Micro Flashcards
1
Q
Chronic granulomatous disease affecting peripheral nerves and superficial tissue (nasal mucosa)?
A
Leprosy
2
Q
Reservoir for Leprosy?
A
Armadillos + humans
3
Q
Acid fast bacilli causing “glove and stocking” loss of sensation?
A
M. leprae
4
Q
Causes diffuse skin lesions esp. Ear + perforation of nasal mucosa+ loss of fingers + atrophy of testicles?
A
Lepromatous Leprosy
5
Q
Fist sings of Lepromatous leprosy?
A
Edema + rhinitis
6
Q
Single peripheral skin lesions w/ low numbers of acid fast bacilli? Prognosis?
A
Tuberculoid leprosy
Good prognosis= spontaneous healing
7
Q
Characterized by low cell-mediated immunity with a Humoral Th2 response (LACK Th1 mediators)?
A
Lepromatous leprosy
8
Q
What is the characteristic of Tuberculoid leprosy immunity response?
A
High cell mediated response with Largely Th1 mediated response
9
Q
Tx of Tuberculoid leprosy?
A
Sulfone (Dapsone) + rifampin for 6 months
10
Q
MOA of Sulfone?
A
Inhibits para-aminobenxoic acid metabolism
11
Q
Tx of lepromatous leprosy?
A
Dapsone + rifampin + Clofazimine (at least 2yrs)
12
Q
Prophylaxis tx for Leprosy in children?
A
Dapsone
13
Q
LEpromatous leprosy is?
A
LEthal
14
Q
Herpes Virus Genome?
A
Enveloped DS linear DNA
15
Q
Method for HHV detection?
A
PCR
Tzanck test
16
Q
Tzanck test?
A
HHV–> smear to detect multi nucleated giant cells in VZV infected skin fragments
17
Q
VZV is a?
A
Alphaherpesvirus
18
Q
HHV6 + HHV7?
A
Betaherpesvirus
19
Q
Latency HHV?
A
Soon after initial infection
NO virus particles are produced
Entire genome maintained extrachromasomally
20
Q
Neurotropic latency?
A
VZV
21
Q
Lymphotrophic latency?
A
HHV6 + HHV7
22
Q
Fever followed by itchy rash starting on scalp and trunk? (primary infection only)
A
Varicella (chickenpox)
23
Q
Shingles?
A
Reactivation of VZV
24
Q
Adult w/ Sudden onset of pain and rash or Pneumonia? Reactivation
A
Shingles (VZV)
25
Tx for Adult w/ Pneumonia and Painful rash?
Acyclovir and Steroids
26
Vaccine for VZV?
Live attenuated vaccine w/ MMR regiment
| adults>50yo: Designed to boost immunity to prevent or lessen Zoster
27
HIGH fever--> Seizures--> Macular rash?
Roseola (HHV 6+7)
28
Age range for HHV 6+7?
3mo -- 6yo
29
Time course for VZV to show up as chickenpox?
Infection-> replication in lymph nodes-> primary viremia-> Replication in organs-> 2nd viremia-> SKIN Vesicular Rash (14 days)
30
Parvovirus structure?
Linear single stranded DNA + nonenveloped
31
Where do parvovirus replicate?
Rapidly dividing cells-> to use active DNA poly
| RBC precursors
32
Virus that causes decreased reticulocyte count?
Parvovirus B19
33
Five most common childhood diseases?
```
Chickenpox
measles
Rubella
Roseola
Parvo B19
```
34
"fifth disease" or "slapped cheek rash"
Erythema infectiosum (B19)
35
Causes "Lacy rash on the trunk and limbs?"
B19 erythema infectiosum
36
Adult experiencing Joint pain or swelling (polyartheritis) + flu like symptoms + small rash?
B19 erythema infectiosum
37
What virus causes transient aplastic crisis in SCD patients?
B19 because it replicates in RBC precursors and thus reduces the reticulocyte count
38
B19 infection in pregnant women?
Transplacentally transmitted to fetus and can cause fetal anemia. hydrops fetalis, or miscarriage
39
Variola virus structure?
Smallpox= Complex ("brick shaped"), intracellular core, lateral bodies, enveloped
Large DS DNA
40
Where does Smallpox replicate?
Even though its a DS DNA virus it replicates in the CYTOPLASM
41
Rash that starts in Head or limbs w/ vesicles that hve a dot in the middle + which become hard then crust over and fall off?
Smallpox infection--> all lesion @ same stage
42
Two basic forms of Smallpox?
Variola major--> 25% death rate
| Variola minor--> 1% death rate
43
Smallpox mode of transmission?
Inhalation causing systemic disease w/ generalized rash
44
pt w/ HIGH fever, malaise, aches, red spots in the mouth and tongue, firm pitted lesions all same stage?
Smallpox infection
45
Afebrile pt w/ superficial lesions all in different stages?
Chickenpox
46
Tropical disease w/ lesions on face, trunk, and limbs?
Childhood Molluscum contagiosum
47
Young adulthood form of Molluscum contagiousum?
Lower abdominal lesions
| Sexually transmitted
48
Lesions disappear 2-12 months
| Large cytoplasmic inclusions in eosinophils?
Molluscum contagiosum (adulthood form)
49
Who should not receive the Live smallpox vaccine?
Pregnant or breast feeding women
Immunocomprimised
People w/ eczema, atopic dermatitis, severe acne
CHF pts
50
Life threatening complications of Live smallpox vaccine?
Progressive vaccinia (CMI defects)
Postvaccinial encephalitis
Eczema
Myopericarditis or heart attacks
51
Measles Prodrome 3Cs?
Coryza
Cough
Conjunctivitis
52
Pt w/ white spots overlying erythematous base in the buccal mucosa?
Koplik spots (measles)
53
Complications of Measles?
Giant cell pneumonia
Acute appendicitis (children)
Otitis media
NON teratogenic
54
3 day Rash beginning at hairline and spreading cephalocaudally + Red spots on Posterior soft/hard palate?
Rubella (Togavirus)
55
Painful Postauricular LAD + polyarthritis?
Rubella (togavirus)
56
Viruses causing polyarthritis in adults?
Rubella + parvovirus
57
Child <2 yo w/ high Fever and maculopapular rash?
Roseola infantum (HHV 6)
58
Child w/ generalized rash >3 days, Temp> 38.3 + cough, conjunctivitis and rhinorhea?
Measles
59
Measles genome and mode of transmission?
- RNA
Lacks NA but has H rather than HA protein
trans: Respiratory route
60
Measles rash coincides w/?
T cell response and clearance of virus
61
Replication in lymphoid tissue results in reticuloendothelial Giant cells?
Early stage of Measles
62
Complication of Measles?
0-1 month--> acute Encephalitis
1-9 months--> Measles inclusion body enceph
1-12 years--> Subacute slerosing Panencep
63
Both measles and mumps are antigenically stable monotypic viruses?
Once infected or vaccinated Immunity is for Life
64
Virus initially infects nasal mucosa + URT epithelium and spreads via lymph nodes?
Mumps
65
Pt with infected Parotid gland?
Mumps (first clinical sign)
66
Complications of mumps?
```
Aseptic meningitis
Deafness
Gonadal atrophy
Myocardial invasion
type I DB
Abortion
```
67
Pt w/ low grade fever, conjunctivitis, sore throat, LAD and Morbilliform rash?
Rubella
68
Rubella virus in pregnant women?
Abortions
| Birth defects: motor or mental, deafness, CHD, cataracts
69
Rubella tx and antivirals?
vaccine for Fetal protection
| NO antivirals because Disease is mild
70
What virus has H protein, lacks NA, and forms intracellular inclusion?
Measles virus
71
Measles virus genome and transmission?
non segmented -RNA
| Respiratory route
72
What does the Rash in measles coincide with?
T cell response and virus clearance
73
Rash lasting >3 days
Temp >38.3
Cough, rhinorrhea, conjunctivitis ?
Measles
74
Wathin-Finkeldey cells= Reticuloendothelial giant cells?
measles replication in lymphoid tissue
75
Maculopapular rash + Koplik spots?
Measles
76
Complication of Measles includes?
ADEM + PIE-> encephalomyelitis (AI demyelinating)
MIBE--> Measles inclusion body encephalitis
SSPE--> Subacute sclerosing panencephalitis
77
Measles vaccine?
Live attenuated--> life long protection
78
Viruses exhibiting monotypic antigenic stability?
Measles + Mumps--> Monotypic meaning no Ag shift or drifts ONE VACCINE needed
79
First clinical sign of Mumps infections?
Infection of Parotid gland
80
Complication of Mumps?
CNS: Aseptic meningitis + Deafness
Few: gonadal + myocardial + abortions
81
Togavirus genome?
Rubella= nonsegmented +RNA
82
Mild disease w/ low fever,conjunctivitis, Sore throat, LAD and RASH?
Rubella
83
Spread of Togavirus (rubella)?
Virus sheds from skin after rash diapers (up to 1mo)
84
Pregnancy and Rubella?
Causes congenital birth defects
85
Rickettsia characteristics?
G- Rods
| Obligate intracellular parasites
86
Rickettsia replication?
Cytoplasm of Endothelial and muscle cells of small BV
87
Vehicle for Rocky mountain spotless fever?
TICKs
88
Flu symptoms--> Rash from ankles+ wrists to palms + soles+ trunk?
Rocky mtn spoted fever (RMSF)
89
Rash on soles and palms w/ significant calf tenderness?
RM Spotted Fever
90
Measures cross reactivity of anti-rickettsial antibodies to Proteus OX strains?
Weil-Felix test
91
Dx of RM Spotted Fever?
Indirect fluorescent Ab assay
| Weil-Felix test
92
Tx of RMSF?
Prevention
| Doxcycyline
93
Typhus mode of transmission?
Body lice
94
Associated w/ Poverty + war?
body lice thus Typhus
95
Ehrlichia chaffeensis (HME) transmission + replication?
Lone Star Deer Ticks
| replicated in MONOCYTES
96
Dx of E. chaffeensis?
Wright/ Giemsa stain of Morulae in Monocytes
97
Tx of E. Chaffeensis?
Doxycycline
98
Morulae?
inclusion bodies formed by replicating microbes
99
What organisms form Morulae?
E. chafeensis
| A phagocytophilia
100
A. phagocytophilia transmission and replication?
Ixodes Deer Tick
| HMA= replicates inside granulocytes
101
Cause of "Rocky mtn Spotless fever?"
A. phagocytophilia (RASH is rare)
102
Cause of "Rocky mtn spotted fever?"
Rickettsia
103
Replicates in monocytes?
Anaplasma
104
Replicates in Granulocyte?
Ehrlichia
105
Cause of relapsing fever in Borrelia?
Undergo Antigenic variation
106
B. burgdorferi is causative agent of?
Lyme disease
107
Lyme disease is transmitted by?
Ixodes deer tick NyMPH
108
Classic Bull's eye rash @ site of bite?
Early Lyme disease
109
Arthritis, Facial palsy, and peripheral neuropathy?
2nd Lyme disease (disseminated)
110
Erosive arthritis @ KNEEs + numbness + Bell Palsy?
Chronic Lyme disease
111
Dx of Lyme disease?
ELISA + Western blot
| PCR based NAATs
112
Tx of early and chronic lyme disease?
Early-> Doxycycline
| Chronic--> IV cephalosporins
113
B hermsii or B recurrentis cause?
Relapsing fever
114
Transmission of B. hermsii?
TIck
115
Transmission of B recurrentis?
Louse
116
Endemic in Western US?
B hermsii
117
Dx and Tx of relapsing fever?
Wright/ Giemsa stain
Serology
Tx: DOXY
118
Leptospira interogans is transmission?
Water contaminated w/ Animal urine
119
Flu symptoms + Renal Damage + Jaundice + Meningitis?
Leptospira
120
Tx and Dx for Leptospirosis?
Serology + penicillin
121
Bartonella hensalae transmission?
Cat scratch fever
122
Swollen lymph nodes and scratch marks--> TX?
Erythromycin or spontaneous
