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What bug causes gastritis?: Helicobacter Pylori
What bug protects itself by producing ammonia?: Helicobacter Pylori
What bug has urease to produce ammonia?: Helicobacter Pylori
What bug induced gastritis in the _____ of the stomach decreases somatostatin from D cells resulting in acid hypersecretion. This results in ____ ulcers.: Helicobacter Pylori, antrum, Duodenal
A ___ test is used to detect urease positive bacteria.: 14C-labeled test, breath out labeled CO2 if have H. Pylori
What is the treatment for H. Pylori: bisthmus therapy + tetracycline/amoxicillin + metronidazole OR metronidazole + imeprazole + clarithromycin
metronidazole + imeprazole + clarithromycin combo is used to treat what?: Helicobacter Pylori
H pylori causes __% of duodenal ulcers and __% of gastric ulcers?: 90%, 70%
What bacteria causes 90% of duodenal ulcers and 70% of gastric ulcers?: Helicobacter Pylori
A malignant ulcer, commonly associated with ____ bacteria has _____ borders?: H. Pylori, heaped borders
Chronic ____ infection is associated with gastric adenocarcinoma and MALT lymphoma: Helicobacter Pylori
Chronic H. pylori infection is associated with what two malignancies?: gastric adenocarcinoma and MALT lymphoma
What gram- bacteria resemble comma shape?: Campylobacter jejuni
What gram- rod grows best at 42C: Campylobacter jejuni
What gram- rod urease- and oxidase+: Campylobacter jejuni
Campylobacter jejuni is ______ for oxidase?: positive
Bacteroides fragilis is best treated with _____: clindamycin
What is the most common species of colonic flora: Bacteroides fragilis
What bug causes GI or peptic abscesses "below the diaphragm" and peritonitis: Bacteroides fragilis
Is Bacteroides fragilis aerobic or anaerobic?: anaerobic
What does Bacteroides fragilis cause?: GI or peptic abscesses "below the diaphragm" and peritonitis
What bug causes epiglottitis, otitis media, pneumonia and meningitis: Haemophilus influenzae type B
What is the most common cause of meningitis in children 6mo to 6yrs: Haemophilus influenzae type B
What bacteria is protected from secretory IgA by IgA protease?: Haemophilus influenzae type B
What bacteria colonizes the upper respiratory tract and causes epiglottitis and otitis media?: Haemophilus influenzae type B
Haemophilus influenzae type B causes what infections? But does not cause what?: epiglottitis, otitis media, pneumonia and meningitis, does not cause flu
What mechanism allows Haemophilus influenzae type B to invade the submucosa and enter the blood: Haemophilus influenzae type B avoids phagocytosis with a capsule
What bacteria requires hemin (X factor) and NAD (V factor) on chocolate agar: Haemophilus influenzae type B
What type of media is used to grow Haemophilus influenzae type B: hemin (X factor) and NAD (V factor) on chocolate agar
What drug is used to treat meningitis caused by Haemophilus influenzae type B: chloramphenicol
What drug is used for local infections of Haemophilus Influenzae type B?: 2nd or 3rd gen cephalosporins like ceftriaxone
What type of vaccine is given against Haemophilus Influenzae type B?: Hib vaccine: capsular polysaccharide type b strain conjugated to diphteria toxoid
What is the Hib vaccine used for?: Haemophilus influenzae type B
When is the best time to vaccinate against Haemophilus influenzae type B?: between 2 and 18 months
What drug is given to close contacts for Haemophilus influenzae type B meningitis: rifampin
What type of Haemophilus influenzae causes pneumonia in adults post recent influenza viral infection: "Non-typeable" H. influenzae
"Non-typeable" H. influenzae causes what type of infection?: pneumonia in adults post recent influenza viral infection
Legionella pneumophila causes what type of infection?: atypical pneumonia
What type of infection is Legionnaire's disease: atypical pneumonia caused by Legionella pneumophila
What gram- rod is best visualized with silver stain?: Legionella pneumophila
What gram- rod is cultured on charcoal yeast extract with iron and cystein?: Legionella pneumophila
What is the best way to visualize Legionella pneumophila?: silver stain
What is the best way to culture Legionella pneumophila?: charcoal yeast extract with iron and cystein
What drug is used to treat Legionella pneumophila?: erythromycin
What is the mode of transmission of Legionella pneumophila: no person-to person contact, infected water source (air conditioners)
What causes wooping cough?: Bordetella pertussis
Bordetella pertussis causes what?: wooping cough
What type of toxin is in bordetella pertussis and how does it work?: AB toxin that ADP ribosylates and inactivates Gi proteins->uninhibited adylate cyclase ->more cAMP->lymphocytosis, decreased phagocytosis by inhibiting chemokine receptor
What bug growes on Bordet-Gengou medium (potato agar): Bordetella pertussis
Bordetella pertussis is grown on what type of medium?: Bordet-Gengou medium (potato agar)
What disease is caused by Brucella species?: undulating fever
What causes undulating fever: Brucella species
How is Brucella species transmitted: animal products (eg. goat cheese) or direct skin contact
Describe 3 characteristics of Brucella species: Gram-, coccobacilli, facultative intracellular
What disease is caused by Francisella tularensis?: talaremias (site specific infection + lymphadenopathy)
What is the reserviour of Francisella tularensis?: Rabbits & deer
What is the vector for Francisella tularensis? (4): ticks, lice, mites, contact with infected animal at skin
What disease is caused by Pasteurella multocida?: cellulitis
Where is Pasteurella multocida found?: Normally inhabits oral cavity of animals
How does infection with Pasteurella multocida: spreads locally to soft tissue (cellulitis) and bone (osteomyelitis)
What infection can humans get from a dog or cat bite: Pasteurella multiocida
What disease is caused by Mycobacterioum tuberculosis: Tuberculosis
What are the 2 types of TB: Primary and secondary
What is extrapulmonary TB (5): CNS (parenchymal TB or meningitis), Vertebral body (Pott's disease = osteomyelitis), Lymphadenitis, Renal, GI
What is a Ghon Complex and where is it found: Hilar nodes + Ghon focus (usually lower lobes); TB granulomas (Ghon focus) with lobar and perihilar lymph node involvement. Reflects primary infection or exposure).
Where is Secondary TB found: Fibrocaseous cavity lesion in the upper lobes
Who is the most likely Non-immune host for TB: child -> primary infection
Who is the most likely partially immune host: Hypersensitized adult -> reinfection (secondary infection) esp in HIV
What is Miliary TB: sever bacteremia with TB
What causes secondary TB: weakened T cell response -> reactivation of pulmonary tubercles in apex -> lg caseous granulomas -> cavitations
Best way to ID TB infection in vitro: acid fast stain of sputum
What is the CXR finding in TB: Ghon complex
Name the 5 first line TB drugs: INH-SPIRE; Streptomycin, Pyrazinamide, Isoniazid, Rifampin, ethambutol
What drug is 2nd line for TB: cycloserine
What drug is used along to TB prophylaxis: Isoniazid
What is the common side effect of TB therapy: hepatotoxicity
What is the mechanism of immune system control of TB: T-cell mediated immunity
What are the symptoms of TB: fever, night sweats, weight loss, and hemoptysis
What bacterium grows in low temp areas such as skin and fingers: Mycobacterium Leprae
What are the 2 forms of Hansen's disease (Leprosy): lepromatous and tuberculoid
Which type of leprosy is worse lepromatous or tuberculoid: lepromatous is worse (failed cell-mediated immuntiy); tuberculoid is self-limited; LEpromatous=LEthal
Where is Mycobacterium Leprae infection often found: skin and superficial nerves
How is Mycobacterium Leprae cultured?: it cannot be cultured
What is the reserviour of Mycobacterium Leprae in the US: armadillos
What drug is used to treat M. leprae?: dapsone
What is dapsone used for and what is it's toxicity?: M. leprae (long term treatment); tox = hemolysis and methemoglobinemia
What are alternative treatment for M. leprae: rifampin and cobo of clofazimine & dapsone
What are the physical findings in lepromatous leprosy: "leonine facies" of lepromatous leprosy = loss of eyebrows, nasal collapse, lumpy earlobe
What disease presents with loss of eyebrows, nasal collapse and lumpy earlobes: Lepromatous leprosy
What disease is caused by Treponema pallidum?: Syphilis
What is the treatment for Syphilis?: penicillin G
Describe primary syphilis: Presents with painless chancre (localized disease)
What infection presents with painless chancre (localized disease): Treponema pallidum (syphilis)
Describe secondary syphilis: Disseminated disease with constitiutional symptoms, maculopapular rash (palms and soles), condyloma lata
What infection presents with condyloma lata): Treponema pallidum (syphilis)
Describe tertiary syphilis: Gummas, aortitis, neurosyphilis (tabes dorasalis), Argyll Robertson pupil
What disease presents with an accomodating but non-reactive pupil, what is this called?: tertiary syphilis, Argyll Robertson pupil
Describe the Argyll Robertson pupil: Consticts with accomodation but is not reactive to light; "prostitutes pupil" accomodates but does not react
What are the 4 clinical signs of tertiary syphilis: broad based ataxia, positive Rohberg, Charcot joints, stroke w/o hypertension
Describe Congenital syphilis (3): Saber shins, saddle nose, deafness
What congenital condition presents with saber shins, saddle nose and deafness: Congenital syphilis
What is the non-specific test for syphilis: VDRL - non-specific antibody that reacts with beaf cariolipin
Under what 6 conditions will a VDRL be false positive: Viral infection (mono, hepatitis), some Drugs, Rheumatic fever, Rheumatoid arthritis, Lupus, Leprosy
What is the most specific test for treponemes: FTA-ABS: Find The Antibody - ABSolutely
What are the features of FTA-ABS: most specific, earliest positive, remains positive longest
If a VDRL is positive and FTA-ABS is negative does the patient have syphilis?: NO, FTA-ABS is more specific than VDRL
What is Treponema pertenue?: causes yaws (a tropical infection that is not an STD, although VDRL is positive)
What bacterium causes yaws?: Treponema pertenue
What shape is Treponema and how to stain for it: Spirochete, dark field microscopy
Where can Rickettsia be found?: intracellularly
Name 2 obligate intracellular parasites: Rickettsia and Clamydia
What obligate intracellular parasites use what resouce produced by the host cell?: Rickettsia and Clamydia use intracellular ATP for energy.
What drug is used to treat Rickettsia?: Tetracyclines
What disease is caused by Rickettsia Rickettsii and what are it's symptoms?: Rocky Mountain Spotted Fever: rash, fever, headache
What causes Rocky Mountain Spotted Fever and what are the symptoms?: Rickettsia Rickettsii: rash, fever, headache
What are 3 types of Rickettsia and what do they cause?: Rickettsia Rickettsii causes Rocky Mountain Spotted Fever, Rickettsia Porwazekii causes epidemic Typhus, Coxiella Burnetii causes Q fever
What are the symptoms of Rickettsia prowazekii infection?: rash, fever, headache, Brill Zinsser disease
What type of bug is Coxiella burnetii?: Rickettsia
What do Poliovirus, Coxsackieviruses A&B and Hepatitis A virus have in common?: They are all Picornovirdae Enteroviruses
What are 4 types of Picornovirdae Enteroviruses: Poliovirus, Coxsackieviruses A &B, and Hep A
What is caused by Coxsackivirus: aseptic meningitis, herpangina - febrile pharyngitis hand food, and mouth diease, myocarditis
What are the Salk/Sabin vaccines used for?: Poliovirus
What is the difference between the Salk and Sabin vaccines: Salk is IPV and Sabin is OPV
What is the shape and RNA/DNA of Picornovirdae like?: Isohedra, non-enveloped, SS+linear
What does Hep A virus cause?: Acute viral hepatitis
Name 5 picornoviruses: Poliovirus, Echovirus, Rhinovirus, Coxsackievirus, HAV
Describe the RNA processing of picornoviruses: RNA is translated into 1 large polypeptide that is cleaved by proteases into functional viral proteins.
Which 3 picornoviruses can cause aseptic (viral) meningitis?: Poliovirus, Echovirus, Coxsackievirus
Describe Rhinovirus (2 features): Non-enveloped RNA virus
What does Rhinovirus cause?: common cold
How many serotypes of Rhinovirus exist?: over 100
What virus causes the common cold?: Rhinovirus
Which Picornaviridae can cause dilated myocarditis?: Coxsackievirus B
What is a cardiac complication of Coxsackievirus B?: dilated myocarditis
What does Coxsackievirus A cause?: herpalgia (red oropharynx veicles, fever, sore throat), hand foot and mouth disease
What is a complication of polio: degeneration of anterior horns, LMN signs
What viral infection presents with LMN signs?: polio
How long is the incubation period of Hep A: 3 weeks
Which Hep virus has no carriers: Hep A
How is Hep A transmitted: fecal-oral route
Describe the production of Hep A virus: naked SS RNA is translated into 1 large polypeptide that is cleaved into functional viral proteins (like all Picornoviruses)
How does Hep A infection usually present: Asymptomatic
Describe the production of Rhinovirus: naked SS RNA is translated into 1 large polypeptide that is cleaved into functional viral proteins (like all Picornoviruses)

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