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Systemic Disease > 11. Infections 3: Viral, Venereal, Inflammation and Unknown > Flashcards

11. Infections 3: Viral, Venereal, Inflammation and Unknown Flashcards

1
Q

Enveloped viruses induce what types of hypersensitivity?

A

4 - cell mediated

3 - antibody mediated

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2
Q

Non-enveloped viruses induce what type of hypersensitivity?

A

3 - antibody production

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3
Q

What type of viruses are retro viruses?

A

Enveloped

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4
Q

How do viruses replicate?

A

Use the transcriptase enzyme to replicate the host’s DNA from its RNA

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5
Q

What characterizes category A HIV/AIDS CD4 + Lymphocyte?

A

CD4 > 500

Persistent generalized lymphadenopathy

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6
Q

What characterizes category B HIV/AIDS CD4 + Lymphocyte?

A

CD4 200-500
Oropharngeal candida
Hairy leukoplakia (oral)

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7
Q

What characterizes category C HIV/AIDS CD4 + Lymphocyte?

A 
CD4 <200
CMV retinitis
Kaposi's sarcoma
Lymphoma
Pneumocystis carnii
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8
Q

What are the ocular signs and symptoms of HIV/AIDS?

A

HIV related vasculopathy

  • Conj vascular sludging
  • CWS
  • Intra-retinal hemes
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9
Q

How is CMV retinits described?

A

Brush fire

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10
Q

What is PORN?

A

Outer retinal necrosis leading to full thickness tissue necrosis with minimal or no vitritis

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11
Q

Who gets PORN?

A

Immunodeficient patients

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12
Q

What does the vitreous look like in PORN?

A

Clear

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13
Q

What typifies acute retinal necrosis syndrome (ARN)?

A

Orbital pain and decreased VA
Vitritis
Healthy patients

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14
Q

What do the histological lesions from CMV look like?

A

Classic Owl’s eye

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15
Q

What are the ocular signs/symptoms of active CMV?

A

Necrotizing retinits

Smouldering borders

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16
Q

What is has less severe retinal disease in CMV, acquired or congenital?

A

Congenital

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17
Q

What are the common signs associated with congenital HSV?

A

*Microcephaly
Skin vesicles
Intra-uterine growth retardation

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18
Q

What are the ocular signs and symptoms of congenital HSV?

A

Posterior lenticular opacification
Microphthalmia
Microcornea

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19
Q

What are the common ocular signs/symptoms of neonatal HSV?

A

*Periocular skin disease

Vit inflammation

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20
Q

What are the signs/symptoms of primary HSV?

A

Acute follicular conjunctivitis

Initial episode of the superficial cornea that then affects the eyelid or conjunctiva

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21
Q

What type of keratitis may occur in recurrent HSV?

A

Necrotizing stromal keratitis (neurotrophic)

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22
Q

How is Mumps spread?

A

Airborne respiratory droplets

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23
Q

What are the systemic signs/symptoms of mumps?

A

Hearing loss
CN palsy
Guillain-Barre syndrome

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24
Q

What are the ocular signs/symptoms of mumps?

A 
Acute dacryoadenitis
Conjunctivitis, episcleritis, scleritis
Disciform stromal keratitis
Uveitis
Retina: AMPPE, choroiditis
Neuritis
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25
Q

What labs can be done for mumps?

A

ELISA

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26
Q

What 3 viruses can cause disciform keratitis?

A

Herpes zoster
Mumps
Varicella

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27
Q

What are the systemic signs/symptoms of congenital rubella?

A

Bilateral hearing loss
Mental retardataion
Meningitis
Dental hypoplasia

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28
Q

What are the ocular signs/symptoms of congenital rubella?

A 
Microphthalmia
Glaucoma
Keratoconus
Spherophakia
Angle dysgenesis
Salt and pepper fundus
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29
Q

What characterizes rubeola (Measles)?

A

Fever/cough
Kplik’s spots on conj mucosa (and other mucosa)
Maculopapular rash

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30
Q

What ocular complication can be seen in measles?

A

Retinitis

Posterior uveitis

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31
Q

Chlamydia can cause what respiratory infection in adults?

A

Pneumonia

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32
Q

How is chlamydia transmitted?

A

Birds

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33
Q

What chlamydia strains are responsible for lymphogranuloma venerum?

A

L1
L2
L3

34
Q

How does lymphogranuloma venerum start?

A

Small genital ulcer

35
Q

Where can lymphogranuloma venerum invade and reproduce?

A

Regional lymph nodes

36
Q

What may happen to lymph nodes in lymphogranuloma venerum?

A

Form large masses (buboes)

37
Q

How is lymphogranuloma diagnosed?

A

Antibody

38
Q

How is lymphogranuloma venerum treated?

A

Tetracycline

Erythromycin

39
Q

Reactive arthritis has spondylarthropathy associated with what?

A

Skin ulcers of mouth and genitals

Keratoderma blennorrhagicum

40
Q

What are the ocular signs/symptoms of neonatal conjunctivitis?

A

5-14 days post birth
Mild conjunctivitis to severe mucopurulent with pseudo-membrane
No follicles in neonates
Tx with systemic therapy

41
Q

What is the incubation of trachoma?

A

7 day

42
Q

What are the ocular signs/symptoms of trachoma?

A 
Chronic conjunctivitis
Affects both eyes
Conj hyperemia
Eyelid edema
Lacrimation
Follicles 7-10 days
Papillae form after follicles
43
Q

What serotypes cause inclusion conjunctivitis?

A

Clhamydia D-K

44
Q

What are the ocular signs/symptoms of inclusion conjunctivitis?

A 
Mild mucopurulent discharge
Usually unilateral
Marked tarsal follicles
Superior corneal opacities and pannus
Inflamed tarsal plate
PAN
No response to topical Abx
45
Q

Which gender is asymptomatic 50% of the time with gonorrhea?

A

Females

46
Q

What is the typical male presentation of gonorrhea?

A

Urethral discharge

Dysuria

47
Q

What are the signs/symptoms of ocular gonorrhea infection?

A

Hyper acute conjunctivitis
Bilateral orbital edema
Chemosis
Conj papillae

48
Q

Ocular gonorrhea has a high risk of what corneal complication?

A

Perforation - it penetrates intact epithelium

49
Q

What agar is used to culture gonorrhea?

A

Blood or chocolate

50
Q

What genes are typically positive in Bechet’s?

A

HLA B51

BLA B5

51
Q

What are the major criteria for Behcet’s?

A

Oral ulcers
Genital ulcers
Non-ulcerative skin lesions
Ocular disease

52
Q

What is the typical FA pattern in Behcet’s?

A

Fern leaf (diffuse capillary leakage)

53
Q

What is the number 1 cause of death associated with sarcoidosis?

A

Pulmonary insufficiency

54
Q

Lupus Pernio is pathongnomonic of what?

A

Sarcoid

55
Q

Lupus pernio has findings that resemble frost bite. Describe it.

A

Hard, indurated skin lesion

56
Q

What are the ocular findings of Lupus pernio?

A

*Band K
*Candle wax drippings
KPs
KCS
ERM

57
Q

What are the ocular findings of Vogt-Koyanagi-Harada?

A 
Sugiura's sign
Bilat uveitis
Iris depigmentation
Mutton fat KPs, PAS
Secondary glaucoma
Complicated cataract
Sunset glow fundus
Dalen-Fuch's nodules
58
Q

What is Sugiura’s sign?

A

Perilimbal depigmentation

59
Q

When does OIS occur?

A

After ipsilateral atherosclerotic carotid occlusive disease

60
Q

What are the common ocular findings in OIS?

A

Iris neo
Increased IOP
Uveitis - PAS, AS

61
Q

In bacterial endocarditis, what causes endothelial damage?

A

Underlying cardiac defect

62
Q

In bacterial endocarditis, circulating bacteria adhere to what?

A

Fibrin-platelet and produce infective endocarditis

63
Q

Osler’s nodes are found in what disease?

A

Bacterial endocarditis

64
Q

What are the common systemic findings of bacterial endocarditis?

A 
Tissue infarction
Vasculitis
Strokes, brain abcess
Meningitis
Glomerulonephritis
Osler's nodes
Janeway's lesions
Petechial hemes
65
Q

What are the ocular findings of bacterial endocarditis?

A

Acute endophthalmitis
Uveitis
Roth spots

66
Q

What is Milroy disease?

A

Primary, congenital lymphedema onset at birth

67
Q

What is Meige disease?

A

Primary lymphedema onset after age 35

68
Q

Where does T wave inversion appear?

A

Leads corresponding to site of infarct

69
Q

If T wave inversion appears on the leads of one side, what may appear on the other side?

A

Reciprocal ST depression

70
Q

Bradyarrhythmias are more common with what infarction?

A

Inferior (inferior brady)

71
Q

Ventricular tachycardia and fibrillation are more common with what infarction?

A

Anteroseptal

72
Q

What is more cardiac specific and sensitive than CK-MB?

A

Troponins T and I

73
Q

What is the first marker to rise following myocardial damage?

A

Serum myoglobin

74
Q

What are the important findings in rheumatic fever?

A

Carditis

Heart valve damage

75
Q

What confirmation is needed for rheumatic fever?

A

Microbiologic with a throat culture or RADT

76
Q

What are some ocular findings that may present during pregnancy?

A

Kruckenberg spindles

K-cone

77
Q

What changes are occurring during days 20-56 after fertilization?

A

Oragnogenesis

Teratogenesis most likely

78
Q

What major drug class is a known fetal teratogen?

A

ACE inhibitors

79
Q

Poor control of gestational diabetes after 10 weeks leads to what?

A

Fetal macrosomia

Increased risk of pre-eclampsia

80
Q

What are the ocular findings in severe eclapsia?

A 
Segmental arteriolar vasospasm
CWS
Retinal heme
Serous detachments
Disc swelling

Systemic Disease (12 decks)

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