I & D Exam 3

pseudomembranous,atrophic,hyperplastic,angular cheilitis,Linear gingival erythema

5 main types of oral candidiasis

entamoeba

cause of dysentery

Giardia and crptosporidium

parasitic cause of traveler’s diarrhea

trichomonas

parasitic cause of vaginitis, urethritis

plasmodium

parasitic cause of malaria

trypansomes

parasitic cause of blood infection; chagas disease, african sleeping sickness

leishmania

parasitic infections of bone marrow, liver, spleen

toxoplasma

parasite that causes CNS infection, encephalitis

pneumocytosis

parasite that causes pneumonia (in AIDS patients)

angular chelitis

which candidiasis infection is associated with mixed infection with staph or strep

C. albicans

most common cause of candidiasis infection

pseudomembranous (thrush)

common candida infection among newborns, HIV pts, after antibiotics, denture users, dry mouth

enterovirus

humans only natural host

coxsackie virus A-16 (enterovirus A-71)

what causes hand foot and mouth disease (HFMD)

primary gingivostomatis (HHV-1)

painful lesions occurr on buccal mucosa, tongue, gingiva, and pharynx, primariyl in children and young adults

10-33 days

window period of nucleic acid test (NAT)

18-45 days

window period of antigen/antibody lab test

18-90 days

window period of rapid antigen/antibody test

23-90 days

window period of antibody test

gag (p24)

gene that encodes structural core of HIV

attach receptor, enter cell, release genome, replicate w/ host cell machinery, self assemble, release from cell

lifecycle of virus

natural killer cells

turned on by viral infection, lyse virus infected cells

hemagglutinin (HA),neuraminidase (NA), M2 Ion channel

viral influenza structure

hemagglutinin (HA)

binds sialic receptors for viral entry, agglutinates. RBCs, antigenic (neutralizing)

matrix

protein that provides structural support to the virus and facilitates the assembly of viral particles.

caspid

the protein shell that encases and protects the viral genome, aiding in the delivery of the viral material into host cells.

membrane glycoprotein

a viral protein embedded in the lipid bilayer that plays a key role in host cell recognition and fusion during viral entry

neuraminidase (NA)

cleaves sialic acid for viral release, degrades mucin, antigenic (non-neutralizing, Abs dont neutralize but decrease spread)

influenza A

associated with seasonal endemics and flu pandemics

Hep C, Candida, mycobateria, TB

common HIV co-infections

antigenic drift

causes epidemics, minor mutations of HA or NA, influenza A,B, C, seasonal changes

antigenic shift

causes pandemic, complete change of HA or NA, influenza A ONLY

influenza A

only influenza virus that can affect both humans and animals

pol

HIV gene that encodes enzymes reverse transcriptase, integrase, and protease

neutralization, type I interferon induction, activation of NK cells

antiviral responses

HHV-3

Which Herpesvirus is associated with Shingles?

pseudomembranous (oral thrush)

curd like plaques that scrape off, sore, burning, metallic taste

atrophic

Often associated with dentures, worn all the time or poorly fitting, Thin epithelium

hyperplastic

white diffuse or pebbly areas do not scrape off, thicken epithelium, mixed atrophic areas, asymptomatic, under-recognized

angular cheilitis

cracking at mouth corners, mixed with staph or strep infection, drooling, treatment in mouth and commisures

linear gingival erythema

oral candidiasis seen in HIV pts, red linear band along gingival margin

lipid envelope

A lipid bilayer that surrounds some viruses, providing protection and facilitating entry into host cells.

TLR3, TLR7, TLR8

which receptors recognize viruses

type I IFNs

immediatee response to virus, direct anti-viral actions, and limits the spread of infection by inducing an antiviral state in neighboring cells.

memory T cell

prevents reactivation of latent virus

antibodies

neutralize virus on re-exposure

CD4 T helper lymphocyte

what cells does HIV infect

gag,env,pol

structural genes of HIV

tat and rev

regulatory genes of HIV that play a crucial role in viral replication and gene expression.

binding of HIV to CD4 T cells

function of env (gp120 & gp41)

protease

enzyme that cleaves viral proteins for maturation

reverse transcriptase

an enzyme that converts viral RNA into DNA, allowing HIV to integrate into the host genome.

integrase

An enzyme that facilitates the integration of viral DNA into the host cell's genome, crucial for the HIV replication cycle.

Acute HIV infection

multiplies and spreads rapidly CD4 cells destroyed, high viral load, increased risk of transmission

chronic HIV

clinical latency, HIV hidden in lymph nodes, transmission still possible

AIDs

CD4 cell count drops below 200 cells/mm³, leading to severe immune system damage and increased susceptibility to opportunistic infections.

acute stage HIV

flu-like symptoms, fever, swollen glands, sore throat, rash, muscle and joint aches, pains and headache

clinical latency stage

no/mild symptoms, still transmittable even when on ART (antiretroviral therapy),

late stage/AIDs

varoius opportunistic infections and cancers, significant immune system damage, often leading to death

Fungal (candida, coccigioidees, cryptococcus), Hep B/C, mycobacteria (TB,MAC), Herpes, CMV, HPV, parasites (cryptosporidium, toxoplasma,histoplasma)

common opportunistic pathogens of HIV

window period

time between HIV exposure and the point at which antibodies or antigens can be detected in the body

post-exposure prophylaxis (PEP)

a preventive treatment started after potential exposure to HIV to reduce the risk of infection

PrEP (pre-exposure prophylaxis)

prophylaxis for people who are HIV-negative but are at risk. of exposure from sex or IV drug use, done daily

HHV-1 Herpes simplex-1

mucocutaneous lesions (oral>genital), encephalitis

HHV-2 Herpes simplex virus-2

mucocutaneous lesions (genital>oral), meningitis

HHV-3 varicella zoster virus

chickenpox, zoster (shingles)

HHV-4 epstein-barr virus

mononucleosis, co-factor in many malignancies

HHV-5 cytomegalovirus

mononucleosis, transplant and AIDS rrelated infections, congenital disease

HHV-6 and HHV-7

roseola

HHV-8/KSV

Kaposi sarrcoma, castleman’s diseease, primary effusion lymphoma.

gingicostomatitis, Herpes labialis, eye infections, cutaneous infections (whitlow), encephalitis

common infections of HHV-1

genital herpes (herpes genitalis), neonatal infections, meningitis

common infections of HHV-2

acyclovir

typical medication for HHV-1 and 2

herpes labialis (HHV-1)

“fever blister, cold sores”, periodic localized recurrence of lesions on vermilion border

herpetic whitlow (HSV-1 60%)

infection on finger or hand, vesicular lesions on finger pustular and painful often associated with direct contact with infected lesions.

herpetic keratoconjunctivitis

dendritic ulcers, can lead to blindness if left untreated, caused by latent HSV-1 in nerve cell or direct contact with either HHV 1 or 2

mollaret meningitis/recurrent lymphomatic meningitis

mostly caused by HHV-2, sudden attacks of meningitis symptoms followed by prolonged symptom free interval

chickenpox (HHV-3)

itchy rash with small fluid filled blisters, easily spread to unvaccinated people,

oral hairy leukoplakia, Burkitt lymphoma, Hodgkins lymphoma, CNS lymphoma, nasopharyngeal carcinoma, post-transplant lymphoproliferative disease

EBV associated malignancies

enterovirus

enter through GI or respiratory tract, ACID STABLE, TLR3 specific, immune response via type I interferons and IgA, ex: coxsackievirus

herpangina (coxsackievirus A)

small vesicles with erythematous base, high fever, self limiting

myositis, myocarditis, and pericarditis

muscle infections of coxsackeivirus A

enterovirus

Most common cause of viral meningitis

viral meningitis cause by enterovirus

acute onset fever, headache, meningismus, photophobia, emesis, rash

oral hairy leukoplakia

NOT premalignant, firm, does not scrape off, caused by EBV. (epstein Barr virus)

epstein barr virus

cause of oral hairy leukoplakia

oral thrush (pseudomembranous)

soft, scrapes off with tongue, caused by candida

HHV-4 and HHV-5

causes of mononucelossi

CMV/HHV-5

most infectious in children and young adults, often asymptomatic, rettinitis, and colitis

roseola (HHV-6 and 7)

high fever and transient rash occurs mostly in children 6-24 mo, via respiratory tract secretions

kaposi’s sarcoma (HHV-8)

AIDS-related infects B cells, macrophages, epithelial cells, endothelial cells, and keratinocytes, associated with primary effusion lymphoma and castlemans disease