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Micro Exam 6 > Cumulative > Flashcards

Cumulative Flashcards

1
Q

Site of multiplication of measles

A

Resp. epithelium & Lymph nodes

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2
Q

Spread of measles from rep site via

A

Monocytes

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3
Q

Stages of Measles Infections

A

Prodome, Rash, Resolution

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4
Q

Characteristics of Prodrome of Mealses

A

1-12 days post inf.Fever3 c’sKoplik Spot’s

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5
Q

Characteristics of Rash of Measles

A

Extensive rash developing 3-4 days following start of prodrome. Ears to forehead to face to neck to chest/trunk to extremities

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6
Q

Characteristics of Resolution of Measles

A

Viremia ceases and inc. in AB titers. Rash disappears in same order appeared.

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7
Q

Causative agent of Measles

A

Paramyxovirus-ssRNA (own RNA pol)Enveloped-F protein (spread inf.)-H protein (hemagg. for attach)

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8
Q

Measles Complications (4)

A

PneumoniaCNS involv.Immunologic SuppressionDiarrhea

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9
Q

Measles comp. of Pneumonia

A

Most measles deaths aged/malnurished at risk

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10
Q

Measles comp. of CNS involv

A

Acute encephalitis (common)Subacute Schlerosing Panencephalitis-FATAL, rare, slow prog.

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11
Q

Measles comp. of Immunologic Suppression

A

Viral induced suppression leads to complicating secondary infections

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12
Q

3 C’s of Prodrome of Measles

A

CoughConjunctivitisCoryza

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13
Q

Transmission of Measles

A

resp dropletshumidity and virion survival inv. related

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14
Q

Communicability of Measles

A

Highly contag.prodrome - 4/5 days post initial rash eruptionshedding prolonged in vit. A. def & immunocomp.

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15
Q

Immunization from Measles infection

A

Life Long Immunity from nat. infection Vaccine requires boosters

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16
Q

Treatment of Measles

A

Symptomatic

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17
Q

What inc. severity of measles infection?

A

Vit. A def.(Supplementation can dec. mortality up to 50%)

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18
Q

Measles Vaccine Info-name, type, dosing, CI

A

MMR - live attenuated1st dose: 12-15mo (must be before start school)2nd dose: 4-6yo or >1mo after 1st**2-5% of pop NOT protected from only first dose*CI: preg, immunodef., egg sens.

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19
Q

Measles outbreaks are from?

A

Non -vaccinated air travelers

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20
Q

How is measles virus maintained?

A

Unbroken human transmission chain (human only virus and no “healthy” carriers)

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21
Q

Measles prevention in people unable to get vaccine?

A

Immuniglobin

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22
Q

Symptoms of Rubella

A

Maculopapular RashMild fever, malaise, coryza, conjuctivits, lymphadenopathy

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23
Q

Causative agent of Rubella

A

Togavirus+ssRNA

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24
Q

Route of transmission of Rubella

A

Resp. Droplets

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25
Q

Communicability of Rubella

A

5 days prior to rash and 5 days post rash-humans only resevoir

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26
Q

Population commonly infected with Rubella

A

Older children, teens, young adults(NOT CHILDREN, opposite of measles)

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27
Q

Diagnosis of Rubella

A

Serology (AB detection) & Clinical

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28
Q

TRX of Rubella

A

Symptomatic & Isolation for 7 days post rash

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29
Q

Prevention of Rubella

A

MMR Vaccine-CI: Pregnancy5-15% of children get fever, rash, lymphadenopathy 5-12 days post vaccine

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30
Q

Complications of Rubella & describe (1)

A

Congenital Rubella Syndrome-maternal inf to fetus-Risk to fetus (earlier in preg, more sev. risk)-CRS patients can transmit disease up to 20mo

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31
Q

Risk to fetus of CRS

A

Heart Defects (PDA, pul stenosis)Eye defectsCNS defectsHearing Loss

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32
Q

What is unusual about the VZV compared to all other herpesvirus’s?

A

Most primary infections have S&S

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33
Q

Causative agent of chickenpox

A

Varicella-Zoster Virus-herpesvirus-dsDNA-Rep in nucleus

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34
Q

S&S of chickenpox

A

Assymetrical vesicular rash following dermatomal patterPruritis lesions (often inf. with bactera)

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35
Q

Stages of chickenpox

A

2 waves of viremia1) Rep in regional lymph node & causes viremia 4-6days post infection2) Rep in liver/spleen & cause viremia 10-14 post infection & cause rash

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36
Q

Most common childhood exanthum in US

A

Chickenpox

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37
Q

Communicability of chickenpox

A

highly contagious via resp. droplets-1-2 days before rash and 4-5 days after

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38
Q

Prodrome seen in chickenpox?

A

Only in older children-fever, malaise, HA

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39
Q

TRX of chickenpox

A

Symptomatic-no aspirin (also none for 28 days post vaccine)VariZIG-immunoglobin or high risk up to 4 days post exposure

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40
Q

Chickenpox vaccine info

A

Varivax - live attenuated-12-18moadults/teens get 2 injectionsCI:preg

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41
Q

Complications of varivax

A

Shingles (risk lower than from natural inf)Mild post infectionBreakthrough Varicella-2 doses reduces risk

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42
Q

Complications of chickenpox

A

GAS b hemolytic infection of lesions

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43
Q

Population most commonly with shingles

A

Adults

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44
Q

Cause of Shingles

A

Reactivation of latent VZV, must have hx of chickenpox

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45
Q

S&S of shingles

A

PAINFUL Rash (pain may precede rash)Unilateral and dermatomal vesicular rash that does not cross midline

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46
Q

10% of pt with shingles have ______ involv.20% of pt with shingles have ______ involv.

A

-ophthalmic branch of CN5-ocular nerves

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47
Q

TRX of shingles

A

SymptomaticVZIG no use (as prevention or trx)

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48
Q

Zostavax Vaccine

A

preventative, live attenuated vaccine for shingles. Decreases pain and duration of infection. High viral load, not used for children, recommend >50yo. Length of efx not known.

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49
Q

Complication of Shingles

A

Post theraputic neuralgia-more common in elderly

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50
Q

Human Herpes Virus 6 causes

A

Exanthem Subitum

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51
Q

Describe clinical appearance of HHV-6

A

High fever for 2-3 days of child that is followed by maculo-papular rose colored rash on the trunk and neck

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52
Q

HHV-6 Epidemiology

A

Common childhood viral inf.-reactivated in immunosuppressed adults and shed in saliva

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53
Q

HHV-6 Description of Virus

A

B-herpes virusdsDNARep. in CD4+ cellsLatent in mono & lymphocytes

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54
Q

Should you isolate a child with HHV-6?

A

Not worth it

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55
Q

TRX/Prevention of HHV-6

A

None

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56
Q

Seasonality of chickenpox

A

Winter-Spring

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57
Q

Parvo Virus b19 Clinical Manifestations

A

Prodrome followed by “slapped cheek” maculopapular rashCT manifestations-arthritis, arthralgia (adults can have just these)

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58
Q

TRX for Parvo Virus B19

A

IG for anemicNSAIDs for inflamm

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59
Q

Parvo Virus B19 Epi

A

ChildrenWinter-Spring

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60
Q

Desc. of Agent Parvo Virus B19

A

ssDNAno latent inf.

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61
Q

Complications of Parvo Virus B19

A

Anemia-attacks RBC precusorsHydrops Fetalis

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62
Q

Dermatophyte

A

Fungi that invade keratin of skin, hair, nails(produce keritinase)

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63
Q

tinea barbae

A

Beard

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64
Q

tinea capitis

A

head

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65
Q

tinea corporis

A

torso

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66
Q

tinea cruris

A

groin

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67
Q

tinea manus

A

hand

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68
Q

tinea pedis

A

foot

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69
Q

tinea unguium

A

nail

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70
Q

Culture of dermatophytes (location of sample, agar, results)

A

Sample taken from under nail is best-Sabouraud Agar (1-4wks)-Dermatophyte Test Medium (used for early detection, does not give species, just confirms dermatophyte present)

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71
Q

Some _______ species of dermatophytes fluoresce?

A

Microsporum

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72
Q

Infective Stage of Dermatophytosis

A

Athroconidium (micro or macro)

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73
Q

Diagnostic Stage of Dermatophytosis

A

Athroconidium (micro or macro)

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74
Q

Transmission of dermatophytosis

A

Athrospore spread via person to person contact or fomites

75
Q

Zoophilic

A

Animal pathogen transmitted to people

76
Q

Athrophophilic

A

Human to human transmission of fungi

77
Q

Geophilic

A

Soil to human transmission of fungi

78
Q

Tinea capitis most common in ________?

A

Children

79
Q

Tinea pedis most common in ________?

A

Adults

80
Q

Tinea unguium most common in ________?

A

Males

81
Q

Dermatophytes most common in _______ regions of world?

A

Tropical & subtropical because of humidity

82
Q

Dermatophyte Lesion (Describe)

A

Lesion with inflammed edge & central clearingHair lossPruritius(Dissemination possible in HIV+)

83
Q

Risk Factors for Dermatophytosis

A

Immunocomp.Communal Baths (hot tubs)Athletics (wrestling, etc)Cushing Syndrome (inc. cortisol inh. immune response)

84
Q

Dermatophytid

A

Hypersensitivity rxn to fungal antigens at distal sight. Common in tinea pedisResult of over treatment

85
Q

Antifungals target?

A

Ergosterol in cell membrane

86
Q

Causative Agents of Tinea Barbae

A

Trichophyon rubrumTrichophyon mentagrophytesTrichophyon verrucosum

87
Q

Causative Agents of Tinea Capitis

A

Microsporum canisTrichophyton mentagrophytesTrichophyton tonsurans

88
Q

Most common tinea capitis agent in USA and trx

A

Trichophyton tonsuransGriseofulvin

89
Q

Causative Agents of Tinea Corporis

A

Microsporum canisTrichophyton rubrum (most important)Trichophyton mentagrophytes

90
Q

Causative Agents of Tinea Cruris

A

Epidermophyton floccosumTrichophyton rubrum (most important)Trichophyton mentagrophytes

91
Q

Causative Agents of Tinea Manus

A

Trichophyton rubrumTrichophyton mentagrophytes

92
Q

Causative Agents of Tinea Pedis

A

Epidermophyton floccosumTrichophyton rubrum (most common)Trichophyton mentagrophytes

93
Q

Most prevalent dermatophytosis

A

Tinea pedis - Trichophyton rubrum

94
Q

Causative Agents of Tinea Unguium

A

Epidermophyton floccosumTrichophyton rubrumTrichophyton mentagrophytes

95
Q

Subcutaneous Fungus Genera

A

FusariumSporothrixModurellaPseudoallescheria

96
Q

Sporothirx schenckii (Sporotrichosis) causes

A

Chronic granulomas & necrosisulcerative lesions

97
Q

Sporotrichosis DOC

A

Itraconazole or Amphotericin B

98
Q

Sporothrix infects and is associated with?

A

lymphatics

99
Q

Most common way to get infected with sporothrix?

A

stuck/punture wound while working in garden

100
Q

Sporothrix found where?

A

Environmental, soil

101
Q

Appearance of sporothrix conidia?

A

Daisies

102
Q

Ticks are _______ feeders & do not ________?

A

Ticks are SLOW feeders and do NOT TRANSMIT DISEASE QUICKLY

103
Q

Hypostome

A

Attachment structure of tick, ventral to mouth

104
Q

Scutum

A

Shield like structure that covers back in male, half of back in female

105
Q

Tick Morph & Stages

A

EggLarvae - 6 legsnymph, tick - 8 legs

106
Q

Ixodes Ticks (carry)

A

Lyme, babesiosis

107
Q

Dermacentor Ticks (carry)

A

Tularemia, RMSF, Colorado tick feverTick Paralysis

108
Q

Amblyomma americanum Ticks (carry)

A

Lone Star TickTularemia, lyme, RMSFTick Paralysis

109
Q

Rhipicephalus sanguineus Ticks (carry)

A

Ehrlichiosis, babesiosis in dogsRMSF, Mediterranean spotted fever

110
Q

Tick Paralysis due to….

A

Dermacentor or Amblyomma americanum tick feeding for days. Paralysis linked to component in female saliva. Can die from resp. paralysis

111
Q

Pyemotes dermatitis is _____ & causes _____?

A

Mitestraw & grain itch, provokes allergic response

112
Q

Demodiciosis (causative agent, description of condition)

A

Demodex folliculorum (mite)Pruitic acne like dermatitis

113
Q

Chigger Dermatitis (causative agent, description of condition, trx)

A

Eutrombicula (mite)-produces pruritis but does NOT burrow-humans are accidental host-TRX OTC anti-pruritics

114
Q

Scabies (causative agent, description of condition)

A

Sarcoptes scabiei (mite)-female mite burrows resulting in pruritcs eruptions-pururitic eruptions stop at folds (hands, wrist, beltline, breasts, genitalia, butt, perineum)

115
Q

Mite genera

A

Pyemotes (straw & grain itch)Demodex (demodiciosis)Eutrombiula (chigger dermatitis)Sarcoptes (scabies)

116
Q

Types of Scabies (Sarcoptes scabiei)

A

Canine: self limiting in peopleCrusted (norwegian) - most intense & linked to HIV/immunodefPediatric - similar to crusted

117
Q

TRX for Scabies

A

Ivermectin or Permethrin

118
Q

Causative agent of lice

A

Pediculus humanus (head & body)Phthirus (pubic) - crabs

119
Q

Causative agent of crabs

A

Pubic licePhthirus

120
Q

Pathophysiology of crabs (phthirus)

A

Eggs are cemented to pubic hair and adults bite (feed) in pubic area(Egg to egg cycle : 3wks)

121
Q

Identification stage of lice/crabs

A

Nits (egg cemented to hair) or seeing lice

122
Q

Pahtophysiology of lice (Pediculus)

A

Eggs are cemented to hair and adults bite (feed) Bloodsuckers are vector for typhus (head lice only)

123
Q

TRX of lice

A

permethrinpediculicides

124
Q

Cause of trichinellosis infection?

A

Eat raw/undercooked meat -esp. pork

125
Q

What is special about trichinella larvae and worms?

A

develop in same host

126
Q

Life Cycle of Trichinella

A

Ingest larvae & released into SIEnter mucosa & mature in 48 hrs to wormWorm lives 4-6wks & females release larvaeLarvae enter circulation & migrate to ACTIVE skeletal muscleLarvae in muscle viable for mo - yrs

127
Q

Clinical Manifestations of Intestinal Phase of Trichinellosis

A

N/V/D, abd painBegin 1-2days post infection & abate 2-5wks later

128
Q

Clinical Manifestations of Systemic Phase of Trichinellosis

A

Myalgia, facial swelling, eosinophilia, subungal splinter hemorrhages, constitutionalBegin within 2wks post inf & last >8wks

129
Q

Complication of heavy infection of Trichinellosis

A

Life threatening heart, CNS, lung, kidney damage

130
Q

Humans are what type of host in Larva Migrans?

A

Accidental!

131
Q

Presumed Diagnosis of Trichinellosis

A

Periorbital Edema, Eosinophila, Hx of eating raw/undercooked meat

132
Q

Larva migrans infection?

A

Accidental ingestion of egg or larvae, larvae migrate through tissues, but do not mature into adult worm. Immune response of host contributes to pathology

133
Q

Causative Agents of Visceral Larva Migrans

A

Toxocara canis (d0g)Toxocara cati (cat)

134
Q

Visceral Larva Migrans most commonly infects?

A

Children who play in soil contaminated with dog or cat feces

135
Q

S&S of VLM are result of?

A

Migrating larvae and host eosinophilic granulomatous response

136
Q

TRX of Trichinellosis

A

Albendazole or Melbendazole

137
Q

TRX of Larva Migrans

A

Albendazle or Melbendazole

138
Q

Causative agents of Cutaneous Larva Migrans

A

Ancylostoma braziliense Ancylostoma caninum

139
Q

S&S of CLM

A

Intially: pruritic red papules at penetration sites2/3days later: pruritic, elevated, serpiginous, red-brown lesionsUsually resolve in 2-8wks

140
Q

Normal Flora of Skin (3)

A

E. coli (-)Mycococcus luteus (+)Staphylococcus epidermis (+)

141
Q

Skin Diseases in Epidermis

A

FolliciiulitisImpetigoAcneSSSS-TSS

142
Q

Skin Diseases in Dermis

A

CarbunclesFurunclesEcthyma

143
Q

Skin Diseases in Sub Q Tissue

A

CarbunclesFurunclesCellulitisErysipelasNecrotizing Fasciitis

144
Q

Skin Diseases in Muscle

A

Myonecrosis

145
Q

Causative agent of acne vulgaris (gram, shape, O2 req.)

A

Propionibacterium acnes(+)pleomorphicNFAreotolerant

146
Q

Causative agent of folliculitis & type each causes

A

S. aureus (folliculitis barbae, Sty)P. aeruginosa (systemic - hot tub)

147
Q

Proteins/Virulence Factors of S. aureus (5)

A

HemolysinCoagulaseLeukocidinProtein AMSCRAMMs (fibronectin binding protein & clumping fact)

148
Q

Toxins Produced by S. aureus

A

Exfoliatin A & B-causes outer layer of skin to slough offPyrogenic (TSST-1)

149
Q

S. aureus Characters

A

(+)NF (axilla, nares, groin)catalase (+)B-hemolytic

150
Q

P. aeruginosa Characters

A

(-)opportunisticPyocyanin & pyoverdin

151
Q

Another term or furuncle

A

Boil

152
Q

Causative Agent of Furuncle

A

S. aureus

153
Q

Where to furuncles develop?

A

Where hair follicles are exposed to friction and perspiration

154
Q

Skin level(s) of furuncle?

A

Dermis & Sub Q (abscess)

155
Q

What is a carbuncle?

A

Aggregate of connected furuncles

156
Q

Causitive agent of carbuncle?

A

S. aureus

157
Q

Treatment of furuncles & carbuncles

A

warm compress, drain, AB

158
Q

Varients of pyoderma?

A

Impetigo (bullous and non-bullous)Ecthyma

159
Q

What is pyoderma?

A

Bacterial skin inflammation marked by pus filled lesions-dermis & epidermis

160
Q

Causative agents of non-bullous impetigo

A

S. aureus (most common)GAS (ex. S. pyogenes)

161
Q

Virulance Factors of GABHS (S. pyogenes)

A

Streptococcal Pyrogenic Exotoxins-superantigens that cause rashM protein-creates sequelae (rheumatic fever, glomerulonephritis)DNAaseHyaluronidaseStreptokinase (dissolbes blood clots)

162
Q

Clinical Manifestations of Nonbullous Impetigo

A

Intraepidermal lesionsErythematous macule to vesicle to rupture to yellow crust exudate

163
Q

Spread of nonbullous impetigo

A

Very infectious, spreads rapidly, bacteria in vesicle, trx to decrease spread

164
Q

Causative agent of bullous impetigo

A

S. aureus

165
Q

Clinical Manifestations of bullous Impetigo

A

Begins as vesicle, enlarge to form bullae clear/yellow fluid, become turbid, rupture and brown crust forms

166
Q

Population and area of body with nonbullous impetigo

A

2-6yoFace, arm, legs

167
Q

Population and area of body with bullous impetigo

A

2-6yoface, legs

168
Q

Caustive Agent of Ecthyma

A

GAS

169
Q

Clinical Manifestations of Ecthyma

A

Ulceraters c green/yellow crust, raised marginsDermis

170
Q

Is ecthyma contagious?

A

Rarely

171
Q

Population and area of body with Ecthyma

A

Children, DM, neglected elderlyLower extremities (most common)

172
Q

TRX of impetigo & ecthyma

A

Inc. hygieneDebrideTopical & oral AB

173
Q

Population with cellulits

A

middle age & older adults

174
Q

Population with erysipelas

A

young children & older adults

175
Q

Most common causitive agent of Cellulits

A

GABHS

176
Q

Causative agents of Cellulits

A

GABHS + (associated c skin lesions - ex: varicella)S. aureus + (does NOT spread as fast as others & assoc. c local abscess)Acinetobacter baumanii - (associated c trauma & invasive devices)Pasteurella multocida - (associated c dog/cat bite & purulent drainage)Aeromonas hydrophila - (associated c freshwater contamination of wound)Vibrio vulnificans - (associated c saltwater contamination of wound)

177
Q

Hallmark S&S of Cellulits

A

HEETHeat, erythema, edema, tenderness

178
Q

Layer of Skin Involved in Cellulits

A

DEEP dermis & Sub Q

179
Q

What should you avoid in cellulitis trx?

A

NSAIDs (mask indicators of worsening disease)

180
Q

Trx of Cellulits

A

Elevate, immobilize, keep skin moist, AB (oral)

181
Q

What is erysipelas?

A

Special form of cellulitis that is caused mainly by GAS and rarely by S. aureus.Found in UPPER dermis & superficial lymphatics(as compared to DEEP of cellulitis)

182
Q

S&S of Erysipelas

A

Raised lesions with clear lines of demarcation.Milian’s ear sign (distingguishing feature)Const. symptoms

183
Q

Anatomical regions of erysipelas

A

Lower extremities & butterfly rash common

184
Q

Trx of erysipelas

A

elevate, immobilize, keep skin moist, AB (parenteral)

Micro Exam 6 (9 decks)

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