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Infectious diseases
UWORLD
| Question | Answer |
|---|---|
| Which immunoglobulin elevation is diagnostic for congenital infection, IgM or IgG? | IgM |
| Which Ig is elevated in a mother with a ToRCHES infection? | Maternal IgG titers are elevated |
| Does the mother or the neonates immunoglobulins titers have elevated both IgM and IgG? | Neonate's IgM and IgG are both elevated |
| Why is IgG elevated in a neonate diagnosed with a TORCH infection? | Maternal IgG titers are passed transplacentally, leading to a elevated neonate IgG levels. |
| What type of vaccine is used for Hepatitis B virus infection? | Recombinant HBsAg to generate anti-HBs antibodies |
| What antibodies are produced by recombinant HBsAg vaccination? | Anti-HBs antibodies |
| How does HBV vaccine prevent infection? | Bind to envelope of circulating virus and inhibiting viral entry |
| Overall, what does the anti-HBs antibodies inhibit and prevent infection and illness? | Viral entry |
| What is the suspected diagnosis of a patient with positive screening serology for HIV but indeterminate Western blot and negative plasma HIV-1? | HSV-2 infection |
| What part of the world is HSV-2 endemic from? | Western Africa |
| What is CCR5? | Co-receptor that enables HIV virus to enter the cells |
| What is prevented by CCR5 blockade? | Viral entry into host cells |
| What is an common example of CCR5 blocker? | Maraviroc |
| What receptor is blocked by Maraviroc? | CCR5 |
| What is the most common cause of skin and soft-tissue abscess formation? | Staphylococcus aureus infection |
| What is the term used by skin and soft-tissue abscess? | Furuncle |
| Why does drainage and antibiotic treatment of a Staph aureus furuncle does not eliminate relapses? | The infection is not cleared from the anterior nares and skin. |
| What is the primary treatment for Diphtheria? | Diphtheria antitoxin |
| What type of immunity does administering diphtheria antitoxin provides? | Passive immunity |
| What is the structure of Bordetella pertussis? | Small, gram-negative coccobacillus |
| What is the common outbreak caused by B. pertussis infection? | Whooping cough in unvaccinated individuals |
| What is the clinical presentation of B. pertussis infection in a unvaccinated child? | First develop mucoid diarrhea followed by severe, paroxysmal cough that is often associated with inspiratory whoop and vomit. |
| What is the first clinical symptom of Pertussis? | Mucoid diarrhea |
| What part of the mucosa or tissue is attacked and affected by B. pertussis? | Ciliated Respiratory epithelium |
| What is the most important preventive measure for Catheter related bloodstream infections? | Proper hand hygiene |
| What disinfectant is used when placing a Central Catheter? | Chlorhexidine |
| What is the most common way to acquire EHEC infection? | Eating undercooked ground beef |
| What pathogen is often associated with consumption of an undercooked meat patty? | EHEC |
| What toxin is produced by EHEC? | Shiga toxin |
| What is the triad seen with HUS? | 1. Acute renal failure 2. Thrombocytopenia 3. Microangiopathic Hemolytic anemia |
| What E.coli strain is associated with development of HUS? | EHEC |
| What is the main way to prevent congenital tetanus besides proper hygiene and umbilical cord care? | Universal vaccination to pregnant women, or those trying to get pregnant |
| How does the Tetanus vaccine in pregnant women protect the fetus from the disease? | Provides passive immunity via transplacental IgG, which serves a protector until live vaccine at the age of 2 months. |
| At what age are newborns receive active immunization against Tetanus? | Age of 2 months |
| What is Phthirus pubis? | Human pubic louse |
| How is Phthirus pubis transmitted? | Sexually via skin-to-skin contact and cause intense pruritus |
| What is often seen in examination of Phthirus pubis (human louse)? | Louse and nits under examination |
| What is the treatment for Phthirus pubis infection? | Topical permethrin |
| What pathogen is the MCC of most oropharyngeal carcinomas? | HPV, especially strains 16 & 18. |
| What areas of the body are referred as Oropharyngeal? | Tonsils and base of tongue. |
| Which strains of HPV are more prone to undergo malignant transformation? | HPV 16 and HPV 18 |
| What virus is an alphavirus spread by mosquitoes to humans in tropical and subtropical areas? | Chikungunya virus |
| What are the initial manifestations of Chikungunya fever? | Self-limited fever, severe polyarthralgia, and a rash. |
| What is a common relapsing or chronic complication of Chikungunya fever? | Arthralgia, polyarthritis (wrist, fingers, ankles), and tenosynovitis |
| Which HIV antiretroviral is known to cause a hypersensitive reaction as a side effect? | Abacavir |
| Which antiretroviral is associated with HLA-B*57:01 allele? | Abacavir |
| Abacavir features: | 1. Strong association with HLA-B*57:01 2. Adverse effect in 2-8% patients of Hypersensitivity reaction |
| What is a pharmacodynamic feature of antibiotics with concentration-dependent killing? | Administered with high doses and lower frequency |
| What is the main advantage of antibiotics with concentration-dependent killing profile? | Prevent adverse effects that may occur with prolonged systemic exposure |
| What is the role of bacterial DNA polymerase I? | Remove RNA primases and replace them with DNA |
| What protein in bacterial replication is known to remove a primases and replace it with DNA? | DNA polymerase I |
| In what direction does the DNA polymerase I work to remove the primase? | 5' to 3' direction |
| What bacterial protein is known to have exonuclease activity? | DNA polymerase I |
| What does exonuclease activity mean or entails? | Removal of primase from replicating DNA by DNA pol I in the 5' --> 3' direction |
| Which bacterial DNA polymerase is the only one with 5' to 3' exonuclease activity? | DNA polymerase I |
| Which key characteristic of some viruses allow them to undergo genetic shifts (reassortment)? | Segmented genomes |
| Segmented viruses are more prone to undergo genetic drift or genetic shift? | Genetic drift |
| What is another way to refer to genetic drifts? | Genetic reassortment |
| What does Reassortment (genetic drift) involve? | Exchange of entire genomic segments, for more dramatic process that the point mutation in genomic shifts |
| Point mutations are causative or a genetic shift or drift? | Genetic shift |
| Which is more drastic or dramatic, a genetic shift or genetic drift? | Genetic drift |
| Histologically how do atypical lymphocytes differ from normal lymphocytes? | Reactive lymphocytes are large, scalloped, and have abundant cytoplasm |
| Atypical lymphocyte or Normal lymphocyte: Large, scalloped, and abundant cytoplasm? | Atypical lymphocyte |
| What activiate Reactive (atypical) lymphocytes? | Pathogen-specific cytotoxic T cells or natural killer cells that form in response to certain intracellular infections |
| What is an important diagnostic feature of Infectious mononucleosis? | Reactive lymphocytosis |
| What is Reactive lymphocytosis? | It is when the lymphocyte count is elevated but the elevation is NOT due to a neoplastic process |
| What is the reason for anergy in Tuberculosis? | Impaired cell- mediated immune response |
| What is the term used to describe a patient with active TB have false-negative tuberculin skin test? | Anergy |
| What are some situations that lead to a False-Negative TST? | Immunocompromised patient, improper injection technique, and recent infection |
| What is a feature of Typhoid strains of Salmonella? | Contain a capsular antigen (Vi) that inhibits neutrophils phagocytosis, neutrophil recruitment, and macrophage-mediated destruction. |
| What is the condition in which Salmonella infection causes widespread systemic disease? | Typhoid fever |
| Which gram-negative bacteria is know to have a Capsular antigen (Vi)? | Salmonella typhi |
| Which HSV type is known to cause herpetic gingivostomatitis? | HSV-1 |
| What is Herpetic gingivostomatitis? | Severe vesicular or ulcerative disease following primary infection with HSV-1 |
| What aids in the diagnosis of HSV-1 infection? | Multinucleated giant cells in a Tzanck smear |
| How is Herpes Reactivation differentiated from Herpetic gingivostomatitis? | Herpes reactivation in the trigeminal ganglia generally results in mild perioral vesicles. |
| What is a featured characteristic of labs in a neonate with HBV infection? | High levels of HBV replication and increased risk for infection |
| What is a common and high risk cause for Acquired Perinatal hepatitis? | Infants born to HBeAg-positive mothers |
| What is the best mode of prevention of gonococcal infection? | Consistent use of condoms |
| What is the common triad of symptomatic disseminated gonococcal disease? | 1. Polyarthralgia, 2. Tenosynovitis, 3. Dermatitis or purulent arthritis |
| What is the MCC of neonatal meningitis? | Group B streptococcus infection |
| What is the major virulence factor of Group B Streptococcus causing neonatal meningitis? | Polysaccharide capsule with abundant sialic acid |
| How does the capsule of GBS cause illness? | Reduces effectiveness of host defense mechanism due to molecular mimicry |
| What medication is used as prophylaxis of meningococcal disease? | Rifampin |
| What is the MC outcome of untreated Hepatitis C virus infection? | Lifelong persistent infections |
| What white blood cells mediate the immune response to M. tuberculosis infection? | Macrophages and T-lymphocytes |
| What are some common conditions that deteriorate the immune system leading to increase risk of active tuberculosis? | CKD, DM, HIV, substance abuse, malnutrition, and advance age |
| How is HSV-1 infected patient clinically presented? | Prodromal symptoms, followed by pruritic, vesicular lesions that appear in successive crops in different stages |
| What are Acute Phase Reactants? | Proteins whose serum concentrations change by > 25% during periods of inflammation |
| What is an unique APR? | Procalcitonin |
| How is Procalcitonin unique among all APRs? | It can rise or fall depending on the etiology (viral or bacterial) of the the infection |
| Low levels of Procalcitonin. Viral or Bacterial source? | Viral source |
| High level of Procalcitonin. Viral or Bacterial source? | Bacterial source |
| What is Pneumocystis pneumonia? | Atypical fungal infection seen primarily in those with advanced AIDS |
| What are the common manifestations of PCP pneumonia? | Slowly (progressive) worsening pulmonary symptoms, hypoxia, and bilateral interstitial infiltrates on CXR |
| How is Pneumocystis jirovecii pneumonia visualized? | Silver stain of respiratory secretions |
| MOA of Azoles: | Inhibit the synthesis of ergosterol by the fungal cytochrome P450 enzymes |
| What is the most important adverse of Azoles? | Suppression of the human P450 system, resulting in many drug-drug interactions |
| What is the role of the bacterial cell wall? | Protects the organism from osmotic stress |
| What is the result of antibiotics that target the bacterial cell wall? | Bacterial cell lysis in hypotonic solutions |
| What are some examples of antibiotics that target the bacterial cell wall? | Fosfomycin, vancomycin, penicillin, and cephalosporins |
| Which antiviral therapy medications do not require intracellular phosphorylation? | Nonnucleoside reverse transcriptase inhibitors (NNRTI) |
| Which of the two does not require intracellular phosphorylation, NRTIs or NNRTIs? | Nonnucleoside reverse transcriptase inhibitors (NNRTI) |
| What are two very common NNRTIs? | Nevirapine and Efavirenz |
| Efavirenz. NRTI or NNRTI? | Nonnucleoside reverse transcriptase inhibitors (NNRTI) |
| Nevirapine. NRTI or NNTI | Nonnucleoside reverse transcriptase inhibitors (NNRTI) |
| What are two common segmented viruses? | Orthomyxoviruses and Rotaviruses |
| What genetic change is often associated with segmented viruses? | Genetic reassortment |
| What is a complication of Paroxysmal Nocturnal Hemoglobinuria? | Formation of membrane attack complexes on erythrocytes |
| What is the first component of the MAC ? | C5 |
| Monoclonal antibody against C5 is often used in: | Paroxysmal Nocturnal Hemoglobinuria |
| What is a adverse effect of using medications against MAC? | Increase risk for encapsulated bacterial infections |
| Which vaccines are required or encouraged for people with PNH? | Neisseria meningitidis and Streptococcus pneumoniae |
| Why do N. meningitidis and S. pneumoniae vaccines are required in people with PNH? | Due to increase risk for infection from encapsulated bacteria |
| What are common practices that lead to Toxic Shock syndrome? | Prolonged use of tampons or wound packing |
| What is the pathogenesis of Toxic Shock syndrome? | Staphylococcus aureus replicates and releases pyrogenic toxic superantigens into the blood, attach to MHC-II complex of APCs, leading to activation of T cells |
| What are clinical manifestations of Toxic Shock syndrome? | Hypotension, high fever, organ failure, diffuse, erythematous rash |
| What immune response is elicited with Inactivated (killed or component) vaccines? | Humoral response |
| How do inactivated vaccines prevent disease? | Prevent viral entry into the cell |
Created by:
rakomi
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