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step1 10.9.12
Microbiology VI
| Question | Answer |
|---|---|
| What are 4 major populations who might get candida albicans? | neonates, steroid use, DM, AIDS |
| What diseases does Candida albicans cause? | vulvovagintis (DM, use of abtx), diaper rash, endocarditis in IVDA, chronic mucocutaneous candidisis |
| What does candida look like at 20 vs 37 degrees? | pseudohyphae and budding yeasts at 20 degrees, germ tubes at 37 degrees |
| What is the Tx for candida albicans? | azole for vaginal. fluconazole or caspofungin for oral. amphotericin B, fluconazole, caspofungin for systemic |
| What does aspergillus look like on microscoe? | septae hyphae with acute angle branching. not dipmorhpic |
| Who gets infected wiht aspergillus funigatus? | IcPt especially those with chronic granulomatous disease |
| What 4 major diseases does aspergillus fumigatus cause? | 1. allergic bronchopulmonary aspergilossis 2. aspergilomas in cavities esp after TB 3. heptaocellulat carcinoma due to aflatoxins 4. invasive disease in lungs |
| What is seen in the microscope for cryptococcus neoformans? | yeasts with wide capsular halos and unequal budding in india ink stain |
| What disease does cryptococcus neoformans cause? | cryptococcal meningitis, cryptococcosis. soap bubbles lesions in brain |
| What are the structural characterisitcs of cryptococcus neoformans and how is it acquired? | heavily encapsulated yeast. no dimorphic. soil and pidgeon droppings and acquired via inhalations or hematogenous spread |
| How do you culture cryptococcus neoformans and what lab test can be used to detect it? | culture on Sabouraud's agar. Latex agglutination test detects polysaccaride capsular Ag and is more specific. |
| What disease does mucor and rhizopus cause and who gets it? | mucormycosis especially in ketoacidotic DM and lukemic Pt |
| What does mucor spp look like under the microscope? | broad, non septaer hyphae branching at wide angles |
| What is the mechanism of mucormycoses? | fungi proliferate in blood vessel wall, pnetrate cribriform plate and enter brain. get rhinocerebral and frontal lobe absesses. black necrotic eschar on face |
| What disease does pneumocystis jirovecii cause? how do you Dx it? | diffuse interstitial pneumonia, diffuse bilateral on CXR, dx by lung biopsy or lavage |
| What can you grow pneumocystis jirovecii on? | disc shaped yeast on methenamine silver stain of lung tissue |
| Who is especially at risk for pneumocystis jirovecii infection? | IcPt, especially AIDS |
| What is the Tx for pneumocystis jirovecii? When should prophylaxis for it begin | TMP-SMX, pentamidine, dapsone. Start prophylax when CD<200 in HIV |
| Dimorhpic, cigarshaped budding yeast living on vegetation. pathogen? | Sporothrix schenkii |
| What is the mech of sporothrix schenikii infection? | usually introduced via trauma like rose thorn (rose gardeners diseseas). local pustule or ulcer with nudules along draining lymphatics |
| What is the Tx for sporothrix schenkii? | itraconazole or potassium iodide |
| What disease does Girdia lamblia cause? How is it transmitted? | bloating, flatulence, fatty diarrhea(esp campers). found in cysts in water |
| How is giardia lamblia Dx? tx? | trophozoites or cysts in stoll. tx: metronidazole |
| What disease is caused by Entamoeba histolytica and how is it transmitted? | bloody diarrhea, liver absess (reddish brown), RUQ pain(flask shaped ulcer in submucosal absess of colon ruptures). transmitted by cysts in water |
| How is Entamoeba histolytica dx and tx? | trophozoites with RBCs in stool or cysts with multiple nuclei in stool. Tx: metronidazole and iodoquinol |
| What disease does Cryptosporidium cause and how is it transmitted? | sever diarrhea in AIDS Pt. mild watery diarrhea otherwise. transmitted thru cysts in the water |
| How is cryptosporidium Dx and tx? | Dx: cysts on acid fast stain Tx: prevention by filtering water supplies |
| What disease does toxoplasma gondii cause and how is it transmitted? | brain absess in HIV (ring enhancing lesion), congenital toxoplasmosis. transmitted via cysts in meat or cat feces. crosses placenta so pregnant stay away from cat |
| New born with chorioretinitis, hydrocephalus, intracranial calcifications. disease? | this is classic triad of congenital toxoplasmosis |
| How is toxoplasmosis gondii Dx and Tx? | Dx via biopsy or serology. tx:sulfadiazine + pyrimethamine |
| What disease does Naelgeria fowleri cause and how is it transmitted? | causes rapidly fatal meningoencephalitis. acquired from swimming in freshwater lakes. protozoa enter thru cribriform plate |
| How is Naelgeria fowleri dx and tx? | dx by amoebas in spinal fluid. tx: amphotericin effective in a few survivors |
| What disease do Trypanosoma brucei, gambiense, rhodesiense cause and how is it transmitted? | cause African sleeping sickenss: large LN, fever(due to Ag variance), somnolence coma. acquired from painful bite of tsetse fly |
| What is the Dx and Tx for Trypanosoma brucei in both blood borne disease and CNS penetration? | Dx: blood smear Tx: suramin for blood bourne, melarsoprol for CNS (SURe is nice to sleep, MELetonin helps with sleep) |
| What disease (SX) do plasmodium spp cause and how are they transmitted? | cause malaria: fever, HA, splenomegaly. Transmitted by anopheles mosquito |
| What is the pattern of malaria caused by Plasmodium vivax/ovale? | 48 hr cycle. fever on 1st and 3rd day. dormant form in liver |
| What is the malaria pattern caused by Plasmodium falciparum? | severe, ireegular fever patterns. parasitized RBCs occlude the brain, kidneys, lungs |
| What is the malaria pattern in an infection by Plasmodium malarie? | 72 hour cycle |
| What is seen on a blood smear in Malaria? | Plasmodium infection. see trophozoite ring. RBC schizont with merozoites |
| What is the Tx for malaria. what must be done if vivax/ovale? | Begin with chloroquine (blocks plasmodium heme polymerase). if it resists use mefloquine. In vavax and ovale primaquine is used for the dormant form in the liver |
| What disease does Babesia cause and how is it transmitted? | babesiosis. fever and hemolytic anemia in NE US. Acquied from Ixodes tick (can coinfect with Lyme) |
| Who is at special risk fro Babesiosis? | asplenics |
| What is seen in a blood smear of Babesia? | ring form, "Maltese Cross" |
| What is the Tx for Babesia? | Qunine, clindamycin |
| What disease does trypanosoma cruzi cause and how is it transmitted? | Chagas' disease(cardiomyopathy, megacolon, megaesophagus) in SA. Caused by reduviid bug (kissing) painless bite |
| How is Chagas' disease caused and how is it Dx and Tx? | Caused by Trypanosoma cruzi. Dx: blood smear Tx: nifurtimox |
| What disease does Leishmania donovani cause and how is it spread? | Visceral leishmaniasis(kala-azar). spiking fevers, hepatosplenomegaly, pancytopenia. Caused by sandfly |
| How is Leishmania donovani dx and tx? | Dx: macrophage with amastigotes tx: sodium stibogluconate |
| What disease does Trichomonas vaginalis cause and how is it transmitted? | vaginitis: fould smelling greenish discharge. itching and burning. bec carful not to confuse with gardenella. Only spread via sex |
| What is the Dx and Tx for Trichomonas vaginalis and tx? | DX:motile trophozoites on wet mount. tx: metronidazole for pt and partner |
| What is the transmission and disease for Enterobius vermicularis (pinworm)? | trans: food contaminated with eggs dis: anal puritis (Scotch tape tests) |
| What is the Tx for Enterobius vermicularis (pinworm)? | -bendazoles or pyrantel pamoate, roundworm |
| What is the transmission and disease for Ascaris lumbricoides (giant roundworm)? | trans: eggs visible in feces Dis: intestinal infectionm |
| What is hte Tx for Ascaris lumbricoides(giant roundworm)? | -bendazoles or pyrantel pamoate,roundworm |
| What is the transmission and disease of Trichenella spiralis? | undercooked meat esp pork. get inflammation of muscle, periorbital edema |
| How do you tx trichenella spiralis? | -benazoles, roundworm |
| What is the transmission and disease of Strongyloides stercoralis? | larvae in soil penetrate skin. get intestinal infection with vomiting diarrhea and anemia |
| How do you treat Strongyloides stercoralis? | -bendazoles or ivermectin, roundworm |
| What is the disease and transmission of Ancylostoma duodenale. Necantor americanus (hookworms)? | larvae penetrate skin of feet. get intestinal infection which can cause anemia due to parasite sucking blood from walls of intestine |
| How do you treat Ancylostoma duodenale. Necantor americanus (hookworms)? | -bendazoles of pyrantel pamoate, roundworm |
| What is the disease and transmission of Dracunulus medinensis? | in drinkign water. causes skin inflammation and ulceration |
| What is the Tx for Dracunculus medinensis? | niridazole, prolonged extraction, worundworm |
| What is the the transmission and disease of Onchocera volvulus? | transmitted by female blackflies. get hyperpigmented skin and river blindness. can have allergic reaction to microfilaria |
| How is onchcerca volvulus Tx? | ivermectin (for (r)iver blindness), roundworm |
| What is the transmission and disease of Loa loa? | from derr fly, horse fly, mango fly. get swelling of skin and worm crawling in conjunctiva |
| How do you treat Loa loa? | diethylcarbamazine, roundworm |
| What is the transmission and disease of Wucheria bancrofti? | female mosquito. get blockage of lymphatics. Takes 9 monnths after bite to get elephatiasis |
| How do you treat Wucheria bancrofti? | diethycarbamazine, roundworm |
| What is the disease and transmission of Toxocara canis? | food contaminated with eggs, causes granulomas(blindness in retina) and viceral larva migrans |
| How do you treat toxocara canis? | diethylcarbamazine, roundworm |
| What is the transmission and disease of taenia solium? | injestion of larvae encysted in prok leads to intestina ltapeworm. cystericosis, mass lesions in brain (Swiss cheese appearance) |
| What is the treatment for Taenia solium? | Praziquantel, tapeworm |
| What is the disease and transmission of Diphyllobothrium latum? | injestion of larvae in raw feshwater fish. causes vitamin B12 deficiency, resulting in anemia |
| What is the Tx for Diphyllobothrium latum? | Praziqunatel, tapeworm |
| What is the transmission and disease of Echinococcus granulosus? What is a major risk of removal? | eggs in dog feces if injest can cause cysts in liver. can get anaphylaxis if ag released from cysts(inject ethanol before removal) |
| How do you treat Echinococcus granulosus? | -bendazoles, tapeworm |
| What is the disease and transmission of Schistosoma? What can a chronic infection with S. haematobium lead to? | snails are host. cercariae penetrate skin of humans and cause granulomas and inflammation of sleen and liver. Chronic can lead to squamos cell carcinoma of liver |
| What is the tx for Schistosoma? | Praziquantel, its a fluke |
| What is the transmission and disease of Clonorchis sinensis? What cancer is it associated with? | undercooked fish, causes inflammation of billiary tract and pigmented gallstones. also associated with cholangicarcinoma |
| What is the Tx for Clonorchis sinensis? | Praziquantel, its a fluke |
| What is the disease and transmission of Paragonimus westermani? | undercooked crab meat. causes inflamamtion and secondary bacterial infection of lung. causing hemoptysis |
| How do you tx Paragonimus westermani? | Praziquantel, its a fluke |
| What is a mnemonic for injested nematodes? | Enterobius, Ascaris, Trichenella-you EAT them to get sick |
| What is a mnemonic for cutaneous nematodes? | Strongyloides, Ancylostoma, Necator. Get into your feet from the SANd |
| Parasite, brain cysts and seizures. organism? | Taenia solium 9cystercircosis) |
| Parasite, liver cysts. organism? | Echinoccous granulosus |
| Parasite, B12 deficiency. prganism? | Diphyllobothrium latum |
| Parasite, biliary disease, cholangiocarcinoma. organism? | Clonorchisis sinensis |
| Parasite. hemoptysis. organism? | Paragonimus westermani |
| Parasite. Portal HTN. organism? | Schistosoma mansoni |
| Parasite. hematuria, bladder cancer. organism? | Schistosome haemotobium |
| Parasite. microcytic anemia. organism? | Ancylostome, Necator |
| Parasite. perianal pleuritis. organism? | Enterobius |
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tjs2123
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