Term
| Define whether any of these category 1 bioterror agents have human-human transmission - inhalation anthrax, smallpox, pneumonic plague, tularemia, botulism, Hemorrhagic fever viruses (ebola, etc). |
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Definition
| No, yes, yes, no, no, yes. |
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Term
| Name this category 1 bioterror agent - spore forming, Gm+ bacillus, encapsulated, non-motile with Medusa head appearance; cutaneous, inhalation, ingestion trans; virulence via capsule, Edema factor(up cAMP), and Lethal factor(down actin); flu-like systemic symptoms, cough, widening mediastinum; treated with cipro and doxy. |
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Definition
| B. anthacis; can cause black skin lesions covered by eschar, the infection aka Woolsorter’s disease due to contact with animal hides. |
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Term
| Name this cat 1 BT agent - aerobic, gram neg, lactose-fermenting rod, safety pin morphology on stain, flea vector, can be aerosol, causes plague with systemic sx and sore throat; can progress to bacteremia and gangrene of fingers. |
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Definition
| Yersinia pestis; treated with strepto and doxy |
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Term
| Name this cat 1 BT agent - small, fastidious, gram neg, “rabbit or deerfly” fever, killed by heat; trans via contact, inhalation, bite; has a typhoidal and ulcerglandular form; CXR shows infiltrate. |
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Definition
| Francisella tularensis, tularemia |
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Term
| Name this cat 1 BT agent - pleomorphic, gram neg, coxbac, intracellular phagolysosome, heat resistant, trans via inhalation or milk, normally asymp, patients develop fever, systemic, pneumonia, Q fever. |
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Definition
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Term
| Name this cat 1 BT agent - gram neg, cocbac, trans via milk, abrased skin, or inhaled, patients develop flu like symptoms and can progress to chronic fatigue or peripheral arthritis/spondylitis, diagnose via culture/serology, treated with strep plus doxy. |
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Definition
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Term
| HIV is most prevalent in sub-saharan Africa, but why is the global prevalence increasing? |
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Definition
| Because of new infections with longer survival times |
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Term
| T or F: the top two transmission risks for HIV are blood and mother-baby. |
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Definition
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Term
| Plasma HIV _____ concentrations are prognostic and represent a useful marker of clinical efficacy of a treatment regimen, though less than CD4 count. |
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Definition
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Term
| What are the 3 impediments to curing HIV infections? |
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Definition
| Resistance, sanctuary sites, latency |
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Term
| What is the mechanism of action of enfuvirtide a fusion inhibitor? |
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Definition
| It blocks the folding of GP41 to form a hairpin structure that is required for the HIV virus to enter CD4 cells |
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Term
| What is the mechanism of Maraviroc which is a CCR5 antagonist? |
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Definition
| It binds and and prevents HIV envelope from binding to CCR5 corecptor for CD4 entry |
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Term
| T or F: The most recent CD4 count is the best predictor of HIV progression and is important in determining response to ART which should be 100-150 cell increase per year. |
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Definition
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Term
| Starting ART for HIV patients is better with _______ CD4 counts or for all patients with CD4 _____ ______ 350 cells. |
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Definition
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Term
| HIV patients should be screen for HLA-B5701 before starting abacavir for _________ ________, and a coreceptor tropism assay for a ________ antagonist. |
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Definition
| Hypersensitivity reaction, CCR5 |
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Term
| What is the mechanism of Zidovudine a NRTI? |
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Definition
| It is a nucleoside analogue reverse transcriptase inhibitor get incorporated into DNA and act as chain terminators in DNA, however there is resistance due to preference for correct substrate and abilities to excise the NRTI |
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Term
| What is the mechanism of Efavirenz an NNRTI? |
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Definition
| It is a non-nucleoside reverse transcriptase inhibitor that is a non-competitve inhibitor of template and substrate binding at a catalytic site where nucleotides bind. |
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Term
| What is the mechanism of raltegavir an HIV integrase inhibitor? |
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Definition
| It prevents the integration of viral DNA into the chrome. |
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Term
| What is the benefit of HIV protease inhibitors? |
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Definition
| They prevent the GAG protein from being cleaved causing maturation of virions after they bud from cells. |
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Term
| What is LDH diagnostic for? |
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Definition
| It reveals high tissue turnover, so hemolysis, HIV, meningitis, or cancer. |
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Term
| The most common cause of intracerebral lesions in persons with HIV is _____________. |
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Definition
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Term
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Definition
| The lowest point of something |
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Term
| What can occur in patients with HIV and CD4 counts less than 100 who recently start ART? |
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Definition
| Immune reconstitution inflammatory syndrome, IRIS, who experience a rapid CD4 and virilogic response from new or old opportunistic organism; normally continue the ART but treat the infection |
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Term
| What is the condition called with a red eye with no pain and no decreased vision, with a clear cornea and good light reflex? |
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Definition
| Conjunctivitis; if there is pain or decreased vision then more than conjunctivitis |
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Term
| T or F: the following organisms are common causes of ocular infection - adenovirus, herpes, Strep Pnuemo, Chlamydial trachoma, Acanthamoeba or Filariasis(protozoans and nematodes), Pseudomonas, CMV, Gonorrhea, H. flu, Tuberculosis, and leprosy. |
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Definition
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Term
| The most common cause of pediatric conjunctivitis is __________ infection. |
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Definition
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Term
| T or F: Orbital cellulitis can be differentiated from preseptal cellulitis via symptoms of proptosis, motility decreased, pain on motion, etc. |
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Definition
| true, otherwise those symptoms would be absent |
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Term
| In addition to corticosteroids reducing inflammation, leukocyte emigration and adhesion, and NO release, they also increase endonucleases to do what? |
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Definition
| Induce apoptosis in lymphocytes and eosinophils. |
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Term
| T or F: in the short term corticos increase Na, sugar, BP, but long term they cause atherosclerosis, osteopenia, cataracts, glaucoma, pancreatitis. |
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Definition
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Term
| Interaction between an APC B7 (aka CD80/86) and what T-cell ligand causes downregulation of Tcells, mimicked by the drug Abatacept? |
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Definition
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Term
| Which of the following chemo agents also function as auto-immune drugs - cyclophosphamide, methotrexate, 6-MP (converted from azathioprine). |
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Definition
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Term
| Which of the following are used to control cytokines - solubilized cytokine receptors (TNFr), antibodies to cytokines, receptor antagonist (IL-ra), opposing cytokine action (IL4,IL10, TGF-b). |
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Definition
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Term
| Cyclosporin and Tacrolimus complex with cyclophilin to block calcineurium and inhibit T and B cell proliferation to treat what diseases? |
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Definition
| Auto immune like RA and SLE. |
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Term
| What is the gender and age distribution in SLE? |
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Definition
| Female 9:1, ages 15-40 for peak incidence |
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Term
| SLE can present with malar or discoid rash, arthritis, serositis (pleura, pericardium), glomerular nephritis, neurologic disease, chronic disease anemia, leuko/thromboemia, and other autoimmuire problems, so what serology test is the most sensitive for SLE? |
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Definition
| ANA; note, autoantibodies are present normally precede SLE by years. |
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Term
| In SLE, apoptotic cells due to UVB light, EBV infection (cross reactive antibodies), or DNA damage, are not cleared rapidly and become necrotic stimulating an __________ __________. |
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Definition
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Term
| TLR9 and TLR7 from dendritic and b cells bind DNA and RNA in immune complexes which may stimulate ____. |
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Definition
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Term
| Immunoregulation failures allow SLE to develop like depleted Foxp3+ in CD4 cells, but what sex hormone allows autoreactive B and T cells to be prolonged in the body? |
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Definition
| Estradiol; note hormone replacement increases flares |
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Term
| Name the antimalarial that is used in SLE and other autoimmune because of the following effects - down cytokines, downs immune complexes, downs phospholipase A2 and inflammation, down estrogen, intercalates DNA. |
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Definition
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Term
| What drug can be used to prevent flares of SLE when a flare is indicated by decreased complement C3,4, increased C3a, anti-dsDNA, and other labs? |
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Definition
| Prednisone and hydroxychloroquinone |
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