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71 Cards in this Set
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What is the *typical clinical syndrome associated with parainfluenza. Treatment?
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Adults: URTI, children LRTI (laryngotracheobronchitis)
Croup (barking cough due to swelling of URTI) Treat with corticosteroids to reduce the swelling of the larynx, supportive |
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How do you treat RSV
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Prophylaxis for premies
Gamma globulin Ribavirin |
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What are the most common causes of pneumonia in kids?
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RSV and parainfluenza
Infect virtually everyone before age of 3 Outbreaks ever winter (kids, preschools) |
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Clinical syndromes of mumps
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Parotid gland swelling
Testicular inflammation Aseptic meningitis and encephalitis (lymph spread not blood spread) |
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Clinical syndromes of measles
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Rash head to toe, starting after 3 days of fever
Blue koplok’s spots in mouth Subacute sclerosing panencephalitis |
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What is the typical surface protein of paramyxoviridae, what does it do
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F protein- fusion of cells →syncitia
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What is the difference between indirect ELISA and sandwich ELISA
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Indirect ELISA cultures for patient antibodies (indirect because you aren’t looking for antigen directly, you’re looking for host response)
Sandwich ELISA looks for antigen in patient |
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What is serology testing?
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Looking for antibodies in patient blood
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What are complications of influenza
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Reyes syndrome in children from Aspirin
Bacterial pneumonia |
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How does rubella evade the immune system
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viral endosome fusion protein prevents fusion of endosome with lysosome
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Describe the rash associated with rubella
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head to toe
maculopapular 3 days |
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What conditions are associated wtih congenital rubella syndrome
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patent ductus arteriosus, deafness, cataracts, glaucoma
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What are some extrahepatic manifestations of Hep C
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cryoglobulinemia, glomerularnephritis, lymphoma
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What organisms cross the placenta
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TOxo
Rubella CMV HErpes, HIV Syphillis |
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Describe transmission of Coxsackie
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survives acidic environments: pools
stool, summer and early fall |
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Differentiate between salk and sabin polio vaccines
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Salk - inactivated, IMJ (no local immunity, no reversion)
Sabin, live oral (local immunity, but chance for reversion) |
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How is polio spread
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aerosol and fecal/oral
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how can neurotropic viruses cross into the brain
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up nerves from skin
through blood brain barrier lymphocytes that traffic to brain |
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What happens to B cells in HIV
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Total antibody levels increase
-B cell hyperplasia -lymph adenopathy -polyclonal activation -increased secretion of antibodies -overactive Reduced response to immunizations -response to new antigens is defective -suboptimal response to immunization |
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How does HIV affect monocytes
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-monocyte serves as resevoir, not destroyed
-can cross BBB and carry HIV to CNS |
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what is the testing protocol for HIV/AIDS
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1. ELISA (high sensivitiy, low specificity)
2. second ELISA 3. Western Blot (use blot paper with antigens and add patients blood + labelled antibodies) |
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What is the best predictor for HIV progression
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% CD4 cells in total lymphocytes
<30% is bad >30% is good |
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What can HIV RNA PCR tell you. What do the results help you determine?
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number of virus copies
severity of infection, relevant medications, response to ARVs |
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What are infections associated with CD4 count <200
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thrush
PCP PML |
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What infections are associated with CDR count <100
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Toxoplasmosis (neurocystercercosis)
CMV retinitis Cryptococcal meningitis |
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What infections are associated with CD4 count <50
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MAC
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What infections are associated with any CD4 count
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Tb
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What are the 4 types of ARVs
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NRTIs (need to be activated)
NNRTI (allosteric binding) Protease inhibitors PI boosters (inhibit CYP 450 enzyme to reduce destruction of PI) |
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What lab tests should you do to determine if you need to give prophylaxis to HIV Patients
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Tb skin test (previous infection)
CD4 count antibodies to toxo (previous infection) antibodies to HbS (previous vaccination or infection) |
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Progression of rash in Chicken Pox
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trunk outwards, centrifugal
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Complications of chicken pox
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reyes syndrome (like in flu)
adults: encephalitis, pneumonia |
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Treatment and prevention for VZV
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prophylaxis VZIG for immunocompromised
treat with acyclovir |
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How can you differentiate between HSV and VZV virus particles
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both look the same on EM
use ELISA/direct immunofluor *makes sense, different antibodies against each of them having one is not protective for the other |
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how can you diagnose HSV encephalitis
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PCR CSF
protein in CSF -->antibodies in CSF CT MRI |
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Where do HSV, VZV, EBV and CMV have their latency
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HSV, VZV in neurons
EBV in B cells CMV in lymphocytes |
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Clinical syndrome, complications and virulence of EBV
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infects B cells in lymph nodes. Causes rapid B cell proliferation -->lymph node enlargement, increased oncogenesis
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what HPV serotypes are responsible for genital warts
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6,11,16,18
Cervical cancer 16,18 |
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What viruses respond to NRTIs
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HIV and Hep B (Hep B has a DNA/RNA intermediate, uses reverse transcriptase, responds to NRTI)
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What clinical syndroms are associated with Adenovirus
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URTI and GI tract (diarrhea)
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What is acyclovir
how is it used what viruses does it work against what viruses does it NOT work against when is it given |
guanosine analogue, needs to be activated by herpes thymidine kinase (therefore only works on herpes viruses)
works against HSV, VZV does NOT work against CMV, EBV given to immunocompetents for severe infections immunocompromised for most infections |
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Amantadine
what it does what it works on |
inhibits uncoating (entry)
only influenza A |
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Oseltamivir
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inhibits release
influenza A and B |
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Macule
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non palpable
change in surface color ill defined, <1cm |
MMR
CMV, EBV Dengue |
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Patch
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large macule
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Papule
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solid elevation
no fluid |
HPV
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Plaque
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broad papule
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nodule
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papule, but deeper
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vesicle
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fluid elevation
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HSV, VZV
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Pustule
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vesicle with purulent material
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bacterial
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petechial
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small hemorrage beneath epidermis
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What is standard therapy for neunatal transmission of HIV prevention
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Triple therapy
AZT, 3TC, protease inhibitor |
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Does Herpes only effect human cells?
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no it also affects animal cells, cultured in eggs
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What CD4 count do you expect to get
PCP MAC |
PCP <200
MAC <50 |
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Does treating HIV early preserve future treatment options?
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No, not correlated
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how does HIV cross the CNS
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through living in monocytes, infected by not destroyed
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what are koplok's spots inidicative of
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measles
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when is measles most infectious?
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4 days prior to the rash
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what virus causes croup?
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parainfluenza
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Describe the rash progression of rubella
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face-trunk-extremities
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describe congenital rubella syndrome
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patent ductus arteriosus
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describe rash for measles
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head to toe
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describe where HSV VZV EBV and CMV reside latently
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HSV and VZV in neurons
EBV in B cells CMV in lymphocytes |
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lamivudine works on which 2 viruses and why
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reverse transcriptase
Hep B and HIV Hep B has an RNA/DNA intermediate |
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What does Adeno cause
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diarrhea
URTI |
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what type of rash do you get with measles
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blanchable
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what does a persistent latent infection mean
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low replication, not totally dormant
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DIC
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meningitis
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maculopapular rash
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measles rubella
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macule
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MMR
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vesicle
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HSV, VZV
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pustule
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bacteria
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