STIs, TORCHES, Childhood Rashes, HIV Flashcards Preview

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Flashcards in STIs, TORCHES, Childhood Rashes, HIV Deck (41):
1

HPV

E6 (p53)-E7(Rb); DNA VIRUS

Low Risk: 6, 11; High Risk: 16, 18, (31, 33)

Most clear virus, few progress to CIN I, fewer to II/III;

Cervical, Anal, Oral, vulvular.

Conoldymoas (PAINLESS****), flat and confluent lesions. CERVICITIS WITHOUT PURULENT DISCHARGE

2

HSV

DNA Virus; HSV1 (oral; trigemnal gang, (Temporal lobe) Enchepalitis in newborns), HSV2 (Genital, sacral ganglia, cervicits, herpetic vsciles, dyuria).

Oral Pharyngitis, painful "shingle-like" type of outbreak in pharyx.

Tx with Zovirax.

Preg women with active lesions should get C-section; if active on nipple don't breast feed.

3

Gonorrhea

G negative (neisseria), 2nd most common STD (prevelent in young adults). COINFECTION WITH CHLAMYDIA COMMON (tx for both)

Cervicits, or Pelvic Inflam Disease (PID; causes scaring of fallopian tubes which messes up ovulation=infertility), skin rash, eye vagina, anus, urethra (GREEN/Colored discharge)

CAN BE ASSYMPTOMATIC.  Tx with DNA PCR (female); Males (gram stain)

Ceftriaxone (Cefalosporin) AND CHLAMYDIA TX (Doxy or Azythromycin)

Can cause Disseminated Septic Joint disease

4

Chlamydia Trichomatus

Gram negative obligate intracuellar bacteria (CANNOT PRODUCE OWN ATP).

Most common for women under 25******; Common co-infection with Gonorrhea

LEADING CAUSE OF PID (infertility from fallopian tube scaring causing poor ovulation).  

ASSYMPTOMATIC WOMEN (cervicits, mucolpurelent discharge*), PID/ectopic pregnancies

Tx: Doxy/Azithromycin And Tx for gonorrhea (cefatriaxone)

Serotype L--Lympogranuloma Venerium: swelling of groin lymph nodes

Fitzhugh Curtis Sydnrome (adhesions between the liver and diaphragm)

5

HIV

ELISA (highly sensitive) followed by Western blot (highly specific, rules out false positives)

6

Scabbies

Parasite, like lyse; common among children can be transmitted sexually.

Gential itching RASH WITH BURROW FROM MITE***

Vesicular maculopapular rash on vuvla.

Dx via visualization of MITE

Permetrhin Cream/shampoo

7

Mulcosum Congentiosa

DOME SHAPED PAPULES WITH CENTRAL DIMPLE

DNA Pox.  Autoinnoculation or close contact

Small painless papules (usually assymptomatic, highly contagious)

Kids/Daycares

Dx: clinical appearance then biopsy looking for viral bodies in cytoplasm

8

Trichomonas Vaginalis

Protazoa, Oval, flagella; TX WITH METRONAZOLE

Most curable and most common

Females with FOUL SMELLING, FROTHY green discharge, STRAWBERRY CERVIX, vulvular edema, itching/burning

Asymptomatic in men; sexual transmission

Dx: Wet mount pH of vagina (w/t 4.5, more alkaine with parasite)

TX PREG WOMEN BECAUSE IT CAN CAUSE PRETERM LABOR AND DELIVERY (LOW BIRTH WEIGHT)

 

 

9

Syphillis

Treponmoa Pallidum: Gram Negative spirocye.

Homosexual men, HIV +, 13-35 yo

Dx: VDRL/RPR antidodies (non-trep antiody titer---false positives w/ autoimmunity); confirm with FTA (once you have infection always will be positive even after you clear it)

ALWAYS TX PREGNANT WOMEN: PENCILLIN (EVEN IF THEY HAVE ALLERGY)

PAINLESS LESION AT INFECTION (high infectioius)

Secondary: More Disseminated: Systemic, fever, maculopapular rash, palms fo sole feet (highly infectious still)

Teritary: neurosphyillus, destruction of vaso vasorum, argyl robersonian pupil (accomodate, but don't react to light), tabes dorslais (not infectious anymore)

 

 

10

Blood Markers for:

Seminoma:
Yolk Sac tumor:
Choriocarcinoma:
Embyronal carcinoma:

o Seminoma: Placental alkaline phosphatase or Lactate Dehydrogenase (whats seen in lysed RBCs) "semen, milk lactate"
o Yolk Sac tumor (endodermal cyst): Alpha feto protein
o Choriocarcinoma: Beta-hCG
o Embyronal carcinoma: Alpha feto AND beta hCG

11

Enlarged ventricles and calcifications on CT with white-yellow lesions on retina.

Congential Toxoplasmosis:

Hydrocephalus, Intracranial Calcifications, and Chorioretinitis

Transplacental Transmission

Also can get seizures, rash, and eye movement defects and hepatosplenomegaly

12

Chorioretiniits, hydrocephaus and intracranial calcifications.

Cause, mode of transmission, and maternal manifestations?

Toxoplasma Gondii

Ingestion of undercooked meat or Cat feces

Assymptomatic, rare lymphadenopathy

13

PDA (Tet of Fallot or Pulmonary Atery Hypoplasia), Cataracts, Deafness?

Cause, mode of transmission, and maternal manifestations?

Rubella (also can have blue berry muffin rash): German Measles (Togavirus; + strand RNA)

Respiratory Droplets

Rash Lymphadenopathy, arthritis

14

Hearing Loss, Seizures, Petcheial Rash

Cause, mode of transmission, and maternal manifestations?

CMV (also have blueberry muffin rash)--UNILATERAL HEARING LOSS****

Sexual Contact, organ transplant

Mononucleosis like sxs

15

Recurrrent infections, Chronic Diarrhea

Cause, mode of transmission, and maternal manifestations?

HIV

Sexual Contact, Needlestick

Variable penetration based on mom's CD4 count

16

Encephaltitis, rash on skin

Cause, mode of transmission, and maternal manifestations?

Herpes simplex 2 (rash will be vesicular)

Skin or mucous membrane contact

Herpetic lesions

17

Facial Abnormalities and Deafness

Cause, mode of transmission, and maternal manifestations?

Syphills (often still birth=hydrops fetalis); notched teeth, saddle nose, short maxilla, saber shins, CN8 deafness

Chancre (1) or disseminated rash (2) more likely than teritary syphyllis to present as infection

Sexual Contact

18

Hydrops Fetalis in newborn

ParvoB19

19

Meningitis in neonate

Group B strep (name?), E coli, Listeria

20

In AIDS Patient:

Systemic Disease

Histoplasmosis Capsulatum

21

In AIDS Patient:

Vascular Proliferation

Bartonella Henselae causing bacillary angiomatosis

22

In AIDS Patient:

Ring enhancing lesion? Tx?

Toxoplasmosis Gondii

Pyrimethamine and Sulfadiazine

23

In Aids Patient:

Meningitis

Cryptococcus Neoformans (NOT CRYPTOSPORIDIUM)

Coccus=Cock=penis has a head=brain=meningitis

Sporidium=spores=oocytes in GI tract

24

In AIDS Patient:

Encephalopathy

JC virus causing PML

JC=Junky Cerebrum (BK virus = Bad kidney)

25

In AIDS Patient:

Retinitis (what else?)

CMV (can also cause esophagitis)

"COTTON WOOL SPOTS on retina"

26

In AIDS Patient:

Oropharyngeal cancer?

Primary CNS lymphoma?

Squamous cell carcinoma?

Superficial Neoplastic proliferation of Vasculature?

EBV

EBV

HPV 16/18/31/33 (usually anal/cervical cancer)

HHV8 (kaposi)--DD this bacillary angiomatosis.  HHV8 you will see skin and GI tract (GI=almost exclusively seen in AIDS pnts aka not middle eastern old dude)

27

In AIDS Patient:

Intersitial Pneumonia?

Pleuritic pain hemoptysis, infiltrates on imaging?

Ground glass appearance on imaging?

Pneumonia?

Tb like disease?

CMV

INVASIVE Aspergillus fumigatus

PJP

S. Pneumoniae

Mycobacterium avium-intracellulare (Mycobacterium avium complex=MAC)

28

Prophylaxis in AIDS at (drug + condition):

CD4<200

<100

<50

 

200: Sulfa (Dapsone if allergic): risk for PJP

100: Reactivation of Toxoplasmosis (Sulfa or Dapsone+pentaminidine+leucovorin)

50: MAC (mycobacterium avaieum): Azithromycin

Nb: Dapsone and sulfa need to watch out for G6PD def

29

Codes for?

pol gene

env

gag

pol: reverse transcriptase (is a POLymerase)

env: gp120/41

gag: p24

30

navirs?

General SEs?

SEs specific for Ritonavir?

Specific for Indinavir/Atazanavir?

Protease inhibitors "navir tease a protease"

SEs: fat redistribution syndrome (cushionoid body type); Pancreatitis

Nephrolithitiasis (atazanavir=increase bilirubin=harmless but distinct jaundice)

 

31

NRTIs?

Need to be activated by thymidine kinase.

COMPETITIVE inhibitors of reversetranscriptase.

32

Didanosine

Type of drug? MOA? SEs?

Pancreatisis.

Class in general: Lactic acidosis

33

Abacavir?

Type of drug? MOA? SEs?

NRTIs: Lactic acidosis

Life threatening Hypersensitivity Rxn

34

Zidovudine

Type of drug? MOA? SEs?

NRTIs: Lactic acidosis

Megaloblastic anemia, bone marrow supression.

Used in prophylaxis, preggers, and occupational exposure.

ZDV (used to be called AZT; this is the big gun to remember)

35

NNRTIs?

MOA? SEs?

Noncompetitive inhibitors of reverse transcriptase

No phosphorylation needed for activation.

SEs: Rash and hepatotoxicity, contraindicated in preggers (except for nevirapine).

 

 

36

Efavirenz?

Type of drug? MOA? SEs?

NNRTI, Rash and haptotoxicity, and teratogen

CNS sxs common (vivid dreams)

37

Nevirapine?

Type of drug? MOA? SEs?

NNRTI

Rasha nd hepatotoxicity, SAFE IN PREGGERS

38

Delaviridine?

Type of drug? MOA? SEs?

NNRTI

Rash and hepatoxicity and no preggers.

39

Raltegravir?

Type of drug? MOA? SEs?

Integrase inhbitor (competitively inhibited HIV integrase)

SEs: hypercholesterolemia

40

Enfuvirtide?

Type of drug? MOA? SEs?

Fusion inhibitor (enFUV stops the FUSion)

binds gp41 inhibiting entry.  

Skin reactions at injection sites

41

Maraviroc?

Type of drug? MOA? SEs?

Fusion inhibitor

Binds CCR-5 on surface of T-cells/monocytes ("change the letters around to macro-avir=antiviral for macros")

Tropism test: before therapy need to test HIV virus for CCR5 tropism