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mmi > Heme Bugs > Flashcards

Heme Bugs Flashcards

1
Q

Describe Hepatitis B Virus

A

Hepadnaviridae

dsDNA, Circular

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2
Q

Hepatitis B Clinical

A

Long incubation, insidious onset

Fever, Malaise, Anorexia, N/V, Abdominal Pain, Chills

Icteric: Jaundice, dark urine, pale stools

Chronic: Cirrhosis–> HCC

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3
Q

Acute HBV Infection Serology (what is +)

A

HBsAg

HBeAg

Anti-HBC-IgM

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4
Q

Clear HBV infection serology (what is +)

A

Anti-HBs IgG

Anti-HBe IgG

IgG anti-HBc

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5
Q

Chronic High Risk HBV Serology (what is +)

A

HBsAg

HBeAg

IgG anti-HBc

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6
Q

Chronic Low Risk HBV (what is +)

A

HBsAg

Anti-HBe IgG

IgG anti-HBc

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7
Q

HBV Vaccinated Serology (what is +)

A

Anti-HBs IgG

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8
Q

Describe Hepatitis C Virus

A

Flaviviridae

(+) ssRNA, Enveloped

Binds CD81 Lipoprotein-R for entry

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9
Q

Who is at risk for Hepatitis C

A

IV drug users

Blood transfusions, organ transplants

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10
Q

Goal of Hepatitis C Treatment

A

No detectable viral RNA in blood 12 weeks after therapy

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11
Q

Describe HIV

A

Retroviridae

2 copies of (+) ssRNA, Enveloped

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12
Q

HIV major polyproteins

A

Gag
Pol
Env

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13
Q

HIV essential retroviral enzymes in Pol Polyprotein

A

RT

Integrase

Protease

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14
Q

Describe the early phase of HIV

A

gp120 uses CCR5 co-receptor

M-Tropic: R5 virus

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15
Q

Later phases HIV

A

gp120 mutations change to CXCR4 co-receptor only found on T Cells

T-Tropic: X4 Virus

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16
Q

Describe Yersinia Pestis

A

Plague

Gram (-) Rod: Enterobacteriaceae

Non-lactose fermenting,. intracellular, coagulase (+)

bipolar, safety-pin shaped

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17
Q

Yersinia Virulence

A

Motile at 25C not 37C

F1 Envelope Ag: blocks phagocytosis

Type III Secretion sys: suppresses cytokine production

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18
Q

How is Yersinia Transmitted

A

bite from infected flea with rodent reservoir

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19
Q

How do you diagnose Yersinia

A

Culture bubo fluid and blood

direct fluorescence

serology

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20
Q

How do you treat Yesinia

A

Aminoglycosides

Killed vaccine for military

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21
Q

What is the pathogenesis of Yersinia

A

Release of LPS: cause systemic toxicity, cutaneous hemorrhagic necrosis

spread to lungs: Necrotizing hemorrhagic pneumonia: rapidly fatal

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22
Q

Describe Francisella Tularensis

A

Gram (-) rod with biological warfare implications

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23
Q

Francisella Virulence

A

Intracellular

Polysaccharide capsule inhibits phago-lysosome fusion

infects monocytes/macrophages: endothelial/hepatocytes

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24
Q

How is Francisella Transmitted

A

Tick bite (dermacentor), trauma, inhale aerosolized form, ingestion/contact infected animals

in rabbits, deer, rodents

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25
Q

What are the phases of Francisella Tularensis disease

A

Ulceroglandular

oculoglandular

pneumonic

all have acute onset of fever, chills, and malaise

26
Q

Tularemia Ulceroglandular phase is characterized by

A

Painful papule at bite site: can progress to ulceration

local Lymphadenopathy*

27
Q

Tularemia Oculoglandular Phase is characterized by

A

Painful Conjunctivitis

regional lymphadenopathy

28
Q

Tularemia Pneumonic phase is characterized by

A

pneumonitis with signs of sepsis rapidly developing

29
Q

How do you diagnose Tularemia

A

Small aerosol particles: high risk of sample collection

Direct staining of specimen: fluorescein labeled Ab

Serodiagnosis: monitor Ab increase

Culture: Chocolate Agar Buffered Charcoal Yeast Extract Agar (hazard)

30
Q

How do you treat Tularemia

A

Streptomycin, Gentamicin

live-attenuated vaccine for high risk patients

31
Q

Describe the Brucella Genus

A

Gram (-) Rods, aerobic

names for animals they infect

32
Q

How is Brucella transmitted

A

direct contact with infected/unimmunized animal

Unpasteurized dairy

Targets Mononuclear Phagocytic system: intracellular growth

33
Q

Brucellosis is characterized by

A

Malaise, chills, sweats, fatigue, myalgia, weight loss, arthralgias, fever

Splenomegaly, hepatomegaly, lymphadenopathy

Septicemia, granulomatous response with central necrosis

Undulant Fever

34
Q

Describe the Undulant Fever of Brucellosis

A

Intensity of fever and symptoms recur/recede in 10 day intervals

lasts months to years

35
Q

How do you diagnose Brucella

A

Culture is hazardous: BSL-3 practices suggested

grow slowly: culture incubated for 2 weeks

Brucella agar is supplemented with horse RBC

Serology: Serum Agglutination

36
Q

How do you treat Brucella

A

Doxycycline with Rifampin

Vaccine for Cattle/High Risk Patients

37
Q

Describe Borrelia Burgdorferi

A

Lyme disese

Spirochete: Gram (-) like structure: cannot see on light microscopy

38
Q

Describe the 3 stages of Lyme Disease

A

I: Rash: erythema Migrans

II: Dissemination: CNS: facial N. Palsy, meningitis, Carditis, arthritis

III: Chronic inflammation: chronic arthritis, CNS

39
Q

What is Borrelia Recurrentis

A

Relapsing fever transmitted by tick of body lice bite

Usually only seen in epidemics

40
Q

Describe the presentation of Relapsing Fever

A

Fever, HA, muscle pain, weakness last about 1 week
–they disappear for a few days then return a few days later

Spirochetes appear with new Ag at each relapse*

Complications: Myocarditis, cerebral hemorrhage, liver failure

41
Q

Diagnose Relapsing fever

A

Samples best when patient is febrile due to increased spirochetes in blood

42
Q

How do you treat Borrelia

A

Doxycycline or Erythromycin

43
Q

Describe Ebola and Marburg Viruses

A

Filoviruses: (-) ssRNA, enveloped, filamentous

bat Vector: primate intermediate in Africa

Close contact with infected fluids/tissues can cause deadly hemorrhagic fevers with systemic inflammation

44
Q

Describe Lassa Fever

A

Arenavirus: (-) ssRNA 2x segments, Enveloped

Rat urine/feces vector in Africa

most infections are mild

Severe: facial/pulmonary edema, bleeding, hypotension, deafness

45
Q

Describe Dengue and Yellow Fever

A

Flaviviruses: (+) ssRNA, Enveloped

Dengue: 1st infection mild, 2nd sever joint pain, HA, eye pain, rash, potential hemorrhagic shock syndrome

Yellow Fever: hepatic/renal issues, jaundice, hemorrhage, multiorgan dysfunction

46
Q

Describe Hantavirus and Crimean-Congo Hemorrhagic Fever

A

Bunyaviruses: (-) ssRNA 3x segments, Enveloped

Hanta: Rodent vector: hemorrhagic fever, renal syndrome

CCHF: tick vector: HA, myalgia, fatigue, N/V

47
Q

Describe Filariasis

A

2 common roundworms: Wucheria Bancrofti, Brugia Malayi

Mosquito Vector with definitive human host

inflammation, lymphatic blockage, swelling of extremities/genitalia

infections usually in Africa, Latin America, India, Pacific Islands, Asia

48
Q

Describe Lymphatic Filiariasis

A

Microfilariae leave lymph to blood: in vessels by day, blood at night
–peak in blood between 9pm-12am (nocturnal)

acute: small enlarged nodes

Frequent infections: dying worm stimulate lymph dilation: hyperplastic changesH

49
Q

How to diagnose Lymphatic Filiariasis

A

Eosinophilia

(+) Serology

50
Q

How to treat Lymphatic Filiariasis

A

Diethyl Carbimazine

Dying worms can cause allergic reaction

51
Q

Describe Diphyllobothrium latum

A

largest human tapeworm

can last for decades

52
Q

How is diphyllobothrium latum transmitted

A

ingestion of larvae in freshwater fish

53
Q

Diphyllobothrium Latum Clinical

A

Abdominal discomfort, diarrhea, vomiting, weight loss

B12 deficiency with pernicious anemia

54
Q

how do you diagnose Diphyllobothrium Latum

A

Eggs in Feces

55
Q

How do you treat Diphyllobothrium Latum

A

Praziquantel

56
Q

Hosts for Malaria: Plasmodium

A

Mosquito: Anopheles: sexual reproduction(gametogony)

Humans/animals: Asexual reproduction (Schizogony)

57
Q

What are the 4 species and disease patterns of malaria

A

P. Vivax: Benign Tertian

P. Ovale: Benign Tertian

P. Malariae: Quartan or Malarial

P. Falciparum: Malignant Tertian

58
Q

Malaria Clinical Overview

A

Chill, fever, rigors relapse and reappear

cold stage: sudden onset chills, shivering

hot stage; intense heat, HA, fatigue, dizzy, anorexia, myalgia, profuse sweating then fever breaks

RBC lysis and agglutination, Hb breakdown can lead to splenomegaly and rupture

59
Q

P. Vivax and Ovale Clinical

A

10-17 day incubation: Vivax dormant liver hypnozoite stage

Recurrence every 48 hours (benign Tertian)

Flu-like: myalgia, anorexia, ha, photophobia, drenching sweat

infection progresses: increased # of ruptured Erythrocytes free merozoites: dump toxic cellular debris/Hb into Circulation

60
Q

P. Malariae Clinical

A

18-40 day incubation

Recur every 72 hours (Quartan/Malarial)

Flu-like: moderate to severe attacks last several hours

low parasitemia, more able to cause chronic infection

61
Q

P. Palciparum Clinical

A

7-10 day incubation

Irregular fever spikes on 48 hours cycle (malignant tertian)

flu-like then rapid daily attacks: chills, fever, N/V/D

severe complications: Cerebral malaria, blackwater fever-kidney damage, thrombosis

Usually fatal if untreated

62
Q
A

mmi (4 decks)

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