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Neoplasia Block > IID first 2 lectures (viral hemorrh fever, and opportunistic fungal infxns) > Flashcards

IID first 2 lectures (viral hemorrh fever, and opportunistic fungal infxns) Flashcards

1
Q

What are the four virus families that can cauyse VHF (viral hemorrhagic fever?)

A
  1. Bunyaviruses,
  2. Flaviviruses,
  3. Arenavruses,
  4. Filoviruses
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2
Q

VHF characteristics, Sx, results, etc.

A
  • zoonotic, animal/insect reservoirs
  • intial sx: fever, lethary, myalgia, then progress to shock, sys failure, death (increased capillary perm/ imapired coag/ imparied cardiac fxn)
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3
Q

Example of Bunyavirus

A

crimean congo fever

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4
Q

example of flavivirus (2)

A

dengue

yellow fever

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5
Q

Examples of arenavirus (2)

A

lassa

LCMV

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6
Q

example of filovirus

A

ebola

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7
Q 
Crimean Congo Fever
reservoir
region
targe
sx
A 
ticks mostly (and small vert)
middle east (and africa)
targets liver and vasc endoth
sx: usual VHF, limb pain
(BUNYAVIRUS)
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8
Q 
Dengue virus
reservoir
region
sx
test
tx
A

aedes aegypti mosquito
India (+ other dev)
sx: general, hypotension, PETECHIAE, tachycardia, clammy extrem, incr vasc perm causes pleural effusion/ascites
Test with TOURNIQUET TEST: inflate BP cuff and check if petechiae
Tx: antypyretics (no NSAIDS bc guillen barre risk) etc
FLAVIVIRUS

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9
Q

Yellow fever virus
reservoir
region
sx

A

aedes mosquito (and monkeys)
Region: w africa, s america, was an outbreak in NOLA (tusom)
Sx: general
FLAVIVIRUS

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10
Q 
Lassa
reservoir
region
sx
test
tx
A 
multimammate rat, its poop contaminates food 
W and Central Africa
sx: VHF, 30% hemorr bleeding
Test with LASV Ag rapid test
Tx: ribavirin ok
(biosafety lvl 4 with dengue)
-can be nosocomial
-LCMV, the other ARENAVIRUS is used as a research tool
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11
Q 
Ebola virus
Reservoir and trasmission
region
sx and timeline
testing
A

mammals, then transmitted via bodily fluids
central to west africa (eg bats)
sx: general, sore throat, conjunctivitis, diarrhea, bleeding gums, high mortality, GI pain
Timeline: headache/fatigue/pain/mild fever (1 week), then severe high fever and vomiting blood, then bleeding/ brusing/ brain dmg, then loss of consciousness, seizures, multi organ, massive int bleeding, death
Test: RDT ,blood via fingerstick, prevent outbreaks
-survivor can carry virus esp in immunopriv sites (brain and eyes)

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12
Q

What 3 disease things can be caused by fungi?

A

Allergies
Mycotoxicoses
Mycoses (infections)–superficial, cut/subcut, sys
often in immunocompromised hosts

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13
Q

Most significant opportunistic fungal pathogen?

A

CANDIDA!

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14
Q

SYSTEMIC fungi infections list

A 
candida albicans etc
Cryptococcus neoformans
Pneumocystitis jiroveci (aka P carinii)
Aspergillus fumigatus and others
ZYgomycetes/mucormycetes like rhizopus
Histoplasma
Blastomyces and coccidiodes (become opportunistic in IC indiv)
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15
Q

SUPERFICIAL fungal infections list

A

Candida
Malassezia
Trichophyton
Epidermophyton (lower 2 are dermatophytes)

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16
Q

Things that can cause OFPs

A

long term use of broad spectrum antibiotics (candida_
immunosuppressive drugs during trnasplants etc
radiation
loss of helper T cells due to AIDS
cancer, burns, IDs, neutropenia, diabetes etc

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17
Q

Which OFP can be dx with India ink to show CAPSULE?

A

Cryptococcosis (neoformans)

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18
Q

Which OFP has septate hyphae that branch at 45deg angles, and which has non-septated hyphae that branch at 90deg angles?

A

45- aspergillosis

90- mucormycosis/zygomycosis

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19
Q

which OFP should be treated with ampho+flucy?

A

cryptococcosis

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20
Q

which OFP is angioinvasive

A

Aspergillosis (fumigatus)

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21
Q

Which OFP is the AIDS defining illness?

A

PCP (peumocystis carinii penumonia) (P jiroveci)

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22
Q

Which OFP can cause cerebromeningeal infection?

A

Cryptococcosis

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23
Q

Which OFP is ONLY always a yeast

A

Cryptococcosis

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24
Q

Which OFP is the ONLY encapsulated fungal pathogen

A

Cryptococcosis

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25
Q

Common antimycotic for OFPs?

A

Amphotericin B! (affects erg in cell MEMBRANE)

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26
Q

Which OFP cannot be cultured?

A

PCP! use xray, broncial biopsy, serology for LDH lvl

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27
Q

What are some impt things fungus possess in cell wall?

A

mannoproteins which are antigenic

SOME have melanin to protecc cells

28
Q

What is the second most common cause of vaginitis in the US?

A

CANDIDA ALBICANS!

29
Q

Which fungi can have hyphae?

A

Asper, Candida, “mycosis”

30
Q

What form is Cryptococcus always in?

31
Q

Which fungi can cause oral esophagitis/creamy white plaques in esoph/ pain on swallowing esp in AIDS/HIV patients?

32
Q

Aspergillosis (fumigatus)

morph

A

-morph: mold with septate hyphae at 45 deg angles

33
Q

Aspergilloma

transmission

A

-trans: ubiq, common lab contaminant, inhalation of airborne conidia (spores)

34
Q

Aspergilloma

clinical course

A

-clin: allergies, bronchopulm, aspergilloma (fungal ball), non-invas or invasive aspergillosis (septae hyphae invade blood vessels, so angioinvasive), toxicosis

35
Q

Aspergilloma

dx

A

-dx: direct exam of sputum or tissue, culture w repeated isolation bc specific, ag determination

36
Q

Aspergilloma

tx

A

-tx: AMPHO B for invasvie infxn, surgical incision of fungal ball

37
Q

what form is HYPHAE?

38
Q

Pnemocystis (jiroveci)
aka
Pneumocystis CARINII PNEUMONIA (PCP)morph
morphology

A

-morph: biphasic with small trophozoites which divide and larger cysts which break open to release more

39
Q

PCP transmission

A

-trans: unknown, many have ab’s by age 2

40
Q

PCP clinical course

what does it show in histo

A

-clin: diffuse interstit plasma cell pneum, PCP: AIDS DEFINING ILLNESS (sx subtle onset of dyspnea, nonprod cough, low grade fever, non-AIDS have aburpt resp deficiency w immunosuppr drug dosage), dissem; foamy eosin exudate from alv cell dmg (honeycomb)

41
Q

PCP dx and tx
can it be cultured
what is elev in PCP

A
  • dx: cannot be cultured, xray, presence in sputum,/BAL/bronchial biopsy, serology for ab’s to organism or increased LDH, PCR
  • tx: antibiotics
42
Q

Mucormycosis/ Zygomycosis (rhizopus, mucor, absidia)

morph

A

-morph: non-septated hyphae that branch at wide 90deg angles, asexual spores in sporangia, ribbons on lung tissue, invades blood vessels

43
Q

Mucormycosis/ Zygomycosis (rhizopus, mucor, absidia)

transmission

A

-trans: inhalation of airborne sp

44
Q

“mycosis” clinical course

A

-clin: rhinocerebral mucormycosis (nasal/facial/CNS in pts with met acidosis or uncontrolled DIABETES, or dental; can have facial swelling/fixated pupils etc), pulm mucormycosis (in cancer/transplant pts), cut mucormycosis (traum implantation), dissem in IC/ill pts, GI mucormycosis from kids ingesting spores etc

45
Q

“mycosis”
dx
what mount with what? whats most useful

A

-dx: tissue sample, nasal mucus scarpings, wet mounts in KOH with calcofluor, histo sections with H&E and PAS (most useful!)

46
Q

Cryptococcosis (neoformans)

morph

A

-morph: ENCAPSULATED! (only encaspulated human fungal pathogen), YEAST (not dimorphic)

47
Q

Cryptococcosis (neoformans)

transmission

A
  • trans: soil with pigeon droppings, inhalation of dessic aeroslized blastopores, VF: capsule (antiphagocytic), GX (immunomodulatory), Melanin (antioxidant)
  • clin: pulm pneumonia (mild to fulm), CNS cerebromengineal, dissem skin and bone lesions
  • dx: direct examination of sputum or CSF in 10% KOH to see yeast cells (no hyphae), INDIA INK to see polysac capsule, culture/serology(latex aggl)
  • tx: self limitiing in healthy indivs, immunocompr need AMPHO B + flucytosine (mening has grave px)
48
Q

Cryptococcosis (neoformans)

clinical course

A

-clin: pulm pneumonia (mild to fulm), CNS cerebromengineal, dissem skin and bone lesions

49
Q

Cryptococcosis (neoformans)

dx

A

-dx: direct examination of sputum or CSF in 10% KOH to see yeast cells (no hyphae), INDIA INK to see polysac capsule, culture/serology(latex aggl)

50
Q

Cryptococcosis (neoformans)

tx

A

-tx: self limitiing in healthy indivs, immunocompr need AMPHO B + flucytosine (mening has grave px)

51
Q

Candidiasis

morph

A

-polymorphic yeast at RT, hyphae.germ tubes (lollipops) at 37C (invasive), pseudohyphae

52
Q

candida

virulence

A

-vf: hyphae adherence, polymorphism, SAPs

53
Q

candida

clinical course

A

-clin: cut: dermatitis, onchomycosis, paronchomycosis; mucosal: vaginitis, oral thrush, orphar/esoph(AIDS pts), perianal, balanitis; chronic mucocutaneous; invasive: fungemia, urinary tract, rnal abcesss, esoph, endocarditis, mengingitis, pulm, endoph, periton

54
Q

candida

dx

A

dx: difficult bc endogenous in normal flora, KOH wet mounts to culture yeast

55
Q

candida

tx

A

tx: tropical antimycotics for skin/mouth/vag, AMPHO B for dissem infxn
- often nosocomial

56
Q

PCP

VFs

A

VF: Major surface glycoprotein, chitin, and other complex cell wall polymers

57
Q

Which OFP is treated with antibiotics?

58
Q

Which VHF presents with petechiae, and how do you test it?

A

DENGUE! (a flavivirus)

you test it with the torniquet test where u inflate the bp cuff and see if it leaves lil red dots

59
Q

What does the multimammate rat cause

A

Lassa virus

60
Q

Which ones are the biosafety lvl 4

A

DENGUE and LASSA!

61
Q

Rhizopus is part of what OFP?

A

Mucormycosis/Zygomycosis!

62
Q

Which OFP may be rhinocerebral

A

Mucormycosis/zygomycosis

63
Q

Which one starts as trophozoites and breaks open to releease more

64
Q

For which 3 OFPs is KOH often used to dx

A

Candida
Mucormycoses
Cryptococcus

65
Q

“mycosis”

tx

A

tx: aggro tx with antimycotics and surgical debridement

Neoplasia Block (16 decks)

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