Fever and lymphadenopathy Flashcards
Causes of lymphadenopathy
- Lymphocyte proliferation in response to local infection
- proliferation of malignant cells that have metastasised to node
- proliferation of malignant lymphocytes
- inflammation in nodes resulting from killing of virus infected lymphocytes
Common lymph node infection causes
Bacterial: Staph aureus, TB
Viral: EBV, CMV, HIV
Herpes viruses and what they cause
Herpes simplex: cold sores
Varicella zoster: chicken pox
EBV: glange
CMV: less severe glandular like illness
EBV features
Transmitted in saliva
Virus transmitted in saliva
Incubation period 4-6 weeks, illness 1-2 usually weeks usually, fever, sore throat, malaise, cervical adenopathy
EBV will remain secreted in saliva
EBV diagnosis
Paul Bunnel test, heterophile antibodies that do not bind to EBV rather RBC’s of horses
or a more sophisticated EBV serology and specific antibodies
Acute HIV infection risk and presentation
Epidemiological risk recent (3-6) exposure glandular fever like illness persistent viraemia and in genital secretions HIV antibodies in blood
HIV stucture basic
lipid bilayer, gp120 (knob) and gp41 attach to CD4
protein core
RNA
Time course of untreated HIV infection
Infection; level rises; TK cells kill infected TH cells; HIV falls; Killing of infected lymphocytes, bried glange like illness; B lymp antibodies; HIV level remains stable; TH cell number falls; TH cell number very low; AIDS; HIV rises
ELISA assay (enzyme linked immunosorbent assay)
1) antigen stuck to base (HIV)
2) serum added (with antibodies either in it or not)
3) anti human antibody with enzyme attaches to antibody
4) reagent added, cleaving enzyme, colour change if antibody is present
AIDS defining illness
pneumocysitis jiroveci; toxoplasma gondii brain abcesses; candidia albicans oesophagititis; cryptococcus neoformans meningitis; karposis sarcoma
HIV treatment
Reverse transcriptase: AT, tenofovir
protease: lopinavir, atazanavir
DNA integration: raltegravir
