Microbiology Flashcards
What symptoms make EBV and CMV differentials for acute hepatitis?
liver inflammation and damage leading to hepatomegaly and elevate liver enzymes.
Yellow Fever- class of virus
flavivirus
Yellow Fever- demographics
MURICA
Yellow Fever- transmission vector
mosquito (aedes aegypti)
Yellow Fever- Sx
after 3-6 days, sudden onset of fever, headache and muscular aches. can be severe liver dmg.
Yellow Fever- Tx
no Tx
Yellow Fever- vaccine
live attenuated
How does schistosoma mansomi cause severe liver damage?
Eggs get trapped there
AWWWWWWW SCHIST
Where in the world does schistosoma mansoni infect?
tropoical/subtropical area
Where in the world does clonorchis sinensis infect?
asia
How do u get clonorchis sinensis?
eating fish with the metacercarial stage
What part of the hepatic tract does clonorchis sinensis attach to to cause damage?
Bile duct
“clones on the bile duct”
What is the major cancer associated with clonorchis sinensis?
Intrahepatic colangiocarcinoma
Where are the 2 liver flukes (Opisthorchis and Fasciola hepatica) found in the world?
Asia and eastern europe
How does Echinococcus granulosus cause liver damage?
large hydatid cysts in the liver
Where can u get E. multilocularis?
wild carnivores
E. multilocularis develops in the liver as a ramifyling mass, resembing what?
a carcinoma
What are the 2 treatments for E. multilocularis liver infections?
surgical excision + benizmidazole
Which parasite causes amebic liver abscesses?
E. histolytica
What type of pathological damage results from E. histolytica damage of the liver?
necrotic liver damage without pus
Which spirochete causes leptospirosis?
leptospira interrogans
Which reservoir does l. interrogans reside in?
domestic and wild animals
OH CRAP FLUFFY
How do humans get l. interrogans?
ingestion or exposure to contaminated water or food (breaks skin)
What are the clinical manifestations of l. interrogans?
influenza like illness for 7 days, hepatitis, jaundice, and hemorrhage in the liver.
This G-, nonmotile, coccobacillus infects reticuloendothelial cells from the respiratory tract, abrasian in the skin, or unpastruized dairy.
Brucellosis
What are the clinical manifestations of brucellosis?
hepatitis, hepatosplenomegaly, tiredness, aches, pains, anxiety, depression and fever.
“damnit pig, you make me fat and tired”
What is the structure of HAV?
naked, icosahedral capsid
What is the genomic composition of HAV?
+sense ssRNA genome
Once HAV acts on a receptor on liver cells, how is it released from the hepatocyte?
exocytosis
What is the mode of transmission for HAV?
fecal-oral
After HAV replicates in the hepatocytes and Kuppfer cells, where is it released into?
The bile
So what is the pathway from ingestion to getting into the poop for HAV?
mouth –> intestines –> blood –> hepatocytes –> bile –> stool
True or False: HAV can be a chronic infection
False.
What type of food is a problem for acquiring HAV?
Shellfish
How long does it take before Sx appear in HAV infections?
10-14 days
Before Sx appear in HAV infected individuals, is there a productive infection?
Yes. an inapparent one.
so bored. heres a story: i had a job as a swim coach in 8th grade for little kids. one time when i was walking home from work this group full of high school girls stopped and asked if i wanted a ride. my house was 3 minutes from where i worked, but being dumb, i agreed. so i got into their car and asked them to take me home. they drove the opposite way from home. i was scared, but it ended up being an awesome evening. got some froyo action, pizza, saw a movie. they dropped me off later after the escapades. my gf at the time (the one with IBS lol) was pissed but i’ll never forget that evening. dont even know their names. never saw them again. awwwww memories. I’M SO COOL.
What Ab can u detect in the blood for Dx of HAV?
Anti-HAV IgM using ELISA
What can u give as a prophylaxis for HAV?
immune serum globulin
When can u give the immune serum globulin after HAV exposure?
< 2 weeks
What type of vaccines can u give for HAV?
killed HAV
What genus is HBV from?
hepadnavirus
What is the structure of HBV?
small, enveloped DNA
DNA YOU HEAR. THE ONLY DNA ONE.
What is the genomic composition of HBV?
small circular dsDNA
Which HBV Ag surrounds the virion core?
core Ag (HBcAg)
Which HBV Ag forms the envelope with the 3 forms of glycoprotein?
surface Ag (HBsAg)
Which HBV Ag is a minor component and shares most of its protein with HBcAg?
Be Ag (HBeAg)
True or False: HBsAg is the infectious portion of HBV
False
True or False: HBsAg is the immunogenic portion of HBV
True
What are the 3 glycoproteins that compose the HBsAg?
S, M, and L
Which glycoprotein (S, M, or L) self-associates into spherical particles that are released from the cells?
S
you can detect this 1 in the blewd
Which glycoprotein (S, M, or L) binds to the liver cell receptors as well as does assembly of the virion by binding the envelope to the capsid?
L
Which glycoprotein (S, M, or L) was processed into the first commercial vaccine?
S
Which 2 HBV Ag’s can be detected in the blood and show an active infection?
HBsAg and HBeAg
If there is a strong reaction by CMI against the HBV infection, what is the final outcome?
Resolution
If there is a weak reaction by CMI against the HBV infection, what is the final outcome?
chronic hepatitis
What % of the US population has HBV?
1/20 people
What % of the world population has HBV?
1/3
What is the biggest potential cancerous outcome from HBV infection?
Primary Hepatocellular Carcinoma (PHC)
In what fluids can u get HBV?
blood, semen, milk, amniotic fluid, and vaginal and menstrual secretions.
What % of all cases of PHC are related to HBV?
80%
True or False: children usually have less severe acute infection Sx than adults.
True
What % of HBV infected individuals develop chronic hepatitis?
5-10%
This form of chronic hepatitis occurs in 1/3 of the indivudals, and is characterized by continued destruction of the liver, leading to scarring, cirrhosis, liver failure, or PHC.
Chronic active hepatitis
This form of hepatitis occurs in 23 of the individuals, usually found accidently on a blood screening, and the biggest soruce for the spread of infection because these indiviuals don’t have Sx.
Chronic passive hepatitis
The HBsAg particles can form immune complexes with Ab’s leading to which type-III hypersensitivity reactions?
Rash, polyarthritis, fever, acute necrotizing vasculitis, and glomerulonephritis
When is HBsAg detected in the blood during an HBV infection?
Only when there is an actively replicating virus.
After what time of detection of HBsAg can we say an HBV infection is chronic?
> 6 mo
The detection of HBsAb in the blood indicates what?
Immunity
The HBs window is the period of time when what 2 factors are not very present?
When the HBsAg can no longer be detected and HBsAb cannot be detected yet
so like if u draw labs and the Ag and Ab are low or 0, u can’t immediately say this person is vaccinated or he doesnt have an infection. u could be in the HBs window and have to do further screening.
So during the HBs window, which Ab can u screen for to see at least there was a recent infection
HBcAb
During what time of the infection can u see the HBeAg?
With active viral replication (acute and chronic active)
During what time of the infection can u see the HBeAb?
Chronic infection
Which is the only marker screened for in the early infection?
HBsAg
During what time period can u give hep B immune globulin after exposure?
Within a week (or to infants with HBsAg+ mothers)
Which RT inhibitor can u give to Tx HBV?
Iamivudine
How do adefovir dipivoxil and famciclovir Tx HBV?
they’re nucleoside analogues
How long can u take interferon-a for the Tx of HBV?
4 months
Which Ag can u use for vaccine preparations against HBV?
HBsAg S gene
After the first HBV vaccine injection, when do u give the 2nd and 3rd?
1 and 6 months
HCV is a big member of what virus family?
Flaviviridae
What is the genomic composition of HCV?
+sense RNA enveloped genome
Which receptors does HCV bind to on hepatocytes and B cells?
CD81 (tetraspanin)
After entry into the hepatocyte, which organelle does HCV enter to bud and assemble?
ER
How does HCV prevent the death of the host cell and promote a persistent infection?
it inhibits apoptosis and interferon-a
What are the main ways u can get HCV?
blood and sex. so tattoos, IV drugs, transfusions, not wearing a love glove, and organ recipients.
What % of HCV pts get acute hepatitis with resolution?
15%
What % of HCV pts get chronic persistent infections?
70%
What is teh predominant Sx in chronic HCV infections?
chronic fatigue
HCV-induced liver failure is exacerbated by what substance?
Alcohol
This is responsible for both the resolution and tissue damage in a HCV infection
CMI
How long after exposure to HCV can u detect viremia?
1-3 wks
Which drug has a 50% recovery rate and is used for the Tx of HCV?
recombinant interferon-a
Which 2 things in the blood can u detect for the Dx of HCV?
HCVAb or RNA genome using ELISA
What % of fulminant hepatitis infections are due to the delta agent (HDV)?
40%
HDV must use the coating of what other hepatitis virus to be functional?
HBV
“ya can’t have D unless ya have B”
What is the genomic composition of HDV?
very small circular ssRNA genome
True or False: if a person gets HDV and HBV at the same time, the biggest risk is a superinfection which can lead to fulminant hepatitis
False. They must have a pre-existing HBV infection to get a superinfection after exposure to HDV
This is the conditon when there is altered brain fxn (hepatic encephalopathy), extensive jaundice, and massive necrosis.
Fulminant hepatitis
What % of fulminant hepatitis cases are fatal?
80%
You can use ELISA to detect what 3 things in the Dx of HDV?
the RNA genome, delta Ag itself, or anti-HDV Ab’s.
True or False: you cannot not treat HDV infections.
False.
What is the route of transmission for HEV?
fecal-oral
Which pt population is at an increased risk of mortality in HEV infections?
Pregnant women