derma- mycobacterial infection Flashcards
0
Q
Endogenous cutaneous tb
A
LV lupus vulgaris SD scrofula derma MTA metastatic tb abscess AMT acute miliary TB OT orificial tb
1
Q
exogenous cutaneous tb
A
PIT primary inoculation tb
TVC tb verrucosa cutis
2
Q
Cutaneous TB common in infant
A
PIT
3
Q
Cutaneous TB via opercutaneous inoculatin, occurs at inoculated site of nonimmune host
A
PIT
4
Q
Cutaneous TB common in male
A
TVC
5
Q
Cutaneous TB common in female
A
LV
6
Q
Cutaneous TB via Percutaneous inoculation, occurs in inoculated site in individual with prior tb infection
A
TVC
7
Q
Cutaneous TB common in 3rd world country and tropics
A
TVC
8
Q
Cutaneous TB common in all ages
A
LV
9
Q
Cutaneous TB common in adolescent and elderly
A
SD
10
Q
Cutaneous TB common in infant and adult who are immunocompromised
A
AMTRAK
11
Q
cutaneous TB is also Common in farmer and butchers from what species of mycobacterium
A
M. Bovis
12
Q
Papule and painless ulcer (tuberculous chancre) in 2-4wks
A
PIT
13
Q
Regional LA in 3-8wks
A
PIT
14
Q
SOP of PIT
A
Exposed skin of minor injuries
15
Q
Papule with violaceous halo (hyperkeratosis, warty, firm plaque, irregular borders)
No LA
A
TVC
16
Q
SOP of TVC
A
Dorsolat hands and fingers
Children- Lowe ext and knees
17
Q
Soft flat papule, ill defined with smooth surface and slightly scaly
A
LV
18
Q
Apple jelly color on diascopy
A
LV
19
Q
SOP of LV
A
Head and neck
20
Q
Hyperkeratotic form of LV = soft tumorous nodule
A
Ulcerative form of LV = punched out, serpinginous
21
Q
Firm, subQ nodule, irrev deep seated which liquifies and perforates
A
SD
22
Q
SOP of SD
A
Parotid, submandibular, supraclavicular
Lat neck
23
Q
Contiguous spread from affected LN
A
SD
24
Most common opportunistic infection in hiv pts in developing countries
TB
25
Route of cutaneous TB
Exogenous
Endogenous
By autoinoculation
26
Oral lesions in tb Develops when..
Ingestion of bovine bacilli in nonpasteurized milk
27
Tuberculous gumma
MTA
28
SubQ abscess, no tender, cold fluctuant to fistula and ulcer.
MTA
29
SOP of MTA
Sites of previous trauma
30
Small yellowih nodule with painful irreg ulcer with undermined borders
OT
31
Results form autoinoculation from progressive TB of internal organs
OT
32
SOP of OT
Oral, pharyngeal - pulmonary tb
Vulva - GU TB
Anal - intestinal TB
33
Convert form neg to Pos skin test on wks of infection
PIT
34
Neg skin test
AMT
35
May be neg or pos skin test
SD
MTA
OT
36
Pos skin test
LV
| TVC
37
Pit, without treatment, usually resovles within __mos with some residual scarring
12 mos
38
LV develops at site of
PIT
39
Cutaneous TB which are limited to skin and can be excised
PIT
| TVC
40
Management of cutaneous TB
Prolonged Treatment with at least 2 drugs
| Isoniazid and rifampin (9mos)
41
Age of fish tank granuloma
20-40yrs old
42
Fish tank granuloma is caused by
M. Marinum
43
Fish tank granuloma is common in m/f
Male
44
Incubation period of Fish tank granuloma
1wk -2mos
45
Fish tank granuloma is benign and self limited. May remain active but a singe papulonodular lesion resolves in
3mos to 3yrs
46
Prophylaxis for Fish tank granuloma
Wear waterproof gloves
47
Drug of choice for Fish tank granuloma
Clarithromycin
| Also ethambutol and rifampin
48
Age of buruli /bairnsdale ulcer
Children and young adult
49
Etiology of buruli /bairnsdale ulcer
M. Ulcerans
50
Sex of buruli/bairnsdale ulcer
Male
51
Got from pricks or cuts from plants (wet, marshy, swampy sites)
Buruli / bairnsdale ulcer
52
Buruli secretes what toxin
Polyketide toxin (mycolactone)
53
Incubation period in buruli/bairnsdale
3mos
54
Painful/painless ulcer in buruli/bairnsdale
Painless subQ ulceration
55
Why should apply heat to buruli ulcer
Because ulcerana prefer cold temp
56
T or F: antimycobacteril is effective to buruli ulcer
False. Ineffective
57
Hansen's disease
Leprosy
58
Chronic granulomatous disease
Leprosy
59
Mycobacterium leprae prefers hot/cold temp
Prefers cold temp
60
T or F: Mycobacterium are obligate afb
True
61
Localized skin involvement and peripheral n involvement
| Few org in skin biopsies
Tuberculoid TLC
62
Generalized involvement
Skin, upper respi mm, RES, adrenal, tested
Many bacilli
Lepromatous LL
63
Combi of tuberculoid and lepromatous
| Many bacilli
Borderline dimorphic BL
64
Classif of leprosy:
Very early lesion
Host response is indeterminate rather than diagnosis
Indeterminate and transitional form
65
Leprosy common in M/F
Male
66
T or F: leprosy has direct relations between skin color and severity of disease
False, inverse relation
67
Main reservoir in leprosy
Humans
68
Other than human, what is the reservoirs of leprosy
Armadillo
Mangabey monkey
Chimpanzees
69
Mode of trnasmiission of leprosy
Uncertain
Droplet infection
Contact with infected soil
Insect vector
70
Clinical expression of body to leprosy infection
Development of granuloma
71
Downgrading and reversal reaction
Lepra type 1 reaction
72
Disease in lepra type 1
Borderline disease BT BL
73
Why does downgrading occurs
Before therapy
74
When does reversal occurs
In response to therapy
75
Lepra type: acutely inflamed, with edema (face, hands, feet) and pain
Type 1
76
Erythema nodosum leprosum
Lepra 2
77
Patients in lepra type 2
LL
78
When does lepra type 2 occurs
After initiation of therapy (within first 2yrs)
79
Lepra type: painful red skin nodules superficially and deeply. Form abscess and ulcer on face and ext
Lepra type2
80
Lepra type: irreg erythema plaque. Many resolve spont or necrosis with ulceration
Lucio's reaction
81
Lepra type: shallow large polygonal sloughing ulceration
Lucio's reaction
82
Lepra type: variant of ENL or sec to arteriolar occlusion
Lucio's reaction
83
Leprosy type: Hypo pigmented hypesthetic macule with raised edges (becomes atopic or depressed)
TT, BT
84
Leprosy type: its advanced lesion results to anesthetic and devoid of skin appendages
TT, BT
85
TT/BT: may resolve spont, not associated with Lepra reaction
TT
86
TT/BT: do not heal spont, type 1 lepra reaction
BT
87
Nerve involved in TT or BT
Ulnar nerve (pinprick test, temp, vibration)
88
Incubation period of tuberculoid leprosy
2-40yrs (5-7yrs)
89
Leprosy type: insidious onset and painless. PNS with persistent or recurrent painful numbness. no trauma
TT! BT
90
Leprosy type: punched out patches
Borderline leprosy
91
Leprosy type: diffuse derma infiltration and thickened Dermis
Diffuse lepromatosis
92
T or F: nerve involvement in LL is more extensive than TT
True
93
Leprosy type: histoid nodule
LL
94
PE of leprosy extremities
Sensory neuropathy
Plantar ulcers
Ulnar and peroneal palsy
Charcot jts
95
PE of leprosy nose
Chronic nasal congestion
Epistaxis
Saddle nose deformity
96
PE of leprosy eyes
Cranial nerve palsies
Lagophthalmus
LL: anterior chamber
Corneal damage
97
PE of leprosy testes
Hypogonadism
98
Pauli-bacillary
1-5 lesions
- afb
TT and BT
99
Multibacillary
>5 lesions
+ afb
BB, LL, BL
100
Treatment for paucibacillary
Dapsone plus rifampin for 6mos
101
Treatment for multi bacillary
Dapsone
Clofazimine
Rifampin
Monthly for 1yrn
102
Slit skin smear
Leprosy
103
M. Leprae has not been cultured in vitro. It grows when inoculated into the
Mouse foot pad
104
Cardinal findings in leprosy
Pt from endemic area
Skin lesion with diminished or loss of sensation
Enlarged peripheral nerves
M. Leprae in skin
105
T or F: amyloidisis can complicate long standing leprosy
True
106
Course and prognosis of BT
2-4mos
107
Course and prognosis of BL
9mos
108
Course and prognosis of lepra type 2
Within 2 yrs
