Toxic Shock Sx
Causative Bugs (2), Pres (TRIAD)?
(Exotoxins from)
- Staph aureus
- Strep pyogenes
PRES = “Fever, Rash, Shock”
Lyme Disease
Epi (incl CLUE), Pres (3 Initial + 3 Later)?
Northeastern U.S. Camper / Hiker.
PRES:
- Erythema migrans (expanding “bull’s eye” / “target” red rash)
- Facial nerve palsy typically BILAT
- Flu-like symptoms
- Neuro (ie encephalopathy, neuropathy)
- Cardiac: AV Nodal block
- MSK: Arthritis
CHRONIC Lyme Disease (ie untreated lyme disease)
Pres (3)?
PRES:
- Myocarditis
- ** BILATERAL Bell’s Palsy (MC CN involved in chronic lyme disease
= CN 7) **
- Infectious Arthritis
Diphtheria
Causative Bug, Pres (3), Micro Finding, DX (2)?
Corynebacterium diphtheriae.
PRES:
- Pseudomembranous Pharyngitis (“grayish-white memb”) w lymphadenopathy
- Myocarditis
- Arrhythmias
FINDING = Gram+ rods w blue/red granules
DX:
- Elek Test: test for diphtheria exotoxin
- Gram-Stain
Cutaneous Anthrax
Pres?
PRES:
- Boil -> Painless necrotic ulcer w black eschar
Pulmonary Anthrax
Pres (Initial + 4 Subsequent)?
PRES: - Flu-like symptoms ... Rapid progression to ... - Fever - Shock - Pulm hem - Mediastinitis
Erythema Infectiosum / 5th Disease (Parvo B19)
Pres?
PRES = “Slapped cheeks” / red rash on face.
“Child with fever” -> “Rash on face” -> “Rash on body”
Leprosy (Hanson Dz)
2 Forms,
Causative Bug + Source,
Locations Affected, Pres (CLUE)?
- Lepromatous
- Tuberculoid
Mycobacterium leprae- Armadillos.
Skin + superficial nerves.
PRES = “glove and stocking” loss of sensation
Lepromatous Leprosy
Immune Response (2), Pres (CLUE + 1)?
IMM:
- LOW cell-mediated immunity
- Th2 response
PRES: Contagious + Lethal
- “Leonine (lion-like) facies”
- Diffuse pres over skin
Tuberculoid Leprosy
Immune Response (2), Pres?
IMM:
- HIGH cell-mediated immunity
- Th1 response
PRES:
- Few hairless skin plaques
Legionnaires’ Dz
Causative Bug, Pres (2)?
Legionella Pneumophila
PRES:
- Fever + SEVERE Pneumonia
- Accompanying CNS + GI symptoms
Typhoid Fever
Causative Bug, Pres (4), Prog?
Salmonella typhi (found only in humans).
PRES:
- Fever
- Headache
- Diarrhea
- “Rose spots on abdomen”
Leptospirosis
Causative Bug + Source, Epi, Pres (3)?
Leptospira interrogans- water contaminated w animal urine.
Surfers / Tropics.
PRES:
- Fever + flu-like symptoms
- Jaundice
- Photophobia w conjunctival suffusion (erythema WO exudate)
Weil Dz (Icterohem Leptospirosis)
Additional Pres (2)?
SEVERE form of Leptospirosis
ADDITIONAL PRES:
- Liver + Kidney dysfunction -> Azotemia
- Hem + Anemia
Rocky Mountain Spotted Fever
Causative Bug + Vector, Epi (incl CLUE), Pres (TRIAD)?
Rickettsia rickettsii. Vector = Tick.
South Atlantic states (esp North Carolina).
PRES:
- Rash: starts at WRISTS / ANKLES -> spreads to center + palms / soles
- Fever
- Headache
Anaplasmosis + Ehrlichiosis
Causative Bugs (VS) + Vector, Micro Finding (incl VS)?
Anaplasma vs Ehrlichia. Vector = Tick.
FINDINGS: Morulae (berry-like inclusions) in cytoplasm.
Granulocytes w morulae vs Monocytes w morulae.
Candida Albicans infection
Possible Pres (5)?
PRES: (superficial or systemic fungal infection)
- Chronic mucocutaneous candidiasis / Disseminated candidiasis
- Diaper Rash
- Endocarditis (IV drug users)
- Oral + Esophageal Thrush (Immunocompromised)
- Vulvovaginitis
Mucormycosis
CB, Mech / Path (2 steps), Location Affected, Micro Finding,
Epi (2), Pres (3), RX?
Mucor + Rhizopus.
MECH:
Fungi proliferate in bl vessel walls (when excess glucose + ketones) ->
Penetrate cribiform plate -> Enter Brain.
Frontal Lobe abscesses.
FINDING: “Irregular nonseptate hyphae branching at broad / wide angles”
EPI:
- Diabetics
- Leukemics
PRES:
- Headache
- Facial pain
- “Black necrotic eschar” on face
RX: Amphotericin B
Q Fever
Causative Bug + Sources (2), Transmission, Pres?
Coxiella burnetti. ** NO arthropod vector **
- Tick feces
- Cattle placenta
TRANS: 2 Sources release spores -> Spores INHALED.
PRES = Pneumonia
Mycosis Fungoides / Sezary Sx
Def’n, Pres (4)?
Mycosis Fungoides: Cutaneous T cell lymphoma
Sezary Sx: Mycosis Fungoides + Malignant T cells in blood
PRES:
- Atypical T cells
- Lymphadenopathy
- Erythroderma
- Hepatosplenomegaly
Chagas Disease
Causative Bug + Source, Epi, Pres (2)?
Trypanosoma cruzi- Reduviid bug.
Primarily in South America.
PRES:
- Cardiomegaly / Dilated Cardiomyopathy
- Megaesophagus + Megacolon
Rubella virus
Pres (Epi + 4)?
PRES: “German / 3-day Measles”. Serious if congenital, mild in children.
- Fever
- Lymphadenopathy (esp postauricular)
- Fine rash: macules that start on face -> spread centrifugally to trunk + extremities
(similar rash pres to Measles)
- Arthralgias
Congenital Rubella
Trans, Pres (Skin CLUE + 2), Comp (3)?
TRANS: Resp droplets
PRES:
- “Blueberry muffin” rash (indic of extramedullary hematopoiesis)
- Cataracts
- Deafness
COMP:
- Pulm art hypoplasia / stenosis
- Septal defects
- PDA
Maternal Rubella
Trans, Pres (3)?
TRANS: Resp droplets
PRES:
- Lymphadenopathy
- Rash
- Arthritis
