Infectious Diseases Flashcards
What are the 3 categories of skin flora
Diphtheroids
Staphylococci
Yeasts
Example of diphtheroid
Propionibacterium acnes
What causes hair follicle infections
Staph aureus
Causes scalding skin syndrome
Staph aureus
Causes impetigo
Step pyrogenes
Causes rocky mountain spotted fever
Rickettsia rickettsii
Causes Lyme disease
Borrelia burgdorferi
How does s aureus avoid host defenses
Has a capsule that prevents phagocytosis
Produces enzymes that degrade tissue
What is folliculitis
Follicle plugged with necrotic tissue
What does inflammation response signal
Attraction of neutrophils
What happens if an infection spreads to adjacent tissue
An abscess forms
What is a small skin lesion called
Furuncle
What is a skin lesion called when it involves multiple follicles
Carbuncle
How do you treat hair follicle infections
Drain boil
Antibiotics
What is s aureus resistant to
Penicillin
What is streptococcal impetigo
Superficial skin infection involving epidermis
From infected non apparent wound
What is a key detail of impetigo
Blisters that break and release plasma
The plasma looks yellow when dry
Details about step pyogenes
Gram pos
Beta hemolytic
Group A
Produces extra cellular products
What can s pyogenes be treated with
Penicillin
Why is s pyogenes called group A strep
Group A cell wall polysaccharide
What is a product pyogenes can produce
Protease
Flesh eating
Causes measles
Rubeola virus
Causes rubella or German measles
Rubella virus
Causes fifth disease
Parvovirus b 19
Causes roseola
Herpesvirus type 6
What causes varicella
Varicella zoster virus
How is chickenpox transmitted
Respiratory secretions and skin lesions
What is incubation of varicella
When is it infective
2 weeks
Infective 1-2 days before rash until they crust over
Describe pathogenesis of varicella
Enter through respiratory route Reliplicates and moves to skin via blood stream Infects living layers of skin Moves to adjacent cells causing lesions Cells lyse Release virus to sensory nerves
What is shingles
Latent infection
Herpes zoster
What allows herpes zoster virus to replicate
Decline in cell mediated immunity
Old age or immunocompromised
Shingles appears in what area
Anywhere
Restricted to area supplied by a sensory nerve
How does body respond to shingles
Inflammation reaction
Memory cells respond
Shingles disappear
What cause cutaneous mycoses
Dermatophytes
What do dermatophytes do
Dissolve keratin in skin for nutrients
What are the 6 steps of wound repair
Vascular spasm to prevent blood loss
Circulating platelets form plug to seal wound
Coagulation
Fibroblasts multiply and form granulation tissue
Granulation tissue is replaced
What type of clotting factors are circulating in blood
Inactivated clotting factors
Like inactivated fibrogen
What causes clotting factors to become activated
Tissue damage
What does fibrinogen convert to
And what causes it to convert
Fibrinogen becomes fibrin
The activation of clotting factors converts fibrinogen
What does fibrin do
Form a mesh
What digests fibrin mesh
Plasmin
Where does plasmin come
Inactivated plasminogen is convert to active plasmin by tissue plasminogen activator
What is pus
Dead neutrophils microorganisms and degraded tissue
Pyogenic means
Pus forming
Pyrogenic means
Fever forming
What helps separate an abscess from normal tissue
Inflammation and clots
Why can having a walled of abscess be bad
It can prevent antimicrobials from reaching the area
Pressure can increase and pathogens can go into blood stream
Area become anaerobic
Are pathogens actively multiplying in an abscess
No
They are not multiplying
What are 4 common bacteria that infect wounds
Staph aureus
Staph epi
Step pyogenes
Pseudomonas eaeuginosa
What is the leading cause of woud infections
Staphylococci
What factors increase the virulence of staph aureus
Coagulase causes clotting to evade phagocytosis
Clumping factor aids in attachment to fibrin
Protein A hide bacteria
Alpha toxin produces hole in host cell membrane
What do staph epi do
Sometimes produce biofilm to prevent phagocytosis
How do you treat wound infections
Methicillin or vancomycin
What does not have a lot of antimicrobial resistance
S pyogenes
Can be treated with penicillin
What are some severe infections caused by streptococci
Pneumonia
Meningitis
Puerperal
Necrotizing fasciitis
What is puerperal
Childbirth fever
Bacterial infection of uterus
What causes necrotizing fasciitis
2 virulent s pyogenes strains
2 extra cellular products produced
Pyrogenic exotoxin A
Exotoxin B
Describe the pathogenesis of necrotizing faaciitis
Colonization enhanced by tissue binding proteins
Subcutaneous fascia is destroyed
Muscle tissue can also be destroyed
Organisms multiply and produce toxins
Organisms and toxins enter blood stream and cause shock
What does pryogenic exotoxin A do
Cause streptococcal toxic shock
What does exotoxin B do
Destroy tissue trough protein breakdown
How do you treat necrotizing faaciitis
Surgery to prevent toxin spread
Maybe amputation
Penicillin if given early doesn’t help against toxins or dead tissue
What is an opportunistic wound pathogen
P aeruginosa
What is p aeruginosa the major cause of
Specifics
Nosocomial infections
Lung infections from contaminated respirator water
Burn infections that turn skin green
What makes aeruginosa virulent
Toxins
And multi drug resistance
Some examples of anaerobic wound infections
Tetanus
Gas gangrene
Lumpy jaw
What causes tetanus
Clostridium tetani
Causes gas gangrene
Clostridium perfringens
Causes lumpy jaw
Actinomycosis israelii
Gram pos filamentous anaerobe
What are the symptoms of tetanus
Painful uncontrolled muscle spasms
Often start with jaw
Describe clostridium tetani
Gram pos
Anaerobe
Rod shaped
Endospore forming
Is tetanus fatal
Yes not in developed world though
Why is tetanus pathogenic
Due to toxin production
What is the path that tetanus toxins take
Blood stream to CNS
What do tetanus toxins do
Block inhibitory neurons so muscles spasm
If inhibitory neurons of brain first affected jaw spasms firsts
Why does tetanus cause death
Paralysis of respiratory muscles
Stomach contents go into lungs
What is tetanus vaccine
Inactivated toxin
What is passive tetanus immunity
Tetanus antibodies
Tetanus immune globulin
What causes swelling in gas gangrene
Gas production
Tissue breakdown
Describe c perfringens
Gram pos Anaerobic Rod Endospore forming In soil
What does c perfringens produce
Alpha toxin which attacks host membranes
Spreads in blood stream leads to red blood cell destruction
What are the areas of upper respiratory system
Ear Eye Sinuses Nasal cavity Tonsils
What are tonsils made of
Lymphoid tissue
What is the role of the mucociliary escalator
Cilia propels mucus up so you can swallow it
Where does the lower Respitory system start
Below epiglottis
What does lower respiratory system include
Larynx Trachea Bronchi Bronchioles Alveoli
What is pneumonitis
Inflammation of lungs
What is pneumonia
Filling of alveoli with pus and fluid
List upper respiratory beacterial infections
Strep throat Pinkye Diphtheria Otitis media Sinus infections
List lower respiratory bacterial infections
Pneumonia
Whooping cough
Tuberculosis
Legionnaires disease
What is strep throat
Streptococcal pharyngitis
What is strep throat caused by
Step pyogenes
Group A
What are 3 complications of strep throat
Scarlet fever
Acute rheumatic fever
Acute glomerulonephritis
What antibiotics treat step throat
Penicillin
Erythromycin
Upper respiratory viral infections
Common cold
Adenovirus sore throat
Lower respiratory viral infections
Influenza
Viral pneumonia( SARS )
Respiratory syncytial virus
Hantavirus pulmonary syndrome
What causes common cold
Rhinovirus
How does rhinovirus infect
Attaches to receptors on respiratory epithelial cells
Multiplies in those cells
Releases more viruses
What causes nasal secretions of cold
Inflammation of injured epithelial cells
When do nasal secretions have high levels of viruses
First 2 or 3 days of a cold
Pneumococcal pneumonia is characterized by
Cough
Sputum
Fever
Chest pain
Describe strep pneumoniae
Gram pos
Diplococci
Thick polysaccharide capsule prevents phagocytosis
80 different strains
When does pneumonia infection develop
When bacteria inhaled into alveoli
What are 3 pneumonia complications
Septicemia
Endocarditis
Meningitis
What is endocarditis
Infection of heart valves
Healthy individuals carry encapsulated strain in throat, why is infection often prevented
Mucociliary escalator prevents lung infection
Risk of infection rises with escalator destruction
Describe the vaccine for pneumonia
Vaccine immunity against 23 strains
Conjugate vaccine for children against 7 strains
What is another term for TB
Consumption
How much of world is infected with TB
One third
Was leading cause of death in 20 the century
How many global TB deaths each year
2 million
How does TB get contracted
Inhalation of organism
Bacteria taken up by pulmonary macrophages in lungs
Resists phagocytosis
When does an intense TB immune reaction occur
2 weeks after infection
What happens to bacilli in TB
Bacilli are lodged in tissue
Then walled off making granulomas
What is a TB granuloma called
Tubercles
Can persist for years
What creates lung cavities
Lysis of macrophages that spill enzymes that degrade tissue
What is the treatment for TB
Attenuated vaccine from M bovis BCG bacille calmette guerin Not very effective Or rifampin and isoniazid Prolonged treatment
What are the targets of rifampin and isoniazid
They target actively growing organisms and metabolically inactive intracellular organisms
What is influenza caused by
Influenza type A
Belongs to orthomyxovirus
Describe influenza type A
Single stranded RNA 8 segments
Spiked envelope
Describe the spikes of influenza envelope
H spike hemagglutinin attached to sialic acids
N spikes neuramidase aids in viral spread by downregulation of sialic acids
How does influenza attach to epithelial cells
H spikes
Spreads by N spikes
How can influenza cause secondary infections
By destroying mucociliary escalator
What are some treatments for influenza and what do they do
Amantadine and rimantadine block uncoating of influenza
Zanamivir and oseltamivir block neuraminidase
What causes influenza pandemics
Major antigenic changes
What occurs in influenza antigenic drift
Changes in hemagglutinin spike
Minimize effectiveness of previous immunity
What occurs in influenza antigenic shift
More dramatic changes
Drastically different strains
Genetic reassortment
What parts of respiratory system are normally sterile
Sinuses Trachea Bronchi Bronchioles Alveoli
What opportunistic pathogen is in nose
Staph aureus
Compare mycoplasm and mycobacterium
Mycobacterium has mycolic acid in cell wall Hard to treat TB Mycoplasm has no cell wall can't be treated Pneumonia type
Where is most flora of digestive system
Oral cavity
Intestines
Esophagus has very little flora
Stomach kills flora
Which intestine has more flora
Large intestine 100 bill per grams of feces Because of abundance of nutrients Source of opportunistic infections Synthesize many vitamins
What bacteria is predominant in large intestine
E coli and other enterobacteria
What 3 bacteria account for most intestinal infections
Vibrio species
Campylobacter jejuni
Enterobacteria
What causes cholera
Details of agent
Vibrio cholerae
Gram neg
Bacillus
Salt tolerant
How much of cholera must be ingested
Large numbers because sensitive to stomach acid
Where does cholera multiply
In small intestine
Adheres to epithelial lining
Describe cholera toxin
Has 2 parts responsible for symptoms
B fragment allows toxins to bind to cells
A fragment. Toxicity causes secretion of Cl and fluid
What is source if cholera
Contaminated water
Crabs and veggies fertilized with human fecal mater
How to prevent cholera
Safe water
Avoid water when traveling
What does e coli cause
Gastroenteritis
Severity Depends on strain
What does e coli produce
Enterotoxin
What are e coli 2 virulence factors
Toxin production
Adherence to small intestine
What are 4 groups of diarrhea causing e coli
Enterotoxigenic
Enteroinvasive
Enteropathogenic
Enterohemorragic
Details about enterotoxigenic
Travelers diarrhea
Adhesins allow intestinal colonization
Some secrete toxins
Details about enteroinvasive
Destruction of intestinal cells leads to bloody diarrhea
Details about enteropathogenic
Outbreaks in hospital nurseries and bottle fed infants
Developing countries
Details about Enterohemmoragic
Found in 1982
Produce toxins that interfere with protein synth
Hemolytic uremic syndrome
O157: H7
What is hemolytic uremic syndrome
Disseminated intravascular coagulation in kidney
What causes e coli epidemics
Person to person
Contaminated food and water
Un pasteurized milk and juice
What are sources of pathogenic e coli strains
Humans
Domestic and wild animals
How to treat e coli in infants
Antibiotics
Antibiotics prolong illness in adults
Causes salmonellosis
Salmonella species
Motile
Gram neg
Enterobacteria
How many serotypes of salmonella are there
2400 serotypes
Most common typhinurium and enteritidis
Where do salmonella adhere
How many are needed
Lower small intestine
Large number
Sensitive to stomach
Where do salmonella multiply
Cell takes up bact in phagocyte
Within phagosome
Discharged through exocytosis
What causes salmonella related dirrhea
Inflammation response increases fluid secretion
What serotypes of salmonella is not easily eliminated
Typhi
Multiply in macrophages and brought to blood stream
Cause septicemia
What serotypes is the exception to the animal source of salmonella
Typhi
Colonization of gall bladder
Typhoid Mary
How do you prevent salmonella
Cook well
Vaccine against typhoid fever
Remove gallbladder of carrier
When are people a symptomatic of hep A
Less than 6 years old
How long does it take to recovery from hep a
2 months
29% of adults hospitalized
Description of hep a pathogenesis
From infected food or water Reaches liver Damages liver as it replicates Virus into bile Eliminated via feces
What is a common source of hep a
Raw shellfish
Restaurants
Describe hep a virus
Single strand RNA
Picornavirus
Only one serotype
What is hep a vaccine for
Travelers
Sewer workers
Healthcare workers
What is gamma globulin
Hep A antibody
Given to exposed individuals
Short term passive immunity
Describe campylobacter jejuni
Gram neg
Rod
Motile
Causes Gillian barre syndrome
What is role of kidney
Filter blood of waste
Create urine
What part of genitourinal system is sterile
Urine and urinary tracts above bladder
What flora are in urethra
Lactobacillus
Staphylococcus
Corynebacterium
Streptococcus
What causes female genital Tract flora to vary
Hormonal status
What happens to flora when estrogen present
Lactobacillus create more acidic ph Increase resistance to pathogens More glycogen With lactobacillus ferments Creates lactic acid
What helps keep urinary tract clean
Flow of urine flushes bact out
Blocking urine increases risk of normal flora infection
What causes e coli bacterial cystitis
Block urine flow
What is cystitis
Inflammation of bladder
What is nephritis
Inflammation of kidney
What is pyelonephritis
Infection of kidney
Describe toxic shock syndrome
S aureus can grow in absorbent tampons
Produces exotoxins
When TSST 1 enters blood stream causes. System wide inflammation
Drops BP = shock
What are verereal genital system diseases
STDs
What causes syphilis
Treponema pallidum
What causes chancroid
Haemophilis ducreyi
Describe neisseria gonorrhea
Gram neg Diplococci Transmitted through sex Enzyme that degrades iga Avoids complement Pili can vary antigenic ally Women are asymptomatic reservoir Has R plasmids
Where does gonorrhea attach
Epithelial cells of urethra
Uterine cervix
Pharynx
Conjunctiva via pili
What is used to treat gonorrhea
Cephalosporins
Like ceftriaxone
What happens to some untreated women with gonorrhea
Pelvic inflammatory disease
Gonorrhea travels up Fallopian tube
Can then infect liver or other organs
Can cause sterility or ectopic pregnancy
What is opthalmia neonatorum
Infected conjunctiva from asymptomatic gonorrhea infected birth canal
All infants receive drops to prevent this
What causes genital herpes
Herpes virus simplex type 2
What herpes virus causes cold sores
Simplex type 1
How many are infected with HSV 2
One in five
45 million
When do herpes symptoms occur
2 to 20 days post infection
Itching and blisters
What causes herpes blisters
Lysis of epithelial cells
Caused by virus
What 2 stages does herpes virus have
Lytic
Latent
Hides in nerve cells
Where are body of motor neurons
In CNS
Where are bodies of sensory neurons
In ganglion
Examples of bacteria that cause meningitis
Haemophilus influenza
Neisseria meningitis
Streptococcus pneumoniae
What can gram neg rods of mothers intestine cause
Meningitis in newborns
What type of bact in vagina can cause meningitis
Group B streptococcus
List examples of nervous system infections
Meningitis
Listeriosis
Leprosy
Botulism
What is petechiae
Red splotches
What is the source of meningococcal meningitis
Humans
Respiratory droplets
How does meningitis infection occur
Bact adhere to mucous membrane via pili
Pass through respiratory epithelium into blood stream
Get into csf
Release exotoxin that drops BP
Describe treatment for meningitis
Vaccine made of purified capsule
Conjugate vaccine for child’s
Can take antibiotics
What causes leprosy
Mycobacterium leprea
Symptoms of leprosy
Dulled sensation of skin
Infected area thickens
Nerves enlarge
Loose extremities
Where does growth of Leprosy occur
Within macrophages
Slow growing
Describe the two types of leprosy
Tubercoloid leprosy Doesn't progress Not transmitted to others Lepromatous leprosy Immune system overwhelmed Respiratory droplets
What can treat tuberculoid leprosy
Dapsone and riframpin
What does arbovirus cause
Viral encephalitis
Lists the different types of arboviruses
Eastern equine encephalitis
Western equine encephalitis
St Louis encephalitis
West Nile
Describe pathogenesis of west Nile
Viruses multiply at site of bite and lymph nodes Cause viremia Virus cross BBB Damage brain Disabilities often remain after recovery
What can haut progression of west Nile
Neutralization antibody
What causes most cases of encephalitis
Lacrosse encephalitis
How fast do rabies patients die
Within 4 days
Where does rabies virus multiply
In muscles cells of infection site
Reaches brain via axon
Once in brain multiplies extensively
What forms at sites of rabies replication
Negri bodies
What is included in blood and lymphatic system
Heart Arteries Veins Spleen Lymph vessels Lymph nodes
What causes nodes to swell
B cells proliferating
What causes septicemia
Gram neg in blood
LPS response
Septic shock
What occurs in septic shock
Urine output drops
Respiration and pulse increase
Arms and legs become cool and dusky
What characterized black plague
Large lymph nodes
Buboes
Bloody sputum if pneumonic
What causes plague
Describe organism
Yersinia pestis
Facultative intracellular bact
Has 3 plasmids
Name the plague plasmids
Pla
Tops
F1
Describe pla
Causes protective clots to dissolve via plasminogen activator
Essential for spread from site of entey
Describe yops
Codes for tops protein and regulates it
Yops interferes with phagocytosis
Produce yops when released from macrophage
Describe F1
Becomes antiphagocyte capsule
Used in plague vaccine
Describe plague pathogenesis
Digestive tract of flea obstructed Flea spits infected material into bite Multiply in macrophage Inflammation of nodes Nodes become necrotic and cause septicemia Can then infect lungs
What is flea type that spreads plague
Oriental rat flea
When is F1 capsule produced
While in macrophage
Deceive plague treatment an prevention
Killed vaccine can provide short term protection Tetracycline to exposed individuals Gentimicin Ciprofloxin Doxycycline All effective if given early
Describe mononucleosis
Long incubation Sore throat dissapear then swollen lymph nodes Begins in throat Stays in saliva for months Then latent in B cells Can be productive or nonproductive
What causes mono
Epstein Barr virus
What does mono cause b cells todo
Produce multiple clones
Produce immunoglobulin
Random antibodies
What is mono treated with
Acyclovir
Inhibits productive infection
What was first sign of aids
Pneumocystis infections in healthy men
How are HIV1 and 2 different
Antigenic ally distinct
HIV1 progresses slower
Describe HIV
Has glycoproteins 120 for attachment to host cells 41 for fusion with host membrane Has reverse transcriptase Integrase Protease
What types of cells does HIV infect
Epithelium
Brain
Macrophages
Helper t
What are receptors on t cells
CD4
CXCR4 coreceptor
How does reverse transcriptase work
RNA made into DNA DNA Integrated into host info by integrase Tells lyse Macrophages slowly release virus
What happens as virus progresses
Cd4 count decreases
Symptoms appear when below 200
Development can be rapid or slow
Describe modes of HIV transmission
Sex
Blood transfusion
Mother to infant
Why is there no vaccine for HIV
Reverse transcriptase is error prone
High rate of genetic mutation
How to treat HIV
Combo of reverse transcriptase inhibitors and protease inhibitors
HAART
What are categories of reverse transcriptase inhibitors
Nucleoside Zidovudine Chain terminator Non nucleoside Nevirapine Bind RT enzyme
What do protease inhibitors do
Act late in infection to prevent packaging of viral proteins
Theories for HIV vaccine
Prevention or therapeutic
Must produce both mucosa land blood stream immunity
Fr cellular an humoral immunity
Aka lie attenuated
What would HIV vaccine have to do
Induce neutralizing antibodies against free virus and prevent spread from cell to cell