• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/510

Click to flip

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;

510 Cards in this Set

  • Front
  • Back
what is sulfamethoxazole used for?
antibacterial, metabolite that inhibits folic acid synthesis
what is trimethoprim used for?
antibacterial, inhbits the enzyme that makes folic acid
what is ciprofloxacin used for?
antibacterial, inhibits DNA gyrase
what is levofloxacin used for?
antibacterial, inhibits DNA gyrase
what is maxifloxacin used for?
antibacterial, inhibits DNA gyrase
what is rifampin used for?
antibacterial and antituberculosis, inhibits RNA polymerase
what is nitrofurantoin used for?
antibacterial, produces intracellular free radicals
What is alpha hemolysis, and how does it show up on blood agar?
incomplete lysis of RBCs. Shows up as green color on blood agar
What is beta hemolysis, and how does it show up on blood agar?
complete lysis of RBCs. Shows up as clear area on blood agar
Which strep bugs are alpha-hemolytic?
strep pneumoniae, strep viridans, random oral strep bugs
Which strep bugs are beta-hemolytic?
Group A, B, C are usually beta-hemolytic
Group A strep is characterized by what organism?
strep pyogenes
What antigens are unique to group A strep?
M,T, and R surface antigens
Strep pyogenes has a capsule made of.........?
hyaluronic acid
Which antigen imparts virulency to group A strep?
M protein
Which antigen in group A strep does not contribute to virulency?
T and R proteins
In what ways does M protein contribute to virulency of strep pyrogenes?
point of attachment for lipoteichoic acids (aid in cell adherence), and prevents the action of complement
What are the 7 substances strep pyogenes secretes extracellularly?
streptolysin O, streptolysin S, pyrogenic exotoxin, streptokinase, hyaluronidase, DNase, proteinase
What does streptokinase do when group A strep bugs secrete it?
dissolves clots in the blood by activating plasminogen
What does hyaluronidase do when group A strep bugs secrete it?
dissolve the ground substance of connective tissue
Group A strep bugs secrete pyrogenic exotoxin; what does it do?
cause fever, damage heart tissue, cause rash
What are the 5 main syndromes caused by group A strep?
pharyngitis, skin infections, Scarlet fever, ARF, APSGN
What is ARF, and how can group A strep cause it?
Acute Rheumatic Fever. autoimmunity against joints, CNS, and heart valves following strep pharyngitis
What is APSGN and how can group A strep cause it?
Acute Post-Strep Glomerulo Nephritis. Immune complexes lodge in the glomerulus after skin or throat infection with strep
What kinds of skin infections can group A strep cause?
abscesses, cellulitis, impetigo
What 3 signs point to Scarlet Fever as the diagnosis?
fever, red rash, strawberry tongue. due to systemic strep pyogenes infection
Beyond the 5 common diseases, Strep pyogenes can also cause rapid, severe infections in:
lung, bone, and brain
Acute Rheumatic Fever never ever follows Strep infection of the......?
Skin. ARF only follows strep pharyngitis
How does Group A strep cause autoimmunity in ARF?
antigenic cross-reaction between the pyogenes antigen and heart-valve antigens
Strep pyogenes secretes streptolysin O. What does it do, and what inhibits it?
lyses RBCs, but not neutrophils. Oxygen impedes it and cholesterol inhibits it.
Strep pyogenes secretes streptolysin S. What does it do, and what inhibits it?
lyses RBCs and neutrophils. Nothing inhibits it
To make a vaccine against group A strep, which protein do you need to bind to?
M protein
What are the 2 main differences in the structure of group A and group B strep?
A: hyaluronic acid capsule, M T R antigens
B: variable capsule makeup, no M T R antigens
Which factor determines the virulency of group B strep?
Lipoteichoic Acid (LTA). The more there is, the more dangerous the bug
The different capsules in group B strep are made of what substances?
glucose, glucosamine, galactose, sialic acid
What is the characteristic organism of the Group B strep bugs?
Strep agalactiae
What 5 things do Group B strep bugs secrete extracellularly?
neuraminidase, protease, beta-hemolysin, hyaluronidase, CAMP
Group B strep secretes neuraminidase. What does it do?
dissovles polysaccharides and glycoproteins
Group B strep secretes CAMP. What does it do?
CAMP enhances lyis of staph aureus
What group is most succeptable to Group B strep infection, and how do they get it?
newborns get it from the vagine or rectum of their moms during birth
Can group B strep cause ARF or APSGN?
NO!!!!! No!!!!! NO!!!!!
What protects newborns from Group B strep infection?
Maternal IgG can cross the placenta and immunize the fetus
What antigen do group D strep and enterococci share?
lipotecholic acid in their cell membrane
What are 2 characteristic bugs from the enterococcus group?
E faecalis and E faecium
Unlike all other streps, Enterococci are resistant to which class of drugs?
Penicillins
What 3 lab tests are used to identify a bug as an enterococcus?
ability to grow in salt solution, ability to grow in bile, ability to hydrolyze esculin
What 2 traits do Group D strep bugs share with enterococci?
ability to grow in bile and ability to hydrolyze esculin
Group D strep and Enterococci are normal indiginous flora found, where?
GI tract, upper respiratory tract, urinary tract, skin
Group G strep bugs are uncommon, but what do they share with group A strep bugs?
have M protein, secrete streptolycin O and streptokinase, cause pharyngitis and APSGN
Group G strep can cause ARF. True or false?
False!!! False!!! False!!! Group G strep does NOT cause ARF, ever!
Group D strep and enterococci can cause heart valve infection. True or false?
True!!! True!!! True!!! Not the same as ARF, but still.
Group C strep are uncommon, but what do they share with Group A strep?
cause pharyngitis, secrete streptolysin O, cause APSGN
What antigen characterizes the Strep Viridans group?
There isn't a group specific antigen
What characteristic is common to all strep viridans bugs?
they are all alpha-hemolytic, producing green biliverdin on blood agar plates
Which two conditions are due to strep viridans infection?
dental caries and endocarditis
How do strep viridans bugs produce their ill effects?
ability to stick to things (like tooth enamel or heart valves)
What percentage of endocarditis cases are due to strep viridans?
50%
Hemophilus Influenzae is gram (positive/negative), (cocci/rod).
H Influenzae is gram negative, and a rod
Strep Pneumoniae is gram (positive/negative), (cocci/rod).
Strep pneumoniae is gram positive, and a cocci
Neisseria Meningitidis is gram (negative/postive), (rod/cocci).
Neisseria meningitidis is a gram negative cocci
What does strep pneumoniae look like under the microscope?
lancet-shaped diplococci
what does neisseria meningitidis look like under a microscope?
bean-shaped diplococci
What factors found in blood does hemophilus influenza require to live?
NAD and heme
Both strep viridans and strep pneumoniae are alpha hemolytic. How do you distinguish them in the lab?
Optochin will kill s. pneumoniae, but not s. viridans
How do you detect neisseria meningitidis in the lab?
antisera against the polysaccharide capsule, usually on latex beads
How do you detect hemophilus influenzae in the lab?
antisera against the polysaccharide capsule, usually on latex beads
What is the most critical virulence factor in h. influenzae, s. pneumoniae, and n. meningitidis?
whether it has a capsule or not
What is unique about h. influenza's capsule, compared to the other encapsulaed bacterias?
shares antigen with other gram-positive bugs, leading to increased incidence of immunity
Which encapsulated bacteria has the most capsular serotypes?
s. pneumoniae has 90 different serotypes in its capsule
What is unique about n. meningitidis's capsule, compared to the other encapsulated bugs?
One serotype is non-immunogenic in humans, which has prevented vaccine development
Which unique enzyme do all encapsulated bacteria secrete?
IgA protease, which chews up IgA. This enables them to infect mucus membranes so easily
What is unique about pneumolysin, secreted by s. pneumoniae?
S. pneumoniae releases pneumolysin when it autolyses itself
do gram positive bacteria have endotoxin?
NO!!!!! only gram negative bacteria have endotoxin
What is the most common cause of meningitis in children and teenagers?
Neisseria meningitidis
What is the most common cause of meningitis in adults?
strep pneumoniae
What is the leading cause of otitis media in children?
s. pneumoniae (50% of cases)
Which drugs are used for prophylactic treatment for people exposed to the encapsulated bacterias?
rifampin and ciprofloxacin
How is polysaccharide vaccine currently used to treat h.influenzae?
It's not, because it is not effective
Why do polysaccharide vaccines not work against h. influenzae?
pure polysaccharides do not induce a T-cell response in infants, to whom this vaccine was given to
How do conjugate vaccines work against h. influenzae?
capsule polysaccharide is joined to inactive diptheria protein, and this produces a T-cell response in infants
Which bugs does the Tetramune vaccine protect against?
h. influenzae, and diptheria, pertussis, tetanus (DPT)
What bug does Menactra vaccine protect against?
N. meningitidis
What bug does Menomune protect against?
N. meningitidis
Menactra vaccine is targeted to what age range?
11-55 years old
Menomune vaccine is targeted to what age range?
2-10 years old
What DISEASE does the Pneumovax vaccine protect against?
S. pneomoniae bacteremia
What DISEASE does the Pneumovax vaccine give no protection against?
S. pneumoniae pneumonia
Which bug does the Prevnar vaccine protect against?
strep pneumoniae
Which is the most expensive routine childhood vaccine, and how much does it cost?
Prevnar, which protects against s. pneumoniae, costs 58$ a pop
Staphylococcus are gram (negative/positive), and catalse (negative/positive)
staph are gram positive, catalase positive
In general, what is the biggest difference between infectious staph and strep?
strep is catalase negative, staph is catalse positive
What are 2 imporant virulence factors staph uses to infect organisms?
Clumping factor and protein A
What does clumping factor do in staph bacteria?
attaches the cell wall to fibrinogen, clumps all the staph cells together to resist phagocytosis
What does protein A do in staph bacteria?
binds the Fc region of antibody, thwarting it and protecting itself from phagocytosis
Lipoteichoic acid in staph bacteria has a special name, and that name is.....?
Ribitol
Some staph strains secrete exfoliatin. What does it do?
dissolves desmosomes at the GM4 glycolipid, causing separation of skin layers in humans
Some staph strains secrete leukolysin. What does it do?
kills WBCs. Common in MRSA
What purpose does coagulase serve in Staph bacteria?
serves to clump bacteria together, where they have a better chance at survival
Some Staph secrete enterotoxin. What does it do?
cause cytokine release from mast cells, leads to food poisoning
Some staph strains secrete TSST-1. What does it do?
causes TNF and interleukin release from WBCs, leads to toxic shock syndrome. Very dangerous
How do staph bacteria genetically recombine?
usually by transduction through a bacteriophage
What is the D-test?
tests to see if staph bugs are resistant to clindamycin when erythromycin is present
What general pattern of distribution does staph tend to follow when it infects you?
Tend to localise. As opposed to strep infections, which tend to spread
Coagulase negative staph is usually less infectious, except when.....?
It can form biofilms on catheters etc. and cause infection through that route
Where do many people carry colonies of Staph Aureus?
In their nostrils
where do many people carry colonies of coagulase-negative staph?
On their skin
which gene does MRSA carry that normal staph aureus does not have? What does it code for?
mecA, which codes for an alternate penicillin binding protein
What are some drugs that will work against MRSA and VRSA?
sulfa/trimethoprim, daptomycin, linezolid, synercid
What is the most common cause of osteomyelitis? What is osteomyelitis?
staph aureus. osteomyelitis is a purulent abcess in the bone
What factors describe Job's Disease?
cold abscesses, poor neutrophil chemotaxis, elevated IgE levels
What 5 signs make up Toxic Shock syndrome?
acute fever, erythroderma, hypotension, involvement of at least 3 major organ systems, exclusion of other disease
What are the main advantages for a bacteria to live inside a eukaryotic cell?
easy access to nutrients, protection from extracellular defense
What distinguishes facultative from obligate intracellular bacteria?
obligate have lost the genes for certain metabolic functions, and so must use the host cell's instead
Name 5 obligate intracellular bacteria species
chlamydia, coxiella, ehrlichia, ricksettia, mycobacterium leprae
Explain the zipper model of cellular entry by bacteria
tight interactions between proteins on the two cell surfaces wrap the cell's membrane around the bacteria, bringing it inside itself
Explain the trigger model of cellular entry by bacteria
bacteria secrete proteins that cause the host cell's membrane to splash and ripple, the bacteria enters during the confusion
Which intracellular bacteria use the zipper method to gain entry into cells?
listeria monocytogenes, mycobacterum tuberculosis, legionella
Which intracellular bacteria use the trigger method to gain entry into cells?
salmonella, shigella
What are some dangers intracellular bacteria face inside of host cells?
phagosomes become lysosomes and try to kill the bug with NADPH oxidase system, nitrous oxide, and other lysozymes
How does listeria escape intracellular defenses?
lyses the phagosome it is in, thus avoiding digestion
How does legionella escape intracellular defenses?
inhibits the phagosome from aquiring lysosomal proteins and enzymes
How does salmonella escape the intracellular defenses of its host cell?
produces superoxide dismutase and catalse to neutralize reactive compounds sent to kill it
What does it mean if a bacteria species is non-fusogenic?
intracellular bacteria that stays in the phagosome, but prevents it from becoming a lysosome
What does it mean if a bacteria species is fusogenic?
intracelluar bacteria that stays in the phagosome even after becoming a lysosome
what is the one fusogenic bacteria?
coxiella burnetti
Which intracellular bacteria lives in RBCs?
bartonella
Name 2 non-fusogenic bacteria
chlamydia, mycobacteria
How do aminoglycosides enter cells?
by pinocytosis
How does tetracycline enter cells?
diffusion
Where in our cells do the aminoglycosides end up?
inside lysosomes and phagosomes
Where in our cells does tetracycline end up?
in the cytosol
why are intracellular bacteria resistant to aminoglycosides?
aminoglycosides work best at pH 7, but end up inside acidic lysosomes inside our cells, where they don't work
why are intracellular bacteria susceptable to tetracycline?
tetracycline works best near pH 7, and end up in the neutral cytosol, so they retain their activity
What is unique about the way listeria can travel throughout the body?
listeria can move between cells without ever leaving the intracellular environment
How do listeria species move around in the cytosol of our cells?
they acquire actin at one end, which they use to move around in and between our cells
How does nitrofurantoin work?
creates reactive species inside of bacteria, which tear up their DNA
What is nitrofurantoin used for, and why?
UTIs, because it concentrates in the kidney but has a very short half-life in the plasma
What is metronidazole used for?
anaerobe and protozoan infection
How does metronidazole work?
creates reactive species inside the pathogen, which tears up their DNA
Which common antibiotics must you be careful of drug-drug interactions with?
Chloramphenicol, Clindamycin, Rifampin, Isoniazid, Metronidazole, Erythromycin, Streptogrammins, Sulfonamides (CRIMES)
How does polymyxin work?
bacteriocidal drug that is like soap, it disrupts the bacterial cell membrane
What would you use polymyxin for?
To kill gram negative bacteria
What kind of bacteria does polymyxin not work against?
gram positive bacteria. Peptidoglycan wall is too thick for the drug to get to the membrane
What would you use daptomycin for?
methicillin and vancomycin resistant Gram positive bacteria
what is naldixic acid's effect on: gram-, gram+, pseudomonas, atypical, and anaerobic bacteria?
gram-: ++
gram+: -
pseudo: -
atypical: +/-
anaerobic: -
What disease would you treat with naldixic acid?
UTI's
what is ciprofloxacin's effect on: gram-, gram+, pseudomonas, atypical, and anaerobic bacteria?
gram-: ++
gram+: +
pseudo: +
atypical: +
anaerobic:-
what diseases would you treat with ciprofloacin?
UTI's, soft tissue infections
what is levofloxacin's effect on: gram-, gram+, pseudomonas, atypical, and anaerobic bacteria?
gram-: ++
gram+: ++
pseudo: -
atypical: +
anaerobe: +
What disease would you treat with levofloxacin?
bronchitis, pneumonia, MRSA
what is moxifloxacin's effect on: gram-, gram+, pseudomonas, atypical, and anaerobic bacteria?
gram-: ++
gram+: ++
pseudo: +
atypical:+
anaerobe:+
What diseases would you treat with moxifloxacin?
use as a last resort against bugs that won't be killed by anything else
Who is contraindicated for treatment with fluoroquinolones?
pregant women and kids under 12
what are 4 side effects of the fluoroquinolones?
GI upset, dizziness, rash, arthralgia
What is the target for fluoroquinolone drugs in gram negative bacteria?
DNA gyrase
What is the target for fluoroquinolone drugs in gram positive bacteria?
topoisomerase 4
What are the species of enterobacteria that commonly cause diarrhea?
shigella, salmonella, E. coli, and yersinia
What bacterial species closely related to enterbacteria commonly cause diarrhea?
cambylobacter, vibrio
The enterobacteria and related species are all gram (negative/positive) (cocci/rods)
all enterobacteria are gram-negative rods
What do campylobacter and vibrio species look like under a microscope?
squiggly or curved
Are enterobacteria aerobic or anaerobic?
they can do either one (facultative anaerobes)
All enterobacteria are oxidase (+/-), catalase (+/-), and glucose fermenting (+/-)
All enterobacteria are oxidase (-), catalase (+), and glucose fermenters
What are the 3 antigens on enterobacteria, and where are they located?
O - On LPS
H - on flagella
K - on the capsule
Which antigen on enterobacteria is associated with increased virulence?
antigen K, on the capsule
In enterobacteria, what makes up the variable region of LPS?
antigen O repeats
Metabolically, what is different between the enterobacteria and the vibrio species?
vibrio are oxidase positive, enterbacteria are oxidase negative
What are 3 genetic ways enterobacteria can change their chromosome?
plasmids, bacteriophage, pathogenicity islands
what are some characteristics of watery diarrhea as a symptom?
copious, no blood or pus, no tissue invasion, pathology in the small intestine
what are some characteristics of dysenteric diarrhea as a symptom?
scant volume, blood or pus or mucus present, tissue invasion, pathology in large intestine
what are some characteristics of bloody/watery diarrhea as a symptom?
copious, some blood or pus, tissue invasion, pathology in colon or ileum
what are some characteristics of hemorrhagic colitis as a symptom?
copious, like liquid blood, no WBCs, no tissue invasion, pathology in large intestine
Name 4 diarrhea-causing bacteria that are not normal gut flora
salmonella, shigella, vibrio cholerae, and ETEC
What are the two mechanisms of pathology in the enterobacteria?
invasive - bugs invade your cells
toxigenic - bugs stay in the lumen, produce poisons
Is vibrio cholerae invasive or toxigenic?
toxigenic
Is ETEC invasve or toxigenic?
toxigenic
Is EHEC invasive or toxigenic?
toxigenic
Is salmonella invasive or toxigenic?
invasive
Is shigella invasive or toxigenic?
both invasive AND toxigenic
Define exotoxin
A substance secreted out of the bacteria that causes symptoms
Define endotoxin
A substance on the surface of the cell (LPS) that causes symptoms
Define enterotoxin
an exotoxin that has specific effects on the intestines
Which intestine is usually affected in a secretory diarrhea?
small intestine
Which intestine is usually affected in an inflammatory diarrhea?
large intestine
roughly how many shigella bugs do you need to ingest to be infected?
10-100
roughly how many salmonella bugs do you need to ingest to be infected?
100-100,000
roughly how many vibrio bugs do you need to ingest to be infected?
10,000-100,000,000
What bug causes Cholera?
vibrio cholerae
Which serotype of Vibrio is the most infectious?
serotype O1
what kind of diarrhea does vibrio cholerae cause?
thin and watery, copious, no blood or pus
What factor determines if the vibrio cholerae bug can colonize the small intestine?
If they have TCP pilus
How do vibrio cholerae bugs obtain the ability to have TCP pilus on their surface?
a bacteriophage
How do vibrio cholerae bugs obtain the ability to make cholera toxin (CTX)?
from a bacteriophage
What is the structure of cholera toxin, and what does each part do?
A and B subunits. B subunit binds to cell surface, A subunit enters the cell
What is the mechanism of cholera toxin within the host cell?
subunit A permanently turns on Adenylate cyclase, which leads to increased Cl- efflux and fluid secretion
How does vibrio cholerae kill enterocytes?
It doesn't. It poisons them, then they live a normal cell lifespan
Should you use antibiotics in people with cholera?
Sure. They might shorten the course of the disease
What is the best treatment for cholera?
rehydration and electrolyte replacement, either orally or IV
Which bacteria most likely causes gastroenteritis in people who ate raw or undercooked shellfish?
vibrio parahemolyticus
What does ETEC stand for?
EnteroToxigenic E. Coli
What kind of diarrhea is caused by ETEC?
watery, loose, copious, no blood or pus
What other symptoms accompany diarrhea caused by ETEC?
vomiting, cramps
Which antibiotics should you use in people who have diarrhea caused by ETEC?
NONE! Don't use antibiotics in these people!
What 2 toxins are responsible for the diarrhea caused by ETEC?
heat-labile enterotoxin and heat-stable enterotoxin
Heat-labile enterotoxin produced by ETEC: how does it work?
Same mechanism of cholera toxin: high cAMP levels -> Cl- efflux -> fluid secretion
Heat-stable enterotoxin produced by ETEC: how does it work?
peptide toxin that raises cGMP levels, which leads to fluid efflux
Where does ETEC set up shop, and how does it do so?
ETEC express adhesins on their fimbriae, which help them stick in the small intestine
How should you treat ETEC-caused diarrhea?
fluid/electrolyte replacement, rest. Infection is self-limiting
What does EPEC stand for?
EnteroPathogenic E. Coli
What age group is commonly affected by EPEC-caused diarrhea?
infants less than a year old
What kind of diarrhea does EPEC cause?
loose, watery, no blood or pus
What other symptoms may be seen along with EPEC-caused diarrhea?
vomiting, low fever
What is the treatment for EPEC-caused diarrhea?
rehydration, restore electrolytes, ANTIBIOTICS.
Which diarrhea-causing e. coli subtype is the only one you should treat with antibiotics?
EPEC. the one with the P
How does EPEC cause diarrhea?
adhere to enterocytes, leading to microvilli destruction, leading to decreased absorption
What does EHEC stand for?
EnteroHemorrhagic E. Coli
What kind of diarrhea does EHEC cause?
hemorrhagic colitis. Lots of liquid blood, no WBCs
In addition to diarrhea, what else does EHEC commonly cause?
hemolytic uremic syndrome (HUS)
Which serotype of EHEC is the most virulent?
O157:H7
Where does EHEC set up shop in the GI tract?
Large intestine (other E. coli sause problems in the small intestine)
How does EHEC cause diarrhea?
adheres to colon cells, produce shiga-like toxins that cause the hemorrhage
What are the 2 ways in which shiga-like toxin produced by EHEC cause problems?
binds to sphingolipids in the bowels and kidneys, and binds to rRNA and stops protein production
What is the most common way invasive enterobacteria get into your tissues?
M cells in the GI tract
What is the most common species of Shigella in the USA?
shigella sonnei
What is the most common species of shigella in India?
shigella Boydii
What is the most common species of shigella in the developing world?
shigella flexnari
What is the most common species of shigella found in homosexual men?
shigella flexnari
What is the most virulent species of shigella?
shigella dysenteriae
In general, what is the name of the disease caused by shigella species?
bacterial dysentary
What is the mechanism of shigella infection?
entry through M-cells -> uptake by macrophages -> lyse macrophages -> invade basal side of enterocytes -> spread directly into neighboring cells
What species of shigella causes the most mild symptoms?
shigella sonnei
true or false: humans are the only resevoir for shigella; they can't live anywhere else
True! Lucky us!
How is shigells spread between people?
the 4 F's: food, fingers, feces, flies
What are the symptoms of dysentary?
fever, malaise, vomiting, early watery diarrhea followed by frequent small bloody/mucusy stools, cramps
How do you treat dystentary caused by shigella?
rehydration, support, antibiotics for severe cases
Which bacteria is the second-most common cause of gastroenteritis?
salmonella
Which bacteris is the most common cause of gastroenteritis?
campylobacter
How does salmonella spread between people?
fecal-oral, and zoonitic through poultry, eggs, contaminated veggies
What is unique about salmonella typhi compared to other salmonellas?
salmonella typhi is more adapted to humans as its host
Which cells in the GI tract do salmonella bugs initially invade?
M cells AND enterocytes both
How long after infection with shigella would you experience symptoms?
1 to 4 days
How long after infection with salmonella would you experience symptoms?
24-48 hours
What are the 3 different infections that salmonella can cause?
gastroenteritis, septicemia, and Typhoid fever
What are the symptoms of salmonella-caused gastroenteritis?
fever, nausea, headache, cramps, watery diarrhea
How do you treat gastroenteritis caused by salmonella?
It is self-limiting, antibiotics are not needed
What are the symptoms of salmonella-caused septicemia?
fever, no diarrhea, positive blood cultures.
How do you treat salmonella-caused septicemia?
antibiotics
What are the symptoms of Typhoid Fever?
inflammatory diarrhea, fever
What is the most severe sequela of Typhoid Fever?
colonize the gall bladder, intestinal perforation
How do you treat Typhoid fever?
Antibiotics. I'm not sure which ones.
Why is it that you can have multiple infections of salmonella?
There are over 2500 different serotypes of salmonella
What are the symptoms of Yersinia gastroenteritis?
invasive, fever, watery diarrhea with blood and leukocytes
What is the most common way of ingesting Yersinia?
with undercooked pork or contaminated dairy products
What is one unique sequela of Yersinia enteritis?
can lead to reactive arthritis (Reiter's Syndrome)
In what patients can Yersinia lead to reactive arthritis?
Those with HLA-B27 can develop Reiter's Syndrome
What are some symptoms of Campylobacter enteritis?
diarrhea, fever, cramps. Half of patients have bloody stools, some have leukocytes
What are 2 unique sequela of campylobacter enteritis?
Reiter's Syndrome, and Gullian Barre Syndrome (nerve demyelination)
What three factors determine the virulency of campylobacter?
invasiveness, enterotoxin production, and cytotoxin production
Where in the GI does campylobacter set up shop?
terminal ileum and proximal colon
How is campylobacter transmitted?
contaminated dairy or water, raw poultry, pets with diarrhea
How common is person-to-person transmission of campylobacter?
Rare rare rare. Doesn't happen much.
What demographics are affected most often by campylobacter?
young infants, and young adult males
How do you treat campylobacter?
antibiotics: erythromycin or fluoroquinolones
what is the most common bacterial human pathogen?
helicobacter
Where does helicobacter set up shop in the GI tract?
stomach, and nowhere else
Is helicobacter invasive or toxigenic?
toxigenic. Does not invade tissues.
What factors increase the virulency of helicobacter?
urease activity, pathogenicity islands in the genome
What factors contribute to helicobacter prevalence in a population?
overcrowding, lower income status, individual genetics. Infections are rarer in more industrialized areas
How do you diagnose helicobacter infection?
urease test on biopsy specimens, breath urease test, histological examination, ELISA
What percentage of peptic ulcers are caused by helicobacter?
70%
What percent of duodenal ulcers are caused by helicobacter?
all of them
What is the treatment for helicobacter?
proton-pump-inhibitor plus bismuth plus tetracycline
What special requirement do Neiserria species require to be grown in culture?
5% carbon dioxide
What are the 5 surface characteristics that Neiserria possess that contribute to their toxicity?
1) Pili
2) OPA proteins
3) Porins
4) Lip-oligo-saccharide
5) IgA protease
In the world of bacteria, what is "phase variation"?
The ability to switch off gene expression in order to avoid exposing antigen to our immune systems
How do pili help N. gonorrhoea cause disease?
Help it adhere to mucosa
How do pili NOT help N. gonorrhoea cause disease?
They are antigenic, and so are potential targets for antibody
How do OPA proteins help N. gonnorrhoea bacteria infect people?
They can help with adhesion at specific sites in our body
Are OPA proteins found in N. gonorrhoea bugs antigenic?
Yes they are, and there are hundreds of different serotypes
N. gonorrhoea bugs have LOS on their surface. What is LOS?
Lipo-Oligo-Saccharaide. Similar to LPS, but doesn't contain the O antigen repeats.
Which surface factor in N gonorrhoea is responsible for the inflammatory process seen in the disease?
LOS
How does N gonorrhoea use IgA protease to infect humans?
IgA protease cleaves the Fc portion of IgA, allowing the bug to adhere to mucosa without interference
What percentage of men will be infected with N. gonorrhoea after one exposure?
20-30%
Are men or women more likely to be asymptomatic carriers of N gonorrhoea?
Women are more likely to be asymptomatic carriers of N Gonorrhoae
What is Opthalmia neonatorum?
when mothers with N Gonorrhoea infect the eyeballs of their infants as they give birth to them
What is the most common cause of N-Gonorrhoea infection in pre-adolescent children?
sexual abuse
How many new cases of gonorrhea arise every year?
600,000
What are some symptoms of local gonorrhea seen only in women?
cervicitis, abscesses in vaginal glands, endometriosis, PID,
What are some symptoms of local gonorrhea seen only in men?
Epididymitis
What are some symptoms of local gonorrhea seen in both men and women?
urethritis, proctitis, pharyngitis, peritonitis, ophthalmia neonatorum in infants
What are some symptoms of systemic (disseminated) gonococcal infections?
Dermatitis-arthritis-tenosynovitis syndrome, septic arthritis, endocarditis, meningitis
PID is more likely to occur in women with what form of N. gonorrhoae infection?
recent asymptomatic gonorrhea is more likely to lead to PID
Histologically, how do you diagnose an infection of N. gonorrhoea?
gram stain the urethral/vaginal exudate, look for neutrophils with diplococci inside them
Which type of agar should N. gonorrhoea be cultured on?
chocolate agar or Thayer-Martin agar
How can you distinguish N gonorrhoea from N meningitidis in the lab?
gonorrhoae is oxidase +, ferments only glucose.
meningititis is oxidase +, fermants glucose AND maltose
What recently developed N. gonorrhoeae detection method is 25-40% more sensitive than culture?
NAAT (nucleic acid amplitude test)
What are some advantages that NAAT testing has over culture, as far as N. gonorrhoea is concerned?
less invasive, can take samples from additional areas, 25-40% more sensitive, can be self-administered
What other STD is commonly seen alongside gonorrhea?
chlamydia tachomatis
What 2 antibiotics are good agents against gonorrhea infections?
doxycycline and azithromycin
What antibiotics should you not use against gonorrhea, because of resistance?
quinolones
How do you treat opthalmia neonatorum?
silver nitrate drops in the eyes soon after birth
4 ways Spirochetes differ from other bacteria:
1) corkscrew shape
2) gram (-), but no LPS
3) thin, hard to see
4) end flagella wind around the body of the cell
What disease does Treponema Pallidum cause?
syphilis
What disease does T. pallidum pertenue cause?
Yaws
What disease does T. pallidum endemicum cause?
Bejel
What disease does T. pallidum carateum cause?
Pinta
How long does it take between initial infection and appearance of primary syphilis?
3 weeks
How long does the primary stage of syphilis last?
2-6 weeks
How long can the asymptomatic phase last between primary and secondary syphilis?
2-24 weeks
How long does the secondary stage of syphilis last?
2-6 weeks
How long can the latent phase of syphilis last between secondary syphilis and tertiary syphilis?
3 to 30 years
What outward sign characterizes primary syphilis?
chancre
How many patients can successfully clear syphilis from their system all on their own?
25%
What outward signs characterizes secondary syphilis?
maculopapular rash on palms and soles of feet, lymphadenopathy, and possible hair loss.
What is the transmissability of syphilis during its various stages of development?
1 - very transmissible
2 - very transmissible
latent - not transmissible
3 - somewhat transmissible
What are some neurological symptoms of tertiary syphilis?
tabes dorsalis, paralysis, insanity
What are some cardiovascular symptoms of tertiary syphilis?
heart failure, aortic aneurysms
How can syphilis affect pregnant women?
It causes the fetus to abort at 20 weeks gestation
What special microscope technique is used to visualize treponema pallidum?
darkfield
What symptoms make up the Jarish-Herxheimer Reaction?
fever, headache, joint pain
What disease context is the Jarish-Herxheimer Reaction seen in, and what causes it?
Penicillin lyses syphilis bugs, which releases irritating chemicals into circulation
What is the difference between the 2 types of serological tests used to find syphilis infections?
One detects actual antigen against treponema, the other uses cross-reacting antigen than actually reacts with reagin
True or false: trepomena pallidum can survive for a long time outside the human body.
False! They usually can't live for more than 24 hours outside your body
What antibiotic is useful against syphilis?
penicillin
Yaws is related to syphilis; how is it different?
non-venereal, ulcers on arms and legs, affects children in tropical regions
Bejel is related to syphilis; how is it different?
non-venereal, ulcers on arms and legs, affects children in desert regions
Pinta is related to syphilis; how is it different?
non-venereal, papules that progress to dark, hyperkeratotic lesions. Found in latin america
What activities commonly cause syphilis outbreaks?
IV drug use and prostitution
Leptospira is a gram (-,+) bacteria, shaped like a (rod/cocci/spirochete)
leptospira is a gram negative spirochete
Leptospirosis symptoms include:
fever; liver and kidney necrosis leading to jaundice, hemorrhage, and nitrogen retention; aseptic meningitis
How long can leptospira remain infectious outside the body of an animal?
several weeks
how long does it take a person to develop symptoms after being infected with leptospira?
1-2 weeks
How do humans catch leptospirosis?
from water or food contaminated with the urine of infected animals
What antibiotics treat the symptoms of leptospirosis, but do not eradicate the infection?
penicillin and tetracycline
What antibiotics are used prophylactically against leptospirosis?
doxycycline
What's wierd about the cell wall of chlamydia?
the peptidoglycan does not contain N-acetylmuramic acid
How do lab techs culture chlamydia samples?
In egg yolks or in tissue cultures
What can be added to tissue culture to allow chlamydia more nutrients?
radiation or cyclohexamide, to slow down eukaryotic metabolism
Chlamydia are dependant on host cells _________ and _______ for energy because they can't re-synthesize their own.
ATP and NADPH
What stain is used to visualize chlamydia inclusions in cells?
giemsa stain
What do chlamydia look like in a giemsa stain?
You can see inclusions near the nucleus
Chlamydia have a biphasic lifestyle. The two phases are called......?
elementary bodies (EB) and
reticulate bodies (RB)
Which phase of chlamydia's life cycle is the transmissable, infectious phase?
The EB phase is what host cells pick up, and also what is released from the lysed host cell
Which phase of chlamyida's life cycle is metabolically active?
The RB phase is when chlamydia multiplies within host cell vacuoles
Which is bigger, elementary bodies or reticulate bodies?
reticular bodies are 1 micron, elementary bodies are 0.3 microns
How long do RBs multiply within a cell before lysing the cell, releasing many EB's?
24-72 hours
What are the 3 common disease-causing species of chlamydia?
c. trachomatis
c. psittaci
c. pneumoniae
How is chlamydia trachomatis transmitted?
direct person-to-person contact
How is chlamydia psittacis transmitted?
bird-to-person transmission, through inhaled dust or water droplets
How is chlamydia pneumoniae transmitted?
person to person through aerosol particles
What sequelae does chlamydia infection cause through antigenic mimicry?
arthritis and atherosclerosis
What is trachoma, and what bug causes it?
chlamydia trachomatis causes inflammed corneas and conjunctiva, leading to scarring and blindness
What is the incubation period for trachoma?
3-10 days
What is the main cause of blindness worldwide?
trachoma
how does one usually aquire trachoma?
you get it in infancy from your mom
How do you treat trachoma?
surgery, antibiotics, facial cleanliness
What are the symptoms of urogenital infections with chlamydia?
urethritis, dysuria, cervicitis, PID, pus discharge from urethra
Both gonorrhea and chlamydia produce urethral pus. On that basis, how do you distinguish between the two?
gonorrhea=bacteria in neutrophils
chalmydia=nothing in neutrophils
What percentage of STD chlamydia infections are asymptomatic?
in men = 50%
in women = 75%
Women with chlamydia have an increased risk for contracting HIV, by how much?
women with chlamydia are 3-5 times more likely to contract HIV, if exposed
What are some sequelae of PID?
scarred fallopian tubes, infertility, ectopic pregnancy, chronic pelvic pain
If a bunch of adolescent girls get tested for chlamydia, how many will be infected?
10%
How many cases of chlamydia are reported every year in the united states?
3 million
NAAT tests for chlamydia have what sensitivity and specificity?
sensitivity = 90%
specificity = 99%
What antibiotics do you use to treat chlamydia infections?
azithromycin or doxycyclin
If a person has HIV and chlamydia, how should you alter your treatment of the chlamydia?
Don't alter it, treat it just like any other chlamydia: azithromycin or doxycyclin
What bug causes Lymphogranulomatous Venereum?
chlamydia trachomatis
What are the symptoms of Lymphogranulomatous Venereum?
small genital ulcer, followed by swollen, purulent inguinal lymph nodes that leak pus
What are some sequelae of Lymphogranulomatous Venereum?
disseminated bacteremia, peritonitis, colitis
What antibiotics would you use to treat Lymphogranulomatous Venereum?
sulfonamides and tetracycline
What bug causes psittacosis?
Uh, chlamydia psittaci, duh
what are some symptoms of psittacosis?
acute pulmonary infection, with fever, headache, malause, myalgia, unproductive cough
Psittacosis resembles what other diseases?
flu or typhoid fever
What is the incubation period for psittacosis?
10 days
What antibiotics work to kill of chlamydia psittaci?
tetracycline and erythromycin
Most cases of chlamydia pneumoniae have what kind of symptoms?
mild upper respiratory illness
chronic respiratory disease can result from chlamydia pneumoniae infection in people with what pre-existing conditions?
asthma, COPD, cystic fibrosis, lung cancer
What is the treatment for chlamydia pneumoniae infections?
tetracycline or erythromycin
Human Papilloma virus are how big? DNA or RNA? Enveloped or not?
50 nanometers wide, DNA, not enveloped.
What is the makeup of the protein capsule of HPV?
two proteins: L1 makes a pentamer, L2 links the pentamers together into an icosohedron
What percent of all cervical cancers are caused by HPV?
100%
What percent of all head and neck cancers are caused by HPV?
25%
HPV codes for E6 protein, which does what to the host cell?
inhibits p53
HPV codes for E7 protein, which does what in the host cell?
binds to Rb protein
What are the three well-known oncogenes within HPV?
E5, E6 and E7
Which cells does HPV infect?
basal epithelial cells, the ones that are most undifferentiated
Which cells release the manufactured HPV?
the outermost squamous epitheilial cells release HPV
What is the lifetime risk among sexually active men and women for contracting HPV?
50-70%
What is the prevalence of HPV infection in the Unites States?
20 million
What is the incidence of HPV infection in the United States?
6.2 million per year
How is HPV most commonly transmitted?
genital-genital, oral-genital, manual-genital sexual contact
What are two ways HPV can be transmitted, but not that often?
mother to infant during birth, and through fomites
What HPV serotypes commonly cause cutaneous warts on hands and feet?
HPV 1,2,4, and 7
What serotype of HPV commonly causes genital warts?
HPV 6 and 11
What serotype of HPV commonly causes warts on the larynx or pharynx?
HPV 6 and 11
What serotype of HPV commonly causes squamous cell carcinoma?
HPV 16, 18, 21, 33, and 45
50% of all squamous cell carcinomas are caused by which serotype of HPV?
HPV 16
20% of all squamous cell carcinomas are caused by which serotype of HPV?
HPV 18
What zone of the cervix gives rise to squamous cell carcinoma?
The transitional zone between the columnar epithelium of the uterus and the squamous epithelium of the vagina
What is the survival rate for head and neck cancers?
50%
What cancers besides cervical and head/neck are commonly caused by HPV?
vulva, penis, anus
WHO divides cervical cancer into 5 stages. From most normal to most malignant, they are:
condyloma -> CIN1 (mild dysplasia) -> CIN2 (moderate dysplasia) -> CIN3 (severe dysplasia) -> invasive cancer
The Bethesda system divides cervical cancer into 4 stages. From mild to malignant, they are:
ASC -> LSIL -> HSIL -> Invasive cancer
LSIL in the bethesda system corresponds to what in the WHO system, regarding cervical cancer?
LSIL = CIN1
HSIL in the bethesday system corresponds to what in the WHO system, regarding cervical cancer?
HSIL = CIN2 and CIN3
What diagnostic test detects cervical cancer changes?
the pap smear
What is the next step if the pap smear shows abnormal cells?
colposcopy
What is the current treatment for cervical cancer?
cryosurgery or loop electrosurgical excision, or creams like imiquimod or podofilox
Gardasil vaccine works against which serotypes of HPV?
HPV 6,11,16,18
Cervarix vaccine works against which serotypes of HPV?
HPV 16,18
What protein are HPV vaccines made out of?
L1 capsule protein
What are some limitations of the HPV vaccine?
high cost, doesn't treat existing infections, does not protect against genotypes causing 30% of cancers
What year was AIDS first described by the CDC?
1981
What year was HIV isolated by the CDC?
1984
When did HIV first jump into humans, and where did it jump from?
HIV jumped from chimpanzees around 1900
Where did HIV first appear in humans?
Central West Africa, Cameroon-ish
About how many people live with AIDS worldwide?
33.2 million
In colorado, which ethnic group has the most HIV infections?
white people
How does primary HIV infection present itself?
fever, aseptic meningitis, mononucleosis-like symptoms
How long after infection with HIV do symptoms first appear?
2-3 weeks
What does an HIV-caused rash look like?
maculopapular rash on the trunk
What receptor does HIV use to enter host cells, and what kind of cells does HIV infect?
CD4 on helper T cells
How long does it take for a new generation of HIV particles to be built inside infected cells?
2.6 days
How long does a helper T cell live after being infected with HIV?
2.2 days
What are the two markers of HIV disease measured during treatment?
CD4+ cell count
plasma HIV RNA level
How many HIV particles are made each day in an infected person?
10 to the 10th power. What would that be? 10,000,000,000, or ten billion
What factors contribute to the rapid pace of HIV evolution?
no proofreading during DNA duplication,
fast replication rate,
selective pressure
what does the word "quasispecies" mean in relation to HIV?
HIV in one person evolves into its own subspecies, which will be slightly different from someone else's HIV viruses
What are the 5 classes of drugs that we use to treat HIV infection?
Protease inhibitors, nucleoside RT inhibitors,
non-nucleotide RT inhibitors,
entry inhibitors,
integrase inhibitors
What co-receptors does HIV use (along with CD4) to gain entry into cells?
CCR5 and CXCR4
How do entry-inhibitors work to supress HIV infection?
bind to CCR5 or CXCR4, so HIV can't use CD4 to get into T cells
People with mutated CCR5 receptors have what response to HIV?
They are HIV resistant, but still susceptable to HIV that uses CXCR4
heterozygotes for the CCR5 mutation have what response to HIV infection?
Their disease is longer, milder, and drawn out
What percent of people are homozygous for the CCR5 mutation?
about 1%
How do nucleoside RT inhibitors supress HIV infection?
nucleoside analogs get incorporated into viral genome by RT, gumming it up and causing termination
How do non-nucleoside RT inhibitors supress HIV infection?
non-competitively bind to RT and cause it to stop working
What are some side effects of non-nucleoside RT inhibitors used to treat HIV infections?
liver toxicity, rash, CNS effects
How do Integrase Inhibitors supress HIV infection?
They block HIV from becoming a provirus inside our own chromosome
How do the protease inhibitors supress HIV infection?
They prevent cleavage (and activation) of precursor proteins inside HIV; virus is still produced, but is ineffective
Why is it so hard to cure HIV infections?
Virus exists dormant as a provirus
Do Herpesviruses have envelopes?
Yes
In what form do Herpesviruses keep their genome?
in the form of double-stranded DNA
In a Herpesvirus, what lies between the capsule and the envelope?
The tegument
In a herpesvirus, what does the tegument layer contain?
viral and cellular proteins, RNA
What 3 broad classes of genes are expressed by herpesviruses?
Immediate Early (IE), Early (E), and Late (L)
In a herpesvirus, what sorts of things do the IE genes usually code for?
DNA binding proteins, proteins for immune evasion
In a herpesvirus, what sorts of things do the E genes usually code for?
nucleotide metabolism, genomic DNA replication
In a herpesvirus, what sorts of things do the L genes usually code for?
structural proteins for the capsule
Where in the infected cell do newly-made herpesviruses mature?
In the golgi
Where in the infected cell is the herpesvirus's DNA replicated?
In the nucleus
How durable are herpesviruses when they are outside of the body?
Herpesviruses are very fragile when they are not inside their host's body
How are herpesviruses transmitted between hosts?
close contact of mucous membranes, usually
Herpesviruses like to exist in the latent form. What does this mean?
Existing as a provirus in the genome of the host, expressing few or no proteins
Herpesviruses can exist in either the lytic or latent phase. What does it mean if the virus is lytic?
Lytic phase is when the virus immediately takes over the cell and kills it by making it make new copies of virus
What binds the herpesvirus envelope to the host cell's membrane?
glycoproteins
When the herpesvirus envelope is merged with the host cell membrane, what is released into the cell?
the capsule and the tegument
Where does the herpesvirus capsule go once the virus enters the host cell?
the capsule travels along microtubules to a nuclear pore
Unlike E and L proteins, the IE proteins in the herpesvirus do not need......what?
to be synthesized by the infected cell; the virus carries them with it in the tegument
Name the 3 alpha herpesviruses.
herpes simplex 1 and 2, and varicella-zoster
What are some characteristics of alpha herpesviruses that set them apart from other herpesviruses?
they are lytic in mucosa/skin cells, and are latent in nerve ganglia
What are some characteristics of beta herpesviruses that set them apart from other herpesviruses?
grow slowly, latent in myeloid and endothelial cells, can be transmitted through saliva, urine, and breastmilk
Name the 3 beta herpesviruses
Human cytomegalovirus (HCMV), HHV-6 and 7
What are some characteristics of gamma herpesviruses that set them apart from other herpesviruses?
lytic phase in epithelial cells, fibroblasts, lymphocytes. Latent phase in B-lymphocytes
Name the 2 gamma herpesviruses.
Epstein Barr virus (EBV) and Kaposi's Sarcoma Herpesvirus (KSHV)
What is the host range of alpha herpesviruses, in general?
broad
What is the host range of gamma herpesviruses, in general?
narrow
What are the clinical manifestations of an HSV infection, in order?
papule, vesicle, pustule
HSV-1 and HSV-2 are responsible for infections, where?
HSV-1 = the mouth
HSV-2 = the genitals
What is the name for the symptom of severe, painful oral and gum sores due to HSV-1 infection?
herpetic gingivostomatitis
Severe pharyngitis in an adolescent or adult is usually caused by one of these three things:
HSV-1 infection
mononucleosis
adenovirus
People with latent HSV-1 shed virus approximately how often?
1 day out of 30, or 3-4% of the time
What two demographic groups are most likely to be victims of HPV infection, and why?
kids older than 6 months (maternal IgG protects until then)
adolescents (sexual contact)
How does the initial herpesvirus infection compare to recurrent infections?
recurrent infections are much less serious and clear up faster, due to established immunity
What are two complications of HSV-1 infection?
herpetic keratitis, and herpes encephalitis
What leads to herpetic keratitis, and what can it cause?
HSV spreads to eyes via saliva on fingers. Normal lesions. Can lead to scarring and blindness
What leads to herpes encephalitis, and what can it cause?
HSV reactivation in the trigeminal ganglion can travel to the brain, causing brain necrosis and CNS injury
How do you diagnose herpes encephalitis, and how do you treat it?
test CSF for HSV DNA. Treat with IV acyclovir
HSV-2 infections are more prevalent in these groups:
the poor, African Americans, women
What are some symptoms of the initial HSV-2 infection?
urethritis, adenopathy, severe genital lesions, headache, fever, malaise
What percent of initial HPV-2 infections are asymptomatic?
70-80%
What are some sequelae of HSV-2 infection?
viral meningitis, severe local lesions
How do you treat a patient with HPV-2 infection?
give acyclovir during the prodrome before the actual outbreak
A person with a prior HSV-1 infection will have (more/less) severe symptoms when they contract HSV-2?
Their symptoms will be less severe, because they already have partial immunity to herpes simplex
HSV infection in neonates is best described as?
fatal. or if not fatal, than severely crippling.
What is the cheapest test used to detect HSV?
Immunoassay using fluorescent antibodies
What is the most expensive test used to detect HSV?
PCR to detect the DNA
first time nfection with CMV is likely to be most severe at what age?
adulthood. In babies, children, and adolescents, it is usually asymptomatic
CMV infection in adults manifests these symptoms:
sore throat, adenopathy, fever, malaise, liver involvement
How can you distinguish mononucleosis caused by CMV from that caused by EBV?
CMV mono will have no heterophil antibodies in the blood, but EBV mono will.
What is the most common way to diagnose CMV infection?
virus culture with spin amplification
CMV infections are most often seen in what type of patients?
Those who are immune compromised (AIDS, transplant, on steroids, etc)
What is the most common manifestation of CMV infection in immune compromised patients?
interstitial pneumonia, 50% fatal
What drug is used to treat CMV?
ganciclovir or foscarnet
What drug does not work at all in treating CMV?
acyclovir
Most babies with CMV infections are asymptomatic, except for those who.....?
Are a fetus while the mother gets her first exposure to CMV
Babies born to 1st-time infected mothers suffer from:
hepatitis, bone marrow suppression, seizures, underdeveloped head/ears/eyes
Babies born to mothers who have a recurrent CMV infection during the pregancy will suffer from.....?
nothing, at first. But they might become deaf later in childhood.
How does a person catch VZV?
Through water droplets in the air carrying the virus
How long does it take to develop symptoms after being infected with VZV?
14-17 days
What are the symptoms of first-time VZV infection?
"dewdrops on a rosebud" lesions (papule, vesicle, pustule, scab on a reddish base), fever
Immunocompromised patients with VZV can expect to experience:
pneumonitis, hepatits, encephalitis
How do you treat VZV infection in immune compromized patients?
acyclovir
VZV vaccine is____% effective, and only ___% of kids develop a very mild form of the disease after vaccination
95% effective, 15% of kids have a mini-disease reaction
Initial VZV infection is called _______. Re-activated VZV infection is called ________.
chickenpox = initial disease. Shingles = reactivated disease
How do you diagnose chickenpox?
clinical diagnosis, but you can do culture and spin amplification if you want to, or PCR older crusty lesions.
How do you diagnose Shingles?
vesicles/pustules in a single dermatome that does not cross the midline
What is the most long-lasting sequala of shingles?
post-herpetic neuralgia, which is persisting pain in the affected area long after the lesions are gone
What 2 things can spur a reactivation of VZV?
being immunocompromised, and growing older
Which of your body's natural processes is protective in keeping herpesvirus infections latent?
antibody production, T-cell activity
HHV-6 causes an infection called.....?
Roseola
Roseola presents in what population, with what symptoms?
children. presents with high fever and rash, and can cause seizures.