Micro N22, 32-3, 62-63, 77

Front 1

Pneumocystis jiroveci (pneumocystis pneumonia) specs

Back 1

fungus; primitive organelle system, little known about metabolism; extracellular-do not invade lung tissue

Front 2

developmental stages of Pneumocystis jiroveci

Back 2

small (1-4 um) trophic form and 5-8 um cyst with thick cell wall and contains up to 8 intracystic sporozoites

Front 3

Giema stain with Pneumocystis jiroveci

Back 3

demonstrates nuclei and trophozoites and intracystic stages

Front 4

silver stain with Pneumocystis jiroveci

Back 4

demonstates cyst walls

Front 5

when is Pneumocystis jiroveci aquired

Back 5

indirect and direct; most kids have antibodies against by 5th year

Front 6

what do Pneumocystis jiroveci adhere to

Back 6

fibronectin and glycorpoteins on type I pneumocytes

Front 7

why are alveolar macrophages in AIDS patients inefficient at clearing Pneumocystis jiroveci

Back 7

HIV alters mannose-receptor-mediated binding and phagocytosis

Front 8

treatment if Pneumocystis jiroveci

Back 8

high-dose trimethoprim-sulfamethoxazole (TMP-SMX) for 21 days; plus steroids when pO2 below 70 mmHg

Front 9

when is TMP-SMX used as prophylaxis of AIDS patients

Back 9

CD4+ <200

Front 10

discharge from candida

Back 10

whitish; can be thick and/or curdy (cottage cheese like)

Front 11

discharge from Trichomonas

Back 11

yellow and frothy

Front 12

discharge of bacterial vaginosis

Back 12

particularly foul smelling

Front 13

Candida albicans specs

Back 13

yeast; may appear as elongated structures in secretions and tissue sections (pseudohyphae); budding reproduction; germ tubes; chlamydospores

Front 14

germ tubes

Back 14

short hyphal filaments

Front 15

chlamydospores

Back 15

reproductive, thick-walled structures of fungus, larger than standard spores produced by molds

Front 16

predisposing factors leading to vaginal candidiasis

Back 16

feminine hygeine products, contraceptives, vaginal medications, broad-spectrum antibiotics, pregnancy, stress, and diabetes mellitus

Front 17

treatment of vulvovaginal candidiasis

Back 17

topical antifungal agents like clotrimazole, miconazole, or nystatin or single dose oral fluconazole

Front 18

HIV type I specs

Back 18

retrovirus in lentivirus family; capsid and surrounding matrix and envelope studded with virus-specific proteins

Front 19

transmembrane protein Env

Back 19

cap made of 3 molecules: gp120, and a stem of 3 gp41 molecules-anchor structure to viral envelope

Front 20

genome of HIV-1

Back 20

2 identical ssRNA copies; 9 genes including 6 regulatory and gag, pol, and anv

Front 21

p17

Back 21

HIV inner membrane matrix protein-lies btwn viral core and envelope

Front 22

process of HIV entering cells

Back 22

gp120 molecules bind CD4 molecules on cell surface=confirmational change; gp120 binds 2nd molecule either CXCR4 or CCR5=pH independent conformational change=fusion of cellular and viral membranes

Front 23

Cryptococcus neoformans (cryptococcal meningitis) specs

Back 23

yeast-like fungus (not dimorphic) with oval, budding yeast cell; thick gelatinous capsule frequently surrounds; capsular antigens A-D

Front 24

diagnosis of Cryptococcus neoformans

Back 24

india ink test and latex agglutination test; grows on most mycologic media (highly mucoid, creamy-white colonies)

Front 25

transmission of Cryptococcus neoformans

Back 25

inhalation of airborne fungus; not transmitted person to person

Front 26

where do Cryptococcus neoformans accumulate once crossing the blood-brain barrier

Back 26

perivascular areas of gray cortical matter and other areas of CNS; multiply and accumulate within brain parenchyma in absence of cell-mediated immunity

Front 27

treatment of Cryptococcus neoformans

Back 27

Amphotericin B for acute meningitis or pneumonia; may add flucytosine; fluconazole=treatment life long due to frequent relapses (unless CD4 count rises)

Front 28

focal brain lesions in AIDS usually caused by

Back 28

T gondii and CNS lymphoma

Front 29

Toxoplasma gondii specs

Back 29

obligate intracellular parasite; 2 forms: proliferative banana-shaped tachyzoites and resting cyst form-slow growing bradyzoites

Front 30

where are active tachyzoites found in Toxoplasma gondii infection

Back 30

tissues in active stage of chronic infection or primary infection

Front 31

where are resting bradyzoites found

Back 31

in muscle and brain during asymptomatic chronic infection

Front 32

definitive hosts of Toxoplasma gondii

Back 32

cats; cattle and pigs are intermediate hosts

Front 33

how is Toxoplasma gondii aquired

Back 33

ingestion of undercooked infected meat, ingestion of material contaminated by cat feces

Front 34

what occurs when Toxoplasma gondii becomes active in brain

Back 34

replicating tachyzoites rupture brain cells and results in focal necrosis

Front 35

base level Toxoplasma gondii titer IgG level in absence of encephalitis in AIDS population

Back 35

1:16; it is >=1:256 in encephalitis

Front 36

treatment of Toxoplasma gondii

Back 36

sulfadiazine and pyrimethamine with or without leucovorin; doesn't eradicate, but reduces severity and length of infection

Front 37

cytomegalovirus specs

Back 37

B-herpesvirus group; dsDNA, protein capsid, lipoprotein envelope; lymphotrophic; single serotype

Front 38

transmission of CMV

Back 38

person to person in saliva, urine, or other body fluids; 50-95% adults in US have by age 40

Front 39

characteristic microscopic changes with CMV infection

Back 39

enlarged cells with intranuclear and intracytoplasmic inclusions which contain viral particles in the target organ; Owl's eye inclusions

Front 40

treatment of CMV

Back 40

ganciclovir with or without anti-CMV immunoglobulin; continued until immunosuppression resolved