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DT1 Exam 2 > Micro > Flashcards

Micro Flashcards

1
Q

superficial fungal infections

A 
outermost layer of skin and hair
pityriasis (tinea) versicola
tinea nigra
black piedra
white piedra
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2
Q

causative agent of pityriasis versicolor

A

malassezia furfur

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3
Q

characteristics of malassezia furfur

A

dimorphic
lipophilic
opportunistic
interfere with melanin production

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4
Q

rash of pityriasis versicolor

A

transient, superficial and scaly

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5
Q

diagnosis of pityriasis versicolor

A

KOH

spaghetti and meatball appearance

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6
Q

causative agent of tinea nigra

A

hortaea (exophilia) werneckii

infection of stratum corneum

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7
Q

rash of tinea nigra

A

asymptomatic well demarcated
slowly expanding brown to black
nonscaly macules with well-defined borders
on palms and soles (from traumatic inoculation)

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8
Q

diagnosis of tinea nigra

A

KOH-yeast like cells with hyphal fragments

rule out diagnosis for malignant melanoma

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9
Q

cutaneous infections

A

infections that extend deeper into the epidermis, as well as invasive hair and nail diseases

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10
Q

favic hair infection

A

inside hair and at the root of the hair shaft

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11
Q

extohrix hair infection

A

outside shaft

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12
Q

endothrix hair infection

A

inside shaft

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13
Q

dermatophytes

A

trichophyton
epidermophyton
microsporum

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14
Q

spread of dermatophyte infections

A

anthropophilic-humans
zoophilic-animals
geophilic-soil

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15
Q

tinea capitis

A

highly contagious
hair becomes grayish, dull and brittle due to ectothrix invasion of hair
hair breaks near base of shaft
more common in prepubescent children

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16
Q

principal agent of tinea capitis

A

t. tonsurans

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17
Q

tinea rash and immune response

A

itchy, redness, scaling or fissuring of skin
ring with irregular borders and a cleared central area
no classical humoral or cell protective immunity
DTH hypersensitivity reaction

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18
Q

tinea manum

A

contact with another site of infection

direct contact with an infected animal or soil

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19
Q

tinea unguium

A

trichophyton rubrum most common cause

rule out candida infections or onichomycosis

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20
Q

laboratory diagnosis of cutaneous infections

A

KOH of hair or scalp scrapings

characterized by specific pattern of growth in culture and by production of macro conidia and micro conidia

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21
Q

subcutaneous infections

A

involves deeper layers of dermis
associated with some form of trauma (splinter, rose bush thorn, insect bite)
feet, hands, arms and buttocks more prone
produce granuloma

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22
Q

examples of subcutaneous infections

A

sporotrichosis
chromoblastomycosis
subcutaenous phaeohyphomycosis

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23
Q

lymphocutaneous sporotrichosis

A

travels to lymphatic

“rose gardener’s disease”

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24
Q

characteristics of S. schenckii

A

naturally found in soil, hay, sphagnum moss, and rosebushes
usually affects farmers, horticulturists, rose gardeners, plant nursery workers
dimorphic fungus

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25
Q

diagnosis of S. schenckii

A

cigar shaped oval-round yeast cell

rosette pattern of conidia at 25 C on Sabouraud’s agar

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26
Q

Asteroid bodies

A

found in S. schenckii

asteroid bodies represent host’s immune response

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27
Q

causative agent for chromoblastomycosis

A

dermaticeous fungi-fonsecaea pedrosi

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28
Q

characteristics of chromoblastomycosis

A

often seen in workers injured with woods

colored lesions that start out scaly and become raised, cauliflower-like lesion

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29
Q

diagnosis of chromoblastomycosis

A

presence of pigmented fungi in tissue section or pus

sclerotic (medlar) bodies

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30
Q

causative agents for subcutaneous phaeohyphomycosis

A

dematiaceous molds-alternaria, bipolaris, curvularia

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31
Q

infections in subcutaneous phaeohyphomycosis

A

abscesses, localized cerebral, subcutaneous, paranasal sinusitis, prosthetic valve endocarditis

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32
Q

diagnosis of subcutaneous phaeohyphomycosis

A

dark hyphae

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33
Q

impetigo

A

superficial skin infections, most frequently in children

staph and strep

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34
Q

folliculitis

A

pyogenic infection in the hair follicles

staph and pseudomonas

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35
Q

furuncles (boils)

A

extension of filliculitis (stye)

staph

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36
Q

carbuncles

A

infection extends to deeper subcutaneous tissue (chills and fever due to systemic spread) with a single inflammatory mass
staph

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37
Q

spreading infections

A

impetigo when in epidermis, erysipelas when involving dermal lymphatics, and cellulitis when subcutaneous fat layer

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38
Q

abscess formation

A

folliculitis, boils, carbuncles

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39
Q

necrotizing infections

A

fasciitis and gas gangrene (myonecrosis)

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40
Q

pustuble

A

most neutrophils with serous fluids within or beneath epidermis

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41
Q

bulla

A

collection of serous fluid and small number of inflammatory cells

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42
Q

common causes of impetigo

A

strep pyogenes

staph aureus

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43
Q

common causes of erysipela

A

strep pyogenes

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44
Q

common causes of necrotizing fasciitis

A

anaerobes and microaerophiles

usually mixed infections

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45
Q

common causes of myonecrosis gangrene

A

clostridium perfringens

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46
Q

enteric fever

A

rose spots containing bacteria

caused by salmonella

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47
Q

septicemia

A

ecthyma gangrenosum

caused by pseudomonas aeruginosa

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48
Q

scarlet fever

A 
erythematous rash (toxin)
caused by strep pyogenes
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49
Q

toxic shock syndrome

A

rash and desquamation (toxin)

caused by staph aureus

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50
Q

characteristics of staph aureus

A 
gram positive
resistant
nonmotile
facultative anaerobe
catalase +, coagulase +
NaCl for growth
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51
Q

clinical manifestations of staph aureus

A

abscesses
systemic diseases
food poisoning
toxic shock syndrome

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52
Q

staph aureus virulence factors

A

staphylococcal toxins (alpha, beta, gamma, PV)
exfoliative toxins
enterotoxins
toxic shock syndrome toxins
enzymes-coagulase, catalase, hyaluronidase, fibrinolysin, lipases, nucleases

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53
Q

characteristics of strep pyogenes

A 
gram + arranged in chains
avoid phagocytosis by capsule, M proteins, C5a peptidase
non-motile
facultative anaerobe 
need blood or serum for isolation
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54
Q

virulence factors of strep pyogenes

A

C carbohydrate
M protein
streptolysin O and S
hyaluronidase, DNAse

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55
Q

risk factors of abscesses, furuncles, and carbuncles

A

all related to hair follicle-pus within the dermis and deeper skin tissues
diabetic, immunologic abnormalities, skin breaches

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56
Q

treatment of abscesses, furuncles, and carbuncles

A

small-warm compresses to help drainage

incision and drainage

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57
Q

impetigo characteristics

A

superficial infection, contagious
seen primarily in children, poor personal hygiene
purulent with crusting
commonly caused by strep pyogenes

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58
Q

non-bullous impetigo

A

papules to vesicles surrounded by erythema
ages 2-5
GAS and staph aureus

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59
Q

risk factors for non-bullous impetigo

A

poverty, crowding, poor hygiene, scabies

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60
Q

pustular impetigo

A

intraepidermal vesicles filled with exudate (pus)
GAS or staph aureus
seen in exposed areas of body during warm, moist weather

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61
Q

bullous impetigo

A 
localized staph scalded skin syndrome
caused by staph aureus of phage group II (toxin A-no cell adhesion)
happens in newborns and young children
no Nikolsky sign
highly communicable
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62
Q

clinical erysipelas

A

tender, superficial erythematous and edematous lesions
infection spreads in upper dermis and superficial lymphatics
mainly affected young and elders
caused by GAS

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63
Q

clinical cellulitis

A

redness, induration, heat and tenderness
accompanied by inflammation of draining lymph nodes
GAS and S. aureus
in unimmunized (h. flu type B)
associated with bites or scratches from cats or dogs (P. multocida)

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64
Q

clinical necrotizing infections of skin and fascia

A

extensive tissue destruction, thrombosis of blood vessels, bacteria spreading along fascial planes
destruction of fascia and fat but may spare skin

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65
Q

type 1 necrotizing fasciitis

A

mixed infection by aerobic and anaerobic bacteria and occurs most commonly after surgical procedures and in patients with diabetes and peripheral vascular disease

66
Q

type 2 necrotizing fasciitis

A

mono-microbial infection caused by GAS or MRSA (mostly GAS)

67
Q

V. vulnificus necrotizing fasciitis

A

rapidly progressive wound infections after exposure to contaminated seawater
development of vesicles or bullae and eventual tissue necrosis
50% mortality

68
Q

myonecrosis clinical manifestation

A

due to c. perfringens, c. septicum, c. histolyticum, c. sordellii
associated with local trauma
gas found in skin (fascia and deep muscle spared)
nonclostridial-mixed anaerobic and aerobic (diabetes with foul odor)
most by GAS

69
Q

staphylococcal scalded skin syndrome

A

perioral eryhtema covers entire body
positive Nikolsky sign-large blister with clear fluid, no organism, no leukocytes
exfoliative toxin destroys intracellular connections in the skin

70
Q

toxic shock syndrome

A

cutaneous and soft tissue involvement

associated with use of tampons

71
Q

characteristics of pseudomonas aeruginosa

A 
gram negative
aerobic
rod shaped
motile (pili and flagella)
grape like odor
environmental bacterium
simple growth requirement
72
Q

pseudomonas folliculitis

A

resulting from immersion in contaminated water (hot tubs, whirlpools, swimming pools)
secondary infection in people who have acne or shave their legs
fingernail infection

73
Q

characteristics of mycobacterium leprae

A

obligately aerobic rod with gram+ like cell wall
mostly infects through aerosols
animal models-armadillo and mice footpads

74
Q

locations of best growth for m. leprae

A

skin histiocytes, endothelial cells and schwann cells of peripheral nerves

75
Q

tuberculoid leprosy

A

red blotchy lesions with anesthetic areas

Th1 mediated; low infectivity

76
Q

lepromatous leprosy

A

diffuse skin lesions
cell mediated immunity is deficient (Th2)
highly infective
nonreactive to lepromin

77
Q

treatment of leprosy

A

lepromatous-dapsone, ribiospfampin, clofazimine for 2 yrs

tuberculoid-dapsone and rifampin for 6 months

78
Q

characteristics of bacillus antrhacis

A

gram positive
spore forming
capsule (D glutamic acid)
exotoxin-edema factor, lethal factor, protective antigen

79
Q

virulence factors for anthracis

A

edema factor+protective=edema toxin
lethal factor+protective=lethal toxin
typical AB type binary toxin

80
Q

edema factor mechanism

A 
adenylate cyclase (similar to pertussis)
activated by calmodulin
increase cAMP (impaired flow of ions and water)
81
Q

lethal factor mechanism

A

protease induces macrophage to produce high levels of cytokines that trigger shock

82
Q

protective antigen

A

promotes entry of EF into phagocytic cells

83
Q

inhalation antrhax

A

aerosolized spores
mediastinal widening
replication occurs within the lung with local exotoxin release
death within 3 days of initial symptoms

84
Q

cutaneous anthrax

A 
most common
painless papule at site of inoculation
progress to ulcer surrounding vesicles
necrotic eschar 
localized tissue necrosis
round black lesion with a rim of edema-malignant pustule
85
Q

diagnosis of anthax

A

no spores in clinical specimen
serpentine chain of bacilli
culture-non hemolytic, sticky colonies

86
Q

protection and therapy for anthrax

A

inactivated cell free product as vaccine
live attenuated also available
teatment-60 days with penicillin, cipro, doxy

87
Q

characteristics of rickettsia

A

weakly gram negative bacilli
obligate intracellular
replicate in cytoplasm of cells
Giemsa and Gimenez stains

88
Q

beta lactams for rickettsia

A

dont work
peptidoglycan is minimal
LPS weak endotoxin

89
Q

R. rickettsii characteristics

A

RMSF
Omp A pathogenic factor for endothelial adherence
replication in cytoplasm and nucleus results in vasculitis
intracellular growth protects from immune clearance

90
Q

R. rickettsii epidemiology

A

most common Rickettsia in USA

April-September

91
Q

vector R. rickettsii

A 
ticks from Ixodeae family
dermacentor andersoni (Rocky mountain states)
dermacentor variabilis (SE US)
92
Q

states with highest incidence of R. rickettsii

A

Arkansas, Delaware, Missouri, North Carolina, Oklahoma, Tennessee

93
Q

reservoir R. rickettsii

A

ticks via transovarian transmission

94
Q

transmission R. rickettsii

A

tick bite
6-10 hrs dormant, avirulent bacteria activated by warm blood meal
translocation of bacteria from salivary glands to human bloodstream

95
Q

RMSF clinical manifestations

A

incubation 2-14 days
fever, chills, headaches, myalgias
centripetal, palms and soles=rash after 3-5 days
abdominal pain, vomiting, hepatitis
respiratory failure, encephalitis, renal failure, hypotension, myocarditis
fatal in 20% of cases if untreated

96
Q

RMSF lab findings

A 
thrombocytopenia, coagulopathy
anemia
normal WBC
hyponatremia
transaminitis
97
Q

diagnosis of RMSF

A

PCR and immunohistochemical in acute phase (notify CDC)
serology but Ab may not be present in initial samples
fourfold change in IgG in paired serum (1st week and 2-4 weeks later)

98
Q

Rickettsia akari characteristics

A

causes rickettsialpox
cosmopolitan
huamns infected by mites

99
Q

transmission R. akari

A

transmitted by infected mites

reservoir is rodent (common house mouse)

100
Q

clinical presentation of rickettsialpox

A

biphasic presentation
first week-papule to ulcer to eschar
incubation for 7-24 days, systemic spread
second phase-fever, headache, photophobia, papulo-vesicular rash, pox like progression (milder than RMSF)

101
Q

characteristics of R. prowazekii

A 
epidemic (louse borne) typhus
humans-reservoir
pediculus humanus (body louse)
disasters, war, famine outside of US
squirrels in US
102
Q

transmission of R. prowazekii

A

louse defecates at site of feeding
may be introduced into abraded or injured skin or mucous membranes by scratching or hand contamination
infectious for as long as 100 days

103
Q

clinical manifestations of R. prowazekii

A 
acute-potentially severe vasculitis (7-14 days) with fever, centrifugal maculopapular rash, CNS symptoms
recrudescent form (Brill-Zinsser disease) 10-50 years after primary infection (flu-like symptoms)
104
Q

diagnosis of R. prowazekii

A

serology (MIF test)

105
Q

characteristics of R. parkeri

A

mainly southern US
American Boutonneuse fever/Tidewater spotted fever
eschars and rash on PE, fever, headaches, myalgias

106
Q

vector of R. parkeri

A

amblyomma maculatum (Gulf coast tick)

107
Q

diagnosis of R. parkeri

A

serology, PCR, culture from skin biopsy

108
Q

treatment for R. parkeri

A

doxycycline

109
Q

characteristics of r. typhi

A

endemic typhus

humans are infected by inoculation of infective flea feces in bite wounds

110
Q

vector r. typhi

A

xenopsylla cheopis (rat flea)

111
Q

reservoir r. typhi

A

rodents

112
Q

clinical manifestations r. typhi

A

non-specific symptoms
fever, headache, chills, myalgias
rash

113
Q

diagnosis r. typhi

A

serology by IFA

114
Q

characteristics of orientia tsutsugamushi

A

scrub typhus

endemic in Asia Pacific rim

115
Q

reservoir and vector for orientia

A

mites
larval mites (chiggers) via transovarian
feed once in a lifetime

116
Q

clinical for orientia

A

severe headache, fever, myalgias
maculopapular rash, spreads centrifugally
CNS complications, heart failure

117
Q

diagnosis for orientia

A

serology IFA

118
Q

treatment of rickettsial and orientia

A

doxycycline
chloramphenicol or fluoroquinolone as alternatives
do not wait for confirmatory serology

119
Q

RMSF in pediatrics treatment

A

doxycycline is drug of choice regardless of age

120
Q

characteristics of erlichia and anaplasma

A

obligate intracellular bacteria
no peptidoglycan or LPS
grow on hematopoietic cells
replicate in phagosomes of host cells

121
Q

morula

A

microcolony of erlichiae within a vacuole

122
Q

ehrlichia chafeensis

A

human monocytic ehrlichiosis

rashless RMSF

123
Q

anaplasma phagocytophilum

A

human granulocytic anaplasmosis

124
Q

reservoir ehrlichia

A

deer, dogs

125
Q

vector ehrlichia

A

ticks (Ambylomma americanum)

126
Q

clinical ehrlichia

A

flu like 1-3 weeks after tick bite

rash (spares hands and feet)

127
Q

diagnosis of ehrlichia

A

serology by IFA
PCR
peripheral blood (Giemsa) to see morulae in monocytes is insensitive

128
Q

reservoir anaplasma

A

deer, sheep, rodents

129
Q

vector anaplasma

A

hard-shelled ticks (Ixodes scapularis and pacificus)

130
Q

location anaplasma

A

northeast/north central states and N. Cali

131
Q

clinical anaplasma

A

1-3 weeks after tick bite-flu like

rash spares hands and feet

132
Q

diagnosis of anaplasma

A

serology by IFA
PCR
PB Giemsa is insensitive

133
Q

laboratory findings for anaplasma and ehrlichia

A

leukopenia
lymphopenia
thrombocytopenia
elevated liver enzymes

134
Q

DOC ehrlichia and anaplasma

A

doxycycline

135
Q

borrelia characteristics

A

weakly staining, gram negative spirochetes
motile (flagella)
difficult to cultivate

136
Q

B. burgdorferi locations

A

NE, Minnesota, Wisconsin

137
Q

vector B. burgdorferi

A

Ixodes scapularis and pacificus

138
Q

reservoir B. burgdorferi

A

white footed mouse and white tailed deer

139
Q

transmission B. burgdorferi

A

transmitted in tick’s saliva during prolonged period

140
Q

clinical manifestations of Lyme disease

A

incubation up to 1 month
early-EM
early disseminated-facial nerve palsy
late-arthritis, carditis, meningitis

141
Q

diagnosis lyme

A

Ig not detectable within 1st 4 weeks
EIA or IFA (sensitive)
Western (specific)

142
Q

treatment of Lyme

A

amoxicillin or cefuroxime for children
doxy for over 8
ceftriaxone for CNS, carditis or recurrent arthritis

143
Q

STARI characteristics

A

Southern
rash of EM and flu-like in non-Lyme endemic areas
associated with bite of Lone Star tick (A. americanum)

144
Q

reservoir STARI

A

white tailed deer

145
Q

diff STARI and Lyme

A

STARI does not have arthritis, neurologic disease, or chronic symptoms
less likely to have multiple skin lesions in STARI

146
Q

B recurrentis characteristics

A 
louse borne (epidemic)
natural disasters, unsanitary conditions
147
Q

endemic tick borne

A

ticks feed nocturnally and contaminate the wound with saliva and feces

148
Q

reservoir for endemic tick borne borrelia

A

rodents, small mammals

149
Q

relapsing fever clinical syndrome

A

incubation for 1 week
biphasic-fever, chills, headaches, hepatosplenomegaly
afebrile for 1 week
return of symptoms

150
Q

diagnosis relapsing fever

A

Giemsa on PB during febrile episode

serology is not useful due to antigenic phase variation

151
Q

treatment relapsing fever

A

doxy

penicillin and erythromycin in pregnant and children under 8

152
Q

characteristics babesia

A

protazoa

sporozoite (ticks) trophozoite to merozoite to gamete

153
Q

most common babesia species

A

babesia microti

154
Q

reservoir babesia

A

white footed mouse

155
Q

vector babesia

A

ixodes tick

156
Q

life cycle babesia

A

blood meal-introduces sporozoites into human host
enter eryhtrocytes and undergo asexual replication
multiplication of blood stage responsible for clinical manifestations

157
Q

clinical babesia

A

hemolytic anemia
influenza like symptoms
splenomegaly, hepatomegaly, jaundice

158
Q

risk factors for babesia

A

asplenia, advanced age, impaired immune function (HIV, malignancy, corticosteroid)

159
Q

diagnosis babesia

A

maltese cross on blood smears
PCR for low levels of parasites
serology not helpful (cannot distinguish between acute or old infection)

160
Q

treatment of babesiosis

A

combination
mild-atovaquone and azithromycin
severe-clindamycin and quinine

DT1 Exam 2 (6 decks)

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