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What bug? Proteus and H. Zoonotic bacteria. Borrelia burdorferi 2. Francisella tularensis 3. Yersinia pestis 4. Pasteurella multocida 5. Brucella spp. Borrelia burgdorferi: Disease states. Lyme disease. Brucella: Disease states. Temperature slowly rises during day, peaks in the evening, and slowly declines to normal by morning. Accompanied by other systemic symptoms.
Brucella: Transmission. Gross mechanism of brucellosis. Penetration of skin but no buboes or primary skin ulcer , conjunctiva, lungs, GI tract 2. Lymphatic spread 3.
Facultative intracellular growth in macrophages, and blood and organ invasion. Francisella Tularensis: Disease states list. Tularemia, either: 1. Pneumonic 2. Oculoglandular 3. Ulceroglandular 4. Describe Ulceroglandular tularemia. Well-demarcated hole in the skin with a black base b. Fever and systemic symptoms c. Francisella tularensis: Transmission. Most common: Handling of infected rabbits or from bites of ticks and deer flies Hundred creatures in total all over US.
Mnemonic: Francis the rabbit is playing in the TULips, with a deerfly on one ear and a tick on the other. Virulence of Francisella tularensis. Diagnosis of Francisella tularensis. Yersinia pestis: Transmission. PESTS like rats harbor the disease and fleas are the vector, biting the skin of humans. Found in campers, hunters, and hikers. Fraction 1 F1 antigen. Enables Yersinia pesitis to resist destruction after phagocytosis facultative intracellular Mnemonic: A rat driving a fuel-injected F1 VW bug V and W antigens fleeing flea-ing from a macrophage.
V antigen. W antigen. Yersinia pestis: Presentation in humans. Lymph node usually inguinal [boubon is Greek for groin] becomes inflamed all four signs. Fever, and headache. Blackish discoloration under skin "Black death".
Disease states caused by Yersinia pestis. Pasteurella Multocida: Transmission. Cat, dog, and animal bites. Also infects birds. Mnemonic: Cat and dog chasing a bird in a "Pasteur". Pasteurella is not. Pasteurella: Treatment. Best breeding ground for Pasteurella Treat with penicillin or doxycycline. Gardnerella: Characterization. Pleomorphic, gram-variable rod. What disease states does Gardnernella cause?
Vaginosis 1. Greenish vaginal discharge with fishy smell 2. Noninflammatory nonpainful 3. Mobiluncus anaerobe is also seen 4. Clue cells are visible vaginal epithelium covered with bacteria 5.
Positive Whiff test. Clue cell, indicative of Gardnerella vaginosis. What does a positive PPD indicate? Current infection 2. Past exposure 3. BCG vaccination. What does a negative PPD indicate? No infection 2. If still negative, anergic. Fast-fermenting lactose bacteria. Fast fermenters: EEK! Too fast! Slow fermenting lactose bacteria. Slow fermenters: 1. Serratia 2. Citrobacter 3. Tuberculosis infection: Gross mechanism.
Inhaled aerosols from infected adults 2. Land in middle or lower lobes of lung highest airflow leading to small area of pneumonitis. Bacteria enter macrophages, multiply, and spread hematogenously. Mechanism of asymptomatic primary TB. Cell-mediated defense walls off foci of bacteria in caseous granulomas 2.
Granulomas heal with fibrosis, calcification and scar formation. Difference between Ghon focus and Ghon complex. Ghon focus: Calcified tubercle in the middle or lower lung Ghon complex: Ghon focus accompanied by perihilar or lobar lymph node calcified granulomas.
What is a Ranke complex? Same as a Ghon complex: Ghon focus accompanied by perihilar or lobar lymph node calcified granulomas. Mechanism of symptomatic primary TB. In the lungs, caseous material liquifies, is extruded out the bronchi and leaves cavitary lesions behind.
Mechanism of secondary Pulmonary TB. Infection occurs at apical areas of lung around the clavicles due to highest oxygen tension caused by decreased pulmonary circulation. Infected areas grow, caseate, liquify and cavitate. TB reactivation sites. Pulmonary Lung parenchyma 2. Pleura 3. Pericardium 4. Scrofula Cervical lymph nodes: most common extrapulmonary site worldwide 5. Kidney Sterile pyuria 6.
Thoracic and lumbar spine Pott's disease 7. Chronic monoarthritis 8. CNS subacute meningitis or parenchymal tuberculoma 9. Miliary TB Millet sized tubercles all over the body. Tuberculosis rule of 5s. Droplet nuclei are 5 micrometers and contain 5 mycobacteria 2. Induration measurements a. Cause of Miliary tuberculosis. Severe bacteremia. Types of Mycobacteria and what they cause. Leprae 2. Tuberculosis 3.
Avium-intracellulare 4. Scrofulaceum 5. What disease state does Mycobacterium Avium-intracellulare cause? Symptoms of tuberculosis. Night sweats 3. Weight loss 4.
Two Langhans type giant cells in which the nuclei are lined up around the periphery of the cell in a horseshoe pattern. Seen in granulomatous conditions like TB. What is Hansen's disease?
What is leprosy caused by? Mycobacterium leprae. Characterization and reservoir of Mycobacterium Leprae. Acid fast bacillus 2. Likes cool temperatures 3. Infects skin and superficial nerves 4. Cannot be grown invitro 5. Reservoir: Armadillos. Presentation of lepromatous leprosy. Loss of eyebrows 2. Nasal collapse 3. Lumpy earlobe. Treatment for leprosy. Long-term oral dapsone Alternative: Rifampin, clofazimine, and dapsone. Toxicity of longterm oral dapsone.
Hemolysis 2. Lepromatous Due to failed cell-mediated immunity. Rickettsiae: Characterization. Obligate intracellular parasites. Rickettsiae: Transmission and presentation. Coxiella: Atypical. Transmitted by aerosol and causes pneumonia All others: Arthropod vector causes classic triad of headache, fever and rash vasculitis. Treatment of Rickettsiae. Difference between spread of rash in typhus and spotted fever. Which bug causes Rocky Mountain spotted fever? Rickettsia rickettsii, transmitted by tick.
Which bug causes endemic typhus? Rickettsia typhi, transmitted by fleas. Which bug causes epidemic typhus? Rickettsia prowazekii, transmitted by human body louse. Which bug causes typhus?
Endemic: Rickettsia typhi, transmitted by fleas Epidemic: Rickettsia prowazekii, transmitted by human body louse. Which bug causes Q fever? Coxiella burnetii, by inhaled aerosols from cowhide and placentas. Remember: Carol Burnett coughing "Q" after inhaling spores from cowhide. What separates Q fever from other rickettsial diseases? Q fever is Queer. Rickettsial, but has an endospore, thus: 1.
Caused by Coxiella burnetii not called Rickettsia 2. No rash 3. No vector inhaled aerosols 4. Negative Weil-Felix 5. Causative organism can survive outside for a long time. Difference in tropism between Chlamydia and Rickettsia. Rickettsia: Endothelial cells of blood vessels Chlamydia: Columnar epithelium. Where is the rash in Rocky Mountain spotted fever found? Palms and soles, migrating to wrists, ankles, then trunk. Where can rashes on the palms and soles of feet be seen?
Rocky mountain spotted fever 2. Syphilis 3. Coxsackie virus A infection hand, foot, and mouth disease. Weil-Felix reaction. Assays for antirickettsial antibodies, which cross-react with Proteus antigen. Typhus: positive or negative Weil-Felix. Rocky mountain spotted fever: positive or negative Weil-Felix.
Q fever: positive or negative Weil-Felix. What bug: Atypical walking pneumonia in prisoner or military recruit younger than Mycoplasma pneumoniae. Describe mycoplasma pneumoniae pneumonia. Atypical walking pneumonia insidious onset, headache, non productive cough, diffuse interstitial infiltrate 2. X-ray looks worse than patient 3. High titer of cold agglutinins IgM. Special culture requirements for: Mycoplasma pneumoniae.
Eaton's agar. Treatment for mycoplasma pneumoniae. Tetracycline or erythromycin. Pencillin resistant because they have no cell wall. Characterization of Mycoplasma pneumoniae. Facultative anaerobe with no cell wall hence no gram stain 2. Only bacterial membrane with cholesterol 3. High titer of cold agglutinins 4. Grown on Eaton's agar. True or False: No Gram-positive bugs have endotoxin.
Listeria monocytogenes has it. Characterize Chlamydia. Elementary body small, dense which Enters cell via endocytosis 2. Initial or Reticulate body, which Replicates In cell by fission. Disease states caused by Chlamydia trachomatis. Reactive arthritis aka Reiter's syndrome 2. Conjunctivitis 3. Non-gonococcal urethritis, cervicitis, and PID. Disease states caused by Chlamydia pneumoniae.
Atypical pneumonia. Disease states caused by Chlamydia psittaci. Chlamydia species. Trachomatis 2. Pneumoniae 3. What is unusual about the chlamydial wall? It lacks muramic acid. Treatment of Chlamydia. Erythromycin or tetracycline. Reservoir for Chlamydia psittaci. Which chlamydia has an animal reservoir?
Psittaci: Avian. Lab diagnosis of chlamydia. Cytoplasmic inclusions seen on Giemsa or fluorescent-antibody stained smear. What disease is caused by Chlamydia Trachomatis serotypes A-C. Chronic infection 2. What disease is caused by Chlamydia Trachomatis serotypes D-K. Ectopic pregnancy 3. Neonatal pneumonia 4. Neonatal conjunctivitis. What disease is caused by Chlamydia Trachomatis serotypes L1-L3. Lymphogranuloma venereum 1. Positive Frei test.
Chlamydia Trachomatis serotypes L1-L3. Acquisition and treatment of neonatal conjunctivitis. Chlamydia trachomatis serotypes D-K acquired by passage through infected birth canal.
Treat with erythromycin eye drops. Characterization of spirochetes. Spiral-shaped bacteria with axial filaments. List of spirochetes. Mnemonic: BLT with spiral bacon 1. Borrelia Big! Leptospira 3. Visualization of Borrelia. Light microscopy with choice of aniline dye: 1. Wright's stain 2. Giemsa's stain. Stages of Lyme disease. Erythema chronicum migrans and flu-like symptoms 2.
Neurologic and cardiac manifestations 3. Autoimmune migratory polyarthritis. Signs and symptoms of Lyme disease. Bell's palsy and other CNS manifestations in Stage 2 2. Arthritis Autoimmune migratory in Stage 3 3. Kardiac block Stage 2 4. Erythema chronicum migrans Stage 1.
What species transmits Borrelia burgdorferi to humans? Ixodes tick. Live o. Classic symptom of Lyme disease and which stage is it in? Erythema chronicum migrans, an expanding "bull's eye" red rash with central clearing. Stage 1. Animal reservoirs for borrelia burgdorferi. White-footed mouse and other small rodens, and the white-tailed deer.
Ixodes tick picks up bugs from these animals and transmits them. Most common setting for Borrelia burgdorferi infection. What disease states does Treponema cause? Treponema Pallidum causes syphilis. What is yaws? Presentation of primary syphilis. Painless chancre localized disease. What stage of syphilis: Painless chancre localized disease. Presentation of secondary syphilis.
Disseminated disease with: 1. What stage of syphilis: Disseminated disease with constitutional symptoms. Secondary syphilis. Presentation of tertiary syphilis. Gummas 2. Aortitis 3. Neurosyphilis tabes dorsalis, general paresis 4. Argyll Robertson pupil. What stage of syphilis: Gummas. What stage of syphilis: Aortitis. What stage of syphilis: Neurosyphilis tabes dorsalis. What stage of syphilis: Argyll Robertson pupil. What stage of syphilis: maculopapular rash palms and soles.
What stage of syphilis: condylomata lata. Presentation of Congenital syphilis. Saber shins 2. Saddle nose 3. What stage of syphilis: Saber shins. Congenital syphilis not a stage. What stage of syphilis: Saddle nose. What stage of syphilis: Deafness. Treatment for Syphilis. Penicillin G. Signs and symptoms of tertiary syphilis. Broad-based ataxia 2. Positive Romberg sign 3. Charcot joints 4. Stroke without hypertension. What is an Argyll-Robertson pupil? Same as prostitute's pupil.
Constricts with accommodation but is not reactive to light. Pathognomonic for tertiary syphilis. What is the prostitute's pupil. Same as Argyll-Robertson pupil. Most specific for treponemes 2. Positive the earliest 3. Remains positive the longest. Active treponemal infection. Probably false positive VDRL 1.
Viruses mono, hepatitis 2. Drugs 3. Rheumatic fever and rheumatoid arthritis 4. Lupus and leprosy. Successfully treated treponemal infection. Sexuality of fungal spores. Asexual mostly. Which fungal infections are transmitted by inhalation of asexual spores? Coccidioidomycosis 2. What are conidia? Asexual fungal spores. What disease states does Candida albicans cause? Thrush esophagitis in immunocompromised patients neonates, steroids, diabetes, AIDS 2.
Disseminated candidiasis to any organ 6. Chronic mucocutaneous candidiasis. Treatment for Candida Albicans infection. Superficial: Nystatin Serious systemic: Amphotericin B. Histologic appearance of Candida Albicans. Budding yeast with pseudohyphae in culture at 20 degrees celsius Germ tube formation at 37 degrees celsius.
Candida albicans: Germ tube formation at 37 degrees celsius. Candida albicans: Budding yeast with pseudohyphae in culture at 20 degrees celsius. Which fungus causes thrush in immunocompromised. Candida albicans. Which fungus causes vulvovaginitis? Candida albicans high pH, diabetes, use of antibiotics. Which fungus is endemic to Southwestern US? Which fungus is endemic to Mississippi and Ohio river valleys. What fungus is this area known for: Southern Ohio. What fungus is this area known for: Southern Illinois.
What fungus is this area known for: Missouri. What fungus is this area known for: Kentucky. Each card catalogues a medically important microorganism, detailing its clinical presentation, pathogenesis, diagnosis, treatment, and other interesting facts.
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