Infectious diseases of the cardiovascular & lymphatic systems

Question 1

For acute endocarditis:

name the microbe(s)

identify type of microbe (e.g., prokaryote, virus, yeast, etc.)

recognize noteworthy symptom(s) for diagnosis

identify mode(s) of transmission

describe prevention and/or treatment

Answer 1

name the microbe(s)
- S. aureus (sometimes S. pyogenes or S. pneumoniae

identify type of microbe (e.g., prokaryote, virus, yeast, etc.)
- Bacteria

recognize noteworthy symptom(s) for diagnosis
- colonization of normal heart valves, fibrin-platelet vegetations

identify mode(s) of transmission
 - enter bloodstream via parenteral route 

describe prevention and/or treatment)
- high level antibiotics in bloodstream

Question 2

For subacute endocarditis:

name the microbe(s)

identify type of microbe (e.g., prokaryote, virus, yeast, etc.)

recognize noteworthy symptom(s) for diagnosis

identify mode(s) of transmission

describe prevention and/or treatment

Answer 2

name the microbe(s)
- oral streptococci

identify type of microbe (e.g., prokaryote, virus, yeast, etc.)
- bacteria

recognize noteworthy symptom(s) for diagnosis
- heart valve colonization

identify mode(s) of transmission
 - dental procedures

describe prevention and/or treatment
- prophylactic amoxicillin

risk factors for colonization

• prior heart valve damage
• congenital malformations

Question 3

What virulence factor helps S. aureus colonize heart valves?

Answer 3

coagulase

Question 4

Which is risk factor contributes to subacute endocarditis?

Dental procedure
Heart valve damage or defect
Nasal colonization by S. aureus
Both A & B
All the above

Answer 4

Both A & B

Question 5

For lyme disease:

name the microbe(s)

identify type of microbe (e.g., prokaryote, virus, yeast, etc.)

recognize noteworthy symptom(s) for diagnosis

identify mode(s) of transmission

describe prevention and/or treatment

Answer 5

name the microbe(s)
- Borrelia burgdorferi

identify type of microbe (e.g., prokaryote, virus, yeast, etc.)
- bacteria

recognize noteworthy symptom(s) for diagnosis
- arthritis, fever, headache, fatigue

identify mode(s) of transmission

• tick vector (nymph)
• deer & mice reservoirs

describe prevention and/or treatment
- antibiotics and prophylaxis

Question 6

What is the characteristic clinical sign of lyme disease? What are the 2nd stage symptoms of lyme disease?

Answer 6

70% of cases present with erythema migrans
bull’s eye rash

second stage:

• joints
• cardiovascular
• nervous

Question 7

For Rocky Mountain spotted fever (RMSF):

name the microbe(s)

identify type of microbe (e.g., prokaryote, virus, yeast, etc.)

recognize noteworthy symptom(s) for diagnosis

identify mode(s) of transmission

describe prevention and/or treatment

Answer 7

name the microbe(s)
- Rickettsia rickettsii

identify type of microbe (e.g., prokaryote, virus, yeast, etc.)
- bacteria

recognize noteworthy symptom(s) for diagnosis

• early measles-like rash and fever
• attacks cardiovascular and nervous systems

identify mode(s) of transmission

• tick vector
• rodent & small mammal reservoirs

Question 8

Which differential symptom is associated with Lyme disease?

Answer 8

bullseye rash

Question 9

What is the vector for Lyme disease and RMSF?

Answer 9

ticks

Question 10

What was HIV called before they knew what it was? Who did it usually infect?

Answer 10

GRID (gay-related immune disorder)

4H disease (homosexual, heroin user, hemophiliac, Haitian)

Question 11

Who was Ryan White?

Answer 11

Boy who showed HIV/AIDS isn’t a gay disease

hemophiliac
contracted HIV via blood transfusion in 1984 (age 13)

Question 12

What is the status of HIV/AIDS today?

Answer 12

more than 30 million infected worldwide
1-2 million in US (cases declining)
40,000 new infections a year (Africa & Asia)
1.8 million deaths in 2010

Question 13

How is HIV transmitted?

Answer 13

HIV is transmitted via blood & body fluids
- direct contact
- vehicle
#7 STD in U.S.

Question 14

What surface proteins are critical for HIV attachment?

Answer 14

gp120
- binds to CD4 (TH cells)

gp41
- initiates entry by fusion

Question 15

What viral proteins are necessary for HIV to carry out its lifecycle?

Answer 15

reverse transcriptase
- RNA→DNA

integrase
- viral latency

protease
- assembly

Question 16

What are AIDS-defining illnesses (ADIs)? What are some examples?

Answer 16

AIDS-defining illnesses (ADIs) are opportunistic infections associated with defective immune system

pneumocystis pneumonia
Kaposi sarcoma
candidiasis
CMV

Question 17

What can be done to deal with the AIDS pandemic?

Answer 17

EDUCATION!
limit contact
test blood
drug cocktails
 - fusion inhibitors
 - RT inhibitors (e.g. AZT)
 - integrase inhibitors
 - protease inhibitors
no vaccine yet!

Question 18

What is the clinical definition of AIDS?

Answer 18

CD4 T cell count drops below 200 per μl

Question 19

Condom usage has reduced cases of HIV infection, whereas ________ has reduced AIDS-related deaths.

Answer 19

Antiretroviral drugs