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Systemic Disease > 10. Infections 2: Fungal, Protozoal, & Spirochetes > Flashcards

10. Infections 2: Fungal, Protozoal, & Spirochetes Flashcards

1
Q

Where does histoplasmosis typically come from?

A

Mississippi and Ohio river valleys

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2
Q

How does histoplasmosis grow in the body?

A

As a mold that converts to a yeast above 37 degrees

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3
Q

What are the major systemic signs/symptoms of histoplasmosis?

A

TB-like granulomatous infection

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4
Q

What are the ocular findings of histoplasmosis?

A

Histo-spots
PPA
CNVM
*No vitritis

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5
Q

What type of organism is histo?

A

Fungus

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6
Q

What does malaria infect?

A

Red blood cells

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7
Q

What causes the fever, chills and rigors associated with malaria?

A

Release of cytokines when RBCs rupture

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8
Q

Patients with what conditions are protected from malaria?

A

Hemoglobin S
Hemoglobin C
Thalassemia

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9
Q

What are the ocular signs of malaria?

A

Roth spots, CWS, mac edema

Conj pallor, hemes

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10
Q

Retinal hemes are prognostic signs for what type of malaria?

A

Cerebral malaria

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11
Q

What are the 4 differentials for Roth Spots?

A

Anemia
Bacterial endocarditis
Leukemia
Malaria

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12
Q

What type of organism of Toxoplasmosis?

A

Intracellular protozoan

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13
Q

How does toxo get around?

A

Oocysts are shed from the intestines of cats, brds, and other mammals

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14
Q

What 2 things are found in humans that can cause toxo?

A

Cysts

Trophozoites

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15
Q

What symptoms are seen in acquired toxo?

A

Mostly asymptomatic

May have lymphadenopathy

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16
Q

How is congenital toxo passed?

A

Trans-placental

17
Q

What are the common CNS signs of congenital toxo?

A

Cerebral calcification
Seizures
Encephalitis

18
Q

What are the ocular signs/symptoms of toxo?

A

Microphthalmia
Cataracts
Scleritis
Acute uveitis

19
Q

What are the common retinal findings in toxo?

A 
Bilateral macular scars in childhood
Chorio-retinitis
CME
RD
Vasculitis
Neo
Vitritis - headlights in fog
20
Q

Active IgM antibodies from toxo can persist for how long?

A

Up to 1 year

21
Q

What test/change is indicative of recent toxo infection?

A

Seroconversion from negative to positive IgG

22
Q

What tests are used to confirm toxoplasmosis infection?

A

Toxo DNA by PCR analysis of CSF

PTOX/PCR

23
Q

When is IgG not useful for diagnosing?

A

In infants under 6 months

24
Q

What types of drugs are used to Tx toxo?

A

Combos - pyrimetamine and sulfa
Clindamycin and sulfa
Trimethoprim and sulfa

25
Q

In immuno-compromised pts, stereoids should never be used without what?

A

Antimicrobials

26
Q

In primary syphilis, where does Chancre occur?

A

At the inoculation site

27
Q

What disseminates through the body in secondary syphilis?

A

T Palladium

28
Q

What produced the dermatologic, ocular, and constitutional manifestsions of secondary syphilis?

A

T Palladium

29
Q

What does tertiary syphilis cause?

A

Aortitis
Gummata
Uveitis, retinitis, optic neuritis
Neurosyphilis

30
Q

What are the common signs of congenital syphilis?

A 
Clutton's joints
Sabre shins
Snuffles
Saddle nose
Frontal bossing
Mulberry molars
Rhagades
Hutchinson's triad
31
Q

What is Hutchinson’s triad?

A

Mulberry molars
Deafness
Interstitial keratitis

32
Q

What are the ocular signs of syphilis?

A

Conj chncre
Interstitial keratitis
Salt and pepper fundus
Argyll-Robertson pupil

33
Q

What labs can be done for syphilis?

A

RPR, VDRL
Darkfield microscopy
Direct fluorescent antibody (DFA)
Biopsy

34
Q

When might RPR and VDRL be non-reactive, but syphilis is actually present?

A

Early in disease
Latency
HiV

35
Q

Why isn’t penicillin useful for tertiary syphilis?

A

Does not reach high levels in the eye or CNS

36
Q

What are the neurologic/cardiac signs of Lyme?

A

CN VI palsy

Bell’s palsy

37
Q

What ocular findings are seen in chronic Lyme?

A

Episcleritis
Keratitis
Granulomatous KPs
Pars planitis/vitritis

38
Q

What are the ocular signs/symptoms of rocky mountain spotted fever?

A

Conj suffusion

Bilateral periorbital edema

Systemic Disease (12 decks)

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