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179 Cards in this Set
- Front
- Back
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The combination of proximal muscle weakness and purplish discoloration of the periorbital region (heliotrope lids) is highly suggestive of what?
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dermatomyositis
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Heliotrope lids (purplish discoloration of the periorbial region) and Gottron's papules (scaly, patchy redness over the knuckles) are classically associated w/ what?
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dermatomyositis
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A progressive inflammatory condition characterized by muscular weakness, a skin rash, and edema of the eyelids and periorbital tissue.
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dermatomyositis
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Celiac dz can present w/ what?
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diarrhea and dermatitis herpetiformis
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An inflammatory condition of muscle of unknown aetiology. Muscle pain and weakness are common symptoms of this condition. When associated with a skin rash the condition is referred to as dermatomyositis.
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polymyositis
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This dz presents w/ muscle weakness, primarily of the shoulder girdle and lower back. It is often assoc w/ giant cell arteritis (headaches, temporal artery tenderness, elevated ESR, and potential for blindness w/o tx.)
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polymyalgia rheumatica
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An inflammatory syndrome occurring in people over age 50 and is characterised by stiffness and pain in shoulder and hip musculature. Patients may complain of weakness in addition to diffuse muscle wasting (atrophy). The blood level of creatine phosphokinase (CPK muscle enzyme) is normal, but the erythrocyte sedimentation rate is elevated. Can also be seen in association with temporal arteritis. Treatment is with non-steroidal anti-inflammatory agents.
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polymyalgia rheumatica
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Progressive muscle weakness during the day, diplopia, and thymomas. Muscle weakness increases during periods of activity and improves after periods of rest.
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myasthenia gravis
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Acute infective polyneuritis that results in a form of peripheral neuropathy with temporary loss of movement and sensation due to inflammation of multiple nerves and loss of myelin.
The exact cause is unknown but has been associated with an abnormal immune response to viral infection, particularly cytomegalovirus infection, in which there is cell-mediated immunity to a component of myelin. The disease may be autoimmune in origin and complete recovery can take up to six months. |
Guillain-Barre syndrome aka acute idiopathic polyneuritis
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Denoting a neoplasm or lesion that grows outward from an epithelial surface.
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exophytic
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The most common tumor arising in the sun-exposed areas of older people. It is relatively rare in African-American people, in whom the tumor often arisis in association w/ scarring processes.
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Squamous cell carcinoma
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What causes squamous cell carcinoma?
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DNA damage caused by UV light.
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What does squamous cell carcinoma look like clinically?
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Shallow ulcers w/ keratinous crust and ulcerated, indurated surrounding. The adjacent skin shows actinic damage.
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What does squamous cell carcinoma look like histologically?
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Nests of squamous epithelial cells which arise from the epidermis and extend into the dermis. The cells have abundant cytoplasm and large vesicular nuclei. There is variable central keratinization w/ horn pearl formation.
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microscopic structures found in some neoplasms of epithelial origin. Called also squamous or keratin pearls.
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horn pearls
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A focus of central keratinization found within concentric layers of abnormal squamous cells, occurring in squamous cell carcinoma. Also called epithelial pearl.
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horn pearl
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Squamous cell carcinoma is graded based on what?
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Degree of anaplasia (well, moderately, or poorly-differentiated.)
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When is invasive squamous cell carcinoma usually discovered?
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When tumors are small and resectable - less than 5% metastasize to distant LN's.
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The most common cutaneous tumors. Account for 70% of the malignant diseases of the skin.
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Basal cell carcinomas.
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Basal cell carcinomas make up what percentage of malignant skin diseases?
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70%
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These skin malignancies are common, slow-growing, and rarely metastasize.
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Basal cell carcinomas.
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Where are basal cell carcinomas predominantly found?
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In areas of skin exposed to sun, particularly in fair-skinned individuals. 80% are on the head and neck.
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This malignant skin disease may present as a papulonodular lesion w/ a pearly translucent edge, an ulcerated destructive lesion (rodent ulcer), a pale plaque w/ variable induration, an erythematous plaque, or a partly cystic nodule.
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Basal cell carcinoma.
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This malignant skin tumor is made up of islands of basaloid cells w/ hyperchomatic nuclei and little cytoplasm. There is palisading of the cells at the periphery. Ulceration is seen in larger lesions and aggressive tumors may extend into the lower dermis.
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basal cell carcinoma
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A rare and potentially lethal skin tumor composed of small round malignant cells containing neurosecretory granules.
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Merkel cell carcinomas
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A rapidly developing neoplasm which may heal spontaneously w/o tx. May minic squamous cell carcinoma histologically.
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Keratoacanthoma
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keratoacanthomas is found where, and among whom?
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It affects sun-exposed areas of skin, mostly in white males over 50 years, and is particularly found in cheeks, nose, ears, and dorsa of hands.
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What does keratocanthoma look like clinically?
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flesh-colored dome-shaped nodules w/ central keratin-filled plug, imparting a crater-like topography, ranging from 1 to several cm.
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flesh-colored dome-shaped nodules w/ central keratin-filled plug, imparting a crater-like topography, ranging from 1 to several cm.
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keratocarcinoma
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What do keratocarcinomas look like microscopically?
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There is a central keratin-filled crater w/ squamous epithelium growing downward into the dermis as irregular tongues. The epithelium has large cells showing evidence of reactive cytologic atypia and abrupt keratinization.
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There is a central keratin-filled crater w/ squamous epithelium growing downward into the dermis as irregular tongues. The epithelium has large cells showing evidence of reactive cytologic atypia and abrupt keratinization.
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keratocarcinoma
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Seborrheic keratosis affects whom?
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Middle-aged and older individuals.
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Round flat plaques from millimeters to centimeters in diameter, arising in the trunk, extremities, head, and neck. Uniformly tan to dark brown and usually show a velvety to granular surface.
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seborrheic keratosis
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Exophytic neoplasms sharply-demarcated from the adjacent epidermis. Sheets of small cells that resemble basal cells. There is no hyperkeratosis and small keratin-filled cysts called horn cysts are seen. When inflamed, they undergo squamous differentiation and show foci of squamous cells resembling eddy currents in a stream.
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seborrheic keratosis
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A vesicular eruption w/ intense itching involving the hands and soles, generally secondary to stress. The vesicles are prone to involute and desquamate. Scales are a late finding.
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Pompholyx or dyshidrotic eczema
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Tx for pompholyx or dyshidrotic eczema
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steroids
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Tinea pedis occurs in two forms: a chronic, scaly, ruborous form caused by ______, and an acute, bullous type caused by _________.
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chronic, scaly, ruberous - T. rubrum
bullous - T. mentagrophytes |
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Any of various fungi causing parasitic infections of the skin, hair, or nails.
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dermatophyte
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to soften by wetting or soaking.
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macerate
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Tinea pedis involves which organisms?
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A dry tinea contains only dermatophytes and normal flora. Once macerated, gram-negative rods (e.g. Pseudomonas) are also involved.
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What is the tx of tinea pedis?
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Antifungals (e.g. imidazoles.) Once macerated, gram-negative rods (e.g. Pseudomonas) may be involved, and these must be treated w/ a non-imidazole (e.g. ciclopirox olamine.)
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Contact dermatitis presents how?
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Red, itchy patches in the area of contact, which may blister, open and ooze, scale, or crust. The lesions may be self-limiting.
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What is the tx for contact dermatitis?
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Avoid the offending substance! Cold compress, oatmeal bath.
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Self-limiting, subepidermal, dense, thick bullae seen frequently in the elderly. IgG's are seen along the basement membrane.
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Bullous pemphigoid.
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What is the tx for bullous pemphigoid?
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astringent soaks, systemic steroids, immunosuppressants
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Spontaneous, self-limited, epidermal or subepidermal eruptions in diabetic patients.
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Bullous diabeticorum
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What is the tx of bullous diabeticorum?
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Draining and local wound care.
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What causes erythema infectiosum?
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Parvovirus B19
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Mild rubella-like erythematous rash that produces arthropathy, especially in women.
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erythema infectiosum
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What are the two components of erythema infectiosum?
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The initial, lytic phase - viral replication causes a transient arrest of erythrocyte production.
Viremic stage - mild flu-like sx w/ pyrexia and chills, lasting 1-3 days. One week later, the virus is rarely detectable, and an erythematous maculopapular rash and arthropathy occur. |
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An eruption of vesicles due to HSV-1, restricted to areas around the mouth, lips, and nostrils.
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Herpes labialis
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Where do HSV-1 eruptions occur?
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Usually around the mouth, lips, and nostrils (herpes labialis) but primary infectious may also involve the oral mucous membranes in children, and the eyes. HSV-1 can also cause genital eruptions, but it is much less likely to do so than HSV-2.
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An eruption of vesicles restricted to areas around the genitalia. Duration and severity of eruptions are generally more severe in females than males.
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HSV-2
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75% of neonatal herpes is caused by what?
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HSV-2 (usually by contamination through the birth canal.)
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What family does EBV belong to?/
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Herpesviridae
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EBV causes which three important conditions?
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Infectious mononucleosis, Burkitt's lymphoma, and undifferentiated nasopharyngeal carcinoma.
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This condition presents w/ a marked lymphocytosis, hepatomegaly, splenomegaly, lymphadenopathy, and lymphoid hyperplasia of the oronasopharynx.
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Infectious mononucleosis
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The peripheral blood smear in infectious mononucleosis shows what?
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atypical lymphocytes of the Downey II type
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What is the px of infectious mononucleosis?
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It is generally self-limiting, but can cause a severe protracted illness.
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EBV primary infections are commonly fatal in patients with what condition?
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X-linked lymphoproliferative syndrome
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What family does cytomegalovirus belong to?
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Herpesviridae
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What sx are shared by both cytomegalovirus mononucleosis and infectious mononucleosis (EBV)?
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atypical lymphocytosis, fever, malaise, and pharyngitis
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Does CMV have a positive or negative heterophile aby test?
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negative
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In what percentage of infectious mononucleosis does a pt have a positive heterophile aby test?
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80%
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What are the two conditions that must be considered in a pt w/ sx of mononucleosis and a negative heterophile aby test?
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CMV
toxoplasmosis |
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Varicella-zoster virus is a member of which family?
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Herpesviridae
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An acute onset, w/ fever and a progressive rash, leading to the formation of vesicles which crust over. Vesicles are common on the mucous membranes of the mouth (esp the palate) as well as on the skin. Eruptions appear early and most acutely on the back, abdomon, and chest. The palpebral conjunctiva, trachea, larynx, rectal, and vaginal mucosa may also be involved.
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Varicella (chickenpox)
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A fungus that causes scalp and skin infections, mostly in children. Acquired from cats or dogs. Matures within 6-10 days. Surface growth is coarsely fluffy w/ a whitish surface. The peripheral areas of the colonies are closely spaced radial grooves and contain yellow pigment. The organism produces numerous long macroconidia that are spindle-shaped, rough, and thick walled, and usually contain more than six compartments.
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Microsporum canis var. carnis
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A fungus that commonly causes athlete's foot, but can invade all parts of the body including hair and nails. The organism matures within 7-10 days. The colonial morphology varies greatly (surface may be buff and powdery or white and downy.) May be pinkish or yellowish. The powdery form will exhibit concentric and radial folds. The reverse side is usu brownish-tan but may occur as colorless, yellow, or red. The hyphae are septate. Macroconidia are cigar-shaped and thin-walled with a narrow attachment to the hyphae, and contain 1-6 cells. Microconidia are small and tear-shaped and clustered on branched conidiophores. Coiled spiral hyphae are often seen.
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Trichophyton mentagrophytes
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an asexually-produced fungal spore
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conidium
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conidium
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an asexually-produced fungal spore
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The most common cause of scalp ringworm in the US.
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Trichophyton tonsurans
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This organism commonly causes scalp ringworm, but can also infect the skin and nails. Matures in 12 days. Colonial morphology is variable w/ surface color varying from white, grayish, yellow, brownish, or rose. May be suede-like w/ radial and concentric folds. Reverse usu reddish brown w/ some pigment diffusing into media. Reverse color can at times be yellow or colorless. Hyphae are septate and have variably-shaped microconidia lining the sides at a perpendicular angle. Macroconidia are rare. Spiral coils can be seen.
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Trichophyton tonsurans
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A type of tinea, usually of the scalp but sometimes affecting glabrous skin, w/ formation of scutula (characteristic disklike crusts,) which may enlarge and coalesce to form prominent honeycomb-like masses; due to infection by the fungus Trichophyton (usu schoenleinii.)
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favus
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Chronic disease caused by Trichophyton schoenleini that results in scalp scarring and alopecia. Infections of nails and skin are possible.
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favus
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This fungus matures in 15 days. Colonial morphology is whitish and slightly downy or waxy. The surface is folded or heaped and "yeast-like." The reverse is colorless or yellowish orange to tan. The colony grows into the agar. Microscopically the hyphae are septate and irregular w/ a knobby appearance. Characteristic antler-like branching structures are formed by subsurface hyphae. Chlamydoconidia are numerous while microconidia are rare and macroconidia are virtually never seen.
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Trichophyton schoenleini (causes favus)
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"favic chandeliers"
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Characteristic antler-like branching structures formed by subsurface hyphae of Trichophyton schoenleini (which causes favus)
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A fungus that produces infections of the skin and nails, but not the hair. Matures in 10 days. The surface of the colony has a brownish-yellow to olive-gray or khaki color, and is lumpy and sparse, becoming folded in the center and grooved radially, then velvety. In several weeks, fluffy white mycelium covers the colony. The reverse is orange to brownish w/ a yellow thin border seen at times. Microscopically the hyphae are septate w/ no microconidia. The macroconidia are smooth, with thin or thick walls, a club-shape w/ rounded ends, 2-6 cells, and singly or clustered. In older cultures the macroconidia often transform into chlamydoconidia.
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Epidermophyton floccosum
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A gram-positive cocci that is catalase negative, esculin positive, hippurate negative, Voges-Proskauer positive, and produces a carmel-like odor. Colonies often require CO2 and are sometimes mistaken for anaerobic streptococci. Colonies can be beta, alpha, or gamma hemolytic. Causes oral infections, bacteremia and endocarditis, thoracic infections, CNS infections, and abdominal infections. In drug addicts it can cause a subcutaneous abscess/cellulitis that can be mistaken as necrotizing fasciitis.
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Streptococcus intermedius group (millerii)
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A gram-positive cocci that is catalase negative, beta hemolytic, and has a Lancefield grouping of B. The organism produces CAMP factor, a thermostable extracellular protein that results in synergistic hemolysin on sheep blood agar w/ the B-lysin of Staph aureus. The organism can cause a variety of infectiouns such as neonatal meningitis, pneumonia, osteomyelitis, endocarditis, and skin/soft tissue infections. Can also cause necrotizing fasciitis.
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Streptococcus agalactiae (group B strep)
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What co-occurs in 98-100% of group B strep (Strep agalactiae) isolates?
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Staph aureus
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What is the tx for group B strep (Strep agalactiae)?
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Ampicillin or penicillin G. Vancomycin for adults who are allergic to penicillin.
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A gram-positive anaerobic rod that produces spores, has a boxcar appearance on Gram stain, produces lecithinase, and produces a double zone of hemolysis on blood agar. Causes a variety of infections such as bacteremia, pleuropulmonary infections, biliary tract infections, intra-abdominal infections, food poisoning, clostridial myonecrosis (gas gangrene), and other soft tissue infections including crepitant cellulitis, suppurative myositis.
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Clostridium perfringens
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An aerobic gram-positive rod that forms spores and is beta-hemolytic. Causes a variety of infections such as bacteremia, endocarditis, food poisoning, opthalmitis, osteomyelitis, soft tissue infections, and necrotizing fasciitis.
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Bacillus cereus
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A gram-positive cocci that is catalase negative, beta-hemolytic, and has Lancefield group A. Can cause necrotizing fasciitis.
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Streptococcus pyogenes
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Most pathogenic species of streptococcus are what?
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Beta-hemolytic
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A gram-positive cocci that is catalase positive and coagulase positive and appears in clusters. Usually beta-hemolytic with yellow colonies. Can cause TSS.
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Staphylococcus aureus
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Sx include severe myalgias, fever, vomiting, and diarrhea. Pt is listless and confused and may rapidly develop severe hypotension w/ hypovolemic shock. Conjunctival inflammation and a "sunburn rash" can develop within hours.
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TSS
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What is the tx of TSS?
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Fluid replacement and IV oxacillin or nafcillin
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An infectious gangrene caused by Clostridium perfringens, usually following local trauma. Pts present w/ prominent pain at the infected area, which has marked swelling and a yellow-bronzed discoloration. There can be grene-black patches of necrosis w/ a serosanguinous discharge. Crepitus is present. The pt generally presents w/ fever and systemic toxicity. The clinical course is extremely rapid.
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Clostridial myonecrosis (gas gangrene)
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What agent causes gas gangrene?
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Clostridium perfringens (this is also known as clostridial myonecrosis)
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An anaerobic gram-positive, boxcar shaped rod that produces a double-zone of hemolysis.
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Clostridium perfringens
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What causes bacteremic pseudomonas gangrenous cellulitis?
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Pseudomonas aeruginosa
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Pts present w/ mild pain at a sharply demarcated necrotic area w/ black eschar and surrounding erythema. There is no crepitus. High fever and systemic toxicity are common. Clinical course is rapid.
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Bacteremic pseudomonas gangrenous cellulitis
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An aerobic gram-negative bacilli that is oxidase positive, grows on MacConkey agar as a nonlactose fermenter, and produces a blue-green pigment w/ a sweet grape-like odor.
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Pseudomonas aeruginosa
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What causes most cases of streptococcal gangrene?
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Strep pyogenes
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What conditions predispose to streptococcal gangrene?
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Diabetes and abdominal surgery. Streptococcal gangrene is usually caused by Strep pyogenes.
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Pts present w/ prominant pain in infected area of necrotic subcutaneous tissue and fascia. The area may appear black or "burned" in appearance. Crepitus is absent. Pts have high fevers and marked systemic toxicity. The clinical course is very rapid.
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Streptococcal gangrene (caused primarily by Strep pyogenes.)
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An aerobic gram-positive cocci that will occur in short to long chains. It is beta-hemolytic, catalase negative, and Lancefield group A.
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Strep pyogenes
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Synergistic necrotizing cellulitis is caused by what?
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A mixture of organisms such as Bacteroides, Peptostreptococcus, E. coli, and other members of Enterobacteriacea.
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What is the most common predisposing factor for synergistic necrotizing cellulitis?
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diabetes
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Pts present w/ prominent pain at infected area, and cellulitis that produces a thick, copious, "dishwater" smelling drainage. Crepitus is often present. The pt will usu have moderate fever and marked systemic toxicity. The clinical course is rapid.
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synergistic necrotizing cellulitis
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What are the most common species of fungi causing necrotizing cutaneous mucomycosis?
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rhizopus, mucor, and absidia species
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What are common predisposing conditions to necrotizing cutaneous mucormycosis?
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diabetes and corticosteroid tx
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The infection site is a central black area w/ a purple raised margin, or a simple black ulcer. Pain is minimal. The pt will present w/ a low-grade fever. Systemic toxicity is variable. The clinical course is rapid.
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necrotizing cutaneous mucormycosis
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An acid-fast bacilli. A slow grower at 31C, and colonies are rough w/ no pigment production. Niacin and nitrate reduction negative. Rarely grows at 37 or above. When suspected, the lab should be notified for proper incubation. Commonly infects superficial body sites, causing chronic ulcers (Buruli). Growth may take 6-12 weeks.
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Mycobacterium ulcerans
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An ulcer of the skin, with widespread necrosis of subcutaneous fat, due to infection with Mycobacterium ulcerans; occurs in Uganda in persons living on the Nile river banks.
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Buruli ulcer
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An acid-fast bacillus. A moderate grower at 31C and 24C. Colonies tend to be smooth to intermediate in roughness. The organism is photochromogenic. Nitrate reduction is negative and niacin is usually negative. Rarely grows at 37C. When suspected, the lab should be notified for proper incubation. Infections involve superficial body sites exposed to contaminated water.
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Mycobacterium marinum
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An acid-fast bacillus, slow-growing at 32 and requires the presence of hemin. Colonies are rough and nonphotochomogenic. Nitrate reduction and niacin are both negative. Isolation can be made on blood or chocolage agar. Infection involves superficial body sites. There is no growth at 37C, and growth at 32C takes 2-7 weeks.
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Mycobacterium haemophilum
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An acid-fast bacillus, slow-growing at 37C with rough colonies that occasionally appear thin or transparent. The organism is nonphotochromogenic. Negative for nitrate reduction and niacin. Growth supported on Loewenstein egg medium better than on 7H11 agar medium.
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Mycobacterium bovis
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How does one distinguish between Mycobacterium tuberculosis and Mycobacterium bovis?
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M. bovis does not reduce nitrate and has a negative niacin test. It does cause TB, but less commonly than M. tuberculosis.
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An acid-fast bacillus, rapidly-growing at 37C with smooth to rough colonies containing filamentous extensions. The organism is nonphotochromogenic, niacin negative, and positive for nitrate reduction. Growth is in less than 7 days.
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Mycobacterium fortuitum
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This species of Mycobacterium is associated w/ skeletal infections, abscesses, and ulcers.
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M. fortuitum
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A type of mycobacterium that is nonpigmented in the dark but produces a yellow pigment on constant exposure to light.
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photochromogen
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A mild superficial infection of the skin characterized by multiple scaly patches varying from white to brown. They are usually asymptomatic and frequently seen on the chest, neck, and abdomon, and occasionally on the face. This condition usually occurs in young adults.
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Tinea versicolor (pityriasis versicolor)
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What is the dx of T. versicolor?
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Dx: clinical findings (multiple scaly hypopigmented patches on upper trunk and neck in a young adult), yeast and short plump golden hyphae seen on scraping under woods lamp.
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What is the tx of T. versicolor?
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Topical tx w/ selenium sulfide, imidazoles, and zinc pyrithione.
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How can hypopigmented patches be distinguished from vitiligo?
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Vitiligo usually presents as periorificial lesions or lesions on the tips of fingers, and is characterized by a complete loss (not just lessening) of pigment.
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Tinea cruris appears as a severly-itching rash, hyperpigmented with sharp margins and cleared centers. Where do these occur?
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In the groin region and gluteal cleft.
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How is Tinea cruris treated?
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Drying powders, ketoconazole cream, and in severe cases, systemic ketoconazole.
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Lesions associated w/ leprosy.
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Pale anesthetic macular skin lesions with associated nerve thickening.
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Bartonella hensalae causes what?
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cat scratch disease
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A condition associated w/ prolonged painful regional lymphadenopathy and malaise. The LN involvement may not be apparent until several days to weeks after the initial wound. 60% of cases are in children.
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cat scratch disease (caused by Bartonella henselae)
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Transmitted by bacteremic cats infested with Bartonella henselae-bearing fleas.
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cat scratch disease
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Px and tx of cat scratch disease
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The condition is self-limited. IV aminoglycoside or PO doxycycline can be considered. The greater concern may be co-infecting pathogens.
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A gram-positive anaerobe that forms long, branching filaments. Masses of filaments in active infections form "sulfur granules," half of which are found on the face and neck.
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Actinomyces israelii
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A gram-negative rod that infects about 25% of all animal bites.
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Pasteurella multocida
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A "swarming" gram-negative rod that produces urease and is associated w/ UTI's. (Swarming refers to the way the organism spreads out in waves of growth to cover an entire culture plate.)
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Proteus mirabilis
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A protozoan that has a cat host, but is not associated w/ cutaneous infections from cat scratches. Rather, it can be asx or reminiscent of mono. In the immunosuppressed, it can cause a life-threatening encephalitis.
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Toxoplasma gondii
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A plump gram-negative bacilli or coccobacilli occuring in pairs or short chains. Oxidase positive. Unlike Neisseria and Moraxella species, which they can be mistaken for, they are catalase negative. They grow on chocolate and sheep blood agar but not on MacConkey agar. Beta-hemolytic and may "pit" or "corrode" the agar surfice.
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Kingella kingae
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A normal inhabitant of the upper respiratory and GU tract, with tropism for cardiac, valvular, joint space, and skeletal tissue. Pts w/ poor hygiene, mucosal ulcerations due to tx for other conditions (e.g. radiation tx) and pts undergoing dental procedures who have underlying heart disease are at increased risk of infection. A member of the HACEK group of organisms.
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Kingella kingae
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HACEK
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Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, and Kingella - microorganisms associated w/ infective endocarditis
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A slender gram-negative bacillus or coccobacillus w/ rounded ends. Oxidase positive and catalase negative. grows on chocolate and sheep blood agar but not on MacConkey agar. Colonies are small, non-beta-hemolytic, and will "pit" or "corrode" the agar surface. Produces a yellow pigment and a "chlorox bleach" odor. Does not produce acid for carbohydrates.
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Eikenella corrodens
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This organism is part of the normal flora of the mouth and upper respiratory tract, and most commonly associated w/ dental and periodontal infections, head and neck infections, otitis media, respiratory infections, and mastoiditis. Pts who are immunocompromised, have previous valvular damage, or are IV drug abusers can develop bacteremia and/or endocarditis due to this organism following dental work. It is a member of the HACEK group.
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Eikenella corrodens
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A gram-variable bacillus w/ a tendency to retain crystal violet stain at the poles, resulting in "tear-drop", "dumbbell", and "lollypop"-shaped organisms. Oxidase positive and catalase negative. Grows slowly on chcolate and sheep blood agar but not on MacConkey agar. Pitting of the agar may occur. Colonies are very small, glistening, and opaque. Indole positive and utilizes sorbitol.
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Cardiobacterium hominis
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This organism is associated exclusively with endocarditis, usu following dental procedure. It is part of the normal respiratory tract flora. Member of the HACEK group.
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Cardiobacterium hominis
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A pale-staining gram-negative coccobacillus. Oxidase positive and catalase positive. Colonies grow slowly, appearing after 48-72 hours. Non-beta-hemolytic. Does not produce indole and does not require factors X or V. ONPG negative. Part of normal oral flora. Assoc w/ endocarditis, wound infections, dental infections, and bacteremia, particularly among those w/ valvular damage or poor oral hygiene. Member of HACEK.
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Actinobacillus actinomycetemcomitans
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Gram-negative coccobacillus, oxidase negative and catalase negative. Does not produce indole and hydrolyzes ONPG. Assoc w/ sinusitis, pneumonia, empyema, otitis media, septic arthritis, wound infections, endocarditis, necrotizing fasciitis, and osteomyelitis, particularly among pts who have had chemotx, trauma, or malignancy. Member of HACEK.
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Haemophilus aphrophilus
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Cellulitis caused by Pseudomonas aeruginosa
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Bacteremic pseudomonas gangrenous cellulitis
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Bacteremic pseudomonas gangrenous cellulitis is caused by what?
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Pseudomonas aeruginosa, an aerobic gram-negative bacillus that is oxidase positive, grows on MacConkey agar as a nonlactose fermenter, and produces a blud-green pigment with a sweet grape-like odor.
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This type of cellulitis occurs in individuals w/ burns and immunosuppression. Pts present w/ mild pain at infected area, which is sa sharply-demarcated necrotic area w/ black eschar and surrounding erythema. There is no crepitus. The pt will generally have a high fever and marked systemic toxicity. Clinical course is rapid. Caused by an aerobic gram-negative bacullus that is oxidase positive, grows on MacConkey agar as a nonlactose fermenter, and produces a blue-green pigment with a sweet grape-like odor.
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Bacteremic pseudomonas gangrenous cellulitis, caused by Pseudomonas aeruginosa
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Agar that contains bile salts, lactose, and neutral red indicator for isolation of enterobacteria
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MacConkey agar
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A disease that occurs in children, with a rash consisting of vesicles on a reddened base, most commonly on hands and feet. Oral ulcers or vesicles can be seen. Fever sometimes occurs. Usually presents in summer or fall.
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Hand-foot-mouth disease, caused by Coxsackie virus
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Blue-gray spots that can be seen in the mouth, which occur prior to the onset of rash in a measles infection.
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Koplik's spots
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When do you see Koplik's spots?
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Koplik's spots are blue-gray spots that can be seen in the mouth, prior to the onset of rash in a measles infection.
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What preceeds the onset of rash in a measles infection?
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The appearance of Koplik's spots, a fever, and a URI.
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This rash is maculopapular and may become confluent. It begins on the face and moves downward and outward, and can spread to hands and feet. Pt can have associated cough, adenopathy, and high fever. This typically occurs in the winter and spring.
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Measles
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A disease that occurs in children, beginning with a high fever, followed by an erythematous and desquamating rash that can affect the entire body. Winter and spring are the typical times for this to occur.
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Kawasaki disease
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Fever, headache, and malaise, plus a rash that includes the wrists, ankles, palms of the hands, and soles of the feet. Typically occurs between April and September.
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Rocky Mountain Spotted Fever, caused by Rickettsia rickettsii
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The most severe cystic acne, having deep cysts, multiple comedones, and marked scarring.
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Acne conglobata
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Multiple scars and keloids in areas where acne lesions were present.
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acne keloidalis
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A Langerhans cell granulomatosis seen in children. Tissues are infiltrated by histiocytes.
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Letterer-Siwe syndrome
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A progressive myopathy which affects the proximal muscles, seen with carcinoma.
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Lambert Eaton syndrome
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A syndrome similar to Sturge Weber syndrome, with angiomas of the face and choroid.
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Lawford's syndrome
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A non-infectious form of endocarditis that can be seen with SLE.
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Libman-Sacks syndrome (Libman-Sacks endocarditis)
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Lorain-Levi syndrome
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pituitary dwarfism
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onychocryptosis
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an ingrown nail
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onychauxis
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a thickened, overgrown nail
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onychogryphosis
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a hooked or incurvated nail
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onycholysis
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the loosening or separation of all or part of the nail from the nail bed
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onychomycosis
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a disease of the nail caused by a fungal infection
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an ingrown nail
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onychocryptosis
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a thickened, overgrown nail
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onychauxis
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a hooked or incurvated nail
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onychogryphosis
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the loosening or separation of all or part of the nail from the nail bed
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onycholysis
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a disease of the nail caused by a fungal infection
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onychomycosis
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a lesion that goes below the surface of the tissue with loss of epidermis and dermis
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an ulcer
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scabs due to the accumulation of dried blood, can be seen w/ impetigo
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crusts
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an elevated lesion of the skin containing pus
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pustule
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a circumscribed area of skin with a different color, not raised or recessed
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a macule, an example would be an age spot
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This typically occurs in obese middle-aged women who are on warfarin for tx of a DVT or PE
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warfarin induced skin necrosis
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What is the mechanism of warfarin induced skin necrosis?
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Warfarin's inability to inhibit protein C
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Heparin binds to antithrombin, increasing inhibition of which two procoagulant proteases?
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Factor Xa and thrombin
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Part of the superficial fascia of the anterior thoracic region. Fibrous processes that come from the fascia that covers the mamma and passes forward to the integument and papilla. This is the structure that retracts the breast skin in breast cancer pts.
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The ligamenta suspensoria (the ligament of Cooper)
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This fascia is located between the Pectoralis minor and Subclavius. It protects the axillary vessels and nerves.
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Clavipectoral or Coracoclavicular fascia
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A portion of the clavipectoral/coracoclavicular fascia that goes from the first rib to the coracoid process
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the costocoracoid ligament
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This fascia covers the surface of the Pectoralis major
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the pectoral fascia
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The pectoralis fascia is called what in the axillary region?
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the suspensory ligament of the axilla
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Which type of collagen is responsible for the tensile strength of a scar?
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Type I collagen.
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