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Microbio Exam 4
Agents and their Diseases
220
Microbiology
Graduate
05/09/2011

Additional Microbiology Flashcards

 


 

Cards

Term
What are three agents that cause infections of the integument? 
Definition

Propionibacterium acnes

Staph aureus

Strep pyogenes

Term
Which agent is the predominant ANAEROBIC member of the normal skin flora? What type of rod is it?
Definition

Propionibacterium acnes

 

Gram positive diptheroid

Term
What are the three normal flora of the skin?
Definition

-Propionibacterium acnes

-diphtheroids

-coagulase negative staph

Term

Which class can be described as "short Gram positive bacilli, like 'Chinese letters?'

 

Definition
Diptheroids
Term
What is the most common skin disease?
Definition
Acne Vulgaris
Term

What population does Acne Vulgaris normally occur in?

 

What is it initially caused by?*

 

The overgrowth of which agent causes inflammatory Acne Vulgaris?

Definition

-adolescent population

 

-alteration in sebaceous physiological processes 

 

-propionibacterium acnes

Term

In the absence of P. Acnes, what is formed from:

 

increased sebum production after puberty

or

follicular canals plugged due to altered physiology?

Definition
microcomedones
Term
In the non-infectious process of acne, what two things can cause canal/duct blockage?
Definition

Keratinization

Desquamation

Term
What non-inflammatory structure may microcomedones evolve into?
Definition
Comedones; open or closed surface pores
Term
What is not present in the non-inflammatory manifestation of acne?
Definition
there is no P. Acnes present
Term

What is a closed comedeone?

 

What is an open comedone? What is the common misconception about open comedones?

Definition

"White head"

 

"Black head'

-the "black" part is not dirt, rather melanin, which results in pigmentation

Term
What are the four main goals of treatment for acne vulgaris?
Definition

-antikeratinizing

-inhibit sebum production

-anti p. acnes

-anti-inflammatory

Term
How long may intermittent treatment of Acne vulgaris take?
Definition
months to years
Term
Name 5 treatments for acne vulgaris that inhibit P. Acnes
Definition

Salicylic acid

Retinoic Acid

Azelaic Acid

Benzoyl Peroxide

Antibiotics 

Term
Which three antibiotics are anti-P acnes?
Definition

erythromycin

clindamycin

doxycycline

Term
Name 4 non-abrasive compounds in medicating cleansing OTC's for acne vulgaris:
Definition

-Topical Vitamin A

-Topical Vitamin C

-Low does retinol

-Alpha hydroxy acid

Term
What three treatments can you use for severe acne?
Definition

-systemic antibiotics

-corticosteroids

-estrogens, anti-androgens, spironolactone

Term
What are the four most harmful actions you can do if you have acne?
Definition

-Frequent, non-medicated vigorous cleansing

-abrasive cleaning

-restricted diet

-squeezing pimples (can lead to inflammatory response)

Term
Is Acne curable? Is the treatment duration less than or more than 6 months?
Definition
No; more than 6 months
Term

Which agent of the integument can be described as Gram-positive cocci

forms pairs, short chains, grape-like clusters

produces coagulase?

Definition
Staph Aureus
Term
The manifestations of Staph Aureus can be grouped into which two groups?
Definition
Non-toxin mediated and toxin mediated
Term

Folliculitis, Furuncles, Carbuncles, and Epidermis impetigo

 

fall under which classification of manifestations of staph aureus integument infection?

Definition
Non-toxin mediated diseases
Term

What is "cured" defined as in HCV?

 

Because it is so expensive and difficult, what are the three criteria for treatment of HCV?

Definition

-persistent loss of HCV RNA in blood during long-term follow-up

 

-persistent elevation of aminotransferases, quantitative HCV RNA, severe histologic changes on liver biopsy

Term
What are the two transmissions for HAV? Which are the major vehicles?
Definition

-Fecal-oral and person-to-person transmission are possible (fecal-oral is bigger)

 

-food and water are major vehicles

Term
Which immunoglobulin in HAV indicates lifelong immunity?
Definition
IgG
Term
Which immunoglobulin in HAV is generally present 5-10 days before symptoms and last for under 6 months? What can this be useful for?
Definition
IgM; It can be useful for diagnosing HAV. 
Term
What are HavRix and Twinrix? Who are they recommended for?
Definition
Killed vaccine for hepatitis A virus; recommended for children and international travelers
Term
Where is HEV common in?
Definition
-underdeveloped countriess mostly in S.E./central asia
Term
Fulminant hepatitis E with liver failure is found very rarely (1%) EXCEPT in which population?
Definition
Pregnant women in their third trimester (25%)
Term
What is the treatment for HEV?
Definition
Supportive treatment only
Term
What "kind" of virus is HIV? What does it have multiple of?
Definition
it is a retrovirus and has multiple serotypes
Term
How long is the incubation period for HIV?
Definition
2-4 weeks
Term
What does M-tropic strain of HIV infect?
Definition
Infects macrophages/primary T lymphocytes
Term
What does M-tropic strain indicate?
Definition
Non-progression of AIDS
Term
What does the T-tropic strain of HIV indicate?
Definition
It indicates that the patient will progress to AIDS rapidly and a steep decline in T-helper cells.
Term

Viral genome for HIV:

 

RNA -->DNA?

or 

DNA--> RNA?

Definition
RNA-->DNA
Term
In HIV, what 2 things convert ssRNA into ssDNA?
Definition

-reverse transcriptase (66)

-ribonuclease H 

Term
What is an important distinction that occurs when HIV ssRNA is converted to ssDNA? Why does this occur?
Definition
Many replication (base pair) errors occur because reverse transcriptase has no proofreading.
Term
Some drugs that target reverse transcriptase also target what?
Definition
DNA-dependent polymerase in mitochondria; (big effect on normal replication)
Term
Once infected with HIV, how long does a person remain infected? How long must he/she be treated for?
Definition
A person remains infected for life and treatment must be lifelong.
Term
In acute phase of infection, where does HIV primarily replicate?
Definition
T cells in the GIT
Term
After three weeks of infection of HIV, what noticeable endoscopic change will occur?
Definition
there will be no more T cells in the GIT
Term
Where does the human immune system battle HIV virus in the body? What happens with a few years?
Definition
lymph nodes (T cells and HIV virion die); eventually, the virus overwhelms the immune system and progresses to AIDS
Term
After all the T-cells are gone from the gut, what is activiated?
Definition
a chronic, generalized/systemic immune activation
Term
What is one of the strongest predictors for progression from HIV infection to AIDS and which may be the main cause of CD4 depletion?
Definition
the strong chronic, systemic immune activation
Term
What is the CD4 count for AIDS?
Definition
<200/mm^3
Term
What is defined as a "slowly progressive demyelinating disease with neuronal loss of the CNS?"
Definition
HAD: HIV-associated dementia
Term
What is the worst risk factor for HAD?
Definition
IV drug abusers
Term
What does HIV affect in the CNS? What doesn't HIV affect in the CNS?
Definition

It affects: monocytes, macrophages, and microglia cells.

 

It does not affect: neurons or oligodendrocytes 

Term
What are the results of HIV infection in the CNS (2)
Definition

-diffuse or focal myelin pallor of white matter (demyelination)

-neuronal loss

Term
What is defined as: neurocognitive impairment demonstrated by cognitive testing but are asymptomatic in their daily life?
Definition
Asymptomatic neurocgnitive impairment (ANI)
Term

What is defined as when the patient has impairments causing mild disturbance of ADL's?

(difficulties in concentration, attention, memory) What does this progress from?

Definition

HIV-associated mild neurocognitive disorder (MND)

This progresses from ANI

Term
What is the full progression of CNS disease via HIV?
Definition
HAD
Term
What are the most common feature of HAD?
Definition
cognitive changes (forgetfulness, confusion, loss of memory)
Term
Which two diagnostic tests detect HIV-specific antibodies? Problem with this test?
Definition
EIA; western blot. Must wait until immune response ("window of no positive serology")
Term
Which viral antigen must be tested for all blood donors? What are they testing for?
Definition
p24 antigen; tests for HIV, especially when "window" period of no antibodies
Term
What are the four strategies to prolong survival in those with HIV?
Definition

-antiretroviral therapy

-P. carinii prophylaxis

-M. Avium prophylaxis

-care by a physician with HIV-care experience

Term
What happens if you stop reverse transcriptase? Which drug type does this? 
Definition

you stop any new virus from infecting person's cells; RTI's and NNRTI's do this (Reverse-transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors)

 

Ex: neveripine; loviride

Term
What do protease inhibitors do? Name three examples.
Definition

Stop maturation of virus. Virus is made, but not infectious.

 

saquinavir; indinavir; amprenavir

Term
What does Selzentry do?
Definition
inhibits HIV-1 co-receptor CCR5
Term
What does Isentres (Raltegravir) do?
Definition
inhibits HIV-1 integrase
Term
Is HIV monotherapy efficacious long term? Why or why not? (2 reasons)
Definition
It is NOT efficacious long term because you get resistance and because of the high mutation rate of the virus.
Term
What is are the results of RTI's(NRTI's)?
Definition
-blocks production of viral DNA and inhibits further DNA synthesis via CHAIN TERMINATION
Term
How does NNRTI work?
Definition
-it attaches to viral reverse transcriptase to block its function and it will block the further prodcution of viral DNA.
Term
Does the latent virus DNA get killed by antiviral therapy? Why or why not?
Definition
No because it is already in the human genome.
Term
What does HAART stand for? What does it consist of?
Definition
Highly active Antiretroviral Therapy: multiple drugs used for treatment of HIV; Old definition is 2 RTI's and something else; now it can be two NRTI's plus something else.
Term
What are the three caveats of HAART?
Definition

-does not prevent all new infections of susceptible cells

-does not kill latent virus (NO CURE!!); latent infected T-cells are the major reservoir

 

-patient is still infectious via sexual contact

Term
What are two reasons why HAART must be adhered to faithfully?
Definition

-drug resistance is a significant problem

-latently infected T cells are the major reservoir. If HAART is stopped prematurely, latent cells will become active and progress to AIDS

Term
What are two reasons why CD4 count increases rapidly with HAART?
Definition

-initial redistribution of memory T cells

-slow repopulation of naive cells

Term
It must be noted that HIV therapy causes a lot of :__________. This is why it is important to know when to start therapy. 
Definition
toxicity
Term
During primary infection, what 2 types of cells does EBV virus infect? After resolution of primary infection, EBV is a latent-persisent infection where?
Definition
epithelia cells and resting B cells; peripheral blood/memory B lymphocytes
Term
During latency, where can Epstein-Barr virus occur due to a lytic infection after B cells spread to oropharynx?
Definition
saliva
Term
If there are non-sense antibodies present in the body, what is the probably agent?
Definition
EBV
Term
What type of antigen is EBV?
Definition
tyoe 1 T-INdependent antigen
Term

What are the two more unusual manifestations of EBV?

 

Definition

splenomegaly

heptaomegaly

Term
Why is there a splenomegaly in EBV?
Definition
The spleen is the major organ for B cells in the body, and in Epstein-Barr disease, there is a huge proliferation of B cells.
Term
What are three complications with EBV?
Definition

lymphomas

hairy leukoplakia

multiple sclerosis

Term
What drug do you never give if someone has infectious mono due to EBV?
Definition
Never give ampicillin!
Term

Treatment for EBV: What kind of treatment?

Ampicillin?

acetominophen?

acyclovir?

corticosteroids?

Definition

supportive; 

 

No ampicillin, acyclovir, corticosteroids.

 

YES to acetominophen. 

Term
Four ways of CMV transmission?
Definition

-secretions

-blood transfusion

-vertical transmission

-organ transplant recipients

(if immunosuppressed, CMV = fatal)

Term

 

Which agent is the most common cause of congenital infection?

Definition
CMV
Term
Which agent are CMV manifestations very similar to?
Definition
EBV (but CMV is much more prevalent)
Term
Are non-toxin mediated diseases contagious? What does that mean if a person is exposed?
Definition
All are contagious which means that a person exposed to infection will be colonized with the virulent strain, but not necessarily develop the disease.
Term
Which four types of agents cause cellulitis?
Definition

1. Gram-positive cocci (pyogenes, aureus, pneumoniae)

2. Gram-negative rods

3. Atypical mycobacteria (necrotizing skin lesions)

4. Fungal agents

Term
Exposure to what predisposes a person to cellulitis and often involves bacteremia? (mycobacterium or vibrio)
Definition
exposure to fresh or seawater
Term
Which epidemiologic factor predisposes a person to cellulitis and involves the agents Pasteurella and Capnocytophaga?
Definition
Animal (cat/dog) scratches or bites
Term
Infections in areas adjacent to the oral cavity/in oral secretions predisposes people to cellulitis caused by which agent?
Definition
Eikenella corrodens
Term
In cellulitis epidemiology, which etiology causes infections that occur within 72 hours of surgery? (2)
Definition

1. gram positive cocci

2. C. perfringens

Term
In cellulitis epidemiology, which etiology causes infections that occur between 10-->30 days? 
Definition

gram-negative rods (facultative anaerobes)

gram-positive cocci

Term
In cellulitis epidemiology, which etiology causes infections that occur between 2-3 months post-operative?
Definition

diphtheroides

coagulase negative staph

Term
Describe the manifestation of the local infection of cellulitis. 
Definition
-inflammation: erythema, pain, edema, warmth, NEVER sharply dermarcated
Term
What treatment must be done for cellulitis?
Definition
I.V. antibiotics
Term
As far as the epidemiology of anthrax, what type of disease is it? And what are the primary hosts?
Definition
Enzootic disease of *herbivores such as sheep, goats, cattle, etc.
Term
What is formed by bacillus anthracis that can survive for years in the soil?
Definition
Anthrax spores
Term
Which type of anthrax accounts for 95% of human cases?
Definition
cutaneous anthrax
Term
In cutaneous anthrax, how does death occur? (2 reasons)
Definition
Death is due to both a Toxemia and a Bacteremia.
Term
Which disease caused by P. aeruginosa must you make sure not to confuse with anthrax?
Definition
Ecthyma
Term
What is the etiologic agent of erysipelas? What is another name for erysipelas?
Definition
Group A Strep; St. anthony's fire
Term
What precedes erysipelas?
Definition
URT or skin infection caused by GAS
Term
Erysipelas is similar to cellulitis except that:
Definition
-the illness begins with systemic signs and an erythema forms that is : bright red and indurated that IS SHARPLY DEMARCATED
Term
Sole reservoir for smallpox?
Definition
humans
Term
How is smallpox virus passed? (2)
Definition

-respiratory secretions

-contact with lesions

Term
4 complications of smallpox?
Definition

-variola keratitis

-encephalitis

-cellulitis

-secondary bacterial infection

Term
DNA polymerase inhibitor that is used in the treatment of smallpox?
Definition
Cidofovir (Vistide)
Term

Which stage of smallpox is described as: 

 

after exposure to the virus, this period is when people do not have any symptoms and feel fine. This period averages 12-14 days and people are not contagious. 

 

Definition
Incubation period
Term

Which stage of smallpox is described as: 

 

first symptoms include fever, malaise, head/body aches. fever is usually very high and people are too sick to carry on ADL's. This stage my last 2-4 days.

Definition
prodrome phase
Term
Which stage of smallpox is the most contagious?
Definition
early rash phase
Term
Where does the early rash begin in smallpox? Within 24 hours, what happens to the rash? What happens to fever? 
Definition
It begins on the tongue and in the mouth; In 24 hours, the rash spreads to all parts of the body; The fever falls down and the patient may feel better.
Term
Which stage of smallpox is described as: the raised bumps become sharply raisd, usually round and firm to touch as if there is a small object under the skin. Like BB pellets under the skin. 
Definition
Pustular rash
Term
What happens after pustules develop in smallpox? What happens after scab phase in smallpox? When is the patient no longer contagious?
Definition
they form scabs; scars are formed. The patient is no longer contagious once all the scabs have fallen off.
Term
Which areas of the body do most lesions of smallpox end up spreading to?
Definition
Extremities
Term
What is the seasonal occurrence of chicken pox?
Definition
Winter-->spring
Term
Where is the virus located in varicella and zoster?
Definition
The virus is located in the lesions; know that the lesions are contagious.
Term
Where do lesions first develop in chickenpox?
Definition
They first develop on the head/scalp and spread to trunk
Term
What is the most common agent of secondary infection that causes the hospitalization of children with varicella?
Definition
Secondary infection by GAS or staph aureus
Term
What does a zoster-infected pt. manifest with?
Definition
VARICELLA! (chickenpox) not ZOSTER (shingles)
Term
What age group does herpes zoster occur in? what types of children does this occur in?
Definition
adults above 60 years old; immunocompromised children
Term
Why does shingles occur?
Definition
Recrudescence of VZV due to waning cellular immunity
Term
Manifestations of herpes zoster:
Definition
ASYMMETRICAL maculopapular crusting rash FOLLOWS DERMATOME or cranial nerve distribution; SEVERE PAIN
Term
What are three complications of herpes zoster?
Definition

-opthalmic/otic zoster

-postherpetic neuralgia (severe burning pain from non-noxious stimuli; very debilitating)

-acute peripheral facial palsy: paralysis 

Term
What must you NOT give for treatment of varicella in children? Why?
Definition
NEVER give aspirin because of Reye's syndrome.
Term
What antiviral therapy for varicella is recommended only for people at high risk for severe disease?
Definition
oral acyclovir
Term
Which antiviral therapies are used for zoster within 72 hours of onset of rash?
Definition
Acyclovir, famciclovir, valacyclovir
Term
What type of vaccine is Varivax and what is it used for?
Definition
Varivax ia a live attenuated vaccine for the prevention of varicella
Term
After administration of Varivax, can children manifest with varicella? what is the difference?
Definition
Children can manifest with with EXTREMELY MILD varicella and no significant sequelae occur.
Term
Name two contraindications for Varivax vaccine:
Definition

-pregnant women 

-immunocompromised children

Term
What is the agent for erythema infectiosum?
Definition
Human Parvovirus B19
Term
Name two other diseases caused by Parvovirus B19?
Definition
Arthropathy and Aplastic Crisis
Term
Treatment of diseases caused by Parvovirus B19?
Definition

-supportive only

-antipyretics, analgesics, and NSAIDS

-transfusion for those with aplastic crisis

Term
Name a risk factor for aplastic crisis:
Definition
immunosuppressed pt. at risk for anemia, chronic bone failure
Term
What is HHV-6 and HHV-7 closely related to?
Definition
CMV
Term
What are the agents for exanthem subitum?
Definition
HHV-6 and HHV-7
Term
primary mode of transmission for HHV-6 and HHV-7? 
Definition
saliva secretions
Term
Agent frequently responsible for first febrile illness in 6-12 months of age?
Definition
HHV-6
Term
HHV-8 is associated with all forms of what complication (particularly in underdeveloped countries)?
Definition
Karposi sarcoma
Term
Agent for which 100% of infected persons are seropositive for? What will cause reactivation of this virus?
Definition
HHV-6; immunosuppression will reactivate virus
Term
What is the agent of pityriasis rosa?
Definition
HHV-7
Term
What is the usual progression of exanthem subitum?
Definition
High fever then defervescence, then rash
Term
Main reason for spinal taps of little children? Why?
Definition
High fever with no rash; spinal tap done to check for aspetic meningitis
Term
What class of virus does mumps, measles, and rubella fall under?
Definition
paramyxoviruses
Term
Age group most infected for measles? Seasonality for measles? portal of entry? primary attack rate for measles (% of infected that manifest Dx)?
Definition

-children <5

-winter-spring

-upper respiratory tract

->90% attack rate

Term
Leading causes of death in children 1-5 in developing countries as complications of measles?
Definition
Diarrhea and pneumonia
Term
What occurs 10-12 days after infection of measles and 3-4 days before exanthem/enanthem?
Definition

PRODROME: 

coryza

unproductive cough

conjunctivitis with photophobia

 

Term
Is the rash for measles symmetrical or asymmetrical? opposite as which disease?
Definition
Measles rash are symmetrical whereas herpes zoster is asymmetrical
Term
Can measles cross the placenta?
Definition
yes
Term
Treatment for measles?
Definition

supportive: vitamin A;

gamma globulin for immunocompromised (6 days after exposure)

Term
Prevention of measles: who do you not administer vaccine to?
Definition
live, attenuated MMR. Don't administer to pregnant women!
Term
Two other names for rubella?
Definition
german/soft measles
Term
Primary age groups for rubella?; seasonality?; Is rubella just as infectious or less infectious than chickenpox and measles?; What populations are at risk?
Definition
adolescents, young adults; winter and spring; rubella is less infectious, meaning there are asymptomatic infections that occur; immigrants from developing countries and continental Europe
Term
Prodromal symptoms present in rubella?
Definition
Prodromal symptoms are minimal/absent; fever is low-grade in rubella vs. high grade in rubeola; arthralgia appears like when caused by human parvovirus B19
Term
Complication of Rubella?; most critical timing for this complication?; consequences?
Definition
CRS: congenital rubella syndrome; first trimester of maternal pregnancy; teratogenicity and birth defects
Term
Lab diagnoses for newborn uses what test? what does each letter stand for? What is measured?
Definition

STRCH test:

syphilis

toxoplasmosis

rubella

CMV

herpes

IgM in cord blood is measured

Term
Treatment for rubella?
Definition
DO NOT TREAT WITH IMMUNOGLOBULIN. Based on risks physicians may actually suggest therapeutic abortion. 
Term
What test do you use before or during pregnancy to determine maternal immune status for rubella?
Definition
LCAT
Term
Name three diseases that are superficial mycoses:
Definition
Pityriasis Versicolor; Black or white piedra; Tinea Nigrans
Term
Agent for pityriasis versicolor? Who is most affected?; clinical manifestations? (3)
Definition

Malassezia furfur; young adults; 

-brown colored patches/lesions on chest abdomen or back

-Pityrosporum folliculitis (acne like pustules on upper trunk/arms)

-Dandruff; seborrhic dermatitis

Term
Treatment of pityriasis versicolor?
Definition

Antifungal (ketoconazole or ciclopirox)

1% selenium sulfide ointment or shampoo (selsun blue)

Term
Agent of black piedra? white piedra?
Definition

Black: piedra hortai

White: trichosporon beigelii

Term
What is formed on external hairshaft?
Definition
Ectothrix is formed, which is a sheath of arthrospores
Term
Although there are no symptoms for black or white piedra, what does white piedra resemble?; Therapy?
Definition
Nits/lice; cut off or shave infected hair
Term
Agent for Tinea Nigrans?; 95% of this happens in what age group? Which gender does it predominate in?
Definition
Hortaea Werneckii; persons under 18 years old; 75% female
Term
Where does the black/brown mottled macules form in tinea nigrans? Treatment?
Definition
It forms on the palm or plamer surface of fingers; keratinolytic agents
Term
Most common fungal agent for dermatophytoses? (ringworm); what does it infect? Other two agents for dermatophytoses?
Definition
trichophyton; hair, skin and nails; epidermophyton and microsporum
Term
Pt. risk factors for pityriasis versicolor and dematophytoses?
Definition
malnutrition, antibiotics, low epithelial cell turnover rate, hyperridosis
Term
Hair, skin, and nails share what common quality?
Definition
They are Keratinized.
Term
"Tinea" indicates what disease?
Definition
Ringworm
Term
Agent for dermatophytic onychomycosis?
Definition
Tinea unguium; nails crumble
Term
Any fungal infection of skin, nails, or hair caused by a fungi other than a dermatophyte is caused by?; three forms? name of diseases?
Definition
candida alblicans; yeast, pseudohyphae; hyphae; dermatomycoses
Term
How to treat cutaneous candidosis?
Definition
1% crystal violet; nystatin, amphotericin B, ketoconazole (systemic) 
Term
Which agent infects gardners and lumberjacks?; clinical manifestations?; how to treat?
Definition
Sporothrix schenckii; painless chronic infections with nodular lesions along lymphatics; itraconazole/amphotericin B; apply heat 4x a day
Term
What must be done to determine etiology of hepatitis before any treatment is initiated?
Definition
blood tests must be done before any treatment!
Term
Three forms of chronic hepatitis (cirrhosis/liver cancer)?
Definition
B, C, and D only
Term
Two characteristics about the incubation period of viral hepatitis? Why can hepatitis transmission be hard to control?
Definition

can be prolonged

is highly variable

 

-patient is infectious before Signs and Symptoms occur

Term
what follows the prodrome phase of hepatitis? do prodromal symptoms continue? High levels of what produce dark urine and clay stool?
Definition
after prodrome phase, there is icteric phase. Yes, prodromal symptoms continue; bilirubin
Term
What happens during convalescent phase of hepatitis?
Definition
disappearnce of jaundice; fatigue may still persist
Term
Which two hepatitis viruses do vaccines exist for A person immune to HBV is also immune to?
Definition
Hep. B virus and Hep. A virus; HDV
Term
What is HBV also known as? Production of which antigen anitbody results in complete recovery from HBV infection and immunity from future infection? What is this called?
Definition
serum hepatitis; production of SURFACE antigen antibody causes "neutralizing immunity"
Term
Which antigen of HBV cannot be detected by clinical kits and does not result in neutralizing immunity?
Definition
Core antigen HBcAg (vs. HbsAg)
Term
Three types of antigen of HBV?
Definition

HBsAg (surface) 

HBcAg (core)

HBeAg (soluble)

Term
Which antigen of HBV has the ability to infect others?
Definition
HBeAg
Term
Transmission of HBV? Most important route of transmission? Two other routes of transmission?
Definition
SSS: serum, saliva, and semen; sexual contact esp. homosexuals. percutaneous (needle stick/IVDU) and perinatally
Term
Nearly all of which groups will develop chronic infection if they have Hep B? What will 15-25% of patients die from?
Definition
infants and young children; cirrhosis/carcinoma
Term
The "natural history" for chronic HBV infection can be divided into which four phases?
Definition

immune tolerance

immune clearance

inactive surface Ag carrier state

reactivation

Term
immune tolerance phase of chronic HBV occurs in patients infected when? persistently normal levels of what?
Definition
patients infected at birth or early childhood; ALT
Term
Treatment of HBV?
Definition
PEG-interferon-@2a; antiviral drugs such as lamivudine, adefovir dipivoxil, entecavir
Term
Passive immunization for HBV occurs via which vaccine? Active immunization is recommended for who? where do you inject active vaccine in adults?
Definition
HBVIG; all children in the US (engerix; tiwnrix) deltoid muscle in adults
Term
What do you administer to infants born to infected mothers with HBV?
Definition

administer BOTH: 

HBIG and HBV vaccine

Term
What does HDV need to replicate?; HDV causes greatest morbidity by how?
Definition
HBV!; increasing severity and accelerating pace of chronic HBV infection (cirrhosis/liver cancer)
Term
What is the most efficient mode of transmission for HDV?
Definition
percutaneous exposures
Term
If HDV is present, what MUST be present?
Definition
HBV! coinfection
Term
Presence of which antibodies to delta antigen helps diagnose HDV?; how to prevent HDV? 
Definition
IgG; treat HBV via pre/post-exposure prophylaxis
Term
Whereas HCV and HDV are RNA viruses, what kind of genome does HBV have?
Definition
DNA genome
Term
What is the single most common reason for liver transplants?
Definition
 HCV; 
Term
What accounts for the most of cases of chronic hepatits (70%) and many cases of ESLD in the US?
Definition
HCV
Term
Which ages are affected in HCV? Where is peak incidence?
Definition
ALL ages are affected; peak incidence is 20-39
Term
In HCV, the rapid accumulation of ______ in the _______ region of the envelope allows the virus to escape ______ ________ by the host. This leads to chronic infection
Definition
MUTATIONS; HYPERVARIABLE; IMMUNE SURVEILLANCE 
Term
Three biggest risk factors of HCV?
Definition

IVDU

repeated transfusions

tattoos/piercings

Term
Chronic liver disease occurs at a high rate (70% of asymptomatic; 85-100% of symptomatic) for which type of hepatitis? 
Definition
HCV
Term
Appearance of what after 5-12 weeks after onset of hepatitis C will diagnose HCV? Presence of what and for how long differentiates acute vs. chronic HCV?
Definition

-appearance of anti-HCV Ab's

-presence of liver enzymes >6 months

Term
Treatment of HCV: (problematic)
Definition

PEG-interferon-@ and ribavirin. 

Very expensive, exteremly difficult to tolerate

Term
What type of virus is HAV (RNA/DNA)? Which populations are at risk for HAV? Main transmission for HAV?
Definition
RNA virus; day-care center workers, closed populations, oyster-eaters; fecal/oral transmission with food and water as major vehicle (person-to-person may occur)
Term
Does HAV become chronic?
Definition
NO. only B, C, and D do
Term
HIV binds to human cells via which two glycoproteins?
Definition
gp41 and gp120
Term

What is the agent for infectious mononucleosis? 

What is the manifestation of IM in early childhood?

Who primarily manifests with IM in the industrialized world?

Definition

1. EBV aka HHV-4

2. SUBCLINICAL manifestation in early childhood

3. primary infection occurs in adolsecsents and adults

Term
If "Downey Cells" are found in blood, what is the likely virus?
Definition
EBV
Term
Which agent is responsible for causing a seropositive marking in nearly 100% of all adults?
Definition
CMV
Term
What do CID and SNHL stand for, and what disease are they associated with?
Definition

CID: cytomegalic inclusion disease

SNHL: bilaterla sensorineural hearing loss

 

CMV!

Term
What does a child with CMV at birth manifest with?
Definition

jaundice

blood clotting

petechial rash

pneumonia(resp. distress)

chorioretinitis of the eye

seizures (microencephaly)

lethargy

motor disability

Term
Outcome of CID?
Definition
Death is common in days to weeks later; survivors have significant sequelae
Term
Number one infection of infancy in the first 3 months?
Definition
CMV!
Term
Four manifestations of CMV in AIDS pt.?
Definition

pnemonia

retinitis

encephalitis

gastroenteritis

Term
If you have a "negative" on which test, should you expect CMV-IM? What shape of cells would you expect to find? 
Definition
Negative heterophile-agglutination test; "owl-eye" cells
Term
Treatment of CMV? Treatment of CMV retinitis in AIDS patients?
Definition

Ganciclovir

Foscarnet

Cidofovir **acyclovir resistant

 

-Formivirsen

Term
How to prevent CMV? 
Definition

CMVIG (esp. for transplant pt.)

Vaccine: orphan drug = phosphoprotein 65; glycoprotein B

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