Micro 3 Flashcards
What are the envelope proteins of HIV
gp41 (transmembrane glycoprotein) and gp120 (docking glycoprotein) whic hare acquired through budding from host cell plasma membrane
What is p24 in HIV?
Capside protein
What is p17 in HIV?
Matrix protein
HIV Genome?
diploid (2 molecules of RNA)
3 genes of HIV and products
env (gp160=gp120 and gp41) gp120 attaches to CD4 cell and gp41 is for fusion and entry
gag (p24): capsid protein
pol is reverse transcriptase, aspartate protease, integrase
Replication of HIV genome
reverse transcriptase makes dsDNA which integrates into the host genome
What receptors does virus bind to?
On CD4+ cells: CD4 and CCR5 (early) or CXCR4 (late) co-receptor
On macrophages: CCR5 and CD4
What people have immunity
CCR5 negative homozygotes. heterozygotes have a slwoer course
What are the rule out and rule in tests of HIV?
Rule out is ELISA because of high sens, low spec.
Rule in is Western blot because of high spec., low sens.
What are the thresholds for CD4 counts
Normal is 500-1500 cells/mm3.
AIDS is either <14%
Where can you find false positives and false negatives in HIV?
Lots of false positives in babies because of anti-gp120 crossing the placenta.
False negatives in first 1-2 mo. of HIV infection
Natural history of HIV mnemonic
4 F stages: Flu-like (acute), feeling fine (latent), falling count, final crisis
Where does HIV replicate in latent phase
Lymph nodes
What kind of cancer increases with HIV?
Non-Hodgkin lymphoma (large cell type) Often on oropharynx (waldeyer ring)
HIV low-grade fevers, cough, hepatosplenomegaly, tongue ulcer
Histoplasma capsulatum (only pulmonary sxs in immunocompetent hosts)
Derm and HIV
Candida, hairy leukoplakia, superficial vascular proliferation, superficial neoplastic proliferation of vasculature
What causes vascular proliferation
Nonmalignant: Bartonella henselae (causes bacillary angiomatosis)
Malignant: HHV-8 (Kaposi’s sarcoma)
HIV diarrhea
Cryptosporidium
Neurologic and HIV
Abscesses, dementia, encephalopathy, meningitis, retinitis
HIV abscess
Toxo
HIV demenia
Directly associated with HIV
HIV encephalopathy
JC virus reactivation (PML)
HIV meningitis
Cryptococcus neoformans
HIV retinitis
CMV
HIV associated cancers and pathogen
Non-Hodgkin lymphoma, Primary CNS lymphoma (both associated with EBV)
Squamous cell carcinoma of anus (HPV)
Difference between toxo and Lymphoma
Toxo has multiple ring-enhancing lesions
HIV respiratory issues
Interstitial pneumonia invasive aspergillosis PCP Typical PNA Tuberculosis like disease
Biopsy of bartonella vs. kaposis
Bartonella has PMN inflammation, Kaposi’s has lymphocytic inflammation
Normal prion protein name and conformation
alpha-helical prion protein (PrP^c) to pathological Beta-pleated form (PrP^sc) that is transmissible
Sporadic spongiform encephalopathy
Creutzfeldt-Jakob disease
Inherited prion disease
Gerstmann-Straussler-Scheinker
Acquired prion disease
Kuru
Day-care diarrhea
Yersinia enterocolitica
Salmonella and shigella lactose
Both NONfermenters
PNA in neonates (<4 wks)
Group B strep, E. coli
Most common PNA in children 4 wk-18 yr
RSV, Mycoplasma, C. trachomatis (infants-3yr), C. pneumoniae (school children), S. pneumo Runts May Cough Chunky Sputum
PNA Adults (18-40 yrs)
Mycoplasma, C. PNA, S. PNA
PNA Adults (40-65 yrs)
S. pna, H. flu, anaerobes, viruses, mycoplasma
PNA elderly
S. pneumo, flu, anerobes, h. flu, gram negative rods
Congenital Toxo
Classic triad: Chorioretinitis, hydrocephalus, and intracranial calcifications
Congenital Rubella
Classic triad: PDA (or pulm. artery hypoplasia), cataracts, and deafness +/- “blueberry muffin” rash
Congenital CMV
Hearing loss, seizures, petechial rash, “blueberry muffin” rash
Congenital HIV
Recurrent infections, chronic diarrhea
Congenital HSV-2
Encephalitis, herpetic lesions
Congenital Syphilis
Often stillbirth, hydrops fetalis; if child survives, facial abnormalities: notched teeth, saddle nose, short maxilla. Saber shins, CN VIII deafness