ID 1

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ID 1
2011-04-25 09:26:30
ID Lab Notes Exam4

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  1. What's the clinical presentation for measles?
    Maculopapular rash with fever & spots on oral mucosa
  2. What are koplik spots and what are they associated with?
    Ulcerated mucosal leasions on oral mucosa in measles
  3. What's the difference between Measles/VZV?
    • Measles: face -> trunk -> proximal extremities
    • VZV: Central (trunk) -> extremities
  4. What are complications of measles?
    Pneumonia, acute encephalitis, subacute sclerosing panencephalitis
  5. What are Warhin-Finkeldy cells and when/where are they found?
    Multinucleated giant cells with eosinophilic inclusions found in lung/sputum during measles infections
  6. What is the clinical presentation of mumps?
    Flu-like symptoms + fever -> parotid/testes swelling, abdominal pain, headache
  7. What lab finding is charactersitic of mumps?
    Increased serum amylase (not significant for pancreatits due to parotid gland swelling)
  8. What are complications of mumps?
    Keratitis, pancreatits (exocrine necrosis), pediatrtic deafness, aseptic meningitis, encephalitis, infertility
  9. What are histological features of Parotitis?
    Desquamation, intersitital edema, mononuclear inflammatory infiltrate
  10. What's the etology of measles?
    Respiratory transmission -> URT replication -> lymphoid tissue -> immune response = rash
  11. Where are the more serious complications of measles seen?
    Poor/malnourished kids
  12. What's the etiology of sterility in mumps?
    Swelling -> infarcts -> fibrosis/atrophy -> sterility
  13. What is the characteristic rash associated with HSV?
    Vesicular and ulcerated lesions on skin and mucosa
  14. 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
  15. In what settings is disseminated HSV likely?
    Infection in those with defective cell mediated immunity (HIV/chemo/neonates)
  16. What are complications of Dissemninated HSV?
    • Lymphadenopathy, pulmonary necrosis
    • Temporal lobe/adrenal gland
  17. What are Cowdry Type -A inclusions and where are they seen?
    Intranuclear inclusions (HSV is in the nucleus)
  18. What are the different syndromes of anthrax?
    Cutaneous, Inhalational, Gastrointestinal
  19. Describe the progression of Cutaneous antrax
    • Painless papule
    • vessicle formation
    • edema/lymphadenopathy
    • rupture -> formation of black eschar
  20. Describe the progression of Inhalational anthrax
    • Inhaltion of spores
    • Macrophages -> LN
    • Germination & toxin release
    • Hemorrhagic mediastinitis
    • Shock
  21. Describe the progression of GI Anthrax
    • Eat contaminated meat
    • Nause, abd pain, vomiting
    • Bloody diarrhea
    • Mortality > 50%
  22. What radiological finding is characteristic of anthrax?
    Mediastinal widening
  23. What type of organism is anthrax?
    Boxcar shaped gram postive rod
  24. What finding is indicative of anthrax septicemia?
    Organisms in the blood
  25. What are the toxins of anthrax and what do they do?
    • EF: adenylate cyclase; cauases increase in cAMP
    • LF: causes cell death
  26. What histological finding is characteristic of inhalational anthrax?
    Pulmonary hemorrhage
  27. What kind of organism is S. aureus?
    gram positive cocci in clusters (grapes)
  28. What is the clinical presentation of S. aureus?
    Involvement of skin and soft tissue of kids and adults
  29. What are non-cutaneous complications of s. aureus?
    Osteomylitis, pneumonia (empyema), infective endocarditis (diabetes), food poisoning, TSS
  30. What is staph scalded skin syndome?
    • Kids with infection in nose/skin
    • A/B toxis cleave desmoglein I (acantholysis)
    • Sunburn rash over body
  31. What's the differentiating characteristic between CML and Leukemoid reaction?
    LAP increase in CML
  32. What type of organism is Entabmoeba Hystolytica?
  33. What's the clinical presentation of Entamoeba histolytica?
    Abdominal pain, bloody diarrhea, weight loss
  34. Where are common involvement of entamoeba histolytica?
    Cecum, ascending colun, splanchnic vessels of liver
  35. What's the histological finding of entamoeba histolytica?
    • Amoeba invasion of submucosa & muscularis propria
    • Lateral spread = flask appearance of ulcer
  36. What's the mechanism of spread of Entamoeba histolytica?
    Fecal oral/Homosexual STI
  37. What's the treatment for entamoeba histolytica/MoA?
    • Metronidazole
    • Ferridoxin Demendent Pyruvate oxioreductase
    • Fermentatian Enzyme
  38. What pulmonary complication is possible with entamoeba histolytica?
    Pleural effusion resulting from rupture through diaphragm into pleural space
  39. How can entamoeba histolytica be identified?
    RBCs in the parasite
  40. 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
  41. What's the histological hallmark of TB?
    Caseating granuloma surrounded by epithelioid histiocytes + AFS
  42. What's a Ghon focus?
    Primary TB lesion
  43. What's a Ghon complex?
    Primary (ghon focus) lesion with hilar LN involvement
  44. What are the outcomes of TB?
    • Primary childhood granuloma -> inactive granuloma
    • 30% Active infection
    • < 5% Active disease
  45. 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
    • Amyloidosis (APP)
  46. What stimulates the conversion of macrophages -> giant cells?
  47. 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