Lect 26

Question 1

infectious mononucleosis is caused by

Answer 1

Epstein-Barr virus

Question 2

What type of lymphoma is linked to epstein barr virus

Answer 2

burkitt’s lymphoma

Question 3

primary ebstein-barr virus replication occurs in the , and then eventually reaches the

Answer 3

• oropharynx
• lymph nodes

Question 4

ebstein-barr virus infection involves what type of cells

Answer 4

• B cell infection, inducing polyclonal expansion of lymphocytes

Question 5

clinical presentation

• sore throat
• symmetrical lymphadenopathy
• fever
• hepatomegaly?
• palatal enanethem at junction of hard and soft palate with petecial lesions

Answer 5

infectious mononucleosis

Question 6

infectious mononucleosis causes increase in what type of cells?

Answer 6

• increase in both T and B cells
• atypical lymphocytes (“Downey cells”)

Question 7

T cell response in infectious mononucleosis is responsible for

Answer 7

• controls and halts infections
• generates most of patients symptoms

Question 8

how is ebstein-barr virus transmitted? is asymptomatic carrier possible?

Answer 8

• person-to-person
• asymptomatic infection frequent

Question 9

peak incidence of infectious mononucleosis

Answer 9

ages 17-25

• virus found in saliva for 1 month

Question 10

how is infectious mononucleosis diagnosed

Answer 10

• patient age and presence of heterophile antibodies
• agglutination of horse RBCs in Monospot test
• confirmation by IgM anti-capsid antigen

Question 11

Cytomegalovirus is most problematic for what patient populations

Answer 11

• immune suppressed
• infections occuring during pregnancy

Question 12

What is stage 1 of lyme disease

Answer 12

• erythema migrans at site of tick bite
  
  • bulls eye pattern
  • expanding
  • fades in less than a month
• flu-like symptoms

Question 13

What is stage 2 of lyme disease

Answer 13

• subacute disseminated disease
  
  • 70% of patients progress to this 2 weeks-months after infection
  • flu-like symptoms
  • asymmetric arthritis attacks
    
    • ​swelling and pain of large joings
  • secondary annular skin lesions (50%)
  • hepatits (20%)
  • meningitis (15%)
  • follicular conjunctivits (10%)

Question 14

What is stage 3 of lyme disease

Answer 14

• chronic disease
  
  • primarily musculoskeletal manifestations
    
    • arthritis attacks
      
      • more persistent, longer in duration

Question 15

Cause of lyme disease in Eurasia

Answer 15

B. garinii and B. afzelii

Question 16

Cause of lyme disease in US and europe

Answer 16

B. burgdorferi

Question 17

Vector of lyme disease

Answer 17

• Tick (Ixodes sp.)
  
  • deer tick
  • black legged tick

Question 18

reservoirs of lyme disease

Answer 18

• small mammals
  
  • rodents, rats, mice, birds
• tick transmission is essential to maintain cycle

Question 19

lyme disease is associated with what environment

Answer 19

• forest edge locations
  
  • ​mouse habitat
    
    • ​humans contact ticks in fields with tall grass and brush

Question 20

how is lyme disease diagnosed

Answer 20

• signs and symptoms
• serology
  
  • EIA + western blot
  • patients typically positive by 4th week of infection

Question 21

What is post treatment lyme disease syndrome

Answer 21

• 10-20% of abx-treated patients have lingering symptoms of fatigue, pain, and joint problems
  
  • most improve with time

Question 22

prevention of lyme disease

Answer 22

• control and avoidance of vector contact
  
  • insecticides with DEET
• vaccine was available