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587 Cards in this Set
- Front
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1. Nausea, vomiting (onset < 6 hr) after eating cold cuts, or potato salad, or mayonnaise, or custards is caused by
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Staphylococcus aureus
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2. Rapid-onset food poisoning mediated by staphylococcal
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Enterotoxin
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3. Tx of staphylococcal food poisoning
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Rehydration
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4. Nausea and vomiting, +/- diarrhea (onset < 6 hr) after eating reheated rice is caused by
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Bacillus cereus
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5. Bacterial spores are resistant to heat due to
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dipicolinic acid core
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6. Nausea, vomiting, watery diarrhea w/ rapid (onset >6 hr) after eating reheated meat or gravy is caused by
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Clostridium perfringens
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7. Peptic-ulcer dz (PUD) in a patient w/o NSAIDs use is caused by
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Helicobacter pylori
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8. Helicobacter pylori attaches to gastric cells inducing
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inflammation and cytokines
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9. Abx treatment and H. pylori eradication significantly impact
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PUD and MALT
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10. First-line, triple-drug regimen for PUD due to H. pylori is
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PPI + clarith + amox
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11. Acute, severe secretory diarrhea, vomiting, severe dehydration, during travel to tropics, is caused by
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Vibrio cholerae
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12. Cholera (A-B, subunit) toxin induces secretion of Na and bicarbonate-rich non-inflammatory fluid from
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Small intestine
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13. Vibrio cholerae is isolated from stool by culture on
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thiosulfate-citrate-buffered sucrose (TCBS) agar
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14. Aerobic, gram negative, comma-shaped bacilli of cholera are microscopically similar to
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Campylobacter
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15. Tx to avoid mortality of cholera is
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Ringer’s lactate with extra K+
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16. Besides rehydration, treat cholera as soon as vomiting ceases with
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doxycyline
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17. Secretory diarrhea, fever and vomiting during travel are caused by
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Enterotoxic E. coli
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18. Secretory diarrhea w/ fatty, foul-smelling stools in campers, hikers;also day-care outbreaks is caused by
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Giardia lamblia
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19. Following ingestion of 15-25 cysts, excysted trophozoites adhere at brush border of enterocytes and contribute to malabsorption. TOW?
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Giardiasis
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20. Dx of giardiasis is confirmed by
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Stool antigen (+)
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21. Giardiasis is specifically treated with
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Metronidazole
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22. Protracted, secretory diarrhea w/ large fluid loss in AIDS is caused by acid-fast protozoa
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Cryptosporidium >> Cyclospora > Isospora
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23. Frank bloody diarrhea, after drinking roadside fruits drinks, is caused by
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E. coli O157:H7
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24. Pathogenesis of hemorrhagic enterocolitis caused by E. coliinvolves
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Shiga toxin (a cytotoxin)
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25. Complication of hemorrhagic enterocolitis in children
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hemolytic uremic syndrome
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26. Profuse diarrhea, fever, vomiting, and dehydration in infants is caused by
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Rotavirus
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27. Mechanism of rotaviral diarrhea involves
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Villus destruction
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28. Infantile watery diarrhea and fever are caused by
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Adenovirus 40,41
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29. Outbreak of nausea, vomiting, fever in adults is caused by
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Norovirus
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30. Cause of nausea/vomiting, abdominal cramps, diarrhea +/- bloody12-48h after eating eggs or poultry or peanut butter?
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Non-typhoidal Salmonella
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31. Abx treatment of uncomplicated acute gastroenteritis due toSalmonella forces condition of
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carrier (in bile ducts) state
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32. Abx used only to treat septic phase of salmonella gastroenteritis is
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ciprofloxacin
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33. Cause of fevers (>103°), headaches; macular rash on torso (“rose spots”) abdominal pain and little diarrhea later in a pt with hx of travel (to tropics)?
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Salmonella typhi
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34. Cause of diarrhea w/ occult blood, abdominal cramping and fever,2d after ingestion of poultry-contaminated salad
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Campylobacter jejuni
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35. Abx to treat campylobacter enteritis with high fevers in pregnancy, and HIV is
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Erythromycin
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36. Cause of dysentery-like illness with fever + abdominal cramps, tenesmus + blood & mucus in children?
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Shigella sonnei
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37. Dysentery due to invasive Shigella spp. in elderly is treated with
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Ciprofloxacin
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38. Cause of dysentery-like illness (+/- pseudoappendicitis) in the northern region after eating cheese
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Yersinia enterocolitica
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39. Cause of dysentery-like illness in a patient w/ hx of broad-spectrum abx use
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Clostridium difficile
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40. Clostridium difficile-associated diarrhea (CDAD) is mediated by toxins
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A (enterotoxin) + B (cytotoxin).
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41. Lab confirmation of CDAD is based on
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stool toxins A or B positive
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42. Besides rehydration and cessation of inciting meds, CDAD is treated with
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Metronidazole (mild) or oral vancomycin (severe/relapse)
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43. Health-care associated (nosocomial) spread of Clostridium difficilediarrhea and protracted outbreak is due to
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Soiling/contact or spores in rooms
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44. Hx of abdominal pain, tenesmus, stools with mucus + blood in a patient, who recently traveled to tropics; CBC: eosinophilia. TOW?
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Amebic dysentery
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45. Stool microscopy to confirm amebic dysentery should reveal characteristic trophozoites of Entamoeba histolytica w/
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endocytosed RBCs (distinction from luminal ameba)
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46. Rx of amebic dysentery involves
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Metronidazole + iodoquinol
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47. Abscesses in liver or peritonitis in travelers w/ or w/o hx of amebic dysentery is confirmed by
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Serology for E. histolytica
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48. A boar hunter develops dysentery after eating meat at campsite; O& P test should reveal a ciliate parasite, known as
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Balantidium coli
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49. Most likely cause of chronic abdominal pain, diarrhea; intestinal obstruction; cholangitis; liver abscess, in children
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Ascaris lumbricides
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50. Ova & Parasite test using microscopy for oval eggs (with a thick coarse shell) in stool confirms
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ascariasis
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51. A child has stomach ache, distended abdomen, poor appetite. “Pearl-colored earthworm”-like organisms in the stool. Major immune response against this infection?
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IgE
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52. DOC of ascariasis is
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Mebendazole
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53. Vomiting, cramping, diarrhea, epigastric pain, weight loss in an immigrant from developing country is caused by
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Strongyloides stercoralis
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54. DOC of strongyloidosis is
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Ivermectin
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55. Pt w/ AIDS (low CD4+ counts) develops pulmonary infiltrates (+eosinophilia) and/or gram negative sepsis. TOW?
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Invasive strongyloidosis
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56. Weakness, fatigue, lightheadedness, dyspnea, pruritis; pallor; iron- deficiency anemia; eosinophilia (hx of outdoor activity). TOW?
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Hookworm (Necator americanas) infection
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57. Fever, periorbital edema, subconjunctival hemorrhages, muscle weakness, and rash, after eating undercooked pork (Lab: eosinophilia., ↑CPK, ↑LDH &). TOW?
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Trichinellosis
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58. Abdominal pain, bloating, altered appetite after ingestion of sushi.CBC: megaloblastic anemia; leukocytosis/eosinophilia. TOW?
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Diphyllobothriasis (fish tapeworm)
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59. Dx of tape worm infection is confirmed by
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Proglottids in stool
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60. Tape worm infections are treated with broad-spectrum agent
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Praziquantel
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61. Cause of fever, lymphadenopathy, hepatosplenomegaly in an immigrant from Africa or Orient; pt recalls wading in stagnant water. RUQ ultrasound (+); CBC: eosinophilia.
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Schistosoma mansoni (Africa)S. japonicum (Far East)
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62. Microscopy of stool in chronic stage of schistosomiasis reveals
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Large eggs with lateral spine.
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63. Chronic stage of schistosomiasis is treated with
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Praziquantel
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64. Patient with acute jaundice is HAV IgM (+); household contact should receive for prophylaxis
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Inactivated HAV vaccine
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65. Patient with jaundice for < 1 week has HBsAg (+), Anti-HBc IgM (+). TOW?
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Acute HBV infection
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66. Multiple sex partners, IDU, infants born to infected mothers are risk groups for which hepatitis virus
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HBV
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67. This is an enveloped, double stranded DNA virus w/ ss-break;transmitted by infective body fluids. TOW?
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HBV
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68. This asymptomatic man has hep serology profile of HBsAg (-), Anti-HBs (+), Anti-HBc IgG (+), Anti-HBc IgM (-). TOW?
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Resolved hepatitis B
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69. This man has jaundice and is HBsAg (+) > 6 months, Anti-HBs (-), HBeAg (+), Anti-HBc IgG (+), HBV DNA > 20,000 IU/ml. TOW?
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Chronic active hepatitis B
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70. This man has jaundice and is HBsAg (+) > 6 months, HBeAg (+)and evidence of necroinflammation. He should receive
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Peg-IFN 2a + lamivudine(or cidofovir)
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71. This man has no jaundice, but HBsAg (+) >6 months, Anti-HBs (-), Anti-HBc IgG (+), HBeAg (-), persistently normal ALT. TOW?
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Inactive HBsAg carrier
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72. This man, at the time of annual physical exam, reveals Anti-HBs (+) and other markers are (-). TOW?
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HBV immunized
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73. Virologic confirmation of chronic jaundice in a HBV-immunized pt w/ IDU or hemodialysis is based on
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HCV RNA > HCV IgG
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74. More chronicity of HCV (than HBV) is due to immune-evasive quasispecies generated during replication (in blood) of
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error-prone HCV RNA virus
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75. Fulminant hepatitis in a patient, who has multiple sexual partners and is HBsAg (+); HBcIgM (-), can be fatal due to what?
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HDV superinfection.
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76. Cause of acute onset of jaundice, nausea, right-upper quadrant pain, hepatomegaly in pregnant women in India
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HEV
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77. Fever, arthralgia, carditis, polyarthritis, chorea, erythema marginatum; elevated WBCs or ESR/CRP. Clinical Dx is confirmed by |
Rising ASO titer |
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78. Type II hypersensitivity due to molecular mimicry in a immunological sequel of streptococcal pharyngitis causes |
Acute rheumatic fever (ARF) |
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79. ARF is diagnosed and treated with |
Anti-streptolysin O (ASO) titer and benzathine penG. |
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80. A man with IDU has flu-like symptoms; 1-3 minor peripheral signs: conjunctival hemorrhage, Janeway lesions, Osler nodes, Roth spots, plus vegetation in tricuspid valve. Blood Cx (BCx) should yield |
S. aureus |
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81. A pt w/ hx of extraction of impacted tooth 3 weeks ago now has subacute (native, mitral-valve) endocardits. BCx should yield |
Viridans streptococci. |
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82. A pt w/ hx of St. Jude bypass 2 months ago has now subacute bacterial endocarditis. BCx should yield |
Staphylococcus epidermidis |
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83. A pt with AIDS and recent hx of UTI has now subacute, native mitral-valve endocarditis. BCx should yield |
Enterococcus faecalis (or faecium) |
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84. DOC of acute endocarditis in patient with IDU due to sensitive S.aureus (MSSA) |
Nafcillin +gentamicin |
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85. DOC of acute endocarditis in patient with IDU due to resistant S. aureus (MRSA). |
Vancomycin + rifampin |
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86. DOC of subacute, native mitral-valve endocarditits due to viridansstreptococci. |
PenG +/- gentamicin |
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87. DOC of subacute, prosthetic-valve endocarditis due toStaphylococcus epidermidis |
Vancomycin + gentamicin |
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88. DOC of subacute, native mitral-valve endocardits due toEnterococcus faecalis (or faecium) |
High-dose ampicillin +gentamicin |
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89. Patient with enterococcal bacteremia fails to respond tovancomycin. MOR of the organism |
D-Ala-D-Ala is changed to DAla-D-lac |
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90. Hx of catheter-related endocarditis, involving prosthetic or nativevalves. BCx (+) for budding yeast. Pt does not respond to AmphoBor fluconazole; should receive |
Caspofungin |
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91. Patient with colon cancer has bacteremia due to |
Streptococcus bovis |
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92. Cause of febrile, malaise, arthralgia, dyspnea, edema, palpitations.ST/T wave change, heart block, dysrhythmias; CXR: cardiomegaly |
Coxsackievirus > echovirus >Trypanosoma cruzi (Chagas) |
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93. Cause of runny nose, red throat, and nasal pus |
Rhinoviruses |
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94. Rhinoviruses and enteroviruses belong to picornavirus family, butthe rhinoviruses differ from enteroviruses on |
Growth at 22oC/noninvasive |
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95. Rhinovirus receptor in the nasal passages and uppertracheobronchial tree is |
ICAM-1 |
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96. Rhinovirus, influenza, parainfluenza, coronavirus, RSV,metapneumovirus, and adenovirus all cause |
Upper-respiratory infections(URIs) |
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97. Sinusitis, otitis, laryngitis, exacerbations of bronchitis and asthmaare mostly secondary to |
Viral URIs |
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98. In HEENT, Streptococcus pneumoniae, non-typable Haemophilus influenzae, Moraxella catarrhalis all cause |
Acute otitis media (AOM) &sinusitis |
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99. AOM and sinusitis are empirically treated with amoxicillin +clavulanate. Why use clavulanate? |
Haemophilus and Moraxellaare beta-lactamase producers |
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100. Cause of pharyngeal pain, dysphagia, fever; red throat +purulent exudate that responds to penicillin |
Streptococcus pyogenes (aka: Group-A Beta-hemolytic Streptococcus = GABHS) |
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101. GABHS is differentiated from GBBHS by what? |
Bacitracin sensitivity |
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102. Common mode of acquisition of URI due to Streptococcus pyogenes? |
Infective droplets |
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103. Major virulence factor with anti-phagocytic function ofStreptococcus pyogenes |
M-protein fibrils |
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104. Damage in posterior pharynx and tonsils due toStreptococcus pyogenes is associated with what host response? |
Pyogenic inflammation |
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105. DOC of acute bacterial pharyngitis in a pt w/ Pen allergy |
Erythromycin > clindamycin |
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106. Pyogenic complication of streptococcal pharyngitis |
Tonsillar abscess |
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107. Toxigenic complication of streptococcal pharyngitis |
Scarlet fever >> TSS (rare) |
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108. Immunologic complication of streptococcal pharyngitis |
Acute rheumatic fever (ARF) |
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109. Cause of fever, red throat + purulent exudate - pseudomembrane with lymphadenopathy, in a pt w/ questionable immunization. |
Corynebacterium diphtheriae |
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110. Gram/special stain of Corynebacterium diphtheriae should reveal |
Gram(+) rods in palisade arrangements/metachromatic granules. |
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111. Virulence genotype of Corynebacterium diphtheriae is acquired by |
Transduction (phage mediated transfer of exotoxin gene) |
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112. Isolate on tellurite agar culture of throat swab for a cause of diphtheria is confirmed by |
Immunodiffusion (ELEK)assay for toxin |
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113. Mechanism of action of exotoxin of Corynebacterium diphtheriae |
ADP ribosylation of EF-2 (inhibits protein synthesis) |
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114. Damage to pharynx and cardiac myosites due toCorynebacterium diphtheriae is mediated by |
Cytotoxicity of A-B toxin |
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115. Virologic Dx of URI symptoms, fever; red throat + purulent exudate; hepato-splenomegaly, lymphadenopathy, in a teenager, is confirmed by |
heterophile antibody (+) |
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116. Host cells preferentially infected by EBV are |
B cells |
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117. EBV is biologically similar to what class of viruses? |
herpes viruses |
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118. Host immune system controls the EBV infection, mediated by |
CD8+ T lymphocytes |
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119. Rash occurs following which antibiotic(s) to treat infectious mononucleosis? |
amoxicillin |
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120. Burkitt's lymphoma in some African population is a B-cell tumor due to oncogenesis by |
EBV |
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121. B-cell tumor in the Oriental population that consumes preserved fish, is due to oncogenesis by |
EBV
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122. Heterophile-negative infectious mononucleosis syndrome is due to ? |
CMV |
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123. Gram-positive bacteria that cause acute otitis media (AOM) |
Streptococcus pneumoniae |
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124. Gram-negative diplococci bacteria that cause AOM |
Moraxellar catarrhalis |
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125. Gram-negative coccobacilli bacteria that cause AOM |
Haemophilus influenzae |
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126. > 7 days of nasal obstruction, rhinorrhea; purulent nasal drainage + frontal pain/tenderness is treated with |
Amoxicillin & Clavulanate |
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127. DOC for acute mastoiditis in a young child is amoxicillin &clavulanate; why? |
Same etiology as AOM |
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128. Cause of "seal-like barking" cough + episodic aphonia w/symptoms of URI in a child |
parainfluenza virus |
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129. Gram-stain-nonreactive organism that causes redness; purulent discharge at lid margin/eye corners, in a newborn |
Chlamydia trachomitis |
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130. Most common cause of redness; tenderness; hyperpurulent d/c; eye stuck shut in AM, lid edema. Gram stain (+) |
Staphylococcus aureus |
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131. Cause of pharyngitis, conjunctivitis, fever with rhinitis, and cervical adenitis in a child. |
Adenovirus |
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132. Cause of burning, gritty feeling in eyes; diffuse conjunctival injection & profuse tearing + preauricular LN. |
Adenovirus
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133. Cause of foreign body sensation, lacrimation, photophobia, conjunctival hyperemia, and ulceration |
HSV-2>>1 |
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134. Cause of severe pain and skin lesions in dermatomal pattern involving the ophthalmic division of the trigeminal nerve. |
VZV |
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135. Cause of painful, swollen, red eyes, with conjunctival hemorrhaging and excessive tearing in an outbreak |
Enterovirus |
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136. Cause of chorioretinitis in AIDS, but CMV antigen (-) |
Toxoplasma gondii |
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137. Cause of painful keratitis, chronic corneal ulcers in contact |
Acanthamoeba spp. |
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138. In an infant w/ ?immunization, 2 wks of paroxysmal coughs, inspiratory "whoop" + post-tussive emesis. TOW? |
Bordetella pertussis |
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139. Pertussis toxin inhibits chemotaxis via downregulation of C3a/C5a receptor, resulting in? |
Lymphocytic leukocytosis in CBC |
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140. Three major virulence factors of "whooping cough" pathogen? |
ADP-ribosylating toxin; tracheal cytotoxin; hemolysin |
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141. Cause of fever + drooling, stridor, dyspnea in a child w/?immunization (pt appears septic) |
Haemophilus influenzae b |
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142. Major virulence factor of Haemophilus influenzaeassociated with pneumonia and meningitis |
Capsular polysaccharide(antiphagocytic and anti-C3b) |
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143. Since, absent spleen places host at increased risk for invasive H. influenzae infection, pre-exposure prophylaxis prior to elective splenectomy is ? |
Hib immunization |
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144. Cause of acute exacerbation (cough, purulent sputum) in pt with chronic bronchitis (COPD); CXR: R/O pneumonia; Lab: sputum reveals Gram-negative coccobacilli. |
Haemophilus influenzae (non capsular types) |
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145. Tx of AECB, caused by an organism that needs NAD +hematin for growth; -lactamase (+), is |
Ceftriaxone (severe) >. Amoxicillin-clavulanate (mild) |
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146. Most common cause of lower-respiratory infections in neonates (babies < 4 wk)? |
Streptococcus agalactiae(aka: group B streptococcus) |
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147. Complicated illness in a newborn of a GBS-colonized mother is |
Sepsis or meningitis |
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148. A mother colonized (recto-vaginally) w/ GBS is at risk for preterm baby or premature membrane rupture. She should receive |
Ampicillin |
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149. An elderly comes up with an abrupt-onset fever, myalgia, headache, malaise, dry cough, sore throat and rhinitis, in winter. Illness could have been prevented w/ ? |
annual influenza vaccine |
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150. Annual influenza vaccine protects at-risk subpopulation w/60% immune protection, and is composed of what 3 viruses? |
A:H1N1 + A:H3N2 + B |
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151. Secondary spread of influenza occurs in a crowded setting(within 6 feet of infected person) via |
respiratory droplets |
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152. Annual vaccine to prevent influenza is needed due to antigenic drift. This occurs due to what genetic mechanism? |
Mutation |
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153. Occasionally serious pandemic of influenza occurs due to antigenic shift. This occurs due to what genetic mechanism? |
Reassortment of 8 genomic segments |
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154. DOC of pts with influenza <48 hours is |
Oseltamivir |
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155. Bacterial superinfection, causing pneumonia, after influenza occurs in elderly (in LTCF) due to what? |
S. pneumoniae > S. aureus(common) (severe) |
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156. A seriously ill young adult w/ necrotizing pneumonia, poorly responding to vancomycin, should get |
Linezolid |
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157. Cause of febrile illness + bronchiolitis in an infant; BALviral culture (+). |
Respiratory syncytial virus(RSV) |
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158. RSV causes seasonal, nosocomial pneumonia outbreaks in the pediatric units via |
Contact spread |
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159. Pathophysiology of asthmatic Sx + Sn in bronchioles in high-risk infants due to RSV involves |
type III hypersensitivity |
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160. Inhaled anti-viral drug used in the sickest infants with bronchiolitis is |
Ribavirin |
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161. Insidious onset of fever, dry cough, malaise and sore throat in young adults. CBC: anemia; CXR: diffuse infiltrates. TOW? |
Mycoplasma pneumoniae |
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162. Dx of “walking pneumonia” in older children and youngadults, while waiting for serology, is supported by |
cold agglutinin (IgM Ab against RBCs) titer 1:32 |
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163. Mycoplasma spp. is an atypical bacterial pathogen and is hard to grow because of fragility due to lack of |
Cell wall |
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164. Beta-lactam abx is ineffective for Tx of mycoplasma pneumonia because |
Wall-less bacteria |
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165. A male child with mycoplasma pneumonia now has systemic rash, covering 10% of his body. TOW? |
erythema multiforme (SJS) |
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166. Cause of upper respiratory Sx, slow onset of cough(laryngitis) >2wks + CXR: patchy infiltrate, viral serology (+) |
Chlamydophila pneumoniae |
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167. The most common cause of community-acquired pneumonia (CAP) is |
Streptococcus pneumoniae |
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168. Cause of rapid onset of high fever, cough, & sputum, dyspnea; tachypnea in an elderly; CXR: lobar infiltrate; CBC: pronounced neutrophilic leukocytosis with left shift, is |
Streptococcus pneumoniae
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169. Gram-positive diplococci from sputum from a patient with lobar pneumonia yield α-hemolytic colonies and are confirmed by |
Capsular swelling (Quelling rxn) |
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170. α-hemolytic colonies of Streptococcus pneumoniae is differentiated from viridans streptococci definitively confirmed by |
Optochin sensitivity |
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171. Population w/ increased incidence of pneumococcal pneumonia is |
AIDS |
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172. increased incidence of colonization of what organism is seen in very young and elderly, crowding, following viral URI (increased PAFreceptors), fall/winter season? |
Streptococcus pneumoniae |
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173. Streptococcus pneumoniae is transmitted P2P by |
Respiratory droplets |
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174. Nasopharyngeal mucosal colonization is facilitated by |
IgA protease |
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175. Streptococcus pneumoniae reaches lungs after nasopharyngeal colonization via |
aspiration |
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176. Major virulence factor, facilitating invasion and dissemination of Streptococcus pneumoniae is |
Polysaccharide capsule |
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177. Pneumococcal cell wall peptidoglycans, teichoic acid elicit |
Inflammation |
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178. Increased Lung cell injury in pneumococcal pneumonia is caused by virulence factor? |
Pneumolysin (alpha-hemolysin) |
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179. Multiple myeloma, C3 deficiency, asplenia - Hg SS, COPD, diabetes, alcoholism, smokers are risk factors for mortality due to |
pneumococcal pneumonia |
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180. Hematologic marker for poor prognosis of pneumococcal pneumonia is |
Leukopenia |
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181. Emipiric DOC of CAP in pts at risk or w/ comorbidity is |
Azithromycin (or levofloxacin) + ceftriaxone |
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182. Pneumonia due to highly penicillin-resistant Streptococcus pneumoniae (Pen MIC >8) should receive |
moxifloxacin or vancomycin |
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183. Mechanism of penicillin resistance in Streptococcus pneumoniae is |
PBP alteration by mutation |
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184. Pt w/ agammaglobulinemia or asplenia or sick-cell anemia or ↓C3 should be vaccinated with |
Pneumococcal polysaccharide vaccine (PPSV: 23-valent) |
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185. Hx: a patient w/ serious CAD now on a ventilator, acquires bronchopneumonia >72 hrs after hospitalization. TOW? |
Pseudomonas aeruginosa(VAP) |
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186. Cause of necrotizing pneumonia >72 hrs after hospitalization of complicated viral illness |
Staphylococcus aureus(assume MRSA) |
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187. Patients that are aspiration prone have hx of |
dysphagia, decreased consciousness |
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188. Hx of a patient w/ seizure illness has fever, cough evolving over 2-4 wks; CXR infiltrate (+).TOW? |
Aspiration pneumonia |
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189. Community-acquired respiratory pathogens that cause aspiration pneumonia |
Streptococcus pneumoniae > Anaerobes |
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190. Hospital-acquired respiratory pathogens that cause aspiration pneumonia |
Gram-negative bacilli > S. aureus +/- anaerobes |
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191. Clinical Dx of sudden dyspnea +/- cyanosis, fever, wheezing, often ARDS-like picture is |
acid-related pneumonia |
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192. Bacterial etiology and Tx of aspiration pneumonia are determined by |
Gram stain (polymicrobic)and culture of sputum |
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193. Empiric DOC of necrotizing pneumonia in a patient with seizure illness |
clindamycin + levofloxacin |
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194. Targeted Abx for anaerobic aspiration pneumonia is |
clindamycin |
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195. Pneumonia in homeless/alcoholics; Gram-positive diplococci in sputum Gram smear. TOW? |
Streptococcus pneumoniae |
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196. Pneumonia in homeless/alcoholics; Gram-negative rods in sputum smear. TOW? |
Klebsiella pneumoniae |
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197. Cause of pulmonary embolism in a pt with IVDU |
Staphylococcus aureus |
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198. Common cause of pneumonia in pts with CF |
Pseudomonas aeruginosa |
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199. Sputum of a patient with hospital-acquired pneumonia yields a Gram-negative rod that is oxidase (+). TOW? |
Pseudomonas aeruginosa
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200. Common cause of external otitis due to hot tub use is |
Pseudomonas aeruginosa
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201. A patient with diabetes has osteomyelitis after penetrating foot injury. TOW? |
Pseudomonas aeruginosa
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202. The most widely used anti-pseudomonal penicillin |
Piperacillin > imipenem |
|
203. The most widely used anti-pseudomonal aminoglycoside |
Tobramicin > gentamicin |
|
204. This pt >50 years, smoking hx, CMI↓ has pneumonia; diarrhea, renal failure. Urine antigen (+) for pathogen. Pt responds to azithromycin. TOW? |
Legionella penumophila |
|
205. Penicillin is ineffective against Legionnaire’s dz because |
Intracellular organism |
|
206. Individuals with defective CMI response has poor prognosisof Legionnaire’s dz because |
Intracellular organism
|
|
207. Asymptomatic patient with PPD (+) |
Latent tuberculosis infection(LTBI) |
|
208. Cough > 2 wks, fever, night sweats, weight loss, hemoptysis, SOB; CXR: upper lobe infiltrate. TOW? |
Active Mycobacterium Tuberculosisinfection |
|
209. Oral drug regimen of choice for treatment of active TB (aka: 1st line drugs) is |
INH+RIF+PZA+EMB (oral)+ Vit B6 |
|
210. Pyridoxine is added to 4-drug therapy for TB to prevent |
neuropathy (due to INH) |
|
211. Pt w/ TB fails to respond to 4-drug regimen w/ INH+RIFresistance because |
Multiply drug-resistant(MDR) TB |
|
212. Pt w/ MDR-TB fails to respond to INH +RIF+FQ+an injectable drug (amikacin, capreomycin, or kanamycin) because |
Extremely-drug resistant(XDR) TB |
|
213. Cause of TB-like Dz that does not respond to 1o TB Tx regimen, in a pt. w/ AIDS |
Mycobacterium avium –intracellulare (aka: MAC) |
|
214. Cause of chronic pneumonia in a patient with cancer, receiving cytotoxic chemotherapy; lung-CT: halo/crescent sign (+)? |
Aspergillus fumigatus |
|
215. Microscopic observation of Aspergillus fumigatus in tissue biopsy sections depends on staining by |
Silver stain |
|
216. Hx of chronic pneumonia w/ lung bpsy histopathology (+)for hyphae 2-4µm wide, septate, acute- angle branching. TOW? |
Aspergillus fumigatus |
|
217. Cause of TB-like LRI in a pt with outdoor activity (Giemsa stain of bronchoscopy specimen: (+) for 2-5 μm yeasts) is |
Histoplasma capsulatum |
|
218. Pt with AIDS has blood culture (+) for histoplasmosis.DOC has effects on |
Ergosterol in fungal cell membrane |
|
219. TB-like Dz w/ ulcerative skin lesions. lung bpsy histopathology (+) for large yeast w/ broad-based bud. DOC? |
Intraconazole |
|
220. Hx of acute onset of cough, fever, infiltrate in a black male with CMI↓; histopathology of lung (+) for a large sac of endospores. DOC? |
Fluconazole (indefinite) |
|
221. Pt w/ aspiration pneumonia with cervico-facial lesion should respond to |
Penicillin G |
|
222. Granular specimen from draining fistulae from a pt withLRI on anaerobic culture should yield |
Actinomyces israelii |
|
223. Pt with AIDS or organ transplant has indolent pneumonia, w/ or w/o CNS abscess or granuloma. TOW? |
Nocardiosis |
|
224. Organism w/ characterization of Gram-positive branching, beaded, filamentous rod, weakly acid fast is |
Nocardia asteroids |
|
225. Hx of non-productive cough, fever and dyspnea evolving over 2-4 wks. CXR (+): bilateral interstitial infiltrates, hypoxemia;↑LDH, CD4 count <200/mm3 in a MSM. TOW? |
Pneumocystis pneumonia |
|
226. DOC of pneumocystis pneumonia (PCP) |
TMP-SMX |
|
227. Pt has urinary urgency, frequency, dysuria; lab: pyuria (+)or nitrite (+). TOW? |
Cystitis due to E. coli |
|
228. Significant UTI is confirmed by semiquantitative MSUculture based on the threshold of |
> 105 cfu/mL |
|
229. Mode of acquisition of uropathogen is |
Endogenous |
|
230. Microbial (structure) factor favoring bacterial persistence/colonization and UTI is |
bacterial binding via fimbriae |
|
231. Factor favoring bacterial persistence/colonization and UTIdespite high osmolarity and urea concentrations and low pH is |
high bacterial growth rates |
|
232. Host factor favoring bacterial persistence/colonization andUTI is |
Urinary stasis |
|
233. Bacterial persistence/colonization and UTI despite frequent voiding and high urinary flow is favored by |
lack of Tamm-Horsfall proteins |
|
234. Pyogenic inflammation in complicated UTI due to Gram- negative bacteria is due to |
Lipopolysaccharide (LPS) |
|
235. Empiric DOC to treat community-acquired UTI in adults is |
ciprofloxacin |
|
236. The abx class that inhibits DNA gyrase or topoisomerase IVand blocks with bacterial DNA replication is |
Fluoroquinolones |
|
237. DOC to treat UTI in pregnant women is |
Nitrofurantoin |
|
238. Gram-positive bacteria that cause uncomplicated UTI in sexually active, young women are |
Staphylococcus saprophyticus |
|
239. Differentiation of Staphylococcus saprophyticus from S. epidermidis (both coagulase negative) is based on |
novobiocin resistance |
|
240. In elderly or pt with risks of urinary stasis, fever, chills, flank pain, and CVA tenderness; Lab: pyuria, casts, nitrite+. TOW? |
Pyelonephritis due to E. coli |
|
241. Pt hospitalized > 72 h for comorbidity has urinaryfrequency, dysuria and foul-smelling urine; w/ flank pain, fever and chills, in the presence of a urinary catheter:Clue: GNR; fermenter; encapsulated; intrinsic ampicillin resistance) Clue: GNR; slow fermenter; red pigment; intrinsic drug resistance) Clue: GNR; swarming growth [very motile]; slow fermenter; intrinsic drug resistance)Clue: GNR; non fermenter; oxidase+, blue pigment; intrinsic drug resistance)Clue: GPC in chains; catalase-neg; grows in high salt; penicillin resistance) |
Klebsiella pneumoniae Serretia marcescens Proteus mirabilisPseudomonas aeruginosaEnterococcus faecalis |
|
242. If a patient with complicated UTI is severely ill or notimproving with therapy, do what rapid test next? |
renal ultrasound (to rule outurinary tract obstruction) |
|
243. For a patient with complicated UTI, once culture andsensitivity available, switch to what? |
Narrow-spectrum abx |
|
244. 2 or more of the following: fever (T>38°C) or hypothermia(T< 36°C), tachycardia (HR>90), tachypnea (RR>20), leukocytosis(WBC>12,000 or differential w/ >10% bands). TOW? |
SIRS |
|
245. SIRS + infection (e.g., positive blood culture) is |
Sepsis |
|
246. Sepsis + organ failure, decreased perfusion (lactic acidosis,oliguria, altered mental status) or low BP. TOW? |
Severe Sepsis |
|
247. Severe sepsis + hypotension despite fluids + lactic acidosis,oliguria, altered mental status. |
Septic Shock |
|
248. Septic shock due to Gram-negative bacteria (e.g., E. coli,Klebsiella spp., or Pseudomonas aeruginosa) is |
Endotoxic Shock |
|
249. Endotoxin that mounts pro-inflammatory cytokines,responsible for endotoxic shock, is |
Lipid A of LPS |
|
250. Genital chancre begins as a papule, ulcerates to form asingle, painless, clean-based ulcer. TOW? |
1o syphilis |
|
251. Cause of genital chancre, begining as a papule, ulcerating toform a single, painless, clean-based ulcer. |
Treponema pallidum |
|
252. A pen-allergy, non-pregnant, female pt w/ fever, "copperpenny" macular lesions on the palms or soles; RPR(+) should betreated with |
Doxycycline |
|
253. Management choice of tabes dorsalis (10-20yrs), iritis,uveitis, or Argyll-Robertson pupils of pen-allergy in a pregnantwoman w/ pen allergy; RPR(+) is |
Desensitization |
|
254. Hx of painful clustered vesicles with an erythematous base;urinary retention in a promiscuous woman. TOW? |
HSV-2 >> 1 |
|
255. Giemsa stain of fluid from a herpetic lesion should reveal |
Multinucleated giant cells |
|
256. Patient with genital herpes does not respond to acyclovir because pt is infected with |
thymidine kinase deficientHSV |
|
257. A pregnant woman with 1o symptomatic HSV-2 infection is at risk of her baby developing |
neonatal (congenital) herpes |
|
258. Cause of painful genital ulcers; purulent, grey base; painful inguinal adenitis, in a man with multiple sexual partners is |
Haemophilus ducreyi |
|
259. Fastidious organism in the infiltrate of the penile ulcer, co- localized with neutrophils and fibrin, in a pt w/ chancroid is |
Haemophilus ducreyi |
|
260. All sex partners of pt with chancroid, regardless of symptoms, should be examined and treated with |
Azythromycin > ceftriaxone |
|
261. New episode of purulent or mucopurulent endocervical exudate visible in the endocervical canal or on endocervical swab. Friability and bleeding may be noted after gentle passage of swab though cervical os. Test for: |
Chlamydia trachomatis andNeisseria gonorrhoeae |
|
262. New episode of purulent or mucopurulent endocervical exudate visible in the endocervical canal or on endocervical swab. Friability and bleeding may be noted after gentle passage of swab though cervical os. Test is |
Nucleic acid amplification tests (NAAT) |
|
263. Most common cause of mucopurulent endocervical exudate(Gram stain non revealing) in a sexually promiscuous woman |
Chlamydia trachomatis D-K |
|
264. Chlamydia trachomatis is an intracellular parasite which lacks |
Muramic acid (cell wall) |
|
265. Dx of mucopurulent urethral discharge, dysuria, penile pruritis is based on |
NAAT of urethral specimen or urine (+) |
|
266. DOC of most frequent cause of nongonococcal urethritis |
Azythromycin > doxycycline |
|
267. Cause of rare genital ulcers, inguinal lymphadenopathy[cytology(-) for multi-nucleated giant cells; RPR (-)] in men is |
Chlamydia trachomatis L1-L3 |
|
268. Hx of systemic Sx/Sn w/ cervical motion tenderness in a woman with turbo-ovarian abscess. TOW? |
PID |
|
269. Cause of mucopurulent urethritis, dysuria, penile pruritis[Smear (+):Gram-negative diplococci co-populated w/ PMNs] is |
Neisseria gonorrhoeae |
|
270. Deficiency in serum factors in a female pt w/ frequent gonorrhea and DGIs is |
C6-C9 |
|
271. Immune evasion of Neisseria gonorrhoeae in frequent mucosal infection is due to |
Antigenic variation of pili. |
|
272. Auxotrophic strains of N. gonorrhoeae with serum(complements) resistance are likely to cause |
Septic arthritis (aka: DGI) |
|
273. Most frequent complication of gonococcal (GC) infection in men |
Epididymitis |
|
274. Cause of "bull headed clap", urethral stricture, prostatitis is |
Neisseria gonorrhoeae |
|
275. Urethritis is treated with ceftriaxone + azythromycin because |
Concurrent GC + Chlamydia |
|
276. Intra-amniotic infection syndrome, following rupture of membranes, without histological (neutrophilic inflammation of chorion, necrosis, micro-abscess formation, amnion basement membrane thickening) or microbiological confirmation, etiology is usually |
polymicrobial (2 or more) |
|
277. Intra-amniotic infection syndrome, following rupture of membranes, without histological (neutrophilic inflammation of chorion, necrosis, micro-abscess formation, amnion basement membrane thickening) or microbiological confirmation, Frequently recovered isolates from pre-term infant placentas(chorioamnionitis): |
Ureaplasma urealyticum, Gardnerella vaginalis. |
|
278. Along with gentamicin, a standard component of treatment for chorioamnionitis is |
Ampicillin |
|
279. Acute onset of intermenstrual bleeding in a non-pregnant woman, recent onset dyspareunia, lower abdominal pain or distension: crampy, fever, pain with bowel movements or constipation. Confirm by tests of |
Gram stain and culture of fluid from surgery (acute endometritis) |
|
280. Diagnosis of chronic endometritis is made by endometrial biopsy with histologic diagnosis based upon |
plasma cells, lymphocytes in endometrial infiltrate |
|
281. An older woman with PID and tubo-ovarian abscess receives ceftriaxone, azythromycin, and metronidazole because |
Polymicrobic (endogenous)infection |
|
282. Cause of anogenital warts w/ histology (+): koilocytes is |
HPV 6 and 11 |
|
283. Cause of atypical squamous cells of undetermined significance (ASCUS) on pap smear w/ no clinical signs of infection is |
HPV 16 and 18 |
|
284. Cause of koilocytotic cells and possible progression to squamous cell carcinoma |
HPV 16 and 18 |
|
285. Next step to identify viral cause of ASCUS on pap smear w/and further management in a woman of age > 29 years is |
Colposcopy > HPV DNA in bpsy |
|
286. Wet prep of vaginal discharge from a pt w/ vaginal pruritis;ectocervical erythema ("strawberry cervix") should reveal |
motile tissue flagellate |
|
287. Clinical syndrome form replacement of normal peroxide- producing Lactobacillus spp. in the vagina with high concentrations of anaerobic bacterial (e.g., Mobiluncus sp and Prevotellasp), G. vaginalis, and Mycoplasma hominis is |
Bacterial vaginosis (BV) |
|
288. Gardnerella and/or Mobiluncus morphotypes in BV are seen with few or absent of |
Lactobacilli |
|
289. Gram stain of vaginal discharge w/ fishy odor from a pt w/ vaginal pruritis but no erythema and normal cervix (in BV) should reveal |
SECs stippled with Gram- variable organisms. |
|
290. DOC of bacterial vaginosis is |
metronidazole |
|
291. Wet prep of curdy discharge (no odor), adhering to vaginal walls, from a pregnant woman w/ recent UTI, who now has severe vaginal pruritis; vulvovaginal area - erythematous should reveal |
budding yeasts with pseudohyphae |
|
292. Normal commensal of skin, GI & GU tracts; endogenous overgrowth of budding yeast, capable of >10 diseases. TOW? |
Candida albicans |
|
293. Mechanism of action of a po DOC of vulvovaginal candidiasis is |
blocks C14 alpha-lanosterol demethylase |
|
294. Hx of flu-like illness, lymphadenopathy, maculopapular rash in a bisexual man. Lab: lymphopenia and transaminase elevations; monospot/all serology (-). TOW? |
Acute retroviral syndrome |
|
295. Time from infection (acquisition) to acute seroconversion detected by HIV serology (ELISA/ WBlot) is |
6-12 weeks. |
|
296. Hx of mononucleosis-like illness and lymphadenopathy in a man who has sex man. Serology (-). What is HIV viral load? |
>10,000 copies/ml |
|
297. Host-cell receptor for HIV-1 infection |
CD4 |
|
298. Homozygous for deletions in what gene renders resistance to infection and some protection against progression. |
CCR5 |
|
299. Host cells that trap HIV and mediate the efficient transinfection of CD4+ T cells are |
Dendritic cells |
|
300. A man, who practices “sex with another man”, hasantibodies to HIV (ELISA and WB) but asymptomatic. TOW? |
Clinical latency |
|
301. What happens to HIV-1 virus when acute retroviral syndrome progresses to clinical latency? |
Virus continues to replicate low level. |
|
302. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count isi. Candidiasis, esophageal, bronchi, trachea, or lungs ii. Cervical cancer, invasiveiii. Coccidioidomycosis, extrapulmonary iv. Cryptococcosis, extrapulmonaryv. Cryptosporidiosis, chronic intestinalvi. Cytomegalovirus retinitis (with vision loss)vii. Encephalopathy, HIV-related viii. Herpes simplex - Chronic ulcersix. Histoplasmosis, disseminated or extrapulmonary x. Isosporiasis, chronic intestinal (duration >1 mo) xi. Kaposi sarcomaxii. Lymphoma, Burkittxiii. Lymphoma, primary, of the brainxiv. Mycobacterium avium complex or Mycobacterium kansasii infection, extrapulmonaryxv. Mycobacterium tuberculosis infection, any site(pulmonary or extrapulmonary)xvi. Pneumocystis pneumoniaxvii. Progressive multifocal leukoencephalopathy xviii. Wasting syndrome due to HIV infection |
CD4+ < 200/microL |
|
303. A man with HIV infection has chronic diarrhea, oral thrush+ toxoplasma encephalitis. Most likely CD4+ count is |
< 50 cells/microL. |
|
304. Most common cause of HIV- associated peripheral skin or mucosal ulcers |
HSV-1 (>> Histo > CMV > VZV > Syphilis) |
|
305. Most common cause of HIV- associated nodules(neoplasia)? |
HHV-8 (aka KSHV) |
|
306. Hx of fatigue, nausea, abdominal pain, diarrhea, fever,chills, night sweats, dry persistent cough w/ SOB and weight loss in a man with AIDS. Lab: PPD (-); blood culture (+) for AFB. TOW? |
Mycobacterium avium- intracellulare (MAI) complex (aka: MAC) |
|
307. Common cause of retinitis, viral pneumonitis or esophagitis in AIDS |
CMV |
|
308. Cases of CMV disease occur with immunosuppression level |
CD4< 50 |
|
309. cytopathology of CMV infected tissue is characterized by large cells with |
nuclear (Cowdry owl’s eye)and cytoplasmic inclusions |
|
310. Hx of progressive CNS dz in a pt w/ AIDS: hemiparesis, visual, ataxia, aphasia, cranial nerves, sensory. Head MRI: ring- enhancing lesions. Toxo antibody (-). TOW? |
JC virus |
|
311. Definitive indication for initial HAART is CD4+ count? |
350/mm3. |
|
312. Objective of ARV Tx is to reduce viremia to what level of genomic RNA/mL |
< 50 copies RNA/mL. |
|
313. Initial regimen of anti-retroviral therapy is |
Emtricitabine + Tenofovir + Efavirenz |
|
314. Abacavir, emtricitabine, lamivudine, zidovudine, tenofovirbelong to what class of antiretrovirals? |
NRTIs |
|
315. Efavirenz, nevirapine belong to what class of antiretrovirals? |
NNRTIs |
|
316. Atazanavir, Lopinavir, Saquinavir belong to what class of antiretrovirals? |
Protease inhibitors |
|
317. This drug binds to gp41 and prevents conformational change required for viral fusion and entry into cells. |
enfuvirtide |
|
318. This drug inhibits integrase, responsible for insertion ofHIV proviral DNA into the host genome. |
raltegravir |
|
319. A man has AIDS and CD4 <200cells/μL or thrush.Antibacterial prophylaxis needed besides HAART is |
TMP-SMX (for PCP) |
|
320. A man has AIDS and CD4 <100 + pos toxo IgG.Chemoprophylaxis needed besides HAART is |
TMP-SMX (for Toxoplasma encephalitis) |
|
321. A man has AIDS and CD4 <100 + PPD >5mm induration.Antibacterial prophylaxis needed besides HAART is |
INH + pyridoxine |
|
322. A man has AIDS and CD4 <50. Antibacterial prophylaxis needed besides HAART is |
azithromycin (for MAC) |
|
323. Hx of fever, a pustule at a cat scratch site, adenopathy, hepatosplenomegaly in a pt w/ AIDS. Warthin-Starry stain tissue (+). TOW (clue: bacillary angiomatosis)? |
Bartonella henselae |
|
324. Leading causes of congenital infections are |
ToRCH3eS-ListTo = Toxoplasma gondiiR = RubellaC = CMVH = HSV-2H = HIV H = HBVS = SyphilisList = Listeria monocytogenes |
|
325. Cause of severe CNS sequelae, chorioretinitis, systemic disease in a neonate (mom at pregnancy had mono-like illness after eating undercooked beef or pork or exposure to oöcysts in catfeces) is |
Toxoplasma gondii |
|
326. Drug for pregnant woman in first trimester to prevent transmission if mother seroconverts is |
Spiramycin |
|
327. Hx of deafness, cataracts, heart defects, or microcephaly ina child (of a seronegative, caregiver mom, exposed to “Blueberrymuffin baby” in 1st trimester). TOW? |
congenital rubella syndrome(CRS) |
|
328. Dx of CRS usually with positive anti-rubella antibody type? |
IgM |
|
329. Microcephaly, seizures, sensorineural hearing loss, feedingdifficulties, petechial rash, hepatosplenomegaly, or jaundice in aneonate. PCR of any body fluid should yield |
CMV |
|
330. After primary infection, CMV, characterized as envelopeddsDNA betaherpesvirus; establishes |
lifelong latency |
|
331. Hepatosplenomegaly, neurologic abnormalities, frequentinfections in a neonate w/ low CD4+ counts. Woman beforebirthing should have received |
Nevirapine |
|
332. Cause of vesicular skin lesions + conjunctivitis in a child(asymptomatic at birth) |
HSV-2 |
|
333. Hx of cutaneous lesions, hepatosplenomegaly, jaundice,saddle nose, and saber shins. Hutchinson teeth, + CN VIII deafnessin a neonate (mom is a prostitute). TOW? |
3o syphilis |
|
334. Neonatal septicemia or meningitis (mom had flu-like Sx andate imported cheese during pregnancy). TOW? |
Listeria monocytogenes |
|
335. What are the SIX red rashes of childhood (acute, febrileexanthema illnesses)?(Clue1: maculopapular rash; off-white lesions on buccal mucosa,MMRV vaccine prevents)(Clue2: maculopapular rash starting on face moving to foot; MMRVprevents)(Clue3: scarlatina rash post pharyngitis)(Clue4: vesicular rash, moderate pain)(Clue5: maculopapular “slapped face” appearance in a young child)(Clue6: maculopapular rash and systemic Dz in immunocompromisedpt) |
MeaslesRubellaScarlet fever (GAS)Chicken pox (VZV)Parvovirus B19HHV-6 |
|
336. Worldwide rubella infection, with only human reservoirsknown this infectious agent is a |
RNA togavirus |
|
337. >95% seropositive after MMRV if >12mos age and lifelongprotection against rubella is conferred with? |
Single dose |
|
338. Cause of single or multiple scaly and/or crusted patchesand/or plaques, affecting the scalp or beard area +/- inflammation. |
Dermatophytes |
|
339. KOH prep of scales from the scalp and plucked hairs fromcutaneous mycoses may reveal? |
hyphae and spores |
|
340. Most common cause of cutaneous mycoses |
Trichophyton spp. |
|
341. Common cause of cutaneous mycosis with animal contact |
Microsporum spp. |
|
342. Oral DOC of cutaneous mycoses |
itraconazole |
|
343. Topical DOC of cutaneous mycoses |
terbinafine |
|
344. Dz w/ subcutaenous lesions w/ slow spread by lymphatic system producing nodules in a gardener, or from rose-thorn injury. |
Sporotrichosis |
|
345. Cause of subcutaenous lesions w/ slow spread by lymphatic system producing nodules in a gardener, or from rose-thorn injury. |
Sporothrix schenckii |
|
346. Dimorphic fungus that grows at 37°C as cigar-shaped yeast, and produces septate hyphae and conidia (in daisy arrangement) at25°C is |
Sporothrix schenckii |
|
347. DOC of sporotrchosis |
itraconazole. |
|
348. Cause of deeper and wider lesions with interconnecting subcutaneous abscesses arising from infection of several neighboring hair follicles, in young children. |
Staphylococcus aureus(Curbuncle) |
|
349. Cause of superficial pustules progressing to erosionscovered by honey-colored crusts, surrounded by erythematous halo, in young children. |
Staphylococcus aureus >> Streptococcus pyogenes (non- bullous impetigo) |
|
350. Dz characterized by bullae and denuded areas after the blisters rupture, covered by thin, varnish-like light brown crusts; regional lymphadenopathy, in children.DOC if lab: gram stain and culture of pus or base of the lesions yieldsGPC in chains.DOC if lab: gram stain and culture of pus or base of the lesions yieldsGPC in clusters. |
Bullous impetigoPenicillin G Nafcillin |
|
351. mecA (SCC) genes which encode PBP2a, w/ low affinity for β-lactams; confers resistance in Staphylococcus aureus against what? |
Nafcillin |
|
352. Cause of spreading (butterfly-wing) erythema on the face that responds to empirical penicillin. |
Streptococcus pyogenes(Erysipelas) |
|
353. Cause of severe pain on his knee w/ site of injury is tender and erythematous. Blood culture may yield? |
Streptococcus pyogenes. (Cellulitis) |
|
354. What is the microbial factor that promotes degradation ofC3b by binding to factor H, the serum β globulin factor |
M protein |
|
355. Other epidemiologically linked or risk-associated causes of cellulitis are:Clue1: cat/dog bite. What?Clue2: Salt water exposure. What? Clue3: Fresh water exposure. What? Clue4: Neutropenia. What?Clue5: Human bite. What? |
Pasteurella multocida / Capnocytophaga canimorous Vibrio vulnificusAeromonas hydrophila Pseudomonas aeruginosa Eikenella corrodens |
|
356. Most likely cause of fever/chills/ night sweats, localizing pain/tenderness or swelling/erythema (lab: ↑ESR, ↑CRP; ↑WBC w/ left shift. Radiology: periosteal elevation.) is |
Staphylococcus aureus(Osteomyelitis) |
|
357. Major antiphagocytic virulence factor of drug-resistant organism that causes osteomyelitis is |
protein A |
|
358. Major neutrophil-damaging virulence factor of drug- resistant organism that causes osteomyelitis is |
Penton-Valentine leukocydin |
|
359. Cause of vertebral, sternoclavicular or pelvic bone infections (in pt w/ IVDU) or osteochondritis of foot (following penetrating injuries through tennis shoes)? |
Pseudomonas aeruginosa |
|
360. Cause of osteomyelitis in pt w/ underlying sickle cell Dz;blood culture +)? |
Salmonella typhimurium |
|
361. Cause of chronic, vertebral osteomyelitis (blood culture negative)? |
Mycobacterium tuberculosis |
|
362. Cause of osteomyelitis in pt. w/ hx of cat bites; GNSR;fastidious growth of wound culture? |
Pasteurella multocida |
|
363. Cause of fever, chills, malaise, joint pain, swelling. PE: tenderness, erythema, heat, swelling, decreased ROM. CBC: leukocytosis w/ neutrophils predominating; joint aspirate: no crystals.Clue1: sexually active; BLCx (-); responds to ceftriaxoneThink of other pathogens (BLCx negative): Clue2: Rheumatoid arthritis?Clue3: IVDU?Clue4: Unpasteurized dairy productsClue5: Diabetes |
Septic arthritisNeisseria gonorrhoeaeS. aureusS. aureus, P. aeruginosaBrucella spp.S. agalactiae (GBS) |
|
364. Dz is characterized by arthritis in up to 6 joints (especially knees, feet), low back pain/stiffness, irritable eyes w/ or w/o redness, conjunctivitis, iritis, malaise.Caused by:Clue1: sexually acquiredClue2: non-sexually acquired |
Reactive arthritisC. trachomatis, N. gonorrhoeae Campylobacter, Salmonella |
|
365. Cause of bacteremia in neutopenic pts with central line or pts with prosthetic devices and catheters; blood culture (+) |
Staphylococcus epidermidis |
|
366. Cause of intraabdominal abscess w/ putrid pus; anaerobicbacteremia in pt with trauma or solid GI tumor? |
Bacteroides fragilis. |
|
367. A woman with obstetric infection has fever > 102oF, SBP <90; diffuse sunburn-like rash or desquamation of palms and soles;multisystem Sx/Sns; vomiting, and diarrhea; BLCx (-). TOW? |
Staphylococcal Toxic shockSyndrome |
|
368. What is the toxin associated with staphylococcal toxicshock syndrome? |
TSST-1 (a superantigen) |
|
369. Cause of severe, watery diarrhea in a woman with toxicshock syndrome? |
Enterotoxin (coregulated withTSST-1) |
|
370. Cause of toxic shock syndrome, which responds tovancomycin and clindamycin? |
MRSA |
|
371. Hx of fever > 38.9oC, SBP < 90 ; diffuse sunburn-like rashor desquamation of palms and soles, in a man w/ necrotizingfasciitis or myositis; multisystem involvement; BLCx (+). TOW? |
Streptococcal toxic shocksyndrome |
|
372. What is the toxin associated with streptococcal toxic shocksyndrome? |
SpeA (superantigen) |
|
373. DOC for streptococcal toxic shock syndrome |
PenG + clindamycin |
|
374. Hx of fever, chills, and hypotension. Blood culture yields a GNR, oxidase (-), lactose fermenting organism on MacConkeyagar. Immunological mediators of sepsis. |
IL-1 and TNF |
|
375. DOC for a neutropenic pt w/ line-associated infection w/immune suppression (hematologic malignancy, organ orhematopoietic stem cell transplantation, chemotherapy); w/ positiveblood cultures and Beta-D-glucan antigenemia? |
Caspofungin |
|
376. DOC for a line-associated infection in a pt w/ GI tumor; lab:positive blood cultures and Beta-D-glucan antigenemia? |
Fluconazole |
|
377. Without prophylaxis with valganciclovir, D+/R- solid organtxp pts will develop |
CMV disease |
|
378. Cause of mononucleosis-like dz with fever, myalgia/arthralgia w/ lab: leukopenia, LFT abnls, in a pt w/ solid organtransplant? |
CMV |
|
379. Lung biopsy reveals large cells with nuclear inclusions(Cowdry owl's eyes inclusion bodies) in a pt with AIDS andinterstitial pneumonia. TOW? |
CMV |
|
380. DOC for CMV antigenemia in a febrile pt with solid organtansplant? |
valganciclovir |
|
381. Cause of hematuria, hemorrhagic cystitis, or uretericstenosis, or interstitial nephritis in a severly immunocompromisedpt? |
BK Virus |
|
382. What is the most common cause of bacteremia associatedw/ foreign device (prostheses, intravenous cathether, or centrallines) in co-morbid, hospitalized pts? |
Staphylococcus epidermidis |
|
383. What is the cause of infections associated w/ ventilatorsupport of respiration in co-morbid pts in the ICU? |
Pseudomonas aeruginosa |
|
384. DOC for a pt w/ travel hx (back from the tropics), who hasflu-like symptoms; splenomegaly; lab: CBC: anemia,thrombocytopenia, hypoglycemia. Blood smear: enlarged RBCsand Schuffner dots. |
mefloquine + primaquine |
|
385. Which drug is contraindicated in specific Tx of liver formof malaria in pts w/ G6PD deficiency? |
Primaquine |
|
386. DOC for a pt w/ travel hx (back from the tropics), who hasflu-like symptoms (fever > 103o F), seizure, hyperparasitemia(>2.5% of RBC), pulmonary edema, or renal failure, or severeanemia? |
Quinidine and doxycycline. |
|
387. Cause of malaria-like illness in an immunosuppressed ptw/o travel hx; lab: blood smear has cross-over rings in the RBCs? |
Babesia spp. |
|
388. A pt from S. America has a week-long fever, anorexia,lymphadenopathy, mild hepatosplenomegaly, and myocarditis; anodular lesion on the arm; blood smear should reveal |
Trypanosoma cruzi |
|
389. Cause of a chronic-stage systemic dz w/ cardiomyopathy,megaesophagus, megacolon, and weight loss in a pt from S.America, who does not respond to nifurtimox. |
Trypanosoma cruzi |
|
390. Cause of protracted fever and Crohn’s, celiac dz, ocularproblems, and lymphadenopathy; duodenal biopsy demonstratingfoamy macrophages in lamina propria? |
Tropheryma whipplei |
|
391. Painless papule (on arms, face, or chest), thenvesicles/bullae, then black eschar + edema evolving over 3-5d is |
Cutaneous anthrax |
|
392. Unique features of cutaneous anthrax include edema, lackof pain and bullous fluid that lacks |
PMNs |
|
393. Cutaneous anthrax can be treated in 7-10 days with |
Ciprofloxacin |
|
394. Fever, chills, sweats, GI sx, cough, malaise, chest pain (3-4d); CXR: wide mediastinum and bloody pleural effusion is |
Inhalation anthrax |
|
395. CT scan in inhalation anthrax may show hyperdense mediastinal nodes and |
pulmonary edema |
|
396. Cultures of blood and respiratory specimens from in inhalation anthrax should yield |
Bacillus anthracis |
|
397. DOC of Inhalation anthrax is |
Ciprofloxacin or levofloxacin> doxycycline |
|
398. Need to treat inhalation anthrax 60 days because |
Spores persist in lungs |
|
399. 60 d total course recommended for any presentation to avoid |
relapse or breakthrough of incubation of spores |
|
400. Post-exposure prophylaxis to prevent inhalation anthrax also requires |
Cipro for 60 days |
|
401. Exposure (time & place to environment) + papule progressing to black eschar on exposed area in 3-4d +/- local edema, often intensely pruritic is |
Cutaneous anthrax |
|
402. Ciprofloxacin, levofloxacin and doxycycline are equivalent to treat cutaneous anthrax. All other abx are |
less effective |
|
403. In the event of an index case of anthrax (although infectionis not P2P communicable), notify public health authorities and local |
infection control |
|
404. Infection control of all types of anthrax (based on non- communicability of the pathogen) warrants only |
Standard precautions |
|
405. Species of Clostridium that causes afebrile, systemic toxic diseases in infants (honey), and in adults foodborne (meat, canned vegetables), wound (injected), iatrogenic (cosmetic) is |
C. botulinum |
|
406. Differential diagnosis of botulism-like symptom/signs should include Myasthenia gravis, Stroke, Chemical Intoxications, Lambert-Eaton Dz, and |
Guillian-Barré |
|
407. Clostridia produces human pathogenic |
neurotoxins types A, B, E, Fand G |
|
408. Many pts w/ flaccid paralysis in the same geography without common food source may be |
Bioterrorism-associated botulism |
|
409. CSF examination in botulism is |
Normal profile (no pleocytosis) |
|
410. Post lab confirmation of food botulism, while waiting for antitoxin may give |
activated charcoal |
|
411. Infection control of all types of botulism (based on non- communicability of the pathogen or toxins) warrants only |
Standard precautions |
|
412. Aerobic slender gram-negative rod, which causes glanders in horses, associated with bioterrorism is |
Burkholderia mallei |
|
413. Acute glanders caused by Burkholderia mallei may produce a localized infection with ulceration following inoculation in the skin; lymphadenopathy; lung infections may present as pneumonia. Acute bloodstream infections can be |
rapidly fatal. |
|
414. If Burkholderia mallei isolated suspect bioterrorism; Quarantine pt & give antibiotics: |
TMP-SMX or Imipenem |
|
415. Multiple cases of glanders: must consider |
bioterrorism. |
|
416. Patients with glanders should be isolated, respiratory precautions. B. mallei spread by |
aerosol. |
|
417. In the DDx of bioterrorism-related pneumonia +pleuritis + hilar adenopathy, include anthrax, plague and |
tularemia |
|
418. Small, pleomorphic, aerobic Gram-neg rod that causes1) bite/abrasion (acquired from tick exposure or contact with rabbits) → nodule/ulcer → node → sepsis, or 2) inhalation (bioterrorism) → acute fever, dry cough. CXR: infiltrates + hilar adenopathy, is |
Francisella turlarensis |
|
419. DOC of tularemia is |
streptomycin |
|
420. For tularemia, if bioterrorism suspected, notify |
local public health |
|
421. Pathogen Francisella turlarensis does not have a person-to- person mode of transmission. Infection control does not require: |
Isolation |
|
422. Acute fever, myalgias, remorrhagic rash, conjunctivitis, pharyngitis, headache, diarrhea, and thrombocytopenia in bioterrorism indicates |
Viral hemorrhagic fever (e.g., Ebola, Marburg) |
|
423. For Lassa, Marburg, and Ebola, person-to-person transmission based infection control (respiratory) precautions and other measures must include: |
Patient isolation |
|
424. Endemic plague in the South West USA is acquired by bite of rodent flea carrying |
Yersinia pestis |
|
425. Aerobic, Gram-neg bipolar rod, which causes painfullymphadenitis (bubonic), fever, chills, headache (afterexposure to rodents, rabbits or fleas) is |
Yersinia pestis |
|
426. Three forms of plague: bubonic (lymph nodes),pneumonic and the third: |
septicemic |
|
427. DOC of plague is |
Doxycycline |
|
428. Pneumonic plague can be transmitted |
from person-person |
|
429. Sudden fever ≥ 102°F , homogeneous vesiculo-pustularrash (unlike common viral exanthems) in multiple pts (in timeand place) is |
Small pox, caused by variollamajor virus |
|
430. Sudden fever ≥ 102°F , homogeneous vesiculo-pustularrash in multiple pts (in time and place) is, main diagnosticdifferential is |
Varicella or zoster |
|
431. For small pox associated bioterrorism, person-to-persontransmission based infection control warrants isolation measuresand |
respiratory precautions |
|
432. No person-to-person transmission are observed (other thanstandard precautions) for the bioterrorism agents: |
Anthrax, botulism (noncommunicable) |
|
433. Fever, headache, neck stiffness, and altered mental status;Kernig's/Brudzinski's sign, rash; CSF: WBC > 2000 or PMNs >1200; glucose < 34, protein > 220CSF gram stain of the most likely pathogen of ABM in a 6 mos-6yr old(or adults > 50 years) should revealCSF gram stain of the most likely pathogen of ABM in an older childor young adult should reveal |
Acute bacterial meningitis(ABM)Gram-positive diplococciGram-negative diplococci |
|
434. Most common cause of sepsis/meningitis innewborns/neonates? |
Streptococcus agalactiae |
|
435. Cause of fever, headache, photophobia, nausea/vomiting, rash, diarrhea, meningeal signs, in older children in the summer months; CSF with 10-<1,000 WBC typical, mostly monos, moderately elevated protein? |
Aseptic meningitis(enteroviruses) |
|
436. Cause of aseptic meningitis in men with exposure to rodents? |
Leptospira interrogans |
|
437. Cause of aseptic meningitis with hx of tick bite and erythema migrans? |
Borrelia burgdorferi |
|
438. Cause of aseptic meningitis with hx of sex with multiple partners; CSF PCR(+): |
HSV-2 > 1 |
|
439. Cause of fever, headache, photophobia, meningismus, in pts w/ solid organ transplant, malignancy, corticosteroid use. CSF glucose < 2/3 serum glucose, elevated protein, WBC > 5 withPMNs |
Listeria monocyotgenes |
|
440. How does Listeria monocytogenes differ from other - hemolytic bacteria |
Gram-positive rods; tumbling motility |
|
441. Cause of chronic meningoencephalitis in a pt, who uses infliximab or native from endemic region; PE: papilledema. CXR (+). Lab: elevated monocytes on differential, low CSF glucose? |
Mycobacterium tuberculosis |
|
442. Test to confirm subacute mengoencephalitis in a, immunocompromised pt (CD4 <100); vesicular skin lesions [CSF profile: protein 30-150mg/dl, monos 10-100]? |
CSF India ink |
|
443. Cause of meningoencephalitis after a hx of respiratory illness after travel to SW USA? |
Coccidioides immitis |
|
444. Test to confirm CNS pathology with fever, cognitive deficits, focal neurologic signs, seizures; temporal lobe involvement on MRI. Lab: no papilledema, CT (no brain lesion)? |
CSF PCR (+) |
|
445. Cause of fever, cognitive deficits, focal neurologic signs, seizures, abnormal mental status with ataxia, hemi-paresis, in a pt w/ AIDS? |
JC virus > HHV-6 |
|
446. Cause of fever, cognitive deficits, focal neurologic signs, seizures or abnormal mental status with ataxia in an adult during outdoor activity? |
West-Nile virus > SLE |
|
447. Hx of fever, cognitive deficits, focal neurologic signs,seizures, in a pt w/ AIDS (CD4 < 50). MRI: multifocal (ringenhancing)lesions in basal ganglia. Rule out? |
Toxoplasma encephalitis (TE) |
|
448. HIV-infected Pt with TE should receive (for life) |
pyrimethamine + leucovorin +sulfadiazine |
|
449. Folinic acid (leucovorin) prevents bone marrow suppressiveeffect of |
Pyrimethamine |
|
450. Cause of confusion, stiff neck, irritability over wks tomonths, in immunocompromised pts; CT/MRI = multifocal lesionsin midbrain, brain stem, & cerebellum; wet mount CSF = motilemacrophage-like organisms |
Acanthamoeba spp. (GAE) |
|
451. Cause of severe headache and other meningeal signs, fever,vomiting, and focal neurologic deficits, frequently progressing tocoma, in a healthy boy (summer diving activity)? |
Naegleria fowleri (PAM) |
|
452. Cause of seizures, chronic headache, symptomatichydrocephalus, in immigrants; pt. successfully responds topraziquantel + anti-convulsant drug? |
Taenia solium(neurocysticercosis) |
|
453. Pt from Africa had fever, lymphadenopathy, chancre, andpruritus weeks ago; now has headaches, somnolence, neuro Sns;slowly responds to pentamidine isothionate or suramin. TOW? |
Sleeping sickness caused byTrypanosoma brucei |
|
454. Hx of rigidity, muscle spasm, and autonomic dysfunction.Trismus due to masseter spasm in an infant w/ umbilical stumpinfection. Neurotoxin interferes w/ |
GABA and glycine |
|
455. Hx of afebrile illness w/ diplopia, dysarthria, dysphoria,dysphagia, in a pt w/ IDU skin poppers with black tar heroin.Neurotoxin blocks the release of |
Acetylcholine |
|
456. Immediate treatment of a male infant w/ constipation, aweak cry, and drooling, hypotonea and cranial neuropathy, afteringestion of home-processed honey. |
Equine immune globulin(infant botulism) |
|
457. Ingestion of a raw potato delivers a new vaccine protein toelicit an immune response. The immune structure to interact withthe vaccine protein? |
Lamina propria mucosae |
|
458. Inflammation and the resulting increase in vascularpermeability permit leakage into damaged or infected sites areeffected by |
Phagocytic cells and acutephase proteins |
|
459. The serum of a pt, who has IgG and IgM deficiency,appears to fix complement in an assay for tetanus antibodies. Whatis the explanation? |
Activation of the alternatepathway |
|
460. A 3-year-old boy with genetic C3 deficiency has recurrent ear and lung infections due to pyogenic bacteria. Deficiency of what? |
B lymphocytes |
|
461. A very young child, w/ recurrent infections due to Staphylococcus aureus, now has numerous granulomas. TOW? |
Chronic granulomatous dz |
|
462. Treatment with which protease enzyme causes decrease in avidity of IgG w/o changing the specificity of the antibody? |
Papain |
|
463. Cells activated by both γ-IFN and CD40 are |
Macrophages |
|
464. High-dose chemo has caused severe bone marrow suppression in a pt with hematologic malignancy. Reversal is plausible with what? |
GCSF |
|
465. Function of the T-lymphocyte receptor (CD3) complex of transmembrane proteins? |
Signal transduction |
|
466. The MHC class I pathway presents an antigen directly to what? |
CD8+ T lymphocytes |
|
467. HSV infection can block the transfer of antigenic peptides from the cytoplasm to the ER of the infected cells. As a result of this, action of what cell type is compromised? |
CD8+ T cells |
|
468. Infection of the thyroid gland can induce the expression of MHC II molecules. Which cell types would initiate an autoimmune response, leading to Hashimoto’s thyroiditis? |
CD4+ T cells. |
|
469. PPD skin test (+) in a pt , who was vaccinated against turberculosis in his native country, reflects response of what cell type? |
CD4+ T lymphocytes (Th1 response γ-IFN) |
|
470. A man with hx of MI is given a morphine injection for a new episode of chest pain; 10 mins later, he has itching and urticaria. Mechanism of this reaction? |
mediators from sensitized mast cells |
|
471. Loss of skin pigments, sense of touch, inability to feel objects and pain in a pt from Africa, whose skin scraping contains AFBs, is caused by |
Th1-mediated DTH reactions |
|
472. A man with polycystic kidney dz, who receives a renal transplant and cyclosporine, develops a high temp and swelling and tenderness in the grafted kidney. TOW? |
Immunity to the donor MHCantigens. |
|
473. A man who now has progressive stupor and laryngeal spasms for 3 days after pt was being attacked by a wild bat in a cave a month ago should have received |
Inactivated rabies virus vaccine |
|
474. Alternative and lectin pathways of complements activated |
bacterial surfaces |
|
475. Classic complement pathway is activated by antibody- antigen complexes involving antibody class type |
IgM >> IgG |
|
476. Chemotactic and anaphylotoxic complements are |
C3a, C5a |
|
477. successful opsonization of all non-encapsulated bacteria are by complement |
C3b |
|
478. Defect or deficiency of which complements predisposes individuals to infections caused by Neisseria spp., the causative agents of gonorrhea and meningitis |
C6-C9 |
|
479. Antimicrobial (immune) response important for intracellular bacterial infections involves cell type |
Th1 CD4 T cells |
|
480. Immune response important for viral infections involves cell type |
CD8 cytolytic T cells |
|
481. Major antibody in secretions and plays a significant role in first-line defense at the mucosal level is |
IgA |
|
482. Main antibody in the initial “primary” immune response andallows good complement activation is |
IgM |
|
483. Fc region of this immunoglobulin binds to eosinophils, basophils and mast cells and is significant mediator of allergic (hypersensitivity) reactions |
IgE |
|
484. What on macrophages enables them to sense that the material is microbial in origin, and must therefore be eliminated quickly? |
Toll-like receptor |
|
485. These oxygen-dependent enzymes: NADPH oxidase, superoxide dismutase, and myeloperoxidase are involved in killing of what? |
Gram-positive bacteria |
|
486. These oxygen-independent enzymes/proteins: lysosome, lactoferrin, defensins and other cationic proteins are involved in killing of what? |
Gram-negative bacteria |
|
487. Infections persist, because m activation is defective, leading to chronic stimulation of CD4+ T cells in what dz? |
Chronic granulomatous Dz |
|
488. Defective respiratory burst, predisposing chronic bacterial infection is associated with deficiency of what? |
Glucose-6-phosphate dehydrogenase (G6PD) |
|
489. All nucleated cells express MHC I antigens |
HLA-A, B, C |
|
490. Antigen-presenting cells express MHC II antigens |
HLA-DP, DQ, DR |
|
491. Lymphocyte proliferation (T, B) and NK → cytotoxicity are undertaken by what cytokine? |
IL-2 |
|
492. B-cell activation, IgE and IgG4 switch, ↓ TH1 cells/ M (phi), ↓IFN-gamma, TH0 → TH2 are all undertaken by what cytokine? |
IL-4 |
|
493. M activation; elevated expression of MHC and FcRs molecules on B cells, IgG2 class switching, increased IL-4 and TH2 are all undertaken by what cytokine? |
IFN gamma |
|
494. The Th1 response, driven primarily by IFN-gamma leads to the activation of |
macrophages |
|
495. The Th2 response, driven primarily by IL-4 and IL-5, leads to the production of IgE and IgG4 and to the activation of |
Mast cells and eosinophils |
|
496. Variable T and B cells in DiGeroge’s syndrome is associated with |
Thymic aplasia |
|
497. No B cells and immunoglobulins in X-linked agammaglobulinemia (Bruton’s) is associated with |
Loss of Btk tyrosine kinase |
|
498. Lack of anti-polysaccharide antibody and impaired T-cell activation causing Wiskott-Aldrich syndrome is associated with |
X-linked-defective WASP gene |
|
499. Inability to control B cell growth in X-linked lympho- proliferative syndrome is associated with |
SH2D1A mutant |
|
500. Glomerulonephritis, pulmonary hemorrhage inGoodpasture’s syndrome is caused by what autoantigen? |
basement membrane collagen type IV |
|
501. Hyperthyroidism in Grave’s Dz is caused by whatautoantigen? |
Thyroid-stimulating hormone |
|
502. Progressive muscle weakness in Myasthenia gravis iscaused by what autoantigen? |
Acetyl choline receptor |
|
503. Brain degeneration, paralysis in Multiple sclerosis (MS) iscaused by what autoantigen? |
Myelin basic protein,proteolipid protein |
|
504. Localized allergies (e.g., drug allergy, asthma, hay fever)and anaphylaxis (food, drug) w/ systemic inflammation throughoutcirculation are associated with reaction? |
Type I hypersensitivity |
|
505. Autoimmune hemolytic anemia: Ab’s produced vs RBCmembrane Ag’s, mismatched blood (transfusion rxn), and allergiesto antibiotics (e.g., penicillins, sulfa drugs) are associated withreaction? |
Type II hypersensitivity |
|
506. Grave’s Disease, Myasthenia Gravis, Goodpasture’ssyndrome are all associated with reaction? |
Type II hypersensitivity |
|
507. Post-streptococcal glomerulonephritis, serum sickness tohorse diphtheria anti-toxin, systemic lupus erythematosis (SLE),and rheumatoid arthritis are all associated with reaction? |
Type III hypersensitivity |
|
508. Poison ivy, erythematous induration in tuberculin skin test,and transplantation/graft rejection are all associated with reaction? |
Type IV hypersensitivity |
|
509. Periodic acid Schiff (PAS) stain targeted at glycogen andmucopolysaccharides is used to diagnose |
Whipple’s disease |
|
510. For microscopic visualization, mycobacteria with highlipid-contentcell wall requires |
Acid-fast stain |
|
511. Acid-fast bacteria (aka: mycobacteria) are visualized bymicroscopy using |
Ziehl-Neelsen stain |
|
512. Non-stainable bacteria that are considered atypical and intracellular may be detected by microscopy using |
Giemsa stain |
|
513. Rickettsia and chlamydia do not stain with Gram stain because they are |
Strictly intracellular |
|
514. Special culture medium required to grow Haemophilus influenzae is |
Chocolate agar w/ X (hematin) and V (NAD) factors |
|
515. Special culture medium required to grow Bordetella pertussis is |
Bordet-Gengou (potato) agar |
|
516. Special culture medium required to grow Corynebacterium diphtheriae is |
Tellurite or Loeffler’s agar |
|
517. Special culture medium required to grow Neisseria gonorrhoeae is |
Thayer-Martin (agar) media |
|
518. Special culture medium required to grow Mycoplasma pneumoniae is |
Eaton’s agar |
|
519. Special culture medium required to grow Mycobacterium tuberculosis is |
Lowenstein-Jensen agar |
|
520. Special culture medium required to grow Legionella pneumophila is |
Buffered charcoal-yeast- extract (BCYE) agar with iron and cysteine |
|
521. Growth/differential medium required to grow and differentiate Escherichia coli from non-sterile body fluid/tissue is |
MacConkey agar |
|
522. Growth/differential medium required to grow and differentiate Staphylococcus aureus from non-sterile body fluid/tissue (e.g., skin, abscesses) is |
Mannitol-salt agar |
|
523. Nutrient rich medium required to support growth of fastidious organisms (e.g., Streptococus pneumoniae, Neisseria meningitidis) from the sterile body fluid/tissue is |
Chocolate agar |
|
524. Special culture medium required to grow moulds or yeasts from a presumed fungal infection is |
Sabouraud’s dextrose agar |
|
525. Thee anaerobes, such as ABC (Actinomyces, Bacteroides, and Clostridium) organisms do not grow in presence of oxygen because they lack |
Catalase and superoxide dismutase |
|
526. The encapsulated bacteria (Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, Klebsiella pneumoniae, Streptococcus agalactae) are all virulent by virtue of the property of resistance to |
Phagocytosis |
|
527. Edema factor and lethal factor carried by protective antigen are associated with |
Bacillus anthracis |
|
528. A-B subunit toxin (plasmid encoded): ADP ribosylating activity is associated with |
Bordetella pertussis |
|
529. Neurotoxin toxin (prophage carrier) that caused flaccidparalysis is associated with |
Clostridium botulinum |
|
530. Enterotoxin A and cytotoxin B are syngerstically active in |
Clostridium difficile |
|
531. Phospholipase C and enterotoxin are non-synergistically (in different diseases) associated with various subspecies of |
Clostridium perfringens |
|
532. Peripheral neuro toxin causing spastic paralysis (carried in plasmid) is associated with |
Clostridium tetani |
|
533. A-B subunit toxin (carried in bacteriophage) causinginhibition of protein synthesis in target cells is associated with |
Corynebacterium diphtheriae |
|
534. Heat-labile toxin (LT, carried/coded in plasmid), heat-stabletoxin (ST, also carried/coded in plasmid), and Shiga-like toxin(carried/coded in bacteriophage) are non-synergistically associatedwith various toxic strains of |
Escherichia coli |
|
535. Exotoxin A is associated with a pyocyanin-producingGram-negative bacterial species: |
Pseudomonas aeruginosa |
|
536. Shiga toxin, an enterotoxin is associated with |
Shigella dysenteriae |
|
537. TSST-1, exfoliating toxin (carried in plasmid), alpha toxin |
Staphylococcus aureus |
|
538. Pyrogenic exotoxin SpeA, SpeC (carried in bacteriophage) and hemolysins O & S (general cytotoxins) are associated with |
Streptococcus pyogenes (know also: M proteins surface virulence factor) |
|
539. Gram-positive Cocci in pairs and chains are: |
o Streptococcus (“Lancetshaped”:Streptococcuspneumoniae)o Enterococcuso Peptostreptococcus(anaerobe) |
|
540. Gram-positive Cocci in Clusters are: |
o Bacillus (large; aerobe)o Clostridium (“Box carshaped”:Clostridiumperfringens)o Corynebacterium(palisading; aerobe)o Propionibacterium(pleomorphic; anaerobe)o Listeria (small) o Nocardia (branching,filamentous, aerobe)o Actinomyces (branching,filamentous, anaerobe) |
|
541. Gram-negative Cocci are |
o Neisseria (diplococci:“kidney bean-shaped”)o Moraxella catarrhalis(diplococci)o Veillonella (anaerobe) |
|
542. Gram-negative Rods are |
o Enterobacteriaceae(E.coli, Klebsiella,Salmonella; “Safety pinshaped”:Yersinia pestis)o Pseudomonaso Bacteroides (anaerobe)o Fusobacterium (anaerobe)o Haemophilus(pleomorphic)o Brucella (coccobacillus)o Vibrio (curved)o Campylobacter (“Seagull”appearance)o Helicobacter (curved) |
|
543. Facultative intracellular bacteria are non-susceptible toβ-lactam antibiotics and are commonly known species of : |
Brucella, Francisella,Legionella, Mycobacterium,Yersinia |
|
544. Non-envelope, icosahedral, smallest virus with linearsingle-stranded (ss-) DNA is |
parvovirus B19 |
|
545. Non-envelope, icosahedral virus with circular doublestranded (ds-) DNA (super-coiled) is |
papilloma viruses; JC, BKviruses |
|
546. Enveloped, icosahedral virus with incomplete, circular dsDNAis |
hepatitis B virus |
|
547. Enveloped, icosahedral virus with linear, ds-DNA is |
herpes viruses (e.g., HSV 1,2;VZV; CMV; EBV; HHV-6;HHV-8 (KSHV)) |
|
548. Enveloped (“Donut”-shaped), largest virus with helical,linear, ds-DNA is |
smallpox |
|
549. Non-enveloped, icosahedral virus with linear, positivepolarity,ss-RNA is |
polioviruses; rhinoviruses;echoviruses;coxsackieviruses;enteroviruses; HAV |
|
550. Non-enveloped, icosahedral ('Star of David') virus withlinear, positive-polarity, ss-RNA is |
noroviruses |
|
551. Enveloped, icosahedral virus with linear, positive-polarity,ss-RNA is |
HCV; dengue virus; yellowfever virus; West Nile virus;Japanese encephalitis virus |
|
552. Enveloped, icosahedral virus with linear, positive-polarity,ss-RNA is |
rubella virus; Eastern equineencephalitis (EEE) and WEEviruses |
|
553. Non-enveloped (“Rota” or wheel-shaped) icosahedral viruswith linear ds-RNA (10 segments) is |
rotaviruses |
|
554. Enveloped, helical virus with linear, negative polarity, ssRNA(8 segments) is |
influenza viruses types A, B,and C |
|
555. Enveloped, icosahedral virus with linear, positive-polarity,ss-RNA (diploid) is |
HIV-1 and 2; HTLV-1 and 2 |
|
556. Enveloped, helical virus with linear, negative-polarity ssRNA(3 segments) is |
Hantaan (Sin Nombre) virus |
|
557. Enveloped (“crown”-shaped virus), helical virus with linear,positive-polarity, ss-RNA is |
SARS Corona virus type 4 |
|
558. Enveloped (“bullet”-shaped virus), helical virus with linear,negative-polarity, ss-RNA is |
rabies virus |
|
559. Enveloped, complex virus with linear, negative-polarity, ssRNAis |
Marburg and Ebola viruses |
|
560. Enveloped (largest RNA viruses), helical virus with linear,negative-polarity, ss-RNA is |
Paraifluenza viruses, Mumps,Measles, RSV |
|
561. Outbreaks of Acinetobacter infections typically occur inintensive care units and healthcare settings housing: |
Very ill patients |
|
562. People with certain health conditions, like weakenedimmune systems or chronic lung diseases (particularly cysticfibrosis), may be more susceptible to infections with |
Burkholderia cepacia. |
|
563. Burkholderia cepacia bacteria are often resistant to |
common antibiotics |
|
564. Diarrhea and fever are the most common symptoms of |
Clostridium difficile infection |
|
565. The most important risk for getting Clostridiumdifficile infection in health-care settings is overuse of |
antibiotics |
|
566. A family of Gram-negative bacteria that are difficult to treathealth care-associated infections because they have high levels ofresistance to antibiotics. |
Carbapenem-resistantEnterobacteriaceae (CRE) |
|
567. Carbapenem-resistant Enterobacteriaceae are |
Klebsiella speciesand Escherichia coli |
|
568. Gram-negative bacteria cause pneumonia, bloodstreaminfections, wound or surgical site infections, and meningitis in |
healthcare settings |
|
569. In medical facilities, MRSA causes life-threateningbloodstream infections, pneumonia and |
surgical site infections |
|
570. Community-acquired CA-MRSA isolates contain thevirulence factor Panton-Valentine leukocidin (PVL) and carry |
staphylococcal cassettechromosome(SCC) mec genes |
|
571. Patients colonized (nare) with MRSA, in health-caresettings are advised to use chlorohexidine, gluconate scrub,povidone iodine, and |
mupirocin ointment for 5 days |
|
572. Products that are used to remove soil, dirt, dust, organicmatter, and germs (like bacteria, viruses, and fungi) are |
Cleaners or detergents |
|
573. Cleaners or detergents work by washing the surface to liftdirt and organisms off |
surfaces (so they can berinsed away with water) |
|
574. Products used to reduce organisms from surfaces but nottotally get rid of them (considered safe) are |
Sanitizers |
|
577. Chemical products that destroy or inactivate germs and preventthem from growing (also used after cleaning for surfaces thathave visible blood or drainage from infected skin) are |
Disinfectants |
|
578. Disinfectants are regulated by the |
Environmental ProtectionAgency (EPA). |
|
579.Pruritus is the most common symptom of head lice infestation andis caused by an allergic reaction to bites by |
Pediculus humanus capitis |
|
580.Lice infestations (pediculosis and pthiriasis) are spread mostcommonly by |
close person-to-person contact |
|
581.The life cycle of the head louse has three stages: |
egg,nymph, and adult |
|
582. Nits, heads lice eggs, are laid by the adult female and are cementedat the base of the |
hair shaft nearest the scalp |
|
583.The egg hatches to release a nymph. The nit shell then becomes amore visible dull yellow and remains attached to the |
hair shaft |
|
584. Nymphs mature after three molts and become adults about |
7 days after hatching |
|
585. The adult louse is tan to grayish-white, about the size of a sesame seed, and has legs numbering: |
6 (each with claws) |
|
586.Treatment for head lice is recommended for persons diagnosed with |
an active infestation |
|
587.Apply lice medicine, also called pediculicide, using prescription medication(s): |
Benzyl alcohol, 5% or ivermectin, 0.5% or malation,0.5% or spinosad 0.9% |
|
588.Body lice infestations (pediculosis) are spread most commonly by close person-to-person contact but are generally limited to persons who live under conditions of |
crowding and poor hygiene |
|
589.The only treatment needed for body lice infestations is |
Improved hygiene and regularchanges of clean clothes |