L27- Blood and Lymph Pathology I Flashcards
list the common bacterial blood-lymph infections and microbe
Yersinia spp: Y. Pestis- Plague
Bartonella spp.:
- B. henselae- Cat-Scratch disease
- B. quintana- Trench fever
- B. Bacilliformis- Carrion’s disease
list the common viral blood-lymph infection and microbe
filoviruses: Marburg and Ebola viruses
list the common parasitic blood-lymph infections and microbe
- Wuchereria bancrofti: filariasis
- Babesia spp.: babesiosis
- Plasmodium spp.: malaria
almost all blood-lymph infections are spread via…..
Zoonotic (from animal or arthropod)
Yersinia spp.:
- Gram(+/-)
- (non-/motile)
- catalase(+/-)
- oxidase(+/-)
- (non-/lactose) fermenter
- (aerobe/anaerobe/facultative)
gram-, motile/non-motile, catalase+, oxidase-, non-lactose fermenter, facultative anaerobe
Yersinia spp.:
- (1) media needed
- (2) shape appearance
1- blood or tissue fluid
2- bipolar / ‘safety pin’ apperance due to polar bodies
Yersinia spp.:
-(1) deadly clinically important strain
- (2) another strain + infection type
- (3) another strain + infection type
1- Y. pestis
2- Y.enterocolitica –> enteric
3- Y. pseudotuberculosis –> septicemia
Y. pestis is responsible for (1) infection, with (2) as reservoirs
- if a spread described is (3) and (4), where no humans are involved, it causes (5) type of (1)
- if spread occurs person-to-person it causes (6) type of (1)
1- plague
2- rodents
(zoonotic / sylvatic and urban)
3- bite from infected flea (xenopsylla cheopis)
4- contact with infected animal
5- bubonic, septicemia plague
6- pneumonic plague
(1) is most common form of plague, caused by (2) via exposure to (3).
1- bubonic plague
2- Yersinia pestis
3- flea bite (after biting infected rodent)
Bubonic Plague clinical features:
- abrupt onset of (1)
- (2) LN changes
- (3) dissemination complications
- (4) mortality rate
1- high fever, chills
2- lymph nodes rapidly become enlarged, tender, elevated, surrounding edema mostly in femoral, inguinal region
3- to lung => secondary pneumonic form
4- 50%
Pneumonic Plague results from contact with (1) caused by (2). Secondary pneumonic plague is caused by (3) with (4) as the only additional feature to differentiate from primary type.
1- people or infected animals with respiratory infections
2- Yersinia pestis
3- hematogenous spread
4- productive cough (instead of dry cough)
Pneumonic Plague clinical features:
- (1) amount of days after inoculation for (2) symptoms to appear
- (3) mortality rate, death within (4) amount of days
- affects about (5)% of people with plague
1- 2-3 days 2- fever, HA, dry cough, hemoptysis, dyspnea, chest pain, muscle weakness 3- 90% 4- 2-6 days 5- 10% (early Tx is required)
(1) is most rareform of plague, caused by (2) via (3) progression. It most commonly affects (4) individuals.
1- Septicemic plague
2- Yersinia pestis
3- develops from bubonic or primary/secondary pneumonic plagues (rapid progression)
4- older people
Septicemic Plague clinical features:
- sudden onset of (1)
- (2) skin changes (hint- 3)
- (3) seen on CXR
- (4) effect on CNS
- (5) is eventual outcome
1- high fever
2- ‘purpuric lesions’ (hemorrhagic changes), purple discoloration via DIC, gangrene (= black death)
3- bilateral infiltrated
4- altered mental status
5- multiorgan failure –> 100% mortality rate
plague in the US is mostly seen in…
SW-USA:
- New Mexico
- Arizona
- Colorado
- California
Y. pestis will infect (1) where it will colonize and have effects in (1)’s (2).
- (3) virulence factor allows it to survive immune system because of (4) function
- (2) helps facilitate the release which is regulated by (5) virulence factor
- (6) after secretion aids it causing bacteremia and surviving immune system in humans
1- fleas
2- colonizes midgut –> replication => intestinal block (aggressive feeding and regurgitation by flea)
3- Pla protease / Murine toxin
4- activates plasminogen + destroys C3b/C5a
5- V Ag, controls type III secretion
6- F1 envelope Ag –> antiphagocytic capsule prevents opsonization
Y. pestis, name the virulence factor:
- (1) controls type III secretions
- (2) forms antiphagocytic capsule preventing opsonization => bacteremia
- (3) activates plasminogen and destroys C3b/C5a
1- V Ag
2- F1 envelope Ag
3- Pla protease / Murine toxin
Most plagues can be diagnosed via (1)
- (2) is evident on CBC
- (3) is evident on CXR
1- needle aspiration (of bubo) + culture OR serology (titers for F1 Ag) OR PCR
2- elevated WBC w/ immature neutrophils
3- rapidly progressing pneumonia
Plague:
- (1) Tx
- (2) and (3) are prevention techniques
1- antibiotics + IV fluids + respiratory support
2- rodent / animal surveillance, rodenticides and insectacides
3- proper protective clothing outdoors, insect repellants, monitoring pets
Bartonella spp.:
- gram(+/-)
- (fast/slow) growing
- (obligate/facultative) intracellular
(4) indicate the motile and non-motile species
Gram-, slow growing, facultative intracellular
- B. bacilliformis is motile (Carrion’s)
- B. henselae is non-motile (Cat Scratch)
list the Bartonella spp. infectious agents
B. henselae: Cat Scratch Disease
B. quintana: Trench Fever
B. bacilliformis: Carrion’s Disease
Cat Scratch Disease is caused by (1) and transmitted by (2) to (3) animals as they are the primary reservoirs. (1) affects (4) population most and is most serious in (5) populations.
1- B. henselae 2- flea, Ctenophalides felis 3- domestic cats 4- children 5- immuno-compromised ppl
After flea bite containing B. henselae, bacteria enter (1) immediately and then (2) later. The disease course is mostly described as (3) in a (4) type time-frame.
(cat scratch disease) 1- endothelial cells 2- erythrocytes 3- benign and self-limiting 4- spontaneous resolution in 1 mo w/ or w/o Tx
Cat scratch disease, caused by (1), first develops (2) in (3) time-frame. (4) is also apparent lasting for months and (5) are the other non-specific symptoms.
1- B. henselae
2- erythematous pustule (at bite/scratch site)
3- 3-10 days (after bite/scratch)
4- regional lymphadenopathy (can be suppurative / drain)
5- fever, malaise, HA, anorexia, joint pain, arthritis, back pain
Cat Scratch Disease, caused by (1):
- (2) Dx
- (3) Tx
- (4) prevention
1- B. henselae
2- biopsy / blood culture OR serology / PCR
3- none, unless immuno-compromised then antibiotics
4- avoid rough play with cats, flea control/Tx, keep cats indoors **all are especially for immuno-compromised people
B. bacilliformis causes (1) and is transmitted by (2). It is restricted to (3) geographical area.
1- Carrion’s Disease
2- sandfly
3- mountains of American Andes
Carrion’s Disease, caused by (1):
- (2) describe phase 1
- (3) describe phase2
1- B. bacilliformis
2- Acute phase = Oroya fever: fever, HA, malaise, abdominal pain, myalgia, pale, hepatomegaly, jaundice, splenomegaly, lymphadenoathy, hemolytic anemia
3- Chronic / eruptive / tissue phase = Verruga peruana (wks to mos later: multiple nodular hemangiomas skin lesions (bacteria invade capillary endothelium –> bacteria filled vacuoles and localized cellular proliferation
Carrion’s disease, caused by (1):
- (2) Dx
- (3) Tx
- (4) prevention
1- B. bacilliformis
2- IFA, ELISA, PCR
3- antibiotics
4- insecticides, repellants and protective clothing, limit activities outdoors in active Sandfly time
B. quintana causes (1) and is transmitted by (2).
1- Trench fever (quintan fever)
2- body louse
Trench fever, cause by (1):
- (2) are the main associated diseases in (3) type areas
- (4) are the general symptoms
- (5) is a key feature of clinical presentation
1- B. quintana
2- culture-negative endocarditis, bacteremia
3- densely popular, poverty, homeless, poor hygienic areas
4- fever, HA w/ retro-orbital pain, restlessness, severe back and shin pain, rash
5- periodic recurrence every 5-6 days up to 8 times
(1) is a related feature in infections due to B. quintana / Trench fever (sometimes B. henselae / Cat Scratch Disease), usually in (2) patients. (3) are similar lesions to (1) seen on the liver/spleen related to (4) infections.
- (5) Dx, (6) Tx for (1)
1- bacillary angiomatosis: single / multiple red cranberry globular lesions (skin, subcutaneous tissue, bone, others) 2- immuno-compromised 3- bacillary peliosis (vascular lesions) 4- B. henselae 5- skin biopsy, serology, culture, PCR 6- antibiotics
Note- Kaposi’s sarcoma is a DDx
describe VHF
viral hemorrhagic fever:
- multi-system syndrome
- vascular system damage => shock
- impairs homeostasis
- severe life-threatening disease
VHF is caused by….
RNA viruses: Bunyaviridae, Flaviviridae, Arenaviridae, Filoviridae***
Filovirus:
- (non-/enveloped) (+/-) sense (ss/ds)(DNA/RNA)
- (5) shape and nucleocapsid shape
- (6) genome structure
- (7) the classifications (hint- 2)
-enveloped, (-) sense ssRNA
5- filamentous, helical capsid
6- non-segmented, linear genome for 7 proteins
7- Marburg-like, Ebola-like
Filovirus enters cell by (1). The virus replicates in the (nucleus/cytoplasm) using (3) protein. Viral exit uses (4) process.
1- receptor binding –> fusion and endocytosis release of genome/capsid
2- cytoplasm
3- RNA-dep. RNA poly for replication and transcription
4- budding off plasma membrane
Ebola is a (1) type virus mostly found in (2) area. (3) are the assumed reservoirs and (4) is the main method of transmission.
1- filovirus
2- Africa
3- fruit bats (but currently reservoir is unknown)
4- individual secretions
Ebola virus:
- (1) incubation period
- onset is (slow/fast)
- (3) are the immediate symptoms
- (4) are the skin Sxs which converts to (5) after 24hrs
- (6) are the dangerous Sxs
- (7) mortality rate
1- 2-21 days
2- fast, abrupt
3- fever, HA, myalgia, sore throat, weakness –> diarrhea, vomiting, stomach pain
4- exanthems (best seen on fair skin): pin-sized papular and erythematous exanthem
5- large, coalescent, well-demarcated, possibly hemorrhagic macules/papules
6- hemorrhagic mucous membranes seen through blood in venipuncture site, hematemesis, hemoptysis, melena, body orifices
7- 50-90%
Ebola virus:
- (1) Dx
- (2) Tx
- (3) prevention
1- ELISA, IH, PCR, virus isolation
2- convalescent serum and IFN suggested but no approved therapies (clinical trials in progress)
3- quarantine of infected individuals (+ animals) and proper management of infected material and personal equipment
