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PPS - From Nelson's > Viral, Parasites > Flashcards

Viral, Parasites Flashcards

1
Q

RNA virus

paramyxoviridae

A

Measles

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2
Q

used for influenza A and B

A

oseltamivir

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3
Q

use for RSV

A

aerosolised ribavirin

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4
Q

used to HSV encephalitis

A

acyclovir

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5
Q

used for CMV

A

ganciclovir

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6
Q

fusion of infected cells with multinucleated giant cells

warthin finkeldey giant cells

A

measles

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7
Q

4 phases of measles

A

incubation, prodromal, exanthematous, recovery

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8
Q

koplik spots appear

A

1-4 days prior to rash in measles

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9
Q

measles antibody appears after __ and lasts up to __

A

1-2 days, 1 month

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10
Q

most common cause of death in measles

A

pneumonia

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11
Q

most common complication of measles

A

acute otitis media

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12
Q

virus of SSPE missing this protein

A

M

involved in budding

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13
Q

diagnosis of SSPE at least one

A
  1. measles antibody in CSF
  2. EEG suppression burst episodes
  3. histologic brain tissue
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14
Q

DOC for SSPE

A

carbamazepine

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15
Q

vit A in measles

A

50, 000 <6mo
100, 000 6-12mo
200,000 >12mo

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16
Q

side effect of measles vaccine

A

thrombocytopenia

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17
Q

single stranded RNA

Togaviridae

A

rubella

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18
Q

maternal rubella infection most severe when

A

first 8 weeks of gestation

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19
Q

rose coloured lesions on oropharynx

A

Forchheimer spots

rubella

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20
Q

most serious complication of postnatal rubella

A

encephalitis

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21
Q

cns rubella similar to SSPE

A

PRP

progressive rubella panencephalitis

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22
Q

most common finding in congenital rubella

A

hearing loss with microcephaly

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23
Q

retinal finding in congenital rubella

A

salt and pepper retinopathy

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24
Q

most serious eye finding in congenital rubella

A

cataract

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25
Q

babies with congenital rubella can excrete virus up to

A

1 year

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26
Q

if preggers had exposure to rubella but with negative antibody

A

repeat test 2-3 weeks
if (+) in either 2nd or 3rd, infection happened
if (-), repeat 3rd test after 6 weeks, if all are (-) then no infection

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27
Q

single stranded RNA

family paramyxoviridae, genus rubulavirus

A

mumps

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28
Q

virus in mumps appears

A

in saliva up to 7 days before symptoms to 7 days after onset of parotid swelling

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29
Q

mumps meningitis manifests __ days after parotitis

A

5 days

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30
Q

T or F:

false negative PPD result after mumps vaccine

A

true

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31
Q

T or F:

egg allergy CI to measles vaccination

A

F

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32
Q

T or F:

egg allergy CI to mumps vaccination

A

T

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33
Q

positive stranded RNA

picornaviridae

A

polio

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34
Q

route of transmission polio

A

fecal oral

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35
Q

polio primarily infects

A

anterior horn cells (motor) and medulla oblongata (cranial nerve nuclei)

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36
Q

t or f:

polio has sensory deficit

A

motor and DTRs only

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37
Q

what is VAPP

A

vaccine associated paralytic polio

some vaccine strains/revertants develop neurovirulent phenotype leading to paralysis

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38
Q

best place to culture polio 1 week after illness

A

stool

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39
Q

maximum paralysis of polio __ days

A

2-3 days after onset of paralysis

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40
Q

t or f

breastfeeding reduces chances of enteroviruses

A

t

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41
Q

hand foot mouth disease frequently caused by

A

coxsakie a16

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42
Q

fever, soar throat, dysphagia, and lesions in posterior pharynx
dx? cause?

A

herpangina

enterovirus 71 but can also be coxsakie A

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43
Q

paroxysmal thoracic pain
dx?
cause?

A

pleurodynia or Bornholm disease

coxsakie B and echovirus

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44
Q

acute haemorrhagic conjunctivitis

A

enterovirus 70 and coxsakie a24

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45
Q

commonly implicated in myocarditis

A

coxsakie b

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46
Q

secondmost cause of orchitis (after mumps)

A

coxsakie

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47
Q

implicated in cases of nephritis and IgA nephropathy

A

enteroviruses

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48
Q

most common cause of viral meningitis in mumps immunised population

A

enteroviruses

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49
Q

css findings in enterovirus meningitis

A

slight pleocytosis, predominantly PMS in first 48 hours, normal or slightly low glucose, normal or slightly high protein

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50
Q

bacterial and viral ddx

Nonspecific febrile illness

A

BACTERIAL
Streptococcus pneumoniae, Haemophilus in uenzae type b, Neisseria meningitides
VIRAL
In uenza viruses, human herpesviruses 6 and 7, human parechoviruses

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51
Q

bacterial and viral ddx

Exanthems/enanthems

A

BACTERIAL
Group A streptococcus, Staphylococcus aureus, N. meningitides
VIRAL
Herpes simplex virus, adenoviruses, varicella-zoster virus, Epstein-Barr virus, measles virus, rubella virus, human herpesviruses 6 and 7, human parechoviruses

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52
Q

bacterial and viral ddx

Respiratory illness/conjunctivitis

A

BACTERIAL
S. pneumoniae, H. in uenzae (nontypeable and type b), N. meningitidis, Mycoplasma pneumoniae, Chlamydia pneumonia
VIRAL
Adenoviruses, in uenza viruses, respiratory syncytial virus, parain uenza viruses, rhinoviruses, human metapneumovirus, coronaviruses

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53
Q

bacterial and viral ddx

Myocarditis/pericarditis

A

BACTERIAL
S. aureus, H. in uenzae type b, M. pneumonia
VIRAL
coxsakie Adenoviruses, in uenza virus, parvovirus, cytomegalovirus

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54
Q

bacterial and viral ddx

Meningitis/encephalitis

A

BACTERIAL
S. pneumoniae, H. in uenzae type b,
N. meningitidis, Mycobacterium tuberculosis, Borrelia burgdorferi, M. pneumoniae, Bartonella henselae, Listeria monocytogenes
VIRAL
Herpes simplex virus, West Nile virus, in uenza viruses, adenoviruses, Epstein-Barr virus, mumps virus, lymphocytic choriomeningitis virus, arboviruses, human parechoviruses

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55
Q

bacterial and viral ddx

Neonatal infections

A

BACTERIAL
Group B streptococcus, Gram-negative enteric bacilli, L. monocytogenes, Enterococcus
VIRAL
Herpes simplex virus, adenoviruses, cytomegalovirus, rubella virus, human parechoviruses

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56
Q

erythema infectiosum or fifth disease

aplastic crisis

A

parvovirus b19

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57
Q

target cells of parvovirus

A

erythroid

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58
Q

most sensitive trimester to parvovirus b19

A

2nd trimester

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59
Q

fever, pruritus, painful edema, erythema localised to distal extremities “gloves and socks”
dx? cause?

A

PPGSS papular purpuric gloves and socks syndrome

parvovirus b19

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60
Q

leading cause of fatal encephalitic in children and adults

A

HSV encephalitis

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61
Q

most common manifestation of HSV1

A

fever blisters or cold sores or herpes labialis

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62
Q

local burning and tenderness over genitals before vesicle formation
vesicles then become ulcers

A

HSV2

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63
Q

area of brain affected by HSV

A

frontal or temporal and limbic system

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64
Q

fever, nuchal rigidity, anosmia, memory loss, peculiar behaviour, expressive aphasia, hallucination, focal seizure

A

HSV enchephalitis

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65
Q

most common cause of recurrent aseptic meningitis

A

Mollaret meningitis - caused by HSV

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66
Q

newborn presents at 8-17 days old of life with vesicles, irritability, lethargy, poor feeding poor tone, seizures

A

neonatal HSV

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67
Q

gold standard for diagnosing HSV

A

viral culture

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68
Q

treatment of HSV encephalitis

A

acyclovir 10mkdose q8 x 14-21 days

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69
Q

treatment of neonatal HSV

A

acyclovir 60mkday TID x 14 (skin), 21 days (disseminated)

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70
Q

t or f

male circumcision is associated with reduced risk go acquiring genital HSV

A

true

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71
Q

what is breakthrough varicella

A

rash that appears after being vaccinated 42days prior

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72
Q

breakthrough varicella caused by

A

wild type virus

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73
Q

infants born to mothers with varicella present high risk if

A

with rash 5 days prior to delivery or 2 days after delivery

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74
Q

varicella igG able to cross placenta after _ weeks aog

A

30 wks

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75
Q

t or f

all preterms should receive ivig if mom develops varicella even if >1wk

A

true

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76
Q

cicatricial skin scarring, limb hypoplasia, microcephaly, chorioretinits, cataracts, hydronephrosis, iugr

A

congenital varicella

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77
Q

secondary bacterial infections associated with varicella

A

strep

staph

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78
Q

neurologic complications of varicella

A

encephalitis and cerebellar ataxia

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79
Q

csf findings varicella

A

mild lymphocytic pleocytosis, slight increase protein, normal glucose

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80
Q

findings on tzanck smear for varicella

A

multinucleated giant cells

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81
Q

triad of fatigue, pharyngitis, generalised lymphadenopathy

A

EBV

mononucleosis

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82
Q

first human virus to be associated with malignancy

A

EBV

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83
Q

EBV associated in HIV adults benign

A

oral hairy leukoplakia

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84
Q

EBV associated in HIV kids

A

lymphoid interstitial pneumonitis

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85
Q

malignant EBV associated

CLAD, eustachian tube blockage, nasal obstruction with epistaxis

A

NPCA

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86
Q

most common childhood cancer in east africa

A

endemic african burkitt lymphoma

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87
Q

protooncogene in burkitt

A

c-myc

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88
Q

hodgkin disease associated with

A

EBV

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89
Q

morbilliform vasculitic rash seen after giving beta lactam antibiotic to patient with mononucleosis

A

ampicillin rash

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90
Q

symmetric rash on cheeks that coalesce into plaques
lasts 15-50 days
dx? associated with?

A

gianotti crosti syndrome

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91
Q

diseases associated with atypical lymphocytosis

A

EBV, CMV, toxoplasmosis, rubella, viral hepatitis, roseola, mumps, tb, typhoid, mycoplasma, malaria, drug reaction

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92
Q

heterophiles antibody test

A

EBV

paul bunnell antibodies

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93
Q

blunt ab trauma in patients with EBV

A

splenic rupture (due to splenomegaly)

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94
Q

prednisone in ebv indicated in

A

airway obstruction, thrombocytopenia,

autoimmune haemolytic anemia, seizure, meningitis

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95
Q

most feared complication in ebv

A

sub scapular splenic hemorrhage

splenic rupture

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96
Q

perceptual distortions in sizes, shapes and spatial relations associated with EBV

A

alice in wonderland syndrome

metamorphsia

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97
Q

immunodeficiency with high mortality to EBV

A

duncan syndrome

x linked lymphoproliferative syndrome

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98
Q

most common opportunistic infection in HIV prior to antiretroviral

A

CMV

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99
Q

largest human herpesvirus

A

cmv

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100
Q

rate of transmission in breast milk CMV

A

60-70%

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101
Q

clinical findings congenital cmv

A

hepatosplenomegaly, petechial rash, jaundice, microcephaly, iugr, hearing loss

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102
Q

lab findings congenital cmv

A

hyperbilirunemia, elevated transaminase, thrombocytopenia, anemia, abnormal cuts/ct

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103
Q

lab diagnosis of CMV

A

recovery of virus within first 3 weeks of life

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104
Q

histopath finding of CMV

A

owl eye inclusion

nuclear and cytoplasmic inclusions

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105
Q

treatment of congenital cmv

A

6wk ganciclovir

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106
Q

roseola infantum
exanthem subitum
sixth disease

A

human herpesvirus 6

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107
Q

high fever which resolves after 72 hours followed by blanching evanescent rash (trunk) 1-3 days

A

roseola infantum
exanthem subitum
sixth disease
human herpesvirus 6

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108
Q

ulcer at uvulopalatoglossal junction

A 
nagayama spot
roseola infantum
exanthem subitum
sixth disease
human herpesvirus 6
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109
Q

mir findings of HHV6

A

areas of hyper intense T2 and fluid attenuation inversion on hippocampus, uncut, amygdala

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110
Q

gold standard for diagnosing HHV6

A

viral culture

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111
Q

most common complication of roseola

A

seizures

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112
Q

kaposi sarcoma

A

hhv 8

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113
Q

anemia, thrombocytopenia, lad

hhv8

A

multi centric castleman disease

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114
Q

primary diagnostic in hhv8

A

elisa

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115
Q

hhv 8

lymphomatous invasion of the pleura, pericardium

A

primary effusion based lymphoma

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116
Q

treatment hhv8

A

rapamycin

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117
Q

rna

orthomyxoviridae

A

influenza

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118
Q

primary human pathogens influenza

A

a and b

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119
Q

minor changes within serotype

A

antigenic drift

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120
Q

major changes within serotype

A

antigenic shift

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121
Q

pathogenesis of influenza

A

infect respiratory epithelium
loss of ciliary function
decreased mucus production

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122
Q

common complications of influenza

A

otitis media

penumonia

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123
Q

secondmost common cause of viral pneumonia

A

parainfluenza

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124
Q

croup

barking cough

A

parainfluenza

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125
Q

narrowing of subglottic region

A

steeple sign

croup

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126
Q

emergency treatment of croup

A

dexamethasone 0.6mg/kg single dose

aerosolised epinephrine

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127
Q

major cause of bronchiolitis

A

RSV

respiratory syncytial virus

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128
Q

one of the most contagious viruses to affect humans

A

rsv

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129
Q

t or f

bronchiolitis is more common in boys

A

true

1.5:1 ratio

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130
Q

first sign of infection RSV

A

rhinorrhea

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131
Q

car findings rsv

A

hyper expansion
peribronchial thickening
interstitial infiltrates

132
Q

definitive diagnosis of RSV

A

viral culture

133
Q

treatment for rsv

A

ribavirin

134
Q

passive immunoprophylaxis in rsv

A

palizumab

135
Q

one of the most common causes of serious lower respiratory tract infections

A

human metapnuemovirus

136
Q

most sensitive test for human metapnuemovirus

A

reverse transcriptase PCR

137
Q

most common manifestation of adenovirus

A

respiratory tract infection

138
Q

cornea and conjunctiva involved by adenovirus

A

epidemic keratoconjunctivitis

139
Q

most frequent cause of common cold

A

rhinovirus

140
Q

important cause of exacerbation of asthma or COPD in adults

A

rhinovirus

141
Q

t or f

rhinovirus associated wheezing is an important risk factor for developing asthma

A

true

142
Q

cause of SARS

A

coronaviruses

143
Q

in early childhood, single most important casuse of severe dehydrating diarrhea

A

rotavirus

144
Q

pathogenesis of viral diarrhea

A

destroy villi

145
Q

most common finding in viral enteritis

A

isotonic dehydration with acidosis

146
Q

complication of rotavirus vaccine

A

intussusception

147
Q

most prevalent viral STI in usa

A

human papillomavirus

148
Q

most common clinically detected cervical lesion hpv

A

LSIL

low grade squamous epithelial lesion

149
Q

infants acquire hpv by passage to infected birth canal leading to recurrent _

A

respiratory papillomatosis

150
Q

hpv related malignant potential

A

epidermodysplasia veruciformis

151
Q

low risk malignant hpv types

A

6 and 11

genital warts

152
Q

high risk malignant hpv types

A

16 and 18

153
Q

repeat cytology for LSIL

A

every 12 months

154
Q

removal of warts

A 
topical podofilox
salicylic acid
cryotherapy
laser
electrosurgery
155
Q

principal vector of japanese encephalitis

A

culex tritaeniorhynchus summarosus

156
Q

4 stages of japanese encephalitis

A

prodromal 2-3 days
acute 3-4 days
subacute 7-10 days
convalescence 4-7 weeks

157
Q

characteristic of jap enceph

A

rapidly changing nervous system signs

158
Q

in dengue severe back pain precedes fever

A

back break fever

159
Q

temperature pattern in dengue

A

biphasic

saddleback

160
Q

dengue hemorrhagic fever

A

fever (2-7 days in duration or biphasic), minor or major hemorrhagic manifestations, thrombocytopenia (≤100,000/μL), and objective evidence of increased capillary permeability (hematocrit increased by ≥20%), pleural e usion or ascites (by chest radiography or ultrasonography), or hypoalbuminemia

161
Q

dengue shock syndrome

A

dengue hemorrhagic fever as well as hypoten- sion, tachycardia, narrow pulse pressure (≤20 mm Hg), and signs of poor perfusion (cold extremities)

162
Q

dengue IgM disappear after

A

6-12 weeks

163
Q

most common cbc finding in dengue

A

hemoconcentration

164
Q

most common complication of dengue in infants and young kids

A

fluid and electrolyte losses, hyperexia, and febrile seizure

165
Q

what receptor does rabies virus utilize

A

nicotinic acetylcholine receptor

166
Q

pathologic hallmark of rabies

A

negri body

clumped viral nucleocapsids that create inclusion bodies

167
Q

most common cause of death in rabies

A

arrhythmia

168
Q

2 clinical forms of rabies

A

encephalitic or furious rabies

paralytic or dumb rabies

169
Q

cardinal signs of rabies

A

hydrophobia

aerophobia

170
Q

most sensitive test for rabies

A

RT PCR

171
Q

prophylaxis of cerebrovascular spasm in rabies

A

nimodipine

172
Q

t or f

bites of rats/mice can cause rabies

A

false

173
Q

t or f

cat bite can cause rabies

A

true

174
Q

HIV envelope protein used in detection assays

A

gp41

175
Q

binding site to CD4 T

A

gp120

176
Q

enzyme critical for HIV assembly

A

protease

177
Q

all kids < 13 years old have HIV via

A

vertical transmission

178
Q

highest percentage of infants with HIV obtained

A

intrapartum

exposure to blood/ cervicovaginal secretions

179
Q

risk of transmission of HIV through breastfeeding

A

9-16%

180
Q

elective cesearen section plus zidovudine decrease HIV transmission by

A

87%

181
Q

reservoirs of HIV in body

A

monocytes

182
Q

first cell to be infected by HIV

A

dendritic cells

183
Q

increased inflammatory response of a subclinical infection in a HIV kid that just started antiretroviral

A

immune reconstitution inflammatory syndrome

due to recovered immune system

184
Q

most common opportunistic infection in children with hiv

A

pneumocystis jirovecii

185
Q

most common fungal infection in hiv kids

A

oral candidiasis

186
Q

neuroimaging in hiv encephalitis

A

cerebral atrophy (85%), ventriculomegaly, basal ganglia calcification, leukomalacia

187
Q

most common GI disease in HIV

A

chronic or recurrent diarrhea with malabsorption, ab pain, dysphagia, failure to thrive

188
Q

infants born to HIV mothers lose maternal antibody at 6-12mo

A

seroreverters

189
Q

to make diagnosis of HIV in infants

A

igM, igA, anti HIV, igG

190
Q

HIV viral diagnostic assay useful in <18m

A

HIV DNA PCR

191
Q

HIV viral testing in newborns should be done

A

1-2 days old

192
Q

if negative HIV viral testing for newborns negative initially, when to repeat

A

1-2months of age

193
Q

HIV can be excluded for infant if

A

2 tests negative with at least 1 test >4mo age

194
Q

for adolescents with HIV, what should we follow? adult or pedia dosing?

A

based on tanner stage
stage 1-3 use pedia dosing
stage 4-5 use adult dosing

195
Q

initial virologic response to ARVs for HIV

A

decrease in load 5 fold after 4-8 weeks

196
Q

maximum response to HIV therapy at

A

12-16week

197
Q

hiv viral load should be measured every

A

3-6 mo

198
Q

potential toxicity of drugs

A

hema- tologic complications (e.g., ZDV); hypersensitivity rash (e.g., efavi- ranz); lipodystrophy (e.g., redistribution of body fat seen with NRTIs, protease inhibitors); hyperlipidemia (elevation of cholesterol and tri- glyceride concentrations); hyperglycemia, and insulin resistance (e.g., protease inhibitors); mitochondrial toxicity leading to severe lactic acidosis (e.g., stavudine, didanosine); electrocardiogram abnormalities (e.g., atazanavir, lopinavir); abnormal bone mineral metabolism (e.g., tenofovir); and hepatic toxicity, including severe hepatomegaly with steatosis.

199
Q

MAC prophylaxis in HIV

A

azithromycin or clarithromycin

200
Q

AFASS

A 
acceptable
feasible
affordable
sustainable
safe
201
Q

2 kinds of parasites

A

protozoan (unicellular)

helminths (multicellular)

202
Q

fever, jaundice, proteinura and hemorrhage

A

yellow fever

203
Q

eosinophilic degradation of hepatocytes

A

councilman bodies

yellow fever

204
Q

nitazoxanide used for

A

cryptosporidium

giargia

205
Q

atovaquone/proguanil use

A

pnemocystis in aids

inhibit liver stage of plasmodium (malaria)

206
Q

artemisinin used for

A

plasmodium vivax

207
Q

drug of choice for asymptomatic amebiasis

A

paromomycin

alternatives: iodoquinol, diloxanide

208
Q

drug of choice amebic menigoencephalitis

A

amphotericin b

209
Q

drug of choice for symptomatic amebiasis

A

metronidazole

210
Q

drug of choice for Ancylostoma caninum (eosinophilic enterocolitis)

A

albendazole

211
Q

drug of choice for ascariasis

A

albendazole

212
Q

drug of choice for Babesiosis

A

atovaquone plus azithromycin

213
Q

drug of choice for Balantidiasis

A

tetracycline

214
Q

drug of choice blastocystis hominis

A

metronidazole

215
Q

drug of choice for Cryptosporidiosis

A

nitazoxanide

216
Q

drug of choice for Cutaneous larva migrans (creeping eruption, dog and cat hookworm)

A

albendazole

217
Q

drug of choice Enterobius vermicularis (pinworm)

A

albendazole

218
Q

drug of choice for

Filariasis (Wuchereria bancrofti, Brugia malayi, Brugia timori)

A

Diethylcarbamazine

219
Q

drug of choice for Loa loa

A

Diethylcarbamazine

220
Q

drug of choice for Tropical pulmonary eosinophilia (TPE)

A

Diethylcarbamazine

221
Q

drug of choice for Onchocerca volvulus

river blindness

A

Invermectin

222
Q

drug of choice for Fasciola hepatica (sheep liver fluke)

A

Triclabendazole

223
Q

drug of choice for Paragonimus westermani (lung fluke)

A

Praziquantel

224
Q

drug of choice for Giardiasis (Giardia duodenalis)

A

metronidazole

225
Q

drug of choice for Hookworm infection (Ancylostoma duodenale, Necator americanus)

A

albendazole

226
Q

drug of choice for Leishmania infection

A

Sodium stibogluconate

227
Q

drug of choice for Lice infestation (Pediculus humanus, Pediculus capitis, Phthirus pubis)50

A

0.5% Malathion

228
Q

drug of choice for P. falciparum acquired in areas of chloroquine resistance

A

Atovaquone/ proguanil

229
Q

drug of choice for P. vivax acquired in areas of chloroquine resistance

A 
Quinine sulfate
plus
doxycycline
plus
primaquine
230
Q

drug of choice
All Plasmodium except chloroquine-resistant P. falciparum and chloroquine-resistant P. vivax (areas without chloroquine resistance)

A

Chloroquine phosphate

231
Q

drug of choice for All Plasmodium

Parenteral (severe infection; chloroquine-sensitive and resistant)

A

Quinidine gluconate (IV)

232
Q

drug of choice for Microsporidiosis

A 
albendazole 
plus  fumagillin (if eye)
233
Q

Scabies (Sarcoptes scabiei)

Drug of choice

A

5% Permethrin

234
Q

drug of choice for Schistosomiasis

A

praziquantel

235
Q

drug of choice for Strongyloidiasis (Strongyloides stercoralis)

A

ivermectin

236
Q 
drug of choice for tapeworm
Diphyllobothrium latum ( sh), Taenia saginata (beef), Taenia solium (pork), Dipylidium caninum (dog)
A

praziquantel

237
Q

drug of choice for Toxoplasmosis (Toxoplasma gondii)

A

Pyrimethamine
plus
sulfadiazine

238
Q

drug of choice for Trichinellosis (Trichinella spiralis)

A

steroids plus albendazole

239
Q

drug of choice for Trypanosoma cruzi

American trypanosomiasis, Chagas disease

A

Benznidazole

240
Q

drug of choice for Visceral larva migrans (Toxocariasis)

A

albendazole

mebendazole

241
Q

drug of choice for Trypanosoma brucei gambiense (West African trypanosomiasis, sleeping sickness)

A

hemolytic: Pentamidine isethionate or suramin

late CNS: Melarsoprol

242
Q

albendazole absorption from the gastrointestinal tract is poor but improved with a concomitant

A

high fat meal

243
Q

serious adverse effect of ivermection

A

Mazzotti reaction
fever, urticaria, swollen and tender lymph nodes, tachycardia, hypotension, arthralgias, oedema, and abdominal pain that occur within seven days of treatment

244
Q

common forms of entamoeba in humans

A

amebic colitis

amebic liver abscess

245
Q

3rd leading cause of parasitic death worldwide

A

amebiasis

246
Q

flasked shaped ulcers in intestinal epithelium

A

amebiasis

247
Q

most common imaging finding in amebic liver abscess

A

single abscess in right hepatic lobe

248
Q

diagnosis of amebiasis

A

presence of e. histolytica in stool exam

249
Q

most common intestinal parasite seen in usa

A

giardia

250
Q

which immunodeficiencie predispose to Giardia infection

A

humoral immunodeficiencies
common variable hypoglammaglobulinemia
x-linked agammaglobulinemia

251
Q

foul smelling greasy stools with no blood, mucus, or leukocytes

A

giardia lamblia

252
Q

test of choice for iardia

A

stool enzyzme immunoassay

253
Q

largest protozoan that infects humans?

vector?

A

balantidium coli

pigs

254
Q

leading protozoal cause of diarrhea in kids

common cause of outbreak in day care centers

A

cryptosporidium

255
Q

cryptosporidiosis in ICC associated with

A

biliary tract disease, pancreatitis, respiratory tract disease

256
Q

diagnostic of choice for cryptosporidiosis

A

enzyme immuoassay

257
Q

most common nonviral STI

A

trichomonas vaginalis

258
Q

frothy discharge with vaginal erythema and cervical hemorrhage

A

strawberry cervix

trichomoniasis

259
Q

leishmaniasis transmitted by

A

phlebotomine sandflies

260
Q

abudant histiocytes and kupffer cells

specialized stellate macrophages located in the liver

A

amastigotes

leishmaniasis

261
Q

positive delayed­type hypersensitivity skin response to leishmanial antigens

A

Montenegro skin test

262
Q

visceral leishmaniasis

A

kala azar

high fever, marked splenomegaly, hepatomegaly and cachexia

263
Q

definitive diagnosis of leishmaniasis

A

amastigotes seen on tissue specimens

264
Q

trypanosomiasis transmitted by

A

tsetsefly

glossina

265
Q

large strawberry like cells supposedly derived from plasma cells in brain

A

morular cells

trypanosomiasis

266
Q

site of bite of tsetse fly

hard painful nodule

A

trypanosomai chancre

267
Q

drowsiness, uncontrollable urge to sleep, ataxia, tremor, rigidity

A

sleeping sickness

trypanosomiasis

268
Q

definitive diagnosis of trypanosomiasis in early stage

A

blood smear

269
Q

arthropod vectors of chagas t. cruzi

A

reduviid inset

wild bedbugs, assassin bugs, kissing bugs

270
Q

local tissue reaction in which trypanosmona lyse the microphages, at site of entry

A

chagoma

271
Q

unilateral painless swelling of eye

A

Romana sign

chagas disease

272
Q

most common presentation of chronic T. Cruzi infection

A

cardiomyopathy

273
Q

fever, chills, sweats, fatigue, anemia, and splenomegaly

A

malaria

274
Q

2 phases of plasmodium

A

human (asexual)

mosquito (sexual)

275
Q

human liver phase of malaria

A

exoerythrocytic phase
sporozoites enter the hepatocytes of the liver, where they develop and multiply asexually as a schizont. After 1-2 wk, the hepatocytes rupture and release thousands of merozoites into the circulation.

276
Q

RBC phase of malaria

A

erythrocytic phase

when they invade RBC, turn into ring form then enlarges to become a trophozoite

277
Q

in malaria fever occurs when

A

erythrocytes rupture and release merozoites into the circulation

278
Q

in malaria fever occurs when

A

erythrocytes rupture and release merozoites/schizont into the circulation

279
Q

t or f

erythrocytes lacking duffy blood group resistant to P vivax

A

true

280
Q

paroxyms of fever in P vivax and ovale

A

48 hours

281
Q

paroxyms of fever P malariae

A

72 hours

282
Q

most severe form of malaria

A

p falciparum

283
Q

complications of p. falciparum

A

cerebral malaria, acute renal failure, respiratory distress from metabolic acidosis, algid malaria and bleeding diatheses

284
Q

congenital malaria

A

fever, restlessness, drowsiness, pallor, jaundice, poor feeding, vomiting, diarrhea, cyanosis, and hepatosplenomegaly

285
Q

diagnosis of malaria

A

blood smear with giema stain

286
Q

thick smear blood malaria

A

to scan

287
Q

thin smear blood malaria

A

to identify species

288
Q

treatment for p. knowlesi

A

chloroquine plus sulfadoxine pyrimethamin

289
Q

used to eradicate hypnozoites in liver

A

primaquine

290
Q

primaquine causes hemolytic anemia in

A

g6pd deficiency

291
Q

most common severe complication of malaria

A

severe malarial anemia

292
Q

first line therapy seizures in malaria

A

benzodiazepines

293
Q

complication in malaria in kids taking quinine

A

hypoglycemia

294
Q

what symptom in malaria is associated with worse outcome

A

jaundice

295
Q

mefloquinone, a prohyacti drug for malaria, should not be given to

A

those with hypersensitivity to the drug,
receiving cardiotropic drugs,
psych disorders, epilepsy, or area with resistance

296
Q

most common latent infection in humans

A

toxoplasma gondii

297
Q

toxoplasmosis acquired by

A

ingesting raw or undercooked food with oocytes

from cats

298
Q

statistics in congenital toxoplasmosis

A

if 1st trimester 17% infected but severe

if 3rd trimester 65% infected but mild

299
Q

toxoplasmic encephalitis with AIDs

A

fever, headache, altered mental status, psychosis, cognitive impairment, seizures, and focal neurologic defects, including hemiparesis, aphasia, ataxia, visual eld loss, cranial nerve palsies, and dysmetria or movement disorders

300
Q

chorioretinitis, hydrocephalus, and cerebral calcifications

A

congenital toxoplasmosis

301
Q

brain calcifications in toxoplasmosis seen in

A

caudate nucleaus
basal ganglia
choroid plexus
subependymal

302
Q

pyrimethamine contraindicated

A

during 1st trimester

303
Q

side effect of pyrimethamine

A

neutropenia

304
Q

what can be concomittantly given to pyrimethamine to prevent bone marriow suppression

A

folinic acid or leukovorin

305
Q

treatment for pregnant women that acquire toxoplasmosis during pregnancy

A

spiramycin

306
Q

causes of lymphatic filariasis

A

brugia malayi, brugia timori, and wuchereria bancrofti

307
Q

recurrent lymphangitis fever headache then eventually obstruction of lymph flow leading to edema

A

filariasis

308
Q

causes chronic scrotal edema

A

wuchereria bancrofti

309
Q

migration worms thru skin lead to transient episodes of pruritus and edema

A

ca;abar swellings

310
Q

muscle fiber after ingestion of this worm contains cyst wall especially from uncooked pork

A

trichinella spiralis

311
Q

snail fever

katayama syndrome

A

acute schistosomiasis

312
Q

cercarial penetration in skin by schistosoma

A

swimmers itch

schitosomal dermatitis

313
Q

fever chills sweating LAD hepatosplenomegaly eosinophilia

A

katayama syndrome

314
Q

beef tapeworm

A

taenia saginata

315
Q

pork tapeworm

A

taenia solium

316
Q

most anterior end of tapeworm anchors to intestine

A

scolex

317
Q

longest human tapeworm

A

diphyllobotrium latum
fish tapeworm
>10m

318
Q

taperworm that causes megaloblastic anemia (low b12 or folate)

A

diphyllobotrium latum

fish tapeworm

319
Q

disease in which pork taperworm taenia solium invade CNS

A

neurocysticercosis

320
Q

presenting finding in neurocysticercosis

A

seizure

321
Q

drug of choice for neurocysticercosis

A

albendazole

+- prednisolone

322
Q

most widespread nematode infection in the world

A

hydatid disease or hydatidosis

Echinococcosis

323
Q

common site Echinococcosis in kids

A

lung

324
Q

preferred therapy in Echinococcosis or hydatid disease

A

CT PAIR

CT guided percutaneous aspiration instillation and reaspiration

325
Q

drug of choice for hydatid disease or Echinococcosis

A

albendazole

326
Q

leading cause of death worlwide

A

tb

PPS - From Nelson's (24 decks)

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