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ID questions

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what is dimorphic
yeast in host, mold outside (yeast=unicellular, budding; molds with hyphae)
which are dimorphic
Blasto, Cocci, Histo, and Paracocci
which give TB like dz
Asper, Mucorales, Cocci, Histo, and Sporo (mostly IC or lung, exc Sporo in normal)
which give pneu like dz
Asper, Blasto, Crypto, Paracocci, PCP
which give meningitis
Cocci, Crypto, Sporo, Candida
how dx Asper
biopsy showing Asper invading
which cause skin dz
Blasto, Sporo, Para, Candida
Which geographic
Blasto (Miss R not Houston), Cocci (SW), Histo (TX), Para (S America)
man with AIDS comes from SE Asia, what suspect
P marneffi
which use serology to dx
Histo and Para (Crypto Ag)
which cause penu and meningits
Crypto
which cause TB and meningitis
Cocci and Sporo
Which cause TB and pneu
Asper
How dx Crypto
Ag
how tx cocci meningitis
Amph B for life
arthroconidia
Cocci
Candida in broad Ab/chronic ill
retina endophthalmitis
mucous infxns in Candida
thrush, leukoplakia, angular chelitis
diaper rash w satelitte lesions
Candida
which not dimorphic
Crypto, Sporo (pcp)
how dx Candida
gram stain, Albicans forms germ tubes
meningitis-if Ha return do another LP
Crypto
which can infect male GU tract
Blasto
describe Blasto histo/path
dimorphic, multinucleated, broad based bud
which method should not be used to dx Blasto
sero
which can infect long bones
blasto
infant with nail infection
chronic candida
which can dx w culture
Blasto, Cocci, Sporo
most crypto dz is
meningitis
soft tissue dz could be
Crypto
how tx Crypto meningitis
amph B + 5FC
describe Crypto path
not dimorphic, thin based bud
disfiguring oropharyn lesions
Para
Para primary infxn
subclinical
systemic dz
Cocci, Histo, para,, Blasto
how dx sporo meningitis
serology
most common sporo dz
lymphocutaneous
arthritis like
Sporothriz
psoriasis like
Sporothrix
in AIDs Sporo
can disseminate
insiduous pneu w/ normal CXR
PCP
diabetic
Mucorales- rhinocerebral rapid, aggressive
dz of Sporo
skin (lymphocutaneous, psoriasis, arthritis), TB, meningitis, (AIDs dissem)
dz of Pneumo
pneumo like in debilitated infant, or TALC pts
dz of Para
Pneu like, disfiguring oropharynx
dz of Crypto
pneu, meningitis, soft tissue (Strep like)
TB like in normal
Sporo
ssDNA
parvovirus
blindness in infant
rubella
Negri inclusion bodies
Rabies
diarrhea in infants
Echo, Cox A, or Corona
HIV OI: hi, med, low CD4 count
hi: PCP, Cocci; med: Crypto, Toxo; low: MAC, CMV
to treat VZV
valacyclovir
can cause retinitis in AIDS
CMV
exacerbate asthma
rhinovirus
tx MAC
clarithro+azithro, ethambutol,rifabutin
tx toxo
pyrimeth w foline+ sulfadiazon
pneu in IV Drug AIDS
S pneu
morph of Rabies
bullet shaped enveloped -ssRNA w helical nucleocapsid
cause of death in rabies
(first spasms) encephalitis, sz
season of Rhinovirus
F,S
season of entero
late summer early fall (remember "entering" fall)
immunity to rhino
IgA
spread of rhino
large particle aerosol
Sjorgen
Hep C
dx rhino
clinical, isolate or culture (>100 serotypes, 1/3 cause dz)
subtypes of Filoviridae
Marburg, Ebola
dx Filo
Ag detection in blood
tx Filo
none
strains Ebola
Zaire (80%mortality), Sudan, Ivory Coast, Reston (assympt)
morph of Filo
lipid enveloped -ssRNA, curvey at one end
hemorrhagic fever spreading among family
Ebola or Marburg
morph Hep C
(Flavi) enveloped!! +ssRNA
dx Hep C
screen w ELISA, confirm immunoblot
tx Hep C
toxic drugs, not effective: interferon & ribofavin
complications HepC
Sjorgen, glomerulo/neph, vasculitis, erythema nodosa, globulin abnormalities, neuro
Hep-pregnancy
B&E
Hep-cancer
B,C
Hep-chronic
B,C,D
morph Hep B
enveloped PARTIAL dsDNA (DNA-RNA-DNA)
HBeAg
measure of infectivity
shed in stool long after sx
Entero, Echo, Cox (3-4mos),
shed in stool before sx
??
dx Entero
clinical
tx Entero
self-limited
child pharyng w exudate
Adenoviridae
strains Entero
68-71
dz Entero
20% respir, meningitis, hemorrhagic conjunctivitis
dz echo
meningitis, febrile exanthem, hand foot mouth, diarrhea in infants
dx echo
clinical or culture throat (not stool, shed in stool 3-4 mos)
systemic echo
mild surface, 10days later dz distant site
Herpes gamma
Karpesi sarcomma
Karpesi Sarcomma risk
Mediterranean, HIV
Herpes Simae
animal bites! Treat immediately (CNS lethal)
child hi F, ( rash as F breaks)
Roseola (HHV6, beta)
mimic polio
entero 71
tx roseola
ganciclovir and foscarnet
roseola latent in
lymph nodes
subtypes roseola
6B-kids F, 6A-adults mono
orchitis/oophoritis
Measles, Mumps
seasonality of Paramyxo
F=parainflu1,2; F/W=RSV; W=metapneumo, lateW/S=para3
koplik spots
Measles
rapid breathing
RSV if child <2
subtypes Flaviviridae
Jap enc, Yellow fever (vaccines), Dengue, TBE, W Nile
dx Flavi
sero (for ALL ARBO)
dsRNA
Rotavirus (all Reo)
ARBO
+ Toga&Flavi, - Bunya,Arena,Filo
-ssRNA
Orthomyxo, Para myxo, Rhabdo (+1/2 ARBO)
hemorr conjunctiv
entero or coxA
5 cap only
Flaviviridae
5 and 3 caps
Togaviridae
ssRNA ambisense
Arenaviridae
strains Rota
A (B only in China)
virus w 6A, 6B forms
Roseola, 6B=kids F/slapface, 6A=adults, mono
how kill Rota
chlorine (not acid)
immunity to rota
Ab to VP4, VP7
immunity IgA
rhinovirus
dx Rota
ELISA on stool (Note-won't detect B!!!!!)
patho of Rota
fecal/oral/fomite, incubate 2 days, replicated in SI--malabsorp
Oral Hairy Leuko, cause and tx
EBV in HIV, tx acyclovir
family Norwalk
Caliciviridae
hand foot mouth
echo
dx Norwalk
RT PCR (can't be cultured)
Flavi transmitted by
mosquito (except TBE tick)
subtypes Arena
Old=Lassa, LCM, New=Argen hemorr, Junin
tx Arena
only Lassa-ribavirin
reservoir of Arena
rodents
atypical lymphs
EBV
2day GI sickness
Norwalk
F, Ha faint rash
LCM (Arenaviridae)
morph Adeno
dsDNA, not envelop
IgM to VCA
EBV
strains Adeno
children 1-7, military 4,7
where Adeno latent
tonsils, adenoids, intestine
heterophile Ab
EBV
Sin Nombre
hantavirus of Bunya (ARBO)
Dz Sin Nombre
severe flu, pulmonary edema, hi WBC
pathol of sin nombre
4 corners area, infect rodents, small % get dz, incubate 8-21 days
blindness in IC
Adenoviridae, CMV
dx Sin Nombre
serology
complications Sin Nombre
HFRS (treat w ribavirin)
dx Cox
A: clinical, B:serotype (6)
morph Corona
+ssRNA with club shaped projections
strains corona
OC43, 229E, SARS
relation of Fru2,6P to PFK activity?
PFK2 is a kinase when deP (insulin/meal) converting more Fru1P to Fru2,6P, activating PFK1 (increase glycolysis)
simple way to think of Fru2,6P as regulator?
fru2,6P hi when lot of reactant (fru1P)
phosphorylation states insulin v glucagon
glucagon put on P (via PK), insulin takes off P (via phosphorylase), so with glucagon enz-P, with insulin enz-noP
"Fasting Phosphorylated"
phosphorylation states of PFK2
when PFK2-deP kinase, when PFK2-P phosphatase
enzymatic steps different in gluconeo
1) pyr carboxylase (pyr to OAA) 2) PEPCK (OAA to PEP) 3) Fru1,6BP (Fru1,6P to Fru6P) 4) glu6P (glu6P to glu). 1,2 replace PK, 3 replaces PFK, 4 replaces GK
regulation and cofactors pyr carboxylase
requires biotin and ATP, activated by acetyl coA
what substrates enter gluconeo
glucogenic aa, alanine, lactate (Cori cycle). GLUCOGENIC=Met, Thr, Val, Arg, His (+/-Ile, Phe, Trp either gluco or keto). KETO=Leu, Lys and acetoacetate.
(I met 3 armadillos hissing illicit phrases trippingly)
way to remember irreversible enzymes in gluconeo
"Pathway produces fresh glu" Pyr carboxy, PEPCK, Fru1,6P, and Glu6P
energy requiring steps of gluconeo
ATP for pyr carboxy, GTP for PEPCK
how can glyceral (from TAG) enter gluconeo
via DHAP/G3P step
where glu6phosphatase enzyme located
only liver and kidney, not muscle so muscle can only create glu6 which can't be exported (used glycolysis)
how is gluconeo turned on and glycolysis turned off
acetyl coA activates pyr carboxy and inactivates PDH (leading pyr to TCA). glucagon deP turning off PK. glucagon also decreases Fru2,6BP which inhibits PFK and induce Fru1,6Phosphatase. low glucose inhibits GK. (levels ATP/NADH also influence)
what shuttle needed in gluconeo
Asp/Mal shuttle to get OAA out of mitochondria for PEPCK rxn
FA synthesis steps
mito acetylcoA converted to citrate so enter cytosol. acetylcoA + malonylcoA + 2NADPH each cycle, until desired length
where malonyl coA from
product of acetylcoA carboxylase

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