lets diagnose! Flashcards by Erin Disney

pimples, furuncles, carbuncles, sty, pus formation

established in hair follicle leading to tissue necrosis
occur as a result of wounds

no vaccine, treated with topical ointment

folliculitis

staphylococcus areus

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mainly in warm summer months
children

flattened red patches that develop into oozing pus filled vesicles that break open (honey colored & pus filled)

very contagious, person-to-person, via fomites, through cuts

can be fatal with out treatment

impetigo

staphylococcus areus (mainly)
streptococcus pyogenes

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toxin based diagnosis

staph in 1 location despite systemic affect

menstrating women (tampon) wound infection

fatigue, confusion, red rash, aches & pain, low BP

some fatal without treatment

S areus in elevated O2 levels and neutral BP

toxic shock syndrome

staph areus + toxic shock syndrome toxin

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infants and children < 5, immunocompromised

normal flora or direct contact

red wrinkling skin near mouth, large blisters filled with fluid, skin sloughs off after 2 days

NO scarring

IV antibiotics, resolve after 7-10 days, low mortality but possible with secondary infection

Scalded Skin Syndrome (SSSS)

Staphylococcus aureus + exfoliative toxin

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through normal flora
thrive on sebum
which triggers inflammation & pus formation
potential scarring

blackheads, cystic acne

Acne

Propionibacterium acnes

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lack of / incomplete vaccination history
mainly children

maculopapular rash, koplik spots, fever, runny nose, cough, conjunctivitis

Measles (rubeola)

measles virus (paramyxovirus)

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children < 10

respiratory secretions or direct contact
vaccination = varivax

exanthematous rash, vesicular rash that progresses ti scabbed lesions, intense itchiness, fever, chills, headache

chicken pox

varicella-zoster virus

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adults > 45

respiratory secretions or direct contact

vesicular skin eruption along dermatome, pain, itchiness, numb / buring

shingles

varicella-zoster virus

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pustular rash disease - zoonosis (sheep, goat, cattle)

most common, rarely fatal

causes necrotic ulcer (eschar)
develops 1-12 days after exposure

contact with endospores (cannot get person-to-person)

cutaneous anthrax

bacillus anthracis

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staphylococcus aureus
streptococcus pyogenes

caused by fast spreading infection in the dermis and subcutaneous tissue

pain, tenderness, swelling, fever, lypph node inflammation

oral antibiotics

cellulitis

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anaerobic and aerobic bacteria (mixed infection)
gram positive cocci & gram negative rods

common after surgery in patients with comorbities / wounds

rare, rapid spreading soft tissue infection, destroys the fascia and surrounding tissues

Necrotizing fasciitis type 1

e. coli
staph aureus
clostridium

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monomicrobial infection

infect healthy patients
route of entry follows trauma, surgery, IV drug use

destroys the fascia and surrounding tissues

Necrotizing fasciitis type 2

streptococcus pyogenes

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gram negative
endospore forming
Obligate anaerobe

Transmission = ubiquitous (through soil)

Abrupt onset following trauma in young men after injection of drug use or in elderly patients with diabetes- transmission via soil

Wound pain (watery) marked swelling, mental confusion, tachycardia, fever, skin legions (brown)
Bullae filled with blue fluid- anaerobe

Crepitus - gas within the tissue (late stages)

Gas gangrene (clostridial myonecrosis)

Clostridium perfringens

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mainly children

direct contact, extremely contagious

organisms get into conjunctiva, induces inflammation

otitis media?

Inflammation
Redness
Mucopurulent discharge
Possible keratitis - inflammation of the cornea

Bacterial Conjunctivitis (Pink Eye)

Streptococcus species

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children, leading cause of traumatic blindness in humans

contact with fomites or fingers; during birth

pathogen triggers purulent discharge that scars conjuctiva

Eyelashes turn inward
Eyelashes abrade
irritate, & scar cornea = blindness

trachoma

chlamydia trachomatis

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Anyone (school aged children)

Sore throat; more painful & longer to resolve (than viral)
White patches on the back of the throat and tonsils (pus exudate)
Little/no cough
Headache
Fever

normal flora/ respiratory droplets

M Proteins

Rapid Antigen Test (possibly B-hemolytic gram positive cocci in chains)

Antibiotics (penicillin)

bacterial pharyngitis

streptococcus pyogenes group A

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Follows local Streptococcus pyogenes infection (bacterial pharyngitis)

Rash on trunk after 24 hrs., spread to extremities (focal infection)

Death can occur because of high fever
Usually resolves in 1-2 weeks

Scarlet Fever (toxemia)

Streptococcus pyogenes

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Follows local Streptococcus pyogenes infection (bacterial pharyngitis)

Most serious

Fever
Malaise
Joint pain
Evidence if inflammation of all parts of the heart
Development of scar tissue
May lead to heart failure

Rheumatic Fever

Streptococcus pyogenes

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commonly affects children

Spreads from normal flora in the oropharynx to the sinus or middle ear

Inflammation, pain, pressure in ear

Treat with broad spectrum antibiotics

otitis media

streptococcus pneumoniae
Moraxella catarrhalis

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virus replicates killing cells, infected cells loss of ciliary activity and fall off, triggering inflammation and stimulating mucus production

Common in fall and spring

spread by respiratory droplets or contact with fomites

Sneezing, and congestion

prevent with hand antisepsis and disinfection

common cold

rhinoviruses

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Diphtheria toxin secreted

Mainly in unvaccinated children

Transmission → droplet contact

Sore throat, localized pain, fever, PSEUDOMEMBRANE in back of throat

pseudomembrane can occulate respiratory passages = death

diphtheria

corynebacterium diphtheriae

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Pertussis toxin

Found primarily in children

High contagious and spread through the air via respiratory droplets

Fever, sneezing, violent coughing “whooping” upon inhalation, rib fractures, Mild dry persistent cough, cyanosis

vaccine

whooping cough

bordetella pertussis

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Contact with rodents / rodent feces

Muscle ache
Hemorrhaging
Renal failure
High fever, headache, myalgia, pulmonary edema leading to severe respiratory compromise

Hantavirus pulmonary syndrome

hanta virus

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Fever, chills, sore throat, nausea/vomiting
Body aches
Extreme fatigue

Mention of vaccine history (of lack of)

Seasonal

“Outbreak”

Anyone, elderly & very young

influenza

Influenza A Virus (orthomyxovirus)

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Smokers, elderly, patients with chronic respiratory disease, immunocompromised summer, early fall Found in freshwater protozoa, humans inhale mist- water gone bad 2-10 day incubation period followed by systemic signs of acute pneumonia outbreak-environmental source Pontiac fever

Legionnaires' disease Legionella pneumophila

Mycolic acid (waxy lipid) Chest X-ray → granuloma / tubercle, dense localized consolidation ``` Weight loss Extreme fatigue Shortness of breath Extreme cough Bloody sputum Acid fast bacilli (sputum test) **** ``` Immunocompromised

Tuberculosis Mycobacterium tuberculosis

``` fever chills congestion cough chest pain rust-colored sputum community acquired ```

Lobar Pneumonia streptococcus pneumoniae

``` coughing fever chest pain thick bloody sputum recurrent chills ```

Nosocomial Pneumonia streptococcus pneumoniae

world wide, Mainly in CA, UT, AZ, NV, NM, CO flea bite (most common) travel to lymph nodes; break into blood stream Bubose (tense, tender swollen lymph node) Fever, chills, malaise Muscle pain Severe headache Treatment → antibiotics Untreated = 50% mortality

Bubonic plague yersinia pestis

world wide, Mainly in CA, UT, AZ, NV, NM, CO untreated bubonic or via respiratory droplets (aerosols) Fever, malaise Severe cough with blody frothy sputum Chest pain Hard to breathe Treatment → antibiotics Untreated = fatal

pneumonic plague yersinia pestis

world wide, Mainly in CA, UT, AZ, NV, NM, CO flea bite spread from lungs to persist in blood, disseminated Hypotension Shock Necrotic skin plaques - cause gangrene (black of black death) Treatment → antibiotics Untreated = fatal

Septicemic plague yersinia pestis

Arises from normal flora Dark stains on teeth - plaque → brush teeth Sensitivity in teeth - caries → filling teeth with amalgam or resin

Dental bacterial diseases Streptococcus mutans

Aries from normal flora Endotoxins and acid trigger inflammation breaking down epithelial cells ``` gum inflammation bleeding at touch tooth loss gingivitis acute necrotizing ulcerative gingivitis (severe) ```

Periodontal disease poryphoromonas gingivalis

Protein inhibits acid production, urease ``` Risk factors → 50% of ppl globally Overuse of anti-inflammatory meds (aspirin) Alcohol consumption Smoking ``` likey fecal-oral (unclear) Attach to gastric epithelial cells Mucus thins epithelia exposed to acid destroying it and underlying tissue ``` Abdominal pain Nausea Vomiting Weight loss Bloody stool ``` detection of urease in stomach biopsy antimicrobial drugs & acid production inhibitors

gastric ulcers Helicobacter pylori

preformed toxins Heat stable enterotoxins → inflame tissue stimulate vomit center of brain Food improperly prepared or stored, causing contamination and toxin production Creamy food, high in salt and sugar INTOXICATION More common in warm months Start 1-6 hours after eating Recover in about 8 hours

bacterial food poisoning Staphylococcus aureus

preformed toxins spore-forming Enterotoxins released during germination under anaerobic conditions Food improperly prepared or stored, causing contamination and toxin production Meat dishes, gravy, cooked and cooled slowly with no refrigeration Watery diarrhea, severe cramping Begins 12-24 hours after ingestion Lasts over than 24 hours

bacterial food poisoning Clostridium perfringens

> or equal to 3 loose stools in a 24-hour period Ingestion of contaminated food Self limiting; no treatment required

acute diarrhea Salmonella

inflammation of the intestine INFECTION (not intoxication)

Bacterial enteritis E. coli

Colonize intestinal epithelium produce Cholera toxin ``` Found globally (Africa and South America) Drinking fecally contaminated water ``` Severe fluid & electrolyte loss Massive diarrhea Rice water stool (shred intestinal mucosa)

Cholera: bacterial enteritis vibrio cholera

Form protective cyst (stable for months) Attach via ventral adhesive disk Interfere with food absorption by host (maximizing available nutrients) Found in every stream in the rocky mountains greasy, frothy, fatty diarrhea. foul smelling stool (rotten eggs), low grade fever, nausea, loss of appetite Most common water born GI disease

giardiasis (beaver fever) giardia spp

fecally-contaminated food @ small intestine → diarrhea @ large intestine (week later) → fever, cramping, diarrhea, dysentery (bloody)

Shigellosis- bacillary dysentery shigella spp

Enterotoxin A and B Most common in patients that have been given broad-spectrum antibiotics Pseudomembranous colitis Severe diarrhea avoid contact with spores and broad spectrum antibiotic

Antibiotic-associated colitis Clostridium difficile

Anyone, normal flora of poultry and other birds and reptiles Colonize intestine disrupting microvilli Acid tolerance protein Consuming contaminated food, ingestion of raw eggs Diarrhea Vomiting Fever (can be severe) Traces of blood Self-limiting, supportive care

Salmonellosis Salmonella enterica serovars

Bacteria phagocytized (not degraded) go to liver slpeen bone marrow and gallbladder Consuming contaminated water ``` Fever Headache Muscle pains Malaise Loss of appetite Diarrhea Perforated intestine (if repeated gastroenteritis), can leading peritonitis and death ```

typhoid fever Salmonella enterica serovars

self limiting acute infection of liver most common fecal-oral via contaminated food and water Person-to-person transmission is possible jaundice followed by fatigue and malaise → result of host response clay-colored stool particularly in children

Viral Hepatitis A Hepatitis A

self limiting acute infection of liver via blood or blood products (sharing IV needle/ sexual) jaundice, dark urine, anorexia, fatigue, nausea, body aches

Viral Hepatitis B Hepatitis B

chronic infection of liver leading cause of liver transplantation parenterally, predominantly by injection drug use acquire in utero and via sexual transmission ``` Fatigue Malaise Anorexia RUQ pain low grade fever lasting 2-10 days jaundice ensues and may last several weeks ```

Viral Hepatitis C Hepatitis C

Form cysts Carried in 10% of world population, kills 100,000 ppl per year Ingestion of cysts released from feces → trophozoites released in the small intestine and migrate to large intestine Avoid contaminated food (undercooked) ``` dysentery Invasive severe diarrhea Colitis Appendicitis ulceration of intestinal mucosa bloody mucus-containing stools pain) ``` Invasive extraintestinal necrotic lesions in liver, lungs, spleen, kidneys, and brain

Amoebic dysentery Entamoeba histolytica

gram negative rod Occur primarily in women Inflammation of urethra spreads to either...bladder (cystitis), Prostate (prostatitis), Kidneys (pyelonephritis) Slight fever Frequent, urgent, painful urination = dysuria

UTI e. coli

(diplococci, fimbriae) Second most common STI Sexually transmitted or can be a neonatal infection ``` Men Urethritis Painful urination Yellowish discharge Can spread causing infertility Diagnosis = Gram negative diplococci in pus ``` Women 50% asymptomatic Both urinary & genital tracts infected Mucopurbulent discharge Painful urination Can lead to PID (scar tissue in fallopian tube, ectopic pregnancies, infertility) Treatment → resistance is common, antibiotics, no vaccine

Gonorrhea Neisseria gonorrhoeae

sex workers, homosexual men, illegal drug users, poses a world-wide problem Spirochete No vaccine Transmitted person-to-person by chancre sore Primary = chancre Secondary = disseminated persistent rash Tertiary = dementia, blindness, paralysis, gummas, heart failure, neurosyphilis

Syphillis Treponema pallidum

Most common STI in US Humans only, women younger than 20 more likely Intracellular growth, provoking intense inflammation Gram Negative sexual or through infected mothers Most asymptomatic ``` Men Urethritis Dysuria Pus discharge Epididymitis Orchitis ``` ``` Women Cervicitis Discharge Salpingitis (inflamed fallopian tubes) PID (painful or asymptomatic) ``` Diagnosis → PCR or ELISA (serology not reliable) antibiotics (reinfection frequent all partners need to be tested), no vaccine

Chlamydia Chlamydia trachomastis

Sore around the mouth (cold sore) Reoccurrence Itchiness prior to lesion eruption

Oral Herpes Herpes Simplex Virus 1

``` vesicles/sores/lesions in genital area Painful itchy NOT open Multiple sexual partners Unprotected sex Never cured; no direct treatment May mention latency ```

Genital Herpes Herpes Simplex Virus 2

Aquired by 50% of sexually active people High previlance world wide Enters body through small cuts in the skin or mucosalmembranes Anogenital warts → primarilly sexually transmitted Infection benign in most cases, present as warts (verruca) verrucous, cauliflower-like excrescences of anogenital skin may be numerous and become confluent -immunocompromised those with cervical carcinoma may present with pain or bleeding during intercourse ONLY ONE WITH A VACCINE

Genital warts Human papillomaviruses (HPV)

gram negative diplococci massive amounts of endotoxin; capsule (a, b, c, y) Colonizes nasopharynx, spread to blood, then meneges → inflammatory swelling occurs ``` Fever Shock Cyanosis Petechial rash Purpura fulinans ``` CSF culture following spinal tap Antibiotics ``` High number of neutrophils Protein levels in CSF are high Low glucose rigidity viral- normal glucose and wbc count inflammation of the meninges, high fever, increased WBC in the CSF ``` poor unless caught early, death in 24-48 hours following onset of symptoms

bacterial meningitis Neisseria meningitidis

Form endospores, obligate anaerobe Gram positive rod- botulinum toxin Anyone, infants most common younger than 1 year Severity depends on the amount of toxin in the blood Foodborne eating improperly canned non-acidic food contaminated with preformed toxin Intoxication ``` Weak and dizzy 1-2 days after eating Blurred vision fixed dilated pupils Dry mouth Constipation Abdominal pain NO FEVER ``` Infant = eating honey Nonspecific (constipation, weak cry) Progress to flaccid paralysis and respiratory arrest Floppy baby syndrome

Botulism clostridium botulinum

Deep wound / through umbilical cord ``` Spastic paralysis Lock jaw Pupils WON'T dilate Unclear vaccination history Fever Anaerobic environment (devitalized tissue) Endospores ```

Tetanus Clostridium tetani

zoonotic disease, dog major reservoir wild animal bites or scratches, or mucosal exposure to infected tissue (CNS) or fluids (saliva) ``` Prodromal vomiting Diarrhea Fever Malaise Muscle pain Sore throat Possible paresthesia Pain Pruritus at infection site ``` ``` Furious Hyperexcitability Agitation Delirium Periods of unconsciousness Bouts of phobias Inspiratory spasms Signs of autonomic dysfunction (hypersalivation) Death in 7 days ``` ``` Paralytic Vague early symptoms Longer course Limb weakness Ascending paralysis Respiratory paralysis ```

rabies rabies virus

Most common cause of encephalitis Acquired by mosquito or tick bite Summer & early fall Birds and small mammals are intermediate hosts Viruses reaches CNS through blood from site of inoculation More serious in children, elderly, and immunocompromised

arboviral encephalitis (general) arboviruses Caused by arthropod-borne viruses

bite of tsete fly cyclical wave of parasites ever 7-10 days due to antigenic variation ``` Inflammation at bite site Week long fever Shortness of breath Cardiac pain Distrubed vision Anemia Increasing weakness Headache Tremors Uncoordinated gate Pain, stiffness of neck Paralysis Patient cant eat becoming emaciated, convulses, constantly sleeping, goes into a coma, dies ``` ``` Acute = death occurs rapidly Chronic = symptoms are drawn out ```

african sleeping sickness Trypansomiasis brucei

blood infection ``` Septic shock Low blood pressure Decrease in body temperature No urine Rapid breathing Blood-clotting Increased heart-rate Anxiety Death Petechiae & osteomyelitis Lymphangitis (long red rash) ``` Diagnosis → confirmed by blood culture Prognosis → depend on causative agent and how rapid treatment is

bacterial septicemia Pseudomonas aeruginosa

Bacterial infection of endothelial surfaces of the inner lining (endocardium) of the heart chambers and valves leading to formation of vegetations (these make it hard for heart to work properly and has difficulty with pumping blood ``` Subacute Fever Malaise Bacteremia Regurgitating heart murmor ``` ``` Acute Rapidly progressive Destroys heart valve Death in a few days Congestive heart failure (bc of fluid accumulation around the heart) ``` Diagnosis → echocardiogram, blood culutre Treatment → antobiotics, long time usually hospitalized

bacterial endocarditis coagulase negative Staph sp or strepto sp

Low helper T cell count (below 200 cells per microliter) Antibodies to HIV Rare and opportunistic infections (presence of these infections indicate that your immune system is so deficient that one now has AIDS) spread by sexual contact rapid weight loss

AIDS Human immunodeficiency virus (HIV)

Travel to area where standing water is common (Africa, South East, South America) Aedes mosquito Fever & chills in a repeating pattern Jaundice Anemia lysis RBC

Malaria Plasmodium falciparum

bite of a hard tick in the Ixodes genus occurs in nymph stage of tick life cycle Spirochete travels from site of tick bite and disseminates into most tissues immune response triggers inflammation phase 2 and phase 3 may be almost entirely immune-driven ``` Phase 1: Erythema migrans Malaise Headaches Dizziness stiff neck severe fatigue Fever Chills muscle & joint pain ``` Phase 2: disseminated rash neurological symptoms cardiac dysfunction Phase 3: severe arthritis

lymes disease Borrelia burgdorferi

Aedes mosquito usually during/ after rainy season ``` sudden onset of fever (2-7) days Severe headache Muscle and joint pain Deep bone pain (break bone fever) Nausea & vomiting Eye pain Rash may present as hemorrhagic fever/shock syndrome when there is increased vascular permeability with plasma leakage into interstitial spaces ```

Dengue Virus denguevirus

Occurs as acute outbreaks in Africa Fever, headache, sore throat, muscle pain, rash, diarrhea, shock and death, hemorrhaging, no mosquitos No vaccine transmission with direct contact with reservoir (bats); bodily fluids, aerosol transmission

ebola ebola virus

occurs through contact with saliva of an infected person general malaise, pharyngitis, tonsillitis, myalgia, symptoms for 1 month but fatigue lasts for several "mono" early teens and young adults

Infectious mononucleosis epstein-barr virus

lets diagnose! Flashcards

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