Thurs Wk 3 Infectious Disease 1 Flashcards

1
Q

HBV produces __ protein that activates synthesis of IGF1/2
also suppresses __ to allow cell cycle progression
over time, as mutations accumulate, __ develops due to viral integration

IgM against HBcAg indicates __/__ infection

can cause massive decline in HCC numbers by __ against HepB

A

HBx
p53
HCC

acute/recurrent

vaccinating

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2
Q

pt w hypoTN, tachycardia/pnea and fever has __ shock
cardiac output is __ early, w peripheral __ and warm extremities
later, SV/CO__ and hypopefusion presents
mediators include __/__/IL6

__ is released to recruit lymphs/activate phagocytosis

pt w aortic regurg and mediastinal widening w positive FTA-ABS has __
begins w __ endarteritis and obliteration
this results in ischemia, and __ of adventitia leading to dilation
FTA-ABS is _ for syphilis

A

septic
inc, VD
dec
TNFA, IL1

INFG

tertiary syphillis
vaso vasorum
weaking

specific

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3
Q

pt w vomiting, D, muscle pains and erythroderma w tampon/nasal packing has __
leads to __ dysfxn w desquamative rash over palms/soles
produces TSST that interacts w APC like __ and variable region of helper T
widespread activation w release of __ resulting in shock

dec bactraial catalase peroxidase provides resistance to I__
must be converted to __ form by catalase peroxidase to stop mycolic acid synthesis

Rifampin inhibits __ dependent RNA poly

A

TSS
multiorgan
Macros
cytokines

isoniazid
active

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4
Q

pt w genital ulcer that is solitary, painless and heaped up has __
gram neg __ that cannot be gram stained
dx w __ tests like VPRL/RPR has high rate of __ due to antibody response taking 4w
use __ test like FTA-ABS instead

gold standard for dx is scraping and visualization on __ w spirochetes

pt w painless ulcer that spreads to LN w painful LAN has __ serovars of CT
usualy in T__ regions

A
Syphilis
spirochete
nontreponemal, false neg
treponemal
DFM

L
tropical

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5
Q

multiple painful, superficial vesicles/ulcerations on erythematous base has __
dx w __ smear or PCR

Deep, purulent, painful ulcer w LAN has H__ chancroid
small gram neg __
Dx w __ and culture/PCR

Klebsiella granulomatis has painless, prog red ulcers w out __
preferred dx is __

A___ is NRTI used for AIDS
AHR assc w HLA __, which alters presentation of self peptides and leads to __ HS rxn
pt has f, malaise, GI sx and delayed __

NNRTI E/N not assc w HLA alleles
may have __ rash or liver enzyme elevation

A

HSV
tzank

h ducreyi
rod
gram stain

LAD
biopsy

Enfavirenz, nevirapine
SJS

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6
Q

E__ is NRTI assc w rash on palms/soles

acquisition of new viral __ protein is necessary to infection new host cells
if avian/human virus mixes, and avian virus can now infect humans, but progeny cannot, __ mixing has occurred
unchanged __ genome w envelope proteins of another strain
due to lacking genetic change, progeny will __ to only having avian properties

Re__ is when segmented viruses exchange whole segments
Re__ is when DNA molecules cross over and exchange DNA

A

emtricitabine

surface
phenotypic
parenta
revert

reassortment
rearranging

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7
Q

EBV infects __ cells and forces them to continuously proliferate called immortilazation
EBV oncogenes activate proliferative and anti-__ signaling pathways
Immune response keeps it __ but can release Ig/B cell products

Pyranazimide must be converted to active form by P___ thus downregulating it can lead to resistance

Isoniazid can also have resistance due to modifying the __ site

A

mature B
apoptotic
held out

pyranazaminidase

binding

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8
Q

__ binds ergosterol to cause fungal cell lysis
can have acute __ related rxn, which can be prevented w antipyretic
has dose dependent __ by dec GFR, so monitor creatinine
may cause __ due to dec renal EPO prodxn
may have T__ at site of inject

Griseofulvin binds __ proteins

Pt w Mono like sx but no sore throat/LAD probably has __ mono
neg to __ antibody test
commonly from infusion of __ blood products, as virus infects leuks of G/M lineage
in either EBV/CMV look for atypical __

A
Amphotercin B
injection
nephrotoxicity
anemia
thrombophlebitis

microtubule

CMV
heterophile
leukocytes
granulocyte/macrophage
lymphocytosis
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9
Q

HIV binds to __/__ via gp120
CCR5 chemokine allows for HIV fusion w cell __
those who do not express __ are resistant to HIV

_ gene in HIV dec expression of MHC class 1
Tat for viral \_\_

NNRTI do not require activation via __
includes N/E
SE include __ rash, hepatotox, and neuropsych

NRTI have __ at end or Abacavir/Tenofovir
Se include LA, lipo__, Panc w D__, BM suppression w Z

Protease inhibs are -__ drug
se include __ comps

Integrase inhibs are -__ drug
se is m__

A

CD4, CCR5
membrane
CCR5

Nef
replication

phos
Nevirapine, efavirenz
SJS

ine, distrophy, Didanosine, zidovidine

navir
metabolic

gravir
myopathy

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10
Q

Penicillins inhibit T__ to stop final cross linking step
joins AA at __ position in peptidoglycan molecule
structurally similar to D-__ d- alanine, allowing for integration
cell wall synth stops, and degredation occurs via bacterial __

Vanc is glycopeptide that binds same residues at __ step

S__ antibiotics compete w PABA for incoporation into FA
T__ inhibits DHFR

A

tranglycosylase
3rd
alanine
autolysins

earlier

sulfonamides
trimethorpim

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11
Q

Double stranded DNA enveloped viruses include H__ like hepB, herpes, and P__

nonenveloped include A__, papova like __, and polymoma like __

vesicles on lips, hard palate, fever LAD is __ in child
lip lesions less severe due to __ from prior infection

if vesicles present on buccal mucose, tongue, soft palate and palms, soles, think __

A

Hepadana, pox

adenovirus, HPV, JC

HSV1
immunity

coxsackie A

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12
Q

infant w mother that has high viral load and HbEAg positive have high risk of __
viral replication occurs __ due to poor IS fxn
thus, infants have high viral load and __
become immune __ to form chronic HBV infection w only mild LFTs
high risk of cirrhosis and __
tx w HepB __ and Ig immediately

pt from LA w no immunocompromisation w seizure and cystic brain lesion has N__ from taenia solium
ingesting eggs from __ leads to cysticercosis
ingesting uncooked pork w larval __ leads to tapeworm infection
embryos attach/penetrate SI and migrate to __ to form fluid filled cyst
may have intracranial __ due to CSF obstrctio
look for cyst/__ on MRI
blood E__ and inc ESR
tx w A__

A
neonatal HepB
rapidly
HBeAg
tolerant
HCC
vaccination
neurocysticercosis
stool
cysts
brain
hypertension
scolex
eosinophilia
albendazole
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13
Q

Bacillus antracis has antiphagocytic __
also antrax __ w protective antigen, edema factor, and lethal factor
protective antigen transports other __ to cytosol
edema facor then acts as calmodulin dependent AC to inc __ prodxn
suppressing __/__
Lethal factor is __ dependent protease to inhibit protein kinase signal
causes A__ and multiorgan disruption

Bordetella pertussis also produces __ toxin producing immune suppression
pertussis toxin __ AC w inc cAMP levels and phagocyte dysfxn

A
capsule
toxin
toxins
cAMP
PMN/macro
Zn
apoptosis

AC
disinhibits

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14
Q

c diff toxin A recruits/activates __ w release of cytokines and fluid loss/diarrhea

Strep __ exotoxin acts as superantigen in strep TSS and scarlet fever

pt w restlessness, agitation, dysphagia, hydrophobia, aerophobia, pharyngeal spasm has __ enceph
virus travels retrograde via PN to __ ganglion and replicates in brain
prophylactic __ is preferred
postexposure prophylaxis w _ and inactivated vaccine by beta-propiolactone

w out tx leads to ascending __ paralysis

A

PMN

pyrogenic

rabies
dorsal root
vaccination
Ig

flaccid

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15
Q

__ fever caused by C burentti
acquired via __ of contaminated animal waste
acute Q fever has nonspecific __ illness for 10d
see debilitating __ that are retroorbital w photophobia
__ is common sx, w lobar presentation
Leuks are __
may see inc liver __ and thrombocytopenia
Chronic may present as infective __ in pt w valvular dz

M__ presents in immunosuppresed pt
may affect __ sinuses w facial/periorbital pain, HA, discharge
may have black __
broad, nonseptae hyphae branching at __ angles
tx w __ and amphotercin B

A
Q, inhalation
febrile
HA
PNA
normal
enzymes
endocarditis
mucormycosis
paranasal
eschar
right
surgery
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16
Q

bacteria have __ that provides shape/resistance to osmotic stress
if cell wall is destroyed, can be killed via placing in __ solution

never use __ for Tb unless pt has positive PPD and no xray findings

RF for parotitis include dec __ flow, meds like A__, obstruction due to N/C, dehydration or post intubation
usually bacterial due to S__
see firm, pre/post __ swelling
trsimus, D_ and systemic sx
Dx w __ showing duct inflammation/obstruction
inc salivary __

A

peptidoglycan cell wall
hypotonic solution

monotherapy

saliary, anticholinergics, neoplasm ,calculus
Staph aureus\
auricular
dysphagia
CT
amylase
17
Q

T lymphocytes protect against opportunistic __ from sperficial infections like esophageal/oral/cutaneous/__
PMN prevents against __ spread
thus, __ candida is seen in neutropenic pt

C perfringens is likely to cause gas __ in anaerobic enviro
visualize on __ to differentiate from necrotizing fasc
also produces late onset __ if ingested
spores germinate in __ and elaborate toxin w watery diarrhea

infant w oral thrush, interstitial PNA, and severe lymphopenia have vertical \_\_
all mothers w HIV must have \_\_
usually 2 N/NRTI and P/N/I inhib
avoid E\_\_ as it is teratogenic
infants treated w Z\_\_
A

Candida
vaginal
hematogenous
disseminated

gangrene
radiographs
gastroenteritis
GI tract

HIV1
HAART
protease, NN, integrase inhib
enfavirenz
ziduvodine
18
Q

pt w fever, systemic sx, relative bradycardia, ab pain diarrhea/constipation and rose spots on abdomen has __
must have recent __
can progress to H__ and ulceration of GI tract w bleeding
transmural necrosis can lead to intestinal __
pt w bile tract abnorms can allow it to __ in bile

D__ is lipopeptide antibiotic used against gram pos MRSA
creates transmembrane __ w ion leakage
cell membrane is __ w inhibition of protein synth
binds/inactivated by __ so do not tx PNA
ineffective against __ bacteria
SE is inc __ levels

Linezolid inhibits __ rRNA of 50s subunit
SE include T, __ neuritis and SS

A
Salmonelli typhi
travel
HSM
perforation
persist
daptomycin
pores
depolarized
surfactant
gram neg
CK

23s
thrombocytopenia, optic

19
Q

prevent recurrence of HSV2 w daily __
cannot tx latent forms, but suppresses __

ability to clot blood is __ test, positive in S Aureus

Gram + cocci catalase + is staph aureus
have __ hemolysis

Coag neg Staph novobiocin sensitive is S __
seen on __ devices
Novobiocin resistant is __

Flucytosine inhibits __/__ synthesis
used w amphotercin B in tx C__

A

valaciclovir
reactivation

coagulase

beta

epidermidis
intravascular
saprophyctus

DNA/RNA
cryptococcus

20
Q

pt w acute fever, thrombocytopenia, hemolytic anemia, inc LFTs, intraerythrocytic inclusions has B__ from Ixodes tick
pt w __ is at inc risk, presentingw ARDS
agent is Babesia __
found in __ US just like Lyme dz
dx w intraerythrocytic ring/__ cross forms

Aminoglycoside resistance from __ of ABP of 30s subunit
also can have protein that inactives A via altering its _

A
Babesiosis
splenectomy
microti
NE
maltese

methylation
structure

21
Q

__ inhibitors to tx HIV can lead to metabolic syndrome
lipo__ w redistribution of fat to ab/back
hyperglycemia by inc __
interactions due to __ metabolism
switch from rifampin to __

after HIV enters cell, it is transcribed to __ by RT
enters nuclease and inserts into host chromos via __
RNA poly 2 then transcribes __ to exit to cytoplasm and begin prodxn
Integrase inhibs thus prevent prodxn of __

M__ is CCR5 antag that prevents binding of HIV

A
protease
dystrophy
insulin resistance
p450
rifabutin

dsDNA
integrase
viral mRNA
viral mRNA

maraviroc

22
Q

Rotavirus can cause __ but is unlikely in US due to vaccination

N__ causes diarrhea/vomiting, w systemic sx
diarrhea is __ due to lack of SB inflammation
linear, _ stranded RNA virus
resistant to acid, bile and __ enzymes
transmitted via __ spread w outbreaks in crowded settings

A

gastroenteritis

norovirus
watery
single
pancreatic
FO