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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.

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2
Q

Treatment for systemic mycoses

A

Fluconazole or itraconazole for local infection; amphotericin B for systemic infection.

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3
Q

Difference between systemic mycoses and TB

A

Similar in that they form granulomas, but there is NO person-person transmission.

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4
Q

Histoplasmosis mnemonic

A

Histo hides (within macrophages).

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5
Q

Where can you find histo?

A

Bird or bat droppings in the Mississippi and Ohio River valleys.

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6
Q

Histo causes what disease

A

PNA

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7
Q

Histo yeast size?

A

Smaller than RBC

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8
Q

Blasto mnemonic

A

Blasto buds broadly.

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9
Q

Blasto on histo

A

Broad-base budding (same size as RBC)

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10
Q

Blasto diasease

A

inflammatory lung disease and can disseminate to skin and bone. Forms granulomatous nodules.

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11
Q

Blasto origin

A

States east of the Mississippi River and Central America.

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12
Q

Coccidio histo

A

Spherule is much larger than RBC and is filled with endospores.

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13
Q

Coccidio location

A

Southwest US, California.

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14
Q

Coccidio diseases

A

PNA and meningitis, can disseminate to bone and skin. Case rate inreases after eartquakes (spores thrown up in dust)

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15
Q

Paracoccidiomycosis location and histo

A

Latin America. Budding yeast with “captain’s wheel” formation (much larger than RBC)

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16
Q

Tinea versicolor organism

A

Malassezia furfur

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17
Q

Tinea versicolor path

A

Degradation of lipids produces acids that damage melanocytes and cause hypopigmented and/or hyperpigmented patches.

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18
Q

Tinea versicolor environment

A

Hot, humid weather

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19
Q

Tinea versicolor tx

A

Topical miconazole, selenium sulfide (Selsun).

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20
Q

Tinea versicolor histo

A

“Spaghetti and meatball” appearance

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21
Q

Tineae apperance on skin

A

Pruritic lesions with central clearing resembling a ring, caused by dermatophytes (Microsporum, Trichophyton, and Epidermophyton.)

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22
Q

Tineae histo

A

Mold hyphae in KOH prep, not dimorphic

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23
Q

Candida vaginal tx

A

Topical azole

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24
Q

Candida oral/esophageal tx

A

Fluconazole or caspofungin

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25
Q

Candida systemic tx

A

Fluconazole, amphotericin B, or caspofungin

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26
Q

Candida histo

A

Dimorphic yeast. Pseudohyphae and budding yeasts at 20 degrees celsius and germ tubes at 37 degrees.

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27
Q

Can Aspergillus cause hepatocellular carcinoma?

A

Some species produce aflatoxins, so YES

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28
Q

Aspergillus fumigatus mnemonic

A

Think “A” for Acute Angles in Aspergillus.

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29
Q

Aspergillus morphology.

A

Not dimorphic. Septate hyphae that branch at 45 degrees. Conidiophore with radiating chaisn of spores.

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30
Q

Cryptococcus brain imaging

A

Soap bubble lesions in brain

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31
Q

Is cryptococcus dimorphic?

A

Not dimorphic, but heavily encapsulated.

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32
Q

Where to find crypto?

A

Soil, pigeon droppings and inhaled with hematogenous spread to meninges.

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33
Q

Specific test for cryptococcus?

A

Latex agglutination test detects polysaccharide capsular antigen

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34
Q

Mucor and Rhizopus spp. disease

A

Mucormycosis in DKA and leukemic patients.

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35
Q

Mucor morphology

A

irregular, broad, nonseptate hyphae branching at wide angles.

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36
Q

PCP tx

A

Bactrim, pentamidine, dapsone (PPx only), atovaquone (PPx only). Start PPx when CD4 <200 in HIV patients.

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37
Q

PCP morphology

A

Disc-shaped yeast on methenamine silver stain.

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38
Q

Sporothrix scheckii dz and path

A

Sporotrichosis (rose gardener’s disease) causes an ascending lymphanigitis with little systemic illness. Local pustule or ulcer with nodules along draining lymphatics.

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39
Q

Sporotrichosis tx

A

Itraconazole or Potassium Iodide

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40
Q

Giardia transmission

A

cysts in ater

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41
Q

Giardia diagnosis

A

Trophozoites or Cysts in stool

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42
Q

What is dysentery?

A

Any inflammation of the colon causing bloody diarrhea.

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43
Q

Entamoeba histolytica presntation

A

Amebiasis: bloody diarrhea (dysentery), liver abscess (Anchovy past exudate), RUQ pain (histology shows flask-shaped ulcer if submucosal abscess of colon ruptures)

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44
Q

Entamoeba transmission

A

Cysts in water

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45
Q

Entamoeba dx

A

Serology and/or trophozoites (with RBCs in the cytoplasm) or cysts (with up to 4 nuclei) in stool.

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46
Q

Entamoeba tx

A

Flagyl; iodoquinol for asx cyst passer

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47
Q

Crytopsoridium presentation

A

Severe diarrhea in AIDS, mild watery diarrhea in immunocompetent

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48
Q

Cryptosporidium transmission

A

oocysts in water

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49
Q

Cryptosporidium dx

A

oocysts on acid-fast stain

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50
Q

Cryptosporidium prevention

A

Filtering city water supplies

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51
Q

Cryptosporidium tx

A

Nitazoxanide in immunocomptenent hosts…what about in AIDS?

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52
Q

Congenital toxo

A

Classic Triad: Chorioretinitis, hydrocephalus, and intracranial calcifications.

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53
Q

Toxo in HIV presentation

A

Brain abscess with ring-enhancing lesions on CT/MRI

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54
Q

Toxo transmission

A

Cysts in meat or oocysts in cat feces; crosses placenta (pregnant women should avoid cats)

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55
Q

Toxo dx

A

Serology, biopsy (tachyzoite)

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56
Q

Toxo tx

A

Sulfadiazine + pyrimethamine

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57
Q

Naegleria fowleri transmission

A

Enters cribriform plate in fresh water lakes

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58
Q

Naegleria dx

A

Amoebas in spinal fluid

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59
Q

Naegleria tx

A

Amphotericin B: slim chance of survival either way

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60
Q

African sleeping sickness caused by

A

Trypanosoma brucei.

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61
Q

Trypanosoma transmission

A

Tsetse fly, a painful bite

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62
Q

Trypanosoma dx

A

Blood smear

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63
Q

African sleeping sickness presentation

A

Enlarged lymph nodes, recurring fever (due to antigenic variation), somnolence, coma

64
Q

African sleeping sickness tx

A

Suramin for blood-borne disease or melarsoprol for CNS penetration (“it sure is nice to go to sleep”; melatonin helps with sleep)

65
Q

Malaria general sxs

A

Fever, HA, anemia, splenomegaly

66
Q

P. vivax/ovale presentation

A

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
Q

P. falciparum presentation

A

Severe; irregular fever patterns; parasitized RBCs occlude capillaries in brain (cerebral malaria), kidneys, lungs

68
Q

P. malariae presentation

A

72 hr cycle (quartan)

69
Q

What mosquitos carry malaria

A

Anopheles

70
Q

Malaria dx

A

Blood smear, trophozoite ring form within RBC, schizont containing merozoites

71
Q

Malaria tx

A

Begin with chloroquine which blocks Plasmodium heme polymerase; if resistant, use mefloquine or atovaquone/proguanil

72
Q

Know heme synthesis pathway!!!

A

!!!!!

73
Q

Life threatening malaria tx

A

IV quinidine (test for G6PD deficiency)

74
Q

Why test for G6PD deficiency in patient with life threatening malaria

A

Because some antimalarials cause hemolysis!!!

75
Q

G6PD and Malaria relationship

A

Decreased risk of infection, but hemolysis from antimalarials is a risk

76
Q

Vivax/ovale tx

A

Add primaquine for hypnozoite (test for G6PD deficiency)

77
Q

Babesia presentation

A

Fever and hemolytic anemia

78
Q

Babesia origin

A

Northeastern US

79
Q

What increases risk of severe disease with Babesia

A

Asplenia

80
Q

Babesia transmission

A

Ixodes tick, may be coinfected with Borrelia

81
Q

Babesia dx

A

Blood smear, ring form, “Maltese cross”; PCR

82
Q

Babesia tx

A

Atovaquone + azithromycin

83
Q

Trypanosoma cruzi presentation

A

Chagas disease; dilated cardiomyopathy, megacolon, megaesophagus

84
Q

Where to find Trypanosoma cruzi

A

South America

85
Q

Chagas disease transmission

A

Reduviid bug (kissing bug) feces, deposited in a painless bite (much like a kiss)

86
Q

Chagas disease dx

A

Blood smear

87
Q

Chagas disease tx

A

Benznidazole or nifurtimox

88
Q

Leishmania donovani presentation

A

Visceral leishmaniasis (kala-azar): spiking fevers, hepatosplenomegaly, pancytopenia

89
Q

Leishmaniasis transmission

A

Sandfly

90
Q

Leishmaniasis dx

A

macrophages containing amastigotes

91
Q

leishmaniasis tx

A

ampho B, sodium stibogluconate

92
Q

Trichomonas vaginalis presentation

A

Vaginitis: foul smelling, greenish discharge, itching and burning

93
Q

Trichomonas cysts transmission

A

NO CYSTS FORMED, can only be transmitted sexually

94
Q

Trich dx

A

Mobile trophozoites on wet mount; “strawberry cervix”

95
Q

Trich tx

A

Flagyl for patient and partner PPx

96
Q

What causes pinworms

A

Enterobius vermicularis

97
Q

Pinworms tx

A

Bendazoles or pyrantel pamoate (worms are Bend-y)

98
Q

What causes giant roundworm

A

Ascaris lumbricoides

99
Q

Roundworm transmission

A

fecal-oral; eggs visible in feces under microscope

100
Q

Roundworm tx

A

Bendazoles or pyrantel pamoate

101
Q

What is strongyloides stercoralis

A

Intestinal infection causing vomiting, diarrhea, epigastric pain (may be peptic ulcer like)

102
Q

Strongyloides transmission

A

Larvae in soil penetrate the skin

103
Q

Strongyloides tx

A

Ivermectin or albendazole

104
Q

What causes hookworms

A

Ancylostoma duodenale, Necator americanus

105
Q

Hookworms path

A

Cause anemia by sucking blood from intestinal walls

106
Q

Hookwroms tx

A

Bendazoles or pyrantel pamoate

107
Q

Tx for onchocerca volvulus

A

Ivermectin (ivermectin for river blindness)

108
Q

Loa loa tx

A

Diethylcarbamazine

109
Q

Wuchereria brancrofti tx

A

Diethylcarbamazine

110
Q

Wuchereria dz

A

Elephantiasis (blocks lymphatic vessels)

111
Q

Toxocara canis tx

A

Albendazole or mebendazole

112
Q

Ingested nematodes mnemonic

A

EAT (fecal-oral): Enterobius, Ascaris, Toxocara
SANd (cutaneous): Strongyloides, Ancylostoma, Necator
LOW (bites): Loa loa, Onchocerca volvulus, Wuchereria bancrofti

113
Q

Taenia solium tx

A

Praziquantel for intestinal infection. Praziquantel for cysticercosis and Albendazole for neurocysticercosis

114
Q

Diphyllobothrium tx

A

Praziquantel

115
Q

Raw freshwater fish disease

A

Diphyllobothrium latum Vitamin B12 deficiency

116
Q

Echinococcus granulosus dz

A

Hydatid cysts in liver: can cause anaphylaxis if antigens release (surgeons preinject with ethanol to kill cysts before removal)

117
Q

Echinococcus tx

A

Albendazole

118
Q

Echinococcus transmission

A

Eggs from dog feces

119
Q

What kind of worms are Cestodes

A

Tapeworms

120
Q

What kind of worms are Trematodes

A

Flukes

121
Q

Schistosoma tx

A

Praziquantel

122
Q

Clonorchis sinensis

A

Praziquantel

123
Q

What infection leads to squamous cell carcinoma of the bladder

A

S. haematobium

124
Q

What is associated with cholangiocarcinoma

A

Clonorchis sinensis

125
Q

Cysticercosis vs. Neurocysticercosis?

A

????

126
Q

What causes microcytic anemia (worms)

A

Ancylostoma, Necator (hookworms)

127
Q

What causes perianal pruritus

A

Enterobius

128
Q

What causes portal HTN

A

Schistosoma mansoni, Schistosoma japonicum

129
Q

What is viral recombination

A

Exchanging genes between 2 chromosomes by crossing over within regions of significant base sequence homology

130
Q

Recombination elaborated…

A

???????

131
Q

What causes worldwide flu pandemics

A

Reassortment between viruses with segmented genomes like flu

132
Q

Viral complementation

A

When one virus needs another one already infected to work (Hep D’s relationship to B)

133
Q

Phenotypic mixing

A

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
Q

Example of viral Phenotypic mixing

A

????

135
Q

Live attenuated vs. Killed/inactivated vaccines

A

Live attenuated induce humoral and cell-mediated immunity. Killed/inactivated only induce humoral immunity but cannot revert to virulence.

136
Q

Live attenuated vaccines

A

Smallpox, Yellow fever, VZV, Sabin polio virus, MMR, Influenza (intranasal)

137
Q

How often do live attenuated vaccines need a boost?

A

No booster needed

138
Q

Immunocompromised patients and vaccines

A

Do not give live vaccines to them or their close contacts

139
Q

Can MMR be given to HIV patients

A

Yes, with no immunodeficiency

140
Q

Killed vaccines

A

Rabies, Influenza (injected), Salk Polio, and HAV vaccines

141
Q

Killed vaccines mnemonic

A

RIP Always: Rabies, Flu, Salk Polio, Hep A

142
Q

Recombinant vaccines

A

HBV (antigen=recombinant HBsAg), HPV (types 6, 11, 16, and 18)

143
Q

All DNA viruses have what genome

A

dsDNA except the Parvoviridae

144
Q

Which DNA viruses are linear genomes

A

All are linear except papilloma, polyoma, and depadnaviruses which are circular

145
Q

All RNA viruses have what genoma

A

All are ssRNA except Reoviridae (repeato-virus is dsRNA)

146
Q

Positive stranded RNA viruses mnemonic

A

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
Q

What naked genomes are infectious

A

Most dsDNA and positive strand ssRNA are infectious. Exceptions are poxviruses and HBV (dsDNA)

148
Q

Where do DNA viruses replicate

A

In the nucleus (except poxvirus)

149
Q

Where do RNA viruses replicate

A

In the cytoplasm (except flu and retroviruses)

150
Q

Viral envelopes mnemonic

A

Give PAPP smears and CPR to a naked Heppy. Papilloma, adeno, parvo, polyoma, calici, picorna, reo, and hepevirus.

151
Q

Where do enveloped viruses get their membrane

A

Mostly from the plasma membrane. herpesviruses acquire envelopes from nuclear membrane.

152
Q

Name the DNA viruses mnemonic

A

2 HHAPPPPY: hepadna, herpes, adeno, pox, parvo, papilloma, polyoma

153
Q

What are the circular DNA viruses

A

papilloma and polyoma (circular, supercoiled) and hepadna (circular, incomplete)

154
Q

What shape are DNA viruses

A

all are Icosahedral except pox (complex)

155
Q

DNA virus replication

A

All replicate in the nucleus except pox (carries own DNA-dependent RNA polymerase)

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