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199 Cards in this Set
- Front
- Back
Endotoxin causes septic shock by causing the release of___
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TNF, IL 1, IL 2
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3 examples of Host response to infection causing the injuriuos effects.
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HBV damaging liver cells, TB causes tissue damage when TB is attempted to be sequesterd, Post-strep glomerulonephirits from immune complex deposition
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Measles aka
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Rubeola
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What class of virus is measles
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RNA paramyxovirus
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Extremem complications of measles?
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Subacute slerosing panencephalitis, inclusion body encephalitis.
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Oral lesions of measles called...
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Koplik spots
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Pathognomonic cells of measles?
Where do you find them? |
Warthink-Finkeldey cells--Multinucleated giant cells with eosinophilic nuclear inclusion bodies.
In thelymphoid organs, lungs and sputum. |
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How does measles affect the lymphoid organs?
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Follicular hyperlasia, large germinal centers, Warthin-Finkeldey cells
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Mumps is a ___ virus.
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Paramyxovirus RNA
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Mumps most often causes enlarged ___
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Parotid glands
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Mumps can infect what organs?
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Parotids, Testes, pancreas, CNS
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Tissue infected with mumps microscopically would show _________
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Intersititial edema, diffuse macrophages, lymphocytes and plasmam cell infiltrates.
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Polio virus is in what family of viruses?
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unencapsulated RNA enterovirus. Other enterods coxsackievirus, echovirus, hep A.
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What part of nervous system can polio invade?
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Motor neurons or brain stem (leads to bulbar poliomyelitis--->resp paralysis)
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WNV is what class of virus?
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Arbovirus (arthopod-borne) of the flavivirus (includes dengue and yellow fevers, eastern encephalitis).
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Symptoms of WNV?
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Acute falccid paralysis due to meningitis, encephalitis, meningoencephalitis). Indistinguishable fomr polio. Rarely hepatitis, myocarditis, pancreatitis.
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Who's at greatest risk for WNV?
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Elderly and immunosuppressed.
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Viruses that cause Viral Hemorrhagic fever?
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BAFF - Bunyaviruses, Areanaviruses, Filoviruses, flaviviruses
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Most viral hemorrhagic fevers infect _________. What causes the hemorrhaging?
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Endothelial cells. Bleeding causes by endothelial dysfunction, platelet dysfunction or thrombocytopenia.
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Herpes viruses are what type?
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DS DNA
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HSV-1 leads to _________.
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Cold sores, gingivostomatitis, corneal blindness
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HSV-2 leads ______.
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Genital warts
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Leading causes of corneal blindness?
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HSV-1 infections
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Worst cases scenario in HSV infections
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Disseminated viseral infections and encephalitis.
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Life cycle of HSV?
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Replicates in infected skin or membrane, resides latently in neurons, spreads from ganglia back to skin or MM.
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Microscopic appearance of HSV infection?
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Cowdry-type A inclusions--Virion inclusions cause chromatin to be compressed against nuclear membrane. Tzanck prep shows multinucleated syncytia.
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In most cases, CMV is ______.
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Asymptomatic nearly always except in neonatesa nd immunosuprressed.
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Most common pathogen infected AIDS victims?
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CMV - life threatening
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Histologic appearance of CMV infection?
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Cellular enlargement, purple intranuclear inclusions with clear halo, small basophilic cytoplasmic inclusions
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Where does VZV lay dormant?
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In sensory dorsal root ganglia.
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Histologic appearance of VZV?
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Vesicles contain epithelial cell intranuclear inclusions. Blisters appear identical to HSV (Intranuclear inclusions compressing chromatin against nuclear membrane).
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Why is Hep B so hard to remove from the body?
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High mutation due to it's DNA denome being transcribed by an RNA template (no proofreading)
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How does Hep B damage liver cells?
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HBV infects hepatocytes but the immune reponses causes the damgage.
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What determines if a person is a Hep B carrier or not?
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cytotoxic T cell response can clear it.
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Hep B puts one at risk for _______
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Hepatocellular carcinoma, cirrhosis and esp. chronic hepatitis.
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3 viruses implicated in causing human cancer?
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EBV, HPV, HTLV-1
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EBV infection symptoms?
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fever, sore throat, generalized lymphadenopathy, splenomegaly, very high WBC count.
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Life cycle of HBV?
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Infects nasopharyngeal or ooparyngeal epitheliaium, progressing to B cells--the reservior. T cells proliferate kill the infected B cells.
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HBV infections demonstrate what special cells in lymph nodes?
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Reed-Sternberg-like cells (large binucleate cells).
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EBV + immunocompromised can lead to _______.
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B-cell lymphoma.
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EBV can lead to what 2 types of cancer?
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B-cell lymphoma and Burkitt's lymphoma.
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Mutation in EBV associated Burkitt's lymphoma?
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8:14 translocation on the c-myc oncogene into the Ig heavy chain region.
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HPV causes what process in ipithelial cells?
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Koilocytosis--vacuolizatoin of epithelial cells.
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How does HPV promote unwanted cell growth?
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E6 and E7 dysregulate the cell cycle.
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Staph aureus virulence factors?
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Surface proteins (adherance), enzymes that degrade host proteins, hemolysins (kill cell membranes), exfoliateive toxins, enterotoxins, superantigens.
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characteristic Staph aureus inflammation?
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Pyogenic local destructive inflammation.
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Staph that infects catheterized, prosthetic heart valve, or IV drug users?
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Staph epidermidis
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Staph that causes UTI?
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Staph saprophyticus.
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All the things strep A (pyogenes) can cause?
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Pharyngitis, scarlet fever, erysipelas, impetigo, rheumatic fever, TSS, necrotizing fascitis, glomerulonephritis.
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95% of people infected with CMV are ________.
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Asymptomatic
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CMV infections in infants produces what disease? CMV in immunocompromised produces what disease?
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Cytomegalic inclusion disease. Disseminated CMV (life threatening)
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Features of Cytomegalic inclusion disease (in infants)?
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Hemolytic anemia, jaundice, hepatosplenomegaly, pneumonitis, deafness, chorioretinitis, brain damaged, Thrombocytopenia.
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Features of disseminated CMV infection?
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Life threatening. Lung, GI, retina primarily involved. focal necrosis and little inflammation.
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Histologic CMV?
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Cellular enlargemnt, large purple intranuclear inclusions surrounded by clear halo with small basophilic cytoplasmic inclusions.
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How is VZV transmitted and how does it spread?
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Aerosols; hematogenously to trunk then head and extremities.
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Histology of vesicles and blisters of VZV?
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Vesicles have epithelial cell intranuclear inclusions; blisters are identical to HSV.
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Where does Herpes zoster (shingles) come from?
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VZV latent in DRG infecting sensory nerves.
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HBV is what kind of virus? Causes chronic or acute hepatitis?
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DNA of hepadnavirus family. Causes both acute and chronic
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How is HBV transmitted?
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Percutaneously, perinatally and sexually.
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Why does HBV stay in the blood for so long?
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Lots of mutations due to it being synthesized by reverse transcription of RNA template (no proof reading).
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How does HBV damage the liver?
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Immune response kills liver, the virus does not.
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What determines if a person is a carrier of HBV or not?
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cytotoxic T-cell immune response.
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Histology of chronic HBV infection?
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Lymphocytic infalmmatino, hepatocytic apoptosis; can lead to cirrhosis and increased risk for hepatocellular carcinoma.
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Three viruses that cause cancer?
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EBV, HPV, HTLV-1
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Infectious mononucleosis symptoms.
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fever, sore throat, generalized lymphadenopathy, hepatosplenomegaly, and VERY high WBC count.
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Progression of EBV virus infection?
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Begins in naso/oropharygeal epithelial cells, infects B cells (the reserivoir), T-cells kill the infected B cells.
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Histology of lymph nodes in EBV infection?
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Increased T cells and Reed-Sternburg-like cells (large binucleate cells).
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EBV can lead to what cancers?
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B-cell lymphoma (in immunocompromised), Burkitt's lymphoma (8:14 translocation on c-myc of heavy chain)
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Histology of HPV?
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Koilocytosis- Perinuclear vacuolization of epithelial cells.
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Mechanisms of HPV's promotion of cell growth?
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E6 and E7 dysregulate the cell cycle.
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Staph aureus virulence factors?
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Adhesion proteins, enzymes that degrade host proteins; toxins: hemolysisns (damage membranes), exfoliative toxins, enterotoxins, superantigens.
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Which staph attacks those with prostetic heart valves and IV drug users?
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Staph epidermidis.
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Which staph frequently causes UTIs?
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Staph saprophyticus
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Two beta hemolytic streps?
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Pyogenes (A), agalactiae (B)
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Strep pyogenes can cause...
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pharyngitis, scarlet fever, erysipelas, impetigo, rheumatic fever, TSS, necrotizing fascitis, glomerulonephritis.
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Strep agalactiae colonizes where?
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The vag.
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Strep agalactiae can cause ____
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Chorioamnionitis in pregnancy and neonatal sepis and meningitis in neonates.
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Alpha hemolytic strep includes...
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Strep pneumoniae, Viridians (including s. mutans).
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Strep. pneumoniae can cause...
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Adult community-acquired pneumonia and meningitis.
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Strep viridians can cause...
where do you find strep viridians? |
Dental caries (S. mutans) and endocarditis.
Normal flora of the mouth. |
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enterocci can cause...
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endocarditis and UTIs.
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Strep virulence factors?
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Capsule (group A), M-proteins inhibit the alternate pathway of completment activation (S. pyogenes), pneumolysis destroy membrane and damage tissue (S. pneumonia)
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Lifecycle of C. diphtheriae? What organs does it affect?
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Colonizes oropharynx and fires off exotoxins to damage the heart, nerves and other organs.
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Virulence factors of C. diphtheriae and what they do?
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B fragment facilitates entry of A subunit. A subunit blocks protein synthesis via ADP ribosylation.
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Listeria Monocytogenes is gram pos or neg?
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Pos.
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Who does Listeria infect?
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Elderly , immunosuppressed, pregnant women and their fetus.
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What causes granulomatosis infantiseptica?
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Listeria Monocytogenes infecting a fetus.
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What does listeria cause?
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Meningitis and sepis in elderly, immunocompromised and pregnant ladies.
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How does listeria infect cells?
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Binds E-cadherin to stimulate phagocytosis, then uses listeriolysin O and phospholipases to excape phagosome and cytoplasm. Then ActA propels the bacteria into adjacent cells.
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three classes of B. anthracis infection.
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cutaneous, Inhalational, Gastrointestinal.
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Signs of cutaneous antrhax infection.
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Painless, pruritic papules leading to vesicles and then to black eschar.
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Signs of resp. antrhax infection.
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Rapid sepsis, shock, death.
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Signs of GI antrhax infection.
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Severe blood diarrhea and often death.
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Anthrax toxins and how they induce damage.
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Edema factor - converts ATP to cAMP leading to cellular water efflux.
Lethal factor- protease that estroyes MAP kinase kinase, killing cells |
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Histology of anthrax-infected cells?
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Necrois, neurto and macrophages, and large rectangular extracellular bacteria chains.
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Nocardia is what kind of bacteria?
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Aerobic Gram-positive in branches. (also stains with modified acid fast stains-Fite-Faraco stain)
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Nocardia asteroides causes what?
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Opportunistic indolent resp infections, often with CNS infection.
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Histology of Nocardia asteroides infected cells.
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Granulation tissue and fibrosis. branching and can be stain with modified acid-fast (Fite-Faraco stain).
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Neisseria are what kind of bacteria?
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Aerobic, gram neg, dipococci
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N. Meningitidis affects which age group?
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5-19 year olds, esp in those w/ terminal complement deficiencies.
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N. Gonorrhoeae symptoms in males, females, and neonates?
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Males- Urethritis
Females- usu. asymptomatic; can lead to PID, infertility and ectopic pregnancy. Neonates- Blindness and rare sepsis. |
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How do Neisseria evade immune responses?
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Expression of alternative genes for adhesive pili and OPA proteins.
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Symptoms of Bordetella pertussis?
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Paroxysm coughs, laryngotracheobronchitis, mucosal erosions, mucopurulent exudate, lymphocytosis.
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Pseudomonas aeruginosa usually affects what 3 groups of people?
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CF, burn victims, neutropenia.
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In CF patients, how does pseudomonas aeruginosa evade immune responses?
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It secretes exopolysaccharide (alginate) forming a protective biofilm.
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What can Pseudomonas aeruginosa do to neutropenics?
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Tissue necrosis via vascular invasion and thrombosis.
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What causes plague?
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Yersinia pestis.
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what causes iletis and mesenteric lymphadenitis?
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Yersinia enterocolitica and yersinia pseudotuberculosis.
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symptoms of the plague?
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Lymph node enlargement (buboes), pneumonia, sepsis, tissue necrosis, neutrophilic infiltrate.
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What causes chancroid (soft chancre)? Symptoms?
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Hemophilus ducreyi. Ulcerative genital infection.
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How do you get Granuloma inguinale?
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STD caused by calymmatobacterium donovani.
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How does granuloma inguinale progress?
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Starts as a papule on genitalia (or mouth/pharynx) then ulcerates and granulates into SOFT PAINLESS mass. Can cause urethral, vulvar or anal strictures.
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Histology of Granuloma inguinale?
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Pithelial hyperplasia at ulcer borders with neutrophils.
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What cells do M. tuberculosis infect?
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Macrophages that should be kill by T-cells 2-4 weeks later.
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First exposure to TB causes what?
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95% asymptomatic, 5% have lobara consolidation, hilar adenopathy and pleural effusion; rarely spreads via lymph-->miliary.
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Symptoms of secondary TB (after latent TB is reactivated)?
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Cavitation in apex of upper luns, low fever, night sweats, weight loss.
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Appearance of primary and secondary TB?
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Primary- Lung and LN granulomas called Ghon complexes.
Secondary-Circumscribed focus of caseation can heal with fibrosis. |
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What population and where in the body do you find Mycobacterium avium-intracellulare complex?
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Immunocompromised folks; widley disseminated throughout the body.
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What organism causes leprosy?
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Mycobacterium leprae.
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How does leprosy spread throughout the body?
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Spreads via the blood after being phaged by monocytes or alveolar macrophages.
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Two types of leprosy and symptoms?
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Tuberculoid- insidious dry scaly skin lesions w/o sensation, peripheral nerve involvemnet.
Lepromatous- Disfiguring,Perineural macrophage and Schwann cell invasion. |
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What determines if a leprosy infection will be tuberculoid or lepromatous?
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Tuberculoid- T-helper 1 response (TNF-gamma)
Lepromatous- ineffective T-helper 2 response. |
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Name the spirochetes.
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Syphilis (treponema pallidum), Borrelia recurrentis (relapsing fever), Lyme (Borrelia burgdorferi)
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Primary syphilis symptoms.
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3 weeks after sexual contact, firm painless raised lesion (CHANCRE) at infection site. Self-healing. Lesion demonstrates endarteritis.
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who gets secondary syphilis?
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75% of those who don't treat their primary syph.
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secondary syphilis symptoms?
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Mucocutaneous lesions, lymphadenopathy, fever, malaise, weight loss.
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Who gets tertiary syphilis?
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1/3 of untreated infected pts. >5 years later.
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Tertiary syphilis symptoms?
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CV syphilis- aortitis (endarteritis of vasa vasorum), aortic root dilation, aneurysm, and aortic valve insufficiency.
Neurosyphilis- meningovascular disease, tabes dorsalis, brain parenchymal disease, or protein, WBCs, low glucose in CSF. |
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When do you see gummas?
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In benign tertiary syphilis.
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congenital syphilis symptoms?
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Death 25%, nasal discharge, skin sloughing, hepatomegaly, skeletal abnorms. Later- notched incisors, deafness, blindness (Hutchinsons triad).
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How is replapsing fever transmitted?
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Louse transmit Borrelia recurrentis (epidemic). Ticks transmit other types of borrelia (endemic).
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What causes the relapses in replapsing fever?
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Variation of the surface proteins of Borrelia
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Symptoms of relapsing fever/
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Chills, fever, HA, DIC, multiorgan failure.
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Lyme dz cause by and transmitted by...
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Borrelia Burgdorferi from ixodes ticks
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Progression of Lyme dz symptoms.
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1. erythema chronicum migrans (bulls eye), fever, Lymphadenopathy.
2. Hematogenous spread; skin lesions, LNopathy, joint and muscle pain, arrhythmias, meningitis. 3. Years later; encephalitis, destructive arthritis. |
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What does the oral anaerobe Fusobacterium necrophorum cause?
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Lemierre syndrome.
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What's Lemierre syndrome?
|
Infection of lateral pharyngeal space with septic jugular vein thrombosis. Caused by Fusobacterium necrophorum.
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What anaerobe causes Bartholin's cysts abscess and tubo-ovarian abscesses?
|
Prevotella species often mixed with E. coli and S. agalactiae.
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What ususallly causes head and neck abscesses?
|
Oral flora--Prevotella, Porphyromonas, mixed with Staph and Strep.
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What usually causes abdominal abscesses?
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Bacteroides fragilis, Peptostreptococcus, Clostridium, E. coli
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Clostridium perfringens and C. Septicum cause...
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Cellulitis, muscle necrosis in wounds (GAS GANGRENE), food poisoning, small bowel infection.
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Histology of gas gangrene?
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Infarct w/o inflammatory cells.
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How does Clostridium tetani cause tetany?
|
Tetanospasmin block GABA, an inhibitory neurotranmitter.
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How does Clostridium botulinum causes flaccid paralysis?
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Binds to motor neuron gangliosides, and cleaves synaptobrevin, blocking Ach release.
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What bacteria causes pseudomembranous colitis in antiboiotic-treated pts.?
|
Clostridium difficle's cytopathic effects.
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What causes trachoma? What does it cause?
|
Chlamydia trachomatis (serotypes A, B, C).
An ocular infection in children. |
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Life cycle of Clamydia trachomatis?
|
Elementary body (EB) is the infective particle that transforms into the reticulate body (RB) inside endosomes.
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Where does C. trachomatis reside in the body.
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In endosommes (an obligate intracellular bacteria).
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Symptoms of Chlamydia?
|
Frequently asymptomatic; epididymitis, prostatitis, PID, pharyngitis, conjunctivitis, perihepatic inflammation, proctitis.
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What causes lymphogranuloma venereum?
|
Chlamydia trachamatis.
|
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Symptoms of lymphogranuloma venereum?
|
Genital lesions with granulomatous and neutrophils. Caused by C. trachomatis.
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Three disease Richettsiae cause
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Typhus, spotted fever, ehrlichiosis.
|
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What causes epidemic typus?
|
Rickettsia prowazekii
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Typhus symptoms.
|
Rash w/ small ehmorrhages to skin ncecrosis and gangrene and internal organ hemorrhages.
CNS typhus- nodules w/ microglial proliferation |
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Where do Typhus and spotted fever organisms proliferate?
|
Endothelial cells causesing vessel necroisis.
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Ehrlichiosis results from _____ infecting _____.
|
Anaplasma phagocytophila or Ehrlichia ewingii infecting neutrophils, or
Ehrlichia chaffeensis infecting macrophages. |
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Symptoms of Ehrlichiosis
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Fever, HA, malaise, resp insufficiency, renal failure, shock.
|
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Candida is normally found...
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On skin, mouth, GI.
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Candida can cause _______ in people with normal immunity.
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Vaginitis (esp. in preganancy), diaper rash, oral thrush.
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Candida can cause _____ in immunodeficient.
|
Mucocutaneous candidiasis (in people with hypoparathyroidism, hypoadrenalism, hypothyroidism.
neutropenic pts.- Invasive candidiasis spread hematogenously causing microabscesses. |
|
What does Cryptococcus neoformans do to healthy people and the immunosuppressed?
|
Healthy - Solitary pulmonary granuloma
Immunosuppresed- Small cysts in gray matter of brain, meningoencephalitis in immunosuppresed and pts. w/ lupus, sarcoidosis. |
|
Who are the infectious molds?
|
Aspergillosis, Zygomycosis (mucomycosis).
|
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Aspergillus + peanuts = ?
|
Can create AFLATOXIN leading to liver cancer.
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Pulmonary lesions leftover from TB, bronchiectasis, infarcts, abscesses can be colonized by...
|
Aspergillus fumigatus, creating aspergillomas
|
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What does aspergillus do to immunosuppresed?
|
Necrotizing pneumonia (target lesions), thrombosis; can lead to hemmorrhage and infarction on necrotizing inflammation.
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Aspergillus + neutropenia =
|
sinusitis, pneumonia, Disseminated aspergillus.
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Asperguillus in previously healthy people leads to...
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An allergic mold.
|
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Zygomycosis affects what kind of patients?
|
Neutropenic, and ketoacidotic diabetics.
|
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What causes zyomycosis?
|
Zygomycetes (Mucor, Absidia, Rhizopus, Cunninghamella). Along with neutropenia, ketoacidosis.
|
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What do zygomycetes do?
|
Can spread from nasal sinues to orbit or brain; can invade arterial walls causing nerosis.
|
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What organism causes malaria?
|
Anopheles misquitos transmit: Plasmodium falciparum causes the most severe, vivax, ovale, and malariae cause less servere types.
|
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How does P. falciparum cause tissue ischemia?
|
Infected RBCs adhere to endothelium, creating vascular occlusion.
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What organs are especially involved in malaria?
|
Splenic occlussion and hepatic enlargement (with Kupffer cells), vascular occlusion leads to hemorrhage and ischemia of the brain.
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|
Three condition that protect against malaria?
|
HbS, Hemoglobin C traits limit malaria proliferation. Some blacks lack the required duffy RBC antigen.
|
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How do you get babesiosis?
|
Ixodes ticks trasmit Babesia microti.
|
|
Babesiosis symptoms?
|
Fever, hemolytic anemia, esp. in debilitated and splenectomized.
|
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What does Babesia microti infect?
|
RBCs (thus the hemolytic anemia), creating the tetrads in RBCs.
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Sandflies transmit..
|
Leishmania species
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|
Leishmaniasis symptoms?
|
Can be cutaneous or mucocutaneous; mild rashes to disfiguring lesions.
|
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Where do leishmanias live in the body?
|
in acidic pagolysosomes
|
|
Tsetse flies transmit..
|
African Trypanosomiasis.
|
|
Symptoms of Trypanosomiasis?
|
Chancres at bite site, fevers, LNopathy, splenomegaly, brain dysfxn (sleeping sickness), cachexia, death.
|
|
Where do Trypanosomas brucei proliferate?
|
In the blood (and in macrophages).
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Chagas causative agent?
|
Trypanosoma Cruzi from triatomids ("kissing bugs").
|
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What activates T. Cruzi?
|
acidic phagolysosomes
|
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Symptoms of Chagas dz?
|
Years after fever, 20% develop cardiomyopathy, arrhythmias, myenteric plexus damage leading to colon and esophageal dilation.
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Who are the Metazoa?
|
Strongyloidiasis, tapeworms, trichinosis, schisto, filariasis, Onchocerciasis.
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Life cycle of the strongyloidiasis.
|
Pentrate the skin, travel in the blood to lungs, ascend trachea, get swallowed, colonize GI, create eggs.
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symptoms of strongyloidiasis.
|
GI symptoms (they invade intestinal mucosa), immunocompromised get disseminated strongyloides.
|
|
Taenia solium (tape worms) symptoms (pork or human).
T. saginata (beef) or Diphyllobothrium latum (fish)? |
Can penetrate the gut wall and disseminate to encyst in brain and other organs.
Stay in GI. |
|
what causes Hydatid disease?
|
Ingestion of echinoccal eggs (Echinococcus granulosus)from dog or fox feces, eggs hatch in duodenum and invade the liver, lungs, and bones forming cysts.
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How do you get trichinosis?
|
Pig and bear meat.
|
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symptoms of trichinosis infection?
|
Adults spread to muscle causing fever, myalgias, eosinophilia, periorbital edema. Increased gut motility.
|
|
Histology of trichinosis?
|
Membrane-bound vacuoles in myocytes surrounded by eosinophils.
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How is Schistosomiasis transmitted? Life cycle?
|
Freshwater snails; penetrate skin and settle in pelvis or portal venous systems, releasing eggs in stool and urine.
|
|
Histology of Schistosomiasis?
|
Eosinophil-rich granulomas and fibrosis in liver.
|
|
Causes of Lymphatic filariasis?
How is it contracted? |
Wucheria bancrofti (90%), Brugia malayi.
Mosquitoes. |
|
Black flies transmit...
|
Onchocerciasis.
|
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Symptoms of Onchocerciasis. Lifecyle?
|
Pruritic dermatitis and blindness. Nematodes mate in the dermis producing a nodule (onchocercoma). Eggs accumulate in the skin and eyes. (black fly)
|