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Micro,Genetic,Clinical

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resexuwe's version from 2017-08-07 15:46

Microbiology

Question Answer
BoneGap junctions
How do you know its an anaerobe?Gas, Bad odor
What makes an adequate sputum sample?<10 epithelial cells and >25 leukocytes per low power field
What bug causes Acute bacterial endocarditis?S.Aureus attacks healthy valves
What bug causes Subacute Bacterial endocarditis?S.Viridans attacks damaged valves
How do you diagnose Rheumatic fever?Need at least 2 SPECC -> Subcutaneous nodules, Polyarthritis, Erythema Marginatum(red margins), Chorea, Carditis MS>AS>TX MAT
What are the only Gram - Diplococci?Neisseria
What is the only Gram+ Diplococci? S. Pneumo
What bugs cause heart block infection?Dont TeLL Chaga Diptheria, Typhoid fever(salmonela typhii), Legionella, Lyme Disease, Chagas disease(T.cruzi)
What are the IgA protease bugs?S.pneumonia, H.influenza, Neisseria
What do the IgA protease bugs cause?Sinusitis, otitis media, pneumonia, bronchitis
What are the simple G- bugs?HE H.influenza, E.coli
What are the atypical (no cell wall) bacteria?CLUMsy Chlamydia, Legionella, Ureaplasma, Mycoplasma
What is the only G+ endotoxin?Listeria
What are the G- exotoxin?H.influenza, Bordatella petrussis
What are the spore forming G+ bacteria?Bacillus Anthracis, C.Botulinum
What bugs cause walking pneumonia?Come My Love for a walk 0-2mo-> Chlamydia pn, 10-30yr-> Mycoplasma pn, >40yr Legionella pn, AIDS/PREMIES-> Pneumo carinii
What causes Cryoglobulinemia?I AM HE -> Influenza, Adenovirus, Mycoplasma, Hep B & C, EBV
What are the Silver stainers?HaLV-C -> Comma -> H.Pylori, Listeria, Vibrio, Campylobact
What bacteria cause diarrhea <8hrs after introduction?CBS Clostridium, Bacillus cereus, S.aureus
What are the G- capsules?Some Killers Have Pretty Nice Capsules -> Salmonella, Klebsiella, H.influenza B, Pseudomonas, Neisseria, Citrobacter
What is the G+ capsule?S.penumo
What are the urease+ bugs?Urease PPUNCH Proteus, Pseudomonas, Ureoplasma, Nocardia, Cryptococcus, H.pylori
What bugs causes Monocytosis?STELS Syphilis, TB, EBV, Listeria, Salmonella
What are the big Mama Anaerobes?Bacteroides Fragilis, S.bovis, C.melanagosepticus
What bugs disrupt G proteins?Pertussis-> inhibits Gi, Cholera-> Stimulates Gs, W.coli-> stimulates Gs
What bacteria cause UTI's and prostatitis?E.coli, Proteus, Klebsiella, Pseudomonas
What bug is associated w/cat scratch?Bartonella Henselar
What bug is associated w/ cat saliva?Pasturella multiocida
What bug is associated w/cat pee?Toxoplasmosis
What bug is associated w/cat caca?Toxacara cati
What diseases are caused by the isodes tick?Lyme diseasebullseye lesion, Babesiosishemolytic anemia, Ehrlichyosispuncture near eye~
What bugs cause hospital abscesses?Day 1-3 -> S.Aureus- Lots of O2, Day4-7 -> S.viridians -> No enzymes, Day >7-> Anaerobes-PMNS
What kind of patients does Staph and Pseudomonas like to attack?DM, Cystic fibrosis pts, Burn pts, Neutropenic pts
What diseases have granulomas?TB, Sarcoidosis, Syphilis, Histiocytosis X, The ellas
What disease provide malaria protection?Sickle cell-> AA's, G-6PD-> Mediterraneans
What bug causes multiple liver abscesses?Entamoeba Histolytica
What bug causes multiple cerebral abscesses?Citrobacter
What has multiple lung aneurysms?Osler-Weber-Rendu
What bugs cause Loeffler syndrome?"NASSA" Necator americanus, Ancylstoma duodenale, Schistosomiasis, Strongyloides, Ascaris Lumbaricoides
What is the symptom of Loeffler syndrome?Pulmonary eosinophilia
What is PIE syndrome?Pulmonary Infiltrate w/ eosinophilia
What diseases have PIE syndrome?Aspergillus, Loefflers, chur-strauss
What disease does Coxsackie AHand foot mout disease
What disease does Coxackie B ?Endocarditis, DM type 1
What bugs cause Meningitis?0-2 mo-> baby BEL -> group B strep, E.coli, Listeria / >2mo-> S.Penumo, 10-21yr-> N.meningitidis
What are the CSF lab values for meningitis?PMNS-> Bacteria / T cell,MP-> Non bacterial / Normal glucose-> viral
What does the Hep B Core Ag tell you?Gone before pt has symptoms (2 mo)
What does the Core Ab tell you?Past infection
What does the surface Ag tell you?Current infection
What does the surface Ab tell you?Vaccination has occurred
What does the E Ag tell you?TRANSMISSIBILITY / INFECTIVITY
What does the E Ab tell you?Low transmissibility
What antibody shows current Hep A infection?IgM
What antibody shows past Hep A infection?IgG
What type of people does Hep E like to infect?Pregnant women, Asians
What is associated w/ Staph aureus?Cellulitis, dairy products, gold pigment, endocarditis, styes, hordeolum(on eyelid)
What is associated with S.pyogenes?LINES, ASO, hyalurinic acid capsule
What is associated w/ s.epidermis?Central lines, VP shunts, white pigment
What is associated w/ propionibacterium acnes?Acne, progesterone -> propionic acid
What is associated w/ Pasteurella Multicoda?Cat/dog saliva -> cellulitis w/ lymphadenitis
What is associated w/ S. saprophyticus?Female UTIs, honey mooners cystitis
What is associated w/ Hemophilus aegyptus?Swollen eyeball w/ pus
What is associated w/ Francisella tularensis?Ulcers at rabbit or deer tick bite site tx-streptomycin
What is associated w/ Pseudomonas aeruginosa?Otitis externa, icthyma granulosum, loves rubber, whirlpool follculitis, ADP ribosylates EF-2
What is associated w/ S. penumoniae?Otitis media, red bulging tympanic membrane
What is associated w/ Fusobacterium?Painful mouth ulcers, gum pus, vincents angina
What is associated w/ S.mutans?dental cavities
What is associated w/ S.viridians?Subacute bacterial endocarditis, green pigment
What is associated w/ S.salivarius?Cold agglutinin test
What is associated w/ S.pyogenes?Rheumatic fever, strain 12 -> PSGN
What is associated w/ Group C strep?Pharyngitis
What is associated w/ C. diptheria?Chinese letter, gray pseudo-membrane, suffocation, ADP ribosylates EF2, heart block, Elek test
What is associated w/ S.pneumonia?G+ diplocococci, rusty sputum, IgA protease, vaccine covers 23 strains
What is associated w/ H.influenza?G- pleomorphic rod, Factors V/X, 5C-Ribose capsule, B-type -> meningitis, epiglotitis, sepsis
What is associated w/ N.catarrhalis?Loves mucus -> attacks respiratory tract
What is associated w/ Chlamydia psittaci?Parakeets, parrots
What is associated w/ Chlamydia Pneumonia?Staccato couging, elementary and reticulaTe bodies
What is associated w/ Mycoplasma pneumonia?Bullous myringitis, ground glass CXR, P1 protein, erythema multiforme
What is associated w/ Legionella pneumonia?AC ducts, silver stains lung, CYEA, Pontiac fever, legionnaires pneumonia
What is associated w/ Pneumocystis carinii pneumonia?AIDS/Premies, rusty sputum, silver stains lung, Increase LDH TX STEROIDS
What is associated w/ Clostridium botulinum?Canned food, honey, inhibits ACh release, resp failure, stool toxin Tx penicillin
What is associated w/ Clostridium tetani?Rusty nail wounds, inhibits GLY release, resp failure, risus sardonicus, tennis racquest shape
What is associated w/ Bordetella petrussis?Whooping cough, ADP ribosylates Gi
What is associated w/ Bacillus anthracis?Black eschar, woolsorters lung disease, D-glu, boxcar like spore Tx ciprofloxacin
What is associated w/ H.Pylori?Duodenal ulcers
What is associated w/ Salmonella?Raw chicken & eggs, turtles , rose typhoids pots, H2S, sickle cell osteomyelitis
What is associated w/ Campylobacter jejuni?Raw chicken & eggs, very bloody diarrhea, inactivated by gastric juice, Guillane-Barre, seagull shape
What is associated w/ Clostridium perfringes?Holiday ham and turkey, DM gas gangrene, soil/feces
What is associated w/ Bacillus cereus?Fried rice, pre-formed toxin
What is associated w/ Listeria monocytogenes?Raw cabage, hotdogs, spoiled milk, migrant workers-> heart block, meningitis, abortions
What is associated w/ Vibrio parahaemolyticus?Raw fish
What is associated w/ Actinomyces?Face fistulas, sulfur granules
What is associated w/ Vibrio vulnificus?Raw oysters, cellulitis in swimmers cuts
What is associated w/ Shigella?Day care outbreaks -> seizures, destroys 60S ribsome, infects M cells
What is associated w/ Vibrios cholera?Rice water diarrhea, ADP ribosylates Gs
What is associated w/ Clostridium Difficile?Explosive Diarrhea -> Pseudomembranous colitis
What is associated w/ Yersinia entercolitica?Presents like appendicitis + Reiters, bloody diarrhea
What is associated w/ S.bovis?Colon cancer
What is associated w/ Clostridium melangosepticus?Colon cancer, Blackpigment
What is associated w/ ETEC?Travlers -> rice water diarrhea
What is associated w/ EHEC?Hemorrhagic -> renal failure
What is associated w/ EIEC?Inflammatory-> loose stool
What is associated w/ EPEC?Pathogenic -> newborn diarrhea
What is associated w/ E,coli?Raw hamburger, ADP ribosylates Gs verotoxin, HUS
What is associated w/ Proteus Mirabilis?Staghorn calculus, UTI Tx norfloxacin
What is associated w/ Klebsiella pneumonia?Alcoholics, currant jelly sputum, UTI, lung fissures, homeless people
What is associated w/ S. saprophyticus?Young & college girls UTI's
What is associated w/ Entercoccous?UTI, infective endocarditis post GI/GU procedure, nitrate negative UTI
What is associated w/ N.meningitides?DIC, pilli, releases tocin in log phase
What is associated w/ Brucella?Farmers/vets, spiking fever 5x a day, animal placentas
What is associated w/ R.rickettsii? Ticks -> rocky mountain spotted fever
What is associated w/ R.akari?Mites -> fleshy papules
What is associated w/ R.prowazekii?Lice, starts on body(rash)
What is associated w/ R.typhi?Fleas, starts in armpit (Rash)
What is associated w/ R.tsutsugamushi?Mites -> scrub typhus
What is associated w/ Coxiella burnetti?Dusty barn -> q fever
What is associated w/ Yersinia pesitis?Rates, fleas -> Bubonic plague
What is associated w/ Bartonella Henselae?Cat scratch -> single painful lymph node, silver stains
What is associated w/ Bacteroides fragilis?Post op bowel abscess, grows in blood clots
What is associated w/ Chlamydia trachmoatis?Neonatal inturned eyelashes/cornea ulcers
What is associated w/ Neisseria gonorrhea?Pili, urethritis, tenovitis, septic arthritis
Low Cd4, with HIV viral load and red lesionsKaposi sarcoma vascular proliferate without bacilli OR Bartonella Angiamatosis vascular proliferate bacilli
Specific for G+ bugs isLipoteichoic acid
Specific for G- bugs isOuter membrane
memorize
Giardia VS Shistosoma Heamtobium LOOKS THE SAME: Diarrhea (Metrondiazole) VS Vomiting blood (Praziquantel)

Clinical Skills

Question Answer
What does pain radiating to the jaw indicate?MI or pericarditis
What does pain radiating to the left shoulder indicate?MI or spleen rupture
What does pain radiating to the scapula indicate?Gall bladder problems
What does pain radiating to the trapezius indicate?Pericarditis
What does pain radiating to the groin indicate?Ureter stones or osteoarthritis of Hip
What is Blumbergs sign?Rebound tenderness -> peritonitis
What is Brudzinskis sign?Bend neck, see knee flexion-> meningitis
What is Chadwicks sign?Purple vagina -> pregnancy
What is Chandelier sign?Cervical motion tenderness -> PID
What is Chovsteks sign?Tap facial nerve -> Muscle spasm
What is Courvoisiers sign?Palpable gall bladder -> cancer (pancreatic)
What is Cozens sign?Dorsiflex wrist causes pain -> lateral epicondylitis -> tennis elbow
What Cullens sign?Bleeding around umblicus -> hemorrhagic pancreatitis
What is Gottrans sign?Scaly patches on MCP, PIP joints-> dermatomyositis
What is Hammans sign?Crunching sound on palpatation -> Subcutaneous emphysema
What Homans sign?Pain calf w/ dorsiflexion -> dvt
What is Kehrs sign?Left shoulder pain ->spleen rupture
What is Kernigs sign?Flexing kneww causes resistance or pain -? meningitis
What is Kussmahls sign?Big neck veins w/ inspiration -> pericardial tamponade
What is Levine sign?Hold clenched fist over sternum -> angina
What is Murphys sign?Pressed gall bladder causes pt to stop breathing -> cholecystitis
What is Obturator sign?Inward rotation of hip causes pain -> appendicitis
What Phalens test?Flexing wrists for 60s causes paresthesia -> carpal tunnel
What is Psoas sign?Extending hip causes pain -> appendicitis
What is Rovsings sign?Palpating LLQ causes RLQ pain -> appendicitis
What is Tinels test?Percussing median nerve causes 1st & 3rd finger pain ->carpal tunnel
What is Trousseaus sign?BP check causes carpal spasm
What is Turners sign?Bleeding into flank -> Hemorrhagic pancreatitis
PCOS labs INCREASED LH, Testosterone, Insulin
memorize

BONE

 

Question Answer
What is Slipped Capital Femoral Epiphysis?Obese boys w/ dull achy pain in the hip and a limp
What is Legg-Calves-Perthes?Limp (femur head avascular necrosis)
What is Osgood-Schlatter?Knee pain (tibial tubercle avascular necrosis)
What is Septic Arthritis?Joint pain (Staph. Aureus) with fever
What is Ankylosis Spondylitis?Ligament ossification → vertebral body fusion, Decrease lumbar curve, Stiffer in morning, Kyphosis, Uveitis, HLA-B27
What is Cauda Equina Syndrome?“Saddle Anesthesia” → can't feel butt, thighs, perineum
Where does bone cancer metastasis occur from?Breast, Prostate, Lung, Kidney
What is Costochondritis?Painful swelling of chest joint bone attachments, worse w/ deep breath
What is Disk Herniation?Straight leg raise → shooting pain
What is Lumbar Stenosis?MRI “Hourglass”, Low back pain
What is Ochronosis = Alkaptonuria?Kids w/ OA, Black urine, homogenitisic acid oxidase deficiency
What is Osteitis Fibrosis Cystica?Inflammation of bone w/ holes due to high PTN
What is Osteogenesis Imperfecta?Blue Sclera, multiple broken bones
What is Osteomalacia = Rickets?(1) Soft bones (waddling gait), (2) Craniotabes (soft skull), (3) Rachitic rosary (costochondral thickening), (4) Harrison's groove, (5) Pigeon breast (sternum protrusion)
What is Osteomyelitis?Infected bones
What is Osteonecrosis = Legg-Calve Perthes?Wedge-shaped necrosis of femur head
What is Osteopenia?Lost bone mass
What is Osteopetrosis?Decrease Osteoclast activity → marble bones (obliterate own bone marrow)
What is Osteoporosis?Loss of bone matrix (not calcification) → compression fractures
What is Osteosclerosis?Thick bones form scarring
What is Paget's disease?(1) “My hat doesn't fit”, (2) Paramyxo Virus, (3) increase osteoclasts/blasts, (4) Fluffy bone, (5) Osteosarcoma, (6) Increase CO heart failure, (7), Deafness, (8) Increase alkaline phosphatase alone
Soft tissue swellingOsteomyelitis S.Aureus -> G+ cocci
memorize