Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

IDIS > Heme-Onc: Systemic Infections I & II > Flashcards

Heme-Onc: Systemic Infections I & II Flashcards

1
Q

what are the infections of the lymphocytes

A
  • HIV/AIDS - T-cells
  • CMV - T-cells + macrophages
  • Infectious mononucleosis - B-cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

HIV pathogenesis

A

HIV destroys T-cells and macrophages

  • T-cell destruction
    • HIV uses its gp120 receptor to bind
      • CD4
      • either CXC-4 / CCR-5
        • T-tropic: binds CXCR-4
        • M-tropic: binds CCR-5
    • once in, replicates itself using host machinery: RT to turn its RNA genome into DNA,
      incorporates into host DNA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

T-tropic HIV binds what receptors? with what protein?

A
  • using gp120 protein, binds Th cells at
    • CD4
    • CXCR-4
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

M-tropic HIV binds what receptors with what protein?

A
  • using gp120 protein, binds Th cells at
    • CD4
    • CCR-5
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the various HIV subtypes and which are m/c in the US?

A
  • HIV-1
    • m/c in US: M-type, B subgroup
  • HIV-2 - seen in west africa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the stages of HIV?

A
  • stage 1: acute HIV infection
  • stage 2: clinical latency stage
  • stage 3: AIDS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

stage 1 of HIV

  • what is seen in the blood during the phase?
  • clinical presentation?
A

acute phase

  • antibodies titers are high at the END of this stage
  • presentation
    • asymptomatic, or
    • mononucleosis sx, or
    • combination of
      • myalgia
      • arthralgia
      • hepatosplenomegaly
      • meningitis
      • encephalitis rash
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

stage 2 of HIV

  • what is seen in the blood during the phase?
  • clinical presentation?
A

clinical latency phase

  • blood
    • antibody titers high throughout
    • CD4 cells drops from 500 → 200
  • presentation
    • lymph nodes start breaking down
    • certain manifestations:
      • AIDS-related complex (ARC)
      • PGL - persistent generalized lymphadenopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

stage 3 of HIV

  • what is seen in the blood during the phase?
  • clinical presentation?
A

= AIDS

  • in the blood
    • CD4+ cells decline below 200 (or, presence of aids defining illness)
    • viral p24 increases
    • HIV antibody titers DECLINES
  • presentation
    • ARC
    • PGL
    • CNS disease
    • wasting disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are the means of transmission of HIV?

what are the m/c way HIV is transmitted

  • in the world
  • in the US
    • in men in the US
    • in women in the US
A
  • transmitted
    • sexually - anal, vaginal
    • maternal-child: placenta, peripartum, breast milk
    • blood - transfusion, needle

most common:

  • world - heterosexual
  • US - homosexual
    • US men = homosexual
    • US women =- heterosexual
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

discuss the classification of AIDS.

how is each class defined?

A

each class is based on the presence of other symptomatic conditions along-side HIV:

A: asymptomatic, acute HIV or PGL

B: conditions that are attributed to HIV infection, but is not quite AIDS defining

  • thrush (but not esophagitis)
  • cervical carcinoma in situ (but not invasive)
  • bacillary angiomatosis
  • hair oral leukoplakia

C: AIDS defining illnesses

  • esophageal candida
  • cervical carcinoma, invasive
  • kaposi sarcoma
  • pneumocystitis jiroveci pneumonia
  • CMV retinitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what clinical presentation of HIV constitutes AID?

A
  • CD4
  • either
    • esophageal candida
    • cervical carcinoma, invasive
    • Kaposi’s sarcoma
    • pneumocystis jiroveci pneumonia
    • CMV retinitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

infectious mononucleosis (IM)

  • etiologic agent?
  • pathogenesis?
A
  • heterophil positive IM
    • EBV infects & multiple in the epithelial cells in the oropharynx → gets disseminated elsewhere
    • infects B-cells by binding to their CD21 receptor, inducing
      • proliferation
      • production of IgM Ab that the B-cells were already making + anti-EBV IgM
        • → immune complex formation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

infectious mononucleosis (IM) - presentation

A
  • asymptomatic (usually)
  • if symptomatic (worse in adults)
    • glandular fever triad:
      • FEVER
      • PHARYNGITIS
        • pharyngeal erythema + edema
        • petechia on the hard/soft palates
      • CERVICAL LYMPHDENOPATHY
    • also
      • palpebral edema
      • splenomegaly / hepatosplenomegaly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
A

pharyngitis: part of glandular triad of IM (Epstein Barr Virus)

  • pharyngeal erythema
  • pharyngeal edema
  • petechia on the hard/soft palates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
A

cervical lymphadenopathy: part of glandular fever triad in IM (Epstein Barr Virus)

17
Q
A

palpebral edema (bilateral upper eyelid swelling) - IM (Epstein Barr Virus)

18
Q

what infectious can cause the glandular fever triad?

what is the glandular fever triad?

A
  • EBV
  • HIV
  • CMV
  • toxoplasmosis

fever + pharyngitis + cervical lymphadenopathy

19
Q

complications of IM

A
  • brain, spinal, nerves
  • hematological
  • other
    • myocarditis
    • pneumonia
    • pancreatitis
    • oral hairy leukoplakia
20
Q

B and T cells

A

= Downy Cells

  • formed by EBV infecting both B and T-cell lymphocytes (CD8, specifically)
  • seen in peripheral blood smears
21
Q

dx of EBV

A
  • Downy cells on blood smear
  • heterophile Ab test (monospot)
    • pts IgM Ab react against RBCs
  • EBV serologies
    • heterophile IgM
      • +/- acute infection
    • anti-VCA IgM & IgG
      • IgM - acute
      • IgG - acute & chronic
    • anti-EBNA Ab - past infection
22
Q

IBV serology - which Abs are seen in

  • acute EBV mononucleosis
  • past EBV infection
A
  • acute infection
    • +/- heterophile Ab
    • anti-VCA IgM
    • anti-VCA IgG
  • past EBV infection
    • anti-VCA IgG
    • anti-EBNA IgG
23
Q

possible AE of IM tx?

A

pt may develop rash if given ampicillin / amoxicillin

24
Q

CMV infections - pathogenesis

A
  • etiological agent (HHV-5) infections T-cells and macrophages
    • spreads cell to cell, then → establishes latency
      • tends to really only infect immunocompromised hosts
25
Q

key manifestations of congenital CMV

A

usually - no symptoms

  • microcephaly
  • intracerebral calcifications
  • CMV choriorhinitis (AIDS defining illness)
  • thrombocytopenia, hepatosplenomegaly
26
Q
A

CMV choriorhinitis

congenital CMV infection

27
Q
A

intracerebral calcifications

congenital CMV infection

28
Q
A

microcephaly

congenital CMV infection

29
Q

children and adults - CMV presentation

A

usually asymptomatic unless host is immunocompromised

  • in non-immunocompromised patients
    • usually asymptomatic
    • if symptomatic:
      • mono-nucleolus like sx
      • pneumonia
      • hepatitis
      • organ transplant rejection
  • in immunocompromised patients:
    • esophagitis
    • colitis
    • choriorinitis (CMV rhinitis)
30
Q

what are the major manifestations of a CMV infection in an immunocompromised patient?

which patients are particularly susceptible to this presentation/

A
  • esophagitis
  • colitis
  • chorioretinitis (CMV retinitis)

*m/c seen in AIDS patients

31
Q

means of transmission of CMV

A
  • congenital - note that CMV is the most common cause viral congenital defects
  • perinatal
  • adults - sexual, transfusions / transplants
32
Q

diagnosis of CMV

A
  • heterophile negative mononucleosis
  • presence of Owl’s eyes
  • atypical lymphocytosis
  • abnormal LFTs
33
Q
A

owl’s eyes

CMV

34
Q
A

owl’s eyes

CMV

35
Q
A

owl’s eyes

CMV

IDIS (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions