Lecture 6 Flashcards by Carter Duggan

What pathogens have respiratory transmission?

Mycobacterium
Mycoplasma
Corynebacterium
Bordetella pertussis
H. influenzae
Legionella Pneumophila

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How fast do mycobacterium grow?

Very slow

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What confers virulence to mycobacterium?

Cord factor

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What confers acid fastness to mycobacterium

Mycolic acid

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M. Tuberculosis CP

Fatigue
Fever
Weight loss
Cough with bloody sputum

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What are the three possible outcomes of M. tuberculosis infection

Heal
Necrosis
From productive lesion (granuloma)

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Mycolic acid function

Prevent attach by lysozyme and complement

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What is lipoarabinomannan (LAM) function

Stimulates cytokine production by host (TNF and IL-6 stimulate HIV)

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What is a granuloma

Mycobacterium survives in macrophage
Macrophage secretes cytokines to recruit immune cells (but can’t kill)
Immune cells swarm and create a huge grouping of cells

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What is the exception to aerosol spread of TB

M. bovis

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What is M. tuberculosis first act?

Attach to respiratory macrophages and invade

Prevent phagolysosome fusion

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M. Tuberculosis cytotoxicity?

Cord factor

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What is miliary TB

Spread of TB via blood to various parts of your body

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TB in your lungs spreads were?

To regional lymph nodes

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What is a caseum?

A fibrous cuff in necrotic tissue that can form around TB and make it look inactive. However it can rupture and lead to reactivation.

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Who is at risk for TB

Immigrants
Other infections (silicosis, emphysema, HIV)
Very old or young
Homeless or destitute

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TB’s has which of the 3 I’s ?

Cytokine mediated inflammation

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PPD tests for?

T cells specific for TB

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Quantiferon Gold tests for?

Release of interferon-gamma

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What is the gold stand for TB test?

PCR with primers for M. Tub.

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What is the only way to diagnose latent vs active TB?

XRAY

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Four drugs for TB?

INH
Rifampin
Pyrazinamide
Ethambutol

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What are secondary drugs for resistant TB?

Fluorquinolones

Aminoglycosides

What causes leprosy?

M. Leprae

Why don't beta-lactams work for TB?

Because of beta-lactamase blaC

M. Leprae treatment

Dapsone (sulfone) and Rifampin

What disease is found only in immunocompromised patients and has similar symptoms to TB?

M. Kansasii

What is most common nosocomial disease in HIV patients?

M. avium-intracellulare

M. avium intracellulare treatment?

Clarithromycin and ethambutol for life

What is mycoplasmas appearance on agar?

Inverted fried egg

What does Mp. pneumonia typically present as

Walking pneumonia Tracheobronchitis Mild fever and non-productive cough

How is Mp. pneumonia spread?

Respiratory droplets

How does Mp. pneumonia adhere?

Has a proline rich adhesion protein

Mp. pneumonia cytotoxicity?

Competes for nutrients Produces ROS and peroxide Does not live in a cell

What shouldn't be given for Mp. pneumonia and why?

PCN | They don't have cell walls

What can be given for Mp. pneumonia if the infection is bad?

Tetracycline | Erythromycin

What is the best treatment right now for MDR TB?

Meropenem and Clavulanate

What are the two main forms of leprosy?

``` Tuberculoid leprosy (paucibacilliary) Lepromatous leprosy (multibacilliary) ```

What is tuberculoid leprosy

Macular lesions | Unilateral nerve damage

What is lepromatous leprosy

Nodular lesions Bilateral nerve death Bone resorption

Of the 3 I's, how does leprosy work?

Inflammation (damages nerve endings)

What are most forms of mycoplasmas?

STDs

What kind of mycoplasma can cause urethral and genital infections?

Is a normal flora | M. genitalium

Which mycoplasma can cause post-partum fever?

M. Hominis

Which mycoplasma can cause non-gonococcal urethritis in males

Ureaplasma urealyticum

How does ureaplasma urealyticum cause non-gonococcal urethritis?

Urease releases ammonia from urea which alkalinizes urine

What is the MOST common cause of non-gonococcal urethritis?

Chlamydia Trachomatis

What allows A portion of AB toxin to interact with environment?

Low pH of phagocytic vesicle causes conformational change

Describe corynebacterium diphtheriae

GramPos Club shaped Pleomorphic Aerobic rod

Clinical presentation of corynebacterium diphtheriae

Cough Sore throat Swollen lymphnodes Sometimes pseudomembrane in back of throat

What is the risk of corynebacterium spreading?

Toxin can spread to multiple places but most often the heart

How does corynebacterium spread?

Respiratory droplets

How does AB toxin get internalized?

B part binds to EGF-like receptor

What does A part of AB toxin bind? What does this do?

NAD | ADP-ribosylates EF-2 (this is a transcription factor so protein synthesis stops)

How does iron effect the synthesis of AB toxin?

Bacteria sense iron and only in the presence of low Fe will they produce AB toxin

If someone is diagnosed with diphtheria, what is the treament?

Large dose of equine antitoxin | PCN and erythromycin to keep bacteria count low

How does corynebacterium get AB toxin?

Beta-phage conversion