Busy. Please wait.
or

show password
Forgot Password?

Don't have an account?  Sign up 
or

Username is available taken
show password

why


Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
We do not share your email address with others. It is only used to allow you to reset your password. For details read our Privacy Policy and Terms of Service.


Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.
Don't know
Know
remaining cards
Save
0:01
To flip the current card, click it or press the Spacebar key.  To move the current card to one of the three colored boxes, click on the box.  You may also press the UP ARROW key to move the card to the "Know" box, the DOWN ARROW key to move the card to the "Don't know" box, or the RIGHT ARROW key to move the card to the Remaining box.  You may also click on the card displayed in any of the three boxes to bring that card back to the center.

Pass complete!

"Know" box contains:
Time elapsed:
Retries:
restart all cards
share
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

Microbiology

QuestionAnswer
When is hepatitis most infective? Prodrome period. 2-10 days, flu-like, fever, n/v. Blood, stool, and semen
What part of hepatitis has dark urine? Acute illness, along with pale stools, RUQ discomfort, fatigue and anorexia
What type of virus is Hepatitis A? Picornavirus, a single stranded RNA virus
How is hepatitis A transmitted? Fecal oral
What is the approximate incubation of hepatitis A? About a month (2-6 weeks)
What type of hepatitis has no chronic phase? Hep A
Post -exposure prophylaxis for HAV needs to be given in what time frame? Within 2 weeks. IgG is needed for ICH or over 40
What kind of virus is hepatitis E? Single stranded RNA, zoonotic with resoviors in swine
What type of Hepatitis causes fulminant hepatitis and death in 20% of Pregnant women? Hepatitis E
When the hepatitis B surface antigen persists after acute infection, this means what? Chronic HBV carrier
How is Hepatitis B transmitted? Blood borne: IVDU and sexual contact, vertical if mom has high viremia in 3rd trimester
What are two institutional risk factors for HBV transmission? dialysis and jails
What are the serum findings for Hepatits-B recovery? Anti-HbS+
What is the serology for chronic HBV? HbS-Ag+
Hepatitis delta is what kind of virus? Defective RNA virus. Needs HBV for infection and replication
What type of virus is Hepatitis C? Single stranded RNA virus
What is the approximate incubation for HepC? Long, about 2 months
HCV co-infection with what causes rapid progression to cirrhosis? HIV
For patients who recover from HepC, what is their serology? Anti-HCV+, HCV-RNA-
What is the serology for chronic HCV? Anti-HCV+ and HCV-RNA+
What hepatitis viruses have high prevalence in Africa, Mediterranean, Amazon, Russia and SE asia HBV and HDV (SE asia is HBV only)
What type of hepatitis causes hepatocellular carcinoma? Hepatitis B and Hepatitis C
What kind of virus is HIV Lentivirus, slow and indolent retrovirus
Causative agent of nausea, vomiting (onset < 6 hr) after eating cold cuts, or potato salad, or mayonnaise, or custards? Staphylococcus aureus
Rapid-onset food poisoning is mediated by what component of staphylococcus? Enterotoxin
Tx of staphylococcal food poisoning? Rehydration
Microbial cause of nausea and vomiting, +/- diarrhea (onset < 6 hr) after eating reheated rice? Bacillus cereus
Bacterial spores are resistant to heat due to what component? dipicolinic acid core
Microbial cause of nausea, vomiting, watery diarrhea w/ rapid (onset >6 hr) after eating reheated meat or gravy? Clostridium perfringens
Most likely cause of persistent dyspepsia in a pt not receiving NSAIDs is Helicobacter pylori
Increased risk of gastric adenocarcinoma and MALT lymphoma H. pylori colonization
Indications to treat H. pylori-associated PUD Presence of organism
Standard first-line abx for PUD due to H. pylori is PPI + clarith + amox
Cause of acute onset of diarrhea with rice-water stools, vomiting, dehydration during travel to South America Vibrio cholerae
Pathophysiology of cholera is due to what mechanism? A-B toxin causes increased cAMP
Cholera pathogen is isolated from stool by culture on selective medium called thiosulfate-citrate-buffered sucrose (TCBS) agar
The comma-shaped cholera organisms are microscopically similar to Campylobacter
Tx of cholera involves Rehydration
Secretory diarrhea, fever and vomiting during travel are caused by Enterotoxic E. coli
Secretory diarrhea w/ fatty, foul-smelling stools in campers, hikers; also day-care outbreaks is caused by Giardia lamblia
Following ingestion of 15-25 cysts, excysted trophozoites adhere at brush border of enterocytes and contribute to malabsorption. Giardiasis
Dx of giardiasis is confirmed by Stool antigen (+)
Giardiasis is specifically treated with Metronidazole
Protracted, secretory diarrhea w/ large fluid loss in AIDS is caused by Cryptosporidium >> Cyclospora > Isospora
rank bloody diarrhea, after eating undercooked meats or drinking fruits drinks, is caused by prepared foods or water, contaminated w/ E. coli O157:H7
Pathogenesis of hemorrhagic enterocolitis caused by E. coli involves Shiga toxin (a cytotoxin)
Complication of hemorrhagic enterocolitis in children hemolytic uremic syndrome
Profuse diarrhea, fever, vomiting, and dehydration in infants is caused by Rotavirus
Mechanism of rotaviral diarrhea involves Villus destruction
Infantile watery diarrhea and fever are caused by Adenovirus 40,41
Outbreak of nausea, vomiting, fever in adults is caused by Norovirus
Cause of nausea/vomiting, abdominal cramps, diarrhea +/- bloody 12-48h after eating eggs or poultry or peanut butter? Non-typhoidal Salmonella
Abx treatment in acute gastroenteritis due to Salmonella spp. is not warranted to avoid carrier (in bile ducts) state
Abx used only to treat septic phase of salmonella gastroenteritis is ciprofloxacin
Cause of fevers (>103°), headaches; macular rash on torso (““rose spots””) abdominal pain and little diarrhea later; PE: bradycardia; hepatosplenomegaly (+/-) in a pt with hx of travel (to tropics)? Salmonella typhi
Cause of diarrhea w/ occult blood, abdominal cramping and fever, 2d after ingestion of poultry-contaminated salad Campylobacter jejuni
Abx to treat campylobacter enteritis with high fevers in pregnancy, and HIV is Erythromycin
Cause of dysentery-like illness with fever + abdominal cramps, tenesmus + blood & mucus in children? Shigella sonnei
Dysentery due to invasive Shigella spp. in elderly is treated with Ciprofloxacin
Cause of dysentery-like illness (+/- pseudoappendicitis or pseudo- crohn syndrome) in the northern region after eating cheese Yersinia enterocolitica
Cause of dysentery-like illness in a patient w/ hx of broad-spectrum abx use Clostridium difficile
Clostridium difficile-associated diarrhea (CDAD) is mediated by toxins A (enterotoxin) + B (cytotoxin).
Lab confirmation of CDAD does not require stool Cx, but is based on EIA for stool toxins A or B
Besides rehydration and cessation of inciting meds, CDAD is treated with Metronidazole (mild) or oral vancomycin (severe/relapse)
Health-care associated (nosocomial) spread of Clostridium difficile diarrhea and protracted outbreak is due to Fecal-oral and/or contact w/ environmental spores
Hx of abdominal pain, tenesmus, stools with mucus + blood in a patient, who recently traveled to tropics; CBC: eosinophilia. Amebic dysentery
Stool microscopy to confirm amebic dysentery should reveal characteristic trophozoites of Entamoeba histolytica w/ endocytosed RBCs (distinction from luminal ameba)
Rx of amebic dysentery involves Metronidazole + iodoquinol
Abscesses in liver or peritonitis in travelers w/ or w/o hx of amebic dysentery is confirmed by Serology for E. histolytica
A boar hunter develops dysentery after eating meat at campsite; O & P test should reveal a ciliate parasite, known as Balantidium coli
Most likely cause of chronic abdominal pain, diarrhea; intestinal obstruction; cholangitis; liver abscess, in children Ascaris lumbricides
Ova & Parasite test using microscopy for oval eggs (with a thick coarse shell) in stool confirms ascariasis
A child has stomach ache, distended abdomen, poor appetite. ““Pearl-colored earthworm””-like organisms in the stool. Major immune response against this infection? IgE
DOC of ascariasis is Mebendazole
Vomiting, cramping, diarrhea, epigastric pain, weight loss in an immigrant from developing country is caused by Strongyloides stercoralis
DOC of strongyloidosis is Ivermectin
Pt w/ AIDS (low CD4+ counts) develops pulmonary infiltrates (+ eosinophilia) and/or gram negative sepsis. Invasive strongyloidosis
Weakness, fatigue, lightheadedness, dyspnea, pruritis; pallor; iron- deficiency anemia; eosinophilia (hx of outdoor activity). Hookworm (Necator americanas) infection
Fever, periorbital edema, subconjunctival hemorrhages, muscle weakness, and rash, after eating undercooked pork (Lab: eosinophilia., ␣CPK, ␣LDH &). Trichinellosis
Abdominal pain, bloating, altered appetite after ingestion of sushi. CBC: megaloblastic anemia; leukocytosis/eosinophilia Diphyllobothriasis (fish tapeworm)
Dx of tape worm infection is confirmed by Proglottids in stool
Tape worm infections are treated with broad-spectrum agent Praziquantel
Cause of fever, lymphadenopathy, hepatosplenomegaly in an immigrant from Africa or Orient; pt recalls wading in stagnant water. RUQ ultrasound (+); CBC: eosinophilia. Schistosoma mansoni (Africa) S. japonicum (Far East)
Microscopy of stool in chronic stage of schistosomiasis reveals Large eggs with lateral spine.
Chronic stage of schistosomiasis is treated with Praziquantel
Patient with acute jaundice is HAV IgM (+); household contact should receive for prophylaxis Inactivated HAV vaccine
Patient with jaundice for < 1 week has HBsAg (+), Anti-HBc IgM (+). Acute HBV infection
Multiple sex partners, IDU, infants born to infected mothers are risk groups for which hepatitis virus HBV
This is an enveloped, double stranded DNA virus w/ ss-break; transmitted by infective body fluids. HBV
This asymptomatic man has hep serology profile of HBsAg (-), Anti-HBs (+), Anti-HBc IgG (+), Anti-HBc IgM (-). Resolved hepatitis B
This man has jaundice and is HBsAg (+) > 6 months, Anti-HBs (-), HBeAg (+), Anti-HBc IgG (+), HBV DNA > 20,000 IU/ml Chronic active hepatitis B
This man has jaundice and is HBsAg (+) > 6 months, HBeAg (+) and evidence of necroinflammation. He should receive Peg-IFN␣ 2a + lamivudine (or cidofovir)
his man has no jaundice, but HBsAg (+) >6 months, Anti-HBs (-), Anti-HBc IgG (+), HBeAg (-), persistently normal ALT. Inactive HBsAg carrier
This man, at the time of annual physical exam, reveals Anti-HBs (+) and other markers are (-) HBV immunized
Virologic confirmation of chronic jaundice in a HBV-immunized pt w/ IDU or hemodialysis is based on HCV RNA > HCV IgG
More chronicity of HCV (than HBV) is due to immune-evasive quasispecies generated during replication (in blood) of error-prone HCV RNA virus
Fulminant hepatitis in a patient, who has multiple sexual partners and is HBsAg (+); HBcIgM (-), can be fatal due to what? HDV superinfection.
Cause of acute onset of jaundice, nausea, right-upper quadrant pain, hepatomegaly in pregnant women in India HEV
Fever, arthralgia, carditis, polyarthritis, chorea, erythema marginatum; elevated WBCs or ESR/CRP. Clinical Dx is confirmed by Rising ASO titer
Type II hypersensitivity due to molecular mimicry in a immunological sequel of streptococcal pharyngitis causes Acute rheumatic fever (ARF)
Type II hypersensitivity due to molecular mimicry in a immunological sequel of streptococcal pharyngitis causes Acute rheumatic fever
Acute rheumatic fever diagnosed and treated with Anti-streptolysin O (ASO) titer and benzathine penG
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 Culture should yield S. aureus
A pt w/ hx of extraction of impacted tooth 3 weeks ago now has subacute (native, mitral-valve) endocardits. Blood culture should yield Viridans streptococci
A pt with AIDS and recent hx of UTI has now subacute, native mitral-valve endocarditis. Culure? Enterococcus faecalis (or faecium)
DOC of acute endocarditis in patient with IDU due to sensitive S. aureus (MSSA) Nafcillin +gentamicin
DOC of acute endocarditis in patient with IDU due to resistant S. aureus (MRSA) Vancomycin + rifampin
DOC of subacute, native mitral-valve endocarditits due to viridans streptococci PenG +/- gentamicin
DOC of subacute, prosthetic-valve endocarditis due to Staphylococcus epidermidis Vancomycin + gentamicin
DOC of subacute, native mitral-valve endocardits due to Enterococcus faecalis (or faecium) High-dose ampicillin + gentamicin
Patient with enterococcal bacteremia fails to respond to vancomycin. Resistance mechanism? D-Ala-D-Ala is changed to D- Ala-D-lac
Hx of catheter-related endocarditis, involving prosthetic or native valves. BCx (+) for budding yeast. Pt does not respond to AmphoB or fluconazole; should receive Caspofungin
Patient with colon cancer has bacteremia due to Streptococcus bovis
Cause of febrile, malaise, arthralgia, dyspnea, edema, palpitations. ST/T wave change, heart block, dysrhythmias; CXR: cardiomegaly Coxsackievirus > echovirus > Trypanosoma cruzi (Chagas)
hinoviruses and enteroviruses belong to picornavirus family, but the rhinoviruses differ from enteroviruses on Growth at 22oC/noninvasive
Rhinovirus receptor in the nasal passages and upper tracheobronchial tree is ICAM-1
Rhinovirus, influenza, parainfluenza, coronavirus, RSV, metapneumovirus, and adenovirus all cause Upper-respiratory infections (URIs)
Sinusitis, otitis, laryngitis, exacerbations of bronchitis and asthma are mostly secondary to Viral URIs
In HEENT, Streptococcus pneumoniae, non-typable Haemophilus influenzae, Moraxella catarrhalis all cause Acute otitis media (AOM) & sinusitis
Acute otitis media and sinusitis are empirically treated with amoxicillin + clavulanate. Why use clavulanate? Haemophilus and Moraxella are ␣-lactamase producers
Cause of pharyngeal pain, dysphagia, fever; red throat + purulent exudate that responds to penicillin Streptococcus pyogenes -Group A hemolytic
Group-A Beta-hemolytic Streptococcus from Group A by Bacitracin sensitivity
Common mode of acquisition of URI due to Streptococcus pyogenes? Infective droplets
Major virulence factor with anti-phagocytic function of Streptococcus pyogenes M-protein fibrils
Damage in posterior pharynx and tonsils due to Streptococcus pyogenes is associated with what host response? Pyogenic inflammation
DOC of acute bacterial pharyngitis in a pt w/ Pen allergy Erythromycin > clindamycin
Pyogenic complication of streptococcal pharyngitis Tonsillar abscess
Toxigenic complication of streptococcal pharyngitis Scarlet fever >> TSS (rare)
Immunologic complication of streptococcal pharyngitis Acute rheumatic fever
Cause of fever, red throat + purulent exudate - pseudomembrane with lymphadenopathy, in a pt w/ questionable immunization Corynebacterium diphtheriae
Gram/special stain of Corynebacterium diphtheriae should show Gram(+) rods in palisade arrangements/metachromatic granules
Virulence genotype of Corynebacterium diphtheriae is acquired by Transduction (phage mediated transfer of exotoxin gene)
Isolate on tellurite agar culture of throat swab for a cause of diphtheria is confirmed by Immunodiffusion (ELEK) assay for toxin
Mechanism of action of exotoxin of Corynebacterium diphtheriae ADP ribosylation of EF-2 (inhibits protein synthesis)
Damage to pharynx and cardiac myosites due to Corynebacterium diphtheriae is mediated by Cytotoxicity of A-B toxin
Virologic Dx of URI symptoms, fever; red throat + purulent exudate; hepato-splenomegaly, lymphadenopathy, in a teenager, is confirmed by heterophile antibody (+)
Host cells preferentially infected by EBV are B cells
EBV is biologically similar to what class of viruses? herpes viruses
Host immune system controls the EBV infection, mediated by CD8+ T lymphocytes
Rash occurs following which antibiotic(s) to treat infectious mononucleosis? amoxicillin
Burkitt's lymphoma in some African population is a B-cell tumor due to oncogenesis by EBV
Nasopharyngeal carcinoma, a B-cell tumor that is common in the Oriental population that consumes preserved fish, is due to oncogenesis by EBV
Heterophile-negative infectious mononucleosis syndrome is due to ? CMV
Gram-positive bacteria that cause acute otitis media Streptococcus pneumoniae
Gram-negative diplococci bacteria that cause acute otitis media Moraxellar catarrhalis
Gram-negative coccobacilli bacteria that cause Haemophilus influenzae
Week + of of nasal obstruction, rhinorrhea; purulent nasal drainage + frontal pain/tenderness is treated with Amoxicillin & Clavulanate
DOC for acute mastoiditis in a young child is amoxicillin & clavulanate; why? Same etiology as acute otitis media
Cause of ““seal-like barking”” cough + episodic aphonia w/ symptoms of URI in a child parainfluenza virus
Gram-stain-nonreactive organism that causes redness; purulent discharge at lid margin/eye corners, in a newborn Chlamydia trachomatis
Most common cause of redness; tenderess; hyperpurulent d/c; eye stuck shut in AM, lid edema. Gram stain shows Staphylococcus aureus
Cause of pharyngitis, conjunctivitis, fever with rhinitis, and cervical adenitis in a child. Adenovirus
ause of burning, gritty feeling in eyes; diffuse conjunctival injection & profuse tearing + preauricular LN. Adenovirus
Cause of foreign body sensation, lacrimation, photophobia, conjunctival hyperemia, and ulceration HSV-2>>1
ause of severe pain and skin lesions in dermatomal pattern involving the ophthalmic division of the trigeminal nerve. VZV
Cause of painful, swollen, red eyes, with conjunctival hemorrhaging and excessive tearing in an outbreak Enterovirus
Cause of chorioretinitis in AIDS, but CMV antigen (-) Toxoplasma gondii
Cause of painful keratitis, chronic corneal ulcers in contact lens users, unresponsive to antibiotics Acanthamoeba spp.
In an infant w/ questionable immunization, 2 wks of paroxysmal coughs, inspiratory "whoop" + post-tussive emesis Bordetella pertussis
Pertussis toxin inhibits chemotaxis via downregulation of C3a/C5a receptor, resulting in? lymphocytic leukocytosis in CBC
Three major virulence factors of ““whooping cough”” pathogen? ADP-ribosylating toxin; tracheal cytotoxin; hemolysin
Three major virulence factors of ““whooping cough”” pathogen? ADP-ribosylating toxin; tracheal cytotoxin; hemolysin
Cause of fever + drooling, stridor, dyspnea in a child w/ ?immunization (pt appears septic) Haemophilus influenzae b
Major virulence factor of Haemophilus influenzae associated with pneumonia and meningitis Capsular polysaccharide (antiphagocytic and anti-C3b)
Since, absent spleen places host at increased risk for invasive H. influenzae infection, pre-exposure prophylaxis prior to elective splenectomy is ? Hib immunization
Major virulence factor of Haemophilus influenzae associated with pneumonia and meningitis Capsular polysaccharide (antiphagocytic and anti-C3b)
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)
Most common cause of lower-respiratory infections in neonates (babies < 4 wk)? Streptococcus agalactiae (aka: group B streptococcus)
Since, absent spleen places host at increased risk for invasive H. influenzae infection, pre-exposure prophylaxis prior to elective splenectomy is ? Hib immunization
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)
Most common cause of lower-respiratory infections in neonates (babies < 4 wk)? Streptococcus agalactiae (aka: group B streptococcus)
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)
Most common cause of lower-respiratory infections in neonates (babies < 4 wk)? Streptococcus agalactiae (aka: group B streptococcus)
Complicated illness in a newborn of a GBS-colonized mother is Sepsis or meningitis
Complicated illness in a newborn of a GBS-colonized mother is Sepsis or meningitis
A mother colonized (recto-vaginally) w/ GBS is at risk for preterm baby or premature membrane rupture. She should receive Ampicillin
A mother colonized (recto-vaginally) w/ GBS is at risk for preterm baby or premature membrane rupture. She should receive Ampicillin
n 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
Annual influenza vaccine protects at-risk subpopulation w/ 60% immune protection, and is composed of what 3 viruses? A:H1N1 + A:H3N2 + B
Secondary spread of influenza occurs in a crowded setting (within 6 feet of infected person) via respiratory droplets
A mother colonized (recto-vaginally) w/ GBS is at risk for preterm baby or premature membrane rupture. She should receive Ampicillin
n 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
Annual influenza vaccine protects at-risk subpopulation w/ 60% immune protection, and is composed of what 3 viruses? A:H1N1 + A:H3N2 + B
n 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
Occasionally serious pandemic of influenza occurs due to antigenic shift. This occurs due to what genetic mechanism? Reassortment of 8 genomic segments
Annual vaccine to prevent influenza is needed due to antigenic drift. This occurs due to what genetic mechanism? Mutation
Annual influenza vaccine protects at-risk subpopulation w/ 60% immune protection, and is composed of what 3 viruses? A:H1N1 + A:H3N2 + B
Occasionally serious pandemic of influenza occurs due to antigenic shift. This occurs due to what genetic mechanism? Reassortment of 8 genomic segments
Bacterial superinfection, causing pneumonia, after influenza occurs in elderly in nursing home? S. pneumoniae > S. aureus
DOC of pts with influenza <48 hours is Oseltamivir
Secondary spread of influenza occurs in a crowded setting (within 6 feet of infected person) via respiratory droplets
Bacterial superinfection, causing pneumonia, after influenza occurs in elderly in nursing home? S. pneumoniae > S. aureus
Annual vaccine to prevent influenza is needed due to antigenic drift. This occurs due to what genetic mechanism? Mutation
A seriously ill young adult w/ necrotizing pneumonia, poorly responding to vancomycin, should get Linezolid
Occasionally serious pandemic of influenza occurs due to antigenic shift. This occurs due to what genetic mechanism? Reassortment of 8 genomic segments
DOC of pts with influenza <48 hours is Oseltamivir
Bacterial superinfection, causing pneumonia, after influenza occurs in elderly in nursing home? S. pneumoniae > S. aureus
RSV causes seasonal, nosocomial pneumonia outbreaks in the pediatric units via Contact spread
A seriously ill young adult w/ necrotizing pneumonia, poorly responding to vancomycin, should get Linezolid
Cause of febrile illness + bronchiolitis in an infant; BAL viral culture (+). Respiratory syncytial virus (RSV)
Pathophysiology of asthmatic Sx + Sn in bronchioles in high-risk infants due to RSV involves type III hypersensitivity
RSV causes seasonal, nosocomial pneumonia outbreaks in the pediatric units via Contact spread
Pathophysiology of asthmatic Sx + Sn in bronchioles in high-risk infants due to RSV involves type III hypersensitivity
Inhaled anti-viral drug used in the sickest infants with bronchiolitis is Ribavirin
Inhaled anti-viral drug used in the sickest infants with bronchiolitis is Ribavirin
Insidious onset of fever, dry cough, malaise and sore throat in young adults. CBC: anemia; CXR: diffuse infiltrates Mycoplasma pneumoniae
Dx of ““walking pneumonia”” in older children and young adults, while waiting for serology, is supported by cold agglutinin (IgM Ab against RBCs) titer ␣1:32
Insidious onset of fever, dry cough, malaise and sore throat in young adults. CBC: anemia; CXR: diffuse infiltrates Mycoplasma pneumoniae
B-lactam abx is ineffective for Tx of mycoplasma pneumonia because Wall-less bacteria
A male child with mycoplasma pneumonia now has systemic rash, covering 10% of his body erythema multiforme (SJS)
Cause of upper respiratory Sx, slow onset of cough (laryngitis) >2wks + CXR: patchy infiltrate, viral serology (+) Chlamydophila pneumoniae
The most common cause of community-acquired pneumonia is? Streptococcus pneumoniae
A male child with mycoplasma pneumonia now has systemic rash, covering 10% of his body erythema multiforme (SJS)
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
Cause of upper respiratory Sx, slow onset of cough (laryngitis) >2wks + CXR: patchy infiltrate, viral serology (+) Chlamydophila pneumoniae
The most common cause of community-acquired pneumonia is? Streptococcus pneumoniae
Gram-positive diplococci from sputum from a patient with lobar pneumonia yield ␣-hemolytic colonies and are confirmed by Capsular swelling (Quelling rxn)
alpha-hemolytic colonies of Streptococcus pneumoniae is differentiated from viridans streptococci definitively confirmed by Optochin sensitivity
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
Cause of upper respiratory Sx, slow onset of cough (laryngitis) >2wks + CXR: patchy infiltrate, viral serology (+) Chlamydophila pneumoniae
The most common cause of community-acquired pneumonia is? Streptococcus pneumoniae
Population w/ incidence of pneumococcal pneumonia is AIDS
Gram-positive diplococci from sputum from a patient with lobar pneumonia yield ␣-hemolytic colonies and are confirmed by Capsular swelling (Quelling rxn)
incidence of colonization of what organism is seen in very young and elderly, crowding, following viral URI ( increase in PAF receptors), fall/winter season? Streptococcus pneumoniae
Streptococcus pneumoniae is transmitted by Respiratory droplets
Nasopharyngeal mucosal colonization is facilitated by IgA protease
Streptococcus pneumoniae reaches lungs after nasopharyngeal colonization via aspiration
Major virulence factor, facilitating invasion and dissemination of Streptococcus pneumoniae is Polysaccharide capsule
Pneumococcal cell wall peptidoglycans, teichoic acid elicit Inflammation
Increased Lung cell injury in pneumococcal pneumonia is caused by virulence factor? Pneumolysin (␣alpha-hemolysin)
Multiple myeloma, C3 deficiency, asplenia - Hg SS, COPD, diabetes, alcoholism, smokers are risk factors for mortality due to pneumococcal pneumonia
Streptococcus pneumoniae is transmitted by Respiratory droplets
Nasopharyngeal mucosal colonization is facilitated by IgA protease
Streptococcus pneumoniae is transmitted by Respiratory droplets
Streptococcus pneumoniae reaches lungs after nasopharyngeal colonization via aspiration
Major virulence factor, facilitating invasion and dissemination of Streptococcus pneumoniae is Polysaccharide capsule
Pneumococcal cell wall peptidoglycans, teichoic acid elicit Inflammation
Increased Lung cell injury in pneumococcal pneumonia is caused by virulence factor? Pneumolysin (␣alpha-hemolysin)
Major virulence factor, facilitating invasion and dissemination of Streptococcus pneumoniae is Polysaccharide capsule
Multiple myeloma, C3 deficiency, asplenia - Hg SS, COPD, diabetes, alcoholism, smokers are risk factors for mortality due to pneumococcal pneumonia
Hematologic marker for poor prognosis of pneumococcal pneumonia is Leukopenia
Hematologic marker for poor prognosis of pneumococcal pneumonia is Leukopenia
Emipiric DOC of community acquired in pts at risk or w/ comorbidity is Azithromycin (or levofloxacin) + ceftriaxone
Increased Lung cell injury in pneumococcal pneumonia is caused by virulence factor? Pneumolysin (␣alpha-hemolysin)
Pneumonia due to highly penicillin-resistant Streptococcus pneumoniae (Pen MIC >8) should receive moxifloxacin or vancomycin
Pneumonia due to highly penicillin-resistant Streptococcus pneumoniae (Pen MIC >8) should receive moxifloxacin or vancomycin
Mechanism of penicillin resistance in Streptococcus pneumoniae is PBP alteration by mutation
Emipiric DOC of community acquired in pts at risk or w/ comorbidity is Azithromycin (or levofloxacin) + ceftriaxone
Pt w/ agammaglobulinemia or asplenia or sick-cell anemia or decreased C3 should be vaccinated with Pneumococcal polysaccharide vaccine (PPSV: 23-valent)
Mechanism of penicillin resistance in Streptococcus pneumoniae is PBP alteration by mutation
Cause of necrotizing pneumonia >72 hrs after hospitalization of complicated viral illness Staphylococcus aureus (assume MRSA)
Hx of a patient w/ seizure illness has fever, cough evolving over 2-4 wks; CXR infiltrate Aspiration pneumonia
Community-acquired respiratory pathogens that cause aspiration pneumonia Streptococcus pneumoniae > Anaerobes
Pt w/ agammaglobulinemia or asplenia or sick-cell anemia or decreased C3 should be vaccinated with Pneumococcal polysaccharide vaccine (PPSV: 23-valent)
Mechanism of penicillin resistance in Streptococcus pneumoniae is PBP alteration by mutation
183. Hx: a patient w/ serious CAD now on a ventilator, acquires bronchopneumonia >72 hrs after hospitalization Pseudomonas aeruginosa (VAP)
Hospital-acquired respiratory pathogens that cause aspiration pneumonia Gram-negative bacilli > S. aureus +/- anaerobes
Cause of necrotizing pneumonia >72 hrs after hospitalization of complicated viral illness Staphylococcus aureus (assume MRSA)
linical Dx of sudden dyspnea +/- cyanosis, fever, wheezing, often ARDS-like picture is acid-related pneumonia
Pt w/ agammaglobulinemia or asplenia or sick-cell anemia or decreased C3 should be vaccinated with Pneumococcal polysaccharide vaccine (PPSV: 23-valent)
Hx: a patient w/ serious CAD now on a ventilator, acquires bronchopneumonia >72 hrs after hospitalization Pseudomonas aeruginosa (VAP)
Hx of a patient w/ seizure illness has fever, cough evolving over 2-4 wks; CXR infiltrate Aspiration pneumonia
Community-acquired respiratory pathogens that cause aspiration pneumonia Streptococcus pneumoniae > Anaerobes
Community-acquired respiratory pathogens that cause aspiration pneumonia Streptococcus pneumoniae > Anaerobes
Hospital-acquired respiratory pathogens that cause aspiration pneumonia Gram-negative bacilli > S. aureus +/- anaerobes
linical Dx of sudden dyspnea +/- cyanosis, fever, wheezing, often ARDS-like picture is acid-related pneumonia
Hospital-acquired respiratory pathogens that cause aspiration pneumonia Gram-negative bacilli > S. aureus +/- anaerobes
Empiric DOC of necrotizing pneumonia in a patient with seizure illness clindamycin + levofloxacin
Pneumonia in homeless/alcoholics; Gram-positive diplococci in sputum Gram smear. Streptococcus pneumoniae
linical Dx of sudden dyspnea +/- cyanosis, fever, wheezing, often ARDS-like picture is acid-related pneumonia
Targeted Abx for anaerobic aspiration pneumonia is clindamycin
Pneumonia in homeless/alcoholics; Gram-negative rods in sputum smear Klebsiella pneumoniae
Pneumonia in homeless/alcoholics; Gram-positive diplococci in sputum Gram smear. Streptococcus pneumoniae
Common cause of pneumonia in pts with CF Pseudomonas aeruginosa
Sputum of a patient with hospital-acquired pneumonia yields a Gram-negative rod that is oxidase (+) Pseudomonas aeruginosa
Common cause of external otitis due to hot tub use is Pseudomonas aeruginosa
A patient with diabetes has osteomyelitis after penetrating foot injury. Pseudomonas aeruginosa
Pneumonia in homeless/alcoholics; Gram-negative rods in sputum smear Klebsiella pneumoniae
The most widely used anti-pseudomonal penicillin Piperacillin > imipenem
The most widely used anti-pseudomonal aminoglycoside Tobramicin > gentamicin
This pt >50 years, smoking hx, dec CMI␣ has pneumonia; diarrhea, renal failure. Urine antigen (+) for pathogen. Pt responds to azithromycin. Legionella penumophila
Penicillin is ineffective against Legionnaire’’s because Intracellular organism
Cause of pulmonary embolism in a pt with IVDU Staphylococcus aureus
Asymptomatic patient with PPD (+) Latent tuberculosis infection
Cough > 2 wks, fever, night sweats, weight loss, hemoptysis, SOB; CXR: upper lobe infiltrate. Active Mycobacterium tuberculosis infection
Pyridoxine is added to 4-drug therapy for TB to prevent neuropathy (due to INH)
Pt w/ TB fails to respond to 4-drug regimen w/ INH+RIF resistance because Multiply drug-resistant (MDR) TB
Common cause of pneumonia in pts with CF Pseudomonas aeruginosa
Cause of TB-like Dz that does not respond to 1o TB Tx regimen, in a pt. w/ AIDS MAC
Sputum of a patient with hospital-acquired pneumonia yields a Gram-negative rod that is oxidase (+) Pseudomonas aeruginosa
Hx of chronic pneumonia w/ lung bpsy histopathology (+) for hyphae 2-4μm wide, septate, acute- angle branching. Aspergillus fumigatus
Common cause of external otitis due to hot tub use is Pseudomonas aeruginosa
Cause of TB-like LRI in a pt with outdoor activity (Giemsa stain of bronchoscopy specimen: (+) for 2-5 micro meter yeasts) is Histoplasma capsulatum
A patient with diabetes has osteomyelitis after penetrating foot injury. Pseudomonas aeruginosa
The most widely used anti-pseudomonal penicillin Piperacillin > imipenem
TB-like Dz w/ ulcerative skin lesions. lung bpsy histopathology (+) for large yeast w/ broad-based bud. Rx? Intraconazole
Hx of acute onset of cough, fever, infiltrate in a black male with dec CMI␣; histopathology of lung (+) for a large sac of endospores. DOC? Fluconazole (indefinite)
Common cause of external otitis due to hot tub use is Pseudomonas aeruginosa
The most widely used anti-pseudomonal aminoglycoside Tobramicin > gentamicin
Granular specimen from draining fistulae from a pt with LRI on anaerobic culture should yield Actinomyces israelii
A patient with diabetes has osteomyelitis after penetrating foot injury. Pseudomonas aeruginosa
The most widely used anti-pseudomonal penicillin Piperacillin > imipenem
This pt >50 years, smoking hx, dec CMI␣ has pneumonia; diarrhea, renal failure. Urine antigen (+) for pathogen. Pt responds to azithromycin. Legionella penumophila
Pt with AIDS or organ transplant has indolent pneumonia, w/ or w/o CNS abscess or granuloma. Nocardiosis
rganism w/ characterization of Gram-positive branching, beaded, filamentous rod, weakly acid fast is Nocardia asteroids
Penicillin is ineffective against Legionnaire’s because Intracellular organism
This pt >50 years, smoking hx, dec CMI␣ has pneumonia; diarrhea, renal failure. Urine antigen (+) for pathogen. Pt responds to azithromycin. Legionella penumophila
Asymptomatic patient with PPD (+) Latent tuberculosis infection
DOC of pneumocystis pneumonia (PCP) TMP-SMX
Cough > 2 wks, fever, night sweats, weight loss, hemoptysis, SOB; CXR: upper lobe infiltrate. Active Mycobacterium tuberculosis infection
Pt has urinary urgency, frequency, dysuria; lab: pyuria (+) or nitrite (+) Cystitis due to E. coli
Pyridoxine is added to 4-drug therapy for TB to prevent neuropathy (due to INH)
Microbial (structure) factor favoring bacterial persistence /colonization and UTI is bacterial binding via fimbriae
Pt w/ TB fails to respond to 4-drug regimen w/ INH+RIF resistance because Multiply drug-resistant (MDR) TB
Factor favoring bacterial persistence/colonization and UTI despite high osmolarity and urea concentrations and low pH is high bacterial growth rates
Pt w/ TB fails to respond to 4-drug regimen w/ INH+RIF resistance because Multiply drug-resistant (MDR) TB
Cause of TB-like Dz that does not respond to 1o TB Tx regimen, in a pt. w/ AIDS MAC
Host factor favoring bacterial persistence/colonization and UTI is Urinary stasis
ause of chronic pneumonia in a patient with cancer, receiving cytotoxic chemotherapy; lung-CT: halo/crescent sign (+)? Aspergillus fumigatus
ause of chronic pneumonia in a patient with cancer, receiving cytotoxic chemotherapy; lung-CT: halo/crescent sign (+)? Aspergillus fumigatus
Host factor favoring bacterial persistence/colonization and UTI despite frequent voiding and high urinary flow is Absence of bactericidal effects of secreted proteins
Hx of chronic pneumonia w/ lung bpsy histopathology (+) for hyphae 2-4μm wide, septate, acute- angle branching. Aspergillus fumigatus
Pyogenic inflammation in complicated UTI due to Gram- negative bacteria is due to Lipopolysaccharide (LPS)
Pt with AIDS has blood culture (+) for histoplasmosis. DOC has effects on Ergosterol in fungal cell membrane
TB-like Dz w/ ulcerative skin lesions. lung bpsy histopathology (+) for large yeast w/ broad-based bud. Rx? Intraconazole
Hx of acute onset of cough, fever, infiltrate in a black male with dec CMI␣; histopathology of lung (+) for a large sac of endospores. DOC? Fluconazole (indefinite)
Cause of TB-like LRI in a pt with outdoor activity (Giemsa stain of bronchoscopy specimen: (+) for 2-5 micro meter yeasts) is Histoplasma capsulatum
Pt w/ aspiration pneumonia with cervico-facial lesion should respond to Penicillin G
Pt with AIDS has blood culture (+) for histoplasmosis. DOC has effects on Ergosterol in fungal cell membrane
Pt with AIDS or organ transplant has indolent pneumonia, w/ or w/o CNS abscess or granuloma. Nocardiosis
TB-like Dz w/ ulcerative skin lesions. lung bpsy histopathology (+) for large yeast w/ broad-based bud. Rx? Intraconazole
rganism w/ characterization of Gram-positive branching, beaded, filamentous rod, weakly acid fast is Nocardia asteroids
Hx of acute onset of cough, fever, infiltrate in a black male with dec CMI␣; histopathology of lung (+) for a large sac of endospores. DOC? Fluconazole (indefinite)
Hx of non-productive cough, fever and dyspnea evolving over 2-4 wks. CXR (+): bilateral interstitial infiltrates, hypoxemia; ␣LDH, CD4 count <200/mm Pneumocystis pneumonia
Pt w/ aspiration pneumonia with cervico-facial lesion should respond to Penicillin G
DOC of pneumocystis pneumonia (PCP) TMP-SMX
Granular specimen from draining fistulae from a pt with LRI on anaerobic culture should yield Actinomyces israelii
Microbial (structure) factor favoring bacterial persistence /colonization and UTI is bacterial binding via fimbriae
Pt with AIDS or organ transplant has indolent pneumonia, w/ or w/o CNS abscess or granuloma. Nocardiosis
Factor favoring bacterial persistence/colonization and UTI despite high osmolarity and urea concentrations and low pH is high bacterial growth rates
Host factor favoring bacterial persistence/colonization and UTI is Urinary stasis
Host factor favoring bacterial persistence/colonization and UTI despite frequent voiding and high urinary flow is Absence of bactericidal effects of secreted proteins
rganism w/ characterization of Gram-positive branching, beaded, filamentous rod, weakly acid fast is Nocardia asteroids
Pyogenic inflammation in complicated UTI due to Gram- negative bacteria is due to Lipopolysaccharide (LPS)
Hx of non-productive cough, fever and dyspnea evolving over 2-4 wks. CXR (+): bilateral interstitial infiltrates, hypoxemia; ␣LDH, CD4 count <200/mm Pneumocystis pneumonia
DOC of pneumocystis pneumonia (PCP) TMP-SMX
Pt has urinary urgency, frequency, dysuria; lab: pyuria (+) or nitrite (+) Cystitis due to E. coli
Microbial (structure) factor favoring bacterial persistence /colonization and UTI is bacterial binding via fimbriae
Factor favoring bacterial persistence/colonization and UTI despite high osmolarity and urea concentrations and low pH is high bacterial growth rates
Host factor favoring bacterial persistence/colonization and UTI is Urinary stasis
Host factor favoring bacterial persistence/colonization and UTI despite frequent voiding and high urinary flow is Absence of bactericidal effects of secreted proteins
Pyogenic inflammation in complicated UTI due to Gram- negative bacteria is due to Lipopolysaccharide (LPS)
Empiric DOC to treat community-acquired UTI in adults is ciprofloxacin
DOC to treat UTI in pregnant women is Nitrofurantoin
Gram-positive bacteria that cause uncomplicated UTI in sexually active, young women are Staphylococcus saprophyticus
Differentiation of Staphylococcus saprophyticus from S. epidermidis (both coagulase negative) is based on novobiocin resistance
An elderly or pt with risks of urinary stasis, fever, chills, flank pain, and CVA tenderness; Lab: pyuria, casts, nitrite+. Pyelonephritis due to E. coli
What causes at UTI that is a gram negative rod, encapsulated and has intrinsic ampicillin resistance? Klebsiella pneumoniae
What causes at UTI that is a gram negative rod, slow fermenter, red pigment? Serretia marcescens
What causes at UTI that is a gram negative rod, mobile, and slow fermenter ? Proteus mirabilis
What causes at UTI that is a non-fermenter, blue pigment especially older woman in nursing home? Pseudomonas aeurginosa
What causes at UTI that is a gram positive chain, catalase negative, grows in salt and penicillin resistant? Enterococcus faecalis
If UTI is not improving with therapy, what test next? Renal ultrasound to look for obostruction
Endotoxin that mounts pro-inflammatory cytokines responsible for endotoxic shock is Lipid A of LPS
Genital chancre starts as a papule, ulcerates to form a single, painless and clean based ulcer is what? Primary Syphilis (Treponema pallidum)
What drug can be given for syphilis if the patient is penn allergic? Doxycycline
A woman presents with painful clustered vesicles with a red base and urinary retention HSV-2
Giemsa stain of fluid from herpetic lesion reveals Multinucleated giant cells
If a patient does not respond to acyclovir for genital herpes, what is the problem thymidine kinase deficient HSV
What is the cause of painful genital ulcers that have pus, grey base with painful inguinal adenitis Haemophilus ducreyi (fastidious organism localized with neutrophils and fibrin in chancroid)
Most common cause of mucopurulent endocervical exudate in a young woman is? Chlamydia trachomatis
What is the treatment for non-gonococcal urethritis Azythromycin
A rare cause of genital ulcers, inguinal lymphadenopathy is Chlamydia trachomatis
What infection can cause cervical motion tenderness in a woman with a tubo-ovarian abcess PID
What is a gram-negative diplococci, PMNs in a man with mucopurulent urethritis Neisseria gonorrhoeae
Immune evasion of neisseria gonorrhoeae Antigenic variation of pili
Auxotrophic strains of N. gonorrhoeae can cause what type of infection? Septic arthritis
What is the most frequent complication of gonococcal infection in men? Epididymitis
Why is urethritis treated with ceftriaxone and azithromycin? Concurrent gonococcus and chlamydia
Koilocytes in endocervical biopsy is HPV 6 and 11
Atypcial squamous cells on pap smear with no infection HPV 16 and 18
Strawberry cervix motile tissue flagellate
Vaginal discharge with fishy odor, normal cervix Gardnerella vaginalis
Bacterial vaginosis of anaerobic mobiluncus species and what other bug? Gardnerella vaginalis
What is the treatment for bacterial vaginosis metronidazole
curdy discharge from pregnant woman? budding yeasts with pseudohyphae
What is a fungus normal commensal of the skin, GI, GU tract? candida albicans
What is the mechanism on drugs for vulvovaginal candidiasis blocks C14alpha-lanosterol demethylase
A young man present with a mono-like illness, ALT elevations and maculopapular rash. Monospot negative, what is it? Acute retroviral syndrome (Less than 10,000 copies/ml=viral load)
What is the time from infection acquisition to acute seroconversion? 6-12 weeks
In what gene is the homozygous deletion that confers resistance to infection and protection against progression CCR5
Host cells that trap HIV and mediate efficient transinfection of CD4+ cells are Dendritic cells
What is the CD4+ count with chronic diarrhea, oral thrush, toxo encephalitis less than 50 cells/ml
What is the most common cause of HIV associated peripheral and mucosal ulcers? HSV-1
What is the most common cause of HIC- associated nodules? HHV-8
AIDs patient with fatigue, abdominal pain, diarrhea, constitutional symptoms, dry cough with SOB? MAC
What causes retinitis, viral pneumonitis and esophagitis in AIDs? CMV
What is the CD4+ count for CMV? Less than 50
Ring enhancing lesions in AIDs patient other than toxo? JC virus. Causes hemiparesis, visual problems, ataxia, aphasia, CN deficit.
Objective of HAART is to reduce viremia to what genomic level of RNA? less than 50 copies
What is the initial HAART drugs? Emtricitabine, tenofovir, efavirenz
What drug binds gp41 and prevents constitutional change required for viral fusion into cells? enfuvirtide
What HIV drug inhibits integrase? raltegravir
What antibiotic is needed with a CD4 count less than 200? TMP-SMX for PCP
What is the treatment for toxo and PCP in AIDs Bactrim
CD4 less than 100 with PPD+, treatment? INH + pyridoxine
What is the antibacterial prophylaxis for MAC? Azithromycin
What bug for an AIDs patient with a cat scratch, HSM, adenopathy? Bartonella henselae
What is the cause of chorioretinitis in a neonate after mom had a mono-like illness post undercooked beef or pork? Toxoplasma gondii
Neonate has deafness, cataracts, heart defects? congenital rubella syndrome
Microcephaly, seizures, sensorineural hearing loss, feeding difficulties, petechial rash, HSM is what? CMV
What virus that establishes life-long latency is a ds-DNA beta-herpesvirus CMV
What Rx should HIV(+) women get before giving birth? Nevirapine
Neonate with cutaneous lesions, jaundice, saddle nose, saber shins, Hutchinson teeth, CN VIII deafness? tertiary syphilis
Neonatal septicemia or meningits when mom had a flu-like sickness after eating cheese? Listeria monocytogenes
What causes a maculopapular rash, off white lesions on buccal mucosa that MMR prevents? Measles
Maculopapular rash starting on face and moving to foot, MMR prevents Rubella
Vesicular rash with moderate pain in kids VZV
Sclarlet fever is what bug Group A strep
Maculopapular slapped face rash in kid? Parvovirus B19
Maculopapular rash and systemic disease in ICH? HHV-6
Rubella virus is what kind of virus? RNA togavirus
What affects scalp and beard resulting in scaly and crusted plaques Dermatophytes (KOH shows hyphae and spores)
Most common cause of cutaneous mycoses Trichophyton
Cutaneous mycosis assoc with animal contact? microsporum
Drug for cutaneous mycoses? itraconazole
Topical drug for cutaneous mycoses terbinafine
Subcutaneous lesions with slow spread in a gardener or from rose-thorn injury? Sporotrichosis (Sporothrix schenckii)
What is a dimorphic fungus that grows as a cigar shaped yeast at 37 and produces septate hyphae and conidia at 25 in flowers? Sporothrix schenckii
Drug used for Sporotrichosis? Itraconazole
What bug causes a curbuncle (subq lesion) Staph aureus
superficial pustules-> erosions covered by honey colored crusts in kids are what bug? Staph aureus>>Strep pyogenes
Bullae that rupture covered by light brown crusts is what diagnosis? Bullous impetigo
mecA gene that encodes PBP2a, has low affinity for beta-lactams = resistance to what drug Nafcillin
What causes Erysipelas, a butterfly wing rash on the face? Strep pyogenes
What is a common cause of cellulitis? Strep pyogenes
What microbial factor promotes degradation of C3b by binding to factor H M protein
Cellulitis caused by a cat bite? Pasteurella multocida
Cellulitis caused by salt water exposure? Vibrio vulnificus
Cellulitis caused by fresh water exposure? Aeromonas hydrophilia
Cellulitis when the patient is neutropenic? pseudomonas aeruginosa
Cellulitis caused by a human bite? Eikenella corrodens
What is the most likely bug causing osteomyelitis (left shift) Staph aureus (protein A is virulence factor)
How does staph aureus damage neutrophils? Penton-Valentine leukocydin
What causes osteomyelitis and osteochondritis in ICH? Pseudomonas aeruginosa
What causes osteomyelitis in a sickle cell patient Salmonella typhimurium
If the blood culture is negative for chronic veretebral osteomyelitis what is the organism? TB
Septic arthritis in sexually active person that responds to ceftriaxone? Neisseria gonorrhoeae
Septic arthritis in a patient with Rheumatoid arthritis? S. Aureus
Septic arthritis in a patient with IVDU? Staph or pseudomonas
Septic arthritis with unpasteurized dairy products consumed? Brucella
Septic arthritis in a diabetic patient? S. agalactiae- group B step
Reactive arthritis sexually acquired? C. trachomatis and gonorrhoeae
Reactive arthritis non-sexually acquired? Campylobacter, Salmonella
Bacteremia in neutropenic patients with a central line? Staphylococcus epidermidis
Intrabdominal abcess with putrid pus or anaerobic bacteremia in a patient with invasive adenocarcinoma? Bacteriodes fragilis
What cause of toxic shock responds to Vanco and clindamycin? MRSA
High fever, diffuse sunburn-like rash, desqumation of palms and soles, necrotizing faciiits is what? Streptococcal toxic shock syndrome
Drugs for streptococcal toxic shock syndrome? PenG+ Clindamycin
**A neutropenic patient has positive blood cultures for Beta-D-Glucan antigenemia, what drug do you prescribe? Caspofungin
**A patient has a line -associated infection and a invasive adenocarcinoma. Positive blood culures for Beta-D-glucan antigenemia. What drug is used? Fluconazole
What causes meningoencephalitis post URI in the SW united states Coccidioides immitis
What will CSF show in a patient with fever, cognitive deficits, focal neurological signs and temporal lobe involvement CSF PCR (+) HSV2
What typically causes fever, cognitive deficits, focal signs, seizures, abnormal mental status with ataxia, hemi-paresis in an AIDS patient? JC virus
Fever, cognitive deficits, focal signs, seizures, changes in mental status with ataxia possible hemiparesis in adult during outdoor activity? West Nile
A patient with a CD4+ count of less than 50 shows cognitive deficits, focal signs, seizures and ring enhancing lesions in the basal ganglia Toxoplasma encephalitis
What long term medications should an HIV patient infected with Toxoplasma encephalitis pyrimethamine + leucovorin + sulfadiazine
Folinic acid (leucovorin) prevents bone marrow suppression effect of what drug pyrimethamine
An ICH presents with confusion, stiff neck, irritability over weeks to months. MRI shows multifocal lesions in the midbrain, brainstem and cerebellum. Wet mount of CSF shows motile macrophage-like organisms. What species is it? Acanthamorba
What is the cause of severe headache, meningeal signs, fever, vomiting, focal signs that progress to a coma in a young child in the summer? Naegleria fowleri
What can cause seizures, chronic headache, hydrocephalus in immigrants that responds to praziquantel and diazepam? Taenia solium
A patient from Africa has a history of fever, lymphadenopathy, chancre and pruritis weeks ago and now has headaches, somnolence and neurological signs. He responds to pentamidine isothionate or sumarin. What is it? Trypanosoma brucei
An infant has a umbilical stump infection, history of rigidity, muscle spasm and autonomic dysfunction. The infant cannot open their mouth due to masseter spasm. Neurotixin interferes with what? GABA and glycine
A patient that is an IVDU has afebrile illness with diplopia, dysarthria, dysphoria, dysphagia. Neurotoxin blocks the release of Acetylcholine
What do you treat an infant with constipation, weak cry, drooling, hypotonia, cranial neuropathy after ingestion of home-processed honey Equine immune globin (infant botulism)
Coagulase positive Staph Aureus
E Coli, Klebsiella, Proteus and Enterobacter are all gram negative bacilli that are enteric lactose fermenters
Pseudomonas is a gream negative rod that does not ferment lactose
B. Fragilis is an anerobic gram negative rod
Septic abortion involves what type of organisms Septic abortion commonly involves anaerobes, possibly including clostridia
What virus cough, coryza, conjunctivitis and Koplik’s spots Measles
Dengue is what type of virus? arbovirus infections
Genetic “shifts” are major reassortments of influenza genome
The “Tzanck” test detects multinucleated giant cells (herpes viruses)
What two malaria species have liver involvement? Vivax and Ovale
A patient returns from Nantucket, blood smear shows ring forms. What predisposed him to this illness? Asplenia. Developed heavy parasite load secondary to babesia infection.
A 16 year old present with fever, sore throat and lymphadenopathy and atypical lymphocytes. What do you treat himwith? No treatment for Mono (EBV)
gram-neg (pink) diplococci that are biscuit or kidney shaped are typical of? meningococci and gonococci
A man visits central America and returns with headache, petechial rash, muscle and joint pain. What can this progress to? Hemorrhagic shock. This is Dengue Fever, spread by mosquito vector
Fibrocaseous cavitary lesion in the upper lobe of lung is what? Secondary (re-activation or reinfection) TB
Enlarged hilar nodes, Ghon focus in lower lobe is Primary TB
What causes Osteomyelits in Diabetics and IVDU? Pseudomonas aeruginosa
What is the cause of Osteomyelitis if you are given little identifying information? Staph aureus
Leukocyte esterase positive uncomplicated UTI that shows metallic sheen on EMB agar is what? E. Coli
UTI with nitrite positive in sexually active otherwise healthy woman? Staphlyococcus saprophyticus
UTI with urease positive, large mucoid capsule and viscous colonies is what? Klebsiella pneumoniae
What strain of UTI produces a red pigment, nosocomial and drug resistant? Serratia marcescens
What UTI bug is often nosocomial and drug resistant? Enterobacter mirabilis
What UTI is associated with a woman in a nursing home, blue green pigment and fruity odor on culture and drug resistant? Pseudomonas aeruginosa
An infant has chorioretinitis, hydrocephalus and intracranial calcifications, what is the bug? Toxoplasma gondii from cat feces. Mom is not ICH.
Infant has a PDA or pulmonary artery hypoplasia, cataracts and deafness. What is the bug? Rubella. Mom had rash, lymphadenopathy and arthritis
Infant has hearing loss, seizures, petechial rash, what is the bug? CMV. Mom contracted sexually or via organ transplant
What does an infant with vertically transmitted HIV present with? Recurrent infections and chronic diarrhea
What are the neonatal manifestations of herpes simplex-2? Temporal encephalitis and herpetic lesions (same as adults)
What congenital infection usually results in stillbirth or hydrops fetalis? Syphilis
Notched teeth, saber shins, saddle nose, short maxilla and CN VIII deafness is what? Congenital syphilis (infant has survived)
Brain cysts, seizues is what parasite? Taenia solium (cysticerosis)
Liver cysts is what parasite? Echinococcus granulosus
B12 deficiency is associated with what parasite? Diphyllobothrium latum
Bilary tract disease and cholangiocarcinoma is what parasite? Clonorchis sinensis
Hemoptysis = what parasite? Paragonimus westermani
Portal hypertension = what parasite? Schistosoma mansoni
Squamous cell carcinoma of the bladder, hematuria =what parasite? Schistosoma haematobium
Microcytic anemia is what parasite(s)? Ancylostoma and Necator
Perianal itching = what parasite? Enterobius
Antigens from cysts can cause anaphylaxis if released? Echinococcus granulosus
Pus, empyema and abcess, think of Staph aureus
Pediatric infection, think of Haemophilus influenzae (including epiglottitis)
Pneumonia in CF, burn infection Pseudomonas aeruginosa
Branching rods in oral infection with sulfer granules Actinomyces israelii
Traumatic open wound, what bug? Clostridium perfringens
Surgical wound is usually what bug? S aureus
Dog or cat bite is what bug? Pasteurella multocida
Current jelly sputum Klebsiella
Positive PAS stain Tropheryma whippelii (Whipple's disease)
Sepsis and meningitis is a newborn Group B strep
Health care proiver acquires infection HBV from needle stick
Fungal infection in diabetic Mucor or Rhizopus species
Asplenic patient (3) S. Pneumoniae, H influenzae B, N meningitidis
Chronic granulomatous disease Catalase positive microbes
Neutopenic patients Candida albicans (systemic), Aspergillus, Pseudomonas
Bilateral Bell's Palsy Borrelia burgdorferi
Created by: tessah10