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Foundations: Infectious Disease 2 Flashcards

1
Q

What is an infectious dose?

A

The amount of pathogen required to cause an infection in the host

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2
Q

What is “shedding”?

A

The successful reproduction, expulsion, and host-cell infection caused by virus progeny

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3
Q

What does PCR do?

A

Amplifies a single or a few copies of a piece of DNA to generate thousands to millions of copies

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4
Q

What does immunofluorescent assays and ELISA do?

A

Use an enzyme immunoassay to detect the presence of a substance (antigen)

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5
Q

What 3 diseases account for half of deaths due to infectious diseases?

A

Tuberculosis
Malaria
AIDS

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6
Q

How is African Trypanosomiasis spread?

A

By the tsetse fly spreading protozoa Trypanosoma brucei

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7
Q

What do parasites produce in African Trypanosomiasis?

A

Tryptophol

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8
Q

Describe symptoms that would present during the early (hemolytic) phase of African Trypanosomiasis.

A

Fever, headaches, arthralgia, pruritis

Parasites invade circulatory and lymphatic systems

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9
Q

Describe the symptoms that would present during the second (neurologic) stage of African Trypanosomiasis.

A

Confusion, poor coordination, disrupted sleep

Parasites invade CNS, pass thru blood brain barrier

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10
Q

How is Cholera spread?

A

Through contaminated drinking water, unsanitary conditions

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11
Q

What bacterium is responsible for Cholera?

A

Vibrio cholerae
gram-
facultative anaerobe
unipolar flagellum

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12
Q

What does Vibrio cholerae secrete and what does it cause?

A

Secretes cholera toxin which produces watery diarrhea

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13
Q

What symptoms would a person with Cholera present with?

A 
Abdominal cramps
watery diarrhea
excessive thirst
dry mucus membranes
sunken eyes
lack of tears
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14
Q

What is one of the most common causes of waterborne illness in the US?

A

Cryptosporidiosis enteritis

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15
Q

How is Cryptosporidiosis spread?

A

Fecal oral

parasites transmitted by microbial cysts (oocysts)

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16
Q

What is the incubation period of Cryptosporidiosis?

A

1-30 days, median of 7 days

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17
Q

When does Cryptosporidiosis shedding stop?

A

After 2 weeks

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18
Q

What cells are primarily affected by Cryptosporidiosis?

A

Intestinal epithelial cells of small intestines and proximal colon

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19
Q

Describe sporadic Cryptosporidiosis.

A

Water-related outbreaks of self-limited diarrhea in immunocompetent host

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20
Q

Describe chronic Cryptosporidiosis.

A

Life-threatening in immunocompromised patients, especially those with HIV

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21
Q

Describe the third main form of Cryptosporidiosis.

A

Diarrhea and malnutrition in young children in developing countries

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22
Q

Where is Cryptosporidiosis most commonly isolated?

A

In HIV+ patients presenting with diarrhea

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23
Q

What populations are at high risk of catching Cryptosporidiosis?

A

Animal handlers
MSM
Ppl having close contact with infected ppl
Young children

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24
Q

How can you diagnose Cryptosporidiosis?

A

Find the antibody in stool
Parasite exam with microscope
Immunofluorescent assays and ELISA to detect antigen and oocysts

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25
How is Dengue Fever spread?
Through bites of Aedes aegypti mosquito in Asia and Africa
26
What symptoms would someone with Dengue Fever present with?
Abrupt fever > 40*C of 2-7 days duration
27
How does mild Dengue Fever present?
Usually in infants and young children | Nonspecific febrile illness
28
How does moderate Dengue Fever present?
``` In older children and adults High fever Severe HA Myalgia/arthralgia Rash ```
29
How does severe Dengue Fever present?
As Dengue hemorrhagic fever High fever Hemorrhaging Circulatory failure
30
How would you test for Dengue Fever?
Look for the antibody (IgM or IgG) A CBC for leukopenia and thrombocytopenia PCR for dengue virus types
31
How would you treat Dengue Fever?
Get rid of standing water. | No specific treatments.
32
How many leukocytes would you find in a CBC for Dengue Fever?
<3500 WBCs/mL (leukopenia)
33
How many platelets would you find in a CBC for Dengue Fever?
<50,000 platelets/mL (thrombocytopenia)
34
What type of infection usually causes hepatitis?
Viral infections
35
Which types lead to chronic disease?
B & C
36
What can hepatitis commonly cause?
Liver cirrhosis cancer transplant
37
What types are typically caused by ingesting contaminated food or water?
A & E
38
What types are usually caused by parenteral contact with infected body fluids?
B, C & D
39
How is HAV spread?
Fecal-oral Ingestion of contaminated water/food (shellfish) Direct contact with infected person
40
When is the greatest infectivity of HAV?
2 weeks before onset of symptoms
41
How long is the incubation period for HAV?
About 28 days
42
Does HAV infection severity increase or decrease with age?
Increases with age
43
What symptoms would a person with HAV present with?
``` Fever dark urine malaise/fatigue jaundice distaste for smoking ```
44
What would you find during a physical exam of someone with HAV?
``` Hepatomegaly fever jaundice icterus hives RUQ tenderness ```
45
What population accounts for over 50% of cases in north American and Europe?
Foreign travel to developing countries
46
What is a normal level of Aspartate Aminotransferase (AST)?
2-4 IU/L
47
What is a normal level of Alanine Aminotransferase (ALT)?
2-40 IU/L
48
What is the normal AST:ALT?
<1
49
What is an AST:ALT >2:1 associated with?
Viral/alcoholic hepatitis, hepatocellular carcinoma
50
What is an AST:ALT 1-2 associated with?
Cirrhosis
51
How high could the AST:ALT get with HAV?
Could exceed 10,000
52
What immunoglobulins are present?
Anti-HAV IgM (onset of symptoms) | Anti-HAV IgG (soon after IgM, persists for years)
53
What titer would appear positive for HAV before IgM and IgG?
Fecal HAV
54
What do you have to do whenever someone tests positive for HAV?
Report to local public health department
55
What would the follow-up recommendations be for someone with HAV?
Can return to work/school 10-14 days after onset of symptoms
56
How would you treat HAV?
No antivirals... resolves spontaneously
57
What type of virus is HAV?
RNA enterovirus | member of Picornavirdae family
58
What type of virus is HBV?
DNA virus | member of Hepadnaviridae family
59
What is the most common infectious disease in the world?
HBV
60
What sex is affected more by HBV?
Male>Female (2:1)
61
How would an individual with acute HBV present?
``` Fever/malaise Anorexia Jaundice/icterus Dark urine/pale stools RUQ pain ```
62
How would an individual with chronic HBV present?
Asymptomatic
63
What would you find during a physical exam of someone with noncirrhotic chronic HBV?
Usually normal
64
Who should you screen and vaccinate if screen is negative?
``` Ppl from endemic areas IV drug users MSM HIV and HCV+ ppl Inmates of correctional facilities ```
65
What is the incubation period for HBV?
6 weeks to 6 months with insidious onset
66
What will be the first evidence of clinical HBV infection?
Elevated HBsAg
67
What does HbeAg indicate?
Viral replication and infectivity (secretory form of HBcAg during incubation period)
68
What is the second evidence of clinical HBV infection?
Anti-HBc (since HbcAg does not appear in the serum)
69
What results would indicate an acute HBV infection?
+IgM HBcAb
70
What results would indicate a chronic HBV infection?
-IgM | +IgG or total HBcAb
71
When does Anti-HBs show up?
After clearance of HBsAg and after successful vaccination against HBV
72
What type of virus is HCV?
RNA virus | family Flaviviridae
73
What ages are most prevalently affected by HCV?
Between 40-60
74
How does acute HCV present?
Symptoms develop about 2 weeks after exposure (rare)
75
How does chronic HCV present?
Mildly symptomatic (fatigue) or asymptomatic elevated ALT/AST for 2-12 weeks
76
What symptoms would a person with acute HCV present with?
Fever, malaise, nausea, jaundice/icterus, dark urine, RUQ pain
77
What percentage of acute HCV become chronic?
70-80%
78
What percentage of chronic HCV is curable?
~50%
79
What are some conditions associated with HCV?
``` Diabetes Metabolic syndrome Iron overload Depression Substance abuse ```
80
What would you find on a physical exam of someone with HCV?
Normal unless advanced fibrosis/cirrhosis
81
What lab tests can be used to test for HCV?
Test for Ab to HCV (4-10 weeks after infection) | Qualitative test for presence/absence of virus (PCR) (2-3 weeks after infection)
82
Why is it beneficial to catch an HCV infection early?
The earlier you catch the disease, the healthier the patient is, the better the patient can take the harsh treatment
83
What type of virus is HDV?
RNA virus that requires the presence of HBV
84
What part of HBV envelopes HDV?
A lipoprotein coat from HBsAg
85
What populations are at high risk for HDV infection?
HBsAg-positive prostitutes, MSM | IV drug users
86
How is HDV spread?
Percutaneous or mucosal contact with infectious blood
87
What signature symptom develops after the disappearance of typical hepatitis symptoms?
Jaundice reflects the initial acute infection
88
What is more likely to happen with concurrent HBV and HDV infections?
Fulminant hepatitis | progress to chronic liver disease
89
Who would you screen for HDV?
Patients who are HBsAg+ Patients with acute/chronic hepatitis Patients with acute HBV
90
How would you diagnose HEV?
Reverse transcriptase PCR to detect the HEV RNA | Immune electron microscopy
91
What is Hepatitis F?
dsDNA that is different from HAV and HEV (both RNA)
92
What is GBV/C?
Usually patients with "hepatitis G" are infected with HBV and/or HCV
93
What cell is infected with HIV?
CD4+ cell
94
What does the HIV release into the CD4+ cell?
Viral RNA and reverse transcriptase
95
How long would it take for an HIV+ patient to develop AIDS without antiretroviral treatment?
About 10 years after transmission
96
What CD4 count defines AIDS?
<200 CD4 cells
97
What is the biggest risk factor for HIV infection?
Sexual activity. It accounts for 70% of world transmission.
98
What is the strongest predictor of heterosexual transmission?
Viral load
99
What is the strongest predictor of transmission risk from mother to child?
Maternal HIV-1 RNA level
100
Can HIV be transmitted via breast milk?
Yes
101
How do you treat HIV+ pregnant women?
Until viral load is undetectable
102
Name another risk factor for HIV infection besides sexual activity.
Recipients of blood products (1975-1985) | IV drug use
103
Name some conditions associated with HIV.
More aggressive Syphilis 100x greater risk for developing TB More rapid cirrhosis in HCV
104
What symptoms could an HIV+ patient present with?
``` Similar to mononucleosis: Fever Adenopathy Pharyngitis Rash Myalgia/arthralgia ```
105
What defines acute retroviral syndrome?
Decline in CD4 lymphocytes Increased viremia 1-4 weeks after transmission high HIV RNA in absence of HIV Ab
106
What defines seroconversion?
Positive HIV Ab test within 4 weeks of acute infection and invariably by 6 months
107
How does acute retroviral syndrome acquired by sexual activity cause infection?
Virus enters in infected macrophages Dendritic cells carry virus to lymph nodes CD4+ cells become infected

Foundations of Clinical Medicine (5 decks)

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