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54 Cards in this Set
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Prion Disease, seen in a classic form as well as a new variant, causes spongiform degeneration in humans
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Creutzfeldt-Jakob-Disease, classic disease has 3 forms (sporadic, familial, and acquired) average age 68. nvCJD is seen in younger (28) caused by eating bovine infected meat
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Member of the flavovirus family, + sense, SS RNA, transmitted most often by the Colex mosquito, now seen in N America
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West Nile Encephalitis, diagnosed by WMV IgM in Serum(+ after 8 days), in normal hosts only causes primary viremia in local vessels or lymphatic cells.
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Result of West Nile Virus in immunosuppressed hosts or the elderly
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CNS 2ndry viremia, leading to encephalitis, brain path reveals scattered microglial nodules, and perivascular inflammatory infiltrates. + ischemic change on CT and MRI
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Treatment for West Nile Virus, St Luis Encephalitis, Echovirus type 9, and Cretzfeldt-Jakob-Disease
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none, only supportive
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Bullet shaped nucleocapsid, surrounded by a lipoprotein envelop, virus with an incubation period of 3 to 8 weeks that is transmitted by the bite of an infected animal.
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Rabies, multiplies at bite site, binds to acetycholine receptors, travels up peripheral nerve to the CNS, where it multiplies in the gray matter. travels back down nerves to salivary glands where it again multiplies.
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Symptoms of Rabies Virus
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paralysis, painful spasms of swallowing muscles, leading to hydrophobia, causes cytotoxic t cells to kill neurons, causing brain damage, causes personality changes and aggression
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pathologic changes seen microscopically in Rabies
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Pink inclusions in neuronal cytoplasm, called negri bodies
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treatment for Rabies
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Once bitten, treatment must begin ASAP with: 3 step prophylaxis, wound cleansing, passive immunity with rabies antiserum, then treat with anti rabies Human Diploid Cell Vacceine
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percent of untreated rabies that is fatal
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100%
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Virus that is transmitted by Kissing an actively infected individual, that may cause encephalitis from secondary infection in older individuals
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herpes simplex type 1, spreads to temporal lobe in brain, causing direct damage, necrosis to brain parenchyma. Cytotoxic t-cell response can cause hemorrhage
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Clinical presentation of HSV-1 related encephalitis
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confusion, seizures, and other symptoms resulting from damage to temporal lobe
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Most common secondary HSV-1 infection in younger healthy adults
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Herpes Labialis
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Treatment for HSV-1 encephalitis
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high dose Acyclovir for 21 days, reducing fatality from 70% to 30%
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Gram + anaerobic rod found in soil that can enter through wound sites, and cause uninhibited muscle rigidity, IE trismus and lockjaw
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Clostridium Tetani (tetanus), forms tetanospasmin in wound site, which enters the axon in peripheral nerve and travel up to the spinal cord. blocks release of inhibitory transmitters glycine and GABA, causing uninhibited excitation of skeletal muscle
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Location of action of tetanospasmin from tetanus
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Spinal cord, at the nerve terminals, it cant cross BBB
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treatment for Tetanus:
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supportive first, secure the airway, then treat with human tetanus immune globulin (passive) then with tetanus toxoid and metronidazole
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Gram +, spore forming rod, that forms a potent neurotoxin, that causes severe neurotoxicity in infants after drinking honey
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Clostridium botulinum
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Mechanism of damage caused by botulism
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forms neurotoxin which is delivered to cholinergic nerve terminals, neuromuscular junctions, and peripheral ganglia (not CNS) where it is internalized into cytoplasm inhibiting acetycholine release, causing flaccid paralysis, respiratory failure and death
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Treatment for Botulism
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supportive, Trivalent (A,B,E) equine antitoxin (ASAP) and purgatives for adults who may still have some in stomach
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Common causative agent in adult botulism
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swollen canned goods (anaerobic bacteria reproducing in the can, causes it to swell)
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Parasite found in pork that can cause infection as adult or as eggs, and the pig is the intermediate host
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Taenia Soleum (pork Tapeworm) can infect intestines as adult, or subcutaneus, occular, and CNS cysticercosis as larvae
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Type of infection by adult Taenia Soleum in humans
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larvae from undercooked pork, trave to and mature in intestine, where they become an adult tapeworm , where they attach via scolex, and live for years, laying their eggs (proglottids) in the stool
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Type of infection by Proglottids (eggs) of Taenia Solium. caused by ingestion of fecally contaminated material
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the ingested eggs hatch in intestine, penetrate mucosa and are carried elsewhere to become Cysticercosis with scolex in the subcutaneus, CNS, and occular tissue.
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Clinical presentation of brain cysticercosis
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Seizures due to mass effect, hydrocephalus effects
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treatment of cysticercosis
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shunting procedures for hydrocephalus, corticosteroids for inflammation and edema, and antiepileptics for seizures.
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Obligate banana shaped, intracellular parasite, transmitted by cats, that with acute and chronic infection, that in immunosuppressed can cause encephalitis
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Toxoplasmma Gondii.
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CD 4 count where toxoplasmosis is commonly seen
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below 200
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Two means of toxoplasmsis transmission to humans
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eating undercooked meat, or handling cat feces.
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Most common cause of a intracranial space occupying lesion in AIDS patients
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Toxoplasmosis
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yeast like fungus, with an oval budding yeast cell and a thick gelatonous capsule, transmitted in Pigeon droppings
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Cryptococcus.
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Microscopic presentation of Cryptococcus in the brain
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India Ink shows budding cells with a sharply demarkated capsule, found in the perivascular gray matter of the brain
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Two means for diagnosing Cryptococcus
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latex agglutination shows cryptococcal polysaccharide antigen, and grows on mycologic medium.
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Population most susceptible to cryptococcus
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AIDS or immune suppressed, is an opportunistic infection, causing meningitis in these groups, and deep mycosis in patients less than 100 CD4
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Food born (soft cheese) facultative anaerobe, gram +, non spore forming, rod that can cause GI upset in adults or serious meningitis in infants, or the elderly
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Lysteria Monocytogenes. produces acid from glucose,
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Main cause of virulance of Lysteria
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Lysterolysin O, phospholipases, and tumbling motility.
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methods to determine serotype of Lysteria
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somatic O or Flagellar M antigens
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At risk groups for Lysteria Meningitis
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Pregnant women, fetuses, neonates, AIDS patients, and the elderly
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Gram - (coffee bean shaped) diplococci with a thin capsule, that are the most common cause of meningitis in children and young adults
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Neisseria Meningitidis, is oxidase + organism that ferments both glucose and maltose.
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Virulance factors of Neisseria:
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Lipooligosaccharide associated endotoxin, and capsule
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Population most at risk for serious neisseria infections
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those with C5-C9 complement deficiency
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Clinical symptoms of Neisseria Meningitidis
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meningitis, sepsis, DIC, purpuric rash
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treatment of Neisseria:
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high dose Penicillin G, or you can use ceftriaxone
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Treatment of Lysteria:
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Penicillin or Ampicillin combined with an aminoglycoside (gentamycin), or TMP/SMX or vancomycin
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Gram + cocci in chains that is the leading cause of bacterial disease and death in newborns worldwide
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Group B (lancefield group B carbohydrate antigen) Strep aka: Strep Agalactiae. in the newborns it is a Type III capsule
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Major Virulance Factor for infant Strep Agalactiae
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The Type III capsular polysaccharide, which is anti-phagocytic, allowing the organisms to disseminate and multiply in the blood and CSF, due to lack of opsonization, and therefore subsequent phagocytic killing by PMN's
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Methods to diagnose S Agalactiae (group B strep)
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CSF or blood cultures that yield glistening gray white colonies, with a narrow zone of B hemolysis on sheep agar. Isolates are catylase - and bacitracin resistant. or Direct antigen testing in urine or CSF
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3 main presetations of newborns with group b strep
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pneumonia, meningitis, and sepsis
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Treatment of Group B Strep
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Penicillin G or Ampicillin, also given with gentamycin for synergy
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Anthropod born, leading cause of encephalitis
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St Louis Encephalitis Virus, can be in 3 families, Bunyaviridae, Togaviridae, and Flaviviridae.
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Vector for St Louis Encephalitis
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tree Hole Mosquito to bird, back to mosquito, then from mosquito to humans. most often in summer months when mosquitos are out
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Two types of Mosquito that transmit St Louis Encephalitis based on location
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Culex tarsalis is in rural and western areas, and Culex Pipiens in urban and eastern areas
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Picornaviridae family small, ether resistant, non enveloped SS RNA virus with cubic symmetry that causes meningitis
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Echovirus type 9, aka enteroviral meningitis
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Cause of 90% of aseptic meningitis, where a cause can be found
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Echovirus type 9, has a seasonal pattern, most common in summer and fall
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Clinical presentations of Echovirus type 9
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aseptic meningitis, pericarditis, myocarditis, and upper/lower respiratory tract infections
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