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33 Cards in this Set
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- Back
- 3rd side (hint)
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What type of virus is each hepatitis?
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Hep A - picornavirus (SS+ RNA)
Hep B - hepadna (dsDNA) Hep C - flavi (RNA) Hep D - delta agent (defective) Hep E - hepevirus (RNA) |
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Which hepatitises can lead to HCC? Which are fecal-oral? Which is worst for pregnant women?
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HBV and HCV --> HCC, chronic active state and cirrhosis
HAV and HEV are fecal oral (at the ends) HEV has high mortality for pregnant women. |
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What is the best measure for detecting active HAV infection?
What other reactive serologies are seen in HAV? |
IgM HAV Ab is best test to detect active HAV infection
IgG HAV Ab indicates prior infection and protection from reinfection |
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What indicates chronic HBV disease?
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IgG HBcAb indicates chronic disease
IgM HBcAb indicates recent disease |
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What indicates high and low transmissibility of HBV?
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HBeAg = high transmissibility
HBeAb = low transmissibility |
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How do the serologies look in someone vaccinated against HBV?
Who had HBV and recovered? |
HBV vaccine --> HBsAb
Complete recovery --> HBsAb and HBcAb |
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How will someone with acute HBV disease appear?
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Acute HBV: HBsAg and HBcAb (IgM)
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What is the window period of HBV?
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Window period is early convalescence. Only HBcAb will be present in serum.
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HIV particles:
p24 gp160 pol p17 |
HIV:
p24 = gag, capsid protein gp160 = env (gp 120 and gp41) pol = reverse transcriptase p17 = matrix protein |
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What does HIV bind to?
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HIV
- binds CXCR4 on CD4 T cells - binds CCR5 on CD4 macros - Mutation of CCR5 on macros lends immunity |
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How is HIV diagnosed? Monitored?
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HIV Dx:
Presumptive: ELISA (rule out via high sensitivity) Confirmation: Western blot (protein) Monitoring: HIV PCR/viral load |
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When is AIDS diagnosed?
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AIDS = CD4+ count below 200 or AIDS indicative condition (e.g. PCP) or CD4 : CD8 < 1.5
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What do ELISA and Western blots look for in HIV Dx? When are there errors?
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ELISA and Western blot - look for antibodies to viral proteins and can be falsely negative in first 1-2 mo of infection or falsely positive in neonates via infected mothers bc anti-gp120 crosses placenta.
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What is the latent phase of HIV infection?
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During latent phase, after acute flu-like illness phase, HIV replicates in lymph nodes.
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What opportunistic infection can affect the eyes of AIDS patients?
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AIDS --> CMV retinitis (CD < 50)
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What opportunistic infections affect AIDS patients' CNS?
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AIDS --> toxoplasmosis (ring-enhancing), CMV encephalopathy, AIDS dementia, PML (JC virus), cryptococcal meningitis
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What is HIV encephalitis?
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HIV encephalitis - occurs late in HIV infection when virus gains access to CNS via infected macros (CCR5) and appears as microglial nodules with multinucleated giant cells
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What transformation occurs in prion dz?
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Prion dz:
Normal prion protein (PrPC) --> B-pleated form (PrPsc) which is transmissible |
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What is the dominant flora of the skin? Oropharynx? Nose? Colon?
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Skin - Staph epidermidis
Oropharynx - viridans group strep Nose - S. epidermidis (colonized by S. aureus) Colon - Bacteroides fragilis > E. coli |
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What kind of poisoning is associated with mayonnaise/ custart? Reheated meat dishes? Contaminated sea food?
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Mayonnaise/ custard - S aureus
Reheated meat - Clostridium perfringes Sea food - Vibrio parahaemolytics or vulnificans |
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Which fungi are transmitted by inhalation of asexual spores?
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Asexual spore inhalation - coccidioides and histoplasmosis
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Fungus that lives in macrophages. Where is it endemic?
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Histoplasmosis lives in macrophages, causes pneumonia and is endemic to OH and MS Rv valles.
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Broad-budding yeast. What type of rxn does it cause in tissue? Where is it endemic?
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Blastomycosis = broad-budding yeast that causes granulomatous nodules in lungs, can disseminate to skin and bone and is endemic to MS Rv and Central America.
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Spherule with endospores. What kind of disease does it cause and where is it most often found?
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Ciccidioides appears as a spherule with endospores that causes pneumonia and meningitis and is native to SW USA and is seen more often after earthquakes (Valley Fever)
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Budding yeast with "captain's wheel" formation?
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Paraciccidioidomycosis is caused by a budding yeast with "captian's wheel" formation. It is endemic to Latin America.
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Which fungi are dimorphic? What does this mean? How are these treated?
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Histo, blasto, paracoccidio, and candida albicans are all dimorphic: cold=mold and heat = yeast.
These, other than candida and along with coccidioides all cause pneumo and can disseminate. Tx with fluconazole or ketoconazole for local and AmpB for systemic. |
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What are the dermatophyte species?
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Dermatophytes: cause tinea
- Microsporum - Trichophyton - Epidermophyton |
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What forms does Candida albicans take? What diseases can it cause?
How is it Tx? |
Candida albicans: yeast with pseudohyphae in culture and germ tube formation at body temp. It can cause oral thrush, diaper rash, vulvovaginitis, endocarditis, disseminated candidiases and chronic mucocutaneous cadidiases.
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Candida: Tx:
Superficial: nystatin Systemic: Amp B |
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What forms does Aspergillus fumigatus take? What diseases can it cause?
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Aspergillus is a monomorphic mold with acute angle septate hypahe that can cause
(1) allergic bronchopulmonary aspergillosis (ABPA) (2) cavitary aspergilloma (fungus ball) (3) chronic granulomatous dz (immunocompromised) |
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What findings are indicative of cryptococcus?
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Cryptococcus:
(1) Heavily encapsulated yeast: India ink staining of capsule or mucicarmine staining (red) (2) Latex agglutination shows polysaccharide capsular antigen (3) Soap bubble lesion in brain (4) Cultured on Sabouraud's agar |
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What fungi preferentially affect diabetics or patients with leukemia/ lymphoma?
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Diabetic / leukemic - Mucormycosis: Mucor and Rhizopus
- Mold with irregular nonseptate hyphae that can also cause rhinocerebral, frontal lobe abscesses |
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What drugs are used as prophylaxis against P. jirovecii? When is this started?
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P. jirovecii is started at CD4+ < 200:
Pentamidine TMP-SMX Dapsone |
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What fungus causes local ulcers or pustules with nodules draining along lymphatics? What does this fungus look like on histo?
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Sporothrix - thorn prick --> pustules and ulcers with nodules along draining lymphatics with cigar-shaped budding yeast visible in pus.
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