MICRO/PATH Flashcards
Name the 7 respiratory pathogen vaccines
1 Pneumococcal pneumonia 2 Flu A and Flu B 3 Haemophilus influenze 4 Whooping cough 5 TB (not in US) 6 Adenovirus 4 and 7 (military only) 7 Anthrax (emergency personnel only)
what is the second most common cause of otitis media?
H. influenzae
OMP38 is found in which pathogen?
acinetobacter
what does OMP38 do
releases cytochrome C and an apoptosis-inducing factor which enter the epithelial cell nucleus and causes the degradation of DNA and other apoptotic phenomena
what is the world’s leading preventable cause of blindness?
Trachoma infection of conjunctiva by Chlamydia
which disease is prevented by giving erythromycin eye drops at birth?
neonatal inclusion conjunctivitis (baby gets it from mom as baby moves through birth canal)
what is the most common sexually transmitted disease in industrialized countries?
chlamydia trachomatis
where does legionella replicate?
in macrophages after inhalation (facultative intracellular aerobe)
what does cord factor do?
toxic to mammalian cells
inhibits PMNs
who makes cord factor?
MTB
nocardia
what are the special mechanism for cell entry for MTB?
directly bind mannose receptors on mphages via cell wall-associated mannosylated glycolipid, LAM, or indirectly via certain complement receptors or Fc receptors
which bug has high cold agglutin titer?
mycoplasma
foamy macrophages are characteristic of ___________bacterial pneumonia
subacute
Name the bug!
Smoker w/ acute onset of fever, rigors, cough, dyspnea, diarrhea, confusion, pulmonary crackles, bronchopneumonia, leukocytosis, hyponatremia and non diagnostic sputum
Legionella
which pneumonia has the highest mortality even if treated?
pseudomonas
Name the bug!
Intubated hospital pt w/ acute onset of fever, chills, confusion purulent sputum, tachycardia, tachypnea, hypotension, pulmonary crackles, bilateral bronchopeneumonia, neutropenia, and gram-negative rods in sputum
pseudomonas
Name the bug:
Middle aged male that’s immunocompromised, insidious onset of dyspnea, dry cough, low fever, tachycardia, tachypnea, elevated LDH and bilateral reticular infiltrates
pneumocystis
_______________pneumonia is the prototype subacute or chronic interstitial pneumonia in an immunocompromised pt.
Pneumocystis
Name the bug!
Adult w/ neutropenia, acute onset of fever, pleuritic chest pain, hemoptysis, tachycardia, tachypnea, pulmonary crackles and nodular infiltrates
Aspergillosis
Name the pathology
Late middle aged female smoker w/ insidious onset of persistent cough, anorexia, weight loss and peripheral lung mass
adenocarcinoma of the lung
Name the pathology:
Late middle aged black male smoker w/ insidious onset of persistent cough, dyspnea, anorexia, wt loss, hemoptysis and central endobronchial lung mass
Squamous cell lung cancer
Name the pathology:
Late middle aged black male smoker w/ insidious onset of persistent cough, dyspnea, anorexia, wt loss, hemoptysis and central endobronchial lung mass
Squamous cell lung cancer
Name the pathology:
Late 60’s male heavy smoker w/ insidious onset of wt loss, cough, dyspnea weakness, central parabronchial lung mass w/ hilar LAD
Small cell carcinoma of the lung
what is the most aggressive type of lung cancer?
small cell carcinoma
which lung cancer has SIADH
small cell lung cancer
where are the neuroendocrine cells derived from in small cell carcinoma of the lung?
neural crest cells
where are the neuroendocrine cells derived from in small cell carcinoma of the lung?
neural crest cells
Name the pathology:
Late middle aged pt w/ insidious onset of anorexia, wt loss, malaise, fatigue, and numerous small rounded lung nodules (more in lower lobes)
metastases to the lung
which bug has no cell wall?
mycoplasma (explains why it has a need for cholesterol in media to grow)
which bug has no peptidoglycan in its cell wall?
chlamydia
what are the classic immunostains for adenocarcinoma of the lung?
CK7
TTF1
what are the classic immunostains for small cell lung cancer?
Synaptophysin
Chromogranin
what is a Ghon complex?
primary TB lesion + hilary lymph node involvement
what is one way you can differentiate histoplasmosis from old TB microscopically?
do a methenamine silver stain
what are the 3 forms of aspergillus disease
allergy
colonization
invasion
Name the pathogen!
Adult black pt that’s immunocompromised, insidious onset of fever, cough, dyspnea, headache, tachycardia, tachypnea, stiff neck and nodular infiltrates
cryptococcus
what is the histologic confirmation for cryptococcus?
mucicarmine stain
what is the most common chronic occupational disease?
silicosis
what are the 2 genes that predispose a pt to getting sarcoidosis?
macrophage HLA, BTLN2 (butyrophillin-like2)
what kinds of cells are characteristically found in sarcoidosis?
CD4 T-helper cells
what kinds of cells are characteristically found in asthma?
eosinophils (inflammatory), CD4 TH2 helper cells that secrete cytokines IL-4, IL-5
what does the diabetic pt in ketoacidosis get if he is has an infection?
mucormycosis
what is bacillus anthracis capsule made of?
Poly D Glutamic acid (it is nonantigenic and prevents phagocytosis)
which bug requires lysogenic conversion to make an exotoxin that could really kill a sick kid?
Corynebacterium diptheriae
which bug charactistically makes sulfur granules?
actinomyces
what is one way you can distinguish actinomyces from nocardia?
nocardia stains AFB+ weakly and actinomyces is AFB-
how do you get actinomyces?
part of normal flora, can become infected when mucosa is disrupted and can lead to abscess (sulfur granules)
how can you get nocardiosis?
inhalation (can lead to lung abscess)
which bug smells like grapes and has procyanin?
pseudomonas
name the bug. has DOT, ICM, intracellular and has a urine antigen test?
legionella
describe the epidemiology of coronavirus?
children get this in the winter (strongly seasonal)
what is Reye’s syndrome?
noninflamm. Cerebral edema, fatty infiltration of liver, hepatic dysfunction (↑LFTs), seen in children that have the flu
how do you get the hantavirus?
breathe in aerosolized rodent urine, saliva, feces in the four corners region of the US
if you have a pt with a history of fatigue and fever leading to dyspnea with rodent exposure, what do they have?
hantavirus
what is the tetrad of lab tests that will help diagnose hantavirus pulmonary syndrome?
- thrombocytopenia
- leukocytosis w/ bandemia
- ↑ hematocrit levels (b/c ultrafiltration by lungs)
- immunoblasts in peripheral blood smear
Serology is useful b/c long incubation period before onset of disease
Name the bug!
Presentation: child 2-8 months october to march begins w/ URT symptoms (cough, low fever)LRT symptoms in 2 days, can prog. to severe cases of wheezing and coughing
RSV
whats the name of the virulence factor for paramyxoviridae that causes cells to fuse together?
Fusion protein (F protein) forms syncytia
whats the name of the virulence factor in adenovirus that has a toxic effect on cells?
Penton protein (which are attachment proteins)
what is the classic triad of aspergillosis in neutropenic patients?
- fever
- pleuritic chest pain
- hemoptysis
which pneumonia characteristically has a high LDH in serum?
pneumocystis
name the bug!
chubby safety pin gram negative rods
yersinia pestis
whats the name of the virulence factor in yersinia pestis that paralyzes phagocytes upon ingestion?
F1 antigen capsule
what are the immunostains for squamous cell lung cancer?
p63
p40
what is an aspergillum?
fruiting body producing conidia in aspergillus
what is the most common presenting ymptoms of pulmonary thromboembolism?
dyspnea
what is the classic triad for fat embolism?
- mental status change
- thrombocytopenia
- petechiae
what is the microscopic pathological hallmark of ILD?
fibroblast foci of immature fibrosis bulging into alveoli from interstitium
what is the histologic hallmark of cryptogenic organizing pneumonia?
Masson bodies= plugs of fibrosing granulation tissue in the alveoli
Name the pathology:
adult with recent surgery, central venous catheterization, malignancy, long haul travel obesity and smoking with sudden onset of dypsnea associated with chest pain, leg pain and swelling tachypnea, hypoxemia and normal chest xray.
pulmonary thromboembolism
name the pathology:
elderly black male with insidious onset of fatigue, anorexia, weight loss, low grade fever, chills, nightsweats, ild cough, mucopurulent sputum, apical cavitary nodules and acid fast bacilli in sputum.
MTB
Name the pathology:
pt with trauma surgery and vascular catheter insertion or removal with sudden onset of dyspnea, single gasp or cough, lightheadedness, tachypnea, tachycardia hypotension, hypoxemia and mill wheel heart murmur
air embolism
Name the pathology:
middle aged male smoker with the insidiuos onset of dyspnea and persistent dry cough bibasilar dry velcro pulmonary crackles and bilateral reticular lung opacities in periphery and at the bases
usual interstitial pneumonia
name the pathology:
hospital pt with shock sepsis pneumonia acute onset of rapidly worsening dypsnea, respiratory distress, tachypnea, diffuse pulmonary crackles and progressive pulmonary infiltrates
ARDS
Name the pathology:
male smoker with acute onset of single strong rigor, high fever, productive cough, rusty sputum, tachypnea, pulmonary crackles, tubular breath sounds, lobar consolidation, leukocytosis and gram-positive diplococci in sputum.
pneumococcus
name the pathology:
hospital pt with acute onset of fever cough dyspnea, tachycardia tachypnea, hypotension, pulmonary crackles, abscessing bronchopneumonia leukocytosis and gram positive cocci in sputum
staph aureus pneumonia
name the pathology:
young pt in winter with insidious onset of malaise, low fever, persistent intractable dry cough, normal wbc count, cold agglutinins and bronchopneumonic reticulor or reticulonodular infiltrates that look worse than the pt.
mycoplasma pneumonia
name the pathology:
pt with long bone fraction 1-3 days ago or black pt with sickle cell crissis now with acute onset of dyspnea, confusion, tachypnea hypoxemia, and petechiae and thrombocytopenia
fat embolism
name the pathology:
tall thin yung male smoker with sudden onset of dyspnea associated with unilateral chst pain and decreased breath sounds on the same side and ocllapsed lung on cxr
pneumothorax
