Term
|
Definition
| Staining is not removable by alcohol |
|
|
Term
| Name this organism - non-motile, non-spore forming, aerobic, weakly gram positive, intracellular parasites, human-human only pathogen, airborne, primary and latent states. |
|
Definition
| Mycobacterium tuberculosis |
|
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Term
| The TB test induration measurement has three categories of 5, 10, and 15mm - which measurement is for immunocompromised, no risk, and high risk? |
|
Definition
| 5 immuno, 10 high risk, 15 no risk |
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Term
| True or False: the factors that may give a false positive Tb test is a non-tuberculosis infection or BCG vaccination, whereas a false negative is due to anergy (immune unresponsiveness) due vaccinations, youth, or immunocompromised. |
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Definition
|
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Term
| Which of the following are the first line of defense in anti-mycobacterial drugs - isoniazid, rifampin, pyrazinamide, ethambutol, streptomycin. |
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Definition
|
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Term
| True or False: the treatment regimen for Tb is first line drugs daily for 2 months then two first line drugs 2-3 week for 4 months. |
|
Definition
| True, the two first lines are isoniazid and rifampin |
|
|
Term
| Is there a prophylactic treatment of latent Tb? |
|
Definition
| Yes, use of isoniazid alone |
|
|
Term
| How effective is BCG vaccine for Tb? |
|
Definition
| Poorly effective, used extensively outside the US |
|
|
Term
| Of the non-tuberculosis mycobacteria what types of disease do they present and what is the environment that they are contracted in? |
|
Definition
| They are usually found in water or liquid sources and they cause pulmonary disease or local soft tissue infections. |
|
|
Term
| Due to the booster phenomenon how do they test people who are retested periodically? |
|
Definition
| They do a two step test with 1-3 weeks in between for an intial negative test |
|
|
Term
| What is the difference in the pathogenesis of acute versus latent Tb infection? |
|
Definition
| Acute - has fever, malaise, cough with complications of pneumonia, caseating pulmonary nodules, or disseminated disease; Latent - is a non-infectious, non-symptomatic state with 5-10% risk of reactivation |
|
|
Term
| Which of the following are used in Tb diagnosis - CR, PPD-Mantoux test, Quantiferon, AFB stain and culture? |
|
Definition
| All of them including presenting clinical syndrome |
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|
Term
| Leprosy is cause by the intracellular gram positive mycobacterium leprae that causes a tuberculoid and a lepromatous disease, differentiate how each version presents clinically, histopathologically, and what cytokine types are used in each. |
|
Definition
| Tuberculoid - elevated defined plaques with reduced sensitivity, granulomas and giant cells, neg. acid fast test, type 1 cytokines (IL2,ifn-gamma); Lepromatous - disseminated nodules and thickening of skin, disorganized granulomas and foamy macros with many bacilli on acid-fast stain, type 2 cytokines (IL4, IL5, IL10). |
|
|
Term
| What is the mechanism of action for tetracyclines? |
|
Definition
| They bind to the 30S subunit inhibiting tRNAs from binding to A site on ribosome complex |
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|
Term
| Tetracyclines enter gram negative bacteria via porins, what are the two mechanisms that these bacteria have developed to resist this drug? |
|
Definition
| Bacteria have modified porins to reduce influx and increased influx by active transport |
|
|
Term
| Which of the following are the adverse affects associated with tetracyclines - gastric discomfort, bone stainging, phototoxicity, or superinfection? |
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Definition
|
|
Term
| Tetracyclines are a very broad spectrum of “cycline” bacteriostatic drugs that attack gram negatives which prevents what diseases? |
|
Definition
| Pneumonia, STI’s including Chlamydia/Pelvic inflammatory disease/LGV, and prophylaxis against malaria |
|
|
Term
| Name this category of antibiotics - active against aerobic organisms only, bactericidal, oto-nephrotoxic, used in synergy for enterococci treatment, that bind to bacterial membrane transport across it then inhibit the 30S protein. |
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Definition
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|
Term
| Which of the following are aminoglycosides and which are macrolides - azithromycin, streptomycin, neomycin, gentamicin, amikacin, kanamycin, erythromycin, clarithromycin. |
|
Definition
| First and last two are macrolides, rest are aminoglycosides |
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|
Term
| Aminoglycosides exhibit ___________ dependent killing with a prolonged post-antibiotic effect. |
|
Definition
| Concentration, where bactericidal activity is proportional to peak concentration; once daily dosing is less toxic but multiple doses can be used for synergy |
|
|
Term
| Which of the following are mechanisms of resistance for aminoglycosides - decreased influx, altered 30S target, modified bacterial enzymes. |
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Definition
|
|
Term
| The mechanism of action that causes a binding to the 50S ribosome is seen in what 3 types of antibiotics? |
|
Definition
| Macrolides, chloramphenicol, and lincosamides (clindamycin and lincomycin) |
|
|
Term
| The macrolides are a broad spectrum bacteriostatic class, but what is the significant difference between erythromycin and azithro/clarithromycin? |
|
Definition
| Erythromycin causes GI upset, the other two are wider spectrum and lower dose frequency |
|
|
Term
| This drug has highest pseudomembranous colitis risk, works against gram positives like Staph and anerobic bacteria, and binds to 50S. |
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Definition
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|
Term
| What drug is a potent anti-anaerobe that is not a protein synthesis inhibitor but works as a bactericidal electron transport inhibitor? |
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Definition
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|
Term
| Which of the following can induce a fever - infection, malignancy (Hodgkin lymphoma), collagen vascular diseases, drugs, central fever due to stroke or head trauma. |
|
Definition
|
|
Term
| Which cytokines cause fever? |
|
Definition
| IL1,6 and IFN-beta, gamma and TNF-a |
|
|
Term
| How many degress above 37C qualifies as a fever? |
|
Definition
|
|
Term
| What are the features required of sepsis? |
|
Definition
| Fever, hypotension, tachycardia, tachypnea; sever sepsis can result in end-organ dysfunction or DIC |
|
|
Term
| What is the classic cause of sepsis that creates a cytokine storm? |
|
Definition
| Exposure to endotoxin LPS from gram negs |
|
|
Term
| In septic shock you get decreased tissue perfusion which leads to metabolic __________? |
|
Definition
| Acidosis, usually lactic due to tissue ischemia and myocardial depression |
|
|
Term
| Which of the following are treatments for sepsis - hemodynamic support, antimicrobials, ventilatory support, activated protein C, insulin therapy for hyperglycemia, use of early goal directed therapy, corticosteroids. |
|
Definition
| All except corticos and activated protein c which are controversial and have a high NNT |
|
|
Term
| Treponema pallidum, Borrelia burgdorferi, and Leptospira interrogans are what all in what cateogry of organisms and how is each transmitted? |
|
Definition
| Spirochetes, T. pallidum is via direct transmission from a single host, B. burgdorferi is from ticks and mammals, L. interrogans is indirectly transmitted via freeliving organisms and mammals |
|
|
Term
| Spirochete motility is via what appendages? |
|
Definition
|
|
Term
| Spirochetes are commonly found in the mouths of persons with ____________? |
|
Definition
|
|
Term
| This organism causes syphilis and is an obligate parasite. |
|
Definition
|
|
Term
| Describe the difference between the lesions of primary and secondary syphilis. |
|
Definition
| Primary has a single painless lesion on the genitals, whereas secondary has disseminated maculopapular lesions on the body including acral skin |
|
|
Term
| T or F: the stigmata of congential syphilis include all of the following - rhinitis, frontal bossing and saddle nose, interstitial keratitits, and widespread hutchinsons teeth. |
|
Definition
|
|
Term
| T or F: Serodiagnosis of syphilis involves both nonspecific, nontreponemal tests VDRL and RPR as well as specific treponemal tests FTA-ABS, MHA-TP. |
|
Definition
| True, the specific tests confirm the positive reactions in the nonspecific tests via antibodies for Treponema specifically |
|
|
Term
| What are the possible complications of syphilis? |
|
Definition
| Meningovascular, neurosyphilis, and gummas(destructive lesions) |
|
|
Term
| This type of spirochete causes relapsing fever and lyme disease. |
|
Definition
| Borellia; B. burgdorferi causes lyme disease |
|
|
Term
| What is the name of the Borellia burgdorferi outer surface protein that allows it to bind to a tick’s gut but when the temperature changes causes it to downregulate and release the organism? |
|
Definition
|
|
Term
| T or F: detection of B. burgdorferi is via a culture of synovial fluid. |
|
Definition
| False, PCR of synovial fluid |
|
|
Term
| What are the risk factors for leptospirosis? |
|
Definition
| Abrased skin and being in a water environment |
|
|
Term
| What is the antibiotic of choice for spirochetes? |
|
Definition
|
|
Term
| This spirochete has renal colonization and causes fever, myalgia, abdominal pain, nausea, vomiting. |
|
Definition
|
|
Term
| Leptospirosis has both an anicteric disease that is more mild and an icteric disease (Weils Syndrome) that can cause renal failure and hemorrhagic pneumonitis, what causes the more severe form? |
|
Definition
| An excessive deposition of agglutinating antibodies delivering endotoxin (LPS) to phagocytes |
|
|
Term
| The diagnosis of acute leptospirosis remains clinical since serologic tests are usually negative at presentation, but what is the gold standard serologic test? |
|
Definition
| MAT, microscopic agglutination test |
|
|
Term
| Of the following which are recommended for the screening and treatment of asymptomatic bacteriuria - premneopausal women, non-preggers, preggers, diabetic women, old, old institutionalized, spinal chord injuries, patients with catheters, urologic interventions? |
|
Definition
| Preggers and uro interventions |
|
|
Term
| Define: Isolation of a significant concentration of bacteria in an appropriately collected urine specimen obtained from a person without symptoms or signs referable to urinary infection. |
|
Definition
|
|
Term
| What is the standard therapy for pyelonephritis considering that since the kidney is such a highly vascular organ this puts patients at risk for a life-threatening bloodstream infection? |
|
Definition
| Hospitalization and IV antibios |
|
|
Term
| T or F: treatment of uncomplicated UTI is a 3 day course in bactrin. |
|
Definition
|
|
Term
| What is the key function of the human body to prevent UTI’s? |
|
Definition
| to completely empty the bladder and have normal urine characteristics |
|
|
Term
| What is the potential complication from a bacteria like Proteus Mirabilis that produces urease which increases urine pH? |
|
Definition
| Causes kidney stones to precipitate and environment for UTI |
|
|
Term
| What is the most common type of nosocomial infection? |
|
Definition
|
|
Term
| What is the most common cause of acute pyelonephritis? |
|
Definition
|
|
Term
| What is the difference between uncomp and complicated UTIs? |
|
Definition
| Uncomp is the most common occurring in the lower urinary tract of women with normal anatomy, Comp is everything else |
|
|
Term
| Patients the present with the triad of flank pain, fever, bacteriuria typically have what disease that can complicate to urosepsis? |
|
Definition
| Pyelonephritis, inflammation or the renal pelvis |
|
|
Term
| Dysuria, suprapubic pain, and changed urine character can be due to a UTI which may cause ______________, inflammation of the bladder. |
|
Definition
|
|
Term
| E. Coli has pathogenicity associated islands, what are they? |
|
Definition
| DNA which contains clusters of virulence factor genes like P fibriae and hemolysin |
|
|
Term
| Uropathogenic E. coli use __________ to bind to uroplakin on the surface of the Facet Cells in the bladder. |
|
Definition
|
|
Term
| Uropathogenic E. coli express a number of different adhesins, including P, type 1, S, and F1C fimbriae, which of these allow E. coli to adhere to kidney cells? |
|
Definition
|
|
Term
| Name this organism - obligate intracellular gram neg bacteria, unique less toxic LPS, reproduction in endosomes of non-phagos, intracellular life cycle allows it to evade immune system for a while, one of the most common causes of STI’s in young adults and blindness worldwide, no vaccine available. |
|
Definition
|
|
Term
| Describe the transmission and resulting disease of the 4 chlamydia strains C. trachomatis, C. pneumoniae, C. psittaci, C. percorum. |
|
Definition
| 1 human contact- STIs like urethritis, cervicitis, and pelvic inflammatory disease as well as trachomatis (conjuntiva infection leading to blindness); 2- human aerosol pharyngitis/pneumonia; 3 and 4 come from birds - pneumonia, endocarditis |
|
|
Term
| Culture, antigen, and nucleic acid amplification tests are all available to determine a Chlamydia infection, which is the test of choice and what is the treatment? |
|
Definition
| NAAT, treat with tetracyclines or macrolides |
|
|
Term
| Name this organism - obligate intracellular gram neg bacteria, transmitted by ticks and fleas, can replicate in many cell types particularly endothelial cells, most common disease is Rocky Mountain Spotted Fever. |
|
Definition
|
|
Term
| Since rickettsia organisms stain poorly with gram stain what is the current test used to identify it that isn’t species specific? |
|
Definition
| Indirect fluorescent antibody test. |
|
|
Term
| Rocky mountain spotted fever presents with rash, fever, chills, headache, and mayalgis, but what are the complications if untreated and what is the treatment? |
|
Definition
| High mortality due to GI, respiratory failure, encephalitis, and renal failure; treatment is tetras and chloramphenicol |
|
|
Term
| Name this organism - smallest free living bacteria without a cell wall, membranes have sterols, facultative anaerobes, P1 adhesin binds to the base of cilia on epithelial cells, infections occur at all ages but are more common in young adults. |
|
Definition
| Mycoplasma and ureaplasma |
|
|
Term
| T or F: M. pneumoniae is spread via the respiratory route through the close contact of infected individuals. M hominis, M. genitalium and Ureaplasma are transmitted by sexual contact. |
|
Definition
|
|
Term
| Describe the transmission and resulting disease of the groups 1. Mycoplasma pneumonia and 2. M. hominis, M. genitalum, Ureaplasma urealyticum. |
|
Definition
| M. pneumonia is spread thru respiratory route and causes atypical pneumonia, the others are spread via sexual contact and cause non-gonococcal urethritis. |
|
|
Term
| Colonization with mycoplasma organisms is associated with infertility spontaneous abortion, vaginitis cervicitis, epididymitis and prostatisis, so what is the treatment to avoid complications? |
|
Definition
| They are sensitive to erythromycin and tetras but insensitive to wall inhibitots. |
|
|
Term
| What is the most common bacterial STD and reportable disease? |
|
Definition
|
|
Term
| T or F: Chlamydia infections in women can cause cervicitis, urethritis, pelvic inflammatory disease, conjunctivitis, proctitis, or pregnancy morbidity and most infections are asymptomatic. |
|
Definition
|
|
Term
| What makes Chlamydia dangerous is that most infections for men and women are asymptomatic so complications can easily occur - what are the complications for men and women? |
|
Definition
| Women - acute infection can lead to ectopic preggers or pelvic pain and silent infections can lead to infertility, Men - Epididymitis, Reiters Syndrome (oligoarthritis and circinate balantis aka weiner plaques) |
|
|
Term
| What are the screening and treatment requirements for Chlamydia? |
|
Definition
| Sexually active women annually adolescent - 25 and you may check older with risk factors, treat with azithromycin and doxy |
|
|
Term
| Name this disease - bacteremia, Sources of infection include symptomatic and asymptomatic infections of pharynx, urethra, cervix, Occurs in < 5% of infected patients, More common in women, Patients with congenital deficiency of C7, C8, C9 are at high risk, arthritis-dermatitis syndrome. |
|
Definition
| Disseminated gonococcal infection |
|
|
Term
| T or F: When treating PID always include anaerobic antimicrobial coverage. |
|
Definition
|
|
Term
| Which of these are criteria required to diagnose pelvic inflammatory disease - uterine or cervical motion tenderness, fever, discharge, WBS in secretions, elevated ESR or CRP, infection with GC or CT. |
|
Definition
|
|
Term
| T or F: for non-STD causes of genital ulcer disease, there are both infectious causes like Candida balantis and impetigo as well as non-infectious such as trauma, malignancy, or drug eruption. |
|
Definition
|
|
Term
| Name this organism - gram negative coccobacillus, sexual trans, painful ulcer forms with necrotic base, inguinal adenopathy, diagnosis made clinically, treat with cephalos or macrolides. |
|
Definition
| Haemophilus ducreyi (Chancroid) |
|
|
Term
| Lymphogranuloma venereum causes papules or shallow ulcers and can cause lympadenitis and proctitis, but what is the most common pathogen to cause it? |
|
Definition
|
|
Term
| Trichomonas vaginalis, bacterial vaginosis, and candida vaginitis are all causes of what symptom and what similar treatment do they use? |
|
Definition
| Vaginitis treated with metronidazole or clindamycin |
|
|
Term
| T or F: UTI’s can be cause by both gram negs like E. coli and psuedomonas and gram pos like enterococci, group B strep, and coag neg staph. |
|
Definition
|
|
Term
| Floroquinolones alter the bacterial DNA topology in both gram negatives and gram pos. but what is its primary enzyme target in each type of bacteria? |
|
Definition
| Gram negs the fluoros activate DNA gyrase, and in gram pos it activates topoisomerase IV. |
|
|
Term
| Name the category of drugs that the following belong to which treat both gram negs and gram pos - Norfloxacin, ciprofloxacin (Cipro)Ofloxacin, Levofloxacin (Levaquin). |
|
Definition
| First gen fluoroquinolones which are mainly used for UTI, GI, and Pneumonia |
|
|
Term
| Which of the following are associated with quinolones, the majority of which have renal excretion - GI upset, dizziness, tendinopathy, hepatotoxicity, hyper/hypoglycemia. |
|
Definition
|
|
Term
| What are the standard regimens for acute uncomplicated bacterial cystitis and acute pyelonephritis? |
|
Definition
|
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