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Dermatology > Micro > Flashcards

Micro Flashcards

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Dermatology Board Prep flashcards
1
Q

Chronic granulomatous disease affecting peripheral nerves and superficial tissue (nasal mucosa)?

A

Leprosy

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2
Q

Reservoir for Leprosy?

A

Armadillos + humans

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3
Q

Acid fast bacilli causing “glove and stocking” loss of sensation?

A

M. leprae

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4
Q

Causes diffuse skin lesions esp. Ear + perforation of nasal mucosa+ loss of fingers + atrophy of testicles?

A

Lepromatous Leprosy

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5
Q

Fist sings of Lepromatous leprosy?

A

Edema + rhinitis

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6
Q

Single peripheral skin lesions w/ low numbers of acid fast bacilli? Prognosis?

A

Tuberculoid leprosy

Good prognosis= spontaneous healing

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7
Q

Characterized by low cell-mediated immunity with a Humoral Th2 response (LACK Th1 mediators)?

A

Lepromatous leprosy

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8
Q

What is the characteristic of Tuberculoid leprosy immunity response?

A

High cell mediated response with Largely Th1 mediated response

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9
Q

Tx of Tuberculoid leprosy?

A

Sulfone (Dapsone) + rifampin for 6 months

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10
Q

MOA of Sulfone?

A

Inhibits para-aminobenxoic acid metabolism

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11
Q

Tx of lepromatous leprosy?

A

Dapsone + rifampin + Clofazimine (at least 2yrs)

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12
Q

Prophylaxis tx for Leprosy in children?

A

Dapsone

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13
Q

LEpromatous leprosy is?

A

LEthal

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14
Q

Herpes Virus Genome?

A

Enveloped DS linear DNA

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15
Q

Method for HHV detection?

A

PCR

Tzanck test

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16
Q

Tzanck test?

A

HHV–> smear to detect multi nucleated giant cells in VZV infected skin fragments

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17
Q

VZV is a?

A

Alphaherpesvirus

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18
Q

HHV6 + HHV7?

A

Betaherpesvirus

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19
Q

Latency HHV?

A

Soon after initial infection
NO virus particles are produced
Entire genome maintained extrachromasomally

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20
Q

Neurotropic latency?

A

VZV

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21
Q

Lymphotrophic latency?

A

HHV6 + HHV7

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22
Q

Fever followed by itchy rash starting on scalp and trunk? (primary infection only)

A

Varicella (chickenpox)

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23
Q

Shingles?

A

Reactivation of VZV

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24
Q

Adult w/ Sudden onset of pain and rash or Pneumonia? Reactivation

A

Shingles (VZV)

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25
Q

Tx for Adult w/ Pneumonia and Painful rash?

A

Acyclovir and Steroids

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26
Q

Vaccine for VZV?

A

Live attenuated vaccine w/ MMR regiment

adults>50yo: Designed to boost immunity to prevent or lessen Zoster

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27
Q

HIGH fever–> Seizures–> Macular rash?

A

Roseola (HHV 6+7)

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28
Q

Age range for HHV 6+7?

A

3mo – 6yo

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29
Q

Time course for VZV to show up as chickenpox?

A

Infection-> replication in lymph nodes-> primary viremia-> Replication in organs-> 2nd viremia-> SKIN Vesicular Rash (14 days)

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30
Q

Parvovirus structure?

A

Linear single stranded DNA + nonenveloped

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31
Q

Where do parvovirus replicate?

A

Rapidly dividing cells-> to use active DNA poly

RBC precursors

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32
Q

Virus that causes decreased reticulocyte count?

A

Parvovirus B19

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33
Q

Five most common childhood diseases?

A 
Chickenpox
measles 
Rubella 
Roseola 
Parvo B19
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34
Q

“fifth disease” or “slapped cheek rash”

A

Erythema infectiosum (B19)

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35
Q

Causes “Lacy rash on the trunk and limbs?”

A

B19 erythema infectiosum

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36
Q

Adult experiencing Joint pain or swelling (polyartheritis) + flu like symptoms + small rash?

A

B19 erythema infectiosum

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37
Q

What virus causes transient aplastic crisis in SCD patients?

A

B19 because it replicates in RBC precursors and thus reduces the reticulocyte count

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38
Q

B19 infection in pregnant women?

A

Transplacentally transmitted to fetus and can cause fetal anemia. hydrops fetalis, or miscarriage

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39
Q

Variola virus structure?

A

Smallpox= Complex (“brick shaped”), intracellular core, lateral bodies, enveloped

Large DS DNA

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40
Q

Where does Smallpox replicate?

A

Even though its a DS DNA virus it replicates in the CYTOPLASM

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41
Q

Rash that starts in Head or limbs w/ vesicles that hve a dot in the middle + which become hard then crust over and fall off?

A

Smallpox infection–> all lesion @ same stage

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42
Q

Two basic forms of Smallpox?

A

Variola major–> 25% death rate

Variola minor–> 1% death rate

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43
Q

Smallpox mode of transmission?

A

Inhalation causing systemic disease w/ generalized rash

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44
Q

pt w/ HIGH fever, malaise, aches, red spots in the mouth and tongue, firm pitted lesions all same stage?

A

Smallpox infection

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45
Q

Afebrile pt w/ superficial lesions all in different stages?

A

Chickenpox

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46
Q

Tropical disease w/ lesions on face, trunk, and limbs?

A

Childhood Molluscum contagiosum

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47
Q

Young adulthood form of Molluscum contagiousum?

A

Lower abdominal lesions

Sexually transmitted

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48
Q

Lesions disappear 2-12 months

Large cytoplasmic inclusions in eosinophils?

A

Molluscum contagiosum (adulthood form)

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49
Q

Who should not receive the Live smallpox vaccine?

A

Pregnant or breast feeding women
Immunocomprimised
People w/ eczema, atopic dermatitis, severe acne
CHF pts

50
Q

Life threatening complications of Live smallpox vaccine?

A

Progressive vaccinia (CMI defects)
Postvaccinial encephalitis
Eczema
Myopericarditis or heart attacks

51
Q

Measles Prodrome 3Cs?

A

Coryza
Cough
Conjunctivitis

52
Q

Pt w/ white spots overlying erythematous base in the buccal mucosa?

A

Koplik spots (measles)

53
Q

Complications of Measles?

A

Giant cell pneumonia
Acute appendicitis (children)
Otitis media
NON teratogenic

54
Q

3 day Rash beginning at hairline and spreading cephalocaudally + Red spots on Posterior soft/hard palate?

A

Rubella (Togavirus)

55
Q

Painful Postauricular LAD + polyarthritis?

A

Rubella (togavirus)

56
Q

Viruses causing polyarthritis in adults?

A

Rubella + parvovirus

57
Q

Child <2 yo w/ high Fever and maculopapular rash?

A

Roseola infantum (HHV 6)

58
Q

Child w/ generalized rash >3 days, Temp> 38.3 + cough, conjunctivitis and rhinorhea?

A

Measles

59
Q

Measles genome and mode of transmission?

A
  • RNA
    Lacks NA but has H rather than HA protein
    trans: Respiratory route
60
Q

Measles rash coincides w/?

A

T cell response and clearance of virus

61
Q

Replication in lymphoid tissue results in reticuloendothelial Giant cells?

A

Early stage of Measles

62
Q

Complication of Measles?

A

0-1 month–> acute Encephalitis
1-9 months–> Measles inclusion body enceph
1-12 years–> Subacute slerosing Panencep

63
Q

Both measles and mumps are antigenically stable monotypic viruses?

A

Once infected or vaccinated Immunity is for Life

64
Q

Virus initially infects nasal mucosa + URT epithelium and spreads via lymph nodes?

A

Mumps

65
Q

Pt with infected Parotid gland?

A

Mumps (first clinical sign)

66
Q

Complications of mumps?

A 
Aseptic meningitis 
Deafness 
Gonadal atrophy
Myocardial invasion
type I DB
Abortion
67
Q

Pt w/ low grade fever, conjunctivitis, sore throat, LAD and Morbilliform rash?

A

Rubella

68
Q

Rubella virus in pregnant women?

A

Abortions

Birth defects: motor or mental, deafness, CHD, cataracts

69
Q

Rubella tx and antivirals?

A

vaccine for Fetal protection

NO antivirals because Disease is mild

70
Q

What virus has H protein, lacks NA, and forms intracellular inclusion?

A

Measles virus

71
Q

Measles virus genome and transmission?

A

non segmented -RNA

Respiratory route

72
Q

What does the Rash in measles coincide with?

A

T cell response and virus clearance

73
Q

Rash lasting >3 days
Temp >38.3
Cough, rhinorrhea, conjunctivitis ?

A

Measles

74
Q

Wathin-Finkeldey cells= Reticuloendothelial giant cells?

A

measles replication in lymphoid tissue

75
Q

Maculopapular rash + Koplik spots?

A

Measles

76
Q

Complication of Measles includes?

A

ADEM + PIE-> encephalomyelitis (AI demyelinating)
MIBE–> Measles inclusion body encephalitis
SSPE–> Subacute sclerosing panencephalitis

77
Q

Measles vaccine?

A

Live attenuated–> life long protection

78
Q

Viruses exhibiting monotypic antigenic stability?

A

Measles + Mumps–> Monotypic meaning no Ag shift or drifts ONE VACCINE needed

79
Q

First clinical sign of Mumps infections?

A

Infection of Parotid gland

80
Q

Complication of Mumps?

A

CNS: Aseptic meningitis + Deafness
Few: gonadal + myocardial + abortions

81
Q

Togavirus genome?

A

Rubella= nonsegmented +RNA

82
Q

Mild disease w/ low fever,conjunctivitis, Sore throat, LAD and RASH?

A

Rubella

83
Q

Spread of Togavirus (rubella)?

A

Virus sheds from skin after rash diapers (up to 1mo)

84
Q

Pregnancy and Rubella?

A

Causes congenital birth defects

85
Q

Rickettsia characteristics?

A

G- Rods

Obligate intracellular parasites

86
Q

Rickettsia replication?

A

Cytoplasm of Endothelial and muscle cells of small BV

87
Q

Vehicle for Rocky mountain spotless fever?

A

TICKs

88
Q

Flu symptoms–> Rash from ankles+ wrists to palms + soles+ trunk?

A

Rocky mtn spoted fever (RMSF)

89
Q

Rash on soles and palms w/ significant calf tenderness?

A

RM Spotted Fever

90
Q

Measures cross reactivity of anti-rickettsial antibodies to Proteus OX strains?

A

Weil-Felix test

91
Q

Dx of RM Spotted Fever?

A

Indirect fluorescent Ab assay

Weil-Felix test

92
Q

Tx of RMSF?

A

Prevention

Doxcycyline

93
Q

Typhus mode of transmission?

A

Body lice

94
Q

Associated w/ Poverty + war?

A

body lice thus Typhus

95
Q

Ehrlichia chaffeensis (HME) transmission + replication?

A

Lone Star Deer Ticks

replicated in MONOCYTES

96
Q

Dx of E. chaffeensis?

A

Wright/ Giemsa stain of Morulae in Monocytes

97
Q

Tx of E. Chaffeensis?

A

Doxycycline

98
Q

Morulae?

A

inclusion bodies formed by replicating microbes

99
Q

What organisms form Morulae?

A

E. chafeensis

A phagocytophilia

100
Q

A. phagocytophilia transmission and replication?

A

Ixodes Deer Tick

HMA= replicates inside granulocytes

101
Q

Cause of “Rocky mtn Spotless fever?”

A

A. phagocytophilia (RASH is rare)

102
Q

Cause of “Rocky mtn spotted fever?”

A

Rickettsia

103
Q

Replicates in monocytes?

A

Anaplasma

104
Q

Replicates in Granulocyte?

A

Ehrlichia

105
Q

Cause of relapsing fever in Borrelia?

A

Undergo Antigenic variation

106
Q

B. burgdorferi is causative agent of?

A

Lyme disease

107
Q

Lyme disease is transmitted by?

A

Ixodes deer tick NyMPH

108
Q

Classic Bull’s eye rash @ site of bite?

A

Early Lyme disease

109
Q

Arthritis, Facial palsy, and peripheral neuropathy?

A

2nd Lyme disease (disseminated)

110
Q

Erosive arthritis @ KNEEs + numbness + Bell Palsy?

A

Chronic Lyme disease

111
Q

Dx of Lyme disease?

A

ELISA + Western blot

PCR based NAATs

112
Q

Tx of early and chronic lyme disease?

A

Early-> Doxycycline

Chronic–> IV cephalosporins

113
Q

B hermsii or B recurrentis cause?

A

Relapsing fever

114
Q

Transmission of B. hermsii?

A

TIck

115
Q

Transmission of B recurrentis?

A

Louse

116
Q

Endemic in Western US?

A

B hermsii

117
Q

Dx and Tx of relapsing fever?

A

Wright/ Giemsa stain
Serology
Tx: DOXY

118
Q

Leptospira interogans is transmission?

A

Water contaminated w/ Animal urine

119
Q

Flu symptoms + Renal Damage + Jaundice + Meningitis?

A

Leptospira

120
Q

Tx and Dx for Leptospirosis?

A

Serology + penicillin

121
Q

Bartonella hensalae transmission?

A

Cat scratch fever

122
Q

Swollen lymph nodes and scratch marks–> TX?

A

Erythromycin or spontaneous

Dermatology (4 decks)

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