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53 Cards in this Set
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Hepatitis A
1. what is it? 2. how is it transmitted? 3. how does it damage liver cells? 4. what is diagnostic of an active infection? 5. what is diagnositc for past infection/immunity |
1. picornavirus: naked ss+RNA
2. fecal-oral route 3. via immune response 4. anti-HAV IgM 5. anti-HAV IgG |
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Hepatitis B
1. what is it? 2. How does it replicate? 3. how is it transmitted? 4. how does it damage liver cells? 5. What are its 3 phases? 6. how is it treated? |
1. hepadnavirus: env dsDNA
2. using RT and an RNA intermediate 3. sex, IV drugs, perinatal 4. via host immune response and immune complexes (rash, arthritis, etc) 5. prodromal (fever, malaise, anorexia, etc); icteric (jaundice, dark urine, pale stool); recovery 6. interferon-alpha, lamivdine/Adefovir (RT Inhib) |
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3 complications of Hepatitis B
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1. Fulminant Hepatitis: severe liver damage (ascities/bleeding) in icteric pts
2. Chronic Infection: cirrhosis/liver failure (5-10% of infections) 3. Primary Hepatocellular Carcinoma: common cancer, often fatal (80% of cases caused by HBV) |
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Diagnosis of Hepatitis B
1. indicative of active infection (acute or chronic) 2. indicative of immunity (passive/natural infection) 3. indicative of acute infection 4. indicative of past or present infection (stays for life) |
1. HBsAg
2. anti-HBsAg 3. anti-HBcAg IgM 4. anti-HBcAg total (IgM+IgG) |
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Hepatitis D
1. what is it? 2. what's it's only structural core protein? what's it packaged with? 3. how does it damage liver cells? 4. which is worse simultaneous HepB/HepD or HepD superinfection in chronic HepB? 5. what does anti-HepD Ab tell you? |
1. ssRNA
2. delta Ag core; w/ HBsAg 3. direct cytopathic effect 4. superinfection (increases jaundice, chance for chronic cirrhosis and fulminant hepatitis) 5. that pt has or has had Hep D (can't tell current stage of disease) |
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Hepatitis C
1. what is it? 2. how is it transmitted? 3. what's it's claim to fame? 4. what does anti-HCV tell you? 5. how do you determine if someone is infectious? 6. tx? |
1. flavivirus: env ss+RNA
2. via blood (needles, perinatal, sex kinda) 3. chronic infection (70-80% of all infections) 4. that at one time pt had HepC (don't know if its acute, chronic, or resolved) 5. PCR for RT 6. alpha INF + Ribavarin |
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Shigellosis (S. sonnei)
1. what is it? 2. resists? 3. creates? 4. where does it invade? 5. toxins? 6. what does it cause? 7. Dx 8. Tx 9. low or high inoculum? |
1. G- bacilli
2. resists low ph of stomach 3. actin tail in host cell 4. local invasive destroying ileal/colonic mucosa 5. Shiga toxin (AB' binds EF1) 6. dysentery 7. neg blood culture, Lactose (-), H2S (-) 8. ciprofloxacin 9. low (as few as 100 organisms) |
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E. coli
1. what is it? 2. what Ags? 3. 5 types 4. Dx |
1. G- bacilli
2. K, O, H Ags 3. enterogtoxigenic (ETEC),enteropathogenic (EPEC), enterohemorrhagic (EHEC), enteroinvasive (EIEC), enteroaggregative (EAEC) 4. lactose (+) = red |
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ETEC
1. most important cause of...? 2. Toxins |
1. traveler's diarrhea
2. Labile toxin (LT): AB toxin causing ADP-ribosylation of G-protein (inc cAMP) Stable toxin (ST): heat stable, activation of guanylate cyclase (inc cGMP) |
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EPEC
1.what does it do to small intestine? 2. what does it cause? |
1. attachment and effacing (A/E lesion)
2. watery diarrhea |
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EHEC
1. what does it produce? 2. Toxins 3. special strain 4. complications 5. DX |
1. A/E lesion; dysentery
2. Shiga toxin: herrhagic colitis via protein sythesis inhib (EF-1) 3. O157:O7 4. Hemolytic Uremic Syndrome (HUS): oligura, edema, pallor leading to anemia/renal failure 5. failure to ferment sorbitol in MacConkey agar |
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symptoms of...
1. EIEC 2. EAEC |
1. dysentery
2. watery diarrhea (mucoid) |
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Salmonella
1. what is it? 2. Ags 3. high or low inoculum? 4. 3 species 5. Dx |
1. G- bacilli
2. LPS O, flagellar H, capsular K. and antiphagocytic Vi capsular Ag 3. high inoculum 4. S. enterica (improper food handling/poultry, eggs), S. poona (reptiles/melons), S. typhi (enteric fever) 5. MacConkey agar: H2S (+), lactose (-) |
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S. typhi
1. reservoir 2. where do they survive? 3. what does it cause? 4. Tx |
1. humans
2. intracellularly in macrophages 3. Enteric/Typhoid fever (fever, bacteremia, RES involvement) 4. chloramphenocol; live oral vaccine |
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S. enterica
1. what does it cause? 2. organisms can colonize... |
1. gastroenteritis (N/V, loose, watery stools)
2. sites of pre-existing structural abnormality/trauma (bone) |
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Campylobacter (C. jejuni)
1. what is it? 2. caused by? 3. where does it infect? 4. C. jejuni infecction is associated w/ what disease? 5. causes what type of diarrhea? |
1. G- bacillus
2. undercooked poultry, direct pet contact 3. colon 4. Guillain Barre syndrome 5. water or dysenteric |
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1. what is the 2nd most common disease in kids?
2. 1st most common diarrheal disease and msot common bacterial pathogen in US? 3. Most common STD in US |
1. Salmonella
2. Campylogbacter 3. Papillomavirus |
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Helicobacter pylori
1. what is it? 2. most common cause of.. 3. virulence factors 4. complications 5. Dx 6. Tx |
1. G- bacillus; motile
2. gastric and duodenal ulcers 3. urease (allows org to persist in low pH); vaculotaing cytotoxin (induced apoptosis); Cag (changes in cellular proteins); Neutrophil activating protein (recruits neutrophils) 4. adenocarcinoma, MALT lymphoma 5. urease + (so are cryptococcus and proteus) 6. Cimetidine/Peopto-Bisomol and 2 of either metronidazole, tetracycline, clarithromycin, or amoxicillin |
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Yersinia enterocolitica
1. what is it? 2. transmitted by... 3. virulence factors 4. what regulates expression of virulence factors? 5. symptoms 6. sometimes resembles... 7. DX |
1. G- coccbacilli
2. animal pathogen transmission to humans (dog licking your face) 3. invasin (binds host integrins); YOPs (effector proteins); Yersinabactin (iron scavenger) 4. Ca++ and temp 5. enterocolitis w/ fever diarrhea, abd pain; enteric fever; terminal ileitis; polyarthritic syndrome7. 7. lactose (-) on MacConkey (cold increases recovery) |
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Vibrio cholera
1. what is it? O2 requirement? What strains are epidemic? 2. transmitted by... 3. Toxins 4. causes what type of diarrhea 5. Dx 6. Tx |
1. G- bacilli; facultative anaerobes; 01 and 0139
2.fecal-oral (shellfish reservoir) 3. Cholera Toxin: AB toxin; ADP-ribosylation of adenylate cyclase (inc cAMP) 4. massive, painless, watery diarrhea, w/o inflammatory cells (rice-water appearance) 5. oxidase (+) in Thiosulfate-citrate-bile salt sucrose (TCBS) 6. tetracycline can shorten duration |
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Vibrio parahaemolyticus
1. what is it? 2. Transmitted by... 3. symptoms 4. how is it different than other diarrhea causing vibrio? |
1. G- bacilli
2. raw shellfish 3. mild to severe watery diarrhea 4. no cholera toxin |
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Clostridium difficile
1. what is it? 2. most common cause of... 3. Toxins 4. symptoms 5. clinical hx of... 6. tx |
1. G+ bacilli; spore former
2. nosocomial diarrhea associated w/ antibiotic use 3. Toxin A (alters cell permeability inc fluid secretion); Toxin B (cytotoxic to epithelial cells) 4. mild to watery diarrhea, classic pseudomembranous colitis, ulcerated epithelium 5. prolonged antibiotic use 6. metronidazole (may use vancomycin if resistant) |
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S. aureus: food poisoning
1. what is it? 2. 3 types 3. how do you get it? 4. Toxins |
1. gram + cocci
2. intoxication, colonizaiton and toxin, invasive (see WBCs) 3. ingesting pre-formed toxin in food (picnics, potato salad, etc) 4. heat stabile Enterotoxins A-E |
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Rotavirus
1. what is it? 2. when is it stable? 3. what causes human disease? 4. what determines serotypes? 5. virulence factors 6. symptoms |
1. reoviridae: naked dsRNA
2. at room temperature 3. groups A (kids), B and C (adults) 4. outer capsid proteins (VP7 and VP4) 5. trypsin/proteolytic enzymes (inc infectivity); NSP4 protein (promotes C++ into enterocytes) 6. explosive watery diarrhea w/p blood cells (mainly symptomatic in kids) |
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Calicivirus
1. 2 types 2. transmitted by... 3. causes 50-60% of... 4. symptoms |
1. Norwalk-like (noroviruses) and sapporo-like
2. fecal-oral (cruises, schools, camps, etc) 3. food/water associated outbreaks of gastroenteritis in North America 4. watery diarrhea, vomiting |
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Enteric Adenovirus
1. what is it? 2. most important serotypes 3. transmitted by... 4. unlike rotavirus, it's more likely to produce... 5. symptoms |
1. naked dsDNA
2. adneoviruses 40 and 41 3. fecal oral (orphanages) 4. prolonged illness 5. gastroenteritis: vomiting, fever, and diarrhea |
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Neisseria gonorrhea
1. what is it? 2. why are some strains asymptomatic? 3. virulence facters 4. complications 5. Dx 6. Tx |
1.G- diplococci
2. lack of C' activation and limited PMN response (b/c of LOS sialyation) 3. pili (adherence); parasite-directed endocytosis; LOS 4. opthalmia neonatorum; PID (ectopic pregnancy, infertility); DGI (rash, fever, purulent arthritis) 5. oxidase + on Thayer Martin/Martin Lewis chocolate agar w/ CO2 supplementation 6. 3rd gen cephalosporin, quinolones, azithromycin, topical silver nitrate/erythromycin (conjunctivitis) |
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What makes up Thayer Martin/Martin Lewis chocolate agar used for N. gonoorhea?
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1. vancomycin: inhib G+
2. colisitin/trimethoprim: inhib G- 3. nystatin/anisomycin: inhib fungi |
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Chlamydia
1. what is it? 2. 3 species 3. Life cycle 4. Dx 5. Tx |
1. obligate intracellular bacterial parasite w/ little peptidoglycan
2. C. trachomatis (STD), C. psittaci (birds/resp infection), C. pneumoniae 3. EB (non-replicative, metabolically inactive infecting unit) > RB (replicates) > 500-1000 EBs released from burst cell 4. EIA followed by DFA or PCR/Amplification($$) 5. erythromycin, tetracycline, quinolones, no B-lactam (atypical cell wall) |
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3 complications of C. trachomatis
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1. inclusion conjunctivitis: neonate infected in birth canal, may also see vaginitis, ear infection, pneumonia, etc
2. lymphogranuloma venereum (LGV): L1, L2, L3; fever, HA, myaligia, painful enlarged inguinal/femoral lymph nodes and hemorrhagic proctitis 3. Trachoma: fly vector, major cause of blindness in underdeveloped countries |
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Malaria
1. what causes it? 2. 4 types 3. hallmark 4. complications 5. Dx 6. Tx |
1. plasmodium infected Anopheles moquitoes
2. P. falciparum, P. vivaz, P. ovale, P. malariae 3. malarial fever paroxysm: chills/rigors then temp increases rapidly, then falls, pt left exhausted 4. blackwater fever (massive hemolysis/renal failure = dark urine) and cerebral malaria (falciparum; delerium, convulsions, coma, death) 5. ring form in RBCs (falciparum) 6. cloroquine (erythrocytic stages), primaquine (kills hypnozoites) |
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Life cycle of Malaria
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1. moquitos inject sporoxoiete (asexual) and they infect liver parenchymal cells
2. develop into schizonts w/ daugther merozoites or hyponozoites that remain dormant (vivax and ovale) 3. schizonts lyse and release merozoites that infect RBCs 4. some RBCs produce gametocytes (sexual) which infect mosquitoes |
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RBCs infected by
1. P. falciparum 2. P. vivax and P. ovale 3. P. malariae |
1. RBCs of all ages
2. reticulocytes 3. senescent RBCs |
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3 Traits that decrease risk of Malaria
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1. Duff Ag (-) RBCs: resist infection w/ merozoites
2. Sickle cell disease 3. Thalassemias: produces fetal Hb that slows maturation of P. falciparum |
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Endocarditis
1. 3 scenarios (and their causes) 2. symptoms |
1. R sided IV drug users (S. aureus), damaged heart valves (viridans strep, HACEK), and prosthetic heart valves (coag neg staph-S. epidermidis)
2. Bacteremia: transient (insignificant), intermittent (assoc w/ infected tissues), and peristent (intravacular infection; consider endocarditis) |
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Cytomegalovirus
1. what is it? 2. transmission 3. where is it found? 4. symptoms 5. Dx 6. Tx |
1. herpes virus: env dsDNA
2. congeintal (transplacental but not perinatal!), oral, sexual, blood, lactation 3. body secretions; semen has highest conc 4. mainly in IS; no tx = blindness and death; congenital: microcephaly, rash, hepatosplenomegaly, mental retardation; post-transplant fever 5. Owl's eye 6. gangcyclovir (bone marrow toxicity), goscarnet (renal toxicity) |
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Ebola/Marburg Virus
1. what is it? 2. reservoir/transmission 3. symptoms |
1. filoviridae: env ss-RNA
2. bats, mokeys/direct contact w/ blood or secretions 3. abrupt onset of fever, HA, vomiting, and diarrhea, rash, red eyes, external/internal bleeding, DIC, massive hemorrhages |
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Papillomavirus
1. what is it? 2. transmission 3. symptoms 4. complications 5. Dx 6. Immunity |
1. naked dsDNA
2. breaks in skin, sex, during birth 3. common warts, larngeal papilloma, anogenital warts (condylamata acuminate) 4. cervical cancer: HPV-16 and 17 assoc w/ oncogenes E-6 (inhib p53) and E-7 (inhib p105) 5. poikilocytic squamous epithelial cells (cyto vacuolization and nuclear enlargement) and colposcopy (acetic acid causes white cervix) 6. anti-L1 & L2 Abs |
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Polyomavirus
1. what is it? 2. JC virus 3. BK virus 4. Dx |
1. naked dsDNA
2. progressive multifocal leukoencephalopathy: speech, vision, coordination, mentation impairment followed by paralysis and death 3. ureteral stenosis (renal transplant pts) and hemorrhagic cystitis (bone marrow transplant pts) 4. immunoperoxidase; CSF is normal |
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HIV
1. what is it? 2. 3 structural genes 3. 5 methods of transmission |
1. retrovirus: ss+RNA (diploid)
2. Gag (encodes p55/p24), Pol (RT, protease, integrase, endonuclease), and Env (gp90>gp160> gp120 + gp41) 3. sex, connatal, breastfeeding, parenteral, blood tranfusion |
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HIV Testing
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1. EIA serum screening
2. if positive repeat 3. if positive again, do western blot 4. western blot negative (no bands) = indeterminant; retest in a couple of months 5. western blot positive (bands for gp41, gp120/160 OR either of these + p24 band) 6. alternative: RT-PCR |
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HIV treatment
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1. RT inhib (nucleoside analog): AZT
2. RT inhib (enzyme): Nevaripine 3. Protease Inhib: Saquinivir 4. Entry Inhib (bind gp120) |
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Dengue fever
1. what is it? 2. transmission 3. geography 4. symmptoms 5. complications 6. tx |
1. flavivirus: env ss+RNA (most important arbovirus in humans)
2. Aedes mosquito 3. hifh fever, frontal HA, joint/mm pain, rash 4. dengue hemorrhagic fever (DHF): severe hemorrhage and hypotension 5. acetaminophen (not NSAIDs) for fever, fluid replacement |
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Human T-cell leukemia virus (HTLV)
1. what is it? 2. how is it different 3. virulence factors 4. HTLV-1 5. HTLV-assoc myelopathy 6. tx |
1. Retrovirus
2. can autoregulate its replication 3. gag/pol/env, tax (transactivator of IL-2 receptor gene), rex (promotes gag/pol/env and transport to cyto) 4. T-cell malignancies (ATLL) 5. aka tropical spastic paraparesis (TSP): demyelinating, weakness of lower body mm 6. RT inhibitors |
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Ascaris lumbricoides
1. what is it? 2. what's it look like? 3. symptoms 4. complications 5. tx |
1. largest intestinal nematode
2. earthworm 3. respiratory and GI symptoms 4. obstruction of appediz or bile/pancreatic duct, intestinal blockage, malabsorption 5. albendazole, mebendazole |
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Hookworm
1. 2 species 2. life cycle 3. symptoms 4. complications 5. tx |
1. Necator amaericanus, Ancylostoma duodenal
2. eggs in feces, rhab > filiform larvae in soil > fil larvae penetrate skin, invade blood, rupture into alveoli > adults live in SI 3. rash (ground itch) b/n toew, resppiratory/GI symptoms 4. anemia and hypoalbumenia (due to blood loss) 5. albendazole, mebendazole |
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Strongyloides stercoralis
1. what is it? 2. lifecycles 3. what is unusual about it? 4. symptoms 5. complications 6. Dx 7. Tx |
1. smallest intestinal nematode
2. hookworm; autoinfection (rhab > filariform in bowel); free living (filariform, not just eggs can be ingested) 3. only nematode that can inc in # w/o leaving host 4. respiratory, NO GI unless heavy infection 5. ulceration, inflammation, and abscess w/ intestinal invasion, red lesions on back/butt 6. crawling on culture plates 7. ivermectin, albedazol |
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Pinworm (Enterobius vermicularis)
1. what is it? 2. where do larvae mature? 3. symptoms 4. Dx 5. Tx |
1. common helminth (often children)
2. cecum 3. anal itching (due to deposition of sticky eggs) 4. scotch tape test 5. albendazole, mebandazole |
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Whipworm (Trichuris trichiura)
1. what is it? 2. larve mature where? 3. symptoms 4. complications 5. Dx 6. Tx |
1. nematode w/ thin anterior 2/3
2. larvae mature in SI then migrate to cecum 3. GI symptoms, growth retardation, rectal prolapse 4. bactermia and/or anemia 5. eosinophilia in severe infections 6. albendazole, mebendazole |
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Taenia spp.
1. two species 2. transmission 3. symptoms 4. complications 5. Dx 6. Tx |
Tapeworm
1.T. saginata (beef/minor), T. solium (pork/severe) 2. eating inadequately cooked beef/pork with cysticerci larvae (eggs of T. solium are infectious too) 3. abdominal discomfort, hunger pains, weight loss, diarrhea 4. cysticerosis 5. calcified lesions of dead cysticerci or neurologica manifestations and SQ nodules (cystercosis) 6. praziquantel, albendazole, corticosteroids, surgeryTaenia |
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(Neuro-)Cysticerocosis
1. cause 2. symptoms 3. result of CNS lesions 4. most common cause of.. |
1. T. solium (pork tapeworm)
2. fever, muscle pain, HA, CSF eosinophilia 3. personality/intellectual changes, seizures, CSF obstruction 4. epilepsy in endemic areas |
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Hymenolepsis nana
1. aka 2. what's unusual about it? 3. where do larvae mature? 4. symptoms 5. Tx |
1. dwarf tapeworm
2. eggs are directly infective to humans w/o intermediate host 3. lumen of duodenum 4. severe diarrhea and abdominal pain 5. praziquantel |
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Diphylobothrium latum
1. what is it? 2. transmission 3. where do eggs embryonate? 4. what do eggs infect? 5. symptoms 6. complications 7. DX 8. Tx |
1. largest human tapeworm, broad or fish tapeworm (proglottids are wider than they are long)
2. eating improperly cooked fish 3. only in cool fresh water 4. copepods 5. abd discomfort, N/V, weight loss 6. bowel obstruction, pernicious megaloblastic anemia 7. operculated eggs in stool, eosinophilia, leukocytosis 8. praziquantel |
