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BECOM 3 > Exam #3 > Flashcards

Exam #3 Flashcards

1
Q

Common cold 2 main causes

A 
#1 Rhinovirus
#2 Influenza virus
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2
Q

rhinitis medicamentosa can occur when?

A

Decongestant should only be used for short term use bc can develop rhinitis medicamentosa (rebound congestion)

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3
Q

Pharyngitis main viral causes

A

1 Adenovirus: can cause exudate like GAS (most common)

#2 Rhinovirus
#3 Coronaviruses
EBV
Coxsackie (hand foot and mouth / herpangina)

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4
Q

Pharyngitis main bacterial causes

A 
GAS
Group C and G
Neisseria 
Fusobacterium
Diphtheriae
Arcanobacterium haemolyticum
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5
Q

How to tell the difference btw GAS and Arcanobacterium haemolyticum caused pharyngitis

A

Arcanobacterium haemolyticum: extremities -> trunk and spares palms/soles
GAS: head/neck -> trunk

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6
Q

Trismus

A

can’t open mouth

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7
Q

Dental Caries cause

A

strep mutans

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8
Q

Acute Ulcerative Gingivitis cause

A

Fusobacterium

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9
Q

Ludwig’s angina

A

cellulitis and abscesses on floor of mouth (leads to tongue elevation -> see under tongue when opens mouth)
-often descend down ant chest wall

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10
Q

Sulfur granules are associate w

A

actinomycetes

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11
Q

Cervicofacial actinomycosis

A

usually starts from other odontogenici infects (caused by actinomyces that form sulfur granules)

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12
Q

Angular cheilitis common cause

A

Candida

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13
Q

Candida stomatitis found in what patients

A

diabetics or immunocompromised

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14
Q

most common cause of oral squamous cell carcinoma

A

HPV subtype 16

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15
Q

Parotitis 2 cause and difference

A

Mumps Virus

Staph aureus: more acute and seen in a hospital setting in an elderly or debilitated patient who is mouth breathing

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16
Q

duct drain submandibular and sublingual salivary glands under tongue

A

Wharton duct

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17
Q

parotid gland duct

A

Stensen’s duct

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18
Q

Sinusitis bacterial causes

A

Strep pneumonia (most common)
Haemophilus influenzae
Moraxella catarrhalis

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19
Q

Sinusitis fungi cause, common symptoms, and common patient

A

Mucormycosis

  • black necrotizing lesion on face
  • diabetics
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20
Q

Sinusitis symptoms

A

Facial pain that inc w bends forward or lies down

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21
Q

Cavernous sinus thrombosis definition

A

occur from a spread of infection in the highly anastomotic venous system retrograde to the base of the skull (usually ethmoid or sphenoid sinusitis)

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22
Q

Cavernous sinus thrombosis symptoms

A

loss of vision, photophobia, eye bulging

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23
Q

Otitis Media causes

A

Strep pneumoniae (most common)
Haemophilus influenza
Moraxella catarrhalis

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24
Q

Bullous myringitis

A

blistering of tympanic membrane

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25
Q

otitis externa in diabetics cause

A

pseudomonas

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26
Q

Erysipelas vs cellulitis

A

Cellulitis: defused borders
Erysipelas: bright read and sharp borders

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27
Q

sinusitis and Facial Cellulits can lead to …. which can cause lateral gaze palsy

A

cavernous sinus thrombosis

-CN VI

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28
Q

Facial Cellulits cause pre-vaccine era

A

Haemophilus influenzae

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29
Q

Thumbprint Xray

A

epiglotitis

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30
Q

Epiglottitis causes

A

Strep pneumoniae

Haemophilus influenzae

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31
Q

Steeple Sign on Xray

A

Croup (laryngotracheobronchitis)

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32
Q

Croup cause

A

Parainfluenza virus

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33
Q

Lemierre’s Syndrome cause and symptoms

A

Fusobacterium necrophorum

Symptoms: soar throat followed by unilateral neck swelling

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34
Q

Cobble stone pattern on Xray

A

Infectious Esophagitis caused by Candida

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35
Q

Infectious Esophagitis causes

A

Candida (most common)
HSV (will show multinucleate cells)
CMV (will show owl’s eyes)

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36
Q

Infectious Cervical Lymphadenitis causes

A

Usually Strep or Staph
Bartonella henselae (Cat Scratch Disease)
Francisella tularensis (Tularemia)
** EBV, CMV, HIV, Toxoplasma, Rubella (posterior cervical)

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37
Q

Infectious Conjunctivitis cause

A

Adenovirus (most common)

Trachoma (Chlamydia trchomatis) seen in neonatal via delivery

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38
Q

Infectious Keratitis bacterial causes

A

Staph aureus

Pseudomonas aeruginosa: via contacts

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39
Q

Infectious Keratitis viral causes and THIER ASSOCIATION

A

Adenovirus: leads to subcorneal infiltrate
HSV: causes dendritic pattern

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40
Q

Diphtheria symptoms and associations

A

Barking cough
Bull neck
Pseudomembrane in nose or on tonsils

**peripheral neuropathy

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41
Q

Diphtheria agar

A

Blood agar

Loeffler’s agar

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42
Q

Atelectasis trachea will deviate

A

towards side of atelectasis

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43
Q

Bronchiectasis causes

A

Cystic Fibrosis
Karagener Syndrome (Dyskinetic Cilia Syndrome)
Aspergillosis
Foreign body aspiration

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44
Q

signet ring sign on X-ray

A

Bronchiectasis

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45
Q

Bronchiectasis bacterial colonization

A

Haemophilus influenzae

Pseudomonas aeruginosa

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46
Q

Tree in bud pattern on xray

A

Bronchiectasis

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47
Q

Kartagener Syndrome symptoms

A

Infertility (sperm flagella doesn’t work)
Bronchiectasis
Chronic Rhinossinusitis
Situs Inversus w Dextrocardia

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48
Q

Aspiration pneumonia locations

A

sup segment of RLL

post segment of RUL

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49
Q

pneumonia phases

A
  1. Pulmonary capillary congestion
  2. Red hepatization (neutrophils and RBCs)
  3. Gray hepatization (neutrophils and fibrin)
  4. Resolution/consolidation (macrophage clear debri)
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50
Q

pneumonia clinical findings

A 
Egophony (E to A changes)
Bronchophony (vocal fremitus by saying 99)
Percussion dullness
Rales
Pleural friction rub
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51
Q

Community Acquired Pneumonia Strep pneumoniae symptoms

A

Rusty sputum

Elevated bilirubin and transaminases

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52
Q

Pneumonia in COPD patients is caused by

A

Haemphilus influenza
Moraxella catarrhalis
Legionella

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53
Q

Community Acquired Pneumonia Staph aureus is see in

A

patients following influenza infection, IV drug users, and cystic fibrosis

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54
Q

Cystic Fibrosis Pneumonia is caused by

A

Staph a
Pseudomonas
Burkholderia

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55
Q

Haemophilus influenzae is a

A

gram neg coccibacillus

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56
Q

Moraxella catarrhalis is a

A

gram neg coccibacillus

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57
Q

bulging fissure sign on xray

A

Klebsiella

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58
Q

Klebsiella is a

A

gram negative rods

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59
Q

Mycoplasma pneumoniae pneumonia is seen in

A

Adolescents and young adults living close quarters (college/military)

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60
Q

Chlamydophila pneumoniae pneumonia is associated w

A

Illness commonly associated with asthmatic bronchitis (bronchospasms) and wheezing

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61
Q

Legionella pneumophilia symptoms

A

Faget’s sign

hyponatremia

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62
Q

Legionella pneumophilia agar

A

Buffered Charcoal Yeast Extract agar

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63
Q

Tularemia is associated w and is seen in

A

significant Hilar Lymphadenopathy

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64
Q

placenta of birthing animals

A

Q fever (Coxiella brunetii)

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65
Q

biological warfare

A

Tularemia

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66
Q

Viral atypical pneumonias causes

  • children
  • adults
  • COPD
A
  • children: Respiratory Syncytial Virus
  • adults: Influenza virus
  • COPD: Metapneumovirus
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67
Q

Severe Acute Respiratory Syndrome (SARS) arises where

A

China

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68
Q

Post-Influenza Bacterial Pneumonia are caused by

A
  1. Strep pneumoniae
  2. Staph a
  3. Haemophilus influenzae
  4. GAS
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69
Q

Associated w infected pet birds

A

Chlamydophila psittaci

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70
Q

Inc Procalcitonin

A

bacterial pneumonia

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71
Q

Pneumonia Treatment

A
  • Healthy Person: Macrolide
  • Chronic Disease/Immunosuppressive Patient: Quinolone
  • Inpatient (non ICU setting): quinolone vs ceftriaxone/macrolide vs ceftriaxone/doxycycline
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72
Q

MIC >2 means

A

penicillin resistant

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73
Q

Bordetella pertussis agars

A

Bordet-Gengou agar

Regan-Lowe Charcoal Blood agar

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74
Q

Bordetella pertussis (“Whooping Cough”) symptoms

A
  • Prolonged cough
  • Paroxysmal staccato cough w inspiratory whoop
  • Tracheitis on bronchoscopy
  • Subconjunctival Hemorrhage
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75
Q

Bordetella pertussis (“Whooping Cough”) symptoms

A
  • Prolonged cough
  • Paroxysmal staccato cough w inspiratory whoop
  • Tracheitis on bronchoscopy
  • Subconjunctival Hemorrhage
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76
Q

Staph and strep agar

A

blood agar

77
Q

Haemophilus agar

A

chocolate agar

78
Q

Klebsiella agar

A

MacConkey agar

79
Q

Pseudomonas agar

A

MacConkey agar

80
Q

Mycobacteria agar

A

Lowestein-Jensen agar

81
Q

Bordetella agar

A

Bordet-gengon

Regan-Lowe Charcoal blood agar

82
Q

Pleural infection signs

A

Low pH
Low glucose
Inc LDH

83
Q

Gohn and Ranke complexes are formed why?

A

Tb causes hypercalcemia leading to Ca2+ lesions

84
Q

Milirary Tb definition

A

Tb disseminated into the blood stream

85
Q

Tb skin test results
Healthy
High Risk Ind
Recent contact

A

Healthy: >15mm
High Risk Ind: >10mm
Recent contact: >5mm

86
Q

PZA resistant Tb

A

M. kansasii

87
Q

Actinomycosis often accompanied by

A

Aggregatibacter

88
Q

Actinomycosis pathology

A

colonized in the oral cavity in nearly all people, pathogenesis begins w the disruption of a mucosal barrier via surgery, trauma, malignancy, or radiation therapy

89
Q

Nocardia stain

A

Ziehl-Neelsen
Kinyoun AFB
**Actinomyces does not show up on

90
Q

Actinomyces histo and gram stain

-AFB

A

45 degree branching and bush like commonly on gram stain

  • gram +
  • AFB -
91
Q

Nocardia histo and gram stain

-AFB

A

90 degree branching that resemble beading appearanc on a gram stain

  • gram +
  • AFB +
92
Q

Histo causes (location)

A

caves/bridge workers where birds

93
Q

Histo plasma stains

A

Wright stain

Silver stain

94
Q

Urine Antigen test

A

legionella
histo
coccidioides

95
Q

Histo associations

A
  • Erythema nodosum

- Oropharyngeal and GI ulcers in immunocomp patients

96
Q

Blasto histo

A

broad based budding

97
Q

blasto association

A

bone (osteomyelitis)

skin lesions

98
Q

Coccidioides histo

A

spherule

99
Q

thin walled cavities

A

Coccidioides

100
Q

CNS related pneumonias

A

nocardia
coccidiodes
cryptococcus

101
Q

Cryptococcosis histo

A

Narrow based budding yeast

102
Q

Cryptococcosis stain

A

Mucicarmine stain

103
Q

if histo is found in GI think

A

AIDs

104
Q

penicilliosis/talaromycosis

A

sausage form

105
Q

Immunocompromised (AIDs) patients in SE Asian think

A

penicilliosis/talaromycosis

106
Q

Paracoccidioidomycosis histo

A

Multiply budding yeast

107
Q

Paracoccidioidomycosis associated lesions

A

Mullberry

108
Q

HALO sign on Xray

A

aspergillosis fungus balls

109
Q

aspergillosis stain

A

silver stain

110
Q

aspergillosis histo

A

septate 45 degree

111
Q

Mucomycosis (Zygomycosis) histo

A

non septate 90 degree

112
Q

Pneumocystis pnuemonia stain

A

Gomori-Methomine Silver stain (sputum)

113
Q

Pneumocystis pnuemonia histo

A

Resembles tea cups or crushed ping-pong balls

114
Q

Pneumocystis pnuemonia compilations associtiaon

A

Spontaneous Pneumothorax

115
Q

1,3 Beta-D-Glucan test for what and except what

A

Tests for fungal infections

  • Zygomycets (mucor)
  • Blasto
  • Cryptococcus
116
Q

Galactomannan test mainly for

A

aspergillus

117
Q

Lung parasites

A
  • ascaris
  • ancyclostoma duodenal/americanus
  • strongyloidiasis
118
Q

Lung parasitic infiltration will have

A

Eosinophils in sputum w Charcot-Leygen crystals

Larvae in sputum

119
Q

Loeffler Syndrome

A

lung issues caused by pulmonary parasites

120
Q

Paragonimiasis is found where in the world

A
  • Eastern Asia and South America

- Diagnosis: eggs in sputum and hemoptysis

121
Q

Paragonimiasis diagnosis by

A

eggs in sputum

hemoptysis

122
Q

Strongyloidiasis histo

A

spiral worm

123
Q

M. canettii vs M. africanum

A

M. canettii: East africa

M. africanum: West africa

124
Q

M. bovis is acquired by

A

cattle/bison/deer/elk and is spread to humans via unpasteurized milk and animal contact via handling, meat or milk (once common in humans, now uncommon, 2% of US cases)

125
Q

smoking toxic chemicals

A
  • Polycyclic Hydrocarbons
  • Nicotine
  • Arsenic
126
Q

lung cancer activation mutations

A 
KRAS
EGFR
cMET
cMYC
VEGF
127
Q

Lung cancer inactivation mutations

A

p16
RASSF1A
p53
Rb

128
Q

Central cancer growth can be

A

Squamous cell

Small cell

129
Q

Squamous cell carcinoma is described histologically how?

A

Intercellular bridges

Keratinizing patterns

130
Q

Chromogranin + lung cancers

A

Small cell

Carcinoid cancer

131
Q

Small cell cell association

A

Kulchisky cells

132
Q

Peripheral lung cancer

A

Adenocarcinoma

133
Q

Adenocarcinoma cells express

A

TTF-1

Napsin A

134
Q

Acinar scarring condition from adenocarcinoma is is appear how histologically?

A

Cavities that are lined w columnar cells

135
Q

Carcinoid Tumor of the Lungs how described how histologically

A
  • Delicate stromal septa that looks like nuclei are creating a fence between it and the rest of the tumor
  • Palisading
136
Q

Carcinoid Syndrome symptoms

A

Diarrhea
Flushing
Cyanosis

137
Q

Lung Hamartoma

A
  • nodules of connective tissue

- intersected with epithelial cleft (lined w ciliated/unciliated cleft)

138
Q

Mutation in TSC2 tumor supressor gene

A

Lymphangioleiomyomatosis

139
Q

rearrangement of ALK gene

A

Inflammatory Myofibroblastic Tumor

140
Q

Pleural Tumors

  • expression
  • cryptic inversion of chromosome 12
A

Expression: CD34+ and keratin negative
Association: cryptic inversion of chromosome 12

141
Q

Malignant Mesothelioma

-expression

A
  • Asbestos exposure

- Deletion of tumor suppressor CDKN2A/INK4a

142
Q

Pancaost Tumor can cause

A
  • Horner Syndrome

- Miosis, ptosis, anhidrosis (no sweating), enothalmost (sunken eyeball)

143
Q

Uncomplicated Cystitis symptoms

-does this require a urine analysis?

A
  1. Dysuria (pain during urination)
  2. Increase frequency
  3. NO VAGINAL DISCHARGE

-No, bc positive dipstick alone has 90% sensitivity

144
Q

Complicated Cystitis includes

A

females w comorbid medical conditions, ALL males, patients w catheters or who are hospitalized

145
Q

Pyelonephritis symptoms

A

All symptoms that apply to cystitis plus

  • Fever
  • Flank/back pain
  • Abdominal pain
  • Naseau, vomiting

**these patients appear very ill while cystitis patients are more or less irritated/uncomfortable

146
Q

WBC/Grandular cast suggest

A

pyelonephritis

147
Q

Prostatitis symptoms

A
  • Pain (perineum, lower abdomen, testicles, penis, and with ejaculation)
  • Bladder obstruction leading to dribbling
  • Potentially blood in semen
  • Inc PSA
148
Q

what do you not want to do w an acute prostatitis patient?

A

DRE, could lead to sepsis due to aggravation

149
Q

Epididymitis symptoms

A
  • Acute onset of testicular pain
  • History of urinary frequency, dysuria, and fever
  • Scrotal erythema, edema, nodule
150
Q

Sepsis qSOFA

A

Infection proven/suspected + 2 of the following

  1. Altered mental status
  2. Resp Rate > 22 breathes/min
  3. Systolic BP <100 mmHg
151
Q

Septic Shock qSOFA

A
  1. vasopressors fail to maintain or are need to maintain MAP > 65 mmHg
  2. Blood Lactate Acid > 2 mmol/L
152
Q

Most sensitive UTI test

A

Leukocyte esterase

153
Q

Most specific UTI test

A

Nitrite

154
Q

+ Nitrite on urine test means

A

gram negative bacteria

-rules out staph sap

155
Q

pH 8-9 on urine test

A

proteus

156
Q

Colonization is described as

A

patients who are negative for leukocyte esterase and nitrite, no symptoms, but have >100,000 cfu/mL bacteria

157
Q

Want to treat pregnant women who are colonized why?

A

because they are at a 30% higher risk for a UTI

158
Q

top 2 causes of community-acquired UTIs

A
  1. E. coli (80% of cases)

2. Staph saprophyticus

159
Q

Coagulase Neg Staphs and novobiocin test

A
  • Staph saprophyticus (novobioicin resistant)

- Staph epidermidis (novobiocin sensitive)

160
Q

Proteus UTI results in

A
  • Staghorn” kidney stone
  • Converts urea to ammonia
  • Urine of pH 8-9 diagnosis
  • Swarming/bullseye on blood agar
161
Q

Hematuria causing Trematode and where it is commonly found

A

Schistosoma haematobium

-Commonly presents in young boys in Ghana (boy period)

162
Q

Enterococcus spp can be identified by

A

Catalase neg
Gamma hemolysis
Grows on 6.5% NaCl media

163
Q

Ferment: Positive (fast) bacteria

A

Escherichia coli

Klebsiella ssp

164
Q

Pseudomonas aeruginosa

  • ferment
  • oxidase
A

Ferment: Negative
Oxidase: Positive

165
Q

Proteus ssp

  • ferment
  • oxidase
  • pH
A

Ferment: Negative
Oxidase: Negative
pH: 8-9

166
Q

Men <35 years old cause of prostatitis and epididymitis

A

STI

Ureaplasma, Chlamydia, Neisseria

167
Q

Men >35 years old cause of prostatitis and epididymitis

A

BPH (benign prostate hyperplasia)

168
Q

Urine leukocytes appear in

A

cystitis and pyelonephritis

169
Q

calcium oxalate crystals observed in urine analysis and metabolic acidosis suspect

A

Etholene Glycol (anitfreeze) consumption

170
Q

Pyuria definition

A

urine containing WBCs

171
Q

amount of WBCs/high powered field suggests UTI

A

10

172
Q

Children infected w respiratory … can present with hematuria

A

adenovirus

173
Q

Sterile Pyuria suggests

A

Most likely indicates STI (Chlamydia trachomatis & Neisseria Gonorrhea)

174
Q

Whiff Test

  • Strong Positive
  • Negative
  • Positive
A
  • Strong Positive: Gardnerella vaginosis
  • Negative: vulvovaginal candidiasis
  • Positive: Trichomonas vaginalis
175
Q

Strawberry cervix

A

Trichomonas vaginalis

176
Q

swim across urine microscopy

A

Trichomonas vaginalis

177
Q

Clue cells - glitter epithelial cells covered in bacteria

A

Gardnerella vaginosis

178
Q

Nephrotic symptoms

A
  • Heavy, selective proteinuria (> 3 g/day)
  • Hypoalbuminemia
  • Edema (less plasma colloid pressure, salt and water retention)
  • Hyperlipidemia
  • Hypercoagulability (loss of AT-III in urine)
179
Q

Nephritic symptoms

A
  • Hematuria (cells, Hb or blood casts)
  • Mild, non-selective proteinuria (< 3g/day)
  • Hypertension (generally mild)
180
Q

Immune complex deposition immunofluorescent

A

granular deposition

181
Q

Anti-neutrophil cytoplasmic antibodies (ANCA)
P-ANCA
C-ANCA

A

P-ANCA: Churg-Strauss Syndrome

C-ANCA: Wegenger’s Granulomatosis

182
Q

Anti-endothelial cell antibodies (EACA) result in

A

EACA increase the adhesiveness of leucocytes to the endothelial cells

183
Q

Cell-mediated glomerular injury is characterized by

A

immunoglobulin-deficient GN

184
Q

IgA nephropathy (Berger disease)

A
  • IgA deposits in mesangium leading to mesangial cell proliferation
  • Most common type of glomerulonephritis worldwide
185
Q

IgA nephropathy often is associated with

A

frequent mucosal/celiac infections/diseases

186
Q

Alport syndrome

A

X linked collagen type IV defect leading to splitting of glomerular BM

187
Q

Thin basement membrane lesion

A
  • GBM widths 150-225 nm
  • Mild-moderate proteinuria
  • most common cause ofbenign familial hematuria
188
Q

Diffuse cortical necrosis often occurs

A
  • after obstetric emergency like abruptio placentae
  • septic shock
  • extensive surgery

BECOM 3 (8 decks)

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