Infectology exam 2/3

Specifics of the immune response against viruses.

Specifics of the immune response against intracellular bacteria, fungi.

Specifics of the immune response against extracellular bacteria.

Cytokine storm, its pathogenesis. Clinical and laboratory signs.

Dynamics of antibody production in case of first and repeated contact with the pathogen. Infections as triggers for autoimmune processes.

Features of immunological memory depending on the type of antigen.

Latent and chronic infections (pathogens and disorders of the immune response, examples).

Post-COVID syndrome.

Laboratory diagnosis of SARS-CoV-2 infection.

Differential diagnosis of a patient with sore throat.

Viral hepatitis A: epidemiology, clinical presentation, diagnosis, treatment and prophylaxis

Epidemiology,
Fecal--oral
Developing countries
1moth incuation

Clinical Presentation,
Fever, malaise, anorexia, nausease, abdominal pain,
Jaundice, pale stool
acute, self limitinng

Diagnosis,
Anti-HAV-IgM antibodies
liver markers ALT AST

Treatment
Supportive: rest, hydration, Avoid alcohol

Prophylaxis:
Vaccinnation (pre & post expoture)

Viral hepatitis B: epidemiology, clinical presentation, diagnosis and treatment.

epidemiology,
blood, sex transmission
2-3 monts incubation

clinical presentation,
Fever, malaise, anorexia, nausease, abdominal pain,
acute or chronic
Jaundice, liver failure, carcinoma

diagnosis
HBsAg
Anti-HBs
Anti-HBc Igm
HBV DNA
liver markers ALT AST

treatment.
Supportive: rest, hydration, Avoid alcohol
antivirals Tenofovir, transplant

Viral hepatitis B:  specific and non-specific prophylaxis.

specific and non-specific prophylaxis.
Vaccination (pre & post), (risk, newborn, child)
Education, safe practives in hospital, safe sex, no sharing needels, screening for donors and risk people

Acute viral hepatitis C: epidemiology, clinical presentation, diagnosis, treatment and possible outcomes.

Epidemiology,
Blood borne
1-2 monts incubation

Clinical presentation,
Asymptomatic
Fever, malaise, anorexia, nausease, abdominal pain,
Jaundice, liver failure, carcinoma

Diagnosis,
HCV RNA (PCR)
Anti-HCV antibodies
liver markers ALT AST

Treatment
Antivirals (Sofosbuvir)

Possible Outcomes.
chronic infection
Spontaneous recovery
Cirrhosis, carcinoma, liver failure

Chronic viral hepatitis C: diagnosis and treatment.

Diagnosis,
HCV RNA (PCR)
Anti-HCV antibodies
assessment of liver fibrosis
liver markers ALT AST

Treatment
Antivirals (Sofosbuvir)

Viral hepatitis E: epidemiology, clinical presentation, diagnosis, treatment and prophylaxis

Epidemiology,
Fecal oral, undercooked meat
Acia/afrika
2-4 mons incubation

Clinical presentation,
Asymptomatic
Fever, malaise, anorexia, nausease, abdominal pain,
Jaundice, liver failure, carcinoma

Diagnosis,
Anti-HEV IgM
Anti-HEV IgG
HEV RNA (PCR)
liver markers ALT AST

Treatment
self limiting
Supportive: Rest,Hydraion, Avoid alcohol

Prophylaxis
safe drinking/food
sanitation
hygine
Vaccine

Viral hepatitis D: epidemiology, clinical presentation, diagnosis, treatment and prophylaxis

epidemiology,
Blood, sex

clinical presentation,

diagnosis,

treatment

prophylaxis

Hemorrhagic fevers – etiology, pathogenetic principles

Etiology,
RNA viruses: Ebola, yellow fever, dengue

Pathogenetic Principles
Viral entry and replication
Viremia: spread though bloodstream
Endothelial injury: increase vascular permeability
immune activation with cytokines
Coagulation disorders
organ damage

Ebola virus infection – epidemiology, clinical symptoms and diagnostic principles

Epidemiology,
In bats, intermediate host human
Blood, body fluids, sex, needles

Clinical symptoms
incubation 2-21 days
Fever, weakenss, headache, myalgia, sore throat
Vomiting, diarrhea, abdominal pain, dehydraiton
Liver/renal/organ failure
Bleeding/coagulation disorder

Diagnostic principles:
symptoms + traveling
Thrombocytopenia, high AST/ALT, coagulation abnormalities
PCR ELISA, Serology

Ebola virus infection – principles of treatment and prevention

Treatment
Supportive: fluids, electrolytes, oxygen, blood pressure, organ support
Antiviral therapy

Prevention
isolation
Contact tracing
Vaccination
Educaiton

Yellow fever – epidemiology, clinical picture and principles of prevention

epidemiology,
Monkeys and human, spread by mosquitos
Afrika, south america

clinical picture
3-6 days incubation
fever, chills, headache, myalgia, nausea,
bradycardia
Jaundice, hemorrhages, pain, vomiting
organ damage

principles of prevention
Vaccination
Mosquito control/avoidance
education

Dengue fever – clinical forms, their symptoms and principles of therapy

forms:

Classical: Mild/moderate
Fever, headache, pain, weakness, nauausea, rash

Hemorrhagic fever: Severe
Hemorrhagic, GI bleeding

shock syndrome:Critical
hypotension, tachycardia, low pulse pressure, organ failure, severe bleeding

Treatment:
Rehydration
Crystaloids
Paracetamol
blood transfusion, platelets

Hanta virus infection – renal syndrome, stages and typical symptoms, diagnostic principles

stages and typical symptoms,
Febrile stage: fever, headace, pain, myalgia, thrombocytopenia
Hypotensive stage: shock, capillary leakage, proteinuria
Oliguric stage: Acute kidney injury, oliguria, proteinuria, hematuria, fluid overload
Diuretic stage: Polyuria, kidney function recovers
Convalescent stage: recovery of renal function

diagnostic principles
Serology
PCR

Urinanalysis
Blood test

Hanta virus infection – cardiopulmonary syndrome, stages and typical symptoms, diagnostic principles

Stages and typical Symptoms,
Prodromal stage: Flue symptoms, nausea, vomiting
Cardiopulmonary stage: Severe respiratory distress, pulmonary edema, cough, tachypnea, dyspnea,hypoxemia,
Convalescent stage: impoved resporatory and cardiac function

Diagnostic Principles.
Serology
PCR
Xray, CT
blood test

Clinical manifestations and diagnosis of pulmonary TB.

Symptoms:
Fever, weight loss, malaise, sweats
pulmonary symptoms: cough, chest pain, dyspnea, wheezing, hoarsness

Diagnosis:
Sputum smear, NAAT,
X ray: upper love infiltrate, cavitations

Peripheral lymph node tuberculosis: clinical manifestation and diagnosis.

Symptoms
Fever, weight loss, malaise, sweats
Lymphadenopathy: painless lymph node swelling → matted

Diagnostics:
Fine needle aspiration cytology
Biopsy
Sputum smear, NAAT,
X ray:

Pleural tuberculosis: clinical manifestation and diagnosis.

Symptoms
Fever, weight loss, malaise, sweats
Sharp local pain, non productive cough, shortness of breath

Diagnostics:
pleural fluid analysis
Biopsy
Sputum smear, NAAT,
X ray

Miliary tuberculosis: characteristics of pathogenesis, clinical and radiological manifestation, principles of diagnosis.

Pathogenesis
Spread of Mycobacterium tuberculosis into bloodstream, causing deposits in multiple organs → “millet seed” appearance

Symptoms:
Fever, weight loss, malaise, sweats
pulmonary symptoms: cough, chest pain, dyspnea, wheezing, hoarseness
Organ specific

Radiological manifisations
Miliary pattern X-ray, ‘‘millet seed like’’

Diagnostics:
Biopsy
Sputum smear, NAAT,
X ray: Millary patten

Microbiological diagnosis of tuberculosis.

ADD MORE??

Specimen collection: from site of disease (Sputum, alveolar, pleural fluid, uring, biopsy)

Microscopy:Smear, staining. Visualize acid fast bacilli

NAAT: PCR,

Culture: gold standard: solid/liquid media

Drug susceptilibility testing: gruide treatment

Diagnostic algorithm of tuberculosis.

Clinical sympoms:
Fever, weight loss, malaise, sweats, cough
Chest X ray
Collect sputum sample, PCR, biopsy, NAAT, culture

Criteria for determining infectiousness of TB patient.

Pulmonary and laryngeal TB produces droplets and are infectious

Positive sputum smear → high bacterial load

Positive culture → active TB

Cavitary lesions on X ray → high bacillary load

cough → Spreads droplets

On or off treatment