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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
Q

Abx mild-mod CAP

A

Amoxicillin or macrolide

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26
Q

Abx: mod-severe CAP

A

Co-amoxiclav + clarithromycin

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27
Q

Macrolides

A

erythromycin, clarithromycin

Inhibit 50S subunit

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28
Q

Aminoglycosides

A 
"GNATS"
Gentamicin
Neomycin
Amikacin
Tobramycin
Streptomycin

Inhibit 30S subunit

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29
Q

Abx: Hosp-Acquired pneum

A

Cipro + Vanco

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30
Q

Abx: aspiration pneum

A

Cefuroxime + metronidazole

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31
Q

Abx: legionella

A

Macrolide + Rifampicin

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32
Q

Abx: pseudomonas pneum

A

Piperacillin + tazobactam

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33
Q

Abx: MRSA

A

Vancomycin

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34
Q

STIs with discharge

A 
Gonorrhea
Chlamydia
Trichomonas
Candida
BV
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35
Q

STIs with ulceration

A 
Syphilis
HSV
LGV
Chancroid
Donovanosis
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36
Q

STIs with Rashes, lumps, growths

A

Scabies
Pubic lice
Genital warts (HPV)
Molluscum contagiosum

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37
Q

PAINFUL genital ulcers

A

Herpes>chancroid

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38
Q

Painless genital ulcer

A

Syphilis>LGV and granuloma inguinale

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39
Q

Pregnant + gonorrhea

A

Opthalmia neonatorum

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40
Q

Tx: gonorrhea

A

250mg IV ceftriaxone

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41
Q

Dx-chlamydia

A

NAAT

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42
Q

Tx-chlamydia

A 
Azithromycin 1g
(Can do 7d doxy but less compliance)
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43
Q

LGV

A

Lymphatic infection, Chlamydia trachomatis L1-L3
Developing world, MSM developed
Tx: doxy 100mg BD 21d

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44
Q

Syphilis

  • bug
  • Dx
A

Treponema pallidum
Majority cases in those with HIV
Dark-ground microscopy
VDRL, RPR

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45
Q

Primary syphilis

A

Ulcer

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46
Q

Secondary syphilis

A

Systemic sxs, rash

Can have neuro involvement

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47
Q

Tertiary syph

A

Gumma (granuloma), 2-20 yrs later
Aortitis
Neurosyph/tabes dorsalis, argyll robertson pupils

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48
Q

Tx-syph

A

IM Ben-pen

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49
Q

Jarisch-Heimer reaction

A

Fever, HA, myalgia in response to Abx for syph

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50
Q

Congenital syphilis

A

HSM, rash, fever, neurosyph, pneumonitis, hutchinson teeth

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51
Q

Chancroid

A

H. ducreyo (G-)
Tropical
Mult painful ulcers

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52
Q

Donovanosis

A 
Granuloma inguinale
Klebsielle granulomatis (G-)
Africa, India, Aboriginal communities
Giemsa stain
Tx-azithro
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53
Q

Trichomonas

  • cause
  • Dx
  • Tx
A

Trichomonas vaginalis
Dx-wet prep microscopy
Tx-metronidazole

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54
Q

BV

A 
Gardnerella, decreased lactobacilli
Increased pH
Fishy odor, discharge
Whiff test (KOH prep), Gram stain, clue cells
Tx: metronidazole
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55
Q

Candidiasis

  • sxs
  • associations
  • Tx
A

Thick white “cottage cheese” discharge, extremely itchy
May be associated with immunodeficiency, diabetes
Fluconazole

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56
Q

Molluscum contagiosum

A 
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
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57
Q

Genital warts

A 
HPV 6,11
Oft asxs.  Warts can recur after tx
Incubation: 3/52-8/12
Home tx: podophyllin cream
Clinic tx: cryotherapy, imiquimod
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58
Q

Superficial fungal infxn-diagnostic tool

A

Wood’s lamp

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59
Q

Tinea versicolor

A

Caused by malassezia furfur.

Skin depigmentation

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60
Q

Dx candida

A

Culture, mannan Abs

Also beta-D-glucan

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61
Q

Dx-aspergillus

A

ELISA, PCR, beta-glucan

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62
Q

Dx-cryptococcus

A

Cryptococcal antigen in serum/CSF

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63
Q

TB

A

do this later

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64
Q

Meningitis-definition

A

Inflamm process of meninges and CSF

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65
Q

Meningoencephalitis-definition

A

Inflamm process of meninges and brain parenchyma

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66
Q

Routes of entry for CNS infections

A

Hematogenous spread
Direct implantation (instrumentation)
Local extension (secondary to infxn)
PNS to CNS, e.g. polio

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67
Q

Meningitis-Signs and Sxs

A

Fever, HA, stiff neck, brain fn disturbance

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68
Q

Causative agents-meningitis

A 
N. men
S. pneum
H. flu
TB
Cryptococcus
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69
Q

Encephalitis-signs and symptoms

A

Brain function disturbance

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70
Q

Encephalitis-causes

A

HSV

Rabies, arboviruses, trypanosoes, prions, amoeba

71
Q

Myelitis

A

Disturbance nerve transmission

Poliovirus

72
Q

Neurotoxins

A

Paralysis, rigid (tetanus) or flaccid (botulism)

73
Q

TB meningitis

A

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
Q

Aseptic meningitis

A 
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
Q

Reportable GI infections

A 
Campylobacter
Salmonella
Shigella
E. coli O157:H7
Listeria
Norovirus
76
Q

Secretory diarrhea

A

No fever/low grade
No WBCs in stool

V cholerae
ETEC, EPEC, EHEC

77
Q

Inflammatory diarrhea

A

Fever
WBC in stool (neutrophils)

C. jejuni
Shigella spp
Non-typhoidal salmonella
EIEC

78
Q

Enteric fever

A

Gastroenteritis:
Fever
WBC in stool (mononuclear cells)

Typhoidal salmonella (S typhi, S paratyphi)
Yersinia spp
Brucella spp

79
Q

Bloody diarrhea-gastroenteritis causes

A

Campylobacter, E. coli, shigella, salmonella (non-typhoidal), vibrio parahemolyticus

80
Q

Cholera

A

Need high infective dose
Kills esp children and those on PPIs
Mimics adenylyl cyclase

81
Q

C. perfringens food poisoning

A

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
Q

C. difficile

A

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
Q

Listeria monocytogenes

A

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
Q

Vibrio parahemolyticus

A

Ingestion raw/undercooked seafood

Major cause of diarrhea in Japan/Caribbean

85
Q

Campylobacter

A 
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
Q

Vibrio cholerae

A

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
Q

Giardia lamblia

A

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
Q

Cryptosporidium parvum

A

Infects jejunum
Severe diarrhea in immunocompromised
Oocysts seen in stool
Tx: reconstitution immune system

89
Q

Rotavirus

A

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
Q

Adenovirus

A

Non-bloody diarrhea. Usu

91
Q

Hepatitis A

A 
Fecal-oral transmission
Often subclinical
Tourists, MSM, sewage workers
Rise in ALT
Vaccine to MSM, travelers
92
Q

Hepatitis B

A

Chronic carrier if >6/12

2-6mo incubation

93
Q

G+ rods

A 
Clostridium
Corynebacterium
Listeria
Bacillus
Mycobacteria
94
Q

G+ branching filamentous

A

Actinomyces

Nocardia

95
Q

Alpha hemolysis

A

S. pneum

Strep viridans

96
Q

Beta hemolysis

A

S pyogenes

S agalactiae

97
Q

Group B strep

A

S pyogenes

98
Q

Group A strep

A

S. agalactiae

99
Q

Gamma hemolysis

A

Enterococci

100
Q

S. pneum is most comm cause of which diseases?

A 
"MOPS"
Meningitis
Otits media
Pneumonia
Sinusitis
101
Q

Corynebacterium diphtheriae

A

Causes diphtheria: pseudomembranous pharyngitis, LAD, myocarditis, arrhythmias.

Toxoid vaccine

102
Q

Gram negative rods

A

H. influenzae
Pasteurella
Brucella
Bordetella pertussis

103
Q

Gram negative–comma shaped

A

C. jejuni
V. cholerae
H. pylori

104
Q

Gram neg rods

A 
Klebsiella
E coli
Enterobacter
Serratia
Shigella
Salmonella
Proteus
Yersinia
Pseudomonas
105
Q

Legionnaire’s disease

A

Legionella pneumophila
Severe pneumonia, fever, GI and CNS symptoms
Hyponatremia

106
Q

Pontiac fever

A

Legionella pneumophila

Mild flu-like illness

107
Q

Pseudomonas aeruginosa

A

Grape-like odor

Wound/burn infections, sepsis, external otitis (swimmer’s ear), UTI, drug use, diabetic osteomyelitis

108
Q

Typhoid

A

Salmonella typhi
Rose spots on abdo, fever, HA, diarrhea
Can remain in GB as carrier state

109
Q

Yersinia

A

Mesenteric adenitis, resembling Crohn’s or apendicitis

110
Q

H pylori

A

Urease positive, creating alkaline environment

RF for peptic ulcers, gastric adenocarcinoma, lymphoma

111
Q

Spirochetes

A

Borrelia
Leptospira
Treponema

112
Q

Bartonella

A

Cat scratch disease

113
Q

Borrelia burgdoferi

A

Lyme disease

114
Q

Borrelia recurrentis

A

Relapsing fever

115
Q

Ehrlichia chafeensis

A

Ehrlichiosis

Lone Star ticks

116
Q

Fransisca tularensis

A

Tularemia

Rabbits

117
Q

pasteurella multocida

A

Cellulitis

Animal bites

118
Q

Treatment for all rickettsial diseases

A

Doxycycline

119
Q

Mucor, Rhizopus spp

A

Mucormycosis in DKA, leukemic pts

120
Q

Palms and soles rash-ddx

A

Rocky Mountain spotted fever
Coxsackie A (hand, foot, and mouth)
Secondary syphilis

121
Q

Rickettsial diseases

A 
Rocky Mountain spotted fever
Typhus
Ehrlichiosis
Anaplasmosis
Q fever
122
Q

Herpes viruses

A 
HSV1, 2
EBV
VZV
CMV
HHV6-roseola
HHV8-Kaposi's
123
Q

DNA viruses

A 
Hepadna
Herpes
Adeno
Pox
Papilloma
Polyoma
Parvo

All double stranded except parvo

124
Q

HBsAg

A

HBV infection

125
Q

anti-HBs

A

Immunity to HBV

126
Q

HBeAg

A

Active viral replication, infectivity

127
Q

Anti-HBeAg

A

Low transmissibility

128
Q

Marker immunization to HBV

129
Q

Bloody diarrhea

A 
Campylobacter
EHEC
EIEC
Shigella
Salmonella
E. histolytica
Yersinia enterocolitica
130
Q

Watery diarrhea

A 
C diff
C perfringens
ETEC
Protozoa
V cholerae
Viruses (noro, rota)
131
Q

Positive nitrites on urine dip

A

Gram negative bacteria

132
Q

Positive leukocyte esterase on urine dip

133
Q

ToRCHeS infections

A

Cross placenta

Toxo
Rubella
CMV
HIV, HSV2
Syphilis
134
Q

Blueberry muffin rash in neonate

A

Congenital rubella, congenital CMV

135
Q

Abx, antivirals, antifungals to avoid in pregnancy

A 
Sulfonamides
Aminoglycosides
Fluoroquinolones
Clarithromycin
Tetracyclines
Ribavirin
Griseofulvin
Chloramphenicol
136
Q

Flying saucer cysts on methensmine silver stain

137
Q

Which bug causes hyponatremia

A

Legionella

138
Q

Tumbling motility

139
Q

Entamoeba histolytica

A

Flask shaped ulcers in colon, cecum

Dysentery, weight loss, liver abscess

140
Q

HHV-8

A

Kaposi’s
Primary effusion lymphoma
Castleman’s

141
Q

HIV treatment regimen

A

Two NRTIs

One NNRTI or PI

142
Q

Phialophora verrucosa

A

Saprophyte on rooting wood.

Warty lesion resembling cauliflower

143
Q

Tinea corporis

144
Q

Cerebral Negri bodies (inclusion bodies)

A

Pathognomonic for rabies

145
Q

Fite stain

146
Q

Acyclovir-mech

A

Guanosine analogue.

Phosphorylated by viral thymidine kinase

147
Q

When do infants get Men C vaccine?

A

3m, 4m, 12m

148
Q

When do infants get PCV?

149
Q

Visceral leishmaniasis

A 
L. Donovani, l. Infantum
Kala-azar
Fever, splenomegaly, can get hepatomegaly.
Can get blackened skin/hyperpigmentation
May closely resemble malaria
150
Q

Cutaneous leishmaniasis

A

L. Major, L. Tropica
Itchy papule that becomes ulcer with raised edges.
Heals within 8m, leaving depigmented scar.
Most common type leishmaniasis

151
Q

Mucocutaneous leishmaniasis

A

L. braziliensis
Destructive and disfiguring facial lesions.
May start in same way as cutaneous but years later, ulceration in mucous membranes and mutilation.

152
Q

Novy-macneal-michelle medium

A

Leishmaniasis

153
Q

First Hep B antibody to appear after infection

154
Q

C diff treatment

A

14 days metronidazole PO
Can repeat if doesn’t work
Then use vanco

Vanco if severe, ileus

155
Q

Sporadic CJD

A 
"Demented LAMB":
Dementia around age 65
LMN signs
Akinetic mutism
Myoclonus
Cortical blindness

EEG for dx

156
Q

Test for variant CJD

A

Tonsillar biopsy

157
Q

LP in CJD

A

Looks for protein 14-3-3

158
Q

Features if variant CJD

A

Younger (ave age 26)
Median survival longer (14m versus 4m)
Psych before neuro features

159
Q

CSF findings: bacterial, viral, TB meningitis

A

Bacterial has neutrophils, increased protein, decreased glucose
Viral has high lymphos
TB like viral but very high protein

160
Q

Spontaneous bacterial peritonitis

A

Boozers with ascites and signs infection
MCCs are E. coli, enterococci

Tx with cefotaxime or third gen ceph

161
Q

Significant factor in whether or clears HCV

A

Virus genotype.

Type 1 harder to clear

162
Q

Sleeping sickness

A

Africa
Tsetse fly
Trypanosomes
When crosses BBB, causes neuro sxs like disturbed sleeping patterns

Tx with pentamidine, suramin

163
Q

Trypanosoma brucei gambiense

A

West and central Africa.
Gradual onset
More common

164
Q

Trypanosoma brucei rhodiense

A 
South and East Africa.
Rapid onset (weeks to months)
165
Q

Tx-Chagas

A

Benzimidazole or nifurtimox

166
Q

Plasmodium knowlesi

A

SE Asia/Borneo

Daily fever

167
Q

Sporozites

A

What mosquito injects into bloodstream

168
Q

Merozites

A 
Sporozites that have multiplied in liver
Contain shizonts ("diamond rings")
169
Q

Hypnozoites

A

Dormant forms in liver

Vivax, oval

170
Q

Tx-falciparum

A 
Admit
Quinine and doxy 5-7 days
Or
Co-artem 3 days
Or
Malarone 3d
171
Q

Malarone

A

Atorvaquone-proguanil

172
Q

Tx-non-falciparum malaria

A 
Chloroquine (kills RBC parasites)
Then primaquine (kills hynozoites)
173
Q

Maurer’s clefts

A

Seen in falciparum

174
Q

Schuffner’s dots

A

Seen in Vivax, ovale

Year 5 Pathology (6 decks)

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