1. Test 8-Micro

Front 1

What type of virus is HPV?

Back 1

small, non enveloped, non-lytic DNA virus; circular DNA genome

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replication site for HPV

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squamous epithelial cells (basal cell layer)

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plantar and palmar warts

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HPV 1-4

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genital warts (condylomata)

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HPV 6,11,16,18,31,33,35

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epidermodysplasia verruciformis

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person is susceptible to specific HPV genotypes with inability to amount an immune response to the virus

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high risk HPV cancer

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16 (express viral E6 (p53) and E7 (Rb tumor suppressor) genes-immortalize human keratinocytes)

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HPV E1 and E2

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E1-helicase that unwinds double stranded DNA
E2-transcription factor

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imiquimod

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stimulates immune response to anogenital HPV infections

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HPV is spread by

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sexual transmission, skin to skin contact and contaminated inanimate objects

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bacillus anthracis is from inhaling spores from

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wool of sheep

Front 11

Toxoplasma gondii is from the oocytes of where?

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cat feces (can cross placenta)

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pylonephritis

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kidney infection

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most important uropathogen is

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E. coli

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E coli virulence factor in acute cystitis

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mannose-sensitive fimbria or FimH (adherence)

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E coli virulence factors in acute nonobstructive pyelonephritis

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P fimbriae (adheres to glycosphingolipid Gal); aerobactin (grabs iron) and hemolysin (lyses host cells)

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common causes of acute bacterial prostatitis

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S. aureus and E coli

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ABH blood group antigens

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bind to the receptors on bacterial cells to prevent attachment to the uroepithelium

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cytokines produced in acute cystitis

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IL6,8, and 10; and IgA and IgG

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pyuria

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leukocytes in the urine

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dysuria

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pain on voiding

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symptoms of bacterial prostatitis

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high fever, pelvic pain, urinary retention

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treatment for acute cystitis

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sulfamethoxazole (TMP/SMX) or trimethoprim (TMP) for 3 days or fluroquinolone

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treatment for pyelonephiritis

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10-14 days of TMP/SMX, TMP or fluroquinolone

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asymptomatic bacteriuria should only be treated in

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pregnant women

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treponema pallidum

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syphilis

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chancroid (Haemophilus ducreyi) causes

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genital ulcer disease

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mucopurulent cervicitis and urethritis are caused by

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gonorrhea and chlamydia

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genital ulcer disease is caused by

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syphilis, chancroid, and genital herpes

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pelvic inflammatory disease

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an ascending infection of the uterus and fallopian tubes most commonly caused by gonococci and chlamydiae leading to infertility,ectopic pregnancy, and chronic pelvic pain

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C trachomatis

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chlamydia

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common site of gonococcal and chlamydial infectiosn

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zone of ectopy (extension of columnar epithelium from the endo cervical canal to the ectocervix)

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intrauterine devices and vaginal douching increase the risk for

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PID

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gonococci PID attach to; mech

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nonciliated epithelial cells by pili and an outer membrane protein known as Opa leading to phagocytosis and replication; tissue damage is from lipo-oligosaccharide (LOS) and peptoglycan; vigorous leukocyte response

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chlamydial PID attaches by; mech

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receptor ligand interations; endocytosis but phagolysosomal fusion does not occur leading to elementary bodies which differentiate into reticulate bodies (metabolic form); released from host cells to infect adjacent cells; greater mononuclear reaction that gonorrhea

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bacterial vaginosis

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asymptomatic or symptomatic disruption of the normal vaginal flora characterized by a malodorous vaginal discharge

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Karposi sarcoma

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herpes 8

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single dose treatment for chlamydia

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azithromycin

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persons with agammablobulinemia are susceptible to

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extracellular bacteria

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defects in cell mediated immunity fall prey to

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viruses, fungi, mycobacteria and other intrecellular agents

Front 40

what is characteristic of the period immediately following a transplant

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neutropenia

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breaching the skin with an intravenous catheter can introduce

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Staph epidermidis

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common infections with burns

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staph aureus, pseudomonas aeruginosa, and candida

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granulocytopenia

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decrease in the number of circulating neutrophils
ex. myelosuppressive cancer chemo

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most important causes of fungal sepsis

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candida and aspergillus

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chronic granulomatous disease (CGD)

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neutorphils fail to mount a respiratory burst during phagocytosis; defect in the enzyme NADPH oxidase and hydrogen peroxide is not formed; patients are at risk for infectiosn with catalase positive organisms like S aureus; treat prophylatically with trimethoprim-sulfamethoxazole

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Th1 cells produce

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interferon gamma and IL2 which activate CD8 cells, macrophages, and NK cells to clear intracellular infections through lysis of infected cells

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TH2 cells produce

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IL4, IL5 and IL10 which causes differentiation of B cells and a highly specific antibody response against extracellular pathogens

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What complement parts are necessary to kill Neisseria species?

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C6, C7, C8 or C9

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most cases of HIV reported where?

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sub-Saharan Africa

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type of virus for HIV

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single stranded positive sense RNA with two copies with a 5' cap and poly A tail at 3'

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pro gene in HIV

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codes for a protease necessary for cleaving pol and gag

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gag gene in HIV

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core proteins

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pol gene in HIV

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reverse transcriptase or RNA dependent DNA polymerase and integrase

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env gene in HIV

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envelope glycoproteins

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binding for HIV

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HIV binds to CD4 receptor via gp120 causing conformational change and then coreceptor (CCR5 or CXCR4) binds; this brings gp41 into approximation with the cell membrane

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tat and rev genes in HIV

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transactivating factors which increase expression of viral RNA and proteins

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Nef protein HIV

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downregulates presence of MHC1 molecules

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Vif protein in HIV

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facilitates destruction of a cellular protein (APOBEC3G) capable of blocking reverse transcriptase when packaged withing the virus particle

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80% of people who received factor 8 before 1984 are infected with

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HIV

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how to test fro HIV

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ELISA confirm with western blot

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zidovudine (azidothymidine or AZT)

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inhibits reverse transcriptase

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p24 antigen in HIV symbolizes

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active viral replication

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normal CD4 ranges

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800-2000

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HIV positive patients who have positive TB tests without active disease should be given

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isoniazid

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most frequent lung infection in AIDS

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P. jiroveci- fever, cough, and shortness of breath

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CMV infections can spread to the

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eye-blindness

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enfuvirtide

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HIV fusion inhibitor

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cardinal symptom of disseminated protozoal infections

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fever

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4 types of malaria

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P. falciparum (any age RBC), P. vivax (reticulocytes), P. ovale (older RBCs), and P. malariae (older RBCs)

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malaria cycle

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in infected mosquitos, plasmodia inhabit the salivary glands as sporozoites and enters the human blood stream and into the liver; sporozoites multiple and mature in liver cells and released into blood as merozoites and invade RBCs; some merozoites enter a sexual gametocyte stage which can be taken up by mosquitos; causes RBCs to be less deformable

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special characteristic of P. falciparum

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contains pfEMP-1 binds infected RBCs to receptos on the endothelial cells of venules and capillaries like ICAM-1 and CD36; also prevented from circulating in the spleen (can't be removed from circulation; irregular fever patters

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parasites in RBCs are inhibited by

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G6PD or thalassemia because it reduces the production of NADPH causing oxidative stress

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P falciparum may be resistant to

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chloroquine

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chloroquine

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blocks heme detoxification in the food vacuole

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babesia microti

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transmitted by a deer tick (Ixodes scapularis); flulike illness, with fever, chills, sweats, muscle aches and fatigue; infects RBCs; parasites form small rings in tetrads; clindamycin plus quinine

Front 76

toxoplasma gondii

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can cause mono like syndrome and congenital infection in first trimester-chorioretinitis; eat inadequately cooked meat or ingesting oocytes in cat feces; cats harbor the sexual cycle; parasites penetrate the gut wall and invade the blood stream and into the brain and heart; high IgM titer; treat with pyrimethamine plus sulfadiazine or clindamycin

Front 77

leishmania

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superficial ulcer to systemic infections; flagellum connected to kinetoplast (mitochondria like and has own DNA); phlebotomine sand flies; produces superoxide dismutase to protect against superoxide produced by macrophages; after being taken up they differentiate into nonflagellate called amastigote; treat with allopurinol and ketoconazole

Front 78

trypanosoma cruzi

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chagas disease; bite of the reduviid "kissing" bug; a chancre or tissue and lymph node swelling may develop at the bite site; can damage to nerves in GI tract (mega esophagus, megacolon) or conduction issues (right bundle branch block) or cardiomyopathy; FIBROSIS, treat with nifurtimox or benznidazole

Front 79

trypanosoma brucei

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african sleeping sickness from tsetse flies; fever and swollen lymph nodes; carries alternative forms of genes for genetic rearrangement; treat with eflornithine

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naegleria fowleri and acanthamoeba are amebas that cause

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meningoencephalitis; treat with imidazoles

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M. genitalium

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transmitted through sexual contact; causes urethritis, cervicitis, and endometriosis; diagnosed by PCR

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M. hominis

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transmitted sexually and vertically; causes PID, chorioamnionitis and postpartum fever; isolated in the CNS of newborns

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U. urealyticum

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transmitted sexually and vertically; causes urethritis, PID, chorioamnionitis and post partum fever; associated with chronic lung disease in premature infants with very low birth weights; has been isolated from the CNS of newborns

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characteristics of mycoplasm pneumonia

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lack a cell wall, require sterols for growth, causes tracheobronchitis and pneumonia, smallest prokaryote to grow on cell free media, highly fastidious, use serology and PCR, no cell wall (murein) so no gram stain; grow slowly

Front 85

how does M. pneumonia bind and where is it located?

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binds to respiratory epithelium through specialized adhesions (bind to carbohydrate receptors on epithelium) or fibronectin; involvement is limited to the respiratory mucosa and not the lung alveoli; bronchopneumonia; occasionally causes hemolytic anemia (check with cold hemagglutinin

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treatment of mycoplasms is with

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erythromycin, tetracycline, or fluoroquinolone