IX - General Pathology of Infectious Diseases Flashcards Preview

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Flashcards in IX - General Pathology of Infectious Diseases Deck (117):
1

These agents cause transmissible spongiform encephalopathies.

Prions(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 321

2

Infected cells show distinct nuclear and ill-defined cytoplasmic inclusions.

CMV infection(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 322

3

Infected cells show glassy nuclear inclusions, frequently with a surrounding halo.

Herpesvirus infection(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 322

4

Infected hepatocytes show diffuse granular (ground-glass) cytoplasm.

Hepatitis B viral infection(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 322

5

Sexually transmitted protozoan that can colonize the vagina and male urethra.

Trichomonas vaginalis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 325

6

Protozoan acquired either by contact with oocyte-shedding kittens or by consumption of cyst-ridden undercooked meat.

Toxoplasma gondii(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 325

7

Size of microorganisms for them to be inhaled directly into the alveoli.

5 um(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 327

8

These microorganisms grow in contaminated food and releases powerful enterotoxins that cause food poisoning symptoms without any bacterial multiplication in the gut.

Staphylococcal strains(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 327

9

Intestinal helminth that cause disease when present in large numbers or cause obstruction of the gut.

Ascaris lumbricoides(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 326

10

Helminth that causes iron deficiency anemia by chronic loss of blood.

Hookworms(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 327

11

Helminth that depletes vitamin B12 giving rise to an illness resembling pernicious anemia.

Diphyllobotrium latum(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 327

12

Placentofetal route as a mode of transmission is also referred to as ________.

Vertical transmission(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 329

13

The ability of bacteria to cause disease.

Virulence(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 331

14

Bacterial surface molecules that bind to host cells.

Adhesins(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 332

15

Filamentous proteins on gram negative bacteria which allow exchange of genes between bacteria, and also involved in adherence.

Fimbriae/pili(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 332

16

Clostridium perfringens produces this toxin that disrupts plasma membranes resulting in digestion of host tissues and collagen.

Alpha toxin (lecithinase)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 334

17

Bacterial toxins with the capacity to stimulate large populations of T lymphocytes, functionally resulting in a "cytokine storm".

Superantigens(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 334

18

Examples of antigen presenting cells.

Dendritic cellsMacrophagesB-cells(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 334

19

A superantigen secreted by S. aureus which causes inflammation, fever and shock. Found in the vagina of menstruating women.

Toxic shock syndrome toxin (TSST-1)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 334

20

Collection of neutrophils which gives rise to localized liquefactive necrosis.

Abscess(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 334

21

High risk agents of bioterrorism which are easily disseminated and has high potential for mortality. An example is smallpox.

Category A(TOPNOTCH)

22

A distinctive form of mononuclear inflammation usually evoked by infectious agents that resist eradication, but are capable of stimulating strong T cell mediated immunity. Characterized by epitheloid cells which may fuse to form giant cells.

Granulomatous inflammation(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 335

23

Agents that are relatively easy to disseminate and produces moderate morbidity and low mortality. An example is E.coli O157:H7 which can cause HUS.

Category B(TOPNOTCH)

24

Includes emerging pathogens that have the potential for mass dissemination with high morbidity and mortality. Examples are Nipah virus and Hanta virus.

Category C(TOPNOTCH)

25

An 8 y/o female presented with fever, sore throat, conjunctivitis, and blotchy, reddish brown rashes on the face, trunk, and extremities. In this condition, lymphoid organs have marked follicular hyperplasia, large germinal center, and randomly distributed Warthin-Finkeldey cells. The most likely cause of this disease is:

Rubeola virus. Warthin-Finkeldey cells are multinucleate giant cells with eosinophilic nuclear and cytoplasmic inclusion bodies. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 355

26

Ulcerated mucosal lesion near the opening of Stensen duct marked by necrosis, neutrophilic exudate, and neovascularization.

Koplik spots - pathognomonic of measles (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 355

27

What protects against reinfection with measles?

Antibody-mediated immunity (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 355

28

Most common extrasalivary gland complication of mumps infection

Aseptic meningitis (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 356

29

A 10 y/o male presented with fever and bilateral swelling and pain of parotid glands aggravated by intake of sour food. What is the most likely finding in the gland interstitium in this disease?

Edematous, diffusely infiltrated by macrophages, lymphocytes, and plasma cells(Mumps) (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 356

30

True of false. Poliovirus infects only humans.

True(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 356

31

Mode of transmission of West Nile virus

Vector-borne (mosquito) (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 356

32

Viruses that most frequently establish latent infections in humans

Herpesviruses (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 357

33

A 10 y/o child presented with vesicular around the lips and cervical lymphadenopathy. Histopathologic finding showed cells containing large, pink to purple intranuclear inclusion that consist of viral replication proteins. The etiologic agent for this condition is:

HSV-1 (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 357

34

A 28 y/o female complained of itchiness and vesicular lesions on her genitalia which later progress to ulcerations. The cause of this condition is:

HSV-2 causing genital herpes (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 357

35

Latent infection with this virus is seen in neuron and/or satellite cells around neurons in the dorsal root ganglia.

Varicella-Zoster Virus (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 357

36

A 62 y/o male presented with painful vesicular rash in a stripe-like pattern over the left side of his trunk. On microscopy, the sensory ganglia contain a dense, predominantly mononuclear infiltrate, with herpetic intranuclear inclusions within neurons. This is a case of:

Shingles/Herpes zoster (TOPNOTCH)

37

Syndrome caused by varicella zoster virus with involvement of geniculate nucleus causing facial paralysis

Ramsay Hunt Syndrome (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 359

38

A neonate was noted to have jaundice, anemia, and hepatosplenomegaly. Patient also had microcephaly, and brain showed foci of calcification. The most likely diagnosis is:

Cytomegalic inclusion disease (caused by CMV) (TOPNOTCH)

39

Morphology of cells in CMV

Prominent intranuclear basophilic inclusion set off from nuclear membrane by a clear halo (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 359

40

A 6 y/o male presented with fever, lymphadenopathy, and hepatomegaly. Lab showed abnormal liver function test and lymphocytosis. These are the most common clinical manifestion in

CMV infection in immunocompetent host. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 360

41

Virus implicated in nasopharyngeal carcinoma and some lymphomas.

Epstein-Barr Virus. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 360

42

A 16 y/o male presented with high fever for a week, sore throat, enlarged lymph node in the posterior cervical and axillary region, and splenomegaly. Peripheral smear showed large lymphocytes with abundant cytoplasm containing clear vacuolization, an oval, indented nucleus and scattered cytoplasmic azurophilic granules (10% atypical lymphocytes). The main target cells of this condition is/are:

B cells and epithelial ells of the oropharynx. (EBV infection) (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 360

43

Patient with EBV infecction will have a positive or negative heterophile antibody reaction (Monospot test)

Positive heterophile antibody reaction. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 362

44

A disorder caused by mutations in the SH2D1A gene, which encodes a signaling protein that participates in T-cell and NK-cell activation and antibody production. It is characterized by an ineffective immune response to EBV.

X-linked lymphoproliferation syndrome (Duncan Disease) (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 362

45

Toxin responsibe for Ritter's disease

Exfoliative A and B toxin(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 363

46

Other term for staphylococcal scalded-skin syndrome.

Ritter's disease (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 363

47

A 5 y/o male was admitted due to sunburn-like rash over the entire body and evolving into fragile bullae. Presence of desquamation of the epidermis occurs at the level of the granulosa layer. What is the cause of this condition?

Staphylococcus aureus (causing Staphylococcal scalded skin syndrome) (TOPNOTCH) Robbins Basic Pathology, 9th ed., p.364

48

Coagulase-negative organism causing opportunistic infections in catheterized patients,patients with prosthetic valves and drug addicts.

Staphylococcus epidermidis (TOPNOTCH) Robbins Basic Pathology, 9th ed., p.364

49

A 30 y/o female was noted to have dyspnea and generalized erythematous rash. She developed hypotension, renal failure, coagulopathy and liver dysfunction. History revealed the use of tampons. The most likely diagnosis is:

Toxic shock syndrome caused by S. aureus (TOPNOTCH) Robbins Basic Pathogy, 9th Ed p. 363

50

A 50 y/o female presented with a 1-week history of progressive, productive cough, and 2 days of spiking fever. Chest examination was notable for decreased breath sounds on the right lower lung field. Chest radiograph demonstrated a right lower lobe infiltrate. A blood culture was subsequently positive for gram positive cocci in pairs. what is the likely organism causing this illness?

Streptococcus pneumoniae. (TOPNOTCH)

51

An 18 y/o female presented with painful swelling in her feet, knees, and wrist. The patient had been well until 10 days prior to admission when she developed a severe sore throat accompanied by fever. What is the most likely cause of his illness?

Streptococcus pyogenes/GABHS(TOPNOTCH)

52

Surface protein present in S. pyogenes responsible for antibodies and T cells cross-reacting with cardiac proteins.

M protein. (TOPNOTCH)

53

A 6 y/o male presented with tonsillopharyngitis, circumoral pallor and erythematous, sandpaper like rashes covering the trunk and extremities. What is the most likely cause of this illness?

This is a case of Scarlet fever caused by Streptococcus pyogenes (TOPNOTCH)

54

A 35 y/o female presented with rapidly spreading erythematous cutaneous swelling on the face with rashes that are sharp, welll-demarcated , serpiginous border forming a butterfly distribution on the face. On histologic exam, there is a diffuse, edematous, neutrophilic inflammation of the dermis and dermis extending to the subcutaneous tissue. This is caused by what microorganism?

S. pyogenes (case of erysipelas) (TOPNOTCH)

55

A 43 y/o male had a two-week history of fever, chills, weakness, and anorexia following a dental extraction. On physical examination, patient had high pitched murmur best heard at the apex. Echocardiogaphy done showed an irregular vegetation attached to mitral valve. The most likely cause of endocarditis in this case is:

Streptococcus viridans. (TOPNOTCH)

56

A 26 y/o previously healthy woman develops fever within 24 hours of delivery of an infant born at 32 weeks. Vaginal swab of the mother revealed Gram positive coci. Blood culture showed organism that are catalase negative, beta-hemolytic on blood agar. The most likely cause of bacteremia is:

Streptococcus agalactiae (Group B Streptococcus) (TOPNOTCH)

57

A 5 y/o old unimmunized child presented with persistent sore throat , cough and fever for 1 week. On examination, the neck was diffusely swollen with tender, bilateral cervical adenopathy. There were hemorrhagic areas on the hard palate and necrotic grayish membrane on the soft palate and tonsils. Morphologic finding of Intense neutrophilic infiltration in the tissues with marked vascular congestion, interstitial edema, and fibrin exudation were noted. This is caused by

Corynebacterium diphtheriae (TOPNOTCH)

58

True or false. Toxin produced by Corynebacterium diphtheriae are the ones responsible for the clinical manifestations of diphtheria.

True. (TOPNOTCH)

59

A 2 mo old male was admitted to the hospital with a history of fever, vomiting, and convulsions. Birth history was unremarkable. CNS finding were suggestive of meningitis. Gram staining of CSF showed mononuclear cells with moderate Gram positive bacilli with tumbling motility. The most likely etiologic agent for this condition is:

Listeria monocytogenes. (TOPNOTCH)

60

This organism causes a painless, pruritic papule developing into a vesicle, which ruptures with remaining ulcer becoming covered with a characteristic eschar.

Bacillus anthracis. (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 366

61

Lesion caused by this organism are typified by necrosis and exudative inflammation rich in neutrophils and macrophages and presence of large, boxcar-shaped gram-positive extracellular bacteria in chains.

Bacillus anthracis. (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 367

62

A 48 y/o male was admitted with a 4 month history of cough with purulent sputum, hremoptysis, and fever. He wa diagnosed with AIDS 2 years earlier and was on antiretivirals irregularly. On examination, HR=98bpm, RR= 26 /min. Chest auscultation revealed decreased breath sounds on the upper third of right hemithorax. CXR demonstrated consolidation in the upper lobe of the right lung. Bronchoscopy with lavage revealed presence of branching filamentous gram positive organism. The organism described is

Nocardia asteroides. (TOPNOTCH)

63

A 17 y/o college student presented with fever, chills, headache, joint pains and myalgia. On physical examination, she is tachycardic, febrile, with mild hypotension. There was noted petechial rashes on her trunk and legs. Gram stain revealed gram-negative coffee-bean shaped diplococci. The most likely cause of this condition is

Neisseria meningitidis. (TOPNOTCH)

64

A 25 y/o female complained of severe pelvic pain and fever. A greenish yellow cervical discharge was detected on physical examination. Gram negative diplococci were isolated from the endocervical swab. What is the most likely cause?

Neisseria gonorrhea (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 368

65

A 2-month old infant was admitted with fever, lymphocytosis, and bouts of violent coughing that often end in vomiting. Blood culture showed small gram-negative rods. The most likely diagnosis is:

Pertussis (TOPNOTCH)

66

Mechanism on how B. pertussis toxin impair host defenses.

Inhibits phagocytosis, inhibits neutrophils and macrophages and paralyzing cilia. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 369

67

Bacteria causing laryngotracheobronchitis with features of bronchial mucosal erosion, hyperemia, and copious, mucopurulent exudate. It may present with hypercellularity and enlargement of mucosal lymph follicles and peribronchial lymph nodes along side a marked peripheral lymphocytosis (up to 90%)

Bordetella pertussis. (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 369

68

A 67 y/o female was admitted with a 1 week history of cough and pleuritic chest pain. Physical examination revealed tachypnea, rhonchi in both upper lobes. The next day, patient's condition deteriorated and had severe respiratory distress. Autopsy revealed extensive bilateral bronchopneumonia and necrosis in the terminal airways in a fleur-de-lis pattern, with striking pale necrotic centers and red, hemorrhagic peripheral areas. The most likely cause of this disease is:

Pseudomonas aeruginosa (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 369

69

An opportunistic aerobic gram-negative bacillus that is frequent, deadly pathogen of people with cystic fibrosis, severe burns, or neutropenia.

Pseudomonas aeruginosa (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 369

70

A 32 y/o female on chronic immunosuppressive therapy was admitted for the management of her abdominal wound infection. On hospital day 18, patient developed erythematous papulovesicules on the left upper chest and right medial leg progressing rapidly to necrotic and hemorrhagic oval ulcers. What organism most likely cause this condition?

Pseudomonas aeruginosa (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 370

71

Organism that causes lymph node enlargement (buboes) with distinct histologic features of massive proliferation of organism, early appearance of effusions with few inflammatory cells, necrosis of tissues and blood vessels with hemorrhage and thrombosis, and neutrophilic infiltrates in necrotic areas.

Yersinia pestis (TOPNOTCH) Robbins Pathologic Basis of Disease, 9th Ed p. 370

72

A 25 y/o male initially presented with a tender erythematous papule on the penis which produce an irregular, painful, non-indurated ulcer over several days. The base of the ulcer is covered by shaggy, yellow-gray exudate. Microscopically, the ulcer contains a superficial zone of neutrophilic debris and fibrin, and an underlying zone of granulation tissue containing areas of necrosis and thrombosis. This infection is caused by:

Haemophilus ducreyi (causing Chancroid) (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 370

73

A 45 y/o sexually active male presented with a 3-month history of few painless ulcerated lesions on the penis and scrotum. The painless nodules slowly evolved to red ulcerated lesions over 1 month. Physical examination revealed multiple, raised, beefy-red nontender round ulcers on the shaft of penis and scrotum. The ulcers had clean friable granulating bases. Microscopic examination with Giemsa stain revealed numerous encapsulated coccobacilli in macrophages. The most likely diagnosis is:

Granuloma inguinale/donovanosis (Klebsiella granulomatis) (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 370

74

A 25 y/o male initially presented with a tender erythematous papule on the penis which produce an irregular, painful, non-indurated ulcer over several days. The base of the ulcer is covered by shaggy, yellow-gray exudate. Microscopically, the ulcer contains a superficial zone of neutrophilic debris and fibrin, and an underlying zone of granulation tissue containing areas of necrosis and thrombosis. This infection is caused by:

Klebsiella granulomatis (TOPNOTCH)

75

True or false. A positive tuberculin test differentiates active disease from infection.

False. A positive tuberculin test signifies T-cell mediated immunity to mycobacterial antigen. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 371

76

How many days or weeks after mycobacterium infection will it develop delayed hypersensitivity to M. tuberculosis as detected by Mantoux skin test?

2-4 weeks (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 371

77

The critical mediator that enables macrophages to contain M. tuberculosis infection by stimulating maturation of phagolysosome, stimulation of expression of inducible nitric oxide synthase and mobilization of defensins against bacteria.

IFN gamma(TOPNOTCH) Robbins Pathologic Basis of Disease, 9th Ed p. 372

78

True or False. Immunity to M. tuberculosis is primarily mediated by TH1 cells.

True. TH1 cells stimulate macrophages to kill the bacteria (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 373

79

Secondary pulmonary tuberculosis classically involves what part of the lungs?

Apex of the upper lobes of one or both lungs. (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 373

80

True or false. The absence of characteristic granulomas in tissues in HIV-positive patients precludes (rule out) the diagnosis of tuberculosis.

False. Atypical features of TB in HIV-positive patients include increase frequency of false-negative sputum smears, tuberculin tests, and absence of granuloma, particularly in the late stages of HIV.(TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 374

81

A 1 to 1.5 cm area of gray-white inflammation with consolidation in primary tuberculosis.

Ghon focus (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 374

82

Most frequent presentation of extrapulmonary tuberculosis.

Lymphadenitis (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 376

83

A 42 y/o male nonsmoker with AIDS began to experience cough, mild hemoptysis, and progressive dyspnea. CD4 cell count was 45 cell/ul. A chest radiograph revealed hilar adenopathy and perihiral infiltrates. AFB smear was negative. Bronchoscopy was done and microscopic finding showed an abundnat acid-fast bacilli within macrophages. The organism causing the illness is:

Mycobacterium avium complex (TOPNOTCH)

84

Pattern of leprosy presenting with dry, scaly skin lesions that lack sensation and often have assymetric involvement of large peripheral nerves.

Tuberculoid leprosy (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 377

85

Pattern of leprosy causing symmetric skin thickening and nodules with widespread invasion of mycobacteria into Schwann cells and into endoneural and perineural macrophages damaging the peripheral nervous system.

Lepromatous leprosy (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 377

86

Pattern of leprosy characterized by TH1 response associated with production of IL-2 and IFN gamma

Tuberculoid leprosy (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 377

87

Pattern of leprosy associated with weak TH1 response and in some cases increase in TH2 response resulting to weak cell-mediated immunity.

Lepromatous leprosy (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 377

88

A 30 y/o male presented with a flat, red, anesthetic skin lesions on his left thigh extending to his knee which had been present for 2 years. These lesions enlarged and develop irregular shapes with indurated, elevated, hyperpigmented margins and depressed pale centers. On microscopic examination, all sites of involvement have granulomatous lesions. Bacilli are almost never found. This is a case of__.

Tuberculoid leprosy/Paucibillary leprosy (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 377

89

This disease presents with macular, papular, or nodular lesion on the face, ears, wrists, elbows and knees, progressing to coalescence of nodular, anesthetic lesions. (+) leonine facies. Morphologic findings of this disease reveals skin and peripheral nerve lesions containing large aggregates of lipid laden macrophages (lepra cells) often filled with asses (globi) of acid fast bacilli.

Lepromatous/multibacillary leprosy (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 378

90

A 19 y/o male presents to the clinic because of a lesion on his penis. Genital exam showed a red, solitary, raised , indurated, non-tender lesion on the ventral side of his penis. Neurologic exam was within normal limits. What is the most likely diagnosis?

Primary syphilis(chancre)(TOPNOTCH)

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)

92

Characteristic of all stages of syphilis

Proliferative endarteritis. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 379

93

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

94

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

95

Most frequent involvement of tertiary syphilis

Aorta (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 380

96

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

98

Late manifestations of congenital syphilis (triad)

Interstitial keratitis, Hutchinson teeth, and eighth-nerve deafness (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 381

99

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

104

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

110

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

112

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

114

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

117

A 44 year old HIV-positive man is admitted for diarrhea of one month duration. Fecalysis did not show parasitic ova or cysts. Colonoscopy showed a diffusely erythematous mucosa. Biopsy was performed which showed sheets of macrophages filled with filamentous structures that were bright pink on acid fast staining. The likely organism is (A) Cryptosporidium parvum (B) Isospora belli (C) Mycobacterium bovis (D) Mycobacterium avim-intracellulare

Mycobacterium avium-intracellulare dx Infectious mononucleosis case (TOPNOTCH) pp326-327

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