Question | Answer |
HA, Fever, GI bleed, shock, death. Mid-zonal liver damage with acidophilic inclusion bodies. Dx? | Yellow Fever |
African teen w/ F, HA, N/V, and rash. Gets better. 4 years later sick w/ rapid deterioration, shock, GI bleed and skin petechial hemorrhage | dengue fever w/ DHF/DSS |
Fever, HA, rash, Vasculitis in skin, liver, CNS. Usual agent? | Rickettsiae, not Q-fever |
American child, in July, bit by tick; F, severe HA, myalgia Dx/ what do you expect next? | RMSF; R. rickettsia; maculopapular rash; dog tick |
October in Greece, F, HA, myalgia, then rash on palms and soles; Dx? Outcome/ | R. conorii; dog tick; favorable |
Brill-Zinsser disease. Caused by | Epidemic typhus; R. prowazekii |
Slum in War torn South America, outbreak, no eshar, F, HA, 5 days later body rash spreading out, delirium and coma Dx? | R. prowazekii; Epidemic typhus; body louse |
Less sever than epidemic typus | Endemic typhus; R. typhi; rat flea |
Japan, eschar, F, HA x 5 days then macular rash. Dx? Transmitted? | O. tsutsugamushi; chiggers |
Gram – spirochete, geimsa stain, F/C wax and wain every 5-7 days Dx? Tx? Transmission? | R. recurrentis; Tetracycline; Ticks |
Erythema Migrans Dx? Tx? 3 latent Sxs? | B. burgdorferi in USA, garinii/afzelii in other parts; Doxy; neurological, cardiovascular, arthritis |
BAKE a key LYME pie | Bell’s palsy, Arthritis, Kardiac block, Erythema migrans |
Q fever Cause? | Coxiella burnetti |
Trench Fever Cause? | Bartonella Quintana |
Granulocytes with berry cluster of organisms | Erlichia chaffeensis |
W. Africans lack this, gives resistance to P. vivax | Duffy antigen |
Most virulent Plasmodium. | falciparum |
Plasmodium that can cause Nephrotic syndrome | P. malariae |
Can leave “sleeping” hypnozoites in liver for up to 2 years to cause relapse | P. ovale and P. vivax |
Plasmodium that can persist at low levels for decades and then cause Sxs from time to time | P. malariae |
Renal failure due to acute tubular necrosis in a traveler to Africa Dx? | P. falciparum |
3 contributors to plasmodium mortality | anemia, hypoglycemia, lactic acidosis |
East? West? African Sleeping Sickness Causes? | T.b. rhodesiense & T.b. gamiense |
Sleeping sickness with swollen chancre at site of bite WorE? | East T.b. rhodesiense |
Winterbottom’s sign, what is it and DDX? | swollen lymph node on back of neck: T.b. rhodesiense or gambiense |
Sleeping sickness Txs? | Rhodesiense: Suramin(IV) then CNS Melarsoprol; Gambiense: pentamidine/eflornithine then eflornithine/ Melarsoprol. |
Chagas’ Disease Cause? Transmission? | T.cruzi; “kissing” bug; painless bite |
Chagas’ Dxtic findings/Sxs? | Chagomas at bite, fever, immediate heart failure; megacolon, megaesophagus; weakening & dilation of the heart ventricles |
Transmitted by sandfly | leishmania parasites |
Leishmania infect what cells? | intracellular macrophages |
Fever, weight loss x months, then hepato-splenomegaly | kala-azar; Visceral leishmaniasis |
Treated kala-azar can result in | PKDL- post kala-azar dermal meishmaniasis. |
3 New World leishmaniasis species | braziliensis, Mexicana, peruviana. |
Bloody urine Dx? Tx? Visual findings and possibilities? | Schistosomiasis (haematobium) Priziquantel; bladder polyps, inflammation; malignant change |
Portal hypertension with perisinusoidal granulomas, Symmers’ pipestem fibrosis Dx | Schistosomaisis |
Swollen scrotum worsening over years, with lower limb involvement Dx? Tx? | Brugeria or Wuchereria; Albendazole |