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124 Cards in this Set
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What are bugs with Gram stain Limitations
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These Microbes May lack Real Color
Treponema, Mycoplasma, Mycobacteria, Legionella, Rickettsia, Chlamydia Silver for Legionella Trep- dark field |
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what are the bugs you use Giemsa Stain for?
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Certain Bugs Really Try my Patience
Chlamydia, Borrelia, Ricketssia, Trypanosomes, Plasmodium |
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What are the Obligate Aerobes
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Nagging Pest Must Breathe
Nocardia, Psuedomonas, Mycobacterium |
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What are the Obligate Anaerobes?
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Anearobes Can't Breath Air
Clostridium, Bacteroides, Actinomyces (lack catalase or SOD) |
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What gives away an anaerobe?
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Foul Smelling!
produce gas in tissue (normal in GI tract) |
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How do you treat Anaerobes?
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Above Diaphragm: clindamycin
Below Diaphragm: metronidazole |
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What are the Obligate intracellular?
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Stay inside when its Really Cold
Ricketssia and Chlamydia can't make their own ATP |
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What are the Facultative Intracellular?
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Some Nasty Bugs May Live FacultativeLY
Salmonella, Neisseria, Brucella, Mycobacterium, Listeria, Francisella, Legionella, Yersinia pestis |
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What are the Encapsulated bacteria?
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SHiNE SKiS
Strep pneumo, Heamophilus influenza, Neisseria, E. Coli, Salmonella, Klebsiella, GBS SHiN (Vaccines) |
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Catalase +
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PLACESS for your cats
Pseudomonas, Listeria, Aspergillus, Candida, E.coli, Staph aureus, Serratia Inc. Risk with CGD |
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Urease + bugs?
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PUNCH KidneyS
Proteus, Ureaplasma, Nocardia, Cryptococus, H.pylori, Klebsiella, Staph Saprophyticus |
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How do you perform a gram stain?
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Cyrstal Violet
Iodine EtOH wash and then a sufranim (counterstain?) for the gram - to turn red |
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What is the PAS stain good at staining?
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PASs the sugar (glycogen)
Whipple disease (Tropheryma Whipplei) |
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Who stains well with Silver stain?
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Fungi, Legionella, H.Pylori
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What are the bugs with special culture requirements?
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H. influenza- chocaloate agar with Factors V/X (NAD, Hematin)
Neisseria- VPN (Thayer Martin Media)- vanco, polymyxin, nystatin B. pertussis- Bordet-Gengou (Bordetta and Bordet) C. Diphteriae- Tellurite, Loffler medium M. Tuberculosis- Lowenstein-Jensen M.pneumoniae- Eaton Agar (Eat to get your cholesterol) Legionella- Charcoal with cystein and Iron Fungi- Sabouraud (Sabs a Fun Guy!) |
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What makes Staph so bad?
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Protein A
Catalase + Beta Hemolytic Toxins: TSST, SSS, Enterotoxin MRSA- altered PBP, resistant to methicillin and nafcillin |
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What are the most common infections with Staph. Epidermidis?
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Infects prosthetic valves and IV catheters- forms an adherent Biofilm
Normal skin flora- can contaminate blood cultures Novobiocin Sensitive (NO StRESs) UREASE + |
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What are the common infections with Staph. Saprophyticus?
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Second most common cause uncomplicated UTIs- women
Novobiocin Resistant (NO StRESs) UREASE + |
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What are the common infections caused by Strep. Pneumo
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Meningitis
Otitis media (Children) Pneumonia- rusty colored sputum Sinusitis |
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What are the characteristics of strep pneumo?
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Gram + diplococci, lancet shaped, Catalase -, alpha hemolytic, Optochin sensitive (OVRPS)
Capsule and IgA (SHiN organism) are virulence factors Increased risk of sepsis in sickle cell and splenectomy (Not able to clear capsule bugs) There is a Conjugated and non conjugated (For elderly) Vaccine (Alone with other SHiN organisms) |
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What are the illnesses caused by Strep. Viridans? What are the characteristic of the bug?
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Dental Caries (S. mutans) and subacute endocarditis with S.sanguinis (means blood)
S. sanguinis makes dextrans which bind to fibrin-platelet aggregates on damaged valves Optochin resistant, alpha hemolytic, normal part of oral pharynx |
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What are the illness caused by GAS, strep. pyogens? What are the characteristic of the bug?
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Pyogenic: Pharyngitis, cellulitis, impetigo
Toxin: Scarlet fever, TSLS, necrotizing fasciitis IM: Rheumatic fever (M-protein mimicry), acute post strep glomerulonephritis GAS, Bacitracin Sensitive (B-BRAS), M protein prevents phagocytosis, but can cause RF due to mimicry ASO titer used to detect post infection (beta hemolytic, destroys RBCs) |
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What are the characteristics of Scarlet Fever?
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Scartet (red) Rash
Sandpaper-like texture Strawberry tongue Circumoral (around the mouth) pallor |
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What can cause post strep glomerulonephritis?
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PSGN: Impetigo and Pharyngitis
RF: only Pharyngitis (JONES) m-proton mimicry of epitope similar to our cells in joints, heart, skin, basal ganglia |
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What are the illness caused by strep. Agalactiae? What are the characteristic of the bug?
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PMS in babies (pneumonia, meningitis, sepsis)
It colonizes the vagina, so think of mom suffering from PMS and giving it to her baby Bacitracin resistant (B-BRAS), beta hemolytic, found in vagina Makes CAMP factor to increase hemolysis of S.Aureus Hippurate Test + Screen pregnant women 35 wks and treat intrapartum with penicillin propholaxis |
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What are the illness of enterococci?
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UTI, Biliary tree infections, subacute endo following GI/GU procedure
VRE (vanco resistant) Can grow in 6.5%NaCl and bile Normal GI tract colony, Pen G resistant, very competent bugs and pick up resistance Tx with Ampicillin, (not cep halos),Vanco or even amino glycoside |
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What do you need to think about if S. Bovis = subacute endocarditis?
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Colon Cancer! Give Penicllin Propho
|
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What are the S/Sx of C. Diptheriae
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Psuedomembran pharyngitis, lymphadenopathy
Myocarditis, arrhythmias AD-ribosylates EF2, beta phage club shaped, Metachromatic blue/red granules and Elek test for toxin (black on Tellurite agar and Loffller) GIVE TOXOID vaccine to prevent |
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How do you kill spores?
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Autoclave at 121C for 15mins
B. anthracis, C. perfringens, C. Tetani (soil) B. cereus, C. botulinum, Coxiella burnetti |
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What are the findings in Closridia infections? What are the characteristic of the bug?
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Gram +, spore forming, obligate anaerobe (Anaerobes can't breath air)
C. Tetani: SNARE, dec. Glycine/GABA ranshaw nucleus, spastic paralysis C. Botulinum: preformed, heat labile, inh. ACh (babies not preformed, produced after eating spores in honey) C. Perfringens: alpha toxin (Lecithinase, phospholipase) myonecrosis (gas gangrene) and hemolysis. Think- its an anaerobe= hates blood because of O2 C. Diff: Toxin A- entero, binds to brush boader Toxin B- disrupts cytoskeleton, killing cell (actin depolymize) psuedomembrane and diarrhea- after clindamycin or ampicillin (tx with metro or vanco) |
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What are the characteristic of the Anthrax?
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Bacillus anthracis, gram + rod, spore forming, Aerobic
Anthrax Toxin: Edema factor inc. cAMP, lethal factor kills cell (MAPK) Unique- has polypeptide capsule (D-glutamate) Serpentine/Medusa head (long chains) cultured |
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Cutaneus Anthrax, characteristics? Pulmonary?
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Boil-like ulcer with black eschar (painless and necrotic)
Pulm: inhaled spore-flu like progressing to fever, pulm hemorrhage, mediastinitis (wide on CXRAY), and shock WOOLSORTERS: inhaled from wool |
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What are the characteristic of the Bacillus cereus?
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Food poisoning, reheated/warm rice (spores germinate)
Emetic: rice and pasta, N/V within 1-5hrs caused by cereulide preformed toxin Diarrheal- watery and GI pain 8-18hrs nothing you can do, preformed toxin |
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What are the characteristic of the Listeria? Illnesses?
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Facultative intracellular (Some Bugs May Live FacultaiveLY), gram +, beta hemolytic, likes COLD TEMP (4C)
Unpasturized MILK, deli meats, Transplacental, vaginal during birth Actin rockets thru cytoplasm, avoid Abs Tumbling motility Only Gram + with LPS Amnionitis, septicemia, spont. abortion during pregnancy Granulomatosis infectiseptica Neonatal meningitis IM compromised meningitis mild GI in healthy patients Tx: mild GI- self limited Ampicillin in infants, compromised, and elderly |
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What are the Ms of Listeria?
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Monocytogens
Milk Meningitis iM compromised Mommies to babies |
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Actinomyces vs. Nocardia?
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Actin: anaerobe, normal oral flora, oral/facial abscess, sulfure granules, penicillin (SNAP)
Nocard: Aerobe, Acid Fast, soil, Pulmonary infxns compromised, cutaneus in competent. sulfa drugs (SNAP), UREASE + |
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What are the extra pulmonary TBs?
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Potts: TB in vertebral body
CNS: paranchymal TB or meningitis Adrenals, LN, GI, Renal Primary= Ghon focus (mid lung) and Hilar Node (Ghon complex) |
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What are the characteristic of the TB?
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TB: Acid fast, high lipid content, mycolic acid
Cord factor in virulent strains inhibits macros maturation and induces release TNF-alpha (causes symptoms) Sulfatides inhibit phagolysomal fusion MAC: intraceulluar, AIDS, disseminated, propho with Azithromycin, grows 41C, inc. LDH/ALK phosph S/Sx: Fever, night sweats, weight loss, hemoptysis |
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What are the characteristic of the TB leprosy?
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Cool Temps
Skin/Superficial nerves- Glove-Stocking sensation loss No growth in vitro Armadillos in Us Lepromatous: diffuse skin, leonine face, communicable Low cell-mediated IM Relies on Th2 and humoral response Dysfiguring, blindness, nodules, amputation from loss of feeling and trauma TBoid: limited to hypo pigmented hairless plaques High T-cell immunity- Th1 TX: DAPSONE and rifampin (TBoid)+ Clofazimine (Lepro) |
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What are the Gram - comma shaped Oxidase + bugs?
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Camp. Jejuni- 42C
Vibrio Cholerae- Alkaline pH H. Pylori- UREASE + |
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What are the Gram - Diploccoci?
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Neisseria Meningitidis- Maltose ferm
gonorrhoeae- non-maltose Meningitis plus patechia=N.Meningitis Waterhouse syndrome too! |
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What are the Coccoid gram -?
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Bruce lee and his crew of He man, fought at the border of the pasture with their cock and balls
Heamopholis influenza Pasteurella Brucella Bordetella pertussis |
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What are the Gram -, lactose fermenting rods?
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KEE, McConKEE agar, grow PINK
Klebsiella-UREASE + E.Coli- Capsule Enterobacter SLow: City Slickers Citrobacter Serratia-red |
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What are the gram -, non lactose fermenting rods?
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SSPPY
Oxidase - Shigelle- Actin rocket Salmonella- capsul (SHiNE SKiS) Proteus- UREASE + Yersinia Oxidase + Pseudomonas- obl. aerobe |
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What bugs are resistant to Penicillin and Vacno?
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Gram - Rods
The outer membrane inhibits entry (also the periplasma space has beta lactams) |
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What are the characteristic of the Neisseria Gonocci?
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Gram - diplococci, ferment glucose, IgA
GoNOcocci- intercellular within neutrophils no capsule no maltose fermentation no Vaccine (rapid antigenic variation pilus protein) Sexually Gonorrhea, septic arthritis (sexual active most common), neonatal conjunctivitis, PID, Fitz-hugh-curtis (adhesions to liver) Tx: Ceftriaxone, (Azithromycin/Doxy for Chlamidia) three Macro axis to cut your balls off |
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What are the characteristic of the Neisseria Meningococci?
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Gram - diplococci, ferment glucose, IgA, capsule (SHiNm)
Maltose ferm Vaccine type B Transmitted by respiratory secretions Meningococcemia meningitis, Waterhouse-Friderichson syndrom (adrenal insufficiency, shock, DIC) Patechial skin rash (vasculitis, even palms and soles) with meningitis! tx: cetriaxone (you'll want three axes and a pen in your eye to stop this headache) Propho: your friends will also want a rifle, three axes, and to flock away from you) |
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H influenza characteristics
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SHiN- capsule (PRP), IgA, vaccine
gram -, coccobacili, small, Chocolate agar (V/X) nontypable= Otitis media, conjunctivitis, bronchitis (mucosal, tx with amoxicillin+ clavulanate) haEMOPhilus Epiglottitis (cherry red glottis with thumbprint sign)- horse and stridor, Emergency airway Meningitis Otitis media Pneumonia tx: Ceftriaxone, rifampin for proph close contacst The He man will chase, you kill him with three axes your fiends can help with a rifle |
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What are the characteristic of Legionella?
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Silver stain, poor gram (These Microbes May Lack Real Color)
Chorcoal with cysteine and iron Detected in urine Hyponatremia no person to person Water source (air conditioning, hot water tanks) S/Sx: Hyponatremia High Fever severe Pneumonia, unilobe Watery Diarrhea Sputum- lots PMNs, few organisms tx: Macrolide or quinolone The MACRO legionnaire won't be a cinch to take down Pontiac fever- mild flu like illness |
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What are the characteristic of Psuedomona?
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Aerobic, gram -, non lactose fermeting, Oxidase +, pyocyanin=blue green color, grape like odor
Water sources (hot tube folliculitis) Endotoxin-LPS Exotoxin A=inactivates EF2 BURN VITCOMS PSEUDO Pneumonia (CF with biofilm) Sepsis External Otitis (Swimmers ear, water!) UTI Drug use and DM Osteomyelitis hot tub Folliculiltis malignant otitis externa in diabetics Ecthyma gangrenosum- necrotic skin lesion in bacteremia (compromised) Tx: Aminoglycosides plus ES penicillins (piperacillin, ticarcillin, cefepime, imipenem, meropenem) This mean pseudo mona is in her prime and won't come down easy, we will have to rope, ti, and pip her down. |
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E. Coli virulence factors?
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Fimbriae- cystitis and pyelonephritis
K capusle- pneumonia, neonatal meningitis LPS endotoxin- septic shock |
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ETEC
EIEC EHEC EPEC |
ETEC: travelers diarrhea, cAMP/cGMP
EIEC: invasive, necrosis, dysentary EHEC: O157:H7, most commong, shiga-like toxin (HUS) dysentary (DOES NOT FERM. SORBITOL) EPEC: adheres to apical surface, flattens villi, prevents absorption- PEDIATRIC diarrhea |
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What are the characteristic of Klebsiella?
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4 As
Aspiration pneumonia Abscess in lungs and liver Alcoholics diAbetics Lobar pneumonia, mucoid produces currant jelly sputum Nosocomial UTIs |
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Salmonella vs. Shigella
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Salmonella: capsule (SHiNE SKiS), facultative intracellular (Some Nast Bugs May Live FacultativeLY)
Flagella (salmon swim) Hematogenous dissemination Animal reservoirs (reptiles) H2S Invades mucosa and causes MONOcytic response Blood diarrhea Non-lactose Shigella: No flagella Cell-Cell transmissiong by actin rocket, no heme spread Human only reservoir Abx help to shorten course (vs. Salmonella) Invades mucosa and has Neutrophil response Bloody poop Non-lactose ferm. |
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What is unique about Salmonella Typhi?
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Typhoid fever, only in humans
ROSE SPOTS on the ABDOMEN, fever, headache, and Diarrhea can remain in carrier state within gallbladder S/Sx: high fever, rose spots abdomen, dec. HR, delirium, diaphoresis |
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What are the characteristic of Camp. Jejuni?
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Blooy dirarrhea in kids
fecal-oral thru poultry, meat, milk S-Shaped, oxidase +, grows at 42C Guillain-Barre syndrome and reactive arthritis |
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What are the characteristic of Vibrio Cholera
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Rice water diarrhea vie exotoxin-Gs, inc. cAMP
Comma shaped, oxidase +, Alkaline media ORAL REHYDRATION |
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What are the characteristic of Yersinia Enterocolitica
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pet feces transmission (puppies)
contaminated milk or pork Mesenteric Adenitis- can mimic Crohns disease or appendicitis (swollen abd LN) |
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What are the characteristic of H. Pylori?
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Comma shaped, gram -, oxidase +, UREASE +, catalase +
Creates alkaline envir in stomach Inc. risk Ulcers (esp. duodenal), adenocarcinoma stomach, and lymphoma (MALT) Triple Therapy: PPI + Clarithromycin+ amoxicillin or metro MAC attack the stomach |
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What are the characteristic of Leptospira interrogans?
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BLT (spirochetes)
Water contaminated with animal urine s/sx: flu like (fevers, malaise, chills), JAUNDICE, photophobia with conjunctiva suffusion (red w/o exudate) Surfers in Hawaii or tropics Like peeing in salt water (Red eyes from the salt and yellow skin from the pee) |
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What is Weils disease? What causes it?
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Leptospira Interrogans!
Icterohemorrhagic leptospirosis- severe Jaundice, azotemia from liver and kidney dysfunction; fever, hemorrhage, and anemia Really yellow skin, kidneys hurt because you peed so much, bleeding-> anemia |
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What are the characteristic of Borrelia Burgdorferi?
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Lyme disease- Ixodes tick (Babesia), reservoir is the mice
Visualize on Giemsa stain (Certain Bugs Really Try my Patience) BAKE a key Lime pie Bells Palsy (bilateral) Arthritis (mono large, then migratory and poly) Kardiac block (AV node) Erythema migrans Neurologic (Encephalopathy, polyneuropathy) tx: Doxycyclin, ceftriaxone The Doxy (dog) riding a cycle will juggling 3 axes, just to get a piece of Key Lime pie |
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What are the characteristic of Syphilis?
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Painless chancre
Dark field to visualize VDRL/RPR (Rapid plasma reagin- cardiolipin cholesterol, lecithin with aggregation is +), confirm with FTA-ABS 2= Systemic maculopapular rash (Palms and soles) Condyloma lata 3= Gummas (chronic granulomas) aortitis (vasa vasorum destruction)- Aortic regurg/root Dilation neurosyphilis (tabes dorsalis, general paresis) Agryl Robertson pupil (accommodates, not reacts) Broad based ataxia, + Romberg, Charcot joint, stroke w/o hypertension Tx: Penicillin G |
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What are the characteristic of Congenital syphilis?
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Saber shins, saddle nose, CN VIII deafness, Hutchinson teeth, mulberry molars,
Tx: treat mother early in pregnancy- transmission early 1st tri |
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How do you do a VDRL?
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nonspecific Abs to beef cardiolipin
FP= mono (EBV), hepatitis, SLE VDRL (Virusis, Drugs, Rheumatic fever, Lupus) |
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What is the Jarish-Herxheimer reaction?
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Flu like after Abx use- killing a lot of bacteria and releasing pyrogens
think of the jaraco missile from iron man- released a lot of bombs when it went off |
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What infection with a dog or cat bite?
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Pasteurella multicocida
cellulitis or osteomyelitis |
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What are the characteristic of Garnerella Vaginalis?
|
gram variable
rey vaginal discharge Fishy smell nonpainful (vs. vaginitis) Clue Cells- eli cells covered with bacteria Tx: metronidazole or clindamycin (anaerobes) |
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How do you treat the Ricketsial Diseases? What are they?
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Doxycicline (tetracyclin)
Ricketssia Ricketsii- tick Rickettsia typhi-endemic (fleas) r. prowazekii-epidemic (human body louse) Ehrlichiosis (Lone star tick) Anaplasmosis (Ixodes) Q fever (cow placenta spores) |
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What are the characteristic of Rocky Mountain spotted fever?
|
south atlantic (dumb name)
Rash WRISTS and ANKLES then spreads to trunk, palms, soles Obligate intracellular organisms (Stay inside when its Really Cold) need CoA and NAD+ (cannot make ATP) Triad: Headache, Fever, Rash (vasculitis) Remember Palms and Soles rashes: CARS (Coxscacki A, Rocky mountain, Syphilis) |
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What are the characteristic of Thyphus?
|
R. Typhi and R. prowazecki (epidemic)
rash CENTRALLY than spread out, sparing palms and soles Headache, fever, rash |
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What are the characteristic of Ehrlichiosis and Anaplasmosis
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Ehrlichiosis and Anaplasmosis= morulea (berry like inclusion) in monocytes and granulocytes, respectively
Vector is the tick |
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What are the characteristic of Q fever?
|
Cow placenta, spores, pneumonia, fever
|
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What are the characteristic of Chlamydia?
|
Intracellular (Stay inside when its Really Cold)
cannot make their own ATP EB form- infectious, enters cell RB form- replicates in cell C. Trachomatis: reactive arthritis (Reiter syndrome), follicular conjunctivitis, urethritis, PID C. pneumonia and C. psittaci (birds) atypical pneumonia transmitted by aerosol Tx: Azythromycin The CLAMS make macro cyclins (big pearls) Giemsa stain (Certain bugs really try my patients) Cell Wall lacks muramic acid |
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What are the characteristic of Chlamydias subtypes?
|
ABC: you can't see
causes blindness due to follicular conjunctivitis in africa D-K: my dick to your kilt Urethritis/PID (ectopic pregnancies), neontal pneumonia (staccato cough from mom), neonatal conjunctivitis (from mom during birth) L1,L2,L2: Lymphogranuloma venereum: small, painless ulcers on the genitals, swollen, painful inquinal lymph nodes that ulcerate (bubuoes) treat with doxycycline |
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Whats a good drug for intracellular infections?
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Doxycycline
|
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What are the characteristic of Mycoplasma Pneumoniae
|
Atypical Walking Pneumonia
(insidious onset, low fever, headache, nonproductive cough, patchy or diffuse interstitial infiltrate) Higher titer of Cold Agglutinins (IgM)- agglutinate or lyse RBCs Grow in Eaton Agar (contains cholesterol) tx: Macs and doxycycline, or fluoroquinolone Common pts<30, military recruited and prisons |
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What are the Atypical Pneumonias?
|
Legionella
Mycoplasma Chlamydia pneumoniae Tx: Macrolide's |
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What are the characteristic of Systemic Mycoses? What are they?
|
Cause Pneumonia and can disseminate, dimorphic (mold cold, yeast heat- except coccidioid is a spherule in tissue)
tx: Fluconazole or itraconazole for local Ampho B for systemic (which can mimic TB due to caseating granuloma formation) Granulomas can increase Ca due to act. of 1,25 hydroxy in act. macros No person to person transmission! |
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What are the systemic mycoses?
|
Histoplasmosis: Histo Hides
Hides within Macros, very small, red inclusions, bird droppings, spelunking, Midwest Blastomycosis: Broad bast buds, Bone East and Midwest Inflammatory lung disease and skin/bone; granulomatous nodules double reflective capsule, about the size RBC Coccidioidomycosis: Southwest, California, New Mexico Pneumonia, Meningitis, Bone, Skin spread Seen after Earthquakes from soil Spherule in body= filled with endospores* Skin lesions- erythema nodosum, arthralgias, fever Paracoccidioidomuycosis: Latin America Budding yeast with Captain Wheel, much larger than RBC Paracoccidio parasails with the captains wheel in latin america |
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What are the characteristic of the Cutaneous mycoses? What are they?
|
Tinea Versicolor: malassezia furfur (on the skin, furry)
makes acids from degrading lipids, damaging melanocytes and cause hypo/hyperpigmented patches Hot, humid weather Spaghetti and meatball appearance tx: topical miconazole, selenium sulfide |
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What are the characteristic of other Tineae?
|
Pedis, cruris, corporis (ringworm on the body) capitis, unquium
Pruritic lesions with central clearing resembling a ring, caused by dermatophytes (microsporum, trichophyton, epidermophyton) See mold hyphae on KOH prep, not dimorphic |
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What are the opportunistic fungi?
|
Candida, aspergillus, cryptococcus, Mucor/Rhizopus, pneumocystic jirovecii
|
|
What are the characteristic of Candida Albicans?
|
Dimorphic: Pseudohyphae (looks like mold, but new cells just fail to separate from previous cell) forms branches
Germ tubes at 37C Oral and esophageal thrush (compromised, neonates, steroids, diabetes, AIDS) vulvovaginitis (Diabetes, ABx)- curd, white discharge Diaper rash Endocarditis in HIV drug users Disseminated Chronic mucocutaneous candidiasis Tx: azoles for vagina fluconazol or caspofungin for oral/esophageal + amphotercin B for systemic |
|
What are the characteristic of Aspergillus?
|
Non Dimorphic: septate hyphae that branch at 45 degrees, conidiophore (dandelion like)
Invasive in compromised and those with CGD (CATALASE +, PLACESS) The A's of Aspergillus Acute angle branching- 45 degrees Allergic Bronchopulmonary aspergillosis Aspergillomas- lung cavities fungus ball Aflatoxin- liver HCC AIDS invase Air crescent sign on fungi balls Azole Allergic Bronchopulmonary aspergillosis- Asthma and cystic fibrosis- bronchiectasis and Eosinophilia (ABPA) tx: Azoles |
|
What are the characteristic of Cryptococcus neoformins?
|
Not dimorphic
Narrow Based Bud Heavily encapsulated Soil and PIGEON droppings India Ink and Mucicarmine stain capsule well Latex Agglutination test detect polysacc. capsule Ag Soap bubble lesions in the brain Cultures Sabouraud agar Cryptococcal meningitis (HIV) also Pneumonia Hematogenous spread |
|
What are the characteristic of Mucor and Rhizopus?
|
Wide Angle non-septate (no clear distinction between one cell and another- no lines) hyphae-irregular and broad (only a mold)
Diabetic Ketoacidosis or Leukemia Patients Fungi proliferate in blood when xs ketone and glucose penetrate cribiform plate, Rhinocerebral,frontal lobe abscess S'Sx: Headache, facial pain, black necrotic eschar on face, cranial nerve involvement tx: ampho B |
|
What are the characteristic of Pneumocystis jirovecci?
|
pneumocystis pneumonia (PCP)- diffuse interstitial pneumonia in AIDS (compromised)
Diffuse, bilateral infiltration on Lung (XRAY) Disc- shaped Yeast- inhaled. Methenamine Silver stain Tx: TMP-SMX propho pentamidine, dapsone (propho), atovaquone (propho) when CD4<200 |
|
What are the characteristic of Sporothrix schenkii?
|
Dimorphic
cigar shaped budding yeast lives in vegetation- rose gardeners disease local pustule or ulcer with nodules along draining lymphatics (ascending lymphangitis) Tx: AZole or POTassium iodide (A roZe in a POT) |
|
What are the characteristic of Giardia Lamblia?
|
Transmission: Cysts in Water
Disease: Bloating, Foul smelling, fatty diarrhea Dx: Trophozoites (pear shaped with 2 eyes) or cysts in stool Tx: Metronidazole Think Fatty Ghirardelli chocolates Campers and hikers drinking bad water, incr. risk in Gays, travelers, and compromised |
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What are the characteristic of Entamoeba histolytica?
|
Transmission: Cysts in Water
Disease: Dysentery, LIVER Abscess (anchovy paste exudate), RUQ pain. Flask shaped ulcer if submucosal abscess of colon ruptures Dx: Serology and/or Trophozoites (w/ RBCs in cytoplasm) or cysts with <4 nuclei in the stool) more round, larger, eat RBCs or have many nuclei in them tx: Metronidazole; iodoquinol for asympt cyst |
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What are the characteristic of Cryptosporidium?
|
Transmission: Oocysts in water
Dx: Oocyts on acid fast stain (pink, round) Disease: Severe diarrhea in AIDs, mild otherwise Tx: prevention (Filter water) nitazoxanide in incompetent host |
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What are the Protozoa infections of the GI tract? What do you see in the stool?
|
Giardia, Entamoeba, Cryptosporidium
Cysts and Oocysts (Acid fast for sporidium) Protozoa GET CraP |
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What are the CNS protozoa infection?
|
Toxoplasma, Naegleria Fowleri, Trypanosoma Brucei
TNT makes your CNS explode |
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What are the characteristic of Toxoplasma?
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Transmission: Cysts in meat, or Oocysts in cat feces
Brain Abscess in HIV- ring enhancing lesions on CT/MRI Dx: Serology or Biopsy (Tachyzoite a crescent shapped cells that is dark pink/blue) tx: Sulfadiazine and pyrimethamine S/Sx HIV: seizure, ring enhancing lesions, Headache |
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What is Congenital Toxo?
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Triad: Chorioretinitis, hydrocephalus, and intracranial calcifications
Vision issues, large head with inc. ICP, and calcifications oocysts can cross placenta and infect baby (avoid CAT poop) TORCHES infection C's Chorioretinitis hydroCephalus intracrantial Cacification |
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What are the characteristic of Naegleria Fowleri?
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Transmission: Swimming in fresh water lakes (Nalgene with fresh water in it)
Naegleria enter the cribiform plate= Rapidly fatal meningoencephalitis Dx: Amoebas in spinal fluid (round, pink with clear halo) Tx: Ampho B (most die) |
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What are the characteristic of Trypanosoma Brucei?
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Transmission: Tsetse fly, painful but
Disease: African sleeping sickness: Enlaged Lymph Nodes, recurring fever (antigenic variation), somnolence, coma Dx: blood smear (red, waxy looking protozoa) tx: Suramin (if in blood) Melarsoprol for CNS (it SURE is nice to sleep, MELAtonin helps) Take a tryp to africa to get knocked out by Bruce Lee and the tsetse |
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What are the Protozoa Hematologic Infections?
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Plasmodium (Malaria) and Babesia (Ixodes, like lyme disease!)
Giemsa stain for Plasmodium (Certain Bugs Really Try my Patience) |
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What are the characteristic of Plasmodium Vivax/Ovale?
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Fever, headache, anemia, splenomgaly
Fever- 48 hour cycle Dormant form- hypnozoite (hypnotized to sleep) only reticulocytes Transmission: Anopheles mosquito Dx: blood smear, trophozoite ring form within RBCs, schizont containing merozoites tx: chloroquine (blocks heme polymerase; if resistant use mefloquine/atovaquone/proquanil life threatening: quinidine (check for GSPD fist!) Primaquine for hypnozoite (G6PD first!) |
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What are the characteristic of Plasmodium Falciparum?
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Fever, headache, anemia, splenomegaly
severe, irregular fever patterns; parasitized RBCs occulde capilaries in brain (cerebral malaria) kidney and lungs reticulocytes and mature RBCs Transmission: Anopheles mosquite Dx: trophozoite ring form in RBCs Schizont containing merozoites tx: chloroquine, if resistant, use quinine/doxycycline |
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What are the characteristic of Plasmodium Malariae?
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Fever, headache, anemia, splenomegaly
72 hour fever cycle, infects only mature RBCs chloroquine, quinidine mefloquine or atovaquone/proguanil |
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What are the characteristic of Babesia?
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Fever and hemolytic anemia
Northeastern US Asplenics increased risk of sever disease Transmitted by Ixodes tick (lyme disease) and may co-infect Dx: blood smear, ring form or maltese cross, PCR Tx: Atovaquone + azythromycin a baby seal loves to catch the zzzz atop the quarry |
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What are the characteristic of Trypansoma cruz
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Trypansoma cruzi (CHAGAS)- chagas disease
Dilated cardiomyopathy, megacolon, megaesophogus (just a dilated GI tract and heart) South America Transmission: Reduviid bug (Kissing big) feces, deposited in a painless bite tx: Benznidazole or nifurtimox Take a cruz in my red benz, wear your nice fur tim |
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What are the characteristic of Leishmania Donovani?
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Visceral Leishmaniasis
Spiking fevers, hepatosplenomegaly, pancytopenia Transmission: Sandfly Dx: Macrophages contain amastigotes (several blue inclusions) Tx: Ampho B, Na Stibogluconate Leishmania is like the tasmanian devil, just ampho terrible and want him to stay bug! |
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What are the characteristic of Trichomonas Vaginalis?
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Vaginitis: Foul smelling, green discharge, ITCHING, BURNING
Sexually transmitted Dx: trophozoites (motile) on wet mount Strawberry cervix! tx: Metronidazole and propholax partner |
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What are the Nematodes (Round worm)
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Enterobius Vermicularis
Ascaris Lumbricoides Strongyloides Stercoralis Ancylostoma Duodenale, Necator americanus |
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What are the characteristic of Enterobius Vermicularis
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pinworm
Transmission: fecal-oral, often self Disease: Intestinal infection causing anal pruritis Dx: scotch tape test tx: Bendazoles oyr pyrantel pamoate Bendazoles because worms are bendy |
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What are the characteristic of Ascaris Lumbricoides
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Giant roundworm
Transmission: fecal oral, eggs visible in feces under microscope Disease: Intestinal infection Tx: Bendazole or pyrantel pamoate |
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What are the characteristic of Strongyloides Stercoralis
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Transmission: Larvae penetrate skin from soil
disease: intestinal infection causing Vomiting, Diarrhea, epigastric pain (may feel like a peptic ulcer). EOSINOPHILIA Tx: Ivermectin or albendazole Flariform larvae penetrate skin, blood, lungs, resp. tract, swallowed into stomach- mate and lay eggs in GI tract Diarrhea, gastroenteritis Strongy-loides= Stool Larvae (vs. Ancylostoma & nectar which eggs are in stool) |
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What are the characteristic of Ancylostoma Duodenale, Necator americanu?
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Hookworms
Transmission: Larvae penetrate skin Disease: intestinal infection causing anemia by sucking blood from GI tract Tx: Bendazoles or pyrantel pamoate Skin-blood-lungs (may cause pneumonia with eosinophilia)- GI tract where adult mature and attach to mucosa with teeth Diarrhea, anemia Eggs in stool |
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What are the characteristic of Onchocerca volvulus?
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Transmission: female blackly bite
Disase: hyper pigmented skin and river blindness (black flies, black skin nodules, black sight) Allergic reaction to microfilaria (move thru skin) possible Tx: Ivermectin (IVERmectin for rIVER blindness) Vulva is like a black hole |
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What are the characteristic of Loa Loa?
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Transmission: Deer fly, horse fly, mango fly
Disease: Swelling in skin, worm in conjunctiva Tx: diethylcarbamazine Angioedema of extremities, if in the eye, patients can sense it moving around dx: microfilariae in blood |
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What are the characteristic of Wuchereria Bancrofti?
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Transmission: Female MAsquito
Disease: Adult worm Blocks lymphatics: ELEPHANTIASIS takes 9mo-1yf to become symptomatic tx: Diethylcarbamazine |
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What are the characteristic of Toxocara canis?
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Transmission: fecal oral from frogs
Disease: Visceral larva migrans Tx: Albendazole or mebendazle Larvae hatch in GI and go to Liver, Lung, other places Eosinophilia, dry cough, fever, night sweats and a skin rash. Can also cause ocular issues |
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Nematode routes of infection
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Ingested- Enterobius, Ascaris, Toxocara (EAT)
Cutaneous- Strongyloides, Ancylostoma, Necator ( into feet from the SANd) Bites: Loa Loa, Onchocerca vulvulus, Wuchereria bancrofti (lay LOW to avoid being bitten) |
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What are the Tapeworms- Cestodes?
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Taenia Solium
Diphyllobothrium Latum Echinococcus granulosus |
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What are the characteristic of Taenia Solium
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Transmission: Ingested larvae encysted in undercooked pork or eating the eggs
Disease: (larvae ingesting cystercerci) Intestinal infection- abd pain, nausea, diarrhea and change in appetite Cysticercosis, neurocysticercosis- musclar pain and swelling, seizure, intracranial hypertension, psychiatric disturbances Adult worms secret proglottids into feces if you ingest the eggs, they hatch and spread to muscle, brain, and liver Dx: stool for eggs and proglottids tx: Praziquantel for intestinal Praziquantel and albendazole for neurocysticercosis |
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What are the characteristic of Diphyllobothrium Latum
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Transmission: Ingested larvae from raw freshwater fish
Disease: Vit. B12 deficiency and anemia Tx: Praziquantal |
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What are the characteristic of Echinococcus granulosus
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Transmission: Ingestion eggs from dog feces, sheep, cattle
Disease: Hydatid cysts in Liver Anaphalaxis if Ags are released during surgery (pre inject with ethanol to kill cysts) mass and eosinophilia eggshel calcifications on CT of liver Tx: Albendazole |
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What are the trematodes?
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Schistosome and Clonorchis sinensis
Eosinophilia, eggs in stool, travel history tx: praziquantel |
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What are the characteristic of Schistosoma?
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Trasmission: Snail is host, cercariae penetrate skin of humans
Disease: Liver and spleen granulomas, fibrosis, and inflammation Chronic: squamous cell carcinoma of the bladder (painless hematuria) tx: praziquantel Eosinophilia, portal hypertension |
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What are the characteristic of Clonorchis sinensis
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Liver Fluke
Transmission: undercooked Fish Disease: Biliary tract inflammation and pigmented gallstones (brown stones)-RUQ pain Associated with Cholangiocarcinoma tx: Praziquantel |
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Parasite hints
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Biliary tract disease, cholangiocarcinoma= Clonorchis sinensis
Brain cysts, seizures= Taenia solium (cysticercosis) Hematuria, bladder cancer (SCC)= schistosoma haematobium Liver (Hydatid cyst): echinococcus granulosus Microcytic Anemia= Ancylostoma, Necator Perianal Pruritus= enterobius Portal HTN= Schistosoma mansoni/japonicum Vit B12 def.= Diphyllobothrium Latum |