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144 Cards in this Set
- Front
- Back
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What is mononucleosis?
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caused by EBV, fever, hepatosplenomegaly, pharyngitis, and lymphadenopathy- posterior auricular
+ heterophil Ab test. |
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What does poxviridae cause?
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Smallpox- only in bioterrorism. vaccine was vaccinia virus
Molluscum contagiosum- in aids, look like warts |
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What is the papilloma virus?
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Causes warts and cervical cancer
16 and 18- cancer |
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What is BK polyomavirus?
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mild or asymptomatic infection in kids. all over the place
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What is JC polyomavirus?
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Causes Progressive Multifocal Leukoencephalopathy in the immunocomprimized.
memory loss, poor speech, and incoordination. |
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What do the adenoviridae cause?
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URIs in kids. rhinitis, conjunctivitis, sore throat, and cough. sometimes pneumonia.
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What does the Parvoviridae cause?
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simple, one DNA
erythema infectiosum (Fifth disease) fever and slapped face. |
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What are teh Arboviruses
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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. |
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What do the Alpha viruses cause?
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encephalitis, fever, headache, altered conciousness, focal neural defects.
WEE- Western equine encephalitis EEE- Eastern equine encephalitis VEE venezuelan equine encephalitis |
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What does the Rubivirus cause?
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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 |
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Describe yellow fever.
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flavivirus
Bite-> 1 wk later- hepatitis, jayundice, fever, backache, nausea, and vomiting (black). can cause councilman bodies (acidophilic inclusions) in liver |
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Describe Dengue fever
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flavivirus
backache, muscle and joint pain, sever headache. Hemorrhagic- shock and hemorrhage in kids. death. |
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Describe West Nile
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flavivirus
mild flue, but can cause encephalitis and death in elderly |
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What is Hantavirus Pulmonary Syndrome?
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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. |
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What are the picornaviridae?
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Enterovirus
- Polio - Coxsckie - Echovirus - New - Hep A infect intestinal epithelial and lymphoid cells. excreted in the feces and spread fecal-oral Rhinovirus- comon cold |
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What is the mechanism of disease in Polio?
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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. |
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What are the differences between Coxsackie A and B?
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A- paralysis and death in mouse with skeletal muscle necrosis. Also Herpangina
B- multiple organs- hear, brain, liver, pancreas, skeletal muscle. Also Pleurodynia, Myocarditis. |
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What is herpangina
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mild self-limiting illness with fever, sore throat, small red-based vesicles over back of throat.
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What are the diffeences in calciviridae, Norwalk, and ROtavirus?
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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) |
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what happens with a rabid dog bite?
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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 |
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Filoveridae-- why should you fear this?
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Ebola- blood everywhere
avoid bodily fluids. |
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What drugs treat herpes?
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acyclovir- activated by thymidine kinase (herpes have it, not CMV)
ganciclovir- kills all, can be toxic to platelets, neutrophils |
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What is the role of acyclovir?
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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 |
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What are the SEs of acyclovir?
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renal toxicity (reversible), CNS- confusion, seizures
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What is the added benefit of Famciclovir and Valacyclovir from Acyclovir?
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increased drug levels after oral absorption.
only herpes zoster and recurrent genital herpes in immunocompromised SEs-headache, nausea, diarrhea, dizziness |
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What is Ganciclovir use for?
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AIDS- CMV retinitis, pneumonitis, esophagitis
BM transplant patients- CMV prophylaxis |
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What are the SEs of Ganciclovir?
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neutropenia, thrombocytopenia
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What is the role of Foscarnet?
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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. |
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What are the nucleoside reverse transcriptase inhibitors?
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zidovudine (AZT, ZDV), didanosine (ddl), zalcitabine (ddC), stavudine (d4T), lamivudine (3TC) and abacavir
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What are the non-nucleoside reverse transcriptase inhibitors?
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Nevirapine, delaviridine, and efavirenz
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What are the protease inhibitors?
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saquinavir, indinavir, ritonavir, nelfinavir
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What is the role of zidovudine (AZT) in HIV?
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Delays progression
reduces mortality reduces maternal-infant transmission |
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What are the SEs of AZT?
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anemia, neutropenia
headache, insomnia, myalgias, nausea CNS disturbances- confusion, seizures |
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What is the role of Limivudine?
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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 |
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What is the role of Didanosine?
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synthetic purine nucleoside analogue.
unstable in acid. Should be taken on an empty stomach. |
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What are the SEs of Didanosine?
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pancreatitis especialy in those with history of pancreatitis, alcoholism, and hyperTGs
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What is the role of zalcitabine?
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NRTI
well absorbed can have oral ulcers |
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What is the role of stavudine?
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NRTI
increase of hepatic transaminases |
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What is the role of Abacavir?
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carbocyclic NRTI
can have Hypersensitivity Rash with fever, fatigue, nausea, vomiting, diarrhea, ab pain, insomnia |
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What major side effect do Didanosine, Azlcitabine and Stavudine cause?
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Peripheral Neuropathy
in the feet, reversible |
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What is the mechanisme of NNRTIs?
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bind noncomptitively to enzyme reverse transcriptase. block DNA polymerase- conformational change and disrupt the catalytic site.
Resistance can develop |
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What is the role of Nevirapine?
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NNRTI
Induces p450 CYP3A. Induces it's own metabolism. |
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What is the role of Delaviridine?
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NNRTI
Inhibits CYP 450, ihibs it's own metabolism |
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What is the role of Efavirenz?
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newest NNRTI
has CNS symps in 50% dysphoric dreams, insomnia, dizziness, impaired concntration, and somnolence |
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What is a common side effect of the NNRTIs?
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Rash
can be ulceration and Stevens-Johnson syndrome |
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What is the role of protease inhibitors in HIV?
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inhibit protease which helps production of HIV particles
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What is the common ending for all the protease inhibitors?
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navir
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What is the role of saquinavir?
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first PI to be approved.
minimal absorption Fortovase (gel covered saquinavir) has increased absorption. |
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What are the SEs of saquinavir?
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GI, diarrhea, nausea, ab discomfort and pain, dyspepsia, vomit
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What is the role of Indinavir
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rapid absorption in fasting state. High-fat/high-protein meal=decreased absorption.
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What are the SEs of Indinavir?
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GI- ab pain, nausea, vomiting with renal insufficiency or acute renal failure.
Nephrolithiasis |
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What is the role of Ritonavir?
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PI
poorly tolerated GI, SEs, nausea, vomiting, diarrhea, ab pain |
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What is the role of nelfinavir?
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PI
diarrhea- mild to moderate |
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What is the role of amprenavir?
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newest PI
GI- nausea, vomit, diarrhea, and ab can cause rash, parathesisas, and depressive or mood disorders |
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What is the role of IL-2 in HIV treatment
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regulatest proliferation of CD4. dramatic rise in CD4.
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What is the role of amantadine?
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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 |
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What drugs are NA inhibitors?
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Oseltamivir
Zanamavir |
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What are some SEs of Oseltamivir?
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dizziness, headache, fatigure, insomnia and vertigo
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What are some SEs of Zanamavir?
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intranasal spary and oral inhaler. Not for COPD. initiated within 2 days of onset can cause nose bleed.
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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 |
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What IFN-alpha used for in viral illness?
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IFN-a- Hep B and C, Kaposi's
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What IFN-Beta used for in viral illness?
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MS
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What IFN-gamma used for in viral illness?
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NADPH oxidase deficiency
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What is the common SE in IFN use?
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Neutropenia
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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 |
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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 |
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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 |
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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 |
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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 |
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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 |
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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 |
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What is the role of Suramin?
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for bloode-borne sleeping sickness
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What is the role of melarsoprol?
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CNS sleeping sickness
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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 |
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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 |
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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 |
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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 |
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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 |
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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 |
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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. |
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Which malaria is really bad?
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falciparum
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What is the role of primaquin in malaria?
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primaquine kills the vivax and ovale in the liver.
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What is the difference between simple and diffuse cutaneous leishmaniasis?
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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. |
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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 |
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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 |
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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 |
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clonorchis sinensis:
what type of worm? how is it transmitted? disease? Rx? |
Trematode
Undercooked fish Inflamm of biliary tract Rx- Praziquantel |
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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 |
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Ancylostoma duodenale
what type of worm? how is it transmitted? disease? Rx? |
Nematode
hookworm that penetrates feet. Intestinal infection Rx- Mebendazol/pyrantel pamoate |
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Ascaris lumbricoides:
what type of worm? how is it transmitted? disease? Rx? |
Nematode, giant roundworm
Eggs in feces intestinal infection Rx- Mebendazole/pyrantel pamoate |
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Enterobius vermicularis:
what type of worm? how is it transmitted? disease? Rx? |
Nematodes
pinworm, Food conaminated with eggs anal pruritus Rx- Mebendazole/pyrantel |
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strongyloides stercoralis:
what type of worm? how is it transmitted? disease? Rx? |
nematode
Larvae in soil penetrate the skin. intestial infection Rx- Ivermectin/thiabendazole |
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Trichinella spiralis:
what type of worm? how is it transmitted? disease? Rx? |
Nematode
Undercooked meat, usually pork; inflamm of muscle, periorbital edema Rx- thiabendazole |
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Dracunculus medinensis:
what type of worm? how is it transmitted? disease? Rx? |
Nematode
In drinking water skin inflamm and ulceration Rx- Niridazole |
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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 |
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Onchocerca volvulus:
what type of worm? how is it transmitted? disease? Rx? |
nematode
blackflies river blindness Diethylcarbamazine |
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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 |
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Wuchereria bancrofti:
what type of worm? how is it transmitted? disease? Rx? |
Female mosquito
blockage of limphatic vessels Rx- Diethylcarbamazine |
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What parasite do you think of:
Brain Cysts and seizures |
Taenia solium
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What parasite do you think of:
Liver cysts |
Echinoccus granulosus
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What parasite do you think of:
B12 deficiency |
Diphyllobothrium latum
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What parasite do you think of:
Biliary tract disease |
Clonorchis sinensis
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What parasite do you think of:
Hemoptysis |
Paragonimus westermani
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What parasite do you think of:
Portal hypertension |
Schistosoma mansoni
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What parasite do you think of:
Hematuria, bladder cancer |
Schistosoma haematobium
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What parasite do you think of:
Microcytic anemia |
Ancylostoma, necator
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What parasite do you think of:
Perianal pruritus |
Enterobius
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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 |
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What causes pneumonia in Children?
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RSV
Mycoplasma Chlamydia pneumo strep pneumo |
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What causes pneumonia in Young Adults?
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Mycoplasma
C. pneumo S. pneumo |
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What causes pneumonia in Older Adults?
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S. pneumo
H. flu anaerobes viruses mycoplasma |
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What causes pneumonia in elderly?
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S. pneumo
virus anaerobes H. flu G- rods |
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What causes nosocomial pneumonia?
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Staph, G- rods
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What causes pneumonia in the immunocomprimised?
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Staph, G- rods, fungi, viruses, pneumocystis carinii
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What causes aspiration pneumonia?
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anaerobes
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what causes pneumonia in alcoholics/IV drug users?
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S. pneumo, Klebsiella, Staph
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What causes post-viral pneumonia?
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Staph, H. Flu
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What causes pneumonia in neonates?
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Group B strep, e. coli
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What causes atypical pneumonia?
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Myco
Legionella chlamydia |
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What causes meningitis in newborns?
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Group B strep
E. Coli Listeria |
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What causes meningitis in kids?
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S. pneumo
N. meningitidis H. flu Enteroviruses |
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What causes meningitis in adults?
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N. meningitidis
enteroviruses s. pneumo HSV |
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What causes meningitis in those >60?
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S. pneumo
G-s listeria |
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What causes meningitis in HIV?
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Cryptococcus, CMV, toxoplasmosis, JC virus
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What causes osteomyelitis in most people?
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S. aureus
most osteomyelitis is in kids |
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What causes osteomyelitis in the sexually active?
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N. gonorrhoeae, septic arthritis is more common
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What causes osteomyelitis in diabetics an ddrug addicts?
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Pseudomonas
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what causes osteomyelitis in sickle cell?
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salmonella
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what causes osteomyelitis in hip replacements?
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s. aureus
s. epidermidids |
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What causes ambulatory UTIs?
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E. coli, Staph saprophyticus, Klebsiella
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What causes hospital UTIs?
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E. coli, proteus, klebsiellsa, serratia, pseudomonas
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what are common nosocomial infections in newborns?
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CMV, RSV
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What are common nosocomials in catheters?
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E. coli, Proteus
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What are common nosocomials with respirators
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Pseudomonas aeruginosa
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What is a common nosocomial from dialysis?
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HBV
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Wha tis a common nosocomial with hyperalimentation?
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Candida Albicans
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Pus, empyema, abscess
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S. Aureus
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Pediatric infection
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H. flu
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pneumonia in CF, brun
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pseudomonas
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traumatic wound opening
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C. perfringens
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Surgical wound
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Aureus
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Currant jelly sputum
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Klebsiella
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Sepsis/meningitis in newborn
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Group B strep
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What antibiotics should be avoided in pregnancy?
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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" |
