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Microbiology Flashcards

1
Q

What is Dermatomycoses?

A

Dermatomycosis is the medical term for fungal infections of the skin and skin appendages.

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2
Q

Superficial mycosis ( dermatomycosis) is a disease of ______ and caused by ________ ?

A

Nail, Skin, and Hair and caused by dermatophytes and non-dermatophytes.

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3
Q

What are examples of Superficial Dermatomycosis?

A
  1. Dermatophytosis
  2. Candidiasis ( cutaneous & mucosal)
  3. Malassezia infection
  4. Tinea nigra
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4
Q

What is the causative organism for Tinea nigra?

A

Hortaea werneckii (Exophiala werneckii )

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5
Q

What is the habitat for Hortaea werneckii?

A

Soil, Compost , Humus, Wood, Sand ( beach) sewage

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6
Q

What is a major risk factor of Tinea nigra?

A

Hyperhydrosis

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7
Q

What is Tinea Nigra?

A

Tinea Nigra ( aka Pityriasis nigra) is a superficial fungal infection of the stratum corner caused by the black yeast - like mould Hortaea werneckii.

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8
Q

Where are the lesions of tinea nigra usually located?

A
  1. Palms
  2. Soles of the feet
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9
Q

What is the microscopical appearance of Hortae wernickii (Exophiala werneckii )?

A

Hyphae - dematiaceous , septa

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10
Q

What are the different types of Malasseziosis?

A

Pityriasis versicoloured
Seborrheic dermatitis
Pityriasis capitis

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11
Q

What are the Causative agents of Pityriasis ?

A

Malassezia furfur ( M. furfur)
Malassezia globosa ( M. globosa)
Malassezia Sympodialis ( M. Sympodialis)
Malassezia restricta ( M. Restricta)

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12
Q

True or False? Malassezia is considered Lipophillic and needs lipids for growth.

A

TRUE!!

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13
Q

What are the most common locations of Pityriasis vesicolor?

A

Neck, Trunk and proximal extremities

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14
Q

What are other names for Pityriasis vesicolour?

A

Tinea vesicolor
Tinea flava
Dermatomycosis furfuracea

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15
Q

Fill in the blanks. “ Pityriasis wapitis ( Dandruff ) is a cluster of ________.”

A

Corneocytes

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16
Q

What is the microscopic appearance of Malassezia spp?

A

Thick-walled round, Budding yeast cells and short angular hyphae
- Sphagetti & meatball appearance

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17
Q

Want are the three main general types of Dermatophytes?

A

Microsporum spp.
Epidennophyton spp.
Trichophytcm spp.

“I MET some Dermatophytes”

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18
Q

True or False? Epidennophyton flocossum affects Skin and Hair ONLY.

A

FALSE !! It affects Skin and Nails only

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19
Q

True or False!! Microsporum spp affects Skin and Hair ONLY.

A

TRUE!!

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20
Q

True or False? Trichophyton sp. affects skin, hair and nails.

A

TRUE!!

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21
Q

What are the Dermatophytes classification by habitat?

A

Man ( anthropophilic)
Animals (Zoophilic)
Soil ( Geophilic)

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22
Q

What are examples of Man ( anthropophilic) dermatophytes?

A

Trichophyton rubum
Trichophyton interdigtale
Epidermophyton floccosum

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23
Q

Microsporum gypseum ( now called Nannizzia gypsea) is considered what type of Dermatophyte?

A

Soil ( Geophilic)

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24
Q

What are examples of Animals ( zoophilic) dermatophytes?

A

Microsporum canis
Trichophyton mentagrophytes
Trichophyton verrucosum

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25
Which type of dermatophyte is the most widely spread dermatophyte that infects humans?
Trichophyton rubrum
26
What is the anatomical location of Tinea corporis (Tinea circinata) ?
Ringworm of body, trunk, face, neck , limbs
27
What is another name for Tinea pedis?
Athletes foot
28
What is the main cause of Onychomycosis?
Tinea unguium
29
What is the anatomical location of Tinea cruris ( Tinea inguinalis )?
Ringworm of groin, perineal/perianal areas
30
What is another name for Tinea inguinalis?
Jock's itch
31
What is the other name for Barber's itch ?
Tinea barbae - ringworm of bear, moustache
32
What are the causative agents for Tinea unguium?
Trichophyton & Epidermophyton species of Dermatophytes.
33
What are examples of Non- dermatophyte moulds that can cause onychomycosis?
Acremonium , Aspergillus, Scopulariopsis, Fusarium
34
What are the causative agents for Onychomycosis?
Dermatophytes ( 80- 90%) Non-dermatophytes Yeast ex Candida spp
35
What is the most common pattern of Onychomycosis?
Distal & Lateral Subungual Onychomycosis ( DSO/ DLSO) - invasion to distal part of nail
36
Which pattern of Onychomycosis occurs when there is invasion of the fungus into the nail plate superficial layer?
Superficial White Onychomycoses (SWO/SO)
37
Describe the Proximal and subungual onychomycosis (PSO ) pattern of Onychomycosis?
This occurs when the fungus invades the surface under the proximal folds of the nail and the infection progresses distally.
38
Which pattern of Onychomycosis is the end-stage of Onychomycosis which can be due to incomplete treatment to any other subtypes of the disease?
Total dystrophic onychomycosis (TDO)
39
What is the most common type of Tinea Pedis?
Interdigital
40
Which clinical pattern of Tinea pedis presents with small vesicles over a background of erythema on the instep of the foot - can be painful also?
Vesicular ( Vesiculubullous)
41
What is the clinical presentation with Interdigital Tinea pedis?
Patients present with macerated skin, with or without erythema and fissures , in the INTERDIGITAL space between the 4th and 5th toes.
42
What clinical presentation is an exacerbation of Interdigital Tinea pedis?
Acute ulcerative
43
What is the second most common type of Tinea pedis - it also presents with dry, hyperkeratotic scales and fissures?
Moccasin ( Hyperkeratotic)
44
What are three types of Hair Invasion?
Endothrix Ectothrix Favic
45
In which type of Hair invasion is the cuticle of the hair destroyed?
Ectothrix
46
What are the different types of Endothrix?
T. violaceum T. Tonsurans T.soundanense V for violaceum V- for Vigilance - Vigilance Teach ENDOcrine ( Endothrix)
47
What are the different types of Ectothrix?
M. canis M. Ferrugineuum M. Audouinii T. Mentagrophytes
48
What microorganism gives an example Favic hair invasion?
Trichophyton schoenleinii
49
What are the types of Tinea capitis?
Non-Inflammatory Inflammatory
50
What are the examples of Non-inflammatory Tinea capitis?
Grey patch Diffuse scale Black dot
51
What are the examples of Inflammatory Tinea capitis?
Diffuse pustular Kerion (Celsi) Favus ( Tinea Favosa)
52
What are the causative agents of Candidiasis?
C.Albicans C. auris C. tropicalis C. Parapsilosis C. Glabrata
53
Erosio interdigitalis blastomycetica (EIB) occurs between which fingers?
Third and Fourth fingers
54
Toe web candidiasis occurs commonly where?
In the fourth interdigital space of the toes.
55
What is the most common type of Candida Onychomycosis?
Candida paronychia, whitlow
56
Which classification of candida onychomycosis involves separation of the nail plate from the nail bed?
Candida oncholysis
57
What is the most severe type of Candida onychomycoses?
Candida granuloma
58
Which type of Candida onychomycosis displays brittle nails and a digit deformity resembling a chicken drumstick ( Pseudoclubbing)?
Candida granuloma
59
What is the treatment for nail onychomycosis?
Terbinafine
60
What is the mechanism of Terbinafine?
Inhibits the fungal enzyme squalene epoxidase
61
What is Impetigo?
Impetigo is an initially vesicular, later crusted superficial infection of the skin.
62
What is the main microorganism causing Impetigo?
Staphylococcus aureus (dominant ) Group A strep Staph & Strep A impetigo
63
The appearance of Honey coloured crusts are associated with?
Impetigo
64
What are examples of non-bullous eruption of Impetigo?
Chicken pox Herpes Folliculitis Erysipelas Insect btes SCabies Ezcematous dermatitis Scabies Tinea corporis
65
What are examples of bullous eruption of Impetigo?
Burns Pephigus vulgaris Bullous pemphigoid Steven-Johnson syndrome
66
What is the first line treatment for Chicken pox?
Mupirocin ( bactroban) - topical ointment 7-10 days
67
What is the treatment for Chicken pox for patients who are allergic to Penicillin?
Cephalexin
68
What is the next in line treatment for patients who DO NOT respond to Mupirocin after 3-5 days?
Augmentin Cefaclor Cephalexin
69
What is Ecthyma?
These are lesion which are similar to impetigo but penetrate through the epidermis
70
What are the causative agents for Ecthyma?
Group A streptococci- De novo or Secondarily Staphylococcus Aureus Pseudomonas aeruginosa bacteremias
71
What is the treatment for Ecthyma?
Topical mupirocin Oral antistaphylococal plus antistreptococall agent (AMPICLOX)
72
What is Folliculitis?
Folliculitis is a pyoderma located within the hair follicle. The legions consist of small (2-5mm) erythematous, sometimes pruritic, papules often topped by a central pustule
73
What are the microorganisms associated with Folliculitis?
Staphylococcus aureus Pseudomonas aeruginosa “SPF ( folliculitis) are us “
74
Which causative agent can give " Hot tub folliculitis"
Pseudomonas aeruginosa
75
What is the treatment for Folliculitis without infection?
Cleanse with antibacterial soap Moist heat for 2-3 times a day
76
What is the treatment for Folliculitis with a suspected inflammation of unknown aetiology?
Mupirocin 2%
77
What is the treatment for Folliculitis with suspected infection from S. Aureus?
Cloxacillin
78
What is the treatment for Folliculitis with suspected infection from Pseudomonas aeruginosa ?
Ciproflaxin Ofloxacin
79
What is a Furnucle?
A furuncle is a deep inflammatory nodule usually developing from a preceding folliculitis.  
80
What is a Carbuncle?
A carbuncle is a deep seated infection of multiple hair follicles that coalesce and spread into the subcutaneous tissues, frequently associated with sinus tracts.
81
What is the suggested workup for Furnucles/Carbuncles?
Physical examination Collect exudate for gram stain and culture Blood culture if septic
82
Which one is normal associated with Fever and Malaise, Furnucles or Carbuncles?
Carbuncles
83
What is the treatment for a patient who has Furnucles/ carbuncles around the nose or central face areas and fever but has a penicillin allergy?
Erythromycin
84
What is Cellulitis?
Cellulitis is a superficial, spreading, warm erythematous inflammation of the skin and subcutaneous tissues.
85
What are the microorganisms associated with Cellulitis?
* Invasive Group A Streptococcus * Staphylococcus aureus various other organisms including: * Group B Streptococcus *Haemophilus influenzae * Pseudomonas aeruginosa PHABS
86
What are the clinical features of Cellulitis caused by Invasive Group A Streptococcus?
Immature granulocytes, Lymphopenia Hypoalbuminemia and hypocalcemia
87
What are the clinical features of Cellulitis caused by Pseudomonas aeruginosa?
Vesicles and bullae Etchyma grangrenosum Gangrenous cellulitis Macular or Maculopapular lesions
88
What are the symptoms of Cellulitis?
Local tenderness Pain Swelling Erythema Fever Chills Itching ( Facial cellulitis) FOUL- SMELLING discharge from site
89
What is Erysipelas ?
Erysipelas is a type of cellulitis which is characterized by an abrupt onset of fiery, red-swelling of the face or extremities.
90
What is the aetiology for Erysipelas?
Mainly Group A Streptococcus Occasionally Staphylococcus aureus
91
What is the Paronychia?
Inflammation involving the folds of tissue around the fingernail
92
What is the aetiology of Paronychia?
* Staphylococcus aureus * Group A Streptococcus * Candida sp. * Pseudomonas aeruginosa
93
What is Decubitus ulcers ?
Decubitus ulcers are cutaneous ulcerations caused by prolonged pressure that result in ischemic necrosis of the skin surface and underlying soft tissues.
94
What is the aetiology for Decubitus ulcers?
Coliform bacteria Pseudomonas aeruginosa Peptostreptococcus Enterococcus sp. Bacteroides sp. Clostridium perfringens
95
Pain in Decubitus ulcers is chatecorized by what stage?
1 or 2
96
If a Decubitus ulcers is in the stages 3 or 4 it is referred to as?
Pain free
97
What specimens should be collected for testing for Subcutaneous mycoses?
Pus from the lesions Swab Blood culture
98
What is the preferred transport medium for specimens from subcutaneous mycoses?
Stuart’s transport media
99
What are the different aspects of Processing of specimen?
Direct Microscopy Culture Antimicrobial susceptibility testing
100
How is Direct Microscopy done?
A gram stain is done on the specimen and examined under a light microscope
101
What are subcutaneous mycoses?
These are results from traumatic traumatic puncture of the skin . They are lesions that develop at the site of implantation of the etiological agent in the subcutaneous tissue.
102
What are the types pf Subcutaneous Mycoses?
Chromomycosis/ Chromoblastomycosis Phaeohyphomycosis Sporotrichosis Maduromycosis (mycetoma)
103
Where are Mycetema most commonly populated?
Tropical & subtropical countries of Asia , Africa , Central America.
104
What are the typical routes of entry for fungus ?
Splinters, Thorns or other sharp objects
105
What are the examples of Sporotrichosis (SPT)?
Schenck's disease Beurmann's disease Rose Gardener's disease Peat moss disease
106
What is the aetiology of Sporotrichosis (SPT)?
Sporothrix Schenckii Sporothrix globosa Sporothrix brasiliensis Sporothrix mexicana
107
What are specific countries with a high incidence of Sporotrichosis (SPT)?
Peru Brazil Mexico
108
What is the natural habitat for Sporotrichosis (SPT)?
Soil , Decaying vegetation , Dead wood , Sphagnum moss, Cornstalks , Hay
109
What are occupations that can increase the risk of exposure of Sporotrichosis (SPT)?
Farming, Gardening, Flower vending, Handling hay , Animal husbandry , Armadillo hunting , Mining
110
What animals are a risk of transmitting Sporotrichosis (SPT)?
Bites from mice, Armadillios , Squirrels, cats & dogs
111
Which microorganism that causes Sporotrichosis (SPT) can be transmitted through the bites of cats?
Sporothrix brasiliensis Cat had my bra
112
What is the Average Incubation period for Sporotrichosis (SPT)?
3 weeks - can occur between 1-10 weeks tho
113
What are the clinical forms of Sporotrichosis (SPT)?
Cutaneous and Extra Cutaneous
114
What are the variants of Cutaneous Sporotrichosis (SPT)?
* Lymphocutaneous sporotrichosis ( 70-75%) * Fixed cutaneous sporotrichosis (20%) * Cutaneous disseminated sporotrichosis)
115
What are the forms of Extra - cutaneous Sporotrichosis (SPT)?
Osteorarticular sporotrichosis Pulmonary sporotrichosis Meningeal sporotrichosis Disseminated sporotrichosis
116
Which variant of Cutaneous Sporotrichosis (SPT) is associated with sporotrichoid chancre?
Fixed cutaneous sporotrichosis
117
What is the treatment for Sporotrichosis?
*Saturated solution of potassium iodide (KI) – drug of choice * Oral Ketoconazole or Itraconazole
118
What s the culture used for Sporotrichosis schenckii?
Sabouraud’s dextrose agar
119
How is the laboratory diagnosis done for Sporotrichosis ?
1. Mould at 25-30 degrees Celsius - Septa hyphae with small oval smooth conidia ( daisy flower like arrangement). 2. Yeast in tissue & culture at 35-37 degrees Celsius - cigar shaped cells , budding yeast cells 3. Asteroid body surrounded by splendore-hoepli
120
What specimens should be collected from a patient with suspected Sporotrichosis ?
- pus, exudate & aspirate from nodules. - curettage or swabs from open lesion
121
What is Chromoblastomycosis?
This is a chronic , granulomatous infection typically confined to the skin and subcutaneous tissues of the feet and legs.
122
What is the aetiology of Chromoblastomycosis?
Fonsecaea compacta Cladosporum carrionii Phialophora verrucosa
123
What is the habitat for Chromoblastomycosis?
Soil , Plant and rotten wood
123
Which type of Subcutaneous mycoses can develop into Elephantits?
Chromoblastomycosis (Verrucous dermatitis)
124
What method is used for the diagnosis for Chromoblastomycosis ?
Direct Microscopy - Material from lesion is placed in a drop of KOH and examined for fungal elements.
125
What is the appearance of Chromoblastomycosis on ?
Rough cauliflower like lesions Copper pennise ( Medlar or Sclerotic bodies - Muriform cells) these appear as' black dots' on appearance
126
What is the most common lesion seen in Chromoblastomycosis ??
Verrucous - warty- like lesions
127
What is the treatment for Chromoblastomycosis ?
* Thiabendazole -,Flucytosine (commonly used drugs) * Cryotherapy, Thermotherapy, Laser therapy,Chemotherapy and Surgery.
128
What are the different types of Mycetoma?
* Actinomycetoma (caused by bacteria) * Botryomycetoma (caused by bacteria) * Eumycetoma (fungal)
129
What is the habitat for Mycetoma?
Plant , Soil, animal, rotten wood, acacia tree, cactus thorns
130
What is the aetiology of Actinomycetoma?
Actinomyadura Nocardia brasiliensis Nocardiopsis Streptomycoses - ANNS
131
What is the aetiology of Botryomycetoma?
Psedomonas aeruginosa E. coli Proteus mirabilis Staphylococcus spp ( most common ) Streptococcus app "B PEPS"
132
What is the aetiology of Eumycetoma ?
Madurella mycetomatis Scedosporiun boydii Trematosphaeria grisea Pseudallescheria boydii,
133
What is the classical triad associated with Mycetoma?
Painless wood hard swelling Discharging sinuses Grains ( Sclerotia )
134
True or False? Specimens with suspected dermatomycoses should be refrigerated.
FALSE!! They SHOULD NOT be refrigerated.
135
What is the best nail specimen?
The crumbly material of the nail bed.
136
How should nail specimens be submitted?
Scrapings Cuttings Occasionally the complete nail
137
How are skin samples collected?
Skin samples are gently scraped from the outer edge of a surface lesion using a sterile scalpel.
138
How are hair samples collected?
Sterile forceps should be used to pluck the hair for culturing.
139
What can be used to detect infected hair using ultraviolet radiation from a mercury vapour source?
Wood's lamp
140
What are the different transport mechanisms for specimens of hair , nail and skin scrapings?
Sterile Petri dishes or screw top containers Dark , dry clean paper Swabs in a suitable transport media
141
What are examples of Direct Microscopy?
* Potassium Hydroxide (KOH) preparation * Potassium Hydroxide with calcofluor- white preparation * Gram stain
142
What is the term given to Infections that may occur within the hair shaft?
Endothrix invasion
143
What is the term given to Infections occur mainly on the outer hair shaft ?
Ectothrix
144
Why should cultures be processed quickly?
The viability of fungi decreases with time & Contaminant overgrowth may hinder the recovery of the pathogen.
145
Which culture for isolation of Fungi contains chloramphenicol and cycloheximide ?
Macrobiotic agar
146
Fill in the blanks. " Sabouraud’s Dextrose Agar-will grow most _______."
Saprophytic fungi
147
What type of fungi is isolated in a Dermatophyte Test Medium?
Dermatophytic fungi - Early recognition of Microsporum, Trichophyton and Epidermophyton generally because of a distinct color change in the medium
148
What type of Fungi Isolation test is used for yeast and moulds?
Potato Dextrose agar (PDA) Brain Heart Infusion (BHI) Agar Blood agar
149
What is the recommended temperature for Isolation of fungi?
30 degrees celsius (86°F)
150
What is the duration for which cultures should be incubated ?
Cultures should be incubated for 30 days and examined at least three times weekly before reporting as negative.
151
Identification of Positive cultures are identified by noting ?
Growth rate Colonial morphology Microscopic structures
152
What is the growth rate for fungi?
* Rapid growers (1-3 days) * Intermediate growers (5-9 days) * Slow growers (2-4 weeks)
153
What features are assed in Colonial morphology of fungi?
* Growth * Colour * Texture * Topography on both the obverse and reverse side of the medium.
154
What are normal types of descriptions of the texture of a fungi?
Cottony or woolly Velvety Granular or powdery Glabrous or waxy
155
What are the characteristics of Microscopic morphology?
* Type, size, shape and arrangement of spores (conidia) * Size and color of hyphae * Septation of hyphae
156
What are the different composition of Lactophenol cotton blue preparation?
* Lactic acid - preserves fungal structure * Phenol – kills any live organisms * Glycerol – prevents drying * Cotton blue – imparts blue colour to structures
157
What test can be used in the identification of Yeast?
Germ tube test - A small amount of the growth is placed in serum and incubated. True germ tube - No constriciton Pseudohyphae - constriction at the origin
158
Which organism gives a Positive Coagulase & Catalase result ?
Staphylococcus aureus
159
What is the Gram reaction for Staphylococcus spp.?
Gram positive cocci in clusters
160
What is the Gram reaction for Streptococcus spp.?
Gram positive cocci in chains
161
What organism is sensitive to Bacitracin?
Group A streptococcus ( Streptococcus pyogenes)
162
What organism gives a positive CAMP test?
Group B streptococcus ( Streptococcus agalactiae)
163
What organism gives a positive CAMP test?
Group D Streptococcus (Streptococcus bovis and the enterococci (Enterococcus faecalis)
164
What is the Gram reaction for Pseudomonas Aeruginosa?
Gram negative Bacillli
165
What organism gives a positive Oxidase result?
Pseudomonas aeruginoasa
166
What is the Gram reaction for Candida albicans ?
Large Gram positive ovoid bodies
167
What is the test to confirm Candida albicans?
Germ Tube - Positive
168

Endocrine System (10 decks)

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