L30- Fever and Lymphadenopathy

Question 1

4 pathological process that can cause lymphadenopathy

Answer 1

proliferation of lymphocytes n response to local infection

malignant metastasis spread of cells

malignant lymphocyte proliferation

inflammation of the lymph node itself

Question 2

bacterial causes of lymaphadenopathy

Answer 2

s. aureus

mycobacterium tuberculosis

Question 3

viral causes of lymphadenopathy

Answer 3

EBV (Glandular fever)
Cytomegalovirus (less severe glandular)
HIV

Question 4

acute EBV infection+

• mode of transmission
• severity based on age

Answer 4

• virus is transmitted in saliva

- more severe in adults > children

Question 5

• symptoms of EBV

- duration

Answer 5

fever
pharyngitis (sore throat)
lymphadenopathy
fatigue
- for about a week

Question 6

changes in lymphocytes in a EBV infection

Answer 6

t cells get atypical lymphocytosis

- bigger nucleus and more cytoplasm to fight off virus

Question 7

why is there splenomegaly in EBV infection?

- what complications can this have?

Answer 7

infected B cells go to the spleen

• other inflammatory cells follow
• can cause splenic rupture (should avoid contact sports)

Question 8

lab diagnosis results for acute EBV infection?

Answer 8

lymphocytosis (increased WBC)
atypical lymphocytes
abnormal liver fucntion tests

Question 9

what is the main diagnostic tool for EBV?

Answer 9

heterophile antibody testing
(Paul Bunnel monospot test)
- produced by infected B cells
- but is not too specific or sensitive

Question 10

what does the anti-VCA antibody test investigate?

Answer 10

anti-VCA (viral capsid antigens) are produced by the body in response to infection- appear relatively quickly

Question 11

3 lab diagnosis of acute CMV infection?

Answer 11

lymphocytosis (plus atypical lymphocytes)
abnormla liver function tests

detect antibodies against CMV

detect CMV in the blood

Question 12

presentation of acute HIV infection

Answer 12

glandular fever like illness

• presence of HIV antibodies inthe blood
• high risk fcators

Question 13

what are the steps of testing for HIV?

Answer 13

ELISA technology - tests for antibodies against HIV (cheap and relatively quick)

could also do PCR- look for HIV RNA presence

Question 14

how does ELISA testing work?

Answer 14

serum sample is added to tray with HIV antigens

• will attach
• anthi human antibody is added
• results in colour change

Question 15

which cells does HIV target?

Answer 15

CD4 cells

• dendritic cells
• T helper cells
• macrophage

Question 16

receptors involved in the HIV-host cell interaction

Answer 16

HIV (gp120) binds to CD4 (host cell)

-also requires the co receptor to enter properly

Question 17

pathophysiology of HIV

Answer 17

it is a retro single strand RNA virus

• incorporates itself in the host cell DNA
• the host cell replicates HIV DNA everytime there is a immune response

Question 18

describe the course of acute HIV infection

decribe the number of viruses and T cells in the blood

Answer 18

immediately the HIV infects dendritic cells, macrophages and T cells and proliferate (sudden increase in HIV in blood- also sudden drop in T cells)

• this presents with flu-like symptoms
• after a few weeks the immune system removes the HIV virus so numbers decrease and T cells rise again

Question 19

describe the course of chronic HIV infection

decribe the number of viruses and T cells in the blood

Answer 19

HIV slowly proliferate over many years

T cells are reduced over time

Question 20

complications of reduced T cells due to HIV

Answer 20

symptoms like EBV

• swollen lymph nodes
• white patch under tongue
• oral candiasis (yeast infection

after severe T cell reduction
- it is referred to as AIDS

Question 21

symtpoms of AIDS

Answer 21

persistent fever
fatigue
weightloss
diarrhoea
persistent infections (that can usually fought off in normal people)

Question 22

forms of HIV therapy

Answer 22

Aantiretroviral therapy

• slow down replication
• improve immune system