Infectious Disease

Front 1

How does bile protect against infection?

Back 1

viruses and bacteria with lipid envelopes

Front 2

What is Ludwig’s angina?

Back 2

caused by Strep sp. or anaerobes
Cellulitis from dental carries, sickle cell, or immunocoomplromise. Potentially life threatening.

Front 3

What causes dental carries?

Back 3

Strep. mutans
Lactobacillus makes them deeper. Makes H202 and lactic acid. Also binds plentifully and strongly epithelial cells. (same lactobacillus that keeps the vaginal environment balanced)

Front 4

How do you treat Ludwig's angina

Back 4

clindamycin or penicillin
and metronidozole

Front 5

What are the 3 types of candidiasis?

Back 5

psudomembranous
erythematous (chronic or acute)
Hyperplastic (leukoplakia) (chronic, raised, --> malignant)

Front 6

What is the treatment for candidiasis?

Back 6

Fluconazole or itraconazole

Front 7

What is Hairy Leukoplakia?

Back 7

disease of lateral boarders of tongue, hickening of mucosal and epithelial cells

EBV (HSV4)

Front 8

How do you treat hairy leukoplakia?

Back 8

Podophyllum resin and acyclovir

Front 9

What deficiencies cause angular stomatitis from either candida or Staph a.?

Back 9

thiamine (B1)
B12
iron

Front 10

B1 deficiency can cause what GI problem?

Back 10

angular stomatitis

Front 11

What is the microbiology of mumps virus?

Back 11

paramyxoviridae (family with Mumps, measles, RSV, Hanta, parainfluenza)
enveloped RNA

Front 12

Patient presents with malaise, arthralgia, earache, anorexia, low grade fever, headache, lower respiratory symptoms, +/- aseptic meningitis. What does this person have?

Back 12

33% are asymptomatic

Mumps (often has parotitis too but I left it out because it is too obvious and does NOT always occur)

Mumps virus (paramyxoviridae - RSV, parainfluenza...)

Front 13

What are complications of the mumps?

Back 13

orchitis/oophoritis, meningitis,

It likes glands and CNS tissue

Front 14

When is the mumps virus contagious?

Back 14

3 days before onset of symptoms
9 days after "

Front 15

How do you diagnose Mumps?

Back 15

isolate paramyxovirus (Mumps virus) in CNS, saliva, or urine
IgM (first few days)
IgG (2 positive samples 2 weeks apart)
or 1 of each (IgM and G)

Front 16

Why do you not give MMR to pregnant women?

Back 16

It is a live attenuated virus.

Front 17

Causes of esophagitis?

Back 17

candida albicans #1
CMV
HSV (middle distal esophagus)
HIV
VZV

Front 18

HSV esophagitis symptoms, Dx (micro), and Tx

Back 18

1st vesicles abruptly onset
2nd raised ulcers (sequelae just like STI etc)

Dx multinucleated giant cells at boarder/edge (Herpiesviridae, ssDNS, enveloped)

Tx: Ganciclovir

Front 19

CMV esophatitis symptoms, Dx (micro), and Tx.

Back 19

slow onset large shallow ulcer
or
slow onset multiple discrete lesions at distal esophagus

Dx: culture

Tx: Ganciclovir

Front 20

How is candida esophagitis treated?

Back 20

clotrimazole

Front 21

What two diseases does H. pylori cause?

Back 21

chronic gastritis and
peptic ulcer disease

Front 22

Systemic symptoms of chronic gastritis as a result of blood loss?

Back 22

Results of blood loss:pale
sweaty
tachycardia
pain/discomfort and the sort

Front 23

Pain and eating in gastric vs peptic ulcers.

Associated age of patients.

Back 23

Gastric = pain when eating 55-65
Peptic = reduced pain when eating 25-75 y-o

Front 24

What blood type more commonly has ulcers from H. pylori?

Back 24

O

Front 25

What is the pathogenesis of PUD?

Back 25

cytokines decrease somatostatin and increase gastrin

Front 26

What are the virulence factors of H. pylori?

Back 26

pH sensing
urease
motile
vac A
cagA gene

Front 27

How are gastritis and ulcers treated?

Back 27

1) PPI, Amoxicillin and clarithromycin
2) PPI, Tetracycline, metronidazole, and Bismuth

Front 28

H&P& labs of clinical manifestation of A or E Hepatitis?

Back 28

Hx: fever, headache, malaise, fatigue, anorexia, vom, diarrhea, jaundice

PE: hepatosplenomegaly
Rt upper quad pain

Labs: elevated AST, ALT, bilirubin

Front 29

When is HAV or HEV contagious?

Back 29

10 days before symptoms, therefore it is self limiting because IgG is made by the time of peek shedding

Front 30

What is the pathogenesis of HAV?

Back 30

Hepatitis infects GI cells --> blood --> liver --> out with bile

Front 31

Microbiology of the blood borne Hepatitis diseases.

Back 31

HBV dsDNA Hepadnaviridae
HCV ssRNA
HDV ssRNA viroid

Front 32

Which blood borne hepatitis infections become chronic.

Back 32

C is most probable (>85%)
B will be more likely if the patient has symptoms initially, will also cause cancer

except in kids, in whom it is the opposite. They are more likely to be chronic and less likely to have symptoms.

Front 33

Which blood borne hepatitis infections become fulminant?

Back 33

10% of chronic HBV (more likely if D is present) become fulminant
20% HCV get cirhosis and 20% of those have failure

Front 34

Common mode of spread for Hep B and C

Back 34

B = sexual
C = PercutaneousH

Front 35

How to diagnose blood borne hepatitis?

Back 35

HBV Seriology for HBV (HBsAg), later HBeAg, then anti-HBs, anti-HBe, and anti-HBc (IgM and IgG)
HCV Seriology for RNA
HDV Seriology for HDV

Front 36

Acute HBV lab results =

Back 36

HBsAg
anti-HBc IgM

Front 37

Window of acute HBV lab results =

Back 37

anti-HBc IgM

Front 38

Early convalescent HBV lab results =

Back 38

anti-HBc IgG
anti-HBs IgG

Front 39

Late convalescent HBV lab results =

Back 39

anti-HBc IgG

Front 40

Chronic active HBV lab results =

Back 40

HBsAg
HBeAg
anti-HBc IgG

Front 41

Chronic persistent lab results =

Back 41

HBsAg
anti-HBe
anti-HBc

Front 42

#1 cause of food poisoning?

micro

Back 42

Staph A

g + cocci in clumps, Beta hemolytic, mannitol salt fermentor, catalase/coagulase +

Front 43

4 causes of food poisoning?

Does each cause diarrhea or vomiting?

What is the time frame?

Back 43

all are gram + bacteria

Staph a. - violent vomiting, 1-4 hr later
Bacillus cereus - either vom 2-3 hr later or dia later
Clostridium perferingens - dia 8 hr
Clostridium botulinum - 1-2 d, paralysis

Front 44

#1 cause of GE in <2 yo?

season?

vomiting or diarrhea?

microbiology

Back 44

rotavirus causes winter diarrhea

dsRNA, naked, Reoviridae, looks like a circle with lots of balls in it (many many more than Caliciviridae)

Front 45

#1 cause of GE overall?
season?

vomiting or diarrhea?

microbiology

Back 45

Norovirus - winter vom/diar

ssRNA caliciviridae, naked

Front 46

#1 cause of summer diarrhea?

micro

Back 46

Norwalk

ssRNA, caliciviridae, naked

Front 47

Which virus causes winter GE in kids >2 and intussusception?

micro

Back 47

Adenovirus

dsDNA

Front 48

Which E. coli does not make a toxin?

Back 48

EPEC (Enteropathogenic)

attaching-effacing only

Front 49

What are the two most common parasitic causes of GE?

Back 49

protozoa Giardia and Cryptosporidiosis

Front 50

What is the treatment for E.coli causing diarrhea?

pharmacology of drug

Back 50

Cipro (floroquinolone - blocks DNA gyrase)

vs Vibrio cholera = tetracycline

Front 51

What is the treatment for Vibrio cholera causing diarrhea?

pharmacology of drug

Back 51

Tetracycline (protein elongation inhibitor, bacteriostatic)

vs. E.coli = cipro (floroquinolone)

Front 52

What serotype of Cholera is more efficacious?

Back 52

O1/O139

Front 53

What is the microbiology of Vibrio cholera?

Back 53

g - curved rod, 1 flagella so it has tumbling motility, oxidase + (not an enteric), ferments on thiosulfate-citrate-bile-sucrose (unlike other types of cholera, which grow but do not ferement)

Front 54

Which is associated with bloody - WBC diarrhea (dysentery), small or lg. intestine?

Back 54

Large

Front 55

Which is associated with tenesmus the small or large intestine?

Back 55

large

Front 56

How are most large intestine, bacterial pathogens treated?

Back 56

C. diff - supportive
Campylobacter - erythromycin if severe
Shigella - supportive
Salmonella - supportive unless it is S. typhi give Ciprofloxacin
E. coli - supportive

This is in contrast to GE bacteria, E. coli, and Vibrio cholera, which are treated with Cipro and tetracycline respectively

Front 57

What bacterial pathogens can cause dysentery and colitis in the large intestine?

Back 57

C. defficile
Campylobacter jejuni
Shigella sp.
Salmonella sp.
E. coli sp.

Front 58

What pathogen is typhoid fever (enteric fever) caused by?

micro

Back 58

Salmonella typhi

(G - rod, motile, citrate +, PAI-1 virulence factor)

Front 59

What is the number 1 cause of dysentery?

micro

Back 59

Campylobacter jejuni

(G - rod, tumbling with S shaped flagella/Seagull shaped, difficult to grow, heat-labile toxin, grows on meat)

Front 60

Patient presents with dysentery. How do you distinguish between Shigella and Salmonella?

Back 60

Salmonella will have fewer WBC's in stool.

Front 61

What is HUS?

What Shigella like bacteria can cause it?

Back 61

HUS is Hemolytic urea syndrome: hemolytic anemia, thrombocytopenia, and renal failure

EHEC O157:H7 causes it

Front 62

What parasite will cause ulcers, abscesses (extra GI too), and dysentery?

Back 62

Entamoeba histolytica (protozoa, amoeba motility)

Front 63

E coli with O157: H7 will likely cause what diseases?

Back 63

dysentery and HUS

EHEC

Front 64

EIEC causes what disease?

Back 64

shigella like diarrhea, with or without dysentery