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Year 5 Pathology > Micro > Flashcards

Micro Flashcards

1
Q

BCG vaccine

A

Variable efficacy in studies
Some studies say protects against miliary and TB meningitis
Given to at risk infants
Mycobacterium bovis

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2
Q

Mycobacterium avium-intracellulare

A

Bad for AIDS patients

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3
Q

Mycobacterium marinum

A

Fishtanks

Single clusters papules/plaques

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4
Q

Leprosy

A

Aka Hansen’s disease.
Mycobacterium leprae and M. lepromatous

Skin depigmentation, sensory neuropathy
Tuberculoid form
Lepromatous form (worse)

Tends to affect peripheries (cooler temp)
Armadillo natural reservoir

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5
Q

Caseating granuloma differential

A

TB

Fungus (especially if they are from Minnesota)

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6
Q

Pneumonia

A

Inflamm alveoli
Lobar, interstitial, or broncho-pneumonia
Fever and chills, productive cough with yellow-green sputum, pleuritic CP and tachypnea, decreased breath sounds, dullness to percussion, elevated WBC count

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7
Q

Lobar pneum

A

Consolidation entire lobe on CXR
MCC: S. pneum (95%) and Kleb pneum

Stages:

  1. Consolidation
  2. Red hepatization
  3. Grey hepatization
  4. Resolution
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8
Q

Klebsiella pneumoniae as cause pneumonia

A

Enteric flora….so aspirated somehow.
Think drunks and physically disabled

CURRENT JELLY SPUTUM

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9
Q

Strep pneum as cause pneumonia

A

MCC community-acquired pneum and secondary pneum

Rusty colored sputum

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10
Q

Secondary pneumonia

A

Bacterial pneumonia superimposed on viral URTI

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11
Q

S. aureus as a cause pneumonia

A

2nd MCC secondary pneum.

Oft complicated by abscess or empyema (NB coagulase positive)

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12
Q

Pseudomonas aeruginosa as cause pneum

A

Associated with CF patients

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13
Q

Moraxelle catarrhalis as a cause of pneum

A

Assoc with COPD

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14
Q

H. influenzae as cause pneum

A

Comm cause secondary pneum and superimposed on COPD (smokers)

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15
Q

Legionella pneumophila as cause pneumonia

A

Community acquired…water source
Superimposed on COPD or immunocompromised
Silver stain

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16
Q

Causes bronchopneum

A 
S aureus
H. flu
P. aerug
M. catarrhalis
Legionella
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17
Q

Bronchopneum on CXR

A

Patchy consolidation around bronchioles. Oft multifocal and B/L

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18
Q

Interstitial pneumonia

A 
=Atypical pneum, "walking pneumonia"
Relatively mild upper resp sxs
**M pneum, Chlamydia pneum
College dorms, military recruits
Influenza in elderly, RSV in infants, Coxiella in farmers
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19
Q

Q fever

A

Coxiella burnetti
Atypical pneum with high fever
Farmers/vets…spores from ticks on cattle or in cattle placentas

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20
Q

Why is Coxiella unique?

A

Although Rickettsial organism, causes pneum, does not require arthropod vector, and does not produce skin rash
(As opposed to other rickettsial diseases)

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21
Q

Chlamydia psittaci

A

Birds.

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22
Q

RTI + AIDS

A

PCP
TB
Cryptococcus

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23
Q

RTI + neutropenia

A

Aspergillus/fungi

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24
Q

RTI + Splenectomy

A

Encapsultaed orgs: SHiN

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25
Abx mild-mod CAP
Amoxicillin or macrolide
26
Abx: mod-severe CAP
Co-amoxiclav + clarithromycin
27
Macrolides
erythromycin, clarithromycin Inhibit 50S subunit
28
Aminoglycosides
``` "GNATS" Gentamicin Neomycin Amikacin Tobramycin Streptomycin ``` Inhibit 30S subunit
29
Abx: Hosp-Acquired pneum
Cipro + Vanco
30
Abx: aspiration pneum
Cefuroxime + metronidazole
31
Abx: legionella
Macrolide + Rifampicin
32
Abx: pseudomonas pneum
Piperacillin + tazobactam
33
Abx: MRSA
Vancomycin
34
STIs with discharge
``` Gonorrhea Chlamydia Trichomonas Candida BV ```
35
STIs with ulceration
``` Syphilis HSV LGV Chancroid Donovanosis ```
36
STIs with Rashes, lumps, growths
Scabies Pubic lice Genital warts (HPV) Molluscum contagiosum
37
PAINFUL genital ulcers
Herpes>chancroid
38
Painless genital ulcer
Syphilis>LGV and granuloma inguinale
39
Pregnant + gonorrhea
Opthalmia neonatorum
40
Tx: gonorrhea
250mg IV ceftriaxone
41
Dx-chlamydia
NAAT
42
Tx-chlamydia
``` Azithromycin 1g (Can do 7d doxy but less compliance) ```
43
LGV
Lymphatic infection, Chlamydia trachomatis L1-L3 Developing world, MSM developed Tx: doxy 100mg BD 21d
44
Syphilis - bug - Dx
Treponema pallidum Majority cases in those with HIV Dark-ground microscopy VDRL, RPR
45
Primary syphilis
Ulcer
46
Secondary syphilis
Systemic sxs, rash | Can have neuro involvement
47
Tertiary syph
Gumma (granuloma), 2-20 yrs later Aortitis Neurosyph/tabes dorsalis, argyll robertson pupils
48
Tx-syph
IM Ben-pen
49
Jarisch-Heimer reaction
Fever, HA, myalgia in response to Abx for syph
50
Congenital syphilis
HSM, rash, fever, neurosyph, pneumonitis, hutchinson teeth
51
Chancroid
H. ducreyo (G-) Tropical Mult painful ulcers
52
Donovanosis
``` Granuloma inguinale Klebsielle granulomatis (G-) Africa, India, Aboriginal communities Giemsa stain Tx-azithro ```
53
Trichomonas - cause - Dx - Tx
Trichomonas vaginalis Dx-wet prep microscopy Tx-metronidazole
54
BV
``` Gardnerella, decreased lactobacilli Increased pH Fishy odor, discharge Whiff test (KOH prep), Gram stain, clue cells Tx: metronidazole ```
55
Candidiasis - sxs - associations - Tx
Thick white "cottage cheese" discharge, extremely itchy May be associated with immunodeficiency, diabetes Fluconazole
56
Molluscum contagiosum
``` dsDNA pox virus Hands and feet in children Adults-genital lesions, sexual contact In adult=HIV until proven otherwise. Giant lesions if immunocompromised Tx-trauma, cryotherapy ```
57
Genital warts
``` HPV 6,11 Oft asxs. Warts can recur after tx Incubation: 3/52-8/12 Home tx: podophyllin cream Clinic tx: cryotherapy, imiquimod ```
58
Superficial fungal infxn-diagnostic tool
Wood's lamp
59
Tinea versicolor
Caused by malassezia furfur. | Skin depigmentation
60
Dx candida
Culture, mannan Abs | Also beta-D-glucan
61
Dx-aspergillus
ELISA, PCR, beta-glucan
62
Dx-cryptococcus
Cryptococcal antigen in serum/CSF
63
TB
do this later
64
Meningitis-definition
Inflamm process of meninges and CSF
65
Meningoencephalitis-definition
Inflamm process of meninges and brain parenchyma
66
Routes of entry for CNS infections
Hematogenous spread Direct implantation (instrumentation) Local extension (secondary to infxn) PNS to CNS, e.g. polio
67
Meningitis-Signs and Sxs
Fever, HA, stiff neck, brain fn disturbance
68
Causative agents-meningitis
``` N. men S. pneum H. flu TB Cryptococcus ```
69
Encephalitis-signs and symptoms
Brain function disturbance
70
Encephalitis-causes
HSV | Rabies, arboviruses, trypanosoes, prions, amoeba
71
Myelitis
Disturbance nerve transmission | Poliovirus
72
Neurotoxins
Paralysis, rigid (tetanus) or flaccid (botulism)
73
TB meningitis
Immunosuppressed pts meninges and basal cisterns of brain and spinal cord Can result in tuberculous granulomas, tuberculous abscesses DON'T give steroids...call a specialist.
74
Aseptic meningitis
``` Most common CNS infection HA, stiff neck, photophobia Non-specific rash No white cells and normal gluc in CSF Coxsackie B and echoviruses =80-90% Self-limiting and resolves in 2/52 ```
75
Reportable GI infections
``` Campylobacter Salmonella Shigella E. coli O157:H7 Listeria Norovirus ```
76
Secretory diarrhea
No fever/low grade No WBCs in stool V cholerae ETEC, EPEC, EHEC
77
Inflammatory diarrhea
Fever WBC in stool (neutrophils) C. jejuni Shigella spp Non-typhoidal salmonella EIEC
78
Enteric fever
Gastroenteritis: Fever WBC in stool (mononuclear cells) Typhoidal salmonella (S typhi, S paratyphi) Yersinia spp Brucella spp
79
Bloody diarrhea-gastroenteritis causes
Campylobacter, E. coli, shigella, salmonella (non-typhoidal), vibrio parahemolyticus
80
Cholera
Need high infective dose Kills esp children and those on PPIs Mimics adenylyl cyclase
81
C. perfringens food poisoning
Normal flora of colon, but not small bowerl--where enterotoxin acts (superantigen) 8-16 hr incubation Watery diarrhea, crmaps, little vomiting lasting 24 hrs
82
C. difficile
Pseudomembranous colitis Abx related--mainly cephalosporins, cipro, clindamycin Forms pseudomembranous colitis ->toxic megacolon. Tx: metronidazole, vanco, stop other unnec Abx, avoid PPIs if poss
83
Listeria monocytogenes
Outbreaks febrile gastroenteritis Beta hemolytic TUMBLING MOTILITY Watery diarrhea, cramps, HA, fever, little vomiting Perinatal infxn: prem, neonatal bacteremia/meningitis Tx: ampicillin, ceftriaxone, cotrimoxazole
84
Vibrio parahemolyticus
Ingestion raw/undercooked seafood | Major cause of diarrhea in Japan/Caribbean
85
Campylobacter
``` Curved, comma, or S shaped Microaerophilic C. jejuni grows at 42 C Oxidase positive Self limiting but sxs can last weeks Only tx if immunocompromised (macrolide) ```
86
Vibrio cholerae
Contamination water and food from human feces Colonization small bowel and secretion enterotoxin A/B causing persistent activation adenylate cyclase Rice water stools without inflamm cells
87
Giardia lamblia
Trophozoite Pear shaped Ingestion of cyst from fecally contaminated water/food Protein and fat malabsorption--foul smelling non-bloody diarrhea, cramps, flatulence, no fever Dx: stool micro, ELISA, "string test" Tx-metronidazole
88
Cryptosporidium parvum
Infects jejunum Severe diarrhea in immunocompromised Oocysts seen in stool Tx: reconstitution immune system
89
Rotavirus
dsDNA Replicates in mucosa small intestine Secretory diarrhea, no inflamm "ROTA=Right Out The Anus" By age 6, most have Abs of at least one type Two exposures result in lifelong immunity
90
Adenovirus
Non-bloody diarrhea. Usu
91
Hepatitis A
``` Fecal-oral transmission Often subclinical Tourists, MSM, sewage workers Rise in ALT Vaccine to MSM, travelers ```
92
Hepatitis B
Chronic carrier if >6/12 | 2-6mo incubation
93
G+ rods
``` Clostridium Corynebacterium Listeria Bacillus Mycobacteria ```
94
G+ branching filamentous
Actinomyces | Nocardia
95
Alpha hemolysis
S. pneum | Strep viridans
96
Beta hemolysis
S pyogenes | S agalactiae
97
Group B strep
S pyogenes
98
Group A strep
S. agalactiae
99
Gamma hemolysis
Enterococci
100
S. pneum is most comm cause of which diseases?
``` "MOPS" Meningitis Otits media Pneumonia Sinusitis ```
101
Corynebacterium diphtheriae
Causes diphtheria: pseudomembranous pharyngitis, LAD, myocarditis, arrhythmias. Toxoid vaccine
102
Gram negative rods
H. influenzae Pasteurella Brucella Bordetella pertussis
103
Gram negative--comma shaped
C. jejuni V. cholerae H. pylori
104
Gram neg rods
``` Klebsiella E coli Enterobacter Serratia Shigella Salmonella Proteus Yersinia Pseudomonas ```
105
Legionnaire's disease
Legionella pneumophila Severe pneumonia, fever, GI and CNS symptoms Hyponatremia
106
Pontiac fever
Legionella pneumophila | Mild flu-like illness
107
Pseudomonas aeruginosa
Grape-like odor | Wound/burn infections, sepsis, external otitis (swimmer's ear), UTI, drug use, diabetic osteomyelitis
108
Typhoid
Salmonella typhi Rose spots on abdo, fever, HA, diarrhea Can remain in GB as carrier state
109
Yersinia
Mesenteric adenitis, resembling Crohn's or apendicitis
110
H pylori
Urease positive, creating alkaline environment | RF for peptic ulcers, gastric adenocarcinoma, lymphoma
111
Spirochetes
Borrelia Leptospira Treponema
112
Bartonella
Cat scratch disease
113
Borrelia burgdoferi
Lyme disease
114
Borrelia recurrentis
Relapsing fever
115
Ehrlichia chafeensis
Ehrlichiosis | Lone Star ticks
116
Fransisca tularensis
Tularemia | Rabbits
117
pasteurella multocida
Cellulitis | Animal bites
118
Treatment for all rickettsial diseases
Doxycycline
119
Mucor, Rhizopus spp
Mucormycosis in DKA, leukemic pts
120
Palms and soles rash-ddx
Rocky Mountain spotted fever Coxsackie A (hand, foot, and mouth) Secondary syphilis
121
Rickettsial diseases
``` Rocky Mountain spotted fever Typhus Ehrlichiosis Anaplasmosis Q fever ```
122
Herpes viruses
``` HSV1, 2 EBV VZV CMV HHV6-roseola HHV8-Kaposi's ```
123
DNA viruses
``` Hepadna Herpes Adeno Pox Papilloma Polyoma Parvo ``` All double stranded except parvo
124
HBsAg
HBV infection
125
anti-HBs
Immunity to HBV
126
HBeAg
Active viral replication, infectivity
127
Anti-HBeAg
Low transmissibility
128
Marker immunization to HBV
anti-HBs
129
Bloody diarrhea
``` Campylobacter EHEC EIEC Shigella Salmonella E. histolytica Yersinia enterocolitica ```
130
Watery diarrhea
``` C diff C perfringens ETEC Protozoa V cholerae Viruses (noro, rota) ```
131
Positive nitrites on urine dip
Gram negative bacteria
132
Positive leukocyte esterase on urine dip
Bacteria
133
ToRCHeS infections
Cross placenta ``` Toxo Rubella CMV HIV, HSV2 Syphilis ```
134
Blueberry muffin rash in neonate
Congenital rubella, congenital CMV
135
Abx, antivirals, antifungals to avoid in pregnancy
``` Sulfonamides Aminoglycosides Fluoroquinolones Clarithromycin Tetracyclines Ribavirin Griseofulvin Chloramphenicol ```
136
Flying saucer cysts on methensmine silver stain
PCP
137
Which bug causes hyponatremia
Legionella
138
Tumbling motility
Listeria
139
Entamoeba histolytica
Flask shaped ulcers in colon, cecum | Dysentery, weight loss, liver abscess
140
HHV-8
Kaposi's Primary effusion lymphoma Castleman's
141
HIV treatment regimen
Two NRTIs | One NNRTI or PI
142
Phialophora verrucosa
Saprophyte on rooting wood. | Warty lesion resembling cauliflower
143
Tinea corporis
Ringworm
144
Cerebral Negri bodies (inclusion bodies)
Pathognomonic for rabies
145
Fite stain
Leprosy
146
Acyclovir-mech
Guanosine analogue. | Phosphorylated by viral thymidine kinase
147
When do infants get Men C vaccine?
3m, 4m, 12m
148
When do infants get PCV?
2m, 13m
149
Visceral leishmaniasis
``` L. Donovani, l. Infantum Kala-azar Fever, splenomegaly, can get hepatomegaly. Can get blackened skin/hyperpigmentation May closely resemble malaria ```
150
Cutaneous leishmaniasis
L. Major, L. Tropica Itchy papule that becomes ulcer with raised edges. Heals within 8m, leaving depigmented scar. Most common type leishmaniasis
151
Mucocutaneous leishmaniasis
L. braziliensis Destructive and disfiguring facial lesions. May start in same way as cutaneous but years later, ulceration in mucous membranes and mutilation.
152
Novy-macneal-michelle medium
Leishmaniasis
153
First Hep B antibody to appear after infection
HBsAg
154
C diff treatment
14 days metronidazole PO Can repeat if doesn't work Then use vanco Vanco if severe, ileus
155
Sporadic CJD
``` "Demented LAMB": Dementia around age 65 LMN signs Akinetic mutism Myoclonus Cortical blindness ``` EEG for dx
156
Test for variant CJD
Tonsillar biopsy
157
LP in CJD
Looks for protein 14-3-3
158
Features if variant CJD
Younger (ave age 26) Median survival longer (14m versus 4m) Psych before neuro features
159
CSF findings: bacterial, viral, TB meningitis
Bacterial has neutrophils, increased protein, decreased glucose Viral has high lymphos TB like viral but very high protein
160
Spontaneous bacterial peritonitis
Boozers with ascites and signs infection MCCs are E. coli, enterococci Tx with cefotaxime or third gen ceph
161
Significant factor in whether or clears HCV
Virus genotype. | Type 1 harder to clear
162
Sleeping sickness
Africa Tsetse fly Trypanosomes When crosses BBB, causes neuro sxs like disturbed sleeping patterns Tx with pentamidine, suramin
163
Trypanosoma brucei gambiense
West and central Africa. Gradual onset More common
164
Trypanosoma brucei rhodiense
``` South and East Africa. Rapid onset (weeks to months) ```
165
Tx-Chagas
Benzimidazole or nifurtimox
166
Plasmodium knowlesi
SE Asia/Borneo | Daily fever
167
Sporozites
What mosquito injects into bloodstream
168
Merozites
``` Sporozites that have multiplied in liver Contain shizonts ("diamond rings") ```
169
Hypnozoites
Dormant forms in liver | Vivax, oval
170
Tx-falciparum
``` Admit Quinine and doxy 5-7 days Or Co-artem 3 days Or Malarone 3d ```
171
Malarone
Atorvaquone-proguanil
172
Tx-non-falciparum malaria
``` Chloroquine (kills RBC parasites) Then primaquine (kills hynozoites) ```
173
Maurer's clefts
Seen in falciparum
174
Schuffner's dots
Seen in Vivax, ovale

Year 5 Pathology (6 decks)

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