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144 Cards in this Set

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What is mononucleosis?
caused by EBV, fever, hepatosplenomegaly, pharyngitis, and lymphadenopathy- posterior auricular
+ heterophil Ab test.
What does poxviridae cause?
Smallpox- only in bioterrorism. vaccine was vaccinia virus
Molluscum contagiosum- in aids, look like warts
What is the papilloma virus?
Causes warts and cervical cancer
16 and 18- cancer
What is BK polyomavirus?
mild or asymptomatic infection in kids. all over the place
What is JC polyomavirus?
Causes Progressive Multifocal Leukoencephalopathy in the immunocomprimized.
memory loss, poor speech, and incoordination.
What do the adenoviridae cause?
URIs in kids. rhinitis, conjunctivitis, sore throat, and cough. sometimes pneumonia.
What does the Parvoviridae cause?
simple, one DNA
erythema infectiosum (Fifth disease) fever and slapped face.
What are teh Arboviruses
RNA viruses. Fever and encephalitis. mosquitos.
Bunyaviridae- California encephalitis and Rift Valley Fever
Togaviridae- alpha (encephalitis) and Rubi(rubella)
Flaviviridae- dengue, yellow fever, west nile, encephalitis.
What do the Alpha viruses cause?
encephalitis, fever, headache, altered conciousness, focal neural defects.

WEE- Western equine encephalitis
EEE- Eastern equine encephalitis
VEE venezuelan equine encephalitis
What does the Rubivirus cause?
RUbella. Mild febrile illness with a rash.
Howeve it causes terrible congenital defects in the first trimester.
Heart- patent ductus, interventricula septal defects, pulmonary artery stenosis
Eye- cataracts, chorioretinitis
CNS- mental retardation, microcephaly, deafness
Describe yellow fever.
flavivirus
Bite-> 1 wk later- hepatitis, jayundice, fever, backache, nausea, and vomiting (black).

can cause councilman bodies (acidophilic inclusions) in liver
Describe Dengue fever
flavivirus
backache, muscle and joint pain, sever headache.
Hemorrhagic- shock and hemorrhage in kids. death.
Describe West Nile
flavivirus
mild flue, but can cause encephalitis and death in elderly
What is Hantavirus Pulmonary Syndrome?
flu like in the four corners. high fevers, muscle aches, cough, nausea, vomitingg. Rapid HR and RR. High WBCs adn RBCs. Disrupted capilary permeability

previously only caused hemorrhagic fever with renal failure.

deer mouse reservoir.
What are the picornaviridae?
Enterovirus
- Polio
- Coxsckie
- Echovirus
- New
- Hep A
infect intestinal epithelial and lymphoid cells. excreted in the feces and spread fecal-oral

Rhinovirus- comon cold
What is the mechanism of disease in Polio?
Infects Peyer's patches, Motor neurons- paralytic poliomyelitis
- fecal oral, respiratory early on

Mild- asymp or mild febrile viral illness is most common.
Aseptic meningitis- 1 wk recovery
Paralytic poliomyelitis- destroys presynaptic motor neurons in ant. horn of the spinal cord. Starts mild, returns with a force 5-10 days later.
What are the differences between Coxsackie A and B?
A- paralysis and death in mouse with skeletal muscle necrosis. Also Herpangina
B- multiple organs- hear, brain, liver, pancreas, skeletal muscle. Also Pleurodynia, Myocarditis.
What is herpangina
mild self-limiting illness with fever, sore throat, small red-based vesicles over back of throat.
What are the diffeences in calciviridae, Norwalk, and ROtavirus?
calciviridae- youn kids and infants. indistinguishable from rotavirus. diarrhea vomiting and fever.
Norwalk- adults, but can be in kids. diarrhea and vomiting (severe)
Rotavirus- acute infectious diarrhea (#1)
what happens with a rabid dog bite?
fearless, aggressive an ddisoriented.
fatal encephalitis
Prodrome: fever, headache, sore throat, fatigue, nausea, snesitive nerves around bite. fasciculations
Acute encephalitis- hyperactive an dagitation.
Negri bodies in cytoplasm
Filoveridae-- why should you fear this?
Ebola- blood everywhere
avoid bodily fluids.
What drugs treat herpes?
acyclovir- activated by thymidine kinase (herpes have it, not CMV)
ganciclovir- kills all, can be toxic to platelets, neutrophils
What is the role of acyclovir?
all herpes but CMV
if given early, it reduces severity and duration. But not used for mild disease.

Requires thymidine kinase for phosphorylation, inhibs DNA polymerase
What are the SEs of acyclovir?
renal toxicity (reversible), CNS- confusion, seizures
What is the added benefit of Famciclovir and Valacyclovir from Acyclovir?
increased drug levels after oral absorption.
only herpes zoster and recurrent genital herpes in immunocompromised

SEs-headache, nausea, diarrhea, dizziness
What is Ganciclovir use for?
AIDS- CMV retinitis, pneumonitis, esophagitis
BM transplant patients- CMV prophylaxis
What are the SEs of Ganciclovir?
neutropenia, thrombocytopenia
What is the role of Foscarnet?
inhibits DNA polymerase and reverse transcriptase. Extended anti-viral activity, also covers HIV, but minimal in AIDS. Used for CMV retinitis and acyclovir resistant strains.

nephrotoxic, seiizures.
What are the nucleoside reverse transcriptase inhibitors?
zidovudine (AZT, ZDV), didanosine (ddl), zalcitabine (ddC), stavudine (d4T), lamivudine (3TC) and abacavir
What are the non-nucleoside reverse transcriptase inhibitors?
Nevirapine, delaviridine, and efavirenz
What are the protease inhibitors?
saquinavir, indinavir, ritonavir, nelfinavir
What is the role of zidovudine (AZT) in HIV?
Delays progression
reduces mortality
reduces maternal-infant transmission
What are the SEs of AZT?
anemia, neutropenia
headache, insomnia, myalgias, nausea
CNS disturbances- confusion, seizures
What is the role of Limivudine?
No dose-limit toxic effects.
decreases viral RNA load
increases CD4
Slows progression to AIDS
Combined with zidovudine as first line.
HBV- monotheraby and with IFN-a. Inhibits DNA replication
What is the role of Didanosine?
synthetic purine nucleoside analogue.
unstable in acid. Should be taken on an empty stomach.
What are the SEs of Didanosine?
pancreatitis especialy in those with history of pancreatitis, alcoholism, and hyperTGs
What is the role of zalcitabine?
NRTI
well absorbed
can have oral ulcers
What is the role of stavudine?
NRTI
increase of hepatic transaminases
What is the role of Abacavir?
carbocyclic NRTI
can have Hypersensitivity
Rash with fever, fatigue, nausea, vomiting, diarrhea, ab pain, insomnia
What major side effect do Didanosine, Azlcitabine and Stavudine cause?
Peripheral Neuropathy
in the feet, reversible
What is the mechanisme of NNRTIs?
bind noncomptitively to enzyme reverse transcriptase. block DNA polymerase- conformational change and disrupt the catalytic site.
Resistance can develop
What is the role of Nevirapine?
NNRTI
Induces p450 CYP3A. Induces it's own metabolism.
What is the role of Delaviridine?
NNRTI
Inhibits CYP 450, ihibs it's own metabolism
What is the role of Efavirenz?
newest NNRTI
has CNS symps in 50%
dysphoric dreams, insomnia, dizziness, impaired concntration, and somnolence
What is a common side effect of the NNRTIs?
Rash
can be ulceration and Stevens-Johnson syndrome
What is the role of protease inhibitors in HIV?
inhibit protease which helps production of HIV particles
What is the common ending for all the protease inhibitors?
navir
What is the role of saquinavir?
first PI to be approved.
minimal absorption
Fortovase (gel covered saquinavir) has increased absorption.
What are the SEs of saquinavir?
GI, diarrhea, nausea, ab discomfort and pain, dyspepsia, vomit
What is the role of Indinavir
rapid absorption in fasting state. High-fat/high-protein meal=decreased absorption.
What are the SEs of Indinavir?
GI- ab pain, nausea, vomiting with renal insufficiency or acute renal failure.
Nephrolithiasis
What is the role of Ritonavir?
PI
poorly tolerated
GI, SEs, nausea, vomiting, diarrhea, ab pain
What is the role of nelfinavir?
PI
diarrhea- mild to moderate
What is the role of amprenavir?
newest PI
GI- nausea, vomit, diarrhea, and ab
can cause rash, parathesisas, and depressive or mood disorders
What is the role of IL-2 in HIV treatment
regulatest proliferation of CD4. dramatic rise in CD4.
What is the role of amantadine?
inhibits flu A, not B
ihibits viral genome by uncoating the host. causes release of dopamine.

Prevents flu, given in parkinsons
Rimantadine- effective with less CNS effects, no change for renal failure
What drugs are NA inhibitors?
Oseltamivir
Zanamavir
What are some SEs of Oseltamivir?
dizziness, headache, fatigure, insomnia and vertigo
What are some SEs of Zanamavir?
intranasal spary and oral inhaler. Not for COPD. initiated within 2 days of onset can cause nose bleed.
Ribavirin:
What is the mechanism?
What is it used for clinically?
What are the SEs?
inhibs guanine synthesis by inhibiting IMP dehydrogenase.
RSV, Hep C
Hemolytic Anemia, teratogenic
What IFN-alpha used for in viral illness?
IFN-a- Hep B and C, Kaposi's
What IFN-Beta used for in viral illness?
MS
What IFN-gamma used for in viral illness?
NADPH oxidase deficiency
What is the common SE in IFN use?
Neutropenia
Entamoeba histolytica
What disease does it cause?
How is it transmitted?
How do you Dx?
How do you Rx?
Disease-
Amebiasis: bloddy diarrhea, liver abscess, RUQ pain
Transmission-Cysts in water
Dx- serology and/or trophozoites or cysts in stool
Rx- Metronidazole, iodoquinol
Giardia lamblia
What disease does it cause?
How is it transmitted?
How do you Dx?
How do you Rx?
Disease
Giardiasis: bloating, flatulence, foul-smelling diarrhea
Cysts in water
Dx- Trophos or cysts in stool
Rx- Metronidazole
Cryptosporidium
What disease does it cause?
How is it transmitted?
How do you Dx?
How do you Rx?
Severe diarrhea in AIDS
Mild in non-HIV
Cysts in water
Dx- Cysts on acid-fast
Rx- none
Toxoplasma
What disease does it cause?
How is it transmitted?
How do you Dx?
How do you Rx?
Brain abscess in HIV, birth defects
Cysts in meat or cat poo
Dx- serology, biopsy
Rx- Sulfadiazine + pyrimethamine
Trichomonas
What disease does it cause?
How is it transmitted?
How do you Dx?
How do you Rx?
Vaginitis: foul-smell, green discharge, itching, burning
Sex
Dx- Throphozoites on wet mount
Rx- metronidazole
Trypanosoma cruzi
What disease does it cause?
How is it transmitted?
How do you Dx?
How do you Rx?
Chagas- dilated cardiomyopathy, megacolon, megaesophagus
Reduviid bug
Dx- Blood smear
Rx- Nifurtimox
Trypanosoma t. gambiense
What disease does it cause?
How is it transmitted?
How do you Dx?
How do you Rx?
West African sleeping sickness- slow progressing fevers, wasting, late neuro symps
Tsetse fly
Dx- blood smear
Rx- Suramin for blood-borne
Melarsoprol for CNS
What is the role of Suramin?
for bloode-borne sleeping sickness
What is the role of melarsoprol?
CNS sleeping sickness
Trypanosoma t. rhodesiense
What disease does it cause?
How is it transmitted?
How do you Dx?
How do you Rx?
East African sleeping sickness- fast progression from fever to neuro- drowsiness, mental, coma, death
Tsetse fly
Dx- blood smear
Rx- Suramin for blood-borne
Melarsoprol for CNS
Leishmania donovani
What disease does it cause?
How is it transmitted?
How do you Dx?
How do you Rx?
Visceral leishmaniasis
Sandfly
Dx- macrophages containing amastigotes
Rx- Soddium Stibogluconate
Babesia
What disease does it cause?
How is it transmitted?
How do you Dx?
How do you Rx?
Babesiosis: fever and anemia
Ixodes tick
Dx- Blood smear, no RBC pigment, appears as maltese cross
Rx- Quinine, clindamycine
Naelgleria
What disease does it cause?
How is it transmitted?
How do you Dx?
How do you Rx?
Rapidly fatal meningoencephalitis
Swimming in freshwater lakes- enter cribiform plate
Dx- Amebas in spinal fluid
Rx- none
Acanthamoeba
What disease does it cause?
How is it transmitted?
How do you Dx?
How do you Rx?
Chronic, granulomatous brain infection in immunocompromised pts. headache, fever, seizure, focal neuro signs.
Dx- CSF and brain tissue has cystss and trophos
Rx- pentamidine

Also infects the cornea. can cause blindness. CLEAN YOUR CONTACTS
Isospora and Microsporidia
What disease does it cause?
How is it transmitted?
How do you Dx?
How do you Rx?
diarrhea in immunocompromised people.
fecal oral
TMP/SMX for Iso
Albendazole for Microsporidida
Which species of malaria burst loose every 48 hrs?
What is the time frame for the others?
Vivax and ovale- 48 hrs.; chills fever and sweat- tertian

malariae- every 72 hrs. Quartan

falciparum- most common and deadly. 36-48 hrs.
Which malaria is really bad?
falciparum
What is the role of primaquin in malaria?
primaquine kills the vivax and ovale in the liver.
What is the difference between simple and diffuse cutaneous leishmaniasis?
simple- at the site of the bite. heals in a year.

Diffuse- chronic, in immunosuppressed. diffuse lesions throughout with a cluster near the nose. can last 20 years.
Taenia solium:
what type of worm?
how is it transmitted?
disease?
Rx?
Cestode (tapeworm)
undercooked pork
mass lesions in the brain, cysticercosis
Rx- Praziquantel/niclosamide
Echinococcus granulosus:
what type of worm?
how is it transmitted?
disease?
Rx?
Cestode (tapeworm)
Eggs in dog feces when ingested can cause cysts in liver; anaphylaxis if echinococcal Ags are released.
Rx- Albendazole
Schistosoma:
what type of worm?
how is it transmitted?
disease?
Rx?
Trematode (fluke)
Snails are host; cercariae penetrate skin of humans
granulomas, fibrosis, and inflamm of spleen and liver
Rx- Praziquantel
clonorchis sinensis:
what type of worm?
how is it transmitted?
disease?
Rx?
Trematode
Undercooked fish
Inflamm of biliary tract
Rx- Praziquantel
Paragonimus westermani:
what type of worm?
how is it transmitted?
disease?
Rx?
Trematode
undercooked crab meat
inflam and 2ndry infection of the lung
Rx- Praziquantel
Ancylostoma duodenale
what type of worm?
how is it transmitted?
disease?
Rx?
Nematode
hookworm that penetrates feet.
Intestinal infection
Rx- Mebendazol/pyrantel pamoate
Ascaris lumbricoides:
what type of worm?
how is it transmitted?
disease?
Rx?
Nematode, giant roundworm
Eggs in feces
intestinal infection
Rx- Mebendazole/pyrantel pamoate
Enterobius vermicularis:
what type of worm?
how is it transmitted?
disease?
Rx?
Nematodes
pinworm, Food conaminated with eggs
anal pruritus
Rx- Mebendazole/pyrantel
strongyloides stercoralis:
what type of worm?
how is it transmitted?
disease?
Rx?
nematode
Larvae in soil penetrate the skin.
intestial infection
Rx- Ivermectin/thiabendazole
Trichinella spiralis:
what type of worm?
how is it transmitted?
disease?
Rx?
Nematode
Undercooked meat, usually pork;
inflamm of muscle, periorbital edema
Rx- thiabendazole
Dracunculus medinensis:
what type of worm?
how is it transmitted?
disease?
Rx?
Nematode
In drinking water
skin inflamm and ulceration
Rx- Niridazole
loa loa:
what type of worm?
how is it transmitted?
disease?
Rx?
Nematode
Deer fly
swelling in skin- can see worm crawling in teh conjunctiva
Rx- Diethylcarbamazine
Onchocerca volvulus:
what type of worm?
how is it transmitted?
disease?
Rx?
nematode
blackflies
river blindness
Diethylcarbamazine
Toxocara canis:
what type of worm?
how is it transmitted?
disease?
Rx?
Nematode
Food contaminated with eggs;
causes granulomas, if in retina-> blindness and visceral larvae migrans
Rx- Diethylcarbamazine
Wuchereria bancrofti:
what type of worm?
how is it transmitted?
disease?
Rx?
Female mosquito
blockage of limphatic vessels
Rx- Diethylcarbamazine
What parasite do you think of:
Brain Cysts and seizures
Taenia solium
What parasite do you think of:
Liver cysts
Echinoccus granulosus
What parasite do you think of:
B12 deficiency
Diphyllobothrium latum
What parasite do you think of:
Biliary tract disease
Clonorchis sinensis
What parasite do you think of:
Hemoptysis
Paragonimus westermani
What parasite do you think of:
Portal hypertension
Schistosoma mansoni
What parasite do you think of:
Hematuria, bladder cancer
Schistosoma haematobium
What parasite do you think of:
Microcytic anemia
Ancylostoma, necator
What parasite do you think of:
Perianal pruritus
Enterobius
What is normal flora of the following:
skin
oropharynx
dental plaqe
colon
vagina
S. epidermidis
viridans strep
streptococcus mutans
bacteroides fragili>e. coli
lactobacillus, E. coli, group B
What causes pneumonia in Children?
RSV
Mycoplasma
Chlamydia pneumo
strep pneumo
What causes pneumonia in Young Adults?
Mycoplasma
C. pneumo
S. pneumo
What causes pneumonia in Older Adults?
S. pneumo
H. flu
anaerobes
viruses
mycoplasma
What causes pneumonia in elderly?
S. pneumo
virus
anaerobes
H. flu
G- rods
What causes nosocomial pneumonia?
Staph, G- rods
What causes pneumonia in the immunocomprimised?
Staph, G- rods, fungi, viruses, pneumocystis carinii
What causes aspiration pneumonia?
anaerobes
what causes pneumonia in alcoholics/IV drug users?
S. pneumo, Klebsiella, Staph
What causes post-viral pneumonia?
Staph, H. Flu
What causes pneumonia in neonates?
Group B strep, e. coli
What causes atypical pneumonia?
Myco
Legionella
chlamydia
What causes meningitis in newborns?
Group B strep
E. Coli
Listeria
What causes meningitis in kids?
S. pneumo
N. meningitidis
H. flu
Enteroviruses
What causes meningitis in adults?
N. meningitidis
enteroviruses
s. pneumo
HSV
What causes meningitis in those >60?
S. pneumo
G-s
listeria
What causes meningitis in HIV?
Cryptococcus, CMV, toxoplasmosis, JC virus
What causes osteomyelitis in most people?
S. aureus
most osteomyelitis is in kids
What causes osteomyelitis in the sexually active?
N. gonorrhoeae, septic arthritis is more common
What causes osteomyelitis in diabetics an ddrug addicts?
Pseudomonas
what causes osteomyelitis in sickle cell?
salmonella
what causes osteomyelitis in hip replacements?
s. aureus
s. epidermidids
What causes ambulatory UTIs?
E. coli, Staph saprophyticus, Klebsiella
What causes hospital UTIs?
E. coli, proteus, klebsiellsa, serratia, pseudomonas
what are common nosocomial infections in newborns?
CMV, RSV
What are common nosocomials in catheters?
E. coli, Proteus
What are common nosocomials with respirators
Pseudomonas aeruginosa
What is a common nosocomial from dialysis?
HBV
Wha tis a common nosocomial with hyperalimentation?
Candida Albicans
Pus, empyema, abscess
S. Aureus
Pediatric infection
H. flu
pneumonia in CF, brun
pseudomonas
traumatic wound opening
C. perfringens
Surgical wound
Aureus
Currant jelly sputum
Klebsiella
Sepsis/meningitis in newborn
Group B strep
What antibiotics should be avoided in pregnancy?
SAFE Moms Take Really Good Care
Sulfonamides- kernicterus
Aminoglycosides- ototoxicity
Flouroquinolones- cartilage
Erythromycin- acute cholestatic hepatitis in mom
Metronidazole- mutagenesis
Tetracyclines- discolored teeth, inhibition of bone growth
Ribavirin- teratogenic
Griseofulvin-Teratogenic
Chloramphenicol- "graybaby"