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Week 5 ppt flashcards
week5
242
Medical
Graduate
02/03/2011

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Term
_% to _% of the population gets influenza every year
Definition
5-20%
Term
direct monetary burden to the US caused by the flu?
Definition
$1-3 billion
Term
where is AIDS epidemic worst in the world
Definition
Africa, some regions reaching 34% infection rate
Term
Annual GDP cost of SARS
Definition
$800 billion
Term
what about viruses cause cancer?
Definition
chronic inflammation from repeated infections
Term
this virus is associated with 99% of all cervical cancer
Definition
papilloma virus (genital warts)
Term
Liver cancer is associated with these two viruses
Definition
HBV HCV
Term
Virus is latin for...
Definition
"slimy liquid, poison"
Term
name how measles, HIV and herpes avoid being destroyed by the immune system?
Definition
Measles and HIV = immunosuppression
Herpes hides in neurons
Term
viruses range from __ to ___ nm in size
cells are about _____nm
Definition
30-300
10,000 (10um)

[size can be used to classify viruses]
Term
viral proteins...
Definition
allow for entry into cell and replication
Term
what is cyclophilin A
Definition
a protein that binds cyclosporin and inhibits calcineurin, which, in turn, prevents release of pro-inflammatory cytokines TNF & IL2.

It is housed inside if HIV and inhibits immune response.
Term
Influenza A has __ RNA strands
Definition
8
Term
what is tissue specificity of a virus called?
Definition
tropism
Term
VEEV:
- what strain infects humans
- what other strains are there
Definition
- 1C
- 1A, B, and D
Term
Papilloma virus strains 16 and 18 are significant because...
Definition
the cause 70% of cervical cancer
Term
Papilloma virus types 6 & 11 are significant because...
Definition
they cause 90% genital warts
Term
what is the function of interferon
Definition
block viral genome replication
Term
NOD like receptors and TLRs recognize viral components and turn on innate defenses
Definition
Term
number of viral particles it could take to infect a host?
Definition
100 million!
Term
if there are no CPE of a virus, how can it still effect a cell?
Definition
metabolic burden
Term
CPEs of viruses:
Definition
- lysis
- non-lytic (apoptosis)
- syncytia
Term
how does measles cause neuropathic effects?
Definition
forms syncytium of neurons
Term
what are the CPEs of WEE EEE VEE (alphaviruses) and what family do they belong to?
Definition
apoptosis-inducing (many cell types)

togaviridae
Term
vector for yellow fever (and family)
Definition
mosquito (flaviviridae)
Term
what are the major targets of most antiretroviral drugs (basic)
Definition
-RNA dependent RNA and DNA pols
-virus specific proteases
Term
ribavirin: what is it and what does it do
Definition
- antiviral drug
- increases error rate of viral pols (is a guanine analog that binds equally well to U and C)
Term
nelfinivir: what is it and what does it do
Definition
HIV protease inhibitor
Term
Enfuvirtide & Schering D: what are they
Definition
HIV entry inhibitors
Term
what is main concern with live-attenuated vaccines?
Definition
reversion to virulent strain
Term
what is disadvantage of inactivated vaccines?
Definition
humoral response only
Term
how many segments of RNA does influenza A have?
Definition
8
Term
what is unique about reovirus RNA?
Definition
it's double stranded
Term
Influenza A is negative or positive sense RNA?
Definition
negative
Term
HCV is - or + sense RNA?
Definition
+
Term
telangiectasis definition
Definition
dilation of capillaries that causes them to look red or purple, often spidery in appearance 'spider angioma'. spider angiomas are caused failure of the sphincteric smooth muscle of the arterioles.

spider angiomas are caused by high levels of estrogen, either from pregnancy or liver failure.
Term
applying pressure to spider angiomas...
Definition
causes the redness to disappear, quickly returning after pressure is released
Term
palmer erythema is and is caused by?
Definition
high estrogen: pregnancy or cirrhosis. same causes as spider angioma
Term
normal levels for AST, ALT and albumin
Definition
AST: 2-45 IU/L
ALT: 10-40 IU/L
albumin: 3.9-5.0 g/dL
Term
what percentage of the US population is estimated to be infected with HCV? How many have chronic infections?
Definition
- 1.8% (3.2 million)
- ~84%, (2.7 million)
Term
what is the leading cause of liver transplantation
Definition
HCV end stage liver disease
Term
is there a vaccine for HCV?
Definition
NO!
Term
how many people worldwide are infected with HCV?
Definition
170 million (3%)
Term
at it's peak, new HCV infections totaled ___thousand (1980). now, new cases are ~___thousand (2007)
Definition
242,000; 17,000

1990, HCV was screened for in blood
Term
chronic HCV accounts for __ deaths per year in the US
Definition
12,000
Term
chance of transmitting HCV in transfusion
Definition
1 in 2 million units transferred. drastic improvement because of screening implemented in 1992
Term
what is the most common mode of transmission for HCV?
Definition
intravenous drug use
Term
HCV is part of which family?
Definition
flaviviridae
Term
HCV: enveloped or naked?
Definition
enveloped
Term
HCV: + or - sense RNA genome?
Definition
+
Term
where (cell types) can the HCV infection be found?
Definition
hepatocytes
T-cells
B-cells
monocytes

CD81 and LDLR are possible ligands for entry
Term
what are possible ligands for entry of HCV?
Definition
CD81 and LDLR
Term
how is HCV protein made?
Definition
+ strand mRNA is translated into a large polyprotien, which is subsequently cleaved by proteases.
Term
Is HCV cytopathic?
Definition
no, damage is mediated by Th1 response, causing inflammation. cytopathic effect is thought to be caused by destruction of infected cells.
Term
HCV response is Th1 or Th2 mediated?
Definition
Th1. This causes chronic inflammation.
Term
what is quasispecies?
Definition
closely related viral species that undergo natural selection. high rate of mutation is inherent in the RNA-dependent RNA/DNA polymerases.

This allows viruses to select for most virulent and contagious strain.
Term
how many genotypes of HCV exist?
Definition
11
Term
which HCV genotypes are most prevalent?
Definition
1a and 1b
Term
genotypes 2 and 3 of HCV are present in __% of people and respond to __
Definition
10-20%
alpha interferon
Term
ribavirin: what is it how does it work?
Definition
antiviral
guanosine analog that inhibits RNA-dependent RNA and DNA pols

can be combined with pegylated alpha-IF for 48 weeks and get a sustained response (30-50%)
Term
fomite definition
Definition
an object that can transmit illness (like a mop or something)
Term
influenza symptoms
Definition
myalgia, pharyngitis, headache, fever
Term
how can influenza spread?
Definition
aerosolized droplets and fomites
Term
incubation time for influenza A
Definition
1-3 days
Term
what is the most common cause of acute respiratory illness requiring medical intervention?
Definition
influenza!
Term
how many segments and proteins does influenza A have?
Definition
11 proteins on 8 segments (same as Influenza B)
Term
Influenza A: interspecies transmission?
Definition
YES
Term
influenza's ability to cause epidemics: in order from most likely to never
Definition
A>B>>>C

B is only in humans; C is in dogs and pigs as well
Term
Influenza has + or - sense RNA genome?
Definition
NEGATIVE, it goes to the nucleus where it creates mRNA and steals 5' caps from host mRNA.
Term
an exchange of RNA between two species of Influenza in a coinfected animal, producing a new strain, is called?
Definition
antigenic shift
Term
Avian influenza (2005) was of what antigenicity?
Definition
H5N1
Term
these symptoms were caused by what?
-intermittent high fevers, persistent cough, thick sputum
-later course: respiratory failure (74%), cardiac failure (42%), renal disfunction (33%).
-lymphopenia and leukopenia
- 2/3 of people progressed to ARDS, all of whom died
Definition
H5N1 avian flue epidemic of 2005
Term
zanamivir is a?
Definition
neuraminidase inhibitor (relenza)
Term
oseltamivir is a?
Definition
neuraminidase inhibitor (tamiflu)
Term
which HAs infect humans?
which NAs infect humans?
Definition
1,2,3,5,9

1,2
Term
What is an IRES site and what virus has one on its genome?
Definition
internal ribosomal entry site, HCV.

The IRES site recruits cellular ribosomes to do the work of translation for the virus.
Term
what are some side effects of interferon treatment?
Definition
fever, myalgia and other flu-like symptoms
Term
how does influenza enter our body?
Definition
attachment and penetration of columnar epithelial cells or Respiratory Tract
Term
why do you get clear, gunky mucus with influenza?
Definition
infection of the mucus cells. (unrelated: macrophages as well as other cells may also become infected)
Term
what is the only DNA virus not to replicate in the genome?
Definition
poxvirus
Term
parvoviridae is a single or double stranded what virus?
Definition
single stranded DNA virus
Term
poxviridae is a single or double stranded what virus?
Definition
double stranded DNA
Term
Herpesviridae (EBV, CMV) is a single or double stranded what virus?
Definition
double stranded DNA
Term
Adenoviridae is a single or double stranded what virus?
Definition
double stranded DNA
Term
Papillomaviridae is a single or double stranded what virus?
Definition
double stranded DNA
Term
Parvovirus causes what?
Definition
aplastic anemia
Term
papilloma virus causes?
Definition
warts, cervical hyperplasia, leukoencephalopathy (a general term that refers to brain-white matter diseases whether the cause is known or not)
Term
Adenovirus causes?
Definition
conjunctivitis, gastroenteritis (gastritis is inflammation of stomach only), uncommon cold
Term
Karposi's sarcoma is cased by virus(es) in this family.
Definition
Herpesviridae
Term
T or F, herpesviridae are enveloped
Definition
True
Term
This virus from the ____ family houses both DNA and RNA (but is considered a DNA virus)
Definition
herpesviridae; CMV
Term
how big is the CMV genome?
Definition
>230kb; >208ORFs. It encodes 3 GPCRs
Term
How does CMV enter a cell?
Definition
heparin sulfate is required, however the ligand is not known. It is possible that EDGFR is involved
Term
CMV tropism?
Definition
glandular, CNS, hematopoetic.

can infect almost all cell types
Term
when CMV enters the cell (fusing envelope), what happens to the capsid?
Definition
it goes to the nucleus and begins viral replication
Term
What types of proteins are produced early in the CMV life cycle? late?
Definition
regulatory proteins including pols; capsid proteins
Term
CMV is a very common infection. By age 40, how many adults are infected with CMV?
Definition
50-80%
Term
what is the most common viral cause of congenital defects?
Definition
CMV; CMV is the most common viral cause of mental retardation. 1/150 children are born with CMV (can be transmitted pre or perinatally. CMV can sit in the vagina and infect the neonate during delivery.

out of these children 1 in 750 develop permanent disabilities (8000 kids a year)
Term
what are two late onset symptoms of a congenital CMV infection? How long after the birth can this appear?
Definition
Hearing and vision loss; months or years
Term
what percentage of mothers who get infected with CMV for the first time during pregnancy (1-4% or all pregnancies) pass CMV vertically?
Definition
33%

keep in mind there is no treatment for CMV
Term
through what substances is CMV spread?
Definition
bodily secretions: urine, saliva, breast milk, blood, tears, semen, and vaginal fluids
Term
what causes mononucleosis?
Definition
EBV (herpesviridae) and CMV
Term
What is the immune response to CMV?
Definition
Humoral: IgM is produced at primary infection and lasts for 3-4 months, but does not return in subsequent infections unless the patient is immunocompromised. IgG persist for life.
Term
Can CMV be treated in any way?
Definition
yes, in immunocompromised patients, ganciclovir and valganciclovir are used. Neonates that have a very severe infection may receive these, but the side effects make it a risky treatment.

no vaccine exists, but there is a push for development.
Term
thrombocytopenia definition and what does it cause?
Definition
Thrombocytopenic means there's a lower than normal number of platelets in the blood. "Purpura" (PURR-purr-ah) refers to purple bruises caused by bleeding under the skin.
Term
what does the genome of retroviridae look like?
Definition
two + sense strands of identical RNA withe 5' cap and polyadenylated 3' end (looks a lot like mRNA. Two tRNAs are base paired to the genome, which act as a primer for RT.
Term
what is integrase? what has integrase? what does it do?
Definition
integrase is a protein in retroviridae that integrates its genome into the hosts genome
Term
oncornavirinae: what are 2 viruses in this family and what do they do?
Definition
HTLV1 & 2 (human t-lymphocyte virus). they make cell immortal. this is a subfamily of retrovirinae
Term
Lentivirnae: what viruses are in this subfamily of retrovirinae?
Definition
HIV1 HIV2
Term
spumavirinae and human placental virus are in what family?
Definition
retrovirinae. neither of these cause disease
Term
Name the 3 big important proteins in HIV?
Definition
Gag (group-specific antigen, capsid protein), Pol, Env (envelope glycoproteins gp120/gp41)
Term
what are these: tat, rev, nef, vif, vpu?
Definition
accessory, regulatory genes in HIV
Term
how big is the HIV1 genome?
Definition
9200kb
Term
from time of infection to time of death from opportunistic pathogen, how many years does a HIV patient have?
Definition
~8 years. AIDS develops when CD4+ count drops below 200 cells/ul
Term
during latent HIV, where does most of the viral replication occur?
Definition
lymph nodes
Term
the extent of an HIV infection depends on:
Definition
CD4+ count
level of viremia
p24 protein levels in blood
Term
what are some things that happens with full-blown-AIDS? (mostly opportunistic infections)
Definition
- HIV wasting syndroms
- Karposi's sarcoma
- Severe CMV infection as well as MAC (mycobacterium avium intracellularae), and pneumocystis carinii pneumonia
Term
about how many adults and children have HIV worldwide?
Definition
adults: 31.3 million
children: 2.1 million
Term
what about gp120 is really important in HIV infection?
Definition
antigenic drift and heavy glycosylation.
Term
What does HIV do to DHT?
Definition
it removes it from the equation! (DHT = delayed type hypersensitivity reaction or type IV hypersensitivity)
Term
NRTI abbreviation: Azidothymadine (Zidovudine)
Definition
AZT or ZDV
Term
NRTI abbreviation: dideoxycitidine (Zalcitabine)
Definition
ddC
Term
NRTI abbreviation:dideoxyinosine (Didanosine)
Definition
ddI
Term
NRTI abbreviation: Stavudine
Definition
d4T
Term
NRTI abbreviation: Lamivudine
Definition
3TC
Term
what are Nevirapine and Delaviridine
Definition
NNRTI's
Term
what are Saquinavir, Ritonavir, Indinavir, Nelfinavir?
Definition
protease inhibitors
Term
what are some common combination therapies for HIV?
Definition
Indinavir/AZT/3TC
Ritonavir/AZT/3TC
Nelfinavir/AZT/3TC
Nevirapine/AZT/ddI
Nevirapine/Indinavir/3TC
Term
what part of gp120 binds to the coreceptor protein and what are these proteins in macrophages and lymphocytes, respectfully.
Definition
V3 loop; CCR5 and CXCR4, respectfully
Term
describe the basic outline of HIV life cycle
Definition
gp120 & gp41 bind CD4 and coreceptor (CXCR4 or CCR5) and allow for fusion of envelope-->viral genome is injected into the cell and RT transcribes the RNA genome into a DNA genome-->this moved to the nuclease where integrase integrates it into the genome-->here, HIV mRNA begins to be produced, the polyproteins are cleaved and eventually new viral particles form--> the capsid detects areas on the membrane that have high concentrations of gp120&gp41 and bud off
Term
how many new HIV virions are produced daily?
Definition
~10^10
Term
lifespan of HIV in the plasma?
Definition
6 hours
Term
lifespan of a HIV infected T-lymphocyte
Definition
(1-3 days) ~1.6 days
Term
T or F, HIV downregulates MHC-I expression?
Definition
True!
Term
HIV primarily dampens Th1 or Th2 response?
Definition
Th1
Term
where is HIV most virulent?
Definition
places antibodies penetrate poorly, i.e. CNS
Term
HIV ___ the immune system to increase its replication.
Definition
activates
Term
What do tegument proteins generally do?
Definition
make cells proliferate or control cellular function
Term
T or F CMV does not infect the salivary glands
Definition
False! salivary glands are one of the primary sites of infection, this is why infants can get CMV postnataly by ingesting breastmilk
Term
2 important cell wall components of fungi.
Definition
chitin and glucan
Term
what is a major target of antifungal drugs?
Definition
ergosterol
Term
saprophytic/saprobic definition
Definition
fungi living in open environment
Term
what is a dimorphic fungus?
Definition
a fungi that lives in a different state between it's saprophytic and parasitic forms.

an example is histoplasma capsulatum, hyphal during saprophytic, yeast-like during parasitic
Term
histoplasma capsulatum causes what?
Definition
cave's disease. its an infection that occurs primarily in immunocompromised patients. it's symptoms resemble TB
Term
zygomycosis is primarily seen in?
Definition
severe diabetics or neutropenic patients
Term
How do fungi reproduce during parasitic phase?
Definition
asexually: budding-->fission-->endosporulation-->elongation
Term
what is a mat or aggregation of hyphae called?
Definition
mycelium

hyphae are the asexual buds of fungal growth. These buds grow out of moulds. these moulds can form fruiting heads called conidia.
Term
what are conidia?
Definition
fruiting heads of a mould.
Term
T or F, most moulds have aseptate or pauciseptate hyphal forms?
Definition
False, most moulds have septate hyphae. Zygomycetes is one of the only to have aseptate hyphae
Term
5 clinical forms of what:
- asymptomatic
- allergic
- superficial
- necrotizing granulomas
- invasive, disseminated
Definition
fungal infection
Term
Th1 response is really important for what type of fungi?
Definition
dimorphic: aspergillus and histoplasma
Term
Candida, Aspergillus and zygomyces are susceptible to what cell type in first line defense?
Definition
neutrophils!
Term
How is cryptococcus acquired?
Definition
inhalation in immunocompromised patients. Diabetics a a bit susceptible indicating that neutrophils are somewhat important for defense against crypto.
Term
meningoencephalitis is the most common clinical manifestation of this fungal disease:
Definition
cryptococcus
Term
T or F, fungal diseases are easily diagnosed as cancers
Definition
True. The granulomatous formations look like tumors on x-rays and neoplasms on histology.
Term
exogenous fungi have their primary infections where, usually?
Definition
Lungs, however they are usually not detected/asymptomatic. In immunocompromised patients, this primary infection will disseminate.
Term
Fusarium will usually infect who?
Definition
fusarium is a fungus that infects burn patients
Term
dermatophytes cause primarily what type of infection?
Definition
dermatophytes are fungi that primarily cause cutaneous infections
Term
Zygomycetes is a phylum of fungi that include what type of highly pathogenic fungi?
Definition
mucormycosis
Term
Aspergillus, zygomycetes, dermatiacius, fusarium, and dermatophytes are what?
Definition
the most common pathogenic fungi
Term
Aspergillus is most commonly acquired through:
Definition
respiratory tract
Term
NAME THAT FUNGUS!:

-Ubiquitous: soil, decaying fruit and vegetables
-Acquired via infection of paranasal sinuses, lung, GI tract, injured skin
-Disease predisposition
-Neutropenia
-Uncontrolled diabetes
-Aggressive, invasive and rapidly progressive disease
-Indolent progressive, relatively rare form
Definition
zygomycetes (mucormycosis)
Term
T or F: the mycellium form occurs during infection
Definition
FALSE. either yeast-like or spherule forms occur during infection. Saprophytic fungi or fungi in culture form mycellium
Term
what is the infective form of fungi?
Definition
the spore! this is formed during the saprophytic phase (sporulation)
Term
NAME WHAT'S IMPORTANT ABOUT THESE FUNGI:
Coccidioides immitus
Blastomyces dermatitidis
Histoplasma capsulatum
Paracoccidioides braziliensis
Sporothrix schenkii
Penicillium marneffei
Definition
they are all dimorphic, coccidioides immitus and histoplasma capsulatum are the two most important (or, covered in lecture)
Term
NAME THAT DIMORPHIC FUNGI:

-Mycelial stage likes dry, arid climes
-Portal of entry lung
-Spectrum of disease
-Subclinical granuloma
-Chronic necrotizing granuloma
-Disseminated


which one is exactly the same except is found in bird droppings and bat guano?
Definition
coccidioides


histoplasma
Term
what size do transmissible agents that cause disease that start with a pulmonary etiology have to be?
Definition
<5uM. for example, the conidia of dimorphic fungii (coccidioides and histoplasmosis)
Term
NAME THAT FUNGI!:

-Once classified as a protozoan but now believed to be more closely related to fungi (ascomycetes)

-Symptomatic infections limited to debilitated children (rare today) and severely T cell immunocompromised patients (mostly AIDS, some transplant patients)

-Causes interstitial pneumonia; severe hypoxia and respiratory failure may occur in AIDS

-Has a cyst-like stage (that may be the sexual form of the fungus) and extracystic trophic forms (formerly called trophozoites)
Definition
pneumocystis carinii (jiroveci/jerovecii)
Term
what fungus has a cyst-like stage (that may be the sexual form of the fungus) and extracystic trophic forms (formerly called trophozoites)
Definition
pneumocystis carinii (jiroveci/jerovecii)
Term
how do you diagnose pneumocystis jiroveci (carinii)
Definition
cystic inclusion of induced sputum or bronchoalveolar lavage
Term
how do polyenes work?
Definition
bind to ergosterol, causing osmotic stress and oxidative stress on the cell. Amphotericin B is an important one.
Term
how do azoles work?
Definition
inhibit ergosterol synthesis
Term
what are echinocandins?
Definition
antifungal drug, a lipopeptide, that inhibits B-1,3 glucan synthesis
Term
this fungus's primary cause of disease is meningoencephalitis, however in aids patients, it can affect every organ.
Definition
cryptococcus neoformans
Term
when aspergillus goes unchecked, and is invasive, it will go into vessels and...
Definition
irritate the vessels and cause thrombi to form
Term
zygomycetes have septate hyphae?
Definition
no, mucormycosis are aseptate
Term
Ascaris Lumbricoides is the ___ ___ and is a ___ cause of ____ world-wide
Definition
largest; nematode (helminth); leading; morbidity
Term
hookworm is a significant cause of what?
Definition
blood loss. there are old and new world hookworms, but they are both clinically important for this reason
Term
strongyloides stercoralis: what is it and what does it cause.
Definition
it's a helminth (nematode) and it is usually innocuous, but is fatal in the immunosuppressed.
Term
Enterobius vermicularis: what is it and what does it cause?
Definition
nematode (common name=pinworm); it's all around the world and causes anal pruritus (pruritus ani is anal itching)
Term
Trichuris trichiuria is what and causes what?
Definition
nematode; is usually innocuous but can be associated with anemia and rectal prolapse.
Term
what are cestodes?
Definition
flatworms or tapeworms.

they are hermaphrotic and lack a digestive tract (unlike nematodes that have an intact one)
Term
Trematoda is what?
Definition
phylogenic 'class' of worms (flukes). schistosoma is an important one, it causes a lot of morbidity and mortality worldwide.
Term
The phylogenic class of tapeworms is called what?
Definition
Cestoda
Term
what are proglottids?
Definition
sexual complete (both male and female organs) segments of cestodes (tapeworms)
Term
giardia lamblia: what is it and what does it cause
Definition
it's a Flagellate protozoan; it causes giardiasis, beaver fever. giardiasis causes diarrhea and can be deadly in immunocompromised hosts.
Term
entamoeba histolytica: what is it?
Definition
it's a protozoan, amoeba.
Term
plasmodium, toxoplasma and cryptosporidium are all what?
Definition
protozoal sporozoa (apicomplexa)
Term
after returning home, how long would it take a malarial infection to produce symptoms?
Definition
days
Term
after returning home, how long would it take a giardia/cryptosporidia infection to produce symptoms?
Definition
several weeks
Term
after returning home, how long would it take a cysticerosis/echinococcus/strongyloides infection to produce symptoms?
Definition
years
Term
if you eat ____ you may get trichinosis. (3 animals)
Definition
pork, bear, walrus
Term
if you eat ___ you may get tapeworm. (3 things)
Definition
raw fish, undercooked beef or pork
Term
pica and ingestion of things like soil may cause this type of infection.
Definition
nematode, visceral larva migrans
Term
pinworm (enterobius vermicularis, a nematode) and taenia solium (a tapeworm that causes cysticercosis) are transmitted...
Definition
by the fecal-oral route.
Term
If you were doing this activity in an endemic area, you may get schistosomiasis.
Definition
wading in freshwater

schistosomiasis is typically a chronic disease, that can be asymptomatic in a large number of infected, however can also cause widespread organ damage. The symptoms are general for an illness (fever, diarrhea, cough, stomach pain), but the blood may be highly eosinophilic.
Term
Chaga's disease and Leishmaniasis are transmitted through...
Definition
bug bites
Term
cryptosporidia, microsporidia and toxoplasma most commonly affect which type of person?
Definition
AIDS patient
Term
high eosinophilia is indicative of...
Definition
parasitic infeciton, there is a very very high correlation to nematode infection!
Term
what is the scotch tape test?
Definition
used to detect pinworms. you put the tape on the anus and look at it under the microscope. if pinworm eggs are seen then you get a diagnosis.
Term
duodenal aspirates ("enterotest") are used for what type of parasite?
Definition
giardia and strongyloides
Term
amebiasis is?
Definition
an infection of entamoeba hystolitica.

aspiration of intestinal ulcers is an excellent way to diagnose this infection.
Term
Trophozoites means?
Definition
it's the stage of parasitic development where they are absorbing nutrients from the host
Term
LV-PVA is good for diagnosing what?
Definition
protozoan trophozoites and cysts.

LV-PVA = low viscosity polyvinyl alcohol: it's a fixative that you put a fecal specimen in in order to preserve it for diagnostic purposes.
Term
Neutral Formalin is good for diagnosing what type of parasitic infection?
Definition
fecal preservation of eggs and cysts.

it's used as a preservative of fecal specimens for concentration or wet preparations with iodine.
Term
if you suspect a parasitic infection, you should examine which fluid/excrement with the following symptoms:
- Diarrhea/dysentery
- fever, chills
- lymphadenopathy
Definition
- feces: look for motile objects
- blood and tissue pathogens
- blood and tissue pathogens
Term
what's up with antibody testing for parasites?
Definition
it's not that great: usually only good for patients that aren't from an endemic area. the presence of antibodies does not indicate an active infection.

Antigen testing (using antigen specific antibody) is way more useful.
Term
what does filarial mean?
Definition
filarial disease is a disease caused by a type of nematode (roundworm) transmitted through biting flies& mosquitos
Term
when should you check for malaria?
Definition
right before the next fever spike (blood sample)
Term
At night, these types of parasites are found at higher concentrations in the blood.
Definition
filarial parasites (this makes since, because they are transmitted by mosquitos and biting flies, which are probably more prevalent at nightgamal)

filariasis is caused by a type of nematode
Term
what are tachyzoites?
Definition
the asexually reporducing oocysts of toxoplasma gondii. they can be found in the intestine and disseminated around the body and brain (most of them are killed off)
Term
what are bradyzoites?
Definition
they are the encased form of tachyzoites from a toxoplasma gondii infection.
Term
this parasite can cause prenatal infection (only if primary) or be acquired by eating raw meat, as well as something else.
Definition
toxoplasma gondii. the other way to get it is through cat feces (oocystic form). Eating bradyzoite cysts in raw meat is how you get it.
Term
FNA or lymph node biopsy of toxoplasma induced lymphadenopathy can mimic what other type of disease?
Definition
Hodgkin lymphoma. This is because the infection is rarely seen, but the expansion of cells will look like hodgkin's. It is really important not to start treatment for hodgkin's when it is toxo because toxo will go away and hodgkin's treatment is rough. 4
Term
toxoplasma can look like what other type of infection?
Definition
mononucleosis (EBV-like) viral infection.
Term
What type of T-cell response is (and what cytokines are) important for fighting off toxoplasma gondii?
Definition
Th1; IL12 and IFN-gamma are important for killing off tachyzoites. If Th1 is suppressed, bradyzoites can reactivate, releasing tachyzoites and causing severe illness.

Primary infection in immunocompromised hosts is very dangerous
Term
what is chorioretinits?
Definition
inflammation of the choroid plexus of the eye. Can be a symptom of congenital toxoplasma infection.
Term
If the T in TORCH is acquired late in pregnancy, what is the likelihood of transmitting it to the baby? What if it is within the first trimester? What happens if the baby gets it early?
Definition
~65% in 2-3 trimester with minimal symptoms to the baby (chorioretinitis is possible);

~15% in early pregnancy, but an infection could mean a number of congenital problems including microcephaly, mental retardation and hydrocephalus.
Term
how do you diagnose toxoplasma gondii?
Definition
serology (IgM/IgG) or PCR (for disseminated case)

identification of tachyzoites by histology is not as common in this country
Term
what disease:
class: coccidia; genus: plasmodium
Definition
malaria
Term
These are parasites that cause what?:
P. falciparum
P. vivax
P. ovale

Which one causes ~15% of all infections and is repsonsible for almost all the deaths?

Which one causes ~80% of all the infections?
Definition
- malarial parasites.

- plasmodium falciparum causes 15% of infections and almost all deaths
- plasmodium vivax causes ~80% of cases
Term
What are anopheles?
Definition
genus of mosquitos (culicidae), that transmit malaria. There are about 460 species, 100 of which are vectors.
Term
malaria causes ___ million deaths per year. ___% of cases are in ____
Definition
1.5-2.7; 90%; Africa
Term
name that parasite:
Replicate (merozoites) in liver (exoerythrocytic stage) and some may remain dormant (hypnozoites) in liver
Definition
plasmodium (vivax & ovale for hypnozoite stage) (malaria)
Term
rupture of RBCs in malaria corresponds to what symptoms?
Definition
fever, chills
Term
describe the febrile paroxysm of malaria
Definition
- begins with chills/rigor 1-2 hours
- fever with warm, dry skin 2-6 hours
- sweats, and drop in temperature to normal 2-4 hours

these symptoms can mimic the prodrome of influenza
Term
chloroquine is used as what? what is the mechanism of its action?
Definition
malarial prophylaxis. it prevents plasmodium from neutralizing the iron group after it's digestion of Hg. The iron is toxic to the parasite, as well as damaging the RBC and causes clearance.

side effects can include crazy nightmares as well as stomach ache, headache, and blurred vision
Term
primaquin is used for what?
Definition
primaquin is an antimalarial drug that is used for the eradication of the dormant hepatic forms of P vivax and P ovale (hypnozoites). a 14 day course is recommended to remove all hypnozoites. the mechanism of action is unknown.
Term
where is chloroquin resistant plasmodium falciparum found?
Definition
central and south africa, panama, and most of south america
Term
what is symbiosis?
Definition
two organisms living together:


commensalism
mutualism
parasitism
Term
what are special about these buggers:

Entamoeba coli
Endolimax nana
Entamoeba harmanni
Entamoeba dispar
Trichomonas hominis
Definition
they are commensal enteric protozoa
Term
what are special about these buggers:


Entamoeba histolytica
Giardia lamblia (intesinalis, duodenalis)
Cryptosporidium parvum
Definition
parasitic enteric protozoa
Term
what is tenesmus?
Definition
frequent or persistent urge or need to empty the bowl. it is caused by inability to empty the bowl and can be extremely painful.
Term
how is entamoeba histolytica transmitted?
Definition
fecal-oral route
Term
An amoeba that ingests RBCs is characteristic of what?
Definition
a pathogenic amoeba
Term
what do the neutrophils look like in a E. histolytica infection?
Definition
they are not around the parasite. this is very characteristic of this type of infection
Term
entamoebas hystolitica is transmitted by?
Definition
fecal-oral (flies), anal intercourse
Term
T or F: E. Histolytica can cause intermediate bouts of diarrhea.
Definition
True. entamoeba histolytica can be asymptomatic and just passively pass cysts through feces, or can cause intermediate or constant diarrhea.

In severe cases E. Histolytica can cause livier ulcers that can rupture and be mistaken for skin cancer on gross appearance.
Term
Why don't you see neutrophils around E. Histolytica?
Definition
because they've developed a lectin that lyses neutrophils
Term
histologically, what do you typically see around amoebas?
Definition
granular eosinophilic cellular debris, and darker nuclear debris
Term
strongyloides stercoralis is most commonly found in what part of the united states?
Definition
southern. but it is found all around the world.
Term
describe the typical lifecycle of a strongyloides stercoralis
Definition
infection through skin-->in blood-->to lung-->through alveoli-->up trachea-->swallowed-->excreted
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