Patient Presentations Flashcards
(117 cards)
Abnormal protein causing neurodegenerative disorders. “Spongiform” degeneration. Polymorphic changes on chromosome 20, at residue 129. 100% fatality.
Prion diseases
PrPsc
Normal has more alpha, is soluble, present on cell surfact. PrPsc is more beta, insoluble, present in vacuoles.
Most common prion disease
CJD
Prion disease with **early onset and longer course. **
familial fCJD
A 60 y/o patient comes in with behavioral changes, disordered sleep, and vision/motor changes. Patient’s family complains of **rapid cognitive decline. **
sCJD
A patient from Papua New Guinea comes to you “shivering”, saying he ate a family member 40 years ago. Your examination reveals tremors, ataxia, and _amyloid plaques in the brain. _
Kuru
True/false: Scrapie, a disease where sheep scrape their coats and do excessive lip-smacking, have hopping gait and seizures . . . is NOT transmissible to humans.
True
When “mad cow disease” gets transmitted to humans, it is called . . .
nvCJD
You do a lymphoid biopsy of your patient’s tonsils and discover PrPsc. What disease most likely caused this?
Your patient probably ate a cow and got infected with nvCJD
Your 28 y/o patient presents with bizarre psychiatric and behavior symptoms. You order an EEG and MRI and see a pulvinar sign as well as **florid plaques. **The diagnosis is confirmbed by biopsy of lymph tissue.
nvCJD
What disease is NOT destroyed by UV light, EtOH, disinfectants, ammonia . . . and can be transmitted by transplants or contaminated neurosurgical instruments.
iatrogenic CJD
MUST: USE DISPOSABLE instruments or steam autoclave, bleach, etc
You see a large brick-shaped DNA virus. It is most likely a
poxvirus
List 4 major poxviruses
smallpox, monkeypox, moluscum contagiosum, orf
A patient comes in with a history of malaise, high fever, vomiting, and severe HA. She says that 2-3 days later, a vesicular rash appeared on her face, palms and soles. When you examine her, you find lesions on her trunk with umbilicated centers. All of the lesions are in the same stage of development.
smallpox
Airborne and contact precautions
- disease is communicable from onset until 7-10 days.
- isolate until scabs separate
smallpox management
A child comes in from a rural tribe in Africa. He presents with a rash that looks like small-pox, but you notice he has puffy cheeks (**lymphadenopathy). **Upon further questioning, he says that he and his pet monkey were playing with a rat.
monkeypox
Your patient presenting with a vesicular rash works at a zoo where they train prairie dogs and gambian giant rats. What disease is your top differential?
monkey pox
You are examining an HIV patient, and discover multiple umbilicated skin papules that measure >1cm. When you open a lesion, is contains *white, waxy curd-like core. *
molluscum contagiosum
A patient comes into your office with reddish nodules on their hands. They work at a slaughter house _(sheep and goats). _
Orf, will self-heal in 3-6 weeks.
An 18 y/o male presents with purulent discharge, dysuria, and urethritis. He reports unprotected sexual activity a week ago. You suspect gonorrhea. How do you treat?
Single dose cephalosporin.
**Widespread penicillin resistance. **
“arthritis-dermatitis syndrome”, characterized by *asymmetrical polyarthritis and tenosynovitis. *Also may have hemorrhagic papules and pustules.
disseminated gonorrhea
You suspect your patient has gonorrhea. What specific kind of media should you ask the lab to use?
Thayer martin
but nucleic acid probes are most commonly used for diagnosis.
What is the most common cause of NGU urethritis?
chlamydia
What causes a
- *proctitis:** rectal strictures, fistulae, abscess
- *reactive arthritis:** immune mediated ASEPTIC arthritis
chlamydia
In this disease, there is an asymptomatic papule/ulcer that occurs 3-30 days post infection. Days to weeks later, there is adenopathy with progress to an **inflammatory mass. **
Lymphogranuloma Venerum
Chlamydia
