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135 Cards in this Set

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How are mumps spread?
Airborne droplets, salivary secretions, urin
What is the classic sign of mumps?
Swollen, painful parotid gland
What vaccine is used against mumps?
MMR, live attenuated vaccine
What is a common name for Rubella?
German measles
How is Rubella spread?
droplet infection
Why is infection with Rubella during pregnancy a concern?
Congenital rubella --> cataracts, MR, deafness

High mortality rate in utero
Is there a vaccine for Rubella
Yes. Live attenuated vaccine
What is the largest human herpes virus?
CMV
cytomegalovirus infection
What is another name for CMV?
salivary gland virus
How is CMV spread?
urine, semen, cervical secretions, STD, blood transfusions, organ transplant
Where does a CMV infection localize?
epithelial cells of the salivary glands, kidney tubule, cervix, epididymis, testes
What are the symptoms of CMV?
usually asymptomatic, though young adults may have fever
what is the most common viral cause of congenital defects in the US?
CMV, cytomegalovirus infection
What defects does CMV cause?
fetal malformations, small size, microcephaly, MR, hearing loss, jaundice
What disease does CMV cause in an immunodeficient patients?
interstitial pneumonia
What kind of virus is Epstein Barr (EBV)?
It is a herpes virus
How is EBV transmitted?
saliva exchange, kissing
What causes the symptoms of EBV?
action of released cytokines; immunologic response; T lymphocytes respond to infected B cells.
How does the EBV virus replicate?
In B lymphocytes binding to C3d receptor on the cells.
What is the EBV triad?
1. Sore throat
2. lymphadenopathy
3. splenomegaly
What disease develops in older children and young adults with EBV?
infectious mononucleosis
Which two diseases result in Burkitt's lymphoma?
EBV and malaria;

malaria weakens the T cell control of EBV
What virus plays a role in 30-50% of Hodgkins disease?
EBV
What 2 ways is smallpox spread?
1. Contact with skin lesions
2. Respiratory tract
What was the 1st disease controlled by immunization?
smallpox
What makes disease eradication possible (4 factors)?
1. no subclinical infections
2. no carrier
3. no animal reservoir
4. effective vacine
What causes smallpox (variola)?
poxvirus (variola major or minor)
What are the 3 characteristics of vector-borne infections?
1. able to transmit to sparse pop
2. virus survives in vector and host
3. sufficient # of vectors to infect large enough pop
What are arboviruses?
arthropod-borne: ticks, mosquitoes, sandflies

can cause fever, rash
What mosquito carries yellow fever person-person?

. . . monkey-person?
p-p Aedes aegypti ("urban" yellow fever)

m-p Haemagogus ("jungle" yellow fever)
What are symptoms of yellow fever, and what is mortality rate?
-Sudden onset of fever, headache, muscular aches
-Severe --> shock, liver damage, death
- 50%
What is the prevention of yellow fever?
- Live attenuated vaccine

- Control of mosquitoes
What is the principal vector for dengue fever?
Aedes aegypti mosquito
What is a common name for dengue fever?
"break-bone" fever
What is the severe form of dengue called?
Dengue hemorrhagic fever syndrome.

Occurs in children in endemic areas. Mortality up to 10%
What are the symptoms of dengue fever?
Malaise, fever, nausea, vomiting, maculopapular rash.
What are the symptoms of dengue hemorrhagic fever syndrome?
Vascular damage, shock, hemorrhage in GI tract and skin due to cytokines
What is the treatment for dengue fever?
None
What are rickettsia?
- Small bacteria
- Obligate parasite
List 4 rickettsial infections
1. Rocky mountain spotted fever
2. Mediterranean spotted fever
3. Epidemic typhus
4. Endemic typhus
What bacteria causes rocky mtn spotted fever?
R. rickettsii
What bacteria causes Mediterranean spotted fever?
R. conorri
What bacteria causes epidemic typhus?
R. prowazeckii
What bacteria causes endemic typhus?
R. typhi
Which is worse, epidemic or endemic typhus?
Epidemic. Fever, headache, flu-like, maculopapular rash, maybe sever meningoencephalitis w/delirium and coma.

Endemic is similar by less severe.
What are the special symptoms of Rocky Mtn spotted fever?
Splenomegaly, neurologic involvement, disseminated intravascular coagulation, shock, and death if not treated immediately.
What is the treatment for Rocky mtn spotted fever?
Immediate tetracycline IV
Where does rash develop in Mediterranean spotted fever?
On palms and soles of feet
What is the mortality rate of Mediterranean spotted fever?
50%
What creature transmits epidemic typhus?
A louse -- Pediculus corporis
Why is epidemic typhus associated with poverty and war?
Clothes and bodies are washed less often.
What causes Lyme disease?
Borrelia spirochete
What transmits Lyme disease?
Ticks of genus Ixodes
What is the classic sign of bite from Lyme disease infected tick?
Bull's eye lesion.

erythema chronicum migrans
What are the effects of untreated Lyme disease?
- neurologic: meningitis, encephalitis, peripheral neuropathy
- cardiologic: congestive heart failure, myopericarditis
- arthritis
What is the leading vector-borne disease in US?
Lyme disease
What protozoa cause malaria?
Plasmodium

- P. falciparum = most virulent

- P. vivax = most common
What vector carries malaria?
female anopheles mosquito
What is the life cycle of the malaria parasite?
- sporozoites in saliva
- liver - mature into merozoites --> bloodstream
- mer's enter red blood cells, multiply, burst (when fever shivering occur)
What is the sexual cycle of Plasmodium (malaria)?
- form male/female gametocytes in RBC
- mosquito feeds on RBC
- gametocytes form zygote
- sporozoites migrate to salivary glands of mosquito
* zygote forms in mosquito, NOT human host
What are symptoms of malaria?
Fever to fatal cerebral or renal disease.

Also headache, vomiting, muscle spasms.
Describe the synchronous cycle times of malaria.
48 or 72 hour periodicity of fever

1. cold & shivering
2. hot, dry stage
3. profuse sweating
Why is P. falciparum malaria fatal during 1st 2 or 3 weeks?
Complications:
- cerebral malaria - headache, neck stiffness, convulsions, coma
- severe anemia due to bursting RBC's
- clots from destroyed RBC's
- hypoglycemia & lactic acidosis - parasites consume glucose
What is the treatment for malaria?
Chloroquinine.

Drugs are strain specific.
What is the common name for African trypanosomiasis?
Sleeping sickness
What protozoa cause trypanosomiasis?
- Trypanosoma brucel gambiense
- Trypanosoma rhodesiense
What is the trypanosomiasis vector?
Tse-tse fly
What are the symptoms of trypanosomiasis?
- chancre
- lymph node enlargement
- fever
- splenomegaly
- CNS involvement
- voracious appetite
- weight loss
- coma
How does T. brucei (trypsanosomiasis) survive so well in the blood?
Antigenic variation
How do you treat sleeping sickness?
arsenical and non-arsenical drugs
What are symptoms of malaria?
Fever to fatal cerebral or renal disease.

Also headache, vomiting, muscle spasms.
Describe the synchronous cycle times of malaria.
48 or 72 hour periodicity of fever

1. cold & shivering
2. hot, dry stage
3. profuse sweating
Why is P. falciparum malaria fatal during 1st 2 or 3 weeks?
Complications:
- cerebral malaria - headache, neck stiffness, convulsions, coma
- severe anemia due to bursting RBC's
- clots from destroyed RBC's
- hypoglycemia & lactic acidosis - parasites consume glucose
What is the treatment for malaria?
Chloroquinine.

Drugs are strain specific.
What is the common name for African trypanosomiasis?
Sleeping sickness
What protozoa cause trypanosomiasis?
- Trypanosoma brucel gambiense
- Trypanosoma rhodesiense
What is the trypanosomiasis vector?
Tse-tse fly
What are the symptoms of trypanosomiasis?
- chancre
- lymph node enlargement
- fever
- splenomegaly
- CNS involvement
- voracious appetite
- weight loss
- coma
How does T. brucei (trypsanosomiasis) survive so well in the blood?
Antigenic variation
How do you treat sleeping sickness?
arsenical and non-arsenical drugs
What protozoa causes Chaga's disease
T. cruzi
What is another name for South American trypanosomiasis?
Chaga's disease
How is Chaga's disease transmitted?
reduviid bug -- kissing bug
What systems does Chaga's disease affect?
Heart and GI

Major cause of death = myocarditis
What is the treatment for Chaga's disease?
arsenicals

* one of the hardest protozoal infections to cure
What are leishmania?
- Intracellular parasites that inhabit macrophages

- Cause leishmaniasis
Which are the leishmania that cause leishmaniasis?
- L. donovani --> visceral

- L. tropica --> cutaneous
Name two types of leishmaniasis.
1. visceral, aka kal-azar -- liver and spleen

2. cutaneous -- skin
What are the symptoms of visceral leishmaniasis (kal-azar)?
Fever, weight loss, then years of hepatomegaly, splenomegaly.

Death from liver failure if untreated
What are the symptoms of cutaneous leishmaniasis?
Ulcers, scarring
How do you treat leishmaniasis?
antimonial compounds
What type of infections are schistosomiasis and filariasis?
helminth infections
What is the basis for the pathology of schistosomiasis?
Schistosome eggs: body becomes hypersensitive to antigens as they pass thru tissue or get trapped in organs
What is urinary schistosomiasis?
Schistosome eggs move thru bladder --> hemorrhage, polyps, possible cancer
What is another common name for filiariasis?
Elephantiasis
What causes filiariasis?
filarial nematodes
Describe lymphatic filiariasis.
- Larvae enter skin
- Develop into long worms in lymph nodes & lymphatics of limbs and groin
- Fever, rash, chronic lymphatic obstruction
What is an arenavirus infection?
- parasite of rodents
- harmless to rodents; severe, lethal in humans
What virus is most common in Sierra Leone hospitals?
- Lassa fever virus

- Contracted from infected rats or their urine.

- If tranferred from patient to caretaker via blood, body fluids, more severe
What virus causes Korean Hemorrhagic fever?
Hantaan virus
Where have there been recent outbreaks of Korean hemorrhagic fever?
SW US. Severe pulmonary disease.
What causes Marburg and Ebola viruses?
filoviruses -- long filamentous single strand RNA
What are the symptoms of Marburg and Ebola viruses?
fever, hemorrhage, rash, disseminated intravascular coagulation
How are Marburg and Ebola viruses treated?
No known treatment
Are there carriers of Marburg and Ebola viruses?
Yes, there appears to be subclinical infection. Found AB's in 18% of one pop
What causes Q (query fever)?
a rickettsia bacteria, Coxiella burnetii
How is the rickettsia Coxiella burnetii (Q fever) different from other rickettsia?
1. not transmitted by arthropods
2. transmission by inhalation
3. main action in lungs; not vascular endothelium
If Q fever becomes chronic, what is the result?
Endocarditis. Can be fatal
What bacteria causes anthrax?
Bacillus anthracis, a spore forming bacteria
What are the 2 types of anthrax?
1. cutaneous

2. pulmonary
What is an eschar? How does it develop?
An eschar is an ulcerated papule caused by anthrax toxin that has an edema factor. Center is black and necrotic
What is the mortality rate of pulmonary anthrax?
100% if not treated
How does pulmonary anthrax begin?
Inhalation of anthrax spores, which enter macropohages.

--> pul edema, hemorrhage, and spread of lethal toxin
How do you treat pulmonary anthrax?

How do you prevent it?
treat - Penicillin -- early and lots

prevent - Vaccine of purified protective antigens
What is the real name for wool sorters disease?
Pulmonary anthrax
What is the cause of plague?
Yersinia pestis
What is the vector for bubonic plague?
Rat flea
What is the difference between bubonic and pneumonic plague?
Bubonic trfr rat-to-human.

Pneumonic trfr human-to-human by droplets if lots of bacteria in lungs
What is clinical path/signs of bubonic plague?
1. bacteria enter skin
2. spread to lymph nodes of armpit, groin
3. form buboes w/ hemorrhagic inflammation
4. spread to blood, septicimia, hemorrhagic
5. multisystem - spleen, liver, lungs, CNS
What causes tularemia, a multisystem zoonosis?
Franchisella tularensis
How are humans infected with tularemia?
Contact w/infected animals or by arthropod vector.

*There is no person-to-person spread
How does tularemia develop in the body?
Febrile illness, lymphatic spread;

Lungs, GI tract, and liver via blood
What is the cause of leptospirosis?
leptospira, spirochetes
How are humans infected with leptospira?
ingestion of contaminated food/water (rat urine), swimming
What are the complications of leptospirosis?
Hepatitis, bacteriuria, meningitis, hemorrhage, kidney and liver failure.

But 90% resolve okay
What is an eschar? How does it develop?
An eschar is an ulcerated papule caused by anthrax toxin that has an edema factor. Center is black and necrotic
What is the mortality rate of pulmonary anthrax?
100% if not treated
How does pulmonary anthrax begin?
Inhalation of anthrax spores, which enter macropohages.

--> pul edema, hemorrhage, and spread of lethal toxin
How do you treat pulmonary anthrax?

How do you prevent it?
treat - Penicillin -- early and lots

prevent - Vaccine of purified protective antigens
What is the real name for wool sorters disease?
Pulmonary anthrax
What is the cause of plague?
Yersinia pestis
What is the vector for bubonic plague?
Rat flea
What is the difference between bubonic and pneumonic plague?
Bubonic trfr rat-to-human.

Pneumonic trfr human-to-human by droplets if lots of bacteria in lungs
What is clinical path/signs of bubonic plague?
1. bacteria enter skin
2. spread to lymph nodes of armpit, groin
3. form buboes w/ hemorrhagic inflammation
4. spread to blood, septicimia, hemorrhagic
5. multisystem - spleen, liver, lungs, CNS
What causes tularemia, a multisystem zoonosis?
Franchisella tularensis