Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Tropical medicine - All clinical images copyright Gorgas course - : Instituto de Medicina Tropical Alexander von Humboldt > Derm > Flashcards

Derm Flashcards

1
Q

Key difference between tropical ulcer and Buruli ulcer? Who gets tropical ulcers? Usual bug?

A

Tropical are painful
Often - bacillus fusiformis

Poor and malnourished

[Buruli undermined border]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Cause of burili ulcer? What is it?

A

Mycobacterium ulcerans
slow-growing acid/alcohol fast bacilli

Usually following minor trauma and inoculation from stagnant water Eg rice farm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Buruli ulcer characteristic findings

A

Painless
Deeply undermined skin at edge
Often has satellite ulcers which communicate sub cut

Usually very invasive - osteomyelitis in 15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Buruli ulcer ix? rx?

A

PCR assay - gold standard
– Direct examination
– Culture
– Skin biopsy (histopathology)

Rifampicin + clary (oral) OR streptomycin (IV) 8 weeks

AND surgical removal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Buruli ulcer control

A

BCG may offer some protection
Long trousers
education + early detection (painless so often delay in seeking rx)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does myiasis mean? 3 main types? Which in Africa? South America?

A

Insect larvae invading sub-cut tissues or body cavities

Tumbu fly - Lies eggs on Ts - Africa
Bot fly - South America
Chiggers / jiggers - flea on feet you makes do jiggs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Tumbu fly other name? scientific name? Pathogenesis? rx? prevent?

A

Putzi fly - cordylobia anthropophaga
[Washing line cord]
Lies eggs on clothes on washing line
-> these hatche when warmed by body
-> causes a boil

rx is to suffocate using petroleum jelly and then remove larvae intact

Prevent by ironing clothes to kill eggs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Bot fly scientific name? Pathogenesis? rx?

A

Dermatobia hominis
[Makes a homis on your dermat]
Deposits eggs directly on skin -> boil lesion
Occlusion eg Jelly + surgical

[Not bad themselves but likely to get infected]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What causes cutaneous larva migrans? rx?

A

Hookworm - usually ancylostoma braziliense

Albendazole 400mg single dose
[or single ivermectin 12mg]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Compare rash from hookworm and from stronglyotides

A

Hookworm - cutaneous lava migrans - very slow moving 2-3mm per day.
-Very itchy and serpingous

Strongly- lava currens - faster moving and linear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Prevention cutaneous lava migrans

A

Footwear on beaches / parks
Ban dogs from beaches (from thier stool)
Dog de worming programmes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Scabies incubation for first infection

A

4-6weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Scabies rx best? cheapest? if severe crusting scabies in HIV?

A

All household treated and dose repeated after 1 week

Permethrin 5% 1st line
Benzyl benzoate 25% (not as good)

Ivermectin if really severe / in HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Name 2 species of louse? rx?

A

Body louse - Pediculus humanus
Pubic louse - Phthirus pubis
Head louse - pediculus capitis

Lotions with Malathion/permethrin / DDT
[can comb out head lice eggs]
Need to heat clothes after body louse to 70 degrees for at least 30 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is mycetoma (madura foot)? Key bugs

A

Chronic swelling with sinus formation discharging

Actinomycete bacteria
-Nocardia brasiliensis (south America)
-streptomyces somaliensis (Africa)

Fungus
-Madurella mycetomatis
[Less aggressive, fewer fistula and more slow growing]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Nocardia appearance? Whats interesting?
Rx?

A

Gram positive rods
form acid-fast beaded branching filaments (like fungi)

Co-trimox
[Bacteria acting like a fungi =antibiotic and anti fungal]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How do you get mycetoma? features?

A

usually from prick from a plant thorn
If on back -> often from carrying wood

Painless swelling
After several years break down to form discharging sinuses
With granules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Rx madurella mycetomatis? Actinomycotic bacteria?

A

Madurella mycetomatis- 1 year itraconazole / fluconazole
+surgery

Actinomycotic - co-trimox
+ streptomycin / amikacin / cef / linezolid / rifampin
[Second one based on drug sensitivities]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

violet warty / ulcerated lesions which are itchy. Chestnut brown fungi or branching hyphae on smears =? cause? rx?

A

Chromoblastomycosis
Fungi from wood - enter through skin trauma
[Chromo colour from wood]

Rx tricky - combination eg itra + terbinafine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

The treatment failure rate for leishmaniasis with SSG

A

25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Malnourished kid with rapidlyprogressive mouth/cheek ulcerating disease is?

A

Noma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is Splendore–Hoeppli phenomenon

A

Protinateous host response to foreign body
-Inflamm cells surrounding grain/cluster of bacteriaa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Fungal mycetoma is called

A

Eumycetoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which mycetoma has branching bacilli? rx

A

Nocardia (braziliensis)
3 weeks of co-trimox + amikacin
Then 22 weeks of co trimox + cycling other abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Which mycetoma can you rx with surgery

A

Early lesions Eumycetoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Lesions on kids face key Ddx in peru

A

Sporothrix schenckii
leishmaniasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Why often cutaneous TB on Forearm or hands

A

Direct inoculation from coughing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Which lesions can follow lymph path ( sporotrichoid lesions)

A

Sporotrichosis
Leishmaniasis
Atypical micobacteria
Nocardiosis
TB
Other endemic fungi - histo, crypto, blasto
Pyodermitis

SLANT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Asteroid bodies on biopsy of cutaneous ulcer most likely

A

Sporotrichosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

If no hyphae or filamentous bacteria in mycetoma what do you suspect

A

Botryomycosis - s aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

2 most common locations of Balamuthiasis

A

Face - often nose
Knee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Lesion on face especially with Painful ulceration in mouth Key Dx

A

Paracocci

If minimal oral involvement -> leish

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

lesion on face and nose with +++ necrosis

A

NK-T cell lymphoma (caused by EBV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Painful ulcerations in mouth and anus

A

Parracocci
Herpes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Molliuscum-like lesions with hepatosplenomegaly and weight loss ? When else do you commonly get molluscum like lesions

A

Paracocci

Disseminated Cryptococcus Eg HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Molliuscum-like lesions with hepatosplenomegaly and weight loss ? When else do you commonly get molluscum like lesions

A

Paracocci

Disseminated Cryptococcus Eg HIV
Mpox
Talaromyces…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Eczematous lesions of the axilla, neck and head

A

Infective dermatitis
From HTLV-1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Which myiasis in Africa vs South America

A

cordylobia anthropophaga in Africa
Dermatobis homis in South America

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Ulcer with amastigotes

A

Leishmaniasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Buruli ulcer sx? Seen on biopsy?

A
  • extensive, mostly painless very deep with undermined borders
  • Acid-fast bacilli on edge of ulcer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Cause of chronic desert sore ulcer? Sx?

A
  • Cutaneous diphtheria

Usually single, painful with adherent Slough
- Paralysis from toxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Hypopigmented raindrop patches on trunk with minor scaling ?

A

Pityriasis versicolor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Chronic arsenic poisoning dermal presentation

A
  • Slate gray colour of skin either small areas of normal skin
  • Hyperkeratosis of palms and soles

Peripheral neuropathy

Raindrop appearance (white spots on darkened skin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Name 2 causes of multiple painful genital ulcers

A

Herpes, chancroid (h ducreyi) , scabies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

3 causes of multiple painless genital ulcers and bugs

A
  • Syphilis t palladium
  • Lymphogranuloma venereum - chlamydia trachomatis
  • Granuloma inguinale - klebisella granulomatis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Anaesthetic lesions

A

Leprosy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Lesions on a childs face biopsy shows this

A

sporotrichosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q
A

Mycetoma foot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q
A

Grains from mycetoma foot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q
A

Grains from mycetoma foot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Differential diagnosis of verrucous plaque

A

Chromoblastomycosis
Tuberculosis Verrucosa Cutis
Leishmaniasis
Sporotrichosis
Fusarium

51
Q

verrucous nodules that are characteristically very slow-growing

A

Chromoblastomycosis

52
Q
A

Verrucous leishmaniasis

53
Q

Lesion of the central face?

A

Balamuthiasis
Balamuthia mandrillaris

54
Q

Edema of the nose and upper lip, ulcerations in the mouth with haemorrhagic spots

A

Paracoccidiodomycosis

55
Q

Central facial edema, mostly of the nasal pyramid and nasal cavity

A

Mucocutaneous leishmaniasis

56
Q

Ulceration of the nasal pyramid and involvement of nasal
mucosa
With PROMINENT NECROSIS

A

NK T cell lymphoma of the nose
[EBV]

57
Q

Swelling starts on forehead and works down
Rx?

A

Rhinoentomophtoromycosis

Zygomycetes infection eg Conidiobolus coronatus

Fluconazole/itraconazole

58
Q

What is this lesion in TB called

A

Scrofula

59
Q
A

Borderline leprosy

60
Q
A

Leprosy

61
Q

lives in Chicago
Comes to Lima with pulmonary disease and cold abscesses on the arms

A

North American Blastomycosis
Blastomyces dermatitides

62
Q

Large painful ulcerations in the mouth and the anus with a cough

A

Paracoccidiodomycosis

63
Q

systemic disease, hepatosplenomegaly, and moluscum like lesions

A

Juvenile or subacute form of Paracoccidiodomycosis

64
Q

Umbilicated, moluscum like lesion in HIV

A

Cryptococcus

65
Q

Painless ulcer what am i? describe?
Characteristics?
Cause?

A

Bururli - Ulcer with an undermined border (

massive necrosis and multiple bacilli
Mycobacterium ulcerans

66
Q

Buruli distribution? Found where?

A

West Africa mostly especially ivory coast
[few in Australia and some in South america]

Around rivers and lakes especially stagnant water

67
Q

M ulcerans pathogenesis - what must it have ?

A

Mycolactone toxin
-> causes destruction but also anaesthesia
-> Also immunosuppression

UNDERMINED borders

67
Q

M ulcerans pathogenesis - what must it have ?

A

Mycolactone toxin
-> causes destruction but also anaesthesia
-> Also immunosuppression

UNDERMINED borders

68
Q

Buruli always ulcer?

A

No may get nodules or plaques

69
Q

Buruli on histology

A

Extensive fat necrosis
clumps of acid-fast bacilli on Ziehl Nielsen stain

70
Q

Differentiate leish and buruli

A

Leish - raised borders, no undermining and minimal necrosis

Buruli - Undermined borders, extensive central necrosis

71
Q

Oral Rx Buruli? common issue?

A

Rifampicin + clary (oral)

Paradoxical reactions may happen in up to
20% of cases
[Therapy diminishes the immunosuppression]

72
Q

Buruli Size?
Amount of inflam infiltrate on histology?
How many mycobacteria ?
Other key features

A
  • A large ulcer with undermined borders
  • Extensive necrosis of fat
  • Inflammatory infiltrate minimal or absent
  • A-F stain with large amounts of bacilli ( only comparable to the amount seen in leprosy)
  • Severely destructive, no inflammation, no pain, undermined borders
73
Q

Why do kids get cutaneous TB chancre on their cheeks? What is almost also always there

A

Kiss from parents - lymphadenitis

Multibacilliary

74
Q

What is a Scrofuloderma

A

Fistulous draining from underlying structure , such
a lymph node ,bone or epididymis

75
Q

What are TB Gummas? Features?

A

Cold abscess as a result of hematogenous
spreading

-Necrosis predominates
-Granulomatous formation can be seen at the center
-Bacilli can be seen

76
Q

What am I? Features?

A

Lupus vulgaris TB
Paucibacilliary

Usual on face - but also hands and feet
Well formed
granulomas , no necrosis

77
Q

Tuberculosis verrucosa cutis differentiate from lupus vulgaris

A

The whole plaque is warty
Pathology is quite similar to lupus vulgaris other that facial
Bacilli not seen

78
Q

Tuberculids are?

A

Ulcerated nodules, posterior aspect of legs
Lobular panniculitis

[Like erythema nodosum but ulcerate]

79
Q

What type of TB am I?

A

Lichen scrofulosorum

80
Q

Cutaneous TB rX?

A

RIPE - same as pulmonary

81
Q

38M
Atrophy of the nasal mucosa and narrowing of the nasal cavity
Ulceration and infiltration of the hard palate mucosa
Biopsy demonstrates - this macrophage which has consumed bacteria =?
Caused by?

A

Rhinoscleroma
Klebsiella rhinoscleromatis
- rx tetracyclines
[Only found in people with genetic susceptibility]

3 phases
* Catarrhal phase
* Proliferative , granulomatous phase
* Sclerotic phase

Biopsy - Lymphocytes, plasma cells , histiocytes , PMNs and giant cells

82
Q

Rhinoscleroma rx?

A

Cipro

83
Q

2 cutaneous diseases caused by klebsiella?

A

Granuloma inguinale - klebsiella granulomatis

Rhinoscleroma - Klebsiella rhinoscleromatis

84
Q

Granuloma inguinale also called? Rx?

A

Donovanosis
Azithromycin

85
Q

Painful, rapidly growing , sloughing ulcer, usually on the leg
Mostly prevalent in tropical areas
Trauma always present , but can be trivial, from scratch to an insect bite =?
Usual cause?
Rx?

A

Tropical ulcer
Fusobacterium, commonly mixed with E. coli or Enterococcus sp.
Doxy + metronidazole

86
Q

child with dental abscess which goes on to cause this? Associated with? Cause? Rx?

A

Noma
Chronic malnutrition, poor dental hygine

Fusiform bacilli + staph/strep

Penicillin + metronidazole

87
Q

What It is the most benign form of endemic treponematosis, with clinical manifestations limited to the skin, including vitiligo like achromic lesions as well as hyperpigmented lesions? Found where?
What happens in late phase?

A

Pinta - Treponema carateum
South and central america

Achromic patches over body prominences after 2-5 years

88
Q

Travel to South Africa and Botswana for safari
Tick bite which turned into image
->Fever malaise muscle pain = ?
Rx?

If there was a Triad of fever, eschar and rash which species?

A

African Tick bite fever - Rickettsia africae
Doxycycline

A disseminated rash is more common in cases
produced by R. conorii

89
Q

Spontaneous abscess in large muscles of limbs / trunk with systemic symptoms
‘wooden’ texture =?
Usual cause?
Rx?

A

Tropical pyomyositis
Staph
IV Abx + drainage

90
Q

rice farmer; works barefoo
10 year history of illness
tumor + fistula + grain discharge (black)
minimal pain initiall
no response to antibiotics
Dx?

A

Black grains = Madurella mycetomatis

91
Q

Mycetoma Ix?

A

Visualise grains
Fine needle aspirate
US/ imaging
PAS / KOH staining
Molecular methods

Grain

92
Q

Which cause of mycetoma may produce red grains ?

A

Actinomadura

93
Q

Eumycetoma vs Actinomycetoma
World distrobution
Agressiveness
Fistula numbers
Sinus appearance
lymphatic spread
Size of grains
Medical vs surgical rx

A
94
Q

2 most common causes of botryomycosis

A

Staphylococcus aureus (40%)
Pseudomonas aeruginosa (20%)

95
Q

Agricultural worker with chronic (years) verrucous or vegetant (cauliflower) lesion =? Cause?

A

CHROMOBLASTOMYCOSIS
-trauma with wood or vegetation

96
Q

Chonic lesion with black dots - on histology

A

Chromoblastomycosis

97
Q

Chromoblastomycosis Rx

A

Cryotherapy / thermotherapy best
-Deep excision in early lesions
[Itraconazole + terbinafine]

fonsecaea pedrosoi

98
Q

What am I ? Most common bug

A

Chromoblastomycosis

fonsecae pedrosoi

fon-sec-aea
[fon proSEC ae with Pedro]

99
Q

Farmers / fishermen with a chronic keloid like lesion on ear / leg.
No black dots visulalied

A

Lobomycosis
Lacazia loboi

100
Q

Chronic lesion
Histology round oval structures; 6 12um
in chains of 2 10 cells, connected by short tubular projections

A

Lacazia loboi (Lobomycosis)

101
Q

Which vaccine should you check with myiasis

A

Tetanus

102
Q

Inflammatory nodule with central crater on Soles/between toes, around toenails most likely? rx?

A

Tunga penetrans
[Itching helps to release eggs]

Extracted with a needle or scissors

▪ Prevention: Wear shoes, flea control

103
Q
A

Tunga penetrans

104
Q
A

Tunga penetrans

105
Q

Name 2 causes of myiasis

A

Dermatobia hominis
Cordylobia anthropophaga
Cochliomyia hominivorax

106
Q

Which fly classicly lies eggs in open wounds

A

Cochlyomyia hominivorax

107
Q

Wound had this removed =?

A

Dermatobia hominis

108
Q

“latigazo” is?

A

vesicular dermatitis caused by Blister Beetle

Paederus species
P. irritans , P. fuscipes, P. australis, P. melampus, P. brasilensis, P.colombius , and P. peregrinus

109
Q

A lesion with a patent hole

A

Dermatobia hominis

110
Q

For paederin to be produced what bacteria are required by blister beetles

A

Pseudomonas species
Only adult females produce paederin

111
Q
A

Blister beetle Eg Paederus irritans

112
Q

What are bed bugs actually called

A

Cimex lectularius

113
Q

Flea bites are typically ?

A

In lines eg line of 3
especially bed bugs

114
Q

Scabies real name

A

Sarcoptes scabiei

115
Q
A

Sarcoptes scabiei burrows

116
Q
A

Sarcoptes scabiei burrows

117
Q
A

Sarcoptes scabiei burrows

118
Q

What causes nodular scabies

A

Hypersensitivity reaction of the host by persisting mite antigens

119
Q
A

Crusted scabies
Ivermectin

120
Q
A

crusted scabies
Ivermectin

121
Q

How do you confirm diagnosis of superficial mycoses

A

KOH stain

122
Q
A

Tinea capitis
Single round patch of alopecia with scaling

123
Q

Tinea capitis caused by? Rx?

A

microsporum canis
-Griseofulvin

Trichophyton tonsurans
-Terbinafine

124
Q
A

Pityriasis versicolor
-Malassezia ssp
M furfur. M globosa and M sympodialis

125
Q

Pigmented lesions on palms/soles

A

Tinea nigra
(Hortaea werneckii)

Tropical medicine - All clinical images copyright Gorgas course - : Instituto de Medicina Tropical Alexander von Humboldt (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions