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Neville and Damm > Ch5 Bacteria (Gonorrhoeae thru Leprosy) > Flashcards

Ch5 Bacteria (Gonorrhoeae thru Leprosy) Flashcards

1
Q

What is the most common reportable bacterial infection in the United States?

A

Neisseria Gonorrhoeae

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2
Q

Gonorrhea: sexual contact (genital areas) Indirect infection is rare (because of _____ and cannot
penetrate intact stratified squamous epithelium). incubation = ________. Affected areas often demonstrate significant ______ discharge, but 10% men and 80% women are ASYMPTOMATIC

A

drying…2 to 5 days…purulent

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3
Q

75% of patients with disseminated gonorrhea = characteristic skin rash develops…what do they look like? Here are they found?

A

Papules and pustules that often exhibit a hemorrhagic component and occur primarily on the extremities

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4
Q

Oral cavity gonorrhea can mimic ______, but what is ONE KEY difference?

A

NUG…LACK OF FETOR ORIS (bad smell)

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5
Q

What is the term for when gonorrhea is spread to the eye during birth of a child?

A

Gonococcal opthalmia neonatorum

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6
Q

What is the gram for neisseria gonorrhoeae? Whats the morphology?

A

gram negative diplococcus

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7
Q

What is the most common coinfection with gonorrhea?

A

chlamydia trachomatis

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8
Q

What is the first line treatment for gonorrhea?

A

IM CEF-TRI-AXONE + azithromycin or doxycycline

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9
Q

What is the estimate for amount of the world population infected with TB?

A

ONE FUCKING THIRD :-O (2 buh-buh-billion)

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10
Q

What are two other mycobacterium besides TB that cause infection?

A

mycobacterium bovis and mycobacterium avium-intracellulare

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11
Q

Besides HIV-infected individuals, how do MOST other cases of NON-TB mycobacterial infections present?

A

localized chronic cervical LAD in otherwise healthy children

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12
Q

What flavor of mycobacterium is most common as an opportunisitic infection in HIV+ pts?

A

Mycobacterium avium-intracellulare

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13
Q

Primary TB is in previously UNEXPOSED pts and ALMOST ALWAYS involves what organ?

A

lungs

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14
Q

What % of patients with TB progress from infection to ACTIVE DISEASE?

A

ONLY 5-10% (usually in immunocompromised)

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15
Q

What is another name for SECONDARY TB? (reactivation of the bug)

A

Miliary TB (resembles millet seeds)

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16
Q

Primary TB is usually ASYMPTOMATIC, but what two symptoms are most likely to occur if symptomatic?

A

fever and pleural effusions

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17
Q

Classically the lesions of secondary TB are located in WHAT REGION of the lungs?

A

APEX

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18
Q

What is the term for TB involvement of the skin?

A

Lupus Vulgaris

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19
Q

What are the three most common head & neck sites for extrapulmonary TB?

A

Cervical lymph nodes, larynx, and middle ear

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20
Q

What are the most common presentations of oral TB? (rare)

A

chronic ulcers or swellings

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21
Q

Because TB can have ulcerations in the mouth and palpable lymph nodes, what is also on the differential?

A

SCC

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22
Q

What is the reported prevalence of oral TB lesions? What are the 2 proposed methods of how pulmonary TB would move to the oral cavity?

A

0.5 - 5% of TB cases have oral manifestations….1) hematogenous spread vs 2) exposure to infected sputum

23
Q

Primary oral TB WITHOUT pulmonary involvement is RARE…what AGE group is more likely to have this?

A

children / adolescents

24
Q

What is the name for a (nonTB) mycobacterial infection obtained from drinking contaminated milk? What are the clinical features? What is a radiographic feature?

A

SCROFULA…enlargment of OROPHARYNGEAL lymphoid tissues and CERVICAL lymph nodes…radio: calcification of the lymph nodes

25
Q

What type of giant cell is seen in a TB granuloma?

A

Langhans (nuclei around the rim)

26
Q

What is the term for a TB granuloma (besides caseating/necrotizing)?

A

tubercle

27
Q

What % of special stains for TB will actually be positive? What is the newer fluorescence microscopy technique called?

A

27-60%….Auramine-rhodamine stains

28
Q

What does PPD stand for in the PPD TB skin test?

A

purified protein derivative

29
Q

Culturing of TB from a patient is recommended for diagnosis. How long does this take?

A

4 to 6 weeks may be required to identify the organism in culture

30
Q

What are the 6 TB meds?

A

PRIEST: pyrazinamide, rifampin, isonazid, ethambutol (not listed in Neville: Streptomycin, T?)

31
Q

What is the name of the vaccine used for positive PPD tests? (given in 85% of the world, but not in US due to controversy of its effectivness)

A

BCG vaccine (Bacilus Clamette-Guerin)

32
Q

What is the bug responsible for LEPROSY?

A

Mycobacterium LEPRAE

33
Q

Where is leprosy thought to first enter the body?

A

nasal or oropharyngeal mucosa

34
Q

Why does leprosy choose to live in the skin, nasal cavity, and the palate?

A

they need a COOL environment

35
Q

In patients with a high immune reaction to leprosy, what is the term?

A

tuberculoid leprosy

36
Q

Which form of leprosy?? Typically, the organisms are not found in skin biopsy specimens, skin test results to heat-killed organisms (LEPROMIN) are positive, and the disease usually is localized.

A

Tuberculoid leprosy

37
Q

In patients with a LOW immune response to leprosy, what is the term?

A

Lepromatous leprosy

38
Q

Which form of leprosy?? These patients exhibit numerous organisms in the tissue, do not respond to lepromin, and have diffuse disease..

A

Lepromatous leprosy

39
Q

What are the 5 categories of leprosy infection?

A 
Tuberculoid leprosy
Lepromatous leprosy
borderline-tuberculoid
borderline-borderline
borderline-lepromatous
40
Q

Woah, what are the incubation periods for tuberculoid and lepromatous leprosy?

A

2-5 years for tuberculoid, 8-12 years for lepromatous

41
Q

_______ leprosy exhibits a small number of well-circumscribed, hypopigmented skin lesions. Nerve involvement usually results in anesthesia of the affected skin, often accompanied by a loss of sweating.

A

tuberculoid (paucibacillary)

42
Q

_______ leprosy begins slowly with numerous, illdefined, hypopigmented macules or papules on the skin that, with time, become thickened

A

Lepromatous (multibacillary)

43
Q

Lepromatous leprosy commonly involves the face and produce enlargements and distort the face, called _______

A

leonine facies

44
Q

COLLAPSE OF THE BRIDGE OF THE NOSE IS PATHOGNOMONIC for ?

A

lepromatous leprosy

45
Q

Leprosy can cause MACROCHEILIA which can be confused clinically and microscopically with ?

A

cheilitis granulomatosa

46
Q

What are the TRIAD of lesions in FACIES LEPROSA?

A

1.atrophy of the anterior nasal spine 2. atrophy of the anterior maxillary alveolar ridge 3. endonasal inflammatory changes

47
Q

What color can the crowns of infected leprosy teeth be in children?

A

red

48
Q

What is one of the most treatable causes of neuropathy in the world?

A

neuropathy caused by leprosy

49
Q

Lepromatous leprosy demonstrates no well-formed granulomas; the typical finding is sheets of lymphocytes intermixed with vacuolated histiocytes known as ______ cells

A

LEPRA

50
Q

Which form of leprosy will show an abundance of organisms on histology? Which will show little or none?

A

Lepromotous = LOTS, tuberculoid = little

51
Q

Can you culture M. Leprae in culture?

A

Nope. ID’d by molecular techniques tho

52
Q

What three abx are given for multibacilliary (lepromatous) leprosy?

A

(RCD) Rifampicin, Clofazimine, Dapsone

53
Q

What two abx are given for paucibacilliary (tuberculoid) leprosy?

A

Rifampicin, dapsone

54
Q

What are the three animals associated with being hosts for mycobacterium leprae?

A

armadillos, chimpanzee, mangabey monkey

Neville and Damm (72 decks)

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