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HSS 3305 > Lecture 8 > Flashcards

Lecture 8 Flashcards

1
Q

Communicable disease

A

Disease transmitted from person to person

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2
Q

Endemic

A

Communicable diseases in which a small number of cases are continually present in the population

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3
Q

Epidemic

A

Communicable diseases concurrently affecting large numbers of people in a population (contained to a defined geographic area)

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4
Q

Pandemic

A

Global, world-wide outbreak across several countries or continents

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5
Q

Direct Transmission

A

Direct physical contact (sex) and Droplet spread (coughing, sneezing)

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6
Q

Indirect transmission through an intermediary mechanism

A

Contaminated food or water
Insects (vector)

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7
Q

Methods of Disease Control

A

Immunization (Active), Plasma containing antibodies/Maternal transmission (Passive), Identification, Isolation, treatment, controlling means of transmission (mask wearing), controlling indirect transmission for contaminated food or water

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8
Q

Isolation

A

Promptly carried out to shorten the time in which others may be infected, Isolation prevents contact with susceptible persons and stops spread

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9
Q

Food or water contamination control

A

Chlorination of water supplies, Effective sewage treatment facilities, Standards for handling, manufacturing, and distributing commercially prepared foods, Eradication and/or control of animal sources and vectors, Physical barriers - nets

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10
Q

Bubonic Plague

A

The black death has a 70% death rate without treatment, and 10% with treatment, one of the most deadly diseases, carried by rodents

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11
Q

STIs

A

Spread primarily by sexual contact (examples: Syphilis, Gonorrhea, Herpes, Chlamydia)

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12
Q

Primary Syphilis

A

Penetrates mucous membranes of the genital tract, oral cavity, rectal mucosa, or through the break in skin; multiplies rapidly throughout the body; forms a chancre (small ulcer) found on the penis, vulva, vagina, oral cavity, or rectum; occurs for 4-6 weeks and can heal without treatment

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13
Q

Secondary Syphilis

A

Systemic infection with skin rash and enlarged lymph nodes (develops after 4-10 wks typically lasts 2-3 years); begins after the chancre has healed and is accompanied with fever, lymphadenopathy, skin rash, shallow ulcers on mucous membranes of oral cavity and genital tract; can subside without treatment

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14
Q

Tertiary Syphilis

A

Late destructive lesions in internal organs (3-15y develops in 15-40% of cases); not generally communicable, Organisms remain active, causing irreparable organ damage due to chronic inflammation; Neuro and ocular syphilis are common in this stage

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15
Q

How to diagnose syphilis

A

Microscopic exam (Detection of Treponema from fluid squeezed from chancre) and Serologic tests (antigen–antibody reactions; Turns positive soon after chancre appears and remains positive for years)

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16
Q

Congenital Syphilis

A

Transmission from mother to child could cause the death of the fetus

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17
Q

Gonorrhea

A

Neisseria gonorrhoeae infection; Primarily infects mucosal surfaces: Urethra, genital tract, pharynx, rectum (symptoms appear about a week after exposure)

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18
Q

Gonorrhea in females

A

Infects mucosa of the uterine cervix and urethral mucosa; profuse vaginal discharge from cervical infection; can be asymptomatic; Infection may spread to fallopian tubes (Salpingitis)

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19
Q

How does gonorrhea manifest

A

Abdominal pain and tenderness, Fever, Leukocytosis

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20
Q

Gonorrhea in males

A

Acute inflammation of the mucosa of anterior urethra, Purulent urethral discharge, Pain on urination, Less likely to be asymptomatic in males than females

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21
Q

Extragenital gonorrhea

A

In the rectum; Pain and tenderness; purulent bloody mucoid discharge (anal sex) or Pharynx and tonsils (Oral-genital sex acts)

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22
Q

Disseminated gonococcal infection

A

Organisms gain access to the bloodstream and spread throughout body; Fever; joint pain; multiple small skin abscesses; infections of the joints, tendons, heart valves, meninges

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23
Q

Gonorrhea Diagnosis and treatment

A

Culture swab (Suspected sites: Urethra, cervix, rectum, pharynx, Blood in disseminated infections)
Nucleic acid amplification test: Based on the identification of nucleic acids in the organism
Treatment: Antibiotics - cefriaxone (some strains are penicillin resistant

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24
Q

Type 1 Herpes simplex virus infection

A

Infects oral mucous membrane and causes blisters; usually infected in childhood, most adults have antibodies to the virus; It may cause genital infections

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25
Q

Type 2 Herpes simplex virus infection

A

Infects genital tract and infections usually occur after puberty; Causes 80% of infections – a higher rate of recurrence, 20% of type 1 due to oral-genital sexual practices and may infect oropharyngeal mucous membranes

26
Q

Herpes Manifestation

A

Vesicles (Small external painful blisters) and shallow ulcers following sexual exposure, Men (Glans or shaft of the penis), Women (Vulva - painful, Vagina or cervix - little discomfort)

27
Q

Herpes diagnosis

A

Intranuclear inclusions in infected cells, Viral cultures from vesicles or ulcers most reliable diagnostic tests, and Serologic tests in some cases

28
Q

Herpes Treatment

A

Antiviral drug shortens the course and reduces the severity, but does not eradicate the virus (orally, per IV, or topically), Cold compress and pain relievers, Deliveries should be done by cesarean section

29
Q

Chlamydia trachomatis infection

A

Most common STD, 3 to 4 million cases per year

30
Q

Chlamydia clinical manifestations

A

Similar to gonorrhea (infection can spread to fallopian tubes to have similar effects), many are asymptomatic

31
Q

Chlamydia in Women

A

Cervicitis and urethritis, involving the uterine cervix, and urethra; moderate vaginal discharge (Major complications: sterility)

32
Q

Chlamydia in Men

A

Nongonococcal urethritis, acute urethral inflammation with frequency and burning on urination (Major complications: epididymitis)

33
Q

Chlamydia Diagnosis

A

Detection of chlamydial antigens in cervical or urethral secretions, Fluorescence microscopy
Cultures (swabs), Nucleic acid amplification tests: based on chlamydial nucleic acids

34
Q

Chlamydia Treatment

A

Antibiotics (azithromycin/doxycycline)

35
Q

Condylomata

A

Anal and genital warts - HPV

36
Q

Trichomonal vaginitis

A

Trichomonas vaginalis infection (protozoan parasite)

37
Q

Scabies and crabs

A

Microscopic mites

38
Q

HIV Virus

A

Attacks the immune system, specifically destroying CD4 T cells, leads to the development of Acquired Immuno Deficiency Syndrome which increases susceptibility to pathogens and opportunistic infections.

39
Q

Genetic material and Proteins in the HIV virus

A

9 kb Genome, ssRNA retrovirus (+ve), codes for 9 proteins, 2 structural proteins (Gag and Env), 1 enzymatic protein (Pol), 6 regulatory proteins (Tat, Rev, Nef, Vif, Vpr, and Vpu)

40
Q

HIV Transmission

A

Sexual contact, Blood and body fluids (seminal, vaginal), Mother to infant (HIV primarily infects CD4 T-cells through interactions with CD4 receptors on the cell surface and GP120 spikes on virus

41
Q

HIV Direct inoculation

A

Intimate sexual contact, linked to mucosal trauma from rectal intercourse

42
Q

HIV Transfusion

A

Contaminated blood or blood products, lessened by routine testing of all blood products, Sharing of contaminated injection needles, Transplacental or postpartum transmission via cervical or blood contact at delivery and in breast milk

43
Q

HIV steps of infection

A
  1. HIV cannot multiply alone. It must be inside a cell before it can make copies of itself.
  2. When HIV infects a cell, it hijacks its machinery.
  3. In the host cell, HIV makes copies of itself.
  4. These newly created virus particles can then go infect other cells.
44
Q

HIV life cycle

A

Binds to CD4 and enters the cell, reverse transcriptase converts RNA into DNA (errors and mutations occur in this step), DNA is then transported into the nucleus, intergrase integrates the viral DNA into the host cell’s genome (can be inactive), once activated genes are transcribed and viral RNA is transported to the cytoplasm, proteins are translated and cleaved by a protease, virions are released at the membrane, T-cells are activated and support the infection

45
Q

HIV replication and Genetic Variability

A

Fast replication and high mutation rate (1/cycle). This provides an adaptive advantage to HIV

46
Q

What mutants are immune to infection with HIV

A

CCR5 (highly expressed in macrophages)

47
Q

CD4 T-cells abnormalities

A

Depletion/cell death, reduced proliferation /regeneration, destruction by infection, indirect and direct destruction by viral proteins

48
Q

HIV to AIDS

A

A healthy individual has between 800 and 1500 CD4T cells in 1 µL of blood. Immune deficits start to emerge below 500 (HIV/other autoimmune diseases), Once this number drops below 200, the individual is described as having AIDS.

49
Q

Cytopathic effects of HIV

A

Cell-cell fusion, accumulation of unintegrated viral DNA, alteration of cell permeability lipids, apoptosis, the release of toxic cytokines by infected cells, destruction of immune responses, inhibition of growth factors, degradation of RNA which reduces protein synthesis

50
Q

CD8 T-cells are destroyers using…)

A

Cell-to-cell contact and secreted factors destroy infected cells (Perforin/Granzyme A, B) and inhibit virus production/promote immune activation (IFNy, TNFa, IL-2, MIP1a/b, RANTES)

51
Q

What is CTL dysfunction caused by

A

Cytokine/ receptor dysregulation, Direct effect of HIV soluble factors, Cell death/ apoptosis, Other immune cell dysfunction, Anergy

52
Q

What is Anti-HIV CTL (CD8) activity associated with

A

LTNP/Elite controllers (some control of the HIV infection and slower disease progression)

53
Q

Early vs. Late Manifestations of HIV infection

A

Early (Asymptomatic, mild febrile illness) and Late (Generalized lymph node enlargement, nonspecific symptoms, fever, weakness, chronic fatigue, weight loss, thrombocytopenia, AIDS)

54
Q

Antibody response to HIV

A

Antibodies are formed within 1 to 6 months, Detection of antibodies provides evidence of HIV infection, Antibodies do not eradicate virus, Virus is detectable by laboratory tests (viral RNA)

55
Q

Signs and Symptoms of AIDS

A

An infected person usually experiences a mononucleosis-like syndrome that may be attributed to the flu or another virus (may be asymptomatic for years)

56
Q

Non-specific symptoms

A

Weight loss, fatigue, night sweats, and fever

57
Q

Viral replication

A

Measure the amount of viral RNA in the blood (Virus replicates in lymph nodes, but the amount of viral RNA in blood reflects extent of viral replication in lymphoid tissue)

58
Q

Treatment for HIV and AIDS

A

No cure for AIDS, antiretroviral agents inhibit HIV viral replication

59
Q

HIV Treatment groups

A

Nonnucleoside reverse transcriptase inhibitors, Nucleoside reverse transcriptase inhibitors (nucleoside analogs), Protease inhibitors, Integrase inhibitors

60
Q

Protease Inhibitors

A

Block the action of viral protease in viral replication; cut viral protein into short segments to assemble around viral RNA to form infectious particles

61
Q

PrEP

A

HIV prevention treatment

HSS 3305 (21 decks)

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