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[h] Microbiology & Antimicrobials Flashcards
[i] Master EL Husseiny’s Essentials of Microbiology & Antimicrobials
[q] ……….. consists mainly of bacteria, can provide useful nutrients (vitamin K and folic acid) and release compounds with antibacterial activity against pathogenic bacterium, and contribute to host defense by competing with invaders for space and nutrients and maintaining normal PH environment.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE5vcm1hbCBGbG9yYS4=[Qq]
[q] Colonization of GI tract is more rapid after vaginal delivery or C-section?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFZhZ2luYWwgZGVsaXZlcnku
Cg==Jm5ic3A7
Cg==QmVjYXVzZSBkdXJpbmcgYSByZWd1bGFyIHZhZ2luYWwgYmlydGgsIGluZmFudHMgY29tZSBpbiBjb250YWN0IHdpdGggYSByaWNoIGRvc2Ugb2YgdGhlaXIgbW90aGVyJiM4MjE3O3MgYmFjdGVyaWEgYXMgdGhleSBhcmUgcHJlc3NlZCB0aHJvdWdoIHRoZSBiaXJ0aCBjYW5hbC4gT24gdGhlIG90aGVyIGhhbmQsIEMtc2VjdGlvbiBiYWJpZXMgZG9uJiM4MjE3O3QgZ2V0IHRoaXMgZXhwb3N1cmUsIHdoaWNoIGlzIGxpa2VseSB0byBiZSB2aXRhbCBpbiBkZXZlbG9waW5nIHRoZSBpbW11bmUgc3lzdGVtIGFuZCBoZWxwaW5nIGl0IHRvIG1hdHVyZS4=[Qq]
[q] Genetic information of a bacterial cell is contained in a single circular molecule of double-stranded DNA, which constitutes the ……….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGJhY3RlcmlhbCBjaHJvbW9zb21lLg==[Qq]
[q] In many bacteria, additional genetic information is contained on ……. which are small circular extrachromosomal DNA molecules that can replicate independently of the chromosome.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHBsYXNtaWQu[Qq]
[q] Prokaryotic ribosomes have a sedimentation constant of 70S, smaller than the 80S ribosomes of eukaryotes. This difference is responsible for the ………. of antibiotics.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNlbGVjdGl2aXR5Lg==[Qq]
[q] ……… in prokaryotes is functional analogue of the mitochondria in eukaryotes.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENlbGwgKGN5dG9wbGFzbWljKSBtZW1icmFuZS4=
Cg==Jm5ic3A7
Cg==[Qq]
[q] …….. are small, circular, nonchromosomal, double-stranded DNA molecules. Capable of self-replication. Contain genes that confer protective properties such as antibiotic resistance or virulence factors or their own transmissibility to other bacteria.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBsYXNtaWQu[Qq]
[q] ………. is the major surface antigens of the Gram-positive bacteria, while ………. is the major surface antigens of the Gram-negative bacteria.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IExpcG90ZWljaG9pYyBhY2lkcywgcG9seXNhY2NoYXJpZGVzIG9mIGxpcG9wb2x5c2FjY2hhcmlkZXMgKExQUyku[Qq]
[q] Peptidoglycans is much thicker in ……… comprising up to 50% of the cell wall material, but much thinner in ……. composed of only one or two sheets comprising 5-10% of the cell wall material.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEdyYW0tcG9zaXRpdmUgYmFjdGVyaWEsIEdyYW0tTmVnYXRpdmUgYmFjdGVyaWEu
Cg==Cg==[Qq][q] …….. is a phospholipid protein bilayer present external to the peptidoglycan layer. The outer surface of the lipid bilayer is composed of molecules of lipopolysaccharides (LPS) which consist of a complex lipid called lipid A chemically linked to polysaccharides.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE91dGVyIG1lbWJyYW5lIChHcmFtIG5lZ2F0aXZlIG9ubHkpLg==
Cg==Jm5ic3A7
Cg==[Qq]
[q] ……. is the space between the cytoplasmic and outer membranes. Contains many hydrolytic enzymes, including β-lactamases.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBlcmlwbGFzbWljIHNwYWNlLg==[Qq]
[q] …….. doesn’t assume a defined recognizable shape, because they lack a rigid cell wall. They are also resistant to cell wall inhibitors, such as penicillin and cephalosporins.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]wqBNeWNvcGxhc21hLg==[Qq]
[q] Motile bacteria use ……… to migrate towards regions where there is a higher concentration of nutrients and solutes and away from disinfecting substances.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEZsYWdlbGxhLg==[Qq]
[q] Moist heat at ……. C for 10-20 minutes is needed to kill spores while 60C is sufficient to kill vegetative forms.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IDEyMS4=[Qq]
[q] Thermal resistance of spores is provided by their high content of ……. and ……?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENhIGFuZCBkaXBpY29saW5pYyBhY2lkLg==[Qq]
[q] ……… is Enzyme that cleaves IgA, allowing bacteria to adhere to and colonize mucous membranes. Secreted
by S pneumoniae, H influenzae type b, and Neisseria (SHiN).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IElnQSBwcm90ZWFzZXMu[Qq]
[q] In case of foreign bodies that is contaminated with S. Epidermidis, the bacteria multiply and communicate with one another to induce synthesis of an extracellular polysaccharide matrix (biofilm) that encases the bacteria. This extracellular matrix is called ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJpb2ZpbG0u[Qq]
[q] …….. refers to the mechanism by which an infectious agent such as a protozoan, bacterium or virus alters its surface proteins in order to evade a host immune response.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFudGlnZW5pYyB2YXJpYXRpb24u[Qq]
[q] When the slide is studied microscopically, cells that absorb the crystal violet and hold onto it will appear blue. These are called ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGdyYW0tcG9zaXRpdmUgb3JnYW5pc21zLg==
Cg==Cg==[Qq][q] If the crystal violet is washed off by the alcohol, these cells will absorb the safranin and appear red. These are called ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGdyYW0tbmVnYXRpdmUgb3JnYW5pc21zLg==
Cg==Jm5ic3A7
Cg==[Qq]
[q] Rickettsia and Chlamydia are intracellular bacteria that do not Gram stain well, we use …… to stain them.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEdpZW1zYS4=[Qq]
[q] Legionella is primarily intracellular microorganism that do not Gram stain well, we use …… to stain it.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNpbHZlciBzdGFpbi4=[Qq]
[q] Thayer Martin agar contains antibiotics that allow the selective growth of Neisseria by inhibiting the growth of other sensitive organisms. This is example of …….. growth media.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNlbGVjdGl2ZS4=[Qq]
[q] MacConkey agar contains a pH indicator; a lactose fermenter like E coli will convert lactose to acidic metabolites → color change. This is example of …….. growth media.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGRpZmZlcmVudGlhbC4=[Qq]
[q] Nocardia, Pseudomonas aeruginosa, and Mycobacterium tuberculosis are examples of obligate (aerobes, anaerobes)?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IG9ibGlnYXRlIGFlcm9iZXMu[Qq]
[q] Fusobacterium, Clostridium, Bacteroides, and Actinomyces are examples of obligate (aerobes, anaerobes)?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IDIuIE9ibGlnYXRlIGFuYWVyb2Jlcy4=[Qq]
[q] ……….. are ineffective against anaerobes because these antibiotics require O2 to enter into bacterial cell.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFtaW5PMmdseWNvc2lkZXMu[Qq]
[q] These organisms are not capable of the metabolic pathways for ATP synthesis and thus must steal ATP from their host. Examples include Rickettsia, CHlamydia, COxiella.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE9ibGlnYXRlIGludHJhY2VsbHVsYXIgYmFjdGVyaWEu[Qq]
[q] Streptococcus pneumoniae, Haemophilus influenzae type B, Neisseria meningitidis, Escherichia coli, Salmonella, Klebsiella pneumoniae, and group B Strep are examples of ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVuY2Fwc3VsYXRlZCBiYWN0ZXJpYS4gU0hpTkUgU0tpUy4=[Qq]
[q] …….. is responsible for the toxic properties of LPS that lead to Gram-negative sepsis and endotoxic septic shock.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IExpcGlkIEEu
Cg==Cg==[Qq][q] …….. can be modified by chemicals or heat to produce a toxoid that still immunogenic, but no longer toxic so can be used as a vaccine.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEV4b3RveGlucy4=
Cg==Cg==[Qq][q] Which phase of bacterial growth curve?
– The initial number of bacterial cells remains constant.
– During this period, the cells adapt to their new environment.
– Enzymes and intermediates are formed to permit growth.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IExhZyBwaGFzZS4=
Cg==Cg==[Qq][q] Which phase of bacterial growth curve?
– There is marked increase in cell number and its rate is accelerated exponentially with time giving a characteristic linear plot on a logarithmic scale.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEV4cG9uZW50aWFsIChsb2dhcml0aG1pYywgbG9nKSBwaGFzZS4=[Qq]
[q] Which phase of bacterial growth curve?
– Exhaustion of nutrients and accumulation of toxic products cause growth to decrease.
– There is slow loss of cells through death which is just balanced by formation of new cells through growth and division.
– The number of viable bacteria remains constant.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN0YXRpb25hcnkgcGhhc2Uu
Cg==Cg==[Qq][q] Which phase of bacterial growth curve?
– The death rate increases and exceeds the multiplication rate due to nutrient exhaustion and accumulation of toxic metabolic end products
– The number of viable bacteria decrease.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IERlY2xpbmUgb3IgZGVhdGggcGhhc2Uu
Cg==Cg==[Qq][q] …….. is a mechanism to incorporate short, linear pieces of DNA into the chromosome to stabilize it. There must be some sequence homology. Recombinase A is required. There is a one-to-one exchange of DNA.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhvbW9sb2dvdXMgcmVjb21iaW5hdGlvbi4=
Cg==Cg==[Qq][q] ……… is the mechanism used to combine Circular pieces of DNA nto the chromosome to stabilize it.. It requires no homology. No DNA is lost. It requires restriction endonucleases.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNpdGUtc3BlY2lmaWMgcmVjb21iaW5hdGlvbi4=
Cg==Cg==[Qq][q] …….. are viruses that parasits bacteria (the bacteria cell serves as a host for the virus). It consists of Head containing the nucleic acid core surrounded by a protein coat (capsid) and Tail consists of a hollow core surrounded by a contractile sheath which ends in a base plate to which tail fibers attaches.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJhY3RlcmlvcGhhZ2VzIChvciBwaGFnZXMpLg==
Cg==Cg==[Qq][q] ……… is the uptake of naked DNA from the environment by competent cells. Captured DNA is incorporated by homologous recombination.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRyYW5zZm9ybWF0aW9uLg==
Cg==Cg==[Qq][q] …….. is gene transfer from one bacterial cell to another involving direct cell-to-cell contact. Sex pili (genes on F factor) play a role in establishing cell-to-cell contact.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENvbmp1Z2F0aW9uLg==
Cg==Cg==[Qq][q] ……. occurs when an error is made in the life cycle of a virulent phage. During the lytic phage cycle, the bacterial DNA is fragmented, and any fragment of DNA (whether chromosomal or plasmid) may be incorporated into the phage head. The phage particle can then transfer the incorporated bacterial DNA into another bacterial host.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEdlbmVyYWxpemVkIHRyYW5zZHVjdGlvbi4=[Qq]
[q] ……… may occur when an error is made in the life cycle of a temperate (lysogenic) phage. Temperate phages introduce their genomic DNA into the bacterial chromosome at a specific site and then excise it later to complete their life cycle. If errors are made during the excision process, then bacterial chromosomal DNA can be carried along into the next generation of viruses.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNwZWNpYWxpemVkIHRyYW5zZHVjdGlvbi4=[Qq]
[q] …….. is A “jumping” process involving a transposon (specialized segment of DNA), which can copy and excise itself and then insert into the same DNA molecule or an unrelated DNA (plasmid or chromosome).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRyYW5zcG9zaXRpb24u
Cg==Cg==[Qq][q] …….. is Gram-positive cocci in clusters, Catalase positive, Coagulase-positive, ferments mannitol on mannitol salt agar and forms golden yellow colonies on blood agar surrounded with a zone of β-hemolysis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN0YXBoeWxvY29jY3VzIGF1cmV1cy4=
Cg==Cg==[Qq][q] ……… is an important adhesion expressed by S. aureus. It leads to attachment of the organism to traumatized tissue and blood clots
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRoZSBjbHVtYmluZyBmYWN0b3IgKGZpYnJpbm9nZW4tYmluZGluZyBwcm90ZWluKS4=[Qq]
[q] …….. binds with the Fc portion of lgG antibodies at the complement-binding site, preventing complement activation. This results in decreased production of C3b, leading to impaired opsonization and phagocytosis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFByb3RlaW4gQS4=
Cg==Cg==[Qq][q] …….. interact with major histocompatibility complex molecules on antigen presenting cells and the variable region of the T lymphocyte receptor to cause a nonspecific polyclonal widespread activation of T lymphocytes.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN1cGVyYW50aWdlbi4=
Cg==Cg==[Qq][q] What is the most likely diagnosis?
26 years old patient presenting with nausea, vomiting and abdominal cramps after 3 hours of eating mayonnaise-containing food (macaroni salad)?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN0YXBoeWxvY29jY2FsIGZvb2QgcG9pc29uaW5nLg==[Qq]
[q] …………. is capable of producing a highly heat-stable protein toxin called enterotoxin that causes a syndrome characterized by nausea, vomiting and abdominal cramps following ingestion of preformed exotoxin (exotoxin formed prior to ingestion).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN0YXBoeWxvY29jY3VzIGF1cmV1cy4=[Qq]
[q] What is the most likely diagnosis?
26 years old female presenting with Fever, vomiting, diarrhea, muscle pain and erythroderma, and hypotension + she admits using vaginal tampons that are left in place for extended period?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRveGljIHNob2NrIHN5bmRyb21lIChUU1MpLiBUU1NUIGFjdHMgYXMgYSBzdXBlcmFudGlnZW4u[Qq]
[q] What is the most likely diagnosis?
4 years old child presenting with moist, red, scalded skin + – Nikolsky’s sign (skin slipping off with gentle pressure), epidermal necrolysis, fever and pain associated with the skin rash?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN0YXBoeWxvY29jY2FsIHNjYWxkZWQgc2tpbiBzeW5kcm9tZSAoU1NTUyku
Cg==Jm5ic3A7
Cg==[Qq]
[q] Staphylococcal Scalded Skin Syndrome (SSSS) is caused by certain strains of Staphylococcus species that produce the ……?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEV4Zm9saWF0aW4gZXhvdG94aW4u[Qq]
[q] …….. is the most common cause of tricuspid endocarditis in intravenous drug users.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFMuIGF1cmV1cy4=[Qq]
[q] …….. is Gram-positive cocci, Catalase positive, Coagulase negative, Novobiocin sensitive and does not ferment mannitol.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN0YXBoIGVwaWRlcm1pZGlzLg==[Qq]
[q] What is the most likely Cause?
9 month age child presenting with symptoms of meningeal irritation after insertion of ventriculoperitoneal shunt for treatment of congenital hydrocephalus?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN0YXBoIGVwaWRlcm1pZGlzLg==[Qq]
[q] After attachment of the Staph epidermidis to the implanted foreign bodies, bacteria multiply and communicate with one another to induce synthesis of ………. that encases the bacteria.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGV4dHJhY2VsbHVsYXIgcG9seXNhY2NoYXJpZGUgbWF0cml4IChiaW9maWxtKS4=[Qq]
[q] S. epidermidis are frequently resistant to methicillin; therefore, ……… is recommended for therapy of serious infections caused by methicillin-resistant strains.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHZhbmNvbXljaW4sIGNvbWJpbmVkIHdpdGggcmlmYW1waW4gb3IgZ2VudGFtaWNpbiBvciBib3RoLg==[Qq]
[q] What is the most likely Cause?
Sexually active young female presenting with urgency, frequency, hesitancy + urine culture shows Catalase positive, Coagulase negative, and Novobiocin resistant microorganism?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN0YXBoeWxvY29jY3VzIHNhcHJvcGh5dGljdXMu[Qq]
[q] ……. is – Gram-positive cocci in chains, Catalase negative, β-hemolytic on blood agar, Bacitracin sensitive and Pyrrolidonyl arylamidase (PYR) positive.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN0cmVwdG9jb2NjdXMgcHlvZ2VuZXMgKEdyb3VwIEEgU3RyZXB0b2NvY2N1czsgR0FTKS4=
Cg==Cg==[Qq][q] M protein is one of the cell surface proteins of S. pyogenes and represents the most important virulence factor. It enables the bacteria to colonize skin and ……?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGluaGliaXQgcGhhZ29jeXRvc2lzLg==[Qq]
[q] Streptolysin O (SLO) is a highly immunogenic protein and induces specific antibody formation (its detection is the basis for the anti-streptolysin O test). Antibodies to Streptolysin O (ASO) titer of > 200 is significant for …….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHJoZXVtYXRpYyBmZXZlci4=[Qq]
[q] What is the most likely diagnosis?
14 years old child presenting with rash that appears on the neck, armpits, and groin that subsequently generalizes to the rest of the body (palms and soles are spared) that resembles sandpaper-like” rash, strawberry tongue, circumoral pallor, 3 days after streptococcal pharyngitis?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNjYXJsZXQgZmV2ZXIu[Qq]
[q] ……… is blistering eruption eventually leading to formation of a golden yellow crust (honey-crusted lesion), is usually seen in children and newborns, frequently occurs periorally, and can be caused by either Staphylococcuseureus and/or Streptococcus pyogenes.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEltcGV0aWdvLg==[Qq]
[q] Cellulitis and erysipelas manifest as areas of skin erythema, edema, and warmth. They differ in that erysipelas involves …….., whereas cellulitis involves the ……?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSB1cHBlciBkZXJtaXMgYW5kIHN1cGVyZmljaWFsIGx5bXBoYXRpY3MsIGRlZXBlciBkZXJtaXMgYW5kIHN1YmN1dGFuZW91cyBmYXQu[Qq]
[q] …… follows pharyngitis but not skin infection, whereas …… is preceded by either skin or throat infection.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFSRiwgQUdOLg==[Qq]
[q] Many patients with rheumatic heart disease eventually require cardiac surgery but early treatment of streptococcal pharyngitis with …… will decrease the need for cardiac surgery in these patients.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IExvbmcgYWN0aW5nIHBlbmljaWxsaW4u[Qq]
[q] Antibodies to M protein of Streptococcus pyogenes cross-react with epitopes on heart myosin and sacrolemmal membrane proteins causing ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFSRi4=
Cg==Cg==[Qq][q] What is the most likely diagnosis?
18 Years old patient presenting with Hypertension, hematuria, nephritic range proteinuria, and RBC casts in the urine following a GAS infection?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFjdXRlIHBvc3RzdHJlcHRvY29jY2FsIGdsb21lcnVsb25lcGhyaXRpcy4=[Qq]
[q] The renal damage in Acute poststreptococcal glomerulonephritis is due to ……… deposition on the glomerular basement membrane and activation of complement.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFnLUFiIGltbXVuZSBjb21wbGV4ZXMu[Qq]
[q] ……. is – Gram-positive cocci, B-hemolytic on blood agar, Bacitracin resistant, Hippurate test positive, and CAMP test positive.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN0cmVwdG9jb2NjdXMgYWdhbGFjdGlhZSAoR3JvdXAgQiBTdHJlcHRvY29jY2k7IEdCUyku[Qq]
[q] …….. produces CAMP factor, which enlarges the area of hemolysis formed by S. aureus.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN0cmVwdG9jb2NjdXMgYWdhbGFjdGlhZSAoR3JvdXAgQiBTdHJlcHRvY29jY2k7IEdCUyku[Qq]
[q] In women who culture positive for GBS or in women who have had an infant affected by GBS in the past, intrapartum …….. is indicated to prevent neonatal GBS sepsis, pneumonia and meningitis. The incidence of group B streptococcal disease in babies less than a week old is declining due to these recommendations.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBlbmljaWxsaW4vQW1waWNpbGxpbi4=[Qq]
[q] …… is – Gram-positive cocci, α hemolytic, and Optochin resistant.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFZpcmlkaWFucyBTdHJlcHRvY29jY2kgKFMuIFNhbmd1aXMsIFMuIE11dGFucyku[Qq]
[q] S. mutans dextran-mediated adherence glues oral flora onto teeth, causing ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGRlbnRhbCBjYXJpZXMu[Qq]
[q] ……. is – Gram-positive Lancet-shaped diplococcic, α hemolysis on blood agar, and Optochin sensitive.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN0cmVwdG9jb2NjdXMgcG5ldW1vbmlhZS4=[Qq]
[q] The most important virulence factor of Streptococcus pneumoniae is the ……. which is antiphagocytic.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHBvbHlzYWNjaGFyaWRlIGNhcHN1bGUu[Qq]
[q] ………. is most common cause of typical pneumonia (especially in sixth decade of life), Adult meningitis, and otitis media and sinusitis in children.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN0cmVwdG9jb2NjdXMgcG5ldW1vbmlhZS4=[Qq]
[q] ……… is the most common cause of bacterial meningitis in adults of all ages. On CSF Gram stain, lancet-shaped Gram-positive cocci are found in pairs.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN0cmVwdG9jb2NjdXMgcG5ldW1vbmlhZS4=[Qq]
[q] ……. is a Gram-positive cocci in chains, Catalase-negative, gamma-hemolytic (no hemolysis on blood agar), can grow in hypertonic 6.5% NaCl and bile (lab test), PYR test positive.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVudGVyb2NvY2NpIChFbnRlcm9jb2NjdXMgZmFlY2FsaXMvZmFlY2l1bSku[Qq]
[q] ………. are normal colonic flora that are penicillin G resistant and cause UTI, biliary tract infections, and subacute endocarditis following GI/GU procedures (Colonoscopy, Cystoscopy).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVudGVyb2NvY2NpIChFLiBmYWVjYWxpcyBhbmQgRS4gZmFlY2l1bSku[Qq]
[q] ……. is a Gram-positive cocci in chains, Catalase-negative, gamma-hemolytic (no hemolysis on blood agar), can grow in bile but not on 6.5% NaCl, PYR test negative.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN0cmVwdG9jb2NjdXMgZ2FsbG9seXRpY3VzIChmb3JtZXJseSBTIGJvdmlzKS4=[Qq]
[q] Every patient with S. bovis bacteremia with or without endocarditis should be examined for ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEdJIHRyYWN0IG1hbGlnbmFuY3kgKGNvbG9uIGNhbmNlciku
Cg==Cg==74KnIEJvdmlzIGluIHRoZSBibG9vZCA9IGNhbmNlciBpbiB0aGUgY29sb24u[Qq]
[q] ……….. Spore- forming gram positive aerobic rods.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJhY2lsbHVzLg==[Qq]
[q] ……….. are Spore- forming gram positive aerobic rods, has polypeptide (poly-D-glutamate) capsule, On microscopy it forms long chains that are described as being “serpentine” or “medusa head” on appearance.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJhY2lsbHVzIGFudGhyYXgu[Qq]
[q] Bacillus anthracis produces an antiphagocytic capsule that contains …….. instead of polysaccharide.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEQtZ2x1dGFtYXRlLg==[Qq]
[q] What is the most likely diagnosis?
27 years old patient who handle livestock hides presenting with skin lesion that started with small papule which changes rapidly to a vesicle, then a pustule, and finally into a necrotic ulcer which blackens to form a characteristic eschar. The lesion is painless and is surrounded by marked edema.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEN1dGFuZW91cyBhbnRocmF4IChtYWxpZ25hbnQgcHVzdHVsZSku[Qq]
[q] What is the most likely diagnosis?
27 years old patient who work in wool processing presenting with myalgia, fever and malaise that rapidly progress to hemorrhagic mediastinitis (widened mediastinum on chest x-ray)?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFB1bG1vbmFyeSBhbnRocmF4Lg==[Qq]
[q] What is the most likely diagnosis?
26 years old patient presenting with nausea, vomiting and abdominal cramps that started 4 hours after eating fried rice in Chinese restaurant?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJhY2lsbHVzIGNlcmV1cyBmb29kIHBvaXNvbmluZyAocmVoZWF0ZWQgcmljZSBzeW5kcm9tZSku[Qq]
[q] ……….. are Spore- forming gram positive Obligate anaerobic rods.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENsb3N0cmlkaXVtLg==[Qq]
[q] What is the most likely diagnosis?
32 years old immigrant presenting with difficulty opening the jaw with characteristic smile, Contractions of back muscles, resulting in backward arching after being wounded by rusted nail while walking barefooted?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRldGFudXMu
Cg==Cg==[Qq][q] Tetanospasmin toxin is a neurotoxin that acts centrally at the level of …….. and work by inhibiting the release of ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBicmFpbiBzdGVtIGFuZCBhbnRlcmlvciBob3JuIGNlbGxzIG9mIHRoZSBzcGluYWwgY29yZCwgdGhlIGluaGliaXRvcnkgbmV1cm90cmFuc21pdHRlcnMgZ2x5Y2luZSBhbmQgZ2FtbWEtYW1pbm9idXR5cmljIGFjaWQgKEdBQkEpIGZyb20gdGhlc2UgaW5oaWJpdG9yeSBuZXVyb25zLg==[Qq]
[q] An immunized mother will be able to pass …….. through the placenta to the fetus and provide passive immunity against neonatal tetanus until the child receives its first tetanus vaccination at two months of age.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGxnRy4=[Qq]
[q] Infant botulism is frequently transmitted due to consuming ………., adult botulism results from consuming …….., typically in canned food.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEMuIGJvdHVsaW51bSBzcG9yZXMgaW4gaG9uZXksIHByZWZvcm1lZCB0b3hpbi4=[Qq]
[q] The botulinum toxin is specific for peripheral nerve endings at the neuromuscular junction where it inhibits the release of ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGFjZXR5bGNob2xpbmUu
Cg==Cg==[Qq][q] What is the most likely diagnosis?
27 years old patient presenting with diplopia, dysphagia, descending, symmetric flaccid paralysis of motor nerves after eating canned salmon?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFkdWx0IGJvdHVsaXNtLg==[Qq]
[q] What is the most likely diagnosis?
6 months child presenting with constipation and weak sucking ability and generalized weakness after consuming honey?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEluZmFudCBib3R1bGlzbSAoZmxvcHB5IGJhYnkgc3luZHJvbWUpLg==[Qq]
[q] Culture and isolation of Clostridium botulinum and bioassay of its toxin are time-consuming procedures, that’s why we use tests based on ……….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVMSVNBIG1ldGhvZG9sb2d5IGFuZCBwb2x5bWVyYXNlIGNoYWluIHJlYWN0aW9uIHRlY2huaXF1ZXMu[Qq]
[q] Local injection of ……….. into the dystonic sternocleidomastoid muscle results in muscular relaxation because the toxin prevents presynaptic release of acetylcholine, the neurotransmitter responsible for muscle contraction, from the nerve terminal at the neuromuscular junction.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGJvdHVsaW51bSB0b3hpbiAoQm90b3gpLg==[Qq]
[q] What is the most likely diagnosis?
25 years old patient presenting with rapid-onset muscle pain, fever, hemorrhagic bullae with dusky surrounding skin, and tissue edema/crepitus after traumatic penetrating injury in his lower limb?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEdhcyBnYW5ncmVuZSAobXlvbmVjcm9zaXMpLsKgTGVjaXRoaW5hc2UsIGFsc28ga25vd24gYXMgcGhvc3Bob2xpcGFzZSBDIG9yIGFscGhhIHRveGluLCBpcyBhbiBlbnp5bWUgdGhhdCBjYXRhbHl6ZXMgdGhlIHNwbGl0dGluZyBvZiBwaG9zcGhvbGlwaWQgbW9sZWN1bGVzIGluIGNlbGwgbWVtYnJhbmVzIGNhdXNpbmcgY2VsbCBseXNpcyAoaW5jbHVkaW5nIFJCQyBoZW1vbHlzaXMpLCB0aXNzdWUgbmVjcm9zaXMgYW5kIGVkZW1hLg==[Qq]
[q] Clostridium Perfringens can also cause a late-onset food poisoning characterized by ………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRyYW5zaWVudCB3YXRlcnkgZGlhcnJoZWEu[Qq]
[q] Spontaneous gas gangrene (nontraumatic) is caused by Clostridium septicum. Most cases of spontaneous gas gangrene are triggered by breakdowns in the gastrointestinal mucosa like ………. or ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGNvbG9uaWMgbWFsaWduYW5jeSwgSW5mbGFtbWF0b3J5IGJvd2VsIGRpc2Vhc2Uu[Qq]
[q] What is the most likely diagnosis?
60 years old patient was hospitalized 2 weeks ago due to pneumonia presenting with watery diarrhea, abdominal pain, and multiple White/yellow membrane-like plaques seen on colonoscopy + the patient was given a long course of fluoroquinolones for treatment of pneumonia?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHBzZXVkb21lbWJyYW5vdXMgY29saXRpcy4=[Qq]
[q] …………. is the best method for diagnosing C difficile colitis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBDUiBkZXRlY3Rpb24gb2YgdG94aW4gQSBhbmQgQiBnZW5lcyBpbiB0aGUgc3Rvb2wu[Qq]
[q] Cases of suspected or proven ……… infection require additional contact precautions, including handwashing with soap and water (alcohol-based hand sanitizers do not kill the spores), gown for any patient contact, and nonsterile gloves that should be changed after contact with contaminated secretions. In addition, a dedicated stethoscope and blood pressure cuff should be left in the patient’s room.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEMgZGlmZmljaWxlLg==
Cg==Cg==[Qq][q] ………… is Gram-positive nonspore-forming rods on blood agar, Beta hemolytic on blood agar, demonstrates tumbling motility at 22 C, and able to multiply at 4°C.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IExpc3RlcmlhIG1vbm9jeXRvZ2VuZXMu[Qq]
[q] Listeria monocytogenes can grow intracellularly. It evades killing when lysosomal contents are dumped into phagosome by Forming rocket tails via ……… that allow intracellular movement and cell-to-cell spread across cell membranes, thereby avoiding antibody
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGFjdGluIHBvbHltZXJpemF0aW9uLg==[Qq]
[q] Infection with listeria in Healthy adults and children with intact cell mediated immunity are generally asymptomatic or presents with ……, but in pregnant, neonates or immunocompromised cause Septicemia and meningitis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IG1pbGQgZ2FzdHJvZW50ZXJpdGlzLA==[Qq]
[q] Listeria is not sensitive to …… and Ampicillin is the treatment of choice.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGNlcGhhbG9zcG9yaW5zLg==[Qq]
[q] ……… is gram-positive non-spore forming rods, Aerobic, produce gray-to-black colonies of club-shaped gram-positive rods arranged in V or L shapes on cysteine-tellurite agar.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENvcnluZWJhY3Rlcml1bSBkaXBodGhlcmlhZS4=
Cg==Cg==[Qq][q] Diphtheria toxin inhibits host cell protein synthesis by ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGNhdGFseXppbmcgdGhlIEFEUC1yaWJvc3lsYXRpb24gb2YgcHJvdGVpbiBlbG9uZ2F0aW9uIGZhY3RvciAyIChFRi0yKS4=[Qq]
[q] What is the most likely diagnosis?
23 years old immigrant patient presenting with suffocation and symptoms of respiratory obstruction + during examination there is grey white membrane in the pharynx firmly adherent to the underling mucosa + throat swab shows – Gray-to-black colonies of club-shaped gram-positive rods arranged in V or L shapes on cysteine-tellurite agar?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHBzZXVkb21lbWJyYW5vdXMgcGhhcnluZ2l0aXMu[Qq]
[q] Diphtheria toxin is absorbed and disseminated through the blood to the susceptible tissues, mainly ……. and ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGhlYXJ0IG11c2NsZSBhbmQgcGVyaXBoZXJhbCBuZXJ2ZXMpLsKgQ2xpbmljYWwgbWFuaWZlc3RhdGlvbnMgaW5jbHVkZSBteW9jYXJkaXRpcywgYXJyaHl0aG1pYSwgaGVhcnQgZmFpbHVyZSwgbmV1cm9wYXRoeSwgcGFyYWx5c2lzLCBhbmQgY29tYS4=[Qq]
[q] Non-pathogenic Corynebacterium can cause severe pseudomembranous pharyngitis after acquiring the Tox gene via …………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGx5c29nZW5pemF0aW9uIGJ5IGEgdGVtcGVyYXRlIGJhY3RlcmlvcGhhZ2Uu[Qq]
[q] Rapid administration of Diphtheria antitoxin is essential. Diphtheria antitoxin work by ………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGluYWN0aXZhdGluZyBhbGwgY2lyY3VsYXRpbmcgdG94aW4sIGJ1dCBpcyBpbmVmZmVjdGl2ZSBhZ2FpbnN0IHRveGluIHRoYXQgaGFzIGFscmVhZHkgZ2FpbmVkIGFjY2VzcyB0byBjYXJkaWFjIG9yIG5ldXJhbCBjZWxscy4=
Cg==Cg==[Qq][q] ……… is gram positive anaerobic Branching rods, Non-acid fast. Yellow aggregations of organisms bound together by proteins look like sulfur granules. Sulfur granules grossly appear yellow; however, hematoxylin and eosin staining gives them basophilic appearance under light microscope.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFjdGlub215Y2VzIGlzcmFlbGlpLg==[Qq]
[q] What is the most likely diagnosis?
18 years old patient with bad oral hygiene presenting with slowly growing mass that began in the setting of oral trauma that has recently been draining yellow pus through the skin?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENlcnZpY29mYWNpYWwgYWN0aW5vbXljb3Npcy4=[Qq]
[q] Treatment of Cervicofacial actinomycosis consists of a prolonged course of parenteral …….. and surgical debridement?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHBlbmljaWxsaW4u[Qq]
[q] ……… is gram positive obligate aerobic Branching rods. Partially acid fast.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE5vY2FyZGlhLg==[Qq]
[q] What is the most likely diagnosis?
34 years old patient who take immunosuppressive drugs for renal transplant presenting with symptoms and x-ray finding that mimic tuberculosis + Gram staining of bronchoalveolar lavage sample shows branching filament microorganism?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IDEuIENhdml0YXJ5IGJyb25jaG9wdWxtb25hcnkgbm9jYXJkaW9zaXMu[Qq]
[q] Treatment of nocardiosis is ……………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHN1bGZvbmFtaWRlcyAoaGlnaCBkb3NlKSBvciB0cmltZXRob3ByaW0vc3VsZmFtZXRob3hhem9sZSAoVE1QLVNNWCku[Qq]
[q] Acid-fastness of mycobacteria and nocardia is due to ……….. of the cell wall.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBoaWdoIGxpcGlkIChteWNvbGljIGFjaWQpIGNvbnRlbnQu[Qq]
[q] Mycobacteria are facultative intracellular pathogens except ………. is obligate intracellular pathogen.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE0uIGxlcHJlYS4=[Qq]
[q] ………… is Obligate aerobe, Acid fast in carbol-fuchsin (Ziehl-Neelsen stain).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE15Y29iYWN0ZXJpdW0gdHViZXJjdWxvc2lzLg==[Qq]
[q] The growth of thick, rope like cords of mycobacterial organisms in a twisted, “serpentine” pattern is consistent with the presence of cord factor. – The presence of cord factor correlates with ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHZpcnVsZW5jZS4=[Qq]
[q] Sulfatides (sulfolipids in cell envelope of mycobacteria tuberculosis) inhibit …….., allowing intracellular survival.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHBoYWdvc29tZS1seXNvc29tZSBmdXNpb24u[Qq]
[q] What is the most likely diagnosis?
60 years old patient presenting with malaise, fatigue, night sweat and fever along with persistent cough and bloody sputum, x-ray findings shows cavitary lesion, calcified nodules in the apex of the lung + sputum sample is positive for acid fast bacilli?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFB1bG1vbmFyeSB0dWJlcmN1bG9zaXMu[Qq]
[q] ……… is obligate intracellular bacteria, Acid fast rods, can be isolated from the nine-banded armadillo for for biochemical and immunological research.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE15Y29iYWN0ZXJpdW0gbGVwcmFlLg==[Qq]
[q] The severity of leprosy depends on the strength of the cell-mediated immune response, with …….. is the milder form and ……….. is the more severe form.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHR1YmVyY3Vsb2lkIGxlcHJvc3ksIGxlcHJvbWF0b3VzIGxlcHJvc3ku
Cg==Cg==[Qq][q] ……… is gram-negative, kidney bean-shaped diplococcic, maltose fermenter, can be cultured on Thayer-Martin VCN (vancomycin/colistin/nystatin) selective medium.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE5laXNzZXJpYSBtZW5pbmdpdGlkaXMu
Cg==Cg==[Qq][q] What is the most likely diagnosis?
34 years old patient presenting with severe headache, projectile vomiting, and stiff neck, and nuchal rigidity + CSF Findings include elevated WBC’s (neutrophils predominant), elevated proteins, low glucose + CSF culture shows gram-negative, kidney bean-shaped diplococcic on Thayer-Martin VCN?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1lbmluZ2l0aXMgZHVlIHRvIE5laXNzZXJpYSBtZW5pbmdpdGlkaXMu[Qq]
[q] What is the most likely diagnosis?
34 years old patient presenting with spiking fevers, chills, arthralgias, and myalgias, as well as purpuric cutaneous lesions and hypotension + Blood culture shows gram-negative, kidney bean-shaped diplococcic on Thayer-Martin VCN?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1lbmluZ29jb2NjZW1pYS4=[Qq]
[q] Waterhouse-Friderichsen syndrome is a complication of meningococcemia that may involve bilateral hemorrhagic destruction of ………, disseminated intravascular coagulation (DIC), and shock.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGFkcmVuYWwgZ2xhbmQu[Qq]
[q] ………. is gram-negative, kidney bean-shaped diplococcic, maltose nonfermenter, can be cultured on Thayer-Martin VCN (vancomycin/colistin/nystatin) selective medium.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE5laXNzZXJpYSBnb25vcnJob2VhZS4=
Cg==Cg==[Qq][q] What is the most likely diagnosis?
27 years old male patient presenting with dysuria, frequency, urgency with purulent urethral discharge after having unprotected sexual intercourse + Gram stain of urethral discharge from affected patients shows Gram negative diplococci within leukocytes?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEdvbm9ycmhlYS4=[Qq]
[q] What is the most likely diagnosis?
27 years old male patient presenting with Mucopurulent cervicitis with cervical motion tenderness + Gram stain of cervical discharge from affected patients shows Gram negative diplococci within leukocytes?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBlbHZpYyBpbmZsYW1tYXRvcnkgZGlzZWFzZSAoUElEKS4=[Qq]
[q] Treatment of gonococcal PID must also always include treatment for ………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEMuIHRyYWNob21hdGlzLiBBIHRoaXJkLWdlbmVyYXRpb24gY2VwaGFsb3Nwb3JpbiB3aWxsIHRyZWF0IHRoZSBnb25vY29jY2FsIGluZmVjdGlvbiwgYW5kIGZ1cnRoZXIgdHJlYXRtZW50IHdpdGggYXppdGhyb215Y2luIG9yIGRveHljeWNsaW5lIGlzIHJlcXVpcmVkIHRvIHRyZWF0IHRoZSBDaGxhbXlkaWEsIHdoaWNoIGlzIG5vdCBzZW5zaXRpdmUgdG8gdGhlIGJldGEtbGFjdGFtcy4=[Qq]
[q] What is the most likely diagnosis?
22 years old male patient presenting with painful, swollen, erythematous knee joint after having unprotected sexual intercourse + synovial fluid sample is purulent with large number of Wbc’s and culture shows gram-negative, kidney bean-shaped diplococcic, maltose nonfermenter on Thayer-Martin VCN (vancomycin/colistin/nystatin) selective medium?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNlcHRpYyBhcnRocml0aXMu[Qq]
[q] …….. is the reason why development of an effective vaccine directed against the gonococcal pilus is so challenging.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFudGlnZW5pYyB2YXJpYXRpb24u
Cg==QW50aWdlbmljIHZhcmlhdGlvbiBpcyBhIHByb2Nlc3MgYnkgd2hpY2ggdGhlIHN0cnVjdHVyYWwgZ2VuZXMgZm9yIHBpbHVzIHByb3RlaW5zIHVuZGVyZ28gcmVjb21iaW5hdGlvbiB3aXRoIGVhY2ggb3RoZXIgdG8gcHJvZHVjZSBuZXcgYW50aWdlbmljIHR5cGVzIG9mIHBpbGksIGFuZCB0aGUgYXJyYXkgb2YgZGlmZmVyZW50IGFudGlnZW5pYyBwaWx1cyB0eXBlcyBwcm9kdWNlZCBieSB0aGlzIG1lY2hhbmlzbSB0aGVvcmV0aWNhbGx5IG1heSBiZSBxdWl0ZSBsYXJnZS4=
Cg==[Qq]
[q] What is the most likely diagnosis?
19 Years old patient presenting with Runny nose, facial pain, headache + gram staining shows Gram-negative diplococcus?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNpbnVzaXRpcyBkdWUgdG8gTW9yYXhlbGxhIGNhdGFycmhhbGlzLg==[Qq]
[q] …….. gram-negative coccobacillary rod, blood-loving organism that requires both X factor (hematin) and V factor (NAD) to grow.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhhZW1vcGhpbHVzIGluZmx1ZW56YWUu[Qq]
[q] Type B capsular material consists of a ribosyl and ribitol phosphate polymer called ………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBvbHlyaWJpdG9sIHBob3NwaGF0ZSAoUFJQKS4=[Qq]
[q] H influenza type B used to be a major cause of severe, invasive infections including ……… , …….. and ………. However, since the advantage of the conjugate Hib vaccine, most H influenza infections are due to non-type B strains that cause noninvasive disease such as ……….., ……….., and …………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGVwaWdsb3R0aXRpcywgbWVuaW5naXRpcywgYW5kIGJhY3RlcmVtaWEuIHNpbnVzaXRpcywgYnJvbmNoaXRpcywgb3RpdGlzIG1lZGlhLCBhbmQgY29uanVuY3Rpdml0aXM=[Qq]
[q] What is the most likely diagnosis?
34 years old immigrant patient presenting with severe headache, projectile vomiting, and stiff neck, and nuchal rigidity + CSF Findings include elevated WBC’s (neutrophils predominant), elevated proteins, low glucose + CSF culture shows gram-negative coccobacillary rod, blood-loving organism that requires both X factor (hematin) and V factor (NAD) to grow?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1lbmluZ2l0aXMgZHVlIHRvIEguIGluZmx1ZW56YSB0eXBlIGIgKEhpYiku[Qq]
[q] What is the most likely diagnosis?
14 years old immigrant patient presenting with fever, dysphagia, drooling, and inspiratory stridor + epiglottis appears cherry red though inspection of the epiglottis + lateral neck x-ray is shown below?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVwaWdsb3R0aXMu[Qq]
[q] The change in the vaccination schedule of Hib conjugate vaccine would most likely affect the epidemiology of ………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1lbmluZ2l0aXMu[Qq]
[q] Colonies of H. influenza will grow around the hemolytic S. aureus colonies resulting in the characteristic ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]ICYjODIyMDtzYXRlbGxpdGUmIzgyMjE7IHBoZW5vbWVub24u
Cg==Cg==[Qq][q] What is the most likely diagnosis?
24 Years old patient presenting with deep, painful ulcers with ragged borders that are associated with a grey exudate and inguinal lymphadenopathy after unprotected sex + Dark field microscopy failed to show any organism?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENoYW5jcm9pZCAoeW91ICYjODIyMDtkbyBjcnkmIzgyMjE7IHdpdGguIEggZHVjcmV5aSku[Qq]
[q] What is the most likely diagnosis?
12 years old child presenting with facial Cellulitis with characteristic mouse-like odor and lymphadenitis + wound culture shows Gram-negative coccobacillary rods?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBhc3RldXJlbGxhIG11bHRvY2lkYSBpbmZlY3Rpb24u[Qq]
[q] What is the most likely diagnosis?
27 years old patient working in skinning rabbits presenting with fever, ulcer at bite site, and regional lymph node enlargement and necrosis + culture of the ulcer shows Gram-negative coccobacillary rods?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHVsY2Vyb2dsYW5kdWxhciBkaXNlYXNlIGR1ZSB0byBGcmFuY2lzZWxsYSB0dWxhcmVuc2lzLg==[Qq]
[q] Pertussis toxin (PTx) has a potent adenylate cyclase activity by ADP ribosylation of ………. –> ↑ cAMP activity that reduces phagocytic activity locally and helps the organism to initiate infection.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEdpIChpbmhpYml0aW5nIG5lZ2F0aXZlIHJlZ3VsYXRvciBvZiBhZGVueWxhdGUgY3ljbGFzZSwgZGlzaW5oaWJpdGlvbiku[Qq]
[q] Adenylate cyclase toxin is Like ……………, adenylate cyclase toxin functions as a calmodulin-dependent adenylate cyclase that causes phagocyte dysfunction and edema.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVkZW1hIGZhY3RvciBvZiBiYWNpbGx1cyBhbnRocmFjaXMu[Qq]
[q] Tracheal cytotoxin (TCT) is not a classic bacterial exotoxin, since it is not composed of protein, but is a peptidoglycan fragment that work by …………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGtpbGxpbmcgY2lsaWF0ZWQgcmVzcGlyYXRvcnkgZXBpdGhlbGlhbCBjZWxscy4=[Qq]
[q] What is the most likely diagnosis?
8 years old immigrant child presenting with paroxysms of intense cough followed by inspiratory gasp, and posttussive vomiting + gram staining shows Gram-negative, aerobic coccobacillus?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFdob29waW5nIGNvdWdoLg==[Qq]
[q] What is the most likely diagnosis?
25 years old farmer presenting with fever, which is usually prolonged and intermittent (in waves rising and falling pattern), chills, weakness, malaise, body aches, sweating and headache + blood culture shows Gram-negative coccobacillus?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJydWNlbGxvc2lzICh1bmR1bGFudCBmZXZlciBvciBtYWx0YSBmZXZlciku[Qq]
[q] ………….. is Gram-negative rods that stains faintly with Gram stain; silver stains improve visualization. Culture must be performed on buffered charcoal yeast extract (BCYE) agar supplemented with L-cysteine and iron.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IExlZ2lvbmVsbGEgcG5ldW1vcGhpbGEu[Qq]
[q] What is the most likely diagnosis?
30 years old patient was on cruise trip presenting with high fever (>39 C), dry cough, mild respiratory distress, neurological symptoms (confusion), and gastrointestinal symptoms (diarrhea), x-ray finding shows a unilobar infiltrate + Sputum Gram stain often shows many neutrophils, but few or no organisms.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IExlZ2lvbm5haXJlcyYjODIxNzsgZGlzZWFzZS4gVGhlIGRpYWdub3NpcyBpcyBtb3N0IGNvbW1vbmx5IG1hZGUgYnkgdGVzdGluZyBmb3IgTGVnaW9uZWxsYSBhbnRpZ2VuIGluIHRoZSB1cmluZS4=
Cg==Cg==[Qq][q] What is the most likely diagnosis?
19 years old patient presenting with bloody diarrhea (blood and pus in stools), and crampy abdominal pain after eating undercooked poultry + culture shows comma or S shaped Gram-negative rod with a polar flagella that allows it to move in a characteristic “corkscrew” fashion, Oxidase +ve, and Grows well at 42.0°C on selective media?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENhbXB5bG9iYWN0ZXIgamVqdW5pIGdhc3Ryb2VudGVyaXRpcy4=[Qq]
[q] ……….. is Triple ⊕ Gram-negative comma shaped gastric bacilli with flagella (catalase ⊕, oxidase ⊕, and urease ⊕).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhlbGljb2JhY3RlciBweWxvcmku[Qq]
[q] Urease breath test is a screening assay for the presence of ………., an indirect means of detecting the presence of Helicobacter pylori, a major cause of duodenal ulcer.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHVyZWFzZSBhY3Rpdml0eS4=[Qq]
[q] Vibrio cholerae is sensitive to stomach acid and most die in the stomach → Requires high dose if stomach acid is normal. But can cause infection with lower infectious dose in cases of ………, ………., and ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGJ1ZmZlcmluZyBjYXBhY2l0eSBvZiBmb29kLCBBY2hsb3JoeWRyaWEsIGFuZCBwcm90b24gcHVtcCBpbmhpYml0b3IgdGhlcmFweS4=[Qq]
[q] Cholera toxin increases levels of cAMP by increasing the activity of adenylate cyclase in intestinal mucosal cells by a mechanism identical to that of ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBoZWF0IGxhYmlsZSB0b3hpbiBwcm9kdWNlZCBieSBFbnRlcm90b3hpZ2VuaWMgRS4gY29saSAoRVRFQyku[Qq]
[q] What is the most likely diagnosis?
23 years old patient presenting with abrupt onset of voluminous massive watery diarrhea, The watery diarrhea is speckled with flakes of mucus and epithelial cells “rice-water stool” + stool culture shows Gram-negative, Comma-shaped rods, Oxidase-positive, and able to grow on alkaline enrichment medium that kills most organisms of the normal flora of the gut?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENob2xlcmEu[Qq]
[q] Healthy patients with V. vulnificus wound contamination usually develop a mild cellulitis, but those with ……….. or ………….. are at high risk for rapidly progressive necrotizing fasciitis with hemorrhagic, bullous lesions and septic shock (hypotension, elevated lactic acid level).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGlyb24gb3ZlcmxvYWQgb3IgbGl2ZXIgZGlzZWFzZS4=[Qq]
[q] ……….. is non-lactose fermenter, Oxidase-positive Gram-negative rods, Aerobic, Motile, Produces pyocyanin and pyoverdine pigment (blue green), and Emits a grape-like, fruity odor.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBzZXVkb21vbmFzIGFlcnVnaW5vc2Eu[Qq]
[q] Although they are structurally different, both diphtheria toxin and exotoxin A ribosylate and inactivate …………., halting human cell protein synthesis and causing cell death.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGVsb25nYXRpb24gZmFjdG9yLTIgKEVGLTIpLg==[Qq]
[q] …………. of Pseudomonas aeruginosa contribute to chronic pneumonia in cystic fibrosis patients due to biofilm formation.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE11Y29pZCBwb2x5c2FjY2hhcmlkZSBDYXBzdWxlLg==[Qq]
[q] What is the most likely diagnosis?
18 years old patient presenting with superficial and self-limited infection of the hair follicles following exposure to swimming pool where the chemicals have not been maintained at appropriate levels + The culture of a pustule will reveal Gram-negative, oxidase positive, non-lactose fermenting, motile rods that produce pigment (pyocyanin, pyoverdine)?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhvdCB0dWIgZm9sbGljdWxpdGlzLg==[Qq]
[q] The most common microorganism isolated from adult cystic fibrosis patient with Recurrent and chronic pneumonias is ………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBzZXVkb21vbmFzIGFlcnVnaW5vc2Eu[Qq]
[q] What is the most likely diagnosis?
40 years old patient who was diagnosed with leukemia presenting with focal areas of vascular destruction and cutaneous necrosis + blood culture shows Gram-negative, oxidase positive, non-lactose fermenting, motile rods that produce pigment (pyocyanin, pyoverdine)?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVjdGh5bWEgZ2FuZ3Jlbm9zdW0u[Qq]
[q] What is the most likely diagnosis?
40 years old diabetic patient presenting with exquisite ear pain and drainage, granulation tissue seen within the ear canal during otoscope examination + culture shows Gram-negative, oxidase positive, non-lactose fermenting, motile rods that produce pigment (pyocyanin, pyoverdine)??
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1hbGlnbmFudCBvdGl0aXMgZXh0ZXJuYSAoc3dpbW1lcuKAmXMgZWFyKS4=[Qq]
[q] ………… is non-lactose fermenter, nonmotile, and Non H2S producer Gram-negative rods.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNoaWdlbGxhLg==[Qq]
[q] ………. is an essential pathogenic mechanism for Shigella infection and is the most significant factor in causing disease.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE11Y29zYWwgaW52YXNpb24u
Cg==VGhlIHByb2R1Y3Rpb24gb2YgdG94aW5zIGlzIGNvbnNpZGVyZWQgbGVzcyBpbXBvcnRhbnQgaW4gdGhlIHBhdGhvZ2VuZXNpcyBvZiBzaGlnZWxsb3NpcyB0aGFuIGlzIGNlbGx1bGFyIGludmFzaW9uIGJlY2F1c2Ugbm9udG94aWdlbmljIHN0cmFpbnMgaGF2ZSBiZWVuIGZvdW5kIHRvIGNhdXNlIHNpZ25pZmljYW50IGRpc2Vhc2Uu[Qq]
[q] ………… work by inactivating the 60S ribosome of the host, thereby halting protein synthesis and causing cell death.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNoaWdhIGFuZCBzaGlnYSBsaWtlIHRveGluIG9mIEVIRUMu[Qq]
[q] Salmonella is sensitive to gastric acidity, but …… is resistant and as few as 100 cells can cause disease.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNoaWdlbGxhLg==[Qq]
[q] What is the most likely diagnosis?
27 years old patient presenting with abdominal pain, cramps, diarrhea with blood, blood and pus in stool, fever, vomiting, and tenesmus + stool culture shows non-lactose fermenter, nonmotile, and Non H2S producer Gram-negative rods?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNoaWdlbGxvc2lzLg==[Qq]
[q] What is the most likely diagnosis?
46 years old patient presenting with rapidly rising fever, and groin lymph node enlargement + lymph node sample shows Gram-negative rods/ coccobacillus that exhibits bipolar staining (resembling a safety pin) on Giemsa or Wright stain?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJ1Ym9uaWMgcGxhZ3VlIGR1ZSB0byBpbmZlY3Rpb24gd2l0aCBZZXJzaW5pYSBwZXN0aXMu
Cg==Cg==RmxlYSBiaXRlcyBpbmZlY3RlZCByb2RlbnRzIChyYXRzKSBhbmQgdGhlbiBsYXRlciB1bmluZmVjdGVkIGh1bWFuIChab29ub3Npcyku[Qq]
[q] ………… is non-lactose fermenter, motile, H2S producer Gram-negative rods and Sensitive to acid → Large infectious dose is required for successful infection
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNhbG1vbmVsbGEu[Qq]
[q] Typhoid strains of Salmonella contain a ……….. that inhibits neutrophil phagocytosis, neutrophil recruitment, and macrophage-mediated destruction. Therefore, typhoid strains are able to undergo extensive replication within the intracellular space of macrophages with subsequent spread through the lymphatic and reticuloendothelial system, leading to a widespread systemic disease (typhoid fever).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGNhcHN1bGFyIGFudGlnZW4gKFZpKS4=[Qq]
[q] What is the most likely diagnosis?
27 years old patient presenting with abdominal pain, cramps, diarrhea with blood, and blood and pus in stool + stool culture shows non-lactose fermenter, motile, and H2S producer Gram-negative rods?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNhbG1vbmVsbGEgRm9vZCBwb2lzb25pbmcu
Cg==SXQgaXMgd29ybGR3aWRlIGluZmVjdGlvbiBjYXVzZWQgYnkgbm9udHlwaG9pZGFsIHNhbG1vbmVsbGEgc3RyYWlucywgY29tbW9ubHkgUy4gRW50ZXJpdGlkaXMgYW5kIFMuIHR5cGhpbXVyaXVtLg==[Qq]
[q] What is the most likely diagnosis?
26 years old patient presenting with abdominal cramping with fever and diarrhea, salmon-colored “rose spots” rash, and hepatosplenomegaly + Blood cultures shows non-lactose fermenter, motile, and H2S producer Gram-negative rods?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFR5cGhvaWQgZmV2ZXIgKGVudGVyaWMgZmV2ZXIpLg==
Cg==Cg==VHlwaG9pZCBmZXZlciAoYWxzbyByZWZlcnJlZCB0byBhcyAmIzgyMjA7ZW50ZXJpYyBmZXZlciYjODIyMTspIGlzIGEgbGlmZS10aHJlYXRlbmluZyBpbGxuZXNzIGNhdXNlZCBieSB0aGUgYmFjdGVyaXVtIFNhbG1vbmVsbGEgdHlwaGkgb3IgU2FsbW9uZWxsYSBwYXJhdHlwaGkuIE90aGVyIHNwZWNpZXMgb2YgU2FsbW9uZWxsYSBhcmUgbm90IGFzc29jaWF0ZWQgd2l0aCB0eXBob2lkIGZldmVyLg==[Qq]
[q]………. is the most common cause of osteomyelitis in patients with sickle cell anemia.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNhbG1vbmVsbGEu[Qq]
[q] What is the most likely diagnosis?
17 years old patient presenting with urgency, frequency, dysuria + urine culture shows Non-lactose-fermenting, Urease positive, and H2S producer gram negative rod?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFVUSSBkdWUgdG8gUHJvdGV1cyBtaXJhYmlsaXMgaW5mZWN0aW9uLg==[Qq]
[q] ……… is a lactose fermenter Enterobacteriaceae, motile, give deep purple/black colonies in MacConkey agar and green metallic sheen on EMB agar.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVzY2hlcmljaGlhIGNvbGku[Qq]
[q] …….. is the most common cause of urinary tract infection in both healthy adults and elderly patients.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEUuIGNvbGku[Qq]
[q] The most common source of E. coli bacteremia is ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSB1cmluYXJ5IHRyYWN0IChVcm9zZXBzaXMpLg==[Qq]
[q] …………… is the most important virulence factors expressed by uropathogenic E coli.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEZpbWJyaWFlLg==[Qq]
[q] ………….. work by preventing binding of tRNA to the 60S ribosomal subunit and inhibiting protein synthesis (similar to shiga toxin).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRoZSBzaGlnYSBsaWtlIHRveGluLg==
Cg==Cg==[Qq][q] The Labile Toxin of Enterotoxigenic E. Coli is very similar to …………. in both structure and mode of action.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENob2xlcmEgdG94aW4u[Qq]
[q] The LT enterotoxin activates adenylate cyclase by activating the stimulatory Gs membrane G protein resulting in conversion of ATP to cAMP, but …….. stimulates the activity of guanylate cyclase in intestinal epithelial cells leading to formation of cGMP resulting also in loss of fluids from the intestine.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRoZSBTVCBlbnRlcm90b3hpbi4=
Cg==Cg==TGFiaWxlIG9uIHRoZSBBaXIgYW5kIFN0YWJsZSBvbiB0aGUgR3JvdW5kLg==
[Qq][q] What is the most likely diagnosis?
24 years old patient presenting with frequency, urgency, dysuria + urine culture shows lactose fermenter Enterobacteriaceae, motile, give green metallic sheen on EMB agar?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFVyaW5hcnkgdHJhY3QgaW5mZWN0aW9uIChVVEkpIGR1ZSB0byBFLiBDb2xpIGluZmVjdGlvbi4=[Qq]
[q] ………… is considered the major virulence factor among E coli strains that cause neonatal meningitis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRoZSBLMSBjYXBzdWxhciBhbnRpZ2VuLg==
Cg==Cg==[Qq][q] ………….. is characterized by microangiopathic hemolytic anemia (mechanical hemolysis with schistocytes on peripheral blood smear), thrombocytopenia (due to platelet consumption), and renal insufficiency (due to ↓ renal blood flow), days after bloody diarrhea from eating undercooked Hamburger.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhlbW9seXRpYy11cmVtaWMgc3luZHJvbWUgKEhVUyku
Cg==Cg==RS4gY29saSBzZXJvdHlwZSBPMTU3OiBINyBpcyB0aGUgbW9zdCBjb21tb24gc3RyYWluIGFzc29jaWF0ZWQgd2l0aCB0aGUgZGlzZWFzZS4=
[Qq][q] …………… is common cause of infantile diarrhea by interfering with water absorption by mucosal cells.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVQRUMgUCA9IHBlZGlhdHJpYyAoZGlhcnJoZWEgaW4gY2hpbGRyZW4pLg==[Qq]
[q] …….. cause bloody diarrhea with a mechanism identical to that caused by shigella spp. but do not produce shiga toxin.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVJRUMgSSA9IEludmFzaXZlIChkeXNlbnRlcnkpLg==[Qq]
[q] What is the most likely diagnosis?
25 years old alcoholic patient presenting with fever, productive cough with current jelly sputum, dyspnea + xray shows lobar infiltrate of the lung + sputum culture shows Lactose-fermenting mucoid colonies on MacConkey agar?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBuZXVtb25pYSBkdWUgdG8gS2xlYnNpZWxsYSBwbmV1bW9uaWFlLg==[Qq]
[q] What is the most likely diagnosis?
19 years old patient presenting with grayish-white discharge with a “fishy” odor that becomes more prominent with addition of potassium hydroxide (Amine whiff test) + Wet mount microscopy of the discharge show clue cells, which are vaginal squamous epithelial cells covered with multiple, small adherent bacteria?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJhY3RlcmlhbCB2YWdpbm9zaXMgZHVlIHRvIEdhcmRuZXJlbGxhIHZhZ2luYWxpcy4=
Cg==Cg==QW5hZXJvYmljIEdyYW0tdmFyaWFibGUgcm9kIChtZWFuaW5nIHRoZXkgbWF5IHN0YWluIGVpdGhlciBuZWdhdGl2ZSBvciBwb3NpdGl2ZSku
[Qq]Bacterial vaginosis is usually treated with metronidazole or clindamycin, but topical regimens may also be used.
[q] Although most infections within the abdominal cavity are polymicrobial, ……….. is a common anaerobic gram-negative bacillus that is frequently isolated.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEIuIGZyYWdpbGlzLg==[Qq]
[q] What is the most likely diagnosis?
35 years old patient presenting with single hard, painless ulcer on his penis after unprotected sexual intercourse + painless enlarged inguinal lymph nodes + smear of the genital ulcer under dark field microscopy shows motile helical microorganism?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFByaW1hcnkgc3lwaGlsaXMgKGNoYW5jcmUpIGR1ZSB0byBpbmZlY3Rpb24gd2l0aCBUcmVwb25lbWEgcGFsbGlkdW0u[Qq]
[q] What is the most likely diagnosis?
35 years old patient presenting with Fever, fatigue, myalgia, headache, and Generalized nontender lymphadenopathy + Maculopapular rash (including palms and soles) + RPR/FTA-ABS is positive?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNlY29uZGFyeSBzeXBoaWxpcyBkdWUgdG8gaW5mZWN0aW9uIHdpdGggVHJlcG9uZW1hIHBhbGxpZHVtLg==[Qq]
[q] What is the most likely diagnosis?
35 years old patient presenting with broad-based ataxia, ⊕ Romberg sign, pupil constricts with accommodation but is not reactive to light + CSF testing of RPR/FTA-ABS is positive?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRlcnRpYXJ5IHN5cGhpbGlzICh0YWJlcyBkb3JzYWxpcykgZHVlIHRvIGluZmVjdGlvbiB3aXRoIFRyZXBvbmVtYSBwYWxsaWR1bS4=[Qq]
[q] What is the most likely diagnosis?
Newborn child presenting with rhagades (linear scars at angle of mouth), snuffles (nasal discharge), saddle nose, notched (Hutchinson) teeth, and CN VIII deafness + RPR/FTA-ABS of the mother is positive?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENvbmdlbml0YWwgc3lwaGlsaXMu
Cg==Cg==[Qq][q] What is the most likely diagnosis?
24 years old patient presenting with fever, chills, headache, myalgia 12 hours after starting treatment with penicillin for syphilis?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEphcmlzY2gtSGVyeGhlaW1lciByZWFjdGlvbiBkdWUgdG8ga2lsbGVkIGJhY3RlcmlhICh1c3VhbGx5IHNwaXJvY2hldGVzKSByZWxlYXNpbmcgZW5kb3RveGlucy4gTW9zdCBjYXNlcyBhcmUgc2VsZi1saW1pdGVkIGFuZCBkbyBub3QgcmVxdWlyZSBpbnRlcnZlbnRpb24u[Qq]
[q] What is the most likely diagnosis?
28 years old sewer worker presenting with fever, Conjunctival suffusion, jaundice and azotemia, hemorrhage, and anemia?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEljdGVyb2hlbW9ycmhhZ2ljIGxlcHRvc3Bpcm9zaXMgZHVlIHRvIGluZmVjdGlvbiB3aXRoIExlcHRvc3BpcmEgaW50ZXJyb2dhbnMu
Cg==Cg==Q29udGFjdCB3aXRoIGFuaW1hbCB1cmluZSBpbiBpbmZlY3RlZCB3YXRlci4=[Qq]
[q] What is the most likely diagnosis?
23 years old patient who was camping in New England presenting with an erythematous macule that enlarges with an advancing erythematous border as the bacteria migrate slowly through the skin outward from the inoculation site?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVyeXRoZW1hIG1pZ3JhbnMgKEVNKSBkdWUgdG8gaW5mZWN0aW9uIHdpdGggQm9ycmVsaWEgYnVyZ2RvcmZlcmku
Cg==Cg==RG94eWN5Y2xpbmUgKDFzdCBsaW5lIGFzIGl0IGhhcyB0aGUgYWR2YW50YWdlIG9mIHNpbXVsdGFuZW91c2x5IHByZXZlbnRpbmcgb3IgdHJlYXRpbmcgY29leGlzdGluZyBodW1hbiBncmFudWxvY3l0aWMgYW5hcGxhc21vc2lzLCBhbiBpbmZlY3Rpb24gYWxzbyBjYXJyaWVkIGJ5IEkuIHNjYXB1bGFyaXMp[Qq]
[q] What is the most likely diagnosis?
25 years old patient presenting with sudden onset fever that persists for 3 to 7 days and is followed by an afebrile interval of several days to several weeks, then the fever relapse?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJlbGFwc2luZyBmZXZlciBkdWUgdG8gaW5mZWN0aW9uIHdpdGggQm9ycmVsaWEgUmVjdXJyZW50aXMu[Qq]
[q] ……….. is obligate intracellular bacterium; cannot make ATP. Not seen on Gram stain because their cell wall lacks classic peptidoglycan (due to reduced muramic acid), rendering β-lactam antibiotics not effective in treatment.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENobGFteWRpYSB0cmFjaG9tYXRpcy4=[Qq]
[q] Serotypes …………. of chlamydia trachomatis are the Leading cause of preventable infectious blindness in Africa.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNlcm90eXBlcyBBLCBCLCBhbmQgQy4=[Qq]
[q] Serotypes …………. of chlamydia trachomatis cause disease characterized by an initial painless small ulcer on the genital mucosa. This ulcer is followed weeks later by swollen, painful inguinal nodes that coalesce, ulcerate, and rupture; these are referred to as buboes. Cytoplasmic inclusions seen on Giemsa or fluorescent antibody-stained smear?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNlcm90eXBlcyBMMSwgMiwgMy4=[Qq]
[q] Serotypes …………. of chlamydia trachomatis cause neonatal conjunctivitis?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNlcm90eXBlcyBEIHRocm91Z2ggSy4=[Qq]
[q] What is the most likely diagnosis?
22 years old patient presenting with headache, fever, maculopapular rash starts on ankles and wrists and then spreads to the trunk, palms, soles, and face (centripetal rash, from extremities to trunk)?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJvY2t5IE1vdW50YWluIHNwb3R0ZWQgZmV2ZXIu
Cg==Cg==TWljcm9vcmdhbmlzbTogUmlja2V0dHNpYSByaWNrZXR0c2lpLCB2ZWN0b3I6IHRpY2sgKERlcm1hY2VudG9yKS4=
[Qq]Rickettsii on the wRists, Typhus on the Trunk.
[q] What is the most likely diagnosis?
22 years old patient presenting with headache, fever, maculopapular rash that starts centrally and spreads out, sparing palms and soles?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFR5cGh1cy4=
Cg==RW5kZW1pYyAoZmxlYXMpOiBSLiB0eXBoaS4=
Cg==[Qq]Epidemic (human body louse): R. prowazekii.
Rickettsii on the wRists, Typhus on the Trunk.
[q] What is the most likely diagnosis?
19 years old patient presenting with fever, chills, myalgia and headache + thrombocytopenia, leukopenia and elevated liver enzymes + mulberry-like inclusions in monocytes?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVocmxpY2hpb3Npcy4=
Cg==Cg==[Qq]MEGA berry: Monocytes = Ehrlichiosis. Granulocytes = Anaplasmosis.
[q] What is the most likely diagnosis?
19 years old patient presenting with fever, chills, myalgia and headache + thrombocytopenia, leukopenia and elevated liver enzymes + mulberry-like inclusions in Granulocytes?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFuYXBsYXNtb3Npcy4=
Cg==Cg==[Qq]MEGA berry: Monocytes = Ehrlichiosis. Granulocytes = Anaplasmosis.
[q] What is the most likely diagnosis?
19 years old farmer presenting with fever, chills, myalgia and retroorbital headache + thrombocytopenia, normal leukocyte count and elevated liver enzymes + symptoms of pneumonia?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFEgZmV2ZXIu
Cg==Q294aWVsbGEgYnVybmV0aWksIG5vIGFydGhyb3BvZCB2ZWN0b3Iu
Cg==[Qq]Treatment: doxycycline (inhibitor of bacterial protein synthesis).
[q] ……….. is the smallest free-living (extracellular) bacteria, Resistant to the beta-lactam antibiotics (penicillin and cephalosporins), Unstainable by the Gram stain (but readily stained by Giemsa stain). They are the only bacteria that contain sterol in the cell membrane and require serum enriched medium containing cholesterol for in vitro culture (Eaton’s agar).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE15Y29wbGFzbWEu[Qq]
[q] What is the most likely diagnosis?
22 years old patient presenting with chronic dry nagging cough, low-grade fever, mild dyspnea + chest x-ray shows bilateral interstitial infiltrate + mild anemia + patient serum able to agglutinate RBCs in vitro at low temperatures?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFdhbGtpbmcgcG5ldW1vbmlhIGR1ZSB0byBpbmZlY3Rpb24gd2l0aCBNeWNvcGxhc21hIHBuZXVtb25pYWUu
Cg==Cg==RHJ1Z3MgdGhhdCBhcmUgZWZmZWN0aXZlIGFnYWluc3QgdGhlIE15Y29wbGFzbWEgZ2VudXMgaW5jbHVkZSBhbnRpLXJpYm9zb21hbCBhZ2VudHMgbGlrZSB0aGUgbWFjcm9saWRlcywgZG94eWN5Y2xpbmUsIG9yIGZsdW9yb3F1aW5vbG9uZS4=
[Qq][q] What is the most likely diagnosis?
21 years old patient presenting with Hypopigmented patches located on the back and chest that is more prominent in summer + KOH mount of skin scales shows spaghetti and meatballs appearance on microscopy?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBpdHlyaWFzaXMgb3IgdGluZWEgdmVyc2ljb2xvciBkdWUgdG8gaW5mZWN0aW9uIHdpdGggTWFsYXNzZXppYSBmdXJmdXIu[Qq]
[q] Tinea ………….. is the dermatophyte infection of the head and scalp. Associated with lymphadenopathy, alopecia, scaling.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENhcGl0aXMu
Cg==Cg==[Qq][q] Tinea ……… occurs on body. Characterized by erythematous scaling rings (“ringworm”) and central clearing. Can be acquired from contact with an infected cat or dog.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENvcnBvcmlzLg==
Cg==Cg==[Qq][q] Tinea ………… occurs in inguinal area. Often does not show the central clearing seen in tinea corporis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGNydXJpcy4=
Cg==Cg==[Qq][q] Tinea …….. is the ringworm of the bearded region.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGJhcmJhZS4=
Cg==Cg==[Qq][q] Tinea ……… is a dermatophyte infection of the foot (athlete’s foot).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHBlZGlzLg==
Cg==Cg==[Qq][q] Tinea …….. occurs on nails (Onychomycosis).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHVuZ3VpdW0u
Cg==Cg==[Qq][q] What is the most likely diagnosis?
50 years old Gardner presenting with reddish nodule that later ulcerates along draining lymphatics appears at the site of thorn prick + skin biopsy shows cigar shaped yeast?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNwb3JvdHJpY2hvc2lzIGR1ZSB0byBpbmZlY3Rpb24gd2l0aMKgU3Bvcm90aHJpeCBzY2hlbmNraWku[Qq]
[q] What is the most likely diagnosis?
34 years old patient presenting with cough, fever, pleuritic chest pain and pulmonary infiltrates and cavitations in the upper lung lobes and calcified nodes and fibrotic scarring after cave exploration in Ohio + Examination of lung biopsy specimens and bone marrow aspirates shows oval or round yeasts within macrophage?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhpc3RvcGxhc21hIGNhcHN1bGF0dW0gaW5mZWN0aW9uLg==
Cg==Cg==SW4gY2FzZSBvZiBkaXNzZW1pbmF0ZWQgaW5mZWN0aW9uICYjODIxMjsmZ3Q7IEJlY2F1c2UgdGhlIGZ1bmd1cyB0YXJnZXRzIGhpc3Rpb2N5dGVzIGFuZCB0aGUgcmV0aWN1bG9lbmRvdGhlbGlhbCBzeXN0ZW0g4oaSIGx5bXBoYWRlbm9wYXRoeSBhbmQgaGVwYXRvc3BsZW5vbWVnYWx5Lg==[Qq]
[q] What is the most likely diagnosis?
34 years old patient presenting with cough, fever, pleuritic chest pain and pulmonary infiltrates and cavitations in the upper lung lobes and calcified nodes and fibrotic scarring after recent travel to arizona + Examination of lung biopsy specimens shows thick-walled spherules packed with endospores?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENvY2NpZGlvaWRlcyBJbW1pdGlzIGluZmVjdGlvbi4=
Cg==Q2FuIGRpc3NlbWluYXRlIHRvIGJvbmUgYW5kIHNraW4g4oaSIEFydGhyYWxnaWFzIChkZXNlcnQgcmhldW1hdGlzbSksIEVyeXRoZW1hIG5vZG9zdW0gKGRlc2VydCBidW1wcykgb3IgbXVsdGlmb3JtZS4=[Qq]
[q] What is the most likely diagnosis?
34 years old patient presenting with cough, fever, pleuritic chest pain and pulmonary infiltrates and cavitations in the upper lung lobes and calcified nodes and fibrotic scarring after recent travel to Mississippi + Examination of lung biopsy specimens shows round yeast with thick, doubly refractive walls “broad based budding”?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJsYXN0b215Y2VzIGRlcm1hdGl0aWRpcy4=
Cg==SW4gaW1tdW5vY29tcHJvbWlzZWQgcGF0aWVudHMsIGJsYXN0b215Y29zaXMgY2FuIGNhdXNlIGRpc3NlbWluYXRlZCBkaXNlYXNlLiBQYXRpZW50cyBtYXkgZXhwZXJpZW5jZSBza2luIGxlc2lvbnMgKHZlcnJ1Y291cyBsZXNpb25zIGNhbiBzaW11bGF0ZSBTQ0MpLCBhbmQgYm9uZSBwYWluIChjYXVzZWQgYnkgbHl0aWMgbGVzaW9ucyku[Qq]
[q] What is the most likely diagnosis?
34 years old patient presenting with cough, fever, pleuritic chest pain and pulmonary infiltrates and cavitations in the upper lung lobes and calcified nodes and fibrotic scarring after recent travel to Great lakes + Examination of lung biopsy specimens shows captain’s wheel” formation?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBhcmFjb2NjaWRpb2lkZXMgYnJhc2lsaWVuc2lzIGluZmVjdGlvbi4=[Qq]
[q] …………. is a mold that is widely present in organic matter. It forms septate hyphae that branch at 45° angles (V-shaped branching).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFzcGVyZ2lsbHVzIGZ1bWlnYXRlcy4=[Qq]
[q] What is the most likely diagnosis?
39 years old patient diagnosed with Hodgkin lymphoma presenting with facial pain (periorbital), headache due to paranasal sinus infection + light microscopy of tissue specimens, which shows V-shaped, narrow, septate hyphae invading the tissue?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEludmFzaXZlIGFzcGVyZ2lsbG9zaXMu
Cg==QW1waG90ZXJpY2luIEIgaXMgdXNlZCB0byB0cmVhdCBpbnZhc2l2ZSBhc3BlcmdpbGxvc2lzLg==[Qq]
[q] What is the most likely diagnosis?
31 years old patient with previous history of pulmonary tuberculosis presenting with cough and hemoptysis + On chest x-ray, there is a radiopaque structure that shifts when the patient changes position?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFzcGVyZ2lsbG9tYXMu
Cg==VGhleSBhcmUgb2Z0ZW4gc3VyZ2ljYWxseSByZW1vdmVkLg==[Qq]
[q] What is the most likely diagnosis?
21 years old patient with previous history of Asthma presenting with wheezes, dyspnea, increased mucus production, very high serum lgE levels, eosinophilia, and lgE plus lgG serum antibodies to Aspergillus.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFsbGVyZ2ljIGJyb25jaG9wdWxtb25hcmF5IHNwZXJnaWxsb3NpcyAoQUJQQSkuwqBUcmVhdG1lbnQgaXMgd2l0aCBjb3J0aWNvc3Rlcm9pZHMu[Qq]
[q]………. is a dimorphic fungus; forms pseudohyphae at 20°C, germ tubes at 37°C.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENhbmRpZGEgYWxiaWNhbnMu[Qq]
[q] What is the most likely diagnosis?
21 years old Asthmatic patient taking inhaled corticosteroids presenting with white patches on the oral mucosa that can be easily scraped off, revealing an erythematous mucosal surface underneath and burning pain of the tongue?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE9yYWwgdGhydXNoIGR1ZSB0byBjYW5kaWRhIGluZmVjdGlvbi4=[Qq]
[q] Unexplained oral thrush in an otherwise healthy person suggests the possibility of ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhJViBpbmZlY3Rpb24u[Qq]
[q] What is the most likely diagnosis?
21 years old female patient on oral contraceptives presenting with vulvar erythema and a thick white vaginal “cottage cheese” discharge + culture shows growth of pseudohyphea?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFZ1bHZvdmFnaW5hbCBjYW5kaWRpYXNpcy4=[Qq]
[q] What is the most likely diagnosis?
35 years old patient who is hospitalized in ICU after bowel resection due to Crohn’s disease is dependent on parenteral nutrition through central venous access presenting with fever, hypotension, tachycardia + Blood culture is negative for bacteria with growth of pseudohyphra?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE5vc29jb21pYWwgYmxvb2Qgc3RyZWFtIGluZmVjdGlvbnMgKEJTSXMpIGR1ZSB0byBjYW5kaWRhIHNwZWNpZXMu
Cg==Cg==[Qq][q] …………. is a fungus exists in the yeast form (single cells) only. It has a thick polysaccharide capsule with antiphagocytic properties. This fungus is present in soil and bird (especially pigeon droppings).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENyeXB0b2NvY2N1cyBuZW9mb3JtYW5zLg==[Qq]
[q] ……… is the most likely primary focus of C. neoformans infection
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGx1bmcu[Qq]
[q] The diagnosis of pulmonary cryptococcosis is made by microscopic examination of bronchopulmonary washings and lung tissue. Cryptococcal yeast appears red on mucicarmine stain. Mucicarmine stain is used to detect ………….. of Cryptococcus neoformans.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBwb2x5c2FjY2hhcmlkZSBjYXBzdWxlLg==
Cg==Cg==[Qq][q]……… is the most common presentation of Cryptococcus neoformans infection.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1lbmluZ2l0aXMu[Qq]
[q] Diagnosis of cryptococcal meningitis is made by examining cerebrospinal fluid stained with ………….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEluZGlhIGluay4=
Cg==Cg==VGhlIEluZGlhIGluayBwcmVwYXJhdGlvbiBzdGFpbnMgdGhlIGJhY2tncm91bmQgd2hpbGUgdGhlIG9yZ2FuaXNtIHJlbWFpbnMgdHJhbnNwYXJlbnQgKG5lZ2F0aXZlIHN0YWluIHRlY2huaXF1ZSkuIFRoZSB0aGljayBwb2x5c2FjY2hhcmlkZSBjYXBzdWxlIHN1cnJvdW5kaW5nIHRoZSB5ZWFzdCBpcyBzZWVuIGFzIGEgcGVyaXBoZXJhbCBjbGVhcmluZyBiZXR3ZWVuIHRoZSBiYWNrZ3JvdW5kIGFuZCB0aGUgZGFyayBjZW50cmFsIHBhcnQgb2YgdGhlIG9yZ2FuaXNtIOKAnFNvYXAgYnViYmxl4oCdIGxlc2lvbnMgaW4gYnJhaW4u
[Qq][q] ………. exist in mold form only. They form broad, nonseptate hyphae that branch at wide, often 90° angles. This fungus is very strongly associated with diabetic ketoacidosis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE11Y29yLCBSaGl6b3B1cywgYW5kIEFic2lkaWEu[Qq]
[q] What is the most likely diagnosis?
27 years old diabetic patient presenting with facial and periorbital pain, headache, and purulent nasal discharge, and Black eschar (necrotic tissue) seen on the nasal turbinates + light microscopy of a tissue specimen shows broad, nonseptate hyphae that branch at wide, often 90° angles. ?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE11Y29ybXljb3Npcy4=[Qq]
[q] What is the most likely diagnosis?
HIV positive patient with CD4 count less than 200 presenting with low grade fever, dyspnea, nonproductive cough + Diffuse, bilateral ground-glass opacities on CXR/CT + Bronchoalveolar lavage sample shows Disc-shaped yeast forms on methenamine silver stain?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBuZXVtb25pYSBkdWUgdG8gUG5ldW1vY3lzdGlzIGppcm92ZWNpaSBpbmZlY3Rpb24u[Qq]
[q] ……… is the most common enteric parasite in the U.S. and Canada, and is a common cause of diarrhea in campers/hikers.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEdpYXJkaWEu[Qq]
[q] Conditions causing ….. deficiency predispose patients to chronic giardiasis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IElnQS4=[Qq]
[q] What is the most likely diagnosis?
19 years old patient who was in camping trip presenting with Bloating, flatulence, foul-smelling, fatty diarrhea + iodine-stained stool smear shows parasitic cysts below?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEdpYXJkaWFzaXMu[Qq]
[q] What is the most likely diagnosis?
19 years old patient who presenting with inflammatory bloody diarrhea, abdominal pain, and flask-shaped ulcer on clonic mucosa+ tissue biopsy shows trophozoites with RBCs in the cytoplasm (the image below)?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFtZWJpYXNpcy4=
Cg==Cg==VHJlYXRtZW50OiBNZXRyb25pZGF6b2xlOyBpb2RvcXVpbm9sIGZvciBhc3ltcHRvbWF0aWMgY3lzdCBwYXNzZXJzLg==[Qq]
[q] What is the most likely diagnosis?
HIV positive patient with CD4 count less than 100 presenting with Severe chronic diarrhea + stool shows Oocysts on acid-fast stain?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENyeXB0b3Nwb3JpZGlvc2lzIGR1ZSB0byBDcnlwdG9zcG9yaWRpdW0gcGFydnVtIGluZmVjdGlvbi4=[Qq]
[q] What is the most likely diagnosis?
HIV positive patient with CD4 count less than 100 presenting with fever, headache, altered mental status, focal neurologic findings, and seizures + MRI or contrast CT of the brain demonstrates multiple ring-enhancing lesions in both hemispheres?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRveG9wbGFzbW9zaXMgZHVlIHRvIFRveG9wbGFzbWEgZ29uZGlpIGluZmVjdGlvbi4=
Cg==Cg==[Qq][q] Hydrocephalus, intracranial calcifications and chorioretinitis form the classic triad of congenital ………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRveG9wbGFzbW9zaXMu[Qq]
[q] Pregnant women should be warned not to handle cat litter in order to prevent contact with …………., which is often found in cat feces?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRveG9wbGFzbWEu
Cg==Rmlyc3QtbGluZSB0cmVhdG1lbnQgb2YgdG94b3BsYXNtb3NpcyBpbmNsdWRlcyBhIGNvbWJpbmF0aW9uIG9mIHB5cmltZXRoYW1pbmUgYW5kIHN1bGZhZGlhemluZS4=[Qq]
[q] What is the most likely diagnosis?
27 years old patient presenting with meningoencephalitis after swimming in freshwater lake + motile trophozoites in CSF?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE5hZWdsZXJpYSBmb3dsZXJpIGluZmVjdGlvbi4=
Cg==Cg==[Qq][q] What is the most likely diagnosis?
27 years old patient presenting with recurring fever, somnolence after being bitten by fly that left Indurated chancre at bite site (painful bite), and enlarged lymph nodes?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRyeXBhbm9zb21hIGJydWNlaS4=[Qq]
[q] What is the most likely diagnosis?
35 years old patient presenting with fever, anemia, headache, splenomegaly after recent travel to India + peripheral blood smear shows ring inclusions and schizont within peripheral erythrocytes?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1hbGFyaWEu[Qq]
[q] ……….. and ……….. are effective in eradicating chloroquine-sensitive Plasmodia from the bloodstream but has no activity against the latent hepatic infections established by P. vivax and P. ovale.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENobG9yb3F1aW5lIGFuZCBhdG92YXF1b25lLXByb2d1YW5pbC4=[Qq]
[q]………… must be used in addition to completely eradicate infections by P. vivax and P. ovale organisms and prevent relapses.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFByaW1hcXVpbmUu[Qq]
[q] Some African species are chloroquine-resistant; these can be treated with …………, a quinine analog.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IG1lZmxvcXVpbmUu[Qq]
[q]……….. chemoprophylaxis for malaria must be continued for 4 weeks after return from endemic region to ensure the elimination of hepatic schizonts (which develops in the liver over 8-30 days).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1lZmxvcXVpbmUu[Qq]
[q] What is the most likely diagnosis?
35 years old patient presenting with fever, anemia, thrombocytopenia, elevated LFTs, headache + peripheral blood smear shows ring inclusions and Maltese cross within peripheral erythrocytes?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJhYmVzaW9zaXMu[Qq]
[q] In the acute phase of Chagas disease, …….. is the main target organ.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBoZWFydC4=[Qq]
[q] Unilateral periorbital swelling (Romaña sign) is characteristic of (acute or chronic) stage of Chagas disease?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFjdXRlLg==[Qq]
[q] In (acute or chronic) stage of Chagas disease, this parasite can also destroy the myenteric plexi in the esophagus, intestines, and ureters, causing secondary achalasia, megacolon, and megaureter, respectively.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGNocm9uaWMu[Qq]
[q] What is the most likely diagnosis?
22 years old patient presenting with chronic, pinkish papule that evolve into a nodule or plaque + skin smear shows Macrophages containing amastigotes with rod-shaped kinetoplasts?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEN1dGFuZW91cyBsZWlzaG1hbmlhc2lzLg==[Qq]
[q] The mode of transmission of Cutaneous leishmaniasis is ……?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNhbmQtZmx5IGJpdGUu[Qq]
[q] What is the most likely diagnosis?
26 years old female presenting with foul-smelling, greenish discharge; itching and burning after having unprotected sexual intercourse + wet mount microscopy shows motile Trophozoites?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRyaWNob21vbmlhc2lzLg==
Cg==Cg==[Qq][q] What is the most likely diagnosis?
7 years old child presenting with perianal itching, most commonly at night + Scotch tape” test in the perianal area reveals the presence of oval, asymmetrically flattened eggs with a bean-shaped appearance?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVudGVyb2JpYXNpcyBkdWUgdG8gaW5mZWN0aW9uIHdpdGggRW50ZXJvYml1cyB2ZXJtaWN1bGFyaXMu
Cg==Cg==JiM4MjExOyBBbGJlbmRhem9sZSBvciBtZWJlbmRhem9sZSBpcyB0aGUgZmlyc3QtbGluZSB0cmVhdG1lbnQu
[Qq][q] What is the most likely diagnosis?
7 years old child presenting with symptoms of intestinal obstruction + Stool microscopy reveals an oval egg with a thick outer shell?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFzY2FyaWFzaXMgZHVlIHRvIGluZmVjdGlvbiB3aXRowqBBc2NhcmlzIGx1bWJyaWNvaWRlcy4=[Qq]
[q] What is the most likely diagnosis?
26 years old patient presenting with causing vomiting, diarrhea, epigastric pain that may feel like peptic ulcer + rhabditiform (noninfectious) larvae in the stool?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN0cm9uZ3lsb2lkaWFzaXMgZHVlIHRvIGluZmVjdGlvbiB3aXRoIFN0cm9uZ3lsb2lkZXMgc3RlcmNvcmFsaXMu[Qq]
[q] Pulmonary symptoms in cases of Strongyloidiasis is due to ………….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRyYW5zcHVsbW9uYXJ5IG1pZ3JhdGlvbi4=[Qq]
[q] ……….. are parasites that cause microcytic anemia by sucking blood from intestinal walls.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhvb2t3b3JtcyAoQW5jeWxvc3RvbWEgZHVvZGVuYWxlLCBOZWNhdG9yIGFtZXJpY2FudXMpLg==
Cg==Cg==[Qq][q] ……….. is a parasite that cause myalgia after eating undercooked pork.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRyaWNoaW5lbGxhIHNwaXJhbGlzLg==[Qq]
[q] ……….. is a parasite that cause Hyperpigmented skin and blindness and is transmitted by Female blackfly bite.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE9uY2hvY2VyY2Egdm9sdnVsdXMu[Qq]
[q] ……….. is a parasite that cause African eye worm. Migration of adult worms is not painful and seldom noticed unless they reach conjunctiva or bridge of nose.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IExvYSBsb2Eu[Qq]
[q] ……….. is a parasite that cause obstruction of lymphatic vessels —> lymphedema, lymphangitis and lymphadenitis, takes 9 ms-1 yr after bite to become symptomatic.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFd1Y2hlcmVyaWEgYmFuY3JvZnRpLg==[Qq]
[q] ……….. is a parasite that cause Visceral larva migrans (larva wanders aimlessly until they die, cause inflammation).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRveG9jYXJhIGNhbmlzLg==[Qq]
[q] Humans are the (definitive, intermediate) host in case of neurocysticercosis and transmission occurs through ingestion of ……………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGh1bWFucyBhcmUgdGhlIGludGVybWVkaWF0ZSBob3N0LCBJbmdlc3Rpb24gb2YgZWdncyBleGNyZXRlZCBpbiBmZWNlcyBvZiBpbmZlY3RlZCBodW1hbiBjYXJyaWVycy4=
Cg==Cg==[Qq][q] ……….. is a parasite that cause Vitamin B12 deficiency (tapeworm competes for B12 in intestine) —-> megaloblastic anemia.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IERpcGh5bGxvYm90aHJpdW0gbGF0dW0u[Qq]
[q] ……….. is a parasite that cause Hydatid cysts in liver, causing anaphylaxis if antigens released and is transmitted through ingestion of eggs from dog feces.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVjaGlub2NvY2N1cyBncmFudWxvc3VzLg==[Qq]
[q] The intermediate host that incubates the infectious larvae of Schistosoma is ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHNuYWlscy4=[Qq]
[q] S. haematobium chronic infection has high association with …………… in Egypt and Africa.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGJsYWRkZXIgY2FyY2lub21hLg==[Qq]
[q] S. mansoni and japonicum have …………… spine in their eggs but S. hematobium has a ……….. spine?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHN1YnRlcm1pbmFsLCB0ZXJtaW5hbC4=
Cg==Cg==[Qq][q] ……….. is a parasite that is associated with pigmented gallstones and cholangiocarcinoma.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENsb25vcmNoaXMgc2luZW5zaXMu[Qq]
[q] What is the most likely diagnosis?
25 years old patient presenting with intensely pruritic rash in the flexor surfaces of the wrist, lateral surfaces of the fingers, and the finger webs, The rash is often worse at night + Skin examination usually shows excoriations with small, crusted, red papules scattered around the region + skin scrapings from excoriated lesions that show mites, ova, and feces under light microscopy?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNjYWJpZXMu[Qq]
[q] First-line therapy of scabies includes topical ……….., which blocks mite neurotransmission by impairing voltage-gated sodium channels.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHBlcm1ldGhyaW4u[Qq]
[q] Most enveloped nucleocapsid viruses acquire lipid bilayer envelopes by budding through the plasma membrane of the host cell. However, …………. bud through and acquire the lipid bilayer envelope from the host cell nuclear membrane.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRoZSBoZXJwZXN2aXJ1c2VzLg==[Qq]
[q] Ether -induced disruption or dissolution of the viral envelope lipid results in …….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGxvc3Mgb2YgdmlyYWwgaW5mZWN0aXZpdHku[Qq]
[q] DNA viruses Contain double-stranded DNA except ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHBhcnZvdmlydXMu[Qq]
[q] are naked viruses except ………………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGhlcnBlc3ZpcnVzZXMsIGhlcGFkbmF2aXJ1c2VzLCBhbmQgcG94dmlydXNlcy4=[Qq]
[q] DNA viruses are linear except …………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHBhcGlsbG9tYS0sIHBvbHlvbWEtLCBhbmQgaGVwYWRuYXZpcnVzZXMgKGNpcmN1bGFyKS4=[Qq]
[q] DNA viruses have icosahedral capsids except ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHBveHZpcnVzZXMu[Qq]
[q] DNA viruses replicate in the nucleus except ……….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHBveHZpcnVzZXMu[Qq]
[q] Parvovirus B19 is attach to human erythroid cells via …..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGJsb29kIGdyb3VwIFAgYW50aWdlbi4=[Qq]
[q] is associated with erythema infectiosum (“fifth disease”), aplastic crises in those with sickle cell anemia, and hydrops fetalis (particularly when infection occurs before the 20th week of gestation).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEIgMTku[Qq]
[q] What is the most likely diagnosis?
10 years old child presenting with prodrome of low-grade fever, headache, malaise, and upper respiratory symptoms followed by the sudden appearance of an erythematous malar rash with circumoral pallor 2-5 days later, this rash has a “slapped-cheek” appearance, As the facial rash fades, an erythematous rash in a reticular, lacelike pattern often appears on the trunk and extremities?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVyeXRoZW1hIGluZmVjdGlvc3VtICgmIzgyMjA7ZmlmdGggZGlzZWFzZSYjODIyMTspLg==[Qq]
[q] Aplastic crisis in sickle cell patients is usually secondary to ……….. infection of erythroid precursor cells in the bone marrow.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHBhcnZvdmlydXMgQiAxOS4=[Qq]
[q] ………. causes hydrops fetalis if transmitted from mother to fetus (pregnant woman with with arthralgia with or without rash —> hydrops fetalis or spontaneous abortion).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHBhcnZvdmlydXMgQiAxOS4=[Qq]
[q] ……….. infects basal cell layer of the stratified squamous epithelium and mucous membranes —-> Hyperkeratosis leads to the formation of the “wart”.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEh1bWFuIFBhcGlsbG9tYSBWaXJ1cyAoSFBWKS4=[Qq]
[q] Serotypes …………… is responsible for this skin lesion?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNlcm90eXBlcyAoMSwgMiwgNiwgMTEpLg==[Qq]
[q] Human papillomavirus (HPV) types 16 and 18 are strongly associated with …………….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGFuYWwgYW5kIGNlcnZpY2FsIHNxdWFtb3VzIGNlbGwgY2FyY2lub21hLg==[Qq]
[q] Integration of HPV DNA leads to high expression of ……….. leading to inactivation of the two suppressor genes p53 and retinoblastoma —> induction of abnormal mitosis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEU2IGFuZCBFNyBnZW5lcyBsZWFkaW5nIHRvIG92ZXJwcm9kdWN0aW9uIG9mIEU2IGFuZCBFNyBwcm90ZWlucy4=[Qq]
[q] koilocytic changes (perinuclear cytoplasmic vacuolization and nuclear enlargement) of squamous epithelium in pap smear is characteristic for infection with ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEh1bWFuIFBhcGlsbG9tYSBWaXJ1cyAoSFBWKS4=[Qq]
[q] Site of latency of BK virus is ……….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJlbnRhbCB0dWJ1bGFyIGVwaXRoZWxpYWwgY2VsbHMu[Qq]
[q] Site of latency of JC virus is ……….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IG9saWdvZGVuZHJvY3l0ZXMu[Qq]
[q] What is the most likely diagnosis?
HIV Patient with CD4 count less than 200 presenting with slowly progressive confusion, ataxia, and motor deficits + slowly progressive confusion, ataxia, and motor deficits?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFByb2dyZXNzaXZlIG11bHRpZm9jYWwgbGV1a29lbmNlcGhhbG9wYXRoeSAoUE1MKSBkdWUgdG8gcmVhY3RpdmF0aW9uIG9mIEpDIHZpcnVzLg==[Qq]
[q] What is the most likely diagnosis?
5 children from day care center presenting with acute onset of fever, pharyngitis, cough, nasal congestion, conjunctivitis, and enlarged cervical nodes?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBoYXJ5bmdvY29uanVuY3Rpdml0aXMgZmV2ZXIgZHVlIHRvIGluZmVjdGlvbiB3aXRoIEFkZW5vdmlydXMu[Qq]
[q] What is the most likely diagnosis?
5 children from day care center presenting with urinary tract infection characterized by dysuria and hematuria?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFjdXRlIGhlbW9ycmhhZ2ljIGN5c3RpdGlzIGR1ZSB0byBpbmZlY3Rpb24gd2l0aCBBZGVub3ZpcnVzLg==[Qq]
[q] What is the most likely diagnosis?
2 years old child presenting with fever, vesiculoulcerative lesions of the oral cavity and tongue, and localized lymphadenopathy?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhlcnBldGljIGdpbmdpdm9zdG9tYXRpdGlzIGR1ZSB0byBwcmltYXJ5IGluZmVjdGlvbiB3aXRoIEhTVi0xLg==
Cg==Cg==JiM4MjExOyBMYXRlbnQgaW4gdHJpZ2VtaW5hbCBnYW5nbGlvbi4=[Qq]
[q] What is the most likely diagnosis?
19 years old patient presenting with perioral blisters that commonly appear after stressful situations + Tzank smear shows intranuclear inclusions and multinucleated giant cells ?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENvbGQgc29yZXMuIFJlYWN0aXZhdGlvbiBvZiBhIGxhdGVudCBIU1YtMSBpbmZlY3Rpb24gaW4gdGhlIHRyaWdlbWluYWwgZ2FuZ2xpYS4=
Cg==Cg==[Qq][q] What is the most likely diagnosis?
40 years old patient presenting with acute onset of headache, fever, mental status changes (lethargy, disorientation), cranial nerve deficits, aphasia and personality changes + MRI shows edema and hemorrhagic necrosis of the temporal lobe?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRlbXBvcmFsIGxvYmUgZW5jZXBoYWxpdGlzIGR1ZSB0byBpbmZlY3Rpb24gd2l0aCBIZXJwZXMgc2ltcGxleCB2aXJ1cyB0eXBlIDEgKEhTVi0xKS4=
Cg==Cg==[Qq][q] What is the most likely diagnosis?
25 years old patient presenting with recurrent, painful genital rash + Tzank smear shows intranuclear inclusions and multinucleated giant cells ?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhlcnBlcyBnZW5pdGFsaXMgZHVlIHRvIGluZmVjdGlvbiB3aXRoIEhTVi0yIGluZmVjdGlvbi4=[Qq]
[q] What is the most likely diagnosis?
5 years old child presenting with fever, malaise, pharyngitis, and a generalized vesicular and pruritic rash. The skin lesions appear as successive crops + Tzank smear shows intranuclear inclusions and multinucleated giant cells ?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENoaWNrZW5wb3gu[Qq]
[q] What is the most likely diagnosis?
26 years old female presenting with unilateral painful, vesicular rash localized on a single dermatome + varicella lgG antibodies?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhlcnBlcyBab3N0ZXIgKHNoaW5nbGVzKS4=
Cg==Cg==[Qq][q] Epstein-Barr Virus establish latency in ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IA==Qg==IGx5bXBob2N5dGVzIChFQg==Viku
[Qq][q] What is the most likely diagnosis?
21 years old male presenting with fever, pharyngitis, lymphadenopathy, hepatosplenomegaly, atypical lymphocytosis, and a positive Monospot test (positive heterophile antibodies)?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhldGVyb3BoaWxlLXBvc2l0aXZlIGluZmVjdGlvdXMgbW9ub251Y2xlb3NpcyAoZ2xhbmR1bGFyIGZldmVyKSBkdWUgdG8gaW5mZWN0aW9uIHdpdGggRXBzdGVpbi1CYXJyIHZpcnVzIChFQlYpLg==[Qq]
[q] Epstein-Barr virus (EBV) commonly infects B cells, stimulating them to enter the cell cycle and proliferate continuously (a process termed “transformation” or “immortalization”) which increase the risk of …………. AIDS patients.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhvZGdraW4gYW5kIG5vbi1Ib2Rna2luJiM4MjE3O3MgbHltcGhvbWFzLCBpbmNsdWRpbmcgdGhlIGFnZ3Jlc3NpdmUgZGlmZnVzZSBsYXJnZSBCLWNlbGwgbHltcGhvbWFzIGFuZCBCdXJraXR0JiM4MjE3O3MgbHltcGhvbWEu[Qq]
[q] What is the most likely diagnosis?
HIV positive patient with CD4 count less than 400 presenting with white patches or plaques on the lateral border of the tongue, these lesions cannot be easily removed with scraping?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhhaXJ5IG9yYWwgbGV1a29wbGFraWEu[Qq]
[q] Cytomegalovirus establish latency in ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IA==bQ==b25vbnVjbGVhciBjZWxscyAoQw==TQ==Viku
[Qq][q] What is the most likely diagnosis?
21 years old male presenting with fever, pharyngitis, lymphadenopathy, hepatosplenomegaly, atypical lymphocytosis, and a negative Monospot test (positive heterophile antibodies)?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhldGVyb3BoaWxlLW5lZ2F0aXZlIG1vbm9udWNsZW9zaXMgZHVlIHRvIGluZmVjdGlvbiB3aXRoIEN5dG9tZWdhbG92aXJ1cy4=[Qq]
[q] What is the most likely diagnosis?
HIV positive patient with CD4 count less than 200 presenting with interstitial pneumonia + lung biopsy shows intranuclear inclusion bodies that have characteristic “Owl-eye” inclusion?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEludGVyc3RpdGlhbCBwbmV1bW9uaXRpcyBkdWUgdG8gQ01WIGluZmVjdGlvbi4=[Qq]
[q] What is the most likely diagnosis?
1 years old child presenting with Febrile seizures followed by erythematous maculopapular rash?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJvc2VvbGEgaW5mYW50dW0gZHVlIHRvIGluZmVjdGlvbiB3aXRoIEh1bWFuIGhlcnBlc3ZpcnVzZXMgNi4=[Qq]
[q] What is the most likely diagnosis?
HIV positive patient with CD4 count less than 200 presenting with red purple skin lesion + Biopsy with lymphocytic inflammation?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEthcG9zaSBzYXJjb21hLg==[Qq]
[q] ……….. replicates in dermis and cause single or multiple (<20) Flesh-colored papule with central umbilication.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1vbGx1c2N1bSBjb250YWdpb3N1bS4=[Qq]
[q] RNA viruses are ssRNA (like our mRNA), except ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IOKAnA==cmU=cGVhdA==bw==LXZpcnVz4oCdICg=[Qq]reovirus) is dsRNA.
[q] RNA viruses are enveloped except for ………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IA==Yw==YWxpY2l2aXJ1c2VzLCA=[Qq]picornaviruses, reoviruses, and hepeviruses (CPR, and hepevirus).
[q] RNA viruses have helical capsids except for ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IA==Yw==YWxpY2l2aXJ1c2VzLCA=[Qq]picornaviruses, reoviruses, flaviviruses, togaviruses, retroviruses and hepeviruses (CPR, FTR and hepevirus).
[q] RNA viruses replicate in the cytoplasm except for ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IA==bw==cnRob215eG92aXJ1c2VzIGFuZCA=cg==ZXRyb3ZpcnVzZXMgKA==[Qq]OR have both a cytoplasmic and a nuclear phase).
[q] Segmented RNA viruses include ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]UmVvdmlydXMsIE9ydGhvbXl4b3ZpcnVzLCBCdW55YXZpcnVzLCBhbmQgQXJlbmF2aXJ1cy4=
Cg==Cg==JiM4MjExOyBST0JBIHNvdW5kcyBsaWtlIHJvYm90LCBwaWVjZXMu[Qq]
[q] …….. is the most common cause of viral gastrointeritis in U.S in older children and adults in daycare centers.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE5vcm92aXJ1cy4=
Cg==Cg==[Qq][q] ………… is the most common cause of aseptic meningitis, accounting for up to 90% of cases. Cerebrospinal fluid analysis in patients with aseptic meningitis typically shows a lymphocytic pleocytosis, modestly elevated protein level, and normal glucose level.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVudGVyb3ZpcnVzLg==
Cg==Cg==[Qq][q] ………. is acute painful febrile pharyngitis, characterized by vesicles on the fauces and tongue which rapidly ulcerate without skin findings due to infection with coxsaki A virus.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhlcnBhbmdpbmEu
Cg==Cg==[Qq][q] ……….. is erythematous papules on the palms and soles with vesicles and ulcers in oral mucosa and around the mouth due to infection with coxsaki A virus.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhhbmQsIGZvb3QsIGFuZCBtb3V0aCBkaXNlYXNlLg==[Qq]
[q] Myocarditis and pericarditis can be caused by which type of coxsaki virus?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGNveHNha2kgQiB2aXJ1cy4=[Qq]
[q] Which type of polio vaccine?
live attenuated vaccine, taken orally, give local and systemic immunity, contraindicated in pregnancy and immunocompromised, and Lose its potency due to improper storage (properly stored at 4° C)?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNhYmluIHZhY2NpbmUgb3JhbCBwb2xpbyB2YWNjaW5lIChPUFYpLg==[Qq]
[q] Which type of polio vaccine?
Formalin inactivated (killed) vaccine, taken intramuscularly, give systemic immunity only, no contraindication in pregnancy and immunocompromised, and may cause minor allergic reaction?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNhbGsgdmFjY2luZSBpbmFjdGl2YXRlZCBwb2xpbyB2YWNjaW5lIChJUFYpLg==[Qq]
[q] What is the most likely diagnosis?
28 years old patient presenting with high fever, black vomitus, jaundice, albuminuria, bleeding from nose, gum, hematemesis, and melena after recent travel to south America + liver biopsy shows Councilman bodies (eosinophilic apoptotic globules)?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFllbGxvdyBmZXZlciBkaXNlYXNlIGR1ZSB0byBpbmZlY3Rpb24gd2l0aCB5ZWxsb3cgZmV2ZXIgdmlydXMgKEZsYXZpdmlyaWRhZSku[Qq]
[q] What is the most likely diagnosis?
31 years old patient presenting with (high-grade fever) with severe pain in the bones, muscles, retroorbital, and joints (breakbone fever), headache and skin rash after recent travel to Mexico with complete resolve of the symptoms within days?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IERlbmd1ZSBmZXZlci4=
Cg==Cg==JiM4MjExOyBQcmltYXJ5IGluZmVjdGlvbiBsZWFkcyB0byBsaWZlbG9uZyBpbW11bml0eSBhZ2FpbnN0IHRoZSBzYW1lIHNlcm90eXBlLCBidXQgaW5kaXZpZHVhbHMgY2FuIGJlIGluZmVjdGVkIHdpdGggYSBkaWZmZXJlbnQgc2Vyb3R5cGUu[Qq]
[q] What is the most likely diagnosis?
31 years old patient presenting with (high-grade fever) with severe pain in the bones, muscles, retroorbital, and joints (breakbone fever), headache and skin rash that progress to marked thrombocytopenia, respiratory/circulatory failure, and shock?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IERlbmd1ZSBoZW1vcnJoYWdpYyBmZXZlci4=
Cg==Cg==JiM4MjExOyBTZWNvbmRhcnkgaW5mZWN0aW9uIHdpdGggYSBkaWZmZXJlbnQgdmlyYWwgc2Vyb3R5cGUgY2FuIGNhdXNlIGEgbW9yZSBzZXZlcmUgaWxsbmVzcywgcG9zc2libHkgZHVlIHRvIGFudGlib2R5LWRlcGVuZGVudCBlbmhhbmNlbWVudCBvZiBpbmZlY3Rpb24sIGVuaGFuY2VkIGltbXVuZSBjb21wbGV4IGZvcm1hdGlvbiwgYW5kL29yIGFjY2VsZXJhdGVkIChub3QgYmx1bnRlZCkgVC1seW1waG9jeXRlIHJlc3BvbnNlcy4=[Qq]
[q] What is the most likely diagnosis?
Newborn child presenting with microcephaly with facial features out of proportion to head size, seizures, hypertonia, and ocular abnormalities + MRI shows Loss of brain mass (cortical thinning, ventriculomegaly) as well as subcortical calcifications are typically present + his mother was in recent travel to brazil before delivery?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENvbmdlbml0YWwgWmlrYSBzeW5kcm9tZS4=[Qq]
[q] Dengue virus, Yellow fever virus, Zika virus and Chikungunya virus are arboviruses transmitted by ……….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHZlY3RvciBpcyBBZWRlcyBtb3NxdWl0b2VzLg==[Qq]
[q] What is the most likely diagnosis?
6 years old immigrant child presenting with maculopapular rash that begins on the face and spreads centrifugally (from the center to extremities) to the trunk and extremities and postauricular and occipital lymphadenopathy?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEdlcm1hbiAoMy1kYXkpIG1lYXNsZXMgZHVlIHRvIGluZmVjdGlvbiB3aXRoIHJ1YmVsbGEgKFRvZ2F2aXJpZGFlKS4=[Qq]
[q] What is the most likely diagnosis?
Newborn child presenting with blueberry muffin, microcephaly, cataracts, deafness, and patent ductus arteriosus + his mother has history of low-grade fever, a maculopapular rash with cephalocaudal progression, and polyarthritis and polyarthralgia in pregnancy?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENvbmdlbml0YWwgcnViZWxsYSBzeW5kcm9tZS4=[Qq]
[q] Which type of arboviruses that cause meningoencephalitis + flaccid paralysis (asymmetric weakness of limbs, fasciculations)?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFdlc3QgTmlsZSBmZXZlci4=
Cg==Cg==[Qq][q] What is the most likely diagnosis?
25 years old patient presenting with fever, dry cough, shortness of breath, fatigue, anosmia (loss of smell), dysgeusia (altered taste) + RT-PCR of nasopharyngeal swab is positive for Enveloped, helical and Positive sense ssRNA?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNldmVyZSBhY3V0ZSByZXNwaXJhdG9yeSBzeW5kcm9tZSBjb3JvbmF2aXJ1cyAyLg==[Qq]
[q] …….. encodes for gp160, a precursor glycoprotein that is cleaved to form the 2 envelope glycoproteins gp120 and gp41. Rapid mutation in this gene results in many gp120 antigenic variants.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVudiBnZW5lLg==[Qq]
[q] ……… encodes the enzymes reverse transcriptase, integrase and protease which participate in viral replication.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBvbCBnZW5lLg==[Qq]
[q] ………. encodes the core proteins, the most important of which is p24.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEdhZyBnZW5lLg==[Qq]
[q] What is the most likely diagnosis?
HIV positive patient with CD4 count less than 500 presenting with Scrapable white plaques on oral cavity + pseudohyphae on microscopy?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE9yYWwgdGhydXNoIGR1ZSB0byBDYW5kaWRhIGFsYmljYW5zIGluZmVjdGlvbi4=[Qq]
[q] What is the most likely diagnosis?
HIV positive patient with CD4 count less than 500 presenting with Unscrapable white plaque on lateral tongue?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE9yYWwgaGFpcnkgbGV1a29wbGFraWEgZHVlIHRvIGluZmVjdGlvbiB3aXRoIEVCVi4=[Qq]
[q] What is the most likely diagnosis?
HIV positive patient with CD4 count less than 500 presenting with red-purple skin lesion + Biopsy with lymphocytic inflammation?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEthcG9zaSBzYXJjb21hIGR1ZSB0byBpbmZlY3Rpb24gd2l0aCBISFYtOC4=[Qq]
[q] What is the most likely diagnosis?
HIV positive patient with CD4 count less than 200 presenting with symptoms of atypical pneumonia + “Ground-glass” opacities on CXR or CT?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBuZXVtb2N5c3RpcyBqaXJvdmVjaWku[Qq]
[q] What is the most likely diagnosis?
HIV positive patient with CD4 count less than 200 presenting with red-purple skin lesion + Biopsy with neutrophilic inflammation?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJhY2lsbGFyeSBhbmdpb21hdG9zaXMgZHVlIHRvIGluZmVjdGlvbiBCYXJ0b25lbGxhIGhlbnNlbGFlLg==[Qq]
[q] What is the most likely diagnosis?
HIV positive patient with CD4 count less than 100 presenting with symptoms of meningitis + Thickly encapsulated yeast on India ink stain?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENyeXB0b2NvY2NhbCBtZW5pbmdpdGlzLg==[Qq]
[q] What is the most likely diagnosis?
HIV positive patient with CD4 count less than 100 presenting with dysphagia + White plaques on endoscopy; yeast and pseudohyphae on biopsy?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENhbmRpZGEgRXNvcGhhZ2l0aXMu
Cg==Cg==[Qq][q] What is the most likely diagnosis?
HIV positive patient with CD4 count less than 100 presenting with dysphagia + punched out ulcers on endoscopy + eosinophilic intranuclear inclusions on biopsy?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhTVi0xIEVzb3BoYWdpdGlzLg==
Cg==Cg==[Qq][q] What is the most likely diagnosis?
HIV positive patient with CD4 count less than 100 presenting with dysphagia + linear ulcerations on endoscopy + intranuclear inclusion with owel eye appearance?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENNViBFc2VvcGhhZ2l0aXMu
Cg==Cg==[Qq][q] What is the most likely diagnosis?
HIV positive patient with CD4 count less than 100 presenting with chronic watery diarrhea + Acid-fast oocysts in stool?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENyeXB0b3Nwb3JpZGl1bSBwYXJ2dW0gaW5mZWN0aW9uLg==[Qq]
[q] What is the most likely diagnosis?
HIV positive patient with CD4 count less than 100 presenting with cotton-wool spots on fundoscopy?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENNViByZXRpbml0aXMu[Qq]
[q] What is the most likely diagnosis?
HIV positive patient with CD4 count less than 100 presenting with solitary ring-enhancing lesion?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEItY2VsbCBseW1waG9tYSAobm9uLUhvZGdraW4gbHltcGhvbWEsIENOUyBseW1waG9tYSkgZHVlIHRvIEVCVi4=[Qq]
[q] What is the most likely diagnosis?
HIV positive patient with CD4 count less than 100 presenting with Nonspecific systemic symptoms (fever, night sweats, weight loss) or focal lymphadenitis, and hepatosplenomegaly + Acid fast bacilli is positive but PCR failed to detect tubercular antigen?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE15Y29iYWN0ZXJpdW0gYXZpdW0taW50cmFjZWxsdWxhcmUsIE15Y29iYWN0ZXJpdW0gYXZpdW0=
CkNvbXBsZXgu[Qq]
[q] What is the most likely diagnosis?
HIV positive patient with CD4 count less than 100 presenting with Multiple ring-enhancing lesions on MRI?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJyYWluIGFic2Nlc3NlcyBkdWUgdG8gaW5mZWN0aW9uIHdpdGggVG94b3BsYXNtYSBnb25kaWku[Qq]
[q] Presumptive diagnosis made with …….. immunoassays. These immunoassays detect ………….. and …………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhJVi0xLzIgQWcvQWIuIHZpcmFsIHAyNCBBZyBjYXBzaWQgcHJvdGVpbiBhbmQgSWdHIEFicyB0byBISVYtMS8yLg==[Qq]
[q] AIDS diagnosis is made by …………… or ……. or ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IA==QUlEUyBkaWFnbm9zaXM6IA==
Cg==[Qq]1. ≤ 200 CD4+ cells/mm3 (normal: 500–1500 cells/mm3).
2. CD4 percentage < 14%.
3. HIV ⊕ with AIDS-defining condition (Pneumocystis pneumonia).
[q] HIV-1/2 Ag/Ab testing is not recommended in babies with suspected HIV due to maternally transferred antibody. We use …… instead.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhJViB2aXJhbCBsb2FkLg==[Qq]
[q] Deletion of both alleles of the gene that codes for the CCR5 receptor (homozygous CCR5 32 deletion) renders the individual ……….. to HIV infection.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHJlc2lzdGFudC4=
Cg==Cg==74KnIEhvbW96eWdvdXMgQ0NSUyBtdXRhdGlvbiDvg6AgaW1tdW5lLg==
[Qq]
Heterozygous CCRS mutation slow course.
[q] Studies have shown that maternal prophylaxis during pregnancy with the nucleoside analog ……. reduces the risk of perinatal transmission by about two-thirds in HIV positive women who have not previously received antiretroviral therapy.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHppZG92dWRpbmUgKFpEViwgQVpUKSwgYSByZXRyb3ZpcmFsIHJldmVyc2UgdHJhbnNjcmlwdGFzZSBpbmhpYml0b3I=[Qq]
[q] What is the most likely diagnosis?
9 years old immigrant child presenting with Cough, Coryza, and Conjunctivitis, and Koplik spots that looks like “grains of sand” on an erythematous base followed by the development of a maculopapular rash that starts at the head/neck and spreads downward within 1-2 days?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1lYXNsZXMgZHVlIHRvIGluZmVjdGlvbiB3aXRoIHRoZSBtZWFzbGVzIHZpcnVzLCBhIG1lbWJlciBvZiB0aGUgcGFyYW15eG92aXJ1cyBmYW1pbHku[Qq]
[q] …………. can reduce measles mortality in malnourished or vitamin-deficient children. It helps prevent and treat these ocular complications (keratitis and corneal ulceration). In addition, it reduces risk of other comorbidities (pneumonia, encephalitis), recovery time, and length of hospital stay
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFZpdGFtaW4gQSBzdXBwbGVtZW50YXRpb24u[Qq]
[q] What is the most likely diagnosis?
7 years old immigrant child presenting with bilateral parotitis with fever, headache, and malaise?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE11bXBzLg==[Qq]
[q] Complications of mumps include ……. and …………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHBhbmNyZWF0aXRpcywgb3JjaGl0aXMgKGxlYWRzIHRvIHN0ZXJpbGl0eSBlc3BlY2lhbGx5IGFmdGVyIHB1YmVydHkpLCBhbmQgYXNlcHRpYyBNZW5pbmdpdGlzLg==
Cg==Cg==[Qq][q] What is the most likely diagnosis?
9 month old infant presenting with his parents with brassy, barking cough (seal-like) and breathing difficulties (inspiratory stridor) + C-xray shows Steeple sign + symptoms resolved after giving racemic epinephrine?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENyb3VwIChBY3V0ZSBsYXJ5bmdvdHJhY2hlb2Jyb25jaGl0aXMpIGR1ZSB0byBpbmZlY3Rpb24gd2l0aCB0aGUgcGFyYWluZmx1ZW56YSB2aXJ1c2VzIChtZW1iZXJzIG9mIFBhcmFteXhvdmlyaWRhZSku
Cg==Cg==[Qq][q] What is the most likely diagnosis?
Premature newborn presenting with rhinorrhea and congestion followed by cough, low-grade fever, and hypoxemia, tachypnea, and retractions with diffuse wheezes and crackles?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFZpcmFsIEJyb25jaGlvbGl0aXMgZHVlIHRvIGluZmVjdGlvbiB3aXRoIFJlc3BpcmF0b3J5IHN5bmN5dGlhbCB2aXJ1cyAoUlNWKS4=
Cg==Cg==JiM4MjExOyBQYWxpdml6dW1hYiBmb3IgUGFyYW15eG92aXJ1cyAoUlNWKSBQcm9waHlsYXhpcyBpbiBQcmVlbWllcy4=
[Qq][q] The most common reservoir of rabies virus in U.S is ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGJhdCwgcmFjY29vbiwgYW5kIHNrdW5rLg==[Qq]
[q] The tropism of Rabies Virus is to ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IG5pY290aW5pYyBhY2V0eWxjaG9saW5lIHJlY2VwdG9ycyBvbiBwZXJpcGhlcmFsIG5lcnZlIGF4b25zLg==[Qq]
[q] What is the most likely diagnosis?
36 years old patient who was in cave exploration trip 1 month ago presenting with nonspecific, flu-like prodrome (malaise, anorexia, mild fever, headache, nausea, vomiting) and a subsequent acute neurologic syndrome that includes agitation, persistent fever, variable consciousness, and painful spasms with swallowing or inspiration?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJhYmllcy4=
Cg==Cg==[Qq][q] ……………. are intracytoplasmic inclusion bodies commonly found in Purkinje cells of cerebellum and in hippocampal neurons in infected animals by direct immunofluorescence and can be used for diagnosis of rabies.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE5lZ3JpIGJvZGllcy4=[Qq]
[q] What is the most likely diagnosis?
46 years old patient who was in recent travel to Congo presenting with flu-like symptoms, diarrhea/vomiting, high fever, myalgia followed by severe hematemesis and melena + PCR shows Enveloped, helical, and Negative sense ssRNA?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVib2xhIHZpcnVzLg==[Qq]
[q] What is the most likely diagnosis?
26 years old child presenting with chills, malaise, fever, muscle pain (myalgia) and respiratory symptoms as rhinitis and pharyngitis?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEluZmx1ZW56YS4=[Qq]
[q] Yearly epidemics are caused by …………. . The rare severe influenza pandemics are always caused by ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGJvdGggdHlwZSBBIGFuZCB0eXBlIEIgdmlydXNlcywgdHlwZSBBIHZpcnVzLg==[Qq]
[q] Viruses with ………….. are capable of genetic shifts through reassortment.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHNlZ21lbnRlZCBnZW5vbWVzIChvcnRob215eG92aXJ1c2VzIGFuZCByb3RhdmlydXNlcyku[Qq]
[q] ………. occurs with Influenza A only. Occurs due to coinfection of cells with two different strains of influenza A (such as when segments of human flu A virus reassort with swine flu A virus). Responsible for Production of a new agent to which population has no immunity that cause influenza pandemics.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFudGlnZW5pYyBzaGlmdC4=
Cg==Cg==[Qq][q] ………. occurs in Influenza A and B. Cause minor changes based on random mutation in hemagglutinin or neuraminidase genes. Responsible for strains that cause yearly influenza epidemics.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFudGlnZW5pYyBkcmlmdC4=[Qq]
[q] What is the most likely diagnosis?
4 years old child from daycare center presenting with acute, self-limited fever and watery diarrhea + child vaccination in not up to date?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJvdGF2aXJ1cy4=
Cg==Cg==JiM4MjExOyBJbmZlY3Rpb24gY2F1c2VzIGRpYXJyaGVhIHZpYSBtdWx0aXBsZSBtZWNoYW5pc21zIGluY2x1ZGluZyB2aWxsb3VzIGJsdW50aW5nIChsb3NzIG9mIGFic29ycHRpdmUgY2FwYWNpdHkpLg==[Qq]
[q] The most common food associated with hepatitis A infection in U.S is ……….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHJhdyBvciBzdGVhbWVkIHNoZWxsZmlzaCAob3lzdGVycyku[Qq]
[q] What is the most likely diagnosis?
19 years old patient presenting with jaundice, malaise, fatigue, anorexia, nausea, vomiting, right upper quadrant pain, Hepatomegaly and AST and ALT spike followed by increases in bilirubin and alkaline phosphatase + serum anti-HAV IgM in patient serum?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhlcGF0aXRpcyBBIGluZmVjdGlvbi4=[Qq]
[q] The hepatitis ……………… genome is a partially double stranded circular DNA molecule, and replication of this genome is accomplished through a reverse transcriptase DNA polymerase that creates an intermediate + single-stranded RNA template.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhCVi4=[Qq]
[q] The most common outcome in HBV-infected adults (> 95%) is …………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGFjdXRlIGhlcGF0aXRpcyB3aXRoIG1pbGQgb3Igc3ViY2xpbmljYWwgc3ltcHRvbXMgdGhhdCBldmVudHVhbGx5IGNvbXBsZXRlbHkgcmVzb2x2ZS4=[Qq]
[q] Which type of HBV antigens?
Noninfective envelope glycoprotein that forms spheres and tubules 22 nm in diameter.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhCc0FnLg==
Cg==Cg==[Qq][q] Which type of HBV antigens?
Nucleocapsid core protein that resides within hepatocytes and is not seen as a serological marker in patient with hepatitis B infection?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhCY0FnLg==[Qq]
[q] Which type of HBV antigens?
Nucleocapsid core and precore protein that is a marker of high infectivity?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhCZUFnLg==[Qq]
[q] Interpret the following Hepatitis B serology?
– HBsAg: Positive.
– IgM anti-HBc: Positive.
– Anti-HBs: Negative.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFjdXRlIEhCViBpbmZlY3Rpb24u[Qq]
[q] Interpret the following Hepatitis B serology?
– HBsAg: Negative.
– IgM anti-HBc: Positive.
– Anti-HBs: Negative.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFdpbmRvdyBwaGFzZS4=[Qq]
[q] Interpret the following Hepatitis B serology?
– HBsAg: Positive.
– IgM anti-HBc: Negative.
– IgG anti-HBc: Positive.
– HBeAg: Positive.
– Anti-HBe: Negative.
– Anti-HBs: Negative.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENocm9uaWMgSEJWIGluZmVjdGlvbiAoSGlnaCBpbmZlY3Rpdml0eSku[Qq]
[q] Interpret the following Hepatitis B serology?
– HBsAg: Positive.
– IgM anti-HBc: Negative.
– IgG anti-HBc: Positive.
– HBeAg: Negative.
– Anti-HBe: Positive.
– Anti-HBs: Negative.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENocm9uaWMgSEJWIGluZmVjdGlvbiAoTG93IGluZmVjdGl2aXR5KQ==[Qq]
[q] Interpret the following Hepatitis B serology?
– HBsAg: Negative.
– IgG anti-HBc: Positive.
– Anti-HBs: Positive.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEltbXVuZSBpbmRpdmlkdWFsIGZvbGxvd2luZyBuYXR1cmFsIGluZmVjdGlvbi4=[Qq]
[q] Interpret the following Hepatitis B serology?
– HBsAg: Negative.
– Anti-HBc: Negative.
– Anti-HBs: Positive.
[c]IFNob3cgbWUg dGhlIGFuc3dl[Qq]
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEltbXVuZSBpbmRpdmlkdWFsIGZvbGxvd2luZyBIQlYgVmFjY2luYXRpb24u[Qq]
[q] Interpret the following Hepatitis B serology?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]Y2hyb25pYyBoZXBhdGl0aXMgQiBpbmZlY3Rpb24gd2l0aCBoaWdoIGluZmVjdGl2aXR5Lg==[Qq]
[q] Interpret the following Hepatitis B serology?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFjdXRlIGhlcGF0aXRpcyBCIGluZmVjdGlvbiB0aGF0IGhhcyBjb21wbGV0ZWx5IHJlc29sdmVkLg==[Qq]
[q] The presence of ………….. in the pregnant mother significantly increases the risk of vertical transmission of the virus?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhCZUFnLg==[Qq]
[q] Which type of hepatitis virus?
– There is no proofreading 3′-5′ exonuclease activity built into the virion-encoded RNA polymerase. As a result, the RNA polymerase makes many errors during replication.
– The tremendous antigenic variety of this virus has significantly slowed efforts to develop a vaccine against the virus.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhlcGF0aXRpcyBDIHZpcnVzLg==
Cg==Cg==[Qq][q] Which type of hepatitis virus?
– Replication-defective RNA virus that is only capable of causing infection when encapsulated with HBsAg of the hepatitis B virus.
– In a population that is universally vaccinated with recombinant HBsAg, then, this virus would not be able to replicate and would cease to be a significant threat.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhlcGF0aXRpcyBEIHZpcnVzLg==[Qq]
[q] Which type of hepatitis virus?
– Unenveloped, single-stranded RNA virus spread through the fecal-oral route.
– The most concerning feature of this virus is the high mortality rate observed in infected pregnant women.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEhlcGF0aXRpcyBFIHZpcnVzLg==[Qq]
[q] Which type of viral genetics?
– Exchange of genes between 2 chromosomes via crossing over within homologous regions.
– The resulting progeny can have recombined genomes with traits from both parent viruses.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJlY29tYmluYXRpb24u[Qq]
[q] Which type of viral genetics?
– When viruses with segmented genomes (influenza virus) exchange genetic material.
– For example, the 2009 novel H1N1 influenza A pandemic emerged via complex viral reassortment of genes from human, swine, and avian viruses.
– Has potential to cause antigenic shift.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJlYXNzb3J0bWVudC4=[Qq]
[q] Which type of viral genetics?
– When 1 of 2 viruses that infect the cell has a mutation that results in a nonfunctional protein, the nonmutated virus “complements” the mutated one by making a functional protein that serves both viruses.
– For example, hepatitis D virus requires the presence of replicating hepatitis B virus to supply HBsAg, the envelope protein for HDV.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENvbXBsZW1lbnRhdGlvbi4=[Qq]
[q] Which type of viral genetics?
– Occurs with simultaneous infection of a cell with 2 viruses.
– For progeny 1, genome of virus A can be partially or completely coated (forming pseudovirion) with the surface proteins of virus B (phenotypic masking). Type B protein coat determines the tropism (infectivity) of the hybrid virus.
– Progeny from subsequent infection of a cell by progeny 1 will have a type A coat that is encoded by its type A genetic material.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBoZW5vdHlwaWMgbWl4aW5nLg==[Qq]
[q] ………. are structural analogs of D-Ala-D-Ala that bind penicillin-binding proteins (transpeptidases) and inhibit it by binding covalently to its active site. The result is failed synthesis of the bacterial peptidoglycan cell wall. The weakened cell wall integrity causes osmotic lysis of the bacterium.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJldGEgbGFjdGFtIGFudGliaW90aWNzIChQZW5pY2lsbGlucywgQ2VwaGFsb3Nwb3JpbnMsIHBlbmVtcywgTW9ub2JhY3RhbXMpLg==[Qq]
[q] ………… are beta-lactamase resistant penicillins because bulky R group blocks access of β-lactamase to β-lactam ring. Reliable for treatment of known or suspected S. aureus (except MRSA; resistant because of altered penicillin-binding protein target site).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFZlcnkgbmFycm93IHNwZWN0cnVtIHBlbmljaWxsaW4gKG1ldGhpY2lsbGluLCBuYWZjaWxsaW4sIG94YWNpbGxpbiwgY2xveGFjaWxsaW4sIGRpY2xveGFjaWxsaW4pLg==[Qq]
[q] ……… are Beta-lactamase sensitive penicillins. Mostly used for gram-positive organisms (S. pneumoniae, S. pyogenes, Actinomyces). Also used for gram-negative cocci (mainly N. meningitidis) and spirochetes (namely T. pallidum).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE5hcnJvdyBzcGVjdHJ1bSBwZW5pY2lsbGluIChQZW5pY2lsbGluIEcgLCBwZW5pY2lsbGluIFYpLg==[Qq]
[q] …….. are Beta-lactamase sensitive penicillins, also combine with clavulanic acid to protect against destruction by β-lactamase. Have wider spectrum, gram-positive cocci (not staph), E. coli, H. influenzae, Listeria monocytogenes (ampicillin), Borrelia burgdorferi (amoxicillin), H. pylori (amoxicillin).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJyb2FkIHNwZWN0cnVtIEFtaW5vcGVuaWNpbGxpbnMgKGFtcGljaWxsaW4gYW5kIGFtb3hpY2lsbGluKS4=[Qq]
[q] …….. are Antipseudomonal, beta-lactamase sensitive penicillins. Have increased activity against gram-negative rods, including Pseudomonas aeruginosa.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEV4dGVuZGVkIHNwZWN0cnVtIHBlbmljaWxsaW4gKFBpcGVyYWNpbGxpbiwgdGljYXJjaWxsaW4pLg==[Qq]
[q] β-lactamase inhibitors include ……… and …….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENsYXZ1bGFuaWMgQWNpZCwgU3VsYmFjdGFtLCBhbmQgVGF6b2JhY3RhbSAoQ0FTVCku[Qq]
[q] Which generation of cephalosporins?
– Spectrum: gram-positive cocci (not MRSA), Proteus mirabilis, E. coli, Klebsiella pneumoniae (PEcK).
– None enter CNS.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEZpcnN0IGdlbmVyYXRpb24gKENlZmF6b2xpbiwgY2VwaGFsZXhpbiku[Qq]
[q] Which generation of cephalosporins?
– Spectrum: gram-positive cocci, Haemophilus influenzae, Enterobacter aerogenes, Neisseria spp, Serratia marcescens, Proteus mirabilis, E. coli, Klebsiella pneumoniae (HENS PEcK).
– None enter the CNS, except cefuroxime.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNlY29uZCBnZW5lcmF0aW9uIChjZWZhY2xvciwgY2Vmb3hpdGluLCBjZWZ1cm94aW1lLCBjZWZvdGV0YW4pLg==[Qq]
[q] Which generation of cephalosporins?
– Spectrum: gram-positive and gram-negative cocci, serious gram-negative infections resistant to other β-lactams.
– Ceftazidime has antipseudomonal activity.
– Most enter CNS; important in empiric management of meningitis and sepsis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRoaXJkIGdlbmVyYXRpb24gKENlZnRyaWF4b25lLCBjZWZvdGF4aW1lLCBjZWZ0YXppZGltZSBhbmQgY2VmaXhpbWUpLg==[Qq]
[q] Which generation of cephalosporins?
– Spectrum: gram-negative organisms, with activity against Pseudomonas and gram-positive organisms.
– Resistant to most beta-lactamases.
– Enters CNS.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEZvdXJ0aCBnZW5lcmF0aW9uIChDZWZlcGltZSku[Qq]
[q] Which generation of cephalosporins?
– Spectrum: broad gram-positive and gram-negative organism coverage.
– Unlike 1st-4th generation cephalosporins, it covers MRSA, and Enterococcus faecalis.
– Does not cover Pseudomonas.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEZpZnRoIGdlbmVyYXRpb24gKENlZnRhcm9saW5lKS4=[Qq]
[q] In case of penicillin allergy, If there is rash to penicillin —> use …………, if there is anaphylaxis to penicillin —> use …….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGNlcGhhbG9zcG9yaW4sIG5vbi1CIGxhY3RhbSAoZm9yIGdyYW0tcG9zaXRpdmUgb3JnYW5pc21zLCBjb25zaWRlciBtYWNyb2xpZGVzOyBmb3IgZ3JhbS1uZWdhdGl2ZSByb2RzLCBjb25zaWRlciBhbWlub2dseWNvc2lkZXMgb3IgYXp0cmVvbmFtIGluIGNhc2Ugb2YgcmVuYWwgaW1wYWlybWVudCku[Qq]
[q] Mechanism of resistance to ……. is change in the structure of penicillin-binding proteins that prevents cephalosporin binding is one mechanism of bacterial resistance to cephalosporins.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEJldGEgbGFjdGFtIGFudGliaW90aWNzLg==[Qq]
[q] ……. is broad spectrum antibiotics that cover Gram-positive cocci, gram-negative rods (Enterobacter, Pseudomonas spp.), and anaerobes. Resistant to beta-lactamases. Important in-hospital agents for empiric use in severe life-threatening infections. Given with cilastatin, a renal dehydropeptidase inhibitor, which inhibits imipenems metabolism to a nephrotoxic metabolite. Cause seizure as a side effect.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEltaXBlbmVtLg==[Qq]
[q] ……….. effective against Gram-negative rods only, no activity against gram positives or anaerobes. For penicillin-allergic patients and those with renal insufficiency who cannot tolerate aminoglycosides. No cross-allergenicity with penicillins or cephalosporins.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEF6dHJlb25hbS4=[Qq]
[q] ……….. Inhibits cell wall peptidoglycan formation by binding D-ala D-ala portion of cell wall precursors. Effective against Gram-positive bugs only, and serious, multidrug-resistant organisms, including (MRSA, Enterococci). Clostridium difficile (oral dose for pseudomembranous colitis). Side effects include: Nephrotoxicity, Ototoxicity, Thrombophlebitis, diffuse flushing “red man syndrome” due to histamine release with rapid IV injection (can largely prevent by pretreatment with antihistamines and slow infusion rate).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFZhbmNvbXljaW4u[Qq]
[q] The mechanism of …… resistance in organisms such as VRE is a substitution of D-lactate in the place of D-alanine during the process of peptidoglycan cell wall synthesis. This prevents the binding of the drug to its usual D-alanine-D-alanine binding site in the cell wall.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHZhbmNvbXljaW4u[Qq]
[q] ……………. is a lipopeptide antibiotic with activity toward Gram-positive organisms including MRSA, it works by disrupting the bacterial membrane through the creation of transmembrane channels. These channels cause leakage of intracellular ions leading to depolarization of the cellular membrane and inhibition of macromolecular (DNA, RNA, and protein) synthesis, which ultimately leads to cell death.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IERhcHRvbXljaW4u[Qq]
[q] ……. is not used in case of pneumonia because it is inactivated by pulmonary surfactant. Associated with increased CPK levels and an increased incidence of myopathy, particularly in patients using other drugs associated with myopathy (statins).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IERhcHRvbXljaW4u[Qq]
[q] ………….. is Bactericidal, accumulated intracellularly in microorganisms via an O2-dependent uptake —> ineffective against anaerobes. Work by irreversible inhibition of initiation Complex through binding of the 30S subunit. Can cause genetic code misreading of mRNA. Also block translocation.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFtaW5vZ2x5Y29zaWRlcyAoR2VudGFtaWNpbiwgTmVvbXljaW4sIEFtaWthY2luLCBUb2JyYW15Y2luLCBTdHJlcHRvbXljaW4pLg==[Qq]
[q] ………… cause Nephrotoxicity, Neuromuscular blockade with ↓ release of Ach (absolute contraindication with myasthenia gravis), Ototoxicity and teratogenic.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFtaW5vZ2x5Y29zaWRlcyAoR2VudGFtaWNpbiwgTmVvbXljaW4sIEFtaWthY2luLCBUb2JyYW15Y2luLCBTdHJlcHRvbXljaW4pLg==[Qq]
[q] Mechanism of resistance to ……. is due to mutations of the genes that encode ribosomal proteins that modify the ribosomal binding sites for these drugs. Another mechanism of resistance is by producing modifying enzymes (bacterial transferase enzymes) that transfer different chemical groups (acetyl groups, methyl group, adenyl groups, and phosphate groups) to the antibiotic molecule outside of the bacterium, thereby decreasing the ability of these drugs to bind to ribosomes and exert their antimicrobial effects.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFtaW5vZ2x5Y29zaWRlcyAoR2VudGFtaWNpbiwgTmVvbXljaW4sIEFtaWthY2luLCBUb2JyYW15Y2luLCBTdHJlcHRvbXljaW4pLg==[Qq]
[q] ……. is Bacteriostatic; bind to 30S and prevent attachment of aminoacyl-tRNA. “Broad-spectrum” antibiotics, with good activity versus chlamydial and mycoplasma species, H. pylori (GI ulcers), Rickettsia, Borrelia burgdorferi, Brucella, Vibrio, and Treponema (backup drug). Also used to treat acne.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRldHJhY3ljbGluZXMgKFRldHJhY3ljbGluZSwgZG94eWN5Y2xpbmUsIG1pbm9jeWNsaW5lKS4=[Qq]
[q] Do not take ……. with milk (Ca2+), antacids (Ca2+ or Mg2+), or iron-containing preparations because divalent cations inhibit drugs’ absorption in the gut.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRldHJhY3ljbGluZXMgKFRldHJhY3ljbGluZSwgZG94eWN5Y2xpbmUsIG1pbm9jeWNsaW5lKS4=[Qq]
[q] ……. use during pregnancy can cause fetal bone growth retardation and discoloration of the deciduous teeth.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRldHJhY3ljbGluZXMgKFRldHJhY3ljbGluZSwgZG94eWN5Y2xpbmUsIG1pbm9jeWNsaW5lKS4=[Qq]
[q] ………. is tetracycline derivative. Binds to 30S, inhibiting protein synthesis. Effective against Multidrug-resistant organisms (MRSA, VRE).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRpZ2VjeWNsaW5lLg==[Qq]
[q] ………… is Bacteriostatic. It elicits its antibacterial effect by binding to the ribosomal 50S subunit and inhibiting the peptidyl transferase enzyme. Thus, it suppresses bacterial protein synthesis. Inhibition of cytochrome P450.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENobG9yYW1waGVuaWNvbC4=[Qq]
[q] ………. can cause both dose-dependent and dose-independent aplastic anemia (pancytopenia). “Gray baby syndrome” in premature infants because they lack liver UDP-glucuronyl transferase.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENobG9yYW1waGVuaWNvbC4=[Qq]
[q] ……… is Bacteriostatic. Blocks peptide transfer (translocation) at 50S ribosomal subunit. Not a macrolide but has the same mechanisms of action and resistance. Treats anaerobic infections above the diaphragm vs. metronidazole treats anaerobic infections below the diaphragm.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IENsaW5kYW15Y2luLg==[Qq]
[q] ……… is Bacteriostatic. Inhibit protein synthesis by blocking translocation; bind to the 23S rRNA of the 50S ribosomal subunit. Effective in treatment of Atypical pneumonias (Mycoplasma, Chlamydia, Legionella), STIs (Chlamydia), gram-positive cocci (streptococcal infections in patients allergic to penicillin), and B. pertussis. Inhibit cytochrome P-450 –> increases serum concentration of theophylline, oral anticoagulants.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1hY3JvbGlkZXMgKGVyeXRocm9teWNpbiwgYXppdGhyb215Y2luLCBjbGFyaXRocm9teWNpbiku[Qq]
[q] ……. cause Gastrointestinal Motility issues, Arrhythmia caused by prolonged QT interval, acute Cholestatic hepatitis, Rash, eOsinophilia as side effects.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1hY3JvbGlkZXMgKGVyeXRocm9teWNpbiwgYXppdGhyb215Y2luLCBjbGFyaXRocm9teWNpbiku[Qq]
[q] Mechanism of resistance to …….. is Methylation of 23S rRNA-binding site prevents binding of drug.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1hY3JvbGlkZXMgKGVyeXRocm9teWNpbiwgYXppdGhyb215Y2luLCBjbGFyaXRocm9teWNpbiku[Qq]
[q] ……….. inhibit protein synthesis by binding to 50S subunit and preventing formation of the initiation complex. Effective in treatment of VRSA, VRE, and drug-resistant pneumococci.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IExpbmV6b2xpZC4=[Qq]
[q] ………. work by Binding to sites on 50S ribosomal subunit, they prevent the interaction of amino-acyl-tRNA with acceptor site and stimulate its dissociation from the complex. Used parenterally in severe infections caused by vancomycin-resistant staphylococci (VRSA) and enterococci (VRE), as well as other drug- resistant, gram-positive cocci.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFF1aW51cHJpc3RpbiBhbmQgZGFsZm9wcmlzdGluLg==[Qq]
[q] ………. is Bacteriostatic (bactericidal when combined with trimethoprim). Inhibit dihydropteroate synthase –> Inhibit folate synthesis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN1bGZvbmFtaWRlcy4=
Cg==Cg==[Qq][q] ……. cause Hypersensitivity (rashes, Stevens-Johnson syndrome), Hemolysis in G6PD deficiency, Phototoxicity, Nephrotoxicity (tubulointerstitial nephritis), and Kernicterus in neonates (avoid in third trimester).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFN1bGZvbmFtaWRlcy4=[Qq]
[q] …………….. is Similar to sulfonamides, but structurally distinct agent. Effective in treatment of leprosy in combination with rifampin.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IERhcHNvbmUu[Qq]
[q] …….. is Bacteriostatic. Inhibits bacterial dihydrofolate reductase. Used in combination with sulfonamides [TMPSMX], causing sequential block of folate synthesis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRyaW1ldGhvcHJpbS4=[Qq]
[q] Trimethoprim, methotrexate, and pyrimethamine all prevent the reduction of folic acid to tetrahydrofolate by inhibiting …….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGRpaHlkcm9mb2xhdGUgcmVkdWN0YXNlLg==[Qq]
[q] ………… isvbactericidal and interfere with DNA synthesis. Inhibit topoisomerase II (DNA gyrase) and topoisomerase IV.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFF1aW5vbG9uZXMgKENpcHJvZmxveGFjaW4sIGVub3hhY2luLCBub3JmbG94YWNpbiwgb2Zsb3hhY2luLCBnZW1pZmxveGFjaW4sIGxldm9mbG94YWNpbiwgbW94aWZsb3hhY2luKS4=[Qq]
[q] ……… cause tendonitis or tendon rupture in people > 60 years old and in patients taking prednisone. Contraindicated in pregnant women, nursing mothers, and children < 18 years old due to possible damage to cartilage (inhibition of chondrogenesis).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFF1aW5vbG9uZXMgKENpcHJvZmxveGFjaW4sIGVub3hhY2luLCBub3JmbG94YWNpbiwgb2Zsb3hhY2luLCBnZW1pZmxveGFjaW4sIGxldm9mbG94YWNpbiwgbW94aWZsb3hhY2luKS4=
Cg==Cg==JiM4MjExOyBGbHVvcm9xdWlub2xvbmVzIGh1cnQgYXR0YWNobWVudHMgdG8geW91ciBib25lcy4=[Qq]
[q] Antibiotics that cause photosensitivity are ………..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]
Cg==MS4gVGV0cmFjeWNsaW5lcy4=
CjIuIFN1bGZvbmFtaWRlcy4=
CjMuIFF1aW5vbG9uZXMu[Qq]
[q] …….. is Bactericidal, antiprotozoal. Forms toxic free radical metabolites in the bacterial cell that damage DNA.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1ldHJvbmlkYXpvbGUu[Qq]
[q] ……… cause metallic taste and Disulfiram-like effect (severe flushing, tachycardia, hypotension).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1ldHJvbmlkYXpvbGUu[Qq]
[q] ………. is Salvage therapy for multidrug-resistant gram ⊝ bacteria (P aeruginosa, E coli, K pneumoniae). cause Nephrotoxicity, neurotoxicity (slurred speech, weakness, paresthesia), respiratory failure as side effects.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFBvbHlteXhpbnMu[Qq]
[q] The primary drugs in combination regimens for treatment of tuberculosis are …….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJpZmFtcGluLCBJc29uaWF6aWQsIFB5cmF6aW5hbWlkZSwgRXRoYW1idXRvbCAoUklQRSBmb3IgdHJlYXRtZW50KS4=[Qq]
[q] …….. inhibits DNA-dependent RNA polymerase, thereby preventing transcription. The subsequent lack of mRNA leads to a deficiency of those proteins necessary for mycobacterial survival.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJpZmFteWNpbnMgKFJpZmFtcGluLCByaWZhYnV0aW4pLg==[Qq]
[q] …….. has been used successfully for chemoprophylaxis for household members and close contacts of patients with invasive meningococcal disease and is the most likely chemoprophylactic agent to be administered in this subject.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJpZmFtcGluLg==[Qq]
[q] ……… cause orange discoloration of secretions (urine, breast milk and tears), and patients should be alerted to the fact that contact lenses will be permanently stained orange.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJpZmFtcGluLg==[Qq]
[q] Rifabutin favored over rifampin in patients with HIV infection due to ………?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGxlc3MgY3l0b2Nocm9tZSBQLTQ1MCBzdGltdWxhdGlvbi4gcmlmQU1QaW4gQU1QaWlmaWVzIGN5dG9jaHJvbWUgUC00NTAsIGJ1dCByaWZhYnV0aW4gZG9lcyBub3Qu[Qq]
[q] Mechanism of resistance to ……. is spontaneous genetic mutations in the bacterial DNA-dependent RNA polymerase.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFJpZmFtcGluLg==[Qq]
[q] …….. ↓ synthesis of mycolic acids. It is a Prodrug requiring conversion by bacterial catalase peroxidase. Bacterial catalase peroxidase (encoded by KatG gene) needed to convert INH to active metabolite.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IElzb25pYXppZC4=[Qq]
[q] INH-induced peripheral neuropathy is caused by ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHB5cmlkb3hpbmUgKHZpdGFtaW4gQjYpIGRlZmljaWVuY3kuIElOSCBiaW5kcyB0aGUgYWN0aXZlIGZvcm0gb2YgcHlyaWRveGluZSwgcmVzdWx0aW5nIGluIHJlbmFsIGV4Y3JldGlvbi4=[Qq]
[q] ……….. may cause drug induced-SLE in slow acetylators.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IElzb25pYXppZC4=[Qq]
[q] Mechanism of resistance to …….. is Mutations leading to underexpression of KatG.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IElzb25pYXppZC4=[Qq]
[q] ……. is a prodrug that is converted to the active compound. Works best at acidic pH (in host phagolysosomes). Can cause hyperuricemia as a side effect.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFB5cmF6aW5hbWlkZS4=[Qq]
[q] …….. is an antimycobacterial agent that inhibits carbohydrate polymerization by inhibiting arabinosyl transferase, thereby preventing peptidoglycan cell wall synthesis. Cause optic neuritis (red-green color blindness), This side effect clinically manifests as decreased visual acuity, central scotoma, or color-blindness and may be reversible with discontinuation of the drug.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFByb25vdW5jZSBldGhhbWJ1dG9sIOKAnGV5ZXRoYW1idXRvbOKAnSBmb3Igb3B0aWMgbmV1cml0aXMu[Qq]
[q] Patients with CD4+ counts <50 cells/µL should be administered prophylactic …… to prevent MAC infection.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGF6aXRocm9teWNpbi4=[Qq]
[q] ………. bind to ergosterol molecules, forming pores in the membrane and allowing leakage of ions (especially K) from the cells. This disruption of cell membrane integrity leads to cell lysis. It depend on the amount of ergosterol (unique to fungi) incorporated into fungal cell membranes for their efficacy.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRoZSBwb2x5ZW5lcyAoYW1waG90ZXJpY2luIEIgYW5kIG55c3RhdGluKS4=[Qq]
[q] ………….. explains the large number of amphotericin B adverse effects.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFtcGhvdGVyaWNpbiBCIGJpbmQgY2hvbGVzdGVyb2wgdG8gc29tZSBkZWdyZWU=[Qq]
[q] Why should you give amphotericin B by slow IV infusion?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFjdXRlIGluZnVzaW9uLXJlbGF0ZWQgcmVhY3Rpb25zLCBzdWNoIGFzIGZldmVyLCBjaGlsbHMsIHJpZ29ycywgYW5kIGh5cG90ZW5zaW9uLiBBY3V0ZSBpbmZ1c2lvbi1yZWxhdGVkIHJlYWN0aW9ucyBhcmUgY29tbW9uLCBhbmQgbW9zdCBmcmVxdWVudCBkdXJpbmcgaW5pdGlhbCBpbmZ1c2lvbnMgKG9mdGVuIGRpbWluaXNoIHdpdGggc3Vic2VxdWVudCBpbmZ1c2lvbnMpLiBQcmVtZWRpY2F0aW9uIHdpdGggYW50aXB5cmV0aWNzIGFuZCBhbnRpaGlzdGFtaW5lcyBjYW4gbGVzc2VuIHRoZSBzZXZlcml0eSBvZiB0aGVzZSBlZmZlY3RzLg==[Qq]
[q] Why should you monitor kidney functions and electrolytes of patients on Amphotericin B?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFtcGhvdGVyaWNpbiBCIGNhdXNlcyBhIGRvc2UtZGVwZW5kZW50IG5lcGhyb3RveGljaXR5IGJlY2F1c2UgaXQgZGVjcmVhc2VzIHRoZSBnbG9tZXJ1bGFyIGZpbHRyYXRpb24gcmF0ZS4=
Cg==Cg==QW1waG90ZXJpY2luIEIgY2FuIGFsc28gY2F1c2Ugc2lnbmlmaWNhbnQgZWxlY3Ryb2x5dGUgYWJub3JtYWxpdGllcyAoaHlwb21hZ25lc2VtaWEgYW5kIGh5cG9rYWxlbWlhKS4gU2V2ZXJlIGh5cG9rYWxlbWlhIGFuZCBoeXBvbWFnbmVzZW1pYSBhcmUgY29tbW9ubHkgc2VlbiBkdXJpbmcgdGhlcmFweSwgYW5kIG9mdGVuIHJlcXVpcmUgZGFpbHkgc3VwcGxlbWVudGF0aW9uLg==[Qq]
[q] Mechanism of resistance to ……… is decreasing the cell membrane ergosterol content.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFtcGhvdGVyaWNpbiBCLg==[Qq]
[q] ………….. are fungicidal and interfere with the synthesis of ergosterol by inhibiting 14-α-demethylase, a fungal P450 enzyme, which converts lanosterol to ergosterol.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEF6b2xlcyAoQ2xvdHJpbWF6b2xlLCBmbHVjb25hem9sZSwgaXRyYWNvbmF6b2xlLCBrZXRvY29uYXpvbGUsIG1pY29uYXpvbGUsIHZvcmljb25hem9sZSku[Qq]
[q] All azoles (increase or decrease) the serum concentrations of drugs metabolized by liver P450 enzymes?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEluY3JlYXNlLsKgVGhlIGF6b2xlcyBpbmhpYml0IHRoZSBhY3Rpdml0eSBvZiB0aGUgaHVtYW4gUDQ1MCBjeXRvY2hyb21lIG94aWRhc2Ugc3lzdGVtLiBUaGlzIHByb3BlcnR5IGxlYWRzIHRvIG11bHRpcGxlIGRydWcgaW50ZXJhY3Rpb25zLg==[Qq]
[q] ……….. are antifungals that ↓ Synthesis of steroids, including cortisol and testosterone ↓ libido, gynecomastia, menstrual irregularities.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGF6b2xlcyAoZXNwZWNpYWxseSB3aXRoIGtldG9jb25hem9sZSku[Qq]
[q] ……… inhibits fungal DNA and RNA biosynthesis by conversion to 5-fluorouracil by fungal cytosine deaminase which after triphosphorylation is incorporated into fungal RNA and inhibits its synthesis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEZsdWN5dG9zaW5lLg==[Qq]
[q] …….. inhibits synthesis of ergosterol of the fungal membrane by inhibiting the enzyme squalene epoxidase.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFRlcmJpbmFmaW5lLg==[Qq]
[q] …….. are a newer group of antifungal medications that inhibit synthesis of the polysaccharide glucan, an essential component of the fungal cell wall. Effective for treatment of Invasive aspergillosis, and Candidemia.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVjaGlub2NhbmRpbnMgKGNhc3BvZnVuZ2luIGFuZCBtaWNhZnVuZ2luKS4=[Qq]
[q] …….. interferes with microtubule function; disrupts mitosis. Deposits in keratin-containing tissues (nails). ↑ cytochrome P-450 and warfarin metabolism.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEdyaXNlb2Z1bHZpbi4=[Qq]
[q] ……….. Blocks detoxification of heme into hemozoin. Heme accumulates and is toxic to plasmodia. Cause Retinopathy; pruritus (especially in dark-skinned individuals) as side effects.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE51Y2xlb3NpZGUgYW5hbG9nIGRydWdzIHN1Y2ggYXMgJiM4MjMwOyYjODIzMDsmIzgyMzA7Li4gcmVxdWlyZSB2aXJhbCBwaG9zcGhvcnlsYXRpbmcgZW56eW1lcyAodmlyYWwgdGh5bWlkaW5lIGtpbmFzZSkgZm9yIGNvbnZlcnNpb24gaW50byB0aGVpciBtb25vcGhvc3BoYXRlIGZvcm0uIE9uY2UgdGhhdCBoYXMgdGFrZW4gcGxhY2UsIGNlbGx1bGFyIGtpbmFzZXMgY2FuIGZ1cnRoZXIgY29udmVydCB0aGUgZHJ1ZyBudWNsZW9zaWRlIG1vbm9waG9zcGhhdGUgaW50byBhIG51Y2xlb3NpZGUgdHJpcGhvc3BoYXRlIHRoYXQgaW50ZXJmZXJlcyB3aXRoIGhlcnBlc3ZpcnVzIHJlcGxpY2F0aW9uIChpbmhpYml0IHZpcmFsIEROQSBwb2x5bWVyYXNlIGJ5IGNoYWluIHRlcm1pbmF0aW9uKS4=[Qq]
[q] Acyclovir, valacyclovir, famciclovir, and ganciclovir.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]ICYjODIzMDsmIzgyMzA7JiM4MjMwOyYjODIzMDsgY2FuIGNhdXNlIE9ic3RydWN0aXZlIGNyeXN0YWxsaW5lIG5lcGhyb3BhdGh5IGFuZCBhY3V0ZSByZW5hbCBmYWlsdXJlIGlmIG5vdCBhZGVxdWF0ZWx5IGh5ZHJhdGVkLsKgSW4gbW9zdCBjYXNlcywgdGhpcyB0b3hpYyBjb21wbGljYXRpb24gaXMgdHJhbnNpZW50IGFuZCBjYW4gYmUgcHJldmVudGVkIChhcyB3ZWxsIGFzIHRyZWF0ZWQpIHdpdGggYWRlcXVhdGUgaHlkcmF0aW9uIGFuZCBkb3NhZ2UgYWRqdXN0bWVudCwgd2hpY2ggaW5jbHVkZXMgc2xvd2luZyB0aGUgcmF0ZSBvZiBpbnRyYXZlbm91cyBpbmZ1c2lvbi4=[Qq]
[q] Acyclovir.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1lY2hhbmlzbSBvZiByZXNpc3RhbmNlIHRvICYjODIzMDsmIzgyMzA7JiM4MjMwOyBpcyBjaGFuZ2VzIGluIEROQSBwb2x5bWVyYXNlIG9yIHRvIG11dGF0ZWQgdmlyYWwgdGh5bWlkaW5lIGtpbmFzZS4=[Qq]
[q] Acyclovir, valacyclovir, famciclovir, and ganciclovir.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFdoaWNoIG9mIHRoZSBmb2xsb3dpbmcgaXMgZWZmZWN0aXZlIGluIHRyZWF0bWVudCBvZiBDTVYgKEFjeWNsb3ZpciwgdmFsYWN5Y2xvdmlyLCBmYW1jaWNsb3ZpciwgYW5kIGdhbmNpY2xvdmlyKT8=[Qq]
[q] ………… binds to pyrophosphate-binding site of enzyme —> inhibits viral DNA and RNA polymerases. Does not require activation by viral kinase.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEdhbmNpY2xvdmlyLg==[Qq]
[q] …… is used for treatment of CMV retinitis in immunocompromised patients when ganciclovir fails. Cause nephrotoxcity electrolyte abnormalities (hypo- or hypercalcemia, hypo- or hyperphosphatemia, hypokalemia, hypomagnesemia) which can lead to seizures.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEZvc2Nhcm5ldC4=[Qq]
[q] ……… is a nucleotide analogue that directly inhibits viral DNA polymerase. Does not require phosphorylation by viral kinase. Used for treatment of CMV retinitis in immunocompromised patients when ganciclovir fails?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEZvc2Nhcm5ldC4=[Qq]
[q] ……….. inhibit neuraminidases of influenza A and B → ↓ release of progeny virus. Beginning therapy within 48 hours of symptom onset may shorten duration of illness.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFphbmFtaXZpciBhbmQgT3NlbHRhbWl2aXIu[Qq]
[q] Regimen of antiretroviral therapy consists of 3 drugs to prevent resistance including ………..and ……….?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IDIgTlJUSXMgYW5kIHByZWZlcmFibHkgYW4gaW50ZWdyYXNlIGluaGliaXRvci4=[Qq]
[q] ……… is antiretroviral drugs that cause Lipodystrophy leading to central obesity and peripheral wasting, Hyperglycemia, inhibition of P-450 and may cause interactions with other drugs.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFByb3RlYXNlIGluaGliaXRvcnMgKEF0YXphbmF2aXIsIERhcnVuYXZpciwgRm9zYW1wcmVuYXZpciwgSW5kaW5hdmlyLCBMb3BpbmF2aXIsIFJpdG9uYXZpciwgU2FxdWluYXZpcik=[Qq]
[q] ……… is a Protease inhibitor that cause nephrotoxicity and nephrolithiasis.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEluZGluYXZpci4=[Qq]
[q] …….. is antiretroviral drugs that Competitively inhibit nucleotide binding to reverse transcriptase and terminate the DNA chain (lack a 3′ OH group).
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE5SVElzIChBYmFjYXZpciwgRGlkYW5vc2luZSwgRW10cmljaXRhYmluZSwgTGFtaXZ1ZGluZSwgU3RhdnVkaW5lLCBUZW5vZm92aXIsIFppZG92dWRpbmUpLg==[Qq]
[q] ………. is a NRTIs used for general prophylaxis and during pregnancy to ↓ risk of fetal transmission and cause anemia as a side effect.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFppZG92dWRpbmUgKFpEViku[Qq]
[q] ………. is a NRTIs that cause nephrotoxicity as a side effect.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IHRlbm9mb3Zpci4=[Qq]
[q] ………. is a NRTIs that cause pancreatitis as a side effect.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGRpZGFub3NpbmUu[Qq]
[q] ………. is a NRTIs that is contraindicated if patient has HLA-B*5701 mutation due to ↑ risk of hypersensitivity.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEFiYWNhdmlyLg==[Qq]
[q] …….. is antiretroviral drugs that bind to reverse transcriptase at site different from NRTIs. Do not require phosphorylation to be active or compete with nucleotides.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE5OUlRJcyAoRGVsYXZpcmRpbmUsIEVmYXZpcmVueiwgTmV2aXJhcGluZSku[Qq]
[q] …….. is NNRTIs that cause Vivid dreams and CNS symptoms and contraindicated in pregnancy.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGVmYXZpcmVuei4=[Qq]
[q] …….. is antiretroviral drugs that Disrupts the ability of HIV to integrate its genome into the host cell’s chromosomes, thus preventing host cellular machinery from being used to synthesize HIV mRNA.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEludGVncmFzZSBpbmhpYml0b3JzIChSYWx0ZWdyYXZpciwgRWx2aXRlZ3JhdmlyLCBSYWx0ZWdyYXZpciku[Qq]
[q] …….. is antiretroviral drugs that selectively bind to the HIV envelope transmembrane glycoprotein gp41 prevent the conformational changes necessary for the viral membrane to fuse with the target cellular membrane.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEVuZnV2aXJ0aWRlLg==[Qq]
[q] …….. is antiretroviral drugs that Binds CCR-5 on surface of T cells/monocytes, inhibiting interaction with gp120.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IE1hcmF2aXJvYy4=[Qq]
[q] Neutropenia is a significant adverse effect of …….. and …….., and its incidence is increased with coadministration of zidovudine.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGdhbmNpY2xvdmlyIGFuZCBBbXBob3RlcmljaW4gQi4=[Qq]
[q] Treatment options for cytomegalovirus-induced retinitis include …….., …….. and ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGdhbmNpY2xvdmlyLCBmb3NjYXJuZXQsIGFuZCBjaWRvZm92aXIu[Qq]
[q] ………. are Glycoproteins normally synthesized by virus-infected cells, exhibiting a wide range of antiviral and antitumoral properties.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IEludGVyZmVyb25zLg==[Qq]
[q] Monophosphorylated form of ribavirin inhibits synthesis of guanine nucleotides by competitively inhibiting ……..?
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IGlub3NpbmUgbW9ub3Bob3NwaGF0ZSBkZWh5ZHJvZ2VuYXNlLg==
Cg==Jm5ic3A7
Cg==[Qq]
[q] ……… RNA-dependent RNA polymerase acting as a chain terminator. Used in combination for treatment of Hepatitis C virus.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IFNvZm9zYnV2aXIu[Qq]
[q] …….. inhibits viral phosphoprotein that plays a key role in RNA replication. Used in combination for treatment of Hepatitis C virus.
[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]
[f]IExlZGlwYXN2aXIu[Qq]
[x][restart]
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