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MOD Exam2 > Virus and Fungi- Hillard > Flashcards

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
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2
Q

Bacterial
CBC
fever
dx

A

CBC = high WBCs, N left shift
Fever = high (adults), low in children
Dx: culture

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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

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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

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5
Q

HSV neonatal infection
HSV nail sx
HSV in immunocompromised

A

intrauterine death , TORCH
Herpetic whitlow
viral encephalitis

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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

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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

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8
Q

Epstein Barr Virus
TR mode
infects, colonizes

A

“kissing d” contaminated toothbrush or utensils, saliva
Directly infects B-cells
Mono

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9
Q

EBV SX

A

fever, sore throat, lymphadenopathy, hepatosleenomegaly, atypical lymphocytosis -enlarged,
you can see rash

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10
Q

EBV risk factor for

A
  1. B-cell lymphoma (burkitt)

2. Nasopharyngeal carcinoma

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11
Q

EBV DX

A

Heterophile Ab test (monospot, do first)

EBV Ab test

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12
Q

Cytomegalovirus
TR mode
SX

A

body fluids

  1. asymptomatic
  2. CMV mononuclease (lymphocytosis + high fever, sore throat) - like mono
  3. reactivates in immunocompromised = choriorentinits
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13
Q

Cytomegalovirus neonatal

A

TORCH virus, intellectual disability

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14
Q

CMV choriorentinitis

A

pain, red, progressive vision loss, blurry vision, floating black spots

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15
Q

CMV vs EBV

A

CMV has higher and longer fevers

owl’s eye seen on histology

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16
Q

Rosela
age
tr mode
sx

A

*HH6
children
saliva
high fever (3-5days) —-> rash all over body

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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

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18
Q

HHV 8 is common in

A

africa, east europe, middle east, AIDS

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19
Q

Hepatitis that is DNA

A

Hep B

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20
Q

Hep A
TR mode
chronic hepatitis or not

A

Enteric (fecal oral, contaminated water food)

NO

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21
Q

Hep B
TR mode
chronic hepatitis or not

A

Parenteral - sex, blood, mom to fetus, needles

YES

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22
Q

Hep C
TR mode
chronic hepatitis or not

A

Parenteral - sex, blood, mom to fetus, needles

YES

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23
Q

Hep D
TR mode
chronic hepatitis or not

A

Parenteral - sex, blood, mom to fetus, needles ONLY WITH HEP B***
YES

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24
Q

Hep E
TR mode
chronic hepatitis or not

A

Enteric (fecal oral, contaminated water food)

NO, except YES to genotype 3

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25
Q

DX for HEP A,C, D, E

A

Ab testing

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26
Q 
DX for Hep B
how to read it
- HBsAg 
- HBeAg 
- HBsAb
- Anti-HBeAg 
- Anti-HBcAg
A

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), +
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27
Q

Acute Hepatitis

A

fatigue, malaise, jaundice (painful liver, N,V)

-HEP A, E-

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28
Q

Fulminant viral hepatitis

A

severe, underlying liver disease

HEP B and HEP D

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29
Q

Chronic Hepatitis

A

asymptomatic, RUQ pain, malaise, fatigue, jaundice

  • > cirrhosis
  • > hepatocellular carcinoma
  • HEP B, HEP C-
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30
Q

hepatitis on liver function test

A

high AST, ALT
high bilirubin
high clotting time

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31
Q

Adenovirus SX

A

upper respiratory tract illness, (can have fever) pharyngitis, cold-like sx
*DNA

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32
Q

Cold SX

A

from RNA

sore throat, rhinorrhea, cough, malaise

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33
Q

3 viruses causing cold

A
  1. rhinovirus
  2. coronavirus
  3. RSV
  4. Metapneumovirus
  5. parainfluenza
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34
Q

RSV

A

Respiratory Syncytial Virus

number 1 cause of pneumonia in young children = giant cell formation

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35
Q

Metapneumovirus

A

2nd cause of pneumonia in young childern, bronchitis

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36
Q

parainfluenza

A

CROUP, “ barking cough”

infection of larynx and bronchous

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37
Q

Papovaviridae : Human papillomavirus

A

common genital warts = condyloma acuminatum

can lead to cervical cancer (E6,E7 proteins—-I TSG) - epithelial dysplasia

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38
Q

what strains of HPV are at higher risk for cervical and oropharyngeal cancer development

A

16, 18, 31, 45

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39
Q

Papovaviridae : Polyoma virus

immunocompetent

A

flu like disease

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40
Q

Papovaviridae : Polyoma virus
immunocompromized
BK and JC strain

A

BK : renal transplant patients get severe problems

JC: seen on AIDS, progressive multifocal leukoencephalopathy - demylenation

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41
Q

BK Polyoma virus

A

infects GU system , hemorrhagic cystitis in bladder and nephritis
hematuria, dysuria, polyuria, low abd pain, high Cr and low kidney function

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42
Q

how to screen for BK Polyoma virus

A

see ground glass inclusions on histology

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43
Q

JC Polyoma virus

A

infects CNS, demyelination lesions, progressive multifocal leukoencephalopathy
- mental changes, speech, cognition, behavior, motor problems = staggering gait

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44
Q

Parovirus B19
SX
other name for it

A 
low fever, headache, sore throat, rash on cheeks* = rash slapped cheeks
Erythma infectiosum (5th's disease)
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45
Q

Parovirus B19 in severe cases can

A

kill RBCs and transient anemia (especially in SS anemia, thalassemia)

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46
Q

Parovirus B19 neonatal

A

fetal hydrops, severe anemia

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47
Q

histology Parovirus B19

A

giant erythroblasts

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48
Q

Poxviridae : Molluscum contagiosum

A

superficial skin infection all over body , “water warts”

young children, immunocompromised

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49
Q

Poxviridae: Smallpox

A

gone in humans

highly contagious, high fever + hard vesicles at same stage

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50
Q

Orthomyxoviridae : influenza
2 virulence facotors
TR mode

A

RNA
1. Hemagglutinin : binding to sialic acid receptors (UppRespTr)
2. Neuraminidase : disrups mucin barrier
air

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51
Q

Orthomyxoviridae : influenza SX

A

high fever, rhinorrhea, cough, myalgias, arthralgia

- had annual vaccine

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52
Q

Antigenic Drift

A

small mutations in Neuraminidase and Hemagglutinin

- milder disease

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53
Q

Antigenic Shift

A

trading RNA segments with another virus (usually in animals) —-> completely new Neuraminidase and Hemagglutinin
= pandemic

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54
Q

Paramyocoviridae : Measles
other name
steps in SX

A

Rubeola

  1. fever, cough, rhinitis, conjunctivitis
  2. Koplik’s spots (oral lesions)
  3. head —-> toe maculopapular rash
    - can lead to pneumonia and encephalitis
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55
Q

Paramyocoviridae : Measles can persist and cause

A

Subacute scelrosing panencephalitis

- slowly progressing neurologic disease (forgetful, distractilibility…)

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56
Q

Paramyxoviridae : Measles spreads

A

by respiratory droplets

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57
Q

Rubella
other name
SX

A

German measles (milder type)
Mild-measles-like illness
- erythematous rash : head —-> toe (maculopapulary)
- flu-like, fever, lymphadenopathy

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58
Q

Rubella neonatal

A

in a TORCH and causes congenial HEART, EYE, EARS, CNS problems

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59
Q

Paramyxoviridae : Mumps

SX steps

A

fever

infects parotid gland (parotitis) + testes (orchitis)

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60
Q

Paramyxoviridae : Mumps

A

childhood vaccination mumps, measles, rubella (MMR)

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61
Q

Coronavirus
TR mode
SX

A

air

common cold

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62
Q

coronavirus

SARS -CoV and COVID-19

A

bar reservoir in china
atypical pneumonia
- can get severe respiratory sx, prothrombic states, encephalitis

63
Q

Coxsackie virus : Coxsackie A

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
Q

Coxsackie A vs herpes

A

bilateral and posterior , and throat lesions in coxsackie A

65
Q

Coxsackie B

boards

A
  1. Pleurodynia : resp infection, fever, CP i on inspiration

2. Myocarditis, Pericarditis : heart inflammation , arrhythmias, hear failure

66
Q

Hantavirus
colonize
area
SX

A

rodent reservoir
SW USA
flu-like illness : high fever, myalgia, cough, N, V)

67
Q

Hantavirus can become

A

Hantavirus pulmonary syndrome : fluid leaks out from pulmonary capillaries, shock, death

68
Q

Diarrhea viruses : 2

A

Norovirus (Norwalk virus)

Rotovirus

69
Q

Norovirus (norwalk virus)

A

N,V, Watery D, can have fever
= institutional settings*
=cruises

70
Q

Rotovirus

A

N,V, Watery D, can have fever
= institutional settings*
can cause infant mortality

71
Q

Rhabdoviridae: Rabies
shape of rna
TR mode

A

bullet shaped RNA
bite (saliva) from warm blooded animals
—-> up the nerve axon —-> CNS

72
Q

Rhabdoviridae: Rabies

SX steps

A
  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
Q

Rhabdoviridae: Rabies once sx start

A

there is no reverse , encephalopathy, death

74
Q

Rhabdoviridae: Rabies prevention and tx if bitten

A

vaccine if high risk

many vaccines of immunoglobulin IgG is given

75
Q

Flaviviridae virus
colonize
TR mode

A

febrile mosquito- born illness, in warm tropical

76
Q

Flaviviridae virus : yellow fever

SX

A

fever, headache, N,V
*Hepatitis + jaundice
(60% mortality if severe)

77
Q

Flaviviridae virus : Dengue fever

SX

A
  • “break-bone fever” - severe backache, joint pain, transient macular rash
    can cause hemorrhage (skin and mucosal bleeding)
78
Q

Flaviviridae virus : Zika virus

SX

A

fever, rash, joint pain, illness resolves

neonatal —-> microcephaly

79
Q

Flaviviridae virus : West Nile Virus
SX
TR mode

A

fever, headache, can have rash
severe: meningitis, encephalitis, paralysis
mosquito –> CNS

80
Q

Flaviviridae virus : togaviridae
SX
TR mode

A

encephalitis (horses + humans)
mosquitos TR from birds
- western equine encephalitis
- eastern equine encephalitis

81
Q

Polio virus

boards

A 
eradicated for the most part 
mild fever repeated fro 1-3 weeks
aseptic meningitis
flaccid asymmetric paralysis 
virus ----> anterior motor neurons)
82
Q

HIV function

A
  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
Q

HIV screening

A

P24 capsid = Ag test for HIV which is surrounded by a p24 capsid

84
Q

HIV : acute

A

1mo -3mo after exposure

mononucleosis- like (mono): fever, fatigue, myalgia, lyphadenopathy, pharyngitis

85
Q

HIV : latency

A

about 7-8 years
lymphadenopathy increased, fever, weight loss, night sweats
- can cause CNS problems
- opportunistic infections

86
Q

CD 4+ normal and abnormal

A

normal : 1000cells/uL
susceptible to infection : 400cells/uL
AIDS : 200cells/uL

87
Q

what are some clinical findings you can see in AIDS patients

A
  • 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
Q

3 diseases when CD 4+ is below 200cells/uL

A
  1. Candida
  2. Cryptococcus neoformans
  3. Toxoplasmosis
89
Q

HIV can cuase what cancers

A
  1. B-cell Lymphomas (from EBV)
  2. Kaposi sarcoma (fromHHV8)
  3. Cervical carcinoma (from HPV)
90
Q

HIV DX

A

Ab/Ag assay fro HIV Abs or p24 Ag
PCR
HIV-1 most common type

91
Q

Fungal Hyphae

A

filamentous multicellular structure , mold

92
Q

Yeast

A

unicellular budding, pseudohyphae

93
Q

spores

A

reproductive single cell hyphae

94
Q

thermally dimorphic fungi

25C, 77F

A

hyphal form

95
Q

thermally dimorphic fungi

37C, 98.6F

A

yeast form

96
Q

superficial fungal infections

A
  1. pityriasis versicolor
  2. tinea nigra
  3. dematophytes
97
Q

subcutaneous fungal infection

A
  1. Sporothrix schenckii - ulcerative nodules

2. chromoblastomyocosis - cauliflower wart-like

98
Q

Pityriasis versicolor (tinea versicolor)

A

hypopigmented or hyperpigmented skin macules

- Malassezia species (spaghetti and meatballs)

99
Q

Tinea nigra

A

dark brown/ black spots (palms, soles)

-Hortaea (Exophaiala) werneckii

100
Q

Dermatophytes 3 types

A
  1. Microsporum
  2. Trichophyton
  3. Epidermophyton
101
Q

Dermatophytes SX

A

pruritic, scaly, circular rash, erythematous ring

102
Q

Tinea corporis

A

main body

ring worm

103
Q

Tinea cruris

A

affect groin scrotum

jock itch

104
Q

Tinea pedis

A

feet, toes

athletes foot

105
Q

tinea capitits

A

scalp mostly in children

106
Q

Tinea unguinium (onchomycosis)

A

nails

107
Q

Tinea barbae

A

hair

108
Q

how to DX fungus

A

KOH scrape

wood lamp

109
Q

Sporothrix schenchii
colonize
TR
SX

A

soli and plant thorns and woods
gardening
hands and feet, into lymph —-> subcutaneous ulcerative nodule

110
Q

Chromoblastomycosis
TR mode
colonizing

A

tropical, subtropical, soil, rotting wood

Sporothix, traumatic implantation (thorns)

111
Q

Chromoblastomycosis

SX

A

violet wartlike lesion : cauliflower wart

  • months to years later-
  • sclerotic bodies on histology (circular, ovid, brown, anucleated structures)-
112
Q

sclerotic bodies function

A

in Chromoblastomycosis

resistant to immune clearing = elicit giant cell reaction

113
Q

Candida albicans 3 types SX

A
  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
Q

Candida albicans is from what

A

pseudohyphae (budding cells often in spore formation)

115
Q

oral Candida albicans is called

A

oral thrust

116
Q

Dimorphic fungi characteristics

A
  • primary lung infection from breathing in spores
  • high eosinophilia
  • granulomas *
  • spread hematogenously (blood : CNS, bone, skin)
  • DX by biopsy, cytology cuture
  • thermally change
117
Q

3 Dimorphic fungi

and how to dx them

A
  1. Histoplasma - urine Ag test
  2. Blastomyces - urine Ag test
  3. Coccidioides - serology
118
Q

Bronchoalveolar lavage

A

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
Q

viewing oral thrust by

A

EGD : esophagogastroduodenoscopy

120
Q

Histoplasma capsulatum
area
colonize

A

mississippi, Missouri, Ohio river valley, Midwest
CAVES : bat droppings
birds, chickens (farm)

121
Q

Histoplasma capsulatum SX

A

asymptomatic in immunocompetent
lung lesions –> cacification
pneumonia (mediastinal lymphadenopathy)-rare
*can look like TB

122
Q

Blastomyces dermatitidis
area
colonize

A

Mississippi river valley, Great lakes

soil, rotten wood

123
Q

Blastomyces dermatitidis SX

A
  • acute or chronic pneumonia (cough, low grade fever, sob)
  • multisystem disease more common to happen then histoplasma
  • skin cutaneous plaques
124
Q

Blastomyces dermatitidis in histology

A

broad based double budding spores

125
Q

Coccidioides immitis
area
colonize

A

SW USA, valleys, dust, earthquakes

Desert areas , inhale spores and inside body –> large spherules

126
Q

Coccidioides immitis SX

A

self-limited acute pneumonia = “valley fever”
CP, fever, cough
- can cause meningitis

127
Q

Cryptococcus Neoformans
colonize
TR

A

Pigeon droppings

large polysaccharide capsule yeast

128
Q

Cryptococcus Neoformans SX

A 
asymptomatic in immunocompetent
immunocompromised : 
- Meningoencenphalitis from lung to blood to brain 
- can cause focal pneumonitits
* common in AIDS or HIV
129
Q

Cryptococcus Neoformans DX

A

Bronchoalveolar lavage or lumbar puncture

India Ink : clear ring around capsule

130
Q

Cryptococcus Gattii
area
colonize

A

australis, papa new guinea, NW US occasionally

soil around fir or eucalyptus

131
Q

Cryptococcus Gattii SX

A

immunocompetent have some SX
immunocompromised :
- SEVERE Meningoencenphalitis from lung to blood to brain
- SEVERE pulmonary problems

132
Q

Aspergillus

colonize

A

grains, peanuts, corn, rice

133
Q

Aspergillus SX

A
  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
Q

Allergic Bronchopulmonary Aspergillosis

A
  • asthma like bronchospasm (IgE)

low grade fever, wheezing, malaise, cough up mucous (pneumonia)

135
Q

Aspergilloma

A

Lung cavitation fills with asoergillus = Fungus ball

like TB, necrotizing infection

136
Q

Aflatoxins

A

made in foods –> chronic liver injury, heptacellular carcinoma

137
Q

Aspergillus classic triad can be seen in some

A
  1. fever
  2. pleuritic CP
  3. hemoptysis
    - immunocompromised
138
Q

Mucormycosis (zygomycosis)

colonize and who

A

soil, decaying material

  1. low N= immunocompromised/ organ transplant,
  2. high glucose + acidic = DM
  3. iron overload = Deferoxamine (has Fe)
139
Q

Mucormycosis (zygomycosis) 2 types

A
  1. Rhinocerebral

2. Pulmonary

140
Q

Mucormycosis (zygomycosis) : Rhinocerebral Mucormycosis

A
  1. acute sinusitis (sinus pain), nasal congestion + discharge
  2. after days : palate, orbit, brain spread
  3. fatal
141
Q

Mucormycosis (zygomycosis) : Pulmonary Mucormycosis

A

nodular masses in lungs, appear like aspergillus
fever
hemoptysis

142
Q

Pneumocystis jiroveci (carinii)
colonized
who

A

most people are exposed, ubiquitous, around us

AIDS, immunocompromised

143
Q

Pneumocystis jiroveci (carinii) SX

A

low grade fever, SOB, nonproductive cough, hypoxia

144
Q

Pneumocystis jiroveci (carinii) histology

A

crushed ping pong balls

145
Q

Mucormycosis (zygomycosis) histology

A

broad non-septated hyphae

146
Q

Aspergillus histology

A

many septal hyphae, acute angle branching

147
Q

2 fungus like bacteria

A
  1. Actinomyces

2. Nocardia asteroides

148
Q

Actinomyces
gram
colonizes

A

gram +

normal oral flora, upper resp, genital tract, GI

149
Q

Actinomyces SX

A

eroding abscess when mucus membrane is disrupted, cervicofacial (mouth), ABD (GI), thoracic (lung) disease

150
Q

Actinomyces histology

A

sulfur granule formation (yellow glossy) = actinomyces mixed with inflammatory debris
- beaded thread-like

151
Q

Nocardia asteroides
gram
TR
who/ colonize

A

gram +
air
opportunistic for immunocompromised

152
Q

Nocardia asteroides type of bacteria

A

acid fast bateria (mycolic acid)

- similar to TB

153
Q

Nocardia asteroides SX

A

pneumonia, lung abscess, cavitation

disseminates

154
Q

fast acid dieseases

A
  1. Nocardia asteroides
  2. TB, lepre, MAC
  3. Rhodococcus Equi (Corynebacterium Equi)
  4. Cryptosporidium Parvum

MOD Exam2 (8 decks)

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