Wednesday - clinical case 4 - Pearson

Question 1

canidida albincans

Answer 1

recent abx
wet prep - pseudohyphae
white discharge, itchiness
no vaccine
topical treatment

Question 2

thrichomonas vaginalis

Answer 2

small pear shaped w/ 4 flagella - motile
many times asymptomatic
white discharge

Question 3

Gardernella vaginalis

Answer 3

clue cell - epithelial cell COVERED in bacteria

Question 4

HPV

Answer 4

like 100 seroytpes
can lead to cancer
 tx is remove warts, but no drugs
6-11 are usually warts
16-18 are worst (malignant)
It's DNA virus but has no polymerase - needs to be in deep layers where cell division is happening. 
E1 - binds to HPV dna- helicase
E2 - helps E1 start
E6 - binds to p53 - stops DNA checkpoint --> can lead to cancer
E7 - squesters E2F via RB

Question 5

HSV-2

Answer 5

painful vesicle 
tx w/ acyclovir
tzanck smear
 - giant multinucleaded cell. 
dsDNA
linear
alphaherpese
can go latent in neurons (vzv is herp)
can lead to encephalitis
no vaccine
CD8 needed
has it's own polymerase (why acyclovir works)

Question 6

HIV

Answer 6

.

Question 7

Treponema Pallidum

Answer 7

syphillis 
inguinal lymph
painless
spirochete, G-
dark feild
VRDL or RPR test (cardiolipin)
FTA-ABS

2ndary - fever sore throat - palms and hands. they disapear after a few weeks.

tertiary - small vessels
gumma - actually painful. spinal cord. pupil

congenital syphilis - leads to miscarage. if not, nasal discharge, bone deformations, cns abnormalities

tx is penicillin

Question 8

Neisseria Gonorrhea

Answer 8

purulent discharge
G-, intracellular diplococci, ox +, only glucose oxidizer
pilli, capsule, IgA protease
thayer martin media
tx - ceftriaxone (sometime with doxy, bc chamidieye infx @ birth)
also causes septic artritis

Question 9

Chlamydia Trachomatis

Answer 9

didn’t actually talk about it.

Question 10

acyclovir

Answer 10

only used for alphaheres
used if recurrent
requires thymidine kinase
chain terminator

gancyclovir is for beta and gamma herp

Question 11

treponema sketchy pic

Answer 11

telescope, observatory

Question 12

chalmydia sketchy pic

Answer 12

pirate ship

Question 13

Neisseria sketchy pic

Answer 13

noir poster
red handcuff - g- diplo
ring = ox +
chocolate agar 
VPN = thayer martin
pili - chains
IgA = ace in hat

gonzo's bar
pillios in chairs = intracellular
no capsule - broken glass
chandallier = PID
wax = white, purulent discharge
fitz-hugh = band violin
one knee = asymetric arthritis
3axes in statue = ceftriaxone, also doxy
baby eyes covered

Question 14

HIV sketchy pic

Answer 14

.

Question 15

HSV sketchy pic

Answer 15

Hermes
DNA = blue
enveloped = tunic (also cowdry bodies - cow hide)
DS linear = road lines
rosepedals 
multimuceated cells - tank
acyclovir - recycle

Question 16

HPV sketchy pic

Answer 16

pill bugs
DNA - blue
naked = david statue
1-4 = wart
6,11 = swallowing bug - respiratory pappilomatosis
6 - anogenital - dropping bug down pants - accumualata = jar

16,18 - eating crab = cancer

Question 17

gardenella sketchy pic

Answer 17

Fish Garden
g+- = graffiti of both colors
plant overgrowth = disturbing normal flora
grayish white discharge from plants
wet mount clue cells = detective looking at missing fish
metronidazole

Question 18

Candida sketchy pic

Answer 18

.

Question 19

thrichomonas sketchy pic

Answer 19

magician 
 - cervix = strawberry
burning, itching, smell = homeless lady
green discharge = lights
motile, wet = car splashing
metronidazole

E6 - fork w/ shrim –> p53 next to crab cracker

E7 - straw - RB = root beer