Exam 3/Final Flashcards
Parrot Fever
Chlamydophila psittaci
Walking pneumoniae
2nd to Mycoplasma pneumoniae as leading cause of walking pneumoniae
Chlamydophila pneumoniae
Highly contagious hazard to poultry worker, veterinarians. (parakeets, macaws, parrots, cockatiels)
Chlamydophila psittaci
Acute infection of the lower respiratory tract, dry hacking cough, enlarged liver and spleen, interaction with birds.
C. psittaci
Unique characteristics to chlamydiacae
- Obligate intracellular
- Exists as 2 distinct morhpologies (EB + RB)
- Double layered cell envelope with NO Peptidoglycan
- Can’t synthesize ATP
Infectious form/morphology of chlamydiacae
Elementary Body (EB) Small and Hardy
Intracellular form/morphology of chlamydiacae
Reticulate Body (RB) Large and Fragile
This species reticulate bodies synthesize large amounts of glycogen and inclusion bodies stain blue with iodine
C. trachomatis
Asymptomatic pneumonia, cold agglutinins in serology, aged 5-15, P1 Adhesions (virulence), lack cell wall
Mycoplasma Pneumoniae
Asymptomatic pneumonia, adult, MIF assay confirmed, Gram -, Obligate intracellular parasite
C. Pneumoniae
C. trachomatis serotype (A, B, Ba, and C
Trachoma - chronic eye infection
C. trachomatis serotype (D-K)
- Inclusion Conjunctivitis (neonatal conjunctivitis
- Non-Gonococcal urethritis (NGU)
C. trachomatis serotype (L)
Lymphogranuloma venerum
Tell-tale sign of C. trachomatis
Neutrophils and cytoplasmic inclusions in exudate
Most common cause of neonatal conjunctivitis in the U.S.
C. trachomatis
Most common bacterial STD in the U.S.
NGU via C. trachomatis
Most common STD in the U.S. overall
HPV
Painful swelling of the inguinal and peri-rectal lymphnodes, replicates in macrophages
Lymphogranuloma venerum (LGV)
Why are Mycoplasma/Ureaplasma resistant to cephalosporins,penicillins, beta-lactams, etc.?
Lack a cell wall, smallest free living organism in nature
Relentless dry hacking cough, non-purulent otitis media, P1 adhesions (causing persistant cough), x-ray shows unilateral patchy pneumonia in lower lobes
Mycoplasma pneumoniae
Fried egg appearance on agar, sexual contact
Mycoplasma hominins or Mycoplasma genitalium
Fried egg apperance, sexual contact, metabolize arginine, post-partum fever
Mycoplasma hominins
3 possible bugs for (NGU) - non-ghonococcal urethritis
Mycoplasma, Ureaplasma, Chlamidophyla
No cell wall, cultured on ureaplasma agar, produces urease
U. urealyticum - either NGU (men), Post partum fever (women)
Three major pathogenic spirochetes
Treponemes
Borellia
Leptospira
Catalase +
Staph sp.
- aureus
- sapro
- epi
Coagulase +
S. Aureus
Catalase -
Strep sp - pyogenes - agalactiae - pneumoniae - veridans Enterococcus
Staph strand novobiocin sensitive?
S. Epidermis
what is a viral capsid made of
proteins called capsomeres
Which viral structure (enveloped or non) is more resistant to environmental conditions?
non-enveloped
Constituents of viral envelope?
Lipid membrane
Host Cell
Glycoprotein spikes (host cell attachment)
Note: more susceptible to environmental conditions because membrane can dry/shrivel up
How are viruses classified?
type of nucleic acid (RNA/DNA)
envelope or not
shape of capsid
Name 3 Enveloped DNA Viruses
Use host cell RNA polymerase to make mRNA
Pox
Herpes
Hapadna
Name 4 Naked DNA Viruses
Use host cell RNA polymerase to make mRNA
Papilloma/Papo (ds)
Adeno (ds)
Parvo (ss)
Polyoma
Name 2 Naked +RNA Viruses
These viruses use themselves as mRNA
Picorna
Calici
Name 3 Enveloped +RNA viruses
These viruses use themselves mRNA
Toga
Flavi
Corona
Name 6 Enveloped -RNA viruses?
These use their own polymerase to make mRNA in the host cell
Rhabdo Filo Orthomyxo Paramyxo Bunya Arena
Which virus is (+/-) and has a double capsid?
Reo
Which virus is (+RNA via DNA) and has an envelope?
Retro
3 methods of entry of viruses into the host
endocytosis (e.g. viropexis) fusion (enveloped viruses) direct injection (possibly naked, capsid left beind)
How do retroviruses replicate?
They use reverse transcriptase (brought with them) to copy their ssRNA chromosome into cDNA.
How will you attack a retrovirus with treatment without hurting the eukaryotic organism?
Target the reverse transcriptase, because it is specific to the virus (reverse transcriptase inhibitor)
What does it mean to have a latent viral infection?
After initial infection the virus becomes inacitve.
- can incorporate into the host cell genome
- can sit quietly in the cytoplasm and freely replicate, waiting for representation (e.g. shingles/herpes in response to stress)
- representation of symptoms can look different from initial infection
Virus modes of transmission
oral droplet inhalation direct inoculation (bites, trauma) direct skin contact (lesions, warts) trans-placental sexual organ transplant
Whats viremia
viruses traveling throughout the body via lymphatics and bloodstream
What are the stages of infection for viral pathogens?
Incubation (after exposure, before symptoms)
Prodromal (vague symptoms present)
Acute (diagnositc symptoms present)
Resolution (decrease in severity of symptoms)
Convalescence (symptoms largely gone)
What is a “lytic” viral infection?
host cell allows virus to replicate until the cell dies
Are perstistant chronic infections “lytic”?
No, they release the viral particles without lysing host cells. Just continually release virions.
Ebstein Barr (EBV) cancer connection?
Burkitt’s Lymphoma
Human Papilloma (HPV) cancer connection?
Cervical Cancer
Hepatitis B (HBV) cancer connection?
Liver Cancer
Hepatitis C (HCV) cancer connection?
Liver Cancer
Human Herpes (HHV-8) cancer connection?
Kaposi’s sarcoma (latent skin lesions)
Human T-Lymphotrophic (HTLV-1) cancer connection?
Adult Leukemia
What are the 2 big characteristic cell changes which can help with viral DX?
- Triggering fusion of cells (multinucleated giant cell, syncitia)
- Inclusion bodies
(e.g. Negri Bodies in cytoplasm - rabies,
Owl’s eye in nucleus - cytomegalovirus )
2 Major pathogenic sp. of Treponemes
T. pallidum (syphilis)
T. carateum (pinta)
T. pallidum causes tissue destruction and lesions, what causes these symptoms?
Host immune response
What characteristics are common to all DNA viruses?
(Exceptions)?
Double Stranded (except parvo) Icosahedral (except pox) Replicate in the nucleus (except pox)
DNA viruses associated with virion polymerase for replication?
All naked + Herpes Paro Papo Adeno Herpes
DNA viruses NOT associated with virion polymerase for replication?
Enveloped (Except Herpes)
Pox
Hepadna
Connection between B19 and anemia/sickel cell patients?
APLASTIC CRISIS:
B19 = parovirus, depletes RBC precursors (binds P antigen). paroviruses can be very severe in anemic/sickle patient
Transmission of B19 parovirus?
respiratory droplets
oral secretions
across placenta
Dx/ Child
Prodrome (fever, sore throat, myalgia)
Rash (cheeks initially, spreading to extremities, relapses)
B19 parovirus
B19 parovirus clinical syndromes
Dx/ Child
Prodrome (fever, sore throat, myalgia)
Rash (cheeks initially, spreading to extremities, relapses)
Dx/ Adult
Above possibly + Arthralgia, Arthritis
Oncogenic potential of HPV?
Cervical cancer (contain E6 and E7 - bind to our tumor suppressor genes)
Why does HPV cause warts
stimulates growth of cell: thickening of basal and prickle layers of the skin and stratum granulosum
HPV serotypes 6/11 associated symptoms?
16/18?
6/11 - Condylomata acuminata - Ano/Genital Warts!(90%)
16/18 - Cervical cancer association
Papsmear comes back + for Koilocytic Cells/ Koilocytes.. Large clue for?
HPV
Vaccine for HPV? Serotypes?
Gardasil - 6, 11, 16, 18
If a virus is spread via Fecal/Oral transmission, what characteristic does it likely have?
It must be naked (more resistant form of virus), can survive that route
Swimming pool conjunctivitis buzzword
Adenovirus
What is special about the Adenovirus vaccine? Unique only to this one.. Hint: Military only
Live; *NON-ATTENUATED, oral. Given only to military personnel for that reason
Clinical Syndromes for Adenovirus
Variola Major (Smallpox, 15-40% mortality) Variola Minor (1% mortality rate)
Differentiate Smallpox and Chickenpox (VZV)
Smallpox lesions are all the same because they don’t present unless they are fully vescularized?
**FIX THIS CARD
Person bought a praiie dog and has smallpox symptoms…
Monkeypox
Single nodular lesion forms at point of contact, resembles cutaneous anthrax and associated with sheep and goats?
Orf - Poxvirus
The pathogenesis of HBV?
Blood, IV drug use, Sex
Chronic HBV pathway, reason for this?
Possible disease outcome?
HBV can go chronic if the host pt. lacks a strong cell-mediated immune response
Acute symptoms followed by possible problems down the road - Cirrhosis, Primary Hepatocellular Carcinoma
Acute symptoms of HBV?
Jaundice, dark urine, flu-like, anorexia
Target of HBV vaccine?
surface antigen HBsAg
List the 7 viruses in the Herpesveridae family
Herpes simplex -1 (HSV-1) - STD cold sores Herpes simplex - 2 (HSV-2) - STD Varicella-Zoster (VZV) - chicken pox Epstein-Barr (EBV) - Mononucleosis Human Cytomegalovirus (HCMV) - Asymptomatic (causes birth defects) Human herpesvirus - 6 (HHV-6 and 8) - Roseola (6)
Notable diagnostic clue about glycoproteins in the envelope of Herpesveridae?
Fusion proteins (cell-cell fusion)
What is the most notable characteristic of the Herpesveridae family?
Latency - remains in the host for life! Remain in ganglia or white blood cells, depending on the type.
HSV-1 latency site
trigeminal ganglia
HSV-2 latency site
sacral ganglia
VZV latency site
dorsal root ganglia
EBV latency site
WBCs (b-cells)
CMV latency site
WBCs (monocytes)
HHV-6 latency site
WBCs (lymphocytes
HSV-1 Disease States (2 major) (3 minor)
Gingivostomatitis (Primary orofacial) Cold Sores (Recurrent stomatitis) Ocular Herpes Herpes gladitorium Encephalitis
Leading cause of viral encephalitis in the U.S.?
HSV-1 (Fatal - 70% mortality rate), Especially beyond neonatal period
Tell tale of viral encephalitis (HSV-1 version)
Temporal Lobe encephalitis
Most common cause of viral encephalitis in neonates?
HSV-2 (birthing process with infected mother)
what is herpes gladiatorum?
known as HSV-1 dermatitis, obtained through contact sports
Typical site of lesions for herpes gladiatorum?
Head and neck (can be moved to other areas through infectious sores)
Presence of gummas is a tell tale sign of this
Treponemes
Two types of HSV-2 infection?
Primary Genital
Recurrent Genital
Symptoms of Primary HSV-2
lesions with profuse watery discharge (2-7 days after contact)
Symptoms of Recurrent HSV-2
occurs via reactivation in sacral sensory ganglia, presents less severe form of primary symptoms
less lesions and shorter duration.
Very painful, localized lesions that show up 1-2 times per year and last about 8-10 days.. Dx
HSV-1 (Recurrent stomatitis)
3 phases of T. Pallidum
Primary
Secondary -
Late(Tertiary)
Primary phase of T. Pallidum symptoms
3-4wks
Painless chancre at innoculation site, begins as papule then erodes to painless ulcer with raised borders.
*Ulcer is highly contagious site of replication
Secondary phase of T. Pallidum symptoms
4-10 wks
Copper-colored rash over Entire Body, “nickel and dime rash” on palms and soles. Patchy Hair-loss “moth-eaten”, Highly infectious like the primary.
*Condylomata lata” - soft fleshy papules
Tertiary phase of T. Pallidum symptoms
3wks - 3mos
Organ/Tissue Destruction
Neurosyphilis
Tertiary - T. pallidum
destruction of either brain parenchyma (dementia) or dorsal roots of spinal chord (tabes dorsalis)
Gummas
Tertiary - T. pallidum
destructive granulomatous lesions in bones, skin, tissues (treponemes usually not found in the lesion)
Difference between early and late Congenital Syphillus
Early: (birth - 2), Extensive cutaneous lesions, Snuffles (mucopurulent rhinitis), osteochondritis of long bones
Late: (>2yrs), Cutaneous gummas, Hutchinson Teeth (notched incisors), Respberry molars, saber shins, saddle nose.
Where does local replication occur for VZV (chicken pox)?
Respiratory Epithelial Cells
What differentiates VZV from Smallpox?
VZV lesions are different sizes and at different stages of development
Smallpox lesions are all the same size and same level of development (because they only present when the virus is fully in the presentation phase)
What are some long term effects of a zoster reactivation outbreak?
Possible long lasting “neuralgia”
Reactivation in the ‘danger’ dermatome can cause encephalitits! (Must prophylax- acyclovair?)
What is the primary target cell for EBV (mono)
Epithelial cells within the oropharynx, especially parotid glands. (UNDERGO LYTIC Infection - reservoir for virus that can infect/transform B-Cells)
Can EBV replicate in B-Cells?
No, EBV can get into/infect B-cells using CD21 marker, however it can’t complete replilcation cycle once inside
Why are teens most affected by EBV (mono)?
Because it is a disease that attacks B-Cells, and teens have very strong immune systems (lots of B-Cells to infect)
What is the reservoir for the EBV?
oropharyngeal epithelial cells
Pt. presents with sore throat, serology shows “heterophile IgM antibodies”. DX?
EBV (Mono), B-Cells proliferate due to being infected and cause a huge immune response.
Common cancers seen in association w/ EBV
Burkitt Lymphoma - usually in jaw (common in africa)
Nasopharyngeal Carcinoma
Hodgkin Lymphoma
CMV can cause a mononucleosis, what makes this mono different from EBV?
The serology shows heterophile (-) antibodies
What is the leading viral cause for congenital infections/defects in the U.S.?
Cytomegalovirus
Who is at greatest risk of a CMV infection?
Fetus via intrauterine transmission
What are common CMV manifestations in the immunosuppressed
Neonates - very severe (birth defects), death
Adults - Pneumonia, Chorioretinitis
Common buzz word for CMV presentation?
Owls eye inclusions
What is the cause of Roseola?
HHV-6
Transmission of HHV-6
Respiratory droplets
Replication site of HHV-6?
WBCs (T and B)
Prodrome of HHV-6?
Very high fever, Then fever subsides and a RASH presents (WITH NO FEVER)
Pt. presents, had a severe fever. After fever subsided and a rash appeared? DX?
HHV-6 - Roseola
Raised purple lesions in an HIV patient, viral cause?
HHV-8 - Kaposi’s sarcoma..
What are the only double stranded RNA viruses?
Reoviurses, RNA (-)
Cruise ship associated gastroenteritis?
Norwalk virus (Calicivirus family) - Comprimise function of intestinal brush border
How are calciviruses (norwalk) usually spread?
Usually fecal/oral, careless food handler
What is the transmission route of Flaviviridae?
Arthopod Vectors - known as the Arboviruses Yellow Fever West Nile St. Louis Japanese Dengue
Hemmhorragic diseases of Arboviruses/Flaviviridae?
Yellow Fever
Dengue Fever
Primary viremia Arboviruses symptoms?
Flu-Like
Secondary viremia Arboviruses symptoms?
can infect the brain (encephalitis), liver, skin, and vasculature
Viral encephalitis? First think – HSV-1, but if there are mosquito bites and its summer?
arboviruses
Common cold viruses #1 and # 2
#1 Rhinovirus #2 Coronavirus
What are the two big things to remember about the transmission/pathogenesis of Picornaveridae?
DO NOT CAUSE ENTERIC DISEASE(diarrhea)
Transmission is fecal-oral
Three major diseases caused by Coxsackieviruses?
Herpangina (vesicular ulcerated lesions around soft palate and uvula)
Hand-Foot and Mouth (vesicular lesions in these areas)
Pleurodyna (devils grip)
What is bacwards/weird about rabies (rhabdovirus) treatment?
We vaccinate after exposure
Leg myalgia in prodrome of a virus is tell-tale of?
US Southwest
Secondary symptoms look like atypical pneumonia
Hantavirus
Infant vs adult VIRAL gastroenteritis?
Infant - Rotavirus
Adult - Norwalk virus
Epidemic vs Pandemic Flu
Endemic- caused by antigenic drift specific location
Pandemic Flu - caused by antigenic shift (worldwide)
Most notable segmented virus? How many segments
Orthomyxos - 8 Segments
What is antigenic shift, when referring to orthomyxoviridae, and what is its significance?
When a new viral sub/serotype appears, many people dont have antibodies against it. Can spread rapidly through a susceptible population.
Which type of influenza can undergo antigenic shift?
Type A - can infect BOTH animals and humans
Types B+C can only infect humans
What is antigenic drift?
Can happen in all RNA viruses.. A or B
Two big names in paramyxoviridae
Measles and Mumps
What are the 5 Classic childhood exanthems?
Measles Rubella Roseola 5th Disease Chickenpox
What is easy about identifying a measles rash?
The three Cs
cough
conjunctivitis
coryza (runny nose)
Also will see Koplick’s spots (usually in the buccal mucosa) right before the rash
Most common complication with measles?
Pneumonia (accounts for 60% of measles deaths)
What is a sclerosing pan encephalitis? And what is it like?
SSPE
- slow neurological disease like in prions
- can take years to present after measles infection
What virus is associated with “croup”
Parainfluenza - barking seal cough caused by tracheitis
Virus associated with painful, bilateral parotid swelling/ parotitis?
Mumps, lytic so it causes intense inflammation
Important associated disease with MUMPS,
Causes orchitis (sterility in men)
What is the most frequent cause of fatal respiratory tract infections in infants or young children?
Respiratory Syncytial Virus (RSV), pneumonia caused in young children
Note: adults and older children can get it but they just show the flu…
Major pathological worry with RSV?
Mucus plugs and fibrin blocking an airway
Transmission vector of Bartonella spp?
Disease Name?
DX
Cats
Cat Scratch Fever
Dx/ Warthin Starry Silver Stain
Normally only seen in immunocomprimised
Transmission vector of Borellia Burgdoferi?
Disease Name?
DX
Tick (deer and mice)
Lyme Disease
AB detection Test
Western Blot Protein
Transmission vector of Borrelia recurrentis?
Disease Name?
DX
Louse (human body)
Relapsing Fever
Dx/ Dark Field Microscopy
Transmission vector of Brucella spp.?
Disease? ** Manifestation (key)
DX
Direct contact w/ goats + sheep (aborted fetuses)
Brucellosis (Undulant Fever) ** Profuse Sweating
Dx/ HISTORY, gram -, cat/ox/urease +
Transmission vector of Campylobacter?
Manifestations?
Puppies/Livestock
Bloody Diarrhea, Guillain-Barra syndrome
Transmission vector of chlamydophila psittaci?
Disease?
Dx?
Parrots/Other Birds Parrot Fever/ Psittaciosis Dx/ hepato/splenomegaly Ab titer or IFA MIF for confirmation
Transmission of coxiella burnetti?
Disease Name?
Dx?
(only Rickettsiae with NO VECTOR -- Spores from tick feces or cattle placenta Q Fever DX/ Serology: Acute --> Phase II antigens only Chronic -> Phase I and II antigens
Transmission vector of Erlichiosis chaffeensis?
Lonestar tick, Dog Tick, Black-legged wood tick
Erlichiosis
Dx/ HME = chaffeensis (monocytic inclusions)
Wright Stained Blood Smear
*** Morula or Raspberry Inclusion
Transmission vector of Francisella tularensis?
Disease
DX?
RABBITS, Ticks
Tularemia
What are fungal cell walls made up of?
Cell membranes?
Chitin
Ergosterol
What agar are fungi most commonly grown on ?
Saouraud Dextrose Agar
What is the term used for a fungal infection
mycoses
Name the three genera of dermatophytes aka tineas (cutaneous mycoses)
Trichophyton
Microsporum
Epidermophyton
Tinea Corporis
smooth skin
Tinea Cruris
groin
Tinea Barbae
beard
Tinea Unguium
under nails
Protozoa are protected from harsh conditions by what?
Evade the immune system via what?
Cyst form allows them to survive harsh envrionments (malaria has no cyst – needs arthropod vector)
Evade immunity through antigenic variation
Metazoa are protected by what?
Evade immunity via?
Protected by a tough external layer (cuticle)
Evade immunity via antigenic variation and host cell lysing
Cat Bite/ Bi-polar staining
Pasturella Multocida
Cat scratch/ Warthin Starry Silver Stain
Bartonella henselae
Just Bi-Polar staining (2 bugs)
Pasturella
Yersinia
Dog bite/gangrene
Capnocytophaga canimorsus
Rat-bite fever/string of beads/fried egg
Streptobacillus moniliformis
rat-bite fever and haverhill fever
Contact with pigs/ Triple sugar iron agar
Erysipelothrix Rhusiopathiae
Exposure to aborted goat/sheep fetuses, urease positive
Brucella — Profuse sweating
Virulence mechanisms of bubonic plague (yersina pestis) - 3 major
F1 Gene - protein capsule
Plasminogen activator (Pla) protease- degrades complement, degrades clots
Yop genes: Type III secretion, antiphagocytic
Major test to diagnose a prion
Western Blot