HIV

Question 1

What is the most common cuase of waterborn illness in USA?

Answer 1

Cryptosporidium

Question 2

What is the infective stage of cryptosporidium?

Answer 2

Round oocyst

Question 3

Intracellular protozoa who’s oocysts are AF-positive and can complete life cycle in single host

Answer 3

Cryptosporidian

Question 4

T or F

Chlorine can be used to deactivate cryptosporidian

Answer 4

False, outer shell is protective against chlorine

Question 5

Cryptosporidium has an outer shell that protects against what?

Answer 5

Chlorine & living outside a host

Question 6

How are humans infected with cryptospora?

Answer 6

Swallowing oocyts (food, WATER, direct contact)

Question 7

Which is the reservoir for cryptosporidium?

Answer 7

Animal intestines

Question 8

What is the pathogenesis of crypto diarrhea?

Answer 8

1-30 cause infection, sporozites invide epithelium along microvilli, envelop in membrane, osmotic or secreoty diarrhea

Question 9

Which immune components are important for protection of a primary cryptosporidian infection?

Answer 9

CD4, INF-gamma, IgA

Question 10

What are the histologic findings of crypto infection?

Answer 10

Fusion or loss of villi, atrophy

Question 11

How do you diagnose crypto?

Answer 11

AF staining for oocysts, DFA, PCR. O&P NEGATIVE

Question 12

Treatment for crypto

Answer 12

Support, HAART in AIDS

Question 13

T or F

Crypto disseminates into the bloodstream in ADIS patients

Answer 13

False, there is no dissemination

Question 14

Oocytes with 4 sporocytes, smaller than 5 um

Answer 14

Crypto

Question 15

Oocytes with no sporocysts and bigger than 10 um

Answer 15

Cyclospora

Question 16

How does cryptosporum cause increase in secretions?

Answer 16

Increase in prostaglandins (no toxin)

Question 17

Which segment of the intestine is most affected by crypto?

Answer 17

Jejunum

Question 18

Consumed berries or travelled and developed watery diarrhea

Answer 18

Cyclospora

Question 19

Reservoir for cyclospora

Answer 19

unknown

Question 20

Transmission of cyclospora

Answer 20

Fecal-oral

Question 21

AF unsporulated cyst passed by host

Answer 21

cyclospora

Question 22

Explain the life cycle of cyclospora

Answer 22

Oocytes passed (not infectious), sporulation at high temps, ingestion of sporulated oocyts, sporozytes released and go to jejunum, sexual & asexual, shed

Question 23

T or F

There is no lifelong immunity from cyclospora

Answer 23

True

Question 24

How to diagnose cyclospora

Answer 24

Wet mount (wet spheres), flurescence (blue-green), PCR

Question 25

Wrinkled spheres w/variable AF staining on wet mount

Answer 25

Cyclospora

Question 26

Blue-gren fluorescence under UV light

Answer 26

Cyclospra

Question 27

How to treat cyclospora

Answer 27

Bactrim & HAART

Question 28

Elipsoid oocyte with 1 or 2 sporoblasts

Answer 28

Isospora belli

Question 29

And immature Isospora oocyte contains how many sporoblasts?

Answer 29

1. It will mature to have 2, which will have 4 sporozoites each.

Question 30

Transmission of isospora

Answer 30

Fecal-oral (food, water)

Question 31

Pathogenesis of isospora

Answer 31

Infects SI, causes atrophy, crypt hypertrophy, inflammation, malabsorption

Question 32

Non-bloody diarrhea, cramps, weight loss, eosinophilia

Answer 32

Isospora

Question 33

How do you diagnose isospora?

Answer 33

Wet mount or acid fast

Question 34

How do you treat isospora?

Answer 34

Bactrim or HAART

Question 35

Which is the least common intestinal coccindian to infect humans?

Answer 35

Isospora

Question 36

Polar filament and resistant spores

Answer 36

Microsporidia

Question 37

Watery diarrhea seen with CD4 counts under 50

Answer 37

Microsporidia or mycobacterium

Question 38

Treatment for microsporidia

Answer 38

Albendezole + HAART

Question 39

Diagnose microsporidia

Answer 39

microscopy, flurescence, PCR (research)

Question 40

MAC common if CD4 counts under

Answer 40

50

Question 41

Treatment for MAC

Answer 41

MAcrolide, ethambutol, HAART

Question 42

CMV treatment

Answer 42

ganciclovir, foscarnet, HAART

Question 43

Punctate hemmorages with ulcerations on colonoscopy, intranuclear inclusions, bloody diarrhea, fecal leukocytes

Answer 43

CMV

Question 44

Diagnose CMV

Answer 44

intranuclear inclusions (pp65 PCR may be positive but not causative)

Question 45

HAART drugs that cause diarrhea

Answer 45

Protease inhibitors (nelfinavir, lopinavir, ritonovir)