Y2B2 Micro- Cardiovascular Diseases Part 2

Front 1

what is mononucleosis characterized by?

Back 1

an increase in mononuclear leukocytes

Front 2

what is the etiologic agent for mononucleosis? what does it have an affinity for?

Back 2

EBV w/ an affinity for B-lymphocytes

Front 3

what would you see on a CBC differential of someone diagnosed w/ mononucleosis?

Back 3

increase in lymphocytes

Front 4

what does the reactive lymph in infectious mononucleosis look like?

Back 4

abundant cytoplasm; chromatin is not as dense as a resting lymphocyte. Remeber the blueing around the edges of the cytoplasm indicating a lot of RNA in the cytoplasm hugging the RBCs.

Front 5

what two types of lymphocytes can you see on blood smear that is indicative of mononucleosis?

Back 5

reactive lymphs and degenerated lymphocytes (smudge cells)

Front 6

what are the EBV antibodies associated with infectious mononucleosis? (4)

Back 6

EBV-VCA (IgM), EBV-VCA (IgG), EBNA, EBV-EA

Front 7

when do you use the viral capsid antigens test?

Back 7

when infectious mononucleosis is suspected, but the heterophile antibody test is negative

Front 8

In IM, when do you normally see the EBV-VCA (IgM)antibody? what does it indicate?

Back 8

during the 1st week of infection indicating best indicator of current infection

Front 9

In IM, when do you normally see the EBV-VCA (IgG) antibody? what does it indicate?

Back 9

about 7 days after exposure indicating either current or past infection.

Front 10

In IM, when do you normally see the EBNA antibody? what does it indicate?

Back 10

appears late in 1st month of infection and persists indefinitely; indicates past infection

Front 11

In IM, what is EBV-EA's indicative of?

Back 11

EBV-carrier state

Front 12

what is the first test you do in someone that you suspect has infectious mononucleosis?

Back 12

heterophil antibody test

Front 13

what happens when the ENV incorporates its genome into host cell DNA? what is potential outcome of this?

Back 13

it establishes a latent infection--> transforms B-cells into immortal, constantly dividing cells (potentially causing cancer)

Front 14

what virus is associated w/ causing Burkitt's lymphoma?

Back 14

EBV--genome detected in tumor cells

Front 15

what is the vector for yellow fever?

Back 15

mosquitos

Front 16

where does the yellow fever virus replicate inside of the body?

Back 16

liver

Front 17

How many phases are involved in yellow fever? what does each phase entail?

Back 17

3 phase: 1) slight fever, headache, muscle aches. 2) remission, 3) delirium, seizures, coma, jaundice, and black vomit

Front 18

how many phases are involved in dengue fever? what does each phase entail?

Back 18

3 phases: 1) Fever, severe pain in the head and muscles (breakbone fever), 2) remission - 24 hrs, 3) return of the fever and a bright red rash.

Front 19

how many strains are there of dengue virus?

Back 19

4

Front 20

what can cause fungemia?

Back 20

complications due to venous or arterial catherization

Front 21

what populations are most at risk for developing fungemia?

Back 21

AIDS/ immunocompromised; pts on antimicrobial therapy, radiation, antineoplastic drugs.

Front 22

what type of endocarditis are IVDA prone to? what is the most common cause?

Back 22

candida endocarditis; candida albicans

Front 23

candidemia is associated with significant ______ and _____ rates.

Back 23

morbidity, mortality

Front 24

what are the four overlapping forms of invasive candidiasis?

Back 24

catheter related candidemia, acute disseminated candidiasis, chronic disseminated candidiasis, deep organ candidiasis

Front 25

what is primary infection of catheter-related candidemia?

Back 25

is on the catheter or related to the fibrin clot which forms on the catheter

Front 26

where does acute disseminated candidiasis originate from?

Back 26

contaminated catheter

Front 27

what is another name for chronic desseminated candidiasis? when does it occur?

Back 27

hepatosplenic candidiasis; exclusively occurs following prolonged episodes of bone marrow dysfunction and neutropenia (leukemia tx)

Front 28

What is the only manifestation of deep organ candidiasis?

Back 28

focal infection of a specific organ

Front 29

name which disseminated form of fungi causes these infections:
1) Pericardium
2) myocarditis, pericarditis, endocarditis
3) lymphadenitis, endocarditis

Back 29

1) coccidioidomycosis (coccidioides immitus)
2) Crytococcosis (cryptococcus neoformans)
3) Histoplasmosis (Histoplasma capsulatum)

Front 30

what is the infectious phase of malaria?

Back 30

the production of sporozoites that migrate from the gut to the salivary glands

Front 31

in malaria, where do the sporozoites invade inside of the human and what do they replicate into?

Back 31

liver cells; replicate many times into merozoites

Front 32

what happens to the RBCs in malaria when they are invaded by merozoites?

Back 32

the merozoites continue to replicate and lyse the RBCs and invade other RBCs

Front 33

what parasite causes the most severe form of malaria? what makes it the most severe?

Back 33

plasmodium falciparum; the parasite infects all erythrocytes any phase of an erythrocytic life cycle.

Front 34

what two parasites cause relapsing malaria? how does this happen?

Back 34

plasmodium vivax, and ovale; after tx, tx-resistant parasites reside dormant in the liver and later multiply in an exoerythrocytic cycle eventually invading RBCs and beginning a typical erythrocytic cycle.

Front 35

what is a complication of recurrent malarial infections?

Back 35

can cause severe anemia

Front 36

which plasmodium produces long-lasting infections and is most often asymptomatic?

Back 36

plasmodium malariae

Front 37

why are the clinical manifestations of malaria delayed?

Back 37

due to prophylaxis txs

Front 38

what is a key indicator of malaria found on a peripheral blood smear? what are they?

Back 38

schuffner's dots- small purplish red granules found in RBCs

Front 39

what are the physical findings of malaria? what physical findings are specific to P. falciparum?

Back 39

elevated temp, weakness, enlarged spleen.
P. falciparum: mild jaundice, heptomegaly.

Front 40

what lab results are indicative of malaria, particularly malaria caused by P. falciparum?

Back 40

mild anemia, thrombocytopenia, elevated bilirubin, aminotransferases

Front 41

what are some complications of severe malaria?

Back 41

cerebral malaria, severe anemia, pulmonary edema, abnormal blood coags, CV collapse, kidney failure, acute kidney failure, hypoglycemia

Front 42

what are the four ways that you can diagnose malaria?

Back 42

blood smear, antigen detection, molecular diagnosis, serology

Front 43

what are the four groups of individuals who have resistance to malaria? why?

Back 43

sickle-cell: erythrocyte membrane is abnormal and becomes stiff under low oxygen tension making them resistant to plasmodium sp infection
hemoglobin C: homozygous (mechanism unknown)
G6DPH deficiency: doesn't allow trophozoites to replicate intracellularly
lack of blood antigens Duffy A and Duffy B: plasmodium parasite requires the Duffy antigen as the receptor site.

Front 44

what population generally has a lack of blood antigens, duffy A and Duffy B?

Back 44

african americans

Front 45

what do the parasites in babesiosis invade and induce?

Back 45

invade RBCs and induce a febrile dz (hemolytic anemia, hemoglobinuria, shock, death)

Front 46

what are the 2 species responsible for the majority of human infections in babesiosis? what are the 2 hosts? which one is the vector?

Back 46

responsible: Babesia microti and divergens
Hosts: white footed mouse and deer tick (ixodes dammini- vector)

Front 47

T/F

in babesiosis humans are accidental hosts and humans are considered dead end hosts because they cannot transfer from human to human.

Back 47

true

except in blood transfusions

Front 48

where does babesiosis regionally occur?

Back 48

coastal areas of NE US, offshore islands of NY and mass

Front 49

what are the two ways in which you can diagnose babesiosis? which one is used just as a confirmatory test?

Back 49

direct blood smears and IFA (confirmatory)

Front 50

what does a direct blood smear of babesiosis look like?

Back 50

tetrad formation- parasites in RBCs.

Front 51

what other dz has the same vector as babesiosis?

Back 51

lyme

Front 52

how are individuals infected with schistosomiasis?

Back 52

through contaminated water;

Front 53

what form of schistosomiasis infects humans?

Back 53

cercariae

Front 54

which schistoma has a prediliction for the bladder? which two are found in fecal matter?

Back 54

bladder: hematobium
fecal: japonicum and mansoni

Front 55

what are the organs infected by schistosomiasis? what does it cause?

Back 55

organs:
a) skin: swimmers itch
b) bladder: granulomatous lesions, hematuria, and urethral occlusions
c) intestines: polyp formation
d) liver: eggs cause hepatomegaly (d/t periportal fibrosis and portal HTN)
e) NS: headaches, disorientation, amnesia, coma
f) heart: arteriolitis and fibrosis --> enlargement and failure of right ventricle.

Front 56

what is a key diagnostic tool for schistosomiasis?

Back 56

eosinophilia

Front 57

what two types of schistoma cause katayama's fever?

Back 57

mansoni and japonicum

Front 58

what type of schistoma can can CNS lesions by depositing eggs in the brain? what about in the spinal cord?

Back 58

brain: japonicum
SC: mansoni, haematobium

Front 59

what are the two host immune responses to schistosomiasis?

Back 59

IgE and eosinophil-mediated cytotoxicity

Front 60

how do you diagnose schistosomiasis? which one can you find in the urine?

Back 60

microscopy (stool and urine), and antibody detection.
Urine--> hematobium

Front 61

what causes chagas disease? chronic form of african sleeping sickness? acute african sleeping sickness?

Back 61

trypanosoma cruzi; trypanosoma brucei gambiense; trypanosoma brucei rhodesiense

Front 62

what does chagas's disease primarily affect?

Back 62

NS and heart

Front 63

what can chronic infections of trypanosoma cruzi cause? what vectors spread it?

Back 63

dementia, damage to heart muscle and death; triatoma infestans, rhodnius prolixis, panstrongylus megistus

Front 64

what regions can you find chagas disease?

Back 64

central and south america

Front 65

what bug specifically infects individuals w/ chaga's disease? how do they do it?

Back 65

reduviid bug... the bugs poop on your face (usually when sleeping) and sometimes directly into eyes. Then you rub the infected fecal material into your eyes, mouth or open cuts. Or by eating uncooked food contaminated by that fecal material.

Front 66

what sign is closely associated with the acute stage of chagas's disease?

Back 66

romana's sign: eye on one side swellings

Front 67

how many stages are associated with chagas's disease? what are they?

Back 67

3;
1) acute phase: romana's sign
2) indeterminate stage: asymptomatic (8-10 weeks after infection)
3) chronic stage: cardiac problems, enlargment of esophagus or large bowl (10-40 yrs after infection)

Front 68

T/F

Trypanosoma brucei gambiense is a rapidly progressing dz.

Back 68

false

trypanosoma brucei RHODESIENSE (acute african sleeping sickness) is rapidly progressing... Trypanosoma brucei GAMBIENSE (chronic african sleeping sickness) is slow-progressing

Front 69

what are kinetoplastids?

Back 69

mitochondrial DNA

Front 70

what is the life cycle of african sleeping sickness?

Back 70

Metacyclic trypomastigotes (MT) --> Long slender (LS) --> Short Stumpy (SS) --> Procyclic trypamastigoes (PT) --> epimastigotes (E)

Front 71

which phase of the life cycle of african sleeping sickness resides in salivary glands? in what insect does the African sleeping sickness reside?

Back 71

metacyclic trypomastigotes-- tsetse fly

Front 72

how do the trypomastigoes of the african sleeping sickness elude the immune system?

Back 72

via antigenic variance (long slender, short stumpy)

Front 73

where are procyclic trypomastigotes develop in african sleeping sickness?

Back 73

in the gut

Front 74

why do relapses occur in african sleeping sickness?

Back 74

d/t antigenic variation of trypanosomal surface--> life cycle exhibits different morphologies

Front 75

what is the hallmark of african sleeping sickness? In which type of african sleeping sickness does this occur more quickly?

Back 75

invasion of the CNS-- NS impairment;
more quickly in trypanosoma rhodensiense

Front 76

what transmits leishmaniasis? what type of dz is this? what parasite causes this?

Back 76

transmitted by sandflies--> vector-borne dz; leshmania donovani

Front 77

where are the amastigote forms of leishmaniasis found?

Back 77

in reticuloendothelial cells of the viscera

Front 78

what are the sxs of leishmaniasis?

Back 78

low grade fever, anemia, protrusion of abdomen d/t enlargement of spleen and liver, edema, diarrhea

Front 79

what are the possible complications of leishmaniasis?

Back 79

post kala-azar dermal lesihmanoid, badly disfigured face

Front 80

what is the diagnostic phase of the leishmaniasis life cycle?

Back 80

amastigoes in the various organs--> identified as LD bodies (Leshmania donovani)

Front 81

what is the geographical distribution of visceral leishmaniasis?

Back 81

south america (mostly), some africa and Mediterranean.

Front 82

what is caused by infections w/ nematodes?

Back 82

filariasis (roundworms)

Front 83

what three species are responsible for most of the morbidity due to filariasis?

Back 83

wuchereria bancrofti, brugia malayi, onchocerca volculus

Front 84

what is the geographical location of loa loa and onchocerca volvulus?

Back 84

Africa

Front 85

what two parasites infiltrate the subcutaneous tissues? lymphatics?

Back 85

subQ: onchocerca volvulus, loa loa
lymphatics: brugia malayi, wuchereria bancrofti

Front 86

where do microfilariae develop into filariform?

Back 86

in arthropod

Front 87

what are the clinical manifestations of lymphatic filariasis?

Back 87

asymptomatic microfilaremia, lymphadema, elphantiasis, febrile lymphagitis

Front 88

what cell type of prominent in filarial infections?

Back 88

eosinophils

Front 89

what are the three diagnostic techniques that we can use for filariasis?

Back 89

microscopic examination, antigen detection, and antibody detection