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Classic Presentations > MICRO > Flashcards

MICRO Flashcards

1
Q

Toxic Shock Sx

Causative Bugs (2), Pres (TRIAD)?

A

(Exotoxins from)

  • Staph aureus
  • Strep pyogenes

PRES = “Fever, Rash, Shock”

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2
Q

Lyme Disease

Epi (incl CLUE), Pres (3 Initial + 3 Later)?

A

Northeastern U.S. Camper / Hiker.

PRES:

  • Erythema migrans (expanding “bull’s eye” / “target” red rash)
  • Facial nerve palsy typically BILAT
  • Flu-like symptoms
  • Neuro (ie encephalopathy, neuropathy)
  • Cardiac: AV Nodal block
  • MSK: Arthritis
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3
Q

CHRONIC Lyme Disease (ie untreated lyme disease)

Pres (3)?

A

PRES:
- Myocarditis
- ** BILATERAL Bell’s Palsy (MC CN involved in chronic lyme disease
= CN 7) **
- Infectious Arthritis

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4
Q

Diphtheria

Causative Bug, Pres (3), Micro Finding, DX (2)?

A

Corynebacterium diphtheriae.

PRES:

  • Pseudomembranous Pharyngitis (“grayish-white memb”) w lymphadenopathy
  • Myocarditis
  • Arrhythmias

FINDING = Gram+ rods w blue/red granules

DX:

  • Elek Test: test for diphtheria exotoxin
  • Gram-Stain
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5
Q

Cutaneous Anthrax

Pres?

A

PRES:

- Boil -> Painless necrotic ulcer w black eschar

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6
Q

Pulmonary Anthrax

Pres (Initial + 4 Subsequent)?

A 
PRES:
- Flu-like symptoms
... Rapid progression to ...
- Fever
- Shock
- Pulm hem
- Mediastinitis
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7
Q

Erythema Infectiosum / 5th Disease (Parvo B19)

Pres?

A

PRES = “Slapped cheeks” / red rash on face.

“Child with fever” -> “Rash on face” -> “Rash on body”

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8
Q

Leprosy (Hanson Dz)

2 Forms,
Causative Bug + Source,
Locations Affected, Pres (CLUE)?

A
  • Lepromatous
  • Tuberculoid

Mycobacterium leprae- Armadillos.

Skin + superficial nerves.

PRES = “glove and stocking” loss of sensation

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8
Q

Lepromatous Leprosy

Immune Response (2), Pres (CLUE + 1)?

A

IMM:

  • LOW cell-mediated immunity
  • Th2 response

PRES: Contagious + Lethal

  • “Leonine (lion-like) facies”
  • Diffuse pres over skin
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10
Q

Tuberculoid Leprosy

Immune Response (2), Pres?

A

IMM:

  • HIGH cell-mediated immunity
  • Th1 response

PRES:
- Few hairless skin plaques

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10
Q

Legionnaires’ Dz

Causative Bug, Pres (2)?

A

Legionella Pneumophila

PRES:

  • Fever + SEVERE Pneumonia
  • Accompanying CNS + GI symptoms
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12
Q

Typhoid Fever

Causative Bug, Pres (4), Prog?

A

Salmonella typhi (found only in humans).

PRES:

  • Fever
  • Headache
  • Diarrhea
  • “Rose spots on abdomen”
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13
Q

Leptospirosis

Causative Bug + Source, Epi, Pres (3)?

A

Leptospira interrogans- water contaminated w animal urine.

Surfers / Tropics.

PRES:

  • Fever + flu-like symptoms
  • Jaundice
  • Photophobia w conjunctival suffusion (erythema WO exudate)
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13
Q

Weil Dz (Icterohem Leptospirosis)

Additional Pres (2)?

A

SEVERE form of Leptospirosis

ADDITIONAL PRES:

  • Liver + Kidney dysfunction -> Azotemia
  • Hem + Anemia
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14
Q

Rocky Mountain Spotted Fever

Causative Bug + Vector, Epi (incl CLUE), Pres (TRIAD)?

A

Rickettsia rickettsii. Vector = Tick.

South Atlantic states (esp North Carolina).

PRES:

  1. Rash: starts at WRISTS / ANKLES -> spreads to center + palms / soles
  2. Fever
  3. Headache
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16
Q

Anaplasmosis + Ehrlichiosis

Causative Bugs (VS) + Vector, Micro Finding (incl VS)?

A

Anaplasma vs Ehrlichia. Vector = Tick.

FINDINGS: Morulae (berry-like inclusions) in cytoplasm.
Granulocytes w morulae vs Monocytes w morulae.

16
Q

Candida Albicans infection

Possible Pres (5)?

A

PRES: (superficial or systemic fungal infection)

  • Chronic mucocutaneous candidiasis / Disseminated candidiasis
  • Diaper Rash
  • Endocarditis (IV drug users)
  • Oral + Esophageal Thrush (Immunocompromised)
  • Vulvovaginitis
18
Q

Mucormycosis

CB, Mech / Path (2 steps), Location Affected, Micro Finding,
Epi (2), Pres (3), RX?

A

Mucor + Rhizopus.

MECH:
Fungi proliferate in bl vessel walls (when excess glucose + ketones) ->
Penetrate cribiform plate -> Enter Brain.

Frontal Lobe abscesses.

FINDING: “Irregular nonseptate hyphae branching at broad / wide angles”

EPI:

  • Diabetics
  • Leukemics

PRES:

  • Headache
  • Facial pain
  • “Black necrotic eschar” on face

RX: Amphotericin B

19
Q

Q Fever

Causative Bug + Sources (2), Transmission, Pres?

A

Coxiella burnetti. ** NO arthropod vector **

  • Tick feces
  • Cattle placenta

TRANS: 2 Sources release spores -> Spores INHALED.

PRES = Pneumonia

20
Q

Mycosis Fungoides / Sezary Sx

Def’n, Pres (4)?

A

Mycosis Fungoides: Cutaneous T cell lymphoma
Sezary Sx: Mycosis Fungoides + Malignant T cells in blood

PRES:

  • Atypical T cells
  • Lymphadenopathy
  • Erythroderma
  • Hepatosplenomegaly
21
Q

Chagas Disease

Causative Bug + Source, Epi, Pres (2)?

A

Trypanosoma cruzi- Reduviid bug.

Primarily in South America.

PRES:

  • Cardiomegaly / Dilated Cardiomyopathy
  • Megaesophagus + Megacolon
22
Q

Rubella virus

Pres (Epi + 4)?

A

PRES: “German / 3-day Measles”. Serious if congenital, mild in children.
- Fever
- Lymphadenopathy (esp postauricular)
- Fine rash: macules that start on face -> spread centrifugally to trunk + extremities
(similar rash pres to Measles)
- Arthralgias

23
Q

Congenital Rubella

Trans, Pres (Skin CLUE + 2), Comp (3)?

A

TRANS: Resp droplets

PRES:

  • “Blueberry muffin” rash (indic of extramedullary hematopoiesis)
  • Cataracts
  • Deafness

COMP:

  • Pulm art hypoplasia / stenosis
  • Septal defects
  • PDA
23
Q

Maternal Rubella

Trans, Pres (3)?

A

TRANS: Resp droplets

PRES:

  • Lymphadenopathy
  • Rash
  • Arthritis
25
Q

Coxsackie B Virus Myocarditis

Comp?

A

COMP:

- Dilated / Congestive Cardiomyopathy

26
Q

Mononucleosis

CB (2), Trans, Cells Affected, Assoc (2),
Pres (4), Micro Finding, DX (Ab)?

A
  • EBV
  • CMV

TRANS: Saliva + Resp secretions. (“Kissing disease”)

CELLS: Infects B cells
- REACTIVE Cytotoxic T cells

ASSOC:

  • Lymphomas: Burkitt + Hodgkin
  • Nasopharyngeal carcinoma

PRES:

  • Fever
  • Lymphadenopathy (esp post cervical)
  • Hepatosplenomegaly
  • Pharyngitis

FINDINGS (on peripheral bl smear): Atypical Lymphocytes (= reactive cytotoxic T cells)

DX: Monospot Test- Heterophile Ab

27
Q

Yellow Fever virus

Trans + Reservoir, Pres (3)?

A

TRANS: Aedes mosquitoe- Human/Monkey reservoir.

PRES:

  • High fever
  • Jaundice
  • Black vomit
28
Q

Measles virus

Pres (5), Comp (2)?

A 
PRES:
- "Koplik Spots" on oral mucosa
- Diffuse maculopapular rash- begins at head and moves down
   (similar rash pres to Rubella)
- Fever
- Conjunctivitis
- Rhinitis + Cough

COMP:

  • Encephalitis / SSPE (SSPE years later)
  • Giant Cell Pneumonia (rare, immunosuppressed)
29
Q

Mumps virus

Pres (3), Comp?

A

PRES: THINK: Big like “POM-poms”

  • Parotitis
  • Orchitis
  • Meningitis (Aseptic)

COMP:
- Sterility (esp after puberty)

30
Q

Rabies virus

Locations Affected (2), Trans, Path, 
Micro Finding, Pres (Course + 4 Stages), RX?
A

(Brain)

  • Purkinje cells (Cerebellum)
  • Neurons (Hippocampus)

TRANS: Bat / Racoon / Skunk bites

PATH: Retrograde migration up axons -> CNS

FINDINGS:
- Negri bodies

PRES: Weeks - month before symptom onset

  1. Fever + Malaise
  2. Agitation + Hydrophobia / Photophobia
  3. Paralysis + Coma
  4. Death

RX: Postexposure wound clean + vaccination w Rabies Ig

Classic Presentations (18 decks)

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