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GI
GI pathology
Question | Answer |
---|---|
Exudative tonsillitis pathogen | viruses: most cases |
Exudative tonsillitis's features | Culture is necessary to differentiate bacterial versus viral infections |
Hairy leukoplakia pathogen | EBV |
Hairy leukoplakia features | Glossitis associated /w bilateral white excrescences on lateral border of tongue: pre-aids-defining lesion |
Herpes labialis's pathogen | HSV type 1 |
Herpes labialis's features | Recurrent vesicular lesions on the lips (virus remains dormant in cranial sensory ganglia) Reactivated by stress, sunlight, and menses |
Herpes Labialis's treatment | Oral acyclovir, valacyclovir, famciclovir; topical acyclovir, penciclovir |
Mumps's pathogen | paramyxovirus |
Mumps's features | Bilateral parotitis (70%) /w increased serum amylase |
Mumps's complications | Meningoencephalitis, unilateral orchitis or oophoritis, pancreatitis |
Herpangin's pathogen | Coxsackievirus |
Herpangin's features | Occurs in children, Multiple vesicles or ulcers on soft palate and pharynx surrounded by erythema |
Hand-foot-mouth disease's pathogen | coxsackievirus |
Cervicofacial actinomycosis's pathogen? | Actinomyces israelii |
Cervicofacial actinomycosis's features | Draining sinus tract from facial or cervical area "sulfur granules" in pus; contain gram-positive, branching filamentous bacteria; anaerobe. Often follows after extraction of an abscessed tooth |
Cervicofacial actinomycosis's treatment | ampicillin, penicillin G |
Diphtheria's pathogen | Corynebacterium diptheriae |
Diphtheria's features? | Toxin produces "shaggy" gray pseudomembrane in posterior pharynx and upper airways |
Diphtheria's treatment | erythromycin |
Peritonsillar abscess's pathogen | Streptococcus pyogenes |
Peritonsillar abscess's features | Uvula deviates to contralateral side; "hot potato" voice; foul-smelling breath. Complication due to tonsillitis |
Peritonsillar abscess's treatment | surgical drainage of pus; penicillin G or V; add clindamycin for serious invasive infections |
Ludwig's angina's pathogen | Aerobic/anaerobic Streptococcus, Eikenella corrodens |
Ludwig's angina features | Cellulitis involving the submaxillary and sublingual space; follows fascial planes and may spread into pharynx, carotid sheath, superior mediastinum |
Ludwig's angina causes | Dental extraction (most common), trauma to floor of mouth |
Ludwig's angina treatment | surgical drainage; clindamycin + metronidazole |
Pharyngitis's pathogen | S. pyogenes |
Pharyngitis's features | Associated /w tonsillitis. Potential for acute rheumatic fever and glomerulonephritis |
Pharyngitis's treatment | Penicillin V |
Scarlet fever's pathogen | S. pyogenes |
Scarlet fever's features | Pharyngitis, tonsillitis, glossitis. Erythrogenic toxin produces rash on skin and tongue (initially white and then stawberry colored) Increased risk for glomerulonephritis. Nephritogenic strains pose no risk for acute rheumatic fever |
Scarlet fever's treatment | Penicillin G or V |
Sialadenitis's pathogen | Staphylococcus auresus |
Sialadenitis's features | Bacterial inflammation of major salivary gland. Secondary to a calculus, which obstructs the duct in postoperative patients |
Sialadenitis's treatment | Oxacillin, nafcillin if methicillin susceptible; TMP/SMX if community-acquired methicillin resistant; vancomycin if methicillin resistant in hopital |
Congenital syphilis' pathogen | Treponema pallidum (spirochetes) |
Congenital syphilis's features | Abnormalities involving incisors (notched and tapered like a peg) and molar teeth (resemble mulberries) |
Congenital syphilis's treatment | aqueous crystaline penicillin G |
Oral thrush's pathogen | Candida albicans (yeast) |
Oral thrush's features | May occur in neonates, immunocompromised patients (common pre-AIDS-defining lesion), diabetes mellitus, and following antibiotic therapy |
Oral thrush's treatment | fluconazole, itraconazole |
Invasive diarrhea characteristics | Pathogens invade enterocytes, low-volume diarrhea. Diarrhea /w blood and leukocytes (i.e., dysentery) |
Invasive diarrhea causes | Shigella spp., campylobacter jejuni, entamoeba histolytica |
Invasive diarrhea screening tests | Fecal smear for leukocytes: Positive in most cases. Order stool culture and stool for O&P |
Secretory Diarrhea characteristics | Loss of isotonic fluid, high-volume diarrhea, Mechanisms: Laxatives, enterotoxins stimulate Cl- channels regulated by cAMP and CGMP, Serotonin increases bowel motility. no inflammation in bowel mucosa |
Secretory diarrhea causes | Laxatives: danger of melanosis coli (black bowel syndrome) /w use of phenanthracene laxatives. Produciton of enterotoxins: vibrio cholerae, enterotoxigenic E. coli. Increased serotonin: carcinoid syndrome |
Secretory diarrhea screening tests | Fecal smear for leukocytes: negative. Stool osmotic gap>100 mOsm/kg |