Micro 05
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| Pertussis toxin | A and B subunits; G protein --> andenylate cyclase --> inc cAMP --> inhibits macrophage and neutrophil phagocytosis
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| When is patient with whooping cough contagious? | 1. catarrhal stage - regular cold like sx's, most contagious; 2. paroxysmal stage - big cough; 3. convalescent - recovering, no longer contagious
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| What to collect whooping cough specimens with? Why? | Calcium alginate swab because B. Pertussis won't grow on cotton.
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| Bordet-Gengou medium | potato blood,and glycerol agar; B. pertussis.
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| Patient over 50 yo, smoker, with pneumonia | Legionella pneumophila
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| Water-loving bacteria | Pseudomonas and Legionella
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| Mists - grocery stores, restaurants | Legionella pneumophila
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| atypical pneumonia with kidney problem (hypoNa, hyperK, metabolic acidosis | Legionella pneumophila
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| How can a patient with Legionella atypical pneumonia get hyponatremia? | Legionella pneumophila affects kidneys --> interstitial nephritis --> knocks off juxtaglomerular apparatus --> low renin, low aldosterone --> lose salt in urine --> hyponatremia
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| How to treat Legionella atypical pneumonia? | Erythromycin
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| Bipolar staining pattern | Yersinia pestis
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| Patient with red hot painful lymph nodes, esp inguinal LNs, blackish discoloration from hemmorrhaging under skin | Yersinia pestis, bubonic plague
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| well demarcated hole in skin with black base, red hot painful lymph nodes | Tularemia; Francisella tularensis
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| Handling rabbits --> pneumonia | Tularemia; Francisella tularensis
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| What is the vector for tularemia? | tick; Francisella tularensis
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| drinking unpasteurized milk, worker in meat packing industry | Brucella
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| aborted animal placenta | Brucella
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| camping in Arizona or Mexico, swollen LNs | Yersinia pestis, bubonic plague
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| Camping in Western U.S., rustic mountain cabin, fever that relapses | Borrelia recurrentis (relapsing fever). This bug is a master at changing its antigens --> cause of the relapses. Must get blood samples during fever episodes only.
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| Consuming cow or goat products in Mexico | Brucella
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| Illness with rise in temp during the day, declining at night | Undulant fever --> Brucellosis, Brucella
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| Cat bite | Pasteurella multocida (don't close the wound! --> anaerobic environment good for P multocida)
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| Cat bite --> low grade fever and malaise | Bartonella henselae, cat scratch disease. Causes a mixed T and T cell hyperplasia in the lymph nodes --> granulomatous microabscesses. See with silver stain. Can also cause bacillary angiomatosis.
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| Stellate granulomas with central necrosis | Bartonella henselae, cat scratch disease. Causes a mixed T and T cell hyperplasia in the lymph nodes --> granulomatous microabscesses. See with silver stain. Can also cause bacillary angiomatosis.
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| Why are Chlamydia and Rickettsia not considered viruses? | They have both DNA and RNA while viruses have either or
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| Diagnosis of conjunctivitis in babies born to moms with Chlamydia infection | inclusion bodies in the cytoplasm of conjunctival cells (initial bodies -- the ones that inhibit phagocytosis and reproduces itself)
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| Organisms that cause atypical pneumonia | viruses, Mycoplasma pneumoniae, Chlamydia psittaci, Chlamydia pneumoniae
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| What is atypical pneumonia vs. regular pneumonia | Regular (Strep pneumoniae): appears very sick, coughs up lots of pus, lungs have infiltrate, rales; Atypical: fever, headache, dry cough, no pus, normal lung exam, streaky infiltrate on lung X-ray.
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| Typical pneumonia in elderly | Moraxella catarrhalis (G-diplococcus)
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| Where do Rickettsia replicate vs. Chlamydia? | Rickettsia: cytoplasm of ENDOthelial cells. Chlamydia: endosomes of columnar EPIthelial cells.
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| Rickettsia - ticks (arthropod) | Rocky Mountain Spotted Fever, Rickettsia rickettsii
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| Rickettsia - louse | Epidemic typhus
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| Rickettsia - flea | Endemic typhus
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| Patient from SouthEastern US (Appalachian range) comes in with fever, conjunctival redness, headache and rash on wrists, palms, ankles, soles. | Rocky Mountain Spotted Fever, Rickettsia rickettsii
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| Why would removing a tick early lead to prevention of Rocky Mountain Spotted Fever? | Tick transmits the Rickettsia within its first 6 to 10 hours of feeding, so if you remove before the transmission, you can prevent the disease
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| Exposure to flying squirrel in Texas --> abrupt fever 2 weeks later, small pink macules on trunk, palms and soles spared | Epidemic typhus
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| Soldier in the trenches, febrile episodes every 5 days | Bartonella quintana
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| Work with cow hides, pneumonia, no rash | Q Fever, Coxiella burnetti, has endospore, must use host's ATP
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| Name the three genera of spirochetes | 1. Treponema, 2. Borrelia, 3. Leptospira
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| Painless chancre with nontender LN swelling, rash on palms and soles and mouth | Treponema pallidum (syphilis)
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| T or F: Antimicrobial therapy can make gummatous syphilis in bones resolve. | TRUE
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| T or F: Antimicrobial therapy can make cardiovascular syphilis (aortic aneurysm and aortic valve insufficiency) resolve. | FALSE
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| CSF analysis yeilds: high neutrophil count, high protein, low glucose | Acute bacterial meningitis
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| CSF analysis yeilds: high lumphocyte count, high protein, low glucose | Subacute meningitis: Mycobacterium TB and Treponema pallidum (neurosyphilis)
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| Hx of syphilis, loss of reflexes and loss of pain and T sensation | Tabes dorsalis, damage to posterior columns and dorsal roots of the spinal cord
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| Pupil constructs during accommodation (near vision) but does not react to light | Argyll-Robertson pupils, midbrain lesion, suggests syphilitic Tabes dorsalis or general paresis
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| In mom that has syphilis, can congenital syphilis be prevented? | Treponema pallidum infxn doesn't damage fetus until 4th month, so treating the mother before then can prevent congenital syphilis.
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| VDRL/RPR | Nonspecific tests for Treponema pallidum. Infection --> cellular damage --> release lipids including cardiolipin and lecithin --> measure the abs that bind to these lipids (in blood and CSF). May have false +
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| FTA-ABS | Specific tests for Treponema pallidum --> soak up all abs against non-pathogenic Treponema strains, then use killed pathogenic Treponema as antigen and see if patient serum has the abs to bind to these antigens
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| Why would patients with syphilis seem to get worse with abx treatment? | killed Treponema releases pyrogen. Sx's should resolve.
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| Condyloma latum | painless wartlike lesion, vulva or scrotum, packed with spirochetes that ulcerates --> extremely contagious
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