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Human Development 2 > Bacteria, Fungal and Protozoal Infections > Flashcards

Bacteria, Fungal and Protozoal Infections Flashcards

1
Q

What are the most common types of death in childhood

A
  • pneumonia and diarrhoea
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2
Q

what is an example of a bacterial infection that progress rapidly in children

A

meningococcal septicaemia

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3
Q

what are prokaryotes

A

bacteria

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4
Q

what are two types of eukaryotes

A
  • fungi

- protozoa

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5
Q

describe prokaryotes

A

= 0.2-2um in diameter

  • single, circular chromosome
  • no nucleus
  • no organelles
  • divide by binary fission
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6
Q

describe eukaryotes

A
  • 10-100um in diameter
  • multiple, linear chromosomes
  • membrane bound nucleus
  • membrane bound organelles such as golgi, ER, mitochondria
  • divide by mitosis
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7
Q

what are the two toxins that are secreted by the host

A
  • exotoxins

- endotoxins

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8
Q

What are exotoxins

A

bacterial toxins secreted by the host

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9
Q

what are endotoxins

A

forms part of the outer membrane of Gram – bacteria

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10
Q

give two examples of exotoxins

A
  • Cholera

- diphtheria

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11
Q

describe what does cholera causes to happen

A

opening of CL- channels that lead to water into gut which leads to secretory diahorrea

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12
Q

what does diphtheria cause to happen

A

 Diphtheria: sore throat with pseudo membrane

• Diphtheria Toxin A inhibits protein synthesis.

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13
Q

What does diphtheria act on

A

Acts on:
o Heart: myocarditis and heart block.
o Nerves further difficulty swallowing, paralysis, diplopia.

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14
Q

what does the endotoxin do

A

 Released during lysis of the organisms.

 Leads to macrophage activation

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15
Q

what is the immunopathology of the host

A

septic shock

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16
Q

describe the pathogenesis of meningococcal disease

A
  • Activation of inflammatory cascade via LPS
  • Causes release of pro-inflammatory cytokines such as. IL-6 and TNF- alpha
  • This causes myocardial depression
  • Endothelial dysfunction which causes capillary leakage and shock
  • Causes a coagulopathy – takes a long time for the blood to clot as the whole coagulation cascade is abnormal

= therefore this inflammatory reaction to LPS causes most the symptoms of septic shock

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17
Q

inflammation reaction to LPS causes most of the …

A

symptoms of septic shock

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18
Q

What are the immunological differences in children in comparison to adults

A

Immunological
• Immaturity
• Lack of memory (cells).

Anatomical
• Thinner skin - premature babies have thinner skin therefore have a lack of barrier response
• Shorter airways
• Anatomy of Eustachian tube
o More straight = otitis media. - this makes it more likely for an illness to invade and progress

Exposure
• Hygiene, nursery/day-care.

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19
Q

infections often present in ….

A

fever

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20
Q

What is the dentition of the a fever

A
  • Temperature above 37.8 degrees
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21
Q

describe the differences in measurement of temperature

A

 0.5 lower in mouth vs. rectal

 1 lower in armpit vs rectal.

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22
Q

what temperature is similar to rectal core temperature

A

= ear temperature

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23
Q

Name some severe bacterial infection

A 
–	Septicaemia
–	Meningitis
–	Pneumonia
–	Epiglottitis
–	Septic arthritis
–	Osteomyelitis
–	Tuberculosis
–	Tetanus
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24
Q

Name some slow bacterial infection

A 
–	Tonsillitis 
–	Otitis media
–	Urinary tract infection
–	Gastroenteritis
–	Impetigo
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25
Q

What the three common causing meningitis and septicaemia

A
  • streptococcus pneumonia
  • neisseria meningitides
  • haemophilus influenza B
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26
Q

describe the different groups of neisseria meningitides

A

o Group B and C

o Increase in Group W since 2009.

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27
Q

What is the definition of septicaemia

A

sepsis with shock

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28
Q

What are the clinical symptoms of septicaemia

A
  • Tachycardia.
  • Tachypnoea.
  • Prolonged capillary refill- blood being sent to organs
  • Low BP (late sign) - common to drop blood pressure due to shock whereas in children this is a pericardia a rest and late sign that they are going to decompensate
  • Rash - doesn’t disappear usually, but you can have septicaemia without any rash
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29
Q

What are the clinical symptoms of meningitis

A
  • High temperature
  • Headaches
  • Vomiting
  • Not able to tolerate bright lights = photophobia
  • Drowsiness
  • Stiff Neck.
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30
Q

What are the causes meningitis

A
  • accumulation of cell between Pia and arachnoid matter

- has inflammatory purulent exudate

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31
Q

What is the diagnosis of meningitis

A
  • Lumbar puncture test

- CSF

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32
Q

What are the changes in the CSF in bacteria meningitis

  • Appearance
  • cells
  • protein
  • glucose
A
  • Appearance = cloudy
  • cells = increase in neutrophils
  • protein = increase
  • glucose = less than 60% of blood glucose
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33
Q

What are the changes in viral meningitis in the CSF

A
  • Appearance = clear
  • cells = lymphocytes increase
  • protein = remain the same
  • glucose= normal
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34
Q

What are the changes in TB meningitis in the CSF

A
  • Appearance = opalescent
  • cells = lymphocyte increase
  • protein = double increase
  • glucose = decrease in 60% of blood glucose
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35
Q

the younger the child the more …

A

non-specific the symptoms are for meningitis

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36
Q

describe how you would diagnose meningitis in a young child

A
  • the younger the child the more non specific the symptoms are for meningitis therefore you have to have a high index of suspicion in an unwell baby
  • for any child that is greater than 3 months old you can do an lumbar puncture
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37
Q

What are the symptoms of meningitis in infants

A
  • Tense or bulging soft
  • High temperature
  • Breathing fast and difficulty breathing
  • Extreme shivering
  • Cold hands and feet
  • Vomiting and refusing to feed
  • Blotchy skin getting paler or turning blue
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38
Q

what vaccinations take place at

  • 8 weeks old
  • 12 weeks old
  • 16 weeks old
  • one year
A

8 weeks old

  • Diphtheria, tetanus, peruses, polio, Hib, HepB,
  • pneumoccoal (13 serotypes)
  • Meningococcal group B
  • rotavirus, gastroenteritis

12 weeks old

  • Diphtheria, tetanus, peruses, polio, Hib, HepB,
  • rotavirus

16 weeks old

  • Diphtheria, tetanus, peruses, polio, Hib, HepB,
  • pneumoccoal (13 serotypes)
  • Meningococcal group B

one year

  • Men B
  • Hib and MenC
  • pneumococcal
  • MMR
39
Q

How many serotypes does the pneumoccoal vaccination have

A

13 serotypes

40
Q

What are the top 3 organisms that can cause problems in young infants before vaccination

A
  • Group B streptococcus
  • E.coli
  • Listeria
41
Q

what antibiotics can you give for GBS, E.coli and listeria

  • for older children
  • and young infants les than 3 months old
A 
•	Older children
–	Ceftriaxone – covers all 3 
•	Young infants (<3 months old)
–	Cefotaxime or ceftriaxone 
–	Amoxicillin (penicillin derivate) also needed for Listeria cover
42
Q

What is the neonatal period

A

Birth to the 28th day (first 28 days of life)

43
Q

What can cause neonatal sepsis transmission from the mother to the baby

A
  • maternal colonisation of the pathogens in colon and vaginal canal (mainly for GBS)
  • this passes vertically onto the baby
44
Q

what is the difference between early and late onset sepsis

A

Early onset in neonatal sepsis is the first 7 days after Birth

late onset in neonatal sepsis is 8-90 days after birth

45
Q

where does late onset sepsis tend to go

A

tends to settle in;

  • bones and joins
  • meningitis
46
Q

what are two types of gram positive bacteria

A

cocci

bacilli

47
Q

name some examples of cocci and bacilli (gram positive bacteria)

A

Cocci

  • Staphylococcus
  • Streptococcus
  • Enterococcus – coloniser of the gut

Bacilli

  • corynebacterium
  • listeria
  • bacillus - such as ceros and anthracis
  • Clostridum = such as tetani, botulinum, difficile
48
Q

what is cerus the cause of

A

cause of vomiting if you reheat fried rice

49
Q

What is anthracis the sue of

A

cause of anthrax

50
Q

what does petani cause

A

causes tetnus

51
Q

what bacteria is neither gram positive nor gram negative

A

mycoplasma

52
Q

describe streptococcus pneumonia

A
  • Pneumococcus
  • Normal flora in 5-70% of people
  • Diploccoci
  • Gram positive
53
Q

what does diplococci mean

A

a bacterium that occurs as pairs of cocci, e.g. pneumococcus

54
Q

what are the vulnerable groups of people that are predisposes to developing pneumococcal infection

A

• Absent / non-functional spleen
– Congenital asplenia – born without a spleen
– Traumatic removal
– Hyposplenism (eg sickle cell) – spleen gets ruined as well

  • Hypogammaglobulinaemia
  • HIV infection
55
Q

name three reasons why you might not have a spleen

A

– Congenital asplenia – born without a spleen
– Traumatic removal
– Hyposplenism (eg sickle cell) – spleen gets ruined as well

56
Q

what bacteria does not having a spleen leave you vulnerable to and how do you treat it

A 
•	Vulnerable to encapsulated bacteria
–	Pneumococcus
–	HiB
–	Meningococcus
•	Vaccination
•	Lifelong penicillin daily
57
Q

what are the invasive and non invasive features of pneumoccoal

A 
Non invasive 
•	Acute otitis media 
•	Sinusitis
•	Conjunctivitis
•	Pneumonia
Invasive 
•	Septicaemia
•	Meningitis
•	Peritonitis
•	Arthritis
•	Osteomyelitis
58
Q

describe an example of how pneumoccoal presents as a non invasive disease

A
  • for example the normally pneumococcus sits in the nasopharynx but in children the otitis mediais more straight therefore th eubacteria can travel to the ear through the Eustachian tube
  • this causes a midd ear infection behind the ear drum
  • an immune response is started
  • pus builds up so that the middle ear becomes like a boil
  • this can cause the eardrum to burst and pus can come out the ear
59
Q

describe how pneumococcal can become an invasive disease

A
  • the pneumococcal in the nasopharynx, this can go into the epithelium and then enter the blood
  • leads to meningitis and sepsis
  • causes osteomyelitis, septic arthritis and peritonitis
60
Q

How do you treat empyema caused by pneumoccoal

A
  • use a chest drain and urokinase

- use video assistant thoracoscopic surgery (VATS)

61
Q

Describe how you diagnose osteomyelitis caused by pneumoccoal

A
  • can take 10 days to show up on the X ray
  • on the X ray it looks more Lucent
  • can do an MRI which will show this up early
62
Q

How do you treat osteomyelitis caused by pneumoccoal

A
  • treatment is antibiotics for 7 weeks in order to make sure that the infection is cleared from the bone
63
Q

How do you treat septic arthritis caused by pneumoccoal

A
  • may need surgery to wash out the infected joint

- then goes on antibiotics

64
Q

What are the two vaccinations used for pneumococcal

A
  • Pneumococcal Polysaccharide Vaccine (PPV)

* Pneumococcal Conjugate Vaccine (PCV).

65
Q

what vaccination in pneumoccoal is used for adults versus what one is used for children

A
  • Pneumococcal Polysaccharide Vaccine (PPV) = adults

* Pneumococcal Conjugate Vaccine (PCV). = children

66
Q

why is the Pneumococcal Conjugate Vaccine (PCV) given to children and not the PPV

A
  • Children cannot have the PPV vaccination as it just contains polysaccharide and they cannot mount an immune response to that
  • the PPV allows a conjugate piece of protein to be bound to the polysaccharide
67
Q

Explain how the pnuemoccoal conjugate vaccine works

A
  • the B cell binds to the bacteria polysaccharide epitope linked to the protein
  • antigen is internalised and processed
  • peptides from the portion component are presented to the T cell
  • activated B cells then produce antibodies against the polysaccharide antigen on the surface of the bacterium
68
Q

what is the main organisms that causes tuberculosis

A

Myobacterium tuberculosis

69
Q

what are the two different types of pathways that can happen when exposed to mycobacterium tuberculosis

A
  • Childhood exposure
  • primary pulmonary infection
  • successful immune response
  • well adult
  • then loose immunity later in life
  • therefore you can have late reactivation of the pulmonary disease
  • this forms a cavity

or

  • Childhood exposure
  • primary pulmonary infection
  • Inadeqaute immune response
  • progressive pulmonary disease leading to death
  • or Hillary extra pulmonary disease leading to death
70
Q

what causes tetanus

A
  • Clostridium tetani, gram-positive bacillus
71
Q

where are the spores for tetanus found

A

spores are found in the soil

72
Q

what can lead you to having tetanus

A
  • lack of maternal vaccination in pregnancy
  • use of unclean blade to cut cord
  • application of mud or dung to cord
73
Q

What are the symptoms of neonatal tetanus

A
  • Weak
  • Lethargic
  • Poor suck
  • Spams
  • Fits
74
Q

what are the two types of fungi and give examples

A

Yeasts
- such as candida

Moulds
- such as aspergillum

75
Q

what type of fungi is candida

A

yeast

76
Q

What type of fungi is aspergillus

A

mould

77
Q

describe yeasts

A
  • unicellular
  • oval or round
  • asexual budding
78
Q

describe moulds

A
  • filamentous fungi

- branching filaments (Hypae)

79
Q

what are common suerpiical mycosis

A 
•	Common
o	Candidiasis: nappy rash.
o	Tinea Corporis: ring worm.
	Treat both with topical antifungal (nystatin). 
•	Occurs in Normal Hosts
80
Q

How do you treat candida and ring worm

A

 Treat both with topical antifungal (nystatin).

81
Q

What is another word for ring work

A

tine corporis

82
Q

what are invasive mycosis

A

o Candidaemia: extremely preterm infant, effects kidneys and brain.

o Pulmonary Aspergillosis: child with chronic granulomatous disease.
 Impaired neutrophil function.

• Opportunistic infections in immunocompromised hosts.

83
Q

how do you treat candidaemia

A
  • IV anti fungal treatment
84
Q

what problems can you have with neutrophils

A
  • Low neutrophil count (neutropenia)

- Impaired neutrophil function (e.g. chronic granulomatous disease)

85
Q

what problems can you have with T cells

A

Congential e.g. SCID

Acquired e.g HIV

86
Q

name 3 types of protozoa

A

Sporozoa
amebae
flagellates

87
Q

Give examples of the three types of protozoa

A

• SPOROZOA
– Plasmodium species (malaria)
– Toxoplasma gondii (toxoplasmosis)
– Cryptosporidium (diarrhoea)

• AMOEBAE
– Entamoeba histolytica (amoebic dysentery)

• FLAGELLATES
– Giardia (diarrhoea, malabsorption)
– Trypanasoma (sleeping sickness, Chagas)
– Leishmania (leishmaniasis)

88
Q

What are the 5 main species of malaria

A

– P.falciparum – most severe, cerebral malaria – most important one to worry about
– P. vivax – dormant stage in the liver and they can reactivate
– P. ovale – dormant stage in the liver and they can reactivate
– P. malariae
– P, Knowlesi - emerging cause, predominantly a primate malaria, jumped from priamtes to humans,

89
Q

Describe the lifecycle of malaria

A
  • Comes from mosquitos
  • Is a sportazie in the mosquito
  • Female injects sportaite into the human
  • Goes into the liver stage
  • Comes a schizont
  • Shizont ruptures
  • Go into the blood cells
  • Becomes a schizont into the red blood cell
  • Eventually ruptures the red blood cells
90
Q

what are the symptoms of malaria

A

• Can be non-specific
– Fever, lethargy, vomiting, diarrhoea

•	Severe disease
–	Anaemia
–	Respiratory distress
–	Cerebral malaria (coma, seizures)
–	Hypoglycaemia
91
Q

what are the treatments of malaria

A
  • Artemisinin
  • Combination treatment (eg Coartem: artemether-lumefantrine)
  • More rapid reduction in parasitaemia
92
Q

what can cause toxoplasmosis

A
  • Oocysts excreted by cats.
  • Pregnant women infected.
  • Multiply in macrophages.
93
Q

What is the presentation of toxoplasmosis in the neonate

A
  • Hepatosplenomaegaly
  • Funducosopy – nasty retinitis
  • Ultrasound scan of the brain – ventricular dilation that can cause hydrocephalus

Human Development 2 (34 decks)

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