11. Diseases Flashcards
Define: Disease
malfunction of body or mind which adversely affects the health of an individual
i.e condition that impairs normal functioning of an organism
Define: Pathogen
micro-organism that causes disease
4 types of pathogen
Bacteria
Virus
Fungus
Protoctista
How do bacteria harm the body?
Produce toxins –> cell damage –> causing symptoms
Secrete enzymes which allow pathogens to spread through tissues
How do viruses harm the body?
Damage host cells and tissues by invading specific target cells
Prevent tissue functioning normally
When sufficient viral particles produced, host cell is ruptured, releasing viral particles to invade new host cells
Some viruses bud off host cell and remain hidden from immune system in membrane bound sacs
What does viral nucleic acid inhibit?
normal call DNA, RNA and protein synthesis
How do fungi harm the body?
secrete enzymes which allow pathogens to spread through tissues
Define: Communicable Disease
Diseases which can spread between individual organisms
Describe what is meant by direct transmission?
Transmitted directly from infected person to uninfected person (e.g. droplets, sex, physical contact)
Describe what is meant by indirect transmission?
transmitted via an intermediate (e.g. air, water, food, vector)
3 Factors that affect the spread of communicable diseases
Overcrowding
Climate
Social factors (e.g. health care, health education)
Cause of Tuberculosis
Mycobacterium tuberculosis
Mycobacterium bovis
Transmission of Tuberculosis
Spread by droplet infection
uninfected person inhales infected droplets released by an infected person when they sneeze/cough
Transmission of Mycobacterium bovis
spread via contaminated meat and unpasteurised milk
First site of TB infection?
Lung tissues
Symptoms of TB primary infection?
Fever
Weight loss
Fatigue
Why is weight loss a symptom of TB primary infection?
Mycobacterium tuberculosis releases hormones which decrease appetite
What happens during the primary infection of TB?
Mycobacterium tuberculosis multiplies and destroys lung tissue
What should a healthy person’s reaction be to the primary infection of TB?
Immune system should deal with infection with no further complication
Who is likely to contract a TB secondary infection?
The Immune-compromised
What happens during the secondary infection of TB?
Phagocytic cells and other cells accumulate around infected cells forming a tubercle (granuloma)
Lung tissue damaged, sputum becomes blood stained
Symptoms of TB secondary infection?
Chest pains
Night Sweats
During TB secondary infection, what happens to
a) lung tissue
b) sputum
a) lung tissue becomes damaged
b) sputum becomes blood stained
Where can secondary TB spread to?
Immune system
Bones
Gut
Kidney
Risk Areas for TB
Homeless Poor housing Overcrowding Refugees Areas with high rate of tourism Areas with high rate of migration Malnutrition/Weakened immune system HIV positive patients
Why are HIV positive patients at risk of TB?
HIV reactivates dormant TB bacteria
How is TB diagnosed?
Microscopic analysis of sputum
Chest X-rays
How long can it take to diagnose TB?
Up to 2 weeks
Treatment of TB?
Isolation of patient for infected period (2-4 weeks)
Intensive care and extensive use of antibiotics
Treatment of pulmonary TB?
6 month course (taken every day) of isoniazid and rifampicin
Plus 2 month course (taken every day) of pyrazinamide and ethambutol
Why is a combination of 2 antibiotics used for the 6 months treatment of pulmonary TB?
to prevent multidrug resistance in bacteria
How long does treatment last if TB has spread to tissues outside the lungs?
12 months
Problems with treatment of TB?
Length - patients fail to complete course
Cost- each TB patient has a TB treatment assigned to them, expensive to isolate patients
High Number of MDR-TB bacteria
Some strains of XDR-TB bacteria
Difficulties in contact tracing
Difficult to detect carriers of TB
Latent TB can occur
Prevention of TB?
Reduce overcrowding Improve ventilation Improve health and nutrition Decrease air pollution Pasteurise milk BCG vaccine Routine testing of cattle DOTS (direct observation treatment, short coure)
How does decreasing air pollution prevent TB?
Decreases inflammation which decreases risk of infection
Define: notifiable disease
disease that has to be reported to the local health authorities if a new case arises
Why is data collected on notifiable diseases?
To allow: trends to be monitored awareness to be raised vaccination programmes to be improved and directed contact tracing to be carried out infected individuals to be isolated
What does HIV stand for?
Human immuno-deficieny virus
What causes HIV?
retrovirus (possesses RNA)
What does HIV use as its host cell?
T-helper cells (T4 helper lymphocytes), macrophages and brain cells
What does reverse transcriptase do in HIV?
creates double stranded DNA copy of virus genome from single stranded RNA once inside host cell
What happens when HIV invades body?
Virus enters T4 helper lymphocytes (host cell)
Reverse transcriptase creates double stranded DNA copy of virus genome for single stranded RNA
Provirus forms
Provirus is copied before T helper cell divides
Viral DNA activated which causes synthesis of viral RNA and viral proteins, producing more viral particles
T-helper cell ruptures
What is a provirus?
Viral DNA copy integrated with T-helper cell DNA
What affect does destroying more and more T-helper cells have?
Increased susceptibility to other infections and diseases
Define: Opportunistic Infections
infections that only seize advantage when immune system is not working efficiently and is weakened.
Transmission of HIV?
Direct contact with bodily fluids of an infected person
Examples of methods of transmission of HIV?
Unprotected sex with infected person
Contaminated syringes/needles
Mother to foetus across placenta
Mother to baby during child birth or via breast milk
HIV viral particles cannot replicate on their own as they are not made of cells. What term is used to describe these types of particles?
Acellular particles
What can’t HIV carry out?
Normal living processes: can't reproduce on their own don't grow don't divide don't transform energy lack machinery for protein synthesis
What type of nucleic acid does the HIV virus contain?
RNA
Which 2 enzymes does HIV have?
Protease
Reverse transcriptase
What protects the genetic material of a virus?
Protein coat called capsid
What is the capsid made of?
Protein units called capsomeres
What is a HIV virus surrounded by?
Viral envelope
Risk areas for HIV?
areas with poor knowledge of the spread of HIV
areas with high prostitution
areas with high degree movement (e.g. ports)
homosexual males
haemophiliacs
promiscuous individuals
Why are homosexual males at risk of HIV?
Rectum has thin lining and less lubrication
Symptoms of HIV?
Weight loss
Fatigue
Susceptible to opportunistic disease
Diagnosis of HIV?
Presence of antibodies to HIV (~6 weeks –> 6 months)
Repeated every 3 months
Prevention of HIV?
Knowledge Monogamy Protected sex Needle exchange Blood screening Contact tracing Give up drugs Prevent needle sharing Abstinence
What happens in the education program of HIV?
Encouraging use of protected sex
Screening blood for HIV before transfusions
Being tested if at risk group
Discouraging infected mothers from breastfeeding
Social consequences of HIV?
Cost of research/NHS
Infected young mothers need to find childcare
Infected young males/females decreases workforce
HIV Hotspots have less tourism
Famine due to inability to work
Problems of HIV?
Latent period (asymptomatic carriers) Mass screening of population not possible due to -cost -worry/fear -social/ethical/religious beliefs -drug resistant patients
Treatment of HIV?
Cannot cure HIV/AIDS but can treat secondary infections
Antiviral treatments can limit reproduction of virus
Example of antiviral treatments given when diagnosed with HIV/AIDS and how it works?
Zidovudine - blocks reverse transcriptase
Problems with vaccines against HIV?
Virus resides inside cells so difficult to access
Virus has high mutation rate
Virus has high variety of antigens on its surface
Ethical/Social concerns associated with HIV?
HIV testing requires consent from patient
Stigma attached to sexual partners/children/health care professionals
Discrimination from insurers/employers
Distress caused by false positives
Conflict about informing sexual partner of HIV+ partner
Restriction to travel to some countries
Define: Epidemiology
study of patterns, distributions and causes of disease in a population
Define: Morbidity
number of people in a population that have the disease
Define: Mortality
number of people that have died from the disease in a population
Define: Endemic
disease that is always present in a population
Define: Epidemic
disease that shows sudden increase in incidence in a population
Define: Pandemic
disease that shows sudden increase ins several populations (i.e the whole world)
Define: Prevalence
number of people who have the disease in a given period of time
Define: Incidence
number of new cases of the diseases in a population per year
List several control measures
education programmes vaccination programmes provision of appropriate medicine drugs improving hygiene improving housing to reduce overcrowding improving nutrition provision of clean water controlling population movements
Examples of infectious diseases
Chicken Pox
Influenza
Severe acute respiratory syndrome (SARS)
Where is chicken pox endemic to?
UK
When is chicken pox most common?
Winter and spring
Prevalence of chicken pox?
Varies from year to year
When is influenza common in the UK?
Winter
Why is there no herd immunity to influenza?
Has high mutation rate producing new different strains
Why is SARS potentially life-threatening?
can lead to life-threatening form of pneumonia
Where and when did SARS originate?
South China in 2002
Examples of Notifiable diseases?
Measles Mumps Whooping Cough Rubella Viral hepatitis TB Anthrax Poliomyelitis Anthrax Malaria Cholera Food Poisoning
First stage of culturing microorganisms?
Preparation of nutrient medium
What happens during the first stage of culturing microorganisms?
Nutrients supplied in a nutrient medium (agar/broth)
Aseptic conditions essential
Second stage of culturing microorganisms?
Inoculation
What happens during the second stage of culturing microorganisms?
Inoculating broth/agar
Aseptically done
Third stage of culturing microorganisms?
Identifying Bacteria
What are the 3 different methods of identifying bacteria?
1) Use of Gram Staining
2) Colony Morphology
3) Cell Morphology
Staining Procedure of Gram Staining?
Prepared slides stained with crystal violet for 30secs
Wash stained slide briefly with distilled water
Flood slide in petri dish with Gram’s iodine
After 1 min, rinse slide with distilled water
Then rinse with 95%alcohol and 5% water
Add Safranin (counterstain) and leave for 30 secs
Blot slide
Allow slide to airdry
What colour are Gram-negative bacteria stained?
Pink
What colour are Gram-positive bacteria stained?
Purple
Why are Gram-negative bacteria stained pink?
Thin peptidoglycan wall covered with lipopolysaccharide layer
Crystal violet binds but alcohol added later in test washes away outer layer –> leaching of violet stain
Safranin stains remaining peptidoglycan layer pink
Why are Gram-positive bacteria stained purple?
Thick peptidoglycan wall not covered with lipopolysaccharide layer
Crystal violet binds to peptidoglycan wall
Alcohol doesn’t remove purple stain
Safranin has no affect
Advantages of Gram-staining method?
Quick
Relatively easy
Disadvantages of Gram-staining method?
Only categorises bacteria into 2 groups
Relies on procedure being carried out correctly
What is Colony morphology?
Observing colonies under microscope
What is a colony?
Small cluster of millions of cloned bacterial cells on surface of agar
What are you looking at when observing colonies?
Colour
Shape (rod/spherical/cork-screw)
Edges (smooth/wavy)
Shiny or matt appearance
Advantages of Colony Morphology?
Quick
Low skill level required as no staining involved
Disadvantages of Colony Morphology?
Unreliable method of identification as many different will have common morphology
3 types of Cell Morphology?
Cocci
Bacilli
Spirilla
Examples of cocci and bacilli?
Cocci - staphylococcus aureus
Bacilli - mycobacterium tuberculosis
Advantages of Cell Morphology?
Quick
Low skill level
Disadvantages of cell morphology?
Unreliable method as many different types of bacilli could lead to misidentification
What can serial dilutions be used for?
Culturing micro-organisms