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34 Cards in this Set

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What is defined as an acute cough?
One that exists for less than three weeks and is most commonly due to an acute respiratory tract infection.
What is defined as subacute cough?
Cough for three to eight weeks.
What is defined as chronic cough?
Cough more than eight weeks.
What are some common causes of chronic cough?
Post-nasal drip (Allergies, Chronic sinusitis), Asthma, Postinfectious, Chronic bronchitis, Gastroesophageal reflux, Heart failure, Medication-induced (especially ACE inh.), and Environmental irritants.
What does PPD stand for? What is the PPD a test for?
Purified Protein Derivitive. It is a TB antigen, if positive they have been exposed and will have a reaction. If neg. you're good.
Inhalation and deposition in the lungs leads to what four possible outcomes?
1. Immediate clearance of the organism
2. Chronic or latent infection
3. Rapidly progressive disease (or primary disease)
4. Active disease many years after the infection (reactivation disease)
What is TB morphology?
Small acid-fast bacilli.
What is the lesion produced by the expansion of the tubercle into the lung parenchyma and lymph node involvement?
Ghon complex.
What do we call the following?: Infected macrophages produce cytokines and chemokines that attract other phagocytic cells, including monocytes, other alveolar macrophages, and neutrophils, which eventually form a nodular granulomatous structure?
Tubercle.
So what is a Mantoux skin test then?
The Mantoux test is a method for administering PPD and involves injection of the substance intradermally.
What exactly is used with the Tuberculin Skin Test?
Purified Protein Derivative (PPD) is prepared by precipitation of protein components from culture filtrate of Mycobacterium Tuberculosis.
What is the proper technique with Tuberculin Skin Testing?
1. MUST be done intradermally
2. MUST form a visible wheal with injection
What are some important points of reading a TB test appropriately?
1. MUST be read at 48-72 hours (reaction is from delayed type hypersensitivity response mediated by T lymphocytes)
2. Test is read by the diameter of the induration, NOT the diameter of erythema!
What are the two big risks for TB?
1. Exposure
2. Immunosupression
If a patient is being tested shortly after exposure to TB, when should you retest the PPD?
Should be done in 6-12 weeks.
What are the most common vectors for rickettsial diseases?
Arthropods (Ticks, Lice, Fleas)
What are the dermatologic signs associated with rickettsial diseases?
Petechiae and purpura from vasculitis.
How does one diagnose a Rickettsial disease?
1) Patient History mainly
2) Physical Exam secondarily
What is the drug of choice for Rickettsial and/or Lyme disease?
Doxycycline
ENDO-Parasites occur in what two distinct forms?
1. Single-celled protozoa.
2. Multicellular called helminths or worms.
T/F
A parasitic infection usually directly kills a host.
False.
What is the #2 killer of humans worldwide?
Parasitic Diseases (Malaria, Sleeping sickness, Schistosomiasis, Amebiasis)
What are the key components of current classification systems?
1. Type of symmetry of the virus capsid (helical versus icosahedral)
2. Presence or absence of a lipid envelope
3. Type and structure of the viral nucleic acid and the strategy used in its replication
What are the two Herpes simplex viruses?
1. Orolabial herpes (typically HSV-1)
2. Genital herpes (typically HSV-2)
What is the Pathophysiology of the Herpes simplex?
1. Virus infects through mucosal membranes or abraded skin
2. Latent infections harbored in neuronal cells (Trigeminal ganglia and Pre-sacral ganglia).
Herpes simplex Clinical Presentations:
1. Oral-facial lesions
a) Primary infections: Gingivostomatitis and pharyngitis
b) Recurrence: Herpes labialis
2. Urogenital lesions
a) Systemic: Headache, fever, malaise, and myalgia
b) Local: Vesicular lesions of external genitalia with pain, itching, dysuria, vagina and urethral discharge, tender inguinal lymph adenopathy
Two distinct clinical presentations of Varicella-Zoster virus infections?
1. Primary infection: Chickenpox
2. Recurrent infections: Herpes zoster
What is the only known reservoir of Varicella-Zoster virus?
Homo Sapiens (humans).
Primary infection in Varicella-Zoster virus is usually spread by what route?
Respiratory route.
T/F
Mechanism and/or stimulus for reactivation of latent infection of Varicella-Zoster virus is due to environmental stressors.
False.
Mechanism or stimulus for reactivation of latent infection is unknown.
What is the incubation period of the Varicella-Zoster virus?
10-21 days.
What should be on a differential diagnosis for exanthematous eruptions?
-Chickenpox/Herpes zoster
-Infectious mononucleosis
-Roseola infantum (Sixth Disease or -Erythema subitum)
-Fifth disease (Erythema infectiosum)
-Measles
-Rubella
-Enteroviral exanthems (Coxsackievirus, Echovirus)
-Rickettsial infections
-Mycoplasma pneumoniae
-Syphilis
-Typhoid fever
-Bacterial toxins
-Drug eruptions
-Live-virus vaccinations
What was the first anti-viral approved for CMV?
Ganciclovir
What virus is Foscarnet used to primarily treat?
CMV (HSV & VZV)