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246 Cards in this Set
- Front
- Back
What is the most common cause of ascending UTIs?
|
E. coli
|
|
associated with urinary stones
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Proteus mirabilis
|
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organism produces urease, which acts on urea to produce ammonia
|
Proteus mirabilis
|
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causes UTIs in young sexually active women
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Staph. saprophyticus
|
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associated with UTI in hospitalized patients
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Staph. epidermis, Enterococcus
|
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T or F - viral causes of UTIs are rare
|
T
|
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virus establishes latency in epithelial cells in kidney tubules and ureter after entering respiratory tract
|
human polyomaviruses
|
|
implicated as cause of hemorrhagic cystitis
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adenovirus
|
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virus infects capillary blood vessels in kidney and can cause renal syndrome
|
hantavirus
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Fungi that can cause UTIs
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Candida, Histoplasma capsulatum
|
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Protozoan causes urethritis in males and vaginitis in females
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Trichomonas vaginalis
|
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Infections with this parasite results in inflammation of the bladder
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Schistosoma haematobium
|
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Mechanical factors that predispose to UTI
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1. shorter female urethra
2. sexual intercourse 3. uncircumcised male |
|
Obstructions to complete bladder emptying (5)
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1. residual urine >2-3ml
2. loss of neruologic control 3. vesicoureteral reflux 4. diabetes mellitus 5. catheterization |
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Where do most urinary tract pathogens originate?
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fecal flora
|
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Which species can actually colonize and infect urinary tract?
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aerobic, facultative (E.coli)
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a product of E. coli that is linked with the capacity to cause kidney damage
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hemolysin
|
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normal pH of urethra
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4.6-8
|
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3 factors that enable healthy urinary tract to be resistant to bacterial colonization
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1. pH
2. chemical content 3. flushing mechanism |
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Clinical features of acute lower UTI
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1. dysuria
2. urgency 3. frequency |
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Appearance of urine in acute lower UTI
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cloudy due to pyuria, bacteria, may contain blood
|
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people lacking antibacterial substances normally found in prostatic fluid may be susceptible to this
|
acute bacterial prostatis
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Infection of kidney complicated by lower UTI symptoms, fever, and pain in kidney
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pyelonephritis
|
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common cause of upper UTI
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Staphylococci
|
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Complications of repeated upper UTIs
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loss of function of renal tissue, hypertension
|
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Quantitative definition of bacteriuria
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over 10^5 organisms/ml (only one bacterial species)
|
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treatment of UTIs
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antibacterial agents
(ex: augmentin) |
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Prevention of UTI
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1. regularly emptying bladder
2. prophylactic use of antibio 3. good catheter care |
|
Host factors that increase risk of STD
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1. genital lesions/ulcers
2. uncircumcised men 3. multiple infection |
|
Causes syphilis
|
Treponema pallidum
|
|
3rd most common STD
|
syphilis
|
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T or F - Treponema pallidum is sensitive to drying, heating, and disinfectants
|
T
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Characterizes intial contact stage of syphilis
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primary painless chancre
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Characterizes primary syphilis
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enlarged inguinal nodes followed by spontaneous healing
|
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Why are inguinal nodes enlarged during primary syphilis?
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proliferation of treponemes in lymph nodes
|
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Characterizes secondary syphilis
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flu-like illness, mucocutaneous rash, headache, fever
|
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What is the pathogenesis during secondary syphilis?
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multiplication and production of lesions in lymph node, liver, joints, muscles, skin, mucous membranes
|
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Pathogenesis in latent syphilis
|
treponemes dormant in possibly the liver and spleen
(covered with lipids) |
|
Characterizes tertiary syphilis
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neurosyphilis, cardiosyphilis, progressive destructive disease
|
|
Pathogenesis in tertiary syphilis
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re-awakening and multiplication of treponemes, dissemination and invasion
|
|
3 results of congenital syphilis
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1. infection resulting in intrauterine death
2. congenital abnormalities 3. silent infection - appear at 2 |
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treatment of syphilis
|
penicillin, tetracycline, doxycycline, erythromycin
|
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Causes gonorrhea
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Neisseria gonorrheae
|
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Reservoir/transmission of gonorrhea
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humans/sexual contact
|
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T or F - Neisseria gonorrheae is sensitive to drying
|
T
|
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Who forms the major reservoir of infection by N. gonorrheae?
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asymptomatic women
|
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4 mechanisms gonococcus uses to attach to mucosal surfaces
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1. fimbriae for attachment
2. LPS - endotoxin activity 3. IgA protease 4. capsule resists phagocytosis |
|
What type of cells do gonococci invade?
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non-ciliated epithelial
|
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What actually causes damage in gonorrhea?
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inflammatory responses elicited by organism
|
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Symptoms of gonorrhea in the male
|
urethral discharge, pain on urination
|
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Symptoms of gonorrhea in women
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vaginal discharge
|
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Complications of gonorrhea in asymptomatic women
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1. PID
2. chronic pelvic pain 3. infertility - damaged fallopian tubes |
|
Type of gonorrheal infection in infants
|
ophthalmia neonatorum
|
|
Is penicillin recommended for treatment of gonorrhea?
|
no
|
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Treatment of gonorrhea
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ceftriazone, ciprofloxacin, spectinomycin
|
|
Causes chlamydial infection
|
chlamydia trachomatis
|
|
Form of C. trachomatis adapted for extracellular survival
|
elementary body
|
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Form of C. trachomatis adapted for intracellular survival
|
reticulate body
|
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Cycle of C. trachomatis
|
enters host through mucosal surface, binds and enters cell through endocytosis, fusion of vesicles with lysosomes is inhibited - EB differentiates into metabolically active RB, which divide and produce EB
|
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Pathogenesis of C. trachomatis in men
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urethritis, epididymitis, proctitis, conjuctivitis
|
|
Pathogenesis of C. trachomatis in women
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urethritis, cervicitis, salpingitis, conjuctivitis
|
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Treatment of chlamydia
|
doxycycline, tetracycline
babies - erythromycin |
|
Causes of inguinal lymphadenopahty
|
genital infections
|
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Causes lymphogranuloma venereum
|
Chlamydiae trachomatis
|
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Treatment of lymphogranuloma venereum
|
tetracycline, doxycycline
|
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Causes chancroid
|
Haemophilus ducreyi
|
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Characterizes chancroid
|
painful genital ulcer, local lymphadenitis
|
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Most common form of genital ulcers in Africa and Asia
|
chancroid
|
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Treatment of chancroid
|
erythromycin, caftraixone, otrimoxazole
|
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Causes donovanosis
|
Calymmatobacterium granulomatis
|
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Characterizes donovanosis
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genital nodules, which form granulomatous ulcers that bleed on contact
|
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Regions where donovanosis is found
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Caribbean, New Guinea, India, central Australia
|
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Treatment of donovanosis
|
tetracycline
|
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Found colonizing genital tracts of healthy sexually active men and women
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Mycoplasma hominis, Ureaplasma urealyticum
|
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Associated with PID and postabortal and postpartum fevers
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Mycoplasma hominis, Ureaplasma urealyticum
|
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Treatment of Mycoplasmas and Non-gonococcal urethritis
|
tetracycline
|
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Normal inhabitant of female genital tract
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Candida albicans
|
|
Symptoms of candida infection
|
irritant vaginitis with cheesy vaginal discharge
|
|
Treatment of Candida infections
|
oral antifungals (fluconazole), nystatin
|
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Causes trichomonas infection
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Trichomonas vaginalis
|
|
Transmission of trichomonas
|
sexual intercourse, bedding, clothing, toilets
|
|
Symptoms of trichomonas in women
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vaginitis with copious foul-smelling discharge, increase in pH
|
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Treatment of trichomonas infection
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metronidazole
|
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Causes bacterial vaginosis
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Gardnerella vaginalis, Bacteroides
|
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Symptoms of bacterial vaginosis
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1. excessive malodorous vaginal discharge
2. vaginal pH >4.5 3. clue cells 4. fishy odor |
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What is pathogenicity of bacterial vaginalis related to?
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disrupting normal acidity of vagina
|
|
What is the genital strain of HSV?
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HSV2
|
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What are symptoms of genital herpes?
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vesicles that break and form shallow ulcers, local lymph nodes swollen, fever, headache, malaise
|
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Where is the latent infection of genital herpes?
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dorsal root ganglion neurons
|
|
Does condom use prevent genital herpes?
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no
|
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Treatment of genital herpes
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topical acyclovir
|
|
What causes genital warts?
|
papillomavirus 6,11,12,16,18,31
|
|
Incubation period of genital warts
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1-6 months
|
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Treatment of genital warts
|
podophyllin
|
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Which strains of papillomavirus are associated with cervical cancer?
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16,18
|
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Which genes normally suppress cell division (tumor-suppressor genes)?
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p53, pRb
|
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Describe papillomavirus
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double-stranded, not enveloped
|
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How does papillomavirus infect host?
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viral DNA integrated into host chromosome and expresses E6,E7
E6 binds to p53, E7 binds to pRb |
|
What affect does E6 binding to p53 have?
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cell continuously divides and enters mitosis
|
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What affect does E7 binding to pRb have?
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e2f binds to promoter and genes are transcribed
|
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Infection of which cells is the major source of transmitted HIV virus?
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peripheral blood mononuclear cells
|
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What causes decrease in CD4 and MHC1 expression in HIV?
|
nef
|
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Describe ARC (AIDS related complex)
|
weight loss, fever, persistent lymphadenopathy, oral candidiasis, diarrhea
|
|
What is the value that is considered AIDS?
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200 CD4/ml
|
|
What lab tests are run to diagnose HIV?
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ELISA, followed by Western blotting, oral swab (gp24)
|
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What could be a problem with an HIV vaccine?
|
induced antibodies against gp120 may combine with virus, attach to monocytes, and be ingested - infection
|
|
Treatment of HIV
|
AZT (nucleoside analog of rt)w/ protease inhibitors
neviropine (non-nucleoside analog) ritonavir (protease inhibitor) |
|
What is the best therapy for HIV?
|
HAART - highly active antiretroviral therapy
|
|
What arthropod commonly attaches to pubic hair and causes infestation?
|
Phthirus pubis
|
|
Treatment of pubic or crab louse
|
malathion
|
|
What causes genital scabies?
|
Sarcoptes scabei
|
|
Treatment of genital scabies
|
10% benzyl benzoate, 1% benzene hexachloride
|
|
How is mumps spread?
|
airborne droplets, salivary secretions, possibly urine
|
|
Where does the mumps virus settle?
|
parotid gland
|
|
What other organs can mumps infect?
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thyroid, pancrease, epididymus
|
|
What type of vaccine is MMR?
|
live attenuated
|
|
What are the effects of congenital mumps?
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deafness, mental retardation, cataracts
|
|
What is the largest human herpesvirus?
|
cytomegalovirus
|
|
How is CMV transmitted?
|
saliva
|
|
How does CMV spread?
|
upper respiratory tract, lymphoid tissue, circulating monocytes and lymphocytes, salivary glands and kidney tubules, cervix, epididymus, testes
|
|
What is the most common viral cause of congenital defects in US and what are the symptoms?
|
CMV, microcephaly, mental retardation, hearing loss, jaundice
|
|
What does CMV cause in immunodeficient patients?
|
interstitial pneumonia
|
|
Treatment of CMV
|
ganciclovir
|
|
How is EBV transmitted?
|
exchange of saliva
|
|
Where does EBV replicate?
|
B lymphocytes binding to cd3 receptor
|
|
What are symptoms of EBV due to?
|
action of cytokines released
|
|
What are the major symptoms of EBV?
|
sore throat, lymphadenopathy, splenomegaly, lethargy
|
|
Treatment of EBV
|
high does of acyclovir
|
|
How has EBV been related to cancer?
|
absence of T cell immunity results in polyclonal leukemia-like B cell proliferation
|
|
What disease are EBV and malaria closley associated with?
|
Burkitt's lymphoma
|
|
How is malaria a co-carcinogen of EBV?
|
it weakens T cell control of the EBV infection
|
|
Which oncogene is related to Burkitt's lymphoma?
|
c-myc
|
|
How was global smallpox eradicated?
|
widespread vaccination using attenuated strain of virus
|
|
When was smallpox completely eradicated?
|
1980
|
|
What are arboraviruses?
|
arthropod-borne viruses
|
|
In arboraviruses, where does the virus multiply?
|
salivary gland
|
|
What transmits yellow fever?
|
mosquito Aedes aegypti
|
|
What is the reservoir of yellow fever?
|
humans
|
|
Treatment of yellow fever
|
live attenuated vaccine, insect repellent
|
|
What is the vector of dengue fever?
|
mosquito A. aegypti
|
|
What is a particularly severe form of dengue fever?
|
dengue hemorrhagic fever syndrome
|
|
Where does dengue fever virus replicate?
|
monocytes, vascular endothelium
|
|
Treatment of dengue fever
|
no antiviral therapy or vaccine
|
|
To which parts of the world is Burkitt's lymphoma restricted?
|
Africa, Papau New Guinea
|
|
To which parts of the world is yellow fever restricted?
|
Africa, Central/South Am., Caribbean
|
|
To which part of the world is dengue fever restricted?
|
S.E. Asia, Pacific, India, Caribbean
|
|
What is break bone fever?
|
dengue fever
|
|
What are rickettsia?
|
small bacteria, which are obligate parasites
|
|
What are typical symptoms of rickettsial infections, and where does it multiply?
|
fever, headache, rash; skin, CNS, liver
|
|
What is caused by R. rickettsii?
|
Rocky mountain spotted fever
|
|
What carries R. rickettsii?
|
dog and wood ticks
|
|
Treatment of rocky mountain spotted fever
|
tetracycline i.v.
|
|
Caused by R. conorri, carried by dog ticks
|
Mediterranean spotted fever
|
|
What transmits epidemic typhus?
|
louse Pediculus corporis
|
|
What causes epidemic typhus?
|
R. prowazeckii
|
|
What is associated with poverty and war?
|
epidemic typhus
|
|
Symptoms of epidemic typhus
|
fever, headache, flu-like, maculopapular rash, severe meningoencephalitis with delirium and coma
|
|
What causes and transmits endemic typhus?
|
R. typhi, rat flea
|
|
What causes and transmits Lyme disease?
|
Borrelia, hard ticks (Ixodes)
|
|
What is the leading vector-borne disease in US?
|
Lyme disease
|
|
What is the lesion characteristic of lyme disease?
|
erythema chronicum migrans
|
|
Additional disease caused by lyme disease
|
neurologic, cardiologic, arthritis
|
|
Treatment of lyme disease
|
penicillin, tetracycline
|
|
What is the most virulent species that causes malaria?
|
P. falciparum
|
|
What is the vector for malaria?
|
female anopheles mosquito
|
|
Which part of the life cycle of plasmodium is in the mosquito's saliva?
|
sporozoites
|
|
Where do the sporozoites mature into merozoites?
|
liver
|
|
What are hypnozoites?
|
merozoites that remain in the liver and lie dormant
|
|
Where do merozoites multiply?
|
red blood cells
|
|
What is the stage of plasmodium during the sexual cycle?
|
gamaetocytes
|
|
When is the sexual cycle of Plasmodium complete?
|
Anopheles mosquito feeds on gamaetocyte containing blood, forms zygote, releases sporozoites
|
|
Most characteristic feature of malaria
|
synchronous cycle times of fever (rupture of merozoites)
|
|
What are complications of malaria that make it fatal?
|
cerebral malaria, severe anemia, hypoglycemia, lactic acidosis
|
|
Treatment of malaria
|
chloroquinine
|
|
Causes African trypanosomiasis
|
Trypanosoma brucei gambiense and T. rhodesiense
|
|
Vector of trypanosomiasis
|
tse-tse fly
|
|
Symptoms of trypanosomiasis
|
swollen chancre, swollen lymph nodes, CNS, coma
|
|
Treatment of trypanosomiasis
|
arsenical drugs (tryparsamide, melarsoprol), non-arsenical drugs (suramin, nitrofurazone, pentamidine)
|
|
Causes chaga's disease
|
T. cruzi
|
|
Transmission of chaga's disease
|
reduviid bug
|
|
Major cause of death in chaga's disease
|
myocarditis
|
|
Treatment of chaga's disease
|
arsenicals
|
|
Transmission of leishmaniasis
|
sandflies
|
|
Visceral leishmaniasis; where does it grow
|
L.Donovani; liver, spleen
|
|
Cutaneous leishmaniasis
|
L. Tropica
|
|
Where does leishmaniasis inhabit?
|
macrophages
|
|
What is the form of leishmaniasis that results in liver failure?
|
kal-azar
|
|
Treatment of leishmaniasis
|
antimonial compounds
|
|
What leads to pathology of disease in schistosomiasis, and what effect is on the body?
|
egg production, hypersensitivity to antigens released by eggs
|
|
Treatment of schistosomiasis
|
praziquantel removes worms, but pathology irreversible in advanced cases
|
|
Causes lymphatic filariasis
|
Brugia, Wuchereria
|
|
Transmission of filariasis
|
mosquito
|
|
Introduction to body of schistosomiasis
|
through skin
|
|
Intro. to body of filariasis
|
through skin
|
|
Locations of filarial worms
|
lymph nodes, lymphatics of limbs and groin
|
|
Which parasite leads to obstruction of lymphatics and gross enlargement of breasts, scrotum, and limbs?
|
filarial nematodes
|
|
Treatment of filariasis
|
diethylcarbamazine (larvae), suramin (adults)
|
|
Arenavirus that infects bush rats of West Africa
|
lassa fever virus
|
|
What is the most commone febrile illness in Sierra Leone?
|
lassa fever virus
|
|
How is lassa fever virus acquired?
|
human exposure to infected rats or their urine
|
|
What virus is associated with Korean Hemorrhagic fever?
|
Hantaan virus
|
|
How has Korean Hemorrhagic fever presented in US?
|
pulmonary disease
|
|
What type of virus causes Marburg and Ebola Hemorrhagic fevers?
|
filovirus
|
|
Symptoms of Marburg and Ebola Hemorrhagic fever
|
fever, hemorrhage, rash, disseminated intravascular coagulation
|
|
Infection of this virus first noticed after exposure to African green monkeys from Uganda
|
Marburg virus
|
|
Location of Ebola
|
Southern Sudan
|
|
Causes Q fever
|
rickettsia - Coxiella burnetii
|
|
How is Coxiella burnetii different from other rickettsia?
|
1. not transmitted by arthropods
2. transmission by inhalation 3. main action in lungs, not endothelium |
|
How are humans infected with Q fever?
|
placenta of infected animal, unpasteurized milk, tissue fluids
|
|
T or F - Q fever can become chronic
|
T
|
|
Treatment of Q fever
|
tetracycline, erythromycin
|
|
What causes anthrax?
|
Bacillus anthracis
|
|
What are two ways to contract anthrax?
|
1. spores
2. infected herbivore |
|
Describe cutaneous anthrax
|
spores germinate at site of entry, producing anthrax toxin, consisting of edema factor
-center becomes black and necrotic (eschar) |
|
What is released from bacilli in pulmonary anthrax?
|
lethal toxin
|
|
Treatment of anthrax
|
penicillin
vaccine of purified protective antigens |
|
What causes the plague?
|
Yersinia pestis
|
|
What is the reservoir of the plague?
|
rodents
|
|
What is the vector of the plague?
|
rat flea
|
|
Is bubonic plague transmitted from person to person?
|
not generally
|
|
How can the plague spread from person to person?
|
droplets causing pneumonic plague
|
|
Sign of plague
|
lymph nodes in armpit and groin become tender and form buboes with hemorrhagic inflammation
|
|
Treatment of plague
|
streptomycin, tetracycline
vaccine of formalin-killed bacteria |
|
What causes tularemia?
|
Franchisella tularensis
|
|
How is tularemia spread?
|
arthropod vectors
|
|
Can tularemia spread from person to person?
|
no
|
|
Describe symptoms of tularemia
|
febrile illness, lymphatic spread, lungs, GI tract, liver
|
|
Treatment of tularemia
|
streptomycin
live attenuated vaccine |
|
What are leptospira?
|
tightly coiled spirochetes
|
|
How are humans infected with Leptospirosis?
|
ingestion of contaminated food, water; aquired by swimming
|
|
Treatment of leptospira
|
penicillin, tetracyclines
|
|
Which species of Brucellae infects cows?
|
B. abortus
|
|
Which species of Brucellae infects goats and sheep?
|
B. melitensis
|
|
Which species of Brucellae infects pigs?
|
B. suis
|
|
Where are Brucellae bacteria present?
|
feces, urine, milk of animals
|
|
What are symptoms of Brucellosis?
|
fever, drenching sweat, aching, weakness, enlarged lymph nodes, spleen
|
|
Describe the chronic stage of Brucellosis
|
tiredness, aches, pains, anxiety, depression
|
|
Where does the adult echinococcus live?
|
intestine of dog
|
|
Where do circulating larvae lodge in echinococcus?
|
liver
|
|
What are the cysts called formed by echinococcus?
|
hydatid cysts
|
|
Treatment of echinococcus
|
praziquantel, surgical removal
|
|
What causes trichinella?
|
T. spiralis
|
|
How are humans infected with T spiralis?
|
eating undercooked meat
|
|
Where does T. spiralis mature?
|
striated muscle
|
|
Symptoms of trichinella
|
fever, joint and muscle pain, hemorrhage, encephalitis, cardiac abnormalities
|
|
Treatment of trichinella
|
antihelmintics (thiabendazole)
|