Micro - Evals 6 Flashcards
(187 cards)
1
Q
VIRUSES AFFECTING CVS AND LYMPHATICS
A
Paramyxovirus Arbovirus Flavivirus - Dengue, Yellow Fever Alphavirus - Chikungunya Togavirus - Rubella virus Picornavirus - Poliovirus and Coxsackievirus Herpesvirus - CMV and EBV Filovirus
2
Q
Type of viremia that is responsible for viral spread of Paramyxovirus to the salivary glands, testes, ovaries, pancreas and CNS
A
Primary viremia
3
Q
Type of viremia that is responsible for generalized viral spread of Paramyxovirus to the salivary glands and other glands, as well as the other body sites including the kidneys
A
Secondary viremia
4
Q
Incubation period of Paramyxovirus
A
2-4 weeks
5
Q
Primary characteristic of mumps infection
A
Gopher-like swelling of the cheeks
6
Q
Prognosis of mumps
A
Self-limiting
Anti-pyretics can be given
7
Q
Site of primary replication of mumps virus
A
Nasal or URT
8
Q
Complications of mumps
A
Orchitis and epididymitis
Pancreatitis
Viral meningitis
Hearing loss
9
Q
Most important in diagnosing mumps
A
History and PE
10
Q
Samples used for serologic testing for mumps
A
Saliva - present after 1 week since onset
Urine - present upto 2 weeks since onset
CSF
11
Q
Timing of collection of sample
A
Within a few days of onset of disease
12
Q
Prevention of mumps
A
Live attenuated mumps vaccine
13
Q
Virus families under Arboviruses
A
Bunyaviridae
Flaviviridae
Togaviridae
14
Q
Diseases caused by Arboviruses
A
Mild undifferentiated fevers
Severe encephalitis
Life-threatening hemorrhagic fever
15
Q
Virus responsible for Crimean-Congo hemorrhagic fever
A
Nairovirus
16
Q
Most important vectors of Arboviruses
A
Mosquitoes
Ticks
Flies
Gnats
17
Q
Incubation period of Arboviruses
A
1 week
18
Q
Characteristics of morbiliform rash
A
Maculopapular
Secondary to endothelial cell damage and increased vascular permeability
19
Q
Flaviviruses are sensitive to
A
Heat
UV radiation
Disinfectants
20
Q
Glycoproteins in Flavivirus lipid envelope
A
M and E glycoproteins
21
Q
E glycoprotein biologic properties
A
Viral cellularity attachment
Endosomal membrane function
Display of sites mediating hemaglutination and viral neutralization
22
Q
Most prevalent flavivirus infection and biggest Arbovirus problem in the world
A
Dengue
23
Q
Transmission of dengue
A
Man-arthropod-man
Also vertical transmission, passively acquired antibodies, pre-existing heterologous dengue antibody
24
Q
Principal mosquito vector of Dengue and Chikungunya
A
Aedes aegypti (polka-dotted day-biters)
25
Syndrome produced by heterologous immunity to dengue
Dengue-Hemorrhagic Fever or Dengue Shock Syndrome
26
Site of viral replication of Flavivirus
Monocytes
27
Increased vascular permeability in DHF-DSS may be due to
Increased levels of soluble TNF
IFN-gamma
Complement system activation
28
Dengue type 1: ?
| Dengue type 2: ?
Dengue type 1: Dengue fever
| Dengue type 2: Dengue hemorrhagic fever
29
Cause of immunopathologic response if DHF
Virus-antibody complex
30
Characteristic symptoms of Breakbone fever
Myalgia and deep bone pain
Saddleback form fever
Scarlatiniform rash
Severe frontal headache and retro-orbital pain (adults)
31
Differentiating feature of DHF from Dengue fever
It has defervescence within 2-7 days
32
Characteristic features of DSS
Shock and hemoconcentration
33
Laboratory diagnosing test with high sensitivity and high specificity
Rapid immunochromatographic test
34
Contraindicated drug when treating Dengue
Aspirin to prevent Reye's syndrome and hemostatic problems
35
Prevention of Dengue
```
Mosquito eradication (4 o'clock habit)
No effective vaccine
```
36
Transmission of Yellow Fever (2 cycles)
Urban yellow fever
| Jungle yellow fever
37
Human-to-human transmission by A. aegypti
Urban yellow fever
38
Infected monkeys-to-humans transmission by Haemagogus
Jungle yellow fever
39
Clinical presentation of frank yellow fever
Sever hemorrhagic manifestations
Oliguria
Hypotension
40
Diagnosis of yellow fever
Usually clinical
| If available: viral isolation, postmortem, serology
41
Prevention of yellow fever
Live attenuated vaccine
42
Three major groups of Alphavirus
West African
Central African
Asian
43
Common physical symptoms of Chikungunya
Redness of eyes
| Difficulty looking at light
44
Prevention of Chikungunya
Piricardin containing insect repellants
| Treating clothes with permethrin
45
Host of Togavirus
Humans only
| No invertebrate host
46
Togavirus transmission
Aerosol droplets
47
Drug that inhibits Togavirus
Amantadine
48
Immunity from Togavirus
Life long immunity but reinfections can still occur
49
Clinical features of Rubella
Maculopapular rash
Lymphadenopathy
Fever
Athropathy
50
Risk of Rubella during pregnancy
Precoception: minimal
0-12 weeks: 100% risk; spontaneous abortion
13-16 weeks: deafness and retinopathy
After 16 weeks: normal development
51
Classical triad of Congenital Rubella Syndrome
Cataracts
Heart defects
Sensorineural deafness
52
Prevention of CRS
Terminate pregnancy
53
Diagnosis of Rubella
Serial rising titers of antibody - HAI, EIA
| Placental biopsy and specific IgM fetal blood
54
Falling rubella antibody titer indicates
Passively acquired maternal antibody
55
Rising rubella antibody titer indicates
Rubella infection
56
Rubella IgM in newborn infant serum
Transplacental infection
57
Prevention of Rubella infection
Antenatal screening
| Live attenuated vaccine - women should not get prenant at least 3 months after vaccination
58
Non-enveloped Picornavirus that causes acute enteroviral infection of the spinal cord that may cause neuromuscular paralysis but are mostly subclinical
Poliovirus
59
Poliovirus serotypes that cause severe disease
Serotypes 1 and 3
60
Only reservoir of Poliovirus
Humans, most commonly children
61
Poliovirus transmission
Fecal-oral route
| Flies as mechanical vectors
62
Incubation period of Poliovirus
1-2 weeks
63
Antibodies occur in
Large intestine and tonsils
Serum
Confers life long immunity
64
Polio must be differentiation of these diseases in order to be diagnosed
GBS
Infant botulism
Encephalomyelitis
65
Prevention
Salk vaccine
| Sabin vaccine
66
Inactivated polio vaccine
Salk vaccine
67
Oral polio vaccine
Sabin vaccine
68
Coxsackievirus commonly causes
Transient neonatal infection
69
Coxsackievirus transmission
Fecal contamination
70
Incubation period of coxsackievirus
2-9 days
71
Diseases caused by CoxA virus
Herpangina
Acute hemorrhagic conjunctivitis
Aseptic meningitis
Hand-foot-and-mouth disease
72
Diseases caused by CoxB virus
Pleurodynia
Aseptic meningitis
Severe generalized disease of infants
Myocarditis and pericarditis
73
Mainstay in diagnosing Coxsackievirus
Viral isolation
74
Herpesvirus transmitted via intimate contact
Cytomegalovirus
75
Common symptoms of CMV
Hepatomegaly, spenomegaly, jaundice, capillary bleeding, microcephaly, ocular inflammation
76
Disease caused by CMV
```
CMV Mononucleosis
Disseminated CMV
CMV pneumonitis
Perinatal CMV
Congenital CMV infection
Cytomegalic Inclusion DIsease
```
77
Most common congenital viral infection
| Second most common cause of mental handicap
Congenital CMV infection
78
Treatment of CMV
Gancyclovir
Foscarnet
Hyperimmune CMV Ig
79
Principal mode of transmission of EBV
Direct oral contact
Contamination with saliva
Also fomites and arthropods
80
Diseases caused by EBV
```
Infectious Mononucleosis/Kissing Disease
Burkitt's lymphoma
Nasopharyngeal carcinoma
EBV induced lymphoproliferative diseases
EBV associated lymphomas
```
81
Notable sign of Infectious Mononucleosis
Sudden leukocytosis
82
Constant feature of Nasopharyngeal carcinoma
High antibody titers to EBV
83
Drug that reduces EBV shedding from the nasopharynx
Acyclovir
84
Filovirus that caused 2014 West African outbreak
Zaire Ebola virus
85
Suspected transmission of Filovirus
```
Fruit bats
Human-to-human via direct contact
Healthcare workers
Mourners of infected cadavers
Sexually
Breastfeeding
```
86
Incubation period for Filovirus
2-21 days
87
PARASITES AFFECTING CVS AND LYMPHATICS
```
Plasmodium
Wuchereria
Brugia
Trypanosoma
Leishmania
Schistosoma
Babesiosis
```
88
Most common protozoan disease affecting man
Plasmodium - Malaria
89
Malarial paroxysm
Cyclic fever
Chills
Sweating
90
Mode of transmission of Plasmodium
Vector-borne - pregnant female Anopheles
| Needle-sharing
91
TRUE or FALSE.
| Malaria is not a major problem in the Philippines.
True
92
Host of Plasmodium
Humans and mosquitoes
93
Infective stage of Plasmodium to man
Sporozoites
94
Schizont development occurs during this stage
Liver stage
95
Entry point of Plasmodium into the liver
Sentinel Kupffer cell
96
Most common victims of Malaria
Pregnant women
| Children
97
Main mode of transmission of Plasmodium
Natural transmission
98
Mode of transmission without sporozoites, exo-erythrocytic cycle or liver phase and hypnozoites
Induces transmission
99
Vectors in Malarial transmission
```
Anopheles flavirostris
Anopheles litoralis
Anopheles maculatus
Anopheles balbancensis
Anopheles mangyanus
```
100
Primary malarial vector in the Philippines
Anopheles flavirostris
101
Malarial vector commonly found in brackish water in Palawan
Anopheles litoralis
102
Parts of proboscis
2 pairs of cutting stylets
| 1 pain of hollow tubes
103
Contents of mosquito's saliva
Anti-hemostatic enzymes
| Anti-inflammatory subtance
104
RoleS of mosquitoes in Malaria
Definitive host
| Biological vector
105
Role of man in Malaria
Intermediate host
106
Parasite ligand and host receptor for entry of sporozoites into liver cells
Parasite ligand: CSP
| Host receptor: Unknown
107
Parasite ligand and host receptor for entry of merozoites into RBC (P. falciparum)
Parasite ligand: EBA175
| Host receptor: Glycophorin A
108
Parasite ligand and host receptor for entry of merozoites into RBC (P. vivax)
Parasite ligand: Pv153
| Host receptor: Duffy factor
109
Parasite ligand and host receptor for cytoadherence of P. falciparum-infected RBC to endothelium
```
Parasite ligand: PfEMP-1
Host receptor: CD36 (endothelium and platelets)
Parasite ligand: KAHRP
Host receptor: ICAM-1 (brain)
Parasite ligand: PfEMP-2
Host receptor: CSA (placenta)
```
110
3 patholophysiologic changes in Malaria
RBC lysis
Knob formation of infected RBC
Metabolic effect (hypoglycemia and acidosis)
111
Histopathologic changes in organs affected
Vascular congestion
Edema
Malarial pigment (HEMOZOIN) deposition
112
Cytokines involved in the pathogenesis of malaria
TNF
IL-1b, IL-6, IL-8
Interferon-y
NO
113
Effects of cytokines in low concentrations
Protective
Inhibit growth of parasites
Hemostatic agent
114
Clinical features of Malaria
```
Malarial proxysms
Jaundice
Pallor and dizziness
Changes in sensorium
Tachycardia
Dry and pale lips
Enlarged spleen and liver
```
115
Malarial paroxysm that is usually mild without complications seen in P. vivax and P. ovale, every 48 hours
Benign Tertian
116
Malarial paroxysm that is usually severe with complications seen in P. falciparum, every 48 hours
Malignant Tertian
117
Malarial paroxysm that is periodical every 72 hours seen in P. malariae
Quartan
118
Malarial paroxysm that is periodical every 24 hours seen in P. falciparum and P. knowlesi
Quotidian
119
Induces fever in Malaria
Hemozoin either directly from RBC lysis or indirectly through GPI
120
Cause of anemia in Malaria
Maturing schizonts either from direct RBC lysis or increased utilization of hemoglobin
121
Factors that lead to hypoglycemia in Malaria
Limited food intake
Increase glucose consumption
Increase Quinin-induces insulin resistance
Inhibition of gluconeogenesis
122
Result of hypoglycemia in Malaria
Compensatory glycogenolysis
123
Laboratory features of Malaria
Decreased Hgb and Hct
| Ring-like parasite in blood smear
124
Small infected RBC
Mature RBC
| Due to P. falciparum, P. malariae, P. knowlesi
125
Large infected RBC
Younger RBC
| Due to P. falciparum P. vivax, P. ovale
126
Diagnostic test of choice of Plasmodium species identification
Thin smear
127
Number of chromatin dots in trophozoite and schizont
```
Trophozoite = 1-2 chromatin dots
Schizont = 2-4 chromatin dots
```
128
Amoeboid and compact form
Schuffner's dots
Fine stippling
P. vivax
129
Band form
James or Ziemann's dots
Regular daisy-like apperance of merozoites
P. malariae
130
Number of merozoites
P. falciparum = maximum of 32 meroizoites
P. vivax = maximum 24 merozoites
P. ovale and P. malariae = maximum of 12 merozoites
131
Maurer's cleft/dots
Acole forms
Multiple parasitism
Banana-shaped gametocyte, may have Laveran's bibs
P. falciparum
132
Amoeboid and compact form
Schuffner's dots
Fine stippling
Irregular rosette-like clusters of merozoites
P. ovale
133
Band form
No stippling
Multiple parasitism
P. knowlesi
134
Deadliest and causes most severe form of malaria
P. falciparum
135
Causes recrudescence
P. falciparum and P. malariae
136
Laboratory test that detects histidine-rich proteins 2 in a strip of filter paper
ParaSight F
137
Causes relapse
P. vivax and P. ovale
138
Causes reinfection
All types
139
End stage of Lymphatic filariasis
Elephantiasis
140
Agents that cause filariasis
W. bancrofti
B. malayi
B. timori
141
Transmission of filarial worms
Oviviparous female mosquito bites
142
Clinical feature
Unrecognized recurrent lymphedema
143
Diagnostic stage of filariasis
Microfilariae/L1
144
Infective stage to humans
L3
145
Role of mosquitoes
Intermediate host
| Biological vector
146
Common filarial vectors
W. bancrofti: Anopheles, Aedes, Culex
| B. malayi: Anopheles, Mansonia
147
Day biting mosquito
Aedes
148
Night biting mosquitoes
Culex and Mansonia
149
Causes occult filariasis
B. malayi
150
Causes scrotal enlargement and lymphedema or elephantiasis
W. bancrofti
151
TRUE or FALSE.
| Presence of worms can elicit both humoral and cell-mediated
True
152
Most common change occuring at the lymphatics
Polypoid endolymphangitis
153
Effect of dead or dying adult worms in the tissues
```
Fibrinoid necrosis
Filarial granuloma (Meyers-Kouvenaar bodies)
```
154
Pathognomonic feature of filariasis seen as a pronounced eosinophilic infiltration in nodular patterns around the worm
Filarial granuloma (Meyers-Kouvenaar bodies)
155
Clinical form of lymphatic filariasis with microfilarimia
Asymptomatic
Acute
Chronic
156
Clinical form of lymphatic filariasis without microfilarimia
Occult
157
Patient has hidden damage to the lymphatic system and kidneys
Asymptomatic
158
Patient has attacks of filarial fever increasing with severity, pain and inflammation of lymph nodes and ducts, nausea and vomiting
Acute
159
Elephantiasis, hydrocele in males, enlarged breast in females
Chronic
160
Hypersensitivity reaction to the worm
Occult
161
Most common manifestation of lymphatic filariasis
Asymptomatic
162
Manifestation of occult filariasis
Pulmonary tropical eosinophilia syndrome
163
Clinical presentation of Pulmonary Tropical Eosinophil syndrome
Pulmonary symptoms
Radiologic changes
Nonspecific weight loss
Increase IgE, eosinoohilia and increased antimalarial AB
164
Conditions that lead to elephantiasis
Chronic edema in subcutaneous tissue
Proliferation of fibrous CT
Thickening of epidermis
165
Diagnosis of filariasis
Identification of microfilariae in blood smear by microscopic examination
166
Methods of microfilariae detection
Wet smear
Thick blood film
Blood concentration techniques
167
Morphology of W. bancrofti during microscopy
```
With hyaline sheath
Short cephalic space
Regular with graceful curve
Round, larger, well-separated body nuclei
No nuclei, pointed tip
```
168
Morphology of B. malayi during microscopy
```
With hyaline sheath
Long cephalic space
Irregular with kinking curves
Small, overlapping body nuclei
Two widely spaced nuclei, blunted tip
```
169
Imaging technique characterized by dancing worms
Ultrasonography
170
Imaging technique that use radioloactive opaque dye
Lymphangiography
171
Imaging technique that use radiolabeled albumin
Lymphoscintigraphy
172
Gold standard biochemical test in diagnosing filariasis
ELISA
173
Drug of choice for filariasis
Diethylcarbamazine
174
Alternative treatment for filariasis if the patient has eye involvement
Ivermectin
175
Preventive mass drug administration
Albendazole with Diethylcarbamazine
| Albendazole with Ivermectin
176
Developmental stage of blood flagellates seen in tissue samples
Amastigote
177
Developmental stage of blood flagellates seen in blood samples
Trypomastigote
178
Causative agent of African sleeping sickness
T. brucei
179
Life cycle/Development of Trypanosoma spp.
Heteroxenous
180
Asexual reproduction of Trypanosoma
Binary fission
181
Evading mechanism of T. brucei
Antigenic variation
182
Distinctive features of T. brucei
Changes from slender trypanosome into a stumpy form
| VSG switching which allows second wave of parasitemia
183
Characteristics of T. b. gambiense
```
Gambian trypanosomiasis, W. African sleeping sickness
Humans are primary reservoir
Winterbottom sign
Chronic/late CNS manifestation
Low parasitemia
Meingo-encephalitism
Lymph fluid is best microscopy specimen
```
184
Characteristics of T. b. rhodesiense
Rhodesian trypanosimiasis, E. African sleeping sickness
Animals are primary reservoir
More fatal and aggressive
High parasitemia
CNS involvement glomerulonephritis or myocarditis
185
Infective stage of Trypanosoma spp.
Metacyclic trypomastigote
186
Diagnostic stage of Trypanosoma spp.
Trypomastigotes
187
Stage of African sleeping sickness characterized by the presence of Trypanosomal chancre and Winterbottom sign
Stage 1 Hemolymphatic
