Micro Flashcards Preview

Year 5 Pathology > Micro > Flashcards

Flashcards in Micro Deck (174):
1

BCG vaccine

Variable efficacy in studies
Some studies say protects against miliary and TB meningitis
Given to at risk infants
Mycobacterium bovis

2

Mycobacterium avium-intracellulare

Bad for AIDS patients

3

Mycobacterium marinum

Fishtanks
Single clusters papules/plaques

4

Leprosy

Aka Hansen's disease.
Mycobacterium leprae and M. lepromatous

Skin depigmentation, sensory neuropathy
Tuberculoid form
Lepromatous form (worse)

Tends to affect peripheries (cooler temp)
Armadillo natural reservoir

5

Caseating granuloma differential

TB
Fungus (especially if they are from Minnesota)

6

Pneumonia

Inflamm alveoli
Lobar, interstitial, or broncho-pneumonia
Fever and chills, productive cough with yellow-green sputum, pleuritic CP and tachypnea, decreased breath sounds, dullness to percussion, elevated WBC count

7

Lobar pneum

Consolidation entire lobe on CXR
MCC: S. pneum (95%) and Kleb pneum

Stages:
1. Consolidation
2. Red hepatization
3. Grey hepatization
4. Resolution

8

Klebsiella pneumoniae as cause pneumonia

Enteric flora....so aspirated somehow.
Think drunks and physically disabled

CURRENT JELLY SPUTUM

9

Strep pneum as cause pneumonia

MCC community-acquired pneum and secondary pneum
Rusty colored sputum

10

Secondary pneumonia

Bacterial pneumonia superimposed on viral URTI

11

S. aureus as a cause pneumonia

2nd MCC secondary pneum.
Oft complicated by abscess or empyema (NB coagulase positive)

12

Pseudomonas aeruginosa as cause pneum

Associated with CF patients

13

Moraxelle catarrhalis as a cause of pneum

Assoc with COPD

14

H. influenzae as cause pneum

Comm cause secondary pneum and superimposed on COPD (smokers)

15

Legionella pneumophila as cause pneumonia

Community acquired...water source
Superimposed on COPD or immunocompromised
Silver stain

16

Causes bronchopneum

S aureus
H. flu
P. aerug
M. catarrhalis
Legionella

17

Bronchopneum on CXR

Patchy consolidation around bronchioles. Oft multifocal and B/L

18

Interstitial pneumonia

=Atypical pneum, "walking pneumonia"
Relatively mild upper resp sxs
**M pneum, Chlamydia pneum
College dorms, military recruits
Influenza in elderly, RSV in infants, Coxiella in farmers

19

Q fever

Coxiella burnetti
Atypical pneum with high fever
Farmers/vets...spores from ticks on cattle or in cattle placentas

20

Why is Coxiella unique?

Although Rickettsial organism, causes pneum, does not require arthropod vector, and does not produce skin rash
(As opposed to other rickettsial diseases)

21

Chlamydia psittaci

Birds.

22

RTI + AIDS

PCP
TB
Cryptococcus

23

RTI + neutropenia

Aspergillus/fungi

24

RTI + Splenectomy

Encapsultaed orgs: SHiN

25

Abx mild-mod CAP

Amoxicillin or macrolide

26

Abx: mod-severe CAP

Co-amoxiclav + clarithromycin

27

Macrolides

erythromycin, clarithromycin

Inhibit 50S subunit

28

Aminoglycosides

"GNATS"
Gentamicin
Neomycin
Amikacin
Tobramycin
Streptomycin

Inhibit 30S subunit

29

Abx: Hosp-Acquired pneum

Cipro + Vanco

30

Abx: aspiration pneum

Cefuroxime + metronidazole

31

Abx: legionella

Macrolide + Rifampicin

32

Abx: pseudomonas pneum

Piperacillin + tazobactam

33

Abx: MRSA

Vancomycin

34

STIs with discharge

Gonorrhea
Chlamydia
Trichomonas
Candida
BV

35

STIs with ulceration

Syphilis
HSV
LGV
Chancroid
Donovanosis

36

STIs with Rashes, lumps, growths

Scabies
Pubic lice
Genital warts (HPV)
Molluscum contagiosum

37

PAINFUL genital ulcers

Herpes>chancroid

38

Painless genital ulcer

Syphilis>LGV and granuloma inguinale

39

Pregnant + gonorrhea

Opthalmia neonatorum

40

Tx: gonorrhea

250mg IV ceftriaxone

41

Dx-chlamydia

NAAT

42

Tx-chlamydia

Azithromycin 1g
(Can do 7d doxy but less compliance)

43

LGV

Lymphatic infection, Chlamydia trachomatis L1-L3
Developing world, MSM developed
Tx: doxy 100mg BD 21d

44

Syphilis
-bug
-Dx

Treponema pallidum
Majority cases in those with HIV
Dark-ground microscopy
VDRL, RPR

45

Primary syphilis

Ulcer

46

Secondary syphilis

Systemic sxs, rash
Can have neuro involvement

47

Tertiary syph

Gumma (granuloma), 2-20 yrs later
Aortitis
Neurosyph/tabes dorsalis, argyll robertson pupils

48

Tx-syph

IM Ben-pen

49

Jarisch-Heimer reaction

Fever, HA, myalgia in response to Abx for syph

50

Congenital syphilis

HSM, rash, fever, neurosyph, pneumonitis, hutchinson teeth

51

Chancroid

H. ducreyo (G-)
Tropical
Mult painful ulcers

52

Donovanosis

Granuloma inguinale
Klebsielle granulomatis (G-)
Africa, India, Aboriginal communities
Giemsa stain
Tx-azithro

53

Trichomonas
-cause
-Dx
-Tx

Trichomonas vaginalis
Dx-wet prep microscopy
Tx-metronidazole

54

BV

Gardnerella, decreased lactobacilli
Increased pH
Fishy odor, discharge
Whiff test (KOH prep), Gram stain, clue cells
Tx: metronidazole

55

Candidiasis
-sxs
-associations
-Tx

Thick white "cottage cheese" discharge, extremely itchy
May be associated with immunodeficiency, diabetes
Fluconazole

56

Molluscum contagiosum

dsDNA pox virus
Hands and feet in children
Adults-genital lesions, sexual contact
In adult=HIV until proven otherwise. Giant lesions if immunocompromised
Tx-trauma, cryotherapy

57

Genital warts

HPV 6,11
Oft asxs. Warts can recur after tx
Incubation: 3/52-8/12
Home tx: podophyllin cream
Clinic tx: cryotherapy, imiquimod

58

Superficial fungal infxn-diagnostic tool

Wood's lamp

59

Tinea versicolor

Caused by malassezia furfur.
Skin depigmentation

60

Dx candida

Culture, mannan Abs
Also beta-D-glucan

61

Dx-aspergillus

ELISA, PCR, beta-glucan

62

Dx-cryptococcus

Cryptococcal antigen in serum/CSF

63

TB

do this later

64

Meningitis-definition

Inflamm process of meninges and CSF

65

Meningoencephalitis-definition

Inflamm process of meninges and brain parenchyma

66

Routes of entry for CNS infections

Hematogenous spread
Direct implantation (instrumentation)
Local extension (secondary to infxn)
PNS to CNS, e.g. polio

67

Meningitis-Signs and Sxs

Fever, HA, stiff neck, brain fn disturbance

68

Causative agents-meningitis

N. men
S. pneum
H. flu
TB
Cryptococcus

69

Encephalitis-signs and symptoms

Brain function disturbance

70

Encephalitis-causes

HSV
Rabies, arboviruses, trypanosoes, prions, amoeba

71

Myelitis

Disturbance nerve transmission
Poliovirus

72

Neurotoxins

Paralysis, rigid (tetanus) or flaccid (botulism)

73

TB meningitis

Immunosuppressed pts
meninges and basal cisterns of brain and spinal cord
Can result in tuberculous granulomas, tuberculous abscesses
DON'T give steroids...call a specialist.

74

Aseptic meningitis

Most common CNS infection
HA, stiff neck, photophobia
Non-specific rash
No white cells and normal gluc in CSF
Coxsackie B and echoviruses =80-90%
Self-limiting and resolves in 2/52

75

Reportable GI infections

Campylobacter
Salmonella
Shigella
E. coli O157:H7
Listeria
Norovirus

76

Secretory diarrhea

No fever/low grade
No WBCs in stool

V cholerae
ETEC, EPEC, EHEC

77

Inflammatory diarrhea

Fever
WBC in stool (neutrophils)

C. jejuni
Shigella spp
Non-typhoidal salmonella
EIEC

78

Enteric fever

Gastroenteritis:
Fever
WBC in stool (mononuclear cells)

Typhoidal salmonella (S typhi, S paratyphi)
Yersinia spp
Brucella spp

79

Bloody diarrhea-gastroenteritis causes

Campylobacter, E. coli, shigella, salmonella (non-typhoidal), vibrio parahemolyticus

80

Cholera

Need high infective dose
Kills esp children and those on PPIs
Mimics adenylyl cyclase

81

C. perfringens food poisoning

Normal flora of colon, but not small bowerl--where enterotoxin acts (superantigen)
8-16 hr incubation
Watery diarrhea, crmaps, little vomiting lasting 24 hrs

82

C. difficile

Pseudomembranous colitis
Abx related--mainly cephalosporins, cipro, clindamycin
Forms pseudomembranous colitis ->toxic megacolon.
Tx: metronidazole, vanco, stop other unnec Abx, avoid PPIs if poss

83

Listeria monocytogenes

Outbreaks febrile gastroenteritis
Beta hemolytic TUMBLING MOTILITY
Watery diarrhea, cramps, HA, fever, little vomiting
Perinatal infxn: prem, neonatal bacteremia/meningitis
Tx: ampicillin, ceftriaxone, cotrimoxazole

84

Vibrio parahemolyticus

Ingestion raw/undercooked seafood
Major cause of diarrhea in Japan/Caribbean

85

Campylobacter

Curved, comma, or S shaped
Microaerophilic
C. jejuni grows at 42 C
Oxidase positive
Self limiting but sxs can last weeks
Only tx if immunocompromised (macrolide)

86

Vibrio cholerae

Contamination water and food from human feces
Colonization small bowel and secretion enterotoxin A/B causing persistent activation adenylate cyclase
Rice water stools without inflamm cells

87

Giardia lamblia

Trophozoite
Pear shaped
Ingestion of cyst from fecally contaminated water/food
Protein and fat malabsorption--foul smelling non-bloody diarrhea, cramps, flatulence, no fever
Dx: stool micro, ELISA, "string test"
Tx-metronidazole

88

Cryptosporidium parvum

Infects jejunum
Severe diarrhea in immunocompromised
Oocysts seen in stool
Tx: reconstitution immune system

89

Rotavirus

dsDNA
Replicates in mucosa small intestine
Secretory diarrhea, no inflamm
"ROTA=Right Out The Anus"
By age 6, most have Abs of at least one type
Two exposures result in lifelong immunity

90

Adenovirus

Non-bloody diarrhea. Usu

91

Hepatitis A

Fecal-oral transmission
Often subclinical
Tourists, MSM, sewage workers
Rise in ALT
Vaccine to MSM, travelers

92

Hepatitis B

Chronic carrier if >6/12
2-6mo incubation

93

G+ rods

Clostridium
Corynebacterium
Listeria
Bacillus
Mycobacteria

94

G+ branching filamentous

Actinomyces
Nocardia

95

Alpha hemolysis

S. pneum
Strep viridans

96

Beta hemolysis

S pyogenes
S agalactiae

97

Group B strep

S pyogenes

98

Group A strep

S. agalactiae

99

Gamma hemolysis

Enterococci

100

S. pneum is most comm cause of which diseases?

"MOPS"
Meningitis
Otits media
Pneumonia
Sinusitis

101

Corynebacterium diphtheriae

Causes diphtheria: pseudomembranous pharyngitis, LAD, myocarditis, arrhythmias.

Toxoid vaccine

102

Gram negative rods

H. influenzae
Pasteurella
Brucella
Bordetella pertussis

103

Gram negative--comma shaped

C. jejuni
V. cholerae
H. pylori

104

Gram neg rods

Klebsiella
E coli
Enterobacter
Serratia
Shigella
Salmonella
Proteus
Yersinia
Pseudomonas

105

Legionnaire's disease

Legionella pneumophila
Severe pneumonia, fever, GI and CNS symptoms
Hyponatremia

106

Pontiac fever

Legionella pneumophila
Mild flu-like illness

107

Pseudomonas aeruginosa

Grape-like odor
Wound/burn infections, sepsis, external otitis (swimmer's ear), UTI, drug use, diabetic osteomyelitis

108

Typhoid

Salmonella typhi
Rose spots on abdo, fever, HA, diarrhea
Can remain in GB as carrier state

109

Yersinia

Mesenteric adenitis, resembling Crohn's or apendicitis

110

H pylori

Urease positive, creating alkaline environment
RF for peptic ulcers, gastric adenocarcinoma, lymphoma

111

Spirochetes

Borrelia
Leptospira
Treponema

112

Bartonella

Cat scratch disease

113

Borrelia burgdoferi

Lyme disease

114

Borrelia recurrentis

Relapsing fever

115

Ehrlichia chafeensis

Ehrlichiosis
Lone Star ticks

116

Fransisca tularensis

Tularemia
Rabbits

117

pasteurella multocida

Cellulitis
Animal bites

118

Treatment for all rickettsial diseases

Doxycycline

119

Mucor, Rhizopus spp

Mucormycosis in DKA, leukemic pts

120

Palms and soles rash-ddx

Rocky Mountain spotted fever
Coxsackie A (hand, foot, and mouth)
Secondary syphilis

121

Rickettsial diseases

Rocky Mountain spotted fever
Typhus
Ehrlichiosis
Anaplasmosis
Q fever

122

Herpes viruses

HSV1, 2
EBV
VZV
CMV
HHV6-roseola
HHV8-Kaposi's

123

DNA viruses

Hepadna
Herpes
Adeno
Pox
Papilloma
Polyoma
Parvo

All double stranded except parvo

124

HBsAg

HBV infection

125

anti-HBs

Immunity to HBV

126

HBeAg

Active viral replication, infectivity

127

Anti-HBeAg

Low transmissibility

128

Marker immunization to HBV

anti-HBs

129

Bloody diarrhea

Campylobacter
EHEC
EIEC
Shigella
Salmonella
E. histolytica
Yersinia enterocolitica

130

Watery diarrhea

C diff
C perfringens
ETEC
Protozoa
V cholerae
Viruses (noro, rota)

131

Positive nitrites on urine dip

Gram negative bacteria

132

Positive leukocyte esterase on urine dip

Bacteria

133

ToRCHeS infections

Cross placenta

Toxo
Rubella
CMV
HIV, HSV2
Syphilis

134

Blueberry muffin rash in neonate

Congenital rubella, congenital CMV

135

Abx, antivirals, antifungals to avoid in pregnancy

Sulfonamides
Aminoglycosides
Fluoroquinolones
Clarithromycin
Tetracyclines
Ribavirin
Griseofulvin
Chloramphenicol

136

Flying saucer cysts on methensmine silver stain

PCP

137

Which bug causes hyponatremia

Legionella

138

Tumbling motility

Listeria

139

Entamoeba histolytica

Flask shaped ulcers in colon, cecum
Dysentery, weight loss, liver abscess

140

HHV-8

Kaposi's
Primary effusion lymphoma
Castleman's

141

HIV treatment regimen

Two NRTIs
One NNRTI or PI

142

Phialophora verrucosa

Saprophyte on rooting wood.
Warty lesion resembling cauliflower

143

Tinea corporis

Ringworm

144

Cerebral Negri bodies (inclusion bodies)

Pathognomonic for rabies

145

Fite stain

Leprosy

146

Acyclovir-mech

Guanosine analogue.
Phosphorylated by viral thymidine kinase

147

When do infants get Men C vaccine?

3m, 4m, 12m

148

When do infants get PCV?

2m, 13m

149

Visceral leishmaniasis

L. Donovani, l. Infantum
Kala-azar
Fever, splenomegaly, can get hepatomegaly.
Can get blackened skin/hyperpigmentation
May closely resemble malaria

150

Cutaneous leishmaniasis

L. Major, L. Tropica
Itchy papule that becomes ulcer with raised edges.
Heals within 8m, leaving depigmented scar.
Most common type leishmaniasis

151

Mucocutaneous leishmaniasis

L. braziliensis
Destructive and disfiguring facial lesions.
May start in same way as cutaneous but years later, ulceration in mucous membranes and mutilation.

152

Novy-macneal-michelle medium

Leishmaniasis

153

First Hep B antibody to appear after infection

HBsAg

154

C diff treatment

14 days metronidazole PO
Can repeat if doesn't work
Then use vanco

Vanco if severe, ileus

155

Sporadic CJD

"Demented LAMB":
Dementia around age 65
LMN signs
Akinetic mutism
Myoclonus
Cortical blindness

EEG for dx

156

Test for variant CJD

Tonsillar biopsy

157

LP in CJD

Looks for protein 14-3-3

158

Features if variant CJD

Younger (ave age 26)
Median survival longer (14m versus 4m)
Psych before neuro features

159

CSF findings: bacterial, viral, TB meningitis

Bacterial has neutrophils, increased protein, decreased glucose
Viral has high lymphos
TB like viral but very high protein

160

Spontaneous bacterial peritonitis

Boozers with ascites and signs infection
MCCs are E. coli, enterococci

Tx with cefotaxime or third gen ceph

161

Significant factor in whether or clears HCV

Virus genotype.
Type 1 harder to clear

162

Sleeping sickness

Africa
Tsetse fly
Trypanosomes
When crosses BBB, causes neuro sxs like disturbed sleeping patterns

Tx with pentamidine, suramin

163

Trypanosoma brucei gambiense

West and central Africa.
Gradual onset
More common

164

Trypanosoma brucei rhodiense

South and East Africa.
Rapid onset (weeks to months)

165

Tx-Chagas

Benzimidazole or nifurtimox

166

Plasmodium knowlesi

SE Asia/Borneo
Daily fever

167

Sporozites

What mosquito injects into bloodstream

168

Merozites

Sporozites that have multiplied in liver
Contain shizonts ("diamond rings")

169

Hypnozoites

Dormant forms in liver
Vivax, oval

170

Tx-falciparum

Admit
Quinine and doxy 5-7 days
Or
Co-artem 3 days
Or
Malarone 3d

171

Malarone

Atorvaquone-proguanil

172

Tx-non-falciparum malaria

Chloroquine (kills RBC parasites)
Then primaquine (kills hynozoites)

173

Maurer's clefts

Seen in falciparum

174

Schuffner's dots

Seen in Vivax, ovale