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1
Q

Direct transmission

A

kissing, sex etc

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2
Q

droplets

A

secretions that stay in the air from coughing, sneezing etc
-covid and the flu

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3
Q

vertical

A

mother to baby in utero

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4
Q

vector

A

through a thing like ticks and mosquitos
-think malaria or lyme

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5
Q

indirect/ vehicle transport

A

-feccal oral or airborne

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6
Q

airborn

A

droplets that linger and land
-aerosolied and cay stay int he room for hours
-varicella, TB
-need an N95
-viral respiratory infections

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7
Q

Define virus

A

obligate intracellular parasite
-can be dna or rna
-can be naked capsid or have an envelope that it steals from the host

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8
Q

types of viral genetics

A

ds rna, ds dna, ssrna, ssdna
-will varyy depending on the type of virus
-treatments can target different genetic materials

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9
Q

what can viruses do?

A

-gain entry to cells
-transmit
-take over cells
-direct cells to replicate viruses
-incite an inflammatory response
-evolve

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10
Q

what can viruses NOT do

A

-move independently
-self replicate
-harness energy

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11
Q

can viruses affect all tissues

A

-yes and they can cause sepsis if they spread systemically

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12
Q

direct viral transmission

A

-blood and body fluid
-respiratory secretions
-fecal/oral

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13
Q

respiratory viral transmission

A

-large droplets and small particle aerosols

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14
Q

nature of the disease is determined by?

A

-what tissues it will target/ troppism of the cirus and permissiveness of cells for viral replication
-the portal of entry of the virus
-access of virus to target tissue
-the strain of the viral pathogen

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15
Q

severity of the disease is determined by

A

-cytopathic ability of the virus
-immune status
-competence of the immune system
-immunopathology
-cirus inoculum size
-length of time before resolution of the infection

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16
Q

if you have a lower viral load you are least likely to?

A

spread the disease around

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17
Q

if the virus has a low virulence the immune system might?

A

get rid of the infection before you become symptomatic

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18
Q

HIV targets

A

CD4 which is on the surface of T cells then it will use that cell to replicate itself

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19
Q

viral pathogenesis

A

-can be an abortive infection
-can by a lytic infection
-can be a persistant infection
-can be a chronic infection, latent, recurrent or transmforming

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20
Q

transforming infection

A

ooncogenic

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21
Q

chronic infection

A

coninuously shedding
-can be without s+s yet you still shed

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22
Q

latent

A

a pause in replication but it can still come back
-syph comes back 10-30 yrs later to attack heart and brain
-the cell has to replicate on its own the virus can not trigger that but the cell replicating can then trigger the virus

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23
Q

why is HIV so hard to cure

A

there will always be a part of it that is latent waiting to be triggered

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24
Q

How can we diagnose a virus?

A

a culture, a cytologic examination/ microscopy, serology, immunoflourescence, rapid test, mass spectrometry, or PCR

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25
why doe we not rlly culture viruses?
bc they take too long
26
what is serology
looking for antibodies by measuring IgM and IgG -this can take a long time -detects infection or immune response -ex: lyme disease may be negative in the first two weeks so at the sight of the rash treat it then recheck
27
how do we detect the viral genome?
PCR/ NAAT testing where we look for a specific genetic sequence then they can quantify the genetic material -however: detecting the genetic material does not mean active infection the genetic material can stick around long after the virus has stopped replicating
28
What are some examples of illnesses we can detect with serology?
EBV, HBV, HCV, HIV
29
how does a virus become a cancer
the viral genome get integrated in the host gemone and disrupts it leading to growth abnormalities -EBV, HTLV, HPV, hep c
30
why are fungi harder to treat
they are more complex and cause harder problems in the body
31
yeast
asexual and unicellular
32
molds
filamentous and asexual or rexual
33
dimorphic
can exist as both yeast (warm) and mold (cold)
34
fungi endemic to the US
-histoplasma, blastomycoses, coccidiomycoses
35
fungi characteristics
non motile, eukaryotic, ridgid cell wall made of chitin and polysaccharides, cell membrane has ergosterol instead of cholesterol
36
what do antifungals target?
-cell membrane
37
how do we detect fungal infection?
detecting proteins (beta glucan in the cell wall and galactomannan)
38
yeast
candida -round or oval -budding
39
molds
aspergillus -tubular/ hyphae structure
40
what/ who is most succeptibal to fungal infections
-immunocomp is main target but fungi can target any tissue (blood, heart valves, cns etc) -non immunocomp we see mucocutaneous infection (target mucous membrane) treat that with topical agent
41
three most common fungal infection?
-candida of the skin/ mucous membrane -nail fungal infection -ringworm
42
where is blastomyces
soil of u.s. and canada
43
most fungal infections are?
opportunistic infections
44
for what fungus is a gram stain useful?
candida
45
what type of fungus will grow in a routine blood culture
yeast
46
which fungus will grow on blood agar
candida
47
what else can we do to detect fungus?
pcr or histopath specimens/ tissue biopsy
48
aspergillus antigen tries to detect what?
serum galactomanna in the cell wall
49
single cell parasite
protozoa -trichomonas, giardia, lamblia, entamoeba histolytica, toxoplasmosis and malaria
50
multicellular parasite
helminth/ worms -flatworm: tapeworm, fluke, roundowrms
51
what worm is common in peds?
round worm/ pinworm (enterobium vermicularis) -common cause of anal itching
52
what is the first test in a bacterial infection
-gram stain because it will tell us if it is gram+ or - -full culture report will take a few days
53
gram postivie
thick wall high in peptidoglycan
54
low peptidoglycan high LPS
gram negative
55
what comes first culture or antibiotic?
-always culture unless there is a life threatening infection then start empiric therapy
56
what is a blood culture
blood taken from 2 different sites, start empiric therapy if necessary -2 sites to minimize contamination -take culture before therapy
57
what is not detecting in a urine culture?
chlamydia
58
what is mycobacteria?
TB -very slow can take weeks
59
what is one std that can be negatively stained?
ghonorrea
60
why can't mycobacteria be gram stained?
too much lipid in the cell wall -acid fast
61
why can't mycoplasma pneumonia be gram stained?
no cell wall/ very small
62
why can't rickettsiae or chlamydiae be gram stained?
intracellular/ very small
63
what cross links peptidoglycan in the bacterial cell wall?
teichoic acid
64
what is an immune stimulator found on gram neg?
LPS/ endotoxin -has a thinner peptidoglycan layer -makes you rlly sick
65
what treats MRSA?
vancomycin
66
is strep gram pos or neg
gram pos
67
what is a common gram neg rod bacteria?
ecoli
68
characteristics of anaerobic infections?
foul smell, necrotic tissue, gas formation in tissue/ discharge
69
where will we not see anaerobic infections?
-gut, skin, mouth
70
what is invasiveness of a bacteria/ virus
virulence factors
71
common virulence factors?
-enzymes that help damage host cells -toxin production that can cause disease -capsules, spores, cilia, flagella, lytic enzymes
72
three common ways to use antibiotics?
prophylaxis, empiric therapy and definitive therapy (when u get the culture bacK)
73
when would be do empiric therapy?
-when we are at risk for resistance or pt has recent antibiotic exposure -drug allergies or interactions
74
what is beta lactams and what are they used for?
PNC/ amoxicillin, used as first line
75
signs that you need to start an antibiotic immedietly?
-sepsis, fever, neutropenia, postivie blood culture, positive CSF culture, brain or spine infection/ abcsess on imaging -can not wait, do empiric while waiting for cultures
76
signs we can wait to start antibiotic?
positive culture from a nonsterile site (not csf or blood) -fever but no neutropenia or septic -chronic osteomyelitis -positive urine culture with no symptoms
77
signs you need to give IV antibiotics?
-postiive CSF or blood -sepsis and unstable, CNS/ brain/ spine infection -resistant organism to oral agents -PNC allergy (pt can be stable)
78
signs you should start with oral antibiotic?
-stable -nonseptic CAP -nonseptic cellulitis -nonseptic pyelonephritis (can take oral abx)
79
when to repeat a blood culture
maybe it was contaminated upon collection, use a port line or periphery
80
which bacteria are NEVER a contaminant from blood culture?
-gram negative rods, s.aureus/mrsa, candida -IV antibiotics until you determine species
81
nonsterile culture sites
-open wound/ fungating tumor -rectal/ throat swab -sputum culture -stool culture -urine from a tube -ascites from tenckoff -surgical drain fluid
82
how does immunocomp raise malignancy risk
the immune police that normally catch malignancy are not working
83
what is one of the most resistant bacteria?
pseudomonas -sometimes ecoli
84
when is endocarditis a risk?
-false heart valve -s.aureus or candida infection -over 48 hours positive culture -cardiac device or graft (not stents)

clinical medicine ID (3 decks)

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