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Quarter 3 > Microbio Exam 2 > Flashcards

Microbio Exam 2 Flashcards

1
Q

Hep C

A

Transfusion associated hep

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2
Q

Hep D

A

delta agent, only in pts with ACTIVE HBV

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3
Q

TB caused by

A

Mycobacterium tuberculosis

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4
Q

Big worry about TB is the spread of it

Often sneaky bc 90% of health infected pts

A

never become ill

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5
Q

Reservoir for Mycobacterium Tuberculosis

A

only HUMANS

transmission: person to person through Aerosol droplet

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6
Q

Prosectors warts

A

Cutaneous skin sx of Tuberculosis

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7
Q

Mycobacterium TB

A

Obligate aerobes

Rod shaped bacillis

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8
Q

M. TB

A

intracellular growth- alveolar macrophages

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9
Q

Harsh tx employed for Mycobacterium TB because:

A

Acid Fast Bacilli (AFB)

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10
Q

Myco TB

A

Ziehl-Neelsen or Kinyoun stains

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11
Q

Myco TB structures that create problem

remember, Acid fast

A

Mycolic acid-prevent dehydration, resist water
Cord factor
Lipoarabinomannan (LAM)- ROI-

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12
Q

Myco TB manifestation

A

Granulomas surrounded by macrophages, giant multi-nuc, fibroblasts, and collagen fibers h

Show on CXR 2-6 wks after infection

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13
Q

Latent TB

A

No risk to spread disease

Still treated

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14
Q

Reactivation or Secondary TB

A

Sign & Sx present
INFECTIOUS to others
may be present wks-months b4 diagnosis

Cough, wt loss, fatigue, fever, night sweats, CP

Lesions- caseous with . necrosis, erode and discharge TB bacilli into bronchi
Erode blood vessel and now spread via blood

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15
Q

Dx of TB

A

CXR
Skin test reactivity
Sputum stain/broth culture to detect Acid Fast bacteria
Rapid blood test- IFN-gamma

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16
Q

Myco TB screening

A

use purified Myco TB protein derivative in TB skin test

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17
Q

TB skin test

A

“Mantoux test”

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18
Q

Tx for TB

A

Extended duration 6-9 months
Chemo
Multi drug regimen

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19
Q

Prophylaxis for TB

A

Isoniazid for 9 months

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20
Q

do BCG (a tuberculosis vaccine)

A

in high endemicity regions

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21
Q

MAC

Mycobacterium avium complex

A

Acid- Fast
water loving- ubiquitous

slow growing

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22
Q

MAC

A

weakly gram (+) aerobic bacilli

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23
Q

MAC epidemiology

A

Ingestion of contaminated water or food

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24
Q

MAC

A

NO person to person transmission like TB

No isolation required

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25
Q

MAC

A

opportunistic Human pathogen

Now the leading cause of Non TB mycobacterium infections in HIV pts

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26
Q

MAC dz spectrum

A

Immunocomp
(middle aged/older males hx smoking)
-cavitary lesions resemble TB

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27
Q

MAC dz spectrum

A

Elderly female Non-smoker
-patchy or nodular CXR
Lady Windermere’s syndrome

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28
Q

MAC and AIDs

A

blood spread- no organ spared

immune system collapses

HAART and abx proph makes infection less prevalent in HIV (+)

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29
Q

MAC dx

A

Microscopy to reveal Acid-Fast and culture
Sterile site isolation of MAC
CXR
PCR- 16S rRNA sequence

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30
Q

Measles

A

multiply in Respiratory and Lymph nodes

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31
Q

Measles

A

Prodromal
High fever
3 C’s (cough, conjunctivitis, coryza)

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32
Q

Measles

A

KOPLIK spots and 3 C’s

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33
Q

Measles

Rash phase-sickest

A

Rash 3-4 d after prodrome starts
Below ears-spreads down
lesions become merged
Highest fever

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34
Q

Measles complications

A

PNA (most deaths)
Bacterial superinfetion
Diarrhea
CNS involvement- Acute sx-atic Encephalitis!!

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35
Q

Measles CNS complication

A

SSPE- Subacute sclerosing panencephalitis

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36
Q

Measles hosts

M for MONKEY

A

Humans and Monkeys

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37
Q

Measles

A

no healthy carrier state

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38
Q

Measles transmission

A

Respiratory droplets-highly contagious

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39
Q

Measles dx

A

Rash and/or Koplik spots
Serology
FA (fluorescent antibody test) from HEENT- Multniucleated giant cells

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40
Q

Measles prevention

A

MMR vaccine
-b4 school
15 mo:1st dose
4-6 yo: 2nd dose

*high risk if exposure deemed likely, can vaccinate under 15 mo

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41
Q

MMR vaccine

A

3rd booster now recommended for some

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42
Q

MMR vaccine

A

Live attenuated

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43
Q

Rubella (german measles)

A

“little red”

Mild exanthematous dz

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44
Q

Rubella

A

requires close and PROLONGED contact

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45
Q

Rubella

A

children often escape infection- the real scare is with CONGENITAL RUBELLA SYNDROME

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46
Q

CRS Congenital Rubella Syndrome

A 
Maternal infectoin during 1st trimester of pregnancy
Cardiac- Pulm stenosis, PTA
Eye- cataract, galucoma
Hearing loss
CNS
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47
Q

CRS Congenital Rubella Syndrome

A

the earlier mother affected- the more severe for child

i.e. first month: 50% chance of CRS

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48
Q

Rubella tx and prevention

A

MMR vaccine
DO NOT GIVE VACCINE TO PREGNANT

May proved IVIG (immunoglobulin) as prophylaxis if pregnant mother exposed in first trimester

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49
Q

Rubella tx

A

Symptomatic

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50
Q

HSV

A

humans are only reservoir

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51
Q

HSV spreads

A

in abscence of immune response

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52
Q

HSV dx

A 
Ballooning patholody
Tzanck smear!
FA- Fluor Antibody for viral antigens
Culture in HeLa, Hep-2 cell lines
PCR to detect HSV 
Antibody tests to reveal HSV1 and 2
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53
Q

HSV tx

A

Acyclovir or Valacyclovir

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54
Q

HSV tx

A

Acyclo and Valacyclo

Thymidine kinase phosphorylates AVC- viral DNA replication bc lacks 3 OH group and cannot polymerize more bases

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55
Q

Chickenpox

A

Asymmetrical

vesicular

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56
Q

Chickenpox

A

Replicates in regional lymph nodes

Replicates in liver and spleen

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57
Q

Chickenpox

A 
Primary viremia 4-6 days after infection
Secondary viremia (rash) 10-14 days after infection
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58
Q

Chickenpox

A

humans only reservoir

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59
Q

Chicken pox transmission

A

Respiratory secretion
Conjunctiva
Vesicles

Highly contagious

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60
Q

Chicken pox incubation

A

15 days

pt most contagous 1-2 days before lesions, and 4-5 days after

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61
Q

Chicken pox tx

A

DO NOT GIVE ASPIRIN (reyes syndrome risk)

Acyclovir is effective
High risk: Immune serum VariZig (immunoglobulin)

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62
Q

Chickenpox vaccine

A

Varivax (live)

VariZig for high risk

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63
Q

Shingles

A

Redness –> papules in 24 hour period

fever, anorexia

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64
Q

Shingles prevention

A

Zostavax (over 50YO)

Shingrix

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65
Q

HHV 6

A

Roseola Infantum

6th dz

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66
Q

HHV 6 Roseola Infantum

A

Fever followed by rose colored rash

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67
Q

HHV 6

A

fever 2-5 days

High fever w/o any obvious source

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68
Q

HHV 6 dx

A

Antibody by EIA

PCR

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69
Q

HHV 6 tx and prevention

A

nothing

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70
Q

Parvovirus

5th dz

A

Erythema infectiousum

infectious with 5 hands, 5th disease, slapped cheek with a HANG 5

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71
Q

Parvovirus

A

pet dog with HAND
5
5th dz

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72
Q

Parvovirus

A

Mild sx-fever, ha , malaise
Followed by SKIN RASH (Slapped cheek)
Resolves in 1-2 wks

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73
Q

Parvovirus

A

rash may involve limbs and trunk

ADULTS: Arthralgias!!! may only have this without any other sx

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74
Q

Parvovirus dx

A

Anti B19 IgM antibody

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75
Q

Parvovirus Tx and prevention

A

Most make full recovery on own
NSAIDs for relief
Immunoglobulin for Anemic pts

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76
Q

HPV prevention

A

Vaccines !!!
Gardasil
M and F ages 9-45

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77
Q

Scabies

A

small mite with short legs

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78
Q

Female scabies

A

fertilized on skin surface
burrows
life cycle in 5 wks- dies in burrow

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79
Q

Male scabies

A 
shorter lifespan
remains on skin surface OR shallow burrow
eggs laid under skin
larva emerges from egg after 4 days
adult mite develops 2 wks after hatching
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80
Q

Pediatric Scabies

A

similar to Norwegian, but lesions may be blood filled

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81
Q

Dx scabies

A

Apply mineral oil, scrap lesion, visualize microscopically (whole mite, mite parts, eggs/fecal pellets)

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82
Q

Tx of Scabies

A

5% Permethrin cream (single app) wash off after 8-14 hrs

Ivermectin (does not kill eggs)

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83
Q

Pubic lice

A

Nits (eggs) cemented to hair

ID by visualizing louse or nit

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84
Q

Tx of Pubic lice

A

Permethrin

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85
Q

Pediculosis

“Lice”

A

can be Capitis: head or

Humanus:body

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86
Q

Pediculosis “lice” pathogenicity

A

Bite irritation (blood sucking parasite)

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87
Q

“Vagabonds dz”

A

years of Lice infestation- darkened thickened skin

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88
Q

Tx of Pediculosis Humanus (body lice)

A

Permethrin

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89
Q

Pulex irritans (human flea)

A

laterally compressed

short spikes on legs allow attachment to host

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90
Q

Pulex irritans (human flea)

A

Parasite-need blood to survive

Inject saliva during blood meal, possesses 15 stubstances which initiate ALLERGIC RESPONSE

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91
Q

Pulex irrritans (human flea)

A

Allergic response
Rash
Tx: 1% Hydrocortisone cream, stop scratching, Antihistamine

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92
Q

RMSF

A 
Tick borne
Brown dog tick
Rickettsia Ricketsii
Gram (-)
Obligate intracellulra
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93
Q

RMSF

A

can be FATAL if not treated in first few days of sx

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94
Q

RMSF sx

A

2-14 days after tick bite
(usually painless bite)
SUDDEN ONSET fever and HA

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95
Q

RMSF early nonspecific sx

A

Fever, HA, n/v, abdominal/ muscle pain, lack of appetite, conjunctival infection

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96
Q

RMSF 2 types of rash

type 1

A

Small, flat pink itchy spots on WRIST, FOREARM, ANKLES (spread to trunk and palms, soles)
2-5 days after infection

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97
Q

RMSF 2 types of rash

type 2

A

Red-purple spotted petechial, pinpoint hemorrhage
6 days after

YIKES- sign of SEVERE and LATE dz

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98
Q

RMSF

A

Small, flat pink spots WRIST/ANKLE (2-5 days)

treat before rash gets to

Pinpoint hemorrhage (6 days)

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99
Q

Dx of RMSF

A

Detectable antibody titers are not visible for 7-10 days post infection

difficult to detect until dz is in late stage

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100
Q

Gold standard dx RMSF

A

Indirect immunofluorescense with a R. Rickettsii antigen

2 samples, 2-4 wks apart

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101
Q

Tx for RMSF

A

DOXY within 5 days of sx

Pregnant: Chloramphenicol (beware aplastic anemia)

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102
Q

Trypanosomatids

A

T. Brucei: African sleeping sickness

T. Cruzi: Chagas

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103
Q

T. Cruzi

A

Chagas

Vector: Triatomine bugs “kissing bugs”

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104
Q

T. Cruzi

A

transmitted through- feces of kissing bug, blood transfusion, organ transplant, congenital

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105
Q

T. Cruzi lifestyle

A

Trypomastigotes –> Amastigotes

Amastigoetes then replicate via binary fission and go back to Trypomastigoses-release into circulation

106
Q

Trypomastigoes

A

ingested during bloodmeal

107
Q

Chagas- 2 stages

A

Acute vs. Chronic

108
Q

Acute Chagas

A 
Nonsp sx (fever, fatigue, rash, n/v/d) + 2 BIG SIGNS
Chagoma (circle next to eye)
Romana's sign (swelling of eyelid near parasite entry)
109
Q

Chronic Chagas

A 
Can be asx for years- even life, THEN
Muscle and Nerve degeneration--> necrosis
Chronic inflammation
Cardiac effects
Intestinal enLARGEment

Heart comp more common than intestinal comp

110
Q

Chagas dx

A

Parasite under microscope

  • Trypomastigotes in Acute phase
  • Amastigotes in Chronic phase
111
Q

Tx of Chagas dz

A

Benznidazole

112
Q

Links to Epstein Barr Virus

A

Mono

Burkitt’s Lymphoma

113
Q

Infectious Mononucleosis (IM)

A

Incubate 1-2 months

Oropharynx–> Lymph nodes

114
Q

Mono

A

B cell infection - spread through lymphatic system

115
Q

Mono prodrome

A

3-5 days of HA, fever, malaise

116
Q

Mono presentation

A

Sore throat, symmetrical lymphadenopathy, FEVER, Hepatomegaly, increased liver enzymes, Jaundice

117
Q

Mono sore throat

A

Hard and soft palate lesions
Increase in both T and B cells
Atypical lymphocytes “Downey cells” in circulation

118
Q

Mono and T cell response

A

T cell response controls and halts infection (also cause of most of pt’s sx)

119
Q

Mono

A

virus found in saliva for about one month

120
Q

EBV

Mono dx

A

Heterophile Antibodies!!!

121
Q

Mono tx

A

Symptomatic

122
Q

Mono

A

Penicillin reaction rash often occurs in pts

123
Q

CMV-Cytomegalovirus

A

similar to EBV (mono), but does not produce Heterophile antibodies

124
Q

CMV

A

Most problematic for: Transplant pts, Immunocomp Pregnant

125
Q

CMV

A

children with minor colds may be source

126
Q

CMV tx

A

Ganciclovir and Immunoglobulin (Cytogam)

127
Q

Mumps

A

Symptomatic

MMR vaccine

128
Q

Lyme dz

A

Borrelia Burgforferi

Dz progression similar to syphilis

129
Q

Lyme dz progression (3 stages)

A
  1. Acute localized Erythema migrans- “bullseye” and flu like sx (fades in less than a month)
  2. Subacute disseminated dz- ARTHRALGIAS and flu like sx
    Secondary annular skin lesions
    Hepatitis
    Meningitis
    Facial palsy
    Conjunctivitis
  3. Chronic- MSK manifestations, worse Arthritis
130
Q

Lyme dz Reservoir

A

Small mammals- rodents, rats, mice, birds (tick transmission essential to maintain cycle)

131
Q

Lyme dz Dx

A

Serology- EIA + Western blot

132
Q

False + tests with Lyme dz

A

Syphilis, mono, Lupus, RA, oral infection w spirochetes

133
Q

Tx of Lyme dz

A

Amoxicillin or

Doxy 10-21 days

134
Q

Vaccine for Lyme dz

A

LYMErix (was available?)

135
Q

New vaccine targeting 6 most common Borrelia species

A

for Lyme dz

Pre-exposure proph with Monoclonal antibodies (passive immunity)

136
Q

Hep A and E

A

only Acute

137
Q

Hep B, C, D

A

can be Acute or Chronic

138
Q

Which types of Hep offer pre/post exposure immunization?

139
Q

Hep A

A

Excreted in feces
Food and water borne
Poor hygiene

140
Q

Hep A

A

Dz typically mild
Entry thru intestine after ingestion
Many ASYMPTOMATIC infections occur

141
Q

HAV dx

A

IgM antibody by ELISA

142
Q

Hep A tx

A

Bed rest
Reduce actiivty
PO fluids
Avoid: drugs, alc, anesthesia

143
Q

Prevent Hep A

A

Handwash
Avoid contaminated food
Post exposure prophylaxis with immunoglobulin
VACCINE available

144
Q

Hep B

A

Chronic –> Liver CA

145
Q

Hep B Antigens

A

Pay attention to third letter
HBs: surface
HBc: core
HBe: surface that tells us pt is INFECTIOUS

146
Q

Hep B

A

Double walled “Dane particle” is the infectious form

147
Q

Hep B spread

A

needle sharing, acupuncture, ear piercing, tattooing

148
Q

Chronic Hep B

A

major source of spread
when pt is Asymptomatic
Mother has HBeAG (e is third letter) greatest risk of spreading

149
Q

Populations at risk for Hep B

A

Healthcare workers

IVDU

150
Q

Hep B sx

A

Incubate 50-180 days

Insidious onset: fever, rash, symmetrical arthralgias

151
Q

Subclinical infection of Hep B (nearly or completely asymptomatic)

A

Anti- HBsAg

self limited in most adults

152
Q

Hep B

A

we always vaccinate BABIES
B for BABIES
bc 90% of perinatal and pediatric infections –> CHRONICITY

153
Q

Complications of Hep B

A

Hepatocellular Carcinoma

154
Q

Sign of Hep B- HALLMARK of initial ongoing infection

A

IgM anti-HBc and HBsAg

155
Q

Past infection of Hep B

A

IgG anti- HBc

156
Q

Chronic infection of Hep B

A

IgG anti-HBc and HBsAg

157
Q

Probable chronic infection of Hep B

A

HBeAg and HBsAg continued detection

158
Q

Hep B Tx

A

Chronic: PEG-interferon
Subunit vaccine available
Immunoglobulins for prophylaxis
Newborn infants of HBsAg + moms: get immunoglob prophylaxis + Hep B vaccine at birth

159
Q

Hep D virus

A

needs Hep B in order to replicate

160
Q

Hep D

A

increases the severity of Hep B

“Fulminant Hep” more likely with Hep D

161
Q

Hep D dz

A

ELISA for DELTA antigen or antibodies

162
Q

Hep D prevention

A

the vaccine for Hep B prevents both B and D
Supportive therapy
PEG interferon to suppress active viral replication

163
Q

Hep C

A

If not type A or B, 90% of Hepatitis cases are this

164
Q

Hep C

A

Hallmark for CHRONIC

post transfusion

165
Q

Hep C

A

Chronic –> Liver cirrhosis and failure

166
Q

Hep C

A

transmission not well understood

Dz onset hard to pinpoint

167
Q

Risk factors for Hep C

A

Anything with needles
Organ transplant
Contact w health care providers

168
Q

Factors that promote Hep C progression to Chronic

A 
Alcohol use
Infection at age <40YO
Male sex
Co-inf w Hep B
HIV
169
Q

Hep C dx

A

Enzyme immunoassay against Hep C
Seroconversoin 24 wks after infection
OFTEN ESCAPE DETECTION

170
Q

What is recommended to detect Hep C since it often escapes diagnosis?

A

Direct assays

171
Q

Hep C tx

A

Direct acting antiviral (DAAs)
Combo regimens
Virus protease or poylmerase inhibitors

172
Q

Hep C tx

A

a-interferon
PEG-interferon for some genotypes
Some regimens do not require interferon

173
Q

Hep C may lead to needing a

A

transplant

174
Q

Two main causes for Liver transplant

A

Cirhossis

Liver CA

175
Q

HIV sx

A

Asx or Sore throat, swollen lymph nodes, mimicking Mono

176
Q

HIV transmission

A

early stages when pts are unaware is when high levels or virus are circulating- HIGH transmission risk

177
Q

AIDs

A

(stage 3 HIV)
CD4 <200
Opportunistic infections take over- CA, Kaposi’s sarcoma, PJP, MAC infection, CMV dz, candidiasis thrush

178
Q

Description of HIV agent

A

Makes copy of itself and inserts into Human chromosome

Host treats it as any normal gene, cant be recognized

Human retrovirus- RNA genome- two copies of RNA virion

179
Q

HIV agent

A

RNA genome- 2 copies
Enveloped
Reverse transcriptase- RNA dependent DNA polymerase
RNA–> DNA, then entered into human genome

180
Q

Target for HIV tx

A

Reverse transcriptase

181
Q

HIV replication

A

Infection of cells w CD4 and Chemokine co-receptor at surface
Th monocyte, macrophage
Reverse transcriptase of viral genome-integration into hose

182
Q

Cytpopathic effects of HIV

A

T (helper) cell loss
and profound immunosupp
Direct virus killing and/or Apoptosis of immune cells

“swarms” group of mutant viruses that develop

183
Q

“swarms”

A

groups of mutant HIV that develop
can multiply rapidly, complicating tx (always morphing to escape med)
Why we need COMBO therapy

184
Q

HIV-1 and HIV-2

A

HIV-1: more common worldwide

HIV-2: West Africa

185
Q

HIV-2 (W. Africa)

A

less easily transmitted
slower progression to AIDs
resistant to NNRTIs

186
Q

HIV dx: detection of Antibody in patient

2 step process

A
  1. EIA screen

2. Western blot (confirmation)

187
Q

HIV dx: direct test

A

Reveal presence of virus RNA or protein antigens

NAT- Nucleic acid test are used to detect and quantify virus

188
Q

Check with donated blood for HIV

A

Antigen p24 or RNA genome by PCR

189
Q

Rapid HIV test

A

new 20 min test
OraQuick Rapid HIV-1/2 antibody test
(estimated that 280K ppl in US are infected but do not know)

190
Q

HIV tx

A 
Combo
Reverse transcriptase inhibitors
Nucleoside analogs
(AZT, ddI, ddC)
Non-nucleoside analogs
Protease inhibitors- stop maturation of viral assembly
Fusion-penetration inhibitors
191
Q

Viral load

A

most tests can detect as low as 50 copies/ml

Persons w HIV: may monitor every 90 days

192
Q

Poliomyelitis

A

Asymmetric flaccid paralysis

destruction of motor neurons in spinal cord

193
Q

Poliovirus

A

Picorna virus

194
Q

Clinical sx of Polio

A
  1. Inapparent- Asx to minor malaise
  2. Abortive illness
  3. Nonparalytic poliomyelitis
  4. paralytic poliomyelitis
195
Q

Post polio syndrome

A 
paralyzed decades ago
Now: muscle weakness, pain, fatigue
30 or more years after paralyzing polio
Not contagious- not detectable levels
Remaining neurons are collapsing d/t overuse
196
Q

IPV- Inactivated polio vaccine

we now use E-IPV, enhanced

A

Injected
Virus is killed
Prevents dz (paralysis), not infection

197
Q

Only polio vaccine used in US

198
Q

Arbovirus

A

West Nile virus
Ticks and mosquitoes
(break chain of transmission by going after these guys)

199
Q

West Nile clinical sx

A

Mostly NOTHING

if sx show, very serious case: still can’t treat though- only make pt comfortable

200
Q

West Nile

A

prevention and educatoin extremely important b cno treatment

201
Q

West Nile sx in severe case

A

AMS, confusion, fever, HA, vertigo, photophobia, n/v,personality change, seizures

Recovery may be complete or long term deficits

202
Q

West Nile

A

1 cause of Viral encephalitis in US overall

203
Q

West Nile dx

A

Antigenic cross rxn

MAC-ELISA is what we use: look for IgM

204
Q

If pt had recent (9 mo) vaccination against Yellow fever and/or Japanese encephalitis,

A

IgM may be detectable for up to 9 months after vaccine, can be false (+) for West Nile

205
Q

If suspect West Nile

A

start Acyclovir

in case it is Herpes Simplex virus

206
Q

Arbovirus (west nile) prevention

A

do not keep sitting water around

207
Q

Zika

208
Q

GBS

A

Guilliane Barre syndrome

209
Q

Rabies

A

virus replicates locally but heads for nervous tissue

210
Q

Rabies, Polio, HSV

A

travel back and forth from body– nervous tissue

211
Q

Rabies

A

Incubate 2-16 wks

5-6 days fatal course when overt sx appear

212
Q

Rabies prodrome

A

mild fever, pharyngitis, HA, burning, pain, increased sensory sensitivity

213
Q

Excitatory phase of rabies (mad dog)

A

anxiety, hydrophobia

214
Q

Paralytic phase

A

coma, hypotension, death

215
Q

Cryptic Rabies

A

contact with Rabid animal

virus can get thru skin

216
Q

Rabies

A

only instance where we immunize after the bite
3 immunizations
99% cure

217
Q

Rabies vaccine

A

HDCV + Hyperimmune serum AFTER contact w reservoir

218
Q

Malaria

A

mosquito born

219
Q

Malaria most common causative agents

A

Vivax and Falciparum

220
Q

Malaria

A

Human phase and mosquito phase

221
Q

Malaria

First: Sporozoites are injected by mosquito’s saliva during blood meal

A

Sporozoites then travel to liver where asexual division occurs–> Schizogony cycle begins (rapid cell division)
-Merozoites are released from Schizogony phase

222
Q

Vaccine target for malaria

A

Sporozoites (what is release by mosq saliva)

223
Q

Merozoites (made from Schizogony in the liver)

A

can infect other liver cells or RBC

224
Q

Once in RBC, Merozoite –> Trophozoite

A

As tropho age, they can develop into Amoeboid tropho and release into bloodstream, infect more cells

225
Q

Schizonts are multinucleated cells that produce

A

Merozoites

226
Q

Some merozoites can even develop into Gametocytes that do not rupture, BUT

A

mosq can then ingest the gametocytes and more reproduction happens inside the mosq

227
Q

Malaria

A

Organism uses up Hgb

Fever and chills d/t Pyrogenic waste after rupture of RBC

228
Q

Malaria

A

Pyrogen travels to hypoth and causes increase in thermal set point

Tumor necrosis factor- TNF; inflammation- intensifies symptoms

229
Q

Malaria

A

1-2 hours of severe shivering and high fever

230
Q

Malaria sx mimic others

A

Fever, vomiting, myalgia, Anemia (d/t RBC destruction), hypotension

Untreated: coma, renal failure, resp distress, death

231
Q

Resistance to Malaria

A 
Sickle cell (virus doesnt want the messed up Hgb)
Duffy antigen (W. african black persons lack antigen, resistant to VIVAX form)
232
Q

Duffy antigen

A

resistant to VIVAX

233
Q

Malaria vaccine

A 
RTS, S (Mosquirix)
somewhat eff against Falciparum
4 injections
low efficacy
Req boosters
234
Q

VIVAX

A

Benign tertian malaria
Rarely fatal
Incubate 9-15 days
infects YOUNG RBCs

235
Q

VIVAX

A

fever every 48 hours lasting 2-6 hours (d/t rupture of schizonts)
chills and shaking every 10-15 min

Relapse common d/t activation of Liver Hypnozoites, can be 3-5 years after initial dz

236
Q

Sickle cell protection against what form of Malaria?

237
Q

Vivax dx

A

Giemsa stain
Enlarged RBC w/Schuffner’s dots
Stipling

238
Q

Vivax tx

A

Chloroquine
Quinine
Doxy
Primaquine

239
Q

Falciparum

A

RBC of ANY age affected
VIRULENT- multiplies rapidly
Fever very high d/t high # of parasites
BLACKWATER FEVER

240
Q

“Blackwater fever” in Falciparum

A

high levels of free hgb
auto-immune rxn host destroys kidney tissue
Chills, fever, rigor, DARK TO BLACK URINE

241
Q

Falciparum crappy scary effects

A

Capillary obstruction bc infected RBC stick to capillary linings

Cerebral: hemorrhage, mania, convulsions, death
GI: freq vomiting
Algid*: skin is cold but internal temperature is high

242
Q

Falciparum is very crappy BUT

A

no relapse d/t no Hypnozoite

243
Q

Vivax and Ovale

A

relapse occur

244
Q

Duffy antigen

A

Vivax

low incidence in W Africa d/t Duffy negative people- dont have this antigen

245
Q

Main cause of Malaria resistance

A

efflux pumps

246
Q

Tx for Malaria

A

Chloroquine or Artemisinin

Atovoquone/proguanil (more expensive)

247
Q

Babesiosis

A

Nantucket fever

248
Q

Babesioss/Nantucket

A

deer tick
Similar sx to Malaria
Small pinpoint lesions

249
Q

Babesiosis/Nantucket is more problematic in

A

Immunocomp

Asplenic

250
Q

Babesiosis/Nantucket is often a co-infection with

251
Q

Babesiosis similar to what form of Malaria?

A

Falciparum (but less severe)

252
Q

Babesiosis is known for what morphology of RBC?

A

Cross like

253
Q

Tx ofBabesiosis

A

Clinda and Quinine

254
Q

E Coli

255
Q

Listeria

A 
Gram +
Coccobacillus
Hot dogs in summer
GI 
Facultative INTRAcellular
all up in your cell 
Lysterlysin O
256
Q

Group B strep

Strep agelecta

257
Q

H. influenza

Listeria

A

Coccobacillus

258
Q

Hep tx

A

Hep A: IgM
Hep B: Hbsurface antigen
Hep C: look for RNA (treat with DAA)
Hep D: Delta antigen

259
Q

HIV

A

EIA and Western blot

260
Q

HIV blood test

A

direct testing for RNA

261
Q

Vivax

A

Stipling

Schuffner

262
Q

Falciparum

A

Maurer’s cells

Maury is falci

Quarter 3 (17 decks)

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