Microbio Exam 2 Flashcards
(262 cards)
1
Q
Hep C
A
Transfusion associated hep
2
Q
Hep D
A
delta agent, only in pts with ACTIVE HBV
3
Q
TB caused by
A
Mycobacterium tuberculosis
4
Q
Big worry about TB is the spread of it
Often sneaky bc 90% of health infected pts
A
never become ill
5
Q
Reservoir for Mycobacterium Tuberculosis
A
only HUMANS
transmission: person to person through Aerosol droplet
6
Q
Prosectors warts
A
Cutaneous skin sx of Tuberculosis
7
Q
Mycobacterium TB
A
Obligate aerobes
Rod shaped bacillis
8
Q
M. TB
A
intracellular growth- alveolar macrophages
9
Q
Harsh tx employed for Mycobacterium TB because:
A
Acid Fast Bacilli (AFB)
10
Q
Myco TB
A
Ziehl-Neelsen or Kinyoun stains
11
Q
Myco TB structures that create problem
remember, Acid fast
A
Mycolic acid-prevent dehydration, resist water
Cord factor
Lipoarabinomannan (LAM)- ROI-
12
Q
Myco TB manifestation
A
Granulomas surrounded by macrophages, giant multi-nuc, fibroblasts, and collagen fibers h
Show on CXR 2-6 wks after infection
13
Q
Latent TB
A
No risk to spread disease
Still treated
14
Q
Reactivation or Secondary TB
A
Sign & Sx present
INFECTIOUS to others
may be present wks-months b4 diagnosis
Cough, wt loss, fatigue, fever, night sweats, CP
Lesions- caseous with . necrosis, erode and discharge TB bacilli into bronchi
Erode blood vessel and now spread via blood
15
Q
Dx of TB
A
CXR
Skin test reactivity
Sputum stain/broth culture to detect Acid Fast bacteria
Rapid blood test- IFN-gamma
16
Q
Myco TB screening
A
use purified Myco TB protein derivative in TB skin test
17
Q
TB skin test
A
“Mantoux test”
18
Q
Tx for TB
A
Extended duration 6-9 months
Chemo
Multi drug regimen
19
Q
Prophylaxis for TB
A
Isoniazid for 9 months
20
Q
do BCG (a tuberculosis vaccine)
A
in high endemicity regions
21
Q
MAC
Mycobacterium avium complex
A
Acid- Fast
water loving- ubiquitous
slow growing
22
Q
MAC
A
weakly gram (+) aerobic bacilli
23
Q
MAC epidemiology
A
Ingestion of contaminated water or food
24
Q
MAC
A
NO person to person transmission like TB
No isolation required
25
MAC
opportunistic Human pathogen
Now the leading cause of Non TB mycobacterium infections in HIV pts
26
MAC dz spectrum
Immunocomp
(middle aged/older males hx smoking)
-cavitary lesions resemble TB
27
MAC dz spectrum
Elderly female Non-smoker
-patchy or nodular CXR
Lady Windermere's syndrome
28
MAC and AIDs
blood spread- no organ spared
immune system collapses
HAART and abx proph makes infection less prevalent in HIV (+)
29
MAC dx
Microscopy to reveal Acid-Fast and culture
Sterile site isolation of MAC
CXR
PCR- 16S rRNA sequence
30
Measles
multiply in Respiratory and Lymph nodes
31
Measles
Prodromal
High fever
3 C's (cough, conjunctivitis, coryza)
32
Measles
KOPLIK spots and 3 C's
33
Measles
Rash phase-sickest
Rash 3-4 d after prodrome starts
Below ears-spreads down
lesions become merged
Highest fever
34
Measles complications
PNA (most deaths)
Bacterial superinfetion
Diarrhea
CNS involvement- Acute sx-atic Encephalitis!!
35
Measles CNS complication
SSPE- Subacute sclerosing panencephalitis
36
Measles hosts
| M for MONKEY
Humans and Monkeys
37
Measles
no healthy carrier state
38
Measles transmission
Respiratory droplets-highly contagious
39
Measles dx
Rash and/or Koplik spots
Serology
FA (fluorescent antibody test) from HEENT- Multniucleated giant cells
40
Measles prevention
MMR vaccine
-b4 school
15 mo:1st dose
4-6 yo: 2nd dose
*high risk if exposure deemed likely, can vaccinate under 15 mo
41
MMR vaccine
3rd booster now recommended for some
42
MMR vaccine
Live attenuated
43
Rubella (german measles)
"little red"
| Mild exanthematous dz
44
Rubella
requires close and PROLONGED contact
45
Rubella
children often escape infection- the real scare is with CONGENITAL RUBELLA SYNDROME
46
CRS Congenital Rubella Syndrome
```
Maternal infectoin during 1st trimester of pregnancy
Cardiac- Pulm stenosis, PTA
Eye- cataract, galucoma
Hearing loss
CNS
```
47
CRS Congenital Rubella Syndrome
the earlier mother affected- the more severe for child
| i.e. first month: 50% chance of CRS
48
Rubella tx and prevention
MMR vaccine
DO NOT GIVE VACCINE TO PREGNANT
May proved IVIG (immunoglobulin) as prophylaxis if pregnant mother exposed in first trimester
49
Rubella tx
Symptomatic
50
HSV
humans are only reservoir
51
HSV spreads
in abscence of immune response
52
HSV dx
```
Ballooning patholody
Tzanck smear!
FA- Fluor Antibody for viral antigens
Culture in HeLa, Hep-2 cell lines
PCR to detect HSV
Antibody tests to reveal HSV1 and 2
```
53
HSV tx
Acyclovir or Valacyclovir
54
HSV tx
Acyclo and Valacyclo
| Thymidine kinase phosphorylates AVC- viral DNA replication bc lacks 3 OH group and cannot polymerize more bases
55
Chickenpox
Asymmetrical
| vesicular
56
Chickenpox
Replicates in regional lymph nodes
| Replicates in liver and spleen
57
Chickenpox
```
Primary viremia 4-6 days after infection
Secondary viremia (rash) 10-14 days after infection
```
58
Chickenpox
humans only reservoir
59
Chicken pox transmission
Respiratory secretion
Conjunctiva
Vesicles
Highly contagious
60
Chicken pox incubation
15 days
| pt most contagous 1-2 days before lesions, and 4-5 days after
61
Chicken pox tx
DO NOT GIVE ASPIRIN (reyes syndrome risk)
Acyclovir is effective
High risk: Immune serum VariZig (immunoglobulin)
62
Chickenpox vaccine
Varivax (live)
| VariZig for high risk
63
Shingles
Redness --> papules in 24 hour period
fever, anorexia
64
Shingles prevention
Zostavax (over 50YO)
| Shingrix
65
HHV 6
Roseola Infantum
| 6th dz
66
HHV 6 Roseola Infantum
Fever followed by rose colored rash
67
HHV 6
fever 2-5 days
| High fever w/o any obvious source
68
HHV 6 dx
Antibody by EIA
| PCR
69
HHV 6 tx and prevention
nothing
70
Parvovirus
| 5th dz
Erythema infectiousum
infectious with 5 hands, 5th disease, slapped cheek with a HANG 5
71
Parvovirus
pet dog with HAND
5
5th dz
72
Parvovirus
Mild sx-fever, ha , malaise
Followed by SKIN RASH (Slapped cheek)
Resolves in 1-2 wks
73
Parvovirus
rash may involve limbs and trunk
| ADULTS: Arthralgias!!! may only have this without any other sx
74
Parvovirus dx
Anti B19 IgM antibody
75
Parvovirus Tx and prevention
Most make full recovery on own
NSAIDs for relief
Immunoglobulin for Anemic pts
76
HPV prevention
Vaccines !!!
Gardasil
M and F ages 9-45
77
Scabies
small mite with short legs
78
Female scabies
fertilized on skin surface
burrows
life cycle in 5 wks- dies in burrow
79
Male scabies
```
shorter lifespan
remains on skin surface OR shallow burrow
eggs laid under skin
larva emerges from egg after 4 days
adult mite develops 2 wks after hatching
```
80
Pediatric Scabies
similar to Norwegian, but lesions may be blood filled
81
Dx scabies
Apply mineral oil, scrap lesion, visualize microscopically (whole mite, mite parts, eggs/fecal pellets)
82
Tx of Scabies
5% Permethrin cream (single app) wash off after 8-14 hrs
Ivermectin (does not kill eggs)
83
Pubic lice
Nits (eggs) cemented to hair
| ID by visualizing louse or nit
84
Tx of Pubic lice
Permethrin
85
Pediculosis
| "Lice"
can be Capitis: head or
| Humanus:body
86
Pediculosis "lice" pathogenicity
Bite irritation (blood sucking parasite)
87
"Vagabonds dz"
years of Lice infestation- darkened thickened skin
88
Tx of Pediculosis Humanus (body lice)
Permethrin
89
Pulex irritans (human flea)
laterally compressed
| short spikes on legs allow attachment to host
90
Pulex irritans (human flea)
Parasite-need blood to survive
| Inject saliva during blood meal, possesses 15 stubstances which initiate ALLERGIC RESPONSE
91
Pulex irrritans (human flea)
Allergic response
Rash
Tx: 1% Hydrocortisone cream, stop scratching, Antihistamine
92
RMSF
```
Tick borne
Brown dog tick
Rickettsia Ricketsii
Gram (-)
Obligate intracellulra
```
93
RMSF
can be FATAL if not treated in first few days of sx
94
RMSF sx
2-14 days after tick bite
(usually painless bite)
SUDDEN ONSET fever and HA
95
RMSF early nonspecific sx
Fever, HA, n/v, abdominal/ muscle pain, lack of appetite, conjunctival infection
96
RMSF 2 types of rash
| type 1
Small, flat pink itchy spots on WRIST, FOREARM, ANKLES (spread to trunk and palms, soles)
2-5 days after infection
97
RMSF 2 types of rash
| type 2
Red-purple spotted petechial, pinpoint hemorrhage
6 days after
YIKES- sign of SEVERE and LATE dz
98
RMSF
Small, flat pink spots WRIST/ANKLE (2-5 days)
treat before rash gets to
Pinpoint hemorrhage (6 days)
99
Dx of RMSF
Detectable antibody titers are not visible for 7-10 days post infection
difficult to detect until dz is in late stage
100
Gold standard dx RMSF
Indirect immunofluorescense with a R. Rickettsii antigen
| 2 samples, 2-4 wks apart
101
Tx for RMSF
DOXY within 5 days of sx
| Pregnant: Chloramphenicol (beware aplastic anemia)
102
Trypanosomatids
T. Brucei: African sleeping sickness
| T. Cruzi: Chagas
103
T. Cruzi
Chagas
| Vector: Triatomine bugs "kissing bugs"
104
T. Cruzi
transmitted through- feces of kissing bug, blood transfusion, organ transplant, congenital
105
T. Cruzi lifestyle
Trypomastigotes --> Amastigotes
Amastigoetes then replicate via binary fission and go back to Trypomastigoses-release into circulation
106
Trypomastigoes
ingested during bloodmeal
107
Chagas- 2 stages
Acute vs. Chronic
108
Acute Chagas
```
Nonsp sx (fever, fatigue, rash, n/v/d) + 2 BIG SIGNS
Chagoma (circle next to eye)
Romana's sign (swelling of eyelid near parasite entry)
```
109
Chronic Chagas
```
Can be asx for years- even life, THEN
Muscle and Nerve degeneration--> necrosis
Chronic inflammation
Cardiac effects
Intestinal enLARGEment
```
Heart comp more common than intestinal comp
110
Chagas dx
Parasite under microscope
- Trypomastigotes in Acute phase
- Amastigotes in Chronic phase
111
Tx of Chagas dz
Benznidazole
112
Links to Epstein Barr Virus
Mono
| Burkitt's Lymphoma
113
Infectious Mononucleosis (IM)
Incubate 1-2 months
| Oropharynx--> Lymph nodes
114
Mono
B cell infection - spread through lymphatic system
115
Mono prodrome
3-5 days of HA, fever, malaise
116
Mono presentation
Sore throat, symmetrical lymphadenopathy, FEVER, Hepatomegaly, increased liver enzymes, Jaundice
117
Mono sore throat
Hard and soft palate lesions
Increase in both T and B cells
Atypical lymphocytes "Downey cells" in circulation
118
Mono and T cell response
T cell response controls and halts infection (also cause of most of pt's sx)
119
Mono
virus found in saliva for about one month
120
EBV
| Mono dx
Heterophile Antibodies!!!
121
Mono tx
Symptomatic
122
Mono
Penicillin reaction rash often occurs in pts
123
CMV-Cytomegalovirus
similar to EBV (mono), but does not produce Heterophile antibodies
124
CMV
Most problematic for: Transplant pts, Immunocomp Pregnant
125
CMV
children with minor colds may be source
126
CMV tx
Ganciclovir and Immunoglobulin (Cytogam)
127
Mumps
Symptomatic
| MMR vaccine
128
Lyme dz
Borrelia Burgforferi
| Dz progression similar to syphilis
129
Lyme dz progression (3 stages)
1. Acute localized Erythema migrans- "bullseye" and flu like sx (fades in less than a month)
2. Subacute disseminated dz- ARTHRALGIAS and flu like sx
Secondary annular skin lesions
Hepatitis
Meningitis
Facial palsy
Conjunctivitis
3. Chronic- MSK manifestations, worse Arthritis
130
Lyme dz Reservoir
Small mammals- rodents, rats, mice, birds (tick transmission essential to maintain cycle)
131
Lyme dz Dx
Serology- EIA + Western blot
132
False + tests with Lyme dz
Syphilis, mono, Lupus, RA, oral infection w spirochetes
133
Tx of Lyme dz
Amoxicillin or
| Doxy 10-21 days
134
Vaccine for Lyme dz
LYMErix (was available?)
135
New vaccine targeting 6 most common Borrelia species
for Lyme dz
| Pre-exposure proph with Monoclonal antibodies (passive immunity)
136
Hep A and E
only Acute
137
Hep B, C, D
can be Acute or Chronic
138
Which types of Hep offer pre/post exposure immunization?
A, B, D
139
Hep A
Excreted in feces
Food and water borne
Poor hygiene
140
Hep A
Dz typically mild
Entry thru intestine after ingestion
Many ASYMPTOMATIC infections occur
141
HAV dx
IgM antibody by ELISA
142
Hep A tx
Bed rest
Reduce actiivty
PO fluids
Avoid: drugs, alc, anesthesia
143
Prevent Hep A
Handwash
Avoid contaminated food
Post exposure prophylaxis with immunoglobulin
VACCINE available
144
Hep B
Chronic --> Liver CA
145
Hep B Antigens
Pay attention to third letter
HBs: surface
HBc: core
HBe: surface that tells us pt is INFECTIOUS
146
Hep B
Double walled "Dane particle" is the infectious form
147
Hep B spread
needle sharing, acupuncture, ear piercing, tattooing
148
Chronic Hep B
major source of spread
when pt is Asymptomatic
Mother has HBeAG (e is third letter) greatest risk of spreading
149
Populations at risk for Hep B
Healthcare workers
| IVDU
150
Hep B sx
Incubate 50-180 days
| Insidious onset: fever, rash, symmetrical arthralgias
151
Subclinical infection of Hep B (nearly or completely asymptomatic)
Anti- HBsAg
| self limited in most adults
152
Hep B
we always vaccinate BABIES
B for BABIES
bc 90% of perinatal and pediatric infections --> CHRONICITY
153
Complications of Hep B
Hepatocellular Carcinoma
154
Sign of Hep B- HALLMARK of initial ongoing infection
IgM anti-HBc and HBsAg
155
Past infection of Hep B
IgG anti- HBc
156
Chronic infection of Hep B
IgG anti-HBc and HBsAg
157
Probable chronic infection of Hep B
HBeAg and HBsAg continued detection
158
Hep B Tx
Chronic: PEG-interferon
Subunit vaccine available
Immunoglobulins for prophylaxis
Newborn infants of HBsAg + moms: get immunoglob prophylaxis + Hep B vaccine at birth
159
Hep D virus
needs Hep B in order to replicate
160
Hep D
increases the severity of Hep B
| "Fulminant Hep" more likely with Hep D
161
Hep D dz
ELISA for DELTA antigen or antibodies
162
Hep D prevention
the vaccine for Hep B prevents both B and D
Supportive therapy
PEG interferon to suppress active viral replication
163
Hep C
If not type A or B, 90% of Hepatitis cases are this
164
Hep C
Hallmark for CHRONIC
| post transfusion
165
Hep C
Chronic --> Liver cirrhosis and failure
166
Hep C
transmission not well understood
| Dz onset hard to pinpoint
167
Risk factors for Hep C
Anything with needles
Organ transplant
Contact w health care providers
168
Factors that promote Hep C progression to Chronic
```
Alcohol use
Infection at age <40YO
Male sex
Co-inf w Hep B
HIV
```
169
Hep C dx
Enzyme immunoassay against Hep C
Seroconversoin 24 wks after infection
OFTEN ESCAPE DETECTION
170
What is recommended to detect Hep C since it often escapes diagnosis?
Direct assays
171
Hep C tx
Direct acting antiviral (DAAs)
Combo regimens
Virus protease or poylmerase inhibitors
172
Hep C tx
a-interferon
PEG-interferon for some genotypes
Some regimens do not require interferon
173
Hep C may lead to needing a
transplant
174
Two main causes for Liver transplant
Cirhossis
| Liver CA
175
HIV sx
Asx or Sore throat, swollen lymph nodes, mimicking Mono
176
HIV transmission
early stages when pts are unaware is when high levels or virus are circulating- HIGH transmission risk
177
AIDs
(stage 3 HIV)
CD4 <200
Opportunistic infections take over- CA, Kaposi's sarcoma, PJP, MAC infection, CMV dz, candidiasis thrush
178
Description of HIV agent
Makes copy of itself and inserts into Human chromosome
Host treats it as any normal gene, cant be recognized
Human retrovirus- RNA genome- two copies of RNA virion
179
HIV agent
RNA genome- 2 copies
Enveloped
Reverse transcriptase- RNA dependent DNA polymerase
RNA--> DNA, then entered into human genome
180
Target for HIV tx
Reverse transcriptase
181
HIV replication
Infection of cells w CD4 and Chemokine co-receptor at surface
Th monocyte, macrophage
Reverse transcriptase of viral genome-integration into hose
182
Cytpopathic effects of HIV
T (helper) cell loss
and profound immunosupp
Direct virus killing and/or Apoptosis of immune cells
"swarms" group of mutant viruses that develop
183
"swarms"
groups of mutant HIV that develop
can multiply rapidly, complicating tx (always morphing to escape med)
Why we need COMBO therapy
184
HIV-1 and HIV-2
HIV-1: more common worldwide
| HIV-2: West Africa
185
HIV-2 (W. Africa)
less easily transmitted
slower progression to AIDs
resistant to NNRTIs
186
HIV dx: detection of Antibody in patient
| 2 step process
1. EIA screen
| 2. Western blot (confirmation)
187
HIV dx: direct test
Reveal presence of virus RNA or protein antigens
| NAT- Nucleic acid test are used to detect and quantify virus
188
Check with donated blood for HIV
Antigen p24 or RNA genome by PCR
189
Rapid HIV test
new 20 min test
OraQuick Rapid HIV-1/2 antibody test
(estimated that 280K ppl in US are infected but do not know)
190
HIV tx
```
Combo
Reverse transcriptase inhibitors
Nucleoside analogs
(AZT, ddI, ddC)
Non-nucleoside analogs
Protease inhibitors- stop maturation of viral assembly
Fusion-penetration inhibitors
```
191
Viral load
most tests can detect as low as 50 copies/ml
| Persons w HIV: may monitor every 90 days
192
Poliomyelitis
Asymmetric flaccid paralysis
destruction of motor neurons in spinal cord
193
Poliovirus
Picorna virus
194
Clinical sx of Polio
1. Inapparent- Asx to minor malaise
2. Abortive illness
3. Nonparalytic poliomyelitis
4. paralytic poliomyelitis
195
Post polio syndrome
```
paralyzed decades ago
Now: muscle weakness, pain, fatigue
30 or more years after paralyzing polio
Not contagious- not detectable levels
Remaining neurons are collapsing d/t overuse
```
196
IPV- Inactivated polio vaccine
| we now use E-IPV, enhanced
Injected
Virus is killed
Prevents dz (paralysis), not infection
197
Only polio vaccine used in US
IPV
198
Arbovirus
West Nile virus
Ticks and mosquitoes
(break chain of transmission by going after these guys)
199
West Nile clinical sx
Mostly NOTHING
| if sx show, very serious case: still can't treat though- only make pt comfortable
200
West Nile
prevention and educatoin extremely important b cno treatment
201
West Nile sx in severe case
AMS, confusion, fever, HA, vertigo, photophobia, n/v,personality change, seizures
Recovery may be complete or long term deficits
202
West Nile
#1 cause of Viral encephalitis in US overall
203
West Nile dx
Antigenic cross rxn
MAC-ELISA is what we use: look for IgM
204
If pt had recent (9 mo) vaccination against Yellow fever and/or Japanese encephalitis,
IgM may be detectable for up to 9 months after vaccine, can be false (+) for West Nile
205
If suspect West Nile
start Acyclovir
| in case it is Herpes Simplex virus
206
Arbovirus (west nile) prevention
do not keep sitting water around
207
Zika
teratogen
208
GBS
Guilliane Barre syndrome
209
Rabies
virus replicates locally but heads for nervous tissue
210
Rabies, Polio, HSV
travel back and forth from body-- nervous tissue
211
Rabies
Incubate 2-16 wks
| 5-6 days fatal course when overt sx appear
212
Rabies prodrome
mild fever, pharyngitis, HA, burning, pain, increased sensory sensitivity
213
Excitatory phase of rabies (mad dog)
anxiety, hydrophobia
214
Paralytic phase
coma, hypotension, death
215
Cryptic Rabies
contact with Rabid animal
| virus can get thru skin
216
Rabies
only instance where we immunize after the bite
3 immunizations
99% cure
217
Rabies vaccine
HDCV + Hyperimmune serum AFTER contact w reservoir
218
Malaria
mosquito born
219
Malaria most common causative agents
Vivax and Falciparum
220
Malaria
Human phase and mosquito phase
221
Malaria
| First: Sporozoites are injected by mosquito's saliva during blood meal
Sporozoites then travel to liver where asexual division occurs--> Schizogony cycle begins (rapid cell division)
-Merozoites are released from Schizogony phase
222
Vaccine target for malaria
Sporozoites (what is release by mosq saliva)
223
Merozoites (made from Schizogony in the liver)
can infect other liver cells or RBC
224
Once in RBC, Merozoite --> Trophozoite
As tropho age, they can develop into Amoeboid tropho and release into bloodstream, infect more cells
225
Schizonts are multinucleated cells that produce
Merozoites
226
Some merozoites can even develop into Gametocytes that do not rupture, BUT
mosq can then ingest the gametocytes and more reproduction happens inside the mosq
227
Malaria
Organism uses up Hgb
| Fever and chills d/t Pyrogenic waste after rupture of RBC
228
Malaria
Pyrogen travels to hypoth and causes increase in thermal set point
Tumor necrosis factor- TNF; inflammation- intensifies symptoms
229
Malaria
1-2 hours of severe shivering and high fever
230
Malaria sx mimic others
Fever, vomiting, myalgia, Anemia (d/t RBC destruction), hypotension
Untreated: coma, renal failure, resp distress, death
231
Resistance to Malaria
```
Sickle cell (virus doesnt want the messed up Hgb)
Duffy antigen (W. african black persons lack antigen, resistant to VIVAX form)
```
232
Duffy antigen
resistant to VIVAX
233
Malaria vaccine
```
RTS, S (Mosquirix)
somewhat eff against Falciparum
4 injections
low efficacy
Req boosters
```
234
VIVAX
Benign tertian malaria
Rarely fatal
Incubate 9-15 days
infects YOUNG RBCs
235
VIVAX
fever every 48 hours lasting 2-6 hours (d/t rupture of schizonts)
chills and shaking every 10-15 min
Relapse common d/t activation of Liver Hypnozoites, can be 3-5 years after initial dz
236
Sickle cell protection against what form of Malaria?
Vivax!
237
Vivax dx
Giemsa stain
Enlarged RBC w/Schuffner's dots
Stipling
238
Vivax tx
Chloroquine
Quinine
Doxy
Primaquine
239
Falciparum
RBC of ANY age affected
VIRULENT- multiplies rapidly
Fever very high d/t high # of parasites
BLACKWATER FEVER
240
"Blackwater fever" in Falciparum
high levels of free hgb
auto-immune rxn host destroys kidney tissue
Chills, fever, rigor, DARK TO BLACK URINE
241
Falciparum crappy scary effects
Capillary obstruction bc infected RBC stick to capillary linings
Cerebral: hemorrhage, mania, convulsions, death
GI: freq vomiting
Algid*: skin is cold but internal temperature is high
242
Falciparum is very crappy BUT
no relapse d/t no Hypnozoite
243
Vivax and Ovale
relapse occur
244
Duffy antigen
Vivax
| low incidence in W Africa d/t Duffy negative people- dont have this antigen
245
Main cause of Malaria resistance
efflux pumps
246
Tx for Malaria
Chloroquine or Artemisinin
| Atovoquone/proguanil (more expensive)
247
Babesiosis
Nantucket fever
248
Babesioss/Nantucket
deer tick
Similar sx to Malaria
Small pinpoint lesions
249
Babesiosis/Nantucket is more problematic in
Immunocomp
| Asplenic
250
Babesiosis/Nantucket is often a co-infection with
Lyme dz
251
Babesiosis similar to what form of Malaria?
Falciparum (but less severe)
252
Babesiosis is known for what morphology of RBC?
Cross like
253
Tx ofBabesiosis
Clinda and Quinine
254
E Coli
Bacillus
255
Listeria
```
Gram +
Coccobacillus
Hot dogs in summer
GI
Facultative INTRAcellular
all up in your cell
Lysterlysin O
```
256
Group B strep
| Strep agelecta
Cocci
257
H. influenza
| Listeria
Coccobacillus
258
Hep tx
Hep A: IgM
Hep B: Hbsurface antigen
Hep C: look for RNA (treat with DAA)
Hep D: Delta antigen
259
HIV
EIA and Western blot
260
HIV blood test
direct testing for RNA
261
Vivax
Stipling
| Schuffner
262
Falciparum
Maurer's cells
| Maury is falci
