Micro Block 10 Atchley not Objective – Flashcards
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| what three ways can diabetes be tested for, what levels indicate diagnosis |
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| blood HBA1C 6.5% and glucosem>125 fasting urine glucose >120 shows glucose in urine - old way |
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| what is the best test for nutritional analysis |
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| pre-albumin |
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| what are the 4 tests in a lipid panel |
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| cholesterol, HDL, LDL, TG |
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| what are the five parts to a hematology test |
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| anemia testing PLT/clotting time ESR sickle cell WBC differential |
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| what are the four anemia tests |
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| RBC count hematocrit Hb indices |
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| what are the three RBC indices, describe them |
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| MCV - mean cell volume MCHC - mean corpuscular Hb concentration RDW - red cell distribution width |
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| what is the purpose of a ESR, what is another option, which is better |
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| ESR - measure sedimentation rate which tells about inflammation C-reactive protien also tells about inflammation and is better because it tells about the action of NSAIDs |
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| what cells are examined in a WBC differential, what are their relative percentages |
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| neutrophils 60% leukocytes 30% monocytes 6% eosinophils 3% beans 1% |
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| what is tested for during endocrine testing (4) |
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| thyroid: T3, T4, TSH B-HCG |
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| what blood disorder can be seen from a CBC (4) |
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| anemia, polycythemia, leukemia, thrombocytopenia |
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| what are the nine immunology lab tests |
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| IgG IgM titer RA/RF monospot rubella/titer syphillis hepatitis CMV |
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| what does a monospot test for |
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| mononucleosis |
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| what are the three syphillis tests |
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| RPR, VDRL FTA-ABS |
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| RFR/VDRl how do they work |
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| use trepillina like antigen which is sensitive but not specific for antibodies to syphilis |
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| what is FTA-ABS what does it stand for |
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| conformation test for syphilis, more specific flourescent trepinemal antigen antibody screen |
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| what type of molecules are looked for in a hepatitis test |
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| anti-HAV, HAV, HBsAg, anti-HBc, anti-HBe, anti-HB |
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| what is checked for in blood type matching, why can this be done |
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| ABO/Rh screen for unsuspected antibodies RBC have no HLA |
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| what is rhogam |
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| Rh immune globulin |
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| what blood components are harvested in the clinical lab, what are they used for (4) |
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| cryopercipitate: concentrated clotting factors (8, hemophelia) fresh frozen plasma: burns packed RBC: trauma platlets |
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| define renal threashold |
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| level in the blodo when they kidney cannot absorb anymore |
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| what 10 things are tested for on urine dip sticks |
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| specific gravity: hydration pH leukocyte esterase blood nitrate ketones bilirubin: liver function urobilinogen protein glucose (>120 excedes renal threashold and glucose will show in urine - diabetes) |
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| define reference range, give some other ways to say this definition |
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| normal normal distribution: range covers 95% of the people. mena +/- two standard deviations expecte, healthy, typical, average, natural, regular, standard, gaussian, normal |
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| what is the reference range determined by (3), what percautions should be taken (2) |
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| age, gender, geographical location find out your hospitals ranges and O2 contant in atmosphere |
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| what are the ten capsulated bacteria, say something special about the ones that deserve it |
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| strep pneumonia (#1 communitu acquired) kelbsiella pneumonia haemophilus influenza pseudomonas aeruginosa (CF silme producer, #1 hospital pneumonia) neisseria meningitidis cryptococcus neoformans (fungi) maningeal E. coli with K1 capsule cacillus anthracis salmonella typhu strep pyogenes with hyalyronic acid capsule |
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| what is kosch's postulate (4), what is wrong with it (3), what are the additions to fix it (2) |
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| approach to lab diagnosis pathogen present in diseased animal pathogen isolated and grown innoculation of animal isolation from re-innoculation the same exceptions: viruses, prions, non-culturable microbes added recovery of pathogen or evidence of its presence in diseased host clinical signs and symptoms compatiable with infection presence |
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| what can be assumed when looking at a lab sample from a sterile site, what are the exceptions |
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| anything that shows up is a concern or a contamination sometimes you have to pull a sterile sample through a non-sterile region (contamination. respiratory, bladder) |
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| what are examples of sterile regions |
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| blood, csf, pleura, peritoneal, synovial, tissues, lower respiratory, bladder |
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| what can be assumed when looking at a lab sample from a non-sterile region, what can you do to fix this |
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| normal flora will be present, know how to identify them and how much is appropirate |
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| what are examples of non-sterile regions |
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| mouth, nose, upper respiratory, skin, GI, urethra |
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| what different ways can a culture based test be done (3) |
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| microscopy: wet mount, stained culture media antibiotic susceptability |
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| what things do non-culture based tests examine |
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| pathogen specific antibodies in serum pathogen antigens or nucleic acids in specimen general or non-specific tests (CBC, flow, chemistry, UA) |
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| what are some generalizations to remember which are gram negative |
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| most pathogens are gram negative rods |
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| what is a back to back lancet, what is it mistaken for |
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| gram positive diplococci - strep pneumonia not all diplococci are s. pneumonia. it could be staph aureus |
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| that does a tzanck smear detect, how is it foemed |
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| detects multinucleated cells from irritated tissue that sloughed off and clumped |
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| what microbes does tzanck find (4) |
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| HSV1: cold sore HSV2: genital herpes VSV: chicken pox, shingles zinc cells clumped: viral infection |
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| what does india ink test for, how does it look, who would you do this test in |
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| identifies cryptococcus neoformans polysaccharide capsule make halo in black (ghost cells) this microbe only shows in immune compormized |
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| silver stain: aka, what does it find |
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| gomori methenamine pneumoncystis juroveci fungi |
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| buffered charcoal yeast extract (BCYE): what does it show legionella |
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| how is a sample collected from the throat |
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| get sample from oropharynx and tonsils avoid lips and cheeks |
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| what is ruled out of a throat ample |
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| strep pyrogenes, group A strep, aka strep throat (B-hemolytic) |
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| what are the key select pathogens from teh throat (4) |
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| S. pneumona (CAP), S. aureus, P, aeruginosa, K. pneumoniae (HAP) |
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| how is a sample collected from a wound |
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| debris completely or it will always be colonized swab center try not to expose to air (first swab put directly into anaerobic container it is toxic) |
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| what is ruled out in a wound swab |
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| anaerobic vs aerovic |
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| what are the key select pathogens in a wound swab (8) give a general reason for their presence |
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| B. fragilis S. aureus S. pyogenes (abscess) C. perfingenes (trauma) S. aureus (surgical) pasturella (dog or car bit) barinella (cat scratch) inchinella crodans (human bite) |
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| spinal culture, what is ruled out (3), what cannot be ruled out (1) |
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| meningitis, abscess, subdural empyema encephalitis |
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| spinal culture key select pathogens (3), what relates them |
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| N. mengitis, s. punemonia, H. influenza capsules |
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| stool rule out 2 |
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| entercolitis, dysentery (bloody diarrhea) |
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| stool: hey select pathogens (4) |
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| sigella, salmonalla, campylobacteri, E. coli |
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| what causes watery stool |
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| viruses or toxins (tx could cause collitis, dont treat) |
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| urine rule out (2) |
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| cystitis, pyelonephritis |
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| urine key select pathogenes (4) |
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| E. COLI enterobacter, proteus, e. faecalis |
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| genital rule out (3), how are they categorized |
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| gonorrhea chlamydia and syphilis - non-gonococcal urethritis. not culturable so cultured for gonorrhea and got nothing. |
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| genital key select pathogens (3) |
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| gonorrhea (culturable) chalydophilia trachomatis treponema pellidum |
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| how do you know it is sputum and not spit |
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| WBC > epithelial cells WBC >10 epithelial cells <10 |
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| when do you get the best sputum sample |
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| morning |
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| what is the number one community acquired pneumonia |
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| strep |
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| what is the number one hospital acquired pneumonia |
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| pseudomonas |
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| ichinella crodens infection: how do you get it, how is it identified |
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| seen in human bite smells like bleach corrodes agar |
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| automated E test: how does it work |
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| new test, better than kirby, no key needed wuantative line on strp shows susceptability |
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| what is the life cycle of neutrophils, 6 steps |
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| blast promyelocyte myelocyte metamyelocyte band segmented and polymononuclear |
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| explain the 5 steps in RBC life |
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| pluripotential stem cells > normoblast > nucleated erythocyte > reticulocyte > erythrocyte |
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| what are part of the myelolytic cell line |
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| neutrophils |
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| myeloblast should make you think |
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| blast abnormal in the blood myeloblast leukemia |
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| how do you differentiate what type of cell a blast is |
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| you dont, its hard. almost undifferentiated. there are some markers than can be stained |
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| what are the three steps in a platelet life |
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| pluripotential stem cell > megakaryoblast > platelet |
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| define pancypenia |
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| all WBC are low, leukemia |
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| define anemia |
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| low RBC, Hb, HCT |
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| define polycythemia |
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| high RBC, Hb, HCT |
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| how is a CNS disease diagnosed, two methods and how to do them |
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| brudizinski's neck sign: flexing the pt neck causes flexion of the hips and knees kernig's knee sign: flex kips to 90 deg and extend knee causes pain |
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| what used to be the trigger to test for HIV |
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| patient with PCP infection |
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| what does CSF look like, how much needs to be collected, why |
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| colorless clear fluid with no WBC 2 tubes to go to microbe study for gram stain and culture, chemistry for glucose and protein, cell count and differential |
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| how is a direct ELISA done |
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| antignic sites are labeled by antibodies and a colored substrate is added that binds to antigen antibody complex |
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| how does a sanwhich ELISA work |
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| unknown antibody is taken from the person anti-HCG on a strip. HCG antigen will be captured by antibodies. another anti-HCG will then be added that has a reporter enzyme on it. substrate will be added that changes color when bound to sandwhiches |
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| aggultination two definitions definition |
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| taking particulate antigen and add antibody (can test for antibody or antigen) soluble antigen + antibody bound to particulate leads to agglutination |
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| what areas can be tested via agglutination |
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| blood, CSF, feces, throat |
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| what is the BEST way to claculate CrCl |
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| ((urine Cr) / (serum Cr)) x flor rate flow rate = (mL of urinein 24h)/(1700 ml/day) |
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| is there any other indicator for kidney function other than Cr, is it better or worse? |
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| inulin, better |
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| what is the normal color of urine, what 6 colors or combinations could urine be |
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| normal: straw yellow amber and clear or cloudy red, black, white (albinuria), orange, brown, blue/green |
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| what medication can turn the urine colors, what is two names for it, what two colors |
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| phenazopyridine/ piridum red or orange |
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| what two things can turn urine blue |
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| methlyene blue, amitriptyline (antidepressant) |
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| so your patient is on a medication that turns their urine a strange color, what does this mean for your chemical tests |
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| dont trust dip stick results |
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| how can urine color indicate hydration |
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| ligher = dilute = hydrated dark = concentrated = dehydrated |
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| what are the normal values for all the parts of a dip stick urine test |
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| all negative except specific gravity (1-1.035) and pH (5-8) |
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| how do you physically do a dip stick test to get the best result |
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| run it on the side and blot it so chemicals dont run together |
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| significance of a glucose urine test (2) |
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| tells if there is hyperglycemia or rengal glucosuria |
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| what 4 conditions can cause hyperglycemia that shows in the urine |
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| diabetes mellitus, thyrotoxicosis, cushing syndrome, severe anxiety |
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| what condition can cause glycosuria, why |
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| pregnacy because kidney threashold drops |
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| what would interfere with a urine glucose test, give an example |
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| reducing agents (ascorbic acid) |
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| what is the normal renal threashold, what is a renal threashold |
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| concentration in the blood where you have to spill over into the urine 160-180 mg/dl |
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| what is the significance in a bilirubin urine test |
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| increased direct bilirubin correlates with serum urobilinogen and serum bilirubin and tells about liver function |
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| what can mess up a bilirubin urine test |
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| prolonged exposure of the sample to light |
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| what is the differnce between direct and indirect bilirubin, explain the process of production |
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| indirect bilirubin must travel on albumin because it isnt water soluble. it is taken to the liver where is conjugated with glucronic acid making it water soluble and puts it into a form that can be directly assayed indirect = unconjungated direct = conjugated |
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| what form of bilirubin do we test in urine chemistry, why |
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| direct because it is conjugated and dosen't stick to albumin and thus can be transferred to urine |
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| what is the significance of a ketone urine test (2) |
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| shows prolnged fasting shows ketoacidosis (diabetic) |
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| when is ketoacidosis an emergency, what qualifies it |
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| diabetic ketoacidosis is an emergency, you can tell it is diabetic because there will be ketones and glucose in the urine. confirm with blood gas showing acidosis |
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| what limits the accuracy of a urine ketone test |
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| it only picks up acetoacetate and not the other ketone bodies |
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| what can cause metabolic acidosis, what type of anion gap (7) |
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| methanol poisoning uremia DKA p- iron ischemia lacric acidosis ethylene glycol (antifreeze) silislate poisoning positive anion gap |
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| what is the significance of specific gravity testing (2) |
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| hydration index diabetes insupidus testing |
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| what causes a change in specific gravity in diabetes insipidus (2) |
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| vasopressing or ADH acting on the kidney |
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| what can interfere or cause error in a specific gravity test (2), give an example |
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| alkaline urine can mess it up does not measure ionized solutes |
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| what test is simillar to a specific gravity test, is it better |
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| refractory test yes |
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| what is the significance of urine blood test (4), give a cause of each |
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| hematuria - nephritis, trauma hemoglobinuria - hemolysis myoglobinuria - rhabdomyolysis myoglobin shows as blood - comes from trauma / crush injury |
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| what can mess up the results to a urine blood test (3) |
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| reducing agents microbial peroxidase (bleach) cannot distinguish between diseases |
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| what is better than a urine blood dip stick test |
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| urine microscopic examination |
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| what are two things that can cause acidic urine |
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| metabolic acidosis high protein diet |
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| what can cause alkaline urine, what about VERY alkaline urine |
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| bacterial overgrowth causes alkaline urine very alkaline urine has been left out too long (>8) |
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| what is the significance of a urine protein test (4) |
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| shows proteinurie and nephrotic syndrome shows if there is inflammation of the bladder or kidney increases in Ig disease |
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| what can interfere with the results of a urine protein test (3) |
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| trace amounts can be misleading - they dont nessesicarly mean disease alkaline urine can mess it up ultra sensitive to albumin which messes up urine protein electrophoresis |
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| what is a warning sign (pre-eclampsia) for eclampsia, when does this condition occur |
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| protein in urine and HBP, pregnacy |
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| define proteinuria. what are the 4 categories of causes |
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| excess protein in urine functional, renal, pre-renal, post-renal |
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| what are three causes of functional proteinuria |
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| severe muscular exertion pregnacy orthostatic proteinuria |
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| what are the three renal causes of proteinuria |
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| glomerulonephritis nephrotic syndrome renal tumor or infection |
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| what are the three causes of pre-renal proteinuria |
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| fever, renal hypoxia, hypertension |
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| what are the three causes of post-renal proteinuria |
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| cystitis urethritis/prostatitis contamination with vaginal secretions |
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| how is urobilinogen made |
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| bilirubin is altered by bacteria into urobilinogen, it should not be in the urine |
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| what is the significance of high urine urobilinogen |
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| increased hepatic processing of bilirubin |
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| what is the significance of low urine urobilinogen |
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| bile obstruction - it never got to the gut to be turned into urobilinogen |
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| what can interfere with a urine urobilinogen test, what is a down side to the test |
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| prolonged urine exposure to oxygen converts urobilinogen to urobilin cannot detect low levels of urobilinogen |
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| what is the significance of a nitrate urine test |
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| shows presence of gram negative bacteria best show for E. coli |
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| what is the best urine dip stick test for a UTI |
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| leukocyte esterase |
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| what can interfere with a nitrate urine test (2) |
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| bacterial over growth bacteria that dont convert nutrate to nitrite |
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| what are the 4 ways to test for a UTI |
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| leukocyte esterase microscopic examination for bacteria urine culture nitrites in urine |
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| what is the significance of leukocyte esterase urine test |
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| finds pyuria, acute inflammation (damage), renal calculus, most sensitivt UTI test |
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| what can cause increased WBC without infection |
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| kidney damage, kidney stone |
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| why is it important to alwasy check the WBC microcope test and compare to the leukocyte esterase test |
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| WBC have to lyse to release leukocyte esterase so if they didnt lyse you could have false results |
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| what are two things that can mess up a leukocyte esterase urine test |
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| oxidizing agents menstural contamination |
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| what 4 things are looked for on a urine how power exam (400x) |
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| >3 erythrocytes >5 leukocytes >2 renal rubular cells >10 bacteria |
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| what 5 things are looked for on a urine low power exam (200x) |
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| >3 hayline casts >1 granular cast >1 WBC cast >1 RBC cast >10 squamous cells |
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| what crystals are seen on a microscopic exam, which are of concern |
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| AA crystals are not a concern unless its in newborns uric acid is a concern in all because it causes gout |
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| what kinds of epithelial cells can be found in the urine (2), what is the significance |
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| normal: sloughing of normal tissue. too much suggests contaimination renal tubular epithelial cells: too many means something is wrong with the kidney - glomerulonephritis? |
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| where are casts made (2) |
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| DCT and CD |
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| what casts are there allowed to be some of |
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| tamm horsfall |
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| what does an increase in WBC, RBC, or granular casts mean |
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| kidney damage |
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| what 4 things are looked for on a urine how power exam (400x) |
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| >3 erythrocytes >5 leukocytes >2 renal rubular cells >10 bacteria |
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| what 5 things are looked for on a urine low power exam (200x) |
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| >3 hayline casts >1 granular cast >1 WBC cast >1 RBC cast >10 squamous cells |
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| what crystals are seen on a microscopic exam, which are of concern |
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| AA crystals are not a concern unless its in newborns uric acid is a concern in all because it causes gout |
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| what kinds of epithelial cells can be found in the urine (2), what is the significance |
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| normal: sloughing of normal tissue. too much suggests contaimination renal tubular epithelial cells: too many means something is wrong with the kidney - glomerulonephritis? |
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| where are casts made (2) |
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| DCT and CD |
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| what casts are there allowed to be some of |
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| tamm horsfall |
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| what does an increase in WBC, RBC, or granular casts mean |
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| kidney damage |
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| what is pyelonephritis, what are 6 signs |
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| kidney infection bacteria, leukocytes leukocyte, granular and waxy casts renal tubular epithelial cast cells |
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| what are the four types of urinary tract infections |
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| urethritis cystitis polynephritis prostatis |
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| what UTI are considered lower |
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| urethritis, cystitis, prostatitis |
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| what UTI are considered upper |
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| polynephritis |
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| what UTI are always complicated |
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| polynephritis |
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| what are the two types of UTI patients, what is the main difference in their care plan |
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| uncomplicated - dip stick test complicated - culture and dip stick |
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| what is the rank of UTI in common bacterial infections |
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| #2 (respiratory is #1) |
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| what risk factor can increase UTI in a uncomplicated patient, how can this be avoided (2) |
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| sexual intercourse: post coital voidiing, prophylactic antibiotics |
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| how is renal abscess diagnosed (2) and treated |
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| CT with contrast, renal ultrasound surgical drainage |
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| explain the two cup test, why is this done |
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| fill one cup with urine, massage prostate, fill another. organisms dont always come out during urinalysis |
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| what are the general symptoms of cystitis (10) |
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| dysuria, urgency, frequency, bladder fullness, suprapubic tenderness, hematuria, painful urination, urethral burning, blood |
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| what conditions cause vaginal discharge (6) |
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| STi, yeast, vaginosis, urethritis, cervicitis, PID |
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| when someone has a UTI what labs will come back positive for sure, which might come back positive (9) |
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| always: leukocyte esterase, microscopic WBC sometimes: nitrites, blood, protein, microscope RBC, granular or WBC casts |
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| what is a condition that can cause RBC in urine that isnt an infection |
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| acute glomerular nephritis (immunological) |
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| name 4 urine collection methods, who they are used in, which is best |
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| mid stream catch: wash, rinse, dry, void, collect midstream (flushes flora out, wipe away antiseptic) foley catheter: any bacteria is significant, lean towards yes for infection suprapubic aspiration - infants. shoulw be no contamination perineal urine collection bag - infants. worry lots about contamination |
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| what is the timing of culture of a urine sample, what can change this, how can you tell if it sat for too long |
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| >2h changes reuslts unless there is perservitives bacteria will be high but leukocyte esterase wont |
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| what are 6 incidence when the patient's urine would be cultured |
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| pyelonephritis repeat uncomplicated UTI men children pregnant women complicated UTI |
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| what are the two ways for microbes to be introduced into the urine |
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| ascending or hematogenous route |
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| explain the ascending route to a UTI |
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| colonization of vagina colonization or urethra entry into the bladder infection sepsis? |
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| explain the hematogenous route to a UTI |
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| spread from blood to body check urine when someone has meningitis |
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| what are common pathogens that cause urethritis, which is #1 (4) |
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| 1. chalmydia trachomatis neisseria gonorrhea, mycoplasma, uroplasma |
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| what are the common pathogens that cause cystitis (6) |
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| E. coli, staph saphrophiticus, proteus mirabilis, klebsiella, enterococcus, adenovirus (hemorrhagic) |
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| what are the common pathogens that cause pyelonephritis (6) |
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| E. coli, staph saphrophiticus, proteus mirabilis, klebsiella, enterococcus, mycoplasma |
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| what are the common pathogens that cause prostatitis (6) |
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| E. coli, staph saphrophiticus, proteus mirabilis, klebsiella, enterococcus, uroplasma |
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| what does schistoma hematobium do when it gets in the body, where can it be acquired |
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| it burrows into the bladder wall and causes a form of cystitis it deposits eggs and causes inflammatory response via eosinophils seen overseas |
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| what causes hemorrhagic cystitis |
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| adenovirus |
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| what is the microbe that causes infection in young sexually active women, how can it be identified in the lab |
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| coagulase negative staphlyococcis saphrophyticus |
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| what is the most common cause of urethritis in men |
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| chalmydia trachomatis |
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| what are the two types of STI |
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| acellular and cellular |
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| what are the acellular STIs (4) |
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| herpes, papilloma, hepb, HIV |
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| what are the three types of cellular STIs |
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| arthropods bacteria protozoa |
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| what arthropods cause STIs (2) |
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| public lice, scabes |
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| what bacteria cause STIs (5) |
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| chylamydia, gonorrhea, haemophilus ducreyi, mycoplasmas, syphilis, BV |
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| what STIs cause sores/ulcers (4) |
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| syphilis, genital herpes (HSV1/2), lymphogranuloma venereum, canceroid |
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| crab lice: official name, appearance, how to get |
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| phthirus pubis pinhead sized light brown insects intimate contact or fomites (dont jump) |
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| where do crab lice like to go, what do they do with their life |
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| moist coarse hair (pubic, beart, eyebrows, eyelashes) lay eggs (nits) at the base of the hair |
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| what are the 4 signs of crab lice |
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| itching, burning, irritation, worse at night |
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| what is the treatment for crab lice (2) |
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| wash linnens and clothes in hot water, Rx |
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| why do crab lice itch |
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| they spit and their spit causes an allergic reaction |
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| scabes: official name, appearance, how to get |
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| sarcoptes scabiei microscopic burrowing insects that lay eggs in skin intimate contact or fomites (dont jump) |
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| 4 signs of scabes |
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| intense itching, often in crevices, worsens at night, small insect bites |
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| how do you diagnose scabes |
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| skin scraping for mites or eggs |
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| how is scabes treated (2) |
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| permethrin, wash hot linnens and clothes |
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| how is HPV spread (2) |
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| sex, other (plantar warts etc) |
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| what are the two types of HPV, which do we have no vaccines against |
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| mucosal dermal: no vaccines |
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| what are the four most common atypical bacteria, why |
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| require weird growth, have to act like a virus mycoplasma, ureaplasma, chylmidia, reckittsia |
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| when you treat someone for chlamydia, what do you always do |
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| treat their partner |
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| how do yu diagnose chlamydia (4) |
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| it is unculturable urethram smear: >5 polymorphic neutrophils tissue culture: costly, time consuming nucleic acid hybridization (gen-probe): tests for gonorrhea and chlamydia DNA amplication test (NAT) |
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| what are the symptoms of PID (5) |
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| uterine adnexal tenderness, cervical motion tenderness, endocervical discharge, fever, lower abdominal pain |
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| what are the complications of PID (3) |
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| chronic pelvic pain in 18% 7x risk of ectopic pregnacy with 1 PID episode 15% risk of infertility with 1 PID episode |
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| how do we categorise STIs that cause sores |
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| painful or painless |
question
| what are the three types of STI that cause painless sores, what are their full names |
answer
| syphilis: treponema pallidum lymphogranumoma venereum (clymatic bubo): chlamydophila trachomatis granuloma inguinale: klebsiella granulomatis |
question
| what two things cause painfil genital sores, what are their full names |
answer
| canceroid: hamophlius ducreyl (soft cancer) genital herpes simplex |
question
| what is the initial test done for syphilis, how is it done, what is the concern |
answer
| RPR/VDRL (prodrome): non trepinemal antigen used for agglutinating tests you can have lots of antibody and get a negative test. cannot detect positive until you dilute the antibody way down |
question
| what is the conformation test for syphilis |
answer
| FRA-ABS (floursecent treponimal antigen) |
question
| how do you get genital herpes (2) |
answer
| asymptomatic shedding, sexual contact |
question
| how is herpes diagnosed (2) |
answer
| culture, serology, PCR |
question
| what are some outdated ways to say HIV |
answer
| gay related immunodeficiency disease lymphadenopathy associated virus human t lymphocyte virus III |
question
| what is the centraldogma of biology |
answer
| dna is transcribed into rna which is translated into protein |
question
| what is the central dogma in HIV |
answer
| reverse transcriptase turns RNA into DNA DNA is transcribed into RNA which is translated into protein |
question
| what is the difference between HIV1 and HIV2 |
answer
| HIV1 is more prevalent and virulent HIV2 isnt as bad but can cause AIDS of untreated |
question
| after HIV attaches what does it do in the cell |
answer
| reverse transcriptase turns viral RNA into DNA integrase puts the DNA into the genome (makes a provirus) DNA is transcribed into RNA which is translated into protein (viral particles) baby HIV buds out |
question
| begining with the primary infection explain the timeline or HIV |
answer
| primary infection acute HIV syndrome: dissemination and arrival at lymphoid organs clinical latency constitutional symptoms opportunistic diseases death |
question
| how long is the clinical latency of HIV |
answer
| can be 10 years if not injected into the blood (2 years) |
question
| what are some of the constitutional symotoms of HIV (5), what is the CD4 count |
answer
| CD4 500 oral candidiasis, shingles, oral thrush, vaginal thrush, HSV-1 |
question
| before the constitutional symptoms, what symptoms are there of HIV in the latency or acute HIV syndrome phases (4) |
answer
| acute pharyngitis, bronchitis, sinusitis, pulmonary TB |
question
| what are the opportunistic infections of HIV, when do they appear |
answer
| CD4 400 kaposkis sarcoma (HSV8) CD4 300 oral hairy leukoplakia, EBV, disseminated TB CD4 200 PCP, cryptococcus, toxoplasmosis CD4 50 MAC, CMV, lymphoma |
question
| when is AIDS diagnosed |
answer
| CD4 <200 or AIDS asociated illness along with a positive HIV test |
question
| what is standard percuation |
answer
| assume everyone is infected, if you glove for someone with HIV then you glove for everyone |
question
| what is the treatment for HIV (2) |
answer
| no cure HAART |
question
| what does HAART stand for, what is the 4 ways it helps |
answer
| highly active antiretroviral therapy combination drug therapy that slows the replication, reduces viral load, improves immune function, delays progression |
question
| what is the success of HAART dependent on (2) |
answer
| compliance despite... complex redigmen adverse side effects |
question
| when on HAART what is HIV doing |
answer
| latent/silent |
question
| why does presence of other STD increase risk of HIV (2) |
answer
| displays risk behavior increases susceptability (sores give route for contamination) |
question
| what is the best solution for HIV (7) |
answer
| avoid sex especially with sex workers, multiple partners, high risk people, anal intercourse use condoms dont share needles do not share razor bladers/toothbrushes |
question
| explain the new ag/ab combo test |
answer
| helps close the viral window a little. if they have enough antibody the antigen load drops a lot so their HIB test may not detect the antigen. this test accounts for both |
question
| what are the three parts of the western blot stip, what are they coding for |
answer
| ENV: viral envelope POL: polymerase, protease (cuts viral particles), integrate (integrates DNA into genome forming provirus), RT Group specific antigen: capsid, matrid |
question
| what is a low budget way to test for HIV/disease progress, explain how it works |
answer
| candidal skin test: everyone should have a positive test. if you do it on a HIV person and they are positive than their type 4 (T cell mediated) hypersensitivity is still good enough to work. when it becomes negative they have the disease and their CD4 is relativly low (anergic sign) |
question
| what are the three clinical categories of HIV, what defines them |
answer
| A: asymptomatic: Acute HIV (POL) B: symptomatic C: AIDS |
question
| what puts someone into category B HIV (10) |
answer
| persistant PID hairy leukoplakia oral recurrant shingles cervical dysplasia/carcinoma idiopathic thrombocytopenic purpura fever/diarrhea > 1mo neuropathy oropharyngela candidiasis bacillary angiomatosis |
