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last minute micro

QuestionAnswer
lepromatous TB low cell-mediated immunity with a humoral Th2 response
tuberculoid TB high cell mediated immmunity with a Th1 reponse; limited to a few skin plaques
bacteria infects skin and superficial nerves, likes cool temps M. leprae
tx of leprosy dapsone 2. rifampin and combination of clofazimine and dapsone
toxicity of dapsone hemolysis and methemoglobinemia
prophylaxis tx for MAC azithromycin
recurring fever due to antigenic variation Trypanosoma brucei
tx for trypanosoma suramin for blood borne disease or melasoprol for CNS penetratio
pleuritic pain, hemoptysis, infiltrates on imaging in HIV pt invasive aspergillosis
TB like disease in HIV MAC Cd4<50
biopsy revelas neutrophilic inflammation (of derm) in HIV bartonella hensleae
due to reactivation of a latent virus, results in demyelination CD4<200 in HIV encephalopathy - JC virus -> PML
biopsy reveals lymphocytic inflammation in HIV HHV8 -> Kaposi's
on lateral tongue of HIV hairy leukoplakia- EBV
during latent phase, where does the virus replicate for HIV? lymph nodes
stages of infxn in HIV 1. flulike acute; 2. feeling fine (latent); 3. falling count; 4. final crisis
HIV diagnosis first? 1. ELISA (Sensitive, high false positive rate; RULE OUT test)
HIV diagnosis second 2. Western blot assay (specific, high false negative rate; RULE IN)
AIDS diagnosis < or = CD4 200 or CD4/8 ratio < 1.5
caveat to tests for HIV they look for Ab to viral proteins; often falsely neg in first 1-2 mo of HIV infection; falsely positive in babies to infected mothers (anti gp120 corsses placenta)
gp120 - attachment to host cell gp41- fusion and entry
gag p24 capsid protein
pol reverse transcriptase
RNA is a ___ genome? diploid - 2 molecules of RNA
what does the virus bind for hiv on T cells CXCR4 or CCR5 co-receptor and CD4 on T cells
what does virus bind on macrophages? for HIV CCR5 and CD4
homozygous CCR5 mutation? GOOD = immunity
heterozygous CCR5 mutation slower course
anti HAVAb IgM IgM antibody to HAV= active hepatitis A
anti HAVAb IgG prior HAV infection; protects against reinfection
HbsAg antigen found on surface of HBV- hepatities B infection
anti HbsAg antibody to HbSAg- immunity to hep B
HbCag antigen associated with core of HBV
anti-HBcAg antibody to HBcAg; IgM = acute/recent infection; IgG = chronic disease/ Positive during window period
HBeAg a second, different antigenic determinant in the HBV core. active viral replication and high transmissibility
anti-hbEAG antibody to e antigen; low transmissibility
acute HBV HBsAg, HBeAg, anti HbCag IgM
window Anti HBcAg
chronic HBV high infectivity HBsAg, HBeAg, anti HbCag IgG
chronic HBC low infectivity HBsQg, antiHBeAg, anti HbCag IGG
RNA hepevirus HEV
fecal oral, especially with waterborne epidemics hepatitis HEV
carrier state for Hepatitis Hep B, C, and D
incubation is short Heb A and Hep E
HCC risk Hep B from oncogene; hep C from chronic inflammation
high mortality in pregnant women hepatitis Hep E
signs and symptoms of all heptatitis virus fever, jaundice, elevated ALT and AST
naked virsues do not rely on an envelope therefore? they are not destroyed by the gut = HAV and HEV
cellular RNA polymerase transcribes RNA from DNA template in which hepatitis? HBV
what does reverse transcriptase do? it transcribes RNA intermediates into DNA genome
what is reverse transcriptase in HBV? DNA dependent RNA polymerase
fever, weight loss, malaise, HA, abdominal pain, melena, HTN, neurologic dysfunction, cutaneous eruptions (purple over skin) PAN - a/w Hep B
travels to CNS by migrating in retrograde fashion up nerve axons rabies
parotitis, orchitis, aseptic meningitis mumps paramyxovirus
giant cell pneumonia as sequelae (rarely, in immunosuppressed) measles
paramyxoviruses parainfluenza (croup); mumps, measles, RSV
characteristic of paramyxocirus contain surface F(Fusion) protein, which causes respiratory epithelial cells to fuse and form multinucleated cells
prevention for pneumonia in premature infants palivizumab (monoclonal ab against F protein)
togavirus rubella, eastern and western equine encephalitis
influenza virus is what viral family? orthomyxovirus- enveloped, negative SS RNA with 8 segment genome
contains hemagglutinin and neuraminidase antigens influenza virus
hemagglutinin in influenza virus - promotes viral entry
neuraminidase in influenza virus - promotes progeny virion release
segmented dsRNA virus reovirus - rotavirus, voltivirus (colorado tick fever)
mechanism of diarrhea for rotavirus villous destruction with atrophy leads to decreased absorption of Na and water
flavivirus transmitted by Aedes mosquito yellow fever virus
high fever, black vomit, jaundice yellow fever
acid labile - destroyed by stomach acid, therefore does not infect the GI tract rhinovirus
all picornaviruses can cause aseptic (viral) meningitis except? rhinovirus and HAV
negative stranded viruses have? own RNA dependent RNA polymerase
negative strnaded RNA viruses Arenaviruses, Bunyavirus, Paramyxovirus, Orthomyxovirus, Filovirus, Rhabdovirus
Created by: ilovemusic007