Virus and Fungi- Hillard Flashcards
1
Q
DNA viruses
A
H : Herpesvirus H : Hepadnavirus - HepB A : Adenovirus - upper resp P : Papovavirus -cervical, HPV P : Parvovirus -RBCs P : Poxvirus y
2
Q
Bacterial
CBC
fever
dx
A
CBC = high WBCs, N left shift
Fever = high (adults), low in children
Dx: culture
3
Q
Viral
CBC
fever
dx
A
CBC = high lymphocytosis, high WBC can be seen
Fever = low (adults), high in children
Dx: serology
Sx : most have skin lesions and affect hematopoietic cells
4
Q
Herpes simplex virus HSV 1 HSV2 TR how long
A
HSV 1: orofacial (acute gingivostomatitis)
HSV 2 : genital
TR : skin to skin
life long
5
Q
HSV neonatal infection
HSV nail sx
HSV in immunocompromised
A
intrauterine death , TORCH
Herpetic whitlow
viral encephalitis
6
Q
Varicella- Zoster Chickenpox
TR
Sx
A
childhood D
highly infectious (air + contact)
Rash : papules–> itchy –> crusts,scarbs (*you see all stages of rash exist together)
fever low, malaise
7
Q
Varicella- Zoster Shingles (Herpes Zoster)
TR
SX
immunocompromised
A
virus is dormant in dorsal root ganglia, reactivated
buringing, painful lesions, dematomal distributions*
encephalitis
8
Q
Epstein Barr Virus
TR mode
infects, colonizes
A
“kissing d” contaminated toothbrush or utensils, saliva
Directly infects B-cells
Mono
9
Q
EBV SX
A
fever, sore throat, lymphadenopathy, hepatosleenomegaly, atypical lymphocytosis -enlarged,
you can see rash
10
Q
EBV risk factor for
A
- B-cell lymphoma (burkitt)
2. Nasopharyngeal carcinoma
11
Q
EBV DX
A
Heterophile Ab test (monospot, do first)
EBV Ab test
12
Q
Cytomegalovirus
TR mode
SX
A
body fluids
- asymptomatic
- CMV mononuclease (lymphocytosis + high fever, sore throat) - like mono
- reactivates in immunocompromised = choriorentinits
13
Q
Cytomegalovirus neonatal
A
TORCH virus, intellectual disability
14
Q
CMV choriorentinitis
A
pain, red, progressive vision loss, blurry vision, floating black spots
15
Q
CMV vs EBV
A
CMV has higher and longer fevers
owl’s eye seen on histology
16
Q
Rosela
age
tr mode
sx
A
*HH6
children
saliva
high fever (3-5days) —-> rash all over body
17
Q
Human Herpes Virus 8
TR mode
SX
A
STI, saliva
Skin red-purple nodules, plaques on body, internal organs
= Kaposi sarcoma - intermediate grade vascular tumor
18
Q
HHV 8 is common in
A
africa, east europe, middle east, AIDS
19
Q
Hepatitis that is DNA
A
Hep B
20
Q
Hep A
TR mode
chronic hepatitis or not
A
Enteric (fecal oral, contaminated water food)
NO
21
Q
Hep B
TR mode
chronic hepatitis or not
A
Parenteral - sex, blood, mom to fetus, needles
YES
22
Q
Hep C
TR mode
chronic hepatitis or not
A
Parenteral - sex, blood, mom to fetus, needles
YES
23
Q
Hep D
TR mode
chronic hepatitis or not
A
Parenteral - sex, blood, mom to fetus, needles ONLY WITH HEP B***
YES
24
Q
Hep E
TR mode
chronic hepatitis or not
A
Enteric (fecal oral, contaminated water food)
NO, except YES to genotype 3
25
DX for HEP A,C, D, E
Ab testing
26
```
DX for Hep B
how to read it
- HBsAg
- HBeAg
- HBsAb
- Anti-HBeAg
- Anti-HBcAg
```
HEP B serology
- HBsAg = live infection (if +)
- HBeAg = high infectivity, +
- HBsAb = immunized, or resolved infection, +
- Anti-HBeAg = low infectivity, +
- Anti-HBcAg = new infection (IgM), old infection (IgG), +
27
Acute Hepatitis
fatigue, malaise, jaundice (painful liver, N,V)
| -HEP A, E-
28
Fulminant viral hepatitis
severe, underlying liver disease
| HEP B and HEP D
29
Chronic Hepatitis
asymptomatic, RUQ pain, malaise, fatigue, jaundice
- >cirrhosis
- > hepatocellular carcinoma
- HEP B, HEP C-
30
hepatitis on liver function test
high AST, ALT
high bilirubin
high clotting time
31
Adenovirus SX
upper respiratory tract illness, (can have fever) pharyngitis, cold-like sx
*DNA
32
Cold SX
from RNA
| sore throat, rhinorrhea, cough, malaise
33
3 viruses causing cold
1. rhinovirus
2. coronavirus
3. RSV
4. Metapneumovirus
5. parainfluenza
34
RSV
Respiratory Syncytial Virus
| number 1 cause of pneumonia in young children = giant cell formation
35
Metapneumovirus
2nd cause of pneumonia in young childern, bronchitis
36
parainfluenza
CROUP, " barking cough"
| infection of larynx and bronchous
37
Papovaviridae : Human papillomavirus
common genital warts = condyloma acuminatum
| can lead to cervical cancer (E6,E7 proteins----I TSG) - epithelial dysplasia
38
what strains of HPV are at higher risk for cervical and oropharyngeal cancer development
16, 18, 31, 45
39
Papovaviridae : Polyoma virus
| immunocompetent
flu like disease
40
Papovaviridae : Polyoma virus
immunocompromized
BK and JC strain
BK : renal transplant patients get severe problems
| JC: seen on AIDS, progressive multifocal leukoencephalopathy - demylenation
41
BK Polyoma virus
infects GU system , hemorrhagic cystitis in bladder and nephritis
hematuria, dysuria, polyuria, low abd pain, high Cr and low kidney function
42
how to screen for BK Polyoma virus
see ground glass inclusions on histology
43
JC Polyoma virus
infects CNS, demyelination lesions, progressive multifocal leukoencephalopathy
- mental changes, speech, cognition, behavior, motor problems = staggering gait
44
Parovirus B19
SX
other name for it
```
low fever, headache, sore throat, rash on cheeks* = rash slapped cheeks
Erythma infectiosum (5th's disease)
```
45
Parovirus B19 in severe cases can
kill RBCs and transient anemia (especially in SS anemia, thalassemia)
46
Parovirus B19 neonatal
fetal hydrops, severe anemia
47
histology Parovirus B19
giant erythroblasts
48
Poxviridae : Molluscum contagiosum
superficial skin infection all over body , "water warts"
| young children, immunocompromised
49
Poxviridae: Smallpox
gone in humans
| highly contagious, high fever + hard vesicles at same stage
50
Orthomyxoviridae : influenza
2 virulence facotors
TR mode
RNA
1. Hemagglutinin : binding to sialic acid receptors (UppRespTr)
2. Neuraminidase : disrups mucin barrier
air
51
Orthomyxoviridae : influenza SX
high fever, rhinorrhea, cough, myalgias, arthralgia
| - had annual vaccine
52
Antigenic Drift
small mutations in Neuraminidase and Hemagglutinin
| - milder disease
53
Antigenic Shift
trading RNA segments with another virus (usually in animals) ----> completely new Neuraminidase and Hemagglutinin
= pandemic
54
Paramyocoviridae : Measles
other name
steps in SX
Rubeola
1. fever, cough, rhinitis, conjunctivitis
2. Koplik's spots (oral lesions)
3. head ----> toe maculopapular rash
- can lead to pneumonia and encephalitis
55
Paramyocoviridae : Measles can persist and cause
Subacute scelrosing panencephalitis
| - slowly progressing neurologic disease (forgetful, distractilibility...)
56
Paramyxoviridae : Measles spreads
by respiratory droplets
57
Rubella
other name
SX
German measles (milder type)
Mild-measles-like illness
- erythematous rash : head ----> toe (maculopapulary)
- flu-like, fever, lymphadenopathy
58
Rubella neonatal
in a TORCH and causes congenial HEART, EYE, EARS, CNS problems
59
Paramyxoviridae : Mumps
| SX steps
fever
| infects parotid gland (parotitis) + testes (orchitis)
60
Paramyxoviridae : Mumps
childhood vaccination mumps, measles, rubella (MMR)
61
Coronavirus
TR mode
SX
air
| common cold
62
coronavirus
| SARS -CoV and COVID-19
bar reservoir in china
atypical pneumonia
- can get severe respiratory sx, prothrombic states, encephalitis
63
Coxsackie virus : Coxsackie A
1. Herpangina : bilateral herpes-like vesicular eruption in back of throat
2. Hand, foot, and mouth disease : pediatric illness, mild fever with red vesicular lesions on had, feet, in and around mouth : children
64
Coxsackie A vs herpes
bilateral and posterior , and throat lesions in coxsackie A
65
Coxsackie B
| boards
1. Pleurodynia : resp infection, fever, CP i on inspiration
| 2. Myocarditis, Pericarditis : heart inflammation , arrhythmias, hear failure
66
Hantavirus
colonize
area
SX
rodent reservoir
SW USA
flu-like illness : high fever, myalgia, cough, N, V)
67
Hantavirus can become
Hantavirus pulmonary syndrome : fluid leaks out from pulmonary capillaries, shock, death
68
Diarrhea viruses : 2
Norovirus (Norwalk virus)
| Rotovirus
69
Norovirus (norwalk virus)
N,V, Watery D, can have fever
= institutional settings*
=cruises
70
Rotovirus
N,V, Watery D, can have fever
= institutional settings*
can cause infant mortality
71
Rhabdoviridae: Rabies
shape of rna
TR mode
bullet shaped RNA
bite (saliva) from warm blooded animals
----> up the nerve axon ----> CNS
72
Rhabdoviridae: Rabies
| SX steps
1. incubation weeks to years
2. fever, headache, sore throat
3. hydrophobia (swallowing causes pharyngeal spasms = scared of drinking), agitation, aggressive, hallucination behavior,
4. paralysis, coma, death
73
Rhabdoviridae: Rabies once sx start
there is no reverse , encephalopathy, death
74
Rhabdoviridae: Rabies prevention and tx if bitten
vaccine if high risk
| many vaccines of immunoglobulin IgG is given
75
Flaviviridae virus
colonize
TR mode
febrile mosquito- born illness, in warm tropical
76
Flaviviridae virus : yellow fever
| SX
fever, headache, N,V
*Hepatitis + jaundice
(60% mortality if severe)
77
Flaviviridae virus : Dengue fever
| SX
* "break-bone fever" - severe backache, joint pain, transient macular rash
can cause hemorrhage (skin and mucosal bleeding)
78
Flaviviridae virus : Zika virus
| SX
fever, rash, joint pain, illness resolves
| neonatal ----> microcephaly
79
Flaviviridae virus : West Nile Virus
SX
TR mode
fever, headache, can have rash
severe: meningitis, encephalitis, paralysis
mosquito --> CNS
80
Flaviviridae virus : togaviridae
SX
TR mode
encephalitis (horses + humans)
mosquitos TR from birds
- western equine encephalitis
- eastern equine encephalitis
81
Polio virus
| boards
```
eradicated for the most part
mild fever repeated fro 1-3 weeks
aseptic meningitis
flaccid asymmetric paralysis
virus ----> anterior motor neurons)
```
82
HIV function
1. RNA retrovirus binds to and infects + kills CD4+ cells
2. protease : makes more copies
3. Gp120 : binds to t-cells
4. Gp41 : fusion to T-cell membrane
83
HIV screening
P24 capsid = Ag test for HIV which is surrounded by a p24 capsid
84
HIV : acute
1mo -3mo after exposure
| mononucleosis- like (mono): fever, fatigue, myalgia, lyphadenopathy, pharyngitis
85
HIV : latency
about 7-8 years
lymphadenopathy increased, fever, weight loss, night sweats
- can cause CNS problems
- opportunistic infections
86
CD 4+ normal and abnormal
normal : 1000cells/uL
susceptible to infection : 400cells/uL
AIDS : 200cells/uL
87
what are some clinical findings you can see in AIDS patients
- oral thrush by candida (pseudomembranous plaque, milk curd looking) tongue into esophagus, red under
- Cryptococcus neoformans : organisms in CSF
- MRI : toxoplasmosis lesions - handling cat little
88
3 diseases when CD 4+ is below 200cells/uL
1. Candida
2. Cryptococcus neoformans
3. Toxoplasmosis
89
HIV can cuase what cancers
1. B-cell Lymphomas (from EBV)
2. Kaposi sarcoma (fromHHV8)
3. Cervical carcinoma (from HPV)
90
HIV DX
Ab/Ag assay fro HIV Abs or p24 Ag
PCR
HIV-1 most common type
91
Fungal Hyphae
filamentous multicellular structure , mold
92
Yeast
unicellular budding, pseudohyphae
93
spores
reproductive single cell hyphae
94
thermally dimorphic fungi
| 25C, 77F
hyphal form
95
thermally dimorphic fungi
| 37C, 98.6F
yeast form
96
superficial fungal infections
1. pityriasis versicolor
2. tinea nigra
3. dematophytes
97
subcutaneous fungal infection
1. Sporothrix schenckii - ulcerative nodules
| 2. chromoblastomyocosis - cauliflower wart-like
98
Pityriasis versicolor (tinea versicolor)
hypopigmented or hyperpigmented skin macules
| - Malassezia species (spaghetti and meatballs)
99
Tinea nigra
dark brown/ black spots (palms, soles)
| -Hortaea (Exophaiala) werneckii
100
Dermatophytes 3 types
1. Microsporum
2. Trichophyton
3. Epidermophyton
101
Dermatophytes SX
pruritic, scaly, circular rash, erythematous ring
102
Tinea corporis
main body
| ring worm
103
Tinea cruris
affect groin scrotum
| jock itch
104
Tinea pedis
feet, toes
| athletes foot
105
tinea capitits
scalp mostly in children
106
Tinea unguinium (onchomycosis)
nails
107
Tinea barbae
hair
108
how to DX fungus
KOH scrape
| wood lamp
109
Sporothrix schenchii
colonize
TR
SX
soli and plant thorns and woods
gardening
hands and feet, into lymph ----> subcutaneous ulcerative nodule
110
Chromoblastomycosis
TR mode
colonizing
tropical, subtropical, soil, rotting wood
| Sporothix, traumatic implantation (thorns)
111
Chromoblastomycosis
| SX
violet wartlike lesion : cauliflower wart
- months to years later-
- sclerotic bodies on histology (circular, ovid, brown, anucleated structures)-
112
sclerotic bodies function
in Chromoblastomycosis
| resistant to immune clearing = elicit giant cell reaction
113
Candida albicans 3 types SX
1. Oral thrust = immunocompromised, esophagitis
2. Vaginalis = itching, discharge, menses, preg, ab, contraceptives can cause it
3. Rash = Diaper rash, under skin folds, obesity and diabetes
114
Candida albicans is from what
pseudohyphae (budding cells often in spore formation)
115
oral Candida albicans is called
oral thrust
116
Dimorphic fungi characteristics
- primary lung infection from breathing in spores
- high eosinophilia
- granulomas *
- spread hematogenously (blood : CNS, bone, skin)
- DX by biopsy, cytology cuture
- thermally change
117
3 Dimorphic fungi
| and how to dx them
1. Histoplasma - urine Ag test
2. Blastomyces - urine Ag test
3. Coccidioides - serology
118
Bronchoalveolar lavage
get material in lung for infections,
tube down airway instilled with saline and traps saline, silver stain for fungal infection detection
can also see cancer
119
viewing oral thrust by
EGD : esophagogastroduodenoscopy
120
Histoplasma capsulatum
area
colonize
mississippi, Missouri, Ohio river valley, Midwest
CAVES : bat droppings
birds, chickens (farm)
121
Histoplasma capsulatum SX
asymptomatic in immunocompetent
lung lesions --> cacification
pneumonia (mediastinal lymphadenopathy)-rare
*can look like TB
122
Blastomyces dermatitidis
area
colonize
Mississippi river valley, Great lakes
| soil, rotten wood
123
Blastomyces dermatitidis SX
- acute or chronic pneumonia (cough, low grade fever, sob)
- multisystem disease more common to happen then histoplasma
- skin cutaneous plaques
124
Blastomyces dermatitidis in histology
broad based double budding spores
125
Coccidioides immitis
area
colonize
SW USA, valleys, dust, earthquakes
| Desert areas , inhale spores and inside body --> large spherules
126
Coccidioides immitis SX
self-limited acute pneumonia = "valley fever"
CP, fever, cough
- can cause meningitis
127
Cryptococcus Neoformans
colonize
TR
Pigeon droppings
| large polysaccharide capsule yeast
128
Cryptococcus Neoformans SX
```
asymptomatic in immunocompetent
immunocompromised :
- Meningoencenphalitis from lung to blood to brain
- can cause focal pneumonitits
* common in AIDS or HIV
```
129
Cryptococcus Neoformans DX
Bronchoalveolar lavage or lumbar puncture
| India Ink : clear ring around capsule
130
Cryptococcus Gattii
area
colonize
australis, papa new guinea, NW US occasionally
| soil around fir or eucalyptus
131
Cryptococcus Gattii SX
immunocompetent have some SX
immunocompromised :
- SEVERE Meningoencenphalitis from lung to blood to brain
- SEVERE pulmonary problems
132
Aspergillus
| colonize
grains, peanuts, corn, rice
133
Aspergillus SX
1. Allergic Bronchopulmonary Aspergillosis
- asthma like bronchospasm (IgE)
2. Aspergilloma : Lung cavitation fills with asoergillus = Fungus ball
3. Aflatoxins made : chronic liver injury, heptacellular carcinoma
134
Allergic Bronchopulmonary Aspergillosis
- asthma like bronchospasm (IgE)
| low grade fever, wheezing, malaise, cough up mucous (pneumonia)
135
Aspergilloma
Lung cavitation fills with asoergillus = Fungus ball
| like TB, necrotizing infection
136
Aflatoxins
made in foods --> chronic liver injury, heptacellular carcinoma
137
Aspergillus classic triad can be seen in some
1. fever
2. pleuritic CP
3. hemoptysis
- immunocompromised
138
Mucormycosis (zygomycosis)
| colonize and who
soil, decaying material
1. low N= immunocompromised/ organ transplant,
2. high glucose + acidic = DM
3. iron overload = Deferoxamine (has Fe)
139
Mucormycosis (zygomycosis) 2 types
1. Rhinocerebral
| 2. Pulmonary
140
Mucormycosis (zygomycosis) : Rhinocerebral Mucormycosis
1. acute sinusitis (sinus pain), nasal congestion + discharge
2. after days : palate, orbit, brain spread
3. fatal
141
Mucormycosis (zygomycosis) : Pulmonary Mucormycosis
nodular masses in lungs, appear like aspergillus
fever
hemoptysis
142
Pneumocystis jiroveci (carinii)
colonized
who
most people are exposed, ubiquitous, around us
| AIDS, immunocompromised
143
Pneumocystis jiroveci (carinii) SX
low grade fever, SOB, nonproductive cough, hypoxia
144
Pneumocystis jiroveci (carinii) histology
crushed ping pong balls
145
Mucormycosis (zygomycosis) histology
broad non-septated hyphae
146
Aspergillus histology
many septal hyphae, acute angle branching
147
2 fungus like bacteria
1. Actinomyces
| 2. Nocardia asteroides
148
Actinomyces
gram
colonizes
gram +
| normal oral flora, upper resp, genital tract, GI
149
Actinomyces SX
eroding abscess when mucus membrane is disrupted, cervicofacial (mouth), ABD (GI), thoracic (lung) disease
150
Actinomyces histology
sulfur granule formation (yellow glossy) = actinomyces mixed with inflammatory debris
- beaded thread-like
151
Nocardia asteroides
gram
TR
who/ colonize
gram +
air
opportunistic for immunocompromised
152
Nocardia asteroides type of bacteria
acid fast bateria (mycolic acid)
| - similar to TB
153
Nocardia asteroides SX
pneumonia, lung abscess, cavitation
| disseminates
154
fast acid dieseases
1. Nocardia asteroides
2. TB, lepre, MAC
3. Rhodococcus Equi (Corynebacterium Equi)
4. Cryptosporidium Parvum
