Micro 2 Flashcards
1
Q
What are some facts about all systemic mycoses
A
All the ones to know can cause pneumonia and can disseminate. All are dimorphic fungi that are mold in cold and yeast at body temperature, escept cocidio which is a spherule in tissue.
2
Q
Treatment for systemic mycoses
A
Fluconazole or itraconazole for local infection; amphotericin B for systemic infection.
3
Q
Difference between systemic mycoses and TB
A
Similar in that they form granulomas, but there is NO person-person transmission.
4
Q
Histoplasmosis mnemonic
A
Histo hides (within macrophages).
5
Q
Where can you find histo?
A
Bird or bat droppings in the Mississippi and Ohio River valleys.
6
Q
Histo causes what disease
A
PNA
7
Q
Histo yeast size?
A
Smaller than RBC
8
Q
Blasto mnemonic
A
Blasto buds broadly.
9
Q
Blasto on histo
A
Broad-base budding (same size as RBC)
10
Q
Blasto diasease
A
inflammatory lung disease and can disseminate to skin and bone. Forms granulomatous nodules.
11
Q
Blasto origin
A
States east of the Mississippi River and Central America.
12
Q
Coccidio histo
A
Spherule is much larger than RBC and is filled with endospores.
13
Q
Coccidio location
A
Southwest US, California.
14
Q
Coccidio diseases
A
PNA and meningitis, can disseminate to bone and skin. Case rate inreases after eartquakes (spores thrown up in dust)
15
Q
Paracoccidiomycosis location and histo
A
Latin America. Budding yeast with “captain’s wheel” formation (much larger than RBC)
16
Q
Tinea versicolor organism
A
Malassezia furfur
17
Q
Tinea versicolor path
A
Degradation of lipids produces acids that damage melanocytes and cause hypopigmented and/or hyperpigmented patches.
18
Q
Tinea versicolor environment
A
Hot, humid weather
19
Q
Tinea versicolor tx
A
Topical miconazole, selenium sulfide (Selsun).
20
Q
Tinea versicolor histo
A
“Spaghetti and meatball” appearance
21
Q
Tineae apperance on skin
A
Pruritic lesions with central clearing resembling a ring, caused by dermatophytes (Microsporum, Trichophyton, and Epidermophyton.)
22
Q
Tineae histo
A
Mold hyphae in KOH prep, not dimorphic
23
Q
Candida vaginal tx
A
Topical azole
24
Q
Candida oral/esophageal tx
A
Fluconazole or caspofungin
25
Candida systemic tx
Fluconazole, amphotericin B, or caspofungin
26
Candida histo
Dimorphic yeast. Pseudohyphae and budding yeasts at 20 degrees celsius and germ tubes at 37 degrees.
27
Can Aspergillus cause hepatocellular carcinoma?
Some species produce aflatoxins, so YES
28
Aspergillus fumigatus mnemonic
Think "A" for Acute Angles in Aspergillus.
29
Aspergillus morphology.
Not dimorphic. Septate hyphae that branch at 45 degrees. Conidiophore with radiating chaisn of spores.
30
Cryptococcus brain imaging
Soap bubble lesions in brain
31
Is cryptococcus dimorphic?
Not dimorphic, but heavily encapsulated.
32
Where to find crypto?
Soil, pigeon droppings and inhaled with hematogenous spread to meninges.
33
Specific test for cryptococcus?
Latex agglutination test detects polysaccharide capsular antigen
34
Mucor and Rhizopus spp. disease
Mucormycosis in DKA and leukemic patients.
35
Mucor morphology
irregular, broad, nonseptate hyphae branching at wide angles.
36
PCP tx
Bactrim, pentamidine, dapsone (PPx only), atovaquone (PPx only). Start PPx when CD4 <200 in HIV patients.
37
PCP morphology
Disc-shaped yeast on methenamine silver stain.
38
Sporothrix scheckii dz and path
Sporotrichosis (rose gardener's disease) causes an ascending lymphanigitis with little systemic illness. Local pustule or ulcer with nodules along draining lymphatics.
39
Sporotrichosis tx
Itraconazole or Potassium Iodide
40
Giardia transmission
cysts in ater
41
Giardia diagnosis
Trophozoites or Cysts in stool
42
What is dysentery?
Any inflammation of the colon causing bloody diarrhea.
43
Entamoeba histolytica presntation
Amebiasis: bloody diarrhea (dysentery), liver abscess (Anchovy past exudate), RUQ pain (histology shows flask-shaped ulcer if submucosal abscess of colon ruptures)
44
Entamoeba transmission
Cysts in water
45
Entamoeba dx
Serology and/or trophozoites (with RBCs in the cytoplasm) or cysts (with up to 4 nuclei) in stool.
46
Entamoeba tx
Flagyl; iodoquinol for asx cyst passer
47
Crytopsoridium presentation
Severe diarrhea in AIDS, mild watery diarrhea in immunocompetent
48
Cryptosporidium transmission
oocysts in water
49
Cryptosporidium dx
oocysts on acid-fast stain
50
Cryptosporidium prevention
Filtering city water supplies
51
Cryptosporidium tx
Nitazoxanide in immunocomptenent hosts...what about in AIDS?
52
Congenital toxo
Classic Triad: Chorioretinitis, hydrocephalus, and intracranial calcifications.
53
Toxo in HIV presentation
Brain abscess with ring-enhancing lesions on CT/MRI
54
Toxo transmission
Cysts in meat or oocysts in cat feces; crosses placenta (pregnant women should avoid cats)
55
Toxo dx
Serology, biopsy (tachyzoite)
56
Toxo tx
Sulfadiazine + pyrimethamine
57
Naegleria fowleri transmission
Enters cribriform plate in fresh water lakes
58
Naegleria dx
Amoebas in spinal fluid
59
Naegleria tx
Amphotericin B: slim chance of survival either way
60
African sleeping sickness caused by
Trypanosoma brucei.
61
Trypanosoma transmission
Tsetse fly, a painful bite
62
Trypanosoma dx
Blood smear
63
African sleeping sickness presentation
Enlarged lymph nodes, recurring fever (due to antigenic variation), somnolence, coma
64
African sleeping sickness tx
Suramin for blood-borne disease or melarsoprol for CNS penetration ("it sure is nice to go to sleep"; melatonin helps with sleep)
65
Malaria general sxs
Fever, HA, anemia, splenomegaly
66
P. vivax/ovale presentation
48 hr cycle (tertian; includes fever on first day and third day, thus fevers are actually 48 hrs apart); dormant form (hypnozoite) in liver.
67
P. falciparum presentation
Severe; irregular fever patterns; parasitized RBCs occlude capillaries in brain (cerebral malaria), kidneys, lungs
68
P. malariae presentation
72 hr cycle (quartan)
69
What mosquitos carry malaria
Anopheles
70
Malaria dx
Blood smear, trophozoite ring form within RBC, schizont containing merozoites
71
Malaria tx
Begin with chloroquine which blocks Plasmodium heme polymerase; if resistant, use mefloquine or atovaquone/proguanil
72
Know heme synthesis pathway!!!
!!!!!
73
Life threatening malaria tx
IV quinidine (test for G6PD deficiency)
74
Why test for G6PD deficiency in patient with life threatening malaria
Because some antimalarials cause hemolysis!!!
75
G6PD and Malaria relationship
Decreased risk of infection, but hemolysis from antimalarials is a risk
76
Vivax/ovale tx
Add primaquine for hypnozoite (test for G6PD deficiency)
77
Babesia presentation
Fever and hemolytic anemia
78
Babesia origin
Northeastern US
79
What increases risk of severe disease with Babesia
Asplenia
80
Babesia transmission
Ixodes tick, may be coinfected with Borrelia
81
Babesia dx
Blood smear, ring form, "Maltese cross"; PCR
82
Babesia tx
Atovaquone + azithromycin
83
Trypanosoma cruzi presentation
Chagas disease; dilated cardiomyopathy, megacolon, megaesophagus
84
Where to find Trypanosoma cruzi
South America
85
Chagas disease transmission
Reduviid bug (kissing bug) feces, deposited in a painless bite (much like a kiss)
86
Chagas disease dx
Blood smear
87
Chagas disease tx
Benznidazole or nifurtimox
88
Leishmania donovani presentation
Visceral leishmaniasis (kala-azar): spiking fevers, hepatosplenomegaly, pancytopenia
89
Leishmaniasis transmission
Sandfly
90
Leishmaniasis dx
macrophages containing amastigotes
91
leishmaniasis tx
ampho B, sodium stibogluconate
92
Trichomonas vaginalis presentation
Vaginitis: foul smelling, greenish discharge, itching and burning
93
Trichomonas cysts transmission
NO CYSTS FORMED, can only be transmitted sexually
94
Trich dx
Mobile trophozoites on wet mount; "strawberry cervix"
95
Trich tx
Flagyl for patient and partner PPx
96
What causes pinworms
Enterobius vermicularis
97
Pinworms tx
Bendazoles or pyrantel pamoate (worms are Bend-y)
98
What causes giant roundworm
Ascaris lumbricoides
99
Roundworm transmission
fecal-oral; eggs visible in feces under microscope
100
Roundworm tx
Bendazoles or pyrantel pamoate
101
What is strongyloides stercoralis
Intestinal infection causing vomiting, diarrhea, epigastric pain (may be peptic ulcer like)
102
Strongyloides transmission
Larvae in soil penetrate the skin
103
Strongyloides tx
Ivermectin or albendazole
104
What causes hookworms
Ancylostoma duodenale, Necator americanus
105
Hookworms path
Cause anemia by sucking blood from intestinal walls
106
Hookwroms tx
Bendazoles or pyrantel pamoate
107
Tx for onchocerca volvulus
Ivermectin (ivermectin for river blindness)
108
Loa loa tx
Diethylcarbamazine
109
Wuchereria brancrofti tx
Diethylcarbamazine
110
Wuchereria dz
Elephantiasis (blocks lymphatic vessels)
111
Toxocara canis tx
Albendazole or mebendazole
112
Ingested nematodes mnemonic
EAT (fecal-oral): Enterobius, Ascaris, Toxocara
SANd (cutaneous): Strongyloides, Ancylostoma, Necator
LOW (bites): Loa loa, Onchocerca volvulus, Wuchereria bancrofti
113
Taenia solium tx
Praziquantel for intestinal infection. Praziquantel for cysticercosis and Albendazole for neurocysticercosis
114
Diphyllobothrium tx
Praziquantel
115
Raw freshwater fish disease
Diphyllobothrium latum Vitamin B12 deficiency
116
Echinococcus granulosus dz
Hydatid cysts in liver: can cause anaphylaxis if antigens release (surgeons preinject with ethanol to kill cysts before removal)
117
Echinococcus tx
Albendazole
118
Echinococcus transmission
Eggs from dog feces
119
What kind of worms are Cestodes
Tapeworms
120
What kind of worms are Trematodes
Flukes
121
Schistosoma tx
Praziquantel
122
Clonorchis sinensis
Praziquantel
123
What infection leads to squamous cell carcinoma of the bladder
S. haematobium
124
What is associated with cholangiocarcinoma
Clonorchis sinensis
125
Cysticercosis vs. Neurocysticercosis?
????
126
What causes microcytic anemia (worms)
Ancylostoma, Necator (hookworms)
127
What causes perianal pruritus
Enterobius
128
What causes portal HTN
Schistosoma mansoni, Schistosoma japonicum
129
What is viral recombination
Exchanging genes between 2 chromosomes by crossing over within regions of significant base sequence homology
130
Recombination elaborated...
???????
131
What causes worldwide flu pandemics
Reassortment between viruses with segmented genomes like flu
132
Viral complementation
When one virus needs another one already infected to work (Hep D's relationship to B)
133
Phenotypic mixing
Viral coinfection means one viral genome can get coated with the surface proteins of the other virus so it can infect a different cell line, but subsequent viruses will be like the normal original one.
134
Example of viral Phenotypic mixing
????
135
Live attenuated vs. Killed/inactivated vaccines
Live attenuated induce humoral and cell-mediated immunity. Killed/inactivated only induce humoral immunity but cannot revert to virulence.
136
Live attenuated vaccines
Smallpox, Yellow fever, VZV, Sabin polio virus, MMR, Influenza (intranasal)
137
How often do live attenuated vaccines need a boost?
No booster needed
138
Immunocompromised patients and vaccines
Do not give live vaccines to them or their close contacts
139
Can MMR be given to HIV patients
Yes, with no immunodeficiency
140
Killed vaccines
Rabies, Influenza (injected), Salk Polio, and HAV vaccines
141
Killed vaccines mnemonic
RIP Always: Rabies, Flu, Salk Polio, Hep A
142
Recombinant vaccines
HBV (antigen=recombinant HBsAg), HPV (types 6, 11, 16, and 18)
143
All DNA viruses have what genome
dsDNA except the Parvoviridae
144
Which DNA viruses are linear genomes
All are linear except papilloma, polyoma, and depadnaviruses which are circular
145
All RNA viruses have what genoma
All are ssRNA except Reoviridae (repeato-virus is dsRNA)
146
Positive stranded RNA viruses mnemonic
I went to a retro toga party where I drank flavored Corona and ate hippy california pickles.
Retrovirus, togavirus, flavivirus, coronavirus, hepevirus, Calcivurs, picornavirus
147
What naked genomes are infectious
Most dsDNA and positive strand ssRNA are infectious. Exceptions are poxviruses and HBV (dsDNA)
148
Where do DNA viruses replicate
In the nucleus (except poxvirus)
149
Where do RNA viruses replicate
In the cytoplasm (except flu and retroviruses)
150
Viral envelopes mnemonic
Give PAPP smears and CPR to a naked Heppy. Papilloma, adeno, parvo, polyoma, calici, picorna, reo, and hepevirus.
151
Where do enveloped viruses get their membrane
Mostly from the plasma membrane. herpesviruses acquire envelopes from nuclear membrane.
152
Name the DNA viruses mnemonic
2 HHAPPPPY: hepadna, herpes, adeno, pox, parvo, papilloma, polyoma
153
What are the circular DNA viruses
papilloma and polyoma (circular, supercoiled) and hepadna (circular, incomplete)
154
What shape are DNA viruses
all are Icosahedral except pox (complex)
155
DNA virus replication
All replicate in the nucleus except pox (carries own DNA-dependent RNA polymerase)
