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Week 6 Micro TA review > Review lectures > Flashcards

Review lectures Flashcards

1
Q

List of things that cause opportunistic infections

A

Main ones:

Candida Albicans

Aspergillus fumigatus

Cryptococcus neoformans

Mucormycosis

Pneumocystis jiroveci

Others: Pseudomonas aeruginosa, JC polyomavirus, Acinetobacter baumanni, Toxoplasma gondii, Cytomegalovirus (HHV5), HHV8 Kaposi’s sarcoma, Cryptosporidium, Paecilomyces

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2
Q

Risk Factors for opportunistic Infections

A

– Acquired defects in cell-mediated immunity

– ->HIV/AIDS

– ->Anti-rejection therapies

–—–> Solid organ transplantation

–—–> Bone marrow transplantation

-–> Corticosteroids

– Neutropenia

–>Cancer patients following cytotoxic chemotherapy

–>Greatest risk in hematologic malignancies

– Inherited immunodeficiency disorders

–>Hyper-IgE syndrome

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3
Q

Candida Albicans as an opportunistic infection morphology

A

Germ Tubes, budding yeasts, pseudohyphae

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4
Q

Candida albicans opportunistic infection clinical manifestation

A

Thrush in immunocompromised (neonates, steroids, diabetes, AIDS),

vulvovaginitis (high pH, diabetes, use of antibiotics),

disseminated candidiasis (to any organ),

chronic mucocutaneous candidiasis.

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5
Q

Candida Albicans opportunistic infections treatment

A

Fluconazole

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6
Q

Aspergillus Fumigatus morphology opportunistic infection

A

45 angle branching septae

rare fruiting bodies

Mold with septate hyphae that branch at acute angles (. Not dimorphic.

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7
Q

Aspergillus Fumigatus clinical presentation immunocompromised infection

A

Ear fungus, lung cavity aspergilloma (“fungus ball”), invasive aspergillosis.

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8
Q

Cryptococcus Neoformans morphology

A

Heavily encapsulated yeast. Not dimorphic.

Narrow based unequal budding

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9
Q

Cryptococcus Neoformans clinical presentations in immunocompromised people

A

Cryptococcal meningitis, cryptococcosis.

Found in soil, pigeon droppings. Culture on Sabouraud’s agar. Stains with India ink. Latex agglutination for polysaccharide capsular antigen is more specific.

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10
Q

Cryptococcus Neoformans diagnosis

A

Culture on Sabouraud’s agar. Stains with India ink. Latex agglutination for polysaccharide capsular antigen is more specific.

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11
Q

Treat cryptococcal meningitis caused by cryptococcus neoformans

A

DOC is amphotericin B and flucytosine

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12
Q

Mucormycosis morphology

A

Mold with irregular nonseptate hyphae branching at wide angles (≥ 90°).

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13
Q

Clinical presentation of mucormycosis

A

Disease mostly in ketoacidotic diabetic and leukemic patients. Proliferates in blood vessels and enters brain. Rhinocerebral, brain abscesses. Headache, facial pain, potential CN involvement.

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14
Q

Pneumocystis jiroveci morphology

A

Yeast (originally classified as protozoan).

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15
Q

Pneumocystis jiroveci diagnosis

A

Silver stain of lung tissue shows sphorozites inside cysts.

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16
Q

Pneumocystis Jiroveci clinical presentation

A

Causes pneumonia (PCP). Most infections asymptomatic.

Immunosuppression (e.g. AIDS) predisposes to disease.

17
Q

Pneumocystis Jiroveci treatment

A

Treat with TMP-SMX, pentamidine. Start prophylaxis when CD4 drops below 200 cells/mL in HIV patients.

18
Q

Opportunistic infections with aids T cell counts

A

PCP

Toxoplasma, esophageal candidiasis, cryptococcal meningitis

CMV (typically retinitis), MAI complex

19
Q

List of Agents of Bioterrorism

A

Bacillus anthracis (anthrax)

Clostridium botulinum

Yersinia pestis (plague)

Francisella tularensis (tularemia)

Variola major (smallpox)

Filoviruses (Ebola, Marburg)

20
Q

Bacillus Anthrax morphology

A

Gram-positive spore-forming bacillus, facultative anaerobe

21
Q

Bacillus Anthrax virulence factors

A

Only polypeptide capsule (D-glutamate).

22
Q

Bacillus Anthrax clinical presentation

A

MCC of death: Inhalational anthrax –> two stages, inhalation of spores; flu-like sx rapidly progressing fever, pulmonary hemorrhage, mediastinitis, and shock

**Need to distinguish from pneumonia on clinical presentation!**

MCC of natural infection: Cutaneous anthrax –> results from deposition of organism onto non-intact skin; painless lesions, black eschar –> can progress to bacteremia and death

GI anthrax: results from ingestion of spores

23
Q

Bacillus Anthrax epidemiology

A

Spores (inhaled, through broken skin, ingested), NO P2P. Wool-sorter’s disease. Patients in contact with animal skins from Africa.

24
Q

Bacillus Anthrax treatment

A

Prompt antibiotic treatment (within 24 hrs)- PCN or Cipro or 90% mortality (in PNA)

Military personnel vaccinated

25
Q

Yersenia Pestis Morphology

A

Gram negative rods; catalase (+), lactose (-), oxidase (-), safety pin appearance on peripheral blood smear

26
Q

Yersenia Pestis clinical presentation

A

Plague: Bubonic (from flea or animal bite –> lymphadenopathy), Pneumonic (secondary to bubonic, septicemic or person to person), septicemic, meningitis, pharyngeal; 2-6 day incubation period

Pneumonic most likely in attack (P2P): fever, cough, dyspnea, bloody sputum

27
Q

Yersenia pestis epidemiology

A

Resp droplets, flea bites, animal reservoirs (avoid animal tissue). Rats, prairie dogs

28
Q

Yersenia Pestis treatment

A

Prompt antibiotic treatment within 24 hrs or 90% mortality (in pneumonia)

29
Q

Variola Smallpox morphology

A

DNA virus; Orthopoxvirus family, Pox in Box

30
Q

Infectious properties smallpox

A

Small inoculum; Aerosol spread

31
Q

Clinical presentation of smallpox

A

Oral or respiratory mucosa –> Lymph Nodes –> asymp viremia to lymph organs (day 3 or 4) –> 2nd viremia (day 8) –> fever, malaise, delirium; 15-40% mortality

32
Q

Smallpox diagnosis

A

Not chicken pox; all pustules are at the same stage

33
Q

Smallpox epidemiology

A

Eradicated; 1 case is EMERGENCY –> disease eradicated in 1977

Not contagious until onset of rash (face/arms first)

34
Q

treatment of smallpox

A
  • Vaccine (vaccinia/cowpox) no longer given (can vaccinate up to 4 days post-exposure)
  • Supportive care
35
Q

TORCHES infections

A

Toxoplasma

Others: VZV, Parvovirus, HIV, HBV, HCV, and Bacterial sepsis (GBS, Listeria, E.coli)

Rubella

Cytomegalovirus

Herpes simplex

Enterovirus

Syphilis

Week 6 Micro TA review (3 decks)

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