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Infectious disease
New set 2023 UWORLD only
| Question | Answer |
|---|---|
| Which type of leukocytes control TB infection? | Macrophages and T-cells |
| What is the structural description of Yersinia pestis? | Small gram (-) bacillus/coccobacillus with bipolar staining |
| What pathogen is known to have a "closed safety pin" shape? | Yersinia pestis |
| What would be the gold standard test for diagnosing syphilis? | Direct visualization by dark-field microscopy or fluorescent antibody testing. |
| What medium is used for culturing Neisseria? | Thayer-Martin medium |
| What are the antibiotics integrated in Thayer-Martin medium? | Vancomycin, Colistin & TMP, and nystatin. |
| What is the CD4 count for HIV-PCP infection risk? | < 200 |
| What is the CD4 count for HIV-toxoplasmosis infection risk? | <100 |
| What is the CD4 count for HIV-MAC infection risk? | <50 |
| What is used as prophylaxis for HIV-opportunistic infections by PCP and Toxoplasmosis? | TMP-SMX |
| What is the prophylaxis for MAC opportunistic infection in HIV patients? | Azithromycin |
| Anaerobic gram (+) bacillus with acute-angle branching | Actinomyces |
| What is a common object that gets colonized by Actinomyces leading to PID? | Copper IUDs |
| What is the treatment for Actinomyces infection? | Penicillin |
| Mnemonic for Actinomyces and Nocardia treatments | SNAP Sulfonylureas --> Nocardia Actinomyces --> Penicillin |
| How is the chicken pox rash described? | Pruritic, vesicular lesions that appear in successive crops in various stages |
| Norovirus is the MCC | Viral gastroenteritis |
| What are some usual places/examples in which there would be norovirus-induced gastroenteritis? | Schools, cruise ships, nursing homes |
| What is the most outdated and oldest TB drug? | Streptomycin |
| What is the MOA of streptomycin? | Interference of the 16s rRNA unit of the bacterial 30S ribosomal subunit |
| How do Streptomycin and aminoglycosides acquire resistance? | Mutations to ribosomal proteins |
| What are the 2 most common NNRTIs? | Nevirapine and Efavirenz |
| What is distinctive between NRTIs and NNRTIs? | NNRTIs do not require activation via intracellular phosphorylation |
| What is the MOA of Protease inhibitors in HIV Tx? | Inhibit the cleavage of polypeptide precursor into mature viral protein |
| What are the associated adverse effects of Protease inhibitors? | Hyperglycemia, lipodystrophy, and drug-drug interaction due to CYP450 inhibition |
| Which fungal infection is at high risk of contraction in neutropenic patients? | Aspergillosis and Candida |
| How is Invasive Pulmonary Aspergillosis clinically presented? | Fever, chest pain, cough, dyspnea, and hemoptysis |
| What pathogen is most likely to cause infection in adults with CF? | Pseudomonas aeruginosa |
| How is P. aeruginosa or ready to cause infection especially in CF patients? | Forms thick biofilm to prevent its full elimination from the body |
| What is the description of the composition and structure of C. diphtheria? | Non-motile, unencapsulated, gram (+) rod |
| What is the mechanism of action of the diphtheria exotoxin? | Inhibits host cell protein synthesis by catalyzing ADP-ribosylation of host cell EF-2 |
| What are the histological findings of C. diphtheria sample? | It resembles "Chinese letters" or V- or Y-shaped chains |
| What are the cytoplasmic findings of C. diphtheria? | Metachromatic granules that stain with aniline (polar) dyes. |
| What is the MC outcome of chronic Hepatitis C infection? | Lifelong persistent infection |
| What is the major virulence factor Grup B streptococcus (S. agalactia)? | Polysaccharide capsule with abundant sialic acid |
| What pathogen infection is seen at increased risk in pts with PNH? | Neisseria |
| What are the side effects of PNH treatment with monoclonal antibody against C5? | Increase change for encapsulated (Neisseria) infections |
| What is the most important potential complication of Group A strep infection? | PSGN |
| What is more commonly seen with the development of PSGN, strep pharyngitis or strep impetigo? | Pharyngitis >>>> impetigo |
| What is the morphology of Candida? | Branching pseudohyphae with ballistoconidia |
| Branching pseudohyphae with ballistoconidia | Candida |
| What disseminated infection is suspected in pt with CVC and recipient of parenteral nutrition? | Candida |
| How is EBV associated with cancer? | Oncogenic virus that ↑ polyclonal B cell proliferation and HETEROPHILE antibody production |
| Which antibody is produced by EBV, especially in cancer association? | Heterophile antibody |
| What "test" is sensitive and highly sensitive for EBV infection? | Heterophile antibody |
| What is the absolute number that indicates neutropenia? | < 500/mm3 |
| To which kind of infections are neutropenic most dangerously exposed? | Gram negative organism that produces endotoxins |
| What are the markers positive for perinatal HBV infection in the neonate? | High viral load and HBeAg (+) |
| What is the MCC of False negatives in TB patients? | Anergy due to impaired cell-mediated immune response |
| MOA of mRNA vaccinees | Deliver mRNA molecules encoding foreign protein into the cytoplasm of host cells. mRNA then is translated by ribosomes and produces a robust adaptive immune response |
| What vitamin supplementation have been beneficial in Measles treatment? | Vitamin A |
| What can be treated with Piperacillin-Tazobactam? | Most gram (-) enteric rods (including P. aeruginosa) and Bacteroides fragilis |
| What gram negative organism is known as "blood loving"? | H. influenza |
| Which factors are needed by H. influenzae in order to grow in a culture? | Requires X (hematin) and V (NAD+) factors |
| Which bacteria can produce factors V and X, required by H. influenzae to grow? | S. aureus |
| What is CCR5? | Co-receptor that enables the HIV virus to enter the cells |
| What action is prevented by CCR5-antagonists? | Viral (HIV) entry into host cells |
| What is the associated adverse effect of Tenofovir? | Damage to the PCT of the kidney, leading to AKI and/or PCT impairment |
| HIV patients are present with glycosuria, proteinuria, and water retention. Which HIV-drug is suspected to cause these findings? | Tenofovir |
| What is the initial presentation/production of IgM and IgG in initial vaccination? | Early IgM response by plasma cells followed by a delayed-onset, longer-lasting IgG response due to T-cell dependent class switching |
| What is the secondary IgM and IgG presentation in secondary immunization? | Due to memory B cells formation, secondary responses are rapid and sustained IgG response with short-term, more muted IgM |
| What are the MC viral causes for inflammatory diarrhea? | Norovirus (#1), rotavirus (in unvaccinated children), and adenovirus |
| What are the MC bacterial causes for inflammatory diarrhea? | S. aureus, B. cereus, C. perfringens, ETEC, V. cholera, Listeria |
| Which parasites cause inflammatory diarrhea? | Giardia, Cryptosporidium, and Cyclospora |
| How is inflammatory diarrhea described? | Watery with no fecal RBCs or WBCs |
| What is the main virulence factor found in Typhoidal salmonella? | Capsular antigen (Vi) |
| What is the MOA of Salmonella's capsular antigen (Vi)? | Inhibition of neutrophil phagocytosis, neutrophil recruitment, and macrophage-mediated destruction |
| Are sterile or non-sterile gloves needed to attend a C. difficile infected patient? | Non-sterile gloves |
| Why is TB monotherapy highly contraindicated? | Fast emergence of mycobacterial antibiotic resistance from rapid, selective gene mutations |
| When is "OK" to use INH-monotherapy in TB patient? | Patient with (+) PPD and a (-) CXR |
| What bug in Latin America harbors protozoal illness leading to Chagas disease? | Triatome bug |
| What conditions/settings are often associated with the Triatome bug? | Adobe walls or thatched roofs |
| What helminth leads to Neurocysticercosis? | Ingestion of Taenia solium eggs |
| What is the MRI imaging of Neurocysticercosis? | More than 1 cystic brain lesion |
| What is a scolex? | Anterior portion of the worm with hooks and suckers |
| What is referred to by phenotyping mixing? | Co-infection of host cell by 2 viral strains |
| Which principle refers to coinfection of parent genome, but reversal to original genes in the progeny? | Phenotypic mixing |
| How does Reassortment differ from Phenotypic mixing? | Reassortment there is gene exchange, thus any changes that happen to 1st generation are also seen (passed down) to progeny |
| What are the 2 mechanisms that regulate the Lac operon? | 1. Negatively (-) by binding to the repressor protein to the operator locus and, 2. Posively (+) by CAMP-CAP bidinng upstream for the promoter regions |
| Which pathogens produce Shiga toxin? | ETEC and Shigella dysentery |
| How do Strep viridians cause endocarditis in pts with pre-existing valvular lesions? | S. viridians adhere to fibrin-platelet aggregates and establish infection |
Created by:
rakomi
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