Micro (and some renal) Flashcards Preview

STEP1 2014 > Micro (and some renal) > Flashcards

Flashcards in Micro (and some renal) Deck (115):
1

Bacteria that secrete enterotoxins

c. perfringens, c. difficile
s. aureus
shigella
yersinia
enterotoxigenic e. coli
vibrio cholera

2

subacute endocarditis

viridans strep
enterococci
coagulase- negative staphylococci such as staph epidermidis

3

penicillinase- sensitive extended spectrum PCNs

h. influenzae
e.coli, enteroccoci
listeria
proteus
salmonella
shigella

4

causes a rash on the hands and feet

Drive Kawasaki CaRS with hands and feet

Kawasaki
Coxsackie A
RMSF
Secondary syphilis

5

Signs of congenital syphilis

saber shins
saddle nose
CN 8 deafness
Hutchinson teeth
mulberry molars
snuffles (blood snot)

6

WAGR complex

Wilms tumor
Aniridia
Genitourinary malformation
mental Retardation (intellectual disability)

7

Risk factors in transitional cell carcinoma development

PeeSAC
Phenacetin
Smoking
Aniline dyes
Cyclophosphamide

8

Acute interstitial nephritis

fever
rash
eosinophilia
azotemia
1-2 wks following drug administration

9

most common tumor of the urinary tract

Transitional cell carcinoma

10

BMP changes in a patient with renal failure

BUN, Cr, potassium increase. hypocalcemia

11

most common renal tumor of early childhood

Wilm's tumor, associated with WT1, WT2 loss of function (these are tumor suppressor genes).
contains embryonic glomerular structures and presents with huge palpable flank mass and/or hematuria

May present with WAGR (beckwith- weidemann)

12

bacterial casts

pyelonephritis

13

WBC casts

pyelonephritis, transplant rejection, tubulostitial inflammation

WBCs in the urine (pyuria) may occur with acute cystitis. Casts only come from the distal convoluted tubule or collecting duct and are indicative of kidney infection.

14

Epithelial cell cast

ATN, toxic ingestion

15

Muddy brown cast

ATN

16

hyaline cast

nonspecific, may be normal with dehydration, formed of epithelial secretions

17

granular (muddy brown) casts

acute tubular necrosis

18

waxy casts

advanced renal disease/ chronic renal failure, 2/2 breakdown of cellular casts/ aggregates/ albumin/ light chains

19

fatty casts

nephrotic syndrome

20

RBC casts

glomerulonephritis, ischemia, malignant hypertension, appears yellow- brown with ragged edges

bladder cancer, kidney stones might produce hematuria without casts. indeed, hematuria can come from anywhere and RBC casts come only from the kidney, specifically the distal convoluted tubule or collecting duct

21

Drugs associated with drug- induced interstitial nephritis

NSAIDs (this can take months to show up)
PCN/cephalosporins, especially methicillin
sulfonamides: TMP/SMX, furosemide, etc.
ciprofloxacin
cimetadine
allopurinol
PPIs
indinavir
mesalamine


presentation: fever, eosinophilia, azotemia, rash
Tx: corticosteroids

22

eosinophilia

DNAAACP

Drugs (NSAIDs, PCN/ cephalosporins)
Neoplasm
Allergis, asthma (Churg- Strauss), allergic bronchopulmonary aspergillosis
Adrenal insufficiency (Addison disease)
Acute interstitial nephritis
Collagen vascular disease (PAN, dermatomyositis)
Parasites (Strongyloides, Ascaris --> Loeffler eosinophilic pneumonitis)
Other: HIV, hyper IgE, hypereosinophilic syndrome, coccidioidomycosis, numerous other potential causes)

23

helminth that causes the most infections in the US

enterobius vermicularis

24

one quarter of the world is infected with this helminth

ascaris lumbricoides

25

helminth with a snail host that causes swimmer's itch

schistosoma species

26

helminth that is the most common predisposing factor for bladder cancer in developing countries

schistosoma hematobium

27

helminth that is contracted by eating undercooked fish and causes an inflammation of the biliary tract

clonorchis sinensis (liver fluke)

28

soil to skin to venous blood to lungs coughed to pharynx then swallowed to the intestines where they reside

strongyloides (skin)

29

ingested to venous blood to lungs, coughed to pharynx then swallowed into the intestine where it resides

ascaris lumbricoides

30

helminth that is contracted by eating undercooked crabmeat and causes inflammation of the lung

paragonimus westermani

31

pork tapeworm

taenia solium

32

responsible for lymphatic filariasis

wuchereria bancrofti

33

adult patient from mexico with new onset seizures and brain calcifications (helminth)

neurocystercercoma (Schistosoma)

34

hookworm

ancylostoma duodenale, necator americanus

35

giant roundworm

ascaris lumbricoides

36

helminth hematuria in a patient from a developing country

schistosoma hematobium

37

What medications for giardia, entamoeba, trichomonas

gardnerella, anaerobic bacteria, h. pylori

metronidazole

38

how to treat most malarias

chloroquine

39

how to treat plasmodium vivax or ovale

chloroquine plus primaquine (check G6PD status)

40

how to treat almost all flukes and tapeworms

praziquantel

41

how to treat hookworm, pinworm, roundworm

benzimadazole or pyrantel pamoate

42

how to treat chagas

benzimidazole or nfurtimox

43

how to treat roundworms

mostly benzymidazoles or pyrantel pamoate

44

how to treat leishmaniasis

cutaneous- sodium stibogluconate
visceral- liposomal amphotericin B

45

how to treat pediculosis capitis and pubis

permethrin, pyrethrin

46

nematodes- roundworms that cause intestinal infections

enterobius vermicularis (pinworm)
ascaris lumbricoides (giant roundworm)
strongyloides stercoralis
ancylostoma duodenale, necator americanus (hookworm)
trichinella spiralis

47

nemotodes- roundworms that infect tissue

onchocerca colculus, loa loa, wuchereria bancrofti (lymphatic filariasis), toxocara canis

48

transmission- pinworm enterobius vermicularis

fecal- oral

dx scotch tape test
sx anal pruritis
tx bendazoles, pyrantel

49

ascaris lumbricoides (giant roundworm) transmission

200,000 eggs or more released daily, human ingests the eggs (even just a little bit), and the worm goes to the lungs, trachea, oropharynx, is then swallowed into the intestine where it matures.

hypersensitivity to ascaris at the lungs can lead to loffler eosinophilic pneumonitis (dyspnea, eosinophilic PNA)

eggs in feces visible under microscope

Tx bendazole or pyrantel pamoate

50

strongyloides stercoralis transmission

larvae in soil penetrate the skin, travel to lungs, trachea, swallow, GI tract, intestinal infection. Tx ivermectin, albendazole

51

ancylostoma duoenale, necatur americanus (hookworm) transmission

larvae penetrate skin, travel to lungs, trachea, swallow, mature at GI tract where they hook into the intestinal wall and suck blood out. abdominal discomfort, anemia. Tx. bendazoles, pyrantal pamoate

52

trichonella spiralis transmission

undercooked meat, meat of wild game, larvae migrate from GI tract to muscles causing myositis, fever, eosinophilia, perorbital edema. Tx: Benzimidazole

53

Feco- orally transmitted nematodes

EAT (enterobius, ascaris in fecal contamination and trichonella spiralis in meat)

54

skin- transmitted nematodes

strongyloides, ancylostoma, and necator, which all penetrate bare feet. Strongyloides is in the soil.
SANd

55

Bites

LOW
loa loa
oncherocerca volvulus
wuchereria bancrofti

56

Cestodes (tapeworms)

taenia solium
diphyllobrothrium latum
echinococcus granulosus

57

Trematodes (flukes)

schistosoma (blood fluke)
clonorchis sinensis (liver fluke)
paraconimus westermani (lung fluke)

58

Schistosoma

eggs into snails, then they penetrate skin to enter into humans (swimmer's itch), in which the schistosomes migrate to lungs or liver and mature.

s. mansoni matures at mesenteric vessels, portal htn
carribean, s. america


s. hematobium goes to the lower urinary tract, leading to scc of bladder (painless hematuria)
western hemisphere, including egypt

embolized eggs may get stuck in the portal system leading to splenomegaly

tx: praziquantel

59

chlonorchis sinensis (liver fluke)

comes from eating undercooked fish. biliary inflammation results in pigmented gallstones, cholangiocarcinoma

tx. praziquantel

60

paragonimus westermani (lung fluke)

sx- chronic bronchitis, hemoptysis, undercooked crab meat

tx: praziquantel

61

taenia solium (pork tapeworm)

ingested larvae that are encysted in undercooked pork lead to intestinal infection, leading to cystercercosis and neurocysticercosis

cysticercosis= larval infection resulting from cyst ingestion leads to myositis at muscles, neurocystercercosis in the brain

tx: praziquantel, albendazole for neurocysticercosis

62

echinococcus granulosus (dog tapeworm)

ingestion of eggs from dog feces.
mature larval cysts occur in the host parenchyma

hydatid cysts in the liver cause anaphylaxis if antigens released (surgeons preinject with ethanol to kill cysts before removal)

tx: albendazole

63

biliary tract disease, cholangiocarcinoma

clonorchis sinensis

64

brain cysts, seizures

taenia colium (cysticercosis)

65

hematuria, bladder cancer

schistosoma haematobium

66

liver (hydatid cysts)

echinococcus granulosus

67

microcytic anemia

anculostoma, necator

68

perianal pruritis

enterobius

69

portal hypertension

schistosoma mansoni, schistosoma japonicum

70

B12 deficiency

diphyllobothrium latum

71

found in SW US including w Texas and CA

coccidiomycosis immitus

72

Mississippi and OH river basin

histoplasma capsulatum

73

San Joaquin valley fever

coccidiomycosis immitus

74

rural Latin America

paracoccidiuides brasiliensis

75

associated with plant thorns and cutaneous injury

sporothrix schenki

76

found in states east of the mississippi river

blastomycosis dermatotiditis

77

found in bird and bat droppings

histoplasmosis capsulatum

78

mold form contains barrel= shaped arthroconidia

cocidioides immitus

79

associated with dust storms

coccidiomycosis immitus

80

broad- based budding of yeast

blastomycosis dermatididis

81

multiple budding of yeast form

paracoccidiomycosis brasiliensis

82

infections associated with birds

H5N1 (avian influenza)
cryptococcus neoformans- pigeon poop
chlamydia psittaci- parrots
WNV- crows
histoplasma capsulatum

83

treatment for sporothrix

potassium iodid, itroconazole is newer (plant a rose in a pot)

84

treatment fo oral candidiasis

fluconazole, nystatin swish and swallow

85

mc opportunistic infection in HIV patients

PCP

86

ppx for cryptococcus in AIDS

fluconazole

87

ppx for PCP in AIDS

TMP-SMX when CD4<200

88

treatment for systemic candidiasis

fluconazole, amphotericin B, echinocandin

89

4 molds that are considered dermatophytes (fungal species invading only superficial layers of skin

trichophyton
microsporum
epidermophyton
malassezia furfur

90

ringworm

tinea corporis, tinea capitis (looks round with a central clearing but there is no actual worm)

91

DNA virus and erythema infectiosum

parvovirus B19

92

heterophile- positive mono

EBV

93

can cause conjunctivitis or diarrhea

adenovirus

94

enlarged cell with owl's eye inclusions

CMV

95

identified with PAP

papillomavirus 16, 18 are high risk

96

milkmaid blsters

vaccinia poxvirus

97

Burkitt lymphoma

EBV

98

gingivostomatitis

HSV1

99

hides in sensory ganglia of S2 and S3

HSV2

100

hides in trigeminal ganglia

HSV1

101

hides in dorsal root ganglia

VZV

102

viral family of JC virus

polyomavirus

103

Downey cells

EBV T cells that target B cells

104

human progressive multifocal leukoencephalopathy

JC Virus polyomavirus

105

oral hairy leukoplakia

EBV

106

multinucleate giant cells on Tzanck test

HSV1,2, VZV

107

only DNA virus that is not double stranded

HBV

108

roseola

HHV6

109

heterophile negative mononucleosis

CMV

110

SCC penis

HPV 16, 28

111

aplastic anemia in SCD

parvovirus B19

112

child with a fever and slapped cheek rash on the face that spreads to the body

parvovirus B19 5th disease

113

where does herpes virus acquire its envelope?

most enveloped viruses get their envelope from plasma membrane when they exit the cell but herpes gets its envelope from the nuclear membrane

114

viral families that are naked

DNA:
parvovirus, adenovirus, papillomavirus, polyoma virus

RNA: calicivirus, picornivirus, reovirus, hepevirus

115

Loffler syndrome

Ascaris lumbricoides
eosinophilic pulmonary infiltrates
most common worldwide cause
Symptoms develop when larvae are within the lungs, approximately 9-12 days after ingesting the ascaris eggs but then subside after about 5-10 days depending on the severity.
symptoms and signs:
- irritating, nonproductive cough, burning substernal discomfort
-dyspnea, blood- tinged sputum
-urticaria for the first few days
-fever over 38.3 (101)
-crackles, wheezing, no consolidation
-hepatomegaly
-CXR: round or oval infiltrates that range in size from millimeters to centimeters in both lung fields
-migratory infiltrates, confluent on perihilar areas, usually clear completely after several weeks