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51 Cards in this Set
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- Back
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exudative tonsillitis
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virus mostly; culture is necessary to differentiate bacterial versus viral infection
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hair leukoplaskia
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EBV virus; glossitis assoc w/ bl white exrescences on lat border o tongue; PRE-AIDS-defining lesion ~200-300 CD4 T cells; **nonsmoker nondrinker w/ HIV +
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Herpes labialis
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HSV type 1, virus; recurrent vesicular lesions on lips (vurs can remain dormant in cranial sensory ganglia); react by stress, sunlight, menses;
Tx: oral acyclovir, valacyclovir, faciclovir, topical acyclovir, penciclovir; can be on mouth and gneital and can be systemic w/ fever, painful LAD if it is recurrent it is w/o fever TZANK prep |
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mumps
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paramyovirus; bl parotitis (70%) w/ inc serum amylas
comlications: meningencephalitis, unilateral orchitis or oophoritis, pancreatitis |
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herpangina
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coxsackievirus in children; multiple vescicles or ulcrs on soft palate and parynx surrounded yb erythema
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hand-foot-mouth disease
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coxsackievirus; in young children; vesicles on mouth and distal extremitites
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cervicofacial actinomycosis
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bact; actinomyces iscrealii; draining sinus tract form facial or cervical area; "sulfur granules" YELLOW in pus; gram + branching filamentous bact; anaerobe
starts after extraction of abscessed tooth Tx: ampicillin, penicillin G |
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diphtheria
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cornebacterium dipheriae; toxin produces "shaggy" gray pseudomembrane in post pharynx and upper airways
Tx: erythromycin |
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pertonsillar abcess
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streptococcus pyogenes; bacteria; uvula dev to contralat side "ho potato" voice; fou-smelling breath; complication tonsillitis
Tx: surgical drainage of pus; penicillin G/V add clindamycin for serious invascive infections |
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ludwig's angina
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aerobic/anaerobic streptococcus, eikenella corrodens; cellutis involving at the submaxillary and sublingual space; follows fascial plances and may spread into parynx, carotid sheath, superior mediastinum
form dental extraciton (MC) trauma to floor of mouth Tx: surgical drainage; clindamycin +metronidazole |
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pharyngitis
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S. pyrogenes; assoc w/ tonsillitis; potential for acute rhematic fever and glomerulonephritis
Tx: penicillin V |
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scarlet fever
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S. pyogenes; pharyngitis, tonsililitis, glossitis
erythrogenic toxin produces rash on skin and tongue (fist white and then srawberry colored); inc risk for glomerulonephritis nephritogenic strains pose no risk for acute rhematic fever Tx: penicillin G/V |
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silaadenitis
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staphylococcus aureus; bact inflammation of major salviary gland; secondary to calculus which obstructs the duct in postop pts
Tx: oxacillin, nafcillin if methicillin susceptible; TMP/SMX if community-acquired methicillin resistant; vancomycin i methicillin resistant in hosp |
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congenital syphilis
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treponema pallidum (spirochete); abnormalities involving incisors (notched and tapered like a peg) and molar teeth resembler mulberries
Tx: aquerous crystlline penicilin G saddle nose; teeth is patheneumonic |
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oral thrust
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candida albicans (pseudohyphae yeast)
may occur in neonates, immunocompromised ptss (common in pre-AIDS defining lesion), DM, and following Ab therapy Tx: fluconazole, itraconazole KOH yeasst test not normal in adults |
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cytomegalovirus
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CC of diarrhea in AIDS when CD4 Th <50-100
Tx: ganciclovir MCC of biliary tract disease and pacreatitis |
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norwalk virus
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MCC of audlt gastroenteritis, N/V diarrhea tha tresolves in 12-24 hrs; occationally fatal; F/O transmission
cruise ships Tx: supportive Secretory |
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rotavirus
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secretory; MCC of childhood diarrhea; esp in winter; F/O transmission
damages ion trasport pump in SI; secretory diarrhea; rotazyme test on stool establishes dx rotavirus vaccine effective in prevention; oral vaccine Tx: oral hydration; nitazoxanide |
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bacillus cereus
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Gram + rod; food poisoning w/ preformed toxin; assoc w/ reheated fried rice/tacos
self-limited |
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campylobacter jejuni
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curved or S-shaped gram- rod
animal resevoirs: cattle, chicken, puppies (MC in children) F/O via contaminated water, poultry, unpasteurized milk; MC food-borne illness and invasive entercolitis; high fever and cramping abdominal pain; organsims in stool w/ blood and leukocytes complications: guillain-barre syndrome (ab cross-react w/ neurons); hemolytic uremic syndrome (HES)- HLA-B27 + seronegative spondyloarthropatyh Tx: azithromycin |
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clostridium botulinum
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Gram + rod; adult food poisoning w/ preformed toxin (blocks release of Ach in presynaptic terminal of neuromuscular junciton in ANS causes descending paralysis, mydriasis, dry mouth
Tx: trivalent antitoxin infant food poisoning often by eating spores in honey (lack protective bact) floppy baby w/ constipation) |
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clostridium difficile
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Gram + rod; assoc w/ pseudomembranous colitis; MCC of nosocomial diarrhea; secretory type of diarrhea; 3% of people; carrier rate inc to >20% in hosp pts (contact w/ spores in environment and F/O contamination); Ab-induced 65-95%; Ab (ampicillin, quinolones, clindamycin) cause overgrowth of toxin producing C diff in colon; toxins A/B release proinflammatory mediatorys and cytokines that attract enutrophils and stim excess fluid secretion (watery diarrhea);
pseudomembrane covers colon mucosea; composed of cellular debris, leukocytes, fibrin and mucin person-person induced in 30% nonsp lab: neutrophilic leukocytosis w/ left shit; fecal leukoctes, dec serum albumin cytotoxin assay of stool has gtr sp than culture of stool**** Tx: metronidazole, vancomycin (resistant strains) |
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E. coli
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Gram- rod; ETEC: cerain strain produce toxin that activate adenylate or guanylate cyclase to secfetory diarrhea (traveler's diarrhea) is 60% of cases; also campylobacter, salmonella and shigella
Tx: levofloxacin STEC (O157:H7) undercooked beef; HES Ab not recommended; may enhance toxin release |
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mycobacterium avium-intracellulare complex (MAC)
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acid-fast rods; diarrhea w/ maabsorption in AIDs <50 CD4
foamy macs in lamina propria stim Whipple's disease |
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mycobacterium tuberculosis
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acid-fast organisms swallowed from primary focus in lung
invade peyer's patches circumfrential spread into lymphatics leads to stricture formation |
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salmonella
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gram - rod; pathogenic salmonella: s. typhi, s. paratyphi, s enteritidis; animal reservois: turtles, hamsters, lizards
salmonella enteritdis enterocolitis: 2nd MC food-borne illness in US; contarcted by eating raw or undercooked egg products, raw milk ect, poultry or drinking comtaminated water tx: ciproloxacin or elvofloxacin typhoid fever cause by S. typhi wk 1: invade peyer's patches and produces syepsis (blood culture best) wk 2: diarrhea (+ stool culture) classic triad of brady, neutorpenia, SM tx: if symptomatic w/ fluoroquuinologne, Ab do not shorten the illness and may inc freq of carrier states chronic carrier state due to GB disease: cholestectomy |
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shigella dysenteriae and shigella sonnei
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gram - rod; no animal reservoirs
highly infectious; children in day care; mental institutions mucosal ulceration; pseudomembranous inflammation in rectosigmoid, dysentery assoc w/ HLA-B27 + seronegative spondyloarthropathy tx:if symptomatic w/ fluorquinolne or azithromycin |
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staph aureus
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gram + coccus; food poisoning w/ preformed toxin; culture food NOT stool
gastroenteritis occurs in 1-6 hrs from eating self-limiting |
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vibrio cholerae
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Gram - comma-shaped rod
enterotoxin stim adenylate cyclas in SI; contract form contaminated water or contaminated seafood esp crustacea...secretory tx: fluid replacement: GLUCOSE and sodium required in oral supp (cotransport system for reabsrotpion) doxycycling or fluoroquinolone |
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yersinia enterocolitica
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gram- coccobacillius w/ bipolar staining; entercolitis in children ; mesenteric lymphadenitis (granulomatous microabscesses) that stim acute appendicitis
assoc w/ HLA-B27 + seroneg spondyloarthopathy tx: TMP-SMX |
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balantidium coli
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protozoan (ciliate) largest protozoan; tramitted by ingestion of cysts in food or water
produces colonic ulcers w/ bloody diarrhea tx: tetracycline |
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cryptosporidium parvum
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protozoan (sporozoa); ingestion of oocysts in food or water 9partially acid fast) responsible for outbreaks of diarrhea in water suppply (milwaukee); MCC diarrhea in AIDS ~50
dx: sotol ag test oosysts partially acid fast tx: if immunocmpetant w/ nitazoxanide (less responsive to drug is deficient) |
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cyclospora, microsproidia, isospora belli
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protozoa (sporozoa) F/O; all are ocmmon pathogens in AIDS diarrhea; cyclospora-rasberries; microsporidia (not partially acid-fast) cyclospora oocysts partially; isospora-partially
tx: cyclospora-TMP-SMX double strength; micorsporidia: albendazole; isospora: TMP-SMX double strength |
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entamoeba histolytica
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protozoa (amoeba) transmitted by ingestion of cysts in food/water; cysts: nonmotile and in formed stool; trophozoites: motle in diarrhea; produces dystentery (blood diarrhea); cysts excyst in the cecum and become torphozoites in the cecum; torphozoites release powerful histolytic agens that porduce flask-shaped ulcers the penetrate portal V tributaries an ddrain tot eh liver to produce a liver abscess (anchoy paste) trophozoites can penetrate HV tributarys to systemic
TROPHOZOITES PHAGOCYTOSE RBCS!!!!!! dx: stool ag test tx: metronidazole |
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giardia lambia
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protozoa (flegallage) MC protozoal cause of diarrhea in US; transmitted by ingestion of cysts in food/water; common in day care, mental hospitals, hikers, water supplies 9cholorination does not kill cysts);anal/oral contact, IgA def, common variabl eimmunodef
produces acute/chornic diarrhea w/ malabsorption (cysts in formed stool; torphozoites in loose stools) dx: stool ag test tx: tinidazole or nitazoxanide |
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anisakis simplex
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intestinal nematode
eat raw fish (sushi), pickled herring; larvae penetrate gastric intestingal mucosa crampinga bdominal pain; epigastric distress w/ N/V diarrhea w/in few hours of eating dx: endoscopy, IgE ab test tx: removal by endoscope or surgery |
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enterobius vermicularis
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pinworms; intestinal nematode; MC helminth in US
ingest egg; eggs deposited in anus by adult worms (prurtis ani) urethritis in girls; acute appendicitis NO ESOINOPHILIA b/c audlt worms aren't invasive tx: albendazole or mebendazole |
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trichuris trichiura
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intestinal nematode (WHIPWORM) ingest eggs
diarrhea: poss rectal porlapse in chidlren dx: stool for ova and parasites; eosinophilia tx: albendazole |
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ascaris lumbircoides
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intestinal nematode; largest; ingest eggs
larval phase through lungs: cough, pneumonitis, eosinophilia (invasion of tissue) bowel obstruciton in audlt phase; no eosinophilia (no invation of tissue) tx: alben/mebendazole |
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necator americanus
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intestinal nematode (HOOKWORM) adults attach to villi result in blood loss/iron def
tx: albend/mebendazole |
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strongyloides stercoralis
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intestinal nematode; filiariform alrvae insoil penetrate the feet to larval phase thorugh the lungs to swallow an dmolt into adults that enter the intestinal mucosa and aly eggs; hatch into rhabditform larvae which enter the intestinal lumen and are passed in the stool; develop into filariform larvae (infective form) in the soil
autoinfection may occur if filariform larvae in the intseting penetrate the mucosa an dmigrate to the lungs to repeat the cycle in immunocompromised pts (AIDS) massive reinfections occurs w/ dissemniation through out the body produces abdominal pain an diarrhea tx: ivermectin |
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diphyllobothrium latum
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intestinal cestode (TAPEWORM); ingest larvae in lake trout (great lakes) porduce diarrhea w/ or w/o B12 def; preferential uptake of vit B12 by work
dx: eggs in stool tx: praziquantel |
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ascending cholangitis
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ecoli, inflammation of bile ducts (cholangitis) from biliary infect and duct obstruction (stone); life threatening; charcot's triad: fever, jaundice, RUQ pain; MCC of multiple liver abscesses
Tx: decompression/drainage; piperacillin-tazobatam |
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liver abscess
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E. Coli, bacteroides fragilis, strep. faecalis
R lobe, solitary; ascending cholangitis (MC); intra-abdominal infection (spread via Portal V, diverticulitis, bowel perf); direct extention (empyema of GB, subphrenic absess); hematogenous spread (bact endocarditis); spiking, intermittent fever; RUQ or R costovertebral angle tenderness; jaundice uncommon dx: ultrasound (lease expensive) CT tx: percutaneous drainage; metronidazole+ceftriaxone |
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granuomatous hepatitis
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mycobacterium Tb, histoplasma capsulatum-->miliary spread
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spontaneous peritonitis
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ecoli in adults-cirrhosis; s. pneumo in children-neprhitic syndrome-->ascites
tx: cefotaxime; no rupture of viscous fever rebound tenderness |
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Leptospira interrogans
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gram neg; tightly wound spirochetes; "shephard's staff; reservois (rats, dogs); excreted in urine; trasmission swimming, farms, miners, sewade; biphasic in septicemia phase=fever, jaudice, hemorrhagic disathesis, RF (intersitial nephritis), conjuctivitis and photophobia, meningitis; phase terminated by appearance of Ab 9beginning of immune phase-->w/ nermerous organism in urine see w/ darkfield micorscopy to confirm; tx penicillin G
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echinococcosis
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sheepherder's disease; intestinal tapeworm (cestode); single/multiple cysts w/ larval forms; cysts in liver (MC), lungs, and brain; eggs develop into largal form only-->adult can lay eggs; infected sheep intermediate host (larval form into liver cyst); dog eat liver (larva dev into adults)-->human eat eggs beocme intermediate host b/c eggs become larvae (penetrate bowel-->liver to produce hydatid cyst; inner germinal lyaer of cysts have portoscolices (larva) in brood capsules-->ruture can produce anaphylaxis; tx: percuaneous drainage+albendazole
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amebiasis
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entamoeba histolytica; portozoan; MCC of liver RL abscess WW (NOT US)
tx: metronidazole-->paromomycin; blood diarrhea |
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clonorchiasis sinesis
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chinese liver fluke intestinal fluide trematode); nonschistosomal life cycle: egg (human)-->ciliated microcidial larva-->infects snail (1st intermediate host) produce fork-tailed cercarial larvae-->2nd intermediate host fish cloriochiasis-->form infective metacercaie-->man ingests fish-->disease-->larvae enter CBD-->audlts; poss cholangiacarcinoma (bile duce cancer)
tx: praziquantel |
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schistosomiasis
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mansoni; flude (trematode) shistosomal life cycle; egg (human-->ciliated micacidial larva-->infects snail 1st-->produce fork-tailed cercarial larvae-->penetrate skin in human-->disease; larvae in SMV-->portal V dev into adult worms an deposit eggs; host dev inflammatory response marked by concentric fibrosis "pipestern cirrhosis" in vessel wall complication sof cirrhosis: portal HTN, ascities, esophageal varices
tx: praziquantel |
