Infectious/Fungal Flashcards
farcy buds
Glanders
infection caused by contact with infected horses
Glanders
Burkholderia mallei
Glanders
Ulcerated nodule at inoculated site with regional lymphadenopathy, plus little nodules along the lymph nodes
-nasal septal perforation
Glanders (*and those little buds along side the lypmh nodes are called farcy buds)
Undulant fever
Brucellosis
Malta fever
Brucellosis
infection cause by direct contact with infected animal or ingestion of dairy (unpasterized) infected meat
Brucellosis
- infection seen in butchers, farmers, vets
- cyclic fevers, arthralgias, hepatosplenomegaly with sometimes a papulonodular eruption
- direct contact with meat or dairy unpasterized milk
Brucellosis
The plaque is transmitted by what animal
flea bites
inflammatory skin plaque in the urinary tract which turns into a weeping or polypoid mass
Malakoplakia
Michaelis-Guptmann bodies (von-Hansemann cells)
Malakoplakia
fistulous tract in the groin plus von hansemann cells and michaelis-gutmann bodies
Malakoplakia
Hebra nose
Rhinoscleroma
Infectious granulomas in nasal mucosa and respiratory tracat, epistaxis, destruction of nasal cartilage
Rhinoscleroma
Mikulicz cell, Russel bodies
Rhinoscleroma
Haverhill fever
rate bite fever
Streptobacillus moniliformis
Rat-Bite fever
Pasteurella multocida
Cat bite
Capnoctytophaga canimorsus
Pasteurella canis
Pasturpella multocida
Dog bite
Eikenella corrodens
Human bite
Gram negative intracellular bacteria
Transmitted by insects
Adheres to and invades erythrocytes
Bartonella
Bacteria causing Oroya fever
Bartonella bacilliformis
other name for Carrions disease
Oroya Fever
another name for Peruvian wart
Oroya Fever
What is the vector for Oroya fever?
sandfly (Lutzomyia verrucarum)
What is the name of the vector for Oroya fever?
Lutzomyia verrucarum (sandfly)
Lutzomyia verrucarum
sandlfl\y that is the vector for Oroya fever
first, a fever and a hemolytic anemia
then, erythematous papules and nodules which resol\ve spontaneously
Oroya fever
Verruga paruana
The chronic stage of Oroya fever
What do you treat Oroya fever with?
Chloramphenicol
Bartonella infection associated with fever in Peru
Oroya fever
Term for infection of raw seafood eating
Vibrio
Bartonella henselae causes what disease?
Cat scratch disease
Vector for cat scratch disease?
cat flea (Ctenocephalides felis)
Ctenocephalides felis
the cat flea, vector in cat scratch disease
Cat scratch disease is caused by what bacteria?>
Bartonella henselae
Cat scratch disease can also cause what syndrome in common with sarcoid?
Parinaud oculoglandular syndrome : unilateral conjunctivitis and regional lymphadenitis
*sidenote tularemia can cause this too!!
What syndrome can be caused by cat scratch disease, tularemia, and sarcoid?
Parinaud oculoglandular syndrome (ipsilateral conjuncitivis and regional lymphadenopathy)
what infectious disease do hunters get?
Tularemia
Erythematous tender papules and nodules resembling multiple PGs, seen mainly in HIV patients
Bacillary angiomatosis
Bacteria that causes bacillary angiomatosis
Bartonella quintana
Bartonella henselae
Bartonella quintana
Bacillary angiomatosis
Vector for Bacillary angiomatosis
lice, ticks, fleas
Shinebone fever also called
Trench fever
Bacteria causing Trench fever
Bartonella quintana
Name the four conditions associated with Bartonella infection
- Ororya fever (fever, hemolytic anemia)
- Cat scratch disease (lymphadenitis after cat scratch)
- Bacillary Angiomatosis (lots of PGs, in HIV pts)
- Trench fever (relapsing fever, sore shins, back pain, transient rash)
A patient has sore shins, relapsing fever, back pain, transient rash
Trench fever
Vector for trench fever
body louse (Pediculus humanus var. corporis)
What does the body louse Pediculus humanus also cause besides Trench fever?
Epidemic typhus
Relapsing fever
Name two diseases that the body louse (Pediculus humanus) is a vector for:
Trench fever
&
Endemic typhus
What two bacteria is the body louse (Pediculus humanus) a vector for?
Bartonella quintana (Trench fever) & Rickettsiae prowazekii (Endemic Typhus)
Name the bacteria and vectors for all of the bartonella causing diseases:
- Oroya fever - bartonella bacilliformis - sandfly(Lutzomyia verrucarum)
- Cat scratch disease - bartonella henselae - cat flea(ctenocejphalidis felis)
- Bacillary angiomatosis - bartonella henselae, quintana - ticks, lice, fle
- Trench fever - bartonella quintana - body louse (pediculus humanas)
What bacteria causes syphilis?
Treponema pallidum
what stage of syphilis is the chancre?
primary stage
how many weeks after primary stage of syphilis does secondary stage happen?
9 weeks
what stage syphilis is the maculopapular rash?
second
stage of syphilis: mucous patches
second
stage of syphilus: lues maligna
second
stage of syphilus: alopecia
second
stage of syphilus: condyloma lata
second
Name the findings of the second stage of syphilus
Maculopapular rash Condyloma lata Lues maligna alopecia mucous patches
Lues maligna
crusted necrotic papulopustular lesions in second stage of syphilus
stage of syphilus:gumma
tertiary
how long after initial infection does the tertiary stage of syphilis happen
3-5 years
stage of syphilis: cardiovascular
tertiary
stage of syphilis: neurosyphilus
tertiary
Argyll Robertson pupil
Tertiary syphilius
tabes dorsalis
tertiary syphilis
Name the findings in the tertiary stage of syphilis
Gumma (syphilitic granulomas)
cardiovascular syphilis
Neurosyphilis (tabes dorsalis, Argyll Robertson pupil)
Jarish-Herxheimer reaction
febrile systemic reaction after the inital dose of antisyphilitic treatment, occurs in abt 75% of patients
-mediated by TNF-alpha
What cytokine is the Jarisch-Herxheimer reaction mediated by?
TNF-alpha
A patient treated for syphilis with IM benzathine PCN, and then gets an intense febrile reaction - what happened?
Jarish-Herxheimer reaction
what is the most sensitive test for primary syphilis?
FTA-ABS
fluorescent treponemal antibody absorption test
which syphilis test remains positive even after treatment?
and which one doesnt?
remains positive after treatment: FTA-ABS
doesnt: RPR,VDRL
how long after infection with primary syphilis will the FTA-ABS test become positive?
3 weeks
Which syphilis tests become nonreactive over time, and especially after treatment?
The non-treponemal test (RPR, VDRL)
which syphilis tests can you get false positive results with? (i.e. are also positive in many other diseases)
RPR/VDRL
In what diseases can you get a positive RPR/VDRL?
syphilis lupus pregnancty malaria old age
RPR and VDRL are not positive until how long?
Not until at least one week after chancre appears (as opposed to 3 weeks after infection in the FTA-ABS test)
This syphilis test detects IgM/IgG to a “reagin” which is a mixture of cardiolipin, l\ecithin, and cholesterol
RPR AND VDRL
which syphilis test would you choose to tract the progress of treatment, and is expressed in a titer form?
RPR/VDRL
culture medium used to diagnose leishmaniasis
Novy-McNeal-Nicolle
treatment for leishmaniasis
pentavalent antimonial (sodium stibogluconate)
pentavalent antimonial is used to treat which disease
cutaneous leishmaniasis
treatment for visceral leishmaniasis
amphotericin B
What do you use to treat RMSF in pregnant ladies?
Chloramphenicol (usually treat with Doxy)
Tick that carries RMSF
Dermacentor andersoni (wood tick western US) Dermacentor variabilis (dog tick in eastern US)
Rickettsiae Rickettsii
RMSF
Fever, HA, myalgias, rash that spreads from hands and feet onto the body
RMSF
Another name for Boutonneuse fever
Mediterranean spotted fever
What does R. conorri cause?
Mediterranean spotted fever (Boutonneuse fever)
Tick vector for Boutonneuse fever
Rhipicephalus sanguineus
Rhipicephalus sanguineus
Tick vector for Mediterranean spotted fever (Boutonneuse fever)
formal name of the BROWN DOG TICK
Rhipicephalus sanguineus
Tache noir
indurated papule at the site of a tick bite which leads to a necrotic ulcer (seen in Meditteranean Spotted fever)
What disease is Tache noir associated with?
Boutonnese fever (Meditteranean spotted fever)
Name the bacteria and vector of Boutonnesuese fever
R. conorii Rhipicephalus sanguineus (brown dog tick)
Riettsialpox: bacteria and vector
R. akari
&
vector: mouse mite (Liponyssodies sanguineus)
What disease is caused by a mouse mite bite?
Rickettsial pox
Liponyssoides sanguineus
Mouse Mite (causes Rickettsialpox)
R. akari
Rickettsialpox
People with HLA-DQ1 are more likely to form which type of leprosy?
Lepromatous (TH2 response)
People with HLA-DR2, HLA-DR3 are more prone to form which type of leprosy?
Tuberculoid (TH1 response)
IL-2, TNF-alpha, IFN-beta are all cytokines seen in what kind of response?
Cell-mediated immune response (TH1)
IL-4, IL-10 represent which type of immune response?
Humoral/antibody mediated (TH2)
A person being treated for lepromatous leprosy has a severe reaction during treatment and develops vasculitis (E nodosum leprosum). What to treat with?
Thalidomide
What do you treat a Type II leprosy reaction state with?
Thalidomide
What do you treat a Type I leprosy reaction state with?
Steroid (treat type II with Thalidomide)
What is the Lucio reaction?
It is the Type 3 leprosy reaction state in which the patient with lepromatous leprosy develops extensive severe vasculitis
Virchow cells
Foamy histiocytes containing M. Leprae in lepromatous leprosy
When is a leprosy patient considered no longer infectious during her treatment?
AFTER THE FIRST DOSE OF RIFAMPIN AND DAPSONE
What is the BCG vaccine?
Live attenuated TB vaccine with bacteria M. Bovis
How long after exposure to TB will your PPD become positive?
2-10 weeks
Tender nodule on guy who cleans out fish tanks
Mycobacterium marinum
R. Prowazekii
Epidemic Typhus (Louse born)
Louse born Typhus
Epidemic Typhus
Vector of Epidemic Typhus
Body louse (Pediculosis humanus var. corporis)
Someone has a pet flying squirrel and they get a rash - what did they get?
Epidemic Typhus (R. Prowazekii), reservoir is the flying squirrel, vector is the body louse
Flea borne Typhus
Endemic Typhus
R. Typhi
Endemic Typhus
Vector for Endemic Typhus
Rat flea (Xenopsylla Cheops) * Everything is bigger EN teXas)
Mite borne Typhus
Scrub Typhus
R. Tsutsugamushi
Scrub Typhus
Vector for Scrub Typhus
Chiggar mites (Trombiculid)
Thrombiculid
Chiggar mite which is a vector for Scrub Typhus
Which ticks cause Human Erlichosis?
Amblyomma and Ixodes scapularis
Coxiella Burnetii
Q fever
Which bacteria causes Q fever?
Coxiella Burnett I
Trichphytan concentricum causes:
Tinea Imbricata
Tinea imbricata cause by:
T. Concentricum
What do you use to culture Leichmeniasis?
NNN culture (Novy-mcNeal-Nicole)
Culture medium for Leichmeniasis
NNN
Novy-mcNeal-Nicole culture medium
Leichmeniasis
What causes MRSA to be resistant?
(PBP2a) Altered penicillin binding protein. Resulting from the mecA gene
What gene encodes the PCP2a protein (causing MRSA resistance)
MecA gene
What is the Panton-Valentine leukocidin (PVL)
Associated with increased virulence in CA-MRSA infections
What part of the body is strep a normal flora?
Vagina and aerodigestive tract
What is the most pathogenic form of strep?
Group A beta-hemolytic strep
What do you treat erysipelas with?
Penicillin
Pastias lines
Linear petechiael streaks along body folds in Scarlett fever
Fever, erythema, then bullae and desquamation in the body folds
Staph Scalded Skin Syndrome
Name four diseases caused by Corynebacterium
Erythrasma
Trichomycosis Axillaris
Pitted Keratolysis
Cutaneous Diptheria
Meat handlers/fish handlers get this gram positive disease
Erysipeloid (painful red purple patches on the hands)
What is the most common gram negative infection that we deal with in dermatology in the US?
Pseudomonas
What chemical in a pseudomonas infection produces the green-blue pigment?
Pyocyanin
What chemical in pseudomonas produces the green-yellow pigment?
Fluorescein
What pigment producing chemical in psuedomonas produces the brown black pigment in pseudomonas?
Pyomelanin
You can get Parinaud-oculoglandular syndrome from what three conditions?
Sarcoidosis
Tularemia
Cat Scratch Disease (bartonella)
Which rickettsial borne illness has a negative Weil-Felix test?
Rickettsialpox
Warthin-Starry stain
Bacillary Angiomatosis
What stain do you use to identify bacillary angiomatosus?
Warthin-Starry
What an atomic structure does Ramsey Hunt syndrome involve?
HSV of the geniculate ganglion
What do you treat treatment resistant HSV with?
foscarnet
Diagnostic criteria for Kawasaki
Crash and Burn
Fever (burn)
C-conjunctivitis R-rash A-adenopathy S-strawberry tongue H-hands and feet
Which can flouresce, endothrix or ectothrix fungi?
Some of ectothrix can
What wavelength does ectothrix fungi flouresce at?
365nm
(365nm - earth, on a mercury (mercury) lamp made of nickel chromium oxide (planets) filter
What wavelength, material, and filter is a Woods lamp?
365nm mercury lamp with a nickel chromium oxide filter
What is the pneumonic for endothrix?
Ringo (t. Rubrum) Gave (t. Gourvilli) Yoko (t. Yaoundé) Two (t. Tonsurans) Squeaky (t. Soudanese) Violins (t. Violaceum)
Most common cause of tinea capitis
T. Tonsurans
Which fungus is endothrix and ectothrix
T. Rubrum
What is the second most (and most inflammatory) cause of tinea capitis?
M. Canus
Which organism causes Favus?
T. Schoenleinii
What chemical causes ectothrix to flouresce?
Pteridine
What chemical causes corynebacterium to flouresce?
Copoporphyrin III
What chemical causes pseudomonas to flouresce?
Pyocyanine
Most common type of tinea pedis
T. Rubrum, T. Floccasum
Cause of bullous tinea pedis
T. Mentagrophytes
Most common cause of onychomycosis
T. Rubrum
Most common type of white superficial spreading onychomycosis
T. Mentag. (But in HIV patients, T rubrum is the most common for white superficial spreading)
What two conditions does t. Mentag cause
Bullous tinea and white superficial spreading onychomycosis
What causes tinea imbricata?
T. Concentricum
What stain outlines fungi black?
GMS
What stain outlines fungi magenta with green background?
PAS
Which stain stains dematiaceous (pigment producing) fungi? Like Tinea Nigra
Fontana-Masson
Which stain stains the capsule of cyrptococcus?
Mucicarmine
What is the chemical that tinea versicolor produces which causes hypopigmentation?
Azelaic acid
What organism causes black Piedra?
Piedraia hortae
What organism causes white piedra?
Trichosporon cutaneum
*cute little white spores!
Tinea corporis aquired from the soil - what organism?
T. Gypsum
Most common organism causing Majocchis granuloma
T. Rubrum
Ketoconazole - fungistatic or fungicidal?>
Fungistatic
Treatment for Tinea Capitis
Griseofulvin 25mg
Name the pneumonic for fluorescent ectothrix
Cats (M. Canus) And (M. Audouninii) Dogs (M. Distortum) Fight (M. Ferrugineum) & Growl (M. Gypsum) Sometimes (T. Schoenleinii)
What kind of fungus (endothrix ectothrix fluorescent, nonfluorescent) is T. Schoenleinii
Ectothrix flourescent
Which is the only flourescent Trichophyton ectothrix
T. Schoenleinii (the rest of them are M. Canus)
What is the candidal infection in between the third and fourth webspace of the finger called?
Erosio interdigitalis blastomycetica
Black widow spider releases what toxin?
Alpha-latrotoxin (Depolarizes neurons)
Surgical abdomen after a spider bite -which spider?
Black widow (lactodectus mactans).
This spider’s toxin is spingomyelinase D
Brown recluse (Loxoseles reclusa)
Brown recluse spider’s toxin
Spingomyelinase D
What does the hobo spider look like?
Herringbone striped pattern on the abdomen
Jumping spider has what kind of toxin
Hyaluronidase (“jump high”
Wolf spider has what kind of toxin?
Histamine
Which spider’s web is funnel shaped?
Hobo spider
Old world Leichmaniasis vector
New world Leichmaniasis vector
(Both sandfly)
Old world:Phlebotomus
New world: Lutzomyia
Tapir face
Perforation of the nasal septum in Mucocutaneous Leichmaniasis (predominantly New World L. Brazilinesis
Mexican who is harvesting chicle gum in the forest gets a ulceration on his ear.
Chiclets ulcer - caused by new world Leichmaniasis
“Black-fever”
“Kala-azar” visceral systemic Leichmaniasis - caused by L. Donovani
White islands in a sea of red
Dengue fever
What type of virus is Orf caused by?
Parapox
Name all of the conditions caused by a pox virus?
Molluscum Orf Miller's nodule Vaccinia Smallpox Cowpox
Solitary red purple nodule on the finger or multiple cherry red nodules at site of inoculation
-working with cows and baby calves
Milkers nodule - Parapox
Vaccinia caused by what kind of virus?
Orthopox, leading tot he vaccinia virus
What is the live virus used for the smallpox vaccine called?
Vaccinia
What is eczema vaccinatum?
Diffuse infection at the site of inoculation of a vaccine in atopic patients
What significant clinically about smallpox?
Vesicles all in the same stage of development
Name two diseases that present similarly to anthrax?
Cowpox
Name the ONLY single stranded virus
Parvovirus. *leutinant parvin from cedarville
What does togavirus give you?
Rubella
What kind of virus is rubella?
Togavirus
What kind of virus is HCV, and what other diseases are caused by it?
Flavivirus -also causes Dengue fever and Yellow fever (RNA virus)
Dengue fever is caused by what kind of virus?
Flavivirus (RNA)
Yellow fever is caused by what kind of virus?
Flavivirus (RNA)
Influenza is caused by what kind of virus?
Orthomyxovirus (RNA)
Rabies caused by which kind of virus
Rhabdovirus
RSV is what kind of virus
Paramyxovirus
Measles and mumps are what kind of virus?
Paramyxovirus
Name some paramyxovirus
Measles, mumps, RSV
HIV and HTLV are what kind of viruses?
Retrovirus
Name the dsDNA viruses
Herpesvirus Hepadenovirus (HBV) Adenovirus Poxvirus Papilloma virus Parvovirus (the only ssDNA)
Name the live attenuated viruses
Influenza nasal spray Measles Mumps Rubella BCG Yellow fever Polio oral Typhoid oral
Treat furuncle on the face near the midline with antibiotics because of the risk of what
Cavernous sinus thrombosis
What three antibodies become positive after infection with Group A Strep?
Antistreptolysin O (ASO), anti-hyaluronidase, anti-DNAse B
What type of bacteria is corynebacteria?
Gram positive rod
Name two examples of gram positive rods
Corynebacteria and Anthrax
What to treat erythrasma with? And what is it caused by
Caused by corynebacterium minutissimum and you treat with topical clindamycin
Pitted keratolysis caused by what bacteria?
Corynebacterium or kytococcus sedentarius
Name the two exotoxins formed by anthrax and name what they each do
Edema toxin - increases cAMP levels
&
Lethal toxin - increases TNFalpha and IL1b
What are the
Conventional treatment of anthrax?
Bioterrorism treatment of anthrax?
Conventional is - PCN
Bioterrorism is cipro or doxy
Madura foot (Actinomycetoma) with grain color: white
Nocardia
Madura foot (Actinomycetoma) with grain color:Pink/cream
Actinomadura Madurai
Madura foot (Actinomycetoma) with grain color: Yellow or brown
Streptomyces
Madura foot (Actinomycetoma) with grain color: Red
Actinomadura pelletieri
Recurrent meningitis in patients with what type of complement deficiency?
C5-9
Streptobacillus moniliformis causes what disease?
Ratbite fever/Haverhill fever
Borrelia burgdorferi
Lyme disease
Acrodermatitis chronic atrophic and
Loss of subcutaneous fat w/thin atrophic skin associated with Lyme disease
Finding in Lyme disease: loss of subcutaneous fate with thin atrophic skin
Acrodermatitis chronic atrophicans
What nerve is commonly affected in early disseminated Lyme disease
Facial nerve
Tick causing Lyme disease in the eastern US
Ixodes dammini (Ixodes scapularis)
Tick causing Lyme disease in the wester US
Ixodes pacificus
Tick causing Lyme disease in Europe
Ixodes ricinus
What do you give to pregnant women to treat Lyme disease?
Amoxicillin (doxycycline in normal folks)
Firm bluish tumor or plaque appearing on the ear lobes of children or the nipples of adults
Borrelial lymphocytoma (lymphocytoma cutis). Caused by b. Afzelli or borriela garinii both only present in Europe
What three diseases are caused by pediculus humanus var. coporis
Louse born relapsing fever
Epidemic typhus
Trench fever
Tick borne relapsing fever caused by what vector
Soft ticks - ornithodoros
Soft ticks - ornithodoros are the vector for what disease?
Tick-born relapsing fever
Name a few other names for Leptospriosis
For Bragg fever
Pretibial fever
Weil disease
Leptospira interrogans
Leptospirosis
Painful pretibial plaques, conjunctivitis, jaundice, diffuse extanthum
Leptospirosis
Painful pretibial plaques
Leptospirosis
Organism which causes Yaws
Treponemum pallidum (subspecies pertunue)
Another name for Frambesia
Yaws
One to few erythematous papules at inoculation site which disappears, then new smaller lesions spread symmetrically over the body, finally can get gum at a, keratoderma, midfacial distruction
Yaws
Treatment for general and non-general treponematoses
Benzathine PCN
Organism causing endemic syphilis (Bejel disease)
Treponema pallidum (endemicum subtype)
Organism causing Pinta (carate)
Treponema carateum
What organism causes Chancroid
Haemophilus ducreyi
Name the disease caused by Haemophilus ducreyi
Chancroid
Gram stain “school of fish”
Haemophilus ducreyi (Chancroid)
Treatment of Chancroid
Azithromycin 1g or Ceftriaxone IM
Bacteria causing Granuloma inguinale
Calymmatobacterium granulomatosis (related to Klebsiella)
Another name for Donovanosis
Granuloma inguinale
Painless subcutaneous papule which ulcerates with painful, beefy, red granulation tissue
Granuloma inguinale
Which venereal disease has Donovan bodies and russel bodies on path?
Granuloma inguinale
Lymphogranuloma venereum is caused by which bacteria
Chlamydia trachomatis
Chlamydia trachomatis
Lymphogranuloma venereum
Gamma-Favre bodies
Lymphogranuloma venereum (Chlamydia trachomatis)
PPD positive how many days after exposure?
2-10 weeks
Patient with TB gets a deep nodule over the cervical lymph node
Scrofuloderma (seen in a sensitized host with low immunity)
*route is contiguous spread from underlying lymphadenitis
Direct inoculation of TB presenting as a painless red-brown papule at the inoculation site
Tuberculous chancre (seen in non-sensitized host with no prior immunity)
What is the most common cutaneous manifestation of TB?
Tuberculosis verrucousa cutis (Warty TB)
- presents as a small indurated hyperkeratotic papule or warty plaque with serpiginous border
- route is exogenous - reinfection with direct inoculation at the site of trauma
Apple jelly red-brown nodules involving the face or neck in a patient with TB
Lupus vulgaris *associated with the highest immunity
Painful erythematous papule ulcerated in the oral cavity with TB
Tuberculosis cutis orificialis
Tiny blue-red papules which become crusted, seen mainly in infants or immunosuppressed patients, associated with TB
Military tuberculosis
What route is military tuberculosis spread?
Hematogenous
Subcutaneous inflammatory nodule with ulceration on posterior calves
Erythema induratum (Bazin)
Ridged wart HPV type
HPV 60
Best site for biopsy of rabies
The neck
Guarneri bodies
Smallpox
Which increases the risk of transmitting HSV infection from mom to fetus more:
-primary infx of the mom vs secondary infx of the mom
PRIMARY infection has a MUCH higher risk of transmission (25-50%)
VS
Secondary infection (2-5%)
What bacteria causes Rhinoscleroma
Klebsiella Pneumonia
Ecthyma gangrenosum is caused by what bacteria
Pseudomonas
What do you treat erythema nodosum leprosum with?
Thalidomide
Name one disease you treat with Thalidomide?
Erythema nodosum leprosum
Culture medium for atypical mycobacteria
Ziehl-Nelson stain; Lowenstein Jensen culture medium
What do you treat a fish tank granuloma with?
Minocycline
Buruli ulcer (bacteria that causes)
M. Ulcerans (this is an atypical mycobacterium
*ulcer on the hand after minor trauma - associated with agricultural activities
Which atypical mycobacterium are photochromagens? (Pigmentation on exposure to light)
M. Kansasii
M. Mariunum
M. Simiae
*monkey swim in kansas in the summer
What three diseases does the Ixodes Scapularis tick cause?
Lyme disease
Babesiosis
Erlichiosis (human granulocytic)
What disease does the Dermacenter tick (American dog tick) cause?
Rocky Mountain Spotted Fever
Ambylomma Americanum tick causes what disease
RMSF, Ehrlichiosis
Which types of Leichmaniasis cause Visceral (Kala-azar)?
L. Donovani
L. Infantry
L. Changasi
Stewart Treves syndrome
Development of angiosarc in the setting of chronic lymphedema
What do you treat the plaque with?
Streptomycin
Treatment for Brucellosis
Doxycycline
Treatment for Glanders
Streptomycin, or doxycycline
Treatment for vibrio
Doxycycline
Treatment for Malakoplakia
Cipro
Treatment for Rhinoscleroma
Cipro
Treatment for Haverhill/rat bite fever
Penicillin
Streptobacillus moniliformis
Rat-bite/Haverhill fever
Fever, arthritis, ulceration of the site of the bite, associated with rash, acral distribution
Ratbite/Haverhill fever (streptobacillus moniliformis)
What percent of cases is RMSF “spotless”
10-20%
B. Garinii
B. Afzelli cause what condition?
Borrelial lymphocytoma (firm bluish tumor or plaque on the earlobes of children, nipples of adults)
Non-venereal treponemal infection with white vitiligo-like lesions on the face, hands, wrists
Pinta (carate) caused by treponema carateum
Gamma Favre bodies
Lymphogranuloma venereum
“The groove sign”
Pathopneumonic in Lymphogranuloma venerem - which is the enlargement of the femoral lymph nodes, separated by Poupart ligament
What is the culture medium to grow leprosy?
None! There is no culture medium trick question. It can only be grown in mouse foot pad or non-banded armadillo
Which two cutaneous manifestations of TB are from an exogenous route, and what is the difference between the two?
Tuberous chancre - in a nonsensitized person
Tuberculosis verrucousa cutis - re-inoculation of a previously sensitized person
Which cutaneous manifestation of TB occurs in a person with the highest immunity?
Lupus vulgaris
Which type of leprosy is cell mediated vs not?
Cell mediated - Tuberculid (CD4 cell prominence :/)
Non cell mediated - Lepromatous (CD8 cell prominence :/)
Describe the three leprosy reaction states and what you treat each with
Type 1 - reversal reaction (upgrading downgrading) - Steroids
Type 2- E. Nodosum leprosum -Thalidomide
Type 3 - Lucio reaction - vasculitis - Steroids
Which is the only leprosy reactional state that you dont treat with steroids?
Type 2 E Nodosum leprosum - treat with Thalidomide!!!!
Buruli ulcer
M. Ulcerans (atypical mycobacteria) presents as a growing ulcer on the abdomen of a child in Africa. Treatment is excision
Treatment for Burulli ulcer
Excision
Quickly name the atypical mycobacteria
M. Marinum - fishtank granuloma M. Ulcerans - Buruli ulcer M. Fortuitum - fast growing M. Adium complex - lung, immunosuppressed M. Kansasii - photochromagens
Name the three photochromagen atypical mycobacteria
M. Kansasii
M. Marinum
M. Simiae
*monkey swim in kansas in the sun
On what part of the hand do you usually find erosio interdigitalis blastomycosis?
Fingers - 3rd webspace
Toes - 4th webspace
What is scytalidium dimidatium and what do you treat it with?
The black nail! A dematiaceous (pigmented) fungus, treat with itraconazole
Treatment for scytalidium dimidatum
Itraconazole
Most common new-world species of Leichmaniasis
L. Braziliensis
Name the causes of mucocutaneous Leichmaniasis
Old world - L. Aethipica
New world - L. Brazillensis, L. Peruviana
What two conditions do you treat with Streptomycin?
Tularemia and the Plague
Name some infections (besides syphilis) that you use penicillin to treat with?
Haverhill fever/Rat bite fever
Leptospirosis
Treatment for amebiasis
Oral metronidazole
Treatment for Chagas’ disease
Nitrofurtimox/benznidazole
First stage -indurated chancre, resolves, fevers, anular erythematous patches, posterior cervical lymphadenopathy, then second stage of daytime somnolence
Sleeping sickness (African Trypanosomiasis)
Another name for African Trypanosomiasis
Sleeping sickness
Vector for African Trypanosomiasis (Sleeping sickness)
Tsetse fly (glossina spp.)
Glossina spp.
Tsetse fly - vector in sleeping sickness (African trypanosomiasis)
Winter bottoms sign associated with what tropical disease?
African sleeping sickness(African trypanosomiasis) caused by the tstste fly glossina spp
Treatment for African sleeping sickness
Suramin
Or
Pentamidine
Pentamidine and suramin are treatments for what tropical disease?
African sleeping sickness (African Trypanosomiasis, caused by tsetse fly)
Treatment for toxoplasmosis
Sulfadiazine with pyrimethamine
Organism causing cutaneous larva migrans
Ancylostoma braziliense
Anclostoma braziliense
Cutaneous larva migrans
Treatment for cutaneous larva migrans
Topical thiabendazole OR oral ivermectin
Calabar swelling
Another name for Loiasis
Another name for Loasis
Calabar swelling
Subcutaneous swelling and conjunctivitis of the eye with a parasite
Loiasis
Vector in Loiasis
Deer or mango fly (Chrysops) *because Loiasis makes you a cyclops after it gets in one eye
What do you treat Loiasis with?
DEC
Treatment for filariasis
DEC
What three protozoan infections do you treat with DEC?
Onchocerciasis
Loiasis
Filariasis
Wuchereria bancrofti
Organism causing filariasis
Another name for Guinea worm disease
Dracunculiasis
Vector for Dracunculiasis
Infected water crustaceans (cyclops)
*remember though that Chrysops which is a deer or mango fly causes Loiasis bc you turn into a cyclops bc it gets in your eye
In which parasitic infection do you get wheezing puritis and urticaria as the worm migrates from the GI tract to lower leg skin?
Draculinosis
Treatment of Dracuculiasis
Thiabendazole
Treatment for onchocerciasis
Ivermectin or
DEC (which causes the Mazzoti reaction)
Treatment for schistosomiasis
Praziquantel
What is the acute form of schistosomiasis called
Katayama fever
Katayama fever
Acute form of schistosomiasis
*Treatment with praziquantel
River blindness
Onchocerciasis
Sub cutaneous nodules containing worms, depigmentation on lower legs, vision loss
Onchocerciasis (river blindness)
What is the rate of movement of the larva migrans in strongyloides (larva currens?)
5-10cm/h
Larva currens
Strongyloides
Treatment for strongyloides (larva currens)
Albendazole, thiabendazole, ivermectin
What is different about the clinical presentation of scabies in kids vs adults?
Can see it on the scalp and face in kids
How do you treat crabs?
Same as head lice (it is lice of the pubic hair)
Maculae Caerulea
Slate gray or blue macules on the pubis of people with pubic lice (phthirus pubis)
How often does the head louse:
Feed?
Lay eggs?
Feeds every 4-6 hours
Lays eggs every 5-10 days
What is a risk in using Malathion as a lice treatment?
Flammable
Old school lice treatment Lindane, and organochloride, no longer first line because of what potential complication
Neural toxicity (seizures, confusion)
A child comes home from school after being treated for a lice breakout in his school and he has a seizure. What was the drug he was most likely treated with?
Lindane
Which lice remedy should you not give if treating someone with allergy to ragweed or crysanthemums?
Pyrethrin
Potential side effect of Pyrethrin lice treatment?
Allergy in person who is allergic to ragweed or cysanthemum (bc pryrethrin is made from crysanathemum)
Which lice treatment is derived from crysanthemums?
Pryrethrin
Name the 4 lice treatments and their side effects
- Malathion - flammable
- Lindaine - neural toxicity
- Pyrmetherin - none. High resistance
- Pyrethrin - cross reaction with crysanthemums/ragweed
At what temperature is histo a yeast and at what temp does it have septae
25 degrees it has hyphae and septae (when you are 25 you get high*)
37 degrees it is a yeast (think has a bun in the oven)
What antibiotic is good to use if pt allergic to PCN?
Erythromycin
What drugs used to treat Gpositives
PCN
Erythromycin
Kephlex
What is the antigen that mediates TSS caused by: Staph Vs Strep Choices: ET-A/ET-B vs SPE-A
Staph - ET-A/ET-B
Strep - SPE-A
C. Minutissimum causes what condition
Erythrasma
C. Tenuis VS C. Minutissimum - which one causes erythrasma and which one causes trichomycosis axillaris?
C. Minutissimum causes erythrasma
C. Tenuis causes trichomycosis axillaris
Treatment for Erysipeloid?
*fish handlers disease, seen in butchers, meat-handlers, red in the third webspace of fingers
Treat with PCN or Erythromycin if PCN allergy
Difference between Ecthyma and Ecthyma Gangrenosum
Ecthyma is a strep infection - treat with dicloxacillin
Ecthyma gangrenosum is a pseudomonal infection - treat with IV amminoglycoside
What do you treat psuedomonal folliculitis with? (Hot tub folliculitis)
NOTHING. It is self limited
Recurrent meningitis patients may have a defect in what cellular pathway component
C5-9
Treatment for meningococcemia
High dose IV PCN or third gen cephalosporin
Treatment for Brucellosis
Streptomycin
or Doxy with Rifampin
Treatment for Glanders
Streptomycin
Treatment for Tularemia
Streptomycin
Treatment for Vibrio
Tetracycline
Treatment for the plague
Streptomycin
Treatment for Malakoplakia
Cipro and surgical removal
Treatment for Rhinoscleroma
Cipro
Treatment for Rat-bite/Haverhill fever
Streptomycin
What is the aminoglycoside used to treat glanders, brucellosis, plague, ratbite fever, tularemia
Streptomycin
What cutaneous infectious diseases does Streptomycin treat?
Glanders Brucellosis Plague Tularemia Rat-bite Fever
*basically all of the weird gram negative ones. Streptomycin is an amminoglycoside!
Treatment for fish tank granuloma (m. Marinum)
Minocycline!
Treatment for Buruli Ulcer
Excision! (Drug therapy is disappointing)
Treatment for fast growing mycobacterial infection (FAC)
Clarithromycin
Treatment for Lobomycosis
Surgical excision (antifungals are ineffective)
Treatment for mycetoma
Oral antifungal (itraconazole, ketoconazole, griseofulvin) and debridement
Treatment for chromobrlastomycosis
Surgery and/or itraconazole
Treatment for sporotrichosis
Itraconazole or supersaturated potassium iodide (for lypmhocutaneous form)
What do you treat the lymphocutaneous form of sporotrichosis with?
SSKI (super-saturated potassium iodide)
A gardener gets a subcutaneous nodule, which ulcerates and then begins spreading up his leg.
What is this?
What does it look like on path?
What is the treatment?
Lymphocutaneous Sporotrichosis
Sporothirx asteroid body (yeast cell with surrounding eosinophilic fringe
Treat with SSKI (supersaturated potassium iodide)
*side note: the treatment for non lymphocutaneous sporotrichosis is just itraconazole
What is a favorable sign in pulmonary coccidiomycosis?
Erythema nodosum
What other condition do coccidomycosis lesions in an HIV patient resemble?
Molluscum
Which deep fungal infection resembles molluscum in an HIV patient?
Coccidiomycosis
Treatment for severe cases of histoplasmosis, less severe cases?
Severe cases - amphotericin B
Nonsevere cases - Ketoconazole
Treatment for blastomycosis and also paracoccidio (South American blastomycosis)
Oral antifungal like itraconazole/ketoconazole
Treatment for Cryptococcus?
Amphotericin B +/- flucytosine
What do you add to amphotericin B to help treat crypto?
Flucytosine
Which antifungal can cause drug induced LE?
Terbinafine and Griseofulvin
Name the two types of treponemal tests for syphilis
FTA-ABS
MHA-TP
*RPR and VDRL are NONtreponemal serologic tests
What are the two most sensitive and specific tests for syphilis
Also
Which is the first serologic test to become positive in syphilis?
- Most sensitive/specific = treponemal tests (FTA-ABS and MHA-TP)
- Quickest to become positive: nontreponemal (RPR/VDRL)
What stain identifies spirochetes of syphilis?
Warthin Starry stain
What does the Warthin Starry stain detecT?
Syphilis spirochetes
What is OVERALL (serologic, treponemal, nontreponemal, path stains ect) most sensitive and specific test to detect PRIMARY syphilis?
Darkfield microscropy
*treponemal tests (FTA-ABS and MHA-TP) are the most sensitive and specific SEROLOGIC tests
And the *nontreponemal tests (VDRL AND RPR) are the serologic tests used to track progress of treatment
What is a stain you can use to determine Kaposis?
HHV -8 (or another name for it is the LANA-1 stain)
What else can tularemia be caused by besides rabbits?
Deer Fly (its actually called deer fly fever sometimes)
Test for Sarcoidosis (old school, not done anymore)
Kevin-siltzback rest ( where they inject ansarcoid granuloma from the spleen into the skin and see if it reacts - yuck)
Kveim-Siltzback test
Test for Sarcoidosis
Two viruses implicated in Gianotti-Crosti syndrome
HBV, EBV (HHV4)
Gianotti Crosti Syndrome - viruses implicated
EBV (HHV4), HBV
Virus implicated in Hand foot and mouth disease
Cocksackie (an enterovirus)
If you see a bite with TWO PUNCTURE WOUNDS what organism could it be
CENTIPEDE
What is the venoumous substance in honey bee venom?
Phospholipase
HPV type EDV (cancerous types)
HPV 5,8
HPV type plantar wart
HPV type 1
HPV type verrucous carcinoma
HPV 6,11
HPV type Heck’s disease
HPV 13, 32
HPV type Butchers wart
HPV 2, 7
HPV ridged wart
HPV 60
HPV Bowenoid papulosis
HPV 16, 18
HPV type flat wart
HPV type 3,10
