Infections and Infestations

Infections and Infestations is further divided into

Viral Exanthems

» What is the difference between an exanthem and an enanthem?
» Which viruses cause exanthems?
» How do viruses cause exanthems?
» Which viruses cause morbilliform (measles-like) eruptions?
» Which viruses cause grouped blisters on a red base?
» Which viruses cause hand, foot, and mouth disease?
» What is the difference between Gianotti-Crosti syndrome and papular acrodermatitis of childhood?
» Which are the most common viruses that cause papular acrodermatitis of childhood?
» Which virus classically causes a lacy eruption?
» Which viruses cause scarlatina (scarlet fever–like) eruptions?
» Which virus causes purpura of the hands and feet?
» Do viral exanthems cause petechiae?
» Can viral exanthems be on one half of the body?
» Which disorder most commonly mimics a viral morbilliform eruption?
» What are the clinical features of roseola infantum (exanthem subitum, sixth disease)?
» How does sunlight exposure affect a viral exanthem?
» What is the STAR complex?
» Which viruses cause the STAR complex?




Bullous Viral Eruptions

» What do herpes simplex (HSV) virus and varicella-zoster virus (VZV) have in common?
» What happens during primary HSV infection?
» What about recurrent infection?
» What is the difference between a primary and an initial HSV infection?
» How is HSV transmitted?
» How long is incubation period for HSV (i.e., the time from initial infection to appearance of vesicles)?
» Define asymptomatic shedding.
» Can you be infected with HSV and not know it?
» How do HSV-1 and -2 differ?
» How do you diagnose HSV infection?
» How is a Tzanck smear performed?
» What are the drugs of choice for treatment of HSV?
» When is chronic suppressive therapy indicated?
» Are patients with genital herpes at greater risk for becoming infected with the human immunodeficiency virus (HIV)?
» What recommendations can you make to a patient with genital herpes to reduce the risk of transmission to his or her partner?
» Can HSV infect the skin in areas other than around the mouth or anogenital areas?
» How does a baby get herpes? Is it a serious problem?
» Describe the natural history of varicella.
» What is shingles?
» Can herpes zoster be recurrent?
» What is disseminated zoster?
» Is herpes zoster contagious?
» What is postherpetic neuralgia?
» How do you diagnose VZV infection?
» What is the treatment for varicella?
» How about herpes zoster?
» Should I be concerned about the patient with herpes zoster involving the tip of the nose?
» Who should get the herpes zoster vaccine?
» What is hand, foot, and mouth disease?
» What is orf?




Warts and Molluscum Contagiosum

» What causes warts?
» Name the common types of warts.
» How frequently are the different cutaneous warts seen?
» Can warts cause cancer?
» What is epidermodysplasia verruciformis (EV)?
» What techniques are used to study warts?
» What techniques are used to study warts?
» Do warts spread?
» How long is the incubation period of warts?
» How can warts be prevented?
» What is the difference between the Gardasil® and Cervarix® HPV vaccines?
» Can HPV live in the human body in a dormant state?
» Are plantar warts caused by a special kind of virus? Are they more difficult to treat?
» What causes the black dots within a wart?
» Can HPV infection have a hereditary basis?
» Are some people more susceptible to warts than others?
» Should all warts be eradicated?
» How should external genital warts (EGWs) be treated?
» What methods are available for the treatment of warts?
» What are common side effects of treatment methods?
» What are “fairy ring” warts?
» Should any treatments be avoided?
» Is there a best way to treat warts?
» How can you tell if a wart is gone?
» How can you be sure that warts will never come back?
» Do any warts come from toads?
» Are molluscum contagiosum a type of wart?




Syphilis

» What causes syphilis?
» Describe the morphologic appearance of T. pallidum.
» Where did syphilis originate?
» How is syphilis transmitted?
» What are the chances of getting syphilis from having sexual intercourse with an infected individual?
» Following inoculation, how long does it take for the primary chancre to appear?
» Describe the typical Hunterian chancre.
» Do syphilitic chancres occur on sites other than the genitalia?
» What is the best way to diagnose primary syphilis?
» How is primary syphilis treated?
» What is the Jarisch-Herxheimer reaction?
» What is the natural history of the untreated syphilitic chancre?
» When does secondary syphilis begin?
» Do patients with secondary syphilis have any symptoms?
» List the common physical findings in secondary syphilis.
» Describe the syphiloderm of secondary syphilis.
» What are condylomata lata? How do they differ from condylomata acuminata?
» What are mucous patches?
» Is there anything characteristic about the alopecia of secondary syphilis?
» How good are physicians at recognizing the signs and symptoms of secondary syphilis?
» What is the best way to diagnose secondary syphilis?
» How should secondary syphilis be treated?
» What stage follows untreated secondary syphilis?
» How is latent syphilis treated?
» When should lumbar punctures be done in patients with syphilis?
» What happens to patients with untreated latent syphilis?
» Name the three major presentations of tertiary syphilis.
» What are the mucocutaneous features of late benign syphilis?
» What was the Tuskegee Study?




Hansen’s Disease (Leprosy)

» What causes leprosy?
» Why is leprosy called Hansen’s disease?
» How is leprosy transmitted?
» Are children and adults equally susceptible to acquiring leprosy?
» Are humans the only host for M. leprae?
» Is leprosy a systemic disease?
» How common is leprosy?
» Are there endemic areas for leprosy in the United States?
» How is leprosy recognized clinically?
» Is there more than one kind of leprosy?
» Does indeterminate leprosy mean that you do not know what type it is?
» What are the two “polar” forms of leprosy? How do they differ?
» Describe dimorphous leprosy.
» What is the unusual feature of the cell-mediated immunity in lepromatous leprosy?
» Define the cytokine response to M. leprae in tuberculoid versus lepromatous patients.
» How is the diagnosis of leprosy usually made?
» What area should be biopsied to detect M. leprae?
» Can the same acid-fast stain used for Mycobacterium tuberculosis be used for the leprosy bacillus?
» What are Virchow cells?
» Is the lepromin skin test helpful in making a diagnosis of leprosy?
» Is the neuropathy in lepromatous leprosy the same as that in diabetic neuropathy?
» Describe a patient with advanced lepromatous leprosy.
» What are the most common complications in leprosy?
» What are the reactional states of leprosy?
» What drugs are used in multidrug therapy for leprosy?
» Do the recommendations of the World Health Organization (WHO) differ from those of the U.S.?
» What are the side effects of the drugs for leprosy treatment?
» What is the most bothersome cutaneous side effect of clofazimine?
» How are the reactional states of leprosy treated?
» Should family members of leprosy patients be treated?
» Can leprosy be eliminated as a worldwide disease, as smallpox has been?




Arthropod Bites and Stings

» What are arthropods? Are most arthropods harmful to humans?
» Describe various ways arthropods injure humans. What insect or arachnid would cause the injury?


Bites and Stings
» How do you diagnose a bite or sting?
» Why are some bites and stings extremely painful or dangerous while others are simply itchy, red, irritating papules?
» One person on a hike is “eaten alive” by mosquitos while his companions are not bothered at all. Do ectoparasites such as mosquitos, ticks, fleas, and mites bite randomly?
» Why are bite reactions to ectoparasites so much different in different people?
» How do you treat bee stings?
» What are the signs of serious systemic reactions to bee, wasp, or ant stings?
» How do you treat anaphylactic syndrome from a bee sting?
» What are the unique characteristics of fire ants and their sting?
» What species of spiders are medically important?
» How do you diagnose and treat the black widow spider bite?
» How do brown recluse spider bites present?
» How should brown recluse spider bites be treated?


Infestations
» What is scabies?
» How is scabies characterized clinically?
» What is Norwegian scabies?
» What agents are used to treat scabies?
» Discuss the three varieties of lice that affect humans.
» How should lice infestations be treated?


Zoonotic Infestations
» How do flea infestations typically present?
» How do you treat a flea infestation?
» How is Cheyletiella infestation recognized in humans? In animals? How does it compare to canine scabies?
» Where do bedbugs live? What do their bites look like?
» Do species of bedbugs that parasitize other animals bite humans?
» What are zoonotic dermatoses?


Insect Vectors
» What are the kissing, or assassin, bugs?
» Why are kissing bugs important?
» What diseases are transmitted by ticks?
» What is the most common tick-borne infectious disease in the United States?
» How does Lyme disease present?
» Why do the tick bites often go unnoticed?
» How do tick bites affect humans? How are ticks removed once they are attached to the skin?
» How do you prevent tick bites?
» Name some important arthropod-borne diseases.
» What are the most effective insect repellents?
 

Bacterial Infections

» Which bacterium is the most common cause of skin infections?
» What kinds of skin infections does Staphylococcus aureus produce?
» Is Staphylococcus aureus the only bacterium that causes impetigo?
» What does staphylococcal impetigo look like?
» Why is staphylococcal impetigo frequently bullous?
» How is bullous impetigo diagnosed?
» How is bullous impetigo treated?
» What is the difference between a furuncle and a carbuncle?
» How do furuncles present?
» What is the best way to treat furuncles?
» Why do some patients develop recurrent staphylococcal impetigo or recurrent furunculosis?
» How is staphylococcal carriage eliminated?
» What is staphylococcal scalded-skin syndrome?
» Describe the presentation of toxic shock syndrome.
» Why is S. aureus frequently found in secondary infections of dermatitis and wounds?
» What is MRSA?
» What is the difference between HA-MRSA and CA-MRSA?
» What types of cutaneous infections are produced by b-hemolytic streptococci?
» How does streptococcal impetigo present?
» What is ecthyma?
» What is blistering distal dactylitis?
» What is erysipelas?
» How do you diagnose erysipelas?
» How is erysipelas treated?
» Describe the cutaneous manifestations of Lyme disease.
» A patient living in an endemic area for Lyme disease reports a history of a tick bite. Should that patient receive antibiotic prophylaxis?
» What types of skin infections does Pseudomonas aeruginosa produce?
» How does ecthyma gangrenosum differ from ecthyma?
» Where do you usually acquire Pseudomonas folliculitis?
» How does Pseudomonas folliculitis present?
» What is the best treatment for Pseudomonas folliculitis?
» How is Wood’s light used in diagnosing Pseudomonas infections?
» What causes tularemia? Where did the name tularemia come from?
» Describe the skin lesions of tularemia.
» How should tularemia be treated?
» What is trichomycosis axillaris?




Mycobacterial Infections

» What is the classification system of mycobacteria?
» What are the staining characteristics of mycobacteria?
» How many species of Mycobacterium cause infection in human beings?
» Name three mycobacteria in the tuberculosis complex responsible for tuberculosis.
» What is tuberculosis?
» What is the difference between a primary and secondary infection?
» Explain the route of infection in cutaneous tuberculosis.
» Who is at risk of acquiring tuberculosis?
» Describe the histopathologic hallmark of tuberculosis.
» How can one acquire primary cutaneous tuberculosis?
» Describe the clinical manifestation of primary-inoculation cutaneous tuberculosis.
» What are the different types of cutaneous tuberculosis?
» What laboratory tests are used to diagnose Mycobacterium tuberculosis?
» Is lupus vulgaris related to lupus erythematosus or lupus pernio?
» Describe the clinical manifestations of lupus vulgaris.
» Where and when does lupus vulgaris develop?
» What is scrofuloderma?
» Name the vaccination against tuberculosis. What type of vaccination is it?
» What drugs are used in the treatment of tuberculosis?
» What are the major side effects of antituberculous agents?
» What factors have led to multidrug-resistant tuberculosis?
» Are there any special treatment considerations for cutaneous tuberculosis?
» What is the mechanism of action of TNF-a in tuberculosis?
» Describe the pathogenesis of the atypical mycobacteria.
» Describe the pathogenesis of the atypical mycobacteria.
» What is a “swimming pool granuloma”?
» What is a Buruli ulcer?
» Describe the clinical manifestations of Mycobacterium avium-intracellulare complex (MAC) in both non-AIDS and AIDS patients.
» Which atypical mycobacteria are associated with mesotherapy?
» Which atypical mycobacteria are associated with tattoos?
» Which atypical mycobacteria have been associated with soft tissue fillers?
» How are infections with rapidly growing mycobacteria managed?
» What are some of the key features of Mycobacterium kansasii?




Superficial Fungal Infections

» What is a dermatophyte?
» How are superficial fungal infections diagnosed?
» On a KOH examination, hyphal-like structures arranged in a mosaic pattern are noted. Does this indicate the presence of a dermatophyte?
» What are the three most commonly used culture media for the growth of dermatophytes?
» Describe some of the presentations of superficial fungal infections caused by dermatophytes.
» Which dermatophyte causes the most fungal infections of skin?
» What is the most common cause of tinea capitis in the United States?
» Name the four clinical patterns of tinea capitis.
» What are the types of hair invasion in tinea capitis? What dermatophytes are associated with each type?
» What is a Wood’s light? What organisms are detected by this exam?
» How is tinea capitis treated?
» What is meant by a carrier state in tinea capitis?
» Name the three types of tinea pedis. Which dermatophyte is most commonly associated with each?
» What nondermatophyte mold can cause mycotic infections that mimic moccasin-type tinea pedis?
» What is a dermatophytid reaction?
» Name and describe the four clinical presentations of onychomycosis.
» Can other diseases mimic onychomycosis?
» What is tinea versicolor?
» How does Malassezia induce both hyperpigmentation and hypopigmentation in the skin?
» How is tinea versicolor diagnosed? Why is it difficult to culture this organism?
» Does Malassezia cause any other skin disease?
» What is tinea nigra?
» What is a Majocchi’s granuloma?
» What is piedra?
» Name the organism most commonly isolated from cutaneous candidiasis.
» How do candidal infections present clinically?
» What factors predispose to candidiasis?
» Which diseases are associated with adult-onset chronic mucocutaneous candidiasis?
» Name the different classes of oral antifungal agents and their mechanisms of action.
» Which hepatic cytochrome is affected by itraconazole, ketoconazole, and fluconazole?
» Which drugs should be used with caution when using ketoconazole, itraconazole, or fluconazole? Why?
» Which drugs are contraindicated when using azole antifungal agents and why?
» Which oral antifungal agents can lower cyclosporine levels?
» Which drugs can affect antifungal drug levels?
» Which antifungal drugs have a limited spectrum of activity in the treatment of superficial fungal infections?




Deep Fungal Infections

» What is a deep fungal infection?

Subcutaneous Fungal Infections
» Discuss the characteristics of subcutaneous mycotic infections.
» What is a dimorphic fungus?
» What occupations are at increased risk of sporotrichosis?
» Describe the clinical manifestations of sporotrichosis.
» How is the diagnosis of cutaneous sporotrichosis made?
» How do you treat cutaneous sporotrichosis?
» What other organisms may present with lymphocutaneous disease?
» What are dematiaceous fungi?
» How do you differentiate chromomycosis from phaeohyphomycosis?
» Which organisms may cause chromoblastomycosis?
» Which organisms cause phaeohyphomycosis?
» How does chromomycosis present?
» Describe the clinical features of phaeohyphomycosis.
» What is Madura foot?
» What are the clinical features of Madura foot?

Systemic Fungal Infections
» Discuss the pathogenesis of the systemic respiratory deep fungi.
» Where is blastomycosis endemic?
» What are the clinical manifestations of blastomycosis?
» Describe the cutaneous findings in disseminated blastomycosis.
» Are immunosuppressed patients at increased risk of disseminated disease with blastomycosis?
» What is the treatment of blastomycosis?
» Where is histoplasmosis endemic?
» What factors are necessary for production of the disease histoplasmosis?
» Discuss the clinical manifestations of histoplasmosis.
» How common are mucocutaneous findings in disseminated histoplasmosis?
» Are there any other cutaneous manifestations of histoplasmosis?
» Where is coccidioidomycosis endemic?
» What are the clinical manifestations of coccidioidomycosis?
» Where is paracoccidioidomycosis endemic?
» Why is paracoccidioidomycosis more common in men?
» What is the most common presenting complaint of paracoccidioidomycosis?
» Which organism is responsible for penicilliosis?
» Where is penicilliosis endemic?
» How does penicilliosis present clinically?
» What is a parasitized histocyte?


Opportunistic Fungal Infections
» Define opportunistic infection.
» What are the common fungal pathogens in HIV infection?
» Discuss the fungal infections seen in organ transplant recipients.
» Discuss the important epidemiologic factors of cryptococcosis.
» How is an infection with cryptococcosis acquired?
» What are the cutaneous manifestations of disseminated cryptococcosis?
» What patient population is at increased risk of aspergillosis?
» How common are cutaneous lesions in aspergillosis?
» Describe the cutaneous lesions in aspergillosis.
» What opportunistic fungus is clinically and histologically similar to Aspergillus?
» What are the most important predisposing factors for acquiring mucormycosis?
» Discuss the clinical manifestations of rhinocerebral mucormycosis.
» Can mucormycosis be acquired from contaminated dressings?
» What is the treatment of mucormycosis?
» For what fungal infections might patients on biologic therapies be at risk?
» What fungal species are considered potential agents of bioterrorism?




Parasitic Infestations

» Where and how does one acquire cutaneous parasitic diseases?
» What is “creeping eruption”?
» How do you treat creeping eruption?
» What is different about larva currens?
» Are there other nematode infestations that cause skin disease?
» How do filarial infections differ from other nematode infections?
» Where is onchocerciasis most prevalent? How is it transmitted?
» Does river blindness cause cutaneous manifestations?
» What are some of the problems with onchocerciasis treatment?
» What is loiasis?
» What causes elephantiasis?
» Can other filarial diseases affect the skin?
» What is myiasis?
» What is a warble?
» What is Congo floor maggot?
» What is tungiasis?
» What is the difference between a chigoe and a chigger?
» Do chiggers burrow into the skin to lay eggs like the sand flea?
» What is leishmaniasis?
» Name the different types of leishmaniasis.
» Can leishmaniasis be contracted in the United States?
» How does cutaneous amebiasis, due to Entamoeba histolytica, present?
» What are the skin findings in American trypanosomiasis?
» What are the skin findings in African trypanosomiasis?
» Describe the cutaneous manifestations of schistosomiasis as they relate to the parasite’s life cycle.
» Are swimmer’s itch and sea bather’s eruption the same thing?
» What is sparganosis?
» Can other tapeworms affect the skin?
» What is Demodex?
» Does Demodex cause skin disease?
» What are morgellons?

 

 

 

 

 

 

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