Rmc Pa - Infectious Disease #2

Front 1

What is defined as an acute cough?

Back 1

One that exists for less than three weeks and is most commonly due to an acute respiratory tract infection.

Front 2

What is defined as subacute cough?

Back 2

Cough for three to eight weeks.

Front 3

What is defined as chronic cough?

Back 3

Cough more than eight weeks.

Front 4

What are some common causes of chronic cough?

Back 4

Post-nasal drip (Allergies, Chronic sinusitis), Asthma, Postinfectious, Chronic bronchitis, Gastroesophageal reflux, Heart failure, Medication-induced (especially ACE inh.), and Environmental irritants.

Front 5

What does PPD stand for? What is the PPD a test for?

Back 5

Purified Protein Derivitive. It is a TB antigen, if positive they have been exposed and will have a reaction. If neg. you're good.

Front 6

Inhalation and deposition in the lungs leads to what four possible outcomes?

Back 6

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)

Front 7

What is TB morphology?

Back 7

Small acid-fast bacilli.

Front 8

What is the lesion produced by the expansion of the tubercle into the lung parenchyma and lymph node involvement?

Back 8

Ghon complex.

Front 9

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?

Back 9

Tubercle.

Front 10

So what is a Mantoux skin test then?

Back 10

The Mantoux test is a method for administering PPD and involves injection of the substance intradermally.

Front 11

What exactly is used with the Tuberculin Skin Test?

Back 11

Purified Protein Derivative (PPD) is prepared by precipitation of protein components from culture filtrate of Mycobacterium Tuberculosis.

Front 12

What is the proper technique with Tuberculin Skin Testing?

Back 12

1. MUST be done intradermally
2. MUST form a visible wheal with injection

Front 13

What are some important points of reading a TB test appropriately?

Back 13

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!

Front 14

What are the two big risks for TB?

Back 14

1. Exposure
2. Immunosupression

Front 15

If a patient is being tested shortly after exposure to TB, when should you retest the PPD?

Back 15

Should be done in 6-12 weeks.

Front 16

What are the most common vectors for rickettsial diseases?

Back 16

Arthropods (Ticks, Lice, Fleas)

Front 17

What are the dermatologic signs associated with rickettsial diseases?

Back 17

Petechiae and purpura from vasculitis.

Front 18

How does one diagnose a Rickettsial disease?

Back 18

1) Patient History mainly
2) Physical Exam secondarily

Front 19

What is the drug of choice for Rickettsial and/or Lyme disease?

Back 19

Doxycycline

Front 20

ENDO-Parasites occur in what two distinct forms?

Back 20

1. Single-celled protozoa.
2. Multicellular called helminths or worms.

Front 21

T/F
A parasitic infection usually directly kills a host.

Back 21

False.

Front 22

What is the #2 killer of humans worldwide?

Back 22

Parasitic Diseases (Malaria, Sleeping sickness, Schistosomiasis, Amebiasis)

Front 23

What are the key components of current classification systems?

Back 23

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

Front 24

What are the two Herpes simplex viruses?

Back 24

1. Orolabial herpes (typically HSV-1)
2. Genital herpes (typically HSV-2)

Front 25

What is the Pathophysiology of the Herpes simplex?

Back 25

1. Virus infects through mucosal membranes or abraded skin
2. Latent infections harbored in neuronal cells (Trigeminal ganglia and Pre-sacral ganglia).

Front 26

Herpes simplex Clinical Presentations:

Back 26

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

Front 27

Two distinct clinical presentations of Varicella-Zoster virus infections?

Back 27

1. Primary infection: Chickenpox
2. Recurrent infections: Herpes zoster

Front 28

What is the only known reservoir of Varicella-Zoster virus?

Back 28

Homo Sapiens (humans).

Front 29

Primary infection in Varicella-Zoster virus is usually spread by what route?

Back 29

Respiratory route.

Front 30

T/F
Mechanism and/or stimulus for reactivation of latent infection of Varicella-Zoster virus is due to environmental stressors.

Back 30

False.
Mechanism or stimulus for reactivation of latent infection is unknown.

Front 31

What is the incubation period of the Varicella-Zoster virus?

Back 31

10-21 days.

Front 32

What should be on a differential diagnosis for exanthematous eruptions?

Back 32

-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

Front 33

What was the first anti-viral approved for CMV?

Back 33

Ganciclovir

Front 34

What virus is Foscarnet used to primarily treat?

Back 34

CMV (HSV & VZV)