Zanki Micro

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A good prognosis occurs with

simultaneous co-infection of Hep
D and Hep B. "Child with diarrhea; patient's puppy had
diarrhea one week ago"
Vs. Superinfection Campylobacter
**Campylobacteria can be transmitted

from domestic animals to humans
-also fecal-oral or person-person
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"Neurological symptoms with CD4 count

<200; imaging shows multiple non- "Thin, white discharge with fishy
enhancing lesions" odor": Bacterial vaginosis from
"Respiratory quinolones" that can Gardnerella vaginalis
PML (JC Virus) be used for 2nd-line treatment of
community aquired pneumonia and Treatment? Metronidazole, Clindamycin
atypical pneumonias
Levofloxacin, moxifloxacin
Legion of ships in background =

Legionella
"Thumb-sign" on lateral X-ray (organism -azole = antifungal

(4) Lactose fermenters
and diagnosis?): H. influenzae, epiglottitis
MacConKEE'S agar --> Klebsiella,
E. coli, Enterobacter, Serratia ketoconzole,fluconazole, itraconazole, etc.
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-navir = Protease inhibitors

-cycline = tetracyclines
-fungin = Echinocandins
1st generation cephalosporins that can be

used to treat skin and soft tissue infections
by Staph and Strep
1st generation cephalosporins can
-penem = carbapenems treat UTIs caused what bacteria?
Cephalexin, Cefazolin
Proteus, E. coli, Klebsiella
used to treat extended spectrum

B-lactamase producers
PEcK
1st-line treatment of Lyme disease A biopsy of a patient with A biopsy of a patient with sporotrichosis
(Borrelia) sporotrichosis (sporothrix (sporothrix schenckii) will reveal
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granulomas consisting of histiocytes,

schenckii) will reveal granulomas multinucleated giant cells and cigar-shaped
consisting of histiocytes, budding yeast
multinucleated giant cells and
Doxycycline cigar-shaped budding yeast
Used in tickborne diseases
A common finding in early leptospirosis

infection is fever and conjunctival
suffusion (eyes) as well as photophobia. A common finding in early
leptospirosis infection is fever and
There is redness but a lack of inflammatory conjunctival suffusion (eyes) as
exudate. well as photophobia.
There is redness but a lack of

inflammatory exudate.
A positive germ tube test is strongly

indicative of Candida albicans.
A positive Lepromin skin test A positive Lepromin skin test A side effect of albendazole is intestinal
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demonstrates good cell mediated response

to Leprosy infection. demonstrates good cell mediated
response to Leprosy infection.
obstruction (from all the immobile worms).

It should also be avoided with pregnant
women (use pyrantel pamoate instead).
A vascular extra-hepatic manifestation of

A unique symptom of rickettsia
Hep B is polyarteritis nodosa.
species is vasculitis with rash.
colonize endothelial cells and cause
endothelial hyperplasia.
A side effect of albendazole is intestinal

obstruction (from all the immobile worms).
It should also be avoided with pregnant
women (use pyrantel pamoate instead).
A Disulfiram-like reaction is indicated by A Disulfiram-like reaction is A Disulfiram-like reaction is indicated by

severe flushing, tachycardia, and indicated by severe flushing, severe flushing, tachycardia, and
hypotension with alcohol tachycardia, and hypotension hypotension with alcohol
with alcohol
A Disulfiram-like reaction is indicated by

severe flushing, tachycardia, and
A KOH stain or culture gives
hypotension with alcohol A KOH stain or culture gives physicians a
physicians a definitive diagnosis in
definitive diagnosis in histoplasmosis,
histoplasmosis,
blastomycosis, coccidioidomycosis (fungal
blastomycosis, coccidioidomycosis
infections)
(fungal infections)
A large lateral spine is a feature in the egg A large lateral spine is a feature in A live attenuated Zoster vaccine is
of S. Mansoni (schistosome) the egg of S. Mansoni recommended for adults over 60.
(schistosome)
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A poor prognosis occurs with Hep B and

A poor prognosis occurs with Hep Hep D superinfection.
B and Hep D superinfection.
A live attenuated Zoster vaccine is
recommended for adults over 60. Hep B then Hep D.
Hep B then Hep D.
A patchy alveolar infiltrate is characteristic A patchy alveolar infiltrate is characteristic

of Blastomycosis on CXR, along with A patchy alveolar infiltrate is of Blastomycosis on CXR, along with
lesions or cavities in the lungs characteristic of Blastomycosis on lesions or cavities in the lungs
"haziness" CXR, along with lesions or cavities "haziness"
in the lungs
"haziness"
A clear CXR with possible lesions A clear CXR with possible lesions Abacavir (ABC) = NRTI
or cavities in the lungs is characteristic or cavities in the lungs is
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of Coccidioidomycosis characteristic
of Coccidioidomycosis
Abacavir hypersensitivity is
associated with the HLA-B 57:01 Actinomyces israelii is a gram positive rod
Abacavir = NRTI allele. that grows in chains that can be treated by
what antibiotic therapy?
Penicillin
Activity of fluoroquinolones
Mostly gram-negative, some gram-positive

Acute endocarditis is most commonly
caused by S. aureus
Acute cholestatic hepatitis is a
much more red flowers (gram neg) than complication of what protein
purple (gram pos) synthesis inhibitor?
Macrolides
Alk phos will be elevated**

***
Acute infection with Hep C is Acutely, trypanosoma cruzi Acyclovir (-clovirs) is a guanosine analog
characterized by a large rise and fall (~6 symptoms are not many (the that is monophorsphorylated by what
mo.) in ALT. disease may be asymptomatic) enzyme?
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Viral thymidine kinase
What viruses are indicated for the use of

acyclovir?
HSV/VZV
60-90% of Hep C will become chronic.
except for some localized

inflammation around the biting site.
Adenovirus infection may

cause tonsilitis, conjuctivitis
or hemorrhagic cystitis.
Adenovirus infection may
Acyclovir triphosphate incorporates into cause tonsilitis, conjuctivitis
viral DNA and inhibits DNA polymerase. or hemorrhagic cystitis.
Adenovirus infection may Adenovirus is a naked dsDNA Adenovirus is a naked dsDNA virus.
cause tonsilitis, conjuctivitis virus.
or hemorrhagic cystitis.
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Administration of penicillin G:
Administration of zidovudine with
IV what other drug may produce
additive myelosuppression?
Ganciclovir
FA: IV and IM
Adult onchocerca volvulus produce

microfilariae, which then migrate
throughout the body.
Adverse effect with the use of Adverse effects of Simeprevir

fluoroquinolones in the elderly?
Photosensitivity and rash
Adult onchocerca volvulus produce
Tendonitis/tendon rupture
microfilariae, which then migrate
throughout the body.
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Adverse effects of Voriconazole
Blurring and changes in color Adverse effects of sofosbuvir

vision/brightness
Adverse effects of daptomycin Fatigue, nausea, headache
Myopathy and rhabodmyolysis
After a dermacentor tick bite, After a dermacentor tick bite,

Aflatoxins are carcinogenic, especially for Francisella enters MΦ Francisella enters MΦ (macrophages),
the developement of hepatocellular (macrophages), spreads through spreads through the reticuloendothelial
carcinoma the reticuloendothelial system to system to cause regional lymphadenopathy.
produced by Aspergillus flavus, found in cause regional lymphadenopathy.
peanuts, grain plants (ex: wheat)
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After a dermacentor tick bite,

Francisella enters MΦ (macrophages),
spreads through the reticuloendothelial
system to cause regional lymphadenopathy.
After coughing up the eggs and After coughing up the eggs and
swallowing, ascaris lumbricoides swallowing, ascaris lumbricoides mature
mature into adults in the small into adults in the small intestine. There,
intestine. There, they multiply and they multiply and are passed into the feces
are passed into the feces to restart to restart the cycle of infection.
the cycle of infection.
After infection, where do the sporozoites After inhalation of Mucormycosis, the

mature into trophozoites? fungi have a predilectation to proliferate
in blood vessel walls, especially where
Liver After ingesting dracunculus there is excess glucose and ketone bodies
medinensis larvae, they penetrate ie: diabetic ketoacidosis in T1DM (high
Remember than sporozoites are the the hosts stomach and intestinal blood sugar and high blood ketones)
infectious form, that is, the one that enters wall, and the copepods die.
the human host
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After inhalation of Mucormycosis, the

fungi have a predilectation to proliferate After inhalation of Mucormycosis,
in blood vessel walls, especially where the fungi have a predilectation to
there is excess glucose and ketone bodies proliferate in blood vessel walls,
ie: diabetic ketoacidosis in T1DM (high especially where there is
blood sugar and high blood ketones) excess glucose and ketone bodies
ie: diabetic ketoacidosis in T1DM
(high blood sugar and high blood After invading blood vessels,
ketones) Mucormycosis will penetrate the cribiform
plate of the skull, entering the brain
After invading blood vessels, After penetrating the cribiform

Mucormycosis will penetrate the cribiform plate, mucormycosis continues to
plate of the skull, entering the brain After maturation in the intestinal proliferate in the blood vessels,
cavity, female dracunculus causing necrosis of tissues
medinenis migrate to the surface of
the skin (usually in lower
extremities) and produce a painful
skin ulcer.
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After transcription from RNA, viral HIV

DNA is transported into the nucleus for
inclusion into the host chromosome by
what enzyme?
Viral Integrase
After sandflies injects After sandflies injects

What gene encodes for this enzyme? Leshmania braziliensis into the Leshmania braziliensis into the skin, the
skin, the parasite becomes the parasite becomes the intracellular
pol intracellular amastigote form in the amastigote form in the host that ends up
host that ends up inside inside macrophages
macrophages
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All + RNA viruses are icosahedral except

for Coronavirus.
After sandflies injects

Leshmania braziliensis into the skin, the All (+) RNA viruses are
parasite becomes the intracellular icosahedral except for Coronavirus.
amastigote form in the host that ends up
inside macrophages
All Clostridia are gram-positive, spore- All Clostridia are gram-positive, All Clostridia are gram-positive, spore-
forming, obligate anaerobes. spore-forming, obligate anaerobes. forming, obligate anaerobes.
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Look at that nice, purple hue (i.e. gram +) Look at that nice, purple hue (i.e. gram +)
Look at that nice, purple hue (i.e.

gram +)
All DNA viruses are ds except

for parvovirus B19.
ssDNA = super small DNA (smallest DNA

All DNA viruses replicate in the nucleus
virus)
(except for Pox).
All DNA viruses have icosahedral
capsid except for Pox.
Pox is the largest DNA virus -- too large to

Capsid is complex enter the nucleus
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All NRTIs require phosphorylation by

cellular enzymes to be activated except for
which drug?
Tenofovir
All RNA viruses are linear except

for BAD (Bunya, Arena, Delta.
All Paramyxoviruses are able to Have a circular genome

form multinucleated giant cells due
to Fusion Protein.
F protein causes respiratory

epithelial cells to fuse and form
multinucleated cells
All RNA viruses are ss except

for Reoviruses.
All RNA viruses are non-segmented All RNA viruses replicate in the cytoplasm
except for BOAR. except for influenza and retroviruses.
Bunya, Orthomyxoa, Arena, Reo
All RNA viruses replicate in the cytoplasm All RNA positive-sense viruses All RNA positive-sense viruses replicate
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except for influenza and retroviruses.
replicate in the cytoplasm with host in the cytoplasm with host cell RNA
cell RNA polymerase. polymerase.
All β-lactam antibiotics are bactericidal, as

cell walls of bacteria
All intestinal nematodes can be treated All intestinal nematodes can be
are essential for growth and development.
with albendazole. treated with albendazole.
Altered penicillin-binding proteins (PBP)

allows methicillin resistance in MRSA.
Allergic bronchopulmonary
aspergillosis is an IgE-mediated
Allergic bronchopulmonary aspergillosis
type I hypersensitivity reaction that
can be treated with corticosteroids to
is most often seen in individuals
reduce IgE response.
suffering from asthma or cystic
fibrosis.
Alternative agent for Rickettsial infections,

especially in pregnancy when doxycycline
is contraindicated Although the most common cause Amikacin = aminoglycoside
of hemolytic uremic syndrome is E.
Chloramphenicol coli O157:H7, it can also be
produced by Shigella.
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Aminoglycoside that can be used as 2nd-

line treatment of TB?
Aminoglycosides can be Aminoglycosides can produce ototoxicity,
Streptomycin nephrotoxic and produce what producing symptoms like tinnitus, vertigo,
complication? etc.
MOA?
Acute tubular necrosis
Binds 30s component of ribosome
Aminopenicillins can be used with

Aminopenicillin used as part of H. clavulanic acid, a β-lactamase inhibitor.
pylori triple therapy
Aminoglycosides have activity
against aerobic gram negative bacilli. Amoxicillin Recall aminopenicillins (amoxicillin,
ampicillin) are penicillinase sensitive, so
using with β-lactamase inhibitors extend
their spectrum
Aminopenicillins can cause rash if given in Aminopenicillins can treat pneumonia

the setting of what viral illness? Aminopenicillins can treat caused by Strep pneumoniae and H.
pneumonia caused by Strep influenzae.
EBV infectious mononucleosis pneumoniae and H. influenzae.
Often mistaken for S. pharyngitis, so if you

suspect Strep and give
amoxicillin/ampicillin and rash develops
---> EBV
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Aminopenicillins that work against H.

influenzae Amoxicillin, ampicillin β-lactamase
susceptibility?
Amoxicillin, ampicillin
Amoxicillin = Extended spectrum
Sensitive
penicillin
Amphotericin B/Flucytosine
combinaton is used for the
treatment of cryptococcal
meningitis.
Amphotericin toxicity commonly presents
Amphotericin = anti-fungal with Type I RTA with severe magnesium
and potassium wasting.
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Ampicillin is oral and poorly

absorbed, so it can be found in high
concentrations in the gut. This
predisposes to infection by what
organism? Ampicillin treats meningitis produced
Ampicillin = extended-spectrum penicillin
by Listeria monocytogenes.
Clostridium difficile
Angioinvasive aspergillosis will present

with fever, cough and hemoptysis
Animals like prairie dogs, rats, or
chipmunks are the reservoirs for
Yersinia pestis (plague). Another agent which may also be
introduced in the treatment of MAC
is Rifabutin
Its activity is similar to that of Rifampin.
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Anti-HBc is the sole marker during

the window period.
Anti-pseudomonal penicillins
Anti-HBs + Anti-HBe or Anti-HBc
Ab = Recovery from Hep B Piperacillin, ticarcillin
Anti-staph penicillins have activity Anti-staph penicillins penicillinase

against what organism? susceptibility?
Anti-staph penicillins are ineffective
against what group of organisms and why?
S. aureus (except MRSA) Resisant
MRSA due to altered PBP target site
Resistant to S. aureus penicillinase S. aureus penicillinase is ineffective

against anti-staph penicillins (nafcillin,
oxacillin, dicloxacillin, methcillin)
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Antibiotic that is a weak inhibitor

Antibiotic that can produce ototoxicity in Antibiotics kill vaginal microflora,
of MAO and can produce serotonin
fetus/newborn allowing microbes such as Candida
syndrome
albicans to flourish
Aminoglycosides results in vaginal candidiasis (vaginal yeast
Linezolid
infection)
Antifungal that inhibits CYP-450

enzyme that converts lonesterol to
ergosterol
Antibodies against postsynaptic ACh
receptors at NMJ? Antimycobacterial therapy that blocks
Azoles arabinosyltransferase, inhibiting
Myasthenia gravis carbohydrate polymerization of the
mycobacterium cell wall
What antibiotic is contraindicated in this
14-⍺-demethylase is a fungal Ethambutol
disease?
CYP-450 enzyme
Aminoglycosides
Ethambutol @ the "wall"
Antimycobacterial treatment that can

precipitate gout attacks Anyclosotoma duodenale and
necator americanus infect the host Aortitis in tertiary syphylis is caused by
Pyrazinamide by walking barefoot, as the destroyed vasovasorum leading to
hookworm larvae penetrate skin of an ascending pathologic aneurysm.
soles of feet.
causes hyperuricemia
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Arboviruses such as Rift-Valley Fever and

California fever are transmitted via Aedes
Aortitis in tertiary syphylis is caused by Aortitis in tertiary syphylis is mosquito.
destroyed vasovasorum leading to caused by destroyed vasovasorum
an ascending pathologic aneurysm. leading to an ascending pathologic
aneurysm.
Are tetracyclines safe for patients in renal-

failure? Why?
Arenavirus can be inactivated by heat and
Yes, because tetracycline is fecally irradiation.
Arena virus has a helical capsid.
excreted
As well as low pH and detergents.
Arenavirus has a granular appearance on Arenavirus is an enveloped negative-sense

electron microscopy. ssRNA virus with a helical capsid.
This is a BOAR (segmented) virus with 2
Arenavirus is transmitted
segments.
via rodents.
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Arenavirus is an enveloped negative-sense Arenavirus is an

ssRNA virus with a helical capsid. enveloped negative-sense ssRNA
This is a BOAR (segmented) virus with 2 virus with a helical capsid.
segments. This is a BOAR (segmented) virus Arenaviruses include LCMV (lymphocytic
with 2 segments. choriomeningitis virus) and Lassa Fever
Encephalitis.
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As the loa loa worm migrates As the loa loa worm migrates through
through subcutaneous tissue of its subcutaneous tissue of its host, it causes
host, it causes transient transient angioedema.
As a facultative intracellular organism, angioedema.
Legionella gram stains poorly.
looks like macrophage with rods inside
Ascaris lumbricoides is diagnosed via eggs

in the feces and eosinophilia.
Ascaris lumbricoides is treated with

albendazole, which work by causing
microtubule dysfunction, making the
worms immobile.
Ascaris lumbricoides is transmitted

by eating eggs that are in
contaminated food or water.
Ascaris lumbricoides is treated with Ascending lymphadenitis Ascending lymphadenitis and cigar-
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albendazole, which work by causing shaped yeast are classic manifestations

microtubule dysfunction, making the and cigar-shaped yeast are classic of Sporothrix schenckii
worms immobile. manifestations of Sporothrix infection/sporotrichosis
schenckii infection/sporotrichosis
Aside from the brain in cerebral

malaria, with other organs can be
affected in P. falciparum infection?
Kidneys (AKI) and lungs

(pulmonary edema).
Aside from the rash, rocky mountain
Liver is commonly affected in all spotted fever is characterized by Headache
Aside from mefloquine, which other strains. fever and myalgias.
quinoline agent can be used for resistant
strains of Plasmodium spp? The increased numbers of These are nonspecific, the most testable
erythrocytes infected and destroyed symptom is the rash.
Quinidine result in toxic cellular debris,
adherence of RBCs
Remember it can cause cinchonism as an to vascular endothelium and other
adverse effect. RBCs. This along with platelets,
leukocytes and malarial pigment
occlude the capillary vessels
(capillary plugging). Thus acute
kidney injury because of ischemia
(capillary obstruction) and
pulmonary edema (not fully
understood, but inflammation-
mediated endothelial damage might
have an important role).
Lung and kidney shaped vests
Aside from seeing the worms crawl across Aside from seeing the worms crawl Aspergillomas are associated with
the eye, another way to diagnose Loa Loa across the eye, another way to Tuberculosis or
infection is to perform a blood smear, diagnose Loa Loa infection is to klebsiella, as both pathologies have pre-
where microfilariae will be seen. perform a blood smear, where existing cavities within the lungs
microfilariae will be seen.
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those with cavities already in their lungs

are susceptible to this infection
Aspirin should be avoided in children with

viral infections (e.g. Influenza, VZV),
unless they have Kawasaki disease.
Aspergillomas are associated with Kawasaki Disease seen in Asian children <
Tuberculosis or 4 years old and should be treated with
klebsiella, as both pathologies have pre- Aspirin
existing cavities within the lungs
Aspergillus fumigatus is not

dimorphic and occurs only as molds

Assembly of HIV virions depends on At risk groups for adenovirus At what CD4 count should patients receive
asparate protease, which cleaves the infection include children, military prophylaxis for Mycobacterium avium?
polypeptide products of HIV mRNA into barracks and public swimming pool
their functional parts. outbreaks. <50
It is encoded for by what gene? pol (i.e. high concentration or drinking What protein synthesis inhibitor can be a
feces) prophylactic?
Epidemic Keratoconjunctivitis:
the sword can't cleave the polypeptide strains 8, 19, 37 (swimming pools Azithromycin
products as common source of outbreak
in summer).
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At what CD4 count should prophylaxis for

Pneumocystis jirovecii be given?
CD4+ count < 200

Atypical pneumonia caused by Chlamydia
What antibiotic should be used?
At what CD4+ count should you species: first line therapy is doxycycline
start prophylaxis for Pneumocystis and second line therapy would be
Trimethoprim-Sulfamethoxazole (TMP-
jiroveci? azithromycin.
SMX)
CD4+ count < 200
to prevent occurance of
Pneumocystis pneumonia (PCP) -
AIDS defining illness
Azithromycin is a macrolide antibiotic that

Azithromycin = macrolide can be used to treat urethritis and cervicitis
Atypical pneumonia caused by Chlamydia caused by what organism?
species: first line therapy is doxycycline
and second line therapy would be Chlamydia trachomatis
azithromycin.
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Azole that can cross the BBB to treat

crytpococcal meningitis
Fluconazole
Azoles inhibit what enzyme?
What other fungal infections is this drug
effective against? 14-⍺-demethylase
Candidiasis Inhibition of this enzyme inhibit the

conversion of?
Aztreonam = monobactam
Lanosterol to ergosterol
Aztreonam is a monobactam that can be BK virus commonly causes nephropathy in

used in patients with a penicillin allergy transplant patients.
B. Pertussis is transmitted
due to lack of cross-reactivity. by respiratory droplets.
BK = Bad kidney
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Babesiosis is diagnosed through a

blood smear, with a maltese cross
apperance of red blood cells.
The cross is forrmed by a tetrad of
trophozoites.
Babesia is most common in the Americas,

particularly the northeast.
Babies with neonatal pneumonia from
Borrelia burgdorferi is more commonly
Chlamydia trachomatis (Serovar D-K) will
transmitted than babesia, but for some
have a characteristic stocatto cough.
reason lots of people in Rhode Island are
serum positive for babesia.
Bacillary angiomatosis is caused

by Bartonella henselae.
Bacillary angiomatosis (B.

henselae) will produce a
neutrophilic infiltrate on biopsy,
while Kaposi sarcoma will
produce a lymphocytic infiltrate on
biopsy.
Babies with neonatal pneumonia from

Chlamydia trachomatis (Serovar D-K) will
have a characteristic stocatto cough.
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Bacillus anthracis is an obligate

aerobe. Bacitracin resistant, encapsuled bacteria: S.
Bacillary angiomatosis transmission is
agalactiae (GBS)
through cat scratches (same as cat scratch
fever).
Bacteria cannot use exogenous folate but

must synthesize it from PABA.
Bacterial enzymes that hydrolyze
the β-lactam ring of certain
penicillins and cephalosporins (β-
lactam's), rendering them inactive Bacterial vaginosis is due to bacterial
overgrowth
Normally vaginal flora contains lactobacilli
β-lactamase with a small amount of anaerobes
Gardnerella is a facultative anaerobe
O=C --- N bond is the weakest

bond, thus it is the site of resistance
for many β-lactamases
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Bactericidal protein synthesis inhibitor that Bartonella hensela causes bacillary

can produce ototoxicity? angiomatosis
in immunocompromised patients.
Aminoglycosides Bactericidal treatment for severe
gram - rod infections
HIV with low CD4 count (<200)
Aminoglycosides (gentamicin)
Besides histoplasmosis, which other fungus

can be detected through urine antigen
testing?
Blastomycosis
Because toxocara canis larvae can
Because toxocara canis larvae can circulate
circulate in the body for years, it is
in the body for years, it is also known as
also known as visceral larva
visceral larva migrans.
migrans.
Besides the classic triad of congenital Biopsy of the regional lymph nodes
toxoplasmosis, what other symptom may with Tularemia will
appear? show caseating granulomas.
Blastomycosis are the same size as RBCs
deafness
Goljan: non-caseating
Sketchy: caseating (emed)
Blastomycosis commonly occurs near the Blastomycosis is a dimorphic Blastomycosis is caused by blastomycosis
Great Lakes, but also in the eastern and fungus that changes form with dermatitidis
southern US as well different temperatures
hence the statue of Robert E. Lee mold in the cold (soil), yeast in the
heat (body)
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inhale mold in the soil, once it

colonizes lungs and reaches body
temperature, turns to yeast
Blood tests of patients with Allergic

Brochopulmonary Asperigillosis will
show increased IgE
Type 1 hypersensitivity reaction,
wheezing, fever, migratory pulmonary
infiltrate, associated with asthma and
cystic fibrosis
Bordetella has an acellular vaccine Bordetella is a gram-negative aerobic

using purified antigens. and non-motile (mobility) bacteria.
Bordetella is very infectious

through respiratory droplets by using a
Bordetella is a gram-
Bordetella is a gram-negative aerobic pilus called filamentous hemagglutinin
negative aerobic and non-motile
and non-motile (mobility) bacteria. (FHA)
(mobility) bacteria.
FHA is associated with biofilm formation
Bordetella produces a pertussis Bordetella produces a pertussis toxin

toxin causing inhibtion of Gi causing inhibtion of Gi receptor.
receptor.
Bordetella is very infectious
through respiratory droplets by using a
pilus called filamentous hemagglutinin pertussis toxin (PTx/ACT) is for adhesion
(FHA) pertussis toxin (PTx/ACT) is for and damage
adhesion and damage
FHA is associated with biofilm formation
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Both Mucormycosis and Aspergillus

Both Mucormycosis and fumigatus can spread to the paranasal
Aspergillus fumigatus can spread to sinuses and result in necrosis around the
the paranasal sinuses and result in nose
necrosis around the nose right-angled branching hyphae in mucor
Borrelia are helical Spirochetes and are
right-angled branching hyphae in acute-angled branching hyphae in
longer than Treponema.
mucor aspergillus
acute-angled branching hyphae in
aspergillus
Branching hyphae of Sporothrix schenckii

can be grown at 25 degrees celcius
Rose-bushes
Brucella is a gram-negative facultative
intracellular bacteria.
requires CO2 to grow.

Branching hyphae similar to that of
rose bushes are classically seen
in Sporothrix schenckii
culture grown at 25 degrees celcius
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Brucella is transmitted via unpasteurized

Brucella is a gram-negative facultative Brucella is associated with dairy and direct contact with farm animals.
intracellular bacteria. osteomyelitis (bone).
i.e. veterinarian, slaughterhouse worker or

requires CO2 to grow.
rancher
Bunyavirus is an enveloped negative-

sense ssRNA virus with 3 circular
segments.
The segmented viruses can be remembered

with the BOAR mnemonic.
Buffered charcoal yeast extract
requires presence of cysteine
and iron to grow Legionella.
Brucella is urease-positive and H2S-

positive.
allows protection from respiratory burst
Bunyavirus is an enveloped negative- Bunyavirus is an Bunyavirus obtains its envelope from

sense ssRNA virus with 3 circular enveloped negative-sense ssRNA the Golgi.
segments. virus with 3 circular segments.
The segmented viruses can be remembered The segmented viruses can be

with the BOAR mnemonic. remembered with the BOAR
mnemonic.
39 of 584 5/12/2018, 9:26 PM

C. Sinensis is treated with praziquantal
C. Difficile infection forms a

C. Difficile infection forms a yellowish
yellowish grey exudate pseudo-
grey exudate pseudo-membrane covering
membrane covering the colonic
the colonic mucosa
mucosa called pseudomembranous
called pseudomembranous colitis.
colitis.
C. diptheriae cardiovascular complications

C. difficile infection is diagnosed are characterized by myocarditis,
by detecting toxins in stool. C. diptheria can cause arrythmias and heart block.
demyelination, producting nerve
deficits in the posterior oropharynx.
lethal effect
C. perfringes may cause anemia by RBC C. tetani and Clostridium botulinum C. tetani causes spastic paralysis.
hemolysis. have a similar MOA.
C. botulinum is flaccid
both Cleave SNARE proteins,
inhibiting release. GABA and
glycine for tetanus and Ach for
Clostridium
40 of 584 5/12/2018, 9:26 PM

C. tetani endospores may be transmitted

through soil, rusty nails and barbed wire. C. tetani releases an exotoxin
C. tetani releases an exotoxin
called tetanospasmin (tetanus called tetanospasmin (tetanus toxin).
toxin).
CMV infections are common with a CD4+

count of?
<50
What guanosine analog can be used to

C. trachomatis (Serotype A-C) infection is C. trachomatis (Serotype
treat?
transmitted by hand to eye contact or via A-C) infection is transmitted
fomites. by hand to eye contact or via
Ganciclovir
fomites.
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CMV is reactivated
by immunosuppresion (i.e.
transplant patients, HIV).
CMV mononucleosis is characterized by a

negative monospot IgG test.
"No mo spots"
CMV is a dsDNA virus that replicates in
the nucleus.
The C in TORCHeS infections.
CN V1 is involved in herpes zoster

CMV retinits is characterized by opthalmicus.
CMV remains latent in mononuclear "pizza pie" appearance on
leukocytes. fundoscopy.
Lymphocytes, monocytes, B cells, T cells,

and MΦs)
CNS complications of foscarnet? CNS involvement of reactivated CNS involvement of reactivated

tuberculosis includes a cavitary tuberculosis includes a cavitary lesion or
Seizures lesion or tuberculoma. tuberculoma.
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Calicivirus is a naked positive-sense

ssRNA virus which produces one long
polyprotein which is cleaved by viral
proteases.
CNS toxoplasmosis can be differentiated

from CNS lymphoma by brain biopsy.
CSF shows no organisms or added
glucose in lumbar puncture of
Toxoplasma encephalitis may cause single
patient with aseptic meningitis.
brain lesion but this more likely indicates
lymphoma. Toxo tends to cause multiple
lesions.
Calicivirus is a naked positive-sense Calicivirus is a naked positive- California, Congo, and Hantavirus belong
ssRNA virus which produces one long sense ssRNA virus which produces to the bunyavirus family.
polyprotein which is cleaved by viral one long polyprotein which is
proteases. cleaved by viral proteases.
43 of 584 5/12/2018, 9:26 PM

Campylobacter infections can cause

reactive arthritis. Campylobacter is a comma- Campylobacter is gram-negative
shaped rod.
Reactive arthritis (Reiter's syndrome) is
one of the seronegative Campy is 1 of 3 comma shaped
spondyloarthropathies (HLA-B27) which rods (spiral)
can be precipitated by a Campy infection
Campylobacter transmission is technically

fecal-oral.
Campylobacter reservoir is
Campylobacter is oxidase-positive. typically poultry. Campylobacter's main reservoir is the
intestinal tract of other animals - guts
perforated and contaminates meat
In the intestines and spreads to

meat through contamination via
punctured intestines
44 of 584 5/12/2018, 9:26 PM

Campylobacter typically causes bloody Can the BCG vaccine for tuberculosis
Campylobactor Jejuni is thermo-
diarrhea. causes a false positive PPD skin test?
philic.
VFs: Cytolethal Distending toxin (CDT) Yes
It prefers to grow in the heat in
(contributes to host cell apoptosis)
temperatures around 42C
if positive it's a type IV HSR
Candida albicans forms germ tubes (true

hyphae) at 37 degrees celcius
Candida albicans is in the yeast

form with pseudo-hyphae
formation at 20 degrees C
Candida albicans is normal flora of the GI

tract, including the oral cavity.
present in up to 40% of population - no
problems in immunocompetent
Candida albicans is dimorphic**, meaning Candidal endocarditis is Candidal endocarditis is commonly seen
it assumes different forms depending on commonly seen in drug users in drug users
the temperature of its environment candida albicans is found growing candida albicans is found growing in
goes against the adage, "mold in the cold, in certain types of heroin - IV certain types of heroin - IV injection can
yeast in the heat", however injection can allow candida allow candida albicans to seed the heart
albicans to seed the heart valves - valves - first valve is encounters is the
forms pseudohyphae and budding yeast at first valve is encounters is the tricuspid valve
20 degrees C tricuspid valve
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germ tubes (hyphae) at 37 degrees C
Carbapenem that is inactivated by

dehydropeptidases in the renal tubule, thus Carbapenem β-lactamase sensitivity
needs to be administered with cilastatin Carbapenems are what class of
Resistant to β-lactamase antibiotics? β-lactams
Imipenem
Cardiovascular adverse effects of Caseating granulomas with central Caseating granulomas with central
fluoroquinolones necrosis & Langerhans giant cells necrosis & Langerhans giant cells
(arrow) are characteristic of (arrow) are characteristic of secondary
Prolonged QT interval secondary tuberculosis. tuberculosis.
46 of 584 5/12/2018, 9:26 PM

Cat Scratch Disease is characterized Catch-scratch disease causes

by regional lymphadenopathy (commonly granulomatous-microabsecces most
cervical and axillary) clinically. commonly in the axillary and
cervical lymph nodes. Cefazolin = 1st generation cephalosporin
Look for distal cat scratches/infection with small papule develops 5-10 days
proximal lymphadenopathy after scratch, progresses to pustule,
then to lymphadenopathy as
immune response limits bacterial
growth.
Cefepime = 4th generation cephalosporin Cefotetan = 2nd generation cephalosporin

Cefotaxime = 3rd generation
cephalosporin
Cefoxitin = 2nd generation cephalosporin Ceftaroline = 5th generation Ceftazidime = 3rd generation
cephalosporin cephalosporin
47 of 584 5/12/2018, 9:26 PM

Ceftriaxone is the DOC for what Cefuroxime = 2nd generation

STD? cephalosporin
Ceftriaxone = 3rd generation cephalosporin
Gonorrhea
Cell wall synthesis inhibitor that

can be used to treat S. epidermidis
infections (endocarditis, hip
implants)
Cell wall synthesis inhibitor that can be
Cell wall synthesis inhibitor that can cause
used to treat C. difficile Vancomycin
ototoxicity
pseudomembranous colitis
Vancomycin
Oral vancomycin
assoc. with
48 of 584 5/12/2018, 9:26 PM

Cell wall synthesis inhibitor that can

produce DRESS syndrome
Cell wall synthesis inhibitor used to treat
Vancomycin
Cell wall synthesis inhibitor used to MRSA
treat MRSA osteomyelitis
Vancomycin
DRESS: drug reaction with eosinophilia Vancomycin
and systemic symptoms
-Allopurinol, anticonvulsants, antibiotics,
sulfa drugs
Cell wall synthesis inhibitors used in the

treatment of S. aureus folliculitis, abscesses
Anti-staph penicillins (nafcillin, oxacillin,

etc.)
Cephalexin = 1st generation cephalosporin
Cellulitis is caused by what (2)

organisms? S. aureus, S. pyogenes
1st generation cephalosporins
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Cephalosporin that can be used to treat Cephalosporin β-lactamase Cephalosporins are what class of
disseminated Lyme disease? susceptibilty antibiotic? β-lactam
Ceftriaxone Resistant
Chicken Pox in kids and adults is

characterized by pneumonia and
encephalitis
Cervicitis caused by Trichomonas
Vaginalis is described as a "strawberry Characteristic petechial rash in
cervix" meningococcemia
Causes vaginitis, cervicitis (strawberry due indicates thrombocytopenia.
to capillary dilation)
Chickenpox is characterized by lesions that Childhood rubella is characterized Children with roseola can develop febrile
are in different stage(s). by postauricular and occipital seizures.
50 of 584 5/12/2018, 9:26 PM

Vs smallpox which are the same stage.
lymphadenopathy.
Chlamydia species are obligate

Chlamydia infections are definitively Chlamydia species are obligate intracellular organisms because they can't
diagnosed via a nucleic-acid intracellular organisms because make their own ATP.
amplification test. they can't make their own ATP.
Chlamydia species can be visualized with Chlamydia species Chlamydia species demonstrate poor gram
a Giemsa stain. demonstrate poor gram staining, staining, due to lack of muramic acid in
due to lack of muramic acid in their cell wall.
their cell wall.
Chlamydia species lack muramic acid, Chlamydia species lack muramic Chlamydia trachomatis (serotype A-C) is
which is a component of the peptidoglycan acid, which is a component of the leading cause of blindness worldwide
cell wall. the peptidoglycan cell wall. (most commonly Africa).
Important because B-lactams are rendered Important because B-lactams are
ineffective. rendered ineffective.
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Chlamydia trachomatis can

Chlamydia trachomatis can cause Reiter's
cause Reiter's Syndrome, which is
Chlamydia trachomatis (serotype A-C) is Syndrome, which is an
an autoimmune arthritis
the leading cause of blindness worldwide autoimmune arthritis characterized by
characterized by antibodies
(most commonly Africa). antibodies attacking joints. Most
attacking joints. Most commonly
commonly affecting the sacroiliac joint or
affecting the sacroiliac joint or
the knee.
the knee.
"Can't See, Can't pee, Can't bend my knee"
"Can't See, Can't pee, Can't bend
my knee"
Chlamydia trachomatis is divided into Chlamydia trachomatis is divided Chlamydia trachomatis is divided into
three serotypes: A-C (Blindness), D-K into three serotypes: A-C three serotypes: A-C (Blindness), D-K
(STI), and L1-L3 (LGV). (Blindness), D-K (STI), and L1-L3 (STI), and L1-L3 (LGV).
(LGV).
Chlamydia trachomatis serotype

D-K causes an STI that is characterized Chlamydia trachomatis serotype Chlamydia pneumoniae causes atypical
by watery discharge. D-K causes an STI that is pneumonia, especially in the elderly.
characterized by watery discharge.
Chlamydia pneumoniae causes atypical Chlamydophila psittaci is Chlamydophila psittaci is transmitted

pneumonia, especially in the elderly. transmitted by bird droppings and by bird droppings and causes atypical
causes atypical pneumonia. pneumonia.
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Cholera attaches to cells by fimbrae.
Chloroquine adverse effects include Chloroquine adverse effects

retinopathy and pruritis (especially in include retinopathy and pruritis
dark-skinned individuals) (especially in dark-skinned
individuals)
Cholera grows on TCBS agar which is Cholera has a high-ID50.

an alkaline medium Cholera grows on TCBS agar
which is an alkaline medium
Cholera is acid-labile, therefore requires a

large-infectious dose.
Cholera is a gram-negative comma-shaped Cholera is a gram-negative comma-

organism. shaped organism.
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Cholera is transmitted through fecal-oral

Cholera is transmitted through
route or ingestion of raw seafood.
fecal-oral route or ingestion of raw
Cholera is oxidase-positive. seafood.
Oysters on the table

Oysters on the table
Chronic Histoplasmosis can look similar

to TB, with cavitary lesions in the upper
lobes of the lungs and calcified nodules
with fibrotic scarring
in general, systemic fungi are
asymptomatic - severe infections (for
instance, those in immunocompromised
patients, result in major symptoms)
Chronic Hep C complications are
characterized by Cirrhosis and calcifications common in the hilar regions
Chronic infection with C.
Hepatocellular Carcinoma.
trachomatis (A-C) causes follicular
conjunctivitis.
Termed "Trachoma"
Chronic Histoplasmosis can look similar Chronic Blastomycosis may cause Chronic Blastomycosis may cause
to TB, with cavitary lesions in the upper Osteomyelitis Osteomyelitis
lobes of the lungs and calcified nodules dissemination from lungs dissemination from lungs commonly
with fibrotic scarring commonly occurs to skin and bone occurs to skin and bone
in general, systemic fungi are
asymptomatic - severe infections (for
instance, those in immunocompromised
patients, result in major symptoms)
54 of 584 5/12/2018, 9:26 PM

calcifications common in the hilar regions
Clindamycin MOA
Cidofovir should be coadministered with
Blocks translocation at 50s ribosomal
what drug to prevent renal excretion?
subunit
Clarithromycin = macrolide
Probenecid
In the Lincomycin family.
Clinical use of Griseofulvin Clinical uses of cidofovir Clostridium perfringens is a spore-forming

gram + bacilli that can be treated by what
Dermatophytosis Acyclovir/ganciclovir resistant cell wall synthesis inhibitor?
HSV, CMV, VZV
Penicillin
Tinea capitis = head, scalp

Crusis = inguinal area (crura attaches
base of penis to ischial pubic rami)
Pedis = athletes foot
55 of 584 5/12/2018, 9:26 PM

Clostridium perfringens is a spore-forming

gram + bacilli that can be treated by what
cell wall synthesis inhibitor?
Penicillin
What other drug is used in the primary

treatment of Clostridium perfringens?
Clostridium tetani is an obligate
Clindamycin anaerobe. Coccidioidomycosis can also cause
erythema nodosum, characterized
by painful red nodules, typically on the
shins
Cocci is more associated than histo, but use
the regions of the U.S. to distinguish b/t the
two
Coccidioidomycosis is a dimorphic fungus, Coccidioidomycosis spherules of Colorado Tick Virus is caused by a
56 of 584 5/12/2018, 9:26 PM

as its form changes based on the endospores are larger than RBCs
temperature of its environment
does NOT follow the adage "mold in cold,
yeast in heat"
mold in cold, spherule of endospores in the
heat, which rupture and release their
endospores Reovirus.
Family: Coltivirus
No rash assoc. with
Coccidioides spherule containing

endospores.
Common Hep B complications are Common Hep B complications are Common Hep B complications are
characterized by rash, arthritis characterized by rash, arthritis characterized by rash, arthritis
and polyarteritis nodosa (PAN). and polyarteritis nodosa (PAN). and polyarteritis nodosa (PAN).
PAN is characterized by beads on a string PAN is characterized by beads on a PAN is characterized by beads on a string
appearance. string appearance. appearance.
57 of 584 5/12/2018, 9:26 PM

Complication seen in infants with Congenital CMV auditory complications

the use of chloramphenicol are characterized by sensorineural hearing
loss.
Gray baby syndrome
Skin turns gray; lack of UDP-

Common etiologies of TSS? Leaving
glucuronyltransferase, which is
gauze, sutures, or tampons in for too long
required for metabolism/excretion
of the antibiotic
Congenital toxoplasmosis can result in a

classic triad of intracranial calcifications,
hydrocephalus and chorioretinitis +/- a
"blueberry muffin rash
Congenital CMV may cause spontaneous

abortions due to Hydrops fetalis. Congenital CMV symptoms are
characterized by thrombocytopenia
(blueberry muffin rash),
sensorineural hearing loss,
Congenital CMV disease may include periventricular calcifications and
pneumonitis, enteritis, and myocarditis in ventriculomegaly.
utero even with Ganciclover therapy.
May also cause deafness in babies.

Note: Toxoplasmosis may cause flu like
symptoms in healthy people but is mostly
asymptomatic.
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Congenital toxoplasmosis can result in a Congenital varicella syndrome Copepods contain dracunculus medinensis
classic triad of intracranial calcifications, = limb hypoplasia, cutaneous larvae.
hydrocephalus and chorioretinitis +/- a dermatomal scarring, blindness They are the intermediate hosts of the
"blueberry muffin rash parasite.
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May also cause deafness in babies.

Note: Toxoplasmosis may cause flu like
symptoms in healthy people but is mostly
asymptomatic.
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Coronavirus is the only (+)-RNA that

is helical.
Corona and SARS belong to Coronavirus

family.
Coronavirus can cause the common

cold like rhinovirus.
No vaccine. Self limiting, do not

give Abx. Supportive Tx of Sx,
reinfection can occur.
Watery to mucopurulent nasal
discharge and congestion.
Cowdry Type A bodies are seen in HSV

and VZV.
Cortimoxazole = combination of TMP-

SMX
Corynebacterium Dipetheria is
DOC in uncomplicated UTIs, preventing/tx transmitted by respiratory droplets.
of PCP, DOC for nocardia, alternative tx
for toxoplasmosis
Cowpox can be transmitted with contact Coxiella burnetii can cause Coxiella burnetii can cause atypical
through infected cow udders. atypical pneumonia with headache, pneumonia with headache, fever and
fever and potentially hepatitis. potentially hepatitis.
Able to be eradicated d/t only 1 serotype Can be prevented by vaccinating Can be prevented by vaccinating vets or
(hence vaccine), no carrier state, and no vets or pasteurising milk. pasteurising milk.
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animal reservoir
Coxiella burnetii can cause atypical Coxiella burnetii is transmitted to humans

pneumonia with headache, fever and via aerosol transmission.
potentially hepatitis. spore like structure that comes in animal
droppings.
Coxiella burnetii is a gram-
Can be prevented by vaccinating vets or
negative bacteria that does not
pasteurising milk.
cause a rash.
62 of 584 5/12/2018, 9:26 PM

Coxiella burnetti is a common cause of

culture negative endocarditis
Coxiella infections are often seen Coxiella infections are often seen
Look for Mitral Valve related murmurs,
in farmers as endospores are in farmers as endospores are inhaled as
Roth Spots (A), Osler Nodes (B), or
inhaled as aerosols from cattle / aerosols from cattle / sheep amniotic fluid
Janeway Lesions (C)
sheep amniotic fluid
63 of 584 5/12/2018, 9:26 PM

Coxsackie B cardiac complications are Coxsackie B virus pulmonary

characterized by dilated cardiomyopathy complication is characterized by
and myocarditis. pleurodynia (Bornholm's
Disease/Devil's Grip). Coxsackie virus is characterized by a red
vesicular rash.
Rash from viral replication within
the epidermal cells resulting in tissue
Unilateral, sharp pain in the chest, damage. Rash occasionally occur on
difficulty breathing buttocks (response to
loose stools). Usually affects <10yo
(usually 2wks-3yrs), but can spread to
family members.
Coxsackievirus is a naked positive-sense

ssRNA virus of the Picorna family. Coxsackievirus is a naked positive-
sense ssRNA virus of the Picorna
family.
Croup is caused by Parainfluenza.
Aka laryngotracheobronchitis
Cryoglobulins are seen with Hepatitis C Cryptococci enter the body via inhalation,
infection. therefore the primary infection resides in
Cryptococcal meningoencephalitis the lungs
has an indolent (slow, lazy) course
that occurs over a period of one to
two weeks. The most common
symptoms are fever, malaise, and
headache.
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Cryptosporidia are uni-cellular, partially

acid-fast staining organisms
Cryptococcus is an opportunistic infection,

with most symptoms occuring in immuno-
compromised patients
(ie: HIV+ patients, those with
malignancies, high-dose steroid therapy,
etc.)
Cryptococcus neoformans (along

with other fungi) can be cultured
on Sabouraud agar.
Sab is a fun-guy!
Cryptosporidium is highly resistant to Cryptosporidium is passed via Cryptosporidium oocysts can be visualized
chlorination, therefore filtration is used to infectious cysts present in stool with an Acid-Fast stain
remove the parasite from water
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***only parasite we learn about through

sketchy that stains acid fast
Cutaneous complication of carbapenems
Skin rash
Cryptosporidium spp infections are often Cryptosporidium oocysts) are often

found in HIV+ patients with CD4 cell transmitted via {{c1
counts < 100/mm3 Prevent by filtering city water
supplies
Cutaneous complication of vancomycin
Diffuse flushing (Red-man syndrome) due

to histamine release Cutaneous involvement in
Cutaneous involvement in blastomycosis
blastomycosis commonly manifests
commonly manifests as a verrucous lesion
as a verrucous lesion with
with irregular borders that may mimic
irregular borders that may mimic
squamous cell carcinoma.
squamous cell carcinoma.
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DDX for Rubella and Measles

childhood exanthems:
Rubella rash: Begins at head and
moves down with postauricular
lymphadenopathy
Measles: Begins at head and moves
down; preceded by cough, coryza, DOC for C. difficile pseudomembranous
conjunctivitis, and Koplik spots colitis
DDX for Colorado Tick Virus (Reovirus)
Metronidazole
vs. RMSF (Rickettsia): No rash assoc. with
Colorado Tick Virus
also treated by oral vancomycin
DOC for ampicillin-resistant H. influenzae DOC for extended spectrum DOC for gonorrhea
β-lactamase producing gram
Ceftriaxone negatives Ceftriaxone
Carbapenems (imipenem)
67 of 584 5/12/2018, 9:26 PM

Dapsone inhibits dihydropteroate synthase

same mechanism as sulfonamides, but
structurally distinct
ultimately inhibits folate synthesis
Delavirdine = NNRTI
Daptomycin has a similar spectrum
to vancomycin except it can treat?
VRE and VR-S. aureus
Deltavirus is also known as Hepatitis D. Dengue fever hematological Dengue fever hematological complications
complications are characterized are characterized by hemorrhagic fever
by hemorrhagic fever and thrombocytopenia.
and thrombocytopenia.
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Diabetic patients are at increase risk of

Dengue fever is characterized by renal
osteomyelitis from Pseudomonas infection.
failure which may lead to septic shock and
even death. Dermatophytes cause Tinea lesions
that are often pruritic (itchy) Foot ulcers/injury from peripheral
neuropathy --> infection
treatment is supportive care and hydration.
Didanosine (ddl) = NRTI Didanosine is an NRTI most

commonly associated with which
adverse effect?
Pancreatitis
Differentiation of Entamoeba
histolytica to the trophozoite form in the
colon allows the parasite to enter the portal
circulation and, eventually, the liver
Diffuse molluscum contagiosum in adults Dihydropteroate synthase is Dilated cardiomyopathy and myocarditis
69 of 584 5/12/2018, 9:26 PM

suggests an HIV infection.

inhibited by what group of
antimicrobials?
Flesh colored umbilicated skin lesions
Sulfonamides
are complications of infection with what
RNA virus? Cox B
Diptheria is an inactivated pertussis toxoid

vaccine.
Dissemination of Histoplasmosis
to the liver and spleen occurs
in immunocompromised patients
Dissemination of blastomycosis commonly
occurs in immunocompromised patients
when in the lungs, is considered a local
infection
Dissemination of Histoplasmosis in
immunocompromised patients to
Dissemination of Blastomycosis from the the liver and spleen results
lungs is most likely to occur in the skin Dissemination of Blastomycosis
from the lungs is most likely to in hepatosplenomegaly, with gross
and bone pathology of these organs
occur in the skin and bone
showing calcifications
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Dissemination of Histoplasmosis in
immunocompromised patients to Dissemination of Histoplasmosis in
Dissemination of paracoccidioidomycosis
the liver and spleen results immunocompromised patients to
can result in cervical, axillary, and inguinal
in hepatosplenomegaly, with gross the liver and spleen results
lymphadenopathy
pathology of these organs in hepatosplenomegaly, with gross
showing calcifications pathology of these organs
showing calcifications
Does Coxiella burnetii cause a rash?
No
Dissemination of paracoccidioidomycosis
can result in cervical, axillary, and inguinal
lymphadenopathy Disulfiram-like reaction is an
adverse effect of what β-lactam
antibiotics?
Cephalosporin
Does Pneumocystis pneumonia have a Does the trophozoite form

productive cough? of Entamoeba histolytica present
with bloody diarrhea? Does the trophozoite form of Giardia
invade the intestinal wall?
No
Yes
No, just attaches
no productive cough (unlike bacterial
pneumonias)
therefore, there is no bloody diarrhea
no consolidations on chest xray (unlike
bacterial pneumonias)
71 of 584 5/12/2018, 9:26 PM

Drug of choice for Mucor
Amphotericin B
Drancuculus medinensis is also

characterized by peripheral
Does the trophozoite form of Giardia eosinophilia.
present with bloody diarrhea?
No
attaches but does not invade the intestinal

wall
Drug of choice for candidal infections of

all types? Drug of choice for invasive Drug of choice treatment of
aspergillosis dermatophytosis and method of
Fluconazole
administration?
Voriconazole
Topical Terbinafine
What else can this drug treat?
esophageal, oropharyngeal, vulvovaginal,
urinary candidiasis, candidemia Some Candida infections
Griseofulvin is oral treatment (and used
when topical agents are resistant)
Can also use ketoconazole, fluconazole,
itraconazole, clotrimazole, miconazole
72 of 584 5/12/2018, 9:26 PM

Drug reactions with tetracycline use in

children
Tooth discoloration, inhibition of long-

bone growth E. coli can produce neonatal meningitis
E. coli can produce neonatal
meningitis only if it has the K only if it has the K antigen.
antigen.
Remember, it chelates with Ca2+
E6 encoded by HPV promotes proteolysis

of p53.
E. coli capsule antigen is K antigen. E. coli will stain pink on

MacConkey because it is a lactose
fermentor. 6 before 7, P before R (E6 E7 P53 Rb)
E7 encoded by HPV promotes proteolysis EBV can cause splenomegaly due EBV can cause splenomegaly due to T-cell
of Rb. to T-cell proliferation. proliferation.
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EBV envelope glycoprotein binds CD21 to

infect B-cells.
EBV is primarily transmitted

Also called CR2, C3d complement receptor through saliva (i.e. kissing).
EBV is a dsDNA virus.
EBV mono patients treated with

amoxicillin/ampicillin will develop a
maculopapular rash if treated for S.
pharyngitis.
EBV remains latent in B-cells. EBV usually causes tender posterior
cervical lymphadenopathy.
ETEC is transmitted via contaminated Early symptoms of Early symptoms of botulism include ptosis
water. botulism include ptosis and diplopia.
and diplopia.
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Ebola and Marburg both cause

hemorrhagic fever, hypovolemic Ebola and Marburg both cause
shock, and end-organ failure within hemorrhagic fever, hypovolemic shock,
days. and end-organ failure within days.
Hemorrhagic Fever Hemorrhagic Fever

Eastern Equine Encephalitis and Western Initially: Fever, pharyngitis, Initially: Fever, pharyngitis, Systemic S/S,
EE belong to toga-virus family. Systemic S/S, Maculopapular rash Maculopapular rash (not always seen-
(not always seen-appears 5 days appears 5 days after onset), conjunctival
after onset), conjunctival injection followed by profuse vomiting and
injection followed by profuse diarrhea (~ 2 days after fever begins)
vomiting and diarrhea (~ 2 days
after fever begins) Later: Severe bleeding and coagulation
abnormalities, including
Later: Severe bleeding and gastrointestinal bleeding, rash, and a
coagulation abnormalities, range of hematological irregularities
including gastrointestinal bleeding, (hemorrhage seen in 30-50%)
rash, and a range of hematological
irregularities (hemorrhage seen in
30-50%)
Ebola and Marburg both cause Echinocandins inhibit the synthesis of

hemorrhagic fever, hypovolemic shock, β-1,3-glucan in the fungal cell wall.
and end-organ failure within days.
Ebola/Marburg hemorrhagic fever
are part of Filo-virus family.
Hemorrhagic Fever
Initially: Fever, pharyngitis, Systemic S/S,
Maculopapular rash (not always seen-
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appears 5 days after onset), conjunctival

injection followed by profuse vomiting and
diarrhea (~ 2 days after fever begins)
Later: Severe bleeding and coagulation

abnormalities, including
gastrointestinal bleeding, rash, and a
range of hematological irregularities
(hemorrhage seen in 30-50%)
Efavirenz = NNRTI Emtricitabine (FTC) = NRTI

Endemic relapsing fever is caused by tick
borne borrelia hermsii and borrelia
duttonii.
(In sketchy book)
Enfuvirtide binds to what viral

Entamoeba histolytica can cause intestinal
glycoprotein, preventing viral entry
Endemic relapsing fever is caused by tick amebiasis, with ulcerations along the
of HIV into CD4+ T-cells?
borne borrelia hermsii and borrelia walls of the colon and bloody diarrhea
duttonii. gp41
(In sketchy book) Patient will also present with RUQ pain
Entamoeba histolytica can cause intestinal Entamoeba histolytica can cause Entamoeba histolytica can cause liver
amebiasis, with ulcerations along the intestinal amebiasis, with abscesses, which are described as having
walls of the colon and bloody diarrhea ulcerations along the walls of the "anchovy paste" consistency
colon and bloody diarrhea
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Patient will also present with RUQ pain

Patient will also present with RUQ
pain
Enterococcus can grow in bile (bile

resistant).
Entamoeba histolytica can cause liver
abscesses, which are described as having
"anchovy paste" consistency
Enterobius vermicularis typically

affects children
Children have less inhibitions of
putting finger in mouth.
Env encoded surface proteins are

first sent to what organelle?
Endoplasmic reticulum
Enterococcus is characterized by UTI, Eosinophilic inclusions seen in Purkinje

endocarditis and biliary tree infection. Cells: Negri Bodies (rabies)
Do U <3 Trees?
Erythromycin can be used to treat neonatal Erythromycin can be used to treat Erythromycin is a macrolide which
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inhibits translocation along the mRNA by

conjunctivitis caused by what organism? binding 50s ribosomal subunit.
Neisseria gonorrhea, Chlamydia

neonatal conjunctivitis caused by
trachomatis
which organisms?
azithromycin has the same MOA.
Neisseria gonorrhea, Chlamydia
trachomatis
Exfoliative dermatitis (Stevens-

Johnson syndrome) is an adverse Exotoxin B from C. difficile disrupts the
Ethambutol = antimycobacterial
effect of what folate synthesis cytoskeleton by depolymerizing actin.
inhibitor?
Sulfonamides
Exotoxins associated with Staph.

aereus include exfoliative toxin,
TSST and enterotoxin. Explain why Rhinovirus, unlike the other
Picorna viruses, does not undergo fecal-
Exotoxin B from C. difficile disrupts the (Associated w/MRSA/VRE) Panton- oral transmission? Because it is acid labile
cytoskeleton by depolymerizing actin. Valentine toxin (PVL): coded on a
phage, causes hemolysis, abscess,
hemorrhagic/necrotizing Thus, acidity of the stomach will neutralize
pneumonia, and bacterial it
endocarditis.
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Extended-spectrum penicillins used to treat

Pseudomonas infections
Factor V used in chocholate Factor X used in chocolate agar is also

Piperacillin, ticarcillin
agar is also known known as Hematin.
as Nicotinamide.
Filovirus is an enveloped negative- Filovirus is an enveloped negative-sense

sense ssRNA virus with a helical ssRNA virus with a helical capsid.
capsid.
Filovirus (Ebola/Marburg) can have

possible transmission through primates.
That is one of the theories as to how Ebola

began or was able to be perpetuated was
through eating primates
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Filovirus is an enveloped negative-sense

ssRNA virus with a helical capsid.
Filoviruses consist of Ebola/Marburg

Hemorrhagic Fever.
Filoviruses (Ebola/Marburg) is
transmitted to healthcare workers
through bodily fluids.
First Aid 2017 Microbiology -

First Aid 2017 Microbiology - Gram First Aid 2017 Microbiology - Gram
Gram Negative Bacilli : Prevotella
Negative Bacilli : Prevotella Negative Bacilli : Prevotella
Prevotella are a group of
Prevotella are a group of gram negative Prevotella is associated with nosocomial
gram negative anaerobes that can
anaerobes that can be a source of infection infections, particularly surgical wound
be a source of infection in
in alcoholics sites, decubitus ulcers, and drains
alcoholics
First Aid 2017 Microbiology - Gram First Aid 2017 Microbiology - First Aid 2017 Microbiology - Gram
Negative Bacilli : Prevotella Gram Negative Bacilli : Prevotella Negative Bacilli : Prevotella
Prevotella is associated with nosocomial Prevotella is associated with Prevotella is associated with lung
infections, particularly surgical wound nosocomial infections, particularly abscesses in alcoholics
sites, decubitus ulcers, and drains surgical wound sites, decubitus
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ulcers, and drains - this is due to aspiration of oropharyngeal

contents (pass out, vomit, aspirate)
First Aid Antiparasites:
Clonorchis sinensis can be treated

with Praziquantel
First Aid 2017 Microbiology - Gram First Aid 2017 Microbiology -

Negative Bacilli : Prevotella Gram Negative Bacilli : Prevotella
Prevotella is associated with lung Treat Prevotella with clindamycin

abscesses in alcoholics
It is an "above the belt" anaerobic
- this is due to aspiration of oropharyngeal infection (therefore use
contents (pass out, vomit, aspirate) clindamycin over metronidazole)
First Aid Antiparasites:
Paragonimus westermani is a trematode

that can be treated with praziquantel. First Aid
Microbiology: Acinetobacter First Aid Microbiology: Acinetobacter
baumannii baumannii
Acinetobacter baumannii is a gram- Acinetobacter baumannii is a gram-

negative bacilli that is oxidase- negative bacilli that is oxidase-positive and
positive and exhibits twitching exhibits twitching motility that is
motility that is associated with associated with severe hospital associated
severe hospital associated infections
infections
First Aid
First Aid Microbiology: Acinetobacter Microbiology: Acinetobacter First Aid Microbiology: Acinetobacter
baumannii baumannii baumannii
Acinetobacter baumannii is a gram- Acinetobacter baumannii is a gram- Acinetobacter baumannii is a gram-

negative bacilli that is oxidase-positive and negative bacilli that is oxidase- negative bacilli that is oxidase-positive and
exhibits twitching motility that is positive and exhibits twitching exhibits twitching motility that is
associated with severe hospital associated motility that is associated with associated with severe hospital associated
infections severe hospital associated infections
infections
First Aid Microbiology: Acinetobacter First Aid First Aid Microbiology: Acinetobacter
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Microbiology: Acinetobacter
baumannii
baumannii
baumannii
Endotrachea intubation puts you at risk
Mechanical ventilation puts you at
for nosocomial pneumonia by P. Multidrug-resistant Acinetobacter
risk for nosocomial pneumonia by
aeruginosa, Klebsiella, Acinetobacter, S. baumannii is treated with polymyxins B
P. aeruginosa, Klebsiella,
aureus and E (colistin)
Acinetobacter, S aureus
will see new infiltrate on CXR, ↑ sputum

will see new infiltrate on CXR, ↑
production
sputum production
First Aid Microbiology: Anaplasma First Aid Microbiology: Anaplasma First Aid Microbiology: Anaplasma
Anaplasma does not Gram stain well Anaplasma is a Gram-negative Anaplasma is a Gram-negative
because it is primarily an intracellular pleomorphic bacterium pleomorphic bacterium
pathogen no cell wall; does not Gram stain no cell wall; does not Gram stain well
when it does Gram stain, it is Gram- well (primarily intracellular) (primarily intracellular)
First Aid Microbiology: Anaplasma

First Aid Microbiology: Anaplasma First Aid Microbiology: Anaplasma
Human Granulocytic
Human Granulocytic Anaplasmosis manifests with Human Granulocytic
Anaplasmosis manifests with severe severe granulocytopenia, with Anaplasmosis manifests with severe
granulocytopenia, with systemic signs of systemic signs of diarrhea, weight granulocytopenia, with systemic signs of
diarrhea, weight loss, and photophobia loss, and photophobia diarrhea, weight loss, and photophobia
severe complications include respiratory severe complications include severe complications include respiratory
failure and kidney failure respiratory failure and kidney failure and kidney failure
failure
First Aid Microbiology: Anaplasma First Aid Microbiology: Anaplasma
Morulae in granulocytes indicates Morulae in granulocytes indicates

anaplasmosis anaplasmosis
morulae are mulberry-like morulae are mulberry-like inclusions
First Aid Microbiology: Anaplasma inclusions
Human Granulocytic
Anaplasmosis manifests with severe
granulocytopenia, with systemic signs of
diarrhea, weight loss, and photophobia
severe complications include respiratory

failure and kidney failure
First Aid Microbiology: Anaplasma First Aid Microbiology: First Aid Microbiology: Antimicrobial
Antimicrobial Concepts Concepts
Ixodes deer tick acts as the vector for
Anaplasma Irreversible inhibition of growth Lowest concentration of an antibiotic that
leads to anaplasmosis prevents visible growth of bacteria
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Minimal inhibitory concentration
Bacteriocidal
First Aid Microbiology:

Antimicrobials to avoid in First Aid Microbiology: Antimicrobials to
pregnancy avoid in pregnancy
The IV use of the antibacterial The IV use of the antibacterial

Chloramphenicol used during Chloramphenicol used during pregnancy
pregnancy is associated with gray is associated with gray baby syndrome
baby syndrome manifesting in manifesting in newborn infants because
First Aid Microbiology: Antimicrobial newborn infants because they do they do not have adequate levels of UDP-
Concepts not have adequate levels of UDP- glucuronyl transferase synthesized in the
glucuronyl transferase liver yet
Reversible inhibition of growth synthesized in the liver yet
Therefore the drug remains unmetabolized,
Bacteriostatic Therefore the drug remains resulting in hypotension and cyanosis,
unmetabolized, resulting in among other effects
hypotension and cyanosis, among
other effects
First Aid Microbiology: Antimicrobials to

avoid in pregnancy
The IV use of the antibacterial

Chloramphenicol used during pregnancy
is associated with gray baby syndrome
manifesting in newborn infants because First Aid Microbiology: Antimicrobials to
Antimicrobials to avoid in
they do not have adequate levels of UDP- avoid in pregnancy
pregnancy
glucuronyl transferase synthesized in the
liver yet The antifungal Griseofulvin induces
The antifungal Griseofulvin
aneuploidy and therefore is
induces aneuploidy and therefore
Therefore the drug remains unmetabolized, contraindicated in pregnancy
is contraindicated in pregnancy
resulting in hypotension and cyanosis,
among other effects
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First Aid Microbiology: Antimicrobials to Antimicrobials to avoid in
avoid in pregnancy
avoid in pregnancy pregnancy
The antimicrobial class fluoroquinolones
The antimicrobial class aminoglycosides is The antimicrobial class
can cause cartilage damage when taken
known for causing the teratogenic effect of aminoglycosides is known for
during pregnancy
congenital hearing loss causing the teratogenic effect of
congenital hearing loss

pregnancy
avoid in pregnancy
The antimicrobial class
avoid in pregnancy The antimicrobial class sulfonamides can
sulfonamides can cause
cause kernicterus when taken during
kernicterus when taken during
The antimicrobial class fluoroquinolones pregnancy
pregnancy
can cause cartilage damage when taken Kernicterus is a bilirubin-induced brain
Kernicterus is a bilirubin-induced
during pregnancy dysfunction that results in spasmodic
brain dysfunction that results in
torticollis, opisthotonus, and Parinaud's
spasmodic torticollis,
Syndrome (Sunset Sign) (google that shit
opisthotonus, and Parinaud's
fam)
Syndrome (Sunset Sign) (google
that shit fam)

First Aid Microbiology: Antimicrobials to First Aid Microbiology: Antimicrobials to
pregnancy
avoid in pregnancy avoid in pregnancy
The antimicrobial class
The antimicrobial class tetracyclines can The antimicrobial class tetracyclines can
tetracyclines can cause discolored
cause discolored teeth and inhibition of cause discolored teeth and inhibition of
teeth and inhibition of bone
bone growth when taken during pregnancy bone growth when taken during pregnancy
growth when taken during
pregnancy

First Aid Microbiology: Antimicrobials to Antimicrobials to avoid in
avoid in pregnancy pregnancy
avoid in pregnancy
The antimicrobial drug clarithromycin can The antimicrobial drug
The antiviral Ribavirin is known as being
cause spontaneous abortion when taken clarithromycin can cause
generally embryocidal / teratogenic
during pregnancy spontaneous abortion when taken
during pregnancy
First Aid Microbiology: Bacterial First Aid Microbiology: Bacterial First Aid Microbiology: Bacterial
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Functional Categories
A polysaccharide antigen alone cannot be
presented to T cells. Examples of anaerobes include
Anaerobes are normal flora in GI
clostridium, bacteroides, fusobacterium,
tract, but are typically pathogenic
and actinomyces.
elsewhere.
First Aid Microbiology: Bacterial First Aid Microbiology: Bacterial

Functional Categories Functional Categories
Examples of catalase positive Examples of catalase positive organisms

organisms may be remembered by may be remembered by the mnemonic
the mnemonic "Cats Need "Cats Need PLACESS to Belch their
PLACESS to Belch their Hairballs."
Hairballs."
First Aid Microbiology: Bacterial Nocardia,
Functional Categories Nocardia, Pseudomonas,
Pseudomonas, Listeria,
Examples of anaerobes include Listeria, Aspergillus,
clostridium, bacteroides, fusobacterium, Aspergillus, Candida,
and actinomyces. Candida, E coli,
E coli, Staphylococci,
Staphylococci, Serratia,
Serratia, B cepacia,
B cepacia, H pylori.
H pylori.
Functional Categories Functional Categories Functional Categories
Examples of catalase positive organisms Examples of encapsulated bacteria Examples of encapsulated bacteria may be
may be remembered by the mnemonic may be remembered with the remembered with the mnemonic "Please
"Cats Need PLACESS to Belch their mnemonic "Please SHINE my SHINE my SKiS."
Hairballs." SKiS."
Pseudomonas aeruginosa
Nocardia, Pseudomonas aeruginosa Streptococcus pneumoniae
Pseudomonas, Streptococcus pneumoniae Haemophilus
Listeria, Haemophilus Influenzae type B
Aspergillus, Influenzae type B Neisseria meningitidis
Candida, Neisseria meningitidis Escherichia coli
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E coli,
Staphylococci,
Serratia,
B cepacia,
H pylori. Escherichia coli Salmonella
Salmonella Klebsiella pneumoniae
Klebsiella pneumoniae group B Strep.
group B Strep.
First Aid Microbiology: Bacterial

Examples of encapsulated bacteria may be

remembered with the mnemonic "Please First Aid Microbiology: Bacterial
SHINE my SKiS." Functional Categories
Pseudomonas aeruginosa Examples of facultative anaerobes include
Examples of facultative anaerobes streptococci, staphylococci, and enteric
Streptococcus pneumoniae
include streptococci, staphylococci,
Haemophilus gram positive bacteria.
and enteric gram positive bacteria.
Influenzae type B
Neisseria meningitidis
Escherichia coli
Salmonella
Klebsiella pneumoniae
group B Strep.
Examples of spore forming bacteria Examples of spore forming bacteria Examples of spore forming bacteria
include include include
Bacillus anthracis (Anthrax), Bacillus anthracis (Anthrax), Bacillus anthracis (Anthrax),
Bacillus cereus (Food poisoning), Bacillus cereus (Food poisoning), Bacillus cereus (Food poisoning),
Clostridium botulinum (Botulism), Clostridium botulinum (Botulism), Clostridium botulinum (Botulism),
Clostridium difficile Clostridium difficile Clostridium difficile
(Pseudomembranous colitis), (Pseudomembranous colitis), (Pseudomembranous colitis),
Clostridium perfringens (Gas gangrene), Clostridium perfringens (Gas Clostridium perfringens (Gas gangrene),
Clostridium tetani (Tetanus) gangrene), Clostridium tetani (Tetanus)
Clostridium tetani (Tetanus)
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First Aid Microbiology: Bacterial Functional Categories
In chronic granulomatous disease, there is
In catalase-positive organisms, catalase
In catalase-positive organisms, a NADPH oxidase deficiency, which leads
degrades H2O2 into H2O and O2) so that
catalase degrades H2O2 into H2O to recurrent infections with certain catalase
{{c3.
and O2) so that {{c3. positive organisms.

First Aid Microbiology: Bacterial First Aid Microbiology: Bacterial Functional Categories
In urease-positive organisms, urease
In chronic granulomatous disease, there is In chronic granulomatous disease, hydrolyzes urea to release ammonia and
a NADPH oxidase deficiency, which leads there is a NADPH oxidase CO2, which increases the pH. This
to recurrent infections with certain catalase deficiency, which leads to recurrent predisposes to struvite stones.
positive organisms. infections with certain catalase Solution on test will turn a deep pink
positive organisms.
In urease-positive organisms, urease In urease-positive organisms, In urease-positive organisms, urease

hydrolyzes urea to release ammonia and urease hydrolyzes urea to release hydrolyzes urea to release ammonia and
CO2, which increases the pH. This ammonia and CO2, which increases CO2, which increases the pH. This
predisposes to struvite stones. the pH. This predisposes to struvite predisposes to struvite stones.
Solution on test will turn a deep pink stones. Solution on test will turn a deep pink
Solution on test will turn a deep
pink
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Normally, encapsulated bacteria are Normally, encapsulated bacteria are Normally, encapsulated bacteria are
opsonized, then cleared by the spleen. opsonized, then cleared by the opsonized, then cleared by the spleen.
However, asplenics have decreased spleen. However, asplenics have However, asplenics have decreased
opsonizing ability and thus increased risk decreased opsonizing ability and opsonizing ability and thus increased risk
for severe infections. thus increased risk for severe for severe infections.
infections.

Functional Categories Functional Categories First Aid Microbiology: Bacterial
Normally, encapsulated bacteria are Normally, encapsulated bacteria are
opsonized, then cleared by the spleen. opsonized, then cleared by the Of the encapsulated bacteria, S
However, asplenics have decreased spleen. However, asplenics have pneumoniae, H influenzae, and N
opsonizing ability and thus increased risk decreased opsonizing ability and meningitidis require vaccines.
for severe infections. thus increased risk for severe
infections.
Reactivation of M tuberculosis has a Reactivation of M tuberculosis has Some bacteria can form spores at the end
predilection for the apices of the lung. a predilection for the apices of the of the stationary phase when nutrients are
lung. limited.

First Aid Microbiology: Bacterial Some vaccines containing

First Aid Microbiology: Bacterial polysaccharide capsule antigens are
Functional Categories Functional Categories conjugated to a carrier protein, enhancing
Some bacteria can form spores at the end immunogenicity by promoting T-cell
Some bacteria can form spores at activation and subsequent class switching.
of the stationary phase when nutrients are the end of the stationary phase
limited. when nutrients are limited.
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Some vaccines containing Some vaccines containing

polysaccharide capsule antigens are polysaccharide capsule antigens
conjugated to a carrier protein, enhancing are conjugated to a carrier protein, First Aid Microbiology: Bacterial
immunogenicity by promoting T-cell enhancing immunogenicity Functional Categories
activation and subsequent class switching. by promoting T-cell activation and
subsequent class switching. Spores are highly resistant to heat and
chemicals.

Spores are highly resistant to heat and
Spores are killed by autoclave. Spores have no metabolic activity.
chemicals.

The capsular polysaccharide of The capsular polysaccharide of
encapsulated bacteria plus a protein encapsulated bacteria plus a protein
Spores have dipicolinic acid in their core.
conjugate can serve as an antigen in conjugate can serve as an antigen in
vaccines. vaccines.
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The encapsulated bacteria vaccines

include The encapsulated bacteria vaccines
include
Pneumococcal vaccine:
PCV13 (pneumococcal conjugate Pneumococcal vaccine:
vaccine) PCV13 (pneumococcal conjugate vaccine)
PPSV23 PPSV23 (pneumococcal polysaccharide
(pneumococcal polysaccharide vaccine with no conjugated protein)
The capsular polysaccharide of vaccine with no conjugated protein)
encapsulated bacteria plus a protein H influenzae type B (conjugate vaccine)
conjugate can serve as an antigen in H influenzae type B (conjugate Meningococcal vaccine (conjugate
vaccines. vaccine) vaccine)
Meningococcal vaccine (conjugate
vaccine)

The urease positive organisms may be

remembered with the mnemonic "Pee
CHUNKSS". First Aid Microbiology: Bacterial
Actinomyces israelii produces yellow
Actinomyces israelii produces
proteus, cryptococcus, H pylori, sulfur granules, which are composed of
yellow sulfur granules, which are
ureaplasma, nocardia, klebsiella, S filaments of bacteria.
composed of filaments of bacteria.
epidermidis, and S saprophyticus
Actinomyces israelii produces yellow Aerobes may be remembered with Aerobes may be remembered with the
sulfur granules, which are composed of the mnemonic "Nagging Pests mnemonic "Nagging Pests Must Breathe."
filaments of bacteria. Must Breathe."
Nocardia, Pseudomonas aeruginosa, and
Nocardia, Pseudomonas MycoBacterium tuberculosis
aeruginosa, and MycoBacterium
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tuberculosis

Functional Categories First Aid Microbiology: Bacterial
Aerobes may be remembered with the
mnemonic "Nagging Pests Must Breathe." Aerobes use an O2 dependent system to
Aerobes use an O2 dependent
generate ATP.
Nocardia, Pseudomonas aeruginosa, and system to generate ATP.
MycoBacterium tuberculosis
Aminoglycosides are ineffective against Aminoglycosides are ineffective Anaerobes are generally foul smelling,
anaerobes because these antibiotics require against anaerobes because these difficult to culture, and produce gas in
O2 to enter into the bacterial cell. antibiotics require O2 to enter into tissue.
the bacterial cell.

Anaerobes are generally foul smelling, Anaerobes are generally foul smelling,
Anaerobes are generally foul
difficult to culture, and produce gas in difficult to culture, and produce gas in
smelling, difficult to culture, and
tissue. tissue.
produce gas in tissue.
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Anaerobes lack catalase and/or superoxide Anaerobes lack catalase and/or superoxide
Anaerobes lack catalase and/or
dismutase and are thus susceptible to dismutase and are thus susceptible to
superoxide dismutase and are thus
oxidative damage. oxidative damage.
susceptible to oxidative damage.
Encapsulated bacteria have capsules which Encapsulated bacteria have Encapsulated bacteria have capsules which
serve as an antiphagocytic virulence factor. capsules which serve as an serve as an antiphagocytic virulence factor.
antiphagocytic virulence factor.
Facultative anaerobes use fermentation and Facultative anaerobes use Facultative anaerobes use fermentation and
other nonoxygen-dependent pathways to fermentation and other nonoxygen- other nonoxygen-dependent pathways to
generate ATP but are not killed by O2. dependent pathways to generate generate ATP but are not killed by O2.
ATP but are not killed by O2.

First Aid Microbiology: Bacterial Functional Categories Functional Categories
Facultative intracellular bacteria Facultative intracellular bacteria may be
Facultative anaerobes use fermentation and may be remembered by the remembered by the mnemonic "Some
other nonoxygen-dependent pathways to mnemonic "Some Nasty Bugs May Nasty Bugs May Live FacultativeLY."
generate ATP but are not killed by O2. Live FacultativeLY."
Salmonella, Neisseria, Brucella,
Salmonella, Neisseria, Brucella, Mycobacterium,
Mycobacterium, Listeria, Francisella, Legionella and
Listeria, Francisella, Legionella and Yersinia pestis.
Yersinia pestis.
Obligate intracellular bacteria include Obligate intracellular bacteria Obligate intracellular bacteria include
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rickettsia, chlamydia, and coxiella. They include rickettsia, chlamydia, and rickettsia, chlamydia, and coxiella. They
rely on host ATP. coxiella. They rely on host ATP. rely on host ATP.

P aeruginosa forms biofilms in
P aeruginosa forms biofilms in respiratory P aeruginosa forms biofilms in respiratory
respiratory tree colonization in
tree colonization in patients with cystic tree colonization in patients with cystic
patients with cystic fibrosis or
fibrosis or ventilator- fibrosis or ventilator-
ventilator-associated pneumonia.
associated pneumonia. Also in contact associated pneumonia. Also in contact
Also in contact lens–associated
lens–associated keratitis. lens–associated keratitis.
keratitis.
Respiratory tree colonization in Respiratory tree colonization in
Respiratory tree colonization in
patients with cystic fibrosis, ventilator- patients with cystic fibrosis, ventilator-
patients with cystic fibrosis,
associated pneumonia. associated pneumonia.
ventilator-associated pneumonia.
Contact lens–associated keratitis Contact lens–associated keratitis
Contact lens–associated keratitis

P aeruginosa forms biofilms in respiratory P. aeruginosa produces a blue-green
tree colonization in patients with cystic P. aeruginosa produces a blue-green
pigment.
fibrosis or ventilator- pigment.
associated pneumonia. Also in contact
lens–associated keratitis.
Respiratory tree colonization in
patients with cystic fibrosis, ventilator-
associated pneumonia.
Contact lens–associated keratitis

S. epidermis is forms biofilms in catheter
S. aureus produces a yellow pigment. S. aureus produces a yellow
and prosthetic device infections.
pigment.

S. epidermis is forms biofilms in catheter Serratia marcescens produces a red
Serratia marcescens produces a red
and prosthetic device infections. pigment.
pigment.
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Viridans streptococci (S mutans, S
Viridans streptococci (S mutans, S
sanguinis) form biofilms in dental plaques forms biofilms in otitis media.
sanguinis) form biofilms in dental
and infective endocarditis.
plaques and infective endocarditis.

First Aid Microbiology: Bacterial Genetics First Aid Microbiology: Bacterial Genetics
Genetics
A Hfr cell is when the F+ plasmid becomes A Hfr cell is when the F+ plasmid becomes
A Hfr cell is when the F+ plasmid
incorporated into bacterial chromosomal incorporated into bacterial chromosomal
becomes incorporated into bacterial
DNA. This occurs via transfer of the DNA. This occurs via transfer of the
chromosomal DNA. This occurs via
leading part of the plasmid and a few leading part of the plasmid and a few
transfer of the leading part of the
flanking chromosomal genes. flanking chromosomal genes.
plasmid and a few flanking
chromosomal genes.
First Aid Microbiology: Bacterial Genetics

Genetics First Aid Microbiology: Bacterial Genetics
A Hfr cell is when the F+ plasmid becomes
incorporated into bacterial chromosomal During transposition, some flanking
DNA. This occurs via transfer of the During transposition, some flanking
chromosomal DNA may be excised chromosomal DNA may be excised and
leading part of the plasmid and a few thus incoporated into a plasmid and
flanking chromosomal genes. and thus incoporated into a plasmid
and transferred to another transferred to another bacterium.
bacterium.
First Aid Microbiology: Bacterial Genetics First Aid Microbiology: Bacterial First Aid Microbiology: Bacterial Genetics
Genetics
During transposition, some flanking In F+ x F- conjugation, the sex pilus on F+
chromosomal DNA may be excised and During transposition, some flanking bacterium contacts F- bacterium. Then, a
thus incoporated into a plasmid and chromosomal DNA may be excised single strand of plasmid DNA is
transferred to another bacterium. and thus incoporated into a plasmid
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transferred across the conjugal bridge.

and transferred to another
bacterium.

First Aid Microbiology: Bacterial Genetics First Aid Microbiology: Bacterial Genetics
Genetics
In F+ x F- conjugation, the sex pilus on F+ In F+ x F- conjugation, the sex pilus on F+

In F+ x F- conjugation, the sex pilus
bacterium contacts F- bacterium. Then, a bacterium contacts F- bacterium. Then, a
on F+ bacterium contacts
single strand of plasmid DNA is single strand of plasmid DNA is
F- bacterium. Then, a single strand
transferred across the conjugal bridge. transferred across the conjugal bridge.
of plasmid DNA is transferred
across the conjugal bridge.
First Aid Microbiology: Bacterial First Aid Microbiology: Bacterial Genetics

Genetics
In specialized and generalized
First Aid Microbiology: Bacterial Genetics In specialized and generalized transduction, parts of the bacterial
transduction, parts of the bacterial chromosomal DNA may be packaged into
In F+ x F- conjugation, there isn't transfer chromosomal DNA may be the phage capsid, and thus is incorporated
of chromosomal DNA. packaged into the phage capsid, and into chromosomes of other bacterium.
thus is incorporated into
chromosomes of other bacterium.

In specialized and generalized Genetics First Aid Microbiology: Bacterial Genetics
transduction, parts of the bacterial
chromosomal DNA may be packaged into In the process of transformation, In the process of transformation, competent
the phage capsid, and thus is incorporated competent bacteria are able to bind bacteria are able to bind and import short
into chromosomes of other bacterium. and import short pieces of pieces of environment naked bacterial
environment naked bacterial chromosomal DNA (from bacterial cell
chromosomal DNA (from bacterial lysis.
cell lysis.
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Genetics
In the process of transformation, competent In Hfr x F- conjugation, the recipient cells
bacteria are able to bind and import short In Hfr x F- conjugation, the remains F- but now may have new bacterial
pieces of environment naked bacterial
recipient cells remains F- but now genes.
chromosomal DNA (from bacterial cell
may have new bacterial genes.
lysis.
First Aid Microbiology: Bacterial First Aid Microbiology: Bacterial Genetics

Genetics
In generalized transduction, a lytic phage
In generalized transduction, a lytic infects bacterium, leading to cleavage of
In Hfr x F- conjugation, the recipient cells phage infects bacterium, leading to bacterial DNA. Then, the phage is released
remains F- but now may have new bacterial cleavage of bacterial DNA. Then, from the lysed cell to infect other bacteria.
genes. the phage is released from the lysed
cell to infect other bacteria.
Genetics
In generalized transduction, a lytic phage In generalized transduction, a lytic phage
infects bacterium, leading to cleavage of In generalized transduction, a lytic infects bacterium, leading to cleavage of
bacterial DNA. Then, the phage is released phage infects bacterium, leading to bacterial DNA. Then, the phage is released
from the lysed cell to infect other bacteria. cleavage of bacterial DNA. Then, from the lysed cell to infect other bacteria.
the phage is released from the lysed
cell to infect other bacteria.
Genetics
In generalized transduction, a lytic phage In specialized transduction, a lysogenic
infects bacterium, leading to cleavage of In specialized transduction, a phage infects bacterium by incorporating
bacterial DNA. Then, the phage is released lysogenic phage infects bacterium viral DNA into the baterial chromosome.
from the lysed cell to infect other bacteria. by incorporating viral DNA into the The DNA is then packged into a phage
baterial chromosome. The DNA is capsid in order to infect other bacterium.
then packged into a phage capsid in
order to infect other bacterium.
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Genetics
In specialized transduction, a lysogenic In specialized transduction, a lysogenic
phage infects bacterium by incorporating In specialized transduction, a phage infects bacterium by incorporating
viral DNA into the baterial chromosome. lysogenic phage infects bacterium viral DNA into the baterial chromosome.
The DNA is then packged into a phage by incorporating viral DNA into the The DNA is then packged into a phage
capsid in order to infect other bacterium. baterial chromosome. The DNA is capsid in order to infect other bacterium.
then packged into a phage capsid in
order to infect other bacterium.
Genetics
In transposition, a segment of DNA (eg In transposition, a segment of DNA (eg
transposon) can jump excision and In transposition, a segment of DNA transposon) can jump excision and
reintegration from one location to another (eg transposon) can jump excision reintegration from one location to another
or transfer genes from plasmid to and reintegration from one location or transfer genes from plasmid to
chromosome. to another or transfer genes from chromosome.
plasmid to chromosome.
Genetics
In transposition, a segment of DNA (eg The F+ plasmid contains genes required for
transposon) can jump excision and In transposition, a segment of DNA sex pilus and conjugation. Bacteria without
reintegration from one location to another (eg transposon) can jump excision this plasmid are termed F-.
or transfer genes from plasmid to and reintegration from one location
chromosome. to another or transfer genes from
plasmid to chromosome.
Genetics
The F+ plasmid contains genes required for The F+ plasmid contains genes required for
sex pilus and conjugation. Bacteria without The F+ plasmid contains genes sex pilus and conjugation. Bacteria without
this plasmid are termed F-. required for sex pilus and this plasmid are termed F-.
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conjugation. Bacteria without this

plasmid are termed F-.
First Aid Microbiology: Bacterial Genetics First Aid Microbiology: Bacterial

Genetics First Aid Microbiology: Bacterial Genetics
To prevent transformation,
To prevent transformation, Transformation is a feature of many
deoxyribonuclease is added to the
deoxyribonuclease is added to the bacteria, including S. pneumoniae, H
environment, thereby degrading naked
environment, thereby degrading influenzae type B, and Neisseria.
DNA in medium.
naked DNA in medium.
Which bacterial toxins are encoded in a

lysogenic phage?

Group A strep erythrogenic toxin
Genetics
Botulinum toxin
Transformation is a feature of many Cholera toxin
bacteria, including S. pneumoniae, H Transformation is a feature of many
Diphtheria toxin
influenzae type B, and Neisseria. bacteria, including S. pneumoniae,
Shiga toxin
H influenzae type B, and Neisseria.
Which bacterial toxins are encoded in a

lysogenic phage? First Aid Microbiology: Bacterial First Aid Microbiology: Bacterial Genetics
Genetics
Group A strep erythrogenic toxin Generalized transduction is a/an packaging
Botulinum toxin Generalized transduction is a/an event.
Cholera toxin packaging event.
Diphtheria toxin
Shiga toxin
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Genetics
Specialized transduction is a/an excision First Aid Microbiology: Bacterial Genetics
event. Specialized transduction is a/an
The transfer and expresssion of newly
excision event.
transferred genes is called transformation.

Structures
A capsule is made up of a organized,
Structures
discreet polysaccharide layer and functions
to protect against phagocytosis.
A spore is present in gram positive
bacteria only.
The transfer and expresssion of newly

transferred genes is called transformation.
Structures Structures Structures
A capsule is made up of a organized, A capsule is made up of a A flagellum is made up of proteins and

discreet polysaccharide layer and functions organized, discreet polysaccharide functions in motility.
to protect against phagocytosis. layer and functions to protect
against phagocytosis.
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Structures
Structures
Structures A pilus/fimbria is made up of
A flagellum is made up of proteins and
glycoproteins and functions to mediate
functions in motility.
A flagellum is made up of proteins adherence of bacteria to cell surface.
and functions in motility.
A pilus/fimbria is made up of A pilus/fimbria is made up of A spore funtions to resist dehydration,

glycoproteins and functions to mediate glycoproteins and functions to heat, and chemicals.
adherence of bacteria to cell surface. mediate adherence of bacteria to
cell surface.
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Structures First Aid Microbiology: Bacterial Structures
Structures
A spore funtions to resist dehydration, A spore is made up of a keratin-like coat,
heat, and chemicals. A spore is made up of a keratin-like dipicolinic acid, peptidoglycan, and DNA.
coat, dipicolinic acid,
peptidoglycan, and DNA.
A spore is made up of a keratin-like coat, A spore is made up of a keratin-like A spore is made up of a keratin-like coat,
dipicolinic acid, peptidoglycan, and DNA. coat, dipicolinic acid, dipicolinic acid, peptidoglycan, and DNA.
peptidoglycan, and DNA.
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Structures First Aid Microbiology: Bacterial Structures
Structures
Lipoteichoic acids (gram positive bacteria Lipoteichoic acids (gram positive bacteria
only}} extend from the membrane to the Lipoteichoic acids (gram positive only}} extend from the membrane to the
exterior of the cytoplasmic membrane. bacteria only}} extend from the exterior of the cytoplasmic membrane.
They function to induce TNF-α and IL-1. membrane to the exterior of the They function to induce TNF-α and IL-1.
cytoplasmic membrane. They
function to induce TNF-α and IL-1.
The endotoxins in the outer membrane, The function of the periplasm is to The function of the periplasm is to
such as lipid A, function to induce TNF accumulate components (such as accumulate components (such as
and IL-1. hydrolytic enzymes) exiting gram hydrolytic enzymes) exiting gram negative
negative cells cells
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Structures
Structures The cell wall functions as a net like
structure to give rigid support and protect
The sex pilus forms during against osmotic pressure damage.
conjugation.

Structures
The outer membrane is present in only

gram negative bacteria.
The cell wall functions as a net like The cell wall functions as a net like The cell wall is made up of peptidoglycan,
structure to give rigid support and protect structure to give rigid support and which is a sugar backbone with peptide
against osmotic pressure damage. protect against osmotic pressure side chains cross-linked by transpeptidase.
damage.
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First Aid Microbiology: Bacterial Structures
Structures First Aid Microbiology: Bacterial
Structures The cytoplasmic membrane is a
The cell wall is made up of peptidoglycan, phospholipid bilayer sac with embedded
which is a sugar backbone with peptide The cell wall is made up of proteins.
side chains cross-linked by transpeptidase. peptidoglycan, which is a sugar Such as penicillin binding proteins and
backbone with peptide side chains other enzymes.
cross-linked by transpeptidase.
The cytoplasmic membrane is a The cytoplasmic membrane is the The cytoplasmic membrane is the site of
phospholipid bilayer sac with embedded site of oxidative and transport oxidative and transport enzymes as well as
proteins. enzymes as well as PBPs involved PBPs involved in cell wall synthesis.
Such as penicillin binding proteins and in cell wall synthesis.
other enzymes.
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First Aid Microbiology: Bacterial Structures
Structures
Structures
The glycocalyx is a loose network of
The cytoplasmic membrane is the site of polysaccharides that mediates adherence to
The glycocalyx is a loose network
oxidative and transport enzymes as well as surfaces.
of polysaccharides that mediates
PBPs involved in cell wall synthesis. Especially foreign surfaces such as
adherence to surfaces.
indwelling catheters.
Especially foreign surfaces such as
indwelling catheters.
The glycocalyx is a loose network of The outer membrane is comerposed The outer membrane is comerposed of an
polysaccharides that mediates adherence to of an outer leaflet (contains outer leaflet (contains endotoxins such as
surfaces. endotoxins such as LPS/LOS), LPS/LOS), embedded proteins (porins and
Especially foreign surfaces such as embedded proteins (porins and other outer membrane proteins), and an
indwelling catheters. other outer membrane proteins), inner leaflet (phospholipids).
and an inner leaflet (phospholipids).
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Structures First Aid Microbiology: Bacterial
Structures
Structures
The outer membrane is comerposed of an
The periplasm is a space between the
outer leaflet (contains endotoxins such as The outer membrane is comerposed
cytoplasmic membrane and the outer
LPS/LOS), embedded proteins (porins and of an outer leaflet (contains
membrane in gram negative bacteria.
other outer membrane proteins), and an endotoxins such as LPS/LOS),
Peptidoglycan is in the middle.
inner leaflet (phospholipids). embedded proteins (porins and
other outer membrane proteins),
and an inner leaflet (phospholipids).
Structures Structures Taxonomy
The periplasm is a space between the The periplasm is a space between Actinomyces is a gram-positive, branching
cytoplasmic membrane and the outer the cytoplasmic membrane and the filamentous bacteria.
membrane in gram negative bacteria. outer membrane in gram negative
Peptidoglycan is in the middle. bacteria.
Peptidoglycan is in the middle.
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Taxonomy First Aid Microbiology: Bacterial Taxonomy
Taxonomy
Actinomyces is a gram-positive, branching Anaplasma, ehrlichia are gram negative,
filamentous bacteria. Anaplasma, ehrlichia are gram pleomorphic bacteria.
negative, pleomorphic bacteria.
Taxonomy Taxonomy Taxonomy
Bacillus is an example of a gram-positive, Bacillus is an example of a gram- Bacteroides are an enteric, gram-negative,
rod (bacillus) bacteria. positive, rod (bacillus) bacteria. rod (bacillus) bacteria.
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Taxonomy
Bacteroides are an enteric, gram-negative, Bartonella is a zoonotic, gram-negative,
rod (bacillus) bacteria. Bacteroides are an enteric, gram- rod (bacillus) bacteria.
negative, rod (bacillus) bacteria.

Taxonomy
Bartonella is a zoonotic, gram-negative, Bordetella is a respiratory, gram-negative,
rod (bacillus) bacteria. Bartonella is a zoonotic, gram- rod (bacillus) bacteria.
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Taxonomy
Bordetella is a respiratory, gram-negative,
Borrelia is a gram-negative spirochete.
rod (bacillus) bacteria. Bordetella is a respiratory, gram-

First Aid Microbiology: Bacterial Taxonomy
Taxonomy
Taxonomy
Brucella is a zoonotic, gram-negative, rod
Borrelia is a gram-negative spirochete.
Brucella is a zoonotic, gram- (bacillus)) bacteria.
negative, rod (bacillus)) bacteria.
Brucella is a zoonotic, gram-negative, rod Burkholderia cepacia is a Burkholderia cepacia is a respiratory,

(bacillus)) bacteria. respiratory, gram-negative, rod gram-negative, rod (bacillus)) bacteria.
(bacillus)) bacteria.
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First Aid Microbiology: Bacterial Taxonomy
Taxonomy First Aid Microbiology: Bacterial
Taxonomy
Campylobacter is an enteric, gram-
Burkholderia cepacia is a respiratory, negative, comma-shaped rod (bacillus))
gram-negative, rod (bacillus)) bacteria. Campylobacter is an enteric, gram-
negative, comma-shaped rod bacteria.

Taxonomy Taxonomy
Taxonomy
Campylobacter is an enteric, gram- Chlamydiae is a gram-negative,
Chlamydiae is a gram-negative,
negative, comma-shaped rod (bacillus)) pleomorphic bacteria.
pleomorphic bacteria.
bacteria. Giemsa stain is used.
Giemsa stain is used.
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Taxonomy
Clostridium is an example of a gram- Corynebacterium is a gram positive, rod
positive, rod (bacillus)) bacteria. Clostridium is an example of a (bacillus) bacteria.
gram-positive, rod (bacillus))
bacteria.

Taxonomy
Corynebacterium is a gram positive, rod E. coli is an enteric, gram-negative, rod
(bacillus) bacteria. E. coli is an enteric, gram-negative, (bacillus)) bacteria.
rod (bacillus)) bacteria.
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Taxonomy Taxonomy
Taxonomy
E. coli is an enteric, gram-negative, rod Enterobacter is an enteric, gram-negative,
(bacillus)) bacteria. rod (bacillus)) bacteria.
Enterobacter is an enteric, gram-

Taxonomy
Enterobacter is an enteric, gram-negative, Francisella is a zoonotic, gram-negative,
rod (bacillus)) bacteria. Francisella is a zoonotic, gram- rod (bacillus)) bacteria.
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Taxonomy
Francisella is a zoonotic, gram-negative, Fusobacterium is an enteric, gram-
rod (bacillus)) bacteria. Fusobacterium is an enteric, gram- negative, rod (bacillus)) bacteria.

Taxonomy
Fusobacterium is an enteric, gram- Gardnerella is a gram-variable, rod
negative, rod (bacillus)) bacteria. Gardnerella is a gram-variable, rod (bacillus) bacteria.
(bacillus) bacteria.
Haemophilus is a respiratory, gram- Haemophilus is a respiratory, gram- Haemophilus is a respiratory, gram-

negative, rod (bacillus)) bacteria. negative, rod (bacillus)) bacteria. negative, rod (bacillus)) bacteria.
H. influenza is coccobacillary. H. influenza is coccobacillary. H. influenza is coccobacillary.
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Taxonomy
Helicobacter is an enteric, gram-negative, Helicobacter is an enteric, gram-negative,
comma-shaped rod (bacillus)) bacteria. Helicobacter is an enteric, gram- comma-shaped rod (bacillus)) bacteria.
negative, comma-shaped rod

Taxonomy
Klebsiella is an enteric, gram-negative, rod Klebsiella is an enteric, gram-negative, rod
(bacillus)) bacteria. Klebsiella is an enteric, gram- (bacillus)) bacteria.
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Taxonomy
Lactobacillus is a gram-positive, rod Legionella is a respiratory, gram-negative,
(bacillus)) bacteria. Lactobacillus is a gram-positive, rod (bacillus)) bacteria.

Taxonomy
Legionella is a respiratory, gram-negative, Leptospira is a gram negative, spirochete
rod (bacillus)) bacteria. Legionella is a respiratory, gram- bacteria.
Leptospira is a gram negative, spirochete Listeria is a gram-positive, rod Listeria is a gram-positive, rod (bacillus))
bacteria. (bacillus)) bacteria. bacteria.
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Taxonomy Taxonomy
Taxonomy Mycoplasma is a gram-negative,
Mycobacterium is a gram-positive, rod
(bacillus)) bacteria. pleomorphic bacteria.
Mycobacterium is a gram-positive, contains sterols which do not gram stain.

Taxonomy
Mycoplasma is a gram-negative, Nocardia is a gram-positive, branching
pleomorphic bacteria. Nocardia is a gram-positive, filamentous bacteria.
contains sterols which do not gram stain. branching filamentous bacteria.
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Taxonomy
Pasteurella is a zoonotic, gram-negative, Pasteurella is a zoonotic, gram-negative,
rod (bacillus)) bacteria. Pasteurella is a zoonotic, gram- rod (bacillus)) bacteria.

Taxonomy
Propionibacterium is a gram-positive, rod Proteus is an enteric, gram-negative, rod
(bacillus)) bacteria. Propionibacterium is a gram- (bacillus) bacteria.
positive, rod (bacillus)) bacteria.
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Taxonomy
Proteus is an enteric, gram-negative, rod Pseudomonas is an enteric, gram-negative,
(bacillus) bacteria. Proteus is an enteric, gram- rod (bacillus)) bacteria.

Taxonomy
Taxonomy First Aid Microbiology: Bacterial
Taxonomy Rickettsiae is a gram-negative,
Pseudomonas is an enteric, gram-negative,
pleomorphic bacteria.
rod (bacillus)) bacteria. Pseudomonas is an enteric, gram- Giemsa stain is used.
Rickettsiae is a gram-negative, Salmonella is an enteric, gram- Salmonella is an enteric, gram-negative,

pleomorphic bacteria. negative, rod (bacillus)) bacteria. rod (bacillus)) bacteria.
Giemsa stain is used.
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Taxonomy
Salmonella is an enteric, gram-negative, Serratia is an enteric, gram-negative, rod
rod (bacillus)) bacteria. Serratia is an enteric, gram- (bacillus)) bacteria.

Taxonomy
Serratia is an enteric, gram-negative, rod Shigella is an enteric, gram-negative, rod
(bacillus)) bacteria. Shigella is an enteric, gram- (bacillus)) bacteria.
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Taxonomy
Shigella is an enteric, gram-negative, rod
Treponema is a gram-negative, spirochete.
(bacillus)) bacteria. Treponema is a gram-negative,
spirochete.

Taxonomy
Vibrio is an enteric, gram-negative, Vibrio is an enteric, gram-negative,
comma-shaped rod (bacillus)) bacteria. Vibrio is an enteric, gram-negative, comma-shaped rod (bacillus)) bacteria.
comma-shaped rod (bacillus))
bacteria.
Yersinia is an enteric, gram-negative, rod Yersinia is an enteric, gram- Yersinia is an enteric, gram-negative, rod
(bacillus))[coccobacilli(sketchy/i-net)] negative, rod (bacillus)) (bacillus))[coccobacilli(sketchy/i-net)]
bacteria. [coccobacilli(sketchy/i-net)] bacteria.
bacteria.
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Taxonomy
Staphylococcus (clusters), streptococcus Staphylococcus (clusters), streptococcus
(chains or pairs), and enterococcus (pairs Staphylococcus (clusters), (chains or pairs), and enterococcus (pairs
or short chains) are examples of gram- streptococcus (chains or pairs), and or short chains) are examples of gram-
positive, spherical (coccus)) bacteria. enterococcus (pairs or short chains) positive, spherical (coccus)) bacteria.
are examples of gram-positive,
spherical (coccus)) bacteria.
moraxella catarrhalis and neisseria are moraxella catarrhalis and neisseria moraxella catarrhalis and neisseria are
examples of gram negative, spherical are examples of gram negative, examples of gram negative, spherical
(coccus) bacteria. spherical (coccus) bacteria. (coccus) bacteria.
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Virulence Factors
A more comprehensive list of the effects of

endotoxins is... First Aid Microbiology: Bacterial
First Aid Microbiology: Bacterial Virulence Factors
Edema Virulence Factors
Nitric oxide Effects OF LPS
DIC/Death Effects OF LPS
Outer membrane
TNF-α
O-antigen + core polysaccharide + lipid A
eXtremely heat stable
IL-1 and IL-6
Neutrophil chemotaxis
Shock
Virulence Factors Virulence Factors Virulence Factors
Effects OF LPS Effects OF LPS Effects OF LPS
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Virulence Factors First Aid Microbiology: Bacterial Virulence Factors
Virulence Factors
Endotoxins work by inducing TNF, IL-1, Endotoxins work by inducing TNF, IL-1,
and IL-6. Endotoxins work by inducing TNF, and IL-6.
IL-1, and IL-6.

First Aid Microbiology: Bacterial Virulence Factors Virulence Factors
Virulence Factors
Host antibodies against Host antibodies against streptococcus
Exotoxins are composed of polypeptide. streptococcus pyogenes toxin pyogenes toxin (ASO) can be used to
(ASO) can be used to diagnose diagnose rheumatic fever.
rheumatic fever.

Virulence Factors
In terms of antigenicity, endotoxins are In terms of antigenicity, exotoxins induce
poorly antigenic. In terms of antigenicity, endotoxins high titer antibodies called antitoxins.
are poorly antigenic.
In terms of antigenicity, exotoxins induce In terms of heat stability, In terms of heat stability, endotoxins are
high titer antibodies called antitoxins. endotoxins are stable at 100 degrees stable at 100 degrees celcius for one hour.
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celcius for one hour.
In terms of heat stability, exotoxins, are In terms of heat stability, exotoxins, In terms of heat stability, exotoxins, are
destroyed rapidly at 60 degrees celcius are destroyed rapidly at 60 degrees destroyed rapidly at 60 degrees celcius
except staphylococcal enterotoxin and E celcius except staphylococcal except staphylococcal enterotoxin and E
coli heat-stable toxin. enterotoxin and E coli heat-stable coli heat-stable toxin.
toxin.

Virulence Factors
In terms of heat stability, exotoxins, are
In terms of vaccines from endotoxins, no
destroyed rapidly at 60 degrees celcius In terms of vaccines from toxoids are formed and no vaccine is
except staphylococcal enterotoxin and E endotoxins, no toxoids are formed available.
coli heat-stable toxin. and no vaccine is available.

Virulence Factors Virulence Factors
First Aid Microbiology: Bacterial Many exotoxins (see image) are AB Many exotoxins (see image) are AB toxins,
Virulence Factors toxins, with B enabling binding and with B enabling binding and triggering
triggering uptake (endocytosis) of uptake (endocytosis) of the active
In terms of vaccines, exotoxin toxiods can the active component (A). The A component (A). The A components are
be used as vaccines. components are usually ADP usually ADP ribosyltransferases
ribosyltransferases (exceptions in (exceptions in image).
image).
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Virulence Factors
Many exotoxins (see image) are AB toxins,

with B enabling binding and triggering
uptake (endocytosis) of the active
component (A). The A components are
Virulence Factors
usually ADP ribosyltransferases
(exceptions in image).
First Aid Microbiology: Bacterial The (LT) toxin of ETEC works by
Virulence Factors overactivating adenylate cyclase (causing
increased cAMP) causing increased
Protein A is expressed by S. aureus. Cl- secretion in the gut and H2O efflux. It
manifests as watery diarrhea.
The (LT) toxin of ETEC works by The (LT) toxin of ETEC works by The (LT) toxin of ETEC works by
overactivating adenylate cyclase (causing overactivating adenylate cyclase overactivating adenylate cyclase (causing
increased cAMP) causing increased (causing increased cAMP) causing increased cAMP) causing increased
Cl- secretion in the gut and H2O efflux. It increased Cl- secretion in the gut Cl- secretion in the gut and H2O efflux. It
manifests as watery diarrhea. and H2O efflux. It manifests as manifests as watery diarrhea.
watery diarrhea.
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The (ST) toxin of ETEC works by The (ST) toxin of ETEC works by The (ST) toxin of ETEC works by
overactivating guanylate cyclase (increased overactivating guanylate cyclase overactivating guanylate cyclase (increased
cGMP), thereby decreasing resportion of (increased cGMP), thereby cGMP), thereby decreasing resportion of
NaCl and H2O in the gut. It manifests as decreasing resportion of NaCl and NaCl and H2O in the gut. It manifests as
watery diarrhea. H2O in the gut. It manifests as watery diarrhea.
watery diarrhea.

Virulence Factors First Aid Microbiology: Bacterial First Aid Microbiology: Bacterial
The (ST) toxin of ETEC works by
overactivating guanylate cyclase (increased The adverse effects of endotoxins The adverse effects of exotoxins are high
cGMP), thereby decreasing resportion of are low (fatal dose on order of (fatal dose on order of 1 ug).
NaCl and H2O in the gut. It manifests as hundreds of micrograms).
watery diarrhea.
The clinical effects of endotoxins include The clinical effects of endotoxins The clinical effects of endotoxins include
fever, shock (hypotension), and DIC. include fever, shock (hypotension), fever, shock (hypotension), and DIC.
and DIC.
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The clinical effects of endotoxins include The endotoxin gene is located on the
fever, shock (hypotension), and DIC. The endotoxin gene is located on plasmid or bacteriophage.
the bacterial chromosome.
The three main effects of endotoxins are The three main effects of The three main effects of endotoxins are
macrophage activation (through TLR4), endotoxins are macrophage macrophage activation (through TLR4),
complement activation, and tissue factor activation (through TLR4), complement activation, and tissue factor
activation. complement activation, and tissue activation.
factor activation.

Virulence Factors
The three main effects of endotoxins are Virulence Factors
Virulence Factors
macrophage activation (through TLR4),
complement activation, and tissue factor The type III secretion system is used by
The type III secretion system is
activation. certain gram negative bacteria such as
used by certain gram negative
pseudomonas, salmonella, shigella, and E.
bacteria such as pseudomonas,
coli.
salmonella, shigella, and E. coli.
The type III secretion system is used by The type III secretion system is The type III secretion system is used by
certain gram negative bacteria such as used by certain gram negative certain gram negative bacteria such as
pseudomonas, salmonella, shigella, and E. bacteria such as pseudomonas, pseudomonas, salmonella, shigella, and E.
coli. salmonella, shigella, and E. coli. coli.
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Virulence Factors
Virulence Factors Typical disease of endotoxins include
The Type III secretion system is also meningococcemia (sepsis by gram negative
The Type III secretion system is rods).
known as the injectisome.
also known as the injectisome.

Virulence Factors
Typical disease of endotoxins include
Typical disease of endotoxins are tetanus,
meningococcemia (sepsis by gram negative Typical disease of endotoxins are botulism, diphtheria.
rods). tetanus, botulism, diphtheria.

Virulence Factors
Virulence Factors
Bacillus anthracis produces edema toxin
Typical disease of endotoxins are tetanus,
Typical disease of endotoxins are (exotoxin), which works by mimicking the
botulism, diphtheria.
tetanus, botulism, diphtheria. adenylate cyclase enzyme resulting in
increased cAMP.
Bacillus anthracis produces edema toxin Bacillus anthracis produces edema Bacillus anthracis produces edema toxin
(exotoxin), which works by mimicking the toxin (exotoxin), which works by (exotoxin), which works by mimicking the
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adenylate cyclase enzyme resulting in mimicking the adenylate cyclase adenylate cyclase enzyme resulting in
increased cAMP. enzyme resulting in increased increased cAMP.
cAMP.

Virulence Factors
Virulence Factors
Bordatella pertussis produces pertussis
Bacterial virulence factors promote evasion
Bacterial virulence factors promote toxin (exotoxin), which works by
of host immune response.
evasion of host immune response. overactivating adenylate cyclase
(increasing cAMP) by disabling Gi. This
impairs phagocytosis to permit survival of
the microbe.
Bordatella pertussis produces pertussis Bordatella pertussis produces Bordatella pertussis produces pertussis
toxin (exotoxin), which works by pertussis toxin (exotoxin), which toxin (exotoxin), which works by
overactivating adenylate cyclase works by overactivating adenylate overactivating adenylate cyclase
(increasing cAMP) by disabling Gi. This cyclase (increasing cAMP) by (increasing cAMP) by disabling Gi. This
disabling Gi. This impairs
impairs phagocytosis to permit survival of impairs phagocytosis to permit survival of
the microbe. phagocytosis to permit survival of the microbe.
the microbe.
Bordatella pertussis produces pertussis Bordatella pertussis produces Clostridium botulinism produces
toxin (exotoxin), which works by pertussis toxin (exotoxin), which botulinum toxin (exotoxin). It is a protease
overactivating adenylate cyclase works by overactivating adenylate that cleaves SNARE (soluble NSF
(increasing cAMP) by disabling Gi. This cyclase (increasing cAMP) by attachment protein receptor), which are a
disabling Gi. This impairs set of protenis required for neuotransmitter
impairs phagocytosis to permit survival of
phagocytosis to permit survival of release via vesicular fusion.
the microbe.
the microbe.
Clostridium botulinism produces Clostridium botulinism produces Clostridium botulinism produces

botulinum toxin (exotoxin). It is a protease botulinum toxin (exotoxin). It is a botulinum toxin (exotoxin). It is a protease
that cleaves SNARE (soluble NSF protease that cleaves SNARE that cleaves SNARE (soluble NSF
attachment protein receptor), which are a (soluble NSF attachment protein attachment protein receptor), which are a
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receptor), which are a set of

set of protenis required for neuotransmitter protenis required for set of protenis required for neuotransmitter
release via vesicular fusion. neuotransmitter release via release via vesicular fusion.
vesicular fusion.

Virulence Factors
Clostridium perfringens presents as
Clostridium perfringens presents as myonecrosis ("gas gangrene") and
Clostridium botulinism produces myonecrosis ("gas gangrene") and hemolysis ("double zone" of hemolysis on
botulinum toxin (exotoxin). It is a protease hemolysis ("double zone" of blood agar) due to degradation of
that cleaves SNARE (soluble NSF hemolysis on blood agar) due to phospholipids.
attachment protein receptor), which are a degradation of phospholipids.
set of protenis required for neuotransmitter
release via vesicular fusion.

Virulence Factors
Clostridium perfringens presents as
Clostridium perfringens presents as Clostridium perfringens produces alpha
myonecrosis ("gas gangrene") and
myonecrosis ("gas gangrene") and toxin (exotoxin). It works through
hemolysis ("double zone" of hemolysis on
hemolysis ("double zone" of phospholipase (lecithinase) that degrades
blood agar) due to degradation of
hemolysis on blood agar) due to tissue and cell membranes.
phospholipids.
degradation of phospholipids.
Clostridium perfringens produces alpha Clostridium perfringens produces Clostridium perfringens produces alpha
toxin (exotoxin). It works through alpha toxin (exotoxin). It works toxin (exotoxin). It works through
phospholipase (lecithinase) that degrades through phospholipase (lecithinase) phospholipase (lecithinase) that degrades
tissue and cell membranes. that degrades tissue and cell tissue and cell membranes.
membranes.
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Clostridium tetani produces . This is a Clostridium tetani produces . This Clostridium tetani produces . This is a
protease that cleaves SNARE (soluble NSF is a protease that cleaves SNARE protease that cleaves SNARE (soluble NSF
attachment protein receptor), which are a (soluble NSF attachment protein attachment protein receptor), which are a
set of proteins required for receptor), which are a set of set of proteins required for
neurotransmitter release via vesicular proteins required for neurotransmitter release via vesicular
fusion. neurotransmitter release via fusion.
vesicular fusion.
Clostridium tetani produces . This is a Corynebacterium diphtheriae Corynebacterium diphtheriae produces

protease that cleaves SNARE (soluble NSF produces diphtheria toxin diphtheria toxin (exotoxin). It works by
attachment protein receptor), which are a (exotoxin). It works by inactivating inactivating elongation factor (EF-2).
set of proteins required for elongation factor (EF-2).
neurotransmitter release via vesicular
fusion.

Virulence Factors Endotoxins are composed of Lipid Endotoxins are composed of Lipid A
A component of LPS (structural component of LPS (structural part of
Corynebacterium diphtheriae produces part of bacteria, released when bacteria, released when lysed.
diphtheria toxin (exotoxin). It works by lysed. Note: Lipotechoic Acid acts as a endotoxin
inactivating elongation factor (EF-2). Note: Lipotechoic Acid acts as a for Gram + bacteria
endotoxin for Gram + bacteria
Endotoxins are composed of O antigen + Endotoxins are composed of O Endotoxins are composed of O antigen +
core polysaccharide + lipid A (the toxic antigen + core polysaccharide + core polysaccharide + lipid A (the toxic
component). lipid A (the toxic component). component).
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Virulence Factors
Endotoxins are composed of O antigen + Endotoxins are found in the outer
core polysaccharide + lipid A (the toxic Endotoxins are found in the outer membrane of gram negative bacteria (both
component). membrane of gram negative cocci and rods.
bacteria (both cocci and rods.

Virulence Factors Virulence Factors First Aid Microbiology: Bacterial
Virulence Factors
Endotoxins are from the outer cell Endotoxins are from the outer cell
membrane of most gram negative bacteria. membrane of most gram negative Endotoxins are not secreted from the cell.
Note: Lipotechoic Acid acts as a endotoxin bacteria.
for Gram + bacteria Note: Lipotechoic Acid acts as a
endotoxin for Gram + bacteria

Virulence Factors
Virulence Factors
Enterohemorrhagic E coli (EHEC)
Endotoxins are not secreted from the cell. produces Shiga-like toxin
produces Shiga-like toxin
(SLT) (exotoxin). It works by inactivating
(SLT) (exotoxin). It works by
the 60S ribosome by removing adenine
inactivating the 60S ribosome by
from rRNA.
removing adenine from rRNA.
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Virulence Factors
Enterotoxigenic E coli (ETEC) Enterotoxigenic E coli (ETEC) forms heat-
produces Shiga-like toxin
forms heat-labile toxin (LT)2 labile toxin (LT)2 (exotoxin) and heat-
(SLT) (exotoxin). It works by inactivating
(exotoxin) and heat-stable toxni stable toxni (ST) (exotoin).
(ST) (exotoin).
from rRNA.
Exotoxins are secreted from the cell. Exotoxins are secreted from the IgA protease is an enzyme that cleaves
cell. IgA, allowing bacteria to adhere to and
colonize mucous membranes.

Virulence Factors
IgA protease is an enzyme that cleaves IgA protease is an enzyme that
IgA protease is secreted by S pneumoniae,
IgA, allowing bacteria to adhere to and cleaves IgA, allowing bacteria to
H influenza type B, and Neisseria.
colonize mucous membranes. adhere to and colonize mucous
membranes.
IgA protease is secreted by S pneumoniae, IgA protease is secreted by S IgA protease is secreted by S pneumoniae,
H influenza type B, and Neisseria. pneumoniae, H influenza type B, H influenza type B, and Neisseria.
and Neisseria.
M protein helps prevent phagocytosis. It M protein helps prevent M protein helps prevent phagocytosis. It
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shares similar epitopes to human cellular phagocytosis. It shares similar shares similar epitopes to human cellular
proteins and may be implicated in acute epitopes to human cellular proteins proteins and may be implicated in acute
rheumatic fever. and may be implicated in acute rheumatic fever.
rheumatic fever.

Virulence Factors First Aid Microbiology: Bacterial
Virulence Factors
Virulence Factors
M protein helps prevent phagocytosis. It
shares similar epitopes to human cellular M protein is expressed by group A
M protein is expressed by group A
proteins and may be implicated in acute streptococci.
streptococci.
rheumatic fever.
Protein A binds Fc region of IgG. This Protein A binds Fc region of IgG. Protein A binds Fc region of IgG. This
prevents opsonization and phagocytosis. This prevents opsonization and prevents opsonization and phagocytosis.
phagocytosis.
Protein A binds Fc region of IgG. This Pseudomnas produces exotoxin A. Pseudomnas produces exotoxin A. It works
prevents opsonization and phagocytosis. It works by inactivating elongation by inactivating elongation factor (EF-2).
factor (EF-2).
Pseudomnas produces exotoxin A. It works Shigella spp. produces Shiga toxin Shigella spp. produces Shiga toxin
by inactivating elongation factor (EF-2). (ST) (exotoxin). It works by (ST) (exotoxin). It works by inactivating
inactivating the 60S ribosome by the 60S ribosome by removing adenine
removing adenine from rRNA. from rRNA.
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Virulence Factors
Staphylococcus aureus exotoxin Staphylococcus aureus exotoxin presents
presents as toxic shock syndrome. as toxic shock syndrome. Symptoms
Shigella spp. produces Shiga toxin
Symptoms include fever, rash, include fever, rash, shock. It can also
(ST) (exotoxin). It works by inactivating
shock. It can also present as food present as food poisoning due to heat stable
poisoning due to heat stable enterotoxin.
from rRNA.
enterotoxin.
Staphylococcus aureus exotoxin presents Staphylococcus aureus exotoxin Staphylococcus aureus exotoxin presents
as toxic shock syndrome. Symptoms presents as toxic shock syndrome. as toxic shock syndrome. Symptoms
include fever, rash, shock. It can also Symptoms include fever, rash, include fever, rash, shock. It can also
present as food poisoning due to heat stable shock. It can also present as food present as food poisoning due to heat stable
enterotoxin. poisoning due to heat stable enterotoxin.
enterotoxin.
Staphylococcus aureus produces toxic Staphylococcus aureus produces Staphylococcus aureus produces toxic
shock syndrome toxin (TSST-1) (exotoxin). toxic shock syndrome toxin shock syndrome toxin (TSST-1) (exotoxin).
This works by binding to MHC II and TCR (TSST-1) (exotoxin). This works by This works by binding to MHC II and TCR
outside of antigen binding site binding to MHC II and TCR outside of antigen binding site
(superantigen), thus causing overwhelming outside of antigen binding site (superantigen), thus causing overwhelming
release of IL-1, IL-2, IFN-gamma, and (superantigen), thus causing release of IL-1, IL-2, IFN-gamma, and
TNF-alpha, leading to shock. overwhelming release of IL-1, IL-2, TNF-alpha, leading to shock.
IFN-gamma, and TNF-alpha,
leading to shock.
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Staphylococcus aureus produces toxic Staphylococcus aureus produces Virulence Factors
shock syndrome toxin (TSST-1) (exotoxin). toxic shock syndrome toxin
This works by binding to MHC II and TCR (TSST-1) (exotoxin). This works by Streptococcus pyogenes exotoxin manifests
outside of antigen binding site binding to MHC II and TCR as toxic shock-like syndorme, with fever,
(superantigen), thus causing overwhelming outside of antigen binding site rash, shock. Can also cause scarlet fever.
release of IL-1, IL-2, IFN-gamma, and (superantigen), thus causing
TNF-alpha, leading to shock. overwhelming release of IL-1, IL-2,
IFN-gamma, and TNF-alpha,
leading to shock.
Streptococcus pyogenes exotoxin manifests Streptococcus pyogenes exotoxin Streptococcus pyogenes exotoxin manifests
as toxic shock-like syndorme, with fever, manifests as toxic shock-like as toxic shock-like syndorme, with fever,
rash, shock. Can also cause scarlet fever. syndorme, with fever, rash, shock. rash, shock. Can also cause scarlet fever.
Can also cause scarlet fever.
Streptococcus pyogenes manifests as RBC Streptococcus pyogenes manifests Streptococcus pyogenes manifests as RBC
lysis and contributes to beta-hemolysis. as RBC lysis and contributes to lysis and contributes to beta-hemolysis.
beta-hemolysis.
Streptococcus pyogenes produces exotoxin Streptococcus pyogenes produces Streptococcus pyogenes produces exotoxin
A. It works by binding to MHC II and TCR exotoxin A. It works by binding to A. It works by binding to MHC II and TCR
outside of the antigen binding site MHC II and TCR outside of the outside of the antigen binding site
(superantigen), which causes antigen binding site (superantigen), (superantigen), which causes
overwhelming release of IL-1, IL-2, IFN- which causes overwhelming release overwhelming release of IL-1, IL-2, IFN-
gamma, and TNF-alpha, leading to shock. of IL-1, IL-2, IFN-gamma, and gamma, and TNF-alpha, leading to shock.
TNF-alpha, leading to shock.
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Virulence Factors Virulence Factors First Aid Microbiology: Bacterial
Virulence Factors
Streptococcus pyogenes produces exotoxin Streptococcus pyogenes produces
A. It works by binding to MHC II and TCR exotoxin A. It works by binding to Streptococcus pyogenes produces
outside of the antigen binding site MHC II and TCR outside of the streptolysin O exotoxin which works
(superantigen), which causes antigen binding site (superantigen), through protein that degrades the cell
overwhelming release of IL-1, IL-2, IFN- which causes overwhelming release membrane.
gamma, and TNF-alpha, leading to shock. of IL-1, IL-2, IFN-gamma, and
TNF-alpha, leading to shock.

Virulence Factors First Aid Microbiology: Bacterial First Aid Microbiology: Bacterial
Streptococcus pyogenes produces
streptolysin O exotoxin which works Streptococcus pyogenes produces The type III secretion system is a needle-
through protein that degrades the cell streptolysin O exotoxin which like protein appendage that facilitates
membrane. works through protein that degrades direct delivery of toxins to the eukaryotic
the cell membrane. host cell.

Virulence Factors
The type III secretion system is a needle- The type III secretion system is a needle-
The type III secretion system is a
like protein appendage that facilitates like protein appendage that facilitates
needle-like protein appendage that
direct delivery of toxins to the eukaryotic direct delivery of toxins to the eukaryotic
facilitates direct delivery of toxins
host cell. host cell.
to the eukaryotic host cell.
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Vibrio cholerae produces cholera toxin Vibrio cholerae produces cholera Vibrio cholerae produces cholera toxin
(endotoxin) which works by overactivating toxin (endotoxin) which works by (endotoxin) which works by overactivating
adenylate cyclase (increasing cAMP) by overactivating adenylate cyclase adenylate cyclase (increasing cAMP) by
permanently activating Gs which leads to (increasing cAMP) by permanently permanently activating Gs which leads to
increased Cl- secretion in gut and H2O activating Gs which leads to increased Cl- secretion in gut and H2O
efflux. increased Cl- secretion in gut and efflux.
H2O efflux.
Vibrio cholerae produces cholera toxin Vibrio cholerae produces cholera Vibrio cholerae produces cholera toxin
(endotoxin) which works by overactivating toxin (endotoxin) which works by (endotoxin) which works by overactivating
adenylate cyclase (increasing cAMP) by overactivating adenylate cyclase adenylate cyclase (increasing cAMP) by
permanently activating Gs which leads to (increasing cAMP) by permanently permanently activating Gs which leads to
increased Cl- secretion in gut and H2O activating Gs which leads to increased Cl- secretion in gut and H2O
efflux. increased Cl- secretion in gut and efflux.
H2O efflux.

Virulence Factors
Virulence Factors First Aid Microbiology: Bacterial Endotoxins are released upon cell lysis or
Virulence Factors by living cells by blebs detaching from the
exotoxins are mainly from certain species outer surface membrane.
of gram positive and gram negative exotoxins are mainly from certain Contrast with exotoxins, which are actively
bacteria. species of gram positive and gram secreted.
negative bacteria.
First Aid Microbiology: Bacterial First Aid Microbiology: Bacterial First Aid Microbiology: Bacterial, Viral,
Virulence Factors Virulence Factors and Fungi Hints
Endotoxins are released upon cell lysis or Endotoxins are released upon cell A patient who is sick and an organ
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by living cells by blebs detaching from the lysis or by living cells by blebs
outer surface membrane. detaching from the outer surface transplant recipient should make you think
Contrast with exotoxins, which are actively membrane. CMV.
secreted. Contrast with exotoxins, which are
actively secreted.
First Aid Microbiology: Bacterial, Viral, First Aid Microbiology: Bacterial, Viral,
First Aid Microbiology: Bacterial,
and Fungi Hints and Fungi Hints
Viral, and Fungi Hints
A patient who is sick and an organ A patient with a positive periodic schiff
A patient with a positive periodic
transplant recipient should make you think stain can often be a sign of tropheryma
schiff stain can often be a sign of
CMV. whipplei (Whipple disease) infection.
tropheryma whipplei (Whipple
disease) infection.
First Aid Microbiology: Bacterial, Viral,

and Fungi Hints
First Aid Microbiology: Bacterial, and Fungi Hints
If on Step you see someone getting sick
"Currant jelly" sputum can often be a sign
after being in contact with a health care
"Currant jelly" sputum can often be of klebsiella.
provider, think HBV (from needlestick).
a sign of klebsiella.
First Aid Microbiology: Bacterial, Viral, First Aid Microbiology: Bacterial, First Aid Microbiology: Bacterial, Viral,
and Fungi Hints Viral, and Fungi Hints and Fungi Hints
A dog or cat bite can often be a sign of A dog or cat bite can often be a sign A pediatric infection is often a sign of
pasteurella multocida. of pasteurella multocida. haemophilus influenzae (including
epiglottitis).
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First Aid Microbiology: Bacterial,
and Fungi Hints and Fungi Hints
A pediatric infection is often a sign of A rash on hands and feet can often be a
A rash on hands and feet can often
haemophilus influenzae (including sign of Coxsackie A virus, Treponema
be a sign of Coxsackie A virus,
epiglottitis). pallidum, or rickettsia rickettsii infection.
Treponema pallidum, or rickettsia
rickettsii infection.

First Aid Microbiology: Bacterial, First Aid Microbiology: Bacterial, Viral,
and Fungi Hints
Viral, and Fungi Hints and Fungi Hints
A rash on hands and feet can often be a
A rash on hands and feet can often A surgical wound with infection should
sign of Coxsackie A virus, Treponema
be a sign of Coxsackie A virus, make you think S. aureus.
pallidum, or rickettsia rickettsii infection.
Treponema pallidum, or rickettsia
rickettsii infection.
A surgical wound with infection should A traumatic open wound should A traumatic open wound should raise
make you think S. aureus. raise worries of clostridium worries of clostridium perfringens
perfringens infection. infection.
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and Fungi Hints First Aid Microbiology: Bacterial, and Fungi Hints
Branching rods in oral infection or sulfur Chronic granulomatous disease can often
granules can often be a sign of actinomyces Branching rods in oral infection or be a sign of catalase positive microbes,
israelii. sulfur granules can often be a sign especially S aureus.
of actinomyces israelii.
and Fungi Hints First Aid Microbiology: Bacterial, and Fungi Hints
Chronic granulomatous disease can often Facial nerve palsy (typically bilateral) can
be a sign of catalase positive microbes, Chronic granulomatous disease can often be a sign of Borrelia burgdorferi
especially S aureus. often be a sign of catalase positive (Lyme disease.
microbes, especially S aureus.
Facial nerve palsy (typically bilateral) can Fungal infection in a diabetic or Neutropenic patients can often be a sign of
often be a sign of Borrelia burgdorferi immunocompromised patient can Candida albicans (systemic) or Aspergillus.
(Lyme disease. often be a sign of .
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First Aid Microbiology: Bacterial, and Fungi Hints
and Fungi Hints
Pneumonia in cystic fibrosis or burn
Neutropenic patients can often be a sign of
Neutropenic patients can often be a infection can often be a sign of
Candida albicans (systemic) or Aspergillus.
sign of Candida albicans (systemic) pseudomonas aeruginosa infection.
or Aspergillus.

and Fungi Hints First Aid Microbiology: Bacterial,
and Fungi Hints
Pneumonia in cystic fibrosis or burn
Pus, empyema, or an abcess can often be a
infection can often be a sign of Pneumonia in cystic fibrosis or
sign of S aures infection.
pseudomonas aeruginosa infection. burn infection can often be a sign of
pseudomonas aeruginosa infection.
Pus, empyema, or an abcess can often be a Sepsis/meningitis in newborn can Sepsis/meningitis in newborn can often be
sign of S aures infection. often be a sign of Group B strep. a sign of Group B strep.
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First Aid Microbiology: Borrelia First Aid Microbiology: Borrelia First Aid Microbiology: Borrelia
Recurrentis Recurrentis Recurrentis
Borrelia Recurrentis is associated with Borrelia Recurrentis is associated Borrelia recurrentis causes relapsing
epidemics amid poor living conditions, with epidemics amid poor living fever, which is due to the bacteria's
famine, and war conditions, famine, and war antigen variation.
antigen variability is what makes it
Prevalent in Ethiopia, Sudan Prevalent in Ethiopia, Sudan reccurent/relapse
First Aid Microbiology: Borrelia

First Aid Microbiology: Borrelia First Aid Microbiology: Borrelia
Recurrentis
Recurrentis Recurrentis
Louse Borne Relapsing
Borrelia recurrentis causes relapsing Louse Borne Relapsing Fever presents with
Fever presents with severe jaundice
fever, which is due to the bacteria's severe jaundice and bleeding, severe
and bleeding, severe changes in
antigen variation. changes in mental status and a prolonged
mental status and a prolonged QT
antigen variability is what makes it QT interval on ECG
interval on ECG
reccurent/relapse
First Aid Microbiology: Borrelia

First Aid Microbiology: Borrelia Recurrentis
Recurrentis First Aid Microbiology: Borrelia
What feature of Borellia Recurrentis
Louse Borne Relapsing Fever presents with Recurrentis makes the fever it
severe jaundice and bleeding, severe generates "Relapsing"? Body Louse is the vector for Borrelia
changes in mental status and a prolonged recurrentis.
QT interval on ECG antigenic variation Pediculus humanus / Phthirus pubis
First Aid Microbiology: Bugs affecting First Aid Microbiology: Bugs First Aid Microbiology: Bugs affecting
Unvaccinated Children affecting Unvaccinated Children Unvaccinated Children
In addition to epiglottitis, H influenzae In addition to epiglottitis, H In addition to epiglottitis, H influenzae

type B can cause fever with dysphagia, influenzae type B can cause fever type B can cause fever with dysphagia,
drooling, difficulty breathing, and with dysphagia, drooling, difficulty drooling, difficulty breathing, and
"thumbprint sign" on x-ray in unvaccinated breathing, and "thumbprint sign" on "thumbprint sign" on x-ray in unvaccinated
children. x-ray in unvaccinated children. children.
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First Aid Microbiology: Bugs affecting

Unvaccinated Children First Aid Microbiology: Bugs First Aid Microbiology: Bugs affecting
affecting Unvaccinated Children Unvaccinated Children
In addition to epiglottitis, H influenzae
type B can cause fever with dysphagia, In addition to epiglottitis, H In addition to phayngitis, corynebacterium
drooling, difficulty breathing, and influenzae type B can cause fever diphtheriae can cause a grayish
"thumbprint sign" on x-ray in unvaccinated with dysphagia, drooling, difficulty oropharyngeal exudate and a painful throat
children. breathing, and "thumbprint sign" on in unvaccinated children.
x-ray in unvaccinated children.
In addition to phayngitis, corynebacterium In unvaccinated children, H In unvaccinated children, H influenza type

diphtheriae can cause a grayish influenza type B can present as B can present as meningitis with
oropharyngeal exudate and a painful throat meningitis with nasopharynx nasopharynx colonization.
in unvaccinated children. colonization.

First Aid Microbiology: Bugs First Aid Microbiology: Bugs affecting
Unvaccinated Children
In unvaccinated children, H influenza type
In unvaccinated children, H In unvaccinated children, H influenzae type
B can present as meningitis with
influenzae type B can cause B can cause epiglottitis.
nasopharynx colonization.
epiglottitis.
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In unvaccinated children, cornebacterium In unvaccinated children, In unvaccinated children, cornebacterium

diphtheriae causes pharyngitis (it cornebacterium diphtheriae causes diphtheriae causes pharyngitis (it
elaborates a toxin that causes necrosis in pharyngitis (it elaborates a toxin elaborates a toxin that causes necrosis in
the pharynx, cardiac, and CNS tissue. that causes necrosis in the pharynx, the pharynx, cardiac, and CNS tissue.
cardiac, and CNS tissue.

First Aid Microbiology: Bugs affecting First Aid Microbiology: Bugs Unvaccinated Children
Unvaccinated Children affecting Unvaccinated Children
In unvaccinated children, measles virus
In unvaccinated children, measles vilus can In unvaccinated children, measles produces a rash but it is preceded by
present as {{c2::a rash beginning at the virus produces a rash but it is cough, {c3::coryza}}, conjunctivitis, and
head and moving down.}] preceded by cough, {c3::coryza}}, blue white (Koplik) spots on buccal
conjunctivitis, and blue white mucosa.
(Koplik) spots on buccal mucosa.

Unvaccinated Children First Aid Microbiology: Bugs First Aid Microbiology: Bugs affecting
In unvaccinated children, measles virus
produces a rash but it is preceded by In unvaccinated children, measles In unvaccinated children, poliovirus can
cough, {c3::coryza}}, conjunctivitis, and virus produces a rash but it is present as menigitis, or also myalgia and
blue white (Koplik) spots on buccal preceded by cough, {c3::coryza}}, paralysis.
mucosa. conjunctivitis, and blue white
(Koplik) spots on buccal mucosa.
In unvaccinated children, poliovirus can In unvaccinated children, rubella In unvaccinated children, rubella virus can
present as menigitis, or also myalgia and virus can present as a rash present as a rash beginning at the head and
paralysis. beginning at the head and moving moving down with postauricular
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down with postauricular lymphadenopathy.

lymphadenopathy.

First Aid Microbiology: Bugs
First Aid Microbiology: Bugs affecting affecting Unvaccinated Children
An asplenic patient is often a sign of
An asplenic patient is often a sign
encapsulated microbes, especially S
In unvaccinated children, rubella virus can of encapsulated microbes,
pneumoniae, H influenza type B, and N
present as a rash beginning at the head and especially S pneumoniae, H
meningitidis.
moving down with postauricular influenza type B, and N
lymphadenopathy. meningitidis.

An asplenic patient is often a sign of

encapsulated microbes, especially S
pneumoniae, H influenza type B, and N
meningitidis. First Aid Microbiology: First Aid Microbiology: Burkholderia
Burkholderia Cepacia Cepacia
Burkholderia cepacia is a gram- Burkholderia cepacia is a gram-negative

negative bacillus bacterium. bacillus bacterium.
respiratory bacteria respiratory bacteria

First Aid Microbiology: Burkholderia
Burkholderia Cepacia First Aid Microbiology: Citrobacter
Cepacia
Freundii
Burkholderia cepacia is catalase-
Burkholderia cepacia is catalase-positive
positive and is a recurrent infection Citrobacter is a gram-negative bacilli
and is a recurrent infection in people with
in people with chronic
chronic granulomatous disease (NADPH
granulomatous disease (NADPH
oxidase deficiency).
oxidase deficiency).
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First Aid Microbiology: Citrobacter

Freundii First Aid Microbiology: Citrobacter
First Aid Microbiology: Citrobacter Freundii
Freundii Citrobacter is a slow lactose
fermenter and thus must be Citrobacter is a slow lactose fermenter and
Citrobacter is a gram-negative bacilli differentiated from serratia thus must be differentiated from serratia
citrobacter does NOT produce red citrobacter does NOT produce red pigment
pigment
First Aid Microbiology: Common Diseases

of HIV+ Adults
As CD4+ cell count goes down, risks of

First Aid Microbiology: Citrobacter reactivation of past infections (eg TB, HSV
First Aid Microbiology: Citrobacter
Freundii shingles), dissemination of bacterial
Freundii
infections and fungal infections (eg
Citrobacter is associated with coccidioidomycosis), and non-Hodgkin
Citrobacter is associated with neonatal
neonatal meningitis and brain lymphomas goes up.
meningitis and brain abscess
abscess
First Aid Microbiology: Common Diseases First Aid Microbiology: Common First Aid Microbiology: Common Diseases
of HIV+ Adults Diseases of HIV+ Adults of HIV+ Adults
As CD4+ cell count goes down, risks of As CD4+ cell count goes down, As CD4+ cell count goes down, risks of
reactivation of past infections (eg TB, HSV risks of reactivation of past reactivation of past infections (eg TB, HSV
shingles), dissemination of bacterial infections (eg TB, HSV shingles), shingles), dissemination of bacterial
infections and fungal infections (eg dissemination of bacterial infections and fungal infections (eg
coccidioidomycosis), and non-Hodgkin infections and fungal infections (eg coccidioidomycosis), and non-Hodgkin
lymphomas goes up. coccidioidomycosis), and non- lymphomas goes up.
Hodgkin lymphomas goes up.
With CD4+ cell count <200/mm3, With CD4+ cell count <200/mm3, With CD4+ cell count <200/mm3,
histoplasma capsulatum is seen in HIV histoplasma capsulatum is seen in histoplasma capsulatum is seen in HIV
positive patiens. Presentation includes HIV positive patiens. Presentation positive patiens. Presentation includes
fever, weight loss, fatigue, cough, dyspnea, includes fever, weight loss, fatigue, fever, weight loss, fatigue, cough, dyspnea,
nausea, vomiting, and diarrhea. Findings cough, dyspnea, nausea, vomiting, nausea, vomiting, and diarrhea. Findings
are oval yeast cells within macrophages. and diarrhea. Findings are oval are oval yeast cells within macrophages.
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yeast cells within macrophages.
With CD4+ cell count <500/mm3, HHV-8 With CD4+ cell count <500/mm3, With CD4+ cell count <500/mm3, HHV-8
is seen in HIV positive adults. Presentation HHV-8 is seen in HIV positive is seen in HIV positive adults. Presentation
is kaposi sarcoma with biopsy with lateral adults. Presentation is kaposi is kaposi sarcoma with biopsy with lateral
inflammation. sarcoma with biopsy with lateral inflammation.
inflammation.
With CD4+ cell count <500/mm3, HPV With CD4+ cell count <500/mm3, With CD4+ cell count <500/mm3, HPV
occurs in HIV positive patients. HPV occurs in HIV positive occurs in HIV positive patients.
Presentation is squamous cell carcinoma, patients. Presentation is squamous Presentation is squamous cell carcinoma,
commonly of anus or cervix. cell carcinoma, commonly of anus commonly of anus or cervix.
or cervix.
First Aid Microbiology: Common Diseases First Aid Microbiology: Common Diseases
of HIV+ Adults First Aid Microbiology: Common of HIV+ Adults
Diseases of HIV+ Adults
With CD4+ cell count <500/mm3, With CD4+ cell count <500/mm3,
bartonella henselae in seen in HIV positive With CD4+ cell count <500/mm3, bartonella henselae in seen in HIV positive
adults. Presentation is bacillary bartonella henselae in seen in HIV adults. Presentation is bacillary
angiomatosis with biopsy with neutrophilic positive adults. Presentation is angiomatosis with biopsy with neutrophilic
inflammation. bacillary angiomatosis with biopsy inflammation.
with neutrophilic inflammation.
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With a CD4+ cell count of < 500/mm3, With a CD4+ cell count of < With a CD4+ cell count of < 500/mm3,
candida albicans presents with oral thrush. 500/mm3, candida albicans presents candida albicans presents with oral thrush.
Scrapable white plaque and psedohyphae with oral thrush. Scrapable white Scrapable white plaque and psedohyphae
on microscopy are often seen. plaque and psedohyphae on on microscopy are often seen.
microscopy are often seen.
With a CD4+ cell count of < 500/mm3, With a CD4+ cell count of < With a CD4+ cell count of < 500/mm3,
EBV often presents with oral hairy 500/mm3, EBV often presents with EBV often presents with oral hairy
leukoplakia and findings of unscrapable oral hairy leukoplakia and findings leukoplakia and findings of unscrapable
white plaque on lateral tongue. of unscrapable white plaque on white plaque on lateral tongue.
lateral tongue.
With a CD4+ cell count < 200/mm3, JC With a CD4+ cell count < With a CD4+ cell count < 200/mm3, JC
virus (reactivation is seen in HIV positive 200/mm3, JC virus (reactivation is virus (reactivation is seen in HIV positive
patients. It presents with progressive seen in HIV positive patients. It patients. It presents with progressive
multifocal leukoencephalopathy with presents with progressive multifocal leukoencephalopathy with
findings of nonenhancing areas of multifocal leukoencephalopathy findings of nonenhancing areas of
demyelination on MRI. with findings of nonenhancing demyelination on MRI.
areas of demyelination on MRI.
With a CD4+ cell count <100/mm3, CMV With a CD4+ cell count <100/mm3, With a CD4+ cell count <100/mm3, CMV
is often seen in HIV positive patients. It CMV is often seen in HIV positive is often seen in HIV positive patients. It
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presents as retinitis, esophagitis, colitis, patients. It presents as retinitis, presents as retinitis, esophagitis, colitis,
pneumonitis, or encephalitis. esophagitis, colitis, pneumonitis, or pneumonitis, or encephalitis.
encephalitis.
With a CD4+ cell count <100/mm3, EBV With a CD4+ cell count <100/mm3, With a CD4+ cell count <100/mm3, EBV
is often seen in HIV positive patients. It EBV is often seen in HIV positive is often seen in HIV positive patients. It
presents as B-cell lymphoma (eg non patients. It presents as B-cell presents as B-cell lymphoma (eg non
Hodgkin, CNS. Findings may be ring lymphoma (eg non Hodgkin, CNS. Hodgkin, CNS. Findings may be ring
enhancing or may be solitary. Findings may be ring enhancing or enhancing or may be solitary.
may be solitary.
With a CD4+ cell count <100/mm3, With a CD4+ cell count <100/mm3, With a CD4+ cell count <100/mm3,
Toxoplasma gondii is often seen in HIV Toxoplasma gondii is often seen in Toxoplasma gondii is often seen in HIV
positive patients. It presents as brain HIV positive patients. It presents as positive patients. It presents as brain
abcesses with findings of multiple ring- brain abcesses with findings of abcesses with findings of multiple ring-
enhacing lesions on MRI. multiple ring-enhacing lesions on enhacing lesions on MRI.
MRI.
aspergillus fumigatus is often seen in HIV aspergillus fumigatus is often seen aspergillus fumigatus is often seen in HIV
positive patients. It presents as hemoptysis in HIV positive patients. It presents positive patients. It presents as hemoptysis
and pleuritic pain with findings of as hemoptysis and pleuritic pain and pleuritic pain with findings of
cavitation or inflitrates on chest imaging. with findings of cavitation or cavitation or inflitrates on chest imaging.
inflitrates on chest imaging.
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With a CD4+ cell count <100/mm3, With a CD4+ cell count <100/mm3,
candida albicans is often seen in HIV With a CD4+ cell count <100/mm3, candida albicans is often seen in HIV
positive patients. It presents as esophagitis candida albicans is often seen in positive patients. It presents as esophagitis
with findings of white plaques on HIV positive patients. It presents as with findings of white plaques on
endoscopy or yeast and pseudohyphae on esophagitis with findings of white endoscopy or yeast and pseudohyphae on
biopsy. plaques on endoscopy or yeast and biopsy.
pseudohyphae on biopsy.
With a CD4+ cell count <100/mm3, With a CD4+ cell count <100/mm3,
cryptococcus neoformans is often seen in With a CD4+ cell count <100/mm3, cryptococcus neoformans is often seen in
HIV positive patients. It presents as cryptococcus neoformans is often HIV positive patients. It presents as
meningitis with findings of encapsulated seen in HIV positive patients. It meningitis with findings of encapsulated
yeast on India ink stain or capsular antigen presents as meningitis with findings yeast on India ink stain or capsular antigen
positive. of encapsulated yeast on India ink positive.
stain or capsular antigen positive.
cryptosoridium spp. is often seen in HIV cryptosoridium spp. is often seen in cryptosoridium spp. is often seen in HIV
positive patients. It presents as chronic, HIV positive patients. It presents as positive patients. It presents as chronic,
watery diarrhea with findings of acid-fast chronic, watery diarrhea with watery diarrhea with findings of acid-fast
oocysts in stool. findings of acid-fast oocysts in oocysts in stool.
stool.
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mycobacterium avium-intracellulare or mycobacterium avium- mycobacterium avium-intracellulare or
mycobacterium avium complex is often intracellulare or mycobacterium mycobacterium avium complex is often
seen in HIV positive patients. It presents as avium complex is often seen in seen in HIV positive patients. It presents as
nonspecific system symptoms (fever, night HIV positive patients. It presents as nonspecific system symptoms (fever, night
sweats, weight loss) or focal nonspecific system symptoms sweats, weight loss) or focal
lymphadenitis. (fever, night sweats, weight loss) or lymphadenitis.
focal lymphadenitis.

of HIV+ Adults
of HIV+ Adults First Aid Microbiology: Common
Diseases of HIV+ Adults With a CD4+ cell count <200/mm3,
pneumocystis jirovecii is often seen in HIV
With a CD4+ cell count <200/mm3, HIV
With a CD4+ cell count <200/mm3, positive patients. It presents with
presents with dementia.
HIV presents with dementia. pneumocystis pneumonia and findings of
"ground-glass" opacities on CXR.
With a CD4+ cell count <200/mm3, With a CD4+ cell count <200/mm3, CMV in HIV positive patients can have
pneumocystis jirovecii is often seen in HIV pneumocystis jirovecii is often seen findings of linear ulcers on endoscopy or
positive patients. It presents with in HIV positive patients. It presents cotton-wool spots on fundoscopy. Biopsy
pneumocystis pneumonia and findings of with pneumocystis pneumonia and will reveal cells with intranuclear (owl eye)
"ground-glass" opacities on CXR. findings of "ground-glass" opacities inclusion bodies.
on CXR.
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First Aid Microbiology: Common Diseases First Aid Microbiology: Common

of HIV+ Adults Diseases of HIV+ Adults
CMV in HIV positive patients can have CMV in HIV positive patients can
findings of linear ulcers on endoscopy or have findings of linear ulcers on
cotton-wool spots on fundoscopy. Biopsy First Aid Microbiology: Disinfection and
endoscopy or cotton-wool spots on
will reveal cells with intranuclear (owl eye) Sterility
fundoscopy. Biopsy will reveal
inclusion bodies. cells with intranuclear (owl eye)
Alcohols function by denaturing proteins
inclusion bodies.
and disrupting cell membranes
not sporicidal
First Aid Microbiology: Disinfection and First Aid Microbiology: First Aid Microbiology: Disinfection and
Sterility Disinfection and Sterility Sterility
Autoclaves use pressurized steam at Autoclaves use pressurized steam Chlorhexidine functions by denaturing
>120°C and may be sporicidal at >120°C and may be sporicidal proteins and disrupting cell membranes
not sporicidal
First Aid Microbiology: Disinfection and First Aid Microbiology: First Aid Microbiology: Disinfection and
Sterility Disinfection and Sterility Sterility
Disinfection and Sterilization: Hydrogen Disinfection refers to ↓ pathogenic Iodine and iodophors function by
peroxide functions by free radical organism counts to safe levels halogenation of DNA, RNA and proteins
oxidation sterilization = inactivation of self- and may be sporicidal
sporicidal propagating biological entities
First Aid Microbiology: Disinfection and

Sterility
First Aid Microbiology: Disinfection and
Disinfection and Sterility
Sterility What is the only method of
disinfection/sterilization that is definitively
Sterilization refers to inactivation
Iodine and iodophors function by sporicidal?
of self-propagating biological
halogenation of DNA, RNA and proteins
entities
and may be sporicidal Hydrogen peroxide
disinfection = ↓ pathogenic
organism counts to safe levels
autoclave, iodine and iodophors may be
sporicidal
First Aid Microbiology: Disinfection and First Aid Microbiology: Ehrlichia First Aid Microbiology: Ehrlichia
Sterility chaffeensis chaffeensis
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What methods of disinfection/sterilization

are not sporicidal? Ehrlichia does not Gram stain well
Ehrlichia is a Gram-negative pleomorphic
because it is primarily an
bacterium
Alcohols and Chlorhexidine intracellular pathogen
does not Gram stain well (primarily
when it does Gram stain, it is
intracellular)
autoclave, iodine and iodophors may be Gram-
sporicidal
First Aid Microbiology: Ehrlichia

chaffeensis First Aid Microbiology: Ehrlichia
chaffeensis
First Aid Microbiology: Ehrlichia Human Monocytotropic
chaffeensis Ehrlichiosis manifests with rash, Human Monocytotropic Ehrlichiosis
myalgia, headache, with systemic manifests with rash, myalgia, headache,
Ehrlichia is a Gram-negative pleomorphic symptoms manifesting in sepsis - with systemic symptoms manifesting in
bacterium especially in immunocompromised sepsis - especially in immunocompromised
does not Gram stain well (primarily patients patients
intracellular)
Thrombocytopenia, leukopenia, and Thrombocytopenia, leukopenia, and
elevated LFTs commonly seen in elevated LFTs commonly seen in lab work
lab work

First Aid Microbiology: Ehrlichia chaffeensis
chaffeensis
Human Monocytotropic
Human Monocytotropic Ehrlichiosis Ehrlichiosis manifests with rash,
chaffeensis
manifests with rash, myalgia, headache, myalgia, headache, with systemic
with systemic symptoms manifesting in symptoms manifesting in sepsis -
Amblyomma (Lone Star tick) acts as the
sepsis - especially in immunocompromised especially in immunocompromised
vector for Ehrlichia chaffeensis
patients patients
leads to Ehrlichiosis
Thrombocytopenia, leukopenia, and Thrombocytopenia, leukopenia, and
elevated LFTs commonly seen in lab work elevated LFTs commonly seen in
lab work

First Aid Microbiology: Ehrlichia First Aid Microbiology: Ehrlichia
chaffeensis
chaffeensis chaffeensis
Morulae in monocytes /
Morulae in monocytes / macrophages Morulae in monocytes / macrophages
macrophages indicates
indicates ehrlichiosis indicates ehrlichiosis
ehrlichiosis
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First Aid Microbiology: Gram

First Aid Microbiology: Gram Negative
Negative Anaerobes
Anaerobes First Aid Microbiology: Gram Negative
Anaerobes
Aspiration of anaerobes
Aspiration of anaerobes
(Peptostreptococcus,
(Peptostreptococcus, Fusobacterium, Bacteroides are anaerobic
Fusobacterium, Prevotella,
Prevotella, Bacteroides) is a cause of Gram-, bacillus bacterium
Bacteroides) is a cause of
pneumonia in alcoholics
pneumonia in alcoholics

Anaerobes
First Aid Microbiology: Gram Negative First Aid Microbiology: Gram Bacteroides lack catalase and/or
Anaerobes Negative Anaerobes superoxide dismutase, making then
susceptible to oxidative damage
Bacteroides is a Gram-negative bacillus Bacteroides is a Gram-negative
bacterium bacillus bacterium
enteric bacteria enteric bacteria

Anaerobes
Bacteroides lack catalase and/or First Aid Microbiology: Gram First Aid Microbiology: Gram Negative
superoxide dismutase, making then Negative Anaerobes Anaerobes
susceptible to oxidative damage
Fusobacterium is a Gram negative Fusobacterium is a Gram negative bacillus
bacillus bacterium bacterium
enteric bacteria enteric bacteria

Negative Anaerobes
First Aid Microbiology: Gram Negative Anaerobes
Anaerobes
Clindamycin is used to treat
Clindamycin is used to treat Anaerobe
Anaerobe infections above the
Fusobacterium is anaerobic infections above the diaphragm
diaphragm
Gram-, bacillus bacterium ex. aspiration pneumonia, lung abscesses,
ex. aspiration pneumonia, lung
and oral infections
abscesses, and oral infections

First Aid Microbiology: Gram Negative Negative Anaerobes
Anaerobes
Anaerobes
Decubitis ulcers, surgical
Decubitis ulcers, surgical wounds, and wounds, and drains are risk factors
Metronidazole is used to
drains are risk factors for nosocomial for nosocomial infection by S.
treat Anaerobe infections below the
infection by S. aureus and gram- anaerobes aureus and gram- anaerobes
diaphragm
(Bacteroides, Prevotella, Fusobacterium) (Bacteroides, Prevotella,
Fusobacterium)
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First Aid Microbiology: HDV First Aid Microbiology: HDV
Anaerobes
HDV is transmitted parenterally, Deltavirus (also known as HDV) is a
Metronidazole is used to
sexually, or perinatally. negative-sense ssRNA virus, which
treat Anaerobe infections below the
requires HBV to replicate.
diaphragm
First Aid Microbiology: HDV First Aid Microbiology: HDV First Aid Microbiology: HDV
Deltavirus (also known as HDV) is a Deltavirus (also known as HDV) is Coinfection with HDV and HBV, leads to a
negative-sense ssRNA virus, which a negative-sense ssRNA virus, long incubation period.
requires HBV to replicate. which requires HBV to replicate.
First Aid Microbiology: HDV

First Aid Microbiology: HDV First Aid Microbiology: HDV
Superinfection with HDV (HDV after
Coinfection with HDV and HBV, leads to a Coinfection with HDV and HBV,
HBV), leads to a short incubation period.
long incubation period. leads to a long incubation period.
Coinfection (HDV with HBV) = long
First Aid Microbiology: HIV Diagnosis
First Aid Microbiology: HDV A diagnosis of HIV is made with ELISA.

First Aid Microbiology: HDV This is sensitive and has a high false
Superinfection with HDV (HDV positive rate with low threshold. Thus it is
Superinfection with HDV (HDV after after HBV), leads to a short a rule out test.
HBV), leads to a short incubation period. incubation period.
Coinfection (HDV with HBV) = long Coinfection (HDV with HBV) =

long
First Aid Microbiology: HIV Diagnosis First Aid Microbiology: HIV First Aid Microbiology: HIV Diagnosis
Diagnosis
A diagnosis of HIV is made with ELISA.
An AIDS diagnosis is made with ≤ 200
This is sensitive and has a high false A diagnosis of HIV is made with CD4+ cells/mm3 (normal: 500–1500
positive rate with low threshold. Thus it is ELISA. This is sensitive and has a cells/mm3).
a rule out test. high false positive rate with low
threshold. Thus it is a rule out test.
Diagnosis
Another way to make an AIDS diagnosis is Another way to make an AIDS diagnosis is
if the patient is HIV positive with an AIDS Another way to make an AIDS if the patient is HIV positive with an AIDS
defining condition (eg pneumocystis diagnosis is if the patient is HIV defining condition (eg pneumocystis
pneumonia) or CD4+ percentage < 14% positive with an AIDS defining pneumonia) or CD4+ percentage < 14%
condition (eg pneumocystis
pneumonia) or CD4+ percentage <
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14%
First Aid Microbiology: HIV First Aid Microbiology: HIV Diagnosis

Diagnosis
Positive results of ELISA on HIV
ELISA/Western blot tests are often falsely
ELISA/Western blot tests are often diagnosis are confirmed with a western
negative in the first and falsely positive
falsely negative in the first and blot assay, which is specific and has a low
initially in babies born to infected mothers
falsely positive initially in babies false positive rate and high threshold.
(anti-gp120 crosses the placenta).
born to infected mothers (anti- Thus, it is considered a rule in test.
gp120 crosses the placenta).
First Aid Microbiology: HIV

Diagnosis
Positive results of ELISA on HIV First Aid Microbiology: HIV Diagnosis
Positive results of ELISA on HIV
diagnosis are confirmed with a western
diagnosis are confirmed with a To detect viral loads in neonates, use PCR.
blot assay, which is specific and has a low
western blot assay, which is
false positive rate and high threshold.
specific and has a low false positive
Thus, it is considered a rule in test.
rate and high threshold. Thus, it is
considered a rule in test.
Diagnosis
ELISA/Western blot tests look for HIV genotyping is used to determine
antibodies to viral proteins. ELISA/Western blot tests look for appropriate therapy.
antibodies to viral proteins.
Diagnosis
HIV genotyping is used to determine Viral load tests determine the amount of
appropriate therapy. Viral load tests determine the viral RNA in plasma. or to monitor the
amount of viral RNA in plasma. or effect of drug therapy.
to monitor the effect of drug A high viral load is associated with a poor
therapy. prognosis.
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A high viral load is associated with

a poor prognosis.
First Aid Microbiology: HTLV-1

As opposed to HIV (another Retrovirus),
As opposed to HIV (another HTLV has icosahedral capsid whereas HIV
Retrovirus), HTLV has icosahedral has a complex and conical capsid.
capsid whereas HIV has a complex
and conical capsid.
Viral load tests determine the amount of
viral RNA in plasma. or to monitor the
effect of drug therapy.
A high viral load is associated with a poor
prognosis.

Besides its cutaneous First Aid Microbiology: HTLV-1
manifestation, Adult T-cell
Besides its cutaneous manifestation, Adult
lymphoma invades the bone, HTLV is an enveloped virus with genetic
T-cell lymphoma invades the bone, causing
causing lytic bone lesions and material that is single stranded, positive-
lytic bone lesions and hypercalcemia.
hypercalcemia. sense, linear configuration, and has 2
copies of its genetic material.
Thus keep as a differential for a patient that
Thus keep as a differential for a
seems to have multiple myeloma
patient that seems to have multiple
myeloma

First Aid Microbiology: HTLV-1 HTLV-1 causes its tumorgenecity due to
DNA integration in CD-4+ T cells.
HTLV is an enveloped virus with
HTLV is an enveloped virus with genetic
genetic material that is single
material that is single stranded, positive- carries Tax (transactivating - analagous to
stranded, positive-sense, linear
sense, linear configuration, and has 2 HIV Tat) gene that encodes Tax protein,
configuration, and has 2 copies of
copies of its genetic material. acts in same cell to upregulate transcription
its genetic material.
of proviral DNA as well as cellular
proteins involved in uncontrolled cell
proliferation
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HTLV-1 causes its tumorgenecity due to

DNA integration in CD-4+ T cells. First Aid Microbiology: HTLV-1
HTLV-1 dermatitis (the cutaneous
carries Tax (transactivating - analagous to HTLV-1 is a retrovirus with a reverse
lesion) can result in superinfection
HIV Tat) gene that encodes Tax protein, transcriptase and can lead to Adult T-Cell
with Strongyloides stercoralis.
acts in same cell to upregulate transcription Lymphoma/Leukemia.
of proviral DNA as well as cellular
proteins involved in uncontrolled cell
proliferation
First Aid Microbiology: HTLV-1 First Aid Microbiology: HTLV-1 First Aid Microbiology: HTLV-1
HTLV-1 is a retrovirus with a reverse HTLV-1 is a retrovirus with a HTLV-1 is common in Japan, West Africa
transcriptase and can lead to Adult T-Cell reverse transcriptase and can lead to and the Carribbean.
Lymphoma/Leukemia. Adult T-Cell Lymphoma/Leukemia.
First Aid Microbiology: Haemophilus

First Aid Microbiology: HTLV-1 Ducreyi
In Adult T-cell lymphoma, adults present
IV drug abuse is an associated risk Chancroid differs from Chancre in that the
with cutaneous lesions
factor for HTLV-1. former is painful and the latter is painless
and caused by Treponema Pallidum
Long latency of onset (20-30 years)
First Aid First Aid Microbiology: Haemophilus

Microbiology: Haemophilus Ducreyi
Ducreyi
Haemophilus Ducreyi is a Gram Negative
Haemophilus Ducreyi is a Gram Coccobacilli that can appears like a school
Negative Coccobacilli that can of fish when gram stained
appears like a school of fish when
First Aid Microbiology: Haemophilus gram stained
Ducreyi
Chancroid differs from Chancre in that the

former is painful and the latter is painless
and caused by Treponema Pallidum
First Aid Microbiology: Haemophilus First Aid Microbiology: Hepatitis E First Aid Microbiology: Hepatitis E
Ducreyi
HEV does not have an envelope HEV does not have an envelope and
Haemophilus Ducreyi is a Gram Negative and therefore is not destroyed by therefore is not destroyed by the gut
Coccobacilli that can appears like a school the gut
of fish when gram stained same with HAV
same with HAV "the vowels hit your bowels"
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"the vowels hit your bowels"
First Aid Microbiology: Hepatitis E

First Aid Microbiology: Hepatitis E Hepatitis E virus (HEV) is transmitted
via fecal-oral route; especially with
Hepatitis E virus (HEV) is a
Hepatitis E virus (HEV) has a short waterborne epidemics.
hepevirus.
(weeks) incubation period/ Hepatitis Worm: A-B-C-D-E
Ends have fecal-oral transmission (A =
mouth; E = anus)
ssRNA, positive-sense.
Everything in between (BCD) is
transmitted parenterally
First Aid Microbiology: Hepatitis E First Aid Microbiology: Hepatitis E First Aid Microbiology: Hepatitis E
Fulminant Hepatitis is a severe form of Fulminant Hepatitis is a severe Fulminant Hepatitis is a severe form of
acute hepatitis that is commonly seen form of acute hepatitis that is acute hepatitis that is commonly seen
following HEV infection in pregnant commonly seen following HEV following HEV infection in pregnant
women. infection in pregnant women. women.

First Aid Microbiology: Hepatitis E First Aid Microbiology: Hepatitis
HEV is associated with high
HAV and HEV do not increase the risk for mortality in pregnant women. Liver biopsy showing patchy necrosis is
Hepatocellular Carcinoma (HCC). indicative of HEV infection.
First Aid Microbiology: Human

First Aid Microbiology: Human
First Aid Microbiology: Human Metapneumovirus
Metapneumovirus
Metapneumovirus
Human Metapneumovirus is a negative-
Human Metapneumovirus causes
Human Metapneumovirus causes sense ssRNA virus.
bronchiolitis and pneumonia in
bronchiolitis and pneumonia in infants.
infants.
Was paramyxoviridae, now part of family
Pneumoviridae
First Aid Microbiology: Human First Aid Microbiology: Human First Aid Microbiology: Human
Metapneumovirus Metapneumovirus Metapneumovirus
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Human Metapneumovirus is the

second most common cause of Human Metapneumovirus is the second
lower respiratory infection in most common cause of lower respiratory
Human Metapneumovirus is a negative-
young children after RSV. infection in young children after RSV.
sense ssRNA virus.
- In comparison with RSV - tends to - In comparison with RSV - tends to
Was paramyxoviridae, now part of family
produce disease that is less severe produce disease that is less severe and
Pneumoviridae
and occurs in slightly older occurs in slightly older children
children - Coinfection can occur
- Coinfection can occur
First Aid Microbiology: Immune

First Aid Microbiology: Immune Response Response to Helminths First Aid Microbiology: Immune Response
to Helminths to Helminths
Eosinophils act to eliminate
Eosinophils act to eliminate helminths that helminths that are coated with Eosinophils act to eliminate helminths that
are coated with IgE by binding them via IgE by binding them via the FceRI are coated with IgE by binding them via
the FceRI (high affinity receptor), and (high affinity receptor), and the FceRI (high affinity receptor), and
releasing Major Basic Protein which is releasing Major Basic Protein releasing Major Basic Protein which is
toxic to parasites which is toxic to parasites toxic to parasites
This is the ADCC subtype of Type 2 This is the ADCC subtype of Type This is the ADCC subtype of Type 2
Hypersensitivity 2 Hypersensitivity Hypersensitivity
- NK cells also contribute to the parasite - NK cells also contribute to the - NK cells also contribute to the parasite
immune response in this manner parasite immune response in this immune response in this manner
manner
First Aid Microbiology: Immune

Response to Helminths
First Aid Microbiology: Immune Response First Aid Microbiology: Immune Response
to Helminths to Helminths
Eosinophils first respond to
parasites via a type 1
Eosinophils first respond to parasites via a Eosinophils first respond to parasites via a
hypersensitivity mechanism by
type 1 hypersensitivity mechanism by type 1 hypersensitivity mechanism by
binding IgE coated
binding IgE coated Helminths specifically: binding IgE coated Helminths specifically:
Helminths specifically:
- secreting histaminase which neutralizes - secreting histaminase which neutralizes
- secreting histaminase which
histamine histamine
neutralizes histamine
- secreting arylsulfatase B which - secreting arylsulfatase B which
- secreting arylsulfatase B which
neutralizes leukotrienes neutralizes leukotrienes
neutralizes leukotrienes
- eosinophils bind IgE by FceRI (High - eosinophils bind IgE by FceRI (High
- eosinophils bind IgE by FceRI
affinity receptors) affinity receptors)
(High affinity receptors)
- This neuters the parasitic inflammatory - This neuters the parasitic inflammatory
- This neuters the parasitic
response by limiting the effects of mast cell response by limiting the effects of mast cell
inflammatory response by limiting
degranulation degranulation
the effects of mast cell
- mast cells and basophils also contribute - mast cells and basophils also contribute
degranulation
to the parasite immune response in this to the parasite immune response in this
- mast cells and basophils also
manner manner
contribute to the parasite immune
response in this manner
First Aid Microbiology: Immune Response First Aid Microbiology: Immune First Aid Microbiology: Immune Response
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Response to Helminths
to Helminths
Eosinophils first respond to
parasites via a type 1
Eosinophils first respond to parasites via a
hypersensitivity mechanism by
type 1 hypersensitivity mechanism by
binding IgE coated
binding IgE coated Helminths specifically:
Helminths specifically:
- secreting histaminase which neutralizes
- secreting histaminase which
histamine to Helminths
neutralizes histamine
neutralizes leukotrienes The immune response to helminths is
neutralizes leukotrienes
mediated by eosinophils
- eosinophils bind IgE by FceRI (High
- eosinophils bind IgE by FceRI
affinity receptors)
(High affinity receptors)
- This neuters the parasitic inflammatory
- This neuters the parasitic
response by limiting the effects of mast cell
inflammatory response by limiting
degranulation
the effects of mast cell
- mast cells and basophils also contribute
degranulation
to the parasite immune response in this
- mast cells and basophils also
manner
contribute to the parasite immune
response in this manner
First Aid Microbiology: Klebsiella

First Aid Microbiology: Klebsiella
Granulomatis
Granulomatis
Klebsiella granulomatis causes
Klebsiella granulomatis causes granuloma
granuloma inguinale which
inguinale which features a painless, beefy
features a painless, beefy red ulcer
red ulcer that bleeds readily on contact
that bleeds readily on contact
also referred to as Donovanosis; not
also referred to as Donovanosis;
First Aid Microbiology: Klebsiella common in US
not common in US
Granulomatis
Cytoplasmic Donovan bodies are

characteristic of Klebsiella granulomatis
bipolar staining; seen on microscopy
First Aid Microbiology: Lactobacillus

Destruction of Lactobacillus predisposes First Aid Microbiology: Lactobacillus
Lactobacillus
people to bacterial vaginosis (gardnerella
invasion). Lactobacillus species are gram-positive
Lactobacillus normally found in
bacillus bacterium.
the vagina.
This can be due to antibiotic treatment
First Aid Microbiology: Lactobacillus First Aid Microbiology: Lassa First Aid Microbiology: Lassa Virus
Virus
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Lassa Virus causes a viral Lassa Virus causes a viral Hemorrhagic

Hemorrhagic Fever that results in Fever that results in an encephalitis.
an encephalitis.
Lactobacillus species are gram-positive
Often affects the GI tract, CV, Respiratory
bacillus bacterium.
Often affects the GI tract, CV, system as well
Respiratory system as well Clinically difficult to distinguish from
Clinically difficult to distinguish Ebola and Marburg
from Ebola and Marburg
First Aid Microbiology: Lice

First Aid Microbiology: Lassa
First Aid Microbiology: Lassa Virus Pediculus humanus / Phthirus pubis can
Virus
act as vectors for Bartonella quintana,
Lassa Virus is an arenavirus, spread by which causes Trench Fever
Lassa Virus is an arenavirus,
rodents.
spread by rodents.
"Five Day Fever", sudden onset with high
common in undeveloped Africa fever, pain moving eyeballs, soreness of
common in undeveloped Africa
muscles of legs and back, frequently
hyperalgesia of the shins

Pediculus humanus / Phthirus pubis can
act as vectors for Bartonella quintana, Pediculus humanus / Phthirus pubis
Pediculus humanus / Phthirus pubis can
which causes Trench Fever can act as vectors for Rickettsia
act as vectors for Rickettsia prowazekii,
prowazekii, which causes epidemic
which causes epidemic typhus
"Five Day Fever", sudden onset with high typhus
fever, pain moving eyeballs, soreness of
muscles of legs and back, frequently
hyperalgesia of the shins

First Aid Microbiology: Lice First Aid Microbiology: Lice
Pediculus humanus/Phthirus pubis
Phthirus pubis is colloquially Treatment for Pediculus humanus/Phthirus
commonly causes intense pruiritis on
known as "Crabs" pubis (lice) includes pyrethroids,
scalp/neck or waistband/axilla
malathion, or ivermectin lotion, and nit
Phthirus pubis saliva generates a
Pubic lice are typically found in a combing
hypersensitivity response to its presence,
persons pubic hair (but can get on pyrethroids and malathion are essentially
which can become stronger over two or
eyelashes) insecticides
more weeks followign initial infestation
First Aid Microbiology: Meningitis

HSV-2 is associated with meningitis,
Treatment for Pediculus humanus/Phthirus
Does West Nile Virus cause whereas HSV-1 is associated with
pubis (lice) includes pyrethroids,
meningitis or encephalitis? encephalitis which elicits a
malathion, or ivermectin lotion, and nit
neuropathology known as Kluver-Bucy
combing
Both :) Syndrome
pyrethroids and malathion are essentially
insecticides
First Aid Microbiology: Meningitis First Aid Microbiology: Meningitis First Aid Microbiology: Meningitis
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HSV-2 is associated with meningitis, HSV-2 is associated with

whereas HSV-1 is associated with meningitis, whereas HSV-1 is In Bacterial Meningitis, do glucose levels
encephalitis which elicits a associated with encephalitis which increase or decrease relative to normal?
neuropathology known as Kluver-Bucy elicits a neuropathology known as
Syndrome Kluver-Bucy Syndrome decrease

First Aid Microbiology: Meningitis First Aid Microbiology: Meningitis
In Bacterial Meningitis, does
In Bacterial Meningitis, do protein levels In Bacterial Meningitis, which cell
opening pressure increase or
increase or decrease relative to normal? type increases relative to normal?
decrease relative to normal?
increase Neutrophils
increase
In Fungal/TB Meningitis, In Fungal/TB Meningitis, In Fungal/TB Meningitis, does opening

do glucose levels increase or decrease do protein levels increase or pressure increase or decrease relative to
relative to normal? decrease relative to normal? normal?
decrease increase increase

In Viral Meningitis,
In Fungal/TB Meningitis, which cell In Viral Meningitis, do protein levels
do glucose levels increase or
type increases relative to normal? increase or decrease relative to normal?
decrease relative to normal?
lymphocytes Normal / Increase
Stay normal

In Viral Meningitis, does opening
In Viral Meningitis, which cell
pressure increase or decrease relative to
type increases relative to normal? In patients afflicted with HIV, infection by
normal?
cryptococcus spp. causes meningitis
lymphocytes
Normal / Increase

What are the most common causes of
The incidence of H influenzae
meningitis in children? (6 mo - 6 yr old)
The incidence of H influenzae meningitis meningitis has greatly decrease due
has greatly decrease due to conjugate H to conjugate H influenzae
- Strep Pneumoniae
influenzae vaccinations. Today cases are vaccinations. Today cases are
- Neisseria Meningitidis
usually seen in nonimmunized children. usually seen in nonimmunized
- H Influenzae Type B
children.
- Enteroviruses
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What are the most common causes
What are the most common causes of What are the most common causes of
of meningitis in children? (6 mo -
meningitis in children? (6 mo - 6 yr old) meningitis in children? (6 mo - 6 yr old)
6 yr old)
- Strep Pneumoniae - Strep Pneumoniae
- Strep Pneumoniae
- Neisseria Meningitidis - Neisseria Meningitidis
- Neisseria Meningitidis
- H Influenzae Type B - H Influenzae Type B
- H Influenzae Type B
- Enteroviruses - Enteroviruses
- Enteroviruses

What are the most common causes of of meningitis in patients 6 yr - 60 yr What are the most common causes of
meningitis in patients 6 yr - 60 yr old? old? meningitis in patients 6 yr - 60 yr old?
- Strep Pneumoniae - Strep Pneumoniae - Strep Pneumoniae

- Neisseria Meningitidis (#1 in Disease) - Neisseria Meningitidis (#1 in - Neisseria Meningitidis (#1 in Disease)
- Enteroviruses Disease) - Enteroviruses
- HSV - Enteroviruses - HSV
- HSV

of meningitis in patients 60 yr +
meningitis in patients 60 yr + old? meningitis in patients 60 yr + old?
old?
- Strep Pneumoniae - Strep Pneumoniae
- Strep Pneumoniae
- Gram (-) Rods - Gram (-) Rods
- Gram (-) Rods
- Listeria - Listeria
- Listeria

of meningitis in the Newborn? (0-6
meningitis in the Newborn? (0-6 mo old) meningitis in the Newborn? (0-6 mo old)
mo old)
- Strep Agalactiae (GBS) - Strep Agalactiae (GBS)
- Strep Agalactiae (GBS)
- E. Coli (GBS) - E. Coli (GBS)
- E. Coli (GBS)
- Listeria - Listeria
- Listeria
What are the viral causes of meningitis? What are the viral causes of What are the viral causes of meningitis?
meningitis?
- Enterovirus - Enterovirus
- HSV2 - Enterovirus - HSV2
- HIV - HSV2 - HIV
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- HIV
- West Nile Virus - West Nile Virus
- West Nile Virus
- VZV - VZV
- VZV

What are the viral causes of meningitis? What should you add to empiric
What should you give empirically if you
meningitis treatment if you suspect
suspect meningitis? ceftriaxone and
- Enterovirus Listeria?
vancomycin.
- HSV2
- HIV Ampicillin
- West Nile Virus
empiric therapy is treatment before
- VZV Empiric treatment is Ceftriaxone
confirmation
and Vancomycin
First Aid Microbiology: Microbial Cultures
For H influenzae you use a chocolate agar

which requires factor V (NAD+) and X
(hematin) from lysed RBCs.
Choc agar is blood agar heated to release
What should you give empirically if you
all nutrients from RBCs for organisms that
suspect meningitis? ceftriaxone and Which enterovirus is especially
cannot lyse RBCs
vancomycin. associated with meningitis?
- Coxsackie Virus
empiric therapy is treatment before
confirmation
First Aid Microbiology: Microbial Cultures First Aid Microbiology: Microbial

Cultures
For H influenzae you use a chocolate agar First Aid Microbiology: Microbial Cultures
For H influenzae you use a
which requires factor V (NAD+) and X
chocolate agar which requires For N gonorrhoeae and N meningitidis a
(hematin) from lysed RBCs.
Choc agar is blood agar heated to release factor V (NAD+) and X (hematin) thayer-martin agar is used.
all nutrients from RBCs for organisms that from lysed RBCs.
cannot lyse RBCs Choc agar is blood agar heated to
release all nutrients from RBCs for
organisms that cannot lyse RBCs
First Aid Microbiology: Microbial Cultures First Aid Microbiology: Microbial First Aid Microbiology: Microbial Cultures
Cultures
For N gonorrhoeae and N meningitidis a The Thayer-Martin agar selectively favors
thayer-martin agar is used. The Thayer-Martin agar selectively growth of Neisseria by inhibiting growth of
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favors growth of Neisseria by gram-positive organisms with vancomycin

inhibiting growth of gram-positive and gram negative organisms with
organisms with vancomycin and Trimethoprim and colistin and fungi with
gram negative organisms with nystatin.
Trimethoprim and colistin and
fungi with nystatin.
Cultures
The Thayer-Martin agar selectively favors The Thayer-Martin agar selectively favors
growth of Neisseria by inhibiting growth of The Thayer-Martin agar selectively growth of Neisseria by inhibiting growth of
gram-positive organisms with vancomycin favors growth of Neisseria by gram-positive organisms with vancomycin
and gram negative organisms with inhibiting growth of gram-positive and gram negative organisms with
Trimethoprim and colistin and fungi with organisms with vancomycin and Trimethoprim and colistin and fungi with
nystatin. gram negative organisms with nystatin.
Trimethoprim and colistin and
fungi with nystatin.
Cultures
B pertussis is cultured with Bordet-Gengou C diptheriae is cultured with a tellurite agar
agar or Regan-Lowe medium. B pertussis is cultured with Bordet- or Loffler medium.
Gengou agar or Regan-Lowe
medium.
Cultures
C diptheriae is cultured with a tellurite agar E coli is cultured with eosin-methylene
or Loffler medium. E coli is cultured with eosin- blue (EMB) agar, producing colonies with
methylene blue (EMB) agar, a green metallic sheen.
producing colonies with a green
metallic sheen.
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First Aid Microbiology: Microbial Cultures First Aid Microbiology: Microbial

Cultures First Aid Microbiology: Microbial Cultures
E coli is cultured with eosin-methylene
Fungi are cultured with sabouraud Fungi are cultured with sabouraud agar.
blue (EMB) agar, producing colonies with
agar. Selective for fungi with an acidic pH
a green metallic sheen.
Selective for fungi with an acidic
pH
Cultures
Indicator (differential) media yields a color Indicator (differential) media yields a color
change in response to the metabolism of Indicator (differential) media yields change in response to the metabolism of
certain organisms. a color change in response to the certain organisms.
metabolism of certain organisms.
Cultures
Lactose fermenting enterics are cultured Lactose fermenting enterics are cultured
with MacConkey agar. A special feature of Lactose fermenting enterics are with MacConkey agar. A special feature of
this selective and differential media is that cultured with MacConkey agar. A this selective and differential media is that
fermentation produces acid, causing special feature of this selective and fermentation produces acid, causing
colonies to turn pink to purple. differential media is that colonies to turn pink to purple.
fermentation produces acid, causing
colonies to turn pink to purple.
Cultures
Lactose fermenting enterics are cultured Legionella is cultured with a charcoal yeast
with MacConkey agar. A special feature of Legionella is cultured with a extract agar buffered with cysteine and
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this selective and differential media is that

fermentation produces acid, causing charcoal yeast extract agar buffered iron.
colonies to turn pink to purple. with cysteine and iron.
Cultures
M pneumoniae is cultured with Eaton agar M pneumoniae is cultured with Eaton agar
which requires cholesterol. M pneumoniae is cultured with which requires cholesterol.
Eaton agar which requires
cholesterol.
First Aid Microbiology: Microbial Cultures First Aid Microbiology: Microbial Cultures
First Aid Microbiology: Microbial
Cultures
M tuberculosis is cultured with MacConkey agar contains a pH indicator,
Lowenstein-Jensen agar. such that a lactose fermenter (ie. E Coli)
M tuberculosis is cultured with
will convert lactose to acidic metabolites
Lowenstein-Jensen agar.
leading to pink to purple colonies.
contains bile salts and dyes which inhibit

gram + growth but allows gram - to grow

First Aid Microbiology: Microbial Cultures Cultures First Aid Microbiology: Microbial Cultures
MacConkey agar contains a pH indicator, MacConkey agar contains a pH MacConkey agar contains a pH indicator,
such that a lactose fermenter (ie. E Coli) indicator, such that a lactose such that a lactose fermenter (ie. E Coli)
will convert lactose to acidic metabolites fermenter (ie. E Coli) will convert will convert lactose to acidic metabolites
leading to pink to purple colonies. lactose to acidic metabolites leading to pink to purple colonies.
contains bile salts and dyes which inhibit contains bile salts and dyes which inhibit
gram + growth but allows gram - to grow contains bile salts and dyes which gram + growth but allows gram - to grow
inhibit gram + growth but allows
gram - to grow
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First Aid Microbiology: Microbial Cultures

Cultures First Aid Microbiology: Microbial Cultures
MacConkey agar contains a pH indicator,
such that a lactose fermenter (ie. E Coli)
selective media favors the growth selective media favors the growth of
will convert lactose to acidic metabolites
of particular organisms while particular organisms while preventing
preventing growth of other growth of other organisms.
contains bile salts and dyes which inhibit organisms.
gram + growth but allows gram - to grow
First Aid Microbiology: Microbial First Aid Microbiology: Microbial Stains

Stains
In the gram stain, bacteria with a thin
In the gram stain, bacteria with a peptidoglycan layer (gram negative) turn
First Aid Microbiology: Microbial Cultures thin peptidoglycan layer (gram red or pink with counterstain.
negative) turn red or pink with
selective media favors the growth of counterstain.
particular organisms while preventing
growth of other organisms.
First Aid Microbiology: Microbial Stains
Organisms that Giemsa stain works well on

may be remembered by the mnemonic
First Aid Microbiology: Microbial "Certain Bugs Really Try my Patience"
Stains
In the gram stain, bacteria with a thick
Chlamydia
peptidoglycan layer (gram positive) retain
In the gram stain, bacteria with a Borrelia
crystal violet dye.
thick peptidoglycan layer (gram Rickettsia
positive) retain crystal violet dye. Trypanosomes
Plasmodium
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Stains
The bacteria that do not gram stain may be
The bacteria that do not gram stain remembered with the mnemonic "The
First Aid Microbiology: Microbial Stains may be remembered with the Little Microbes May Unfortunately Lack
mnemonic "The Little Microbes Real Color But Are Everywhere"
Organisms that Giemsa stain works well on May Unfortunately Lack Real
may be remembered by the mnemonic Color But Are Everywhere" Treponema
"Certain Bugs Really Try my Patience" Leptospira
Treponema Mycobacteria
Chlamydia Leptospira Mycoplasma
Borrelia Mycobacteria Ureaplasma
Rickettsia Mycoplasma Legionella
Trypanosomes Ureaplasma Rickettsia
Plasmodium Legionella Chlamydia
Rickettsia Bartonella
Chlamydia Anaplasma
Bartonella Ehrlichia
Anaplasma
Ehrlichia

Stains The flourescent antibody stain is used to
The India ink stain is used for cryptococcus
identify many bacteria and viruses.
neoformans.
The India ink stain is used for eg FTA-ABS for syphilis.
cryptococcus neoformans.
First Aid Microbiology: Microbial Stains First Aid Microbiology: Microbial First Aid Microbiology: Microbial Stains
Stains
The flourescent antibody stain is used to The periodic acid-schiff stain is used to
identify many bacteria and viruses. The periodic acid-schiff stain is diagnose Whipple disease (tropheryma
eg FTA-ABS for syphilis. used to diagnose Whipple disease whipplei).
(tropheryma whipplei).
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First Aid Microbiology: Microbial Stains First Aid Microbiology: Microbial Stains
Stains
The periodic acid-schiff stain stains The silver stain is used for fungi,
glycogen and mucopolysaccharides. legionella, and helicobacter pylori.
The periodic acid-schiff stain stains
glycogen and mucopolysaccharides.

First Aid Microbiology: Microbial Stains Stains
The ziehl-neelsen stain is used for acid-
The silver stain is used for fungi, The ziehl-neelsen stain is used for fast bacteria such as mycobacteria and
legionella, and helicobacter pylori. acid-fast bacteria such as nocardia as well as protozoa such as
mycobacteria and nocardia as well cryptosporidium oocysts.
as protozoa such as
cryptosporidium oocysts.
First Aid Microbiology: Microbial Stains First Aid Microbiology: Microbial First Aid Microbiology: Microbial causes
causes of Brain Abscesses of Brain Abscesses
The ziehl-neelsen stain is used for acid-
fast bacteria such as mycobacteria and The most common infections The most common infections causing brain
nocardia as well as protozoa such as causing brain abscess are viridians abscess are viridians streptococci and
cryptosporidium oocysts. streptococci and staphylococcus staphylococcus aureus.
aureus.
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First Aid Microbiology: Microbial causes First Aid Microbiology: Microbial First Aid Microbiology: Microbial causes
of Brain Abscesses causes of Brain Abscesses of Brain Abscesses
Multiple brain abscesses are usually from Multiple brain abscesses are usually Oral anaerobes are commonly involved in
bacteremia. from bacteremia. brain abscess if a dental infection or
extraction precedes the abcess.
of Brain Abscesses causes of Brain Abscesses of Brain Abscesses
Oral anaerobes are commonly involved in Oral anaerobes are commonly Otitis media and mastoiditis can lead to
brain abscess if a dental infection or involved in brain abscess if a dental abcess in the temporal lobe and/or
extraction precedes the abcess. infection or extraction precedes the cerebellum.
abcess.
First Aid Microbiology: Microbial causes

First Aid Microbiology: Microbial First Aid Microbiology: Microbial causes
of Brain Abscesses
causes of Brain Abscesses of Brain Abscesses
Otitis media and mastoiditis can lead to
Sinusitis} } or {{c1 can lead to Sinusitis} } or {{c1 can lead to frontal lobe
abcess in the temporal lobe and/or
frontal lobe abscess. abscess.
cerebellum.

First Aid Microbiology: Microbial causes of Diarrhea
of Brain Abscesses causes of Brain Abscesses C dificile can cause watery diarrhea,
Toxoplasma reactivation in AIDS can occasionally bloody diarrhea, and
Toxoplasma reactivation in AIDS pseudomembranous colitis. It is associated
cause a brain abscess. can cause a brain abscess. with antibiotics and PPIs.
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First Aid Microbiology: Microbial causes First Aid Microbiology: Microbial

of Diarrhea causes of Diarrhea First Aid Microbiology: Microbial causes
of Diarrhea
C dificile can cause watery diarrhea, C dificile can cause watery
occasionally bloody diarrhea, and diarrhea, occasionally bloody C perfrinigens can cause watery diarrhea as
pseudomembranous colitis. It is associated diarrhea, and pseudomembranous well as gas gangrene.
with antibiotics and PPIs. colitis. It is associated with
antibiotics and PPIs.

causes of Diarrhea of Diarrhea
of Diarrhea Campylobacter can cause bloody Campylobacter can cause bloody diarrhea.
diarrhea. It is a a comma or s It is a a comma or s shaped organism that
C perfrinigens can cause watery diarrhea as shaped organism that grows at 42 grows at 42 degrees celcius.
well as gas gangrene. degrees celcius.
First Aid Microbiology: Microbial causes First Aid Microbiology: Microbial causes
of Diarrhea of Diarrhea
causes of Diarrhea
Campylobacter can cause bloody diarrhea. E histolytica, a protozan, can cause bloody
E histolytica, a protozan, can cause
It is a a comma or s shaped organism that diarrhea through amebic dystery or liver
bloody diarrhea through amebic
grows at 42 degrees celcius. abcess.
dystery or liver abcess.

of Diarrhea
E histolytica, a protozan, can cause bloody
E histolytica, a protozan, can cause Enteroinvasive E coli can cause bloody
diarrhea through amebic dystery or liver
bloody diarrhea through amebic diarrhea and invade colonic mucosa.
abcess.
dystery or liver abcess.
of Diarrhea causes of Diarrhea of Diarrhea
Enteroinvasive E coli can cause bloody Enterotoxigenic E coli can cause Enterotoxigenic E coli can cause watery
diarrhea and invade colonic mucosa. watery diarrhea (travelers' diarrhea (travelers' diarrhae). It produces
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diarrhae). It produces heat labile heat labile and heat stable toxins}}.
and heat stable toxins}}.
Enterotoxigenic E coli can cause watery Protozoa, such as giardia and Protozoa, such as giardia and
diarrhea (travelers' diarrhae). It produces cryptosporidium can cause watery cryptosporidium can cause watery
heat labile and heat stable toxins}}. diarrhea. diarrhea.

First Aid Microbiology: Microbial causes causes of Diarrhea of Diarrhea
of Diarrhea
Salmonella (non typhodial) can Salmonella (non typhodial) can cause
Protozoa, such as giardia and cause bloody diarrhea. It has an bloody diarrhea. It has an animal reservoir
cryptosporidium can cause watery animal reservoir (esp. poultry and (esp. poultry and eggs).
diarrhea. eggs).

of Diarrhea
Salmonella (non typhodial) can cause
Salmonella (non typhoidal) is Salmonella (non typhoidal) is lactose
bloody diarrhea. It has an animal reservoir
lactose negative and has flagellar negative and has flagellar motility.
(esp. poultry and eggs).
motility.
causes of Diarrhea
Shigella toxin can cause bloody diarrhea. It Shigella toxin can cause bloody diarrhea. It
Shigella toxin can cause bloody
produces Shiga toxin (human reservoir produces Shiga toxin (human reservoir
diarrhea. It produces Shiga toxin
only. only.
(human reservoir only.
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causes of Diarrhea
Shigella toxin is lactose negative and has Shigella toxin is lactose negative and has
Shigella toxin is lactose negative
very low ID50. It can also cause bacillary very low ID50. It can also cause bacillary
and has very low ID50. It can also
dysentery. dysentery.
cause bacillary dysentery.
V. cholerae are comma shaped organisms V. cholerae are comma shaped V. cholerae are comma shaped organisms
that can cause rice-water diarrhea, organisms that can cause rice-water that can cause rice-water diarrhea,
especially from infected seafood. diarrhea, especially from infected especially from infected seafood.
seafood.
V. cholerae are comma shaped organisms Viruses such as rotavirus, Viruses such as rotavirus, norovirus, and
that can cause rice-water diarrhea, norovirus, and adenovirus can adenovirus can cause watery diarrhea.
especially from infected seafood. cause watery diarrhea.

First Aid Microbiology: Microbial causes of Diarrhea
causes of Diarrhea
of Diarrhea
Y enterocolitica can cause bloody diarrhea.
Y enterocolitica can cause bloody
Viruses such as rotavirus, norovirus, and It can also lead to day care outbreaks and
diarrhea. It can also lead to day care
adenovirus can cause watery diarrhea. pseudoappendicitis.
outbreaks and pseudoappendicitis.
Y enterocolitica can cause bloody diarrhea. enterohemorrhagic E coli, strain enterohemorrhagic E coli, strain O157:H7
It can also lead to day care outbreaks and O157:H7 can cause bloody diarrhea can cause bloody diarrhea with associated
pseudoappendicitis. with associated HUS (hemolytic HUS (hemolytic uremic syndrome). It
uremic syndrome). It makes Shiga- makes Shiga-like toxin.
like toxin.
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of Diarrhea causes of Diarrhea First Aid Microbiology: Microbial causes
of Food Poisoning
enterohemorrhagic E coli, strain O157:H7 enterohemorrhagic E coli, strain
can cause bloody diarrhea with associated O157:H7 can cause bloody diarrhea B cereus can be derived from reheated rice.
HUS (hemolytic uremic syndrome). It with associated HUS (hemolytic
makes Shiga-like toxin. uremic syndrome). It makes Shiga-
like toxin.

First Aid Microbiology: Microbial causes of Food Poisoning
causes of Food Poisoning
of Food Poisoning
C botulinum can be derived from
C botulinum can be derived from
B cereus can be derived from reheated rice. impromerly canned foods (toxins) or raw
impromerly canned foods (toxins)
honey (spores).
or raw honey (spores).
of Food Poisoning of Food Poisoning
C perfringens can be derived from reheated E coli O157:H7 can be derived from
C perfringens can be derived from
meat. undercooked meat.
reheated meat.
of Food Poisoning causes of Food Poisoning of Food Poisoning
E coli O157:H7 can be derived from L monocytogenes can be derived L monocytogenes can be derived from deli
undercooked meat. from deli meats and soft cheeses. meats and soft cheeses.
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of Food Poisoning
of Food Poisoning causes of Food Poisoning
S aureus can be derived from meats,
S aureus and B cereus food posoning starts S aureus and B cereus food
mayonnaise, custard, and preformed toxin.
quickly and ends quickly. posoning starts quickly and ends
quickly.
of Food Poisoning of Food Poisoning
S aureus can be derived from meats, Salmonella can be derived from poultry,
Salmonella can be derived from
mayonnaise, custard, and preformed toxin. meat, and eggs.
poultry, meat, and eggs.

of Food Poisoning
of Food Poisoning causes of Food Poisoning
V vulnificus can cause wound infections
V parahaemolyticus and V vulnificus can V parahaemolyticus and V
from contact with contaminated water or
be derived from contaminated seafood. vulnificus can be derived from
shellfish.
contaminated seafood.
of Food Poisoning causes of Pneumonia of Pneumonia
V vulnificus can cause wound infections Common causes of hospital Common causes of hospital acquired
from contact with contaminated water or acquired pneumonia are S aureus, pneumonia are S aureus, Pseudomonas,
shellfish. Pseudomonas, and other enteric and other enteric gram negative rods.
gram negative rods.
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of Pneumonia First Aid Microbiology: Microbial First Aid Microbiology: Microbial causes
causes of Pneumonia of Pneumonia
Common causes of pneumonia in the
elderly include S pneumoniae, influenza Common causes of pneumonia in Common causes of pneumonia in IV drug
virus, anaerobes, H influenzae, and gram the elderly include S pneumoniae, users include S pneumoniae and S aureus.
negative rods. influenza virus, anaerobes, H
influenzae, and gram negative rods.

First Aid Microbiology: Microbial causes causes of Pneumonia of Pneumonia
of Pneumonia
Common causes of pneumonia in Common causes of pneumonia in adults
Common causes of pneumonia in IV drug adults (18-40 years) include (18-40 years) include mycoplasma, C
users include S pneumoniae and S aureus. mycoplasma, C pneumoniae, S pneumoniae, S pneumoniae, and viruses
pneumoniae, and viruses (eg (eg influenza).
influenza).
of Pneumonia causes of Pneumonia of Pneumonia
Common causes of pneumonia in adults Common causes of pneumonia in Common causes of pneumonia in
(40-65 years) include S pneumoniae, H adults (40-65 years) include S alcoholics are klebsiella and anaerobes
influenzae, anaerobes, viruses, and pneumoniae, H influenzae, usually due to aspiration (eg
mycoplasma. anaerobes, viruses, and peptostreptococcus, fusobacterium,
mycoplasma. prevotella, and bacteroides).
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of Pneumonia
First Aid Microbiology: Microbial of Pneumonia
Common causes of pneumonia in causes of Pneumonia
alcoholics are klebsiella and anaerobes
Common causes of pneumonia in
usually due to aspiration (eg Common causes of pneumonia in aspiration iclude anaerobes.
peptostreptococcus, fusobacterium, aspiration iclude anaerobes.
prevotella, and bacteroides).

of Pneumonia causes of Pneumonia First Aid Microbiology: Microbial causes
of Pneumonia
Common causes of pneumonia in children Common causes of pneumonia in
(4 weeks to 18 years include viruses children (4 weeks to 18 years Common causes of pneumonia in
(RSV), mycoplasma, C trachomatis include viruses (RSV), immunocompromised patients are S
(infants-3 year olds), C pneumoniae mycoplasma, C trachomatis aureus, enteric gram negative rods, fungi,
(school aged children), and S (infants-3 year olds), C pneumoniae viruses, and P jirovecii (with HIV).
pneumoniae}}. (school aged children), and S
pneumoniae}}.
of Pneumonia causes of Pneumonia of Pneumonia
Common causes of pneumonia in Common causes of pneumonia in Common causes of pneumonia in neonates
immunocompromised patients are S neonates include Group B include Group B streptococci and E coli.
aureus, enteric gram negative rods, fungi, streptococci and E coli.
viruses, and P jirovecii (with HIV).
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First Aid Microbiology: Microbial causes First Aid Microbiology: Microbial of Pneumonia
of Pneumonia causes of Pneumonia
Common causes of postviral pneumonia
Common causes of pneumonia with cystic Common causes of postviral include S pneumoniae, S aureus, and H
fibrosis}] include {{c2. pneumonia include S pneumoniae, influenzae.
S aureus, and H influenzae.

of Pneumonia causes of Pneumonia
atypical causes of pneumonia include atypical causes of pneumonia

mycoplasma, legionella, and chlamydia First Aid Microbiology: Moraxella
include mycoplasma, legionella,
Catarrhalis
and chlamydia
Moraxella is a cause of otitis media and
sinusitis in healthy individuals
bronchitis is also associated
First Aid Microbiology: Moraxella

Catarrhalis
First Aid Microbiology: Moraxella First Aid Microbiology: Moraxella
Catarrhalis Moraxella is aerobic, and thus on culture
Catarrhalis
must be differentiated from neisseria
Moraxella is an opportunistic species by NYC media
Moraxella is a frequent cause of
exacerbations of what respiratory tract pathogen, and is a resident of the
Thayer Martin (NYC) agar is selective for
disease? oropharynx
Neisseria
COPD oropharynx
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First Aid Microbiology: Moraxella

Catarrhalis First Aid Microbiology: Moraxella
Catarrhalis
Moraxella is aerobic, and thus on culture
must be differentiated from neisseria Moraxella is aerobic, and thus on
species by NYC media culture must be differentiated from
neisseria species by NYC media
Thayer Martin (NYC) agar is selective for First Aid Microbiology: Mycobacterium
Neisseria Thayer Martin (NYC) agar is Avium
selective for Neisseria
Mycobacterium avium infection is
suspected in HIV patients with CD4+ cell
count < 100 cells/mm3 and presenting with
fever, night sweats, weight loss and focal
lymphadenitis

First Aid Microbiology: Mycobacterium First Aid Microbiology: Mycobacterium
Mycobacterium Avium
Avium Avium
Mycobacterium avium infection is
Mycobacterium avium infection is Mycobacterium avium infection is
suspected in HIV patients with
suspected in HIV patients with CD4+ cell suspected in HIV patients with CD4+ cell
CD4+ cell count < 100 cells/mm3
count < 100 cells/mm3 and presenting with count < 100 cells/mm3 and presenting with
and presenting with fever, night
fever, night sweats, weight loss and focal fever, night sweats, weight loss and focal
sweats, weight loss and focal
lymphadenitis lymphadenitis
lymphadenitis
First Aid Microbiology: Mycobacterium First Aid Microbiology:

Marinum Mycobacterium Marinum
First Aid Microbiology: Mycobacterium
Mycobacterium marinum leads to hand Mycobacterium marinum leads to Scrofulaceum
infection in aquarium handlers hand infection in aquarium
Infection occurs following inoculation of a handlers Mycobacterium scrofulaceum leads to
skin abrasion or puncture and manifests as Infection occurs following cervical lymphadenitis in kids
a localized granuloma or sporotrichotic inoculation of a skin abrasion or
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puncture and manifests as a

lymphangitis localized granuloma or
sporotrichotic lymphangitis
First Aid Microbiology: Nairovirus
Besides the congo and

crimea, Nairovirus also is found in
First Aid Microbiology: Mycobacterium
the Middle East
Scrofulaceum Crimean-Congo Hemorrhagic Fever can
lead to Disseminated Intravascular
Therefore the US military keeps
Mycobacterium scrofulaceum leads to Coagulation, Shock and ARDS.
stocks of Ribavirin to protect
cervical lymphadenitis in kids 30% of people die by second week of
personnel deployed to Afghanistan
illness
and Iraq (Ribavirin is effective in
vitro but no trial evidence to
support use)

Crimean-Congo Hemorrhagic
Crimean-Congo Hemorrhagic Fever can
Fever can lead to Disseminated Nairovirus causes Crimean-Congo
lead to Disseminated Intravascular
Intravascular Coagulation, Shock Hemorrhagic Fever
Coagulation, Shock and ARDS.
and ARDS. symptoms involve fever, muscle pains,
30% of people die by second week of
30% of people die by second week headache, bleeding into the skin
illness
of illness
First Aid Microbiology: Non EHEC/ETEC

First Aid Microbiology: Nairovirus First Aid Microbiology: Nairovirus
E Coli
Nairovirus is a bunyavirus with negative Nairovirus is a bunyavirus with
EIEC causes bloody diarrhea
ssRNA (genetic structure) negative ssRNA (genetic structure)
Due to invasion of the colonic mucosa

E Coli First Aid Microbiology: Non EHEC/ETEC
First Aid Microbiology: Non
E Coli
EHEC/ETEC E Coli
What type of toxin does
enteropathogenic Escherichia coli (EPEC) Enteroinvasive Escherichia
Enteroinvasive Escherichia
produce? coli (EIEC) invades intestinal/colonic
coli (EIEC) clinically presents
mucosa, causing necrosis, inflammation
similar to Shigella infection
Produces no toxin and subsequent dysentery
First Aid Microbiology: Non

EHEC/ETEC E Coli First Aid Microbiology: Non EHEC/ETEC
E Coli
E Coli
Enteropathogenic Escherichia
Enteroinvasive Escherichia
coli (EPEC) adheres to apical Enteropathogenic Escherichia coli (EPEC)
coli (EIEC) invades intestinal/colonic
surface and flattens villi, preventing usually causes diarrhea in children
mucosa, causing necrosis, inflammation
absorption EPEC = Pediatrics
and subsequent dysentery
produces no toxin
First Aid Microbiology: Non EHEC/ETEC First Aid Microbiology: Normal First Aid Microbiology: Normal Human
E Coli Human Flora Flora
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In terms of normal flora, neonates

B fragilis and E coli (E coli > B fragilis)
delivered by C-section have no
are present in the colon.
flora but {{c1::are rapidly
Enteropathogenic Escherichia coli (EPEC)
colonized after birth.
usually causes diarrhea in children
EPEC = Pediatrics
First Aid Microbiology: Normal Human First Aid Microbiology: Normal First Aid Microbiology: Normal Human
Flora Human Flora Flora
B fragilis and E coli (E coli > B fragilis) Lactobacillus is present in the Lactobacillus is present in the vagina, but it
are present in the colon. vagina, but it also colonized by E also colonized by E coli and group B strep.
coli and group B strep.
First Aid Microbiology: Normal Human

First Aid Microbiology: Normal First Aid Microbiology: Normal Human
Flora
Human Flora Flora
S epidermis is present on the nose. It also
S epidermis is present on the nose. S mutans is present in dental plaque.
colonized by S aureus.
It also colonized by S aureus.
First Aid Microbiology: Normal Human First Aid Microbiology: Normal Human
First Aid Microbiology: Normal
Flora Flora
Human Flora
S mutans is present in dental plaque. S. epidermis is located on the skin.
S. epidermis is located on the skin.
First Aid Microbiology: Nosocomial

First Aid Microbiology: Normal Human Infections
First Aid Microbiology: Normal
Flora
Human Flora
Aspiration from the recumbant or supine
Viridians group streptococci are present in position often lands in the superior right
Viridians group streptococci are
the oropharynx. lower lobe or the posterior right upper lobe
present in the oropharynx.
- These patients have purulent malodorous
sputum
- Aspiration from the standing / upright
position often lands in the right inferior
lower lobe
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First Aid Microbiology: First Aid Microbiology: Nosocomial

Nosocomial Infections Infections
Infections
Decubitus Ulcers, Surgical Decubitus Ulcers, Surgical

Decubitus Ulcers, Surgical Wounds, and
Wounds, and Drains are most Wounds, and Drains caused by gram
Drains are most commonly associated with
commonly associated with Staph negative anaerobes are most commonly
Staph Aureus, along with gram
Aureus, along with gram caused by Bacteroides, Prevotella,
negative anaerobes
negative anaerobes Fusobacterium
First Aid Microbiology: Nosocomial First Aid Microbiology:

Infections Nosocomial Infections
Decubitus Ulcers, Surgical Decubitus Ulcers, Surgical Infections
Wounds, and Drains caused by gram Wounds, and Drains caused by
negative anaerobes are most commonly gram negative anaerobes are most Endotracheal intubation nosocomial
caused by Bacteroides, Prevotella, commonly caused by Bacteroides, infections are associated with increased
Fusobacterium Prevotella, Fusobacterium sputum production

Infections
In the medical setting, patients who start
In the medical setting, aspiration is often In the medical setting, aspiration is
convulsing (seizures) or pass out have an
secondary to altered mental status and often secondary to altered mental
increased risk of aspirating the contents of
old age status and old age
their stomach

First Aid Microbiology: Nosocomial Nosocomial Infections
Infections
Infections
In the medical setting, antibiotic
In the medical setting, antibiotic use is a
In the medical setting, patients who start use is a risk factor for clostridium
risk factor for clostridium difficile
convulsing (seizures) or pass out have an difficile infections
infections
increased risk of aspirating the contents of
their stomach - watch out for patients who
- watch out for patients who develop
develop watery diarrhea and
watery diarrhea and leukocytosis
leukocytosis
First Aid Microbiology: Nosocomial First Aid Microbiology: First Aid Microbiology: Nosocomial
Infections Nosocomial Infections Infections
In the medical setting, aspiration is a risk In the medical setting, aspiration is In the medical setting, aspiration is a risk
factor for polymicrobial gram negative a risk factor factor for polymicrobial gram negative
bacterial infections that are often for polymicrobial gram negative bacterial infections that are often
anaerobes bacterial infections that are often anaerobes
anaerobes
Ex. Klebsiella Ex. Klebsiella
- these are patients who are in the Ex. Klebsiella - these are patients who are in the
medical setting who are in the - these are patients who are in the medical setting who are in the
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medical setting who are in the

recumbant position or have passed out recumbant position or have recumbant position or have passed out
passed out
First Aid Microbiology: Nosocomial First Aid Microbiology: First Aid Microbiology: Nosocomial
Infections Nosocomial Infections Infections
Intravascular catheters are most Intravascular catheters are most Intravascular catheters are most
commonly associated with Staph Aureus, commonly associated with Staph commonly associated with Staph Aureus,
Staph Epidermidis (Long Term), and Aureus, Staph Epidermidis (Long Staph Epidermidis (Long Term), and
Enterobacter Term), and Enterobacter Enterobacter

First Aid Microbiology: Nosocomial First Aid Microbiology: Nosocomial
Nosocomial Infections
Infections Infections
Mechanical ventilation and
Mechanical ventilation and endotracheal Mechanical ventilation and endotracheal
endotracheal intubation are
intubation are associated with late onset intubation are associated with late onset
associated with late onset infections
infections of: infections of:
of:
- Pseudomonas Aeruginosa - Pseudomonas Aeruginosa
- Pseudomonas Aeruginosa
- Klebsiella - Klebsiella
- Klebsiella
- Acinetobacter - Acinetobacter
- Acinetobacter
- Staph Aureus - Staph Aureus
- Staph Aureus
P aeruginosa is associated with a sweet P aeruginosa is associated with a sweet
P aeruginosa is associated with a
odor odor
sweet odor

Infections
Mechanical ventilation and endotracheal First Aid Microbiology: First Aid Microbiology: Nosocomial
intubation are associated with late onset Nosocomial Infections Infections
infections of:
Mechanical ventilation Nosocomial infections caused by
- Pseudomonas Aeruginosa nosocomial infections aspiration are often polymicrobial, often
- Klebsiella are associated with observance of a involve gram negative bacteria, and are
- Acinetobacter new infilitrate on CXR often anaerobes
- Staph Aureus
P aeruginosa is associated with a sweet

odor
First Aid Microbiology: First Aid Microbiology: Nosocomial

First Aid Microbiology: Nosocomial Infections
Nosocomial Infections
Infections
Nosocomial infections caused by Patients who aspirate their stomach
Nosocomial infections caused by contents when passed out typically fall into
aspiration are often
aspiration are often polymicrobial, often one of four categories
polymicrobial, often involve gram
involve gram negative bacteria, and are
negative bacteria, and are often
often anaerobes Addicts (3A's)
anaerobes
- Alcoholics
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- drug Abusers
- diAbetics
as well as
- Patients who suffer from seizures
- Alcoholics are ethanol addicts, drug

Abusers are drug addicts, and diAbetics
are sugar addicts
- when patients pass out, they are much
more likely to aspirate their stomach
contents

Infections
Patients who aspirate their stomach

contents when passed out typically fall into First Aid Microbiology: Nosocomial
one of four categories Infections
Addicts (3A's) First Aid Microbiology: Urinary Catherization is associated with

- Alcoholics Nosocomial Infections nosocomial infections by E coli,
- drug Abusers Klebsiella, Proteus spp
- diAbetics Renal Dialysis Units and Needle
as well as Sticks are associated with HBV When you see signs of
- Patients who suffer from seizures and HCV infections
- Alcoholics are ethanol addicts, drug and a patient who has been cath'd put this
Abusers are drug addicts, and diAbetics into your differential
are sugar addicts
- when patients pass out, they are much
more likely to aspirate their stomach
contents

Urinary Catherization is associated with Urinary Catherization is Infections
nosocomial infections by E coli, associated with nosocomial
Klebsiella, Proteus spp infections by E coli, Klebsiella, Water aerosols in the medical setting can
Proteus spp be associated with Legionella infections
When you see signs of
When you see signs of Look for signs of
and a patient who has been cath'd put this and a patient who has been cath'd
into your differential put this into your differential
First Aid Microbiology: Nosocomial First Aid Microbiology: First Aid Microbiology: Osteomyelitis
Radiographs are insensitive early on in the
What are the two most common causes of What are the two most common course of osteomyelitis
nosocomial infections? causes of nosocomial infections?
- E. Coli, which cause UTIs - E. Coli, which cause UTIs
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- S. Aureus, which cause Wound - S. Aureus, which cause Wound

infections infections
First Aid Microbiology: Osteomyelitis
Radiographs can be useful in chronic

osteomyelitis

Osteomyelitis First Aid Microbiology: Osteomyelitis
The most common cause of The most common cause of osteomyelitis

osteomyelitis is in patients with is in patients with Cat and Dog Bites is
Cat and Dog Bites is Pasteurella Pasteurella Multocida
Multocida

First Aid Microbiology: Osteomyelitis First Aid Microbiology: Osteomyelitis
Osteomyelitis
The most common cause/s of osteomyelitis The most common cause/s of osteomyelitis
The most common cause/s of
is in IV Drug Use is Pasteurella is in sexually active patients is Septic
osteomyelitis is in IV Drug Use is
Multocida, Candida, Staph Aureus are Arthritis (more common) and Neisseria
Pasteurella Multocida, Candida,
most common Gonorrhea (more rare)
Staph Aureus are most common

Osteomyelitis First Aid Microbiology: Osteomyelitis
The most common cause/s of osteomyelitis
The most common cause/s of The most common cause/s of osteomyelitis
is in sexually active patients is Septic
osteomyelitis is in sickle cell is in sickle cell disease patients is
Arthritis (more common) and Neisseria
disease patients is Salmonella and Salmonella and Staph Aureus
Gonorrhea (more rare)
Staph Aureus
First Aid Microbiology: Osteomyelitis First Aid Microbiology: First Aid Microbiology: Osteomyelitis
Osteomyelitis
The most common cause/s of osteomyelitis The most common causes of osteomyelitis
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The most common causes of

osteomyelitis is in patients with is in patients with Vertebral Involvement
is Staph Aureus
Vertebral Involvement is is Mycobacterium Tuberculosis
Mycobacterium Tuberculosis (specifically Pott's Disease) and Staph
Assume if no other risk factor information
(specifically Pott's Disease) and Aureus
is given in scenario
Staph Aureus
What is the best diagnostic modality for

detecting acute osteomyelitis and detailing
anatomic involvement?
MRI
Osteomyelitis
The most common causes of osteomyelitis
The most common causes of
is in Prosthetic Joint Replacement
osteomyelitis is in Prosthetic Joint
patients is Staph Epidermidis and Staph
Replacement patients is Staph
Aureus
Epidermidis and Staph Aureus
First Aid Microbiology: Other

First Aid Microbiology: Other Vibrio First Aid Microbiology: Parasite Hints
Vibrio Species
Species
Biliary tract disease and
Contaminated seafood is associated
Contaminated seafood is associated cholangiocarcinoma are associated with
with Vibrio vulnificus food
with Vibrio parahaemolyticus food clonorchis sinensis.
poisoning.
poisoning.
also causes wound infections from

contact with contaminated water or
shellfish
First Aid Microbiology: Parasite Hints First Aid Microbiology: Parasite

First Aid Microbiology: Parasite Hints
Hints
Biliary tract disease and
Brain cysts and seizures are associated
cholangiocarcinoma are associated with Biliary tract disease and
with taenia solium (neurocysticercosis).
clonorchis sinensis. cholangiocarcinoma are associated
with clonorchis sinensis.
First Aid Microbiology: Parasite Hints First Aid Microbiology: Parasite First Aid Microbiology: Parasite Hints
189 of 584 5/12/2018, 9:26 PM

Hints
Hematuria and squamous cell bladder
Brain cysts and seizures are associated
Brain cysts and seizures are cancer are associated with schistosoma
with taenia solium (neurocysticercosis).
associated with taenia solium haematobium.
(neurocysticercosis).
First Aid Microbiology: Parasite Hints First Aid Microbiology: Parasite

First Aid Microbiology: Parasite Hints
Hints
Hematuria and squamous cell bladder
Liver (hyatid) cysts are associated with
cancer are associated with schistosoma Hematuria and squamous cell
echinococcus granulosus.
haematobium. bladder cancer are associated with
schistosoma haematobium.
Hints
Liver (hyatid) cysts are associated with Microcytic anemia is associated with
echinococcus granulosus. Microcytic anemia is associated ancylostoma and necator.
with ancylostoma and necator.
Hints
Microcytic anemia is associated with Myalgias and periorbital edema are
ancylostoma and necator. Myalgias and periorbital edema are associated with trichinella spiralis.
associated with trichinella spiralis.
Hints
Myalgias and periorbital edema are Perianal pruritus is associated with
associated with trichinella spiralis. Perianal pruritus is associated with enterobius.
enterobius.
Hints
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Portal hypertension is associated with Portal hypertension is associated with

schistosoma mansoni and schistosoma Portal hypertension is associated schistosoma mansoni and schistosoma
japonicum. with schistosoma mansoni and japonicum.
schistosoma japonicum.
First Aid Microbiology: Parasite

First Aid Microbiology: Parasite Hints First Aid Microbiology:
Hints
Peptostreptococcus
Vitamin B12 deficiency is associated with
Vitamin B12 deficiency is
diphyllobothrium latum. Peptostreptococcus is a gram-positive
associated with diphyllobothrium
anaerobic cocci bacteria that is associated
latum.
with alcoholism
normal microbiota of female lower

reproductive tract
First Aid Microbiology: First Aid Microbiology:

Peptostreptococcus Peptostreptococcus
Peptostreptococcus
Peptostreptococcus is a gram-positive Peptostreptococcus is a gram-
Peptostreptococcus is associated with
anaerobic cocci bacteria that is associated positive anaerobic cocci bacteria
lung abscesses in alcoholics
with alcoholism that is associated with alcoholism
- this is due to aspiration of oropharyngeal
normal microbiota of female lower normal microbiota of female lower
reproductive tract reproductive tract
First Aid Microbiology: First Aid Microbiology: Prions

Peptostreptococcus
Peptostreptococcus In the body, PrPsc resists protease
Treat peptostreptococcus with degradation and facilitates the conversion
Peptostreptococcus is associated with
clindamycin of still more PrPc to PrPsc.
lung abscesses in alcoholics
It is an "above the belt" anaerobic
- this is due to aspiration of oropharyngeal
infection (therefore use
clindamycin over metronidazole)
First Aid Microbiology: Prions First Aid Microbiology: Prions

First Aid Microbiology: Prions
The beta pleated (PrPsc) form of The beta pleated (PrPsc) form of prions are
Outside of the body, prions are resistant to transmissible via CNS-related tissue
prions are transmissible via CNS-
standard sterilizing procedures, including (iatrogenic CJD) or food contaminated by
related tissue (iatrogenic CJD) or
autoclaving. BSE-infected animal products (variant
food contaminated by BSE-infected
animal products (variant CJD). CJD).
First Aid Microbiology: Prions First Aid Microbiology: Prions First Aid Microbiology: Prions
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Accumulation of PrPsc results in Accumulation of PrPsc results in

Bovine spongiform encephalopathy (BSE)
spongiform encephalopathy and dementia, is a prion disease also known as mad cow
spongiform encephalopathy and
ataxia, and death disease.
dementia, ataxia, and death
First Aid Microbiology: Prions First Aid Microbiology: Prions First Aid Microbiology: Prions
Bovine spongiform encephalopathy (BSE) Creutzfeldt-Jakob disease is a kind Creutzfeldt-Jakob disease is a kind of prion
is a prion disease also known as mad cow of prion disase that results in disase that results in rapidly progressive
disease. rapidly progressive dementia. dementia.

First Aid Microbiology: Prions First Aid Microbiology: Prions
Prion diseases are caused by the
Kuru is an acquired prion disaese most Kuru is an acquired prion disaese conversion of a normal (predominantly
prevalent in tribal populations practicing most prevalent in tribal populations alpha helical) protein (termed prion protein
human cannibalism. practicing human cannibalism. PrPc) to a beta pleated form (PrPsc).
Prion diseases are caused by the First Aid Microbiology: First Aid Microbiology:
conversion of a normal (predominantly Propionibacterium Propionibacterium
alpha helical) protein (termed prion protein
PrPc) to a beta pleated form (PrPsc). Propionibacterium is a gram- Propionibacterium is a gram-positive
positive bacillus bacterium. bacillus bacterium.
anaerobic anaerobic
First Aid Microbiology: Protozoa Route of

Infection
First Aid Microbiology: First Aid Microbiology: Four nematodes route of infection
Propionibacterium Propionibacterium are through ingestion, these being
- Enterobius
Propionibacterium is anaerobic and a cause Propionibacterium is anaerobic and - Ascaris
of bacterial acne. a cause of bacterial acne. - Toxocara
Gram+ bacillus bacterium Gram+ bacillus bacterium - Trichinella
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First Aid Microbiology: Protozoa Route of First Aid Microbiology: Protozoa First Aid Microbiology: Protozoa Route of
Infection Route of Infection Infection
Four nematodes route of infection Four nematodes route of infection Four nematodes route of infection
are through ingestion, these being are through ingestion, these being are through ingestion, these being
- Enterobius - Enterobius - Enterobius
- Ascaris - Ascaris - Ascaris
- Toxocara - Toxocara - Toxocara
- Trichinella - Trichinella - Trichinella
Three nematodes route of infection are Three nematodes route of Three nematodes route of infection are
through the skin, these being infection are through the skin, these through the skin, these being
- Strongyloides being - Strongyloides
- Ancylostoma - Strongyloides - Ancylostoma
- Necator - Ancylostoma - Necator
- Necator
Three nematodes route of infection are Three nematodes route of Three nematodes route of infection are
through their bites, these being infection are through their bites, through their bites, these being
- Loa Loa these being - Loa Loa
- Onchocerca volvulus - Loa Loa - Onchocerca volvulus
- Wucheria bancrofti - Onchocerca volvulus - Wucheria bancrofti
- Wucheria bancrofti
First Aid Microbiology: Receptors

First Aid Microbiology: Receptors used by First Aid Microbiology: Receptors used by
used by Viruses
Viruses Viruses
CMV mediates invasion by binding
CMV mediates invasion by binding CMV mediates invasion by binding
heparan sulfate located on
heparan sulfate located on vascular heparan sulfate located on vascular
vascular endothelial cells and
endothelial cells and leukocytes endothelial cells and leukocytes
leukocytes
First Aid Microbiology: Receptors used by First Aid Microbiology: Receptors First Aid Microbiology: Receptors used by
Viruses used by Viruses Viruses
EBV mediates invasion by binding CD21, EBV mediates invasion by binding EBV mediates invasion by binding CD21,
a receptor for C3d of the complement CD21, a receptor for C3d of the a receptor for C3d of the complement
system, which is found on respiratory complement system, which is found system, which is found on respiratory
epithelium and B cells on respiratory epithelium and B epithelium and B cells
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cells
First Aid Microbiology: Receptors First Aid Microbiology: Receptors used by

used by Viruses Viruses
HIV mediates invasion by binding HIV mediates invasion by binding CD4

CD4 (main receptor) with envelope (main receptor) with envelope gp120; also
gp120; also binding CCR5 as a binding CCR5 as a coreceptor on
coreceptor on Macrophages Macrophages (during early infection),
(during early infection), OR binding CXCR4 as a coreceptor on T
First Aid Microbiology: Receptors used by
OR binding CXCR4 as a Cells (during late infection)
Viruses
coreceptor on T Cells (during
late infection)
EBV mediates invasion by binding CD21,
a receptor for C3d of the complement
system, which is found on respiratory
epithelium and B cells
CCR5 and CXCR4 are both CCR5 and CXCR4 are both chemokine
chemokine receptors receptors
First Aid Microbiology: Receptors used by First Aid Microbiology: Receptors

Viruses used by Viruses
HIV mediates invasion by binding CD4 HIV mediates invasion by binding

(main receptor) with envelope gp120; also CD4 (main receptor) with envelope
binding CCR5 as a coreceptor on gp120; also binding CCR5 as a
Macrophages (during early infection), coreceptor on Macrophages
OR binding CXCR4 as a coreceptor on T (during early infection),
Cells (during late infection) OR binding CXCR4 as a
Viruses
coreceptor on T Cells (during
late infection)
HSV mediates initial invasion by binding
heparan sulfate
Then spreads to local sensory neurons and

then travels retrograde to sensory ganglia
CCR5 and CXCR4 are both chemokine CCR5 and CXCR4 are both
receptors chemokine receptors
First Aid Microbiology: Receptors used by First Aid Microbiology: Receptors First Aid Microbiology: Receptors used by
Viruses used by Viruses Viruses
Parvovirus B19 mediates invasion of Parvovirus B19 mediates invasion Rabies initially binds to the Nicotinic
RBCs by binding P antigen located on the of RBCs by binding P antigen ACh Receptor located on muscle cells,
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located on the extracellular surface

extracellular surface
then after replicating travels retrograde via

- P antigens are glycoproteins that
- P antigens are glycoproteins that can be the PNS to the CNS, where it binds to the
can be used as an alternate blood
used as an alternate blood grouping to Neural Cell Adhesion Molecule (NCAM)
grouping to ABO
ABO located on brain cells
- UPEC (uropathogenic e coli - a
- UPEC (uropathogenic e coli - a main
main cause of e coli
cause of e coli pyelonephritis) binds
pyelonephritis) binds various P
various P antigens via its PAP Pili
antigens via its PAP Pili
First Aid Microbiology: Receptors

used by Viruses First Aid Microbiology: Receptors used by
Viruses
Viruses
Rhinovirus mediates invasion of
cells by binding ICAM-1 (CD54), Rhinovirus mediates invasion of cells by
Rabies initially binds to the Nicotinic
a receptor involved in the tight binding ICAM-1 (CD54), a receptor
ACh Receptor located on muscle cells,
binding (adhesion) step of involved in the tight binding (adhesion)
then after replicating travels retrograde via
leukocyte extravasation step of leukocyte extravasation
the PNS to the CNS, where it binds to the
Neural Cell Adhesion Molecule (NCAM)
In leukocyte extravasation, In leukocyte extravasation, ICAM-1
located on brain cells
ICAM-1 classically binds the classically binds the LFA-1 integrin
LFA-1 integrin expressed on expressed on leukocytes
leukocytes
First Aid Microbiology: Red Rashes of

First Aid Microbiology: Red Rashes First Aid Microbiology: Red Rashes of
Childhood
of Childhood Childhood
Rashes from Parvovirus B19 appear with
Rashes from Parvovirus Rashes from Streptococcus
"slapped-cheek" rash on face
B19 appear with "slapped-cheek" Pyogenes appear with an erythematous
rash on face rash on face that resembles sandpaper
- This is found in Fifth Disease
(Erythema Infectiosum)
- This is found in Fifth Disease - This is found in Scarlet Fever
(Erythema Infectiosum)
can cause hydrops fetalis in

can cause hydrops fetalis in pregnant - patients have fever and sore throat
pregnant women
women
First Aid Microbiology: Red Rashes of First Aid Microbiology: Red Rashes First Aid Microbiology: Red Rashes of
Childhood of Childhood Childhood
Rashes from Streptococcus Rashes from Streptococcus Rashes from Varicella Zoster
Pyogenes appear with an erythematous Pyogenes appear with an Virus appear with an vesicular rash that
rash on face that resembles sandpaper erythematous rash on face that begins on the trunk, that spreads to the
resembles sandpaper face and extremities with lesions of
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different stages
- This is found in Scarlet Fever
- patients have fever and sore

- patients have fever and sore throat throat
First Aid Microbiology: Red Rashes of First Aid Microbiology: Red Rashes of
Childhood First Aid Microbiology: Red Rashes Childhood
of Childhood
Rashes from Varicella Zoster Rashes from Varicella Zoster
Virus appear with an vesicular rash that Rashes from Varicella Zoster Virus appear with an vesicular rash that
begins on the trunk, that spreads to the Virus appear with an vesicular begins on the trunk, that spreads to the
face and extremities with lesions of rash that begins on the trunk, that face and extremities with lesions of
different stages spreads to the face and extremities different stages
with lesions of different stages
- This is found in Scarlet Fever - This is found in Scarlet Fever

Rashes from Human Herpesvirus Rashes from Human Herpesvirus Rashes from Human Herpesvirus
6 appear with asymptomatic rose-colored 6 appear with asymptomatic rose- 6 appear with asymptomatic rose-colored
macules on the body after several days of colored macules on the body after macules on the body after several days of
high fever several days of high fever high fever
- This is found in Roseola (exanthem - This is found in Roseola - This is found in Roseola (exanthem
subitum) (exanthem subitum) subitum)
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- can also present with febrile

- can also present with febrile seizures and seizures and usually affects infants - can also present with febrile seizures and
usually affects infants usually affects infants
Rashes from Measles virus have a Rashes from Measles virus have a Rashes from Measles virus have a
confluent maculopapular rash that starts confluent maculopapular rash that confluent maculopapular rash that starts
at the head/neck and spreads downward starts at the head/neck and spreads at the head/neck and spreads downward
following a prodromal fever downward following a prodromal following a prodromal fever
fever
- This is found in Rubeola (Measles) - This is found in Rubeola (Measles)

- This is found in Rubeola
(Measles)
- Prodromal fever has cough,

- Prodromal fever has cough, coryza, coryza, and conjunctivitis, - Prodromal fever has cough, coryza,
and conjunctivitis, followed by koplik followed by koplik spots (bright and conjunctivitis, followed by koplik
spots (bright red spots w/ blue-white red spots w/ blue-white center on spots (bright red spots w/ blue-white
center on buccal mucosa) buccal mucosa) center on buccal mucosa)
Rashes from Rubella virus begin with Rashes from Rubella virus begin Rashes from Rubella virus begin with
discrete pink macules and papules that with discrete pink macules and discrete pink macules and papules that
begin at the head and move centrifugally; papules that begin at the head and begin at the head and move centrifugally;
spread to trunk and extremities as a fine move centrifugally; spread to trunk spread to trunk and extremities as a fine
desquamating rash and extremities as a fine desquamating rash
desquamating rash
- This is found in Rubella (German - This is found in Rubella (German

Measles) - This is found in Rubella Measles)
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(German Measles)
- Also see a postauricular

- Also see a postauricular lymphadenopathy - Also see a postauricular
lymphadenopathy lymphadenopathy

Childhood
Rashes from Rubella virus begin with First Aid Microbiology: Red Rashes of
discrete pink macules and papules that First Aid Microbiology: Red Rashes
Childhood
begin at the head and move centrifugally; of Childhood
spread to trunk and extremities as a fine Rashes from Coxsackie Virus type A have
desquamating rash Rashes from Coxsackie Virus type
oval-shaped vesicles on palms and soles, as
A have oval-shaped vesicles on
well as vesicles and ulcers in the oral
palms and soles, as well as vesicles
mucosa
- This is found in Rubella (German and ulcers in the oral mucosa
Measles)
This is due to Hand-Foot-Mouth disease
This is due to Hand-Foot-Mouth
disease
- Also see a postauricular

lymphadenopathy
Rashes from Coxsackie Virus type A have Rashes from Coxsackie Virus type
oval-shaped vesicles on palms and soles, as A have oval-shaped vesicles on
well as vesicles and ulcers in the oral palms and soles, as well as vesicles
mucosa and ulcers in the oral mucosa
This is due to Hand-Foot-Mouth disease This is due to Hand-Foot-Mouth

disease
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The above red rash of childhood is caused

by Coxsackie Virus A and is known as
Hand-Foot-Mouth Disease

First Aid Microbiology: Red Rashes
Childhood
First Aid Microbiology: Red Rashes of of Childhood
Childhood
The above red rash of childhood is

caused by Human Herpesvirus
The above red rash of childhood is caused 6 and is known as Roseola
by Human Herpesvirus 6 and is known as
by Coxsackie Virus A and is known as (exanthem subitum)
Roseola (exanthem subitum)
Hand-Foot-Mouth Disease
The above red rash of childhood is The above red rash of childhood is caused
caused by Measles virus and is by Parvovirus B19 and is known as Fifth
The above red rash of childhood is caused known as Rubeola (Measles) Disease (aka Erythema Infectiosum)
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by Measles virus and is known as Rubeola

(Measles)

First Aid Microbiology: Red Rashes of Childhood
Childhood
of Childhood

caused by Parvovirus B19 and is
known as Fifth Disease (aka
by Parvovirus B19 and is known as Fifth The above red rash of childhood is caused
Erythema Infectiosum)
Disease (aka Erythema Infectiosum) by Rubella virus and is known as
Rubella (German Measles)

Childhood First Aid Microbiology: Red Rashes of
Childhood
of Childhood

caused by Streptococcus
Pyogenes and is known as Scarlet
The above red rash of childhood is caused by Streptococcus Pyogenes and is known
Fever
by Rubella virus and is known as as Scarlet Fever
Rubella (German Measles)
First Aid Microbiology: Red Rashes of First Aid Microbiology: Red Rashes
Childhood of Childhood
First Aid Microbiology: Scabies
Sarcoptes scabiei burrows into the stratum

corneum, causing scabies
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The above red rash of childhood is caused caused by Varicella-Zoster
by Varicella-Zoster Virus and is known as Virus and is known as Chickenpox
Chickenpox
First Aid Microbiology: Scabies First Aid Microbiology: Scabies

Sarcoptes scabiei is transmitted via Sarcoptes scabiei is treated with permethrin
Sarcoptes scabiei is common in children
skin-to-skin contact or fomites cream
and crowded populations (jails, nursing
skin-to-skin contact is most will also want to wash all clothing/bedding
homes)
common and treat all close contacts

First Aid Microbiology: Streptococcus
Scabies is characterized by Bovis
Scabies is characterized by pruiritis and
pruiritis and serpiginous burrows
serpiginous burrows
pruiritis is worse at night; burrows Streptococcus bovis colonizes the gut
pruiritis is worse at night; burrows located
located in webspace of hands and
in webspace of hands and feet
feet
First Aid Microbiology: Streptococcus First Aid Microbiology:

Bovis Streptococcus Bovis
Bovis
Streptococcus bovis infections can Streptococcus bovis infections can
manifest in bacteremia and subacute manifest in bacteremia and
Streptococcus bovis is Gram-positive
endocarditis subacute endocarditis
First Aid Microbiology: Time Course of

HIV Infection

Bovis
Streptococcus Bovis
Streptococcus bovis is associated with
Streptococcus bovis is treated with
colon cancer
penicillin prophylaxis
should evaluate for colon cancer if linked
to endocarditis
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HIV Infection

First Aid Microbiology: Time HIV Infection
Course of HIV Infection
During the clinical latency phase of HIV
During the clinical latency phase of infection, the virus replicates in lymph
HIV infection, the virus replicates nodes
in lymph nodes
First Aid Microbiology: Time Course of First Aid Microbiology: Time Course of
HIV Infection First Aid Microbiology: Time HIV Infection
How does the amount of HIV RNA change How does the number of CD8+ T cells
during HIV infection? How does the number of CD4+ T change during HIV infection?
cells change during HIV infection?
see picture. see picture.
see picture.
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First Aid Microbiology: Time Course of First Aid Microbiology: Time HIV Infection
HIV Infection Course of HIV Infection
What are the stages of untreated HIV
How does the number of anti-envelope What are the stages of untreated infection?
bodies (gp120) change during HIV HIV infection?
infection? Flu like (acute)
Flu like (acute) Feeling fine (latent)
see picture. Feeling fine (latent) Falling count
Falling count Final crisis
Final crisis

First Aid Microbiology: Time HIV Infection
Moderate immunocompromise during HIV
Moderate immunocompromise infection is defined as <400 CD4+
during HIV infection is defined as cells/mm3
<400 CD4+ cells/mm3
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First Aid Microbiology: ToRCHeS First Aid Microbiology: ToRCHeS First Aid Microbiology: ToRCHeS
Infections Infections Infections
Nonspecific signs common to many Nonspecific signs common to many Rubella is transmitted via respiratory
ToRCHeS infections include ToRCHeS infections include droplets.
hetaposlenomegaly, jaundice, hetaposlenomegaly, jaundice,
thrombocytopenia, and growth retardation. thrombocytopenia, and growth
retardation.
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First Aid Microbiology: ToRCHeS

First Aid Microbiology: ToRCHeS Infections
Infections First Aid Microbiology: ToRCHeS
Infections The maternal manifestation of
Syphilis is transmitted through sexual cytomegalovirus is usually asymptomatic,
contact. The maternal manifestation of occasionally with mononucleosis-like
cytomegalovirus is usually illness.
asymptomatic, occasionally with
mononucleosis-like illness.
The maternal manifestation of rubella is The maternal manifestation of The maternal manifestation of HIV is
rash, lymphadenopathy, polyarthritis, and rubella is rash, lymphadenopathy, variable, depending on CD4+ count.
polyathralgia. polyarthritis, and polyathralgia.
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Infections
Infections
The maternal manifestation of toxoplasma
The maternal manifestation of HIV is
The maternal manifestation of gondii is usually asymptomatic, but rarely
variable, depending on CD4+ count.
toxoplasma gondii is usually with lymphadenopathy.
asymptomatic, but rarely with
lymphadenopathy.
The maternal manifestation Herpes The maternal manifestation Herpes The maternal manifestations of syphilis are
simplex virus-2 is usually asymptomatic, simplex virus-2 is usually chancre (primary) and disseminated rash
sometimes with herpetic (vesicular) asymptomatic, sometimes with (secondary) (these are the two stages most
lesions. herpetic (vesicular) lesions. likely to result in fetal infection).
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First Aid Microbiology: ToRCHeS First Aid Microbiology: ToRCHeS

Infections First Aid Microbiology: ToRCHeS Infections
Infections
The maternal manifestations of syphilis are The neonatal manifestation of
chancre (primary) and disseminated rash The neonatal manifestation of cytomegalovirus is hearing loss, seizures,
(secondary) (these are the two stages most cytomegalovirus is hearing loss, petechial rash, "blueberry muffin" rash, and
likely to result in fetal infection). seizures, petechial rash, "blueberry periventircular calcifacations.
muffin" rash, and periventircular
calcifacations.
The neonatal manifestation of herpes The neonatal manifestation of The neonatal manifestation of syphilis is
simplex virus-2 is meningoencephalitis and herpes simplex virus-2 is often stillbirth, hydrops fetalis, facial
herpetic (vesicular) lesions. meningoencephalitis and herpetic abnormalities, saber shins, and CN VIII
(vesicular) lesions. deafness.
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The neonatal manifestation of syphilis is Infections
often stillbirth, hydrops fetalis, facial The neonatal manifestation of HIV is
abnormalities, saber shins, and CN VIII The neonatal manifestation of HIV recurrent infections and chronic diarrhea.
deafness. is recurrent infections and chronic
diarrhea.
The neonatal manifestations of toxoplasma The neonatal manifestations of The neonatal maninfestations of rubella
gondii include chorioretinits, toxoplasma gondii include include abnormalitise of the eye and ear,
hydrocephalus, and intracranial chorioretinits, hydrocephalus, and and congenital heart disease. Can also
calcifacions. Can also present with a intracranial calcifacions. Can also present with a blueberry muffin rash.
blueberry muffin rash. present with a blueberry muffin
rash.
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Infections
The neonatal maninfestations of rubella First Aid Microbiology: ToRCHeS
include abnormalitise of the eye and ear, Infections HIV is transmitted via sexual contact and
and congenital heart disease. Can also needlestick.
present with a blueberry muffin rash. HIV is transmitted via sexual
contact and needlestick.
Herpes simplex virus-2 is transmitted via Herpes simplex virus-2 is Parvovirus B19 can cause hydrops fetalis
skin or mucous membrane contact. transmitted via skin or mucous in neonates.
membrane contact.
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First Aid Microbiology: ToRCHeS First Aid Microbiology: ToRCHeS Infections
Infections Infections
Streptoccus agalactiae, E coli, and listeria
Parvovirus B19 can cause hydrops fetalis Streptoccus agalactiae, E coli, and monocytogenes can be transmitted from
in neonates. listeria monocytogenes can be mother to fetus and are causes of
transmitted from mother to fetus meningitis in neonates.
and are causes of meningitis in
neonates.
ToRCHeS infections are defined as ToRCHeS infections are defined as Toxoplasma gondii is transmitted via cat
microbes that may pass from mother to microbes that may pass from feces or ingestion of undercooked meat.
fetus. mother to fetus.
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First Aid Microbiology: ToRCHeS First Aid Microbiology: ToRCHeS

Infections First Aid Microbiology: ToRCHeS Infections
Infections
Toxoplasma gondii is transmitted via cat Cytomegalovirus is transmitted via sexual
feces or ingestion of undercooked meat. Cytomegalovirus is transmitted via contact and organ transplants.
sexual contact and organ
transplants.
First Aid Microbiology: Tropheryma First Aid Microbiology: First Aid Microbiology: Tropheryma
Whipplei Tropheryma Whipplei Whipplei
Infection by Tropheryma Whipplei can be Infection by Tropheryma Infection by Tropheryma Whipplei can be
observed Neurologically, manifesting Whipplei can be observed observed Neurologically, manifesting
commonly with symptoms of dementia and Neurologically, manifesting commonly with symptoms of dementia and
seizures, but in some cases commonly with symptoms of seizures, but in some cases
pathognomonically with oculomasticatory dementia and seizures, but in some pathognomonically with oculomasticatory
myorythmia. cases pathognomonically with myorythmia.
oculomasticatory myorythmia.
oculomasticatory myorythmia = eye oculomasticatory myorythmia = eye
movement disturbances + myoryhthmia oculomasticatory myorythmia = movement disturbances + myoryhthmia
(rapidly repetitive movements of the facial eye movement disturbances + (rapidly repetitive movements of the facial
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muscles) myoryhthmia (rapidly repetitive muscles)

movements of the facial muscles)
First Aid Microbiology: Tropheryma

Whipplei
Whipplei
Infection by Tropheryma Whipplei is Tropheryma Whipplei
usually observed at first as a migratory
Treatment of Tropheryma
oligo-Arthritis, occuring potentially years Previous exposure to infected soil
Whipplei involves Doxycycline +
before any digestive tract symptoms occur. or animals is/are the main risk
Hydroxychloroquine.
factor/s for Tropheryma Whipplei.
Tend to involve the large joints
sulfonamides added for neurological sx

Tropheryma Whipplei
Tropheryma Whipplei causes

Cardiac symptoms, causing
First Aid Microbiology: Tropheryma inflammation of which layers of the
Whipplei
Whipplei heart?
Tropheryma Whipplei causes a
Treatment of Tropheryma Endocardium, Myocardium,
malabsorption of Vitamin D which leads to
Whipplei involves Doxycycline + Pericardium
complications of hyper-parathyroidism;
Hydroxychloroquine.
and increased MSH which leads to
This can be observed on physical
hyperpigmentation of the skin.
sulfonamides added for neurological sx exam as development of a new
murmur or development of heart
failure

First Aid Microbiology: Tropheryma First Aid Microbiology: Tropheryma
Tropheryma Whipplei
Whipplei Whipplei
Tropheryma Whipplei causes a
Tropheryma Whipplei causes a Tropheryma Whipplei causes a
malabsorption of Vitamin D which
malabsorption of Vitamin D which leads to malabsorption of Vitamin D which leads to
leads to complications of hyper-
complications of hyper-parathyroidism; complications of hyper-parathyroidism;
parathyroidism; and increased MSH
and increased MSH which leads to and increased MSH which leads to
which leads to hyperpigmentation
hyperpigmentation of the skin. hyperpigmentation of the skin.
of the skin.
First Aid Microbiology: Tropheryma First Aid Microbiology: First Aid Microbiology: Tropheryma
Whipplei Tropheryma Whipplei Whipplei
Tropheryma Whipplei causes an overall Tropheryma Whipplei causes an Tropheryma Whipplei causes an overall
malabsorption syndrome, which manifests overall malabsorption syndrome, malabsorption syndrome, which manifests
in symptoms of diarrhea, abdominal pain, which manifests in symptoms of in symptoms of diarrhea, abdominal pain,
and weight loss that are observed in the diarrhea, abdominal pain, and and weight loss that are observed in the
disease course. weight loss that are observed in the disease course.
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disease course.

Tropheryma Whipplei
Whipplei Whipplei
Tropheryma Whipplei invades
Tropheryma Whipplei invades Tropheryma Whipplei invades
macrophages in the intestinal
macrophages in the intestinal lamina macrophages in the intestinal lamina
lamina propria as well as the
propria as well as the mesenteric nodes that propria as well as the mesenteric nodes that
mesenteric nodes that can be
can be diagnosed with a PAS stain on can be diagnosed with a PAS stain on
diagnosed with a PAS stain on
biopsy. biopsy.
biopsy.
These are described as "foamy" These are described as "foamy"

These are described as "foamy"
macrophages (Goljan-> similar to N. pick macrophages (Goljan-> similar to N. pick
macrophages (Goljan-> similar to
disease) disease)
N. pick disease)

Tropheryma Whipplei
Whipplei Whipplei
Tropheryma Whipplei is a gram-
Tropheryma Whipplei is a gram-positive Tropheryma Whipplei is a gram-positive
positive bacilli that causes
bacilli that causes Whipple's Disease, that bacilli that causes Whipple's Disease, that
Whipple's Disease, that is more
is more often found in elderly caucasian is more often found in elderly caucasian
often found in elderly caucasian
men. men.
men.
First Aid Microbiology: UTI's First Aid Microbiology: UTI's
A urease test will be positive for A urease test will be positive for the
the following UTIs: following UTIs:
Whipplei
- S Saprophyticus - S Saprophyticus
Immunodeficiency helps
- Proteus spp (mirabilis and - Proteus spp (mirabilis and vulgaris of
segue Tropheryma Whipplei from a
vulgaris of note) note)
carrier state of disease to an active state of
- Klebsiella Pneumoniae - Klebsiella Pneumoniae
disease.
Note: An extremely rare cause of Note: An extremely rare cause of Urease +
Urease + UTI is Ureaplasma UTI is Ureaplasma
First Aid Microbiology: UTI's First Aid Microbiology: UTI's First Aid Microbiology: UTI's
A urease test will be positive for the Ascension of a UTI from the Ascension of a UTI from the urethra to the
following UTIs: urethra to the kidney causes kidney causes pyelonephritis
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- S Saprophyticus
- Proteus spp (mirabilis and vulgaris of
note) pyelonephritis
- Klebsiella Pneumoniae
Note: An extremely rare cause of Urease +

UTI is Ureaplasma
Cystitis is primarily caused by the Cystitis is primarily caused by the Cystitis presents with symptoms of
ascension of microbes from urethra to ascension of microbes from dysuria, frequency, urgency, and
bladder urethra to bladder suprapubic pain
Cystitis presents with symptoms of Cystitis presents with symptoms of Cystitis presents with symptoms of
dysuria, frequency, urgency, and dysuria, frequency, urgency, and dysuria, frequency, urgency, and
suprapubic pain suprapubic pain suprapubic pain
First Aid Microbiology: UTI's

First Aid Microbiology: UTI's Iatrogenic causes of increased
Iatrogenic causes of increased leukocyte
leukocyte esterase count include
esterase count include
GU malignancies do cause an increased
leukocyte esterase count? - indwelling urinary catheter
- indwelling urinary catheter
- recent instrumentation of GU
- recent instrumentation of GU tract
tract

In elderly males, the most common
In adult males, the most common risk risk factor for cystitis is enlarged In male infants, the most common risk
factor for cystitis is vesicoureteral reflux prostate factor for cystitis is congenital defects
promotes urinary stasis

Pain from cystitis is localized to the Pain from cystitis is localized to the
suprapubic region, whereas pain suprapubic region, whereas pain from
Low urine pH can cause a false negative
from pyelonephritis is localized to pyelonephritis is localized to the flanks
Nitrites test
the flanks which also manifests as which also manifests as costovertebral
costovertebral angle tenderness angle tenderness
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Pain from cystitis is localized to the Pain from cystitis is localized to the Pain from cystitis is localized to the
suprapubic region, whereas pain from suprapubic region, whereas pain suprapubic region, whereas pain from
pyelonephritis is localized to the flanks from pyelonephritis is localized to pyelonephritis is localized to the flanks
which also manifests as costovertebral the flanks which also manifests as which also manifests as costovertebral
angle tenderness costovertebral angle tenderness angle tenderness

Pyelonephritis is characterized by First Aid Microbiology: UTI's
Pyelonephritis is characterized by systemic systemic symptoms due to the
symptoms due to the kidneys significant kidneys significant connection to Sterile pyuria and negative urine cultures
connection to the bloodstream the bloodstream suggest urethritis by neisseria gonorrhoae
or chlamydia trachomatis as these
Ex. Inflammatory mediators from the Ex. Inflammatory mediators from bacteria are intracellular
kidney, such as IL-1, TNF-a, IL-6, can the kidney, such as IL-1, TNF-a,
enter the bloodstream, cross the blood- IL-6, can enter the bloodstream, N Gonorrhoae invades neutrophils,
brain barrier, and enter the OVLT and cross the blood-brain barrier, and whereas Chlamydia Trachomatis invades
stimulate expression of PGE2 to alter the enter the OVLT and stimulate any type of cells (elementary body -
hypothalamic set point and cause fever expression of PGE2 to alter the enfectious, reticulate body - replicating)
(and the reflex chill response) hypothalamic set point and cause
fever (and the reflex chill response)

The class of drugs SGLT-2
inhibitors is used for treating
Sterile pyuria and negative urine cultures
diabetes mellitus and can actually
suggest urethritis by neisseria gonorrhoae The leading microbial cause of UTI's is
significantly increase your risk of
or chlamydia trachomatis as these Escherichia Coli, whose main virulence
getting a UTI
bacteria are intracellular factor for this pathology is its
Pili/Fimbriae
SGLT-2 inhibitors work by
N Gonorrhoae invades neutrophils,
inducing more glucosuria, by
whereas Chlamydia Trachomatis invades Pili / Fimbriae mediate attachment to lining
inhibiting the reabsorption of
any type of cells (elementary body - of the GU / Kidneys
glucose at the kidneys (inhibiting
enfectious, reticulate body - replicating)
the SGLT2 Na-Glucose cotransport
channel)

The leading microbial cause of UTI's is
UTI's are 10x more common in
Escherichia Coli, whose main virulence UTI's are 10x more common in women
women than in men because they
factor for this pathology is its than in men because they have shorter
have shorter urethras which
Pili/Fimbriae urethras which predisposes to colonization
predisposes to colonization by fecal
by fecal flora
flora
Pili / Fimbriae mediate attachment to lining
of the GU / Kidneys
While the Nitrite test detects most gram While the Nitrite test is good for With Cystitis, do you see WBCs or WBC
negative UTIs, a notable exception is UTIs, Gram + species do not form casts in urine?
Pseudomonas Aeruginosa nitrites and thus will display a
negative nitrite test WBCs only
Pseudomonas does NOT have nitrate
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Thus Staph Saprophyticus and

reductase like the other gram negative UTI
Enteroccocus will give false
bugs
negatives
inflammatory causes of increased inflammatory causes of increased Diabetes Mellitus is predisposing risk
leukocyte esterase count include leukocyte esterase count include factor for UTIs due to it causing
glucosuria
- interstitial cystitis - interstitial cystitis
- chronic interstitial nephritis - chronic interstitial nephritis Glucosuria provides a fertile feeding
ground for UTI bugs

Diabetes Mellitus is predisposing risk
factor for UTIs due to it causing Enterococcus spp are a cause of Enterococcus spp are a cause of UTI that
glucosuria UTI that can also cause biliary tree can also cause biliary tree infections and
infections and endocarditis endocarditis
Glucosuria provides a fertile feeding
ground for UTI bugs
First Aid Microbiology: UTI's Klebsiella Pneumoniae is the third

Klebsiella Pneumoniae is the
third leading cause of UTI leading cause of UTI
GU malformations are predisposing
anatomical risk factors for UTIs
Leukocyte Esterase is a sensitive Leukocyte Esterase is a sensitive Leukocyte Esterase is a sensitive

diagnostic marker of UTIs that is evidence diagnostic marker of UTIs that is diagnostic marker of UTIs that is evidence
of WBC activity evidence of WBC activity of WBC activity
demonstrates inflammation from immune demonstrates inflammation from demonstrates inflammation from immune
response (enzyme produced by active immune response (enzyme produced response (enzyme produced by active
leukocytes by active leukocytes leukocytes

Nitrites is a specific diagnostic
Nitrites is a specific diagnostic marker of marker of UTIs caused by that is Nitrites is a specific diagnostic marker of
UTIs caused by that is evidence of Gram - evidence of Gram - bacteria UTIs caused by that is evidence of Gram -
bacteria activity activity bacteria activity
Most UTI bugs are Gram -, but not all... Most UTI bugs are Gram -, but not Most UTI bugs are Gram -, but not all...
all...
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Proteus Mirabilis is a cause of UTI that

when plated on agar causes the following
growth pattern
Pseudomonas can cause a UTI that

Pseudomonas can cause a UTI that gives
gives off a fruity odor, and
off a fruity odor, and produces a blue
produces a blue green pigment
green pigment when cultured
when cultured
"Swarming motility", urine also produces

an ammonia scent

Serratia Marcescens is a cause of
Pseudomonas can cause a UTI that gives UTI that when cultured produces a Staphylococcus Saprophyticus is the
off a fruity odor, and produces a blue red pigment second leading cause of UTI
green pigment when cultured
this is often nosocomial and drug
resistant

catheterization is a predisposing
Staphylococcus Saprophyticus is the catheterization is a predisposing risk
risk factor for UTIs since it can
second leading cause of UTI factor for UTIs since it can cause irritation
cause irritation and inflammation
and inflammation of the urethral lining as
of the urethral lining as well as
well as acting as a nidus for seeding
acting as a nidus for seeding

catheterization is a predisposing
catheterization is a predisposing risk
risk factor for UTIs since it can
factor for UTIs since it can cause irritation kidney surgery is a predisposing risk factor
cause irritation and inflammation
and inflammation of the urethral lining as for UTIs
of the urethral lining as well as
well as acting as a nidus for seeding
acting as a nidus for seeding
obstruction is a predisposing risk factor pregnancy is a reproductive risk Cystitis presents with WBCs in the urine,
for UTIs that can eventually over time also factor for UTIs where as Pyelonephritis causes WBC
lead to hydronephrosis casts in the urine.
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Cystitis presents with WBCs in the
Cystitis presents with WBCs in the urine, Cystitis presents with WBCs in the urine,
urine, where as
where as Pyelonephritis causes WBC where as Pyelonephritis causes WBC
Pyelonephritis causes WBC
casts in the urine. casts in the urine.
casts in the urine.
First Aid Microbiology: Ureaplasma

Urealyticum
First Aid Microbiology: Urealyticum
Ureaplasma Urealyticum
Ureaplasma Urealyticum can cause UTIs
Ureaplasma is transmitted via sexual
Ureaplasma does not Gram stain contact
Keep in differential in patients with UTIs
well because it has no cell wall
that on culture do not gram stain well and
not considered an STI
are Urease +
First Aid Microbiology: Vaginal Infections
Do Trichomonas vaginal infections cause

inflammation?
Urealyticum First Aid Microbiology: Vaginal Yes
Infections
What is the urease expression
of Ureaplasma spp? Do Candida vaginal
infections cause inflammation?
Positive
Yes
Trichomonas markedly inflames the cervix,

resulting in a presentation that resembles
the "dimpling" of a strawberry (the
buzzword here being the patient has a
Strawberry Cervix)
First Aid Microbiology: Vaginal

Infections
First Aid Microbiology: Vaginal Infections Does Candida Vulvovaginitis have

an odor associated with it (and if so First Aid Microbiology: Vaginal Infections
Does Bacterial Vaginosis have an odor what does it smell like)?
associated with it (and if so what does it Does Gardnerella Vaginalis vaginal
smell like)? No odor infection cause inflammation?
Yes, Fishy Odor No

in real life, yeast infections can be
described as having a musty or
"yeasty (beer)" smell, but for step -
think no odor (but go by other
buzzwords to rule in)
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Does Trichomonas vaginitis have an odor First Aid Microbiology: Vaginal Infections
Infections
associated with it (and if so what does it
smell like)? During puberty there is an estrogen guided
During puberty there is an estrogen
increase in the growth of
guided increase in the growth of
Yes, Putrid Odor c2::lactobacillus}} which break down
c2::lactobacillus}} which break
glycogen into lactic acid, lowering the pH
down glycogen into lactic acid,
from 7 to 4
lowering the pH from 7 to 4
In real life, often described as Fishy Odor
but for Step think of Fish Odor being
associated with Gardnerella

First Aid Microbiology: Vaginal Infections Infections First Aid Microbiology: Vaginal Infections
The "wet mount" test smears a slide with The "wet mount" test smears a slide The "wet mount" test smears a slide with
vaginal discharge, adds a drop of 10-20% with vaginal discharge, adds a drop vaginal discharge, adds a drop of 10-20%
potassium hydroxide to one side (makes it of 10-20% potassium hydroxide to potassium hydroxide to one side (makes it
easier to see trichomonas and one side (makes it easier to see easier to see trichomonas and
gardnerella) and adds a drop of saline to trichomonas and gardnerella) and gardnerella) and adds a drop of saline to
ther other side (selects for yeast cells) adds a drop of saline to ther other ther other side (selects for yeast cells)
side (selects for yeast cells)

Infections Under light microscope, what unique
features do Candida infections have?
Under light microscope, what
unique features Pseudohyphae and Budding Yeasts
First Aid Microbiology: Vaginal Infections do Candida infections have?
The "wet mount" test smears a slide with Motile flagellate Candida is dimorphic and is a
vaginal discharge, adds a drop of 10-20% protozoa/trophozoites blastoconidia forming yeast
potassium hydroxide to one side (makes it
easier to see trichomonas and
gardnerella) and adds a drop of saline to
ther other side (selects for yeast cells)
First Aid Microbiology: Vaginal Infections First Aid Microbiology: Vaginal Infections
Under light microscope, what unique Infections What is gold standard treatment for
features do Gardnerella infections have? Gardnerella?
What is gold standard treatment
Clue Cells for Candida? Metronidazole
-Azoles REMEMBER - rule of thumb is

Metronidazole is anaerobic infections
BELOW the belt, Clindamycin is above
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A clue cell is a sloughed mucosal

squamous epithelial cell covered in many
adherent Gardnerella

First Aid Microbiology: Vaginal First Aid Microbiology: Vaginal Infections
What is gold standard treatment Infections
for Trichomonas? What is the normal vaginal pH for a
What is the normal vaginal pH for a woman before puberty and after
Metronidazole reproductive age woman? menopause?
REMEMBER - rule of thumb is pH = 4 pH = 7

Metronidazole is anaerobic
infections BELOW the belt, Clindamycin
is above

First Aid Microbiology: Vaginal Infections Infections First Aid Microbiology: Vaginal Infections
What is the pH of the vaginal discharge What is the pH of the vaginal What is the pH of the vaginal discharge
caused by Bacterial Vaginosis? discharge caused by Candida caused by Trichomonas Vaginitis?
Vulvovaginitis?
> 4.5 > 4.5
4.0 = normal
First Aid Microbiology: Vaginal Infections First Aid Microbiology: Vaginal First Aid Microbiology: Vaginal Infections
Infections
What microbial species causes the What microbial species causes the
following presentation / vaginal secretion? What microbial species causes the following presentation / vaginal secretion?
following presentation / vaginal
secretion?
Candida Albicans
Gardnerella Vaginalis
Note the thick, cottage cheese like Trichomonas
Note how the discharge looks like
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appearance a thin watery liquid Note the yellow-green discharge
First Aid Microbiology: Viral Functional First Aid Microbiology: Viral

Categories Functional Categories First Aid Microbiology: Viral Functional
Categories
All DNA viral genomes are linear except All DNA viral genomes are linear
papilloma-, polyoma-, and hepadnaviruses except papilloma-, polyoma-, and All DNA viruses except the parvoviridae
(circular). hepadnaviruses (circular). are dsDNA.
First Aid Microbiology: Viral First Aid Microbiology: Viral Functional

First Aid Microbiology: Viral Functional Categories
Categories
All RNA viruses except Reoviridae All RNA viruses except Reoviridae are
All DNA viruses except the parvoviridae ssRNA.
are ssRNA.
are dsDNA.
First Aid Microbiology: Viral Functional First Aid Microbiology: Viral First Aid Microbiology: Viral Functional
Categories Functional Categories Categories
All RNA viruses except influenza virus All RNA viruses except influenza All RNA viruses except influenza virus
and retroviruses replicate in the cytoplasm. virus and retroviruses replicate in and retroviruses replicate in the cytoplasm.
the cytoplasm.
All DNA viruses except poxvirus replicate All DNA viruses except poxvirus All DNA viruses except poxvirus replicate
in the nucleus. replicate in the nucleus. in the nucleus.
First Aid Microbiology: Viral Functional First Aid Microbiology: Viral

Categories Functional Categories First Aid Microbiology: Viral Functional
Categories
Generally, enveloped viruses acquire their Generally, enveloped viruses
envelopes from plasma mebrane when they acquire their envelopes from Naked nucleic acids of negative strand
exit from cell. Exceptions include plasma mebrane when they exit ssRNA and dsRNA viruses are not
herpesviruses, which acquire envelopes from cell. Exceptions include infectious because they require
from nuclear membrane. herpesviruses, which acquire polymerases contained in the complete
envelopes from nuclear membrane. virion.
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Naked nucleic acids of negative strand Naked nucleic acids of negative

ssRNA and dsRNA viruses are not strand ssRNA and dsRNA viruses Purified nucleic acids of most dsDNA
infectious because they require are not infectious because they (except poxviruses and HBV) and positive
polymerases contained in the complete require polymerases contained in strand ssRNA viruses are infectious.
virion. the complete virion.
First Aid Microbiology: Viral Functional

First Aid Microbiology: Viral
Categories
Categories DNA viruses typically have linear
DNA viruses typically have linear
genomes, except papilloma and polyoma
genomes, except papilloma and
Purified nucleic acids of most dsDNA (circular, supercoiled), and hepadna
polyoma (circular, supercoiled),
(except poxviruses and HBV) and positive (circular, incomplete).
and hepadna (circular, incomplete).
strand ssRNA viruses are infectious.

Categories First Aid Microbiology: Viral Functional
Categories
genomes, except papilloma and polyoma DNA viruses are typically double stranded,
genomes, except papilloma and
(circular, supercoiled), and hepadna except parvo (single stranded).
polyoma (circular, supercoiled),
(circular, incomplete).
and hepadna (circular, incomplete).
First Aid Microbiology: Viral Functional First Aid Microbiology: Viral Functional
Categories Categories
DNA viruses are typically double stranded, DNA viruses are usually icosahedral
DNA viruses are usually
except parvo (single stranded). except pox (complex).
icosahedral except pox (complex).
DNA viruses replicate in the nucleus DNA viruses replicate in the Naked (nonenveloped) viruses include
except pox (carries its own DNA- nucleus except pox (carries its own papillomavirus, adenovirus, parvovirus,
dependent RNA polymerase). DNA-dependent RNA polymerase). polyomavirus, calcivirus, picornavirus,
reovirus, and hepevirus.
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Categories First Aid Microbiology: Viral First Aid Microbiology: Viral Functional
Functional Categories Categories
Naked (nonenveloped) viruses include
papillomavirus, adenovirus, parvovirus, Positive stranded RNA viruses Positive stranded RNA viruses include
polyomavirus, calcivirus, picornavirus, include retrovirus, togavirus, retrovirus, togavirus, coronavirus,
reovirus, and hepevirus. coronavirus, hepevirus, calicivirus, hepevirus, calicivirus, and picornavirus.
and picornavirus.

First Aid Microbiology: Viral Genetics
First Aid Microbiology: Viral Functional Genetics
Categories An example of complementation, is that
An example of complementation, is
hepatitis D virus requires the presence of
include hepadna, herpes, adeno, pox, that hepatitis D virus requires the
replicating hepatitis B virus to supply
parvo, papilloma, and polyoma. presence of replicating hepatitis B
HBsAg, the envelope protein for HDV.
virus to supply HBsAg, the
envelope protein for HDV.

First Aid Microbiology: Viral Genetics Genetics
In phenotypic mixing, the type B protein
An example of complementation, is that In phenotypic mixing, the type B
coat determines the tropism (infectivity) of
hepatitis D virus requires the presence of protein coat determines the tropism
the hybrid virus. However, the progeny
replicating hepatitis B virus to supply (infectivity) of the hybrid virus.
from this infection have a type A coat that
HBsAg, the envelope protein for HDV. However, the progeny from this
is encoded by its type A material.
infection have a type A coat that is
encoded by its type A material.
First Aid Microbiology: Viral Genetics First Aid Microbiology: Viral First Aid Microbiology: Viral Genetics
Genetics
In phenotypic mixing, the type B protein Complementation is when 1 of 2 viruses
coat determines the tropism (infectivity) of Reassortment has potential to cause that infect the cell has a mutation that
the hybrid virus. However, the progeny antigenic shift. results in a nonfunctional protein and to
from this infection have a type A coat that compensate the nonmutated virus
is encoded by its type A material. "complements" the mutated one by making
a functional protein that serves both
viruses.
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Genetics First Aid Microbiology: Viral Genetics
Complementation is when 1 of 2 viruses
Complementation is when 1 of 2 Phenotypic mixing occurs with
that infect the cell has a mutation that
viruses that infect the cell has a simultaneous infection of a cell with 2
results in a nonfunctional protein and to
mutation that results in a viruses. In it, genome of virus A can be
compensate the nonmutated virus
nonfunctional protein and to partially or completed coated (forming
"complements" the mutated one by making
compensate the nonmutated virus pseudovirion) with the surface proteins}}
a functional protein that serves both
"complements" the mutated one by of Virus B.
viruses.
making a functional protein that
serves both viruses.

First Aid Microbiology: Viral Genetics First Aid Microbiology: Viral Genetics
Genetics
Phenotypic mixing occurs with Phenotypic mixing occurs with
Phenotypic mixing occurs with
simultaneous infection of a cell with 2 simultaneous infection of a cell with 2
simultaneous infection of a cell
viruses. In it, genome of virus A can be viruses. In it, genome of virus A can be
with 2 viruses. In it, genome of
partially or completed coated (forming partially or completed coated (forming
virus A can be partially or
pseudovirion) with the surface proteins}} pseudovirion) with the surface proteins}}
completed coated (forming
of Virus B. of Virus B.
pseudovirion) with the surface
proteins}} of Virus B.

First Aid Microbiology: Viral Genetics First Aid Microbiology: Viral
Genetics Recombination is exchange of genes
Reassortment is When viruses with between 2 chromosomes by crossing over
segmented genomes (eg influenza virus) Reassortment is When viruses with within regions of significant base sequence
exchange genetic material. segmented genomes (eg influenza homology.
virus) exchange genetic material.
First Aid Microbiology: Viral Genetics First Aid Microbiology: Viral First Aid Microbiology: Viral Structures
Genetics
Recombination is exchange of genes Fill in the labels (mentally)
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Recombination is exchange of
between 2 chromosomes by crossing over
genes between 2 chromosomes by
within regions of significant base sequence
crossing over within regions of
homology.
significant base sequence
homology.
First Aid Microbiology: Viral Structures First Aid Microbiology: Viral First Aid Microbiology: Viral Vaccines
Structures
Fill in the labels (mentally) Killed viral vaccines include rabies,
Fill in the labels (mentally) Influenza (injected), Salk Polio, and HAV
vaccines.
First Aid Microbiology: Viral Vaccines First Aid Microbiology: Viral

Vaccines First Aid Microbiology: Viral Vaccines
Killed viral vaccines include rabies,
Killed/inactivated vaccines induce Killed/inactivated vaccines induce only
Influenza (injected), Salk Polio, and HAV
only humoral immunity but are humoral immunity but are stable.
vaccines.
stable.

Vaccines First Aid Microbiology: Viral Vaccines
First Aid Microbiology: Viral Vaccines
Live attenuated viral vaccines Live attenuated viral vaccines include

Killed/inactivated vaccines induce only
include MMR, Yellow fever, MMR, Yellow fever, Rotavirus, Influenza
humoral immunity but are stable.
Rotavirus, Influenza (intranasal), (intranasal), Chickenpox (VSV), Smallpox,
Chickenpox (VSV), Smallpox, and and Sabin polio virus.
Sabin polio virus.
First Aid Microbiology: Viral Vaccines First Aid Microbiology: Viral First Aid Microbiology: Viral Vaccines
Vaccines
MMR = measles, mumps, and rubella. It is MMR = measles, mumps, and rubella. It is
a live attenuated vaccine that can be given MMR = measles, mumps, and a live attenuated vaccine that can be given
to HIV positive patients who do not show rubella. It is a live attenuated to HIV positive patients who do not show
signs of immunodeficiency. vaccine that can be given to HIV signs of immunodeficiency.
positive patients who do not show
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signs of immunodeficiency.
First Aid Microbiology: Viral Vaccines First Aid Microbiology: Viral First Aid Microbiology: Viral Vaccines
Vaccines
MMR = measles, mumps, and rubella. It is
Subunit viral vaccines include HBV
a live attenuated vaccine that can be given Subunit viral vaccines include HBV (antigen=HBsAg) and HPV (types 6, 11,
to HIV positive patients who do not show (antigen=HBsAg) and HPV (types 16, and 18).
signs of immunodeficiency. 6, 11, 16, and 18).
First Aid Microbiology: Zika

How do you treat Zika virus?
If a pregnant woman transmits Zika
Zika is a flavivirus
Supportive care, there is currently no in utero, it can lead to congenital
has envelope, ssRNA, icosahedral
definitive treatment microcephaly or miscarriage

Zika virus is most commonly transmitted
Zika virus is diagnosed by RT-
Zika outbreaks are more common in by Aedes mosquito
PCR or serology
tropical and subtropical climates can also have sexual and vertical
transmission
First Aid Microbiology: Zoonosis First Aid Microbiology: Zoonosis First Aid Microbiology: Zoonosis
Anaplasma spp. causes anaplasmosis. It is Anaplasma spp. causes

Anaplasma spp. causes anaplasmosis. It is
transmitted by ixodes ticks (lives on deer anaplasmosis. It is transmitted by transmitted by ixodes ticks (lives on deer
and mice). ixodes ticks (lives on deer and and mice).
mice).
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Bartonella spp. causes cat scratch disease Bartonella spp. causes cat scratch disease
and bacillary angiomatosis. It is Bartonella spp. causes cat scratch and bacillary angiomatosis. It is
transmitted by cat scratches. disease and bacillary angiomatosis. transmitted by cat scratches.
It is transmitted by cat scratches.
First Aid Microbiology: Zoonosis First Aid Microbiology: Zoonosis

First Aid Microbiology: Zoonosis
Bartonella spp. causes cat scratch disease Borrelia burgdoferi causes Lyme disease. It
and bacillary angiomatosis. It is Borrelia burgdoferi causes Lyme is transmitted by Ixodes ticks (live on deer
transmitted by cat scratches. disease. It is transmitted by Ixodes and mice).
ticks (live on deer and mice).

Borrelia burgdoferi causes Lyme disease. It Borrelia recurrentis causes Borrelia recurrentis causes relapsing fever.
is transmitted by Ixodes ticks (live on deer relapsing fever. It is transmitted by It is transmitted by louse. Recurrent due to
and mice). louse. Recurrent due to variable variable surface antigens.
surface antigens.
Borrelia recurrentis causes relapsing fever. Borrelia recurrentis causes Brucella spp. causes brucellosis/undulant
It is transmitted by louse. Recurrent due to relapsing fever. It is transmitted by fever. It is transmited by unpasteurized
variable surface antigens. louse. Recurrent due to variable dairy.
surface antigens.
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Campylobacter causes bloody diarrhea. It
Brucella spp. causes brucellosis/undulant
Brucella spp. causes is transmitted by feces from infected
fever. It is transmited by unpasteurized
brucellosis/undulant fever. It is pets/animals and contaminated meats/foods
dairy.
transmited by unpasteurized dairy. /hands.

Campylobacter causes bloody diarrhea. It Campylobacter causes bloody diarrhea. It
is transmitted by feces from infected Campylobacter causes bloody is transmitted by feces from infected
pets/animals and contaminated meats/foods diarrhea. It is transmitted by feces pets/animals and contaminated meats/foods
/hands. from infected pets/animals and /hands.
contaminated meats/foods/hands.
Chlamydophila psittaci causes psittacosis. Chlamydophila psittaci causes Chlamydophila psittaci causes psittacosis.
It is transmitted by parrots and other birds. psittacosis. It is transmitted by It is transmitted by parrots and other birds.
parrots and other birds.
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Coxiella burnetii causes Q fever. It is Coxiella burnetii causes Q fever. It is
transmitted by aerosols of cattle/sheep Coxiella burnetii causes Q fever. It transmitted by aerosols of cattle/sheep
amniotic fluid. is transmitted by aerosols of amniotic fluid.
cattle/sheep amniotic fluid.

Ehrlichia chaffeensis causes ehrlichiosis. It Ehrlichia chaffeensis causes ehrlichiosis. It
is transmitted by amblyomma (the lone star Ehrlichia chaffeensis causes is transmitted by amblyomma (the lone star
tick). ehrlichiosis. It is transmitted by tick).
amblyomma (the lone star tick).
Francisella tularensis causes tularemia. It is Francisella tularensis causes Francisella tularensis causes tularemia. It is
transmitted by ticks, rabbits, and deer flies. tularemia. It is transmitted by ticks, transmitted by ticks, rabbits, and deer flies.
rabbits, and deer flies.
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Leptospira spp. causes leptospirosis. It is Leptospira spp. causes Leptospira spp. causes leptospirosis. It is
transmitted by animal urine in water and leptospirosis. It is transmitted by transmitted by animal urine in water and
recreational water use. animal urine in water and recreational water use.
recreational water use.
Leptospira spp. causes leptospirosis. It is Mycobacterium leprae causes Mycobacterium leprae causes leprosy. It is
transmitted by animal urine in water and leprosy. It is transmitted by humans transmitted by humans with lepromtaus
recreational water use. leprosy and armadillos.
with lepromtaus leprosy and
armadillos.
Mycobacterium leprae causes leprosy. It is Mycobacterium leprae causes Pasteurella multocida causes cellulitis and
transmitted by humans with lepromtaus leprosy. It is transmitted by humans osteomyeletis. It is transmitted by animal
leprosy and armadillos. with lepromtaus leprosy and bites (cats, dogs).
armadillos.
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Pasteurella multocida causes cellulitis and Pasteurella multocida causes Pasteurella multocida causes cellulitis and
osteomyeletis. It is transmitted by animal cellulitis and osteomyeletis. It is osteomyeletis. It is transmitted by animal
bites (cats, dogs). transmitted by animal bites (cats, bites (cats, dogs).
dogs).
Ricketssia rickettsii causes Rocky Ricketssia rickettsii causes Rocky Ricketssia rickettsii causes Rocky
Mountain spotted fever. It is trasmitted by Mountain spotted fever. It is Mountain spotted fever. It is trasmitted by
demacentor (dog tick). demacentor (dog tick).
trasmitted by demacentor (dog
tick).
Rickettsia prowazekii causes epidemic Rickettsia prowazekii causes Rickettsia prowazekii causes epidemic
typhus. It is transmitted human to human epidemic typhus. It is transmitted typhus. It is transmitted human to human
via body louse. human to human via body louse. via body louse.
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Rickettsia typhi causes endemic typhus. It Rickettsia typhi causes endemic typhus. It
is transmitted by fleas. Rickettsia typhi causes endemic is transmitted by fleas.
typhus. It is transmitted by fleas.
Salmonella spp. (except S typhi) causes Salmonella spp. (except S typhi) causes
Salmonella spp. (except S typhi)
diarrhea (which may be bloody), vomiting, causes diarrhea (which may be diarrhea (which may be bloody), vomiting,
fever, and abdominal cramps. It is bloody), vomiting, fever, and fever, and abdominal cramps. It is
transmitted by reptiles and poultry. transmitted by reptiles and poultry.
abdominal cramps. It is transmitted
by reptiles and poultry.
Salmonella spp. (except S typhi) causes Salmonella spp. (except S typhi) Salmonella spp. (except S typhi) causes
diarrhea (which may be bloody), vomiting, causes diarrhea (which may be diarrhea (which may be bloody), vomiting,
fever, and abdominal cramps. It is bloody), vomiting, fever, and fever, and abdominal cramps. It is
transmitted by reptiles and poultry. abdominal cramps. It is transmitted transmitted by reptiles and poultry.
by reptiles and poultry.
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Yersinia pestis causes plague. It may be Yersinia pestis causes plague. It may be
transmitted by fleas (rats and prairie dogs Yersinia pestis causes plague. It transmitted by fleas (rats and prairie dogs
are reservoirs). may be transmitted by fleas (rats are reservoirs).
and prairie dogs are reservoirs).
First Aid Microbiology:: Eikenella

Corrodens
Eikenella Corrodens is a gram-negative

coccobacillus that creates a pit in the agar
of which its growing
zoonosis is infectious disease transmitted zoonosis is infectious disease - Pleomorphic (often coccobacillus though)
between animals and humans. - catalase negative, oxidase positive, urease
transmitted between animals and
humans. negative
First Aid Microbiology:: Eikenella First Aid Microbiology:: Eikenella First Aid Microbiology:: Eikenella
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Corrodens
Eikenella Corrodens is a gram-negative

coccobacillus that creates a pit in the agar
of which its growing
- Pleomorphic (often coccobacillus though) Corrodens

Corrodens
- catalase negative, oxidase positive, urease
negative Eikenella Corrodens is a normal
Eikenella Corrodens is a normal flora of
flora of the mouth and is very
the mouth and is very commonly
commonly associated with human
associated with human bite wound
bite wound infections and
infections and infections in cancers of the
infections in cancers of the head
head and neck
and neck
Fusobacterium and Bacteroides are also
Fusobacterium and Bacteroides are
commonly associated
also commonly associated
First Aid Microbiology:: Eikenella

First Aid Microbiology:: Eikenella First Aid Microbiology:: Eikenella
Corrodens
Corrodens Corrodens
Eikenella Corrodens is associated
Eikenella Corrodens is a normal flora of Eikenella Corrodens is associated
with endocarditis with negative
the mouth and is very commonly with endocarditis with negative blood
blood cultures
associated with human bite wound cultures
Part of HACEK group of organism
infections and infections in cancers of the Part of HACEK group of organism that is
that is associated with culture
head and neck associated with culture negative
negative endocarditis
endocarditis (Haemophilus,
(Haemophilus, Aggregatibacter,
Fusobacterium and Bacteroides are also Aggregatibacter, Cardiobacterium,
Cardiobacterium,
commonly associated Eikenella, Kingella)
Eikenella, Kingella)
First Aid Microbiology: First Aid Microbiology:

Prophylactic treatment Chancroid is an STD caused
Prophylactic treatment for Mycobacterium
for Mycobacterium avium- by Haemophilus ducreyi that presents
avium-intracellulare in an HIV patient with
intracellulare in an HIV patient with painful genital ulcers with
< 50 CD4+ cells/mm3
with < 50 CD4+ cells/mm3 exudate and inguinal adenopathy
is Azithromycin/Clarithromycin
is Azithromycin/Clarithromycin
First Aid Pharmacology: First Aid Pharmacology: Antimicrobials -

Antimicrobials - Antiparasitics Antiparasitics
Anti-malarial drugs (especially Anti-malarial drugs (especially
Chancroid is an STD caused
primaquine) are known to cause primaquine) are known to cause
by Haemophilus ducreyi that presents
hemolysis in patients with G6PD hemolysis in patients with G6PD
with painful genital ulcers with
deficiency deficiency
exudate and inguinal adenopathy
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First Aid Pharmacology: Antimicrobials -

Antiparasitics
Diphyllobothrium latum can be treated

First Aid Pharmacology: by Praziquantel
Antiparasitics Antimicrobials - Antiparasitics
Diethylcarbamazine is an Diphyllobothrium latum is transmitted by

Chloroquine is used in the treatment of ingestion of larvae in raw fish
plasmodial species other than P antihelminthic agent that works by
falciparum (frequency of resistance too inhibiting arachidonic acid
high) metabolism in microfiliria
This makes the microfiliriae more
susceptible to innate immune
attack, but doesn't kill the parasites
outright

Antiparasitics
If a case of malaria is life-threatening,
If the causative organism for If the causative organism for malaria is P
treat it with IV quinidine or
malaria is P vivax/ovale, add vivax/ovale, add primaquine for
{{c2::artesunate}}
primaquine for effectiveness effectiveness against the hypnozoite form
- Quinidine inhibits hemozoin
against the hypnozoite form Primaquine generates reactive oxygen
biocrystalization
Primaquine generates reactive species that inhibit electron transport chain
- Artesunate generates Free radical species
oxygen species that inhibit electron in plasmodium
which damage plasmodia
transport chain in plasmodium
First Aid Pharmacology: Antimicrobials - First Aid Pharmacology: First Aid Pharmacology: Antimicrobials -
Antiparasitics Antimicrobials - Antiparasitics Antiparasitics
If the causative organism of malaria is If the causative organism of Iodoquinol is an amebacide that works by
resistant to chloroquine, use mefloquine malaria is resistant to chloroquine, chelation of Iron essential for amoeba
or atovaquone/proguanil use mefloquine or metabolism
- Mefloquine inhibits hemozoin atovaquone/proguanil
biocrystallization - Mefloquine inhibits hemozoin
- Atovaquone inhibits the parasite electron biocrystallization
transport chain - Atovaquone inhibits the parasite
- proguanil inhibits Dihydrofolate electron transport chain
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Reductase - proguanil inhibits Dihydrofolate

Reductase

Antiparasitics
Leishmaniasis is treated by Stibugluconate

First Aid Pharmacology: and amphotericin B
First Aid Pharmacology: Antimicrobials - Antimicrobials - Antiparasitics
Antiparasitics
Ivermectin is an anti-helminthic
Ivermectin is an anti-helminthic therapy that works by binding to
therapy that works by binding to glutamate gated chloride channels
glutamate gated chloride channels in in invertebrate nerve and muscle
invertebrate nerve and muscle cells cells
This results in cellular hyperpolarization, This results in cellular

followed by paralysis and death hyperpolarization, followed by
paralysis and death

Antiparasitics
First Aid Pharmacology: Antimicrobials - First Aid Pharmacology: Melarsoprol is an antiparasitic that works
Antiparasitics Antimicrobials - Antiparasitics by inhibiting pyruvate kinase and
trypanothione reductase
Mebendazole inhibits the formation of Mebendazole inhibits the formation - Disruption of Pyruvate Kinase inhibits
helminth microbutules and irreversibly of helminth microbutules and energy production and gives a lot of side
blocks glucose uptake. irreversibly blocks glucose uptake. effects
- Trypanothione Reductase is the
equivalent of Glutathione Reductase for
trypanosomes (this is what kills the
parasite)
First Aid Pharmacology: Antimicrobials - First Aid Pharmacology: Antimicrobials -

First Aid Pharmacology:
Antiparasitics Antiparasitics
Antimicrobials - Antiparasitics
Melarsoprol is an antiparasitic that works Miltefosine is an antiparasitic that works
Miltefosine is an antiparasitic
by inhibiting pyruvate kinase and by inhibiting cytochrome c oxidase
indciated for leishmania and
trypanothione reductase resulting in apoptosis like cell death of the
{{c2::naegleria fowleri}
- Disruption of Pyruvate Kinase inhibits parasite
energy production and gives a lot of side
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effects
- Trypanothione Reductase is the
equivalent of Glutathione Reductase for
trypanosomes (this is what kills the
parasite)

Praziquantel is used Praziquantel is used in antihelminthic

in antihelminthic therapy and therapy and works by increasing membrane
works by increasing membrane permeability to calcium ions and
permeability to calcium ions and interfering with adenosine uptake
interfering with adenosine uptake
Antiparasitics - Calcium paralyzes parasites, aiding in
- Calcium paralyzes parasites, phagocytosis by host immune reaction
Nitazoxanide is an antiparasitic that works aiding in phagocytosis by host - Schistosomes can't synthesize purines de
by inhibiting Pyruvate Synthase immune reaction novo
- Schistosomes can't synthesize
Pyruvate Synthase is for anaerobes as purines de novo
Pyruvate Dehydrogenase is to aerobes

Antiparasitics
First Aid Pharmacology: Rosacea can be treated by ivermectin by

Antimicrobials - Antiparasitics targeting parasitic mites of the genus
First Aid Pharmacology: Antimicrobials - {{c2::demodex}
Antiparasitics
Pyrimethamine is an antiprotozoan
therapy that works by inhibiting
Pyrimethamine + Dapsone is used as a
Dihydrofolate Reductase
second line option to prevent
Pneumocystis Jiroveci Pneumonia in
Typically given with leucovorin (to
patients with HIV/AIDS
reduce folate deficiency side fx)
and sulfadiazine (blocks
dihydropteroate synthetase)
Stibogluconate is an antiparasitic Suramin is an antiparasitic that Taenia solium is treated by Albendazole,

antimonial that is toxic to Leishmania spp. combines with glycolytic enzymes and if it reaches the brain
to inhibit energy metabolism (neurocysticerosis) can be treated by
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Praziquantel
neurocysticercosis/cysticercosis are caused

by taenia
Used for Peripheral blood

Trypansoma Brucei infections

Antiparasitics
Taenia solium is treated by Albendazole,

and if it reaches the brain
(neurocysticerosis) can be treated by
Praziquantel
neurocysticercosis/cysticercosis are caused First Aid Pharmacology:

by taenia Antimicrobials - Antiparasitics
Teania saginatum is treated First Aid Pharmacology: Antimicrobials -

by Praziquantel Antiparasitics
To avoid heme toxicity, Plasmodia spp

biocrystallize heme into hemozoin.
hemozoin collects in the plasmodia
digestive vacuole
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First Aid Pharmacology: Antimicrobials - Antimicrobials - Antiparasitics Antiparasitics
Antiparasitics
Treat P falciparum with Treat P falciparum with
To avoid heme toxicity, Plasmodia spp artemether/lumefantrine or artemether/lumefantrine or
biocrystallize heme into hemozoin. atovaquone/proguanil atovaquone/proguanil
hemozoin collects in the plasmodia
digestive vacuole
Treat P falciparum with Treat P falciparum with What drug should be used to treat the
artemether/lumefantrine or artemether/lumefantrine or luminal form of amebiasis in asymptomatic
atovaquone/proguanil atovaquone/proguanil amebiasis?
Diloxanide

Antiparasitics
First Aid Pharmacology: Antimicrobials - Ancylostoma duodenale, Necator
Antiparasitics americanus
(hookworms) causes intestinal infection
When Hemoglobin is digested by
When Hemoglobin is digested by with anemia and is treated
Plasmodia spp for nutrients,
Plasmodia spp for nutrients, (globin is with Bendazoles or pyrantel pamoate
(globin is used, heme is not), the
used, heme is not), the parasite releases parasite releases heme which is
heme which is toxic to plasmodia. toxic to plasmodia.
Plasmodia is intracellular inside RBC Plasmodia is intracellular inside
RBC
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Ascaris lumbricoides (giant

roundworm) causes intestinal infection
with possible obstruction at ileocecal
valve and is treated with Bendazoles
Ancylostoma duodenale, Necator Ancylostoma duodenale, Necator

americanus americanus
(hookworms) causes intestinal infection (hookworms) causes intestinal
with anemia and is treated infection with anemia and is treated
with Bendazoles or pyrantel pamoate with Bendazoles or pyrantel
pamoate

Antiparasitics
Ascaris lumbricoides (giant

roundworm) causes intestinal infection
with possible obstruction at ileocecal
valve and is treated with Bendazoles

Chloroquine is an antimalarial Chloroquine is an antimalarial that blocks

that blocks detoxification of heme detoxification of heme into hemozoin
into hemozoin
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Cryptosporidium causes severe

Cryptosporidium causes severe diarrhea diarrhea in AIDS patients but is a Cryptosporidium causes severe diarrhea
in AIDS patients but is a mild disease mild disease characterized by in AIDS patients but is a mild disease
characterized by watery diarrhea in watery diarrhea in characterized by watery diarrhea in
immunocompetent hosts and is treated immunocompetent hosts and immunocompetent hosts and is treated
with Prevention (filtering water) or is treated with Prevention with Prevention (filtering water) or
nitazoxanide in immunocompetent hosts (filtering water) or nitazoxanide nitazoxanide in immunocompetent hosts
in immunocompetent hosts

Antiparasitics
Echinococcus granulosus causes hydatid

cysts in the liver which can lead to
anaphylaxis if antigens are released and
is treated with Albendazole
Antiparasitics
Diphyllobothrium
Diphyllobothrium latum causes Vitamin
latum causes Vitamin B12
B12 deficiency and is treated
deficiency and is treated
with Praziquantel
with Praziquantel
Echinococcus granulosus causes hydatid Enterobius vermicularis Enterobius vermicularis

cysts in the liver which can lead to (pinworm) causes intestinal (pinworm) causes intestinal infection with
anaphylaxis if antigens are released and infection with anal pruritis and anal pruritis and is treated
is treated with Albendazole is treated with Bendazoles or with Bendazoles or pyrantel pamoate
pyrantel pamoate
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Lice are blood-sucking insects that cause Lice are blood-sucking insects that Lice are blood-sucking insects that cause
intense pruritis, pink macules and papules cause intense pruritis, pink macules intense pruritis, pink macules and papules
in intertriginous regions and are treated and papules in intertriginous in intertriginous regions and are treated
with pyrethroids, malathion, or regions and are treated with pyrethroids, malathion, or
ivermectin lotion and nit combing with pyrethroids, malathion, or ivermectin lotion and nit combing
ivermectin lotion and nit combing

First Aid Pharmacology: Antimicrobials - Loa loa causes swelling in the skin Loa loa causes swelling in the skin with
Antiparasitics with worms present in the worms present in the conjunctiva and
conjunctiva and is treated is treated with Diethylcarbamazine
Lice are blood-sucking insects that cause with Diethylcarbamazine
intense pruritis, pink macules and papules
in intertriginous regions and are treated
with pyrethroids, malathion, or
ivermectin lotion and nit combing
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Antiparasitics
Onchocerca volvulus causes skin changes,

loss of elastic fibers, river blindness and
is treated with Ivermectin
First Aid Pharmacology: Antimicrobials - First Aid Pharmacology:
Malaria causes a form of cyclic fever, Malaria causes a form of cyclic

headache, anemia, splenomegaly and fever, headache, anemia,
is treated with Chloroquine (for sensitive splenomegaly and is treated
species) with Chloroquine (for sensitive
species)

Antiparasitics
Onchocerca volvulus causes skin changes, Antimicrobials - Antiparasitics Antiparasitics
loss of elastic fibers, river blindness and
is treated with Ivermectin Schistosoma causes liver and Schistosoma causes liver and spleen
spleen enlargement, fibrosis, enlargement, fibrosis, inflammation OR a
inflammation OR a chronic chronic infection that leads to squamous
infection that leads to squamous cell carcinoma of the bladder and is treated
cell carcinoma of the bladder and with Praziquantel
is treated with Praziquantel
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Strongyloides stercoralis Strongyloides stercoralis Strongyloides stercoralis

(threadworm) causes intestinal infection (threadworm) causes intestinal (threadworm) causes intestinal infection
with vomiting, diarrhea, epigastric pain infection with vomiting, diarrhea, with vomiting, diarrhea, epigastric pain
(like a peptic ulcer) and is treated epigastric pain (like a peptic (like a peptic ulcer) and is treated
with Ivermectin or bendazoles ulcer) and is treated with Ivermectin or bendazoles
with Ivermectin or bendazoles
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Toxocara canis causes inflammation and First Aid Pharmacology: Antimicrobials -

Toxocara
damage to intestinal wall, commonly Antiparasitics
canis causes inflammation and
infecting the heart/liver/CNS and is treated damage to intestinal wall,
with Bendazoles Toxoplasma gondii causes a classic triad
commonly infecting the
of chorioretinitis, hydrocephalus, and
heart/liver/CNS and is treated
intracranial calcifications and is treated
with Bendazoles
with Sulfadiazine and pyrimethamine

Toxoplasma gondii causes a classic triad Toxoplasma gondii causes a
Antiparasitics
of chorioretinitis, hydrocephalus, and classic triad of chorioretinitis,
intracranial calcifications and is treated hydrocephalus, and intracranial
Trichinella spiralis causes intestinal
with Sulfadiazine and pyrimethamine calcifications and is treated
infection where larvae encyst in straited
with Sulfadiazine and
muscles and is treated with Bendazoles
pyrimethamine
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Antimicrobials - Antiparasitics First Aid Pharmacology: Antimicrobials -
Antiparasitics
Antiparasitics
Trichuris trichiura aka
(Whipworm) is an intestinal Trichuris trichiura aka (Whipworm) is an
Trichinella spiralis causes intestinal
nematode that can cause rectal intestinal nematode that can cause rectal
infection where larvae encyst in straited
prolapse and is treated prolapse and is treated by bendazoles
muscles and is treated with Bendazoles
by bendazoles
First Aid Pharmacology: Antimicrobials - First Aid Pharmacology: Antimicrobials -

Antiparasitics First Aid Pharmacology: Antiparasitics
Trypanosoma brucei causes enlarged Trypanosoma brucei causes enlarged
lymph nodes, recurring fever, somnolence, Trypanosoma lymph nodes, recurring fever, somnolence,
and eventually coma and is treated brucei causes enlarged lymph and eventually coma and is treated
with Suramin for blood borne disease or nodes, recurring fever, somnolence, with Suramin for blood borne disease or
melarsoprol for CNS penetration and eventually coma and is treated melarsoprol for CNS penetration
with Suramin for blood borne
disease or melarsoprol for CNS
penetration
Wuchereria bancrofti causes blockage of Wuchereria Iodoquinol is an orally active luminal

lymphatic vessels and is treated bancrofti causes blockage of agent used to eliminate E. histolytica.
with Diethylcarbamazine lymphatic vessels and is treated
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with Diethylcarbamazine

Antiparasitics
Iodoquinol is an orally active luminal

agent used to eliminate E. histolytica.

Mebendazole is a microtubule Mebendazole is a microtubule inhibitor

inhibitor used in antihelminthic used in antihelminthic therapy
therapy
First-line treatment for UTI Flavivirus is an enveloped positive- Flavivirus is an enveloped positive-sense
sense RNA virus which is RNA virus which is characterized by a
TMP-SMX characterized by a single non- single non-segmented RNA.
segmented RNA.
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Flavivirus is an enveloped positive-sense

RNA virus which is characterized by a
single non-segmented RNA.
Flucytosine is converted to 5-fluorouracil

by fungal cytosine deaminase.
Flaviviruses consist of HCV,

Yellow, Dengue, StL, West Nile. cytosine is only different from uracil by an
amino group
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Flucytosine → 5-FU → 5-FdUMP

Flucytosine is used in combination with
What enzyme is inhibited?
amphotericin B for the treatment of what
two fungal infections? Fluoroquinolones can be used to treat what
Thymidylate synthetase
Salmonella infections?
Systemic candidiasis, cryptococcus
Gastroenteritis, osteomyelitis
5-fluorodeoxyuridine
monophosphate
remember salmonella osteomyelitis is

common in sickle cell patients
Fluoroquinolones inhibit prokaryotic

topoisomerase II and topoisomerase IV.
Fluoroquinolones should be avoid

with the use of Ca++, Fe++, Mg++ Folate synthesis inhibitors that can produce
topoisomerase II introduces negative hemolytic anemia in G6PD deficiency?
which would decrease absorption.
supercoils and and opens DNA to expose
DNA to replication enzymes Sulfonamides
topoisomerase IV prevents sister chromatid
from getting twisted and recombined
Chelation will decrease absorption
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Following fusion into the cell, viral HIV

RNA is reverse transcribed into?
dsDNA in the cytoplasm via reverse

transcriptase
DNA then travels to nucleus for integration

into nuclease by viral integrase
For more severe Tinea infections

or persistant Onychomycosis
(manifestations of dermatophytes),
oral Griseofulvin is used
deposits in keratin containing
tissues (ie: skin and nails)
For 25-50% of patients, babezia infectios is
subclinical or mild.
These patients can spontaneously recover.
Foscarnet should be given to patients with

CMV when there is a UL97 kinase gene
mutation leading to resistance to
ganciclovir.
For pregnant women & children with For pregnant women & children
Lyme disease, treat with amoxicillin & with Lyme disease, treat with
cefuroxime amoxicillin & cefuroxime
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Francisella Telarensis is a gram- Francisella Telarensis is a gram- Francisella Telarensis is a gram-

negative coccobacilli that is a facultative negative coccobacilli that is a negative coccobacilli that is a facultative
intracelluar bacteria. facultative intracelluar bacteria. intracelluar bacteria.
Function of Protein A: S. aureus virulence GBS (S. agalactiae) prophylaxis

factor that binds IgG Fc region and
prevents phagocytosis Penicillin G
GAS erythrogenic toxin genes are
encoded in a lysogenic phage
through specialized transduction.
GI complications of carbapenems
GIT adverse effects of fluoroquinolones?
Nausea, vomiting, diarrhea GI complications with macrolides
Nausea, vomiting, diarrhea
Diarrhea
Recall that erythromycin stimulates

MMC's, which increase GI motility
GIT complications of tetracyclines Ganciclovir triphosphate incorporates into

Gag is a structural gene which what structure to halt synthesis of viral
GI distress (diarrhea, nausea, vomiting) encodes p24 retrovirus DNA?
core protein(s).
DNA polymerase
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Gardnerella Vaginalis can be diagnosed Gardnerella Vaginalis can be Gardnerella Vaginalis has a fishy odor.
by adding 10% KOH and detecting the diagnosed by adding 10% KOH and
odor produced, known as the whiff test. detecting the odor produced,
known as the whiff test.
Gardnerella Vaginalis is gram-

variable (pleomorphic) rod. Gardnerella Vaginalis is gram-
VF: Vangiolysin (active when the variable (pleomorphic) rod.
concetration is large enough for quorum VF: Vangiolysin (active when the Gardnerella Vaginalis is treated with
sensing). concetration is large enough for metronidazole.
quorum sensing).
Giardia (parasite) commonly presents with

bloating, flatulence and foul-smelling
watery diarrhea
Giardia symptoms is synonymous with the
regret that fills your stomach after
devouring $10 worth of taco bell (recall
that $10 goes a long way at T-bell)
Gentamicin = aminoglycoside
Gardnerella Vaginalis occurs when the
pH is >4.5.
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Giardia is ingested in the cyst form.
Giardia is ingested in the cyst After ingestion, it differentiates into the

form. trophozoite form.
After ingestion, it differentiates Trophozoite - multiplying stage of

into the trophozoite form. protozoa
Trophozoite - multiplying stage of

protozoa
Giardia is a parasite commonly

transmitted through consumption of poorly
purified water
notice that in this form is has flagella
notice that in this form is has
flagella
(B = Cyst)
(B = Cyst)
Glycopeptide used for treatment for S.

aureus with altered PBPs
Glycylcyclines (Tigecycline) are clinically
Vancomycin used for broad spectrum coverage
Glycylcycline (Tigecycline) side (anaerobic, Gram+, Gram-) and MDR
effects include nausea and organisms or infections requiring deep
vomiting tissue penetration
MDR = multidrug-resistant, ex. MRSA,

VRE
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Glycylcyclines (Tigecycline) are clinically

used for broad spectrum coverage
(anaerobic, Gram+, Gram-) and MDR Glycylcyclines (Tigecycline) functions by
Glycylcyclines (Tigecycline) are
organisms or infections requiring deep binding to 30S, inhibiting protein synthesis
generally bacteriostatic
tissue penetration
tetracycline derivative; bacteriostatic
MDR = multidrug-resistant, ex. MRSA,
VRE
Gram + rod with exotoxin that inhibits

protein synthesis via ADP-ribosylation of
EF2? Corynebacterium diptheriae
Treatment? Erythromycin
Gp41 surface
Recall pseudomonas (gram neg) has
glycoprotein facilitates HIV fusion
exotoxin A that also has same MOA
Gp120 surface glycoprotein allows HIV to and entry of HIV into host CD4
attach and enter CD4+ T-cells. T-cell.
Gram - diplococcus that can be treated with Gram positive rod that grows in Gram-positive bacteria have a cell wall that
penicillin? chains, treated by penicillin is easily crossed by β-lactams and does not
require presence of porins.
N. meningitidis Actinomyces israelii
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Gram - have porins that can be altered,

thus increasing B-lactam resistance
Griseofulvan can
Great lakes and Ohio river valley are activate CYP-450, which can cause Griseofulvin = antifungal
buzzwords for which fungus? unwanted drug interactions.
Blastomycosis
As well as along the east coast
Gross pathology of Cryptococcus infection

appears as "soap-bubble" lesions in the
gray matter of the brain
Griseofulvin has a tropism for what type of
tissue?
Griseofulvin is associated with GI
Keratin containing tissue
side-effects
if you eat a lot of "griseo" greasy
food, you will have an upset
i.e. nails, skin, hair stomach
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Gross pathology of Cryptococcus infection

appears as "soap-bubble" lesions in the
gray matter of the brain
Group B Strep (S. agalactiae) is bacitracin-

Group A Strep. (GAS) resistant.
is ß-hemolytic.
Group B Strep causes newborn septic Group B Strep causes newborn

syndrome from vaginal delivery. Group B Strep has a positive CAMP test,
septic syndrome from vaginal meaning it enhances zone of hemolysis
delivery. when plated with S. aureus.
Group B Strep hydrolyzes sodium Group B Strep is also known Groups of reticular bodies are represented
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hippurate.
by inclusion bodies in
Chlamydia infections under the
microscope.
as Strep agalactiae
Guardasil HPV vaccine protects against

HPV 6, 11, 16, 18.
Guanasine analog used to treat CMV Guardasil HPV vaccine is what
type of vaccine? Subunit
Ganciclovir
Guarnieri bodies are intracytoplasmic Guarnieri bodies are

inclusion bodies that are the sites of viral Guillain-Barre syndrome is noted by its
intracytoplasmic inclusion bodies
replication of Pox virus. ascending symmetrical flaccid paralysis.
that are the sites of viral replication
of Pox virus. Botulism would be the descending
paralysis
H. Influenza is transmitted by aerosol's. H. influenza clinical manifestations H. influenza contains IgA protease which
can be remembered with the cleaves IgA.
mnemonic "EMOP": epiglottitis,
meningitis, otitis media, pneumonia
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Primarily children
H. influenza is associated with meningitis

H. influenza is a gram- in children.
negative coccobacillary shaped bacteria. H. influenza is a gram-
negative coccobacillary shaped
bacteria.
H. influenza type B and Neisseria

both have IgA protease.
H. influenza is encapsulated, therefore

asplenic and sickle cell patients are at
H. influenza vaccine grants immunity
increased risk for infection.
against B capsular antigen.
(This is opposite to Neisseria where you get
immunity to all antigens EXCEPT B)
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H. influenza vaccine is conjugated to

Diptheria toxoid through polyribosylribitol
phosphate of the polysaccharide capsule. H. influenzae can be grown on blood agar
H. influenza vaccine should be with S. aureus.
given to children between 2-18
The capsule is the most important VF for months of age.
H. influenzae, and know its component is S. aureus will lyse RBC and provide Factor
PRP. I've seen it pop up a few times in X
relation to H. influenza when doing board
review questions.
H. influenzae contains what anti-

phagocytic virulence
factor? Polysaccharide capsule
H. influenzae vaccine contains

Capsulated chocolate cherries in the polysaccharide capsule
picture conjugated to diptheria toxoid.
H. pylori can be tested with Urea breath
test which has radioactive urea
(C-13) swallowed
exhaled as CO2 and NH3 by urease

positive organisms
H. pylori is associated with increased risk

of MALToma and gastric adenocarcinoma
(malignancies).
H. pylori is a gram-
H. pylori is a gram-negative comma-
negative comma-shaped organism.
shaped organism.
All comma-shaped bacteria are
All comma-shaped bacteria are oxidase
oxidase positive (vibrio, c. jejuni
positive (vibrio, c. jejuni and h. pylori)
and h. pylori)
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H. pylori is associated with increased risk

of MALToma and gastric adenocarcinoma
(malignancies).
H. pylori is triple positive,
meaning it is catalase, oxidase, and
urease positive. H. pylori produces urease, producing a
high-pH environment.
This is how H. pylori survives in acidic

mucosa
HBV may be transmitted during child birth HBeAg is associated with high HBsAg indicates active infection.
(i.e. TORCH infection). infectivity and transmissibility.
Hep B is too big to cross placenta, only

transmitted at birth (blood).
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HHV-6 infects CD-4 cells.

HEV belong to the Hepe family.
Which may cause immunosuppression by
replicating in T-cells, B-cells and
oropharyngeal epithelium.
HCV, Yellow fever, Dengue, StL, West

Nile belong to the Flavivirus family.
HHV-6 is associated with roseola.
This might be my least favorite

drawing
HHV-6 is a dsDNA virus. HHV-8 is a dsDNA virus.
HIV and HTLV are part of Retrovirus HIV drugs with the suffix -tegravir HIV gp120 receptor binds to the host
family. cell CD4 molecule and CCR5/CXCR4
Integrase inhibitors chemokine receptor.
InTEGRase inhibitors:
raltegravir, elvitegravir,
dolutegravir
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HIV patients need toxoplasmosis

prophylaxis when their CD4 counts are
<100 and they're positive for IgG
antibodies.
HIV is a(n) enveloped positive-sense RNA
diploid virus.
IgG against toxoplasmosis.
HIV is a(n) enveloped positive-
sense RNA diploid virus.
HIV progesses to AIDS when the CD4 HPV 1-4 causes verruca vulgaris HPV encodes E6 and E7 which promotes
count is <200. (cutaneous common wart). proteolysis of p53 and Rb respectively.
HIV can also be diagnosed as AIDS if an
AIDS-defining illness is present even with
CD4 count >200.
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HPV encodes E6 and E7 which

promotes proteolysis of p53 and Rb,
HPV encodes E6 and E7 which
respectively.
promotes proteolysis of p53 and
Rb, respectively.
HPV has a predilection for stratified

squamous cells.
I've seen a couple of questions asking

about "patient with verrucous lesions" or
some way to describe HPV and they will
expect you to know what other areas it can
effect (i.e. stratified squamous of the true
vocal cords --> laryngeal pipllomatosis)
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HPV is a naked dsDNA virus.
HPV is a naked dsDNA virus.

HPV 1-4 cause cutaneous common wart
(verruca vulgaris).
HPV 6-11 may cause laryngeal HPV 6-11 may cause laryngeal
papillomatosis and condyloma acuminata. papillomatosis and condyloma
acuminata.
Do not confuse with condyloma lata which HSV prophylaxis in immunocompromised
is syphilis! Do not confuse with condyloma lata states
which is syphilis!
Acyclovir
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HSV-1 is the number 1 cause of sporadic

HSV prophylaxis in pregnant women with encephalitis in the united states.
active recurrent genital herpes HSV, EBV, CMV, VZV, HHV are
in the herpes family.
Acyclovir (w/ bizzare behavior).
HSV-1 lies latent in the trigeminal

ganglion. HSV-2 may cause aseptic meningitis in
adolescents and adults.
HSV-2 lies latent in the sacral
ganglia.
HSV-2 may cause aseptic meningitis in HSV1 causes temporal lobe HSV1/2 are enveloped linear dsDNA
adolescents and adults. encephalitis w/ bizzare behavior. viruses.
Altered consciousness, seizures, Replicates in the nucleus. The H in

muscle weakness, may not see Torches.
nuchal rigidity.
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HSV1/2 are enveloped linear dsDNA

viruses. Haemophilus influenza can be Haemophilus is a Coccobacillary-shaped
grown on chocolate agar. bacteria.
Replicates in the nucleus. The H in
Torches.
Hantavirus infection is characterized

Hantavirus infection is by pulmonary capillary leak, hemorrhagic
characterized by pulmonary fever and pre-renal azotemia.
capillary leak, hemorrhagic fever
and pre-renal azotemia.
Hairy cell leukemia can be treated with
what interferon?
IFN-⍺
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Hantavirus infection is characterized

by pulmonary capillary leak, hemorrhagic
fever and pre-renal azotemia.
Hantavirus is transmitted
through aerosolized rodent urine/feces.
Hantavirus is not an arbo-virus.
Hantavirus pulmonary complications are Headache and hypotension are Hematin (X) and V (NAD) are two factors
characterized by pulmonary edema and immediate infusion-related required for growth on Chocolate agar.
pneumonia. toxicities of which antifungal?
Amphotericin H. influenza
Pre-renal azotemia, pulmonary edema,

pneumonia, hemorrhagic fever
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Hematologic complications of
Hematologic complication of linezolid chloramphenicol
Thrombocytopenia Anemia, aplastic anemia

Hematologic complications of Hep
B are characterized by aplastic
anemia.
Hemolytic Uremic Syndrome (E. Hemolytic Uremic Syndrome (E. coli

Hematological complications of
coli O157:H7, Shigella) damage O157:H7, Shigella) damage endothelial
ganciclovir
endothelial cells, resulting in cells, resulting in platelet microthrombi
platelet microthrombi and and producing characteristic schistocytes
Bone marrow suppression (leukopenia,
producing found on blood smear.
neutropenia, thrombocytopenia)
characteristic schistocytes found on
blood smear.
Hemolytic anemia presents as bite cells Hemolytic uremic syndrome (E. Hemolytic uremic syndrome most
and Heinz bodies in RBCs. coli O157:H7, Shigella) most commonly damages the vessels of the
commonly involves the vessels of kidneys, while thrombotic
the kidney. thrombocytopenic purpura most commonly
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involves the vessels of the CNS.
Damage --> platelet microthrombi Hence TTP will more commonly be

--> microangiopathic hemolytic associated with CNS abnormalities
anemia
Hep A infection in adults is characterized

by jaundice and aversion to smoking.
Hep A carries a good prognosis.
It is self-limiting and there is no

Hep A has an inactivated vaccine.
carrier/chronic state
Hep A infection in adults is characterized Hep A is a self-limiting infection Hep A is a self-limiting infection which
by jaundice and aversion to smoking. which may last for one month and may last for one month and is carried by no
is carried by no one. one.
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Hep A is a self-limiting infection which

may last for one month and is carried by no
one.
Hep A is commonly seen in travelers to

Hep A is acid-stable. endemic areas.
i.e. can be transmitted fecal-orally
Hep A is a naked positive-sense ssRNA Hep A is a naked positive-sense Hep B diagnostic markers showing only
virus of the picornavirus family. ssRNA virus of the picornavirus anti-HBs Ab indicates Hep B
family. immunization.
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If it were anti-HBsAb with anti-HBe or

anti-HBc, then it would indicate recovery
from Hep B infection
Hep B is an enveloped circular partially

dsDNA virus. Hep B is an enveloped circular
partially dsDNA virus.
Becomes fully ds during replication.
Becomes fully ds during
replication.
Hep B may be transmitted through Blood,

Baby-making, Birthing, IV drug use.
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Hep C and Rhinovirus both

exhibit antigenic variability making
Hep B renal extrahepatic conditons are vaccines difficult to produce.
characterized by GN and
Hep B undergoes replication
membranoproliferative GN.
intranuclearly and cytoplasmically
in the cell.
Membranoproliferative can occur with B

or C
Hep D is an enveloped negative- Hep D is an enveloped negative-sense

Hep C virus lacks 3' to 5' exonuclease sense RNA virus. RNA virus.
activity in the viral RNA polymerase
leading to antigenic variability.
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Hep D requires HBsAg to be infectious.

Hepatic complications in chronic Hepatitis C belongs to the Flavivirus
Hep B infections are characterized family.
by cirrhosis and hepatocellular
carcinoma.
Hepatitis C is an enveloped positive-sense

RNA virus. Hepatitis C is an
enveloped positive-sense RNA
virus.
Hepatitis D belongs to Deltavirus family.
Hepatitis C virus infection is most likely to Herpes Zoster can be diagnosed by Herpes Zoster can cause Herpes Zoster
become chronic. Multinucleated giant cells on Opthalmicus if CN V1 branch is involved.
Tzanck smear and PCR of skin
lesion
Forehead lesions and possible vision loss

HSV-1, HSV-2, VZV
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PCR of skin lesion is test of choice
Herpes Zoster rash distribution Herpetic whitlow caused by HSV-1 and 2

is dermatomal. Herpes labialis (cold sores) is is described as "dew-drops on a rose pedal"
caused by HSV-1. appearance.
Above the waist
Histoplasma capsulatum may be

diagnosed by MΦs with Histoplasma is dimorphic, meaning the
intracellular oval bodies (KOH), temperature of its surroundings determines
Histoplasma are smaller than RBCs serum and urine rapid antigen test. the form of the fungus
Since we see many histoplasmas inside a another feature shared amongst all
macrophage, this should make sense, since systemic fungi
a macrophage is only slightly larger than a
RBC mold in the cold (soil), yeast in the heat
(body, 37 C)
Histoplasma, Blastomycosis and most* Histoplasmosis can also cause Hookworm mature in the small intestine.
other systemic fungi are found in the mold erythema nodosum, characterized After the voyage through skin, blood,
form in soil and the yeast* form in the by painful red nodules, typically lungs, and GI tract.
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body
all systemic fungi are dimorphic on the shins
**Coccidioidomycosis is found in a Cocci is more associated than histo,
spherules of endospores in the body but use the regions of the U.S. to
distinguish b/t the two
Hookworms are blood suckers, since they

Hookworms are blood suckers, attach to the gut wall and feed from the
since they attach to the gut wall and capillaries in intestinal villae. Thus,
feed from the capillaries in patients can develop iron deficiency
intestinal villae. Thus, patients can anemia.
develop iron deficiency anemia.
Hookworm patients can develop iron
deficiency anemia, thus presence of
microcytic and hypochromic blood cells
can be seen histologically.
How can you differentiate GAS from

GBS?
Hot tub folliculitis is caused by GAS is Bacitracin sensitive

Pseudomonas. How are tetracyclines eliminated?
Fecally
Pseudomonas thrives in aquatic
environments
Look for people who go on vacation or
something and develop red rash all over Thus safe to give in patients with
the body renal failure
How do adults get botulism?Ingestion of How does Griseofulvin influence How is Giardiasis treated?
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cytochrome p450 activity?
Increase
preformed toxin
Metronidazole
vs. babies, which is ingestion of spores**
- Since it causes watery diarrhea, also
remember to rehydrate patients
- Tell patients to avoid alcohol (disulfiram
like reaction)
How is the fungus Aspergillus

transmitted?
Inhalation
How is artesunate (artemisin) administered
in severe malaria infections? conidiophores are released into the
air, inhaled by humans
IV
How many life-cycle stages

does Entamoeba histolytica have?
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Hyper/hypopigmented patches of IFN therapy used in the treatment of

Pityriasis Versicolor on the skin Hypomagnesemia is a complication multiple sclerosis
commonly occur on the chest and back, seen in which anti-CMV therapy?
especially in individuals who spend a lot of IFN-β
time in the sun Foscarnet
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IFN-⍺ can be used in the treatment of what

leukemia? IV drug users are at an increased risk of
IFN-⍺ can be used to treat which causing candidal endocarditis, most
Hairy Cell Leukemia hepatitis infections? commonly of the tricuspid valve
the first valve encountered w/ IV injection
Hep B and C of a drug is the tricuspid (venous blood
flow)
IV echinocandin can be used to

treat Candidemia.
If the patient is
If the patient is immunocompromised,
immunocompromised,
strongyloides stercoralis infection can lead
strongyloides stercoralis infection
to hyperinfection and dissemination of the
can lead to hyperinfection and
worms due to inflammation of the
dissemination of the worms due to
intestinal wall.
inflammation of the intestinal wall.
If toxocara canis larva get to the eyes, it IgG antibodies against penicillin Imipenem = Carbapenem
can also cause blindness. bind to the surface of RBCs, giving
a positive direct Coombs test.
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Immuno-compromised (ie: those on

glucocorticoids, HIV+/AIDS) and
diabetic patients are especially susceptible
to Mucormycosis infections
Imipenem needs to be administered with
specifically patients with leukemia and
what other drug to decrease inactivation of Imipenem should always be neutropenia
the drug in renal tubules administered with cilastin, a
dehydropeptidase inhibitor in renal
Cilastin tubules.
Immuno-compromised (ie: those on

glucocorticoids, HIV+/AIDS) and
In PML, JC virus kills oligodendrocytes by
diabetic patients are especially susceptible
demyelinating throughout CNS.
to Mucormycosis infections
specifically patients with leukemia and
neutropenia
In C.
perfringes infection, lecithinase
can cause RBC hemolysis.
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In addition to diarrhea,
campylobacter can cause invasive
In Yellow fever, liver involvement will bacteremia.
cause jaundice, while massive GI
hemorrhages can cause black vomitus and Campylobacter can penetrate the
bloody stool. gut to cause bacteremia
In addition to medical
treatment, aspergillomas will need to be
surgically removed
fungal balls within the lungs
In aseptic meningitis glucose levels

are normal.
In adult Hep B infection is characterized
by ALT > AST on liver function test. In adults, togavirus is characterized
by arthritis.
Associated with immune complex
formation.
In aseptic meningitis protein levels are In congenital toxoplasmosis, In elephantiasis, wuchereria bancrofti goes
high. hydrocephalus may lead to seizures. into the lymphatics and causes disruption
of the lymphatic system.
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In entorbius vermicularis, eggs are

at the anus but can be transmitted
In elephantiasis, wuchereria bancrofti goes via the fecal oral route. In hookworm infection, there will be high
into the lymphatics and causes disruption The eggs are very itchy, so you eosinophil count.
of the lymphatic system. scratch your butt (even when
sleeping) then when you fingers get
near your mouth they can enter the
oral route.
In neonates 90% of Hep B infections

become chronic, while in adults 10%
become chronic.
In patients with cutaneous In patients with cutaneous leishmaniasis,
leishmaniasis, Leishmania Leishmania Braziliensis consumes the
Braziliensis consumes the flesh of flesh of its victim, causing disfiguring
Neonate has 90% of his cookie left, mom its victim, causing disfiguring ulcers
has 10% ulcers
In some cases of onchocerca volvulus In some cases of onchocerca In the CAMP test, Group B Strep plated
infection, the microfilariae migrate to the volvulus infection, the microfilariae with S. aureus shows an increasing zone of
eyes, causing blindness. migrate to the eyes, causing hemolysis.
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blindness.
In Enterobius vermicularis, infection

happens when female pin worms lay eggs
at the anus.
In women, vaginal candida infections do In women, vaginal candida
not occur when the vaginal pH is > 4 infections do not occur when the
normal vaginal pH: acidic, ~3.8-4.2 (avg: 4 vaginal pH is > 4
pH) normal vaginal pH: acidic, ~3.8-4.2
in women, candida infections do not occur (avg: 4 pH)
after 4 pH in women, candida infections do
not occur after 4 pH
In Enterobius vermicularis, infection

happens when female pin worms lay eggs
at the anus.
In trypanosoma brucei, In trypanosoma brucei, tryomastigotes will

tryomastigotes will be seen on the be seen on the blood smear.
blood smear. Can alse see in spinal fluid and lymph
Can alse see in spinal fluid and nodes.
lymph nodes.
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In Lyme disease, the white footed mouse is In Lyme disease, the white footed In Lyme disease, the white footed mouse is
the main reservoir (host of larvae) while mouse is the main reservoir (host the main reservoir (host of larvae) while
the deer is the obligatory host (host of of larvae) while the deer is the the deer is the obligatory host (host of
adult tick) obligatory host (host of adult adult tick)
tick)
Humans are a dead end host & don't play a Humans are a dead end host & don't play a
role in the tick life cycle Humans are a dead end host & role in the tick life cycle
don't play a role in the tick life
cycle
Increased levels of IgE in Allergic

Increased levels of IgE in Allergic Increased levels of IgE in Allergic
bronchopulmonary aspergillosis
bronchopulmonary aspergillosis leads to bronchopulmonary aspergillosis leads to
leads to eosino-philia, causing
eosino-philia, causing intense eosino-philia, causing intense
intense inflammation of airways
inflammation of airways and mucus plugs inflammation of airways and mucus plugs
and mucus plugs in terminal
in terminal bronchioles. Repeated attacks in terminal bronchioles. Repeated attacks
bronchioles. Repeated attacks may
may lead to bronchiectasis. may lead to bronchiectasis.
lead to bronchiectasis.
Bronchiectasis - lung's airways become Bronchiectasis - lung's airways become
Bronchiectasis - lung's airways
damaged, leading to lack of mucus damaged, leading to lack of mucus
become damaged, leading to lack of
clearance clearance
mucus clearance
Individuals with chronic granulomatous

disease are susceptible to Candida and
Aspergillus due to them being a catalase-
positive organisms
Indinavir is a protease inhibitor that CGD - lack of NADPH oxidase, therefore
is associated with what renal cannot perform respiratory burst. Immune
complication? system uses H2O2 made by bacteria
instead, however catalase positive
Increased levels of creatine kinase will be Nephrolithiasis organisms have peroxisomes (with the
seen using what HAART drug? enzyme catalase) which neutralize their
H2O2, therefore we cannot use their H2O2
Integrase inhibitors (i.e. Raltegravir) because it has already been degraded.
Therefore, we are susceptible to infection
indigo princess by catalase-positive organisms.
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Individuals with chronic granulomatous Individuals with chronic

disease are susceptible to Candida and granulomatous disease are
Aspergillus due to them being a catalase- susceptible to Candida and
positive organisms Aspergillus due to them being
CGD - lack of NADPH oxidase, therefore a catalase-positive organisms
cannot perform respiratory burst. Immune CGD - lack of NADPH oxidase,
system uses H2O2 made by bacteria therefore cannot perform
instead, however catalase positive respiratory burst. Immune system
organisms have peroxisomes (with the uses H2O2 made by bacteria
instead, however catalase positive Infection of B-cells by HHV-8 can
enzyme catalase) which neutralize their cause Primary Effusion Lymphoma (B-cell
H2O2, therefore we cannot use their H2O2 organisms have peroxisomes (with
the enzyme catalase) which lymphoma)
because it has already been degraded.
Therefore, we are susceptible to infection neutralize their H2O2, therefore we
by catalase-positive organisms. cannot use their H2O2 because it
has already been degraded.
Therefore, we are susceptible to
infection by catalase-positive
organisms.
Infection of coccidioidomycosis occurs Infection Infection of coccidioidomycosis occurs

commonly in the skin and lungs, with of coccidioidomycosis occurs commonly in the skin and lungs, with
dissemination to bone and meninges commonly in the skin and lungs, dissemination to bone and meninges
with dissemination to bone and
meninges
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Infection with trichinella spiralis causes

symptoms such as fever, vomiting, and
periorbital edema.
Infection with trichinella spiralis
causes symptoms such as fever,
vomiting, and periorbital edema.
Infection with dracunculus medinensis

happens by drinking contaminated water
with copepods, which are crustaceans
found in the sea and fresh water.
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Inflammation caused by LOS can lead

to leaky capillaries which may lead
to shock (i.e. Waterhouse-Friderichsen
Inflammation caused by LOS can
syndrome).
lead to leaky capillaries which may
lead to shock (i.e. Waterhouse- Inflammation of the endometrium
Friderichsen syndrome). associated with retained products of
conception, miscarriage, abortion, or
foreign body (IUD)?
Endometritis
Treatment?
Clindamycin + gentamycin
Influenza contains hemagluttinin Inhibition of fungal cell wall synthesis

which binds (2-6 linked) sialic acid
and promotes viral entry and Echinocandins
neuraminidase, which promotes
progeny virion release.
(Sialic acid is found in membranes CELL WALL, not cell membrane

of upper respiratory)
Also seen in Paramyxo
Influenza belongs to the Orthomyxo

family.
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Intranuclear inclusion bodies seen in HSV

and VZV are called Cowdry Type A
Intranasal influenza vaccine is a Bodies.
Intestinal biopsy with flask-shaped lesions
is diagnostic of Entamoeba histolytica live-attenuated vaccine.
IgG and IgA response.
Irreversible protein synthesis inhibitor that

can be used to treat pseudomonas
Aminoglycosides
Irreversible protein synthesis

Is H. pylori motile?
inhibitors that can produce
nephrotoxicity
yes!
Aminoglycosides
Isoniazid can cause an asymptomatic rise Isoniazid can have multiple drug Isoniazid is a prodrug that is activated by
in LFTs (aminotransferases). interactions due to inhibition what enzyme?
of cytochromeP450.
Catalase-peroxidase
can be symptomatic/asymptomatic
What gene is this encoded by?
KatG
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JC virus CNS lesions can be

differentiated from
toxoplasma lesions by imaging
with non-enhancing lesions.
Isoniazid is used in the treatment
of tuberculosis.
JC virus is reactivated at a CD4 count
<200.
Kaposi sarcoma biopsy can be Kidney complications in Hantavirus are

differentiated from bacillary characterized by pre-renal azotemia.
angiomatosis by a lymphocytic
infiltrate.
Pre-renal azotemia, pulmonary edema,

JONES criteria for Rheumatic Fever: J: hemorrhagic fever
joints (polyarthritis), O: heart (pancarditis), Lymphocytic infiltrate should make
N: subQ nodules, E: erythema marginatum, sense because it's... a virus
S: Sydenham's Chorea
Klebsiella Pneumoniae is urease-positive, Klebsiella, Enterobacter, and Klebsiella, Serratia, and Enterobacter are
meaning it can predispose to kidney Serratia are all common causes of most commonly associated with
stones. nosocomial UTI's and are multidrug nosocomial UTI's and
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pneumonia infections
resistant.
Hence you will need to treat with

Carbapenems
LCMV and Lassa Fever belong to the

Lack of proofreading leads to
Arena-virus family.
antigenic variability in Hepatitis C.
Lamivudine = NRTI
Viral RNA polymerase lacks 3' -->
5' proofreading exonuclease
activity
Latent tuberculosis infections present Legionairre's Disease is associated Legionella grows on Buffered charcoal
with positive PPD skin test. with atypical pneumonia. yeast extract (BCYE) agar.
requires iron and cysteine
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Legionnaire's will show a patchy

infiltration with consolidation pattern on
Legionellaires' disease is X-ray.
associated with hypo-natremia.
Atypical pneumonia
Legionella's transmission is thorugh
aerosol from contaminated water (i.e. A/C,
environmental water).
Legonnaires' disease is more common

among smokers.
Think middle age male who is a smoker or Lepromatous form of Leprosy Leprosy is also known as Hansen's disease.
heavy drinker. transmitted through human to
human transmission.
Leptospira interrogans can be described

Leprosy is not contained in a Lepromatous as question mark or spiral shaped.
response.
Described as having "hook shaped" ends
Leptospira does not gram stain well

because it is too thin to be
visualized.
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Leptospira is found in water contaminated

with animal urine. Leptospira travels via
hematogenous spread and can
Associated with water sports, where there affect different organs (eg liver,
is exposure to water contaminated with kidney).
animal (i.e. dog) urine.
Usually rode turbine (survives in water/soil VF: hyaluronidase (mediates tissue
up to 3 months) invasion) Leptospirosis is endemic to tropical
regions as well as being prevalent among
surfers.
Highest incidence in US is in Hawaii.
Lethal Factor (LF) is an exotoxin

that acts as a protease and cleaves
MAP Kinase, a signal transduction
protein that is responsible for
cell growth.
Levels of creatinine phosphokinase (CPK)
should be monitored in patients receiving
what antibiotic therapy?
Daptomycin
Leptospirosis is endemic to tropical
regions as well as being prevalent among
surfers.
Highest incidence in US is in Hawaii.
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Lipopeptide antibiotic used to treat right-

Linezolid is a weak inhibitor of sided S. aureus (MSSA or
Levels of creatinine phosphokinase (CPK) MAO and, when combined with MRSA) endocarditis
should be monitored in patients receiving certain psychiatric medications, can
prolonged daptomycin therapy. produce serotonin syndrome. Daptomycin
SSRI's and other serotonergic

medications
Liver ALT is normal in neonatal

hepatitis. Loa loa also causes eosinophilia.
Listeria grows well in cold ("cold

enrichment") temperatures.
Grows well at refrigeration temperatures.
ALT is high in adults.
Loa loa can be treated by Loa loa is transmitted by deer flies. Local, mild infections
diethylcarbamazine and albendazole. Also horse flies and mango flies. of Blastomycosis are treated with -azole
drugs, ie: Itraconazole
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Local, mild infections of Candida albicans

(for example, candidal diaper rash) are
treated with topical -azole drugs Local, mild infections of Histoplasmosis
Local, mild infections of are treated with -azole drugs,
Coccidioidomycosis are treated ie: fluconazole, ketoconazole
with -azole drugs, ie: ketoconazole pinecones for "cone-azoles"
Local, mild infections Local, mild infections of Aspergillus

of Aspergillus fumigatus are treated fumigatus are treated with -azole drugs (ie:
with -azole drugs (ie: Voriconazole) Voriconazole)
Local, mild infections
of Paracoccidioidomycosis are treated
with -azole drugs, ie: Itraconazole
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Lyme disease is transmitted by a(n) Ixodes

Lyme disease is transmitted by a(n) tick bite and is caused by Borrelia
Ixodes tick bite and is caused by burgdorferi.
Long term administration of Linezolid can Borrelia burgdorferi. Also transmits erliciosis and bubesiosis
lead to optic and peripheral neuropathy. Also transmits erliciosis and
bubesiosis
Lyme disease is treated with Doxycycline

Lymphocytic choriomeningitis
and Ceftriaxone.
Lyme disease is treated with virus infection is characterized
Damage is from our own immune response
Doxycycline and Ceftriaxone. by meningoencephalitis and fever.
and not due to toxins.
Damage is from our own immune
response and not due to toxins.
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Lymphocytic choriomeningitis
virus infection is characterized
by meningoencephalitis and fever.
Lymphogranuloma venereum Lymphogranuloma venereum (Serotype
(Serotype L1-L3) is characterized L1-L3) is characterized by
by small, painless genital ulcers. It small, painless genital ulcers. It progresses
progresses to tender to tender lymphadenopathy with drainage
lymphadenopathy with drainage from the inguinal lymph nodes.
from the inguinal lymph nodes. Groove sign at inguinal ligament (not
Groove sign at inguinal ligament painful) due to large inguinal nodes pulling
(not painful) due to large inguinal on ligament.
nodes pulling on ligament.
MMR and VZV (chickenpox)

vaccines can be given to patients
Lymphogranuloma venereum (Serotype with CD4 count greater than 200.
L1-L3) is characterized by MMR is a Live-attenuated vaccine.
small, painless genital ulcers. It progresses
to tender lymphadenopathy with drainage
from the inguinal lymph nodes.
Groove sign at inguinal ligament (not
painful) due to large inguinal nodes pulling
on ligament.
MOA of Isoniazid MOA of linezolid

MMR is a live-attenuated vaccine.
Decrease mycolic acid synthesis Binds to 50s subunit to prevent formation
of the initiation complex
class only: enzymes targeted are

AcpM (enoyl acyl carried protein
reductase) and KasA (B-ketoacyl-
ACP synthase)
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MOA of macrolides
Bind to 23s rRNA of the 50S ribosomal

subunit, blocking translocation
MOA of oseltamivir, zanamivir?
Inhibits influenza neuraminidase to

inhibit release of progeny virus MRSA obtain resistance by altering PBP.
Macrolide used as part of triple therapy for

H. pylori
Clarithromycin Macrolides (azithromycin) treat atypical

Macrolides (azithromycin) treat
atypical "walking" pneumonia "walking" pneumonia caused
caused by Legionella, Chlamydia, by Legionella, Chlamydia,
and Mycoplasma. and Mycoplasma.
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Macrolides (erthromycin) are Macrolides can be used to treat

inhibitors of Cyt P-450. community aquired pneumonia caused by
S. pneumonia, H. infuenza,
Macrolides (azithromycin) treat atypical and Moraxella catarrhalis.
"walking" pneumonia caused
by Legionella, Chlamydia,
and Mycoplasma.
Main clinical uses of

fluoroquinolones (-oxacin) Major GI complication of Clindamycin
Macrolides can produce what
cardiovascular side effect? Gram negative rods of urinary and Pseudomembranous colitis (C. difficile)
GI tracts
Prolong QT interval
can produce a mild, osmotic diarrhea as

well
Major side efect of flucytosine?
Bone marrow toxicity (anemia, leukopenia,

thrombocytopenia)
This adverse effect is most related to what?

Malaria is characterized by fever,
5-fluorouracil, a toxic antineoplastic headache, anemia and
splenomegaly Malassezia furfur can cause many more
problems, other than just Pityriasis
Versicolor, in immunocompromised
patients
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Measles and Mumps belong to the

Paramyxo-virus family.
Male athlete on long-term treatment for

Maraviroc MOA
athletes foot with drug resistant fungi.
When they begin to take oral anti-fungal,
Binds chemokine CCR-5 on host
they develop gynecomastia.
T-cells, inhibiting interaction with
viral gp120
Ketoconazole
Mechanism of resistance of
aminoglycosides
Mechanism of resistance in isoniazid
Acetylation, phoshorylation, or
Underexpression of KatG Mechanism of resistance of macrolides
adenylation of the drug
Methylation of 23S rRNA-binding site
↓ catalase → ↓ INH production
23S rRNA is component of 50s ribosome;

prevents drug from binding
Macrolide Methylation
Mechanism of resistance of tetracyclines Megaloblastic anemia is an adverse Method of administration of Amphotericin

effect of what antibiotic? to treat fungal CNS infections
Decrease influx pump or increase efflux
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Intrathecal
pump to prevent accumulation of the drug

Trimethoprim
intrathecal = into CSF
Amphotericin does not cross BBB
Plasmid-encoded transport pump
Bone marrow suppression
Metronidazole can treat what infection

caused by Gardnerella?
Bacterial vaginosis
What other drug can be used to treat this?
Clindamycin
Metronidazole clinical use mnemonic

GET GAP:
Giardia
Entamoeba
Metronidazole clinical use can be
Trichomonas
remembered with the mnemonic
Gardnerella vaginalis
GET GAP on the Metro with
Anaerobes (Bacteroides, C difficile)
metronidazole
Pylori, H. (w/ PPI and clarithromycin for
"triple therapy")
Metronidazole clinical use mnemonic Metronidazole clinical use Metronidazole clinical use mnemonic
298 of 584 5/12/2018, 9:26 PM

GET GAP: mnemonic GET GAP: GET GAP:

Giardia Giardia Giardia
Entamoeba Entamoeba Entamoeba
Trichomonas Trichomonas Trichomonas
Gardnerella vaginalis Gardnerella vaginalis Gardnerella vaginalis
Anaerobes (Bacteroides, C difficile) Anaerobes (Bacteroides, C Anaerobes (Bacteroides, C difficile)
Pylori, H. (w/ PPI and clarithromycin for difficile) Pylori, H. (w/ PPI and clarithromycin for
"triple therapy") Pylori, H. (w/ PPI and "triple therapy")
clarithromycin for "triple therapy")
Metronidazole has activity against what

bacteria?
Metronidazole clinical use mnemonic Metronidazole clinical use
Anaerobic bacteria (bacteroides, prevotella,
GET GAP: mnemonic GET GAP:
fusobacterium, clostridium)
Giardia Giardia
Entamoeba Entamoeba
Trichomonas Trichomonas
Gardnerella vaginalis Gardnerella vaginalis
Anaerobes (Bacteroides, C difficile) Anaerobes (Bacteroides, C
Pylori, H. (w/ PPI and clarithromycin for difficile)
"triple therapy") Pylori, H. (w/ PPI and
clarithromycin for "triple therapy")
Metronidazole is a substitute for what other

drug in H. pylori triple therapy in patients Microscopically, when diagnosing
with a penicillin-allergy? Gardnerella Vaginalis, clue cells can be
seen which are epithelial cells coated with
Amoxicillin Metronidazole is used as treatment bacteria.
for which intestinal parasites? Clue cells: epithelial cells covered in
Gram+/- rod bacteria.
Giardia; Entamoeba histolytica
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Microscopically, when diagnosing Mild GI complication of

Gardnerella Vaginalis, clue cells can be Clindamycin
seen which are epithelial cells coated with
bacteria. Diarrhea
Clue cells: epithelial cells covered in
Gram+/- rod bacteria.
Mississippi river valley and Ohio river
Produces an osmotic diarrhea that valley are buzzwords for which fungus?
is more mild than
pseudomembranous colitis Histoplasmosis
Central and midwestern US
Monobactams such as Aztreonam are what

class of antibiotics? β-lactams
Monobactam (aztreonam) β-lactamase Monobactam that can be used in
susceptbility patients with a penicillin allergy
Resistant Aztreonam
Most cases of primary tuberculosis Most often, severe fungal infections Motile (+) or non-motile (-):
infections become latent. occur Klebsiella Pneumoniae: -
in immunocompromised/suppressed Enterobacter: +
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Serratia: +
Serratia (Triceritops) and Enterobacter are

motile, while the Klebsiella (Club-tail) isn't
patients
Mucosal ulcers in the upper respiratory

tract and mouth are characteristic of
Paracoccidioidomycosis.
Motility in Salmonella vs. Shigella gums of mouth - have ragged borders with
Mucocutaneous lesions and small spots of hemorrhage
Salmonella is motile (Salmon swim) lymphadenopathy should point
you towards which fungal
infection?
Paracoccidioidomycosis
Mucosal ulcers in the upper respiratory Mucosal ulcers in the upper Mumps causes Meningitis, orchitis,
tract and mouth are characteristic of respiratory tract and mouth are and parotitis.
Paracoccidioidomycosis. characteristic of
gums of mouth - have ragged borders with Paracoccidioidomycosis.
small spots of hemorrhage gums of mouth - have ragged MOmPs
borders with small spots of
hemorrhage
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Mycobacterial cell wall component
Mycolic acid
What stain can be used?
Ziehl-Neelsen stain (carbol fuschin)
Mycobacterial infections are treated with a

combination of drugs
Mumps replicate in the salivary glands.
can cause swollen parotid glands.
Since they tend to develop resistance.
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Mycobacterium leprae stains acid fast and

contains mycolic acid in the cell envelope.
Mycobacterium Avium Complex (MAC) is
a common cause of disseminated dieases in
AIDS patients Mycobacterium leprae is an acid-
fast bacillus.
particularly in the late stages.
Mycobacterium leprae thrives in cool

Mycobacterium leprae stains acid fast and Mycobacterium leprae thrives in temperatures, thus affecting the
contains mycolic acid in the cell envelope. cool temperatures, thus affecting extremities.
the extremities.
Mycobacterium marinum presents

Mycobacterium leprae cannot be grown in Mycobacterium scrofulaceum presents
with hand infection in aquarium
vitro. with cervical lymphadenitis in children.
handlers.
Mycobacterium tuberculosis is an obligate

aerobe.
Mycobacterium tuberculosis grows can be visualized with Auramine-
on Lowenstein Jensen medium. rhodamine stain (used for acid-fast bacilli)
takes 2-6 weeks
Mycobacterium tuberculosis can be
transmitted through respiratory droplets
from human to human.
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Mycobacterium tuberculosis is treated with Mycobacterium tuberculosis is treated with

Rifampin, Isoniazid, Pyrazinamide, & Mycobacterium tuberculosis is Rifampin, Isoniazid, Pyrazinamide, &
Ethambutol. treated with Rifampin, Isoniazid, Ethambutol.
RIPE Pyrazinamide, & Ethambutol. RIPE
Isoniazid can cause a B6 def. RIPE Isoniazid can cause a B6 def.
Isoniazid can cause a B6 def.
Mycobacterium tuberculosis is treated with Mycobacterium tuberculosis resides Mycobacterium tuberculosis resides in
Rifampin, Isoniazid, Pyrazinamide, & in macrophages where it macrophages where it can reactivate.
Ethambutol. can reactivate.
RIPE Macrophage cage (proliferates in
Isoniazid can cause a B6 def. Macrophage cage (proliferates in macrophages)
macrophages)
Mycobacterium tuberculosis stains Mycoplasma Pneumoniae can cause cold

Mycobacterium tuberculosis spreading to agglutination of red blood cells.
the vertebrae is called Pott's disease. acid fast.
IgM mediated and can lead to lysis of the
Due to high concentration of RBCs. Can cause raynauds phenomenom.
mycolic acid in cell wall
Mycoplasma Pneumoniae causes walking Mycoplasma Pneumoniae has an

pneumonia. increased incidence in military recruits.
Mycoplasma Pneumoniae Increased incidence in young adults
commonly occurs in young adults. especially in areas of close contact
(military recruit)
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Mycoplasma Pneumoniae is grown on

Eaton's agar. Mycoplasma Pneumoniae's cell
Needs cholesterol to divide/multiply so you Mycoplasma pneumoniae's cell wall is
membrane contains cholesterol unique in that it has no cell wall.
have to add it to the agar, to grow the (sterols).
"mulberry" colonies It is gram-indeterminate.
sterols are present in eukaryotic

membranes so unique for a bacteria (no walls around the rink)
NRTIs inhibit phosphodiester bond

Myopathy is an adverse effect of what formation in which direction?
lipopeptide antibiotic? NNRTI mechanism of action
3' to 5'
Daptomycin Allosteric inhibition of RT
dept = daptomycin
NRTIs prevent replication of HIV viral

genome by terminating elongation of
proviral DNA due to lack of a 3'-OH.
Naegleria fowleri can enter the CNS

Naegleria fowleri can cause through the cribiform plate.
menigoencephalitis. Note the cribs.
When it's the cause, the disease is Goes up nose, through cribiform plate, to
primary amoebic CNS.
meningoencephalitis.
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Naegleria fowleri can enter the CNS

through the cribiform plate. Naegleria fowleri is diagnosed with Naegleria fowleri is treated with
Note the cribs. a lumbar puncture. amphoterecin.
Goes up nose, through cribiform plate, to "champagne tap" is a perfect
CNS. lumbar puncture.
Nafcillin = Anti-staphylococcal penicillin

Naked DNA Viruses may be Naked DNA Viruses may be remembered
remembered by the mnemonic by the mnemonic "PAPP."
"PAPP."
Parvo, Adeno, Papilloma, Polyoma.
Parvo, Adeno, Papilloma,
Polyoma.
Name 3 different presentations of Name 5 common infections caused by

Naked viruses are more stable than infection with Strep. agalactiae Staph. aureus.
enveloped viruses.
(1) Neonatal meningitis (1) Pneumonia
(2) Sepsis (2) Septic arthritis
They are more stable and thus are typically (3) Pneumonia (3) Abscesses
transmitted fecal-orally. Enveloped are less (4) Acute bacterial endocarditis
stable in nature and are more often (5) Osteomyelitis
transmitted through mosquitoe bite,
aerosol droplets, etc.
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Negri bodies can be found in the

hippocampus and cerebellum of the brain.
Negative monospot test indicates

Nasopharyngeal carcinoma is associated
CMV mononucleosis.
with Asian patients with EBV.
"No mo-spots"
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Neisseria meningitidis contains an IgA

protease that cleaves IgA at the hinge
region.
Neisseria gonorrhea is non-encapsulated.
Allows bacteria to adhere and colonize

mucous membranes
Neisseria spp. are gram-negative
Idk why they would put the dot over the Meningitidis is capsulated
oxidase-positive diplococci.
picture but ok.
Are also catalase positive but not
mentioned.
Neomycin = aminoglycoside
Neisseria gonorrheae is facultative
intracellular inside PMNs Neisseria gonorrheae is facultative
(polymorphonuclear leukocytes). intracellular inside PMNs
(polymorphonuclear leukocytes).
Nephrotoxicity and crystalline nephropathy

can be prevented in acyclovir treatment
with what variable?
Adequate hydration
Neonatal conjunctivitis due to
Neonatal conjunctivitis due to Chlamydia
Chlamydia trachomatis usually
trachomatis usually doesn't present until
doesn't present until 1-2 weeks after
1-2 weeks after birth. In contrast to
birth. In contrast to Niesseria
Niesseria gonorrhea, which will result in
gonorrhea, which will result in
symptoms of neonatal conjunctivitis 1-5
symptoms of neonatal
days after birth.
conjunctivitis 1-5 days after birth.
Neurologic side effects of acyclovir Neurological complication of Nevirapine = NNRTI

carbapenems
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Delirium, confusion, vertigo,

Seizure
hallucinations
Newborns born to a mother infected with Newborns born to a mother Newborns born to a mother infected with
Chlamydia trachomatis (serovar D-K) can infected with Chlamydia Chlamydia trachomatis (serovar D-K) can
develop neonatal conjunctivitis and/or trachomatis (serovar D-K) can develop neonatal conjunctivitis and/or
pneumonia. develop neonatal conjunctivitis pneumonia.
and/or pneumonia.
Nocardia CNS complications are

characterized by brain abscess formation.
Nocardia is a filamentous gram-

positive organism which may
cause cavitary lesions in the lungs.
Nocardia is more common in males.
Norwalk (Noro) virus belongs to the Nucleic acid synthesis inhibitors Of all the worms that migrate into the
Calicivirus family. that can prolong QT interval lungs, ascaris lumbricoides is most likely
to cause respiratory symptoms.
Fluoroquinolones (-oxacin)
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Once hookworm larvae penetrate skin, they Once hookworm larvae penetrate Once hookworm larvae penetrate skin, they
get in the bloodstream, make their way to skin, they get in the bloodstream, get in the bloodstream, make their way to
the lungs and ascend the bronchial tree, and make their way to the lungs and the lungs and ascend the bronchial tree, and
keep going up until they are coughed up ascend the bronchial tree, and keep keep going up until they are coughed up
and swallowed. going up until they are coughed up and swallowed.
and swallowed.
Once inside the body, Once inside the body, blastomycosis in

blastomycosis in the yeast the yeast form replicates via broad based
form replicates via broad based budding
budding blastomycosis exhibits broad based
Once in the lungs, ascaris lumbricoides go
blastomycosis exhibits broad based budding (alliteration at its finest)
through the capillaries, into the alveoli, and
budding (alliteration at its finest)
there ascend into the bronchus, where they
are swallowed.
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Once inside the body, blastomycosis in

the yeast form replicates via broad based
budding
blastomycosis exhibits broad based
budding (alliteration at its finest)
Once the chlamydia

Once ascaris lumbricoides eggs hatch in
bacterium has finished replicating
the small intestine, larvae migrate through
inside the cell it exits as
the gut wall, into the blood stream, and
a elementary body and goes on to
finally to the lungs.
infect more cells.
Onchorcea volvulus is diagnosed One diagnostic tool for Trichomonas

Once ascaris lumbricoides eggs hatch in by seeing microfilariae on a skin Vaginalis is wet mount which would show
the small intestine, larvae migrate through biopsy under the microscope. motile trophozoites
the gut wall, into the blood stream, and Wet mount is also used for gardnerella and
finally to the lungs. even candida
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One diagnostic tool for Trichomonas

Vaginalis is wet mount which would show One diagnostic tool for
motile trophozoites Trichomonas Vaginalis is wet
Wet mount is also used for gardnerella and mount which would show
even candida motile trophozoites
Wet mount is also used for
gardnerella and even candida
One of the main functions of rifampin and

rifabutin is to activate cytochrome P450.
However, since rifabutin is a less potent

activator, it is indicated in the treatment of
tuberculosis in HIV patients as they are
usually on anti-retroviral medications
which the cytochrome P450 system
metabolizes.
One way to distinguish Trichomonas from Only Influenza A can Opportunistic infections with
Gardnerella is that Trichomonas shows undergo antigenic shift. Cryptosporidium are seen with Hyper-IgM
trophozoites on wet mount syndrome, most commonly caused by a
Recent famous outbreaks: H1N1 defective CD40L
(swine/bird/human mix, mild), - CD40L is found on T helper cells that
H5N1 (avian flu, fatal), H7N9 (bird have been activated in an antigen
flu, mild) dependent manner; binding of CD40 on B
cells with CD40L (along with cytokine
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stimulation) allows B cells to class switch

- therefore, without class switching, you
can only make IgM (and IgD)
Oral vancomycin is 2nd line treatment for

C. difficile pseudomembranous colitis.
Opportunistic infections with
Cryptosporidium are seen with Hyper-IgM Metronidazole 1st line
syndrome, most commonly caused by a
defective CD40L
- CD40L is found on T helper cells that Oral thrush of the mouth that
have been activated in an antigen appears as a white exudate on
dependent manner; binding of CD40 on B mucous membranes is due
cells with CD40L (along with cytokine to candida albicans
stimulation) allows B cells to class switch
- therefore, without class switching, you
can only make IgM (and IgD)
Orchocerca volvulus is also

Orchitis is most commonly caused characterized by eosinophilia. Organ transplant patients are at risk for
by Mumps which can lead to CMV pneumonia.
infertility and testicular atrophy.
Organism that causes tularemia? Orthomyxovirus is an

enveloped negative-sense ssRNA with 8
Francisella tularensis segments.
Aminoglycoside antibiotic that can be used Orthomyxovirus is transmitted

to treat? by respiratory droplets.
Streptomycin
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also can use tetracyclines
Orthomyxovirus is an
enveloped negative-sense ssRNA with 8 Orthomyxovirus is an
segments. enveloped negative-sense ssRNA
with 8 segments.
Osletamivir = neuraminidase inhibitor
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Owl eye inclusion bodies which may be

seen in hodgkins lymphoma are also a Oxacillin = anti-staphylococcal
nonspecific indication for CMV. penicillin PERCH (Polio, Echo, Rhino, Cox, Hep A)
belong to Picorna family.
Not specific to CMV
PSGN develops 2 weeks after PSGN develops 2 weeks after

GAS impetigo or pharyngitis. GAS impetigo or pharyngitis.
PPD (+) can be from current infection or

past exposure.
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Parainfluenza belongs to the Paramyxo-

Paracoccidioidomycosis is virus family.
Paracoccidioidomycosis are larger a dimorphic fungus that changes
than RBCs form with different temperatures
mold in cold (environment), yeast
in heat (body)
Paramyxovirus is an
Paramyxovirus is an enveloped negative- Paramyxovirus is an enveloped negative-
enveloped negative-sense ssRNA
sense ssRNA virus that is transmitted sense ssRNA virus that is transmitted
virus that is transmitted
by respiratory droplets. by respiratory droplets.
by respiratory droplets.
Parvo B19 causes aplastic anemia Parvo B19 causes aplastic anemia with a
with a cobweb look in sickle cell cobweb look in sickle cell patients.
patients.
Parogonimus westermonti is treated with
praziquantal.
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Parvo B19 infects erythroid precursors in Parvo B19 is characterized by

the bone marrow, increasing the risk of ssDNA.
aplastic crisis.
All DNA viruses are ds except

Viral cytopatholgy results in inactivation of parvovirus (ss)
Parvo B19 is the smallest DNA virus.
erythroid precursor cells which may result
in a drop in the hematocrit (some with Positive or negative sense.
acute anemia)
Parvo B19 rash directional Pasteurella exhibits a bipolar (safety-pin)

Parvo B19 may cause hydrops fetalis in
movement is characterized stain similar to Yersnia enterocolitica.
pregnant women.
by starting on the face and moving
downward.
TORCHES
It's a lacy rash (i.e. like a network).
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Pasteurella is catalase-positive
Pasteurella is catalase-positive and oxidase-positive.
Pasteurella is gram-negative. and oxidase-positive.
it is a facultative anaerobe
it is a facultative anaerobe
Pasteurella virulence factor is a capsule.
Pastuerella Multocidida treatment

Pastuerella Multocidida treatment includes
includes penicillin and a beta
penicillin and a beta lactamase inhibitor
lactamase inhibitor to prevent
to prevent resistance.
resistance.
beta lactamase = amoxicillin and
beta lactamase = amoxicillin and
clavulanic acid.
clavulanic acid.
Patient suspected of having S. pharyngitis Patient with sore-throat has red- Patients who are slow-acetylators are at
given amoxicillin/ampicillin, and develops rash that begins on the trunk and increased risk of toxicity by what anti-
rash. This is most likely due to? neck, then spreads to the mycobacterial drug?
extremities before eventually
Patient is infected with EBV (infectious desquamating. Isoniazid
mono), not Strep
Scarlet Fever
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GAS
FYI: Sketchy says it spares the face,
other sources say otherwise
Patients with amoebic liver

abscesses complain of right upper
quadrant pain with hepatomegaly
Patients with IgG anti-HAV cannot be re-

infected.
Patients with leptospirosis often suffer
myalgia of the calves and jaundice due to
liver dysfunction.
The IgG indicates prior infection or
vaccination and is protective against re-
infection
70-80% of lesions are solitary
Patients with terminal

complement deficiencies (C5-C9)
are susceptible to N. meningitidis.
Patients with Influenza are at risk for
superimposed pneumonia by Staph
aureus.
Activation of complement system
MAC is essential host defense
mechanism
-Neisseria have thin cell walls thus
MRSA (#2) and Strep. pneumo (#1) post flu
are susceptible to MAC attack
bacterial pneumonia.
Patients with leptospirosis often suffer
myalgia of the calves and jaundice due to
liver dysfunction.
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Patients with Mucormycosis can present

with rhinocerebral and frontal lobe
Patients with Mucormycosis can abscesses
present with rhinocerebral and
frontal lobe abscesses
Patients with Influenza are at risk for
superimposed pneumonia by Staph
aureus.
MRSA (#2) and Strep. pneumo (#1) post flu

bacterial pneumonia.
Patients with visceral leishmaniasis will Patients involved with water sports are
have scattered hyperpigmented spots that Patients with visceral leishmaniasis typical of naegleria fowleri.
look black will have scattered hyperpigmented Eg hiking, camping, hot springs, etc.
spots that look black
Peanuts and Grain crops (ex: Peanuts and Grain crops (ex: wheat) are
Patients involved with water sports are wheat) are associated associated with aflatoxins produced
typical of naegleria fowleri. with aflatoxins produced by Aspergillus flavus
Eg hiking, camping, hot springs, etc. by Aspergillus flavus can result in hepatocellular carcinoma
can result in hepatocellular
carcinoma
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Pegylated-IFN-⍺ is usually used in

combination with Ribavirin in the
treatment of hepatitis C.
Penicillin V can treat pharyngitis Penicillin V is acid stable, meaning it can

caused by what organism? be given orally.
S. pyogenes
Penicillin can treat meningitis caused Penicillin has the strongest activity Penicillin used to treat Listeria
by Neisseria meningitidis. against what group of organisms? monocytogenes meningitis
Gram positive (Staph and Strep) Ampicillin
Except S. aureus, which produce

penicillinases
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Penicillins can cause what type of

Penicillins can cause a direct hypersensitivity reaction?
Penicillins are what class of Coombs + hemolytic anemia.
antibiotics? β-lactams Type 1 IgE mediated
People with reduced stomach acid (i.e.

PPI) and asplenics (sickle cell disease) are
two groups of people at increased risk of
Penicillins can produce what renal People in close quarters (i.e. cruise Salmonella infections.
complication? ships, daycares) and those
consuming shellfish are at risk of
Allergic interstitial nephritis developing Norovirus (Norwalk
Virus) infection.
Fecal-oral route. Only a small

amount needed for infection.
Cytopathology alters integrity of
brush border of small intestine.
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People with reduced stomach acid (i.e.

PPI) and asplenics (sickle cell disease) are
two groups of people at increased risk of
Salmonella infections.
Peripheral neuropathy seen with the use of
Peptigoglycan cell walls have isoniazid can be corrected with pyridoxine
repeating D-ala-D-ala (B6).
oligopeptides.
Periventricular calcifications are found in

CMV congenital syndrome.
Pertussis toxin is produced by Bordatella

Pertussis toxin is produced by
and impairs Gi, which impairs
Bordatella and impairs Gi, which
phagocytosis of the microbe.
impairs phagocytosis of the
microbe.
Pertussis toxin ribosylates and inactives Pertussis toxin ribosylates and Piperacillin and ticarcillin are
Gi, producing an increase in cAMP. inactives Gi, producing an increase antipseudomonal penicillins that are used
in cAMP. with β-lactamase inhibitors to extend their
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acts like anthracis toxin edema factor

stimulates pancreatic islet cells
(hypoglycemia, increased histamine acts like anthracis toxin edema
sensitivity) factor
stimulates pancreatic islet cells
(hypoglycemia, increased histamine activity.
sensitivity)
Clavulonate: piperacillin, amoxicillin

Sulbactam, tazobactam: piperacillin,
ampicillin
Pleomorphic gram variable rod that

can cause bacterial vaginosis?
Pityriasis Versicolor is characterized by Gardnerella vaginosis

hyper or hypopigmented patches on a
patient's skin Protein synthesis inhibitor used to
Malassezia furfur results in pityriasis treat?
versicolor in healthy individuals
Clindamycin
Pneumocystis jiroveci has a respiratory
transmission
Metronidazole can treat too
Pneumocystis jiroveci in the Pneumocystis jirovecii, formerly Pneumocystis pneumonia can be said to
immunocompetent presents with what Pneumocystis carinii, is an have a "ground-glass" or crushed ping-
symptoms? opportunistic fungi that appears as pong ball appearance on chest-xray
cysts containing dark oval bodies
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on microscopy.
Asymptomatic - None :)
only presents with symptoms in

immunocompromised
Pneumocystis pneumonia is a diffuse, Pneumonia with diarrhea is suggestive of

interstitial pneumonia Pneumonia with diarrhea is
Legionnaires' disease.
diffuse - throughout the lungs suggestive of Legionnaires'
disease.
pneumonias)
Pol (HIV) gene encodes reverse Polio destroys the cells of the anterior horn
transcriptase, aspartate protease and Pol (HIV) gene encodes reverse of the LMN cell bodies of the spinal cord.
integrase. transcriptase, aspartate protease and
integrase.
Polio is characterized by an ancesding Poliovirus is a cause of aseptic Poliovirus is a naked positive-sense RNA
flaccid asymmetric paralysis cocentrated in meningitis. virus which is acid-stable.
the lower legs. aka abortive poliomyelitis 3 serotypes, nucleocapsids provide
tropism.
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Vs. Wednig-Hoffman, which is symmetric

paralysis and destruction of anterior horn
of LMN cells
Poliovirus is a naked positive-sense RNA Poliovirus is a naked positive-sense

virus which is acid-stable. RNA virus which is acid-stable. Poliovirus replicate in lymphoid tissue
3 serotypes, nucleocapsids provide 3 serotypes, nucleocapsids provide where it remains for 2-3 weeks.
tropism. tropism.
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Polyomavirus is a naked circular dsDNA

Polyoma virus family includes JC virus.
and BK.
Poliovirus replicates in lymphoid tissues

such as the tonsils and peyer's patches
Polyomavirus is a naked circular dsDNA Post-herpetic neuralgia is a common

virus. Polyomaviruses include JC and complication of Herpes Zoster.
BK virus.
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Pox Virus replicates in the Cytoplasm.
Poxvirus carries its own DNA-

dependent RNA polymerase.
Poxvirus is the largest DNA virus.
Exocsytosis after being packaged

by the Golgi apparatus.
Poxvirus is an enveloped dsDNA virus.

Poxvirus is an enveloped dsDNA Poxvirus replicates in the cytoplasm.
virus.
Recall its the largest DNA virus, thus "too

large to get into the nucleus" -- the ONLY
DNA virus that does not replicate in the
nucleus
Praziquantal is the treatment for Pregnant women are at risk of Pregnant women are cultured at 35 weeks
cysticercosis (Tinnea cestode infection,non transplacental transmission because strep agalactiae (GBS) is passed
CNS) of Toxoplasma gondii and so through the vaginal canal during delivery.
should avoid changing cat litter.
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Oocysts are found in animal feces

(mainly cats). Pregnant women
should avoid undercooked meat and
cats to be safe.
**Give intrapartum penicillin at 35

weeks**
Probenecid should be administered with

which antiviral therapy to prevent renal
excretion and potential toxicity?
Prevention of gonococcal/Chlamydia
Primary Tb affects
conjunctivitis in newborn Cidofovir
the lower/middles lobes of the lung.
Erythromycin
Prodome HIV is characterized by flu-like Prodome Rubeola infection may Prodrug of ganciclovir?
symptoms and lymphadenopathy be remembered with the mnemonic
the "4 C's of Measles (rubeola)" Valganciclovir
Cough What is the advantage?

Coryza
Conjunctivitis Better oral bioavailability
Coplik (Koplik)
Rash is preceded by the 4 C's
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Prodrug that inhibits NS5B RNA-

dependent-RNA-polymerase
Sofosbuvir
Progression Progression of paracoccidioidomycosis can
What virus is this drug used in? of paracoccidioidomycosis can result in spreading from cervical lymph
result in spreading from cervical nodes to the lungs, causing granulomas
HCV lymph nodes to the lungs, "granulomatous nature" to
causing granulomas paracoccidioidomycosis
"granulomatous nature" to
NS5B is a viral phosphoprotein involved in paracoccidioidomycosis
viral replication, etc.
Progressive mutlifocal Prokaryotes (i.e. bacteria) have a Prophylactic treatment for H. influenza
luekoencephalopathy is caused by JC virus 70s ribosome made up of 30s and is rifampin
(polyoma). 50s subunits. (kid with riffle associated with sick
children)
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Hence 50s and 30s inhibitors do

not interfere with human 80s
ribosomes
Prophylaxis antibiotic against encapsulated

bacteria (S. pneumoniae, H. influenzae) in Prophylaxis before dental
asplenic patients procedures in patients at high risk
for endocarditis
Amoxicillin
Amoxicillin
Prophylaxis for Mycobacterium avium-

intracellulare involves azithromycin
when CD4+ count <50 cells/mm3
Prophylaxis for Mycobacterium

Prophylaxis for Mycobacterium tuberculosis infection includes Rifampin
tuberculosis infection includes & Isoniazid.
Rifampin & Isoniazid.
First two letters of RIPE (in brown)
Prophylaxis for Mycobacterium avium- First two letters of RIPE (in brown)
intracellulare involves azithromycin
when CD4+ count <50 cells/mm3
Prophylaxis of Neisseria meningitidis? Protease inhibitors can produce Protein A is a virulence factor for S.
lipodystrophy, characterized by? aureus.
Rifampin
Central adiposity, insulin resistance
native american with meningitis mohawk

disorder of lipid and CHO
metabolism with central adiposity
331 of 584 5/12/2018, 9:26 PM

and insulin resistance
Protein synthesis inhibitor that can

Protein synthesis inhibitor that can be used
lead to optic neuropathy Protein synthesis inhibitor that can produce
to treat Gardnerella vaginalis
an aplastic anemia
Linezolid
Clindamycin
Chloramphenicol
Protein synthesis inhibitor that can produce Protein synthesis inhibitor that causes tooth
anemia discoloration and inhibition of bone growth
Protein synthesis inhibitor that can in children
Chloramphenicol produce photosensitivity
Tetracycline
Tetracyclines
Reversible; inhibits protein synthesis in
mammalian mitochondrial ribosomes,
producing bone marrow toxicity
Protein synthesis inhibitor that, when Protein synthesis inhibitor used for Protein synthesis inhibitor used in the
expired, is associated with Fanconi empiric treatment of meningitis in treatment of Legionella atypical pneumonia
syndrome (type 2 RTA) developing countries
Macrolides (azithromycin)
Tetracycline Chloramphenicol
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Protein synthesis inhibitor used to Protein synthesis inhibitor used to treat

treat S. pyogenes (GAS) soft tissue acne
Protein synthesis inhibitor used in the
infections (cellulitis, necrotizing
treatment of VRE?
fasciitis)) Tetracyclines
Linezolid
Clindamycin
also clindamycin
Proteus is a urease-positive organism that

can produce struvite kidney stones.
Protein synthesis inhibitors used in the

treatment of atypical pneumonia caused by
Mycoplasma pnuemonia
Proteus Mirabilis is a gram-
Doxycycline, azithromycin
negative facultative anaerobe.
Along with Urease, it also produces

H2s.
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Proteus produces which type of kidney

stones?
Proteus produces struvite stones
that precipitate with high-pH due to MAP (also known as struvite stones)
production of urease.
Proteus is associated with a "fishy" odor.
Pseudomonas being catalase-

Pseudomonas Exotoxin A acts by ADP positive, increases the risk for Pseudomonas causes nosocomial
ribosylation of EF2 inhibits protein patients with Chronice pneumonia and respiratory failure in Cystic
synthesis. Granulomatous disease. Fibrosis patients.
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Pulmonary anthrax may move

to mediastinal lymph nodes which
progresses to hemorrhagic mediastianitis.
Pseudomonas colonies (biofilm) have Pseudomonas has the same toxin

blue-green pigment. as Diptheria.
Pulmonary surfactant antagonizes what

antibiotic?
Pyocyanin and pyoverdin are blue-
Daptomycin green pigments found in
pseudomonas infections.
fluorescein is another exoenzyme

Hence should not be usesd to treat (all pro-inflammatory)
pneumonia Pyrantel pamoate is used in
antihelminthic therapy
Pyrimethamine is an anti- Pyrimethamine/sulfadiazine is used to treat

Pyrazinamide = anti-mycobacterial
protozoal (toxoplasmosis) therapy what protozoal infection?
used in combination with
sulfadiazine that works by Toxoplasmosis
inhibiting what enzyme?
Dihydrofolate reductase
pyramid hat = pyramethamine
dyed eggs = sulfadiazine
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RSV belongs to the Paramyxo-virus family.
Rabies encephalitis is characterized

by photophobia, hydrophobia and
hypersalivation.
Rabies belongs to Rhabdo-virus

family.
Rabies is characterized by fever and rabies Rabies is characterized by fever Rabies travels to the CNS in a retrograde
encephalitis. and rabies encephalitis. direction by the use of dynein.
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Reactivation of CMV in HIV patients is Reactivation of CMV in HIV patients is

characterized by retinits, esophageal ulcers characterized by retinits, esophageal ulcers
and colitis. Reactivation of CMV in HIV and colitis.
patients is characterized
by retinits, esophageal ulcers and
colitis.
Red rashes/blisters that appear in

sunexposed areas may occur with what
protein synthesis inhibitor? Reiter's Syndrome is characterized by a
Reiter's Syndrome is characterized triad of reactive arthritis, uveitis,
by a triad of reactive and urethritis.
Tetracyclines
arthritis, uveitis, and urethritis.
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Renal complications of vancomycin
Nephrotoxic
Renal complications of acyclovir

All cell wall synthesis inhibitors are
Reiter's Syndrome is characterized by a
Interstitial nephritis, crystalline nephrotoxic except nafcillin and oxacillin,
triad of reactive arthritis, uveitis,
nephropathy which are lipid soluble and excreted in the
and urethritis.
bile
Reovirus is a naked dsRNA virus with 11 Reovirus is a naked dsRNA virus Reyes Syndrome is characterized by fatty
segments. with 11 segments. liver, hepatomegaly and encephalitis.
Will uncouple mitochondria proton

gradient along the electron transport chain
in the hepatic cells.
Cow with fat liver
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Rhabdovirus (rabies) is an Rhabdovirus (rabies) is an Rhabdovirus (rabies) is an

eveloped, negative-sense ssRNA bullet- eveloped, negative-sense eveloped, negative-sense ssRNA bullet-
shaped virus with a helical capsid. ssRNA bullet-shaped virus with shaped virus with a helical capsid.
a helical capsid.
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Rhabdovirus (rabies) is an
eveloped, negative-sense ssRNA bullet-
shaped virus with a helical capsid.
Rhabdovirus binds to nicotinic

acetylcholine receptors on the Rhabdovirus initially infects neurons at
motor end plate. the post-synaptic motor endplate.
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Rhabdovirus replicates in the motor

nuerons and travels to the dorsal root
ganglia. Rhabdovirus replicates in
the motor nuerons and travels to
the dorsal root ganglia.
Rhinovirus is a naked positive-sense

ssRNA.
Ribavirin can be used in the Ribavirin is activated by intracellular

management of what enzymes and blocks viral RNA
paramyxovirus? polymerase.
RSV
inhibits IMP dehydrogenase, inhibiting
guanine nucleotide synthesis
Rhinovirus is a naked positive-sense
ssRNA. palivizumab is preferred in children
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Rickettsia are described as having Rickettsia is technically a gram-negative

a coccobacilliary shape. organism, however it doesn't gram stain
Rickettsia is a(n) obligate well at all.
intracellular organism. AKA Gram-indeterminate
Rickettsia organisms are unable to

Rickettsia is technically a gram-negative Rickettsia organisms are unable to produce CoA and NAD+.
organism, however it doesn't gram stain produce CoA and NAD+. This is why the organism is obligate
well at all. This is why the organism is intracellular, because it needs to get these
AKA Gram-indeterminate obligate intracellular, because it from the host.
needs to get these from the host.
Rickettsia prowazekii outbreaks may be Rickettsia rickettsii is transmitted

seen in military camp recruits and through direct biting from the dermacentor
prisoners of war. tick.
Close contact allows for human to human Rickettsia rickettsii can be
visualized with giemsa stain. Dermacentor tick can also transmit
spread. Tuleremia
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Rifampin can be used in the prophylaxis of

Rickettsia rickettsii is transmitted Rifampin = antimycobacterial what gram negative diplococci?
through direct biting from the dermacentor
tick. Neisseria meningitidis
Dermacentor tick can also transmit does have activity against gram
Tuleremia positive and negative
Rifampin is a potent CYP inducer that can Ring-enhancing lesions on a CT scan of

reduce the concentration of what class of the brain tips you to what pathology?
drugs?
Angioinvasive aspergillosis
Protease inhibitors (-navir)
Rift Valley fever is characterized if a patient is presenting with seizures,
by seizure and encephalitis. focal neuro-deficits, has a cough,
symptoms of pneumonia, in the past has
Use rifabutin instead
had TB, may think TB, but also need to
keep in mind aspergillosis
Roseola is also called exanthem

subitum.
Roseola causes a fever which last 4 days. Roseola is also known as sixth's disease.
Generally over 104 degrees. Rash is associated with immune "Ro-six-ola" = Exanthem subitum
complex formation. Prodromal
high fever may trigger infantile
seizures. Occasionally mild upper
respiratory symptoms. In some
infants, disease may be fever
without rash.
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Roseola is caused by HHV-6.
Roseola most commonly Rotashield is a live-attenuated oral vaccine

affects children (6 months to 2 used in protection against Rotavirus.
years) and is usually self-limiting.
Rotavirus viral enterotoxin that produces

Rotavirus is more common in the winter. secretory diarrhea via inc. Cl-
Rotavirus transmission is fecal-oral.
permeability: NSP4
Shit-stained water
Rubella is characterized by
a maculopapular rash which starts at face,
moves downward and lasts for 3 days.
Rotovirus, adenovirus, and norovirus all
cause watery diarrhea.
Rubella belongs to the Toga-virus
family. Measles also starts at the face and moves
down, but is preceded by cough, coryza,
conjunctivitis, Coplik (Koplik; blue-white)
spots
Rubella is characterized by Rubeola is also known as Measles. S. agalactiae neonatal respiratory
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a maculopapular rash which starts at face,

moves downward and lasts for 3 days.
Measles also starts at the face and moves

down, but is preceded by cough, coryza,
conjunctivitis, Coplik (Koplik; blue-white)
spots
complications are characterized by
neonatal pneumonia.
S. aureus pneumonia is most common

after Influenza infection.
S. aureus is characterized by B-hemolytic S. aureus normally colonizes the

hemolysis. nares.
S. epidermidis/saprophyticus are
coagulase-negative.
S. aureus will turn mannitol agar bright

yellow.
S. bovis can produce subacute

endocarditis.
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SSPE (subacute sclerosing

panencephalitis) is seen 5-15 years
after infection with measles
(rubeola). Sabin polio vaccine is a live attenuated
vaccine that induces humoral and cellular
SPE B is associated with necrotizing Progressive, usually fatal CNS immunity and has an IgA and IgG
fasciitis. disease. response.
First signs are
behavioral. Second sign is loss of Boosters recommended when traveling to
motor control and coordination. endemic areas.
Those who survive are severely Compared to Salk virus, which is only IgG
impaired mentally response
and physically.
The risk factors for SSPE:
acquiring primary measles at an
early age (<2 years) AND defective
forms of the virus.
Sabin polio vaccine is a live attenuated

vaccine that induces humoral and cellular
immunity and has an IgA and IgG Salk vaccine forms only IgG Salk vaccine is a killed vaccine.
response. antibodies.
Boosters recommended when traveling to

endemic areas. Killed vaccines only induce
Compared to Salk virus, which is only IgG humoral immunity
response
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Salmonella has a high infectious dose.

Salmonella are facultative
intracellular within macrophages.
Because it is acid-labile.
Salmonella and Shigella can invade the GI

tract via M-cells of Peyer patches.
Salmonella is acid-labile and requires a

high infectious dose, while Shigella is acid-
stable and requires a low infectious dose.
Salmonella is H2S-positive and Salmonella is H2S-positive and

stains Black on hektoen agar stains Black on hektoen agar
All motile enteric colonies stain black on All motile enteric colonies stain
hektoen agar black on hektoen agar
Salmonella is indole-negative. Salmonella E. contains a type 3

Salmonella E. contains a type 3 secretion
secretion system that detects
system that detects eukaryotic cells.
lack of tryptophanase eukaryotic cells.
Salmonella Typhi is always from a human Salmonella Typhi is always from Salmonella Typhi is characterized by "pea
source. a human source. soup" diarrhea and can be treated
with fluoroquinolone or a cephalosporin
harbored in the Gall bladder harbored in the Gall bladder (ie. ceftriaxone).
Salmonella Typhi is characterized by "pea Salmonella Typhi is characterized Salmonella Typhi is characterized by "pea
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soup" diarrhea and can be treated by "pea soup" diarrhea and can be soup" diarrhea and can be treated
with fluoroquinolone or a cephalosporin treated with fluoroquinolone or with fluoroquinolone or a cephalosporin
(ie. ceftriaxone). a cephalosporin (ie. ceftriaxone). (ie. ceftriaxone).
Salmonella enteritidis (non- Salmonella enteritidis infection is

typhi Salmonella) is characterized most Salmonella enteritidis infection is characterized by inflammatory (bloody)
commonly by gastroenteritis. characterized by inflammatory diarrhea.
(bloody) diarrhea.
S. typhi produces "pea-soup" diarrhea

S. typhi produces "pea-soup"
diarrhea
Salmonella typhi has a live attenuated

vaccine. Salmonella typhi has a live
attenuated vaccine.
San Joaquin Valley fever are buzzwords

for which fungus?
Coccidioidomycosis
Scalded skin syndrome is caused by

S. aureus.
Schistosomiasis is treated with
praziquantal.
Sandflies carry the infective promastigote

form of Leishmania braziliensis
Selective IgA deficiency is the most Selenium Sulfide (Selsun Blue) is Selenium Sulfide (Selsun Blue) is used as
common 1* immunodeficiency and used as treatment for M. furfur due treatment for M. furfur due to it promoting
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to it promoting shedding of shedding of the stratum corneum

the stratum corneum
increases susceptibility to Giardia

infections
M. Fufur infects the stratum

corneum M. Fufur infects the stratum corneum
Shiga-toxin most commonly binds to the

60s subunit of ribosomes.
Serology with IgM antibodies to

Severe cases of babesia infection
histoplasmosis,
can result in malaria like symptoms
blastomycosis, coccidioidomycosis
and death.
(systemic fungi) signifies recent infection
Shigella has a low ID50 (infectious dose).
Shigella can be treated

Shigella can be treated with macrolides
with macrolides
and fluoroquinolones.
and fluoroquinolones.
Shigella is a facultative intracellular Shigella is a gram-negative rod Shigella is a gram-negative rod (+shape)
organism which contains a type III (+shape) with a low-infectious dose with a low-infectious dose due to being
secretion system. due to being acid-stable. acid-stable.
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Slapped-cheek rash/fifth disease/erythema

infectiosum is caused by Parvo B19.
Shigella motility? Associated with immune-complex

Since the STI from Chlamydia
trachomatis is only characterized formation.
Immotile A low grade fever that lasts a week, then
by watery discharge, symptoms
can go unnoticed and it could becomes a lacy reticular pattern that goes
develop into pelvic inflammatory down the
disease. body.
Can also increase risk for ectopic
preganancies.
Spectrum of activity of aztreonam

Spectrum of Vancomycin
Aerobic gram (-) rods only
Gram + bugs only
Some examples of macrolides

are Azithromycin and Clarithromycin
Note: They are usually combined with

Ethambutol to treat MAC infections
Spectrum of amoxicillin, ampicillin? Spectrum of carbapenems Spore former that causes gas gangrene,
treated by penicillin
Broad spectrum Broad
Clostridium perfringens
Effective against gram positive
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cocci, gram negative rods, aerobes,

and anaerobes (gas mask)
Sporothrix schenckii is dimorphic,

meaning it assumes different forms
depending on the temperature of its
environment
Sporothrix schenckii is a dimorphic yeast

Sporothrix schenckii lesions are
with a cigar-shaped, unequal budding
granulomas made of histiocytes and giant
yeast in human tissue, and a mold form in
cells
plants (commonly rose thorns).
Mold in the cold (soil) yeast in the

heat (body)
Stage 1 of Lyme disease involves

Sporothrix schenckii will result in a
Erythema-Migrans aka a "Bull's eye"
local pustule, or ulcer, at the site of trauma
rash + Flu-like symptoms
and first entry
3-30 days after bite.
ie: thorn from a rose bush pricks the skin
then ascending up the lymphatic drainage
Sporotrichosis diagnosis is
confirmed via culture or biopsy
Stage 1 of Lyme disease involves Stage 2 of Lyme disease includes Stage 2 of Lyme disease includes Heart
Erythema-Migrans aka a "Bull's eye" Heart block + Bilateral facial block + Bilateral facial nerve palsy.
rash + Flu-like symptoms nerve palsy. 3-10 weeks. Beginning of meningism,
3-30 days after bite. 3-10 weeks. Beginning of polyarthralgia and bells.
meningism, polyarthralgia and
bells.
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Staph. aureus is a catalase-

positive, coagulase-positive, gram-positive
bacteria.
Stage 3 of Lyme disease is characterize

by Migratory polyarthritis +
Encephalopathy. Stage 3 of Lyme disease is
May happen after a latent period. characterize by Migratory
Migratory polyarthritis is aka arthritis of polyarthritis + Encephalopathy.
large joints May happen after a latent period.
Other CNS: lymphocytic meningitis & Migratory polyarthritis is aka
memory difficulty arthritis of large joints
Other CNS: lymphocytic meningitis
& memory difficulty
1 1
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Staph. epidermidis/saprophyticus
are gram-positive, catalase-positive,
urease-positive and coagulase-
negative.
Staph. Aureus is coagulase-

positive.
Staph. aureus pneumonia appears as

a patchy infiltrate on chest x-ray.
Staphylococcus epidermidis is novobiocin

sensitive
Stavudine (d4T) = NRTI Strep pneumonia conjugate vaccine for

children produces an IgG response.
Staphylococcus saprophyticus is
novobiocin resistant
stavudine is nucleoside, not tide
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Strep pneumonia contains IgA

protease, allowing bacteria to
adhere and colonize the mucous
membranes.
Strep pneumonia is bile-sensitive (soluble).

Strep pneumonia conjugate vaccine for
children produces an IgG response.
Cannot grow in bile, unlike S. viridans
Strep pneumonia is the #1 cause Strep pneumonia is encapsulated, thus will

Strep pneumonia is optochin-sensitive. of meningitis, otitis media, present a problem in sickle cell patients.
pneumonia and sinusitis.
MOPS
Strep pneumonia polysaccharide vaccine in Strep pneumonia polysaccharide Strep pneumonia produces lobar
adults produces an IgM response. vaccine in adults produces an IgM pneumonia with a rusty sputum.
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response.
Strep pneumonia shares the same virulence

factor as H. influenza type b and Neisseria.
Strep viridans is optochin-resistant.
Cleaves IgA, allowing bacteria to adhere

and colonize mucous membranes
Strep pyogenes exotoxin (SPE) A
and C are considered superantigens.
Strep viridans produces a-hemolytic

Streptococcus agalactiae (Group B Streptococcus agalactiae (Group B
hemolysis.
strep) is bacitracin resistant strep) is bacitracin resistant
Streptogramins (quinupristin,
Streptococcus pyogenes (Group A strep) is Streptococcus pyogenes (Group A
dalfopristin) function by binding to 50S,
bacitracin sensitive strep) is bacitracin sensitive
inhibiting protein synthesis
Streptomycin = aminoglycoside
Streptomycin is clinically used as a 2nd

Streptomycin functions by binding
line treatment for Mycobacterium
to 30S, inhibiting protein synthesis
tuberculosis
Streptomycin side effects include

Streptomycin side effects include tinnitus, tinnitus, vertigo, ataxia, Streptomycin side effects include tinnitus,
vertigo, ataxia, nephrotoxicity nephrotoxicity vertigo, ataxia, nephrotoxicity
side effects for aminoglycosides in general side effects for aminoglycosides in side effects for aminoglycosides in general
general
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Strongyloides stercoralis can also Strongyloides stercoralis can also

propagate by autoinfecting its host, propagate by autoinfecting its host, in
in which the eggs hatch in the which the eggs hatch in the intestinal wall,
intestinal wall, and the larvae make and the larvae make their way through the
their way through the bloodstream bloodstream to the lungs again.
to the lungs again.
Streptomycin side effects include tinnitus,
vertigo, ataxia, nephrotoxicity
side effects for aminoglycosides in general
Strongyloides stercoralis larvae enter via

the soles of the feet. Substitute for amoxicillin in H. pylori triple
therapy in penicillin-allergic patients
Structural analogues of PABA Metronidazole
Sulfonamides
Suffix for protease inhibitors = -navir

Sulfonamides are contraindicated in Sulfonamides are Cyt-p450 inhibitors and
pregnancy due to the risk thus can cause multiple drug interactions.
Indinavir, Ritonavir, etc. of kernicterus in infants.
Sulfonamides can displace bilirubin from Sulfonamides can displace what Sulfonamides can produce hemolytic
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drug from albumin, producing

anticoagulation and bleeding? anemia in patients deficient in what
albumin, producing kernitcerus in infants. enzyme?
Warfarin
G6PD
Symmetric ascending paralysis is Symmetric ascending paralysis is

associated with associated with campylobacter bacterial
campylobacter bacterial infections infections and influenza viral infections.
and influenza viral infections.
Surgical excision of necrotic tissues is an

important step in the treatment of
Mucormycosis
Symptoms of reactivated tuberculosis

Symptoms of reactivated include cough, night sweats, &
tuberculosis include cough, night hemoptysis.
Symptoms give a clue as to where the sweats, & hemoptysis.
parasite is. For tryponosoma brutei,
sleeping sickness indicates CNS and spinal
fluid problems, fevers for the blood, and
lymphadenopathy for the lymph nodes.
Symptoms of the vaginitis caused by a Symptoms of the vaginitis caused Symptoms of the vaginitis caused by a
Trichomonas Vaginalis infection include by a Trichomonas Vaginalis Trichomonas Vaginalis infection include
burning, itching, and malodorous discharge infection include burning, itching, burning, itching, and malodorous discharge
and malodorous discharge
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Symptoms of trypanosoma cruzi infection

include megacolon, mega-esophagus, and
Symptoms of trypanosoma cruzi dilated cardiomyopathy.
infection include megacolon, mega- Megacolon can present as acute abdomen
esophagus, and dilated or constipation.
cardiomyopathy.
Megacolon can present as acute
abdomen or constipation.
Symptoms of the Tuberculin form of

Leprosy include demarcated hairless
lesions on the skin.
AKA paucibacillary (skin involvement)
Systemic (disseminated) infections

of Histoplasmosis are treated
with Amphotericin B
reserved only for potentially life-
threatening infections due to side-
effect profile Systemic (disseminated) infections
of coccidioidomycosis are treated
of Blastomycosis are treated
with Amphotericin B
with Amphotericin B
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Systemic (disseminated) infections of Candida albicans are treated
of Candida albicans are treated with Amphotericin B and Capsofungin
with Amphotericin B
and Capsofungin
Systemic (disseminated) infections of
paracoccidioidomycosis are treated
with Amphotericin B

of Candida albicans are treated
with Amphotericin B and Capsofungin
Temporal lobe encephalitis is caused
by HSV-1.
TSST-1 acts by binding MHC-II on
T-cells, producing cytokine storm.
Tenofovir (TDF) = Nucleotide reverse Teratogenic effects of Teratogenic hepatitis C therapy

transcriptase inhibitor fluoroquinolones?
Ribavirin
Damage to growing cartilage
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Terbinafine causes accumulation of

what substrate?
Terbinafine = antifungal Squalene

Tetanus toxin inhibits inhibitory release of
GABA and glycine from Renshaw cells in
the spinal cord.
Tetanus toxin travels in a retrograde axonal Tetracyclines reversibly bind to what unit
manner to the CNS. Tetanus vaccine consists of a toxoid of the bacterial ribosome?
(deactivated toxin).
30s
toxin conjugated to a protein to

increase immunogenicity
The 3 most common symptoms of The 3 most common symptoms of The 3 most common symptoms of
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Cryptococcal infection are Cryptococcal infection are Cryptococcal infection are
Fever Fever Fever

Pneumonia (recall lungs are primary site Pneumonia (recall lungs are Pneumonia (recall lungs are primary site
of infection via inhalation) primary site of infection via of infection via inhalation)
Meningitis inhalation) Meningitis
Meningitis
remember that Cryptococcus is the

remember that Cryptococcus is the most most common cause of fungal remember that Cryptococcus is the most
common cause of fungal meningitis, can meningitis, can present with common cause of fungal meningitis, can
present with common symptoms of common symptoms of meningimus present with common symptoms of
meningimus (stiff neck) (stiff neck) meningimus (stiff neck)
The 3 phases of HIV are:
1.Prodome
2..Latent
3.AIDS
The 3 symptoms associated with
lepramatous leprosy are symmetric glove
and stocking neuropathy, skin lesion on
The 3 most common symptoms of extensor surfaces, and "leonine facies".
Cryptococcal infection are
Fever
Pneumonia (recall lungs are primary site
of infection via inhalation)
Meningitis
remember that Cryptococcus is the most

common cause of fungal meningitis, can
present with common symptoms of
meningimus (stiff neck)
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The 3 dermatophytes are: The 3 dermatophytes are:

1. Trichophyton The 3 dermatophytes are: 1. Trichophyton
2. Epidermophyton 1. Trichophyton 2. Epidermophyton
3. Microsporum 2. Epidermophyton 3. Microsporum
3. Microsporum
The 3 dermatophytes are: The BOAR RNA viruses (Bunya, The CD4 count in CMV infections is <50.
1. Trichophyton Orthomyxo, Arena, Reo)
2. Epidermophyton are segmented viruses.
3. Microsporum
The Caribbean, Central America,

the west of the Panama canal, and
some countries in the Middle East
are the only areas in which there are
The CD4 limit for macrolide prophylaxis still Chloroquine-sensitive strains
for Mycobacterium Avium Complex of Plasmodium
(MAC) is a CD4 count of less than 50.
No picture on Sketchy, but The First AID mnemonic for Lyme disease
commented by Andrew. is: a Key Lyme pie to the FACE
Feel free to erase it.
Facial nerve palsy (bilateral)
Arthritis
Cardiac Block
Erythema migrans
Recall: MAC is a common cause of

disseminated disease in AIDS patients
hence the low CD4 count.
The First AID mnemonic for Lyme disease The First AID mnemonic for Lyme The First AID mnemonic for Lyme disease
is: a Key Lyme pie to the FACE disease is: a Key Lyme pie to the is: a Key Lyme pie to the FACE
362 of 584 5/12/2018, 9:26 PM

FACE
Facial nerve palsy (bilateral) Facial nerve palsy (bilateral)
Facial nerve palsy (bilateral)
Arthritis Arthritis
Arthritis
Cardiac Block Cardiac Block
Cardiac Block
Erythema migrans Erythema migrans
Erythema migrans
The Five virulence factors of

GAS are Capsule, Streptolysin O,
Streptokinase, DNAse, and SpeA-C.
The GI manifestations of
Shigella are Inflammatory & bloody
diarrhea.
The GAS capsule The diarrhea progresses from watery to

contains hyaluronic acid. bloody
The HBV vaccine (Gardasil) is a The Influenza killed vaccine is injected IM.
subunit (recombinant HBsAg)
The Giardia trophozoites in stool turn vaccine. Only IgG response.
into cysts, thereby allowing them to infect
other people
Only two subunit vaccines are HPV
(6, 11, 16, 18) and HBV (HBsAg)
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9vHPV protects against all gardasil

+ 31,33,45,52 and 58.
The MMR vaccine is

contraindicated in pregnant women
and when CD4 is <200 (HIV).
Also in other immunocompromised
individuals (i.e.
Cyclosporine/Tacrolimus)
The Lepromatous response of Leprosy is

associated with poorly demarcated
lesions on extensor surfaces of
extremities.
The MMR vaccine is contraindicated

in pregnant women.
The Pox family of viruses The Rotavirus and Coltivirus

includes Smallpox, Cowpox, Mol. belong to the Reovirus family.
contagiosum.
Don't forget that the reovirus is the

The adult loa loa worm can migrate to the
only dsRNA virus
eye, causing transient inflammtion and
edema after crawling under the conjunctiva
of the eye.
Thus, it is also called African eye worm.
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The animal considered the reservoir

of leprosy in the United States is
The adult loa loa worm can migrate to the the Armadillo.
eye, causing transient inflammtion and
The bacterium which causes leprosy
edema after crawling under the conjunctiva
is Mycobacterium leprae.
of the eye.
Thus, it is also called African eye worm.
The bronchoalveolar lavage (BAL) sample The bronchoalveolar lavage (BAL)

The bronchopulmonary washing of tissue
is stained with methamine silver to identify sample is stained with methamine
samples for diagnosis of Cryptococcus
the fungus Pneumocystis jiroveci in silver to identify the fungus
utilizes mucicarmine (red) or
Pneumocystis Pneumonia, Pneumocystis jiroveci in
methanamine (silver) stains
revealing "disk-shaped yeast" Pneumocystis Pneumonia,
revealing "disk-shaped yeast"
mucicarmine stain^
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The bronchopulmonary washing of tissue

samples for diagnosis of Cryptococcus
utilizes mucicarmine (red) or
methanamine (silver) stains
The bunyaviruses are California, The characteristic exam findings of

Congo, Hanta. patients with Visceral leishmaniasis are
fever, pancytopenia, weakness, and
hepatosplenomegaly
mucicarmine stain^
The chickenpox rash begins on the trunk

and spread to the face and extremities.
The chest X-Ray of a patient with Rash is in different stages.

The characteristic exam findings of Mycoplasma Pneumoniae would
patients with Visceral leishmaniasis are show a reticulonodular or "patchy"
fever, pancytopenia, weakness, and infiltrate.
hepatosplenomegaly
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The clinical manifestation of The clinical manifestation of

Coccidioidomycosis is similar to acute The clinical manifestation of Coccidioidomycosis is similar to acute
pneumonia; cough, fever and arthralgia Coccidioidomycosis is similar to pneumonia; cough, fever and arthralgia
(painful joints) acute pneumonia; cough, fever and (painful joints)
arthralgia (painful joints)
The clinical presentation of Histoplasma

capsulatum are pneumonia, erythema
nodosum and hepatosplenomegaly.
The cysts of Cryptosporidium consist of 4

motile sporozoites
The cyst form of Entamoeba

histolytica resides in the small
intestines, while differentation to
the trophozoite form occurs in the
colon
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The dermatophyte Microsporum can be

indentified via Wood's lamp
The dermatophyte Wood's lamp can only identify
Microsporum can be indentified microsporum
via Wood's lamp
Wood's lamp can only identify
microsporum
The cysts of Cryptosporidium consist of 4

motile sporozoites
The drugs used to treat babesiosis are

atovaquone and azithromycin.
Azithromycin is a ma-"crow"-lide.
The drug used to treat lepromatous leprosy

is Clofazamine.
The drug used to treat leprosy
caused by Mycobacterium leprae
Lepromatous leprosy presents diffusely is Rifampin.
over the skin with leonine or lion-like
facies.
The drugs used to treat babesiosis are The early symptoms of filovirus The early symptoms of filovirus are
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atovaquone and azithromycin.

Azithromycin is a ma-"crow"-lide.
are characterized by fever characterized by fever and petechial rash.

and petechial rash.
The envelope for the Pox virus obtained

from itself (creates own evelope).
The enveloped DNA families viruses are
Hepadna, Herpes, Pox.
Hep B obtains envelope from ER, Pox Virus
creates its own
The envelope of Hep B virus is

obtained from the ER.
The five signs of congenital Rubella are:

1.Congenital cataracts The foul-smelling diarrhea seen in a
2.Sensory-neural deafness The foul-smelling diarrhea seen in a Giardia infection is due to steatorrhea*
3.Blueberry muffin rash Giardia infection is due (fatty diarrhea)
4.Jaundice to steatorrhea* (fatty diarrhea) *buzzword!
5.Patent ductus arteriosus *buzzword!
fatty, yellow stools - due to fat

malabsorption fatty, yellow stools - due to fat
malabsorption
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The four A's of Klebsiella are Alcoholics,

Abscesses, Aspiration, diAbetes. The fungal cell membrane
contains ergosterol rather than
cholesterol found in mammalian The fungus Malassezia furfur causes
membranes. Pityriasis Versicolor
malice seezia, pity rye asis
cell membrane, not cell wall
The fungus Malassezia furfur causes

Pityriasis Versicolor The fungus Sporothrix schenckii
The fungus Sporothrix schenckii causes Sporotrichosis
malice seezia, pity rye asis causes Sporotrichosis
The general prodromal symptoms with a The hepadna virus family includes The herpes family of viruses includes HSV,
rickettsial infection are headache and fever. HBV. EBV, CMV, VZV, HHV.
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The host for the parasite Leishmania The incubation period for Rickettsia
Braziliensis are vertebrates The incubation period for rickettsii is 2-14 days and causes
Note: Especially humans Rickettsia rickettsii is 2-14 days a maculopapular rash.
and causes a maculopapular rash. (or petechial. non-pruritic)
(or petechial. non-pruritic)
The main clinical finding of parainfluenza

is a patient with croup having "steeple
sign" on Chest X-ray. The mechanism behind the purple lesions
in Kaposi Sarcoma is upregulating VEGF
causing vascular proliferation.
(H. influenza will have "thumb sign" on

lateral view d/t epiglottitis)
The major complication of ascaris
lumbricoides infection is intestinal
obstruction, which occurs at the
ileocecal valve.
The most common cause of mycobacterial The most common drug in the The most important finding for diagnosis
infections in clinical cases is treatment of leprosy is Dapsone. of Leishmania braziliensis is amastigotes
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seen within macrophages. This

requires requires aspirate of marrow,
spleen, lymph nodes, or skin lesions which
are then spread on a slide and analyzed
The cytoplasm around the big purple nuclei

of the macrophages are filled with tiny
stained nuclei of the amastigotes
Nontuberculous or Atypical Mycobacteria
The natural life cycle of rickettsia

The name of the illness caused by prowazekii generally involves a
Rickettsia prowazekii is known vertebrate (usually squirrel) and an
invertebrate host human body The number one carrier of rabies are bats,
as epidemic typhus.
louse. while other common carriers
Epidemic meaning this is a widespread
The louse defacates near feeding include foxes, skunks and other rodents.
rampant infection..
sites, you scratch this site allowing
NOTE: This is different from endemic the larvae to get into your blood.
typhus (from Rickettsia typhi)
Side note R. prowazekii also
appears to be the closest free-living
relative to mitochondria.
The number one carrier of rabies are bats, The oral The oral antifungal drug Terbinafine is
while other common carriers antifungal drug Terbinafine is used used to treat onychomycosis
include foxes, skunks and other rodents. to treat onychomycosis (dermatophyte infection of nails)
(dermatophyte infection of nails) terbinafine turbin
terbinafine turbin
The papilloma virus family includes HPV. The pol gene encodes for reverse The pol gene encodes for reverse
transcriptase, aspartate protease, transcriptase, aspartate protease, and
and integrase. integrase.
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The pol gene encodes for reverse The poxviruses include smallpox, The primary treatment for
transcriptase, aspartate protease, and cowpox and molloscum Brucella includes tetracyclyne/doxycycline
integrase. contagiosum. along with rifampin.
The primary treatment for The prognosis of naegleria fowleria The prognosis of naegleria fowleria is poor
Brucella includes tetracyclyne/doxycycline is poor because of because of meningoencephalitis.
along with rifampin. meningoencephalitis.
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The rash from Rickettsia rickettsii is

distinctly different from that of Rickettsia
The rash associated with Rickettsia prowazekii in that this rash begins at the
prowazekii starts at the trunk and extremities and moves towards the trunk.
The prophylactic drug of choice used to
spreads towards the extremities. Can coalesce to ecchymosis and predispose
prevent disseminated disease when the
to gangrene of the extremeties.
CD4 count is less than 50 is Azithromycin
/ Clarithromycin
The rash in roseola appears after The reduviid bug bites around the victim's
The rash from rickettsia prowazekii spares the fever has subsided. mouth to deposit feces into the open
the hands, feet, and head. wound. This can be exacerbated by
scratching that area.
In measles the rash and fever occur
simultaneously.
The repeating polysaccharide capsular The reservoir for Brucella The reservoir for S. typhi is within the gall
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antigens of the Cryptococci capsule are the

main virulence factor of the fungus,
bladder.
making it anti-phagocytic
similar to the capsule of bacteria!
are Farm animals (cows, goat,

sheep, pigs).
The roseola rash is characterized by The roseola rash spares the face.
several days of high fever followed
by diffuse macular rash.
Other sources say it doesn't spare the face,

Fever generally lasts 4 days (4 so just be careful with this one I guess
The resistance of P falciparum to suns) followed by diffuse, lacy body
chloroquine is due to a membrane pump rash that spares the face
The route of transmission of

coccidioidomycosis is through
inhalation of spores in dust
ie: dust storms, earthquakes in the The second messenger cAMP is increased
san joaquin valley of california - by cholera AB type toxin by permanent
hence coccidioidomycosis is also activation of Gs.
The route of strongyloides stercoralis is
known as san joaquin valley fever
feet --> blood --> brochial tree -->
swallowing --> mature in GI tract.
Similar to other intestinal nematodes
coccidioido = "presidio" san

joaquin
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The signs of onchocerca volvulus The signs of onchocerca volvulus infection

infection are scattered prutic are scattered prutic papules which can later
papules which can later become become hyperpigmented and
hyperpigmented and hypopigmented spots can also occur
hypopigmented spots can also (usually on the shins of older patients).
The side effects of Dapsone occur (usually on the shins of older
are agranulocytosis and hemolytic anemia patients).
in patients with G6PD deficiency.
The symptoms of epidemic typhus

include arthralgias, myalgias, pneumonia,
The symptoms of epidemic typhus encephalitis, and the patchy rash.
include arthralgias, myalgias, Encephalitis with confusion and dizziness
pneumonia, encephalitis, and the which can cause COMA.
patchy rash.
Encephalitis with confusion and
dizziness which can cause COMA.
The steatorrhea in Giardia is
hypothesized to stem from excess mucus
production that impairs fat absorption in
the intestines
fatty, yellow, foul-smelling stools
The symptoms of epidemic typhus The three toxins associated with The toxicities that result from NRTIs are
include arthralgias, myalgias, pneumonia, pertussis are pertussis based in part by the inhibition of what?
encephalitis, and the patchy rash. toxin, adenylate cyclase toxin and
Encephalitis with confusion and dizziness tracheal toxin Mitochondrial DNA synthesis
which can cause COMA.
some NRTIs are capable of inhibiting

human DNA polymerase-y
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The transmission of Parvo B19 is through

The transmission of adenovirus is
respiratory droplets and vertical
through respiratory droplets and
transmission.
fecal oral.
A TORCHES disease. Fecal-oral route is
Gains access via R-mediated
also another transmission source.
endocytosis after using viral fibers
to bind to the coxsackie-adenovirus
receptors (CAR). Viral proteins of
the capsid determine the target cell.
The transmission of poliovirus is fecal-

oral.
The transmission of rhinovirus is via The treatment for CMV is Ganciclovir.

The transmissions of HIV are
fomites and respiratory droplets.
primarily through sexual
intercourse, blood transfusions or
IVDU.
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The treatment for cholera is

Supportive/Rehydration therapy.
If this pops up on a test, pick saline

The treatment for Trichomonas
infusion or whatever shit that insinuates
Vaginalis is metronidazole
rehydration; DO NOT PICK
Remember to treat both partners!
ANTIBIOTICS (although you can use
antibiotics to treat, it probably won't be the
The treatment for Treponema Palladium answer
(Syphilis) is penicillin.
Effective against neurosyphilis. Doxy or
azithromycin can also be given.
The treatment for for Bacillus Anthracis

are fluoroquinolones and doxycycline.
The treatment for rickettsia species
The treatment for onchocerca is doxycycline and chloramphenicol if
volvulus is ivermectin. pregnant.
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The treatment for rickettsia species

is doxycycline and chloramphenicol if The treatment for the Lepromatous The treatment for the Lepromatous
pregnant. form of Leprosy involves form of Leprosy involves Dapsone,
Dapsone, Rifampin, & Rifampin, & Clofazimine.
Clofazimine.
The treatment for Yersinia spp.

is aminoglycosides with tetracycline.
(flywheel)
The treatment for Tuberculoid Leprosy The treatment for Tuberculoid
includes Dapsone & Rifampin. Leprosy includes Dapsone &
Rifampin.
The treatment for Yersinia spp. The treatment of Enterococcus are

is aminoglycosides with tetracycline. Linezolid and Tigecycline.
(flywheel) The treatment of Bordetella
pertussis are macrolides.
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The treatment options for

Pseudomonas include Piperacillin +
Sulbactam, Fluoroquinolones
The treatment options for
and Aminoglycosides.
Pseudomonas include Piperacillin
+ Sulbactam, Fluoroquinolones
and Aminoglycosides.
The treatment of Tularemia is Gentamicin

(aminoglycoside).
The treatment options for The triad of congenital rubella is The two Tinnea species of Cestodes are T.
Pseudomonas include Piperacillin + characterized by congenital Soleum and T. Sagginatum
Sulbactam, Fluoroquinolones cataracts, sensory-neural deafness
and Aminoglycosides. and PDA.
Also jaundice, blueberry muffin

rash
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The two Tinnea species of Cestodes are T.

Soleum and T. Sagginatum
The two reoviruses are rotavirus

and colorado tick virus.
The two species of MAC are M Avium and

M Intracellulare.
They are collectively known as

Mycobacterium Avium-Intracellulare
(MAI)
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The two treatments for tryaponosoma

brucei infection are suramin treatment for
the peripheral blood infection and The two treatments for
melarsoprol treatment for the CNS tryaponosoma brucei infection are
infection. suramin treatment for the peripheral
suramin=serum blood infection and melarsoprol
b/c the tryaponosoma brucei infection treatment for the CNS infection.
penetrates into the CNS, the medications suramin=serum The vaccine for Yellow Fever is a live-
do so as well, leading to fairly severe side b/c the tryaponosoma brucei attenuated vaccine.
effects. infection penetrates into the CNS,
the medications do so as well,
leading to fairly severe side effects.
The vector for wuchereria bancrofti

infection is a female mosquito.
The weil-felix test tests the cross reactivity

The vector for Togavirus is a mosquito. of rickettsia and proteus vulgaris.
The test is not sensitive or specific.
The yeast of Sporothrix schenckii takes on The yeast of Sporothrix schenckii

a cigar shape under microscope takes on a cigar shape under The 1st stage of the life cycle for
cigar-shaped rose-buds microscope chlamydia species is known as
cigar-shaped rose-buds the elementary stage.
Elementary bodies -- Enfectious/Enters the
cell via Endocytosis
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The 1st stage of the life cycle for

chlamydia species is known as
The 2nd stage of the chlamydia The 2nd stage of the chlamydia species life
the elementary stage.
species life cycle is known as cycle is known as the reticulate body.
Elementary bodies -- Enfectious/Enters the
cell via Endocytosis the reticulate body.
The Lepromatous form of Leprosy is

The Lepromatous form of Leprosy is The Lepromatous form of associated with glove & stocking
associated with "Leonine facies". Leprosy is associated with neuropathy.
"Leonine facies". AKA multibacillary, skin and nasal passage
involvement.
The RNA Deltavirus (Hep D) family

requires HBsAg to infect.
The Lepromatous form of Leprosy is The M2 protein of Influenza

associated with glove & stocking manipulates pH for viral
neuropathy. uncoating.
AKA multibacillary, skin and nasal passage
Creates H+ pores which leads to
involvement.
replication when pH is correct.
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The Wright stain & Giemsa stain are

used to visualize Borrelia burgdorferi.
ELISA is insensitive if performed too
early.
The elementary bodies are
The elementary bodies are
the infectious form of chlamydia
the infectious form of chlamydia species
species that enter cells
that enter cells via endocytosis.
via endocytosis.
Once inside they transform into reticulate
Once inside they transform into
bodies.
reticulate bodies.
The knee joint is most commonly affected

The localized swellings of loa loa The localized swellings of loa loa infection
by gonococcal septic arthritis.
infection are referred to as calabar are referred to as calabar swellings.
swellings.
The nasopharynx is the first place

colonized by N. meningitidis. The reticulate body is the active The reticulate body is the active form of
form of Chlamydia species, Chlamydia species, which multiplies
which multiplies via binary fission via binary fission inside of cells.
inside of cells.
The yops gene is secreted via a type III

secretion system in Yersinia pestis.
The weil-felix test is an agglutination test The weil-felix test is an
used to diagnose rickettsial infection. agglutination test used to
diagnose rickettsial infection.
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The Cryptococci capsule is made up of

repeating polysaccharide capsular
The Cryptococci capsule is made antigens
up of repeating polysaccharide
The yops gene is secreted via a type III
capsular antigens
secretion system in Yersinia pestis.
The gag structural gene encodes for virion

core proteins p24 and p17.
The convalescent stage is the third clinical The convalescent stage is the third
stage of Bordatella infection and can last clinical stage of Bordatella
for months (100 days). infection and can last for months
(100 days).
The gag structural gene encodes for virion There is no N. gonorrhea vaccine This neuroimaging is found in CMV
core proteins p24 and p17. due to antigenic variation of the congenital infection and is called
pilus proteins. periventricular calcifications.
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Thrombophlebitis is an immediate
infusion-related toxicity of what anti-
Those with EBV infectious mononucleosis Thrombophlebitis is a complication
fungal?
should avoid contact sports due to risk of of what cell wall synthesis
ruptured spleen. inhibitor?
Amphotericin
Vancomycin
Splenomegaly is due to T-cell proliferation
Tinea capitis affects the head and scalp Tinea capitis is a dermatophyte Tinea corporis affects the body
infection of the scalp, often caused
by Trichophyton spp., and almost
always occurs in young children
Adults with tinea capitis are often
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immunocompromised or
immunosuppressed.
Tinea cruris affects the groin

a.k.a "jock itch" Tinea is commonly referred to as Tinea pedis affects the foot
"ringworm" a.k.a athlete's foot
caused by dermatophytes
Recall that crura attaches the base of the

penis to the ischiopubic rami
To diagnose strongyloides stercoralis, find

larvae in stool and eosinophilia.
Eggs are laid INTO the intestinal wall, so
are not passed into the stool. Intsead will
only find larvae.
To diagnose dracunculus
medinensis infection, worms will
be seen coming out of the skin.
To begin infection of onchocerca volvulus,
the black fly bites the human host and
deposits larvae in the skin. These then
penetrate deeper in the skin and mature
into adults.
To diagnose wuchereria bancrofti, a thick To diagnose enterobius To diagnose enterobius vermicularis,

blood smear is performed to see the vermicularis, simply put a piece of simply put a piece of scotch tape near the
organisms. scotch tape near the anus in the anus in the morning.
morning. The eggs will stick to the tape and be
The eggs will stick to the tape and visible under a microscope.
be visible under a microscope.
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To diganose hookworm, eggs are found in

the stool.
To treat dracunculus medinensis,

slowly extract the worm with a To treat enterobius vermicularis, use
small stick. This process can be pyrantel pamoate or albendazole.
made faster with metronidazole.
To treat strongyloids sterocoralis infection,

use albendazole or ivermectin. Tobramycin = aminoglycoside
Cobra-mycin
To treat wuchereria bancrofti,

diethyl carbamazine is used.
Togavirus are enveloped positive-sense Togavirus are enveloped positive- Togavirus is transmitted by respiratory
RNA viruses. sense RNA viruses. droplets.
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Topical protein synthesis inhibitor

Togavirus synthesizes a long polyprotein that can be used to treat acne
precursor that is cleaved by host and viral
proteases. Clindamycin
Topical macrolides are not efficacious in

treating neonatal conjunctivitis caused by
Also in tetracyclines video
C. Trachomatis, you have to give them
an oral form (i.e. azithromycin).
Toxic Shock Like Syndrome is caused by

what organism? GAS
Topical macrolides are not

Topical macrolides are not efficacious in
efficacious in treating neonatal
treating neonatal conjunctivitis caused by
conjunctivitis caused by C.
C. Trachomatis, you have to give them
Trachomatis, you have to give them
Toxocara canis also is characterized by Toxocara canis is treated with Toxoplasma gondii can cause brain
eosinophilia. albendazole. abscesses in immunocompromised
patients, showing as ring enhancing lesions
on CT or MRI.
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Especially in HIV patients.
Toxoplasma gondii can cause brain

abscesses in immunocompromised
Toxoplasmosis can be transmitted via cysts
patients, showing as ring enhancing lesions Toxoplasmosis can be diagnosed in undercooked meat (food).
on CT or MRI. by serology or biopsy.
remember: also transmitted via cat feces
Especially in HIV patients. note: serology may be positive and transplacentally.
without active infection as a large
proportion of people have been
exposed in the past.
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Toxoplasmosis can be treated with

sulfadiazine and pyrimethamine.
Toxoplasmosis prophylaxis should
be administered at what CD4
count?
<100 Traditional treatment for cutaneous

leishmaniosis is stibogluconate
Drugs used for prophylaxis?
Trimethoprim-Sulfamethoxazole
(TMP-SMX)
Traditional treatment for cutaneous Transmission of Blastomycosis Transmission of Histoplasma occurs

leishmaniosis is stibogluconate occurs via inhalation of aerosol- through the respiratory tract
ized spores along with the rest of systemic fungi
inhalation of soil mold spores, spores in bird and bat droppings are
where it colonizes the lungs, inhaled and enter the lungs, where they are
reaches body temperature, and ingested by macrophages
changes to yeast (dimorphic)
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Transmission of mucormycosis infection is Treat Mycoplasma Pneumoniae infection

Transmission of with macrolides.
via spore inhalation paracoccidioidomycosis occurs Don't use cell wall inhibitors like
via respiratory droplets penicillin.
Treat PML (Pesty Mites and Lice) with Treat PML (Pesty Mites and Lice) Treat PML (Pesty Mites and Lice) with
PML (Permethrin, Malathion, Lindane), with PML (Permethrin, Malathion, PML (Permethrin, Malathion, Lindane),
because they NAG you (Na, AchE, GABA Lindane), because they NAG you because they NAG you (Na, AchE, GABA
blockade) (Na, AchE, GABA blockade) blockade)
Treat PML (Pesty Mites and Lice) with Treat PML (Pesty Mites and Lice) Treat PML (Pesty Mites and Lice) with
PML (Permethrin, Malathion, Lindane), with PML (Permethrin, Malathion, PML (Permethrin, Malathion, Lindane),
because they NAG you (Na, AchE, GABA Lindane), because they NAG you because they NAG you (Na, AchE, GABA
blockade) (Na, AchE, GABA blockade) blockade)
Treatment for Bartonella henselae

(cat-scratch)? Treatment for Coxiella is nothing, it is self-
limiting.
Azithromycin May be prevented by pasteurization of
Treat PML (Pesty Mites and Lice) with
milk.
PML (Permethrin, Malathion, Lindane),
because they NAG you (Na, AchE, GABA
blockade)
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Treatment for H. influenza otitis,

pneumoniae, sinusitis
Amoxicillin
Treatment for HCV includes

Treatment for HCV includes ribavirin with
ribavirin with interferon alpha as
Ceftriaxone for H. influenza meningitis; interferon alpha as well as a protease
well as a protease inhibitor.
Amoxicillin for mucosal infections assoc. inhibitor.
Can also use a polymerase inhibitor
with H. influenza Can also use a polymerase inhibitor via
via base analogs (i.e.
base analogs (i.e. sofosbuvir/sovaldi)
sofosbuvir/sovaldi)
Treatment for Treponema pallidum

infection
Benzathine penicillin
Treatment for Proteus is sulfonamides. Treatment for S. epidermidis

endocarditis is vancomycin.
Long acting form of penicillin
Treatment for rabies includes passive-

immunity (rhabdovirus immunoglobulins)
and a killed vaccine.
Treatment for osteomyelitis from
Treatment for neonates exposed to HBV
dog/cat bite
includes immunoglobulins and vaccine.
Penicillin for Pasteurella multocida Passive immunity: Rabies Ig Ab in wound.
(i.e. mom is infected) Active immunity: shot on days 1,3,7,14 in
side OPPOSITE wound (so active Ig
doesn't neutralize it).
If vaccinated prior, just 2 booster doses on
days 1,3, no RIg given.
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Treatment for rabies includes passive-

immunity (rhabdovirus immunoglobulins)
and a killed vaccine.
Passive immunity: Rabies Ig Ab in wound. Treatment for sinusitis caused by

Active immunity: shot on days 1,3,7,14 in Moraxella catarrhalis, H. influenza
side OPPOSITE wound (so active Ig
doesn't neutralize it). Amoxicillin
If vaccinated prior, just 2 booster doses on Treatment for visceral leishmaniosis is
days 1,3, no RIg given. amphotericin B
Treatment for visceral leishmaniosis is Treatment of Brucellosis Treatment of Cryptococcal meningitis

amphotericin B consists of a joint therapy
Doxycycline of Amphotericin B and
Flucytosine followed by maintenence
therapy with fluconazole
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Treatment of Cryptococcal meningitis

consists of a joint therapy
of Amphotericin B and
Flucytosine followed by maintenence
therapy with fluconazole
Treatment of GAS will prevent Treatment of GAS: Penicillin

rheumatic fever but not PSGN.
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Treatment of MSSA S. aureus

Treatment of Kaposi Sarcoma? osteomyelitis
Treatment of HSV encephalitis?
IFN-⍺ Anti-staph penicillins (nafcillin, oxacillin,

Acyclovir
methicillin, dicloxacillin)
Treatment of S. aureus right-sided Treatment of acute prostatitis?

endocarditis
Treatment of VZV TMP-SMX
Anti-staph penicillins (nafcillin, oxacillin,
dicloxacillin, methicillin) Famcyclovir, valacyclovir
also in fluoroquinolones video
higher bioavailability
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Treatment of culture-negative endocarditis

caused by Coxiella
Treatment of anaerobic infections (eg, Doxycycline

Bacteroides spp., Clostridium perfringens)
in aspiration pneumonia, lung abscesses, Treatment of anaerobic infections
and oral infections in aspiration pneumonia, lung
abscesses, and oral infections Recall tetracyclines accumulate
Clindamycin intracellularly
Clindamycin
Mouth anaerobes: fusobacterium,

pevotella, peptostreptococcus, bacteroides
Treatment of lung abscess Treatment of nocardia?
Clindamycin Sulfonamides
Treatment of neonatal HSV?
Acyclovir
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Treatment of nocardia
Sulfonamides (TMP-SMX)
Treatment of systemic infections with

Treatment of primary and recurrent dimoprhic fungi?
genital HSV infections
Itraconazole
Acyclovir
Treatment of vaginal candidiasis
Fluconazole, topical azoles (clotrimazole,

Treatment of tinea unguium miconazole), nystatin
(onychomycosis)
Treatment of the plague caused by Yersinia Terbinafine
Doxycycline with steptomycin
onychomycosis occurs on nails
399 of 584 5/12/2018, 9:26 PM

Treatment to prevent breakouts in

HSV: acyclovir and valcyclovir
Violet (Valcyclovir) Trashcan (recyclo)

Treatment of D. Latum (cestode) is
Treatment of D. Latum (cestode) is
praziquantal and niclosamide
praziquantal and niclosamide
Treatment?
IFN-⍺
Treponema Palladium can be

transmitted through sexual Treponema Palladium is a spiral
intercourse. shaped spirochete.
Also shared needles, blood
transfusion and transplacental
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Treponema Palladium is a spiral Treponema Palladium cannot be Treponema Palladium cannot be grown
shaped spirochete. grown in culture, only in rabbit in culture, only in rabbit testes.
testes.
Trichinella spiralis also causes severe Trichinella spiralis also causes

myalgias (muscle ache) since after severe myalgias (muscle ache)
ingestion of cysts, the cysts develop into since after ingestion of cysts, the
larvae, enter bloodstream, and form cysts cysts develop into larvae, enter
within the striated muscle cells causing bloodstream, and form cysts within
inflammation. the striated muscle cells causing
inflammation.
Trichinella spiralis infection is

characterized by eosinophilia.
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Trichomonas Vaginalis infection occurs in

Trichinella spiralis is found in undercooked a pH of >4.5
meat, such as pork. Trichinella spiralis is treated with So does Gardnerella but Candida is found
albendazole. in normal pH (<4.5)
Trimethoprim can produce what

teratogenic defects?
Neural tube defects

Trichomonas Vaginalis is transmitted
Trichomonas Vaginalis symptoms
sexually
include a yellow green (color)
Like other STIs, oftentimes, males don't cervical discharge
show symptoms
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Trimethoprim inhibits what enzyme?

Triple therapy for H. pylori
Triple therapy for H. pylori includes PPI,
Dihydrofolate reductase includes PPI, amoxicillin, and
amoxicillin, and clarithromycin.
clarithromycin.
PPI (H+ bomb), amoxicillin (ammo), and
PPI (H+ bomb), amoxicillin
clarithromycin (ma-crow-lide)
(ammo), and clarithromycin (ma-
Use metronidazole if allergic to amoxicillin
crow-lide)
Use metronidazole if allergic to
amoxicillin
Triple therapy for H. pylori includes PPI,

amoxicillin, and clarithromycin.
Trypanosoma brucei has a variable surface
PPI (H+ bomb), amoxicillin (ammo), and glycoprotein coat and thus undergoes
clarithromycin (ma-crow-lide) Trypanosoma brucei causes
recurrent fevers. costant antigenic variation.
Use metronidazole if allergic to amoxicillin
Trypanosoma brucei has a variable surface Trypanosoma brucei is endemic to Trypanosoma brucei is motile with flagella.
403 of 584 5/12/2018, 9:26 PM

southeastern and western Africa
glycoprotein coat and thus undergoes

costant antigenic variation.
Trypanosoma cruzi can also be diagnosed

by a heart biopsy showing trypanosomas Trypanosoma cruzi gets into the heart by
within cardaic myocytes (infrequently burrowing into the endocardium.
done).
Trypanosoma cruzi does its damage

by tunneling into tissue and feeding
on the blood and lymph of its
victim.
Tryponosama is mobile with a single

Tryponosama is mobile with a flagella.
single flagella.
Trypanosoma cruzi is located in south and
central america.
Mentioned in intro.
Tryponosoma brucei has variable surface Tryponosoma brucei has variable Tuberculosis
glycoprotein coats undergoing constant surface glycoprotein coats
antigenic variation, allowing it to evade the undergoing constant antigenic Interferon-γ release assay (IGRA) has
host's immune system and enabling chronic variation, allowing it to evade the fewer false positives from BCG
infection (leading to recurrent fevers). host's immune system and enabling vaccination than PPD testing
chronic infection (leading to
recurrent fevers). IFN-γ release assay tests cell mediated
response by seeing if macrophages release
IFN-γ when presented with antigen. These
assays don't get false positives from
patients who are BCG vaccinated, thus are
the preferred methods of testing for these
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patients.
Tularemia is caused by Francisella

tularensis. Tularemia is transmitted via
the dermacentor tick.
can be aerosolized for use in bioterrorism

Tuberculosis
does not induce oxidative burst
PPD (-) can be from no infection,
sarcoidosis, or HIV infection.
HIV infection produces PPD (-) due to low

CD4+ cell count
Tularemia will present with a painful ulcer

at the site of infection and will eventually
involve the regional lymph Type 2 Dengue Virus is also called Urinary antiseptic used for treatment of
nodes (regional lymphadenopathy). Break-Bone Fever. uncomplicated UTI's in pregnancy
Nitrofurantoin
Bc of severe, painful backache,
muscle, and joint pain, and severe
headache 2 things to know: used for UTIs in
pregnancy and can trigger hemolysis in
G6PD
-TMP-SMX, quinolones are
contraindicated in pregnancy
Use of IFN-y Use of corticosteroids with

Use oral macrolides to treat the chronic
fluoroquinolones can increase the
conjunctivitis caused by C. trachomatis
Treatment of chronic granulomatous risk of tendon and cartilage
(serovar A-C).
disease damage.
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VPN (Martin-Thayer/NY) agar is a

selective medium enriched
with Vancomycin, Polymyxin
and Nystatin.
Vancomycin, Polymyxin, Nystatin.

VZV is transmitted by respiratory
droplets.
VZV is an enveloped DS DNA virus.
VZV treatment includes Acyclovir and

Valacyclovir.
VZV remains dormant in DRG
VZV is an enveloped DS DNA virus.
VZV vaccine can be given to HIV patients VZV vaccine is a live attenuated Vaginitis that presents with itching,
with CD4 counts >200. vaccine. copious secretion, and “cottage cheese”
appearing clumps are signs of vaginal
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Live attenuated vaccines shouldn't be given

to HIV patients with low CD4 count.
candidiasis
Virus assoc. with pneumonia in transplant

Valacyclovir is an anti-herpetic prodrug of patients: CMV
acyclovir that has what advantage?
Improved bioavailability
Virulence factor phospholipase C
of Pseudomonas degrades cell
membranes.
They also have flagella (VF)
Weil's disease can cause jaundice due to

liver dysfunction.
Visual adverse effects of ethambutol?
Can also cause renal dysfunction.
Optic neuropathy (red-green color
blindness)
Weight loss:gain or loss is

eye-thambutol
commonly seen in Giardia
infections
excess mucus production inhibits
fat absorption in the intestines,
leading to steatorrhea
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West Nile Virus neurological West Nile Virus neurological

West Nile Virus neurological
complications are characterized complications are characterized
complications are characterized
by seizures, encephalitis and meningitis. by seizures, encephalitis and meningitis.
by seizures, encephalitis and
meningitis.
Can also lead to flaccid paralysis, and can Can also lead to flaccid paralysis, and can
eventualy lead to seizures and coma eventualy lead to seizures and coma
Can also lead to flaccid paralysis,
and can eventualy lead to seizures
and coma
What 2 species of Trypanosoma cause What HAART drugs can produce What HAART drugs will prevent the
African Sleeping sickness? hepatotoxicity? transcription of HIV mRNA?
(1) T. brucei gambiense NNRTIs Integrase inhibitors (-gravir)

(2) T. brucei rhodesiense
Think of the places where they can be prevents viral dsDNA integration -->
found. normally uses host cell RNA pol to produce
viral mRNAs (i.e. transcription)
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What HIV envelope proteins are encoded What HIV therapy drugs act through
What HIV therapy drug is
for by env? Gp41 and gp120 allosteric inhibition of HIV reverse
associated with bone marrow
transcriptase?
suppression?
NNRTI
Zidovudine
What IFN therapy can be used in the What IFN therapy can be used in What IFN therapy may produce drug-
treatment of chronic granulomatous the treatment of renal cell induced SLE?
disease? carcinoma?
IFN-⍺
IFN-y IFN-⍺
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What NRTI can produce agranulocytosis as

a result of bone marrow suppression?
What NRTI is associated with What TB drug can be used as monotherapy
Zidovudine
anemia? for latent TB?
Zidovudine Isoniazid
do not administer with ganciclovir,
otherwise patient will have severe
myelosuppression
"Iso"-lated
What TB drug is associated with Vitamin

What adverse effect in know to be What adverse effect is associated with all
B6 deficiency?
caused by Quinidine? RIPE anti-mycobacterial therapies?
Isoniazid
Cinchonism Hepatotoxicity
Cinchonism = Headache + Tinnitus
Rifampin, Isoniazid, Pyrazinamide,

Ethambutol
Tin can
What aminopenicillin has a long oral What anti-TB drug can predispose What anti-fungal therapy that can produce
bioavailability? to sideroblastic anemia? gynecomastia and decreased libido in men?
Amoxicillin Isoniazid Ketonconazole
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What enzyme is inhibited by this drug?
17,20-desmolase
causes B6 deficiency = ↓ heme = ↑
iron in mitochondria
What anti-herpetic can produce obstructive What anti-mycobacterial can cause

What anti-herpetic drug can
crystalline nephropathy? hyperuricemia, precipitating gout attacks?
produce CNS side effects such as
confusion, delirium, vertigo,
Acyclovir Pyrazinamide
hallucinations?
Acyclovir (-clovir)
recall that weak acids compete with urate
for excretion
What anti-mycobacterial drug can cause What anti-mycobacterial drug can What anti-mycobacterial drug can reduce
drug-induced lupus? cause seizures? protease inhibitor concentrations?
Isoniazid Isoniazid Rifampin
What antibody is characteristically elevated What drug should be used instead?

in drug-induced lupus?
Rifabutin
Anti-histone antibodies
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What anti-mycobacterial inhibits DNA-

dependent RNA polymerase? What anti-retroviral can produce
nephrolithiasis?
Rifampin What anti-mycobacterial treatment
can cause drug induced lupus? Indinavir
Isoniazid
blocks transcription
indigo princess
What anti-retroviral drug is contraindicated

in HLA-B 5701 mutation?
What anti-retroviral drug can produce
insomnia and dysphoric dreams? Abacavir
What anti-retroviral drug is
associated with pancreatitis?
Efavirenz
Didanosine
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What anti-retroviral drugs can have What anti-retroviral drugs can

hyperglycemia due to insulin resistance? produce dyslipidemia?
What anti-retroviral therapy drugs can
Protease inhibitors Protease inhibitors (-navir) cause mitochondrial toxicity?
NRTIs
some NRTIs are capable of inhibiting

human DNA polymerase-y
What antibiotic has the highest risk of

What anti-viral agent can produce What antibiotic can produce causing pseudomembranous colitis?
hypocalcemia? neuromuscular blockade?
Clindamycin
Foscarnet Aminoglycosides
What antibiotic inhibits dihydrofolate What antibiotic is used in bowel What antibiotic should be avoided with
reductase? prep before bowel surgery? antacids/milk/iron?
Trimethoprim Neomycin Tetracycline
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Poorly absorbed, so it stays in the Ca++ or Mg++ or Fe++ will chelate the
gut for a long time drug, decreasing absorption
-just remember that they're all divalent
cations and it should make sense as to
what products you can and can't use
What antifungal drug inhibits nucleic acid

What antibiotics will have a
synthesis?
What antibiotics are used for prophylaxis positive direct Coombs test?
and treatment of Pneumocystis jirovecii Flucytosine
pneumonia? Penicillin
Trimethoprim-Sulfamethoxazole (TMP-
SMX)
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What antifungal produces a characteristic

infusion-related toxicity of fever and chills
What antimycobacterial can precipitate
("shake and bake")? What antimycobacterial
anion gap metabolic acidosis?
activates cytochrome P450?
Amphotericin
Isoniazid
Rifampin
isoniazid inhibits
What antimycobacterial inhibits

What antimycobacterial can produce a red-
carbohydrate polymerization of the
green color blindness? What antimycobacterial can
mycobacterium wall?
produce optic neuropathy?
Ethambutol
Ethambutol
Ethambutol
What enzyme does it block?
Arabinosyltransferase
blocks synthesis of arabinogalactan
415 of 584 5/12/2018, 9:26 PM

What antimycobacterial is the

preferred treatment of TB in HIV patients?
Rifabutin
What antiviral therapy is associated What are the 4 ways water is purified from
with a type IV hypersensitivity HAV?
Why?
reaction? Chlorination
Bleach
Rifampin is a strong activator of cyt-p450,
Abacavir UV radiation
Rifabutin is not
Boiling
Rifampin ramps up p450, but rifabutin

does not
What are the effects of NNRTIs on the

cytochrome p450?
What are the adverse effects on the
What are the adverse effects of integrase kidney of cidofovir? Varying; can induce or inhibit
inhibitors?
Nephrotoxicity, renal insufficiency
Increased creatine kinase (rhabdomyolysis)
What are the major differences between What are the teratogenic effects of What azole can be used to treat
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Smallpox and Chicken pox?

Aspergillus?
Small pox lesions are synchronous (occur aminoglycosides in newborns?
at same stage), while chickenpox (VZV) Voriconazole
lesions are asynchronous (different Deafness
stages).
What can be used in the treatment of

condyloma acuminatum?
IFN-⍺
What carbapenem has decreased
What virus causes condyloma risk of seizures and is stable to
acuminatum? dehydropeptidase? What carbapenem is not effective against
pseudomonas?
HPV Meropenem
Imipenem
Imipenem has increased risk
What cells does HHV-6 (Roseola) infect? What cephalosporin can be used for What cephalosporin can be used to treat
emperic treatment of meningitis? MRSA?
CD4 Cells
Ceftriaxone Ceftaroline
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What cephalosporin has a long half-life, What characteristic of Malassezia

making it useful for surgical prophylaxis? furfur makes it problematic for
neonates receiving TPN in the What chemokine receptor is Maraviroc
NICU? specific for?
Cefazolin
Lipophilic CCR-5
due to lipids in the TPN (M. furfur

is lipophilic) - can infect line that is
infusing TPN into blood, resulting
in fungisemia - can infect adults,
but symptoms are NOT as severe
What class of broad spectrum

antibiotics can be used against
severe nosocomial infections or
after other drugs have failed? What clinical syndrome is associated with
"beefy-red tongue" concurrent with
Carbapenems pharyngitis? Scarlet Fever
What class of antibiotic is Streptomycin?
Aminoglycoside
What combination is used to treat What demographic is Entamoeba What demographic of people are at risk for
crytpococcal meningitis? histolytica associated with? Tinea (ringworm) infections?
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Flucytosine, amphotericin
Athletes
MSMs (men who have sex w/ men) swimmers that walk barefoot, wrestlers
that have body contact with mats
What diagnostic test(s) is/are run to test for

Giardia? What drug is associated with a orange
color of body fluids (urine, tears, sweat,
Stool O&P (ova and parasites); ELISA sputum)?
stool antigen
What drug can be used for
Rifampin (rifamycins)
toxoplasmosis prophylaxis in HIV
patients?
Should you discontinue use?
TMP-SMX
No, it is harmless
What drug should be used for general What drugs should be used What effect does tetracyclines have on
Haemophilus influenza prophylaxis and to treat toxoplasmosis? absorption of divalent cations?
prophylaxis in contacts of children with
Haemophilus influenza? Pyrimethamine/sulfadiazine Decrease
Rifampin
recall these ions chelate tetracyclines -->

increased ionization --> decreased
absorption
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What enzyme is inhibited by

Terbinafine?
What envelope protein of HIV is
responsible for fusion and entry into the Squalene epoxidase
What enzyme is required to convert
host cell?
Isoniazid to an active metabolite?
gp41
Bacterial catalase-peroxidase
What enzymes are inhibited by What forms of HSV/VZV is acyclovir

fluoroquinolones? active against?
What flavivirus can cause
meningoencephalitis? West Nile
Topoisomerase II (DNA gyrase) and Active forms, not the latent
Virus
topoisomerase IV
nucleoside analogs can only work in

replicating viruses (i.e. if drug is dormant,
it cannot insert into replicating DNA)
hence not a cure, but will decrease

symptoms of acute phase
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What fungal enzyme converts flucytosine

What formulation of amphotericin to 5-fluorouracil?
can be used to decrease
What forms the triphosphate of nephrotoxicity? Cytosine deaminase
ganciclovir?
Liposomal amphotericin
Host kinases
Liposomal aphotericin B,
amphotericin B lipid complex, etc.
What fungus is actually a reverse of

the dimorphic adage,
with yeast in the cold and mold in
the heat?
Candida albicans
normally: mold in the cold, yeast in

the heat
What generation of cephalosporin is used
for the prophylaxis and therapy of
Candida albicans is yeast in the
abdominal/pelvic cavitiy infections?
What fungus causes histoplasmosis? cold, with pseudohyphae
mold in the heat, with germ tubes
2nd generation cephalosporins
Histoplasma Capsulatum (true hyphae)
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What generation of cephalosporins can be

used to treat UTI's caused by gram What gram (-) can cause a significant
negative bacteria (PEcK)? What generation of cephalosporins infection in burn-wound
have the largest spectrum of patients? Pseudomonas
1st generation cephalosporins activity?
4th and 5th
Spectrum increases as you go down

(5 > 1)
What gram negative species are covered by

2nd generation cephalosporins?
What gram staining group have porins in
H. influenzae, Enterobacter aerogenes, their wall?
Neisseria spp., Serratia marcescens + PEK
Gram negative, and thus can downregulate
porins in β-lactam resistance
What gram stain do spirochetes
take up?
Same gram - covered as 1st gen (PEK) +
HENS
none: spirochetes do not gram stain
What group of anti-retroviral drugs can What group of antibiotics can What group of antibiotics can produce
produce Stevens-Johnson Syndrome? produce crystalluria? kernicterus in infants?
NNRTIs Sulfonamides Sulfonamides
What property allows them to do this?
Sulfonamides are metabolized by High protein binding ability, thus can

liver and renally excreted, so they
422 of 584 5/12/2018, 9:26 PM

displace bilirubin from albumin
can precipitate in the urine
What group of drugs are

monophosphorylated by viral
thymidine kinase?
Acyclovir, famciclovir, valacyclovir

(-clovir)
What group of drugs would increase the
What group of antimicrobials inhibit What enzymes form the risk of tendon and cartilage damage in the
prokaryotic DNA gyrase (topoisomerase triphosphate? elderly (> 60)?
II) and topoisomerase IV?
Host enzymes Fluoroquinolones
Fluoroquinolones
some blockage of human topoisomerase, so

can block cells involved in bone/cartilage
growth
What group of folate synthesis inhibitors What hepatitis C treatment What highly resistant bacteria
can produce urticaria, rash, and ever? predisposes to photosenstivitiy and is Trimethoprim-Sulfamethoxazole
rash? effective against?
Sulfonamides (sulfa-allergy)
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MRSA
Simeprevir
not first-line (or 2nd or 3rd for that matter)

simmering = simeprevir
What infections does Strep. pyogenes

(GAS) cause?
(1) Impetigo
(2) Pharyngitis
(3) Cellulitis/Erysipelas
What is an adverse effect of intrathecal

amphotericin administration?
What is an ELISA looking for
when testing for Giardia? Seizures
Stool antigens
What is difference in adults and What is the CD4+ count threshold What is the DDX for Kaposi
infants/children with Hep A? for the development of candidal Sarcoma? Bacillary angiomatosis caused
Children will not have jaundice esophagitis? by B. henslae
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< 100
AIDS-defining illness - a CD4+

count less than 100 means the
patient is susceptible to
development of candidal
esophagitis
What is the etiology of laryngeal

papillomatosis?
What is the MOA of exfoliative toxin in
What is the drug of choice for
Scalded-Skin Syndrome? Cleavage of the HPV 6 and 11
treatment of
middle epidermis --> sloughing of upper
Sporotrichosis/Sporothrix schenckii
layers of epidermis
infection? can lead to laryngeal carcinoma
Itraconazole
What is the function of GAS What is the key finding in acute tubular
M-protein? Antiphagocytic, inhibits necrosis?
activation of complement What is the function of exotoxin A
that causes GAS Toxic Shock-Like Muddy, brown casts
Syndrome? Binds to MHC II and
TCR outside of antigen binding site Nephrotoxic antibiotic that can produce
to cause overwhelming release of acute tubular necrosis?
IL-1, IL-2, IFN-γ, and TNF-α,
producing shock Aminoglycosides
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What is the main use of Ribavirin?
Hepatitis C
What other virus can it be used for?
RSV
What is the main immune diffense against What is the main immune diffense
Giardia? against Giardia?
IgA produced by Peyers Patches in the GI IgA produced by Peyers Patches in not 1st line for RSV
the GI
What is the mainstay treatment for What is the major target on host What is the mechanism of resistance
dermatophytes/Tinea infections? cells for HIV? against acyclovir?
Topical -azoles (clotrimazole) CD4+ on T-cells Mutation of viral thymidine-kinase
clotrimazole = lotrimin What two chemokine receptors are

co-receptors to this target?
CCR5, CXCR4
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What is the most common predisposing

factor to mucormycosis? What is the only nucleotide NRTI?
What is the only dsRNA
Diabetic ketoacidosis virus? Reovirus Tenofovir
proliferates in the setting of high blood

sugar and high ketones (ie: diabetic
ketoacidosis in T1DM)
What is the route of giardia transmission?
Fecal-oral
individuals (typically "world travelers")

become infected when they visit a region
indigenous to giardia and drink unfiltered
What is the pharmicological treatment of
water - water is typically infected with
Mucormycosis?
animal, or human, feces
Amphotericin B
What is the prophylactic treatment

for Syphilis?
Benzathine Penicillin G
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What is the treatment of choice for

Malassezia furfur (M. furfur)?
What is the solution of choice for
treatment of Sporotrichosis/Sporothrix Selenium sulfide (selsun blue)
schenckii infection? What is the treatment for
symptomatic infections promotes shedding of the stratum corneum,
SSKI (saturated solution of potassium of Entamoeba histolytica? which is where M. furfur infects the skin
iodide)
Metronidazole
not really used much anymore
What mycobacterial treatment can inhibit

What is unique about B.
cytochrome P450?
anthracis capsule?
Isoniazid
It is the only bacterium with a protein
capsule (D-glutamate)
What lipopeptide that can be used
What can be used to treat B. anthracis to treat VRE? rifampin ramps up, isoniazid inhibits
(anthrax)?
Daptomycin
Fluoroquinolones (-oxacin)
Resisting the van
What neurological side effects are What neurotoxic effects are What non-3rd generation group of
associated with NRTIs? associated with isoniazid? cephalosporin can be used to treat bacterial
meningitis?
Peripheral neuropathy Seizures, peripheral neuropathy
Cefepim
What vitamin induced deficiency
can be precipitated by isoniazid?
3rd generation is 1st line empiric treatment
B6
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B6 induced peripheral neuropathy
What organism produces lockjaw?
C. tetani
What is the function of this toxin?
Tetanus toxin (tetanospasmin) cleaves

SNARE, inhibiting the releaes of GABA
and glycin
What nucleic acid synthesis inhibitors can
be used in the treatment of pyelonephritis?
What organism is associated with a
Fluoroquinolones (-oxacin) fruity-grape odor? Pseudomonas
What organisms are implicated in acute What other antibiotic has a similar What other symptoms are associated with
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atypical pneumonia in Legionnaires'

disease? Hyponatremia, high fever,
neurologic symptoms, diarrhea
Pneumonia with GI symptoms, CNS

prostatitis?
symptoms, hyponatremia, high fever....
MOA to macrolides?
Legionella
In older men most common bacterium is E.
coli; in young males consider C. Clindamycin
trachomatis, N. gonorrhoeae
Treatment?
TMP-SMX
chronic can be infectious or non-infectious

also fluoroquinolones
What parasite is commonly associated with What population is most associated with
individuals who go camping and do Giardia infections?
not purify their water before consumption?
What performs the first Campers
Giardia phosphorylation of ganciclovir?
(Drinking unpurified water)
CMV viral kinase
What gene encodes the kinase?
UL97
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What protein synthesis inhibitor inhibits

Cyt P-450?
What protein synthesis inhibitor can
produce peripheral neuropathy? What protein synthesis inhibitor Macrolides (erythromycin)
can prolong the QT interval?
Linezolid
Macrolide antibiotic
What protein synthesis inhibitor is used

primarily in developing countries?
What renal complication can IFN-⍺ What rifamycin is the preferred treatment
Chloramphenicol be used to treat? of TB in HIV positive patients?
Renal Cell Carcinoma Rifabutin due to less Cyt-P450 stimulation
Empiric treatment of meningitis
What shape do the lesions present as What strains of HPV are associated What structure does amphotericin B bind
in Entamoeba histolytica? with squamous cell carcinomas? to, forming membrane pores?
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HPV 16-18, 31, 33

"Flask-shaped" Ergosterol
seen with the man drinking from an

erlenmeyer flask
What tests (3) are used to diagnose

What tests (3) are used to diagnose Entamoeba histolytica?
Entamoeba histolytica?
Stool O&P (ova and parasites); ELISA
Stool O&P (ova and parasites); stool+serum antigen test; Serology to
What test is useful for rapid diagnosis of ELISA stool+serum antigen test; detect Entamoeba antibodies
Legionella? Urine antigen test Serology to detect Entamoeba
antibodies
urine test for LPS antigen for serotype 1
looks for cysts (C) and trophozites looks for cysts (C) and trophozites (D) in
(D) in stool stool
What tests (3) are used to diagnose What topical azoles are used to
Entamoeba histolytica? treat vaginal candidiasis? What toxin in Rotavirus produces secretory
diarrhea? NSP4 toxin
Stool O&P (ova and parasites); ELISA Clotrimazole, miconazole
stool+serum antigen test; Serology to
detect Entamoeba antibodies What other drugs are used to treat
vulvovaginal candidiasis?
Oral Fluconazole, Nystatin
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looks for cysts (C) and trophozites (D) in

stool
What two electrolyte deficiencies may be

seen in treatment with amphotericin?
Mg+, K+
What transmission is Entamoeba
histolytica associated with?
What treatments are available for
Anal-oral transmission asymptomatic cyst passers of
Entamoeba?
paromomycin or iodoquinol
- iodoquinol works by chelating

iron needed for amoeba metabolism
- paromomycin is a protein
synthesis inhibitor by inhibiting
16S Ribosomal RNA
What two groups of RNA viruses have What two organism inactive What two organisms are echinocandins
long polyprotein products that are cleaved elongation factor 2? Pseudomonas, effective against?
by viral proteases? Picorna and Toga C. diptheriae
Candida, Aspergillosus
433 of 584 5/12/2018, 9:26 PM

Aspergillus scarecrow
What type of anemia can isoniazid

predispose to?
Sideroblastic anemia
What will the ferritin levels be?
Increase
What type of anemia may be seen

What type of vaccine is rabies? Killed
in the use of Trimethoprim or TMP-
↓ heme production = ↑ iron = ↑ ferritin SMX combination therapy?
(iron trapped in mitochondria)
Megaloblastic anemia
What virus cause SARS or What virus is treated by What virus produces Kaposi Sarcoma?
MERS? Coronavirus ganciclovir?
HHV-8
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What interferon can be used to treat?
IFN-⍺
CMV
What viruses produce this

encephalitis shown in the picture?
What viruses encode for the thymidine Toga family (Eastern/Western

kinase needed to monophosphorylate /Venezuelan Equine Encaphlitis)
acyclovir?
HSV/VZV
What vitamin deficiencies can occur with a
Giardia infection?
Fat Soluble (ADEK)
excess mucus production impairs fat

absorption in the intestines, results in
steatorrhea
What β-lactam antibiotic can be used for What's the MOA of Quinolides What's the mosquito species that transmits
left-sided endocarditis caused by Strep (chloroquine, primaquine and Malaria?
viridans and Strep bovis? mefloquine)?
Anopheles
Penicillin G Inhibition of heme polymerase in
Plasmodium spp
Inhibition of heme polymerase

leads to buildup of toxic
hemoglobin metabolites within the
malarial parasite.
435 of 584 5/12/2018, 9:26 PM

Colorful beads joined together as a

polymer
What's the treatment for non-resistant

strains of Plasmodium spp? When a patient with Aspergillomas takes
an upright chest X-ray, the fungal balls will
Chloroquine be in the inferior lobes, as they are gravity
dependent
Remember that it doesn't affect
hypnozoites! Primaquine does, though
When a patient looks to have severe
pneumonia via CXR but presents
with mild symptoms, it is termed
walking or atypical pneumonia.
upright chest XR, fungus balls will fall to

the bottom of the cavity
When individuals consume water filled

with cysts of Giardia, infection occurs
When performing a Lepromin skin test,

you are testing a Type IV hypersensitivity
reaction.
When mosquitoes with wuchereria

bancrofti bite, the larvae penetrate
the skin and enter the lymphatics,
where they produce microfilariae.
cysts of giardia are transmitted fecal-orally
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When should Chloramphenicol be used for

the treatment of Rickettsial infections
instead of 1st-line doxycycline?
When starting a patient on When starting a patient on Infliximab
Pregnancy (TNF-α inhibitor), you must test a patient
Infliximab (TNF-α inhibitor), you
must test a patient for tuberculosis for tuberculosis infection.
infection.
by PPD
only in 1st and 2nd trimester
by PPD
When treating a patient for Chlamydia you When treating a patient for
Chlamydia you must always When tuberculosis reactivates, it primarily
must always include ceftriaxone in your
include ceftriaxone in your affects the upper lobes of the lung.
treatment regimen, due to the chance of co-
infection with Neisseria gonorrhea. treatment regimen, due to the
chance of co-infection
with Neisseria gonorrhea.
Where can hypnozoites (latent form of

Plasmodium) be found in the human body?
When toxocara canis larvae get
When toxocara canis larvae get inside the Liver (hepatocytes)
inside the human, they never
human, they never actually mature out of
actually mature out of the larvae
the larvae phase. Instead, they continue to Remember that only P. vivax and ovale
phase. Instead, they continue to
circulate the body for years. produce hypnozoites
circulate the body for years.
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Liver shape in oval shield of Hipnotist

warlord: Hypnozoites in hepatocytes
Where do the fungi Dermatophytes reside

in the body? Which HAART therapy can produce lactic
acidosis?
Skin
Where does rhinovirus grow best? NRTI's
cutaneous fungi - dermatophyte in greek
URT (around 33 degrees Celsius)
means "skin plant"
therefore they implant themselves on the
skin and rarely ever invade
Which anti-herpetic has an increased oral

bioavailability?
Valacyclovir
Which Picorna virus causes the common

cold? Rhinovirus Which anti-fungal can produce
anti-adronergic side effects?
Ketoconazole
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Which anti-retroviral therapy drug is used

to prevent vertical transmission in Which anti-retroviral therapy drugs
Which antimalarial agent commonly is
pregnancy and breastfeeding? are teratogenic?
used for resistant strains of Plasmodium
NNRTIs spp?
Zidovudine
Mefloquine
Which class of antimalarials agents are

used for severe P. falciparum infections?
Which antimalarial agents are Artemisins

Which antimalarial agent is used to
eradicate hypnozoites? delivered IV for severe (life-
threatening) malaria? Such as Artesunate or Artemether.
The 2015 Nobel prize of medicine
Primaquine
Artesunate and quinidine celebrated their discovery (irrelevant
pimping material).
Atovaquone + proguanil can also be used,

notice that the artist is painting them
Ivy over artist and Dining queen
Which condition makes the administration

Which form of Plasmodium is carried by
of primaquine contraindicated in the Which form of Entamoeba Anopheles in its saliva?
treatment of Malaria ? histolytica is infectious when
ingested? Sporozoites
G6PD deficiency
Cyst form
G6PD deficiency: Glucose-6-phosphate
dehydrogenase deficiency
Primaquine is the only antimalarial

quinoline that accumulates in tissue cells.
This property is what allows it to destroy
hypnozoites, but it can also lead to anemia
in patients with G6PD deficiency, which
greatly increases the susceptibility of RBCs
to oxidant stress. Anopheles on spore (fungus): Sporozoites
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Which fungal infection is

characterized by a yeast form with
multiple buds that radiate
Which fungal infection can, when
out from a central vacuole?
disseminated, infect the meninges and
cause meningitis?
Paracoccidioidomycosis
Coccidioidomycosis
yeast form in the lungs Which fungus commonly contaminates
results in the classic headache and stiff sputum cultures?
neck
Candida albicans
due to it being a part of normal flora of the

oral cavity, present in up to 40% of the
population
Which fungus has a "spaghetti and Which intestinal parasite(s) is/are ingested
meatball" appearance on KOH prep? via contaminated water in the cyst form?
Malassezia furfur Giardia; Entamoeba histolytica;

Cryptosporidium
Which hematological finding is

pathognomonic of Plasmodium
ovale and vivax infection?
Schüffner's stippling
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Which non-quinoline antimalarial agents

are used for prophylaxis and treatment of
Malaria in travelers to chloroquine-
resistant areas?
Atovaquone + Proguanil
Which layer of the skin does the fungus
Malassezia furfur (M. furfur) reside?
Stratum Corneum
most superficial layer - makes sense - M. Which lobe of the liver is most
furfur sits on top of the skin, therefore commonly involved with amoebic
infects the top layer (corn sprinkled on top liver abscesses?
layer of lasagna)
Right lobe
70-80% of lesions are solitary
Which of the herpes virus remains dormant Which of the protease inhibitors has Which pathologic condition is protective
in the sacral ganglia? HSV-2 the greatest CYP-450 inhibitory against P. falciparum?
effects?
Sickle cell disease
Ritonovir
Sickle shaped RBCs can't be infected by

Plasmodium spp. This also explains the
prevalence of Drepanocytosis in african
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endemic areas populations. How can a

gene disperse that way if it isn't giving it's
carrier an advantage for survival?
Which ribosomal subunit is

targeted by Linezolid?
50s Which species of Plasmodium can cause

Cerebral malaria?
Which quinoline is used for prophylaxis P. falciparum

and treatment of Malaria in travelers to
chloroquine-resistant areas? Cerebral malaria consists on capillary
plugging of the brain from
Mefloquine an accumulation of malarial pigment and
masses of cells that can result in coma and
death.
Red head dress on African warlord
Which species of Plasmodium has a Which species of Plasmodium has a Which species of Plasmodium have an
quartan fever cycle (72 hours)? tertian fever cycle (48 hours)? irregular pattern of fever?
P. malariae P. vivax and ovale P. falciparum
That is, the fever appears on day 1, and As in, 1st day fever (0 hours), and
then again after 72 hours, on day 4. then again fever at the 3th day (48
0 hours = 1st day, 24 hours = 2nd day, 48 hours).
442 of 584 5/12/2018, 9:26 PM

= 3rd day, 72 = 4th day.
0 hours = 1st day, 24 hours = 2nd

day, 48 = 3rd day.
P. malariae as in "mal aire" (bad odor).

African warlord with an axe and
Silly Andrew Berg, that's not italian, it's
oval shield: P. vivax and ovale
spanish.
Irregular ups and downs of torn shirt:

Irregular pattern of fever
Pendulum changing color: Tertian

fever cycle
4 bottoms in tunic, 1st and 4rt colored:
Quartan fever cycle
Which species of Plasmodium is banana-

shaped in the peripheral blood smear?
Which species of Plasmodium produce the

Which species of Plasmodium most severe infection?
produce dormant hypnozoites
(latent form)? P. falciparum
P. vivax and ovale
P. falciparum
African overlord with false mask: P.

falciparum
Banana shaped red head dress
Which stains are used on a blood smear to Which two drugs eliminate cysts of Who should treatment be given to with
diagnose Malaria? Entamoeba histolytica in the Trichomonas vaginalis?
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lumen of the intestine?
Paramycin; Iodoquinol
Considered luminal agents

Metronidazole to both patient and partner
Blood and Giemsa stains
Blood Gems: Blood and Giemsa stains
pair of mice running into the

tunnel; queen iodo's head in the
dig site
Why are aminoglycosides only effective

Whooping cough is caused by Bordetella Whooping cough organism? B. against aerobic gram negatives?
pertussis. pertussis
Require oxygen for transport into the cell
Drug of choice? Macrolides
(erythromycin)
Why could the use of ritonavir be Why doesn't hepatitis C have a Why should tetracyclines be avoided with
advantageous in HIV therapy? vaccine? Antigenic variability of milk?
the envelope due to lack of 3' --> 5'
Greatest inhibitor of Cytochrome P-450, exonuclease Divalent cations will chelate the drug,
which can boost the concentration of other decreasing absorption
protease inhibitors
Same tent seen in Rhinovirus
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Wucherira bancrofti is also

characterized by eosinophilia.
Yellow Fever and Dengue are both

Will Pneumocystis pneumonia show transmitted by the Aedes egyptei mosquito.
consolidations on chest xray?
No

pneumonias)
Yellow Fever and Dengue belong to the Yersinia enterocolitica can be transmitted
Yersinia enterocolitica can be through puppy feces.
Flavi-virus family.
prevented with a killed vaccine
producing a humoral immune
response.
Also blood products
Yersinia enterocolitica is resistant to cold Yersinia enterocolitica may be Yersinia enterolitica is associated
temperatures. transmitted through contaminated with bloody diarrhea in toddlers.
milk.
Listeria and Yersinia enterocolitica are

both resistant to cold temperatures and
found in milk. (culture at 4C)
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Yersinia pestis (plague) is transmitted by

Yersinia pestis (plague) first fleas.
spreads to the lymph nodes,
forming characteristic buboes.
Bite of infected fleas that have bitten

Yersinia enterolitica is associated
infected ground squirrels, prairie dogs,
with bloody diarrhea in toddlers.
Commonly in inguinal LN --> then wood rats, or chipmunks, which are the
can spread and cause septicemia, reservoir of the bacterium
causing widespread necrosis
Yersinia pestis (plague) often escapes the Yersinia pestis (plague) often
lymph nodes to produce septicemia and escapes the lymph nodes to produce
cause widespread necrosis of the organs. septicemia and cause widespread
necrosis of the organs.
Yersinia pestis is facultative intracellular.
Flea bite --> lymph nodes (buboes) -->

blood stream --> septicemia/septic Flea bite --> lymph nodes (buboes)
shock/organ necrosis/DIC --> blood stream -->
septicemia/septic shock/organ
necrosis/DIC
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Zanamivir = neuraminidase inhibitor
Zidovudine (ZDV) = NRTI Zidovudine is used to decrease the vertical

transmission of HIV.
What is the historical
name? Azidothymidine (AZT)
know both names
p24 protein is encoded by gag retrovirus

gene.
(Non-cancerous) Oral Hairy
Leukoplakia in HIV patients with
EBV 10-20 years after being infected with
trypanosoma cruzi, chagas disease
develops.
Symptoms of Chagas include megacolon,
megaesophagus, and dilated
cardiomyopathy.
11 RNA segments are in rotavirus. 80-90% percentage of CMV congenital

10-20 years after being infected with infections are asymptomatic.
trypanosoma cruzi, chagas disease
develops. BOAR = segmented viruses
Symptoms of Chagas include megacolon,
megaesophagus, and dilated
cardiomyopathy.
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AIDS/Immunosuppressed, elderly
russian men and african men are
groups at risk for HHV-8.
A capsule is antiphagocytic component of
Pseudomonas. Endemic areas of africa.
Actinomyces israaelii is associated with

jaw trauma and recent dental work.
Cervical facies actinomyces infection
Active trypanosoma cruzi infection Active trypanosoma cruzi infection is

is diagnosed by blood smear, diagnosed by blood smear, whereas chronic
whereas chronic (Chagas) (Chagas) trypanosoma cruzi is diagnosed
trypanosoma cruzi is diagnosed with serology and clinical symptoms.
with serology and clinical
Actinomyces israaelii is associated with symptoms.
jaw trauma and recent dental work.
Cervical facies actinomyces infection
Acutely, trypanosoma cruzi is treated with Adenovirus and HSV-1 are two viral
nifurtimox. causes of conjunctivitis.
No known effective treatment for chronic
Chagas. Acyclovir is the treatment against
EBV (weak activity). HSV-1 diagnosed with fluorescein staining
448 of 584 5/12/2018, 9:26 PM

Albendazole and pyrantel pamoate can be

used to treat hookworm, but most
Adenovirus is the most common important is to wear shoes.
cause of viral conjunctivitis.
Adenovirus is the most common cause of
tonsillitis.
(ONLY non-purulent conjuctivitis).
Allergic Bronchopulmonary Allergic Bronchopulmonary

Asperigillosis (ABPA) is a result Asperigillosis (ABPA) is a result Allergic Bronchopulmonary
of inhalation of the Aspergillus fumigatus of inhalation of the Aspergillus Asperigillosis (ABPA) is a type 1
fungus and presents with fumigatus fungus and presents with hypersensitivity reaction caused by the
wheezing, fever and migratory wheezing, fever and migratory fungus Aspergillus fumigatus
pulmonary infiltrate pulmonary infiltrate Type 1 hypersensitivity reaction, wheezing,
fever, migratory pulmonary infiltrate
Type 1 hypersensitivity reaction, wheezing, Type 1 hypersensitivity reaction,
fever, migratory pulmonary infiltrate wheezing, fever, migratory
pulmonary infiltrate
Allergic Bronchopulmonary Amantadine and Rimanatine are Aminoglycosides are protein synthesis
Asperigillosis (ABPA) is a type 1 Influenza M2 protein inhibitors, inhibitors that block release of ACh at the
hypersensitivity reaction caused by the thus preventing viral uncoating. NMJ, producing a neuromuscular
449 of 584 5/12/2018, 9:26 PM

blockade.
fungus Aspergillus fumigatus
Type 1 hypersensitivity reaction, wheezing, Allows increased dopamine release
fever, migratory pulmonary infiltrate in CNS.
Aminoglycosides are protein synthesis Aminoglycosides are unique because they

inhibitors that block release of ACh at the Aminoglycosides are unique are protein synthesis inhibitors that are
NMJ, producing a neuromuscular because they are protein synthesis bacteriocidal.
blockade. inhibitors that are bacteriocidal.
Most are bacteristatic

Most are bacteristatic
Aminopenicillins are a group of penicillins

Aminoglycosides require O2 for uptake that can produce Stevens-Johnson
Aminoglycosides require O2 for syndrome, a reaction that produce bullae
into the cell.
uptake into the cell. formation and fever.
hence they are ineffective against

anaerobes hence they are ineffective against
anaerobes
Aminopenicillins are a group of penicillins Amoxicillin and ceftriaxone can be Amoxicillin and ceftriaxone can be used to
that can produce Stevens-Johnson used to treat Lyme disease in treat Lyme disease in children and pregnant
syndrome, a reaction that produce bullae children and pregnant women. women.
formation and fever.
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Doxycycline is 1st choice Doxycycline is 1st choice
Amoxicillin is an aminopenicillin that

should be used to treat Lyme disease in
pregnant women and children. Amphotericin B is the DOC for Amphotericin and nystatin are anti-fungals
serious systemic fungal infections. that bind to ergosterol to form holes in the
fungal cell membrane.
Doxycycline is first-line
Amphotericin is an anti-fungal that

damages the renal tubular cells, Amphotericin toxicity results from non-
which can produce anemia due to selective binding to mammalian cholesterol
Amphotericin and nystatin are anti-fungals membranes.
that bind to ergosterol to form holes in the decreased erythropoietin
fungal cell membrane. production.
Ampicillin is aminopenicillin that can be Ampicillin is an aminopenicillin Ancyclostoma duodenale and necator
used to treat enterococcus infection (E. that can produce americanus are two types of hookworms
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found in the southern USA.
faecalis, E. faecium).
pseudomembranous colitis.
Amp up the diarrhea

-wasn't in sketchy :[
Ancyclostoma duodenale and necator

americanus are two types of hookworms
found in the southern USA.
Angioinvasive aspergillosis Angioinvasive aspergillosis disseminates

disseminates upon reaching the upon reaching the blood vessels, resulting
blood vessels, resulting in endocarditis
in endocarditis
Angioinvasive aspergillosis disseminates Angioinvasive aspergillosis disseminates

Angioinvasive aspergillosis
upon reaching the blood vessels, resulting upon reaching the blood vessels, resulting
disseminates upon reaching the
in kidney failure in ring enhancing brain lesions
blood vessels, resulting in kidney
presents with seizures and focal neuro-
failure
deficits
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Angioinvasive aspergillosis invades blood

Angioinvasive vessels, disseminating rapidly throughout
the body
aspergillosis invades blood
vessels, disseminating rapidly
throughout the body
Angioinvasive aspergillosis disseminates

upon reaching the blood vessels, resulting
in ring enhancing brain lesions
presents with seizures and focal neuro-
deficits
acute-angled septated hyphae

invade the vessels in surrounding acute-angled septated hyphae invade the
tissues vessels in surrounding tissues
Angioinvasive aspergillosis is treated with Angioinvasive aspergillosis is Angioinvasive aspergillosis occurs due to
Amphoterecin B treated with Amphoterecin B Aspergillus fumigatus infection in the
immuno-compromised
ie: patients with neutropenia from
leukemia or lymphoma
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Angioinvasive aspergillosis occurs due to

Aspergillus fumigatus infection in the Animal (dog) bites are the Animals/pets can be a source of
immuno-compromised transmission for Pasteurella. dermatophytes and, therefore, Tinea
ie: patients with neutropenia from infection, especially in younger individuals
leukemia or lymphoma
Anti-HBs is the marker for recovery or

immunization from Hep B.
Recovery: Anti-HBs Ab + Anti-HBe or Anti-HepB IgG antibodies should Anti-Streptolysin O (ASO) titers should be
Anti-HBc Ab be given with vaccination to checked to confirm GAS as the cause for
Immunized: Anti-HBs Ab infants at risk of Hep B infection. glomerulonephritis or rheumatic fever.
Anti-staph penicillins are anti-bacterials Antibiotics and OCPs (oral Antigenic drift are minor point mutations
that have bulky-R groups that block access contraceptives) can predispose in HA or NA genes in the Influenza viral
of β-lactamase ring, making them individuals to vaginal yeast genome.
penicillinase resistant. infections
Ie: candida albicans
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Arenavirus is a segmented virus that can

cause Lassa Fever and LCMV.
Antigenic shift is the sudden reassortment

of Influenza genome segments between
species.
Aquatic environments are suitable
There are 16 HA subtypes, 9 NA subtypes, for Pseudomonas.
8 viral genes and an M2 protein (lots of
variations possible).
Arenavirus is ambisense meaning it can

Arenavirus is ambisense meaning it
encode both + and - sense RNA.
can encode both + and - sense
RNA. Argyle Robertson is characterized by
pupils that accommodate to distance but
do not react to light.
Argyll Robertson: involve efferent

pupillary fibres on the dorsal aspect of
the Edinger-Westphal nucleus. Ventral
fibers are spared.
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Armadillos are the main reservoir

Ascaris lumbirocides is also known as the
for Mycobacterium leprae in the
Argyle Robertson is characterized by giant roundworm.
U.S.
pupils that accommodate to distance but
do not react to light.
Argyll Robertson: involve efferent

pupillary fibres on the dorsal aspect of
the Edinger-Westphal nucleus. Ventral
fibers are spared.
Ascaris lumbirocides is also known as the

giant roundworm.
Ascaris lumbricoides infection can

Ascaris lumbricoides infection can be
be asymptomatic, or present with
asymptomatic, or present with signs of
signs of malnutrition or respiratory
malnutrition or respiratory symptoms.
symptoms.
Aspergillomas are solid balls of fungus Aspergillomas are solid balls of

present in the lungs, result from fungus present in the lungs, result
Aspergillus fumigatus infection from Aspergillus fumigatus
Aspergillomas (fungus balls - solid balls of infection
fungus within the lungs) Aspergillomas (fungus balls - solid
balls of fungus within the lungs)
Aspergillus fumigatus is a monomorphic

fungus which is catalase (+).
those with cavities already in their

lungs are susceptible to this
infection
456 of 584 5/12/2018, 9:26 PM

ie: those with tuberculosis or

klebsiella

ie: those with tuberculosis or klebsiella
upright chest XR, fungus balls will

be at the bottom of the cavity
upright chest XR, fungus balls will be at

the bottom of the cavity
Aspergillus forms conidiophores with Aspergillus forms conidiophores Aspergillus has an acute (<45°)-angle
fruiting bodies with fruiting bodies branching hyphae with septations
released into the air, inhaled by humans released into the air, inhaled by
humans
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notice the septations within the branches
Aspergillus has an acute (<45°)-angle Aspergillus has an acute (<45°)- Asplenic patients are more likely to be
branching hyphae with septations angle branching hyphae with symptomatic with babesiosis and have
septations higher risk of severe disease.
Patients with sickle cell are asplenic from
the get-go due to autosplenectomy.
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notice the septations within the

branches
notice the septations within the branches
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Atypical pneumonia is produced by RSV

in infants < 6 months.
Azithromycin and clarithromycin are
Azithromycin and clarithromycin
macrolides that can be used to treat
are macrolides that can be used to
Mycobacterium avium.
treat Mycobacterium avium.
Azithromycin is a macrolide antibiotic that

can be used to treat urethritis and cervicitis
caused by Chlamydia trachomatis. Azithromycin is a macrolide Azithromycin is a macrolide antibotic that
antibotic that can be used in can be used in prophylaxis of
prophylaxis of Mycobacterium Mycobacterium avium in patients with
avium in patients with CD4 count < CD4 count < 50.
50.
Azithromycin will treat infections by Aztreonam is a monobactam that can treat

Bartonella henselae. Aztreonam is a monobactam serious systemic infections (meningitis,
effective against Pseudomonas. pneumonia, sepsis) with gram negative
pathogens.
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BK Virus is a polyoma virus that can

produce a nephropathy in transplant
patients.
BAD- Bunya, Arena, Delta are the
3 RNA viruses with a circular
genome.
(i.e. Ureteral stenosis/BK Associated
Nephropathy (BKVAN))
B cell immunodeficiencies generally
predispose to GI giardiasis
BK Virus is a polyoma virus that can BK virus, adenovirus BK virus, adenovirus

produce a nephropathy in transplant and cyclophosphamide are and cyclophosphamide are associated with
patients. associated with hemorrhagic hemorrhagic cystitis.
cystitis.
(i.e. Ureteral stenosis/BK Associated

Nephropathy (BKVAN))
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BK virus is a polyoma virus which may

cause nephropathy and hemorrhagic
cystitis.
BK and CMV both affect transplant
patients.
Babesia causes fever and hemolytic anemia

(predominantly in the northeastern US)
and is treated with Atovaqone +
azithromycin
Babesia infection leads to a higher risk of

severe disease in sickle cell disease.
Babesia causes fever and hemolytic anemia Babesia causes fever and hemolytic
(predominantly in the northeastern US) anemia (predominantly in the
and is treated with Atovaqone + northeastern US) and is treated
azithromycin with Atovaqone + azithromycin
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Babesia is carried by the ixodes Babesia is carried by the ixodes tick, and is
tick, and is spread to humans spread to humans through its saliva.
Babesia infection leads to a higher risk of
through its saliva. The longer the tick is attached, the higher
severe disease in sickle cell disease.
The longer the tick is attached, the the chance of transmission
higher the chance of transmission
Babesiosa infection causes primarily blood

related symptoms, including hemolytic
anemia, hemoglobinuria, and resulting
jaundice.
Babesiosa infection can cause irregulary

cycling fevers. Babesiosa infection can cause
irregulary cycling fevers.
Babesiosa infection causes primarily blood

related symptoms, including hemolytic
anemia, hemoglobinuria, and resulting
Babezia is a parasitic protoza that Babezia is a parasitic protoza that causes
jaundice.
causes babesiosis. babesiosis.
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Bacillus anthracis colonies show a halo of

projections, sometimes refered to as
Bacillus anthracis classically causes "medusa head" appearance.
pulmonary infection in those who
work with wool and animal hide.
in U-world question stem

Babys are typically affected with Strep
agalactiae.
B for Babys and B-hemolytic
Bacteroides and E. coli are commonly

implicated in intraabdominal (i.e. abscess)
infections where a perforated appedicitis
ruptured.
Bacitracin inhibits cell wall formation by Bacitracin inhibits cell wall
inhibiting dephosphorylation of formation by inhibiting
Bactoprenol dephosphorylation of Bactoprenol
Usually polymicrobial, but B. fragilis and
E. coli are the most prominent organisms
isolated
Bactrim (Sulfamethoxazole/Trimethoprim Bartonella Henselae is the cause of Bats are the viral reservoir for filovirus.
(TMP-SMX)) can be used in prophylaxis Cat Scratch Disease.
and treatment of pneumocystis specifically the fruit bat.
pneumonia in patients without sulfa drug
allergies
recall that prophylaxis begins when a
patient's CD4+ count is < 200
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Birds are the reservoir for the West Nile

virus.
Benzathine Penicillin G is used as Benzathine Penicillin G is used as

prophylaxis of strep pharyngitis in prophylaxis of strep pharyngitis in
children with prior rheumatic fever children with prior rheumatic fever
Blood transfusions (before the 90's) Blood transfusions (before the 90's)
and IVDU are common modes of and IVDU are common modes of Bowel intussusception is the main
transmission of Hepatitis C. transmission of Hepatitis C. complication of RotaShield (Rotavirus
live-attenuated vaccine).
Don't forget placental,sex and breast Don't forget placental,sex and

feeding. breast feeding. d/t stimulation and enlargement of Peyer's
Patches
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Bunyavirus is an RNA segmented

Bronchoalveolar lavage (BAL biopsy) is
virus that includes Hantavirus.
used to confirm diagnosis of Pneumocystis
pneumonia
via bronchoscopy
C. Difficile is a gram-positive obligate

anaerobe that is characterized by watery
diarrhea and exotoxin attachment to the
brush border.
C. perfringens is a spore former that

produces a double zone of hemolysis.
req. anaerobic environment to be grown**

C. Difficile is a gram-
C. Difficile is a gram-positive obligate
positive obligate anaerobe that is
anaerobe that is characterized by watery
characterized by watery diarrhea
diarrhea and exotoxin attachment to the
and exotoxin attachment to the
brush border.
brush border.
CARS- Coxsackie A, Rickettsia, Syphilis

are three organisms that cause rash on the
C. perfringens is the only organism which C. perfringens produces gas
hands and feet.
can cause food poisoning in adults via gangrene (myonecrosis).
ingestion of spores.
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CMV esophagitis is characterized by a

single, deep, linear ulcerations found in the
esophagus on endoscopy.
CCR5 chemokine receptor is used in CD4 and CCR5/CXCR4 are host

early HIV infection. receptors which allow HIV entry
into T-cells.
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CMV is the number 1 cause of

CMV is the #1 cause of virus induced mental retardation and
sensorineural hearing loss from CMV treatments include Ganciclovir and
hearing loss.
congenital viral infection. foscarnet.
Woah, this is big. Goljan says about

40-50% will be positive for this
infection during their life.
Calicivirus is commonly associated with

diarrhea on a cruise ship.
Calici, Hepe, Reo, Picorna are the

CXCR4 chemokine receptor is used naked positive-sense RNA viruses. 90% of all diarrhea outbreaks are on
in late HIV infection.
cruises
Campylobacter jejuni may cause reactive Candida albicans results in white

arthritis or bloody diarrhea. Campylobacter is the most classic patches in the oral cavity that can be
cause of Guillain-Barre. scraped away
Autoimmune response with

demyelination of peripheral nerves
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Candida albicans is the most common

Candida albicans causes diaper rash due
cause of opportunistic mycoses Candida albicans causes diaper to the heat and humidity within a baby's
ie: immunocompromised patients rash due to the heat and humidity diaper
(HIV/AIDS, neutropenic patient, diabetics) within a baby's diaper
Candida albicans is commonly found Candida albicans is commonly

found growing on heroin. Candida albicans that extends from the
growing on heroin.
IV injection of the drug can mouth to the esophagus
IV injection of the drug can therefore lead
therefore lead to candidal is known as candidal esophagitis, which is
to candidal endocarditis
endocarditis an AIDS-defining illness
the first valve encountered is the tricuspid
the first valve encountered is the
tricuspid
Candida albicans that extends from the Catheters are a common cause of
Cat Scratch Fever is caused by
mouth to the esophagus nosocomial UTIs by pseudomonas.
Bartonella henselae in
is known as candidal esophagitis, which is immunocompotent patients.
an AIDS-defining illness
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Cefazolin is a cephalosporin that Ceftriaxone is a cephalosporine that can be

Cavernous sinus thrombosis is a serious can be used for surgical prophylaxis used to treat endocarditis by S. viridans
complication of Mucormycosis fungal to prevent S. aureus wound and HACEK organisms.
infection infections.
Chicken is the reservoir for Salmonella

enteritidis.
Ceftriaxone should be given for H.
influenza meningitis or systemic disease.
Cephalosporinase is a type
of β-lactamase that cleaves
cephalosporins.
Chlamydia spp. are obligate

Chlamydia spp. are obligate intracellular Chlamydia spp. are obligate intracellular
intracellular bacteria which are
bacteria which are diagnosed via NAAT bacteria which are diagnosed via NAAT
diagnosed via NAAT (PCR).
(PCR). (PCR).
McCoy cell cultures used before
McCoy cell cultures used before NAAT McCoy cell cultures used before NAAT
NAAT
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Chloramphenicol MOA
Chloramphenicol MOA Blocks peptidyltransferase at 50s

ribosomal subunit
Blocks peptidyltransferase at 50s
ribosomal subunit
Peptidyltransferase catalyzes formation of

peptide bond
Peptidyltransferase catalyzes
formation of peptide bond
Chlamydia is the most commonly reported

STI reported in the United States.
Chloramphenicol is an antibiotic that can

produce gray baby syndrome in infants
due to lack of liver UDP-
glucuronyltransferse.
Chloramphenicol resistance can

Enzyme is required for arise from production of Chloramphenicol resistance can arise from
metabolism/excretion of the antibiotic acetyltransferase, a plasmid- production of acetyltransferase, a plasmid-
encoded enzyme that inactivates the encoded enzyme that inactivates the drug.
drug.
Cholera toxin permanently activates Gs, Cholera toxin permanently Cidofovir and foscarnet are direct DNA
leading to increased Cl- secretion in the activates Gs, leading to increased polymerase inhibitors used in the treatment
gut. Cl- secretion in the gut. of of acyclovir/ganciclovir resistant HSV,
VZV, or CMV.
Water will follow Cl- Water will follow Cl-
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Cidofovir and foscarnet are direct DNA

polymerase inhibitors used in the treatment
of of acyclovir/ganciclovir resistant HSV,
VZV, or CMV. Cidofovir and foscarnet are two anti-viral
Cidofovir and foscarnet are two
anti-viral agents used to treat CMV agents used to treat CMV by binding
by binding directly to viral DNA directly to viral DNA polymerase.
polymerase.
do not require phosphorylation by a viral

do not require phosphorylation by a kinase.
viral kinase.
Cidofovir is a neucleoside analog that can Clarithromycin is a macrolide that

be used in the treatment of CMV with can be given with atovaquone to Clindamycin and poor hand washing are
UL97 mutation and HSV with thymidine treat Babesia. the main causes of nosocomial C. Difficile
kinase mutations. infection.
"Clean"-damycin
First Aid says azithromycin, so just
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remember macrolides in general
Clindamycin is a protein synthesis Clindamycin is a protein synthesis inhibitor

inhibitor that can be used in the that can be used to treat infection with
treatment of aspiration pneumonia Clostridium perfringens.
caused by airway Strep and oral
anaerobes.
Clindamycin and poor hand washing are penicillin as well (cell wall synthesis)
the main causes of nosocomial C. Difficile Oral anaerobes = fusobacterium,
infection. bacteroides, peptostreptococcus
"Clean"-damycin
Clindamycin is a protein synthesis inhibitor

that can be used to treat lung abscesses
Clonorcha sinensis and Paragonimus
caused by anaerobic infections.
Clonorcha sinensis westermani are two organisms with
and Paragonimus westermani are operculated eggs.
two organisms with operculated
For aspiration pneumonia and lung eggs.
abscesses, think oral anerobes
(fusobacterium, bacteroides,
peptostreptococcus)
-typical question stem: alcoholics,

anesthetized patients, epileptics (anything
with loss of conciousness that caused
aspiration of oropharyngeal contents)
Clostridium Botulinum is a gram-positive Clostridium Botulinum is a gram- Clostridium perfringes is a gram-positive,
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rod-shaped, obligate anaerobic, spore-

positive bacilli which causes
bacilli which causes botulism. forming pathogenic bacterium
botulism.
characterized by myonecrosis.
Clotrimazole and miconazole are the most

commonly used topical azoles.
Clostridium perfringes is a gram-

Clostridium perfringes is a gram-positive,
positive, rod-shaped, obligate
rod-shaped, obligate anaerobic, spore-
anaerobic, spore-forming
forming pathogenic bacterium
pathogenic bacterium characterized
characterized by myonecrosis.
by myonecrosis.
Clotrimazole and miconazole are the most Clotrimazole and miconazole are topical
commonly used topical azoles. Clotrimazole and miconazole are azoles that can be used to treat
topical azoles that can be used to dermatophytosis (tinea infections).
treat dermatophytosis (tinea
infections).
Colorado Tick fever is Colorado Tick fever is characterized

characterized by myalgia, fevers by myalgia, fevers and vomiting.
and vomiting.
Colonoscopy (suspect colon cancer) should
be performed with S. bovis infection.
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Colorado Tick fever is characterized

Condoloma Latta is characterized
by myalgia, fevers and vomiting.
by a lot of bumps that are flat
topped near the anus. Congenital syphilis is characterized
(smooth,moist,flat) by saber shins, Hutchinson teeth
and deafness.
Saber shins = anterior bowing of tibia

Hutchinson teeth = notched incisors or
mulberry molars
Congenital syphilis is
Congenital syphilis is characterized characterized by saber Congenital syphilis is characterized
by saber shins, Hutchinson teeth shins, Hutchinson teeth by saber shins, Hutchinson teeth
and deafness. and deafness. and deafness.
Saber shins = anterior bowing of tibia Saber shins = anterior bowing of Saber shins = anterior bowing of tibia
Hutchinson teeth = notched incisors or tibia Hutchinson teeth = notched incisors or
mulberry molars Hutchinson teeth = notched incisors mulberry molars
or mulberry molars
Contaminated water is the route of Cord factor is a virulence factor of

transmission of Hep A in Mycobacterium tuberculosis that
developing countries. activates macrophages forming a
granuloma to wall off the bacteria.
Contact lens wearers are at risk for corneal
Cord factor causes the release of cytokines
ulcers/keratitis from Pseudomonas
(like TNF-α) to cause macrophages to form
infection.
a granuloma
FA17 pg. 139
Cord factor is a virulence factor of Cord factor is a virulence factor of Corona, Retro, Flavi, Toga are the
Mycobacterium tuberculosis that Mycobacterium tuberculosis that enveloped positive-sense RNA viruses.
activates macrophages forming a activates macrophages forming a
granuloma to wall off the bacteria. granuloma to wall off the bacteria.
Flavored Corona at the Retro Toga party
Cord factor causes the release of cytokines Cord factor causes the release of
475 of 584 5/12/2018, 9:26 PM

(like TNF-α) to cause macrophages to form

a granuloma cytokines (like TNF-α) to cause
macrophages to form a granuloma
Corynebacterium diphtheriae is a
gram-positive rod that contains
metachromatic (blue/red)
granules. Cows are the intermediate host for T.
Sagginatum
Corona, SARS are the two genus of the

Corona family.
Coxiella burnetti is an obligate intracellular

Coxiella burnetti is an obligate organism that causes Q fever.
intracellular organism that causes Q
fever.
Cows are the intermediate host for T.

Sagginatum
Coxiella burnetti is an obligate intracellular Coxsackie A is the number 1 cause Coxsackie A virus causes hand, foot and
organism that causes Q fever. of viral meningitis. mouth disease.
CARS: Cox A, Rickettsia (RMSF),

Syphilis all cause rash on hands and feet
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Croup "Steeple Sign"

(Parainfluenza)
Cryoglobulins are serum proteins (IgM) in

Creamy, white, purulent discharge is seen Hep C virus which precipitate in colder
with Gonorrhea. temperatures.
Chlamydia is thin and watery
Cryptococcus neoformans is 5-10 Cryptococcus neoformans is 5-10

micrometers in diameter and its micrometers in diameter and its Cryptococcus is urease-positive
morphology can be described as narrow- morphology can be described as separates crypto from other fungi
based, with unequal budding. narrow-based, with unequal
note the unequal budding budding.
note the unequal budding
Cryptococcus is urease-positive Cutaneous leishmaniasis is caused Cutaneous leishmaniasis is caused

separates crypto from other fungi by Leishmania braziliensis by Leishmania braziliensis
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Cyptosporidium is a parasite that causes Cyptosporidium is a parasite that Cyptosporidium is a parasite that causes
severe diarrhea in causes severe diarrhea in severe diarrhea in
immunocompromised/suppressed (ie: immunocompromised/suppressed immunocompromised/suppressed (ie:
HIV/AIDS) patients (ie: HIV/AIDS) patients HIV/AIDS) patients
most common organism identified in HIV+ most common organism identified most common organism identified in HIV+
patients who have unrelenting diarrhea in HIV+ patients who have patients who have unrelenting diarrhea
unrelenting diarrhea
in individuals who are immunocompetent, in individuals who are in individuals who are immunocompetent,
crytosporidium causes mild, watery immunocompetent, crytosporidium crytosporidium causes mild, watery
diarrhea causes mild, watery diarrhea diarrhea
Cysticsarcosis is a complication of Tinnea D. Latum is the longest tapeworm.

species, caused by the ingestion of eggs in Diagnosis involves visualizing proglottid
water. segments on stool O&P
Cytotoxic T-cells mediate damage

in Hep B infection.
Virus travels to hepatocytes,

completes dsDNA genome; the CTL
response damages the liver cells
CD8 T-cells respond to viruses
D. Latum is the longest tapeworm. D. Latum is the longest tapeworm.

Diagnosis involves visualizing proglottid Diagnosis involves visualizing
segments on stool O&P proglottid segments on stool O&P
Dapsone + Rifampin + Clofazimine is the
treatment for leprematous form
of Mycobacterium leprae
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Dapsone + Rifampin + Clofazimine is the Dapsone + Rifampin is the Dapsone + Rifampin is the treatment
treatment for leprematous form treatment for tuberculoid form for tuberculoid form of Mycobacterium
of Mycobacterium leprae of Mycobacterium leprae leprae
Daptomycin is a lipopeptide that can be

used to treat MRSA bactermia.
Dapsone and Atovaquone are used

Dapsone and Atovaquone are used as
as prophylaxis for Pneumocystis
prophylaxis for Pneumocystis
jirovecii infection
jirovecii infection
Start prophylaxis when CD4+
Start prophylaxis when CD4+ count < 200
count < 200 cells/mm3 in HIV
cells/mm3 in HIV patients
patients
Daptomycin is ineffective in the Daptomycin is ineffective in the treatment

treatment of pneumonia due to of pneumonia due to inactivation by
Daptomycin is a lipopeptide used to treat pulmonary surfactant.
MRSA infections. inactivation by pulmonary
surfactant.
Dark field microscopy is needed for direct Deer mouse are the hantavirus Delavirdine, Efavirenz, and Nevirapine are
visualization of Treponema Palladium. reservoir. all NNRTIs used in HIV therapy.
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Fun fact: Outbreak of Sin Nombre

virus (the Four Corners outbreak in
the 90's where people started
blaming the Native Americans) in
the SW was due to increased
Silver stain can also be used. rainfall that year that lead to an
increase in population of deer mice
and, thus, an increase in chance
transmission with humans
(sweeping attics and inhaling all
the rat shit).
Delavirdine, Efavirenz, and Nevirapine are

all NNRTIs used in HIV therapy. Delavirdine, Efavirenz, and
Nevirapine are all NNRTIs used in
HIV therapy.
Dengue can cause thrombocytopenia and
hemorrhagic fever.
Dermatophytes are responsible for rashes Diabetes predisposes individuals

known as Tinea Dermatophytes are responsible for to Candida albicans infection
Dermatophytes colonize the skin, Tinea is rashes known as Tinea
the disease it causes - multiple types of Dermatophytes colonize the skin,
each Tinea is the disease it causes -
multiple types of each
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Diabetes predisposes individuals

to Candida albicans infection
Diffuse Large B-cell lymphoma is

associated with AIDS.
Diloxanide furoate is used in the treatment
of asymptomatic amebiasis; not available
in the US.
remains luminal amebicide of choice;

metronidazole does not work on luminal
form of the drug
Diphyllobothrium latum is a fish Diphyllobothrium latum is a fish Diphyllobothrium latum is a fish

tapeworm, which causes diarrhea (GI tapeworm, which causes diarrhea tapeworm, which causes diarrhea (GI
outcome) and is associated with a B12 (GI outcome) and is associated with outcome) and is associated with a B12
deficiency and megaloblastic anemia a B12 deficiency and megaloblastic deficiency and megaloblastic anemia
(vitamin deficiency/associated pathology). anemia (vitamin (vitamin deficiency/associated pathology).
deficiency/associated pathology).
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Doxycycline is a protein synthesis inhibitor

that binds to the 30s subunit and can be
Doxycycline and azithromycin are protein used in the treatment of chlamydia.
Doxycycline and azithromycin are
synthesis inhibitors that can be used to treat
protein synthesis inhibitors that can
atypical pneumonia caused by Mycoplasma
be used to treat atypical pneumonia
pneumonia. (inhibit the binding of aminoacyl-tRNA to
caused by Mycoplasma pneumonia.
the mRNA-ribosome complex.)
Atypical pneumonia, PID, urethritis,
cervicitis, etc.
-Also macrolides (azithromycin), but they
bind to 50s
E. Granulosus (cestode) infections present E. Granulosus (cestode) infections present

with hydatid cysts in the liver, with E. Granulosus (cestode) infections with hydatid cysts in the liver, with
eggshell calcifications in the liver on CT. present with hydatid cysts in the eggshell calcifications in the liver on CT.
liver, with eggshell calcifications in
the liver on CT.
E. coli is the leading cause of gram- E. coli is the leading cause of EBV is characterized by infectious
negative sepsis. gram-negative sepsis. mononucleosis with a positive monospot
IgG test.
Tender lymphadenopathy, fever, pharyngitis

and tonsillar exudate.
Monospot is a heterophile test.
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EBV is characterized by reactive CD8+

T-cells (Downey or atypical cells) seen on
EBV is characterized by reactive blood smear.
CD8+ T-cells (Downey or atypical
cells) seen on blood smear.
EBV is characterized by infectious
mononucleosis with a positive monospot
IgG test.
Tender lymphadenopathy, fever, pharyngitis

and tonsillar exudate.
Monospot is a heterophile test.
Earthquakes are a risk factor for Earthquakes are a risk factor for the
ELISA is a screening test for HIV. the spread spread of coccidoidomycosis infection due
of coccidoidomycosis infection due to their ability to kick up dust and their
to their ability to kick up dust and high prevalence in the Southwestern U.S.
their high prevalence in the due to the San Andreas Fault
Southwestern U.S. due to the San
Andreas Fault
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Echinocandins are fungal cell wall

synthesis inhibitors that can be used to treat Echinocandins are fungal cell wall
esophageal candidiasis. synthesis inhibitors that can be used
to treat invasive aspergillosis.
Echinococcus presents as a mass in the

liver that is treated surgically
Ecthyma gangrenosum
in Pseudomonas patients are
characterized as black necrotic skin
lesions.
Efavirenz is an NNRTI that can produce

Echo, Cox, Polio are three enteroviruses CNS symptoms (dizziness, drowsiness,
that cause aseptic meningitis. headache, psychosis).
Ecthyma gangrenosum occurs from

perivascular invasion and release
of tissue-destructive exotoxins,
causing vascular destruction and
insufficient blood flow
Common in neutropenic,
hospitalized, or burn patients, or
patients with catheters
Efavirenz is an NNRTI that can produce Endemic (African) Burkitt Endemic (African) Burkitt lumphoma is
insomnia and nightmares. lumphoma is characterized by a characterized by a large jaw lesion and
large jaw lesion and swelling. swelling.
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Endemic Burkitt Lymphoma is

characterized by starry sky appearance on
histological exam. Enfuvirtide is a HAART drug that
binds gp41, inhibiting fusion and
entry of HIV.
Remember, sporadic form is most
commonly seen in the abdomen (had a Entamoeba histolytica presents as a mass
U-world question on this; pt. had mass in the liver that is treated
around the intestines, high mitotic index, pharmacologically
etc.) you do not drain the liver abscesses of
Entamoeba histolytica, instead treat with
metronidazole + paramycin/iodoquinol
Entamoeba histolytica causes blood Entamoeba Enterococcus faecalis is a strain of

diarrhea (dysentery), liver abscess histolytica causes blood diarrhea Enterococcus that is more prevalent, but
("anchovy paste" exudate), RUQ pain with (dysentery), liver abscess ("anchovy less pathogenic.
histology showing a flask-shaped ulcer and paste" exudate), RUQ pain with
is treated with Metronidazole (iodoquinol histology showing a flask-shaped
for asymptomatic cyst passers) ulcer and is treated
with Metronidazole (iodoquinol
for asymptomatic cyst passers)
Enterococcus faecium is a strain of Env structural (HIV) gene Env structural (HIV) gene encodes gp41
enterococcus that is more pathogenic, but encodes gp41 and gp120 which are and gp120 which are viral envelope
less prevalent. viral envelope proteins for proteins for infiltration.
infiltration.
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Erysipelas is an infection of the upper

dermis and superficial lymphatics caused Erythema Nodosum symbolizes a Erythema Nodosum symbolizes a robust
by GAS, and presents with a well-defined robust immune response, therefore immune response, therefore this symptom
demarcation between infected and normal this symptom of coccidioidomycosis and
skin. of coccidioidomycosis and histoplasmosis typically occurs in
histoplasmosis typically occurs in otherwise healthy patients
otherwise healthy patients
Typically occurs more often in Typically occurs more often in cocci, but
cocci, but use region of country to use region of country to differentiate b/t
differentiate b/t cocci and histo cocci and histo
Erythromycin is a macrolide antibiotic that

can be used to treat diptheria caused by
Erythema multiforme may occur 1-2 weeks Corynebacterium diptheriae.
after HSV infection. Erythrogenic exotoxin (SPE) is a
toxin associated with scarlet fever.
Type IV HSR.
Erythromycin is an antibiotic that Exfoliative toxin A and B produces Explosive, watery diarrhea is the main
stimulates motilin receptors, producing scalded-skin syndrome. clinical complication of Norwalk virus.
diarrhea.
Vomiting often present, most common
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cause of diarrhea in adults.

Watery diarrhea also caused by rotavirus,
norovirus, adenovirus
Can be used to stimulate peristalsis
FTA-Ab is a specific (confirmatory) test FTA-Ab is a specific (confirmatory) test

for a positive screening of Treponema FTA-Ab is a specific (confirmatory) for a positive screening of Treponema
Palladium. test for a positive screening Palladium.
(Or TPPA) of Treponema Palladium. (Or TPPA)
(Or TPPA)
Fanconi syndrome is a cause of Farm animals are a major reservoir as

Face → down is the direction of the Coxiella is contained in spore like
type 2 RTA that is associated with
maculopapular rash in Measles (rubeola). structures in animal feces.
use of expired tetracyclines.
Farm animals are a major reservoir as Fidaxomicin is a macrocyclic

Coxiella is contained in spore like Fidaxomicin is a macrocyclic antibiotic
antibiotic used to treat C. difficile
structures in animal feces. used to treat C. difficile by inhibiting RNA
by inhibiting RNA polymerase.
polymerase.
FDA approved for use of C. difficile

FDA approved for use of C. difficile colitis;
colitis; as effective as vancomycin
as effective as vancomycin and lower rates
and lower rates of relapsing
of relapsing disease
disease
****
****
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Fluconazole is an azole antifungal that can

be used to treat vaginal candidiasis.
Filamentous hemagglutinin is the protein Fimbriae are a virulence factor
responsible for Pertussis' ability to attach to necessary for E. coli to produce a
human cells. UTI.
(Catarrhal → Paroxysmal → Convalescent)
Fluoroquinolones (-oxacin) are inhibitors

Fluoroquinolones should not be
of prokaryotic topoisomerase that can be
administered to children <18 due to
used to treat acute prostatitis.
Fluoroquinolones are nucleic acid damage to growing cartilage.
synthesis inhibitors that can be
used to treat Salmonella
gastroenteritis and osteomyelitis.
FA and class notes say <18
Foscarnet is the treatment for CMV when Foscarnet is an antiviral therapy Foscarnet is used in the treatment of CMV
the UL97 kinase gene mutation leads to that can predispose to hypokalemia. retinitis when ganciclovir fails.
resistance to ganciclovir.
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Fusobacterium is a gram-negative
anaerobe found in the mouth that
Fusion protein is a virulence factor can produce lung abscesses.
contained in all
paramyxoviruses (parainfluenza, measles,
Fusobacterium and
mumps, and RSV).
peptostreptococcus are sampled
I.e. can form syncytium. from a lung abscess. Which of the
following is the most likely
predisposing cause? (Seizures was GAS virulence factor is streptokinase.
answer)
-Anaerobes (Fusobacterium,
peptostreptococcus, bacteroides) or
S. aureus
-Caused by aspiration of
oropharyngeal contents (esp. in
patients predisposed to loss of
conciousness (epileptics,
alcoholics) or bronchial obsturction
Gametocytes are the form that can

reproduce sexually in the Plasmodium life
cycle
They are also the form that infects the

Ganciclovir and valganciclovir are
mosquito from an infected human host.
guanosine analogs used as CMV
Remember, they dont reproduce sexually
Ganciclovir treatment for CMV prophylaxis in transplant patients.
until the get to the mosquito's gut. That is,
all forms of reproduction inside the human
host are asexual.
Merozoites can either keep reproducing

inside the human host, or the can become
gametocytes to infect Anopheles
mosquitoes.
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Giardia lamblia causes bloating, Giardia lamblia causes bloating, Glomerulonephritis (PSGN) is a type III
flatulence, foul-smellng, fatty diarrhea flatulence, foul-smellng, fatty HS that is preceded by GAS pharyngitis or
(often seen in campers/hikers) and is diarrhea (often seen in skin infection.
treated with Metronidazole campers/hikers) and is treated with
Metronidazole
Griseofulvin deposits in keratin- Griseofulvin is a microtubule fungal

containing tissues, such as skin and nails, Griseofulvin deposits in keratin- inhibitor that can produce a disulfiram-
and is therefore used for severe containing tissues, such as skin and like reaction.
dermatophyte infections nails, and is therefore used for
severe Tinea (ringworm) or persistant severe dermatophyte infections
onychomycosis severe Tinea (ringworm) or
persistant onychomycosis
Griseofulvin is an antifungal agent that Griseofulvin is an oral treatment of

binds to microtubules, disrupting mitosis. superifical fungal infections.
used when topical agents are

resistent
Group B Strep has a positive CAMP test.
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Guillain Barre syndrome is a neurological

complication associated with
Group B Strep is the number 1 cause of
Campylobactor and Influenza.
meningitis in neonates.
Guarnieri bodies are the sites of
viral replication of Pox virus.
Will not present with classic signs (stiff
Ascending paralysis. Findings include high
neck, etc.)
protein with low WBCs.
Guillain Barre syndrome is a neurological

complication associated with
Campylobactor and Influenza.
Ascending paralysis. Findings include high Guillain-Barre syndrome

protein with low WBCs. and congenital microcephaly are Guillain-Barre syndrome and congenital
two conditions associated with microcephaly are two conditions associated
Zika virus (flavivirus). with Zika virus (flavivirus).
Most cases are mild to Most cases are mild to asymptomatic.
asymptomatic.
H. influenza is characterized by H. influenza is characterized by an

a "cherry-red" epiglottitis in inflammed epiglottis, inspiratory stridor,
Gummas in tertiary syphilis are children. and drooling in children
characterized by a soft growth with a firm
necrotic center.
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HBV and HCV are the 2 primary causes of

hepatocellular carcinoma from a virus.
HA, NA, F are the virulence factors in HA and F are the virulence factors
Mumps. in Measles (rubeola).
Mumps and Parainfluenza contain all 3. No NA
HBeAg marker indicates high

HBV is not a retrovirus but has reverse HBsAg marker indicates activate infection
infectivity with Hep B.
transcriptase. with Hep B.
HBeAg is secreted by infected

hepatocyte into circulation and
indicates active viral replication
and therefore high transmissibility
HHV-8 (Kaposi Sarcoma) causes primary

HHV-7 is a less common cause of effusion lymphoma.
roseola.
HEV genus falls in the Hepe family. A type of B cell lymphoma.
Primarily HHV-6
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HHV-8 causes proliferation of vasculature

via disregulation of VEGF.
HIV retinitis is characterized by

Vascularity gives the lesions a violet color "cotton wool" spots on fundoscopy
of CMV patient.
HIV, HTLV are the Retroviruses.
HIV uses CCR5 and CXCR4 co-receptors HPV 16, 18, 31 and 33 are HPV 6-11 cause condyloma acuminata on
to bind to target host cells. associated with squamous cell the genitals.
carcinoma of the cervix, vulva,
vagina, anus, and penis.
Left: HPV 1-4 Verruca vulgaris; Right:
HPV 6-11 Condyloma acuminata
Add 15 to 16 and 18 to remember

31 and 33. (16/18 are more
common)
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HSV-1, HSV-2, VZV are all characterized

by multinucleated giant cells on Tzanck
smear.
HSV and VZV can be diagnosed with a
Tzank smear.
HSV-1 is characterized by herpes

labialis, keratoconjunctivitis and
temporal lobe encephalitis .
Hemagglutinin (HA) is a virulence factor Hemagluttinin antigens Hemagluttinin, M2 protein

that binds sialic acid and promotes viral determine influenza's tropism. and Neuraminidase are the virulence
entry. factors for Influenza.
Parainfluenza, Mumps, Measles
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Hemorrhagic cystitis is a bladder

complication of adenovirus
infection.
Hep B is a DNA virus associated with

Hemorrhagic cystitis in adenovirus membranous glomerulonephritis.
Also caused by BK nephropathy
infection is characterized by gross
(renal transplant pt)
hematuria.
Also MPGN below (tram-track

appearance).
Kidneys are damaged by PAN.
Hepatitis A infection leads to an aversion Hepatitis C is transmitted through Herpes Zoster (shingles) is a painful rash
to smoking. blood products and IV drug users. that follows a dermatomal distribution.
Rarely crosses the midline, if it crosses it

mean it is disseminated VCV.
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Herpes Zoster (shingles) is the reactivated

Herpes genitalis associated with HSV-2
form of VZV. Herpes genitalis associated with causes a painful inguinal
HSV-2 causes a painful inguinal lymphadenopathy.
lymphadenopathy.
Herpetic whitlow is caused by HSV-1 & 2 Herpetic whitlow is caused by

and is common in dentists and health care HSV-1 & 2 and is common in
workers. dentists and health care workers.
Histoplasma Capsulatum is associated

with bat and bird droppings, therefore
spelunkers who explore caves are at risk,
or farmers with chicken coops.
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Histoplasma and Coccidiodes are

two organisms associated with
cavitatary lung lesions and
erythema nodosum.
Histoplasma Capsulatum is associated Hodgkin Lymphoma (RS cells that look

with bat and bird droppings, therefore like Owl's Eyes) and Endemic or African
spelunkers who explore caves are at risk, Burkitt Lymphoma (large jaw lesion and
or farmers with chicken coops. swelling)
Hutchinson teeth are notched incisors or Hyponatremia, high fever, diarrhea, ICAM-1 receptor is the host-cell receptor
mulberry molars. headache/confusin (CNS) which rhinovirus attaches to in the URT.
symptoms assoc. with Legionnaires'
atypical pneumonia Grows best in cool temp. (33C) such as
URT.
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IFN-⍺ is a interferon that is used to treat INF-a is an interferon that can be used in
malignant melanoma. IFN-⍺ is a interferon therapy that the treatment for Hep B (and Hep C).
may produce a flu-like syndrome,
depression, tinnitus, and
retinopathy.
IV saline can be administered before/with IVDU most commonly obtain

IVDU, Diabetics are two
amphotericin to reduce nephrotoxicity. endocarditis from S. aureus.
groups susceptible to osteomyelitis
from Pseudomonas.
Hence it will be most commonly on

Injected into the veins, infection of tricuspid valve
diabetic foot ulcer, infection
through foot injury
IgA protease is a virulence factor used by Inclusion bodies are seen under a India ink stains and outlines the heavy
Neisseria meningitidis that is also found microscope in Chlamydia infected capsule that surrounds Cryptococci fungi,
in S. pneumonia and H. influenza. cells. giving it a unique "halo" appearance
Inclusion bodies = Elementary
bodies
Also seen in S. pneumonia, H. influenza
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India ink stains and outlines the heavy

capsule that surrounds Cryptococci fungi,
giving it a unique "halo" appearance
Infants and children (<5) have an Influenza (orthomyxovirus) is the only

increased risk of RNA virus which replicates in the nucleus.
gastroenteritis from rotavirus. Most common cause of the flu, strains
ABC.
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Ingestion of spores (honey, juice) is the

route of transmission in babies with
Influenza is the most important botulism.
orthomyxovirus.
vs. adults (ingestion of preformed toxin)

Influenza is part of the orthomyxo family.
Irreversible inhibition of the initiation

complex through binding of the 30S
subunit
MOA of aminoglycosides
Inspiratory stridor is the main presenting Intrapartum penicillin should be

symptom of Croup. given to preggos for Group B Strep
prophylaxis.
35 weeks *****
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Irreversible inhibition of the initiation

complex through binding of the 30S
subunit
MOA of aminoglycosides
Itraconazole is an azole that is used
to treat Sporothrix schenckii
sporotrichosis.
Jarisch Herxheimer reaction is the dying

spirochetes releasing cytokines (i.e.
LPS) characterized by fever and chills.
Form of endotoxic shock. This is a good

indicator that the treatment is working.
Jarisch Herxheimer reaction is the dying KOH is used to prep oral scrapings Kaposi's Sarcoma is characterized by
spirochetes releasing cytokines (i.e. when attempting to diagnose oral violacious lesion on the nose, extremities,
LPS) characterized by fever and chills. candidiasis mucous membranes and hard palate.
Form of endotoxic shock. This is a good

indicator that the treatment is working.
May be present as a plaque, patch, macule,

or nodule. These rise from primitive
mesenchymal cells involving angiogenesis
causing the violaceus color.
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Keratoconjunctivitis (HSV-1) is
characterized by serpiginous ulcers
Kaposi's sarcoma can produce lesions in on the cornea seen on fluorescein
the GI tract caused by HHV-8. slit lamp exam.
Ketoconazole is an anti-fungal that can
Due to viral replication in the inhibit overproduction of cortisol and treat
corneal epithelium. symptoms of Cushing's disease.
seems like a scant fact but have actually
come across this in quite a few questions
Ketoconazole is an antifungal that can

Ketoconazole is an antifungal that inhibit 17,20-desmolase, the first step of of
can inhibit 17,20-desmolase, the steroid synthesis from cholesterol.
first step of of steroid synthesis
Ketoconazole is an anti-fungal therapy that
from cholesterol.
can produce menstrual irregularities in
women.
ketoconazole inhibits mammalian

cytophrome p450 enzymes
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Klebsiella Pneumoniae has a large Klebsiella Pneumoniae is a member of the

Klebsiella Pneumoniae lung abscesses mucoid capsule, which gives the enterobacter family that is non-motile.
sputum a thick, viscous appearance.
"Currant-Jelly" sputum
Klebsiella, Enterobacter and

Serratia from the enterobacter
family are associated Koilocyte
with nosocomial infections,
pneumonia, and UTI.
Klebsiella is a urease-positive bacteria

often confused with Tuberculosis on chest
x-ray.
Sampled from transformation zone.
Koplik spots are characterized by red spots Lamivudine is an NRTI that can be Ledipasvir is an NS5A inhibitor given with
with a blue or white center found on the used in the treatment of Hep B. Sofosbuvir and Simeprevir in the
buccal mucosa in Measles. treatment of hepatitis C.
lamivudine is an old treatment. New
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treatment is PEG IFN-a and

entecavir + tenofovir (rev
transcript inhibs).
Legionnaires' atypical pneumonia is

associated with hyponatremia, diarrhea,
CNS symptoms and high fever.
Pneumonia with GI symptoms, CNS

symptoms, hyponatremia, high fever....
Legionella
Legionella is associated with pontiac

fever which is characterized as self-
limiting fever and malaise. Legionella is grown on buffered
charcoal yeast extract.
grows black colonies on BCYE
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Leishmania donovani causes spiking Leishmania Leishmania donovani causes spiking

fevers, hepatosplenomegaly, donovani causes spiking fevers, fevers, hepatosplenomegaly,
pancytopenia and is treated hepatosplenomegaly, pancytopenia and is treated
with Amphotericin B and/or sodium pancytopenia and is treated with Amphotericin B and/or sodium
stibogluconate with Amphotericin B and/or stibogluconate
sodium stibogluconate
Levofloxacin and ciprofloxacin are nucleic

Levofloxacin and ciprofloxacin are acid synthesis inhibitors that are used in the
Leukoplakia results in white patches in nucleic acid synthesis inhibitors treatment of Pseudomonas aureginosa
the oral cavity that can NOT be scraped that are used in the treatment of UTI.
away Pseudomonas aureginosa UTI.
Precancerous
elevate and cip

elevate and cip
Linezolid is a protein synthesis inhibitor Linezolid is a protein synthesis inhibitor

Linezolid is a protein synthesis
that can treat nosocomial pneumonia used to treat both MRSA and VRE.
inhibitor that can treat nosocomial
caused by MRSA infections. pneumonia caused by MRSA
infections.
Lipid degradation produces acid that Lipid degradation produces

damages melanocytes in Pityriasis acid that damages melanocytes in
Versicolor (results in Pityriasis Versicolor (results in
hypo/hyperpigmentation) hypo/hyperpigmentation)
caused my M. furfur caused my M. furfur
Listeria monocytogenes is the 3rd most

leading cause of neonatal meningities
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Lymphocytes infiltrate the portal Lymphocytes infiltrate the portal tract

tract killing hepatocytes, leading to killing hepatocytes, leading to fibrosis and
fibrosis and cirrhosis in HCV cirrhosis in HCV infection.
infection.
Liver damage due to inflammation.

Liver damage due to inflammation. Lymphoid aggregates can be seen on liver
Listeria monocytogenes is the 3rd most biopsy
Lymphoid aggregates can be seen
leading cause of neonatal meningities
on liver biopsy
M-protein and Hyaluronic acid capsule are

antiphagocytic virulence factors for GAS.
M-protein is a GAS virulence M2 protein is an Influenza virulence factor

factor that causes antibody inhibited by Amantadine.
production which cross-reacts with
myosin in the heart, causing
rheumatic fever.
Molecular mimicry
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MMR and VZV are the two live viral

vaccines that can be given to patients with
CD4 counts > 200.
MRSA has an altered PBP target

Macrolide and Ciftriaxone are the
site and are thus resistant to anti-
treatment for Strep pneumonia.
staph penicillins.
Nafcillin oxacillin, dicloxacillin,

methicillin
Macrolides bind to the 23S rRNA

of the 50S ribosomal subunit,
blocking translocation.
Macrolides have a slightly wider spectrum
Macrolides (Azithro) and fluoroquinolones than penicillins, thus are a common
can be used to treat Legionella. substitute for patients with penicillin
allergy.
tx covered in pharm lectures
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Malassezia furfur can infect the Malassezia furfur can infect the
Malassezia furfur (M. furfur) produces blood (fungicemia) of neonates receiving
melanocyte damaging acids via lipid blood (fungicemia) of neonates
receiving TPN, causing TPN, causing severe symptoms
degradation due to lipids in the TPN (M. furfur is
results in the hypo/hyperpigmentation seen severe symptoms
due to lipids in the TPN (M. furfur lipophilic) - can infect adults, but
in pityriasis versicolor symptoms are NOT as severe
is lipophilic) - can infect adults, but
symptoms are NOT as severe
Maraviroc is a CCR5 inhibitor for HIV.

Measles is characterized by cough,
coryza, conjunctivitis and koplik
spots followed by maculopapular
"mare-w/-rock" (horses shoes are made of rash.
rock :P) Meats and cream-based foods are
implicated foods in S. aureus
gastroenteritis.
Think pastries, mayo with short-onset
Metachromatic (red and blue) granules are Metronidazole functions by Metronidazole functions by forming toxic
seen in C. diptheriae. forming toxic free radical free radical metabolites in the bacterial
metabolites in the bacterial cell that cell that damage DNA
damage DNA
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Metronidazole functions by forming toxic

free radical metabolites in the bacterial
cell that damage DNA
Metronidazole is the amebicide of choice
Metronidazole is a free-radical for treating invasive amebiasis caused by
forming antibacterial that can be E. histolytica.
used in the treatment of
polymicrobial anaerobic infections
(intra-abdominal infections).
covered in antimicrobials
Mixed cellularity Hodgkin

Lymphoma and Burkitt Lymphoma
are two lymphomas associated with Mixed cellularity Hodgkin's lymphoma is
EBV infection. more commonly associated with EBV.
Miliary tuberculosis is a systemic form
that is lethal.
Owl = Reed Sternberg Cells for
Hodgkin
Molluscum contagiosum (Pox) are flesh- Molluscum contagiosum (Pox) are Mucormycosis hyphae are non-septated
colored, dome-shaped, umbilicated lesions flesh-colored, dome-shaped, with wide-angled (90°) branching
on the trunk with a waxy surface. umbilicated lesions on the trunk
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with a waxy surface.
Mucormycosis hyphae are non-septated

with wide-angled (90°) branching
Multiple serotypes makes vaccines

for rhinovirus improbable.
>100
Mycobacterium avium-intracellulare
causes disseminated non-TB disease in
AIDS patients.
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NNRTIs are reverse transcriptase inhibitors

that do not require phosphorylation to be
MΦs (macrophages) and helper T-cells are N. meningitidis contains LOS activated.
the cells that HIV infects. instead of LPS which cause an
inflammatory response.
NRTI's are nucleoside/-tide analogs that Naegleria fowleri causes rapidly Naegleria fowleri causes rapidly fatal
can produce lipodystrophy. fatal meningoencephalitis and meningoencephalitis and is treated
is treated with Amphotericin B with Amphotericin B
more associated with protease inhibitors
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Nasopharyngeal carcinoma is a cancer

Nalidixic acid is a 1st generation associated with Asian patients with EBV.
Nafcillin is the treatment for non-MRSA
quinolone that treats gram negative
Staph infection.
uncomplicated UTIs.
Necrotizing fasciitis is caused by GAS and

enters through trauma openings causing
Nasopharyngeal carcinoma is a cancer Nasopharyngeal carcinoma is a infection and ultimately necrotic skin with
associated with Asian patients with EBV. cancer associated with Asian large bullae.
patients with EBV.
Negri bodies are eosinophilic inclusions Negri bodies are eosinophilic Negri bodies are eosinophilic inclusions
found in the purkinje cells of the inclusions found in the purkinje found in the purkinje cells of the
cerebellum and pyramidal cells of cells of the cerebellum and cerebellum and pyramidal cells of
hippocampal neurons. pyramidal cells of hippocampal hippocampal neurons.
neurons.
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Negri bodies are eosinophilic inclusions Neomycin is an aminoglycoside Neuraminidase promotes the release
found in the purkinje cells of the that is poorly absorbed, thus it stays of virion progeny (influenza, paramyxo,
cerebellum and pyramidal cells of in the gut, making it a useful etc.) by cleaving silica acid.
hippocampal neurons. prophylactic before bowel surgery.
leads to URT infection -> viremia +

cytokines release -> myalgia -> access to
lungs -> desquamination of
bronchial/alveolar epithelium -> viral
pneumonia then secondary bacterial
pneumonia.
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Neurocysticercosis is a cestode disease,

presenting with seizures and lesions in the
Neurocysiticercosis is treated with brain visible on CT.
albendazole (cestode/tinnea disease, within Neurocysiticercosis is treated with
CNS) albendazole (cestode/tinnea disease,
within CNS)
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Neurocysticercosis is a form of
cysticercosis infecting the CNS.
Presents with seizures, lesions on Brain,
eyes and skin.
Nitrofurantoin is a urinary antiseptic can

Neutralized TNF-α causes trigger hemolysis in G6PD deficiency
reactivated tuberculosis in patients.
immunocompromised patients.
2 things to know: used for UTIs in

G6PD
Nitrofurantoin is a urinary antiseptic can Nocardia cutaneous infections are Nocardia cutaneous infections are
trigger hemolysis in G6PD deficiency characterized by indurated lesions characterized by indurated lesions and an
patients. and an inflammatory reaction. inflammatory reaction.
2 things to know: used for UTIs in

G6PD
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Nocardia is a filamentous-branching gram-

Nocardia is a filamentous- positive organism that can cause brain
Nocardia cutaneous infections are abscesses.
characterized by indurated lesions and an branching gram-positive organism
inflammatory reaction. that can cause brain abscesses.
Non-capsulated strains of H. influenza are

the most common cause of mucosal and
invasive infections since the capsular type
B vaccine was introduced.
Nocardia is a gram-positive,
Nocardia is a gram-positive, catalase-
catalase-positive soil organism that
positive soil organism that has an increased
has an increased risk in patients
risk in patients with CGD.
with CGD.
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Non-enhancing multifocal brain lesions in

the white matter will be seen on Northeastern U.S. is the geographic
neuroimaging of a patient with PML. distribution of Lyme disease.
Norovirus is the most common

Vs. toxoplasma which is ring-enhancing calicivirus.
lesions
Crown represents lesions
Nystatin is a polyene that can be used to

Nystatin is a polyene that can be treat vaginal candidiasis.
Norwalk (Noro) virus genus belongs to the
Calici family. used to treat vaginal candidiasis.
Oligodendrocytes are damaged in

PML. Onchocerca volvulus is often found around
rivers in Africa, Central America, and
South America.
October is the optimal time to receive an
Influenza vaccine.
Gives the body time to mount response for

flu-season
Oral Hairy Leukoplakia in HIV patients is Oral Hairy Leukoplakia is an Orchocerta volvulus infection is also
a non-cancerous lesion on the lateral unscrapable white plaque on lateral known as river blindness and is the second
tongue that can arise as a complication of tongue associated with EBV. most common cause of blindness due to
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EBV.
infection.
After trypanoma (from chlamydia)
Non-cancerous
Oseltamivir and Zanamivir inhibit Oseltamivir and Zanamivir inhibit

Orchocerta volvulus infection is also Influenza neuraminidase, which Influenza neuraminidase, which decreases
known as river blindness and is the second decreases the release of progeny the release of progeny virus.
most common cause of blindness due to virus.
infection.
After trypanoma (from chlamydia)
Osletamivir and Zanamivir are effective

against what virus? Osletamivir and Zanamivir are
effective against what virus?
Treatment and prevention of Influenza A Otitis externa is a type of ear infection
and B Treatment and prevention of associarted with pseudomonas.
Influenza A and B
Burrows into the mastoid bone, primarily

in elderly, diabetic patients
Otitis media is an ear complication PCR is the test of choice for HSV. PERCH: Polio, Echo, Rhino, Cox,
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associated with H. influenza.

HAV are the five Picorna genus.
usually due to S. pneumo
PSGN is a complication of GAS

Palivizumab is an antibody that Palivizumab is an antibody that targets
pharyngitis or skin infection that presents
targets RSV F proteins for RSV F proteins for prophylaxis in infants.
with hematuria (cola-colored urine) and
facial swelling. prophylaxis in infants.
Paracoccidioidomycosis has a
Paracoccidioidomycosis has a geographical distribution localized to
geographical distribution localized South America
to South America referred to as the "Brazillian
Papilloma, Polyoma, and Hepadna are referred to as the "Brazillian Blastomycoses"
DNA virus families with circular Blastomycoses"
genomes.
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Parainfluenza, RSV, Measles, Mumps are

the Paramyxoviruses.
Parainfluenza (Croup) is associated with
"Seal bark cough."
Parainfluenza and mumps are
members of the Paramyxo family
that contain all three virulence
Pathogenicity: Innoculation which lead
factors (HA, NA, F).
to Viremia (local replication in parotid
gland) ->systemic infection ->
(testes/ovaries, CNS/PNS, eye, ear) ->
(Pancreas -> leads to juvenile DM).
Parogoniumus westermonti is a fluke that Paromomycin is an aminoglycoside

presents with chronic cough and bloody Parogoniumus westermonti is a luminal agent that is effective against
sputum. fluke that presents with chronic Entamoeba histolytica.
cough and bloody sputum.
Paromomycin is an aminoglycoside
luminal agent that is effective against Penicillin-binding proteins are
Entamoeba histolytica. bacterial enzymes involved in cell
wall synthesis that are the target
site for β-lactam antibiotics.
Penicillinase is a type of β-lactamase that

cleaves penicillins.
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Pentamidine can be used in prophylaxis Pertussis toxin disables

and treatment of pneumocystis Pertussis toxin disables
chemokine receptors for lymphocytes,
pneumonia in patients with sulfa drug chemokine receptors for
producing lymphocytosis.
allergies lymphocytes, producing
recall that prophylaxis begins when a lymphocytosis.
ADP disables Chemokine receptor for
patient's CD4+ count is < 200 lymphocytes
normal treatment (Bactrim) is combo of ADP disables Chemokine
Sulfamethoxazole/Trimethoprim receptor for lymphocytes
Pertussis toxin disables

chemokine receptors for lymphocytes,
producing lymphocytosis.
ADP disables Chemokine receptor for

lymphocytes Pigs are the intermediate host for T. Pigs are the intermediate host for T. Solium
Solium
Pneumocystis pneumonia can present with

a "ground-glass" appearance on chest xray
Pneumocystis jiroveci is
Pneumocystis jiroveci is responsible for
responsible for causing
causing Pneumocystic pneumonia
Pneumocystic pneumonia
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may not see anything at all
Pneumocystis pneumonia can present with

a "ground-glass" appearance on chest xray Pneumocystis pneumonia causes
diffuse interstitial pneumonia that
may take on a ground-
glass appearance on chest xray
Pneumonia is a respiratory complication in

Measles.

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Post-herpetic neuralgia is Post-herpetic neuralgia is the most

Poliomyelitis is characterized by characterized by pain along the common complication of shingles.
meningitis, encephalitis, GI symptoms and dermatomal distribution after
is caused by poliovirus. shingles rash subsides.
Poxvirus have a dumbell shaped core. Primary syphilis is characterized by

Primary syphilis is characterized by painless genital chancre which heal in 3 to
painless genital chancre which heal 6 weeks.
in 3 to 6 weeks. Chancres appear 1-3 weeks after infection.
Chancres appear 1-3 weeks after Highly infectious state.
infection. Highly infectious state.
Protease inhibitors are a group of

anti-retroviral inhibitors of HIV-1
Primary syphilis is characterized by protease that can produce
painless genital chancre which heal in 3 to lipodystrophy (Cushing-like
Pseudomonas = obligate aerobe
6 weeks. syndrome).
Chancres appear 1-3 weeks after infection.
Highly infectious state.
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Pseudomonas and
Diptheria produce a toxin
which ADP ribosylates and Pseudomonas can cause Ecthyma
Pseudomonas infection is characterized by
inactivates EF2, inhibiting protein gangrenosum, which are black necrotic
nosocomial pneumonia and respiratory
synthesis. lesions on the skin
failure in cystic fibrosis patients.
Pseudomonas = exotoxin A
Diptheria = diptheria toxin (AB
toxin)
Pseudomonas can produce a blue-green

pigment, fruity odor, and is associated Pseudomonas is a gram-negative organism
with nosocomial UTI's. Pseudomonas infection is associated with otitis externa.
associated with burn patients.
aeruginosa is a gram negative rod
Pseudomonas produces a similar toxin that Psuedomonas is associated with

has the same MOA as C. diptheria toxin. "fruity-grape" odor.
Pyrantel pamoate is the treatment of choice

for hookworm (ancyclostoma duodenale
and necator americanus) and enterobius
vermicularis.
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RSV attaches to alveolar epithelium via

G-protein on the viral envelope.
Pyrazinamide is an anti-
mycobacterial that is converted to
pyrazinoic acid, lowering the pH of
the environment.
Pyrantel pamoate is the treatment of choice

for hookworm (ancyclostoma duodenale mechanism largely unknown
and necator americanus) and enterobius
vermicularis.
RSV attaches to alveolar epithelium via RSV is the number 1 cause of pneumonia
G-protein on the viral envelope. and bronchiolitis in infants <6 months of
RSV is the most common viral age.
cause of atypical pneumonia in
infants < 6 months.
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Rabies virus is characterized

histologically as a bullet-shaped
virus.
Rabbits/rodents/deer are the main

reservoir of Francisella.
Transmitted via ticks
Rabies is part of the Rhabdovirus family.
Raltegravir prevents HIV genome Rapid plasma reagent (RPR) is a

Rapid plasma reagent (RPR) is a
integration into the host cell by binding screening test for Treponema
screening test for Treponema Palladium
viral integrase. Palladium with a high incidence of
with a high incidence of false positives.
false positives.
Mono, rheumatoid factor, SLE, leprosy or
Mono, rheumatoid factor, SLE,
IV drug user cause false positive
InTEGRase inhibitors: raltegravir,
526 of 584 5/12/2018, 9:26 PM

elvitegravir, dolutegravir
leprosy or IV drug user cause false

positive
Respiratory insufficiency is a
common cause of death from
poliovirus due to paralysis of the Retrovirus is the only RNA virus with a
Reovirus is the only dsRNA virus. diaphragm. diploid genome.
Makes sense if you're losing motor

function
Reverse Transcriptase is utilized by Hep B Reyes Syndrome is associated with Reyes Syndrome is associated with viral
to form a DNA intermediate. viral infections (VZV and influenza infections (VZV and influenza B) that have
B) that have been treated with been treated with aspirin.
aspirin.
Not considered a retrovirus because it does
not integrate into the host genome.
Goes from ssDNA to ssRNA then to
dsDNA, because it contains its own reverse
transcriptase.
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Rhinovirus is a Picorna virus that is acid-

Rheumatic fever is a type II HS that is labile.
preceded by GAS pharyngitis.
Rhinovirus binds to ICAM-1 in the
The rest are acid stable. This is why it's
URT.
transmitted through respiratory droplets
and aerosols.
Ribavarin is a nucleoside analog that can

Rhizopus is essentially a bread mold, and be used to treat adults with RSV.
is one of the major causes of Rhizopus is essentially a bread
Mucormycosis mold, and is one of the major
causes of Mucormycosis Mainly a Hep C therapy; not used for
children or preggos
Ribavarin is a nucleoside analog that can Ribavirin is a guanine nucleoside Ribavirin is a nucleoside analog that
be used to treat adults with RSV. analog that is used in the treatment inhibits IMP dehydrogenase, inhibiting
of hepatitis C. synthesis of guanine nucleotides.
Mainly a Hep C therapy; not used for

children or preggos
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Rose colored macules on the abdomen is

the rash distribution that may be seen in S.
Rifampin prophylaxis in groups with close
typhi.
contact to patients with N. meningitidis.
Rifampin used in leprosy will delay

the resistance to dapsone.
rifampin given monthly delays

emergence of resistance to dapsone
Rota, Colti are the Reoviruses. Rotavirus is a cause of infantile Rotavirus is the #1 cause of severe diarrhea
gastroenteritis that produces villous in children and infants.
destruction with atrophy that leads
to ↓ absorption of N+ and loss of
K+.
under 5.
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Rubella is characterized by postauricular

Rubella, EEE, WEE are the Togaviruses. Rubella is characterized by lymphadenopathy and a rash that starts at
postauricular and occipital the head and moves downward.
lymphadenopathy with childhood
exanthem.
Ruptured cysts from Echinococcus Ruptured cysts from Echinococcus

Ruptured cysts from Echinococcus
Granulosus (cestode) during removal can Granulosus (cestode) during removal can
Granulosus (cestode) during
lead to anaphylaxis. lead to anaphylaxis.
removal can lead to anaphylaxis.
S. Haematoium (schistosome) have a large S. Haematoium (schistosome) have S. Haematoium (schistosome) have a large
terminal spine, and lead to hematuria in a large terminal spine, and lead to terminal spine, and lead to hematuria in
bladder and increase risk of bladder cancer hematuria in bladder and increase bladder and increase risk of bladder cancer
risk of bladder cancer
530 of 584 5/12/2018, 9:26 PM

S. aureus is the most common cause of skin

abscesses.
S. agalactiae (Group B Strep) is a S. aureus and S. pyogenes (GAS)
bacitracin resistant gram-positive are two causes of impitigo.
encapsulated bacteria.
Collection of pus in walled-off infection
within deeper layers of skin
agalactiae
S. aureus can cause septic S. aureus contains enterotoxin, a pre-

S. aureus is the most common cause of arthritis which is an invasion of formed heat stable exotoxin that causes
osteomyelitis. the synovial membrane food poisoning from eating meat, cream-
characterized by a yellow, turbid based foods (mayo!).
synovial fluid with high
neutrophils.
S. aureus is a coagulase-positive bacteria S. aureus is a coagulase- S. aureus is a β-lactamase producing

associated with furuncle and carbuncles. positive bacteria associated with bacteria resistant to penicillin.
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furuncle and carbuncles.
S. aureus is commonly associated in

S. aureus is the most common cause S. aureus is the only Staph organism that is
lactational mastitis in breast-feeding
of septic arthritis. coagulase-positve.
mothers.
S. aureus will ferment mannitol and turn

S. epidermidis is normal flora of the
bright yellow on mannitol salt agar. S. pneumonia and H. influenza are
skin and thus can contaminate
primarily associated with otitis media.
blood cultures.
MSA contains 7.5 to 10% salt and

mannitol.
SARS/MERS is caused by coronavirus

and can lead to acute respiratory distress
syndrome (ARDS).
S. viridans effects previously
damaged heart valves.
S. viridans (mutans and sanguinis) form

dental plaques.
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SARS/MERS is caused by coronavirus

and can lead to acute respiratory distress
syndrome (ARDS).
Saber shins are characterized by anterior

Saber shins are characterized bowing of the tibia.
by anterior bowing of the tibia.
Salk is the killed polio vaccine.
Salmonella is a gram-
negative, non-lactose Salmonella is a gram-negative, non-
encapsulated fermenter that lactose encapsulated fermenter that
stains white on MacConkeys agar stains white on MacConkeys agar and
and resides in undercooked resides in undercooked chicken.
chicken.
Sandflies are the vector for Leishmania

Braziliensis and they will inject the
parasite into the skin of humans
Salmonella is a gram- Humans are the hosts

Salmonella is a gram-negative, non- negative, non-lactose
lactose encapsulated fermenter that encapsulated fermenter that
stains white on MacConkeys agar and stains white on MacConkeys agar
resides in undercooked chicken. and resides in undercooked
chicken.
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Sandflies are the vector for Leishmania Sandflies are the vector
Braziliensis and they will inject the for Leishmania Braziliensis and
parasite into the skin of humans Scabies are mites that burrow into the
they will inject the parasite into the
stratum corneum and cause pruritis
skin of humans
Humans are the hosts (serpiginous burrows in webspace of
hand/feet) and is treated with permethrin
Humans are the hosts
cream, washing/drying all
clothing/bedding, and treating close
contacts.
Scabies are mites that burrow into the

stratum corneum and cause pruritis Scalded-Skin Syndrome is
(serpiginous burrows in webspace of characterized by a rash that occurs
hand/feet) and is treated with permethrin in neonates with a Scarlet Fever is an infection caused by
cream, washing/drying all positive Nikolsky sign. Strep pyogenes that presents with
clothing/bedding, and treating close erythematous, sandpaper-like rash with
contacts. fever and sore throat.
Nikolsky sign: minor pressure
induces skin seperation
Schistosomes can cause swimmer's itch Schistosomes mature in the liver, and then
when they penetrate the skin Schistosomes can cause swimmer's travel upstream through the portal veins.
itch when they penetrate the skin against bloodflow
Schizont divides into merozoites which

burst from hepatocyte and infect RBC
(Plasmodium life cycle)
Schizont is the mature form of trophozoites

Schistosomes mature in the liver, and then Schistosomes mature in the liver, (asexual reproduction), in which the
travel upstream through the portal veins. and then travel upstream through parasite has divided multiple times in the
against bloodflow the portal veins. host cell. Then, they release merozoites
against bloodflow which are the form that can infect RBCs,
which then again mature into an schizont
inside the RBCs. Until they reach
maduration, they are called trophozoites
(after RBCs infection).
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Secondary syphilis is characterized Secondary syphilis is characterized Secondary syphilis is characterized

by rash on palms and soles of feets by rash on palms and soles of feets by rash on palms and soles of feets
and condoloma latta, months to weeks and condoloma latta, months to and condoloma latta, months to weeks
after infection. weeks after infection. after infection.
Serum and Urine rapid antigen Serum and Urine rapid antigen tests can
tests can also be used to also be used to detect Histoplasma
detect Histoplasma
Secondary syphilis is characterized
by rash on palms and soles of feets
and condoloma latta, months to weeks
after infection.
Shigella can cause hemolytic

Shigella can cause hemolytic uremic Shigella can cause hemolytic uremic
uremic syndrome most commonly
syndrome most commonly in children syndrome most commonly in children
in children (<10).
(<10). (<10).
Progerminal diarrhea following
Progerminal diarrhea following with acute Progerminal diarrhea following with acute
with acute
renal failure (glomerular damage). renal failure (glomerular damage).
renal failure (glomerular damage).
Shigella is indole positive and

Shigella is indole positive and stains green Shigella is indole positive and stains green
stains green on hektoin agar
on hektoin agar on hektoin agar
Immotile, non-lactose, non H2S,
Immotile, non-lactose, non H2S, Immotile, non-lactose, non H2S,
LPS(endotoxin) leads to
LPS(endotoxin) leads to inflammation LPS(endotoxin) leads to inflammation
inflammation
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Simeprevir is an HCV protease inhibitor

Silver stain is required to visualize Silver stain is required to visualize that can inhibit cytochrome P450.
Legionella. the organism that causes Pontiac
Fever.
remember it's gram-negative
Simeprevir is an NS3/4A protease inhibitor

Simeprevir is an NS3/4A protease
that prevents viral replication.
inhibitor that prevents viral
replication.
NS= nonstructural 3 protein
NS= nonstructural 3 protein
Simmering = Simeprevir Skirrow agar has been developed for
Simmering = Simeprevir selective isolation of Campylobacter jejuni
and Campylobacter coli from human feces.
AKA Campy agar (10% RBC with 5

antimicrobial)
Smallpox is characterized by lesions in the

Smallpox is characterized by same stage(s).
lesions in the same stage(s).
Skirrow agar has been developed for vs chickenpox.

vs chickenpox.
selective isolation of Campylobacter jejuni
and Campylobacter coli from human feces.
AKA Campy agar (10% RBC with 5

antimicrobial)
Snails are the intermidiate host for P. Snails are the intermidiate host for Snails are the intermidiate host for P.
Westermonti, and can be transmitted by P. Westermonti, and can be Westermonti, and can be transmitted by
eating undercoked crab meat with larvae. transmitted by eating undercoked eating undercoked crab meat with larvae.
Also has operculated eggs. crab meat with larvae. Also has Also has operculated eggs.
operculated eggs.
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Sporothrix schenckii is classically

contracted via cuts from rose thorns, as
Sporothrix schenckii is classically
well as tree bark, bushes, and plants
contracted via cuts from rose
aka rose-gardener's disease
thorns, as well as tree bark, bushes,
and plants Sporozoites of cryptosporidium attach to
aka rose-gardener's disease the intestinal wall, causing watery diarrhea
and small intestine damage
- cryptosporidium is associated with the
small intestine
- watery diarrhea is associated with
immunocompetent hosts, whereas severe
diarrhea is associated with AIDS patients
Sporozoites of cryptosporidium attach to Strep agalactiae is Hippurate positive.

the intestinal wall, causing watery diarrhea Staph epidermidis is a coagulase-
and small intestine damage negative Staph that has the ability
- cryptosporidium is associated with the to synthesize extracellular
small intestine polysaccharide matrix (biofilm).
- watery diarrhea is associated with
immunocompetent hosts, whereas severe
diarrhea is associated with AIDS patients Seen with foreign body infections
(i.e. kid with ventriculoperitoneal
shunt develops infection)
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Strep pneumonia is a gram-positive

"Lancet-shaped" diplococci. Strep pneumonia is the number 1
cause of MOPS.
Strep viridans is normal flora of the

oropharynx that can produce dental caries.
Strep mutans and mitis are part of the

Viridans group strep
Strep viridans is the most common cause of Streptogramins combination of

subacute endocarditis. quinupristin-dalfopristin is used to
treat infections caused by multi-
drug resistant Staph or
Think of pt. with MVP or rheumatic fever vancomycin-resistant E. faecium
who will have damaged heart valves going (but not E. faecalis).
to get teeth cleaning Streptokinase is a GAS virulence factor
can be given to patients with clots.
streptokinase converts plasminogen to

plasmin, which is fibrinolytic.
Streptolysin-O is antigenic, thus can be Subacute sclerosing panencephalitis

used to diagnose GAS as a cause of (SSPE) is a neurological complication of
glomerulonephritis or pharyngitis. Measles (rubeola).
Pt. with history of measles or

Stress reactivates HSV-1. unvaccinated; 5-15 years later, develop
neurological changes
538 of 584 5/12/2018, 9:26 PM

Sulfamethoxazole is a PABA analog that

blocks dihydropteroate synthase.
Sulbactam and taxobactam are β-lactamase

Sulbactam and taxobactam are
inhibitors that can be added with ampicillin
β-lactamase inhibitors that can be
or piperacillin to extend their activity.
added with ampicillin or
piperacillin to extend their activity.
Sulfamethoxazole is a PABA analog that Sulfatides are a virulence factor of Sulfatides are a virulence factor of
blocks dihydropteroate synthase. Mycobacterium tuberculosis that Mycobacterium tuberculosis that prevent
prevent phagolysosome fusion. phagolysosome fusion.
Sulfatides accumulate in the Sulfatides accumulate in the lysosomes →

lysosomes → create incompetent create incompetent lysosomes
lysosomes
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Summer months are a common time for

infection with coxsackie virus.
Sulfatides are a virulence factor of
Sulfonamides are folic acid
Mycobacterium tuberculosis that prevent
synthesis inhibitors that can
phagolysosome fusion.
produce phototoxicity.
Sulfatides accumulate in the lysosomes →
create incompetent lysosomes
Systemic effects of blastomycosis typically T-cell deficient patients are more

occur when patients are in an likely to get superficial Candida TMP-SMX or Pentamidine is the treatment
immunocompromised state infections, whereas neutropenic for Pneumocystis jirovecii
dissemination occurs in an patients are more likely to have
immunocompromised state, local lung disseminated candidiasis
infection otherwise (hematogenous).
540 of 584 5/12/2018, 9:26 PM

(cane)
TSST-1 superantigen binds MHC-II on

T-cells producing cytokine storm and TSS. Tabes Dorsalis in tertiary syphilis is
Tabes Dorsalis in tertiary syphilis
is characterized by demyelination characterized by demyelination of nerves
of nerves and posterior walls of the and posterior walls of the spinal cord.
spinal cord.
Tabes Dorsalis in tertiary syphilis

Tabes Dorsalis in tertiary syphilis leads to leads to loss of proprioception Tabes Dorsalis in tertiary syphilis leads to
loss of proprioception and Argyll and Argyll Robertson (prostitutes loss of proprioception and Argyll
Robertson (prostitutes pupil). pupil). Robertson (prostitutes pupil).
Argyll Robertson: involve efferent Argyll Robertson: involve efferent Argyll Robertson: involve efferent
pupillary fibres on the dorsal aspect of the pupillary fibres on the dorsal pupillary fibres on the dorsal aspect of the
Edinger-Westphal nucleus aspect of the Edinger-Westphal Edinger-Westphal nucleus
nucleus
Terbinafine is an anti-fungal that can

Terbinafine is an anti-fungal that produce hepatotoxicity.
can produce GI side effects.
Telithromycin is a macrolide antibiotic that

is contraindicated in patients with
myasthenia gravis.
Tertiary syphilis is characterized by Tertiary syphilis is characterized Tertiary syphilis is characterized by

formation of gummas and aortitis. by formation of gummas formation of gummas and aortitis.
and aortitis.
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Tetracyclines accumulate intracellularly, Tetracyclines accumulate intracellularly,

Tetracyclines accumulate
making them effective against Rickettsia making them effective against Rickettsia
intracellularly, making them
and Chlamydia. and Chlamydia.
effective against Rickettsia and
Chlamydia.
Th1 cells respond to the Tuberculin form

Th1 cells respond to the Tuberculin of Leprosy.
Tetracyclines are contraindicated in form of Leprosy.
pregnancy because they can deposit in fetal
Cell mediated immunity - macrophages
teeth and cause bone deformity.
Cell mediated immunity - contain bacteria
macrophages contain bacteria
Th2 cells respond during a Lepromatous Th2 cells respond during a The hard palate is the most common
response to Leprosy infection. Lepromatous response to Leprosy location of Kaposi lesions.
infection.
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The ixodes tick (deer tick) is the vector not The ixodes tick (deer tick) is the The ixodes tick (deer tick) is the vector not
just for babesia, but also for borrelia vector not just for babesia, but also just for babesia, but also for borrelia
burgdforferi, which causes lime disease. for borrelia burgdforferi, which burgdforferi, which causes lime disease.
Thus, coinfection is common in babesia causes lime disease. Thus, Thus, coinfection is common in babesia
infection. coinfection is common in babesia infection.
infection.
The true vocal cords are a part of the

respiratory epithelium which HPV can
infect.
Sort of deviating from micro here, but

recall that HPV has a tropism for stratified
squamous; this question can then be turned
to test your understanding of basic
histology, like of the upper respiratory tract
-The true vocal cords are the only part of
the URT with stratified squamous
Tinnea eggs are found in feces Tinnea eggs are found in feces
contaminated water. contaminated water.
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Toxocara canis is transmitted via food

contaminated with dog or cat feces. Toxocara canis is transmitted via
food contaminated with dog or cat
Tracheal toxin is produced by Bordetella
feces.
and functions to damage ciliated
epithelial tissue.
Tracheal toxin is produced by Bordetella

and functions to damage ciliated
epithelial tissue. Trichomonas vaginalis causes Trichomonas vaginalis causes vaginitis and
vaginitis and other -itis of the other -itis of the urogenital tract including
urogenital tract including cervictis cervictis described as "strawberry cervix"
described as "strawberry cervix"
Trichomonas vaginalis causes vaginitis and

other -itis of the urogenital tract including Trichomonas Trichomonas vaginalis causes foul-
cervictis described as "strawberry cervix" vaginalis causes foul-smelling, smelling, greenish vaginal discharge and
greenish vaginal discharge and is treated with metronidazole
is treated with metronidazole
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Trophozoites appear in a ring-

shaped form withing the RBCs in
perypheral blood smear
(Plasmodium life cycle)
Trophozoites in
stool is diagnostic of Giardia infection
Tricuspid valve is the most commonly

affected valve with S. aureus
endocarditis.
Inmature schizont = Trophozoite
recall that trophozoites of giardia attach to

the intestinal walls
Trypanosoma brucei can cause cervical and Trypanosoma brucei can cause
axillary lymphadenopathy. cervical and axillary Trypanosoma brucei causes African
It moves to the lymph nodes after entering lymphadenopathy. sleeping sickness.
the blood. It moves to the lymph nodes after Include trypanosoma brucei gambiense and
entering the blood. tryanosoma brucei rhodesiense.
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Trypanosoma brucei causes African

sleeping sickness. Trypanosoma brucei is transmitted by the
Include trypanosoma brucei gambiense and Trypanosoma brucei is transmitted bite of the tsetse fly.
tryanosoma brucei rhodesiense. by the bite of the tsetse fly.
Trypanosoma cruzi causes dilated Trypanosoma cruzi causes dilated Trypanosoma cruzi causes dilated
cardiomyopathy with apical atrophy, cardiomyopathy with apical cardiomyopathy with apical atrophy,
megacolon, megaesophagus and is treated atrophy, megacolon, megacolon, megaesophagus and is treated
with Benznidazole or nifurtimox megaesophagus and is treated with Benznidazole or nifurtimox
with Benznidazole or nifurtimox
Type B capsular form of H. influenza can

cause meningitis.
Trypanosoma cruzi is transmitted by the

reduviid, or "kissing bug". Trypanosoma cruzi is transmitted Unencapsulated forms cause mucosal
by the reduviid, or "kissing bug". infections
Tzank smear shows multinucleated giant Tzank smear Ulceroglandular type of Tularemia is the
cells characteristic of VZV and HSV shows multinucleated giant cells most common type in the U.S.
546 of 584 5/12/2018, 9:26 PM

infections.
characteristic of VZV and HSV
(Syncytia). infections.
(Syncytia).
Uncooked shellfish is the route of

transmission of Hep A in developed
countries.
VDRL is a screening test for VDRL is a screening test for Treponema

Treponema Palladium but is Palladium but is not specific.
not specific.
VZV is a herpes virus which remains Vancomycin inhibits cell wall synthesis by
Vancomycin inhibits cell wall
dormant in the DRG (reservoir). directly binding D-ala-D-ala oligopeptides.
synthesis by directly binding D-ala-
D-ala oligopeptides.
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Vancomycin is a cell wall synthesis

inhibitor that can be used as empiric
treatment of meningitis from penicillin- Vancomycin is a glycopeptide that
resistant Strep pneumo. can be used to treat Enterococcus Vancomycin is the treatment for MRSA.
infections.
Vancomycin resistance occurs in Vancomycin resistance occurs in

Enterococcus via amino acid modification Enterococcus via amino acid
of D-Ala-D-Ala to D-Ala-D-Lac. modification of D-Ala-D-Ala to
D-Ala-D-Lac. Visceral leishmaniasis is also known as
black fever or kala-azar
Visceral leishmaniasis is also known as Visceral leishmaniasis is caused Visceral leishmaniasis is caused
black fever or kala-azar by Leishmania donovani by Leishmania donovani
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Visceral leishmaniosis will cause

pancytopenia when it infects the bone
marrow
Visceral leishmaniasis is the worse of all Visceral leishmaniasis is the worse

leishmaniosis and is 100% fatal if left of all leishmaniosis and is 100%
untreated fatal if left untreated
Vitamin A is a fat soluble vitamin used to

prevent severe exfoliative dermatitis in
malnourished children with Measles.
Visceral leishmaniosis will cause
pancytopenia when it infects the bone Visceral leishmaniosis will cause
marrow pancytopenia when it infects the
bone marrow
Vitamin A is a supplementation which can Vitamin A is a supplementation Voriconazole is an antifungal that can
reduce morbidity and mortality from which can reduce morbidity and produce blurred vision and changes in
measles in malnourished children. mortality from measles in color vision.
malnourished children.
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Warthin-Starry stain is required for

Bartonella henselae.
Bartonella does not gram-stain well
Warthin-Finkeldey Cells are multi- Warthin-Finkeldey Cells are multi-

nucleated giant cells (fused lymphocytes) nucleated giant cells (fused
seen in Measles. lymphocytes) seen in Measles.
Waterhouse-Friderichsen syndrome is Waterhouse-Friderichsen syndrome

characterized by hemorrhage of the adrenal is characterized by hemorrhage
glands. of the adrenal glands.
15% mortality rate 15% mortality rate
LOS induced inflammation LOS induced inflammation
⇒ ↑ Vascular permeability ⇒ ↑ Vascular permeability
⇒ ↑ Exudation ⇒ ↑ Exudation
⇒ ↓ Perfusion ⇒ ↓ Perfusion Watery (secretory) diarrhea is produced by
⇒ Reflexive vasoconstriction ⇒ Reflexive vasoconstriction Cholera.
⇒ Ischemic adrenals ⇒ Ischemic adrenals
(WFS can occur due to other organisms, and in that (WFS can occur due to other organisms,
case inflammation would not be due to LOS) and in that case inflammation would not be
due to LOS)
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Weil's disease is a severe form of Weil's disease is a severe form of

leptospira infection which can cause Weil's disease is a severe form of leptospira infection which can cause
jaundice and azotemia from liver and leptospira infection which can jaundice and azotemia from liver and
kidney dysfunction. cause jaundice and azotemia from kidney dysfunction.
Fever, Hemorrhage, and Anemia can also liver and kidney dysfunction. Fever, Hemorrhage, and Anemia can also
be seen Fever, Hemorrhage, and Anemia be seen
can also be seen
Western Blot is a confirmatory test for Western, Eastern and Venezuelan Whooping cough is a cough that causes a
HIV. Equine Encephalitis cough on expiration and a "whoop" on
(WEE,EEE,VEE) are the three inspiration.
Babies should have PCR(NAAT) done to types of Toga arbovirus.
test for HIV as Western blot and ELISA will
always come up positive. Venezuelan is also known as
Chikungunya virus. Also known as the "100 day cough"
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Widdened mediastinum (mediastinitis) can

be seen in CXR of pulmonary anthrax
Wuchereria bancrofti causes Wuchereria bancrofti causes elephantiasis,
infection.
elephantiasis, which is a which is a complication of long standing
complication of long standing lower extremity lymphodema.
lower extremity lymphodema.
Wuchereria bancrofti is also characterized Wuchereria bancrofti is also

by coughing, since microfilariae can travel characterized by coughing, since
to the lungs, causing a hypersensitivy microfilariae can travel to the
reaction. lungs, causing a hypersensitivy
reaction. Yellow Fever is characterized by
councilman bodies on liver biopsy.
Also seen in Hep A
Yellow Fever is characterized with Yersinia pestis causes the plague

jaundice, backache, and black and is treated with Tetracyclines +
vomitus/bloody stool. streptomycin.
Young children are affected by H.

influenza meningitis.
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Zidovudine is the best anti-retroviral HIV

drug for pregancy/post-partum.
Up to 6 weeks post-partum.
Zinc metalloprotease is the main
Zinc metalloprotease is the main virulence
virulence factor for Legionella.
factor for Legionella.
its cytotoxic and inhibits PMN
its cytotoxic and inhibits PMN production,
production, inhibits superoxide
inhibits superoxide reduction and
reduction and deactivates IL-1,
deactivates IL-1, CD4 and TNF.
CD4 and TNF.
gingivostomatitis is the first sign of HSV-1

infection.
anti-HBc is the marker during the
window period of Hep B.
anti-HAV IgM is the best test to detect

acute hepatitis A.
anti-HAV IgG indicates prior HAV

infection and/or prior vaccination;
protective against reinfection
gp120 is an HIV surface glycoprotein that gp41 is a surface glycoprotein that koilocytic change can be seen in invasive
mediates attachment to the host CD4+ facilitates HIV fusion and entry. carcinoma of the cervix.
T-cell.
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Acyclovir or Valcyclovir are used to

prevent breakouts of HSV.
β-lactamases are bacterial enzymes

that cleave the β-lactam ring. Also used to treat VZV; does not effect
latent forms of HSV and VZV.
Penciclovir, Famcyclovir. These are pro-
drugs. Once activated they become specific
for the viral polymerase. Can relieve
symptoms and shorten disease period.
post-coital bleeding is a Buzz word for
HPV cervical cancer.
Acyclovir or Valcyclovir are used to Aminoglycans are often synergistic Aminoglycans are often synergistic
prevent breakouts of HSV. with β-lactam antibiotics to with β-lactam antibiotics to increase their
increase their ability to penetrate ability to penetrate cells.
cells.
Also used to treat VZV; does not effect
latent forms of HSV and VZV.
Penciclovir, Famcyclovir. These are pro- This is the idea behind combination
drugs. Once activated they become specific This is the idea behind combination therapies (i.e. vancomycin and gentamicin)
for the viral polymerase. Can relieve therapies (i.e. vancomycin and to treat endocarditis
symptoms and shorten disease period. gentamicin) to treat endocarditis
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Antigenic shift of the Influenza viral

Antigenic drift is associated with epidemic Antigenic drift is associated genome is associated with pandemic
outbreaks of Influenza. with epidemic outbreaks of outbreaks.
Influenza.
Antigenic shift of the Influenza viral Aztreonam is a monobactam that is only

genome is associated with pandemic Aztreonam is a monobactam that is
effective against aerobic gram (-) rods.
outbreaks. only effective against aerobic gram
(-) rods.
Bacillary angiomatosis is capillary Bacillary angiomatosis is capillary Bacillary angiomatosis will show a
proliferation involving skin and visceral proliferation involving skin and neutrophilic infiltrate and can be treated
organs in AIDS patients, which simulates visceral organs in AIDS patients, with doxycycline.
Kaposi sarcoma. which simulates Kaposi sarcoma.
Difference is bacillary angiomatosis will Difference is bacillary

have a neutrophilic infiltrate angiomatosis will have a
neutrophilic infiltrate
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Bacillary angiomatosis will show a Blastomycosis can also appear on the east
neutrophilic infiltrate and can be treated Bacillary angiomatosis will show a
coast
with doxycycline. neutrophilic infiltrate and can be
treated with doxycycline.
Along with the great lakes and ohio river

valley
Blastomycosis can also appear on the east

coast
Bordetella pertussis can be grown
Bordetella pertussis can be grown on
on Bordet-Gengou agar and Regan-
Bordet-Gengou agar and Regan-Lowe
Lowe medium.
medium.
Can also use serology or

Can also use serology or NAAT/PCR
NAAT/PCR
Along with the great lakes and ohio river
valley
Bordetella infection (bacterial) can be Bordetella infection (bacterial) can Bronchopulmonary washings can be used
mistaken for a viral infection due to be mistaken for a viral infection to diagnose Cryptococcal infection
lymphocytosis. due to lymphocytosis. recall that the lungs are the primary site of
infection (due to inhalation)
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Bronchopulmonary washings can be used

to diagnose Cryptococcal infection
recall that the lungs are the primary site of
infection (due to inhalation)
Brucella can travel through Brucella can travel through multiple

multiple endothelial organs causing endothelial organs causing enlargement
enlargement of spleen, liver and of spleen, liver and lymph nodes.
lymph nodes. markings on cow
markings on cow
Brucellosis is characterized by an undulant Brucellosis is characterized by Brucellosis is characterized by an undulant

fever, chills and anorexia an undulant fever, chills fever, chills and anorexia
and anorexia
Undulent just means it rises and falls. Undulent just means it rises and falls.
Undulent just means it rises and
falls.
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C. Sinensis (trematode) is also known as

the Chinese Liverfluke, and leads to biliary C. Sinensis (trematode) is also
fibrosis, pigmented gallstones and known as the Chinese Liverfluke, C. Sinensis is a trematode/fluke, which has
cholangiocarcinoma. and leads to biliary fibrosis, operculated eggs and has biliary
pigmented gallstones and complications.
cholangiocarcinoma.
Candida albicans does not change Candida albicans does not change the
C. Sinensis is a trematode/fluke, which has the vaginal pH vaginal pH
operculated eggs and has biliary normal vaginal pH: acidic, ~3.8-4.2 normal vaginal pH: acidic, ~3.8-4.2 (avg: 4
complications. (avg: 4 pH) pH)
in women, candida infections do in women, candida infections do not occur
not occur after 4 pH after 4 pH
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Cholera produces an enterotoxin

(CTx/choleragen) that permanently
activates Gs.
increases CLCA and CFTR dependent Cl-

secretion
Cholera produces a secretory diarrhea Cholera produces a secretory

describes as "rice-water" stools. diarrhea describes as "rice-water"
stools.
Cholera produces an enterotoxin

(CTx/choleragen) that permanently
activates Gs. Coccidioidomycosis is found in the
Coccidioidomycosis is found in the Southwestern United States
Southwestern United States
increases CLCA and CFTR dependent Cl-

secretion
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Coccidioidomycosis is mold in the soil and

spherules of endospores in the body, Coccidioidomycosis is mold in the
which can rupture and spread throughout soil and spherules of endospores
the lungs and rest of the body in the body, which can rupture and
does NOT follow the adage "mold in cold, spread throughout the lungs and
yeast in heat" rest of the body
mold in cold, spherules of endospores in Coccidiomycosis have a characteristic
does NOT follow the adage "mold
the heat, which rupture and release their mold form containing barrel-shaped
in cold, yeast in heat"
endospores arthroconidia.
mold in cold, spherules of
endospores in the heat, which
rupture and release their endospores
Coccidiomycosis have a characteristic Coccidiomycosis have a Congenital varicella syndrome is

mold form containing barrel-shaped characteristic mold form containing characterized by limb hypoplasia,
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cutaneous dermatomal scarring and

blindness.
arthroconidia.
barrel-shaped arthroconidia.
Congenital varicella syndrome is Corynebacterium Diptheria will have a

Corynebacterium Diptheria will
characterized by limb hypoplasia, positive Elek's test for toxin.
have a positive Elek's test for
cutaneous dermatomal scarring and
toxin.
blindness.
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Cryptococci are heavily encapsulated
Corynebacterium diptheria will produce a Corynebacterium diptheria will

gray pseudomembrane on the posterior produce a gray pseudomembrane
pharynx and upper airways. on the posterior pharynx and upper
airways.
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Cryptococci are heavily encapsulated
Cryptococcus is found mainly in pigeon

Cryptococcus is found mainly droppings and soil
in pigeon droppings and soil
Cryptococcus is the most common cause of Cryptococcus is the most common Cryptosporidium can be treated with the
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fungal meningitis cause of fungal meningitis

can disseminate from the lungs to the CSF can disseminate from the lungs to macrolide antibiotic spiramycin
can present with common symptoms of the CSF
meningimus (stiff neck) can present with common
symptoms of meningimus (stiff
neck)
***not FDA approved in the US
Daptomycin MOA
Daptomycin MOA
Inserts lipid tail and disrupts gram positive
Inserts lipid tail and disrupts gram cell membrane, causing depolarization and
Cryptosporidium can be treated with the
positive cell membrane, causing cell death
macrolide antibiotic spiramycin
depolarization and cell death
***not FDA approved in the US
Deferoxamine, which chelates both iron Deferoxamine, which chelates both

and aluminum, acts as a siderophore for iron and aluminum, acts as a Dermatophytes contain keratinase,
the species Rhizopus, enhancing its growth siderophore for the species allowing them to subsist off keratin, a
and pathogenicity. This leads to an Rhizopus, enhancing its growth and protein resistant to most organisms.
increased risk for Mucormycosis. pathogenicity. This leads to an this is why dermatophytes are commonly
increased risk for Mucormycosis. found in the skin (tinea - "ringworm") and
nails (onychomycosis)
Echinococcus Granulosus is a Echinococcus Granulosus is a cestode,

cestode, which can be transmitted which can be transmitted through dog
through dog feces, with sheep as feces, with sheep as the intermitten hosts.
Dermatophytes contain keratinase, the intermitten hosts.
allowing them to subsist off keratin, a
protein resistant to most organisms.
this is why dermatophytes are commonly
found in the skin (tinea - "ringworm") and
nails (onychomycosis)
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Enterococcus resistance to Enterococcus resistance to vancomycin

vancomycin occurs via amino acid occurs via amino acid modification of
modification of D-Ala-D-Ala to D-Ala-D-Ala to D-Ala-D-Lac.
Echinococcus Granulosus is a cestode,
which can be transmitted through dog D-Ala-D-Lac.
feces, with sheep as the intermitten hosts.
A change in the terminal pentapeptide
A change in the terminal from D-ala-D-ala to D-ala-D-lac in the
pentapeptide from D-ala-D-ala to cross bridges of the peptidoglycan cell
D-ala-D-lac in the cross bridges of wall.
the peptidoglycan cell wall.
Gardnerella vaginalis does change the

vaginal pH
normal vaginal pH: acidic, ~3.8-4.2 (avg: 4
pH)
in women, candida infections do not occur
after 4 pH
Gardnerella Vaginalis is characterized by Gardnerella Vaginalis is

a fishy smelling, grayish-white characterized by a fishy smelling,
(color) discharge from the vagina. grayish-white (color) discharge
from the vagina.
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H. influenza produces a "thumbprint

Gardnerella vaginalis does change the H. influenza produces a
(epiglottitis)" sign on X-ray.
vaginal pH "thumbprint (epiglottitis)" sign on
normal vaginal pH: acidic, ~3.8-4.2 (avg: 4 X-ray.
pH)
in women, candida infections do not occur
after 4 pH
H. pylori is associated with gastritis and

H. pylori is associated with gastritis
ulcers, most commonly in the duodenum.
and ulcers, most commonly in the
duodenum.
Duodenal ulcers are characterized by

decreased post prandial pain and weight
Duodenal ulcers are characterized
gain
by decreased post prandial pain
and weight gain H. pylori most commonly infects
the antrum of the stomach.
Hemolytic uremic syndrome is Hemolytic uremic syndrome is most

most commonly associated with E. commonly associated with E. coli
coli O157:H7 and has a O157:H7 and has a
characteristic microangiopathic characteristic microangiopathic hemolytic
H. pylori most commonly infects hemolytic anemia. anemia.
the antrum of the stomach.
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Hilar lymphadenopathy + peripheral Hilar lymphadenopathy + peripheral

granulomatous lesion in middle/lower granulomatous lesion in middle/lower
Hilar lymphadenopathy +
lung lobe are known as the Ghon lung lobe are known as the Ghon
peripheral granulomatous lesion
Complex in Mycobacterium tuberculosis Complex in Mycobacterium tuberculosis
in middle/lower lung lobe are
infections. infections.
known as the Ghon Complex in
Mycobacterium tuberculosis
Presents after a primary tuberculosis Presents after a primary tuberculosis
infections.
infection infection
Presents after a primary
tuberculosis infection
Histoplasma is endemic to the central and Histoplasma is endemic to the Histoplasma will characteristically present
midwestern United States central and midwestern United on histology as macrophages with oval
along the mississippi and ohio river States bodies
valleys along the mississippi and ohio after staining with KOH prep
river valleys
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symbolizes what macrophages with ovoid

bodies filled with histoplasma look like
Histoplasma will characteristically present

on histology as macrophages with oval
bodies
after staining with KOH prep
Histoplasmosis targets Histoplasmosis targets

the reticuloendothelial system, the reticuloendothelial system, ultimately
ultimately resulting in resulting in dissemination to the liver and
dissemination to the liver and spleen
spleen gross presentation may reveal
gross presentation may reveal calcifications in these organs
calcifications in these organs
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symbolizes what macrophages with ovoid

bodies filled with histoplasma look like
Hyphae of Tinea lesions due to

dermatophytes are seen with KOH prep
of skin scrapings
Hooks are a feature on the proglottid head Hooks are a feature on the
of T. Solium seen on O&P proglottid head of T. Solium seen
on O&P
Hyphae of Tinea lesions due to Hyphae of Tinea lesions due to Latex agglutination test is used to detect
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dermatophytes are seen with KOH prep

of skin scrapings
dermatophytes are seen with KOH

prep of skin scrapings
the polysaccharide capsular antigen

present in Cryptococci
Latex agglutination test is used to detect

the polysaccharide capsular antigen Legionella is an oxidase-positive organism
Legionella is an oxidase-positive
present in Cryptococci which causes atypical pneumonia.
organism which causes atypical
pneumonia.
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Military recruits are given a live-attenuated

vaccine for adenovirus. Military recruits are given a live-
attenuated vaccine for adenovirus. Mucormycosis is caused primarily by
Mucor sp. and Rhizopus
No one else gets the vaccine because it has
oncogenic potential. Self limiting for No one else gets the vaccine
everyone else. because it has oncogenic potential.
Self limiting for everyone else.
NSP4 toxin found in Rotavirus causes

NSP4 toxin found in Rotavirus secretory diarrhea via increased chloride
causes secretory diarrhea via permeability.
increased chloride permeability.
Mucormycosis is caused primarily by

Mucor sp. and Rhizopus
Disrupts microvillus cytoskeleton and
Disrupts microvillus cytoskeleton barrier function.
and barrier function. Remember water will always follow the
Remember water will always follow ions.
the ions.
NSP4 toxin found in Rotavirus causes Naegleria fowleri is associated with Naegleria fowleri is associated with
secretory diarrhea via increased chloride freshwater and nasal irrigation and freshwater and nasal irrigation and contact
permeability. contact lens solutions. lens solutions.
Really any stagnant water is a good Really any stagnant water is a good
enviroment for naegleria fowleri to enviroment for naegleria fowleri to
multiply. multiply.
Disrupts microvillus cytoskeleton and
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barrier function.
Remember water will always follow the
ions.
Onychomycosis describes dermatophyte

Nitazoxanide is an antiprotozoal used Nitazoxanide is an antiprotozoal infection of the nails
exclusively in immunocompetent hosts to used exclusively in Onychomycosis is also known as Tinea
treat cryptosporidium immunocompetent hosts to treat unguium
cryptosporidium
Oocysts that stain acid-fast on Stool O&P

Onychomycosis describes dermatophyte Oocysts that stain acid-fast on
are indicative of Cryptosporidium
infection of the nails Stool O&P are indicative
Onychomycosis is also known as Tinea of Cryptosporidium
unguium
Orthomyxo is the only RNA virus that Orthomyxo is the only RNA virus Osteomyelitis (bone) is an infection that
replicates in the nucleus. that replicates in the nucleus. occurs from dog bites most commonly
with Pasteurella.
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Osteomyelitis (bone) is an infection that Pasteurella is a gram-negative Pasteurella is a gram-negative organism

occurs from dog bites most commonly organism that can be grown on 5% that can be grown on 5% sheep agar.
with Pasteurella. sheep agar.
Penicillin treats dog bites infected with

what gram-neg coccobacillus? Penicillin treats dog bites infected Pneumocystis pneumonia is an AIDS-
with what gram-neg coccobacillus? defining illness that presents with a CD4+
Pasteurella multocida count < 200
Pasteurella multocida due to Pneumocystis jiroveci
Pneumocystis pneumonia is an AIDS- Protein synthesis inhibitors that can Protein synthesis inhibitors that can
defining illness that presents with a CD4+ prolong the Q-T interval, prolong the Q-T interval, predisposing to
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predisposing to torsades de pointes torsades de pointes
count < 200 Macrolide adverse effect in the CVS

due to Pneumocystis jiroveci Macrolide adverse effect in the
CVS
Proteus exhibits a "swarming" motility Proteus exhibits a "swarming" motility

when plated due to flagella. when plated due to flagella.
Proteus exhibits a "swarming"
motility when plated due to
flagella.
Tumbling motility = Listeria Tumbling motility = Listeria
Tumbling motility = Listeria
Proteus is a bug associated with UTI, Proteus is a bug associated with Quinupristin-dalfopristin is a combination
producing an ammonia scent. UTI, producing an ammonia scent. of two streptogramins that inhibit
translation by binding the 50s ribosome
Mirabilis (indole positive) is differentiated Mirabilis (indole positive) is

from vulgaris by a negative indole differentiated from vulgaris by a
Indole positive = bright red negative indole
Indole positive = bright red
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Quinupristin-dalfopristin is a combination
of two streptogramins that inhibit Rabies virus travels in a retrograde
Rabies virus travels in a retrograde direction to the CNS after binding to ACh
translation by binding the 50s ribosome
direction to the CNS after binding receptors.
to ACh receptors.
Reversibly bind to the 30s subunit,

preventing aminoacyl-tRNA from binding
to the acceptor (A) site
Tetracycline MOA
Rapid urine antigen test can be used for Rapid urine antigen test can be used
quick diagnosis of Legionella. for quick diagnosis of Legionella.
urine test for LPS antigen for serotype 1 urine test for LPS antigen for
serotype 1
also aminoglycosides, glycyclines
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Reversibly bind to the 30s subunit,

preventing aminoacyl-tRNA from binding
to the acceptor (A) site
Tetracycline MOA
Rotavirus is a dsRNA virus that

Rotavirus is a dsRNA virus that produces watery diarrhea.
produces watery diarrhea.
also aminoglycosides, glycyclines
S. Japonicum (schistosome) has a small or S. Japonicum (schistosome) has a S. Mansoni and S. Japonicum are
absent spine on eggs. small or absent spine on eggs. schitosomes that cause portal hypertension
and liver cirrhosis, leading to jaundice
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S. Mansoni and S. Japonicum are

schitosomes that cause portal hypertension S. Mansoni and S. Japonicum are S. epidermidis is a gram-positive organism
and liver cirrhosis, leading to jaundice schitosomes that cause portal that infects prosthetic devices (hip
hypertension and liver cirrhosis, implants, heart valves) and IV catheters by
leading to jaundice producing biofilms.
S. epidermidis is a gram-positive organism Shigella is a gram-negative rod that Shigella is a gram-negative rod that is
that infects prosthetic devices (hip is associated with ankylosing associated with ankylosing
implants, heart valves) and IV catheters by spondylitis (HLA-B27 associated spondylitis (HLA-B27 associated
producing biofilms. autoimmune disease). autoimmune disease).
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Shigella is a non-motile gram-negative rod

that expresses specificity for M-cells
(Microfold) of the Peyer Patches.
Shigella is a gram-negative rod that Shigella penetrates mucous membrane by

Shigella is a gram-negative rod that passing through M-cells via endocytosis
spreads from cell-cell via actin filaments. spreads from cell-cell via actin --> spreads laterally --> ulceraton of the
filaments. mucosa and leakage of blood and mucus
--> patients pass stools mixed with blood
and mucus.
Shiga-like toxin of E. coli O157:H7 can

damage endothelial cells, leading to renal
insufficiency and uremia
Shigella is a non-motile gram-negative rod Snails are the intermediate host for Snails are the intermediate host for
that expresses specificity for M-cells Clonorchis sinesnsis (trematode) Clonorchis sinesnsis (trematode)
(Microfold) of the Peyer Patches.
Shigella penetrates mucous membrane by
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passing through M-cells via endocytosis

--> spreads laterally --> ulceraton of the
mucosa and leakage of blood and mucus
--> patients pass stools mixed with blood
and mucus.
Shiga-like toxin of E. coli O157:H7 can

damage endothelial cells, leading to renal
insufficiency and uremia
Sporothrix schenckii spreads in an ascend- Sporothrix schenckii spreads in Strep viridans produces dextrin, which
ing pattern along the path of lymphatic an ascend-ing pattern along the bind to fibrin-platelet aggregates on
drainage path of lymphatic drainage damaged heart valves.
physical trauma (cut from rose thorn) physical trauma (cut from rose
allows infection to enter lymphatic system thorn) allows infection to enter
lymphatic system
Strep viridans produces dextrin, which

bind to fibrin-platelet aggregates on
damaged heart valves.
dalfopristin) and Linezolid are used
dalfopristin) and Linezolid are used to
to treat VRE
treat VRE
VRE = vancomycin-resistant
VRE = vancomycin-resistant enterococcus
enterococcus
Trypanosoma cruzi can cause chagas Trypanosoma cruzi can cause VanA gene from vancomycin-resistant
disease. chagas disease. Enterococcus to S. aureus is an example
of transposition.
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Visceral leishmaniasis can affect Visceral leishmaniasis can affect almost

VanA gene from vancomycin-resistant almost every organ but most every organ but most commonly it affects
Enterococcus to S. aureus is an example commonly it affects the liver, the liver, spleen, and bone marrow
of transposition. spleen, and bone marrow
Yersinia enterocolitica is a gram-negative Yersinia enterocolitica is a gram-negative

coccobacillus (+shape) with bipolar coccobacillus (+shape) with bipolar
staining. Yersinia enterocolitica is a gram- staining.
negative coccobacillus (+shape)
with bipolar staining.
Candida albicans forms Candida albicans forms Candida albicans forms

pseudohyphae and budding yeast at 20 pseudohyphae and budding yeast pseudohyphae and budding yeast at 20
degrees C (cold) at 20 degrees C (cold) degrees C (cold)
and germ tubes (hyphae) at 37 degrees and germ tubes (hyphae) at 37 and germ tubes (hyphae) at 37 degrees
C (heat) degrees C (heat) C (heat)
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dimorphic fungus, however does not dimorphic fungus, however does not
follow the adage "mold in the cold, yeast in follow the adage "mold in the cold, yeast in
the heat" dimorphic fungus, however does the heat"
not follow the adage "mold in the
cold, yeast in the heat"
Malassezia furfur is a fungus part of Malassezia furfur is a fungus part of

normal skin flora, thriving in hot Malassezia furfur is a fungus part normal skin flora, thriving in hot
and humid conditions of normal skin flora, thriving in hot and humid conditions
humidity allows M. furfur to convert to its and humid conditions humidity allows M. furfur to convert to its
disease form humidity allows M. furfur to disease form
convert to its disease form
Oral candidiasis is seen in the immuno- Oral candidiasis is seen in the Oral candidiasis is seen in the immuno-
compromised or those using oral steroids immuno-compromised or those compromised or those using oral steroids
using oral steroids
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blue inhaler in child's hand -

blue inhaler in child's hand - important to important to wash mouth out after blue inhaler in child's hand - important to
wash mouth out after using oral steroids to using oral steroids to prevent wash mouth out after using oral steroids to
prevent candidiasis candidiasis prevent candidiasis
Oral and Esophageal candidiasis can be Oral and Esophageal candidiasis can be
treated with Nystatin Oral and Esophageal candidiasis treated with Nystatin
liquid; "swish and spit" or "swish and can be treated with Nystatin liquid; "swish and spit" or "swish and
swallow" liquid; "swish and spit" or "swish swallow"
and swallow"
Polymyxin B is a cationic detergent that Polymyxin B is a cationic detergent that

Polymyxin B is a cationic detergent
disrupts cell membranes; useful against disrupts cell membranes; useful against
that disrupts cell membranes; useful
multi-drug resistant P. aeruginosa and multi-drug resistant P. aeruginosa and
against multi-drug resistant P.
Acinetobacter baumannii. Acinetobacter baumannii.
aeruginosa and Acinetobacter
baumannii.
Schisotosomiasis is caused by Schisotosomiasis is caused by

Schisotosomiasis is caused by
Schisotosoma, a trematode with snails as Schisotosoma, a trematode with snails as
Schisotosoma, a trematode with
an intermediate host. an intermediate host.
snails as an intermediate host.
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Trophozoites that contain endocytosed Trophozoites that contain endocytosed

RBCs are diagnostic of Entamoeba RBCs are diagnostic of Entamoeba
histolytica Trophozoites that contain histolytica
endocytosed RBCs are diagnostic
of Entamoeba histolytica
Yersinia enterocolitica is a gram-negative Yersinia enterocolitica is a gram- Yersinia enterocolitica is a gram-negative

rod that can cause mesenteric negative rod that can cause rod that can cause mesenteric
lymphadenitis, mimicing appendicitis. mesenteric lymphadenitis, lymphadenitis, mimicing appendicitis.
mimicing appendicitis.
Metronidazole is a bactericidal and Metronidazole is a bactericidal and Metronidazole is a bactericidal and

antiprotozoal that can cause the following antiprotozoal that can cause the antiprotozoal that can cause the following
adverse effects: disulfiram-like reaction following adverse effects: adverse effects: disulfiram-like reaction
with alcohol, headache, metallic taste disulfiram-like reaction with with alcohol, headache, metallic taste
alcohol, headache, metallic taste
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β-lactam antibiotics inhibit what

family of enzymes involved in cell
Metronidazole is a bactericidal and
wall synthesis?
antiprotozoal that can cause the following
adverse effects: disulfiram-like reaction
Penicillin binding proteins
with alcohol, headache, metallic taste
PBP's are enzymes that cross-link a

bacterial cell wall
Inhibition of cell wall synthesis
leads to activation of autolytic
system
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A good prognosis occurs with

Vs. Superinfection Campylobacter

**Campylobacteria can be transmitted

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"Neurological symptoms with CD4 count

Legion of ships in background =

"Thumb-sign" on lateral X-ray (organism -azole = antifungal

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-navir = Protease inhibitors

1st generation cephalosporins that can be

Proteus, E. coli, Klebsiella

used to treat extended spectrum

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granulomas consisting of histiocytes,

Used in tickborne diseases

A common finding in early leptospirosis

There is redness but a lack of

A positive germ tube test is strongly

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demonstrates good cell mediated response

obstruction (from all the immobile worms).

A vascular extra-hepatic manifestation of

A side effect of albendazole is intestinal

A Disulfiram-like reaction is indicated by A Disulfiram-like reaction is A Disulfiram-like reaction is indicated by

A Disulfiram-like reaction is indicated by

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A poor prognosis occurs with Hep B and

A patchy alveolar infiltrate is characteristic A patchy alveolar infiltrate is characteristic

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Mostly gram-negative, some gram-positive

Alk phos will be elevated**

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Viral thymidine kinase

What viruses are indicated for the use of

except for some localized

Adenovirus infection may

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Adult onchocerca volvulus produce

Adverse effect with the use of Adverse effects of Simeprevir

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Adverse effects of Voriconazole

Blurring and changes in color Adverse effects of sofosbuvir

Myopathy and rhabodmyolysis

After a dermacentor tick bite, After a dermacentor tick bite,

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Show Learn more from Golgi

After a dermacentor tick bite,

Show Learn more from Golgi

After infection, where do the sporozoites After inhalation of Mucormycosis, the

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After inhalation of Mucormycosis, the

After invading blood vessels, After penetrating the cribiform

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After transcription from RNA, viral HIV

After sandflies injects After sandflies injects

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All + RNA viruses are icosahedral except

After sandflies injects

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