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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
Common antimycotic for OFPs?
Amphotericin B! (affects erg in cell MEMBRANE)
26
Which OFP cannot be cultured?
PCP! use xray, broncial biopsy, serology for LDH lvl
27
What are some impt things fungus possess in cell wall?
mannoproteins which are antigenic | SOME have melanin to protecc cells
28
What is the second most common cause of vaginitis in the US?
CANDIDA ALBICANS!
29
Which fungi can have hyphae?
Asper, Candida, "mycosis"
30
What form is Cryptococcus always in?
YEAST!
31
Which fungi can cause oral esophagitis/creamy white plaques in esoph/ pain on swallowing esp in AIDS/HIV patients?
CANDIDA
32
Aspergillosis (fumigatus) | morph
-morph: mold with septate hyphae at 45 deg angles
33
Aspergilloma | transmission
-trans: ubiq, common lab contaminant, inhalation of airborne conidia (spores)
34
Aspergilloma | clinical course
-clin: allergies, bronchopulm, aspergilloma (fungal ball), non-invas or invasive aspergillosis (septae hyphae invade blood vessels, so angioinvasive), toxicosis
35
Aspergilloma | dx
-dx: direct exam of sputum or tissue, culture w repeated isolation bc specific, ag determination
36
Aspergilloma | tx
-tx: AMPHO B for invasvie infxn, surgical incision of fungal ball
37
what form is HYPHAE?
MOLD!
38
Pnemocystis (jiroveci) aka Pneumocystis CARINII PNEUMONIA (PCP)morph morphology
-morph: biphasic with small trophozoites which divide and larger cysts which break open to release more
39
PCP transmission
-trans: unknown, many have ab's by age 2
40
PCP clinical course | what does it show in histo
-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
PCP dx and tx can it be cultured what is elev in PCP
- dx: cannot be cultured, xray, presence in sputum,/BAL/bronchial biopsy, serology for ab's to organism or increased LDH, PCR - tx: antibiotics
42
Mucormycosis/ Zygomycosis (rhizopus, mucor, absidia) | morph
-morph: non-septated hyphae that branch at wide 90deg angles, asexual spores in sporangia, ribbons on lung tissue, invades blood vessels
43
Mucormycosis/ Zygomycosis (rhizopus, mucor, absidia) | transmission
-trans: inhalation of airborne sp
44
"mycosis" clinical course
-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
"mycosis" dx what mount with what? whats most useful
-dx: tissue sample, nasal mucus scarpings, wet mounts in KOH with calcofluor, histo sections with H&E and PAS (most useful!)
46
Cryptococcosis (neoformans) | morph
-morph: ENCAPSULATED! (only encaspulated human fungal pathogen), YEAST (not dimorphic)
47
Cryptococcosis (neoformans) | transmission
- 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
Cryptococcosis (neoformans) | clinical course
-clin: pulm pneumonia (mild to fulm), CNS cerebromengineal, dissem skin and bone lesions
49
Cryptococcosis (neoformans) | dx
-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
Cryptococcosis (neoformans) | tx
-tx: self limitiing in healthy indivs, immunocompr need AMPHO B + flucytosine (mening has grave px)
51
Candidiasis | morph
-polymorphic yeast at RT, hyphae.germ tubes (lollipops) at 37C (invasive), pseudohyphae
52
candida | virulence
-vf: hyphae adherence, polymorphism, SAPs
53
candida | clinical course
-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
candida | dx
dx: difficult bc endogenous in normal flora, KOH wet mounts to culture yeast
55
candida | tx
tx: tropical antimycotics for skin/mouth/vag, AMPHO B for dissem infxn - often nosocomial
56
PCP | VFs
VF: Major surface glycoprotein, chitin, and other complex cell wall polymers
57
Which OFP is treated with antibiotics?
PCP
58
Which VHF presents with petechiae, and how do you test it?
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
What does the multimammate rat cause
Lassa virus
60
Which ones are the biosafety lvl 4
DENGUE and LASSA!
61
Rhizopus is part of what OFP?
Mucormycosis/Zygomycosis!
62
Which OFP may be rhinocerebral
Mucormycosis/zygomycosis
63
Which one starts as trophozoites and breaks open to releease more
PCP!
64
For which 3 OFPs is KOH often used to dx
Candida Mucormycoses Cryptococcus
65
"mycosis" | tx
tx: aggro tx with antimycotics and surgical debridement

Neoplasia Block (16 decks)

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