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Infectious Disease Flashcards

1
Q

Pathogenesis of Measles

  • Reservior
  • Route of infection
  • Binds which molecules to enter cells?
A
  • Reservior: only humans
  • Starts in RT
  • Spreads to reticuloendothelial tissue
  • virus binds CD46 and signaling lymphocytic activation molecule (SLAM) of T cells
  • Dissemination results in shedding into urine and respiratory tract secretions before rash initiates
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2
Q

Patient presents with small red spots with a blue/white center on the bucal mucosa, Cough, and conjunctivitis. A few days later he develops a rash. Microscopic examination shows cells pictured below. What is the disease?

A

Measles (Rubeola)

  • (-) ssRNA
  • Giant cells: Warthin-Finkeldey cells (characteristic)
  • Koplik spots also characteristic
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3
Q

What are possible severe outcomes of measles?

A
  1. Subacute sclerosing panencephalitis
    • defective infection of CNS
  2. Postinfectious encephalitis
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4
Q

In what secretions is the measles virus found before the rash begins?

A
  • Urine
  • Respiratory tract secretions
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5
Q

Patient presents with swelling of the parotid glands and testicular pain.

  1. What is the disease?
  2. How is it spread?
  3. What are other complications?
  4. What cell type is found in excess in the parotid glands?
A
  1. Mumps
  2. by aerosols
  3. Complications:
    • Orchitis (testicular pain)
    • Oophoritis
    • Aseptic meningitis
  4. Mononuclear cell infiltrate, Neutrophils in lumen of parotids
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6
Q

Patient presents with history of fever, headache, pharyngitis, and abdominal pain. Currently presents with paralysis (LMN signs).

  1. What is the disease?
  2. How is it spread?
  3. What are CSF findings?
A
  1. Poliomyelitis (poliovirus)
  2. Fecal-oral route, so general symptoms are GI
  3. CNS shows
    • elevated WBCs (pleotropy)
    • slight increase in protein (FA)
    • no change in glucose (FA)
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7
Q

Patient presents with fever, pharyngitis, and abdominal pain in addition to nuchal rigidity and muscle and back pain. CSF shows increased WBCs.

  1. What is the disease?
  2. What is the cause?
  3. How is it spread?
A
  1. Aseptic meningitis
  2. Poliovirus (major illness)
  3. fecal-oral route
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8
Q

Patient presents with rash on trunk, lymphadenopathy, and arthralgia. In addition they have a fever, headache, stiff neck, and altered CNS function. Lab tests show elevated IgM in the CSF.

  1. What is the disease?
  2. What is the cause?
  3. How is it transmitted?
  4. What are the reserviors?
A
  1. Encephalitis
  2. West Nile Virus
  3. blood, transplacentally
  4. Reservior: crows, birds
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9
Q

Patient presents with fever, rash, myalgia, joint and bone pain, and vomiting. Blood has increased leukocytes. History of travel to S. America.

  1. What is the disease?
  2. What is the pathogenesis?
A
  1. Dengue Fever
  2. Path:
    • circulates in monocytes
    • Lysis of cells causes release of TNF and IFN-gamma
    • TNF: increased vasc permeability
    • complement cascade activated
      • C3a and C5a increase vasc perm
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10
Q

Patient presents with 3 day fever, rash, myalgia, joint and bone pain, and vomiting. Also presents with gingival hemorrhage.

  1. What is the disease?
A
  1. Dengue hemorrhagic fever.
  2. May progress to hypovolemic shock
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11
Q

What are complications of Dengue hemorrhagic fever?

A
  1. Thrombocytopenia
  2. DIC
  3. Hemorrhage
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12
Q

HSV

  1. Nuclear material
  2. Transmission
  3. Location of latent infection
  4. Microscopic presentation
A
  1. dsDNA
  2. sex, saliva, vesicle fluid
  3. HSV-1: trigeminal ganglia; HSV-2: sacral ganglia
  4. Multinucleated giant cell with eosinophilic intranuclear inclusions (Cowdry inclusions, Picmonic)
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13
Q

Patient presents with gingivitis with ulcers and perioral lesions. Lab tests find dsDNA.

  1. What is the disease?
  2. What is the cause?
A
  1. Gingivostomatitis (oral-facial herpes)
  2. HSV (1)
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14
Q

Patient presents with dysuria and painful, pruritic vesicles with urethral discharge. Lab analysis shows dsDNA.

  1. What is the disease?
  2. What is the cause?
A
  1. genital herpes
  2. HSV-2
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15
Q

Patient presents with headache, fever, vomiting, stiff neck, cerebral edema, and seizures. Patient also has anosmia and memory loss.

  1. What is the disease?
  2. What is the cause?
  3. What is the pathology?
A
  1. Viral encephalitis
  2. HSV-1
  3. Path:
    • All viral:
      • lymphocytic infiltrate
      • glial proliferation in meninges, cortex, white matter
    • HSV:
      • necrosis in temporal lobe
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16
Q

Patient presents with headache, fever, vomiting, stiff neck, photophobia and myalgia. Lab tests show dsDNA.

  1. What is the disease?
  2. What is the cause?
A
  1. Viral meningitis
  2. HSV-2
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17
Q

Patient presents with acute onset of pain in eye, conjunctivitis with a discharge, blurred vision, and “dendritic body” lesion shown below.

  1. What is the disease?
  2. What is the cause?
A
  1. Keratoconjunctivitis
  2. HSV (1)
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18
Q

Patient presents with history of pain, burning, and itching around mouth. A Papule appeared that turned into a vesicle and is now a crust.

  1. What is the disease?
  2. What is the cause?
A
  1. Herpes labialis (cold sore)
  2. HSV (1)
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19
Q

Which type of HSV causes genital infection?

A

HSV-2

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20
Q

CMV

  1. Reservoir
  2. Transmission
  3. Pathology
  4. Characteristic cytology
  5. Clinical Manifestations
A
  1. Humans only
  2. body fluids, perinatal, congenital
  3. prevent MHC I expression
  4. Owl’s eye cell
  5. Clinical:
    • Cytomegalic inclusion disease
    • Perinatal infection
    • Mono
    • Hepatitis
    • In immunocompromised: Pneumonia, chorioretinitis, esophagitis, CNS infection
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21
Q

Patient presents with fatigue, fever, pharyngitis, and mild hepatitis. Lab tests are negative for heterophile Abs. Cells found are shown below.

  1. What is the disease?
  2. What is the cause?
A
  1. Mononucleosis
  2. CMV
    • EBV is positive for heterophile Abs
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22
Q

Patient presents at birth with jaundice, rash, and respiratory distress. Cytology below.

  1. What is the disease?
  2. What is the cause?
A
  1. Cytomegalic inclusion disease
  2. CMV
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23
Q

What can be the long-term effects of Perinatal infection by CMV?

A
  • loss of hearing
  • developmental effects on intelligence
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24
Q

What are the diseases CMV causes in immunocompromised patients?

A
  1. Chorioretinitis
  2. Esophagitis
    • ulcerations, difficulty swallowing, diarrhea
  3. Hemorrhagic pneumonia
  4. Polyradiculopathy
    • ascending weakness, loss of deep tendon reflexes, loss of bowel and bladder control
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25
Patient presents with fever, headache, and sore throat in addition to a rash that started on the head and has spread to the trunk. Some spots are papules, some are vesicles, some are crusts. 1. What is the disease? 2. What is the cause? 3. How is it transmitted?
1. Chickenpox 2. VZV 3. Respiratory secretions or vesicle fluid
26
Patient has history of pain and neuralgia. A few days later a rash appears. The rash is along the lines of a dermatome and does not cross the midline. 1. What is the disease? 2. What is the cause? 3. What is the Pathogenesis? 4. What is the infiltrate?
1. Shingles 2. VZV 3. Path: * latent infection in sensory nerve (dorsal root ganglia) * neuronal necrosis * Mononuclear infiltrate
27
HBV 1. Genetic material 2. Reservior 3. Transmission
1. circular, partially-dsDNA (some parts are ssDNA) * enveloped 2. humans only 3. body fluids, transplacental
28
What is the pathogenesis and end result of chronic hepatitis?
* Path: * mononuclear infiltrate * Fibrosis * Necrosis * In chronic active, no anti-s or c Ab * End result: * cirrhosis * hepatocellular carcinoma
29
To what does EBV bind to enter B-cells?
CD-21
30
What proteins are expressed in EBV infection?
1. EB Nuclear Ag (EBNA) * EBNA-2 = cyclin D expression to stimulate cell cycle 2. latent protein 3. Latent membrane protein (LMP) * LMP-1 activates B-cells
31
What events are associated with transformation in EBV?
1. t8;14 w/ c-myc gene 2. LMP-1 activates B cells 3. EBNA-2 stimulates cyclin D and cell cycle progression
32
Patient presents with with fever, fatigue and pharyngitis. Lab tests are positive for heterophile Abs and the cells shown below. 1. What is the disease? 2. What is the cause? 3. How is it transmitted? 4. What is the cell called?
1. Mononucleosis 2. EBV 3. intimate contact (eg: saliva) 4. Downy cell
33
Pathogenesis of EBV
34
HPV 1. Transmission 2. Pathogenesis (molecular and cellular) 3. resulting disease
1. direct contact or inanimate objects with compromised skin 2. Path: * integrates dsDNA genome into host * E6 and E7 are expressed and inhibit cell cycle regulation * Hyperplasia of skin and cancer results * koilocytic changes to epithelium 3. Disease: * warts (Condyloma acuminatum) * cervical squamous cell carcinoma and adenoma
35
What is pictured?
Cervical squamous cell carcinoma Swirls are called keratin pearls
36
Which of the staphylococcus produce coagulase?
S. aureus
37
In S. aureus infection, 1. What inhibits opsonization? 2. What inhibits chemotaxis and phagocytosis 3. What is a common resistance? 4. What toxins are produced?
1. What inhibits opsonization? * Protein A 2. What inhibits chemotaxis and phagocytosis? * capsule/biofilm 3. What is a common resistance? * beta-lactamase 4. What toxins are produced? * alpha-toxin (cytolytic/necrosis) * Leukocidin (cytolytic for macrophage)
38
What super antigens are produced by S. aureus? What diseases do they cause?
1. Enterotoxins * food poisoning 2. Pyrogenic exotoxins (TSST-1) * Toxic shock syndrome 3. Exfoliatins * Scalded skin syndrome * impetigo
39
What is pictured?
Staphylococcus Characteristic grape-bunch formation
40
Patient presents with both fluid-filled blisters and crusts. Lab tests are catalase (+) and coagulase (+). * What is the disease? * What is the cause? * With what toxin is it associated?
* Bullous impetigo * S. Aureus * exfoliative toxin/epidermalytic toxin
41
Patient presents with a diffuse rash and flaccid bullae. Nikolsky's sign is positive (epidermis easily separates with slight pressure). Lab tests are catalase (+) and coagulase (+). * What is the disease? * What is the cause? * With what toxin is it associated?
* Scalded skin syndrome * S. aureus * exfoliative toxin
42
What is the difference between SIRS, sepsis, and septic shock?
* SIRS (systemic inflammatory response syndrome) * fever, increased WBC count, HR, respiration * No evidence of infection * Sepsis * same as above but with infection * Septic shock * same as above but with organ dysfunction and hypotensive shock (BP \<60)
43
Patient presents with fever, chills, petichiae, and heart murmur. Lab tests are positive for catalase and coagulase. * What is the disease? * What is the cause?
* Native valve infective endocarditis * S. aureus
44
Patient presents with acute onset of fever, dyspnea, tachypnea, and a mucopurulent sputum. Lab tests are positive for catalase and coagulase. * What is the disease? * What is the cause?
* Pneumonia * often hemorrhagic necrosis with absess/ pneumatocele formation * S. aureus
45
What connective tissue disorders are associated with S. aureus?
1. Osteomyelitis * bone destruction, pain, swelling, fever 2. Septic arthritis * local inflammation, pain, and swelling of one joint Both may progress to sepsis
46
Patient presents with fever, myalgia, rash, and erythema that blanches on pressure. Lab tests are positive for catalase and coagulase. * What is the disease? * What is the cause? * With what toxin is it associated?
* Toxic shock syndrome * S. aureus * TSST-1
47
What are the virulence factors of S. pyogenes?
1. M protein 2. Streptolysin S * O2 stable 3. Streptolysin O * O2 labile 4. SPEA * scarlet fever and strep toxic shock
48
Patient presents with pharyngitis and a rash that blanches with pressure with circum-oral pallor. After almost a week the rash desquamates. Lab tests are negative for catalase but show SPEA. * What is the disease? * What is the cause? * With what toxin is it associated?
* Scarlet fever * Strep. pyogenes * SPEA (exotoxin)
49
Patient presents with pharyngitis and a raised lesion with distinct borders on the face. Lab tests are catalase negative. * What is the disease? * What is the cause?
* Erysipela * Strep. pyogenes
50
Patient has history of papule that developed into vesicle, then pustule, and now has a thick, amber-colored crust. Lab tests are catalase negative. * What is the disease? * What is the cause?
* Impetigo * Strep. pyogenes
51
What is the most common cause of life-threatening invasive bacterial infection in neonates?
strep. agalactiae
52
Infant presents with respiratory distress, cyanosis, hypotension, and jaundice 10 hours after birth. * What is the disease? * What is the cause? * With what is it associated? * What are some complications?
* Early onset neonatal infection by Strep. agalactiae * Associated with obstetric complications * Complications: * septicemia (60%) * pneumonia (30%) * meningitis (10%)
53
Patient presents with septicemia and meningitis 2 weeks after birth. * What is the disease? * What is the cause?
* Late onset neonate infection by Strep. agalactiae
54
What infections are caused by strep. agalactiae in adults?
1. bacteremia/septicemia (30-40%) 2. skin and soft tissue (15-40%) 3. UTI (5-15%)
55
Streptolysin S or O is indicative of which bacteria?
Strep. pyogenes
56
Pneumolysin O is indicative of which bacteria? What is its function?
Strep. pneumoniae Function: cytotoxic; causes alveolar edema and hemorrhage
57
Patient presents with fever, chills, chest pain, and cough productive of rusty-colored sputum. There is consolidation of the lungs restricted to lobar compartments. * What is the disease? * What is the cause? * What is the composition of the infiltrate?
* lobar pneumonia * Strep. pneumoniae * neutrophils followed later by macrophages
58
What diseases are most commonly caused by Strep. pneumoniae?
1. **M**eningitis 2. **O**titis media 3. **P**neumonia 4. **S**inusitis \*\*Think MOPS
59
What are the virulence factors of Strep. pneumoniae?
1. capsule 2. pneumolysin O * O2-labile hemolysin that causes alveolar edema and hemorrhage
60
Patient presents with pharyngitis with an adherent pseudomembrane. * What is the disease? * What is the cause? * What is the pathogenesis?
* diphtheria * Corynebacterium diphtheriae * Path: * A-B exotoxin * B binds receptors, A inactivates EF-2 and inhibits protein synthesis
61
What severe manifestations can develop with diphtheria?
1. Myocarditis (with arrhythmia) 2. Neurologic symptoms * paralysis of soft palate
62
How does Listeria monocytogenes evade the immune system?
* Intracellular pathogen * spreads between cells without leaving a cell * forms actin tails (Act A surface protein induces actin polymerization) * forms projections that are injested by neighboring cells * Reduces MHC expression on host cell
63
How is Listeria monocytogenes transmitted? What is its path in the body (tissues affected)?
* Transmitted by * food * transplacentally * blood =\> CNS
64
What diseases are caused by Listeria monocytogenes?
* Gastroenteritis * Septicemia in pregnancy * Early neonatal infection * resp distress and sepsis * Late onset * meningitis * Purulent meningitis in adults * followed by seizures and movement disorders\*\*
65
Pregnant patient presents with fever, headache, myalgia and arthralgia. CSF shows increased monocytes. What is the disease? What is the cause?
Disease: septicemia Cause: Listeria monocytogenes
66
Patient presents shortly after birth with respiratory distress and sepsis. What is the cause?
Early-onset infection Listeria monocytogenes
67
Patient presents with fever, nausea, vomiting, and neck stiffness that lasts a few days followed by seizures and movement disorders. What is the disease? What is the cause?
* Disease: (purulent) meningitis * Cause: Listeria monocytogenes
68
Patient presents with abdominal pain, fever, chills, bloody diarrhea, and pharyngeal psudomembrane. Endospores are found in lab tests. What is the disease? What is the cause?
* Disease: intestinal anthrax * Cause: Bacillus anthracis Abdominal pain = mesenteric lymphadenitis Bloody diarrhea = GI necrosis Fever/Chills with shock = toxemia
69
Patient has a history of flu-like symptoms for the past few days. He now presents with fever, chills, and dyspnea. Imaging is shown below. What is the disease? What is the cause? What is its pathology?
* Disease: Inhalation anthrax * Cause: bacillus anthracis * Path: * Edema factor * Lethal factor * (Polyglutamic acid capsule = antiphagocytic) * Image: * left pleural effusion * **mediastinal widening**
70
Patient presents with a pustule with bluish-black fluid. Lab tests show endospores. What is the disease? What is the cause? What is the next step in the disease process?
* Disease: Cutaneous anthrax * Cause: Bacillus anthracis * Lesion will form a crusted, painless eschar
71
What are the exotoxins produced by Bacillus anthracis? What are their functions?
1. Edema factor * calmodulin-dependent adenylate cyclase * Increase cAMP * altered ion flux and hypersecretion 2. Lethal factor * metallopeptidase * Inhibits MAP kinase * apoptosis and necrosis
72
Patient presents with pneumonia. Abcesses and draining sinuses are found in the lungs. Brain abcesses are also found. Sulfur granules are found in the lesions and the organism is acid fast. The organism is shown below. What is the cause?
Nocardia asteroides gram stain shows filaments that branch
73
Patient presents with ankle and foot pain and swelling with abcess formation and draining sinuses. Sulfur granules are found in the lesions, and the organism is acid-fast. What is the disease? What is the cause?
* Disease: Madura foot * Nocardia brasiliensis
74
Patient presents with fever, headache, vomiting, leukocytosis, and petechiae along the waist where the top of the pants are. Lab results show thrombocytopenia. What is the disease? What is the cause? What are the associated virulence factors?
* Disease: meningococcemia * Cause: Neisseria meningitidis * Virulence factors * antiphagocytic capsule * LOS * proinflammatory * induces necrosis and DIC
75
Patient presents with sudden onset of fever, headache, nausea, and myalgia. What is the disease? What is the cause? What are the associated virulence factors?
* Disease: Meningitis * Cause: Neisseria meningitidis * Virulence factors * antiphagocytic capsule * LOS * proinflammatory * induces necrosis and DIC No seizure (w/ seizure = L. monocytogenes)
76
Neisseria meningitidis * Transmission * Virulence factors * Diseases and characteristic symptoms
* Transmission * inhaled * Virulence factors * antiphagocytic capsule * LOS * proinflammatory * induces necrosis and DIC * Diseases and characteristic symptoms * Meningococcemia * thrombocytopenia * sepsis with petechiae/ecchymoses (found where pressure is applied to skin, belts etc) * Meningitis * Myalgia * absence of seizure (Listeria monocytogenes)
77
Male patient presents with dysuria with a copious purulent exudate in addition to unilateral testicular pain and swelling. What is the disease? What is the cause? What are the associated virulence factors?
* Disease: Urethritis with epididymitis (genital infection in men) * Cause: N. gonorrheae * Virulence factors: * Pili (bind CD46 for adherance) * OPA (penetrate cell membrane)
78
Female patient presents with cervicitis with a purulent vaginal discharge and dysuria. What is the disease? What is the cause? What severe complications can result?
* Disease: Cervicitis and urethritis (female genital infection) * Cause: Neisseria gonorrheae * Complications: * Pelvic inflammatory disease * Lower genital tract infection * **infertility**
79
Neisseria gonorrhea * What are the virulence factors? * What diseases does it cause?
* Virulence factors: * Pili (bind CD46 for adherance) * OPA (penetrate cell membrane) * Disease: * Genital infection
80
Patient presents with paroxysmal cough with inspiratory whoops. Lab shows lymphocytosis. What is the disease? What is the cause? What are the associated virulence factors?
* Disease: whooping cough * Cause: Bordetella pertussis * Virulence factors: * Pertussis toxin * Invasive adenylate cyclase
81
Bordetella pertussis * Virulence factors and function * Stages of disease
* Virulence factors (delivery by type III secretion) * Invasive adenylate cyclase: increases cAMP * in phagocytes, inhibits phagocytic activity * pertussis toxin: ribosylates G-proteins causing increased cAMP * increased secretions, histamine sensitization, lymphocytosis, necrosis * Disease: Whooping cough * Catarrhal stage: flu-like symptoms * rhinorrhea, fever * Paroxysmal cough stage
82
Patient presents with sepsis with the necrotic lesions shown below. What is the disease? What is the cause?
* Disease: Sepsis with characteristic ecthyma gangrenosum * Cause: pseudomonas aeruginosa
83
Psuedomonas aeruginosa * Virulence factors * Diseases
* Virulence factors: * **Pyocyanin pigment** (proinflammatory, produce ROS) (characteristic) * LPS * Capsule/glycocalyx/biofilm (resist phagocytosis, opsonization, antibiotics) * heat-labile hemolysin * Exotoxins A and S (protein synthesis) * Antibiotic resistance * Disease * necrotizing pneumonia * especially in cystic fibrosis patients (incurable, associated with biofilm) * Sepsis with ecthyma gangrenosum * Wound and burn infection * Folliculitis (hot tub folliculitis) * External otitis * Keratitis * nosocomial UTI
84
What is the characteristic virulence factor of pseudomonas?
Pyocyanin pigment
85
What bacteria is associated with pneumonia in cystic fibrosis patients?
Pseudomonas aeruginosa
86
Patient presents with abrupt onset of high fever, chills, and headache. Physical exam shows painful lymphadenopathy. What is the disease? What is the cause? How is it transmitted? What are the complications/progression of the disease?
* Disease: bubonic plague * Cause: Yersinia pestis * Transmission: flea bite, prarie dogs * Progression * Pneumonic plague (hemorrhagic and necrotizing) * Septicemic plague (endotoxemia, DIC, vascular collapse)
87
Patient presents with genital ulcer and inguinal lymphadenitis with a draining sinus tract. What is the disease? What is the cause?
* Disease: Chancroid * Cause: Haemophilus ducreyi * Helps transmit HIV
88
Patient presents with fever, hemoptysis, and chest pain. The patient is PPD+. What is the disease? What is the cause? What is the pathogenesis?
* Disease: Progressive Primary TB * Cause: Mycobacteria tuberculosis * Path: Th1 hypersensitivity reaction.
89
Patient presents with fever, night sweats, weight loss, and hemoptysis. New lesions are found on the lungs localized to the apex of the upper lobes. The patient is PPD+. What is the disease? What is the cause?
* Disease: Secondary TB * Mycobacteria tuberculosis
90
Patient presents with mild pneumonitis with flu-like symptoms. Chest radiography shows hilar adenopathy and subpleural granulomas. Patient is PPD+. What is the disease? What is the cause? What is the presentation shown on radiography called?
Disease: Primary TB Cause: Mycobacteria tuberculosis Presentation: Ghon complex
91
Patient is PPD+ and presents with the lesions on the spleen as shown below. What is the disease? What is the cause?
* Disease: Miliary TB * Mycobacteria tuberculosis
92
Mycobacteria leprae * Cellular Pathology * Disease
* Pathology * strict intracellular parasite * macrophages and schwann cells * Capsule: glycolipid and lipoarabinomannan * Induces TLR on schwann cells * TLR binds lipopeptides of M. leprae and induce apoptosis * rapid demyelination of peripheral nerves * CMI (Th1) mediates early damage * Th2 mediates late damage (lepromatous) * Disease: Leprosy
93
Patient presents with few hypopigmented, anesthetic lesions in addition to skin and muscle atrophy. What is the disease? What is the cause? What is the predominant immune response?
* Disease: Tuberculoid leprosy (hansen disease) * Cause: Mycobacteria leprae * Response: Th1 (CMI)
94
Patient presents with bilateral, symmetrical distribution of papules and nodules with peripheral neuropathy and hypergammaglobulinemia. What is the disease? What is the cause? What is the primary immune response at this stage?
* Disease: Lepromatous leprosy * Cause: Mycobacteria leprae * Response: Th2 (humoral)
95
Patient presents with an inflammatory lesion shown below and inguinal lymphadenopathy. What is the lesion called? What is the disease? What is the cause?
* Lesion = chancre * Primary syphilis * Treponema pallidum
96
Patient presents with fever, headache, arthralgia, and sore throat. There are crusted lesions on the skin and a genital lesion shown below. No bugs were grown on culture. What is the lesion called? What is the disease? What is the cause?
* Lesion: condylomata lata * Disease: Secondary syphilis * Cause: Treponema pallidum Not able to be grown on culture
97
Which form of syphilis presents with generalized seizures? What is the cause of the seizures?
Meningovascular syphilis seizures caused by endarteritis obliterans, causing occlusion of vessels to the CNS
98
Which form of syphilis presents with changes in personality, tremors, ataxia, and other CNS signs?
Parenchymatous syphilis (late/tertiary) General paresis and Tabes Dorsalis
99
Which form of syphilis causes aneurysm of the ascending aorta?
Cardiovascular syphilis endarteritis obliterans occludes aorta
100
What is the difference between early and late congenital syphilis?
Early: * Before age 2 * vesicular rash and systemic signs Late: * After age 2 * CNS problems * bone development issues * periostitis * osteochondritis * Hutchinson teeth (small, notched incisors)
101
Treponema pallidum * Transmission * characteristics * Evasion of immune system * Disease
* Transmission * close contact or transplacental * characteristics * gram negative * Doesn't grow on lab medium * Evasion of immune system * coated with host fibronectin * inhibits phagocytosis * Disease * syphilis
102
Patient has a history of fever, chills, headache, and myalgia, which went away for almost a week before returning. Presents with hepatosplenomegaly. A blood smear is shown below. What is the disease? What is the cause? What is the vector?
* Disease: Relapsing fever * Cause: Borrelia hermsii * Vector: tick
103
What are the vectors that carry Borrelia recurrentis and B. hermsii?
* Recurrentis: lice * most common in S. America * Hermsii: ticks * most common in western US
104
During first visit, patient presents with skin lesions and facial nerve palsy. A few weeks later, he returns with arthritis of the large joints. What is the disease? What is the cause? What is the vector?
* Disease: Lyme disease * Cause: Borrelia burgdorferi * Vector: deer tick
105
What are the stages of lyme disease progression?
106
What is characteristic of infections caused by anaerobes?
abscess formation with foul-smelling exudate
107
What infections are caused by anaerobic, non-spore forming gram positive cocci (streptococcus)?
1. Brain abcess 2. Aspiration pneumonia 3. Intra-abdominal infection 4. Female pelvic infection
108
P. acnes * Characteristics * Disease
* Characteristics * gram positive rod * non-spore forming * anaerobe * Disease: * acne vulgaris
109
Bacteroides fragilis * Characteristics * Diseases
* Characteristics * anaerobic * gram negative rod * Diseases: * intra-abdominal infection * anaerobic bacteremia * Community acquired gastroenteritis
110
Patient presents a green-black lesion with visible gas formation following trauma. What is the disease? What is the cause (physiological and organism)?
* Disease: myonecrosis (gas gangrene) * Physiology: * extensive muscle necrosis * Organism: * Clostridium perfringens
111
What exotoxins are produced by Clostridium perfringens?
* alpha-toxin * necrosis * hepatic tox * myocardial dysfunction * beta-toxin * enteritis necroticans (necrosis and HTN) * theta-toxin * pore-forming hemolysin
112
Patient presents with lockjaw and spastic paralysis. What is the disease? What is the cause? What is the mechanism of disease?
* Disease: Tetanus * Cause: Clostridium tetani * Mechanism: * tetanospasmin neurotoxin degrades synaptobrevin * blocks release of inhibitory neurotransmitters
113
Patient presents with bilateral cranial nerve dysfunction (dry mouth, blurred vision, diplopia, difficulty swallowing) and symmetric descending weakness and paralysis. What is the disease? What is the cause? What is the mechanism of disease?
* Disease: Botulinum tox? * Cause: Clostridium botulinum * Mechanism: * neurotoxin inhibits ACh release from cholinergic synapses * paralysis or autonomic dysfunction
114
Patient presents with fever, abdominal pain, and profuse bloody diarrhea with characteristic inflammatory plaques and ulcerations. What is the disease? What is the cause? What toxins are produced?
* Disease: pseudomembranous entercolitis * Cause: Clostridium difficile * Toxins: * enterotoxin A: fluid secretion * cytotoxin: actin depolymerization and cell death
115
Patient presents with inguinal lymphadenopathy with a painful node that ruptured forming a draining sinus. Lab tests find elementary and reticulate bodies in cells. What is the disease? What is the cause?
* Disease: Lymphogranuloma venereum * Chlamydia trachomatis * Serotypes L1-3
116
Patient has history of follicular conjunctivitis with some scarring of the cornea. Presents with eyelashes that have grown inward, causing more corneal scarring. What is the disease? What is the cause?
* Disease: Trachoma * Cause: Chlamydia trachomatis * Serotypes A, B, C
117
Patient presents with conjunctivitis and a urogenital infection with dysuria and a moderate purulent discharge. Lab tests show intracellular elementary and reticulate bodies. What organism causes this disease?
Oculogenital disease Chlamydia trachomatis Serotypes D-K
118
Patient presents with fever, heachache, myalgia, vomiting, and diarrhea. CSF lymphocytosis and confusion are also present. Inclusions are found in monocytes. What is the disease? What is the cause? What is the vector?
* Disease: human monocytic ehrlichiosis * Cause: Ehrlichia chaffeensis * Vector: lone star tick
119
Patient presents with fever, headache, myalgia, vomiting, and CNS manifestations. Inclusions are found in neutrophils (monocytic cells). What is the disease? What is the cause? What is the vector?
* Disease: Human granulocytic anaplasmosis * Cause: Anaplasmosis phagocytophilum * Vector: Deer ticks
120
Patient presents with abrupt onset of fever, headache, and myalgia. A macular rash with petechiae began on the wrists, palms, and ankles and has now become generalized. What is the disease? What is the cause? What is the vector?
* Disease: Rocky Mountain spotted fever * Cause: Rickettsia rickettsii * Vector: wood or dog tick
121
Common characteristics of Candida infection of mucous membrane
* pseudomembrane * Oral candidiasis * Genital (with burning, itching, purulent discharge) * Esophagitis (difficulty swallowing)
122
Patient presents with erythematous, dry, scaly, pruritic lesions of the skin. Labs show germ tubes. What is the disease? What is the cause?
* Disease: Intertriginous candidiasis * Cause: Candida albicans * may have germ tubes or pseudohyphae
123
Patient presents with a fever and cough productive of mucoid, bloody sputum. Labs show pseudohyphae and budding yeasts, shown below. What is the disease? What is the cause?
* Disease: Bronchopulmonary candidiasis * Cause: Candida albicans * May have germ tubes or pseudohyphae
124
What systemic diseases can be caused by Candida infection?
1. esophagitis 2. GI candidiasis 3. Fungemia 4. Bronchopulmonary candidiasis 5. UT 6. Endocarditis 7. Hepatosplenic candidiasis 8. CNS candidiasis
125
Which fungus has a capsule?
Cryptococcus neoformans
126
Cryptococcus neoformans * Virulence factors * Diseases
* Virulence factors * Capsule (only fungus with this) * block T cell activation * Inhibits phagocytosis * Melanin * protect from UV damage * Diseases: * Acute pulmonary * Skin lesions * CNS infection: meningoencephalitis * soap-bubble lesion
127
Patient presents with long history of sinus congestion and pain. Microscopy shows thin, septate hyphae with acute angle branching. What is the disease? What is the cause?
* Disease: Aspergilloma (fungus ball in sinuses) * Cause: Aspergillus
128
Patient presents with persistent productive cough, hemoptysis, wheezing, and dyspnea. Microscopy shows thin, septate hyphae with acute angle branching. What is the disease? What is the cause?
* Disease: Aspergilloma in lungs * Cause: Aspergillus
129
Aspergillus * Characteristics * Diseases
* Characteristics: * soil fungus * septate, acute angle branching hyphae * Disease: * Allergic bronchopulmonary aspergillosis * Aspergilloma (sinus or lung) * Invasive pulmonary aspergillosis
130
Patient presents with facial pain, edema, and orbital cellulitis. Patient also has diabetes. Microscopy shows fungi with non-septate filaments with right-angle branching. What is the disease? What is the cause?
* Disease: Rhinocerebral mucormycosis * Cause: mucormycosis
131
Mucormycosis * Characteristics * Diseases
* Characteristics * soil fungi * nonseptate filaments with right-angle branching * Disease limited to immunocompromised and diabetics * Disease: * Rhinocerebral: skin and possible brain involvement * Pulmonary: necrotic pneumonia * Cutaneous: Cellulitis
132
In the plasmodium life cycle, what is sporogony? What is schizogony? Where does each stage take place?
* Sporogony = sexual cycle * occurs in mosquito * Schizogony = asexual cycle * occurs in human
133
In the plasmodium cycle, which form infects hepatocytes? RBCs?
* Hepatocytes: infected by sporozoites * occurs before RBC can be infected * RBCs: infected by merozoites
134
In the Plasmodium life cycle, which stage can remain dormant in the liver? Which forms of plasmodia produce this life cycle stage?
Hypnozoites Formed by P. vivax and P. ovale
135
Plasmodium life cycle: Sporogony
136
Plasmodium life cycle: Schizogony
137
What is the malaria paroxysm? To which step in the life cycle does it correspond?
* Chills and rigors followed by fever spikes up to 104 F * Later profuse sweating and fatigue * Corresponds to release of merozoites from rupturing schizonts (RBC lysis)
138
What are the pathology and symptoms of infection by Plasmodium falciparum?
Path: * Malaria with microvascular disease * trophozoite-infected RBC adheres to endothelium of microvasculature * hypoxia with obstruction Symptoms * Malaria paroxysm * Hypoglycemia (from parasite feeding) * Hemoglobinuria * Blackwater fever * May progress to Seizures and coma
139
Patient presents with gradual onset of fever and fatigue, followed by hemolytic anemia. Organisms are found in RBCs in the forms of rings and triads. What is the infecting organism? What is the vector?
* Cause: Babesia microti * Vector: tick
140
Patient presents with an ulcerative "pizza" lesion. What is the infectious agent? What are the two forms of this agent? What is the vector?
* Cause: Leishmania * Vector: Sandfly (only of promastigote) * Forms: * promastigote: free-living, transmitted * amastigote: intracellular form, in reticuloendothelial tissue
141
What are the two life stages of Leishmania?
* promastigote: * free-living * transmitted by sand fly * amastigote: * intracellular form * reticuloendothelial tissue
142
Patient presents with fever, chills, facial edema, lymphadenopathy, and myocarditis. What is the disease? What is the infectious agent?
* Disease: Chagas * transmitted by reduviid (kissing) bug * Cause: * Trypanosoma cruzi
143
Trypanosoma cruzi * Transmission vector * Life cycle * Disease * Complications
* Transmission vector * Reduviid (kissing) bug * Life cycle * trypomastigote: free-living in blood * amastigote: intracellular, parasitizes myocardium * Disease * Chagas * Complications * CHF
144
Trypanosoma brucei * Vector * Life Cycle * Disease
* Transmission vector * Tsetse fly * Life cycle * only one stage * trypomastigotes are free form and replicate in blood * Disease * African sleeping sickness
145
Schistosoma: mansoni vs haematobium * Type of helminth * Path (same for both) * Infected tissue
* Fluke (flat w/ branching alimentary tracts) * Path: * Formation of granulomas around eggs * Fibrosis * Infected tissue: * Mansoni: GI and liver * Haematobium: Bladder
146
What are the differences between Nematodes, Cestodes, and Trematodes?
* Nematodes (roundworms) * cylindrical body * tubular GI tract * sexes are separate * Cestodes (tapeworms) * flattened bodies * no GI tract * both sex organs in same organism * Trematodes (flukes) * flattened bodies * branching GI
147
Patient presents with lymphadenopathy and lymphedema in the legs. Epithelial hyperkeratosis has left the leg scaly. What is the disease? What are the possible infectious agents?
* Disease: * Lymphatic filariasis with elephantiasis * Infectious agents: * Wuchereria bancrofti (Tropics) * Brugia malayi (SE Asia)
148
Patient presents with an itchy dermatitis associated with a granulomatous reaction that develops around adult worms. There is also keratitis of the cornea. Samples show worms with cylindrical bodies. What is the disease? What is the infectious agent? Where are larvae found?
* Disease: Onchoceriasis (river blindness) * Cause: Onchocerca volvulus * Larvae: in connective tissue of skin

Pathology (27 decks)

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