Airborne Infectious Diseases Flashcards

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1
Q

In regards to airborne diseases, what is the major portal of entry?

A

Respiratory tract (nose, mouth) involving mucous membranes

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2
Q

Describe this Airborne Disease: Streptococcal Pharyngitis

(AKA/Causative Agent/Characteristic, Virulence Factors, Tissue/Organs Affected, SXS, Diagnosis, Treatment, Preventative Measures)

A

AKA/Causative Agent/Characteristc

  • AKA: Strep Throat
  • CA: Streptococcus pyogenes
  • Characteristic: Gram-positive, chains;
    group A streptococci (GAS) - inv Lancefield classification based on CW structure for Streptococci

Virulence Factors

Produces:

  • β hemolysin [Super Ag; exotoxin]
    -> (completely lyse RBC = clear zone)
  • Streptokinase
    -> (dissolve/pvt blood clot form.)
  • Hyaluronidase
    -> (dissolve CT)
  • Capsules and M proteins
    -> (adherence)

Tissue/Organ Affected

  • Upper Respiratory Tract (Lungs)

Reservoir

  • x

Mode of Transmission

  • x

Predisposing Factors

  • x

Incubation Period

  • x

SXS

  • Inflammation/Erythema: throat, tonsils, otitis media/middle ear
  • Fever (bc type 1 exotoxin/SuperAg)

Diagnosis

  • Serological test = rapid antigen detection (look antigen)
  • β hemolysis on blood agar (look clear zone)

Treatment

  • ABX (Penicillin)

Preventative Measures

Good Respiratory Hygiene:

  • Cover mouth/nose
  • Wear mask

MISC

  • x
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3
Q

Describe this Airborne Disease: Scarlet Fever

(AKA/Causative Agent/Characteristic, Virulence Factors, Tissue/Organs Affected, SXS, Diagnosis, Treatment, Preventative Measures, Misc.)

A

AKA/Causative Agent/Characteristic

  • AKA: Scarlatina
  • CA: Streptococcus pyogenes
  • Characteristic: Gram-positive, chains;
    group A streptococci (GAS) - inv Lancefield classification based on CW structure for Streptococci

Virulence Factors

Produces:

  • Erythrogenic toxin
    -> prod. by lysogeny = phage conversion
    -> toxin gene from bacteriophage → integrates into the chromosome of S. pyogenes → becomes a prophage → S. pyogenes erythrogenic toxin.
  • β hemolysin [Super Ag; exotoxin]
    -> (completely lyse RBC = clear zone)
  • Streptokinase
    -> (dissolve/pvt blood clot form.)
  • Hyaluronidase
    -> (dissolve CT)
  • Capsules and M proteins
    -> (adherence)

Tissue/Organ Affected

  • Upper Respiratory Tract (Lungs)

Reservoir

  • x

Mode of Transmission

  • x

Predisposing Factors

  • x

Incubation Period

  • x

SXS

Toxemia (Sys Inf):

  • Flat, bright red, sandpaper rash on UB
  • Strawberry tongue
    -> Inflammed/red bumpy tongue with white coating
  • High fever
  • Sore Throat

Diagnosis

  • Serological test = rapid antigen detection (look antigen)
  • β hemolysis on blood agar (look clear zone)

Treatment

  • ABX (Penicillin)

Preventative Measures

Good Respiratory Hygiene:

  • Cover mouth/nose
  • Wear mask

MISC

  • Common in children
  • Rare today
  • Most common cause of death in children in 1800s
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4
Q

Describe this Airborne Disease: Diphtheria (Toxigenic Strain)

(Causative Agent/Characteristic, Virulence Factors, Tissue/Organs Affected, SXS, Diagnosis, Treatment, Preventative Measures, Misc.)

A

AKA/Causative Agent/Characteristic

  • AKA: X
  • CA: Corynebacterium diphtheria
    -> 2 strains
  • Characteristic: Gram-positive, Bacilli; pleomorphic (irreg cube shape); Very resistant to drying = stays on surfaces

Virulence Factors

Produces:

  • Potent, Diphtheria exotoxin
    -> Low LD50
    -> Prod by lysogeny = phage conversion via virus

Tissue/Organ Affected

  • Upper Respiratory Tract (Lungs)

Reservoir

  • x

Mode of Transmission

  • x

Predisposing Factors

  • x

Incubation Period

  • x

SXS

Toxemia (Sys Inf):

  • Partial Paralysis of the soft palate and pharynx
    -> Difficulty breathing = death
  • Heart and Kidney damage

Diagnosis

  • Throat Swab = culture sample

Treatment

MUST START IMMEDIATELY:

  • ABX (Penicillin)
  • Diphtheria Antitoxin

Preventative Measures

  • Diphtheria Vaccine
    -> DTaP: Diphtheria, Tetanus, acellular Pertussis; children less 6yr
    ->TDaP: Tetanus, Diphtheria, acellular Pertussis; less conc than DTaP; teens/young adult
    ->Td: Tetanus, Diphtheria toxoid; booster vaccine

MISC

  • Vaccine ≠ lifelong immunity (bc requires multiple vaccine)
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5
Q

Describe this Airborne Disease: Diphtheria (Nontoxigenic Strain)

(Causative Agent/Characteristic, Tissue/Organs Affected, SXS, Diagnosis, Treatment, Preventative Measures, Misc.)

A

AKA/Causative Agent/Characteristic

  • AKA: X
  • CA: Corynebacterium diphtheria
    -> 2 strains
  • Characteristic: Gram-positive, Bacilli; pleomorphic (irreg cube shape); Very resistant to drying = stays on surfaces

Virulence Factors

  • x

Tissue/Organ Affected

  • Upper Respiratory Tract (Lungs)

Reservoir

  • x

Mode of Transmission

  • x

Predisposing Factors

  • x

Incubation Period

  • x

SXS

  • Early SXS: Sore throat, fever
  • Later SXS: Formation of tough, greyish pseudomembrane on throat
    -> Blocks air passage to lung = death

Diagnosis

  • Throat Swab = culture sample

Treatment

MUST START IMMEDIATELY:

  • ABX (Penicillin)

Preventative Measures

  • Diphtheria Vaccine
    -> DTaP: Diphtheria, Tetanus, acellular Pertussis; children less 6yr
    ->TDaP: Tetanus, Diphtheria, acellular Pertussis; less conc than DTaP; teens/young adult
    ->Td: Tetanus, Diphtheria toxoid; booster vaccine

MISC

  • No toxin produced
  • Vaccine ≠ lifelong immunity (bc requires multiple vaccine)
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6
Q

Is contact or vehicle transmission more contagious and why?

A

Vechile transmission is more dangerous because its airborne transmission MORE than 1 meter away

Contact transmission = less than 1 meter away

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7
Q

What are the most comon type of infectious diseases world-wide?

A

Respiratory tract infectious diseases

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8
Q

In regards to airborne diseases, what is a common predisposing factor?

A

crowds

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9
Q

In regards to airborne diases, what are the most effective preventative measures?

A

Good respiratory hygeine (cover nose/mouth; mask)

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10
Q

Name structures of the respiratory system in the upper respiratory tract and lower respiratory tract

A

URT: Nose, Oral Cavity, pharynx (throat), middle ear, auditory tube

LRT: larynx (voicebox), trachea, bronchial tubes, alveoli; ciliary escalatory, respiratory mucus

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11
Q

Name host defenses against airbone pathogens

A
  • Normal Microbiota: compete against invading pathogens
  • Mucus: traps pathogens
  • Lysozyme: enzyme that destorys pathogens
  • Ciliary escalatory: moves mucus up and out the body
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12
Q

Bacterial growth on blood agar helps to differentiate between what?

Provide examples

A

Helps differentiate between different streptococcal species that cause airborne diseases

Ex: Streptococcus pyogenes vs. Streptococcus pneumoniae

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13
Q

RBC serve as a ___________ _________

A

nutrient source

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14
Q

RBC are lysed by toxins called ________ (__________) in the process called __________

A

hemolysins (type 1 exotoxin; Super Ag)
hemolysis

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15
Q

Compare β hemolysis vs α hemolysis

A

β hemolysis:

  • Completley destory RBC = clear zone
  • Ex: Streptococcus pyogenes

α hemolysis:

  • Partially destroy RBC = green zone
  • Ex: Streptococcus pneumoniae
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16
Q

Describe this Airborne Disease: Pertussis

(AKA/Causative Agent/Characteristic, Virulence Factors, Tissue/Organs Affected, Incubation Period, SXS, Diagnosis, Treatment, Preventative Measures, Misc.)

A

AKA/Causative Agent/Characteristic

  • AKA: Whooping Cough
  • CA: Bordetella pertussis
  • Characteristic: Gram-negative, coccobacillus (oval)

Virulence Factors

  • Tracheal cytotoxin
    -> Damages ciliated cells = stop ciliary escalator = no mucus moves up and out
  • Capsule
    -> Attach to ciliated cells in trachea

Tissue/Organ Affected

  • Lower Respiratory Tract

Reservoir

  • x

Mode of Transmission

  • x

Predisposing Factors

  • x

Incubation Period

  • Days - Week (5-10d)

SXS

  • Cold-like symptoms
  • Violent, uncontrollable cough
  • Gasping (for air)

Diagnosis

  • Culture of throat mucus sample

Treatment

  • ABX

Preventative Measures

  • DTaP Vaccine
  • TDaP Vaccine

MISC

  • Highly Contagious
17
Q

Describe this Airborne Disease: Pneumococcal Pneumonia

(AKA/Causative Agent/Characteristic, Virulence Factors, Tissue/Organs Affected, Predisposing Factors, SXS, Diagnosis, Treatment, Preventative Measures, Misc.)

A

AKA/Causative Agent/Characteristic

  • AKA: Typical Pneumonia
  • CA: Streptococcus pneumoniae (90 strains)
  • Characteristic: Gram-positive, encapsulated diplococci

Virulence Factors

  • Large Capsule
    -> Attachment
  • α hemolysin
    -> Partially lyses RBC’s = green zone

Tissue/Organ Affected

  • Lower Respiratory Tract (Lungs)

Reservoir

  • x

Mode of Transmission

  • x

Predisposing Factors

  • Age (very young/old)

Incubation Period

  • x

SXS
Acute Symptoms:

  • High fever
  • Difficulty breathing
  • Chest pain = fluid accumulation at level of alveoli = interferes with gas exchange

Diagnosis

  • Serological (Blood) test = look for pathogen or Ab
  • α hemolysis on blood agar
  • Presence of capsular antigen in urine

Treatment

  • ABX (Penicillin)

Preventative Measures

  • Pneumococcal conjugate vaccine (protects against 13 strains based on capsule structure;PCV13 or Prevnar13R)

MISC

  • Atypical Pneumonia: caused by non-bacterial microbes;
    -> ex: viral Pneumonia (influenzavirus)/fungal pneumonia.
    -> common in immunocompromised host
18
Q

Describe this Airborne Disease: Tuberculosis

(Causative Agent/Characteristic, Virulence Factors, Tissue/Organs Affected, Mode of Transmission, SXS, Diagnosis, Treatment, Preventative Measures, Misc.)

A

AKA/Causative Agent/Characteristic

  • AKA: x
  • CA: Mycobacterium tuberculosis
    -> MDR strain: resists 1st line drugs; use 2nd line drugs
    -> XDR strains: resist 2nd line; PT isolate
  • Characteristic: Acid-fast bacterium, bacilli, obligate aerobe, Fungus-like growth, mycolic acid in the cell wall

Virulence Factors

  • Mycolic Acid
    -> Make bacteria resistant to drying; allow bacteria to multiply in macrophages (inhibit dig. enz. of lysosome)

Tissue/Organ Affected

  • Lower Respiratory Tract (Lungs)

Reservoir

  • x

Mode of Transmission

  • Droplet Transmission

Predisposing Factors

  • x

Incubation Period

  • x

SXS
Chronic Symptoms (Sys Inf):

  • Blood cough (alveolar dmg)
  • Persistent Low-grade fever
  • Night sweats
  • Weight loss
  • Weakness

Diagnosis

1) Tuberculin Skin Test:

  • inj Tuberculin protein = check hardness days later

2) Chest X-ray (or CT scan):

  • White spots = tubercle formation

3) Acid-fast staining

  • Culture lung sputum sample = look for pink acid-fact bacilli

Treatment

  • Multi-drug therapy (min. 6 months)
  • First-line drugs: ABX
  • Second-line drugs
    -> used for treatment of drug-resistant Tuberculosis

Preventative Measures

  • BCG vaccine (not used in US)

MISC

  • Leading cause of death from infectious diseases worldwide
  • 1/3 world’s pop. have latent TB
  • Miliary Tuberculosis
    -> (SYS TB inf; Bact spreads from primary lesion -alveolus- to other areas of lung, liver and NS, bone)
19
Q

Describe this Airborne Disease: Influenza

(AKA/Causative Agent/Characteristic, Virulence Factors, Resevoir, Mode of Transmission, Predisposing Factors, SXS, Diagnosis, Treatment, Preventative Measures, Misc.)

A

AKA/Causative Agent/Characteristic

  • AKA: Flu
  • CA: Influenza Virus - RNA, (Some viral strains = Viral/Atypical Pneumonia)
  • Characteristic: Enveloped, spikes (Influenza Types A, B, C, D; based on capsid protein)

Virulence Factors

  • Protein Spikes:
    -> HA (H) spikes
    -> NA (N) spikes
  • Antigenic Variation of Spike:
    -> genetic recombination & formation; mix human virus spikes and non-human virus spikes (HswNhk)

Tissue/Organ Affected

  • X

Reservoir

  • 1° = Humans
  • 2° = Birds, farm animals

Mode of Transmission

  • Zoonoses (animal -> human)
  • Droplet Transmission
  • Airborne Transmission

Predisposing Factors

  • Age (Infants and Elderly)

Incubation Period

  • x

SXS
Acute Symptoms:

  • Fever
  • Chills
  • Headache & muscle ache
  • No intestinal symptoms

Diagnosis

  • Difficult to diagnose
    -> Because of acute symptoms

Treatment

  • Antivirals
    -> (inhaled/oral; against Type A within 30 hours)
  • Supportive Treatment

Preventative Measures

  • Multivalent vaccine: killed, multi-strains
    -> Composition determined annually
    -> No long-term immunity
  • Nasal spray flu vaccine
    -> Live, weakened virus

MISC

  • Type A - causes most Flu pandemics
  • Low mortality; Thousands of deaths in the US annually
  • Spanish Flu pandemic killed 20+ million people
20
Q

Describe this Airborne Disease: Coronavirus Disease 2019 (Covid-19)

(AKA/Causative Agent/Characteristic, Virulence Factors, Resevoir, Mode of Transmission, Predisposing Factors, Incubation Period, SXS, Diagnosis, Treatment, Preventative Measures, Misc.)

A

AKA/Causative Agent/Characteristic

  • AKA: 2019 Novel Coronavirus (Covid-19)
  • CA: SARS-CoV-2; Coronaviridae Family
    -> RNA
  • Characteristic: Enveloped, spikes, several human variants

Virulence Factors

  • Multiply in ciliated epithelial cells of the respiratory tract
  • Antigenic Variation of Spike
    -> high mutation rates

Tissue/Organ Affected

  • x

Reservoir

  • 1° = Animals (bats, intermediate animal host; pangolin)
  • 2° = Humans

Mode of Transmission

  • Zoonoses (animal -> human)
  • Fomites
  • Droplet Transmission
  • Airborne Transmission

Predisposing Factors

  • Crowds
  • Poor health

Incubation Period

  • Days - Weeks (4 - 14d)

SXS
Range from mild -> severe:

  • Shortness of breath -> respiratory failure
  • Septic shock -> multiple organ failure
  • Loss of taste/smell
  • Dry cough
  • Fever
  • Headache
  • Fatigue

Diagnosis

  • PCR
  • Antigen test (saliva, nasal/throat swab)
  • Serology

Treatment
Treatment is not usually required:

  • Antivirals
    -> MIld-moderate: Antiviral tablets
    -> Severe: Antiviral, steroids, Ab

Preventative Measures

  • Frequently wash hands
  • Social Distancing
  • Respiratory hygiene
  • Vaccine
    -> Moderna: mRNA; 2 shots
    -> Pfiezer: mRNA; 2 shots
    -> J&J/ Janseen: viral vector; 1 shot

MISC

  • First detected in open markets in China (2019)
  • Coronaviridae family is responsible for several diseases:
    -> SARS: (SARS-CoV-1; epidemic)
    -> MERS: (MERS-CoV; epidemic)
    -> Covid-19: (SARS-CoV-2; pandemic)
21
Q

Describe this Airborne Disease: Smallpox

(AKA/Causative Agent/Characteristic, Virulence Factors, Mode of Transmission, SXS, Diagnosis, Preventative Measures, Misc.)

A

AKA/Causative Agent/Characteristic

  • AKA: Variola
  • CA: Variola Virus - DNA
    -> Variola Major - Larger mortality
    -> Variola Minor - Low mortality
  • Characteristic: Enveloped

Virulence Factors

  • Proteins called SPICE (smallpox inhibitor of complement enzymes)

Tissue/Organ Affected

  • x

Reservoir

  • x

Mode of Transmission

  • Airborne Transmission

Predisposing Factors

  • x

Incubation Period

  • x

SXS
Viremia (Sys Inf):

  • Pus (WBC/dead tissue) - filled lesions = raised rash

Diagnosis

  • Serology

Treatment

  • x

Preventative Measures

  • Vaccine
    -> Live vaccinia (Cowpox) virus
    -> Mild to severe side effects

MISC

  • Highly contagious
  • Completely eradicated (from human pop) by vaccination
  • Potential for bioterrorism
22
Q

Describe this Airborne Disease: Chickenpox

(AKA/Causative Agent/Characteristic, Virulence Factors, Tissue/Organ Affected, Reservoir, Mode of Transmission, Predisposing Factors, Incubation Period, SXS, Diagnosis, Treatment, Preventative Measures)

A

AKA/Causative Agent/Characteristic

  • AKA: Varicella
  • CA: Varicella-Zoster Virus, Herpesviridae family, HHV-3 - DNA Virus
  • Characteristic: Enveloped

Virulence Factors

  • Multiply in epithelial cells of URT -> Viremia
  • Become latent in CNS

Tissue/Organ Affected

  • Upper Respiratory Tract

Reservoir

  • Humans

Mode of Transmission

  • Droplet Transmission

Predisposing Factors

  • Daycare

Incubation Period

  • Weeks (10 - 21d)
    -> Longer than Measles

SXS
Viremia (Sys Inf):

  • Itchy rash
  • Fluid-filled vesicles on face, chest & back = raised rash
  • Fever
  • Headache

Diagnosis

  • Type (flat vs. raised/pus vs. fluid filled) & location of the rash

Treatment

  • Calamine lotion
    -> (relieves itching)
  • Non-aspirin medication in children

Preventative Measures

  • Varicella Vaccine
    -> Live, attenuated/weakened virus

MISC

  • x
23
Q

Describe this Airborne Disease: Shingles

(AKA/Causative Agent/Characteristic, Virulence Factors, Predisposing Factors, SXS, Diagnosis, Treatment, Preventative Measures, Misc.)

A

AKA/Causative Agent/Characteristic

  • AKA: Herpes Zoster
  • CA: Reactivation of latent Varicella-Zoster Virus - DNA
  • CHRTX: (Enveloped)

Virulence Factors

  • Reactivation: Travels along sensory nerves of skin

Tissue/Organ Affected

  • x

Reservoir

  • x

Mode of Transmission

  • x

Predisposing Factors

  • Age (elderly)
  • Immunocompromised person
  • Stress

Incubation Period

  • x

SXS

  • Fluid-filled, MERGING band-like rash = raised rash
  • EXCRUCIATING nerve pain (post-herpetic neuralgia)
  • Blisters scab (form in 7-10d)

Diagnosis

  • Type (flat vs. raised/pus vs. fluid-filled) and location of rash

Treatment

  • Antivirals
    -> (management; relieve/suppress SXS)

Preventative Measures

  • Shingles/Zoster Vaccine
    -> (ex: Shingrix)

MISC

  • Rash Limited to one side of the body (doesn’t cross midline)
24
Q

Describe this Airborne Disease: Measles

(AKA/Causative Agent/Characteristic, Virulence Factors, Reservoir, Mode of Transmission, Incubation Period, SXS, Diagnosis, Treatment, Preventative Measures, Misc.)

A

AKA/Causative Agent/Characteristic

  • AKA: Rubeola
  • CA: Rubeola Virus - RNA
  • Characteristic: Enveloped, spikes antigenically stable

Virulence Factors

  • Attachment by H & F proteins

Tissue/Organ Affected

  • x

Reservoir

  • Humans

Mode of Transmission

  • Droplet Transmission

Predisposing Factors

  • x

Incubation Period

  • Weeks (10 - 12d)
    -> Shorter than Chickenpox

SXS
Viremia (Sys Inf):

  • Merging macular (flat) rash
    -> Face -> neck -> trunk -> extremities
  • Koplik spots - clustered, white lesions on the oral mucosa
  • High fever
  • Conjunctivitis (pink eye)
  • Dry cough
  • Runny nose

Diagnosis

  • Based on SXS
  • Serology

Treatment

  • No treatment available
  • Supportive care

Preventative Measures

  • Monovalent measles vaccine (use single strain pathogen)
  • MMR - prevents Measles, Mumps, Rubella

MISC

  • Vaccine required once
  • Complications
    -> Encephalitis in 1 out of 1000 cases
    -> Viral Pneumonia
25
Q

Describe this Airborne Disease: Rubella

(AKA/Causative Agent/Characteristic, Reservoir, Mode of Transmission, Incubation Period, SXS, Diagnosis, Treatment, Preventative Measures, Misc.)

A

AKA/Causative Agent/Characteristic

  • AKA: German Measles or 3-Day measles
  • CA: Rubella Virus - RNA
  • Characteristic: Non-enveloped

Virulence Factors

  • x

Tissue/Organ Affected

  • x

Reservoir

  • Humans

Mode of Transmission

  • Droplet Transmission

Predisposing Factors

  • x

Incubation Period

  • Weeks (14 - 21d)

SXS

  • Discrete macular (flat) rash
    -> last short days
    -> Face -> neck -> trunk -> extremities
  • Mild/No fever
  • Conjunctivitis (pink eye)
  • Cough
  • Runny Nose

Diagnosis

  • Based on SXS
  • Serology

Treatment

  • No treatment available
  • Supportive care

Preventative Measures

  • MMR - prevents Measles, Mumps, Rubella

MISC

  • Life-long immunity (after inf)
  • Complications: Congenital Rubella Syndrome
    -> Maternal inf during 1st trimester
    -> Fetal damage
    -> Cataracts, Cardiac abnormalities, deafness, intellectual disabilities
    -> 15% mortality within 1st year of life
26
Q

Describe the pathogenesis of Tuberculosis

A
  1. Mycobacterium tuberculosis is inhaled -> lung -> alveolus
  2. Monocyte from BV (around alveolus) travels into alveolus -> macrophage -> ingests pathogen -> bacteria multiply in macrophage -> inflamatory response
  3. Aggregation of activated macrophages with ingested pathogen = Tubercle Lesion
  4. Dying macrophages release bacteria (after bact multiplcation)
    -> 4a. Bact. stop growing in tubercle lesion = dz process stops = lesions heal and calcify = bacteria dormant/no spread = Latent Tuberculosis (“local” inf)
    -> 4b. Bact. multiply outside macrophage -> tubercle ruptures -> rel. bacteria lungs/CV system = Miliary Tuberculosis (sys inf)

CV = cardiovascular

27
Q

In regards to the MMR vaccine, does one of the “M” protect against German Measles? Why or why not?

A

No, one of the M DOES NOT protect against German Measles. German measles is clinically known as Rubella. Therefore, the R protects against German Measles, while the first M protects against Rubeola (Measles)

MMR = Measles (Rubeola), Mumps, Rubella.(German Measles)