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clinical medicine ID > intro > Flashcards

intro Flashcards

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
Q

why doe we not rlly culture viruses?

A

bc they take too long

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26
Q

what is serology

A

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

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27
Q

how do we detect the viral genome?

A

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

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28
Q

What are some examples of illnesses we can detect with serology?

A

EBV, HBV, HCV, HIV

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29
Q

how does a virus become a cancer

A

the viral genome get integrated in the host gemone and disrupts it leading to growth abnormalities
-EBV, HTLV, HPV, hep c

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30
Q

why are fungi harder to treat

A

they are more complex and cause harder problems in the body

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31
Q

yeast

A

asexual and unicellular

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32
Q

molds

A

filamentous and asexual or rexual

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33
Q

dimorphic

A

can exist as both yeast (warm) and mold (cold)

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34
Q

fungi endemic to the US

A

-histoplasma, blastomycoses, coccidiomycoses

35
Q

fungi characteristics

A

non motile, eukaryotic, ridgid cell wall made of chitin and polysaccharides, cell membrane has ergosterol instead of cholesterol

36
Q

what do antifungals target?

A

-cell membrane

37
Q

how do we detect fungal infection?

A

detecting proteins (beta glucan in the cell wall and galactomannan)

38
Q

yeast

A

candida
-round or oval
-budding

39
Q

molds

A

aspergillus
-tubular/ hyphae structure

40
Q

what/ who is most succeptibal to fungal infections

A

-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
Q

three most common fungal infection?

A

-candida of the skin/ mucous membrane
-nail fungal infection
-ringworm

42
Q

where is blastomyces

A

soil of u.s. and canada

43
Q

most fungal infections are?

A

opportunistic infections

44
Q

for what fungus is a gram stain useful?

A

candida

45
Q

what type of fungus will grow in a routine blood culture

A

yeast

46
Q

which fungus will grow on blood agar

A

candida

47
Q

what else can we do to detect fungus?

A

pcr or histopath specimens/ tissue biopsy

48
Q

aspergillus antigen tries to detect what?

A

serum galactomanna in the cell wall

49
Q

single cell parasite

A

protozoa
-trichomonas, giardia, lamblia, entamoeba histolytica, toxoplasmosis and malaria

50
Q

multicellular parasite

A

helminth/ worms
-flatworm: tapeworm, fluke, roundowrms

51
Q

what worm is common in peds?

A

round worm/ pinworm (enterobium vermicularis)
-common cause of anal itching

52
Q

what is the first test in a bacterial infection

A

-gram stain because it will tell us if it is gram+ or -
-full culture report will take a few days

53
Q

gram postivie

A

thick wall high in peptidoglycan

54
Q

low peptidoglycan high LPS

A

gram negative

55
Q

what comes first culture or antibiotic?

A

-always culture unless there is a life threatening infection then start empiric therapy

56
Q

what is a blood culture

A

blood taken from 2 different sites, start empiric therapy if necessary
-2 sites to minimize contamination
-take culture before therapy

57
Q

what is not detecting in a urine culture?

A

chlamydia

58
Q

what is mycobacteria?

A

TB
-very slow can take weeks

59
Q

what is one std that can be negatively stained?

A

ghonorrea

60
Q

why can’t mycobacteria be gram stained?

A

too much lipid in the cell wall
-acid fast

61
Q

why can’t mycoplasma pneumonia be gram stained?

A

no cell wall/ very small

62
Q

why can’t rickettsiae or chlamydiae be gram stained?

A

intracellular/ very small

63
Q

what cross links peptidoglycan in the bacterial cell wall?

A

teichoic acid

64
Q

what is an immune stimulator found on gram neg?

A

LPS/ endotoxin
-has a thinner peptidoglycan layer
-makes you rlly sick

65
Q

what treats MRSA?

A

vancomycin

66
Q

is strep gram pos or neg

A

gram pos

67
Q

what is a common gram neg rod bacteria?

A

ecoli

68
Q

characteristics of anaerobic infections?

A

foul smell, necrotic tissue, gas formation in tissue/ discharge

69
Q

where will we not see anaerobic infections?

A

-gut, skin, mouth

70
Q

what is invasiveness of a bacteria/ virus

A

virulence factors

71
Q

common virulence factors?

A

-enzymes that help damage host cells
-toxin production that can cause disease
-capsules, spores, cilia, flagella, lytic enzymes

72
Q

three common ways to use antibiotics?

A

prophylaxis, empiric therapy and definitive therapy (when u get the culture bacK)

73
Q

when would be do empiric therapy?

A

-when we are at risk for resistance or pt has recent antibiotic exposure
-drug allergies or interactions

74
Q

what is beta lactams and what are they used for?

A

PNC/ amoxicillin, used as first line

75
Q

signs that you need to start an antibiotic immedietly?

A

-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
Q

signs we can wait to start antibiotic?

A

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
Q

signs you need to give IV antibiotics?

A

-postiive CSF or blood
-sepsis and unstable, CNS/ brain/ spine infection
-resistant organism to oral agents
-PNC allergy (pt can be stable)

78
Q

signs you should start with oral antibiotic?

A

-stable
-nonseptic CAP
-nonseptic cellulitis
-nonseptic pyelonephritis (can take oral abx)

79
Q

when to repeat a blood culture

A

maybe it was contaminated upon collection, use a port line or periphery

80
Q

which bacteria are NEVER a contaminant from blood culture?

A

-gram negative rods, s.aureus/mrsa, candida
-IV antibiotics until you determine species

81
Q

nonsterile culture sites

A

-open wound/ fungating tumor
-rectal/ throat swab
-sputum culture
-stool culture
-urine from a tube
-ascites from tenckoff
-surgical drain fluid

82
Q

how does immunocomp raise malignancy risk

A

the immune police that normally catch malignancy are not working

83
Q

what is one of the most resistant bacteria?

A

pseudomonas
-sometimes ecoli

84
Q

when is endocarditis a risk?

A

-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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