Chapter 23

Question 1

lacerations, contusions,

Answer 1

Laceration: occur when tissue is torn
Contusion: caused by blow that crushed tissues

Question 2

B) What is collagen, fibronectin, fibrinogen, and fibrin?

Answer 2

Collagen:a firbrous material the main supportive protien of skin

Fibronogen: blood protien

Fibronectin: is a fibrous glycoprotien occurs both in circulation and tissue, and binds cells and other tissue substances together

Fibrin: fibrinogen is converted to bibrine whis forms clots in the damaged vessles.

Question 3

C) How does wound healing happen? [Figure 23.1]

Answer 3

1. cut blood vessels bleed into the wound. fibrin froms clots in severed capillaries
2. blood clot forms in the wound and phagocytes destroy microbes
3. wound fills with granulation tissue and blood sessels regrow.
4. granulation tissue shrinks and fibroblasts secrete collagen, forming scar tissue. Collagen contracts and epithelium regenerates

Question 4

1) What is granulation tissue?

Answer 4

Tissue made to fill in damaged area it is red, translucent fibrous material.

Question 5

D) What is an abscess and when do they form? How are they treated?[Figure 23.2]

Answer 5

is a localized collection of pus surounded by inflamed tissue.
Form as a result of the bodies immune defenses. helps localize infection.
Issue: in trying to treat them their chemical nature intereferes with some anitbiotics so they must be surgically drain in order to fix them.

Question 6

1)What is pus?

Answer 6

a thick yellowish fluid composed of living and dead leukocytes, tissue debres, and protiens

Question 7

E) What type of wound is more likely to have an anaerobic infection? Which bacteria is usually the culprit?

Answer 7

puncture wounds, small diameter, deep an contaminated with dirt.

Question 8

A) What are the consequences of a wound becoming infected? [Table 23.1]

Answer 8

Staph aureus
Strep pyogenes
pseudomonas aerugosa

Question 9

B) Which Staphylococcus species infect human wounds? [Figure 23.3 and 23.4]

Answer 9

aureus

Question 10

1) What are the symptoms? What does pyogenic mean?

staph aureus

Answer 10

pyogenic: meaning they generate pus.
Symptoms: inflamation, swelling, red, tender, fever
tss can occur is it is toxin producing strain: highfever, drop in bp, and shock

Question 11

2) What are Staphylococcus aureaus’ virulence factors? What are superantigens?

Answer 11

proteinase, lipase, and hyaluronidases together cause tissue damage. capsules, coagulase, and protein A (is released from bacterial surface and reacts with circulating antibodies and result in complement system and therefore intense inflamatory response) protect cell from attack.
Superantigens: produced by some strains. these endotoxins can react with hleper t cells activating then and cause them to release cytokines leading to toxic shock.

Question 12

3) How do individual get these infections?

Answer 12

some are carriers, and so can infect themselves or others with open wounds.

Question 13

4) What is MRSA, VISA, VRSA and what problems for treatment do they pose?

Answer 13

MRSA- methycillin resistant staph a ( all b-lacams), but can be treated with vancomycin, sulfa drugs,tetracyclines, clindamycin
VISA- Vancomycin-intermediate staph a. oxalynidols are effective in treatment
VRSA- Vancomysin resistant staph a.

Question 14

C) What causes “flesh-eating disease”? [Figure 23.5]

Answer 14

Strep pyogenes

Question 15

1) What are the symptoms?

strep pyogenes

Answer 15

necoritzing fascitis (inflamation of the facia and deteriorization) severe pain, swelling, fever, and confusion. overlying skin becomes stretched and discolored due to swelling, can lead to shock and death

Question 16

2) How does this infection progress?

strep pyogenes

Answer 16

-f protien that helps with colonization of a wound.
destroys the subcutaneous tissue and fascia.
Some cases can destroy the m.
Does damage with enzyme
-Strptolysins which break down the blood clots
-Hylurondases- break down connections between cells
- deoxyribonucleases
Necrotizing ones produce
exotoxin A a super antigen that causes shock
exotoxin B protease destroys the tissue.

As tissues break down osmotic pressure inc, and fliuds move to area causing swelling
as the bacteria grow they produce m proties. This binds to fibrinogen. this complex then binds to nuetrophils causing then to release strong inglamatory molecules ( heparine binding protiens) wich increase the permeability of vessels.
Mprotiens also can stop phagocytosis be breaking down C3B.

-SPE: strep pyogenic exotoxins- super antigens, which activate t cells causing them to realease cytokines. high levels in blood stream = tss

Question 17

3) How does this infection happen? How is it treated?

flesh eating disease

Answer 17

diabetes cancer, and alchohol

treated with surgery/ treatment

Question 18

D) What are the symptoms of a Pseudomonas aeruginosa infection? What are it’s virulence factors? [Figure 23.6]

Answer 18

chills, fever, skin lesions and shock
virulence factors:
exotoxin a: stops protien synthesis in the host
exoenzyme s: works with protease to break down lechitin, an important lipid in cells.
pigment pycocyann: uses up iron from the environment and inhibits the growth of other bacteria, and inhibits the nasal cillia and repiratory epihlium

Question 19

1) How are these infections acquired and how are they treated? pseudomonas aerugosa

Answer 19

moisture, so plants, comsmetics etc.

floronquoles, gentamycin, and impenim

Question 20

A) What are the symptoms of lockjaw? What causes it? What mechanisms does it use to infect? [Figure 23.7, 23.8, 23.9 and Table 23.3]

Answer 20

Clostridium tetani
Symptoms:Bbegins with restlessness, difficulty swallowing,and sometimes seizures. painful and uncontrolable cramp like muscle spasms,spasms begin with jaw muscles.spasms can cause to fractures. many will die of pneumonia from lung damage caused by regurgitated stomach contents into the lung.

Virulance factors: bacteria stays in wound but releases toxins
-tetanospasmin: (ab pprotien) b portion attatches to the receptors of motor neurons then a portion goes in via endocytosis then this caries it to the spinal cord where it prevents the neurons from releasing the inhibitory neurons blocking their actions and causing muscles to sams with no control. Typically spreads from wound to the side opposite to the spinal collumn then downward. If it enters bloodstream it will first affect the brain affecting the jaw first.

Question 21

2) How is lockjaw acquired?

Answer 21

eating foods with contaminated spores… so fecal contamination. tattoos, splinters, etc

Question 22

3) What is the treatment? How can it be prevented? [Table 23.2]
tetanus

Answer 22

keeping up on the vaccine/
treatment: tetanus immune globuline: a preperation of antibodies to the toxin. they bind to it ( if unbound ot neuron), but if bound all they can do for that is give m. relaxents.

Question 23

B) What are the symptoms of clostridial myonecrosis? What causes it? What mechanisms does it use to infect? [Figure 23.10 and Table 23.4]

Answer 23

“gas gangrene”
cause clostridium perfingens.
symptoms: swelling, thin bloody/brown fluid leaks from wounds (may be frothy because of gas bubbles) skin becomes tight and black. then coma

Virulance factors: gorws in poorly oxigenated and dead tissues.

-alpha toxin: destroys lechitin leading to cell lysis in host cells.
-Collagenase
- Hyalurinase:
As ti breaks down food it produces co2 which accumulate in the tissue. if in blood stream can kill rbcs, and damage vessels. not serious until it invades the m for unknown reasons.

Question 24

1) How does one acquire this infection and how is it treated?
tetanus

Answer 24

dirt and animal feces enter a wound. also found in some vaginas of healthy women, and if they have self abortion can lead to it.
treatment: surgical removal of all dead tissues, penicillins. also hyperbaric oxygen chambers to oxygenate the tissues better.

Question 25

C) What are the symptoms of actinomycosis? What causes it? What mechanisms does it use to infect?[Figure 23.11, 23.12 and Table 23.5]

Answer 25

“lump jaw”
cause: actinomyces (most cases)
Symptoms: slow progressive swellng under skin that eeventually burst and drain pus. days later more can reapear in same area. usually in neck and jaw, but sometimes in genital tract of women.
- diagnosed by yellowish colonies called sulfur granules found in wound drainage

Question 26

1) How does one acquire this infection and how is it treated?actinmycosis

Answer 26

puncture of skin, can be part of normal microbiota of mouth, intestines, respiratory tract or vagina.usually begins with a mouth wound (not person to person)
treated: penicillin and tetracyclines

Question 27

A) What are some diseases that can be transmitted through a human bite?

Answer 27

usually normal microbiota of mouth, and sometimes syphillis, hep b and c

Question 28

B) What are the symptoms of an infected human bite? What can cause the infection? What mechanisms do they use to infect? [Table 23.6]

Answer 28

symptoms, swelling, bad smelling pus.
Cause: anaerobic strep, fusiform, spirochetes, anaerobic gram neg rods, sometimes staph aureus
release toxins and enzymes

Question 29

1) What is a synergistic infection? human bite

Answer 29

sum effect of all organisms together is greater than the sum of their individual effects

Question 30

2) How can these infections be treated? human bite

Answer 30

opening wound and cleaning it. a coupld antibmicrobials because multiple bacteria, some are resistant to penicillin ect.

Question 31

C) What are the symptoms of a bite wound that is infected with Pasteurella multocida? [Table 23.7]

Answer 31

swelling, and abcess. from animals

Question 32

1) What details are known of it’s pathogenesis?

pasteurella multocida

Answer 32

some produce toxin that kills cells by affecting protien synthesis, and cell cycle regualtion. if left untreated can lead to endocarditis and menningitis

Question 33

2) How does one acquire this type of infection and how is it treated?
pasteurella multocida

Answer 33

in human, and other animal bites, most common in cat bites. 
amoxicillin clavimante ( combo of amox. with b lactamase inhibitor.

Question 34

D) What are the symptoms of bartonellosis? What causes it? What mechanisms does it use to infect?[Figure 23.13 and Table 23.8]

Answer 34

“cat scratch disease” swelling, pus filled pimple, lymphnode enlargment
Cause: Baronella henselae

VIrulence: not known.
sometimes in the blood stream causing peliosis hepatitis and bacillary angiomatosis

Question 35

1) How do individuals acquire this infection and how is it treated? bartonellosis

Answer 35

bites, fleabites, saliva

Treated: ampicillin

Question 36

E) What are the symptoms of streptobacilliary rat bite fever? What causes it? What mechanisms does it use to infect? [Table 23.9]

Answer 36

bite heals and 10 days later they develop chills fever, m aches,vomiting, sometimes a rash followed by joint pain.
Cause: streptobaccillus moniliformis
It can spontaneously form L forms
through bite, sratch, sometimes ingestion. Most recover within 2 weeks, but complications such as brain abcesses, or infected heart valves.

Question 37

1) What are L-forms? rat bite fever.

Answer 37

variants that lack a cell wall.

Question 38

2) rat bite fever how are they treated?

Answer 38

treatment: penicillin

Question 39

A) What are the symptoms of sporotrichosis? What causes it? What mechanism does it use to infect? [Figure 23.14, 23.15 and Table 23.10]
1) How does one acquire the infection and how is it treated?

Answer 39

“rose gardener diseases”
Symptom: chronic ulcer froms on wound site., along with slowly progressing series of ulcerating nodules develop. lymph nodes enlarge.
Cause: fUNGI Sporothrix schenckii ( lives in soil and vegiatation)

multiplying fungi cause a red pimple that bleeds ( no pus) and the infection follows lymphatic vessels. Without treatment it can be chronic and go for years.
warm temperate climates working in greenhouse, carpenter etc.
wear gloves and long sleeved shirt
Treatment: oral treatment of potassium iodine