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Microbiology > E5 > Flashcards

E5 Flashcards

1
Q

Gastritis

A

Inflammation of the stomach

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2
Q

Gastroenteritis

A

inflammation of the stomach and intestines

-syndrome characterized by nausea, vomiting, diarrhea and abdominal discomfort/pain

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3
Q

Diarrhea

A
  • frequent loose and fluid filled stools

- usually resulting in disease of the small intestine

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4
Q

Dysentery

A
  • inflammatory disorder of the GI tract often associated
  • diarrhea with blood and pus in the feces
  • pain, fever, abdominal cramps
  • usually resulting form disease of the large intestine
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5
Q

Enteritis

A

inflammation of the intestines, especially the small intestine

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6
Q

Enterocolitis

A

inflammation of the mucosa of the samll and large intestine

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7
Q

Colitis

A

inflammation of the colon

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8
Q

inflammatory GI bacteria

A
  • elicit intestinal inflammation by causing damage to intestine
  • more likely to see fecal occult or visible blood
  • fecal leukocytes due to increased immune response in lumen
  • non-typhoidal salmonella, campy, c.diff, EHEC, EIEC, shigella, vibrio parahaemolyticus, yersinia
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9
Q

non-inflammatory GI bacteria

A
  • passing through the intestine or adhere to intestinal epithelium without symptomatic damage to epithelium
  • no known toxins or produce non-cytotoxic toxin
  • increase in electrolyte and water efllux
  • EPEC, ETEC, Vibrio cholerae, Listeria monocytogenes
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10
Q

Bacteria with watery/bloody diarrhea

A 
EHEC
Campy
SHigella
Yersinia
EIEC
C Diff
Vibrio parahaemolyticus
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11
Q

Bacteria with watery non-bloody diarrhea

A 
EPEC
ETEC
food-poisoning
Cl perferingens
BAcillus cereus
Bibrio cholerae
Salmonella
Listeria monocytogenes
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12
Q

When does symptom onset occur from bacterial preformed toxin?

A

1-8 hours after ingestion

-staph aureus, bacilius cereus, c botulinum

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13
Q

When does symptom onset occur from bacterial toxin produced after ingestion?

A

8-16 hours after ingestion

  • eat a lot of organisms or spores
  • bacilus cereus, C perferingens, C botulinum
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14
Q

When does symptom onset occur from virulence factor producing bacteria?

A

16+ hours after ingestion
adherence, growth, and then virulence factor production
-shigella, salmonella, listeria, EHEC, EPEC ETEC, EIEC, Campy, Vibrio

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15
Q

What are the two types of bacterial food poisoning?

A
  • toxins produced by bacteria in food before consumption

- large numbers of spores ingested, which germinate in intestine and bacteria produce toxins

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16
Q

What four bacteria cause food poisoning?

A

staph aureus
C botulinum
C perferingens
B cereus

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17
Q

What bacteria affects the stomach?

A

Helicobacter pylori

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18
Q

What bacteria is associated with home canning and honey?

A

Clostridium botulinum

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19
Q

What bacteria is associated with floppy baby disease and worstening symptoms 1-3 days post onset of symptoms?

A

Clostridium botulinum

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20
Q

What bacteria is associated with meat and gravies below reccomended temperature?

A

Clostridium perfringens

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21
Q

What bacteria is associated with improper storage of cooked rice?

A

Bacillus cereus (emetic form)

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22
Q

Which bacteria associated with food poisoning onset within 1-8 hours post ingestion?

A
  • staph aureus
  • clostridium botulinum
  • bacillus cereus (emetic form)
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23
Q

Which bacteria associated with food poisoning onset within 8-16 hours post ingestion

A
  • clostridium botulinum
  • clostridium perferingens
  • bacillus cereus (diarrheal form)
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24
Q

What bacteria is assoicated with heart burn, nausea, and dull stomach pain?

A

Helicobacter pylori

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25
Q

What bacteria is diagnosed by C13 labeled CO2 exhaled in a urea breath test?

A

Helicobacter pylori

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26
Q

What bacteria are associated with small intestine infections?

A
  • listeria monocytogenes
  • EPEC
  • ETEC
  • Salmonella typhi
  • Nontyphoidal Salmonella
  • campylobacteri jejuni
  • vibrio cholerae
  • vibrio parahemolyticus
  • yersinia enterocoltica
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27
Q

What bacteria is associated with ready to eat meats and raw vegetables?

A

Listeria monocytogenes

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28
Q

What bacteria is associated with Internalin A, LLO, and ActA?

A

Listeria monocytogenes

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29
Q

What bacteria is diagnosed by presence in normally sterile areas and by cold enrichment, B-hemolytic and motility testing?

A

Listeria monocytogenes

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30
Q

What is the treatment for listeria?

A

beta lactam or trimethoprim-sulfamethoxazole

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31
Q

What is MacConkey agar used for?

A
  • check for lactose fermentation
  • red = positive (e coli)
  • white = negative (shigella and salmonella)
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32
Q

What is an indole test used for?

A
  • test for indole production
  • red = positive (E coli, Vibrio)
  • white = negative (salmonella)
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33
Q

What is Hektoen agar used for?

A
  • test for H2S porduciton
  • positive = black = Salmonella
  • negative = non-black = Shigella
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34
Q

What bacteria uses VacA and CagA?

A

Helicobacter pylori

  • VacA = create vacuoles in host cell
  • CagA = T4SS cytoskeletal disruption
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35
Q

What bacteria is associated with infant watery diarrhea w/o fever (developing countries)?

A

EPEP

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36
Q

What bacteria is associated with BfpA, intimin, and TiR?

A

EPEP

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37
Q

What bacteria is associated with a loss of microvili due to formation of an actin pedestal?

A

EPEP

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38
Q

How does EPEP present in culture?

A

positive MacConkey = lactose fermentation

postive Indole

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39
Q

What bacteria is associated with traverlers diarrhea from contaminated water and ice?

A

ETEC

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40
Q

What bacteria is associated with LT and ST toxins?

A

ETEC

  • LT heat liable = AB toxin increase cAMP
  • ST heat stable = increase cGMP
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41
Q

What bacteria is associated with a 13 day incubation, and 4 weeks of fever?

A

Salmonella Typhi

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42
Q

What bacteria is associated with infection of the gall bladder?

A

Salmonella Typhi

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43
Q

What bacteria is associated with ruffled M cells?

A

Salmonella Typhi

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44
Q

How does Salmonella Typhi present in culture?

A

Negative MacConkey = no lactose ferment

+ H2S on Hektoen

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45
Q

What is the treatment for Salmonella Typhi?

A

Depends on susceptiblity

  • fluoroquinolone
  • trimethoprim-sulfamethoxazole
  • broad spectrum cephalosporin
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46
Q

What bacteria are associated with turtles and peanut butter?

A

Non typhoidal salmonella

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47
Q

What bacteria is associated with onset 6-48 hrs post ingestion with bloody diarrhea 3-4 days up to 1-2 weeks?

A

Non typhoidal salmonella

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48
Q

How does Non-typhoidal salmonella present in culture?

A

Negative MacConkey = no ferment lactose

Positive H2S on Hektoen

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49
Q

What bacteria is associated with guillen barre syndrome?

A

campylobacter jejuni

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50
Q

What bacteria is the major GI infection in developed countries?

A

campylobacter jejuni

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51
Q

How does campy present in culture?

A

Grows at 42C and in microaerophilic environment

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52
Q

What bacteria is associated with abrupt onset of massive amounts of rice water diarrhea?

A

Vibrio Cholera

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53
Q

What bacteria is associated with natural disasters and poor sanitation conditions?

A

Vibrio Cholera

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54
Q

What is the action of cholera toxin?

A

Increase cAMP = efflux of water

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55
Q

What bacteria is associated with Kanagwa hemolysin?

A

Vibrio Parahaemolyticus

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56
Q

What is the mechanism of action of Kanagwa hemolysin?

A

Induce chloride secretion to cause watery diarrhea

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57
Q

What bacteria is associated with consumption of raw shellfish?

A

Vibrio parahaemolyticus

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58
Q

What bacteria presents with acute mesenteric lymphadenitis with fever and bloody diarrhea?

A

Yersinia enterocolita

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59
Q

What bacteria is associated with improperly cooked pork (Europe)?

A

Yersinia enterocolita

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60
Q

How does yersinia enterocolita present in culture?

A

safety pin

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61
Q

What bacteria cause infection of the large intestine?

A

Clostridium difficle
EHEC
Shigella
EIEC

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62
Q

What bacteria is associated with fulminant colitis with toxic megacolon (potential obstruction and easy perforation)?

A

Clostridium difficile

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63
Q

What bacteria is associated with opportunistic infection post antibiotic treatment?

A

Clostridium difficile

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64
Q

What is the treatment for clostridium difficile?

A

Oral vancomycin or metronidazole

65
Q

What bacteria is associated with contamination of hamburger, veggies, and fruit?

66
Q

What bacteria is associated with sequelae and kidney failure?

67
Q

What bacteria is associated with Shiga toxin?

A

EHEC and shigella

68
Q

How does shiga toxin work?

A
  • AB cleave parts of 60S subunit of ribosome blocking translation
  • travels in blood to receptor Gb3 found in glomeruli causing renal damage
69
Q

What bacteria is associated with fever, bloody diarreah, tenesmis that lasts 3-5 days?

A

Shigella (dysenteriae)

70
Q

What bacteria is associated with T3SS of Ipa and movement by actin polymerization?

71
Q

How does shigella present in culture?

A

Negative MacConkey = no lactose ferment

Negative H2S in Hektoen

72
Q

What presents like Shigella without toxin?

73
Q

What bacteria can be vaccinated prophylactically?

A

Salmonella typhi

-intramuscular or oral

74
Q

What are the protozoa that infect the GI tract?

A
  • amoeba = entabmoeba histolitica
  • flagellates = giardia lamblia
  • ciliates = balantiasis
  • sporozoans = cryptosporidium parvum, cyclospora cayetanesis, isospora belli, microsporidia
75
Q

What presents with heme positive stool and no fever?

A

entamoeba histolitica = amebiasis

76
Q

What protozoa is diagnosed by presence of an amoeba +/- cyst in stool?

A

entamoeba histolitica = amebiasis

77
Q

What protozoa is associated with greasy floating foul-smelling stools with lots of flatulence?

A

Giardia lamblia = giardiasis

78
Q

What protozoa is diagnosed by presence of cysts in formed stool and trophozoite in loose stool?

A

Giardia lamblia = giardiasis

79
Q

What protozoa presents as bloody diarrhea associated with pigs or swine?

A

balantidium coli = balantidiasis

80
Q

What protozoa is associated with watery diarrhea and acid-fast oocyte presence in stool that lasts 1-2 weeks?

A

cryptosporidium parvum = cryptosporidiasis

81
Q

What protozoa is associated with contaminated raspberries and basil (produce from central and south america)?

A

cyclospora cayetanesis = cyclosporiasis

82
Q

What protozoa is associated with watery diarrhea that is prolonged over time and presents with acid-fast oocyte (UV fluoresce) in the stool?

A

cyclospora cayetanesis = cyclosporiasis

83
Q

What protozoa is associated with diarrhea with fever and acid-fast fluorescent oocyte in the stool?

A

Isospora belli = isosporiasis

84
Q

What protozoa is associated with dissemination to eyes and organs?

A

microsporidia = microsporiosis

85
Q

How is entamoeba treated?

A

metronidazole: interfere with energy prod and nucleic acids

86
Q

How is giardia treated?

A

metronidazole: interfere with energy prod and nucleic acids

87
Q

How is cryptosporidium treated?

A

nitazoxamide: interfere with energy metabolism

88
Q

How are cyclospora and isospora treated?

A

sulfonamide/sulfadiazine: interfere with folic acid synthesis

89
Q

What are the major characteristics of nematodes?

A
  • roundworms
  • non segmented bodies
  • separate sexes: need infected by 2 or more to be shedding eggs
  • adult worms do not replicate in man
  • complete digestive system
  • non fatal, cause malnutrition
  • children = symptomatic
  • disease = adult presence in GI
  • Most common in SE US
  • identified by egg morphology
  • some pass through other tissues = eosinophilia
90
Q

What is a geohelminth?

A
  • nematode infection acquired through contact with infected soil
  • needs to spend part of its life cycle in soil
  • ascaris and trichuris = ingesion of infectious eggs
  • strongyloids and hookworms = penetration of skin
91
Q

What nematode presents as eggs in stool ready to infect that appear flat on one side?

A

Enterobius vermicularis = pinworm

92
Q

What nematode presents as lemon shaped eggs in stool?

A

Trichuris trichura = whipworm

93
Q

What nematode presents as rectal prolapse in children?

A

trichuris trichura = whip worm

94
Q

What nematode presents as bumpy eggs in stool? or larvae and eosinophils in sputum?

A

ascaris lumbricoides = ascariasis

95
Q

What nematode requires eggs to be in soil for 3 weeks to mature internal larvae?

A

trichuris trichura = whipworm

96
Q

What nematode requires eggs to develop in soil for two weeks?

A

ascaris lumbricoides = ascariasis

97
Q

What nematode presents as plain eggs in stool?

A

necator americanus and ancylostoma duodenale = hookworm

98
Q

What nematode requires eggs to hatch in soil?

A

Hookworm necator americanus

99
Q

What nematode presents as larvae in the stool?

A

strongyloides stercoralis = strongyloidiasis

100
Q

What nematode can reproduce in human or in soil so that larvae may penetrate skin?

A

strongyloides stercoralis = strongyloidiasis

101
Q

What nematode infection is commonly seen disseminated in patients taking immunosuppressive glucocorticoid therapy?

A

strongyloides stercoralis = strongyloidaisis

102
Q

What are the treatements for pinworm (enterobus vermicualris)?

A
  • mebendazole = inhibit mitosis in parasite

- pyrantel pamoate = muscle paralysis in parasite

103
Q

What are the treatments for whipworm (trichuris trichiura)?

A

mebendazole = inhibit mitosis in parasite

104
Q

What are the treatements for ascariasis (ascaris lumbricoides)?

A

mebendazole: inhibit mitosis in parasite

105
Q

What are the treatments for hookworm (necator americanus)?

A

albendazole and mebendazole: inhibit mitosis in parasite

106
Q

What are the treatments for strongyloidiasis (strongyloides stercoralis)?

A

thiabendazole: inhbiit mitosis in parasite

- ivermectin: cause muscle paralysis in parasite

107
Q

What are the three basic structures of adult tapeworms (cestodes)?

A
  • scolex: rounded head of worm with hooks +/- suckers
  • neck: area from which new body segments are generated
  • body (strobila): long segmented structure where individual segmetns are called proglottids
108
Q

What are the characteristics of cestodes?

A
  • tapeworms
  • segmented bodies
  • hermaphroditic
  • absorb nutrients
  • one type humans are definitive host where adults reside in small intestine: beef, pig, and fish
  • second type humans are intermediate host where larvae are present in various tissues : dog and pig
109
Q

What are the characteristics of trematodes?

A
  • flukes
  • non-segmented (leaf shape)
  • hermaphroditic
  • primitive gut
  • humans are definitive host
  • freshwater snails act as intermediate host
  • larval form released from snail encyst on fish, shellfish, or vegetation, and are acquired by ingestion
110
Q

What cestode is associated with consumption of contaminated undercooked beef?

A

taenia saginata = beef tapeworm

111
Q

What cestode is associated with consumption of contaminated undercooked pork?

A

taenia solium = pork tapeworm

112
Q

What cestode is associated with fecal oral contamination without Hx of dog?

A

Taenia solium = pork tapeworm

113
Q

What cestode is associate with punctate lesions on MRI?

A

taenia solium = pork tapeworm

114
Q

What cestode is associated with consumption of contaminated raw fish?

A

diphylobothrium latum = fish tapeworm

115
Q

what cestode is associated with macrolytic anemia caused by a B12 deficiency?

A

diphylobothrium latum = fish tapeworm

116
Q

What cestode is not associated with consumption of contaminated meat?

A

echinococcus granulosus = dog tapeworm

117
Q

What cestode is associated with hyatid cysts that can perpetuate anaphylaxis when ruptured?

A

echinococcus granulosus = dog tapeworm

118
Q

What is the treatment for cestode/tapeworm?

A
  • GI: praziquantal = increase Ca permeability of worm tegument = depolarization causing increase immune detection and spastic paralysis
  • Extra: benzimidazole = inhibit mitosis
119
Q

What is the trematode associated with diarrhea, hemorrage, ulcers, and abcess after consumption of fresh water plant?

A

-fasicolopsis buski = intestinal fluke

120
Q

What is the trematode associated with fever, eosinophila, and biliary obstruction after consumption of fresh water plant?

A

fasicola hepatica = liver fluke

121
Q

what is the trematode associated with biliary obstruction, jaundice, hepatomegally, gallstones and increased biliary cancer risk after consumption of raw fish?

A

opsithicorsis (clonorchis) sinensis = liver fluke

122
Q

What is the treatment for trematodes associated with the liver?

A

-proziquantal= increase Ca permeability fo worm to cause depolarization allowing increased immune detection and spastic paralysis

123
Q

What is the treatment for trematodes associated with the intestines?

A

Benzimadole to inhibit mitosis

124
Q

What are the three main clinical presentations of hepatitis?

A

acute hepatitis
chronic hepatitis
fulminant hepatitis

125
Q

What are the symptoms of acute viral hepatitis?

A
  • jaundice: yellowing of the skin and eyes due to increased bilirubin levels
  • dark urine
  • acholic stool: light, clay colored stool due to reduction in bile production
  • prodrome: 1-2 week prior to jaundice = headache, myalgia, arthralgia, fatigue, nausea, vomiting, pharyngitis, mild fever
126
Q

What are the blood tests associated with acute viral hepatitis?

A
  • bilirubin >3mg/dL
  • bilirubin in urine = liver disease
  • ALT and AST elevation
  • ALT 1000U/L
127
Q

What is chronic viral hepatitis?

A
  • hepatitis that does not resolve within 6 months
  • predisposes to liver cirrhosis and hepatocellualr carcinoma
  • immune system responsible for liver destruction
128
Q

What is fulminant viral hepatitis?

A
  • rapid severe hepatitis
  • massive hepatic necrosis
  • encephalopathy = confusion, disorientation, death
  • edema
  • complications: cerebral edema, brainstem compression, GI bleed, sepsis, organ failure
  • liver transplant to survive
129
Q

Which strains of hepatitis are fecal-oral transmitted?

130
Q

Which strains of hepatitis have DNA?

131
Q

Which strains of hepatitis can have chronic infection?

A

B, C, and D

132
Q

What type of hepatitis is associated with 28 day incubation and resolution in 2 months with no chronic illness?

133
Q

What type of vaccine is the HAV vaccine?

A

inactivated whole virus

-2 dose injection for children at 1 yr and those at high risk for infection or complication from infection

134
Q

What type of hepatitis is associated with potent surface antigen during active infection?

135
Q

What type of hepatitis is associated with incubation of 90 days and increased chronic disease in younger populations?

136
Q

What type of vaccine is the HBV vaccine?

A
  • HBsAg injection 3 doses

- children at birth and adults at risk for infection

137
Q

What is the treatment for HBV?

A
  • acute = none

- chronic = oral polymerase inhibitor or cell intrinsic immune modulator

138
Q

What is the procedure for post-exposure prophylaxis for HBV?

A
  • give HBV vaccine and HBIg
  • premature infants with HBsAg+ mom
  • fullterm infant with HBsAg+ mom
  • percuatneous exposed health care worker
139
Q

What type of hepatitis is associated with chronic infection after infection with contaminated needles?

140
Q

What is the testing for HCV?

A
  • screen test = Ab fro anti-HCV Ab

- confirmatory = nucleic acid base test for detection of viral genome

141
Q

What is the treatment for HCV?

A

-12-24 week oral combo direct acting antiviral

142
Q

What drug works for HCV NS3/4A?

A

protease inhibitor

143
Q

What drug works for HCV NS5A?

A

virion assembly inhbiitors

144
Q

What drug works for HCV NS5B?

A

RNA polymerase inhibitor

145
Q

What type of hepatitis is associated with dependency on another hepatitis virus?

A

HDV needs HBV

146
Q

What hepatitis causes increased fulminant?

A

HDV HBV coinfection

147
Q

What hepatitis directly causes hepatic injury?

148
Q

What hepatitis is associated with US travel to western asia and increased death in pregnant women?

149
Q

What are the viruses associated with gastroenteritis?

A

rotavirus
norovirus
adenoviruses 40 and 41
astrovirus

150
Q

What virus is associated with flacid paralysis?

A

poliomyelitis

151
Q

What is the current mode of vaccination for polio?

A

inactivated virus for 4 doses

152
Q

What virus has a 1-3 day incubation and presents in diarrhea, and vomiting for 4-7 days?

153
Q

What virus is common in immunosuppressed children but not AIDS pt?

154
Q

What virus is associated with the NSP4 toxin that causes calcium release in the intestine?

155
Q

What type of vaccine is used for rotavirus?

A
  • oral
  • 2006 2 dose cross b/w human and bovine
  • 2008 3 dose live attenuated
  • all children before 12 weeks
156
Q

What virus manifests 24-48 hours incubation with nausea vomit and diarrhea for 24-60 hours?

157
Q

What virus is the most common cause of non-bacterial gastroenteritis in the US?

158
Q

What virus manifests after 8-10 days with diarrhea for 7-8 days?

A

Adenovirus

Microbiology (5 decks)

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