Cumulative Flashcards
(184 cards)
1
Q
Site of multiplication of measles
A
Resp. epithelium & Lymph nodes
2
Q
Spread of measles from rep site via
A
Monocytes
3
Q
Stages of Measles Infections
A
Prodome, Rash, Resolution
4
Q
Characteristics of Prodrome of Mealses
A
1-12 days post inf.Fever3 c’sKoplik Spot’s
5
Q
Characteristics of Rash of Measles
A
Extensive rash developing 3-4 days following start of prodrome. Ears to forehead to face to neck to chest/trunk to extremities
6
Q
Characteristics of Resolution of Measles
A
Viremia ceases and inc. in AB titers. Rash disappears in same order appeared.
7
Q
Causative agent of Measles
A
Paramyxovirus-ssRNA (own RNA pol)Enveloped-F protein (spread inf.)-H protein (hemagg. for attach)
8
Q
Measles Complications (4)
A
PneumoniaCNS involv.Immunologic SuppressionDiarrhea
9
Q
Measles comp. of Pneumonia
A
Most measles deaths aged/malnurished at risk
10
Q
Measles comp. of CNS involv
A
Acute encephalitis (common)Subacute Schlerosing Panencephalitis-FATAL, rare, slow prog.
11
Q
Measles comp. of Immunologic Suppression
A
Viral induced suppression leads to complicating secondary infections
12
Q
3 C’s of Prodrome of Measles
A
CoughConjunctivitisCoryza
13
Q
Transmission of Measles
A
resp dropletshumidity and virion survival inv. related
14
Q
Communicability of Measles
A
Highly contag.prodrome - 4/5 days post initial rash eruptionshedding prolonged in vit. A. def & immunocomp.
15
Q
Immunization from Measles infection
A
Life Long Immunity from nat. infection Vaccine requires boosters
16
Q
Treatment of Measles
A
Symptomatic
17
Q
What inc. severity of measles infection?
A
Vit. A def.(Supplementation can dec. mortality up to 50%)
18
Q
Measles Vaccine Info-name, type, dosing, CI
A
MMR - live attenuated1st dose: 12-15mo (must be before start school)2nd dose: 4-6yo or >1mo after 1st**2-5% of pop NOT protected from only first dose*CI: preg, immunodef., egg sens.
19
Q
Measles outbreaks are from?
A
Non -vaccinated air travelers
20
Q
How is measles virus maintained?
A
Unbroken human transmission chain (human only virus and no “healthy” carriers)
21
Q
Measles prevention in people unable to get vaccine?
A
Immuniglobin
22
Q
Symptoms of Rubella
A
Maculopapular RashMild fever, malaise, coryza, conjuctivits, lymphadenopathy
23
Q
Causative agent of Rubella
A
Togavirus+ssRNA
24
Q
Route of transmission of Rubella
A
Resp. Droplets
25
Communicability of Rubella
5 days prior to rash and 5 days post rash-humans only resevoir
26
Population commonly infected with Rubella
Older children, teens, young adults(NOT CHILDREN, opposite of measles)
27
Diagnosis of Rubella
Serology (AB detection) & Clinical
28
TRX of Rubella
Symptomatic & Isolation for 7 days post rash
29
Prevention of Rubella
MMR Vaccine-CI: Pregnancy5-15% of children get fever, rash, lymphadenopathy 5-12 days post vaccine
30
Complications of Rubella & describe (1)
Congenital Rubella Syndrome-maternal inf to fetus-Risk to fetus (earlier in preg, more sev. risk)-CRS patients can transmit disease up to 20mo
31
Risk to fetus of CRS
Heart Defects (PDA, pul stenosis)Eye defectsCNS defectsHearing Loss
32
What is unusual about the VZV compared to all other herpesvirus's?
Most primary infections have S&S
33
Causative agent of chickenpox
Varicella-Zoster Virus-herpesvirus-dsDNA-Rep in nucleus
34
S&S of chickenpox
Assymetrical vesicular rash following dermatomal patterPruritis lesions (often inf. with bactera)
35
Stages of chickenpox
2 waves of viremia1) Rep in regional lymph node & causes viremia 4-6days post infection2) Rep in liver/spleen & cause viremia 10-14 post infection & cause rash
36
Most common childhood exanthum in US
Chickenpox
37
Communicability of chickenpox
highly contagious via resp. droplets-1-2 days before rash and 4-5 days after
38
Prodrome seen in chickenpox?
Only in older children-fever, malaise, HA
39
TRX of chickenpox
Symptomatic-no aspirin (also none for 28 days post vaccine)VariZIG-immunoglobin or high risk up to 4 days post exposure
40
Chickenpox vaccine info
Varivax - live attenuated-12-18moadults/teens get 2 injectionsCI:preg
41
Complications of varivax
Shingles (risk lower than from natural inf)Mild post infectionBreakthrough Varicella-2 doses reduces risk
42
Complications of chickenpox
GAS b hemolytic infection of lesions
43
Population most commonly with shingles
Adults
44
Cause of Shingles
Reactivation of latent VZV, must have hx of chickenpox
45
S&S of shingles
PAINFUL Rash (pain may precede rash)Unilateral and dermatomal vesicular rash that does not cross midline
46
10% of pt with shingles have ______ involv.20% of pt with shingles have ______ involv.
-ophthalmic branch of CN5-ocular nerves
47
TRX of shingles
SymptomaticVZIG no use (as prevention or trx)
48
Zostavax Vaccine
preventative, live attenuated vaccine for shingles. Decreases pain and duration of infection. High viral load, not used for children, recommend >50yo. Length of efx not known.
49
Complication of Shingles
Post theraputic neuralgia-more common in elderly
50
Human Herpes Virus 6 causes
Exanthem Subitum
51
Describe clinical appearance of HHV-6
High fever for 2-3 days of child that is followed by maculo-papular rose colored rash on the trunk and neck
52
HHV-6 Epidemiology
Common childhood viral inf.-reactivated in immunosuppressed adults and shed in saliva
53
HHV-6 Description of Virus
B-herpes virusdsDNARep. in CD4+ cellsLatent in mono & lymphocytes
54
Should you isolate a child with HHV-6?
Not worth it
55
TRX/Prevention of HHV-6
None
56
Seasonality of chickenpox
Winter-Spring
57
Parvo Virus b19 Clinical Manifestations
Prodrome followed by "slapped cheek" maculopapular rashCT manifestations-arthritis, arthralgia (adults can have just these)
58
TRX for Parvo Virus B19
IG for anemicNSAIDs for inflamm
59
Parvo Virus B19 Epi
ChildrenWinter-Spring
60
Desc. of Agent Parvo Virus B19
ssDNAno latent inf.
61
Complications of Parvo Virus B19
Anemia-attacks RBC precusorsHydrops Fetalis
62
Dermatophyte
Fungi that invade keratin of skin, hair, nails(produce keritinase)
63
tinea barbae
Beard
64
tinea capitis
head
65
tinea corporis
torso
66
tinea cruris
groin
67
tinea manus
hand
68
tinea pedis
foot
69
tinea unguium
nail
70
Culture of dermatophytes (location of sample, agar, results)
Sample taken from under nail is best-Sabouraud Agar (1-4wks)-Dermatophyte Test Medium (used for early detection, does not give species, just confirms dermatophyte present)
71
Some _______ species of dermatophytes fluoresce?
Microsporum
72
Infective Stage of Dermatophytosis
Athroconidium (micro or macro)
73
Diagnostic Stage of Dermatophytosis
Athroconidium (micro or macro)
74
Transmission of dermatophytosis
Athrospore spread via person to person contact or fomites
75
Zoophilic
Animal pathogen transmitted to people
76
Athrophophilic
Human to human transmission of fungi
77
Geophilic
Soil to human transmission of fungi
78
Tinea capitis most common in ________?
Children
79
Tinea pedis most common in ________?
Adults
80
Tinea unguium most common in ________?
Males
81
Dermatophytes most common in _______ regions of world?
Tropical & subtropical because of humidity
82
Dermatophyte Lesion (Describe)
Lesion with inflammed edge & central clearingHair lossPruritius(Dissemination possible in HIV+)
83
Risk Factors for Dermatophytosis
Immunocomp.Communal Baths (hot tubs)Athletics (wrestling, etc)Cushing Syndrome (inc. cortisol inh. immune response)
84
Dermatophytid
Hypersensitivity rxn to fungal antigens at distal sight. Common in tinea pedisResult of over treatment
85
Antifungals target?
Ergosterol in cell membrane
86
Causative Agents of Tinea Barbae
Trichophyon rubrumTrichophyon mentagrophytesTrichophyon verrucosum
87
Causative Agents of Tinea Capitis
Microsporum canisTrichophyton mentagrophytesTrichophyton tonsurans
88
Most common tinea capitis agent in USA and trx
Trichophyton tonsuransGriseofulvin
89
Causative Agents of Tinea Corporis
Microsporum canisTrichophyton rubrum (most important)Trichophyton mentagrophytes
90
Causative Agents of Tinea Cruris
Epidermophyton floccosumTrichophyton rubrum (most important)Trichophyton mentagrophytes
91
Causative Agents of Tinea Manus
Trichophyton rubrumTrichophyton mentagrophytes
92
Causative Agents of Tinea Pedis
Epidermophyton floccosumTrichophyton rubrum (most common)Trichophyton mentagrophytes
93
Most prevalent dermatophytosis
Tinea pedis - Trichophyton rubrum
94
Causative Agents of Tinea Unguium
Epidermophyton floccosumTrichophyton rubrumTrichophyton mentagrophytes
95
Subcutaneous Fungus Genera
FusariumSporothrixModurellaPseudoallescheria
96
Sporothirx schenckii (Sporotrichosis) causes
Chronic granulomas & necrosisulcerative lesions
97
Sporotrichosis DOC
Itraconazole or Amphotericin B
98
Sporothrix infects and is associated with?
lymphatics
99
Most common way to get infected with sporothrix?
stuck/punture wound while working in garden
100
Sporothrix found where?
Environmental, soil
101
Appearance of sporothrix conidia?
Daisies
102
Ticks are _______ feeders & do not ________?
Ticks are SLOW feeders and do NOT TRANSMIT DISEASE QUICKLY
103
Hypostome
Attachment structure of tick, ventral to mouth
104
Scutum
Shield like structure that covers back in male, half of back in female
105
Tick Morph & Stages
EggLarvae - 6 legsnymph, tick - 8 legs
106
Ixodes Ticks (carry)
Lyme, babesiosis
107
Dermacentor Ticks (carry)
Tularemia, RMSF, Colorado tick feverTick Paralysis
108
Amblyomma americanum Ticks (carry)
Lone Star TickTularemia, lyme, RMSFTick Paralysis
109
Rhipicephalus sanguineus Ticks (carry)
Ehrlichiosis, babesiosis in dogsRMSF, Mediterranean spotted fever
110
Tick Paralysis due to....
Dermacentor or Amblyomma americanum tick feeding for days. Paralysis linked to component in female saliva. Can die from resp. paralysis
111
Pyemotes dermatitis is _____ & causes _____?
Mitestraw & grain itch, provokes allergic response
112
Demodiciosis (causative agent, description of condition)
Demodex folliculorum (mite)Pruitic acne like dermatitis
113
Chigger Dermatitis (causative agent, description of condition, trx)
Eutrombicula (mite)-produces pruritis but does NOT burrow-humans are accidental host-TRX OTC anti-pruritics
114
Scabies (causative agent, description of condition)
Sarcoptes scabiei (mite)-female mite burrows resulting in pruritcs eruptions-pururitic eruptions stop at folds (hands, wrist, beltline, breasts, genitalia, butt, perineum)
115
Mite genera
Pyemotes (straw & grain itch)Demodex (demodiciosis)Eutrombiula (chigger dermatitis)Sarcoptes (scabies)
116
Types of Scabies (Sarcoptes scabiei)
Canine: self limiting in peopleCrusted (norwegian) - most intense & linked to HIV/immunodefPediatric - similar to crusted
117
TRX for Scabies
Ivermectin or Permethrin
118
Causative agent of lice
Pediculus humanus (head & body)Phthirus (pubic) - crabs
119
Causative agent of crabs
Pubic licePhthirus
120
Pathophysiology of crabs (phthirus)
Eggs are cemented to pubic hair and adults bite (feed) in pubic area(Egg to egg cycle : 3wks)
121
Identification stage of lice/crabs
Nits (egg cemented to hair) or seeing lice
122
Pahtophysiology of lice (Pediculus)
Eggs are cemented to hair and adults bite (feed) Bloodsuckers are vector for typhus (head lice only)
123
TRX of lice
permethrinpediculicides
124
Cause of trichinellosis infection?
Eat raw/undercooked meat -esp. pork
125
What is special about trichinella larvae and worms?
develop in same host
126
Life Cycle of Trichinella
Ingest larvae & released into SIEnter mucosa & mature in 48 hrs to wormWorm lives 4-6wks & females release larvaeLarvae enter circulation & migrate to ACTIVE skeletal muscleLarvae in muscle viable for mo - yrs
127
Clinical Manifestations of Intestinal Phase of Trichinellosis
N/V/D, abd painBegin 1-2days post infection & abate 2-5wks later
128
Clinical Manifestations of Systemic Phase of Trichinellosis
Myalgia, facial swelling, eosinophilia, subungal splinter hemorrhages, constitutionalBegin within 2wks post inf & last >8wks
129
Complication of heavy infection of Trichinellosis
Life threatening heart, CNS, lung, kidney damage
130
Humans are what type of host in Larva Migrans?
Accidental!
131
Presumed Diagnosis of Trichinellosis
Periorbital Edema, Eosinophila, Hx of eating raw/undercooked meat
132
Larva migrans infection?
Accidental ingestion of egg or larvae, larvae migrate through tissues, but do not mature into adult worm. Immune response of host contributes to pathology
133
Causative Agents of Visceral Larva Migrans
Toxocara canis (d0g)Toxocara cati (cat)
134
Visceral Larva Migrans most commonly infects?
Children who play in soil contaminated with dog or cat feces
135
S&S of VLM are result of?
Migrating larvae and host eosinophilic granulomatous response
136
TRX of Trichinellosis
Albendazole or Melbendazole
137
TRX of Larva Migrans
Albendazle or Melbendazole
138
Causative agents of Cutaneous Larva Migrans
Ancylostoma braziliense Ancylostoma caninum
139
S&S of CLM
Intially: pruritic red papules at penetration sites2/3days later: pruritic, elevated, serpiginous, red-brown lesionsUsually resolve in 2-8wks
140
Normal Flora of Skin (3)
E. coli (-)Mycococcus luteus (+)Staphylococcus epidermis (+)
141
Skin Diseases in Epidermis
FolliciiulitisImpetigoAcneSSSS-TSS
142
Skin Diseases in Dermis
CarbunclesFurunclesEcthyma
143
Skin Diseases in Sub Q Tissue
CarbunclesFurunclesCellulitisErysipelasNecrotizing Fasciitis
144
Skin Diseases in Muscle
Myonecrosis
145
Causative agent of acne vulgaris (gram, shape, O2 req.)
Propionibacterium acnes(+)pleomorphicNFAreotolerant
146
Causative agent of folliculitis & type each causes
S. aureus (folliculitis barbae, Sty)P. aeruginosa (systemic - hot tub)
147
Proteins/Virulence Factors of S. aureus (5)
HemolysinCoagulaseLeukocidinProtein AMSCRAMMs (fibronectin binding protein & clumping fact)
148
Toxins Produced by S. aureus
Exfoliatin A & B-causes outer layer of skin to slough offPyrogenic (TSST-1)
149
S. aureus Characters
(+)NF (axilla, nares, groin)catalase (+)B-hemolytic
150
P. aeruginosa Characters
(-)opportunisticPyocyanin & pyoverdin
151
Another term or furuncle
Boil
152
Causative Agent of Furuncle
S. aureus
153
Where to furuncles develop?
Where hair follicles are exposed to friction and perspiration
154
Skin level(s) of furuncle?
Dermis & Sub Q (abscess)
155
What is a carbuncle?
Aggregate of connected furuncles
156
Causitive agent of carbuncle?
S. aureus
157
Treatment of furuncles & carbuncles
warm compress, drain, AB
158
Varients of pyoderma?
Impetigo (bullous and non-bullous)Ecthyma
159
What is pyoderma?
Bacterial skin inflammation marked by pus filled lesions-dermis & epidermis
160
Causative agents of non-bullous impetigo
S. aureus (most common)GAS (ex. S. pyogenes)
161
Virulance Factors of GABHS (S. pyogenes)
Streptococcal Pyrogenic Exotoxins-superantigens that cause rashM protein-creates sequelae (rheumatic fever, glomerulonephritis)DNAaseHyaluronidaseStreptokinase (dissolbes blood clots)
162
Clinical Manifestations of Nonbullous Impetigo
Intraepidermal lesionsErythematous macule to vesicle to rupture to yellow crust exudate
163
Spread of nonbullous impetigo
Very infectious, spreads rapidly, bacteria in vesicle, trx to decrease spread
164
Causative agent of bullous impetigo
S. aureus
165
Clinical Manifestations of bullous Impetigo
Begins as vesicle, enlarge to form bullae clear/yellow fluid, become turbid, rupture and brown crust forms
166
Population and area of body with nonbullous impetigo
2-6yoFace, arm, legs
167
Population and area of body with bullous impetigo
2-6yoface, legs
168
Caustive Agent of Ecthyma
GAS
169
Clinical Manifestations of Ecthyma
Ulceraters c green/yellow crust, raised marginsDermis
170
Is ecthyma contagious?
Rarely
171
Population and area of body with Ecthyma
Children, DM, neglected elderlyLower extremities (most common)
172
TRX of impetigo & ecthyma
Inc. hygieneDebrideTopical & oral AB
173
Population with cellulits
middle age & older adults
174
Population with erysipelas
young children & older adults
175
Most common causitive agent of Cellulits
GABHS
176
Causative agents of Cellulits
GABHS + (associated c skin lesions - ex: varicella)S. aureus + (does NOT spread as fast as others & assoc. c local abscess)Acinetobacter baumanii - (associated c trauma & invasive devices)Pasteurella multocida - (associated c dog/cat bite & purulent drainage)Aeromonas hydrophila - (associated c freshwater contamination of wound)Vibrio vulnificans - (associated c saltwater contamination of wound)
177
Hallmark S&S of Cellulits
HEETHeat, erythema, edema, tenderness
178
Layer of Skin Involved in Cellulits
DEEP dermis & Sub Q
179
What should you avoid in cellulitis trx?
NSAIDs (mask indicators of worsening disease)
180
Trx of Cellulits
Elevate, immobilize, keep skin moist, AB (oral)
181
What is erysipelas?
Special form of cellulitis that is caused mainly by GAS and rarely by S. aureus.Found in UPPER dermis & superficial lymphatics(as compared to DEEP of cellulitis)
182
S&S of Erysipelas
Raised lesions with clear lines of demarcation.Milian's ear sign (distingguishing feature)Const. symptoms
183
Anatomical regions of erysipelas
Lower extremities & butterfly rash common
184
Trx of erysipelas
elevate, immobilize, keep skin moist, AB (parenteral)
