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;
185 Cards in this Set
- Front
- Back
- 3rd side (hint)
|
Influenza Symptoms associated (3) |
1. Fever 2. Malaise 3. Myalgia |
|
|
|
Influenza
Determinants of epidemic (5) |
1. Transmissibility 2. Virulence 3. Susceptibility 4. Adaptation to human host 5. Degree of antigenic match to the recommended vaccine |
|
|
|
Influenza 2 glycoproteins that further classify Influenza A |
1. Hemagglutinin 2. Neuramidase |
|
|
|
Influenza Main purpose of Hemagglutinin |
Viral attachment protein |
|
|
|
Influenza Where does it bind (what receptors) |
Sialic acid receptors |
|
|
|
Influenza Main purpose of neuramidase |
Cleaves the virus from cell mwmbrane |
|
|
|
Influenza Why is neuramidase needed (2) |
1. Facilitate cell release 2. Prevent aggregation |
|
|
|
Influenza What allows influenza A to do gene reassortment |
Segmented nature |
_________ nature |
|
|
Influenza
what is gene reassortment |
When a single cell is infected with 2 different strains |
|
|
|
INFLUENZA
2 natures of influenza A genomes |
1. Plasticity 2. Segmentation |
P and S |
|
|
INFLUENZA
Plasticity allows Influenza A to do what |
React to prevailing immunity through immunogenic epitope modification |
|
|
|
INFLUENZA
Plasticity leads to what |
Drift
Clue p is the opposite of d |
Antigenic _________ |
|
|
INFLUENZA Segmentation allows what |
Reassortment of genes that code proteins between variants |
|
|
|
INFLUENZA
Segmentation leads to what |
Antigenic Shift
Both starts with Letter S |
Antigenic _________ |
|
|
INFLUENZA Between shift and drift which has the capacity to develop a pandemic |
Shift ** Shift sounds like **** |
|
|
|
INFLUENZA Differences in Drift and Shift in terms of change (minor or major) Drift: Shift: |
Drift: minor Shift: major |
|
|
|
INFLUENZA What changes happen in drift and shift |
Drift: Point mutations but subtype is the same Shift: new subtype |
|
|
|
INFLUENZA
What is the receptor found in humans |
α-2,6-galactose receptors |
|
|
|
INFLUENZA What is the receptor found in birds |
α-2,3-galactose receptors |
|
|
|
INFLUENZA What is the receptor found in pigs |
α-2,6-galactose receptors α-2,3-galactose receptors |
|
|
|
INFLUENZA Why are pigs commonly implicated in pandemics? |
Because they have both kinds of sialic acid receptors found in humans and birds |
|
|
|
INFLUENZA What is unique about AH1N1 |
It has a quadruple reassortment virus |
Number |
|
|
INFLUENZA What are the components of AH1N1 |
Two genes from pigs 1 gene from birds 1 gene from human |
|
|
|
INFLUENZA What is the mode of transmission in AH5N1 |
Contact with birds |
|
|
|
INFLUENZA
Incubation period |
48-72 Hours |
|
|
|
INFLUENZA
Signs and symptoms (4) |
Rinorrhea Sore throat Conjunctivitis Cough |
|
|
|
INFLUENZA Symptoms that distinguish it from other respiratory illnesses (4) |
Fever Fatigue Myalgia Malaise |
|
|
|
INFLUENZA General findings during PE |
Appears ill Sweating Coughing Non-purulent conjunctivitis Pharyngeal erythema |
|
|
|
INFLUENZA PE findings of the lungs (3) |
Rales Ronchi Wheezint |
|
|
|
INFLUENZA Rashes? |
None |
|
|
|
INFLUENZA
What are the complications (5) |
1. Pneumonia 2. Myositis 3. Pericarditis 4. Post-infectious acute demyelinating encephalomyelitis 5. Guilliain-Barre syndrome |
|
|
|
INFLUENZA What are the three kinds of pneumonia that can develop |
1. Primary Influenza viral 2. Secondary bacterial 3. Mixed viral and bacterial |
|
|
|
INFLUENZA Who are more prone to complications (4) |
1. > 65 years old 2. Underlying cardiopulmonary disease 3. Immunosuppressed 4. Pregnant women in 2nd and 3rd trimester |
|
|
|
INFLUENZA What specimen is best to diagnose influenza |
Nasopharyngeal |
|
|
|
INFLUENZA
When should specimens be collected |
Within 48 hours of onset of symptoms |
|
|
|
INFLUENZA What is the most sensitive and most specific diagnostic method |
PCR |
|
|
|
INFLUENZA What is the blood finding in influenza |
Mild leukopenia |
|
|
|
INFLUENZA A WBC of > 15,000/μl suggests what |
Secondary bacterial infection |
|
|
|
INFLUENZA You should suspect secondary bacterial infection when WBC is how much |
> 15,000 / μL |
|
|
|
INFLUENZA How will you treat? |
Supportive |
|
|
|
INFLUENZA How do you limit Influenza sickness |
Vaccination |
|
|
|
INFLUENZA What drug class is used in the management of influenza |
Neuramidase inhibitors |
|
|
|
INFLUENZA What are some drugs that are neuramidase inhibitors |
1. Oral oseltamivir 2. Nasal spray zanamivir 3. IV peramivir and zanamivir |
|
|
|
MALARIA What are the 5 species known to transmit malaria |
1. P. falciparum 2. P. ovale 1. P. falciparum2. P. ovale3. P. knowlesi4. P. malariae5. P. vivax 1. P. falciparum2. P. ovale3. P. knowlesi4. P. malariae5. P. vivax 1. P. falciparum2. P. ovale3. P. knowlesi4. P. malariae5. P. vivax 1. P. falciparum2. P. ovale3. P. knowlesi4. P. malariae5. P. vivax 3. P. knowlesi 4. P. malariae 5. P. vivax |
FOlK Music Video |
|
|
MALARIA What is the infective stage |
Sporozoites |
|
|
|
MALARIA How many hosts does malaria have |
2 |
|
|
|
MALARIA What is/are the hosts of malaria |
Mosquito Humans |
|
|
|
MALARIA
What mosquito transmits the bacteria |
Female Anopheles mosquito |
|
|
|
MALARIA How many cycles are there in the infection |
3 |
|
|
|
MALARIA What are the cycles in malaria infection |
1. Erythrocytic 2. Extra-erythrocytic 3. Sporogonic |
|
|
|
MALARIA What are the infective stages |
Sporozoites |
|
|
|
MALARIA What are the diagnostic stages |
1. Schizont 2. Gametocytes 3. Trophozoites |
|
|
|
MALARIA Incubation period |
10-15 days |
|
|
|
MALARIA Symptoms (6) |
Fever Headache Chills Fatigue Abdominal discomfoet Muscle ache |
|
|
|
MALARIA Which species causes anemia and can rapidly progress if left untreated |
P. falciparum |
|
|
|
MALARIA If P. falciparum infection is not treated right away, what are possible consequences |
Anemia Rapid progression |
|
|
|
MALARIA What are drugs given if it's a P. malariae infection (2) |
Artesunate Artemetherlumefantrine |
|
|
|
MALARIA What can be given if it's uncomplicated area and there's no resistance |
Chloroquine Amodiquine |
|
|
|
MALARIA What etiologic agents have an additional stage |
P. vivax P. ovale |
|
|
|
MALARIA What is the additional stage in P. vivax and P. oale |
Hypnozoite |
|
|
|
MALARIA What should be given in P. vivax and P. ovale infections |
Primaquine |
|
|
|
MALARIA How do you prevent malaria infections (4) |
1. Insecticied-treated mosquito nets 2. Rapid diagnosis 3. Patient management 4. Chemoprophylaxis |
|
|
|
Dengue What is the family and genus of the virus |
Family: flaviviridae Genus: falvivirus |
|
|
|
Dengue How many serotypes are there |
4 |
|
|
|
Dengue If you get infected with dengue, are you immune? |
Yes, but to that serotype. You can get infected to other serotypes |
|
|
|
Dengue Dengue infection success can be due to what (2) |
1. Globalization 2. Adaptation to urbanity |
|
|
|
Dengue What is the main method of transmission |
Bite of a female aedes mosquito that is infected |
|
|
|
Dengue Can you state the infective cycle? |
Infected human --> bitten by female mosquito --> female mosquito is infected --> bites an uninfected human --> human gets infected |
|
|
|
Dengue What are the 2 possible vectors |
1. Aedes aegypti 2. Aedes albopticus |
|
|
|
Dengue When do aedes aegypti feed more often |
Early in the morning Evening before dusk |
|
|
|
Dengue Incubation period |
4-7 days |
|
|
|
Dengue What is the term that is characteristic of the fever |
Breakbone fever |
|
|
|
Dengue What are the componets of breakbone fever (5) |
Fever
Frontal headache Retro-orbital pain Back pain Severe myalgias |
|
|
|
Dengue What are the symptoms during the first day (4) |
Macular rashes Adenopathy Palatal vesicles Scleral injection |
|
|
|
Dengue What are some additional symptoms (4) |
Anorexia Nausea Vomiting Marked cutaneous hypersenstivity |
|
|
|
Dengue Approximately what days are days of defervescence |
Days 3-5 |
|
|
|
Dengue What symptoms are to be expected during defervescence time (4) |
1. Maculopapular rash that begins on trunk and spreads to face and extremities 2. Epistaxis 3. Scattered petechiae 4. GI bleeding from pre-exisiting lesions |
|
|
|
Dengue How many phases does the dengue progression have |
3 |
|
|
|
Dengue What are the phases of dengue progression |
1. Febrile phase
2. Critical phase 3. Recovery phase |
|
|
|
Dengue What can be expected in the febrile phase (2) |
1. Fever which may cause neuro effects and seizures 2. Dehydration |
|
|
|
Dengue What is expected in the critical phase (3) |
1. Shock 2. Severe hemorrhage 3. Organ impairment |
|
|
|
Dengue What is expected in the recovery phase |
1. Reabsorption fluid overload 2. Hypervolemia |
|
|
|
Dengue Why will there be hypervolemia |
If there's too much IV fluid therapy or if IV fluid therapy has been extended into the recovery period |
|
|
|
Dengue What are the three case classifications |
1. Suspect 2. Probable 3. Confirmed |
|
|
|
Dengue What is a suspect case |
Previously well person with acute febrile illness of 2-7 days with signs and symptoms of dengue |
|
|
|
Dengue What is a probable case |
Suspect + Laboratory test CBC: leukopenia w/ or w/o thrombocytopenia Dengue NS1, antigen test or dengue IgM antibody test |
|
|
|
Dengue What can you expect in a CBC of a probable case patient |
Leukopenia with or without thrombocytopenia |
|
|
|
Dengue What are the laboratory tests that can complement a probable case |
1. CBC: leukopenia w/ or w/o thrombocytopenia 2. Dengue NS1 3. Antigen test 4. Dengue IgM antibody test |
|
|
|
Dengue What is a confirmed case (2) |
1. Viral culture isolation 2. PCR |
|
|
|
Dengue What is the criteria for probable dengue without warning signs |
1. Live in or travel to dengue endemic area 2. Fever of 2-7 days duration and two of the following - Headache - Body malaise - Myalgia - Arthralgia - Retro-orbital pain - Anorexia - Nausea - Vomiting - Diarrhea - Flushed skin - Rash (petechiae or herman's) |
|
|
|
Dengue What are warning sings |
1. Abdominal pain or tenderness 2. Persistent vomiting 3. Clinical fluid accumulation 4. Mucosal bleed 5. Lethargy 6. Restlessness 7. Liver enlargement > 2 cm 8. Increase in HCT with decrease in platelet count |
|
|
|
Dengue What is expected of severe dengue (3) |
1. Severe plasma leakage 2. Severe bleeding 3. Severe organ involvement |
|
|
|
Dengue Plasma leakage can lead to what (2) |
1. Shock 2. Fluid accumulation with respiratory distress |
|
|
|
Dengue What are some organs that are involved in severe dengue |
Liver CNS Kidneys |
|
|
|
Dengue What is expected effects of the liver in severe dengue |
AST or ALT > / = 1,000 |
|
|
|
Dengue What are the expected effects of the CNS in severe dengue (2) |
Seizures Impaired consciousness |
|
|
|
Dengue What are the expected effects of severe dengue on the heart |
Myocarditis |
|
|
|
Dengue What are the severe effects in the kidneys |
Renal failure |
|
|
|
Dengue What are the lab findings in severe dengue (3) |
1. Leukopenia 2. Thrombocytopenia 3. Elevated serum aminotransferase |
|
|
|
Dengue What are the three testing options |
1. NS1 antigen detection ELISA 2. Antibody capture (IgG/IgM) ELISA 3. PCR |
|
|
|
Dengue Which is used for first 5 days of illness |
NS1 antigen detection ELISA |
|
|
|
Dengue What test is used for infections beyond 5 days |
Antibody capture (IgG/IgM) ELISA |
|
|
|
Dengue What is the most commonly employed diagnostic test |
Antibody capture (IgG/IgM) ELISA |
|
|
|
Dengue What is the limitation of Antibody capture (IgG/IgM) ELISA |
Cross reactivity with other flaviviruses |
|
|
|
Dengue What is used for PCR |
Blood serum |
|
|
|
Dengue When can PCR be used |
First 5 days |
|
|
|
Dengue Limitation of PCR |
Labor-intensive and very costly |
|
|
|
Dengue What is the treatment for dengue (4) |
1. Supportive or symptomatic management 2. Fluids 3. Adequate bed rest 4. Avoidance of NSAIDs, aspirin, steroids |
|
|
|
Dengue What are the drugs to be avoided (3) |
1. NSAIDs 2. Aspirin 3. Steroids |
|
|
|
Dengue Why should NSAIDs, aspirin, and steroids be avoided |
Tendency for bleeding |
|
|
|
Dengue What happens to the patient in the first 3 days |
highly febrile |
|
|
|
Dengue What are expected complications in the first three days because the patient is highly febrile |
Dehydration |
|
|
|
Dengue When can shock or bleeding occur (in terms of days) |
Days 3-6 |
|
|
|
Dengue What are the days of reabsorption |
Days 6-10 |
|
|
|
What are the three diseases that are transmitted by the Aedes mosquitoes |
1. Dengue 2. Chikungunya 3. Zika |
|
|
|
Chikungunya Virus What are the vectors of the virus (2) |
1. Aedes aegypti 2. Aedes albopticus |
|
|
|
Chikungunya Virus What are the 2 symptoms that distinguish the virus from dengue since presentation is the same |
1. Desquamating rashes 2. Migrating polyarthritis |
|
|
|
Chikungunya Virus Incubation period |
2-10 days |
|
|
|
Chikungunya Virus What are the signs and symptoms (2) |
1. Fever 2. Severe arthralgia 3. Chills 4. Anorexia 5. Conjunctival injection 6. Headache 7. Nausea 8. Photophobia 9. Migrating polyarthritis 10. Desquamating rash 11. Petechiae 12. Epistaxis |
|
|
|
Chikungunya Virus In migrating polyarthritis, which joints are commonly affected |
SMALL JOINTS |
|
|
|
Chikungunya Virus In children, what is the visual lesion |
Bullous lesion (not maculopapular or petechial rash) |
|
|
|
Chikungunya Virus What are the findings in diagnostic tests (3) |
1. Elevated AST 2. Elevated CRP 3. Mild thrombocytopenia |
|
|
|
Chikungunya Virus Treatment (3) |
1. Supportive 2. NSAIDs 3. Chloroquine |
|
|
|
Chikungunya Virus Chloroquine is for what |
Refractory arthritis |
|
|
|
Zika Virus What are the ways the virus can be transmitted |
1. Mosquito bites 2. Pregnant women to fetus 3. Sexual contact 4. Blood transfusion 5. Organ transplantation |
|
|
|
Zika Virus Incubation period |
3-14 days |
|
|
|
Zika Virus How long do symptoms last |
2-7 days |
|
|
|
Zika Virus Infections and immunity? |
likely to be protected from future zika infection |
|
|
|
Zika Virus What are the common symptoms |
1. Fever 2. Headache 3. Joint pain 4. Muscle pain 5. Non-purulent conjunctivitis 6. Vomiting 7. Hermatospermia 8. Hearing impairment |
|
|
|
Zika Virus What is the main two things that can be used to diagnose Zika virus |
1. History of exposure 2. Symptoms |
|
|
|
Zika Virus It can only be confirmed by ________ |
laboratory tests |
|
|
|
Zika Virus What are specimens that can be used to diagnose zika virus (3) |
1. Blood 2. Urine 3. Semen |
|
|
|
Zika Virus In these people (3), there should be safe sexual practice for __________ months |
Six months of safe sexual practice 1. asymptomatic males who are returning from areas where Zika virus is active 2. Symptomatic males 3. Females who may or may not have had symptoms |
|
|
|
Zika Virus What are the 2 diagnostic tests that can be used |
1. Nucleic Acid Testing 2. Serology (IgM detection) |
|
|
|
Zika Virus Patient has been experiencing symptoms for 5 days. What testing should be done |
NAT Testing |
|
|
|
Zika Virus Patient has been experiencing symptoms for 9 days. What testing should be done |
Serology (IgM detection) |
|
|
|
Zika Virus When should NAT testing be utilized |
If patient symptoms are < / = 7 days |
|
|
|
Zika Virus When should Serology be done |
If patient symptoms are >/= 7 days |
|
|
|
Zika Virus What are the two main things that Zika causes during pregnancy |
1. Brain abnormalities 2. Trigger of Guillain-Barre Syndrome |
|
|
|
Zika Virus What are the components of birth defects that may be caused by Zika (6) |
1. Microcephaly 2. Brain damage 3. Seizures 4. Ear and eye problem 5. Problem in moving limbs 6. Feeding difficulty |
|
|
|
Zika Virus treatment |
Supportive No absolute and definitive treatment |
|
|
|
What is the most important viral encephalitis in Asia |
Japanese Encephalitis |
|
|
|
Japanese Encephalitis In what areas is this common |
Irrigated rice fields |
|
|
|
Japanese Encephalitis What is the vector |
Culex species |
|
|
|
Japanese Encephalitis Incubation period |
5-15 days |
|
|
|
Japanese Encephalitis Signs and symptoms |
1. Fever 2. Nausea 3. Vomiting 4. Diarrhea 5. Cough 6. Aseptic meningitis 7. Meningoencephalitis 8. Seizures 9. Parkinsonian presentation |
|
|
|
Japanese Encephalitis Treatment |
No definite treatment Seizure control Airway security |
|
|
|
Japanese Encephalitis How do you prevent |
Vaccine |
|
|
|
Japanese Encephalitis Two forms of vaccines |
1. Inactivated 2. Live attenuated |
|
|
|
Japanese Encephalitis Vaccine dosage and administration schedule |
2 IM doses, 28 days apart Second dose administered 1 week before travel |
|
|
|
Japanese Encephalitis At what age is the vaccine given |
7 months |
|
|
|
Schistosomiasis What are the 5 species responsible for transmitting schistosomiasis |
1. S. mansoni 2. S. mekongi 3. S. japonicum 4. S. haematobium 5. S. intercalatum |
|
|
|
Schistosomiasis S. mansoni can be found where |
1. South America 2. Caribbean 3. Africa 4. Middle East |
|
|
|
Schistosomiasis S. mansoni goes to where |
Superior mesenteric veins to large intestine |
|
|
|
Schistosomiasis S. haematobium can be found where |
1. Africa 2. Middle East |
|
|
|
Schistosomiasis S. haematobium goes to where |
venous plexus of the bladder and rectal venules |
|
|
|
Schistosomiasis S. japonicum is found where |
Far East |
Japan is found where? |
|
|
Schistosomiasis S. japonicum goes to where |
Superior mesenteric veins to the small intestine
|
Japan is a small country |
|
|
Schistosomiasis S. mekongi is found where |
Southeast Asia |
|
|
|
Schistosomiasis S. intercalatum is found where |
West Africa |
|
|
|
Schistosomiasis Intermediate host? |
Snails |
|
|
|
Schistosomiasis Final host? |
Humans |
|
|
|
Schistosomiasis Infective stage? |
Cercariae |
|
|
|
Schistosomiasis Diagnostic stage |
Eggs found in urine and feces |
|
|
|
Schistosomiasis What are the three phases/stages? |
1. Acute 2. Active 3. Chronic |
|
|
|
Schistosomiasis What do you call the acute phase |
Katayama's Fever |
|
|
|
Schistosomiasis When does the acute phase occur |
weeks after infection |
|
|
|
Schistosomiasis What are clinical manifestations of acute phase (6) |
1. Fever 2. Cough 3. Abdominal pain 4. Diarrhea 5. Hepatosplenomegaly 6. Eosinophilia |
|
|
|
Schistosomiasis What CNS changes can S. japonicum do |
Cerebral granulomatous disease |
|
|
|
Schistosomiasis What CNS changes can S. mansoni and S. haematobium do |
Granulomatous lesions around the egg in the spinal cord --> transverse myelitis with flaccid paraplegia |
|
|
|
Schistosomiasis In other organs what are the 2 things that can happen |
1. Granulomatous reactions 2. Fibrosis |
|
|
|
Schistosomiasis What are the other organ effects caused by S. mansoni (6) |
1. COlonic polyposis with bloody diarrhea 2. Portal hypertension 3. Splenomegaly 4. Pulmonary hypertension 5. Glomerulonephritis 6. CNS lesions |
|
|
|
Schistosomiasis What are the other organ effects caused by S. japonicum (5) |
1. Portal hypertension 2. Splenomegaly 3. Pulmonary hypertension 4. Glomerulonephritis 5. CNS lesions |
|
|
|
Schistosomiasis What are the other organ effects caused by S. haematobium (6) |
1. Cystitis 2. Ureteritis 3. Heamturiam 4. Pulmonary hypertension (rare) 5. Glomerulonephritis 6. CNS lesions |
|
|
|
Schistosomiasis What is the main diagnostic tool |
Microscopic identifiaction of eggs in stool and urine |
|
|
|
Schistosomiasis If you are suspecting S. mansoni or S. japonicum, what do you have to do |
Stool exam |
|
|
|
Schistosomiasis If you are suspecting S. haematobium, what do you have to do |
Urine exam |
|
|
|
Schistosomiasis How many courses should be done |
One course can be curative but repeat treatment after 2-4 weeks to increase effectiveness |
|
|
|
Schistosomiasis Patient's pre-treatment exam was positive for eggs. What will you do |
Follow up exam 1-2 months after treatment to confirm successful cure |
|
|
|
Schistosomiasis What drug can be used for treatment of mansoni, haematobium, and japonicum |
Praziquantel |
|
|
|
Schistosomiasis Dose for mansoni, haematobium, and intercalatum |
40mg/kg/day divided into 2 doses |
|
|
|
Schistosomiasis Dose for mekongi and japonicum |
60 mg/kg/day divided into 3 doses |
|
|
|
Schistosomiasis Describe the eggs of haematobium |
Size: large Spine: conspicuous terminal spine Miracidium: found in urine |
|
|
|
Schistosomiasis Describe the eggs of mansoni |
Size: large Spine: prominent lateral spine near posterior end Shape: tapered anterior end and slightly curved Miracidium: found in stool |
|
|
|
Schistosomiasis Describe the eggs of japnoicum |
Size: large Spine: smaller and less conspicuous Shape: round |
|
