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Pathology (AR) > Micro > Flashcards

Micro Flashcards

1
Q

Visceral Leishmaniasis

A

Leishmania donovani

Kala-azar = black sickness - grey skin

MASSIVE SPLENOMEGALY

fevers, rigors, sweats, poor appetite, wt loss, hepatomegaly

pancytopenia secondary to hyposplenism

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2
Q

Cutaneous Leishmaniasis

A

tropica/mexicana

crusted lesion at site of bite

may be underlying ulcer

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3
Q

Mucocutaneous Leishmaniasis

A

Braziliensis

Skin lesions may spread to involve mucosae of nose and pharynx etc.

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4
Q

Leishmaniasis

Caused by

Spread by

Dx

Tx

A

Intracellular protozoa leishmania

Sand flies

Novy-Macneal-Nicolle medium

Tx = sodium stibogluconate

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5
Q

African trypanosomiasis

A

Sleeping sickness

Spread by tsetse fly

West Africa (Gambiense)

East Africa (Rodesiense) - more acute

Trypanosoma chancre

Enlarged posterior cervical LNs, CNS involvement (SOMNOLENCE)

Mx:

Early - IV pentamide or suramin

Late/CNS involvement - IV melarsoprol

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6
Q

American trypanosomiasis

A

Chagas disease

Trypanosoma cruzi

Periorbital oedema may be seen

Chronic changes = heart and GIT

myocarditis

Tx: azole or nitroderivatives (benzidazole or nifurtimox)

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7
Q

Amoebiasis

Caused by?

Spread by?

Features?

Tx?

A

Entamoeba hystolitica

faecal oral route

Amoebic dysentry:

profuse bloody diarrhoea and trophizites on stool microscopy

Amoebic liver abscess:

single mass in R lobe, fever and RUQ pain

FLASK SHAPED ULCER

Tx: METRONIDAZOLE and paromycin in luminal disease

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8
Q

Leptospirosis

Caused by?

Spread via?

Features?

EMQs?

Mx:

A

spirochaete leptospira interogans

Spread via contact with infected rat urine

Fever, flu like

RENAL FAILURE
JAUNDICE

SUBCONJUNCTIVAL HAEMORRHAGE

Headache

EMQs: sewage worker, farmer, vet, abattoir

Mx:

High dose BENPEN or DOXY

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9
Q

Brucellosis/Maltese fever

Syptoms

A

Non specific, incl osteomyelitis and meningoencephalitis

severely debilitating often chronic

fever, profuse sweating SMELLS LIKE HAY

joint and muscle pain

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10
Q

Brucellosis/Maltese fever

Incubation and transmission

A

G -ve faculative intracellular bacteria

3-4w - 7-10m

Contact with infected animals e.g. farmer, vet, abattoir

Consumption of infected products e.g. infected unpasteurized milk, cheese

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11
Q

Brucellosis/Maltese fever

Dx and Tx

A

BM culture, blood culture, serology

Prolonged therapy (4-6w)

TETRACYCLINE or DOXYCYCLINE plus STREPTOMYCIN

Rifampacin and amikacin can also be used

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12
Q

Plague

A

Yersinia pestis

Bubonic, pneumonic or septicaemic

Dx: PCR

Tx: streptomycin, doxycycline, gentamicin

If meningitis: chloramphenicol

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13
Q

Borellia

A

Relapsing fever

Doxycycline

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14
Q

Rickettsia

A

ticks, fleas, lice

Rocky mountain spotten fever

African tick bite fever

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15
Q

Schistosoma Haematobium

A

Urinary schistosomiasis

Swimmers itch, returned from africa

RF for SCC of the bladder

Features: frequency, haematuria, bladder calcification

Mx: single oral dose PRAZIQUANTEL

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16
Q

Sporadic CJD

A

somatic prnp mutation or spontaneous conversion of PrPc to PRPsc

Rapid, progressive dementia

Cortical blindness

Mean age 46-75

Survival = 6m

EEG - periodic triphasic changes

MRI - normal

CSF - 14-3-3

PM - spongiform vacuolation, PrP amyloid plaques

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17
Q

Acquired CJD

A

Variant CJD

Iatrogenic CJD

Kuru

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18
Q

Variant CJD

A

Exposure to BSE

Younger, 30y, survival = 14m

EEG - non specific slow waves

MRI - posterior thalamus highlighted = PULVINAR SIGN

PM - PrPsc 4T in CNS and lymphoreticular tissue, florid plaques

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19
Q

Iatrogenic CJD

A

Innoculation with human prions e.g. surgery

Progressive ataxia –> dementia

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20
Q

Kuru

A

Canabalistic prion exposure

Progressive cerebellar syndrome

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21
Q

Inherited CJD

A

Familial CJD

Gerstmann–Sträussler–Scheinker syndrome

Fatal familial insomnia

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22
Q

P. falciparum

Severe infection and complications

A

Severe infection:

schizonts on a blood film

parasitaemia > 2%

hypoglycaemia

acidosis

temperature > 39 °C

severe anaemia

Complications:

cerebral malaria: seizures, coma

acute renal failure: blackwater fever, secondary to intravascular haemolysis, mechanism unknown

ARDS

hypoglycaemia

DIC

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23
Q

P. falciparum Tx

Uncomplicated

Severe

A

Oral ACT e.g.

artemether plus lumefantrine

artesunate plus amodiaquine

artesunate plus mefloquine

artesunate plus sulfadoxine-pyrimethamine

dihydroartemisinin plus piperaquine

Severe:

IV artesunate

IV quininie

If parasite count > 10% then exchange transfusion

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24
Q

Vivax

A

fever every 48h

Film: schuffer dots

Tx:

Primaquine and chloroquine to destroy hypnozoites

Oral ACT

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25
Q

Ovale

A

Fever every 48h

Film: Schuffer dots

Primaquine and chloroquine to destroy hypnozoites

Oral ACT

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26
Q

Malariae

A

Fever every 72h

Nephrotic syndrome

Tx: ACT/chloroquine

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27
Q

Tinea capitis

A

Scalpringworm

Causes scarring/alopecia

Dx: green fluorescence under wood’s lamp

Tx: Oral antifungals

Terbinatine for tricophyton tonsurans

Griseofulvin for micosporym canis

Topical ketoconazole

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28
Q

Tinea corporis

A

RIngworm

Trichyphyton rubrum

Tx: oral fluconazole

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29
Q

Tinea pedis

A

Athletes foot

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30
Q

Candida Dx

A

culture mannan abs

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31
Q

Aspergillus

A

Pneumonia in immunocomp

Dx: elisa, pcr, b glucan

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32
Q

Cryptococcus

A

Immunocomp (HIV)

Meningitis - insidious onset

Dx: cryptococcal antigen in serum/csf

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33
Q

Better test for haemophilus than chocolate agar

A

latex particle agglutination and PCR

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34
Q

GOld std dx for leptospirosis

A

microscopic agglutination test

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35
Q

Neisseria meningitides virulence factors

A

capsule, endotoxin and IgA1 protease

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36
Q

Recurrent aseptic meningitis =

A

mollaret’s meningitis (HSV 1+2)

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37
Q

Higouménakis’ sign and clutton joints

A

congenital syphilis

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38
Q

giemsa stain

A

klebsiella granulomatis

Donovanosis

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39
Q

maculopapular rash, low platelets, hyponatraemia and raised liver enzymes

A

Rocky mountain fever

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40
Q

SE of trimethoprim

A

megaloblastic anaemia and hyperkalaemia

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41
Q

Candidaemia dx

A

blood b-D glucan

42
Q

castaneda medium

A

brucellosis

43
Q

oseltamivir

zanamivir

laninamivir

peramivir

A

neuraminidase inhibitors

44
Q

spaghetti and meatballs

A

pityriasis versicolor

45
Q

tx sporothrix schenkii

A

fluconaxole and oral KI

46
Q

mississippi river

A

histoplasma capsulatum

47
Q

cauliflower warty lesion

A

phialophora verrucosa

48
Q

plasma amylase

A

mumps

49
Q

COPD pneumonia

A

moraxella catarrhalis

50
Q

brucellosis tx

A

doxy and gent

51
Q

lyme tx

A

doxy

52
Q

tonsillar biopsy, useful for..?

A

variant CJD

53
Q

best test for Hep C

A

RNA PCR (VL)

54
Q

which genotype of hep c is less likely to respond to tx

A

genotype 1

55
Q

winterbottom’s sign

A

Trypanosoma brucei gambiense

posterior cervical LNs

56
Q

T. cruzi tx

A

bennximidazole or nfurtimox

57
Q

Falciparum film

A

maurer’s clefts

58
Q

Salmonella Tx

traveller’s diarrhoea tx

A

cipro

clarithromycin

59
Q

incubation <1w

A

meningococcus

diptheria

influenza

scarlet fever

60
Q

incubation 1-2w

A

malaria

dengue

typhoid

measles

61
Q

incubation 2-3w

A

mumps

rubella

chicken pox

62
Q

incubation >3w

A

IM

CMV

viral Hep

HIV

63
Q

Hep C tx

A

Peg-IFNa

Ribavirin

Protease inhibitor (e.g. boceprevir, simeprevir, telaprevir)

64
Q

Most common cause of diarrhoea in HIV

A

cryptosporidium

65
Q

RSV prevention

A

Ribavirin aerosol (guanosine analogue)

Palivizumab is a monoclonal antibody against RSV

66
Q

CMV tx

A

Gancyclovir

67
Q

Varicella zoster tx

A

Valaciclovir

68
Q

Influenza A

A

Amantidine

69
Q

Tx for severe resistant herpes

A

Foscarnet

70
Q

Macrolides treat:

A

legionella/mycoplasma, bartonella, campylobacter, diptheria, c.psittaci/pneumoniae/trachomatis

71
Q

Cause of exanthem subitum

A

HHV6

72
Q

Naturally ocurring cytokine, inhibits HIV fusion to CD4+

A

MIP-1a

73
Q

Tx for severe sytemic infection before organism has been identified

A

CEFUROXIME

74
Q

slums, river water

A

cryptosporidium parvum

75
Q

Rat bite, 10d later - fever, malaise, headache and myalgia

A

spirilluminus

76
Q

undulant fever, bone pain, malaise (3w)

A

brucellosis

77
Q

Brucella from goats

from cattle

A

Melitensis (g-ve coccobacilli)

Abortus

78
Q

itchy scaly rash on soles of feet

A

trichophytum rubrum

79
Q

pityrosporum orbiculare

A

pityriasis versicolor

80
Q

pigeon racing

A

cryptococcus

81
Q

Post viral reactive arthritis

A

Rubella

P B19

HBV

82
Q

Post bacterial reactive arthritis

A

Dysentry:

Shigella, salmonella, yersinia, campylobacter

Urethritis:

chlamydia, ureaplasma

Other:

GAS, N. gonorrhoeae, brucella, TB (Poncet’s)

83
Q

Post infectious reactive arthrirtis

A

Lyme disease

Rheumatic fever

84
Q

Well defined ovoid shape with a surrounding sclerotic margin bit little involcrum in tibia

A

brodie’s abscess

85
Q

clutton’s joints

A

syphilis

86
Q

drug induced fever

A

abx e.g. co-trimoxazole

87
Q

DDx ring enhancing lesions

A

brain abscess

toxoplasmosis

tuberculoma

CNS lymphoma

88
Q

anatomical abnormalities of the renal tract and also cavitating pneumonia

A

klebsiella

89
Q

broad spect abx for UTI

A

ampicillin

90
Q

pseudomonal infxn

A

ceftazidime

91
Q

haemorrhagic cystitis in kids

A

adenovirus

92
Q

schistosoma mansoni

A

bowel and liver

diarrhoea

93
Q

schistosoma haematobium

A

bladder

painless haematuria

scc of bladder

94
Q

microfilariae in peripheral blood, marked eosinophilia and Sx affecting LNs

A

Wucheria bancrofti

95
Q

undercooked pork

‘eating competition’

periorbital oedema, conjunctivitis, 3w hx chills

gastric bx = encysted larvae

A

Trichinella spiralis

96
Q

small pale bodies in stools, mild epigastric pain

A

taenia saginata

97
Q

Dark urine

A

P. falciparum

98
Q

tear drop trophozites

A

giardia

99
Q

machado guerrero test positive

A

Trypanosoma cruzi

100
Q

chorioretinitis, hydrocephalus, seizures and hepatosplenomegaly

A

congenital toxoplasma

Pathology (AR) (25 decks)

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