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Endocrine System > Microbiology > Flashcards

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
Q

Which type of dermatophyte is the most widely spread dermatophyte that infects humans?

A

Trichophyton rubrum

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26
Q

What is the anatomical location of Tinea corporis (Tinea circinata) ?

A

Ringworm of body, trunk, face, neck , limbs

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27
Q

What is another name for Tinea pedis?

A

Athletes foot

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28
Q

What is the main cause of Onychomycosis?

A

Tinea unguium

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29
Q

What is the anatomical location of Tinea cruris ( Tinea inguinalis )?

A

Ringworm of groin, perineal/perianal areas

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30
Q

What is another name for Tinea inguinalis?

A

Jock’s itch

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31
Q

What is the other name for Barber’s itch ?

A

Tinea barbae - ringworm of bear, moustache

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32
Q

What are the causative agents for Tinea unguium?

A

Trichophyton & Epidermophyton species of Dermatophytes.

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33
Q

What are examples of Non- dermatophyte moulds that can cause onychomycosis?

A

Acremonium , Aspergillus, Scopulariopsis, Fusarium

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34
Q

What are the causative agents for Onychomycosis?

A

Dermatophytes ( 80- 90%)
Non-dermatophytes
Yeast ex Candida spp

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35
Q

What is the most common pattern of Onychomycosis?

A

Distal & Lateral Subungual Onychomycosis ( DSO/ DLSO) - invasion to distal part of nail

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36
Q

Which pattern of Onychomycosis occurs when there is invasion of the fungus into the nail plate superficial layer?

A

Superficial White Onychomycoses (SWO/SO)

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37
Q

Describe the Proximal and subungual onychomycosis (PSO ) pattern of Onychomycosis?

A

This occurs when the fungus invades the surface under the proximal folds of the nail and the infection progresses distally.

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38
Q

Which pattern of Onychomycosis is the end-stage of Onychomycosis which can be due to incomplete treatment to any other subtypes of the disease?

A

Total dystrophic onychomycosis (TDO)

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39
Q

What is the most common type of Tinea Pedis?

A

Interdigital

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40
Q

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?

A

Vesicular ( Vesiculubullous)

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41
Q

What is the clinical presentation with Interdigital Tinea pedis?

A

Patients present with macerated skin, with or without erythema and fissures , in the INTERDIGITAL space between the 4th and 5th toes.

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42
Q

What clinical presentation is an exacerbation of Interdigital Tinea pedis?

A

Acute ulcerative

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43
Q

What is the second most common type of Tinea pedis - it also presents with dry, hyperkeratotic scales and fissures?

A

Moccasin ( Hyperkeratotic)

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44
Q

What are three types of Hair Invasion?

A

Endothrix
Ectothrix
Favic

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45
Q

In which type of Hair invasion is the cuticle of the hair destroyed?

A

Ectothrix

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46
Q

What are the different types of Endothrix?

A

T. violaceum
T. Tonsurans
T.soundanense

V for violaceum V- for Vigilance - Vigilance Teach ENDOcrine ( Endothrix)

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47
Q

What are the different types of Ectothrix?

A

M. canis
M. Ferrugineuum
M. Audouinii
T. Mentagrophytes

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48
Q

What microorganism gives an example Favic hair invasion?

A

Trichophyton schoenleinii

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49
Q

What are the types of Tinea capitis?

A

Non-Inflammatory
Inflammatory

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50
Q

What are the examples of Non-inflammatory Tinea capitis?

A

Grey patch
Diffuse scale
Black dot

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51
Q

What are the examples of Inflammatory Tinea capitis?

A

Diffuse pustular
Kerion (Celsi)
Favus ( Tinea Favosa)

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52
Q

What are the causative agents of Candidiasis?

A

C.Albicans
C. auris
C. tropicalis
C. Parapsilosis
C. Glabrata

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53
Q

Erosio interdigitalis blastomycetica (EIB) occurs between which fingers?

A

Third and Fourth fingers

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54
Q

Toe web candidiasis occurs commonly where?

A

In the fourth interdigital space of the toes.

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55
Q

What is the most common type of Candida Onychomycosis?

A

Candida paronychia, whitlow

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56
Q

Which classification of candida onychomycosis involves separation of the nail plate from the nail bed?

A

Candida oncholysis

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57
Q

What is the most severe type of Candida onychomycoses?

A

Candida granuloma

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58
Q

Which type of Candida onychomycosis displays brittle nails and a digit deformity resembling a chicken drumstick ( Pseudoclubbing)?

A

Candida granuloma

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59
Q

What is the treatment for nail onychomycosis?

A

Terbinafine

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60
Q

What is the mechanism of Terbinafine?

A

Inhibits the fungal enzyme squalene epoxidase

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61
Q

What is Impetigo?

A

Impetigo is an initially vesicular, later crusted superficial infection of the skin.

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62
Q

What is the main microorganism causing Impetigo?

A

Staphylococcus aureus (dominant )
Group A strep

Staph & Strep A impetigo

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63
Q

The appearance of Honey coloured crusts are associated with?

A

Impetigo

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64
Q

What are examples of non-bullous eruption of Impetigo?

A

Chicken pox
Herpes
Folliculitis
Erysipelas
Insect btes
SCabies
Ezcematous dermatitis
Scabies
Tinea corporis

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65
Q

What are examples of bullous eruption of Impetigo?

A

Burns
Pephigus vulgaris
Bullous pemphigoid
Steven-Johnson syndrome

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66
Q

What is the first line treatment for Chicken pox?

A

Mupirocin ( bactroban) - topical ointment 7-10 days

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67
Q

What is the treatment for Chicken pox for patients who are allergic to Penicillin?

A

Cephalexin

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68
Q

What is the next in line treatment for patients who DO NOT respond to Mupirocin after 3-5 days?

A

Augmentin
Cefaclor
Cephalexin

69
Q

What is Ecthyma?

A

These are lesion which are similar to impetigo but penetrate through the epidermis

70
Q

What are the causative agents for Ecthyma?

A

Group A streptococci- De novo or Secondarily
Staphylococcus Aureus
Pseudomonas aeruginosa bacteremias

71
Q

What is the treatment for Ecthyma?

A

Topical mupirocin
Oral antistaphylococal plus antistreptococall agent (AMPICLOX)

72
Q

What is Folliculitis?

A

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
Q

What are the microorganisms associated with Folliculitis?

A

Staphylococcus aureus
Pseudomonas aeruginosa

“SPF ( folliculitis) are us “

74
Q

Which causative agent can give “ Hot tub folliculitis”

A

Pseudomonas aeruginosa

75
Q

What is the treatment for Folliculitis without infection?

A

Cleanse with antibacterial soap
Moist heat for 2-3 times a day

76
Q

What is the treatment for Folliculitis with a suspected inflammation of unknown aetiology?

A

Mupirocin 2%

77
Q

What is the treatment for Folliculitis with suspected infection from S. Aureus?

A

Cloxacillin

78
Q

What is the treatment for Folliculitis with suspected infection from Pseudomonas aeruginosa ?

A

Ciproflaxin
Ofloxacin

79
Q

What is a Furnucle?

A

A furuncle is a deep inflammatory nodule usually developing from a preceding folliculitis.

80
Q

What is a Carbuncle?

A

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
Q

What is the suggested workup for Furnucles/Carbuncles?

A

Physical examination
Collect exudate for gram stain and culture
Blood culture if septic

82
Q

Which one is normal associated with Fever and Malaise, Furnucles or Carbuncles?

A

Carbuncles

83
Q

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?

A

Erythromycin

84
Q

What is Cellulitis?

A

Cellulitis is a superficial, spreading, warm erythematous inflammation of the skin and subcutaneous tissues.

85
Q

What are the microorganisms associated with Cellulitis?

A
  • Invasive Group A Streptococcus
  • Staphylococcus aureus
    various other organisms including:
  • Group B Streptococcus
    *Haemophilus influenzae
  • Pseudomonas aeruginosa

PHABS

86
Q

What are the clinical features of Cellulitis caused by Invasive Group A Streptococcus?

A

Immature granulocytes, Lymphopenia
Hypoalbuminemia and hypocalcemia

87
Q

What are the clinical features of Cellulitis caused by Pseudomonas aeruginosa?

A

Vesicles and bullae
Etchyma grangrenosum
Gangrenous cellulitis
Macular or Maculopapular lesions

88
Q

What are the symptoms of Cellulitis?

A

Local tenderness
Pain
Swelling
Erythema
Fever
Chills
Itching ( Facial cellulitis)
FOUL- SMELLING discharge from site

89
Q

What is Erysipelas ?

A

Erysipelas is a type of cellulitis which is characterized by an abrupt onset of fiery, red-swelling of the face or extremities.

90
Q

What is the aetiology for Erysipelas?

A

Mainly Group A Streptococcus
Occasionally Staphylococcus aureus

91
Q

What is the Paronychia?

A

Inflammation involving the folds of tissue around the fingernail

92
Q

What is the aetiology of Paronychia?

A
  • Staphylococcus aureus
  • Group A Streptococcus
  • Candida sp.
  • Pseudomonas aeruginosa
93
Q

What is Decubitus ulcers ?

A

Decubitus ulcers are cutaneous ulcerations caused by prolonged pressure that result in ischemic necrosis of the skin surface and underlying soft tissues.

94
Q

What is the aetiology for Decubitus ulcers?

A

Coliform bacteria
Pseudomonas aeruginosa Peptostreptococcus
Enterococcus sp.
Bacteroides sp.
Clostridium perfringens

95
Q

Pain in Decubitus ulcers is chatecorized by what stage?

A

1 or 2

96
Q

If a Decubitus ulcers is in the stages 3 or 4 it is referred to as?

A

Pain free

97
Q

What specimens should be collected for testing for Subcutaneous mycoses?

A

Pus from the lesions
Swab
Blood culture

98
Q

What is the preferred transport medium for specimens from subcutaneous mycoses?

A

Stuart’s transport media

99
Q

What are the different aspects of Processing of specimen?

A

Direct Microscopy
Culture
Antimicrobial susceptibility testing

100
Q

How is Direct Microscopy done?

A

A gram stain is done on the specimen and examined under a light microscope

101
Q

What are subcutaneous mycoses?

A

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
Q

What are the types pf Subcutaneous Mycoses?

A

Chromomycosis/ Chromoblastomycosis
Phaeohyphomycosis
Sporotrichosis
Maduromycosis (mycetoma)

103
Q

Where are Mycetema most commonly populated?

A

Tropical & subtropical countries of Asia , Africa , Central America.

104
Q

What are the typical routes of entry for fungus ?

A

Splinters, Thorns or other sharp objects

105
Q

What are the examples of Sporotrichosis (SPT)?

A

Schenck’s disease
Beurmann’s disease
Rose Gardener’s disease
Peat moss disease

106
Q

What is the aetiology of Sporotrichosis (SPT)?

A

Sporothrix Schenckii
Sporothrix globosa
Sporothrix brasiliensis
Sporothrix mexicana

107
Q

What are specific countries with a high incidence of Sporotrichosis (SPT)?

A

Peru
Brazil
Mexico

108
Q

What is the natural habitat for Sporotrichosis (SPT)?

A

Soil , Decaying vegetation , Dead wood , Sphagnum moss, Cornstalks , Hay

109
Q

What are occupations that can increase the risk of exposure of Sporotrichosis (SPT)?

A

Farming, Gardening, Flower vending, Handling hay , Animal husbandry , Armadillo hunting , Mining

110
Q

What animals are a risk of transmitting Sporotrichosis (SPT)?

A

Bites from mice, Armadillios , Squirrels, cats & dogs

111
Q

Which microorganism that causes Sporotrichosis (SPT) can be transmitted through the bites of cats?

A

Sporothrix brasiliensis

Cat had my bra

112
Q

What is the Average Incubation period for Sporotrichosis (SPT)?

A

3 weeks - can occur between 1-10 weeks tho

113
Q

What are the clinical forms of Sporotrichosis (SPT)?

A

Cutaneous and Extra Cutaneous

114
Q

What are the variants of Cutaneous Sporotrichosis (SPT)?

A
  • Lymphocutaneous sporotrichosis ( 70-75%)
  • Fixed cutaneous sporotrichosis (20%)
  • Cutaneous disseminated sporotrichosis)
115
Q

What are the forms of Extra - cutaneous Sporotrichosis (SPT)?

A

Osteorarticular sporotrichosis
Pulmonary sporotrichosis
Meningeal sporotrichosis
Disseminated sporotrichosis

116
Q

Which variant of Cutaneous Sporotrichosis (SPT) is associated with sporotrichoid chancre?

A

Fixed cutaneous sporotrichosis

117
Q

What is the treatment for Sporotrichosis?

A

*Saturated solution of potassium iodide (KI) – drug of choice

  • Oral Ketoconazole or Itraconazole
118
Q

What s the culture used for Sporotrichosis schenckii?

A

Sabouraud’s dextrose agar

119
Q

How is the laboratory diagnosis done for Sporotrichosis ?

A
  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
Q

What specimens should be collected from a patient with suspected Sporotrichosis ?

A
  • pus, exudate & aspirate from nodules.
  • curettage or swabs from open lesion
121
Q

What is Chromoblastomycosis?

A

This is a chronic , granulomatous infection typically confined to the skin and subcutaneous tissues of the feet and legs.

122
Q

What is the aetiology of Chromoblastomycosis?

A

Fonsecaea compacta
Cladosporum carrionii
Phialophora verrucosa

123
Q

What is the habitat for Chromoblastomycosis?

A

Soil , Plant and rotten wood

123
Q

Which type of Subcutaneous mycoses can develop into Elephantits?

A

Chromoblastomycosis (Verrucous dermatitis)

124
Q

What method is used for the diagnosis for Chromoblastomycosis ?

A

Direct Microscopy - Material from lesion is placed in a drop of KOH and examined for fungal elements.

125
Q

What is the appearance of Chromoblastomycosis on ?

A

Rough cauliflower like lesions

Copper pennise ( Medlar or Sclerotic bodies - Muriform cells) these appear as’ black dots’ on appearance

126
Q

What is the most common lesion seen in Chromoblastomycosis ??

A

Verrucous - warty- like lesions

127
Q

What is the treatment for Chromoblastomycosis ?

A
  • Thiabendazole -,Flucytosine (commonly used drugs)
  • Cryotherapy, Thermotherapy, Laser therapy,Chemotherapy and Surgery.
128
Q

What are the different types of Mycetoma?

A
  • Actinomycetoma (caused by bacteria)
  • Botryomycetoma (caused by bacteria)
  • Eumycetoma (fungal)
129
Q

What is the habitat for Mycetoma?

A

Plant , Soil, animal, rotten wood, acacia tree, cactus thorns

130
Q

What is the aetiology of Actinomycetoma?

A

Actinomyadura
Nocardia brasiliensis
Nocardiopsis
Streptomycoses
- ANNS

131
Q

What is the aetiology of Botryomycetoma?

A

Psedomonas aeruginosa
E. coli
Proteus mirabilis
Staphylococcus spp ( most common )
Streptococcus app

“B PEPS”

132
Q

What is the aetiology of Eumycetoma ?

A

Madurella mycetomatis
Scedosporiun boydii
Trematosphaeria grisea
Pseudallescheria boydii,

133
Q

What is the classical triad associated with Mycetoma?

A

Painless wood hard swelling
Discharging sinuses
Grains ( Sclerotia )

134
Q

True or False? Specimens with suspected dermatomycoses should be refrigerated.

A

FALSE!! They SHOULD NOT be refrigerated.

135
Q

What is the best nail specimen?

A

The crumbly material of the nail bed.

136
Q

How should nail specimens be submitted?

A

Scrapings
Cuttings
Occasionally the complete nail

137
Q

How are skin samples collected?

A

Skin samples are gently scraped from the outer edge of a surface lesion using a sterile scalpel.

138
Q

How are hair samples collected?

A

Sterile forceps should be used to pluck the hair for culturing.

139
Q

What can be used to detect infected hair using ultraviolet radiation from a mercury vapour source?

A

Wood’s lamp

140
Q

What are the different transport mechanisms for specimens of hair , nail and skin scrapings?

A

Sterile Petri dishes or screw top containers
Dark , dry clean paper
Swabs in a suitable transport media

141
Q

What are examples of Direct Microscopy?

A
  • Potassium Hydroxide (KOH) preparation
  • Potassium Hydroxide with calcofluor- white preparation
  • Gram stain
142
Q

What is the term given to Infections that may occur within the hair shaft?

A

Endothrix invasion

143
Q

What is the term given to Infections occur mainly on the outer hair shaft ?

A

Ectothrix

144
Q

Why should cultures be processed quickly?

A

The viability of fungi decreases with time
& Contaminant overgrowth may hinder the recovery of the pathogen.

145
Q

Which culture for isolation of Fungi contains chloramphenicol and cycloheximide ?

A

Macrobiotic agar

146
Q

Fill in the blanks. “ Sabouraud’s Dextrose Agar-will grow most _______.”

A

Saprophytic fungi

147
Q

What type of fungi is isolated in a Dermatophyte Test Medium?

A

Dermatophytic fungi

  • Early recognition of Microsporum, Trichophyton and Epidermophyton generally because of a distinct color change in the medium
148
Q

What type of Fungi Isolation test is used for yeast and moulds?

A

Potato Dextrose agar (PDA)
Brain Heart Infusion (BHI) Agar
Blood agar

149
Q

What is the recommended temperature for Isolation of fungi?

A

30 degrees celsius (86°F)

150
Q

What is the duration for which cultures should be incubated ?

A

Cultures should be incubated for 30 days and examined at least three times weekly before reporting as negative.

151
Q

Identification of Positive cultures are identified by noting ?

A

Growth rate
Colonial morphology
Microscopic structures

152
Q

What is the growth rate for fungi?

A
  • Rapid growers (1-3 days)
  • Intermediate growers (5-9 days)
  • Slow growers (2-4 weeks)
153
Q

What features are assed in Colonial morphology of fungi?

A
  • Growth
  • Colour
  • Texture
  • Topography on both the obverse and reverse side of the medium.
154
Q

What are normal types of descriptions of the texture of a fungi?

A

Cottony or woolly
Velvety
Granular or powdery
Glabrous or waxy

155
Q

What are the characteristics of Microscopic morphology?

A
  • Type, size, shape and arrangement of spores (conidia)
  • Size and color of hyphae
  • Septation of hyphae
156
Q

What are the different composition of Lactophenol cotton blue preparation?

A
  • Lactic acid - preserves fungal structure
  • Phenol – kills any live organisms
  • Glycerol – prevents drying
  • Cotton blue – imparts blue colour to structures
157
Q

What test can be used in the identification of Yeast?

A

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
Q

Which organism gives a Positive Coagulase & Catalase result ?

A

Staphylococcus aureus

159
Q

What is the Gram reaction for Staphylococcus spp.?

A

Gram positive cocci in clusters

160
Q

What is the Gram reaction for Streptococcus spp.?

A

Gram positive cocci in chains

161
Q

What organism is sensitive to Bacitracin?

A

Group A streptococcus ( Streptococcus pyogenes)

162
Q

What organism gives a positive CAMP test?

A

Group B streptococcus ( Streptococcus agalactiae)

163
Q

What organism gives a positive CAMP test?

A

Group D Streptococcus (Streptococcus bovis and the enterococci (Enterococcus faecalis)

164
Q

What is the Gram reaction for Pseudomonas Aeruginosa?

A

Gram negative Bacillli

165
Q

What organism gives a positive Oxidase result?

A

Pseudomonas aeruginoasa

166
Q

What is the Gram reaction for Candida albicans ?

A

Large Gram positive ovoid bodies

167
Q

What is the test to confirm Candida albicans?

A

Germ Tube - Positive

168
Q
A

Endocrine System (10 decks)

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