Infectious diseases Flashcards

1
Q

What is the pathogenesis of HSV infection?

A
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2
Q

What are the clinical manifestations of HSV?

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Oral facial infection: gingivostomatitis and pharyngitis (most common clinical manifestation of HSV1 infection), herpes labialis (most common clinical manifestation of reactivation of HSV 1 infection): vesicular lesions on an erythematous base of oral mucosa commonly referred to as cold sores
Genital herpes: recurrence of genital herpes common but less severe and shorter duration
CNS infection: HSV encephalitis (neonates: HSV1/HSV2, in adults –> nearly all causes are HSV1), HSV meningitis (HSV2), Bells palsy
Ocular infection: HSV keratitis (chemosis, conjunctivitis and characteristic dendritic lesions of cornea), chorioretinitis, acute retinal necrosis
Cutaneous manifestation: herpetic whitlow (HSV infection of the finger –> complication of primary oral or genital herpes by inoculation of virus through a break in skin barrier), herpes gladiatorum (face, neck and arms), eczema herpeticum (atopic dermatitis patients are at risk), erythema multiforme
Visceral infections: HSV proctitis, HSV esophagitis, HSV hepatitis (both HSV1 and HSV2. Lab findings: leukopenia, coagulopathy, elevated serum aminotransferase level and bilirubin), HSV pneumonitis (uncommon except in immunocompromised patients): results from direct extension of herpetic tracheobronchitis into lung parenchyma

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3
Q

What are the biochemical tests for HSV?

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4
Q

What is medical treatment for HSV infection?

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5
Q

What are the general features of varicella zoster virus?

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6
Q

What is the pathogenesis of VZV?
Primary and reactivation

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7
Q

What are the SS of chickenpox?

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8
Q

What are the SS of shingles?

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9
Q

What is the biochemical tests for VZV?

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10
Q

What is treatment for varicella and herpes zoster (shingles)

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11
Q

What is the treatment for complicated VZV infection?

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12
Q

What are the complications of chickenpox?

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13
Q

What are the complications of shingles?

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14
Q

What is the prevention of VZV?

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15
Q

What is the triad of infectious mononucleosis, route of transmission?

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16
Q

what is the ddx of infectious mononucleosis

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17
Q

What is the pathogenesis of infectious mononucleosis?

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18
Q

What general features and PE for infectious mononucleosis?

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19
Q

What biochemical tests for infectious mononucleosis and results

A

CBC with DC: leukocytosis with lymphocyte predominance
Peripheral blood smear: lymphocytosis, atypical lymphocytosis (defined as atypical lymphocyte >10% of total lymphocytes. Atypical cells are primarily mature CD8+ CTL that have been antigenically activated
LFT: may show hepatitis pattern
Heterophile antibodies (monospot test): latex agglutination assay using horse RBC as substrate for heterophile antibodies to agglutinate
EBV specific antibodies: EBV VCA IgM (most valuable), EBNA (nuclear antigen)
EBV DNA PCR

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20
Q

What is the general management of infectious mononucleosis?

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21
Q

What are the complications of infectious mononucleosis?

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22
Q

What is the pathogenesis of mumps?

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23
Q

What specific symptom of mumps?

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24
Q

What biochemical test for mumos:

A

CBC with DC
Serology: IgM in serum confirms acute infection
RT-PCR
Viral culture

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25
Q

What is complications of mumps infection?

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26
Q

What is prevention of mumps?

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27
Q

What is mode of transmission, incubation period and infectious period of measles?

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28
Q

What are the RF of measles infection?

A
  • Children too young to be vaccinated
  • Individuals without vaccination
  • Individuals without a 2nd dose of vaccination
  • Individuals with vaccination but failed to elicit a protective immune response (very small
    fraction of those immunized)
  • Travelers to areas where measles is endemic or contact with ill person arriving from those countries
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29
Q

What is the pathogenesis of infection of measles?

A

 Infection occurs in upper respiratory tract epithelium
 Viral replication in upper respiratory tract epithelial cells and LNs leads to primary viremia in
around 2 – 3 days
 Subsequent dissemination to distal reticuloendothelial sites such as spleen leads to secondary
viremia in around 5 – 7 days
* Secondary viremia leads to spread to respiratory tract and other organs

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30
Q

What is clinical course of measles?

A
31
Q

What Ix for measles?

A
32
Q

What treatment for measles?

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33
Q

What are the complications of measles?

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34
Q

When is vaccination for measles done?

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35
Q

What is the general features of rubella
mode of transmission
incubation period and infecitous period

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36
Q

What are the SS for rubella?

A
37
Q

What Ix and tx for rubella?

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38
Q

What are the complications of rubella>

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39
Q

How to diagnose maternal rubella
Management of women with possible exposure to rubella virus
dx of congenital rubella infection after delivery

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40
Q

How to prevent rubella?

A
41
Q

What are the regions affected by enteric fever
What transmission and reservoir?

A
42
Q

What bacteria causes enteric fever?

A
43
Q

What is the clinical course of enteric fever
What SS?
Complications

A
44
Q

What tests for suspicion of enteric fever?

A
45
Q

What is management of enteric fever?

A
46
Q

What is the prevention of typhoid/paratyphoid fever?

A
47
Q

What is ricketssia
what mode of transmission and incubation period?

A
48
Q

What is the geographical distribution of rickettsial illness?

A
49
Q

What is the rickettsia and orientia species categorized into?

A
50
Q

What is the pathogenesis of rickettsial illness?

A

Bacteria are transmitted via arthropod saliva during bite
* Bacteria multiply and penetrate skin at site of arthropod bite
* Primary target cells are vascular endothelial cells except for Orientia tsutsugamushi and Rickettsia akari which infects monocytes
* Replication in endothelial cells of small blood vessels causes vasculitis and local hemorrhage and certain species cause local skin necrosis (eschar) at exposure site
* Regional lymphadenopathy is common in infection with Orientia tsutsugamushi and some members of spotted fever group

51
Q

What is SS of ricketssial illness?

A
52
Q

What is SS of rocky mountain spotted fever (rickettsial)?

A
53
Q

What is SS of Meditteranean spotted fever (rickettsial)?

A
  • Classic triad variably present
  • Presents with rash that may be macular, maculopapular or purpuric
  • Presence of inoculation eschar at tick bite sites
  • Associated laboratory features include thrombocytopenia, hyponatremia and abnormal
    LFT
54
Q

What is SS of epidemic typhus (rickettsial)?

A
  • Classic triad variably present
  • Presents with macular or petechial rash that spread centrifugally
    o Centrifugal spread meaning lesions first arise on trunk and spread gradually towards the wrist and ankles
  • Neurological symptoms are common and range from confusion, seizure to coma
  • Inoculation eschar is typically NOT present at sites
  • Associated laboratory features include thrombocytopenia and abnormal LFT
55
Q

What is SS of murine typhus (rickettsial)?

A
  • Classic triad occurs in 15% of cases
  • Presents with macular or petechial rash that spread centrifugally
    o Centrifugal spread meaning lesions first arise on trunk and spread gradually towards the wrist and ankles
  • Inoculation eschar is typically NOT present at sites
  • Associated laboratory features include anemia, thrombocytopenia, hyponatremia and
    abnormal LFT
56
Q

What is SS of scrub typhus (rickettsial)?

A
  • Classic triad variably present
  • Presents with rash in 30% of cases and is macular, transient and pale
  • Distinct feature includes eschar in 50% of cases and may be multiple and associated localized lymphadenopathy
  • Neurological symptoms may be present ranging from slight intellectual blunting to delirium and coma
  • Associated laboratory features include anemia, thrombocytopenia, hyponatremia and abnormal LFT
57
Q

What tests for rickettsia?

A
58
Q

What treatment for rickettsia?

A
59
Q

What is the micbio of dengue virus?

A
60
Q

What is the pathogenesis of dengue fever?

A
61
Q

What is the clinical manifestation of dengue fever?

A
62
Q

What are the 3 categories of symptomatic dengue virus infection and description based on WHO 1997 (outdated)?

A
63
Q

What are the 3 categories of symptomatic dengue virus infection and description based on WHO 2009 ?

A
64
Q

How to confirm dx of dengue fever?

A

 Early phase of illness
* Detection of virus by cell culture
* Detection of viral nucleic acid by nucleic acid amplification tests
* Detection of viral antigens by ELISA
 End of acute phase of illness
* Detection of antibodies by serology

65
Q

What biochemical tests done for dengue fever?

A
66
Q

What are the virus types causing malaria?
What conditions protect against malaria?

A

 5 Different types of plasmodium species
* Plasmodium falciparum (most common and severe)
o Most prevalent malaria parasite on the African continent and responsible for most malaria-related deaths globally
* Plasmodium vivax
o Dominant malaria parasite in most countries outside of sub-Saharan Africa
* Plasmodium malariae
* Plasmodium ovale
* Plasmodium knowlesi

 Conditions that protects against malaria
* G6PD deficiency
* Thalassemia
* Hemoglobinopathies (Hb S/C/SC/E/F)

67
Q

What is the region, transmission and incubation period for malaria?

A
68
Q

What is the life cycle of plasmodium species in human hosts?

A
69
Q

What is the classical SS for malaria?

A
70
Q

What are the SS of severe malaria?

A
71
Q

What biochemical tests for malaria?

A
72
Q

What is the treatment of uncomplicated malaria?

A
73
Q

What is the treatment for complicated malaria?

A
74
Q

What is done for prevention of malaria?

A