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Microbiology Unit 3 > 7 Infectious Mono And Lyme > Flashcards

7 Infectious Mono And Lyme Flashcards

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Biology 101 flashcards
1
Q

____________ infection causes infectious mononucleosis

A

Epstein-Barr Virus (EBV)

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2
Q

Burkitt’s Lymphoma is linked to _______ infection in some regions of the world

A

EBV

Really just in certain parts of Africa -

One of the strongest virus-cancer links

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3
Q

Incubation period for mono is …

A

1-2 months

Primary virus replication occurs in the oropharynx, virus eventually reaches lymph nodes

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4
Q

Mono is a ___ cell infection

A

B cell infection, inducing polyclonal expansion of lymphocytes

BUT Sx are from T-cell reaction

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5
Q

Dissemination of mono infection is …

A

Through lymphoreticular system of infected cells

Prodromal period of 3-5 days (HA, fever, malaise, fatigue)

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6
Q

Typical mono presentation

A

Sore throat, symmetrical LAD, fever

Sometimes hepatomegaly with increased liver enzymes and jaundice

More commonly, splenomegaly

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7
Q

What does the throat look like in mono patients?

A

Palatal enanthem at junction of hard and soft palate with petechial lesions

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8
Q

Mono is characterized by presence of _______ cells in circulation

A

Atypical lymphocytes (“Downey cells”)

These are mostly T cells and responsible for a lot of the Sx

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9
Q

How is EBV spread?

A

Worldwide distribution
Person-to-person transmission
Asymptomatic infection (or mild infection) of children frequent

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10
Q

Peak incidence of mono is in ages…

A

17-25

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11
Q

EBV virus can be found in saliva for …

A

About 1 month or more (makes it easier to spread)

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12
Q

Diagnosis of mono is difficult because…

A

It mimics other diseases (CMV, rubella, hepatitis, strep)

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13
Q

Key factors in the diagnosis of mono

A

Patient age (TEEN) and the presence of HETEROPHILE ANTIBODIES

Agglutination of horse RBCs in Monospot test

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14
Q

What is the downside of the Monospot test?

A

AGE-SPECIFIC REACTIVITY

Pre-teen patients may not have strong heterophile antibody response**

For younger patients, confirmation by serology (IgM anti-virus capsid antigen, anti-VCA)

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15
Q

Treatment for Mono?

A

Symptomatic relief

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16
Q

What happens if you mistake mono for strep and treat with penicillin?

A

A rash that they will forever mistake for a penicillin allergy

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17
Q

Which virus is considered the “troll” of transplantation?

A

Cytomegalovirus (CMV)

18
Q

Virus similar to EBV but does not produce heterophile antibodies

A

CMV

19
Q

CMV infection is most problematic for…

A

Transplant patients

Immune suppressed patients

Infections occurring during pregnancy

20
Q

What is the major source of CMV infections?

A

Children with minor colds (snotty nosed kids)

21
Q

How do you treat CMV?

A

Ganciclovir and immunoglobulin (Cytogam) - esp helpful for transplant patients

22
Q

How is Mumps treated and prevented?

A

Symptomatic relief (no antivirals available)

Vaccination is the main method of control

MMR used in US contains the Jeryl Lynn attenuated virus strain

23
Q

Do you end up with lifelong immunity from Mumps with the MMR?

A

Not if you have an egg or neomycin sensitivity

24
Q

The Great 2006 Mumps outbreak in Iowa was mostly due to…

A

Breakthrough cases in already MMR vaccinated persons

Calls in to question the typical MMR protocol (may need to add a third booster?)

25
Q

Lyme Disease is named for…

A

Location of definitive description (Old Lyme, CT)

26
Q

What lead to the initial discovery of the etiology of Lyme disease?

A

Unusual cluster of juvenile arthritis

27
Q

Lyme disease progresses through several stages in a pattern similar to…

A

Syphilis

Like syphilis, this disease can mimic other conditions complicating the diagnosis

28
Q

Stage 1 of Lyme disease is characterized by…

A

Acute localized disease

Erythema migrants at the site of the tick bite in 70-80%
• Bulls eye pattern
• Expanding
• Fades in less than a month but can be hidden
• Patients may have flu-like symptoms

29
Q

Stage 2 of Lyme disease is the _______ disease

A

Subacute, disseminated

70% of untreated patients go to stage 2 weeks to months after infection

Flu like symptoms

ASYMMETRIC ARTHRITIS ATTACKS with swelling and pain of large joints (60%)

MULTIPLE SECONDARY ANNULAR SKIN LESIONS days to weeks after infection (50%)

20% of untreated pt show hepatitis

MENINGITIS in 15% of untreated patients (subacute but FACIAL PALSY)

Nonspecific follicular conjunctivitis in 10% of stage 1 or 2 patients

30
Q

Stage 3 of Lyme disease is …

A

Chronic disease

Primarily musculoskeletal manifestations

Arthritis attacks become more persistent, longer duration in second and third year after infection

In 10% arthritis is chronic (at least one year of unremitting joint inflammation)

31
Q

What is the organism that causes Lyme disease in North America and Europe

A

Borreliella burgdorferi

In Eurasia - B. garinii and B. afzelii

32
Q

90% of cases of Lyme disease in the US occur in …

A

Upper Midwest and east coast

CT, RI, NY, NJ, PA, DE, MD, Wi

33
Q

What is the vector for Lyme disease?

A

Tick - specifically the deer tick or black-legged tick

Ixodes sp.***

34
Q

What is the reservoir for Lyme disease?

A

Small mammal reservoirs (rodents, rats, MICE) and birds

Tick transmission is essential to maintain cycle (no trans-ovarian tick transmission)

35
Q

Lyme disease is associated with what type of location?

A

Forest edge

Think MOUSE HABITAT - humans contact ticks in fields with tall grass and brush

36
Q

How is Lyme diagnosed?

A

Clinical findings - SSx and exposure in endemic area

Serology
• EIA plus Western blot if EIA is positive**
• Patients typically positive by 4th week

37
Q

What can cause false positives for Lyme?

A 
Syphilis
Mono
SLE
RA
Oral infection with spirochete
38
Q

What is the best way to prevent Lyme disease?

A

Control and avoidance of vector
• Repellents with DEET
• Careful checks for attached ticks after outdoor activities
• Control tick sources such as mice

39
Q

What happened to the Lyme vaccine?

A

Taken off the market b/c it induced symptoms

There’s now a promising new anti-Lyme mouse vaccine though…

40
Q

What is the treatment for Lyme disease?

A

For patients with Symptoms - amoxicillin or doxycycline for 10-21 days

Prophylactic treatment is not generally done (risk doesn’t justify it)

41
Q

Post Treatment Lyme Disease Syndrome resembles what?

A

Reiter’s syndrome

10-20% of abx treated patients have lingering Sx of fatigue, pain, and joint problems

May reflect residual tissue damage and auto-immune responses

Most improve with time

Microbiology Unit 3 (10 decks)

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