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