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Questions and Answers
A patient presents with gingivostomatitis, characterized by vesicular lesions on the gums and lips. Which virus is most likely responsible for these findings?
A patient presents with gingivostomatitis, characterized by vesicular lesions on the gums and lips. Which virus is most likely responsible for these findings?
- Epstein-Barr virus (EBV)
- Herpes simplex virus type 1 (HSV-1) (correct)
- Human herpesvirus 6 (HHV-6)
- Varicella-zoster virus (VZV)
A patient with suspected viral encephalitis undergoes a lumbar puncture. Which of the following cerebrospinal fluid (CSF) findings is most indicative of HSV encephalitis?
A patient with suspected viral encephalitis undergoes a lumbar puncture. Which of the following cerebrospinal fluid (CSF) findings is most indicative of HSV encephalitis?
- Increased opening pressure, increased protein, and normal glucose (correct)
- Normal opening pressure, normal protein, and decreased glucose
- Decreased opening pressure, decreased protein, and increased glucose
- Decreased opening pressure, increased protein, and decreased glucose
Which of the following mechanisms of action (MOA) describes how acyclovir is effective in treating HSV encephalitis?
Which of the following mechanisms of action (MOA) describes how acyclovir is effective in treating HSV encephalitis?
- Blocking viral attachment to host cells
- Inhibiting viral DNA polymerase (correct)
- Inhibiting viral reverse transcriptase
- Disrupting the viral protein coat
A patient is diagnosed with infectious mononucleosis (mono) caused by the Epstein-Barr virus (EBV). Which cellular receptor does EBV primarily target for attachment and entry into host cells?
A patient is diagnosed with infectious mononucleosis (mono) caused by the Epstein-Barr virus (EBV). Which cellular receptor does EBV primarily target for attachment and entry into host cells?
A patient presents with symptoms suggestive of Epstein-Barr virus (EBV) infection. A Monospot test is performed. What immunological principle underlies the Monospot test's ability to detect EBV infection?
A patient presents with symptoms suggestive of Epstein-Barr virus (EBV) infection. A Monospot test is performed. What immunological principle underlies the Monospot test's ability to detect EBV infection?
A patient presents with unilateral vesicles on a specific dermatome that does not cross the midline. Which of the following viruses is most likely responsible for this presentation?
A patient presents with unilateral vesicles on a specific dermatome that does not cross the midline. Which of the following viruses is most likely responsible for this presentation?
A child presents with several days of high fever followed by a macular eruption. Which of the following viruses is the most likely cause?
A child presents with several days of high fever followed by a macular eruption. Which of the following viruses is the most likely cause?
An immunocompromised patient, positive for HIV, presents with violaceous, raised cutaneous plaques. Which of the following viruses is most likely associated with this patient's condition?
An immunocompromised patient, positive for HIV, presents with violaceous, raised cutaneous plaques. Which of the following viruses is most likely associated with this patient's condition?
A child presents with a 'slapped-cheek' appearance and a lace-like reticular rash on the trunk. Which virus is the most likely cause of this presentation?
A child presents with a 'slapped-cheek' appearance and a lace-like reticular rash on the trunk. Which virus is the most likely cause of this presentation?
A patient with sickle cell disease experiences a sudden drop in red blood cells (RBCs), indicating an aplastic crisis. Which virus is most commonly associated with causing aplastic crisis in these patients?
A patient with sickle cell disease experiences a sudden drop in red blood cells (RBCs), indicating an aplastic crisis. Which virus is most commonly associated with causing aplastic crisis in these patients?
A child presents with profuse, watery diarrhea. Which of the following viruses is the most likely causative agent?
A child presents with profuse, watery diarrhea. Which of the following viruses is the most likely causative agent?
A child presents with a rash that initially appeared on the face and then spread to the trunk, arms, and legs, sparing the palms and soles. Which vitamin is known to reduce the morbidity associated with this infection?
A child presents with a rash that initially appeared on the face and then spread to the trunk, arms, and legs, sparing the palms and soles. Which vitamin is known to reduce the morbidity associated with this infection?
An unvaccinated child develops ataxia, myoclonus, vision defects, and changes in behavior years after a measles infection. Which complication of measles is most likely?
An unvaccinated child develops ataxia, myoclonus, vision defects, and changes in behavior years after a measles infection. Which complication of measles is most likely?
A newborn presents with oral thrush, interstitial pneumonia, and severe lymphopenia. The infant's mother is HIV-positive and used intravenous drugs during pregnancy. What is the most likely route of transmission of HIV to the infant?
A newborn presents with oral thrush, interstitial pneumonia, and severe lymphopenia. The infant's mother is HIV-positive and used intravenous drugs during pregnancy. What is the most likely route of transmission of HIV to the infant?
A patient with HIV develops Pneumocystis jirovecii pneumonia. At what CD4+ T-cell count is this opportunistic infection most likely to occur?
A patient with HIV develops Pneumocystis jirovecii pneumonia. At what CD4+ T-cell count is this opportunistic infection most likely to occur?
A patient with AIDS presents with memory loss, imbalance, clumsiness, and difficulty finding words. A biopsy reveals microglial nodules with multinucleated giant cells. What is the most likely diagnosis?
A patient with AIDS presents with memory loss, imbalance, clumsiness, and difficulty finding words. A biopsy reveals microglial nodules with multinucleated giant cells. What is the most likely diagnosis?
A patient presents with oral ulcers and a rash on the palms and soles. Which of the following viruses is the most likely causative agent?
A patient presents with oral ulcers and a rash on the palms and soles. Which of the following viruses is the most likely causative agent?
A patient presents with fever, polyarthritis, lymphopenia, and a history of recent travel to Puerto Rico. Which of the following viruses is the most likely cause?
A patient presents with fever, polyarthritis, lymphopenia, and a history of recent travel to Puerto Rico. Which of the following viruses is the most likely cause?
A patient who recently underwent a solid organ transplant presents with pneumonitis. Histological examination of a transbronchial biopsy reveals cells with inclusions. Which virus is most likely the cause?
A patient who recently underwent a solid organ transplant presents with pneumonitis. Histological examination of a transbronchial biopsy reveals cells with inclusions. Which virus is most likely the cause?
Which of the following mechanisms of action describes how amphotericin B works to treat fungal infections?
Which of the following mechanisms of action describes how amphotericin B works to treat fungal infections?
A 30-year-old patient presents with intense pruritus in the genital area and admits to multiple sexual partners. Upon examination, small insects are noted attached to the pubic hair. Which of the following treatments is most appropriate?
A 30-year-old patient presents with intense pruritus in the genital area and admits to multiple sexual partners. Upon examination, small insects are noted attached to the pubic hair. Which of the following treatments is most appropriate?
A patient from Central America presents with new-onset seizures. Brain imaging reveals multiple ring-enhancing lesions with calcifications. Which of the following is the most likely causative agent?
A patient from Central America presents with new-onset seizures. Brain imaging reveals multiple ring-enhancing lesions with calcifications. Which of the following is the most likely causative agent?
A patient diagnosed with malaria is prescribed chloroquine. What is the mechanism of action of chloroquine in treating malaria?
A patient diagnosed with malaria is prescribed chloroquine. What is the mechanism of action of chloroquine in treating malaria?
A patient with malaria is prescribed primaquine. What is the purpose of using primaquine in the context of malaria treatment?
A patient with malaria is prescribed primaquine. What is the purpose of using primaquine in the context of malaria treatment?
A patient with malaria is treated with chloroquine but remains symptomatic. Further testing reveals the presence of Plasmodium vivax. Why might chloroquine not have been effective in this case?
A patient with malaria is treated with chloroquine but remains symptomatic. Further testing reveals the presence of Plasmodium vivax. Why might chloroquine not have been effective in this case?
A blood smear from a patient with malaria shows that red blood cells of all ages are infected. This finding is most characteristic of which Plasmodium species?
A blood smear from a patient with malaria shows that red blood cells of all ages are infected. This finding is most characteristic of which Plasmodium species?
A patient develops neutropenia following chemotherapy treatment. What is the most common cause of neutropenia in this context?
A patient develops neutropenia following chemotherapy treatment. What is the most common cause of neutropenia in this context?
A patient in the hospital develops a bloodstream infection after insertion of an intravascular catheter. Which of the following organisms is most commonly associated with this type of infection?
A patient in the hospital develops a bloodstream infection after insertion of an intravascular catheter. Which of the following organisms is most commonly associated with this type of infection?
A patient presents with a painful genital ulcer. Gram stain is negative for typical organisms. Which of the following is the most likely causative agent?
A patient presents with a painful genital ulcer. Gram stain is negative for typical organisms. Which of the following is the most likely causative agent?
A patient presents with genital warts and is diagnosed with condyloma acuminatum. Which of the following best describes these lesions?
A patient presents with genital warts and is diagnosed with condyloma acuminatum. Which of the following best describes these lesions?
A researcher is studying the mechanism of action of maraviroc. Which of the following cellular processes is directly inhibited by this drug?
A researcher is studying the mechanism of action of maraviroc. Which of the following cellular processes is directly inhibited by this drug?
A patient with a confirmed HIV diagnosis develops resistance to protease inhibitors. Which is the most likely underlying mechanism contributing to this resistance?
A patient with a confirmed HIV diagnosis develops resistance to protease inhibitors. Which is the most likely underlying mechanism contributing to this resistance?
West Nile Virus is transmitted to humans through the bite of an infected mosquito. Prior to infecting humans, where does the virus typically replicate?
West Nile Virus is transmitted to humans through the bite of an infected mosquito. Prior to infecting humans, where does the virus typically replicate?
A patient presents with fever, paralysis, and a history of recent contact with bats. Which of the following viruses should be most suspected?
A patient presents with fever, paralysis, and a history of recent contact with bats. Which of the following viruses should be most suspected?
Which of the following is the function of hemagglutinin in the influenza virus?
Which of the following is the function of hemagglutinin in the influenza virus?
A neonate is diagnosed with Cytomegalovirus (CMV) following the presentation of jaundice, hepatomegaly, and intracranial calcifications. Which type of infection is most commonly associated with this presentation?
A neonate is diagnosed with Cytomegalovirus (CMV) following the presentation of jaundice, hepatomegaly, and intracranial calcifications. Which type of infection is most commonly associated with this presentation?
What is the mechanism of action of azole antifungals?
What is the mechanism of action of azole antifungals?
A lung biopsy from a patient with suspected fungal infection demonstrates large, round yeasts with doubly refractile walls and single broad-based buds.. Which fungal infection is most likely?
A lung biopsy from a patient with suspected fungal infection demonstrates large, round yeasts with doubly refractile walls and single broad-based buds.. Which fungal infection is most likely?
A patient who is being treated with amphotericin B for mucormycosis begins to experience muscle weakness and cardiac arrhythmias. Which of the side effects listed below would be most likely responsible for these manifestations?
A patient who is being treated with amphotericin B for mucormycosis begins to experience muscle weakness and cardiac arrhythmias. Which of the side effects listed below would be most likely responsible for these manifestations?
A gardener develops a lesion on their hand after being pricked by a rose thorn. Over the next few weeks, more papules develop, moving proximally up their arm. Which is a likely causative agent?
A gardener develops a lesion on their hand after being pricked by a rose thorn. Over the next few weeks, more papules develop, moving proximally up their arm. Which is a likely causative agent?
Flashcards
HSV-1 Presentation
HSV-1 Presentation
Gingivostomatitis (vesicular lesions on gums and lips).
HSV Encephalitis Presentation
HSV Encephalitis Presentation
Confusion, increased lumbar puncture opening pressure/protein, normal glucose.
Acyclovir MOA
Acyclovir MOA
Inhibit Viral DNA Polymerase.
Epstein-Barr virus (EBV)
Epstein-Barr virus (EBV)
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EBV Attachment
EBV Attachment
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EBV Associated Disease
EBV Associated Disease
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Monospot test
Monospot test
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Varicella-zoster Presentation
Varicella-zoster Presentation
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HHV-8 Presentation
HHV-8 Presentation
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Parvovirus B19 Presentation
Parvovirus B19 Presentation
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Rotavirus Presentation
Rotavirus Presentation
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Measles Presentation
Measles Presentation
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HIV Congenital Presentation
HIV Congenital Presentation
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Antiretroviral therapy (ART)
Antiretroviral therapy (ART)
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HIV Encephalopathy Presentation
HIV Encephalopathy Presentation
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Variola Virus Presentation
Variola Virus Presentation
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Enterovirus Presentation
Enterovirus Presentation
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Rabies Virus Presentation
Rabies Virus Presentation
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Cytomegalovirus (CMV)
Cytomegalovirus (CMV)
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Sporothrix schenckii Presentation
Sporothrix schenckii Presentation
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Pubic Lice
Pubic Lice
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Neurocysticercosis
Neurocysticercosis
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Chloroquine, Artemisinin or Atovaquone-proguanil
Chloroquine, Artemisinin or Atovaquone-proguanil
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Primaquine
Primaquine
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Neutropenia
Neutropenia
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Chemotherapy-induced neutropenia Cause
Chemotherapy-induced neutropenia Cause
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Catheter Related Bloodstream infections
Catheter Related Bloodstream infections
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Chancroid
Chancroid
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Condyloma accuminatum
Condyloma accuminatum
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Adenovirus Presentation
Adenovirus Presentation
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HIV integrase
HIV integrase
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HIV antiretroviral resistance
HIV antiretroviral resistance
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HIV Cell Attachment Involves
HIV Cell Attachment Involves
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CCR5 treatment
CCR5 treatment
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HPV cause
HPV cause
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Influenza virus virology
Influenza virus virology
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Azoles MOA
Azoles MOA
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Echinocandins MOA
Echinocandins MOA
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Allylamines MOA
Allylamines MOA
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Study Notes
- The existing study notes have been updated with the information in the provided text
Lice (Pubic)
- Phthirus pubis is the parasite responsible for pubic lice
- Intense pruritus in the genital area, especially with multiple sex partners, is a key sign
- Topical permethrin serves as the treatment
Neurocysticercosis
- Taenia solium (pork tapeworm) is the pathogen
- New seizures, brain calcifications, and a history of immigration are indicative
- Brain imaging shows calcifications
Malaria
- Plasmodium species is the pathogen
- Chloroquine, Artemisinin or Atovaquone-proguanil eliminate susceptible erythrocytic forms of all Plasmodium species
- Primaquine prevents relapses for Plasmodium vivax and Plasmodium ovale infections
- Plasmodium vivax and ovale have an exoerythrocytic liver stage (hypnozoite) unaffected by chloroquine
- Blood smear can detect malaria
Plasmodium falciparum
- Has the ability to infect RBCs of all ages, increasing its parasitemia compared to other plasmodium species
Febrile Neutropenia
- Neutropenia involves a low number of neutrophils in the blood
Chemotherapy-Induced Neutropenia
- It is caused most often by bacterial flora due to damage across mucosal sites
Catheter-Related Bloodstream Infections
- Nosocomial bloodstream infections usually stem from intravascular catheters
- They are associated with staphylococcus aureus and staphylococcus epidermidis
Chancroid
- Painful ulcers characterize it
- Haemophilus ducreyi is the cause
Condyloma Accuminatum
- Genital warts are present
- There is no ulceration observed
Adenovirus
- Results in self-limited upper respiratory infection, or gastroenteritis
- It's a double-stranded, non-enveloped DNA virus
HIV
- Integrase will inhibit production of viral mRNA
- Mutations in the pol gene happens with the HIV strain and it transcribes many enzymes attached by antiretroviral therapy
- Antiretroviral resistance mainly appears due to inconsistent antiretroviral therapy
- Cell attachment impacts CD4 (T cells)
- Protease inhibitors such as ritonavir/lopinavir are treatments
- Mutations in protein processing leads to resistance to Protease inhibitors
- Using NRTIs and NRTIS are effective in treating this
- HIV can use CCR5 or CXCR4 receptors to enter cells such as helper T cells and macrophages
- CCR5 allows for HIV to enter macrophages more
- Maraviroc is a treatment option for CCR5 which inhibits CCR5; therefore, it will not treat CXCR4 strains
- CXCR4 allows for HIV to enter T lymphocytes more
Variola Virus
- Results in smallpox
- Vesiculopustular rash with lesions at the same stage of development
West Nile Virus
- Fever with neuroinvasive symptoms, extremity weakness, confusion, and flaccid paralysis are indicative of this virus
- This is found more in the summer months
- Mosquito bites transmit this
- The virus replicates in birds and is then uptaken by mosquitoes feeding on the birds
- Mosquitoes bite humans and infect them after feeding on birds, there are multiple dead birds in the area
Human Papilloma Virus (HPV)
- Oropharyngeal carcinomas are caused by HPV-16 and HPV-18
Rabies Virus
- Spasms, paralysis and exposure to bats are indicative
- Inactivated vaccine can be used as prophylaxis
Influenza Virus
- Negative sense, single stranded RNA virus
- Hemagglutinin promotes progeny viral entry and lets the virus in
- Neuraminidase promotes progeny viral release and sends the virus away
Cytomegalovirus (CMV)
- Jaundice, hepatomegaly, rash and intracranial calcifications are indicative of neonatal presentation
- TORCH infection can be seen
- Mothers may have a febrile illness that they recovered from
Candida Infection
- Azoles block the fungal enzyme lanosterol 14-alpha-demethylase a CYP450-dependent enzyme that converts lanosterol to ergosterol
Echinocandins
- Caspofungin and micafungin inhibit the synthesis of glucan, a component of the cell wall
Pyrimidines
- Flucytosine converts to 5-fluorouracil in the fungal cell and interferes with RNA and protein synthesis
Allylamines
- Terbinafine inhibits squalene epoxidase, which inhibits the synthesis of ergosterol
- Tinea Corporis uses allylamines
Mucormycosis
- Amphotericin B is the treatment
- Side effects consists of severe hypokalemia and hypomagnesemia
Blastomyces dermatitidis
- Great Lakes region, and Ohio and Mississippi River Valleys have this fungus
- This fungus is found in soil
- Pneumonia can be seen
- Large, round yeasts with doubly refractile wall and single broad-based bud exists and can be found with biopsy
Cryptococcus neoformans
- India ink (or mucicarmine) stain detects Cryptococcus neoformans
- Budding yeast forms with thick capsules
Aspergillus fumigatus
- Fungi that infects HIV patients (<50 CD4) and worsens asthma (allergic bronchopulmonary aspergillosis)
Histoplasmosis capsulatum
- Tiny intracellular yeast forms and tuberculate macroconidia grown at room temperature can be found in smears
- Transmission impacts inhalation of spores that are found in bird or bat droppings
Sporothrix schenckii
- Skin lesions on hand that travel proximally up the arm are indicative of this dimorphic fungus
- Elongated yeast cells with narrow-based buds can be found with microscopy, it exists as yeast at room temperature
- This exists due to contact with soil and plant materials
Sporotrichosis
- Trauma allows it to get into the skin where it's more common in soil
- Site of initial trauma results in a papule, following by smaller papules moving proximal up the extremity
Coccidioides immitis
- Fungus endemic to central valley of California
- Self-limited respiratory illness
- Large spherules containing endospores can be found with microscopy
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