Sheet3-表格 1 Flashcards
What disesase does Trichomonas Vaginalis cause?
Vaginitis: foul-smelling, greenish discharge; itching and burning
What do you tx P. Carinii with?
TMP-SMZ, or pentamidine, or dapsone
What do you use to culture cryptococcus?
Sabouraud’s Agar
What do you use to Diagnose E. Histolytica?
Serology and/or trophozoites or cysts in stool
What do you use to stain Cryptococcus?
India Ink
What do you use to tx cryptosporidium?
nothing
What do you use to Tx Giardiasis?
Metronidazole
What do you use to tx T. Vaginalis?
Metronidazole
What do you used to dx P. Carinii?
Lung biopsy or lavage, methenamine silver stain
What do you used to Tx Candida Albicans?
Nystatin for superficial infection, Amphotericin B for systemic
What does Alba mean?
white
What does dimorphic mean?
fungi that are mold in the soil (low temp) and yeast in tissue (higher/body temp 37 C)
What is diagnostic for L. donovani?
Macrophages containing amastigotes
What is diagnostic of T. Vaginalis?
Trophozoites on wet mount
What is histoplasmosis associated with?
bird or bat droppings
What is the progression of S. Schenckii infection?
traumatic introduction into the skin, typically by a thorn (‘rose gardner’s’ disease) , causes local pustule or ulcer with nodules along draining lymphatics (ascending lymphangitis) . Little systemic illness.
What is the vector for L. donovani?
Sandfly
What is the vector for T. Cruzii?
Reduviid Bug
What is the vector for T. Gambiense and Rhodesiense?
Tsetse fly
What is used to dx African sleeping sickness?
Blood smear
What is used to dx T. Cruzii?
blood smear
What is used to dx toxoplasma?
serology and biopsy
What is used to treat D. Medinensis?
Niridazole
What is used to Treat E. Histolytica?
Metronidazole and Iodoquinol
What is used to tx african sleeping sickness?
Suramin for bloodborne disease or melaroprol for CNS penetration
What is used to tx Ancylostoma duodenale?
Mebendazole/pyrantel pamoate
What is used to tx Ascaris Lumbricoides?
Mebendazole/pyrantel pamoate
What is used to tx Clonorhis sinensis?
Praziquantel
What is used to tx E. Granulosus?
Albendazole
hug my baby~
kiss u~
What is used to tx E. Vermicularis?
Mebendazole/pyrantel pamoate
What is used to tx L. Donovani?
Sodium Stibogluconate
What is used to tx Loa loa?
diethylcarbamazine
What is used to tx malaria?
Chloroquine ( primaquine for vivax, ovale) , sulfadoxine + pyrimethamine, mefloquine,
quinine
What is used to tx O. Volvulus?
Ivermectin
What is used to tx Paragonimus Wetermani?
Praziquantel
What is used to tx S. Stercoralis?
Ivermectin/thiabendazole
What is used to tx schistosoma?
Praziquantel
What is used to tx T. Canis?
diethylcarbamazine
What is used to tx T. Cruzii?
Nifurtimox
What is used to tx T. Spiralis?
Thiabendazole
What is used to tx taenia solium infection?
Praziquantel/niclosamide; albendazole for cysticercosis
What is used to tx toxoplasma?
sulfadiazine + pyrimethamine
What is used to tx W. Bancrofti?
diethylcarbamazine
What patient population is susceptible to Mucor disease?
Ketoacidotic patients and Leukemic patients
What stain do you use for lung tissue when you are detecting P. Carinii?
silver
What state predisposes you to P. Carinii infection?
Immunosuppression
What test can be used to detect polysaccharide capsular antigen of Cryptococcus?
latex agglutination test
What types of infections can Candida Albicans cause?
systemic or superficial fungal in fections
When do you start prophylaxis in HIV patients?
when the CD4 drops below 200 cells/mL
Where do the mucor and rhizopus species fungi proliferate?
in the walls of blood vessels and cause infarction of distal tissue
Where is Blastomycosis endemic?
States east of the Mississippi River and Central America
Where is Coccidioidomycosis endemic?
SWUS, California (San Joaquin Valley or destert (desert bumps) ‘Valley fever’)
Where is Histoplasmosis endemic?
Mississippi and Ohio River valleys
Where is Paracoccioidomycosis endemic?
Rural Latin America
All viruses are haploid except _________?(1)
Retroviruses, which have two identical ssRNA molecules (diploid).
Bites from what 3 animals are more prone to rabies infection than a bite from a dog?
Bat, Raccoon, and Skunk
Define complementation?
When one of 2 viruses that infects the cell has a mutation that results in a nonfunctional protein. The nonmutated virus ‘complements’ the mutated one by making a functional protein that serves both viruses.
Define genetic drift.
Minor changes based on random mutations.
Define genetic shift.
Reassorment of viral genome (such as when human flu A virus recombines with swine flu A virus.)
Define phenotypic mixing?
When virus A acquires virus B coat proteins and acts like virus B but its progeny will
have virus A genome and coat.
Define reassortment?
- When viruses with segmented genomes (eg. infl uenza virus) exchange segments.
- High frequency recombination. Cause of worldwide pandemics.
Define recombination?
Exchange of genes between 2 chromosomes by crossing over within regions of significant base sequence homology.
Describe its incubation period and whether or not it has a carrier.
- Short incubation period (3 weeks)
- No carriers
Describe its incubation period and whether or not it has a carrier.
- Long incubation (3 months)
- has carriers
Describe the general concept of bacterial super infection which can occur with
influenza infection? S
A life-threatening illness where a bacterial infection is superimposed on an existing
viral infection.
Describe the genetic and physical properties of influenza virus?
- Enveloped
- ssRNA virus with segmented genome
- prone to genetic changes
Describe the migration of rabies within the CNS.
It migrates in a retrograde fashion within the CNS up n. axons.
Describe the physical shape and duration of incubation for rabies.
- Bullet-shaped capsid (illus. in book)
- long incubation period (wks. - 3 months)
Describe the technique and purpose for performing a Tzanck test?
- assay for herpes
- make a smear of an opened skin vesicle to detect multinucleated giant cells
Describe whether or not it has a carrier.
has carriers
Does HDV have carriers?
Yes
Explain the concept of a slow virus infection.
Virus exists in patient for months to years before it manifests as clinical disease.
From the following selection which classes are considered infectious and which aren’t:
dsDNA, ds RNA, (-)ssRNA, (+) ssRNA.
- Infectious: dsDNA (except poxviruses and HBV) and (+) ssRNA
- Noninfectious: dsRNA and (-) ssRNA
HCV is a common form of hepatitis in what US population?
IV drug users
How does a Monospot test work?
It detects heterophil antibodies by agglutination to sheep RBC’s
How is RNA translated and processed in picornaviruses?
RNA is translated into one long polypeptide that is cleaved by proteases into many small proteins.
How many segments and what sense is the RNA genome of influenza viruses?
- 8 segments
- negative sense
How many serotypes do paramyxoviruses have except parainfluenza which has ___?
- 1 - 4
Into what class RNA or DNA to all segmented viruses fall?
RNA
Killed vaccines induce what type of immunity?
Humoral, with no possibility of the virus reverting to virulence
Live attenuated vaccines induce what type of
immunity?
Humoral and Cellular - with a risk of the virus reverting to virulence
Mneumonic for rotavirus symptoms: ROTA
Right Out The Anus
Mneumonic: Hep D:
Defective, Dependent on HBV
Mneumonic: Hep E:
Enteric, Expectant mothers, Epidemics
Mneumonic: Hep A:
Asymptomatic (usually)
Mneumonic: Hep B:
Blood-borne
Mneumonic: picoRNAvirus
pico = ‘small’ RNA viruses
Name 2 common bacterial infections in AIDS pts.
TB, M. avium-intracellulare complex
Name 2 common protozoan infections in AIDS pts.
Blood-borne pico = ‘small’ RNA viruses
Name 3 members of the arborvirus family.
Flavivirus, Togavirus, and Bunyavirus
Name 3 possible sequelae of measles infection?
- SSPE
- encephalitis
- giant cell pneumonia (rare;found in immunocompromised persons)
Name 4 common fungal infections in AIDS pts.
- Thrush (Candida ablicans)
- cryptococcosis (cryptococcal meningitis)
- histoplasmosis
- Pneumocystis pneumonia
Name 4 common viral infections in AIDS pts.
- HSV
- VZV
- CMV
- progressive multifocal
leukoencephalopathy (JC virus)
Name 4 herpesviruses using the mneumonic: Get herpes in a CHEVrolet.
- CMV
- HSV
- EBV
- VZV
Name 4 main segmented viruses using the mneumonic BOAR.
- Bunyaviruses
- Orthomyxoviruses (influenza virus)
- Arenaviruses
- Reoviruses
Name eveloped DNA viruses (3). HPH
- Hepadna
- Pox
- Herpes
Name naked DNA viruses (3). PAP
- Parvo
- Adeno
- Papova
‘You need to be naked for a PAP smear.’
Name the 3 naked RNA viruses Naked CPR).
- Calcivivirus
- Picornavirus
- Reovirus
Name the characteristic cytoplasmic inclusions seen in neurons infected with rabies.
Negri bodies
Name the DNA enveloped viruses (3).
- Herpesviruses (herpes simplex virus types 1 and 2, VZV, CMV, EBV)
- HBV
- smallpox virus
Name the DNA nucleocapsid viruses (2).
Adenovirus, Papillomaviruses
Name the DNA viruses using the mneumonic ‘HHAPPPy viruses.’
- Hepadnavirus
- Herpesviruses
- Adenovirus
- Parvovirus
- Papovavirus
- Poxvirus
Name the illness caused by rabies and 2 primary symptoms.
Encephalitis, fatal is not prevented, with seizures and hydrophobia.
Name the members of the PaRaMyxovirus using the letters in bold (4 viruses).
- Parainfluenza
- RSV
- Measles
- Mumps
Name the recombinant vaccine available (1).
HBV (antigen = recombinant HBsAg)
Name the RNA enveloped viruses (9).
- Influenza viruses
- parainfluenza viruses
- RSV
- measles
- mumps
- rubella
- rabies
- HTLV
- HIV
Name the RNA nucleocapsid viruses (3).
- Enteroviruses (poliovirus, coxsackievirus, echovirus, hepatitis A virus)
- rhinovirus
- reovirus
Name the vaccines that are killed (4).
- rabies
- influenza
- hepatitis A
- SalK=Killed
Name the vaccines that are live attenuated (6).
- MMR
- Sabin polio
- VZV
- yellow fever
Of these 3 markers (HBsAg, HBsAb, HBcAg), which ones are positive in each of the 4 phases below: (acute disease, window phase, complete recovery, chronic carrier).
- HBsAg, HBcAg
- HBcAg
- HBsAb, HBcAg
- HBsAg, HBcAg
On HIV, what is gp41 and gp120?
envelope protein
On HIV, what is p24? (illus. p. 205)
rectangular nucleocapsid protein
Roughly, what are the time periods for acute, latent, and immunodefi cient stages of HIV?
Acute: 1-3 months
Latent: 3 months-3 years
Immunodeficient.: 3 yrs.- death
(diagram p. 205 that follows serologic course).
Statement: HEV resembles HAV in:
course, severity, and incubation,
Use the mneumonic PERCH to name members of the Picornavirus family.
- Poliovirus
- Echovirus
- Rhinovirus
- Coxsackievirus
- Hepatitis A
Viral nucleic acids with (choose) same/different nucleic acids as host are infective alone; others require special enzymes (contained in intact virion.)
same
What 2 antigens are used to classify influenza?
Neuraminadase, Hemagglutinin
What age group is the primary target of
paramyxoviruses?
children
What antiviral treatment is approved for influenza A (especially prophylaxis) but not for influenza B & C
Amantadine and Rimantadine
mua~~
kiss kiss~
What antiviral treatment is approved for influenza A and B?
Zanamivir
What are Councilman bodies and what are they pathomneumonic for?
acidophilic inclusions seen in the liver of those with yellow fever
What are the 3 C’s of measles?
- Cough
- Coryza
- Conjunctivitis
What are the 4 C’s of HCV.
Chronic, Cirrhosis, Carcinoma, Carriers
What are the 4 most common diseases caused by prions?
- Creutzfeldt-Jakob disease (CJD: rapid progressive dementia) - kuru - scrapie (sheep) -'mad cow disease'
What are the causes of SSPE and PML in
immunocompromised pts.
- Late sequelae of measles
- Reactivation of JC virus
What are the common diseases (1) and routes of transmission(1) for HHV-8?
- high fever
- black vomitous
- jaundice
What are the common diseases (1) and routes of transmission(1) for HHV-8?
- Kaposi’s sarcoma (HIV pts.)
- sexual contact
What are the common diseases (2) and routes of transmission(2) for EBV?
- infectious mono, Burkitt’s lymphoma
- resp. secretions, saliva
What are the common diseases (2) and routes of transmission(2) for HSV-2?
- herpes genitalis, neonatal herpes
- sexual contact, perinatal
What are the common diseases (3) and routes of transmission(1) for VZV?
- varicella zoster (shingles)
- encephalitis
- pneumonia
What are the common diseases (3) and routes of transmission(2) for HSV-1?
- gingivostomatitis keratoconjunctivitis temporal lobe encephalitis herpes labialis
- respiratory secretions and saliva
What are the common diseases (3) and routes of transmission(6) for CMV?
- congenital infection, mono, pneumonia
- congenital, transfusion, sexual contact, saliva, urine, transplant
What are the general characteristics of a prion?
infectious agent that does not contain RNA or DNA, consists only of protein
What are the major viruses of the paramyxovirus family? (4)
- parainfluenza (croup)
- RSV
- Measles
- Mumps
What are the primary symptoms of the mumps virus? (MOP)
- aseptic Meningitis
- Orchitis
- Parotitis (mumps give you bumps = parotitis)
What are the primary viruses of the picornavirus family? (PERCH)
- Poliovirus
- Echovirus
- Rhinovirus
- Coxsackievirus
- Hepatitis A
What are two classic illness caused by arborviruses?
- dengue fever (break-bone fever)
- yellow fever
What general form of encephalopathies do prions present as?
spongiform encephalopathies
What genetic property does segmentation afford viruses and how does this play into
flu epidemics?
- Segmentation allows reassorment to occur in RNA viruses
- this contributes to antigenic shifts which cause most flu pandemics.
What group has a high mortality rate from HEV?
pregnant women
What hematologic finding is characteristic of mono?
abnormal circulating cytotoxic T cells (atypical
lymphocytes)
What is HBcAb, and what does it indicate?
Antibody to HBcAg; IgM HBcAb indicates recent disease
What is HBcAg?
Antigen associated with core of HBV
What is HBeAb, and what does it indicate?
Antibody to e antigen; indicates low transmissibility
What is HBeAg, and what does it indicate?
it is a 2nd differrent antigen marker of HBV core; indicates transmissibility (HBeAg=Beware)
What is HBsAb, and what does it do?
Antibody to HBsAg; provides immunity to hepatitis B
What is HBsAg, and what does it indicate?
Antigen found on surface of HBV; continued presence indicates carrier state
What is IgM HAVAb, and what is it used to detect?
IgM antibody to HAV; best test to detect active hepatitis A
What is meant by the ‘window period’ in HBV infection, and what is positive in this period?
It is the period between disappearance of HBsAg and appearance of Anti-HBs; HBcAb is pos. during this period.
What is the classic vector for arborvirus?
Arthropods (mosquitos, ticks, etc.) ARBOR=Arthropod Borne
What is the function of reverse transcriptase in HIV?
synthesize dsDNA from RNA for integration into host genome.
What is the major mode of protection from influenza virus?
Killed viral vaccine which is reformulated each year and is given to those in high risk of
infection (elderly, health-workers, etc.)
What is the method behind ELISA/Western blot and during what period of HIV
infection are they often negative?
look for abs to viral proteins; false negatives common in first 1-2 months of infection
What is the mneumonic for remembering the Tzanck smear?
Tzanck heavens I don’t have herpes.
What is the only DNA virus that is not double stranded?
Parvoviridae (ssDNA)
What is the only RNA virus that has dsRNA?
Reoviridae [‘repeatovirus’ (reovirus) is
dsRNA]
What is the viral cause of the common cold?
- Rhinovirus, 100+ serotypes
- Rhino has a Runny nose.
What neurologic infection can picornaviruses (except rhinoviruses and hepatitis A
viruses) cause?
Aseptic Meningitis
What physical finding is diagnostic for measles?
Koplik spots (bluish-gray spots on buccal mucosa)
What population should not receive a live vaccine?
Those who are immunocompromised and their close contacts.
What reproductive complication can mumps
cause?
sterility; especially after puberty
What shape are all the DNA viruses? Which virus (1) is the exception?
- Icosahedral
- Poxvirus (complex)
What test is used to make thepresumptive dx of HIV, and then, which test confirms the dx?
ELISA (sensitive w/ high false + and low threshold); Western blot (specifi c, high false - rate with high threshold)
What tests are gaining popularity for monitoring drug tx efficacy in HIV?
PCR/viral load tests
What type of genome does HIV have?
diploid RNA
What type of nucleic acid structure does rotavirus have?
segmented dsRNA
What type of transcription occurs and what type of polymerase does it possess?
- Reverse transcription
- the virion contains an RNA
- dependent DNA polymerase
What type of virus is HAV and how is it transmitted?
- RNA picornavirus
- fecal
- oral route
What type of virus is HBV and how is it transmitted?
- DNA hepadnavirus
- parenteral, sexual, and maternal
- fetal routes
What type of virus is HCV and how is it transmitted?
- RNA flavivirus
- via blood and resembles HBV in its course and severity
What type of virus is HDV and what is special about its envelope?
- delta agent, it is a defective virus
- requires HBsAg as its envelope
What type of virus is HEV and how is it transmitted?
- RNA calicivirus
- enteric transmission; causes water-borne epidemics
What variant of dengue fever is found in Southeast Asia?
hemorrhagic shock syndrome
What virus causes and what are the classic symptoms of mononucleosis?
- EBV
- fever, hepatosplenomegaly, pharyngitis,
lymphadenopathy (esp. posterior auricular nodes)
What virus causes yellow (=flavi) fever, and what is its vector and reservoirs (2)?
- flavivirus
- Aedes mosquitos
- monkey or human reservoir
What virus is the most common global cause of infantile gastroenteritis and acute diarrhea (in the US).
Rotavirus
Where do enveloped viruses acquire their envelopes, and what virus is the exception to
this rule?
- Plasma membrane
- Herpesviruses which acquire their envelope from the nuclear membrane
Where in the cell do DNA viruses replicate, and which virus is the exception to this
rule?
- Nucleus
- exception:
poxvirus in cytoplasm (carries DNA-dependent RNA polymerase)
Where in the cell do RNA viruses replicate, and what 2 viruses are the exception to
this rule?
- Cytoplasm
- exception: influenza virus and retroviruses
Which marker tests are appropriate for each phase of hepatitis infection:
Incubation, Prodrome/acute
illness, Early Convalescence,
Late Convalescence.
- HBsAg
- HBsAg (Anti-HBc)
- Anti-HBc
- Anti-HBs (anti-HBc)
Which two DNA viruses don’t have a linear genome? (they’re circular)
Papovaviruses and Hepadnaviruses
Which two hepatitis viruses follow the fecal-oral route?
A and E; ‘The vowels hit your bowels.’
Which two hepatitis viruses predispose to hepatocellular carcinoma?
HBV and HCV
Why is mono called the ‘kissing disease?’
- Peak incidence occurs during peak kissing years 15-20 yo
- (saliva transmission)
3 main roles of Ig binding to bacteria
- opsonization
- neutralization
- complement activation
A defect in phagocytosis of neutrophils owing to lack of NADPH oxidase activity or similar enzymes is indicative of what immune deficiency disease?
Chronic granulomatous disease
After exposure to what 4 things are preformed
(passive) antibodies given?
Tetanus toxin, Botulinum toxin, HBV, or Rabies.
All nucleated cells have what class of MHC proteins?
class I MHC proteins
Anaphylaxis, asthma, or local wheal and flare are possible manifestations of which type
of hypersensitivity?
Type I
Anti-gliadin autoantibodies are associated with what disease?
Celiac disease
Anti-Scl-70 autoantibodies are associated with what disease?
diffuse Scleroderma
Autoimmune hemolytic anemia, Rh disease
(erythroblastosis fetalis), and Goodpasture’s syndrome are examples of what kind of
hypersensitivity reaction?
type II hypersensitivity
Class I major histocompatibilty complex
consists of …
1 polypeptide, with B2-microglobulin
Class II major histocompatibilty complex
consists of …
2 polypeptides, an a and a B chain
Cytotoxic T cells have CD(?), which binds to class (?) MHC on virus-infected cells.
CD8 binds to class I MHC
Define acute transplant rejection.
Cell-mediated due to cytotoxic T lymphocytes
reacting against foreign MHCs. Occurs weeks after transplantation.
Define adjuvant.
Adjuvants are nonspecific stimulators of the immune response but are not immunogenic by themselves.
Define chronic transplant rejection.
Antibody-mediated vascular damage (fibrinoid necrosis)–irreversible. Occurs months to years after transplantation.
