Cardiovascular & Lymphatic Flashcards

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1
Q

What does the cardiovascular system do?

A

Circulates blood through the body tissues. Delivers substances to and removes substances from cells.

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2
Q

What is the flow in the lymphatic system?

A

Plasma leaves blood capillaries to become interstitial fluid. Lymph capillaries transport interstitial fluid to lymph vessels and nodes, picking up microorganisms and infectious agents.

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3
Q

Does interstitial fluid contain cells?

A

No. It should not.

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4
Q

What do lymph nodes contain?

A

Fixed macrophages, B cells and T cells.

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5
Q

Buboes

A

Swollen lymph nodes

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6
Q

Septicemia

A

acute illness due to presence of pathogens or their toxins in the blood

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7
Q

Sepsis

A

systemic inflammatory response syndrome SIRS

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8
Q

Lymphangitis

A

Inflamed lymph vessels

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9
Q

Severe sepsis

A

Decreased blood pressure and dysfunction of at least one organ

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10
Q

Septic shock

A

Sepsis and uncontrollable decreased blood pressure

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11
Q

Why do blood vessels dilate during sepsis?

A

1) Endotoxin and exotoxins trigger vasodilation

2) Blood vessels dilate in order to release more macrophages into the interstitial fluid.

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12
Q

What is endotoxin shock?

A

Endotoxins (lipopolysaccharides) from gram negative bacteria cause a severe drop in blood pressure

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13
Q

How do you treat endotoxin shock?

A

Treatment involves neutralizing the LPS components and inflammatory-causing cytokines

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14
Q

What is gram-positive sepsis?

A

Potent exotoxins cause toxic shock syndrome.

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15
Q

Give some examples of gram positive sepsis?

A

Usually hospital acquired infections such as
- enterococcus faecium and enterococcus faecalis (inhabit the colon, colonize wounds and are resistant to many antibiotics)

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16
Q

Streptococcus and staphylococcus bacteria are …

A

gram positive bacteria

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17
Q

What are the group B streptococci?

A

Streptococcus agalactiae which causes neonatal sepsis

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18
Q

What is puerperal sepsis?

A

Also called puerperal fever and childbirth fever. Caused by streptococcus pyogenes. This is transmitted to the mother during childbirth. Infects the uterus and may progress to infection of the abdominal cavity (peritonitis).

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19
Q

Endocarditis

A

Inflammation of the endocardium

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20
Q

Subacute bacterial endocarditis

A

Impairs the function of the heart valves. Alpha-hemolytic streptococci from an oral or tonsil infection.

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21
Q

Acute bacterial endocarditis

A

Caused by staphylococcus aureus

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22
Q

Pericarditis

A

Inflammation of the sac around the heart. Caused by streptococci. Fairly rare disease.

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23
Q

Rheumatic fever

A

Autoimmune complications of streptococcus progenies infections. Inflammation of the heart valves and subcutaneous nodules at the joints owing to immune reaction against streptococcal M protein.

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24
Q

How do you detect these heart diseases?

A

You will not hear the normal lub-dub but will hear murmurs and other abnormal sounds.

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25
Q

Sydenham’s chorea

A

Purposeless, involuntary, rapid, uncoordinated, jerking movements. Primarily affecting the face, hands and feet.

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26
Q

Tularemia

A

Gram-negative bacilli Francisella tularensis. Zoonotic disease transmitted from rabbits, ticks and insects by deer flies. Creates an ulcer at the site of entry. Bacteria reproduce in phagocytes and enlarge regional lymph nodes. Mortality is less than 30%.

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27
Q

Brucellosis (Undulant Fever)

Name for the different animals.

A

Brucella (aerobic gram-negative rods)
B. abortus - cows
B. suis - swine
B. melitensis - goats, sheep and camels

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28
Q

How is brucellosis transmitted?

A

Transmitted via milk from infected animals or contact with them. Persists in the reticuloendothelial system (monocytes and macrophages).

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29
Q

What symptoms does Brucellosis cause?

A

Malaise, night sweats, muscle aches, not usually fatal.

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30
Q

What is anthrax caused by?

A

Bacillus anthracis: gram-positive, endospore-forming aerobic rod. Found in soil and primarily affects grazing animals. Spores introduced into the body are taken up by macrophages and germinate, enter the bloodstream and release toxins.

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31
Q

How is anthrax treated?

A

Treated with ciprofloxacin or doxycycline and through vaccination of livestock

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32
Q

What are the virulence factors that bacillus anthraces produces?

A

1) Protective antigen: binds the toxins to target cells, permitting their entry
2) Edema toxin: causes local swelling and interferes with phagocytosis
3) Lethal toxin: targets and kills macrophages
4) Amino acid capsule that avoids an immune response

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33
Q

Cutaneous anthrax

A

Endospores enter through a minor cut. 20% mortality without treatment.

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34
Q

GI anthrax

A

Ingestion of undercooked, contaminated food. 50% mortality rate

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35
Q

Inhalational (pulmonary) anthrax

A

Inhalation of endospores. Bacteria enter the bloodstream; progresses into septic shock. Near 100% mortality rate!

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36
Q

Ischemia

A

Loss of blood supply to tissue

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37
Q

Necrosis

A

Death of tissue

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38
Q

Gangrene

A

Death of soft tissue

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39
Q

Gas gangrene

A

Caused by clostridium perfringens (exam!) which is a gram-positive, endospore forming anaerobic rod. Grows in necrotic tissue, produces toxins that move along muscle bundles

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40
Q

How is gas gangrene treated?

A

Surgical removal of necrotic tissue and/or use of a hyperbaric chamber

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41
Q

What are cat and dog disease?

A
  • Pasteurella multocida (gram-negative rod) causes sepsis.

- Staphylococcus, streptococcus, corynebacterium

42
Q

What is cat scratch disease caused by?

A

Bartonella henselae. Aerobic, gram negative. Lives in RBC’s in cats, carried in the blood of 50% of cats. Multiplies in the digestive system of cat fleas. Cat claws contaminated with flea feces scratch humans. Forms a papule at infection site and swollen lymph node

43
Q

Rat Bite fever is caused by?

A

Transmitted via rat bites. Streptobacillary rat bite fever. Found in NA. Caused by streptobacillus moniliformis which is a filamentous, gram negative, pleomorphic bacteria.

44
Q

Spirillar fever

A

Caused by spirillum minus. Similar to streptobacillary rat-bite fever

45
Q

Plague

A

Caused by yersinia pestis, a gram negative rod. Transmitted by rat flea. Endemic to rats, ground squirrels, and prairie dogs

46
Q

What is a defining characteristic of spirochetes?

A

Flagella inside the plasma membrane

47
Q

What are symptoms of the plague?

A

Bacteria enter the bloodstream and proliferate in lymph tissue causing intense swellings called buboes.

48
Q

Lyme disease is caused by?

A

Borrelia burgdorferi. Most common tick borne disease in the US.

49
Q

What is the most common reservoir for lyme?

A

Field mice. Nymphal stage of the Ixodes tick feeds on mice and infects humans. Ticks feed on deer but are not infected. Ticks must attach for two to three days to transfer bacteria.

50
Q

First phase of lyme disease

A

Bull’s eye rash, flulike symptoms

51
Q

Second phase of lyme

A

Irregular heartbeat, encephalitis, facial paralysis, memory loss

52
Q

Third phase

A

Arthritis due to an immune response

53
Q

How is lyme borreliosis (lym disease) diagnosed?

A

ELISA, indirect fluorescent-antibody FA test or Western blot. Treated with antibiotics.

54
Q

What does HME stand for?

A

Human monocytotropic ehrlichiosis. Caused by Ehrlichia chaffeensis. Gram-negative, rickettsia-like, obligately intracellular. These form aggregates in monocytes.

55
Q

What is the vector for HME?

A

Lone Star tick is the vector; reservoir is the white-tailed deer

56
Q

What is HGA?

A

Human granulocytic anaplasmosis caused by anaplasma phagocytophilum. Vector is the Ixodes tick.

57
Q

EXAM: What is typhus caused by?

A

Rickettsia. Obligate intracellular parasites. Infect the endothelial cells of the vascular system. Block and rupture small blood vessels. Spread by arthropod vectors.

58
Q

What causes typhus fever?

A

Rickettsia prowazekii. It is carried by the body louse Pediculus humans corporis

59
Q

What causes endemic murine typhus?

A

Rickettsia typhi. Transmitted by the rat flea. Murine = mouse, rodents are common hosts. Indistinguishable from typhus fever.

60
Q

EXAM: Rocky Mountain spotted fever (tickborne typhus)

A

Caused by rickettsia rickettsii. Spread by wood ticks, dog ticks. Measles-like rash, also appears on palms and soles. Mortality rate higher than others 20% instead of 5%

61
Q

What is a common cause of childhood cancer in Africa?

A

Burkitt’s lymphoma, timor of the jaw due to epstein barr virus (human herpesvirus 4). Malaria suppresses the immune system response to this virus.

62
Q

Infectious mononucleosis is caused by?

A

Epstein-Barr virus. Transmitted via saliva with an incubation of 4 to 7 weeks.

63
Q

What are the symptoms of infectious mononucleosis?

A

Fever, sore throat, swollen lymph nodes, enlarged spleen. Replicates in resting memory B cells

64
Q

Malaria is transmitted via..

A

Mosquito bite transmits sporozoite into bloodstream.

65
Q

What is the cycle of malarial transmission?

A

Sporozoite enters the liver cells (schizogony) resulting in release of merozoites into bloodstream. Merozoites infect RBC’s and again undergo schizogony. This ruptures RBC’s releasing toxins. Chills and fever alternate. Some merozoites develop into gametocytes and are taken up by a mosquito, repeating the cycle.

66
Q

What causes malaria?

A

Plasmodium parasite. Transmitted by Anopheles mosquitoes. Affects 300-500 million globally, 2-4 million deaths annually

67
Q

Why is it difficult to develop a vaccine?

A

Plasmodium rapidly mutates and evades immune response. Difficult to diagnose.

68
Q

What are prophylactic treatments?

A

Chloroquine. Malarone.

69
Q

What is the main treatment for malaria?

A

Artemisinin

70
Q

What is leishmaniasis?

A

Protozoan parasites of the genus leishmania. Transmitted in saliva from female sandflies.

71
Q

Leishmania donovani

A

visceral, invades internal organs

72
Q

Leishmania tropica

A

cutaneous; forms a papule that ulcerates and leaves a scar

73
Q

Leishmania braziliensis

A

Mucocutaneous, affects mucous membranes

74
Q

Babesiosis

A

Caused by Babesia microti. Carried by Ixodes ticks. Resembles malaria. Parasites replicate in RBC’s and cause fever, chills, night sweats. Treated with atovaquone and azithromycin

75
Q

Schistosoma haematobium

A

Urinary

76
Q

Schistosoma japonicum

A

Intestinal inflammation, found in Asia

77
Q

Schistosoma mansoni

A

Intestinal inflammation, found in South America

78
Q

EXAM: Kawasaki syndrome

A

Acute febrile illness of unknown etiology. Most often affects younger children.

79
Q

Signs and symptoms of Kawasaki

A

High fever, widespread rash, hands and feet swelling, swollen lymph glands. Treated with aspirin.

80
Q

Epstein-Barr virus associated with

A

Multiple sclerosis, autoimmune attack on nervous system.

81
Q

Hodgkin’s lymphoma (Epstein-Barr associated)

A

Tumors of the spleen, lymph nodes and liver

82
Q

Nasopharyngeal cancer

A

Epstein Barr associated

83
Q

Cytomegalovirus (human herpesvirus 5)

A

Remains latent in white blood cells. Infected cells swell (“owl’s eyes” inclusions). May be asymptomatic or mild in adults.

84
Q

Cytomegalic inclusion disease (CID)

A

Transmitted across the placenta; causes mental retardation or hearing loss in newborns. Transmitted sexually, via blood, saliva or by transplanted tissue.

85
Q

Chikungunya virus

A

Related to virus causing western and eastern equine encephalitis. Transmitted by Aedes mosquitoes. High fever, severe joint pain, rash, blisters but low death rate.

86
Q

Yellow fever

A

Virus is injected into the skin from Aedes aegypti mosquito. Fever, chills, headache, nausea, vomiting. Jaundice from liver damage. Endemic in tropical areas. No treatment. Attenuated vaccine.

87
Q

Dengue and severe dengue

A

Milder than yellow fever, transmuted by A. aegypti. Endemic to Caribbean and tropical environments. Asymptomatic and mild (dengue) to severe bleeding and organ impairment (severe dengue). No animal reservoir. No vaccine or effective drug treatment.

88
Q

Marburg virus (Emerging Viral Hemorrhagic Fevers)

A

Also called green monkey virus. Transmitted via African monkeys. Headache, high fever, vomiting blood, profuse bleeding internally and externally.

89
Q

Lassa fever (EVHF)

A

Arenavirus, found in rodent urine in West Africa

90
Q

Ebola hemorrhagic fever (EVHF)

A

Caused by ebolavirus, a filovirus similar to Marburg virus. Reservoir is the cave dwelling fruit bat near the Ebola River in Africa.

91
Q

How is Ebola spread?

A

Via contact with infected body fluids. Damages blood vessel walls and interferes with coagulation such that blood leaks into surrounding tissue. Mortality rate of 90%.

92
Q

Hantavirus pulmonary syndrom (Emerging Viral Hemorrhagic Fever)

A

Caused by Sin Nombre virus. Fatal pulmonary infection where fluids fill the lungs. Found in western U.S.

93
Q

Hantavirus hemorrhagic fever with renal syndrome

A

Found more in Asia and Europe. Affects kidney function

94
Q

Chagas’ Disease (cause, vector, reservoir)

A

American Trypanosomiasis. Caused by Trypanosoma cruzi which is a flagellated protozoan. The reservoir is rodents, opossums and armadillos. Vector is the reduviid bug (kissing bug) which poops trypanosomes into bite wounds of humans.

95
Q

What is the chronic form of Chagas?

A

Megaesophagus and megacolon, death due to heart damage. Therapy is difficult due to trypanosome multiplying intracellularly.

96
Q

What are the 4 major types of plasmodium parasites causing malaria?

A

1) Plasmodium vivax - mildest but most prevalent form, dormant in liver.
2) Plasmodium ovale and 3) Plasmodium malariae - benign; restricted geographically
4) Plasmodium falciparum - most deadly, severe anemia, blocks capillaries, affects the kidneys, liver and brain

97
Q

Bubonic plague

A

Bacterial growth in blood and lymph. Most common form. 50-75% mortality rate.

98
Q

Septicemic plague

A

septic shock due to bacteria in the blood

99
Q

Pneumonic plague

A

bacteria in the lungs, easily spread via airborne droplets, near 100% mortality rate.

100
Q

Relapsing fever

A

Caused by borrellia, a spirochete. Transmitted by soft ticks that feed on rodents. High fever, jaundice, rose-coloured skin spots. Treated with tetracycline