***REVIEW SLIDES*** Flashcards
Nigeria or Niger and rodent excretia
Lassa Fever Virus
Most likely etiologic agent of joint pain, fever, and headache after traveling to SE asia
What about if it’s negative for that one?
Dengue or Break bone fever
Chicangunya… Dengue CAN transition to hemorrhagic easier and more often
What’s the major difference between measles and mumps as far as secondary infections?
Which affects more people (according to the PDF)?
Because mumps is of the parotid gland it is near the ears and can cause permanent deafness as secondary infection. It also affects the pancreas, testes, ovaries, and can cause meningitis as secondary complications of the infection. The mumps is MORE SEVERE in adults!
Measles (rubeola) is more of a respiratory infection that has a cough, rhinitis, HIGH fever, red eyes, and a macropapular rash.
The secondary complications include diarrhea (high fever), pneumonia (cough/rhinitis), inflammation of the brain/encephalitis (macropapular rash etc), and blindness (red eyes).
An easy way to remember is mEaslEs has two E’s which effects the EyEs.
Measles affects more people! Nearly 20 million people worldwide with 90K deaths / year!
Measles or Mumps effects the eyes?
An easy way to remember is mEaslEs has two E’s which effects the EyEs.
Measles or Mumps effects the parotid gland and ears?
Mumps causes Bumps on the parotid… which is close to your ears and can cause deafness!
What are the symptoms of the Measles (Rubeola)?
How about Secondary complications?
Measles Symptoms:
Cough Rhinitis HIGH fever Red Eyes Macropapular Rash
Secondary complications:
Pneumonia
Inflammation of Brain (Encephalitis)
Diarrhea
Blindness
Symptoms:
Cough Rhinitis HIGH fever Red Eyes Macropapular Rash
Secondary complications:
Pneumonia
Inflammation of Brain (Encephalitis)
Diarrhea
Blindness
Measles (Rubeola)
affects more people Mumps or Measles?
Measles… 20 Million worldwide w/ 90K deaths a year
What are the symptoms of the Mumps)?
How about Secondary complications?
Symptoms:
Parotitis Pain muscles Pain head (headache) Fever Fatigue
Secondary complications:
Permanent Deafness
Pancreatitis
Meningitis
Gonadal Swelling
Symptoms:
Parotitis Pain muscles Pain head (headache) Fever Fatigue
Secondary complications:
Permanent Deafness
Pancreatitis
Meningitis
Gonadal Swelling
Mumps
Where do you find GP 120 and GP 41?
How do they interact with cells (attachment)?
How about P24?
GP-120 and GP-41 are on the envelope of the HIV virus.
GP-120 is the outer circular surface antigen.
GP-41 is the transmembrane protein.
GP-120 attaches to CD-4 (or coinfects w/ another retrovirus)
GP-41 attaches to CXCR-4.
P24 is the capsid (protein) that surrounds the core. The core has two single-strands of HIV-1 (or HIV-2) RNA as well as Reverse Transcriptase.
What type of virus is HIV? What name does it have and why (i.e. what does it use to create a new viral DNA)?
What happens to the new viral DNA?
HIV is an RNA Virus.
It is called a Retrovirus because it uses Reverse Transcriptase. This means that it has Reverse Transcriptase instead of RNA polymerase and it uses RNA strands as a template to produce new viral DNA.
The new viral DNA is incorporated into the host cell’s DNA— remains latent for a prolonged period of time.
What are the 6 steps mentioned as interaction between HIV & Cells?
Which two are unusual?
- Attachment
- RNA strands enter the host cell
***3. Reverse Transcriptase produces new viral DNA
***4. Viral DNA into host cell’s DNA
*** = UNUSUAL CHARACTERISTICS
- Alters CD4 ability to produce cytokines
- New virions released from infected cells by BUDDING (ultimately kills the CD4 cell)
what types of cells does HIV infect primarily?
CD4 Helper T-cells
Monocytes
Macrophages
What are the names and estimated time periods of the Stages of HIV infection?
Stage 1 — Primary HIV Infections– 1 to 4 months
Stage 2 — Latent (asymptomatic) period
Stage 3 — Persistent Generalized Lymphadenopathy or AIDS related Complex (ARC)
Stage 4 — AIDS (Acquired Immune Deficiency Syndrome) AKA Symptomatic Period
Stage 1 of HIV name?
Shedding causes what to be detectable?
S/S’s?
When does it transition to the next phase?
Stage 1 — Primary HIV Infections– 1 to 4 months
At a MODERATE RATE it Sheds causing p24 antigen to be detectable 2-6 weeks after infection (antibodies of p24 detectable)
S/S’s: Mononucleosis-like or “flu-like” symptoms
Fever, night sweats, malaise, rash, muscle and joint pain, and Possible Lymphadenopathy
After 1 to 3 weeks of symptoms it becomes “asymptomatic” causing the transition to next phase or Latent (asymptomatic) period
Stage 2 of HIV name?
Shedding causes what to be detectable?
S/S’s (what is decreasing and at what rate)?
When does it transition to the next phase?
Stage 2 — Latent (asymptomatic) period
Viruses replicate and shed at LOW rate; HIV antibodies are detectable (not p24 antigen)
NO S/S’s (asymptomatic), but CD4 gradually decreasing
Transitions is when replication and shedding increases to HIGH rate and Antibody to p24 diminishes yet p24 antigen becomes elevated again like stage 1
Stage 3 of HIV name?
Shedding at what rate… causes what to be detectable?
S/S’s ? When do opportunistic infections begin?
Rate of CD4 decrease?
When does it transition to the next phase?
Stage 3 — Persistent Generalized Lymphadenopathy or AIDS related Complex (ARC)
Virus replication and shedding at HIGH RATE– p24 antigen elevated again; Antibody to p24 diminishes
PGL - Persistent Generalized Lymphadenopathy – Lymph nodes remain swollen for months with no other signs of infection. Night sweats, weight loss, diarrhea.
- Karposi’s sarcoma.
- Opportunistic infections - develop when CD4 are less than 300 / mm3 and you start to see Oral yeast infections, Recurrent shingles, Bacterial skin infections
Gradual reduction of CD4 count
what is not detectable in stage 2 of HIV?
p24 antigens!!! the antibody is detectable… NOT the antigen!
What is a huge transition point from stage 2 to stage 3 of HIV?
Virus replication and shedding at HIGH RATE– p24 antigen elevated again; Antibody to p24 diminishes
When do we start seeing opportunistic infections begin?
Stage 3 — Persistent Generalized Lymphadenopathy or AIDS related Complex (ARC)
-Opportunistic infections - develop when CD4 are less than 300 / mm3 and you start to see Oral yeast infections, Recurrent shingles, Bacterial skin infections
What is the first sign of clinical aids?
Chronic oropharyngeal and esophageal candidiasis
Candida Albicans causing
Stage 4 of HIV name?
CD4 level? What about CD8 and antibodies?
CMI and Humoral Immunity?
S/S’s of the opportunistic infections begin?
Stage IV – AIDS [Acquired Immune Deficiency Syndrome] (symptomatic period)
Significant decrease of CD4 cells (<200/mm3);
- moderate decrease of CD8 cells.
- Antibodies to HIV are ineffective.
No CMI or HI
(b) Opportunistic infections – become more severe as CD4 count decreases
• Tuberculosis
• Pneumocystis carinii (protozoan) – pneumonia
• Fungal infections: Histoplasmosis, Coccidioidomycosis, Cryptococcal meningitis
• Toxoplasmosis gondii (protozoan) – brain
• Herpes simplex virus, types 1 and 2
• Cryptosporidium – intestinal
• Cytomegalovirus – retina, esophagus, colon
• Mycobacterium avium complex – disseminated
(c) Central Nervous System involvement – Dementia
What are the dermatophytes (3)?
What doe they cause?
Microsporum, Trichophyton, Epidermophyton
Tinea capitus (ring worm of scalp) Tinea pedis (athlete's foot) Tinea corporis Teina cruis (jock itch) toenail fungal infection
If you see tinea think?
Dermatophytes:
Microsporum, Trichophyton, Epidermophyton
FUNGI
Toxin with server symptoms?
Toxin without symptoms or milder?
Aspergillus flavus - toxin that causes often severe liver damage improperly stored nuts, grains, seeds and other foods (moisture)
Stachybotrys chartarum - mycotoxins that pose increased risk of allergy and asthma
Tinea pedis and tinea capitis?
Dermatophytes:
Microsporum
Trichophytic
Epidermophytic
Thrush
Candida albicans
Systemic infection called “Desert Fever”
Coccidiodes immitis
Meningitis due to microbe with thick capsul
Cryptococcus neoformans
Vaginitis
Candida albicans
PID = Peptostreptococcus
wood splinter trauma leading to SUBCUTANEOUS LESION
Sporothrix schenckii
Pulmonary infection following inhalation of spores in Ohio or Missouri
Histoplasma capsulatum
Opportunistic infection of the fingernails
Candida albicans #1 ( and also Dermatophytes)
Two “cold-like” viruses
Adenovirus
Parainfluenza
Pleurodynia and myocarditis
Enterovirus AKA Coxsackie
croup and bronchitis, especially in children
1 - Parainfluenza
outbreaks late winter - early spring
shedding for weeks
Affects all ages
similar to RSV
common cold, bronchiolitis, pneumonia, croup
Human Metapneumovirus (hMPV)
6 A’s of Adenovirus
ARD 80% in military recruits
Atypical pneumonia
A cold-like disease
A cause of GI
A cause of conjunctivitis
Also sore throat and cystitis
congenital leads to impairment of CNS
Cytomegalovirus (CMV)
congenital cytomegalic inclusion disease in children
CMV w/ mono, microcephaly, jaundice, multiple organs
impairment of CNS mental/physical retardation
Febrile mononucleosis
pneumonitis, hepatitis, GI ulcerations, encephalopathy
weakened CMI
Cytomegalovirus (CMV)
These are seen in the latent virus infection in immunosuppressed/compromised, AIDS, transplants, etc
conjunctivae affected
Leptospira (fever, headache, myalgia, chills conjunctival involvment leading to renal and liver failure)
Adenovirus
Herpes simplex (keratoconjunctivitis)
Measles (red eyes and secondary blindness)
Dengue Fever (conjunctivitis w/ breakbone)
Zika (conjunctivitis w/ headache (w/ GBS?)
(Arguably many/all of the Hemorrhagic Fever’s as well)
(fever, headache, myalgia, chills conjunctival involvment leading to renal and liver failure)
Leptospira interrogans
(keratoconjunctivitis)
Herpes simplex
(red eyes and secondary blindness)
Measles
(conjunctivitis w/ breakbone)
Dengue Fever
conjunctivitis w/ headache (w/ GBS?)
Zika (semen can pass on, as well as mosquitoes, or from mother via blood to fetus)
S/S’s:
Fever, rash, joint pain
conjunctivitis w/ headache (w/ GBS?)
microcephaly
sore throat, cough, general body aches
EBOLA
Epstein-Barr virus (EBV)
Adenovirus (potentially)
Long term medical effects in survivors?
Ebola
EBOLA S/S’s:
sore throat, cough, general body aches
Sudden onset fever, intense weakness
vomitting, diarrhea, rash, internal & external bleeding
acute fever, flu-like, muscle aches, rash/ erythema/ petechiae
hemorrhage / capillary leakage
Inhalation of spores?
Histoplasma capsulatum
Coccidiodes immitus
Asperilligus fumigatus
If you suspect your patient has Ebola hemorrhagic fever, what do you need to differentiate the signs and symptoms from?
Lassa, Malaria, Typhoid, and other viral hemorrhagic fevers
What hemorrhagic fever virus causes fever, severe joint pain, conjunctivitis, and headache?
Dengue
- the primary common cold agent in infants & young children
Respiratory Syncytial Virus (RSV), aka Human Orthopneumovirus
What type of virus causes mucous membrane lesions or water warts on the skin and is transmitted via touching the affected skin?
DNA Poxvirus AKA Molluscum Contagiosum Virus (MCV)
How is Variola Major Virus spread?
spread via aerosolized virus in droplets and powdered scabs and rapidly inactivated by UV light and disinfectants
Variola Major Virus AKA smallpox
What fungal pathogen is part of the normal flora of the mouth, throat, large intestine, vagina, and skin and can cause opportunistic infections from mild to life-threatening?
Candida albicans
What fungal pathogen causes severe invasive infections, is often multi-drug resistant, is difficult to identify with standard lab methods, and causes outbreaks in healthcare settings?
Candida auris
What are white patchy lesions in the mouth and are most common in infants?
Oral thrush
Select the correct pairing.
Hepatitis B—enveloped RNA virus
Hepatitis A—small, enveloped DNA virus
Hepatitis C—small, lipid-enveloped RNA virus
Norwalk—enveloped RNA
Hep C - small, lipid-enveloped RNA virus
_____ are deposited around the perianal region
Requiring which test?
Pinworm eggs (Enterobius vermicularis)
Pinworm Prep- Scotch Tape Prep
