|
Most of these fungi exist as mold in the cold, and yeast in the heat. "COLD MOLD, YEAST HEAT"
|
Systemic mycoses:
Histoplasmosis Blastomycosis Coccidioidomycosis (this one is NOT a yeast in tissue, but a spherule) Paracoccidioidomycosis |
|
This systemic fungus "hides" in macrophages
|
Histoplasma = "Histo Hides"
|
|
This systemic fungus is commonly seen in spelunkerer's (cave explorer's) & from bird/bat droppings
|
Histoplasma
|
|
What are the 5 bugs (bacteria, fungi, viruses) that can cause dz from birds?
|
Histoplasmosis (bats/birds/cave exploreres)
Cryptococcus Chlamydia Avian influenza virus WNV |
|
Systemic mycosis bug that looks like a "Captain's wheel"
|
Paracoccidioidomycosis - found in Latin America
"Paracoccidio Parasails with captain's wheel all the way to Latin America" |
|
A man got a splinter while walking though a garden yesterday. 2 days later he has a nodular pustule on his hand, that seems to be creeping up past the wrist. Culture shows cigar-shaped yeasts.
Dx? Tx? |
Dx: Sporotrichosis from Sporothrix schenckii
Tx: itraconazole or POTassium iodide ("plant a rose in the pot" (itraconazole sounds kind of rough...so does sporothrix...) |
|
What is the MOA of amphotericin B?
|
Amphotericin TEARS HOLES in the plasma membrane = binds ERGOSTEROL (unique to fungi) and forms membrane pores = leakage of electrolytes
|
|
What is the MOA of Nystatin?
|
SAME as amphotericin B (TEARS HOLES in the plasma membrane = binds ERGOSTEROL (unique to fungi) and forms membrane pores = leakage of electrolytes)
|
|
What is the MOA azole drugs?
|
Indirectly block ergosterol SYNthesis but inhibiting the P450 enzyme which converts lanosterol to ergosterol
|
|
Only this fungal med can be used for cryptococcal meningitis in AIDS because it can cross the BBB.
|
Fluconazole
|
|
Which endocrine side effect are caused by azole drugs?
|
they block hormone synthesis (ie. testosterone) = gynecomastia
|
|
Fungal tx used for invasive aspergillosus
|
cASPofungin = ASPergillosis
- blocks synthesis of beta-glucan |
|
Two fungal drugs used for dermatophytoses infections ("phytons") and onychomycosis (toe/fingernail infections)
|
Terbinafine (blocks a precursor of ergosterol formation, squalene epoxidase)
and Griseofulvan (grab's microtubule's with it's greasy fingers) |
|
Parasite that causes bloody diarrhea and liver abscesses
|
entamoeba histolytica
- "flash shaped ulcers" - RBC's in the cytoplasm of entamoeba! |
|
Meningitis in AIDS pt's
Severe diarrhea in AIDS pt's Brain abscess in AIDS pt's |
cryptococcus neoformans
cryptosporidium Toxoplasma gondii |
|
AID's pt has SEVERE diarrhea...which stain is used to confirm the dx?
|
ACID-FAST stain for cryptosporidium
3 bugs are acid fast: mycobacterium nocardia cryptosporidium (only one that is a protozan!) |
|
AID's pt has SEVERE diarrhea...which stain is used to confirm the dx?
|
ACID-FAST stain for cryptosporidium
3 bugs are acid fast: mycobacterium nocardia cryptosporidium (only one that is a protozan!) |
|
This protozoan causes rapidly fata meningoencephalitis, and is aquired from swimming in FRESHWATER lakes.
|
Naegleria fowleri
- think of NALGENE bottle filled with FRESHWATER containing Naegleria - enters CNS via cribriform plate - Tx with Amp. B |
|
A guy was visiting Africa. He now has recurring fever and feels very sleepy. He remembers that some fly bit him a few days ago and it was very painful.
Dx? Tx? |
Trypansoma brucei, gambiense or rhodensiense (NOT cruzi!!)
- African sleeping sickness; enlarged LN; recurring fever d/t ANTIGENIC variation; sleepy, coma - d/t bite of a TSETSE FLY and is PAINFUL!!! Tx: SURamin (blood borne) or MELArsoprol for CNS; Also pentamidine; ("It SURe is nice to go to sleep. MELAtonin helps with sleep") |
|
A guy was visiting South America and now has cardiomyopathy, megacolon and megaesophagus. He doesn't remember being bit because there was no pain of any kind
Dx? Which bug bit him? Tx? |
Dx: trypanosoma cruzi = Chaga's dz
Transmitted by the Reduviid bug, which is a PAINLESS bite (unlike the rest of the trypanosoma spp which is from the Tsetse fly = painful bite) Tx: Nifurtimox |
|
A woman presents with spiking fevers, heptosplenomegaly and pancytopenia. Culture shows macrophages containing a parasite that lacks flagella.
Dx? Vector? Tx? |
Leishmania donovani
- visceral leishmaniasis: spiking fevers, hepatosplenomegaly, pancytopenia Vector: SANDFLY!!! Tx: sodium stibogluconate |
|
Which protozoan is transmitted via the SANDFLY??
|
Leishmania donovani
|
Pt has daily fevers.
Dx? |
Plasmodium FALCIPARUM: malaria
|
Pt has daily fevers.
Dx? |
Plasmodium FALCIPARUM: malaria
|
|
How do the different types of plasmodium differ in their fever frequency?
|
Plasmodium falciparum = daily cycles
P. vivax/ovale = every other day P. malariae = every 3 days |
|
"rigid banana shaped gametes in RBC's"
or Trophozoite ring form in RBC's |
Plasmodium falciparum!!!
|
|
A guy was visiting Connecticut and he notices a tick on his arm. He pulls it out with his hands, and a few days later brings it to a doctor. The doctor thinks the pt has Lyme dz. However, the blood smear shows a maltese cross and some ring forms in RBC's
Dx? Vector? Tx? |
Babesia causing Babesiosis
- fever and hemolytic anemia - blood smear: maltese cross & ring forms (like P. falciparum) Vector: Ixodes tick (same as Borrelia burgdorferi in Lyme dz..can coinfect!) Tx: quinine, clindamycine |
|
A 19 yo female is sexually active. She presents with a foul-smelling, frothy/greenish discharge. She says it burns and itches down there. You stain the discharge and see a parasite that has flagella and has (corckscrew-like) motility
Dx? Tx? |
Trichomonas vaginals (greenish discharge!!!)
- don't confuse with Gardnerella vaginalis (clue cells!) - both trichomonas and gardnerella increase the pH of the vagina!! Tx: metronidazole (same as Gardnerella!) |
|
This helminth is dx via the Scotch tape test
|
Enterobius vermicularis
- anal pruritis Tx: -bendazoles or pyrantel pamoate |
|
Giant roundworm found in GI tract
|
Ascaris lumbricoides
- eggs ingested..grow in GI..burrow though the GI wall and get into blood..spread systemically and also into alveoli of lungs where they lay eggs = you cough up the eggs and swallow them again = reinfect self!! Can also cause "Loeffleurs eosinophilic pneumonitis" Tx: -bendazoles or pyrantel pamoate |
|
A man eats some undercooked meat. He has muscle aches. Muscle biopsy shows a larva in the muscle...
Dx? |
Trichinella spiralis
tx: -bendazoles |
|
This helminth penetrates the SKIN and then can infect the GI tract & lungs, and cause autoinfection after you cough it up.
|
Strongyloides stercoralis (don't confuse wtih ascaris lumbricoides...which is acquired by ingestion of its eggs)
- can cause pneumonitis, malabsorption & autoinfection Tx: -bendazoles or invermectin |
|
These two helminths penetrate intact skin of BARE FEET, then migrate to lungs and can cause dry cough/fever/pneumonitis, and can also cause anemia by sucking blood from the GI tract.
|
Ancylostoma duodenale ("ankle")
& Necator americanus BOTH are HOOKworms..which hook to your feet when you walk - can cause an intense skin itch & a SERPIGINOUS eruption on feet |
|
Which 3 nematodes infect via ingestion?
Which 3 nematodes infect via cutaneous entry? |
Ingestion - Enterobius, Ascaris, Trichinella
- "you'll get sick if you EAT these!" Cutaneous - Strongyloides, Ancylostoma, Necator - "these get into your feet from the SANd!" |
|
Causes river blindness.
What is the vector? Tx? |
Onchocerca volvulus
- "river blindness" Vector: female BLACKfly = causes darkness = blindness! Tx: IVERmectin (for rIVER blindness!) |
|
Causes elephantiasis
Vector |
Wuchereria bancrofti
- takes 9 mo to 1 yr after bite to get elephantiasis sx Vector: female mosquito |
|
helminth that can cause granuloma formations (blindiness if in eyes) and visceral larva migrans that can lead to hepatosplenomegally.
Occurs from handling dogs or cats |
Toxocara!
Toxocara canis - dogs Toxocara cati = cats |
|
What are the other (undestandable) names for:
Nematodes Cestodes Trematodes |
Nematodes = roundworms; Tx: mostly -bendazoles & some pyrantel pamoate & ivermectin
- enterobius vermicularis - ascaris lumbricoides - trichinella spiralis - strongyloides stercoralis - ancylostoma duodenale - necator americanus - onchocerca volvulus - wuchereria bancrofti - toxocara canis Cestodes = tapeworms; Tx: praziquantel or bendazoles - Taenia solium - Diphyllobothrium latum - Echinococcus granulosus Trematodes = flukes = leaf shaped! Tx: praziquantel - Schistosoma - Clonorchis sinensis - paragoniumus westermani |
|
Tapeworm infection from eating undercooked pork
Tx? |
Taenia solium
- can cause custicercosis or neurocysticercosis = mass lesions in brain ("swiss cheese" appearance) which can present as altered mental status or other CNS problems!! Tx: - bendazoles (esp. if CNS sx) or praziquantel |
|
This tapeworm can cause pernicious anemia sx from ingestion of larvae from raw freshwater fish!
Tx? |
Diphyllobothrium latum
- Causes Vit B12 deficiency = anemia!! Tx: praziquantel |
|
This tapeworm can cause cysts in liver and ANAPHYLAXIS if the Ag is release from the cysts
Tx? |
Echinococcus granulosus
- eggs in DOGS feces. - ANAPHYLAXIS!!! Tx: - bendazoles |
|
This helminth causes RECTAL PROLAPSE
|
Trichuris trichiura
- likes the cecum! - can also cause appendicitis |
|
Which helminth?
inflammation of the biliary tract, which causes pigmented gallstones & possible colangiocarcinoma Tx? |
Clonorchis sinensis = from undercooked fish
- PIGMENTED gallstones - BILIARY tract infection - CHOLANGIOCARCINOMA Tx: praziquantel |
|
This helminth has it's vector as the SNAIL...which can penetrate the skin when you step on it.
Tx? |
Schistosoma
- inflammation of the spleen & liver = portal HTN; hepatosplenomegally; ascites Tx: praziquantel |
|
This helminth, which looks like a leaf, can infect the lung and cause hemoptysis
Tx: praziquantel |
Paragonimus westermani
- from undercooked CRAB meat - can cause a 2* bacterial infection leading to HEMOPTYSIS Tx: praziquantel |
|
Main treatment for Pediculosis capitis, caused byb Pediculus humanus...AKA lice
& Pediculosis pubic = Phthirus pubis...AKA "crabs" |
Permethrin cream
or Pyrethin FOR LICE AND CRABS! (for crabs, all sexual partners must be tx, and bedding/clothing must be changed) |
|
Which vaccines are LIVE attenuated?
|
induce both humoral and cell-mediated immunity
SMALLpox YELLOW fever CHICKENpox (VZV) SABIN's polio virus MMR InFLUenza (intranasal) "The live small yellow chickens get sabin's & MMR & FluI!" |
|
Which vaccines are the KILLED vaccines?
|
induce only humoral immunity, but stable
Rabies Influenza (IM) salk Polio HAV "RIP Always" |
|
Which two vaccines are the recombinant vaccines?
|
HBV
HPV |
|
Which 3 vaccines are egg-based?
|
MMR
Influenza (need skin test) Yellow fever (need skin test) |
|
What is the Tzanck test for?
|
for HSV1, HSV2 and VZV
it's a smear of an opened skin vesicle to detect MULTINUCLEATED GIANT CELLS!!! |
|
A 5 mo girl has had very high fevers for a few days. Yesterday her fever broke, but she developed a lacy body rash. Dx?
|
HHV-6 = Roseola
|
|
Aplastic crisis in sickle cell dz is most commonly caused by which virus?
|
Parvovirus B19!
|
|
Which virus causes Fifths disease?
|
Parvovirus B19
|
|
Kid presents with reddened conjunctiva, swollen eyelids & watery discharge.
What is the most common bug causing this? |
Adenovirus = most common cause of conjunctivitis (naked, double stranded DNA)
|
|
This virus is dangerous to fetuses because if transmitted, can cause hydrops fetalis.
|
Parvovirus B19
|
|
This virus causes PML (progressive multifocal leukoencephalopathy) in HIV
|
JC virus!
|
|
What two drugs are used for Hep C tx?
|
Alpha-Interferon
& Ribovirin |
|
Which virus causes molluscum contagiosum?
|
Poxvirus
molluscum contagiosum = flesh-colored dome lesions with central dimple |
|
Which virus leads to SSPE (subacute sclerosing panencephalitis?
|
Rubeola virus (measles)
|
|
Which virus "makes your parotid glands and testes as big as POM-poms?"
|
Mumps!
|
|
How does the rabies virus get to the CNS?
|
migrates in a retrograde fashion up nerve axons
|
|
Which protein on the HIV attaches to host T cells?
|
gp120 ***********!!!!
|
|
People who are homozygous for CCR5 have which course of HIV?
What if heterozygous CCR5 mutation? |
homozygous CCR5 = immunity to HIV
heterozygous CCR5 = slower course |
|
HIV gp120 virus binds which receptors on the T cells?
Which receptors on macs? |
T-cells = CXCR4 & CD4
macs = CCR5 & CD4 |
|
A baby is born to a mother who is HIV positive. There was no mixing of blood during labor. The ELISA & Western blot tests say that the baby has a + HIV test. Is the baby really infected with the HIV virus?
|
NO
the Anti-gp120 antibodies from the mother can cross the placenta and hang out in the baby, thus giving + ELISA (screening) and western blot (confirmation) tests, since they both look for Ab in the serum. The actual HIV virus does NOT cross the placenta! |
|
What are the TORCHHS (TORCH) infections?
|
Toxoplasma gondii
Other (Parvovirus B19) Rubella CMV HIV Herpes simplex virus Syphilis |
|
A child is born and presents with chorioretinitis, hydrocephalus and intracranial calcification's.
Which bug caused this problem? |
Toxoplasma gondii (TORCH infection)
|
|
A child is born and presents with heart dz (murmur heard), cataracts and deafness
Which bug caused this problem? |
Rubella (TORCH infection)
- may also present with a "blueberry muffin" rash |
|
A child is born and presents with a rash an UNILATERAL hearing loss.
Which bug caused this problem? |
CMV (TORCH infection)
- may also have a microcephaly, jaundice and growth retardation, seizures |
|
These two TORCHHS infections can cause hydrops fetalis
|
Syphilis
Parvovirus B19 |
