Med Micro Block 2

KNOW THESE SOFT TISSUE DISEASES

• Causes of Erysipelas:
  • Streptococcus pyogenes

• Causes of Folliculitis:
  • Staphylococcus aureus
  • Pseudomonas aeruginosa
  • Candida albicans

• Abscess vs Furuncle vs Carbuncle:
  • Abscess — collection of pus
  • Furuncle — a boil from infected hair follicle
  • Carbuncle — a bigger furuncle

• Causes of Abscesses/Furuncles/Carbuncles:
  • Staphylococcus aureus
  • Actinomyces israelii
  • Pasteurella multocida

• Causes of Pustules/Pyoderma:
  • Staphylococcus aureus
  • Streptococcus pyogenes
  • Bartonella henselae
  • Nocardia brasiliensis
  • Streptobacillus moniliformis
  • Eikenella corrodens

• Causes of Toxogenic Rash:
  • Staphylococcus aureus
  • Streptococcus pyogenes

• Types of Skin Necrosis:
  • Myonecrosis — necrosis of muscle
  • Necrotizing Fasciitis — necrosis of fascia, epidermis, dermis, (with or without muscle)
  • Gangrene — loss of vascular supply –> loss of tissue mass

• Causes of Necrotizing Faschiitis:
  • Streptococcus pyogenes
  • Clostridium perfringens
  • Vibrio vulnificans

• Causes of Ulcers/Granulomas:
  • Francisella tularensis
  • Leishmania
  • Mycobacterium
  • Sporothrix schenckii
  • Dracunculus medinesis (“Guinea Worm”)

• Causes of Eschar:
  • Spirillum minus
  • Orf virus
  • Bacillus anthracis
  • Pseudomonas aeruginosa

• Causes of Cutaneous Hyperkeratosis:
  • Human Papilloma Virus (HPV)
  • Molluscum contagiosum

• Causes of Vesicular Lesions:
  • Herpes Simplex 1 and 2

• Causes of Tineas:
  • Dermatophytes
  • Malassezia furfur

• Causes of Osteomyelitis:
  • Salmonella
  • Staphyloccus aureus
  • Pseudomonas

• Causes of Myositis:
  • Trichinella spiralis

• Causes of Abdominal Infection:
  • Bacteroides fragilis
  • Enterococcus faecalis
  • Prevotella melaninogenica
  • Acinetobacter baumanii

KNOW THESE CNS INFECTIONS

• Causes of Meningitis:
  • Purulent Meningitis — Neisseria, Strep pneumo, H. influenza
  • Neonatal Purulent Meningitis — E. coli, Strep agal, Listeria
  • Chronic Meningitis — Cryptococcus neoformans

• Causes of Meningoencephalitis:
  • Primary Amebic Meningitis — Naegleria fowleri
  • Polio — Polio virus
  • African Sleeping Sickness — Trypanosoma brucei

• Causes of Encephalitis:
  • Arbovirus — “ARthropod-BOurne VIRUS” — Togaviridae, Flaviviridae, Bunyaviridae
  • Lyme Disease — Borrelia burgdorferi
  • Rabies — Rabies virus
  • Progressive Multifocal Leukoencephalopathy — JC Virus.

• Causes of Neuritis:
  • Tetanus — Clostridium tetani
  • Leprosy — Mycobacterium leprae

KNOW THESE WORD ASSOCIATIONS FOR SOFT TISSUE DISEASES

• Erysipelas — Strep pyogenes
• Gram positive, Catalase negative, β-hemolytic — Strep pyogenes
• Streptolysin O — immunogenic, strep pyogenes
• Impetigo — Strep pyogenes and Staph aureus
• MSA — Staph aureus — Mannitol Salt Agar
• Pyocyanin/Pyochelin — Pseudomonas — blue and green pigments
• Hot Tub Folliculitis — Pseudomonas
• Otitis Externa — Pseudomonas
• Blue/Green colonies — Pseudomonas
• MacConkey’s Agar detects what — detects lactose fermentation
• Colorless on MacConkey’s Agar — Pseudomonas
• Mucocutaneous, Oral, Cutaneous, Erosio interdigitalis, and Onychomycosis forms — Candidiasis
• Sulfur Granules in pus — Actinomyces israelii
• Woody, lumpy skin — Actinomyces israelii
• Molar tooth shaped colony — Actinomyces israelii
• Bipolar Staining — Pasteurella multocida, Yersinia pestis, Klebsiella granulomatis (BYPASS YOUR CLUB)
• Non-bipolar Staining — Bartonella henselae
• Cat Scratch with Fever — Bartonella henselae — Cat Scratch Fever
• Cat Scratch no Fever — Pasteurella multocida
• Leukotoxin, ToxA — Pasteurella (Pastor’s cat is soft but toxic!!!)
• Soft Abscess with Lymphadenopathy — Pasteurella multocida
• Look like Safety Pins — Pasteurella multocida
• Marble Abscess — Staph aureus
• Non-acid fast Carbuncle — Actinomyces israelii
• Weak acid fast Carbuncle — Nocardia brasiliensis
• Contagious, Exudative Rash without Fever — Impetigo
• Bacillary angiomatosis — Bartonella henselae, which also causes Cat Scratch Fever
• Warthin Starry’s Silver Stain — Bartonella
• Cherry angioma-like lesion — Bacillary angiomatosis, Bartonella
• Don’t Culture, because takes 40 days to grow — Bartonella
• trehalose dimycolate — aka cord factor, makes acid-fast cell walls acidic
• Cord Factor — aka trehelose dimycolate, makes acid-fast cell walls acidic
• Resembles Kaposi’s Sarcoma — Bartonella henselae
• Urease-positive Pustule — Nocardia brasiliensis
• Nodular Lymphangitis — Nocardia brasiliensis, Sporothrix schenkii (NO NO SPO)
• Acid-Fast Cell Wall — Nocardia brasiliensis, Mycobacterium
• Pustule from Soil — Nocardia brasiliensis
• Cats cause Pustule — Bartonella
• Cats cause Carbuncle — Pasteurella
• Rat Bite Fever — Streptobacillus moniliformis — rate bites, then pustules forms 10 days after, also Spirillum minus.
• bead-like chain — Streptobacillus moniliformis
• Fist Fight — Eikenella corrodens
• Urease-negative Pustule — Eikenella
• Air pockets in soft tissue — Eikenella
• Smells
• like Beach — Eikenella
• Scalded Skin Disease — aka Ritter’s Disease — Staph aureus
• Ritter’s Disease — aka Scalded Skin Disease — Staph aureus
• Nikolsky’s Sign — Ritter’s Disease, Scalded Skin Disease — Staph aureus
• bullae due to toxins — Scalded Skin Disease
• diffuse maculopapular rash due to toxins — Toxic Shock Syndrome
• Toxic Shock Syndrome — Staph aureus or strep pyogenes
• Tampons — Toxic Shock Syndrome — Staph aurues or strep pyogenes
• Toxigenic Rash without fever — Scalded Skin Disease
• Toxigenic Rash with fever — Toxic Shock Syndrome
• Toxigenic Rash in Kids — Scalded Skin Disease (staph aureus)
• Myonecrosis/Necrotizing Fasciitis — Strep pyogenes
• Myonecrosis/Gas Gangrene — Clostridium perfringens (anaerobe)
• Necrotizing Fasciitis only — Vibrio vulnificus
• Anti-Streptolysin O Screen — Strep pyogenes
• Lecithinase — Clostridium perfringens
• RTX Toxin — Vibrio vulnificus
• Necrotizing Fasciitis from Respiratory Droplets — Strep pyogenes
• Necrotizing Fasciitis from spores in soil on wound — Clostridium perfringens
• Necrotizing Fasciitis from sea water on wound — Vibrio vulnificus
• Gram Negative Necrotizing Fasciitis — Vibrio vulnificus
• α-toxin — aka lecithinase, Clostridium perfringens.
• Nagler Reaction — Clostridium perfringens — detects lecithinase
• Marine Water — vibrio vulnificus
• Curved Rod — Vibrio vulnificus
• Siderophores — Vibrio vulnificus — a type of hemolysin
• rabbits — Francisella tularensis
• Ulcer by tick — Francisella
• Sand Fly — Leishmania
• Kala Azar — Leishmania
• Oriental Sore — Leishmania
• Arkansas — Francisella
• Need Cysteine — Francisella tularensis
• Tularemia — Francisella
• Ulceroglandular and Oculoglandular — Tularemia — Francisella
• Promastigote/Amastigote — Leishmania
• Non-caseating granuloma — Type IV Mycobacterium
• Rose thorns — Sporothrix schenckii
• Cigar-Shaped Yeast — Sporothrix schenckii
• Thermally dimorphic — Sporothrix schenckii
• Sinus Tracts — Salmonella (Osteomyelitis), Sporothrix schenckii
• Guinea Worm — Dracunculus medinesis
• Copepods — Guinea Worm (Dracunculus medinesis)
• Animal Hide/Soil Spores — Bacillus Anthracis
• Eschar on Taxidermist — Bacillus Anthracis
• Eschar on Farmer — Orf Virus
• Eschar on Immunocompromised — Pseudomonas
• Virus from Oxen, Deer — Orf Virus
• Long-Term Treatment for Eschar — Bacillus Anthracis
• Self-Limiting Eschar — Orf virus
• Combo Antibiotics Eschar — Pseudomonas
• EF/LF/PA exotoxins — Bacillus anthracis — Edema Factor/Lethal Factor/Protective Antigen
• Resemble Brown Recluse Spider bite — Bacillus anthracis, Orf virus
• Painless Eschar — Bacillus anthracis
• Painful Eschar — Pseudomonas aeruginosa
• Ecythema gangrenosa — Pseudomonas eschar
• Rate Bite Fever — Spirillum minus — eschar, fever…. also streptobacillus minus
• Warts — Human Papilloma Virus (HPV)
• Double Stranded Circular DNA, nonenveloped– HPV
• E6, E7 — HPV — inactivates p53, causes cancer
• HPV 6, 11 — Genital Warts
• HPV 16, 18 — Cervical Cancer
• Koilocytes — HPV — shrunken nucleus in vacuole
• Henderson-Paterson Bodies — Molluscum Contagiosum (Eosinophilic inclusion bodies)
• Vesicular Lesions — Herpes Simplex Virus 1 and 2
• Gingivostomatitis — Cold Sores — Herpes Simplex Virus
• Genital Herpes — Herpes Simplex Virus
• Herpetic Whitlow — Herpes Simplex Virus – lesions on fingers
• Herpes at Trigeminal Ganglion — Gingivostomatitis
• Herpes at Sacral Ganglia — Genital Herpes
• Herpes at Brachial Ganglia — Herpetic Whitlow
• Tzanck Smear — Herpesviridae
• HSV-1 — oral herpes
• HSV-2 — genital herpes
• Third Trimester or Perinatal Infection — HSV — C-section
• Reactivated by UV, trauma to skin — Herpes Simplex Virus
• MTE Triad — The Dermatophyes — Microsporum, Trichophyton, Epidermophyton
• Septated Hyphae — The Dermatophyes, aspergillus (vs. Mucor and Rhizopus)
• Arthrospores — The Dermatophyes
• Hair fluoresce under Woods Lamp — Microsporum (The Dermatophyes)
• Yeast Benign, Mold pathogenic — Malassezia furfur, opposite of sporothrix schenckii
• Tinea Versicolor — Malassezia furfur
• Azelaic Acid and Malassezin — Malassezia furfur — A –> block melanin synth. M –> apoptosis of melanocytes
• Hypopigmented Skin Fluoresce under Woods Lamp — Malassezia furfur
• Pruritic Tinea — The Dermatophyes
• Nonpruritic Tinea — Malassezia furfur
• Tinea corporis — Ring Worm — The Dermatophyes
• Technetium-99 Pyrophosphate — Osteomyelitis — test to see where bone infections are
• Gram Negative Oxidase Negative — Salmonella, E. Coli, Klebsiella
• H2S — Salmonella
• Green Colonies with Black Dot on Hektoen Agar — Salmonella
• Antibiotics don’t work — Salmonella
• Myositis — Trichinella spiralis
• Raw Pork — Trichinella
• Gram Positive Abdominal Infection — Enterococcus faecalis
• ENT Bile-Esculin Agar — Enterococcus faecalis
• BBE Bile-Esculin Agar — Bacteroides fragilis
• Lancefield Group D — Enterococcus faecalis (DEF)
• High Dose Antibiotics Needed — Enterococcus faecalis
• Heparinase, Succinic Acid — Bacteroides fragilis
• Heparinase action– promote thrombophlebitis
• Succinic acid action — resists phagocytosis
• Heparinase, Collagenase — Prevotella melaninogenica
• Combo Antibiotics in Abdominal Infection — Enterococcus faecalis
• Combo Antibiotics — Enterococcus faecalis, Pseudomonas aeruginosa
• No Lipid A in LPS — Bacteroides fragilis

KNOW THESE WORD ASSOCIATIONS FOR CNS DISEASES

• Maltose AND Glucose fermentation — Neisseria meningitidis (vs. gonorrhea, Glucose fermentation only)
• Meningitis preceded by Respiratory Illness — Neisseria meningitidis
• Meningitis preceded by Head Trauma — Hemophilus influenza
• Pneumolysin — Strep Pneumo
• Kernig’s Sign, Brudzinski’s Sign — Meningitis
• Meningococcemia — Neisseria meningitidis
• Pneumococcal Meningitis — Strept pneumo
• Childhood Purulent Meningitis — Hemophilus influenza
• Optochin Sensitive — Strep Pneumo
• Encapsulated and Unencapsulated forms — Hemophilus influenza (Hib vaccine targets capsular form)
• Group A Strep — Strep pyogenes
• No Group Strep — Strep pneumo
• Group B Strep — Strep agalactiae
• Hippurate hydrolysis — Strep agalactiae and Listeria monocytogenes
• Camp Positive — Strep agalactiae, List mono, Campylobacter
• Cold Enrichment — List mono, Yersinia pestis
• Act A — List mono
• Indole Positive — E. Coli (vs. Klebsiella, differentiate in pneumonia)
• Lactose fermenting on MacConkey’s Agar — E. coli (vs. Pseudomonas)
• Soft Cheeses (cold) — List mono
• Chronic Meningitis — Cryptococcus neoformans
• Pigeon droppings — Crypt neo
• Meningitis in HIV patients — Crypt neo
• GXM capsule — Crypt neo
• Mannan/Melanin products — Crypt neo
• Soap Bubble Lesions in Brain — Crypt neo
• Fungal meningitis — Crypt neo
• Primary Amebic Meningitis (PAM) — Naegleri fowleri
• Warm Water — Naegleri fowleri
• Enters through Cribiform Plate — Naegleri fowleri
• Olfactory Hallucinations — Naegleri fowleri
• Feeding Cups virulence factors — Naegleri fowleri
• Negative sense ssRNA viral encephalitis — Bunyaviridae, Rabies
• Helical viral encephalitis — Bunyaviridae (toga and flavi both icosahedral)
• Encephalitis from horses via mosquito — Togaviridae
• Encephalitis from birds via mosquito — Flaviviridae
• Encephalitis from rodents via mosquito — Bunyaviridae
• Venezuelan/Eastern/Western Equine Encephalitis — Togaviridae
• St. Louis/West Nile/Japanese Encephalitis — Flaviridae
• LaCrosse Encephalitis — Bunyaviridae
• Viral Encephalitis in Elderly — Flaviviridae
• Viral Encephalitis in Children — Togaviridae, Bunyaviridae
• Gram negative Spirochete — Borrelia
• White Foot Mouse and White Tail Deer –> Ticks — Borrelia burgdoferi
• Lyme Disease — Borrelia burgdoferi
• Bull’s Eye Rash — Lyme Disease (Borrelia burgdoferi) (Bull’s Eye Rash –> Bell’s Palsy –> Stiff Joints –> Encephalitis)
• Rhabdoviridae — Rabies
• Protein G — Rabies (needed to get into neurons)
• Negri Bodies — Rabies
• Human Diploid Cell Vaccine (HDCV) — Rabies
• Days 1,3, 7, 14 — Rabies vaccination treatment (HDCV)
• dsDNA Naked virus — JC Virus
• 80% of people seropositive –JC Virus, CMV, BK Virus
• Replicate in Tonsils — JC Virus
• Demyelinating Disease –> Personality Change — JC Virus (Progressive multifocal leukoencephalopathy)
• Progressive multifocal leukoencephalopathy (PML) — JC Virus
• Non-enhancing white matter lesions — JC Virus
• Picornaviridae Family — Coxsackie, Polio
• Iron Lung — Polio
• Attack Anterior Horn Cells in Spinal Cord — Polio
• Flaccid Paralysis — Polio, Botulism
• binds CD155 — Polio (CD155 in spinal cord cells)
• Inactive Polio Vaccine — Salk Vaccine
• Live Polio vaccine — Sabin Vaccine (NO LONGER USED IN US)
• Most Common Polio Serotype — Type I
• Tetanus – Clostridium tetani
• Gram positive Spore-forming Anaerobe — Clostridium
• Tennis Racket Appearance — Clostridium tetani
• Spastic Paralysis — Tetanus
• Risus Sardonicus — Lockjaw — Tetanus
• Opisthotonos — Back Spasm — Tetanus
• Treat with GABA agonist — Clostridium tetani (Tetanus) (treat with Benzodiazepines)
• Infects Umbilical Stump in neonates — Clostridium tetani
• Inhibits inhibitory neurons — Tetanospasmin (degrades synaptobrevin)
• Hansen’s Disease — Leprosy (Mycobacterium leprae)
• Leprosy — Mycobacterium leprae
• Armadillos — Mycobacterium leprae (leprosy)
• Loss of Eyebrows, Nasal Collapse, Lumpy Earlobes — Mycobacterium leprae (leprosy)
• Leprosy with Strong Cellular Response — Tuberculoid Leprosy
• Leprosy with Strong Humoral Response — Lepromatous Leprosy
• Lepromin Positive — Tuberculoid Leprosy
• Lepromin Negative — Lepromatous Leprosy
• Leprosy with asymmetrical macular rashes — Tuberculoid Leprosy
• Leprosy with symmetrical nodular lesions — Lepromatous Leprosy
• Self-Limiting Leprosy — Tuberculoid Leprosy
• Lethal Leprosy — Lepromatous Leprosy
• Infects Lower-temperature body parts — Leprosy
• PGL-1 capsule — Leprosy (allows survival in tissue macrophages)
• Dapsone — Leprosy treatment
• African Sleeping Sickness — Trypanosoma brucei
• Tsetse Fly — Trypanosoma brucei
• Trypomastigote injected form — T. brucei
• Chancre –> Cachexia –> Coma — African Sleeping Sickness (T. brucei)
• Winterbottom’s Sign — African Sleeping Sickness (T. brucei) — Posterior cervical lymph node swollen
• Suramin and Melarsoprol — African Sleeping Sickness treatment (T. brucei)
• Dog Tapeworm — Echinococcus granulosus
• Ingest dog feces with hydatid cyst — Dog Tapeworm, Echinococcus granulosus (calcifies in brain)