5: bacterial Flashcards

1
Q

increased risk of impetigo in adults with

A

HIV, diabetes, dialysis

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2
Q

most common impetigo; cause and appearance

A

nonbullous most common
strep pyogenes + staph aureus
cornflakes glued to skin

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3
Q

bullous impetigo cause and age

A

more in newborns; caused by staph aureus

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4
Q

erysipela eponym

A

saint anthony’s fire

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5
Q

erysipela most common location

A

leg associated with athlete’s foot (tinea pedis)

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6
Q

facial erisypelas ddx

A

lupus, melasma, angioedema

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7
Q

erisypela skin texture

A

peau d’orange

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8
Q

scarlet fever tongue

A

white strawberry first 2 days

red strawberry days 4-5

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9
Q

scarlet fever skin rash description

A

subnurn with goose pimples (erection of hairs_’ also sandpaper rash

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10
Q

sanpaper rash

A

scarlet fever

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11
Q

orange peel skin infection

A

erysipelas

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12
Q

pastia’s lines

A

red streaks in skin folds 2/2 vessel fragility in scarlet fever

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13
Q

red streaks in scarlet fever

A

pastia’s lines

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14
Q

tonsillar concretions why

A

keratin, bacteria, foreign material

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15
Q

dystrophic calcification in tonsil

A

tonsillolith, calcified concretions

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16
Q

diphtheria caused by

A

C diphtheriae (Klebs-Loffer)

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17
Q

primary syphilis lesion

A

chancre

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18
Q

secondary syphilis lesions

A

skin rash, mucous patches, condyloma lata

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19
Q

condyloma lata syphilis stage

A

2

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20
Q

mucous patches syphilis stage

A

2

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21
Q

chancre syphilis stage

A

1

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22
Q

skin rash syphilis stage

A

2

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23
Q

mucous patch over oral commissure

A

syphilis stage 2, split papules

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24
Q

split papules syphilis stage

A

2; mucous patches on commissures

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25
Q

widespread secondary syphilis when and name

A

lues maligna, especially in HIV+

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26
Q

pupil does not react to light infection

A

Argyll-Robertson, tertiary syphilis

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27
Q

glossitis in tertiary syphilis

A

interstitial glossitis/lobulated tongue

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28
Q

glossitis syphilis stage

A

3

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29
Q

luetic glossitis

A

atrophy and loss tongue papillae

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30
Q

congenital syphilis triad

A

hutchinson’s teeth, ocular keratitis, eighth nerve deafness

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31
Q

initial response to tx in syphilitic pts

A

Jarisch Herxheiner – fever, malaise, headache, exacerbation of skin lesions

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32
Q

infection with gonorrhea during childbirth

A

gonococcal ophthalmia neonatorum

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33
Q

complication of gonorrhea in women

A

pelvic inflammatory disease

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34
Q

muultiple small foci of TB

A

miliary TB

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35
Q

TB vs pneumonia

A

TB low grade fever vs pneumonia high

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36
Q

skin involvement in TB

A

lupus vulgaris

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37
Q

lupus vulgaris

A

skin involvement in TB

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38
Q

wasting syndrome in TB

A

consumption

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39
Q

calcified cervical TB LN

A

scrofula

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40
Q

scrofula

A

calcified cervical TB LN

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41
Q

false negative PPD settings

A

HIV+, sarcoidosis, Hodgkins, measles

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42
Q

TB tx

A

isoniazid, rifampin, pyrazinamide

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43
Q

two forms of leprosy

A

tuberculoid (localized/paucibacillary) and lepromatous (diffuse/multibacillary/nerve involement, leonine fascies, collapse of nose bridge, oral lesions)

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44
Q

oral lesions which leprosy

A

diffuse/lepromatous

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45
Q

facies leprosa why

A

bone destruction

atrophy of anterior nasal spine, maxillary alveolar ridge, endonasal infalmmation

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46
Q

lepra cells

A

vauolated histiocytes, mainly multibacillary lepra

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47
Q

noma agents

A

fusobacterium necrophorum and Prevotella intermedia

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48
Q

noma causes/settings

A

measles, leukemia, AIDS

poor OH, poverty, malnitrition

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49
Q

actinomyces 2 species

A

israelii and viscosus

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50
Q

forms of actinomycosis

A

cervicofacial, abdominopelvic, pulmonary

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51
Q

sulfur granules agents

A

actinomycosis and botryomycosis (S aureus infection)

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52
Q

cat scracth disease agent

A

bartonella henselae

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53
Q

bartonella henselae causes

A

cat scratch disease and bacillary angiomatosis

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54
Q

cat scratch disease associated syndrome

A

oculoglandular syndrome of parinaud

conjunctival granuloma and periauricular lymphadenopathy

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55
Q

conjunctival granuloma and periauricular lymphadenopathy

A

oculoglandular syndrome of parinaud

cat scratch disease associated

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56
Q

oculoglandular syndrome of parinaud

A

conjunctival granuloma and periauricular lymphadenopathy

cat scratch disease associated

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57
Q

bacillary angiomatosis agent

A

bartonella henselae

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58
Q

scarlet fever why rash

A

bacterial toxins attack blood vessels

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59
Q

cause of scarlet fever

A

group A beta hemolytic streps

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60
Q

pastia’s lines

A

red streaks in skin folds in scarlet fever

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61
Q

tonsillitis most commonly 2/2

A

viral (70%)

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62
Q

cause of diphtheria

A

corynebacterium diphth

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63
Q

bull neck

A

edematous neck in diphth

64
Q

mucous patches of syphilis histo

A

exocitosis adn spongiosis

65
Q

widespread secondary syphilis

A

lues maligna

66
Q

gumma histo

A

granulomatous inflammation

67
Q

gumma most common sites

A

palate or tongue

68
Q

tongue in 3ry syphilis

A
interstitial glossitis (lobulated, lingula muscles contract after healing of gummata)
luetic glossitis -- diffuse atrophy and loss of tongue papillae
69
Q

congenital syphilis triad

A

hutchinsons teeth,
ocular keratiis (opacified cornea)
eighth nerve deafness

70
Q

mulberry molars other names

A

fournier’s or moon molars

71
Q

congenital syphilis 4 non-triad features

A

frontal bossing, short mx, high arched palate, saddle nose

72
Q

saber shin feature of infx

A

syphilis

anterior bowing of tibia 2/2 periostitis

73
Q

rhagades

A

perioral fissuring in syphilis

74
Q

unilateral enlargement of clavicle infection and name

A

higoumenakis sign in syphilis

75
Q

higoumenaki sign

A

syphilis

unilateral enlargement of clavicle

76
Q

perioral fissuring in suphilis

A

rhagades

77
Q

painless synovitis and enlargement of joints in syphilis

A

clutton’s joint

78
Q

clutton’s joint

A

painless synovitis and enlargement of joints in syphilis

79
Q

stains for syphilis

A

warthin starry or steiner (silver)

80
Q

serology for syphilis

A

VDRL, RPR, FTA-ABS (best)

81
Q

antibiotic adverse reaction in syphilis

A

Jarisch-Herxheiner reaction:
secondary release of endotoxin when abx kill large numbers of bacteria

fever, malaise, headache, exacerbation of skin lesions

82
Q

fever, malaise, headache, exacerbation of skin lesions in pt given penicillin for syphilis

A

Jarisch-Herxheiner reaction:

secondary release of endotoxin when abx kill large numbers of bacteria

83
Q

Jarisch-Herxheiner reaction

A

secondary release of endotoxin when abx kill large numbers of bacteria

fever, malaise, headache, exacerbation of skin lesions

84
Q

most common reportable bacterial infx in US

A

neisseria gonorrhear

85
Q

racial gonorrhea

A

19x more common in AA

86
Q

symptoms in M vs F gonorrhea

A

80% F asymptomatic

10% M asymptomatic

87
Q

site of infx in M vs F gonorrhea

A

M urethra

F cervix

88
Q

significant complication of gonorrhea in F

A

pelvic inflammatory disease

uterus and ovarian tubes

89
Q

disseminated gonorrhea

A

papules and pustules with hemorrhage in skin of extremities

90
Q

oral gonorrhea

A

NUG-like but no odor

aphthae in soft palate and oropharynx

91
Q

NUG-like but no odor

A

oral gonorrhea

92
Q

gonorrhea in infant during birth

A

goncoccal ophthalmia neonatorum

93
Q

oral TB; locations for primary and secondary

A

chronic painless ulcer (rarely also nodular, granular, or leukoplakic)

primary – gingiva, mucobuccal fold, exo site
seconday - tongue, palate, lips

94
Q

histo term for TB granuloma

A

tubercle

95
Q

TB stains

A

acid fast and ziehl nielssen

96
Q

what does PPD test indicate

A

exposure to TB

97
Q

false negative PPD possible in who

A

HIV+, sarcoid, Hodfkin, measles

98
Q

TB tx

A

isoniazid+rifampin +pyrazinamide +ethambutol

99
Q

vaccine against TB

A

BCG (bacille calmet-guerin)

100
Q

scrofula infected by what

A

m bovis –> enlargement of oropharyngeal and cervial LN, can become calcified

101
Q

leprosy types

A

tuberculoid - localized - usually paucibacillary

lepromatous - diffuse - usually multibacillary

102
Q

multibacillary leprosy face and mouth

A

leonine facies, collapse of nose bridge, yellow/red oral papules that ulcerate

103
Q

facies leprosa look and reason

A

triad: atrophy of anterior nasal spine, atrophy of mx alveolar ridge, endonasal inflammation
2/2 bone destruction

104
Q

leprosy teeth

A

pulp involvement –> vascular damage –> red discoloration of crown

105
Q

which form of leprosy has granulomas

A

only tuberculoid; few bacilli

106
Q

lepra cells

A

multibacillary lepra
vacuolated histiocytes
rich in bacilli

107
Q

special stain for lepra

A

acid fast, Fite method

108
Q

tx for lepra

A

rifampin

109
Q

NOMA causative

A

fusobacterium necrophorum and prevotella intermedia

110
Q

NOMA inciting factors

A

often preceded by measles
also herpes, varicella, scarlet fever, TB, gastroenteritis, bronchopneumonia

AIDS, cancer, poor OH, poverty, malnutrition etc

111
Q

actinomycosis organisms and staining

A

A israelii and A viscosus

G+, silver+

112
Q

colonies of actinomyces in tonsillar crypts

A

concretions

113
Q

actinomycosis locations

A

55% cervicofacial
25% abdomino pelvic
15% pulmonary
then other (skin, ileocecal, GU)

114
Q

sulfur granules what are and seen in

A

large yellow flecks = colonies of bacteria

actinomycosis 
and botryomycosis (S aureus)
115
Q

large yellow flecks which infx

A
actinomycosis 
and botryomycosis (S aureus)

bacterial colonies
aka sulfur granules

116
Q

botryomycosis histo

A

abundant necrosis with admixed basophilic concretions surrounded by eosinophilic band (Splendori-Hoeppli phenomenon: in vivo formation of eosinophilic material around microbes)

117
Q

splendori-hoeppli phenomenon

A

eosinophilic band around basophilic concretions

botryomycosis

118
Q

actino clinical (location and look)

A

wooden induration of angle of MD with abscess and sinus tract

also tongue, subMD gland, parotid
poss osteomyelitis, tonsillar hyperplasia

periapical; and in cysts

119
Q

special stains for actino

A

Grocott methenamine silver

Brown and Brenn

120
Q

cat scratch dz causative

A

bartonella henselae and quintana

121
Q

most common cause of chronic regional LAD in children

A

cat scratch dz

122
Q

cat scratch dz clinical - and oral

A

papule/pustule along scratch line
50% single LN involvement

if oral: mass in buccal mucosa

consider also:
oculoglandular syndrome of parinaud
conjunctival granuloma and preauricular LAD

123
Q

oculoglandular syndrome of parinaud

A

conjunctival granuloma and preauricular LAD in cat scratch dz

124
Q

conjunctival granuloma and preauricular LAD

A

oculoglandular syndrome of parinaud

cat scratch dz

125
Q

cat scratch dz histo and stains

A

granulomatous infalmmation with central stellate abscess

warthin starry or Brown Hopps

126
Q

bacillary angiomatosis cause and mech

A

bartonella henselae

subQT vascular proliferation

127
Q

bacillary angiomatosis clinical and histo ddx

A

clinical ddx from Kaposi

histo similar to histiocytoid hemangioma

128
Q

sinusitis most common cause and predisposing factors

A

blockage of ostiomeatal complex

presidposing: recent upper respiratory viral infx and allergic rhinitis

129
Q

bacteria in acute sinusitis

A

S pneum, H influ, Moraxella catarrhalis

130
Q

klebsiella infx of nasal cavity

A

rhinoscleroma

131
Q

rhinoscleroma

A

klebsiella infx of nasal cavity

132
Q

phases of rhinoscleroma

A

rhinitic, florid, fibrotic

133
Q

rhinoscleroma clinical

A

anesthesia of soft palate, uvula hypertrophy

hebra’s nose – destruction of nasal cartilage with formation of nodules

134
Q

destruction of nasal cartilage with formation of nodules

A

hebra’s nose in rhinoscleroma (klebsiella)

135
Q

hebra’s nose

A

destruction of nasal cartilage with formation of nodules in rhinoscleroma (klebsiella)

136
Q

special cells in rhinoscleroma; general histo and stains

A

Mikulicz – large m/ph with clear vacuolated/foamy c/pl

seen in association with plasma cells, lymphocytes, and fibrosis (late stage)

warthin starry (best), Giemsa, gram

137
Q

rhinoscleroma ddx

A

leprosy (need acid fast), TB, PCM, extranodla Rosai-Dorfman

138
Q

most common vector borne illness in US

A

Lyme dz - through deer tick – Borrelia burgdorgferi

139
Q

borrelia burgdorferi

A

lyme dz

140
Q

bartonella

A

cat scratch and bacillary angiomatosis

141
Q

lyme dz classic clinical

A

erythematous papular rash of extremities (erythema migrans)

can involve joints, heart, CNS

142
Q

group and infx of strep pyogenes

A

group A beta hemolytic strep

impetigo, erysipelas, scarlet fever

143
Q

calssic group a beta hemolytic strep

A

pyogenes

144
Q

corynebacterium morphology and toxin

A

gram + rod

exotoxin –> necrosis

145
Q

diphtheria clinical + organ damage

A

pseudomembrane on tonsils
LAD
bull neck

damages heart, kidney

146
Q

neisseria morphology and culture conditions

A

G- coffee bean diplococci
chocolate agar + CO2
aerobic

147
Q

mycobacterium leprae aka, morphology, oxygen

other names for disease

A

Mycobacterium leprae
( Hansen’s bacillus spirilly )
 Aerobic rod shaped

Leprosy ( Hansen disease)

148
Q

noma agents

A

Fusobacterium necrophorum

Prevotella Intermedia

149
Q

st anthony’s fire seen in x3

A

1- Erysipelas
2- Ergotism
3- Herpes zoster

150
Q

diseases with saddle nose

A
1-Syphilis
2-Leprosy
3-Wegeners
4- Polychondritis
5-Drug abusers (cocaine)
6- α-mannosidosis
151
Q

+ve lepromin test eponymous rxn

A

Mitsuda rxn -

= intradermal injection of armadillo-derived lepra bacilli

152
Q

risks with chronic cutaneous lepra lesions

A

SCC

153
Q

stellate abscess

A

cat scratch bartonella

154
Q

cat scratch stains

A

Brown Hoppe and Warthin Starry

155
Q

noninvasive mycetoma causative

A

aspergillus fumigatus – antroliths and chronic sinusitis