E2- Mono and Lyme Disease Flashcards
What is the causative agent of Mononucleosis?
Epstein-Barr virus
What cancer in linked to the EBV?
Burkitt’s lymphoma (In regions in Africa- environmental, occurs earlier in life)
Where does the primary EBV replicate?
Oropharynx and eventually reaches lymph nodes
What type of cell is infected by EBV?
B cell infection inducing polyclonal expansion of lymphocytes
How does Mononucleosis present?
Sore throat (palatal enanthem with petechial lesions) Lymphadenopathy Fever Hepatomegaly/splenomegaly Increased liver enzymes and jaundice
What type of cell appears in circulation of Mononucleosis and what does it do?
Atypical lymphocytes (Downey Cells) Controls and halts infections
What generates most of the sxs in Mononucleosis?
T cell response
How is Mononucleosis transmitted?
Person-to-person
Virus is found in saliva for ~1 mo
What age group has the highest incidence of Mononucleosis?
17-25
What is used to dx Mononucleosis?
Monospot test (if pt has heterophile antibodies it will agglutinate in horse RBCs) Confirm via serology (IgM, anti-VCA)
What is used to tx Mononucleosis?
Symptomatic
What is the monospot test dependent upon? Why?
Age
Pre-teen pts may not have strong heterophile antibody response
What is the main difference bteween EBV and Cytomegalovirus (CMV)?
CMV does not produce heterophile antibodies
Who is CMV most problematic for?
Transplant and immunosuppressed pts
Pregnant women
If you give penicillin to a pt with mono, what will happen?
Penicillin reaction-rash
Who man be a source of many CMV infections?
Children with minor colds
How is Mumps controlled?
Vaccines (MMR)
Who should not receive the MMR vaccine?
Egg or neomycin sensitive pts
What is the causative agent of Lyme disease?
Borrelia burgdorferi
What disease is Lyme disease similar to?
Syphilis
What are the clinical manifestations of stage 1 of Lyme disease?
Acute localized rash
Erythema migrans at site of tick bite
Bulls eye rash (only in 80% of pts and fades in less than 1 mo)
Flu-like sxs
What are the clinical manifestations of stage 2 of Lyme disease?
Subacute disseminated disease (2 wks- months later)
Flu-like sxs
Asymmetric arthritis attacks (swelling/pain of large joints- kn ees)
Multiple annular skin lesions
(hepatitis, meningitis, follicular conjunctivitis are less common)
What are the clinical manifestations of stage 3 of Lyme disease?
Chronic disease
Musculoskeletal manifestations
Arthritis attacks become more persistent and last longer
What are the tick vectors of Lyme disease?
Deer tick or black legged tick
What are some small animal reservoirs of Lyme disease?
Rodents, rats, mice, and birds
A substantial portion of human infections are transmitted by ticks in what stage?
Nymphal stage (very small)
How is Lyme disease dx?
Serology- EIA plus Western blot if EIA is positive
What is a problem with serology testing for Lyme disease?
False positives
When do pts typically become positive in serology testing of Lyme disease?
4th week of infection
What may occur after treatment of Lyme disease?
Post Treatment Lyme Disease Syndrome
Lingering fatigue, pain, and joint problems
How is Lyme disease prevented?
Avoidance of vector contact
Repellents with DEET
What is the treatment of CMV?
Ganciclovir and immunoglobulin
What is the treatment for symptomatic Lyme disease?
Amoxicillin or doxycycline for 10-21 days
