Infectious Disease Flashcards
Interaction between two organisms in which both organisms benefit:
mutualism
Interaction between two organisms in which one organism benefits and the other is neither harmed or helped
Commensalisms
Example of commensalism:
C. Albicans
- Bind to or enter host cells
- Release endotoxins or exotoxins
- Please enzymes that degrade tissue components
- Damage blood vessels and cause ischemic injury
- Induce host inflammatory and immune responses
These are all ways that:
pathogens can injure cells and cause tissue damage
- Prions
- Viruses
- Bacteria
- Chlamydia
- Rickettsia
- Mycoplasma
- Fungi
- Protozoa
- Helminths
- Ectoparasites
These are all:
pathogens
What are the steps to viral infection and replication? (5)
- attach
- penetrate
- reproduce
- assemble
- release
Give an example of a transient viral infection:
Hep A
Give an example of a chronic latent viral infection:
herpes simplex virus
Give an example of chronic productive viral infection
Hep B
Give examples of transforming viral infections:
Epstein Barr virus or HPV
Natural reservoir for human herpes virus (HHV):
humans
HHV-1:
HHV-2:
HHV-3:
HHV-4:
HHV-5:
HHV-8:
HHV-1: HSV1
HHV-2: HSV2
HHV-3: Varicella zoster virus
HHV-4: Epstein Barr virus
HHV-5: cytomegalovirus
HHV-8: Kaposi sarcoma associated virus
Flu-like illness with fever, malaise, arthaglia, headache, and cervical lymphadenopathy:
Primary herpetic gingivostomatitis
What ganglion is affected in HSV infection?
Trigeminal ganglion
Herpes infection behind the ear: (common in wrestlers)
herpes gladiatorum
around eye involvement with HSV:
HSV autoinoculation
Herpes of the cornea:
keratitis
- focal mucosal destruction; a t-lymphocyte mediated cytotoxic reaction:
recurrent aphthous stomatitis
Describe the evolution of an aphthous ulcer:
- erythematous macule
- ulceration
- fibrinous membrane
The precipitating factors for current aphthous stomatitis include: (7)
- SLS
- Stress
- Trauma
- Allergies
- Acidic foods/juices
- Gluten
- Endocrine alterations
Clinical forms o recurrent aphthous stomatitis include:
- minor aphthae
- major aphthae
- herpetiform
What is a key difference in the recovery of minor vs. major aphthae?
Major involves scarring
How can we differentiate between herpetiform aphthae and recurrent intra-oral herpes simplex>
Herpetiform aphthae is located on non-keratinized mucosa and and does not begin as vesicles
Describe the vesicular stage presence, number of lesions, and location of lesions of recurrent herpes:
- Yes
- Multiple, confluent
- Masticatory mucosa
Describe the vesicular stage presence, number of lesions, and location of lesions of recurrent aphthae:
- No
- Frequently solitary
- Moveable tissue
Aphthous-like lesions may be associated with systemic diseases such as:
- beichet’s syndrome
- reiter syndrome
- inflammatory bowel syndrome (ulcerative colitis & Crohn’s disease)
- Maslabsoprtion syndromes (gluten sensitive enteropathy)
- cyclic neutropenia
- HIV/AIDS
Discuss the transmission of Varicella (chicken pox)
transmission by inspirations of infected droplets
What ganglion is involved in the latent phase of varicella zoster (shingles phase)
dorsal spinal ganglion
Varicella = _____
Herpes zoster= ____
chickenpox; shingles
Hepatitis A is ___ infection
transient
Name two viruses that involve chronic latent infections:
- cytomegalovirus
- HSV
Name a virus that is considered a chronic productive infection:
Hep B virus
Name two viruses that are considered transforming infections:
- epstein barr
- HPV
Atypical lymphocytes called downey cells are characteristic of:
infectious mononucleousis (HHV-4)
What cell is shown in this image? What are they characteristic of?
Atypical lymphocytes called downey cells; infectious mononucleosis (HHV-4)
What gingival disease is associated with infectious mononucleosis?
necrotizing ulcerative gingivitis
What laboratory tests are used to test for infectious mononucleosis?
- monospot test
- EBV- specific testing
- heterophile antibody (although non-specific for EBV)
What is the heterophile antibody induced by EBV infection? (for mono)
IgM antibody
The antibody involved in infectious mononucleosis is a ____ antibody
heterophile
The heterophile (IgM) antibody induced by the EBV infection binds to ____ antigen of sheep and bovine RBCs
Paul-bunnell
Infectious mononucleosis tends to be ____ and recommended treatment is ___.
symptomatic; bed rest to prevent splenic rupture
Epithelial hyperplasia associated with EBV infection:
Oral Hairy Leukoplakia
What is a common location for oral hairy leukoplakia?
lateral border of tongue
Although oral hairy leukoplakia is associated with EBV infection, it may occur:
in any immunodeficiency state
What is shown in this picture?
Hairy Tongue- NOT oral hairy leukoplakia
What is shown in this image? What is this condition often associated with?
Oral hairy leukoplakia (epithelial hyperplasia); infectious mononucleosis) (EBV)
What is shown in this image? What is this condition often associated with?
Oral hairy leukoplakia (epithelial hyperplasia); infectious mononucleosis) (EBV)
Cytomegalovirus (CMV) may also be called:
HHV-5
Most of the population is affected by CMV by age:
60
Most CMV infections are:
asymptomatic
What are the stages of cytomegalovirus? (3)
- initial infection
- latency
- reactivation
This histological slide is characteristic of:
Cytomegalovirus
Cytomegalovirus is similar to ____ but is _____ negative
infectious mononucleosis (EBV); heterophile antibody negative
Rarely, what comorbities may accompany cytomegalovirus?
acute sialadenitis with painful swelling & xerostomia
A result of cytomegalovirus in immunocompromised individuals include: (2)
- retinitis- blindness
- colitis
Self-limited disease that occurs in epidemics of flu-like symptoms in young children:
coxsackie virus group A
Coxsackie Virus Group A is transmitted by:
fecal-oral and airborne routes
Herpangia involves what type of symptoms?
constitutional
Begins as small vesicles that rupture and ulcerate:
herpangia
Common locations of herpangia include:
posterior oral cavity and oropharynx
Vesicular eruption of hands, feet and anterior mouth:
Hand Foot and Mouth Disease
Another name for measles:
rubeola
Measles (rubeola) is a ____ disease often seen in ____, characterized by ___
communicable; children; skin rash
Children are given the ____ vaccine to protect against measles (rubeola)
MMR
_____ are characteristic of Measles (rubeola)
Koplik spots
“grains of salt” on an erythematous base:
Koplik spots (characteristic of measles)
Koplik Spots in measles signify:
foci of epithelial necrosis
Infectious parotitis:
mumps
Acute viral parotitis (mumps) may also be considered:
endemic parotitis
Acute viral parotitis (mumps) is a _____ disease seen in ____ and is vaccinated against with the ____ vaccination
communicable; childhood; MMR
Mumps is _____% ______ infection
30% subclinical
Mumps involves ____ constitutional symptoms
prodromal
Disease characterized by salivary gland swelling and discomfort:
mumps
What is occurring in this image and what is this characteristic of?
salivary gland swelling; mumps
What is an elevated laboratory finding in mumps? Why?
Elevated serum amylase- released from granules during lysis of acing cells
Describe the test for mumps:
specific serologic tests
Complications of mumps (rare in the young and more common in older individuals) include: (8)
- orchitis
- oophoritis
- mastitis
- meningitis
- thyroiditis
- pancreatitis
- sterility
- hearing loss
Bacterial pathogens can cause what types of infections?
- transient bacterial infections
- localized infections
- systemic infections
Bacterial pathogens may be ___ or ___
intracellular or extracellular
Tuberculosis is caused by:
mycobacterium tuberculosis
What is the most common infection with mycobacterium tuberculosis?
pulmonary infection
Mycobacterium tuberculosis is a ____ pathogen that causes ____ disease
intracellular; granulomatous
____ of the world population is infected with tuberculosis
1/3
Leading infectious cause of death after aids
tuberculosis
Tuberculosis targets disadvantaged populations such as:
- homeless
- malnourished
- overcrowded
Active tuberculosis cases are increasing due to:
- HIV infection
- Immigration
Growth of the organism in a TB patient:
Destructive, symptomatic disease in a TB patient:
Infection; active disease
Transmission of tuberculosis is by: (3)
- droplet nuclei (1-5 microns)
- stay airborne for long periods of time
- reach the pulmonary alveoli
Type of TB that occurs with a previously unexposed (unsensitized) person:
Primary pulmonary tuberculosis
Primary pulmonary tuberculosis is associated with ____ (parenchymal lung lesion and hilarious nodal lesion)
Gohn Complex
Parenchymal lung lesion and hailer nodal lesion associated with primary pulmonary tuberculosis:
gohn complex
What host response controls the infection in primary pulmonary tuberculosis?
Cell-mediated immunity
____ and ____ are both seen in primary pulmonary tuberculosis
fibrosis & calcification
Viable organisms may be dormant in lesions of latent disease in tuberculosis but may:
reactivate if immune defenses are lowered
What is seen in the images? what is this characteristic of?
Acid Fast Bacilli; tuberculosis
Mycobacterium tuberculosis intracellular pathogen contains ____ which blocks fusion of phagosome with lysosome
TB cord factor
TB cord factor is responsible for:
blocking fusion of phagosome with lysosome
Diagnosis of TB includes: (3)
- chest radiograph
- sputum culture
- molecular biologic tools
Treatment of TB involves ____ regimens including the drugs: (6)
multi-drug regimens;
- isoniazid
- rifampin
- ethambutol
- streptomycin
- pyrazinimide
- rifabutin
Symptoms of active TB include: (5)
- Chronic cough
- Hemoptysis
- Weight loss
- Night sweats
- Fever
What test is used to test for tuberculosis?
Mantoux tuberculin skin test (PPD Test)
The Mantoux tuberculin skin test (PPD test) is a ____ reaction to the protein from M. tuberculosis
type IV delayed hypersensitivity
_____ tuberculin injection is how the Mantoux tuberculin skin test is performed
Intracutaneous
In a PPD test, what occurs with a positive result?
T-cells sensitized by prior infection are recruited to the area and this produces an area of induration
What does it mean if someone has a positive tuberculin skin test? (3)
- individual has been infection
- cell-mediated hypersensitivity exists
- does NOT indicate active disease
Describe the Bacillus Calmette-Guerin (BCG) Vaccination for TB: (4)
- what type of vaccination is it
- what does it cause
- Is it effective
- Territories of its use
- Live, attenuated strain of mycobacterium bovis
- Causes a positive PPD reaction
- Effectiveness is uncertain
- Not used in the U.S
The bacillus calmette-guerin (BCG) vaccine is used for:
TB
Tuberculous lymphadenitis of the neck:
scrofula
Scrofula is tuberculous lymphadenitis of the neck caused by:
mycobacterium bovis infection from infected milk
How do we prevent scrofula infections? (2)
- pasteurization of milk
- tuberculosis control for cattle
Syphillis is caused by what organism?
Treponema Pallidum
What are the 2 forms of syphilis and what are there transmissions?
- Acquired Syphilis- sexual transmission
- Congenital Syphilis- in utero transmission
Clinical stages of untreated acquired syphilis (and their time frames)
- Primary (1 week to 3 months)
- Secondary (1 to 12 months)
- Tertiary (late) (1 to 30 years)
Latent syphilis infections can relapse into:
secondary syphilis infections
These images show ___ which is characteristic of ___
Primary Chancre of syphilis (Primary infection)
These images show ___ which is characteristic of ___
Primary Chancre of syphilis (Primary infection)
This image shows ___ which is characteristic of ___
Primary Chancre of syphilis (Primary infection)
Lesions of secondary syphilis include:
- skin rash
- mucous patch
- condyloma lata
These images are characteristic of:
Secondary syphilis
What is shown in these images? What is it characteristic of?
Maculopapular rash- secondary syphilis
What is shown in these images? What is it characteristic of?
Mucous patch of secondary syphilis
Most destructive stage of syphilis:
tertiary syphilis
___ & ____ are signs of tertiary syphilis
Gumma & Syphilitic glossitis
Tertiary syphilis may have nervous system involvement called:
neurosyphilis (tabes dorsalis)
Tertiary syphilis may have cardiovascular system involvement resulting in:
aneurysm of ascending aorta
What systems may involved in tertiary syphilis?
nervous system & cardiovascular system
What are shown in these images? What is this characteristic of?
Gumma; tertiary syphilis
What lesions are associated with the following stages of syphilis?
- Primary
- Secondary
- Tertiary
Discuss there infectivity:
- chancre- infectious
- mucous patch- infectious
- gumma- not infectious
Lesions of congenital syphilis include:
- snuffles
- saddle nose
- rhagades
- Hutchinson’s incisors
- mulberry molars
Congenital syphilis depressed nasal bridge=
saddle nose
Dental stigmata of congenital syphilis include:
Hutchinson’s incisors & mulberry molars
Hutchinson’s Triad of Congenital Syphilis includes:
- Blind- interstitial keratitis
- Deaf
- Dental anomalies
Describe the laboratory tests for syphilis:
- culture-
- microscopy-
- Serologic tests-
- cannot culture
- dark field or fluorescence microscopy
- Non-treponemal tests- reagin- antibody to cardiolipin & Treponemal tests specific for T. Pallidum
Discuss the non-treponemal tests- reagin- antibody to cardiolipin for syphilis (2):
- VDRL- Veneral disease research laboratory
- RPR- Rapid plasma reagin
Discuss the Treponemal Tests - specific for T. Pallidum for syphilis (2):
- FTA-ABS: fluorescent treponema antigen absorption
- MHA- TP- microhemagglutinin- treponema pallidum
Actinomycosis is a ____ pathogen
fungal
The diseases caused by fungi may be: (4):
- superficial
- subcutaneous
- systemic
- opportunistic
Fungal disease of the skin, hair or nails:
superficial
What is an example of a fungal infection that causes superficial disease?
dermatophytes
Fungal disease of the dermis and subcutaneous tissue:
subcutaneous
What is an example of a fungal infection that causes subcutaneous disease?
Sporotricosis
Deep fungal infections of internal organs:
systemic
What is an example of a fungal infection that causes systemic disease?
Histoplasmosis
Fungal infection of an immunocompromised host:
opportunistic
What is an example of an opportunistic fungal infection?
Candidiasis
Histoplasmosis is endemic to:
Mississippi River Valley
Transmission of histoplasmosis is by:
inhalation of spores (bird droppings & dust particles)
______ infection is usual of histoplasmosis?
sub-clinical
Histoplasmosis presents similar to ____ syndrome
flu-like
Deep fungal infection of the lungs caused by the inhalation of spores:
Histoplasmosis
Discuss the components of histoplasmosis (4):
- ____ of spores
- ____
- Specific ___
- _____ of organism
- ___ ____
- inhalation of spores
- phagocytosis
- specific immunity
- killing of organism
- dystrophic calcification
What is the arrow pointing to?
Histoplasma capsulatum
Histoplasma capsulatum is a ___ fungus meaning:
dimorphic fungus- yeast @ body temp and mold in nature
What percent of the population is infected by histoplasma capsulatum?
80-90%
What is the most common systemic fungal infection in the USA?
histoplasma capsulatum (histoplasmosis I believe)
Histoplasmosis infection of the elderly, debilitated, immunosuppressed or AIDS patients:
Disseminated histoplasmosis
Disseminated histoplasmosis involves the spread to:
extra-pulmonary sites
____ lesions such as ____ and ____ lesions are involved with disseminated histoplasmosis
adrenal lesions; addisons disease
oral lesions
Valley fever =
coccidioidomycosis
- Deep fungal infection of the lungs
- 40% develop respiratory symptoms
- Disseminated disease may occur
- Common in southwestern areas
Coccidioidmycosis
Clinical forms of oral candidiasis include: (5)
- Pseudomembranous (thrush)
- Erythmatous (atrophic)
- Hyperplastic
- Angular Cheilitis (Perleche)
- Central Papillary Atrophy
What clinical form of candidiasis is pictured?
pseudomembraneous (thrush)
What form of candidiasis may also be called thrush?
pseudomembraneous
What clinical form of candidiasis is pictured?
Erythematous (atrophic)
What form of candidiasis may be considered atrophic candidiasis?
erythematous
What clinical form of candidiasis is pictured?
hyperplastic
What clinical form of candidiasis is pictured?
angular cheilitis (perleche)
What for of candidiasis may be called perleche?
angular cheilitis
What clinical form of candidiasis is pictured?
central papillary atrophy
What clinical form of candidiasis is pictured?
acute pseudomembranous candidiasis (thrush)
What clinical form of candidiasis is pictured?
pseudomembranous candidiasis
What is the treatment for pseudomembranous candidiasis?
Fluconazole (diflucan) 100mg
What clinical form of candidiasis is pictured?
atrophic candidiasis
____ agar has a low pH and gentamicin to inhibit bacterial growth (and allow for candidiasis growth)
sabauraud agar
What feature is present on oral exfoliative cytology for diagnosis candidiasis fungal infections?
candida pseudohyphae
What clinical form of candidiasis is pictured?
erythematous candidiasis
What is the treatment for erythematous candidiasis?
fluconazole (diflucan) 100 mg
What clinical form of candidiasis is pictured?
erythematous candidiasis
What is one way someone can get a candidiasis infection due to medication?
steroid inhalers
Angular cheilitis may also be called:
Perlache
What clinical form of candidiasis is pictured?
angular cheilitis
What are the treatment options for angular cheilitis?
- Clotrimazole (Mycelex) Cream 1%
- Nystatin/ Triamcinolone Ointment
- Vytone Cream
What clinical form of candidiasis is pictured?
hyperplastic candidiasis
Central papillary atrophy may also be called:
median rhomboid glossitis
What clinical form of candidiasis is pictured? (give both names)
Central papillary atrophy (mediam rhomboid glossitis)
chronic mucocutaneous candidiasis is caused by:
T-cell defect
What clinical form of candidiasis is pictured?
chronic mucocutaneous candidiasis
candidiasis is common in what type of infection?
HIV