Skin IV

Question 1

describe the classification of Mycobacterium species

Answer 1

Question 2

cutaneous TB can be caused by ____ which can lead to ___ and ____

Answer 2

cutaneous TB can be caused by Mycobacterium tuberculosis which can cause tuberculosis verrucosa and lupus vulgaris

Question 3

in mycobacterium avium-intracellulare complex, the bacteria survive inside ____ and cause _____

Answer 3

in mycobacterium avium - intracellulare complex, the bacteria survive inside macrophages and cause lymphadenitis

Question 4

Mycobacterium kansasii causes chronic infection of ____ and causes fever, swollen ____ and lung ____ and ____

Answer 4

Mycobacterium kansasii causes chronic infection of the lungs and causes fever, swollen lymph nodes and lung crackles and wheezing

Question 5

Mycobacterium marinum causes ____ granulomas and single ___ or ____ where a cut was that breaks down to form a crusty sore or abscess

Answer 5

Mycobacterium marinum causes fish tank granulomas and single lump or pustule where a cut was that breaks down to form a crusty sore or abscess

Question 6

the optimal growth of Mycobacterium marinum occurs at ____ and the bacteria rarely causes ____

Answer 6

the optimal growth of Mycobacterium marinum occurs at low temperatures and the bacteria rarely causes lung disease

Question 7

Mycobacterium ulcerans causes ____ and is commonly found in ____

Answer 7

Mycobacterium ulcerans causes Buruli ulcer and is commonly found in Central and West Africa around areas of lush vegetation and swamps

Question 8

Mycobacterium ulcerans initially causes a ____ and after 1-2 months the ____ breaks down to form a ____

Answer 8

Mycobacterium ulcerans initially causes a nodule and after 1-2 months the nodule breaks down to form a shallow ulcer (Buruli ulcer)

Question 9

Mycobacterium chelonae causes ____ wounds, ____ nodules or abscess and is a ___ grower on medium

Answer 9

Mycobacterium chelonae causes non-healing wounds, subcutaneous nodules or abscess and is a rapid grower on medium

Question 10

M. chenloae are increasing in patients with ____

Answer 10

M. chenloae are increasing in patients with cystic fibrosis

Question 11

name the 2 Mycobacterium species that are considered rapid growers

Answer 11

• M. chenolae
• M. fortuitum

Question 12

M. fortuitum often infects ____ and ____

Answer 12

M. fortuitum often infects wounds and surgical-site infections

Question 13

M. fortuitum can cause local ____ disease, ____, ____ infections, and ____ disease

Answer 13

M. fortuitum can cause local cutaneous disease, osteomyelitis, joint infections, and ocular disease

Question 14

Mycobacterium spp. are stained with ___ on ____ medium

Answer 14

Mycobacterium spp. are stained with Ziehl Neelson on Lowenstein-Jensen medium

Question 15

list the stages of Ziehl Neelson staining

Answer 15

Question 16

Mycobacterium leprae is a ____-growing organism that multiples in ____ and ____

Answer 16

Mycobacterium leprae is a slow-growing organism that multiples in macrophages and Schwann cells

Question 17

describe the clinical presentation of leprosy

Answer 17

anesthesia of skin lesions

peripheral nerve thickening and tenderness

change of pigmentation

Question 18

in tuberculoid leprosy, there is ____ with ____ borders or a large ____-pigmented ____ which is asymmetrical

Answer 18

in tuberculoid leprosy, there is a large single red patch with well-defined borders or a large hypo-pigmented macula which is asymmetrical

Question 19

in lepromatous leprosy, there are many ____ with extensive ____

Answer 19

in lepromatous leprosy, there are many erythematous macula, papules or nodules with extensive disfiguring skin lesions

Question 20

in tuberculoid leprosy (aka ____), there is a strong ____-mediated immunity, ____ in tissues with few bacilli and ____ infectivity

Answer 20

in tuberculoid leprosy (aka Paucibacillary Hansen disease), there is a strong cell-mediated immunity (TH1),granulomain tissues with few bacilli andlow infectivity

Question 21

in lepromatous leprosy (aka ____), there is a strong ____-mediated immunity, abundant ___ in skin and peripheral nerves and is _____

Answer 21

in lepromatous leprosy (aka Multibacillary Hansen disease), there is a strong humoral-mediated immunity, abundant bacilli in skin and peripheral nerves and is infectious

Question 22

transmission of leprosy is via ____ or ____

Answer 22

transmission of leprosy is via inhalation of infectious aerosols or skin contact with resp. secretions and wound exudates

Question 23

leprosy is endemic in ____ (animal)

Answer 23

leprosy is endemic in armadillos

Question 24

M. leprae cannot grow in ____

Answer 24

M. leprae cannot grow in cell-free cultures

Question 25

list the 3 characteristics of chronic disease caused by Actinomycosis

Answer 25

* abscess formation * tissue fibrosis * draining sinus

Question 26

describe the characteristics of Actinomyces

Answer 26

Question 27

in Actinomycosis, the sinus tracts discharge purulent material containing \_\_\_\_

Answer 27

in Actinomycosis, the sinus tracts discharge purulent material containing **sulfur granules**

Question 28

list the risk factors for Actinomycosis

Answer 28

* dental procedures * poor dental hygiene * usse of IUDs

Question 29

in about 50% of cases, the initial lesion in Actinomycosis is \_\_\_\_

Answer 29

in about 50% of cases, the initial lesion in Actinomycosis is **cervicofacial ("lumpy jaw")**

Question 30

the traiditional treatment for Actinomycosis is ____ for prolonged periods of time along with ___ of diseased tissue

Answer 30

the traiditional treatment for Actinomycosis is **high-dose antibiotics** for prolonged periods of time along with **surgical removal** of diseased tissue

Question 31

death due to Rickettsia is ascribed to damage of \_\_\_, resulting in \_\_\_\_

Answer 31

death due to Rickettsia is ascribed to damage of **endothelial cells**, resulting in **leakage of plasma, decrease in blood volume and shock**

Question 32

2 stains that can be used for Rickettsia organisms are ____ and \_\_\_\_

Answer 32

2 stains that can be used for Rickettsia organisms are **Maccchiavello stain** and **Giema stain**

Question 33

in the ____ test, anti-rickettsial antibodies cross-react and agglutinate

Answer 33

in the **Weil-Felix** test, anti-rickettsial antibodies cross-react and agglutinate

Question 34

R. prowazekii is transmitted via ___ and causes acute \_\_\_\_

Answer 34

R. prowazekii is transmitted via lice and causes acute **febrile illness**

Question 35

in North America, the ____ is the reservoir for R. prowazekii

Answer 35

in North America, the **flying squirrel** is the reservoir for R. prowazekii

Question 36

contrast Ehrlichiosis and Anaplasmosis

Answer 36

Question 37

the pathogenesis of Human Monocytic Ehrlichiosis (HME) is that it blunts the ____ by suppressing production of ____ which leads to \_\_\_\_

Answer 37

the pathogenesis of Human Monocytic Ehrlichiosis (HME) is that it blunts the **immune system** by suppressing production of **TNF-a** which leads to **opportunistic infections (e.g. candidiasis)**

Question 38

Human Granulocytic Anaplasmosis (HGA) has very similar symptoms to HME, except that in HGA, ___ is very rare

Answer 38

Human Granulocytic Anaplasmosis (HGA) has very similar symptoms to HME, except that in HGA, **rash** is very rare

Question 39

\_\_\_ are the main reservoir for L. interrogans (causes leptospirosis)

Answer 39

**rats** are the main reservoir for L. interrogans (causes leptospirosis)

Question 40

describe the clinical signs of Leptospirosis

Answer 40

* sudden high fever, chills, headache, muscle aches, conjunctivitis, vomiting * skin presentation = petechial rash that lasts less than 24 hours

Question 41

in Leptospirosis, the skin presentation is ____ which lasts \_\_\_\_

Answer 41

in Leptospirosis, the skin presentation is **petechial rash** which lasts **less than 24 hours**

Question 42

70% of patients with Lyme disease develop a ____ rash (\_\_\_\_)

Answer 42

70% of patients with Lyme disease develop a **bull's eye** rash (**erythema migrans**)

Question 43

Lyme disease has a complex \_\_\_\_-year cycle

Answer 43

Lyme disease has a complex **2**-year cycle

Question 44

Lyme disease is a non-fatal, slowly progressive syndrome that mimics ___ and \_\_\_\_

Answer 44

Lyme disease is a non-fatal, slowly progressive syndrome that mimics **neuromuscular** and **rheumatoid conditions**

Question 45

if untreated, Lyme disease can progress to ___ and ____ symptoms with \_\_\_\_

Answer 45

if untreated, Lyme disease can progress to **cardiac** and **neurological** symptoms with **polyarthritis**