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Exam #2 Flashcards

1
Q

Which organism is heat sensitive = killed by pasteurization?

A

MTB

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2
Q

Transmission of MTB vs. MAC?

A
  • MTB: person to person

- MAC: contaminated water/food (NOT person to person)

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3
Q

What organism has mycolic acids, cord factor, LAM?

A

MTB

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4
Q

What organism shows as IFN-gamma on blood test?

A

MTB

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5
Q

Three groups most affected by MTB?

A
  • IC
  • Children
  • HIV/AIDS
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6
Q

Which organism is ubiquitous, acid fast, weak G+?

A

MAC

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7
Q

What is the leading cause of NTM in HIV+ population?

A

MAC

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8
Q

What two “characters”/populations are described with MAC? How does each present on CXR?

A
  • Middle-aged/old man, smoker = cavitary

- “Lady Windermere” aka elderly woman, NON-smoker = patchy/nodular

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9
Q

What is important when obtaining a sample for MAC? What is seen on PCR?

A

STERILE SITE

- PCR shows 16s rRNA sequence

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10
Q

What population is Mycobacterium abscessus seen?

A

CF

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11
Q

What vaccination is associated with false+ in MTB?

A

BCG vaccine

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12
Q

What population is Measles most common in? What two risk factors further increase risk?

A

Children

- Severe is malnourished or Vitamin A deficient

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13
Q

What two findings are pathognomonic for Measles? What other two symptoms often follows these findings?

A
  1. Prodrome
    - 3 C’s (cough, coryza, conjunctivitis)
    - Koplik spots
  2. RASH + FEVER (head to toe)
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14
Q

What two complications are associated with Measles?

A
  • PNA = most common cause of death

- Acute symptomatic encephalitis = high fatality

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15
Q

What two preventions can be used for Measles?

A
  • MMR II

- BayGam (immunoglobulin) for exposed non-vaccinated

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16
Q

Which condition is NOT associated with children and caused by close/prolonged contact?

A

Rubella

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17
Q

What complication is associated with Rubella, and when does it often present?

A

CRS in 1st trimester of pregnancy

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18
Q

What condition can infect the CNS AND can be latent?

A

Herpes Simplex Virus (HSV)

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19
Q

What condition has lifelong immunity but possibility of recrudescence?

A

Herpes Simplex Virus (HSV)

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20
Q

For Herpes Simplex Virus (HSV), when is recrudescence risk increased?

A

If initial outbreak was larger/more extensive

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21
Q

Is asymptomatic shedding of Herpes Simplex Virus (HSV) possible?

A

YES

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22
Q

Differentiate HSV-1 from HSV-2.

A
  • HSV-1: common in early in life = oral

- HSV-2: seen later in life, associated with sex = GENITAL

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23
Q

What diagnostic tool is used for Herpes Simplex Virus (HSV), and what will is how? What other finding may be seen?

A

Tzanck smear shows large/fused cells

- Ballooning pathology

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24
Q

What is the treatment for Herpes Simplex Virus (HSV)?

A

Acyclovir

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25
Q

What cancer is associated with Human Papillomavirus Virus (HPV), and what is the prevention (what ages)?

A

Cervical CA

- Gardasil vaccination in ages 9-45 years

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26
Q

What two conditions are associated with VZV?

A
  • Chickenpox = Varicella

- Shingles = Herpes Zoster

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27
Q

When is peak occurrence of Chickenpox, and in what population is it most seen?

A

Winter/Spring peak

- Ages 5-9 years

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28
Q

Where does Chickenpox replicate for its first and second viremia?

A
  1. Replicates in lymph nodes = primary viremia

2. Replicates in liver and spleen = secondary viremia

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29
Q

What condition involves prodrome symptoms in older children/adult, but NOT seen in young children?

A

Chickenpox

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30
Q

Is treatment necessary for Chickenpox?

2

A

NO…

- But if needed, Acyclovir

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31
Q

What medication should NOT be administered in a patient with Chickenpox, and why?

A

ASA = possible Reyes Syndrome

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32
Q

What type of VZV is associated with significant disease/damage, and how would you treat?

A

Congenital/Neonate VZV

- VariZig for high-risk exposed to infection

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33
Q

What is the prevention for Chickenpox? What is the prevention for Shingles (2)? How are the two related?

A
  • Chickenpox: Varivax
  • Shingles: Zostavax, Shingrix

Zostavax is the same virus used in Varivax, but higher potency for Shingles

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34
Q

What is the primary symptom associated with Shingles? What system is sometimes affected by Shingles?

A

PAIN (searing, burning, stabbing) +/- rash in unilateral dermatomal pattern
- Consider involvement of ophthalmic branch of CN V

NOTE: pain can precede rash by days/weeks

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35
Q

How do you treat Shingles?

What complication is associated with Shingles?

A 
NO treatment (self-limited)
- Comp: post-herpetic neuralgia
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36
Q

What is another name for Human Herpes Virus 6 (HHV-6), and how does it present? What population is it common in?

A

Roseola Infantum

  • Fever the rose-colored rash
  • Common in children
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37
Q

What is the treatment for HHV-6?

A

NONE = self-limited

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38
Q

What is the treatment for Parvovirus 19?

A

NONE = self-limited (NSAIDs)

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39
Q

What is another name for Parvovirus 19, and how does it present in children? In adults?

A

Fifth Disease

  • Slapped cheek rash then maculopapular rash
  • ADULTS: may be only arthritis/arthralgia
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40
Q

What condition is caused by a G+, anaerobic rod organism found in skin/sebaceous glands?

A

Acne Vulgaris

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41
Q

What is the progression of symptoms seen with Acne Vulgaris (3)? Which part is inflammatory?

A

Papules → Pustule → Nodule (severe)

- Pustules and Nodules inflammatory

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42
Q

What are the two organism that cause Folliculitis? Are they G+ or G-? How does each present symptomatically?

A

Staph aureus = G+
- Pustules/nodules

P. aeruginosa = G-
- Maculopapular rash (itchy)

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43
Q

What are the two treatments for Staph aureus Folliculitis?

A
  • Clindamycin ointment

- Benzoyl Peroxide wash

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44
Q

What organism causes “Hot Tub” Folliculitis? Tell me about it (3)?

A

P. aeruginosa

  • G- RODS
  • Pyoverdin/Pyocyanin
  • Opportunistic
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45
Q

Are Furuncles or Carbuncles typically recurrent?

A

Furuncles = recurrent

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46
Q

What organism causes Furuncles/Carbuncles?

A

Staph aureus (G+)

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47
Q

What three populations are most affected by Furuncles/Carbuncles?

A
  • Obese
  • IC
  • DM
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48
Q

What is the treatment for BOTH Furuncles/Carbuncles? How is treatment different between the two?

A

BOTH: drain abscess

  • Furuncles: MRSA-effective abx
  • Carbuncles: MRSA-effective abx + RIF
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49
Q

How is Impetigo different from Ecthyma?

A
  • Impetigo: superficial

- Ecthyma: deep/ulcerative

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50
Q

What are the two subtypes of Impetigo, and what organisms cause each?

A
  • Non-bollous: Staph aureus (G+) or Strep pyogenes = GAS (G+)
  • Bollous: Staph aureus (G+) ONLY
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51
Q

What two organisms cause Ecthyma?

A
  • Staph aureus (G+)

- Strep pyogenes = GAS (G+)

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52
Q

What specific organism causes Staphylococci Scalded Skin Syndrome?

A

Staph TOXIN (not the bacteria itself)

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53
Q

What condition involves sterile bullae?

A

Staphylococci Scalded Skin Syndrome

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54
Q

What condition involves a positive NIkolsky’s sign?

A

Staphylococci Scalded Skin Syndrome

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55
Q

What is the treatment for Staphylococci Scalded Skin Syndrome? What if it is severe?

A

Penicillinase-resistant, anti-Staph abx

- If severe, treat as burns

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56
Q

How is Erysipelas different from Cellulitis?

A
  • Erysipelas: superficial; raised lesions with sharp borders

- Cellulitis: deeper; indistinct borders with spreading

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57
Q

What condition involves +/- wound; deeper; indistinct borders with spreading?

A

Cellulitis

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58
Q

What organism causes Erysipelas?

A

Strep pyogenes = GAS (G+)

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59
Q

What two organisms cause Cellulitis?

A
  • Strep pyogenes = GAS (G+)

- Staph aureus (G+)

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60
Q

What medication should be avoided in the treatment of Erysipelas and Cellulitis, and why?

A

NSAIDs

- Can mask pain of myonecrosis

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61
Q

What is the primary cause of Pasteurella multocida?

A

CAT BITE

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62
Q

What condition involves draining pus, fluctuance, white/yellow center with head?

A

MRSA

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63
Q

What two diagnostic tests can be used to diagnose MRSA, and what is seen with each?

A
  • mecA gene on PCR

- MecA protein with latex agglutination

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64
Q

What condition involves deeper tissue and mixed aerobe + anaerobe?

A

Necrotizing Fasciitis

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65
Q

What condition involves pain out of proportion and NO PUS?

A

Necrotizing Fasciitis

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66
Q

What two conditions involves HEET?

A
  • Cellulitis

- Necrotizing Fasciitis

67
Q

What condition spreads along the fascia? What is often spared, and why?

A

Necrotizing Fasciitis

- Muscle spared because good blood supply

68
Q

What are the two types of Necrotizing Fasciitis, and what organisms cause each?

In what population is each seen?

A

Type 1: polymicrobic (anaerobe + aerobe/anaerobe)
- DM

Type 2: monomicrobic (Strep pyogenes (G+))
- HEALTHY

69
Q

What bacterial skin infection is considered an emergency? How is it treated? What other tx may be considered?

A

Myonecrosis

- Treated with SURGERY (HBOT?)

70
Q

What organism causes Myonecrosis, and what symptom is pathognomonic?

A

Clostridium pefringens Type A

- Sxs: crepitus

71
Q

What two organisms cause Toxic Shock Syndrome, and in what population does each present? What symptom is often common for both?

A

EXOTOXIN SUPERANTIGENS

  • Strep pyogenes = GAS (G+): already ill (bacteremic +NF)
  • Staph aureus (G+): HEALTHY (surgery or menstrual)

Sunburn-like rash of whole body for both

72
Q

What is required for growth of Dermatophytes?

73
Q

What two virulence factors are associated with Trichophyton Dermatophytes? Describe each.

A
  • Galactomannan peptide

- Crude antigens (CHO = immediate, peptide = delayed)

74
Q

What diagnostic tool is used for Dermatophytes? What is seen?

A

DTM = selective and differential

- pH change = red color change

75
Q

What three fungal elements are seen in Dermatophytes?

A
  • Arthrospores
  • Microconidia (asexual spore)
  • Macroconidia (asexual spore)
76
Q

What is a Dermatophytid?

A

ALLERGIC RXN to Dermatophytes

77
Q

How can you differentiate Trichophyton Dermatophytes from Microsporum Dermatophytes?

A
  • Trichopyton = NOT fluorescent

- Microsporum = fluorescent

78
Q

What three virulence factors are seen with both Trichophyton Dermatophytes AND Microsporum Dermatophytes?

A
  • Hyphae
  • Microconidia (asexual spore)
  • Macroconidia (asexual spore)
79
Q

What is the most common Trichophyton Dermatophyte?

A

Trichophyton mentagrophytes

80
Q

What two organisms can cause Tinea Capitis, and what is specific of each?

A
  • M. canis = ectothorix (around hair follicle)

- T. tonsurans = endothorix (within hair follicle)

81
Q

How are Tinea Corporis and Tinea Cruris transmitted (2)? What three risk factors are associated with both?

A

Transmitted via direct AND indirect contact

- RF: DM, obesity, excessive sweating

82
Q

What condition is often associated with Candida co-infection?

A

Tinea Unguium (Onychomycosis)

83
Q

What is the most common opportunistic fungal infection worldwide?

84
Q

What five causes are associated with Candida spread (i..e possible risk factors)?

A
  • Absence of normal flora
  • Intro into abnormal site
  • “Pathologic” change
  • Immune defect
  • Use of broad-spectrum abx
85
Q

What are all species of Candida capable of, and which type is better at this?

A

ATTACHMENT

- Germ tube is more adhesive (than yeast cells)

86
Q

G+ cells, yeast cells, pseudohyphae and true hyphae are indicative of what organism?

87
Q

How can you differentiate between types of Candida infection, and what two forms involve germ tubes?

A

Chromagar can diff.

- Germ tubes ONLY seen with C. albicans and C. dubliniensis

88
Q

What is another name for Malassezia furfur, and how does it present on microscopy/KOH?

A

Tinea Versicolor

- “Spaghetti & meatballs” on KOH

89
Q

What is required for growth of Malassezia furfur?

A

Lipophilic growth factor = FAT

90
Q

What is another name for Hortaea werneckii, and how does it present on microscopy/KOH?

What is another key characteristic of Hortaea werneckii?

A

Tinea nigra
- DIMORPHIC on KOH (yeast and mold)

It is an extreme halotolerant

91
Q

What organism is a small mite with short legs?

A

Sarcoptes scabiei (Scabies)

92
Q

What condition involve pruritus worse at night?

A

Sarcoptes scabiei (Scabies)

93
Q

What two populations often present with Sarcoptes scabiei (Scabies)?

A
  • Children

- Elderly

94
Q

In what population is Norwegian Scabies most prevalent?

A

HIV

- Crusted/very itchy lesions

95
Q

How does Pediatric Scabies present?

A

Blood-filled lesions

96
Q

What organism is larger than Scabies?

A

Phthirus pubis (Crabs)

97
Q

What condition is caused by a “blood-sucking parasite” that cements itself to hair/clothing fibers?

A

Pediculosis (Pediculus humanus)

98
Q

What condition is associated with “Vagabonds disease”, and what is this?

A

Pediculosis (Pediculus humanus)

- Darkened skin with LONG-TERM exposure

99
Q

What organism is a parasite that NEEDS blood, but does NOT live on humans?

A

Pulex irritant (Human Flea)

100
Q

What organism has short spikes on its legs, and what do these allow for?

A 
Pulex irritant (Human Flea)
- Allows for attachment to host
101
Q

What organism CAN JUMP and symptomatically presents as linear bites on the lower extremities?

A

Pulex irritant (Human Flea)

102
Q

What organism causes RMSF, and what are two characteristics of this?

A

Rickettsia rickettsii

  • G-
  • Obligate intracellular
103
Q

What symptoms are associated with RMSF (3)?

A

Fever, HA

- THEN RASH (macular and painless to petechial/painful)

104
Q

What condition involves macular and painless rash that progresses to a petechial and painful rash?

105
Q

What diagnosis is used for RMSF?

A

Indirect immunofluorescence

106
Q

What organism causes Chagas disease, and what is one virulence factor is contains?

A

Trypanosoma cruzi

- Flagella (it is a protozoa)

107
Q

What two symptoms are seen with ACUTE Trypanosoma cruzi (Chagas disease)?

A
  • Romaña’s sign

- Chagoma

108
Q

What condition involves Romaña’s sign?

A

ACUTE Trypanosoma cruzi (Chagas disease)

109
Q

Are fleas or scabies contagious?

A

SCABIES = contagious (spread by direct contact)

110
Q

What will be seen diagnostically for ACUTE Trypanosoma cruzi (Chagas disease)? What about CHRONIC? What tool is used for each?

A
  • ACUTE: Trypomastigotes = blood smear

- CHRONIC: Amastigotes = biopsy

111
Q

What is linked with IM/EBV?

A

Burkett’s Lymphoma

112
Q

What is the peak age associated with IM, and how can this affect diagnosis? How is it diagnosed, and what is seen?

A

17-25 years: use Monospot and see Heterophile Ab

- If peds (younger), have to use IgM anti-VCA

113
Q

What condition involves Heterophile Antibodies on diagnosis?

114
Q

What condition involves “Downey Cells” on diagnosis?

115
Q

IM/EBV and CMV are very similar, so how can you differentiate the two?

A

CMV = NO Heterophile Antibodies

116
Q

What three populations are most affected by CMV?

A
  • Pregnant
  • IC
  • Transplant patients
117
Q

What is the prevention for Mumps, and when is it contraindicated (2)?

A

MMR II vaccine

- NOT if egg sensitivity or Neomycin sensitivity

118
Q

What organism causes Lyme Disease, and what two characteristics are exhibited by the vector/what is the vector?

A

Borrelia burgdorferi

- TICKS (nymphal stage, questing)

119
Q

What symptom is seen with ACUTE Lyme Disease?

A

Erythema Migrans (bullseye rash)

120
Q

What symptom is seen with subacute or chronic Lyme Disease?

A

Asymmetric arthritis

121
Q

What two diagnostic tools are used for Lyme Disease?

A

EIA then Western Blot

122
Q

Which four conditions can cause false+ on EIA when diagnosing Lyme Disease?

A
  • Syphilis
  • EBV
  • SLE
  • RA
123
Q

What types of Hepatitis are associated with a shorter incubation period?

A

A, E

- ALSO only acute and fecal-oral transmission

124
Q

What type of Hepatitis does NOT have a vaccine for prevention?

125
Q

What is a major reservoir of HBV, and why?

A

Chronic HBV

- Can still shed even if asxs

126
Q

What is a major complication of HBV?

A

Primary hepatocellular carcinoma

127
Q

How is Hepatitis A transmitted?

A

Contaminated food or water

128
Q

How is Hepatitis B transmitted (3)?

A
  • Needle-sharing
  • Sex
  • Mother to fetus
129
Q

How is Hepatitis C transmitted (5)?

A
  • Transfusions
  • Transplants
  • IDIOPATHIC
  • IVDU
  • Sex
130
Q

What is the hallmark of Hepatitis C?

A

CHRONICITY

131
Q

What can increase the severity of Hepatitis B, and is fairly common?

A

Hepatitis D co-infection (COMMON)

132
Q

What is the primary treatment for Hepatitis C (2)?

A

DAAs +/- interferon

133
Q

Why can’t you treat Hepatitis C with DAAs if you also have a Hepatitis B co-infection?

A

DAAs can inhibit Hepatitis C BUT ACTIVATE HEP B

134
Q

What is the primary recommendation for Hepatitis A?

135
Q

What three characteristics can differentiate HIV-1 form HIV-2? How is HIV-2 generally treated?

A

HIV-2 is…

  • Less transmitted
  • Has slower progression to AIDS
  • Resistant to NNRTIs

NEEDS COMBO THERAPY

136
Q

What are the five possible transmission routes for HIV?

A
  • Sex
  • Parenteral
  • Perinatal
  • Transplant
  • Occupational (HC)
137
Q

With sexual transmission of HIV, what two conditions can create further increased risk for HIV contraction?

A
  • HSV

- Syphilis

138
Q

What constitutes HIV progression to AIDS?

A

CD4 T cell count <200

139
Q

What are four “AIDS-defining” conditions?

A
  • Kaposi’s sarcoma
  • PCP
  • PNA
  • MAC infection
140
Q

What is the diagnostic plan for HIV (2)?

A

EIA then Western Blot

141
Q

What can be used to test HOW much HIV virus is present?

142
Q

What is the most effective treatment for HIV?

A

RTI + PI in HAART

143
Q

What should be used to evaluate the effectiveness of HIV treatment?

A

TRENDS of viral load (effective treatment = viral load decreases)

144
Q

What does U = U mean, and for what condition is it used?

A

Undetectable = Untransmittable so if viral load is low enough, HIV is not contagious

145
Q

What is the asexual stage of Malaria? What is the sexual stage?

A
  • Asexual: trophozoites

- Sexual: gametocytes

146
Q

What two things are released by humans to cause symptoms of Malaria?

A
  • Pyrogens = fever/chills

- Tissue Necrosis Factor (TNF) = intensifies sxs

147
Q

What three symptoms are often associated with Malaria?

A
  • HIGH FEVER
  • Anemia
  • Hypotension
148
Q

What two conditions/things are associated with host resistance of P. vivax?

A
  • Sickle Cell Anemia

- Presence of/expressed Duffy gene

149
Q

What specific organism does the Malaria vaccine act on, and what is the vaccine called?

A

Mosquirix

- Acts on P. falciparum

150
Q

What Malaria organism infects young erythrocytes?

151
Q

What diagnostic tool is used in Malaria?

A

Giemsa stain

152
Q

What Malaria organism presents as enlarged RBCs with Schuffner’s dots?

153
Q

How does P. vivax differ from P. falciparum in terms of cells infected?

A
  • P. vivax = few infected

- P. falciparum = MANY infected

154
Q

Which two Malaria organisms CAN relapse, and how?

A

Activation of liver hypnozoites

  • P. vivax
  • P. ovale
155
Q

What Malaria organism infects ALL erythrocytes?

A

P. falciparum

156
Q

What Malaria organism can cause possible capillary obstruction, and how?

A

P. falciparum

- infected RBCs stick to capillary linings = clots

157
Q

What Malaria organism presents as RBCs with double or multiple ring stages?

A

P. falciparum

158
Q

What Malaria organism presents with Maurer’s clefts?

A

P. falciparum

159
Q

What Malaria organism infects older erythrocytes?

A

P. malariae

160
Q

What Malaria organism presents as basket or band-shaped, and what is this?

A

P. malariae

- Trophozoites

161
Q

What Malaria organism presents as rosette-shaped, and what is this?

A

P. malariae

- Schizonts

162
Q

What is the primary reason behind multidrug resistance for treatment of Malaria? What is another possible cause?

A

Efflux pumps

- P is becoming increasingly independent of binding Duffy antigen

163
Q

What condition involves “cross-like” morphology of RBCs?

A

Babesia microti

164
Q

What organism causes Babesia microti?

A

Deer tick bites

MICRO (11 decks)

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