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Path Exam 2 > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

1
Q

describe the etiology of the disease seen in the image

A
  • etiology:
    • inhalation of spores in bird and bat droppings (caves)
      • Ohio, Appalachia, Mississippi River Valley
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2
Q

describe the most specific test for the condition seen in the image

A

latex agglutination test using antibodies = most specific

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3
Q

____ causes the disease seen in the image

A

Streptococcal pneumonia causes lobar pneumonia in healthy young adults exposed to cold, strain, exhaustion

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4
Q

describe the populations most at risk for the disease seen in the image

A

children, elderly, bedridden, immunocompromised, hospitalized

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5
Q

describe the investigations for the disease seen in the image

A
  • investigation:
    • histoplasma antigens in blood and urine by PCR
    • biopsy: intracellular organism
      • acute = in PMNs
      • chronic = budding yeast in macrophages (increased pH to survive)
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6
Q

describe the pathogenesis of the disease seen in the image

A
  • pathogenesis:
    • inhalation of spores → tropism for endothelial cells of blood vessels → angio-invasive → disseminated → endothelial damage → thrombosis → ischemia → hypoxia
      • most common in cerebral hemispheres: red infarct
      • lung, GI, sinuses
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7
Q

describe the etiology of the image

A
  • etiology: S. aureus and S. pyogenes
    • contact with fomites, patients with poor hygiene
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8
Q

describe the etiology of the disease seen in the image

A

Rocky Mountain Spotted fever (viral)

  • etiology: Rickettsia rickettsii (obligate intracellular bacteria)
    • transmitted by tick bites (seen mainly in campers/hikers)
    • predilection for endothelial cells and smooth muscles of arterioles
    • perivascular inflammatory infiltrate: macrophages, lymphocytes and plasma cells
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9
Q

describe the pathogenesis of the disease seen in the image

A
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10
Q

describe the immune cells found in the disease seen in the image

A
  • infiltration of PMNs + lymphocytes + monocytes + giant cells (mixture of acute + chronic in all fungi)
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11
Q

describe the images seen

A
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12
Q

describe the complications of the disease seen in the image

A
  • may lead to abscesses, empyema
    • caused by Klebsiella followed by S. aureus
  • complications: sepsis, DIC, lung abscess, empyema, pleural fibrosis
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13
Q

describe the location on the body of the disease seen in the image

A
  • oral thrush: gray-white, dirty gray pseudomembrane
  • esophagitis: seen in AIDS and hematolymphoid malignancies
  • vaginitis: seen in diabetes, pregnancy, oral contraceptive pills
    • itching, soreness, redness, thick (creamy cheese) discharge
  • skin infxn: onychomycosis, paronychia, folliculitis, balanitis, diaper rash
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14
Q

describe the acute vs chronic form of the disease seen in the image

A
  • acute: in immunocompromised patients
    • contained in the lungs; see PMNs
    • asymptomatic or flu-like
  • chronic: presents exactly like TB
    • fever, weight loss, cough with hemoptysis
    • immunocompetent: caseating granuloma (like TB) mostly in upper lobe
      • difference on CXR = multiple foci (buckshot dystrophic calcification)
      • TB only has one focus but x-ray is identical to that of miliary TB
    • immunocompromised pts: disseminated bc cannot form a granuloma to contain it in the lungs
      • go to cells of RES → lymphadenopathy, splenomegaly, hepatomegaly, bone marrow suppression (pancytopenia)
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15
Q

describe the prognosis of the disease seen in the image

A
  • prognosis: based on site of bite (distance from bite site to brain determines prognosis)
    • leg bite has better prognosis than neck bite
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16
Q

describe the etiology of the disease seen in the image

A
  • etiology: RNA virus → bite by bat, dogs, raccoons, foxes, skunks
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17
Q

which cells are found in the locations affected with the disease seen in the image?

A

PMNs + lymphocytes + monocytes + giant cells (mixture of acute + chronic in all fungal infxns)

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18
Q

impetigo causes direct damage via enzymes _____ and spreads by _____

A

impetigo causes direct damage via enzymes hyaluronidase and collagenase and spreads by fomites

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19
Q

the proclivity of ___ to invade the ___ directly sets it apart from other fungi which reach the ___ by hematogenous dissemination from distant sites

A

the proclivity of Mucor to invade the brain directly sets it apart from other fungi which reach the brain by hematogenous dissemination from distant sites

  • Mucor may spread to the brain through vascular invasion or by direct extension through the cribriform plate
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20
Q

describe the organs affected by the disease seen in the image

A
  • most common CMV in AIDS patients: retinitis (CMV retinitis) → cotton wool appearance
    • can also affect lungs (interstitial “atypical” pneumonia), GI (esophagitis), gastritis, duodenitis, colitis
    • most common complication of CMV in organ transplant or kidney/liver → CMV nephritis/hepatitis
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21
Q

describe the presentation of the disease seen in the image

A
  • presentation: loss of consciousness/stupor, hydrophobia, spasms of pharyngeal muscles, respiratory failure (#1 cause of death bc it interferes with respiratory areas in brainstem)
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22
Q

describe the etiology of the disease seen in the image

A

Coxsackie A or B (virus)

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23
Q

describe the etiology of the disease seen in in the image

A
  • Zygomycetes: Mucor, Rhizopus, Absidia
    • opportunistic fungi in all immunocompromised
    • prevalent in pts with DKA bc low pH favors growth of organism & availability of glucose
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24
Q

describe the investigations for the disease seen in the image

A
  • investigation: Tzanck smear = scrape vesicle and stain with Giemsa to visualize Tzanck cells (multinucleated giant cells) in syncytia formation
    • intranuclear eosinophil inclusions = Cowdry type A
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25
Q

describe the investigation for the disease seen in the image

A
  • investigation:
    • bronchoalveolar lavage & stain with silver stain
      • black cup-shaped cyst
26
Q

describe the investigation for the disease seen in the image

A
  • urine sample, PCR for virus DNA, antibody titers
    • cytopathic effects (inclusions): cytomegaly (enlarged cell and nucleus), formation of intranuclear basophilic inclusions (Owl’s eyes), intracytoplasmic inclusions which are mostly basophilic
27
Q

describe the complications for the diease seen in the image

A
  • complication:
    • dilated cardiomyopathy = swollen and can’t pump blood
    • arrhythmias and heart failure if affects conduction fibers
28
Q

describe the pathogenesis of the disease seen in the image

A
  • no ischemia
  • combination of direct damage by virus and damage via immune response/lymphocytic infiltration
    • more damage done by immune system (indirect damage, CTL cells)
29
Q

describe the investigation for the disease seen in the image

A
  • investigation: PCR (virus) after endomyocardial biopsy
    • note: PCR almost always best for viruses
30
Q

describe the presentation of the disease seen in the image

A
  • presentation (1 week after bite): fever, headache, myalgia and vasculitic rash (starts from extremities and moves inward/proximal)
    • can go to lung or brain and cause endothelial damage → thrombus
    • skin: hypoxia → ischemia → gangrene
    • brain: stroke/red infarct
    • lung: red infarct
31
Q

describe the pathogenesis of the disease seen in the image

A
  • inhalation of respiratory droplets → chicken pox → varicella zoster dormant in DRG → activates when immunocompromised
    • unilateral painful vesicles which follow a single dermatome
32
Q

which patients are most at risk for the disease shown in the image?

A
  • opportunistic: diabetic pts, immunocompromised (AIDS) and patients on broad-spectrum antibiotics
    • invasive form can disseminate → abscesses
33
Q

describe the pathogenesis of the disease seen in the image

A
  • pathogenesis:
    • spores in pigeon droppings → inhalation → granulomas with giant cells
      • usually involve lungs and brains
      • inflammatory reaction is absent due to inert capsule
      • if disseminated → meningitis
        • NO fever or neck stiffness (bc no inflammation) but WILL see headache, increased intracranial pressure, projective vomiting, photophobia
34
Q

describe the presentation of disease in the image

A
  • presentation: honey-colored crusts on face
35
Q

describe the spread of the disease seen in the image

A
  • contracted via body fluids (transplacental, saliva, urine, breast milk, blood transfusion) and organ transplant or vertically transmitted
36
Q

describe the presentation for the disease seen in the image

A
  • presentation:
    • sero-sangrenous nasal discharge, fever, pain and headache & rhino-facial-palatal necrosis
37
Q

describe the presentation of the disease seen in the image

A
  • fever, pleuritic chest pain worse on inspiration, dyspnea, productive cough with bloody sputum
38
Q

describe diagnostic tests for the disease seen in the images

A
39
Q

describe a differential for the disease seen in the image

A
  • R. prowazeki: causes epidemic typhus (via lice)
    • loves endothelial cells and causes thrombosis
    • difference in rash; starts from trunk and spreads out
  • Coxiella Burnetti (Q-fever): Negative Weil-Felix test but immunofluorescent
    • no skin rash & ring granuloma on liver biopsy (fat surrounded by epithelioid cells)
40
Q

describe the etiology of the disease seen in the image

A
  • inhalation of aspergillus (mycelial form)
    • no effect in immunocompetent
    • A. flavus = aflatoxin & A. fumigatus = gliotoxin
41
Q

describe the presentation and outcome of the disease seen in the image

A
  • presentation: flu-like or asymptomatic
  • common outcome: complete resolution
42
Q

describe the course of the disease shown in the picture

A
  • superficial skin infxn affecting only epidermis → complete resoultion (no fibrosis)
    • S. pyogenes impetigo: 2 weeks after can have hematuria and decreased urinary output (oliguria) → post-streptococcal glomerulonephritis
43
Q

describe the presentation of the disease seen in the image

A
44
Q

describe the definitive diagnosis of the disease seen in the image

A
  • definitive diagnosis: made on autopsy (Negri bodies - intracytoplasmic eosinophilic inclusions found in neurons)
    • not PCR because the virus is found in the neurons
45
Q

describe the image seen

A
46
Q

describe the presentation of the disease seen in the image

A
  • depends on organ (transplant affects organ, AIDS patient effects retina more often)
    • tropism for endothelial cells
    • intracranial calcifications
    • polyclonal B cell activator
    • immunocompetent: infectious mononucleosis
47
Q

the disease seen in the image is caused by _____

A

lobular bronchopneumonia is caused by Klebsiella, E. coli, Pseudomonas, Staph

48
Q

describe diagnosis of the disease seen in the image

A
  • squamous epithelium → stain with PAS, silver stain, mucicarmine
    • budding yeast with pseudohyphae (Chinese letter appearance)
49
Q

describe the pathogenesis of the disease seen in the image

A
  • URT infxn → acute bronchitis → spread of inflammatory exudate to adjacent alveoli → destruction of bronchioles & alveoli
    • no macrophages in bronchioles to clean up the debris → scarring
50
Q

the disease shown in the image mainly affects ___

A

the disease shown in the image mainly affects AIDS patients (CD4 <200)

51
Q

describe the pathogenesis of the disease seen in the image

A
  • pathogenesis:
    • aspergilloma (fungal ball): colonize a pre-existing cavity from TB or lung abscess (pneumonia)
    • allergic bronchopulmonary aspergillosis: type I and type III hypersensitivity
      • seen in pts with bronchial asthma → inhale → colonizes → causes wheezing, dyspnea, productive cough and fever → exacerbation of asthma
    • disseminated aspergillosis: angio-invasive → ONLY in immunocompromised
      • invades blood vessel wall → thrombosis → coagulative necrosis
      • most common organs = brain and lung → stroke and necrotizing pneumonia
52
Q

describe the locations where the disease in the image can be found

A
  • GOAT regions: Georgia, Oklahoma, Alabama, Tennessee
53
Q

describe the images seen

A
54
Q

summarize the differences between lobar pneumonia and bronchopneumonia

A
55
Q

describe the spread of the disease seen in the image within the body

A
  • virus spreads from PNS to CNS via retrograde axonal transport
56
Q

describe investigations for the disease seen in the image

A
  • Best investigation = skin biopsy with immunofluorescent staining
  • 2nd best = Positive Weil-Felix test (latex agglutination test)
    • indirect test → looks for antibodies
57
Q

describe investigations for the disease seen in the image

A
  • investigation:
    • stain with PAS, silver, mucicarmine
      • slender organisms, septate hyphae that branch at acute angles
58
Q

describe the immune cells found in the disease seen in the image

A

infiltration of PMNs + lymphocytes + monocytes + giant cells (mixture of acute + chronic in all fungi)

59
Q

describe the etiology of the disease seen in the image

A
  • etiology:
    • found in spores in pigeon droppings → opportunistic infxn in immunocompromised HIV patients (CD4 <100)
60
Q

describe the presentation of the disease seen in the image

A
  • presentation:
    • fever, dyspnea on exertion, dry cough (because produces “cotton candy” exudate in alveolar space → not able to produce sputum) & interstitial pneumonia → inflammation and thickening of alveolar wall w/ sparse mononuclear infiltrate

Path Exam 2 (4 decks)

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