Infectious Disease Test #2
Terms
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- What are the other four names that also are used for Measles?
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1. Rubeola
2. Hard Measles
3. Red Measles
4. Morbilli - What is the aka for Mumps?
- Infectious Parotitis
- What are the two aka's for Rubella?
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1. German Measles
2. 3-Day Measles - What is the aka for Polio?
- Infantile Paralysis
- What is the aka for Chickenpox?
- Varicella
- What is the aka for Herpes Zoster?
- Girdle
- What are the two aka's for Fifth Disease?
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1. Erythema Infeciosum
2. Academy Rash - What is the aka for Pertussis?
- Whooping Cough
- What are the four paramyxovirus's that cause human disease?
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1. Measles
2. Mumps
3. Parainfluenza Virus
4. Respiratory Syncytial Virus (RSV) - What four viruses are Enveloped?
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1. Measles
2. Rubella
3. Respiratory Syncytial Virus
4. Parainfluenza Virus - What three viruses are ssRNA?
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1. Rubella
2. Respiratory Syncytial Virus
3. Parainfluenza Virus - What virus is an RNA virus?
- Measles
- What viruses can be transmitted via respiratory droplets?
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1. Measles
2. Mumps
3. Rubella
4. Polio
5. Chickenpox
6. Fifth Disease - What virus can be transmitted by direct contact with saliva?
- Mumps
- What virus can be transmitted via fecal-oral?
- Polio
- What virus can adults infect children, but children cannot infect adults?
- Herpes-Zoster
- What are the symptoms/pathogenesis of measles?
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1. Koplik's spots
2. fever
3. coryza
4. cough
5. conjunctivitis
6. blotchy maculopapular rash on face
7. vasculitis
8. Warthin-Finkeldey Giant Cells - What virus causes parotitis?
- Mumps
- What are the symptoms/pathogenesis of Mumps?
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1. Parotitis
2. Viremia
3. fever
4. 1/2 of people contracting mumps have CNS involvement - What is the pathogenesis of Polio?
- Infects the pharynx (tonsils), small intestine (peyers patches), then viremia in body.
- What are the symptoms/pathogenesis of Chickenpox?
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1. Viremia
2. Fever (worse in adults)
3. Malaise
4. rash on trunk
5. itchy vesicles that burst, forming scabs - What is the name given to Herpes-Zoster upon reactivation?
- Shingles
- When Shingles are activated in herpes-zoster, what gets inflammed?
- The Dorsal Nerve Root Ganglion (DNRG)
- What is the appearence and location of shingles when it manifests?
- A unilateral rash around the thoracic area
- What virus is associated with Slapped Cheak Rash?
- Fifth Disease
- Fifth disease manifests with what symptoms/pathology?
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Slapped Cheak Rash
Arthralgia
Chronic Hemolytic Anemia
Lace-like rash on trunk and limbs -
What are the symptoms/pathogenesis of Respiratory Syncytial Virus?
In Infants?
In Children and Adults?
In the Elderly? -
Bronchiolitis and Pneumonia in children < 1 year of age
Cold-like illness in children and adults
Severe flu-like illness and pneumonia in the elderly - What is the bacterial agent for Diptheria?
- Corynebacterium Diphtheriae
- What is the bacterial agent for Tetanus?
- Clostridium Tetani
- What is the bacterial agent for Pertussis?
- Bordetella Pertussis
- What is the bacterial agent for Hemophilus Influenza?
- It is the blood loving agent of influenza
- Is diptheria gram (-) or gram (+)?
- Gram (+)
- What type of toxin does Diptheria have?
- Exotoxin
- What kind of toxin does Tetanus have?
- Monotypic Neurotoxin
- What kind of toxin does pertussis have?
- Both an endotoxin, and several exotoxins (cytotoxin and pertussis toxin)
- What are the toxic effects of diptheria?
- 1. fatty degeneration of liver, adrenals, kidneys, peripheral nerves, and myocardium
- What are the toxic effects of tetanus?
- The neurotoxin binds to the post synaptic membrane blocking reciprocal inhibition. Rigidity occurs because opposing muscles contract simultaneously
- What are the toxic effects of pertussis?
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The cytotoxin kills epithelial cells.
The pertussis toxin induces high lymphocytosis, inhibits adenalate cyclase, and blocks phagocytosis - How is diptheria transmitted?
- Organisms are usually inhaled, and sometimes it is in raw milk
- What are the clinical manifestations of diptheria?
- A grayish psuedomembrane forms in throat from coagulation of dead respiratory epithelial cells, bacteria, fibrin, and pus.
- How is tetanus transmitted?
- Tetanus spores can enter through puncture wounds.
- What are the clinical manifestations of tetanus?
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Rigidity
Spasms
Pain/Stiffness in abdomen
Lock Jaw
Risus Sardonicus (sustained spasm in facical mm.)
Dysphagia - Tetanus can lead to what secondary manifestation?
- Pneumonia following aspiration of fluid
- What is the name used for tetanus that affects the newborns?
- Tetanus Neonatorum
- How is Tetanus Neonatorum contracted?
- From the infected umbilicus of an unvaccinated mother
- What are the clinical manifestations of pertussis?
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Upper respiratory tract infection lasts for weeks, including 3 stages:
Stage 1 = Catarrhal - 1 week acute restricted infection of respiratory epithelium. Includes fever, runny nose, conjunctivitis, cough
Stage 2 = Paroxysmal - 1-6 weeks of multiplication and acute inflammation (laryngotracheobronchitis) mucus clogs airways, worsening cough with inspiratory whoop and vomiting. Fatalities occur from pneumonia in infants.
Stage 3 = Convalescent - 6-12 weeks of recovery - What are the secondary manifestations of pertussis?
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pneumonia (may be fatal in infants)
seizures (although infrequent) - Hemophilus Influenza flora are normally found where within the body?
- The nasopharynx
- What is the pathogenic property of hemophilus influenza?
- It has a capsule. There are 6 capsule types (A-F). B is BAD!
- What are the symptoms/pathogenesis of hemophilus influenza?
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Urinary Tract Infections
Tonsilitis
Otitis Media (Hib is 2nd leading cause of ear infection)
Pharyngitis
Acute Epiglottitis
Childhood Meningitis (can cause permanent brain damage: blindness, deafness, mental retardation, cerebral palsy, hydrocephaly)
Pneumonia - What is a secondary condition that can occur from hemophilus influenza?
- A urinary tract infection my lead to a respiratory tract infection, which can cause death in 24 hours if there is no tracheostomy.
- What bacteria is the primary cause of bacterial meningitis worldwide?
- Hemophilus Influenza
- What is the most characteristic feature of Measles?
- Koplik spots - red with white center
- What is the most characteristic feature of Mumps?
- Swollen Parotid gland
- What is the most characteristic feature of Rubella?
- Rash during spring and during epidemics
- What is the most characteristic feature of Chickenpox?
- Rash on trunk, spreads to arms, face, legs, itchy vesicles that burst and form scabs
- What is the most characteristic feature of Croup?
- Croup is also known as laryngotracheobronchitis. Is a symptom of Parainfluenza. Croup is a barking cough with inspiratory stridor
- What is the most characteristic feature of Fifth Disease?
- Mild "slapped cheak" rash, and arthralgia
- What is the most characteristic feature of Diptheria?
- Grayish pseudomembrane in throat made up of bacteria, dead respiratory epithelial cells, pus
- What is the most characteristic feature of Pertusis?
- A paroxysmal cough followed by inspiratory whoop and vomiting
- What is the most characteristic feature of Tetanus?
- Risus Sardonicus - Spasm of facial muscles
- Why do public health officials promote vaccines for diseases that have been dramatically reduced already?
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1. To defend against asymptomatic carriers.
2. To defend against people carrying the virus into the U.S. from other countries.
3. To defend against people who have had incomplete vaccinations. -
Subacute Sclerosing Panencephalitis:
What is the agent?
What is the group in the population most at risk? -
Agent:
- Measles
- Enveloped RNA Virus
- Morbillivirus of the Paramyxoviridae
Group:
A fatal condition in adults who had measles when they were under the age of 2 (CNS degeneration) -
Orchitis:
What is the agent?
What is the group in the population most at risk? -
Agent:
- Mumps
- Paramyxoviridae
Group:
Post pubescent males and adults -
Shingles:
What is the agent?
What is the group in the population most at risk? -
Agent:
- Varicella-Zoster
Group:
Predominantly a disease of middle/old age, 60 yrs +. -
Giant Cell Pneumonia:
What is the agent?
What is the group in the population most at risk? -
Agent:
- Measles from multinucleated giant cells (Warthin-Finkeldey Giant Cells)
Group:
- Found in protein malnourished children less than 5 years of age -
Erythema Infectiosum:
What it the agent?
What is the group in the population most at risk? -
Agent:
- Fifth Disease
- Human Parvovirus B19
Group:
- Adults from household and schools that have contracted it from children -
Risus Sardonicus:
What it the agent?
What is the group in the population most at risk? -
Agent:
- Tetanus
- Chlostridium Tetani
Group:
- Drug addicts, elderly, immunocompromised -
Childhood Meningitis:
What it the agent?
What is the group in the population most at risk? -
Agent:
- Hemophilus Influenza
- Gram (-) aerobic, coccobacillus
Group:
- Children age 6 months - 2 years old -
Acute Epiglottitis:
What is the agent?
What is the group in the population most at risk? -
Agent:
- Hemophilus Influenza
- Gram (-), aerobic, coccobacillus
Group:
- Children 5 years old or less -
Croup:
What is the agent?
What is the group in the population most at risk? -
Agent:
- Parainfluenza Virus
- Enveloped paramyxovirus
- ssRNA
Group:
- Children under 3 years of age -
Regarding Congenital Rubella Syndrome (CRS):
Describe cardinal characteristics?
Indicate when during pregnancy risk is greatest? -
Cardinal Characteristics:
Abortion; cataracts, glaucoma, heart defects, deafness, mental retardation.
When during pregnancy?
When a pregnant woman aquires it in the first month of pregnancy -
Pros and Cons of vaccination for :
Measles? -
Pro - 95% effective
Con - Demyelinating encephalopathy in 1 in a million vaccines -
Pros and Cons of vaccination for :
Mumps? -
Pro - Life long immunity
Con - None -
Pros and Cons of vaccination for :
Rubella? -
Pro - reduced incidence of Congenital Rubella Syndrome (CRS) in children 1-12 by 70%
Con - None identified in notes -
Pros and Cons of vaccination for :
Polio? -
Pro - Trivalent Oral Polio Vaccine (TOPV) has reduced disease by 1000X, can stop epidemics, easy to administer (taken orally)
Con - Salk Inactivated Polio Vaccine (IPV) requires injection. TOPV may revert to virulent form in 1/2.5 million vaccinations) -
Pros and Cons of vaccination for :
Tetanus? -
Pro - Only about 50 cases per year in U.S from vaccination
Con - Mortality rate is 45% -
Pros and Cons of vaccination for :
Diptheria? -
Pro - Immunization protects against toxic effects of diptheria. Protection good for 10 years.
Con - Immunization does not protect against colonization -
Pros and Cons of vaccination for :
Pertussis? -
Pro - 90% effective in infants
Con - May cause encephalopathy, seizure, SIDS, but investigation does not support causal role. Most common side effect is inconsolable crying for 24 hours -
Pros and Cons of vaccination for :
Hemophilus Influenza? -
Pro - 98% decline in incedence. Less than 10 fatalities per year.
Con - None identified -
Regarding Post Polio Sydrome:
What is it?
Who is at risk?
What is the treatment?
What is the prognosis? -
What is it? - Paralytic poliomyelitis that develops 25-35 years after apparent recovery.
Who is at risk? - Adults from 25 years +
What is the treatment? - No treatment
Prognosis? - profound weakness, pain, loss of muscle mass in previously affected limb -
What is the likelihood of eradication for:
Measles? - Good, as humans are only reservoir and disease dies out in isolated communities. Recovery from disease confers life-long immunity in most people. Is a stable single antigenic type, so can be controlled better.
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What is the likelihood of eradication for:
Mumps? - Vaccine confers life long immunity. Single antigenic type easier to eradicate.
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What is the likelihood of eradication for:
Rubella? - Good. Aggressive campaign to immunize children age 1-12 has reduced incidence by 70%
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What is the likelihood of eradication for:
Polio? - Possible. Humans are only reservoir, so eradication is possible with IPV vaccine
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What is the likelihood of eradication for:
Tetanus? - Possible, but unlikely. Vaccination has reduced incidence to 50 cases per year. But, drug addicts and elderly with low immune status at higher risk.
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What is the likelihood of eradication for:
Diptheria? - Unlikely. immunization only protects against toxic effects, not colonization.
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What is the likelihood of eradication for:
Pertussis? - Good. Vaccine is 90% effective
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What is the likelihood of eradication for:
Hemophilus Influenza? - good. 98% decline in incidence from vaccine.
- What obstacles exist to the widespread use of a vaccine for RSV?
- The vaccine, Formalin may cause disease upon natural re-exposure to RSV