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428 Cards in this Set
- Front
- Back
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what are the roles of GI flora?
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innate immunity
acquired immunity metabolic related to obesity |
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Decrease in the lactobacilli population shifts the vaginal pH over 4.5.
When this happens, there’s a risk for: |
-Overgrowth of coccobacilli
-Sometimes, overgrowth of yeast -An environment more susceptible to other pathogenic organisms |
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what are obligate pathogens?
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pathogens that should never be in your flora
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what are vectors?
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organisms that transmit an infectious agent
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what is a resivor
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species that can hold onto a disease
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what is the genetic variable for fighting an infection?
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HLA/MHC molecules they inherited
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are bacteria eukaryotes or prokaryotes?
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prokaryotes
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bacterial follow ____ growth then ____
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exponential growth then limited
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what are two treatments for c diff?
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normal floral transplantation
fecal transplantation |
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what is a plasmid?
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small circular DNA molecules that are separate from the main bacterial chromosome
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what is f factor involved in?
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conjugation
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what do r plasmids do?
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transfer genes for antibiotic resistance by bacterial conjugation
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f factor creates ____ between itself and ___
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cytoplamic bridg between itself and bacteria it comes in contact with. it recerates portion of genome and gives its copy to other bacteria
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A bacterium with ____ can grasp another bacterium (sometimes even from another species), create a “mating bridge”, and transfer genetic information to the other bacterium.
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sex pili
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what is transformaton?
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bacteria absorbing stray bacteria from their surroundings
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what is transduction?
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Bacteria gain resistance by having it transmitted to them from a virus.
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all bacteria have ___ and ___ some have ____
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protien coat
DNA on interior phospholipid membrane |
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the viral life cycle can be either ___ or ___
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lytic or lysogenic
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describe lytic viral replication
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-viral protiens bind to receptors on hosts cell
-viral nuclic acid enters cell -When activated, viral DNA triggers viral duplication, using the host’s molecules and organelles -The host cell is destroyed, and newly replicated viruses are released |
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describe lysogenic vrial replication
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-Lysogenic viruses get into cells, then insert themselves into the cell’s genome.
-Every time the cell divides, the viral DNA is copied -once there is a large numbr of carriers, a trigger causes virus to remove itself from genome then do lytic viral rep |
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by inserting itself into the cells DNA, the virus ____
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hides from immune system
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what is a prophage?
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the inserted phage DNA
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how does an RNA virus enter a host cell?
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Glycoprotein spikes contact host cell receptors
Viral envelope fuses with host plasma membrane |
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how is RNA genome of RNA virus released?
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it is uncoated
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describe reproductive cycle of RNA virus
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-enters cell
-uncoated -mRNA synthesis using a viral enzyme -Protein synthesis -RNA synthesis of new viral genome -Assembly of viral particles |
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what are the three ways emerging viruses cause human disease?
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1) mutations
2) contact between species 3) spread from isolated populations |
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why are alot of emerging viruses RNA viruses?
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bc RNA has no proofreader
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what are examples of emerging viruses?
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HIV
Ebola virus West Nile virus SARS avian flu |
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HIV is a ____ consisting of what three things?
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retrovirus
1) a membrane coating 2) two copies of RNA genome 3) reverse transcriptase |
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what is reverse transcriptase?
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an enzyme that produces DNA from an RNA template
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what is a retrovirus?
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special classification of RNA virus
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reverse transcriptase uses ___ to produce ___. then produces ___
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RNA to produce one DNA
complememntary DNA strand |
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describe retrovirus replication
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-reverse transcriptase uses RNA to produce one DNA
-reverse transcriptase then produces complementary strand -Viral DNA enters the nucleus and integrates into the chromosome -Provirus DNA is used to produce mRNA -mRNA is translated to produce viral proteins -Viral particles are assembled and leave the host cell |
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what is a provirus?
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Viral DNA that enters the nucleus and integrates into the chromosome
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HIV attacks ___ and ____
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t cells
uses them to make copies of itself |
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how long is lysogenic phase before t cells are destroyed in HIV?
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3-5 years
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what do chemotactic chemicals do?
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attract WBC from capillary into interstitital barrier
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describe what happens during an inate injury response
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1) entry of bacteria injures tissue
2) vasodilation to area, increasing blood flow 3) increase in protien permeability resulting in diffusion of protien and filtraiton of fluid into interstitial fluid 4) chemotaxis 5) destruction of bacteria 6) repair |
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describe anemia of chronic disease
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liver retains Fe and Zn and secretes acute phase proteins
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what happens when cytokines reach the brain?
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they cause behaviors associated with infection
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what happens when prostaglandinls reach brain?
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they cause fever
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what happens when cytokines reach the bone marrow?
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they increase monocyte/neutrophil release
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during infection what two things reach liver and what do they cause?
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IL1 and TNF reach liver, causing production and release of opsonins + protease inhibitors (antivirals)
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what are protease inhibitors?
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antivirals
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what is c reactive protien?
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-made in liver
-opsonin -elevated in inflammation and heart disease |
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where are acute phase protiens released from and what do they do?
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from liver
opsinize the invading bacteria |
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how can marginalating neutrophils detect inflamatory mediators?
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chemotaxis
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how do marginalating neutrophils move into vessle space?
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diapedesis
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When a patient takes steroids, his/her WBC’s tend to ___
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demarginalate
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These particles of the “invader” often will be recognized by ___
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adaptive arm of immune system
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what are phagocytocit cells?
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Monocytes (Macrophages, Dendritic Cells)
Neutrophils Eosinophils |
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opsonins are part of ____
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complement system
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wat determines passage of particles into bacterium?
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cell membrane
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bacteria may also have____ which requires ___ to get through
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outer capsule
opsiniztion |
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what is nitric oxide involved in in phagocytosis?
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regulation of inflamatory process
and extracellular killing of microbes |
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what are cytokies involved in in phagocytosis?
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activation of clotting and anticlotting pathways
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dendritic cells arise from ___ just like ____
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monocytes
macrophages |
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what do dendritic cells do?
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-move to epithelia surface
-engulf "non self" cells -take it to lymphatic tissue so it can be processed and detected |
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what are the two main catagories of leukocytes?
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granular and agranular
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what are the granulocytes?
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neutrophils
eosinophils basophils |
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what are the agranulocytes?
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monocytes and lymphocytes
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describe eosinophils
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Defend against parasitic worms; engulf pollen and animal dander.
Granules contain toxic molecules that attack parasites |
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describe basophils
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Non-phagocytic
Contribute to allergic reactions |
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describe monocytes
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Phagocytic
Migrate to tissues and become macrophages |
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what are lymphocytes?
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b cells and t cells
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the complement system is composed of ____
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plasma protiens that lyse bacteria
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what does MAC do?
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ruptures the bacterial membrane causing lysis of the bacteria and death of the organism.
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is the compliment cascade activated by specific or nonspecific innate immune response?
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both
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what are interfurons?
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nonspecific innate immunity agains viruses
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when a cell gets infected with a virus it makes ___ that ___
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interfuerons that attach to all "self" cells they can find. those cells now make antivirals
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what is the incubation for varicella?
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9-21 days
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when is varicella contagious?
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2 days before rash until all lesions crusted
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what is the prodrome in varicella?
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fever preceeds vesicles
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desribe rash of varicella
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begins on trunk, spreads to face
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describe lesions of chicken pox
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dew drop on a rose petal, then umbilicated & cloudy, then crust
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do you have a fever with chicken pox?
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yes
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what is the course for varicella?
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1-2 weeks
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what is the lab diagnosis for varicella?
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: tzanck smear, culture, antibody titers
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what can be used in early disease of varicella?
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antivirals
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Severe and even fatal varicella has been reported in otherwise healthy children receiving ___
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intermittent courses of high-dose corticosteroids
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what is the most common complication of varicella in adults?
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pneumonia
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what is neurologic complication in varicella?
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Encephalitis & Reyes Pneumonia in immunocompromised
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what are other names for roseola?
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exanthem subitum, sixth disease
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what is etiology of roseola?
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herpes virus 6 or 7
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What is transmission for roseola?
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person to person spread through contact or secretions
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when does roseola typically occur?
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after maternal antibodies wear off, 6-15 months
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roseola happens in almost all ____
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infants
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describe clinical manifestation of roseola
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high fever for 3-7 days and then erythematous maculopapular rash lasting hours to days
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roseola is often acompanied by ___
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cervical and post-occipital lymphadenopathy, gastrointestinal or respiratory tract signs, and inflamed tympanic membranes
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what is complication of fever in roseola?
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seizure
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what is diagnostic testing for roseola?
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antibody titers
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what is another name for Erythema Infectiosum?
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5ths disease
baby measles 3 day fever |
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what is etiology for fifths disease?
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Human parvovirus B19 is a DNA-containing virus
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how is fifths disease transmitted?
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contact with respiratory tract secretions, percutaneous exposure to blood or blood products
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what is incubation period for fifths disease?
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4-14 days but can be as long as 21 days
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when do rash and joint symptoms occur in fifths disease?
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2-3 weeks after infection
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what is clinical manifestation of fifths disease?
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mild systemic symptoms, fever in 15% to 30% of patients, and, frequently, a distinctive rash (slapped cheek)
-symmetric, maculopapular, lace-like, and often pruritic rash also occurs on the trunk, moving peripherally to involve the arms, buttocks, and thighs |
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fifths disease is no longer contagous after ___
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rash appears
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when is fetal risk the biggest during pregnancy for fifths disease
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during first half of pregnancy
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what makes a fifths disease rash worse?
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hot temp
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can you feel a fifths disease rash?
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no
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fifths disease does not have ___ and ___ that are seen with measles
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cough or corzya
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what is treatment for fifths disease?
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supprotive
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the rubella virus is a ___ virus
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RNA
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when is peak infection for rubella?
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late winter and early spring
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what precentage of rubella victims are asymptomatic?
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25-50%
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when is maximum communicability for rubella?
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few days before and 5 to 7 days after the onset of the rash
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why do we immunize against rubella?
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congenital rubella syndrome can cause lots of birth defects
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what is the incubation period for rubella?
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14-23 days
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what is clinical manifestation of rubella?
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-erythematous maculopapular rash,
-generalized lymphadenopathy -Low-grade fever |
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for rubella, The occurrence of congenital defects is 50% or higher if infection occurs during ___
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first month of pregnancy
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what is treatment for rubella?
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supprotive. stay out of daycare for 7 days after onset of rash
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what is another name for measles?
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Rubeola
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what is etiology for measles?
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highly contagious viral disease, up to 90% secondary infection rate
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vaccine failure occurs in ____% of meaasles vaccines which is why ___
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5%
you get a second dose |
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when are patints contagous with measles?
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1 to 2 days before the onset of symptoms (3 to 5 days before the rash) to 4 days after appearance of the rash
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what is incubation period for measles?
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8-12 days
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what is clinical manifestation for measles?
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fever
cough, corzya, conjunctivitis Erythematous maculopapular rash Pathognomonic enanthem (Koplik spots) |
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when do pathognomonic enanthem occur in measles? what are they?
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before onset of rash
white spots inside cheek |
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what are complications of measles?
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up to 30% develop pneumonia, ear infections and diarrhea
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what is Subacute sclerosing panencephalitis (SSPE)? what causes it?
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degenerative central nervous system disease characterized by behavioral and intellectual deterioration and seizures, is a result of a persistent measles virus infection that develops years after the original infection
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what disease has subacute sclerosisng panencephalitis as a complication? who is most at risk
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measles
kids under one who get disease |
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what is diagnostic test for measles?
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IgM antibody (detectable at least one month after onset of rash)
- you could also compare paired IgG from onset to 2-4 weeks later |
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is exposure to measles a contraindicaion to vaccination?
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no
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In addition to vaccine, measles susceptible household contacts also should receive
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IG (passive)
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when should the first dose of the measles vaccine be given?
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at 12-15 months of age
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what causes mumps?
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paramyxovirus
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how is mumps spread?
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direct contact via the respiratory route
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does mumps cause problems with pregnancy/
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no
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when is mumps more common>/
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late winter and spring
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In immunized children, most cases of parotitis are not due to mumps but rather ___ or ___
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cytomegalovirus and enterovirus
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when is maximum communicatability for mumps?
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1 to 2 days before the onset of parotid swelling to 5 days after the onset of parotid swelling
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what is incubation period for mumps?
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16-18 days
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what is diagnostic testing for mumps?
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throat swabs
Acute and convalescent IgG antibody titers |
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what is treatment for mumps?
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supportive
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what causes diptheria?
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Corynebacterium diphtheriae
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in diptheria, Organism is excreted from the nose, throat, eye, and skin lesions for ____
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2-6 weeks after infection
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what is incubation period for diptheia?
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2-5 days
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what is transmission for diptheria?
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airborne or contact with infection secretions or lesions
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what is clinical manifestation for diptheria?
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-pseudomembranous nasopharyngitis or obstructive laryngotracheitis
-low grade fever -respitory symptoms during first 1-2 days |
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what are complicatoins of diptheria?
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upper airway obstruction
myocarditis peripheral neuropathies |
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what is diagnostic test for diptheria?
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Specimen should be obtained from beneath the membrane
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what is treatment for diphtheria?
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Antitoxin
erythromyocin or penicillin |
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what is recomended for patients and carriers with pharyngeal diphtheria until 2 cultures from both the nose and the throat are negative for C diphtiria
|
droplet percautions
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what is the etiology of Ebstien barr virus?
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herpes virus
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what is incubation for ebstien barr virus?
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4-6 weeks
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the ebstien barr virus is associated with ____ and ___ although rare
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with Burkitt’s lymphoma & nasopharyngeal cancer
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what is clinical manifestation of ebstien barr virus?
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Fever, sore throat, swollen lymph nodes & fatigue lasting 1-4 weeks
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is ebstien barr virus associated with pregnancy problems?
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no
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what tests diagnose mono?
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elevated WBC with 10% “atypical lymphocytes” or a positive “monospot” test
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monospot test wont be possitive untill _____
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5days-2 weeks of illness
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when does ebstien barr virus typically resolve?
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1-2 months
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how is influenza spread?
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respiratory droplets or contact w/ infected object
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when is influenza infectious?
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1 day prior to and 5 days after becoming ill
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each influenza vaccine contains ___
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3 viruses
2 a and 1 b |
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how long does it take for influenza vaccine to become effective?
|
2 weeks
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what are zymptoms of influenza?
|
Fever (>101) – Sore throat
Cough – Myalgia Fatigue |
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Detection of influenza is more likely from specimens collected within
|
first three days of illness onset
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describe pattern of rash in measles
|
starts in head and moves down and out
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what is rubella also called?
|
german measles
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can you be vaccinated for roseola?
|
no
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what causes tetnus?
|
clostridium tetani
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where are tetnus spores found?
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in soil and feces
|
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how do humans usually contract tetnus?
|
wound: spores regenerate under anaerobic conditions and disperse via bloodstream
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how do tetnus toxins act on peripheral and central nervous systems?
|
interfere with release of neurotransmitters
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what is incubation period for tetnus?
|
3-21 days
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in tetnus, the shorter the incubation period, the ____
|
higher likelhood of death
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can tetnus be transmitted between persons?
|
no
|
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what are the two clinical patternes of tetnus?
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generalized
neonatal |
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describe the generalized type of tetnus
|
trismus, stiffness in neck, difficulty swallowing, rigid abdominal muscles
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what is trsimus?
|
lockjaw
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describe neonatal tetnus
|
Occurs in newborns born to a mother who is not immune
Typically occurs through infected umbilical stump |
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wound cultures for tetnus are often ___
|
negative
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what should be administered if someone has tetnus?
|
Tetanus Toxoid (vaccine) and Tetanus Immune Globulin (TIG) should be administered, the latter to bind unbound toxin
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what is norovirus?
|
Most common cause of gastroenteritis and foodborne illness in US
|
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what are symptoms of norovirus?
|
severe N & V, diarrhea, headache, fever, myalgia for 1-2 days
|
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what is rotavirus?
|
sporadic, seasonal, often severe cause of gastroenteritis in infants & young children
|
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what are symptoms of rotavirus?
|
Vomiting, fever & watery diarrhea for 4-6 days
|
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what is the rotavirus resivor?
|
humans
|
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how is rotavirus transmitted?
|
fecal-oral
|
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what is incubation period for rotavirus?
|
24-72 hours
|
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how long does rotavrius shead?
|
8 days
|
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how do you prevent rotavirus?
|
vaccine
|
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the first exposure of children to rotavirus is usually ____
|
long illness (up to 10 days)
|
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what characterizes vibrio cholera?
|
massive fluid loss due to grey watery diarrhea
no fever no blood |
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in severe cholera, __ are used
|
antibiotic
|
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what part of body does shigella effect?
|
large intestines
|
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what is transmission for shigella?
|
fecal-oral
|
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what is incubation for shigella?
|
1-3 days
|
|
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what are symptoms of shigella?
|
wattery loose stools
posisble fever and cramps |
|
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what can shorten course of shigella?
|
antibiotics
|
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what should be avoided with shigella?
|
anti diarrea meds
|
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what are rare complicatoins of shigella?
|
bacteremia, Reiter’s syndrome, toxic megacolon
|
|
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what is camplyobactr?
|
Acute zoonotic bacterial illness, variable presentation, typically C. jejuni
|
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what is often the exposure for camplylobactr?
|
undercooked meat, contaminated food and water, occasionally pets
|
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camplyobactr is rarely ___
|
transmitted between persons
|
|
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what are symptoms of camplyobactr?
|
fever
abdominal pain diarrea (+/- blood, +/- mucus,+ WBC) |
|
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what is incuation for camplyobactr?
|
2-5 days
|
|
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how long does camplyobactr last?
|
1-2 weeks
|
|
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what is Clostridium Perfringens?
|
Enterotoxin disease, characterized acute onset of colic and diarrhea, fever and vomiting usually absent
|
|
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how long does clostridium perfiningens last?
|
<24 hours
|
|
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what is incubation for clostridium perfinignes?
|
6-24 hours
|
|
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what often causes outrbeaks of clostridium perfiningens?
|
ingestion of food containing soil or feces
inadequately heated or reheated meats |
|
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what is stapholococus areus?
|
Intoxication characterized by abrupt, violent onset – severe N, V, cramps; may have diarrhea and subnormal temperature
|
|
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what is incubation period for stapholococus areus?
|
less than 4 hours
|
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what is transmission for staph areus?
|
food and improper food handling
|
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what is Clostridium Botulinum?
|
Acute paralytic illness caused by C. botulinum that commonly grows in soil and produces a toxin
|
|
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what often causes clostridium botulinum?
|
impropper food canning
|
|
|
what are the three types of clostridium botulism?
|
foodborne (25%), wound, infant (72%)
|
|
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what are symptoms of clostridium botulism/
|
droopy eyelids, blurred vision, descending paralysis, slurred speech, difficulty swallowing
|
|
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what is normal incubation period for clostridium botulism?
|
18-36 hours
|
|
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what is treatment for clostridium botulism?
|
antitoxin for adults
immune globin for infants |
|
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what is e coli O157:H7?
|
shigatoxin (hemorrhagic)
|
|
|
what is e coli 0157:H7 associated with?
|
hemolytic uremic syndrome-by hemolytic anemia, thrombocytopenia (decrease in platlets), and acute renal dysfunction
|
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what is the most common resivor for e coli 0157:h7?
|
cattle
|
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how does e coli primarily occur?
|
through ingestion of feces-contaminated food, and direct contact with animals
|
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what is incubation for e coli
|
2-4 days but up to 10
|
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e coli is excreted in stool up to ___in adults and ___ in kids
|
1 week
3 weeks |
|
|
who is at greatest risk for of hemolytic uremic syndrome?
|
children under 5 and elderly
|
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what characterizes salmonella?
|
characterized by acute onset of headache, abd pain, diarrhea, occ. N & V
|
|
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what are most common ways to get salmonella?
|
chicken, turtles, and lizards
|
|
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what is incubation for salmonella?
|
6-72 hours
|
|
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how long does salmonella last?
|
several days to several weeks
|
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listeria is ___ source of foodborn illness
|
uncommon
|
|
|
what are symptoms of listeria?
|
fever, myalgia, headache, N& V, also - septicemia, meningitis, endocarditis
|
|
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what is biggest concern with listeria?
|
pregnant women and newborns
|
|
|
listeria is associated with
|
non-pasteurized milk & milk products, such as cheese, hot dogs and deli meats
|
|
|
what is incubation for listeria?
|
longer than most
3-70 days median 21 days |
|
|
what is Bacillus Cereus?
|
produces exoenzymes, found in soil, foods left at ambient temperature after cooking
|
|
|
what are symptoms of bacillus cerus?
|
vomiting/diarrea
|
|
|
what is incubation for bacillus cerus?
|
0.5-6 hrs with vomiting, 6-24 hrs with diarrhea
|
|
|
what is Cryptosporidiosis?
|
Parasitic infection characterized by profuse & watery diarrhea,
|
|
|
in cryptosporidosis in children, what preceeds diarrea?
|
N/V
|
|
|
where do you find Cryptosporidiosis outrbreaks?
|
recreational water (waterslides, swimming pools) and drinking water
|
|
|
how long does cryptosporidiosis last?
|
up to 30 days
|
|
|
what is transmission for cryptosporidiosis?
|
fecal-oral
|
|
|
what is incubation for cryptosporidosis?
|
1-12 days (median 7)
|
|
|
how do you detect cryptosporidosis?
|
oocysts on fecal smears; also - ELISA antibody assays
|
|
|
what is necessary for those with cryptosporidosis?
|
isolation percautions
|
|
|
what is Giardia Lamblia?
|
protezoan that primarily effects small intestine
|
|
|
describe symptoms of Giardia Lamblia
|
self limited diarrea but can lead to chronic diarrhea, steatorrhea, frequent loose and pale greasy stools, malabsorption and weight loss
|
|
|
what is main way of getting giardia lamblia?
|
drinking unfiltered water
cooling systems |
|
|
when does giardia lamblia usually occur?
|
july-october
|
|
|
how do you detect giardia lamblia?
|
cysts or trophozoites in feces
ELISA or DFA to find antigens in the stool |
|
|
what is incubation for giardia lamblia?
|
3-25 days, median 7-10
|
|
|
what is transmission for giardia lamblia?
|
fecal-oral
|
|
|
what is not sufficient to kill giardia lamblia?
|
chlorine
|
|
|
what is rabies?
|
an RNA virus that is transmitted to humans by infected animals
|
|
|
what is treatment for rabies?
|
post exposure prophylaxis
one dose Human Rabies Immune Globulin (HRIG) and 4 doses rabies vaccine |
|
|
what are signs and symptoms of rabies?
|
non-specific and flu-like: weakness, general discomfort, fever, headache
cerebral dysfunction, anxiety, confusion, agitation |
|
|
once signs and symptoms of rabies appear, ____
|
person will not survive
|
|
|
how do you test humns for rabies?
|
saliva, serum, spinal fluid, and skin biopsies of hair follicles at the nape of the neck
|
|
|
when would you do a c section of the mother had HIV?
|
if viral load was over 1,000
|
|
|
if CD4 count was between 100-200, patient would experience:
|
PCP
Histoplamsosis, PML, CMV |
|
|
if CD4 count was between 50-100 patient would experience:
|
toxoplamsosis, cryptosporidosis, cryptococcosis
|
|
|
if CD4 count was less than 50, patient would experince:
|
MAC
|
|
|
what type of virus is HIV?
|
lentivirus
|
|
|
what type of HIV is primarily found in US?
|
HIV1
|
|
|
in HIV it is an average of ___ untill antibody test is positive but can take as long as ____
|
25 days
3 months |
|
|
when does acute infection occur in HIV?
|
2-6 weeks after exposure
|
|
|
how long does acute infection occur in HIV?
|
2-4 weeks
|
|
|
HIV replication progressivly depletes ___
|
CD4 lymphocytes
|
|
|
what is CD4 count for AIDs?
|
below 200
|
|
|
what is HAART? what does it do?
|
Highly active antiretroviral therapy
slows disease progression |
|
|
if someone is pregnant with HIV when do you give them antivirals?
|
3rd trimester
|
|
|
how do you test infants for HIV?
|
neuclic acid testing
|
|
|
alot of HIV associated infections are ___
|
fungal
|
|
|
what likes to travel with HIV?
|
syphlis
|
|
|
what is used for systemic infection of canadisis?
|
flucanozole
|
|
|
what is Histoplasmosis?
|
fungus, that grows as a yeast at body temperatures in mammals,
|
|
|
histoplasmosis is endemic to ___
|
OH, MO and MS River Valley
|
|
|
what can spread histoplamsosis
|
bats
|
|
|
histoplasmosis is associated with ___
|
renovation, construction activities
|
|
|
what are symptoms of histoplasmosis?
|
flu like
pulmonary |
|
|
histoplasmosis usually _____ but if necassary ______
|
clears up without treatment
antifungal therapy |
|
|
how is Cytomegalovirus spread?
|
body fluids
|
|
|
cytomegalovirus is a ____
|
lifetime virus
|
|
|
cytomegalovirus can pass from ____
|
mother to child
|
|
|
congenital infection with cytomegalovirus symptoms include
|
Jaundice, rash, low birth weight, splenomegaly, hepatomegaly & hepatic dysfunction, seizures
|
|
|
cytomegalovirus in immunocompromised pateitns have symptoms such as:
|
retinitis (pizza pie)
diarrea pneumnoia encephalitis heptitits |
|
|
healthy people with cytomegalovirus symptoms:
|
mono like
|
|
|
how do you treat cytomegalovirus?
|
antivirals
|
|
|
what are symptoms of gonorrea in men?
|
dysuria or have a penile discharge epidemyitis
(1-14 days after exposure) |
|
|
what are symptoms of gonorrea in women?
|
dysuria, increased vaginal discharge or bleeding between periods
|
|
|
untreaed gonorrea in woman can lead to
|
eutopic pregnancy, pelvic inflamatory disease, infertility
|
|
|
what are symptoms of anal gonorrea infection?
|
bleeding buring discharge
|
|
|
gonorrea can cause___
|
bloodstream or joint infections
|
|
|
untreated gonorrea increases ____
|
risk of contracting HIV
|
|
|
how is gonorrea treated?
|
antibiotic
|
|
|
what causes syphillis?
|
Treponema pallidium
|
|
|
what are the stages of syphillis>
|
primary, secondary and late/latent
|
|
|
how is syphilllis transmitted?
|
direct contact with a syphilis lesion
|
|
|
can syphilis be transmitted from mother to child?
|
yes
|
|
|
describe primary syphillis
|
chancre”, a firm, round, painless lesion,
|
|
|
what is incubation for syphillis?
|
10-90 days, 21 median
|
|
|
describe secondary syphillis
|
Development of non-pruritic body rash after chancre heals
fever, lymphadenopathy, sore throat, patchy hair loss, headaches, weight loss, muscle aches, fatigue |
|
|
latent syphilis becomes _____
|
neurologic disease
|
|
|
syphilis means ___ risk of HIV
|
2-5 times risk
|
|
|
how do you treat sypilis?
|
pen G
|
|
|
what is most frequent bacterial STI?
|
chlymidia
|
|
|
who is at greatest risk for chlymidia?
|
teenage girls bc cervix is not totally closed
|
|
|
what is a symptom of chlymidia for men?
|
penile discharge, dysuria, pain or pruritus around meatus
|
|
|
what is symptom of chlymidia in women>
|
asymptomatic, or may depend on infection: vaginal discharge, dysuria or if spreads to fallopian tubes may develop fever, abdominal pain, LBP, nausea, pain during intercourse, bleeding between periods
|
|
|
if patient has gonorrea do you treat chlymidia?
|
yes
|
|
|
if patient has chlymidia do you treat gonorrea?
|
no
|
|
|
chlymiidia ___ risk of HIV
|
increases
|
|
|
in pregnant women, chlymidia results in ____ for infant
|
child at risk of chlamydial pneumonia or conjunctivitis
|
|
|
untreated chlymidia in men is ___
|
much less likely to cause infection
|
|
|
how do you treat chlymidia?
|
Azithromycin
|
|
|
herpes simplex vesicles typically have
|
1-2 days of tingling, burning, itching. May have low grade fever & malaise
|
|
|
viral shedding of herpes simplex occurs untill ___
|
crusted
|
|
|
herpes simplex is contagious until ____
|
lesion heals
|
|
|
what is course of herpes simplex?
|
5-14 days
|
|
|
what is MOA for Acyclovir?
|
decrease viral shedding, new lesion formation & promotes healing
|
|
|
herpes simplex on penis is which type?
|
2
|
|
|
what is prodrome for herpes zoster?
|
pain or itching, fever, headache, fatigue
|
|
|
herpes zoster is ___course to clear shedding
|
10-21 day
|
|
|
what is most common STI in US?
|
HPV
|
|
|
what HPV types cause genital warts?
|
6-11
|
|
|
what HPV types are responsible for most cancers?
|
16 and 18
|
|
|
where can males have genital warts (HPV)?
|
anus
|
|
|
what causes TB?
|
Mycobacterium tuberculosis
|
|
|
pigmented species of mycobacteria are ____
|
rarely associated with disease
|
|
|
Mycobacterium fortuitum complex is ____ and also includes ___
|
non pigmented and found in soil
mycobacterium abcesses |
|
|
M. fortuitum most commonly causes
|
skin, bone and joint disease
|
|
|
m frotuitum disease is typically ___ but ____
|
chronic but progressive
|
|
|
what is MAC?
|
Mycobacterium Avium Complex
|
|
|
MAC includes ___ and ____
|
M. avium and M. intracellulare
|
|
|
MAC in children causes
|
cervical lymphadenitis
|
|
|
MAC in HIV person causes
|
disseminated disease and pneumonia
|
|
|
what is etiology of MAC?
|
enviromental: food, water, air
|
|
|
what are symptoms of MAC?
|
night sweats, weight loss, abdominal pain, fatigue, diarrhea, and anemia
|
|
|
how do you diagnose MAC?
|
AFB smear
|
|
|
how do you treat MAC?
|
at least 2 antimicrobials, one of which should be either clarithromycin or azithromycin
Second drug is usually ethambutol |
|
|
Iron deficiency anemia and protein malnutrition linked to ___
|
hookworm
|
|
|
are hook worms more common in adults or children?
|
adults
|
|
|
how do you treat Helminth Infections?
|
deworming with antihelminth drugs
|
|
|
what does Enterobius vermicularis cause?
|
pinworms
|
|
|
pinworms most commonly occurs in ___
|
5-10 year olds
|
|
|
what is natural host of pinworms: humans or animals?
|
humans
|
|
|
what is most common symptom of pinworms?
|
itching around anus that is worse at night
|
|
|
how do you treat pinworms?
|
antifungal
|
|
|
which maliaria strain has shorter incubation and is more severe?
|
p. falciparum
|
|
|
how long does a malarial attack last?
|
6-10 hours
|
|
|
what are the three stages of malaria?
|
1) cold
2) hot 3) sweat |
|
|
what are symptoms of malaria?
|
fever, chills, sweats, headaches, nausea and vomiting, body aches, general malaise
|
|
|
how do you diagnose malaria?
|
thick and thin blood smears
|
|
|
describe mefloquine (Lariam®)
|
malaria med thats good bc it is short only once a week but wierd effects such as night terrors
|
|
|
west nile disease can progress to
|
neurodegenerative disesee
|
|
|
what are symptom for west nile?
|
high fever, headache, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, vision loss, numbness and paralysis
|
|
|
what causes toxiplasmosis?
|
Toxoplasma gondii protozoan parasite
|
|
|
how is toxiplasmosis transfered?
|
food/waterborne, animal to human, mother to child, rare case
|
|
|
toxiplasmosis ussually _____
|
does not cause illness in healthy people
|
|
|
can toxiplasmosis be transmitted from mother to child?
|
yes
|
|
|
what can play an important role in spread of toxiplasmosis?
|
cats
|
|
|
testing for toxiplasmosis is ____
|
complicated
|
|
|
who needs to be treated if they get toxiplasmosis>
|
immunocompromised
pregnant women |
|
|
what does Borrelia burgdorferi cause?
|
lyme disease
|
|
|
what are symptoms of lyme disease?
|
fatigue, chills, fever, headache, myalgia and joint aches, and lymphadenopathy
bulls eye (Erythema migrans ) facial or bells palsey headache |
|
|
describe bulls eye
|
erythema migrans
non itchy |
|
|
how do you test for lyme disease?
|
antibody titers
|
|
|
what is used to treat lyme disease?
|
doxycycline
|
|
|
what does Rickettsia rickettsii cause?
|
rocky mountain spotted fever
|
|
|
what animal causes lyme disease?
|
deer tick
|
|
|
what animal causes rocky mountain spotted fever?
|
dog tick
|
|
|
in rocky mountin spotted fever, 70% of the time, _____
|
patients dont recall a bite
|
|
|
describe symptoms of Rocky mountain spotted fever
|
initial sudden severe headache/fever
rash N&V |
|
|
describe rash of rocky mountain spotted fever
|
appears 2-5 days after the onset of fever as small, flat, pink, macules on the wrists, forearms, and ankles
can include palms and soles |
|
|
severe rocky mountain spotted fever rash ___
|
red to purple, spotted (petechial) rash is severe
|
|
|
what is treatment for rocky mountain spotted fever?
|
Doxycyclin
|
|
|
what is gold standard test for rocky mountain spotted fever?
|
Immunofluorescent assay (IFA)– paired tests showing four-fold increase in IgG
|
|
|
what is the gold standard for chlymidia testing?
|
DNA probe
|
|
|
you are typically able to detect antibiodies for HIV after ____ of infection
|
3-8 weeks
|
|
|
what is the screening test for HIV?
|
ELISA
|
|
|
what is confirmitory test for HIV?
|
western blot or IFA
|
|
|
which is senstiive? which is specific? ELISA and western blot
|
ELISA=sensitive
Western blot= specific |
|
|
describe P 24 antigen test for HIV
|
not used often because it is not very sensitive or specific but used in early testing situations
|
|
|
how long does it take for HIV home testing?
|
3-7 days
|
|
|
what is screening test for syphilis?
|
Venereal Disease Research Lab (VDRL) or rapid plasma reagent (RPR) tests
|
|
|
what is diagnostic test for syphilis?
|
Fluorescent treponemal antibody absorption test (FTA-ABS) and Treponema pallidum particle agglutination assay (TPPA)
|
|
|
what is test for chlymidia?
|
nucleic acid amplification tests (NAAT)
|
|
|
how do you diagnose disease in antibodies?
|
typically need “paired” tests at least 10 -14 days apart and a 4 fold increase from baseline levels to consider a test “positive”
|
|
|
which is often a false positive: igM or ogg?
|
igM
|
|
|
flu tests usualy have ___ sensitiviity and ____ specificity and many ____
|
low
low false negatives |
|
|
adaptive immunity uses _____which recognize ___ molecules called _____
|
lymphocytes
specific antigens |
|
|
what do antibodies attach to?
|
antigens
|
|
|
when a B cell surface receptor is secreted it is called a ____
|
antibody
|
|
|
t cell receptors only bind to ____
|
antigen+MHC combo.
|
|
|
t cells are further divided into ___ and ____
|
CD4 helper T cells and CD8 cytotoxic T cells
|
|
|
what is the function of antibodies?
|
to bind to specific antigens
|
|
|
what does IgE do?
|
binds to allergens and parasites
|
|
|
what is a Fc receptor?
|
a receptor on certain cells that binds to the “tail” of antibodies once the antibody’s binding site has “caught” a microbe.
|
|
|
what is the purpose of Fc receptors?
|
It’s an opsonizer. Helps phagocytes hold on to a pathogen in order to ingest it.
|
|
|
what is a transfusion reaction>
|
illness caused when erythrocytes are destroyed by antibodies during blood transfusion.
|
|
|
who figgured out smallpox vaccine?
|
jenner
|
|
|
hepititis B vaccination utilizes ___
|
the surface protien
|
|
|
T cells can only recognize an antigen when ____
|
when it’s located out on the plasma membrane attached to an MHC molecule.
|
|
|
what is diff between class 1 and class 2 MHC molecules?
|
cass 1= on all cells
class 2=only on the surface of macrophages, activated B cells, activated T cells, and thymus cells. |
|
|
only ___ can activate helper T cells
|
class 2 MHC
|
|
|
what is an epitope?
|
when an antigen is stuck to MHC
|
|
|
why is it so hard to activate helper t cells?
|
Helper T cells turn up the volume on ALL immune system function
|
|
|
what helps helper Ts do their job?
|
cytokines
|
|
|
what does passive immunity come from?
|
antibodies
|
|
|
what does active immunity come from?
|
vaccine or pathogen
|
|
|
which type of immunity results in no memory cells?
|
passive
|
|
|
placenta= Ig___
breast milk= Ig___ |
G
A |
|
|
what is the purpose of vaccines?
|
produce active immunity through antigen-antibody reaction
|
|
|
how many doses of DPT do you get? how effective is it at avoiding pertusis?
|
4
70-90% |
|
|
what is an innactivated vaccine?
|
grow virus or bacterium in culture, then inactivate it with heat or chemicals
|
|
|
which is less effected by circulating antibodies: live attenuated or inactivated vaccine?
|
inactivated vaccine
|
|
|
how many doses are usually required for an innactivated vaccine?
|
3-5
|
|
|
what are examples of whole cell innactivated vaccines?
|
polio
hepatitis A rabies |
|
|
what are examples of fractional subunit innactivated vaccines?
|
hepatitis B, influenza, acellular pertussis, human papillomarvirus
|
|
|
what are toxicoid vaccines?
|
made from “detoxified” toxins produced by bacteria
|
|
|
what are examples of toxicoid vaccines?
|
botulism and diptheria
|
|
|
what are polysacharide vaccines?
|
inactivated subunit vaccine composed of long chains of sugar molecules that make up the surface capsule of certain bacteria
|
|
|
what are the three types of polysacharide vaccines?
|
: pneumococcal, meningococcal, and Salmonella Typhi
|
|
|
polysacharide vaccines dont work well in ___
|
children under 2
|
|
|
response of polysaccharides: mostly IgM or IgG?
|
IgM
|
|
|
what are Conjugated polysaccharide vaccines ?
|
combined with a protein to boost response
|
|
|
what are examples of Conjugated polysaccharide vaccines ?
|
Haemophilus influenzae type, pneumococcal, meningococcal
|
|
|
what are Recombinant vaccines?
|
genetically engineered or modified vaccines
|
|
|
what are examples of recombinant vaccines?
|
-Hepatitis B & human papillomavirus vaccines
-live influenza will only replicate in nasopharynx not lungs |
|
|
Live typhoid vaccine is ___
|
recombinant vaccine for Salmonella typhi
|
|
|
why dont we do oral pollio vaccine anymore?
|
although it is more effective it is associated with more side effects. not necessary when polio is not active in our communties
|
|
|
what does the a in DTaP mean?
|
accelular (only antigens necessary)
|
|
|
what is IPV?
|
inactivated polio virus
|
|
|
what is VAERS?
|
insurance program for vaccine manufactures
|
