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Pathology -- Infectious Disease > Infectious Disease -- Bacterial V - Anthrax, Syphilis, and Mycobacterial Infections > Flashcards

Infectious Disease -- Bacterial V - Anthrax, Syphilis, and Mycobacterial Infections Flashcards

1
Q

Anthrax causative organism?

A

Bacillus anthracis

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2
Q

Bacterial features of Anthrax?

A

Highly Pathogenic
Encapsulated
G+ Rod
Spore Producing

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3
Q

Method of Anthrax transmission?

A

Contact with animals, animal hides, or animal products

Inhalation of powder if weaponized

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4
Q

Which animals are most prone to be all full of Anthrax

A

Sheep and Goats

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5
Q

Progresion of Anthrax

A

Cutaneous – Small hemmorrhagic pustule into black eschar
Painful Lymphadenitis
Pulmonary – Woolsorter’s Disease
Extensive pneumo. w/ serofibrinous exudation
Septicemia, DIC, Death

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6
Q

Anthrax bacteremia may give rise to…

A

meningitis

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7
Q

Virulence factors associated with Anthrax

A

Antiphagocytic Activity/Leukopenia inducing
Edema Factor
Cytotoxic Factor

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8
Q

Why is Anthrax considered a good potential weapon of biological terrorism

A

Stability in Environemnt
High Virulence
Ease of Respiratory Transmission

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9
Q

How is Anthrax controlled

A

There is a vaccine (limited use in US)
Penicillin
Doxy

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10
Q

Mycobacterium tuberculosis is what type of staining

A

Acid Fast Staining

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11
Q

Speed of Mycobacterium tuberculosis growth

A

pretty slow

Mostly facultative intracellular invaders

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12
Q

Virulence factors associated with Mycobacterium tuberculosis?

A

Glycolipids promote intracellular resistance to intra killing
Inhibit interferon-activation of macrophages
Prevent phago-lysosomal membrane fusion
Stimulate destructive cell-mediated inflammatory injury

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13
Q

Mycobacterium tuberculosis histologic hallmarks

A

Caseating Granulomas

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14
Q

Transmission for Mycobacterium tuberculosis

A

Requires Sustained Contact

Associated with Poverty, Malnourishment, Immunosuppression (AIDS), Elderly, Alcoholism

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15
Q

Pathogenesis of Mycobacterium tuberculosis?

A

Destructive lesions caused by Type 4 rxn

Granuloma

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16
Q

Components of a Granuloma

A

Plump, Round Histiocytes (epithelioid cells)
Langerhan’s multinucleate giant cell
Peripheral collar of fibroblasts
Lymphocytes

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17
Q

What causes granuloma formation.

A

Inability of macrophage to kill bacteria –> Persistent Infections
Development of TH1 cells –> IFN-g
TNF induces chemotaxis of more monocytes + epitheloid

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18
Q

Key features of a granuloma formation

A

Persistent infection by mycobacterium
Type 4 HS
Synthesis of IFN-g
Granuloma, eventual fibrosis + caseous necrosis

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19
Q

Features of Primary or Latent Tuberculosis

A

Individual lacking previous contact with TB
Formation of Ghon focus in middle of lobes
Typically Causes fibrosis, Calcification (rarely progression)

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20
Q

Who usually has progression of Primary tuberculosis to miliary/meningtis

A

Children

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21
Q

What is a Ghon complex?

A

Primary lung lesion with a caseating granuloma in a draining lymph node

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22
Q

Causes of Secondary Tuberculosis

A

Reactivation

Reinfection

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23
Q

Symptoms seen in secondary tuberculosis

A

Cavitary lesions in apical lobes – Higher oxygen tension
Satellite lesions in nodes are distinctly rare
Fever, Night Sweats, Weakness, Loss of Appetite, Weight Loss, Productive Cough, Blood-streaked symptoms

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24
Q

What is seen when secondary tuberculosis spreads to tertiary?

A

Extension to other parts of the lung, empyema
Miliary tuberculosis (bacteremia)
Isolated-organ TB

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25
Q

How does the TB spread out of the lungs

A

Drainage of organisms into lymphatic leads to organism dumping into the blodo via thoracic duct

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26
Q

How to diagnose Mycobacterium tuberculosis?

A

Gold Standard – Positive Culture Organism (not AFB)
AFB in sputum
Characteristic X ray findings
Quantiferon Test

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27
Q

Characteristic findings of Mycobacterium tuberculosis infection

A

Cavitary Lesion

Calcification of lymph nodes

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28
Q

What is a Mycobacterium tuberculosis Quantiferon Test?

A

An in vitro measure of interferon production in response to exposure to Mycobacterium tuberculosis

29
Q

What happens to most folks exposed to Mycobacterium tuberculosis

A

Pretty much Nothing.
No infection or latent infection.
Change in PPD status

30
Q

Progression to Secondary Mycobacterium tuberculosis adds in what symptoms

A

Pulmonary symtpoms
AFB in sputum
X ray changes

31
Q

Most common presentation of Tertiary TB

A

Miliary TB in lung

32
Q

Pathogenesis of Leprosy

A

Involvement of skin – Macular, Papular, or Nodular Lesions
Infection of Nerves – Ulnar, Peroneal
Greatest effects in coolest parts of the body

33
Q

Organism responsible for leprosy

A

Mycobacterium leprae

34
Q

Two types of leprosy

A

Tuberculoid

Lepromatous

35
Q

What happens in lepromatous leprosy

A

Lack of TH1 mediated immunity
Proliferation of Organism in macrophages (foam cells)
Contagious

36
Q

What is some generic crap you should know about Syphilis

A

Microaerophilic spirochete
Outer sheath that masks bacterial antigens
Sexual and transplacental transmission

37
Q

Organism responsible for Syphilis

A

Treponema pallidum

38
Q

How do diagnose Syphilis

A

RPR/VRDL - Nonspecific Cardiolipin antibody test
Dark field microscopy + silver stain
Specific fluorescent trep. antibody (FTA-Abs)

39
Q

Dark field microscopy can diagnose which stages of Syphilis

A

Primary and Secondary

40
Q

RPR/VRDL have false positives in what illnesses

A

Mono, Lupus

41
Q

Antibodies vs. Presence of Organism.

Primary Syphilis

A

No Antibodies + Organism Present

42
Q

Antibodies vs. Presence of Organism.

Secondary Syphilis

A

Antibodies + Organism Present

43
Q

Antibodies vs. Presence of Organism.

Tertiary Syphilis

A

Antibodies + No organisms

44
Q

Syphilis pathogenesis

A
  • Scarcity of treponemes and inflammatory infiltrate suggest central role for immune response in lesions.
  • Chancres infiltrated with TH1
  • Antibody response doesn’t eliminate the infection
  • Endarteritis central to pathology of all lesions (Vasculitis)
45
Q

Type of infiltrate associated with Syphilis

A

Lymphoplasmacytic

like Lyme Disease

46
Q

Primary Syphilis is characterized by…

A

Development of Hard Chancre + Spirochete invasion
Intense mononuclear infiltrate w/ plasma
Obliterative endarteritis
Vessel wall Infiltrates

47
Q

Secondary syphilis occurs ____ weeks after primary chancre

A

2-10

48
Q

Describe Secondary Syphilis

A

Painless Macular Plaques of Skin ad Mucous Membranes
Condylomata Lata
Widespread muco-cutaneous regious/Red-brown lesions

49
Q

What are condylomata lata

A

Wart-like lesions on the genitals in secondary syph

50
Q

Tertiary syphilis requires a latent period of at least…

A

5 years

51
Q

System most commonly affected by Tertiary Syphilis

How?

A

Cardiovascular
Damage to Proximal Aorta/Aortic Root
Obliterative Endarteritis
Aneurysms and Dissections/Coronary Insufficiency

52
Q

Non-CV symptoms of Tertiary Syph

A
  • Neurosyphilis (Chronic Meningoencephalitis, Tabes Dorsalis, Charcot’s Joint)
    Syphilitic Gumma
53
Q

What is tabes dorsalis

A

Foot Drop

54
Q

What is Charcot’s Joint

A

Sensry loss causes person to lose the ability yo feel their feet
People knock them into the ground, eventually hurt the ankle/knee

55
Q

CSF Findings in Neurosyphilis

A

Pleiocytosis
Increased Protein
Decreased Glucose

56
Q

Pathology of Tertiary Syphilis

A

Lymphoplasmacytic Infiltrates
Obliterative endarteritis
Focal epithelioid Granulomas
Type 4 rxn

57
Q

What happens in obliterative endarteritis

A

Endothelial proliferation and intimal fibrosis

58
Q

The important details about Congenital syphilis

A

Fetus born within 5 years of infection
Can cause late abortion
Saddle Nose Deformity, Saber Shin, Hutchison teeth
Liver and Lungs fucked up

59
Q

Symptoms specific to late occuring form of congenital syphilis

A

Interstitial Keratitis and CN8 deafness

60
Q

Mycoplasma cause two types of disease. Name them and a causative organism for each.

A

Pneumonia - Mycoplasma pneumoniae

Urethritis - Ureaplasma urealyticum, Mycoplasma hominis

61
Q

What is BCG vaccine

A

A vaccination for TB

Extremely variable, not universally protective

62
Q

How is leprosy transmitted

A

respiratory aerosols

63
Q

Leprosy is propagated in what animal?

Why?

A

Armadillo

Low Core Temperature

64
Q

Key feature of nerve invovlement in lepros?

A

anesthesia of the skin

65
Q

Tuberculoid Leprosy has a strong TH_ response

A

1

TH1 sucks in lepramatous

66
Q

What do tuberculoid leprosy granulomas look like?

A

Indurated, flat, hyperpigmented margins with depressed pale centers

67
Q

Is it easy to find bacteria in a tuberculoid lep. granuloma?

A

Paucibacillary (few bacteria seen in lesions)

68
Q

Describe lepramatous leprosy lesions

A

Diffuse with lipid laden macrophages containing many bacteria (multibacillary)

69
Q

Which form of leprosy is contagious?

A

leptramatous

Pathology -- Infectious Disease (23 decks)

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