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ID Lab Notes Exam4
What's the clinical presentation for measles?
Maculopapular rash with fever & spots on oral mucosa
What are koplik spots and what are they associated with?
Ulcerated mucosal leasions on oral mucosa in measles
What's the difference between Measles/VZV?
: face -> trunk -> proximal extremities
: Central (trunk) -> extremities
What are complications of measles?
Pneumonia, acute encephalitis, subacute sclerosing panencephalitis
What are Warhin-Finkeldy cells and when/where are they found?
Multinucleated giant cells
inclusions found in lung/sputum during
What is the clinical presentation of mumps?
Flu-like symptoms + fever -> parotid/testes swelling, abdominal pain, headache
What lab finding is charactersitic of mumps?
(not significant for pancreatits due to parotid gland swelling)
What are complications of mumps?
Keratitis, pancreatits (exocrine necrosis), pediatrtic deafness, aseptic meningitis, encephalitis, infertility
What are histological features of Parotitis?
Desquamation, intersitital edema, mononuclear inflammatory infiltrate
What's the etology of measles?
Respiratory transmission -> URT replication -> lymphoid tissue -> immune response = rash
Where are the more serious complications of measles seen?
What's the etiology of sterility in mumps?
Swelling -> infarcts -> fibrosis/atrophy -> sterility
What is the characteristic rash associated with HSV?
Vesicular and ulcerated lesions on skin and mucosa
What is Herpes Keratitis and what's the difference between epithelial/stromal types?
HSV leading to blindness
: direct virus cytolysis
: Immune reaction to HSV
In what settings is disseminated HSV likely?
Infection in those with defective cell mediated immunity (HIV/chemo/neonates)
What are complications of Dissemninated HSV?
Lymphadenopathy, pulmonary necrosis
Temporal lobe/adrenal gland
What are Cowdry Type -A inclusions and where are they seen?
Intranuclear inclusions (HSV is in the nucleus)
What are the different syndromes of anthrax?
Cutaneous, Inhalational, Gastrointestinal
Describe the progression of Cutaneous antrax
rupture -> formation of black eschar
Describe the progression of Inhalational anthrax
Inhaltion of spores
Macrophages -> LN
Germination & toxin release
Describe the progression of GI Anthrax
Eat contaminated meat
Nause, abd pain, vomiting
Mortality > 50%
What radiological finding is characteristic of anthrax?
What type of organism is anthrax?
Boxcar shaped gram postive rod
What finding is indicative of anthrax septicemia?
Organisms in the blood
What are the toxins of anthrax and what do they do?
: adenylate cyclase; cauases increase in cAMP
: causes cell death
What histological finding is characteristic of inhalational anthrax?
What kind of organism is S. aureus?
gram positive cocci in clusters (grapes)
What is the clinical presentation of S. aureus?
Involvement of skin and soft tissue of kids and adults
What are non-cutaneous complications of s. aureus?
Osteomylitis, pneumonia (empyema), infective endocarditis (diabetes), food poisoning, TSS
What is staph scalded skin syndome?
Kids with infection in nose/skin
A/B toxis cleave desmoglein I (acantholysis)
Sunburn rash over body
What's the differentiating characteristic between CML and Leukemoid reaction?
LAP increase in CML
What type of organism is Entabmoeba Hystolytica?
What's the clinical presentation of Entamoeba histolytica?
Abdominal pain, bloody diarrhea, weight loss
Where are common involvement of entamoeba histolytica?
Cecum, ascending colun, splanchnic vessels of liver
What's the histological finding of entamoeba histolytica?
Amoeba invasion of submucosa & muscularis propria
Lateral spread =
flask appearance of ulcer
What's the mechanism of spread of Entamoeba histolytica?
Fecal oral/Homosexual STI
What's the treatment for entamoeba histolytica/MoA?
Ferridoxin Demendent Pyruvate oxioreductase
What pulmonary complication is possible with entamoeba histolytica?
Pleural effusion resulting from rupture through diaphragm into pleural space
How can entamoeba histolytica be identified?
RBCs in the parasite
What's the gross difference between primary and secondary TB?
: focus & LN appear as white caseation along horizontal fissure
: cavitary lesions confined to apices of lung
What's the histological hallmark of TB?
Caseating granuloma surrounded by epithelioid histiocytes + AFS
What's a Ghon focus?
Primary TB lesion
What's a Ghon complex?
Primary (ghon focus) lesion with hilar LN involvement
What are the outcomes of TB?
Primary childhood granuloma -> inactive granuloma
30% Active infection
< 5% Active disease
What are sequelae of TB?
Adrenal Gland - Addison's disease (chronic autoimmunity)
Thoracic Cavity - empyema
GI tract - intestinal TB
Lungs - TB Pneumoniae
Vertebrae - Potts Disease
Meningies - Cranial nerve palsies
What stimulates the conversion of macrophages -> giant cells?
What's the characteristic histological finding of CMV?
Prominent Cowdry type A nuclear inclusions resembling owls' eyes
Distinct nuclear and ill-defined cytoplasmic inclusions in the lung