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FA Micro III Flashcards

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1
Q

What is Treponema - tricky Ts

A

spirochete, causes syphillis, or yaws (T. pertenue)

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2
Q

Trichamonas vaginalis - tricky Ts

A

protozoan, STD

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3
Q

trypanosoma - tricky Ts

A

protozoan, causes chagas dz, or african sleeping sickness

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4
Q

toxoplasma - tricky Ts

A

protozoan, a TORCH infection

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5
Q

trichinella spiralis -tricky Ts

A

nematode in undercooked meat

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6
Q

taenia solium - tricky Ts

A

tapeworm larvae (intestinal infection) in pork or eggs (neurocystircercosis) in food/water contaminated with human feces

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7
Q

What components make up the naked icosahedral viral structure

A

nucelocapsid, nucleic acid

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8
Q

What components make up the enveloped icosahedral viral structure

A

surface protein, lipid bilayer, capsid, nucleic acid

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9
Q

What components make up the eveloped helical viral structure

A

surface protein, matrix/core protein, lipid bilayer, nucleic acid and nucleocapsid protein

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10
Q

exchange of genes between 2 chromosomes by crossing over within regions of significant base sequence homology

A

recombination

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11
Q

when viruses with a segmented genomes (influenza virus) exchange segments, high frequency recombination, cause of worldwide influenza pandemics

A

reassortment

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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

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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

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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

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15
Q

What kind of immunity to killed/inactivated viral vaccines induce, and what is the benefit

A

only humoral, stable

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16
Q

Which kind of viral vaccine requires a booster

A

killed/inactivated

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17
Q

In which pts is it dangerous to give live vaccines to

A

immunoCised - or their close contacts

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18
Q

Name the live attenuated vaccines

A

smallpox, yellow fever, VZV, Sabin’s polio virus, MMR

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19
Q

What is the only live attenuated vaccine that can be given to HIV pos pts

A

measles, mumps, rubella, MMR

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20
Q

What are the killed viral vaccines

A

rabies, influenza, salk polio, HAV

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21
Q

What are the recombinant vaccines

A

HBV (antigen = recombinant HBsAg) HPV (6, 11,16,18)

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22
Q

What is only exception of DNA viruses that are not double stranded

A

parvoviridae

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23
Q

What are the only circular DNA viruses

A

papilloma, polyoma, hepadnavirus

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24
Q

What are the only double stranded RNA viruses

A

reoviridae, rotavirus

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25
Q

What are the positive stranded RNA viruses

A

retrovirus, togavirus, flavivirus, coronavirus, hepevirus, calicivirus, picornavirus

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26
Q

which purified viral nucleic acids are infectious and which are not

A

infectious = most of dsDNA (not pox/HBV) (+) strand ssRNA (same as mRNA); non infecitious = (-) ssRNA, dsRNA

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27
Q

which viruses are kind of diploid and what are the others

A

diploid - retroviruses, 2 ssRNA molecules, all others are haploid

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28
Q

Where do DNA viruses replicate

A

nucleus, except parvovirus

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29
Q

Where do RNA viruses replicate

A

cytoplasm, except influenza and retroviruses

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30
Q

Which are the naked viruses

A

calicivirus, picornavirus, reovirus, parvovirus, adenovirus, papilloma, polyoma

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31
Q

Where do most enveloped viruses acquire their envelopes from and what are the exceptions

A

plasma membrane, exceptions are herpesvirus which acquire from nuclear membrane

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32
Q

Which are the DNA enveloped viruses

A

herpesviruses, HBV, smallpox

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33
Q

Which are the DNA nucleocapsid viruses

A

adenovirus, papilloviruses, parvovirus

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34
Q

Which are the RNA enveloped viruses

A

influenza virus, parainfluenza virus, RSV, measles virus, mumps virus, rubella virus, rabies virus, HTLV, HIV

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35
Q

Which are the RNA nucelocapsid viruses

A

enteroviruses, rhinovirus, reovirus (rotavirus)

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36
Q

Which are the herpesviruses

A

HSV1 and 2, VZV, CMV, EBV

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37
Q

Which are the enteroviruses

A

poliovirus, coxsackievirus, echovirus, HAV

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38
Q

Which are the HHAPPPPy viruses

A

hepadna, herpes, adeno, pox, parvo, papilloma, polyoma

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39
Q

Which DNA virus is not double stranded

A

parvo - single stranded

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40
Q

Which DNA viruses are not linear

A

papilloma, polyoma (circular, supercoiled) and hepadna (circular incomplete)

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41
Q

Which DNA virus is not icosahedral

A

pox - complex

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42
Q

Which DNA virus does not replicate in the nucleus

A

pox - carries own DNA dependent RNA polymerase

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43
Q

HBV causes what kind of hepatitis, what is the vaccine, and what enzyme does it have

A

acute or chronic, vaccine is HBsAg, reverse transcriptase though not a retrovirus

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44
Q

What does adenovirus cause

A

febrile pharyingitis, acute hemorrhagic cystitis, pneumonia, conjunctivitis (watery)

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45
Q

What does parvovirus cause

A

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

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46
Q

What does papillomovirus cause

A

HPV - warts (1, 2, 6, 11), CIN, cervical cancer (16, 18) vaccine available

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47
Q

What does polyomavirus cause

A

JC - progressive mutlifocal leukoencephalopathy in HIV

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48
Q

What does poxvirus cause

A

smallpox - although eradicated, could be used in germ warfare Vaccinia - cowpox “milkmaid’s blisters” Molluscum contagiosum - flesh colored dome lesions with central dimple

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49
Q

What diseases can HSV 1 cause and what is the route of transmission

A

gingivostomatitis, keratoconjunctivitis, temporal lobe encephalitis, herpes labialis - respiratory secretions, saliva

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50
Q

What disease can HSV 2 cause and what is the route of transmission

A

herpes genitalis, neonatal herpes - sexual contact, perinatal

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51
Q

What diseases can VZV cause and what is the route of transmission

A

shingles/chickenpox, encephalitis, pneumonia - respiratory secretions

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52
Q

What diseases can EBV cause and what is the route of transmission

A

infectious mononucleosis, Burkitt’s lymphoma, nasopharyngeal carcinoma - respiratory secretions, saliva

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53
Q

What diseases can CMV cause and what is the route of infection

A

congenital infection, mononucleosis with negative monospot, pneumonia - congenital, transfusion, sexual contact, saliva, urine, transplant

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54
Q

What is the characteristic feature of cells infected by CMV

A

owl’s eye inculsions

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55
Q

What diseases can HHV-6 cause and what is the route of transmission

A

roseola, high fevers for several days that can cause seizures, followed by a macular papular rash - not determined

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56
Q

What diseases can HHV-8 cause and what is the route of transmission

A

Kaposi’s Sarcoma in HIV pts, sexual contact

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57
Q

Where doe HSV1 cells remain latent

A

trigeminal ganglia

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58
Q

Where do HSV2 cells remain latent

A

sacral ganglia

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59
Q

Where do VZV cells remain latent

A

trigeminal and dorsal root ganglia

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60
Q

Where do EBV cells remain latent

A

B cells

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61
Q

Where do CMV cells remain latent

A

mononuclear cells

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62
Q

What test is done with a smear of an openedskin vesicle to detect multinucleated giant cells and what is used for

A

Tzanck test - assay for HSV1, 2 and VZV

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63
Q

What happens in EBV mononucleosis, and what cells does it infect

A

B cells, fever hepatosplenomegaly, pharyngitis, lymphadenopathy

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64
Q

Which location is common for lymphadenopathy in EBC mononucleosis

A

posterior cervical lymph nodes

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65
Q

In which age group is the peak incidence for mononucleosis, and how are the reactive cytotoxic T cells termed?

A

15-20, atypical lymphocytes

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66
Q

Are atypical lymphocytes actually atypical?

A

No they are T cells reacting to EBV infected cells

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67
Q

What cancers are associated with EBV virus

A

Hodgkin lymphoma, endemic Burkitt lymphoma, nasopharyngeal carcinoma

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68
Q

What is a positive Monospot test

A

heterophil antibodies detected by agglutination of sheep RBCs

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69
Q

What are the two reoviruses and what do they cause

A

reovirus - colorado tick fever, rotavirus - #1 cause of fatal diarrhea in children

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70
Q

How many segments are typically in reoviruses

A

10 to 12

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71
Q

What are the two poliovirus vaccines

A

salk/sabin - IPV/OPV respectively

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72
Q

What does echovirus do

A

aseptic meningitis

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73
Q

What does rhinovirus do

A

common cold

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74
Q

What does coxaskcievirus do

A

aspepti meningitis, herpangina (febrile pharyngitis) hand foot mouth dz, myocarditis

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75
Q

Which hepatitis virus is the hepevirus

A

HEV

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76
Q

What does norwalk virus do

A

viral gastroenteritis

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77
Q

Which flaviviruses are also arboviruses and which are not

A

Yellow fever, dengue, st. louis encephalitis, west nile virus - HCV not

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78
Q

Which of the togoviruses are arboviruses and which are not

A

eastern equine virus, wesetern equine virus - rubella not

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79
Q

What makes a virus a retrovirus - name two

A

reverse transcriptase - HIV, HTLV -T cell leukemia

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80
Q

What does coronavirus do

A

common cold and SARS

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81
Q

How many segments in influenza virus and to what family does it belong

A

8 - orthomyoxovirus

82
Q

What viruses make up the PaRaMyxovirus family and what do they do

A

parainfluenza - croup, RSV - bronchiloitis in babies, Rx - ribavirin, Rubeola (Measles) Mumps

83
Q

What virus is in the rhabdovirus family

A

rabies

84
Q

What virus is in the filovirus family and what does it do

A

ebolo/marburg - hemorrhagic fever - often fatal

85
Q

What viruses make up the arena virus family

A

LCMV - lymphocytic choriomeningitis virus, Lassa fever encephalitis - spread by mice

86
Q

In the bunyavirus family which are arboviruses and which are not

A

california encephalitis, sandfly/Rift Valley fevers , crimean-congo hemorrhagic fever NOT - hantavirus causing hemorrhagic fever pneumonia

87
Q

What virus is in the deltavirus family

A

HDV

88
Q

What must negative stranded viruses do and what must they bring with them to do it

A

transcribe negative strand to positive - RNA dependent RNA polymerase

89
Q

What are the neg strand RNA viruses

A

arenaviruses, bunyaviruses, paramyxoviruses, orthomyxoviruses, filoviruses, rhabdoviruses - Always Bring Polymerase Or Fail Replication

90
Q

Which are the segmented viruses and what feature do they all share

A

RNA viruses - BOAR = Bunyavirus, Orthomyxovirus, Arenaviruses, Reoviruses

91
Q

What feature of influenza can lead to worldwide pandemics of flu

A

8 segments of neg stranded RNA undergo high frequency recombinatino via reassortment

92
Q

Which are the picornaviruses - and what is there the common features

A

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
Q

How many serologic type of rhinovirus are there and what can destroy it

A

> 100, acid labile, destroyed by stomach acid, does not infect GI

94
Q

What is yellow fever transmissed by and what are the symptoms

A

aedes mosquitos with monkey or human resevoir,; high fever, black vomitus, and jaundice

95
Q

What is the most important global cause of infantile gastroenteritis, what kind of virus is it, and what is the pathophys

A

rotavirus, dsRNA reovirus, villous destruction with atrophy leads to dec absorption of Na and H2O - day care centers and kindegartnes

96
Q

enveloped ssRNA with segmented genome (8)

A

influenza virus

97
Q

What feature of influenza virus promotes it entry into cells

A

hemagluttin

98
Q

What feature of influenza virus promotes progeny virion release

A

neuraminidase

99
Q

What are patients at risk for during infection with influenza virus

A

bacterial superinfection

100
Q

Reassortment of viral genome (human flu A virus recombines with swine flu A virus

A

genetic shift - pandemic

101
Q

Minor changes based on random mutation

A

genetic drift - epidemic

102
Q

What kind of virus is the seasonal influenza virus

A

killed viral vaccine

103
Q

What does Rubella virus cause

A

German measles - fever, posauricular tenderness, lymphadenopathy, arthralgias, fine truncal rash, mild disease in children but serious congenital disease (a TORCH infxn)

104
Q

In which population do paramyxovirus cause disease and what do they cause

A

children; parainfluenza (croup seal like barking cough), mumps, measles and RSV (bronchiolitis, PNA) in infants

105
Q

What does parainfluenza cause

A

croup - seal like barking cough

106
Q

What surface protein do all paramyxoviruses contain and what does it cause

A

surface F protein, causes respiratory epithelial cells to fus and form multinucleated cells

107
Q

What drug is used in RSV to neutralize F protein

A

palivizumab

108
Q

What does rubeloa virus cause

A

measles - koplik spots on buccal mucosa are diagnostic

109
Q

What are koplick spots, and when/how does the rash present in measles infxn

A

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
Q

What are possible sequelae of measles infxn

A

subacute sclerosing panencephalitis is rare, and giant cell PNA in immunoCised

111
Q

What are the 3 C’s for measles

A

cough, coryza, conjunctivitis

112
Q

What other virus is it important not to confuse with measles

A

HHV-6 roseola

113
Q

What are the symptoms of mumps

A

parotis, orchitis and aseptic meningitis

114
Q

What is the main complication of mumps

A

sterility

115
Q

What are negri bodies and when are they seen

A

characteristic cytoplasmic inclusion bodies in neurons infected with rabies virus; commonly found in Purkinje cells of cerebellum

116
Q

Describe the rabies virus

A

bullet shaped capsid, long incubation period before sx onset

117
Q

When should prophylactic vaccination of rabies vaccination occur

A

immediately upon exposure

118
Q

What is the progression of disease in rabies infxn

A

fever, malaise leading to agitation, photophobia, hydrophobia leading to paralysis, coma and death

119
Q

What animals carry rabies virus

A

bat, racoon, skunk

120
Q

How do rabies virus reach the CNS

A

travels retrograde fashion up nerve axons

121
Q

rubella - lots of spots

A

togavirus, german 3 day measles

122
Q

rubeola - lots of spots

A

paramyxovirus; measles

123
Q

roseola - lots of spots

A

HHV-6; high fevers followed by diffuse maculopapular rash

124
Q

varicella - lots of spots

A

herpesvirus; chickenpox and zoster

125
Q

variola - lots of spots

A

poxvirus - smallpox no longer present outside labs

126
Q

What are the signs of viral hepatitis

A

episodes of fever, jaundice and inc AST/ALT

127
Q

transmitted fecal-oral, short incubation, no carriers usually asymptomatic - hep virus and family

A

HAV - RNA picornavirus

128
Q

How is HBV transmitted primarily and how long is the incubation period for

A

parenteral, sexual, maternal fecal routes - 3 months

129
Q

What kind of virus and family are HBV

A

DNA hepadnavirus

130
Q

What is the process of replication for HBV and are there carriers

A

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
Q

What kind of virus is HCV and how is transmitted

A

RNA flavivirus, transmitted primarily via blood and resembles HBV in its course and severity

132
Q

Which hepatitis causes post-transfusion hepatitis

A

HCV

133
Q

In what population does HCV cause hepaitits

A

IVDU

134
Q

What are the 4 Cs of HCV

A

chronic, cirrhosis, carcinoma, carriers

135
Q

What does HDV require and what are the possible infxns it can cause

A

HBsAg as envelope, can coinfect or superinfect (worse prognosis)

136
Q

Are there carriers for HDV

A

yes

137
Q

What kind of virus is HEV and what does it cause

A

RNA hepevirs, transmitted enterically and causes water borne epidemics -resembles HAV in course, severity, incubation -high mortality in pregnant women

138
Q

In who does HEV have high mortality

A

pregnant women

139
Q

What doe HBV and HCV infxn predispose to

A

active hepatitis, cirrhosis and HCC

140
Q

Why aren’t naked viruses destroyed in the gut (A and E)

A

no envelope

141
Q

What are the best serologic markers to detect for active Hep A

A

anti-HAVAb IgM

142
Q

What does anti HAVAb IgG indicate

A

prior HAV infection - protects against reinfection

143
Q

What does HBsAg indicate

A

antigen found on the surface on HBV, indicates hepatitis B infection

144
Q

What does Anti HBsAg indicate

A

antibody to HBsAg, indicates immunity to hep B

145
Q

What is HBcAg

A

antigen associated with core of HBV

146
Q

What does Anti HBcAg (IgM) indicate

A

acute/recent infection

147
Q

What does Anti HBcAg (IgG) indicate

A

chronic disease, positive during window period

148
Q

What is HBeAg

A

a second, different antigenic determinant of the HBV core, HBeAg indicates active viral replication and therefor high transmissability

149
Q

What is Anti-HBeAg

A

antibody to HBeAg, indicates low transmissability

150
Q

What are the AST/ALT relationships in viral hepatitis vs alcoholic hepatitis

A

ALT > AST in viral, AST > ALT in EtOH

151
Q

What serum makers are present in acute HBV

A

HBsAg, HBeAg, IgM - Anti- HBcAg

152
Q

What serum markers are present in the window period of HBV infxn

A

IgG Anti-HBcAg

153
Q

What serum markers are present in Chronic Hep B with high infectivity

A

HBsAg, HbeAg, and IgG Anti-HBcAg

154
Q

What are the serum markers of Chronic hep B with low infectivity

A

HBsAg, anti-HBeAb, anti-HBcAb IgG

155
Q

What serum markers indicate Hep B recovery

A

Anti-HBsAb, Anti-HBeAb, Anti-HBcAb

156
Q

What are the markers of Hep immunity

A

Anti-HBsAb

157
Q

What kind of genome does HIV have

A

dipoid RNA

158
Q

What does p24 do

A

capsid protein

159
Q

what does gp41 do

A

fusion and entry

160
Q

what dpes gp120 do

A

attachment to host T cell

161
Q

what are gp120 and gp41 together

A

envelope proteins

162
Q

What does reverse transcriptase do in HIV

A

synthesized dsDNA from RNA; dsDNA integrates into host genome

163
Q

What are the 3 structural proteins coded for by the HIV genome

A

env - gp120 and gp41, gag - p24, pol -reverse transcriptase

164
Q

What proteins do the HIV virus bind on T cells and MACS and what confers immunity to HIV

A

CXCR4 on CD4 cells, CCR5 on CD4 and MACS - homozygous CCRF mutation confer immunity, CCR5 heterozygoes have slower course

165
Q

How is the presumptive HIV diagnosis made

A

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
Q

What HIV parameter allows providers to monitor effect of durg therapy

A

PCR/Viral load

167
Q

When is the AIDS dx made

A

CD4 less than or equal to 200, or HIV pos with AIDS defining conditino like pneumocytsis jerovici or a CD4/CD8 < 1.5

168
Q

Why are ELISA/Western blot test falsely positive in babies born to mothers infected with HIV

A

anti gp120 crosses the placenta

169
Q

What are the 4 phases of HIV

A

flulike (acute), feeling fine (latent), falling count, final crisis

170
Q

Where does HIV virus duplicate during latent phase

A

lymph nodes

171
Q

What OI/disease occurs in the brain of AIDS pts

A

cryptococcal meningitis, toxoplasmosis, CMV encelphalopathy, AIDS dementia, PML from JC virus

172
Q

What OI/disease occurs in the eyes of AIDS pts

A

CMV retinitis

173
Q

What OI/disease occurs in the mouth and throat of AIDS pts

A

thursh, HSV, CMV, oral hairy leukoplakia from EBV

174
Q

What OI/diseease occurs in the lungs of AIDS pts

A

Pneumocystis jerovici PNA, TB, histoplasmosis

175
Q

What OI/disease occurs in the GI of AIDS pts

A

cryptosporidium, mycobacterium avium-intracellulare, CMV colitis, non Hodgkin lymphoma from EBV, Isospora belli

176
Q

What OI/disease occurs in the skin of AIDS pts

A

shingles from VZV, kaposi sarcoma from HHV-8

177
Q

What Oi/disease occurs on the genitals of AIDS pts

A

genital herpes, warts, cervical cancer from HPV

178
Q

What OI’s are HIV pos patients at risk for with CD4 < 400

A

oral thrush, tinea pedis, reactivation VZV, reactivation TB, bacterial infxns (H flu, S pneumo, Salmonella)

179
Q

What OI’s are HIV pos patients at risk for with CD4 < 200

A

reactivation HSV, cyrptosporidious, isospora, disseminated coccidioidomycosis, pneumocystis PNA

180
Q

What OI’s are HIV pos patients at risk for with CD4 < 100

A

Candidal esophagitis, toxoplasmosis, histoplasmosis

181
Q

What OI’s are HIV pos patients at risk for with CD4 < 50

A

CMV retinitis and esophagitis, disseminated M avium intracellulare, cryptococcal meningoencephalitis

182
Q

What are neoplasms associated with HIV

A

KS from HHS-8, invasive cervical caricoma from HPV, and primary CNS lymphoma, non-Hodgkin’s lymphoma

183
Q

What are prion disease caused by

A

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
Q

What does accumulation of PrPsc result in

A

spongiform encephalopathy and dementia, ataxia and death.

185
Q

What are the three forms of prion diesase

A

sporadic -Creutzfeldt Jakob disease, rapidly progressive dementia; inheritid -Gerstmann-Straussler-Scheinker syndrome; or acquired (kuru)

186
Q

What is the nl flora on the skin

A

S. epidermidis

187
Q

What is the nl flora in the nose

A

S. epidermidis; colonized by S. aureus

188
Q

What is the nl flora in the oropharynx

A

viridans group streptococci

189
Q

What is the nl flora of a dental plaque

A

streptococcus mutans

190
Q

What is the nl flora of the colon

A

bacteroides fragilis > E. coli

191
Q

What is the nl flora of the vagina

A

lactobacillus, colonized by E. coli and group B strep

192
Q

What kind of flora do neonates born by c section have

A

none - but are colonized rapidly after birth

193
Q

What bugs can cause food poisoning from contaminated seafood, and which of these can cause wound infections from contact with contaminated water or shellfish

A

food poisoning = Vibrio parahaemolyticus and V. vulnificus, wound = just vulnificus

194
Q

What can cause food poisoning in reheated rice

A

B. cereus

195
Q

What can cause food poisoning in meat, maynaisse custard with pre-formed toxin

A

S. aureus

196
Q

What can cause food poisoning in reheated meat dishes

A

C. perfringens

197
Q

What can cause food poisoning in improperly canned foods (bulging cans)

A

C. botulinum

198
Q

What can cause food poisoning in undercooked meat

A

E. coli 0157:H7

199
Q

What can cause food poisoning in poultry, meat and eggs

A

Salmonella

200
Q

What is the course of illness with food poisoning from S. aurues and B. cereus

A

starts quickly and ends quickly

First Aid Microbiology (4 decks)

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