After gram negatives in first aid, fungi

Question 1

Spirochetes

Answer 1

Spiral shaped bacteria with axial filaments. BLT. Borrelia, Leptospira, and Treponema. Borrelia use Giemsa or Wright stain. Treponema use dark field microscopy.

Question 2

Leptospira interrogans

Answer 2

Water contaminated with animal urine. Leptospirosis: flu, jaundice, photophobia with conjunctivitis. Surfers in Hawaii. Can cause Weil Disease: jaundice and azotemia from liver and kidney dysfunction….fever, hemorrhage, and anemia.

Question 3

Lyme Disease

Answer 3

Cause = Borrelia burgdorferi, tick transmission by Ixodes (also vector Babesia). Reservoir is mouse b/c important for tick lifecycle. Tx = doxycycline, ceftriaxone.
FAKE and key Lyme pie: F - facial nerve palsy A - arthritis K - cardiac block E - erythema migrans (bulls eye)

Question 4

Syphilis

Answer 4

Spirochete treponema pallidum. Primary = Painless chancre. Screen with VDRL and confirm with FTA - ABS. 2 = Rash on palms and soles. Secondary = systematic.
tertiary = gummas, vasa vasorum destruction (aortitis), tabes dorsalis, Argyll Robertson pupil (will not contrict to light but will contrict accomodation).
Congenital: Saber shins, saddle nose CN VIII deafness, Hutchinson teeth, mulberry molars.
TX = penicillin G

Question 5

Garnerella vaginalis

Answer 5

Gram variable rod. Vaginosis - gray vaginal discharge with fishy smell. not painful. Clue cells - vaginal epithelial cells covered with bacteria. Tx = metronidazole

Question 6

Rickettsial disease tx

Answer 6

For all is doxycycline

Question 7

Rickettsial disease with rash

Answer 7

Rocky Mountain Spotted fever: Rickettsia rickettsia. Rash at wrists and ankles and then to trunk.
Typhus:
Endemic (fleas) - R typhi.
Epidemic (human body lice) - R. Prowazekii - rash starts centrally and spreads out.
Ricketsii on wRist. Typhus on Trunk.

Question 8

Rickettsia with no rash

Answer 8

Erlichiosis (tick) - monocytes with morula in cytoplasm.
Anaplasmosis (tick) - granulocytes with morula in cytoplasm. morula is bacteria in phagosome.
Q fever is Queer - no rash or vector. Not in the rickettsia genus. Coxiella burnetii - infection via inhaled spores from cattle placenta. Presents as pneumonia.

Question 9

Chalmydiae

Answer 9

Obligate intracellular that cause mucosal infections. Cannot make their own ATP. Elementary body = Enfectious b/c enters cell via Endocytosis. Reticulate body Replicates in cell. Chlamydia trachomatis - reactive arthritis, conjunctivitis, nongonococcal urethritis, and PID. C. pneumonia and C. psittaci cause atypical pneumonia. TX - azithromycin or doxycycline. C. psittaci - avian reservoir. LAB: Giemsa stain
SEROTYPES: ABC -Cause follicular conjunctivitis in Africa. African/Blindness/Chronic Infection. D-K: urethritis, PID…everything else. neonatal disease.
L1-L3: inguinal node swelling.

Question 10

Mycoplasma pneumoniae

Answer 10

Atypical pneumonia - nonproductive cough, interstitial pneumonia. High cold agglutinins (IgM) - can lyse RBCs.
Grow on Eatons agar. No cell wall..no gram stain. Tx - macrolide or fluoroquinolone (no penicillin b/c no cell wall).

Question 11

Histoplasma

Answer 11

Midwest. Causes pneumonia. Histo Hides in macrophages - intracellular. from bird or bat droppings.

Question 12

Blastomyces

Answer 12

Midwest. Broad based budding yeast. Inflammatory lung disease.

Question 13

Coccidiodes

Answer 13

SW US. Pneumonia and meningitis. Spherule filled with endospores.

Question 14

Paracoccidiodes

Answer 14

Budding yeast with captain wheel appearance. In Latin America.

Question 15

Tinea Versicolor

Answer 15

Caused by Malassezia furfur. Causes hypopigmented/hyperpigmented patches. In hot, humid weather. Tx - Topical miconazole, selenium sulfide. Spaghetti and meatball appearance on KOH prep.

Question 16

candida albicans

Answer 16

Dimorphic: pseudohyphae and budding yeast in cold. germ tubes in warm.

Question 17

Aspergillus fumigatus

Answer 17

Septate hyphae that branch at 45 degree angle. A = acute angle in aspergillus.

Question 18

Cryptococcus neoformans

Answer 18

heavy capsule yeast - stain with India Ink. Found in soil and pidgeon droppings. Causes meningitis in HIV pt.

Question 19

Mucor

Answer 19

Nonseptate hyphae that branch at wide angles. Disease in DKA pts. Cause black eschar on face.

Question 20

Pneumocystis jirovecii

Answer 20

causes interstitial pneumonia. disc shaped yeast on silver stain of lung tissue. Tx - TMP-SMX. Start prophylaxis when CD4 drops <200 in HIV pt.

Question 21

Sporothrix Schenckii

Answer 21

Cigar shaped budding yeast that lives on vegetation. Spores introduced into skin by trauma. Usually a thorn - eg rose. Causes local ulcer with nodules along ascending lymphatics. Tx: itraconazole or potassium iodide.