Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
127 Cards in this Set
- Front
- Back
|
Define typhus
|
Artropod bite--> Sudden onset chills, flu-like feelings in 1-3 weeks --> death from vascular collapse or bacterial pneumonia
|
|
|
What are the 3 subtypes of Typhus?
|
Epidemic (sudden onset, reservorir = flying squirrel and humans, vector = lice), Endemic (reservoir = rats, vector = lice), Scrub (reservoir = rodents, vector = mites)
|
|
|
Where does the rash start for typhus?
|
around the waiste - spreads peripherally, spares palms, soles, face
|
|
|
Define Rocky Mountain Spotted Fever
|
abrupt fever, H, chills, rash, starts on extremities and spreads to trunk.
VERY high predilection for capillary endothelium => extreme endothelial damage Causes fulminant shock, vasculitis, thrombosis, primarily in Appalachia |
|
|
Whats the reservoir and cause of Rocky Mountain Spotted Fever
|
Reservoir = dogs, rodents
Cause = Rickettsia Rickettsiae |
|
|
Define Q fever
|
fever, chills, pneumonitis, without rash
The one rickettsial disease NOT spread by the bite of an arthropod Transmitted via inhalation Reservoir = cattle/sheep, esp pregnant ones cause = Coxiella burnetti |
|
|
Trench fever is spread how?
|
inhalation of lice feces --> bone pain, rash
|
|
|
A positive Weil-Felix test means what?
|
That patient has a Rickettsial disease
|
|
|
What causes Erythema infectiosum?
|
5ths Disease or Slapped cheek disease
= bright red cheeks bilaterally --> reticular rash of arms (can also cause aplastic anemia and spontaneous abortion) Cause = parvovirus B19 |
|
|
What causes Leukencephalopathy?
|
JC virus, a papoviridae
Demyelinates CNS by infecting and killing oligodendrocytes Frequently infects humans but only causes disease in immunocompromised. |
|
|
When HPV infects squamous epi cells, it causes what?
|
peri-nuclear clearing ie koilocytes
|
|
|
What two genes are expressed by HPV that encode for proteins that INactivate tumor supressor genes p53 and Rb?
|
E6 and E7
|
|
|
HPV types 1-4 cause what?
|
plantar and skin warts
|
|
|
HPV types what cause condyloma acuminata?
|
6 and 11
|
|
|
Which HPV types inc risk for carcinoma of infected area?
|
ALL types inc risk, but MOST RISK is b/c of: 16, 18, 30's, 40's, 50's
|
|
|
Vaccination with HPC vaccine protects against what HPV types?
|
6, 11, 16, 18
|
|
|
Adenovirus causes what?
|
URI
|
|
|
Whats the only reservoir for smallpox?
|
humans
transmission via respiratory route |
|
|
Route of smallpox?
|
Respiratory route --> URI --> lymph nodes --> enters blood --> enters organs --> fever, malaise, RASH of trunk and face that later spreads to trunk then extremities
|
|
|
Tx smallpox?
|
Smallpox vaccine + cidofovir + probenacid
|
|
|
Define Molluscum Contagiosum?
|
small pink papules with indented crater in center filled with white core = "umbilicated papules"
Transmission = direct contact Kids with it on gentials need to be evaluated for sexual abuse |
|
|
Tx Molluscum contagiosum?
|
curretage or liquid nitrogen
|
|
|
Define Hepatitis B symptoms, transmission, risks?
|
Symptoms = often asymptomatic
Transmission = blood, sexual, mother-newborn Outcome = hepatocellular carcinoma |
|
|
What determines whether a pt with Hep B becomes a chronic carrier?
|
their immune system at the time they are infected
ex = new borns are more likely to become chronic carriers than adults |
|
|
Dx of Hep B?
Tx Hep B? |
+ HBsAg
Tx = Interferon alpha |
|
|
HSV 1 causes what? HSV 2?
|
HSV 1 = oral herpes
HSV 2 = genital herpes |
|
|
Where does herpes of the mouth lay dormant? herpes of the genital area?
|
Mouth = Trigeminal ganglion
Genitals = Lumbar and sacral Dorsal root ganglion |
|
|
What percent of population is infected with HSV-1?
|
80%
|
|
|
DOC HSV-1
|
Acyclovir
|
|
|
Name for the HSV infection in the mouth
|
Gingivostomatitis
|
|
|
FEver blisters and cold sores are caused by what?
|
HSV ie herpes labialis
|
|
|
Herpes infection of eye called what?
|
Herpes Keratoconunctivitis
|
|
|
Herpes of the brain? Fingers? neonatal herpes prevented how?
|
Brain = Herpes encephalitis
Fingers = herpetic whitlow neonatal herpes prevented with C-section |
|
|
Dew drop on rose petal is indicative of what type of infection?
|
varicella zoster ie chicken pox
upper respiratory mucosa --> spreads by blood to skin --> causes vesicular rash --> crusts become puritic, infectious until all lesions crusted over |
|
|
Shingles is what?
|
reactivation of latent VZV
Dx = Tzanck smear Tx = Symptomatic, Acyclovir, DOC = Gabapentin Prevention = shingles vaccine |
|
|
You see heterophile Abs and atypical lymphocytes in a pt with mono (fatigue, lymphadenopathy, pharyngitis, splenomegaly). Dx? Tx?
|
EBV (Epstein-Barr virus)
Tx = symptomatic |
|
|
"starry sky" appearance of biopsy and c-myc oncogene activated. Dx?
|
Burkitt's Lymphoma
|
|
|
Heterophile NEGATIVE, Owl's eye intranuclear inclusions (multi-nucleated giant cells with very prominent intranuclear inclusions). Dx? Tx? Diseases produced?
|
Dx = CMV
Tx = Ganciclovir with Valganciclovir Diseases = mono, retinits, interstitial pneumonitis, hepatits, cytomegalic inclusion disease |
|
|
Roseola (human herpesvirus 6) (AKA exanthem subitum, 6ths disease) has what symptoms associated with it?
|
abrupt onset fever lasts 1-5 days, pink rash on trunk occurs AFTER fever ends
Transmission = respiratory route Tx = Symptomatic |
|
|
What causes Kaposi's sarcoma in AIDS pts, the most common cancer in AIDS pts? DX? TX?
|
HHV-8 ie KSHV
Inactivates Rb --> uncontrolled cell growth --> malignancy of vascular endothelium --> dark purple/flat to nodular lesions in skin, oral cavity, GI tract, lungs DX = biopsy lesions Tx = Sx or radiation and interferon alpha or vinblastine |
|
|
What causes the common cold?
|
Rhinovirus
|
|
|
Pathogenesis of poliovirus?
|
Replicated in oropharynx --> small intestine (lymphoid tissue) --> bloodstream --> CNS where it replicates in motor neurons (in ant. horn of spinal cord) and kills those cells
|
|
|
What are the 4 types of Polio?
|
Inapparent asymptomatic, abortive poliomyelitis = most common, non-paralytic poliomyelitis, paralytic poliomyelitis --> flacid paralysis
* type of polio determined by pts immune status |
|
|
Coxsackie A causes what?
|
Herpangina (fever, sore throat, tender visicles on oropharynx), Hand-foot-mouth disease
|
|
|
Coxsackie B causes what?
|
Myocaridits --> dilated cardiomyopathy
Bornholm disease = "Devil's grip" = fever, pleuritic chest pain |
|
|
#1 cause of Gastroenteritis in kids?
|
Rotavirus (fecal-oral transmission)
|
|
|
Orthomyxoviridae ie Influenza A, B, C causes what symptoms?
|
fever, chills, H, myalgia, cough x3 days in healthy, non-immunized individuals
|
|
|
Influenza C - should we worry?
|
no, minor respiraoty illness
Tx and prevention don't exist |
|
|
Which influenza's can cause atypical pneumonia, Reye's syndrome, secondary bacterial pneumonia?
|
Influenza A and B
|
|
|
Which is epidemic and which pandemic between Influenza A and B?
|
Endemic = Influenza A
Epidemic = Influenza B |
|
|
Dx and Tx for Influenza A and B?
|
Dx = Flu OIA nd Quickvue influenza test (detects viral antigen) or Zstatflu (detects viral neuraminidase)
Tx = Symptomatic, terminate progression of Flu A or B with Oseltamivir or Zanamivir |
|
|
What are the spikes on influ A and B that allow our immune system to recognize them?
|
H antigen (hemagglutinin) and N antigen (neuraminidase = sialic acid)
|
|
|
Pathogenesis of Rubeola ie Measles?
|
Enters upper respiratory tract --> enters blood --> enters RES (reticuloendothelial system) --> enters skin vasculature endo --> RASH (starts of face and progresses downward
Koplik's spots (red lesions with white center in mouth) Prevention = MMR Tx = Vitamin A (+ ribavirin in adults) |
|
|
Mortality rate of Rubeola?
|
10% (most die from measle's encephalitis)
|
|
|
"Steeple sign on x-ray", harsh barking cough. Dx?
|
Croup ie Parainfluenza virus
|
|
|
Mumps symptoms?
|
Parotitis (tender, inflammed parotid gland that spontaneously resolve in 1 week), Orchitis (inflamm and extreme pain of testes), Aseptic meningitis = H, F, meningismus, benign/self-limited
|
|
|
#1 lower repiratory tract infection in infants? Tx?
|
RSV (respiratory syncytial virus)
Tx = intense supportive and ribavirin |
|
|
Ribella AKA German Measle's causes what symptoms?
|
2-3 week incubation then rash on face that spreads downward
=milder and shorter than measle's Prevention = MMR Congenital Rubella Syndrome = the congenitally acquired German Measle's |
|
|
T/F: Coronavirus is the second most common cause of the common cold
|
TRUE (rhinovirus = #1)
|
|
|
What causes SARS = severe acute respiratory syndrome (atypical pneumonia with high Fever, nonproductive cough, dyspnea, H, Hypoxia). Dx? Tx?
|
Coronavirus
Dx = ground glass appearance on x-ray Tx = Interferon alpha and steroids |
|
|
What are the Arbo viruses ie viruses that are arthropod borne ie assoc with the bite of an arthropod?
|
Togavirus, Flavaviridae, Bunyaviridae, Reoviridae
|
|
|
Togaviridae ie Alphavirus causes what?
|
EEE = Eastern Equine Encephalitis
Vector = mozquito, Reservoir = Birds Host = human, horses WEE = Western Equine Encephalitis Vector = mosquito, Reservoir = birds, hosts = humans, horse |
|
|
Flavavirus ie Flavaviridae can cause St. Louis Fever, Yellow Fever, and Dengue Fever, all of which have what vecotr?
|
Mosquito
|
|
|
Bunyavirus causes what?
|
Hantavirus = Hantavirus pulmonary syndrome
Reservoir = deer mice Host = humans Transmission = Respiratory route Flu-like symptoms then respiratory failure, 60% mortality rate, even with hospital support |
|
|
+ Negri bodies, incubation 2-16 weeks after being bit by any mammal. Fever, anorexia, sensory changes at bite site for several days, painful throat spasm with swallowing, seizures, paralysis. Dx?
|
Rabies - nearly 100% death rate
Tx = comfort Prevention = pre-exposure = rabies vaccine post-exposure = rabies vaccine and rabies immunoglobulin |
|
|
Ebola hemorrhagic fever can cause what?
|
fever, H, D, V, thrombocytopenia, hemorrhage, shock, DIC, 100% mortality rate
Reservoir = unknown Tx = supportive |
|
|
Norovirus Gastroenteritis typically occurs where?
|
school, camps, cruise ships
|
|
|
What are some slow viral diseases of CNS?
|
AIDs Dementia complex (caused by HIV), Subacute Sclerosing Panencephalitis (Caused by Rubeola), Progressive Multi-focal Leukoencephalopathy (caused by JC virus)
|
|
|
Kuru, AKA "trembling disease" has what symptoms?
|
rigid limbs, pathologic bursts of laughter, placidity and muteness, death within 3-12 months secondary to decubitus ulcers (massive) or pneumonia
Acquired via canabalism of human brain |
|
|
Define Creutzfeld-Jacob disease
|
Memory loss, ataxia, rigidity
Death within 3-12 months of symptom onset Acquired via tissue transplants or human growth hormone |
|
|
Scrapie is a disease of what animals that can be given to humans?
|
sheep
|
|
|
Variant Creutfeld-Jacob disease has symptoms similar to Creutzfeld-Jacob, but occurs when?
|
disease occurs generally in broader range, including people in their 20s.
Acquired by ingestion of food contaminated with beef or sheep |
|
|
T/F: Fatal Familial Insomnia results in death
|
TRUE
|
|
|
Symptom of Gerstmann-Straussler Scheinker disease?
|
Spastic paresis and ataxia
|
|
|
Adult human T cell Leukemia/Lymphoma causes what?
|
Lymphadenopathy, Hepatosplenomegaly, Lytic bone lesions, skin lesions
|
|
|
HTLV-associated Myelopathy causes what?
|
gait disturbance, lower extremity weakness, low back pain, bladder/bowel incontinence
Imitates MS, progresses over years, females > males |
|
|
HIV genes and gene products?
|
gp160 when cleaved becomes gp 41 and gp 120
gp41 binds CCR5 and CXCR4 gp120 binds CD4 receptors |
|
|
What are the HIV genes?
|
gag, pol, env, tat, nef
|
|
|
Dx of HIV?
|
ELISA, confirmation with Western blot
neg ELISA doesn't rule out HIV though because pt could be in acute stages of disease |
|
|
Whats the risk of obtaining HIV after a percutaneous needle stick with HIV?
|
0.3%
Infectious dose of HIV is >>>>>> greater than Hep B |
|
|
Transmission of HIV?
|
sex, breast milk, IVDU, birth canal, transplacentally, blood transfer
|
|
|
How do we monitor HIV?
|
CD4 count, CBC, electrolytes, liver function test, kidney function test, RPR, pap smear, Hep A, B, C serology, anti-toxoplasma gondii IgG, TST, gonorrhea and chalmydia test
|
|
|
HIV Tx?
|
ART = HAART
|
|
|
What are the 3 stages of HIV?
|
Early, acute (2 weeks after infection, resolves in 2 weeks = lymphadenopathy, sore throat, lethargy, rash on extremities and trunk (NOT soles/palms) (anti-HIV Abs formed within 3-4 weeks after infection)
Middle, latent (lasts for years, aymptomatic so CLINICALLY latent but virus is not latent) Late, Immunodeficient (AIDS) |
|
|
Define AIDS
|
CD4 < 200
AIDS-defining infection (pneumocystis pneumonia, toxoplasmosis, CMV, retinitis, mycobacterium avium complex (MAC), progressive focal leukoencephalopathy) AIDS-defining cancer (Kaposi's sarcoma, lymphoma, invasive cervical cancer) AIDS complicating infections (TB. chronic isosporiasis, cryptosporidiosis, histoplamosis, chronic pulmonary HSV, HIV dementia) |
|
|
HOW are molds formed?
|
fungal cells that unite end-to-end to form one long string of cells known as a hyphus, multiple hyphuae together form mycelium = visibly hairy or fuzzy area we say is "mold"
|
|
|
Dermatophytosis, which is puritic papules/vesicles, broken hair/nails, and red ring with central clearing is caused by what fungi?
|
Epidermophyton, Trichophyton, Microsporum (glows under wood's lamp)
|
|
|
Tinea versicolor, which s hypo-pigmented areas, pruritis, scaling is caused by what?
|
Malassezia furfur
|
|
|
Mycetoma = pus-draining abcess is caused by what?
|
"tree-shaped sporangia"
Petroellidium, Madurella |
|
|
Sporotrichosis or local pustules at site of puncture is caused by what?
|
Cigar-shaped budding yeast = Sporothrix shenkii
|
|
|
Coccidiomycosis is caused by what?
|
Soil: arthospores are inhaled
tissue: endospores Causes Valley fever with + skin test in immunocompromised |
|
|
Histoplasmosis is acquired how?
|
inhale spores --> spores become oval/budding yeast, lives in soil, particularly that which is rich with bird droppings, also bat guano
Symptoms = TB, spread to liver and spleen, heals by calcification |
|
|
Cryptococcus causes what infection?
|
Crytococcus neoformans = yeast that may develop pseudohyphae
Risk = bird (esp pigeon) droppings Yeast inahled -> asymptomatic or pneumonia --> dissemination to CNS |
|
|
Candidiasis causes what?
|
vulvovaginitis, thrush, esophagitis, intertrigo, esophagitis, endocarditis
|
|
|
Aspergillosis cause what?
|
V-shaped hyphae
Grow in warm cavities, ie lung, sinuses, external auditory canal. Cause fungus balls, allergic bronchopulmonary aspergillosis --> asthma symptoms and high IgE titer |
|
|
What is injected into bloodstream when a mosquito bites a human?
|
sporozoite --> within 30 minutes they enter the liver --> develop into merozoits = the only form that can enter RBCs --> enter RBCs and evelop --> develop new merozoites --> severe hemolysis due to RBC lysis every 48 hrs. --> gametocytes are the only life cycle stage that can be successfully consumed by mosquitos
|
|
|
How long is the incubation before symptoms start from a malaria infection?
|
2 weeks
Tx = Chloroquine chloroquine-resistant = Doxy or Tetra or clinda PLUS quinine...Tx for P. vivax and P. ovale must include Primaquine |
|
|
How do we Dx Babesia = malaria-like symptoms?
|
vector = tick
Range = NE US and California Dx = blood smear shows trophozoites in RBC that occur in pairs or tetrads = maltese cross formation Tx = quinine and Clindamycin |
|
|
Pneumocystic carinni is asymtomatic in most but can cause what in some people?
|
Diffuse interstitial pneumonia
Common in AIDS pts and premies Alveolar cysts --> inflamm --> frothy exudate -- Inc O2 exchange --> in late state AIDS -- disseminate to liver, spleen, lymph nodes, bone marrow Dx = bronchial levage with silver stain of specimen Tx = Trimethoprim-Sulfamethoxazole |
|
|
Pt with cat develops Toxoplasmosis gondii. Symptoms?
|
Toxo encephalitis
Congenital toxo --> mental retardation, heart defects, chorioretinitis, hepatosplenomegaly, jaundice, intracranial calcification Acquired from cat feces Tx = pyramethamine + Sulfadiazine + Leucovorin |
|
|
Tx for Leishmania donovani = vector is sand fly and reservoir is dogs, foxes, rodents
|
Symptoms = Kala-azar and black sickness, GI bleeding, weight loss, hyperpigmentation --> black sickness
Tx = Stibogluconate (for cutaneous) Amphoteracin B (for mucosal or systemic) 100% death without Tx |
|
|
What causes Chagas disease?
|
Trypanosoma cruzi
in S. America Vector = reduviid bug - kissing bug bite --> facial edema --> focal nodule --> myocyte invasion and GI plexus --> arrhythmias or CHF or toxic megacolon or mega-esophagus Tx = Nifurtimox |
|
|
Trypanosoma brucei subspecies gambiense and rhodesience cause what symptoms?
|
African sleeping sickness
enter skin via bite --> enter blood --> enter lymph nodes --> 1st fever = spikes every 2 weeks, 2nd = lymphadenopathy 3rd = encephalopathy, sleep-wake cycle messed up, mod changes, slurred speech, tremors, apathy, somnolence, coma Tx = Suramin or Pentamidine |
|
|
Entamoeba histolytica, an intestinal protozoa, pathogenesis?
|
cysts --> divide into 8 trophozoites --> cause tear-drop shaped ulcers in colon (bloody diarrhea) --> may enter portal vein --> enter liver --> cause hepatic abcess
Transmission = fecal-oral, sexually (particularly anal), Cysts only killed with iodine and filters |
|
|
Giardia Lamblia, pathogenesis?
|
Causes giardiasis
Transmitted fecally-orally Reservoir = many mammals, Cyst, Trophozoite --> infects small intestine --> non bloody foul smelling Diarrhea (due to malabsoprtion of fat and protein due to inflamm. Assoc with hikers, campers Dx = "String test" |
|
|
Why is Cryptosporidium life threatening in immuno-compromised individuals?
|
small intestine infection --> severe watery diarrhea --> becomes life threatening bc of dehydration and electrolyte imbalance
Dx = AF stain of fecal smear |
|
|
Pathogenesis of Naegleria fowleri?
|
acquired by swimming in warm water in southern US --> enters nasal mucosa and passes through cribiform plate --> purulent meningoencephalitis -> rapidly fatal
|
|
|
T/F: Nematodes are round worms, Playhelminthes are flat worms and encompass trematodes (flukes), Cestodes (tape worms)
|
TRUE
|
|
|
Define Schistosoma
|
free-swimming immature forms in water enter skin --> enter blood --> enter arterial circulation --> enter liver --> MATURE --> migrate against portal flow to live in preferred mesenteric vessel
|
|
|
Pathogenesis of schistosomes?
|
Itching/dermatitis at entry site --> fever, chills, D, lymphadnopathy, hepatosplenomegaly, eosinophilia --> period of being symptom-free --> bleeding and Manroni japonicum = portal HTN, OR Hematobium = bladder fibrosis and bladder cancer
|
|
|
Pathogenesis Clonorshis?
|
ingestion of contaminated fish --> cysts excyst in small intestine --> swim retrograde up bile ducts --> mature --> mate --> eggs go out with stool --> lads to cholangitis
|
|
|
Taenia solium is obtained from what?
|
pigs
Ingested- --> enters intestine --> matures into adult tape worm --> mate --> eggs excreted with stool --> human ingests eggs via fecal-oral transmission --> eggs hatch --> immature forms penetrate intestine wall and develop into cysticerci --> H, V, focal neuro deficits, seizures, uveitis, retinitis --> cysticerocosis --> death |
|
|
Taenia saginata is obtained from what?
|
beef --> small intestine --> eggs passed with stool --> cycle continued by raw sewage contamination of grazing land --> eggs hatch in cattle intestine and migrate to skeletal muscle
|
|
|
Diphyloobothrium latum is obtained from what?
|
fish 00> raw/undercooked freshwater fish --> settle in intestine --> consume B12, causing B12 deficiency
|
|
|
Echinococcus granulosus, or dog tape worm, develops into cysts where?
|
lung, liver, brain
Causing hemptysis, rupture of cyst = fatal anaphylaxis, liver dysfunction, H, focal neuro deficits, fatal anaphylaxis |
|
|
Whats the most common tape worm in the US?
|
Hymenolepsis nana
|
|
|
Most common tape worm of dogs and cats?
|
Dipylidium caninum
injest infected fleas from infected dogs and cats Most asymptomatic |
|
|
#1 helminth in US?
|
pinworm
occurs only in humans, Dx = scotch tape perianal pruritis, esp at night Ingests egg --> hatch in sm. intestine --> mature into adult --> migrate to colon --> mate --> at night migrate to anus to lay eggs |
|
|
Dx of Ascaris lumbricoides?
|
Dx = detect eggs in stool via O and P
Ingest eggs --> hatch in sm. intestine --> larvae migrate through gut wall --> enter blood steam --> enter lungs --> enter bronchi and trachea --> coughed up --> swallowed --> go to small intestine --> MATURE into adults --> migrate to colon --> mate --> produce effs passed in stool |
|
|
Symptoms of Necator americanus?
|
American hook worm
Pruritis at entry site, D, V, Abd, pain, Fe-deficient anemia walk barefoot or recline in moist soil, grass --> larvae penetrate skin --> enter lung --> ascend --> swallowed --> go to sm intestine --> MATURE --> feed on blood of GI capillaries and produce eggs passed with stool |
|
|
What hook worm has teeth?
|
Ancylostoma duodenale
|
|
|
Strongyloides stercoralis worm causes what?
|
Usually asymptomatic (trick question) BUT can cause watery diarhea, pmeumonitis, if immunocompromized can be fatal
|
|
|
Tricheinella spiralis worm causes what?
|
Fever, myalgia, periorbital edema, esosinophilia, +/- CNS and cardiac symptoms
Obtained from undercooked bear or pork |
|
|
Symptoms of Wuchereria bancrofti?
|
Filariasis (massive lymph node obstruction with limb edema)
Asymptomatic initially --> fever, lymphangitis, cellulitis, lymph node swelling, edema and fibrosis of legs and genitals + Blood test |
|
|
What worm causes Onchocerciasis (=pruritis with dermatitis, lizard skin, blinding eye lesion
|
Onchocerca volvulus
- blood test, + skin biopsy |
|
|
What worm causes Loiasis?
|
Loa Loa
conjunctiva with adult worm crawling across it + blood test |
|
|
What worm causes dranunculiasis?
|
Dranunculus medinensis
LITERALLY makes pts skin crawl burning, pruritic ulcerated and blistered papules Dx = see worm movement under skin Tx = rolling worm around stick slowly |
