microbioOneliners.csv

1. Cause of nausea; vomiting (onset < 6 hr) after eating cold cuts; or potato salad; or mayonnaise; or custards implicated. TOW?

2. Staphylococcal food poisoning is mediated by what?

3. Tx of staphylococcal food poisoning

4. Cause of nausea and vomiting; +/- diarrhea (onset < 6 hr) after eating reheated rice. TOW?

5. What makes bacterial spores resistant to heat

6. Cause of nausea; vomiting; watery diarrhea w/ rapid onset (6-12 hr) after eating reheated meat or gravy implicated. TOW?

7. Persistent dyspepsia in those not receiving NSAIDs is tested for what?

8. Increased risk of gastric adenocarcinoma and MALT lymphoma.

9. Indications to treat H. pylori-associated PUD

10. Standard first line treatment for PUD due to H. pylori is what?

11. Hx of acute onset of diarrhea with rice-water stools; vomiting; dehydration in a pt during travel to South America. TOW?

12. Sx and Sn of cholera are due to what?

13. Cholera pathogen is isolated from stool by culture on thiosulfate-citarate-buffered sucrose (TCBS) agar. Why sucrose (and not glucose)?

14. The comma-shaped cholera organisms are microscopically similar to

15. Tx of cholera involves

16. Secretory diarrhea; fever and vomiting during travel are caused by

17. Secretory diarrhea w/ fatty; foul-smelling stools in campers; hikers; also day-care outbreaks are caused by

18. Following ingestion of 15-25 cysts and excystation; trophozoites with flat ventral surface adhere at brush border of enterocytes and contribute to malabsorption. TOW?

19. Dx of giardiasis is confirmed by

20. Specific Rx of giardiasis involves

21. Protracted; secretory diarrhea w/ large fluid loss in AIDS is caused by (clue: acid-fast organisms)

22. Frank bloody diarrhea; after eating undercooked meats or drinking fruits drinks; is caused by prepared foods or water; contaminated w/

23. Mechanism of blood loss in hemorrhagic enterocolitis involves

24. Complication of hemorrhagic enterocolitis in children

25. Profuse diarrhea; fever; vomiting; and dehydration in infants is caused by

26. Mechanism of rotaviral diarrhea involves

27. Infantile watery diarrhea and fever are caused by

28. Outbreak of nausea; vomiting; fever in adults is caused by

29. Cause of nausea/vomiting; abdominal cramps; diarrhea +/- bloody 8-48h after eating eggs or poultry or peanut butter?

30. Primary gastroenteritis progressing to chronic carrier state of Salmonella in bile ducts is common due to

31. Abx used to treat septic phase salmonella gastroenteritis is

32. Cause of fevers (>103�) abdominal pain; headaches; little diarrhea; macular rose-colored spots (rash). PE: bradycardia; hepatosplenomegaly (+/-) in a pt with hx of travel (to tropics)?

33. Cause of occult-bloody diarrhea; abdominal cramping and fever; 2d after ingestion of salad from meat-contaminated cutting-boards?

34. Abx for campylobacter enteritis with prolonged; high fevers in pregnancy; and HIV is

35. Cause of dysentery-like illness with fever + abdominal cramps; tenesmus + blood & mucus in children?

36. Tx of dysentery due to Shigella flexneri or S. dysenteriae in elderly involves

37. Cause of dysentery-like illness in the northern region after eating cheese; pseudoappendicitis or pseudo-crohn syndrome?

38. Cause of dysentery-like illness in a patient on broad-spectrum abx?

39. Diarrhea due to Clostridium difficile is mediated by

40. Clostridium difficile diarrhea is confirmed by

41. Tx of Clostridium difficile diarrhea involves

42. Health-care associated spread of Clostridium difficile diarrhea and protracted outbreak is due to

43. Cause of dysentery involving abdominal pain; tenesmus; stools with mucus + blood in a patient; who recently traveled to tropics; CBC: eosinophilia?

44. Positive stool test using microscopy for trophozoites w/ intracellular RBCs confirms

45. Rx of amebic dysentery involves

46. Abscesses in liver or peritonitis in travelers w/ or w/o hx of amebic dysentery is confirmed by

47. Chronic abdominal pain; diarrhea; follows intestinal obstruction; cholangitis; liver abscess; in children in Southern States. Lab: O & P (+) for eggs (oval with a thick coarse shell). TOW?

48. Ova & Parasite test using microscopy for oval eggs (with a thick coarse shell) in stool confirms what?

49. A child has stomach ache; distended abdomen; poor appetite. �Pearl-colored earthworm�-like organisms in the stool. Major immune response against this infection?

50. DOC of ascariasis is

51. Vomiting; cramping; diarrhea; epigastric pain; weight loss in an immigrant from developing country is caused by

52. DOC of strongyloidosis is

53. Pt w/ high dose steroids or HIV/AIDS develops pulmonary infiltrates (+ eosinophilia) and/or gram negative sepsis. TOW?

54. Weakness; fatigue; lightheadedness; dyspnea; pruritis; pallor; iron-deficiency anemia. CBC: elevated eosinophils. TOW?

55. Fever; periorbital edema; subconjunctival hemorrhages; muscle weakness; rash; after ingestion of undercooked meat (e.g.; pigs; wild game). Lab: ? CPK; LDH & eosinophilia. TOW?

56. Vague abdominal pain; bloating; altered appetite after ingestion of sushi. CBC: megaloblastic anemia (B12 deficiency); eosinophilia with mild leukocytosis. TOW?

57. Dx of tape worm infection is confirmed by

58. Tx of tape worm infection involves

59. Fever; lymphadenopathy; hepatosplenomegaly in an immigrant from Africa or Orient; pt recalls an itch within a day of fresh water exposure. RUQ ultrasound (+); CBC: eosinophilia. TOW?

60. Stool in chronic stage of schistosomiasis yields

61. Rx of chronic stage of schistosomiasis involves

62. Patient with acute jaundice is HAV IgM (+). What should the family contact receive for prophylaxis?

63. Patient with jaundice for < 1 week has HBsAg (+); Anti-HBc IgM (+). TOW?

64. Multiple sex partners; IDU; infants born to infected mothers are risk groups for which hepatitis virus

65. This is an enveloped; double stranded DNA virus w/a ss-break; transmitted by infective body fluids. TOW?

66. This asymptomatic man has hep serology: HBsAg (-); Anti-HBs (+); Anti-HBc IgG (+); Anti-HBc IgM (-). TOW?

67. This man has jaundice and HBsAg (+) > 6 months; Anti-HBs (-); HBeAg (+); Anti-HBc IgG (+); HBV DNA > 20;000 IU/ml. TOW?

68. A pt w/ chronic active hepatitis with evidence of necroinflammation should receive

69. This man has no jaundice; but HBsAg (+) >6 months; Anti-HBs (-); Anti-HBc IgG (+); HBeAg (-); persistently normal ALT. TOW?

70. This man; at the time of annual physical exam; reveals Anti-HBs (+) and other markers are (-). TOW?

71. Virologic confirmation of chronic jaundice in a pt w/ IDU or hemodialysis; vasculitis and glomerulonephritis is based on

72. Heterogeneous; immune-evasive quasispecies (mutants)generated during replication of hepatitis C virus in blood causes

73. Fulminant hepatitis in a patient; who has multiple sexual partners and is HBsAg (+); HBcIgM (-); can be fatal due to what?

74. Acute onset of jaundice; nausea; right-upper quadrant pain; hepatomegaly in pregnant women in India. TOW?

75. Fever; arthralgia; carditis; polyarthritis; chorea; erythema marginatum; elevated WBCs or ESR/CRP. Clinical Dx is confirmed by

76. Type II hypersensitivity due to molecular mimicry is the mechanism of a immunological sequel of streptococcal infection; called

77. Tx of ARF includes

78. A man with IDU has flu-like symptoms;1-3 minor peripheral signs: (conjunctival hemorrhage; Janeway lesions; Osler nodes; Roth spots). vegetation in tricuspid valve) Blood Cx (BC) should yield

79. A pt w/ hx of extraction of impacted tooth 3 weeks ago now has subacute (native; mitral-valve) endocardits. BC should yield

80. A pt w/ hx of St. Jude bypass 2 months ago has now subacute bacterial endocarditis. BC should yield

81. A pt with AIDS and recent hx of UTI has not subacute (native-mitral valve) endocarditis. BC should yield

82. Tx of acute endocarditis in patient with IDU due to S. aureus (MSSA).

83. Tx of acute endocarditis in patient with IDU due to S. aureus (MRSA).

84. Tx of subacute (native; mitral-valve) endocarditits due to viridans streptococci.

85. Tx of subacute (prosthetic-valve) endocarditis due to Staphylococcus epidermidis

86. Tx of subacute (native mitral-valve) endocardits due to Enterococcus faecalis (or faecium)

87. Patient with enterococcal bacteremia fails to respond to vancomycin. MOR?

88. Hx of catheter-related endocarditis; involving prosthetic & native valves. WBC >9;000. BC (+) for budding yeast. Pt does not respond to AmphoB or fluconazole. Tx now?

89. Patient with colon cancer has bacteremia due to what?

90. Hx of febrile; malaise; arthralgia; dyspnea; edema; palpitations. ST/T wave change; heart block; dysrhythmias. Imaging studies: chest XR w/ cardiomegaly. TOW?

91. Rhinorrhea; red throat; and nasal pus are caused by

92. Rhinoviruses and enteroviruses belong to picornavirus family; but the rhinoviruses differ from enteroviruses on

93. Rhinovirus receptor in the nasal passages and upper tracheobronchial tree is

94. Rhinovirus; influenza; parainfluenza; coronavirus; RSV; metapneumovirus; and adenovirus all cause

95. Sinusitis; otitis; laryngitis; exacerbations of bronchitis and asthma are mostly secondary to

96. In HEENT; Streptococcus pneumoniae; non-typable Haemophilus influenzae; Moraxella catarrhalis all cause

97. AOM and sinusitis are empirically treated with amoxicillin + clavulanate. Why use clavulanate?

98. Cause of pharyngeal pain; dysphagia; fever; red throat + purulent exudate that responds to penicillin

99. GABHS is differentiated from GBBHS by what?

100. Common mode of acquisition of URI due to Streptococcus pyogenes?

101. Major virulence factor (with anti-phagocytic function) of

102. Damage in posterior pharynx and tonsils due to Streptococcus pyogenes is associated with what host reaction?

103. DOC of acute bacterial pharyngitis in a pt w/ Pen allergy

104. Pyogenic complication of streptococcal pharyngitis

105. Toxigenic complication of streptococcal pharyngitis

106. Immunological complication of streptococcal pharyngitis

107. Cause of fever; red throat + purulent exudate -pseudomembrane with lymphadenopathy; in a pt from Russia

108. Gram/special stain of Corynebacterium diphtheriae should reveal

109. Virulence genotype of Corynebacterium diphtheriae is acquired by

110. Isolate on tellurite agar culture of throat swab for a cause of diphtheria is confirmed by

111. Mechanism of action of exotoxin of Corynebacterium diphtheriae

112. Damage to pharynx and cardiac myosites due to Corynebacterium diphtheriae is mediated by

113. Virologic Dx of URI symptoms; fever; red throat + purulent exudate; hepato-splenomegaly; lymphadenopathy; in a teenager; is confirmed by

114. Host cells preferentially infected by EBV are

115. EBV is biologically similar to what class of viruses?

116. Host immune system controls the EBV infection; mediated by

117. Rash occurs following which antibiotic(s) to treat infectious mononucleosis?

118. Burkitt's lymphoma in some African population is a B-cell tumor due to oncogenesis by

119. Nasopharyngeal carcinoma; a B-cell tumor that is common in the Oriental population that consumes preserved fish; is due to oncogenesis by

120. Heterophile-negative infectious mononucleosis syndrome is due to ?

121. Gram-positive bacteria that cause acute otitis media (AOM)

122. Gram-negative diplococci bacteria that cause AOM

123. Gram-negative coccobacilli bacteria that cause AOM

124. > 7 days of nasal obstruction; rhinorrhea; purulent nasal drainage + frontal pain/tenderness is treated with

125. DOC for acute mastoiditis in a young child is amoxicillin & clavulanate; why?

126. Cause of �seal-like barking� cough + episodic aphonia w/ symptoms of URI in a child

127. Gram-stain-nonreactive organism that causes redness; purulent discharge at lid margin/eye corners; in a newborn

128. Most common cause of redness; tenderess; hyperpurulent d/c; eye stuck shut in AM; lid edema. Gram stain (+)

129. Cause of fever; conjunctivitis; pharyngitis with rhinitis; cervical adenitis in a child.

130. Cause of burning; gritty feeling in eyes; diffuse conjunctival injection & profuse tearing + preauricular LN.

131. Cause of foreign body sensation; lacrimation; photophobia; conjunctival hyperemia; and ulceration

132. Cause of severe pain and skin lesions in dermatomal pattern involving the ophthalmic division of the trigeminal nerve.

133. Cause of painful; swollen; red eyes; with conjunctival hemorrhaging and excessive tearing in an outbreak

134. Cause of chorioretinitis in AIDS; but CMV antigen (-)

135. Cause of painful keratitis; chronic corneal ulcers in contact lens users; unresponsive to abx.

"136. In an infant w/ ?immunization; 2 wks of paroxysmal coughs; inspiratory ""whoop"" + post-tussive emesis. TOW?"

137. Pertussis toxin inhibits chemotaxis via downregulation of C3a/C5a receptor; resulting in?

138. Three major virulence factors of �whooping cough� pathogen?

139. Cause of fever + drooling; stridor; dyspnea in a child w/ ?immunization (pt appears septic)

140. Major virulence factor of Haemophilus influenzae associated with pneumonia and meningitis

141. Since; absent spleen places host at increased risk for invasive H. influenzae infection; pre-exposure prophylaxis prior to elective splenectomy is ?

142. Acute exacerbation of chronic bronchitis (AECB) is caused by an organism that needs NAD + hematin for growth; ?-lactamase (+). DOC?

143. Most common cause of lower-respiratory infections in neonates (babies < 4 wk)?

144. Complicated illness in a newborn of a GBS-colonized mother is

145. A mother colonized (recto-vaginally) w/ GBS is at risk for preterm baby or premature membrane rupture. She should receive

146. An elderly comes up with an abrupt-onset fever; myalgia; headache; malaise; dry cough; sore throat and rhinitis; in winter. Illness could have been prevented w/ ?

147. Annual influenza vaccine protects at-risk subpopulation w/ 60% immune protection; and is composed of what 3 viruses?

148. Secondary spread of influenza occurs in a crowded setting (within 6 feet of infected person) via

149. Annual vaccine to prevent influenza is needed due to antigenic drift. This occurs due to what genetic mechanism?

150. Occasionally serious pandemic of influenza occurs due to antigenic shift. This occurs due to what genetic mechanism?

151. Treat persons with influenza <48 hours with

152. Bacterial superinfection; causing pneumonia; after influenza occurs in elderly (in LTCF) due to what?

153. A seriously ill young adult w/ necrotizing pneumonia; poorly responding to vancomycin; should get

154. Cause of febrile illness + bronchiolitis in an infant; BAL viral culture (+).

155. Major cause of seasonal pneumonia outbreaks in the pediatric units via contact spread (by HCWs) is

156. Mechanism of asthmatic Sx + Sn w/ pathology in bronchioles in high-risk infants due to RSV is

157. Inhaled drug used in the sickest infants with bronchiolitis (yet questionable efficacy) is

158. Insidious onset of fever; dry cough; malaise and sore throat in young adults. CBC: anemia; CXR: diffuse infiltrates. TOW?

159. Dx of �walking pneumonia� in older children and young adults; while waiting for serology; is supported by

160. ?-lactam abx is ineffective for Tx of mycoplasma pneumonia because

161. A male child with mycoplasma pneumonia now has systemic rash; covering 10% of his body. TOW?

162. Cause of upper respiratory Sx; slow onset of cough (laryngitis) >2wks + CXR: patchy infiltrate; viral serology (+). TOW?

163. Hx of rapid onset of high fever; cough; & sputum; dyspnea; tachypnea in an elderly; CXR: lobar infiltrate; CBC: pronounced neutrophilic leukocytosis with left shift. TOW?

164. Gram-positive diplococci from sputum from a patient with lobar pneumonia yield ?-hemolytic colonies and are confirmed by what test?

165. ?-hemolytic colonies of Streptococcus pneumoniae is differentiated from viridans streptococci definitively confirmed by what test?

166. Population w/ ?incidence of pneumococcal pneumonia

167. ? incidence of colonization of what organism is seen in very young and elderly; crowding; following viral URI (? PAF receptors); fall/winter season?

168. Streptococcus pneumoniae is transmitted person-to-person via what?

169. Nasopharyngeal mucosal colonization is facilitated by

170. Streptococcus pneumoniae reaches lungs after nasopharyngeal colonization via

171. Major virulence factor; facilitating invasion and dissemination of Streptococcus pneumoniae bacteria

172. Pneumococcal cell wall peptidoglycans; teichoic acid elicit

173. ? lung cell injury; bacterial growth; and bacteremia are caused by

174. Multiple myeloma; C3 deficiency; agammaglobulinemia; asplenia - Hg SS; chronic diseases - COPD; cancer; diabetes; alcoholism; smokers are risk factors for mortality due to

175. Risk factor for poor prognosis of pneumococcal pneumonia

176. Emipiric DOC of community-acquired pneumonia (CAP) in individuals w/ risk or comorbidity is

177. Pneumonia due to highly penicillin-resistant Streptococcus pneumoniae (Pen MIC >8) should receive

178. Mechanism of penicillin resistance in Streptococcus pneumoniae is

179. Pt w/ agammaglobulinemia or asplenia or sick-cell anemia or ?C3 should be vaccinated with

180. Hx: a patient w/ serious CAD now on a ventilator; acquires bronchopneumonia >72 hrs after hospitalization. TOW?

181. Cause of necrotizing pneumonia >72 hrs after hospitalization of complicated viral illness

182. Hx of a patient w/ seizure illness has fever; cough evolving over 2-4 wks; CXR infiltrate (+). Gram stain: polymicrobic. TOW?

183. Empiric DOC of necrotizing pneumonia in a patient with seizure illness

184. Pneumonia in homeless/alcoholics; Gram-positive diplococci in sputum Gram smear. TOW?

185. Pneumonia in homeless/alcoholics; Gram-negative rods in sputum smear. TOW?

186. Cause of pulmonary embolism in a pt with IVDU

187. Common cause of pneumonia in pts with CF

188. Sputum of a patient with hospital-acquired pneumonia yields a Gram-negative rod that is oxidase (+)/ pyocyanin(+). TOW?

189. Common cause of external otitis due to hot tub use is

190. A patient with diabetes has osteomyelitis after penetrating foot injury. TOW?

191. The most widely used anti-pseudomonal penicillin

192. The most widely used anti-pseudomonal aminoglycoside

193. This pt >50 years; smoking hx; CMI? has pneumonia; diarrhea; renal failure. Urine antigen (+) for pathogen. Pt responds to azithromycin. TOW?

194. Penicillin is ineffective against Legionnaire�s dz because

195. Individuals with defective CMI response has poor prognosis of Legionnaire�s dz because

196. Asymptomatic patient with PPD (+)

197. Cough > 2 wks; fever; night sweats; weight loss; hemoptysis; SOB; CXR: upper lobe infiltrate. TOW?

198. Oral drug regimen of choice for treatment of active TB (aka: 1st line drugs) is

199. Pyridoxine is added to 4-drug therapy for TB because

200. Pt w/ TB fails to respond to 4-drug regimen w/ INH+RIF resistance because

201. Pt w/ MDR-TB fails to respond to INH +RIF+FQ+an injectable drug (amikacin; capreomycin; or kanamycin) because

202. Cause of TB-like Dz that does not respond to 1o TB Tx regimen; in a pt. w/ AIDS

203. Cause of chronic pneumonia in a patient with cancer; receiving cytotoxic chemotherapy; lung-CT: halo/crescent sign (+)?

204. Hx of chronic pneumonia w/ lung bpsy histopathology (+) for hyphae 2-4?m wide; septate; acute- angle branching. TOW?

205. Hx of TB-like LRI in a pt with outdoor activity; bronchoscopy: Giemsa (+) for 2-5 ?m yeasts. TOW?

206. Pt with AIDS has blood culture (+) for histoplasmosis. DOC has effects on

207. TB-like Dz w/ ulcerative skin lesions. lung bpsy histopathology (+) for large yeast w/ broad-based bud. DOC?

208. Hx of acute onset of cough; fever; infiltrate in a black male with CMI?; histopathology of lung (+) for a large sac of endospores. DOC?

209. Pt w/ aspiration pneumonia with cervico-facial lesion should respond to

210. Granular specimen from draining fistulae from a pt with LRI on anaerobic culture should yield

211. Pt with AIDS or organ transplant has indolent pneumonia; w/ or w/o CNS abscess or granuloma. TOW?

212. Organism w/ characterization of Gram-positive branching; beaded; filamentous rod; weakly acid fast is

213. Hx of fever; cough; progressing to pulmonary hemorrhage in a pt who works at a wool-sorting factory; CXR: mediastinitis. TOW?

214. Hx of non-productive cough; fever and dyspnea evolving over 2-4 wks. CXR (+): bilateral interstitial infiltrates; hypoxemia; ?LDH; CD4 count <200/mm3 in a man who has sex with man (MSM). TOW?

215. DOC of pneumocystis pneumonia (PCP)

216. Pt has urinary urgency; frequency; dysuria; lab: pyuria (+) or nitrite (+). TOW?

217. Significant UTI is confirmed by semiquantitative MSU culture based on the threshold of

218. Mode of acquisition of uropathogen is

219. Microbial (structure) factor favoring bacterial persistence /colonization and UTI is

220. Factor favoring bacterial persistence/colonization and UTI despite high osmolarity and urea concentrations and low pH is

221. Host factor favoring bacterial persistence/colonization and UTI is

222. Host factor favoring bacterial persistence/colonization and UTI despite frequent voiding and high urinary flow is

223. Pyogenic inflammation in complicated UTI due to Gram-negative bacteria is due to

224. Empiric DOC to treat community-acquired UTI in adults is

225. These drugs inhibit DNA topoisomerases (DNA gyrase and topoisomerase IV) by binding to DNA-enzyme complexes; thereby interfering with bacterial DNA replication. What?

226. Avoid fluoroquinolones for the empiric Tx of UTI in pregnant women; alternative is

227. Gram-positive bacteria that cause uncomplicated UTI in sexually active; young women are

228. Differentiation of Staphylococcus saprophyticus from S. epidermidis (both coagulase negative) is based on

229. In elderly or pt with risks of urinary stasis; fever; chills; flank pain; and CVA tenderness; Lab: pyuria; casts; nitrite+. TOW?

230. Pt hospitalized > 72 h for comorbidity has urinary frequency; dysuria and foul-smelling urine; w/ flank pain; fever and chills; in the presence of a urinary catheter: Clue 1: GNR; fermenter; encapsulated; intrinsic ampicillin resistance Clue2: GNR; slow fermenter; red pigment; intrinsic drug resistance Clue 3: GNR; swarming growth [very motile]; slow fermenter; intrinsic drug resistance Clue 4: GNR; non fermenter; oxidase+; blue pigment; intrinsic drug resistance Clue 5: GPC in chains; catalase-neg; grows in high salt; penicillin resistance

231. If a patient with complicated UTI is severely ill or not improving with therapy; do what rapid test next?

232. For a patient with complicated UTI; once culture and sensitivity available; switch to what?

233. Genital chancre begins as a papule; ulcerates to form a single; painless; clean-based ulcer. TOW?

234. Cause of genital chancre; begining as a papule; ulcerating to form a single; painless; clean-based ulcer.

"235. Hx of pen-allergy in a non-pregnant woman; who has fever; ""copper penny"" macular lesions on the palms and/or soles; RPR(+). DOC?"

236. Hx of pen-allergy in a pregnant woman; who is RPR(+) and has tabes dorsalis (10-20yrs); or iritis; uveitis; iridocyclitis; Argyll-Robertson pupils. Manage how?

237. Hx of painful clustered vesicles with an erythematous base; urinary retention in a promiscuous woman. TOW?

238. Giemsa stain of fluid from a herpetic lesion should reveal

239. Patient with genital herpes does not respond to acyclovir because pt is infected with

240. A pregnant woman with 1o symptomatic HSV-2 infection is at risk of her baby developing

241. Cause of painful genital ulcers (no induration); purulent; dirty grey base; painful inguinal adenitis (bubos); in a man with multiple sexual partners

242. Fastidious organism found within the granulocytic infiltrate of the penile ulcer and co-localized with neutrophils and fibrin; in a pt w/ chancroid is

243. All sex partners of pt with chancroid; regardless of symptoms; should be examined and treated with

244. Most common cause of mucopurulent endocervical exudate (Gram stain non revealing) in a sexually promiscuous woman

245. Dx of mucopurulent urethral discharge; dysuria; penile pruritis is based on

246. DOC of most frequent cause of nongonococcal urethritis

247. Cause of rare genital ulcers; inguinal lymphadenopathy [cytology(-) for multi-nucleated giant cells; RPR (-)] in men is

248. Hx of systemic Sx/Sn w/ cervical motion tenderness in a woman with turbo-ovarian abscess. TOW?

249. Cause of mucopurulent urethritis; dysuria; penile pruritis

250. Hx of frequent gonorrhea and disseminated gonococcal infection in a woman is due to deficiency in serum factors?

251. Immune evasion of Neisseria gonorrhoeae in frequent mucosal infection is due to

252. Auxotrophic strains of N. gonorrhoeae (needing arginine for growth) and also with serum (complements) resistance are likely to cause

253. Most frequent complication of gonococcal (GC) infection in men

"254. Cause of ""bull headed clap""; urethral stricture; prostatitis is"

255. Urethritis is treated with ceftriaxone + azythromycin because

256. An older woman with PID and tubo-ovarian abscess receives ceftriaxone; azythromycin; and metronidazole because

257. Cause of anogenital warts w/ histology (+): koilocytes is

258. Cause of atypical squamous cells of undetermined significance (ASCUS) on pap smear w/ no clinical signs of infection is

259. Cause of koilocytotic cells and possible progression to squamous cell carcinoma

260. Next step to identify viral cause of ASCUS on pap smear w/ and further management in a woman of age > 29 years is

"261. Wet prep of vaginal discharge from a sexually promiscuous woman w/ vaginal pruritis; ectocervical erythema (""strawberry cervix"") should reveal"

262. Gram stain of vaginal discharge w/ fishy odor from a sexually promiscuous woman w/ vaginal pruritis but no erythema and normal cervix should reveal

263. DOC of bacterial vaginosis (BV) is

264. Disruption of normal vaginal flora and depletion of lactobacilli in pt with BV cause overgrowth of anaerobic Mobiluncus species and

265. Wet prep of curdy discharge (no odor); adhering to vaginal walls; from a pregnant woman w/ recent UTI; who now has severe vaginal pruritis; vulvovaginal area - erythematous should reveal

266. Normal commensal of skin; GI & GU tracts; endogenous overgrowth of budding yeast; capable of >10 diseases. TOW?

267. Mechanism of action of a po DOC of vulvovaginal candidiasis is

268. Hx of flu-like illness; lymphadenopathy; maculopapular rash in a bisexual man. Lab: lymphopenia and transaminase elevations; monospot/all serology (-). TOW?

269. Time from infection (acquisition) to acute seroconversion detected by HIV serology (ELISA/ WBlot) is

270. Hx of mononucleosis-like illness and lymphadenopathy in a man with MSM. Serology (-). What is HIV viral load?

271. Host-cell receptor for HIV-1 infection

272. Homozygous for deletions in what gene renders resistance to infection and some protection against progression.

273. Host cells that trap HIV and mediate the efficient transinfection of CD4+ T cells are

274. A man; who practices �sex with another man�; has antibodies to HIV (ELISA and WB) but asymptomatic. TOW?

275. What happens to HIV-1 virus when acute retroviral syndrome progresses to clinical latency?

276. A man who practices �sex with another man�; is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is i. Candidiasis; esophageal; bronchi; trachea; or lungs ii. Cervical cancer; invasive iii. Coccidioidomycosis; extrapulmonary iv. Cryptococcosis; extrapulmonary v. Cryptosporidiosis; chronic intestinal vi. Cytomegalovirus retinitis (with vision loss).. f this.. you get the damn point.. i'm not finishing this shit

277. A man with HIV infection has lymphadenopathy; chronic diarrhea; oral thrush + herpes lesions. Expected CD4+ count is

278. Most common cause of HIV- associated peripheral skin or mucosal ulcers

279. Most common cause of HIV- associated nodules (neoplasia)?

280. Hx of fatigue; nausea; abdominal pain; diarrhea; fever; chills; night sweats; dry persistent cough w/ SOB and weight loss in a man with AIDS. Lab: PPD (-); blood culture (+) for AFB. TOW?

281. Common cause of retinitis; viral pneumonitis or esophagitis in AIDS

282. Hx: progressive CNS dz in a pt w/ AIDS: hemiparesis; visual; ataxia; aphasia; cranial nerves; sensory. MRI: ring-enhancing lesions. Toxo antibody (-). TOW?

283. Definitive indication for initial HAART (CD4+ count?) is

284. Objective of ARV Tx is to reduce viremia to what level of genomic RNA/mL

285. Initial regimen of anti-retroviral therapy is

286. Abacavir; emtricitabine; lamivudine; zidovudine; tenofovir belong to what class of antiretrovirals?

287. Efavirenz; nevirapine belong to what class of antiretrovirals?

288. Atazanavir; Lopinavir; Saquinavir belong to what class of antiretrovirals?

289. This drug binds to gp41 and prevents conformational change required for viral fusion and entry into cells.

290. This drug inhibits integrase; responsible for insertion of HIV proviral DNA into the host genome.

291. A man has AIDS and CD4 <200cells/?L or thrush. Antibacterial prophylaxis needed besides HAART is

292. A man has AIDS and CD4 <100 + pos toxo IgG. Chemoprophylaxis needed besides HAART is

293. A man has AIDS and CD4 <100 + PPD >5mm induration. Antibacterial prophylaxis needed besides HAART is

294. A man has AIDS and CD4 <50. Antibacterial prophylaxis needed besides HAART is

295. Hx of fever; a pustule at a cat scratch site; adenopathy; hepatosplenomegaly in a pt w/ AIDS. Warthin-Starry stain tissue (+). TOW (clue: bacillary angiomatosis)?

296. Mnemonic of the leading causes of congenital infections

297. Cause of chorioretinitis; intracraneal calcifications; and hydrocephalus in a neonate (mom at pregnancy had mono-like illness after eating raw meat) is

298. Hx of deafness; cataracts; heart defects; microcephaly; or mental retardation in a child (of a seronegative mom; exposed to �Blueberry muffin baby� in a very poor neighborhood). TOW?

299. Microcephaly; seizures; sensorineural hearing loss; feeding difficulties; petechial rash; hepatosplenomegaly; or jaundice in a neonate. PCR of urine should yield

300. Hepatosplenomegaly; neurologic abnormalities; frequent infections in a neonate w/ low CD4+ counts. Woman before birthing should have received

301. Cause of vesicular skin lesions + conjunctivitis in a child (asymptomatic at birth)

302. Hx of cutaneous lesions; hepatosplenomegaly; jaundice; saddle nose; saber shins. Hutchinson teeth; + CN VIII deafness in a neonate (mom is a prostitute). TOW?

303. Neonatal septicemia or meningitis (mom had flu-like Sx and ate imported cheese during pregnancy). TOW?

304. What are the SIX red rashes of childhood (acute; febrile exanthema illnesses)? Clue1: maculopapular rash; off-white lesions on buccal mucosa; vaccine preventable virus Clue2: maculopapular rash; vaccine preventable virus Clue3: scarlatina rash post pharyngitis Clue4: vesicular rash; moderate pain Clue5: maculopapular �slapped face� appearance Clue6: maculopapular rash and generalized sx/sn in an immunocompromised pt

305. Cause of single or multiple scaly and/or crusted patches and/or plaques; affecting the scalp or beard area +/- inflammation.

306. KOH prep of scales from the scalp and plucked hairs from cutaneous mycoses may reveal?

307. Most common cause of cutaneous mycoses

308. Common cause of cutaneous mycosis with animal contact

309. Oral DOC of cutaneous mycoses

310. Topical DOC of cutaneous mycoses

311. Dz w/ subcutaenous lesions w/ slow spread by lymphatic system producing nodules in a gardener; or from rose-thorn injury.

312. Cause of subcutaenous lesions w/ slow spread by lymphatic system producing nodules in a gardener; or from rose-thorn injury.

313. Dimorphic fungus that grows at 37�C as cigar-shaped yeast; and produces septate hyphae and conidia (in daisy arrangement) at 25�C is

314. DOC of sporotrchosis

315. Cause of deeper and wider lesions with interconnecting subcutaneous abscesses arising from infection of several neighboring hair follicles; in young children.

316. Cause of single or multiple; isolated or coalescent; small; superficial pustules progressing to erosions covered by stuck-on; honey-colored crusts; surrounded by erythematous halo; in young children.

317. mecA (SCC) genes which encode PBP2a; w/ low affinity for ?-lactams; confers resistance in Staphylococcus aureus against what?

318. Dz characterized by bullae and denuded areas after the blisters rupture; covered by thin; varnish-like light brown crusts; regional lymphadenopathy; in children. DOC 1. if lab: gram stain and culture of pus or base of the lesions yields GPC in chains. DOC 2. if lab: gram stain and culture of pus or base of the lesions yields GPC in clusters.

319. Cause of spreading (butterfly-wing) erythema on the face that responds to empirical penicillin.

320. Cause of severe pain on his knee w/ site of injury is tender and erythematous. Blood culture may yield?

321. What is the microbial factor that promotes degradation of C3b by binding to factor H; the serum ? globulin factor

322. Other causes of cellulitis: Clue1: cat/dog bite. What? Clue2: Salt water exposure. What? Clue3: Fresh water exposure. What? Clue4: Neutropenia. What? Clue 5: Human bite?

323. Most common cause of Dz characterized by fever/chills/ night sweats; localizing pain/tenderness or swelling/erythema; elevated ESR; CRP; elevated WBC and platelets. Radiology: periosteal elevation.

324. Major antiphagocytic virulence factor of drug-resistant organism that causes osteomyelitis is

325. Major neutrophil-damaging virulence factor of drug-resistant organism that causes osteomyelitis is

326. Cause of vertebral; sternoclavicular or pelvic bone infections (in pt w/ IVDU) or osteochondritis of foot (following penetrating injuries through tennis shoes)?

327. Cause of osteomyelitis in pt w/ underlying sickle cell Dz; blood culture +)?

328. Cause of chronic; vertebral osteomyelitis (blood culture negative)?

329. Cause of osteomyelitis in pt. w/ hx of cat bites; GNSR; fastidious growth of wound culture?

330. Dz is characterized by fever; chills; malaise; joint pain;swelling. PE: tenderness; erythema; heat; swelling; decreased ROM. CBC: leukocytosis w/ neutrophils predominating; joint aspirate: no crystals; yields bacteria. TOW? Caused by? Clue1: sexually active; blood culture negative; responds to ceftriaxone Clue2: Rheumatoid arthritis? Clue3: IVDU? Clue4: Unpasteurized dairy products Clue5: Diabetes-Grp B strep.

331. Dz is characterized by arthritis in up to 6 joints (especially knees; feet); low back pain/stiffness; irritable eyes w/ or w/o redness; conjunctivitis; iritis; malaise. TOW? Caused by: Clue1: sexually acquired Clue2: non-sexually acquired

332. Cause of bacteremia in neutopenic pts with central line or pts with prosthetic devices and catheters; blood culture (+) coagulase-negative bacteria.

333. Cause of intraabdominal abscess w/ putrid pus; anaerobic bacteremia in pt with trauma or solid GI tumor?

334. A woman with obstetric infection has fever > 102oF; SBP < 90; diffuse sunburn-like rash or desquamation of palms and soles; multisystem Sx/Sns; vomiting; and diarrhea; blood culture negative. TOW?

335. What is the toxin associated with staphylococcal toxic shock syndrome?

336. Cause of severe; watery diarrhea in a woman with toxic shock syndrome?

337. Cause of toxic shock syndrome; which responds to vancomycin and clindamycin?

338. Hx: in a man w/ necrotizing fasciitis or myositis or gangrene; fever > 38.9oC; SBP < 90 ; diffuse sunburn-like rash or desquamation of palms and soles.. Multisystem involvement. Blood culture positive. TOW?

339. What is the toxin associated with streptococcal toxic shock syndrome?

340. DOC for streptococcal toxic shock syndrome

341. Hx: Fever; chills; and hypotensive. Blood culture yields a GNR; oxidase (-); lactose fermenting organism on MacConkey agar. Immunological mediators of sepsis.

342. DOC for a line-associated infection in a pt w/ GI tumor; lab: positive blood cultures and ?-D-glucan antigenemia?

343. DOC for a neutropenic pt w/ line-associated infection w/ immune suppression (hematologic malignancy; organ or hematopoietic stem cell transplantation; chemotherapy); w/ positive blood cultures and ?-D-glucan antigenemia?

344. Cause of mononucleosis-like dz with fever; myalgia/ arthralgia w/ lab: leukopenia; LFT abnls; in a pt w/ solid organ transplant?

345. Lung biopsy reveals large cells with nuclear inclusions (Cowdry owl's eyes inclusion bodies) in a pt with AIDS and interstitial pneumonia. TOW?

346. DOC for CMV antigenemia in a febrile pt with solid organ tansplant?

347. Cause of hematuria; hemorrhagic cystitis; or ureteric stenosis; or interstitial nephritis in a severly immunocompromised pt?

348. DOC for a pt w/ travel hx (back from the tropics); who has flu-like symptoms; splenomegaly; lab: CBC: anemia; thrombocytopenia; hypoglycemia. Blood smear: enlarged RBCs and Schuffner dots.

349. Which drug is contraindicated in specific Tx of liver form of malaria in pts w/ G6PD deficiency?

Primaquine

350. DOC for a pt w/ travel hx (back from the tropics); who has flu-like symptoms (fever > 103oF); seizure; hyperparasitemia (>2.5% of RBC); pulmonary edema; or renal failure; or severe anemia?

351. Cause of malaria-like illness in an immunosuppressed pt w/o travel hx; lab: blood smear has cross-over rings in the RBCs?

352. A pt from S. America has a week-long fever; anorexia; lymphadenopathy; mild hepatosplenomegaly; and myocarditis; a nodular lesion on the arm. Blood smear should reveal motile species of what?

353. Cause of a chronic-stage systemic dz w/ cardiomyopathy; megaesophagus; megacolon; and weight loss in a pt from S. America; who does not respond to nifurtimox.

354. Cause of protracted fever and Crohn�s; celiac dz; ocular problems; and lymphadenopathy; duodenal biopsy demonstrating foamy macrophages in lamina propria?

355. What is the most common cause of bacteremia associated w/ foreign device (prostheses; intravenous cathether; or central lines) in co-morbid; hospitalized pts?

356. What is the cause of infections associated w/ ventilator support of respiration in co-morbid pts in the ICU?

357a. Hx: fever; headache; neck stiffness; and altered mental status; Kernig's/Brudzinski's sign other focal neurologic findings; rash; headache; seizures + myalgia; CSF: WBC > 2000 or PMNs > 1200; glucose < 34; protein > 220

357b. CSF gram stain of the most likely pathogen of ABM in a 6 mos-6yr old (or adults > 50 years) should reveal

357c. CSF gram stain of the most likely pathogen of ABM in an older child or young adult should reveal

358. Most common cause of sepsis/meningitis in newborns/neonates?

359. Cause of fever; headache; photophobia; nausea/vomiting; rash; diarrhea; meningeal signs; in older children in the summer months; CSF with 10-<1;000 WBC typical; mostly monos; moderately elevated protein?

360. Cause of aseptic meningitis in men with exposure to rodents?

361. Cause of aseptic meningitis with hx of tick bite and erythema migrans?

362. Cause of aseptic meningitis with hx of sex with multiple partners; CSF PCR(+)?

363. Cause of fever; headache; photophobia; meningismus; in pts w/ solid organ transplant; malignancy; corticosteroid use. CSF glucose < 2/3 serum glucose; elevated protein; WBC > 5 with PMNs?

364. How does Listeria monocytogenes differ from other ?-hemolytic bacteria?

365. Cause of chronic meningoencephalitis in a pt; who uses infliximab or native from endemic region; PE: papilledema. CXR (+). Lab: elevated monocytes on differential; low CSF glucose?

366. Test to confirm subacute mengoencephalitis in a; immunocompromised pt (CD4 <100); vesicular skin lesions [CSF profile: protein 30-150mg/dl; monos 10-100]?

367. Cause of meningoencephalitis after a hx of respiratory illness after travel to SW USA?

368. Test to confirm CNS pathology with fever; cognitive deficits; focal neurologic signs; seizures; temporal lobe involvement on MRI. Lab: no papilledema; CT (no brain lesion)?

369. Cause of fever; cognitive deficits; focal neurologic signs; seizures; abnormal mental status with ataxia; hemi-paresis; in a pt w/ AIDS?

370. Cause of fever; cognitive deficits; focal neurologic signs; seizures or abnormal mental status with ataxia in an adult during outdoor activity?

371. Cause of fever; cognitive deficits; focal neurologic signs; seizures; in a pt w/ AIDS (CD4 < 100). Brain CT or MRI: multifocal (ring-enhancing) lesions; affecting basal ganglia; Pt receives pyrimethamine + leucovorin + sulfadiazine for life

372. Cause of confusion; stiff neck; irritability over wks to months; in immunocompromised pts; CT or MRI = multifocal lesions in midbrain; brain stem; & cerebellum; wet mount CSF = motile macrophage-like organisms.

373. Cause of severe headache and other meningeal signs; fever; vomiting; and focal neurologic deficits; frequently progressing to coma; in a healthy boy (summer diving activity)?

374. Cause of seizures; chronic headache; symptomatic hydrocephalus; in immigrants from Mexico; Central or S. America); pt. successfully responds to praziquantel + anti-convulsant drug?

375. Hx of fever; lymphadenopathy; chancre; and pruritus weeks ago; in a pt from Africa; progressing to headaches; somnolence; abnormal behavior; pt. responds slowly to pentamidine isothionate or suramin. TOW?

376. Hx of rigidity; muscle spasm; and autonomic dysfunction. Trismus or lock jaw due to masseter spasm in an infant w/ umbilical stump infection (secondary to poor birth delivery hygiene). Clostridial toxin interferes w/

377. Hx of foodborne (chili) afebrile illness w/ diplopia; dysarthria; dysphoria; dysphagia; alert; and descending flaccid paralysis in a pt w/ IDU skin poppers with black tar heroin. Clostridial toxin blocks the release of

378. Immediate treatment of a male infant w/ constipation; a weak cry; and drooling; hypotonea and cranial neuropathy; after ingestion of home-processed honey.

379. Ingestion of a raw potato delivers a new vaccine protein to elicit an immune response. The immune structure to interact with the vaccine protein?

380. Inflammation and the resulting increase in vascular permeability permit leakage into damaged or infected sites are effected by

381. The serum of a pt; who has IgG and IgM deficiency; appears to fix complement in an assay for tetanus antibodies. What is the explanation?

382. A 3-year-old boy with genetic C3 deficiency has recurrent ear and lung infections due to pyogenic bacteria. Deficiency of what?

383. A very young child; w/ recurrent infections due to Staphylococcus aureus; now has numerous granulomas. TOW?

384. Treatment with which protease enzyme causes decrease in avidity of IgG w/o changing the specificity of the antibody?

385. Cells activated by both ?-IFN and CD40 are

386. High-dose chemo has caused severe bone marrow suppression in a pt with hematologic malignancy. Reversal is plausible with what?

387. Function of the T-lymphocyte receptor (CD3) complex of transmembrane proteins?

388. The MHC class I pathway presents an antigen directly to what?

389. HSV infection can block the transfer of antigenic peptides from the cytoplasm to the ER of the infected cells. As a result of this; action of what cell type is compromised?

390. Infection of the thyroid gland can induce the expression of MHC II molecules. Which cell types would initiate an autoimmune response; leading to Hashimoto�s thyroiditis?

391. PPD skin test (+) in a pt ; who was vaccinated against turberculosis in his native country; reflects response of what cell type?

392. A man with hx of MI is given a morphine injection for a new episode of chest pain; 10 mins later; he has itching and urticaria. Mechanism of this reaction?

393. Loss of skin pigments; sense of touch; inability to feel objects and pain in a pt from Africa; whose skin scraping contains AFBs; is caused by

394. A man with polycystic kidney dz; who receives a renal transplant and cyclosporine; develops a high temp and swelling and tenderness in the grafted kidney. TOW?

395. A man who now has progressive stupor and laryngeal spasms for 3 days after pt was being attacked by a wild bat in a cave a month ago should have received

396. Alternative and lectin pathways of complements activated

397. Classic complement pathway is activated by antibody-antigen complexes involving antibody class type

398. Chemotactic and anaphylotoxic complements are

399. successful opsonization of all non-encapsulated bacteria are by complement

400. Defects or deficiency which complements predisposes individuals to infections caused by Neisseria spp.; the causative agents of gonorrhea and meningitis

401. Antimicrobial (immune) response important for intracellular bacterial infections involves cell type

402. Immune response important for viral infections involves cell type

403. Major antibody in secretions and plays a significant role in first-line defense at the mucosal level is

404. Main antibody in the initial �primary� immune response and allows good complement activation is

405. Fc region of this immunoglobulin binds to eosinophils; basophils and mast cells and is significant mediator of allergic (hypersensitivity) reactions

406. What on macrophages enables them to sense that the material is microbial in origin; and must therefore be eliminated quickly?

407. These oxygen-dependent enzymes: NADPH oxidase; superoxide dismutase; and myeloperoxidase are involved in killing of what?

408. These oxygen-independent enzymes/proteins: lysosome; lactoferrin; defensins and other cationic proteins are involved in killing of what?

409. Infections persist; because m? activation is defective; leading to chronic stimulation of CD4+ T cells in what dz?

410. Defective respiratory burst; predisposing chronic bacterial infection is associated with deficiency of what?

411. All nucleated cells express MHC I antigens

412. Antigen-presenting cells express MHC II antigens

413. Lymphocyte proliferation (T; B) and NK ? cytotoxicity are undertaken by what cytokine?

414. B-cell activation; IgE and IgG4 switch; ? TH1 cells/ M?; ? IFN-?; TH0 ? TH2 are all undertaken by what cytokine?

415. M? activation; elevated expression of MHC and FcRs molecules on B cells; IgG2 class switching; increased IL-4 and TH2 are all undertaken by what cytokine?

416. The Th1 response; driven primarily by IFN-? leads to the activation of

417. The Th2 response; driven primarily by IL-4 and IL-5; leads to the production of IgE and IgG4 and to the activation of

418. Variable T and B cells in DiGeroge�s syndrome is associated with

419. No B cells and immunoglobulins in X-linked agammaglobulinemia (Bruton�s) is associated with

420. Lack of anti-polysaccharide antibody and impaired T-cell activation causing Wiskott-Aldrich syndrome is associated with

421. Inability to control B cell growth in X-linked lympho-proliferative syndrome is associated with

422. Glomerulonephritis; pulmonary hemorrhage in

Goodpasture�s syndrome is caused by what autoantigen?

423. Hyperthyroidism in Myasthenia gravis is caused by what autoantigen?

424. Progressive muscle weakness in Grave�s Dz is caused by what autoantigen?

425. Brain degeneration; paralysis in Multiple sclerosis (MS) is caused by what autoantigen?

426. Localized allergies (e.g.; drug allergy; asthma; hay fever) and anaphylaxis (food; drug) w/ systemic inflammation throughout circulation are associated with reaction?

427. Autoimmune hemolytic anemia: Ab�s produced vs RBC membrane Ag�s; mismatched blood (transfusion rxn); and allergies to antibiotics (e.g.; penicillins; sulfa drugs) are associated with reaction?

428. Grave�s Disease; Myasthenia Gravis; Goodpasture�s syndrome are all associated with reaction?

429. Post-streptococcal glomerulonephritis; serum sickness to horse diphtheria anti-toxin; systemic lupus erythematosis (SLE); and rheumatoid arthritis are all associated with reaction?

430. Poison ivy; erythematous induration in tuberculin skin test; and transplantation/graft rejection are all associated with reaction?