Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
262 Cards in this Set
- Front
- Back
|
most common cause of pneumonia and bronchiolitis in infants
|
Respiratory syncytial virus
|
|
|
antigen shift requires a new egg based vaccine
|
influenza
|
|
|
most common cause of viral meningitis, myocarditis, and pericarditis
|
Coxsackievirus
|
|
|
most common viral cause of gastroenteritis in adults
|
Norwalk virus
|
|
|
acid labile virus transported by fingers to the eyes and nose
|
Rhinovirus
|
|
|
virus destroying anterior horn cells leading to paralysis in an elderly man who recently visited his young great grandchild
|
poliovirus
|
|
|
virus causing acute hemorrhagic conjuctivitis
|
enterovirus
|
|
|
virus causing inspiratory stridor in 5 month old infant with an anterior x-ray of the neck showing a steeple sign.
|
Parainfluenza
|
|
|
Virus associated with acute appendicitis, giant cell pneumonia, and slow virus disease causing demyelination
|
Rubeola
|
|
|
Virus transmitted by animal bite and aerosolization that causes hydrophobia and encephalitis
|
Rabies virus
|
|
|
Virus transmitted by mouse urine or feces to man who has ARDS and renal failure. He lives on Navajo reservation in Northern Arizona.
|
Hantavirus
|
|
|
Virus transmitted by mouse urine or feces that produces severe meningitis and encephalitis
|
lymphocytic choriomeningitis virus
|
|
|
virus that produces severe encephalitis that is transmitted by mosquitos. The reservoir of the virus is wild birds. Humans and horses are dead end host.
|
Eastern equine encephalitis virus
|
|
|
Virus transmitted by mosquitos that produces encephalitis. Reservoir is crows and other birds. Disease began in New York and has now spread to the west
|
West Nile Virus
|
|
|
Most common cause of gastroenteritis in children, particularly during the winter months. Virus produces a secretory diarrhea often requiring glucose-containing hypotonic salt solution replacement
|
Rotavirus
|
|
|
Most common acquired immunodeficiency syndrome.
Virus is cytolytic to CD4 T-cells |
HIV
|
|
|
Teratogenic virus that produces sensorineural hearing loss in neonates and rash with painful postauricular lymphadenopathy in children and adults
|
Rubella virus
|
|
|
Retrovirus that produces T-cell leukemia and lymphoma
|
HTLV
|
|
|
Virus transmitted from infected patient secretions that produces a hemorrhagic fever in Africa.
|
Ebola virus
|
|
|
DNA virus associated with heterophile antibodies against horse RBCs. Produces atypical lymphocytosis, nasopharyngeal carcinoma, and malignant lymphoma involving the CNS and lymph nodes
|
EBV
|
|
|
Virus associated with parotitis, pancreatitis, orchitis, and a self-limited meningoencephalitis
|
Mumps virus
|
|
|
Virus associated with recurrent infections on the lips, conjunctivitis, and hemorrhagic necrosis of the temporal lobes
|
HSV-1
|
|
|
Virus transmitted by a mosquito bite that was a common cause of hemorrhagic fever in Vietnam
|
Dengue virus
|
|
|
Virus transmitted by the bite of a tick that produces biphasic fever, rash, and encephalitis.
|
Colorado tick fever virus
|
|
|
Virus transmitted by a mosquito that produces midzonal liver cell necrosis often leading to fulminant hepatic failure
|
yellow fever virus
|
|
|
Virus associated with recurrent vesicular lesions in the anogenital region, meningitis, and congenital infections in neonates
|
HSV-2
|
|
|
What is the primary reservoir cell for HIV in the CNS?
|
microglial cell: these cells are the macrophages of the CNS and used to a circulating monocyte, which carry the virus into the CNS
|
|
|
an HIV positive patient with fever, night sweats, cough, dyspnea with exertion, a CD4 T-helper cell count of 350 cells/mm, and a cavitary apical lung disease most likely has an infection due to:
|
Mycobacterium tuberculosis
|
|
|
The most common fungal infection and cause of odynophagia in an HIV positive patient is:
|
candidiasis
- Candidia is the MC fungal infection in HIV |
|
|
The most common systemic fungus infecting the CNS in patients with AIDS is:
|
Cryptococus
|
|
|
A patient with AIDS has protracted watery diarrhea. A stool sample reveals oocysts that are acid-fast. The most-likely diagnosis is:
|
Cryptosporidosis
- sprozoan: Isospora belli is also a sporozoan that produces AIDS diarrhea and also has partially acid fast oocysts |
|
|
A white plaque like lesion on the lateral aspect of the tongue that doesn't scrape off in an HIV + patient with a CD4 T cell count of 350 cells/mm is most likely caused by....
|
EBV: it is not premalignant and is not AIDS-defining
|
|
|
A patient with AIDS has cotton wool exudates in the retina, watery diarrhea, biliary tract disease, and odynophagia. The most likely pathogen is:
|
CMV
- ganciclovir is the Rx of choice. - use Foscarnet if this doesn't work |
|
|
A beefy red, exquisitely painful perirectal ulcer with vesicles involving hte gluteal folds in an HIV + patient is most likely due to
|
Herpes simplex
in these locations it is not AIDS-defining |
|
|
what opportunistic infections are most likely to appear in the early manifestation of AIDS?
|
Shingles due to Herpes zoster
Hairy leukoplakia due to EBV Oral candidiasis |
|
|
A patient with AIDS has raised, painful erythematous lesions that blanch with pressure. A biopsy reveals an inflammatory type of vasculitis. A silver stain reveals organisms in the endothelial cells. The patient most likely has:
|
bacillary angiomatosis: due to Bartonella hensalae.
It simulates Kaposi's sarcoma |
|
|
the rapidly increasing incidence of primary central nervous system malignant lymphoma in the US parallels the rapidly increasing incidence of:
|
HIV
- HIV in concert with EBV cause primary CNS lymphoma |
|
|
An anorectal biopsy in a 35 year old homosexual revelas infiltrating squamous cell carcinoma. This is most likely secondary to:
|
HPV proctitis: due to unprotected anal intercourse
|
|
|
What body fluids have the greatest risk factor for transmitting HIV?
|
Colostrum
next to blood breast milk has the greatest viral burden. Breast feeding is contraindicated - urine, tears, saliva all carry the virus |
|
|
the major mode of transmission of HIV in developing countries is
|
heterosexual vaginal intercourse: greatest risk is male to female.
Receptive intercourse between man is the MC mechanism in the US |
|
|
During the asymptomatic latent clinical phase of HIV infections, the virus is primarily trapped in:
|
lymph nodes by follicular dendritic cells
reservoirs of the virus during the stage |
|
|
In HIV + patients, autoimmune disease is most commonly manifested by:
|
thrombocytopenia
it is the MC hematological manifestation of AIDS type II HSR IgG antibodies directed against GpIIb:IIIa fibrinogen receptor |
|
|
Hypergammaglobulinemia in AIDS patient is most often secondary to:
|
polyclonal stimulation of B cells by EBV
|
|
|
Which of the following test is used to initially screen blood for HIV?
|
ELISA test for gp-120 antibody
- the p24 capture assay to detect p24 antigen is positive when the patient initially contracts HIV and when they develop an AIDS defining lesion |
|
|
Which of the following test is used to confirm a positive or indefinite ELISA for HIV?
|
Western blot assay
- it requires the presence of antibodies against p24, gp41 and either gp120 or gp160 hence it has greater specificity |
|
|
what test is usually positive when the patient first contracts HIV and when the patient develops an AIDS defining lesion?
|
p24 capture assay
- it detects the p24 antigen and is positive when the patient is initially contracts HIV and when they develop an AIDS defining lesion. It is negative during the early symptomatic phase |
|
|
What test provide the best overall information concerning the viral burden in a patient with AIDS?
|
HIV RNA by PCR
|
|
|
List some AIDS defining lesions
|
Pneumocystis jiroveci pneumonia
Systemic candidiasis Kaposi's sarcoma |
|
|
what is the most common mode of transmission of HIV in a medical personnel?
|
needle stick exposure from an HIV + patient
1/300 chance of becoming HIV + Must go on triple therapy for 6 months |
|
|
What is the most common mode of transmission of HIV in the USA at the present time?
|
receptive anal intercourse between males
|
|
|
what is the most common method of transmitting HIV to a fetus?
|
Transplacental vertical transmission with vertical transmission by breast feeding a close second
|
|
|
a 23 year old pregnant woman is found to be positive for HIV antibody. What would you do for treatment of her and prevention of transmission to the baby?
|
Newborn will have a positive ELISA test: anti-gp120 is an IgG antibody
Mother should be treated with zidovudine (AZT) which reduces the risk of the baby becoming HIV + to < 10% |
|
|
What would you expect in lab findings in a patient that has AIDS?
|
anergy to cutaneous skin testing with Candida
Decreased CD4 T- helper cells count Mitogen blastogenesis of T-cells should be abnormal Immunoglobulin G levels are increased due to EBV polyclonal stimulation Lymph nodes will not show caseating granulomas because helper T-cells are required for granuloma formation |
|
|
The median time for primary HIV Infection to development of AIDS is approximately
|
10 years
this is why the prevalence of HIV has increased in the US. the longer the duration of a disease the greater the prevalence |
|
|
the most common cause of space occupying lesion in the CNS in AIDS that presents with focal seizure activity is:
|
Toxoplasmosis
|
|
|
The treatment for the most common initial AIDS-defining illness is:
|
TMP/SMX: pneumocystis is the MC initial AIDS defining illness
|
|
|
the most common cause of recurrent pneumonia in patient with AIDS is
|
Streptococcus pneumonia
|
|
|
The most common cause of fever, night sweats, and weight loss in patients with AIDS, who has helper T-cell count < 50 cells/mm is?
|
disseminated Mycobacterium avium intracellulare
note the decreased helper T-cell count |
|
|
What complications in AIDS is directly due to the HIV virus?
|
Dementia
Wasting syndrome |
|
|
Provide an accurate description of HIV.
|
gp120 antigen attaches to CD4 on the helper T-cell
p24 antigen peaks at two separate times during the infection reverse transciptase converts genome RNA into double stranded DNA |
|
|
what does the env gene code for in AIDS?
|
encodes gp120/gp41
|
|
|
what does the pol gene encode in AIDS?
|
reverse transcriptase and integrase
|
|
|
what does the gag gene encode?
|
p24 antigen
|
|
|
what group of immunizations can be given to a patient with AIDS?
|
killed polio vaccine
hepatitis B vaccine MMR Hemophilus influenzae type b Pneumovax/influenza DPT |
|
|
Virus that produces congenital infection, atypical lymphocytosis, infections transmitted by blood transfusions, and disseminated disease in AIDS. It produces hypertrophied cells with basophilic intranuclear inclusions
|
CMV
|
|
|
Pathogen that is transmitted sexually and produces PID and non-specific urethritis
|
Ureaplasma urealyticum
|
|
|
Childhood viral infection associated with high fevers often precipitating febrile convulsions.
When fever breaks, a rash occurs |
HHV-6: Roseola
|
|
|
Most common viral cause of hemorrhagic cystitis
|
adenovirus
|
|
|
intraleukocytic pathogen that is transmitted by a tick that produces a disease resembling Rocky Mountain Spotted fever except for absence of rash
|
Ehrlichia chaffeenisis
|
|
|
Viral gene products inactivate TP53 and RB Suppressor genes. Associated with lesions in the anogenital region that are either benigh or malignant
|
HPV
|
|
|
Virus that produces a slow virus type of encephalitis that is commonly seen in AIDS patients
|
JC virus
- progressive multifocal leukoencephalopathy |
|
|
Virus that is latent in sensory ganglia that produces painful vesicular rashes that follow a sensory dermatome. Like HSV-1 and -2, the Tzank prep is positive.
|
Varicella zoster virus
-shingles |
|
|
Pathogen associated with an atypical pneumonia and coronary artery disease
|
Chlamydia pneumonia
|
|
|
Pathogen transmitted by a tick that produces vasculitis producing lesions that begin on the palm and extend to the trunk
|
Rickettsia rickettsiae
|
|
|
Virus that produces multiple, raised umbilicated lesions with a central crater containing granular material that can produce other skin lesions.
|
Molluscum contagiosum virus
|
|
|
Virus associated with macules, papules, vesicles, and pustules that are at different stages of development. Associated with Reye's syndrome. Influenza virus can also be associated with Reye syndrome.
|
Varicella virus
|
|
|
Virus now eradicated by immunization that produces pustular lesions that are at the same stage of development. May be used for biological warfare.
|
Smallpox
|
|
|
Spongiform encephalopathy leading to dementia
|
Creutzfeldt-Jakob disease
caused by infectious particles lacking DNA and RNA (called prions) |
|
|
Pathogen that produces atypical pneumonia in areas with crowded conditions and is associated with cold agglutinins and bullous myringitis
|
Mycoplasma pneumoniae
|
|
|
pathogen not transmitted by a vector that produces atypical pneumonia and granulomatous hepatitis
It commonly occurs in veterinarians, those in contact with farm yard manure, and those working in slaughterhouses |
Coxiella burnetii (Q fever)
|
|
|
Pathogen with elementary bodies within metaplastic squamous cells. Associated with STD and blindnes
|
Chlamydia trachomatis
|
|
|
Virus associated with a "slapped face" appearance, aplastic anemia, anemia, arthritis, and spontaneous abortions.
|
Parvovirus
|
|
|
Pathogen that produces zoonosis in those who own pet stores that sale parrots and parakeets
|
Chlamydia psittaci
|
|
|
Serology of a patient with HBV who is non-infective and in the serologic gap.
|
Positive Anti-HBc-IgM
|
|
|
Serology of patient who has recovered from Hepatitis B
|
Positive Anti-HBc-IgG
Positive Anti-HBs |
|
|
Serology of patient who has been vaccinated against HBV
|
Positive Anti-HBs
|
|
|
Serology of patient who is symptomatic acute HBV
|
positive HBsAg
positive HBeAg/HBV DNA positive Anti-HBc-IgM |
|
|
Serology of patient with infective chronic HBV
|
+ HBsAg
+ HBeAg/HBV DNA + Anti-HBc-IgG |
|
|
Serology of patient who is a "healthy carrier" for hepatitis B
|
+ HBsAg
+ Anti-HBc-IgG |
|
|
Type of hepatitis with no protective antibodies
|
HCV
HDV presence of IgG antibodies indicates that they have an active infection |
|
|
Types of hepatitis with no chronic state
|
HAV
HEV |
|
|
Most common type of hepatitis found in daycares
|
HAV
reason why all day care children are vaccinated against HAV |
|
|
Most common types of hepatitis leading the hepatocellular carinoma
|
HBV
HCV |
|
|
Most common type of hepatitis associated with polyarteritis nodosa
|
HBV
produces vasculitis |
|
|
most common hepatitis in travelers to places outside the US
|
HAV
|
|
|
Most common hepatitis in jails and corrective institutes
|
HAV
|
|
|
Most common sexually transmitted types of hepatitis
|
HAV
HBV HCV |
|
|
Most common cause of posttransfusion hepatitis and chronic hepatitis
|
HCV
also MC hepatitis without jaundice |
|
|
MC type of hepatitis prevented by immunization with hepatitis B vaccine
|
HBV
HDV also prevents HCC from HBV postnecrotic cirrhosis |
|
|
MC type of hepatitis transmitted parenterally
|
Hepatitis B, C, D
|
|
|
Most common type(s) of hepatitis with protective antibodies
|
HAV
HBV HEV |
|
|
Most common hepatitis producing fulminant hepatitis in patients with pre-existing hepatitis
|
HDV
|
|
|
Most common type(s) of hepatitis transmitted by the fecal-oral route
|
Hepatitis A and E
|
|
|
Most common type of hepatitis in homosexuals
|
HAV
unprotected anal intercourse virus in feces |
|
|
Most common type(s) of hepatitis with chronic hepatitis
|
HBV
HCV (most common) HDV |
|
|
Most common type of hepatitis associated with cryoglubulins, type I membranoproliferative glomerulonephritis, and porphyria cutanea tarda.
|
hepatitis C
|
|
|
Hepatitis associated with glomerulonephritis and polyarteritis nodosa
|
HBV
|
|
|
Most common type of hepatitis transmitted by accidental needle stick
|
HBV
also underscores why HBV is the MC systemic disease in IVDA. HBV is also the most common viral hepatitis |
|
|
most common cause of nonsocomial septiciemia, UTIs, spontaneous perotinitis in ascites in adults, traverlers diarrhea, and hemolytic uremic syndrome
|
E.coli
|
|
|
MCC of toxic shock syndrome in menstruating women, wound abscesses, osteomyolitis, impetigo, and acute bacterial endocarditis in IVDA
|
Staphylococcus aureus
|
|
|
Pathogen that produces a rash in fish handlers
|
Erysipelothrix rhusiopathiae
|
|
|
Pathogen responsible for poisoning producing paralysis of young children who eat honey
|
Clostridium botulinum
- infant botulism: toxin develops after colonization of bowel |
|
|
Farmer and his wife are brought to the ER with paralysis and mydriasis
|
Clostridium botulinus
- adult botulism, preformed toxin that blocks release of Ach, improperly sterilized bottled goods |
|
|
MCC of spontaneous peritonitis in ascites in children with nephrotic syndrome, otitis media, sinusitis, community acquired typical pneumonia, sepsis in sickle cell disease, and meningitis in patients over 18 years old.
|
Streptococcus pneumonia
|
|
|
MCC of rheumatic fever and glomerulonephritis
|
Streptoccous pyogenes: rheumatic fever is a type II and IV HSR and post-streptococcal glomerulonephritis is a type III HSR
|
|
|
Patient with colon cancer due to UC develops acute endocarditis
|
Streptococcus bovis
|
|
|
Infant whose umbilical cord has not yet fallen off develops opisthotonus
|
Clostridium tetani
|
|
|
sexually active 23 year old woman develops dysuria. Urine culture grows out a coagulase negative organism
|
Staphylococcus saprophyticus
|
|
|
65 year old woman with a recent total hip replacement develops acute endocarditis
|
Staphylococcus epidermidis
|
|
|
24 year old man develops gastroenteritis after eating refried beans. Gram positive rods are present in stool
|
Bacillus cereus
|
|
|
35 year old woman with a history of congenital heart disease develops fever and pansystolic murmur at apex that does not increase in intensity with deep help inspiration shortly after a root canal
|
Streptococcus viridans
|
|
|
24 yr old woman with a history of PID complains of RUQ pain when she twists her torso doing aerobics. A laprascope reveals adhesions between the liver capsule and peritoneum
|
Neisseria gonorrhoeae
- Fitz-Hughs-Curtis syndrome |
|
|
65 year old type 2 diabetic with sever peripheral vascular disease develops an infection of the big toe. The toe is gangrenous and has a foul smelling exudate and crepitance in teh underlying SQ tissue
|
Clostridium perfringens
|
|
|
a 32 year old heroin addict is unable to open his jaw and has painful muscle contractions.
|
Clostridium tetani
- neurotoxin inhibits glycine |
|
|
62 year old woman with scurvy had numerous dental caries
|
Streptococcus mutans
|
|
|
a 14 year old boy develops fever, petechia, and nuchal rigidity. He later develops septic shock and bleeding from all orifices. Autopsy reveals bilateral hemorrhage of adrenal glands.
|
Neisseria meningitidis
- Waterhouse-Friderichsen syndrome with DIC |
|
|
A pregnant woman, who eats goat cheese for lunch, delivers a baby with sepsis and meningitis
|
Listeria monocytogenes
|
|
|
A pregnant woman with premature rupture of membranes has a newborn who develops sepsis and meningitis
|
Streptococcus agalactiae
|
|
|
a 70 year old woman develops diarrhea while in the hospital with pneumonia. A proctoscope reveals a yellow pseudomembrane in the rectum
|
Clostridium difficile
|
|
|
An unimmunized child develops dysphonia and painful cervical lymphadenopathy
Oral exam reveals a shaggy gray membrane in the posterior pharynx |
Corynebacterium diptheriae
|
|
|
a 62 year old man with COPD develops fever and a cough productive of greenish yellow sputum. A gram stain reveals gram negative diplococci
|
Moraxella catarrhalis
|
|
|
a 22 year old man has severe cystic acne
|
Propionibacterium acnes
|
|
|
a 45 year old woman develops a draining sinus tract in the jaw 6 weeks following removal of an abscessed tooth on the same side. Yellow granules are present in the draining exudate
|
Actinomyces israeli
also commonly infects IUDs |
|
|
a 45 year old man who works in the post office, opens a letter that has a white powder in it. He develops a lung condition and dies
|
Bacillus antrhacis
|
|
|
A 2 year old child in a day care center develops fever and bloody diarrhea. The fecal smear for leukocytes is positive. The organism is gram negative and dose not ferment lactose
|
Shigella sonnei
|
|
|
A 49 year old man who is post heart transplant, develops severe pneumonia. A gram stain of the sputum reveals a gram positive filamentous bacteria that is partially acid fast
|
Nocardia asteroides
|
|
|
a 23 year old woman complains of foul smelling vaginal discharge after sexual intercourse
Vaginal pH is 5.5 A cervical pap smear reveals organisms adhering to superficial squamous cells |
Gardnerella vaginalis
-bacterial vaginosis - clue cells |
|
|
a 30 year old man with a pet iguana develops severe enterocolitis with a positive fecal smear for leukocytes
|
Salmonella enteritidis
- Iguanas are reservoirs for Salmonella |
|
|
a 48 year old woman has an alkaline urine that smells like ammonia
an ultrasound reveals a large calculus in the renal pelvis of the right kidney |
Proteus mirabilis
- magnesium ammonia phosphate or struvite stone, urease producers |
|
|
a febrile 22 year old man with sickle cell disease develops lytic lesions in the right femur
|
Salmonella paratyphi
- osteomyelitis |
|
|
an 82 year old man in a nursing home develops fever and a cough productive of thick, bloody, mucoid sputum. A chest x-ray reveals right lower lobe lobar pneumonia.
|
Klebsiella pneumonia
- MC typical pneumonia in nursing home residents -common in alcoholics, but S. pneumonia is still the MC typical pneumonia |
|
|
a 28 year old man develops a severe, secretory type of diarrhea shortly after eating oysters in New Orleans. Physical exam reveals gram negative comma shaped organisms in his stool.
|
Vibrio cholera
or Vibrio parahaemolyticus |
|
|
a veterinarian develops a cellulitis of the right index finger after being bitten by a cat
|
Pasteurella multocida
|
|
|
a 30 year old woman develops a high fever, abdominal pain, and bloody diarrhea after eating improperly cooked chicken. the fecal smear for leukocytes is positive and s-shaped negative bacteria are noted in the stool.
|
Campylobacter jejuni
|
|
|
a febrile 5 year old child complains of severe abdominal pain. Laparotomy reveals a normal vermiform appendix but enlarged mesenteric lymph nodes. Frozen sections reveals granulomatous microabscessses without caseation
|
Yersinia entercolitica
- mesenteric adenitis stimulating acute appendicitis |
|
|
a patient with AIDS develops pneumonia with a cough productive of a red-pigmented sputum
|
Serratia marcescens
produces red pigment |
|
|
A 48 year old smoker who works in the grocery produce section, develops a high fever, cough with bloody sputum, and muscle aches and pains. A silver stain of sputum reveals organisms
|
Legionella pneumophila
- mist can transmit organism |
|
|
a 28 year old man with AIDS develops red, non-pruritic lesions. A biopsy reveals vessel inflammation and small organisms that are visible with a silver stain
|
Bartonella henselae
|
|
|
a 42 year old alcoholic with cirrhosis develops a skin and soft tissue infection. He normally shucks oysters for a living in a restaurant in New Orleans.
|
Vibrio vulnificus
|
|
|
a 2 year old child who has not been immunized properly, has had rhinorrhea and a conjunctivitis for the last week ad now has developed a cough at the end of expiration followed by an inspiratory whoop.. His WBC is 40,000 cells/mm with predominately mature lymphocytes
|
Bordetella pertussis
- whooping cough with absolute lymphocytosis |
|
|
a physician in Iraq has a patient with fever, diarrhea, splenomegaly, sinus bradycardia, and absolute neutropenia
|
Salmonella typhi
|
|
|
pathogens that cause pneumonia in ICUS, death in burn patients, malignant external otitis in diabetics, death in CF patients, and osteomyolytis in puncture wounds through rubber foot wear.
|
Pseudomonas aeruginosa
|
|
|
pathogen that causes peptic ulcer disease, gastric adenocarcinoma, and malignant lymphoma
|
Helicobacter pylori
|
|
|
A rabbit hunter develops ulceration of papular lesions on the forearm and painful axillary lymphadenopathy. He recalls picking off a tick in the area of the skin lesion
|
Francisella tularensis
|
|
|
a mammalogist studying prairie dogs in Arizona develops painful, enlarged draining inguinal lymph nodes. He recalls being bitten by fleas when examining dead prairie dogs.
|
Yersinia pestis
|
|
|
a 4 year old child develops pink eye. A gram stain of watery exudate reveals a small gram negative coccobacillary organism
|
Haemophilus aegyptius
|
|
|
a 3 year old child who has not be properly immunized develops fever and nuchal rigidity. A spinal tap reveals increased protein, neutrophils, and decreased glucose. A gram stain reveals small gram negative coccobacillary organisms.
|
Haemophilus influenzae
|
|
|
a 48 year old man who works in the Grand Canyon as a mule handler for trips into the canyon develops ulcerative lesions on the skin of his forearm along with painful regional lymphadenopathy. A biopsy of the lesion reveals granulomatous inflammation
|
Burkholderia mallei
|
|
|
a 24 year old man develops painful ulcer on his penis and painful inguinal lymph nodes. A gram stain of the ulcer reveals gram negative rods oriented to the same direction like a "school of fish"
|
Haemophilus ducreyi
|
|
|
a sheepherder develops high fever, generalized lymphadenopathy, and hepatosplenomegaly. He later develops osteomyolitis
|
Brucella melitensis
|
|
|
a man from New Guinea develops genital ulceration without lymphadenopathy. A Giemsa stain of a biopsy of the lesion shows a granulomatous reaction with macrophages containing phagocytosed organisms.
|
Calymmatobacterium granulomatis
- granuloma inguinale, note the absence of lymphadenopathy, macrophage with organisms called Donovan bodies |
|
|
a 48 year old smoker who works in a grocery produce section develops a high fever, cough with bloody sputum, and muscle aches and pains. A silver stain of sputum reveals organisms.
|
Legionella pneumophila
- mist can transmit the organism |
|
|
a 28 year old man with AIDS develops red, non-pruritic lesions. A biopsy reveals vessel inflammation and small organisms that are visible with a silver stain.
|
Bartonella henselae
- also causes cat scratch fever |
|
|
A 42 year old alcoholic with cirrhosis develops a skin and soft tissue infection. He normally shucks oysters for a living in New Orleans.
|
Vibrio vulnificus
|
|
|
A 2 year old child who has not been immunized properly, has had rhinorrhea and a conjuctivitis for the last week and now has developed a cough at the end of expiration followed by an inspiratory whoop. His WBC count shows 40,000 cells/mm with predominately mature lymphocytes
|
Bordetella pertussis
- whooping cough with absolute lymphocytosis |
|
|
A physician in Iraq has a patient with fever, diarrhea, splenomegaly, sinus bradycardia, and absolute neutropenia
|
Salmonella typhi
|
|
|
Pathogen that causes pneumonia in ICUs, death in burn patients, malignant external otitis in diabetics, death in CF, osteomyelytis in puncture wounds through rubber footwear.
|
Pseudomonas aeruginosa
|
|
|
Pathogen that causes peptic ulcer disease, gastric adenocarcinoma, and malignant lymphoma
|
H. pylori
|
|
|
A rabbit hunter develops ulceration of papular lesion on the forearm and painful axillary lymphadenopathy
He recalls picking a tick off in the area of the lesion |
Francisella tularensis
|
|
|
a mammalogist studying prairie dogs in Arizona develops painful, enlarged draining inguinal lymph nodes. He recalls being bitten by fleas when examining dead prairie dogs.
|
Yersinia pestis
|
|
|
a 4 year old child develops pink eye. A gram stain of the watery exudate reveals small gram negative coccobacillary organisms
|
Haemophilus aegyptius
|
|
|
a 3 year old child who has not been properly immunized develops fever and nuchal rigidity. A spinal tap reveals increased protein, neutrophils, and decreased glucose. A gram stain reveals small gram negative coccobacillary organisms
|
Haemophilus influenzae
|
|
|
a 48 year old man who works in the grand canyon as a mule handler for trips into the canyon develop ulcerative lesions on the skin of his forearm along the painful regional lymphadenopathy. A biopsy of the lesion reveals granulomatous inflammation
|
Burkholderia mallei
- patient has glanders |
|
|
a 24 year old man develops painful ulcer on his penis and painful inguinal lymph nodes. A gram stain of the ulcer reveals gram negative rods oriented in the same direction like a school of fish.
|
Haemophilus ducreyi
-chancroid |
|
|
A sheepherder develops high fever, generalized lymphadenopathy, and hepatosplenomegaly. He later develops osteomyolitis
|
Brucella melitensis
|
|
|
A man from New Guinea develops genital ulceration without lymphadenopathy. A Giemsa stain of a biopsy of the lesion shows a granulomatous reaction with macrophages containing phagocytosed organisms.
|
Calymmatobacterium granulomatis
|
|
|
Street person with punched out erosions of interdental papillae covered by gray necrotic pseudomembrane
|
Fusobacterium
- trench mouth |
|
|
Anaerobe involved in subdiaphragmatic abscess
|
Bacteroides fragilies
|
|
|
Anaerobes involved in lung abscesses due to aspiration of oropharyngeal material
|
Prevotella melanogenicus
S. Fusobacterium |
|
|
Pathogen involved in hand infection in patient recovering from a fist fight
|
Eikenella corrodens
|
|
|
a 25 year old woman with a maculopapular, erythematous rash on the palms and soles develops fever and intensification of the rash after being treated with penicilin
|
Treponema pallidum
- secondary syphilis - Jarisch Herxheimer reaction |
|
|
non-spirochetal pathogen responsible for rat bite fever in slum areas
|
Streptobacillus moniliformis
|
|
|
a 52 year old man with decreased vibratory sensation, ataxic gait, absent DTRs in the lower extremities, pupils that accomodate but does not react to direct light, and a positive VDRL in the CSF
|
Treponema pallidum
- tabes dorsalis with Argyll-Robertson pupil |
|
|
Teenager with blindness, peg teeth, mulberry molars, saddle nose deformity, rhagades
|
Treponema pallidum
- congenital syphilis - blindness due to interstitial keratitis |
|
|
Farm boy with fever, jaundice, conjunctivitis, and dark field positive tightly coiled spirochetes in the urine. The boy commonly swims in ponds
|
Leptospira interrogans
- Weil's disease |
|
|
a Patient with reactivation TB develops small bowel obstruction. A barium study reveals narrowing of the lumen in the terminal ilium
|
Mycobacterium tuberculosis
- intestinal TB from swallowing organisms |
|
|
Atypical Mycobacteria that requires light for growing in culture. It produces lung disease similar to M. tubercuolosis
|
M. kansasii
|
|
|
surgical removal of enlarged lymph nodes in a child reveals granulomatous inflammation of acid fast bacilli
|
Mycobacterium scofulaceum
|
|
|
a patient with a prosthetic hip joint develops acid fast disease
|
M. fortitum-chelonei
|
|
|
patient in long island with a h/o tick bite develops erythematous concentric appearing rash in the area of the tick bite. The patient also has a hemolytic anemia with intraerythrocytic organisms noted in the peripheral smear
|
Borrelia burgdorferi
- Lyme disease with erythema chronicum migrans and hemolytic anemia due to BAbesia |
|
|
Patient in Colorado with a h/o tick bite develops high fever with periods of relapse, an erythematous rash, and hepatosplenomegaly. Spirochetal organism are present in the peripheral blood smear
|
Borrelia recurrentis
- relapsing fever develops new antigens |
|
|
patient in Texas has multiple hypopigmented macular skin lesions. He has a positive lepromin skin test.
|
Mycobacterium leprae: tuberculoid
- intact cellular immunity - granulomas present - no organisms - autoamputation of digits |
|
|
patient from India has nodular lesions on the face. Lepromin skin test is negative. Skin biopsy reveals a Grenz zone underlying which are foamy macrophages with acid fast organisms. During treatment she develops erythmea nodosum and is placed on thalidomide
|
Mycobacterium leprae: lepromatous
- deficient cellular immunity - no granulomas - numerous organisms - erythema nodosum leprosum during dapsone Rx |
|
|
patient with AIDS develops malabsorption
Small bowel biopsy reveals foamy macrophages in lamina propria that has acid fast bacilli |
Mycobacterium avium intracellulare
- MAI produces Whipple's like syndrome - CD4 count < 100 |
|
|
Farmer who drinks unpasteurized milk develops small bowel obstruction. A barium study reveals a string sign in the terminal ilium
|
Mycobacterium bovis
|
|
|
A man who works in a pet store in the fish department develops rash on his hands. Culture reveals acid fast organisms that grow best in light.
|
Mycobacterium marinum
|
|
|
A sexually active woman has flat, raised lesions in the anogenital region. A few weeks ago, she had a PAINLESS ulcer on the labia majora. An RPR test is initially reported as negative but becomes positive after multiple dilutions of the serum
|
Treponema pallidum
- secondary syphilis with condyloma lata - prozone phenomenon-antibody excess |
|
|
Spelunker in Ohio develops a solitary coin lesion in the right upper lobe
|
Histoplasma capsulatum
-bat/chicken excreta, macrophages phagocytose yeast forms |
|
|
Chicken farmer in Arkansas has multiple calcifications in the lungs and spleen
|
Histoplasma capsulatum
- chicken excreta - marked dystrophic calcification |
|
|
Anthropologist studying Native American artifacts in Sonoran desert develops a painful nodule on the shins
|
Coccidioides immititis
- erythema nodosum association - arthropsores in dust |
|
|
Pulmonary infections after earthquake in Southern California
|
Coccidioides immitis
-arthrospores in the dust |
|
|
Bridge painter in New York city develops a lung infection
|
Cryptococcus neoformans
- pigeon excreta |
|
|
Patient with AIDS develops meningitis
Positive India ink prep in CSF |
Cryptococcus neoformans
|
|
|
Wildlife manager in Great Lakes area who occasionally traps beavers develops a verrucoid appearing skin lesion and lung disease
|
Blastomyces dermatitidis
beavers are reservoirs for Giardia too |
|
|
Bronchial asthma, fungus ball, hemorrhagic infarctions in lungs
|
Aspirgillus fumigatus
|
|
|
Diabetic recovering from ketoacidosis develops frontal lobe abscess
|
Mucor species
- rhinocerebral mucormycosis |
|
|
Wood's light positive circular erythematous lesion with clear center on the skin
|
Trichophyton rubrum
- tinea corporis |
|
|
Skin hypopigmentation
scaly dermatitis of the scalp |
Malassezia furfur
- tinea versicolor, seborrheic dermatitis, spaghetti and meatballs KOH prep |
|
|
Woods light positive area of alopecia with block dots
|
Microsporum canis
- tinea capitis infection of the outer hair shaft |
|
|
Woods light negative area of alopecia with black dots
|
Trichophyton tonsurans
- tinea capitis - infection of inner hair shaft |
|
|
Lobster fisherman, forester planting pine seedlings, elderly woman who is a rose gardener develops an area of ulceration on the hands and lymphocutaneous nodules
|
Sporothrix schenckii
- sporotrichosis - the fist 2 due to sphagnum moss |
|
|
Alopecia with crusting of the scalp
|
Trichophyton schoeneleinii
- tinea captiis, favus |
|
|
patient living in swamps in southern Georgia develops a lesion in the foot characterized by subcutaneous swelling and multiple draining sinuses with granules. the patient walks barefoot most of the time.
|
Pseudallescheria/Nocardia asteroides (mycetoma)
|
|
|
Carpenter develops a raised, verrucoid lesion. Biopsy reveals a granulomatous reaction and brown staining organisms.
|
Phialophora
Cladosporium (chromomycosis, splinters, dematiaceous fungi) |
|
|
Infant with fiery red rash and white exudate in gluteal folds
|
Candida albicans
- yeast and pseudohyphae |
|
|
HIV positive patient with oral thrush and hairy leukoplakia develops fever, dyspnea, tachypnea, and lung consolidation in both lungs. CD4 T-cell count is 200
|
Pneumocystis jiroveci
|
|
|
patient from south America develops lung disease. Biopsy reveals yeast in multiple buds resembling a ships wheel.
|
Paracoccidioides braziliensis
- south american blastomycosis |
|
|
AIDS diarrhea with acid-fast occysts.
|
Cryptosporidium parvum, Cayetanensis
Isospora belli |
|
|
AIDS diarrhea with spores in stool
|
Microsporidia species
|
|
|
Newborn infection with calcification of basal ganglia and blindness in woman who breeds cats.
Space occupying lesion in the brain in a patient with AIDS |
Toxoplasma gondii
|
|
|
patient returning from Mexico develops blood diarrhea
Trophozoites with erythrophagocytosis noted in stools |
Entamoeba histolytica
- flask shaped ulcers in cecum, liver abscesses |
|
|
Soft lens wearer who does a lot of fresh water skiing develops meningoencephalitis and severe keratitis
|
Acanthamoeba castellanii
- Nagleria fowleri also causes meningoencephalitis |
|
|
hemolytic anemia associated with tick bite
|
Babesia mcroti
carried by Ioxides tick |
|
|
Malaria associated with fever every 72 hours and diffuse membranous glomerulopathy
|
Plasmodium malarieae
|
|
|
Malaria not contracted by blacks who are Duffy antigen negative
|
Plasmodium vivax
- tertian fever patter: every 48 hours |
|
|
Malaria associated with multiple ring form infestation and banana shaped gametocytes
|
plasmodium falciporum
- quotidian fever pattern severe disease often involving CNS |
|
|
Blood sporozoans transmitted by bite of female Anopheles mosquito
|
Plasmodium vivax
Plasmodium malarieae Plasmodium falciparum |
|
|
Ciliate producing colonic ulcer and blood diarrhea
|
Balantidium coli
- largest cysts and trophozoites in stool |
|
|
Hemoflagellate with only trypanosomes that produce an encephalitis leading to sleeping and eventual starvation. Transmitted by the tstse fly.
|
Trypanosoma gambiense
African sleeping sickness, increased IgM, antigen variation, winterbottom's sign |
|
|
Pathogen associated with chronic heart failure, acquired achalasi and Hirschsprung's disease. Trypanosomes in blood and amastigotes in tissue. Xenodiagnosis is frequently used.
|
Trypansomoa cruzi
American trypanosomiasis, reduviid bug used to make Dx, Romana's sign in area of bite on face called chagoma |
|
|
Woman with severe cervicitis and vaginitis
frothy green exudate male partner with urethritis |
Trichomonas vaginalis
|
|
|
Chronic diarrhea with malabsorption in a patient with IgA deficiency
Positive string test and urine antigen test |
Giardia lamblia
contaminates water supply and mountain streams beaver is a reservoir |
|
|
Transmitted by sandfly and produces massive hepatosplenomegaly
macrophages phagocytose leishmanial forms |
Leishmania donovani
- visceral leishmaniasis Kala azar only leishmanial forms in tissue |
|
|
transmitted by sandfly and produces cutaneous and mucocutaneous disease that offers immunity with recovery
|
Leishmania tropical/braziliensis
|
|
|
Invasive helminth that has larval phase in the lungs and is often disseminated in AIDS patients and a common cause of autoinfection and superinfection. Filariform larae in soil. No eggs in stool.
|
Strongyloides stercoralis
- intestinal nematode |
|
|
Produces eosinophilia in its transmigration through the lungs and bowel obstruction in its adult form.
|
Ascaris lumbricoides
intestinal nematode |
|
|
Invasive helminth that is associated with rectal prolapse in children
|
Trichuris trichiura
intestinal nematode |
|
|
Invasive helminth with larval phase in the lung that is associated with iron deficiency
|
Necator americanus
intestinal nematode |
|
|
Associated with eating sushi and sashimi
|
Anisakis simplex
intestinal nematode rx is surgical excision |
|
|
Invasive helminth where the adult can be the definitive host in one manifestation of the disease and intermediate host in another manisfestation of the disease associated with focal epileptic seizures
|
Taenia solium
-cestode - human who eats infected pork with larvae develops adults in the intestine (definitive host) - human who ingests eggs develops cysticeri (larvae) that produce retinitis and CNS cysts (man is intermediate host) |
|
|
Invasive helminth associated with vitamin B12 deficiency that cannot be corrected with intrinsic factor, pancreatic enzymes, or antibiotics
|
Diphyllobothrium latum
-cestode -fish tape worm |
|
|
Non-invasive helminth associated with pruritus ani, appendicitis, urethrititis in little girls
|
Enterobius vermicularis
- intestinal nematode - MC helminth in US - scotch tape test for embryonated eggs |
|
|
Basque sheepherder has cystic lesion in the liver
|
Echinococcus granulosis
- cestode, hydatid cysts - dog is definitive host - man is intermediate host |
|
|
Pig farmer develops muscle pain
Exam reveals splinter hemorrhage in nails and pain in deltoid muscle. Radiograph reveals numerous areas of dystrophic calcification in muscle |
Trichinella spiralis
- trichinosis - intestinal nematode - eating improperly cooked pork - larvae encysts in striated muscle |
|
|
Adult with 3 dogs and 20 cats has pronounced eosinophilia
PE reveals hepatosplenomegaly |
Toxocara canis/cati
- intestinal nematode, visceral larva migrans - man is dead end host for larvae |
|
|
Child who commonly plays in an uncovered sandbox, develops pruritic skin lesions with tunnels in subcutaneous tissue
|
Ancyclostoma species
- intestinal nematode - cutaneous larva migrans - man dead end host |
|
|
A cattle farmer has proglottidis in his stool
|
Taenia saginata
-cestode - beef tapeworm |
|
|
pathogen transmitted by a mosquito that produces lymphedema
Microfilaria are present in the blood at night |
Wucheria bancrofti
tissue nematode elephantiasis |
|
|
Most common tapeworn infection in the US
|
Hymenolepsis nana
|
|
|
Spider with painful bite that causes severe thigh and abdominal muscle cramps and hypertensive crisis
|
Latrodectus mactans
- black widow - neurotoxin of black widow - red hour glass on ventral surface |
|
|
spider that commonly bites at night and produces necrotic skin ulcers
|
Loxosceles recluses
- necrotoxin of brown recluse spider |
|
|
pathogen produces pipe stem cirrhosis leading to portal HTN, ascites, and esophageal varices. Eggs have prominent lateral spines
|
Schistosoma mansoni
- trematode - adults lay eggs in portal vein |
|
|
Pathogen causes squamous cell carcinoma of bladder. Egg has nipple at the end.
|
Schistosoma hematobium
- adults lay eggs in urinary venous plexus |
|
|
Clonorhcis sinensis
|
Chinese liver fluke
the only other parasite that produces cancer cholangiocarcinoma second intermediate host is transmitted by eating fish paste |
|
|
Hiker in the Sonoran desert feels sharp pain in his foot when he puts his hiking boots on. His big toe initially hurts and then becomes numb as well as the rest of hist leg. Another hiker calls in for help. In the ER the patient develops HTN, and is beginning to exhibit signs of paralysis. Later he develops pancreatitis
|
Centruroides gertschi
scorpion presence with HTN is very characteristic pancreatitis is another characteristic finding |
|
|
A patient develops pruritic erythematous rash while at a picnic
patient notices red organisms on his skin |
chiggers (mite)
|
|
|
a patient develops a pruritic erythematous rash in the web spaces of his right hand. A burrow is noted in the spaces
|
Sarcoptes scabies
human itch mite spares the palms and soles of adults children do not develop intertriginous lesions but lesions on the palms and soles |
|
|
a second year medical student recognizes a moving organism in the pubic hair in a man he is checking for hernia
|
Phthirus pubis (crabs)
|
|
|
a second year medical student notices white eggs attached to hairs in a child he is examining
|
Pedicularis humanis capitis
- head lice - eggs called nits |
|
|
A second year medical student notices moving organisms in the underwear of a patient he is examining
|
Pedicularis humanis corporis
- body lice 0 adults live in clothes and do not attach to skin Rx not for patient but for clothes with malathion or DDT |
|
|
a plumber crawling under the house develops numerous painful bites that quickly develop a wheal and flare followed by vesiculations and skin necorisis
|
fire ants
|
|
|
a patient from China who sells herbs and other produce develops a severe lower respiratory tract infection that spreads systemically. Other members of the family develop the same infection
|
palm civet
the patient has SARS which is first transmitted to humans via handling of palm civets. The disease then spreads to other family members through human to human contact. The diagnosis is made by viral detection by PCR or detection of antibodies |
