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;
70 Cards in this Set
- Front
- Back
|
Lyme Disease Manifestations (mnemonic) and treatement
|
BAKE a key Lyme pie (stages not in order)
Bilateral Bell's Palsy [stage 2] Arthritis (chronic monoarthritis or chronic migrating polyarthritis) [stage 3] Kardiac block [stage 2] Erythema migrans [stage 1] Doxycycline (early); ceftriaxone (late) |
|
|
Syphilis screen
|
VDRL (venereal disease research laboratory)
tests for antibodies reactive to beef cardiolipin nonspecific. also positive due to Viruses Drugs Rheumatic fever Lupus and Leprosy also Treponema Pertinue, causative of Yaws |
|
|
Rash on Palms and soles
Distinguish two Rickettsial Rashes name two diseases with PEELING of palms and soles vescicular rash on palms and soles |
Drive CARS with palms and soles
Coxsackie A RMSF (endemic to EAST coast) Syphilis Rickettsia on wRistsv, Typhus on the Trunk Acrodynia (Hg poisoning) Kawasaki Disease Coxsackie A virus (also presents with oral ulcers) hand-foot-mouth disease |
|
|
E. Coli virulence factors
E. Coli exotoxins |
fimbriae- cystitis and pyelonephritis
K capsule- pneumonia and neonatal meningitis LPS endotoxin- septic shock dysentery: EIEC- enteroinvasive (shiga toxin without HUS) diarrhea: ETEC- ADP ribo, increased cAMP cholera toxin solo diarrhea in kids: EPEC- no toxin HUS: EHEC- hemorrhagic, endothelial damage, narrowed renal vascular lumen, RBC are damaged, platelets consumed laboratory: DOES NOT FERMENT SORBITOL |
|
|
Klebsiella
|
Currant Jelly Sputum in pneumonia, also nosocomial UTI
Rapid lactose fermenter (mcconKEE's) 4A's Aspiration Pneumonia diAbeetus Alcoholic Abcess in lung |
|
|
IS LPS capable of preventing penicillin and vancomycin entry?
|
first aid page 150 says so, in the case of gram negative bacilli
|
|
|
Rifampin is sufficient prophylaxis in what?
Rifampin causes rapid development of resistance if used as a monotherapy in what? What are the side effects and mechanism of Rifampin? mnemonic |
prophylaxis in close contacts of H. Flu and N. Mening infected patients
4 R's RNA polymerase inhibitor Revs up Cyp450 Red/orange body fluids Rapid resistance if monotherapy in TB & leprosy |
|
|
Dapsone mechanism
Dapsone toxicities |
inhibition of bacterial DHF synthesis. Competes w/ PABA for enzyme binding (similar to SMX sulfonamides)
hemolysis and methemoglobinemia |
|
|
Pseudomonas lab diagnosis
toxin |
oxidase positive lactose non-fermenter
toxin A (inactivates EF-2) |
|
|
Listeria Monocytogenes
vs. Shigella |
Actin rockets, "tumbling motility"
Actin polymerization |
|
|
Salmonella
vs. Shigella |
Lactose non-fermenters.
both cause dysentery Salmonella have flagella (salmon swim) Shigella move cell-to-cell by actin polymerization |
|
|
Spirochetes
|
(Big) BLT ?
Borellia Bergdorferi (Big, light microscope with analine dyes (wright or giemsa) Leptospira Interrogans ? Treponema Pallidum (dark field microscopy) |
|
|
2 Infectious agents associatied with animal urine
|
Leptospiral interrogans (a spirochete)
causes jaundice, photophobia & conjunctivitis. Surfers in the tropics. may also cause icterohemorrhagic leptospirosis, as severe form of with jaundice and azotemia. fever, hemorrhage, anemia. Hantavirus |
|
|
Zoonontics
|
Borrelia b. - ixodes deer & mice
Borrelia recurrentis. - louse (variable surface antigen) louis Pasteurella m. - cellulitis, osteomyelitis; animal bites Bartonella h. - cat scratch (mistaken for kaposi's, lymphocytic vs. neutrophilic inflammation on biopsy) BrUcella - UNdulant fever UNpasteurized milk Fracisella t. - tick, rabbits & deer Yersinia p. - plague; flea bite, rodents, prarie dogs |
|
|
Clue cells
|
I don't have a Clue why I smell fish in the vagina garden. (nonpainful, not necessarily an STD, though associated w/sex)
Gardenerella Vaginalis, Mobiluncus (anaerobe) is also involved. Clue cells, epithelial cells covered with bacteria. |
|
|
Spore formers
|
Baccilus gm+
Clostridium gm + coxiella burnetti rickettsial (obligate intracellular, w/ aerosol spores that cause q fever) |
|
|
Rickettsia
|
Causing headache, fever, rash:
Rickettsia rickettsii Rickettsia typhi Rickettsia Prowazekii Ehrlichia Causes Pneumonia Coxiella Burnetii Weil-Felix: mix serum with Proteus antigen, antibodies agglutinate (except Coxiella Burnetii) Tx all with doxycycline |
|
|
Coxiella Burnetii
|
Is Q(ueer)
causes Q fever negative weil-felix is a spore-former (spores in tick poop and cow placenta) No arthropod vector Rickettsia is not in the genus name |
|
|
Obligate intracellular
|
Rickettsia (need CoA and NAD+)
Chlamydia (need ATP) (chlamys=cloak) |
|
|
bugs with inclusion bodies
|
HSV cowdry a
CMV owl eyes VZV cowdry a Rabies negri bodies polio cowdry b adeno cowdry b Chlamydia |
|
|
Chlamydia species-specific infections
Trachomatis Serovar specific-infections Chlamydia is resistant to what typical antibiotic and why? |
Trachomatis: urethritis, PID, conjunctivitis, reactive arthritis (aka Reiter's, HLA-B27 seronegative arthritis). BUT SOMETIMES ASYMPTOMATIC/UNDIAGNOSED
Pneumoniae and Psittaci: atypical pneumonia ABC: African/Blindness/Chronic infection L1-L3: lymphogranuloma venerium (can be confused with granuloma inguinale (donovanosis from klebsiella granulomatis), anal cancer from HPV, ulcerative colitis or crohn's) D-K dick or all other sympotoms. Giemsa stain (like trypanosoma) differentially stains bacterial cells pink, human cells blue Resistant to penicillin due to lack of muramic acid in cell wall. Treat with docycycline or azithromycin (protein synth inhibitors) |
|
|
Reactive arthritis
|
GI infections: Salmonella, Shigella, Campylobacter
STI: chlamydia, gonorrhoea |
|
|
Atypical Pneumonia
|
Mycoplasma
Legionella Chlamydia Obligate or facultative intracellular bugs |
|
|
Mycoplasma Pneumoniae
|
no cell wall (peptidoglycan layer); penicillin resistant
cholesterol in cell membrane use tetracyclines or erythromycin (a variation on the tetracycline, macrolide theme) Cold agglutinins (IgM) |
|
|
Cold agglutinin disease
|
Agglutination or cell lysis? distinct?
Primary (idiopathic) or secondary autoimmune hemolytic disease Secondary: Adults: lymphoma, CLL Children: mycoplasma, Mononucleosis, HIV IgM Mexico is cold |
|
|
Actinomyces and Nocardia
|
Actinomyces is normal flora, can cause disease in immunocompetent hosts. Yellow sulfur granules.
Nocardia is not normal flora, immunocompromised hosts are particularly at risk. Acid fast, frequently mistaken for TB. Treatment is a snap: Sulfa for Nocardia Actinomyces gets Penicillin |
|
|
Histoplasmosis
|
Histo hides in macrophages
|
|
|
Superficieal mycoses
tinea or pityriasis versicolor tinea nigra |
malasezzia furfur
looks like spaghetti and meatballs on KOH prep exophiala wernieckii dark spots on palms and soles tx: topical imidazoles or selenium sulfide in dandruff shampoo |
|
|
Cryptococcus
|
Encapsulated. visualize halo with INDIA ink
Pigeon droppings, causes meningioencephalitis (may also cause sx of dimorphics). 3/4 cases in AIDS. (Histo is bird and bat, and causes pneumonia) |
|
|
cutaneous mycoses (hair, skin, and nails)
|
Microsporum
trichophyton epidermophyton candida albicans |
|
|
subcutaneous mycoses
|
sporothrix schenckii
sporotrichosis: ulcerated lesion spreads along lymph tract Tx: azoles, potassium iodide for potting roses phialophora & cladosporium chromoblastomycosis, cauliflower lesions |
|
|
Dimorphic fungi
|
Coccidiodes (big problem for AIDS in the SW)
Histoplasma Blastomyces Asymptomatic to mild pneumonia Rarely, can cause disseminated disease: meningitis, bone lytic granulomas, skin granulomas, mimicking TB Histo and Coccidio are sometimes mild, but all Blasto infections require aggressive treatment with Amphotericin B or intraconazole. |
|
|
Candida in competent vs. compromised
|
thrush (distinguish from EBV leukoplakia), yeast infection, diaper rash
esophagitis, bloodstream invasion (normal flora elsewhere, but never in blood) Dimorphic also, germ tube forms at 37deg |
|
|
Aspergillus
|
1. ABPA: Allergic bronchopulmonary aspergillosis
type 1 w/IgE, eosinophilia (asthma) or type 4 (cell-mediated w/ lung infiltrates) 2. aspergilloma requires surgery 3. invasive disease in post-chemo, high-dose steroids, NADPH oxidase (CGD), AIDS; very poor prognosis aflatoxins cause liver damage and cancer. Acute angles vs. 90 deg angles in mucor and rhizopus |
|
|
Rhizopus and Mucor
|
diabetus
penetrate cribriform plate. |
|
|
Pneumocystis
|
Diffuse CXR bilateral
methenamine silver stain prophylactic TMP SMX at <200 CD4 |
|
|
Trichomonas
|
vaginitis. ITCHY and Smelly (vs. gardenerella, just smelly).
greenish discharge. motile trophozooites on wet mount. GET GAP (gardnerella also) |
|
|
Babesia
|
Northeast from Ixodes tick (like Borellia of Lyme)
maltese cross and ring forms in RBC Tx: quinine, clinda |
|
|
Plasmodium which hemolytic diseases select for which organisms?
vivax/ovale falciparum malariae |
Anopheles mosquito
vivax/ovale has dormant hypnozoites that chill in the liver, must add primaquine to treat. every other day cycle falciparum has a daily cycle. more severe. |
|
|
leschmania donovani
|
leishmaniasis: cutaneous or visceral
hepatosplenomegaly (classically a very big spleen) tx: antimony or sodium stibogluconate (Sb=antimony) |
|
|
Trypanosoma Brucei
|
african sleeping sickness from tsetse fly (PAINFUL BITE)
antigenic variation causes recurring fever, Tx: Suramine, Melarsoprol MELAtonin SURE would be nice to let me sleep with all these bugs painfully biting me in my sleep |
|
|
Trypanosoma Cruzi
|
Chagas; painless bite from reduviid
megaesophagus, megacolon, megaheart (dilated cardiomyopathy) Tx: nifurtimox |
|
|
Cryptosporidium
|
severe diarrhea in AIDS patients, milder diarrhea in non-aids
acid-fast cysts in stool |
|
|
anal pruritus
|
enterobius vermicularis
pinworm |
|
|
worms with lung cycles FINISH THIS CARD
|
ASCARIS
|
|
|
Picornaviruses
|
Perch on a peak (pico)
Polio Echo Rhino Coxsackie HepA Cause viral meningitis (not Rhino or HepA), especially Coxsackie |
|
|
Congenital CMV
|
#1 congenital infection causing malformations, (a common infection)
asymptomatic or mono-like in mother Chorioretinitis Ventricular Calcifications hydrocephalus (like toxo) PLUS HEARING LOSS |
|
|
Congenital Toxoplasmosis
|
Asymptomatic or lymphadenopathy in mother
Chrioretinitis Hydrocephalus Ventricular calcifications |
|
|
Congenital Rubella
|
a Toga virus
Symptomatic mother: rash, lymphadenopathy, arthritis vaccine Heart disease (pulm stenosis and PDA) Deafness Cataracts +/- bluberry muffin rash |
|
|
Congenital HSV
|
1 lesion absoute contraindication to vaginal delivery
temporal encephalitis herpetic lesions |
|
|
congenital syphilis
|
stillbirth
hydrops fetalis notched teeth, saddle nose, short maxilla, saber shins |
|
|
congenital HIV
|
not TORCH, strictly speaking, doesn't cause malformations
tx with HAART or zidovudine or deliver by c-section |
|
|
Hemophilus Ducreyi
|
Chancroid
painful, do cry |
|
|
heart defect in infat of diabetic mother
|
Transposition
|
|
|
heart defect in 22q11 syndromes
|
truncus arteriosus, tetralogy of fallot
think thymus, truncus |
|
|
Down's
|
endocardial cushion, ASD, VSD
|
|
|
Congenital rubella
|
PDA, septal defects, pulmonary stenosis
|
|
|
Monckeberg
|
medial calcification, often of radial or ulnar arteries, benign but visible on x-ray
|
|
|
cystic medial necrosis
|
cause of aortic dissection
marfan's, ehlers-danlos, hypertension |
|
|
aortic aneurysm
|
hypertension, syphilis
|
|
|
Myocardium changes 0-4 h
|
no changes
|
|
|
myocardium changes 4-12 hours
|
early coagulative necrosis
|
|
|
myocardium changes 12-24 hours
|
contraction bands
beginning of neutrophil immigration |
|
|
myocardium changes 2-4 days
|
hyperemia and acute inflammation in tissue surrounding infarction
neutrophils have invaded extensive necrosis Risk of arrhythmia |
|
|
myocardium changes 5-10 days
|
maximally yellow and soft due to macrophage degradation of structural components.
Risk of wall rupture |
|
|
7 weeks post-mi
|
ventricular aneurysm, lined by scar tissue
|
|
|
MI markers
|
Troponin is top. Most specific. elevated at 4hrs, for 7-10 days
CK-MB is less specific, but is gone in 2-3 days, so is good for diagnosis of Reinfarction (MB- MI Bonus) ST elevation or pathologic Q waves: Transmural infarct ST depression: subendocardial infarct <50% of wall, less well-perfused |
|
|
Q-waves
|
electrical hole post-MI, a sign of previous myocardial infarction seen in transmural infarct
|
|
|
ST-elevation
|
systolic current from living tissue to dead tissue in transmural infarction. Registers as an ST elevation.
ST elevation in All Leads is Pericarditis. |
|
|
ST-depression
|
systolic current from epicardium to endocardium. Away from body surface = ST depression
|
