HD NBME Prep - 2

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1. A 21-year-old HIV-positive male presents M. avium- 8. List whether the structure belongs to -pilus: both
with malaise, fever, and enlarging lymph intracellulare gram +, gram -, or both: -flagellum: both
nodes in his right cervical region. A -pilus -thin
microscopic section from one of the enlarged -flagellum peptidoglycan
lymph nodes that is stained with an acid-fast -thin peptidoglycan layer layer: gram -
stain reveals the presence of numerous ("too -thick peptidoglycan layer -thick
many to count") acid-fast bacilli (AFB). -cell wall peptidoglycan
Granulomas are not found. Blood cultures -periplasmic space layer: gram +
obtained for AFB culture are positive, as are -teichoic acid -cell wall: both
cultures from intestinal biopsy. Which of the -lipopolysaccharide -periplasmic space:
mycobacterial species is most likely the -outermembrane gram -
cause of this patient's acute illness? -teichoic acid:
gram +
2. A 58-year-old man developed tinnitus, Gentamycin
-
vertigo and signs of kidney failure after
lipopolysaccharide:
being treated for Escherichia coli septicemia
gram -
while hospitalized for colon cancer surgery.
-outermembrane:
What antibiotic was he most likely given?
gram -
3. An alcoholic/diabetic presents with lobar Klebsiella
9. A patient presents with folliculitis after hot tub folliculitis =
pneumonia and red currant jelly sputum.
returning from a beach vacation where Pseudomonas
What is a likely diagnosis?
he said he spent time in the hot tub.
4. A child presents with flu-like symptoms and a H. influenza What is a likely diagnosis?
cherry-red epiglottis. What is the likely infection
10. A patient presents with Mycobacterium
diagnosis?
hypopigmented or reddish skin leprae
5. From what organism does IgA protease IgA protease patches with definite loss of sensation,
come? What is its function? - secreted thickened peripheral nerves and acid-
by fast bacilli on skin smears or biopsy.
Streptococci, What is the likely diagnosis?
H. influenza,
11. A patient presents with watery Campylobacter
Neisseria
diarrhea and abdominal cramping. jejuni
"SHiN"
Upon examination of a stool specimen,
Cleaves IgA
you find an oxidase +, comma-shaped
to colonize
organism that grows in 42*C. What is
mucosa
the likely diagnosis?
6. From what organism does M Protein come? M Protein -
12. A patient presents with watery V. cholera
What is its function? Group A
diarrhea and abdominal cramping.
Strep
Upon examination of a stool specimen,
Prevents
you find an oxidase +, comma-shaped
phagocytosis
organism that grows in alkaline media.
7. From what organism does Protein A come? Protein A - What is the likely diagnosis?
What is its function? secreted by
13. A rash of pneumonia goes through a Mycoplasma
S. aureus
prison/military barracks. What is the pneumonia
binds Fc
most likley cause of the pneumonia?
region of Ig
to prevent 14. Two genus of bacteria are obligate Rickettsia,
opsonization intracellular organisms. What are they, Chlamydia
and and why? **they cannot make
phagocytosis their own ATP, so
they have to be
intracellular
15. What antigen is detected by
the ASO antibody, and what
disease is it used to diagnose?
16. What are 3 obligate
anaerobes? What makes them
obligate anaerobes?
17. What are 4 major obligate
aerobes?
18. What bacteria produces
CAMP factor, and what is the
effect on culture?
19. What bugs do not gram stain
well?
20. What gram-positive cocci
causes pneumonia, meningitis,
and sepsis in neonates?
21. What gram-positive cocci is
commonly associated with
UTI? What about UTI in
pregnant women?
22. What gram positive, weakly
acid-fast organism causes
pulmonary infection in
immunocompromised
patients?
23. What is "Eaton's agent"?
ASO antibody detects
Streptolysin O of S.
pyogenes
used to test for rheumatic
fever
Clostridium
Bacteriodes
Actinomyces
**They all lack the proper
enzymes (superoxide
dismutase, catalase) to deal
with reactive oxygen
species
"Nagging Pests Must
Breathe"
Nocardia
Pseudomonas aeruginosa
Mycobacterium tuberculosis
Bacillus anthracis
CAMP factor - produced by
Strep agalactiae
causes a wider zone of
hemolysis formed by S.
aureus on culture plate
"These Rascals May
Microscopically Lack Color"
Treponema
Rickettsia
Mycobacteria
Mycoplasma
Legionella pneumophila
Chlamydia
S. agalactiae
UTI - enterococcus (Group
D Strep)
UTI, pregnant women -
Streptococcus agalactiae
Nocardia
Eaton's agent =
Mycobacterium
pneumoniae
requires Eaton's agar for
culture
24. What is indicated by a Positive quellung - add
positive quellung reaction? specific anticapsular antisera
Examples? to culture, and if the bug in
question is encapsulated, it
will swell
Streptococcus
Klebsiella pneumonia
H. influenza
N. meningitidis
Salmonella
25. What organism causes S. aureus
acute bacterial
endocarditis?
26. What organism causes a C. perfringens
double zone of hemolysis
on blood agar?
27. What organism causes Viridans Strep (S. mutans)
dental caries?
28. What organism causes gas C. perfringens
gangrene?
29. What organism excretes a Clostridium tetani
toxin that blocks the
release of inhibitory
neurotransmitter GABA?
30. What organism fails to stain Legionella
well with gram stain, but
stains well with silver stain?
31. What organism is catalase S. viridans
negative, alpha-hemolytic "OVRPS"
and optochin resistant?
32. What organism is catalase S. pneumoniae
negative, alpha-hemolytic "OVRPS"
and optochin sensitive?
33. What organism is encoded Corynebacterium diphtheriae
by the beta-Prophage?
34. What organism produces a Pseudomonas aeruginosa
blue-green pigment?
35. What organism produces actinomyces israelii
yellow "sulfur" granules? "Isreal has yellow sand"
36. What organism releases a C. botulinum - causes flaccid
toxin that inhibists the paralysis
release of acetylcholine?
37. What organism requires a Legionella
charcoal yeast extract agar,
buffered with cysteine for
culture?
38. What organism requires a H. influenzae
media of chocolate agar V = NAD+
with factors V and X for X = hematin
culture? What are V and X?
39. What organism requires a Thayer-Martin medium for culture? What is in the Neisseria (including N. gonorrhea)
medium? Thayer-Martin = VPN (Vancomycin,
Polymixin, Nystatin)
40. What organisms cause subacute bacterial endocarditis? Viridans strep, Enterococcus faecalis
41. What stains with acid-fast? Mycobacteria (TB)
42. What three organisms stimulate adenylate cyclase? What are the mechanisms and V. cholera - stimulates Gs, causes rice-water
effects? stool
E. coli - stimulates Gs, causes watery
diarrhea
B. pertussis - inhibits Gi, causes whooping
cough
43. What two organisms fail to stain with gram stain, but stain well with Giemsa stain? Chlamydia, Borrelia
44. Which organism demonstrates a characteristic "tumbling motility" on examination of Listeria monocytogenes - tumbling motility
a sample? What are common symptoms? causes mild gastroenteritis in healthy
individuals
causes meningitis in immunocompromised
patients
causes amnionitis, sepsis, spontaneous
abortion in pregnant women
causes granulomatosis infantisceptica and
neonatal meningitis