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Kaplan Qbank USMLE



Author7 Posts
  #1

1. how are the toxin mechanisms for scarlet fever and scalded skin syndrome different?

2. what immune cell plays the key role in rick. rick. arthropathy?

3. what are two microbes with fleas as the vector?

4. what organism is positive for nalidixic acid?

5. what is the microscopic appearance of coryne dip "granules"?

6. what are the two main diagnostic means for chlamydia? for mycoplasma?

  #2

for 3) yersina and ric. typhi
for 5) metachromatic granules
for 6) for chlamyda...flouroscent antibody test and spl. cultures like tisue cultures
for mycoplasma...fried egg colonies on eaton's media, pcr is also used

  #3

1.exfoliatin
2.No idea.....i suppose lymphocytes
4.No idea....positive in which sense....if its sensitivity then E.coli
5.club shapped at end of the bacilli dark staining(voluntin granumes)

  #4

Campylobacter jejuni and coli are both sensitive to nalidixic acid. I remember that cephalothin and nalidixic acid could be used to aid in the ID of this organism. E. coli can be ID easily by an MCI TSI (malonate, citrate, indole).

  #5

1. superantigen (strep) vs. desmoglein toxin (exfoliatin) (staph)
2. TH1
3. yersinia pestis, rick typhi
4. c jejuni (didn't know about coli! i guess cause it's a quinolone lots of gram negs should be - don't know why they specifically mention cj a lot)
5. blue cells, red granules
6. chlamyd - elisa, pcr. mycoplasma - cold agglutinins, complement fixation

hey sasaki - what is "tsi"?

  #6

I have never used that methodology for ID of E. coli. Most laboratories use automated identification systems nowadays, and don't use conventional media. Vitek or Microscan are the systems most micro labs use now.

Rapid ID of EC can be made with a spot indole, assuming the colony is lactose positive, purple and flat on MacConkey agar (EMB agar is not used much any more). The indole must be performed off of Blood agar. Then a citrate slant can be set up and incubated overnight. EC is indole positive and citrate negative (IF it is a lactose fermenter. A nonlactose fermenter needs more reactions before you can call it EC - and there are some NLF EC's). Another rapid test that can be used is PGUA - a manufactured medium where the organism is inoculated into a tube with a bit of the PGUA agar in the bottom. After one hour, the medium will turn yellow if the bug is EC. Kovac's reagent is added for the indole reaction. Again, this test is only used on LF purple flat colonies.

Most places that use Vitek just set up a GNI+ card that has the various sugars and decarboxylases encased in the card. The cards are automatically read by the machine and the ID comes out within 3-5 hours.

The real world of micro is different than the world of micro that is studied for tests.

___________________
Clinical Microbiology since 1974

  #7

TSI is triple sugar iron agar. I used to use this medium back in the 70's to screen colonies on stool cultures. This is a medium that is not used much any more either. I've seen them used for stool screening of non-lactose fermenters more than routine identification of gram negatives in urines and other cultures.

TSI, however, is the definitive medium used to ID Erysipelothrix rhusopathiae (in case you're interested). H2S production for this organism must be on this medium.

___________________
Clinical Microbiology since 1974







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