Microbiology--Mycology/Parisitology

Question 1

Mississipi and Ohio River valleys

Answer 1

Histoplasmosis–macrophage filled with histoplasma; bird/bat droppings

Question 2

East of mississippi river and central america

Answer 2

blastomycosis; broad based budding; granulomatous nodules

Question 3

Southwestern US, California

Answer 3

Coccidioiodmycosis–erythema nodosum, arthralgias, pneumonia, meningitis

Question 4

Latin America

Answer 4

Paracoccidioidomycosis–buddying yeast with captains wheel formation

Question 5

melanocyte damage causing hypopigmented/hyperpigmented patches; spaghetti and meatball appearance

Answer 5

Tinea versicolor (malassezia spp)–degrades lipids producing acids that cause damage

Question 6

septate hyphae that branch at 45 degree angle

Answer 6

aspergillus fumigatus–acute angles–some spp produce aflatoxins which are associated with HCC

Question 7

found in soid, pigeon droppings

Answer 7

cryptococcus neoformans–grown on Sabouraud agar, stains with india ink (halos) or mucicarmine; latex agglutination test detects polysaccharide capsular antigen is more specific

Question 8

soap bubble lesions in the brain

Answer 8

cryptococcus neoformans

Question 9

irregular, broad, nonseptate hyphae branching at wide angles

Answer 9

mucor/rhizopus–seen in ketoacidotic diabetic/leukemic patients; fungi proliferate in blood vessel walls, penetrate cribiform plate, enter brain; black necrotic eschar on fase;

Question 10

dimorphic yeast, pseudohyphae/budding yeasts at 20 C; germ tubes at 37 C

Answer 10

candida albicans

Question 11

disc shaped yeast on methenamine silver stain of lung tissue

Answer 11

pneumocystis jirovecii–prophylaxis when CD4 count drops below 200

Question 12

local pustule with ascending lymphangiitis after rose thorn prick

Answer 12

Sporothrix schenckii–dimorphic cigar shaped budding yeast that lives on vegetation

Question 13

bloating, flatulence, foul smelling fatty diarrhea (campers/hikers)

Answer 13

giardia lamblia–look for trophozoites/cysts in stool

Question 14

bloody diarrhea, liver abscess, RUQ pain

Answer 14

entamoeba histolytica–serology or stool–cysts/RBCs/nuclei in parasite

Question 15

severe diarrhea in aids patients, oocytes on acid fast stain

Answer 15

cryptosporidum

Question 16

ring enhancing brain lesion in HIV patient

Answer 16

toxoplasma gondii

Question 17

chorioretinitis, hydrocephalus, intracranial calcifications in infant

Answer 17

congenital toxoplasma infection

Question 18

rapidly fatal meningoencephalitis after swimming in freshwater lake

Answer 18

naegleria fowleri–amoeba in spinal fluid that enters via cribiform plate

Question 19

enlarged lymph nodes, recurring fever, somnolence, coma

Answer 19

Trypanosoma brucei–african sleeping sickness, tsetse fly; tx with suramin for blood borne disease or melarsoprol for CNS penetration

Question 20

fevers 48 hrs apart

Answer 20

Plasmodium vivax/ovale–dormant form in liver

Question 21

severe irregular fever patterns; brain/kidney/lung involvement

Answer 21

Plasmodium falciparum–parasitized RBCs occlude capillaries

Question 22

72 hr cycle

Answer 22

Plasmodium malariae

Question 23

fever and hemolytic anemia in Northeast US

Answer 23

babesiosis via tick; on blood smear will see ring form and maltese cross form; trx with atovaquone + azithromycin

Question 24

dilated cardiomyopathy; megacolon; megaesophagus

Answer 24

Chagas disease via trypanosoma cruzi–South America; kissing bug transmits; tx with bensnidazole or nifurtinox

Question 25

spiking fevers, hepatosplenomegaly, pancytopenia

Answer 25

Leishmaniasis: leishmania donovani via sandfly; macrophages containing amastigotes

Question 26

foul green smelling discharge from vagina; itching and burning

Answer 26

trichomonas vaginalis--cannot exist outside human; seen on wetmount, strawberry cervix; metronidazole

Question 27

intestinal infection with anal pruritus

Answer 27

enterobius vermicularis (pinworm); tx with bendazoles or pyrantel

Question 28

intestinal infection causing vomiting, diarrhea, epigastric pain

Answer 28

strongyloides stercoralis--ivermectin or albendazole

Question 29

intestinal infection causing anemia by sucking blood from inestinal walls

Answer 29

ancylostoma duodenale, necator americanus (hookworms)--bendazoles or pyrantel pamoate

Question 30

hyperpigmented skin and river blindness; black skin nodules

Answer 30

onchocerca volvulus-ivermectin; blackfly, black skin nodules, black sight

Question 31

Swelling in skin, worm in conjunctiva

Answer 31

loa loa via fly--diethylcarbamazine

Question 32

blocks lymphatic vessels causing elephantiasis

Answer 32

wuchereria bancrofti--takes 1 yr after bite to see symptoms--diethylcarbamazine

Question 33

Nematode routes of infection:

Answer 33

get sick if you EAT these: enterobius, ascaris, toxocara; get into your feed from the SANd: strongyloides, ancylostoma, necator; lay LOW to avoid bites: loa loa, onchocerca volvulus, wuchereria bancrofti

Question 34

ingestion of larvae in undercooked pork

Answer 34

taenia solum--intestinal infection--praziquantel

Question 35

ingestion of eggs in undercooked pork

Answer 35

cysticerosis, neurocysticercosis--praziquantel, albendazole for neuro

Question 36

ingestion of larvae from freshwater fish

Answer 36

diphyllobothrium latum--vitamin B12 deficiency (tapeworm competes for B12)-->anemia; praziquantel

Question 37

ingestion of eggs from dog feces

Answer 37

eichinococcus granulosus--hyatid cysts in liver that cause anaphylaxis if antigens released--albendazole

Question 38

chronic infection can lead to SCC of bladder

Answer 38

schistosoma (fluke); snails are host; praziquantel

Question 39

undercooked fish; biliary tract inflammation gallstones, cholangiocarcinoma

Answer 39

clonorchis sinensis--praziquantel

Question 40

portal hypertension

Answer 40

schistosoma mansoni/japonicum