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Pathology I > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

what is a pathogen

A

organism capable of causing disease

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2
Q

what does high virulence cause

A

disease in a healthy population

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3
Q

what does low virulence cause

A

disease only in susceptible populations

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4
Q

describe an opportunistic infection

A
  • non pathogenic organism
  • low virulence
  • immunocompromised host
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5
Q

describe mutualism

A
  • interaction between two organisms
  • both organisms benefit
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6
Q

describe commnsalism and give an example

A
  • interaction between two organisms
  • one organism benefits
  • other is neither harmed nor helped
  • ex: C. albicans
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7
Q

how do pathogens injure cells and cause tissue damage

A
  • bind to or enter host cells
  • release endotoxins or exotoxins
  • release enzymes that degrade tissue components
  • damage blood vessels and cause ischemic injury
  • induce host inflammatory and immune responses
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8
Q

what are the general principles of viral infections

A
  • intracellular parasites
  • cell type specific
  • viral latency
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9
Q

what is a virus made off

A

nucleic acid

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10
Q

what are the steps in viral infection and replication

A
  • attach
  • penetrate
  • reproduce
  • assemble
  • release
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11
Q

what are the types of viral infections

A
  • transient infections
  • chronic latent infections
  • chronic productive infections
  • transforming infections
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12
Q

what is an example of a transient infection

A

hepatitis A virus

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13
Q

what is an example of a chronic latent infection

A

herpes simplex virus

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14
Q

what is an example of a chronic productive infection

A

hepatitis B virus

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15
Q

what is an example of a transforming infections

A

Epstein Barr Virus, Human Papilloma Virus

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16
Q

what are the resevoir of human herpes virus

A

humans

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17
Q

what are the periods of HHV

A

latency
- reactivation

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18
Q

what is HHV-1

A

herpes simplex virus Type 1

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19
Q

what is HHV-2

A

herpes simplex virus type 2

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20
Q

what is HHV-3

A

varicella zoster virus

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21
Q

what is HHV-4

A

epstein barr virus

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22
Q

what is HHV-5

A

cytomegalovirus

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23
Q

what is HHV-8

A

Kaposi Sarcoma associated virus

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24
Q

what is the transmission of HSV

A
  • contact with affected individual shedding virus
  • symptomatic active lesions
  • asymptomatic viral shedding
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25
Q

what is another name for HHV -1

A

-herpes labialis
- fever blister
- cold sore

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26
Q

describe the lesions in HHV-1 and common location

A

start as vesicles then rupture and turn into ulcers
- mostly oral infections

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27
Q

where are HSV-2 infections located

A

mostly genital infections

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28
Q

what is a primary infection with herpes simplex virus and what age does it occur with

A
  • initial exposure to virus in an individual without immunity
  • occurs at young age after physical contact with infected individual
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29
Q

what percentage of population of US has antibodies to HSV

A

80%

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30
Q

describe the presentation of primary herpetic gingivostomatitis

A
  • flu like illness with fever, malaise, arthralgia, headache
  • cervical lymphadenopathy
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31
Q

what tissues in the oral cavity are affected in primary herpetic gingivostomatitis and primary infection with herpes simplex virus

A

all tissues in the oral cavity

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32
Q

where do recurrent herpes labialis occur and what is the presentation

A
  • anywhere
  • patient will be sick and have systemic signs
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33
Q

where do recurrent intra oral herpes occur and give examples of the tissues it would be on

A
  • on bound down mucosa
  • on keratinized mucosa
  • on nonmovable tissues
  • ex: hard palate and attached gingiva
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34
Q

where does the herpes simplex virus stay dormant in its latent phase

A

trigeminal ganglion

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35
Q

what cells are affected by the herpes simplex virus

A

epithelial cells

36
Q

describe the histopathology of herpes viruses

A

they all look the same, the clinical presentation is what differs

37
Q

when is herpes gladiatorum spread

A

in close contact sports like wrestling

38
Q

what is recurrent aphthous stomatitis

A
  • canker sore
  • focal mucosal destruction
  • T lymphocyte mediated cytotoxic reaction
39
Q

is recurrent aphthous stomatitis an infectious disease

A

NO

40
Q

what is the presentation of recurrent aphthous stomatitis

A

yellowish purulent exudate covering the ulcer with a red/erythematous halo surrounding the ulcer

41
Q

what is the evolution of an aphthous ulcer

A

erythematous macule -> ulceration -> fibrinous membrane

42
Q

what are the precipitating factors for recurrent aphthous stomatitis

A
  • sodium lauryl sulfate (SLS)
  • stress
    -trauma
  • allergies
  • acidic foods/ juices
  • gluten
  • endocrine alterations
43
Q

where do recurrent aphthous stomatitis lesions occur

A
  • nonkeratinized mucosa
  • non bound down mucosa
  • movable mucosa
44
Q

what are the 3 categories of recurrent aphthous stomatitis

A
  • minor aphthae
  • major aphthae
  • herpetiform aphthae
45
Q

how long do recurrent aphthous stomatitis lesions, primary herpes lesions and recurrent herpes

A

about 2 weeks

46
Q

what lesions have a clinical history of having lesions prior

A
  • minor aphthae
  • major aphthae
  • recurrent herpes
47
Q

describe minor aphthae

A
  • recurrent
  • shallow, painful ulcerations on non keratinized mucosa
  • solitary or multiple lesions
  • heals in two weeks
48
Q

describe major aphthae

A

-larger (greater than 0.5cm)
- deeper- may heal with scarring
- heal slowly- weeks to months

49
Q

describe herptiform aphthae

A
  • crops of small, shallow, painful ulcers
  • heal in two weeks
  • short remissions
50
Q

herpetiform aphthae resembles recurrent intra oral herpes simplex BUT:

A
  • located on non keratinized mucosa
  • does not begin as vesicles
51
Q

is there a vesicular stage in recurrent herpes? recurrent aphthae?

A

-yes
- no

52
Q

what is the number of lesions in recurrent herpes? recurrent aphthae?

A
  • multiple, confluent
  • frequently solitary
53
Q

what is the location of recurrent herpes? recurrent aphthae?

A
  • masticatory mucosa (keratinized)
  • moveable mucosa (nonkeratinized)
54
Q

what systemic diseases are associated with aphthous like lesions

A
  • Behcet’s syndrome
  • Reiter’s syndrome
  • IBS: ulcerative colitis and Chron’s Disease
  • malabsorption syndromes: gluten sensitive enteropathy
  • cyclic neutropenia
  • HIV/AIDS
55
Q

what is the primary infectiion with varicella zoster virus

A
  • varicella
  • chicken pox
56
Q

what is the recurrent infection with varicella zoster virus

A
  • zoster
    -shingles
57
Q

what cells are seen in varicella zoster virus histology

A

Tzanck cells

58
Q

describe varicella (chicken pox)

A
  • transmission by inspiration of infected droplets
  • clinical disease in most individuals
  • constitutional symptoms
  • skin lesions begin on face/trunk
  • vesicles in repeated waves
  • heal without scarring
  • can be intra oral
59
Q

where does the varicella (chicken pox) stay dormant

A

in the spinal ganglion

60
Q

describe herpes zoster (shingles)

A
  • prodrome of pain, paresthesia
  • unilateral dermatomal involvement
61
Q

what is the clinical presentation of the lesions associated with herpes zoster (shingles)

A
  • vesicles that will rupture -> ulcerations
62
Q

what is the progression of pain in shingles

A
  • prodromal pain
  • acute pain
  • chronic pain: post herpetic neuralgia
63
Q

describe epstein barr virus

A
  • herpes virus- HHV-4
  • most adults EBV+
  • latency
  • tropism for B lymphocytes
  • infects epithelial cells of oral mucosa, oropharynx and nasopharynx
64
Q

what are the associations of epstein barr virus with human disease

A
  • infectious mononucleosis
  • lymphomas- NHL (Burkitt lymphoma) and HL
  • nasopharyngeal carcinoma
  • oral hairy leukoplakia
65
Q

what are the clinical features of infectious mononucleosis

A
  • debilitating EBV infection
  • self limiting
  • young adults
  • salivary transmission
  • fatigue
  • malaise
  • lymphadenopathy
  • fever
  • sore throat
66
Q

what is the blood test for mono

A
  • increased lymphocytes
  • atypical lymphocytes called Downey Cells
67
Q

how can infectious mononucleosis affect the oral cavity

A

can cause necrotizing ulcerative gingivitis

68
Q

what are the other laboratory tests for infectious mononucleosis

A
  • heterophile antibody: IgM antibody - induced by EBV infection. binds to Paul-Bunnell antigen of sheep and bovine RBCs. non specific antibody- not specific for EBV
  • monospot test- detects heterophile antibody
  • EBV specific testing
69
Q

what is the treatment for infectious mononucleosis

A
  • symptomatic therapy
  • bed rest, prevent splenic rupture
70
Q

describe oral hairy leukoplakia and where it is found

A
  • epithelial hyperplasia associated with EBV infection
  • lateral border of tongue
  • in any immunodeficient state
71
Q

what is hairy tongue

A

elongation of filiform papilla

72
Q

what is cytomegalovirus

A
  • HHV-5
  • most of population affected by age 60
  • most CMV infections are asymptomatic
73
Q

what are the stages of cytomegalovirus

A
  • initial infection
  • latency
  • reactivation
74
Q

acute infection by cytomegalovirus is similar to:

A

infectious mononucleosis (EBV)

75
Q

describe the acute infection by cytomegalovirus histology

A

heterophile antibody negative

76
Q

what are the oral symptoms associated with acute infection by cytomegalovirus

A

rarely acute sialadenitis with painful swelling and xerostomia

77
Q

what can cytomegalovirus infections in immunocompromised individuals cause

A
  • retinitis: blindness
  • colitis
78
Q

describe Coxsackie group A

A

self limited disease that occurs in epidemics of flu like symptoms in young children

79
Q

how is coxsackie group A transmitted

A

fecal- oral and airbrone

80
Q

describe herpangina and where its found

A
  • constitutional symptoms
  • begins as small vesicles that rupture and ulcerate
  • posterior oral cavity and oropharynx
81
Q

describe the lesions of hand foot and mouth disease

A

vesicular eruption of hands, feet and anterior mouth

82
Q

describe measles (rubeola)

A
  • childhood infection
  • communicable disease
    -skin rash
  • measles, mumps, rubella (MMR) immunization
83
Q

describe the presentation of measles

A
  • koplik spots- intra oral spots
  • “grains of salt” on an erythematous base
  • foci of epithelial necrosis
84
Q

describe mumps

A

-childhood infection
- communicable disease
-measles, mumps, rubella (MMR) immunization
- 30% subclinical infection
- prodromal constitutional symptoms
- salivary gland swelling and discomfort

85
Q

what are the lab findings in mumps

A
  • elevated serum amylase - released from granules during lysis of acinar cells
  • specific serologic tests
86
Q

what are the complications of mumps

A
  • rare in young and more common in older individuals
  • orchitis, oophoritis, mastitis, meningitis, thyoiditis, pancreatitis
  • sterility, hearing loss
87
Q
A

Pathology I (24 decks)

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