ID questions
Terms
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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