ID

Question 0

Name the 3 types of mycetoma and examples of organisms that cause each.

Answer 0

Actinomycotic mycetoma: filamentous aerobic/anaerobic orgs (e.g. Nocardia brasiliensis, Actinomadura madurae)

Eumycotic mycetoma: true fungi (e.g. Acremonium, Aspergillus, Fusarium, Pseudoallescheria boydii, Exophiala, Curvularia, Madurella, Leptosphaeria, Pyrenochaeta)

Botryomycosis: true bacteria (e.g. S.aureus, Pseudomonas)

Question 1

The human body louse transmits:

Answer 1

Trench fever
Relapsing fever
Epidemic typhus

Question 2

What organism causes white piedra?

Answer 2

Trichosporon cutaneum (formerly T.beigelii), T.ovoides, T.inkin, T.asahii (Black Piedra = Piedraia hortae)

Question 3

What HLA type is associated with recurrent HSV-related erythema multiforme?

Answer 3

HLA B15

Question 4

Differential diagnosis of lesions that look like molluscum.

Answer 4

Coccidiodomycosis, cryptococcus, histoplasmosis, penicilliosis

Question 5

What causes milker’s nodule?

Answer 5

Paravaccinia virus (a poxvirus of genus parapoxvirus)

Question 6

Name the Dermatophytes.

Answer 6

Trichophyton, Microsporum, Epidermophyton

Most common = T.rubrum

Question 7

What are the causes of tinea capitis with FLUORESCENT ECTOTHRIX?

Answer 7

“Cats And Dogs Fight and Growl Sometimes”

M. canis
M. auduoinii
M. distortum
M.ferrugineum
M.gypseum
T.schoenleinii 

(All Microsporum except last one)

Question 8

What are the causes of ENDOTHRIX

Answer 8

“Ringo Gave Yoko Two Squeaky Violins”

T.rubrum (can cause endo/ecto)
T. gourvilli
T. yaounde
T.tonsurans
T.soudanense
T. violaceum 

(note that all are Trichophyton; none fluoresce)

Question 9

What causes a positive Wood’s lamp exam?

Answer 9

PTERIDINE in dermatophytes (Cats and Dogs…)

COPROPORPHYRIN III (Corynebacterium)

PYOCYANIN (Pseudomonas)

Question 10

Ddx of Sporotrichoid Spread?

Answer 10

Most common = atypical mycobacteria (M. marinum > M.chelonae, M.kansasii), Sporotrichosis (Sporothrix schenckii), Nocardiosis, Pyogenic bacteria (Staph aureus, Strep pyogenes), Pseudoallescheria boydii; Leishmaniasis, Tularemia, TB, other dimorphic fungi, opportunistic fungi, Glanders, Cat-scratch disease, Anthrax, Cowpox, Acanthamoeba species; don’t forget melanoma!

Question 11

What causes favus-type tinea capitis? What is the charactieristic hair finding on KOH exam?

Answer 11

T.schoenleinii, T.violaceum, M.gypseum (She’s a Violent Gypsy)

On KOH you see arthroconidia and airspaces within hair shaft

Question 12

What causes seabathers eruption? What is presentation? How can it be prevented?

Answer 12

Cause: jellyfish larvae (Linuche unguiculata); itchy rash under BATHING suit after swimming in the SEA; prevent by washing off after swimming.

Compare to Swimmer’s itch – fresh water, exposed skin, caused by avian schistosomes)

Question 13

Heck’s disease (focal epithelial hyperplasia) is caused by which HPV types?

Answer 13

HPV 13 and 32

Question 14

Which HPV causes common warts?

Answer 14

HPV 1, 2, 4

Question 15

Which HPV causes Butcher’s warts?

Answer 15

HPV 2 and 7

Question 16

Which HPV most commonly causes epidermodysplasia verruciformis? Mutations?

Answer 16

HPV 5; others include 2, 3, 8-10, 12, 14, 15, 17 (SCC In EV associated with 5 and 8)

Mutations: EVER1 (TMC6) and EVER2 (TMC8) - warts forever and ever

Question 17

Which HPV most commonly causes epidermodysplasia verruciformis? Mutations? Treatment?

Answer 17

HPV 5; others include 2, 3, 8-10, 12, 14, 15, 17 (SCC In EV associated with 5 and 8)

Mutations: EVER1 (TMC6) and EVER2 (TMC8) - warts forever and ever
Tx: Soriatane

Question 18

What are the live vaccines?

Answer 18

“MMR Vaccines Suck For Your Old Patients Taking Biologics”

MMR
VZV
Smallpox
Flumist (nasal flu)
Yellow fever
Oral (oral Polio and oral Typhoid; injectable versions are killed)
BCG

Question 19

Bowenoid papulosis, cervical cancer and periungual SCC are associated with which HPV types?

Answer 19

HPV 16 and 18; others 31, 33, 51

Question 20

What bugs cause chromomycoses? What is charactistic histopath finding?

Answer 20

“Pedro’s Compact Car is Very Wet”

Fonseaca pedrosei (#1)
Fonseaca compacta
Cladosporium carrionii
Phialophora verrucosa
Rhinocladiella aquaspersa

Finding = Medlar bodies, “copper pennies,” typically in groups.

Question 21

What is the treatment for M.marinum infection?

Answer 21

Minocycline (or doxy, bactrim, clarithromycin) for 1-2 months after lesions resolve

Question 22

What is the cause of bullous tinea pedis?

Answer 22

T.mentagrophytes

Question 23

What is Ramsay Hunt syndrome? Treatment?

Answer 23

VZV infection of geniculate ganglion; presents with ipsilateral facial paralysis, tinnitus/auditory symptoms. Vesicles on external ear and/or tympanic membrane.
Tx = acyclovir and steroids.

Question 24

Malignancies associated with HHV8 (5)?

Answer 24

Kaposi's sarcoma
Multicentric Castleman's (non-malignant)
Primary effusion lymphoma
NK/T-cell lymphoma
Plasmablastic lymphoma

Question 25

Bacillus anthracis’s virulence factors include its capsule and two toxins. What are the toxins and what do they do? Treatment for anthrax?

Answer 25

Edema toxin: increases levels of cAMP

Lethal toxin: increases TNF-alpha and IL-1-beta –> shock and death

Tx: penicillin for conventional cases; cipro or doxy if bioterrorism associated

Question 26

What is the main cause of mucocutaneous leishmaniasis? Visceral leishmaniasis? What type is most common in Iraq?

Answer 26

Mucocutaneous: L.braziliensis (central/south America)
Visceral: L.donovani, L. infantum (India, Sudan)
Iraq: L.major – cutaneous disease only; heals spontaneously and has no risk of recurrence/viscerotropic disease

Question 27

HHV 8 is implicated in which three malignancies / tumors?

Answer 27

Kaposi’s sarcoma
Primary effusion lymphoma
Castleman’s

Question 28

Name 8 conditions related to EBV.

Answer 28

Hydroa vacciniforme
Gianotti-Crosti
Mono
Genital ulcers
Oral hairy leukoplakia
Lymphoproliferative disorders and lymphoma
post-transplant lymphoproliferative disorder
Severe sensitivity to mosquito bites