Exam 1 Flashcards
(221 cards)
1
Q
Acquired immunity is considered…
A
Antigen specific. T and B cell immunities
2
Q
Innate immunity is considered…
A
Defenses found in the body that are not as specific, such as macrophages and white blood cells, or barriers such as skin and mucosal linings
3
Q
Immature neutrophils are called…
A
Band cells
4
Q
Neutrophils are the ___ common
A
Most
5
Q
Lymphocytes consist of _____ and perform the actions of ____
A
B and T cells, cell mediated immune defense and the production of antibodies
6
Q
Monocytes perform the action of ____ and are considered part of which immune response?
A
Transforming into macrophages and assisting in phagocytosis, innate immunity
7
Q
Eosinophils are commonly found ___
A
In the fight against parasites
8
Q
Basophils perform the action of…
A
Releasing histamine
9
Q
Name the granulocytes
A
Neutrophils, basophils, eosinophils
10
Q
Name the agranulocytes
A
Lymphocytes and monocytes
11
Q
Cycle of the B lymphocyte:
A
B cells with surface receptor to a specific antigen present after initial exposure to the antigen, then when the antigen presents again, B cells transforms into plasma cell and starts to create antibodies against the antigen
12
Q
Role of cd4 helper cells
A
Play a large role in antigen presenting, start the process for B cells
13
Q
Role of cd8 cytotoxic cells
A
Bind to infected cells and induce apoptosis
14
Q
What is the difference between cell mediated and humoral immunity?
A
Cell mediated protects against viral infections, or intracellular pathogens, and is mediated by T cells. Humoral protects against extra cellular pathogens and their toxins, and is mediated by B lymphocytes and their antibodies
15
Q
MHC class 1 focuses on
A
Self versus non self, with cd8 cells
16
Q
MHC class 2
A
Focused on external pathogens with cd4 cells
17
Q
IgM characteristics
A
Acute antibody, first one created when exposed to an antigen, disappears within 2-3 weeks after exposure
18
Q
IgG characteristics
A
Later response of antibody, determines immunity, can cross the placenta
19
Q
IgA characteristics
A
Mucosal antibody, when low it is common to have respiratory and mucosal infections
20
Q
IgE characteristics
A
Found in allergies and parasitic infections
Anaphylaxis
21
Q
Sepsis
A
Disregulation response to infection, can lead to MODS, body cannot support its own blood pressure and starts shutting down
22
Q
Hep A characteristics
A
Transmitted fecal oral, not endemic to the US so comes with people that travelled, no chronic condition of HAV
Fever, nausea, vomiting, anorexia, large and tender liver, pale stools and dark urine, jaundice
Elevated aminotransferase levels, increased AST and ALT levels
23
Q
HBV characteristics
A
DNA virus, transmitted through blood/high risk sex/other bodily fluids, long incubation period, can become chronic then cirrhotic (and maybe even hepatocellular carcinoma)
24
Q
Describe different markers for HBV
A
HBsAg- active infection or vaccinated
HBsAb- immunity, don’t know if they had the infection or were vaccinated, just know that they are immune
HBcAb- present following active infection, NOT vaccination (vaccination only contains the outer surface of the virus, not the viral core)
HBeAg- indicated that the soluble component of the core is in the blood, actively infected by HBV
HBeAb- the acute phase of the infection is over and there is a decrease in infectivity
25
Rotavirus characteristics
Fecal-oral, ubiquitous, causes more problems in children, stable RNA virus that can last for weeks if not cleaned
26
Rotavirus symptoms
Nausea, vomiting, severe dehydration, best to orally rehydrate.
27
Diphtheria characteristics
Can be asymptomatic carriers, causes respiratory or cutaneous dz, spread mainly by respiratory secretions
28
Diphtheria symptoms
Inflammation of respiratory tract and skin, caused by the exotoxins (extremely potent)
Cutaneous- chronic wound with grey pseudo membrane
Oropharyngeal- nasal discharge, laryngeal inflammation and grey pseudomembrane
Could later cause myocarditis or cranial nerve palsies from the toxins
29
Pertussis virus characteristics
Bordetella pertussis, pleomorphic (alters shape and size to respond to environment)
Travels on droplets, adults are the main reservoir
30
Pertussis stages
Catarrhal- nonspecific signs/symptoms, highly contagious
Paroxysmal- bouts of severe coughing followed by vomiting and exhaustion
Convalescent- susceptible to other respiratory infections, gradual recovery where coughing lessens, but bouts may occur
31
Pertussis characteristics
Causes profound lymphocytosis, in adults may appear as bronchitis, but consider if cough lasts longer than 2 weeks. Diagnose with a nasopharyngeal swab *all the way through the nose to the back of the "throat"
32
Tetanus characteristics
Clostridium tetani, ubiquitous, blocks GABA release in the inhibitory spinal neurons to cause spasms
33
Tetanus symptoms
Early on- spasticity at the sight, tingling, stiff jaw/neck
Later on- hyperrelfexia, spasms from minor triggers, trismus, risus sardonicus, constipation, asphyxia, rigidity of muscles
34
Which three organisms should asplenic patients be vaccinated for and why?
Neisseria, haeophilus, strep pneumoniae
The spleen plays a large role in opsonizing encapsulated organisms, and these three are encapsulated
35
H influenzae characteristics
Most significant strain of haemophilus
Causes epiglottitis- obstructs airway, whistling while breathing, can't handle secretions
May produce beta lactamase, don't use amoxicillin, but use augmentin instead
36
Human papillomavirus characteristics
Causes genital warts, cervical cancer, anal cancer, and head/neck cancer.
Transmitted via sexual contact. Vaccine for it
37
Streptococcus pneumoniae "pneumococcus" characteristics
Encapsulated bacteria, in normal flora, causes respiratory issues.
Vaccine prevents: bacteremia, endocarditis, meningitis, and septic arthritis.
38
Pneumococcus diagnoses and most common presentations now?
Sputum culture for pneumonia
Pneumonia, otitis media, sinusitis, mastoiditis
39
Poliovirus characterstics?
RNA, fecal-oral spread, often asymptomatic, vaccine prevents it
40
What are the neurological complications of poliovirus?
Meningoencephalitis, anterior horn disease (weakness and maybe paralysis, possible respiratory failure, bulbar poliomyelitis)
41
Influenza characteristics of the virus
RNA, droplet transmission (some airborne), three types (A B and C) with type A further classified by H and N surface proteins
42
What does the v after a type of influenza mean?
V means variant, or the strain that previously only infected an animal can now infect humans
43
Why does mortality for influenza differ for different age groups?
Based upon prior exposure and immunity to the specific strain
44
Influenza signs and symptoms
Abrupt onset of fever, chills, malaise, myalgias, cough and sore throat (respiratory disease more than GI disease, but GI can be present in addition to the other symptoms)
45
Measles
| Rubeola characteristics
RNA, transmitted via droplets, very high attack rate, vaccine quite effective with herd immunity as the goal
46
Measles rubeola signs and symptoms
About 2 week incubation, nonspecific fever cough etc, but KOPLIK'S SPOTS are pathognomonic, exanthem that starts at the head and spreads inferiorly
47
mumps characteristics
RNA virus, transmitted via droplets, 2-3 week incubation
48
Mumps signs and symptoms
Parotitis, could cause orchitis or meningitis, fever, malaise and anorexia
49
Rubella characteristics
RNA, transmitted via droplets and trans-placentally, IG can be given to exposed patients. Vaccine is live so can't be pregnant when you have it
50
Rubella signs and symptoms
Prodrome fever and malaise, then maculopapular rash that starts on face and spreads inferiorly, maybe arthritis, posterior cervical lymphadenopathy, 2-3 week incubation
51
Congenital rubella syndrome
Teratogen, heart, eye and brain malformations, blueberry muffin lesions
52
Neisseria meningitidis characteristics
Gram negative bacteria, encapsulated, transmitted via respiratory droplets, infective in crowded areas
Bacteria enters nasopharynx then blood
53
Neisseria meningitidis sign to worry about
Non-blanching rash and fever!
54
Consequences of N meningitidis?
Sepsis, Waterhouse-Fridrichson syndrome (hemorrhage and infarction of adrenal glands that worsens shock)
55
How is neisseria meningitidis diagnosed?
Through culture
56
What is the etiology of rabies?
Caused by rhabdovirus, transmitted through saliva, enters body through animal bite, usually wild animals
57
What is the pathophysiology of rabies?
3-7 week incubation depending on the distance of the wound from the CNS, brain then salivary glands
BULLET SHAPED
CYTOPLASMIC INCLUSION BODIES
58
What are the two types of CNS rabies?
Furious (encephalitic) and dumb (paralytic)
59
What are the classic manifestations of rabies and which type of rabies is it?
Aerophobia, hydrophobia, excess salivation, seizures, agitation
Encephalitic "furious" rabies
60
What is the less common presentation of rabies and what are the signs/symptoms?
Dumb aka paralytic, ascending, mimics Guilin-barre. Along with furious/encephalitic rabies, progresses to coma, ANS dysfunction and death
61
What is the common postexposure/prophylaxis for potential rabies exposure?
Human rabies immune globulin, full dose infiltrated around the wound or if unable, injected IM. Then 4 injections of the vaccination
62
How many species of what genus causes malaria?
5 species of plasmodium
63
Which genus/species of malaria is the most virulent? Which species/genus is also common in the US?
Plasmodium falciparum, plasmodium vivax
64
What is the classic malarial paroxysm?
Chills, high fever, then sweats. Can appear well between episodes, and the fever is irregular and cyclical
65
What are the physical findings of malaria infection?
Extreme splenomegaly, mild hepatomegaly, jaundice, anemia
66
What are some of the subjective findings of a malaria infection?
Malaise, myalgia so, arthralgias, cough, chest pain, abdominal pain, anorexia, nausea, vomiting & diarrhea
67
A high parasite load and organ dysfunction are characteristic of a _____________ infection
P. Falciparum
68
What is the gold standard for testing for malaria?
Giemsa-stained blood smear
69
What is the finding indicative of malaria infection on a giemsa-stained blood smear?
Trophozoites
70
What is the name and type of bacteria that causes Lyme disease?
Borrelia burgdorferi, spirochete
71
How long does a tick have to feed to transmit Lyme disease
24-36 hours
72
Stage 1 lyme's disease signs and symptoms
Flu-like, Bulls-eye around the tick bite (erythema migrans)
73
Stage 2 lyme's disease signs and symptoms
Happens if the person is left untreated, malaise, fever, fatigue, achiness
```
Can have neurological manifestations (bell's palsy, aseptic meningitis) or can have
Cardiac manifestations (myo/pericarditis with atrial or ventricular arrhythmias or block)
```
74
Stage 3 Lyme disease
Late disease, months to years later
Arthritis, memory loss, mood changes, sleep disturbance, paresthesias
75
Genus/species that causes Rocky Mountain spotted fever?
Rickettsia rickettsii, gram negative non-motile
76
RMSF pathophysiology
Vasculitis, increased vascular permeability, edema, activation of inflammatory and coagulation mechanisms
Leakage of fluid from the bloodstream to tissues can be devastating
77
What is "classic" RMSF?
Fever, headache, rash in a person with a history of a tick bite
78
Describe the rash found for RMSF
Centripetal rash, usually involving wrists and ankles, characteristic involvement of palms and soles, petechiae
79
Complications of RMSF
Pulmonary edema, adult respiratory distress syndrome, arrhythmias, GI bleeding, skin necrosis, etc.
80
Best treatment for RMSF
Doxycycline
81
What is the genus of viruses that causes dengue? What mosquito?
Flavivirus
Aedes
82
Signs and symptoms of dengue
Sudden onset of high fever and chills, break bone aching, sore throat, prostration, maculopapular rash. As rash fades, petechiae on extensor surface of limbs appears
83
Describe the 4 Cardinal features of dengue hemorrhagic fever
Increased vascular permeability, marked thrombocytopenia, fever lasting 2-7 days, and hemorrhagic tendency
Dengue shock syndrome when shock is present in addition to the above 4 criteria
84
Describe the tourniquet test
Blood pressure cuff is inflated for 5 minutes, 10 or more petechiae within one inch is positive. Seen in dengue hemorrhagic fever
85
What causes yellow fever? Where are the endemic areas?
Flavivirus, Aedes mosquito
Africa and South America
86
What are signs and symptoms of mild yellow fever?
Malaise, headache, fever, retro-orbital pain, N/V, photophobia
87
Signs and symptoms of severe yellow fever
"Period of intoxication", fever, bradycardia, hypotension, jaundice, hemorrhage, delirium
88
Common laboratory findings of yellow fever
Proteinuria, elevated bilirubin, leukopenia, elevated AST and ALT
89
Zika virus
Often asymptomatic, mainly causes microcephaly in babies with pregnant mom contracting virus, may see guillian-barre syndrome
90
Ebola signs and symptoms
Diffuse non-pruritic rash, watery diarrhea, N/V, can be hemorrhagic with blood in stool, etc. can be neurological with altered levels of consciousness, can be ocular with photophobia and blurred vision
91
What is yersinia pestis?
Plague!
92
Describe bubonic plague
Most common, sudden fever/chills/headache, buboes (painful and massive enlargement of nodes)
93
Pneumonic plague
Airborne transmission, bloody sputum and rapidly worsening respiratory distress, almost 100% fatal
94
C. Trachomatis commonly causes:
Chlamydia! Aka urethritis & cervicitis
95
What are the female signs and symptoms of chlamydia?
Sometimes asymptomatic, mucopurulent urethral or cervical discharge, bleeding, abdominal/pelvic pain, dysuria and urinary frequency
96
What are the male signs and symptoms of chlamydia?
Asymptomatic, mucoid or watery urethral discharge, dysuria, epididymitis, prostatitis, inflammation of rectal area (proctitis)
97
Common saying wth c. Trachomatis
"Can't see, can't pee, can't climb a tree"
Arthritis, uveitis and urethritis
98
Lymphogranuloma venereum (LGV) characteristics
Acute & chronic STI caused by C. Trachomatis l1-l3
Infection spreads to lymph channels and lymph nodes of genital and rectal areas
99
Symptoms of LGV
Ulcerative lesion on external genitalia, local pain and itching, inguinal buboes, tender lymphadenopathy, anorectal pain, discharge, rectal bleeding
100
Neisseria gonorrhoeae clinical presentation in men
Dysuria, copious purulent discharge, painful inflammation
101
Neisseria gonorrhoeae clinical presentation in females
More likely to be asymptomatic
Symptoms increase during menses
Pain/frequency/urgency with urination, purulent urethral discharge, vaginitis, cervicitis, PID
102
PID
Upper genital tract infection
Cervical tenderness (chandelier sign), peri hepatic adhesions (fitz-Hugh-Curtis syndrome)
103
Clinical sydromes of disseminated gonorrhea
Purulent arthritis & dermatitis/tenosynovitis/polyarthralgias
104
Purulent conjunctivitis with periorbital edema, think...
Gonorrhea conjunctivitis, can lead to ulceration, scarring, and visual impairment
105
HSV-1 characteristics
Acquired usually in childhood, usually through saliva, milder symptoms
106
HSV-2
Trasmitted sexually, 90% of the time causes genital herpes
107
Describe HSV infection presentation
Small, painful & multiple grouped vesicular lesions
Pustules-ulcers-crusting-healing
108
HSV lab findings
Intra nuclear inclusion bodies and multinucleated giant cells on a tzanck preparation
109
HPV characteristics
Human papillomavirus, usual route of entry is skin/mucous membranes, generally causes genital warts
110
HPV clinical presentation
None, plantar warts, anogenital warts, fissured skin
111
Organism causing syphilis
Spirochete treponema pallidum
112
Primary syphilis s/s
PAINLESS chancre usually on genitals, painless regional LAD, eventual potential pain from secondary bacterial infection
113
Secondary syphilis s/s
Weeks-6 months after chancre
Fever, LAD, palms and soles in many cases, nonpruritic macular/papular skin lesions, mucous patches, alopecia
114
Latent syphilis
After secondary lesions
Early latent- w/in previous 12 months, infectious
Late latent- infection >12 months ago, hidden and noninfectious except in vertical transmission
115
Latent syphilis s/s
Localized gummatous rxn, diffuse inflammation (involves CNS and large arteries), painless nodules, destructive gummas, osteitis/arthritis
116
Neurosyphilis 4 classifications
Asymptomatic neuroinvasion
Meningovascular syphilis
Tabes dorsalis
General paresis
117
Meningovascular syphilis
Changes to cerebral vascular structures, HA, irritability, unequal reflexes, CVA
118
Tabes dorsalis
Degeneration of parenchyma of posterior columns of spinal cord
Romberg sign (loss of balance with eyes closed), pupils accomodate but don't react
119
General paresis
Involvement of cerebral cortex, impairs memory, concentration, personality changes, tenor of fingers and lips, irritability, headaches
120
Syphilis testing
Nontreponemal test (VDRL or RPR), if positive, then treponemal Ab test
121
Main treatment for syphilis
Very PCN responsive
122
Trichomonas vaginalis
Anaerobic protozoan parasite that is transmitted through sexual contact
123
Male symptoms of trichomonas
Pruritus, irritation inside of the penis, burning after urination/ejaculation, discharge, dyspareunia
124
Female symptoms of trichomonas
Pruritus, burning, redness, soreness of external genitalia, frothy discharge, dyspareunia
125
Strawberry cervix is a sign of...
Trichomonas
126
General treatment of trichomonas
Metronidazole
127
What causes chancroid?
Haemophilus ducreyi
128
Chancroid characteristics
Painful ulcer with ragged/dirty-appearing base, inguinal LAD. Rare in US
129
Granuloma inguinale characteristics
Granulomatous infection, DONOVAN BODIES are pathognomonic on staining
Chronic in course
130
Histoplasmosis characteristics
Dimorphic fungus, grows inside macrophages, bird/bat droppings, usually asymptomatic
131
Histoplasmosis symptoms
Fever/cough/chest pain,
| Cavitary lung lesions may occur, can form granulomas
132
Histoplasmosis testing
Urinary Ag, serologies, tissue bx, CT is the best imaging
133
Blastomycosis presentation is similar to...
Histoplasmosis
134
Treatment for blasto/histomycosis
Itraconazole
135
What is the smallpox virus?
Poxvirus, DNA virus. Only one serotype so eradicated from the globe due to vaccine
136
How is smallpox transmitted?
Airborne or direct contact
137
Smallpox symptoms/signs
Fever/malaise, then centrifugal rash (starts in the middle and works outward), vesicles of smallpox are all at the same stage of development
Macules-papules-vesicles-pustules-crusted
138
Who is still vaccinated for smallpox?
Military personnel
139
What disease does bartonella henselae cause?
Catch scratch disease
140
Cat scratch characteristics
Pleomorphic gram negative, can't grow in standard cx, transmitted by cat scratches or bites
141
Cat scratch disease signs and symptoms
Fever, tender LAD near scratch site, rash or granulomas, if immunocompromise, can see bacillary angiomatosis, macular star or inflammation of retina and optic nerve
142
Bartonella Quintana causes what disease?
Trench fever, a blood stream infection caused by lice.
143
Trench fever characteristics
HA and post orbital pain, sudden fever, bone pain
144
Kawasaki disease characteristics
Medium vessel vasculitis, coronary artery aneurysm is the most important consequence
145
Kawasaki disease acute phase
High fever, conjunctival erythema, strawberry tongue and cracked lips, swelling/rash of hands and feet
146
Kawasaki disease subacute phase
Desquamation of digits, thrombocytosis, coronary artery aneurysm
147
Kawasaki disease convalescent phase
Beau lines of nails
148
Kawasaki disease treatment
IV immunoglobulin and aspirin (the only reason to give aspirin to pediatric patients)
149
Coxsackie characteristics
Fecal oral route, can shed virus in stool for several weeks after infection resolves, hand/foot/mouth disease
150
Hand foot mouth disease signs and symptoms
Fever, sore mouth, red papules and small grey vesicles on hands, feet, mouth, butt, genitals
151
Erythema infectiosum characteristics
"Fifth disease", human parvovirus B19, springtime epidemic, common in adults! Transmitted through respiratory secretions and blood
152
Erythema infectiosum signs and symptoms
Slapped cheek, lacy rash, usually supportive treatment.
153
Erythema infectiosum problem areas
Pregnancy- hydrops fetalis
Sickle cell disease- aplastic anemia, pancytopenia
154
Roseola infantum characteristics
Aka exanthem subitum or 6th disease
Herpesvirus 6 and 7, ubiquitous
155
Roseola infantum clinical findings
High fever, maculopapular rose colored rash when fever breaks, erythematous tympanic membranes
156
Molluscum contagiosum characteristics
Pox virus infection that is common, transmitted through contact
Genital molluscum on a child- sexual abuse
Facial molluscum on adult- HIV until proven otherwise
157
Molluscum contagiosum dx
Dome shaped umbilicated papules
158
Verruca vulgaris
Common warts, rough grey surface, will resolve usually without treatment
159
Verruca plana
Flat warts, often grouped, highest rate of spontaneous remission
160
Verruca plantaris
Plantar warts, toughest to treat, commonly at pressure points in feet and uncomfortable, no skin lines
161
General mycobacterium characteristics
Aerobe, intracellular, non motile rod, slow growing, hydrophobic, acid fast bacilli
162
Main difference between TB and NTM
TB spreads only by respiratory droplets and airborne transmission, and NTM infections are acquired directly from the environment
163
4 possible outcomes after inhalation of M. Tuberculosis
1. Immediate clearance
2. Latent infection (non infectious)
3. Primary disease (immediate onset of active disease)
4. Reactivation disease (onset of disease many years after exposure)
164
Latent TB findings
No symptoms, but positive TST or IGRA. Normal CXR and negative respiratory smear and culture specimens
165
Name some high risk patients for TB and what their TST reaction size of induration would be
HIV, close contact with a case, immunosurpressed patients
Less than or equal to 5 mm induration
166
Name some moderate risk patients for TB and their TST reaction size of induration
People with chronic disease or IV drug users, children younger than 4, foreign born from a country with incidence, or people in high risk settings
Greater than or equal to 10 mm
167
Name some low risk TB patients and their TST reaction size of induration
Healthy individuals 4 or older
Greater than or equal to 15 mm
168
Describe the IGRA
More objective, can detect latent TBI, more specific for TB versus NTM infection.
169
Active pulmonary TB s/s
Weight loss, fever, night sweats, cough, hemoptysis
170
Lab testing for active TB
AFB stain, need to request it, then 3 consecutive morning sputum samples
171
Ghon complex
Calcified lung nodule commonly found in TB CXR
172
Ranke complex
Calcified ipsilateral lymph node commonly found in TB CXR
173
Reactivation TB commonly presents with...
Fibrocavitary apical disease
174
If you have TB, test for...
HIV. And vice versa!
175
Cervical lymphadenitis from mycobacteria, aka _____ and what causes it in adults vs. children?
Scrofula
Adults: M. Tuberculosis
Children: M. Avium, or NTM
176
What are some common skin and soft tissue infections caused by NTM? What are they usually treated with?
Abscess, septic arthritis, and osteomyelitis.
Treated with macrolides
177
Leprosy characteristics
Caused by mycobacterium leprae, intracellular parasite, human to human transmission requiring prolonged and intimate human contact.
Involved skin and peripheral nerves
178
Leprosy s/s
Lesions involve cooler body tissues, macular lesions, erythematous nodules, diffuse infiltration of the skin
Motor abnormalities with nerves
179
Tuberculoid leprosy
Cellular immunity in tact, benign and less progressive
180
Lepromatous leprosy
Progressive and malignant, defective cellular immunity, leonine facies, severe ulcerations and loss of tissue
181
Cutaneous candidiasis s/s
Erythema, intense pruritis, tenderness or pain
Erythematous papules and or pustules, confluent centrally with peripheral satellite regions, possible erosion
182
Candida vulvovaginitis s/s
Inflamed, swollen vaginal and valvular tissue, intense vaginal itching, white and clumpy discharge
183
What are the recommendations for ASA?
Low dose ASA recommended for prevention of CVD and colorectal cancer in 50-59 age range
- need to take for 10 years
- life expectancy of 10 years
- no increased risk of bleeding
- greater than 10% 10-year CVD risk
184
Screening for high BP
All adults 18 years and older
185
Screening for HTN, how often?
40 years or older with increased risk for HTN, annually
18-39 with normal BP and no risk factors, 3-5 years
186
Lipid screening
Men 35 and older,
Men 20-35 if they have increased risk
Women 45 and older
20-45 if they have increased risk
187
AAA screening
One time ultrasounds in men 65- 75 who have EVER smoked
188
Breast cancer screening
Still unclear...
Q 1-2 years women 40 or 50 years and older
189
Cervical cancer screening
21-65 year old women with a cervix
190
Lung cancer screening
55-80 yrs with 30-pack year hx AND currently smoke, or quit within the last 15 years
191
Colorectal cancer screening
50-75
192
DM screening
40-70 years who are overweight or obese
193
Fall prevention
Community dwelling adults 65 and older, suggest exercise/physical therapy and vitamin D supplementation
194
Osteoporosis screening
65 years and older, women
195
HIV screening
All patients 15-65
196
HIV virus general characteristics
Retrovirus, lentivirus genus.
HIV-1 is more common and more severe
HIV-2 is more indolent, mostly just in Africa
197
What to proteins are needed for HIV to connect?
CCR5 and CD4
198
Acute retroviral syndrome is from...and its characteristics?
a primary HIV infection
Mono-like dz
Fever, LAD, pharyngitis, rash, HA, etc.
High viral load in this time
199
HIV effects on the immune system
Lymphatic tissue deteriorates and fibrosis with inflammation, hyperactive immune system which just allows the virus to replicate more, lowered CD4 counts, monocytes/macrophages are a reservoir
200
HIV presentation in the oropharynx
Hairy leukoplakia
Unlike thrush, it cannot be scraped off
201
HIV skin manifestations
Molluscum on the face in an adult is HIV until proven otherwise!
Norwegian scabies
Disseminated cryptococcus and histoplasmosis
202
HIV eye manifestations
CMV retinitis is the most common cause of HIV associated blindness
203
HIV manifestations in the heart
Inflammation and coronary artery disease, effusions, cardiomyopathy
204
HIV and the brain
CNS lymphoma, toxoplasmosis
205
When do you start prophylaxis for OI in HIV patients?
When the cd4 count drops below 200 (usually)
206
Cryptococcosis characteristics
Caused by encapsulated yeast Cryptococcus neoformans
Acquired pulmonary route
Common cause of meningitis in HIV patients, also very high opening pressure and can cause brain herniation.
207
Cryptosporidiosis
Protozoal diarrhea in HIV patients, cholera-like diarrhea
208
Kaposi sarcoma
Commin in HIV patients progressing to AIDS, human herpesvirus type 8, cutaneous patches/plaques/nodules that become brown with time
209
Primary CNS lymphoma
In AIDS patients, CFS cytology for malignancies
210
CNS toxoplasmosis
In AIDS patients, significant for pregnancy
211
What is the most commonly occuring OI in HIV?
Pneumocystis jiroveccii
212
pneumocystis jiroveccii s/s
Fungal lung infection, progressive respiratory failure, "groundglass" filtrates, lungs sound normal but they have a hard time oxygenating
213
What is included in the SOFA score?
Mental status, respiratory rate, and systolic blood pressure
214
What cell types are most active in chronic inflammation?
Monocytes and macrophages
215
What does COMPS stand for and what pathogen causes it?
Conjunctivitis, otitis, meningitis, pneumonia, sinusitis
Strep. Pneumoniae
216
What is the diagnostic test for the flu?
ELISA
But often clinically diagnosed, especially if it is the right clinical picture during flu season
217
Which disease has one of the highest attack rates in all infectious dz?
Measles rubeola!
218
What is the dx test for dengue?
Serologies (IgM and IgG ELISAs)
219
What is the preferred test for chlamydia?
NAAT
220
What is the gold standard for gonorrhea and what is starting to replace it?
Culture, NAAT is starting to replace it
221
What is the preferred test for trichomonas?
NAAT
