Usmle Step 1: Microbiology - Best One But Its From 07

Front 1

Function and chemical composition of bacterial structure: Peptidoglycan

Back 1

Function:
1. Rigid support
2. Protects against osmotic pressure

Chemical composition:
Sugar backbone with cross-linked peptide side chains

Front 2

Function and chemical composition of bacterial structure: Cell wall/cell membrane

Back 2

Gram positives only

Function: Major surface antigen

Chemical composition: Teichoic acid, which induces TNF and IL-1

Front 3

Function and chemical composition of bacterial structure: Outer membrane

Back 3

Gram negatives only

Function: Site of endotoxin (lipopolysaccharide) and major surface antigen

Chemical composition: Lipid A induces TNF and IL-1, and polysaccharide is the antigen

Front 4

Function and chemical composition of bacterial structure: Plasma membrane

Back 4

Function: Site of oxidative and transport enzymes

Chemical composition: Lipoprotein bilayer

Front 5

Function and chemical composition of bacterial structure: Ribosome

Back 5

Function: Protein synthesis

Chemical composition: 50S and 30S subunits

Front 6

Function and chemical composition of bacterial structure: Periplasm

Back 6

Function: Space between the cytoplasmic membrane and outer membrane in gram-negative bacteria

Chemical composition: Contains many hydrolytic enzymes, including beta-lactamases

Front 7

Function and chemical composition of bacterial structure: Capsule

Back 7

Function: Protects against phagocytosis

Chemical composition: Polysaccharide (except Bacillus anthracis which contains D-glutamate)

Front 8

Function and chemical composition of bacterial structure: Pilus/fimbria

Back 8

Function: Mediates adherence of bacteria to cell surface; sex pilus forms attachment between 2 bacteria during conjugation

Chemical composition: Glycoprotein

Front 9

Function and chemical composition of bacterial structure: Flagellum

Back 9

Function: Motility

Chemical composition: Protein

Front 10

Function and chemical composition of bacterial structure: Spore

Back 10

Function: Provides resistance to dehydration, heat, and chemicals

Chemical composition: Keratin-like coat and dipicolinic acid

Front 11

Function and chemical composition of bacterial structure: Plasmid

Back 11

Function: Contains a variety of genes for antibiotic resistance, enzymes, and toxins

Chemical composition: DNA

Front 12

Function and chemical composition of bacterial structure: Glycocalyx

Back 12

Function: Mediates adherence to surfaces, especially foreign surfaces (eg indwelling catheters)

Chemical composition: Polysaccharide

Front 13

Function of this structure: IgA proteases

Back 13

Function: Allow some organisms to colonize mucosal surfaces

Front 14

Which bacteria have IgA proteases?

Back 14

1. Streptococcus pneumoniae
2. Neisseria meningitidis
3. Neisseria gonorrheae
4. Hemophilus influenzae

Front 15

Which bacterial substances induce cytokines, and which are they?

Back 15

Cytokines induced:
1. IL-1
2. TNF

Gram positive inducer: Teichoic acid

Gram negative inducer: Lipopolysaccharide (Endoxtoxin)

Front 16

What does the capsule of Bacillus anthracis consist of?

Back 16

D-glutamate

Front 17

What bacterial structure contains D-glutamate?

Back 17

Capsule of Bacillus anthracis

Front 18

What are the main differences between gram negative and gram positive organisms?

Back 18

Peptidoglycan cell wall: Gram positive has thick. Gram negative has thin.

Flagellar basal body rings: Gram positive has two. Gram negative has four.

Outer antigen: Gram positive: Teichoic acid. Gram negative: Lipidpolysaccharide

Periplasmic space: Gram positive does not have. Gram negative has.

Porin channel: Gram positive does not have. Gram negative has.

Lysozyme and penicillin attack: Gram positive are sensitive. Gram negative are resistant.

Front 19

What bacteria do not gram stain well?

Back 19

Mnemonic: These Rascals May Microscopically Lack Color

1. Treponema
2. Rickettsia
3. Mycobacteria
4. Mycoplasma
5. Legionella pneumophila
6. Chlamydia

Front 20

Why does the following bug not gram stain well?: Treponema

Back 20

Too thin to be visualized

Front 21

Why does the following bug not gram stain well?: Rickettsia

Back 21

Intracellular parasite

Front 22

Why does the following bug not gram stain well?: Mycobacteria

Back 22

high-lipid-content cell wall

Front 23

Why does the following bug not gram stain well?: Mycoplasma

Back 23

No cell wall

Front 24

Why does the following bug not gram stain well?: Legionella pneumophila

Back 24

Primarily intracellular

Front 25

Why does the following bug not gram stain well?: Chlamydia

Back 25

Intracellular parasite which lacks muramic acid in cell wall

Front 26

How is the following bug visualized?: Treponema

Back 26

1. Darkfield microscopy
2. Fluorescent antibody staining
3. silver stain

Front 27

Why does the following bug not gram stain well?: Mycobacteria

Back 27

Acid fast for high lipid content cell wall

Front 28

What are the stages of bacterial growth and what are their relative lengths?

Back 28

1. Lag phase: x
2. Log phase: 1.5x
3. Stationary phase: 2.5x
4. Death phase: 4x

Front 29

What happens in the following phase of bacterial growth, and where does it fall in the order?: Lag

Back 29

1st phase: Metabolic activity without division

Front 30

What happens in the following phase of bacterial growth, and where does it fall in the order?: Log

Back 30

2nd phase: Rapid cell division

Front 31

What happens in the following phase of bacterial growth, and where does it fall in the order?: Stationary

Back 31

3rd phase: Nutrient depletion slows growth

Front 32

What happens in the following phase of bacterial growth, and where does it fall in the order?: Death

Back 32

4th phase: Prolonged nutrient depletion and buildup of waste products leads to death

Front 33

Bacterial endotoxins and exotoxins: Source?

Back 33

Exotoxin: Certain species of gram positive and gram negative bacteria

Endotoxin: Cell wall of most gram-negative bacteria

Front 34

Bacterial endotoxins and exotoxins: Secreted from cell?

Back 34

Exotoxin: Yes

Endotoxin: No

Front 35

Bacterial endotoxins and exotoxins: Chemistry

Back 35

Exotoxin: Polypeptide

Endotoxin: Lipopolysaccharide

Front 36

Bacterial endotoxins and exotoxins: Location of genes

Back 36

Exotoxin: Plasmid or bacteriophage

Endotoxin: Bacterial chromosome

Front 37

Bacterial endotoxins and exotoxins: Toxicity (fatal dosage)

Back 37

Exotoxin: High (fatal dose on the order of 1 microgram)

Endotoxin: Low (fatal dose on the order of hundreds of micrograms)

Front 38

Bacterial endotoxins and exotoxins: Clinical effects

Back 38

Exotoxin: Toxin specific

Endotoxin: Fever and shock

Front 39

Bacterial endotoxins and exotoxins: Mode of action

Back 39

Exotoxin: Toxin specific

Endotoxin: Includes TNF and IL-1

Front 40

Bacterial endotoxins and exotoxins: Antigenicity

Back 40

Exotoxin: Induces high-titer antibodies called antitoxins

Endotoxin: Poorly antigenic

Front 41

Bacterial endotoxins and exotoxins: Vaccines

Back 41

Exotoxin: Toxoids used as vaccines

Endotoxin: No toxoids formed and no vaccine available

Front 42

Bacterial endotoxins and exotoxins: Heat stability

Back 42

Exotoxin: Destroyed rapidly at 60 degrees celsius (except Staphylococcal enterotoxin)

Endotoxin: Stable at 100 degrees celsius for 1 hour

Front 43

Bacterial endotoxins and exotoxins: Typical diseases

Back 43

Exotoxin: Tetanus, botulism, diphtheria

Endotoxin: Meningococcemia, sepsis by gram negative rods

Front 44

Mechanism of superantigens

Back 44

1. Bind directly to MHC II and T cell receptor
2. Large numbers of T cells are activated.
3. Stimulates release of IFN-gamma and IL-2

Front 45

Mechanism of ADP ribosylating A-B toxins

Back 45

Interfere with host cell function

1. B (binding) component binds to a receptor on surface of host cell.
2. The toxin is endocytosed.
3. A (active) component attaches an ADP-ribosyl to a host cell protein.
4. That protein's function is altered.

Front 46

List of bugs that release superantigens

Back 46

1. Staphylococcus aureus
2. Streptococcus pyogenes

Front 47

List of bugs that release ADP ribosylating A-B toxins

Back 47

1. Corynebacterium diphtheriae
2. Vibrio cholerae
3. E. coli
4. Bordetella pertussis

Front 48

What to know about exotoxins released by Staphylococcus aureus

Back 48

Superantigens
1. TSST-1 causes toxic shock syndrome (fever, rash, shock).
2. Enterotoxins cause food poisoning.

Front 49

What to know about exotoxins released by Streptococcus pyogenes

Back 49

Scarlet fever (superantigen)
1. Erythrogenic
2. Causes toxic shock-like syndrome

Streptolysin O (hemolysin). The antigen for ASO antibody is found in rheumatic fever

Front 50

What to know about exotoxins released by Corynebacterium diphtheriae

Back 50

ADP ribosylating A-B toxin (similar to Pseudomonas exotoxin A)

Encoded by beta-prophage

Disease: Pseudomembranous pharyngitis (grayish-white membrane) with lymphadenopathy

Mechanism:
Inactivates elongation
factor 2 (EF-2)

Mnemonic: ABCDEFG
ADP ribosylation
Beta-prophage
Corynebacterium
Diphtheriae
Elongation Factor 2
Granules (metachromatic)

Front 51

What to know about exotoxins released by Vibrio cholerae

Back 51

1. A-B toxin ADP ribosylates Gs protein thus:
2. Permanently activates Gs protein
3. Constant stimulation of adenylyl cyclase which:
4. Increases pumping of Cl into gut
5. H2O follows it
6. Leads to rice water diarrhea

Front 52

What to know about exotoxins released by E. coli

Back 52

E.coli 0157:H7 produces Shiga toxin.

ADP ribosylating A-B toxins

Heat-labile: Permanent activation of adenylyl cyclase (cholera-like mechanism) leading to watery diarrhea

Heat-stabile: Stimulates guanylate cyclase

Mnemonic: Labile like the Air, Stabile like the Ground.

Front 53

What to know about exotoxins released by Bordetella pertussis

Back 53

1. ADP ribosylating A-B toxin
2. Permanently disables Gi
3. Constant stimulation of adenylate cyclase
4. Causes whooping cough
5. Also inhibits chemokine receptor causing lymphocytosis

Front 54

What to know about exotoxins released by Clostridium perfringens

Back 54

alpha toxin (aka lecithinase) causes:
1. gas gangrene
2. myonecrosis
3. hemolysis (See double zone of hemolysis on blood agar.)

PERFringens PERForates a gangrenous leg.

Front 55

What to know about exotoxin released by Clostridium botulinum

Back 55

Properties:
1. Preformed
2. Heat-labile

Mechanism:
Blocks the release of acetylcholine causing:
1. anticholinergic symptoms
2. CNS paralysis (especially cranial nerves)
3. Floppy baby syndrome

BOTulinum is from bad BOTtles of food and honey and sausage (causes flaccid paralysis)

Front 56

What to know about exotoxins released by Clostridium tetani

Back 56

Blocks the release of inhibitory neurotransmitter glycine from Renshaw cells in the spinal cord. Causes "lockjaw"

Front 57

What to know about exotoxins released by Bacillus anthracis

Back 57

1 toxin in the toxin complex is edema factor, an adenylate cyclase

Front 58

What to know about exotoxins released by Shigella

Back 58

Shiga toxin (also produced by E.coli 0157:H7).

Cleaves host cell rRNA. Also enhances cytokine release causing hemolytic uremic syndrome.

Front 59

Endotoxin: What is it and where is it found?

Back 59

Lipopolysaccharide found in the outer membrane of gram-negative bacteria. Heat stable.

Front 60

Endotoxin: What does it activate and what do they release?

Back 60

1. Macrophages (IL-1, TNF, Nitric oxide)
2. Alternative complement pathway (C3a, C5a)
3. Hageman factor (Coagulation cascade)

Front 61

What mediators are released when endotoxin activates macrophages, and what do they do?

Back 61

1. IL-1: Fever
2. TNF: Fever and Hemorrhagic tissue necrosis
3. Nitric Oxide: Hypotension (shock)

Front 62

What mediators are released when endotoxin activates the alternative complement cascade, and what do they do?

Back 62

1. C3a: Hypotension and edema
2. C5a: Neutrophil chemotaxis

Front 63

What mediators are released when endotoxin activates Hageman factor, and what do they do?

Back 63

Coagulation cascade: Disseminated intravascular coagulopathy

Front 64

What method is used to differentiate Neisseria?

Back 64

Sugar fermentation

Front 65

What do meningococci ferment?

Back 65

MeninGococci ferment Maltose and Glucose

Front 66

What do gonococci ferment?

Back 66

Gonococci ferments Glucose

Front 67

What are the pigment producing bacteria and what pigments do they produce?

Back 67

Staphylococcus aureus: Yellow pigment (Aureus means gold in Latin)

Pseudomonas aeruginosa: blue-green pigment

Serratia marcescens: red pigment (think red maraschino cherries)

Front 68

Special culture requirements for: Hemophilus influenzae

Back 68

Chocolate agar with factors V (NAD) and X (hematin)

Mnemonic: When a child has "flu" mom goes to five (V) and dime (X) to buy some chocolate.

Front 69

Special culture requirements for: Neisseria gonorrhoeae

Back 69

Thayer-Martin media

Front 70

Special culture requirements for: Bordetella pertussis

Back 70

Bordet-Gengou (potato) agar

Front 71

Special culture requirements for: M. tuberculosis

Back 71

Lowenstein-Jensen agar

Front 72

Special culture requirements for: Lactose-fermenting enteric bacteria

Back 72

Pink colonies on MacConkey's agar

Front 73

Special culture requirements for: Legionella

Back 73

Charcoal yeast extract agar buffered with increased iron and cysteine

Front 74

Special culture requirements for: Fungi

Back 74

Sabouraud's agar

Front 75

What microbes can be stained with: Congo red

Back 75

Amyloid. Apple-green birefringence in polarized light (because of beta-pleated sheets)

Front 76

What microbes can be stained with: Giemsa's

Back 76

1. Borrelia
2. Plasmodium
3. Trypanosomes
4. Chlamydia

Front 77

What microbes can be stained with: periodic acid-Schiff (PAS)

Back 77

Glycogen and mucopolysaccharides. Used to diagnose Whipple's disease

Front 78

What microbes can be stained with: Ziehl-Neelsen

Back 78

Acid-fast bacteria.

Front 79

What microbes can be stained with: India ink

Back 79

Cryptococcus neoformans

Front 80

What microbes can be stained with: Silver stain

Back 80

1. Fungi
2. PCP (Pneumocystis Pneumonia)
3. Legionella
4. Treponema

Front 81

For the following genetic transfer procedure, explain the process: Conjugation

Back 81

Direct cell to cell DNA transfer

Front 82

For the following genetic transfer procedure, explain the process: Transduction

Back 82

Phage-mediated cell to cell DNA transfer

Front 83

For the following genetic transfer procedure, explain the process: Transformation

Back 83

Purified DNA taken up by a cell

Front 84

For the following genetic transfer procedure, explain the processd: Transposition

Back 84

DNA transfer to same or another chromosome or plasmid WITHIN a cell

Front 85

For the following genetic transfer procedure, give the types of cells involved: Conjugation

Back 85

Prokaryotic

Front 86

For the following genetic transfer procedure, give the types of cells involved: Transduction

Back 86

Prokaryotic

Front 87

For the following genetic transfer procedure, give the types of cells involved: Transformation

Back 87

Prokaryotic or eukaryotic

Front 88

For the following genetic transfer procedure, give the types of cells involved: Transposition

Back 88

Prokaryotic or eukaryotic

Front 89

For the following genetic transfer procedure, give the nature of DNA transferred: Conjugation

Back 89

Chromosomal or plasmid

Front 90

For the following genetic transfer procedure, give the nature of DNA transferred: Transduction

Back 90

Generalized transduction: Any gene

Specialized transduction: Only certain genes

Front 91

For the following genetic transfer procedure, give the nature of DNA transferred: Transformation

Back 91

Any DNA

Front 92

For the following genetic transfer procedure, give the nature of DNA transferred: Transposition

Back 92

DNA sequences "jumping genes"

Front 93

What is lysogeny?

Back 93

When the genetic code for a bacterial toxin is encoded in a lysogenic phage.

Front 94

Name 4 lysogenic toxins.

Back 94

BCDE

1. Botulinum
2. Cholera
3. Diphtheria
4. Erythrogenic toxin of Streptococcus Pyogenes

Front 95

List four obligate aerobes.

Back 95

Nocardia, Pseudomonas aeruginosa, Mycobacterium tuberculosis, Bacillus

Mnemonic: Nagging Pests Must Breathe

Front 96

Where in the lung does M. tuberculosis prefer, and why?

Back 96

Apices of the lung, as they have the highest PO2.

Front 97

What conditions occur concurrently with P. Aeruginosa infection?

Back 97

1. Burn wounds
2. Nosocomial pneumonia
3. Pneumonias in Cystic Fibrosis patients

Front 98

List 3 obligate anaerobes

Back 98

Clostridium, Bacteroides, and Actinomyces

Front 99

What enzymes do obligate anaerobes lack?

Back 99

Catalase (aka glutathione peroxidase)

AND/OR

Superoxide dismutase (converts O2-radical[ie superoxide] to H2O2)

Front 100

Why are anaerobes foul-smelling?

Back 100

They produce short-chain fatty acids.

Front 101

What do anaerobes produce in tissue?

Back 101

CO2 and H2 gases

Front 102

Where are anaerobes normal flora?

Back 102

1. GI tract
2. Between teeth and gums

Front 103

What antibiotics are particularly ineffective against anaerobes?

Back 103

AminO2glycosides, as they require O2 to enter the bacterial cell.

Front 104

List the obligate intracellular bacteria.

Back 104

Rickettsia and Chlamydia.

Mnemonic: Stay inside (cells) when it is Really Cold

Front 105

What is the defining characteristic of obligate intracellular bacteria.

Back 105

Can't make their own ATP.

Front 106

List the facultative intracellular bacteria.

Back 106

Mnemonic: Some Nasty Bugs May Live FacultativeLY

Salmonella, Neisseria, Brucella, Mycobacterium, Listeria, Francisella, Legionella, Yersinia

OR

Mnemonic: My Liege, Your Niece Lists Frank, Bruce and Sam.

Mycobacterium, Leigonella, Yersinia, Neisseria, Listeria, Francisella, Brucella, Salmonella.

Front 107

List four major examples of encapsulated bacteria

Back 107

1. Streptococcus pneumoniae
2. Hemophilus influenzae (especially B serotype)
3. Neisseria meningitidis
4. Klebsiella pneumoniae

Front 108

What does a positive quellung reaction indicate?

Back 108

Positive quellung: If encapsulated bug is present, capsule swells when specific anticapsular antisera are added.

Mnemonic: Quellung = capsular "swellung"

Front 109

In which vaccines does the capsule serve as an antigen?

Back 109

Pneumovax, H influenzae B, Meningococcal vaccines

Front 110

What does conjugation with protein do to vaccines that have a capsular antigen?

Back 110

Increases the immunogenicity and T-cell dependent responce.

Front 111

Which bacteria form spores?

Back 111

Gram positive soil bugs (eg Bacillus anthracis, Clostridium perfringens, Clostridium tetani)

Front 112

How can one destroy spores?

Back 112

Autoclave (as is done to surgical equipment)

Front 113

Which bacteria are alpha hemolytic?

Back 113

Streptococcus (all catalase-negative)

If optochin sensitive, bile soluble, or quellung positive: Streptococcus Pneumoniae

If optochin resistant, bile insoluble, or quellung negative: Streptococcus Viridans (eg S. Mutans)

Front 114

Which bacteria are beta-hemolytic?

Back 114

Rods:
Listeria monocytogenes

Cocci:
If catalase positive and coagulase positive: Staphylococcus Aureus

If catalase negative, Streptococcus.
Then, if bacitracin sensitive, S. pyogenes. If bacitracin resistant, S. agalactiae.

Front 115

What are the important points about Listeria monocytogenes?

Back 115

1. Tumbling motility
2. Meningitis in newborns
3. Unpasteurized milk

Front 116

Gram positive: Which are catalase positive and which are catalase negative?

Back 116

Positive: Staph
Negative: Strep

Front 117

Gram positive: Which are catalase positive bacteria make coagulase?

Back 117

Staph aureus does.

Staph epidermidis and saprophyticus do not.

Front 118

What is Protein A?

Back 118

Virulence factor of Staphylococcus Aureus. Binds Fc-IgG, inhibiting complement fixation and phagocytosis.

Front 119

What disease states does Staphylococcus Aureus cause?

Back 119

Inflammatory:
1. Skin infections
2. Organ abscesses (acute bacterial endocarditis, osteomyelitis)
3. Pneumonia

Toxin-mediated:
1. Toxic shock syndrome (TSST-1)
2. Scalded skin syndrome (exfoliative toxin)
3. Rapid-onset food poisoning (ingestion of preformed enterotoxin)

Front 120

What disease states does Streptococcus Pyogenes cause?

Back 120

Pyogenic
1. Pharyngitis
2. Cellulitis
3. Impetigo

Toxigenic
1. Scarlet fever
2. Toxic shock syndrome

Immunologic
1. Rheumatic fever
2. Acute glomerulonephritis

Front 121

What are two sequelae of Streptococcus Pyogenes pharyngitis?

Back 121

Rheumatic fever and acute glomerulonephritis

Mnemonoic: PHaryngitis gives you rheumatic PHever and glomerulonePHritis

Front 122

Which antibody enhances host defenses against Streptococcus Pyogenes?

Back 122

Antibody to M protein

Front 123

Antibody to M protein enhances host defenses against what?

Back 123

Streptococcus Pyogenes

Front 124

What does ASO titer detect?

Back 124

Recent S. Pyogenes infection

Front 125

How can one detect recent S. Pyogenes infection?

Back 125

ASO titer

Front 126

What are the signs and symptoms of rheumatic fever?

Back 126

1. Subcutaneous nodules
2. Polyarthritis
3. Erythema marginatum
4. Chorea
5. Carditis (bacterial endocarditis)

Mnemonic: No "rheum" for SPECCulation

Front 127

What is streptococcus pneumoniae the most common cause of?

Back 127

1. Meningitis
2. Otitis media (in children)
3. Pneumonia
4. Sinusitis

S. pneumoniae MOPS are Most OPtochin Sensitive

Front 128

What is the most common cause of meningitis?

Back 128

Streptococcus pneumoniae

Front 129

What is the most common cause of otitis media?

Back 129

Streptococcus pneumoniae

Front 130

What is the most common cause of pneumonia?

Back 130

Streptococcus pneumoniae

Front 131

What is the most common cause of sinusitis?

Back 131

Streptococcus pneumoniae

Front 132

What is indicated by "rusty" sputum?

Back 132

Streptococcus pneumoniae infection

Front 133

What are common associations with Pneumococcus?

Back 133

Streptococcus Pneumoniae

1. "Rusty" sputum
2. Sepsis in sickle cell anemia 3. splenectomy

Front 134

What does sepsin in sickle cell anemia indicate?

Back 134

Streptococcus pneumoniae

Front 135

What do Group B streptococci cause?

Back 135

B for Baby

1. Pneumonia
2. Meningitis
3. Sepsis

Front 136

3 most common causes of meningitis in infants younger than 3 months of age

Back 136

1. E. coli
2. Listeria monocytogenes
3. Group B streptococcus

Front 137

How do infants with meningitis present?

Back 137

1. Fever
2. Vomiting
3. Poor feeding
4. Irritability

Front 138

Name the Lancefield Group D bacterial categories and examples of each.

Back 138

Enterococci:
1. Enterococcus faecalis
2. Enterococcus faecium

Non-enterococci
1. Streptococcus bovis
2. Streptococcus equinus

Front 139

What is Streptococcus bovis infection a sign of?

Back 139

Colonic malignancy

Front 140

What kind of hemolysis do enterococci cause?

Back 140

Variable

(CMMRS says alpha; FA says variable and gamma)

Front 141

What drug resistances do the enterococci show?

Back 141

1. Penicillin G
2. Ampicillin
3. Vancomycin

Front 142

What is Lancefield grouping determined by?

Back 142

Differences in the C carbohydrate on the bacterial cell wall

Front 143

Which Group D bacteria are hardier?

Back 143

Enterococci are hardier than nonenterococci. They can grow in 6.5% NaCl

Front 144

A colony of bacteria grows in 6.5% NaCl. What is it?

Back 144

Enterococcus

Front 145

What disease states/problems does Staphylococcus epidermidis cause?

Back 145

Infection of prosthetic devices and catheters. Contaminates blood cultures.

Front 146

How is Streptococcus Viridans characterized?

Back 146

1. Alpha hemolysis
2. Optochin resistant
3. Normal mouth flora

(Mnemonic: Viridans lives in the mouth because it is not afraid of-the-chin)

Front 147

Where is Strep. Viridans part of the normal flora?

Back 147

Oropharynx

Front 148

What disease states/problems does Streptococcus Viridans cause?

Back 148

1. Dental caries (Streptococcus mutans)
2. Subacute Bacterial endocarditis (Streptococcus Sanguis)

Front 149

What disease states does Streptococcus mutans cause?

Back 149

Dental caries

Front 150

What disease states does Streptococcus sanguis cause?

Back 150

Subacute bacterial endocarditis

Sanguis = blood, lots of blood in the heart.

Front 151

How are clostridia characterized?

Back 151

1. Gram positive rods
2. Spore forming
3. Obligate anaerobes

Front 152

What disease state does Clostridium difficile cause, and what is its mechanism?

Back 152

Disease state: pseudomembranous colitis secondary to clindamycin or ampicillin use. (Mnemonic: DIfficile causes DIarrhea)

Mechanism:
1. Antibiotic kills off protective flora
2. C. difficile takes hold and proliferates
3. Produces cytotoxin, an enterotoxin.
4. Cytotoxin kills enterocytes.

Front 153

Treatment for C. difficile infection

Back 153

Metronidazole

Front 154

Lab diagnosis basis for Cornyebacterium diphtheriae

Back 154

Gram positive rods with metachromatic granules, grown on tellurite agar (aka Loffler's coagulated serum medium)

Front 155

How is Bacillus anthracis characterized?

Back 155

1. Gram positive rod
2. Spore forming
3. Protein capsule

Front 156

Which bacteria have a protein capsule?

Back 156

Bacillus anthracis (the only one)

Front 157

What are the mechanisms of anthrax infection and disease?

Back 157

1. Non-inhalation contact with bacillus anthracis
2. Formation of malignant pustule (painless ulcer)
3. Progression to bacteremia
4. Death

1. Inhalation of spores
2. Development of flulike symptoms that rapidly progress to fever, pulmonary hemorrhage and shock.

Front 158

What organism: Development of flulike symptoms followed by fever, pulmonary hemorrhage and shock.

Back 158

Inhalation anthrax: Bacillus anthracis

Front 159

What do skin lesions in anthrax look like?

Back 159

Vesicular papules covered by black eschar

Front 160

What is Woolsorter's disease

Back 160

Inhalation of Bacillus anthracis spores from contaminated wool

Front 161

What organism: Gram-positive rods forming long branching filaments resembling fungi

Back 161

Actinomyces israelii or Nocardia asteroides

Front 162

What organism: Oral or facial abscesses with yellow granules in sinus tracts

Back 162

Actinomyces israelii

Front 163

What disease state does Actinomyces israelii cause?

Back 163

Oral or facial abscesses with yellow granules draining out skin through sinus tracts

Front 164

How is Actinomyces israelii characterised?

Back 164

Gram-positive anaerobic rods forming long branching filaments resembling fungi (Nocardia also has this description)

Causes oral or facial abscesses with yellow granules

Front 165

How is Nocardia asteroides characterized?

Back 165

Gram-positive (weakly acid fast) rods forming long branching filaments resembling fungi (Actinomyces also has this description)

Front 166

What disease state does Nocardia asteroides cause?

Back 166

Pulmonary infection in immunocompromised patients

Front 167

What is the treatment for Actinomyces israelii?

Back 167

Penicillin

Mnemonic: SNAP (Sulfa for Nocardia; Acintomyces use Penicillin)

Front 168

What is the treatment for Nocardia Asteroides?

Back 168

Sulfonamides

Mnemonic: SNAP (Sulfa for Nocardia; Acintomyces use Penicillin)

Front 169

Penicillin G and Gram negative bugs

Back 169

Gram-negatives are resistant to benzyl penicillin G. The gram-negative outer membrane layer inhibits entry of penicillin G and vancomycin.

May be susceptible to penicillin derivatives such as ampicillin.

Front 170

What bacteria genus can live in neutrophils?

Back 170

Neisseria

Front 171

How are neisseria characterized?

Back 171

Gram-negative cocci that resemble paired coffee beans

Front 172

Gonococcus and meningococcus: Polysaccharide capsule

Back 172

G: No
M: Yes

Front 173

Gonococcus and meningococcus: Maltose fermentation

Back 173

G: No (Gonococcus ferments Glucose)
M: Yes (MeninGococcus ferments Maltose and Glucose)

Front 174

Gonococcus and meningococcus: Vaccine availability

Back 174

G: No
M: Yes

Front 175

What disease states does Gonococcus cause?

Back 175

1. Gonorrhea
2. septic arthritis
3. neonatal conjunctivitis
4. PID

Front 176

What disease states does Meningococcus cause?

Back 176

1. Meningococcemia
2. Meningitis
3. Waterhouse-Friderichsen syndrome

Front 177

What is Waterhouse-Friderichsen syndrome?

Back 177

massive, usually bilateral, hemorrhage into the adrenal glands caused by fulminant meningococcemia.

Characterised by overwhelming bacterial infection, rapidly progressive hypotension leading to shock, disseminated intravascular coagulation (DIC) with widespread purpura, particularly of the skin, and rapidly developing adrenocortical insufficiency associated with massive bilateral adrenal hemorrhage.

Front 178

What disease states does Haemophilus Influenzae cause?

Back 178

HaEMOPhilus causes
1. Epiglottitis
2. Meningitis
3. Otitis media
4. Pneumonia

Does not cause flu (that's a virus)!

Front 179

How is Haemophilus Influenzae characterized?

Back 179

Small gram-negative coccoid rod.

Front 180

How is Haemophilus Influenzae transmitted?

Back 180

Aerosol

Front 181

Which type of Haemophilus Influenzae is most pathogenic?

Back 181

capsular type B

Front 182

Treatment for Haemophilus Influenzae meningitis

Back 182

Ceftriaxone

Front 183

Prophylaxis for Hemophilus Influenzae

Back 183

Vaccine: Type B polysaccharide conjugated to diphtheria toxoid or other protein. Given between 2 and 18 months of age.

Close contacts of infected person: Rifampin

Front 184

How are enterobacteriaceae characterized?

Back 184

Gram negative diverse group

Mnemonic: COFFEe

3. Capsule (K [kapsular] antigen related to virulence of the bug)
2. O antigen (somatic antigen which is the polysaccharide of endotoxin)
4. Flagella (H antigen found in motile species)
5. Ferment glucose
6. Enterobacteriaceae (woo!)

Front 185

Enterobacteriaceae list

Back 185

1. Escherichia coli
2. Klebsiella pneumoniae
3. Proteus mirablis
4. Enterobacter sp.
5. Serratia
6. Shigella
7. Salmonella
8. Yersinia enterocolitica

Front 186

What disease states does Klebsiella cause?

Back 186

1. Pneumonia in alcoholics and diabetics (In the name: Klebsiella pneumoniae)
2. Nosocomial UTIs (large mucoid capsule and viscous colonies)

Mnemonic: AAA (Aspiration pneumonia, Abscess in lungs, Alcoholics)

Front 187

Signs and symptoms of Klebsiella infection

Back 187

1. Red currant jelly sputum
2. Abscess in lungs

Front 188

Orange sputum: What bugs?

Back 188

1. Pneumococcus
2. Klebsiella (or described as "red currant jelly sputum")

Front 189

Red currant jelly sputum: What bug?

Back 189

Klebsiella

Front 190

Lactose-fermenting enteric bacteria

Back 190

Mnemonic: Test lactose with MacConKEE’S.

1. Citrobacter
2. Klebsiella
3. E. coli
4. Enterobacter
5. Serratia

Front 191

Salmonella vs. Shigella: Lactose fermenter?

Back 191

Neither

Front 192

Salmonella vs. Shigella: Motile

Back 192

Both (Though, the evidence that shigella is motile is recent.)

Can invade and disseminate hematogenously.

Front 193

Salmonella vs. Shigella: Animal reservoir

Back 193

Salmonella: Yes
Shigella: No

Front 194

Shigella transmission

Back 194

4 Fs:
1. Food
2. Fingers
3. Feces
4. Flies

Front 195

Salmonella vs. Shigella: Virulence

Back 195

Salmonella: 100,000 organisms
Shigella: 10 organisms

Front 196

True or False: Salmonellosis symptoms may be prolonged with antibiotic treatments

Back 196

True

Front 197

What type of inflammatory response is seen in Salmonellosis?

Back 197

Monocytes

Front 198

Transmission of Yersinia enterocolitica

Back 198

1. Pet feces (eg puppies)
2. Contaminated milk or pork

Front 199

Yersinia enterocolitica infection: Clinical presentation

Back 199

1. Outbreaks are common in day-care centers
2. Can mimic Crohn's or appendicitis

Front 200

What bug causes contamination of this food: Seafood

Back 200

Vibrio:
1. parahaemolyticus
2. vulnificus

Front 201

What bug causes contamination of this food: Reheated rice

Back 201

Bacillus cereus

Mnem: "Food poisoning from reheated rice? Be serious!"

Front 202

What bug causes contamination of this food: Meat

Back 202

1. Staphylococcus Aureus (starts quickly and ends quickly)
2. Salmonella (including poultry)
3. Clostridium perfringens (reheated meat dishes)
4. Vibrio (parahaemolyticus, vulnificus) (in seafood)
5. E. coli O157:H7 (undercooked meat)
6. Clostridium Botulinum (in sausage)

Front 203

What bug causes contamination of this food: Mayonnaise

Back 203

Staphylococcus Aureus (starts quickly and ends quickly)

Front 204

What bug causes contamination of this food: Custard

Back 204

Staphylococcus Aureus (starts quickly and ends quickly)

Front 205

What bug causes contamination of this food: Reheated meat

Back 205

Clostridium perfringens

Mnem: "Food poisoning from reheated meat? Clostridium perfringens!"

Front 206

What bug causes contamination of this food: Bulging cans

Back 206

Clostridium botulinum

(BOTulinum is from bad BOTtles of food and honey and sausage)

Front 207

What bug causes contamination of this food: Sausage

Back 207

Clostridium botulinum

(BOTulinum is from bad BOTtles of food and honey and sausage)

Front 208

What bug causes contamination of this food: Honey

Back 208

Clostridium botulinum

(BOTulinum is from bad BOTtles of food and honey and sausage)

Front 209

What bug causes contamination of this food: Poultry

Back 209

Salmonella

Front 210

What bug causes contamination of this food: Eggs

Back 210

Salmonella

Front 211

Bloody or watery diarrhea: Vibrio parahaemolyticus

Back 211

Either bloody or watery

Front 212

Bloody or watery diarrhea: Campylobacter

Back 212

Bloody

Front 213

Bloody or watery diarrhea: Salmonella

Back 213

Bloody

Front 214

Bloody or watery diarrhea: Shigella

Back 214

Bloody

Front 215

Bloody or watery diarrhea: Enterohemorrhagic E. coli

Back 215

Bloody

Front 216

Bloody or watery diarrhea: Enteroinvasive E. coli

Back 216

Bloody

Front 217

Bloody or watery diarrhea: Yersinia enterocolitica

Back 217

Bloody

Front 218

Bloody or watery diarrhea: C. difficile

Back 218

Bloody

Front 219

Bloody or watery diarrhea: Entamoeba histolytica

Back 219

Bloody

Front 220

Bloody or watery diarrhea: Enterotoxigenic E. coli

Back 220

Watery

Front 221

Bloody or watery diarrhea: Vibrio cholerae

Back 221

Watery

Front 222

Bloody or watery diarrhea: C. perfringens

Back 222

Watery

Front 223

Bloody or watery diarrhea: Protozoa

Back 223

Watery

Front 224

Bloody or watery diarrhea: Viruses

Back 224

Watery

Front 225

Diagnosis: Bloody diarrhea with oxidase-positive comma or S-shaped organisms grown at 42 degrees celsius

Back 225

Campylobacter

Front 226

Diagnosis: Bloody diarrhea with motile, lactose negative gram negative bugs

Back 226

Salmonella or Shigella

Shigella have a very low ID50 and cause dysentery

Front 227

Diagnosis: Bloody diarrhea with schistocytes and azotemia

Back 227

Enterohemorrhagic E coli (eg O157:H7)

Caused by shiga-like toxin

Front 228

Diagnosis: Bloody diarrhea with hemolytic uremic syndrome

Back 228

Enterohemorrhagic E coli (eg O157:H7)

Caused by shiga-like toxin

Front 229

Diagnosis: Bloody diarrhea with pathologic section revealing bacteria invading colonic mucosa

Back 229

Enteroinvasive E. coli

Front 230

Diagnosis: Bloody diarrhea with symptoms of appendicitis

Back 230

Yersinia enterocolitica

Front 231

Diagnosis: Bloody diarrhea in a day care center

Back 231

Yersinia enterocolitica

Front 232

Diagnosis: Bloody diarrhea with pseudomembranous colitis

Back 232

Clostridium dificile

Front 233

Diagnosis: Bloody diarrhea with protozoans

Back 233

Entamoeba histolytica

Front 234

Diagnosis: Watery diarrhea in someone who just visited Mexico

Back 234

Enterotoxigenic E coli (no preformed toxin)

Front 235

Diagnosis: Watery diarrhea with comma-shaped organisms

Back 235

Vibrio cholerae

Front 236

Diagnosis: Watery diarrhea with appearance of rice water

Back 236

Vibrio cholerae

Front 237

Diagnosis: Watery diarrhea with gangrenous leg

Back 237

Clostridium perfringens

Front 238

Diagnosis: Watery diarrhea in an immunocompromised patient

Back 238

Protozoa (eg Giardia or Cryptosporidium)

Front 239

Diagnosis: Watery diarrhea

Back 239

Think viruses first.

Rotavirus
Adenovirus
Norwalk virus

Front 240

Difference between mechanisms of cholera and pertussis toxins

Back 240

Cholera: Permanently activates Gs (turns the "on" on)

Pertussis: Permanently disables Gi (turns the "off" off)

Front 241

What is edema factor?

Back 241

A toxin in the Bacillus Anthracis exotoxin complex that functions as adenylyl cyclase

Front 242

Disease states caused by Legionella (list only)

Back 242

1. Asymptomatic infection
2. Pontiac fever
3. Legionnaires disease

Front 243

Describe Pontiac fever

Back 243

Caused by Legionella. Presents like influenza. Strikes suddenly and completely resolves in one week. Originally described in the Pontiac Michigan government AC.

Front 244

Describe Legionnaires' disease

Back 244

Very high fever with severe pneumonia

Front 245

Treatment for Legionella

Back 245

Has a beta-lacatamase (penicillin-resistant)

1. Erythromycin
2. Rifampin

Front 246

Diagnosis: Pneumonia in a smoker >50 years of age. Gram stain of pus shows many neutrophils with few microbes.

Back 246

Legionella

Front 247

Special culture requirements for: Legionella

Back 247

Grows on charcoal yeast extract culture with iron and cysteine
Mnemonic: French legionnaire with silver helmet, sitting around a campfire (charcoal medium) with a canteen of water (water transmission) and his iron dagger-he is no sissy (cysteine).

Front 248

Legionella: Gram stain

Back 248

Gram negative. Gram stains poorly (use silver stain)


Mnemonic: French legionnaire with silver helmet, sitting around a campfire (charcoal medium) with his iron dagger-he is no sissy (cysteine).

Front 249

Legionella: How transmitted?

Back 249

Aerosol transmission from environmental water sources (AC, Showers, whirlpools, cooling towers, supermarket produce mist)

Mnemonic: French legionnaire with silver helmet, sitting around a campfire (charcoal medium) with a canteen of water (water transmission) and his iron dagger-he is no sissy (cysteine).

Front 250

Pseudomonas: Disease states

Back 250

PSEUDDOburnnas
1. Pneumonia (especially in CF)
2. Sepsis (black lesions on skin)
3. External otitis (swimmer's ear)
4. UTI (nosocomial and drug-resistant)
5. Drug use
6. Diabetic Osteomyelitis
7. Burns and wound infections
8. Hot tub folliculitis

Front 251

Pseudomonas: Organism characterization

Back 251

1. Gram-negative rod
2. non-lactose fermenting
3. Aerobic (think AERuginosa) and oxidase positive (cytochrome c oxidase for oxidative phosphorylation)
4. Produces pyocyanin (blue-green) pigment
5. Fruity odor

Front 252

What to know about exotoxins produced by: Pseudomonas aeruginosa

Back 252

Exotoxin A is an ADP ribosylating A-B toxin (similar to Diphtheria toxin)

Mechanism:
Inactivates elongation
factor 2 (EF-2)

Also has endotoxin (as it is gram negative) which produces fever and shock.

Front 253

Diagnosis: Sepsis in burn victim

Back 253

Most likely Pseudomonas

Front 254

Treatment for pseudomonas

Back 254

Aminoglycoside

plus

Extended-spectrum penicillin (eg piperacillin, ticarcillin)

Front 255

Helicobacter pylori: Disease states

Back 255

Causes:
1. Gastritis
2. 90% of duodenal ulcers

Risk factor for:
1. Peptic ulcer
2. Gastric carcinoma

Front 256

Helicobacter pylori: Characterization

Back 256

1. Gram negative rod
2. Urease-positive
3. Creates alkaline environment

Front 257

Treatment for Helicobacter Pylori

Back 257

Triple treatment

1. Metronidazole with one of the two combos below

$:
2. Bismuth (eg Pepto-Bismol)
3. Either Tetracycline or Amoxicillin

$$:
2. Omeprazole
3. Clarithromycin

Front 258

What bug?: Urease-positive gram-negative bacteria

Back 258

Proteus and H. Pylori

Front 259

Zoonotic bacteria

Back 259

1. Borrelia burdorferi
2. Francisella tularensis
3. Yersinia pestis
4. Pasteurella multocida
5. Brucella spp. (Undulant fever from dairy/contact with animals)

Mnemonic: Bugs From Your Pet Undulate and Unpasteurized dairy gives you Undulant fever

Front 260

Borrelia burgdorferi: Disease states

Back 260

Lyme disease

Front 261

Brucella: Disease states

Back 261

Undulant fever/Brucellosis. Temperature slowly rises during day, peaks in the evening, and slowly declines to normal by morning.

Accompanied by other systemic symptoms.

Front 262

Brucella: Transmission

Back 262

from animal contact (meat worker, farmer, veterinarian) or unpasteurized milk

Front 263

Gross mechanism of brucellosis

Back 263

1. Penetration of skin (but no buboes or primary skin ulcer), conjunctiva, lungs, GI tract
2. Lymphatic spread
3. Facultative intracellular growth in macrophages, and blood and organ invasion

Front 264

Francisella Tularensis: Disease states (list)

Back 264

Tularemia, either:
1. Pneumonic
2. Oculoglandular
3. Ulceroglandular
4. Typhoidal

(Don't POUT when you've got tularemia.)

Front 265

Describe Ulceroglandular tularemia

Back 265

a. Well-demarcated hole in the skin with a black base
b. Fever and systemic symptoms
c. Swollen/red/painful purulent lymph nodes

Similar to plague, but with skin ulcer, and low mortality.

Front 266

Francisella tularensis: Transmission

Back 266

Most common: Handling of infected rabbits or from bites of ticks and deer flies

Hundred creatures in total all over US.

Mnemonic: Francis the rabbit is playing in the TULips, with a deerfly on one ear and a tick on the other.

Front 267

Virulence of Francisella tularensis

Back 267

Very. (10 organisms cause disease.)

Front 268

Diagnosis of Francisella tularensis

Back 268

Clinical picture, PPD-like skin test, and titers of Francisella Ig

Front 269

Yersinia pestis: Transmission

Back 269

PESTS like rats harbor the disease and fleas are the vector, biting the skin of humans. Found in campers, hunters, and hikers.

Mnemonic: A rat driving a fuel-injected (F1) VW bug (V and W antigens) fleeing (flea-ing) from a macrophage.

Front 270

Fraction 1 (F1) antigen

Back 270

Enables Yersinia pesitis to resist destruction after phagocytosis (facultative intracellular)

Mnemonic: A rat driving a fuel-injected (F1) VW bug (V and W antigens) fleeing (flea-ing) from a macrophage.

Front 271

V antigen

Back 271

Enables Yersinia pesitis to resist destruction after phagocytosis (facultative intracellular)

Mnemonic: A rat driving a fuel-injected (F1) VW bug (V and W antigens) fleeing (flea-ing) from a macrophage.

Front 272

W antigen

Back 272

Enables Yersinia pesitis to resist destruction after phagocytosis (facultative intracellular)

Mnemonic: A rat driving a fuel-injected (F1) VW bug (V and W antigens) fleeing (flea-ing) from a macrophage.

Front 273

Yersinia pestis: Presentation in humans

Back 273

1. Lymph node (usually inguinal [boubon is Greek for groin]) becomes inflamed (all four signs).
2. Fever, and headache.
3. Blackish discoloration under skin ("Black death")

Front 274

Disease states caused by Yersinia pestis

Back 274

Bubonic plague/pneumonic plague

Front 275

Pasteurella Multocida: Transmission

Back 275

Cat, dog, and animal bites. Also infects birds.

Mnemonic: Cat and dog chasing a bird in a "Pasteur".

Front 276

T/F: All Zoonotic Gram negative bugs are facultative intracellular.

Back 276

False. Pasteurella is not.

Front 277

Pasteurella: Treatment

Back 277

Do not suture wound after dog or cat bite/scratch. (Best breeding ground for Pasteurella)

Treat with penicillin or doxycycline.

Front 278

Gardnerella: Characterization

Back 278

Pleomorphic, gram-variable rod.

Front 279

What disease states does Gardnernella cause?

Back 279

Vaginosis
1. Greenish vaginal discharge with fishy smell
2. Noninflammatory (nonpainful)
3. Mobiluncus (anaerobe) is also seen
4. Clue cells are visible (vaginal epithelium covered with bacteria)
5. Positive Whiff test

Front 280

Clue cell, indicative of Gardnerella vaginosis

Back 280

What is this?

Front 281

What does a positive PPD indicate?

Back 281

1. Current infection
2. Past exposure
3. BCG vaccination

Front 282

What does a negative PPD indicate?

Back 282

1. No infection
2. Anergy (due to: steroids, immunocompromise, malnutrition), inject candida/mumps vaccine into other arm. If still negative, anergic.

Front 283

Fast-fermenting lactose bacteria

Back 283

Fast fermenters: (EEK! Too fast!)
1. E.coli
2. Enterobacter sp.
3. Klebsiella

Front 284

Slow fermenting lactose bacteria

Back 284

Slow fermenters:
1. Serratia
2. Citrobacter
3. "Others"

Front 285

Tuberculosis infection: Gross mechanism

Back 285

1. Inhaled aerosols from infected adults
2. Land in middle or lower lobes of lung (highest airflow) leading to small area of pneumonitis.
3. Bacteria enter macrophages, multiply, and spread hematogenously.

Front 286

Mechanism of asymptomatic primary TB

Back 286

1. Cell-mediated defense walls off foci of bacteria in caseous granulomas
2. Granulomas heal with fibrosis, calcification and scar formation

Front 287

Difference between Ghon focus and Ghon complex

Back 287

Ghon focus: Calcified tubercle in the middle or lower lung

Ghon complex: Ghon focus accompanied by perihilar or lobar lymph node calcified granulomas

Front 288

What is a Ranke complex?

Back 288

Same as a Ghon complex: Ghon focus accompanied by perihilar or lobar lymph node calcified granulomas

Front 289

Mechanism of symptomatic primary TB

Back 289

1. Large caseous granulomas develop in the lungs/other organs.
2. In the lungs, caseous material liquifies, is extruded out the bronchi and leaves cavitary lesions behind.

Front 290

Mechanism of secondary Pulmonary TB

Back 290

1. Infection occurs at apical areas of lung around the clavicles due to highest oxygen tension caused by decreased pulmonary circulation.
2. Infected areas grow, caseate, liquify and cavitate.

Front 291

TB reactivation sites

Back 291

1. Pulmonary (Lung parenchyma)
2. Pleura
3. Pericardium
4. Scrofula (Cervical lymph nodes: most common extrapulmonary site worldwide)
5. Kidney (Sterile pyuria)
6. Thoracic and lumbar spine (Pott's disease)
7. Chronic monoarthritis
8. CNS (subacute meningitis or parenchymal tuberculoma)
9. Miliary TB (Millet sized tubercles all over the body)

Front 292

Tuberculosis rule of 5s

Back 292

1. Droplet nuclei are 5 micrometers and contain 5 mycobacteria
2. 5% risk of reactivation in first 2 years and then 5% lifetime risk
3. Patients with HIV ("High five") have 5+5% yearly reactivation risk.
4. Induration measurements
a. HIV: >5 mm
b. High risk: >5+5 mm
c. Everyone else: >5+5+5 mm

Front 293

Cause of Miliary tuberculosis

Back 293

Severe bacteremia

Front 294

Types of Mycobacteria and what they cause

Back 294

Mnemonic: Identifying mycobacteria is no Light TASK

Mycobacterium
1. Leprae
2. Tuberculosis
3. Avium-intracellulare
4. Scrofulaceum
5. Kansasii

Front 295

What disease state does Mycobacterium Avium-intracellulare cause?

Back 295

bugs are multiple drug resistant and cause disseminated disease in AIDS

Front 296

Symptoms of tuberculosis

Back 296

1. Fever
2. Night sweats
3. Weight loss
4. Hemoptysis

Front 297

Two Langhans type giant cells in which the nuclei are lined up around the periphery of the cell in a horseshoe pattern.

Seen in granulomatous conditions like TB

Back 297

What is this?

Front 298

What is Hansen's disease?

Back 298

leprosy

Front 299

What is leprosy caused by?

Back 299

Mycobacterium leprae

Front 300

Characterization and reservoir of Mycobacterium Leprae

Back 300

1. Acid fast bacillus
2. Likes cool temperatures
3. Infects skin and superficial nerves
4. Cannot be grown invitro
5. Reservoir: Armadillos

Front 301

Presentation of lepromatous leprosy

Back 301

"Leonine facies"
1. Loss of eyebrows
2. Nasal collapse
3. Lumpy earlobe

Front 302

Treatment for leprosy

Back 302

Long-term oral dapsone

Alternative: Rifampin, clofazimine, and dapsone

Front 303

Toxicity of longterm oral dapsone

Back 303

1. Hemolysis
2. Methemoglobinemia

Front 304

2 forms of leprosy

Back 304

1. Lepromatous (Due to failed cell-mediated immunity. Lep. is Lethal)
2. Tuberculoid (self=limiting)

Front 305

Rickettsiae: Characterization

Back 305

Obligate intracellular parasites. Need CoA and NAD.

Front 306

Rickettsiae: Transmission and presentation

Back 306

Coxiella: Atypical. Transmitted by aerosol and causes pneumonia

All others: Arthropod vector causes classic triad of headache, fever and rash (vasculitis)

Front 307

Treatment of Rickettsiae

Back 307

Tetracycline

Front 308

Difference between spread of rash in typhus and spotted fever

Back 308

tyPHus is centriPHugal (moves outwards)

sPotted fever is centriPetal (moves inwards)

Both are caused by Rickettsiae

Front 309

Which bug causes Rocky Mountain spotted fever?

Back 309

Rickettsia rickettsii, transmitted by tick

Front 310

Which bug causes endemic typhus?

Back 310

Rickettsia typhi, transmitted by fleas

Front 311

Which bug causes epidemic typhus?

Back 311

Rickettsia prowazekii, transmitted by human body louse

Front 312

Which bug causes typhus?

Back 312

Endemic: Rickettsia typhi, transmitted by fleas

Epidemic: Rickettsia prowazekii, transmitted by human body louse

Front 313

Which bug causes Q fever?

Back 313

Coxiella burnetii, by inhaled aerosols from cowhide and placentas.

Remember: Carol Burnett coughing "Q" after inhaling spores from cowhide.

Front 314

What separates Q fever from other rickettsial diseases?

Back 314

Q fever is *****. Rickettsial, but has an endospore, thus:

1. Caused by Coxiella burnetii (not called Rickettsia)
2. No rash
3. No vector (inhaled aerosols)
4. Negative Weil-Felix
5. Causative organism can survive outside for a long time.

Front 315

Difference in tropism between Chlamydia and Rickettsia

Back 315

Rickettsia: Endothelial cells of blood vessels

Chlamydia: Columnar epithelium

Front 316

Where is the rash in Rocky Mountain spotted fever found?

Back 316

Palms and soles, migrating to wrists, ankles, then trunk.

Front 317

Where can rashes on the palms and soles of feet be seen?

Back 317

1. Rocky mountain spotted fever
2. Syphilis
3. Coxsackie virus A infection (hand, foot, and mouth disease)

Front 318

Weil-Felix reaction

Back 318

Assays for antirickettsial antibodies, which cross-react with Proteus antigen

Front 319

Typhus: positive or negative Weil-Felix

Back 319

positive

Front 320

Rocky mountain spotted fever: positive or negative Weil-Felix

Back 320

positive

Front 321

Q fever: positive or negative Weil-Felix

Back 321

negative

Front 322

What bug: Atypical walking pneumonia in prisoner or military recruit younger than 30

Back 322

Mycoplasma pneumoniae

Front 323

Describe mycoplasma pneumoniae pneumonia

Back 323

1. Atypical walking pneumonia (insidious onset, headache, non productive cough, diffuse interstitial infiltrate)
2. X-ray looks worse than patient
3. High titer of cold agglutinins (IgM)

Front 324

Special culture requirements for: Mycoplasma pneumoniae

Back 324

Eaton's agar

Front 325

Treatment for mycoplasma pneumoniae

Back 325

Tetracycline or erythromycin.

Pencillin resistant because they have no cell wall.

Front 326

Characterization of Mycoplasma pneumoniae

Back 326

1. Facultative anaerobe with no cell wall (hence no gram stain)
2. Only bacterial membrane with cholesterol
3. High titer of cold agglutinins
4. Grown on Eaton's agar

Front 327

True or False: No Gram-positive bugs have endotoxin.

Back 327

False. Listeria monocytogenes has it.

Front 328

Characterize Chlamydia

Back 328

Obligate intracellular parasites

Front 329

2 forms of chlamydia

Back 329

1. Elementary body (small, dense) which Enters cell via endocytosis

2. Initial or Reticulate body, which Replicates In cell by fission

Front 330

Disease states caused by Chlamydia trachomatis

Back 330

1. Reactive arthritis (aka Reiter's syndrome)
2. Conjunctivitis
3. Non-gonococcal urethritis, cervicitis, and PID

Front 331

Disease states caused by Chlamydia pneumoniae

Back 331

Atypical pneumonia

Front 332

Disease states caused by Chlamydia psittaci

Back 332

Atypical pneumonia

Front 333

Chlamydia species

Back 333

1. Trachomatis
2. Pneumoniae
3. Psittaci

Front 334

What is unusual about the chlamydial wall?

Back 334

It lacks muramic acid.

Front 335

Treatment of Chlamydia

Back 335

Erythromycin or tetracycline

Front 336

Reservoir for Chlamydia psittaci

Back 336

Avian

Front 337

Which chlamydia has an animal reservoir?

Back 337

Psittaci: Avian

Front 338

Lab diagnosis of chlamydia

Back 338

Cytoplasmic inclusions seen on Giemsa or fluorescent-antibody stained smear

Front 339

What disease is caused by Chlamydia Trachomatis serotypes A-C

Back 339

1. Chronic infection
2. Blindness in Africa

Mnemonic: ABC: Africa, Blindness, Chronic infection

Front 340

What disease is caused by Chlamydia Trachomatis serotypes D-K

Back 340

1. Urethritis/PID
2. Ectopic pregnancy
3. Neonatal pneumonia
4. Neonatal conjunctivitis

Front 341

What disease is caused by Chlamydia Trachomatis serotypes L1-L3

Back 341

Lymphogranuloma venereum
1. acute lymphadenitis with a positive Frei test
2. ulcers
3. rectal strictures

Mnemonic: L1-3: Lymphogranuloma

Front 342

Positive Frei test

Back 342

Chlamydia Trachomatis serotypes L1-L3

Front 343

Acquisition and treatment of neonatal conjunctivitis

Back 343

Chlamydia trachomatis serotypes D-K acquired by passage through infected birth canal. Treat with erythromycin eye drops.

Front 344

Characterization of spirochetes

Back 344

Spiral-shaped bacteria with axial filaments

Front 345

List of spirochetes

Back 345

Mnemonic: BLT with spiral bacon

1. Borrelia (Big!)
2. Leptospira
3. Treponema

Front 346

Visualization of Borrelia

Back 346

Light microscopy with choice of aniline dye:
1. Wright's stain
2. Giemsa's stain

Front 347

Stages of Lyme disease

Back 347

1. Erythema chronicum migrans and flu-like symptoms
2. Neurologic and cardiac manifestations
3. Autoimmune migratory polyarthritis

Front 348

Signs and symptoms of Lyme disease

Back 348

Mnemonic: BAKE a Key Lime pie

1. Bell's palsy (and other CNS manifestations in Stage 2)
2. Arthritis (Autoimmune migratory in Stage 3)
3. Kardiac block (Stage 2)
4. Erythema chronicum migrans (Stage 1)

Front 349

What species transmits Borrelia burgdorferi to humans?

Back 349

Ixodes tick. Live o

Front 350

Classic symptom of Lyme disease and which stage is it in?

Back 350

Erythema chronicum migrans, an expanding "bull's eye" red rash with central clearing. Stage 1.

Front 351

Animal reservoirs for borrelia burgdorferi

Back 351

White-footed mouse and other small rodens, and the white-tailed deer. Ixodes tick picks up bugs from these animals and transmits them.

Front 352

Most common setting for Borrelia burgdorferi infection

Back 352

In the summer months in northeastern US (Lyme, CT)

Front 353

What disease states does Treponema cause?

Back 353

Treponema Pallidum causes syphilis.

Treponema Pertenue causes yaws (a non-STD tropical infection with positive VDRL)

Front 354

What is yaws?

Back 354

Treponema Pertenue causes yaws (a non-STD tropical infection with positive VDRL)

Front 355

Presentation of primary syphilis

Back 355

Painless chancre (localized disease)

Front 356

What stage of syphilis: Painless chancre (localized disease)

Back 356

Primary

Front 357

Presentation of secondary syphilis

Back 357

Disseminated disease with:
1. constitutional symptoms (fever, lymphadenopathy)
2. maculopapular rash (palms and soles)
3. condylomata lata

Mnemonic: Secondary means Systemic

Front 358

What stage of syphilis: Disseminated disease with constitutional symptoms

Back 358

Secondary syphilis

Front 359

Presentation of tertiary syphilis

Back 359

1. Gummas
2. Aortitis
3. Neurosyphilis (tabes dorsalis, general paresis)
4. Argyll Robertson pupil

Front 360

What stage of syphilis: Gummas

Back 360

tertiary syphilis

Front 361

What stage of syphilis: Aortitis

Back 361

tertiary syphilis

Front 362

What stage of syphilis: Neurosyphilis (tabes dorsalis)

Back 362

tertiary syphilis

Front 363

What stage of syphilis: Argyll Robertson pupil

Back 363

tertiary syphilis

Front 364

What stage of syphilis: maculopapular rash (palms and soles)

Back 364

Secondary syphilis

Front 365

What stage of syphilis: condylomata lata

Back 365

Secondary syphilis

Front 366

Presentation of Congenital syphilis

Back 366

1. Saber shins
2. Saddle nose
3. Deafness

Front 367

What stage of syphilis: Saber shins

Back 367

Congenital syphilis (not a stage)

Front 368

What stage of syphilis: Saddle nose

Back 368

Congenital syphilis (not a stage)

Front 369

What stage of syphilis: Deafness

Back 369

Congenital syphilis (not a stage)

Front 370

Treatment for Syphilis

Back 370

Penicillin G

Front 371

Signs and symptoms of tertiary syphilis

Back 371

1. Broad-based ataxia
2. Positive Romberg sign
3. Charcot joints
4. Stroke without hypertension

Front 372

What is an Argyll-Robertson pupil?

Back 372

Same as prostitute's pupil. Constricts with accommodation but is not reactive to light. Pathognomonic for tertiary syphilis.

Front 373

What is the prostitute's pupil.

Back 373

Same as Argyll-Robertson pupil. Constricts with accommodation but is not reactive to light. Pathognomonic for tertiary syphilis.

Front 374

What is FTA-ABS used for?

Back 374

FTA-ABS: Find the Antibody-Absolutely
1. Most specific for treponemes
2. Positive the earliest
3. Remains positive the longest

Front 375

Interpret: Positive VDRL, Positive FTA

Back 375

Active treponemal infection

Front 376

Interpret: Positive VDRL, Negative FTA

Back 376

Probably false positive

VDRL
1. Viruses (mono, hepatitis)
2. Drugs
3. Rheumatic fever and rheumatoid arthritis
4. Lupus and leprosy

Front 377

Interpret: Negative VDRL, Positive FTA

Back 377

Successfully treated treponemal infection

Front 378

Sexuality of fungal spores

Back 378

Asexual (mostly)

Front 379

Which fungal infections are transmitted by inhalation of asexual spores?

Back 379

1. Coccidioidomycosis
2. Histoplasmosis

Front 380

What are conidia?

Back 380

Asexual fungal spores

Front 381

What disease states does Candida albicans cause?

Back 381

1. Thrush esophagitis in immunocompromised patients (neonates, steroids, diabetes, AIDS)
2. endocarditis in IV drug users
3. vaginitis post-antibiotic use
4. diaper rash
5. Disseminated candidiasis to any organ
6. Chronic mucocutaneous candidiasis

Front 382

Treatment for Candida Albicans infection

Back 382

Superficial: Nystatin

Serious systemic: Amphotericin B

Front 383

Histologic appearance of Candida Albicans

Back 383

Budding yeast with pseudohyphae in culture at 20 degrees celsius

Germ tube formation at 37 degrees celsius

Front 384

Candida albicans: Germ tube formation at 37 degrees celsius

Back 384

What is this?

Front 385

Candida albicans: Budding yeast with pseudohyphae in culture at 20 degrees celsius

Back 385

What is this?

Front 386

Which fungus causes thrush in immunocompromised

Back 386

Candida albicans

Front 387

Which fungus causes vulvovaginitis?

Back 387

Candida albicans (high pH, diabetes, use of antibiotics)

Front 388

Which fungus is endemic to Southwestern US?

Back 388

Coccidioidomycosis

Front 389

Which fungus is endemic to Mississippi and Ohio river valleys

Back 389

Histoplasmosis

Front 390

What fungus is this area known for: Southern Ohio

Back 390

Histoplasmosis

Front 391

What fungus is this area known for: Southern Illinois

Back 391

Histoplasmosis

Front 392

What fungus is this area known for: Missouri

Back 392

Histoplasmosis

Front 393

What fungus is this area known for: Kentucky

Back 393

Histoplasmosis

Front 394

What fungus is this area known for: Tennessee

Back 394

Histoplasmosis

Front 395

What fungus is this area known for: Arkansas

Back 395

Histoplasmosis

Front 396

What fungus is this area known for: Southern California

Back 396

Coccidiomycosis

Front 397

What fungus is this area known for: Southern Arizona

Back 397

Coccidiomycosis

Front 398

What fungus is this area known for: Mississippi river valley

Back 398

Histoplasmosis (also Blastomycosis)

Front 399

What fungus is this area known for: Ohio river valley

Back 399

Histoplasmosis (also Blastomycosis)

Front 400

What fungus is this area known for: Southwestern US

Back 400

Coccidiomycosis

Front 401

What fungus is this area known for: Rural Latin America

Back 401

Paracoccidioidomycosis

Front 402

What fungus is this area known for: Wisconsin

Back 402

Blastomycosis

Front 403

What fungus is this area known for: Minnesota

Back 403

Blastomycosis

Front 404

Spherule filled with endospores in coccidioidomycosis

Back 404

What is this?

Front 405

Characterize histoplasmosis histologically

Back 405

Tiny yeast inside macrophages. Thin cell wall with no true capsule.

Front 406

What is the vector for histoplasmosis?

Back 406

Bird or bat droppings

Front 407

What do bird and bat droppings carry?

Back 407

Histoplasmosis

Front 408

histoplasmosis showing intracellular organisms in bone marrow macrophages

Back 408

What is this?

Front 409

Paracoccidioidomycosis (captain's wheel appearance)

Back 409

What is this?

Front 410

Blastomycosis (Big, Broad-Based Budding)

Back 410

What is this?

Front 411

What characterizes dimorphic fungi?

Back 411

Mold in soil (lower temperature) and yeast in tissue (body temperature)

Mnemonic: Cold is mold, heat is yeast

Front 412

List the dimorphic fungi

Back 412

Histoplasmosis, Blastomycosis, and Paracoccidioidomycosis (but not coccidioidomycosis which is a spherule in tissue)

Front 413

Treatment for coccidiomycosis

Back 413

Local: Fluconazole or ketoconazole

Systemic: Amphotericin B

Front 414

Treatment for paracoccidiomycosis

Back 414

Local: Fluconazole or ketoconazole

Systemic: Amphotericin B

Front 415

Treatment for Histoplasmosis

Back 415

Local: Fluconazole or ketoconazole

Systemic: Amphotericin B

Front 416

Treatment for Blastomycosis

Back 416

Local: Fluconazole or ketoconazole

Systemic: Amphotericin B

Front 417

What is cultured on Sabouraud's agar?

Back 417

Fungi (specifically dimorphic fungi)

Front 418

What disease state does Malassezia furfur cause?

Back 418

Tinea versicolor: Hypopigmented skin lesions which occur in hot humid weather.

Front 419

Treatment for Tinea versicolor

Back 419

Topical miconazole or selenium sulfide (Selsun)

Front 420

What resembles spaghetti and meatballs histologically?

Back 420

combination of mycelium strands and numerous spores of Malassezia furfur in KOH prep

Front 421

What disease state does Cladosporium werneckii cause?

Back 421

Tinea nigra: Infection of keratinized layer of skin. Appears as brownish spot.

Front 422

What causes Tinea versicolor?

Back 422

Malassezia furfur

Front 423

What causes Tinea nigra?

Back 423

Cladosporium werneckii

Front 424

Treatment for Tinea nigra

Back 424

topical salicylic acid

Front 425

What are the common dermatophytes and what do they cause?

Back 425

Microsporum, Trichophyton, and Epidermophyton

cause all the tineas except for versicolor and nigra

Front 426

What causes Tinea corporis?

Back 426

Dermatophytes (such as Microsporum, Trichophyton, and Epidermophyton)

Front 427

What causes Tinea cruris?

Back 427

Dermatophytes (such as Microsporum, Trichophyton, and Epidermophyton)

Front 428

What causes Tinea pedis?

Back 428

Dermatophytes (such as Microsporum, Trichophyton, and Epidermophyton)

Front 429

What causes Tinea capitis?

Back 429

Dermatophytes (such as Microsporum, Trichophyton, and Epidermophyton)

Front 430

What causes Tinea unguium?

Back 430

AKA Tinea onychomycosis.

Dermatophytes (such as Microsporum, Trichophyton, and Epidermophyton)

Front 431

What causes Tinea onychomycosis?

Back 431

AKA Tinea unguium.

Dermatophytes (such as Microsporum, Trichophyton, and Epidermophyton)

Front 432

How does Tinea corporis present?

Back 432

Ring shape with a red raised border

Front 433

How does Tinea cruris present?

Back 433

AKA jock itch

Itchy red patches on groin and scrotum

Front 434

How does Tinea capitis present?

Back 434

Scaling on the scalp

Front 435

How does Tinea unguium/onychomycosis present?

Back 435

Nails are thickened discolored and brittle

Front 436

Lab diagnosis of dermatophyte infection

Back 436

1. Dissolve skin scrapings in KOH, which digests the keratin. Microscopic examination reveals branched hyphae.

2. Direct examination of skin with Wood's light (UV light at 365 nm wavelength) will fuoresce green if Microsporum.

Front 437

Treatment for dermatophyte infection

Back 437

1. Topical imidazoles
2. Oral griseofulvin (Tinea capitus and tinea unguium)

Front 438

What causes a fungus ball?

Back 438

Aspergillus

Front 439

What disease states does Aspergillus cause?

Back 439

1. Allergic bronchopulmonary aspergillosis
2. Lung cavity aspergilloma
3. Invasive aspergillosis

Front 440

Histologic appearance of aspergillus

Back 440

Mold (not dimorphic) with septate hyphae that branch at a V-shaped (45 degree) angle). Rare fruiting bodies.

Front 441

Aspergillus (septate hyphae branching at 45 degrees with fruiting bodies)

Back 441

What is this?

Front 442

What disease states does cryptococcus neoformans cause?

Back 442

1. Cryptococcal meningitis
2. Cryptococcosis

Front 443

Histologic appearance of cryptococcus neoformans

Back 443

5-10 micrometer yeasts with wide capsular halo. Narrow based unequal budding.

Front 444

How is cryptococcus neoformans stained?

Back 444

1. India ink
2. Latex agglutination test for polysaccharide capsular antigen

Front 445

Where is cryptococcus neoformans found?

Back 445

Soil and pigeon droppings.

Front 446

What is the histologic appearance of Mucor?

Back 446

Just like Rhizopus

Mold with irregular, broad, empty looking, nonseptate hyphae branching at wide angles (over 90 degrees)

Front 447

What is the histologic appearance of Rhizopus?

Back 447

Just like Mucor

Mold with irregular, broad, empty looking, nonseptate hyphae branching at wide angles (over 90 degrees)

Front 448

Which patients are likely to have Mucor/Rhizopus?

Back 448

1. Ketoacidotic diabetics
2. Leukemics

Front 449

Where in the body does Mucor/Rhizopus proliferate?

Back 449

1. Walls of blood vessels, causing infarction of distal tissue
2. Rhinocerebral frontal lobe abscesses

Front 450

What is pneumocystis jirovecii?

Back 450

Formerly pneumocystis carinii. Yeast (originally classified as a protozoan)

Front 451

What disease states does Pneumocystis cause?

Back 451

Most infection sasymptomatic. Immunosuppresion predisposes to disease.

Front 452

How is pneumocystis diagnosed?

Back 452

Lung biopsy or lavage. Methenamine silver stain of lung tissue.

Front 453

Treatment for pneumocystis

Back 453

Combination of TMP-SMX, Pentamidine, and Dapsone.

Front 454

Characterization of sporotrix schenckii

Back 454

Dimorphic fungus that lives on vegetation.

Front 455

Presentation of sporotrichosis

Back 455

1. Traumatically introduced into the skin by a thorn
2. Local pustule/ulcer with nodules along draining lymphatics (ascending lymphangitis)
3. Little systemic illness

Front 456

What is rose gardener's disease?

Back 456

Sporotrichosis

Front 457

Histologic appearance of sporotrix schenckii

Back 457

Cigar-shaped yeast visible in pus with unequal budding

Front 458

Treatment for sporotrichosis

Back 458

Itraconazole or potassium iodide

Front 459

What disease states does Entamoeba histolytica cause?

Back 459

1. Amebiasis
2. Bloody diarrhea (dysentery)
3. liver abscess
4. RUQ pain

Front 460

What disease states does Giardia lamblia cause?

Back 460

1. Giardiasis
2. Bloating
3. Flatulence
4. Foul-smelling diarrhea

Front 461

What diseases are found in campers and hikers?

Back 461

Yersinia pestis and Giardia lamblia

Front 462

What disease states does Cryptosporidium cause?

Back 462

Diarrhea

1. AIDS: Severe
2. Non-HIV: Mild watery

Front 463

What disease states does Toxoplasma cause?

Back 463

1. HIV: Brain abscess
2. Birth defects (ring-enhancing brain lesions)

Front 464

What disease states does Plasmodium cause?

Back 464

Malaria:
1. Cyclic fever
2. Headache
3. Anemia
4. Splenomegaly
5. Severe cerebral malaria (with Plasmodium falciparum)

Front 465

What disease states does Trichomonas cause?

Back 465

Trichomonas vaginalis causes vaginitis with foul-smelling greenish discharge, strawberry-colored mucosa, and itching and burning. Motile on wet prep.

Front 466

What disease states does Trypanosoma cruzi cause?

Back 466

Chagas' disease:
1. Dilated cardiomyopathy
2. Megacolon
3. Megaesophagus

Front 467

What disease states does Trypanosoma gambiense cause?

Back 467

African sleeping sickness

Front 468

What disease states does Trypanosoma rhodesiense cause?

Back 468

African sleeping sickness

Front 469

What disease states does Leishmania donovani cause?

Back 469

Visceral leishmaniasis (kala-azar or black fever):
fever, weight loss, anaemia and substantial swelling of the liver and spleen

Front 470

What disease states does Naegleria cause?

Back 470

Rapidly fatal meningoencephalitis

Front 471

What disease states does Babesia cause?

Back 471

Babesiosis: Fever and anemia

Front 472

Which protozoa are transmitted by cysts?

Back 472

1. Entamoeba histolytica
2. Giardia lamblia
3. Cryptosporidium
4. Toxoplasma

All water cysts except Toxo (cysts in meat or cat feces)

Front 473

Which protozoa are transmitted by insect?

Back 473

1. Plasmodium (Anophales mosquitoes)
2. Trypanosoma cruzi (Reduviid bug)
3. Other trypanosomas (Tsetse fly)
4. Leishmania (Sandfly)
5. Babesia (Ixodes tick)

Front 474

Which protozoa are transmitted by swimming in freshwater lakes?

Back 474

Naeglaria (via cribriform plate)

Front 475

Which protozoa are transmitted sexually?

Back 475

Trichomonas vaginalis

Front 476

Which protozoa are transmitted by mosquito?

Back 476

Plasmodium

Front 477

Which protozoa are transmitted by reduviid bug?

Back 477

Trypanosoma cruzi (the enses are transmitted by the tsetses, cruzii by reduviid))

Front 478

Which protozoa are transmitted by tsetse fly?

Back 478

Trypanosoma gambiense and rhodesiense (the enses are transmitted by the tsetses, cruzii by reduviid))

Front 479

Which protozoa are transmitted by sandfly?

Back 479

Leishmania

Front 480

Which protozoa are transmitted by ixodes tick?

Back 480

Babesia

Front 481

How do you diagnose: Giardia lamblia

Back 481

Trophozoites or cysts in stool (classic pair shaped organism with double nuclei like owl eyes)

Front 482

How do you diagnose: Entamoeba histolytica

Back 482

1. Trophozoites or cysts in stool

AND/OR

2. Serology

Front 483

How do you diagnose: Cryptosporidium

Back 483

Cysts on acid-fast stain

Front 484

How do you diagnose: Toxoplasma

Back 484

Serology, biopsy

Front 485

How do you diagnose: Plasmodium

Back 485

Blood smear

Front 486

How do you diagnose: Trypanosoma

Back 486

Blood smear

Front 487

How do you diagnose: Babesia

Back 487

Blood smear, no RBC pigment, appears as "maltese cross"

Front 488

How do you diagnose: Leishmania

Back 488

Macrophages containing amastigotes

Front 489

How do you diagnose: Naegleria

Back 489

Amebas in spinal fluid

Front 490

Treatment for: Entameba histolytica

Back 490

Metronidazole and iodoquinol

Front 491

Treatment for: Giardia lamblia

Back 491

Metronidazole

Front 492

Treatment for: Trichomonas vaginalis

Back 492

Metronidazole

Front 493

Treatment for: Cryptosporidium

Back 493

None

Front 494

Treatment for: Naegleria

Back 494

None

Front 495

Treatment for: Plasmodium

Back 495

1. Choloroquine
2. additonal Primaquine (for P. vivax and P. ovale to prevent relapse or liver damage)
3. sulfadoxine plus pyrimethamine
4. Mefloquine
5. Quinine

Front 496

Treatment for: Trypanosoma cruzi

Back 496

Nifurtimox

Front 497

Treatment for: Trypanosoma gambiense and rhodesiense

Back 497

If blood-borne, suramin.

If CNS penetration, melarsoprol.

Front 498

Treatment for: Leishmania

Back 498

Sodium stibogluconate

Front 499

Treatment for: Babesia

Back 499

Qunine, clindamycin

Front 500

Treatment for: Toxoplasma

Back 500

Sulfadiazine plus pyrimethamine

Front 501

Type of bug: Candida albicans

Back 501

Dimorphic fungus, cutaneous OR systemic infection

Front 502

Type of bug: Coccidioides immitis

Back 502

Monomorphic fungus, systemic infection

Front 503

Type of bug: Histoplasma capsulatum

Back 503

Dimorphic fungus, systemic infection

Front 504

Type of bug: Blastomyces dermatidis

Back 504

Dimorphic fungus, systemic infection

Front 505

Type of bug: Paracoccidioides brasiliensis

Back 505

Dimorphic fungus, systemic infection

Front 506

Type of bug: Malassezia furfur

Back 506

Monomorphic fungus, superficial infection

Front 507

Type of bug: Cladosporium werneckii

Back 507

Monomorphic fungus, superficial infection

Front 508

Type of bug: Microsporum

Back 508

Monomorphic fungus, cutaneous infection

Front 509

Type of bug: Trichophyton

Back 509

Monomorphic fungus, cutaneous infection

Front 510

Type of bug: Epidermophyton

Back 510

Monomorphic fungus, cutaneous infection

Front 511

Type of bug: Aspergillus fumigatus

Back 511

Monomorphic fungus, opportunistic systemic infection

Front 512

Type of bug: Cryptococcus neoformans

Back 512

Monomorphic fungus, opportunistic systemic infection

Front 513

Type of bug: Mucor

Back 513

Monomorphic fungus, opportunistic systemic infection

Front 514

Type of bug: Rhizopus

Back 514

Monomorphic fungus, opportunistic systemic infection

Front 515

Type of bug: Pneumocystis jirovecii

Back 515

Monomorphic fungus, opportunistic systemic infection

Front 516

Type of bug: Sporothrix schenckii

Back 516

Dimorphic fungus, subcutaneous infection with some lymphatic spread

Front 517

Type of bug: Entamoeba histolytica

Back 517

Protozoan

Front 518

Type of bug: Giardia lamblia

Back 518

Protozoan

Front 519

Type of bug: Naegleria

Back 519

Protozoan

Front 520

Type of bug: Plasmodium

Back 520

Protozoan

Front 521

Type of bug: Cryptosporidium

Back 521

Protozoan

Front 522

Type of bug: Toxoplasma

Back 522

Protozoan

Front 523

Type of bug: Trichomonas

Back 523

Protozoan

Front 524

Type of bug: Trypanosoma

Back 524

Protozoan

Front 525

Type of bug: Leishmania

Back 525

Protozoan

Front 526

Type of bug: Babesia

Back 526

Protozoan

Front 527

Type of bug: Taenia solium

Back 527

Helminth: Cestode (Tapeworm)

Front 528

Type of bug: Echinococcus granulosus

Back 528

Helminth: Cestode (Tapeworm)

Front 529

Type of bug: Schistosoma

Back 529

Helminth: Trematode (fluke)

Front 530

Type of bug: Clonorchis sinensis

Back 530

Helminth: Trematode (fluke)

Front 531

Type of bug: Paragonimus westermani

Back 531

Helminth: Trematode (fluke)

Front 532

Type of bug: Ancylostoma duodenale

Back 532

Helminth: Nematode (roundworm)

Front 533

Type of bug: Ascaris lumbricoides

Back 533

Helminth: Nematode (roundworm)

Front 534

Type of bug: Enterobius vermicularis

Back 534

Helminth: Nematode (roundworm)

Front 535

Type of bug: Strongyloides stercolaris

Back 535

Helminth: Nematode (roundworm)

Front 536

Type of bug: Trichinella spiralis

Back 536

Helminth: Nematode (roundworm)

Front 537

Type of bug: Dracunculus medinensis

Back 537

Helminth: Nematode (roundworm)

Front 538

Type of bug: Loa loa

Back 538

Helminth: Nematode (roundworm)

Front 539

Type of bug: Onchocera volvulus

Back 539

Helminth: Nematode (roundworm)

Front 540

Type of bug: Toxocara canis

Back 540

Helminth: Nematode (roundworm)

Front 541

Type of bug: Wuchereria bancrofti

Back 541

Helminth: Nematode (roundworm)

Front 542

Type of bug: Treponema

Back 542

Spirochete

Front 543

Which worm: Undercooked pork

Back 543

1. Taenia solium (tapeworm)
2. Trichinella spiralis (roundworm)

Front 544

Which worm: Brain cysts

Back 544

Taenia solium (tapeworm)

Front 545

Which worm: Liver cysts

Back 545

Echniococcus granulosus (tapeworm)

Front 546

Important points about echinococcus granulosus

Back 546

Tapeworm (Cestode)
1. Ingested eggs from dog feces
2. Liver cysts
3. Cysts release antigens and cause anaphylaxis

Front 547

Taenia solium: Treatment

Back 547

Praziquantel/niclosamide. Albendazole for cysticercosis

Front 548

Echinococcus granulosus: Treatment

Back 548

Albendazole

Front 549

Characterization of Schistosoma

Back 549

Fluke (Trematode)
1. Hosted by snails
2. Penetrate skin of humans

Front 550

Presentation of Schistosoma

Back 550

Spleen and liver:
1. Granulomas
2. Fibrosis
3. Inflammation

Front 551

Schistosoma: Treatment

Back 551

Praziquantel

Front 552

Which worm: Portal hypertension

Back 552

Schistosoma mansoni

Front 553

Which worm: Hematuria

Back 553

Schistosoma haematobium

Front 554

Which worm: Bladder cancer

Back 554

Schistosoma haematobium

Front 555

Important points about Clonorchis sinensis

Back 555

Fluke (trematode)
1. Undercooked fish
2. Inflammation of biliary tract

Front 556

Which worm: Undercooked fish

Back 556

Clonorchis sinensis

Front 557

Clonorchis sinensis: Treatment

Back 557

Praziquantel

Front 558

Which worm: B12 deficiency

Back 558

Diphyllobothrium latum (tapeworm)

Front 559

Which worm: Undercooked crab meat

Back 559

Paragonimus westermani (fluke)

Front 560

Important points about Pargonimus westermani

Back 560

Trematode (fluke)
1. Undercooked crabmeat
2. Inflammation and secondary bacterial infection of the lung
3. Hemoptysis

Front 561

Which worm: Hemoptysis

Back 561

Paragonimus westermani (fluke)

Front 562

Paragonimus westermani: Treatment

Back 562

Praziquantel

Front 563

Which worm: Microcytic anemia

Back 563

Ancylostoma (aka hookworm) and Necator (both roundworms)

Front 564

Which worm: Perianal pruritus

Back 564

Enterobius vermicularis (aka pinworm, a roundworm)

Front 565

Important points about Ancylostoma duodenale

Back 565

Nematode (roundworm)
1. Aka hookworm
2. Larvae penetrate skin of feet
3. Intestinal infection can cause anemia

Front 566

Ancylostoma duodenale: Treatment

Back 566

Mebendazole/pyrantel pamoate

Front 567

Important points about Ascaris lumbricoides

Back 567

Nematode (roundworm)
1. Aka giant roundworm (Up to 1 foot in length!)
2. Eggs are visible in feces.
3. Intestinal infection

Front 568

Ascaris lumbricoides: Treatment

Back 568

Mebendazole/pyrantel pamoate

Front 569

Important points about Enterobius vermicularis

Back 569

Nematode (roundworm)
1. Aka pinworm
2. Food contaminated with eggs
3. Intestinal infection
4. Anal pruritus (scotch tape test)

Front 570

Enterobius vermicularis: Treatment

Back 570

Mebendazole/pyrantel pamoate

Front 571

Important points about Strongyloides stercoralis

Back 571

Nematode (roundworm)
1. Larvae in soil penetrate the skin
2. Intestinal infection

Front 572

Strongyloides stercoralis: treatment

Back 572

Ivermectin/thiabendazole

Front 573

Important points about Trichinella spiralis

Back 573

Roundworm (nematode)
1. Undercooked meat, usually pork
2. Inflammation of muscle
3. Periorbital edema

Front 574

Trichinella spiralis: Treatment

Back 574

Thiabendazole

Front 575

Important points about Dracunculus medinensis

Back 575

Nematode (roundworm)
1. In drinking water
2. Skin inflammation and ulceration

Front 576

Dracunculus medinensis: Treatment

Back 576

Niridazole