HIV Flashcards
What is the most common cuase of waterborn illness in USA?
Cryptosporidium
What is the infective stage of cryptosporidium?
Round oocyst
Intracellular protozoa who’s oocysts are AF-positive and can complete life cycle in single host
Cryptosporidian
T or F
Chlorine can be used to deactivate cryptosporidian
False, outer shell is protective against chlorine
Cryptosporidium has an outer shell that protects against what?
Chlorine & living outside a host
How are humans infected with cryptospora?
Swallowing oocyts (food, WATER, direct contact)
Which is the reservoir for cryptosporidium?
Animal intestines
What is the pathogenesis of crypto diarrhea?
1-30 cause infection, sporozites invide epithelium along microvilli, envelop in membrane, osmotic or secreoty diarrhea
Which immune components are important for protection of a primary cryptosporidian infection?
CD4, INF-gamma, IgA
What are the histologic findings of crypto infection?
Fusion or loss of villi, atrophy
How do you diagnose crypto?
AF staining for oocysts, DFA, PCR. O&P NEGATIVE
Treatment for crypto
Support, HAART in AIDS
T or F
Crypto disseminates into the bloodstream in ADIS patients
False, there is no dissemination
Oocytes with 4 sporocytes, smaller than 5 um
Crypto
Oocytes with no sporocysts and bigger than 10 um
Cyclospora
How does cryptosporum cause increase in secretions?
Increase in prostaglandins (no toxin)
Which segment of the intestine is most affected by crypto?
Jejunum
Consumed berries or travelled and developed watery diarrhea
Cyclospora
Reservoir for cyclospora
unknown
Transmission of cyclospora
Fecal-oral
AF unsporulated cyst passed by host
cyclospora
Explain the life cycle of cyclospora
Oocytes passed (not infectious), sporulation at high temps, ingestion of sporulated oocyts, sporozytes released and go to jejunum, sexual & asexual, shed
T or F
There is no lifelong immunity from cyclospora
True
How to diagnose cyclospora
Wet mount (wet spheres), flurescence (blue-green), PCR
Wrinkled spheres w/variable AF staining on wet mount
Cyclospora
Blue-gren fluorescence under UV light
Cyclospra
How to treat cyclospora
Bactrim & HAART
Elipsoid oocyte with 1 or 2 sporoblasts
Isospora belli
And immature Isospora oocyte contains how many sporoblasts?
- It will mature to have 2, which will have 4 sporozoites each.
Transmission of isospora
Fecal-oral (food, water)
Pathogenesis of isospora
Infects SI, causes atrophy, crypt hypertrophy, inflammation, malabsorption
Non-bloody diarrhea, cramps, weight loss, eosinophilia
Isospora
How do you diagnose isospora?
Wet mount or acid fast
How do you treat isospora?
Bactrim or HAART
Which is the least common intestinal coccindian to infect humans?
Isospora
Polar filament and resistant spores
Microsporidia
Watery diarrhea seen with CD4 counts under 50
Microsporidia or mycobacterium
Treatment for microsporidia
Albendezole + HAART
Diagnose microsporidia
microscopy, flurescence, PCR (research)
MAC common if CD4 counts under
50
Treatment for MAC
MAcrolide, ethambutol, HAART
CMV treatment
ganciclovir, foscarnet, HAART
Punctate hemmorages with ulcerations on colonoscopy, intranuclear inclusions, bloody diarrhea, fecal leukocytes
CMV
Diagnose CMV
intranuclear inclusions (pp65 PCR may be positive but not causative)
HAART drugs that cause diarrhea
Protease inhibitors (nelfinavir, lopinavir, ritonovir)
