Measles
(genus, structure, transmission, predominant cells?)

Measles: cell surface receptors

croup, pneumonia, diarrhea w/ protein-losing enteroptahy, keratitis w/ scarring & blindness, encephalitis, hemorrhagic rashes

blotchy, reddish-brown rash; initially on face, centrifugal progression;
histo: dilated skin vessels edema, mononuclear perivascular inflamm infiltrates

Koplik Spots;
ulcerated mucosal lesions in oral cavity near opening Stensen duct; appear w/ necrosis, neutrophilic exudates and neovascularization

Cough, Coryza, Conjunctivitis

follicular hyperplasia, randomly
distributed multinucleated giant cells
(Warthin-Finkelday cells)

peribronchial and interstitial mononuclear cell infiltration; multinucleated w/ glassy eosinophilic intranuclear inclusions

Mumps
(genus, structure, transmission?)

non-suppurative enlargement of parotid gland; appear doughy, enlarged, moist and reddish brown upon removal

parotid gland: interstitium is diffusely infiltrated w/ lymphocytes, macrophages, plasma cells, which compress the acini & ducts; lumen of ducts contain neutrophils and necrotic debris

Polio
(genus, structure, transmission?)

receptor in Polio?

formalin-fixed polio vaccine

live attenuated vaccine

Pathogenesis of polio

poliovirus replication in
motor neurons of spinal cord

poliovirus replication in brain stem

flaccid paralysis w/ muscle wasting and hyporeflexia; leg deformity

aggregates of chronic inflamm cells w/ multinucleated giant cells; focal microglial proliferation w/ microglial nodules

Dengue
(genus, transmission?)

fever, myalgia, joint pain, headache,
retro-orbital pain w/ generalized
transient macular rash

hypoproteinemia, thrombocytopenia, prolonged bleeding time, elevated prothrombin time

conjunctival hemorrhage, maculopapular/scariatiniform rash;
small blood vessels: endothelial swelling, perivascular edema, infiltration w/ mononuclear inflamm cells

large, pink to purple intranuclear inclusions
"Cowdry Type A inclusions"

fever, periorificial cold sores, intraepithelial vescles (intracellular edema and
ballooning degeneration), may burst
and form crusting and ulceration

Gingivostomatitis; vesicular eruption from tongue extending to retropharynx

swollen eryhtematous lesions
of fingers and palms

vesicles on genital mucous membranes and external genitalia; vesicles may burst = crusts, ulcers

neonates: lymphadenopathy, splenomegaly, necrotic foci throughout lungs, liver, adrenal glands, CNS

cornea: virus induced cytolysis of
superficial epithelium

cornea: mononuclear cell infiltrate around keratinocytes and endothelial cells; leads to neovascularization, scarring, opacities, blindness

Kaposi varicelliform eruption,
eczema herpeticum, esophagitis, bronchopneumonia, hepatitis;
occurs in immunosuppressed

acute VZV infection

reactivation of latent VZV infection

VZV transmission

macules -> vesicles;
first occur on trunk, spread outwards toward head, upper and lower extremities;
"dew drops on a rose petal"

lesions occur unilaterally, usually accompanied by intense itching,
burning, and pain

asymptomatic or mononucleosis-like infections among healthy individuals

most common viral opportunistic
pathogen in AIDS

transmission of CMV

microcephaly w/ calcification,
intrauterine growth retardation,
jaundice, hepatosplenomegaly, thrombocytopenia, anemia
(viral)

Owl's eye appearance: enlargement of infected cell, large intracellular basophilic inclusion bodies surrounded by clear halo

infectious mononucleosis

associated w/ development of:
nasopharyngeal carcinoma, Burkitt's lymphoma, B cell non-Hodgkin's lymphoma, Hodgkin's lymphoma

transmission of EBV?

benign self-limited lymphoproliferative disease; sore throat, lymphadenopathy, hepatosplenomegaly, atypical lymphocytes

EBV binds to what receptor?

PBS: lymphocytosis, atypical lymphocytes (CD8 T-cells, CD16 NK cells);
large lymphocytes w/ abundant cytoplasm, azurophilic granules, vacuolizations, ovoid/ folded/indented nucleus; tends to be indented by surrounding RBCs

hepatomegaly, atypical lymphocytes in portal tracts & sinusoids, foci of parenchymal necrosis

lymphadenopathy (usually post.
cervical, axillary, inguinal); expansion of paracortical areas

splenomegaly, expansion of white
follicles and red pulp sinusoids
= tense, fragile capsule;
gross: solid, fleshy, hyperemic cut surface

enzyme: invasive potential
(staph)

enzyme: spreading factor
(staph)

enzyme: fibrinolysis
(staph)

enzyme: produces boils/furuncles
(staph)

toxin: hemolysin, dermonecrotic, lethal to platelets, acts on vascular smooth ms
(staph)

toxin: sphingomyelinase
(staph)

toxin: detergent-like peptide
(staph)

toxin: hemolysin
(staph)

lyses phagocytic cells
(staph)

cleaves desmoglein 1;
keratinocytes detach
(staph)

fever, shock, multisystem involvement
(staph)

acute, self-limiting food poisoning; stimulates vomiting center
(staph)

binds to Fc portion of Ig
(staph)

focal suppurative inflammation of skin and subcutaneous tissue; confined locally to superficial layer; seen in moist, hairy areas (e.g. back of neck, axilla);
starts in single hair follicle
(organism? infection?)

deeper suppuration, spreading laterally; involves skin, subcutaneous tissue, subcutaneous fascia; burrows, errupts in multiple adjacent skin sinuses
(organism? infection?)

extensive neutrophilic infiltrate w/in alveoli; destruction of alveoli septae
(organism? infection?)

chronic suppurative
infection of apocrine glands
(organism? infection?)

sun-burn like rash all over body;
fragile bullae; skin loss;
seen in children w/ infections of nasopharynx and skin
(organism? infection?)

M protein

pharyngitis, impetigo, rheumatic fever, glomerulonephritis
(organism?)

neonatal sepsis, meningitis
(organism?)
clue: strep

abdominal abscess, UTI, endocarditis
(organism?)
clue: strep

dental caries, endocarditis, abscesses
(organism?)

lobar pneumonia, meningitis, endocarditis
(organism?)

rapidly spreading bilateral
erythematous cutaneous swelling
w/ well-demarcated serpiginous borders; neutrophilic infiltration, minimal tissue destruction; butterfly distribution
(organism? infection?)

epiglottic swelling, punctate
abscesses of tonsillar crypts
(organism? infection?)

transmission of C. diptheriae?

thick gray coating at the back of the throat; histo: neutrophils, fibrin, necrotic debris
(organism? infection?)

Listeria: pore-forming protein to escape phagolysosome

Listeria: actin polymerization

purulent exudates covering leptomeninges; neutrophils w/in subarachnoid space;
G(+) intracellular
(organism? infection?)

focal abscesses which alternate w/
grayish or yellow nodules; necrotic, amorphous tissue debris in lungs, liver, spleen, lymph nodes
(organism? infection?)

red papular rash over extremities; asbcesses in placenta;
meconium smear: G(+)
(organism? infection?)

ulcerations in skin; painless, pruritic papule
-> vesicle, enlarges, edema w/ regional lymphadenopathy -> black eschar;
massive subepidermal edema, extensive dermal necrosis w/ intense PMN infiltration
(organism? infection?)

fever, dyspnea, hypotension, death; symmetric widening of mediastinum w/ mediastenitis; numerous foci of hemorrhage; perihilar and peribronchial lymphadenopathy
(organism? infection?)

opportunistic; indolent illness; fever, weight loss, coughing, may disseminate to CNS = brain abscess
(organism?)

opportunistic; cellulitis, lymphocutaneous disease, actinomycetoma w/
nodule formation, can progress to
chronic draining fistulae
(organism?)

beaded, branched G(+);
suppurative inflamm w/ central liquefaction, granulation tissue w/ fibrosis, no granuloma formation
(organism?)

bacterial meningitis, meningococcemia
(organism?)

males: urethritis;
purulent discharge, dysuria
(organism?)

females: asymptomatic, cervicitis,
urethritis, pelvic inflammatory disease,
fibrosis -> sterility,
(organism?)

ophthalmia neonatorum
(organism? treatment?)

bilateral adrenal hemorrhage w/ hypoadrenergic stage; rapid hypotension, shock, DIC, vasculitic purpura
(organism? infection?)

transmission of N. gonorrhea

Morning drop

Whooping cough

toxin: ADP-ribosylates and inactivates guanine nucleotide-binding proteins; paralyze cilia

focal necrosis of epithelium, PMN infiltration, peribronchial inflammation, interstitial pneumonia, mucosal erosion, mucus plugs, atelectasis, dec. oxygenation, convulsions

bacilli entangled with cilia
(organism? infection?)

wound and burn infection, meningitis, necrotizing pneumonia, otitis externa; nosocomial, opportunistic
(organism?)

necrotic and hemorrhagic oval
skin lesions, well-demarcated; form perivascular blue haze; thrombosis and hemorrhage may be present
(organism? infection?)

Soft Chancre
(organism?)

papule -> ulcer;
painful, edges are ragged and not indurated; base: yellowish grey exudate
(organism? infection?)

papule -> ulcer;
painless, edges are indurated;
base: friable w/ abundant granulation tissue, bleed easily
(organism? infection?)

painless ulcer w/ beefy red granulation tissue at base, indurated edges; lymphatic obstruction and lymphedema -> elephantiasis
(organism? infection?)

histo: dense inflammatory infiltrate (histiocytes, plasma cells) w/ small abscesses; small round encapsulated coccobacilli enclosed w/in cytoplasm of macrophages
(organism? infection?)

granuloma: aggregates of epitheloid cells rimmed by lymphocytes, plasma cells and fibroblasts; caseation necrosis
(organism? infection?)

gray white parenchymal focus
+ hilar lymph nodes w/ caseation
(what is this called?)

radiologically detectable calcification when Ghon complex undergoes fibrosis

foamy macrophages containing mycobacterium

anapical lesion w/ cavitation
(organism? infection?)

organs resistant to TB?

TB bacilli enter venous blood;
minute yellow-white foci in lung

serous pleural effusions, tuberculous empyema, obliterative fibrous pleuritis, hemoptysis

lining of airways become
studded w/ granulomas; spread
through lymphatic channels or from expectorated infectious material

TB bacilli enter systemic arterial system
(what organs are most commonly affected?)

TB in vertebrae

most common form of extrapulmonary TB; usually involves cervical lymph node in children

ingestion of contaminated/unpasteurized milk, swallow expectorated material; granulomas may lead to ulceration of ileum

low grade fever, night sweats, mucoid to purulent sputum, hemoptysis, pleuritic pain

presumptive diagnosis for TB

Gold Standard for TB diagnosis

abundant acid-fast bacilli w/in macrophages; no granuloma; (-) PPD

focal areas of skin pallor and
anesthesia; dry, scaly lesions;
paucibacillary, strong T-cell immunity
(organism? infection?)

granuloma w/ surrounding epitheloid cells, giant cells, mononuclear inflammatory cells; no or scanty AFB; non-necrotizing
(organism? infection?)

nodular lesions found bilaterally; numerous, eventually coalesce; results in marked folding of skin, forehead, eyebrows, ear lobes, nose
(organism? infection?)

Lepra cells

Globi in Leprosy

red snappers w/in macrophages
(organism? infection?)

hard chancre:
painless, shallow, indurated ulcer
(organism? infection?)

ulceration, chronic inflammation, vasculitis, obliterative end-arteritis
(organism? infection?)

erythematous plaque, ulcerates to form a clean-based shallow ulcer w/
indurated margins = button-like
(organism? infection?)

concentric endothelial and fibroblastic proliferative thickening; fibrosis of tunica intima resulting in lumen obliteration, intimal fibrosis
(organism? infection?)

rash at palms and soles; may be maculopapular, pustular, or scaly; may be follicular, anular, pustular, or scaling
(organism? infection?)

mucocutaneous changes: broad-based elevated plaques in moist areas of skin
(organism? infection?)

rash, condylomata latum, lymphadenopathy
(organism? infection?)

syphilitic aortitis, neurosyphilis, gummas
(organism? infection?)

progressive dilatation of aortic root and arch; end-arteritis of vaso-vasorum; aortic regurgitation and insufficiency -> aneurysm
(organism? infection?)

meningiovascular disease, tabes dorsalis, general paresis
(organism? infection?)

pleocytosis, elevated protein levels,
dec. glucose
(organism? infection?)

nodular lesions or destructive ulcerative lesions; white gray and rubbery; centers of coagulated necrotic material and margins composed of palisading macrophages and fibroblasts
(organism? infection?)

gummas: scarring in liver
(organism? infection?)

before 2y/o: nasal discharge and congestion, bullous or desquamating rash, osteochondritis, periostitis, saddle nose deformity, anterior bowing/ saber shin, liver and lung fibrosis
(organism? infection?)

after 2y/o: interstitial keratitis, Hutchinson teeth, 8th nerve deafness
(organism? infection?)

Lyme disease
(organism? vector?)

arteritis w/ onion-skin lesion

villous hypertrophy, lining cell hyperplasia, abundant lymphocytes and plasma cells in subsynovium;
onion-skinned arteritis

extensive erosion of cartilage; painful, swollen joints; usually large joints e.g. knee

erythema chronicum migrans: bull's eye
(infection? stage?)

skin lesions, migrating muscle & joint pains;
CNS: meningoencephalitis, cranial neuritis; Cardio: heart block, pericarditis, myocarditis;
migratory arthritis
(infection? stage?)

destructive chronic arthritis, acrodermatitis atrophicans, neuropathy, encephalitis
(infection? stage?)

foul smelling, thin exudate, bullae may rupture, gas bubbles, bluish black and soft to friable semi-fluid muscles; extensive myonecrosis, hemolysis, vascular thrombosis
(organism? infection?)

most common bacterial STI in the US, leading cause of infertility, leading cause of blindness

infectious form of Chlamydia

metabolically active form of Chlamydia

chronic keratoconjunctivitis; progress to scarring and blindness
(organism? serotype? infection?)

urogenital infections, inclusion conjunctivitis
(organism? serotype?)

suppurative inguinal lymphadenitis; stellate abscesses surrounded by epitheloid cells; ulcer can pass away unnoticed; extensive scarring leading to fistula and strictures
(organism? serotype? infection?)

linear fibrotic depression parallel to inguinal ligament bordered above and below by enlarged and matted lymph nodes covered by erythematous skin
(what is this called? infection?)

Q fever
(organism? transmission?)

petechiae/purpura initially occurring on ankles and wrist, eventually becoming generalized
(infection? vector?)

appears as eschar, initially found on the site of the bite, usually on trunk, spreading to extremities
(infection? vector?)

tropism to infect endothelial cells and vascular smooth muscles = vascular leakage and thrombosis;
can lead to hypovolemic shock, pulmonary edema, peripheral edema, renal failure, coma

infective stage of malaria

stage responsible for clinical manifestations in malaria

splenomegaly; blood vessels plugged w/ parasitized RBC; poor perfusion, hypoxia, ischemia, infarction; surrounded by small focal inflammatory reactions
(Dürck granulomas)

spleen: fibrotic & brittle w/ thick capsule and fibrous trabeculae; gray-black (hemozoin)

hepatomegaly w/ hemozoin pigment;
kidney: large, congested, dusting of pigment in glomeruli, hemoglobin casts

RBC rosettes, stick along endothelial lining = hemorrhages, vascular stasis, clogging of lumen = hypoxia, ischemia, infarction

Dürck granulomas, degeneration of neurons, focal ischemic softening, scant inflammatory infiltrates

heart: nonspecific focal hypoxic lesion; progressive anemia, circulatory stasis;
lungs: pulmonary edema or shock w/ DIC

Babesiosis
(organism? transmission? reservoir?)

fever, hemolytic anemia; no hemozoin;
shock, hypoxia, jaundice, hepatic necrosis, acute renal tubular necrosis, ARDS, erythrophagocytosis, visceral hemorrhages

Maltese cross

Leishmaniasis
(transmission? infective stage?)

promastigote: forms dense glycocalyx activates C3b deposition and MAC insertion

promotes adhesion of promastigotes to macrophages; zinc-dependent proteinase

amastigote: phagolysosome: pH 4.5

weight loss, hepatosplenomegaly, lymphadenopathy, pancytopenia, fever, myalgia; immune-complex mediated mesangioproliferative glomerulnephritis; hyperpigmentation of skin = black skin "Kala-azar"
(organism? infection?)

ulcers on exposed skin;
tropical sore: starts as itching indurated papule -> shallow expanding ulcer
w/ heaped up borders;
heals by involution; purple edematous plaque w/ central necrotic crust
(organism? infection?)

espundia;
moist lesion in nasal septa,
anus or vulva; disfiguring
(organism? infection?)

begins as single skin nodules, continues spreading; aggregates of foamy macrophages stuffed w/ leishmania

African Typanosomiasis/
African Sleeping Sickness
(organism? transmission? infective stage?)

intermittent fever, lymphadenopathy, splenomegaly, progressive brain dysfunction/ sleeping sickness,
cachexia, death;
large, red, rubbery chancre;
concentrate in capillary loops, Mott cells

American Typanosomiasis/
Chagas disease
(organism? transmission?)

chagoma: transient, erythematous nodule

high parasitemia, fever, progressive cardiac dilation & failure; intracellular pseudocysts; focal myocardial cell necrosis; four-chamber cardiac dilation

striking inflammatory infiltration of myocardium; heart is dilated, rounded w/ inc. size & weight; mural thrombi; scattered myocardial cell necrosis esp. towards apex of left ventricle = dilation and thinning;
dilated cardiomyopathy, arrythmias, megacolon, esophageal dilation

mainly in duodenal crypt; penetrate skin, invade lungs, trachea, swallowed, inhabit small intestine, asexual reproduction; autoinfection

transmission of cystercosis

white to opalescent lesion in brain

Taenia solium

Taenia saginata

humans are accidental hosts; ingestion of contaminated food

outer non-nuclear later;
inner nucleated layer w/ brood capsules containing protoscolice

hydatid disease: invasion of?

Trichinosis
(organism? transmission?)

patchy interstitial myocarditis;
lungs: focal edema, hemorrhage;
skeletal ms: coiled larva, membrane bound vacuoles w/in nurse cells, loss of striations, formation of collagenous capsule, angiogenesis;
CNS: focal gliosis