Final overview 30-41 Flashcards
What to treat chlaymidia with
symptoms
-Male - urethritis, epididmytis
Female - cervicitis, sterile pyuria, ectopic pregnancy, infertility
Chlamydia trachomatis
-replicates inside cell
- Initial infection is mild and self-limited
- antibodies against the major outer membrane protein can neutralise organisms - can get latent infection
- recurrent infection can produce severe inflammation resulting in tissue damage and scarring
- due to exaggerated host CMI response
- because cross reacting heat shock protein aggravated by persisting intracellular chlamydia antigen so body reacts to own heat shock protein get damage
urine test males, vaginal swab females
AZITHROMYCIN this works by binding to the 50S subunit of the bacterial ribosome
what to treat gonhorrhea with
Niserrea gonorrhoea
-has pillin , adherence proteins, toxins
Urethral infection in males - most are symptomatic, anterior urethritis - discharge and dysuria
- is easy if you use high does of cefriaxoane and azithromycin
- cannot use only azithromycin because it is resistant
Complications of gonhorrhea in males and femals?
- epididymitis
- can also get rectal infection
- pharangeal infeciton - from oral sex
- endocervical infection in females but normally asymptomatic (if symptomatic then will get vaginal discharge)
- Pelvic inflammatory disease -
PID
primary cervicitis, infection may spread
-long term - csan get chornic pain, inferitlity, ectopic pregnancy
Symptoms - vainal discharge or bleeding, signs - abdominal tenderness
Caues
- chlamydia
- gonohhroea
Treatment 0 depedns on cause
Ceftriazone, plus dozycyline
Complications - chronic pain, inferitlity
test for glandular fever
Take blood sample - white cells - lots of cytotoxic lymphocytes going to the site of infection to kill the viral producing cells
- abnormal liver function tests
- also have monospot test (antibodies stick to the virus)
- also have a test that detects antibodies sticking to other stuff e.g it binds to guinea pig, sheep, horse RBCs - something on the surface of these RBCs that will stic to these - heterophile antibodies (dont actually attatch to EPV).
how to test for EBV, CMV
EBV - lymphocytosis, atypical lymphocytes, abnormal liver function tests, monospot test, antibodies that bind to EBV preset or EBV antigens present
CBV - lymphocytosis, atypical lymphocytes, abnormal liver functon tests
-detection of antivodies - igM or igG to CMV, detection of CMV In blood
what are some complications from hiv - aids
oral infection - oral candidis
- also can get kaposis sarcoma
- and meningitis
Type 2 Hypersensitivity reactions
-what immune processes occur
- antibody dependent cellular cytotoxicity
- Complement activation, leading to MAC to kill cell
- C3b activation of complement which attracts neutrophils for phagocytosis
- also lead to complement
- this can lead to tissue damage where antibodies are bound and also activate c3b which will be an attachment for neutrophils
- neutrophils will phagocytose this
Mechanisms of tolerance
1.Clonal deletion - central - bone marrow and thymus (deletes self reacting t or b cells)
ALso have peripheral tollerance
- can get signal to self antigen, however no response of danger signals so no response = anergy
- have t regulator cells that control self-reactive cells
- some parts of our body that we make antigen, and immune system doesnt get to see it. e.g privileged sites e.g testes and ovaries
- sequestrated antigens
- if damage these areas, and teh antigens become accesible then could get immune mediated damage
Atopic eczema
- in epidermis, profilaggrin is converted to filaggrin making a natural moisturising factor that helps to cement the brick wall together
- can get a mutation with this gene, and found that these people are far more likely to have atopic eczema
- as if there is none of the filaggrin, then will beable to get things get through the dermis layer easier
-can do patch testing
2 things you can get with aids
- candida albicans oesophagitis (oral and oesophageal mucosal disease due to this)
- Cryptococcus neoformans (meningitis)
what does candida albicans look like on microsscpoy?
It is seen as black yeast, with hyphae on gram stain
-grows well on blood agar
Cryptococcus neoformans
- pulmonary infection - due to inhalation of aerosolised fungus from environment
- is spread via blood to CSF
- meningitis in immunodeficient people
- chronic lymphocytic meningitis - slow deterioration of mental state, with head ache and fever
Cryptococcus neoformans
- pulmonary infection - due to inhalation of aerosolised fungus from environment
- is spread via blood to CSF
- meningitis in immunodeficient people
- chronic lymphocytic meningitis - slow deterioration of mental state, with head ache and fever
-cryptococcal antigen positive in blood test
gram negative bacilli found in lung
Pseudomonas aeruginosa
