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GI

GI pathology

QuestionAnswer
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
Created by: schrla