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166 Cards in this Set
- Front
- Back
Actinomycosis is caused by what anaerobic gram-positive rod?
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Actinomyces Israelii
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Chronic suppurative nodules and sinus tracts with and exudate containing "sulfur granules" is characteristic of what gram-positive infection?
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Actinomycosis
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What bacterial infection causes a "Lumpy Jaw"?
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Actinomycosis
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What is the most common source of an Actinomycosis infection?
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Endogenous oral flora
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What are the 3 risk factors associated with Actinomycosis?
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1) Poor oral hygiene
2) Penetrating foreign bodies 3) Dental procedures |
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What are the 4 types of aerobic filamentous bacteria known to cause an Actinomycetoma?
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1) Nocardia Brasilensis
2) Actinomadura Madurae 3) Actinomadura Pelletieri 4) Streptomyces Somaliensis |
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What causes a chronic, slowly progressive SQ infection characterized by tumefaction, draining sinuses, and an exudate containing grains?
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Actinomycetoma
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What body part is most commonly affected with Acintomycetoma?
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The foot
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What is the most common source of an Actinomycetoma?
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Exogenous like soil
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Anthrax is caused by what gram-positive spore-forming rod?
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Bacillus Anthracis
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Cutaneous anthrax is caused by contact with what?
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Infected wild or domestic animals or their products
(wool, goat, animal hides and bones) |
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B. Anthracis has what 2 exotoxins?
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1) Edema Toxin
2) Lethal Toxin |
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The edema toxin of B. Anthracis is composed of what 2 parts?
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Edema Factor (EF) + Protective Antigen (PA)
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The lethal toxin of B. Anthracis is composed of what 2 parts?
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Lethal Factor (LF) + Protective antigen (PA)
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Which exotoxin of anthrax causes gelatinous edema of the skin by inducing an increase in cAMP levels?
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Edema Toxin
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The lethal factor portion of the lethal toxin causes shock and death in what form of anthrax?
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Disseminated Anthrax
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In disseminated anthrax lethal toxin causes shock and death via the release of what 2 cytokines?
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1) TNF-alpha
2) IL-1β |
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Protective antigen (PA) is responsible for what in the pathogenesis of anthrax?
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PA is responsible for the entry of exotoxins into the cell by receptor-mediated endocytosis
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Having antibodies to what will prevent the actions of Edema factor and lethal factor in the pathogenesis of anthrax?
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Antibodies to PA
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What are the 3 clinical forms of anthrax?
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1) Cutaneous (most common)
2) Inhalation 3) GI |
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What is the treatment for bioterrorism associated anthrax?
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Cipro or Doxy
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What is the treatment for conventional anthrax?
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PCN
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What is the initial primary skin lesion of anthrax?
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"Malignant pustule"
Starts as a painless papule |
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The initial painless papule of anthrax evolves into a hemorrhagic blister with surrounding non pitting edema with ultimately forms what characteristic feature of anthrax?
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Painless black eschar
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What type of bacteria causes Bartonellosis?
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Aerobic Gram-negative bacilli of the genus Bartonella
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Aerobic Gram-negative bacilli of the genus Bartonella cause what 4 diseases?
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1) Cat-Scratch Disease
2) Bacillary Angiomatosis 3) Trench Fever 4) Oroya Fever |
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Oroya fever is also known by what 2 names?
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1) Carrion's Disease
2) Verruga Peruana |
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What bacteria causes
Cat-Scratch Disease? |
Bartonella Henselea
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What is the vector in Cat-Scratch Disease?
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The cat flea:
Ctenocephalides Felis |
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TRUE or FALSE?
The vector in Cat-Scratch Fever, cat flea: Ctenocephalides Felis is transmitted from cat to human. |
FALSE
The cat flea: Ctenocephalides Felis is transmitted from cat to cat only |
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How does a human contract Cat-Scratch disease?
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By being bitten or scratch by a cat infected via the cat flea Ctenocephalides Felis
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How is Cat-Scratch disease treated?
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Most cases spontaneously resolve on their own
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Bartonella Henslea is the causative agent of what 2 disease?
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1) Cat-Scratch Disease
2) Bacillary Angiomatosis |
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Bacillary Angiomatosis is caused by what 2 organisms?
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1) B. Henselae (most common)
2) B. Quintana |
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What 2 abx are used to treat bacillary angiomatosis?
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Erythromycin and Doxy
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Bartonella Quintana is the causative organism in what 2 diseases?
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1) Bacillary angiomatosis
2) Trench fever |
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What bacteria causes Trench Fever?
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Bartonella Quintana
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What is the principle vector in Trench Fever?
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Human body louse:
Pediculus humanus corporis |
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What 2 antibiotics are used to treat trench fever?
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Erythromycin and Doxy
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What is the causative organism in Oroya Fever?
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Bartonella Bacilliformis
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What is the principal vector in Oroya Fever?
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The Sandlfy:
Lutzomyia Verrucarum |
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What secondary superinfection do you have to worry about in a patient infected with Carrion's Disease?
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Salmonella
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What is the treatment of Oroya fever?
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Chloramphenicol
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What 3 diseases are caused by the Borrelia species?
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1) Lyme Disease
2) Louse-Borne Relapsing Fever 3) Tick-Borne Relapsing Fever |
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What 2 continents do you commonly see Louse-Borne Relapsing fever?
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South America and Africa
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Where in the US is Tick-Borne Relapsing fever seen?
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Western US
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What Borrelia species causes Lyme Disease?
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Borrelia Burgdorferi
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What Borrelia species causes Louse-Borne Relapsing Fever?
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Borrelia Recurrentis
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What 2 Borrelia species cause Tick-Borne Relapsing Fever?
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1) Borrelia Duttonii
2) Borrelia Hermsii |
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What is the treatment for Lyme disease?
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For Preggers and kids <9yo = Amoxicillin
for everyone else its Doxy |
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What is the vector for Lyme Disease in the Northeast US?
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Ixodes Dammini
= Ixodes Scapularis |
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What is the vector for Lyme Disease in the Western US?
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Ixodes Pacificus
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What is the vector for Lyme Disease in Europe?
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Ixodes Ricinus
(They eat more rice in europe) |
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What is the vector for Louse-Borne Relapsing fever?
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Human body Louse
Pediculus Humanus |
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What is the vector for Tick-Borne Relapsing fever?
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Soft-bodied ticks
Ornithodoros |
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What are the 2 clinical skin features of Lyme disease?
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1) Erythema Migrans
2) Acrodermatitis Chronic Atrophicans |
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What are the 5 clinical features of both Tick-borne and Louse-borne Relapsing fever?
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1) Paroxysmal fevers
2) Headache 3) Lymphocytoma 4) Myalgias 5) Erythematous or petechial macules on the trunk & extremities |
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What antibiotic can be used to treat all 3 forms of Borreliosis?
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Doxycycline
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Name the 4 causative organisms implicated in Botryomycosis
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1) Staph Aureus
2) Pseudomonas Aeruginosa 3) E. Coli 4) Proteus species |
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What is the characteristic clinical feature of Botryomycosis?
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Chronic or subacute suppurative nodules or plaques
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What will you find on light microscopy with Botryomycosis?
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Granular bodies
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What are the 4 risk factors associated with Botryomycosis?
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1) Immunosuppresion (HIV)
2) DM 3) Trauma 4) ETOHism |
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What is the causative organism of Ecthyma Gangrenosum?
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Pseudomonas Aeruginosa Septicemia
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"Gunmetal gray" infarcts with surrounding erythema are the characteristic features of what infection?
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Ecthyma Gangrenosum
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What gram-positive rod causes Erysipeloid?
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Erysipelothrix Rhusiopathiae
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People who work in what 2 fields are at risk for Erysipeloid?
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Handlers of contaminated raw fish or meat
Fisherman or Butchers |
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A tender, well-demarcated, violaceous lesion with raised margins and central clearing, typically on the hand or finger is characteristic of what?
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Erysipeloid
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What abx is used to treat Erysipeloid?
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PCN
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What is the causative organism in Glanders?
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Burkholderia Mallei
(Glanders likes the bitches in Burkas) |
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Glanders is a disease caused by contact with what animal?
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Infected Horses
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Sarah AcMoody is at risk for getting what disease?
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Glanders
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An ulcerated nodule with regional lymphadenopathy in a jockey is classic presentation for what disease?
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Glanders
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Glanders is treated with what 2 abx?
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Imipenem or Doxy
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Meningococcemia is caused by what gram-negative diplococcus?
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Neisseria Meningitides
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Young children and patients with type of deficiency are at risk for developing meningococcemia?
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Patients with Complement deficiencies
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Petechiae that often progress to large ecchymotic or necrotic areas on the trunk and extremities with fever, chills, meningitis and hypotension most likely are infected with what?
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Neisseria Meningitides
(meningococcemia) |
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What 2 antibiotics are used to treat meningococcemia?
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IV PCN or Rocephin
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What is the causative organism in pitted keratolysis?
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Micrococcus Sedentarius
(PPK on feet from being sedentary) |
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What infectious disease presents with shallow 1-2mm pits on the plantar surface of the feet?
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Pitted Keratolysis
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What 3 topical agents can be used to treat infection with Micrococcus Sedentarius?
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1) Topical E-mycin
2) Topical clinda 3) BPO |
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Haverhill Fever is another name for what?
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Rat-bite Fever
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What is the causative organism in Rat-bite fever?
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Streptobacillus Moniliformis
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How does one acquire infection with Haverhill Fever?
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From rodents or contaminated food
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What are the 3 characteristic features of Rat-bite fever?
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1) Fever
2) Arthralgias 3) Rash (nonspecific red macules or papules which can become generalized) |
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What abx treats rat-bite fever?
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PCN
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What is the causative organism in Rhinoscleroma?
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Klebsiella Pneumoniae Rhinoscleromatis
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What are the characteristic features of Rhinoscleroma?
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Hypertrophic plaques on the external nares
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Mikulicz cells on histopathology are pathomnemonic for what?
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Rhinoscleroma
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What abx treats Rhinoscleroma?
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Cipro
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What phage group of staph aureus produce exotoxins, which can produces bullous or exfoliative skin lesions?
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Phage group 2
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What 4 cutaneous eruptions are caused by Staph?
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1) Toxic Shock Syndrome (TSS)
2) SSSS 3) Bullous Impetigo 4) Staphylococcal Scarlet fever |
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What % of TSS are non-menstral cases?
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50%
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What exotoxins are causative in non-menstral cases of TSS?
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Enterotoxins B and C
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What toxin causes TSS in menstrual cases?
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TSST-1 (TSS toxin 1)
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Along with Fever, and hypotension what skin findings do you see with TSS?
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Generalized scarlatiniform eruption followed by desquamation
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The exotoxins that cause SSSS are targeting what human antigen?
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Desmoglein 1
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What 2 toxins cause SSSS?
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Exfoliative toxins/Epidermolytic toxins A and B
(ET-A and ET-B) |
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What antigen do ET-A and ET-B bind to in the pathogenesis of SSSS?
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Desmoglein 1
|
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What 3 patient populations are at risk for developing SSSS?
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1) Children under 5
2) Adults with Renal failure 3) Adults with immunodeficiency |
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What will culture of a bullous lesion in SSSS reveal?
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Nothing
|
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Where is the site of staphylococcal infection in SSSS?
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Distant (extra-lesional)
-usually mucous membranes which is why culture of skin lesions will be negative for staph |
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Is Nikolsky's sign positive or negative in lesional skin in SSSS?
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Positive
|
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Is Nikolsky's sign positive or negative in non-lesional skin in SSSS?
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Positive
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What level is the split with SSSS?
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Sub-granular blister
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What 3 staphylococcal exotoxins cause Bullous impetigo?
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1) Exfoliative toxin A
2) Exfoliative toxin B 3) TSST-1 |
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Where is the site of staphylococcal infection in bullous impetigo?
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At the site of the lesion
|
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What do you expect to see on cultures of skin lesions in bullous impetigo
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Staph or strep
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What level is the split in bullous impetigo?
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Sub-corneal blister
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What type of rash do you see with Staphylococcal Scarlet Fever?
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Generalized scarlatiniform rash
|
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What are the 3 distinguishing features of Scarlet fever?
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1) Pastia's lines
2) Strawberry tongue 3) Pharyngitis |
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TRUE or FALSE?
In Staphylococcal Scarlet Fever the only symptom seen is the generalized scarlatiniform rash, NONE of the other systemic symptoms of classic Scarlet fever are seen. |
TRUE
|
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Impetigo (non-bullous), Folliculitis/Furunculosis, Sycosis barbae, Ecthyma, Cellulitis, Botryomycosis, Acute paronychia, Felon (Staphylococcal Whitlow), Purpura Fulinans and Endocarditis represent what?
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Diseases that are not usually but CAN BE caused by Staphylococcal Infections
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Tense blisters filled with purulent fluid and surrounding erythema on the dorsal surface of distal fingers and toes caused by Group A β-hemolytic streptococcus is known as what?
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Blistering Distal Dactylitis
|
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What level is the split with SSSS?
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Sub-granular blister
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What 3 staphylococcal exotoxins cause Bullous impetigo?
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1) Exfoliative toxin A
2) Exfoliative toxin B 3) TSST-1 |
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Where is the site of staphylococcal infection in bullous impetigo?
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At the site of the lesion
|
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What do you expect to see on cultures of skin lesions in bullous impetigo
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Staph or strep
|
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What level is the split in bullous impetigo?
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Sub-corneal blister
|
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What type of rash do you see with Staphylococcal Scarlet Fever?
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Generalized scarlatiniform rash
|
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What are the 3 distinguishing features of Scarlet fever?
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1) Pastia's lines
2) Strawberry tongue 3) Pharyngitis |
|
TRUE or FALSE?
In Staphylococcal Scarlet Fever the only symptom seen is the generalized scarlatiniform rash, NONE of the other systemic symptoms of classic Scarlet fever are seen. |
TRUE
|
|
Impetigo (non-bullous), Folliculitis/Furunculosis, Sycosis barbae, Ecthyma, Cellulitis, Botryomycosis, Acute paronychia, Felon (Staphylococcal Whitlow), Purpura Fulinans and Endocarditis represent what?
|
Diseases that are not usually but CAN BE caused by Staphylococcal Infections
|
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Tense blisters filled with purulent fluid and surrounding erythema on the dorsal surface of distal fingers and toes caused by Group A β-hemolytic streptococcus is known as what?
|
Blistering Distal Dactylitis
|
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Ecthyma, Non-bullous impetigo, Erysipelas, Cellulitis, Gangrenous Cellulitis (infectious gangrene, necrotizing fasciitis), Streptococcal toxic-shock-like syndrome, and endocarditis are all examples of what?
|
Other Streptococcal infections
(usually not caused by strep but can be caused by strep) |
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Name the 4 major disease caused by Group A β-hemolytic streptococcus.
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1) Blistering Distal Dactylitis
2) Perianal Streptococcal "Cellulitis" 3) Scarlet Fever 4) Purpura Fulminans |
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What is the clinical presentation of Perianal streptococcal "cellulitis"
|
Sharply demarcated tender erythematous plaque in the perianal region in children
|
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Pyrogenic exotoxin (erythrogenic toxin) types A, B and C mediate what GABHS disease?
|
Scarlet Fever
|
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What 2 lab tests will be positive in Scarlet fever?
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1) Positive strep throat culture
(in early infection) 2) Positive ASO titer |
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What typical systemic finding should you check for when suspecting scarlet fever?
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Streptococcal pharyngitis
|
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A child between 2-10yo with a recent history of strep throat presents to you with a sandpaper rash, what is the dx?
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Scarlet fever
|
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What 2 symptoms compose the enanthem of Scarlet Fever?
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1) Exudative Pharyngitis
2) Strawberry tongue |
|
Name the exanthem: Diffuse erythematous eruption with "sandpaper" texture, beginning on the head and neck, then generalizes, sparing the palms/soles with circumoral pallor.
|
Scarlet Fever
|
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Describe Pastia's Lines
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Linear petechial patches in axillae and antecubital fossa associated with Scarlet Fever
|
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What are Pastia's lines associated with?
|
Scarlet Fever
|
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When should you expect to see desquamation with Scarlet fever? In the beginning or towards resolution?
|
Desquamation usually starts on the face and ears upon resolution of the exanthem
|
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Purpura Fulminans is most commonly associated with what organism?
|
Group A β-hemolytic strep
|
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Name the disease that causes hemorrhagic infarction of the skin caused by DIC
|
Purpura Fulminans
|
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Name the disease that presents clinically as symmetric, large, ecchymotic areas with irregular ("geographic") borders on the extremities, ears, and most, most commonly
|
Purpura Fulminans
|
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What organism causes Trichomycosis Axillaris?
|
Corynebacterium tenuis
|
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Yellowish brown concentrations on axillary hair shafts is the characteristic clinical presentation of what?
|
Trichomycosis Axillaris
|
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What are 3 tx options for Trichomycosis Axillaris?
|
1) Shaving armpit hair
2) BPO gel 3) Topical E-mycin |
|
Tularemia is caused by what organism?
|
Francisella Tularensis
|
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What disease is most commonly caused by contact with infected rabbits?
|
Tularemia
|
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Dr. Fox and Elmer Fudd are both equally at risk for contracting what disease?
|
Tularemia
(Rabbit Hunters) |
|
Ulceroglandular, Glandular, Chancriform, Oculoglandular, Typhoidal, Pulmonary, Oropharyngeal and Meningeal are all possible forms of what disease?
|
Tularemia
|
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What is the most common form of Tularemia?
|
Ulceroglandular
|
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Describe the clinical presentation of the most common (Ulceroglandular) form of Tularemia.
|
Chancre like ulcer with raised borders and regional lymphadenopathy; typically on the finger or hand
|
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Where does Tularemia most commonly present?
|
Finger or hand
|
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What abx treats Tularemia?
|
Streptomycin
|
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Oroya Fever and Verruga Peruana represent 2 stages of the same infection, which is the acute stage?
|
Oroya Fever (Carrion's Disease) is the acute febrile stage
|
|
Verruga Peruana is the chronic or acute stage of infection with B. bacilliformis?
|
Chronic
|
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After the acute Oroya Fever (Carrion's Disease) stage, the eruptive verruga peruana then occur which clinically are identical to what other infectious disease?
|
The eruptive verruga peruana are clinically and histologically identical to Bacillary Angiomatosis
|
|
Describe the clinical presentation of verruga peruana
|
Angiomatous, pyogenic-granuloma-like lesions
|
|
Verruga Peruana can present in 3 different distributions, what are they?
|
1) Mular Form= large and few in number
2) Miliary Form= small and disseminated 3) Nodular and Deep |
|
Since 1945, 89% of US cases of the Bubonic Plague have occurred in what region of the US?
|
The Rocky Mountain states
|
|
How does one catch Rat-Bite Fever (Haverhill Fever)?
|
Direct contact with infected rats or other small rodents
|
|
Which group of obligate, intracellular, Gram-negative bacteria are transferred to humans through their natural reservoirs, blood-sucking arthropods?
|
Rickettsiae
|
|
What 3 species of Rckettsia make up the "Typhus Group"?
|
1) Rickettsia Prowazekii
2) Rickettsia Typhi 3) Rickettsia Tsutsugamushi |
|
Louse-borne epidermic typhus is caused by what Rickettsia species?
|
Rickettsia Prowazekii
|
|
Mouse, Cat, or Rat Flea Borne Endemic Typhus is caused by what Rickettsia species?
|
Rickettsia Typhi
|
|
Scrub typhus, a mite-borne infection is caused by what Rickettsia species?
|
Rickettsia Tsutsugamushi
|
|
Humans contract Epidemic Typhus from an infestation of what?
|
Body Lice (Pediculus Humanus)
|
|
Endemic Typhus is a natural infection of rats and mice, transmitted to humans by the same rat flea that transmits the plague known as?
|
Xenopsylla Cheopis
|
|
Scrub typhus is also known as what?
|
Tsutsugamushi Fever
|
|
The primary lesion of Scrub Typhus is an erythematous papule at the site of the mite bite, most commonly found on what 3 areas?
|
1) Scrotum
2) Groin 3) Ankle |
|
What is the vector for scrub typhus?
|
Trombiculid red mite (Chigger)
|