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Infectious diseases > 23- Systemic infections > Flashcards

23- Systemic infections Flashcards

1
Q

triad of symptoms for infectious mononucleosis

A

fever
tonsillar pharyngitis
lymphadenopathy (symmetric and generalised)
- extra: white/gray/green/necrotic tonsils; palatal petechiae

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2
Q

who is the major reservoir for EBV

A

humans

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3
Q

T/F approx 90-95% of adults are EBV positive

A

T

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4
Q

T/F EBV acquired during childhood is often subclinical

A

T

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5
Q

peak incidence of EBV

A

15-24

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6
Q

is infectious mono more common in children or adults

A

Children

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7
Q

how does EBV shed

A

salivary secretions for 6 months after the onset of the illness

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8
Q

T/F EBV is a very contagious disease

A

F

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9
Q

incubation period for EBV lasts

A

4-8 Weeks

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10
Q

rare complications of mono

A

peritonsillar abscess or airway occlucsion (1%), due to edema of soft palate and tonsils

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11
Q

is splenomegaly common in mono

A

yes, 50-60%. recedes after 3rd week of illness

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12
Q

is mono related to a rash

A

yes, generalised maculo-papular rash, often post ampicillin, amoxicillin

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13
Q

T/F absence of cervical lymphadenopathy and fatigue make mono unlikely

A

T

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14
Q

DX of mono

A

atypical lymphocytes and lymphocytosis

  • heterophile antibodies (produced by abnormal B cells- called monospot test) react to unrelated antigens (paul bunnell - latex agglutination using horse RBC)
  • ELISA
  • IgM VCA; acute infection
  • IgG VCA: persistant infection
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15
Q

tx for mono

A

supportive care

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16
Q

T/F CMV in a competent host is asymptomatic or presents as mono

A

T

17
Q

CMV transmission route

A
  • sexual exposure
  • close contact: urine, upper resp
  • blood or tissue
  • perinatal exposure
18
Q

can CMV have a rash

A

yes, maculopapular with 1/3 of ppl exposed to ampicillin

19
Q

dx of CMV

A

antibodies, PCR

20
Q

Tx of CMV

A

most cases are asymptomatic, and if they have symptoms its self limited with a recovery in days to weeks

21
Q

toxoplasmosis is due to

A

intracellular protozoan parasite

22
Q

infection with T gondii sx

A

asymptomatic

in immunocompromised theres acute systemic infection or posterior uveitis

23
Q

toxoplasmosis reactivation results in

A

multiple CNS abscess like, round processes with ring enchancement

24
Q

how can people become infected with T gondii

A
  • eating undercooked meat of animals harboring tissue cysts
  • consuming food or water contaminated with cat feces
  • blood transfusion or organ transplantation
  • mother to fetus
25
Q

congenital toxoplasmosis appears as

A
  • look normal on prenatal US
    Intracranial calcifications, ventricular dilatation, hepatic enlargement, ascites, increased placental thickness
  • later symptoms are potential vision loss, mental disability, seizures
26
Q

if a person has a new infection which antibody is present first

A

IgM

27
Q

tx for toxoplasmosis

A

is usually self limited,

  • treat those with severe or longer symptoms
  • treat pregnant women with pyrimetamine and sulfadiazine
28
Q

leptospirosis is due to

A

spirochete bacteria

29
Q

transmission of leptospira

A

by contact of urine of infected animals to mucous membranes; conjunctiva, skin cuts, abrasions of humans
Bacteria can survive for weeks to months in urine contaminated water and soil
There are outbreaks after heavy rainfall

30
Q

which disease can be biphasis

A

leptospirosis
First phase: acute febrile bacteremic phase for 2-9 days
Second phase: immune phase with renewed fever (here the bacteria is absent from the blood but present in the urine)
Can occur with jaundice and renal failure (Weils disease). pulmonary hemorrhage, ARDS, uveitis, myocarditis

31
Q

sx of leptospira

A

MOST INFECTIONS ARE ASYMPTOMATIC

  • fever, rigors, myalgias, headache
  • conjunctival suffusion and redness, and subconjunctival hemorrhages
32
Q

tx of leptospira

A

for mild sx: doxycycline
or azithromycin, ampicillin, amoxicillin
severe dx: IV penicillin and ceftriaxone

33
Q

The majority of reactive lymphocytes in pts with infectious mononucleosis are

A

CD8 cytotoxic t cells

34
Q

What is an IgG avidity assay in CMV

A

To measure the binding strength between IgG antibodies and virus
It helps distinguish primary CMV infection from past infection
- Following a primary infection IgG have low binding strenght (low avidity) and 2-4 months after they have high avidity

35
Q

a serious complication of leptospirosis is

A

severe pulmonary disease with pulmonary hemorrhage

Infectious diseases (36 decks)

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