Microbiology (X bacteria, fungi yet)

Question 1

Features of giardia (2). Tx?

Answer 1

multinucleated trophozoites in stool, fatty diarrhea

Metronidazole

Question 2

Features of entamoeba (4). Tx?

Answer 2

dysentery, liver anchovy paste abscess, colon biopsy flask-shaped ulcers, trophozoites with engulfed RBC
Metronidazole

Question 3

How to stain cryptosporidium

Answer 3

acid fast stain

Question 4

Toxoplasma gondii CNS features on MRI

Answer 4

multiple ring enchancing lesion

Question 5

Features of congenital toxoplasmosis (3)

Answer 5

chorioretinitis, hydrocephalus, intracranial calcification

Question 6

Transmission of toxoplasma? Tx? Confirmatory test?

Answer 6

cyst in meat (most common), cat feces
sulfadiazine+pyrimethamine
Tachyzoite on biopsy (crescent shaped)

Question 7

Transmission of naegleria? Confirmatory test?

Answer 7

swimming in warm fresh water. enter via cribiform plate.

Amoebas in CSF

Question 8

Sx of trypanosoma brucei? Transmission? Confirmatory test?

Answer 8

Sleepiness, coma.
Tse tse fly (painful bite)
trypanomastigote in blood smear (eel-like)

Question 9

Treatment for trypanosoma brucei

Answer 9

Oya-sur-mel
suramin for blood borne
melarsoprol for CNS

Question 10

which subtype malaria cause cerebral malaria

Answer 10

P falciparum

Question 11

Fever cycle of each type of malaria subtype

Answer 11

vivax, ovale (2-day cycle)
falciparum (irregular)
malariae (3-day cycle)

Question 12

Unique features of F vivax/ovale

Answer 12

Schuffner stippling (red granules) in RBC

Question 13

Feature of Babesia. (2) transmission?

Answer 13

hemolytic anemia. “Maltese cross” + ring form.

Ixodes tick transmission

Question 14

What does tyrpanosoma cruzi cause? Sx? Transmission? Tx?

Answer 14

BIG and rich with BENZ and wearing FUR, KISSing ladies
Chagas disease
Dilated cardiomyop, big esophagus, big colon, big face (periorbiral swelling),
Transmission with kissing bug (reduviid bug)
Treat with benznidazole, nifurtimox

Question 15

Leishmania subtype? Difference in sx? Transmission? Confirmatory finding?

Answer 15

Visceral/cutaneous
Visceral: fever, pancytopenia, causing hepatosplenomegaly
Cutaneous: skin ulcer
Sandfly transmission
Findings: Macrophages containing amstigotes

Question 16

Trichomanas vaginalis features on vagina (3). Treatment?

Answer 16

Greenish discharge, strawberry cervix, ph >4.5

Metronidazole

Question 17

Nematodes routes of transmission

1. Ingested?
2. Cutaneous?
3. Bites?

Answer 17

1. EATTT: enterobius, ascaris, toxocara, trichinella, trichuris
2. got in in the SANd: strongyloides, ancylostoma, necator
3. lay LOW to avoid getting bitten: Loa loa, Onchocerca, Wuchereria bancrofti

Question 18

Features of entrobius vermicularis. (2) Transmission?

Answer 18

anal pruritus, seeing egg via tape test. EATTT

Question 19

Features of ascaris lumbricoides (4). Transmission?

Answer 19

ileocecal valve obstruction, biliary obstruction, Loeffler syndrome. Knobby coated oval eggs in feces.
EATTT

Question 20

Features of strongyloides. (4) Transmission?

Answer 20

GI, pulmonary, cutaneous inflammation. Hyperinfection

SANd

Question 21

Features of ancylostoma, necator. Transmission?

Answer 21

microcytic anemia (suck intestinal wall), cutaneous larva migrans (serpiginous rash).
SANd

Question 22

Features of Trichinella spiralis. (1) Transmission?

Answer 22

Cyst in striated muscles*** (myositis). EATTT

Question 23

Features of Toxocara canis. (1) Transmission?

Answer 23

Visceral larva migrans (liver, eyes, CNS, heart inflammation). EATTT

Question 24

Features of Onchocerca volvulus. (2) Transmission? Tx?

Answer 24

black skin nodules, black sight (river blidness), LOW transmission with black fly).
Ivermectin

Question 25

Features of Loa Loa. (2) Transmission?

Answer 25

skin swelling, worm in conjunctiva. LOW transmission with deer fly, horse fly, mango fly. Treat with diethylcarbamazine

Question 26

Features of Wucheriaria bancrofti, Brugia malayi. (1) Transmission?

Answer 26

Lymphatic fillariasis

LOW transmission with mosquito. Treat with diethylcarbamazine

Question 27

Features of Taenia solium. (2) Transmission? Tx?

Answer 27

Intestinal tapeworm (larvae ingestion), neurocysticerosis (eggs ingestion).

Praziquantel. Neurocysticerosis (albendazole)

Question 28

Features of Diphyllobothrium latum.(1) Transmission?

Answer 28

Vitamin B12 deficiency, megaloblastic anemia.

Eat raw fish

Question 29

Features of Echinococcus granulosus.(2) Transmission? Tx?

Answer 29

Hydatid cyst with eggshell calcification in liver.
Cyst rupture cause anaphylaxis
Food contaminated with dog feces( echinoco-gou3-cus)
Albendazole

Question 30

Treatment principle of all endoparasites?

Answer 30

Nematodes (except LOW): all albendazole

Cestodes and trematodes (except echinococcus and neurocysticerosis): all praziquantel

Question 31

Features of schistosoma. Subtype? Difference? (2) Transmission?

Answer 31

S Mansoni (egg with lateral spine, lead to portal hypertension)
S Mansoni (egg with rounded spine, lead to portal hypertension) 
S haematobium (egg with terminal spine, lead to SCC of bladder and pulmonary HPT)
Penetrate skin through snails in contaminated fresh water

Question 32

Features of clonorchis sinensis. (2) Transmission?

Answer 32

cholangitis (pigmented gallstone), assoc with cholangiocarcinoma.
Eat undercooked fish

Question 33

Sarcoptes infection causes what disease? Tx?

Answer 33

Scabies.

Permethrin cream, oral ivermectin

Question 34

Pediculus/Phthirus transmits which bacteria via which organism? Tx? (4)

Answer 34

Blood sucking lice.
Transmits Rickettsia, Borrelia, Bartonella
Tx: Pyrethroids, malathion, ivermectin, nit combing

Question 35

Leishmania subtypes and features? vector?

Answer 35

Kala-azar, cutaneous
Features of kala azar: grey discoloration of skin of hands, hepatosplenomegaly, pancytopenia, fever
Features of cutaneous leishmaniasis: skin ulcers
Vector: sandfly