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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?
Bacteroides fragilis is best treated with _____
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?
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
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
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?
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?
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
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
What drug is used along to TB prophylaxis
What is the common side effect of TB therapy
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
What drug is used to treat M. leprae?
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?
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?
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?
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?
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?
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?
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?
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
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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