E7 Flashcards
What are the characteristics of strep pneumoniae?
Gram -, catalase -, chain, pollysaccharide capsule, alpha hemolytic, latex agglutination, susceptible to optochin and bile
What are the buzzwords for strep pneumoniae?
- bacteremia in elderly and very young
- pneumolysin and IgA
- acute onset with high mortality and neurological sequelae in survivors
What are the treatments for strep pneumoniae?
Vancomycin w/ cephalosporin
What is the vaccine for strep pneumoniae?
Polysaccaride capsule conjugated to nontoxoid diptheria toxin (13 serotypes)
- highly immunogenic
- dose at 2, 4,6 mo and booster 12-15mo
What are the characteristics of neisseria meningitidis?
gram -, diplococci, polysaccharide capsule, oxidase +, catalase +, oxidizes glucose and maltose
What are the buzzwords for neisseria meningitidis?
- severe bacteremic infection
- peaks in <1yr and 15-24yr
- inc 3-4day w/ abrupt fever, hypotension, and rash
- 5 serotypes: C, B, Y, W-135, A
What is the treatment for neisseria meningitidis?
- penicillin if known
- prophylactic of close
What is the vaccine for neisseria meningitidis?
- MPV/MPV4: adults over 55
- MCV4: conjugated to nontoxic diptheria toxin,routine 11-55, 1-55 for high risk
- SeroB: in adolescents and high risk
What are the characteristics of streptococcus agalactiae?
gram + cocci, catalase -, beta-hemolytic,
What are the buzzwords for streptococcus agalactiae?
- <2mo and african american
- Ab opsonization is protective
- Risk: maternal infection, prolonged rupture, previous infant with GBS, low Ab
- early = bacteremia, late = same with meningitis
What is the treatment for streptococcus agalactiae?
Penicillin
-screen at 35-36 wk pregnancy intrapartum penicillin
What are the characteristics of Haemophilus Influenzae B?
gram - rod, polysaccharide capsule, encapsulated, latex agglutination
What are the buzzwords for H influenzae type b?
- non-encapsualted: pinkeye otitis media, sinusitis
- encapsulataed: meningitis, epiglottitis
What is the treatment for H influenza type B?
Penicillin
What is the vaccine for H influenza type B?
Conjugated vaccine with anti-PrP Ab
-highly immunogenic, given at 2 mo
What are the characteristics of Clostridium tetani?
gram + rod, anaerobe, spore forming
What are the buzzwords for clostridium tetani?
- neurotoxin = tetanospasm
- entry = spores in wound/trauma, umbilical stump
- AB toxin = internalized inactivate inhibitory NT causing spastic paralysis
- early= lock jaw, neck stiff, difficult to swallow
How is clostridium tetani treated?
- IgG = passive immunity
- tetanus toxoid = active immunitiy
- clean wound and antibiotic with supportive
What is the vaccine for clostridium tetani?
- vaccinate with tetanus toxoid DTaP
- begin at 2 mo, booster every 10 y
What are the characteristics for clostridium botulinum?
gram + rod, anaerobic, spore forming
What are the buzzwords for clostridium botulinum?
- spores: improperly cannned food and honey
- intoxication of preformed toxin
- floppy baby
- AB toxin = B binds, A enter motor neuron inhibit Ach to cause flaccid paralysis
- 12-72 hr post with descending paralysis
What are the characteristics of listeria monocytogenes?
gram + rod, motile in environment
What are the buzzwords for listeria?
- consumption of contaminated cheese and deli meat
- common in immunosuppressed and pregnant
What are the buzzwords for mycobacterium tuberculosis?
- AIDS opportunistic
- disease of lung that can spread to other sites and infect CNS
What are the buzzwords of coccidiodes imitus?
- easily airborne arthronocidia in environment
- San Jauquin CA, S. Ariona
- meningitis = slow, 1%, start with flu
What is the treatment for coccidiodes imitus?
-Amphotericin B
What are the characteristics of cryptococcus neoformans?
- leading form fungal meningitis
- encapsulated yeast
- slow, intermittent headache with CNS = weeks to months
- AIDS = 10-20% get meningitis
- India Ink for capsule
What is the treatment for cryptococcus neoformans?
- 6-10w with amphotericin B + 5-fluoro/fluconazole
- relapse in AIDS may require suppressive
What are the buzzwords for zygomycoses?
- predispose: immunosuppressed, diabetic, burns
- non-septate hyphae w/ sporangia
- rhinocerebral: diabetic, inf in sinuses and moves out
- hyphae at 90
What is the treatment for zygomycoses?
Amphotericin B
What are the buzzwords for Naeglaria fowleri?
- acquired in warm water with nasal inoculation
- fatal in 1 wk
- S States with Neti Pot
- trophozoites in biopsy or CSF
What is the treatment for Naeglaria fowleri?
Amphotericin B
What are the buzzwords for Acanthamoeba Keratitis?
- chronic cornea infection
- associated with contact elnses and homemade solution
- disseminate in lesion in brain
What is the treatment for Acanthamoeba Keratitis?
Topical, eye enucleation, corneal transplant
What are the buzzwords for toxoplasma gondii?
- congenital= still birth, blind, MR
- occular = asymptomatic lesion
- Aids= encephalitis with ring lesion
- transmit: undercooked lamb/pork and cat litter
- pregnant avoid
What is the treatment for toxoplasma gondii?
- treat pregnant
- congenital treat 1 yr
- immuno= prophylactic prevent reactivation
What are the buzzwords for taenia solium?
- undercooked pork with embryonated eggs
- create space filling lesion and induce local inflammation
- neurocysticercosis: seizure and neurologic defects
- common in immigrant hispanic
What are the buzzwords for visceral larval migrans?
- Tocoxari canis and cati = domestic dogs
- granulomatoous lesions = seizpures and encepalopathy
- eye most commonly effected
- no eggs in feces
What is the treatment for visceral larval migrans?
Symptomatic relief
-steroids
What are the buzzwords for West Nile Virus?
- normal b/w mosquito and bird with horse and human dead end host
- transmission with transfusion, transplant, breastfeed
- inc 3-14d with symptom 3-6d
- 1/150 severe neurological (elderly)
- > 50 with unexplained encephailitis/meningitis in summer or fall
What is the treatment for West Nile?
supportive with vaccine for horse
What are the buzzwords for St. Louis Encephalitis Virus?
- cullez mosquito from birds to humans with horse reservoir
- 5-15day inc with sudden fever
- severe - convulsions and spastic paralysis
What is the treatment for St. Louis Encephalitis Virus?
Supportive with most requiring hospitallization
What are the buzzwords for Japanese Encephalitis Virus?
- leading encephalitis in Asia
- highly fatal, survivors high rate neurologic sequelae
What are the buzzwords for Eastern Equine Encephalitis?
- E. seaboard and gulf coast
- outbreak summer and fall
- inc 4-10 day rapidly progressing to seizure and coma
- 1/3 will die, survivors left with neurologic damage requiring institution
What are the buzzwords for Western Equine Encephalitis?
- W US and Canada
- June and July
- most asymptomatic with children most affected
- low mortality
What are the buzzwords for Venezuelan Equine Encephalitis?
- S and C America
- most asymptomatic
- mild flu 3-5 days
- CNS involve - disorient, nuchal ridgid, convulsion, paralysis
What are the buzzwords for LaCrosse Encephalitis?
- midwest and mid-atlantic
- mainly kids
- reservoir chipmunk and squirrel
- nonspecific summer illness, 50% severe in kids
What are the buzzwords for rabies?
- infected saliva bite commonly dog or bat
- inc days -> month
- start nonspecific -> CNS
- behavior changes= hydrophobia
- coma and death
- negri bodies post mortum in animals
What is the treatment for rabies?
1 dose IgG and 5 dose Vaccine ( ASAP, 3, 7, 14, and 28 day)
-vaccinate high risk animals
What are the buzzwords for lymphocytic chorio meningitis virus?
- rodent born= through urine feces and saliva (mus musculus)
- severe in pregnant
- inc 1-2 week
- biphasic, 1 wk fever vomit, frew day remission, 2nd phase with meningitis or encephalitis
What are the buzzwords with prions?
- Kuru= spongiform encephalopathy from cannibalism of infected berains
- scrapie madcow, CJD
- PrP c v PRPsc
- congenital, transmitted, spontaneous
- slow progressive neurodegeneration, with death after clinical symptoms
What are the buzzwords for S. aureus in septic shock?
- Gram +, cocci, catalase and coag +
- LTA -> TLR2-> TNFa, IL1/6
- TSST1 heat and proteolytic resistant exotoxin
What are the buzzwords for streptococcus in septic shock?
- gram +, catal -
- local infection
- pain and nonspecific symptoms -> liver and renal involvement
- most bacteremic
- SpeA and SpeC progenic exotoxins bind MHC 2
How is shock treated?
- hypotension = iv fluids
- hypoxia = ventilation theraphy
- DIC = transfusion plasma and platelets or heparin
- bacteria = antibiotics with vanco and gentamicin
What are the buzzwords for viridans streptococcus?
- mitis anad salivarius
- subacute bacterial endocarditis
- alpha hemolytic
- weeks to months
How is viridans streptococcus treated?
penicillin
-vancomycin for resistant
What are buzzwords for infectious mono?
- EBV target infected B cell
- symp: lymphadenitis, splenomegaly
- young adults
- heterophile Ab
- rash with ampicillin
- day 7= Anti EB, Anti- VCA IgM
- day 10 = IgG and Anti EBNA
- Downey cells
What is the treatment for infectious mono?
-rest, hydration, avoid strenuous activity
What are the buzzwords for oral hairy leukoplakia?
- immunosuppressed
- active EBV replication
What is the treatment for oral hairy leukoplakia?
Antiherpetic drugs, podophyllin resin
What are the buzzwords for burkitt’s Lymphoma?
- EBV, B cell origin
- present in jaw of children
- endemic
- cofactor = malaria and immunosuppression
What are hte buzzwords for Hodgkins Disease?
- EBV, b cell origin w/o ties to specific translocations
- nontender lymphadenopathy in neck and chest
- reed Sternberg cell
What are the buzzwords for nasopharyngeal carcinoma?
- EBV epithelial cell cancer
- facial pain, fullness in sinus throat, hearing loss
- cofactor: genetic and diet
What are the buzzwords for post transplantational lymphoproliferative disorder?
- EBV
- abn proliferation of lymphoid
- fever, fatigue, wt loss, progressive encephalopathy
- risk: EBV at time of transplant
What is the treatment for transplantational lymphoproliferative disorder?
- reduce immunosuppression
- rituximab
- conventional chemo
What is the treatment for CMV?
- Gancyclovir (viral polymerase inhibitor) or Valganocyclovir (goes to gancyclovir)
- Cidofovir (viral polym inh more toxic) or foscarnet (inh of cmv polymerase)
What are buzzwords for CMV mono-like illness?
- inc 2-6day, symp 2-6wk
- fever, non-exudative pharyngitis, abn T cell, no heterophile Ab
- primary inf CMV
What are the buzzwords for CMV inclusion body disease?
- most common congenital viral inf
- hepatosplenomegaly, jaundice, petechial rash
- pregnant avoid spit of young child
What are the buzzwords for CMV in immunosuppressed?
- Transplant: CMV pneumonitis, GI, GVHD
- AIDS: CMS petinitis (eye), GI, pneumo
What are the buzzwords for myocarditis?
- most preventable in adult men
- SOB, exercise intolerance
- B19 parvovirus, HHV-6
- CHF of unknown origin
What are the buzzwords of mumps?
- ssRNA, 1 serotype, 5-14yr
- swollen tender parotid, anorexia
- bilateral parotid swell >2 day
What is the vaccine for mumps?
Live attenuated MMR and MMV
- 1st: 12-15mo and 2nd at 4-6yr
- adult = 1 dose
What are the buzzwords for Kaposi Sarcoma?
- classic= middle east/mediteranean with few lesions and mild
- endemic: equatorial africa, aggressive in prepuscent fatal in 3yr
- transplant= lesions leave once immunosuppression stops
- aids = widespread
What are the buzzwords for HHV-8?
- enveloped dsDNA, latent in KS
- transmission = sexual and needle
What are the buzzwords for Adult T-cell lymphoma?
T cell origin
- flower cells
- lymphadeno, hepatosplenomeg, hypercalcemia
- S Japan, Carribean, C Africa
- over 55yr
What are the buzzwords for HTLV-1 Assoicated Myelopathy?
- demyelination of neurons in spinal cord
- higher in adult women
- stiff gait, lower ext weak, incontinence, bedridden in 10yr
What are the buzzwords for HTLV-1?
- infects CD4 and CD8
- retrovirus, enveloped ssRNA
- Japan, C Africa, Carribean
- transmission: nursing, transfusion, sex
What are the buzzwords for trypanosmoma brucei?
- Africa with tsete fly
- early = lymph, late= cns invasion
- E Africa: inc 2-3 wk, CNS 3-4 wk (from animal and human)
- W Africa: inc wk-mo, CNS after wk-yr ( from humans)
What is the treatment for trypanosoma brucei?
Melarsoprol: will killyou 80% effective
Fluoromethylornithine = doctors w/o borders
What are the buzzwords for trypanosoma cruzi?
- chagas
- S+C america
- widespread vector and reservoir in US
- Chagoma/Roman sign
- chronic= inf cardiac = chf and megacolon decades after
What are teh buzzwords for leishmania sp?
- worldwide rare in US, opportunistic HIV
- bite female sand flies
- visceral = disseminated through reticuloendothelial
- causes systemic immunosuppression = death by 2 infection
- very old/young, malnourished
- IFN-gamma to resolve
What are the treaments for leshmania?
heavy metals or toxic drugs
What are the buzzwords for plasmodium sp?
- malaria
- bite inf mosquitoes
- release of merozoites and lysis of RBC
- cold stage 14-60m, hot stage 2-6, sweat stage 8-12 hr
- anemia (falciparum mature and young, vival and ovale only young)
- natural resistant
what are the treatments for malaria?
-eradicated vector, prophylaxis of travelers
What are the buzzwords for babesia?
- upper MW, CA, new england
- bite of tick (rodent and cattle )
- inc 1-8wk with hemolytic anemai, fever, chill, mylagia
- risk: elderly, asplenic, immunosuppressed
WHat are the buzzwords for filiarisis?
- wucheri bancrofit, and brugia malayi
- asia
- bite of mosquitos with larvae to lymphatics
- upper and lower extremities and male genitalia
- tropical pulmonary eosinophilia
- elephantitis
- microfilarie in blood smear
What is the treatment for filiarisis?
- DEC kills microfilarie and damages adults
- steroids counteract allergy to dying worms
- severe disease= surgery
What are the buzzwords for schistosomiasis?
- S America, Middle EAst, Asia, Philipines
- Mansoni- v plexus large GI
- Janonicum - v plexus small GI
- Haematobium- v plexus bladder
- hepatic and intestinal dysfuncion, or increased issues with bladder
- eggs in feces or urine
- snails
