Micro-Bacterial/parasitic

Front 1

Bacteria tend to be _______ (like fungus) not systemic, like viruses

Back 1

localized

Front 2

G+ cocci, catalase +, Coagulase (-)

Back 2

Staph epidermidis

Front 3

G+ cocci, catalase +, Coagulase +

Back 3

S. Aureus

Front 4

G+ cocci, catalase (-) beta hemolyitic, Group A, Bacitracin sensitive.

Back 4

Strep Pyogenes

Front 5

G+ cocci, catalase (-) beta hemolyitic, Group B, CAMP/Hippurate sensitive

Back 5

Strep Agalactiae

Front 6

G+ cocci, catalase (-) alpha hemolyitic, Optochin/Bile sensitivity

Back 6

Step Pneumonia

Front 7

G+ cocci, catalase (-), gamma hemolyitic, Bile Esculin (+) grows with 6.5% NaCl

Back 7

Enterococcus

Front 8

Pt with eczema presents with a superficial epidermal vesicopustule that began shortly after a mild trauma to the area. The lesion progresses to form an erythromatous tender papule to a honey colored crusted scab
Dx?
Organism?

Back 8

Impetigo
Staphylococcus aureus and/or Group A Streptococcus (strep pyogenes)

Front 9

Previous case is cultured and grows G+ cocci in clusters, catalase +, coagulase +

Back 9

Staphylococcus aureus

Front 10

G+ cocci in pairs & chains, catalase (-), Bacitracin sensitive with M protein

Back 10

Group A Streptococcus (Strep Pyogenes)

Front 11

A deeper form of impetigo that extends into the dermis caused by group A beta-hemalytic streptococci (GABHS).

Back 11

Ecthyma

Front 12

Women presents with a small erythematous papules topped by a central pustule under her arm after shaving.
Dx –
Most common organism:

Back 12

Folliculitis - infection in the hair follicle
Staph aureus

Front 13

Woman with folliculitis doesn’t get it treated. Infection envelops the whole hair follicle and also adjacent subcutaneous tissue. A deep inflammatory nodule develops
Dx:
Most common organism:

Back 13

Furuncles (boils)
Staph aureus

Front 14

Woman with furuncles doesn’t get checked out and several furnucles develop close together and join. The infection extends further into subcutaneous fat areas
Dx:
Most common Organism:

Back 14

Carbuncles
Staph aureus

Front 15

pt with previous open wound developes an acute, severe, rapidly spreading infection of the skin and subcutaneous tissues. The infection spreads to the blood and pt develops fever w/ chills and sweats may be present.
Dx:
Most common organisms:

Back 15

Cellulitis
Streptococcus pyogenes or Staphylococcus aureus.

Front 16

Pt presents with fever and superficial cellulitis w/lymphatic involvement of the face (or lower extremities)
Dx:
Most common organism:

Back 16

Erysipelas
Streptococcus pyogenes.

Front 17

Swine farmer presents with a purpulish red non vesiculated inflammation sharply defined by a distinct but irregular raised border on the hands. A cx is done and grows a Gram positive, non-motile nonsporulating microaerophilic rod
DX:
Organism:

Back 17

Erysipiloid
Erysipelothrix rhusiopathiae.

Front 18

15 y/o boy develops small cysts form in the hair follicles due to blockage of the orifices by retention of sebum and keratinous material. Some cysts are white, some cysts are black
DX:
Organism:

Back 18

Acne vulgaris
Propionibacterium acnes (microaerophilica bacteria) or Malassezia furfur (Lipophilic yeast)

Front 19

Baby d/c from newborn nursery develops blisters. Cx shows baby is colonized with S. Aureus that produces an exfoliative toxin (ET).
DX:

Back 19

Bullous Impetigo

Front 20

Pt presents with generalized blistering. Blood culture shows Staph aureus. Staph Aureus is typed and found to be part of a phage group II type 71 strain that produces exfoliative toxin (ET).
DX:

Back 20

Staphyloccocal “Scalded Skin Syndrome” (SSSS)

Front 21

Pt leaves her tampon in too long and develops a rash that looks like scarlet fever and results in desquamation.
Dx:
Superantigen:

Back 21

Toxic Shock Syndrome
Staphylococcus aureus toxin (TSST-1)

Front 22

Pt presents w/ a pharyngeal infection which procedes to a cutaneous red rash followed by desquamation. Cx shows Streptococcus pyogenes & presence of streptococcal pyrogenic exotoxins (super antigens that activate T cells non specifically)
DX:

Back 22

Scarlet fever

Front 23

Pt presents with rash and severe itching. You note the presents of mites (anthropods) that mate and lay eggs in the skin.

Dx:
Bug:

Back 23

Scabies-
Sarcoptes scabiei

Front 24

13 y/o boy in Virginia presents with extremely pruritic erythematous papule. He has history of playing in grasses and shrubs.
Dx:

Back 24

Chigger mites (Trombiculidae)

Front 25

13 y/o girl reports itchy scalp. PE shows eggs (nits) cemented to hair. You also note presence of a hematophagous arthropod insect.

DX:

Back 25

Pediculous. humanus var. capitis is the (head louse)

Front 26

Pt reports intense itching in pubic region. PE shows eggs cemented to hair. You also note presence of a hematophagous arthropod insect with an appearance similar to a crab.

DX-

Back 26

Phthirus pubis- pubic or crab louse

Front 27

Pt reports waking up with bites. Labs show low hgb. You also note presence of a hematophagous arthropod insect.

•Dx-

Back 27

bed bugs,Cimex lectularius (temperate regions) & C. hemipterus (tropics)

Front 28

Pt presents with rash and severe itching. You note the presents of mites (anthropods) that mate and lay eggs in the skin.

Dx:
Bug:

Back 28

Scabies-
Sarcoptes scabiei

Front 29

13 y/o boy in Virginia presents with extremely pruritic erythematous papule. He has history of playing in grasses and shrubs.
Dx:

Back 29

Chigger mites (Trombiculidae)

Front 30

13 y/o girl reports itchy scalp. PE shows eggs (nits) cemented to hair. You also note presence of a hematophagous arthropod insect.

DX:

Back 30

Pediculous. humanus var. capitis is the (head louse)

Front 31

Pt reports intense itching in pubic region. PE shows eggs cemented to hair. You also note presence of a hematophagous arthropod insect with an appearance similar to a crab.

DX-

Back 31

Phthirus pubis- pubic or crab louse

Front 32

Pt reports waking up with bites. Labs show low hgb. You also note presence of a hematophagous arthropod insect.

•Dx-

Back 32

bed bugs
Cimex lectularius (temperate regions) & C. hemipterus (tropics)

Front 33

Bullous Impetigo is a dz that causes the skin to slough off, it is caused by this organism.

Back 33

Staph. aureus

Front 34

What is the sloughing off of the skin in Bullous Impetigo due to. Infectious organism? Inflammation?

Back 34

NO. It is due to an EXFOLIATIVE TOXIN that is produced by S. aureus

Front 35

The E.T. of S. aureus acts as a serine protease that can cleave human _______, an adhesion molecule in the skin. This causes a blister to be formed and allows bacteria to spread under the skin. Blisters occur at the site of infection of S. aureus. Between 10-30% of people in the population are colonized with S. aureus on their skin. These people have a propensity to get this type of disease

Back 35

desmoglein 1

Front 36

Strains of S. aureus can be typed based on their susceptibility to different bacteriophages. The S. aureus phage type that causes Bullous Impetigo is often group II phage type ____. So, if you plate S. aureus and it is susceptible to this phage type , you know that this bacterium has a propensity to cause this disease.

Back 36

71

Front 37

_________ involves the same type of exfoliative toxin and the same phage type of Staph aureus as bullous impetigo. However, this dzs toxin is not elaborated only at the site of infection; it also enters the systemic circulation. In bullous impetigo, on the other hand, the toxin’s effects are only at the site of infection.

Back 37

Scalded skin syndrome

Front 38

The mechanism that causes toxic shock syndrome is quite different from the mechanism that causes scalded skin syndrome. TST is caused by ____________ which is a super antigen that can over activate T-cell receptors. Over activation of T-cells leads to overproduction of a homing chemical that targets these activated T-cells to the skin. This results in inflammation and desquamation of the skin. This is the dermal manifestation of this disease. S.S.S., on the other hand, is caused by an ________ that has nothing to do with the super activation of T-cells.

Back 38

Staphylococcal toxic shock syndrome toxin (TSST-1)
exfoliative toxin

Front 39

Toxic shock syndrome is mostly caused by ____ and less commonly by Strep. It is mediated by super antigens. Scarlet fever is mostly caused by ____ and less commonly by Staph. It is also mediated by super antigens.

Back 39

Staph
Strep