PATHO LE2: Infectious Part 1

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Infectious
Jessica Margaux Mercado
Flashcards by Jessica Margaux Mercado, updated more than 1 year ago
Jessica Margaux Mercado
Created by Jessica Margaux Mercado about 9 years ago
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Question Answer
Measles (genus, structure, transmission, predominant cells?) Paramyxovirus ssRNA respiratory droplets mononuclear cells
Measles: cell surface receptors CD46: inactivates C3 convertases, SLAM: T-cell activation; both bind to hemagglutinin = agglutination
croup, pneumonia, diarrhea w/ protein-losing enteroptahy, keratitis w/ scarring & blindness, encephalitis, hemorrhagic rashes Measles
blotchy, reddish-brown rash; initially on face, centrifugal progression; histo: dilated skin vessels edema, mononuclear perivascular inflamm infiltrates Measles
Koplik Spots; ulcerated mucosal lesions in oral cavity near opening Stensen duct; appear w/ necrosis, neutrophilic exudates and neovascularization Measles
Cough, Coryza, Conjunctivitis Measles
follicular hyperplasia, randomly distributed multinucleated giant cells (Warthin-Finkelday cells) Measles
peribronchial and interstitial mononuclear cell infiltration; multinucleated w/ glassy eosinophilic intranuclear inclusions Measles Pneumonia w/ Measles Giant Cells
Mumps (genus, structure, transmission?) Paramyxovirus RNA virus droplet inhalation
non-suppurative enlargement of parotid gland; appear doughy, enlarged, moist and reddish brown upon removal Mumps Parotitis
parotid gland: interstitium is diffusely infiltrated w/ lymphocytes, macrophages, plasma cells, which compress the acini & ducts; lumen of ducts contain neutrophils and necrotic debris Mumps Parotitis
Polio (genus, structure, transmission?) Enterovirus RNA Virus oral-fecal route
receptor in Polio? CD155
formalin-fixed polio vaccine Salk
live attenuated vaccine Sabin
Pathogenesis of polio retrograde transport along motor neuron axons --> CNS
poliovirus replication in motor neurons of spinal cord Spinal Poliomyelitis
poliovirus replication in brain stem Bulbar Poliomyelitis
flaccid paralysis w/ muscle wasting and hyporeflexia; leg deformity Poliomyelitis
aggregates of chronic inflamm cells w/ multinucleated giant cells; focal microglial proliferation w/ microglial nodules Poliomyelitis
Dengue (genus, transmission?) Flavivirus Aedes aegypti
fever, myalgia, joint pain, headache, retro-orbital pain w/ generalized transient macular rash Dengue Fever
hypoproteinemia, thrombocytopenia, prolonged bleeding time, elevated prothrombin time Dengue Hemorrhagic Fever
conjunctival hemorrhage, maculopapular/scariatiniform rash; small blood vessels: endothelial swelling, perivascular edema, infiltration w/ mononuclear inflamm cells Dengue Fever
large, pink to purple intranuclear inclusions "Cowdry Type A inclusions" Herpes Simplex Virus Infection
fever, periorificial cold sores, intraepithelial vescles (intracellular edema and ballooning degeneration), may burst and form crusting and ulceration Herpes Simplex Virus Infection
Gingivostomatitis; vesicular eruption from tongue extending to retropharynx HSV-1
swollen eryhtematous lesions of fingers and palms Herpetic whitlow
vesicles on genital mucous membranes and external genitalia; vesicles may burst = crusts, ulcers HSV-2 Genital Herpes
neonates: lymphadenopathy, splenomegaly, necrotic foci throughout lungs, liver, adrenal glands, CNS neonatal herpes infection
cornea: virus induced cytolysis of superficial epithelium Herpes Epithelial Keratitis
cornea: mononuclear cell infiltrate around keratinocytes and endothelial cells; leads to neovascularization, scarring, opacities, blindness Herpes Stromal Keratitis
Kaposi varicelliform eruption, eczema herpeticum, esophagitis, bronchopneumonia, hepatitis; occurs in immunosuppressed Disseminated skin and visceral herpes infection
acute VZV infection Chickenpox
reactivation of latent VZV infection Shingles
VZV transmission aerosols, droplet inhalation
macules -> vesicles; first occur on trunk, spread outwards toward head, upper and lower extremities; "dew drops on a rose petal" Chickenpox
lesions occur unilaterally, usually accompanied by intense itching, burning, and pain Herpes Zoster
asymptomatic or mononucleosis-like infections among healthy individuals CMV
most common viral opportunistic pathogen in AIDS CMV
transmission of CMV transplacental perinatal droplet inhalation sexual contact iatrogenic transmission
microcephaly w/ calcification, intrauterine growth retardation, jaundice, hepatosplenomegaly, thrombocytopenia, anemia (viral) congenital CMV, Cytomegalic Inclusion Disease
Owl's eye appearance: enlargement of infected cell, large intracellular basophilic inclusion bodies surrounded by clear halo CMV
infectious mononucleosis EBV
associated w/ development of: nasopharyngeal carcinoma, Burkitt's lymphoma, B cell non-Hodgkin's lymphoma, Hodgkin's lymphoma EBV
transmission of EBV? saliva, kissing
benign self-limited lymphoproliferative disease; sore throat, lymphadenopathy, hepatosplenomegaly, atypical lymphocytes Infectious mononucleosis
EBV binds to what receptor? CD21: receptor for CD3 component of complement on B cell
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 EBV infection
hepatomegaly, atypical lymphocytes in portal tracts & sinusoids, foci of parenchymal necrosis EBV
lymphadenopathy (usually post. cervical, axillary, inguinal); expansion of paracortical areas EBV
splenomegaly, expansion of white follicles and red pulp sinusoids = tense, fragile capsule; gross: solid, fleshy, hyperemic cut surface EBV
enzyme: invasive potential (staph) Coagulase
enzyme: spreading factor (staph) Hyaluronidase
enzyme: fibrinolysis (staph) Staphylokinase
enzyme: produces boils/furuncles (staph) Lipase
toxin: hemolysin, dermonecrotic, lethal to platelets, acts on vascular smooth ms (staph) a-toxin
toxin: sphingomyelinase (staph) B-toxin
toxin: detergent-like peptide (staph) d-toxin
toxin: hemolysin (staph) y-toxin
lyses phagocytic cells (staph) Leukocidin
cleaves desmoglein 1; keratinocytes detach (staph) Exfoliative toxin
fever, shock, multisystem involvement (staph) TSS protein, superantigen
acute, self-limiting food poisoning; stimulates vomiting center (staph) Enterotoxin
binds to Fc portion of Ig (staph) Protein A
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?) Staph; Furuncle
deeper suppuration, spreading laterally; involves skin, subcutaneous tissue, subcutaneous fascia; burrows, errupts in multiple adjacent skin sinuses (organism? infection?) Staph; Carbuncle
extensive neutrophilic infiltrate w/in alveoli; destruction of alveoli septae (organism? infection?) Staph; Lung abscess
chronic suppurative infection of apocrine glands (organism? infection?) Staph; Hidradenitis
sun-burn like rash all over body; fragile bullae; skin loss; seen in children w/ infections of nasopharynx and skin (organism? infection?) Staph; Staphylococcal Scalded-Skin Syndrome/ Ritter Disease
M protein Strep
pharyngitis, impetigo, rheumatic fever, glomerulonephritis (organism?) Strep pyogenes
neonatal sepsis, meningitis (organism?) clue: strep Strep agalactiae
abdominal abscess, UTI, endocarditis (organism?) clue: strep Enterococcus faecalis, etc.
dental caries, endocarditis, abscesses (organism?) Viridans strep
lobar pneumonia, meningitis, endocarditis (organism?) Strep pneumoniae
rapidly spreading bilateral erythematous cutaneous swelling w/ well-demarcated serpiginous borders; neutrophilic infiltration, minimal tissue destruction; butterfly distribution (organism? infection?) Strep; Erysipelas
epiglottic swelling, punctate abscesses of tonsillar crypts (organism? infection?) Strep Pharyngitis
transmission of C. diptheriae? aerosols skin shedding
thick gray coating at the back of the throat; histo: neutrophils, fibrin, necrotic debris (organism? infection?) Diptheria
Listeria: pore-forming protein to escape phagolysosome Listeriolysin O
Listeria: actin polymerization Act A
purulent exudates covering leptomeninges; neutrophils w/in subarachnoid space; G(+) intracellular (organism? infection?) Listeria monocytogenes; Meningitis
focal abscesses which alternate w/ grayish or yellow nodules; necrotic, amorphous tissue debris in lungs, liver, spleen, lymph nodes (organism? infection?) Listeria monocytogenes Infection in neonates & immunosuppressed
red papular rash over extremities; asbcesses in placenta; meconium smear: G(+) (organism? infection?) Neonates w/ L. monocytogenes sepsis
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?) B. anthracis; Cutaneous Anthrax
fever, dyspnea, hypotension, death; symmetric widening of mediastinum w/ mediastenitis; numerous foci of hemorrhage; perihilar and peribronchial lymphadenopathy (organism? infection?) B. anthracis; Inhalational Anthrax/Woolsorter's
opportunistic; indolent illness; fever, weight loss, coughing, may disseminate to CNS = brain abscess (organism?) Nocardia asteroides
opportunistic; cellulitis, lymphocutaneous disease, actinomycetoma w/ nodule formation, can progress to chronic draining fistulae (organism?) Nocardia brasiliensis
beaded, branched G(+); suppurative inflamm w/ central liquefaction, granulation tissue w/ fibrosis, no granuloma formation (organism?) Nocardia
bacterial meningitis, meningococcemia (organism?) N. meningitidis
males: urethritis; purulent discharge, dysuria (organism?) N. gonorrhea
females: asymptomatic, cervicitis, urethritis, pelvic inflammatory disease, fibrosis -> sterility, (organism?) N. gonorrhea
ophthalmia neonatorum (organism? treatment?) N. gonorrhea; tetracycline silver nitrate
bilateral adrenal hemorrhage w/ hypoadrenergic stage; rapid hypotension, shock, DIC, vasculitic purpura (organism? infection?) N. meningitidis; Waterhouse-Friderichsen Syndrome
transmission of N. gonorrhea oral, anal, vaginal, perinatal
Morning drop Gonorrhea
Whooping cough Bordetella pertussis
toxin: ADP-ribosylates and inactivates guanine nucleotide-binding proteins; paralyze cilia Pertussis Toxin
focal necrosis of epithelium, PMN infiltration, peribronchial inflammation, interstitial pneumonia, mucosal erosion, mucus plugs, atelectasis, dec. oxygenation, convulsions Whooping Cough
bacilli entangled with cilia (organism? infection?) B. pertussis; Whooping Cough
wound and burn infection, meningitis, necrotizing pneumonia, otitis externa; nosocomial, opportunistic (organism?) Pseudomonas aeruginosa
necrotic and hemorrhagic oval skin lesions, well-demarcated; form perivascular blue haze; thrombosis and hemorrhage may be present (organism? infection?) P. aeruginosa; Ecthyma gangrenosum
Soft Chancre (organism?) Hemophilus ducreyi
papule -> ulcer; painful, edges are ragged and not indurated; base: yellowish grey exudate (organism? infection?) H. ducreyi Soft chancre
papule -> ulcer; painless, edges are indurated; base: friable w/ abundant granulation tissue, bleed easily (organism? infection?) Klebsiella granulomatis; Granuloma Inguinale
painless ulcer w/ beefy red granulation tissue at base, indurated edges; lymphatic obstruction and lymphedema -> elephantiasis (organism? infection?) K. granulomatis; Granuloma Inguinale
histo: dense inflammatory infiltrate (histiocytes, plasma cells) w/ small abscesses; small round encapsulated coccobacilli enclosed w/in cytoplasm of macrophages (organism? infection?) K. granulomatis; Granuloma Inguinale "Donovan bodies"
granuloma: aggregates of epitheloid cells rimmed by lymphocytes, plasma cells and fibroblasts; caseation necrosis (organism? infection?) M. tuberculosis; Primary TB
gray white parenchymal focus + hilar lymph nodes w/ caseation (what is this called?) Ghon complex
radiologically detectable calcification when Ghon complex undergoes fibrosis Ranke Complex
foamy macrophages containing mycobacterium TB in immunosuppressed
anapical lesion w/ cavitation (organism? infection?) M. tuberculosis; Secondary TB
organs resistant to TB? heart, striated muscles, thyroid, pancreas
TB bacilli enter venous blood; minute yellow-white foci in lung Miliary Pulmonary Disease
serous pleural effusions, tuberculous empyema, obliterative fibrous pleuritis, hemoptysis Progressive Pulmonary TB
lining of airways become studded w/ granulomas; spread through lymphatic channels or from expectorated infectious material Endobronchial, Endotracheal, Laryngeal TB
TB bacilli enter systemic arterial system (what organs are most commonly affected?) Systemic Miliary TB; meninges, kidneys, adrenals, spleen, liver, bone marrow, fallopian tubes
TB in vertebrae Pott's Disease
most common form of extrapulmonary TB; usually involves cervical lymph node in children Scrofula/Lymphadenitis
ingestion of contaminated/unpasteurized milk, swallow expectorated material; granulomas may lead to ulceration of ileum Intestinal TB
low grade fever, night sweats, mucoid to purulent sputum, hemoptysis, pleuritic pain TB
presumptive diagnosis for TB AFB stain
Gold Standard for TB diagnosis Culture
abundant acid-fast bacilli w/in macrophages; no granuloma; (-) PPD MAC
focal areas of skin pallor and anesthesia; dry, scaly lesions; paucibacillary, strong T-cell immunity (organism? infection?) M. leprae; Tuberculoid Leprosy
granuloma w/ surrounding epitheloid cells, giant cells, mononuclear inflammatory cells; no or scanty AFB; non-necrotizing (organism? infection?) M. leprae; Tuberculoid Leprosy
nodular lesions found bilaterally; numerous, eventually coalesce; results in marked folding of skin, forehead, eyebrows, ear lobes, nose (organism? infection?) M. leprae; Lepromatous leprosy, Leonine facies
Lepra cells lipid-laden macrophages
Globi in Leprosy leprae cells filled w/ acid-fast bacilli
red snappers w/in macrophages (organism? infection?) M. leprae; Lepromatous Leprosy
hard chancre: painless, shallow, indurated ulcer (organism? infection?) Treponema pallidum; Syphilis
ulceration, chronic inflammation, vasculitis, obliterative end-arteritis (organism? infection?) Treponema pallidum; Syphilis
erythematous plaque, ulcerates to form a clean-based shallow ulcer w/ indurated margins = button-like (organism? infection?) Treponema pallidum; Primary Syphilis
concentric endothelial and fibroblastic proliferative thickening; fibrosis of tunica intima resulting in lumen obliteration, intimal fibrosis (organism? infection?) T. pallidum; obliterative end-arteritis
rash at palms and soles; may be maculopapular, pustular, or scaly; may be follicular, anular, pustular, or scaling (organism? infection?) Treponema pallidum; Secondary Syphilis
mucocutaneous changes: broad-based elevated plaques in moist areas of skin (organism? infection?) T. pallidum Secondary Syphilis, Condylomata latum
rash, condylomata latum, lymphadenopathy (organism? infection?) T. pallidum Secondary Syphilis
syphilitic aortitis, neurosyphilis, gummas (organism? infection?) T. pallidum; Tertiary Syphilis
progressive dilatation of aortic root and arch; end-arteritis of vaso-vasorum; aortic regurgitation and insufficiency -> aneurysm (organism? infection?) T. pallidum; Tertiary Syphilis, Syphilitic Aortitis
meningiovascular disease, tabes dorsalis, general paresis (organism? infection?) T. pallidum; Tertiary Syphilis, Symptomatic Neurosyphilis
pleocytosis, elevated protein levels, dec. glucose (organism? infection?) T. pallidum; Tertiary Syphilis, Asymptomatic Neurosyphilis
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?) T. pallidum; Tertiary Syphilis, Gumma
gummas: scarring in liver (organism? infection?) T. pallidum; Tertiary Syphilis, Hepar lobatum
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?) T. pallidum; Congenital Syphilis, Early/Infantile Syphilis
after 2y/o: interstitial keratitis, Hutchinson teeth, 8th nerve deafness (organism? infection?) T. pallidum; Congenital Syphilis, Late/Childhood/Tardive Syphilis
Lyme disease (organism? vector?) Borrelia burgdorferi; Ixodes scapularis (deer tick)
arteritis w/ onion-skin lesion Lyme arthritis
villous hypertrophy, lining cell hyperplasia, abundant lymphocytes and plasma cells in subsynovium; onion-skinned arteritis Early Stage Lyme Disease
extensive erosion of cartilage; painful, swollen joints; usually large joints e.g. knee Late Stage Lyme Disease
erythema chronicum migrans: bull's eye (infection? stage?) Stage 1 Lyme Diseae
skin lesions, migrating muscle & joint pains; CNS: meningoencephalitis, cranial neuritis; Cardio: heart block, pericarditis, myocarditis; migratory arthritis (infection? stage?) Stage 2 Lyme Disease
destructive chronic arthritis, acrodermatitis atrophicans, neuropathy, encephalitis (infection? stage?) Stage 3 Lyme Disease
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?) C. perfringes; cellulitis/gas gangrene
most common bacterial STI in the US, leading cause of infertility, leading cause of blindness Chlamydial infection
infectious form of Chlamydia Elementary body
metabolically active form of Chlamydia Reticulate body
chronic keratoconjunctivitis; progress to scarring and blindness (organism? serotype? infection?) Chlamydia A, B, C; trachoma
urogenital infections, inclusion conjunctivitis (organism? serotype?) Chlamydia D to K;
suppurative inguinal lymphadenitis; stellate abscesses surrounded by epitheloid cells; ulcer can pass away unnoticed; extensive scarring leading to fistula and strictures (organism? serotype? infection?) Lymphogranuloma venereum Chlamydia trachomatis L1, L2, L3
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?) Groove sign; Lymphogranuloma venereum
Q fever (organism? transmission?) Coxiella burnetti; aerosols, fomites
petechiae/purpura initially occurring on ankles and wrist, eventually becoming generalized (infection? vector?) Rocky Mountain Spotted Fever; tick bite
appears as eschar, initially found on the site of the bite, usually on trunk, spreading to extremities (infection? vector?) Scub Typhus; mite bite
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 Rickettsia
infective stage of malaria Sporozoites
stage responsible for clinical manifestations in malaria Merozoites
splenomegaly; blood vessels plugged w/ parasitized RBC; poor perfusion, hypoxia, ischemia, infarction; surrounded by small focal inflammatory reactions (Dürck granulomas) Malaria
spleen: fibrotic & brittle w/ thick capsule and fibrous trabeculae; gray-black (hemozoin) Malaria
hepatomegaly w/ hemozoin pigment; kidney: large, congested, dusting of pigment in glomeruli, hemoglobin casts Malaria
RBC rosettes, stick along endothelial lining = hemorrhages, vascular stasis, clogging of lumen = hypoxia, ischemia, infarction Malignant Cerebral Malaria
Dürck granulomas, degeneration of neurons, focal ischemic softening, scant inflammatory infiltrates Malignant Cerebral Malaria
heart: nonspecific focal hypoxic lesion; progressive anemia, circulatory stasis; lungs: pulmonary edema or shock w/ DIC Malaria
Babesiosis (organism? transmission? reservoir?) Babesia microti, Babesia divergens; deer tick, blood transfusion; reservoir: white-footed mouse
fever, hemolytic anemia; no hemozoin; shock, hypoxia, jaundice, hepatic necrosis, acute renal tubular necrosis, ARDS, erythrophagocytosis, visceral hemorrhages Babesiosis
Maltese cross Babesiosis
Leishmaniasis (transmission? infective stage?) sandfly; promastigote
promastigote: forms dense glycocalyx activates C3b deposition and MAC insertion lipophosphoglycan
promotes adhesion of promastigotes to macrophages; zinc-dependent proteinase Gp63
amastigote: phagolysosome: pH 4.5 proton-transporting ATP-ase
weight loss, hepatosplenomegaly, lymphadenopathy, pancytopenia, fever, myalgia; immune-complex mediated mesangioproliferative glomerulnephritis; hyperpigmentation of skin = black skin "Kala-azar" (organism? infection?) L. donovani, infantum, chagasi Visceral Leishmaniasis
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?) L. major, mexicana, braziliensis Cutaneous Leishmaniasis
espundia; moist lesion in nasal septa, anus or vulva; disfiguring (organism? infection?) L. braziliensis Mucocutaneous Leishmaniasis
begins as single skin nodules, continues spreading; aggregates of foamy macrophages stuffed w/ leishmania Diffuse Cutaneous Leishmaniasis
African Typanosomiasis/ African Sleeping Sickness (organism? transmission? infective stage?) T. gambiense, T. rhodesiense; Tsetse fly; trypomastigotes
intermittent fever, lymphadenopathy, splenomegaly, progressive brain dysfunction/ sleeping sickness, cachexia, death; large, red, rubbery chancre; concentrate in capillary loops, Mott cells African Typanosomiasis/ African Sleeping Sickness
American Typanosomiasis/ Chagas disease (organism? transmission?) T. cruzi; kissing bugs (Triatoma)
chagoma: transient, erythematous nodule Chagas disease
high parasitemia, fever, progressive cardiac dilation & failure; intracellular pseudocysts; focal myocardial cell necrosis; four-chamber cardiac dilation Acute Chagas Disease/ Acute Myocarditis
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 Chronic Chagas Disease
mainly in duodenal crypt; penetrate skin, invade lungs, trachea, swallowed, inhabit small intestine, asexual reproduction; autoinfection Strongyloides stercoralis
transmission of cystercosis ingestion of undercooked pork, food/water
white to opalescent lesion in brain Cysticercus cellulosae
Taenia solium pork tapeworm
Taenia saginata beef tapeworm (doesn't encyst)
humans are accidental hosts; ingestion of contaminated food Hydatid disease; Echinococcus granulosus
outer non-nuclear later; inner nucleated layer w/ brood capsules containing protoscolice Hydatid cyst
hydatid disease: invasion of? Liver, lungs, bones
Trichinosis (organism? transmission?) Trchinella spiralis; ingestion of undercooked meat (pigs, boars, horses)
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 Trichinosis
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