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1
Q

2 most common cause of hematogenous osteomyelitis

A
  1. S. aureus

2. S. pyogenes

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2
Q

Osteomyelitis in DM

A

polymicrobial (contiguous spread from infected foot ulcer)

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3
Q

Diptheria toxin - gene

Diptheria - treatment

A

Tox gene

treatment: active + passive immunization, antibiotics (penicillin or erytrhomycin)

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4
Q

MC eye related complication of CMV

A

chorioretinitis

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5
Q
  1. Enrichment media
  2. reducing media
  3. synthetic media
A
  1. contains special growth factors required for some organisms (example is H. inf)
  2. remove oxygen (for anareobics)
  3. Al chemical contains are known
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6
Q

MMR vaccination - pregnancy

A

avoid pregnancy for 4 weeks

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7
Q

Sporotrichosis - biopsy

A

granuloma

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8
Q

Lactobacilli - characteristics

A

gram (+) - major part of normal vagianl flora in balacne with other colonizers at normal vaginal pH 3.8-4.5

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9
Q

causes of primary ovarian insuficiency

A
  1. smoking
  2. radiation
  3. chemotherapy
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10
Q

hydrop fetalis - symptoms

A

severe anemia, heart failure, pleural effusion, pericardial effusion, ascitis

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11
Q

Extrapulmonary manifesations of M. pneumonia

A
  1. anemia 2. Steven-Johnoson syndrome 3. Joint pains 4. encephalitis 5. cardiac rhythm disturbances 6. Bullous myringitis
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12
Q

S. aureus meningitis is common in

A

neurosurgical patients

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13
Q

Listeria - temperature

A

tumbling motility at 22 C

can be calture at temperature as low as 4 C

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14
Q

chanchroid - treatment

A

ceftriaxone

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15
Q

Fever + anaphylaxis

A

no fever in anaphylaxis (low il-1)

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16
Q

causes of common flue (by frequency, and season)

A
  1. Rhinovirus (esp winter)
  2. Coronovirus (esp winter)
  3. Adenovirus (MC in children)
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17
Q

CMV retinitis –>

A

cooton wood exudates, perivascular hemorrhage + necrotizing vasculitis –> Retinal detachment

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18
Q

special feature of adenovirus and orthomyxovirus as common flu

A

adeno –> similar to A strep (exudate tonslis + cervical adenopathy)
orthomyxo –> high fever

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19
Q

HSV 1 - primary vs reactivation

A

1ry: gingiva tongue, palate, pharynx involvement along with systemic symptoms
reactivation: mild perioral vesicles

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20
Q

Latent TB - transmission

A

no

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21
Q
  1. diagnostic test for gonorrhea

2. diagnostic test for chlamydia

A

both PCR

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22
Q

Mucormycosis is caused by

A
  1. Rhizopus
  2. Mucor
  3. Absidia
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23
Q

pneumonia with retoorbital headaches

A 
Q fever (also increasd liver enzymes, thrombocytopenia etc) 
NORMAL LEUKOCYTES
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24
Q

Dengue fever - mechansim

A

transmitted by Aedes (4 serotypes) –> 1ry infection leads to lifelong immunity agaisnt the same serotype
–> 2ry infection with different viral serotype can cause sever illness due to antibody depended enhancement of infection, enhanced IC formation, and/or accelerated T cells responses–> can cause hemorrhagic fever

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25
mouse-like odor - microbe?
Pasteruella multocida (also indole (+)
26
EBV vs CMV mediated infectious mononucleosis according to clinical presentation
pharyngitis + lymphadenopathy are seen less commonly than EBV
27
2 examples of preforemed enterotoxin
B. cereus | S. aureus
28
diarrhea with monocytes
salmonela typhi
29
viral infectivity is often destroyed by heating to
50-60 C for 30 mins (with a few exceptions)
30
infant botulism - diagnosis
elisa or PCR of toxins
31
Tetanospasim travels within the ..... to reach the spinal cord
motor neuron (retrograde)
32
torticolis?
cervical dystonia of the sternocleidomastoid muscle
33
West Nile also causes
neuroinvasive diseae that can present as encephalitis, meningitis, or flaccid paralysis (anti WNV antibodies)
34
Candida in sputum
not indicate disease --> Candida is normal inhabitant of GI (including oral cavity)
35
abortive infection
vrirus enter the cell but does not produce new virus
36
Roseola - pattern of rash
start in trank --> goes to face + extremities (vs measles + rubella)
37
Taenia solium is endemic in
Central + South america
38
mucormycosis - how to diagnose
biopsy
39
HBV treatment
1. IFN-α 2. entecavir 3. tenofovir
40
pneumonia by pseudomonas - treatment
gentamycin
41
UTI treatment in sulfa allergy
nitrofurantoin
42
nitrofurantoin in pregnancy
safe
43
pneumonia - fist line of treatment
azyththromycin
44
katayaam fever - mechanism and manifestation
Schistosomiasis: | 1. fever 2. hepatosplenomegaly 3. eosinophilia
45
Gold standard of M. pneumonia detection
PCR
46
aspiration pneumonia vs pneumonitis according to onset
pneumonia: days after aspiration pneumonitis: hours after aspiration
47
Schistosoma diagnosis
eggs is stool
48
WBC in CSF in meningitis (viral vs bacterial)
viral --> less than 500 | bacterial --> more than 1000
49
How listeria survive in the cell
listeriolysin 0 (a preformed toxin) selectively activated within acidified phagosomes --> escape from phagosome
50
EBV protein that binds CD21
gp350
51
lepromatous vs tuberculoid leprosy according to skin test, immunity, bacterial load
lepromatous: increased load, (-) lepromin test, Th2 tuberculoid: decreased load, (+) lepromin test, Th1
52
Increased risk of osteomyelitis in increased age - mechanism
nutritient arteries develop a corkscrew anatomy --> allows bacteria more easily to penetrate the marrow cavity + cause local infection
53
staphyloccoci according to mannitol fermentation
only S. aureus
54
MCC of oppurstunistic mycosis
candida
55
Defnitive treatment of biofil producing orgnaism
remove the foreign body
56
an example that increases the risk for S. epidermidis meningitis
ventriculoparietal shunt placement for meningitis
57
histoplasma in immunocompromised
1. systemic symptoms 2. painful oral ulcers 3. lymphadenopathy 4. hepatosplenomegaly
58
Pertussis phases
1. Catarrhal phase (like URI) 2. Paroxysmal phase - severe coughing spells with clasic inspiratory whoop or post-tussive emesis 3. Convalescent phase - cough improves
59
C. neoformans - extraCNS manifestations
rare: Lungs: cough with scant sputum production, dyspnea, or pleuritic chest pain Skin: papules, pustules, nodules, ulcers (less than 10%)
60
bacterial pneumonia 2ry to viral infection - mechanism
virally induced damaged to the mucociliary clearance | --> S. pneumonia, S. aureus, H. infl
61
infectious dose of shigella, C. jejuni, E. hemolytica, Giardia
shigella --> 10-500 : depending on age, comditio of host, species of shigella C. jejuni --> 500 E. histolytica --> 1-10 Giardia 1-10
62
drugs that increased the risk of parotitis (also other risk factors)
anticholinergics | other risk factors: intubation. dehydration, obstruction
63
babesiosis also causes
1. flu-like 2. thrombocytopenia 3. abdominal liver function test
64
virus that causes Steven Johnson
CMV
65
how to distinguish E. coli from Enterobacter
E.coli is indole (+)
66
CMV in HIV - spasticity?
radiculopathy --> trouble in walkin, spasticity, not able to urinate
67
physiologic leukorrhea
women have 1-4 ml of white to yellow, mostly odorless discharge daily
68
bug that produce DNAase
S. pyogenes
69
trichomonas vaginalis in men
urethritis | MC asymptomatic
70
pathognomonic histology for hepatic schistosomiasis
periportal "pipestem" fibrosis
71
Inactivated (killed) bacteria vaccines
1. virbrio cholera | 2. Yersinia pestis
72
B. burgdorferi vaccine contains
recombinant bacterial outer surface protein
73
Bacteria - how to survive intracellulary
1. by blocking the fusion of phagosomes with lysosome (salmonela + TB) 2. by inhibiting phagolysosome acidification (TB) 3. Escaping from phagosome into the cytpsol (Listeria, Shigella)
74
Both toxins of C difficile inactivates
Rho regulatory proteins
75
warm reaction agglutination - treatment
steroids
76
actinomyces - sulfur granules - colour
yellow --> become basophilic under the microscope with the hematoxilin eosin
77
other virulence factor of S. pneumonia, beside capsule
IgA protease, adhensins, pneuomolysin (cytotoxin that causes pores in cell membrane + cell lysis)
78
Intraabdominal infections are polymcrobial, with ....... being the most prominent
1. B. fargilis | 2. E.coli
79
cellulitis associated with freshwater or seawater exposure
1. Aeromonas hydrophila | 2. Vibrio vulnificus
80
B19 virus protein binds to
erythrocyte P antigen
81
Dracunculus medinensis - transmission / causes
- Drink water with lavrae | - skin + soft tissue infection
82
H. inf - satellite phenomenon
grows around S. aureus due to NAD supplementation
83
scabie rash - due to / worse when
- due to delayed IV hypersensitivity to the mite, mite feces, mite egss - worse at nights
84
necrotizing fascitis - course / treatment
severe pain + swelling at the site of trauma or recent surgery --> quickly become hypotensive + develop septic shock treatment: aggressive surgical debridement of all necrotic tissue along with empiric broad spectrum antibiotcs due to high incidence of polymicrobial infection
85
C. difficile - necessary before examining the patient
Nonsterile gloves + gown
86
B. henselae is visuable in
Warthin-starry stain
87
findaxomicin - group?
macrolide
88
Chikungunya
- a febrile illness with flulike, polyarthralgia/arthritis, rash - AEDES mosquito (like Yellow + Dengue)
89
neurocisticercosis image
fluidfilled larval cyst with minimal enhancement + no associated edema
90
Septic abortion - presentation / due to / treatment
presentation: fever, abd pain, uterine tenderness, foul-smelling discharge after pregnancy termination due to: S. aureus, E. coli due to seeding of the uterine cavity during instrumentation treatment: antibiotics, surgical evacuation to remove the nidus long term complication --> Asherman syndrome
91
urease breath test for H. pylori
consume (13)C labeled urea + his breath is then (after 30 mins) monitored for the presence of (13)C labeled C13 (antibiotics or PPI during 2-4 wks pior the test may cause FN)
92
Isosporal belli causes
produce diarrhea in HIV (+)
93
Strongyloides stercolaris infection - diagnosis
rhabditiform (noninfectious) larvae in the stool
94
Strongyloides stercolaris - HYPERINFECTION SYNDROME
rhabditiform (noninfectious) larvae --> mature in filariform larva in the GI --> autoinfection cycle --> Hyperinfection syndrome (dissemination + multiorgan dysfunction/septic shock) (esp in immunospressants or HTLV infection)
95
microscopic appearance of b. anthracis in media
serpentine or medusa head
96
aspergillus has been associated with contaminated ..... preparations
glucocorticoid
97
Bromoacetycholine - mechanism of action
inhibits choline acetyltrasferaase, blocking the sysnthesis of Ach from acetate + choline
98
Granuloma inguinale
- donovanosis - caused by Klebsiella granulomatis - painless progressive red serpiginous ulcerative lesions without lymphadenopathhy - diagnosis: gram (-) culture / biopsy (Donovan bodies: deeply staining gram (-) intracytoplasmic cysts) - if left untreated --> scarring + strictures --> lymphatic obstruction --> lymphadema (elephantiasis)
99
LPS vs LOS
LOS (on Neisseria) lacks the 0 antigen | --> lipooligosaccharide --> sometimes also refereed as LPS
100
mechanism of mycoplasma induced anemia
similarity between antigens in the cell membranes of Mycoplasma + the cell membrane of erythrocytes (I-antigen)
101
hyaluronate - bacteria
``` present in the capsule of S. pyogenes + has antiphagocytic activity not immunogenic (vs M protein) ```
102
Most important steps for prevention of central venous catherter infections
1. proper hand hygiene 2. full barrier precautions during insertions 3. Chlorhexidine skin disinfection 4. Avoidance of femoral insertion site 5. Removal of the catheter when it is no longer needed (catheter replacement, oral antibiotics and topical atnimicrobial oitments do not prevent,
103
initial of empiric therapy coag (-) staph infection
vancomicin (due to widespread methicillin resistance, esp in nosocomial infections) - if methicillin sensitive --> switch to nafcillin or oxacillin
104
Type III secretion system (injectisome) type of bacteria
gram (-)
105
cutaneous anthrax
painless papule surrounded by vesicle --> ulcer with black eschar (painless, pencrotic)
106
Bacilluls cereus - types and causes
``` emetic type (preformed heat labile toxin, cerulide, like cholera) --> in 5 h diarrheal type (heat sable) --> watery nonbloody in 8-18 h ```
107
Cord Factor
cell wall of Mycobacterium --> surpentine cords --> inhibits macrophage maturation + induces TNF-a secretion (virulence)
108
Mycobacterium - sulfatides
surface glycolipids --> inhibit phagolysosomal fusion
109
salmonela vs shigella according to immune response
salmoneal typhi --> monocytes other salmonela --> PMN shigella --> PMN
110
sporothrix schenckii - treatment
intraconazole or potassium iodide
111
T. cruzi - map / treatment
S. america | Benzidazole or nifurtimox
112
vaccine - eggs
inf, measles , mumps, yello
113
close contacts of immunocompromised - vaccines
not live polio or infl
114
HSV-2, VZV, CMV - latent state
sacral ganglion dorsal root or trigeminal ganglia mononuclear cells
115
CMV receptor | Rhinovirus receptor
integrins (heparan sulfate) | ICAM-1
116
simeprevir - clinical use
chronic HCV in combination with Ledipasvir (NS5A inhibitor) | not monotherapy
117
Clindamycin - clinical use
1. anaerobic upper diaphragm 2. Gardenella vaginalis 3. invasive A strep infection
118
Macrolides - clinical use
atypicals pneuonia chlamydia pertusis GRAM + cocci (STREP INFECTION IF ALLERGIC TO PENICILLINS)
119
Bunyaviridae - virus
1. california encephalitis 2. Rift valley 3. Crimean congo hemorrhagic fever 4. Hantavirus
120
flavivirus - virus
1. Yellow 2. HCV 3. dangue 4. west nile 5. st Louis encephalitis
Microbiology
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