FA Micro III Flashcards
1
Q
What is Treponema - tricky Ts
A
spirochete, causes syphillis, or yaws (T. pertenue)
2
Q
Trichamonas vaginalis - tricky Ts
A
protozoan, STD
3
Q
trypanosoma - tricky Ts
A
protozoan, causes chagas dz, or african sleeping sickness
4
Q
toxoplasma - tricky Ts
A
protozoan, a TORCH infection
5
Q
trichinella spiralis -tricky Ts
A
nematode in undercooked meat
6
Q
taenia solium - tricky Ts
A
tapeworm larvae (intestinal infection) in pork or eggs (neurocystircercosis) in food/water contaminated with human feces
7
Q
What components make up the naked icosahedral viral structure
A
nucelocapsid, nucleic acid
8
Q
What components make up the enveloped icosahedral viral structure
A
surface protein, lipid bilayer, capsid, nucleic acid
9
Q
What components make up the eveloped helical viral structure
A
surface protein, matrix/core protein, lipid bilayer, nucleic acid and nucleocapsid protein
10
Q
exchange of genes between 2 chromosomes by crossing over within regions of significant base sequence homology
A
recombination
11
Q
when viruses with a segmented genomes (influenza virus) exchange segments, high frequency recombination, cause of worldwide influenza pandemics
A
reassortment
12
Q
When 1 of 2 viruses that infects the cell has a mutation that results in nonfxnal protein, what is called when the nonmutated makes a fxnal protein that serves both viruses
A
complementation
13
Q
this occurs with simultaneous infection of a cell with 2 viruses, genome of virus A can be partially or completely coated forming a pseudovirion with the surface protein of of virus B - which virus determines infectivity of the phenotypically mixed virus, and what will the progeny of this infection have
A
phenotypic missing, infectivity of type B, progeny will of second infection will have coat from virus A
14
Q
What kind of immunity to live attenuated viral vaccines induce and what is the concern
A
humoral and cell mediate, can revert to virulence
15
Q
What kind of immunity to killed/inactivated viral vaccines induce, and what is the benefit
A
only humoral, stable
16
Q
Which kind of viral vaccine requires a booster
A
killed/inactivated
17
Q
In which pts is it dangerous to give live vaccines to
A
immunoCised - or their close contacts
18
Q
Name the live attenuated vaccines
A
smallpox, yellow fever, VZV, Sabin’s polio virus, MMR
19
Q
What is the only live attenuated vaccine that can be given to HIV pos pts
A
measles, mumps, rubella, MMR
20
Q
What are the killed viral vaccines
A
rabies, influenza, salk polio, HAV
21
Q
What are the recombinant vaccines
A
HBV (antigen = recombinant HBsAg) HPV (6, 11,16,18)
22
Q
What is only exception of DNA viruses that are not double stranded
A
parvoviridae
23
Q
What are the only circular DNA viruses
A
papilloma, polyoma, hepadnavirus
24
Q
What are the only double stranded RNA viruses
A
reoviridae, rotavirus
25
What are the positive stranded RNA viruses
retrovirus, togavirus, flavivirus, coronavirus, hepevirus, calicivirus, picornavirus
26
which purified viral nucleic acids are infectious and which are not
infectious = most of dsDNA (not pox/HBV) (+) strand ssRNA (same as mRNA); non infecitious = (-) ssRNA, dsRNA
27
which viruses are kind of diploid and what are the others
diploid - retroviruses, 2 ssRNA molecules, all others are haploid
28
Where do DNA viruses replicate
nucleus, except parvovirus
29
Where do RNA viruses replicate
cytoplasm, except influenza and retroviruses
30
Which are the naked viruses
calicivirus, picornavirus, reovirus, parvovirus, adenovirus, papilloma, polyoma
31
Where do most enveloped viruses acquire their envelopes from and what are the exceptions
plasma membrane, exceptions are herpesvirus which acquire from nuclear membrane
32
Which are the DNA enveloped viruses
herpesviruses, HBV, smallpox
33
Which are the DNA nucleocapsid viruses
adenovirus, papilloviruses, parvovirus
34
Which are the RNA enveloped viruses
influenza virus, parainfluenza virus, RSV, measles virus, mumps virus, rubella virus, rabies virus, HTLV, HIV
35
Which are the RNA nucelocapsid viruses
enteroviruses, rhinovirus, reovirus (rotavirus)
36
Which are the herpesviruses
HSV1 and 2, VZV, CMV, EBV
37
Which are the enteroviruses
poliovirus, coxsackievirus, echovirus, HAV
38
Which are the HHAPPPPy viruses
hepadna, herpes, adeno, pox, parvo, papilloma, polyoma
39
Which DNA virus is not double stranded
parvo - single stranded
40
Which DNA viruses are not linear
papilloma, polyoma (circular, supercoiled) and hepadna (circular incomplete)
41
Which DNA virus is not icosahedral
pox - complex
42
Which DNA virus does not replicate in the nucleus
pox - carries own DNA dependent RNA polymerase
43
HBV causes what kind of hepatitis, what is the vaccine, and what enzyme does it have
acute or chronic, vaccine is HBsAg, reverse transcriptase though not a retrovirus
44
What does adenovirus cause
febrile pharyingitis, acute hemorrhagic cystitis, pneumonia, conjunctivitis (watery)
45
What does parvovirus cause
B19 virus - aplastic crisis in sickle cell, slapped cheek rash in kids, erythema infectosum (5th disease), RBC destruction in fetus leads to hydrops fetalis and death, pure RBC aplasia and RA like symtpoms in adults
46
What does papillomovirus cause
HPV - warts (1, 2, 6, 11), CIN, cervical cancer (16, 18) vaccine available
47
What does polyomavirus cause
JC - progressive mutlifocal leukoencephalopathy in HIV
48
What does poxvirus cause
smallpox - although eradicated, could be used in germ warfare Vaccinia - cowpox "milkmaid's blisters" Molluscum contagiosum - flesh colored dome lesions with central dimple
49
What diseases can HSV 1 cause and what is the route of transmission
gingivostomatitis, keratoconjunctivitis, temporal lobe encephalitis, herpes labialis - respiratory secretions, saliva
50
What disease can HSV 2 cause and what is the route of transmission
herpes genitalis, neonatal herpes - sexual contact, perinatal
51
What diseases can VZV cause and what is the route of transmission
shingles/chickenpox, encephalitis, pneumonia - respiratory secretions
52
What diseases can EBV cause and what is the route of transmission
infectious mononucleosis, Burkitt's lymphoma, nasopharyngeal carcinoma - respiratory secretions, saliva
53
What diseases can CMV cause and what is the route of infection
congenital infection, mononucleosis with negative monospot, pneumonia - congenital, transfusion, sexual contact, saliva, urine, transplant
54
What is the characteristic feature of cells infected by CMV
owl's eye inculsions
55
What diseases can HHV-6 cause and what is the route of transmission
roseola, high fevers for several days that can cause seizures, followed by a macular papular rash - not determined
56
What diseases can HHV-8 cause and what is the route of transmission
Kaposi's Sarcoma in HIV pts, sexual contact
57
Where doe HSV1 cells remain latent
trigeminal ganglia
58
Where do HSV2 cells remain latent
sacral ganglia
59
Where do VZV cells remain latent
trigeminal and dorsal root ganglia
60
Where do EBV cells remain latent
B cells
61
Where do CMV cells remain latent
mononuclear cells
62
What test is done with a smear of an openedskin vesicle to detect multinucleated giant cells and what is used for
Tzanck test - assay for HSV1, 2 and VZV
63
What happens in EBV mononucleosis, and what cells does it infect
B cells, fever hepatosplenomegaly, pharyngitis, lymphadenopathy
64
Which location is common for lymphadenopathy in EBC mononucleosis
posterior cervical lymph nodes
65
In which age group is the peak incidence for mononucleosis, and how are the reactive cytotoxic T cells termed?
15-20, atypical lymphocytes
66
Are atypical lymphocytes actually atypical?
No they are T cells reacting to EBV infected cells
67
What cancers are associated with EBV virus
Hodgkin lymphoma, endemic Burkitt lymphoma, nasopharyngeal carcinoma
68
What is a positive Monospot test
heterophil antibodies detected by agglutination of sheep RBCs
69
What are the two reoviruses and what do they cause
reovirus - colorado tick fever, rotavirus - #1 cause of fatal diarrhea in children
70
How many segments are typically in reoviruses
10 to 12
71
What are the two poliovirus vaccines
salk/sabin - IPV/OPV respectively
72
What does echovirus do
aseptic meningitis
73
What does rhinovirus do
common cold
74
What does coxaskcievirus do
aspepti meningitis, herpangina (febrile pharyngitis) hand foot mouth dz, myocarditis
75
Which hepatitis virus is the hepevirus
HEV
76
What does norwalk virus do
viral gastroenteritis
77
Which flaviviruses are also arboviruses and which are not
Yellow fever, dengue, st. louis encephalitis, west nile virus - HCV not
78
Which of the togoviruses are arboviruses and which are not
eastern equine virus, wesetern equine virus - rubella not
79
What makes a virus a retrovirus - name two
reverse transcriptase - HIV, HTLV -T cell leukemia
80
What does coronavirus do
common cold and SARS
81
How many segments in influenza virus and to what family does it belong
8 - orthomyoxovirus
82
What viruses make up the PaRaMyxovirus family and what do they do
parainfluenza - croup, RSV - bronchiloitis in babies, Rx - ribavirin, Rubeola (Measles) Mumps
83
What virus is in the rhabdovirus family
rabies
84
What virus is in the filovirus family and what does it do
ebolo/marburg - hemorrhagic fever - often fatal
85
What viruses make up the arena virus family
LCMV - lymphocytic choriomeningitis virus, Lassa fever encephalitis - spread by mice
86
In the bunyavirus family which are arboviruses and which are not
california encephalitis, sandfly/Rift Valley fevers , crimean-congo hemorrhagic fever NOT - hantavirus causing hemorrhagic fever pneumonia
87
What virus is in the deltavirus family
HDV
88
What must negative stranded viruses do and what must they bring with them to do it
transcribe negative strand to positive - RNA dependent RNA polymerase
89
What are the neg strand RNA viruses
arenaviruses, bunyaviruses, paramyxoviruses, orthomyxoviruses, filoviruses, rhabdoviruses - Always Bring Polymerase Or Fail Replication
90
Which are the segmented viruses and what feature do they all share
RNA viruses - BOAR = Bunyavirus, Orthomyxovirus, Arenaviruses, Reoviruses
91
What feature of influenza can lead to worldwide pandemics of flu
8 segments of neg stranded RNA undergo high frequency recombinatino via reassortment
92
Which are the picornaviruses - and what is there the common features
polio, echo, rhino, coxsackie, HAV - enteroviruses = fecal oral; large polypeptide that is cleaved by proteases into functional viral proteins - can cause aspetic meningitis (except rhino and HAV)
93
How many serologic type of rhinovirus are there and what can destroy it
>100, acid labile, destroyed by stomach acid, does not infect GI
94
What is yellow fever transmissed by and what are the symptoms
aedes mosquitos with monkey or human resevoir,; high fever, black vomitus, and jaundice
95
What is the most important global cause of infantile gastroenteritis, what kind of virus is it, and what is the pathophys
rotavirus, dsRNA reovirus, villous destruction with atrophy leads to dec absorption of Na and H2O - day care centers and kindegartnes
96
enveloped ssRNA with segmented genome (8)
influenza virus
97
What feature of influenza virus promotes it entry into cells
hemagluttin
98
What feature of influenza virus promotes progeny virion release
neuraminidase
99
What are patients at risk for during infection with influenza virus
bacterial superinfection
100
Reassortment of viral genome (human flu A virus recombines with swine flu A virus
genetic shift - pandemic
101
Minor changes based on random mutation
genetic drift - epidemic
102
What kind of virus is the seasonal influenza virus
killed viral vaccine
103
What does Rubella virus cause
German measles - fever, posauricular tenderness, lymphadenopathy, arthralgias, fine truncal rash, mild disease in children but serious congenital disease (a TORCH infxn)
104
In which population do paramyxovirus cause disease and what do they cause
children; parainfluenza (croup seal like barking cough), mumps, measles and RSV (bronchiolitis, PNA) in infants
105
What does parainfluenza cause
croup - seal like barking cough
106
What surface protein do all paramyxoviruses contain and what does it cause
surface F protein, causes respiratory epithelial cells to fus and form multinucleated cells
107
What drug is used in RSV to neutralize F protein
palivizumab
108
What does rubeloa virus cause
measles - koplik spots on buccal mucosa are diagnostic
109
What are koplick spots, and when/how does the rash present in measles infxn
red spots with blue/white center on buccal mucosa, rash presents last - spreads from head to toe and includes hands and feet (vs. truncal rash in rubella)
110
What are possible sequelae of measles infxn
subacute sclerosing panencephalitis is rare, and giant cell PNA in immunoCised
111
What are the 3 C's for measles
cough, coryza, conjunctivitis
112
What other virus is it important not to confuse with measles
HHV-6 roseola
113
What are the symptoms of mumps
parotis, orchitis and aseptic meningitis
114
What is the main complication of mumps
sterility
115
What are negri bodies and when are they seen
characteristic cytoplasmic inclusion bodies in neurons infected with rabies virus; commonly found in Purkinje cells of cerebellum
116
Describe the rabies virus
bullet shaped capsid, long incubation period before sx onset
117
When should prophylactic vaccination of rabies vaccination occur
immediately upon exposure
118
What is the progression of disease in rabies infxn
fever, malaise leading to agitation, photophobia, hydrophobia leading to paralysis, coma and death
119
What animals carry rabies virus
bat, racoon, skunk
120
How do rabies virus reach the CNS
travels retrograde fashion up nerve axons
121
rubella - lots of spots
togavirus, german 3 day measles
122
rubeola - lots of spots
paramyxovirus; measles
123
roseola - lots of spots
HHV-6; high fevers followed by diffuse maculopapular rash
124
varicella - lots of spots
herpesvirus; chickenpox and zoster
125
variola - lots of spots
poxvirus - smallpox no longer present outside labs
126
What are the signs of viral hepatitis
episodes of fever, jaundice and inc AST/ALT
127
transmitted fecal-oral, short incubation, no carriers usually asymptomatic - hep virus and family
HAV - RNA picornavirus
128
How is HBV transmitted primarily and how long is the incubation period for
parenteral, sexual, maternal fecal routes - 3 months
129
What kind of virus and family are HBV
DNA hepadnavirus
130
What is the process of replication for HBV and are there carriers
yes carriers, celullar RNA poly transcribes RNA from DNA template, reverse transcriptase transcribes DAN genome from RNA intermediate - virion enzyme is DNA dependent DNA poly
131
What kind of virus is HCV and how is transmitted
RNA flavivirus, transmitted primarily via blood and resembles HBV in its course and severity
132
Which hepatitis causes post-transfusion hepatitis
HCV
133
In what population does HCV cause hepaitits
IVDU
134
What are the 4 Cs of HCV
chronic, cirrhosis, carcinoma, carriers
135
What does HDV require and what are the possible infxns it can cause
HBsAg as envelope, can coinfect or superinfect (worse prognosis)
136
Are there carriers for HDV
yes
137
What kind of virus is HEV and what does it cause
RNA hepevirs, transmitted enterically and causes water borne epidemics -resembles HAV in course, severity, incubation -high mortality in pregnant women
138
In who does HEV have high mortality
pregnant women
139
What doe HBV and HCV infxn predispose to
active hepatitis, cirrhosis and HCC
140
Why aren't naked viruses destroyed in the gut (A and E)
no envelope
141
What are the best serologic markers to detect for active Hep A
anti-HAVAb IgM
142
What does anti HAVAb IgG indicate
prior HAV infection - protects against reinfection
143
What does HBsAg indicate
antigen found on the surface on HBV, indicates hepatitis B infection
144
What does Anti HBsAg indicate
antibody to HBsAg, indicates immunity to hep B
145
What is HBcAg
antigen associated with core of HBV
146
What does Anti HBcAg (IgM) indicate
acute/recent infection
147
What does Anti HBcAg (IgG) indicate
chronic disease, positive during window period
148
What is HBeAg
a second, different antigenic determinant of the HBV core, HBeAg indicates active viral replication and therefor high transmissability
149
What is Anti-HBeAg
antibody to HBeAg, indicates low transmissability
150
What are the AST/ALT relationships in viral hepatitis vs alcoholic hepatitis
ALT > AST in viral, AST > ALT in EtOH
151
What serum makers are present in acute HBV
HBsAg, HBeAg, IgM - Anti- HBcAg
152
What serum markers are present in the window period of HBV infxn
IgG Anti-HBcAg
153
What serum markers are present in Chronic Hep B with high infectivity
HBsAg, HbeAg, and IgG Anti-HBcAg
154
What are the serum markers of Chronic hep B with low infectivity
HBsAg, anti-HBeAb, anti-HBcAb IgG
155
What serum markers indicate Hep B recovery
Anti-HBsAb, Anti-HBeAb, Anti-HBcAb
156
What are the markers of Hep immunity
Anti-HBsAb
157
What kind of genome does HIV have
dipoid RNA
158
What does p24 do
capsid protein
159
what does gp41 do
fusion and entry
160
what dpes gp120 do
attachment to host T cell
161
what are gp120 and gp41 together
envelope proteins
162
What does reverse transcriptase do in HIV
synthesized dsDNA from RNA; dsDNA integrates into host genome
163
What are the 3 structural proteins coded for by the HIV genome
env - gp120 and gp41, gag - p24, pol -reverse transcriptase
164
What proteins do the HIV virus bind on T cells and MACS and what confers immunity to HIV
CXCR4 on CD4 cells, CCR5 on CD4 and MACS - homozygous CCRF mutation confer immunity, CCR5 heterozygoes have slower course
165
How is the presumptive HIV diagnosis made
ELISA test is sensitive but high false pos rates and low threshold - RULE OUT test - pos test are confirmed with western blot - High false neg, high threshold
166
What HIV parameter allows providers to monitor effect of durg therapy
PCR/Viral load
167
When is the AIDS dx made
CD4 less than or equal to 200, or HIV pos with AIDS defining conditino like pneumocytsis jerovici or a CD4/CD8 < 1.5
168
Why are ELISA/Western blot test falsely positive in babies born to mothers infected with HIV
anti gp120 crosses the placenta
169
What are the 4 phases of HIV
flulike (acute), feeling fine (latent), falling count, final crisis
170
Where does HIV virus duplicate during latent phase
lymph nodes
171
What OI/disease occurs in the brain of AIDS pts
cryptococcal meningitis, toxoplasmosis, CMV encelphalopathy, AIDS dementia, PML from JC virus
172
What OI/disease occurs in the eyes of AIDS pts
CMV retinitis
173
What OI/disease occurs in the mouth and throat of AIDS pts
thursh, HSV, CMV, oral hairy leukoplakia from EBV
174
What OI/diseease occurs in the lungs of AIDS pts
Pneumocystis jerovici PNA, TB, histoplasmosis
175
What OI/disease occurs in the GI of AIDS pts
cryptosporidium, mycobacterium avium-intracellulare, CMV colitis, non Hodgkin lymphoma from EBV, Isospora belli
176
What OI/disease occurs in the skin of AIDS pts
shingles from VZV, kaposi sarcoma from HHV-8
177
What Oi/disease occurs on the genitals of AIDS pts
genital herpes, warts, cervical cancer from HPV
178
What OI's are HIV pos patients at risk for with CD4 < 400
oral thrush, tinea pedis, reactivation VZV, reactivation TB, bacterial infxns (H flu, S pneumo, Salmonella)
179
What OI's are HIV pos patients at risk for with CD4 < 200
reactivation HSV, cyrptosporidious, isospora, disseminated coccidioidomycosis, pneumocystis PNA
180
What OI's are HIV pos patients at risk for with CD4 < 100
Candidal esophagitis, toxoplasmosis, histoplasmosis
181
What OI's are HIV pos patients at risk for with CD4 < 50
CMV retinitis and esophagitis, disseminated M avium intracellulare, cryptococcal meningoencephalitis
182
What are neoplasms associated with HIV
KS from HHS-8, invasive cervical caricoma from HPV, and primary CNS lymphoma, non-Hodgkin's lymphoma
183
What are prion disease caused by
conversion of a normal cellular protein termed prion protein (PrPc) toa beta pleated form (PrPsc) which is transmissible, resists degradation and facilitates conversion of still more PrPc to PrPsc
184
What does accumulation of PrPsc result in
spongiform encephalopathy and dementia, ataxia and death.
185
What are the three forms of prion diesase
sporadic -Creutzfeldt Jakob disease, rapidly progressive dementia; inheritid -Gerstmann-Straussler-Scheinker syndrome; or acquired (kuru)
186
What is the nl flora on the skin
S. epidermidis
187
What is the nl flora in the nose
S. epidermidis; colonized by S. aureus
188
What is the nl flora in the oropharynx
viridans group streptococci
189
What is the nl flora of a dental plaque
streptococcus mutans
190
What is the nl flora of the colon
bacteroides fragilis > E. coli
191
What is the nl flora of the vagina
lactobacillus, colonized by E. coli and group B strep
192
What kind of flora do neonates born by c section have
none - but are colonized rapidly after birth
193
What bugs can cause food poisoning from contaminated seafood, and which of these can cause wound infections from contact with contaminated water or shellfish
food poisoning = Vibrio parahaemolyticus and V. vulnificus, wound = just vulnificus
194
What can cause food poisoning in reheated rice
B. cereus
195
What can cause food poisoning in meat, maynaisse custard with pre-formed toxin
S. aureus
196
What can cause food poisoning in reheated meat dishes
C. perfringens
197
What can cause food poisoning in improperly canned foods (bulging cans)
C. botulinum
198
What can cause food poisoning in undercooked meat
E. coli 0157:H7
199
What can cause food poisoning in poultry, meat and eggs
Salmonella
200
What is the course of illness with food poisoning from S. aurues and B. cereus
starts quickly and ends quickly
