Term
|
Definition
|
|
Term
|
Definition
| above 1.0 mg/dL = elevated |
|
|
Term
| How many LDH's are there? |
|
Definition
|
|
Term
| How can you tell that a platelet is just sitting on top of a RBC or is in it? |
|
Definition
| On top = halo around it ... bc of pressure |
|
|
Term
|
Definition
|
|
Term
|
Definition
| falciprum, ovale, vivax, malaria |
|
|
Term
| What kind of mosquito transfers Malaria? |
|
Definition
|
|
Term
| What does malaria sporozoite do in the liver? |
|
Definition
-invades hepatocytes
-undergoes asexual replication -> merozoites
- 6-14 days |
|
|
Term
| What is a malarial infected hepatocyte called right before it bursts? |
|
Definition
|
|
Term
|
Definition
| Organelle that excretes, burrows for infection |
|
|
Term
|
Definition
Histidine-rich protein bumps on an infected RBC
- makes it "sticky" so it attaches to endothelial cells...
- only Faciparum
- can attach to ICAM I
- can attach to capillaries in the brain -> CNS problems |
|
|
Term
|
Definition
A cell filled with daughter merozites that's about to burst.
-tissue schizont
-blood schizont |
|
|
Term
| How long does it take for the blood cell lyse and releases malaria? |
|
Definition
|
|
Term
| Why does Falcip attach to endothelial cells? |
|
Definition
|
|
Term
| How is P. vivax/ovale different than P. falciparum? |
|
Definition
- stay in the liver and go dormant.
- make Hypnozoites (vivax and ovale -> reactivation) |
|
|
Term
| Where do you see schizont? |
|
Definition
|
|
Term
| Falciparum Hemazoin (characteristics) |
|
Definition
-black
-inclusion body of leftover heme from eating the Hb |
|
|
Term
| What is the vector for Babesiosis? |
|
Definition
|
|
Term
| What part of the tick does Babesiosis live? |
|
Definition
|
|
Term
| Does Babesiosis go to the liver? |
|
Definition
|
|
Term
| What does Babesiosis do in the RBC? |
|
Definition
| Divides into 4 mirazoite (tetrad) |
|
|
Term
| Why don't most people from the endemic areas of Malaria die from it? |
|
Definition
| Hemaglobbinopathies (ex. sickle cell) |
|
|
Term
|
Definition
| can survive on basis of immune response |
|
|
Term
| Why is the distribution of Vivax Malaria different than the distribution of Faciparum Malaria? |
|
Definition
- West Africa doesn't have as much P. Vivax as P. Falciparum.
- The people there don't have the Duffy Group of receptor |
|
|
Term
| How do you diagnose malaria? |
|
Definition
- thin peripheral smear (dried, fixed, stained)... but if it's negative, it doesn't completely exclude malaria
- Dipstick test for P. Falciparum only... but will be positive in someone who's had it before
- |
|
|
Term
| How do you make a thick smear? |
|
Definition
- put a drop of blood on slide
- use corner of slide to mix it up a little -> lyse
- stain
- air dry but don't fix |
|
|
Term
| Why might the thin smear be negative in a person positive for Malaria? |
|
Definition
- Prophylactic drugs
- time lapse |
|
|
Term
| Where do you get babesiosis? |
|
Definition
| North, NE in the US... not tropical |
|
|
Term
| What clears abnormal blood cells from the body? |
|
Definition
|
|
Term
| What's a Howell-Jolly body? |
|
Definition
basophilic nuclear remnants (clusters of DNA) in circulating erythrocytes.
- can be seen when you don't have a functional spleen |
|
|
Term
| What are complication of severe malaria? |
|
Definition
| mini-strokes in any organ |
|
|
Term
|
Definition
| Quinidine (from Cinchona plant bark) |
|
|
Term
| When would you NOT use Cloroquine for Falciparum? |
|
Definition
| if it comes from Sub-saharan Africa ... probably resistant |
|
|
Term
| Why wouldn't you use Quinidine as a prophylaxis? |
|
Definition
| There are a lot of side effects |
|
|
Term
|
Definition
|
|
Term
| How is malaria prevented? |
|
Definition
- Permethrin insecticide
- mosquito nets
- dusk/dawn
- Cloroquine *won't prevent infection!
(also used as a treatment for really mild malaria) |
|
|
Term
| How long should you prophylax someone for malaria? |
|
Definition
- a wk before (so you know you can tolerate it) - 4 wks after (bc you're only targeting the blood phase)
- Methloquin (psychiatric side effects!) but good for chloroquin resistant malaria
- Chloroquin
- Doxycycline |
|
|
Term
| How can we shorten the amount of time that you need the malaria prophylaxic for? |
|
Definition
- take Malarone or Primaquin (causal prophylaxis)
- can stop a week after you come back |
|
|
Term
| How do you kill P vivax Hypnozoites? |
|
Definition
Radical cure
***make sure they don't have G6PD defiencies
Primaquin |
|
|
Term
| How is babesiosis managed? |
|
Definition
Mild = arizthromycin + atovaquone
Severe (10% parazitinemia) = Clindamycin + Quinine + exchange blood transfusion |
|
|
Term
| When is Malaria considered severe? |
|
Definition
|
|
Term
| What does fever, confusion, pleocytosis, and elevated proteins in CSF indicate? |
|
Definition
|
|
Term
| What does a serum aspartate aminotransferase of 164 U/L indicate? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Key differences between HME and HGA |
|
Definition
HME - CSF w. pleocytosis and elevated protein levels
HGA - doesn't usually have CNS involvement |
|
|
Term
|
Definition
|
|
Term
| What's the organism responsible for HME? |
|
Definition
|
|
Term
| What's responsible for HGA? |
|
Definition
|
|
Term
| What states are HME most prominent in? |
|
Definition
| South Central, Southeast, Midatlantic US |
|
|
Term
| What states are HGA most common in? |
|
Definition
|
|
Term
| What cells do Erlichea Erlingii target? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Lone Star Tick (A. americanum) |
|
|
Term
|
Definition
|
|
Term
| Where do the gram (-) Erlichea like to replicate? |
|
Definition
- Vacuole in cytoplasm of monocytes
- prevent lysosomal fusion |
|
|
Term
| What are the two types of Erlichea cells that grow in vacuoles? |
|
Definition
Dense Cell (DC) - spread infection
Reticular cells (RC) - grow |
|
|
Term
| How do you manage ehrlichiosis and anaplasmosis? |
|
Definition
- Doxycyline (start when you strongly suspect, don't wait for confirmatory test)
- Pregnant -> Rifampin
- Chloramphenicol can also be used
- Can see results in 24 hrs!! (if not... maybe babesia) |
|
|
Term
| Is palpable spleen common in EBV? |
|
Definition
|
|
Term
| A pt comes in w. sore throat w. exudate. What do you do? |
|
Definition
- throat swab culture
- rapid strep test |
|
|
Term
|
Definition
|
|
Term
| What's the marker for CMV? |
|
Definition
|
|
Term
| Can a rash help you distinguish between EBV, CMV, and HIV? |
|
Definition
| Nope. it can be present in any |
|
|
Term
| What are the rersevoir cells in EBV? |
|
Definition
|
|
Term
| What will you find in routine lab tests w. EBV? |
|
Definition
| -atypical lymphocytes (irregular nuc... etc) |
|
|
Term
Interpret:
(+) IgG EBNA and IgG VCA
(-) absence of IgM VCA
(-) heterophile Ab |
|
Definition
|
|
Term
|
Definition
- rest (no contact sports for 1 mo)
- prednizone for upper airway obstruction, immunosuppressed Pt
- no more Acylovir |
|
|
Term
|
Definition
- splenic rupture (no contact sports for 3 wks, no strenuous exercise for 4 wks)
- meningitis |
|
|
Term
| Which cancer is associated with EBV? |
|
Definition
Burkitt's lymphoma (African)
nasopharyngeal carcinoma (Asia)
Hodgkin's lymphoma
Hairy cell leukemia |
|
|
Term
| What happens to EBV pt to ampicillin? |
|
Definition
| Rash! but not an PCN allergic reaction |
|
|
Term
| Which mucosal cells are most succeptable to HIV infection? |
|
Definition
| Ones with Dendritic Cells. Anal, Oral?? |
|
|
Term
| What are the three HIV-1 variants? |
|
Definition
- TCL-tropic CXCR4 receptor
- Dual tropic
- M tropic (more common) CCR5 receptor |
|
|
Term
|
Definition
1. ELISA - detects Ab's ... might not work w. acute HIV infections (+ before western blot)
2. HIV-1 RNA **? RT-PCR (works well for acute too)
3. HIV p24 Ag - 4th generation EIA... not common yet |
|
|
Term
| When will a HIV pt get a FN for a ELISA test? |
|
Definition
- too immunocompromised to make Ab's
- early Antiretroviral intervention will prevent Ab reaction
- acute HIV |
|
|
Term
| What proteins are detected by HIV Western Blot? |
|
Definition
GAG, POL proteins
- gp160, gp120, gp41, p55, p31, p24
*** need 2 bands = positive
< 2 bands = indeterminate |
|
|
Term
| Will ELISA detect HIV-1 or HIV-2? |
|
Definition
|
|
Term
| When will HIV RNA reach it's highest value during infection? |
|
Definition
|
|
Term
| When does HIV RNA become detectable? |
|
Definition
| 10-12 days after infection |
|
|
Term
| When does HIV Ab titer become detectable? |
|
Definition
| around 27 days... after 4 wks |
|
|
Term
| What are HIV/Acute Retroviral Syndrom Sx? |
|
Definition
fever, weight loss, malaise, lymphadenopathy, rash, liver/spleen enlargement, myalgia, sores...
*** not commonly seen in the clinic!! Bc ppl don't come in until it's chronic |
|
|
Term
|
Definition
|
|
Term
| Acute HIV (HIV RNA, CD4+ cell levels) |
|
Definition
- drop in Cd4+
- rapid increase of HIV RNA
*** Then ... eventually catches on that HIV is harmful and the CD4 rallies at the beginning of clinical latency |
|
|
Term
|
Definition
|
|
Term
| What should happen w a HIV pt at a CD4 count of 350? |
|
Definition
| Antiviral therapy (HAART)! so that CD4 cells can increase |
|
|
Term
| What do you need to do before starting ART for HIV? |
|
Definition
- Baseline CD4 count/viral load (monitoring)
- Resistance testing (genotyping for medication)
- Baseline LFT's, chemistry and lipid panel (monitor adverse Rxns)
- test for coinfections! (Hep A,B,C, Toxoplasma Ig, etc)
- HLA-B*5701 screening (screen for Abacavir hypersensitivity reaction)
- CCR5 tropism assay (determine med) |
|
|
Term
| When should you start ART? |
|
Definition
**Any of the following
- history of AIDS-defining illness (oral thrush)
- CD4 count <350 cells/microL
- pregnant women (prevent transmission)
- HIV-associated nephropathy (HIVAN)
- Hepatitis B (HBV) co infection, when HBV Tx is indicated |
|
|
Term
|
Definition
| 2 NRTI and then a 3rd drug from other groups |
|
|
Term
|
Definition
Bone marrow suppression: anemia, leucopenia
Peripheral Neuropathy
Pacreatitis
***Abacavir: hypersensitivity RXN |
|
|
Term
|
Definition
- drug-drug interaction
- severe skin rash
- Hepatitis
- Rapid resistance if dose missed
- hepatitis |
|
|
Term
|
Definition
- Paresthesias
- Diarrhea
- Nausea and Vomiting
- Hypertriglyceridemia
- Hyperglycemia
- Hypercholesterolemia
- Nausea/Vomiting
-... |
|
|
Term
| What is the DDx for Mononucleosis? |
|
Definition
-Epstein Bar Virus (heterophile +, monospot)
-CMV (h -, hepatitis, Ab/IgM test)
-HIV1 (non-tender lymhadenopathy, percutaneous ulcers) |
|
|
Term
|
Definition
|
|
Term
|
Definition
| variation in shape due to defect in maturation of RBC precursors in bone marrow or fragmentation of circulating RBC's |
|
|
Term
|
Definition
red cells that are slightly larger than normal and grayish blue in color on wright-giemsa stain
- prematurely released reticulocytes ...
- color = residual amounts of rRNA |
|
|
Term
|
Definition
- Severe Iron Deficiency
- Thalassemias (alpha/beta)
- **Anemia due to Chronic Disease can sometimes be microcytic... usually normacytic |
|
|
Term
| What are the three stages of Iron Deficiency? |
|
Definition
- Negative Iron Balance: demand exceeds absorption
- Iron deficient erythropoiesis
- Iron deficient anemia |
|
|
Term
|
Definition
-possible causes: blood loss, pregnancy, growth spurts, inadequate dietary intake
- Decreased iron stores ->decrease serum ferritin level
- Red cell morphology and indices are normal |
|
|
Term
| Iron-deficient erythropoiese |
|
Definition
- transferrin saturation -> 15-20%
- Hb synthesis is impaired
- microcytic cells appear
- hypochromic reticulocytes in circulation |
|
|
Term
| Iron-deficiency anemia Fe labs |
|
Definition
-Decreased Hb, Hc
-Decreased percent saturation 15-20%
-increased TBIC
-decreased serum Fe
-decreased Ferritin levels |
|
|
Term
| What is a common cause of iron deficiency in adult males? |
|
Definition
|
|
Term
|
Definition
- four 5 membered pyrrole rings
- held together w. bridges |
|
|
Term
| What bonds does the Heme iron form? |
|
Definition
- 4 pyrrole N atoms
- proximal histidine from Hb or Mb
- optional sixth bond w. O2 |
|
|
Term
|
Definition
-Tetrameric proteins of a mix of:
- alpha, beta, gamma chains
- each subunit has hydrophobic core, hydrophillic |
|
|
Term
|
Definition
- Hereditary spherocytosis
- Immune Hemolytic Anemia |
|
|
Term
| How is Hereditory Spherocytosis transmitted? |
|
Definition
| Autosomal dominant disorder |
|
|
Term
| AutoImmune Hemolytic Anemia (AIHA) |
|
Definition
-autoantibody directed against a red cell antigen
-usually in spleen, liver, and bone marrow (where there's a lot of macrophages)
-extravascular hemolysis |
|
|
Term
|
Definition
- Cold Agglutination IgG
- Direct Coombs Test IgG |
|
|
Term
|
Definition
- immune suppress (prednisone, corticosteroids)
- spenectomy |
|
|
Term
| Blood is connective tissue what basic things comprise it? |
|
Definition
-Cells and cell fragments (Formed Elements)
-Plasma (Serum + Clotting Proteins) |
|
|
Term
| What is the difference between serum and plasma? |
|
Definition
Plasma is Serum + Clotting proteins, if you remove the clotting proteins from plasma you get serum.
Removing the cellular elements from blood yields plasma (centrifugation). |
|
|
Term
|
Definition
| infected RBC -> uninfected RBC |
|
|
Term
|
Definition
| infected cell attaches to infected cells |
|
|
Term
|
Definition
-thrombocytopenia
-and/or leukopenia
-pleiocytosis (HME only)
-elevated liver enzymes (ALT/AST) |
|
|
Term
|
Definition
HME - not usually seen
HGA - more commonly seen |
|
|
Term
|
Definition
|
|
Term
|
Definition
1. Elisa= 92% spec,sens... IgM: acute IgM/IgG: reactivation
2. cell culture
3. Rapid test: pp65 Surface Ag test |
|
|
Term
|
Definition
| - monospot test - heterophile agglutination test |
|
|
Term
| Infectious Monocytosis labs |
|
Definition
-atypical lymphocytes in CBC
-loss of basophilic cytoplasm
-elongated nucleus |
|
|
Term
|
Definition
Abacavir (ABC)
Didanosine (DDL)
Starudine |
|
|
Term
|
Definition
|
|
Term
|
Definition
-Nelfinavir
-Indinavir
-Tipranavir |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
