Flashcards in IX - General Pathology of Infectious Diseases Deck (117)
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91
A 34 y/o male presented with circular violaceous, papulosquamous lesions on his palms, soles, and entire body. He admitted having unprotected sex with his new partner 6 weeks before the onset of his lesions. Broad-based plaques were noted in the inner thighs and anogenital region. Silver-gray erosions were noted on the pharyngeal and genital area. What is the most likely diagnosis(and stage)?
Secondary syphilis. (TOPNOTCH)
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Characteristic of all stages of syphilis
Proliferative endarteritis. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 379
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Serologic test/s that are sensitive for secondary syphilis
Both non-treponemal antibody tests and antitreponemal antibody tests. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 379
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Serologic tests that are very sensitive for tertiary and latent syphilis.
Treponemal tests (Fluorescent Treponemal antibody absorption test, T pallidum enzyme immunoassay test) (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 379
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Most frequent involvement of tertiary syphilis
Aorta (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 380
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A 39 y/o male presented with a white-gray and rubbery mass on the forehead that had been slowly progressive over the previous 6 years. Biopsy showed that lesion have centers of coagulated, necrotic material and margins composed of plump, palisading macrophages and fibroblasts surrounded by large number of mononuclear leukocytes. What is the lesion described?
Syphilitic gumma (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 381
97
A neonate presented with snuffles, bullous eruption of the palms and soles, saddle nose deformity, and anterior bowing of the tibia. What is the most likely cause?
T. pallidum (causing congenital syphilis) (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 381
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Late manifestations of congenital syphilis (triad)
Interstitial keratitis, Hutchinson teeth, and eighth-nerve deafness (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 381
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Disseminated infection from this microorganism cause secondary skin lesions, lymphadenopathy, migratory joint and muscle pain, cardiac arrythmias, and meningitis.
Borrelia burgdorferi (causing congenital syphilis) (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 381
100
A 60 y/o male presented with severe pain and edema of left foot and leg, bullous vesicles, and foul-smelling wound discharge 3 days after sustaining a crushing injury. Crepitations were noted over the inflamed muscles. What is the most likely cause of this condition?
Clostridium perfringens (causing gas gangrene/clostridium myonecrosis) (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 383
101
Most common sexually transmitted bacterial disease
Chalmydia trachomatis infection(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 383
102
A 28 y/o male presented with painful, swollen lymph node at the inguinal area, associated with fever, and myalgia. Two weeks prior, patient recalled had a small, painless pustule on the scrotum. The most likely diagnosis is:
Lymphogranuloma venereum (TOPNOTCH)
103
Lymph node involvement in this condition is characterized by a granulomatous inflammatory reaction associated with irregularly shaped foci of necrosis containing neutrophils (stellate abscess).
Lymphogranuloma venereum (caused by Chlamydia trachomatis)(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 384
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Presents with dysphagia and retrosternal pain; endoscopic findings of white plaques and pseudomembranes resembling oral thrush on the esophageal mucosa.
Candida esophagitis(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 386
105
Associated with intense itching and thick, curd-like discharge common in women who are diabetic, pregnant, or on OCP.
Candida vaginitis(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 386
106
A 70 y/o male, with prior history of TB, presents with occassional cough, hemoptysis, fever, and respiratory distress. CXR showed a mass surrounded by a crescentic rim on the right upper lobe within a cavitary lesion. Biopsy done revealed no malignant cell. This is most likely a case of:
Pulmonary aspergilloma (TOPNOTCH)
107
A 60 y/o diabetic female presented with fever and left periorbital pain and sweling. A nasal eschar involving the enitre nose with discharge from the nasal cavity. Biopsy from the eschar showed foci of nonseptate fungal hyphae and hyphal branches at right angles. The most likely cause of her condition is:
Mycormycetes (TOPNOTCH)
108
The etiology of cerebral malaria, wherein brain vessels are plugged with parasitized red vessels. Around the vessels are ring hemorrhages related to local hypoxia. (TOPNOTCH)
Plasmodium falciparum (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 392
109
What is the major cause of sudden death in Chagas disease?
Cardiac arrythmia. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 395
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The causative agent of Chagas disease
Trypanosoma cruzi (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 394
111
Nematode that causes patchy interstitial myocarditis characterized by many eosinophils and scattered giant cells.
Trichinella spiralis (TOPNOTCH) Robbins Basic Pathology, 9th ed., 397
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Pathogenesis of hepatic fibrosis in schistomiasis
Eggs carried into the parenchyma cause severe chronic inflammation; TH2 response and activated macrophages. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 398
113
Pipe-stem fibrosis of the liver, portal enlargement without intervening regenerative nodules, and granuloma are associated with infection caused by:
Schistosoma mansoni and S. japonicum. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 398
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A chronic carrier state of typhoid fever is most likely due to persistence of the organism in the:
Gall bladder (TOPNOTCH)
115
A 38 y/o man with AIDS present with deteriorating mental status. Lumbar tap was done. CSF was stained with india ink and mucicarmine revealed capsulated yeasts that stain bright red. What is the most likely diagnosis?
Cryptococcosis (TOPNOTCH)
116
A 53 year old woman presents with 5 days of productive cough and high grade fevers. Crackles were auscultated at the left lung. Sputum cultures grew Streptococcus pneumoniae. Her lungs will show which histologic picture? (A) suppurative inflammation with sparing of alveolar septa (B) thickened alveolar septa with mononuclear infiltrates (C) lysis of alveolar walls and coalescing abscesses (D) epithelioid macrophages and giant cells
suppurative inflammation with sparing of alveolar septa (TOPNOTCH)Robbins Basic Pathology, 8th Ed p334-335
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